-
Clinics and Practice May 2024The relevance of assessing the gingival phenotype prior to the initiation of periodontal, orthodontic, or prosthetic therapy has been clearly demonstrated. However,... (Review)
Review
The relevance of assessing the gingival phenotype prior to the initiation of periodontal, orthodontic, or prosthetic therapy has been clearly demonstrated. However, publications on this subject are either old or concerned with the means of assessing the gingival phenotype or the main factors likely to modify it. The main objective of this systematic review of the literature was therefore to investigate the prevalence of different gingival phenotypes in adults in good general health and with a healthy periodontium. A systematic review of the literature was performed following the guidelines of PRISMA recommendations using an electronic search strategy on four databases (PubMed, Scopus, Cochrane Library, and Embase) complemented by a manual search. Three independent authors were involved in study selection, data extraction, and bias assessment. Results: Of 807 articles, 17 of them, published between 2012 and 2023, involving 3277 subjects from 11 countries and 9766 dental sites, fulfilled the inclusion criteria. The prevalence of the gingival phenotype could not be determined at the level of an individual or a dental arch because all the publications assessed this phenotype only at the level of certain dental sectors, and were not chosen at random. The maxillary central incisors and maxillary or mandibular first molar sectors were associated with a high and thick gingival phenotype, independently of the dental morphology, gender, and age of adult subjects. Furthermore, in these regions, this gingival phenotype tended to be associated with a thick vestibular bone table. In contrast, maxillary and mandibular incisors and premolars more often had a thin gingival phenotype. For other teeth, the results were less conclusive. It is important not to rely solely on the overall appearance of the dentition but to independently assess the thickness and height of the gingiva at each dental site requiring intervention. Finally, this study highlights a key point, namely the need for further longitudinal studies to determine the prevalence in healthy adults. For practicality and feasibility reasons, these studies should be designed according to therapeutic needs, dental sector by dental sector, and within homogeneous source populations. PROSPERO registration: CRD 42023392602.
PubMed: 38804396
DOI: 10.3390/clinpract14030064 -
Clinical Case Reports Jun 2024This article describes a successful case of auto-transplantation of a mandibular third molar to replace a non-restorable second molar, highlighting the efficacy of this...
KEY CLINICAL MESSAGE
This article describes a successful case of auto-transplantation of a mandibular third molar to replace a non-restorable second molar, highlighting the efficacy of this procedure in restoring function with factors like asepsis, surgical technique, and postoperative care contributing to the success.
ABSTRACT
This case report describes successful auto-transplantation of a mandibular third molar to replace a non-restorable second molar in a 66-year-old patient. The procedure involved atraumatic extraction, repositioning, and stabilization of the donor tooth, followed by postoperative care and 1-year follow-up. The favorable outcome highlights the potential of mature third molar transplantation as an effective approach for replacement of missing or non-restorable permanent molar teeth to restore esthetics and function. The success of the procedure was attributed to factors such as asepsis, atraumatic surgical technique, preservation of the periodontal ligament (PDL) vitality, minimal extraoral time, optimal occlusion, and adequate fixation. At the 1-year follow-up, the patient was asymptomatic with stable occlusion, highlighting the optimal efficacy of the procedure.
PubMed: 38799524
DOI: 10.1002/ccr3.8911 -
Progress in Orthodontics May 2024Skeletal anterior open bite (SAOB) represents one of the most complex and challenging malocclusions in orthodontics. Orthodontic treatment supported by miniplates enable...
BACKGROUND
Skeletal anterior open bite (SAOB) represents one of the most complex and challenging malocclusions in orthodontics. Orthodontic treatment supported by miniplates enable to reduce the need for orthognathic surgery. Transverse dimension may be affected by intrusion biomechanics. This study aims to assess transverse bone alterations in patients with SAOB who underwent orthodontic treatment with absolute anchorage using four miniplates.
METHODS
A total of 32 patients of both sexes, with an average age of 33.8 years, diagnosed with SAOB and treated orthodontically with four miniplates (one in each hemiarch), were selected for this study. Tomographic examinations were performed before (T1) and after (T2) orthodontic treatment. Linear measurements (width of the maxillary base, maxillary alveolar, maxillary root, maxillary dental cusp, mandibular alveolar) and angular measurements (maxillary intermolar angle) were assessed in these images. The Shapiro-Wilks normality tests were applied to verify data distribution, and the paired t-test was used to compare the initial and final measures obtained.
RESULTS
Among the evaluated parameters, the maxillary alveolar width, maxillary dental cusp width, mandibular alveolar cusp width, and intermolar angle showed statistically significant differences between T1 and T2 (p < 0.05). However, maxillary base and maxillary root widths showed no significant difference (p > 0.05).
CONCLUSIONS
Intrusion and distalization with miniplates in SAOB therapy may lead to significant expansive changes, due to molars cusps width and buccal inclination increase restricted at the alveolar level.
Topics: Humans; Orthodontic Anchorage Procedures; Male; Female; Open Bite; Adult; Bone Plates; Mandible; Maxilla; Cephalometry; Alveolar Process; Tooth Movement Techniques; Tomography, X-Ray Computed; Young Adult; Orthodontic Appliance Design
PubMed: 38797777
DOI: 10.1186/s40510-024-00519-1 -
BMC Biotechnology May 2024To establish a strategy for stem cell-related tissue regeneration therapy, human gingival mesenchymal stem cells (hGMSCs) were loaded with three-dimensional (3D)...
BACKGROUND
To establish a strategy for stem cell-related tissue regeneration therapy, human gingival mesenchymal stem cells (hGMSCs) were loaded with three-dimensional (3D) bioengineered Matrigel matrix scaffolds in high-cell density microtissues to promote local tissue restoration.
METHODS
The biological performance and stemness of hGMSCs under 3D culture conditions were investigated by viability and multidirectional differentiation analyses. A Sprague‒Dawley (SD) rat full-thickness buccal mucosa wound model was established, and hGMSCs/Matrigel were injected into the submucosa of the wound. Autologous stem cell proliferation and wound repair in local tissue were assessed by histomorphometry and immunohistochemical staining.
RESULTS
Three-dimensional suspension culture can provide a more natural environment for extensions and contacts between hGMSCs, and the viability and adipogenic differentiation capacity of hGMSCs were significantly enhanced. An animal study showed that hGMSCs/Matrigel significantly accelerated soft tissue repair by promoting autologous stem cell proliferation and enhancing the generation of collagen fibers in local tissue.
CONCLUSION
Three-dimensional cell culture with hydrogel scaffolds, such as Matrigel, can effectively improve the biological function and maintain the stemness of stem cells. The therapeutic efficacy of hGMSCs/Matrigel was confirmed, as these cells could effectively stimulate soft tissue repair to promote the healing process by activating the host microenvironment and autologous stem cells.
Topics: Animals; Drug Combinations; Laminin; Proteoglycans; Collagen; Rats, Sprague-Dawley; Humans; Rats; Mesenchymal Stem Cells; Wound Healing; Tissue Scaffolds; Cell Differentiation; Cell Proliferation; Gingiva; Cell Culture Techniques, Three Dimensional; Cells, Cultured; Tissue Engineering; Male; Mouth Mucosa
PubMed: 38796454
DOI: 10.1186/s12896-024-00862-5 -
Medicina Oral, Patologia Oral Y Cirugia... May 2024Patients at high risk for obstructive sleep apnea (OSA) are characterized by intermittent transient hypoxias and upper respiratory tract collapse, with reactive oxygen...
BACKGROUND
Patients at high risk for obstructive sleep apnea (OSA) are characterized by intermittent transient hypoxias and upper respiratory tract collapse, with reactive oxygen production and oxidative imbalance which causes an inflammatory cascade. This can generate negative effects on the periodontium, causing severe tooth attachment loss. This study aimed to determine the association between periodontitis and the risk of OSA in adults who attend outpatient otolaryngology consultations.
MATERIAL AND METHODS
A cross-sectional observational study was carried out with 118 patients seen in the otolaryngology service of the Hospital Victor Lazarte Echegaray-ESSALUD in Trujillo (Peru), between September and October 2023. The presence and severity of periodontitis were determined using the Page and Eke criteria, and the presence and severity of OSA risk were determined using the STOP-BANG questionnaire. The results were analyzed using Chi-square, Spearman correlation and logistic regression tests, considering a significance level of p<0.05.
RESULTS
An association was found between periodontitis and risk of OSA (p=0.000), obtaining a positive relationship with rs=0.527. In addition, there was an association between periodontitis and DM2 (p=0.028) and bronchial asthma (0.017). No association was found between periodontitis and sex (0.503) or age (0.741).
CONCLUSIONS
There is an association between periodontitis and the risk of OSA in Peruvian adult patients who attended outpatient otolaryngology consultations. This association was also found according to age, sex, smoking, DM2 and asthma. In addition, an association was found between periodontitis and DM2 and asthma, but not with sex and age.
PubMed: 38794941
DOI: 10.4317/medoral.26561 -
Medicina (Kaunas, Lithuania) May 2024The regeneration of periodontal bone defects continues to be an essential therapeutic concern in dental biomaterials. Numerous biomaterials have been utilized in this... (Review)
Review
The regeneration of periodontal bone defects continues to be an essential therapeutic concern in dental biomaterials. Numerous biomaterials have been utilized in this sector so far. However, the immune response and vascularity in defect regions may be disregarded when evaluating the effectiveness of biomaterials for bone repair. Among several regenerative treatments, the most recent technique of in situ tissue engineering stands out for its ability to replicate endogenous restorative processes by combining scaffold with particular growth factors. Regenerative medicine solutions that combine biomaterials/scaffolds, cells, and bioactive substances have attracted significant interest, particularly for bone repair and regeneration. Dental stem cells (DSCs) share the same progenitor and immunomodulatory properties as other types of MSCs, and because they are easily isolable, they are regarded as desirable therapeutic agents in regenerative dentistry. Recent research has demonstrated that DSCs sown on newly designed synthetic bio-material scaffolds preserve their proliferative capacity while exhibiting increased differentiation and immuno-suppressive capabilities. As researchers discovered how short peptide sequences modify the adhesion and proliferative capacities of scaffolds by activating or inhibiting conventional osteogenic pathways, the scaffolds became more effective at priming MSCs. In this review, the many components of tissue engineering applied to bone engineering will be examined, and the impact of biomaterials on periodontal regeneration and bone cellular biology/molecular genetics will be addressed and updated.
Topics: Humans; Tissue Engineering; Bone Regeneration; Tissue Scaffolds; Biocompatible Materials; Periodontium
PubMed: 38792956
DOI: 10.3390/medicina60050773 -
Medicina (Kaunas, Lithuania) Apr 2024: The upper posterior teeth are typically regarded as being exclusively inferior to the maxillary sinus (MS). The expansion of the nasal fossa above the maxillary...
: The upper posterior teeth are typically regarded as being exclusively inferior to the maxillary sinus (MS). The expansion of the nasal fossa above the maxillary alveolar base (MAB) needs better investigation. The hypothesis was raised that the MAB in the upper premolar region, which is usually addressed by surgeons for the elevation of the antral floor, is not exclusively beneath the MS. Therefore, we aimed to document the possible upper relations of the MAB as antral, nasal, or both. : A total of 145 CBCT scans were used to study four types of MAB: type 1-antral; type 2-antral with a palatal recess; type 3-antral and nasal; type 4-nasal. In type 2, the orthoradial width of the alveolar bone, the rectilinear width of the antral floor, and the maximum depth of the palatal recess were measured. For type 3, the MAB width and the straight widths of the antral and nasal segments of the MAB were measured. : Type 1 was found in 67.24%, type 2 in 13.45%, type 3 in 16.21%, and type 4 in 3.1% of the 290 MSs investigated. Palatal recesses were found in 11.72% of the MSs on the right side and 15.17% of the MSs on the left side. Types 1 and 2 exhibited strongly statistically significant bilateral symmetry (Pearson's Chi2 = 86.42, < 0.001). Type 3 correlated equally with contralateral types 1 and 3. The bilateral symmetry for types 1-3 was stronger in the males (Pearson's Chi2 = 47.83, < 0.001) than in the females (Pearson's Chi2 = 56.96, < 0.001). There were no statistically significant associations between sex and the unilateral anatomical type. : The MAB in the upper second premolar area should not be considered to be exclusively antral during surgeries or in anatomical teaching.
Topics: Humans; Male; Female; Bicuspid; Middle Aged; Cone-Beam Computed Tomography; Alveolar Process; Adult; Maxillary Sinus; Aged; Maxilla
PubMed: 38792909
DOI: 10.3390/medicina60050726 -
International Journal of Molecular... May 2024Orthodontic space closure following tooth extraction is often hindered by alveolar bone deficiency. This study investigates the therapeutic use of nuclear factor-kappa B...
Orthodontic space closure following tooth extraction is often hindered by alveolar bone deficiency. This study investigates the therapeutic use of nuclear factor-kappa B (NF-κB) decoy oligodeoxynucleotides loaded with polylactic-co-glycolic acid nanospheres (PLGA-NfDs) to mitigate alveolar bone loss during orthodontic tooth movement (OTM) following the bilateral extraction of maxillary first molars in a controlled experiment involving forty rats of OTM model with ethics approved. The decreased tendency of the OTM distance and inclination angle with increased bone volume and improved trabecular bone structure indicated minimized alveolar bone destruction. Reverse transcription-quantitative polymerase chain reaction and histomorphometric analysis demonstrated the suppression of inflammation and bone resorption by downregulating the expression of tartrate-resistant acid phosphatase, tumor necrosis factor-α, interleukin-1β, cathepsin K, NF-κB p65, and receptor activator of NF-κB ligand while provoking periodontal regeneration by upregulating the expression of alkaline phosphatase, transforming growth factor-β1, osteopontin, and fibroblast growth factor-2. Importantly, relative gene expression over the maxillary second molar compression side in proximity to the alveolus highlighted the pharmacological effect of intra-socket PLGA-NfD administration, as evidenced by elevated osteocalcin expression, indicative of enhanced osteocytogenesis. These findings emphasize that locally administered PLGA-NfD serves as an effective inflammatory suppressor and yields periodontal regenerative responses following tooth extraction.
Topics: Animals; Polylactic Acid-Polyglycolic Acid Copolymer; Rats; Nanospheres; Tooth Movement Techniques; Oligodeoxyribonucleotides; Tooth Socket; Male; NF-kappa B; Wound Healing; Alveolar Bone Loss; Tooth Extraction
PubMed: 38791262
DOI: 10.3390/ijms25105223 -
International Journal of Molecular... May 2024Periodontitis is linked to the onset and progression of oral squamous cell carcinoma (OSCC), an epidemiologically frequent and clinically aggressive malignancy. In this... (Review)
Review
Periodontitis is linked to the onset and progression of oral squamous cell carcinoma (OSCC), an epidemiologically frequent and clinically aggressive malignancy. In this context, and , two bacteria that cause periodontitis, are found in OSCC tissues as well as in oral premalignant lesions, where they exert pro-tumorigenic activities. Since the two bacteria are present also in endodontic diseases, playing a role in their pathogenesis, here we analyze the literature searching for information on the impact that endodontic infection by or could have on cellular and molecular events involved in oral carcinogenesis. Results from the reviewed papers indicate that infection by and/or triggers the production of inflammatory cytokines and growth factors in dental pulp cells or periodontal cells, affecting the survival, proliferation, invasion, and differentiation of OSCC cells. In addition, the two bacteria and the cytokines they induce halt the differentiation and stimulate the proliferation and invasion of stem cells populating the dental pulp or the periodontium. Although most of the literature confutes the possibility that bacteria-induced endodontic inflammatory diseases could impact on oral carcinogenesis, the papers we have analyzed and discussed herein recommend further investigations on this topic.
Topics: Humans; Porphyromonas gingivalis; Fusobacterium nucleatum; Mouth Neoplasms; Fusobacterium Infections; Carcinogenesis; Bacteroidaceae Infections; Carcinoma, Squamous Cell; Periodontitis; Animals; Cytokines
PubMed: 38791123
DOI: 10.3390/ijms25105083 -
Biomedicines May 2024Periodontal defects present a significant challenge in dentistry, necessitating innovative solutions for comprehensive regeneration. Traditional restoration methods have... (Review)
Review
Periodontal defects present a significant challenge in dentistry, necessitating innovative solutions for comprehensive regeneration. Traditional restoration methods have inherent limitations in achieving complete and functional periodontal tissue reconstruction. Tissue engineering, a multidisciplinary approach integrating cells, biomaterials, and bioactive factors, holds tremendous promise in addressing this challenge. Central to tissue engineering strategies are scaffolds, pivotal in supporting cell behavior and orchestrating tissue regeneration. Natural and synthetic materials have been extensively explored, each offering unique advantages in terms of biocompatibility and tunable properties. The integration of growth factors and stem cells further amplifies the regenerative potential, contributing to enhanced tissue healing and functional restoration. Despite significant progress, challenges persist. Achieving the seamless integration of regenerated tissues, establishing proper vascularization, and developing biomimetic scaffolds that faithfully replicate the natural periodontal environment are ongoing research endeavors. Collaborative efforts across diverse scientific disciplines are essential to overcoming these hurdles. This comprehensive review underscores the critical need for continued research and development in tissue engineering strategies for periodontal regeneration. By addressing current challenges and fostering interdisciplinary collaborations, we can unlock the full regenerative potential, paving the way for transformative advancements in periodontal care. This research not only enhances our understanding of periodontal tissues but also offers innovative approaches that can revolutionize dental therapies, improving patient outcomes and reshaping the future of periodontal treatments.
PubMed: 38791052
DOI: 10.3390/biomedicines12051090