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Exploring Recent Decreases in First Molar Sealants among US Children. 探索美国儿童第一颗臼齿密封剂最近的减少情况。
Pub Date : 2024-05-01 Epub Date: 2024-02-27 DOI: 10.1177/00220345241231774
M Lin, S O Griffin, C H Li, L Wei, L Espinoza, C Y Wang, G Thornton-Evans

Analyses of National Health and Nutrition Examination Survey (NHANES) data suggested a significant decrease in sealant prevalence among children between 2011 to 2014 and 2015 to 2018. We explore whether this decrease could be associated with possible changes in 1) clinical sealant delivery, 2) dental materials (i.e., increased use of glass ionomer [GI] sealants resulting in an inability to detect sealant fragments that still provide preventive benefits or increased use of composite restorations leading to misclassifying sealants as restorations), and 3) examination sensitivity and specificity. We used NHANES data to estimate the prevalences of sealants, untreated caries, and restorations in ≥1 first permanent molar among children aged 7 to 10 y and used Medical Expenditure Panel Survey data to estimate the annual clinical delivery of sealants and fluoride treatments. We examined changes in outcomes between 2 periods (P < 0.05) controlling for selected sociodemographic characteristics. NHANES sealant examination quality was based on the reference examiner's replicate examinations. The adjusted prevalence of sealants decreased relatively by 27.5% (46.6% vs. 33.8%). Overall, untreated caries decreased. Untreated caries and restoration decreased among children without sealants. Annual clinical sealant delivery did not change, whereas fluoride treatment delivery increased. The decrease in sealant prevalence held when assessed for various age ranges and NHANES cycle combinations. While sealant examination specificity remained similar between the periods, sensitivity (weighted by the proportion of exams by each examiner) decreased relatively by 17.4% (0.92 vs. 0.76). These findings suggest that decreased sealant prevalence was not supported by decreased clinical sealant delivery nor increased use of composite restorations. Decreased examination sensitivity, which could be due to an increased use of GI sealants, could contribute to the decrease in sealant prevalence. The decrease in caries among children without sealants could suggest the increased use of GI sealants. However, we could not rule out that the decrease in caries could be attributable to increased fluoride treatment delivery.

对美国国家健康与营养调查(NHANES)数据的分析表明,在 2011 年至 2014 年和 2015 年至 2018 年期间,儿童的封闭剂使用率显著下降。我们探讨了这种下降是否与以下方面可能发生的变化有关:1)临床密封剂供应;2)牙科材料(即玻璃离子聚合物密封剂的使用增加,导致无法检测到仍能提供预防益处的密封剂碎片,或复合修复体的使用增加,导致将密封剂误认为修复体);3)检查敏感性和特异性。我们使用 NHANES 数据估算了 7-10 岁儿童中封闭剂、未治疗的龋齿和≥1 颗第一恒磨牙修复的流行率,并使用医疗支出小组调查数据估算了每年封闭剂和氟化物治疗的临床用量。我们研究了两个时期之间结果的变化(P < 0.05),并对选定的社会人口特征进行了控制。NHANES 密封剂检查质量基于参考检查人员的重复检查结果。调整后的封闭剂使用率相对下降了 27.5%(46.6% 对 33.8%)。总体而言,未经治疗的龋齿有所减少。在未使用封闭剂的儿童中,未经治疗的龋齿和修复有所减少。每年的临床封闭剂用量没有变化,而氟化物治疗用量有所增加。在对不同年龄段和 NHANES 周期组合进行评估时,封闭剂使用率的下降趋势保持不变。虽然封闭剂检查的特异性在不同时期保持相似,但敏感性(按每位检查人员的检查比例加权)相对下降了 17.4%(0.92 对 0.76)。这些发现表明,临床封闭剂用量的减少或复合树脂修复体使用量的增加并不支持封闭剂使用率的下降。检查敏感性的降低可能是由于消化道封闭剂使用的增加,这也可能是封闭剂使用率降低的原因之一。未使用封闭剂的儿童的龋齿率下降,可能表明使用消化道封闭剂的情况有所增加。不过,我们也不能排除龋齿减少的原因可能是氟化物治疗的增加。
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引用次数: 0
Letter to the Editor, "Autophagy Plays a Crucial Role in Ameloblast Differentiation". 致编辑的信,“自噬在成釉细胞分化中起关键作用”。
Pub Date : 2024-04-01 Epub Date: 2023-11-15 DOI: 10.1177/00220345231210462
S Sukseree, R Gruber, E Tschachler, L Eckhart
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引用次数: 0
Biological Properties of 3D-Printed Zirconia Implants with p-Cell Structures. 具有 p 细胞结构的 3D 打印氧化锆假体的生物特性。
Pub Date : 2024-04-01 Epub Date: 2024-02-19 DOI: 10.1177/00220345231222819
W Qin, M H Shen, N Gan, B H Xing, J Sun, Z Zhao, T Jiao

Research on 3-dimensional (3D) printed porous zirconia-based dental implants is still in its infancy. This study aimed to evaluate the biological responses of novel zirconia implants with p-cell structures fabricated by 3D printing. The solid zirconia samples exhibited comparable density, 3-point flexural strength, and accelerated aging properties compared to specimens prepared previously by conventional methods. Cell-based experiments showed that the p-cell structure promoted cell proliferation, adhesion, and osteogenesis-related protein expression. Mechanical tests showed that both p-cell and control implants could withstand a torque of 35 Ncm without breaking. The mean maximum breaking loads of p-cell and control implants were 1,222.429 ± 115.591 N and 1,903.857 ± 250.673 N, respectively, which were much higher than the human physiological chewing force and human mean maximum occlusal force. An animal experiment showed that the bone trabeculae around the implants were significantly thicker, more numerous, and denser in the p-cell group than in the control group. This work could provide promising guidance for further exploring 3D printing techniques for porous zirconia bionic implants in dentistry.

有关三维(3D)打印多孔氧化锆牙科植入物的研究仍处于起步阶段。本研究旨在评估通过三维打印技术制造的具有多孔结构的新型氧化锆种植体的生物反应。与之前用传统方法制备的样本相比,固体氧化锆样本表现出相当的密度、三点抗弯强度和加速老化性能。基于细胞的实验表明,p-细胞结构促进了细胞增殖、粘附和成骨相关蛋白的表达。机械测试表明,p-细胞和对照组植入物都能承受 35 Ncm 的扭矩而不断裂。p-cell 种植体和对照组种植体的平均最大断裂载荷分别为 1,222.429 ± 115.591 N 和 1,903.857 ± 250.673 N,远高于人体生理咀嚼力和人体平均最大咬合力。动物实验表明,p-细胞组种植体周围的骨小梁明显比对照组厚、多、密。这项研究为进一步探索牙科中多孔氧化锆仿生种植体的 3D 打印技术提供了很好的指导。
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引用次数: 0
Intelligently Quantifying the Entire Irregular Dental Structure. 智能量化整个不规则牙齿结构
Pub Date : 2024-04-01 Epub Date: 2024-02-19 DOI: 10.1177/00220345241226871
H Liu, J Duan, P Zeng, M Shi, J Zeng, S Chen, Z Gong, Z Chen, J Qin, Z Chen

Quantitative analysis of irregular anatomical structures is crucial in oral medicine, but clinicians often typically measure only several representative indicators within the structure as references. Deep learning semantic segmentation offers the potential for entire quantitative analysis. However, challenges persist, including segmentation difficulties due to unclear boundaries and acquiring measurement landmarks for clinical needs in entire quantitative analysis. Taking the palatal alveolar bone as an example, we proposed an artificial intelligence measurement tool for the entire quantitative analysis of irregular dental structures. To expand the applicability, we have included lightweight networks with fewer parameters and lower computational demands. Our approach finally used the lightweight model LU-Net, addressing segmentation challenges caused by unclear boundaries through a compensation module. Additional enamel segmentation was conducted to establish a measurement coordinate system. Ultimately, we presented the entire quantitative information within the structure in a manner that meets clinical needs. The tool achieved excellent segmentation results, manifested by high Dice coefficients (0.934 and 0.949), intersection over union (0.888 and 0.907), and area under the curve (0.943 and 0.949) for palatal alveolar bone and enamel in the test set. In subsequent measurements, the tool visualizes the quantitative information within the target structure by scatter plots. When comparing the measurements against representative indicators, the tool's measurement results show no statistically significant difference from the ground truth, with small mean absolute error, root mean squared error, and errors interval. Bland-Altman plots and intraclass correlation coefficients indicate the satisfactory agreement compared with manual measurements. We proposed a novel intelligent approach to address the entire quantitative analysis of irregular image structures in the clinical setting. This contributes to enabling clinicians to swiftly and comprehensively grasp structural features, facilitating the design of more personalized treatment plans for different patients, enhancing clinical efficiency and treatment success rates in turn.

不规则解剖结构的定量分析在口腔医学中至关重要,但临床医生通常只测量结构内的几个代表性指标作为参考。深度学习语义分割为整个定量分析提供了可能。然而,挑战依然存在,包括边界不清导致的分割困难,以及在整个定量分析中获取临床所需的测量地标。以腭齿槽骨为例,我们提出了一种人工智能测量工具,用于不规则牙齿结构的整体定量分析。为了扩大适用范围,我们加入了参数更少、计算要求更低的轻量级网络。我们的方法最终使用了轻量级模型 LU-Net,通过补偿模块解决了边界不清晰造成的分割难题。我们还进行了额外的釉质分割,以建立测量坐标系。最终,我们以符合临床需求的方式呈现了结构内的全部定量信息。该工具取得了出色的分割结果,在测试集中,腭齿槽骨和釉质的狄斯系数(0.934 和 0.949)、相交大于结合(0.888 和 0.907)和曲线下面积(0.943 和 0.949)都很高。在随后的测量中,该工具通过散点图将目标结构内的定量信息可视化。在将测量结果与代表性指标进行比较时,该工具的测量结果显示与基本真实值没有显著的统计学差异,平均绝对误差、均方根误差和误差间隔都很小。布兰德-阿尔特曼图和类内相关系数表明,与人工测量结果相比,两者的一致性令人满意。我们提出了一种新颖的智能方法来解决临床环境中不规则图像结构的整个定量分析问题。这有助于临床医生快速、全面地掌握结构特征,为不同患者设计更个性化的治疗方案,从而提高临床效率和治疗成功率。
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引用次数: 0
Composite Containing Calcium Phosphate Particles Functionalized with 10-MDP. 含有 10-MDP 功能化磷酸钙颗粒的复合材料。
Pub Date : 2024-04-01 Epub Date: 2024-01-29 DOI: 10.1177/00220345231225459
R A A da Silva, R B Trinca, H S Vilela, R R Braga

The phosphate ester monomer 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) is capable of bonding to hydroxyapatite and, for this reason, is a key component of several self-etch adhesives. In this study, dicalcium phosphate dihydrate particles (DCPD; CaHPO4.2H2O) were functionalized with 10-MDP and used to formulate an experimental composite with 50 vol% inorganic content (3:1 DCPD:silanated barium glass ratio) dispersed in a BisGMA/TEGDMA matrix. The tested hypothesis was that DCPD functionalization would improve the composite's mechanical performance without compromising Ca2+ release. Composites containing nonfunctionalized DCPD or only reinforcing glass (in both cases, with or without 10-MDP mixed in the resin phase) were used as controls. Materials were tested for degree of conversion (DC; by Fourier transform infrared spectroscopy), water sorption (WS) and solubility (SL; according to ISO 4049), biaxial flexural strength (BFS)/modulus (FM) after 24 h and 5 mo in water, and 28-d Ca2+ release in water (by plasma-coupled optical emission spectroscopy). Data were analyzed using analysis of variance/Tukey test (alpha: 5%). DCPD functionalization did not interfere with DC. The composite containing functionalized DCPD showed significantly lower WS and SL in comparison with the material formulated with nonfunctionalized particles. The presence of 10-MDP (as a functionalizing agent or dispersed in the resin phase) reduced the composite's initial BFS and FM. After 5 mo in water, the composite with functionalized DCPD and both glass-only composites were able to maintain their mechanical properties at levels statistically similar to what was observed after 24 h. Ca2+ release was significantly reduced in both formulations containing 10-MDP. In conclusion, DCPD functionalization with 10-MDP increased the composite's resistance to hydrolytic degradation, improving its mechanical stability after prolonged water storage. However, the impaired water transit at the particle-matrix interface led to a reduction in Ca2+ release.

磷酸酯单体 10-甲基丙烯酰氧癸基二氢磷酸酯(10-MDP)能够与羟基磷灰石结合,因此是几种自刻蚀粘合剂的主要成分。在这项研究中,二水磷酸二钙颗粒(DCPD;CaHPO4.2H2O)被 10-MDP 功能化,并用于配制一种无机物含量为 50 Vol%(DCPD:硅烷化玻璃钡比例为 3:1)、分散在 BisGMA/TEGDMA 基质中的实验复合材料。测试假设是,DCPD 功能化将改善复合材料的机械性能,同时不影响 Ca2+ 的释放。含有未官能化 DCPD 或仅含有增强玻璃的复合材料(在这两种情况下,树脂相中都混有或不混有 10-MDP)被用作对照组。对材料的转化度(DC;通过傅立叶变换红外光谱法)、吸水性(WS)和可溶性(SL;根据 ISO 4049 标准)、在水中浸泡 24 小时和 5 个月后的双轴抗弯强度(BFS)/模量(FM)以及在水中浸泡 28 天后的 Ca2+ 释放量(通过等离子体耦合光学发射光谱法)进行了测试。数据采用方差分析/Tukey 检验(α:5%)进行分析。DCPD 功能化不会干扰 DC。与使用非官能化颗粒配制的材料相比,含有官能化 DCPD 的复合材料的 WS 和 SL 明显较低。10-MDP 的存在(作为官能化剂或分散在树脂相中)降低了复合材料的初始 BFS 和 FM。在水中浸泡 5 个月后,含有功能化 DCPD 的复合材料和两种纯玻璃复合材料都能保持其机械性能,在统计上与 24 小时后观察到的情况相似。总之,用 10-MDP 对 DCPD 进行官能化可增强复合材料的抗水解降解能力,从而提高其在长时间储水后的机械稳定性。然而,颗粒-基质界面上的水分传输受阻导致 Ca2+ 释放量减少。
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引用次数: 0
Effect of Periodontitis and Periodontal Therapy on Oral and Gut Microbiota. 牙周炎和牙周治疗对口腔和肠道微生物群的影响
Pub Date : 2024-04-01 Epub Date: 2024-02-16 DOI: 10.1177/00220345231222800
G Baima, I Ferrocino, V Del Lupo, E Colonna, V Thumbigere-Math, G P Caviglia, I Franciosa, G M Mariani, M Romandini, D G Ribaldone, F Romano, M Aimetti

Mounting evidence indicates that periodontitis-related oral bacteria may contribute to gut microbial dysbiosis. This clinical study aimed to explore the oral-gut microbial signatures associated with periodontitis and to longitudinally evaluate the effect of periodontal treatment on the oral and gut microbial composition. Stool and saliva samples from generalized stage III/IV periodontitis patients (n = 47) were collected and analyzed by 16S ribosomal RNA gene amplicon sequencing, before and 3 mo after steps I to II of periodontal therapy. Periodontally healthy matched subjects (n = 47) were used as controls. Principal component analysis was carried out to identify oral-gut microbial profiles between periodontitis patients at baseline and healthy subjects; periodontitis samples were longitudinally compared before and after treatment. β-Diversity of gut microbial profiles of periodontitis patients before treatment significantly differed from healthy controls (P < 0.001). Periodontal therapy was associated with a significant change in gut microbiota (P < 0.001), with post-treatment microbial profiles similar to healthy volunteers. A higher abundance of Bacteroides, Faecalibacterium, Fusobacterium, and Lachnospiraceae was noted in fecal samples of periodontitis patients at baseline compared to healthy controls. In contrast, Lactobacillus was the only genus more abundant in the latter. Additionally, periodontal therapy led to a parallel reduction in the salivary carriage of periodontal pathobionts, as well as gut Bacteroides, Lachnoclostridium, Lachnospiraceae, Oscillospiraceae, and Ruminococcaceae, to levels similar to healthy controls. Collectively, discriminating oral-gut microbial signatures of periodontitis were found. Periodontal treatment both mitigated oral dysbiosis and altered gut microbial composition, signifying potential broader implications for gastrointestinal health and disease.

越来越多的证据表明,与牙周炎相关的口腔细菌可能会导致肠道微生物菌群失调。这项临床研究旨在探索与牙周炎相关的口腔-肠道微生物特征,并纵向评估牙周治疗对口腔和肠道微生物组成的影响。研究人员收集了全身性 III/IV 期牙周炎患者(n = 47)的粪便和唾液样本,并在牙周治疗步骤 I 至 II 之前和之后 3 个月对样本进行了 16S 核糖体 RNA 基因扩增片段测序分析。牙周健康的匹配受试者(47 人)作为对照。进行主成分分析以确定牙周炎患者基线与健康受试者之间的口腔肠道微生物特征;对治疗前后的牙周炎样本进行纵向比较。治疗前牙周炎患者肠道微生物图谱的 β-多样性与健康对照组有显著差异(P < 0.001)。牙周治疗与肠道微生物群的显著变化有关(P < 0.001),治疗后的微生物图谱与健康志愿者相似。与健康对照组相比,牙周炎患者的粪便样本中乳酸杆菌、粪杆菌、镰刀菌和漆树菌的丰度较高。相比之下,乳酸杆菌是后者中唯一较多的菌属。此外,牙周治疗也会导致牙周致病菌的唾液携带量以及肠道乳杆菌属、拉氏菌属、拉氏ospiraceae、Oscillospiraceae 和 Ruminococcaceae 的唾液携带量减少,达到与健康对照组相似的水平。总之,我们发现了牙周炎的口腔-肠道微生物特征。牙周治疗既缓解了口腔菌群失调,又改变了肠道微生物组成,这对胃肠道健康和疾病具有潜在的广泛影响。
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引用次数: 0
Neighborhood Deprivation and Changes in Oral Health in Older Age: A Longitudinal Population-Based Study. 邻里贫困与老年人口腔健康的变化:基于人口的纵向研究。
Pub Date : 2024-04-01 Epub Date: 2024-02-27 DOI: 10.1177/00220345231224337
S G Ganbavale, E Papachristou, J C Mathers, A O Papacosta, L T Lennon, P H Whincup, S G Wannamethee, S E Ramsay

The aim of this study was to examine the extent to which neighborhood-level socioeconomic factors (objective and perceived) are associated with poor oral health in older adults over time, independent of individual socioeconomic position. Data for this cross-sectional and longitudinal observation study came from a socially and geographically representative cohort of men aged 71 to 92 y in 2010-12 (n = 1,622), drawn from British general practices, which was followed up in 2018-19 (aged 78-98 y; N = 667). Dental measures at both times included number of teeth, periodontal pocket depth, self-rated oral health, and dry mouth. Neighborhood deprivation was based on Index of Multiple Deprivation (IMD) and a cumulative index measuring perceptions about local environment. Individual-level socioeconomic position was based on longest-held occupation. Multilevel and multivariate logistic regressions, adjusted for relevant sociodemographic, behavioral, and health-related factors, were performed to examine the relationships of dental measures with IMD and perceived neighborhood quality index, respectively. Cross-sectionally, risks of tooth loss, periodontal pockets, and dry mouth increased from IMD quintiles 1 to 5 (least to most deprived); odds ratios (ORs) for quintile 5 were 2.22 (95% confidence interval [CI], 1.41-3.51), 2.82 (95% CI, 1.72-4.64), and 1.51 (95% CI, 1.08-2.09), respectively, after adjusting for sociodemographic, behavioral, and health-related factors. Risks of increased pocket depth and dry mouth were significantly greater in quintile 5 (highest problems) of perceived neighborhood quality index compared to quintile 1. Over the 8-y follow-up, deterioration of dentition (tooth loss) was significantly higher in the most deprived IMD quintiles after full adjustment (OR for quintile 5 = 2.32; 95% CI, 1.09-4.89). Deterioration of dentition and dry mouth were significantly greater in quintile 5 of perceived neighborhood quality index. Neighborhood-level factors were associated with poor oral health in older age, both cross-sectionally and longitudinally, particularly with tooth loss, and dry mouth, independent of individual-level socioeconomic position.

本研究的目的是探讨邻里层面的社会经济因素(客观的和感知的)在多大程度上与老年人长期的口腔健康状况不良有关,而与个人的社会经济地位无关。这项横断面和纵向观察研究的数据来自一个具有社会和地理代表性的队列,该队列中的男性在2010-12年间的年龄为71至92岁(n=1622),他们来自英国的全科诊所,该队列在2018-19年间接受了随访(年龄为78至98岁;n=667)。这两个时间段的牙科测量指标包括牙齿数量、牙周袋深度、口腔健康自评和口干。邻里贫困程度基于多重贫困指数(IMD)和衡量当地环境感知的累积指数。个人层面的社会经济地位基于从事时间最长的职业。在对相关的社会人口、行为和健康相关因素进行调整后,分别进行了多层次和多变量逻辑回归,以检验牙科指标与多重贫困指数(IMD)和感知邻里质量指数之间的关系。从横截面来看,牙齿脱落、牙周袋和口干的风险从IMD五分位数1到5(从最贫困到最贫困)依次增加;调整社会人口、行为和健康相关因素后,五分位数5的几率比(ORs)分别为2.22(95% 置信区间[CI],1.41-3.51)、2.82(95% CI,1.72-4.64)和1.51(95% CI,1.08-2.09)。与五分位数 1 相比,五分位数 5(问题最多)的感知邻里质量指数出现牙周袋深度增加和口干的风险明显更高。在 8 年的随访中,经过全面调整后,最贫困的 IMD 五分位数人群的牙质恶化(牙齿脱落)程度明显更高(五分位数 5 的 OR = 2.32;95% CI,1.09-4.89)。在感知邻里质量指数的五分位数中,牙质恶化和口干的程度明显更高。无论从横向还是纵向来看,邻里层面的因素都与老年人口腔健康状况不佳有关,尤其是与牙齿脱落和口干有关,与个人层面的社会经济地位无关。
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引用次数: 0
In Situ Photo-Crosslinkable Protein Bioadhesive for Bone Graft Fixation. 用于骨移植固定的原位光交联蛋白生物粘合剂
Pub Date : 2024-04-01 Epub Date: 2024-02-05 DOI: 10.1177/00220345231224709
J Yun, I H Nam, H Lee, Y K Jo, H Lee, S H Jun, H J Cha

Bone grafting is a fundamental dental surgery procedure widely used for implant placement and periodontal disease management treatments. Despite its broad applications, vertical bone augmentation presents unique challenges, including the risk of graft displacement due to gravitational and masticatory forces. Traditional physical stabilization methods introduce additional complexities and risks, underscoring the need for innovative fixation technologies. This study aimed to develop an in situ photo-crosslinkable bioadhesive hydrogel (iPBAH) as a multifunctional bone graft binder to enhance the process of bone reconstruction. The bioadhesive is composed of mussel-derived adhesive protein (MAP) fused with the cell-adhesive peptide RGD. The numerous tyrosine residues in MAP facilitate rapid photo-crosslinking, enabling efficient hydrogel formation using visible blue light. Subsequently, iPBAH underwent comprehensive characterization to evaluate its suitability as a multifunctional bone graft binder. iPBAH efficiently underwent in situ crosslinking through harmless exposure to visible light within minutes and displayed several exceptional properties, including a microporous structure, underwater adhesion, extended durability, high compressive strength, and biocompatibility. In vivo assessments, using male Sprague-Dawley rats, demonstrated that iPBAH binder significantly enhanced bone regeneration in a rat calvarial bone defect model. The in situ crosslinking of the iPBAH binder during bone graft transplantation can effectively fill irregular and complex defect shapes while simultaneously preventing graft material leakage. The improved physical attributes of the bound graft material can enhance its resistance to external forces, thereby ensuring sustained retention over time. Moreover, the interaction between iPBAH and surrounding tissues promotes adhesion and integration of the graft material with host tissues in the defect area. In addition, the included RGD peptide in iPBAH can augment inherent cell recruitment, adhesion, and growth, consequently expediting osteogenesis.

植骨是一种基本的牙科手术方法,广泛用于种植体植入和牙周病治疗。尽管应用广泛,但垂直骨增量术也面临着独特的挑战,包括因重力和咀嚼力而导致移植骨移位的风险。传统的物理稳定方法带来了额外的复杂性和风险,突出了对创新固定技术的需求。本研究旨在开发一种原位光交联生物粘合剂水凝胶(iPBAH),作为一种多功能骨移植物粘合剂,以改善骨重建过程。这种生物粘合剂由贻贝源粘合蛋白(MAP)与细胞粘合肽 RGD 融合而成。MAP 中的大量酪氨酸残基有助于快速光交联,从而在可见蓝光下高效形成水凝胶。iPBAH 可在数分钟内通过无害的可见光照射实现原位交联,并显示出多种优异特性,包括微孔结构、水下粘附性、持久性、高抗压强度和生物相容性。使用雄性 Sprague-Dawley 大鼠进行的体内评估表明,iPBAH 粘合剂可显著促进大鼠腓骨缺损模型中的骨再生。在骨移植过程中,iPBAH 粘合剂的原位交联可有效填充不规则和复杂的缺损形状,同时防止移植材料渗漏。粘合后的移植物材料物理属性得到改善,可增强其抵抗外力的能力,从而确保长期的持续保留。此外,iPBAH 与周围组织的相互作用还能促进移植材料与缺损区域宿主组织的粘附和整合。此外,iPBAH 中的 RGD 肽还能增强固有细胞的募集、粘附和生长,从而加快成骨过程。
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引用次数: 0
Response to Letter, "Autophagy Plays a Crucial Role in Ameloblast Differentiation". 对题为 "自噬在釉母细胞分化中发挥关键作用 "的信件的回复
Pub Date : 2024-04-01 Epub Date: 2024-02-21 DOI: 10.1177/00220345241231770
C Iwaya, J Iwata
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引用次数: 0
Heterogeneous Association of Tooth Loss with Functional Limitations. 牙齿缺失与功能限制的异质性关联
Pub Date : 2024-04-01 DOI: 10.1177/00220345241226957
Y Matsuyama, J Aida, K Kondo, K Shiba

Tooth loss is prevalent in older adults and associated with functional capacity decline. Studies on the susceptibility of some individuals to the effects of tooth loss are lacking. This study aimed to investigate the heterogeneity of the association between tooth loss and higher-level functional capacity in older Japanese individuals employing a machine learning approach. This is a prospective cohort study using the data of adults aged ≥65 y in Japan (N = 16,553). Higher-level functional capacity, comprising instrumental independence, intellectual activity, and social role, was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC). The scale ranged from 0 (lowest function) to 13 (highest function). Doubly robust targeted maximum likelihood estimation was used to estimate the population-average association between tooth loss (having <20 natural teeth) and TMIG-IC total score after 6 y. The heterogeneity of the association was evaluated by estimating conditional average treatment effects (CATEs) using the causal forest algorithm. The result showed that tooth loss was statistically significantly associated with lower TMIG-IC total scores (population-average effect: -0.14; 95% confidence interval, -0.18 to -0.09). The causal forest analysis revealed the heterogeneous associations between tooth loss and lower TMIG-IC total score after 6 y (median of estimated CATEs = -0.13; interquartile range = 0.12). The high-impact subgroup (i.e., individuals with estimated CATEs of the bottom 10%) were significantly more likely to be older and male, had a lower socioeconomic status, did not have a partner, and had poor health conditions compared with the low-impact subgroup (i.e., individuals with estimated CATEs of the top 10%). This study found that heterogeneity exists in the association between tooth loss and lower scores on functional capacity. Implementing tooth loss prevention policy and clinical measures, especially among vulnerable subpopulations significantly affected by tooth loss, may reduce its burden more effectively.

牙齿脱落在老年人中很普遍,并与机能下降有关。目前还缺乏关于某些人对牙齿脱落影响的易感性的研究。本研究采用机器学习方法,旨在调查日本老年人牙齿脱落与高级功能能力之间关系的异质性。这是一项前瞻性队列研究,使用的是日本年龄≥65 岁成年人的数据(N = 16,553 人)。研究使用东京都老年学研究所能力指数(TMIG-IC)对老年人的高级功能能力(包括工具独立性、智力活动和社会角色)进行了评估。该指数从 0(最低功能)到 13(最高功能)不等。采用双稳健目标最大似然估计法来估算牙齿缺失(有牙齿)与社会角色之间的人群平均关联。
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Journal of dental research
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