Three dimensionally printed template with an interproximal isolation design guide consecutive closure of multiple diastema with injectable resin composite.

OBJECTIVE: This article describes a novel 3D-printed template armed with interproximal matrices to isolate interproximal contact areas and guide injectable resin composite for consecutive closure of multiple diastema. CLINICAL CONSIDERATIONS: Among several treatment options proposed for diastema closure, direct resin composite is noninvasive and easy to repair. The "composite injection technique" has been introduced to improve time efficiency and reduce technique sensitivity for clinicians. However, in the case of multiple diastema, the overflow of excess resin materials onto the adjacent teeth during injection poses challenges for recontouring the interproximal anatomy. A 3D-printed template with special-designed gaps at interproximal areas was designed and fabricated based on a virtual diagnostic wax-up. Flowable resin composite was then consecutively injected through the template to close diastemata at multiple adjacent teeth. CONCLUSION: This technique using a 3D-printed template with interproximal isolation design contributed to an efficient and accurate operation for multiple anterior diastema closure. CLINICAL SIGNIFICANCE: Efficient and accurate freehand buildups of composite restoration for multiple diastema are challenging in operative dentistry. The described noninvasive full digital workflow provides a predictable method to accurately recontour the multiple target restorations and reduce the chair-side time and technical sensitivity.

Influence of Abutment Screw-Tightening Methods on the Screw Joint: Immediate and Long-Term Stability.

Objective: To evaluate the influence of screw-tightening methods on the immediate and long-term stability of dental implant screw joints. Methodology. A total of 150 implants of three different implant systems with different diameters were used in this study. Each group was divided into three subgroups (n = 5), according to the tightening methods (A-tightening with recommended torque and retorque after 10 min; B-tightening with recommended torque, then loosening and immediate retorque; C-tightening with recommended torque only once). The operating time of tightening the assemblies was recorded. Ten minutes later, the immediate removal torque (IRT) (Ncm) was measured. After retightening the assemblies, a dynamic load between 20 and 200 N was applied for 105 cycles, and the postloading removal torque (PRT) (Ncm) was measured. Scanning electron microscopy (SEM) was used to observe the surface topography of the screws. Results: For different types of implants, the IRTs were 11.92 ± 1.04-34.12 ± 0.36 Ncm for method A, 11.64 ± 0.57-33.96 ± 0.29 Ncm for method B, and 10.30 ± 0.41-31.62 ± 0.52 Ncm for method C, and the IRTs of methods A and B were 6.28%-21.58% higher than that of method C (P ≤ 0.046). The PRTs were 4.08 ± 0.77-29.86 ± 0.65 Ncm for method A, 4.04 ± 0.40-29.60 ± 0.36 Ncm for method B, and 2.98 ± 0.26-26.38 ± 0.59 Ncm for method C, and the PRTs of methods A and B were 11.77%-44.87% higher than that of method C (P ≤ 0.016). The removal torque loss rates of methods A (12.49% ± 0.99%-65.88% ± 4.83%) and B (12.84% ± 0.96%-65.35% ± 1.95%) were 3.04%-7.74% lower than that of method C (16.58% ± 0.56%-71.10% ± 1.58%) (P ≤ 0.017). The operating time of method A was much longer than those of methods B and C (P < 0.001). The structural integrity disruption of the screw thread was observed according to the SEM results in all postloading groups. Conclusions: Method B (torquing and then loosening and immediate retorquing) increases the screw joint immediate stability by 6.28%-21.58% and the long-term stability by 11.77%-44.87% compared with method C (torquing only once), has comparable screw joint stability compared with method A (retorquing after 10 min), saves time and is recommended in clinical settings.

The mechanical properties, tribological behaviors and color stability of a feldspar nanoceramics strengthening extrinsic stain for high-translucent zirconia.

The present work is aimed to explore the mechanical properties, tribological behaviors and color stability of nanoceramics and microceramics strengthened extrinsic stain coatings (NS and MS) upon high-translucent zirconia (TZ). The Na-rich feldspar ceramics component, microstructure and particle size of NS and MS were verified. The mechanical properties including elastic modulus and hardness of NS were enhanced compared to MS. Reciprocating wear tests under a ball-on-plate configuration manifested that the reduced coefficient of friction, wear depth and wear volume loss of NS was evaluated after 1 × 10 4 cycles and the wear scar morphology of NS characterized by microcracks while MS featured more delamination and wear debris. Post toothbrushing simulation revealed that the color stability of extrinsic stain coatings was elevated with the addition of feldspar nanoceramics. The feldspar nanoceramics strengthening extrinsic stain exhibited enhanced elastic modulus, hardness, wear resistance and color stability, especially for TZ.

The Application of Small Molecules to the Control of Typical Species Associated With Oral Infectious Diseases.

Oral microbial dysbiosis is the major causative factor for common oral infectious diseases including dental caries and periodontal diseases. Interventions that can lessen the microbial virulence and reconstitute microbial ecology have drawn increasing attention in the development of novel therapeutics for oral diseases. Antimicrobial small molecules are a series of natural or synthetic bioactive compounds that have shown inhibitory effect on oral microbiota associated with oral infectious diseases. Novel small molecules, which can either selectively inhibit keystone microbes that drive dysbiosis of oral microbiota or inhibit the key virulence of the microbial community without necessarily killing the microbes, are promising for the ecological management of oral diseases. Here we discussed the research progress in the development of antimicrobial small molecules and delivery systems, with a particular focus on their antimicrobial activity against typical species associated with oral infectious diseases and the underlying mechanisms.

WDR5 promotes the tumorigenesis of oral squamous cell carcinoma via CARM1/ß-catenin axis.

Oral squamous cell carcinoma (OSCC) is a malignancy all over the world. WD repeat domain 5 (WDR5) is involved in cancer progression. In addition, it was reported that WDR5 is upregulated in head and neck cancer, while its role in OSCC is unknown. First, the expression of WDR5 in oral cancer tissues and cells was examined by qRT-PCR, IHF and western blot. CCK-8 assay was performed to test the cell viability. Cell migration was assessed by transwell assay. Knocking down WDR5 or CARM1 in oral cancer cells to detect its function on cancer growth, WDR5 and CARM1 were significantly upregulated in OSCC. Silencing WDR5 suppressed OSCC cell viability and migration. CARM1 level in OSCC cells was significantly inhibited by WDR5 downregulation, and CARM1 elevation could rescue the effect of WDR5 knockdown on tumorigenesis of OSCC. Moreover, silencing of WDR5 notably inactivated ß-catenin signaling pathway, while this phenomenon was restored by CARM1 overexpression. Silencing of WDR5 attenuated the tumorigenesis of OSCC via CARM1/ß-catenin axis. Thus, WDR5 might be a target for OSCC treatment.

d-Alanine metabolic pathway, a potential target for antibacterial drug designing in Enterococcus faecalis.

Enterococcus faecalis (E. faecalis) is associated with persistent root canal infection because of its biofilm and various virulence factors. However, E. faecalis exhibits extensive drug resistance. d-Alanine (D-Ala) metabolism is essential for bacterial peptidoglycan biosynthesis. d-cycloserine (DCS), a second line drug used in the treatment of Mycobacterium tuberculosis infection, can inhibit two key enzymes in D-Ala metabolism: alanine racemase and d-alanine-d-alanine ligase. The aim of this study was to evaluate the effect of D-Ala metabolism on E. faecalis growth, cell wall integrity, biofilm formation and virulence gene expression by additional DCS with or without D-Ala. The results showed that DCS inhibited the planktonic growth and biofilm formation of E. faecalis in a dose-dependent manner. Both the minimum inhibitory concentration (MIC) and minimum biofilm inhibition concentration (MBIC) of DCS against E. faecalis were 200 µg/ml, whereas 50 µg/ml of DCS could inhibit planktonic growth and biofilm formation effectively. The addition of DCS also resulted in bacterial cell wall damage, biofilm surface roughness increase and biofilm adhesion force reduction. Moreover, the treatment of DCS downregulated the expression of asa1, esp, efaA, gelE, sprE, fsrB and ace genes. However, all of these inhibitory effects of DCS could be rescued by the addition of exogenous D-Ala. Meanwhile, DCS exhibited no toxicity to HGEs and HOKs. Therefore, D-Ala metabolic pathway in E. faecalis is a potential target for drug designing.

Inhibitory effects of sodium new houttuyfonate on growth and biofilm formation of Streptococcus mutans.

The present study aimed to assess the impact of sodium new houttuyfonate (SNH) on growth and biofilm formation of Streptococcus mutans, and the combinatorial effects of SNH with cariostatic agents. The effects of SNH on S. mutans planktonic cultures were assessed by growth curve assay. The effects of SNH on S. mutans biofilm and extracellular polysaccharides (EPS) production were observed via crystal violet (CV) assay, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay, colony-forming unit (CFU) counting assay, scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM). Quantitative real-time polymerase chain reaction (qPCR) was applied to investigate the regulatory effects of SNH on the expression of virulence genes of S. mutans. Checkerboard microdilution assay was performed to investigate the combinatorial effects of SNH with two common cariostatic agents. SNH acted as an inhibitor on planktonic cell growth, biofilm formation and EPS production of S. mutans. SNH also downregulated the expression of gtfBCD and comDE systems and exhibited synergism with chlorhexidine (CHX). In conclusion, this study indicated a possibility for SNH to become an anticaries agents by its antimicrobial activity and synergistic effects with CHX against S. mutans.

A Novel Small Molecule, LCG-N25, Inhibits Oral Streptococcal Biofilm.

Dental caries is a chronic oral infectious disease caused by cariogenic biofilm adhered on the tooth surface. Our previous study demonstrated that a repurposed natural compound napabucasin (NAP) showed good antimicrobial activity against oral streptococcal biofilms. The current study designed a novel small molecule, namely LCG-N25, using NAP as a lead compound, and aimed to investigate its potential as an antimicrobial agent in the control of dental caries. LCG-N25 was designed and synthesized with reference to the structure of NAP. The minimal inhibitory concentrations and the minimal bactericidal concentrations of LCG-N25 against Streptococcus mutans, Streptococcus sanguinis, and Streptococcus gordonii were evaluated by microdilution method. The antimicrobial activity of LCG-N25 was further evaluated by crystal violet staining, colony forming units counting, biofilm metabolism assay, dead/live fluorescent staining, and scanning electron microscopy. The effect of LCG-N25 on the extracellular polysaccharides of biofilms was determined by both anthrone-sulfuric acid method and fluorescent staining. The microbial composition of streptococcal biofilms after LCG-N25 treatment was further visualized and quantified by fluorescence in situ hybridization. Besides, the cytotoxicity of LCG-N25 was evaluated by Cell Counting Kit-8 assay, and repeated exposure of S. mutans to LCG-N25 treatment was performed to assess if this novel compound could induce drug resistance of this cariogenic bacterium. We found that LCG-N25 exhibited a good antibacterial activity, low-cytotoxicity, and did not induce drug resistance of cariogenic S. mutans. These findings suggest that LCG-N25 may represent a promising antimicrobial agent that can be used as an adjuvant to the management of dental caries.

Interactions Between Neutrophils and Periodontal Pathogens in Late-Onset Periodontitis.

Late-onset periodontitis is associated with a series of inflammatory reactions induced by periodontal pathogens, such as Porphyromonas gingivalis, a keystone pathogen involved in periodontitis. Neutrophils are the most abundant leukocytes in the periodontal pocket/gingival crevice and inflamed periodontal tissues. They form a "wall" between the dental plaque and the junctional epithelium, preventing microbial invasion. The balance between neutrophils and the microbial community is essential to periodontal homeostasis. Excessive activation of neutrophils in response to periodontal pathogens can induce tissue damage and lead to periodontitis persistence. Therefore, illuminating the interactions between neutrophils and periodontal pathogens is critical for progress in the field of periodontitis. The present review aimed to summarize the interactions between neutrophils and periodontal pathogens in late-onset periodontitis, including neutrophil recruitment, neutrophil mechanisms to clear the pathogens, and pathogen strategies to evade neutrophil-mediated elimination of bacteria. The recruitment is a multi-step process, including tethering and rolling, adhesion, crawling, and transmigration. Neutrophils clear the pathogens mainly by phagocytosis, respiratory burst responses, degranulation, and neutrophil extracellular trap (NET) formation. The mechanisms that pathogens activate to evade neutrophil-mediated killing include impairing neutrophil recruitment, preventing phagocytosis, uncoupling killing from inflammation, and resistance to ROS, degranulation products, and NETs.

Phytotherapy in the management of denture stomatitis: A systematic review and meta-analysis of randomized controlled trials.

Medicinal plant extracts are commonly applied for infectious diseases and are perceived as alternatives to conventional antimicrobial agents. We aimed to confirm the efficacy of phytotherapy for denture stomatitis compared with conventional therapies and placebo. A comprehensive literature search was conducted in Pubmed, Embase, Cochrane Library (CENTRAL), Scopus, and Web of Science, in addition to manual searching. Randomized controlled trials (RCTs) published in English, and studying the treatment of denture stomatitis with herbal medicines, were included. The outcome measures included the relief of clinical signs, reduced Candida colony counts, adverse effects, and patient satisfaction. Nineteen RCTs were included for a systematic review based on selection criteria. Two of them were analyzed using a random-effects model. There was no difference in the relief of clinical signs (odds ratio (OR) = 0.96; 95% confidence interval (CI): 0.43-2.15) and microbiological improvement (OR = 1.74; 95% CI: 0.55-5.45) between propolis and miconazole. Most of the included studies showed that phytomedicines had fewer side effects and more patient satisfaction than antifungals or disinfectants. However, further RCTs with more standardly prepared herbal formulations are required to verify the clinical efficacy of phytotherapy as an alternative or adjunctive therapy for denture stomatitis.

Ursolic acid inhibits multi-species biofilms developed by Streptococcus mutans, Streptococcus sanguinis, and Streptococcus gordonii.

OBJECTIVE: The current study aimed to assess the antimicrobial activity of ursolic acid (UA) against multi-species biofilms formed by Streptococcus mutans, Streptococcus sanguinis, and Streptococcus gordonii, as well as to measure its biocompatibility. METHODS: Crystal violet staining, CFU counting, CCK-8 assays and scanning electron microscopy (SEM) were applied to investigate the effect of UA on multi-species biofilms. UA's effect on exopolysaccharides (EPS) production was measured using confocal laser scanning microscopy (CLSM) and the anthrone-sulfuric acid method. Fluorescent in situ hybridization (FISH) was applied to visualize and quantify the microbial composition of multi-species biofilms. Quantitative real-time PCR (qRT-PCR) was used to measure the expression of virulence genes of S. mutans, S. sanguinis, and S. gordonii under UA treatment. Moreover, CCK-8 assays were performed to evaluate its cytotoxicity against human oral keratinocytes (HOKs) and human gingival epithelial cells (HGEs). RESULTS: The results showed that UA had significant antimicrobial activity against common oral streptococci. UA also reduced the EPS synthesis of oral streptococci and suppressed gtf genes' expression. In addition, UA reduced the proportion of S. mutans in multi-species biofilms. Besides, UA had low cytotoxicity against HOKs and HGEs. CONCLUSIONS: UA exhibited antibiofilm activity against oral pathogenic bacteria and had the potential to be used in dental caries treatment.

Silenced Myeloblastosis Protein Suppresses Oral Tongue Squamous Cell Carcinoma via the microRNA-130a/Cylindromatosis Axis.

BACKGROUND: Oral tongue squamous cell carcinoma (OTSCC) represents oral epithelial cell damage. Myeloblastosis (MYB) is involved in OTSCC. This study tried to probe roles of MYB in OSCC with potential axis. METHODS: Expression of MYB and miR-130a in OTSCC was detected. Western blot analysis was utilized to determine epithelial-mesenchymal transition-related protein levels. Dual-luciferase reporter gene assay certified the target relation between miR-130a and CYLD. Moreover, xenograft tumors in nude mice were applied to confirm the in vitro experiments. RESULTS: Both MYB and miR-130a were highly expressed in OTSCC, which promoted cell growth. Meanwhile, silenced miR-130a discouraged cell development enhanced by overexpressed MYB. CYLD was poorly expressed in OTSCC and targeted by miR-130a. Additionally, MYB knockdown activated CYLD to suppress OTSCC by downregulating miR-130a. CONCLUSION: Our experiment supported that silenced MYB suppressed OTSCC malignancy by inhibiting miR-130a and activating CYLD. This investigation may provide novel insights for OTSCC treatment.