Impressions

Research Explores Eggshell Membrane’s Potential in Bone Regeneration

A new study published in Biomaterials Advances revealed that eggshell membrane can be used as a biomaterial for dental and bone regeneration. The research was conducted by researchers from the University of Granada, affiliated with the Biohealth Research Institute in Granada, and in conjunction with colleagues from the Andalusian Earth Sciences Institute (IACT) of the Spanish National Research Council (CSIC). They were assisted by experts from the National University of Colombia, the Andalusian Health Service and Universities of Oviedo and Jaén.

The biomaterial, which is composed of myriad of collagens coated with hyaluronic acid and proteins, highlights the double function vital for dental applications and bone regeneration. More specifically, the material used in the study is made up of eggshell membrane from a laying hen, which has an outer surface coated with nanocrystalline calcium phosphate apatite. This helped prevent mineralization and preserved the internal surface. Jaime Gómez Morales, principal investigator at IACT’s Laboratory of Crystallographic Studies, described using a novel vapor diffusion crystallization technique to create a bifunctional biomaterial. This material mimics bone apatite’s properties, with an osteoinductive exterior and an interior that resists cell invasion.

The study, which earned the 2023 Spanish Institute of Egg Studies Research Award, dives into the membrane’s composition, which involves the mammillate structures that are important for calcium carbonate nucleation. Coupled with the vapor diffusion crystallization technique, this characteristic produces a biomaterial that serves as a barrier to cell invasion on one side and is osteoinductive on the other. This theoretically could replace existing materials in guided bone regeneration. Additionally, the membrane is resorbable.

In vitro studies have shown the biomaterial’s capability to prompt cells that are bone forming, enhance biocompatibility and mechanical properties. This shows promise beyond the regeneration of bone to dental applications such as pulp capping, a more compatible choice than existing materials thanks to its composition of calcium phosphate.

The researchers highlighted the possibilities in fields like regenerative dentistry and traumatology. It is leading to a patent registration and serves as a big milestone by spotlighting the beneficial and versatile elements of eggshell membrane in medical applications.

The Black Death Pandemic May Have Reshaped Oral Microbiomes and Modern Health

The Second Plague Pandemic in the mid-14^th century could have altered the oral microbiomes of humans, according to a new study. Also known as Black Death, this pandemic significantly reduced the population of Europe. The Penn State and University of Adelaide study finds that what happened then might be impacting the chronic diseases in humans in modern-day time.

The study, published in Nature Microbiology, is a result of 235 samples from people buried across Scotland and England and is the largest of such kind. The samples come from the time period of 2200 B.C. to 1853 A.D. and establishes a connection between modern chronic diseases like cardiovascular issues, obesity and modern microbiomes. The results included the discovery of two bacterial communities: One made up of Methanobrevibacter, which is almost extinct, and another primarily from Streptococcus, which is common today. What is interesting is that nearly 11% of the microbiome composition variation is linked to temporal changes, which includes the aftermath of Black Death.

Laura Weyrich, associate professor at Penn State, said the changes to diet post-pandemic could have influenced the shifts in these microbiomes. This is because the Streptococcus group featured traits connected to modern diets that include a lot of carbohydrates and a low level of fiber. Additionally, the research, which was supported by the Australian Research Council and National Science Foundation, connects the Streptococcus group to periodontal disease and the Methanobrevibacter group to skeletal pathologies.

The study sheds light on the evolution of oral microbiomes as well as how we understand modern non-communicable diseases.

Daily Toothbrushing Reduces Pneumonia and ICU Mortality in Hospitalized Patients

Hospitalized patients may significantly benefit health-wise from toothbrushing. A new study by the Harvard Pilgrim Health Care Institute and Brigham and Women’s Hospital found that daily toothbrushing is connected to a reduction in pneumonia acquired from the hospital, specifically in patients on mechanical ventilation.

Pneumonia acquired in a hospital is typically caused by oral bacteria gaining entry into the lungs, which poses a serious threat to immunocompromised or frail patients. And because toothbrushing on a daily basis decreases oral bacteria, the risk is lowered. The study’s lead author, Michael Klompas, MD, MPH, noted the cost efficiency and effectiveness of this basic strategy.

The meta-analysis and systemic review conducted by the research team uncovered that toothbrushing is also linked to lower ICU mortality rates. Additionally, ICU patients had less days in which they were on mechanical ventilation and overall shorter stays on ICU if they brushed their teeth.

The study, published in JAMA Internal Medicine, largely focused on adults in the ICU, and only two of them examined how impactful toothbrushing was on non-ventilated patients. The study’s researchers hope the benefits do extend to non-ICU patients, however.

Dr Klompas is advocating that hospitals adopt policies that ensure toothbrushing occurs in patients that are hospitalized, hinting that care teams should be able to assist if the patient needs it.

Study Explores Oral Health Decline in Patients Undergoing Surgical Obesity Treatment

There is a concerning trend as it relates to the deterioration of oral health in people who have surgical obesity treatment. A thesis from the University of Gothenburg shows that this impacts patients with a BMI of 40 or more, or those with additional medical complications such as diabetes and a BMI of 35 or more. These patients went through surgery to either medically treat or surgically remove the elements of their body responsible for obesity.

The study, which was part of the larger BAriatic surgery SUbstitution and Nutrition (BASUN) study, included 118 people considered to be obese. The patients who had surgical treatment saw a bump in tooth enamel caries of 15.0 to 19.1 lesions on average, as well as an increase in deeper dentine caries (from 4.3 to 6.4 lesions) over a two-year period. The associations were significant even after incorporating factors like other medical conditions and socioeconomic status.

The author of the thesis, Negin Taghat, emphasized the wide ranging implications of the study. Specifically, Taghat, who is a dentist with Swedish Public Dental Service, highlighted that patients who went through surgical treatment for obesity also experienced chewing difficulties and tooth hypersensitivity. This obviously resulted in a poor oral quality of life and social discomfort.

The study is a notice for health care professionals to be aware of the potential connection between oral health changes and obesity treatment. Understanding this will assist with preventive measures and extending care that is comprehensive for the patients. The larger BAriatic surgery SUbstitution and Nutrition study compared the long-term outcomes of medical and surgical obesity treatments and long-term outcomes.

Study Results in Potential Breakthrough in Tissue Regeneration Over Traditional Root Canals

The future of dental care may look a little different. That is because new research by ADA Forsyth scientists points to using tissue regeneration over root canal treatments. The scientists set out to explore a technology intended to treat endodontic diseases, which impacts pulp inside teeth. Specifically, the study delves into regenerative capabilities of Resolvin E1 (RvE1), a molecule that is part of the Specialized Pro-resolving Mediators (SPMs) class. These specific molecules are produced naturally within the body and serve an important role in controlling disease-associated inflammation.

Senior Scientist at ADA Forsyth, Dr Thomas Van Dyk highlighted the limitations of modern root canals, such as the extraction of large amounts of dentin and the elevated risk of tooth fractures. The research aims to help establish a method for regenerating dental pulp rather than leaning on traditional methods of filling the root. Dental pulp inflammation usually stems from tooth damage related to caries, injury or cracks. This can lead to infection that can hurt the pulp and create more complications if not treated.

The research included applying RvE1 to different levels of damaged and infected pulp to analyze its anti-inflammatory and regenerative properties. The study found that RvE1 promoted the regeneration of pulp in instances of direct pulp-capping of living or vital pulp. This is similar to reversible pulpitis. Also identified was the mechanism that supports tissue regeneration. Additionally, while RvE1 didn’t create regeneration in necrotic and badly infected pulp, it did slow the infection rate and inflammation, which helped prevent periapical lesions from forming. These are traditionally associated with infections like this. Past studies have shown that pulp regeneration does happen if an infected root canal is cleaned out prior to RvE1 treatment.

The implications of these results go far beyond dental applications. Dr Van Dyk indicates that because RvE1 promoted the formation of stem cells that can differentiate into various tissues like bone, dentin, fat, or cartilage, then this technology might have a big impact on regenerative medicine. It also has the potential to help with bone growth in other areas of the body, which might be a significant medical treatment advancement.