Search Results (51)

Background: Gingival recession is a common condition involving apical displacement of the gingival margin, leading to root surface exposure and associated complications such as dentin hypersensitivity and root caries. Among the most effective treatment options are the tunneling technique (TUN) and the coronally advanced flap (CAF), both combined with connective tissue grafts (CTGs). This study aimed to evaluate and compare the clinical outcomes of TUN + CTG and CAF + CTG in terms of root coverage and keratinized tissue width (KTW) over a 6–12-month follow-up. Methods: A randomized, double-blind clinical trial was conducted following CONSORT guidelines (ClinicalTrials.gov ID: NCT06228534). Participants were randomly assigned to receive either TUN + CTG or CAF + CTG. Clinical parameters, including gingival recession depth (REC) and KTW, were assessed at baseline as well as 6 months and 12 months postoperatively using a calibrated periodontal probe. Statistical analysis was performed using descriptive statistics and linear mixed models to compare outcomes over time, with a significance level set at 5%. Results: Both techniques demonstrated significant clinical improvements. At 6 months, mean root coverage was 100% in CAF + CTG cases and 97% in TUN + CTG cases, while complete root coverage (REC = 0) was observed in 100% and 89% of cases, respectively. At 12 months, root coverage remained stable, at 99% in the CAF + CTG group and 97% in the TUN + CTG group. KTW increased in both groups, with higher values observed in the CAF + CTG group (3.53 mm vs. 3.11 mm in TUN + CTG at 12 months). No significant postoperative complications were reported. Conclusions: Both TUN + CTG and CAF + CTG are safe and effective techniques for treating RT1 and RT2 gingival recession, offering high percentages of root coverage and increased KTW. While CAF + CTG achieved slightly superior coverage and tissue gain, the TUN was associated with better aesthetic outcomes and faster recovery, making it a valuable alternative in clinical practice. Full article

Bcakground: The deepithelialized free gingival graft (DGG) technique provides high-quality connective tissue grafts (CTGs) with predictable outcomes for recession coverage. This study evaluates a novel method of free gingival graft (FGG) deepithelialization using an Er,Cr:YSGG laser (LDEE) for treating multiple gingival recessions. Methods: A split-mouth study was conducted on 46 (n = 46) recessions in nine patients (23 per test and control group). Sites were randomized. Full-thickness palatal grafts were harvested with a scalpel. In the test group (LDEE), deepithelialization was performed extraorally using an Er,Cr:YSGG laser (2780 nm; 2.5 W, 83.3 mJ, 30 Hz, 600 µm tip). In the control group (DEE), a 15c scalpel was used. All CTGs were applied using the modified coronally advanced tunnel (TUN) technique. Clinical parameters—recession depth (RD), keratinized tissue width (KT), gingival thickness (GT), pocket depth (PD), clinical attachment loss (CAL), pink esthetic score (PES), approximal plaque index (API), mean root coverage (MRC), and complete root coverage (CRC)—were assessed at baseline (T0), 3 months (T1), and 6 months (T2). Results: Both LDEE and DEE groups showed significant improvements in RD, KT, GT, PD, and CAL over time (p < 0.001). At T1 and T2, KT was significantly higher in the LDEE group (T1: 3.73 ± 0.72 mm; T2: 3.98 ± 0.76 mm) compared to the DEE group (T1: 3.21 ± 0.61 mm; T2: 3.44 ± 0.74 mm; p < 0.05). Other parameters (RD, GT, PD, CAL) showed no statistically significant intergroup differences at any time point (p > 0.05). After 6 months, MRC was 95% and CRC 82.6% for LDEE, compared to 94.8% and 82.6% for DEE (p > 0.05). PES scores were similar between groups at all time points (p > 0.05). Conclusions: Both laser- and scalpel-deepithelialized grafts effectively treated gingival recessions. LDEE combined with TUN resulted in significantly greater KT width compared to DEE + TUN. Full article

Skin aging causes reduced hydration, elasticity, and increased wrinkles. Recent safety and compliance concerns over oral collagen supplements have increased interest in plant-based alternatives like Hibiscus sabdariffa with antioxidant and anti-aging properties. However, clinical evidence regarding its efficacy remains limited. We aimed to evaluate the effects of this plant-based collagen alternative (VC-H1, Hibiscus Enzyme Extract) supplement on skin hydration, transepidermal water loss (TEWL), desquamation, elasticity, and wrinkle reduction in photoaged individuals. A randomized, double-blind, placebo-controlled clinical trial was conducted with 98 participants (aged 35–60 years) presenting with dry skin and periorbital wrinkles. Participants randomly received 1.5 g/day of VC-H1 or placebo for 12 weeks. Skin hydration, TEWL, deep moisture, keratin index, elasticity, and wrinkle parameters were assessed at baseline, 6 weeks, and 12 weeks. VC-H1 supplementation significantly increased skin hydration, reduced the TEWL and keratin index, and improved deep moisture content for those receiving it compared with the controls. Wrinkle depth significantly decreased, and skin elasticity also improved. Those in the VC-H1 group showed greater overall improvement than those in the control group. Oral VC-H1 supplementation significantly improved skin hydration, elasticity, and wrinkle reduction, suggesting its potential as a plant-based alternative to traditional collagen supplements for skin rejuvenation. Full article

Urothelial carcinoma (UC) is a common genitourinary malignancy. Smoking, exposure to arsenic in drinking water, and age can increase the risk of developing UC. Neoadjuvant cisplatin-based chemotherapy prior to radical cystectomy is the standard treatment for the muscle invasive form of UC (MIUC). Tumors of the basal/squamous (Ba/Sq) subtype of MIUC are aggressive, express basal keratins (KRT5, 6, and 14), are associated with squamous differentiation (SD), and frequently develop chemotherapy resistance. The SOX2 transcription factor is a marker of UC stem cells, and its expression is associated with poor overall and disease-free survival. We hypothesized that the attenuation of SOX2 would reduce the expression of basal keratins and increase the chemotherapy response in human UC cells. For this study, we performed lentiviral knockdown (KD) of SOX2 expression in two separate arsenite (As³⁺)-transformed UROtsa (As_I, As_II), 5637, and RT4 cells. Cellular growth and colony-forming ability was inhibited in all UC cell lines after SOX2 KD. We demonstrate that SOX2 KD in the UC cells of the Ba/Sq subtype (As_I, As_II, 5637) decreased the expression of stem-associated proteins, oncoproteins, and basal keratins. Additionally, there was an induction of several luminal markers and enhanced cisplatin sensitivity following the repression of SOX2. Lastly, proteomics revealed reductions in lipid-, cholesterol-, and interferon-signaling pathways after SOX2 KD. This study provides a better understanding of the regulation of key genes responsible for defining the Ba/Sq subtype of UC and demonstrates that the inhibition of SOX2 improves chemotherapy response in UC. Full article

Background: Ensuring a minimum peri-implant keratinized mucosa width (PIKM-W) is critical for maintaining dental implant health, as inadequate PIKM-W is associated with increased risks of plaque accumulation, mucosal inflammation, and peri-implantitis. While epithelialized connective tissue grafts (ECTGs) are considered the gold standard for soft tissue augmentation, they often lead to significant patient morbidity. Xenogeneic dermal matrices (XDMs) offer a less invasive alternative, but are prone to shrinkage, particularly in the mandible. The aim of this study was to evaluate a new surgical method to overcome these limitations with the combination of a narrow band of ECTG (autogenous strip graft, ASG) and an XDM to augment the PIKM-W in the posterior mandible. Methods: Twelve patients with a PIKM-W of less than 2 mm in the mandible underwent peri-implant soft tissue augmentation using this combined approach. Changes in the PIKM-W were measured preoperatively; immediately postoperatively; and at 1, 3, 6, 9, and 12 months. Graft remodeling (shrinkage or contraction) and PIKM thickness (PIKM-T) were also evaluated over time. Results: Preoperatively, the mean PIKM-W was 0.39 ± 0.40 mm and the PIKM-T was 1.36 ± 0.43 mm. At 6 months, the mean PIKM-W was 4.93 ± 0.98 mm and the PIKM-T was 2.88 ± 0.80 mm, with shrinkage of 39.2 ± 14.1%. By 12 months, the mean PIKM-W stabilized at 4.58 ± 1.28 mm and the PIKM-T stabilized at 2.83 ± 0.65 mm, with shrinkage of 42.2% ± 16.8%. Conclusions: There were statistically significant differences in clinical parameters between the baseline and 6 and 12 months (p < 0.05). This technique demonstrated the potential for stable augmentation of PIKM-W and PIKM-T over time, with manageable shrinkage. However, further studies with larger sample sizes are needed to confirm its clinical efficacy as an alternative for mandibular keratinized mucosa augmentation around implants. Full article

Background and Objectives: Gingival recession is a common periodontal condition that can lead to aesthetic and functional problems if untreated, necessitating the development of effective root coverage techniques. The aim of this study was to compare two different root coverages for localized gingival recession on the lower anterior teeth using a partially de-epithelialized connective tissue graft (PE-CTG). Materials and Methods: This study included 18 patients (20 teeth) with lower anterior tooth recession. In the tPECTG group (seven patients, eight teeth), the recipient site was prepared with supraperiosteal tunneling. In the vPECTG group (11 patients, 12 teeth), the recipient site was prepared using the vestibular incision subperiosteal tunnel access technique. In both groups, partially de-epithelialized connective tissue was harvested from the hard palate using a high-speed handpiece diamond burr. The change in root coverage was evaluated based on vertical recession and keratinized tissue (KT) values before surgery and 6 months after surgery. Results: The mean root coverage was 89.01% across all cases, with the tPECTG and vPECTG groups achieving 87.85% and 89.78%, respectively. The average KT gain was 3.48 ± 1.37 mm, with the tPECTG group showing 3.94 ± 1.74 mm and the vPECTG group showing 3.17 ± 1.03 mm. No significant differences were found between the two groups for either parameter (p > 0.05). Conclusions: Within the limitations of this retrospective case series, vPECTG was as effective as tPECTG, but easier. Moreover, in both groups, the keratinized gingival width increased, and the mucogingival junction was maintained. Full article

The outermost surface of wool is covered by a scale layer, posing challenges to some steps of fabric processing. This layer, primarily composed of keratin, resists degradation by conventional proteases due to its high disulfide bond content. Protease K, an extracellular serine endo-proteinase derived from Tritirachium album Limber (tPRK), is known for its ability to digest native keratin. However, its limited activity against keratin has restricted its application in wool scale layer treatment. In this study, the substrate-binding pocket of tPRK was engineered, yielding the mutant N162A, which demonstrated an 84% increase in catalytic activity toward keratin. Additionally, the catalytic efficiency (k_cat/K_m) of N162A on keratin improved by 44.52%. Structural analysis indicated that modifications in the substrate-binding pocket reduced steric hindrance during substrate entry while enhancing substrate binding. Additionally, 3.3 mg/mL of amino acids were released within 6 h, which were catalyzed by N162A, with a 61% increase compared to the native tPRK. Moreover, the N162A variant effectively reduced the scale layer thickness without compromising the tensile strength of the wool, maintaining its mechanical properties. The findings provide a sustainable strategy for the wool industry while broadening the scope of biotechnological applications in the textile sector. Full article

Background: Cervical cancer is the most important cancer type found in women throughout the world. Numerous research studies are being performed to investigate the effectiveness of different strategies for the imaging and treatment of locally advanced cervical cancer, which are showing favorable outcomes. Brachytherapy is characterized by the application of very high radiation doses to target tumor cells with the least exposure to normal tissues. Methods: In the present case study, we report a 43-year-old female patient suffering from cervical cancer belonging to urban origin, with no personal pathological history, who presented herself to the gynecology department of the Bihor County Emergency Clinical hospital with vaginal bleeding. The histopathological examination of the cervix showed squamous cell carcinoma. The treatment was performed with neoadjuvant chemotherapy and concurrent chemoradiotherapy. Results: According to the clinical and histopathological examination, a diagnosis of non-keratinizing squamous carcinoma of the uterine cervix at FIGO stage III C1 was established. Radio-chemotherapy was performed, as well as periodic imaging assessments with a CT of the chest, pelvis, and abdomen, without local and distant relapse. FDG PET imaging was performed for the management and follow-up of cervical cancer by retrieving the SUVmax value. Conclusions: The post-therapeutic complications are represented by the vaginal stenosis installed 6 months after the end of the radiotherapeutic treatment. Full article

Urothelial carcinoma (UC) is prevalent, especially in elderly males. The high rate of recurrence, treatment regime, and follow-up monitoring make UC a global health and economic burden. Arsenic is a ubiquitous toxicant that can be found in drinking water, and it is known that exposure to arsenic is associated with UC development. Around 25% of diagnosed UC cases are muscle-invasive (MIUC) which have poor prognosis and develop chemoresistance, especially if tumors are associated with squamous differentiation (SD). The immortalized UROtsa cell line is derived from normal human urothelium and our lab has malignantly transformed these cells using arsenite (As³⁺). These cells represent a basal subtype model of MIUC and the tumors derived from the As³⁺-transformed cells histologically and molecularly resemble clinical cases of the basal subtype of MIUC that have focal areas SD and expression of the basal keratins (KRT1, 5, 6, 14, and 16). Our previous data demonstrate that KRT6 protein expression correlates to areas of SD within the tumors. For this study, we performed a lentiviral knockdown of KRT6 in As³⁺-transformed UROtsa cells to evaluate the effects on morphology, gene/protein expression, growth, colony formation, and cisplatin sensitivity. The knockdown of KRT6 resulted in decreased expression of the basal keratins, decreased growth, decreased colony formation, and increased sensitivity to cisplatin, the standard treatment for MIUC. The results of this study suggest that KRT6 plays a role in UC cell growth and is an exploitable target to increase cisplatin sensitivity for MIUC tumors that may have developed resistance to cisplatin treatment. Full article

This systematic review investigates the efficacy of using connective tissue grafting (CTG) versus an acellular dermal matrix (ADM) for soft tissue management in immediate implant placement (IIP). The study focuses on comparing the soft tissue thickness (STT) and keratinized tissue width (KTW) changes post-implantation. Adhering to the PRISMA guidelines, a comprehensive literature search was conducted, targeting randomized clinical trials and cohort studies involving soft tissue grafting in conjunction with IIP. Data extraction and analysis focused on STT and KTW measurements from baseline to follow-up intervals of at least 6 months. The statistical analyses included the weighted mean differences and heterogeneity assessments among the studies. The meta-analysis revealed no significant difference in the STT gain between CTG and ADM at 12 months, with the weighted mean differences favoring the control group but lacking statistical significance (CTG: 0.46 ± 0.53 mm, p = 0.338; ADM: 0.33 ± 0.44 mm, p = 0.459). The heterogeneity was high among the studies, with discrepancies notably influenced by individual study variations. Similarly, the changes in KTW were not significantly different between the two grafting materials. Conclusions: Both CTG and ADM are viable options for soft tissue management in IIP, with no significant difference in efficacy regarding the soft tissue thickness and keratinized tissue width outcomes. Future research should aim to minimize the heterogeneity and explore the long-term effects to better inform clinical decisions. Full article

The skin is covered by a protective mucus layer, which is essential to the innate defense mechanism of fish. Investigating the response of skin mucus to various toxic stresses is crucial for enhancing its ability to tackle environmental challenges and developing strategies to mitigate toxic effects. Alkalinity stress assays (50 mmol/L NaHCO₃) were conducted on crucian carp (Carassius auratus) from Lake Dali Nur (pH = 9.6) and Ping Xiang red crucian carp from freshwater (pH = 7) over 7 days. The expression of skin mucous proteins was analyzed using the liquid chromatography (LC)-spectrometry (MS)/MS Analysis-Data-independent acquisition (DIA) mode. A total of 12,537 proteins were identified across 20 samples from four groups, with 12,025 quantified. In the alkaline water population, high alkali stress resulted in the up-regulation of 139 proteins and the down-regulation of 500 proteins. In contrast, the freshwater population showed an increase in 112 proteins and a decrease in 120; both populations had a total of 23 genes up-regulated and 21 down-regulated. The protein regulatory network for the alkaline water group included 3146 pairwise interactions among 464 nodes, with only 20 being differentially expressed proteins. Conversely, the freshwater group’s network comprised just 1027 specific interactions across 337 nodes, with 6 corresponding to differentially expressed proteins. A common protein regulatory network responding to high alkali stress was extracted and visualized for both populations. Based on their regulatory relationships and expression levels, these proteins are hypothesized to play similar roles under high alkali stress. Notably, the alpha-globin fragment and keratin type I cytoskeletal 13-like proteins showed markedly up-regulated expression, with the alpha-globin fragment increasing nearly a thousandfold from an extremely low level. This suggests it could serve as a potential biomarker for alkali tolerance, warranting further investigation. Full article

Equine gastric ulcer syndrome (EGUS) is a common condition in horses. This study explores the use of liquid proteomics to identify new biomarkers in saliva and serum to monitor EGUS treatment. The proteomes of horses with EGUS before and after a successful treatment with omeprazole were analysed. In saliva, 503 proteins were identified, with 7 upregulated and 6 downregulated post-treatment. Among the proteins that changed, there was an increase in vimentin, linked to wound healing, and a decrease in podocalyxin, associated with tissue damage. In serum, 206 proteins were found, with significant changes in 5. Keratin type I increased, supporting epithelial integrity, whereas immunoglobulin lambda decreased, indicating a reduced immune response. Gene ontology analysis revealed a decrease in immune-related pathways after successful treatment. Overall, 13 proteins in saliva and 5 in serum showed significant changes after treatment, highlighting the differential responses of saliva and serum in EGUS. This report creates new avenues for discovering potential biomarkers to monitor EGUS treatment, which is of high importance for the management of this prevalent disease. Full article

This study aimed to assess clinical and radiographic outcomes, including implant survival, marginal bone loss, and patient satisfaction, in individuals with severe bone atrophy treated using a newly developed system of short and extra-short implants. A total of 44 implants (37 short and 7 extra-short) were placed with immediate loading in 11 patients. The patients were followed up at between 6 and 24 months. Bone changes, keratinized mucosa, bleeding on probing, probing depth, crown-to-implant ratio, and patient satisfaction were evaluated. An implant survival and success rate of 100% was observed. The peri-implant bone condition showed no significant associations between marginal bone loss (MBL) and gingival recession. In extra-short implants, the crown-to-implant ratio did not affect MBL in the evaluated times. However, short implants showed a statistically significant inverse correlation between mesial measurement and crown-to-implant ratio (p = 0.006) and between distal measurement and crown-to-implant ratio (p = 0.004) over six months. Plaque was present in the mesiobuccal regions in 38.64% of the implants, with extra-short implants having the highest relative frequency (71.4%). Bleeding was observed in 18.9% of the short implants in the mesiolingual region and 14.3% of the extra-short implants. There was a statistically significant association between bleeding on probing in the mesiobuccal region and the type of implant (p = 0.026). The analysis of probing depth showed no difference between the types of implants. Within the limits of this study, short and extra-short implants presented similar clinical and radiographic behavior of soft and hard tissues in the evaluated times. Full article

Background/Aim: The stability of peri-implant tissues is crucial for the long-term success of dental implant treatments. A new cervical implant design has been developed to address the challenges associated with peri-implant tissue stability, featuring a concave cervical portion to increase tissue volume in this area. The present study aimed to clinically evaluate the effectiveness of the new cervical implant design in maintaining peri-implant tissue stability. Materials and Methods: Five clinical cases involving completely edentulous patients were selected, in which 25 implants were installed. The marginal bone level around each implant was assessed at three different time points—T0: immediately after the prosthesis installation, T1: 6 months post installation, and T2: at the last control visit, up to 38 months later. Measurements were taken to analyze changes in marginal bone levels (MBLs) and the keratinized mucosa (KM) over time. Furthermore, the keratinized mucosa (KM) around the implants was evaluated. Results: The mean and standard deviation values of the marginal bone levels at each time point were as follows—T0: 0.59 ± 0.55 mm; T1: 1.41 ± 0.59 mm; T2: 1.76 ± 0.69 mm. Statistical analysis showed significant differences across the time points (ANOVA p < 0.0001). The overall mean KM values were 3.85 mm for T1 and T2, showing the stability of the peri-implant soft tissues at ≥1-year controls. Conclusion: Within the limitations of the present study, the results showed that the Collo implants presented measured MBL values increasing within the time range analyzed in each case but within the normal values cited in the literature for these types of rehabilitation treatments. However, the measured KM values presented, in all cases, an average above the values referenced in the literature as a minimum for maintaining the health of the peri-implant tissues. Full article

Introduction: Acantholytic squamous cell carcinoma (aSCC) is a rare clinicopathological subtype of cutaneous squamous cell carcinoma, accounting for approximately 4.9% of all SCC cases. However, there are currently no standardized criteria for the diagnosis of aSCC. This systematic review is the first to summarize the clinical and molecular features of aSCC. Methods: A systematic search of Medline, Embase, Scopus, and PubMed was performed. All articles in English or French were included, with no restriction of publication date. All articles with original data pertaining to clinical or molecular characteristics of aSCC were included. Two reviewers screened articles and resolved conflicts. Results: Our systematic review included 52 studies on the clinical and molecular features of aSCC, including a total of 482 patients (76% male, mean age at diagnosis 68.9 years): 430 cases assessed clinical features, while 149 cases assessed molecular features. The most common location of aSCC was the head and neck (n = 329/430; 76.5%). In terms of morphology, most lesions were described as nodules (n = 93/430, 21.6%), with common surface changes being hyperkeratosis (n = 6), erosion (n = 6), ulceration (n = 5), and crusting (n = 3). With regard to dermoscopy, only six cases were noted in the literature, including findings such as ulceration (n = 3), keratin clots (n = 2), and erosions (n = 2). Thirty-four studies discussed the molecular markers of aSCC, with the most prevalent markers being cytokeratins. CD15 negativity was noted in 23 cases, while common endothelial vascular markers such as CD34 (n = 16), CD31 (n = 15), factor VIII-related antigen (n = 10), and ERG (n = 1) were often not expressed. Finally, expression of intracellular adhesion molecules (i.e., E-cadherin, CD138) was markedly decreased compared to non-acantholytic invasive SCC. Conclusions: This systematic review summarizes the clinical characteristics and molecular features of aSCC. As clinical differentiation can be difficult, clinicopathological correlation with molecular markers may help ensure proper diagnosis. Full article