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Oral and Maxillofacial Surgery Sep 2023This randomized controlled clinical trial compared soft tissue changes following a novel vestibular atraumatic extraction technique (test group) versus the conventional... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
This randomized controlled clinical trial compared soft tissue changes following a novel vestibular atraumatic extraction technique (test group) versus the conventional incisal atraumatic extraction approach (control group) while implementing the vestibular socket therapy for immediate implant placement.
METHODS
Thirty patients with hopeless maxillary anterior teeth requiring atraumatic extraction were randomly assigned into two equal groups to receive either test or control. Vertical soft tissue alterations in mm were measured at baseline and 12 months post-restoration using intraoral digital scans at three reference points, distal papilla, mid-facial gingival margin, and mesial papilla, as well as pink esthetic scores (PESs) after 12 months.
RESULTS
Vestibular extraction technique showed significant soft tissue improvement and creeping when compared to incisal extraction (P < 0.05). The test group showed soft tissue measurements with a mean (± SD) of 0.26 (± 0.58), 0.39 (± 0.64), and 0.05 (± 0.37) mm for the mesial papilla, mid-facial gingival margin, and distal papilla respectively. While the incisal extraction technique demonstrated gingival recession at the distal papilla, mid-facial gingival margin, and mesial papilla of - 0.37 (± 0.54) mm, - 0.32 (± 0.68) mm, and - 0.39 (± 0.59) mm respectively. The overall PESs after 12 months were 12.67 (± 1.59) in vestibular extraction group, while incisal extraction group was 11.40 (± 1.40), with significant difference between them (P = 0.03).
CONCLUSION
This investigation suggests that both studied techniques were successful in the atraumatic extraction of hopeless severely damaged teeth. The novel vestibular extraction technique might be considered an alternative reliable atraumatic extraction approach compared to the conventional incisal extraction when performing the vestibular socket protocol for immediate implant placement with soft tissue enhancement.
Topics: Humans; Dental Implants; Immediate Dental Implant Loading; Gingiva; Tooth Socket; Tooth Extraction; Esthetics, Dental; Dental Implants, Single-Tooth; Treatment Outcome
PubMed: 35718834
DOI: 10.1007/s10006-022-01089-4 -
Cureus Jan 2024A healthy gingival structure showcases a knife-edged gingival margin, firmly adherent to the tooth surface, accompanied by a cone-shaped or pointed interdental papilla,...
A healthy gingival structure showcases a knife-edged gingival margin, firmly adherent to the tooth surface, accompanied by a cone-shaped or pointed interdental papilla, mirroring the lowest point in the gingival margin, termed the gingival zenith. Tooth transposition denotes an anomaly in tooth positioning, commonly involving the canine and the first maxillary premolar. It represents a form of ectopic eruption, wherein two adjacent teeth interchange positions within the same quadrant of the dental arch. Laser wavelengths are utilized for precise incision of gingival tissues to address restorative, cosmetic, and periodontal needs. Post-operatively, rapid healing and diminished discomfort are frequently observed, often eliminating the necessity for periodontal packing or sutures. Gingivectomy is the accepted modality for the establishment of esthetics in situations with abnormal gingival contour. This study highlights the use of contemporary technology namely a 940 nm diode laser for correction of gingival zenith to achieve optimal esthetics post orthodontic treatment.
PubMed: 38304687
DOI: 10.7759/cureus.51495 -
The Journal of Advanced Prosthodontics Dec 2023This study aimed to predict the positional coordinates of incisor points from the scan data of conventional complete dentures and verify their accuracy.
PURPOSE
This study aimed to predict the positional coordinates of incisor points from the scan data of conventional complete dentures and verify their accuracy.
MATERIALS AND METHODS
The standard triangulated language (STL) data of the scanned 100 pairs of complete upper and lower dentures were imported into the computer-aided design software from which the position coordinates of the points corresponding to each landmark of the jaw were obtained. The x, y, and z coordinates of the incisor point (X, Y, and Z) were obtained from the maxillary and mandibular landmark coordinates using regression or calculation formulas, and the accuracy was verified to determine the deviation between the measured and predicted coordinate values. Y was obtained in two ways using the hamular-incisive-papilla plane (HIP) and facial measurements. Multiple regression analysis was used to predict Z. The root mean squared error (RMSE) values were used to verify the accuracy of the X and Y. The RMSE value was obtained after cross-validation using the remaining 30 cases of denture STL data to verify the accuracy of Z.
RESULTS
The RMSE was 2.22 for predicting X. When predicting Y, the RMSE of the method using the HIP plane and facial measurements was 3.18 and 0.73, respectively. Cross-validation revealed the RMSE to be 1.53.
CONCLUSION
Y and Z could be predicted from anatomical landmarks of the maxillary and mandibular edentulous jaw, suggesting that Y could be predicted with better accuracy with the addition of the position of the lower border of the upper lip.
PubMed: 38205124
DOI: 10.4047/jap.2023.15.6.281 -
Clinical Oral Investigations Dec 2023To assess the long-term aesthetic and functional aspects of implant-supported crowns in lateral (ISC-L) and canine positions (ISC-C).
OBJECTIVES
To assess the long-term aesthetic and functional aspects of implant-supported crowns in lateral (ISC-L) and canine positions (ISC-C).
MATERIALS AND METHODS
Thirty-two patients (14 males, 18 females, mean age: 23.1, SD:2.0) with an ISC-L or ISC-C participated in this prospective cohort study at baseline (T0) and in the long-term follow-up (T1, mean years: 11.1, SD: 1.0). Twenty-four patients (11 males, 13 females) participated in T1. Patient-reported outcomes (PROM) were rated using surveys with questions related to aesthetics and function. The colour of the implant crown and the buccal gingiva, the appearance of the papilla, periodontal health and temporomandibular disorder (TMD) outcomes were assessed in a clinical examination. The Mann-Whitney, Chi-square and Signed Rank tests were performed.
RESULTS
Patients with an ISC-L and ISC-C were equally satisfied with the crown shape and colour at T0 and T1. No differences in TMD outcomes were reported by the patients and no clinical signs of TMD were observed. At T1, ISC-C had more bleeding on probing and a three mm greater pocket depth than ISC-L (p = 0.03, p = 0.01, respectively). At T0, operators graded the crown colour of ISC-L as being too dark (35%) and ISC-C as being too light (40%). At T1, no difference was seen between the two groups regarding crown colour, gingiva colour and the papilla (p = 0.2749, p = 0.2099, p = 0.8053, respectively).
CONCLUSIONS
The PROM and clinical examination show that ISC-L and ISC-C are equivalent with regard to aesthetics and function in the long term.
CLINICAL RELEVANCE
Although ISC-L and ISC-C are aesthetically and functionally comparable in the long term, ISC-Cs are more likely to impact periodontal health.
Topics: Male; Female; Humans; Young Adult; Adult; Follow-Up Studies; Prospective Studies; Esthetics, Dental; Dental Implants; Crowns; Dental Prosthesis, Implant-Supported
PubMed: 37940682
DOI: 10.1007/s00784-023-05344-0 -
Frontiers in Bioscience (Landmark... Jul 2023RUNX2 (Runt-related transcription factor 2) acts as a key regulator in the odontogenic differentiation of human dental pulp stem cells (hDPSCs). Moreover, the inclusion...
BACKGROUND
RUNX2 (Runt-related transcription factor 2) acts as a key regulator in the odontogenic differentiation of human dental pulp stem cells (hDPSCs). Moreover, the inclusion of exon 5 is important for RUNX2 function. Our previous study showed that Y-Box Binding Protein 1 (YBX1) promoted RUNX2 exon 5 inclusion and mineralization of hDPSCs. However, the regulatory mechanism of RUNX2 exon 5 alternative splicing needed further exploration.
METHODS
The expression level of heterogeneous nuclear ribonucleoprotein A1 (hnRNP A1) during the odontogenic differentiation of hDPSCs was analyzed by RT-PCR and Western blot. The roles of hnRNP A1 in the alternative splicing of RUNX2 exon 5 and the odontogenic differentiation of dental mesenchymal cells were analyzed by gain- and loss-of-function experiments.
RESULTS
Surprisingly, we found an alternative splicing factor, hnRNP A1, which had an opposite role to YBX1 in regulating RUNX2 exon 5 inclusion and odontogenic differentiation of hDPSCs. Through gain- and loss-of-function assay, we found that hnRNP A1 suppressed the inclusion of RUNX2 exon 5, resulting in the inhibition of odontoblastic differentiation. The overexpression of hnRNP A1 can inhibit the expression of ALP (alkaline phosphatase) and OCN (osteocalcin), and the formation of mineralized nodules during the odontogenic differentiation of both hDPSCs and mouse dental papilla cells (mDPCs), whereas the opposite results were obtained with an hnRNP A1 knockdown preparation.
CONCLUSIONS
The present study indicated that hnRNP A1 suppressed RUNX2 exon 5 inclusion and reduced the odontogenic differentiation ability of hDPSCs and mDPCs.
Topics: Animals; Humans; Mice; Cell Differentiation; Cells, Cultured; Core Binding Factor Alpha 1 Subunit; Dental Pulp; Exons; Heterogeneous Nuclear Ribonucleoprotein A1; Stem Cells
PubMed: 37525910
DOI: 10.31083/j.fbl2807139 -
Clinical Oral Investigations Jan 2024To evaluate the stability of periodontal tissues 3 (T), 6 (T), and 12 (T) months after esthetic crown lengthening (ACL) and the possible correlations between changes in...
OBJECTIVES
To evaluate the stability of periodontal tissues 3 (T), 6 (T), and 12 (T) months after esthetic crown lengthening (ACL) and the possible correlations between changes in those structures.
MATERIALS AND METHODS
Twenty individuals were evaluated through clinical assessment, photography, and tomography. Measurements included gingival margin (GM), clinical crown length (CCL), interdental papilla height (PH) and width (PW), gingival thickness (GT), bone thickness (BT), probing depth (PD), distance between alveolar crest and GM, distance between alveolar crest and cementoenamel junction. Nonparametric and correlation statistics were performed (p < 0.05).
RESULTS
CCL at T was 7.42 ± 0.70 mm and increased to 9.48 ± 0.49 mm immediately after ACL, but it decreased to 8.93 ± 0.65 mm at T. PD decreased 0.60 mm from T to T, and it increased 0.39 mm from T to T. BT decreased 0.20 mm, while GT increased 0.29 mm from T to T. Both PW and PH showed enlargement in T. A positive moderate correlation was found between CCL/T and CCL/T, GT/T and AC-GM/T, BT/T and GT/T. A few negative moderate correlations were PD/T and CCL/T, PD/T and PH/T, PD/T and BT/T.
CONCLUSIONS
ACL procedure was effective. Although some rebound occurred, that was not clinically important. PD tended to reestablish its original length, partially due to a migration of GM during the healing period. Besides, a thickening of supracrestal soft tissues was observed.
CLINICAL RELEVANCE
The present study centers on the factors influencing the stability of periodontal tissues after esthetic crown lengthening, underscoring the procedure's influence on esthetics and biology and the need for careful treatment planning.
Topics: Humans; Crown Lengthening; Esthetics, Dental; Gingiva; Periodontium; Alveolar Process
PubMed: 38180519
DOI: 10.1007/s00784-023-05458-5 -
The Saudi Dental Journal Dec 2023Nanoparticulate Ca(OH) had greater antibacterial effect than conventional Ca(OH). Conversely, a study reported that nanoparticulate Ca(OH) had toxicity against murine...
The viability of human dental pulp cells and apical papilla cells after treatment with conventional calcium hydroxide and nanoparticulate calcium hydroxide at various concentrations.
INTRODUCTION
Nanoparticulate Ca(OH) had greater antibacterial effect than conventional Ca(OH). Conversely, a study reported that nanoparticulate Ca(OH) had toxicity against murine fibroblast. However, the study of nanoparticulate Ca(OH), involving human dental pulp cells (DPCs) and apical papilla cells (APCs) is lacking. The aim of this study is to compare the effects of conventional Ca(OH) and nanoparticulate Ca(OH) on the viability of DPCs and APCs.
METHODS
Primary human DPCs/APCs from the 3rd to 5th passage were divided into control and experimental groups. In the control group, cells were cultured in complete media. In the experimental group, cells were cultured in complete media containing 10, 100, or 1000 μg/mL of either conventional Ca(OH) or nanoparticulate Ca(OH) for 1, 3, 5, and 7 days. After the treatment period, the cells were tested for viability using MTT assay.
RESULTS
DPCs treated with conventional Ca(OH) in all concentrations at day 5 revealed significantly higher proliferation compared to nanoparticulate Ca(OH) treated groups. In additions, DPCs treated with 1000 µg/ml nanoparticulate Ca(OH) at day7 were significantly lower proliferation compared to DPCs treated with conventional Ca(OH). In contrast, APCs treated with 1000 µg/ml nanoparticulated Ca(OH) were significantly higher proliferation than APCs treated with 1000 µg/ml conventional Ca(OH) at day7.
CONCLUSIONS
Nanoparticulate Ca(OH) increased the viability of APCs and can be an alternative choice of intracanal medication for regenerative endodontic procedures. However, Nanoparticulate Ca(OH) exerted some effects on DPCs. The use of nanoparticulate Ca(OH) has no advantages over the conventional Ca(OH) for vital pulp therapy.
PubMed: 38107041
DOI: 10.1016/j.sdentj.2023.08.001 -
Journal of Periodontal & Implant Science Oct 2023The aim of this study was to investigate the relationships between gingival thickness (GT) and keratinized gingiva width (KGW), papilla height (PH), and crown ratio (CR)...
PURPOSE
The aim of this study was to investigate the relationships between gingival thickness (GT) and keratinized gingiva width (KGW), papilla height (PH), and crown ratio (CR) by employing transgingival probing and an intraoral scanner (IOS).
METHODS
This cross-sectional study examined 360 maxillary anterior teeth from 60 patients. GT was assessed using transgingival probing with an endodontic spreader. KGW, CR, and PH were measured using an IOS. One-way analysis of variance, the Student's -test, and Spearman correlation coefficients were employed for statistical analysis.
RESULTS
Higher GT was significantly associated with thinner KGW in the central region (=0.019). There was no statistically significant difference in GT between teeth (=0.06). PH was lower in lateral teeth than in canines (=0.047), with a PH of 2.99 mm in lateral teeth. The KGW was narrower in canines than in central teeth (=0.007). A moderate correlation was observed between KGW and PH in the central region (=0.01), while a weak negative correlation was found between KGW and CR (=0.043).
CONCLUSIONS
A moderate negative correlation was found between GT and KGW, as well as between PH and KGW in central teeth. In contrast, a weak negative correlation existed between CR and KGW. The PH (2.99 mm) was lower in lateral teeth than in canines. The traditional paradigm, which suggests a positive correlation between KGW and GT, was re-evaluated by measuring KGW using an IOS.
PubMed: 37524382
DOI: 10.5051/jpis.2204320216 -
The Saudi Dental Journal Jan 2024The aim of this study was to evaluate the osteogenic differentiation ability and proliferation of apical papilla stem cells using nanoparticles of Neo MTA and bioactive...
OBJECTIVE
The aim of this study was to evaluate the osteogenic differentiation ability and proliferation of apical papilla stem cells using nanoparticles of Neo MTA and bioactive glass.
METHODS
Neo MTA and bioactive glass 45S5 nanoparticles were prepared and characterized using a transmission electron microscope and X-ray diffraction. Apical papilla stem cells were harvested from freshly-extracted fully-impacted wisdom teeth, cultured, and characterized using flow cytometric analysis. Tested nanomaterials were mixed and samples were classified into four equal groups as follows; Negative control group: SCAP with Dulbecco's modified eagle's medium, Positive control group: SCAP with inductive media, First experimental group: Neo MTA nanoparticles with SCAP, Second experimental group: Bioactive glass nanoparticles with SCAP. Osteoblastic differentiation was assessed using an alkaline phosphatase assay and RANKL expression using specific polyclonal antibodies by fluorescence microscope The proliferation of SCAP was assessed using cell count and viability of Trypan Blue in addition to an MTT assay.
RESULTS
Isolated SCAP showed a non-hematopoietic origin. Neo MTA showed the highest ALP concentration followed by bioactive glass nanoparticles, and negative control. Bioactive glass nanoparticles showed the highest H score for RANKL protein expression followed by Neo MTA, and negative control. Bioactive glass nanoparticles showed the highest viable cell count.
CONCLUSIONS
SCAP isolation is achievable from extracted fully impacted immature third molars. Both tested nanobiomaterials have the ability to induce osteogenic differentiation and proliferation of SCAP.
PubMed: 38375392
DOI: 10.1016/j.sdentj.2023.10.018 -
European Journal of Dentistry May 2024The aim of this study was to evaluate the osteogenic differentiation ability and proliferation of apical papilla stem cells (SCAPs) using chitosan-coated...
OBJECTIVE
The aim of this study was to evaluate the osteogenic differentiation ability and proliferation of apical papilla stem cells (SCAPs) using chitosan-coated nanohydroxyapatite and bioactive glass nanoparticles.
MATERIALS AND METHODS
Hydroxyapatite, chitosan-coated nanohydroxyapatite, and bioactive glass 45S5 nanoparticles were prepared and characterized using a transmission electron microscope and X-ray diffraction. SCAPs were harvested from freshly extracted impacted wisdom teeth, cultured, and characterized using flow cytometric analysis. Tested nanomaterials were mixed and samples were classified into five equal groups as follows: negative control group: SCAP with Dulbecco's modified eagle's medium, positive control group: SCAP with inductive media, first experimental group: nanohydroxyapatite with SCAP, second experimental group: chitosan-coated nanohydroxyapatite with SCAP, third experimental group: bioactive glass nanoparticles with SCAP. Osteoblastic differentiation was assessed using an alkaline phosphatase (ALP) assay. Receptor activator of nuclear factor kappa beta ligand (RANKL) expression was evaluated using specific polyclonal antibodies by fluorescence microscope. The proliferation of SCAP was assessed using cell count and viability of trypan blue in addition to an 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay.
RESULTS
Isolated SCAP showed a nonhematopoietic origin. Chitosan-coated nanohydroxyapatite showed the highest ALP concentration followed by nanobioactive glass, nanohydroxyapatite, and negative control. Chitosan-coated nanohydroxyapatite showed the highest H score followed by nanobioactive glass, nanohydroxyapatite, and negative control in RANKL expression. Chitosan-coated nanohydroxyapatite showed the highest viable cell count.
CONCLUSION
SCAP isolation is achievable from extracted fully impacted immature third molars. All tested biomaterials have the ability to induce osteogenic differentiation and proliferation of SCAP. Composite nanoparticle materials show better osteogenic differentiation and proliferation of SCAP than single nanoparticles.
PubMed: 38442913
DOI: 10.1055/s-0043-1777044