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IntroductionWithin the last decades, collagen types I and III have been established as a sufficient biomaterial for GBR and GTR procedures. They might also be an adequate matrix for soft tissue augmentations. However, collagen materials differ significantly regarding resorption time, biodegradation pattern and the invasion of inflammatory cells.The aim of the present study was to compare the biodegradation and tissue integration of native, differently processed and cross-linked collagen scaffolds in rats.MethodsFour experimental porcine collagen matrices of 1.0 mm thickness, developed for soft tissue augmentation procedures, were tested. Based on the same native dermal Type I and III collagen, native (ND, Mucoderm® prototype), specifically defatted (DD), ethylene dioxide cross-linked (ECL) and dehydrothermally cross-linked (DCL) dermis collagen (AAP/Botiss Biomaterials, Berlin, Germany) were evaluated. Two specimens of 1 × 1 cm were fixed around a non-absorbable spacer using non-absorbable sutures. After rehydration, specimens (N = 8) were randomly allocated in unconnected subcutaneous pouches on the back of 40 Wistar rats. Rats were divided into five groups (1, 2, 4, 8 and 12 weeks), including eight animals each. After each period, eight rats were sacrificed and explanted specimens were prepared for histological analysis. The following parameters were evaluated: membrane thickness as a sign of biodegradation and volume stability, cell ingrowth, vascularization, tissue integration and foreign body reaction.ResultsBiodegradation pattern of the non cross-linked collagen scaffolds differed only slightly in terms of presence of inflammatory cells and cell invasion into the matrix. In terms of biodegradation, ECL displayed a considerable slower resorption than ND, DCL and DD. Chemical cross-linking using ethylene dioxide showed a significant higher invasion of inflammatory cells.ConclusionWithin the limits of the present study it was concluded that the processing techniques influenced the collagen properties in a different intensity. Dehydrothermal cross-linking and special defatting did not notably change the biodegradation pattern, whereas cross-linking using ethylene dioxide led to significant higher volume stability of the matrix. However, ECL showed an increased inflammatory response and compromised tissue integration. Therefore, ethylene dioxide seems to be not suitable for stabilization of collagen matrices for soft tissue augmentation procedures.

First generation tetraploids were produced by hydrostatic pressure treatment before the first cleavage and raised until the adult stage. Their survival and growth were severely depressed when compared to the diploid control: after two years, no ovulated females were found although males produced sperm at 1 and 2 years of age and were mated individually with diploid females. The progenies were consistently normal with high survival rates. They were found to be almost all triploids by karyology, which failed to detect a significant rate of aneuploidies. However, the fertilizing ability of tetraploid males was always low (0 to 97% of the control; average 40%). Several arguments presented here support the hypothesis that diploid spermatozoas, which are wider than haploid ones, would be frequently blocked during their penetration through the micropyle canal. Second generation tetraploids were produced after such matings by heat shocks, causing the retention of the second polar body. Their survival and growth were much more satisfactory than in the first generation, although still lower than in diploid and triploid controls issuing from diploid parents. Performances of second generation triploids were comparable to those of diploids, and slightly better than those of conventional triploids issuing from diploid parents. 94.5% of the second generation tetraploids were male.

Overall, the results suggest that PADM is a promising substitute for autogenous soft tissue grafts in periodontal surgery.

Implant-supported prosthodontics requires precise impressions to achieve a passive fit. Since the early 1990s, in vitro studies comparing different implant impression techniques were performed, capturing the data mostly mechanically. The purpose of this study was to evaluate the accuracy of three different impression techniques digitally. Dental implants were inserted bilaterally in ten polymer lower-arch models at the positions of the first molars and canines. From each original model, three different impressions (A, transfer; B, pick-up; and C, splinted pick-up) were taken. Scan-bodies were mounted on the implants of the polymer and on the lab analogues of the stone models and digitized. The scan-body in position 36 (FDI) of the digitized original and master casts were each superimposed, and the deviations of the remaining three scan-bodies were measured three-dimensionally. The systematic error of digitizing the models was 13 μm for the polymer and 5 μm for the stone model. The mean discrepancies of the original model to the stone casts were 124 μm (±34) μm for the transfer technique, 116 (±46) μm for the pick-up technique, and 80 (±25) μm for the splinted pick-up technique. There were statistically significant discrepancies between the evaluated impression techniques (p ≤ 0.025; ANOVA test). The splinted pick-up impression showed the least deviation between original and stone model; transfer and pick-up techniques showed similar results. For better accuracy of implant-supported prosthodontics, the splinted pick-up technique should be used for impressions of four implants evenly spread in edentulous jaws.

For better accuracy of implant-supported prosthodontics, the splinted pick-up technique should be used for impressions of four implants evenly spread in edentulous jaws.

IntroductionTo determine the esthetic outcome of implant-based reconstructions after autologous and allogeneic bone grafting.MethodsFrom 2003 to 2009, 67 patients underwent alveolar ridge augmentation and were enrolled in the study, 41 meet the inclusion criteria and 31 agreed to take part in the study. Patients were 18-69 years old (mean: 49.3 ± 13.8 years), and predominantly female. Patients received bone block grafts either autologous (n = 48) (AUBB) or allografts (ABB) (n = 19). Implants were inserted 4-7 months (autografts) or 5-6 months (allografts) after bone grafting. The Pink Esthetic Score (PES) as well as radiographic and subjective assessments were employed for the outcome analysis. The PES was assessed twice within one month based on digital photographic images that were randomly rearranged between evaluations by three independent, experienced investigators.ResultsAcross all observations and investigators, the average PES was 7.5 ± 2.6 without differences between implants inserted in auto- and allografted bone, respectively. Patients assessed the allograft procedures as less painful and would have repeated it more often. The intra-rater reliability was excellent (correlation coefficients 0.7-0.9). The inter-observer agreement was lower (correlation coefficients 0.6-0.8).ConclusionsBone grafting with ABB allografts yields equivalent results to autologous grafting, and patients appreciate the omission of bone harvesting. The PES is a reliable method but should be performed by the same individual.

On the basis of results from previous trials and mechanistic models, concerns have been raised about the occurrence of severe cardiovascular events (SCEs) following the initiation of the anti-interleukin (IL)-12/23p40 monoclonal antibody ustekinumab.Findings: Following a case-time-control analysis based on the French National Health Insurance database 2010-2016, we suggest that the initiation of anti-IL-12/23p40 could trigger acute coronary syndrome or stroke in patients with a high baseline cardiovascular risk.Meaning: Ustekinumab treatment should be prescribed with caution to patients at high cardiovascular risk.