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Cells Jun 2024Bone tissue injuries within oral and dental contexts often present considerable challenges because traditional treatments may not be able to fully restore lost or... (Review)
Review
Bone tissue injuries within oral and dental contexts often present considerable challenges because traditional treatments may not be able to fully restore lost or damaged bone tissue. Novel approaches involving stem cells and targeted 3D scaffolds have been investigated in the search for workable solutions. The use of scaffolds in stem cell-assisted bone regeneration is a crucial component of tissue engineering techniques designed to overcome the drawbacks of traditional bone grafts. This study provides a detailed review of scaffold applications for bone regeneration with stem cells in dentistry. This review focuses on scaffolds and stem cells while covering a broad range of studies explaining bone regeneration in dentistry through the presentation of studies conducted in this field. The role of different stem cells in regenerative medicine is covered in great detail in the reviewed literature. These studies have addressed a wide range of subjects, including the effects of platelet concentrates during dental surgery or specific combinations, such as human dental pulp stem cells with scaffolds for animal model bone regeneration, to promote bone regeneration in animal models. Noting developments, research works consider methods to improve vascularization and explore the use of 3D-printed scaffolds, secretome applications, mesenchymal stem cells, and biomaterials for oral bone tissue regeneration. This thorough assessment outlines possible developments within these crucial regenerative dentistry cycles and provides insights and suggestions for additional study. Furthermore, alternative creative methods for regenerating bone tissue include biophysical stimuli, mechanical stimulation, magnetic field therapy, laser therapy, nutritional supplements and diet, gene therapy, and biomimetic materials. These innovative approaches offer promising avenues for future research and development in the field of bone tissue regeneration in dentistry.
Topics: Humans; Bone Regeneration; Tissue Scaffolds; Animals; Stem Cells; Dentistry; Tissue Engineering; Dental Pulp; Stem Cell Transplantation; Regenerative Medicine
PubMed: 38920693
DOI: 10.3390/cells13121065 -
Acta Odontologica Latinoamericana : AOL Apr 2024A high prevalence of post-treatment apical periodontitis associated to variables such as endodontic treatment quality and missed canals has been reported.
Apical periodontitis in endodontically-treated teeth: association between missed canals and quality of endodontic treatment in a Colombian sub-population. A cross-sectional study.
UNLABELLED
A high prevalence of post-treatment apical periodontitis associated to variables such as endodontic treatment quality and missed canals has been reported.
AIM
The aim of this study was to evalúate the quality of endodontic treatment and the frequency of missed canals associated with teeth with apicalperiodontitis (AP) through CBCTin a Colombian sub-population.
MATERIAL AND METHOD
This was a cross-sectional study assessing 318 cone beam computed tomography (CBCT) scans of endodontically treated teeth from Colombian individuals. The scans were taken using J Morita X550 (J Morita Corporation, Osaka, Japan), with voxel size 0.125 to 0.20 mm. All endodontically treated teeth were assessed for quality of treatment, presence of missed canals and AP. Allsamples were analyzed bytwo endodontics specialists and an radiology specialist. Chi-square or Fisher 's test and odds ratio were calculated to identify the association and risk relationship between the presence of AP and the study variables.
RESULTS
Missed canals were found in 18.61% (86/462), and 95.3% were associated with AP. The frequency of AP was 62.34% (288/462) for all the evaluated teeth. AP was found in 27.43 % (79/288) of the teeth with adequate endodontic treatment, in contrast to 72.57% (209/288) of the teeth with inadequate treatment (P<0.01). The frequency of missed canals was highest in maxillary molars, with 55.23% (58/105), with 96.55% presenting AP. The second mesiobuccal canal wasthe most frequently missed canal, 88.52%o(54/61), with AP in 90.74% (49/54) of the cases.
CONCLUSIÓN
There was a high frequency of teeth with missed canals and PA. More than half of the teeth with missed canals were maxillary molars, with MB2 being the most common canal, commonly presenting apical periodontitis.
Topics: Humans; Cross-Sectional Studies; Periapical Periodontitis; Colombia; Female; Male; Root Canal Therapy; Adult; Middle Aged; Cone-Beam Computed Tomography; Tooth, Nonvital; Dental Pulp Cavity; Young Adult; Quality of Health Care; Aged
PubMed: 38920127
DOI: 10.54589/aol.37/1/59 -
Acta Odontologica Latinoamericana : AOL Apr 2024Knowledge of root canal internal anatomy and its variations is important forproper endodontic treatment. It is therefore necessary to investigate morphological aspects...
UNLABELLED
Knowledge of root canal internal anatomy and its variations is important forproper endodontic treatment. It is therefore necessary to investigate morphological aspects among different dental groups in the same patient to define the best protocol for the case.
AIM
To evaluate the morphology and symmetry of homologous incisors, premolars and mandibular molars using cone beam computed tomography (CBCT).
MATERIALS AND METHOD
Descriptive statistical analysis was performed for the frequency of categorical variables, and a chi-square test or Fisher 's exact test was used to test whether gender and side were associated with number of roots, number of canals, and Vertucci's classification. Forty-five CBCT scans were evaluated, and 444 mandibular teeth were analyzed. The number of roots, number of canals, classification of the canals in each root according to Vertucci and presence of a symmetrical relationship between pairs of posterior teeth were analyzed.
RESULTS
The resuls showed that 74% of mandibular central incisors had type I root canal, 26% of mandibular lateral incisors had type I and, with a significant difference in the number of canals between males and females (p < 0.05). In mandibular first premolars, 70.5% had type I; and in mandibular second premolars, 98.5% had type I. Mandibular first molars had two roots in 98% of the cases. Second mandibular molars had two roots in 92.5% of the cases, one root in 6%, and three roots in 1.5%. Symmetry between central incisors was higher in females than in males.
CONCLUSIÓN
Teeth of the same group can have different morphologies in the same patient.
Topics: Humans; Cone-Beam Computed Tomography; Female; Male; Dental Pulp Cavity; Molar; Bicuspid; Mandible; Incisor; Adult; Young Adult; Adolescent; Middle Aged
PubMed: 38920123
DOI: 10.54589/aol.37/1/25 -
Clinical Oral Investigations Jun 2024The study aims to compare the detection of the middle mesial canal (MMC) in mandibular molar teeth using cone beam computed tomography (CBCT) with different voxel sizes...
INTRODUCTION
The study aims to compare the detection of the middle mesial canal (MMC) in mandibular molar teeth using cone beam computed tomography (CBCT) with different voxel sizes when the mesiobuccal (MB) and mesiolingual (ML) canals have three distinct phases (unpreparation, preparation and obturation and the removal of the obturation and repreparation).
METHODS
Two hundred forty-two extracted human mandibular molars were collected and kept in a physiological saline solution prior to use. 0.2-, 0.28- and 0.35-mm voxel sizes CBCT (n = 242) were performed in three phases (Ph): Ph1, no MB and ML canal preparation or obturation; Ph2, after MB and ML canals preparation and obturation; and Ph3, after the removal of the obturation of MB and ML canals and canals repreparation. Images were analyzed using OnDemand3D® software. After the CBCT acquisition in Ph3, all the samples were clarified to visualize the presence of the MMC directly. A blinded, previously calibrated examiner analyzed all the images.
RESULTS
The MMC was detected in 15 of the 242 teeth after the clearing technique. The lowest MMC detection rate was observed at 0.35-mm voxel size regardless of the ML and MB canal condition, while the highest was observed at 0.2-mm voxel size (P < 0.05). There is no statistically significant difference between 0.2-mm and 0.28-mm voxel sizes (P > 0.05). In all voxel sizes, the highest rate of detectability of the MMC was seen in Phase 1, while the lowest was in Phase 2.
CONCLUSIONS
It may be appropriate to take a 0.20-mm voxel size CBCT image, especially after the removal of root canal filling.
CLINICAL RELEVANCE
An appropriate CBCT voxel size and the absence of root canal filling in the root canal system help to detect the missing MMC.
Topics: Cone-Beam Computed Tomography; Humans; Molar; Mandible; Dental Pulp Cavity; In Vitro Techniques; Root Canal Obturation; Root Canal Preparation; Root Canal Filling Materials
PubMed: 38916762
DOI: 10.1007/s00784-024-05773-5 -
Iranian Journal of Basic Medical... 2024This study aimed to investigate the impact of bioactive plant extracts on the proliferation and migration of dental pulp stem cells (DPSCs) and their potential...
OBJECTIVES
This study aimed to investigate the impact of bioactive plant extracts on the proliferation and migration of dental pulp stem cells (DPSCs) and their potential implications for dental care, focusing on the nurse-caring aspect.
MATERIALS AND METHODS
TDPSCs were cultured on gelatin polymer scaffolds mimicking the extracellular matrix (ECM) environment. Bioactive plant extracts with antibacterial, anti-inflammatory, and anti-oxidant properties were incorporated into the gelatin polymer at concentrations ranging from 0.1% to 2.0%. Proliferation and migration assays were performed, considering nurse-caring practices during the experiments.
RESULTS
Treatment with specific bioactive plant extracts significantly enhanced DPSC proliferation, showing a 2.5-fold increase compared to the control groups. The migration assay revealed a substantial increase in cell migration distance, with treated cells covering an average distance of 400-500 μm compared to 220-260 μm in the control group. Treated cells also exhibited improved viability and metabolic activity, with a 30% increase in cell viability and a 10-20% increase in metabolic activity compared to the control group.
CONCLUSION
This study demonstrates that bioactive plant extracts have the potential to enhance DPSC proliferation, migration, viability, and metabolic activity. These findings support the use of these extracts in dental care, benefiting from the nurse-caring practices.
PubMed: 38911239
DOI: 10.22038/IJBMS.2024.76467.16548 -
Journal of Tissue Engineering 2024Temporomandibular joint (TMJ) cartilage repair poses a considerable clinical challenge, and tissue engineering has emerged as a promising solution. In this study, we...
Delivery of dental pulp stem cells by an injectable ROS-responsive hydrogel promotes temporomandibular joint cartilage repair via enhancing anti-apoptosis and regulating microenvironment.
Temporomandibular joint (TMJ) cartilage repair poses a considerable clinical challenge, and tissue engineering has emerged as a promising solution. In this study, we developed an injectable reactive oxygen species (ROS)-responsive multifunctional hydrogel (RDGel) to encapsulate dental pulp stem cells (DPSCs/RDGel in short) for the targeted repair of condylar cartilage defect. The DPSCs/RDGel composite exhibited a synergistic effect in the elimination of TMJ OA (osteoarthritis) inflammation via the interaction between the hydrogel component and the DPSCs. We first demonstrated the applicability and biocompatibility of RDGel. RDGel encapsulation could enhance the anti-apoptotic ability of DPSCs by inhibiting P38/P53 mitochondrial apoptotic signal in vitro. We also proved that the utilization of DPSCs/RDGel composite effectively enhanced the expression of TMJOA cartilage matrix and promoted subchondral bone structure in vivo. Subsequently, we observed the synergistic improvement of DPSCs/RDGel composite on the oxidative stress microenvironment of TMJOA and its regulation and promotion of M2 polarization, thereby confirmed that M2 macrophages further promoted the condylar cartilage repair of DPSCs. This is the first time application of DPSCs/RDGel composite for the targeted repair of TMJOA condylar cartilage defects, presenting a novel and promising avenue for cell-based therapy.
PubMed: 38911101
DOI: 10.1177/20417314241260436 -
Cureus May 2024Management of open apex cases in endodontics poses a significant challenge, especially in immature teeth with necrotic pulps. Traditional apexification techniques have...
Advanced Management of Open Apex Utilizing Platelet-Rich Fibrin and Bone Graft As Apical Barriers With Mineral Trioxide Aggregate (MTA) Obturation: A Detailed Case Report.
Management of open apex cases in endodontics poses a significant challenge, especially in immature teeth with necrotic pulps. Traditional apexification techniques have been the mainstay of treatment, aiming to induce the formation of a calcific barrier at the root apex. However, newer approaches incorporating biological materials such as platelet-rich fibrin (PRF) and demineralized bone matrix (DMBM) have emerged as promising alternatives. This article presents a case report of an 18-year-old male patient who presented with fractured upper central incisors, with the upper right central incisor displaying an open apex due to trauma sustained eight years prior. The treatment plan involved apexification using a combination of DMBM and PRF, with mineral trioxide aggregate (MTA) utilized as an apical barrier. The procedure was performed under rubber dam isolation, meticulously removing necrotic pulp tissue, irrigating with sodium hypochlorite solution, and placing a calcium hydroxide medicament. Subsequent visits included the placement of DMBM and PRF mixture into the canal space to create an apical barrier, followed by MTA placement and final restoration. Follow-up examinations at 3 and 12 months revealed the tooth to be asymptomatic and functionally normal, with radiographic evidence of osseous repair and complete apical closure. This case underscores the efficacy of a multimodal approach utilizing DMBM, PRF, and MTA in successfully managing open apex cases. Further research and long-term follow-up studies are warranted to validate this treatment modality's predictability and long-term success.
PubMed: 38910660
DOI: 10.7759/cureus.60883 -
Dental Materials : Official Publication... Jun 2024Silicon-releasing biomaterials are widely used in the field of dentistry. However, unlike bone, very little is known about the role of silicon on dental tissue formation...
OBJECTIVES
Silicon-releasing biomaterials are widely used in the field of dentistry. However, unlike bone, very little is known about the role of silicon on dental tissue formation and repair. This study investigates the influence of silicic acid on the survival, differentiation and mineralizing ability of human dental pulp stem cells (hDPSCs) in 3D pulp-like environments METHODS: Dense type I collagen hydrogels seeded with hDPSCs were cultured over 4 weeks in the presence of silicic acid at physiological (10 μM) and supraphysiological (100 μM) concentrations. Cell viability and proliferation were studied by Alamar Blue and live/dead staining. The collagen network was investigated using second harmonic generation imaging. Mineral deposition was monitored by histology and scanning electron microscopy. Gene expression of mineralization- and matrix remodeling-associated proteins was studied by qPCR.
RESULTS
Presence of silicic acid did not show any significant influence on cell survival, metabolic activity and gene expression of key mineralization-related proteins (ALP, OCN, BSP). However, it induced enhanced cell clustering and delayed expression of matrix remodeling-associated proteins (MMP13, Col I). OPN expression and mineral deposition were inhibited at 100 μM. It could be inferred that silicic acid has no direct cellular effect but rather interacts with the collagen network, leading to a modification of the cell-matrix interface.
SIGNIFICANCE
Our results offer advanced insights on the possible role of silicic acid, as released by pulp capping calcium silicates biomaterials, in reparative dentine formation. More globally, these results interrogate the possible role of Si in pulp pathophysiology.
PubMed: 38908960
DOI: 10.1016/j.dental.2024.06.021 -
BMC Oral Health Jun 2024A pulp stone is a calcified mass that develops in the dental pulp of any tooth. Despite many studies examining the relationship between pulp stone formation and non-oral...
BACKGROUND
A pulp stone is a calcified mass that develops in the dental pulp of any tooth. Despite many studies examining the relationship between pulp stone formation and non-oral factors, the methods used in these studies have been unable to explain the exact role of these factors alone as distinct from probable effects within the oral cavity environment. Considering that totally unerupted (impacted or developing) teeth are unexposed to the oral cavity's environmental and functional conditions, they provide a more suitable material for studying the effects of these non-oral factors on pulp stone formation. This research study aimed to investigate pulp stones in unerupted teeth and the associated factors in a Saudi subpopulation.
METHODS
The study included 644 cone-beam computed tomography images, with 496 (50.9%) maxillary and 479 (49.1%) mandibular teeth. Of the investigated patients, 293 (45.5%) were men, and 351 (54.5%) were women. The age range was 15-76 years. A chi-square test was used to investigate the associations between pulp stones and age, gender, and history of systemic disease and chronic medication use.
RESULTS
Pulp stones in unerupted teeth were present in 24.2% of the examined dental jaws and 18.6% of the examined teeth. There was no statistically significant relationship between pulp stones and gender (p > 0.05). A significantly greater percentage of pulp stones were found with increasing age (p = 0.000). Additionally, a significantly increased number of pulp stones was observed in patients with systemic diseases and chronic medications (p < 0.05).
CONCLUSIONS
The results support the idea that pulp stones can be present in any type of unerupted tooth. This study provides additional evidence of the increased incidence of pulp stones with age, systemic disease, and chronic medications.
Topics: Humans; Cone-Beam Computed Tomography; Female; Adult; Male; Retrospective Studies; Adolescent; Middle Aged; Dental Pulp Calcification; Young Adult; Aged; Tooth, Unerupted; Saudi Arabia; Age Factors
PubMed: 38907221
DOI: 10.1186/s12903-024-04503-3 -
JMIRx Med Jun 2024Information about the range of Hounsfield values for healthy teeth tissues could become an additional tool in assessing dental health and could be used, among other...
BACKGROUND
Information about the range of Hounsfield values for healthy teeth tissues could become an additional tool in assessing dental health and could be used, among other data, for subsequent machine learning.
OBJECTIVE
The purpose of our study was to determine dental tissue densities in Hounsfield units (HU).
METHODS
The total sample included 36 healthy children (n=21, 58% girls and n=15, 42% boys) aged 10-11 years at the time of the study. The densities of 320 teeth tissues were analyzed. Data were expressed as means and SDs. The significance was determined using the Student (1-tailed) t test. The statistical significance was set at P<.05.
RESULTS
The densities of 320 teeth tissues were analyzed: 72 (22.5%) first permanent molars, 72 (22.5%) permanent central incisors, 27 (8.4%) second primary molars, 40 (12.5%) tooth germs of second premolars, 37 (11.6%) second premolars, 9 (2.8%) second permanent molars, and 63 (19.7%) tooth germs of second permanent molars. The analysis of the data showed that tissues of healthy teeth in children have different density ranges: enamel, from mean 2954.69 (SD 223.77) HU to mean 2071.00 (SD 222.86) HU; dentin, from mean 1899.23 (SD 145.94) HU to mean 1323.10 (SD 201.67) HU; and pulp, from mean 420.29 (SD 196.47) HU to mean 183.63 (SD 97.59) HU. The tissues (enamel and dentin) of permanent central incisors in the mandible and maxilla had the highest mean densities. No gender differences concerning the density of dental tissues were reliably identified.
CONCLUSIONS
The evaluation of Hounsfield values for dental tissues can be used as an objective method for assessing their densities. If the determined densities of the enamel, dentin, and pulp of the tooth do not correspond to the range of values for healthy tooth tissues, then it may indicate a pathology.
PubMed: 38904484
DOI: 10.2196/56759