Customed 3D-printed Polyetheretherketone (PEEK) Implant for Secondary Salvage Reconstruction of Mandibular Defects: Case Report and Literature Review.

Given the insufficient height of single-barrel fibula and inadequate bone volume of double-barrel vascularized fibula in mandibular reconstruction, it is a better choice to combine the upper full-thickness vascularized fibula with the lower half-thickness nonvascularized fibula. However, the nonvascularized fibula may fail due to complications, affecting the facial shape and occlusal function. Polyetheretherketone is a thermoplastic polymer used for bone defect reconstruction due to its good mechanical properties and biocompatibility. This case report mainly presents a secondary salvage reconstruction of the mandible by using customed 3-dimensional-printing polyetheretherketone, which restored the continuity and symmetry of the mandible, improved the patient's facial shape, and restored functional occlusion through dental implants. After a 28-month follow-up, no complications occurred, and the patient was satisfied with the final restoration.

Treatment methods toward improving the anti-infection ability of poly(etheretherketone) implants for medical applications.

Due to its favorable chemical stability, biocompatibility, and mechanical properties, Poly(etheretherketone) (PEEK) is a promising material for repairing bone and dental hard tissue defects. However, there are critical disadvantages: PEEK is biologically and chemically inert, which influences osseointegration of implants and bonding strength of prostheses, and its mechanical properties still cannot meet the requirements for some medical applications. Furthermore, bacterial infections and inflammatory reactions often accompany bone defects caused by trauma or inflammation or teeth loss caused by periodontitis. Previous studies mainly focused on enhancing PEEK's bioactivity and mechanical performance, but PEEK also lacks effective anti-infection ability. Thus, it is necessary to improve its anti-infection ability, and this is considered in this paper from two aspects. The first is to inhibit the attachment and growth of bacteria on the material, and the second is to endow the material with immunoregulatory ability, which means mobilizing the host immune system to protect tissue from inflammation. In this review, we analyze and discuss the existing treatment methods to improve the antibacterial and immunomodulatory abilities of PEEK addressing their limitations, relevant future challenges, and required research efforts.

Twelve undescribed derivatives of ganoderic acid isolated from Ganoderma luteomarginatum and their cytotoxicity against three human cancer cell lines.

Lanostane triterpenoids are thought to be the main underlying preclinical antitumor secondary metabolites of the genus Ganoderma. To further explore the potential cytotoxic triterpenoids from Ganoderma luteomarginatum, the ethyl acetate soluble fraction of 95% ethanolic extract was systematically studied. Twelve previously undescribed lanostane-type triterpene acids were isolated from the fruiting bodies of G. luteomarginatum, and their structures were elucidated by extensive spectroscopic analyses. Among them, 11 compounds have an unusual ß-configuration for OH-15. All isolates were assessed for cytotoxic activities using three human cancer cell lines (A549, HGC-27, and SMMC-7721) and one human normal cell line (LO2). (17Z)-3ß,7ß,15ß-Trihydroxy-11,23-dioxolanost-8,17(20)-dien-26-oate and (20E)-15ß-hydroxy-3,7,11,23-tetraoxolanost-20(22)-en-26-oate exhibited significant selective cytotoxicity against HGC-27 cells and A549 cells, respectively, with IC50 values of 6.82 ± 0.77 and 13.67 ± 1.04 µM, while 3ß,7ß,15ß-trihydroxy-11,23-dioxolanost-8-en-26-oate inhibited the proliferation of both A549 and SMMC-7721 cells. In addition, Hoechst fluorescence 33,258 staining and Annexin V-FITC/PI double staining proved that (17Z)-3ß,7ß,15ß-trihydroxy-11,23-dioxolanost-8,17(20)-dien-26-oate could induce apoptosis in HGC-27 cells. Furthermore, a comparison of the results in this study and previous literature demonstrated that ganoderic alcohols have stronger cytotoxicity than the corresponding derivatives of ganoderic acid in the genus Ganoderma.

Simultaneous arthroplasty and distraction osteogenesis for the treatment of ankylosis of the temporomandibular joint and secondary mandibular deformities in children.

The purpose of this study was to explore the use of simultaneous arthroplasty and distraction osteogenesis in the treatment of children with ankylosis of the temporomandibular joint (TMJ) and secondary mandibular deformities. Between January 2012 and December 2016, 17 children (7 boys and 10 girls, mean (range) age 7 (4-12) years) were treated. Preoperatively, the mean (range) maximal incisal opening was 1.4 (0-5) mm. Distraction osteogenesis was used to elongate the mandibular body or ramus, or both, after the release of ankylosis. Distraction began after five to seven days at a rate of 0.5mm twice daily, and the distractor was removed three to five months after the completion of distraction. The mean (range) follow-up time after removal was 29.6 (16-45) months, and the distance of distraction was 14.4 (10-18) mm. After treatment, all patients had satisfactory outcomes, a good facial profile, alignment of the midline lower incisor, and a level occlusal plane. The mean (range) maximum incisal opening reached 35.7 (31-41) mm. Bone formation across the distraction gap was good. The mean minimum axial area of the airway increased from 61.4mm to 96.4mm (p<0.01). No patients had a recurrence of ankylosis during follow up. Our results suggest that simultaneous arthroplasty and distraction osteogenesis is feasible in this group.

High expression of TMEM40 contributes to progressive features of tongue squamous cell carcinoma.

Transmembrane protein 40 (TMEM40) is a 23­kDa protein and its association with tongue squamous cell carcinoma (TSCC) remains unclear. This study aimed to investigate the expression and clinical significance of TMEM40 in TSCC and its roles in TSCC cells. Immunohistochemical analysis was performed to detect the expression levels of TMEM40 in 60 tongue tissue samples. Furthermore, TMEM40 was overexpressed and inhibited in two TSCC cell lines by transfection with pEZ­M98­TMEM40 plasmid or TMEM40 small interfering RNA, respectively. Cell Counting Kit­8 and colony formation assays were used to investigate the effects of TMEM40 on cell proliferation and colony formation ability, respectively. Flow cytometry was performed to determine cell apoptosis and cycle conditions of transfected cells. Wound­healing and Transwell assays were processed to explore the effects of TMEM40 on cell migration and invasion, respectively. The results indicated that TMEM40 expression levels were significantly increased in TSCC tissues compared with adjacent normal tongue tissues (P<0.01). Clinicopathological analysis revealed that TMEM40 expression was positively correlated with pathological TNM (pTNM) status (P<0.05), histological grade (P<0.001) and clinical stage (P<0.01), but not with sex or age. Results of cell proliferation, apoptosis, migration and invasion assays indicated that when TMEM40 had been successfully overexpressed or knocked down in CAL27 and SCC9 TSCC cell lines, cell growth and invasion increased in the TMEM40 overexpressing cells, while they decreased in TMEM40­knockdown cells. Furthermore, experiments revealed that TMEM40 knockdown resulted in increased levels of p53 and Bax, and decreased levels of MMP­9, which indicated that TMEM40 regulated cell apoptosis and migration via involvement of p53, Bax and MMP­9 in TSCC cells. Our findings indicated that increased expression of TMEM40 contributed to progressive features of TSCC via regulation of p53, Bax and MMP­9.

Lanostane triterpenoids from Ganoderma luteomarginatum and their cytotoxicity against four human cancer cell lines.

Lanostane triterpenoids are major metabolites of macrofungi from the genus Ganoderma and possess enormous substitution diversity and remarkable biological activities, especially anticancer, antioxidant, and anti-inflammatory effects. The present phytochemical investigation resulted in the isolation of nine undescribed lanostane triterpenoids and five known analogues from the fruiting bodies of Ganoderma luteomarginatum, which was first phytochemically studied by our group. Chemical structures were elucidated based on spectroscopic evidence. (5α,23E)-27-nor-lanosta-8,23-dien-3,7,25-trione and (5α,23E)-27-nor-3ß-hydroxylanosta-8,23-dien-7,25-dione are undescribed triterpenoids with an unusual 27-nor-lanostane carbon skeleton. All isolates were assayed for their cytotoxic activities using four human cancer cell lines (HGC-27, HeLa, A549, and SMMC-7721) and one human normal cell line (LO2), and the structure-cytotoxicity relationships were preliminarily explored. (5α,24E)-3ß-acetoxyl-26-hydroxylanosta-8,24-dien-7-one exhibited the highest cytotoxicity against HeLa and A549 cell lines, with IC50 values of 1.29 and 1.50 µM, respectively.

Management of Temporomandibular Joint Ankylosis With Dentofacial Deformities in Children.

This retrospective study described the authors' experience in the treatment of temporomandibular joint (TMJ) ankylosis with dentofacial deformities in 18 pediatric patients during a 4-year period. These patients underwent different types of arthroplasty with condylar reconstruction, simultaneously with treatment of dentofacial deformities. Re-ankylosis was confirmed if maximal incisal opening (MIO) was <20 mm. Clinical outcomes were evaluated in terms of oral function, radiography, and medical photography. Patients were followed up for a mean time of 24.8 months. No infections, re-ankylosis, or permanent facial nerve damage were found during the hospitalization or follow-up period. All patients achieved significant improvements in MIO and oral function. The dentofacial deformities in most patients were improved to varying degrees. The results provided more useful information for the management of the pediatric patients with TMJ ankylosis and secondary dentofacial deformities. Early treatment and close follow-up play an important role in the management of these patients.

Study progress of the correlation between peri-implantitis, IL-1β, TNF-α and NF-κB signal transduction / 口腔疾病防治

@#Increasing numbers of edentulous patients and patients with dental defects are willing to accept implant restorations. However, the development of peri-implantitis is a major factor leading to implant failure. The worsening of peri-implantitis promotes the secretion of inflammatory cytokines such as IL-1β and TNF-α and the gene expression of RANKL, inhibits the gene expression of OPG, and increases osteoclast activity, which promotes bone absorption indirectly and leads to a negative balance in bone metabolism. To gain knowledge about the relationship between peri-implantitis and NF-κB signaling pathways, this article summarizes related reports about peri-implantitis and NF-κB signaling pathways, explores the regulatory mechanism by which peri-implantitis affects bone metabolism and NF-κB signaling, discusses the effect of immunological cytokines on NF-κB signaling pathways when inflammation arises, and provides a theoretical foundation for peri-implantitis research and prevention.

[Osteoblastic early attachment onto the surface of bioadhesive peptide modified pure titanium].

OBJECTIVE: To investigate the long-term integrity and the biological function of interface between the bioadhesive peptide modified implant surface and peri-implant tissue. METHODS: A short bioadhesive peptide containing Glycine-Tyrosine-Arginine-Glycine-Asparticacid-Serine (GYRGDS) sequence was immobilized onto the titanium implant surface by means of sol-gel coating technique and self-assembled monolayers (SAM). The chemical composition and organic functional groups on the titanium surfaces were characterized using XPS (X-ray photoelectron spectroscopy) and FTIR (Fourier transform infrared spectrometer). The adhesive strength and stability of osteoblasts on various implant surfaces were compared under flow condition. RESULTS: The results showed that alkali/hot water aging treatment could apparently improve the content of -OH functional groups of titanium surface. The chemical reactive Ti-O-Ti bonding at the surface of titanium played a vital role in inducing the formation of organosilane SAM. GYRGDS peptide can be covalently grafted onto the surface of titanium by SAM technique. The resistance of freshly adherent osteoblasts to detachment by flow was shear time dependent. When the four groups were compared under the same flow stress condition (2.05 Pa) at three specific time spans (30 min, 1 h, 2 h), the cells retention rates in GYRGDS-grafted groups were 93.0%, 54.4%, 34.4% respectively and were much higher than those in non-coated groups. CONCLUSIONS: It was suggested that GYRGDS might have positive effects on maintaining stability and adherence of cells onto the substrates under flow condition.

The change in retentive force of magnetic attachment by abrasion.

Magnets are frequently applied to removable dentures as retentive attachments. A magnet-retained removable overdenture might be slightly shifted from side to side by eccentric movement in the mouth, and the surface of magnetic attachment may be worn as a result. However, the relationship between the retentive force of magnetic attachment and its surface abrasion has not been reported. The purpose of this research is to investigate this relationship. Ten Mgfit DX 400 magnetic attachments for natural tooth roots were used for this experiment. The magnetic attachments were embedded in autopolymerizing acrylic resin, and ten pairs of specimens were fabricated. A 5-mm repeated gliding motion was applied on each pair of specimens until 30 000, 50 000, or 90 000 cycles had been achieved. The abrasion machine was under 5 kg loading, and the slide speed was 60 times/min. The retentive force of magnetic attachment was measured with a tension gauge at (1) before gliding; (2) after 30 000 gliding cycles; (3)after 50 000 gliding cycles; or (4) after 90 000 gliding cycles. The average change of retentive force of ten magnetic attachments after 30 000, 50 000, and 90 000 gliding cycles was 0.016 N, 0.003 N, and -0.008 N, respectively. The change was statistically analyzed using a paired-sample t test, which showed that the number of gliding cycles did not affect the retentive force of magnetic attachment significantly. The surface of magnetic attachment after gliding was observed by a microscope, and the abrasion of this attachment surface is clearly seen.

[Changes of endothelium-dependent vasodilation in patients with impaired glucose tolerance and type 2 diabetes].

OBJECTIVE: To investigate the changes of endothelium-dependent flow-mediated dilation (FMD) in patients with impaired glucose tolerance (IGT) and Type 2 diabetes (T2DM) and its influencing factors. METHODS: The patients with IGT and T2DM were divided into IGT group (n=36), T2DM without vascular complication group (DM1;n=57), and T2DM with vascular complication group (DM2;n=31). And 25 normal subjects served as controls (NC group). The FMD was measured by high resolution ultrasound.The serum levels of tumor necrosis factor-alpha (TNF-alpha) and high sensitive C-reactive protein (hs-CRP) were detected with ELISA, and nitric oxide (NO) with Griess Reaction. The serum glucose, lipids, and other indexes were also detected. RESULTS: Compared with the NC group, the serum levels of triglyceride (TG) total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C), hs-CRP, and TNF-alpha significantly increased (P<0.05), but the serum levels of high density lipoprotein-cholesterol (HDL-C), the NO, and FMD significantly decreased (P<0.05) in the IGT, DM1, and DM2 group. With the progress of diabetes, FMD level descended. Pearson correlation analysis showed a negative correlation between FMD and glycosylated hemoglobin (HbA1c), insulin resistant index (HOMA-IR),TG,TC,hs-CRP, and TNF-alpha (P<0.01), but a positive correlation between FMD and NO,HDL-C (P<0.01) in IGT and T2DM patients. In multiple linear stepwise regression with FMD as dependent variable, NO,HbA(1)c,HDL-C,HOMA-IR, TNF-alpha, and hs-CRP showed a significant association with FMD (P<0.01). CONCLUSION: Endothelium-dependent vasodilation is impaired in patients with IGT and T2DM,which is associated with hyperglycaemia, insulin-resistance, hyperlipemia, and inflammation.

[Color Doppler flow image of Budd-Chiari syndrome].

OBJECTIVE: To evaluate the diagnostic value of color Doppler flow image (CDFI) for the diagnosis of Budd-Chiari syndrome (B-CS). METHODS: CDFI findings of 35 patients with B-CS were retrospectively analyzed and compared with the findings of venography of inferior vena cava (IVC). RESULTS: Thirty-four patients were diagnosed as B-CS by CDFI, while one patient with local tunica stenosis was misdiagnosed. The correct diagnostic rate was 97.1%. In the 34 patients, CDFI displayed stenosis or occlusion in the hepatic vein and IVC in 24 patients, IVC only in 8,and hepatic vein only in 2. CONCLUSION: CDFI may be a principal non-invasive technique to diagnose B-CS.

[Effects of rosiglitazone on endothelium-dependent vasodilation in patients with Type 2 diabetes].

OBJECTIVE: To investigate the effects of rosiglitazone on endothelium-dependent vasodilation in patients with Type 2 diabetes. METHODS: Eighty-three newly diagnosed patients with Type 2 diabetes were divided into metformin group (metformin 750 mg/d), therapeutic alliance group (rosiglitazone 4 mg/d and metformin 750 mg/d), and rosiglitazone group (rosiglitazone 4 mg/d), and 25 normal subjects were as the control group. All patients were treated for 12 weeks. The height, weight, blood pressure, fasting plasma glucose (FPG), fasting serum insulin (FINS), glycosylated hemoglobin (HbA1c), triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and serum nitric oxide (NO) were measured before and after the therapy. The body mass index (BMI) and homeostasis model assessment-insulin resistant index (HOMA-IR) were calculated. The flow-mediated dilatation (FMD) and endothelium independent dilatation (EID) were measured by high-resolution ultrasound. RESULTS: The BMI, TG, TC, LDL-C, FPG, HBA1c, HOMA-IR were higher (P<0.01), but HDL-C, NO, FMD were lower (P<0.01) in all diabetic groups than those in the control group before the treatment. After the 12-week treatment, TG, FPG, HBA1c, HOMA-IR decreased significantly in all the diabetic groups (P<0.01); FINS decreased, but HDL-C, NO, FMD and EID increased (P<0.01) in therapeutic alliance group and rosiglitazone groups, while HDL-C, FINS, NO, FMD had no change in metformin group compared with those before the treatment. CONCLUSION: Endothelium-dependent vasodilation function is impaired in patients with Type 2 diabetes. The therapy with rosiglitazone can increase the serum NO level, and improve endothelium-dependent vasodilation,but metformin has no influence on the above-mentioned indexes.