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Journal of the American Dental... Aug 2023Corticosteroids are used to manage pain after surgical tooth extractions. The authors assessed the effect of corticosteroids on acute postoperative pain in patients... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Corticosteroids are used to manage pain after surgical tooth extractions. The authors assessed the effect of corticosteroids on acute postoperative pain in patients undergoing surgical tooth extractions of mandibular third molars.
TYPES OF STUDIES REVIEWED
The authors conducted a systematic review and meta-analysis. The authors searched the Epistemonikos database, including MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and the US clinical trials registry (ClinicalTrials.gov) from inception until April 2023. Pairs of reviewers independently screened titles and abstracts, then full texts of trials were identified as potentially eligible. After duplicate data abstraction, the authors conducted random-effects meta-analyses. Risk of bias was assessed using Version 2 of the Cochrane Risk of Bias tool and certainty of the evidence was determined using the Grading of Recommendations Assessment, Development and Evaluation approach.
RESULTS
Forty randomized controlled trials proved eligible. The evidence suggested that corticosteroids compared with a placebo provided a trivial reduction in pain intensity measured 6 hours (mean difference, 8.79 points lower; 95% CI, 14.8 to 2.77 points lower; low certainty) and 24 hours after surgical tooth extraction (mean difference, 8.89 points lower; 95% CI, 10.71 to 7.06 points lower; very low certainty). The authors found no important difference between corticosteroids and a placebo with regard to incidence of postoperative infection (risk difference, 0%; 95% CI, -1% to 1%; low certainty) and alveolar osteitis (risk difference, 0%; 95% CI, -3% to 4%; very low certainty).
PRACTICAL IMPLICATIONS
Low and very low certainty evidence suggests that there is a trivial difference regarding postoperative pain intensity and adverse effects of corticosteroids administered orally, submucosally, or intramuscularly compared with a placebo in patients undergoing third-molar extractions.
Topics: Humans; Molar, Third; Acute Pain; Adrenal Cortex Hormones; Dry Socket; Postoperative Complications; Pain, Postoperative
PubMed: 37500235
DOI: 10.1016/j.adaj.2023.04.018 -
BioMed Research International 2023After tooth extraction, alveolar bone resorption is inevitable. This clinical phenomenon challenges dental surgeons aiming to restore esthetic and function. Alveolar... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
After tooth extraction, alveolar bone resorption is inevitable. This clinical phenomenon challenges dental surgeons aiming to restore esthetic and function. Alveolar ridge preservation can be applied to minimize dimensional changes with a new socket grafting material, an autogenous dentin graft, produced by mechanically and chemically processing natural teeth. This study assessed the safety and efficacy of using autogenous dentin biomaterial in alveolar ridge preservation.
MATERIALS AND METHODS
Patients with nonrestorable maxillary anterior teeth bounded by natural sound teeth were included in this study. After a detailed clinical and tomographic examination, eligible participants were randomly allocated into two groups. The control group had spontaneous healing of extraction sockets. The study group had their extraction sockets filled with autogenous dentin biomaterial after processing their extracted retained roots with the KometaBio device. Standardized cone beam computed tomography (CBCT) scans were repeated four months later. A full-thickness mucoperiosteal flap reflection was achieved under local anesthesia to get core biopsies for histomorphometric analysis, and dental implants were placed at the same session.
RESULTS
A total of 32 eligible patients were included in this study ( = 16 in each group). Both groups had significantly higher facial soft tissue thickness after four months than baseline ( < 0.05). However, the study group showed statistically significant lesser dimensional changes than the control group according to the standardized CBCT scans. Furthermore, core biopsies confirmed an excellent remodeling of the autogenous dentin biomaterial in the study group. In comparison, only new thin bone trabeculae-filled sockets were in the control group.
CONCLUSION
Autogenous dentin graft can be safely and successfully used for alveolar ridge preservation. Optimal graft remodeling histologically, better ridge dimensional stability, and uneventful wound healing support its clinical application. This trial is registered with TCTR20220615002.
Topics: Humans; Tooth Socket; Biocompatible Materials; Alveolar Process; Alveolar Bone Loss; Tooth Extraction; Mouth, Edentulous; Dentin; Alveolar Ridge Augmentation
PubMed: 38179035
DOI: 10.1155/2023/7932432 -
Veterinary Sciences Nov 2023S100A7 is an inflammation-related protein and plays an essential role in host defenses, yet there is little research about the relationship between mastitis and S100A7...
S100A7 is an inflammation-related protein and plays an essential role in host defenses, yet there is little research about the relationship between mastitis and S100A7 expression in dairy goats. Here, according to the clinical diagnosis of udders, SCC, and bacteriological culture (BC) of milk, 84 dairy goats were grouped into healthy goats ( = 25), subclinical mastitis goats ( = 36), and clinical mastitis goats ( = 23). The S100A7 concentration in subclinical mastitis goats was significantly upregulated than in healthy dairy goats ( = 0.0056) and had a limited change with clinical mastitis dairy goats ( = 0.8222). The relationship between log SCC and S100A7 concentration in milk was positive and R = 0.05249; the regression equation was Y = 0.1446 × X + 12.54. According to the three groups, the log SCC and S100A7 were analyzed using the receiver operating characteristics (ROC) curve; in subclinical mastitis goats, the area under the ROC curve (AUC) of log SCC was 0.9222 and < 0.0001, and the AUC of S100A7 concentration was 0.7317 and = 0.0022, respectively; in clinical mastitis goats, the AUC of log SCC was 0.9678 and < 0.0001, and the AUC of S100A7 concentration was 0.5487 and = 0.5634, respectively. In healthy goats, S100A7 was expressed weakly in the alveolus of the mammary gland of healthy goats while expressed densely in the collapsed alveolus of mastitis goats. Moreover, expression increased significantly in mastitis goats than in healthy dairy goats. In this research, results showed the effects of mastitis on the S100A7 expression in the mammary gland and S100A7 concentration in milk and the limited relationship between SCC and mastitis, which provided a new insight into S100A7's role in the host defenses of dairy goats.
PubMed: 37999476
DOI: 10.3390/vetsci10110653 -
Nature Methods Nov 2023Understanding the dynamic pathogenesis and treatment response in pulmonary diseases requires probing the lung at cellular resolution in real time. Despite advances in...
Understanding the dynamic pathogenesis and treatment response in pulmonary diseases requires probing the lung at cellular resolution in real time. Despite advances in intravital imaging, optical imaging of the lung during active respiration and circulation has remained challenging. Here, we introduce the crystal ribcage: a transparent ribcage that allows multiscale optical imaging of the functioning lung from whole-organ to single-cell level. It enables the modulation of lung biophysics and immunity through intravascular, intrapulmonary, intraparenchymal and optogenetic interventions, and it preserves the three-dimensional architecture, air-liquid interface, cellular diversity and respiratory-circulatory functions of the lung. Utilizing these capabilities on murine models of pulmonary pathologies we probed remodeling of respiratory-circulatory functions at the single-alveolus and capillary levels during disease progression. The crystal ribcage and its broad applications presented here will facilitate further studies of nearly any pulmonary disease as well as lead to the identification of new targets for treatment strategies.
Topics: Mice; Animals; Lung; Rib Cage; Intravital Microscopy
PubMed: 37710017
DOI: 10.1038/s41592-023-02004-9 -
Journal of Dentistry Jun 2024This review was to offer a comprehensive analysis of currently available evidence on post-extraction alveolar socket healing, including i) the histological and molecular... (Review)
Review
OBJECTIVE
This review was to offer a comprehensive analysis of currently available evidence on post-extraction alveolar socket healing, including i) the histological and molecular events during alveolar socket healing, ii) the dimensional ridge alterations after socket healing and controversies relating to sinus pneumatisation, iii) the patient-specific factors, procedural elements, and site-related variables influencing socket healing, iv) techniques and effectiveness of alveolar ridge preservation (ARP) procedure, and v) the philosophies and cost-effectiveness of ARP in clinical practice.
SOURCES AND STUDY SELECTION
To investigate the dimensional profiles of the alveolar ridge following unassisted healing, an overview of systematic reviews was conducted in February 2024 by two independent reviewers. Four electronic databases were searched in Pubmed, Embase, Web of science and Cochrane Library between 2004 and 2024 to identify all relevant systematic reviews on post-extraction healing. A further manual search of reviews was also conducted. The articles were further reviewed in full text for relevance. The AMSTAR-2 appraisal tool was adopted to assess methodological quality. Current research pertaining to other listed objectives was objectively analysed in narration.
DATA
11 out of 459 retrieved studies were selected and ultimately covered in this review on the dimensional changes of alveolar ridge following natural healing: Seven systematic reviews and four systematic reviews with meta-analyses. The methodological quality of all included reviews was critically low.
CONCLUSION
This review thoroughly examines the healing profiles of post-extraction alveolar sockets and highlights the dynamic process with overlapping phases and the inter-individual variability in outcomes. ARP procedure is a potential strategy for facilitating prosthetic site development, while the current evidence is limited. Herein, an individualised and prosthetically driven approach is crucial. Further well sized and designed trials with novel biomaterials need to be undertaken, and the role of artificial intelligence in predicting healing and assisting clinical decision-making could be explored.
CLINICAL SIGNIFICANCE
By advancing our understanding of alveolar socket healing and its management strategies, clinicians can make more informed decisions regarding patient and site level assessment and selection, surgical techniques, and biomaterial choices, ultimately contributing to the enhanced healing process with reduced complications and improved quality of life for patients undergoing tooth extraction and dental implant treatments.
Topics: Humans; Tooth Socket; Tooth Extraction; Wound Healing; Alveolar Process; Alveolar Ridge Augmentation; Alveolar Bone Loss
PubMed: 38574844
DOI: 10.1016/j.jdent.2024.104986 -
Dentistry Journal Aug 2023After tooth extraction, the alveolar ridge undergoes a physiological process of remodelling and disuse atrophy. Socket augmentation (SA) has been shown to preserve... (Review)
Review
After tooth extraction, the alveolar ridge undergoes a physiological process of remodelling and disuse atrophy. Socket augmentation (SA) has been shown to preserve alveolar bone volume in order to facilitate implant placement and reduce the need for staged grafting at a later date. Although autogenic grafting has been shown to be the gold standard in bone regeneration, it has significant disadvantages. To prevent post-extraction volumetric alterations and alveolar bone resorption occurring, alternative grafting materials, including xenografts, alloplasts, and allografts, have been used successfully in fresh extraction sites. However, these materials act mostly as bio-scaffolds and require a slower integration period of 6-8 months prior to implant placement. Recently, the use of autologous platelet-rich fibrin (PRF) has been advocated alongside socket augmentation as a method of bio-enhancement of healing of soft and hard tissues. PRF contains platelet-derived growth factors, hormones, and bioactive components such as cytokines that have been shown to promote angiogenesis and tissue regeneration during wound healing. The aim of this article is to review the evidence base for the SA technique Clinical benefits of SA will be discussed with a reference to two cases. Therefore, this narrative review will discuss the post-extraction bone changes, the importance of SA, and the bio-enhancement role of PRF in the management of extraction site defects when the alternative technique of immediate implant placement is not possible or contraindicated.
PubMed: 37623292
DOI: 10.3390/dj11080196 -
Clinical Oral Investigations Aug 2023To investigate the histomorphometric changes occurring in alveolar ridge preservation (ARP) based on the use of different plasma concentrates (PCs) in randomized... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To investigate the histomorphometric changes occurring in alveolar ridge preservation (ARP) based on the use of different plasma concentrates (PCs) in randomized clinical trials (RCT). There is controversy whether the placement of PCs in ARP is effective in the formation of new bone.
MATERIALS AND METHODS
A systematic review search was conducted in PubMed, Scopus, Web of Science, and Cochrane Database to answer the PICO question: In patients undergoing tooth extraction followed by ARP, do PCs alone in the post-extraction socket in comparison with spontaneous healing improve new vital bone formation percentage in histomorphometric analysis after more than 10 weeks? The risk of bias was assessed and a meta-analysis was conducted.
RESULTS
Of 3809 results, 8 studies were considered suitable for inclusion. A total of 255 teeth were extracted in 250 patients. Regarding the PCs used, ARP was performed with platelet- and leukocyte-rich fibrin (L-PRF) in 120 sockets, and with pure platelet-rich plasma (P-PRP) in 31 sockets and 104 sockets were controlled. PCs improved new bone formation in ARP with respect to the spontaneous healing group (SMD = 1.77, 95%C.I. = 1.47-2.06, p-value < 000.1). There were no differences between the different PCs (L-PRF and P-PRP).
CONCLUSION
The results of this meta-analysis support the efficacy of the use of PCs in new bone formation in ARP. With respect to the different types of PCs studied, no differences were observed.
CLINICAL RELEVANCE
When planning implant surgery after tooth extraction, treatment with PCs should be considered for ARP. Any PC increases new bone formation compared to spontaneous healing.
Topics: Humans; Tooth Socket; Alveolar Process; Osteogenesis; Tooth; Platelet-Rich Plasma; Tooth Extraction; Fibrin; Alveolar Ridge Augmentation
PubMed: 37439800
DOI: 10.1007/s00784-023-05126-8 -
Clinical Oral Investigations Dec 2023To assess whether in animals or patients with ≥ 1 tooth extracted, hyaluronic acid (HyA) application results in superior healing and/or improved complication... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To assess whether in animals or patients with ≥ 1 tooth extracted, hyaluronic acid (HyA) application results in superior healing and/or improved complication management compared to any other treatment or no treatment.
MATERIALS AND METHODS
Three databases were searched until April 2022. The most relevant eligibility criteria were (1) local application of HyA as adjunct to tooth extraction or as treatment of alveolar osteitis, and (2) reporting of clinical, radiographic, histological, or patient-reported data. New bone formation and/or quality were considered main outcome parameters in preclinical studies, while pain, swelling, and trismus were defined as main outcome parameters in clinical studies.
RESULTS
Five preclinical and 22 clinical studies (1062 patients at final evaluation) were included. In preclinical trials, HyA was applied into the extraction socket. Although a positive effect of HyA was seen in all individual studies on bone formation, this effect was not confirmed by meta-analysis. In clinical studies, HyA was applied into the extraction socket or used as spray or mouthwash. HyA application after non-surgical extraction of normally erupted teeth may have a positive effect on soft tissue healing. Based on meta-analyses, HyA application after surgical removal of lower third molars (LM3) resulted in significant reduction in pain perception 7 days postoperatively compared to either no additional wound manipulation or the application of a placebo/carrier. Early post-operative pain, trismus, and extent of swelling were unaffected.
CONCLUSIONS
HyA application may have a positive effect in pain reduction after LM3 removal, but not after extraction of normally erupted teeth.
CLINICAL RELEVANCE
HyA application may have a positive effect in pain reduction after surgical LM3 removal, but it does not seem to have any impact on other complications or after extraction of normally erupted teeth. Furthermore, it seems not to reduce post-extraction alveolar ridge modeling, even though preclinical studies show enhanced bone formation.
Topics: Humans; Animals; Tooth Socket; Hyaluronic Acid; Trismus; Dry Socket; Tooth Extraction; Molar, Third; Pain
PubMed: 37963982
DOI: 10.1007/s00784-023-05227-4 -
Frontiers in Bioengineering and... 2023Many viral infections, including the COVID-19 infection, are associated with the hindrance of blood oxygenation due to the accumulation of fluid, inflammatory cells, and...
Many viral infections, including the COVID-19 infection, are associated with the hindrance of blood oxygenation due to the accumulation of fluid, inflammatory cells, and cell debris in the lung alveoli. This condition is similar to Acute Respiratory Distress Syndrome (ARDS). Mechanical positive-pressure ventilation is often used to treat this condition, even though it might collapse pulmonary capillaries, trapping red blood cells and lowering the lung's functional capillary density. We posit that the hyperosmotic-hyperoncotic infusion should be explored as a supportive treatment for ARDS. As a first step in verifying the feasibility of this ARDS treatment, we model the dynamics of alveolar fluid extraction by osmotic effects. These are induced by increasing blood plasma osmotic pressure in response to the increase of blood NaCl concentration. Our analysis of fluid drainage from a plasma-filled pulmonary alveolus, in response to the intravenous infusion of 100 ml of 1.28 molar NaCl solution, shows that alveoli empty of fluid in approximately 15 min. These modeling results are in accordance with available experimental and clinical data; no new data were collected. They are used to calculate the temporal change of blood oxygenation, as oxygen diffusion hindrance decreases upon absorption of the alveolar fluid into the pulmonary circulation. Our study suggests the extraordinary speed with which beneficial effects of the proposed ARDS treatment are obtained and highlight its practicality, cost-efficiency, and avoidance of side effects of mechanical origin.
PubMed: 37936822
DOI: 10.3389/fbioe.2023.1250312 -
European Journal of Dentistry Oct 2023This research aimed to determine OX40 and OX40L mRNA expression in blood samples of naive oral squamous cell carcinoma (OSCC) patients in different histological...
OBJECTIVES
This research aimed to determine OX40 and OX40L mRNA expression in blood samples of naive oral squamous cell carcinoma (OSCC) patients in different histological grades and clinical stages. The in silico analysis was performed using the STRING database for functional association and a better understanding of the interactions of OX40 and its ligand with other proteins.
MATERIALS AND METHODS
In this study, we recruited 141 newly diagnosed patients of OSCC. Levels of OX40 and OX40L mRNA expression were explored using real-time quantitative polymerase chain reaction. An in silico tool was also utilized to evaluate the OX40/OX40L interactome.
RESULTS
The results showed higher OX40 expressional levels in the late stage (23-fold) compared with the early stage (8.5-fold) ( = < 0.001). A similar trend was seen in OX40L mRNA expression, revealing a fold change of 5.8 in the early stage in comparison to 9.9-fold change in the late stage ( = < 0.001). Overexpression of OX40 and OX40L was found in different histological grades ( = 0.005 and = < 0.001, respectively). Overexpression of OX40 and OX40L was detected in habits such as smoking and paan intake, whereas statistically significant upregulation was observed in the cheek, lip, and alveolus tumors. However, there was no substantial difference in OX40 and OX40L expression based on age or gender. The functional interactions, that is, interactomes of OX40 and OX40L with other proteins have been determined by in silico analysis.
CONCLUSION
Based on current study findings, despite OX40 and OX40L upregulation in newly diagnosed OSCC patients, it is speculated that the physiological function of these molecules is altered due to immune system exhaustion.
PubMed: 36652956
DOI: 10.1055/s-0042-1760375