[A follow-up study of the severe occlusal surface wear of implant-supported full-arch prostheses]

Objective: To evaluate the severe occlusal surface wear of implant-supported full-arch prostheses, and to explore the risk factors affecting the severe occlusal surface wear of implant-supported full-arch prostheses. Methods: Five hundred and thirty-five patients who received implant-supported fixed complete dental prostheses or implant-overdentures and completed at least one follow-up 3 months after the delivery of definitive prostheses were enrolled from October 1994 to October 2021 in this retrospective cohort study. The information on demographics, implants, definitive prostheses, and related outcomes was collected. Cox proportional hazard regression model was adopted to analyze the risk factors of the severe wear of occlusal surfaces in implant-supported full-arch prostheses. Univariate analysis was performed on the factors that may affect the severe wear of occlusal surfaces, and the parameters of P<0.10 in univariate analysis were included in multivariate analysis to explore the risk factors affecting the severe wear of occlusal surfaces in implant-supported full-arch prostheses. Results: Severe wear of the posterior occlusal surfaces was detected in 114 prostheses with a duration of 61.4 (33.3, 89.4) months. 13 cases occurred≤2 years after the delivery of definitive prostheses, 44 cases>2 years and≤5 years, 44 cases>5 years and≤10 years, and the other 13 cases>10 years. There was no significant difference in the average time of severe occlusal surface wear between implant-supported fixed complete dental prostheses and implant-overdentures in the maxilla (Z=-1.03, P=0.303). However, in the mandible, it was 48.2 (31.2, 80.2) and 79.2 (51.3, 119.1) months respectively, which was statistically significant (Z=-2.93, P=0.003). Cox proportional hazard regression model showed opposed fixed dentition, bruxism, and posterior resin occlusal surfaces were risk factors (P<0.05) affecting the severe wear of the occlusal surfaces. Conclusions: Severe occlusal surface wear was clinically common with the prolonged application of implant-supported full-arch prostheses. Prostheses opposed to fixed dentition, in patients with bruxism, and made of posterior resin materials were at higher risk of severe occlusal surface wear on the posterior artificial teeth. Regular follow-up, patients' behavior guidance, and clinicians' appropriate intervention were necessary to manage this complication.

Single-stage computer-assisted approach for tumour resection and functional restoration of Brown class III maxillary defects-titanium mesh and zygomatic implants combined with vascularized anterolateral thigh flap

The functional restoration of Brown class III maxillary defects is a challenging endeavour in oral and maxillofacial surgery. Conventional reconstruction techniques with osseous free flaps have certain limitations, such as the need for multiple operations and greater patient morbidity. This study introduces a single-stage computer-assisted approach for tumour resection and functional restoration of these defects using titanium mesh, zygomatic implants, and a vascularized anterolateral thigh flap (ALTF). Virtual surgical planning was used to simulate tumour resection, titanium mesh placement, and zygomatic implant insertion. Surgery was performed under the guidance of mixed reality and surgical navigation. The tumour was resected by total hemimaxillectomy, and the reconstruction was performed using a pre-bent patient-specific titanium mesh for the orbital floor and two zygomatic implants placed and exposed through tunnels in an ALTF. The ALTF survived without any perioperative complications. A fixed prosthesis with built-in titanium frame was delivered 4 months postoperatively. At the 1-year follow-up, there was no tumour recurrence, the implants were osseointegrated, and aesthetics and masticatory function were satisfactory. An occlusal force of 155 N was attained on the reconstructed side, compared to 127 N on the non-surgical side.

Overexpression of a Zea mays Brassinosteroid-Signaling Kinase Gene ZmBSK1 Confers Salt Stress Tolerance in Maize

Salinity has become a crucial environmental factor seriously restricting maize (Zea mays L.) growth, development and productivity. However, how plants respond to salt stress is still poorly understood. In this study, we report that a maize brassinosteroid-signaling kinase gene ZmBSK1 plays a significant role in salt stress response. Expression pattern analysis revealed that the transcript level of ZmBSK1 was upregulated by NaCl treatment both in maize leaves, roots, and stems. Phenotypic and physiological analysis showed that overexpression of ZmBSK1 in maize improved salt tolerance by reducing the malondialdehyde (MDA) content, the percentage of electrolyte leakage, O₂ ^- and H₂O₂ accumulation under salt stress, relying on the increases of antioxidant defense enzyme activities and proline content. qRT-PCR analysis showed that overexpression of ZmBSK1 also positively modulated the expression levels of reactive oxygen species (ROS)-scavenging and proline biosynthesis-related genes under salt stress. Moreover, immunoprecipitation-mass spectrometry (IP-MS) assay and firefly luciferase complementation imaging (LCI) assay showed that ZmBSK1 could associate with heat shock protein ZmHSP8 and 14-3-3-like protein ZmGF14-6, and their gene expression levels could be significantly induced by NaCl treatment in different maize tissues. Our findings unravel the new function of ZmBSK1 in salt stress response, which provides the theoretical bases for the improvement of maize salt resistance.

[Immediate rehabilitation of edentulous mandibles with implant-supported full-arch prostheses by intra-oral welding technique: a two-year follow-up]

Objective: To evaluate the 2-year clinical outcome of immediate loading implant-supported fixed full-arch prostheses in mandibles using intra-oral welding technique and to discuss the characteristics of the technique. Methods: Totally 15 patients (4 males and 11 females) who treated with immediate rehabilitation of edentulous mandibles with implant-supported full-arch prostheses from July 2015 to February 2019 in Department of Implantology, Peking University School and Hospital of Stomatology were included in the present study. The patients' average age was 64.2±9.3 years. In each case, 4 implants were placed in the mandible area, a titanium bar was connected with each of the implants by using intra-oral welding technique as the Ti-metal framework of the prostheses. Pre-fabricated abutment-level fixed prostheses were delivered immediately after the surgery. A total of 60 implants, 15 mandibles were treated. Biological and mechanical complications, hygiene of the tissue-contacted surface of the restoration and patients' satisfactory grade were recorded. The radiological fitness of welded frameworks to abutments, survival rate of implants and marginal bone loss were calculated and analyzed. The observation period of the study was 24-55 months, with an average of 34.9 months. Results: All of the 15 cases of welded bar-abutment frameworks were fixed on implants with well passive fitness in clinical and radiological level. However, 2 of the 60 implants were failed by loss of osseointegration, and the result of implant survival rate of 96.7% in 2 years. The average marginal bone loss was (0.7±0.2) mm. The average bleeding index of the 58 implants remained was under 3 without clinical signs of gingival swelling, tenderness or fistula. No mechanical complications, such as break or distortion of the implants, occurred. Fracture of artificial teeth and complex resin area happened in 6 of the 15 prostheses. The average debris index was 3.4±0.4 and the hygiene of the tissue-contact areas was under satisfactory condition. Conclusions: Using the intra-oral welding technique to achieve a rigid splint of implants, the clinical outcome of the newly performed technique was predictable in early stage. The frame structure remained stable to avoiding the occurrence of mechanical complications. The provisional restoration could be expected to provide long functional period. Long term result of the treatment were needed for further observation.

[Plaque accumulation at the fitting surface and cleaning status in patients with full-arch implant-supported fixed prostheses: a cross sectional study]

Objective: To observe the plaque accumulation at the fitting surface and oral hygiene status in patients with full-arch implant-supported fixed prostheses, and explore the possible influencing factors. Methods: Twenty-eight patients [17 males and 11 females, (63.0± 10.8) years old] with 40 full-arch implant-supported fixed prostheses (18 maxillary and 22 mandibular) were collected from January 2012 to September 2020 in Department of Implantology, Peking University School and Hospital of Stomatology. Plaque accumulation at the fitting surfaces were evaluated during the follow-up visit after 6 months following definitive prostheses delivery, by analyzing the digital photographs recorded by ImageJ. Meanwhile, the cleanliness of the fitting surface of prostheses and oral hygiene status were recorded. The oral hygiene habits and the patients' satisfaction with the prostheses were investigated by questionnaire, and the difference of plaque accumulation between different cleaning habits of dentures were compared. Results: The debris index of the fitting surface of the 40 full-arch implant-supported fixed prostheses were 3.28±0.75, and the percentage of area covered with plaque was (51.6±19.0)%. The debris index and plaque accumulation of the mandibular prostheses were significantly higher than that of the maxillary prostheses (P<0.05). In most mandibular prostheses (16/22), calculus was attached to the lingual side of the anterior tooth area. The reserved cleaning space of the restoration showed more plaque accumulation than in other parts. There was no significant difference in the percentage of area covered with plaque between groups with different cleaning habits. The satisfaction survey results indicated the "clean" project had a lowest score. Conclusions: The cleanliness of patients with full-arch implant-supported fixed prostheses was poor, and the hygiene status of the mandibular prostheses was worse than that of maxillary, especially in the anterior tooth area of mandibular prostheses. The influence of different cleaning habits on plaque accumulation was not observed.

BRASSINOSTEROID-SIGNALING KINASE 1 phosphorylating CALCIUM/CALMODULIN-DEPENDENT PROTEIN KINASE functions in drought tolerance in maize

Drought stress seriously limits crop productivity. Although studies have been carried out, it is still largely unknown how plants respond to drought stress. Here we find that drought treatment can enhance the phosphorylation activity of brassinosteroid-signaling kinase 1 (ZmBSK1) in maize (Zea mays). Our genetic studies reveal that ZmBSK1 positively affects drought tolerance in maize plants. ZmBSK1 localizes in plasma membrane, interacts with calcium/calmodulin (Ca²⁺ /CaM)-dependent protein kinase (ZmCCaMK), and phosphorylates ZmCCaMK. Ser-67 is a crucial phosphorylation site of ZmCCaMK by ZmBSK1. Drought stress enhances not only the interaction between ZmBSK1 and ZmCCaMK but also the phosphorylation of Ser-67 in ZmCCaMK by ZmBSK1. Furthermore, Ser-67 phosphorylation in ZmCCaMK regulates its Ca²⁺ /CaM binding, autophosphorylation and transphosphorylation activity, and positively affects its function in drought tolerance in maize. Our results reveal an important role for ZmBSK1 in drought tolerance and suggest a direct regulatory mode of ZmBSK1 phosphorylating ZmCCaMK.

[Immediate rehabilitation of the edentulous and potential edentulous jaws with implant-supported full-arch prostheses: a retrospective analysis of 225 cases]

Objective: To evaluate the outcomes of immediate rehabilitation of the edentulous and potential edentulous jaws with implant-supported full-arch prostheses and analyse the risk factors of the complications. Methods: This retrospective study included 273 patients treated with immediate rehabilitation of the edentulous and potential edentulous jaws with implant-supported full-arch prostheses from April 2008 to December 2018 in Department of Implantology, Peking University School and Hospital of Stomatology. The patients' sex, age, place of residence, jaw position, opposing dentition, number of implants, diameter and length of implants, abutment height and abutment angle were recorded. The survival rate of implants and marginal bone loss were calculated and analyzed. Cox proportional hazards ratio model was adopted to analyze the potential risk factors of prosthetic complications. Results: A total of 225 patients (288 jaws) and 1 260 implants were included, with 126 males and 99 females, aged (57.3±11.0) years, with a following time of (5.04±3.08) years. The 1-year cumulative survival rate of implants was 98.0% (1 235/1 260). Forty-eight implants were lost during the follow-up, with 39 implants in the maxillae and 9 implants in the mandible. The risk of implant failure of the maxillae ［7.2% （39/541）］ is significantly higher than that of the mandible ［1.3% （9/719）］ (P<0.01). Average marginal bone loss at 1 and 5 years was (0.7±0.2） mm and （1.1±0.3） mm. One hundred and twenty patients experienced prosthetic complications including screw/abutment loosening (44 cases), screw/abutment fracture (2 cases) and artificial tooth/denture base fracture (99 cases). The possibility of immediate prosthesis fracture within 6-8 months was high but declined over the following years with the final prosthesis delivered. Cox regression analysis showed that the use of 17° abutments in the anterior region was significantly related to the prosthetic complications （hazard ratio=1.797, P=0.002）. Conclusions: Immediate rehabilitation of the edentulous jaws with implant-supported full-arch prostheses can be a predictable technique. The immediate prosthetic mechanical complication prevalence was high. The use of 17° abutments in the anterior region may increase the risk of screw/abutment loosening. It is necessary to review in time.

Thr420 and Ser454 of ZmCCaMK play a crucial role in brassinosteroid-induced antioxidant defense in maize

Calcium/calmodulin-dependent protein kinase (CCaMK) has been shown to play important roles in brassinosteroid (BR)-induced antioxidant defense and enhancing the tolerance of plants to drought stress. The autophosphorylation of CCaMK is a key step for the activation of CCaMK, thus promoting substrate phosphorylation. However, how CCaMK autophosphorylation function in BR-induced antioxidant defense is not known yet. Here, seven potential autophosphorylation sites of ZmCCaMK were identified using mass spectroscopy (liquid chromatography-tandem mass spectrometry [LC-MS/MS]) analysis. The transient gene expression analysis in maize protoplasts showed that Thr420 and Ser454 of ZmCCaMK were important for BR-induced antioxidant defense. Furthermore, Thr420 and Ser454 of ZmCCaMK were crucial for improving drought tolerance and alleviating drought induced oxidative damage of plants via overexpressing various mutant versions of ZmCCaMK in tobacco (Nicotiana tabacum). Mutations of Thr420 and Ser454 in ZmCCaMK substantially blocked the autophosphorylation and substrate phosphorylation of ZmCCaMK in vitro. Taken together, our results demonstrate that Thr420 and Ser454 of ZmCCaMK are crucial for BR-induced antioxidant defense and drought tolerance through modulating the autophosphorylation and substrate phosphorylation activities of ZmCCaMK.

Xyloglucan endotransglucosylase-hydrolase30 negatively affects salt tolerance in Arabidopsis

Plants have evolved various strategies to sense and respond to saline environments, which severely reduce plant growth and limit agricultural productivity. Alteration to the cell wall is one strategy that helps plants adapt to salt stress. However, the physiological mechanism of how the cell wall components respond to salt stress is not fully understood. Here, we show that expression of XTH30, encoding xyloglucan endotransglucosylase-hydrolase30, is strongly up-regulated in response to salt stress in Arabidopsis. Loss-of-function of XTH30 leads to increased salt tolerance and overexpression of XTH30 results in salt hypersensitivity. XTH30 is located in the plasma membrane and is highly expressed in the root, flower, stem, and etiolated hypocotyl. The NaCl-induced increase in xyloglucan (XyG)-derived oligosaccharide (XLFG) of the wild type is partly blocked in xth30 mutants. Loss-of-function of XTH30 slows down the decrease of crystalline cellulose content and the depolymerization of microtubules caused by salt stress. Moreover, lower Na+ accumulation in shoot and lower H2O2 content are found in xth30 mutants in response to salt stress. Taken together, these results indicate that XTH30 modulates XyG side chains, altered abundance of XLFG, cellulose synthesis, and cortical microtubule stability, and negatively affecting salt tolerance.

[Quantitative three-dimensional methodology based on intraoral scan to assess the soft tissue contour alterations following single immediate implant and immediate provisionalization in maxillary central incisor: a 1-year prospective study]

Objective: To establish a quantitative three-dimensional method based on intraoral scan and apply it to evaluation of the facial soft tissue contour alterations following single immediate implant and immediate provisionalization (IIPP) in central incisor via intraoral scanning. Methods: This study was a prospective clinical study. The trial was conducted at Department of Implantology, Peking University School and Hospital of Stomatology, from January 2016 to September 2017. Twenty-nine eligible consecutive patients (15 women, 14 men) with a mean age of (34.3±12.0) were included and received immediate replacement of the failure maxillary single central incisor. A screw-retained immediate restoration was delivered for each patient. At 6-month follow-up, impression was taken and a screw-retained permanent restoration was performed for each patient. The anterior maxillary region was scanned by an intraoral scanning system at pre-surgery and 1-year follow-up. The Standard Tessellation Language (STL) files were output to a dedicated software and superimposed. Mid-facial recession and gingival zenith symmetry at 1-year follow-up were measured in the digital models. Three-dimensional configurations of the contour change volume were calculated and reconstructed for visual analysis. Furthermore, the following parameters were used to analyze the reconstructed volume: mean contour change in thickness (△d), mesio-distal width (D(W)), coronal-apical height (D(H)), contour change at 0, 1, 2, 3, 4, 5 mm apical to the free gingival margin on the implant site. Results: Twenty-seven out of twenty-nine enrolled patients were finally available for analysis. At 1-year follow-up, the mid-facial mucosa level at implant site was (0.23±0.39) mm apical to the gingival zenith of the contralateral tooth. In general, a contour collapse was found in every patient. △d, D(W) and D(H) of the collapsed volume were (0.62±0.22), (11.03±1.74) and (6.82±1.52) mm, respectively. Contour change at 0, 1, 2, 3, 4, 5 mm apical to the free gingival margin on the implant site were (0.54±0.48), (0.87±0.62), (1.03±0.46), (0.96±0.52), (0.90±0.52), (0.89±0.57) mm. Conclusions: The described quantitative measurement based on intraoral scan can be an effective method for assessment of soft tissue contour changes. At 1 year following single IIPP treatment in maxillary incisor, free gingival margin is stable, with only mild recession. The mean level of the facial soft tissue contour collapse is 0.62 mm.

[Complications of implant-supported full-arch immediate prosthesis: a retrospective analysis of 114 cases]

Objective: To evaluate the feasibility of long-term function of implant-supported full-arch immediate prosthesis via assessing the complications and risk factors. Methods: This historical cohort study included patients treated with implant-supported full-arch restoration under immediate loading protocol between April, 2008 to June, 2016 and wearing the immediate prosthesis for more than 6 months. Medical charts were reviewed for patients' general information, implant information, prosthetic information and details of prosthetic complications. COX proportional hazards ratio model was adopted to analyze the potential risk factors for prosthesis fracture. Results: A total of 114 patients with a mean age of (56.7±10.2) years old and 144 prostheses were included. The median wearing time of immediate prosthesis was 17.6 months. Sixty-two (54%) patients experienced prosthetic complication, 30 of them suffered more than once. Artificial teeth fractures were more common in anterior region while resin base fractured more often in the posterior region. The possibility of immediate prosthesis fracture in the first year was high but declined over the following years. COX regression analysis showed that fibre-reinforcement (HR=0.486, P=0.017) and rigid opposing dentition (HR=2.272, P=0.016) were significantly related to the prosthesis fracture. Conclusions: Long-term function of implant-supported full-arch immediate prosthesis renders a high prosthetic complication prevalence, featuring the prosthesis fracture as the most common complication and the first year of highest fracture probability. Fibre-reinforced acrylic immediate prosthesis may function well in cases with a removable denture restored opposing jaw.

[Lateral cephalometric analysis of patients with maxillary alveolar protrusion and advanced periodontitis treated with immediate implants and cross-arch fixed prostheses]

Objective: To investigate the changes of the lateral cephelometric landmarks of soft tissue and hard tissue of patients with maxillary alveolar protrusion and advanced periodontitis treated with immediate implants and cross-arch fixed prostheses. Methods: From January 2013 to October 2016, consecutive patients with advanced periodontitis and maxillary alveolar protrusion in need of immediate implants and cross-arch fixed prostheses were included in this study. All the patients were treated with provisional cross-arch fixed prostheses supported with 4 to 6 immediate implants after extraction of all the residual teeth and reduction of excessive alveolar bone. After 6 months, a final cross-arch fixed prosthesis was delivered. The lateral cephalometric landmarks of soft tissue and hard tissue at the time of pre-operation and final prosthesis delivery were analyzed. The change of patients' facial aesthetics was assessed using visual analogue scale (VAS). Results: Ten patients were included in the study. All the patients underwent full arch rehabilitation of both jaws supported by a total of 89 dental implants. In the maxillae, the average number of inserted implants were 4.5. The mean height of alveolar bone reduction was (6.3±1.8) mm. Both the distance of U1-NA (the upper incisor to nasion-A point line) and U1-PP (the upper incisor to palatal plane) were significantly reduced by (5.5±2.7) mm and (1.6±1.2) mm, respectively. The angle of U1-SN (between upper incisor to sella-nasion line) was reduced by 9.6°±8.1°palatally. The nasolabial angles were significantly increased by 10.5°±6.4°. Both the patients and dentists considered that the facial aesthetics was improved greatly after the treatment. Conclusions: With the reduction of excessive alveolar bone and the realignment of artificial teeth, the treatment of immediate implants and cross-arch fixed prostheses could improve the facial aesthetics of the patients with advanced periodontitis and maxillary alveolar protrusion.

[Systematic review and meta-analysis on the effect of implant supported overdentures on the oral health related quality of life of edentulous patients]

Objective: To evaluate the effect of implant related treatment on the oral health related quality of life (OHRQoL) of edentulous patients. Methods: The CNKI, Wanfang database and Medline, EMBASE, Cochrane Library databases that include randomized clinical trials comparing implant supported overdentures with conventional complete denture for edentulous patients were retrived. Nine studies involving 769 cases were included and meta-analysis was conducted. Results: The standardized mean difference (SMD) of oral health impact profile (OHIP) score was 1.63 (95%CI: 1.25-2.02) and improved after implant related treatment, which was significantly better than the conventional complete denture (0.87, 95% CI: 0.54-1.20). Conclusions: Implant supported overdentures improved patient's OHRQoL and showed better performance compared to the overdentures complete dentures.

[All-on-4 occlusion study: using T-Scan Ⅲ occlusal analysis system]

OBJECTIVE

To investigate the occlusal force distribution and the characteristics of the occlusion time of patients with All-on-4 rehabilitation at different occlusion position using T-Scan Ⅲ occlusal analysis system.

METHODS

Thirteen volunteers with All-on-4 rehabilitation were included in this study. T-Scan Ⅲ occlusal analysis system was used to measure the occlusal force distribution and the time character of the patients at intercuspal position, protrusive position, and lateral excursive position.

RESULTS

Maximum intercuspation: the left and right premolars took most of the occlusal force, namely (17.3±3.1)%, (15.8 ± 4.6)%, (15.5 ± 2.2)% and (15.2 ± 5.5)% (24, 25, 14, 15), the implants areas including the premolar and anterior teeth took (64.0±6.7)%, (19.2±8.0)% of occlusal force. The left and right sides took the respective percentages of (50.5±6.1)%, (49.5±6.1)%, and there was no difference. Protrusion position: the region (11, 12, 21, 22) commitment to take the percentage of (90.4±27.7)%. Occlusion time: 0.18(0.11, 0.26) s, disclusion time: 0.52 (0.35, 1.14) s . At the left and right lateral position, 8 patients were single teeth-supported occlusion, 5 patients were group fuctional occlusion, the average occlusion time was 0.20(0.13, 0.34) s, and DT was 1.07 (0.58, 1.46) s.

CONCLUSIONS

At maximum intercuspation: the implants areas including the premolar and anterior teeth were the occlusal force centers; the force concentrated in the area (11, 12, 21, 22) at the protrusion position. The lateral occlusal pattern shows multiformity.

Investigation of polychlorinated biphenyl removal from contaminated soil using microwave-generated steam

A feasibility study of polychlorinated biphenyl (PCB) removal from contaminated soils using microwave-generated steam (MGS) was performed. Initial experimental results show that MGS effectively removed PCBs from contaminated soil with an overall removal efficiency of greater than 98% at a steam-to-soil mass ratio of 3:1. Removal efficiency was found to be dependent upon the amount of steam employed, expressed as a mass ratio of steam applied to soil mass. Evaporation was identified as a major mechanism in removing PCBs from the soil. Rapid expansion and evaporation of pore water by microwave dielectric heating accelerated evaporation rates of PCB molecules. Increased solubility of PCBs into the heated aqueous phase is also hypothesized. Together these effects increase mass-transfer rates, thus enhancing removal of PCBs from the soil.

The anatomy of the lateral cutaneous nerve of the thigh--a possible donor nerve for facial nerve repair

One hundred anterior branches of the lateral cutaneous nerve of the thigh were dissected and measured in 50 adult cadavers. The results show that this nerve was present in all sides, and the average length from the point of the nerve piercing the fascia lata to the point of its first branch was about 79 mm, the average width was 2.25 mm, and the average thickness was 0.79 mm. It was found that the nerve was approximately along the line between the anterior superior iliac spine and the midpoint of the upper margin of the patella. This study presents a simple method of locating this nerve for clinical reference. The results also reveal that this nerve is a possible donor for facial nerve repair.