Ultrathin Ni-Fe MOF Nanosheets: Efficient and Durable Water Oxidation at High Current Densities.

Efficient, durable, and economical electrocatalysts are crucial for advancing energy technology by facilitating the oxygen evolution reaction (OER). Here, ultrathin Ni-Fe metal-organic skeleton (MOF) nanosheets were created in situ on nickel foam (NiFe-UMNs/NF). The catalyst exhibited excellent OER catalytical abilities, with only 269 mV overpotentials at 250 mA cm-2. Besides, when integrated with Pt/C/NF, NiFe-UMNs/NF held the potential for application in industrial alkaline water electrolysis with an initial voltage retention of approximately 86% following a continuous operation of 100 h at a current density of 250 mA cm-2. The super performance of the NiFe-UMNs/NF catalyst was attributed to ultrathin morphology, super hydrophilicity, and synergistic effects between Ni and Fe within the MOF. In situ Raman showed that NiFe-UMNs were converted to NiFeOOH as the active species in the OER process. Density functional theory revealed that iron doping accelerated the rate-determining step and reduced the OER reaction energy barrier. This work elucidated a promising electrocatalyst for OER and enriched the practical implementation of MOF materials.

Impact of periodontitis on type 2 diabetes: a bioinformatic analysis.

BACKGROUND: Periodontitis is strongly associated with type 2 diabetes (T2D) that results in serious complications and mortality. However, the pathogenic role of periodontitis in the development of T2D and the underlain mechanism have not been fully elucidated. METHODS: A Mendelian randomization (MR) was performed to estimate the causality between two diseases. Bioinformatics tools, including gene ontology and pathway enrichment analyses, were employed to analyze the common differentially expressed genes (DEGs) in periodontitis and T2D. MR and colocalization analyses were then utilized to investigate the causal associations between potential pathogenic gene expression and the risk of T2D. Single cell-type expression analysis was further performed to detect the cellular localization of these genes. RESULTS: Genetically predicted periodontitis was associated with a higher risk of T2D (OR, 1.469; 95% CI, 1.117-1.930; P = 0.006) and insulin resistance (OR 1.034; 95%CI 1.001-1.068; P = 0.041). 79 common DEGs associated with periodontitis and T2D were then identified and demonstrated enrichment mainly in CXC receptor chemokine receptor binding and interleutin-17 signaling pathway. The integration of GWAS with the expression quantitative trait locis of these genes from the peripheral blood genetically prioritized 6 candidate genes, including 2 risk genes (RAP2A, MCUR1) and 4 protective genes (WNK1, NFIX, FOS, PANX1) in periodontitis-related T2D. Enriched in natural killer cells, RAP2A (OR 4.909; 95% CI 1.849-13.039; P = 0.001) demonstrated high risk influence on T2D, and exhibited strong genetic evidence of colocalization (coloc.abf-PPH4 = 0.632). CONCLUSIONS: This study used a multi-omics integration method to explore causality between periodontitis and T2D, and revealed molecular mechanisms using bioinformatics tools. Periodontitis was associated with a higher risk of T2D. MCUR1, RAP2A, FOS, PANX1, NFIX and WNK1 may play important roles in the pathogenesis of periodontitis-related T2D, shedding light on the development of potential drug targets.

Does dynamic navigation assisted student training improve the accuracy of dental implant placement by postgraduate dental students: an in vitro study.

OBJECTIVES: To assess the accuracy of implant placement in models and satisfaction in dynamic navigation assisted postgraduate dental students training. METHODS: Postgraduate dental students who had at least one year of dental clinical practice with no experience in dental implant surgeries were included. Students were instructed to make treatment plans in the dynamic navigation system. Each student placed two maxillary right incisors, using freehand approach at first and then under dynamic navigation. The implant position was compared with treatment plan. Factors influencing the accuracy of implants placed under dynamic navigation were analyzed. Student acceptance towards the training and use of dynamic navigation was recorded using a questionnaire. RESULTS: A total of 21 students placed 42 implants. For freehand implant placement, the median entry point deviation, apex point deviation, and implant axis deviation was 3.79 mm, 4.32 mm, and 10.08°. For dynamic guided implant placement, the median entry point deviation, apex point deviation, and implant axis deviation was 1.29 mm, 1.25 mm, and 4.89° (p < 0.001). The accuracy of dynamic guided implant was not influenced by student gender or familiarity with computer games. All students were satisfied with the training. CONCLUSIONS: Dynamic navigation system assisted students in improving the accuracy of implant placement and was well accepted by students.

Enhanced control of periodontitis by an artificial intelligence-enabled multimodal-sensing toothbrush and targeted mHealth micromessages: A randomized trial.

AIM: Treatment of periodontitis, a chronic inflammatory disease driven by biofilm dysbiosis, remains challenging due to patients' poor performance and adherence to the necessary oral hygiene procedures. Novel, artificial intelligence-enabled multimodal-sensing toothbrushes (AI-MST) can guide patients' oral hygiene practices in real-time and transmit valuable data to clinicians, thus enabling effective remote monitoring and guidance. The aim of this trial was to assess the effect of such a system as an adjunct to clinical practice guideline-conform treatment. MATERIALS AND METHODS: This was a single-centre, double-blind, standard-of-care controlled, randomized, parallel-group, superiority trial. Male and female adults with generalized Stage II/III periodontitis were recruited at the Shanghai Ninth People's Hospital, China. Subjects received a standard-of-care oral hygiene regimen or a technology-enabled, theory-based digital intervention consisting of an AI-MST and targeted doctor's guidance by remote micromessaging. Additionally, both groups received guideline-conform periodontal treatment. The primary outcome was the resolution of inflamed periodontal pockets (≥4 mm with bleeding on probing) at 6 months. The intention-to-treat (ITT) analysis included all subjects who received the allocated treatment and at least one follow-up. RESULTS: One hundred patients were randomized and treated (50 tests/controls) between 1 February and 30 November 2022. Forty-eight tests (19 females) and 47 controls (16 females) were analysed in the ITT population. At 6 months, the proportion of inflamed periodontal pockets decreased from 80.7% (95% confidence interval [CI] 76.5-84.8) to 52.3% (47.7-57.0) in the control group, and from 81.4% (77.1-85.6) to 44.4% (39.9-48.9) in the test group. The inter-group difference was 7.9% (1.6-14.6, p < .05). Test subjects achieved better levels of oral hygiene (p < .001). No significant adverse events were observed. CONCLUSIONS: The tested digital health intervention significantly improved the outcome of periodontal therapy by enhancing the adherence and performance of self-performed oral hygiene. The model breaks the traditional model of oral health care and has the potential to improve efficiency and reduce costs (NCT05137392).

Leveraging Large Language Models for Improved Patient Access and Self-Management: Assessor-Blinded Comparison Between Expert- and AI-Generated Content.

BACKGROUND: While large language models (LLMs) such as ChatGPT and Google Bard have shown significant promise in various fields, their broader impact on enhancing patient health care access and quality, particularly in specialized domains such as oral health, requires comprehensive evaluation. OBJECTIVE: This study aims to assess the effectiveness of Google Bard, ChatGPT-3.5, and ChatGPT-4 in offering recommendations for common oral health issues, benchmarked against responses from human dental experts. METHODS: This comparative analysis used 40 questions derived from patient surveys on prevalent oral diseases, which were executed in a simulated clinical environment. Responses, obtained from both human experts and LLMs, were subject to a blinded evaluation process by experienced dentists and lay users, focusing on readability, appropriateness, harmlessness, comprehensiveness, intent capture, and helpfulness. Additionally, the stability of artificial intelligence responses was also assessed by submitting each question 3 times under consistent conditions. RESULTS: Google Bard excelled in readability but lagged in appropriateness when compared to human experts (mean 8.51, SD 0.37 vs mean 9.60, SD 0.33; P=.03). ChatGPT-3.5 and ChatGPT-4, however, performed comparably with human experts in terms of appropriateness (mean 8.96, SD 0.35 and mean 9.34, SD 0.47, respectively), with ChatGPT-4 demonstrating the highest stability and reliability. Furthermore, all 3 LLMs received superior harmlessness scores comparable to human experts, with lay users finding minimal differences in helpfulness and intent capture between the artificial intelligence models and human responses. CONCLUSIONS: LLMs, particularly ChatGPT-4, show potential in oral health care, providing patient-centric information for enhancing patient education and clinical care. The observed performance variations underscore the need for ongoing refinement and ethical considerations in health care settings. Future research focuses on developing strategies for the safe integration of LLMs in health care settings.

Does intra-oral scan improve the impression accuracy of full-arch implant-supported prostheses: A systematic review and meta-analysis.

OBJECTIVES: The present study aimed to systematically review the studies comparing the accuracy of intraoral scan (IOS) and conventional implant impressions (CI) in completely edentulous patients. MATERIALS AND METHODS: Electronic searches were performed in PubMed, Embase and Cochrane CENTRAL up to December 1, 2023. Clinical studies and in vitro studies reporting the accuracy of digital full arch impressions were included. The primary outcome is the 3-dimensional deviations between the study reference models. A risk of bias assessment was performed for clinical studies. A stratified meta-analysis and a single-armed meta-analysis were conducted. RESULTS: A total of 49 studies were included, with 8 clinical studies and 41 in vitro studies. For comparison between IOS and conventional impressions, studies were categorized into two groups based on the different measurement methods employed: RMS and CMM. In studies using RMS, the result favored the IOS in the unparalleled situation with the mean difference of -99.29 µm (95% CI: [-141.38, -57.19], I2 = 81%), while the result was opposite with the mean difference of 13.62 µm (95% CI: [10.97, 16.28], I2 = 26%) when implants were paralleled. For different brands of IOS, the accuracy ranged from 76.11 µm (95% CI: [42.36, 109.86]) to 158.63 µm (95% CI: [-14.68, 331.93]). CONCLUSIONS: Accuracy of intraoral scan is clinically acceptable in edentulous arches, especially for unparalleled implants. More clinical studies are needed to verify the present finding.

Accuracy of robotic surgery for dental implant placement: A systematic review and meta-analysis.

OBJECTIVES: To systematically analyze the accuracy of robotic surgery for dental implant placement. MATERIALS AND METHODS: PubMed, Embase, and Cochrane CENTRAL were searched on October 25, 2023. Model studies or clinical studies reporting the accuracy of robotic surgery for dental implant placement among patients with missing or hopeless teeth were included. Risks of bias in clinical studies were assessed. Meta-analyses were undertaken. RESULTS: Data from 8 clinical studies reporting on 109 patients and 242 implants and 13 preclinical studies were included. Positional accuracy was measured by comparing the implant plan in presurgery CBCT and the actual implant position in postsurgery CBCT. For clinical studies, the pooled (95% confidence interval) platform deviation, apex deviation, and angular deviation were 0.68 (0.57, 0.79) mm, 0.67 (0.58, 0.75) mm, and 1.69 (1.25, 2.12)°, respectively. There was no statistically significant difference between the accuracy of implants placed in partially or fully edentulous patients. For model studies, the pooled platform deviation, apex deviation, and angular deviation were 0.72 (0.58, 0.86) mm, 0.90 (0.74, 1.06) mm, and 1.46 (1.22, 1.70)°, respectively. No adverse event was reported. CONCLUSION: Within the limitation of the present systematic review, robotic surgery for dental implant placement showed suitable implant positional accuracy and had no reported obvious harm. Both robotic systems and clinical studies on robotic surgery for dental implant placement should be further developed.

Nerve Growth Factor-Preconditioned Mesenchymal Stem Cell-Derived Exosome-Functionalized 3D-Printed Hierarchical Porous Scaffolds with Neuro-Promotive Properties for Enhancing Innervated Bone Regeneration.

The essential role of the neural network in enhancing bone regeneration has often been overlooked in biomaterial design, leading to delayed or compromised bone healing. Engineered mesenchymal stem cells (MSCs)-derived exosomes are becoming increasingly recognized as potent cell-free agents for manipulating cellular behavior and improving therapeutic effectiveness. Herein, MSCs are stimulated with nerve growth factor (NGF) to regulate exosomal cargoes to improve neuro-promotive potential and facilitate innervated bone regeneration. In vitro cell experiments showed that the NGF-stimulated MSCs-derived exosomes (N-Exos) obviously improved the cellular function and neurotrophic effects of the neural cells, and consequently, the osteogenic potential of the osteo-reparative cells. Bioinformatic analysis by miRNA sequencing and pathway enrichment revealed that the beneficial effects of N-Exos may partly be ascribed to the NGF-elicited multicomponent exosomal miRNAs and the subsequent regulation and activation of the MAPK and PI3K-Akt signaling pathways. On this basis, N-Exos were delivered on the micropores of the 3D-printed hierarchical porous scaffold to accomplish the sustained release profile and extended bioavailability. In a rat model with a distal femoral defect, the N-Exos-functionalized hierarchical porous scaffold significantly induced neurovascular structure formation and innervated bone regeneration. This study provided a feasible strategy to modulate the functional cargoes of MSCs-derived exosomes to acquire desirable neuro-promotive and osteogenic potential. Furthermore, the developed N-Exos-functionalized hierarchical porous scaffold may represent a promising neurovascular-promotive bone reparative scaffold for clinical translation.

The potential causal path between periodontitis stage diagnosis and vegetable consumption is mediated by loss of posterior functional tooth units and masticatory function.

AIM: Emerging evidence points to a two-way relationship between periodontitis and dietary choices and, thus, nutrition. This study aimed to assess the potential cause-effect relationship between the periodontitis stage, loss of functional tooth units (FTUs), masticatory function, and intake of different food groups using path analysis. MATERIALS AND METHODS: A single calibrated examiner determined the periodontitis stage of a consecutive sample of 241 Chinese subjects reporting for tooth replacement. Their masticatory function was quantified by the mixing ability of a two-colour chewing gum. Validated food frequency questionnaires were used to calculate the intake of 33 food group items by an experienced calibrated rater. After verification of assumptions, visual structural equation modeling was performed with Amos 23. The consistency of results and the potential modifying effect of age were assessed in 9043 subjects from the NHANES database. RESULTS: Highly significant models were constructed using periodontitis stage and age as exogenous factors. Periodontitis stage diagnosis significantly affected the number of posterior FTUs and oral health-related quality of life (OHRQoL, path coefficient [PC] = -0.55 and -0.20, p < .05, respectively). In the model, FTUs also had an independent effect on OHRQoL (PC = 0.23, p < .05). FTUs determined the level of masticatory function (PC = -0.38, p < .05), which in turn affected vegetable intake but not fruit or meat intake (PC = -0.18, p < .0.5, PC = 0.06, NS and PC = 0.11, NS, respectively). The effect of age was significant for vegetable and meat intake and was also correlated with periodontitis stage diagnosis. Analysis of the NHANES database confirmed the negative impact of periodontitis on the number of occluding pairs and vegetable consumption for the 18-44, 45-60 and >60 age groups. CONCLUSIONS: Periodontitis showed a potential cause-effect pathway affecting vegetable intake across cultures and age groups. The size of the effect is potentially of clinical and public health significance. Additional studies, including intervention trials, are required to test this potential mechanism linking oral health to nutrition.

Anaerobic Degradation of Dicamba via a Novel Catabolic Pathway by a Consortium Enriched from Deep Paddy Soil.

Dicamba is widely used in the paddy field to control broadleaf weeds. Dicamba easily migrates to deep soil, which is anoxic; however, the anaerobic catabolism of dicamba in paddy soil is still unknown. In this study, an anaerobic dicamba-degrading consortium was enriched from deep paddy soil. The consortium completely degraded 0.83 mM dicamba within 7 days. Five metabolites were identified, one of which is a new metabolite, 2,5-dichlorophenol, and a novel anaerobic dicamba degradation pathway was proposed. 2.5 mM dicamba, 1.5-2.0% NaCl, and 20 mM electron acceptors Na2SO4, NaNO3, and FeCl3, and 0.5 mM or more of metabolites 3-CP and 2,5-DCP strongly inhibited the degradation efficiency. During enrichment, the microbial community of the consortium was significantly changed with OTU numbers, and diversity decreased. The study is valuable to elucidate the catabolism and ecotoxicology studies of dicamba in paddy soil and to facilitate the engineering application of anaerobic technology to treat dicamba-manufacturing wastewater.

Improved positional accuracy of dental implant placement using a haptic and machine-vision-controlled collaborative surgery robot: A pilot randomized controlled trial.

AIM: To compare the implant accuracy, safety and morbidity between robot-assisted and freehand dental implant placement. MATERIALS AND METHODS: Subjects requiring single-site dental implant placement were recruited. Patients were randomly allocated to freehand implant placement and robot-assisted implant placement. Differences in positional accuracy of the implant, surgical morbidity and complications were assessed. The significance of intergroup differences was tested with an intention-to-treat analysis and a per-protocol (PP) analysis (excluding one patient due to calibration error). RESULTS: Twenty patients (with a median age of 37, 13 female) were included. One subject assigned to the robotic arm was excluded from the PP analysis because of a large calibration error due to the dislodgement of the index. For robot-assisted and freehand implant placement, with the PP analysis, the median (25th-75th percentile) platform global deviation, apex global deviation and angular deviation were 1.23 (0.9-1.4) mm/1.9 (1.2-2.3) mm (p = .03, the Mann-Whitney U-test), 1.40 (1.1-1.6) mm/2.1 (1.7-3.9) mm (p < .01) and 3.0 (0.9-6.0)°/6.7 (2.2-13.9)° (p = .08), respectively. Both methods showed limited damage to the alveolar ridge and had similar peri- and post-operative morbidity and safety. CONCLUSIONS: Robot-assisted implant placement enabled greater positional accuracy of the implant compared to freehand placement in this pilot trial. The robotic system should be further developed to simplify surgical procedures and improve accuracy and be validated in properly sized trials assessing the full spectrum of relevant outcomes.

[Osteotome sinus floor elevation with tapered implants: a short-term evaluation].

PURPOSE: The aim of this study was to evaluate the short-term clinical outcome of tapered implants placed in posterior maxilla with osteotome sinus floor elevation (OSFE) technique. METHODS: The study population comprised 40 patients in whom 44 Astra tapered implants were inserted with OSFE technique from March to September in 2019. The surgical indication was that the bone height below the maxillary sinus was considered to be 2mm ~8mm. Astra tapered implants were inserted. Prosthetic restoration was completed 4 months after surgery. The implant success rate and stability, as well as osseointegration of the implant were clinically evaluated, and bone gain around the implants were measured. The data were analyzed using SPSS 19.0 software package. RESULTS: During the study period,the implant survival rate was 100%. The mean variation of implant stability quotient(ISQ) was 12.07±5.86. The mean value of ISQ ranged from 67.55±8.07 to 79.62±5.08. The average marginal bone loss was (0.32±0.29) mm. The endo-sinus bone gain(ESBG) was (1.06±0.4) mm. No mechanical complication was observed. The average probing depth around the implant was (3.2±1.51) mm, the bleeding on probing rate was(11.36±4.28)%, and the modified plaque index was 1.23±0.43. CONCLUSIONS: Astra tapered implants were found to produce predictable results in osteotome sinus floor elevation surgery. Further properly designed clinical trials are required to validate the use of tapered dental implants in sinus floor elevation technique.

One-piece versus two-piece zirconia abutment supported single implant crown in the esthetic region: 3-Year results from a split-mouth randomized controlled clinical trial.

OBJECTIVES: To compare the clinical, radiographic, and immunological outcomes between one-piece versus two-piece zirconia abutments supported single implant crowns in the esthetic region. MATERIALS AND METHODS: The study followed a split-mouth, double-blind, and randomized controlled clinical design for a duration of 3 years. Twenty-two eligible patients with 44 implants were randomly assigned to two groups: Group 1 (one-piece zirconia abutment with zirconia base, n = 22) and Group 2 (two-piece zirconia abutment with titanium base, n = 22). The primary outcome was the technical complication rate. Additionally, survival rates, cytokines concentrations in peri-implant crevicular fluid (PICF), peri-implant conditions, marginal bone loss, and pink/white esthetics score (PES/WES) were assessed as secondary outcomes. RESULTS: Twelve of 22 patients attended the 1-year follow-up (due to the COVID pandemic), and 19 patients attended the 3-year examination. Two abutments in Group 1 were fractured after 10 and 12 months in function. Additionally, one screw loosening occurred in Group 1 at 1-year follow-up. The 3-year technical complication rate was significantly higher in Group 1 than that in Group 2 (15.79% vs. 0%, p < .001). The 3-year implant survival rate was 100% in both groups. The concentration of IFN-γ in PICF was significantly upregulated in Group 2 (p = .018). Furthermore, the IL-6 concentration was positively correlated with BOP% (p = .020). CONCLUSIONS: Two-piece zirconia abutments exhibited superior technical performance compared to one-piece designs during a 3-year follow-up in the anterior region. However, further long-term research is necessary to verify the immunological stability of two-piece zirconia abutments.

Accuracy of intraoral scan with prefabricated aids and stereophotogrammetry compared with open tray impressions for complete-arch implant-supported prosthesis: A clinical study.

OBJECTIVES: The aim of this clinical study was to compare the accuracy of intraoral scan system (IOS) with prefabricated aids and stereophotogrammetry (SPG) compared with open tray implant impression (OI) for complete-arch implant-supported fixed dental prostheses (CIFDP). MATERIALS AND METHODS: Patients needing CIFDP were enrolled in this study. OI, reference standard, IOS with prefabricated aids, and SPG were performed for each patient. Distance and angle deviations between all pairs of abutment analogs, root mean square (RMS) errors between the aligned test and reference model, and chairside time were measured. The effect of inter-abutment distance, jaw (maxilla or mandible), number of implants, and arch length on deviations was analyzed. The mixed effect model was applied to analyze deviations and RMS errors. RESULTS: Fifteen consecutive individuals (6 females and 9 males, 47-77 years old) with 22 arches (9 upper and 13 lower jaws) and 115 implants were included. There was no significant difference in distance deviation comparing SPG and IOS with OI (p > .05). IOS showed a significantly greater angle deviation and RMS errors than SPG (median 0.40° vs. 0.31°, 69 µm vs. 45 µm, p < .01). The inter-abutment distance was negatively correlated with the accuracy of SPG and IOS (p < .05). The chairside time for IOS, SPG, and OI was 10.49 ± 3.50, 14.71 ± 2.86, and 20.20 ± 3.01 min, respectively (p < .01). CONCLUSIONS: The accuracy of SPG and IOS with prefabricated aids was comparable. IOS was the most efficient workflow.

circRNF13, a novel N6-methyladenosine-modified circular RNA, enhances radioresistance in cervical cancer by increasing CXCL1 mRNA stability.

BACKGROUND: Circular RNAs (circRNAs) and N6-methyladenosine (m6A) have been shown to play an increasingly critical role in the development of different cancers. However, there is limited evidence on how circRNAs and m6A interact to affect the radiosensitivity of cervical cancer (CC). This study provides a mechanistic understanding of the novel m6A-regulated circRNF13 in enhancing radioresistance in CC. METHODS: Differentially expressed circRNAs were identified from radiosensitive and radioresistant CC tissues. Meanwhile, these circRNAs were subjected to methylated RNA immunoprecipitation (Me-RIP). Finally, the effects of these circRNAs on radiosensitivity were characterized. RESULTS: CircRNF13 was poorly expressed in CC patients that were sensitive to concurrent radiochemotherapy. Experiments conducted both in vitro and in vivo confirmed that the knockdown of circRNF13 potentiated the radiosensitivity of CC cells. Further mechanistic studies revealed that METTL3/YTHDF2 promoted the degradation of circRNF13 and subsequently affected the stability of CXC motif chemokine ligand 1 (CXCL1), ultimately enhancing the radiosensitivity of CC cells. CONCLUSION: This study identified circRNF13 as a novel m6A-modified circRNA and validated the METTL3/YTHDF2/circRNF13/CXCL1 axis as a potential target for CC radiotherapy.

IL-33 and HMGB1 modulate the progression of EAE via oppositely regulating each other.

Interleukin-33 (IL-33) and high mobility group box 1 (HMGB1) have been reported to play crucial and distinct roles in experimental autoimmune encephalomyelitis (EAE). However, little is known about their interaction in the progression of EAE. In this study, the dynamic expression and release of IL-33 and HMGB1 in different stages of EAE in vivo, and their interaction in vitro were explored. We found that HMGB1 was dominant in pre-onset stage of EAE, while IL-33 was dominant in peak stage. Moreover, both blockade of extracellular HMGB1 in the central nervous system (CNS) and conditional knockout of HMGB1 in astrocytes decreased IL-33 release. HMGB1 promoted the release of IL-33, while IL-33 reduced the release of HMGB1 from primary astrocytes in vitro. Taken together, IL-33 and HMGB1 in the CNS jointly participate in the EAE progression and the inhibitory effect of IL-33 on HMGB1 may be involved in the self-limiting of EAE.

Synthesis and Biomedical Applications of DNA Hydrogel.

Deoxyribonucleic acid (DNA), as a natural polymer material, carries almost all the genetic information and is recognized as one of the most intelligent natural polymers. In the past 20 years, there have been many exciting advances in the synthesis of hydrogels using DNA as the main backbone or cross-linking agent. Different methods, such as physical entanglement and chemical cross-linking, have been developed to perform the gelation of DNA hydrogels. The good designability, biocompatibility, designable responsiveness, biodegradability and mechanical strength provided by DNA building blocks facilitate the application of DNA hydrogels in cytoscaffolds, drug delivery systems, immunotherapeutic carriers, biosensors and nanozyme-protected scaffolds. This review provides an overview of the main classification and synthesis methods of DNA hydrogels and highlights the application of DNA hydrogel in biomedical fields. It aims to give readers a better understanding of DNA hydrogels and development trends.

Association of crown emergence angle and profile with dental plaque and inflammation at dental implants.

BACKGROUND: The shape of implant restorations is critical for function and aesthetics. It may also be important in peri-implant tissue health preservation. This study aimed to associate the restorative contour of a single crown with marginal dental plaque accumulation, tissue inflammation and probing depths. METHODS: Subjects with a single screw-retained implant restoration were clinically examined. The presence of dental biofilm, tissue inflammation and probing pocket depths were the dependent variables. The emergence angle, profile and depth of the mucosal tunnel were measured on superimposed digital scans of the crown soft-tissue complex, the removed crown mounted on an analogue and the soft tissue. RESULTS: One hundred twenty two subjects (46.7% female, 68.9% never smokers, 77% with treated periodontitis and 52.5% participating in regular supportive peri-implant care) were examined. The emergence angles at the mucosal margin were 15.3 ± 9.4°, 12.7 ± 8.5°, 31.3 ± 11.8° and 19.2 ± 9.8° for the mesial, distal, vestibular and oral aspects of the crowns. The largest emergence profile angles were observed on the vestibular aspect (74.6% of cases), reaching a maximum of 61.7°, and profiles were convex in 59% of cases. Generalized estimating equations indicated that the site-specific platform-level emergence angle and profile and depth of the mucosal tunnel were significantly associated with the presence of detectable plaque accumulation (p < .01) and bleeding on probing (p < .02). CONCLUSIONS: Subtle variations in the shape of the restorative crown are associated with biofilm accumulation and mucosal inflammation. These findings are important for 3D implant planning/positioning and preservation of peri-implant tissue health.

Accuracy and safety of a haptic operated and machine vision controlled collaborative robot for dental implant placement: A translational study.

OBJECTIVES: Multiple generations of medical robots have revolutionized surgery. Their application to dental implants is still in its infancy. Co-operating robots (cobots) have great potential to improve the accuracy of implant placement, overcoming the limitations of static and dynamic navigation. This study reports the accuracy of robot-assisted dental implant placement in a preclinical model and further applies the robotic system in a clinical case series. MATERIALS AND METHODS: In model analyses, the use of a lock-on structure at robot arm-handpiece was tested in resin arch models. In a clinical case series, patients with single missing teeth or edentulous arch were included. Robot-assisted implant placement was performed. Surgery time was recorded. Implant platform deviation, apex deviation, and angular deviation were measured. Factors influencing implant accuracy were analyzed. RESULTS: The in vitro results showed that with a lock-on structure, the mean (SD) of platform deviation, apex deviation, and angular deviation were 0.37 (0.14) mm, 0.44 (0.17) mm, and 0.75 (0.29)°, respectively. Twenty-one patients (28 implants) were included in the clinical case series, 2 with arches and 19 with single missing teeth. The median surgery time for single missing teeth was 23 (IQ range 20-25) min. The surgery time for the two edentulous arches was 47 and 70 min. The mean (SD) of platform deviation, apex deviation, and angular deviation was 0.54 (0.17) mm, 0.54 (0.11) mm, and 0.79 (0.22)° for single missing teeth and for 0.53 (0.17) mm, 0.58 (0.17) mm, and 0.77 (0.26)° for an edentulous arch. Implants placed in the mandible had significantly larger apex deviation than those in the maxilla. CONCLUSION: Cobot-assisted dental implant placement showed excellent positional accuracy and safety in both the in vitro study and the clinical case series. More technological development and clinical research are needed to support the introduction of robotic surgery in oral implantology. Trial registered in ChiCTR2100050885.

Relevant domains, core outcome sets and measurements for implant dentistry clinical trials: The Implant Dentistry Core Outcome Set and Measurement (ID-COSM) international consensus report.

AIM: Lack of consistently reported outcomes limits progress in evidence-based implant dentistry and quality of care. The objective of this initiative was to develop a core outcome set (COS) and measurements for implant dentistry clinical trials (ID-COSM). MATERIALS AND METHODS: This Core Outcome Measures in Effectiveness Trials (COMET)-registered international initiative comprised six steps over 24 months: (i) systematic reviews of outcomes reported in the last 10 years; (ii) international patient focus groups; (iii) a Delphi project with a broad range of stakeholders (care providers, clinical researchers, methodologists, patients and industry representatives); (iv) expert group discussions organizing the outcomes in domains using a theoretical framework and identifying the COSs; (v) identification of valid measurement systems to capture the different domains and (vi) final consensus and formal approval involving experts and patients. The methods were modified from the best practice approach following the Outcome Measures in Rheumatoid Arthritis Clinical Trial and COMET manuals. RESULTS: The systematic reviews and patient focus groups identified 754 (665 + 89, respectively) relevant outcome measures. After elimination of redundancies and duplicates, 111 were formally assessed in the Delphi project. By applying pre-specified filters, the Delphi process identified 22 essential outcomes. These were reduced to 13 after aggregating alternative assessments of the same features. The expert committee organized them into four core outcome areas: (i) pathophysiology, (ii) implant/prosthesis lifespan, (iii) life impact and (iv) access to care. In each area, core outcomes were identified to capture both the benefits and harms of therapy. Mandatory outcome domains included assessment of surgical morbidity and complications, peri-implant tissue health status, intervention-related adverse events, complication-free survival and overall patient satisfaction and comfort. Outcomes deemed mandatory in specific circumstances comprised function (mastication, speech, aesthetics and denture retention), quality of life, effort for treatment and maintenance and cost effectiveness. Specialized COSs were identified for bone and soft-tissue augmentation procedures. The validity of measurement instruments ranged from international consensus (peri-implant tissue health status) to early identification of important outcomes (patient-reported outcomes identified by the focus groups). CONCLUSIONS: The ID-COSM initiative reached a consensus on a core set of mandatory outcomes for clinical trials in implant dentistry and/or soft tissue/bone augmentation. Adoption in future protocols and reporting on the respective domain areas by currently ongoing trials will contribute to improving evidence-informed implant dentistry and quality of care.