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Medicina (Kaunas, Lithuania) May 2024Peri-implant soft tissue deficiency (PSTD) is a significant factor impacting aesthetics, particularly in the anterior zone, where labial bone resorption and thin...
Peri-implant soft tissue deficiency (PSTD) is a significant factor impacting aesthetics, particularly in the anterior zone, where labial bone resorption and thin peri-implant phenotypes are common. The occurrence of a gray color around the implant fixture due to PSTD can be aesthetically concerning in the esthetic zone. In cases involving natural teeth, autogenous soft tissue grafts such as subepithelial connective tissue grafts (SCTGs), free gingival grafts (FGGs), and coronally advanced flaps (CAFs) are commonly utilized. However, there are limited reports of using bone grafts in conjunction with these techniques for modifying the gingival phenotype around both teeth and implants. In the presented cases where PSTD resulted in visible gray coloration of the implant fixture in the esthetic zone, mechanical and chemical decontamination of the exposed implant surface was performed using a titanium brush and tetracycline (Tc) HCl. Subsequently, to enhance peri-implant mucosa thickness and mask the titanium color, simultaneous SCTG and bone grafting procedures were conducted. Within the limitations of these case reports, successful esthetic outcomes were achieved and maintained without recurrence for 3-6 years following the simultaneous subepithelial connective tissue graft and bone graft procedures. These findings suggest the potential efficacy of this combined approach in addressing PSTD and enhancing aesthetic results around dental implants, though further studies are needed to validate these outcomes.
Topics: Humans; Connective Tissue; Bone Transplantation; Female; Phenotype; Gingiva; Esthetics, Dental; Adult; Middle Aged; Male; Dental Implants
PubMed: 38929458
DOI: 10.3390/medicina60060841 -
Children (Basel, Switzerland) May 2024Increased surface roughness and discoloration of the direct restorative materials used in pediatric patients affect the longevity of restorations and impair children's...
Increased surface roughness and discoloration of the direct restorative materials used in pediatric patients affect the longevity of restorations and impair children's oral health. Many factors can alter these properties. One of these factors is the intake of dietary supplements. It is crucial to predict the properties of restorative materials when exposed to dietary supplements to maintain the dental care of children. Thus, this study aimed to investigate the effect of various syrup-formed dietary supplements on the average surface roughness and color stability of current restorative materials used in pediatric dentistry. Seven different restorative materials (conventional glass ionomer [Fuji IX GP], resin-modified glass ionomer, [Fuji II LC], zirconia-reinforced glass ionomer [Zirconomer Improved], polyacid-modified composite resin [DyractXTRA], bulk-fill glass hybrid restorative [Equia Forte HT Fill], conventional resin composite [Charisma Smart], and resin composite with reactive glass fillers [Cention N]) were tested. The specimens prepared from each type of restorative material were divided into five subgroups according to dietary supplements (Sambucol Kids, Resverol, Imunol, Umca, and Microfer). These specimens were immersed daily in supplement solution over a period of 28 days. Surface roughness and color difference measurements were performed at baseline and at the 7th and 28th days. The color difference and Ra values showed that there was an interaction among the type of restorative material, type of dietary supplement, and immersion time factors ( < 0.05). Whereas lower Ra values were found in the composite resin group, the highest Ra values were found in the conventional glass ionomer group. All supplements caused increasing color difference values, and Resverol and Umca showed higher discoloration values above the clinically acceptable threshold. The intake of dietary supplement type, the immersion time of the dietary supplement, and the restorative material type affected the surface roughness and color stability of the tested direct restorative materials. All of the experimental groups showed higher Ra values than clinically acceptable surface roughness values (0.2 µm). The color difference values also increased with the immersion time.
PubMed: 38929225
DOI: 10.3390/children11060645 -
Diagnostics (Basel, Switzerland) Jun 2024This study aimed to assess the impact of artificial intelligence (AI)-driven noise reduction algorithms on metal artifacts and image quality parameters in cone-beam...
OBJECTIVE
This study aimed to assess the impact of artificial intelligence (AI)-driven noise reduction algorithms on metal artifacts and image quality parameters in cone-beam computed tomography (CBCT) images of the oral cavity.
MATERIALS AND METHODS
This retrospective study included 70 patients, 61 of whom were analyzed after excluding those with severe motion artifacts. CBCT scans, performed using a Hyperion X9 PRO 13 × 10 CBCT machine, included images with dental implants, amalgam fillings, orthodontic appliances, root canal fillings, and crowns. Images were processed with the ClariCT.AI deep learning model (DLM) for noise reduction. Objective image quality was assessed using metrics such as the differentiation between voxel values (ΔVVs), the artifact index (AIx), and the contrast-to-noise ratio (CNR). Subjective assessments were performed by two experienced readers, who rated overall image quality and artifact intensity on predefined scales.
RESULTS
Compared with native images, DLM reconstructions significantly reduced the AIx and increased the CNR ( < 0.001), indicating improved image clarity and artifact reduction. Subjective assessments also favored DLM images, with higher ratings for overall image quality and lower artifact intensity ( < 0.001). However, the ΔVV values were similar between the native and DLM images, indicating that while the DLM reduced noise, it maintained the overall density distribution. Orthodontic appliances produced the most pronounced artifacts, while implants generated the least.
CONCLUSIONS
AI-based noise reduction using ClariCT.AI significantly enhances CBCT image quality by reducing noise and metal artifacts, thereby improving diagnostic accuracy and treatment planning. Further research with larger, multicenter cohorts is recommended to validate these findings.
PubMed: 38928694
DOI: 10.3390/diagnostics14121280 -
International Journal of Molecular... Jun 2024Bone regeneration involves multiple factors such as tissue interactions, an inflammatory response, and vessel formation. In the event of diseases, old age, lifestyle, or... (Review)
Review
Bone regeneration involves multiple factors such as tissue interactions, an inflammatory response, and vessel formation. In the event of diseases, old age, lifestyle, or trauma, bone regeneration can be impaired which could result in a prolonged healing duration or requiring an external intervention for repair. Currently, bone grafts hold the golden standard for bone regeneration. However, several limitations hinder its clinical applications, e.g., donor site morbidity, an insufficient tissue volume, and uncertain post-operative outcomes. Bone tissue engineering, involving stem cells seeded onto scaffolds, has thus been a promising treatment alternative for bone regeneration. Adipose-derived mesenchymal stem cells (AD-MSCs) are known to hold therapeutic value for the treatment of various clinical conditions and have displayed feasibility and significant effectiveness due to their ease of isolation, non-invasive, abundance in quantity, and osteogenic capacity. Notably, in vitro studies showed AD-MSCs holding a high proliferation capacity, multi-differentiation potential through the release of a variety of factors, and extracellular vesicles, allowing them to repair damaged tissues. In vivo and clinical studies showed AD-MSCs favoring better vascularization and the integration of the scaffolds, while the presence of scaffolds has enhanced the osteogenesis potential of AD-MSCs, thus yielding optimal bone formation outcomes. Effective bone regeneration requires the interplay of both AD-MSCs and scaffolds (material, pore size) to improve the osteogenic and vasculogenic capacity. This review presents the advances and applications of AD-MSCs for bone regeneration and bone tissue engineering, focusing on the in vitro, in vivo, and clinical studies involving AD-MSCs for bone tissue engineering.
Topics: Bone Regeneration; Humans; Mesenchymal Stem Cells; Adipose Tissue; Animals; Mesenchymal Stem Cell Transplantation; Tissue Engineering; Tissue Scaffolds; Osteogenesis; Cell Differentiation
PubMed: 38928517
DOI: 10.3390/ijms25126805 -
International Journal of Molecular... Jun 2024Polyurethane (PU) is a promising material for addressing challenges in bone grafting. This study was designed to enhance the bone grafting capabilities of PU by...
Polyurethane (PU) is a promising material for addressing challenges in bone grafting. This study was designed to enhance the bone grafting capabilities of PU by integrating hydroxyapatite (HAp), which is known for its osteoconductive and osteoinductive potential. Moreover, a uniform distribution of HAp in the porous structure of PU increased the effectiveness of bone grafts. PEG/APTES-modified scaffolds were prepared through self-foaming reactions. A uniform pore structure was generated during the spontaneous foaming reaction, and HAp was uniformly distributed in the PU structure (PU15HAp and PU30HAp) during foaming. Compared with the PU scaffolds, the HAp-modified PU scaffolds exhibited significantly greater protein absorption. Importantly, the effect of the HAp-modified PU scaffold on bone repair was tested in a rat calvarial defect model. The microstructure of the newly formed bone was analyzed with microcomputed tomography (μ-CT). Bone regeneration at the defect site was significantly greater in the HAp-modified PU scaffold group than in the PU group. This innovative HAp-modified PU scaffold improves current bone graft materials, providing a promising avenue for improved bone regeneration.
Topics: Polyurethanes; Animals; Durapatite; Tissue Scaffolds; Rats; Bone Regeneration; Skull; Rats, Sprague-Dawley; X-Ray Microtomography; Male; Porosity; Bone Transplantation
PubMed: 38928145
DOI: 10.3390/ijms25126440 -
Bioengineering (Basel, Switzerland) Jun 2024(1) Background: When placing implants in the maxillary posterior region with insufficient alveolar bone, a maxillary sinus elevation is necessary. Autogenous bone,...
(1) Background: When placing implants in the maxillary posterior region with insufficient alveolar bone, a maxillary sinus elevation is necessary. Autogenous bone, though biologically ideal, poses risks and discomfort due to donor site harvesting. Block-type autogenous tooth bone graft material, made from the patient's own extracted tooth, offers similar biological stability without these drawbacks. (2) Methods: This study observed the progress of 19 implant patients who were treated with maxillary sinus elevation procedures using block-type autogenous tooth bone graft material at the Daegu Catholic University Medical Center. Extracted teeth were processed into demineralized tooth block bone. After elevating the sinus membrane, implants and the tooth bone graft material were placed in the space, and the bony window was repositioned. Postoperative evaluations through clinical observation and radiographic imaging assessed sinus membrane elevation, alveolar bone height increase, and implant osseointegration. (3) Results: Results showed proportional increases in alveolar bone height to the graft material size, with long-term stability. No postoperative complications occurred, even with sinus membrane perforation, and implants remained stable. (4) Conclusions: The study concludes that maxillary sinus lifts using block-type autogenous tooth bone graft material provide excellent bone induction and biocompatibility, making this a highly beneficial method for both dentists and patients.
PubMed: 38927869
DOI: 10.3390/bioengineering11060633 -
Bioengineering (Basel, Switzerland) Jun 2024Tooth decay, also known as caries, is a significant medical problem that harms teeth. Treatment is based on the removal of the carious material and then filling the...
Tooth decay, also known as caries, is a significant medical problem that harms teeth. Treatment is based on the removal of the carious material and then filling the cavity left in the tooth, most commonly with amalgam or composite resin. The consequences of filling failure include repeating the filling or performing another treatment such as a root canal or extraction. Dental amalgam contains mercury, and there is a global effort to reduce its use. However, no consensus has been reached regarding whether amalgam or composite resin materials are more durable, and which is the best restorative material, when using randomized clinical trials. To determine which material is superior, we performed a retrospective cohort study using a large database where the members of 58 dental clinics with 440 dental units were treated. The number of failures of the amalgam compared to composite resin restorations between 2014 and 2021 were compared. Our data included information from over 650,000 patients. Between 2014-2021, 260,905 patients were treated. In total, 19,692 out of the first 113,281 amalgam restorations failed (17.49%), whereas significantly fewer composite restorations failed (11.98%) with 65,943 out of 555,671. This study indicates that composite is superior to amalgam and therefore it is reasonable to cease using mercury-containing amalgam.
PubMed: 38927815
DOI: 10.3390/bioengineering11060579 -
Bioengineering (Basel, Switzerland) Jun 2024Over time, numerous surgical procedures and biomaterials have been proposed for the reconstruction of post-extraction bone defects, each with their advantages and...
BACKGROUND
Over time, numerous surgical procedures and biomaterials have been proposed for the reconstruction of post-extraction bone defects, each with their advantages and disadvantages. The main objective of this study was to evaluate dimensional changes in the alveolar bone 3 months after tooth extraction, before implant planning, comparing alveolar ridge preservation (ARP) with spontaneous healing.
METHODS
A total of 84 patients with non-restorable molars were included in the study. Forty-two patients received ARP with advanced platelet-rich fibrin (A-PRF) and spontaneous healing was evaluated in these patients. Cone beam computed tomography (CBCT) analysis performed before and after surgical intervention was used to determine the changes in vertical and horizontal bone dimensions produced after tooth extraction.
RESULTS
CBCT measurements showed reduction in both vertical and horizontal alveolar bone size in both groups. For the study group, the alveolar parameters (height, width) were higher compared to the control group. The percentage variations between dimensional differences from the two groups were 38.58% for height, and for width were 36.88% at 0 mm, 35.56% at 3 mm, 36.61% at 5 mm, and 38.73% at 7 mm. The differences were statistically significant ( ˂ 0.0005).
CONCLUSIONS
The results obtained after ARP with A-PRF showed a reduced loss of bone volume compared to spontaneous healing.
PubMed: 38927802
DOI: 10.3390/bioengineering11060566 -
Bioengineering (Basel, Switzerland) May 2024The aim of this systematic review and meta-analysis was to compare static compression forces between direct composite resin restorations and indirect restorations for... (Review)
Review
The aim of this systematic review and meta-analysis was to compare static compression forces between direct composite resin restorations and indirect restorations for posterior teeth. All studies comparing mechanical properties of direct versus indirect restorations of posterior teeth were included from 2007 up to February 2024. A meta-analysis was conducted for static compression fracture resistance. Medline, Central, and Embase databases were screened. Twenty-four articles were included in the qualitative synthesis, and sixteen studies were finally included in the quantitative synthesis. There was no difference in terms of fracture resistance between direct and indirect restorations for posterior teeth ( 0.16 for direct and indirect composite resin restorations and 0.87 for direct composite resin restorations and indirect ceramic restorations). Also, sub-group analysis with or without cusp coverage in each group revealed no discernable difference. Based on this study, it can be concluded that the choice between direct and indirect restoration approaches may not significantly impact fracture resistance outcomes. There was no statically significant difference between direct and indirect restorations for posterior teeth in all cases of restorations with or without cusp coverage and no matter the used materials. However, to better evaluate these materials, further studies are warranted.
PubMed: 38927772
DOI: 10.3390/bioengineering11060536 -
Biomedicines Jun 2024the COVID-19 pandemic has brought to light the intricate interplay between viral infections and preexisting health conditions. In the field of kidney diseases, patients...
INTRODUCTION
the COVID-19 pandemic has brought to light the intricate interplay between viral infections and preexisting health conditions. In the field of kidney diseases, patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD) and Chronic Kidney Disease (CKD) face unique challenges when exposed to the SARS-CoV-2 virus. This study aims to evaluate whether SARS-CoV-2 virus infection impacts renal function differently in patients suffering from ADPKD and CKD when compared to patients suffering only from CKD.
MATERIALS AND METHODS
clinical data from 103 patients were collected and retrospectively analyzed. We compared the renal function of ADPKD and CKD patients at two distinct time points: before COVID-19 infection (T0) and 1 year after the infection (T1). We studied also a subpopulation of 37 patients with an estimated glomerular filtration rate (eGFR) < 60 mL/min and affected by ADPKD and CKD.
RESULTS
clinical data were obtained from 59 (57.3%) ADPKD patients and 44 (42.7%) CKD patients. At T1, ADPKD patients had significantly higher serum creatinine levels compared to CKD patients, and a significantly lower eGFR was observed only in ADPKD patients with eGFR < 60 mL/min compared to CKD patients ( < 0.01, < 0.05; respectively). Following COVID-19 infection, ADPKD-CKD patients exhibited significantly higher variation in both median serum creatinine ( < 0.001) and median eGFR ( < 0.001) compared to CKD patients.
CONCLUSION
the interplay between COVID-19 and kidney disease is complex. In CKD patients, the relationship between COVID-19 and kidney disease progression is more established, while limited studies exist on the specific impact of COVID-19 on ADPKD patients. Current evidence does not suggest that ADPKD patients are at a higher risk of SARS-CoV-2 infection; however, in our study we showed a significant worsening of the renal function among ADPKD patients, particularly those with an eGFR < 60 mL/min, in comparison to patients with only CKD after a one-year follow-up from COVID-19 infection.
PubMed: 38927508
DOI: 10.3390/biomedicines12061301