This study retrospectively evaluated the effects of bone density, staging strategy, implant stability, healing process, implant length, surface type, and photofunctionalization on early implant ...failure.
Consecutive study samples at Yokohama City University Hospital were analyzed for their early implant failure potentially influenced by patient-, surgical protocol-, and implant-related factors. Through the screening process using univariate analysis for those factors, candidate influential factors such as bone density, staging strategy, the level of initial implant stability, postoperative wound breakdown, the length of implants, the surface type of implants, and use or nonuse of photofunctionalization were selected as independent variables in forward multivariate logistic regression analysis. The odds ratio (OR) for candidate factors was calculated.
A total of 563 implants placed in 219 patients from 2005 to 2017 were analyzed for their early implant failure. Stepwise logistic regression analysis finally identified postoperative wound breakdown (OR = 0.21) and the use of photofunctionalization (OR = 0.30) that significantly reduced the risk of early implant failure (P < .01 and P < .05, respectively). The implant failure rate was 10.0% with postoperative wound breakdown and 1.0% without it, whereas it was 4.3% without photofunctionalization and 1.3% with it.
Among various patient-, surgical protocol-, and implant-related factors, the absence of postoperative wound breakdown and use of photofunctionalization significantly reduced the risk of early implant failure. It was notable that photofunctionalization, a unique, chairside measure to improve implant surfaces, was effective exclusively among implant-related factors.
The objective of this study was to compare the rate of implant stability development of as-received and photofunctionalized dental implants in regular and complex cases.
Forty-nine implants (24 ...as-received and 25 photofunctionalized) placed in regular or complex cases (simultaneous guided bone regeneration, sinus elevation, or fresh extraction sockets) were studied. Photofunctionalization was performed by ultraviolet (UV) treatment of implants for 15 minutes using a photo device immediately prior to placement, and the generation of superhydrophilicity was confirmed. Implant stability was evaluated by measuring the implant stability quotient (ISQ) at placement (ISQ1) and at stage-two surgery (ISQ2). The rate of implant stability development was evaluated by calculating the osseointegration speed index (OSI), defined as the ISQ increase per month (ISQ2-ISQ1/healing time in months). The percentage of innate bone support at placement was evaluated clinically and radiographically.
The average OSI was considerably greater for photofunctionalized implants (3.7 ± 2.9) than for as-received implants (0.0 ± 1.0). The OSI in complex cases was 4.2 ± 3.2 for photofunctionalized implants and 0.2 ± 0.9 for as-received implants. The OSI in cases with simultaneous sinus elevation was 5.5 ± 3.5 for photofunctionalized implants and 0.2 ± 1.1 for as-received implants. Photofunctionalized implants showed significantly higher ISQ2 values than as-received implants. Photofunctionalized implant ISQ2 values were greater than 60, regardless of primary stability and innate bone support at placement. In multivariate analysis including the effects of photofunctionalization, age and sex of patients, and diameter and length of implants, photofunctionalization showed the strongest influence on the OSI for both regular and complex cases, while other factors influenced the OSI only in certain conditions.
Photofunctionalization accelerated the rate and enhanced the final level of implant stability development compared with as-received implants, particularly for implants placed into poor-quality bone and other complex cases. Photofunctionalization was a stronger determinant of implant stability than all the other tested implant- and host-related factors.
Despite the fact that radiation is one of the standard therapies in the treatment of patients with oral cancer, tumours can recur even in the early stages of the disease, negatively impacting ...prognosis and quality of life. We previously found that CD11b(+) bone marrow-derived cells (BMDCs) were recruited into human glioblastoma multiforme (GBM), leading to re-organization of the vasculature and tumour regrowth. However, it is not yet known how these cells contribute to tumour vascularization. In the present study, we investigated the role of infiltrating CD11b(+) myeloid cells in the vascularization and recurrence of oral squamous cell carcinoma (OSCC). In a xenograft mouse model, local irradiation caused vascular damage and hypoxia in the tumour and increased infiltration of CD11b(+) myeloid cells. These infiltrating cells showed characteristics of M2 macrophages (M2Mφs) and are associated with the promotion of vascularization. M2Mφs promoted tumour progression in recurrence after irradiation compared to non-irradiated tumours. In addition, we found that CD11b(+) myeloid cells, as well as CD206(+) M2Mφs, are increased during recurrence after radiotherapy in human OSCC specimens. Our findings may lead to the development of potential clinical biomarkers or treatment targets in irradiated OSCC patients.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Non-alcoholic fatty liver disease (NAFLD) is a hepatic manifestation of metabolic syndrome that is closely associated with multiple factors such as obesity, hyperlipidemia and type 2 diabetes ...mellitus. However, other risk factors for the development of NAFLD are unclear. With the association between periodontal disease and the development of systemic diseases receiving increasing attention recently, we conducted this study to investigate the relationship between NAFLD and infection with Porphyromonas gingivalis (P. gingivalis), a major causative agent of periodontitis.
The detection frequencies of periodontal bacteria in oral samples collected from 150 biopsy-proven NAFLD patients (102 with non-alcoholic steatohepatitis (NASH) and 48 with non-alcoholic fatty liver (NAFL) patients) and 60 non-NAFLD control subjects were determined. Detection of P. gingivalis and other periodontopathic bacteria were detected by PCR assay. In addition, effect of P. gingivalis-infection on mouse NAFLD model was investigated. To clarify the exact contribution of P. gingivalis-induced periodontitis, non-surgical periodontal treatments were also undertaken for 3 months in 10 NAFLD patients with periodontitis.
The detection frequency of P. gingivalis in NAFLD patients was significantly higher than that in the non-NAFLD control subjects (46.7% vs. 21.7%, odds ratio: 3.16). In addition, the detection frequency of P. gingivalis in NASH patients was markedly higher than that in the non-NAFLD subjects (52.0%, odds ratio: 3.91). Most of the P. gingivalis fimbria detected in the NAFLD patients was of invasive genotypes, especially type II (50.0%). Infection of type II P. gingivalis on NAFLD model of mice accelerated the NAFLD progression. The non-surgical periodontal treatments on NAFLD patients carried out for 3 months ameliorated the liver function parameters, such as the serum levels of AST and ALT.
Infection with high-virulence P. gingivalis might be an additional risk factor for the development/progression of NAFLD/NASH.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Ultraviolet (UV)-mediated photofunctionalization has earned considerable attention for the enhancement of the biologic capabilities of titanium. The effects of photofunctionalization on bone ...augmentation and gap closure were examined using titanium implants and mesh in a rat femur model.
An acid-etched titanium implant (4-mm length, 1-mm diameter) was placed in the gluteal tuberosity that resembles a knife-edge-like edentulous ridge. The lower half of the implant was located in a 2-mm-diameter defect created in the bone without cortical bone support; the upper half was exposed and covered with a titanium mesh to provide augmentation space. After 12 and 24 days of healing, specimens were subjected to microcomputed tomography (micro-CT)- and histology-based bone morphometry in three zones of analysis: augmentation, cortical bone-implant gap, and bone marrow. A biomechanical push-in test was performed to examine the strength of bone-implant integration. Photofunctionalization was performed by treating titanium implants and mesh with UV light for 12 minutes.
Photofunctionalized titanium mesh and implants were hydrophilic, whereas untreated controls were hydrophobic. Bone volume was significantly greater in photofunctionalized implants and mesh than in untreated implants in all zones on days 12 and 24. Bone-to-implant contact of photofunctionalized implants was greater than that of untreated implants, not just in the bone marrow but also in the gap and augmented zones. The strength of osseointegration was three times greater for photofunctionalized implants than for untreated implants.
Use of photofunctionalized titanium mesh and implants effectively enhanced vertical bone augmentation, cortical bone-implant gap closure, and osseointegration without innate bone support.
Abstract Coating biomaterials with a thin hydroxyapatite (HA) was proven effective in enhancing bone compatibility. Segmental bone defects are considered as the most difficult defect to repair in ...bone regeneration therapy. We developed submicron-thin HA-coated titanium fiber mesh scaffolds to reconstruct immediately loaded segmental mandibular defects and evaluated their bone compatibility in vitro and in vivo . Human osteoblasts attachment, proliferation, and osteocalcin expression in non- and HA-coated scaffolds were evaluated. A 10-mm long segmental bone defect in a rabbit mandibular bone was reconstructed with non- or HA-coated scaffolds, which were removed at 9 and 21 weeks, to evaluate the mechanical strength of the bone-scaffold connection and the bone formation around the scaffold. Expression of osteocalcin was greater in HA-coated scaffolds. In vivo bone formation in HA-coated scaffolds was greater than that in non-coated scaffolds at 21 weeks. Newly formed bone in HA-coated scaffolds mostly restored bone continuity. Scanning electron microscopy identified strong integration of the bone and HA-coated scaffolds. The mechanical strength of the bone-scaffold connection was 3-fold greater in HA-coated scaffolds than that in non-coated scaffolds. These results suggest that a thin HA-coated titanium fiber mesh scaffold is a bone-compatible mandibular reconstruction device in immediately loaded segmental defects.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Abstract Objective To evaluate the therapeutic results and control of occult neck metastasis in patients with T2-4N0 oral tongue squamous cell carcinoma treated with retrograde superselective ...intra-arterial chemotherapy and daily concurrent radiotherapy. Study Design Forty two patients with T2-4N0 tongue cancer (17 with late T2, 13 with T3, and 12 with T4a disease, M0) were treated with intra-arterial chemoradiotherapy. Treatment consisted of retrograde superselective intra-arterial chemotherapy (docetaxel 50-70 mg/m2 , cisplatin 125-175 mg/m2 ) and daily concurrent radiotherapy (50-70 Gy) for 5-7 weeks. Results The median follow-up for all patients was 46.5 (range, 8-105) months. Primary site complete response was achieved in 42 (100%) of 42 cases. Three-year overall survival, progression-free survival, and local control rates were 85.0%, 77.8%, and 91.7%, respectively. Delayed neck metastasis was detected in 5 (11.9%) of 42 cases. Grade 3 or 4 toxic changes included oral mucositis in 92.9%, neutrophil count decreased in 21.4%, and platelet count decreased in 4.8%. Grade 3 toxicities included anemia in 16.7%, radiation dermatitis in 9.5%, nausea in 4.8%, and fever in 2.4%. Conclusions Retrograde superselective intra-arterial chemotherapy for T2-4N0 tongue cancer provided good overall survival and local control rates, and was effective for occult neck metastasis.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Purpose The new technology of photofunctionalization with ultraviolet (UV) light for titanium implants has earned considerable attention. We hypothesized that UV light treatment would enhance bone ...formation on titanium mesh. Materials and Methods We implemented in vitro and in vivo experiments to examine the effectiveness of UV treatment for bone formation on titanium mesh surfaces. Titanium mesh for medical use was prepared as samples, which were autoclaved and stored under dark ambient conditions for 4 weeks. UV treatment was performed for 12 minutes. Carbon contamination, hydrophilicity, and protein adhesion of the titanium mesh surface were examined in an in vitro model. Bone tissue formation around the titanium mesh was observed in a rat femur bone model. The Mann-Whitney U test was used to examine differences between the untreated and UV-treated groups. P values of < .05 were considered significant. Results UV-mediated photofunctionalization reduced carbon contamination rates on the untreated titanium mesh surfaces. The hydrophobic surface of the untreated titanium mesh became superhydrophilic after UV-mediated photofunctionalization ( P < .01). The amount of protein adsorbed onto the titanium was 1.5 to 3 times greater on the photofunctionalized titanium mesh surfaces than on the untreated titanium mesh surfaces ( P < .01). In the animal experiment, the newly formed bone on the UV-treated titanium mesh was approximately 2.5 times greater than that on the untreated mesh ( P < .05). Conclusions UV-mediated photofunctionalization is effective, as demonstrated by the enhanced bone tissue formation on the titanium mesh. Future studies will focus on bone augmentation using an UV-mediated photofunctionalized titanium implant and mesh.
In cases of head and neck cancer treated with intra-arterial chemotherapy, no objective indices are available for determining the distribution of anticancer drugs administered to multiple arteries. ...To establish such indices, noninvasive measurements of drug concentrations are required in the arterial perfusion area of each artery. In MRI, changes in 1/T1 (Δ1/T1) are correlated with the contrast agent concentration. We focused on these properties and investigated whether it is possible to estimate anticancer drug concentrations within tissue based on Δ1/T1.
We employed the fast spin echo (FSE) sequence to determine optimum imaging parameters using a phantom. Subsequently, contrast agent was administered via the lingual and external carotid arteries for seven cases of tongue cancer. Δ1/T1 were then measured in tumor and nontumor tissues. The results of this study were compared with those of a previous study in which intratumor concentrations of anticancer agent were measured in excised specimens.
The optimum imaging parameters for the FSE was two repetition times (TR, 500 and 1000 ms). When compared with the external carotid artery administration, the lingual artery administration of contrast agent resulted in significantly higher Δ1/T1 in both tumor and nontumor tissues (2.13 and 2.62 times, respectively). The multiplying factor for the nontumor tissue and high homogeneity of the contrast agent concentration were reasonably consistent with the results of the previous study.
This method can be applied to estimating intratissue concentrations of intra-arterially administered anticancer drugs, thus possibly providing useful information in determining the distribution of anticancer drugs.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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