Natural short-lived halogens exert an indirect cooling effect on climate.

Observational evidence shows the ubiquitous presence of ocean-emitted short-lived halogens in the global atmosphere1-3. Natural emissions of these chemical compounds have been anthropogenically amplified since pre-industrial times4-6, while, in addition, anthropogenic short-lived halocarbons are currently being emitted to the atmosphere7,8. Despite their widespread distribution in the atmosphere, the combined impact of these species on Earth's radiative balance remains unknown. Here we show that short-lived halogens exert a substantial indirect cooling effect at present (-0.13 ± 0.03 watts per square metre) that arises from halogen-mediated radiative perturbations of ozone (-0.24 ± 0.02 watts per square metre), compensated by those from methane (+0.09 ± 0.01 watts per square metre), aerosols (+0.03 ± 0.01 watts per square metre) and stratospheric water vapour (+0.011 ± 0.001 watts per square metre). Importantly, this substantial cooling effect has increased since 1750 by -0.05 ± 0.03 watts per square metre (61 per cent), driven by the anthropogenic amplification of natural halogen emissions, and is projected to change further (18-31 per cent by 2100) depending on climate warming projections and socioeconomic development. We conclude that the indirect radiative effect due to short-lived halogens should now be incorporated into climate models to provide a more realistic natural baseline of Earth's climate system.

Risk of Severe Maternal Morbidity Associated with Maternal Comorbidity Burden and Social Vulnerability.

OBJECTIVE: We evaluated the associations of the obstetric comorbidity index (OB-CMI) and social vulnerability index (SVI) with severe maternal morbidity (SMM). STUDY DESIGN: Multicenter retrospective cohort study of all patients who delivered (gestational age > 20 weeks) within a university health system from January 1, 2019, to December 31, 2021. OB-CMI scores were assigned to patients using clinical documentation and diagnosis codes. SVI scores, released by the Centers for Disease Control and Prevention (CDC), were assigned to patients based on census tracts. The primary outcome was SMM, based on the 21 CDC indicators. Mixed-effects logistic regression was used to model the odds of SMM as a function of OB-CMI and SVI while adjusting for maternal race and ethnicity, insurance type, preferred language, and parity. RESULTS: In total, 73,518 deliveries were analyzed. The prevalence of SMM was 4% (n = 2,923). An association between OB-CMI and SMM was observed (p < 0.001), where OB-CMI score categories of 1, 2, 3, and ≥4 were associated with higher odds of SMM compared with an OB-CMI score category of 0. In the adjusted model, there was evidence of an interaction between OB-CMI and maternal race and ethnicity (p = 0.01). After adjusting for potential confounders, including SVI, non-Hispanic Black patients had the highest odds of SMM among patients with an OB-CMI score category of 1 and ≥4 compared with non-Hispanic White patients with an OB-CMI score of 0 (adjusted odds ratio [aOR] 2.76, 95% confidence interval [CI] 2.08-3.66 and aOR 10.07, 95% CI 8.42-12.03, respectively). The association between SVI and SMM was not significant on adjusted analysis. CONCLUSION: OB-CMI was significantly associated with SMM, with higher score categories associated with higher odds of SMM. A significant interaction between OB-CMI and maternal race and ethnicity was identified, revealing racial disparities in the odds of SMM within each higher OB-CMI score category. SVI was not associated with SMM after adjusting for confounders. KEY POINTS: · OB-CMI was significantly associated with SMM.. · Racial disparities were seen within each OB-CMI score group.. · SVI was not associated with SMM on adjusted analysis..

Rectal cytomegalovirus ulcer in an immunocompetent patient: an uncommon cause of lower gastrointestinal bleeding.

We report the case of an 80-years-old male patient who presented with hematochezia without hemodynamic compromise and with a history of laryngeal squamous-cell carcinoma that was operated on 2 weeks before the bleeding episode.

Mechanistic insight into the microtubule and actin cytoskeleton coupling through dynein-dependent RhoGEF inhibition.

Actin-based stress fiber formation is coupled to microtubule depolymerization through the local activation of RhoA. While the RhoGEF Lfc has been implicated in this cytoskeleton coupling process, it has remained elusive how Lfc is recruited to microtubules and how microtubule recruitment moderates Lfc activity. Here, we demonstrate that the dynein light chain protein Tctex-1 is required for localization of Lfc to microtubules. Lfc residues 139-161 interact with Tctex-1 at a site distinct from the cleft that binds dynein intermediate chain. An NMR-based GEF assay revealed that interaction with Tctex-1 represses Lfc nucleotide exchange activity in an indirect manner that requires both polymerized microtubules and phosphorylation of S885 by PKA. We show that inhibition of Lfc by Tctex-1 is dynein dependent. These studies demonstrate a pivotal role of Tctex-1 as a negative regulator of actin filament organization through its control of Lfc in the crosstalk between microtubule and actin cytoskeletons.

Fine-mapping of 98 obesity loci in Mexican children.

BACKGROUND/OBJECTIVES: Mexico has one of the highest prevalence of childhood obesity in the world. Genome-wide association studies (GWAS) for obesity have identified multiple single-nucleotide polymorphisms (SNPs) in populations of European, East Asian, and African descent. The contribution of these loci to obesity in Mexican children is unclear. We assessed the transferability of 98 obesity loci in Mexican children and fine-mapped the association signals. SUBJECTS/METHODS: The study included 405 and 390 Mexican children with normal weight and obesity. Participants were genotyped with a genome-wide dense SNP array designed for Latino populations, allowing for the analysis of GWAS index SNPs as well as fine-mapping SNPs, totaling 750 SNPs covering 98 loci. Two genetic risk scores (GRS) were constructed: a "discovery GRS" and a "best-associated GRS", representing the number of effect alleles at the GWAS index SNPs and at the best-associated SNPs after fine-mapping for each subject. RESULTS: Seventeen obesity loci were significantly associated with obesity, and five had fine-mapping SNPs significantly better associated with obesity than their corresponding GWAS index SNPs in Mexican children. Six obesity-associated SNPs significantly departed from additive to dominant (N = 5) or recessive (N = 1) models, and a significant interaction was found between rs274609 (TNNI3K) and rs1010553 (ITIH4) on childhood obesity risk. The best-associated GRS was significantly more associated with childhood obesity (OR = 1.21 per additional risk allele [95%CI:1.17-1.25], P = 4.8 × 10-25) than the discovery GRS (OR = 1.05 per additional risk allele [95%CI:1.02-1.08], P = 8.0 × 10-4), and was also associated with waist-to-hip ratio, fasting glucose, fasting insulin and triglyceride levels, the association being mediated by obesity. An overall depletion of obesity risk alleles was observed in Mexican children with normal weight when compared to GWAS discovery populations. CONCLUSIONS: Our study indicates a partial transferability of GWAS obesity loci in Mexican children, and supports the pertinence of post-GWAS fine-mapping experiments in the admixed Mexican population.

Genetic contribution to waist-to-hip ratio in Mexican children and adolescents based on 12 loci validated in European adults.

BACKGROUND/OBJECTIVES: The prevalence of abdominal obesity in Mexican children has risen dramatically in the past decade. Genome-wide association studies (GWAS) for waist-to-hip ratio (WHR) performed predominantly in European descent adult  populations have identified multiple single-nucleotide polymorphisms (SNPs) with larger effects in women. The contribution of these SNPs to WHR in non-European children is unknown. SUBJECTS/METHODS: Mexican children and adolescents (N = 1421, 5-17 years) were recruited in Mexico City. Twelve GWAS SNPs were genotyped using TaqMan Open Array and analyzed individually and as a gene score (GS). RESULTS: Mexican boys and girls displayed 2.81 ± 0.29 and 3.10 ± 0.31 WHR standard deviations higher than children and adolescents from the United States. WHR was positively associated with TG (ß = 0.733 ± 0.190, P = 1.1 × 10-4) and LDL-C (ß = 0.491 ± 0.203, P = 1.6 × 10-2), and negatively associated with HDL-C (ß = -0.652 ± 0.195, P = 8.0 × 10-4), independently of body mass index. The effect allele frequency (EAF) of 8 of 12 (67%) SNPs differed significantly (P < 4.17 × 10-3) in Mexican children and European adults, with no evidence of effect allele enrichment in both populations (4 depleted and 4 enriched; binomial test, P = 1). Ten out of 12 SNPs (83.3%) had effects that were directionally consistent with those reported in GWAS (P = 0.04). HOXC13 rs1443512 displayed the best fit when modeled recessively, and was significantly associated with WHR under a recessive mode of inheritance (ß = 0.140 ± 0.06, P = 2.3 × 10-2). Significant interactions with sex were also observed for HOXC13 rs1443512 and the GS on WHR (P = 2.2 × 10-2 and 1.2 × 10-2, respectively). HOXC13 rs1443512 (ß = 0.022 ± 0.012, P = 4.7 × 10-2) and the GS (ß = 0.007 ± 0.003, P = 7.0 × 10-3) were significantly associated with WHR in girls only. CONCLUSIONS: This study demonstrates that Mexican children are at high risk for abdominal obesity and detrimental lipid profiles. Our data support a partial transferability of sex-specific European GWAS WHR association signals in children and adolescents from the admixed Mexican population.

[Proctocolitis by cryptococcus in an immunocompetent patient: first report in Peru]. / Proctocolitis por criptococo en inmunocompetente: primer reporte de caso en Per ú.

Cryptococcosis is a typical opportunistic fungal infection in immunocompromised patients especially those with HIV (human immunodeficiency virus). We report a case of primary intestinal criptococosis in a 57 year old women HIV negative with one year of abdominal pain and hematochezia. Colonoscopy reveals nodular and friable mucosa from rectum to distal descending colon. We report the first case of gastrointestinal criptococosis in Peru in an immunocompetent patient.

[Gastric polyps: experience in Daniel Alcides Carrion Hospital 2014-2016]. / Pólipos gástricos: experiencia en el hospital Daniel Alcides Carrión - Callao 2014-2016.

OBJECTIVE: The purpose of this study was to determine the prevalence of the different types of gastric polyps in the Daniel Alcides Carrión Hospital between the years of 2014 and 2016, and also define the endoscopic and histopathological characteristics of the lesions. MATERIALS AND METHODS: 7559 endoscopic reports were reviewed, in which 148 gastric polyps were found. The patients age and sex as well as the localization, number, size and macroscopic and microscopic aspects of the polyps were recorded. RESULTS: The prevalence of gastric polyps was 1.9%; 74.3% of these were found in women with an average age of 61.5 years. 59.4% of the gastric polyps found were singular, and the majority were located on the body and antrum of the stomach. 74.29% of the polyps were less than 1 cm in diameter and 83.64% of these were sessile when seen macroscopically. According to the histological type, it was found that the majority of gastric polyps were hyperplasic (76.4%), followed by fundic gland polyps (17.5%) and gastric adenomas (6.1%). It was also found that multiple gastric polyps were associated with fundic gland polyps while singular polyps were most likely hyperplastic or adenomas. CONCLUSION: The prevalence of fundic gland polyps has increased, while the other types of polyps have maintained their estimated prevalence.

[Heterotopic gastric mucosa in duodenum: endoscopic and histological features]. / Mucosa gástrica heterotópica en duodeno: características clínicas endoscópicas e histológicas.

OBJECTIVE: The aim of this study was characterized sin duodenum the heterotopic gastric mucosa. MATERIALS AND METHODS: The slides with the diagnosis of heterotopic gastric mucosa during 2014-2015, were reviewed, and clinical, histological and endoscopic data was to collected for every case. RESULTS: 45 cases of heterotopic gastric mucosa in duodenum were found, 91.1% were located in duodenum bulb and 73.2%, presenting as polyps in 73.2% of cases. In all cases, parietal cell was identified as main criteria for the diagnosis. Neither Helicobacter pylori nor dysplasia were identified. CONCLUSIONS: Our data confirm its non neoplastic nature. Heterotopic gastric mucosa should be taken into account in diagnosis of duodenal polyps. Parietal cells identification in duodenal mucosa is essential in differential diagnosis with peptic duodenitis.

[Celiac disease and negative serology villous atrophy: histological comparison and immunohistochemical study of CD3, CD4, CD8 and CD56 lymphocytes]. / Enfermedad celíaca vs. atrofia villositaria serológicamente negativa: similitudes y diferencias histológicas y en el perfil inmunohistoquímico de linfocitos CD3, CD4, CD8 y CD56.

UNLABELLED: There is a group of enteropathies recently known as seronegative villous atrophy (SNVA), which can simulate celiac disease. OBJECTIVE: The aim of this study was to describe histological and immunohistochemical differences between a group of Celiac disease and SNVA patients. MATERIAL AND METHODS: Microscopy reexamination and Immunohistochemistry study were performed for a group of 15 celiac patients and 19 SNVA patients. Histological features as severe atrophy, crypt hyperplasia, plasma cells number, eosinophils number, neutrophils presence were studied; CD4, CD8, CD3, and CD56 markers were studied through immunohistochemistry. RESULTS: There was a significant difference between the frequency of observation of crypt hyperplasia (p=0.0348) and plasma cells (p=0.0348) in celiac disease patients than SNVA patients. In celiac disease was bigger. The number and distribution of CD 8, CD4 and CD56 lymphocytes was similar in both groups. The percentage of CD3 positive intraepithelial lymphocytes (p=0.0144) was higher in SNVA. CONCLUSION: Histological and immunohistochemical evaluation shows more similarities than differences. The differences found in this study suggest more humoral immune response in celiac disease than in SNVA.

Evaluation of maxillary sinus width on cone-beam computed tomography for sinus augmentation and new sinus classification based on sinus width.

PURPOSE: The degree of difficulty in performing lateral window sinus augmentation may depend on the morphology of the maxillary sinus. The aim of this was to measure the distances between the medial and lateral sinus wall (sinus width [SW]) at different levels and apply those SW values to formulate a new sinus classification. MATERIALS AND METHODS: Edentulous sites adjacent to maxillary sinuses with inadequate ridge height (RH; <10 mm) were included from cone-beam computed tomography database in the University of Michigan. SW was measured at the heights of 5, 7, 10, 13, and 15 mm from alveolar crest at the edentulous sites. Mean SW was stratified by residual RH into three different groups (group 1: <4 mm, group 2: ≥4 and <7, and group 3: ≥7 and <10), study sites (first and second premolars and molars), and measurement levels. RESULTS: Three hundred and twenty subjects (mean 50.1 years old) with 422 edentulous sites were included. Mean SW was wider at molar sites, higher measurement levels, and sites with shorter residual RH. Mean SW at the lower (average 2.3 mm from sinus floor) and higher boundary (15 mm from the alveolar crest) of lateral window osteotomy was 9.0 (2.8) and 16.0 (4.4) mm, respectively. Narrow, average, or wide sinuses were classified when the SW was <8, 8-10 and >10 mm at the lower boundary or <14, 14-17 and >17 mm at the upper boundary, respectively. CONCLUSION: SW at levels that were relevant to lateral window sinus augmentation was measured. The proposed sinus classification could facilitate communication between health providers and determine the degree of easiness of sinus augmentation. It might be particularly useful for the selection of grafting materials and surgical approaches. Further studies are required to test its clinical implications.

Microstructural and densiometric analysis of extra oral bone block grafts for maxillary horizontal bone augmentation: a comparison between calvarial bone and iliac crest.

PURPOSE: The main purpose of the present clinical study was to compare architectural metric parameters using micro-computed tomography (µ-CT) between sites grafted with blocks harvested from the intramembranous origin calvarium and endochondral origin iliac crest for horizontal bone augmentation in the maxilla. The second aim was to compare primary stability of implants placed in both types of block grafts. MATERIAL AND METHODS: Nine consecutive healthy partially edentulous patients requiring extensive horizontal bone reconstruction in the maxilla were included in this study from July 2011 to March 2012. A total of 14 block grafts (seven each from the calvarium and iliac crest) were studied. After 6-7 months of the bone regeneration surgery, 43 implants were placed. Twenty-four implants (55.2%) were placed on calvaria (group 1) and 19 (44.8%) on iliac crest (group 2). All implants were clinically stable. A resonance frequency analysis (RFA) and µ-CT analysis were performed. Furthermore, two randomly biopsies were selected for histomorphometric analysis. RESULTS: Micro-CT analyses evidenced completely different parametric values between intramembranous and endochondral extra oral bone block grafts, being the group 1 higher in density and in % of bone volume. However, these parametric values cannot be considered statistically different due to the sample size, excepting the trabecular thickness, which is statistically higher for group 1 (P = 0.06). CONCLUSION: Calvarial bone blocks for horizontal maxillary augmentation provided a higher degree of bone volume and density than the iliac crest bone grafts. Nonetheless, both grafts provide implant with the same primary stability, as assessed by RFA.

A systematic review on marginal bone loss around short dental implants (<10 mm) for implant-supported fixed prostheses.

PURPOSE: This systematic review aimed to evaluate the effect of implant length on peri-implant marginal bone loss (MBL) and its associated influencing factors. MATERIAL AND METHODS: An electronic search of the PubMed and MEDLINE databases for relevant studies published in English from November 2006 to July 2012 was performed by one examiner (AM). Selected studies were randomized clinical trials, human experimental clinical trials or prospective studies (e.g., cohort as well as case series) with a clear aim of investigating marginal bone loss of short dental implants (<10 mm) supporting fixed prostheses. A random-effect meta-regression model was used to determine the relationship between the effect size mean MBL and the covariate "implant length." Additionally, a subgroup analysis, by means of a random-effect one-way ANOVA model, comparing mean MBL values at different levels of each factor ("type of connection" and "type of prostheses") was also performed. RESULTS: The meta-regression of mean MBL on the moderator "implant length" was found to be insignificant (P = 0.633). Therefore, it could not be concluded that implant length had an effect on peri-implant MBL. In addition, standardized differences in mean MBL on the subgroups short (<10 mm) and standard (≥ 10 mm) implants, as determined by the meta-analysis (random-effect model), were found to be statistically insignificant (P = 0.222). CONCLUSIONS: Within limitations of the present systematic review, it could be concluded that short dental implants (<10 mm) had similar peri-implant MBL as standard implants (≥ 10 mm) for implant-supported fixed prostheses.

Structural social determinants and catastrophic illnesses in municipalities in the Colombian department of Valle del Cauca.

OBJECTIVE: To explore possible associations between self-reported prevalence of catastrophic illnesses such as chronic renal failure, HIV/AIDS and cancer and a set of structural social determinants. METHODS: Ecological study using data from the 2005 Population Census conducted by the National Administrative Department of Statistics (DANE), focusing on municipalities in the Colombian department of Valle del Cauca that experienced the highest prevalence rates for catastrophic illnesses during 2000-2005. Associations were measured with Pearson's chi-squared statistic and Fisher's Exact Test. Prevalence ratios were calculated, with 95% confidence intervals. RESULTS: Statistically significant associations were observed between catastrophic illnesses and social structural determinants in the form of illiteracy, deficient sanitary infrastructure, quality of housing units and access to health services. CONCLUSIONS: A role was observed for social determination of catastrophic illnesses in this context. However, additional analyses are required that recognize the complexity of health-determining processes and that explore the interrelationships among social, structural, behavioral and psychosocial determinants in depth.

Implants for orthodontic anchorage: success rates and reasons of failures.

INTRODUCTION: The aims of this study were to analyze the success rate of mini-implants and miniscrews and to report the reasons behind them. MATERIALS AND METHODS: An electronic literature search from PubMed databases and a hand search in implant- and orthodontic-related journals were performed until December 31, 2011. Human clinical studies in English that reported temporary anchorage devices used for orthodontic purpose with at least 6 months follow-up were included. In addition, the minimal number of implants had to be at least 10. Implants placed in maxilla, mandible, and hard palate were included. RESULTS: The initial search resulted in 847 articles, of which 46 were further evaluated. Finally, 29 studies were qualified and classified into 2 groups: implants placed in maxilla and mandible (group 1) and implants placed in hard palate (group 2). A meta-analysis performed for groups 1 and 2 showed 87.8% and 93.8% survival rate, respectively. In addition, the most common cause for implants failure was surgery-related factors. CONCLUSION: Mini-implant survival rate is location dependent, with those placed in the palate showing higher success rates. In addition, failures most commonly occur because of surgery-related factors.

Effect of location on primary stability and healing of dental implants.

PURPOSE: To study implant primary stability and bone healing using resonance frequency analysis in different anatomical locations 4 months after placement. MATERIAL AND METHODS: Fifty-six partially edentulous patients restored by dental implants were included. Overall, 214 implants were placed without bone or soft tissue augmentation. All implants were placed with the same drilling protocol and implant insertion torque (35-40 N · cm). RESULTS: The mean implant stability quotient (ISQ) value at baseline for all the locations was 75.4 mm (95% confidence interval, 74.20-76.59 mm). Higher ISQ values were found in the mandible. A significant difference between ISQ values of each location (P < 0.001) was identified. The mean values obtained showed an increase (3.4%) in all the locations, being greater in the posterior lower and upper maxillae (3.8%), whereas for the anterior maxilla, it was the least (1.5%) 4 months after healing. This increase was statistically significant in the posterior upper and lower maxillae (P < 0.001). CONCLUSION: Higher implant stability was found in mandible compared with maxilla in both periods, immediately after insertion and 4 months later. Therefore, according to ISQ values, restoring implants immediately after insertion or after a healing period of 4 months represents safe time points.

[Rectal mucosal prolapse syndrome: study of cases. Hospital Daniel A Carrion, Lima, Peru, 2010-2013]. / Síndrome de prolapso de mucosa rectal: estudio de casos. Hospital Daniel A Carrión,Lima, Perú. 2010-2013.

OBJECTIVE: to describe the clinical, endoscopic, and histological characteristics of rectal mucosal prolapse syndrome, formerly known as Solitary rectal ulcer, in patients from a general hospital. MATERIAL AND METHODS: All patient diagnosed as rectal mucosal prolapse syndrome during 2010-2013 was selected; the medical history war reviewed and the histological slides were reevaluated by two pathologists. RESULTS: 17 cases of rectal mucosal prolapse syndrome were selected, the majority were males under 50 years, the most common clinical findings were rectal bleeding (82%) and constipation (65%), the endocopic findings were heterogeneous,: erythema (41%), ulcers (35%) and elevated lesions (29%). All cases presented fibromuscularhyperplasia in lamina propia and crypt distortion in the microscopic evaluation. CONCLUSION: In our study of rectal mucosal prolapse syndrome. The most common clinical findings were rectal bleeding and constipation. Erythematous mucosa was the most common endoscopic finding.

Metabolomics of Red Wines Aged Traditionally, with Chips or Staves.

Traditionally and alternatively aged wines' odour activity values (OAVs) are investigated to differentiate and highlight the differences between the selected methods. An analysis of the volatile aroma compounds of wines derived from ageing in barrels, oak chips, and staves was performed using stir bar sorptive extraction chromatography-mass spectroscopy (SBSE-GC-MS). The results showed that alcohols, esters, and oak compounds were the main contributors to aroma, and their OAVs were higher in the stave samples after 3 months than in the samples from the other two systems of ageing. Furthermore, wines aged with staves have stronger fruity, spiced, and woody aromas, while samples aged in barrels present more chemistry-driven, floral, caramelly, and creamy aromas. The staves-medium plus toast (SMPT at 3 months > 225) and chips-medium plus toast (CMPT at 3 months > 170) showed the highest levels of aromatic series, suggesting that alternative systems provided more powerful aromas than traditional systems, such as barrels-medium plus toast (BMPT at 3 months > 150). A principal component analysis (PCA), orthogonal partial least squares (OPLS) analysis, and cluster analysis allowed for a clear differentiation to be made between red wines according to ageing systems and ageing times. The odour activity values fingerprint in winemaking is a feasible approach to characterise and distinguish wines. Moreover, OAVs provide important information on the effects of production methods on wine quality and aroma profile.

Implant surface detoxification: a comprehensive review.

OBJECTIVE: Nonsurgical treatment has been shown to be effective in dealing with inflammatory lesions around implant without bone loss. However, when bone loss is noticed, surgical treatment may be needed. Nonetheless, before the surgical approaches can be effective, the contaminated implant surface has to be detoxified. Many detoxifying agents/techniques have been proposed and have shown varieties of outcomes, these include but not limited to: citric acid, chlorhexidine, local and systemic antibiotics, hydrogen peroxide, air-powder abrasive, laser and photodynamic therapy, and implantoplasty using burs. Hence, the aim of this review was to evaluate them in terms of their ability in achieving implant surface detoxification. MATERIALS AND METHODS: A search of PubMed and a hand search of articles were conducted up to December 2011. Different keywords related to the treatment of peri-implant diseases were used. RESULTS: At this time, all techniques/agents have shown to be equally effective to detoxify the contaminated implant surface. CONCLUSION: Comparative studies of different detoxification methods are heterogeneous, leaving a few voids when selecting a specific technique for detoxifying the contaminated implant surface.

Effect of rhBMP-2 upon maxillary sinus augmentation: a comprehensive review.

PURPOSE: The purpose of this review was to summarize the recent in vitro and in vivo research findings in areas where rhBMP-2 was used as a grafting material for sinus augmentation. MATERIALS AND METHODS: An electronic literature search for relevant articles published in English was conducted in the PubMed database from February 1996 to August 2012. Randomized clinical trials or prospective human clinical and animal trials were included with the primary objective to compare and evaluate the effectiveness of rhBMP-2 for sinus augmentation. RESULTS: A total of 3 human studies and 4 animal trials qualified the selection criteria that were included in this review. In humans, the selected studies indicated that rhBMP-2 induces new bone formation with comparable bone quality or amount of newly formed bone to that induced by autogenous bone graft. Furthermore, no differences have been reported between new bone induced by rhBMP-2 and native bone. Animal model studies also demonstrated regular bone formation induced by rhBMP-2, followed by normal maturation of new bone. CONCLUSION: All these studies demonstrate the osteoinductive and osteogenic capacity of rhBMP-2 and support it as an alternative for autogenous bone in sinus floor augmentation.