Expert consensus on odontogenic maxillary sinusitis multi-disciplinary treatment

Odontogenic maxillary sinusitis (OMS) is a subtype of maxillary sinusitis (MS). It is actually inflammation of the maxillary sinus that secondary to adjacent infectious maxillary dental lesion. Due to the lack of unique clinical features, OMS is difficult to distinguish from other types of rhinosinusitis. Besides, the characteristic infectious pathogeny of OMS makes it is resistant to conventional therapies of rhinosinusitis. Its current diagnosis and treatment are thus facing great difficulties. The multi-disciplinary cooperation between otolaryngologists and dentists is absolutely urgent to settle these questions and to acquire standardized diagnostic and treatment regimen for OMS. However, this disease has actually received little attention and has been underrepresented by relatively low publication volume and quality. Based on systematically reviewed literature and practical experiences of expert members, our consensus focuses on characteristics, symptoms, classification and diagnosis of OMS, and further put forward multidisciplinary treatment decisions for OMS, as well as the common treatment complications and relative managements. This consensus aims to increase attention to OMS, and optimize the clinical diagnosis and decision-making of OMS, which finally provides evidence-based options for OMS clinical management.

Gingipain from Porphyromonas gingivalis causes insulin resistance by degrading insulin receptors through direct proteolytic effects

Periodontitis is a critical risk factor for the occurrence and development of diabetes.Porphyromonas gingivalis may participate in insulin resistance(IR)caused by periodontal inflammation,but the functional role and specific mechanisms of P.gingivalis in IR remain unclear.In the present study,clinical samples were analysed to determine the statistical correlation between P.gingivalis and IR occurrence.Through culturing of hepatocytes,myocytes,and adipocytes,and feeding mice P.gingivalis orally,the functional correlation between P.gingivalis and IR occurrence was further studied both in vitro and in vivo.Clinical data suggested that the amount of P.gingivalis isolated was correlated with the Homeostatic Model Assessment for IR score.In vitro studies suggested that coculture with P.gingivalis decreased glucose uptake and insulin receptor(INSR)protein expression in hepatocytes,myocytes,and adipocytes.Mice fed P.gingivalis tended to undergo IR.P.gingivalis was detectable in the liver,skeletal muscle,and adipose tissue of experimental mice.The distribution sites of gingipain coincided with the downregulation of INSR.Gingipain proteolysed the functional insulin-binding region of INSR.Coculture with P.gingivalis significantly decreased the INSR–insulin binding ability.Knocking out gingipain from P.gingivalis alleviated the negative effects of P.gingivalis on IR in vivo.Taken together,these findings indicate that distantly migrated P.gingivalis may directly proteolytically degrade INSR through gingipain,thereby leading to IR.The results provide a new strategy for preventing diabetes by targeting periodontal pathogens and provide new ideas for exploring novel mechanisms by which periodontal inflammation affects the systemic metabolic state.

Expert consensus on the diagnosis and therapy of endo-periodontal lesions

Endo-periodontal lesions (EPLs) involve both the periodontium and pulp tissue and have complicated etiologies and pathogenic mechanisms,including unique anatomical and microbiological characteristics and multiple contributing factors.This etiological complexity leads to difficulties in determining patient prognosis,posing great challenges in clinical practice.Furthermore,EPL-affected teeth require multidisciplinary therapy,including periodontal therapy,endodontic therapy and others,but there is still much debate about the appropriate timing of periodontal therapy and root canal therapy.By compiling the most recent findings on the etiology,pathogenesis,clinical characteristics,diagnosis,therapy,and prognosis of EPL-affected teeth,this consensus sought to support clinicians in making the best possible treatment decisions based on both biological and clinical evidence.

Removal of nonimpacted third molars alters the periodontal condition of their neighbors clinically, immunologically, and microbiologically

Considering the adverse effects of nonimpacted third molars(N-M3s)on the periodontal health of adjacent second molars(M2s),the removal of N-M3s may be beneficial to the periodontal health of their neighbors.This study aimed to investigate the clinical,immunological,and microbiological changes of the periodontal condition around M2s following removal of neighboring N-M3s across a 6-month period.Subjects with at least one quadrant containing an intact first molar(M1),M2,and N-M3 were screened and those who met the inclusion criteria and decided to receive N-M3 extraction were recruited in the following investigation.M2 periodontal condition was interrogated before M3 extraction(baseline)and at 3 and 6 months postoperatively.Improvements in clinical periodontal indexes of M2s in response to their adjacent N-M3 removal,along with changes in inflammatory biomarkers among gingival crevicular fluid(GCF)and the composition of subgingival plaque collected from the distal sites of the M2s of the targeted quadrant were parallelly analyzed.Complete data of 26 tooth extraction patients across the follow-up period were successfully obtained and subsequently applied for statistical analysis.Compared to the baseline,the periodontal condition of M2s was significantly changed 6 months after N-M3 removal;specifically,the probing depth of M2s significantly reduced(P<0.001),the matrix metalloproteinase(MMP)-8 concentration involved in GCF significantly decreased(P=0.025),and the abundance of the pathogenic genera unidentified Prevotellaceae and Streptococcus significantly decreased(P<0.001 and P=0.009,respectively).We concluded that N-M3 removal was associated with superior clinical indexes,decreased GCF inflammatory biomarkers,and reduced pathogenic microbiome distribution within the subgingival plaque.Although the retention or removal of N-M3s continues to be controversial,our findings provide additional evidence that medical decisions should be made as early as possible or at least before the neighboring teeth are irretrievably damaged.

A 3D-printed molybdenum-containing scaffold exerts dual pro-osteogenic and anti-osteoclastogenic effects to facilitate alveolar bone repair

The positive regulation of bone-forming osteoblast activity and the negative feedback regulation of osteoclastic activity are equally important in strategies to achieve successful alveolar bone regeneration. Here, a molybdenum(Mo)-containing bioactive glass ceramic scaffold with solid-strut-packed structures(Mo-scaffold) was printed, and its ability to regulate pro-osteogenic and antiosteoclastogenic cellular responses was evaluated in vitro and in vivo. We found that extracts derived from Mo-scaffold(Moextracts) strongly stimulated osteogenic differentiation of bone marrow mesenchymal stem cells and inhibited differentiation of osteoclast progenitors. The identified comodulatory effect was further demonstrated to arise from Mo ions in the Mo-extract,wherein Mo ions suppressed osteoclastic differentiation by scavenging reactive oxygen species(ROS) and inhibiting mitochondrial biogenesis in osteoclasts. Consistent with the in vitro findings, the Mo-scaffold was found to significantly promote osteoblastmediated bone formation and inhibit osteoclast-mediated bone resorption throughout the bone healing process, leading to enhanced bone regeneration. In combination with our previous finding that Mo ions participate in material-mediated immunomodulation, this study offers the new insight that Mo ions facilitate bone repair by comodulating the balance between bone formation and resorption. Our findings suggest that Mo ions are multifunctional cellular modulators that can potentially be used in biomaterial design and bone tissue engineering.

Periodontitis may induce gut microbiota dysbiosis via salivary microbiota

The aim of this study was to identify whether periodontitis induces gut microbiota dysbiosis via invasion by salivary microbes.First,faecal and salivary samples were collected from periodontally healthy participants(PH group,n=16)and patients with severe periodontitis(SP group,n=21)and analysed by 16S ribosomal RNA sequencing.Significant differences were observed in both the faecal and salivary microbiota between the PH and SP groups.Notably,more saliva-sourced microbes were observed in the faecal samples of the SP group.Then,the remaining salivary microbes were transplanted into C57BL6/J mice(the C-PH group and the C-SP group),and it was found that the composition of the gut microbiota of the C-SP group was significantly different from that of the C-PH group,with Porphyromonadaceae and Fusobacterium being significantly enriched in the C-SP group.In the colon,the C-SP group showed significantly reduced crypt depth and zonula occludens-1 expression.The m RNA expression levels of pro-inflammatory cytokines,chemokines and tight junction proteins were significantly higher in the C-SP group.To further investigate whether salivary bacteria could persist in the intestine,the salivary microbiota was stained with carboxyfluorescein diacetate succinimidyl ester and transplanted into mice.We found that salivary microbes from both the PH group and the SP group could persist in the gut for at least 24 h.Thus,our data demonstrate that periodontitis may induce gut microbiota dysbiosis through the influx of salivary microbes.

A novel CCCH-type zinc finger protein SAW1 activates OsGA20ox3 to regulate gibberellin homeostasis and anther development in rice

Male sterility is a prerequisite for hybrid seed production.The phytohormone gibberellin(GA)is in-volved in regulating male reproductive development,but the mechanism underlying GA homeostasis in anther development remains less understood.Here,we report the isolation and characterization of a new positive regulator of GA homeostasis,swollen anther wall 1(SAW1),for anther development in rice(Oryza sativa L.).Rice plants carrying the recessive mutant allele saw1 produces abnormal anthers with swollen anther wall and aborted pollen.Clustered regularly interspaced short palindromic repeats(CRISPR)/CRIPSR-associated protein 9-mediated knockout of SAW1 in rice generated similar male sterile plants.SAW1 encodes a novel nucleus-localizing CCCH-tandem zinc finger protein,and this protein could directly bind to the promoter region of the GA synthesis gene OsGA20ox3 to induce its anther-specific expression.In the saw1 anther,the significantly decreased OsGA20ox3 expression resulted in lower bio-active GA content,which in turn caused the lower expression of the GA-inducible anther-regulator gene OsGAMYB.Thus,our results disclose the mechanism of the SAW1-GA20ox3-GAMYB pathway in controlling rice anther development,and provide a new target gene for the rapid generation of male sterile lines by genome editing for hybrid breeding.

Evolution of gene regulatory network of C_(4) photosynthesis in the genus Flaveria reveals the evolutionary status of C_(3)-C_(4) intermediate species

C_(4) photosynthesis evolved from ancestral C_(3) photosynthesis by recruiting pre-existing genes to fulfill new functions.The enzymes and transporters required for the C_(4) metabolic pathway have been intensively studied and well documented;however,the transcription factors(TFs)that regulate these C_(4) metabolic genes are not yet well understood.In particular,how the TF regulatory network of C_(4) metabolic genes was rewired during the evolutionary process is unclear.Here,we constructed gene regulatory networks(GRNs)for four closely evolutionarily related species from the genus Flaveria,which represent four different evolutionary stages of C_(4) photosynthesis:C_(3)(F.robusta),type Ⅰ C_(3)-C_(4)(F.sonorensis),type Ⅱ C_(3)-C_(4)(F.ramosissima),and C_(4)(F.trinervia).Our results show that more than half of the co-regulatory relationships between TFs and core C_(4) metabolic genes are species specific.The counterparts of the C_(4) genes in C_(3) species were already co-regulated with photosynthesis-related genes,whereas the required TFs for C_(4) photosynthesis were recruited later.The TFs involved in C_(4) photosynthesis were widely recruited in the type Ⅰ C_(3)-C_(4) species;nevertheless,type Ⅱ C_(3)-C_(4) species showed a divergent GRN from C_(4) species.In line with these findings,a ^(13)CO_(2) pulse-labeling experiment showed that the CO_(2) initially fixed into C_(4) acid was not directly released to the Calvin–Benson–Bassham cycle in the type Ⅱ C_(3)-C_(4) species.Therefore,our study uncovered dynamic changes in C_(4) genes and TF co-regulation during the evolutionary process;furthermore,we showed that the metabolic pathway of the type Ⅱ C_(3)-C_(4) species F.ramosissima represents an alternative evolutionary solution to the ammonia imbalance in C_(3)-C_(4) intermediate species.

Third molar-related knowledge,attitudes,behaviors,and medical history of 904 Chinese adults:a cross-sectional survey

This study investigated the perceptions and medical history of third molars(M3s)and assessed the prevalence of visible M3s(V-M3s)among 904 Chinese adults.The enrolled participants were interviewed to complete a structural questionnaire focused on sociodemographic information and their understanding of,attitudes toward,behaviors regarding,and medical history with respect to M3s.In addition,the number of V-M3s in the cohort was determined by oral examination.Logistic regression analysis was performed to explore the association between individuals'sociodemographic characteristics and their perception of M3s or the presence of V-M3s.The Chi-square test was used to compare the actions taken against symptomatic M3s and the corresponding outcomes among different groups divided according to respondents'sociodemographic factors.In total,904 completed questionnaires were gathered and analyzed.Nearly half(43.9%)of the respondents knew nothing about M3s,and only 12.7%provided correct answers to all the questions asked.Male sex,older age,occupation involving physical labor,and no previous dental experience were active factors in unawareness of M3s.Male sex was also significantly associated with the presence of at least one V-M3 and negative behavior about symptomatic M3s.In terms of medical history,192 participants reported having had at least one M3 extracted(438 in total),and 72.6%of the M3s were removed due to the presence of related symptoms or pathologies.In conclusion,the population investigated had a shortage of knowledge about M3s and adopted negative attitudes and actions about M3-related problems.