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Clinical Oral Investigations Jun 2024To investigate the four-year clinical outcome and marginal bone loss around narrow-diameter implants in patients with uncontrolled diabetes mellitus type 2 (T2DM) and...
OBJECTIVES
To investigate the four-year clinical outcome and marginal bone loss around narrow-diameter implants in patients with uncontrolled diabetes mellitus type 2 (T2DM) and normo-glycemic individuals.
MATERIALS AND METHODS
In 11 T2DM patients with a concentration of glycated hemoglobin (HbA1C) > 6.5% (test group) and 15 normoglycemic patients (HbA1C < 6.0%; control group), one narrow-diameter tissue level implant, placed in the posterior maxilla or mandible, was investigated. The clinical parameters probing depth (PD), bleeding on probing (BOP), attachment loss (CAL), recession, and papilla bleeding index (PBI) were assessed manually after 24 and 48 months of function. The paired digital periapical radiographs were analyzed regarding the change in marginal bone level (MBL) from baseline to 48 months post-op. The technical complications were recorded.
RESULTS
In the T2DM group, 11 patients were available for follow-ups. The overall implant survival rate after 48 months was 100%. The differences in means for the clinical parameters and the MBL between the T2DM and normo-glycemic patients for the observation period were statistically non-significant. No technical complications were recorded.
CONCLUSIONS
The study demonstrated an encouraging clinical outcome with ND implants in patients with uncontrolled T2DM compared to non-diabetics after 48 months' post loading.
CLINICAL RELEVANCE
Patients with HbA1C > 6.5% may benefit from the treatment with narrow-diameter implants by avoiding complex surgical interventions with augmentation procedures. REGISTRATION NUMBER (CLINICALTRIALS.GOV): NCT04630691.
Topics: Humans; Male; Female; Middle Aged; Case-Control Studies; Diabetes Mellitus, Type 2; Treatment Outcome; Dental Prosthesis Design; Dental Implants; Glycated Hemoglobin; Aged; Dental Implantation, Endosseous; Alveolar Bone Loss; Periodontal Index; Adult; Hyperglycemia
PubMed: 38907052
DOI: 10.1007/s00784-024-05786-0 -
Journal of Applied Oral Science :... 2024To explore the feasibility of injectable platelet-rich fibrin (i-PRF) in regenerative endodontics by comparing the effect of i-PRF and platelet-rich fibrin (PRF) on the... (Comparative Study)
Comparative Study
OBJECTIVE
To explore the feasibility of injectable platelet-rich fibrin (i-PRF) in regenerative endodontics by comparing the effect of i-PRF and platelet-rich fibrin (PRF) on the biological behavior and angiogenesis of human stem cells from the apical papilla (SCAPs).
METHODOLOGY
i-PRF and PRF were obtained from venous blood by two different centrifugation methods, followed by hematoxylin-eosin (HE) staining and scanning electron microscopy (SEM). Enzyme-linked immunosorbent assay (ELISA) was conducted to quantify the growth factors. SCAPs were cultured with different concentrations of i-PRF extract (i-PRFe) and PRF extract (PRFe), and the optimal concentrations were selected using the Cell Counting Kit-8 (CCK-8) assay. The cell proliferation and migration potentials of SCAPs were then observed using the CCK-8 and Transwell assays. Mineralization ability was detected by alizarin red staining (ARS), and angiogenesis ability was detected by tube formation assay. Real-time quantitative polymerase chain reaction (RT-qPCR) was performed to evaluate the expression of genes related to mineralization and angiogenesis. The data were subjected to statistical analysis.
RESULTS
i-PRF and PRF showed a similar three-dimensional fibrin structure, while i-PRF released a higher concentration of growth factors than PRF ( P <.05). 1/4× i-PRFe and 1/4× PRFe were selected as the optimal concentrations. The cell proliferation rate of the i-PRFe group was higher than that of the PRFe group ( P <.05), while no statistical difference was observed between them in terms of cell mitigation ( P >.05). More importantly, our results showed that i-PRFe had a stronger effect on SCAPs than PRFe in facilitating mineralization and angiogenesis, with the consistent result of RT-qPCR ( P <.05).
CONCLUSION
This study revealed that i-PRF released a higher concentration of growth factors and was superior to PRF in promoting proliferation, mineralization and angiogenesis of SCAPs, which indicates that i-PRF could be a promising biological scaffold for application in pulp regeneration.
Topics: Platelet-Rich Fibrin; Humans; Cell Proliferation; Microscopy, Electron, Scanning; Enzyme-Linked Immunosorbent Assay; Neovascularization, Physiologic; Regenerative Endodontics; Cells, Cultured; Real-Time Polymerase Chain Reaction; Intercellular Signaling Peptides and Proteins; Reproducibility of Results; Cell Movement; Stem Cells; Time Factors; Feasibility Studies; Analysis of Variance; Dental Papilla; Reference Values
PubMed: 38896639
DOI: 10.1590/1678-7757-2023-0449 -
Scientific Reports Jun 2024Notum is a direct target of Wnt/β-catenin signaling and plays a crucial role as a Wnt inhibitor within a negative feedback loop. In the tooth, Notum is known to be...
Notum is a direct target of Wnt/β-catenin signaling and plays a crucial role as a Wnt inhibitor within a negative feedback loop. In the tooth, Notum is known to be expressed in odontoblasts, and severe dentin defects and irregular tooth roots have been reported in Notum-deficient mice. However, the precise expression pattern of Notum in early tooth development, and the role of Notum in crown and root patterns remain elusive. In the present study, we identified a novel Notum expression in primary enamel knot (EK), secondary EKs, and dental papilla during tooth development. Notum-deficient mice exhibited enlarged secondary EKs, resulting in broader cusp tips, altered cusp patterns, and reduced concavity in crown outline. These alterations in crown outline led to a reduction in cervical tongue length, thereby inducing root fusion in Notum-deficient mice. Overall, these results suggest that the secondary EK size, regulated by the Wnt/Notum negative feedback loop, has a significant impact on the patterns of crown and root during tooth morphogenesis.
Topics: Animals; Mice; Gene Expression Regulation, Developmental; Mice, Knockout; Molar; Odontogenesis; Receptors, G-Protein-Coupled; Tooth Crown; Tooth Root; Wnt Signaling Pathway
PubMed: 38871845
DOI: 10.1038/s41598-024-64340-w -
Acta Odontologica Scandinavica Jun 2024Non-surgical therapeutics to reconstruct lost interdental papilla are evolving; these include hyaluronic acid injection. The aim of this systematic review is to evaluate...
OBJECTIVE
Non-surgical therapeutics to reconstruct lost interdental papilla are evolving; these include hyaluronic acid injection. The aim of this systematic review is to evaluate the efficacy, safety, and long-term outcomes of hyaluronic acid injection in the treatment of black triangles and reconstruction of lost interdental papilla in anterior teeth.
MATERIALS AND METHODS
The protocol was registered in PROSPERO (CRD42023446875) and in accordance with the Cochrane Handbook of Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 'PRISMA'. The search involved four databases, PubMed/MEDLINE, The Cochrane Library, Google Scholar, and ProQuest for ''grey literature' with additional manual search for studies published up to May 2024. Human clinical studies of a prospective nature (randomised clinical trials and prospective cohort studies) were included. Exclusion criteria were case reports, case series, review articles, letter to editor, personal opinion, and animal studies. Furthermore, studies which utilised hyaluronic acid injection in conjunction with other therapeutic material, tissue graft, or any surgical procedure were also excluded. The data were extracted independently by the two authors and incorporated after consensus. The risk of bias was assessed using the RoB2: the revised Cochrane risk of bias tool for randomised clinical trials and the Newcastle Ottawa scale for prospective cohort studies.
RESULTS
24 studies, 15 prospective clinical studies and nine randomised clinical trials, were included with a total of 898 interdental papillae injected with hyaluronic acid. The studies showed promising outcomes in the reconstruction of lost interdental papilla with minimal adverse reactions. Risk of bias assessment among prospective clinical studies revealed 13 good quality studies with only two poor studies while the randomised clinical trials consisted of three with low, one with some concern, and five studies with high risk of bias. However, due to the high heterogeneity, a meta-analysis was not feasible. Conclusion: Hyaluronic acid injection is an effective minimally invasive approach in treating black triangles and reconstructing lost interdental papilla in the anterior teeth. Further long-term well-designed randomised clinical trials employing standardised procedures are essential to validate this treatment and provide better quality of evidence.
Topics: Hyaluronic Acid; Humans; Dental Papilla
PubMed: 38864684
DOI: 10.2340/aos.v83.40864 -
The Saudi Dental Journal May 2024This study aimed to classify the crowns of maxillary central incisors into distinct categories and to examine the associations between these crown forms and morphometric...
OBJECTIVE
This study aimed to classify the crowns of maxillary central incisors into distinct categories and to examine the associations between these crown forms and morphometric characteristics in an ethnically diverse Asian population. This is significant for the treatment planning and management of cases, especially for the anterior teeth, from the restorative and aesthetic points of view.
METHOD AND MATERIALS
Clinical measurements and photographic data were collected from 160 participants, comprising students, staff, and patients of the Faculty of Dentistry, Universiti Kebangsaan Malaysia. The crown length, crown width, contact surface, papilla height, papilla fill, keratinized mucosa width, and gingival tissue thickness were measured. Cluster analyses were performed to identify the different crown form categories and corresponding characteristics.
RESULTS
The mean crown width measured 7.093 ± 0.637 mm, while the mean crown length was 10.209 ± 0.966 mm. Three crown-form clusters were identified: triangular (50 %), square/tapered (23.1 %), and square (26.9 %) shapes. The triangular cluster had a significantly higher mean papilla height (4.64 mm ± 0.818) and the highest incidence of incomplete papilla fill (17.5 %). The chi-squared test showed a significant difference in crown forms between the different ethnicities, χ2 (2, 160) = 0.033.
CONCLUSION
Within this diverse Asian population, the crown form demonstrates three clusters: triangular, square/tapered, and square, characterized by a notably small average crown width and crown length. Most participants predominantly exhibited triangular crown forms with reduced crown width, crown length, and crown width/ crown length ratio. Furthermore, noticeable variations in crown forms and their morphometric attributes were observed among the three ethnic groups: Malays, Chinese, and Indians.
PubMed: 38766282
DOI: 10.1016/j.sdentj.2024.02.017 -
Journal of Oral Biosciences Jun 2024The development of bio-three-dimensional (bio-3D) printers has led to significant advances in regenerative medicine. Three-dimensional constructs, including spheroids,...
OBJECTIVES
The development of bio-three-dimensional (bio-3D) printers has led to significant advances in regenerative medicine. Three-dimensional constructs, including spheroids, are maintained by extracellular matrix proteins secreted by cells so that the cells can be cultured in conditions closer to the physiological environment. This study aimed to create a useful 3D construct as a model of the dentin-pulp complex.
METHODS
We examined the expression patterns of extracellular matrix proteins and cell proliferation areas in a 3D construct created using O9-1 cells derived from cranial neural crest cells of mice. The 3D construct was created by sticking the spheroid cultures onto a needle array using a bio-3D printer.
RESULTS
Cell proliferation areas along with characteristic expression of tenascin C and DMP1 were evaluated. The expression of tenascin C and DMP1 was significantly enhanced in the spheroids compared to that in two-dimensional cultures. Moreover, cell proliferation regions and tenascin C expression were confirmed in the outer layer of spheroids in the embryonic stem cell medium, with insignificant DMP1 expression being observed. Interestingly, in a 3D construct cultured in calcification-induction medium, DMP1 expression was promoted, and DMP1-positive cells existed in the outermost layer without overlapping with tenascin C expression.
CONCLUSIONS
The extracellular matrix proteins, tenascin C and DMP1, were expressed in a polarized manner in spheroids and 3D constructs, similar to the findings in the dental papilla. Therefore, these 3D constructs show potential as artificial models for studying odontogenesis.
Topics: Neural Crest; Animals; Mice; Printing, Three-Dimensional; Tenascin; Cell Proliferation; Extracellular Matrix Proteins; Cell Line; Spheroids, Cellular; Tissue Engineering
PubMed: 38750954
DOI: 10.1016/j.job.2024.05.005 -
Clinical Oral Investigations May 2024This split-mouth randomized study aimed to assess efficacy of leucocyte-platelet-rich fibrin (L-PRF) versus connective tissue graft (CTG) in achieving root coverage (RC)... (Randomized Controlled Trial)
Randomized Controlled Trial
Treatment of multiple adjacent gingival recessions using leucocyte- and platelet-rich fibrin with coronally advanced flap: a 12-month split-mouth controlled randomized clinical trial.
OBJECTIVE
This split-mouth randomized study aimed to assess efficacy of leucocyte-platelet-rich fibrin (L-PRF) versus connective tissue graft (CTG) in achieving root coverage (RC) for multiple adjacent gingival recessions (MAGRs) throughout 12-month period.
MATERIALS AND METHODS
The study enrolled 59 teeth from 12 patients with Miller Class I MAGRs ≥ 2 mm on bilateral or contralateral sides. Patients were randomly assigned to receive coronally advanced flap (CAF) with either CTG (control) or L-PRF (test) treatment. Various parameters, including plaque and gingival index, clinical attachment level, recession depth, probing depth, recession width (RW), papilla width (PW), keratinized tissue width (KTW), gingival thickness (GT), percentage of RC, complete root coverage (CRC), and location of the relative gingival margin concerning the cemento-enamel junctions (GMCEJ) after CAF, were recorded at baseline, 3-, 6-, and 12-months post-surgery. On June 29, 2021 the study was registred to ClinicalTrials.gov (NCT04942821).
RESULTS
Except KTW and GT gain, all clinical parameters, RC, and CRC were similar between the groups at all follow-up periods (p > 0.05). The higher GT and KTW gains were detected in the control group compared to test group at 12 months (p < 0.05). Both RC and CRC were positively associated with initial PW and GMCEJ, but negatively with initial RW (p < 0.05).
CONCLUSIONS
The current study concludes that L-PRF were equally effective as CTG in treating MAGRs in terms of RC and CRC. Additionally, RC and CRC outcomes appeared to be influenced by GMCEJ, PW, and RW.
CLINICAL RELEVANCE
L-PRF could represent a feasible substitute for CTG in treating MAGRs.
Topics: Humans; Gingival Recession; Platelet-Rich Fibrin; Male; Female; Surgical Flaps; Adult; Leukocytes; Middle Aged; Periodontal Index; Connective Tissue; Treatment Outcome
PubMed: 38691209
DOI: 10.1007/s00784-024-05694-3 -
Biology Mar 2024Dental pulp infections are common buccal diseases. When this happens, endodontic treatments are needed to disinfect and prepare the root canal for subsequent procedures....
Dental pulp infections are common buccal diseases. When this happens, endodontic treatments are needed to disinfect and prepare the root canal for subsequent procedures. However, the lack of suitable in vitro models representing the anatomy of an immature root canal hinders research on regenerative events crucial in endodontics, such as regenerative procedures. This study aimed to develop a 3D microphysiological system (MPS) to mimic an immature root canal and assess the cytotoxicity of various irrigating solutions on stem cells. Utilizing the Dental Stem Cells SV40 (DSCS) cell line derived from human apical papilla stem cells, we analyzed the effects of different irrigants, including etidronic acid. The results indicated that irrigating solutions diminished cell viability in 2D cultures and influenced cell adhesion within the microphysiological device. Notably, in our 3D studies in the MPS, 17% EDTA and 9% 1-hydroxyethylidene-1, 1-bisphosphonate (HEBP) irrigating solutions demonstrated superior outcomes in terms of DSCS viability and adherence compared to the control. This study highlights the utility of the developed MPS for translational studies in root canal treatments and suggests comparable efficacy between 9% HEBP and 17% EDTA irrigating solutions, offering potential alternatives for clinical applications.
PubMed: 38666833
DOI: 10.3390/biology13040221 -
European Journal of Orthodontics Jun 2024The most common treatment approaches for patients missing maxillary lateral incisors are implant replacement (IT) and orthodontic space closure (SC). Treatment...
INTRODUCTION
The most common treatment approaches for patients missing maxillary lateral incisors are implant replacement (IT) and orthodontic space closure (SC). Treatment techniques change and improve over time, and it is of interest to know if improvements differ between the methods.
AIM
To compare the aesthetic outcome and other clinical findings in patients with one or two missing maxillary lateral incisors who were treated with a 10-year difference in time, with either orthodontic space closure or implant replacement.
MATERIAL AND METHODS
A total of 88 patients were included in the study. Forty-four patients treated between 2011 and 2018 were included as the latter cohort (LC). The LC was compared to the early cohort (EC; n = 44), treated between 2001 and 2008. A total of 132 teeth was analysed: 62 teeth in the EC (28 teeth in IT cases and 34 teeth in SC cases) and 70 teeth in the LC (34 teeth in IT cases and 36 teeth in SC cases). Long-term clinical and aesthetic outcomes were evaluated.
RESULTS
An improvement over time was found in crown length, BoP, papilla, the inclination of incisors, and overall appearance in IT cases and in crown colour and overbite in SC cases. A deterioration over time was found in crown length and BoP among the SC cases.
CONCLUSION
Among the IT cases, an improvement in outcomes was noted over time. When comparing SC cases the colour of the crown and overbite had improved, while crown length and BoP had deteriorated over time.
Topics: Humans; Esthetics, Dental; Incisor; Female; Male; Orthodontic Space Closure; Maxilla; Anodontia; Time Factors; Adult; Adolescent; Treatment Outcome; Retrospective Studies; Young Adult
PubMed: 38656537
DOI: 10.1093/ejo/cjae018 -
BioRxiv : the Preprint Server For... Mar 2024Regeneration of dentin and odontoblasts from dental pulp stem cells (DPSCs) is essential for permanent tooth maintenance. However, the identity and role of endogenous...
Regeneration of dentin and odontoblasts from dental pulp stem cells (DPSCs) is essential for permanent tooth maintenance. However, the identity and role of endogenous DPSCs in reparative dentinogenesis are elusive. Here, using pulp single-cell analysis before and after molar eruption, we revealed that endogenous DPSCs are enriched in GFP coronal papilla-like cells with Cre labeling. These GFP cells are long-term repopulating cells that contribute to the majority of pulp cells and new odontoblasts after eruption. Upon molar injury, DPSCs localize into the injury site and differentiate into new odontoblasts, forming -GFP and -GFP dentinal tubules and reparative dentin. Single-cell and FACS analysis showed that GFP DPSCs are the most primitive cells with stem cell marker expression and odontoblast differentiation. Taken together, our findings demonstrate that labels postnatal DSPCs, which are the main source of pulp cells and new odontoblasts with reparative dentinogenesis .
PubMed: 38585950
DOI: 10.1101/2024.03.21.586156