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Clinical Oral Investigations Jan 2024To assess treatment options for the reconstruction of the lost interdental papilla and to evaluate evidence for their efficacy. (Review)
Review
OBJECTIVES
To assess treatment options for the reconstruction of the lost interdental papilla and to evaluate evidence for their efficacy.
METHODS
An electronic search (Medline, Embase and the Cochrane Library Database and OpenGray) and a hand search were carried out to identify all types of studies investigating interdental papilla reconstruction (except for reviews) with a minimum of 3 months follow-up.
RESULTS
Forty-five studies were included in the study including 7 RCTs, 2 cohort studies, 19 case series and 17 case reports. Fifteen studies reported on the use of hyaluronic acid, 6 studies on platelet-rich fibrin, 16 studies on soft tissue grafting, 4 studies on orthodontics and 4 on additional modalities. The most common outcome measures were black triangle dimensions and papillary fill percentage. Meta-analysis was not possible due to the high heterogeneity of the studies.
CONCLUSION
There are various options for interdental papilla reconstruction of which hyaluronic acid injections, PRF, surgical grafting and orthodontics seem to improve outcomes at a minimum 3 months. The use of soft tissue grafting with sub-epithelial connective tissue graft seems to be associated with the most robust evidence for the longer-term reduction of 'black triangles'. There is insufficient evidence to make recommendations to clinicians. Further research is needed in the form of well conducted RCTs with longer follow ups and patient reported outcome measures.
CLINICAL RELEVANCE
Patients frequently complain about the appearance of black triangles and their management options seem unclear. This systematic review provides insight into the available reconstructive options.
Topics: Humans; Gingiva; Hyaluronic Acid; Dental Care; Electronics
PubMed: 38231354
DOI: 10.1007/s00784-023-05409-0 -
International Dental Journal Apr 2024Simvastatin has emerged as having a promising role in controlling stem cell behaviours. This study aimed to evaluate the effects of simvastatin on the viability, growth,...
AIM
Simvastatin has emerged as having a promising role in controlling stem cell behaviours. This study aimed to evaluate the effects of simvastatin on the viability, growth, and migration of stem cells isolated from apical papillae (SCAPs) in vitro.
METHODS
SCAPs were isolated and characterised. The viability and proliferation were assessed using live/dead and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assays, respectively. Cell migration was evaluated using scratch assays. Cell cycle progression and apoptosis were examined using flow cytometry analysis.
RESULTS
Simvastatin at a concentration of 100 to 1000 nM did not exhibit cytotoxicity. Simvastatin reduced cell numbers at days 3 and 7. In addition, simvastatin markedly decreased colony formation in both colony number and cell density in a dose-dependent manner. An increase in apoptosis was observed at day 7. There was statistically significant increased in sub G0 population. An in vitro cell migration was attenuated in a dose-dependent manner.
CONCLUSION
Simvastatin affects SCAPs' viability, proliferation, and cell migration. The reduction of cell viability at day 7 could be due to apoptotic induction.
Topics: Humans; Simvastatin; Stem Cells; Flow Cytometry; Apoptosis
PubMed: 38220513
DOI: 10.1016/j.identj.2023.10.015 -
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 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 -
Clinical Oral Investigations Jan 2024To investigate in vitro effects of a nanoparticle bioceramic material, iRoot BP Plus, on stem cells from apical papilla (SCAP) and in vivo capacity to induce pulp-dentin...
OBJECTIVES
To investigate in vitro effects of a nanoparticle bioceramic material, iRoot BP Plus, on stem cells from apical papilla (SCAP) and in vivo capacity to induce pulp-dentin complex formation.
MATERIALS AND METHODS
The sealing ability of iRoot BP Plus was measured via scanning electron microscopy (SEM). SCAP were isolated and treated in vitro by iRoot BP Plus conditioned medium, with mineral trioxide aggregate (MTA) conditioned medium and regular medium used as controls, respectively. Cell proliferation was assessed by BrdU labeling and MTT assay and cell migration was evaluated with wound healing and transwell assays. Osteo/odontogenic potential was evaluated by Alizarin red S staining and qPCR. Pulp-dentin complex formation in vivo was assessed by a tooth slice subcutaneous implantation model.
RESULTS
iRoot BP Plus was more tightly bonded with the dentin. There was no difference in SCAP proliferation between iRoot BP Plus and control groups (P > 0.05). iRoot BP Plus had a greater capacity to elevated cell migration (P < 0.05) and osteo/odontogenic marker expression and mineralization nodule formation of SCAP compared with MTA groups (P < 0.05). Furthermore, the new continuous dentine layer and pulp-like tissue was observed in the iRoot BP Plus group in vivo.
CONCLUSIONS
iRoot BP Plus showed excellent sealing ability, promoted the migration and osteo/odontogenesis of SCAP and induced pulp-dentin complex formation without affecting the cell proliferation, which indicated iRoot BP Plus was a promising coronal sealing material in REPs.
CLINICAL RELEVANCE
The coronal sealing materials play crucial roles for the outcomes of REPs. This study showed that iRoot BP Plus has good coronal sealing and promote pulp-dentin complex formation compared with MTA, providing experimental evidences for the clinical application of iRoot BP Plus as a promising coronal seal material in REPs.
Topics: Humans; Culture Media, Conditioned; Regenerative Endodontics; Cell Differentiation; Dental Pulp; Silicates; Cell Proliferation; Oxides; Calcium Compounds; Drug Combinations; Aluminum Compounds
PubMed: 38170260
DOI: 10.1007/s00784-023-05468-3 -
Biomimetics (Basel, Switzerland) Dec 2023Chitosan, a natural polysaccharide sourced from crustaceans and insects, is often used with hydrogels in wound care. Evaluating its cytotoxicity and antimicrobial...
UNLABELLED
Chitosan, a natural polysaccharide sourced from crustaceans and insects, is often used with hydrogels in wound care. Evaluating its cytotoxicity and antimicrobial properties is crucial for its potential use in dentistry.
OBJECTIVE
To investigate the mechanical properties of gelatin hydrogels based on decaethylated chitosan and antimicrobial activity against and their biological effects with stem cells from apical papilla (SCAPs).
MATERIAL AND METHODS
Gelatin-chitosan hydrogels were synthesized at concentrations of 0%, 0.2% and 0.5%. Enzymatic and hydrolytic degradation, along with swelling capacity, was assessed. Fourier transform infrared spectroscopy (FTIR) analysis was employed to characterize the hydrogels. The interaction between hydrogels and SCAPs was examined through initial adhesion and cell proliferation at 24 and 48 h, using the Thiazolyl Blue Tetrazolium Bromide (MTT assay). The antimicrobial effect was evaluated using agar diffusion and a microdilution test against . Uniaxial tensile strength (UTS) was also measured to assess the mechanical properties of the hydrogels.
RESULTS
The hydrogels underwent hydrolytic and enzymatic degradation at 30, 220, 300 min and 15, 25, 30 min, respectively. Significantly, ( < 0.01) swelling capacity occurred at 20, 40, 30 min, respectively. Gelatin-chitosan hydrogels' functional groups were confirmed using vibrational pattern analysis. SCAPs proliferation corresponded to 24 h = 73 ± 2%, 82 ± 2%, 61 ± 6% and 48 h = 83 ± 11%, 86 ± 2%, 44 ± 2%, respectively. The bacterial survival of hydrogel interaction was found to be 96 ± 1%, 17 ± 1.5% ( < 0.01) and 1 ± 0.5% ( < 0.01), respectively. UTS showed enhanced ( < 0.05) mechanical properties with chitosan presence.
CONCLUSION
Gelatin-chitosan hydrogels displayed favorable degradation, swelling capacity, mild dose-dependent cytotoxicity, significant proliferation with stem cells from apical papilla (SCAPs), substantial antimicrobial effects against and enhanced mechanical properties. These findings highlight their potential applications as postoperative care dressings.
PubMed: 38132514
DOI: 10.3390/biomimetics8080575 -
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 -
F1000Research 2023The problem of missing teeth persists in all age groups. The main objective of implants in dentistry is to provide a restoration that reconstructs the shape and restores...
BACKGROUND
The problem of missing teeth persists in all age groups. The main objective of implants in dentistry is to provide a restoration that reconstructs the shape and restores esthetics and functions of edentulous areas. The objectives of this study are to compare the crestal bone level changes and papillary fill after placement of implants in fresh extraction socket, i.e. immediate implant placement, and healed extraction socket, i.e. delayed or conventional implant placement, and to assess other clinical parameters such as modified plaque index (mPI), modified gingival index (mGI) and gingival biotype in between the groups and within the groups.
METHODS
18 patients were recruited in the study out of which 9 patients received implants as per immediate implant placement protocol (group 1) and 9 patients received implants as per conventional implant placement protocol (group 2). All patients were evaluated for gingival biotype, mPI and mGI and papillary fill was assessed as per Jemt's papilla score as clinical parameters. Implant site was assessed for radiographic bone loss using Image J software. Statistical analysis was performed using independent t test, paired t test and chi square test.
RESULTS
At the end of 1 year, results showed that crestal bone loss was seen more in the immediate group than the conventional group. Conventional implants showed better papillary fill than implants placed in fresh extraction sockets. Plaque scores were assessed as per modified plaque index, which showed better results in the conventional group. Modified gingival index was used to assess gingival status which showed better results in the immediate group one year later.
CONCLUSIONS
Findings from the study suggest that crestal bone loss was found to be increased in the immediate group than the conventional group and papillary fill was better in the conventional group than the immediate group.Registration: CTRI ( CTRI/2019/09/021340).
Topics: Humans; Prospective Studies; Tooth Socket; Treatment Outcome; Gingiva
PubMed: 38106651
DOI: 10.12688/f1000research.131411.1 -
PeerJ 2023Dental papilla cells (DPCs) are one of the key stem cells for tooth development, eventually forming dentin and pulp. Previous studies have reported that PER2 is...
BACKGROUND
Dental papilla cells (DPCs) are one of the key stem cells for tooth development, eventually forming dentin and pulp. Previous studies have reported that PER2 is expressed in a 24-hour oscillatory pattern in DPCs . , PER2 is highly expressed in odontoblasts (which are differentiated from DPCs). However, whether PER2 modulates the odontogenic differentiation of DPCs is uncertain. This research was to identify the function of PER2 in the odontogenic differentiation of DPCs and preliminarily explore its mechanisms.
METHODS
We monitored the expression of PER2 in DPCs differentiated . We used PER2 overexpression and knockdown studies to assess the role of PER2 in DPC differentiation and performed intracellular ATP content and reactive oxygen species (ROS) assays to further investigate the mechanism.
RESULTS
PER2 expression was considerably elevated throughout the odontoblastic differentiation of DPCs . Overexpressing boosted levels of odontogenic differentiation markers, such as dentin sialophosphoprotein (), dentin matrix protein 1 (), and alkaline phosphatase (), and enhanced mineralized nodule formation in DPCs. Conversely, the downregulation of inhibited the differentiation of DPCs. Additionally, downregulating further affected intracellular ATP content and ROS levels during DPC differentiation.
CONCLUSION
Overall, we demonstrated that PER2 positively regulates the odontogenic differentiation of DPCs, and the mechanism may be related to mitochondrial function as shown by intracellular ATP content and ROS levels.
Topics: Reactive Oxygen Species; Dental Papilla; Cell Differentiation; Odontoblasts; Adenosine Triphosphate
PubMed: 38084142
DOI: 10.7717/peerj.16489 -
International Journal of Clinical... Sep 2023To compare and evaluate the regenerative potential of blood clots and platelet-rich fibrin (PRF) in IYNPT based on the revised American Academy of Endodontics (AAE)...
Comparative Evaluation of the Regenerative Potential of Blood Clot and Platelet-rich Fibrin in Young Permanent Teeth Based on the Revised American Academy of Endodontics Clinical Considerations for Regenerative Procedure: 2016.
AIM
To compare and evaluate the regenerative potential of blood clots and platelet-rich fibrin (PRF) in IYNPT based on the revised American Academy of Endodontics (AAE) clinical considerations for regenerative endodontics 2016.
MATERIALS AND METHODS
A total of 20 patients (7-12 years) with immature young necrotic permanent teeth were included and irrigation and disinfection were done using the revised AAE protocol. Teeth were randomly categorized into PRF scaffolding and conventional bleeding technique. The cases were followed up for 1, 3, and 6 months for clinical and radiographic evaluation.
RESULT
At 6 months there was no significant difference between the groups in terms of clinical healing and periapical healing. A significant statistical difference was noted at the end of 6 months with respect to apical closure within the PRF group. A significant difference was seen in the increase in dentin thickness between groups with PRF showing more increase.
CONCLUSION
The PRF scaffold can be used as it induces the regenerative potential of stem cells at the apex.
HOW TO CITE THIS ARTICLE
Prakash AJ, Naik SV, Attiguppe P. Comparative Evaluation of the Regenerative Potential of Blood Clot and Platelet-rich Fibrin in Young Permanent Teeth Based on the Revised American Academy of Endodontics Clinical Considerations for Regenerative Procedure: 2016. Int J Clin Pediatr Dent 2023;16(S-2):S149-S154.
PubMed: 38078024
DOI: 10.5005/jp-journals-10005-2654