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  5. Woodpecker超声设备在牙科临床应用中的研究进展

Woodpecker超声设备在牙科临床应用中的研究进展

文献检索匿名用户发表于 2026年07月02日 08:452阅读
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查找桂林啄木鸟超声喷砂洁牙机机所有临床文献

Based on the provided evidence, here is an overview of clinical literature mentioning "Woodpecker" (啄木鸟) ultrasonic devices, specifically in relation to dental applications:

1. Minimally Invasive Caries Removal Techniques:

  • Study Focus: An in vitro assessment evaluated the efficiency and effectiveness of three minimally invasive (MI) techniques, including ultrasonic abrasion using a "WOODPECKER, GUILIN, China" device, in removing deep dentin carious lesions from extracted carious molars .
  • Methodology: Forty extracted carious molars were treated using various methods: conventional rotary excavation (control), chemomechanical caries removal agent (Brix 3000), ultrasonic abrasion (WOODPECKER, GUILIN, China), and Er, Cr: YSGG laser ablation (BIOLASE San Clemente, CA, USA) . Assessments included excavation time, DIAGNOdent pen readings, Raman spectroscopy, Vickers microhardness, and scanning electron microscope combined with energy dispersive X-ray spectroscopy (SEM-EDX) .
  • Findings: The study supported the efficiency of MI methods, including ultrasonic abrasion, as conservative alternatives to rotary excavation for caries removal, providing a promising strategy for clinical dental practice . While the rotary method had the shortest excavation time, MI techniques like ultrasonic abrasion resulted in lower phosphate and higher organic content, associated with lower microhardness in deeper dentin layers, and smooth residual dentin without smearing and patent dentinal tubules .

2. Piezo-assisted Rhinoplasty:

  • Study Focus: A study aimed to optimize closed-approach preservation rhinoplasty by using ultrasonic piezo-assisted techniques for enhanced precision .
  • Instrumentation: This study specifically mentioned "Woodpecker (Guilin, China) SS18 and SS4 inserts" as being optimized to enhance cutting efficiency for the removal of the perpendicular plate of the ethmoid, and for lateral and transverse osteotomies during rhinoplasty procedures .
  • Findings: The use of piezoelectric instruments, including those from Woodpecker, improved precision and reduced trauma, supporting advanced closed preservation rhinoplasty techniques . The study observed a 6% revision rate, predominantly for dorsal contour adjustments, with minimal intraoperative bleeding, swelling, and postoperative pain, demonstrating the effectiveness of piezoelectric assistance .

3. Bacterial Decontamination on Implants:

  • Study Focus: A study aimed to evaluate three different methods of decontaminating implants with three different surfaces (machined, sandblasted and acid-etched (SLA), and hydroxyapatite (HA)-coated) .
  • Methodology: Dental implants were coated with Escherichia coli biofilm and then treated with a sonic scaler mechanical debridement using a "Woodpecker PT5 sonic scaler" (1st group), a combination of sonic scaler and chemical agent Perisolv® (2nd group), and Er:YAG laser treatment (3rd group) .
  • Findings: The highest level of decontamination for machined-surface implants was achieved with the scaler and Perisolv® group, while for HA-coated implants, the Er:YAG laser irradiation method was most effective . The study concluded that the method of peri-implantitis management should be customized according to the type of implant surface .

4. General Ultrasonic Scalers in Periodontal Therapy and Implant Maintenance:

While "Woodpecker" is not explicitly mentioned in all these contexts, ultrasonic scalers and devices are broadly discussed as tools in dental care.

  • Guided Biofilm Therapy (GBT): One randomized controlled clinical trial evaluated the effectiveness of the GBT protocol, which includes an ultrasonic scaler, compared to conventional instrumentation (including sonic scaler) in non-surgical periodontal therapy (NSPT) for reducing pathologically increased pocket probing depths . The GBT protocol, which incorporates ultrasonic scalers, resulted in comparably good clinical treatment outcomes in stage III-IV periodontitis patients, with a significantly shorter treatment time than conventional methods .
  • Aerosol Spread: A study evaluated particle spread associated with various common periodontal aerosol-generating procedures (AGPs), including ultrasonic scaling, in simulated and clinical settings . It found that ultrasonic scalers generated a significant amount of aerosol and droplet particles up to 1.2 m from the source, but the use of high-volume suction (HVS) effectively reduced 82-93% of these particles . Clinically, routine ultrasonic supragingival scaling produced few detectable traces of salivary protein, suggesting that contamination primarily consists of irrigant rather than organic matter from the oral cavity .
  • Vector Scaler System: A systematic review examined the effect of instrumentation with the "Vector ultrasonic scaler" on human teeth, comparing it to conventional ultrasonic instruments and/or hand instrumentation . The Vector ultrasonic scaler provided comparable clinical and microbiological periodontal healing results as scaling and root planing and conventional ultrasonic systems in moderately deep pockets, and was considered a gentle root debridement device for supportive periodontal therapy, though it required extra time for instrumentation .
  • Long-term Implant Maintenance: A systematic review on long-term implant maintenance strategies found that evidence favors glycine powder air-polishing and ultrasonic devices over traditional mechanical debridement with curettes in improving clinical parameters around implants, such as reducing inflammation .
  • Non-surgical Therapy for Peri-implantitis: A systematic review evaluating the efficacy and safety of non-surgical treatment of peri-implantitis noted that while the evidence neither supported nor refuted the clinical efficacy of submucosal debridement using curettes or ultrasonic scalers alone, adjunctive local delivery of antibiotics, submucosal glycine powder air polishing, or Er:YAG laser treatment resulted in greater reduction in bleeding on probing compared to submucosal debridement using curettes with adjunctive chlorhexidine irrigation .

In summary, "Woodpecker" (啄木鸟) ultrasonic devices from Guilin, China, are explicitly mentioned and evaluated in the context of minimally invasive caries removal and piezo-assisted rhinoplasty, demonstrating their application and efficacy in these specialized dental and surgical fields . Additionally, a "Woodpecker PT5 sonic scaler" was specifically used in a study evaluating bacterial decontamination of dental implants . Broader discussions on ultrasonic scalers in periodontal therapy, aerosol management, and implant maintenance also highlight the general utility and effectiveness of such devices in dental clinical practice .

References

1An in vitro assessment of the residual dentin after using three minimally invasive caries removal techniques.PubMed

Rand Mohammed Al-Sagheer, Ali J Addie, Lamis A Al-Taee
To evaluate the efficiency and effectiveness of three minimally invasive (MI) techniques in removing deep dentin carious lesions. Forty extracted carious molars were treated by conventional rotary excavation (control), chemomechanical caries removal agent (Brix 3000), ultrasonic abrasion (WOODPECKER, GUILIN, China); and Er, Cr: YSGG laser ablation (BIOLASE San Clemente, CA, USA). The assessments include; the excavation time, DIAGNOdent pen, Raman spectroscopy, Vickers microhardness, and scanning electron microscope combined with energy dispersive X-ray spectroscopy (SEM-EDX). The rotary method recorded the shortest excavation time (p < 0.001), Brix 3000 gel was the slowest. DIAGNOdent pen values ranged between 14 and 18 in the remaining dentin and laser-ablated surfaces recorded the lowest reading (p < 0.001). The Ca:P ratios of the remaining dentin were close to sound dentin after all excavation methods; however, it was higher in the ultrasonic technique (p < 0.05). The bur-excavated dentin showed higher phosphate and lower matrix contents with higher tissue hardness that was comparable to sound dentin indicating the non-selectiveness of this technique in removing the potentially repairable dentin tissue. In contrast, the MI techniques exhibited lower phosphate and higher organic contents associated with lower microhardness in the deeper dentin layers. This was associated with smooth residual dentin without smearing and patent dentinal tubules. This study supports the efficiency of using MI methods in caries removal as conservative alternatives to rotary excavation, providing a promising strategy for the clinical dental practice.

2Optimizing Closed-Approach Preservation Rhinoplasty by Ultrasonic Piezo-assisted Techniques for Enhanced Precision.PubMed

Ruben Guilarte, Gerardo Malzone
BACKGROUND: Preservation rhinoplasty, particularly dorsal preservation, has gained prominence with the advent of piezoelectric instruments, which minimize trauma and enhance precision in bone reshaping. This approach presents unique challenges, especially in closed techniques, where spatial limitations complicate the use of piezotomes. OBJECTIVES: The aim of this study was to evaluate outcomes of piezo-assisted preservation rhinoplasty performed with specialized instrumentation to enhance visibility, precision, and postoperative recovery in closed rhinoplasty procedures. METHODS: In a cohort of 734 patients undergoing primary rhinoplasty between May 2021 and April 2023, piezoelectric instruments facilitated closed preservation techniques. Cases were documented with a focus on instrument adaptation, bone reshaping precision, and the mitigation of postoperative complications. RESULTS: A 6% revision rate was observed, predominantly for dorsal contour adjustments, with minimal intraoperative bleeding, swelling, and postoperative pain, demonstrating the effectiveness of piezoelectric assistance. Woodpecker (Guilin, China) SS18 and SS4 inserts were specifically optimized to enhance cutting efficiency for removal of the perpendicular plate of the ethmoid, and for lateral and transverse osteotomies. CONCLUSIONS: Piezo-assisted rhinoplasty improves precision and reduces trauma, supporting advanced closed preservation rhinoplasty techniques. Although all osteotomies can now be performed with ultrasonic piezotomes, enhanced instrument design may further refine outcomes, facilitating minimally invasive, aesthetically superior results.

3Evaluation of the three methods of bacterial decontamination on implants with three different surfaces.PubMed

Paweł Kubasiewicz-Ross, Małgorzata Fleischer, Artur Pitułaj, et al.
BACKGROUND: The main goal of the treatment of the peri-implantitis is to decontaminate the surface of the implant, thereby enabling further treatment involving, e.g., guided bone regeneration. Since new implants of the rougher surface were introduced to the common dental practice, decontamination is even more difficult. OBJECTIVES: The aim of the study was to evaluate 3 different methods of decontaminating implants with 3 different surfaces. MATERIAL AND METHODS: A total of 30 dental implants with 3 different surface types (machined, sandblasted, and acid-etched (SLA) and hydroxyapatite (HA)-coated) were used in the study. Each group of implants was coated with Escherichia coli biofilm and cultivated. Afterwards, the implants were transferred to the jaw model and treated with a different method: sonic scaler mechanical debridement with a Woodpecker PT5 sonic scaler (1st group), and mechanical debridement with sonic scaler and with the combination with chemical agent Perisolv® (2nd group), and with Er:YAG laser treatment (3rd group). Each implant was treated with the specific method and sent for further microbiological evaluation. RESULTS: The highest level of decontamination was achieved for machined-surface implants and the lowest for HA-coated implants. The method with the highest biofilm reduction was the scaler and Perisolv® group. The highest level of decontamination of HA-coated implants were achieved for Er:YAG laser irradiation method. CONCLUSIONS: In the following paper, the superiority of combined chemical-mechanical method of decontaminating the surface of the implant on SLA and machined-surface implants was proved. On the contrary, Er:YAG laser irradiation was reported as the best option for decontamination of the HA-coated implants. In our opinion, it is a significant finding, revealing that the method of peri-implantitis management should be considered in accordance to the type of the surface of the implant (customized to the surface of the implant).

4Biomechanical Analysis of Woodpecker Response During Pecking Using a Two-Dimensional Computational Model.PubMed

Shailesh Ganpule, Sunil Sutar, Kaustaubh Shinde
Traumatic brain injury (TBI) and chronic traumatic encephalopathy (CTE) due to the impact is a critical health concern. Impact mitigation strategy is a vital design paradigm to reduce the burden of TBI and CTE. In this regard, woodpecker biomimicry continues to attract attention. However, a direct comparison between a woodpecker and human biomechanical responses is lacking. Toward this end, we investigate the biomechanical response of a woodpecker during pecking using a two-dimensional head model. We also analyze the response of concurrent human head model to facilitate direct comparison with woodpecker response. The head models of woodpecker and human were built from medical images, the material properties were adopted from the literature. Both woodpecker and human head models were subjected to head kinematics obtained during pecking and resulting biomechanical response is studied. For the pecking cycle simulated in this work, peak rotational velocity and acceleration were ∼15 rad/s and 7,057 rad/s. These peak values are commensurate with the kinematics threshold values reported in human TBI. Our results show that, for the same input acceleration, the strains and stresses in the woodpecker brain are approximately six times lower than that of the human brain. The stress reduction is mainly attributed to the smaller size of the woodpecker head. The effect of pecking frequency and multiple pecking cycles have also been studied. It is observed that the strains and stresses in the brain are increased by ∼100% as pecking frequency is doubled. During multiple pecking cycle, dwell period of ∼90 ms tend to relax the stresses in the woodpecker brain; however, the amount of relaxation depends on the value of the decay constant. The comparison of biomechanical response against the axonal injury threshold suggests that for peak rotational acceleration of 7,057 rad/s the maximum principal strain in the brains of woodpecker and human exceed the threshold limit. Acceleration scaling relationship between a woodpecker and equivalent human response is also developed as a function of head size. We obtain a scaling factor, , of 0.11 for baseline head sizes and a scaling factor of 1.03 as the human head size approaches woodpecker head size.

5Mechanisms linking hypertriglyceridemia to acute pancreatitis.PubMed

Lóránd Kiss, Gabriella Fűr, Sailaja Pisipati, et al.
Hypertriglyceridemia (HTG) is a metabolic disorder, defined when serum or plasma triglyceride concentration (seTG) is >1.7 mM. HTG can be categorized as mild to very severe groups based on the seTG value. The risk of acute pancreatitis (AP), a serious disease with high mortality and without specific therapy, increases with the degree of HTG. Furthermore, even mild or moderate HTG aggravates AP initiated by other important etiological factors, including alcohol or bile stone. This review briefly summarizes the pathophysiology of HTG, the epidemiology of HTG-induced AP and the clinically observed effects of HTG on the outcomes of AP. Our main focus is to discuss the pathophysiological mechanisms linking HTG to AP. HTG is accompanied by an increased serum fatty acid (FA) concentration, and experimental results have demonstrated that these FAs have the most prominent role in causing the consequences of HTG during AP. FAs inhibit mitochondrial complexes in pancreatic acinar cells, induce pathological elevation of intracellular Ca concentration, cytokine release and tissue injury, and reduce the function of pancreatic ducts. Furthermore, high FA concentrations can induce respiratory, kidney, and cardiovascular failure in AP. All these effects may contribute to the observed increased AP severity and frequent organ failure in patients. Importantly, experimental results suggest that the reduction of FA production by lipase inhibitors can open up new therapeutic options of AP. Overall, investigating the pathophysiology of HTG-induced AP or AP in the presence of HTG and determining possible treatments are needed.

6Guided biofilm therapy versus conventional protocol-clinical outcomes in non-surgical periodontal therapy.PubMed

Miriam Cyris, Julia Festerling, Maren Kahl, et al.
BACKGROUND: The aim of the randomized controlled clinical trial study was to evaluate the effectiveness in reducing pathologically increased pocket probing depths (PPD > 3 mm) using the Guided Biofilm Therapy (GBT) protocol (adapted to the clinical conditions in non-surgical periodontal therapy (NSPT): staining, air-polishing, ultrasonic scaler, air-polishing) compared to conventional instrumentation (staining, hand curettes/sonic scaler, polishing with rotary instruments) both by less experienced practitioners (dental students). METHODS: All patients were treated according to a split-mouth design under supervision as diseased teeth of quadrants I/III and II/IV randomly assigned to GBT or conventional treatment. In addition to the treatment time, periodontal parameters such as PPD and bleeding on probing (BOP) before NSPT (T0) and after NSPT (T1: 5 ± 2 months after T0) were documented by two calibrated and blinded examiners (Ethics vote/ Trial-register: Kiel-D509-18/ DRKS00026041). RESULTS: Data of 60 patients were analyzed (stage III/IV: n = 36/ n = 24; grade A/ B/ C: n = 1/ n = 31/ n = 28). At T1, a PPD reduction of all diseased tooth surfaces was observed in 57.0% of the GBT group and 58.7% of the control group (p = 0.067). The target endpoint (PPD ≤ 4 mm without BOP) was achieved in 11.5% for GBT (conventional treatment: 11.2%; p = 0.714). With the exception for number of sites with BOP, which was at T1 15.9% in the GBT group and 14.3% in the control group (p < 0.05) no significant differences between the outcomes of the study were found. At 30.3(28.3) min, the treatment time was significantly shorter in GBT than in the control group at 34.6(24.5) min (p < 0.001). CONCLUSIONS: With both protocols (GBT/ conventional instrumentation) comparably good clinical treatment results can be achieve in NSPT in stage III-IV periodontitis patients. TRIAL REGISTRATION: The study was registered before the start of the study and can be found under the number DRKS00026041 in the German Clinical Trials Register. The registration date was 19/08/2021.

7Simulated and clinical aerosol spread in common periodontal aerosol-generating procedures.PubMed

Anthony Puljich, Kexin Jiao, Ryan S B Lee, et al.
OBJECTIVES: This study evaluated particle spread associated with various common periodontal aerosol-generating procedures (AGPs) in simulated and clinical settings. MATERIALS AND METHODS: A simulation study visualized the aerosols, droplets, and splatter spread with and without high-volume suction (HVS, 325 L/min) during common dental AGPs, namely ultrasonic scaling, air flow prophylaxis, and implant drilling after fluorescein dye was added to the water irrigant as a tracer. Each procedure was repeated 10 times. A complementary clinical study measured the spread of contaminated particles within the dental operatory and quantified airborne protein dispersion following 10 min of ultrasonic supragingival scaling of 19 participants during routine periodontal treatment. RESULTS: The simulation study data showed that air flow produced the highest amount of splatters and the ultrasonic scaler generated the most aerosol and droplet particles at 1.2 m away from the source. The use of HVS effectively reduced 37.5-96% of splatter generation for all three dental AGPs, as well as 82-93% of aerosol and droplet particles at 1.2 m for the ultrasonic scaler and air polisher. In the clinical study, higher protein levels above background levels following ultrasonic supragingival scaling were detected in fewer than 20% of patients, indicating minimal particle spread. CONCLUSIONS: While three common periodontal AGPs produce aerosols and droplet particles up to at least 1.2 m from the source, the use of HVS is of significant benefit. Routine ultrasonic supragingival scaling produced few detectable traces of salivary protein at various sites throughout the 10-min dental operatory. CLINICAL RELEVANCE: The likelihood of aerosol spread to distant sites during common periodontal AGPs is greatly reduced by high-volume suction. Clinically, limited evidence of protein contaminants was found following routine ultrasonic scaling, suggesting that the the majority of the contamination consisits of the irrigant rather than organic matter from the oral cavity.

8Andrographolide Mitigates Inflammation and Reverses UVB-Induced Metabolic Reprogramming in HaCaT Cells.PubMed

Carolina Manosalva, Pablo Alarcón, Lucas Grassau, et al.
Andrographolide (AP), a bioactive compound from , is known for its anti-inflammatory and antioxidant properties, both essential for wound healing. However, its effects on energy metabolism during tissue repair and its role in UVB-induced photoaging remain poorly understood. This study explored AP's multitarget therapeutic effects on wound healing under photoaging conditions (PhA/WH) using network pharmacology and experimental validation. Scratch wound assays showed that AP promoted keratinocyte migration in UVB-exposed HaCaT cells. Bioinformatic analysis identified 10 key targets in PhA/WH, including TNF-α, IL-1β, JUN, PPARγ, MAPK3, TP53, TGFB1, HIF-1α, PTGS2, and CTNNB1. AP suppressed UVB-induced pro-inflammatory gene expression (, , , and ) and inhibited the phosphorylation of ERK1/2 and P38, while enhancing Hypoxia-Inducible Factor-1alpha ( and peroxisome proliferator-activated receptors expression. GC/MS-based metabolomics revealed that AP reversed UVB-induced disruptions in fatty acid metabolism, glycolysis/gluconeogenesis, and tricarboxylic acid (TCA) cycle, indicating its role in restoring the metabolic balance necessary for tissue regeneration. In conclusion, andrographolide modulates key inflammatory and metabolic pathways involved in wound repair and photoaging. These mechanistic insights contribute to a better understanding of the molecular processes underlying skin regeneration under photodamage and may inform future therapeutic strategies.

9The effect of the Vector scaler system on human teeth: a systematic review.PubMed

D E Slot, T J G Koster, S Paraskevas, et al.
AIM: To review the available literature, considering the effect of instrumentation with the Vector ultrasonic scaler on human teeth in vitro and in vivo compared to conventional ultrasonic instruments and/or hand instrumentation. The assessed effects are calculus removal, time of instrumentation, root surface aspects, cell attachment, patients' perception, bleeding upon probing, pocket depth, clinical attachment loss and microbiological effects. MATERIALS AND METHODS: MEDLINE-PubMed and the Cochrane Central register of controlled trials (CENTRAL) were searched up through January 2008 to identify appropriate studies. RESULTS: Independent screening of the titles and abstracts of 270 MEDLINE-PubMed and 15 Cochrane papers resulted in 15 suitable publications. The studies differed in design and outcome, so this review summarizes the outcomes in a descriptive manner. Comparisons are presented against conventional ultrasonic system and scaling and root planing. CONCLUSION: The Vector ultrasonic scaler provided comparable clinical and microbiological periodontal healing results as scaling and root planing and conventional ultrasonic system in moderately deep pockets. The Vector ultrasonic scaler may be used as a gentle root debridement device for supportive periodontal therapy, as an alternative to other conventional ultrasonic system. The operator should however consider the extra time needed for instrumentation.

10Long-term Implant Maintenance: A Systematic Review of Home and Professional Care Strategies in Supportive Implant Therapy.PubMed

Tiago Guimarães Araújo, Cristiano Soares Moreira, Rodrigo Amigo Neme, et al.
UNLABELLED: The aim of this study is review the efficacy of different techniques of home care and professional care for long-term implant maintenance, when compared with their respective standard procedures (regular brushing or mechanical debridement with curette), in changing clinical parameters, such as bleeding on probing, probing depth, plaque score and gingival index, as reported in randomized clinical trials. MATERIALS AND METHODS: A systematic literature search of randomized clinical trials was performed using the PubMed (MEDLINE), EMBASE and Cochrane library databases. A qualitative review was conducted to compare all the different techniques of home care and professional care for long-term implant maintenance. RESULTS: Initial search involved a total of 816 articles, 233 via Pubmed (Medline), 306 via the Cochrane Library, and 483 via EMBASE, while an additional 16 articles were collected through manual screening. A total of 29 articles were assessed by full-text read for eligibility and a final count of 13 studies were included in systematic review. The results of the risk of bias assessment for the included RCTs according to the 'RoB 2'. Results favored glycine powder air-polishing and ultrasonic devices over traditional mechanical debridement with curettes in improving clinical parameters. In at-home care, water flossers with chlorhexidine were able to reduce inflammation. CONCLUSIONS: Evidence points towards the use of glycine powder air-polishing and the use of ultrasonic devices for reduction of inflammation around implants, and for home care, many existing techniques seem to be able to control tissue inflammation, but the use of chlorhexidine in water-flossers seems to be a promising strategy.

11Episodic ataxia type 2.PubMed

Michael Strupp, Andreas Zwergal, Thomas Brandt
Episodic ataxia type 2 (EA 2) is a rare neurological disorder of autosomal dominant inheritance resulting from dysfunction of a voltage-gated calcium channel. It manifests with recurrent disabling attacks of imbalance, vertigo, and ataxia, and can be provoked by physical exertion or emotional stress. In the spell-free interval, patients present with central ocular motor dysfunction, mainly downbeat nystagmus. A slow progression of cerebellar signs accompanied by a slight atrophy of midline cerebellar structures is commonly observed during the course of the disease. EA 2 is caused most often by the loss of function mutations of the calcium channel gene CACNA1A, which encodes the Ca(v)2.1 subunit of the P/Q-type calcium channel and is primarily expressed in Purkinje cells. To date, more than 30 mutations have been described. Two effective treatment options have been established for EA 2: acetazolamide (ACTZ), which probably changes the intracellular pH and thereby the transmembraneous potential, and 4-aminopyridine (4-AP), a potassium channel blocker. Approximately 70% of all patients respond to treatment with ACTZ, but the effect is often only transient. In an open trial, 4-AP prevented attacks in five of six patients with EA 2, most likely by increasing the resting activity and excitability of the Purkinje cells. These findings were confirmed by experiments in animal models of EA 2. Many aspects of the pathophysiology (e.g., induction of the attacks) and treatment of EA 2 (e.g., mode of action of ACTZ and 4-AP) still remain unclear and need to be addressed in further animal and clinical studies.

12Non-surgical therapy for the management of peri-implantitis: a systematic review.PubMed

Manoj Muthukuru, Arbia Zainvi, Enrique O Esplugues, et al.
UNLABELLED: Peri-implantitis is characterized by mucosal inflammation and loss of supporting peri-implant bone. OBJECTIVE: The objective of this systematic review was to evaluate the efficacy and safety of non-surgical treatment of peri-implantitis. MATERIALS AND METHODS: MEDLINE, Embase, and Web of Science were searched to identify randomized clinical trial studies that assessed non-surgical treatment of peri-implantitis with a minimum follow-up period of 3 months. RESULTS: From a total of 29 abstracts, nine trials were included in this systematic review. Adjunctive local delivery of antibiotics, submucosal glycine powder air polishing, or Er:YAG laser treatment resulted in greater reduction in bleeding on probing compared with submucosal debridement using curettes with adjunctive irrigation with chlorhexidine. In addition, greater reductions in probing depths were found following adjunctive local delivery of antibiotics. The evidence neither supported nor refuted the clinical efficacy of submucosal debridement using curettes or ultrasonic scalers alone. No progressive bone loss was found following any of the assessed treatments over a maximum observation period of 12 months. Only two studies reported implant survival rates, which were 100% over 6 months. CONCLUSIONS: The available evidence suggested that submucosal debridement with adjunctive local delivery of antibiotics, submucosal glycine powder air polishing, or Er:YAG laser treatment may reduce clinical signs of peri-implant mucosal inflammation to a greater extent relative to submucosal debridement using curettes with adjunctive irrigation with chlorhexidine. Long-term randomized controlled trials are needed to assess the efficacy of non-surgical therapy on progressing bone loss, implant survival rates, and measures of oral health-related quality of life.

13Diabetes as a consequence of acute pancreatitis.PubMed

Ericka Charley, Brett Dinner, Kimberly Pham, et al.
Diabetes is a highly prevalent disease that was initially simplified into three major types: Type 1, type 2 and gestational diabetes. With the global rise in incidence of acute pancreatitis (AP), a lesser-known type of diabetes referred to as diabetes of the exocrine pancreas (DEP) is becoming more recognized. However, there is a poor understanding of the inherent relationship between diabetes and AP. There is established data about certain diseases affecting the exocrine function of the pancreas which can lead to diabetes. More specifically, there are well established guidelines for diagnosis and management of DEP caused be chronic pancreatitis. Conversely, the sequelae of AP leading to diabetes has limited recognition and data. The purpose of this review is to provide a comprehensive summary of the prevalence, epidemiology, pathophysiology and future research aims of AP-related diabetes. In addition, we propose a screening and diagnostic algorithm to aid clinicians in providing better care for their patients.

14GIPR Agonism Inhibits PYY-Induced Nausea-Like Behavior.PubMed

Ricardo J Samms, Richard Cosgrove, Brandy M Snider, et al.
The induction of nausea and emesis is a major barrier to maximizing the weight loss profile of obesity medications, and therefore, identifying mechanisms that improve tolerability could result in added therapeutic benefit. The development of peptide YY (PYY)-based approaches to treat obesity are no exception, as PYY receptor agonism is often accompanied by nausea and vomiting. Here, we sought to determine whether glucose-dependent insulinotropic polypeptide (GIP) receptor (GIPR) agonism reduces PYY-induced nausea-like behavior in mice. We found that central and peripheral administration of a GIPR agonist reduced conditioned taste avoidance (CTA) without affecting hypophagia mediated by a PYY analog. The receptors for GIP and PYY (Gipr and Npy2r) were found to be expressed by the same neurons in the area postrema (AP), a brainstem nucleus involved in detecting aversive stimuli. Peripheral administration of a GIPR agonist induced neuronal activation (cFos) in the AP. Further, whole-brain cFos analyses indicated that PYY-induced CTA was associated with augmented neuronal activity in the parabrachial nucleus (PBN), a brainstem nucleus that relays aversive/emetic signals to brain regions that control feeding behavior. Importantly, GIPR agonism reduced PYY-mediated neuronal activity in the PBN, providing a potential mechanistic explanation for how GIPR agonist treatment reduces PYY-induced nausea-like behavior. Together, the results of our study indicate a novel mechanism by which GIP-based therapeutics may have benefit in improving the tolerability of weight loss agents.

15Novel drug targets for the early treatment of acute pancreatitis: Focusing on calcium signaling.PubMed

Jin-Hao Chen, Robert Sutton, Li Wen
Acute pancreatitis (AP) is a common but potentially devastating disease characterized at onset pathophysiologically by premature activation of digestive enzymes within the pancreas. Despite an abundance of preclinical research and, until recently, a series of disappointing clinical trials, no specific disease modifying pharmacological treatment has yet been approved for this condition. Recent novel approaches to understanding the molecular pathogenesis of AP provide us with renewed optimism for translational drug discovery. Although digestive enzyme activation is the hallmark of AP, a critical mechanism that initiates AP is intracellular calcium (Ca) overload in pancreatic parenchymal cells, which triggers mitochondrial dysfunction, endoplasmic reticulum (ER) stress, and impairs autophagic flux. These processes are pivotal to the disease and present a range of drug targets, associated with the inflammatory responses that drive local and systemic inflammation in AP. Progress in translation has now been made, targeting the ORAI channel with the inhibitor zegocractin (Auxora) to reduce pancreatic injury and inflammatory responses in human AP. Herein we evaluated potential drug targets for the early treatment of AP, focused on intra-acinar mechanisms of injury central to the onset and severity of AP. Our analysis highlights the opportunities and progress in translating these molecular insights into clinical therapies.

16Difelikefalin for pruritus associated with renal disease.PubMed

Lucio Manenti, Paride Fenaroli
Chronic kidney disease-associated pruritus (CKD-aP) has been recognized for over a century. The complex pathophysiology of CKD-aP makes it challenging to find an effective treatment; the proposed therapeutic options come from anecdotal reports and small clinical trials, which at best compare the test drug against placebo. Gabapentinoids have shown relevant efficacy but there are serious safety concerns about their possible central nervous system toxicity. Recently difelikefalin, a κ-opioid receptor agonist, has been the first Food and Drug Administration (FDA)-approved drug for moderate-severe CKD-aP treatment. Approval from other regulatory agencies is expected in 2022. In this article, preclinical, pharmacokinetic and safety studies on difelikefalin are reported, but a great part of the data derive from meeting abstracts and non-peer-review communications and this is a possible cause for concern regarding bias in publication. A review of published and unpublished studies about difelikefalin in CKD-aP treatment is provided. Currently, two published large trials show that difelikefalin offers a new therapeutic opportunity to treat CKD-aP, a condition that leads to both worse survival and quality of life in hemodialysis patients.

17Hypertriglyceridemia-induced acute pancreatitis in children: A mini-review.PubMed

John M Grisham, Andrew H Tran, Kate Ellery
Severe hypertriglyceridemia (HTG) is a known metabolic cause of acute pancreatitis (AP) in pediatric patients. The incidence of hypertriglyceridemia-induced acute pancreatitis (HTG-AP) is less well established in pediatric compared to adult patients. Studies in adults suggest that higher risk of AP occurs when triglyceride levels (TG) are >1,000 mg/dL. Most common etiologies for severe HTG in pediatric patients are either from primary hypertriglyceridemia, underlying genetic disorders of lipid and TG metabolism, or secondary hypertriglyceridemia, separate disease or exposure which affects TG metabolism. Most common theories for the pathophysiology of HTG-AP include hydrolysis of TG by pancreatic lipase to free fatty acids leading to endothelial and acinar cell damage and ischemia, as well as hyperviscosity related to increased chylomicrons. Though there are varying reports of HTG-AP severity compared to other causes of AP, a steadily growing body of evidence suggests that HTG-AP can be associated with more severe course and complications. Therapeutic interventions for HTG-AP typically involve inpatient management with dietary restriction, intravenous fluids, and insulin; select patients may require plasmapheresis. Long term interventions generally include dietary modification, weight management, control of secondary causes, and/or antihyperlipidemic medications. Though some therapeutic approaches and algorithms exist for adult patients, evidence-based management guidelines have not been well established for pediatric patients.
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