The Need for Re-education of Dental Practitioners Regarding the Management of Dental Infections During The COVID-19 Pandemic: From The Perspective of A Dual-Degree Oral And Maxillofacial Surgery Clinic

Due to the ongoing COVID-19 pandemic, hospitals around the world implement various measures to prevent the spread of infection among medical staff. Due to an excessive overload of intensive care units (ICUs), medical staff of various disciplines was assigned to COVID-19 patients upon the official announcement of the outbreak. In the countries where education to become an oral and maxillofacial surgeon (OMFS) requires a degree in both stomatology (DDS) and medicine (MD), OMFSs were also assigned to work in ICUs to manage the COVID- 19 patients. On the other hand, some of the departments, including oral and maxillofacial surgery clinics, have also decided to work in double teams to ensure that only one team had a patient contact and the remaining half of the staff could be protected from COVID-19 infection

Mesenchymal Stem Cells for Optimizing Bone Volume at the Dental Implant Recipient Site

Inadequate bone volume at the implant recipient site presents a clinical challenge for many dental practitioners. To overcome these problems, several approaches have been developed and are currently used, including bone grafting strategies and distraction osteogenesis. Mesenchymal stem cells (MSCs) have gained their popularity within the last two decades, with regard to promising clinical results in improving the bone architecture at the implant recipient site. The aim of this chapter was to briefly outline the accessibility properties, differentiation capacities, isolation, and characterization of MSCs with regard to optimizing bone volume in dental implantology. Additionally, potential benefits and pitfalls are discussed in comparison with the conventional bone augmentation techniques

Organic Bone Matrix Component Type I and V Collagen Are Not Destructed in Bisphosphonate-Associated Osteonecrosis of the Jaws

Background and objectives: The investigation of the pathophysiology behind medication-related osteonecrosis (MRONJ) of the jaw mostly focuses on alterations in osteoclast and osteoblast cell activity, but changes in the organic and inorganic bone matrix have rarely been studied. The aim of this study was to investigate whether collagen, the main organic component of extracellular bone matrix, is destructed in osteonecrosis of the jaw secondary to antiresorptive medication. Material and methods: Bone samples of patients with MRONJ (n = 15, control group n = 3) were demineralized, and collagen fragments were separated from intact collagen pellets by ultrafiltration. The quantification of mature collagen cross-links hydroxylysylpyridinoline (HP) and lysylpyridinoline (LP) in pellets and ultrafiltrates was performed by high-performance liquid chromatography (HPLC). The detection of hydroxyproline (Hyp) was carried out using a spectrophotometric assay. In addition, collagen chains were analyzed by sodium dodecylsulfate-polyacrylamide gel (SDS-PAGE). Results: The results revealed significantly higher concentrations of HP, LP and Hyp in pellet samples. In addition, there were no significant differences between samples from MRONJ patients and those of the control group. These results were paralleled by SDS- PAGE. Conclusion: These findings suggest that MRONJ does not involve the destruction of type I and V collagen molecules, in contrast to previously reported destruction by osteoradionecrosis

Introducing a Novel Experimental Model for Osseo-Disintegration of Titanium Dental Implants Induced by Monobacterial Contamination: An In-Vivo Feasibility Study

Background and Objectives: The aim of the current study was to establish an osseo-disintegration model initiated with a single microorganism in mini-pigs. Materials and Methods: A total of 36 titanium dental implants (3.5 mm in diameter, 9.5 mm in length) was inserted into frontal bone (n: 12) and the basis of the corpus mandible (n: 24). Eighteen implants were contaminated via inoculation of Enterococcus faecalis. Six weeks after implant insertion, bone-to-implant contact (BIC) ratio, interthread bone density (ITBD), and peri-implant bone density (PIBD) were examined. In addition to that, new bone formation was assessed via fluorescence microscopy, histomorphometry, and light microscopical examinations. Results: Compared to the sterile implants, the contaminated implants showed significantly reduced BIC (p < 0.001), ITBD (p < 0.001), and PBD (p < 0.001) values. Around the sterile implants, the green and red fluorophores were overlapping and surrounding the implant without gaps, indicating healthy bone growth on the implant surface, whereas contaminated implants were surrounded by connective tissue. Conclusions: The current experimental model could be a feasible option to realize a significant alteration of dental-implant osseointegration and examine novel surface decontamination techniques without impairing local and systemic inflammatory complications

Microbiological Characteristics and Surgical Management of Animal-Bite-Related Oral & Maxillofacial Injuries: A Single Center's Experience

The objective of the current study is to retrospectively evaluate animal-bite injuries and to gain insight into the epidemiology, accident consequences and treatment concept of these accidents in oral and maxillofacial surgery. Data of patients, who were admitted January 2015 and April 2021, were retrospectively evaluated regarding the patients' characteristics (age, gender), facial distribution of substance defects/partial amputations, duration of hospitalization, operation treatments and antibiotic treatments. Data of 75 patients were included. Patients were bitten by dogs (n = 69.92%), cats (n = 4) and horses (n = 2). Lower eyelid/cheek complex was the most affected region (n = 37, 32.74%). Most of the patients between 0 and 3 years had to be operated on under general anesthesia (p = 0.011), while most of the adults could be operated on under local anesthesia (p = 0.007). In the age group 0-12 years, 30 patients (68%) were operated on under general anesthesia. Ampicillin/Sulbactam (48%) was the antibiotic most used. Antibiotics were adjusted after wound swabs in case of wound infections or critical wound conditions. This means that resistant antibiotics were stopped, and sensitive antibiotics were used. Structured surgical and antibiotic management of animal-bite wounds in the maxillofacial region is the most important factor for medical care to avoid long-term aesthetic consequences. Public health actions and policies under the leadership of an interdisciplinary committee could improve primary wound management, healing outcome and information status in the general population

Cytocompatibility of Novel Algae-PLA Membranes For Guided Bone Regeneration At The Level of Types I, III And V Collagen Expression

Statement of the problem: In recent years, the development of innovative and increasingly optimized barrier membranes has focused on marine algae, which as a biopolymer can form a membrane composite together with polylactic acid, thus a combination could show numerous advantages such as antioxidant, antitumor, antibacterial, antiviral as well as antiallergic properties. Furthermore, algae can be produced in an ecologically sustainable way and offer an alternative for patients who refuse treatment with bovine or porcine derived membranes due to ethical or religious reasons.Objective: In this study, four different algal membranes were evaluated for their cytocompatibility with cultured human fibroblasts and osteoblasts.Materials & Methods: Mem-Lok® (Collagen Matrix, New Jersey, USA) as a resorbable collagen membrane and ArgonautTM (Botiss Biomaterials, Zossen, Germany) as a native pericardium GBR/GTR membrane served as reference membranes (RMs). As the negative control cells incubated with normal culture medium only were used. In addition to the cell viability and proliferation assays water soluble tetrazolium (WST), MTT and BrdU, a real time semiquantitative real time PCR (RT-PCR) was developed to investigate in vitro cytocompatibility at the level of types I, III and V collagen expression. A sandblasted- large grid-acid ached titanium surface (Dentcon® Dental Implant Systems, Ankara, Turkey) served as a positive inactive control group for osteoblastic cytocompatibility.Results: For human osteoblasts, the algal membranes showed very good proliferation levels in WST-1, MTT as well as BrdU, indicating cytocompatibility. Examination of the expression behavior of type I, type III, and type V collagen genes showed no evaluable results. However, the RT-PCR should be repeated with the incorporated optimizations to be able to make a statement regarding the success of bone, skin, and connective tissue regeneration after a possible application of the membrane in maxillofacial injury treatment.Conclusion: The investigated collagen types are essential for a proper healing of defects in both soft and bone tissue, as they have fundamental functions such as stability and structural integrity of the tissues

A Novel Surface Modification Strategy via Photopolymerized Poly-Sulfobetaine Methacrylate Coating to Prevent Bacterial Adhesion on Titanium Surfaces

Recent investigations on the anti-adhesive properties of polysulfobetaine methacrylate (pSBMA) coatings had shown promising potential as antifouling surfaces and have given the impetus for the present paper, where a pSBMA coating is applied via photopolymerization on a macro-roughened, sandblasted, and acid-etched titanium implant surface in order to assess its antifouling properties. Current emphasis is placed on how the coating is efficient against the adhesion of Enterococcus faecalis by quantitative assessment of colony forming units and qualitative investigation of fluorescence imaging and scanning electron microscopy. pSBMA coatings via photopolymerization of titanium surfaces seems to be a promising antiadhesion strategy, which should bring substantial benefits once certain aspects such as biodegradation and osseointegration were addressed. Additionally, commercial SAL-titanium substrates may be coated with the super-hydrophilic coating, appearing resistant to physiological salt concentrations and most importantly lowering E. faecalis colonization significantly, compared to titanium substrates in the as-received state. It is very likely that pSBMA coatings may also prevent the adhesion of other germs

Initiated Chemical Vapor Deposition (iCVD) Functionalized Polylactic Acid-Marine Algae Composite Patch for Bone Tissue Engineering

The current study aimed to describe the fabrication of a composite patch by incorporating marine algae powders (MAPs) into poly-lactic acid (PLA) for bone tissue engineering. The prepared composite patch was functionalized with the co-polymer, poly (2-hydroxyethyl methacrylate-co-ethylene glycol dimethacrylate) (p(HEMA-co-EGDMA)) via initiated chemical vapor deposition (iCVD) to improve its wettability and overall biocompatibility. The iCVD functionalized MAP-PLA composite patch showed superior cell interaction of human osteoblasts. Following the surface functionalization by p(HEMA-co-EGDMA) via the iCVD technique, a highly hydrophilic patch was achieved without tailoring any morphological and structural properties. Moreover, the iCVD modified composite patch exhibited ideal cell adhesion for human osteoblasts, thus making the proposed patch suitable for potential biomedical applications including bone tissue engineering, especially in the fields of dentistry and orthopedy

Marine Algae Incorporated Polylactide Acid Patch: Novel Candidate for Targeting Osteosarcoma Cells without Impairing the Osteoblastic Proliferation

Biodegradable collagen-based materials have been preferred as scaffolds and grafts for diverse clinical applications in density and orthopedy. Besides the advantages of using such bio-originated materials, the use of collagen matrices increases the risk of infection transmission through the cells or the tissues of the graft/scaffold. In addition, such collagen-based solutions are not counted as economically feasible approaches due to their high production cost. In recent years, incorporation of marine algae in synthetic polymers has been considered as an alternative method for preparation grafts/scaffolds since they represent abundant and cheap source of potential biopolymers. Current work aims to propose a novel composite patch prepared by blending Sargassum vulgare powders (SVP) to polylactide (PLA) as an alternative to the porcine-derived membranes. SVP-PLA composite patches were produced by using a modified solvent casting method. Following detailed material characterization to assess the cytocompatibility, human osteoblasts (HOBs) and osteosarcoma cells (SaOS-2) were seeded on neat PLA and SVP-PLA patches. MTT and BrdU assays indicated a greater cytocompatibility and higher proliferation for HOBs cultured on SVP-PLA composite than for those cultured on neat PLA. SaOS-2 cells cultured on SVP-PLA exhibited a significant decrease in cell proliferation. The composite patch described herein exhibits an antiproliferative effect against SaOS-2 cells without impairing HOBs' adhesion and proliferation

Awareness and Knowledge of SARS-CoV-2 Infection among Dental Professionals According to the Turkish National Dental Guidelines

The objective of the current survey was to assess the awareness of the dental professionals according to the principals described by the Turkish Dental Association (TDA). A questionnaire including the socio-demographic data, specialties/academic degree, institutions/affiliations, the knowledge about COVID-19, the number of patients examined and dental treatments performed during the COVID-19 pandemic, the knowledge of protection based on the guidelines described by TDA, contamination with COVID-19 and the psychological complaints has been used. A total of 947 (63.1%) dentists enrolled the study. The results showed satisfactory knowledge about the COVID-19 etiology, mode of transmission and the pre-procedural cautions as the majority of them had a fair level of knowledge with significantly higher knowledge among specialized respondents. The participants have also recorded a good judgment towards performing the emergency dental treatment during the current COVID-19 pandemic which corresponds with the guidelines determined by TDA. Considering the updates on the transmission of COVID-19 and protective strategies, there is an urgent need for improvement of dentists&rsquo; knowledge about risk assessment via training programs. The incidence of positive testing among dental professionals also necessitates immediately testing of asymptomatic Turkish dental professionals