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Enterococcus faecalis Extracellular Vesicles Promote Apical Periodontitis 粪肠球菌胞外小泡促进根尖牙周炎的发生
IF 7.6 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-04-29 DOI: 10.1177/00220345241230867
R.Y. Ma, Z.L. Deng, Q.Y. Du, M.Q. Dai, Y.Y. Luo, Y.E. Liang, X.Z. Dai, S.M. Guo, W.H. Zhao
Enterococcus faecalis is an important contributor to the persistence of chronic apical periodontitis. However, the mechanism by which E. faecalis infection in the root canals and dentinal tubules affects periapical tissue remains unclear. Bacterial extracellular vesicles (EVs) act as natural carriers of microbe-associated molecular patterns (MAMPs) and have recently attracted considerable attention. In this study, we investigated the role of EVs derived from E. faecalis in the pathogenesis of apical periodontitis. We observed that E. faecalis EVs can induce inflammatory bone destruction in the periapical areas of mice. Double-labeling immunofluorescence indicated that M1 macrophage infiltration was increased by E. faecalis EVs in apical lesions. Moreover, in vitro experiments demonstrated the internalization of E. faecalis EVs into macrophages. Macrophages tended to polarize toward the M1 profile after treatment with E. faecalis EVs. Pattern recognition receptors (PRRs) can recognize MAMPs of bacterial EVs and, in turn, trigger inflammatory responses. Thus, we performed further mechanistic exploration, which showed that E. faecalis EVs considerably increased the expression of NOD2, a cytoplasmic PRR, and that inhibition of NOD2 markedly reduced macrophage M1 polarization induced by E. faecalis EVs. RIPK2 ubiquitination is a major downstream of NOD2. We also observed increased RIPK2 ubiquitination in macrophages treated with E. faecalis EVs, and E. faecalis EV-induced macrophage M1 polarization was notably alleviated by the RIPK2 ubiquitination inhibitor. Our study revealed the potential for EVs to be considered a virulence factor of E. faecalis and found that E. faecalis EVs can promote macrophage M1 polarization via NOD2/RIPK2 signaling. To our knowledge, this is the first report to investigate apical periodontitis development from the perspective of bacterial vesicles and demonstrate the role and mechanism of E. faecalis EVs in macrophage polarization. This study expands our understanding of the pathogenic mechanism of E. faecalis and provides novel insights into the pathogenesis of apical periodontitis.
粪肠球菌是慢性根尖周炎持续存在的重要原因。然而,根管和牙本质小管中的粪肠球菌感染影响根尖周组织的机制仍不清楚。细菌胞外囊泡(EVs)是微生物相关分子模式(MAMPs)的天然载体,最近引起了广泛关注。在本研究中,我们研究了粪大肠杆菌衍生的 EVs 在根尖牙周炎发病机制中的作用。我们观察到粪大肠杆菌 EVs 可诱导小鼠根尖周炎性骨破坏。双标记免疫荧光显示,根尖病变中的粪大肠杆菌 EVs 增加了 M1 巨噬细胞的浸润。此外,体外实验证明了粪大肠杆菌 EVs 在巨噬细胞中的内化作用。用粪大肠杆菌 EVs 处理后,巨噬细胞倾向于向 M1 型极化。模式识别受体(PRR)可以识别细菌 EVs 的 MAMPs,进而引发炎症反应。因此,我们进行了进一步的机理探索,结果表明粪大肠杆菌 EV 显著增加了细胞质 PRR NOD2 的表达,抑制 NOD2 可明显降低粪大肠杆菌 EV 诱导的巨噬细胞 M1 极化。RIPK2 泛素化是 NOD2 的主要下游作用。我们还观察到用粪大肠杆菌 EVs 处理的巨噬细胞中 RIPK2 泛素化增加,RIPK2 泛素化抑制剂明显减轻了粪大肠杆菌 EV 诱导的巨噬细胞 M1 极化。我们的研究揭示了EVs被认为是粪大肠杆菌毒力因子的潜力,并发现粪大肠杆菌EVs可通过NOD2/RIPK2信号传导促进巨噬细胞M1极化。据我们所知,这是首次从细菌囊泡的角度研究根尖牙周炎的发展,并证明了粪大肠杆菌 EVs 在巨噬细胞极化中的作用和机制。这项研究拓展了我们对粪大肠杆菌致病机制的认识,并为根尖周炎的发病机制提供了新的见解。
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引用次数: 0
Artificial Intelligence in Orthodontics: Critical Review 人工智能在正畸学中的应用:批判性评论
IF 7.6 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-04-29 DOI: 10.1177/00220345241235606
N.F. Nordblom, M. Büttner, F. Schwendicke
With increasing digitalization in orthodontics, certain orthodontic manufacturing processes such as the fabrication of indirect bonding trays, aligner production, or wire bending can be automated. However, orthodontic treatment planning and evaluation remains a specialist’s task and responsibility. As the prediction of growth in orthodontic patients and response to orthodontic treatment is inherently complex and individual, orthodontists make use of features gathered from longitudinal, multimodal, and standardized orthodontic data sets. Currently, these data sets are used by the orthodontist to make informed, rule-based treatment decisions. In research, artificial intelligence (AI) has been successfully applied to assist orthodontists with the extraction of relevant data from such data sets. Here, AI has been applied for the analysis of clinical imagery, such as automated landmark detection in lateral cephalograms but also for evaluation of intraoral scans or photographic data. Furthermore, AI is applied to help orthodontists with decision support for treatment decisions such as the need for orthognathic surgery or for orthodontic tooth extractions. One major challenge in current AI research in orthodontics is the limited generalizability, as most studies use unicentric data with high risks of bias. Moreover, comparing AI across different studies and tasks is virtually impossible as both outcomes and outcome metrics vary widely, and underlying data sets are not standardized. Notably, only few AI applications in orthodontics have reached full clinical maturity and regulatory approval, and researchers in the field are tasked with tackling real-world evaluation and implementation of AI into the orthodontic workflow.
随着正畸数字化程度的不断提高,某些正畸生产流程,如间接粘接托盘的制作、矫治器的生产或线的弯曲都可以实现自动化。然而,正畸治疗计划和评估仍然是专科医生的任务和职责。由于预测正畸患者的生长情况和对正畸治疗的反应本质上是复杂和个性化的,因此正畸医生会利用从纵向、多模态和标准化正畸数据集中收集到的特征。目前,正畸医生利用这些数据集做出明智的、基于规则的治疗决策。在研究中,人工智能(AI)已被成功应用于协助正畸医生从这些数据集中提取相关数据。在这里,人工智能已被应用于临床图像的分析,例如头颅侧位图中的自动地标检测,以及口内扫描或照片数据的评估。此外,人工智能还被应用于帮助正畸医生为治疗决策提供决策支持,如是否需要进行正颌外科手术或正畸拔牙。目前人工智能在正畸学领域的研究面临的一个主要挑战是普及性有限,因为大多数研究使用的都是单中心数据,存在很大的偏差风险。此外,在不同的研究和任务中比较人工智能几乎是不可能的,因为结果和结果指标差异很大,而且基础数据集也没有标准化。值得注意的是,目前只有少数人工智能在正畸领域的应用达到了临床成熟和监管批准的程度,该领域的研究人员正肩负着在正畸工作流程中对人工智能进行真实世界评估和实施的任务。
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引用次数: 0
A Novel Mechanism of MSCs Responding to Occlusal Force for Bone Homeostasis 间充质干细胞响应咬合力促进骨平衡的新机制
IF 7.6 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-04-26 DOI: 10.1177/00220345241236120
F. Wang, H. Wang, H. Zhang, B. Sun, Z. Wang
Alveolar bone, as tooth-supporting bone for mastication, is sensitive to occlusal force. However, the mechanism of alveolar bone loss after losing occlusal force remains unclear. Here, we performed single-cell RNA sequencing of nonhematopoietic (CD45) cells in mouse alveolar bone after removing the occlusal force. Mesenchymal stromal cells (MSCs) and endothelial cell (EC) subsets were significantly decreased in frequency, as confirmed by immunofluorescence and flow cytometry. The osteogenic and proangiogenic abilities of MSCs were impaired, and the expression of mechanotransducers yes associated protein 1 ( Yap) and WW domain containing transcription regulator 1 ( Taz) in MSCs decreased. Conditional deletion of Yap and Taz from LepR+ cells, which are enriched in MSCs that are important for adult bone homeostasis, significantly decreased alveolar bone mass and resisted any further changes in bone mass induced by occlusal force changes. Interestingly, LepR-Cre; Yapf/f; Tazf/f mice showed a decrease in CD31hi endomucin (Emcn)hi endothelium, and the expression of some EC-derived signals acting on osteoblastic cells was inhibited in alveolar bone. Mechanistically, conditional deletion of Yap and Taz in LepR+ cells inhibited the secretion of pleiotrophin (Ptn), which impaired the proangiogenic capacity of LepR+ cells. Knockdown in MSC-derived Ptn repressed human umbilical vein EC tube formation in vitro. More important, administration of recombinant PTN locally recovered the frequency of CD31hiEmcnhi endothelium and rescued the low bone mass phenotype of LepR-Cre; Yapf/f; Tazf/f mice. Taken together, these findings suggest that occlusal force governs MSC-regulated endothelium to maintain alveolar bone homeostasis through the Yap/Taz/Ptn axis, providing a reference for further understanding of the relationship between dysfunction and bone homeostasis.
牙槽骨作为咀嚼时的牙齿支撑骨,对咬合力非常敏感。然而,失去咬合力后牙槽骨流失的机制仍不清楚。在此,我们对去除咬合力后小鼠牙槽骨中的非造血细胞(CD45-)进行了单细胞 RNA 测序。免疫荧光和流式细胞术证实,间充质基质细胞(MSCs)和内皮细胞(EC)亚群的频率明显下降。间充质干细胞的成骨和促血管生成能力受损,间充质干细胞中的机械传导相关蛋白1(Yap)和含WW结构域的转录调节因子1(Taz)的表达减少。LepR+细胞中富含对成人骨平衡非常重要的间充质干细胞,有条件地缺失LepR+细胞中的Yap和Taz会显著降低牙槽骨质量,并抑制咬合力变化引起的骨量进一步变化。有趣的是,LepR-Cre; Yapf/f; Tazf/f 小鼠显示出 CD31hi 内皮素(Emcn)hi 内皮细胞的减少,一些作用于成骨细胞的 EC 衍生信号在牙槽骨中的表达受到抑制。从机制上讲,LepR+细胞中Yap和Taz的条件性缺失抑制了褶皱素(Ptn)的分泌,从而削弱了LepR+细胞的促血管生成能力。敲除间充质干细胞衍生的 Ptn 可抑制体外人脐静脉 EC 管的形成。更重要的是,在局部给予重组 PTN 可恢复 CD31hiEmcnhi 内皮的频率,并挽救 LepR-Cre; Yapf/f; Tazf/f 小鼠的低骨量表型。综上所述,这些研究结果表明,咬合力通过Yap/Taz/Ptn轴调控间充质干细胞调节内皮维持牙槽骨稳态,为进一步了解功能障碍与骨稳态之间的关系提供了参考。
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引用次数: 0
Tongue-Coating Microbial and Metabolic Characteristics in Halitosis 口臭的舌苔微生物和代谢特征
IF 7.6 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-04-16 DOI: 10.1177/00220345241230067
Y. Zhang, K.L. Lo, A.N. Liman, X.P. Feng, W. Ye
Halitosis is a common oral condition, which leads to social embarrassment and affects quality of life. Cumulative evidence has suggested the association of tongue-coating microbiome with the development of intraoral halitosis. The dynamic variations of tongue-coating microbiota and metabolites in halitosis have not been fully elucidated. Therefore, the present study aimed to determine the tongue-coating microbial and metabolic characteristics in halitosis subjects without other oral diseases using metagenomics and metabolomics analysis. The participants underwent oral examination, halitosis assessment, and tongue-coating sample collection for the microbiome and metabolome analysis. It was found that the microbiota richness and diversity were significantly elevated in the halitosis group. Furthermore, species from Actinomyces, Prevotella, Veillonella, and Solobacterium were significantly more abundant in the halitosis group. However, the Rothia and Streptococcus species exhibited opposite tendencies. Eleven Kyoto Encyclopedia of Genes and Genomes pathways were significantly enriched in the halitosis tongue coatings, including cysteine and methionine metabolism. Functional genes related to sulfur, indole, skatole, and cadaverine metabolic processes (such as serA, metH, metK and dsrAB) were identified to be more abundant in the halitosis samples. The metabolome analysis revealed that indole-3-acetic, ornithine, and L-tryptophan were significantly elevated in the halitosis samples. Furthermore, it was observed that the values of volatile sulfur compounds and indole-3-acetic abundances were positively correlated. The multiomics analysis identified the metagenomic and metabolomic characteristics to differentiate halitosis from healthy individuals using the least absolute shrinkage and selection operator logistic regression and random forest classifier. A total of 19 species and 39 metabolites were identified as features in halitosis patients, which included indole-3-acetic acid, Bacillus altitudinis, Candidatus Saccharibacteria, and Actinomyces species. In conclusion, an evident shift in microbiome and metabolome characteristics was observed in the halitosis tongue coating, which may have a potential etiological significance and provide novel insights into the mechanism for halitosis.
口臭是一种常见的口腔疾病,会导致社交尴尬并影响生活质量。累积的证据表明,舌苔微生物群与口腔内口臭的发生有关。舌苔微生物群和代谢物在口臭中的动态变化尚未完全阐明。因此,本研究旨在通过元基因组学和代谢组学分析,确定无其他口腔疾病的口臭受试者的舌苔微生物和代谢特征。参与者接受了口腔检查、口臭评估和舌苔样本采集,以进行微生物组和代谢组分析。结果发现,口臭组的微生物群丰富度和多样性明显增加。此外,口臭组中放线菌属、普雷沃特菌属、维龙菌属和索尔杆菌属的物种明显更多。然而,罗氏菌和链球菌则表现出相反的趋势。在口臭舌苔中,《京都基因和基因组百科全书》中的 11 个通路明显富集,包括半胱氨酸和蛋氨酸代谢。在口臭样本中,与硫、吲哚、鳐鱼碱和尸碱代谢过程有关的功能基因(如 serA、metH、metK 和 dsrAB)含量较高。代谢组分析表明,口臭样本中的吲哚-3-乙酸、鸟氨酸和 L-色氨酸明显升高。此外,还发现挥发性硫化合物的含量与吲哚-3-乙酸的含量呈正相关。多组学分析利用最小绝对收缩和选择算子逻辑回归和随机森林分类器确定了区分口臭和健康人的元基因组和代谢组特征。结果发现,口臭患者共有 19 个物种和 39 种代谢物,其中包括吲哚-3-乙酸、高度芽孢杆菌、酵母菌和放线菌。总之,在口臭舌苔中观察到了微生物组和代谢组特征的明显变化,这可能具有潜在的病因学意义,并为口臭的机制提供了新的见解。
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引用次数: 0
Periodontitis, Dental Procedures, and Young-Onset Cryptogenic Stroke 牙周炎、牙科手术与青年隐源性中风
IF 7.6 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-04-16 DOI: 10.1177/00220345241232406
J. Leskelä, J. Putaala, N. Martinez-Majander, L. Tulkki, M. Manzoor, S. Zaric, P. Ylikotila, R. Lautamäki, A. Saraste, S. Suihko, E. Könönen, J. Sinisalo, P.J. Pussinen, S. Paju
Periodontitis is associated with an increased risk of ischemic stroke, and the risk may be particularly high among young people with unexplained stroke etiology. Thus, we investigated in a case-control study whether periodontitis or recent invasive dental treatments are associated with young-onset cryptogenic ischemic stroke (CIS). We enrolled participants from a multicenter case-control SECRETO study including adults aged 18 to 49 y presenting with an imaging-positive first-ever CIS and stroke-free age- and sex-matched controls. Thorough clinical and radiographic oral examination was performed. Furthermore, we measured serum lipopolysaccharide (LPS) and lipotechoic acid (LTA) levels. Multivariate conditional regression models were adjusted for stroke risk factors, regular dentist visits, and patent foramen ovale (PFO) status. We enrolled 146 case-control pairs (median age 41.9 y; 58.2% males). Periodontitis was diagnosed in 27.5% of CIS patients and 20.1% of controls ( P < 0.001). In the fully adjusted models, CIS was associated with high periodontal inflammation burden (odds ratio [OR], 95% confidence interval) with an OR of 10.48 (3.18–34.5) and severe periodontitis with an OR of 7.48 (1.24–44.9). Stroke severity increased with the severity of periodontitis, having an OR of 6.43 (1.87–23.0) in stage III to IV, grade C. Invasive dental treatments performed within 3 mo prestroke were associated with CIS, with an OR of 2.54 (1.01–6.39). Association between CIS and invasive dental treatments was especially strong among those with PFO showing an OR of 6.26 (1.72–40.2). LPS/LTA did not differ between CIS patients and controls but displayed an increasing trend with periodontitis severity. Periodontitis and recent invasive dental procedures were associated with CIS after controlling for multiple confounders. However, the role of bacteremia as a mediator of this risk was not confirmed.
牙周炎与缺血性脑卒中风险的增加有关,在脑卒中病因不明的年轻人中,这种风险可能尤其高。因此,我们在一项病例对照研究中调查了牙周炎或最近的侵入性牙科治疗是否与年轻时发生的隐源性缺血性中风(CIS)有关。我们从一项多中心病例对照 SECRETO 研究中招募了参与者,包括年龄在 18 至 49 岁、首次出现影像学阳性 CIS 的成人,以及无中风的年龄和性别匹配的对照组。我们进行了全面的临床和放射口腔检查。此外,我们还测量了血清脂多糖(LPS)和脂回声酸(LTA)水平。多变量条件回归模型对中风风险因素、定期看牙医和卵圆孔状态进行了调整。我们共纳入了 146 对病例对照(中位年龄为 41.9 岁;58.2% 为男性)。27.5%的CIS患者和20.1%的对照组患者被诊断患有牙周炎(P < 0.001)。在完全调整模型中,CIS 与高牙周炎症负担有关(几率比 [OR],95% 置信区间),OR 为 10.48(3.18-34.5),与严重牙周炎有关,OR 为 7.48(1.24-44.9)。脑卒中严重程度随牙周炎严重程度的增加而增加,III 至 IV 期 C 级的 OR 为 6.43(1.87-23.0)。脑卒中前 3 个月内进行的侵入性牙科治疗与 CIS 相关,OR 为 2.54(1.01-6.39)。在患有 PFO 的患者中,CIS 与侵入性牙科治疗之间的关系尤为密切,OR 值为 6.26(1.72-40.2)。LPS/LTA 在 CIS 患者和对照组之间没有差异,但随着牙周炎严重程度的增加而呈上升趋势。在控制了多种混杂因素后,牙周炎和最近的侵入性牙科手术与 CIS 相关。然而,菌血症在这一风险中的中介作用并未得到证实。
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引用次数: 0
Spatiotemporal Evolution of Developing Palate in Mice 小鼠腭部发育的时空演变
IF 7.6 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-04-15 DOI: 10.1177/00220345241232317
B. Wang, Z. Zhang, J. Zhao, Y. Ma, Y. Wang, N. Yin, T. Song
The intricate formation of the palate involves a series of complex events, yet its mechanistic basis remains uncertain. To explore major cell populations in the palate and their roles during development, we constructed a spatiotemporal transcription landscape of palatal cells. Palate samples from C57BL/6 J mice at embryonic days 12.5 (E12.5), 14.5 (E14.5), and 16.5 (E16.5) underwent single-cell RNA sequencing (scRNA-seq) to identify distinct cell subsets. In addition, spatial enhanced resolution omics-sequencing (stereo-seq) was used to characterize the spatial distribution of these subsets. Integrating scRNA-seq and stereo-seq with CellTrek annotated mesenchymal and epithelial cellular components of the palate during development. Furthermore, cellular communication networks between these cell subpopulations were analyzed to discover intercellular signaling during palate development. From the analysis of the middle palate, both mesenchymal and epithelial populations were spatially segregated into 3 domains. The middle palate mesenchymal subpopulations were associated with tooth formation, ossification, and tissue remodeling, with initial state cell populations located proximal to the dental lamina. The nasal epithelium of the palatal shelf exhibited richer humoral immune responses than the oral side. Specific enrichment of Tgfβ3 and Pthlh signals in the midline epithelial seam at E14.5 suggested a role in epithelial–mesenchymal transition. In summary, this study provides high-resolution transcriptomic information, contributing to a deeper mechanistic understanding of palate biology and pathophysiology.
腭的形成错综复杂,涉及一系列复杂的事件,但其机理基础仍不确定。为了探索腭部的主要细胞群及其在发育过程中的作用,我们构建了腭细胞的时空转录图谱。我们对胚胎 12.5 天(E12.5)、14.5 天(E14.5)和 16.5 天(E16.5)的 C57BL/6 J 小鼠腭部样本进行了单细胞 RNA 测序(scRNA-seq),以确定不同的细胞亚群。此外,还利用空间增强分辨率omics测序(stereo-seq)来描述这些亚群的空间分布特征。将 scRNA-seq 和立体测序与 CellTrek 相结合,注释了腭部发育过程中的间充质和上皮细胞成分。此外,还分析了这些细胞亚群之间的细胞通讯网络,以发现腭发育过程中的细胞间信号传导。通过对中腭的分析,间充质和上皮细胞群在空间上被分为三个区域。中腭间充质亚群与牙齿形成、骨化和组织重塑有关,其初始状态细胞群位于牙层近端。与口腔侧相比,腭架鼻腔上皮表现出更丰富的体液免疫反应。在E14.5时,Tgfβ3和Pthlh信号在中线上皮接缝中的特异性富集表明了其在上皮-间质转化中的作用。总之,这项研究提供了高分辨率的转录组信息,有助于加深对腭生物学和病理生理学的机理认识。
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引用次数: 0
Strategies for Improving Impaired Osseointegration in Compromised Animal Models 改善受损动物模型骨结合能力的策略
IF 7.6 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-04-15 DOI: 10.1177/00220345241231777
J. Deng, C. Van Duyn, D. J. Cohen, Z. Schwartz, B. D. Boyan
Implant osseointegration is reduced in patients with systemic conditions that compromise bone quality, such as osteoporosis, disuse syndrome, and type 2 diabetes. Studies using rodent models designed to mimic these compromised conditions demonstrated reduced bone-to-implant contact (BIC) or a decline in bone mineral density. These adverse effects are a consequence of disrupted intercellular communication. A variety of approaches have been developed to compensate for the altered microenvironment inherent in compromised conditions, including the use of biologics and implant surface modification. Chemical and physical modification of surface properties at the microscale, mesoscale, and nanoscale levels to closely resemble the surface topography of osteoclast resorption pits found in bone has proven to be a highly effective strategy for improving implant osseointegration. The addition of hydrophilicity to the surface further enhances osteoblast response at the bone-implant interface. These surface modifications, applied either alone or in combination, improve osseointegration by increasing proliferation and osteoblastic differentiation of osteoprogenitor cells and enhancing angiogenesis while modulating osteoclast activity to achieve net new bone formation, although the specific effects vary with surface treatment. In addition to direct effects on surface-attached cells, the communication between bone marrow stromal cells and immunomodulatory cells is sensitive to these surface properties. This article reports on the advances in titanium surface modifications, alone and in combination with novel therapeutics in animal models of human disease affecting bone quality. It offers clinically translatable perspectives for clinicians to consider when using different surface modification strategies to improve long-term implant performance in compromised patients. This review supports the use of surface modifications, bioactive coatings, and localized therapeutics as pragmatic approaches to improve BIC and enhance osteogenic activity from both structural and molecular standpoints.
骨质疏松症、废用综合征和 2 型糖尿病等全身性疾病会降低患者的种植体骨结合力。利用啮齿动物模型模仿这些受损情况进行的研究表明,骨与种植体的接触(BIC)减少或骨矿物质密度下降。这些不良影响都是细胞间通信中断的结果。目前已开发出多种方法来弥补受损条件下固有的微环境改变,包括使用生物制剂和种植体表面改性。事实证明,在微观、中观和纳米层面对表面特性进行化学和物理修饰,使其与骨中破骨细胞吸收凹坑的表面形貌非常相似,是改善种植体骨结合的一种非常有效的策略。表面亲水性的增加进一步增强了骨-种植体界面的成骨细胞反应。这些表面修饰可以单独使用,也可以联合使用,通过增加骨生成细胞的增殖和成骨分化,增强血管生成,同时调节破骨细胞的活性,实现新骨的净形成,从而改善骨结合。除了对表面附着细胞的直接影响外,骨髓基质细胞和免疫调节细胞之间的交流对这些表面特性也很敏感。本文报告了在影响骨质的人类疾病动物模型中,钛表面改性技术单独或与新型疗法相结合所取得的进展。它为临床医生在使用不同的表面改性策略改善受损患者的长期植入性能时提供了可转化的临床视角。本综述从结构和分子角度支持使用表面改性、生物活性涂层和局部治疗作为改善 BIC 和增强成骨活性的实用方法。
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引用次数: 0
The Alcohol Harm Paradox in Periodontitis 牙周炎的酒精危害悖论
IF 7.6 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-04-12 DOI: 10.1177/00220345241235614
L.M. Oliveira, F.B. Zanatta, S.A. Costa, T.R. Pelissari, S.E. Baumeister, F.F. Demarco, G.G. Nascimento
Individuals of lower socioeconomic position (SEP) experience a greater rate of alcohol-related harms, yet they consume equal or lower amounts of alcohol than higher-SEP individuals. This phenomenon, called the “alcohol harm paradox” (AHP), gained attention recently, and different mechanisms have been proposed to explain it. Since both SEP and alcohol have been suggested to be associated with periodontitis risk, we conducted a secondary analysis using data from the National Health and Nutrition Examination Survey 2011 to 2012 and 2013 to 2014 cycles, aiming to examine 1) whether the association between alcohol consumption and periodontitis is modified by SEP and 2) the extent to which the effect of SEP inequalities on periodontitis is mediated by and/or interacts with alcohol consumption. We set educational attainment as the main SEP proxy and tested the poverty income ratio in subsequent sensitivity analyses. Effect measure modification analysis was employed, considering heavy drinking as exposure, and causal mediation analysis based on the potential outcome’s framework decomposed the effect of SEP on periodontitis in proportions attributable to mediation and interaction. Models were fitted using binary logistic regression and adjusted for sex, ethnicity, age, body mass index, smoking status, diabetes, binge drinking, and regular preventive dental visits. The analytical sample comprised 4,057 participants. After adjusting for covariates, less educated heavy drinkers presented 175% (odds ratio, 2.75; 95% confidence interval [CI], 2.04–3.72) higher odds of periodontitis than their counterparts, and super-additive associations were found (relative excess risk due to interaction: 1.35; 95% CI, 0.49–2.20). Additionally, −69.5% (95% CI, −122.1% to −16.8%) of the effects of education on periodontitis were attributable to interaction with heavy drinking, consistent with the AHP. No contribution was found for the mechanism of mediation. Heavy drinking disproportionately impacts the occurrence of periodontitis in lower-SEP individuals. Lower-SEP individuals seem to experience differential effects of heavy drinking on periodontitis.
与社会经济地位较高的人相比,社会经济地位较低的人与酒精相关的危害更大,但他们的酒精消费量却与之相当或更低。这种现象被称为 "酒精危害悖论"(AHP),最近引起了人们的关注,并提出了不同的解释机制。由于 SEP 和酒精都被认为与牙周炎风险有关,我们利用 2011 至 2012 年和 2013 至 2014 年两次全国健康与营养调查的数据进行了二次分析,旨在研究:1)酒精消费与牙周炎之间的关联是否会因 SEP 而改变;2)SEP 不平等对牙周炎的影响在多大程度上受酒精消费的介导和/或与酒精消费相互作用。我们将教育程度作为主要的 SEP 替代指标,并在随后的敏感性分析中测试了贫困收入比率。我们采用了效应测量修正分析,将大量饮酒视为暴露,并根据潜在结果框架进行了因果中介分析,将 SEP 对牙周炎的影响分解为可归因于中介和相互作用的比例。使用二元逻辑回归对模型进行了拟合,并对性别、种族、年龄、体重指数、吸烟状况、糖尿病、暴饮暴食和定期牙科预防就诊进行了调整。分析样本包括 4,057 名参与者。在对协变量进行调整后,受教育程度较低的酗酒者患牙周炎的几率比同龄人高出 175%(几率比,2.75;95% 置信区间 [CI],2.04-3.72),并且发现了超叠加关系(交互作用导致的相对超额风险:1.35;95% CI,0.49-2.20)。此外,教育对牙周炎影响的-69.5%(95% CI,-122.1% 至-16.8%)可归因于与大量饮酒的交互作用,这与 AHP 一致。在中介机制方面没有发现任何贡献。大量饮酒对低教育水平人群牙周炎的发生产生了不成比例的影响。大量饮酒对牙周炎的影响似乎与低教育水平人群不同。
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引用次数: 0
Microstructural, Micromechanical Atlas of the Temporomandibular Joint Disc 颞下颌关节盘微结构、微机械图谱
IF 7.6 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-04-10 DOI: 10.1177/00220345241227822
N. Jiang, P. Tan, Y. Sun, J. Zhou, R. Ren, Z. Li, S. Zhu
The temporomandibular joint (TMJ) disc is mainly composed of collagen, with its arrangement responding to efficient stress distribution. However, microstructural and micromechanical transformations of the TMJ disc under resting, functional, and pathological conditions remain unclear. To address this, our study presents a high-resolution microstructural and mechanical atlas of the porcine TMJ disc. First, the naive microstructure and mechanical properties were investigated in porcine TMJ discs (resting and functional conditions). Subsequently, the perforation and tear models (pathological conditions) were compared. Following this, a rabbit model of anterior disc displacement (abnormal stress) was studied. Results show diverse microstructures and mechanical properties at the nanometer to micrometer scale. In the functional state, gradual unfolding of the crimping cycle in secondary and tertiary structures leads to D-cycle prolongation in the primary structure, causing tissue failure. Pathological conditions lead to stress concentration near the injury site due to collagen interfibrillar traffic patterns, resulting in earlier damage manifestation. Additionally, the abnormal stress model shows collagen damage initiating at the primary structure and extending to the superstructure over time. These findings highlight collagen’s various roles in different pathophysiological states. Our study offers valuable insights into TMJ disc function and dysfunction, aiding the development of diagnostic and therapeutic strategies for TMJ disorders, as well as providing guidance for the design of structural biomimetic materials.
颞下颌关节(TMJ)椎间盘主要由胶原蛋白组成,其排列对有效的应力分布做出反应。然而,颞下颌关节椎间盘在静息、功能和病理条件下的微结构和微机械转变仍不清楚。为了解决这个问题,我们的研究提供了猪颞下颌关节盘的高分辨率微结构和机械图谱。首先,研究了猪颞下颌关节盘(静息和功能状态)的天真微观结构和机械性能。随后,对穿孔和撕裂模型(病理条件)进行了比较。随后,研究了兔椎间盘前部移位模型(异常应力)。研究结果表明,在纳米到微米尺度上,椎间盘具有不同的微观结构和机械性能。在功能状态下,二级和三级结构中的卷曲周期逐渐展开,导致一级结构中的 D 周期延长,造成组织破坏。病理状态下,由于胶原纤维间的交通模式,会导致损伤部位附近的应力集中,从而提前出现损伤。此外,异常应力模型显示胶原蛋白损伤始于初级结构,并随着时间的推移扩展到上层建筑。这些发现凸显了胶原蛋白在不同病理生理状态下的各种作用。我们的研究为颞下颌关节盘功能和功能障碍提供了宝贵的见解,有助于颞下颌关节疾病诊断和治疗策略的开发,并为结构生物仿生材料的设计提供指导。
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引用次数: 0
A Polygenic Score Predicts Caries Experience in Elderly Swedish Adults 多基因评分可预测瑞典老年人的龋齿情况
IF 7.6 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-04-08 DOI: 10.1177/00220345241232330
N. Fries, S. Haworth, J.R. Shaffer, A. Esberg, K. Divaris, M.L. Marazita, I. Johansson
Caries is a partially heritable disease, raising the possibility that a polygenic score (PS, a summary of an individual’s genetic propensity for disease) might be a useful tool for risk assessment. To date, PS for some diseases have shown clinical utility, although no PS for caries has been evaluated. The objective of the study was to test whether a PS for caries is associated with disease experience or increment in a cohort of Swedish adults. A genome-wide PS for caries was trained using the results of a published genome-wide association meta-analysis and constructed in an independent cohort of 15,460 Swedish adults. Electronic dental records from the Swedish Quality Registry for Caries and Periodontitis (SKaPa) were used to compute the decayed, missing, and filled tooth surfaces (DMFS) index and the number of remaining teeth. The performance of the PS was evaluated by testing the association between the PS and DMFS at a single dental examination, as well as between the PS and the rate of change in DMFS. Participants in the highest and lowest deciles of PS had a mean DMFS of 63.5 and 46.3, respectively. A regression analysis confirmed this association where a 1 standard deviation increase in PS was associated with approximately 4-unit higher DMFS ( P < 2 × 10−16). Participants with the highest decile of PS also had greater change in DMFS during follow-up. Results were robust to sensitivity analysis, which adjusted for age, age squared, sex, and the first 20 genetic principal components. Mediation analysis suggested that tooth loss was a strong mediating factor in the association between PS and DMFS but also supported a direct genetic effect on caries. In this cohort, there are clinically meaningful differences in DMFS between participants with high and low PS for caries. The results highlight the potential role of genomic data in improving caries risk assessment.
龋病是一种部分遗传的疾病,因此多基因评分(PS,个人遗传倾向的总结)有可能成为风险评估的有用工具。迄今为止,针对某些疾病的多基因评分已显示出临床实用性,但还没有针对龋齿的多基因评分进行过评估。本研究的目的是在瑞典成年人队列中测试龋齿的 PS 是否与疾病经历或增量相关。利用已发表的全基因组关联荟萃分析的结果,对龋齿的全基因组PS进行了训练,并在一个由15460名瑞典成年人组成的独立队列中构建了该PS。瑞典龋病和牙周炎质量登记处(SKaPa)的电子牙科记录用于计算龋坏、缺失和填充牙面(DMFS)指数和剩余牙齿数量。通过测试单次牙科检查时 PS 与 DMFS 之间的关联以及 PS 与 DMFS 变化率之间的关联,对 PS 的性能进行了评估。PS值最高和最低十分位数的参与者的平均DMFS分别为63.5和46.3。回归分析证实了这一关联,即PS每增加1个标准差,DMFS就会增加约4个单位(P < 2 × 10-16)。PS值最高十分位数的参与者在随访期间的DMFS变化也更大。敏感性分析对年龄、年龄平方、性别和前20个遗传主成分进行了调整,结果是稳健的。中介分析表明,牙齿缺失是PS与DMFS之间关联的一个强有力的中介因素,但也支持龋齿的直接遗传效应。在该队列中,龋齿PS高和PS低的参与者之间的DMFS存在有临床意义的差异。研究结果凸显了基因组数据在改善龋齿风险评估方面的潜在作用。
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引用次数: 0
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Journal of Dental Research
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