High-dose pulsed hyaluronidase for managing nasal skin necrosis following hyaluronic acid treatment in nasolabial folds: A case report.

The growing popularity of soft tissue filler injections has brought attention to the associated risks, particularly vascular complications, and their treatments. This case report focuses on a 34-year-old female who developed nasal skin necrosis following hyaluronic acid (HA) filler injection for nasolabial fold (NLF) enhancement. Despite the careful procedure, complications emerged rapidly, emphasizing the critical importance of prompt diagnosis and intervention. A total of 10,000 turbidity reducing units (TRU) of hyaluronidase (HSE) were administered in a high-dose pulsed manner, alongside hyperbaric oxygen therapy. The patient experienced a gradual but significant improvement over 60 days. This case underscores the need for constant vigilance in aesthetic medicine and the potential consequences of even minute HA amounts, exceeding zero, in causing severe vascular events.

Evaluation of IL-4, MIP-1α, and MMP-9 gene expression levels in peri-implant tissues in peri-implantitis.

This case-control study evaluated the gene expression levels of interleukin (IL)-4, macrophage inflammatory protein type 1 alpha (MIP-1α), and metalloproteinase (MMP)-9, factors involved in the formation of giant cells in healthy peri-implant tissue and peri-implantitis. Thirty-five subjects (15 healthy and 20 with peri-implantitis), who met the inclusion and exclusion criteria, were included in this study. The peri-implant tissue biopsies were subjected to total RNA extraction, DNAse treatment, and cDNA synthesis. Subsequently, the reaction of real-time PCR was performed to evaluate the gene expression levels of IL-4, MIP-1α, and MMP-9 concerning the reference gene. IL-4 gene expression showed higher (18-fold) values in the Peri-Implantitis Group of Patients when compared with the Healthy (Control) Group (p<0.0001). Although MIP- 1α and MMP-9 gene expression levels were higher in diseased implants, they showed no significant differences (p=0.06 and p=0.2337), respectively. Within the limitations of this study, the results showed that in tissues affected by peri-implantitis, only levels of Il-4 were increased when compared with tissues in the control group.

Evaluation of IL-4, MIP-1α, and MMP-9 gene expression levels in peri-implant tissues in peri-implantitis

Abstract This case-control study evaluated the gene expression levels of interleukin (IL)-4, macrophage inflammatory protein type 1 alpha (MIP-1α), and metalloproteinase (MMP)-9, factors involved in the formation of giant cells in healthy peri-implant tissue and peri-implantitis. Thirty-five subjects (15 healthy and 20 with peri-implantitis), who met the inclusion and exclusion criteria, were included in this study. The peri-implant tissue biopsies were subjected to total RNA extraction, DNAse treatment, and cDNA synthesis. Subsequently, the reaction of real-time PCR was performed to evaluate the gene expression levels of IL-4, MIP-1α, and MMP-9 concerning the reference gene. IL-4 gene expression showed higher (18-fold) values in the Peri-Implantitis Group of Patients when compared with the Healthy (Control) Group (p<0.0001). Although MIP- 1α and MMP-9 gene expression levels were higher in diseased implants, they showed no significant differences (p=0.06 and p=0.2337), respectively. Within the limitations of this study, the results showed that in tissues affected by peri-implantitis, only levels of Il-4 were increased when compared with tissues in the control group.

Resumo Este estudo caso-controle teve como objetivo avaliar a expressão gênica dos níveis de interleucina (IL)-4, proteína inflamatória de macrófagos tipo alfa 1 (MIP-1α) e metalopreoteinase (MMP)-9, todos fatores envolvidos na formação de células gigantes em tecidos peri-implantares saudáveis e com peri-implantite. Trinta e cinco indivíduos (15 saudáveis e 20 com peri-implantite) foram incluídos nesse estudo seguindo os critérios de inclusão e exclusão. Os tecidos peri-implantares foram submetidos a extração do RNA total, tratamento de DNAse e síntese de cDNA. Subsequentemente, a reação de PCR em tempo real foi realizada para avaliar os níveis da expressão de IL-4, MIP-1α, e MMP-9 em relação ao gene de referência. O nível de expressão de IL-4 foi estatisticamwente maior (18 vezes) nos tecidos de pacientes com peri-implantite quando comparados aos pacientes saudáveis (grupo controle) (p<0,0001). Embora os níveis de expressão de MIP- 1α e MMP-9 apresentassem maiores valores nos implantes doentes, esses níveis não foram estatisticamente significantes (p=0.06 and p=0.2337) respectivamente. Dentro das limitações desse estudo, os resultados mostraram que nos tecidos afetados pela peri-implantite, apenas os nívies de IL-4 estavam aumentados quando comparados ao grupo controle.

The Potential Role of a Surface-Modified Additive-Manufactured Healing Abutment on the Expression of Integrins α2, ß1, αv, and ß6 in the Peri-Implant Mucosa: A Preliminary Human Study.

The stability of peri-implant soft tissues is essential for long-term success. Integrins play a vital role in biological processes through developing and maintaining cell interactions; however, few studies have evaluated the effects of modifications to abutment surfaces on cell adhesion across integrin expression. Therefore, this pilot study assessed the influence of different surface topographies of titanium healing abutments prepared by additive manufacturing (AM) on the gene expression levels of the integrin subunits α2, ß1, αv, and ß6 in the human peri-implant mucosa. Thirteen healthy adults were included. Depending on the number of required implants, the subjects were distributed in different groups as a function of healing abutment topography: group 1 (fully rough surface); group 2 (upper machined + lower rough); group 3 (rough upper surface + lower machined); group 4 (fully machined). A total of 40 samples (n = 10/group) of the peri-implant mucosa around the abutments were collected 30 days after implant placement, and subsequently, the gene expression levels were evaluated using real-time PCR. The levels of gene expression of ß1-subunit integrin were upregulated for individuals receiving fully rough surface abutments compared with the other surface topographies (p < 0.05). However, the healing abutment topography did not affect the gene expression levels of the α2, αv, and ß6 integrin subunits in the human peri-implant mucosa (p > 0.05). This preliminary study suggested that controlled modifications of the surface topography of titanium healing abutments produced by AM may influence the quality of the peri-implant mucosa in the early stages of the soft tissue healing process.

Transcription Factor AhR, Cytokines IL-6 and IL-22 in Subjects with and without Peri-Implantitis: A Case Control-Study.

Peri-implantitis is a plaque-associated condition characterized by mucosal inflammation and subsequent progressive loss of supporting bone; it is caused by bacterial biofilm, but the host response triggered by bacterial stimulation promotes the release of cells and mediators that culminate in tissue destruction. The Aryl-hydrocarbon Receptor (AhR) is associated with IL-22 production by Th22 and Th17 CD4+ Th cells. The presence of IL-6 may promote the Th22 phenotype. The present case-control study evaluated the gene expression of AhR, IL-22, and IL-6 in the peri-implant tissues of healthy and peri-implantitis patients. Tissue biopsies were collected from thirty-five volunteers (15 healthy and 20 with peri-implantitis). A real-time PCR reaction was utilized to assess the AhR, IL-22, and IL-6 gene expression levels relative to the reference gene (GAPDH). The results were analyzed using the Mann-Whitney test with a significance level of 5%. Higher levels of gene expression of AhR and IL-6 were detected in peri-implantitis tissues. The IL-22 gene expression levels did not differ between groups. In conclusion, higher gene expression levels for AhR and IL-6 were detected in the soft tissues of peri-implantitis patients. IL-22 did not vary between conditions, which may indicate the loss of the immunomodulatory role of IL-22 in periimplantitis.

Assessment of the reproducibility and precision of milling and 3D printing surgical guides.

BACKGROUND: Technology advancement has rising in the past decade and brought several innovations and improvements. In dentistry, this advances provided more comfortable and quick procedures to both the patient and the dental surgeon, generating less predictability in the final result. Several techniques has been developed for the preparation of surgical guides aiming at the optimization of surgical procedures. The present study aimed to evaluate the reproducibility and precision of two types of surgical guides obtained using 3D printing and milling methods. METHODS: A virtual model was developed that allowed the virtual design of milled (n = 10) or 3D printed (n = 10) surgical guides. The surgical guides were digitally oriented and overlapped on the virtual model. For the milling guides, the Sirona Dentsply system was used, while the 3D printing guides were produced using EnvisionTEC's Perfactory P4K Life Series 3D printer and E-Guide Tint, a biocompatible Class I certified material. The precision and trueness of each group during overlap were assessed. The data were analyzed with GraphPad software using the Kolmogorov-Smirnov test for normality and Student's t test for the variables. RESULTS: The Kolmogorov-Smirnov test showed a normal distribution of the data. Comparisons between groups showed no statistically significant differences for trueness (p = 0.529) or precision (p = 0.3021). However, a significant difference was observed in the standard deviation of mismatches regarding accuracy from the master model (p < 0.0001). CONCLUSIONS: Within the limits of this study, surgical guides fabricated by milling or prototyped processes achieved similar results.

Alveolar Ridge Preservation Using a Bovine derived Bone Graft in Association with Titanium Foil - A Prospective Case Series.

AIMS: To estimate the change in the alveolar ridge by means of a new alveolar ridge preservation (ARP) approach, using an anodized titanium foil (Tseal) associated with a bovine bone graft (BBG) by cone-beam computerized tomography. MATERIALS AND METHODS: Sixteen patients, each presenting one hopeless tooth, were selected and these teeth were carefully extracted. The alveolar socket was filled with BBG and the Tseal was trimmed and adapted to the bone crest. The primary outcome variable was the change in the alveolar dimension (AD) measurements between baseline (T1) and 6 months (T2) 1mm below the palatal bone. RESULTS: Imaging assessment of AD demonstrated a decreased value in all subjects. The absolute rate and percentage of absorption between T1 and T2 time point showed statistically significant differences. The mean AD varied from 9.88 ± 2.04 mm (T1) to 8.85 ± 1.92 mm (T2). On average, this ARP procedure maintained 89.55% ± 6.11% of the distance of between the buccal and palatal wall. No differences were observed between the maxilla and mandible (p greater than 0.05). CONCLUSION: The application of a bovine bone graft covered with Tseal resulted in clinically important horizontal preservation of the alveolar ridge at 6 months after extraction.

Treg and TH17 link to immune response in individuals with peri-implantitis: a preliminary report.

BACKGROUND AND OBJECTIVES: Treg and TH17 cells influence the inflammatory process in periodontal diseases and could also play in a similar pattern, an essential role in immune-inflammatory mechanisms involved in the destruction of the peri-implant tissues, peri-implantitis. Therefore, this study evaluated the levels of RORγT and FOXP3 gene expression in subjects with peri-implantitis and healthy peri-implant tissues. METHODS: A total of 35 subjects with implant-supported restorations in both diseased and healthy clinical conditions (n = 15 healthy; n = 20 peri-implantitis) were included in this study. Peri-implantitis was defined as probing depth > 5 mm, bleeding on probing and/or suppuration, and peri-implant bone loss >4 mm. Peri-implant tissue biopsies were collected for analysis of the mRNA, RORγT, and FOXP3 expression levels. The samples were submitted to total RNA extraction, treatment with DNAse, and cDNA synthesis. Subsequently, real-time PCR reaction was performed to evaluate the levels of RORγT and FOXP3 gene expression to the reference gene. These were analyzed by the non-parametric Mann-Whitney method with a level of significance of 5%. RESULTS: Higher gene expression levels of the transcription factors RORγT and FOXP3 were detected in the tissues affected by peri-implantitis when compared with healthy tissues (p < 0.05). CONCLUSIONS: The present study demonstrated the possible existence of a hybrid TH17-Treg profile, based on the gene expression of transcription factors inducing differentiation of these cells. Further studies must be designed to gain a better understanding of the immunological mechanisms involved in the pathogenesis of peri-implantitis. CLINICAL RELEVANCE: The levels of RORγT and FOXP3 transcription factors that were linked to cells with the FOXP3+RORγT+ phenotype could be used as a predictor of peri-implantitis progression.

Mechanical Properties of the Mandible in Postmenopausal Women Under Aledronate Treatment.

AIMS: This study evaluated the mechanical properties of mandibular bone tissue retrieved from postmenopausal women under alendronate treatment. METHODS: Twenty postmenopausal women were divided into two groups: healthy postmenopausal subjects (control group) and osteoporotic subjects treated with alendronate (alendronate group). Mandibular bone samples were retrieved with a trephine bur at the time of dental implant placement and fixed in 4% formalin. Samples were processed for hard tissue histology, and the bone surface was analyzed for nanohardness measurement. Nanohardness and elastic modulus were evaluated by using a Berkovich tip with elastic modulus of 1.016x106 MPa, Poisson coefficient of 0.3, and a load of 100 mN. Each cycle was configured with a load time of 18 seconds (speed of 1 mN/second), the discharge time of 18 seconds, and a rest time of 5 seconds during indentation at a depth of 10 µm. RESULTS: The control group presented the highest values for nanohardness and elastic modulus (p less than 0.05) in relation to the osteoporotic subjects. CONCLUSIONS: Within the limitations of the study, it can be concluded that treatment with alendronate negatively influenced the mechanical properties of mandibular bone in postmenopausal women by reducing bone nanohardness and elastic modulus.

Severe magnesium deficiency compromises systemic bone mineral density and aggravates inflammatory bone resorption.

We sought to evaluate the effects of magnesium (Mg) intake deficiency on bone metabolism in rats with induced periodontal disease (PD). Holtzman rats were randomly divided into two groups: Control - animals fed a standard diet and test - animals fed a diet with 90% Mg deficiency. After 60 days on the diets, all animals received ligature on the lower left first molars to induce PD. Animals were euthanized after 30 days following ligature placement. Blood and urine were collected for determination of serum concentrations of Mg, calcium, osteocalcin (OCN), alkaline phosphatase and parathyroid hormone (PTH) by enzyme-linked immunosorbent assay, and the urinary concentration of deoxypyridinoline (DPD). Systemic bone mineral density (BMD), bone volume and architectural bone parameters were evaluated by micro-CT in L4 lumbar vertebrae and mandible. Tartrate-resistant acid phosphatase staining and immunohistochemical (IHC) analysis of inducible nitric oxide synthase (iNOS), Runt-related transcription factor 2 (RUNX2), CD86, CD80, proliferating cell nuclear antigen, vascular endothelial growth factor, OCN and osteopontin were investigated. Reverse-transcription polymerase chain reaction was employed to assess mRNA expression of receptor-activator of nuclear factor-kB ligand, osteoprotegerin (OPG) and interleukin (IL)-6. Mg deficiency was associated with higher concentrations of PTH and DPD, and significant decrease on both systemic and mandibular BMD, as well as greater severity of alveolar and trabecular bone loss. Significant increase in osteoclasts was observed in the test group with PD. IHC analysis showed significant increase in the expression of iNOS and decreased expression of OCN and RUNX2. Increased IL-6 mRNA and decreased OPG mRNA expressions were evidenced in the test group with PD. Mg deficiency caused systemic effects indicative of altered bone metabolism in the vertebrae and affected both immune and stromal cells, aggravating inflammatory bone resorption in the ligature-induced model of periodontitis.

Evaluation of bone turnover after bisphosphonate withdrawal and its influence on implant osseointegration: an in vivo study in rats.

OBJECTIVES: The aim of this study was to investigate bone turnover alterations after alendronate (ALD) withdrawal and its influence on dental implants osseointegration. MATERIALS AND METHODS: Seventy female Wistar rats were randomly divided in 2 groups that received on day 0 either placebo (control group-CTL; n = 10) or 1 mg/kg sodium alendronate (ALD; n = 60) once a week for 4 months. At day 120, ALD treatment was suspended for 50 animals. Then, a titanium implant was placed in the left tibia of each rat that were randomly allocated in five subgroups of ten animals each, according to the period of evaluation: day 0 (INT-0), day 7 (INT-7), day 14 (INT-14), day 28 (INT-28), and day 45 (INT-45) after ALD withdrawal. CTL group and a group that received ALD until the end of the experimental period (non-interrupted group-non-INT; n = 10) underwent implant placement on day 120. Animals were euthanized 28 days after implant surgery. Bone mineral density (BMD) of femur and lumbar vertebrae were evaluated by DXA, biochemical markers of bone turnover were analyzed by ELISA, and bone histomorphometry was performed to measure bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO). RESULTS: All groups receiving ALD showed higher BMD values when compared to CTL group, which were maintained after its withdrawal. Decreased concentrations in all bone turnover markers were observed in the non-INT group, and in the groups in which ALD was discontinued compared to the CTL group. The non-INT group showed lower %BIC and notably changes in bone quality, which was persistent after drug withdrawal. CONCLUSION: Collectively, the findings of this study demonstrated that ALD therapy decreased bone turnover and impaired bone quality and quantity around dental implants, and that its discontinuation did not reverse these findings. CLINICAL RELEVANCE: The severe suppression of bone turnover caused by the prolonged use of ALD may alter the capacity of bone tissue to integrate with the implant threads impairing the osseointegration process.

Protein and mRNA detection of classic cytokines in corresponding samples of serum, gingival tissue and gingival crevicular fluid from subjects with periodontitis.

BACKGROUND AND OBJECTIVE: Little is known about the correspondence of cytokines detected among the different biological matrices used in periodontal research and whether locally-detected cytokine mRNA can also be identified at the translated protein level. The aims of this study were to compare: (a) the detection of classic cytokines at protein level in corresponding samples of serum, gingival tissue and gingival crevicular fluid (GCF) in subjects with periodontitis and (b) the detection of cytokines at protein level in GCF and tissue with their detection at mRNA level in tissue. MATERIAL AND METHODS: Protein concentrations of IL-1ß, IL-6 and TNF-α were measured in corresponding samples of GCF, gingival tissue and serum from 125 subjects with chronic periodontitis by multiplex immunoassay. The mRNA levels of these cytokines were evaluated in the same gingival tissue by qPCR. RESULTS: The mean protein concentrations of IL-1ß and TNF-α were higher in tissue and GCF than in serum (P < 0.05). The mean protein concentration of IL-6 was higher in tissue, followed by serum and GCF, respectively (P < 0.05). Using serum as the gold standard, detection of IL-1ß in GCF and IL-6 in tissue had the highest sensitivity (100%), while detection of IL-6 in the GCF had the lowest sensitivity (77.9%). Using tissue as the gold standard, the detection sensitivities of IL-1ß, IL-6 and TNF-α were 93.6%, 78.4% and 94.2%, respectively, in GCF. Using mRNA as the gold standard, the detection of IL-1ß and IL-6 at the protein level in tissue (100.0%) had the highest sensitivity, while the detection of IL-6 in GCF (77.9%) had the lowest sensitivity. CONCLUSION: Tissue and GCF exhibited overall higher protein concentrations of cytokines than serum. GCF presented good reliability for identifying the target cytokines at protein level, when compared with detecting tissue cytokines at protein level. GCF and tissue presented high sensitivities for detecting cytokines at the protein level, when compared with detecting tissue cytokines at the mRNA level. The sensitivity for the identification of cytokines in the GCF depended on the target cytokine, where IL-6 was the least likely cytokine to be detected in this matrix.

Microbiologic Analysis of Immediately Loaded Full-Arch Implant-Retained Prosthesis Protocol After 2 Years of Loading: A Retrospective Study.

PURPOSE: The All-on-4 treatment concept has been shown to be an effective clinical procedure; however, to date, no studies have analyzed the subgingival microbiota present in these restorations. The purpose of this study was to evaluate the microbial profile of the subgingival biofilm around dental implants placed in the All-on-4 protocol and compare the microbial profile around axial and tilted implants. MATERIALS AND METHODS: Fourteen subjects treated by the All-on-4 concept were evaluated clinically and microbiologically. Subgingival biofilm was collected from each patient, and the amount of 40 species of bacteria was assessed using the checkerboard DNA-DNA hybridization technique. RESULTS: The results for the indices of probing depth (PD), bleeding on probing, marginal bleeding, and visible plaque were 2.32 mm, 46%, 60%, and 57%, respectively. Tilted implants presented a significantly higher mean PD and Plaque Index compared with axial implants (P < .05). Fusobacterium nucleatum ssp vincentii, Veillonella parvula, and Fusobacterium nucleatum ssp polymorphum were found in higher levels; however, no difference in the microbial composition was observed between tilted and axial implants (P > .05). Tilted implants presented statistically higher mean levels for the orange complex in relation to the axial implants (P < .05). CONCLUSION: Despite the clinical success rate of the All-on-4 protocol, the subgingival biofilm of tilted implants presented a higher proportion for the orange complex pathogens in comparison to axial implants. These data could suggest that subjects with this modality of implant-supported restoration must be aware that they need a more rigorous maintenance protocol.

Effect of educational and self-care therapies on masticatory performance of women with painful temporomandibular disorder / Efeito das terapias educacionais e do autocuidado sobre o desempenho mastigatório de mulheres com disfunção temporomandibular dolorosa

Introduction: Temporomandibular disorders (TMD) can compromise masticatory performance due to the presence of pain, muscular dysfunction and limitation of mandibular movements. Substantial improvements in TMD pain can be achieved through therapeutic approaches including education and self-care. Objective: The aim of the present study was to investigate the impact of these treatment modalities in the masticatory performance of women with painful TMD. Material and method: Fifty-two women were randomly divided into three groups: Control Group (CG); Education Group (received education about TMD) (EG); Self-Care and Education Group (received education about TMD and instructions self-care therapies) (SEG). The education instructions about TMD and self-care therapies were transmitted through a video and printed illustrative material. The masticatory performance was evaluated through the sieves method ​​with natural tested foods in the evaluation periods: baseline evaluation, 30 days after and 60 days of follow-up. Data were analyzed and used with a one-way ANOVA parametric test for mean comparison of CG, EG and SEG groups (α = 0.05). Result: The masticatory performance of the participants was similar, irrespective of the proposed treatments, at baseline (p=.604), 30 days (p=.450) and 60 days (p=.669). Conclusions: The results indicated that treatment with educational and self-care therapies over a period of 60 days had no impact on the masticatory performance of women with painful TMD.

Introdução: As disfunções temporomandibulares (DTM) podem comprometer a capacidade mastigatória devido à presença de dor, disfunção muscular e limitação dos movimentos mandibulares. Melhorias substanciais da dor relacionada à DTM podem ser alcançadas através de abordagens terapêuticas incluindo a educação e os autocuidados. Objetivo: O objetivo do presente estudo foi investigar o impacto dessas modalidades de tratamento no desempenho mastigatório de mulheres com DTM dolorosa. Material e método: Cinquenta e duas mulheres foram divididas aleatoriamente em três grupos: Grupo Controle (CG); Grupo Educação (receberam instruções sobre DTM) (EG); Grupo de Autocuidado e Educação (receberam instruções sobre DTM e instruções sobre terapias de autocuidado) (SEG). As instruções de educação sobre DTM e terapias de autocuidado foram transmitidas através de vídeo e material ilustrativo impresso. O desempenho mastigatório foi avaliado através do método dos tamises com alimentos testes naturais nos períodos de avaliação: atendimento inicial, 30 dias após e ao fim de 60 dias de acompanhamento. Os dados obtidos, em porcentagem, foram analisados e foi utilizado o teste paramétrico ANOVA one-way para comparação das médias dos grupos CG, EG e SEG (α= 0,05). Resultado: O desempenho mastigatório dos participantes foi semelhante, independentemente dos tratamentos, no atendimento inicial (p=0,604), após 30 dias (p=0,450) e após 60 dias (p=0,669). Conclusão: Os resultados indicam que o tratamento com terapias educativas e de autocuidado durante um período de 60 dias não teve impacto no desempenho mastigatório das mulheres com DTM dolorosa.

Expression Levels of Semaphorins 3A, 3B, 4A, and 4D on Human Peri-implantitis.

PURPOSE: To evaluate the gene expression levels of semaphorins 3A, 3B, 4A, and 4D in both healthy and diseased implants. MATERIALS AND METHODS: Subjects with peri-implantitis presented clinical attachment loss, probing depth ≥ 5 mm, bleeding on probing and/or suppuration, and radiographic bone loss > 4 mm. Peri-implant tissue biopsy specimens were sampled for analysis of the mRNA expression levels for semaphorins 3A, 3B, 4A, and 4D. A real-time polymerase chain reaction was performed, and the gene expression levels of semaphorins in relation to the housekeeping gene were analyzed by using the nonparametric Mann-Whitney test (P < .05). RESULTS: Thirty-five subjects (16 men, 19 women; mean age: 54.12 ± 2.34 years) with implant-supported restorations, using screw-shaped dental implants with internal or external hexagon were enrolled in this study. Higher levels of semaphorins 3A and 4D were detected in the peri-implantitis compared with the healthy tissues (P = .0011 and P = .0404, respectively), whereas Sem4A levels were significantly higher in the control group (P < .0001). Differences between groups in the expression levels of Sem3B were not significant. CONCLUSION: Advanced peri-implantitis lesions showed higher levels of gene expression for Sem3A and Sem4D and lower levels of Sem4A in comparison to tissues obtained from a healthy dental implant.

Custom Cast Ball Attachments Used on Outdated Implants to Restore a Maxillary Implant-Supported Overdenture.

The lack of compatible prosthetic components can be a complication during oral rehabilitation using outdated implants. The aim of the present clinical report was to describe an alternative technique for the fabrication of a maxillary implant-supported overdenture in a patient with 20-year-old dental implants using castable spherical patterns and ball attachments. The patient had been wearing a relined bar/clip overdenture in the mandible on 4 external-hexagon dental implants and a relined complete denture in the maxilla on 4 internal-hexagon implants due to abutment screw fracture inside of the implants, losing the attachment system. The remaining maxillary dental implants did not possess attachments compatible with current systems due to configuration changes by the manufacturer in the dental implant's platform and the components over time. Therefore, castable spherical patterns and cast ball attachments were used to fabricate a maxillary implant-supported overdenture. The mandible rehabilitation was performed using 4 osseointegrated dental implants with a fixed implant-supported prosthesis. The use of cast ball attachments on the maxillary dental implants avoided invasive procedures on the remaining implants. Considering the lack of available compatible prosthetic components for the osseointegrated implants, this technique was considered a viable and satisfactory treatment option.

Transforming growth factor-ß, interleukin-17, and IL-23 gene expression profiles associated with human peri-implantitis.

OBJECTIVES: The mRNA expression profiles of IL-23/Th17 and the Treg-associated cytokine TGF-ß in peri-implantitis are currently under research. This study characterized the IL-17, IL-23, and TGF-ß gene expression levels in healthy and diseased peri-implant tissues and correlated these data with radiographic bone loss. MATERIAL AND METHODS: Peri-implant soft tissues from 40 subjects (20 healthy controls with mean age of 59.4 ± 6.3, and 20 with peri-implantitis with mean age of 56.6 ± 5.5) were enrolled in this study, and real-time PCR (RT-PCR) was used to define the profile of IL-17, IL-23, and TGF-ß gene expression. RESULTS: Higher levels of TGF-ß mRNA were observed in biopsies taken from healthy controls, and the IL-23 mRNA levels were significantly increased in the peri-implantitis group (P < 0.0001). No differences in IL-17 mRNA levels were observed between the two groups (P > 0.05). CONCLUSIONS: Data presented in this report demonstrated a predominant Th17 response in peri-implantitis subjects based on the higher levels of IL-23 and lower levels of TGF-ß detected.

Mandibular kinesiographic pattern of women with chronic TMD after management with educational and self-care therapies: A double-blind, randomized clinical trial.

STATEMENT OF PROBLEM: Limited mandibular movements are one of the most important signs of temporomandibular disorders (TMDs) and may cause functional difficulties. PURPOSE: The purpose of this double-blind, randomized clinical trial was to evaluate the effect of treatment with only educational or education associated with self-care therapies on the pattern of mandibular movements of women with chronic painful TMDs. MATERIAL AND METHODS: Forty-two women were selected and randomly divided into 3 groups, control group (CG, n=13), education group (EG, n=16), and education and self-care group (ESG, n=13), according to the sequence of treatment they received. A kinesiograph device recorded mandibular movements during maximum mouth opening and mastication at baseline (T0) and at 30-day (T1) and 60-day (T2) follow-up. Kinesiographic data were statistically analyzed using 1-way ANOVA, followed by the Bonferroni test for multiple comparisons of means (α=.05). RESULTS: The ESG group demonstrated an improvement in the maximum vertical opening (MVO= 5.1 ±3.4 mm; P=.012) and anteroposterior mandibular movement (MAM) during maximum opening (7.4 ±9.5; P=.019), significantly higher than that of the EG (MVO=1.8 ±3.5 mm; MAM=0.8 ±5.0 mm) and the CG (MVO=0.9 ±3.8 mm; MAM=0.8 ±4.4 mm) after 30 days of follow-up. Moreover, at T1, vertical mandibular movement during mastication was significantly higher in the ESG group (17.4 ±1.7 mm) than in the EG group (15.0 ±2.8, P=.027). No significant differences were found between the women who received treatment with educational and self-care therapies for 60 days and the women who received this treatment for 30 days. CONCLUSIONS: In the short-term, education and self-care treatment positively influenced the mandibular movement pattern of women with chronic painful TMDs.

In Vitro Assessment of the Abrasion Resistance of Two Types of Artificial Teeth Submitted to Brushing.

PURPOSE: To assess the effect of brushing with different solutions on the abrasion resistance of two types of acrylic resin teeth. MATERIALS AND METHODS: Maxillary premolars from two types of acrylic teeth (Biotone and Biotone IPN) were divided into six groups (n = 12), according to the solution used during brushing: distilled water (control), coconut soap, or dentifrice. A mechanical brushing machine was used to simulate approximately 1 year of brushing (11,000 strokes). The weight loss (WL) of teeth was obtained from the difference between the initial (IW) and final weight (FW) of each specimen, and the mean of percentage of weight loss (PWL) was calculated for each group. Data were analyzed using the Kruskal-Wallis test, followed by Bonferroni's post-test comparison (α = 0.05). RESULTS: A statistically significant difference was found for the factor solution (p < 0.001). Brushing using dentifrice caused the highest values of weight loss (-0.50%), in comparison with the groups brushed with coconut soap (0.00%) or distilled water (0.00%). CONCLUSIONS: For both types of artificial teeth, brushing with dentifrice produced higher abrasion than brushing with coconut soap or water.