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A Novel Framework for Optimizing Peri-Implant Soft Tissue in Subcrestally Placed Implants in Single Molar Cases: Integrating Transitional and Subcrestal Zones for Biological Stability
Chiyun Won
Background: The peri-implant soft tissue seal plays a critical role in the long-term success of subcrestally placed implants (SPIs). However, conventional biologic width models, originally developed for natural teeth, fail to fully account for the complex three-dimensional peri-implant soft tissue adaptation. This study introduces a novel framework that integrates the concepts of the Transitional Zone (TZ) and Subcrestal Zone (SZ) to optimize peri-implant soft tissue stability and function. Methods: A three-dimensional peri-implant soft tissue analysis (3DSTA) was conducted using CBCT imaging and clinical evaluation. This study defines key parameters, including Crest to Restoration Distance (CRD), Soft Tissue Thickness (STT), and Self-Sustained Soft Tissue (SSST), to assess the biologic and structural adaptation of peri-implant soft tissue in SPI cases. Results: A mathematical model was developed to determine optimal implant placement depth, considering emergence angle (EA), soft tissue thickness (STT), and peripheral crestal offset (PCO). SSST, composed of TZ and SZ, was identified as a critical factor in maintaining peri-implant health by providing a wider biologic width and enhancing resistance to microbial infiltration. The importance of sub-mucosal coronal flaring in SPI was highlighted, demonstrating that a broader contact zone improves peri-implant tissue adaptation and biologic stability. Implant Paper Point Probing (IPPP) was introduced as a novel diagnostic tool to assess the peri-implant sulcus seal and differentiate healthy peri-implant soft tissue from pathological pockets. Conclusions:This study presents a novel peri-implant soft tissue framework, shifting from a two-dimensional biologic width model to a three-dimensional analytical approach. By integrating TZ and SZ as components of SSST, this model provides clinical guidelines for optimal emergence profile design, SPI placement depth, and peri-implant soft tissue management. Future studies should focus on validating these findings through histological investigations and long-term clinical trials to refine peri-implant soft tissue optimization strategies.
Background: The peri-implant soft tissue seal plays a critical role in the long-term success of subcrestally placed implants (SPIs). However, conventional biologic width models, originally developed for natural teeth, fail to fully account for the complex three-dimensional peri-implant soft tissue adaptation. This study introduces a novel framework that integrates the concepts of the Transitional Zone (TZ) and Subcrestal Zone (SZ) to optimize peri-implant soft tissue stability and function. Methods: A three-dimensional peri-implant soft tissue analysis (3DSTA) was conducted using CBCT imaging and clinical evaluation. This study defines key parameters, including Crest to Restoration Distance (CRD), Soft Tissue Thickness (STT), and Self-Sustained Soft Tissue (SSST), to assess the biologic and structural adaptation of peri-implant soft tissue in SPI cases. Results: A mathematical model was developed to determine optimal implant placement depth, considering emergence angle (EA), soft tissue thickness (STT), and peripheral crestal offset (PCO). SSST, composed of TZ and SZ, was identified as a critical factor in maintaining peri-implant health by providing a wider biologic width and enhancing resistance to microbial infiltration. The importance of sub-mucosal coronal flaring in SPI was highlighted, demonstrating that a broader contact zone improves peri-implant tissue adaptation and biologic stability. Implant Paper Point Probing (IPPP) was introduced as a novel diagnostic tool to assess the peri-implant sulcus seal and differentiate healthy peri-implant soft tissue from pathological pockets. Conclusions:This study presents a novel peri-implant soft tissue framework, shifting from a two-dimensional biologic width model to a three-dimensional analytical approach. By integrating TZ and SZ as components of SSST, this model provides clinical guidelines for optimal emergence profile design, SPI placement depth, and peri-implant soft tissue management. Future studies should focus on validating these findings through histological investigations and long-term clinical trials to refine peri-implant soft tissue optimization strategies.
Posted: 17 February 2025
Postherpetic Pseudolymphomatous Angiosarcoma Concealed Within Milia En Plaque: Expanding the Spectrum of Wolf Isotopic Response with a Literature Review
Marina Corral-Forteza,
Noelia Pérez-Muñoz,
Maria-Teresa Fernández-Figueras
Posted: 17 February 2025
Non-alcoholic Fatty Liver Disease (NAFLD) Management in the Community
Yongsoo Park,
Kyung Soo Ko,
Byung Doo Rhee
Posted: 17 February 2025
Influence of PAC, a Curcumin Analog Inhibitor of NF-κB, on the Radiosensitivity of Breast Tumor Cells
Reema Alzeer,
Najla Al-Harbi,
Maha Al-Ghamdi,
Sara Bin Judia,
Basem Alotaibi,
Abdullah Alsuliman,
Khaled Al-Hadyan,
Rafa Almeer,
Ghazi Alsbeih
Posted: 17 February 2025
The Relationship Between Dietary Factors and Skin Cancer Development: Clinical Relevance
Homer S. Black
Posted: 17 February 2025
Prevalence of Hypertension in Adolescents: Differences Between 2016 ESH and 2017 AAP Guidelines
Caterina Carollo,
Luigi Peritore,
Alessandra Sorce,
Emanuele Cirafici,
Miriam Bennici,
Luca Tortorici,
Riccardo Polosa,
Giuseppe Mulè,
Giulio Geraci
Posted: 17 February 2025
Tree Nut and Extra Virgin Olive Oil Supplementation and Epigenetic Aging—A Feasibility Study
Lindsay M Reynolds,
Timothy D Howard,
Carl D Langefeld,
Mara Z Vitolins
Tree nut and extra virgin olive oil (EVOO) supplementation can improve cardiometabolic health. However, the effects of tree nut and EVOO consumption on aging biology is unknown. We carried out an exploratory four-week tree nut and EVOO supplementation intervention in 33 adults 48 – 81 years of age (mean age: 68 ± 9 years) with metabolic syndrome to generate preliminary data on a measure of biological aging – epigenetic aging, and qualitatively explored participants’ interest in knowing their epigenetic aging measures. Epigenetic aging was measured in all participants at baseline and after the 4-week intervention (DunedinPACE and GrimAge). At baseline, participants had advanced epigenetic aging measured by the DunedinPACE biomarker but not the GrimAge biomarker, with 100% of participants having DunedinPACE>1 (Wilcoxon test, p=3.73E-9), and 38% of participants having AgeAccelGrim>0 (Wilcoxon test, p=0.48). 84% of participants reported they thought they could participate in a similar 3-4 year study. The majority (77%) of participants educated about epigenetic aging reported they very much wanted to know their epigenetic age (77%), and that they would be somewhat likely (29%) or very likely (57%) to eat tree nuts and EVOO daily if it slowed biological aging. There was not a significant (p<0.05) change in epigenetic aging measures from baseline to after the 4-week intervention. This study further substantiates advanced epigenetic aging in individuals with metabolic syndrome. This pilot study also demonstrates participant interest in learning about biological age and supports the potential for biological aging measures to motivate behavior change.
Tree nut and extra virgin olive oil (EVOO) supplementation can improve cardiometabolic health. However, the effects of tree nut and EVOO consumption on aging biology is unknown. We carried out an exploratory four-week tree nut and EVOO supplementation intervention in 33 adults 48 – 81 years of age (mean age: 68 ± 9 years) with metabolic syndrome to generate preliminary data on a measure of biological aging – epigenetic aging, and qualitatively explored participants’ interest in knowing their epigenetic aging measures. Epigenetic aging was measured in all participants at baseline and after the 4-week intervention (DunedinPACE and GrimAge). At baseline, participants had advanced epigenetic aging measured by the DunedinPACE biomarker but not the GrimAge biomarker, with 100% of participants having DunedinPACE>1 (Wilcoxon test, p=3.73E-9), and 38% of participants having AgeAccelGrim>0 (Wilcoxon test, p=0.48). 84% of participants reported they thought they could participate in a similar 3-4 year study. The majority (77%) of participants educated about epigenetic aging reported they very much wanted to know their epigenetic age (77%), and that they would be somewhat likely (29%) or very likely (57%) to eat tree nuts and EVOO daily if it slowed biological aging. There was not a significant (p<0.05) change in epigenetic aging measures from baseline to after the 4-week intervention. This study further substantiates advanced epigenetic aging in individuals with metabolic syndrome. This pilot study also demonstrates participant interest in learning about biological age and supports the potential for biological aging measures to motivate behavior change.
Posted: 17 February 2025
Critically Ill COVID-19 Patients May Exhibit Plasma Hypercoagulability Despite Escalated Anticoagulation
Soslan Shakhidzhanov,
Anna Filippova,
Elizaveta Bovt,
Andrew Gubkin,
Gennady Sukhikh,
Sergey Tsarenko,
Ilya Spiridonov,
Denis Protsenko,
Dmitriy Zateyshchikov,
Elena Vasilieva
Posted: 17 February 2025
A Comprehensive Review of Blepharopigmentation
Shiva Ram Male,
Sushma Nandyala
Posted: 17 February 2025
Surgical Options for Hallux Rigidus Based on Etiology: A Review and Commentary
Kenichiro Nakajima
Posted: 17 February 2025
Opioid Analgesics: Rise and Fall of Ligand Biased Signalig and Future Perspectives in the Quest for the Holy Grail
Émile Breault,
Rebecca L. Brouillette,
Terence E. Hébert,
Philippe Sarret,
Élie Besserer-Offroy
Opioid analgesics have been used for more than 5,000 years and remain the main pain medications prescribed today. Although morphine is considered the gold standard of pain relief, this selective µ-opioid receptor (MOP) agonist provides only moderate relief for many chronic pain conditions, and produces a number of unwanted effects that can affect the patient’s quality-of-life, prevent adherence to treatment or lead to addiction. In addition to the lack of progress in developing better analgesics, there have been no significant breakthroughs to date in combating the above-mentioned side effects. Fortunately, a better understanding of opioid pharmacology has given renewed hope for the development of better and safer pain medications. In this review, we describe how clinically approved opioids were initially characterized as biased ligands and what impact this approach might have on clinical practice. We also looked at the preclinical and clinical development of biased MOP agonists, focusing on the history of oliceridine, the first specifically designed biased analgesic. In addition, we explore the discrepancies between ligands with low intrinsic efficacy and those with biased properties. Finally, we examine the rationale behind the development of biased ligands during the opioid crisis.
Opioid analgesics have been used for more than 5,000 years and remain the main pain medications prescribed today. Although morphine is considered the gold standard of pain relief, this selective µ-opioid receptor (MOP) agonist provides only moderate relief for many chronic pain conditions, and produces a number of unwanted effects that can affect the patient’s quality-of-life, prevent adherence to treatment or lead to addiction. In addition to the lack of progress in developing better analgesics, there have been no significant breakthroughs to date in combating the above-mentioned side effects. Fortunately, a better understanding of opioid pharmacology has given renewed hope for the development of better and safer pain medications. In this review, we describe how clinically approved opioids were initially characterized as biased ligands and what impact this approach might have on clinical practice. We also looked at the preclinical and clinical development of biased MOP agonists, focusing on the history of oliceridine, the first specifically designed biased analgesic. In addition, we explore the discrepancies between ligands with low intrinsic efficacy and those with biased properties. Finally, we examine the rationale behind the development of biased ligands during the opioid crisis.
Posted: 17 February 2025
The Oral Candida Carriage and Oral Risk Habits of a Group of Sri Lankan Male Patients with Oral Fibroepithelial Polyps
Manosha Perera,
Irosh Perera
Posted: 17 February 2025
Oncological Complications of Liver Transplant: A Narrative Re-View on De Novo and Donor-Transmitted Cancers
Tancredi Vincenzo Li Cavoli,
Armando Curto,
Erica Nicola Lynch,
Andrea Galli
Posted: 17 February 2025
Prognostic Value of Claudin 18.2, Isocitrate Dehydrogenase-1, and Neutrophil-to-Lymphocyte Ratio in Unresectable Pancreatic Ductal Adenocarcinoma
Ebru Karcı,
Ahmet Bilici,
Ferhat Özden,
Elif Kuzucular,
Harun Muğlu,
Ömer Fatih Ölmez,
Özgür Açıkgöz,
Özcan Yıldız
Posted: 17 February 2025
Non-Melanoma Skin Cancer: Dermatoscopic Diagnostic Clues in Dark-Skinned Mexican Individuals
Esli Camila Sanchez Moreno,
Andrea Carolina Machado Sulbaran,
Lizbeth Riera Leal,
Yveth Marlene Ortiz Garcia,
Luis Roberto Olivas Roman,
Annie Riera Leal
Background/Objectives: Skin cancer is increasingly prevalent. Non-melanoma skin cancers pose a challenge, as most lesions are diagnosed at later stages and often lead to complications. Although dermatoscopy has emerged as a valuable tool that enhances the confidence of dermatologists, specific patterns for accurately identifying various subtypes of non-melanoma skin cancer have yet to be detailed. This study aimed to investigate dermatoscopic clues that facilitate accurate diagnosis of non-melanoma skin cancer among dark-skinned Mexican individuals. There is insufficient acknowledgment of high skin cancer rates among non-Whites. Methods: The study included fifty-three patients diagnosed with non-melanoma skin cancer, aged 39 to 89, who visited an academic dermatology department for skin examinations. Two certified dermatologists evaluated at least three dermatoscopy images for each lesion. A biopsy was taken to confirm the preliminary diagnosis. Statistical analysis was performed using GraphPad Prism v8.0, considering a probability (p) value of less than 0.05 as significant. Results: Most patients were classified as phototype III. Patients with phototype IV were younger at the time of diagnosis. Basal cell carcinomas were the most common cancer subtype. Nodular and ulcerated tumors were the most prevalent morphology. The dermatoscopic examination revealed that 60% of the lesions were pigmented, with a predominance of polymorphic vascular patterns. Squamous cell carcinomas exhibited monomorphic vascular structures. Both groups' blood vessel arrangements and specific patterns were primarily radial. Conclusions: This study did not demonstrate the effectiveness of the non-melanoma skin cancer dermatoscopy criteria in distinguishing basal cell carcinomas from squamous cell carcinomas. However, certain factors, such as pigmentation and linear vessels, seem to occur more frequently in nodular basal cell carcinomas.
Background/Objectives: Skin cancer is increasingly prevalent. Non-melanoma skin cancers pose a challenge, as most lesions are diagnosed at later stages and often lead to complications. Although dermatoscopy has emerged as a valuable tool that enhances the confidence of dermatologists, specific patterns for accurately identifying various subtypes of non-melanoma skin cancer have yet to be detailed. This study aimed to investigate dermatoscopic clues that facilitate accurate diagnosis of non-melanoma skin cancer among dark-skinned Mexican individuals. There is insufficient acknowledgment of high skin cancer rates among non-Whites. Methods: The study included fifty-three patients diagnosed with non-melanoma skin cancer, aged 39 to 89, who visited an academic dermatology department for skin examinations. Two certified dermatologists evaluated at least three dermatoscopy images for each lesion. A biopsy was taken to confirm the preliminary diagnosis. Statistical analysis was performed using GraphPad Prism v8.0, considering a probability (p) value of less than 0.05 as significant. Results: Most patients were classified as phototype III. Patients with phototype IV were younger at the time of diagnosis. Basal cell carcinomas were the most common cancer subtype. Nodular and ulcerated tumors were the most prevalent morphology. The dermatoscopic examination revealed that 60% of the lesions were pigmented, with a predominance of polymorphic vascular patterns. Squamous cell carcinomas exhibited monomorphic vascular structures. Both groups' blood vessel arrangements and specific patterns were primarily radial. Conclusions: This study did not demonstrate the effectiveness of the non-melanoma skin cancer dermatoscopy criteria in distinguishing basal cell carcinomas from squamous cell carcinomas. However, certain factors, such as pigmentation and linear vessels, seem to occur more frequently in nodular basal cell carcinomas.
Posted: 17 February 2025
Uncovering Subclinical Cardiac Involvement in Vedoss: An Echocardiographic Driven Study
Eugenio Capparelli,
Eleonora Zaccara,
Ilaria Suardi,
Antonella Laria,
Laura Castelnovo,
Eleonora Mauric,
Daniela Bompane,
Antonio Tamburello,
Maria Iacovantuono,
Maria Sole Chimenti
Posted: 17 February 2025
The Use of Remote Sensing for Estimating the Risk of Transmission and Predicting Cases of Malaria in Argentina
Ana C. Cuéllar,
Roberto D. Coello Peralta,
Davis Calle Atariguana,
Martha Palacios Macias,
Paul L. Duque,
Liliana M. Galindo,
Mario O. Zaidenberg,
María J. Dantur Juri
Posted: 17 February 2025
Ruptured Intracranial Dermoid Cyst with Fat Dissemination: A Clinical Case Mimicking an Epidermoid Cyst and Review of the Literature
Kalvis Verzemnieks,
Roberts Tumelkans,
Sintija Strautmane,
Verners Roberts Kalejs,
Julija Dolgopolova,
Egils Valeinis,
Tatjana Tone,
Arturs Balodis
Background. Intracranial dermoid cysts (IDC) are rare benign congenital intracranial lesions. In the case of IDC rupture, these lesions may manifest clinically. Cysts may be visualized on non-enhanced computed tomography (NECT) and magnetic resonance imaging (MRI), facilitating discussions between clinicians and radiologists to determine cyst content and potential dissemination in cases of rupture. This case report describes an IDC rupture presenting as fat-containing lesions in the subarachnoid space and ventricular system, resembling a subarachnoid hemorrhage on MRI. Case report. A thirty-two-year-old Caucasian male patient was admitted to the hospital due to recurrent headache and visual impairment that began at the age of thirty-one. MRI revealed a lesion radiologically consistent with a ruptured dermoid or epidermoid cyst in the anterior fossa with a mass effect on the optic nerve intracranial segments, the chiasma opticum, and proximal optic tracts. The patient underwent a successful neurosurgical resection of the lesion, and histopathological analysis confirmed the diagnosis of a dermoid cyst. The postoperative period was uneventful. MRI follow-up revealed residual tissue of the IDC without any volume increase. Multiple punctate fat-containing lesions were noted, similar to previous MRI. The patient reported no complaints at discharge. Follow-up MRI imaging demonstrated no recurrence or progression of the dermoid cyst at 4 months, 1 year, and 2 years. Conclusion. IDC rupture is a rare event that may present clinically and appear as a blooming artifact on MRI, mimicking subarachnoid hemorrhage. Fat-containing lesions in the subarachnoid space and ventricular system can demonstrate findings indicative of an IDC rupture. MRI diffusion-weighted imaging (DWI) and decreased apparent diffusion coefficient (ADC) values may mimic an epidermoid cyst, a phenomenon rarely described in the literature, further complicating the diagnostic process.
Background. Intracranial dermoid cysts (IDC) are rare benign congenital intracranial lesions. In the case of IDC rupture, these lesions may manifest clinically. Cysts may be visualized on non-enhanced computed tomography (NECT) and magnetic resonance imaging (MRI), facilitating discussions between clinicians and radiologists to determine cyst content and potential dissemination in cases of rupture. This case report describes an IDC rupture presenting as fat-containing lesions in the subarachnoid space and ventricular system, resembling a subarachnoid hemorrhage on MRI. Case report. A thirty-two-year-old Caucasian male patient was admitted to the hospital due to recurrent headache and visual impairment that began at the age of thirty-one. MRI revealed a lesion radiologically consistent with a ruptured dermoid or epidermoid cyst in the anterior fossa with a mass effect on the optic nerve intracranial segments, the chiasma opticum, and proximal optic tracts. The patient underwent a successful neurosurgical resection of the lesion, and histopathological analysis confirmed the diagnosis of a dermoid cyst. The postoperative period was uneventful. MRI follow-up revealed residual tissue of the IDC without any volume increase. Multiple punctate fat-containing lesions were noted, similar to previous MRI. The patient reported no complaints at discharge. Follow-up MRI imaging demonstrated no recurrence or progression of the dermoid cyst at 4 months, 1 year, and 2 years. Conclusion. IDC rupture is a rare event that may present clinically and appear as a blooming artifact on MRI, mimicking subarachnoid hemorrhage. Fat-containing lesions in the subarachnoid space and ventricular system can demonstrate findings indicative of an IDC rupture. MRI diffusion-weighted imaging (DWI) and decreased apparent diffusion coefficient (ADC) values may mimic an epidermoid cyst, a phenomenon rarely described in the literature, further complicating the diagnostic process.
Posted: 17 February 2025
The Role of the Sirtuin Family Histone Deacetylases in Acute Myeloid Leukemia – a Promising Road Ahead
Piotr Strzałka,
Kinga Krawiec,
Aneta Wiśnik,
Dariusz Jarych,
Magdalena Czemerska,
Izabela Zawlik,
Agnieszka Pluta,
Agnieszka Wierzbowska
Posted: 17 February 2025
Efficacy and Safety of Ashwagandha Root Extract Sustained-Release Capsules in Healthy Adult, Stressed Subjects: A Randomized, Double-Blind, Placebo-Controlled, Parallel-Group, Three-Arm Clinical Trial
Shefali Thanawala,
Rajat Shah,
Kiran Bhupathiraju,
Krishnaraju Venkata Alluri,
Prabakaran Desomayanandanam,
Arun Bhuvenendran
Posted: 17 February 2025
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