Peri-implant diseases, such as peri-implant mucositis and peri-implantitis, pose significant challenges to the long-term prognosis of dental implants. This study aimed to comprehensively compare peri-implantitis with ...Peri-implant diseases, such as peri-implant mucositis and peri-implantitis, pose significant challenges to the long-term prognosis of dental implants. This study aimed to comprehensively compare peri-implantitis with periodontitis from cytological and histopathological perspectives, shedding light on the morphological characteristics associated with peri-implantitis. Thirteen patients, including six with peri-implantitis and seven with periodontitis, were included in the study. Cytological examination of affected gingival mucosa revealed distinct differences between the two conditions. Peri-implantitis exhibited an inflammatory background predominantly composed of neutrophils with lobulated nuclei, accompanied by stratified squamous epithelial cells showing signs of keratinization. In contrast, periodontitis showed a similar neutrophilic inflammatory background but with non-keratinized epithelial cells. Histopathological examination further confirmed these differences, with peri-implantitis showing keratinized epithelium in the inner epithelial layer. This histological finding aligns with the notion that peri-implantitis has a distinct mucosal profile compared to periodontitis. Additionally, cytological analysis revealed that peri-implantitis had a lower occurrence rate of Light green-positive cells, indicating a tendency toward keratinization. This finding suggests that the presence of keratinized mucosa might be associated with peri-implant health, although further research is needed to clarify this relationship. Overall, this study demonstrates the potential of cytological examination and Papanicolaou staining for assessing mucosal inflammatory conditions and distinguishing between keratinized and non-keratinized cells. These findings underscore the utility of oral mucosal smears as a valuable tool for diagnosing peri-implantitis and enhancing our understanding of its pathogenesis.展开更多
Purpose: Currently, bacteriological examinations of implant treatments target periodontopathic bacteria such as red complex bacteria, including Porphyromonas gingivalis, and detect them qualitatively or quantitatively...Purpose: Currently, bacteriological examinations of implant treatments target periodontopathic bacteria such as red complex bacteria, including Porphyromonas gingivalis, and detect them qualitatively or quantitatively. However, it seems that those examinations do not reflect the peri-implant tissue conditions precisely, because periodontopathic bacteria are also frequently detected from healthy peri-implant sites. The purpose of the present study was to investigate bacteria species most involved in peri-implantitis using a PCR method. Methods: Polymerase chain reaction (PCR) primers in this study were designed based on partial sequences of 16S rDNA of bacteria species involved in peri-implantitis that were described in numerous previous studies. Peri-implant sulcus fluid (PISF) samples were collected from thirty periodontally healthy patients with implants (HI) and thirty patients with peri-implantitis (PI). Each detection frequency of bacteria species in PISFs of both groups was investigated using a PCR method, and was compared using Fisher’s exact test. Results: In PI group, detection frequencies of Corynebacterium durum, Fretibacterium fastidiosum and Slackia exigua were significantly higher than those of HI group (p P. gingivalis and Tannerella forsythia belonging to red complex were frequently detected in the PISF samples of HI group (p > 0.05). Conclusion: It was suggested that monitoring C. durum and F. fastidiosum levels in PISF samples was useful as a clinical indicator for the evaluation of peri-implant tissue conditions.展开更多
Hypoxia(low oxygen level) is an important feature during infections and affects the host defence mechanisms. The host has evolved specific responses to address hypoxia, which are strongly dependent on the activation...Hypoxia(low oxygen level) is an important feature during infections and affects the host defence mechanisms. The host has evolved specific responses to address hypoxia, which are strongly dependent on the activation of hypoxia-inducible factor 1(HIF-1).Hypoxia interferes degradation of HIF-1 alpha subunit(HIF-1α), leading to stabilisation of HIF-1α, heterodimerization with HIF-1 beta subunit(HIF-1β) and subsequent activation of HIF-1 pathway. Apical periodontitis(periapical lesion) is a consequence of endodontic infection and ultimately results in destruction of tooth-supporting tissue, including alveolar bone. Thus far, the role of HIF-1 in periapical lesions has not been systematically examined. In the present study, we determined the role of HIF-1 in a wellcharacterised mouse periapical lesion model using two HIF-1α-activating strategies, dimethyloxalylglycine(DMOG) and adenovirusinduced constitutively active HIF-1α(CA-HIF1 A). Both DMOG and CA-HIF1 A attenuated periapical inflammation and tissue destruction. The attenuation in vivo was associated with downregulation of nuclear factor-κappa B(NF-κB) and osteoclastic gene expressions. These two agents also suppressed NF-κB activation and subsequent production of proinflammatory cytokines by macrophages. Furthermore, activation of HIF-1α by DMOG specifically suppressed lipopolysaccharide-stimulated macrophage differentiation into M1 cells, increasing the ratio of M2 macrophages against M1 cells. Taken together, our data indicated that activation of HIF-1 plays a protective role in the development of apical periodontitis via downregulation of NF-κB, proinflammatory cytokines, M1 macrophages and osteoclastogenesis.展开更多
One-step apexification using mineral trioxide aggregate(MTA) has been reported as an alternative treatment modality with more benefits than the use of long-term calcium hydroxide for teeth with open apex.However,ortho...One-step apexification using mineral trioxide aggregate(MTA) has been reported as an alternative treatment modality with more benefits than the use of long-term calcium hydroxide for teeth with open apex.However,orthograde placement of MTA is a challenging procedure in terms of length control.This case series describes the sequence of events following apical extrusion of MTA into the periapical area during a one-step apexification procedure for maxillary central incisor with an infected immature apex.Detailed long-term observation revealed complete resolution of the periapical radiolucent lesion around the extruded MTA.These cases revealed that direct contact with MTA had no negative effects on healing of the periapical tissues.However,intentional MTA overfilling into the periapical lesion is not to be recommended.展开更多
The distinction of some particular forms of periapical area, involving diseases from regular periapical disease, is a matter of considerable importance when choosing a correct treatment. The aim of this study is to de...The distinction of some particular forms of periapical area, involving diseases from regular periapical disease, is a matter of considerable importance when choosing a correct treatment. The aim of this study is to describe the differential diagnosis of F,eriapical diseases from six rare cases in clinical practice. The six rare cases are examples of situations where it is difficult to make a differential diagnosis in clinical practice. By retrospective surveys on the clinical examination, radiographs and pathological results, six patients referred to endodontic treatment in our department were analyzed for the accuracy of diagnosis and therapy. The pathoses of the six cases included two atypical radical cysts, periapical cemental dysplasia, cemento-ossifying fibroma, thymus cancer metastasis in the periapical site and tuberculosis. This report indicates that endodontists should be cognizant of a few particular circumstances when clinically treating periapical diseases.展开更多
BACKGROUND In this case,platelet-rich fibrin(PRF)was added to guided tissue regeneration as a biomaterial in proper order for immediate planting in aesthetic area with periapical infection.CASE SUMMARY With the histor...BACKGROUND In this case,platelet-rich fibrin(PRF)was added to guided tissue regeneration as a biomaterial in proper order for immediate planting in aesthetic area with periapical infection.CASE SUMMARY With the history of endodontic failure in maxillary central incisor,a 34-year-old female patient required the extraction of maxillary anterior residual root and immediate implantation.Cone beam computed tomography and clinical observation were used to assess the regeneration of soft and bone tissue.Before operation,cone beam computed tomography showed the anterior residual root had serious periapical periodontitis with insufficient labial bone in the aesthetic zone.The patient underwent immediate implant placement and reconstruction of the bone substitution by modified guided bone regeneration.The barrier was a three-layer structure of PRF-collagen membrane-PRF that covered the mixture of PRF and Bio-Oss to promote both osteogenesis and soft tissue healing.At 6 mo postoperatively,the definitive crown was placed after accomplished finial impression.One-year follow-up showed a satisfactory aesthetic effect with no obvious absorption of the labial bone and soft tissue.CONCLUSION The use of PRF in combination with guided bone regeneration can serve as a reliable and simple adjuvant for immediate implanting in infected socket and result in a stable osteogenic effect with good aesthetic outcome.展开更多
Objective:To determine the antimicrobial effects of grape seed on peri-implantitis microflora.Methods:The grape seed extract was tested against peri-implantitis microflora most commonly found in craniofacial implants ...Objective:To determine the antimicrobial effects of grape seed on peri-implantitis microflora.Methods:The grape seed extract was tested against peri-implantitis microflora most commonly found in craniofacial implants including reference strains of Staphylococcus aureus(S.aureus),Escherichia coli(E.coli),Candida albicans(C.albicans)and clinical strains of S.aureus,Klebsiella pneumonia(K.pneumonia)and Candida parapsilosis(C.parapsilosis)by disk diffusion test.Minimum inhibitory concentrations(MIC)and minimum cidal concentrations(MCC)were determined using modified agar dilution millpore method.The extract was further combined with polyethylene glycol and propylene glycol,and was tested for antimicrobial effects.Results:Grape seed extract showed positive inhibitory effects with S.aureus at MIC of 0.625 mg/mL and MCC of1.25 mg/mL respectively.However the extracts showed minimal or no reactivity against strains of E.coli,K.pneumonia,C.parapsilosis and C.albicans.The use of grape seed extract in combination with polyethylene glycol and propylene glycol also showed dose dependent inhibitory effect on S.aureus.Conclusions:The results of the study showed that grape seed has potential antimicrobial effects which can be further studied and developed to be used in the treatment of infected skinabutment interface of craniofacial implants.展开更多
Cellular fibronectin (cFn) is a type of bioactive non-collagen glycoprotein regarded as the main substance used to maintain periodontal attachment. The content of cFn in some specific sites can reflect the progress ...Cellular fibronectin (cFn) is a type of bioactive non-collagen glycoprotein regarded as the main substance used to maintain periodontal attachment. The content of cFn in some specific sites can reflect the progress of periodontitis or peri-implantitis. This study aims to evaluate the expression of cFn messenger RNA (mRNA) in tissues of adult periodontitis and peri-implantitis by real-time fluorescent quantitative polymerase chain reaction (PCR) and to determine its clinical significance. A total of 30 patients were divided into three groups of 10: healthy, adult periodontitis and peri-implantitis. Periodontal tissue biopsies (1 mmx I mmx I mm) from each patient were frozen in liquid nitrogen. Total RNA was extracted from these tissues, and the content, purity and integrity were detected. Specific primers were designed according to the sequence, and the mRNA expression levels of cellular fibronectin were detected by real-time PCR. The purity and integrity of the extracted total RNA were both high, and the specificity of amplified genes was very high with no other pollution. The mRNA expression of cFn in the adult periodontitis group (1.526+0.441) was lower than that in the healthy group (3.253+0.736). However, the mRNA expression of cFn in the peri-implantitis group (3.965+0.537) was significantly higher than that in the healthy group. The difference revealed that although both processes were destructive inflammatory reactions in the periodontium, the pathomechanisms were different and the variation started from the transcription level of the cFn gene.展开更多
Peri-implantitis has been defined as an inflamematory condition involving dental implants, surrounding mucosa and bone, which lose supporting bone. Although high success rates for endosseous implants have been reporte...Peri-implantitis has been defined as an inflamematory condition involving dental implants, surrounding mucosa and bone, which lose supporting bone. Although high success rates for endosseous implants have been reported, failures occur, and some implants are lost or removed. At least 10% of the failures have been suggested to be the result of peri-implantitis. One of the major causes of the peri-implantitis is the bacterial colonization of implant surfaces but additional risk factors such as periodontitis, poor oral hygiene, tobacco consumption, prepost operative therapies and genetic susceptibility should be considered. In the present study a real-time PCR bases assay was designed to detect and quantify red complex species, then used to investigate 307 periodontal pocket samples from 127 periodontitis patients and 180 controls. Results demonstrated a significant higher prevalence of red complex species and increased amount of Porphyromonas gingivalis and Treponema denticolain periodontal pocket of periodontitis. Since a higher risk of peri-implantitis occurs in periodontally affected patients, detection and treatment of bacteria is a fundamental objective to ensure dental implant survival.展开更多
Objective To evaluate the incidence of two-rooted mandibular premolar morphology using full-mouth periapical film series in a Chinese population,with particular emphasis on bilateral incidence,so as to provide a clini...Objective To evaluate the incidence of two-rooted mandibular premolar morphology using full-mouth periapical film series in a Chinese population,with particular emphasis on bilateral incidence,so as to provide a clinical anatomical basis for root canal treatment in mandibular premolars.Methods A total of 2015 patients who underwent dental treatment and had full mouth periapical radiographs at the Peking University School of Stomatology from April 2011 to April 2012 were enrolled in this study.Three experienced dentists reviewed the patients' periapical films and classified the root morphology of mandibular premolars bilaterally.The incidence of unilateral and bilateral double roots were recorded and calculated,including confirmed and suspected bucco-lingual root types.Results In terms of the morphology of two-rooted mandibular first premolars,of the 2015 cases with complete root formation,two-rooted first premolars were detected in 120 cases,with a total number of 159 teeth.According to the number of teeth,the overall incidence of double roots was 4.03%(159/3972).In terms of the morphology of two-rooted mandibular second premolars,of the 2015 cases with complete root formation,two-rooted second premolars were detected in 24 cases,with a total number of 33 teeth.According to the number of teeth,the overall incidence of double roots was 0.85%(33/3880).Conclusions The roots of mandibular premolars display specific morphological patterns.Based on a large sample,we observed and calculated not only the occurrence rate of bucco-lingual and mesio-distal double roots in first and second mandibular premolars,but also the incidence of unilateral or bilateral double roots within the same mandible.These findings could provide useful information on the anatomical structure of mandibular premolars for endodontic,prosthodontic and surgical procedures,and could improve the quality of treatment and reduce complications.展开更多
The purpose of this pilot study was to evaluate whether periapical granulomas can be differentiated from periapical cysts in vivo by using dental magnetic resonance imaging(MRI). Prior to apicoectomy, 11 patients with...The purpose of this pilot study was to evaluate whether periapical granulomas can be differentiated from periapical cysts in vivo by using dental magnetic resonance imaging(MRI). Prior to apicoectomy, 11 patients with radiographically confirmed periapical lesions underwent dental MRI, including fat-saturated T2-weighted(T2 wFS) images, non-contrast-enhanced T1-weighted images with and without fat saturation(T1 w/T1 wFS), and contrast-enhanced fat-saturated T1-weighted(T1 wFS+C) images. Two independent observers performed structured image analysis of MRI datasets twice. A total of 15 diagnostic MRI criteria were evaluated, and histopathological results(6 granulomas and 5 cysts) were compared with MRI characteristics. Statistical analysis was performed using intraclass correlation coefficient(ICC), Cohen’s kappa(κ), Mann–Whitney U-test and Fisher’s exact test. Lesion identification and consecutive structured image analysis was possible on T2 wFS and T1 wFS+C MRI images. A high reproducibility was shown for MRI measurements of the maximum lesion diameter(intraobserver ICC = 0.996/0.998; interobserver ICC = 0.997), for the "peripheral rim" thickness(intraobserver ICC = 0.988/0.984; interobserver ICC = 0.970), and for all non-quantitative MRI criteria(intraobserver-κ = 0.990/0.995; interobserver-κ = 0.988). In accordance with histopathological results, six MRI criteria allowed for a clear differentiation between cysts and granulomas:(1) outer margin of lesion,(2) texture of "peripheral rim" in T1 wFS+C,(3)texture of "lesion center" in T2 wFS,(4) surrounding tissue involvement in T2 wFS,(5) surrounding tissue involvement in T1 wFS+C and(6) maximum "peripheral rim" thickness(all: P < 0.05). In conclusion, this pilot study indicates that radiation-free dental MRI enables a reliable differentiation between periapical cysts and granulomas in vivo. Thus, MRI may substantially improve treatment strategies and help to avoid unnecessary surgery in apical periodontitis.展开更多
Objective: To analyze the effect of tea polyphenols combined with photodynamic therapy on the efficacy and RANKL and Shh levels in patients with early peri-implantitis. Methods:Eighty patients with early peri-implanti...Objective: To analyze the effect of tea polyphenols combined with photodynamic therapy on the efficacy and RANKL and Shh levels in patients with early peri-implantitis. Methods:Eighty patients with early peri-implantitis admitted to our hospital from January 2017 to December 2018 were randomly divided into the observation group and the control group;the control group was treated with photodynamic therapy, and the observation group was treated with tea polyphenols combined with photodynamic therapy. The levels of mPLI, PPD, mSBI and BOP were measured before treatment and 3 months after the treatment, and the levels of CRP, TNF-α, IL-6, RANKL and Shh in the gingival crevicular fluid were measured. Results:The levels of mPLI, PPD, mSBI and BOP in the observation group were significantly lower than those in the control group, and the difference was statistically significant (P<0.05). The levels of CRP, TNF-α, IL-6, RANKL and Shh in the gingival crevicular fluid were observed in the observation group. The differences were significantly lower than the control group, and the difference was statistically significant (P<0.05). Conclusions: The combination of tea polyphenols and photodynamic therapy for patients with early peri-implantitis can significantly improve clinical efficacy and reduce the inflammatory response, and can effectively improve the levels of RANKL and Shh in gingival crevicular fluid.展开更多
We established a novel identification method for oral Rothia species using one-step multiplex PCR analysis to investigate whether the monitoring of oral <em>Rothia</em> species levels is useful for peri-im...We established a novel identification method for oral Rothia species using one-step multiplex PCR analysis to investigate whether the monitoring of oral <em>Rothia</em> species levels is useful for peri-implantitis risk assessment, and to examine the oxygen concentration that these organisms need for growth <em>in vitro</em>. The mean number and proportion of <em>Rothia </em><em>aeria </em>in peri-implant sulcus fluid (PISF) samples was significantly higher in the healthy implant group than in the peri-implantitis group (P < 0.05). Moreover, <em>R. aeria</em> under aerobic conditions vigorously grew compared with those under anaerobic conditions, and this organism grew only at the upper layer where high oxygen concentrations existed in a semi-liquid nutrient medium. Therefore, the monitoring of <em>R. aeria</em> levels may be suitable as an indicator of healthy peri-implant tissue conditions for the prevention of peri-implantitis.展开更多
Background: Human beta-defensins (HBDs), epithelial-derived antimicrobial peptides, contribute to gingival health and periodontal disease. Particularly, the upregulation of HBD-3 expression in periodontal tissues is d...Background: Human beta-defensins (HBDs), epithelial-derived antimicrobial peptides, contribute to gingival health and periodontal disease. Particularly, the upregulation of HBD-3 expression in periodontal tissues is described to contribute to periodontal tissue regeneration. Specifically, the upregulation of HBD-3 expression in periodontal tissues is described to contribute to periodontal tissue regeneration. But there has been insufficient investigation of the inner epithelium in peri-implantitis, especially the HBD expression patterns as protection against oral infection. Objectives: The purpose of this study was to investigate the histopathological characteristics of the inner implant epithelium in peri-implantitis using histopathological and immunohistochemical methods and to compare it with the inner marginal epithelium in periodontitis. Materials and Methods: The biopsied cases consisted of 10 peri-implantitis, 11 periodontitis, and 10 controls. HE observation, measurement of the thickness of the inner epithelium, and immunohistochemical analysis for Ki-67 and HBD-3 were conducted. Results: Concerning the thickness of the inner epithelium, it was significantly higher in periodontitis (156.2 [138.0, 186.4] μm) than in peri-implantitis and control, 70.7 [67.5, 97.5] μm and 80.7 [76.6, 89.4] μm, respectively (p Conclusion: Decreased production of HBD-3 in keratinocytes composing the inner implant epithelium may be one of the factors affecting tissue repair in peri-implantitis.展开更多
Purpose: This study investigated the attitude of patients, grouped by the Brinkman index, towards smoking by using the Kano Test for Social Nicotine Dependence (KTSND) and their knowledge of peri-implantitis. Methods:...Purpose: This study investigated the attitude of patients, grouped by the Brinkman index, towards smoking by using the Kano Test for Social Nicotine Dependence (KTSND) and their knowledge of peri-implantitis. Methods: The participants were 3093 new patients who visited the Tokyo Medical and Dental University Hospital from January 2012 to December 2013 for an oral implant. The methodology included a questionnaire about sex, age, smoking status, daily average number of cigarettes, years of smoking, knowledge of peri-implantitis, and the KTSND. The patients were grouped according to their smoking status by calculating their Brinkman index (over 200 or not): current smokers with the possibility of nicotine dependence (BI(+)CS), current smokers with no possibility of nicotine dependence (BI(-)CS), ex-smokers (ES), and non-smokers (NS). The Brinkman index is obtained by multiplying one’s daily average number of cigarettes by the number of years they have been smoking. Results: Data were collected from 2182 respondents (response rate = 71%). The KTSND scores of BI(+)CS (16.89 ± 4.26) were significantly higher than the scores of ES (11.99 ± 4.52) and NS (11.53 ± 5.01). In current smokers, there were no significant differences between BI(+)CS and BI(-)CS. The patients replied “I don’t know” about peri-implantitis most often in all groups;however, there were no significant differences between the groups. Discussion: BI(+)CS were more dependent on nicotine in social situations than the other groups were. In Japan, a Brinkman index over 200 is required for a nicotine-dependence management fee to be instituted for health insurance treatment. This is a major concern for young smokers, who may be excluded from treatment because their years of smoking are substantially less. Results revealed that there were no significant differences between BI(+)CS and BI(-)CS. Therefore, it was suggested that the Brinkman index did not sufficiently group the participants.展开更多
文摘Peri-implant diseases, such as peri-implant mucositis and peri-implantitis, pose significant challenges to the long-term prognosis of dental implants. This study aimed to comprehensively compare peri-implantitis with periodontitis from cytological and histopathological perspectives, shedding light on the morphological characteristics associated with peri-implantitis. Thirteen patients, including six with peri-implantitis and seven with periodontitis, were included in the study. Cytological examination of affected gingival mucosa revealed distinct differences between the two conditions. Peri-implantitis exhibited an inflammatory background predominantly composed of neutrophils with lobulated nuclei, accompanied by stratified squamous epithelial cells showing signs of keratinization. In contrast, periodontitis showed a similar neutrophilic inflammatory background but with non-keratinized epithelial cells. Histopathological examination further confirmed these differences, with peri-implantitis showing keratinized epithelium in the inner epithelial layer. This histological finding aligns with the notion that peri-implantitis has a distinct mucosal profile compared to periodontitis. Additionally, cytological analysis revealed that peri-implantitis had a lower occurrence rate of Light green-positive cells, indicating a tendency toward keratinization. This finding suggests that the presence of keratinized mucosa might be associated with peri-implant health, although further research is needed to clarify this relationship. Overall, this study demonstrates the potential of cytological examination and Papanicolaou staining for assessing mucosal inflammatory conditions and distinguishing between keratinized and non-keratinized cells. These findings underscore the utility of oral mucosal smears as a valuable tool for diagnosing peri-implantitis and enhancing our understanding of its pathogenesis.
文摘Purpose: Currently, bacteriological examinations of implant treatments target periodontopathic bacteria such as red complex bacteria, including Porphyromonas gingivalis, and detect them qualitatively or quantitatively. However, it seems that those examinations do not reflect the peri-implant tissue conditions precisely, because periodontopathic bacteria are also frequently detected from healthy peri-implant sites. The purpose of the present study was to investigate bacteria species most involved in peri-implantitis using a PCR method. Methods: Polymerase chain reaction (PCR) primers in this study were designed based on partial sequences of 16S rDNA of bacteria species involved in peri-implantitis that were described in numerous previous studies. Peri-implant sulcus fluid (PISF) samples were collected from thirty periodontally healthy patients with implants (HI) and thirty patients with peri-implantitis (PI). Each detection frequency of bacteria species in PISFs of both groups was investigated using a PCR method, and was compared using Fisher’s exact test. Results: In PI group, detection frequencies of Corynebacterium durum, Fretibacterium fastidiosum and Slackia exigua were significantly higher than those of HI group (p P. gingivalis and Tannerella forsythia belonging to red complex were frequently detected in the PISF samples of HI group (p > 0.05). Conclusion: It was suggested that monitoring C. durum and F. fastidiosum levels in PISF samples was useful as a clinical indicator for the evaluation of peri-implant tissue conditions.
基金supported by the National Institute of Dental and Craniofacial Research(NIDCR)the National Center for Research Resources(NCRR)of the National Institutes of Health(NIH)under award numbers R21DE023178,R01DE024796,and S10RR027553
文摘Hypoxia(low oxygen level) is an important feature during infections and affects the host defence mechanisms. The host has evolved specific responses to address hypoxia, which are strongly dependent on the activation of hypoxia-inducible factor 1(HIF-1).Hypoxia interferes degradation of HIF-1 alpha subunit(HIF-1α), leading to stabilisation of HIF-1α, heterodimerization with HIF-1 beta subunit(HIF-1β) and subsequent activation of HIF-1 pathway. Apical periodontitis(periapical lesion) is a consequence of endodontic infection and ultimately results in destruction of tooth-supporting tissue, including alveolar bone. Thus far, the role of HIF-1 in periapical lesions has not been systematically examined. In the present study, we determined the role of HIF-1 in a wellcharacterised mouse periapical lesion model using two HIF-1α-activating strategies, dimethyloxalylglycine(DMOG) and adenovirusinduced constitutively active HIF-1α(CA-HIF1 A). Both DMOG and CA-HIF1 A attenuated periapical inflammation and tissue destruction. The attenuation in vivo was associated with downregulation of nuclear factor-κappa B(NF-κB) and osteoclastic gene expressions. These two agents also suppressed NF-κB activation and subsequent production of proinflammatory cytokines by macrophages. Furthermore, activation of HIF-1α by DMOG specifically suppressed lipopolysaccharide-stimulated macrophage differentiation into M1 cells, increasing the ratio of M2 macrophages against M1 cells. Taken together, our data indicated that activation of HIF-1 plays a protective role in the development of apical periodontitis via downregulation of NF-κB, proinflammatory cytokines, M1 macrophages and osteoclastogenesis.
基金supported by the National Research Foundation(NRF) of Koreafunded by the Ministry of Education,Science and Technology(MEST) (No.2011-0014231,Dr.Seok-Wood Chang),Korea
文摘One-step apexification using mineral trioxide aggregate(MTA) has been reported as an alternative treatment modality with more benefits than the use of long-term calcium hydroxide for teeth with open apex.However,orthograde placement of MTA is a challenging procedure in terms of length control.This case series describes the sequence of events following apical extrusion of MTA into the periapical area during a one-step apexification procedure for maxillary central incisor with an infected immature apex.Detailed long-term observation revealed complete resolution of the periapical radiolucent lesion around the extruded MTA.These cases revealed that direct contact with MTA had no negative effects on healing of the periapical tissues.However,intentional MTA overfilling into the periapical lesion is not to be recommended.
基金supported by Science and Technology committee of Shanghai (10JC 1408800)
文摘The distinction of some particular forms of periapical area, involving diseases from regular periapical disease, is a matter of considerable importance when choosing a correct treatment. The aim of this study is to describe the differential diagnosis of F,eriapical diseases from six rare cases in clinical practice. The six rare cases are examples of situations where it is difficult to make a differential diagnosis in clinical practice. By retrospective surveys on the clinical examination, radiographs and pathological results, six patients referred to endodontic treatment in our department were analyzed for the accuracy of diagnosis and therapy. The pathoses of the six cases included two atypical radical cysts, periapical cemental dysplasia, cemento-ossifying fibroma, thymus cancer metastasis in the periapical site and tuberculosis. This report indicates that endodontists should be cognizant of a few particular circumstances when clinically treating periapical diseases.
基金Supported by Department of Finance of Jilin Province,No.JCSZ2019378-21 and JCSZ2019378-27Jilin Scientific and Technological Development Program,No.20200201302JC.
文摘BACKGROUND In this case,platelet-rich fibrin(PRF)was added to guided tissue regeneration as a biomaterial in proper order for immediate planting in aesthetic area with periapical infection.CASE SUMMARY With the history of endodontic failure in maxillary central incisor,a 34-year-old female patient required the extraction of maxillary anterior residual root and immediate implantation.Cone beam computed tomography and clinical observation were used to assess the regeneration of soft and bone tissue.Before operation,cone beam computed tomography showed the anterior residual root had serious periapical periodontitis with insufficient labial bone in the aesthetic zone.The patient underwent immediate implant placement and reconstruction of the bone substitution by modified guided bone regeneration.The barrier was a three-layer structure of PRF-collagen membrane-PRF that covered the mixture of PRF and Bio-Oss to promote both osteogenesis and soft tissue healing.At 6 mo postoperatively,the definitive crown was placed after accomplished finial impression.One-year follow-up showed a satisfactory aesthetic effect with no obvious absorption of the labial bone and soft tissue.CONCLUSION The use of PRF in combination with guided bone regeneration can serve as a reliable and simple adjuvant for immediate implanting in infected socket and result in a stable osteogenic effect with good aesthetic outcome.
文摘Objective:To determine the antimicrobial effects of grape seed on peri-implantitis microflora.Methods:The grape seed extract was tested against peri-implantitis microflora most commonly found in craniofacial implants including reference strains of Staphylococcus aureus(S.aureus),Escherichia coli(E.coli),Candida albicans(C.albicans)and clinical strains of S.aureus,Klebsiella pneumonia(K.pneumonia)and Candida parapsilosis(C.parapsilosis)by disk diffusion test.Minimum inhibitory concentrations(MIC)and minimum cidal concentrations(MCC)were determined using modified agar dilution millpore method.The extract was further combined with polyethylene glycol and propylene glycol,and was tested for antimicrobial effects.Results:Grape seed extract showed positive inhibitory effects with S.aureus at MIC of 0.625 mg/mL and MCC of1.25 mg/mL respectively.However the extracts showed minimal or no reactivity against strains of E.coli,K.pneumonia,C.parapsilosis and C.albicans.The use of grape seed extract in combination with polyethylene glycol and propylene glycol also showed dose dependent inhibitory effect on S.aureus.Conclusions:The results of the study showed that grape seed has potential antimicrobial effects which can be further studied and developed to be used in the treatment of infected skinabutment interface of craniofacial implants.
基金the National Natural Science Foundation(Project No.81070868/H1409)the State Key Laboratory of Oral Diseases,Sichuan University.
文摘Cellular fibronectin (cFn) is a type of bioactive non-collagen glycoprotein regarded as the main substance used to maintain periodontal attachment. The content of cFn in some specific sites can reflect the progress of periodontitis or peri-implantitis. This study aims to evaluate the expression of cFn messenger RNA (mRNA) in tissues of adult periodontitis and peri-implantitis by real-time fluorescent quantitative polymerase chain reaction (PCR) and to determine its clinical significance. A total of 30 patients were divided into three groups of 10: healthy, adult periodontitis and peri-implantitis. Periodontal tissue biopsies (1 mmx I mmx I mm) from each patient were frozen in liquid nitrogen. Total RNA was extracted from these tissues, and the content, purity and integrity were detected. Specific primers were designed according to the sequence, and the mRNA expression levels of cellular fibronectin were detected by real-time PCR. The purity and integrity of the extracted total RNA were both high, and the specificity of amplified genes was very high with no other pollution. The mRNA expression of cFn in the adult periodontitis group (1.526+0.441) was lower than that in the healthy group (3.253+0.736). However, the mRNA expression of cFn in the peri-implantitis group (3.965+0.537) was significantly higher than that in the healthy group. The difference revealed that although both processes were destructive inflammatory reactions in the periodontium, the pathomechanisms were different and the variation started from the transcription level of the cFn gene.
文摘Peri-implantitis has been defined as an inflamematory condition involving dental implants, surrounding mucosa and bone, which lose supporting bone. Although high success rates for endosseous implants have been reported, failures occur, and some implants are lost or removed. At least 10% of the failures have been suggested to be the result of peri-implantitis. One of the major causes of the peri-implantitis is the bacterial colonization of implant surfaces but additional risk factors such as periodontitis, poor oral hygiene, tobacco consumption, prepost operative therapies and genetic susceptibility should be considered. In the present study a real-time PCR bases assay was designed to detect and quantify red complex species, then used to investigate 307 periodontal pocket samples from 127 periodontitis patients and 180 controls. Results demonstrated a significant higher prevalence of red complex species and increased amount of Porphyromonas gingivalis and Treponema denticolain periodontal pocket of periodontitis. Since a higher risk of peri-implantitis occurs in periodontally affected patients, detection and treatment of bacteria is a fundamental objective to ensure dental implant survival.
文摘Objective To evaluate the incidence of two-rooted mandibular premolar morphology using full-mouth periapical film series in a Chinese population,with particular emphasis on bilateral incidence,so as to provide a clinical anatomical basis for root canal treatment in mandibular premolars.Methods A total of 2015 patients who underwent dental treatment and had full mouth periapical radiographs at the Peking University School of Stomatology from April 2011 to April 2012 were enrolled in this study.Three experienced dentists reviewed the patients' periapical films and classified the root morphology of mandibular premolars bilaterally.The incidence of unilateral and bilateral double roots were recorded and calculated,including confirmed and suspected bucco-lingual root types.Results In terms of the morphology of two-rooted mandibular first premolars,of the 2015 cases with complete root formation,two-rooted first premolars were detected in 120 cases,with a total number of 159 teeth.According to the number of teeth,the overall incidence of double roots was 4.03%(159/3972).In terms of the morphology of two-rooted mandibular second premolars,of the 2015 cases with complete root formation,two-rooted second premolars were detected in 24 cases,with a total number of 33 teeth.According to the number of teeth,the overall incidence of double roots was 0.85%(33/3880).Conclusions The roots of mandibular premolars display specific morphological patterns.Based on a large sample,we observed and calculated not only the occurrence rate of bucco-lingual and mesio-distal double roots in first and second mandibular premolars,but also the incidence of unilateral or bilateral double roots within the same mandible.These findings could provide useful information on the anatomical structure of mandibular premolars for endodontic,prosthodontic and surgical procedures,and could improve the quality of treatment and reduce complications.
基金supported by a grant from the Dietmar Hopp Foundation (grant number: 23011228 grant holders: A.J. and S.H.)receive funding from a postdoctoral fellowship of the Medical Faculty of the University of Heidelberg
文摘The purpose of this pilot study was to evaluate whether periapical granulomas can be differentiated from periapical cysts in vivo by using dental magnetic resonance imaging(MRI). Prior to apicoectomy, 11 patients with radiographically confirmed periapical lesions underwent dental MRI, including fat-saturated T2-weighted(T2 wFS) images, non-contrast-enhanced T1-weighted images with and without fat saturation(T1 w/T1 wFS), and contrast-enhanced fat-saturated T1-weighted(T1 wFS+C) images. Two independent observers performed structured image analysis of MRI datasets twice. A total of 15 diagnostic MRI criteria were evaluated, and histopathological results(6 granulomas and 5 cysts) were compared with MRI characteristics. Statistical analysis was performed using intraclass correlation coefficient(ICC), Cohen’s kappa(κ), Mann–Whitney U-test and Fisher’s exact test. Lesion identification and consecutive structured image analysis was possible on T2 wFS and T1 wFS+C MRI images. A high reproducibility was shown for MRI measurements of the maximum lesion diameter(intraobserver ICC = 0.996/0.998; interobserver ICC = 0.997), for the "peripheral rim" thickness(intraobserver ICC = 0.988/0.984; interobserver ICC = 0.970), and for all non-quantitative MRI criteria(intraobserver-κ = 0.990/0.995; interobserver-κ = 0.988). In accordance with histopathological results, six MRI criteria allowed for a clear differentiation between cysts and granulomas:(1) outer margin of lesion,(2) texture of "peripheral rim" in T1 wFS+C,(3)texture of "lesion center" in T2 wFS,(4) surrounding tissue involvement in T2 wFS,(5) surrounding tissue involvement in T1 wFS+C and(6) maximum "peripheral rim" thickness(all: P < 0.05). In conclusion, this pilot study indicates that radiation-free dental MRI enables a reliable differentiation between periapical cysts and granulomas in vivo. Thus, MRI may substantially improve treatment strategies and help to avoid unnecessary surgery in apical periodontitis.
基金supported by Project of Science Bureau of Nanchong(No.16YFZJ0027).
文摘Objective: To analyze the effect of tea polyphenols combined with photodynamic therapy on the efficacy and RANKL and Shh levels in patients with early peri-implantitis. Methods:Eighty patients with early peri-implantitis admitted to our hospital from January 2017 to December 2018 were randomly divided into the observation group and the control group;the control group was treated with photodynamic therapy, and the observation group was treated with tea polyphenols combined with photodynamic therapy. The levels of mPLI, PPD, mSBI and BOP were measured before treatment and 3 months after the treatment, and the levels of CRP, TNF-α, IL-6, RANKL and Shh in the gingival crevicular fluid were measured. Results:The levels of mPLI, PPD, mSBI and BOP in the observation group were significantly lower than those in the control group, and the difference was statistically significant (P<0.05). The levels of CRP, TNF-α, IL-6, RANKL and Shh in the gingival crevicular fluid were observed in the observation group. The differences were significantly lower than the control group, and the difference was statistically significant (P<0.05). Conclusions: The combination of tea polyphenols and photodynamic therapy for patients with early peri-implantitis can significantly improve clinical efficacy and reduce the inflammatory response, and can effectively improve the levels of RANKL and Shh in gingival crevicular fluid.
文摘We established a novel identification method for oral Rothia species using one-step multiplex PCR analysis to investigate whether the monitoring of oral <em>Rothia</em> species levels is useful for peri-implantitis risk assessment, and to examine the oxygen concentration that these organisms need for growth <em>in vitro</em>. The mean number and proportion of <em>Rothia </em><em>aeria </em>in peri-implant sulcus fluid (PISF) samples was significantly higher in the healthy implant group than in the peri-implantitis group (P < 0.05). Moreover, <em>R. aeria</em> under aerobic conditions vigorously grew compared with those under anaerobic conditions, and this organism grew only at the upper layer where high oxygen concentrations existed in a semi-liquid nutrient medium. Therefore, the monitoring of <em>R. aeria</em> levels may be suitable as an indicator of healthy peri-implant tissue conditions for the prevention of peri-implantitis.
文摘Background: Human beta-defensins (HBDs), epithelial-derived antimicrobial peptides, contribute to gingival health and periodontal disease. Particularly, the upregulation of HBD-3 expression in periodontal tissues is described to contribute to periodontal tissue regeneration. Specifically, the upregulation of HBD-3 expression in periodontal tissues is described to contribute to periodontal tissue regeneration. But there has been insufficient investigation of the inner epithelium in peri-implantitis, especially the HBD expression patterns as protection against oral infection. Objectives: The purpose of this study was to investigate the histopathological characteristics of the inner implant epithelium in peri-implantitis using histopathological and immunohistochemical methods and to compare it with the inner marginal epithelium in periodontitis. Materials and Methods: The biopsied cases consisted of 10 peri-implantitis, 11 periodontitis, and 10 controls. HE observation, measurement of the thickness of the inner epithelium, and immunohistochemical analysis for Ki-67 and HBD-3 were conducted. Results: Concerning the thickness of the inner epithelium, it was significantly higher in periodontitis (156.2 [138.0, 186.4] μm) than in peri-implantitis and control, 70.7 [67.5, 97.5] μm and 80.7 [76.6, 89.4] μm, respectively (p Conclusion: Decreased production of HBD-3 in keratinocytes composing the inner implant epithelium may be one of the factors affecting tissue repair in peri-implantitis.
文摘Purpose: This study investigated the attitude of patients, grouped by the Brinkman index, towards smoking by using the Kano Test for Social Nicotine Dependence (KTSND) and their knowledge of peri-implantitis. Methods: The participants were 3093 new patients who visited the Tokyo Medical and Dental University Hospital from January 2012 to December 2013 for an oral implant. The methodology included a questionnaire about sex, age, smoking status, daily average number of cigarettes, years of smoking, knowledge of peri-implantitis, and the KTSND. The patients were grouped according to their smoking status by calculating their Brinkman index (over 200 or not): current smokers with the possibility of nicotine dependence (BI(+)CS), current smokers with no possibility of nicotine dependence (BI(-)CS), ex-smokers (ES), and non-smokers (NS). The Brinkman index is obtained by multiplying one’s daily average number of cigarettes by the number of years they have been smoking. Results: Data were collected from 2182 respondents (response rate = 71%). The KTSND scores of BI(+)CS (16.89 ± 4.26) were significantly higher than the scores of ES (11.99 ± 4.52) and NS (11.53 ± 5.01). In current smokers, there were no significant differences between BI(+)CS and BI(-)CS. The patients replied “I don’t know” about peri-implantitis most often in all groups;however, there were no significant differences between the groups. Discussion: BI(+)CS were more dependent on nicotine in social situations than the other groups were. In Japan, a Brinkman index over 200 is required for a nicotine-dependence management fee to be instituted for health insurance treatment. This is a major concern for young smokers, who may be excluded from treatment because their years of smoking are substantially less. Results revealed that there were no significant differences between BI(+)CS and BI(-)CS. Therefore, it was suggested that the Brinkman index did not sufficiently group the participants.