Evaluation of the accuracy of implant placement by using fully guided versus partially guided tissue-supported surgical guides with cylindrical versus C-shaped guiding holes: A split-mouth clinical study

Statement of problemThe accuracy of partially guided implant placement protocols in comparison with fully guided protocols is still unclear. C-shaped guide holes have become popular; however, their effect on drilling and implant position accuracy has not been thoroughly investigated.PurposeThe purpose of this split-mouth clinical study was to evaluate the accuracy of implant placement by using fully guided versus partially guided surgical guides with cylindrical versus C-shaped guiding holes.Material and methodsAdopting 80% power of the study in calculating sample size, a total of 48 implants were placed in the mandibular interforaminal area of 12 edentulous participants, who were randomly divided into 2 groups: a fully guided group, comprising 24 implants placed on 1 side by using a fully guided protocol and a partially guided group, comprising 24 implants placed on the other side in a partially guided protocol. Each group was further subdivided into 2 subgroups: cylindrical, including 12 implants placed through cylindrical guide holes, and C-shaped (12 implants) placed through C-shaped guiding holes. Postoperative cone beam computed tomography scans were made, and based on image fusion, the total deviations between the virtually preplanned and actual implant positions were determined and compared between both groups and subgroups. The linear horizontal deviation of the implant hexagon and apex, together with apical depth deviation and angular deviations between the position of the actually placed and virtually planned implants, were analyzed in 3 dimensions. The Kolmogorov-Smirnov test of normality was used. Comparisons were carried out by using the Kruskal-Wallis test. Post hoc pair-wise comparisons when the Kruskal-Wallis test was significant were carried out by using the Dunn-Sidak test (α=.05).ResultsNo statistically significant differences were found in coronal linear deviation (P>.05), apical linear deviation (P>.05), apical depth deviation (P=.086), or angular deviation (P=.247), between the fully guided protocol and the partially guided protocol.ConclusionsThe accuracy of partially guided implant placement was clinically comparable with that of fully guided placement whether the guiding holes were cylindrical or C-shaped.     

Mitigation of acetamiprid – induced renotoxicity by natural antioxidants via the regulation of ICAM,NF-kB and TLR 4 pathways

BackgroundAcetamiprid (ACMP) is a member of the neonicotinoid group of insecticides. It is extensively used worldwide. The misuse of ACMP creates danger hazards to human and animal.MethodsACMP induced renal damage evidenced by an increase in kidney injury biomarkers. So the goal of this work is to clarify the reno protective effect of Quercetin (Qrctn) and/or Nano-glutathione (N-Gluta) solely or in combination to counterbalance the danger effect of ACMP. All treatments with the previous agents were coadministered orally with ACMP for one month.ResultsACMP ingestion caused a significant rise in serum creatinin, urea, and uric acid, TNF α along with renal cystatin C, lipid peroxidation and nitric oxide with the concomitant decline in the levels of reduced glutathione and IL-10 levels. Protein expression of ICAM was upregulated as well as mRNA expression of NF-κB while mRNA expression of Nrf2 was down-regulated. Immune histochemistry of TLR 4 revealed strong immune reaction. The administration of Qrctn or N-Gluta either individually or together modulated all the preceding aforementioned parameters.ConclusionFascinatingly Qrctn and N-Gluta combination was the most powerful regimen to frustrate ACMP reno-toxicity and may be deliberate as a hopeful applicant for renal therapy.     

The acidic tumor microenvironment promotes the reconversion of nitrite into nitric oxide: towards a new and safe radiosensitizing strategy.

PURPOSE: The biological status of nitrite recently evolved from an inactive end product of nitric oxide catabolism to the largest intravascular and tissue storage of nitric oxide (NO). Although low partial O(2) pressure favors enzymatic reconversion of nitrite into NO, low pH supports a nonenzymatic pathway. Because hypoxia and acidity are characteristics of the tumor microenvironment, we examined whether nitrite injection could preferentially lead to NO production in tumors and influence response to treatments. EXPERIMENTAL DESIGN: The effects of nitrite were evaluated on arteriole vasorelaxation, tumor cell respiration and tumor blood flow, oxygenation, and response to radiotherapy. RESULTS: We first showed that a small drop in pH (-0.6 pH unit) favored the production of bioactive NO from nitrite by documenting a higher cyclic guanosine 3',5'-monophosphate-dependent arteriole vasorelaxation. We then documented that an i.v. bolus injection of nitrite to tumor-bearing mice led to a transient increase in partial O(2) pressure in tumor but not in healthy tissues. Blood flow measurements failed to reveal an effect of nitrite on tumor perfusion, but we found that O(2) consumption by nitrite-exposed tumor cells was decreased at acidic pH. Finally, we showed that low dose of nitrite could sensitize tumors to radiotherapy, leading to a significant growth delay and an increase in mouse survival (versus irradiation alone). CONCLUSIONS: This study identified low pH condition (encountered in many tumors) as an exquisite environment that favors tumor-selective production of NO in response to nitrite systemic injection. This work opens new perspectives for the use of nitrite as a safe and clinically applicable radiosensitizing modality.     

Development and maturation of the fibrous components of the arterial roots in the mouse heart

The arterial roots are important transitional regions of the heart, connecting the intrapericardial components of the aortic and pulmonary trunks with their ventricular outlets. They house the arterial (semilunar) valves and, in the case of the aorta, are the points of coronary arterial attachment. Moreover, because of the semilunar attachments of the valve leaflets, the arterial roots span the anatomic ventriculo‐arterial junction. By virtue of this arrangement, the interleaflet triangles, despite being fibrous, are found on the ventricular aspect of the root and located within the left ventricular cavity. Malformations and diseases of the aortic root are common and serious. Despite the mouse being the animal model of choice for studying cardiac development, few studies have examined the structure of their arterial roots. As a consequence, our understanding of their formation and maturation is incomplete. We set out to clarify the anatomical and histological features of the mouse arterial roots, particularly focusing on their walls and the points of attachment of the valve leaflets. We then sought to determine the embryonic lineage relationships between these tissues, as a forerunner to understanding how they form and mature over time. Using histological stains and immunohistochemistry, we show that the walls of the mouse arterial roots show a gradual transition, with smooth muscle cells (SMC) forming the bulk of wall at the most distal points of attachments of the valve leaflets, while being entirely fibrous at their base. Although the interleaflet triangles lie within the ventricular chambers, we show that they are histologically indistinguishable from the arterial sinus walls until the end of gestation. Differences become apparent after birth, and are only completed by postnatal day 21. Using Cre‐lox‐based lineage tracing technology to label progenitor populations, we show that the SMC and fibrous tissue within the walls of the mature arterial roots share a common origin from the second heart field (SHF) and exclude trans‐differentiation of myocardium as a source for the interleaflet triangle fibrous tissues. Moreover, we show that the attachment points of the leaflets to the walls, like the leaflets themselves, are derived from the outflow cushions, having contributions from both SHF‐derived endothelial cells and neural crest cells. Our data thus show that the arterial roots in the mouse heart are similar to the features described in the human heart. They provide a framework for understanding complex lesions and diseases affecting the aortic root.