Clinical outcomes of gingivoperiosteoplasty for unilateral cleft lip and palate performed in early childhood.

Conventional gingivoperiosteoplasty (GPP) performed during infancy adversely affects maxillary development. However, the outcomes of this procedure in early childhood have rarely been reported. Therefore, we examined the postoperative outcomes of GPP conducted in patients aged 1.5 years with unilateral cleft lip and palate (UCLP). This study included 87 non-syndromic patients with complete UCLP who had undergone early two-stage palatoplasty during the 1999-2004 period. The protocol comprised soft palate plasty at 1 year of age and hard palate closure at 1.5 years of age. In the GPP group (n = 34), we introduced the GPP procedure during hard palate closure; in the non-GPP group (n = 53), the labial side of the alveolar cleft remained intact. We examined computed tomography images taken at 8 years of age to observe bone formation at the alveolar cleft site. We also conducted cephalometric analysis to examine maxillary development at 12 years of age. Bone bridges at the alveolar cleft site were observed in 92% and 5.6% of the GPP and non-GPP groups, respectively. Moreover, 56% of the GPP group did not require secondary alveolar bone grafting (sABG), whereas all the patients in the non-GPP group underwent sABG. No statistically significant differences were noted in the maxillary anteroposterior length (GPP: 45.5 ± 3.7 mm, non-GPP: 45.9 ± 3.5 mm, p = 0.67) and sella-nasion-point A angle (GPP: 75.6 ± 4.5°, non-GPP: 73.8 ± 12.6°, p = 0.49). This study's findings suggest that GPP performed at 1.5 years of age minimises the necessity of sABG and does not exert a negative influence on maxillofacial development.

IMPLANT-SUPPORTED DENTAL PROSTHESES MAY PRESERVE OROFACIAL HARD AND SOFT TISSUES.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: De Souza AB, Papaspyridakos P, Weber HP, Vazouras K, Matarazzo F. Effect of dental implant therapy on the preservation of orofacial tissues: A systematic review and meta-analysis. Clin Oral Implants Res. 2023;34 Suppl 26:240-256. doi:10.1111/clr.14106. PMID: 37750525. SOURCE OF FUNDING: No private or public funding was received for this research. CONFLICT OF INTEREST: The authors declare that they have no competing interests. TYPE OF STUDY/DESIGN: Systematic review (with meta-analysis).

LIMITED DATA SHOWS POTENTIAL OF FLAPLESS SURGERY FOR ENHANCED BUCCAL BONE PRESERVATION IN IMMEDIATE IMPLANT PLACEMENT.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Pitman J, Christiaens V, Callens J, Glibert M, Seyssens L, Blanco J, Cosyn J. Immediate implant placement with flap or flapless surgery: A systematic review and meta-analysis. J Clin Periodontol. 2023 Jun;50(6):755-764. doi: 10.1111/jcpe.13795. Epub 2023 Mar 5. PMID: 36843361. SOURCE OF FUNDING: The study was funded by the authors and their affiliated institutions. TYPE OF STUDY/DESIGN: Systematic review with meta-analysis.

A review on guided bone regeneration using titanium mesh.

The gold standard for bone regeneration in atrophic ridge patients is guided bone regeneration (GBR). This makes it possible to get enough bone volume for an appropriate implant-prosthetic rehabilitation. The barrier membranes must meet the primary GBR design requirements, which include adequate integration with the surrounding tissue, spaciousness and clinical manageability. Titanium mesh's superior mechanical qualities and biocompatibility have broadened the indications of GBR technology, enabling it to be used to restore alveolar ridges with more significant bone defects. GBR with titanium mesh is being used in many clinical settings and for a range of clinical procedures. Furthermore, several advancements in digitalization and material modification have resulted from the study of GBR using titanium mesh. Hence, we report a review on the various characteristics of titanium mesh and its current use in clinical settings for bone augmentation.

Osseous Outcomes of Cleft Alveolar Bone Grafting with Allograft and Platelet-Rich Fibrin: Preliminary Study with Radiological Outcome.

OBJECTIVE: Cleft lip and palate are the most common craniofacial malformations worldwide. The alveolar cleft is treated with a bone graft, between 4 and 7 years of age in mixed dentition. This is an important step because it provides good quality jawbone and a better support of the lip and the alar cartilage on the side of the cleft. Bone autografting with iliac harvesting remains the most commonly used technique, but it is not without risks. Allograft techniques have therefore been described to reduce this morbidity (pain, infectious risk, hemorrhagic risk, fracture risk). The aim of this study was to evaluate, one year after allografting, the efficiency and consolidation of the bone allograft in the alveolar cleft. SETTING: A retrospective study was conducted in the department of pediatric craniomaxillofacial surgery in the Woman-Mother-Child Hospital in Lyon, France. PATIENTS: This series includes 22 patients or 25 alveolar cleft bone grafts, including 16 boys and 6 girls, with an average age of 6.1 years. MAIN OUTCOME MEASURES: Quantify the residual bone allograft by evaluating the ratio between the volume of the bone graft and the volume of the initial space on pre- and post-operative cone beam computed tomography. RESULTS: The residual bone allograft percentage at 1 year was 58.5% (± 22.3). CONCLUSIONS: Alveolar cleft bone graft with bone allograft is an alternative to iliac autografting to reduce donor site morbidity.

Comparison of implant placement at crestal and subcrestal levels in aesthetic zone: A finite element analysis.

PURPOSE: The success rate of the implant treatment, including aesthetics and long-term survival, relies heavily on preserving crestal peri-implant bone, as it determines the stability and long-term outcomes. This study aimed to demonstrate the stress differences in the crestal bone resulting from dental implant placement at various depths relative to the crestal bone level using finite element analysis. MATERIALS AND METHODS: Three study models were prepared for implant placement at the crestal bone level (CL), 1 mm depth (SL-1), and 2 mm depth (SL-2). Implants were placed in the maxillary central incisor region of each model, and 100 N vertical and oblique forces were applied. The von Mises, maximum principal (tensile), and minimum principal (compressive) stresses were evaluated. RESULTS: The CL model exhibited the highest stresses on the implant, abutment, and abutment screws under vertical and oblique forces. For maximum principal stress in the crestal bone under vertical force, the SL-2, SL-1, and CL models recorded values of 6.56, 6.26, and 5.77 MPa, respectively. Under oblique forces, stress values for SL-1, SL-2, and CL were 25.3, 24.91, and 23.76 MPa, respectively. The CL model consistently exhibited the lowest crestal bone stress at all loads and the highest stress values on the implant and its components. Moreover, considering the yield strengths of the materials, no mechanical or physiological complications were noted. CONCLUSIONS: Placing the implant at the crestal level or subcrestally beyond the cortical layer could potentially reduce stress and minimize crestal bone loss. However, further studies are warranted for confirmation.

Alveolar Ridge Preservation Using a Collagenated Xenograft: A Randomized Clinical Trial.

OBJECTIVES: This study sought to evaluate the efficacy of cancellous bovine bone mineral granules and 10% porcine collagen (deproteinized bovine bone mineral with collagen [DBBM-C]; (OCS-B Collagen® [Straumann XenoFlex], NIBEC, Korea) in a mouldable block form, with or without socket seal, using autogenous free gingival graft (FGG). METHODS: Fifty-four patients were included and randomly assigned to one of three groups: (1) spontaneous healing (control group), (2) alveolar ridge preservation (ARP) using DBBM-C (DBBM-C group), and (3) ARP employing DBBM-C sealed with FGG (DBBM-C/FGG group). Bone biopsy and implant fixture placement were performed 180 days after ARP. Cone-beam computed tomography, histological analysis, implant stability, and three-dimensional volumetric analysis were conducted. RESULTS: Of the 54 patients, 4 dropped out owing to loss of follow-up and osseointegration failure. The changes in alveolar bone during follow-up were not significantly different. Between 84- and 180-day postextraction, the volume of the DBBM-C and DBBM-C/FGG groups was maintained at 3 mm below the alveolar ridge crest (0.72 ± 0.80 mm, 6.05 ± 6.69%), whereas the volume in the control group decreased (-0.37 ± 1.31 mm, -2.10% ± 8.37%) (P = .026). The DBBM-C/FGG group exhibited less horizontal ridge resorption at 1 mm below the alveolar crest (-9.19 ± 5.09 mm, -73.67% ± 32.53%) between preextraction and 84 days postextraction (P = .049). In all groups, the implant stability quotient remained above 70. CONCLUSIONS: Within the limitations of this study, both ARP using DBBM-C with and without socket sealing effectively preserved the width dimension of the alveolar ridge, with no significant difference in alveolar bone resorption. However, socket sealing appeared to enhance the stability of the bone graft and bone quality. CLINICAL RELEVANCE: The use of DBBM-C for ARP seems to aid in volume maintenance as compared with spontaneous healing. Gingival sealing with an FGG can help maintain the width of the alveolar ridge. This clinical trial was not registered prior to participant recruitment and randomization. This study was registered at WHO ICTRP (https://trialsearch.who.int/Trial2.aspx?TrialID=KCT0008266).

Assessment of Incomplete Apical Bone Coverage of Maxillary Premolar and Molar Roots Using Cone Beam Computed Tomography in 161 Dogs.

This retrospective study assessed maxillary premolar and molar teeth and identified roots with incomplete apical bone coverage using cone beam computed tomography in 161 dogs. The associated dorsal anatomic sites that the roots communicated with were the ventral nasal meatus, maxillary recess, infraorbital canal, and pterygopalatine fossa. The study found that all roots of the maxillary premolar and molar teeth have the potential for incomplete apical bone coverage, with 26.7% having incomplete apical bone coverage. No significant association with sex was found. A significant association with weight was found, and this lowered with increasing body weight. Facial index, as a determinate of skull shape, was found to be significant in only 35.7% of roots in univariate and 14.2% of roots in multivariate modeling. Knowledge of the anatomy of these roots plays an important role in safe and effective extraction techniques, in reducing iatrogenic trauma, and in understanding the potential local effects of periodontal and endodontic disease.

Immediate single-tooth implant placement in bony defect sites: A 10-year randomized controlled trial.

BACKGROUND: It is unclear whether an intact buccal bony plate is a prerequisite for immediate implant placement in postextraction sockets. The aim of this 10-year randomized controlled trial was to compare peri-implant soft and hard tissue parameters, esthetic ratings of, and patient-reported satisfaction with immediate implant placement in postextraction sockets with buccal bony defects ≥5 mm in the esthetic zone versus delayed implant placement after alveolar ridge preservation. METHODS: Patients presenting a failing tooth in the esthetic region and a buccal bony defect ≥5 mm after an extraction were randomly assigned to immediate (Immediate Group, n = 20) or delayed (Delayed Group, n = 20) implant placement. The second-stage surgery and provisional restoration placement occurred 3 months after implant placement in both groups, followed by definitive restorations 3 months thereafter. During a 10-year follow-up period, marginal bone levels (primary outcome), buccal bone thickness, soft tissue parameters, esthetics, and patient-reported satisfaction were recorded. RESULTS: The mean marginal bone level change was -0.71 ± 0.59 mm and -0.36 ± 0.39 mm in the Immediate Group and the Delayed Group after 10 years (p = 0.063), respectively. The secondary outcomes were not significantly different between both groups. CONCLUSIONS: Marginal bone level changes, buccal bone thickness, clinical outcomes, esthetics, and patients' satisfaction following immediate implant placement, in combination with bone augmentation in postextraction sockets with buccal bony defects ≥5 mm, were not statistically different to those following delayed implant placement after ridge preservation in the esthetic zone. PLAIN LANGUAGE SUMMARY: Immediate implant placement in case of a failing tooth is a favorable treatment option for patients because it considerably shortens treatment time and the number of surgical treatments. The question is if an intact buccal bone wall is necessary for immediate implant placement. A 10-year study was performed in which 20 patients with a failing tooth in the frontal region of the upper jaw were treated with immediate implant placement and were compared with 20 patients in whom a more conventional treatment strategy was followed in which the failing tooth was first removed and the bone gap restored and the implant placed in a second step. After a 10-year follow-up period, it appeared that the bone around the implant was very stable, gums were healthy, and patients were very satisfied with the result. There was no difference between the two treatment procedures. Such results mean that professionals can discuss the procedure with the patient and apply the individual's preference.

Radiographic changes after alveolar ridge preservation using autogenous raw tooth particles versus xenograft: A prospective controlled clinical trial.

OBJECTIVE: The use of extracted teeth has been introduced as an option for bone grafting. However, the current method requires special machines and solutions, posing significant time and cost. The aim of this study was to evaluate the clinical performance of autogenous raw tooth particles (RTP), a grafting material made from a ground tooth using basic equipment, for alveolar ridge preservation. MATERIALS AND METHODS: Twenty-three patients (12 study/11 control), having 14 and 13 sites were included for the study and control groups (commercially available xenograft), respectively. Radiographic measurements were taken at the baseline and the 4-month follow-up appointment. Furthermore, a questionnaire survey concerning the general preference of the type of graft to receive (if needed), before and after knowing the price, was distributed at the completion of the procedure for patients to answer. RESULTS: Alveolar ridge width change was -1.03 ± 0.64 and -0.84 ± 0.35 for the study and the control groups, respectively. Regarding the height, the study group showed a buccal and lingual change of -0.66 ± 0.48 and -0.78 ± 0.81, respectively, while this was -0.78 ± 0.56 and -0.9 ± 0.41 for the xenograft group. There was no statistically significant difference between the groups. Patients preferred the raw tooth particles over other grafting materials (p = .01). CONCLUSION: No core biopsies were taken to evaluate bone formation, which should be done in future studies. Within its limitations, the current study demonstrated that RTP graft could be an alternative graft for bone augmentation, offering a new cost-effective option for clinicians when available.

Periodontal evaluation after maxillary expansion with a tooth-bone-borne expander in growing patients : A randomized clinical trial.

PURPOSE: This two-arm parallel randomized controlled trial aimed to evaluate and compare periodontal changes due to rapid maxillary expansion (RME) using tooth-bone-borne and tooth-borne devices in growing patients via clinical examinations and cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Forty-two eligible patients (aged 11-14 years; transverse maxillary deficiency, posterior crossbite) were screened and divided into two groups based on the treatment received (randomization was performed using computer-generated numeric sequences): hybrid hyrax tooth-bone-borne group (TBB) and hyrax tooth-borne group (TB). The primary outcome was the change in cortical bone thickness (by CBCT). In addition, the clinical attachment level (CAL), gingival recession, and bleeding were assessed. Both examinations were performed before and 3 months after the activation phase. Intergroup comparisons were performed using analysis of covariance (ANCOVA; P < 0.05). RESULTS: Twenty-one patients (12 girls and 9 boys; mean initial age, 13.3 years) were included in the TBB group and 21 (5 girls and 16 boys; mean initial age, 13.2 years) were included in the TB group. The TB group exhibited a decrease in buccal bone thickness in the first premolars and first molars at all three evaluated levels. Specifically, tooth 14 at 3 mm from the enamel-cement junction showed a significant width reduction (0.7 mm; p < 0.001), accompanied by a notable increase in palatal cortical thickness at 6 mm of enamel-cement junction (1.13 mm; p < 0.001). CONCLUSIONS: RME resulted in buccal bone thickness reduction at the first premolar with hyrax treatment. In the molar region, both devices resulted in cortical bone alterations that were less pronounced in the TBB group.

Fibrin-konjac glucomannan-black phosphorus hydrogel scaffolds loaded with nasal ectodermal mesenchymal stem cells accelerated alveolar bone regeneration.

BACKGROUND: Effective treatments for the alveolar bone defect remain a major concern in dental therapy. The objectives of this study were to develop a fibrin and konjac glucomannan (KGM) composite hydrogel as scaffolds for the osteogenesis of nasal mucosa-derived ectodermal mesenchymal stem cells (EMSCs) for the regeneration of alveolar bone defect, and to investigate the osteogenesis-accelerating effects of black phosphorus nanoparticles (BPNs) embedded in the hydrogels. METHODS: Primary EMSCs were isolated from rat nasal mucosa and used for the alveolar bone recovery. Fibrin and KGM were prepared in different ratios for osteomimetic hydrogel scaffolds, and the optimal ratio was determined by mechanical properties and biocompatibility analysis. Then, the optimal hydrogels were integrated with BPNs to obtain BPNs/fibrin-KGM hydrogels, and the effects on osteogenic EMSCs in vitro were evaluated. To explore the osteogenesis-enhancing effects of hydrogels in vivo, the BPNs/fibrin-KGM scaffolds combined with EMSCs were implanted to a rat model of alveolar bone defect. Micro-computed tomography (CT), histological examination, real-time quantitative polymerase chain reaction (RT-qPCR) and western blot were conducted to evaluate the bone morphology and expression of osteogenesis-related genes of the bone regeneration. RESULTS: The addition of KGM improved the mechanical properties and biodegradation characteristics of the fibrin hydrogels. In vitro, the BPNs-containing compound hydrogel was proved to be biocompatible and capable of enhancing the osteogenesis of EMSCs by upregulating the mineralization and the activity of alkaline phosphatase. In vivo, the micro-CT analysis and histological evaluation demonstrated that rats implanted EMSCs-BPNs/fibrin-KGM hydrogels exhibited the best bone reconstruction. And compared to the model group, the expression of osteogenesis genes including osteopontin (Opn, p < 0.0001), osteocalcin (Ocn, p < 0.0001), type collagen (Col , p < 0.0001), bone morphogenetic protein-2 (Bmp2, p < 0.0001), Smad1 (p = 0.0006), and runt-related transcription factor 2 (Runx2, p < 0.0001) were all significantly upregulated. CONCLUSIONS: EMSCs/BPNs-containing fibrin-KGM hydrogels accelerated the recovery of the alveolar bone defect in rats by effectively up-regulating the expression of osteogenesis-related genes, promoting the formation and mineralisation of bone matrix.

Local application of 0.8% hyaluronic acid gel as an adjunct to minimally invasive nonsurgical treatment of periodontal intrabony defects-A randomized clinical trial.

AIM: The aim of this study was to evaluate the clinical and radiographic effects of hyaluronic acid (HA) gel application as an adjunct to minimally invasive nonsurgical treatment (MINST) in intrabony defects ≥3 mm. METHODS: A total of 36 patients were included and randomly assigned to two groups: (a) MINST + HA (test; n = 17) and (b) MINST (control, n = 19). Subgingival 0.8% HA gel was applied in intrabony defects of test group and repeated 4 weeks following MINST protocol. Clinical measurements including probing depth (PD), clinical attachment level (CAL), and gingival recession (GR) were recorded at baseline and repeated at 3 and 6 months. Radiographic evaluation was performed at baseline and 6 months. RESULTS: Test group showed significantly greater reduction in PD and gain in CAL at 3 months compared to baseline than that of controls (p < .05), but the changes (Δ) at 6 months compared to baseline did not differ between the groups (p > .05). Although, both groups showed statistically significant GR in all evaluated time periods (p < .05), control group showed higher ΔGR than that of test group (p < .05). There was no significant difference between the groups in terms of radiographic defect fill/bone gain (p > .05). CONCLUSIONS: The additional use of 0.8% HA gel in the treatment of periodontal intrabony defects did not provide additional benefits in clinical and radiographic parameters. On the other hand, GR measurements showed favorable results in the test group.

Role of Sticky Bone in the Management of Various Alveolar Bone Defects: A Systematic Review.

AIM: This systematic review aimed to evaluate the effectiveness of sticky bone in managing various alveolar bone defects, examining both its benefits and drawbacks. MATERIALS AND METHODS: The review adhered to PRISMA guidelines and employed a thorough search strategy using major databases, medical subject headings (MeSH) keywords, and Boolean operators. As a result, the systematic review identified 12 studies focusing on the efficacy of sticky bone in treating alveolar bone defects. Inclusion criteria consisted of randomized controlled trials and case series reporting on the outcomes of sticky bone use for bone defect treatment. Two examiners meticulously performed screening, data extraction, and bias assessment, with the risk of bias evaluated using the Cochrane tool. RESULT: The findings indicated significant improvements in bone quality, width, height, and volume, with enhanced predictability in socket preservation and implant placement. Sticky bone was particularly effective in ridge augmentation, guided bone regeneration, and filling periodontal defects, often outperforming alternatives like concentrated growth factors (CGFs) and autologous fibrin glue (AFG). It simplified procedures and reduced resorption during healing, underscoring its value as a versatile adjunct in bone reconstruction surgery. CONCLUSION: Sticky bone demonstrated exceptional results in various oral surgeries, effectively addressing issues such as furcation defects, bone loss, and ridge augmentation, with significant clinical and radiographic improvements. Further research is needed to explore its full potential and refine protocols for broader oral surgery and periodontics applications.

Variations in the alveolar bone morphology in maxillary molar area: a retrospective CBCT study.

BACKGROUND: This study quantitatively analyzed the anatomic structure of the alveolar bone in the maxillary molar region at three potential locations for Temporary Anchorage Device (TAD) placement. Additionally, the study compared the variability in this region across different age groups, sagittal skeletal patterns, vertical facial types, and sexes. METHODS: In this retrospective cone-beam computed tomography study, the buccal alveolar bone was analyzed in the posterior molar area of 200 patients, the measurement items include buccal alveolar bone height, alveolar bone thickness, interradicular distance, and maxillary retromolar space. RESULTS: Buccal alveolar height was greatest in the U56 region. The interradicular space was largest in the U56 region and increased from the alveolar crest to the sinus floor. Buccal alveolar bone thickness was highest in the U67 region and generally increased from the alveolar crest to the sinus floor. The maxillary retromolar space gradually increased from the alveolar crest to the root apex. CONCLUSIONS: TADs are safest when placed in the buccal area between the maxillary second premolar and the first molar, particularly at the 9 mm plane. The U67 region is the optimal safe zone for TAD placement for maxillary dentition distalization. TADs placement in adolescents can be challenging. Maxillary third molar extraction can be considered for maxillary dentition distalization.

Experimental Inoculation of Aggregatibacter actinomycetemcomitans and Streptococcus gordonii and Its Impact on Alveolar Bone Loss and Oral and Gut Microbiomes.

Oral bacteria are implicated not only in oral diseases but also in gut dysbiosis and inflammatory conditions throughout the body. The periodontal pathogen Aggregatibacter actinomycetemcomitans (Aa) often occurs in complex oral biofilms with Streptococcus gordonii (Sg), and this interaction might influence the pathogenic potential of this pathogen. This study aims to assess the impact of oral inoculation with Aa, Sg, and their association (Aa+Sg) on alveolar bone loss, oral microbiome, and their potential effects on intestinal health in a murine model. Sg and/or Aa were orally administered to C57Bl/6 mice, three times per week, for 4 weeks. Aa was also injected into the gingiva three times during the initial experimental week. After 30 days, alveolar bone loss, expression of genes related to inflammation and mucosal permeability in the intestine, serum LPS levels, and the composition of oral and intestinal microbiomes were determined. Alveolar bone resorption was detected in Aa, Sg, and Aa+Sg groups, although Aa bone levels did not differ from that of the SHAM-inoculated group. Il-1ß expression was upregulated in the Aa group relative to the other infected groups, while Il-6 expression was downregulated in infected groups. Aa or Sg downregulated the expression of tight junction genes Cldn 1, Cldn 2, Ocdn, and Zo-1 whereas infection with Aa+Sg led to their upregulation, except for Cldn 1. Aa was detected in the oral biofilm of the Aa+Sg group but not in the gut. Infections altered oral and gut microbiomes. The oral biofilm of the Aa group showed increased abundance of Gammaproteobacteria, Enterobacterales, and Alloprevotella, while Sg administration enhanced the abundance of Alloprevotella and Rothia. The gut microbiome of infected groups showed reduced abundance of Erysipelotrichaceae. Infection with Aa or Sg disrupts both oral and gut microbiomes, impacting oral and gut homeostasis. While the combination of Aa with Sg promotes Aa survival in the oral cavity, it mitigates the adverse effects of Aa in the gut, suggesting a beneficial role of Sg associations in gut health.

A five-in-one novel MOF-modified injectable hydrogel with thermo-sensitive and adhesive properties for promoting alveolar bone repair in periodontitis: Antibacterial, hemostasis, immune reprogramming, pro-osteo-/angiogenesis and recruitment.

Periodontitis is a chronic inflammatory disease caused by plaque that destroys the alveolar bone tissues, resulting in tooth loss. Poor eradication of pathogenic microorganisms, persistent malignant inflammation and impaired osteo-/angiogenesis are currently the primary challenges to control disease progression and rebuild damaged alveolar bone. However, existing treatments for periodontitis fail to comprehensively address these issues. Herein, an injectable composite hydrogel (SFD/CS/ZIF-8@QCT) encapsulating quercetin-modified zeolitic imidazolate framework-8 (ZIF-8@QCT) is developed. This hydrogel possesses thermo-sensitive and adhesive properties, which can provide excellent flowability and post-injection stability, resist oral fluid washout as well as achieve effective tissue adhesion. Inspirationally, it is observed that SFD/CS/ZIF-8@QCT exhibits a rapid localized hemostatic effect following implantation, and then by virtue of the sustained release of zinc ions and quercetin exerts excellent collective functions including antibacterial, immunomodulation, pro-osteo-/angiogenesis and pro-recruitment, ultimately facilitating excellent alveolar bone regeneration. Notably, our study also demonstrates that the inhibition of osteo-/angiogenesis of PDLSCs under the periodontitis is due to the strong inhibition of energy metabolism as well as the powerful activation of oxidative stress and autophagy, whereas the synergistic effects of quercetin and zinc ions released by SFD/CS/ZIF-8@QCT are effective in reversing these biological processes. Overall, our study presents innovative insights into the advancement of biomaterials to regenerate alveolar bone in periodontitis.

Severe Discoloration of the Alveolar Bone Secondary to Long-Term Minocycline Therapy: A Case Report.

Minocycline, the synthetic derivative of the antibiotic tetracycline, has been used for a variety of medical treatments. One such use for minocycline is for acne vulgaris. Although widely used, minocycline has a common side effect of discoloration of tissues, including bone, skin, and mucosa. This case report presents a 19-year-old female patient with a history of long-term minocycline therapy for acne vulgaris who presented for periodontal esthetic crown lengthening. The initial exam revealed a blue-gray discoloration of the mucosa. Upon surgical exploration, it was discovered that the discoloration originated from the underlying alveolar bone with minimal gingival involvement. Surgical removal and recontouring of the bony exostoses revealed that the bone remained deeply stained. Although the discolored bone was not fully removed, the patient was able to obtain an acceptable esthetic result.

Alveolar bone loss is a significant contributor to tooth loss in dentate HIV+ patients: A retrospective study.

BACKGROUND: The study objectives were to determine tooth loss prevalence and to investigate the relationship between tooth loss and potential risk factors among adult dentate HIV+ patients on newer antiretroviral therapy (ART) regimens. METHODS: Health records of 450 human immunodeficiency virus (HIV)-infected individuals were surveyed. Eighty-eight records of dentate HIV+ individuals with full-mouth periodontal charting and intra-oral periapical radiographs were identified. We collected data on demographics, systemic risk factors, oral health, and HIV disease measures. Caries exposure and alveolar bone loss (ABL) were radiographically assessed. RESULTS: Eighty-eight percent of patients showed tooth loss. Patients with ABL ≥15% had a higher number of missing teeth (p < .01). Stepwise regression analyses indicated that tooth loss was positively associated with age (ß = 0.45, p < .01) and ABL (ß = 0.39, p < .01). By contrast number of years on ART was negatively associated with tooth loss (ß = -0.28, p < .05). CONCLUSIONS: Tooth loss remains prevalent among HIV+ patients, and periodontal disease is a significant contributor. The number of years on ART seem to improve oral health behavior and reduce tooth loss.