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ObjectiveBecause curcumin's anti-inflammatory properties may protect the brain from neurodegeneration, we studied its effect on memory in non-demented adults and explored its impact on brain amyloid and tau accumulation using 2-(1-{6-[(2-[F-18]fluoroethyl)(methyl)amino]-2-naphthyl}ethylidene)malononitrile positron emission tomography (FDDNP-PET).MethodsForty subjects (age 51-84 years) were randomized to a bioavailable form of curcumin (Theracurmin® containing 90 mg of curcumin twice daily [N = 21]) or placebo (N = 19) for 18 months. Primary outcomes were verbal (Buschke Selective Reminding Test [SRT]) and visual (Brief Visual Memory Test-Revised [BVMT-R]) memory, and attention (Trail Making A) was a secondary outcome. FDDNP-PET signals (15 curcumin, 15 placebo) were determined in amygdala, hypothalamus, medial and lateral temporal, posterior cingulate, parietal, frontal, and motor (reference) regions. Mixed effects general linear models controlling for age and education, and effect sizes (ES; Cohen's d) were estimated.ResultsSRT Consistent Long-Term Retrieval improved with curcumin (ES = 0.63, p = 0.002) but not with placebo (ES = 0.06, p = 0.8; between-group: ES = 0.68, p = 0.05). Curcumin also improved SRT Total (ES = 0.53, p = 0.002), visual memory (BVMT-R Recall: ES = 0.50, p = 0.01; BVMT-R Delay: ES = 0.51, p = 0.006), and attention (ES = 0.96, p

BackgroundOur group has shown that in vivo tau brain binding patterns from FDDNP-PET scans in retired professional football players with suspected chronic traumatic encephalopathy differ from those of tau and amyloid aggregate binding observed in Alzheimer's disease (AD) patients and cognitively-intact controls.ObjectiveTo compare these findings with those from military personnel with histories of mild traumatic brain injury(mTBI).MethodsFDDNP-PET brain scans were compared among 7 military personnel and 15 retired players with mTBI histories and cognitive and/or mood symptoms, 24 AD patients, and 28 cognitively-intact controls. Nonparametric ANCOVAs with Tukey-Kramer adjusted post-hoc comparisons were used to test for significant differences in regional FDDNP binding among subject groups.ResultsFDDNP brain binding was higher in military personnel compared to controls in the amygdala, midbrain, thalamus, pons, frontal and anterior and posterior cingulate regions (p < 0.01-0.0001). Binding patterns in the military personnel were similar to those of the players except for the amygdala and striatum (binding higher in players; p = 0.02-0.003). Compared with the AD group, the military personnel showed higher binding in the midbrain (p = 0.0008) and pons (p = 0.002) and lower binding in the medial temporal, lateral temporal, and parietal regions (all p = 0.02).ConclusionThis first study of in vivo tau and amyloid brain signals in military personnel with histories of mTBI shows binding patterns similar to those of retired football players and distinct from the binding patterns in AD and normal aging, suggesting the potential value of FDDNP-PET for early detection and treatment monitoring in varied at-risk populations.

ObjectivesTo determine whether psychological well-being in people with mild cognitive impairment (MCI), a risk state for Alzheimer disease (AD), is associated with in vivo measures of brain pathology.MethodsCross-sectional clinical assessments and positron emission tomography (PET) scans after intravenous injections of 2-(1-{6-[(2-[F18]fluoroethyl)(methyl)amino]-2-naphthyl}ethylidene)malononitrile (FDDNP), a molecule that binds to plaques and tangles, were performed on middle-aged and older adults at a university research institute. Volunteers were aged 40-85 years with MCI (N = 35) or normal cognition (N = 29) without depression or anxiety. Statistical analyses included general linear models, using regional FDDNP-PET binding values as dependent variables and the Vigor-Activity subscale of the Profile of Mood States (POMS) as the independent variable, covarying for age. The POMS is a self-rated inventory of 65 adjectives that describe positive and negative feelings.ResultsScores on the POMS Vigor-Activity subscale were inversely associated with degree of FDDNP binding in the posterior cingulate cortex (r = -0.35, p = 0.04) in the MCI group but not in the control group.ConclusionPsychological well-being, as indicated by self-reports of greater vigor and activity, is associated with lower FDDNP-PET binding in the posterior cingulate cortex, a region involved in emotional regulation, in individuals with MCI but not in those with normal cognition. These findings are consistent with previous work indicating that deposition of brain amyloid plaques and tau tangles may result in noncognitive and cognitive symptoms in persons at risk for AD.

IntroductionPrevious research has identified modifiable risk factors for Alzheimer's disease (AD) in older adults. Research is limited on the potential link between these risk factors and subjective memory impairment (SMI), which may precede AD and other dementias. Examination of these potential relationships may help identify those at risk for AD at a stage when interventions may delay or prevent further memory problems. The objective of this study was to determine whether risk factors for AD are associated with SMI among different age groups.MethodTrained interviewers conducted daily telephone surveys (Gallup-Healthways) of a representative community sample of 18,614 U.S. respondents, including 4,425 younger (age 18 to 39 years), 6,365 middle-aged (40 to 59 years), and 7,824 older (60 to 99 years) adults. The surveyors collected data on demographics, lifestyles, and medical information. Less education, smoking, hypertension, diabetes, less exercise, obesity and depression, and interactions among them, were examined for associations with SMI. Weighted logistic regressions and chi-square tests were used to calculate odds ratios and confidence intervals for SMI with each risk factor and pairwise interactions across age groups.ResultsDepression, less education, less exercise, and hypertension were significantly associated with SMI in all three age groups. Several interactions between risk factors were significant in younger and middle-aged adults and influenced their associations with SMI. Frequency of SMI increased with age and number of risk factors. Odds of having SMI increased significantly with just having one risk factor.ConclusionsThese results indicate that modifiable risk factors for AD are also associated with SMI, suggesting that these relationships occur in a broad range of ages and may be targeted to mitigate further memory problems. Whether modifying these risk factors reduces SMI and the eventual incidence of AD and other dementias later in life remains to be determined.

Ten keys for successful esthetic-zone single immediate implants encapsulate in an evidence-based manner the treatment planning and replacement of single hopeless teeth in the maxillary anterior sextant. These include two treatment-planning, five surgical, and three prosthetic keys, which, collectively, aim to minimize soft- and hard-tissue complications for an optimal esthetic implant restoration. The Straightforward, Advanced, and Complex (SAC) classification is designed to aid clinicians in the treatment planning of dental implant cases. As per this classification, cases are stratified by the degree of surgical and restorative risk and complexity for both the surgical and prosthetic phases of treatment. A technique-sensitive and skill-demanding task, the replacement of multiple adjacent teeth in the esthetic zone poses significant challenges for clinicians and is considered a complex SAC procedure surgically and restoratively. This article presents a case report on the replacement of multiple adjacent teeth in the esthetic zone, demonstrating the use of 10 key principles to achieve an optimal esthetic outcome. [ABSTRACT FROM AUTHOR]

Ten keys for successful esthetic-zone single immediate implants encapsulate in an evidence-based manner the treatment planning and replacement of single hopeless teeth in the maxillary anterior sextant. These include two treatment-planning, five surgical, and three prosthetic keys, which, collectively, aim to minimize soft- and hard-tissue complications for an optimal esthetic implant restoration. The Straightforward, Advanced, and Complex (SAC) classification is designed to aid clinicians in the treatment planning of dental implant cases. As per this classification, cases are stratified by the degree of surgical and restorative risk and complexity for both the surgical and prosthetic phases of treatment. A technique-sensitive and skill-demanding task, the replacement of multiple adjacent teeth in the esthetic zone poses significant challenges for clinicians and is considered a complex SAC procedure surgically and restoratively. This article presents a case report on the replacement of multiple adjacent teeth in the esthetic zone, demonstrating the use of 10 key principles to achieve an optimal esthetic outcome. [ABSTRACT FROM AUTHOR]

The article evaluates three systematic reviews published within the issue, including reviews of the articles "Esthetic Outcomes Following Immediate and Early Implant Placement in the Anterior Maxilla: A Systematic Review" by Stephen T. Chen and Daniel Buser, "Soft Tissue Augmentation Procedures for Mucogingival Defects in Esthetic Sites" by Robert A. Levine and David L. Cochran and "Influence of Restorative Procedures on Esthetic Outcomes in Implant Dentistry: A Systematic Review" by William C. Martin, Adrien Pollini and Dean Morton, with statements and recommended clinical procedures regarding optimizing esthetic outcomes in implant dentistry.

Purpose: The objectives of this systematic review are (1) to quantitatively estimate the esthetic outcomes of implants placed in postextraction sites, and (2) to evaluate the influence of simultaneous bone augmentation procedures on these outcomes. Materials and Methods: Electronic and manual searches of the dental literature were performed to collect information on esthetic outcomes based on objective criteria with implants placed after extraction of maxillary anterior and premolar teeth. All levels of evidence were accepted (case series studies required a minimum of 5 cases). Results: From 1,686 titles, 114 full-text articles were evaluated and 50 records included for data extraction. The included studies reported on single-tooth implants adjacent to natural teeth, with no studies on multiple missing teeth identified (6 randomized controlled trials, 6 cohort studies, 5 cross-sectional studies, and 33 case series studies). Considerable heterogeneity in study design was found. A meta-analysis of controlled studies was not possible. The available evidence suggests that esthetic outcomes, determined by esthetic indices (predominantly the pink esthetic score) and positional changes of the peri-implant mucosa, may be achieved for single-tooth implants placed after tooth extraction. Immediate (type 1) implant placement, however, is associated with a greater variability in outcomes and a higher frequency of recession of > 1 mm of the midfacial mucosa (eight studies; range 9% to 41% and median 26% of sites, 1 to 3 years after placement) compared to early (type 2 and type 3) implant placement (2 studies; no sites with recession > 1 mm). In two retrospective studies of immediate (type 1) implant placement with bone graft, the facial bone wall was not detectable on cone beam CT in 36% and 57% of sites. These sites had more recession of the midfacial mucosa compared to sites with detectable facial bone. Two studies of early implant placement (types 2 and 3) combined with simultaneous bone augmentation with GBR (contour augmentation) demonstrated a high frequency (above 90%) of facial bone wall visible on CBCT. Recent studies of immediate (type 1) placement imposed specific selection criteria, including thick tissue biotype and an intact facial socket wall, to reduce esthetic risk. There were no specific selection criteria for early (type 2 and type 3) implant placement. Conclusions: Acceptable esthetic outcomes may be achieved with implants placed after extraction of teeth in the maxillary anterior and premolar areas of the dentition. Recession of the midfacial mucosa is a risk with immediate (type 1) placement. Further research is needed to investigate the most suitable biomaterials to reconstruct the facial bone and the relationship between long-term mucosal stability and presence/absence of the facial bone, the thickness of the facial bone, and the position of the facial bone crest. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this review was to evaluate the clinical outcomes for the different time points of implant placement following tooth extraction. Materials and Methods: A PubMed search and a hand search of selected journals were performed to identify clinical studies published in English that reported on outcomes of implants in postextraction sites. Only studies that included 10 or more patients were accepted. For implant success/survival outcomes, only studies with a mean follow-up period of at least 12 months from the time of implant placement were included. The following outcomes were identified: (1) change in peri-implant defect dimension, (2) implant survival and success, and (3) esthetic outcomes. Results and Conclusions: Of 1,107 abstracts and 170 full-text articles considered, 91 studies met the inclusion criteria for this review. Bone augmentation procedures are effective in promoting bone fill and defect resolution at implants in postextraction sites, and are more successful with immediate (type 1) and early placement (type 2 and type 3) than with late placement (type 4). The majority of studies reported survival rates of over 95%. Similar survival rates were observed for immediate (type 1) and early (type 2) placement. Recession of the facial mucosal margin is common with immediate (type 1) placement. Risk indicators included a thin tissue biotype, a facial malposition of the implant, and a thin or damaged facial bone wall. Early implant placement (type 2 and type 3) is associated with a lower frequency of mucosal recession compared to immediate placement (type 1). [ABSTRACT FROM AUTHOR]

Purpose: The aim of this review was to evaluate the techniques and outcomes of postextraction ridge preservation and the efficacy of these procedures in relation to subsequent implant placement. Materials and Methods: A MEDLINE/PubMed search was conducted and the bibliographies of reviews from 1999 to March 2008 were assessed for appropriate studies. Randomized clinical trials, controlled clinical trials, and prospective/retrospective studies with a minimum of five patients were included. Results: A total of 135 abstracts were identified, from which 53 full-text articles were further examined, leading to 37 human studies that fulfilled the search criteria. Many different techniques, methodologies, durations, and materials were presented in the publications reviewed, making direct comparison difficult. Conclusions: Despite the heterogeneity of the studies, it was concluded that ridge preservation procedures are effective in limiting horizontal and vertical ridge alterations in postextraction sites. There is no evidence to support the superiority of one technique over another. There is also no conclusive evidence that ridge preservation procedures improve the ability to place implants. [ABSTRACT FROM AUTHOR]

Early implant placement is one treatment option for implant therapy following single-tooth extraction in the anterior maxilla. The surgical technique presented here is characterized by tooth extraction without flap elevation, a 4- to 8-week soft tissue healing period, implant placement in a correct three-dimensional position, simultaneous contour augmentation on the facial aspect with guided bone regeneration using a bioabsorbable collagen membrane combined with autogenous bone chips and a low-substitution bone filler, and tension-free primary wound closure. The surgical step-by-step procedure is presented with a case report. In addition, the biologic rationale is discussed. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this article was to review the current literature with regard to survival and success rates, along with the clinical procedures and outcomes associated with immediate and delayed implant placement. Materials and Methods: A MEDLINE search was conducted of studies published between 1990 and June 2003. Randomized and nonrandomized clinical trials, cohort studies, case-control studies, and case reports with a minimum of 10 cases were included. Studies reporting on success and survival rates were required to have follow-up periods of at least 12 months. Results: Thirty-one articles were identified. Most were short-term reports and were not randomized with respect to timing of placement and augmentation methods used. All studies reported implant survival data; there were no reports on clinical success. Peri-implant defects had a high potential for healing by regeneration of bone, irrespective of healing protocol and bone augmentation method. Sites with horizontal defects (HD) of 2 mm or less healed by spontaneous bone fill when implants with rough surfaces were used. In the presence of HDs larger than 2 mm, or when socket walls were damaged, concomitant augmentation procedures with barrier membranes and bone grafts were required. Delayed implant placement allowed for resolution of local infection and an increase in the area and volume of soft tissue for flap adaptation. However, these advantages were diminished by simultaneous buccolingual ridge resorption and increased requirements for tissue augmentation. Discussion: Immediate and delayed immediate implants appear to be predictable treatment modalities, with survival rates comparable to implants in healed ridges. Relatively few long-term studies were found. Successful clinical outcomes in terms of bone fill of the peri-implant defect were well established. However, there was a paucity of data on long-term success as measured by peri-implant tissue health, prosthesis stability, and esthetic outcomes. Conclusions: Short-term survival rates and clinical outcomes of immediate and delayed implants were similar and were comparable to those of implants placed in healed alveolar ridges. [ABSTRACT FROM AUTHOR]

The relationship between radiographic crestal alveolar bone mass and changes in clinical periodontal attachment level following guided tissue regeneration (GTR) was evaluated in this retrospective study. A total of 12 intrabony two- or three-walled defects and 12 adjacent nondiseased proximal sites in 10 nonsmoking adult subjects received subgingival debridement and GTR using resorbable (Resolut; five sites) or nonresorbable (Gore-Tex; seven sites) barrier membranes. At a mean of 48.8 months posttreatment, clinical periodontal attachment level alterations were measured, and crestal alveolar bone mass changes on digital subtraction radiographic images derived from serial periapical radiographs were analyzed to correct for between-film geometric and contrast density differences. Intrabony defects exhibited a mean clinical periodontal attachment level gain of 2.3 ± 0.4 mm, in contrast to a mean loss of 0.5 ± 0.2 mm in adjacent nondiseased interproximal sites. Digital subtraction radiography revealed an increase in crestal alveolar bone mass at all intrabony sites treated with GTR and a decrease in three of the adjacent nondiseased sites. Site-based analysis yielded an odds ratio of 36 (P < .001) for the association between radiographic increases in crestal alveolar bone mass and clinical periodontal attachment level gains of = 2 mm. These results suggest a strong concordance between digital subtraction radiographic assessments of crestal alveolar bone mass and clinical periodontal attachment level in evaluating the long-term effects of GTR at human interproximal intrabony defects. [ABSTRACT FROM AUTHOR]

This article describes a grafting technique using connective tissue to predictably obtain primary closure of extraction sockets treated with an esteopromotive membrane technique. This technique was used for a total of 24 sites in 22 consecutive patients to regenerate alveolar bone in severely damaged ridges and in conjunction with implants immediately installed into extraction sites. Two sites (8.3%) were complicated by premature membrane exposure that necessitated early removal. In the remaining 22 sites, membranes remained completely covered for a mean period of 23.75 weeks (SD = 8.21 weeks, range = 10 to 38 weeks). Connective Tissue Grafting for Primary Closure of Extraction Sockets Treated With an Osteopromotive Membrane Technique: Surgical Technique and Clinical Results. Connective Tissue Grafting for Primary Closure of Extraction Sockets Treated With an Osteopromotive Membrane Technique: Surgical Technique and Clinical Results. [ABSTRACT FROM AUTHOR]

The article discusses clinical procedures regarding the placement of dental implants in extraction sockets. The authors claim that high clinical success rates are typically reported when implants are placed according to standard indications. The ways in which implant placements are determined following tooth extraction is examined, specifically focusing on the attainment of specific soft and hard tissue characteristics of healing sockets. Several different protocols for implant placement in extraction sockets are detailed.

Purpose To evaluate the relationship between defects of the facial socket wall at extraction and dimensional changes 8 weeks later in maxillary central and lateral incisor sockets. Materials and methods A total of 34 consecutive patients requiring single tooth implants in the anterior maxilla (27 central and 7 lateral incisors) were evaluated. Orofacial external ridge, bone dimensions and the location of the socket bone crest were measured at extraction and again 8.5 ± 2.91 weeks later. The status of the facial bone wall was recorded at the same time points. Results At extraction, 16 of 34 sites (47%) had intact facial bone. There were fenestration defects at 9 of 34 sites (26.5%) and dehiscence defects at 9 of 34 sites (26.5%). A significant reduction ( P < 0.001) in the external orofacial ridge dimension occurred (mesial 1.4 ± 1.30 mm or 12.1%, facial 2.5 ± 1.46 mm or 22.2%, distal 1.1 ± 0.83 mm or 10.5%), with greatest change at dehiscence (3.3 ± 1.80 mm or 28.4%) and fenestration sites (2.8 ± 1.40 mm or 24.9%). A significant reduction in orofacial bone dimension occurred (mesial 0.8 ± 0.80 mm or 9.3%, P < 0.001; facial 1.2 ± 1.03 mm or 18.3%, P < 0.001; distal 0.4 ± 0.65 mm or 5.5%, P < 0.01). Vertical resorption of the bone crest was most marked at the mid-facial aspect (1.4 ± 1.94 mm, P < 0.001). Initial fenestration defect sites demonstrated the greatest vertical dimensional change (2.9 ± 2.67 mm; P = 0.008). Of 16 sites with initially intact facial bone, 9 sites (56.3%) developed dehiscence defects after 8 weeks. Of the 9 initial sites with fenestration defects, 5 (55.6%) turned into dehiscence defects. All 9 sites with initial dehiscence defects healed with persistence of the dehiscence. Conclusions Eight weeks after flapless extraction of maxillary central and lateral incisors, a reduction in the orofacial dimensions of the ridge was observed due to resorption of the facial bone of the socket. Tooth type (maxillary central incisor) and thin tissue phenotype significantly influenced the outcomes. The dimensional alterations were most pronounced at sites that initially had fenestration and dehiscence defects of the facial bone. [ABSTRACT FROM AUTHOR]

The 10 keys for successful esthetic-zone single immediate implants encapsulate in an evidencebased manner the treatment planning and replacement of single hopeless teeth in the maxillary anterior sextant. These include 2 treatment-planning, 5 surgical, and 3 prosthetic keys, which, collectively, aim to minimize soft- and hard-tissue complications for an optimal esthetic implant restoration. The straightforward, advanced, and complex (SAC) classification was designed to aid clinicians in the treatment planning of dental implant cases. Cases are stratified by the degree of surgical and restorative risk and complexity for both the surgical and prosthetic phases of treatment. Based on the 10 keys, the management of an immediate implant in the esthetic zone is considered a complex SAC procedure. As described in this article, a complex SAC procedure requires careful patient selection and treatment planning, along with precise execution by skillful clinicians, to achieve successful results. [ABSTRACT FROM AUTHOR]