Patients' perceived health service needs for osteoarthritis (OA) care: a scoping systematic review.

OBJECTIVE: To identify and synthesise evidence regarding patients' perceived health service needs related to osteoarthritis (OA). DESIGN: A comprehensive systematic scoping review of MEDLINE, PsycINFO, EMBASE and CINAHL (1990-2016) was performed to capture information regarding patient perceived health service needs related to OA. Risk of bias and quality of included articles were assessed. Relevant data were extracted and collated to provide a systematic review of the existing literature. RESULTS: Of the 1384 identified manuscripts, 21 were relevant to areas of patient perceived need, including needs related to medical care, pharmacologic therapy, physiotherapy and exercise therapy and alternative medicine. Key findings included (1) Symptom control drove the need for both conventional and complementary services. (2) An individualized relationship was sought with a practitioner knowledgeable in OA care and who adopted a holistic approach, whether providing conventional or alternative therapies. (3) Medications were required to obtain symptomatic relief, with use tempered by recognition of potential side effects and financial cost. (4) The need for allied health services was recognised, although patient and system issues were barriers to uptake. (5) Patient's attitudes towards joint replacement, orthoses and physical aids were influenced by patient preferences and previous healthcare experiences. CONCLUSION: Patient perceived needs are similar to those suggested by clinical guideline recommendations. Better aligning patient perceived needs with healthcare requirements may improve OA outcomes and optimise healthcare system utilisation.

Systematic scoping review of patients' perceived needs of health services for osteoporosis.

Health service planners, administrators and providers need to understand the patients' perspective of health services related to osteoporosis to optimise health outcomes. The aims of this study were to systematically identify and review the literature regarding patients' perceived health service needs relating to osteoporosis and osteopenia. A systematic scoping review was performed of publications in MEDLINE, EMBASE, CINAHL and PsycINFO (1990-2016). Descriptive data regarding study design and methodology were extracted and risk of bias assessed. Aggregates of patients' perceived needs of osteoporosis health services were categorised. Thirty-three studies (19 quantitative and 14 qualitative) from 1027 were relevant. The following areas of perceived need emerged: (1) patients sought healthcare from doctors to obtain information and initiate management. They were dissatisfied with poor communication, lack of time and poor continuity of care. (2) Patients perceived a role for osteoporosis pharmacotherapy but were concerned about medication administration and adverse effects. (3) Patients believed that exercise and vitamin supplementation were important, but there is a lack of data examining the needs for other non-pharmacological measures such as smoking cessation and alcohol. (4) Patients wanted diagnostic evaluation and ongoing surveillance of their bone health. This review identified patients' needs for better communication with their healthcare providers. It also showed that a number of important cornerstones of therapy for osteoporosis, such as pharmacotherapy and exercise, are identified as important by patients, as well as ongoing surveillance of bone health. Understanding patients' perceived needs and aligning them with responsive and evidence-informed service models are likely to optimise patient outcomes.

A family history of knee joint replacement increases the progression of knee radiographic osteoarthritis and medial tibial cartilage volume loss over 10 years.

OBJECTIVES: Osteoarthritis (OA) has a genetic component but it is uncertain if the offspring of those with knee OA are at a greater risk. The aim of this study was to describe radiographic OA (ROA) progression and cartilage loss over 10 years in a midlife cohort with some having a family history of OA and some community based controls. METHODS: 220 participants [mean-age 45 (26-61); 57% female] were studied at baseline and 10 years. Half were adult offspring of subjects who underwent knee replacement for OA and the remainder were randomly selected controls. Joint space narrowing (JSN) and osteophytes were assessed on radiographs and cartilage volume (tibial, femoral and patellar), cartilage defects, bone marrow lesions (BMLs) and meniscal tears were assessed on Magnetic resonance imaging (MRI). RESULTS: For ROA, there was a significant difference between offspring and controls in unadjusted analysis for change in total ROA, medial JSN, total medial, total lateral and total osteophyte scores. This difference persisted for medial JSN (difference in ratios = +1.93 (+1.04, +3.51)) only, after adjustment for confounders and baseline differences. In unadjusted analysis for cartilage loss, offspring lost more cartilage at the medial tibial (difference in means = -79.13 (-161.92, +3.71)) site only. This difference became of borderline significance after adjustment for baseline differences (P = 0.055). CONCLUSION: The offspring of subjects having a total knee replacement have a greater worsening of ROA (both JSN and osteophytes) and higher medial tibial cartilage volume loss over 10 years. Most of these changes are mediated by differences in baseline characteristics of offspring and controls except for increase in medial JSN.

Anosognosia, neglect and quality of life of right hemisphere stroke survivors.

BACKGROUND AND PURPOSE: Anosognosia and neglect may coexist in stroke patients. Neglect patients often report poor quality of life (QOL), whereas patients suffering from other cognition disorders with poor insight report better QOL. This study investigates the relationship between anosognosia, neglect and QOL amongst stroke survivors. METHODS: Stroke survivors who met the criteria were used as a sampling pool. Sixty stroke patients were observed in this study, amongst whom 20 patients with anosognosia and neglect (A+N+), 20 patients with neglect but not anosognosia (A-N+) and 20 patients with neither anosognosia nor neglect (A-N-) were selected from the sampling pool based on demographic characteristics matched with the A+N+ group. A questionnaire (SS-QOL) was used to collect the QOL perceived by the stroke survivors. RESULTS: The perceived QOL of the A+N+ group was significantly better than those of the other groups, including the subscales of self-care, mobility, work/productivity, upper extremity, mood, family role and social role. However, the A+N+ group had poor balance level and more fall incidents were reported. CONCLUSION: The A+N+ group perceived better QOL but had more falls and poorer balance than the other groups. Health providers should work with caregivers aggressively in preventing accidents.

Blood pressure and age associated with silent autonomic dysreflexia during urodynamic examinations in patients with spinal cord injury.

STUDY DESIGN: An observational study. OBJECTIVES: To investigate the factors associated with silent autonomic dysreflexia (AD) during urodynamics (UD) in spinal cord injury (SCI) patients. SETTING: Taichung city, Taiwan, ROC. METHODS: Blood pressure (BP) and symptoms of AD were continuously monitored during UD, and systolic blood pressure (SBP) elevations >20 mmHg was considered an AD reaction. AD patients were divided into a symptomatic group and a silent group (without AD symptoms), and variables (basic demographic data, hemodynamic data and UD parameters) were compared. RESULTS: A total of 42 patients, 21 in symptomatic and 21 in silent AD groups, were analyzed. Symptomatic group had significantly greater diastolic blood pressure (DBP) increment and rates of SBP/DBP changes (change of BP divided by duration) as compared to the silent group (29.5 vs 21.7 mmHg; 4.8 vs 2.3 mmHg min(-1) and 2.8 vs 1.4 mmHg min(-1)) (P<0.05). The cutoff points of these three variables, determined by receiver operating characteristic analysis, are: DBP increment of 21 mmHg and rates of SBP/DBP change of 2.27 and 1.16 mmHg min(-1). Age had a weak negative correlation with DBP change (Pearson's r=-0.377, P=0.048) and the silent group was significantly older than the symptomatic group (49.4 vs 40.1 years, P<0.05). CONCLUSION: Patients with more symptomatic AD tended to have significant DBP elevation and more rapid SBP/DBP increments, and this was negatively correlated with age. Aging decreases AD symptoms and the magnitude of DBP elevation, possibly through the mechanism of decreased baroreceptor sensitivity. BP monitoring during UD and other invasive procedures is strongly recommended, especially for elderly SCI patients.

Smoking cessation in Taiwanese male smokers with coronary artery disease: influencing factors and policy implications.

AIM: To investigate factors affecting smoking cessation in male smokers with coronary artery disease. DESIGN: A descriptive, correlation, cross-sectional study was conducted. METHODS: Data were collected using a questionnaire constructed by a literature review of research on smoking cessation in male smokers including demographics and smoking background, as well as psychological, interpersonal and environmental factors. A total of 130 male patients with coronary artery disease were recruited from the cardiac clinic at a regional hospital in Taiwan from August to December 2008. The response rate was 93% (n = 121). Descriptive statistics, chi-square, t-tests and logistic regression analysis were conducted. RESULTS: During the survey, 64.5% of the respondents reported that they had stopped smoking after a coronary event. Five factors were significantly associated with smoking cessation after diagnosis of coronary artery disease: age, the severity of heart diagnoses, antismoking norms (perceived that smoking was against the social norms), nicotine dependence level, and contrary views of smoking (perceived negative expectancy of smoking). Multivariate analysis revealed antismoking norms to be the most important predictor (AOR = 4.27; P < .05) after adjusting age. CONCLUSION: The study highlights the need to develop smoking cessation interventions that specifically counsel patients with coronary artery disease about these information, such as the disease risk and development, health consequences of smoking, and dependence therapy. Additionally, government support for tobacco control programmes in hospitals and elsewhere is designed to have a beneficial effect on patients' smoking behaviours primarily by increasing antismoking norms.

Life Expectancy in Pre-Frail and Frail States with and without Disability: 18-Years of Follow-Up Data from the HEPESE Study Using the Markov Chain Method.

We estimated the total life expectancy (TLE), frailty-free life expectancy (FFLE), frail life expectancy (FLE), pre-frail life expectancy (PFLE), and FLE with and without disability among 2,000 Mexican Americans aged ≥67 years over an 18-year period. Frailty was defined as the presence of ≥2 criteria (weight loss, weakness, self-reported exhaustion, slowness). We used the Markov chain method to estimate the TLE, FFLE, FLE, PFLE, and FLE with and without disability by age and gender. TLE at age 67 was 17.49 years (women) and 15.54 years (men); FFLE was 6.50 years (women) and 6.45 years (men); PFLE was 6.48 years (women) and 5.42 years (men); FLE was 4.51 years (women) and 3.67 years (men); and FLE with disability was 2.13 years (women) and 1.13 years (men). In conclusion, Mexican American older women had fewer years of non-frail LE, more pre-frail or frail years, and more years with disability than men.

Decadal stability in coral cover could mask hidden changes on reefs in the East Asian Seas.

Coral reefs in the Central Indo-Pacific region comprise some of the most diverse and yet threatened marine habitats. While reef monitoring has grown throughout the region in recent years, studies of coral reef benthic cover remain limited in spatial and temporal scales. Here, we analysed 24,365 reef surveys performed over 37 years at 1972 sites throughout East Asia by the Global Coral Reef Monitoring Network using Bayesian approaches. Our results show that overall coral cover at surveyed reefs has not declined as suggested in previous studies and compared to reef regions like the Caribbean. Concurrently, macroalgal cover has not increased, with no indications of phase shifts from coral to macroalgal dominance on reefs. Yet, models incorporating socio-economic and environmental variables reveal negative associations of coral cover with coastal urbanisation and sea surface temperature. The diversity of reef assemblages may have mitigated cover declines thus far, but climate change could threaten reef resilience. We recommend prioritisation of regionally coordinated, locally collaborative long-term studies for better contextualisation of monitoring data and analyses, which are essential for achieving reef conservation goals.

Influences of bioavailability, trophic position, and growth on methylmercury in hakes (Merluccius merluccius) from Northwestern Mediterranean and Northeastern Atlantic.

Methylmercury (MeHg) determinations in hake, its food-chain, and the surrounding waters and sediments allowed us to show that the higher length or age normalized mercury concentrations of Northwestern Mediterranean (Gulf of Lions: GoL) muscle hakes compared to its Northeastern Atlantic (Bay of Biscay: BoB) counterpart are due to both biotic and abiotic differences between their ecosystems. Bioenergetic modeling reveals that the slower growth rate of Mediterranean hake favors the MeHg bioaccumulation in the fish muscle and explains most of the difference between GOL and BoB hake populations. In addition, the waters of the Mediterranean hake habitat favor a higher MeHg exposition, due to the upper position of the thermohalocline, where MeHg is formed. Furthermore, we show that, within the Mediterranean hake population, a major increase in the biomagnification power (the slope of the relationships between logMeHg and δ(15)N), from 0.36 up to 1.12, occurs when individuals enter adulthood, resulting from the combined effects of lowering growth rate and change in feeding habits. Finally, δ(15)N normalized Hg concentrations indicate that the highest Hg concentrations are for hake from the shelf edge and the lowest are for hake from the Rhône prodelta area, suggesting a lower Hg bioavailability in inshore environments, consistent with MeHg distributions in water, sediment, and preys.

Effects of Aspirin on Odontogenesis of Human Dental Pulp Cells and TGF-ß1 Liberation from Dentin In Vitro.

Aim: This in vitro study aimed to investigate the roles of aspirin (ASA) and its concentrations on the odontogenesis of human dental pulp cells (HDPCs) and to investigate the influence of ASA on TGF-ß1 liberation from dentin. Methodology. HDPCs were cultured in a culture medium with 25, 50, 75, 100, and 200 µ·g/mL ASA and 0 µ·g/mL ASA as a control. The mitochondrial activity of HDPCs was assessed using an MTT assay. Crystal violet staining and triton were used to evaluate cell proliferation rates. ALP activity was measured with a fluorometric assay. Expressions of DSP and RUNX2 were determined with the ELISA. DSP and RUNX2 mRNA levels were measured with RT-qPCR. Alizarin red staining was conducted to evaluate the mineralized nodule formation. Dentin slices were submerged in PBS (negative control), 17% EDTA (positive control), and ASA before collecting the solution for TGF-ß1 quantification by the ELISA. The data were analyzed by the t-tests and ANOVA, followed by the Tukey post hoc tests. P values < 0.05 were considered statistically significant. Results: The results showed that 25-50 µ·g/mL ASA promoted mitochondrial activity of HDPCs at 72 h (P < 0.05) and yielded significantly higher proliferation rates of HDPCs than the control at 14d and 21d (P < 0.001). All concentrations of ASA promoted odontogenic differentiation of HDPCs by enhancing the levels of DSP and RUNX2, their mRNA expression, and mineralization in a dose-dependent manner. Also, ASA yielded significantly higher TGF-ß1 liberation after conditioning dentin for 5 min (25, 200 µ·g/mL; P < 0.001) and 10 min (200 µ·g/mL; P < 0.05). Conclusions: This in vitro study demonstrated that ASA, especially in high concentrations, promoted the odontogenesis of HDPCs and TGF-ß1 liberation from dentin, showing the potential of being incorporated into the novel pulp capping materials for dental tissue regeneration.

Continuous-time photon-stimulated desorption spectroscopy studies on soft x-ray-induced reactions of CF3Br adsorbed on Si(111)-7×7.

Continuous-time core-level photon-stimulated desorption (PSD) spectroscopy was used to study the soft x-ray-induced reactions of CF(3)Br molecules adsorbed on Si(111)-7×7 near the Si(2p) edge (98-110 eV). The monochromatic synchrotron radiation was employed as a soft x-ray light source in the photon-induced reactions and also as a probe for investigating the produced fluorination states of the bonding surface Si atom in the positive-ion PSD spectroscopy. Several different surface coverages were investigated. The PSD spectra from the low-CF(3)Br-covered surfaces show the production of surface SiF species, while those from the high-CF(3)Br-covered surfaces depict the formation of surface SiF, SiF(2), and SiF(3) species. The photolysis cross section of the submonolayer CF(3)Br-covered surface is determined as ∼4.3×10(-18) cm(2). A comparison with the results on CF(3)Cl/Si(111)-7×7 surface is discussed.

Encapsulation of bacterial cells in cytoprotective ZIF-90 crystals as living composites.

Exploiting metal-organic frameworks (MOFs) as selectively permeable shelters for encapsulating engineered cells to form hybrid living materials has attracted increasing attention in recent years. Optimizing the synthesis process to improve encapsulation efficiency (EE) is critical for further technological development and applications. Here, using ZIF-90 and genetically engineered Escherichia coli (E. coli) as a demo, we fabricated E. coli@ZIF-90 living composites in which E. coli cells were encapsulated in ZIF-90 crystals. We illustrated that ZIF-90 could serve as a protective porous cage for cells to shield against toxic bactericides including benzaldehyde, cinnamaldehyde, and kanamycin. Notably, the E. coli cells remained alive and could self-reproduce after removing the ZIF-90 crystal cages in ethylenediaminetetraacetic acid, suggesting a feasible route for protecting and prolonging the lifespan of bacterial cells. Moreover, an aqueous multiple-step deposition approach was developed to improve EE of the E. coli@ZIF-90 composites: the EE increased to 61.9 ± 5.2%, in contrast with the efficiency of the traditional method (21.3 ± 4.4%) prepared with PBS buffer. In short, we develop a simple yet viable strategy to manufacture MOF-based living hybrid materials that promise new applications across diverse fields.

Mars Extant Life: What's Next? Conference Report.

On November 5-8, 2019, the "Mars Extant Life: What's Next?" conference was convened in Carlsbad, New Mexico. The conference gathered a community of actively publishing experts in disciplines related to habitability and astrobiology. Primary conclusions are as follows: A significant subset of conference attendees concluded that there is a realistic possibility that Mars hosts indigenous microbial life. A powerful theme that permeated the conference is that the key to the search for martian extant life lies in identifying and exploring refugia ("oases"), where conditions are either permanently or episodically significantly more hospitable than average. Based on our existing knowledge of Mars, conference participants highlighted four potential martian refugium (not listed in priority order): Caves, Deep Subsurface, Ices, and Salts. The conference group did not attempt to reach a consensus prioritization of these candidate environments, but instead felt that a defensible prioritization would require a future competitive process. Within the context of these candidate environments, we identified a variety of geological search strategies that could narrow the search space. Additionally, we summarized a number of measurement techniques that could be used to detect evidence of extant life (if present). Again, it was not within the scope of the conference to prioritize these measurement techniques-that is best left for the competitive process. We specifically note that the number and sensitivity of detection methods that could be implemented if samples were returned to Earth greatly exceed the methodologies that could be used at Mars. Finally, important lessons to guide extant life search processes can be derived both from experiments carried out in terrestrial laboratories and analog field sites and from theoretical modeling.

Requirement of Zn to demonstrate HCO3-stimulated ATPase activity of rat small intestinal brush border.

The existence of a membrane-bound HCO3-stimulated ATPase in intestinal mucosa is controversial. A crude brush border fraction of rat small intestinal homogenates contained HCO3-ATPase activity which was inhibited by preincubation with 3 mM EDTA. Alkaline phosphatase activity of this preparation was also inhibited in a parallel, time-dependent fashion by preincubation with EDTA. When 5 mM ZnSO4 accompanied 3 mM EDTA in the preincubation mix, preservation of both enzyme activities occurred, demonstrating a requirement of Zn for the activity of both these phosphatases. These studies support the earlier contention that HCO3-ATPase and alkaline phosphatase activities may be different properties of the same enzyme, and raise the possibility that the ATPase could play a role in intestinal ion transport. The failure to identify a membrane-bound HCO3-ATPase by other workers could be due to the exposure of EDTA which occurred in their tissue preparation.

Atomic structure of the Ag/Ge(111)-(sq.rt.(3) x sq.rt.(3)) surface: From scanning tunneling microscopy observation to theoretical study.

The atomic structure of the Ag/Ge(111)-(sq.rt.(3) x sq.rt.(3))R30 degrees surface is studied by scanning tunneling microscopy (STM) and the density functional theory (DFT) calculations. Our STM images have shown a structure which is different from the widely accepted honeycomb-chained-triangle (HCT) model before. The structure is similar to the inequivalent triangle (IET) model found for the Ag/Si(111)-(sq.rt.(3) x sq.rt(3))R30 degrees surface. This model proposed two types of silver triangles with different sizes in the unit cell, corresponding to the bright spots and the dark spots in the STM image. A distinguishable hexagonal pattern of the IET structure was well disclosed in the temperature range from 100 to 473 K in our STM studies for Ag/Ge(111)-(sq.rt.(3) x sq.rt.(3))R30 degrees. Furthermore, the result of the DFT calculations showed that the IET structure is 0.20 eV energetically more stable than the HCT model. Besides, the Ge triangles, which were not disclosed in earlier STM research, are found in this study.

Lower lymphocyte to monocyte ratio is a potential predictor of poor outcome in patients with cerebral venous sinus thrombosis.

Background: Lymphocyte to monocyte ratio (LMR) is associated with functional outcome in patients with stroke. But the relationship between the LMR value and the prognosis of cerebral venous sinus thrombosis (CVST) has not been investigated. Methods: CVST patients, admitted to the First Affiliated Hospital of Zhengzhou University, were retrospectively identified from November 2010 to January 2017. Functional outcomes of patients were evaluated with the modified Rankin Scale (mRS). Patients were divided into good (mRS 0-2) and poor (mRS 3-6) outcomes groups. Univariate and multivariate Cox regression analyses were used to assess the relationship between LMR and the poor survival outcome. Results: A total of 228 patients were included of which 41 had poor outcomes (18.0%). The duration of follow-up was 22 months (6-66 months). LMR (2.3±1.2 vs 3.2±1.8, p<0.01) was significantly lower in the poor outcome group. Multivariate Cox regression analysis showed that LMR (HR 0.726, 95% CI 0.546 to 0.964, p=0.027) was a independent predictor of poor prognosis. Conclusions: LMR may be a predictor of poor prognosis in CVST patients.

Photon-exposure-dependent photon-stimulated desorption for obtaining photolysis cross section of molecules adsorbed on surface by monochromatic soft x-ray photons.

Photon-exposure-dependent positive- and negative-ion photon-stimulated desorption (PSD) was proposed to study the photoreactions and obtain the photolysis cross sections of molecules adsorbed on a single-crystal surface by monochromatic soft x-ray photons with energy near the core level of adsorbate. The changes in the F(+) and F(-) PSD ion yields were measured from CF(3)Cl molecules adsorbed on Si(111)-7x7 at 30 K (CF(3)Cl dose=0.3x10(15) molecules/cm(2), approximately 0.75 monolayer) during irradiation of monochromatic soft x-ray photons near the F(1s) edge. The PSD ion yield data show the following characteristics: (a) The dissociation of adsorbed CF(3)Cl molecules is due to a combination of direct photodissociation via excitation of F(1s) core level and substrate-mediated dissociation [dissociative attachment and dipolar dissociation induced by the photoelectrons emitting from the silicon substrate]. (b) the F(+) ion desorption is associated with the bond breaking of the surface CF(3)Cl, CF(2)Cl, CFCl, and SiF species. (c) the F(-) yield is mainly due to DA and DD of the adsorbed CF(3)Cl molecules. (d) The surface SiF is formed by reaction of the surface Si atom with the neutral fluorine atom, F(+), or F(-) ion produced by scission of C-F bond of CF(3)Cl, CF(2)Cl, or CFCl species. A kinetic model was proposed for the explanation of the photolysis of this submonolayer CF(3)Cl-covered surface. Based on this model and the variation rates of the F(+)F(-) signals during fixed-energy monochromatic photon bombardment at 690.2 and 692.6 eV [near the F(1s) edge], the photolysis cross section was deduced as a function of energy.

Maxillary sinus floor elevation using a tissue-engineered bone complex with OsteoBone and bMSCs in rabbits.

OBJECTIVES: To evaluate the effects of maxillary sinus floor elevation by a tissue-engineered bone complex with OsteoBone(trade mark) and bone marrow stromal cells (bMSCs) in rabbits. MATERIAL AND METHODS: Autologous bMSCs from adult New Zealand rabbits were cultured and combined with OsteoBone(trade mark) at a concentration of 20 x 10(6) cells/ml in vitro. Twenty-four animals were used and randomly allocated into groups. For each time point, 16 maxillary sinus floor elevation surgeries were made bilaterally in eight animals and randomly repaired by bMSCs/material (i.e. OsteoBone), material, autogenous bone and blood clot (n=4 per group). A polychrome sequential fluorescent labeling was also performed post-operatively. The animals were sacrificed 2, 4 and 8 weeks after the procedure and evaluated histologically as well as histomorphometrically. RESULTS: New bone area significantly decreased from weeks 2 to 8 in the blood clot group, while bone area in the autologous bone reduced from weeks 4 to 8. In both groups, a significant amount of fatty tissue appeared at week 8. Accordingly, augmented height in both groups was also significantly decreased from weeks 2 to 8. The bone area in the material-alone group as well as in the bMSCs/material group, on the other hand, increased over time. Significantly more newly formed bone area and mineralization was observed in the center of the raised space in the bMSCs/material group than in the material-alone group. The augmented height was maintained in these two groups throughout the course of this study. CONCLUSION: These results suggest that OsteoBone can successfully be used as a bone graft substitute and that the combination of this material with bMSCs can effectively promote new bone formation in sinus elevation.

A Pilot Study on the Efficacy of a Treatment Algorithm to Detoxify Dental Implant Surfaces Affected by Peri-implantitis.

This in vitro pilot study was performed to determine whether a treatment algorithm including mechanical debridement, followed by air powder abrasion with glycine, followed by citric acid conditioning with vigorous flushing of the surface with sterile water after each step, is capable of decontaminating an infected implant surface. A total of 14 dental implants that were deemed hopeless due to advanced peri-implantitis were extracted. Of these, 6 implants served as tests and had their exposed surfaces treated with the decontamination protocol, 6 served as untreated controls, and 2 were mechanically treated only, followed by rubbing the surface with sterile saline. All implants were placed in culture with human osteoprogenitor cells for 72 hours, and evaluation was performed using scanning electron microscopy. The 6 test implants all demonstrated attachment and proliferation of the normal human osteoprogenitor cells on their prior exposed and decontaminated surfaces. All of the untreated control and the mechanically debrided, sterile water-treated implants failed to demonstrate this same success. The results suggest that this protocol can decontaminate an implant surface affected by peri-implantitis. Further studies are warranted to determine if this technique would demonstrate similar success over a greater number of implants and whether this outcome may occur in humans.