Chosun University Dental Hospital

The goal of the present meta-analysis was to identify factors that contribute to P300 event-related brain potential (ERP) differences in patients with schizophrenia compared to unaffected controls in an attempt to characterize the clinically relevant dimensions underlying P300 deficits in patients with schizophrenia. P300 effect size (d) was smaller in amplitude and longer in latency in schizophrenic patients compared to normal controls, with the strongest effects obtained from the auditory oddball. Paranoid subtype demonstrated larger P300 amplitude effect sizes than other disease subtypes, and P300 latency effect size decreased with disease duration. Psychopathology severity and antipsychotic medications were unrelated to P300 amplitude effect size. Gender proportion, educational level, and stimulus and task variables also affected P300 amplitude and latency effect sizes. The findings are used to formulate a theoretical account of the empirical data and provide suggestions for maximizing the utility of the P300 component in the assessment of schizophrenia.

Vibrio vulnificus causes acute cell death and a fatal septicaemia. In this study, we show that contact with host cells is a prerequisite to the acute cytotoxicity. We screened transposon mutants defective in the contact-dependent cytotoxicity. Two mutants had insertions within two open reading frames in a putative RTX toxin operon, the rtxA1 or rtxD encoding an RTX toxin (4701 amino acids) or an ABC type transporter (467 amino acids). An rtxA1 mutation resulted in a cytotoxicity defect, which was fully restored by in trans complementation. The expression of RtxA1 toxin increased after host cell contact in a time-dependent manner. The RtxA1 toxin induced cytoskeletal rearrangements and plasma membrane blebs, which culminated in a necrotic cell death. RtxA1 colocalized with actin and caused actin aggregation coinciding with a significant decrease in the F/G actin ratio. The RtxA1 toxin caused haemolysis through pore formation (radius 1.63 nm). The rtxA1 deletion mutant was defective in invading the blood stream from ligated ileal loops of CD1 mice. The rtxA1 null mutation resulted in over 100-fold increase in both intragastric and intraperitoneal LD(50)s against mice. Overall, these results show that the RtxA1 toxin is a multifunctional cytotoxin and plays an essential role in the pathogenesis of V. vulnificus infections.

Receptor activator of NF-kappaB (RANK) is a recently cloned member of the tumor necrosis factor receptor (TNFR) superfamily, and its function has been implicated in osteoclast differentiation and dendritic cell survival. Many of the TNFR family receptors recruit various members of the TNF receptor-associated factor (TRAF) family for transduction of their signals to NF-kappaB and c-Jun N-terminal kinase. In this study, the involvement of TRAF family members and the activation of the JNK pathway in signal transduction by RANK were investigated. TRAF1, 2, 3, 5, and 6 were found to bind RANK in vitro. Association of RANK with each of these TRAF proteins was also detected in vivo. Expression of RANK in cultured cells also induced the activation of JNK, which was blocked by a dominant-negative form of JNK. Furthermore, by employing various C-terminal deletion mutants of RANK, the regions responsible for TRAF interaction and JNK activation were identified. TRAF5 was determined to bind to the C-terminal 11 amino acids and the other TRAF members to a region N-terminal to the TRAF5 binding site. The domain responsible for JNK activation was localized to the same region where TRAF1, 2, 3, and 6 bound, which suggests that these TRAF molecules might mediate the RANK-induced JNK activation.

BACKGROUND: Obesity-induced hepatic lipid accumulation causes lipotoxicity, mitochondrial dysfunction, oxidative stress, and insulin resistance, and is implicated in non-alcoholic hepatic pathologies such as steatohepatitis and fibrosis. Heme oxygenase-1 (HO-1), an important antioxidant enzyme catalyzing the rate-limiting step in heme degradation, protects against oxidative stress, inflammation, and metabolic dysregulation. Here, we demonstrate that the phytochemical, quercetin, a natural polyphenol flavonoid, protects against hepatic steatosis in obese mice fed a high-fat diet, and that it does so by inducing HO-1 and stimulating increased hepatic mitochondrial oxidative metabolism. METHODS: Male C57BL/6 mice were fed a regular diet (RD), a high-fat diet (HFD), and an HFD supplemented with quercetin for 9 weeks. Levels of mitochondrial biogenesis and oxidative metabolic transcripts/proteins were measured by real-time PCR and/or Western blotting. HO-1 transcripts/proteins were measured real-time PCR and/or Western blotting. RESULTS: Quercetin upregulated genes involved in mitochondrial biogenesis and oxidative metabolism in lipid-laden hepatocytes and the livers of HFD-fed obese mice, and this was accompanied by increased levels of the transcription factor, nuclear erythroid 2-related factor 2 (Nrf-2), and HO-1 protein. The HO-1 inducer hemin and the HO-1 byproduct carbon monoxide (CO) also enhanced hepatic oxidative metabolism in HFD-fed obese mice. Moreover, the metabolic changes and the lipid-lowering effects of quercetin were completely blocked by the HO-1 inhibitor ZnPP and by deficiency of Nrf-2. CONCLUSION: These findings suggest that quercetin stimulates hepatic mitochondrial oxidative metabolism by inducing HO-1 via the Nrf-2 pathway. Quercetin may be useful in protecting against obesity-induced hepatosteatosis.

Defect-specific bone regeneration using 3-dimensional (3D) printing of block bone has been developed. Polycaprolactone (PCL) is biocompatible polymer that can be used as 3D scaffold. The aim of this study is to assess the biocompatibility and osteogenic efficacy of 3D printed PCL scaffold and to evaluate the effectiveness of β-tricalcium phosphate (β-TCP) addition in PCL scaffold. In this work, four circular defects (diameter: 8 mm) in rabbit calvarium were randomly assigned to (1) negative control (control), (2) PCL block (PCL), (3) PCL mixed with 10 wt% β-TCP (PCL/β-TCP), and (4) PCL/β-TCP plus collagen membrane (PCL/β-TCP + M). Animals were euthanized at 2 (n = 5) and 8 weeks (n = 5). Results indicated that in micro-CT, PCL/β-TCP + M showed the highest total augmented volume and new bone volume at 8 weeks, but there was no significant difference among four groups. Histomorphometrically, PCL, PCL/β-TCP, and PCL/β-TCP + M showed the significantly higher total augmented area compared to the control. PCL/β-TCP + M showed the highest new bone area but not statistically higher than the control. New bone formation deep inside the scaffold was observed only in β-TCP added scaffold. PCL showed high biocompatibility with great volume maintenance. Addition of β-TCP to PCL seemed to increase hydrophilicity and osteoconductivity. Developments in 3D-printed PCL material are expected. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1254-1263, 2019.

Implant-supported restoration of the maxillary anterior segment that is biologically, functionally, and esthetically acceptable following traumatic injuries in the maxillary anterior segment is always complex.1 Careful extraction2 of the fractured root, residual labial bone preservation, proper flap design, ideal positioning of the implant, appropriate soft-tissue contour, and the crown emergence are all important steps necessary to achieve a predictable, stable, functional, and esthetic success. However, healing of the tissues is always difficult to control and the development of new techniques and materials to improve these treatments is still necessary. The use of platelet concentrates is an interesting approach.Platelet concentrates for surgical use are widely used and continuously investigated in oral and maxillofacial surgery.3 The objective is to gather platelet growth factors and to inject them on a surgical site to stimulate the healing process. A significant percentage of the literature is focused on the platelet-rich plasma (PRP) families. PRP4–7 is a liquid platelet suspension often activated into a platelet-rich gel (like fibrin glues).Another technology called leukocyte- and platelet-rich fibrin (L-PRF) allows for the preparation of strong fibrin membranes enriched with cells (activated platelets, leukocytes, circulating cells)8 and platelet growth factors.9 This autologous healing biomaterial is free of additives (no anticoagulant during blood harvest, no chemicals for activation), simple, inexpensive, and quick to prepare (15 minutes for all steps). This technique is specifically adapted to the practical needs in daily implant dentistry. Several articles have reported the use of these L-PRF membranes for the stimulation of bone and gingival healing during subantral sinus augmentations10 and global rehabilitations using dental implants.11,12 The effect of these membranes on soft tissue healing and maturation is particularly significant.13In this case letter, the replacement of a fractured central incisor with immediate postextraction implant and crown placement is presented step by step with the use of L-PRF.A 45-year-old woman presented with an endodontically treated maxillary right central incisor that was fractured during a recent sport-related accident (Figure 1). The tooth presented with a Class 2 crown mobility suggesting a longitudinal fracture of the crown corresponding to a deep infrabony pocket on the labial surface. Probing pocket depths and mobility of adjacent teeth were within normal limits. Radiographic examination of the tooth demonstrated an incomplete endodontic treatment but without periapical radiolucency (Figure 2).Following removal of the crown (Figure 3a and 3b), a vertical bony defect was observed on the labial surface of the tooth, what may lead to a lack of support for the soft tissue volume and an unesthetic implant restoration profile emergence. The fractured root was carefully removed and a thorough curettage of the remaining alveolus was performed to eliminate any residual infective tissue in the avulsion socket that could compromise the osseointegration of an immediately placed implant.A tapered 4.3 mm collar diameter and 11.5 mm length implant (Ossean, Intra-Lock, Boca Raton, Fla) was placed (Figure 4), reaching 60 Ncm primary stability. The final decision on immediate loading was made after implant placement using insertion torque and resonance frequency analysis as acceptance criteria. A straight titanium abutment was screwed into the implant at 35 Ncm and adapted to the incisal emergence profile (Figures 5 and 6).L-PRF was produced following the standard procedure (Process protocol, Nice, France).9 To fill the space between the labial surface of the implant and the residual labial bone wall, a mix of L-PRF and cortico-cancellous porcine bone (Gen-Os, Tecnoss, Turin, Italy) was placed. The bio-implant graft was covered and protected with a L-PRF membrane (Figure 7), and no suture was used.A provisional crown was then prepared and cemented with the provisional bonding cement, TempBond (Kerr, Orange, Calif) (Figures 8a and b). To reduce lateral forces, the provisional crown had no occlusal contact with the opposing arch. Some excess of L-PRF membrane was cut away on the labial and palatal sides. The patient was instructed to eat a soft diet and avoid placing food in the area of the provisional crown during the first 6 weeks.Two days following the surgery, the tissues presented a positive healing characteristic (Figure 9), and at 7 days postop the gingival esthetic profile was well defined (Figure 10). At this time, an esthetic adaptation of the collar was done by relining the crown with resin relining material. Regular clinical and radiographic controls were subsequently performed and no technical complications such as screw loosening, resin fracture or pain upon chewing were noted during the 3 month postsurgical osseointegration time period.After 3 months (Figure 11), a zirconia straight abutment was prepared and a full-ceramic crown was constructed with CEREC (Sirona, Bensheim, Germany) CAD/CAM technology (Figure 12a and b). The matured gingival tissue guided the emerging profile of the tooth. After 6 months, the final result appears to be satisfactory (Figure 13). Two years later (Figure 14), the restoration is stable and esthetic. The gingival tissue has continued to mature, as observed that the gingival collar has an improved contour and thicker biotype than in the initial months following surgery.Immediate postextraction implants in the maxillary esthetic area are currently used frequently and are subtle, exacting treatments. The use of healing materials such as L-PRF are well suited to these applications because this material has a robust stimulating effect on the healing of soft and osseous tissues.14 Moreover, as a strong solid fibrin membrane, it is particularly easy to use in implant dentistry and periodontology. It additionally offers a protective effect (both mechanical and biological) to the grafted area.11,12The immediate implant and bone graft allows for the maintenance and regeneration of the damaged labial bone wall. The dental implant serves as a support for three dimensional reconstruction (vertical, horizontal, and labial/lingual thickness).15 Without the immediate placement of the implant and graft material, the alveolar ridge after extraction would resorb significantly, resulting in the absence of adequate bone volume for ideal implant positioning. This is particularly true for patients with a thin alveolar ridge and gingival tissue. However immediate implant placement and bone grafts are always sensitive to the gingival quality, as the gingival tissue has to cover and protect the site. If the gingival tissue is weak or damaged, dehiscence can appear in the covering tissue leading to the contamination of the grafted site. For this reason, some authors recommend the use of connective tissue grafts to reinforce the peri-implant tissues.16 The L-PRF is therefore especially indicated in this application. The fibrin membrane of L-PRF acts as a bio-barrier, protecting the implant and the graft from the oral environment. Moreover, by providing growth factors, leukocytes, and a permeable fibrin matrix for the growth of endothelial and epithelial cells, this healing material stimulates neoangiogenesis and accelerates gingival healing and maturation.Many authors have shown the positive impact of immediate loading on the protection of peri-implant bone levels and osseointegration.17,18 This technique offers advantages for patient comfort and the healing process. It also facilitates a natural healing and maturation of the peri-implant bone and soft tissues around the crown, therefore to achieve a more esthetic and predictable emergence profile for the prosthetic restoration.19 Combined with L-PRF, this immediate crown offers the possibility to secure the L-PRF membrane in a stable position without suture, and also to use it as a transitory supporting material for the regeneration of the gingival tissue. Additionally, the temporary crown shapes the ideal profile emergence.In this type of treatment, the quality and design of the implant are similarly important. The macrodesign of the implant20 and its surface21 are aspects of the technologies that permit the clinician to have greater control and improve the treatment outcome.22 In this case, the use of a tapered implant was adapted to the shape of the alveolus, preserving the osseous structure surrounding the socket during immediate implant placement. The implant also presents a recent specific microrough nanorough chemically-enhanced surface (Ossean)23,24 which may also be an element of the success.Finally from a practical standpoint, the L-PRF is easy to use on the surgical site. The elastic consistency of the L-PRF membrane allows the clinician to punch it around a prosthetic pillar (abutment). The antihemorrhagic properties of L-PRF are also advantageous and convenient for this type of surgery.25 In this protocol, a flapless approach is used to avoid flaps and incisions that could significantly reduce micro-vascularization in critical areas like the interincisal papillae that would interfere with the cicatrization and the final esthetic result. Because of its texture and healing properties, the L-PRF membranes allowed for the use of a micro-surgical approach without incisions and sutures, leading to an optimal tissue healing.The authors have no conflict of interest to report.This work for the development of regenerative implantable materials is supported by a grant from the National Research Foundation of Korea (NRF) funded by the Korean government-MEST (No. 2011-0030121).

Obesity-induced adipose inflammation plays a crucial role in the development of obesity-induced metabolic disorders such as insulin resistance and type 2 diabetes. In the presence of obesity, hypertrophic adipocytes release inflammatory mediators, including tumor necrosis factor-alpha (TNFα) and monocyte chemoattractant protein-1 (MCP-1), which enhance the recruitment and activation of macrophages, and in turn augment adipose inflammation. We demonstrate that the soy peptide Phe-Leu-Val (FLV) reduces inflammatory responses and insulin resistance in mature adipocytes. Specifically, the soy peptide FLV inhibits the release of inflammatory cytokines (TNFα, MCP-1, and IL-6) from both TNFα-stimulated adipocytes and cocultured adipocytes/macrophages. This inhibition is mediated by the inactivation of the inflammatory signaling molecules c-Jun N-terminal kinase (JNK) and IκB kinase (IKK), and the downregulation of IκBα in the adipocytes. In addition, soy peptide FLV enhances insulin responsiveness and increases glucose uptake in adipocytes. More importantly, we, for the first time, found that adipocytes express peptide transporter 2 (PepT2) protein, and the beneficial action of the soy peptide FLV was disrupted by the peptide transporter inhibitor GlySar. These findings suggest that soy peptide FLV is transported into adipocytes by PepT2 and then downregulates TNFα-induced inflammatory signaling, thereby increasing insulin responsiveness in the cells. The soy peptide FLV, therefore, has the potential to prevent obesity-induced adipose inflammation and insulin resistance.

OBJECTIVES: The aim of this study was to evaluate the cytotoxicity, setting time and compressive strength of MTA and two novel tricalcium silicate-based endodontic materials, Bioaggregate (BA) and Biodentine (BD). MATERIALS AND METHODS: Cytotoxicity was evaluated by using a 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-5-((phenylamino)carbonyl)-2H-tetrazolium hydroxide (XTT) assay. Measurements of 9 heavy metals (arsenic, cadmium, chromium, copper, iron, lead, manganese, nickel, and zinc) were performed by inductively coupled plasma-mass spectrometry (ICP-MS) of leachates obtained by soaking the materials in distilled water. Setting time and compressive strength tests were performed following ISO requirements. RESULTS: BA had comparable cell viability to MTA, whereas the cell viability of BD was significantly lower than that of MTA. The ICP-MS analysis revealed that BD released significantly higher amount of 5 heavy metals (arsenic, copper, iron, manganese, and zinc) than MTA and BA. The setting time of BD was significantly shorter than that of MTA and BA, and the compressive strength of BA was significantly lower than that of MTA and BD. CONCLUSIONS: BA and BD were biocompatible, and they did not show any cytotoxic effects on human periodontal ligament fibroblasts. BA showed comparable cytotoxicity to MTA but inferior physical properties. BD had somewhat higher cytotoxicity but superior physical properties than MTA.

OBJECTIVES: To evaluate implant survival rate, any complications, and changes in residual alveolar bone height (RABH) using saline or platelet-rich fibrin (PRF) filling after hydraulic transcrestal sinus lifting. METHODS: Dental implants were placed after hydraulic transcrestal sinus lifting and the filling of saline (20 patients) or PRF (20 patients). Outcome measurements were implant survival, any complications, and RABH changes. Cone-beam computed tomography (CBCT) scans were taken and compared preoperatively (T0), immediately postoperatively (T1), at 3 months (T2), 6 months (T3), and 12 months postoperatively (T4), respectively. RESULTS: In a total of 40 patients, 45 implants with a mean length of 10.4 ± 0.8 mm were placed in posterior maxilla of a mean RABH of 6.8 ± 1.1 mm. The increase in RABH peaked at T1, and continuous drooping of the sinus membrane was observed but stabilized at T3. Meanwhile, the gradual increase in the radiopacities was found below the lifted sinus membrane. The PRF filling induced the radiographic intrasinus bone gain of 2.6 ± 1.1 mm, which was significantly more than 1.7 ± 1.0 mm of saline filling at T4 (p < .05). All the implants were in function with no significant complications over the one-year follow-up period. CONCLUSIONS: In this randomized case-control study, the feasibility of hydraulic transcrestal sinus lifting without bone graft was confirmed and PRF might be a better filler to support the elevated sinus membrane. However, adjunctive bone grafting should still be indicated for cases requiring more than 2-3 mm of intrasinus bone gain.

PURPOSE: The cortical bone thickness on the anterior region is important for achieving implant stability. The purpose of this study was to examine the thickness of the cortical and cancellous bones on the anterior region of the maxilla and mandible. MATERIALS AND METHODS: Twenty-five cadaver heads were used (16 male and 9 female; mean death age, 56.7 years). After the long axis of alveolar process was set up, it was measured in 5 levels starting from 2 mm below the cementoenamel junction (L1) at intervals of 3 mm. All data was analysed statistically by one-way ANOVA at the .05 significance level. RESULTS: The cortical bone thickness according to measurement levels in both the labial and lingual sides increased from L1 to L5, and the lingual side below L3 was significantly thicker than the labial side on the maxilla and mandible. In particular, the labial cortical bone thickness in the maxilla was the thinnest compared to the other regions. The cancellous bone thickness according to measurement levels increased from L1 to L5 on the maxilla, and on the mandible it was the thinnest at the middle level of the root. CONCLUSION: For implant placement on the anterior region, a careful evaluation and full knowledge on the thickness of the cortical and cancellous bone are necessary, therefore, these results may provide an anatomic guideline to clinicians.

BACKGROUND: The aim of this study is to examine the association between asthma and periodontitis in a representative sample of Korean adults from the Sixth Korean National Health and Nutrition Examination Survey (KNHANES) in 2014. METHODS: This study conducts a cross-sectional evaluation using 2014 KNHANES data to describe the association between current asthma condition and chronic periodontitis while adjusting for sociodemographic characteristics and lifestyle factors. Presence of periodontitis is evaluated by community periodontal index defined by the World Health Organization, and current asthma condition is defined as "currently suffering from asthma condition." RESULTS: The study population comprises a total of 5,976 patients aged 19 years and older, representing 40.7 million Koreans. A multivariable logistic regression analysis with weighted observations reveals patients with current asthma condition are ≈5 times more likely to be associated with periodontitis (adjusted odds ratio [OR]: 5.36; 95% confidence interval [95% CI]: 1.27 to 22.68). In addition, 83% of patients who regularly receive scheduled antiasthmatic medications are less likely to have a diagnosis of periodontitis than individuals who do not receive medication regularly (adjusted OR: 0.17; 95% CI: 0.05 to 0.57). However, the association is not significant if treatment with antiasthmatic medication is delivered on an "as-needed" basis (adjusted OR:1.80; 95% CI: 0.87 to 3.74). CONCLUSIONS: Findings from the current study show a positive association between periodontitis and current asthma condition. In addition, patients taking scheduled antiasthmatic medications are less likely to be diagnosed with periodontitis. Due to limitations of study design and available data from the national survey, well-designed follow-up studies are needed to confirm these findings.

The purpose of this study was to analyze the incidence and risk factors of possible inferior alveolar nerve (IAN) injury after extraction of the mandibular third molars. A total of 6182 patients were examined for 10,310 mandibular third molar teeth. Panoramic radiography and patients’ medical records were used to analyze age, gender, and impaction pattern of the mandibular third molar. Cone beam computed tomography (CBCT) was used to investigate the detailed pathway of the inferior alveolar nerve and evaluated the presence of symptoms of nerve damage after tooth extraction. In CBCT, 6283 cases (61%) of the inferior alveolar nerve were actually in contact with the root of the mandibular third molar. The correlation with the panoramic signs of root darkening (p &lt; 0.001), root deflection (p &lt; 0.001), interruption of the IAN (p &lt; 0.001), diversion of the IAN (p &lt; 0.001), and narrowing of the IAN (p &lt; 0.001) had statistical significance. Of the 4708 patients who underwent surgical extraction, 31 (0.658%) complained of nerve damage. Among them, 30 patients (0.637%) complained of symptoms of inferior alveolar nerve damage, and 1 patient (0.02%) complained of symptoms of lingual nerve damage. There was a significant correlation with IAN injury in cases where the roots became dark at the IAN area (p = 0.018) and there was diversion of the IAN at the root area (p = 0.041). When the narrowing of the IAN and the lingual driving pathway of the inferior alveolar nerve appeared simultaneously in CBCT, the risk of IAN injury was high.

OBJECTIVE: To compare infection control (IC) knowledge, attitudes and practice of dentists across eight countries. METHODS: Self-administered infection control surveys were completed by 1,874 clinicians in eight countries. Practitioner's knowledge, attitudes, and practice of infection control were examined using over 100 variables. Chi-squared statistics (α = 0.05) were used to compare respondents from different national groups. RESULTS: Immunizations rates varied significantly across the eight countries (p < 0.01) with Asian countries having a lower rate of immunization against HBV than the United States practitioners. Perceived risk of acquiring HIV varied significantly across the study groups (p < 0.01); China had the lowest portion (75%). Dentists in the US reported 92% surface barrier use; only 15% in China reported use. Only 58% of practitioners in Pakistan reportedly used disposable exam gloves; 97% of US practitioners regularly use these gloves. For all groups assessed, including the United States, little over 50% of practitioners understood and practiced Universal/Standard (UP/SP) precautions effectively. CONCLUSION: Analyses from this study suggest that the dental IC knowledge and practice varied widely across the eight countries of interest. Many of the countries were found to have barriers to access IC materials. Results indicate that all eight countries could use improved education standards for universal precautions. CLINICAL SIGNIFICANCE: Knowledge, attitudes and practice of dental safety vary in different parts of the world. This study compares the compliance rates in dental safety among countries and pegs them to the level of practice in the United States. This study also provides evidence-based data on the needs in the regions surveyed and could be used to implement remedial educational measures in improving safe practices.

AIM: Among numerous constituents of Panax ginseng, a constituent named Ginsenoside Rb1 (G-Rb1) has been studied to diminish inflammation associated with diseases. This study investigated the anti-inflammatory properties of G-Rb1 on human dental pulp cells (hDPCs) exposed to lipopolysaccharide (LPS) and aimed to determine the underlying molecular mechanisms. METHODOLOGY: The KEGG pathway analysis was performed after RNA sequencing in G-Rb1- and LPS-treated hDPCs. Reverse-transcription polymerase chain reaction (RT-PCR) and western blot analysis were used for the assessment of cell adhesion molecules and inflammatory cytokines. Statistical analysis was performed with one-way ANOVA and the Student-Newman-Keuls test. RESULTS: G-Rb1 did not exhibit any cytotoxicity within the range of concentrations tested. However, it affected the levels of TNF-α, IL-6 and IL-8, as these showed reduced levels with exposure to LPS. Additionally, less mRNA and protein expressions of vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) were shown. With the presence of G-Rb1, decreased levels of PI3K/Akt, phosphorylated IκBα and p65 were also observed. Furthermore, phosphorylated ERK and JNK by LPS were diminished within 15, 30 and 60 min of G-Rb1 exposure; however, the expression of non-phosphorylated ERK and JNK remained unchanged. CONCLUSIONS: G-Rb1 suppressed the LPS-induced increase of cell adhesion molecules and inflammatory cytokines, while also inhibiting PI3K/Akt, phosphorylation of NF-κB transcription factors, ERK and JNK of MAPK signalling in hDPCs.

VR and AR technology have gradually developed to the extent that they could help operators in the surgical field. In this study, we present a case of VR simulation for preoperative planning and AR navigation applied to orthognathic surgery. The average difference between the preplanned data and the post-operative results was 3.00 mm, on average, and the standard deviation was 1.44 mm. VR simulation could provide great advantages for 3D medical simulations, with accurate manipulation and immersiveness. AR navigation has great potential in medical application; its advantages include displaying real time augmented 3D models of patients. Moreover, it is easily applied in the surgical field, without complicated 3D simulations or 3D-printed surgical guides.

To guide barrier membrane choice in the treatment of peri-implant alveolar bone defects, we evaluated guided bone regeneration (GBR) using titanium (Ti) mesh or Bio-Gide membrane, independently or in combination, for repair of alveolar bone defects in Beagle dogs. Six months after extraction of the mandibular premolars and first molars from three beagle dogs, we inserted implants assigned into 3 groups and covered with the following membrane combinations: Group A: Implant + Bio-Oss + Ti-mesh, Group B: Implant + Bio-Oss + Bio-Gide, and Group C: Implant + Bio-Oss + Ti-mesh + Bio-Gide. At 6 months, micro-CT revealed that bone volume/total volume (BV/TV), trabecular number (Tb.N), and trabecular thickness (Tb.Th) was significantly greater in Group C than the other two groups, while trabecular separation (Tb.Sp) was significantly lower, suggesting improved bone regeneration. The distance between bands of three fluorescent tracking dyes was significantly greater in Group C, indicating faster deposition of new bone. The Bio-Oss particles were ideally integrated with newly deposited bone and bone thickness was significantly larger in Group C. These findings suggest that combination of Bio-Gide membrane and titanium mesh can effectively repair peri-implant alveolar bone defects, achieving enhanced bone regeneration compared to titanium mesh or Bio-Gide alone, and therefore providing a novel treatment concept for clinical implant surgery.

PURPOSE: The purposes of this study were to assess the dentists' subjective satisfaction with the crestal approach sinus (CAS) kit, a device for maxillary sinus membrane elevation by the crestal approach using a special drilling system and hydraulic pressure, and to summarize the subjective satisfaction of dental implants placed after a sinus lift procedure with the CAS kit. METHODS: Thirty dental clinicians who had experience with dental implant placement after a sinus lift procedure with the CAS kit from June 2010 to May 2012 were included in this study. The questionnaire for the evaluation of the dentists' subjective satisfaction with the CAS kit was sent to the respondents and returned. The questionnaire was composed of two main parts. The first part was related to the sinus membrane perforation rate. The second part was related to the dentists' subjective satisfaction with the CAS kit. RESULTS: A total of 28 dentists answered the questionnaire. Among 924 implant cases, sinus membrane perforation occurred in 38 cases (4.1%). Among the 28 dentists, 26 dentists (92.9%) were satisfied or very satisfied with the CAS kit. In particular, 24 dentists (85.7%) reported that safety, cutting performance, and user-friendliness of the CAS drill were advantages of the CAS kit. However, 7 dentists (25%) did not routinely use the hydraulic lifter for sinus membrane elevation. CONCLUSIONS: From the survey, it was shown that the respondents were generally satisfied with the CAS kit and that the cutting performance and safety of the drill component were considered strengths of the CAS kit.

This study investigates the potential of propolis-embedded zeolite nanocomposites for dental implant application. Propolis-embedded zeolite nanocomposites were fabricated by complexation of propolis and zeolites. Then, they were pelleted with Poly(L-lactide) (PLA)/poly(ε-caprolactone) (PCL) polymer for the fabrication of a dental implant. The chemical properties of propolis were not changed during the fabrication of propolis-embedded zeolite nanocomposites in attenuated total reflection-fourier transform infra-red (ATR FT-IR) spectroscopy measurements. Propolis was continuously released from propolis-embedded zeolite nanocomposites over one month. PLA/PCL pellets containing propolis-embedded zeolite nanocomposites showed longer sustained release behavior compared to propolis-embedded zeolite nanocomposites. Propolis-embedded zeolite nanocomposite powder showed similar antibacterial activity against C. albicans in an agar plate and formed an inhibition zone as well as chlorohexidine (CHX) powder. Eluted propolis solution from PLA/PCL pellets also maintained antibacterial activity as well as CHX solution. Furthermore, eluted propolis solution from PLA/PCL pellets showed significant antibacterial efficacy against C. albicans, S. mutans and S. sobrinus. Dental implants fabricated from PLA/PCl polymer and propolis-embedded zeolite nanocomposites also have antibacterial efficacy and negligible cytotoxicity against normal cells. We suggest that PLA/PCl pellets containing propolis-embedded zeolite nanocomposites are promising candidates for dental implants.

PURPOSE: There has been considerable controversy about the placement of barrier membranes over osteotomy and graft sites in sinus bone grafts via the lateral window approach. Particularly when the sinus membrane remains intact, clinicians should consider the benefits and costs of a barrier membrane. This article presents clinical and radiologic findings following repositioning of a detached bony window without a barrier membrane in the lateral approach for maxillary sinus bone grafts. MATERIALS AND METHODS: After a complete 360-degree osteotomy on the lateral maxillary wall, a bony window was outfractured and separated from the sinus membrane by gentle elevation. After the sinus membrane was confirmed to be intact, grafting was carried out and the bony window was repositioned over the graft material without rigid fixation or a barrier membrane. Clinical and radiologic examinations were performed 6 months postoperative. The relationships between the patterns of gap bone healing, number of implants, time of implant placement (simultaneous with grafting or staged), and thickness of the lateral sinus wall were analyzed. The Fisher exact test and Spearman nonparametric correlation coefficient were employed for statistical evaluation. RESULTS: All 23 included patients experienced no complications. Overall external cortical healing and bone regeneration in the gap between the repositioned window and the lateral wall of the sinus were satisfactory. No significant differences in the patterns of gap bone healing were found, with respect to the number of implants placed or time of implant placement. As the lateral sinus wall was thinner, gap bone healing was better. To date, no implants have failed. CONCLUSION: A detached bony window that is repositioned on graft material might function as a barrier membrane in the lateral approach for maxillary sinus bone grafts.

AIM: Bone harvesting from the anterior nasal spine (ANS) is frequently used to correct peri-implant bone defects, particularly during implant placement in the anterior maxilla. However, many clinicians are concerned about the postoperative effect of removing the ANS on the nasal outline, as the ANS is integral to supporting the nose. This study aimed to describe the technique of ANS bone grafting and to investigate postoperative effects of bone harvesting from the ANS on the overall nasal shape. MATERIAL AND METHODS: Fifteen patients with single maxillary first incisal rehabilitation using dental implant were enrolled in this prospective clinical study. Simply by extending the subperiosteal dissection in the same surgical field without additional local anesthesia, a bone block of about 0.25-0.5 ml could be harvested from the ANS. Nose width (NW), nasolabial angle (NLA), and nasal tip depth (NTD) were measured and analyzed by lateral and frontal photographs taken preoperatively (T0), and at postoperative 1 week (T1), 3 months (T2), and 6 months (T3). Postoperative complications were also recorded. RESULTS: A significant increase in NW and decrease in both NLA and NTD were found at T1 (P < 0.05). At T3, NW, NLA and NTD returned to preoperative measurements at T0 without major complications. CONCLUSIONS: The ANS could be an effective and easily accessible intraoral source for autologous bone. Despite acute soft tissue swelling, the net postoperative effects of removing the ANS on the overall nasal shape, including on nasal tip collapse or widening of the nose base, were negligible.