Supramolecular self-assembly of novel thermo-responsive double-hydrophilic and hydrophobic Y-shaped [MPEO-b-PEtOx-b-(PCL)2] terpolymers

Nonlinear amphiphilic block copolymer architectures with precisely controlled structures bring new challenges to biomedical materials research.

Biocompatible succinic acid-based polyesters for potential biomedical applications: fungal biofilm inhibition and mesenchymal stem cell growth

Poly(alkene succinates) are promising materials for specialized medical devices and tissue engineering, presenting intrinsic properties, such as; fungal biofilm inhibition, biocompatibility and stem cells controlled growth promotion.

Automated CBED processing: sample thickness estimation based on analysis of zone-axis CBED pattern

An automated processing of convergent beam electron diffraction (CBED) patterns is presented. The proposed methods are used in an automated tool for estimating the thickness of transmission electron microscopy (TEM) samples by matching an experimental zone-axis CBED pattern with a series of patterns simulated for known thicknesses. The proposed tool detects CBED disks, localizes a pattern in detected disks and unifies the coordinate system of the experimental pattern with the simulated one. The experimental pattern is then compared disk-by-disk with a series of simulated patterns each corresponding to different known thicknesses. The thickness of the most similar simulated pattern is then taken as the thickness estimate. The tool was tested on [0 1 1] Si, [0 1 0] α-Ti and [0 1 1] α-Ti samples prepared using different techniques. Results of the presented approach were compared with thickness estimates based on analysis of CBED patterns in two beam conditions. The mean difference between these two methods was 4.1% for the FIB-prepared silicon samples, 5.2% for the electro-chemically polished titanium and 7.9% for Ar(+) ion-polished titanium. The proposed techniques can also be employed in other established CBED analyses. Apart from the thickness estimation, it can potentially be used to quantify lattice deformation, structure factors, symmetry, defects or extinction distance.

Impact of radiation history, gender and age on bone quality in sites for orthodontic skeletal anchorage device placement

AIMS

Stability of orthodontic miniscrew implants is prerequisite to their success and durability in orthodontic treatment. As investigations revealed a positive correlation of miniscrew stability to periimplant bone quality, it has been the aim of this study to analyze the bone structure of resection preparations of human mandibles histologically by investigating the samples according to age, gender and exposure to radiotherapy.

METHODS

Inflammation- and tumor-free alveolar bone sections from human mandibles (n = 31) with previously diagnosed carcinoma, chronic osteomyelitis or cysts were analyzed histomorphologically and histomorphometrically as to the dimension of trabeculae in cancellous areas. Group A investigated the impact of a history of radiation therapy, group B of gender and group C contrasted biopsies from individuals aging under 60 or over 60 years. Statistics were performed using the Kruskal-Wallis-test.

RESULTS

Radiation, gender and age did not significantly influence bone density. The mean bone density averaged 40.7 ± 15.0% of spongiosa for the total collective with a median age of 58.4 years ± 14.7 years.

CONCLUSIONS

Our findings provide new information on bone quality, thus contributing to a more precise evaluation of the parameters affecting and those not affecting miniscrew implant stability. On the basis of these results, the formulation of clinical guidelines for risk assessment of therapeutic approaches in patients prior to insertion of orthodontic skeletal anchorage devices seems to be conceivable.

Comparison of shear bond strength of plastic and ceramic brackets

OBJECTIVES

The purpose of this in vitro study is to compare the shear bond strength of various esthetic brackets used in conjunction with two different adhesive systems.

METHODS

Five non-silanized ceramic brackets (Aspire Gold/Forestadent, Clarity™/3M Unitek, CLEAR/Adenta, Contour Twin/ODS, QuicKlear/Forestadent) and four plastic brackets (Aesthetik-Line®/Forestadent, Brillant®/Forestadent, Composite Clear®/ODS, Elegance®/Dentaurum) were bonded either with Transbond™ XT (3M Unitek, Monrovia, CA, USA) or with ConTec SE (Dentaurum, Ispringen, Germany) to bovine permanent mandibular incisors. Twelve specimens were tested in each group, thus, bonding 60 ceramic and 48 plastic brackets with either adhesive to a total of 216 teeth. Shear bond strength was measured in accordance with the DIN 13990-2 standard governing test methods for the entire attachment-adhesive-enamel system. The fracture surfaces resulting from shear-induced debonding were analyzed via light microscopy.

RESULTS

The combinations Clarity™ + Transbond™ XT, CLEAR® + Transbond™ XT, and Contour Twin + Transbond™ XT exhibited shear bond strengths of over 10 MPa. The Adhesive Remnant Index scores of the various bracket types varied widely according to the different bracket-base designs. No enamel fractures were observed.

CONCLUSION

Some bracket-adhesive combinations in this study attained shear bond strengths approaching those of metal brackets. The risk of debonding-related enamel defects is comparable with different esthetic bracket combinations. Manufacturers' recommendations for the adhesive systems to be used with their brackets should be strictly adhered to.

A systematic review and meta-analysis of experimental clinical evidence on initial aligning archwires and archwire sequences

The aim of the study was to assess treatment effects and potential side effects of different archwires used on patients receiving orthodontic therapy. Electronic and manual unrestricted searches were conducted in 19 databases including MEDLINE, Cochrane Library, and Google Scholar until April 2012 to identify randomized controlled trials (RCTs) and quasi-RCTs. After duplicate study selection, data extraction, risk of bias assessment with the Cochrane risk of bias tool, and narrative analysis, mean differences (MDs) with confidence intervals (CIs) of similar studies were pooled using a random-effects model and evaluated with GRADE. A total of 16 RCTs were included assessing different archwire characteristics on 1108 patients. Regarding initial archwires, meta-analysis of two trials found slightly greater irregularity correction with an austenitic-active nickel-titanium (NiTi) compared with an martensitic-stabilized NiTi archwire (corresponding to MD: 1.11 mm, 95% CI: -0.38 to 2.61). Regarding archwire sequences, meta-analysis of two trials found it took patient treated with a sequence of martensitic-active copper-nickel-titanium (CuNiTi) slightly longer to reach the working archwire (MD: 0.54 months, 95% CI: -0.87 to 1.95) compared with a martensitic-stabilized NiTi sequence. However, patients treated with a sequence of martensitic-active CuNiTi archwires reported general greater pain intensity on the Likert scale 4 h and 1 day after placement of each archwire, compared with a martensitic-stabilized NiTi sequence. Although confidence in effect estimates ranged from moderate to high, meta-analyses could be performed only for limited comparisons, while inconsistency might pose a threat to some of them. At this point, there is insufficient data to make recommendations about the majority of initial archwires or for a specific archwire sequence.

Strong association of variants around FOXE1 and orofacial clefting

Nonsyndromic orofacial clefting (nsOFC) is a common, complex congenital disorder. The most frequent forms are nonsyndromic cleft lip with or without cleft palate (nsCL/P) and nonsyndromic cleft palate only (nsCPO). Although they are generally considered distinct entities, a recent study has implicated a region around the FOXE1 gene in both nsCL/P and nsCPO. To investigate this hypothesis, we analyzed the 2 most strongly associated markers (rs3758249 and rs4460498) in 2 independent samples of differing ethnicities: Central European (949 nsCL/P cases, 155 nsCPO cases, 1163 controls) and Mayan Mesoamerican (156 nsCL/P cases, 10 nsCPO cases, 338 controls). While highly significant associations for both single-nucleotide polymorphisms were obtained in nsCL/P (rs4460498: p Europe = 6.50 × 10(-06), p Mayan = .0151; rs3758249: p Europe = 2.41 × 10(-05), p Mayan = .0299), no association was found in nsCPO (p > .05). Genotyping of rs4460498 in 472 independent European trios revealed significant associations for nsCL/P (p = .016) and nsCPO (p = .043). A meta-analysis of all data revealed a genomewide significant result for nsCL/P (p = 1.31 × 10(-08)), which became more significant when nsCPO cases were added (p nsOFC = 1.56 × 10(-09)). These results strongly support the FOXE1 locus as a risk factor for nsOFC. With the data of the initial study, there is now considerable evidence that this locus is the first conclusive risk factor shared between nsCL/P and nsCPO.

Novel poly(ethylene oxide monomethyl ether)-b-poly(ε-caprolactone) diblock copolymers containing a pH-acid labile ketal group as a block linkage

Acidic physiological conditions trigger degradation of amphiphilic block copolymers containing a ketal group as a block linkage into biocompatible degradation products.

Osteoimmunological mechanisms involved in orthodontically and bacterially induced periodontal stress

BACKGROUND AND OBJECTIVE

Orthodontic tooth movement is known to cause sterile inflammation of the periodontal ligament (PDL). It may also be accompanied by pathological effects of external apical root resorption, with interindividual differences in the incidence and extent of resorption. An involvement of autoimmunological mechanisms is currently under discussion. This study aimed to improve our understanding of similarities between the inflammatory mechanisms underlying the pathophysiology of periodontitis and root resorption.

MATERIALS AND METHODS

Human PDL cells were stimulated with interleukin (IL)-1β/IL-17A/IFN-γ, or left non-stimulated. Their potential for phagocytosis was then evaluated by incubation with dextran or E. coli or S. aureus particles, followed by flow cytometric and immunohistochemical analysis. Real-time polymerase chain reaction (PCR) was used to analyze receptor activator of NF-κB ligand (RANKL) and osteoprotegerin (OPG) expression in PDL cells. Verification was obtained in vivo by studying IL-17A, RANKL, and OPG expression in biopsies of inflamed periodontal tissues and in biopsies of rat maxillae with mechanically induced root resorption. Statistical analysis included Wilcoxon's rank sum test to analyze gene expression data and one-way ANOVA in conjunction with Tukey's post hoc test to analyze flow cytometric data.

RESULTS

PDL cells phagocytosed foreign particles under both inflammatory and non-inflammatory conditions. Furthermore, IL-17A significantly downregulated RANKL expression while significantly upregulating OPG expression in PDL cells. These immunomodulatory cytokines were also demonstrable in both inflammatorily altered periodontal tissues and root resorption lacunae, while the incidence of IL-7A was strikingly variable in resorption areas.

CONCLUSION

PDL cells were demonstrated to effect phagocytosis and to express immunomodulatory molecules, which proves their capability of participating in periodontal osteoimmunological processes. The development of root resorption and periodontitis appears to be governed by similar pathophysiological mechanisms.

Numerical simulation and biomechanical analysis of an orthodontically treated periodontally damaged dentition

BACKGROUND AND OBJECTIVE

Once periodontitis has been completely resolved, one common follow-up method is to carry out orthodontic treatment to take advantage of the residual bone, i.e., via tooth intrusion. In this study, the biomechanical behavior of teeth in a reduced periodontium was studied by numerically simulating upper-incisor intrusion accomplished with various orthodontic mechanics.

MATERIALS AND METHODS

Using the finite element method, a patient-customized 3D model of a periodontally reduced dentition was generated in order to simulate tooth movement. The morphology of this upper-jaw model was derived from cone-beam computed tomography (CBCT) datasets of four patients. Material parameters were adopted from previous investigations, including teeth (E=20 GPa), periodontal ligament (PDL) (bilinear elastic; E1=0.05 MPa; E2=0.20 MPa; ε12=7%), and bone (homogeneous, isotropic; E=2 GPa). Two intrusion scenarios were used, the first drawing from Burstone's segmented-arch technique to intrude four splinted incisors at a time, and the second one using cantilevers to intrude single incisors. The aforementioned PDL material parameters were varied in several ways to simulate different biological and biomechanical states of PDL. All simulations were recalculated with an idealized, periodontally intact model to assess the effect of bone loss by way of comparison.

RESULTS

Single-tooth intrusion via cantilever mechanics was accompanied by less rotation than the segmented-arch approach. Both intrusion systems involved significantly greater degrees of tooth displacement and PDL load in the periodontally reduced model.

CONCLUSION

Periodontally reduced dentitions are associated with an increased load on periodontal tissue. This can be counteracted by reducing orthodontic force levels and by selecting mechanics that do not harm the tissue. In so doing, the use of numerical methods may greatly facilitate individualized computer-aided treatment-planning strategies.

MRI graduation of osseous reaction and drill hole consolidation after arthroscopic Bankart repair with PLLA anchors and the clinical relevance

PURPOSE

Conventionally, radiography studies revealed prolonged glenoidal drill hole visibilities with an unclear influence to the clinical outcome after arthroscopic Bankart repair using Poly-Laevo-Lactic-Acid (PLLA) anchors. The primary aim of the present study was the separated assessment of drill hole consolidation (DHC) and the concomitant osseous reaction (OR) of the glenoidal bio-degradation process in new specific magnetic resonance grading systems. In accordance with the specific DHC and the OR graduation, the clinical relevance was the secondary focus.

METHODS

Twenty-eight patients with arthroscopic Bankart repair using knotless PLLA anchors were prospectively followed and analyzed using a clinical scoring system (3, 6, 15 and 32 months). The T2-weighted OR and T1-weighted DHC were assessed using specific magnetic resonance imaging grading protocols (15 and 32 months).

RESULTS

Longitudinal assessments revealed successive clinical status improvements over time (32 months: Rowe 95.7 ± 3.8; Walch-Duplay 93.8 ± 6.6; Constant 93.9 ± 4.5; ASES 93.8 ± 6.9; DASH 28.6 ± 7.2; NAS(pain) 1.1 ± 1.3; NAS(function) 1.3 ± 1.4). The initial OR level regressed over the 15-32 month period while the DHC showed significant drill hole reductions (P < 0.05). The inferior glenoid revealed a significantly increased bio-degradation capacity (P < 0.05) with drill hole enlargements in 14.3%. Neither the OR nor the drill hole enlargements influenced the clinical status. In no case were clinical or radiologic signs for a foreign body reaction.

CONCLUSION

Knotless bio-anchors provide secure glenoidal fixation for Bankart repair without any specific clinical or MR evidence of an inflammatory response. The clinical status remained unaffected by the bio-degradation process.

LEVEL OF EVIDENCE

IV.

[Database supported electronic retrospective analyses in radiation oncology: establishing a workflow using the example of pancreatic cancer]

PURPOSE

Especially in the field of radiation oncology, handling a large variety of voluminous datasets from various information systems in different documentation styles efficiently is crucial for patient care and research. To date, conducting retrospective clinical analyses is rather difficult and time consuming. With the example of patients with pancreatic cancer treated with radio-chemotherapy, we performed a therapy evaluation by using an analysis system connected with a documentation system.

MATERIALS AND METHODS

A total number of 783 patients have been documented into a professional, database-based documentation system. Information about radiation therapy, diagnostic images and dose distributions have been imported into the web-based system.

RESULTS

For 36 patients with disease progression after neoadjuvant chemoradiation, we designed and established an analysis workflow. After an automatic registration of the radiation plans with the follow-up images, the recurrence volumes are segmented manually. Based on these volumes the DVH (dose volume histogram) statistic is calculated, followed by the determination of the dose applied to the region of recurrence. All results are saved in the database and included in statistical calculations.

CONCLUSION

The main goal of using an automatic analysis tool is to reduce time and effort conducting clinical analyses, especially with large patient groups. We showed a first approach and use of some existing tools, however manual interaction is still necessary. Further steps need to be taken to enhance automation. Already, it has become apparent that the benefits of digital data management and analysis lie in the central storage of data and reusability of the results. Therefore, we intend to adapt the analysis system to other types of tumors in radiation oncology.

Potential role of high mobility group box protein 1 and intermittent PTH (1-34) in periodontal tissue repair following orthodontic tooth movement in rats

OBJECTIVES

Recent studies indicate that high mobility group box protein 1 (HMGB1) can be released by necrotic and damaged cells and functions as an alarmin that is recognized by the innate immune system. Little is known about the role of HMGB1 within the periodontal ligament (PDL). Therefore, we examined HMGB1 expression by PDL cells in vitro and compared the findings to an in vivo model of orthodontically induced tooth root resorption. In addition, we addressed the question of whether a potentially anabolic intermittent administration of parathyroid hormone (iPTH) would modulate the expression of HMGB1.

MATERIALS AND METHODS

In confluent PDL cell cultures, HMGB1 messenger RNA (mRNA) expression was quantified by real-time polymerase chain reaction. In a rat model comprising 25 animals, mechanical loading for 5 days was followed by administration of either iPTH (1-34) systemically or sham injections for up to 56 days. HMGB1 expression was determined by means of immunohistochemistry and histomorphometry.

RESULTS

The in vitro experiments revealed an inhibitory effect of iPTH on basal HMGB1 mRNA expression in confluent PDL cells. In vivo, the mechanical force-induced enhanced HMGB1 protein expression declined time dependently. Intermittent PTH further inhibited HMGB1 expression. The significantly higher basal HMGB1 protein expression in the former compression side was followed by a more pronounced time- and iPTH-dependent decline in the same area.

CONCLUSIONS

These data indicate a major role for HMGB1 in the regulation of PDL wound healing following mechanical load-induced tissue injury.

CLINICAL RELEVANCE

The findings point to the potential benefit of iPTH in the attempt to support these immune-associated reparative processes.

Human periodontal ligament cells facilitate leukocyte recruitment and are influenced in their immunomodulatory function by Th17 cytokine release

The objective of this in vitro study was to examine the immunomodulatory impact of human periodontal ligament (PDL) cells on the nature and magnitude of the leukocyte infiltrate in periodontal inflammation, particularly with regard to Th17 cells. PDL cells were challenged with pro-inflammatory cytokines (IL-1ß, IL-17A, and IFN-γ) and analyzed for the expression of cytokines involved in periodontal immunoinflammatory processes (IL-6, MIP-3 alpha, IL-23A, TGFß1, IDO, and CD274). In order to further investigate a direct involvement of PDL cells in leukocyte function, co-culture experiments were conducted. The expression of the immunomodulatory cytokines studied was significantly increased under pro-inflammatory conditions in PDL cells. Although PDL cells did not stimulate leukocyte proliferation or Th17 differentiation, these cells induced the recruitment of leukocytes. The results of our study suggest that PDL cells might be involved in chronic inflammatory mechanisms in periodontal tissues and thus in the transition to an adaptive immune response in periodontitis.