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Cells Jun 2019Periodontitis is a prevalent infectious disease worldwide, causing the damage of periodontal support tissues, which can eventually lead to tooth loss. The goal of... (Review)
Review
Periodontitis is a prevalent infectious disease worldwide, causing the damage of periodontal support tissues, which can eventually lead to tooth loss. The goal of periodontal treatment is to control the infections and reconstruct the structure and function of periodontal tissues including cementum, periodontal ligament (PDL) fibers, and bone. The regeneration of these three types of tissues, including the re-formation of the oriented PDL fibers to be attached firmly to the new cementum and alveolar bone, remains a major challenge. This article represents the first systematic review on the cutting-edge researches on the regeneration of all three types of periodontal tissues and the simultaneous regeneration of the entire bone-PDL-cementum complex, via stem cells, bio-printing, gene therapy, and layered bio-mimetic technologies. This article primarily includes bone regeneration; PDL regeneration; cementum regeneration; endogenous cell-homing and host-mobilized stem cells; 3D bio-printing and generation of the oriented PDL fibers; gene therapy-based approaches for periodontal regeneration; regenerating the bone-PDL-cementum complex via layered materials and cells. These novel developments in stem cell technology and bioactive and bio-mimetic scaffolds are highly promising to substantially enhance the periodontal regeneration including both hard and soft tissues, with applicability to other therapies in the oral and maxillofacial region.
Topics: Dental Cementum; Genetic Therapy; Humans; Periodontal Ligament; Periodontitis; Regeneration; Stem Cell Transplantation; Stem Cells; Tissue Engineering; Tissue Scaffolds
PubMed: 31167434
DOI: 10.3390/cells8060537 -
Dental Traumatology : Official... Aug 2022Tooth resorption is either a physiological or a pathological process resulting in loss of dentin and/or cementum. It may also be associated with bone loss. Currently... (Review)
Review
Tooth resorption is either a physiological or a pathological process resulting in loss of dentin and/or cementum. It may also be associated with bone loss. Currently there is no universal classification for the different types of tooth resorption. This lack of a universal classification leads to both confusion amongst practitioners and poor understanding of the resorptive processes occurring in teeth which can result in incorrect/inappropriate diagnoses and mis-management. When developing a classification of diseases and/or conditions that occur within the body, several criteria should be followed to ensure a useful classification. The classification should not only include pathological conditions but also physiological conditions. Since tooth resorption can be either pathological or physiological, a classification of tooth resorption should include both of these categories. Any classification of diseases should be possible to use clinically, meaningful, useful, clear and universal. It should enable easy storage, retrieval and analysis of health information for evidenced-based decision-making. It should also be possible to share and compare data and information between different institutions, settings and countries. A classification of tooth resorption should be developed by combining anatomical, physiological and pathological approaches. For some types of resorption, the aetiological approach should also be incorporated. A classification of tooth resorption that uses simple, relevant and appropriate terminology based on the nature and location of the resorptive process occurring in teeth is proposed. There are two broad categories of internal and external tooth resorption which are sub-divided into three types of internal tooth resorption (surface, inflammatory, replacement) and eight types of external tooth resorption (surface, inflammatory, replacement, invasive, pressure, orthodontic, physiological, idiopathic). The clinician's understanding, diagnosis and management of tooth resorption can be facilitated by using this simple classification which should ideally be used universally by the entire dental profession to ensure clarity and to avoid confusion.
Topics: Dental Cementum; Humans; Molar; Root Resorption; Tooth Resorption
PubMed: 35605161
DOI: 10.1111/edt.12762 -
Journal of Dental Research Feb 2017External apical root resorption during orthodontic treatment implicates specific molecular pathways that orchestrate nonphysiologic cellular activation. To date, a... (Review)
Review
External apical root resorption during orthodontic treatment implicates specific molecular pathways that orchestrate nonphysiologic cellular activation. To date, a substantial number of in vitro and in vivo molecular, genomic, and proteomic studies have supplied data that provide new insights into root resorption. Recent mechanisms and developments reviewed here include the role of the cellular component-specifically, the balance of CD68, iNOS M1- and CD68, CD163 M2-like macrophages associated with root resorption and root surface repair processes linked to the expression of the M1-associated proinflammatory cytokine tumor necrosis factor, inducible nitric oxide synthase, the M1 activator interferon γ, the M2 activator interleukin 4, and M2-associated anti-inflammatory interleukin 10 and arginase I. Insights into the role of mesenchymal dental pulp cells in attenuating dentin resorption in homeostasis are also reviewed. Data on recently deciphered molecular pathways are reviewed at the level of (1) clastic cell adhesion in the external apical root resorption process and the specific role of α/β integrins, osteopontin, and related extracellular matrix proteins; (2) clastic cell fusion and activation by the RANKL/RANK/OPG and ATP-P2RX7-IL1 pathways; and (3) regulatory mechanisms of root resorption repair by cementum at the proteomic and transcriptomic levels.
Topics: Animals; Cytokines; Dental Cementum; Humans; Orthodontics, Corrective; Root Resorption; Signal Transduction
PubMed: 27811065
DOI: 10.1177/0022034516677539 -
Australian Dental Journal Jun 2014The aim of this review is to discuss the clinical utility of stem cells in periodontal regeneration by reviewing relevant literature that assesses the... (Review)
Review
The aim of this review is to discuss the clinical utility of stem cells in periodontal regeneration by reviewing relevant literature that assesses the periodontal-regenerative potential of stem cells. We consider and describe the main stem cell populations that have been utilized with regard to periodontal regeneration, including bone marrow-derived mesenchymal stem cells and the main dental-derived mesenchymal stem cell populations: periodontal ligament stem cells, dental pulp stem cells, stem cells from human exfoliated deciduous teeth, stem cells from apical papilla and dental follicle precursor cells. Research into the use of stem cells for tissue regeneration has the potential to significantly influence periodontal treatment strategies in the future.
Topics: Bone Transplantation; Dental Cementum; Dental Pulp; Dental Sac; Gingiva; Guided Tissue Regeneration, Periodontal; Humans; Intercellular Signaling Peptides and Proteins; Mesenchymal Stem Cells; Periodontal Ligament; Periodontium; Regeneration; Stem Cells; Tissue Engineering; Tissue Scaffolds; Tooth, Deciduous; Wound Healing
PubMed: 24111843
DOI: 10.1111/adj.12100 -
Australian Dental Journal Mar 2016External inflammatory resorption is one of the potential consequences of trauma to the teeth. It occurs when there has been loss of cementum due to damage to the... (Review)
Review
External inflammatory resorption is one of the potential consequences of trauma to the teeth. It occurs when there has been loss of cementum due to damage to the external surface of the tooth root during trauma, plus the root canal system has become infected with bacteria. It is characterized by the radiographic appearance of loss of tooth substance with a radiolucency in the adjacent periodontal ligament and bone. The loss of cementum allows the intracanal bacteria and/or their endotoxins to reach the periodontal ligament more readily and this can lead to the development of the inflammatory resorptive process. External inflammatory resorption can ultimately lead to loss of the tooth if it is not managed in a timely manner. There are some injuries that are very likely to develop this type of resorption and a preventive approach can be adopted by commencing root canal treatment immediately as part of the emergency management of such cases. In cases where the resorptive process is already established, root canal treatment can arrest the resorption and encourage hard tissue repair. The use of a corticosteroid-antibiotic intracanal medicament has been shown to be particularly useful in the prevention and management of external inflammatory resorption. Calcium hydroxide should not be used as an immediate medicament because of its inherent toxicity and irritant properties but it is valuable as a subsequent medicament to encourage hard tissue repair where required. This review outlines the external inflammatory resorptive process and the management strategies that can be employed to prevent it from occurring, and to treat it if already present.
Topics: Calcium Hydroxide; Dental Cementum; Dental Pulp Cavity; Humans; Periodontal Ligament; Root Canal Irrigants; Root Canal Therapy; Root Resorption; Tooth Injuries; Tooth Root
PubMed: 26923450
DOI: 10.1111/adj.12400 -
Journal of Periodontal Research Aug 2017Though cementum of the tooth root is critical for periodontal structure and tooth attachment and function, this tissue was not discovered and characterized on human... (Review)
Review
Though cementum of the tooth root is critical for periodontal structure and tooth attachment and function, this tissue was not discovered and characterized on human teeth until a full century later than enamel and dentin. Early observations from the seventeenth to the nineteenth centuries by Marcello Malpighi, Antonie van Leeuwenhoek, Robert Blake, Jacques Tenon and Georges Cuvier founded a confusing and conflicting nomenclature that obscured the nature of cementum, often conflating it with bone. Advances in microscopy and histological procedures yielded the first detailed descriptions of human cementum in the 1830s by Jan Purkinje and Anders Retzius, who identified for the first time acellular and cellular types of cementum, and the resident cementocytes embedded in the latter. Comparative anatomy studies by Richard Owen and others over the latter half of the nineteenth century identified coronal and radicular cementum varieties across the Reptilia and Mammalia. The functional importance of cementum was not appreciated until detailed anatomical studies of the periodontium were performed by G.V. Black and others in the late nineteenth and early twentieth centuries. These early studies on cementum laid the foundation for more advanced understanding of cementum ultrastructure, composition, development, physiology, disease, genetics, repair and regeneration throughout the twentieth and into the twenty-first century.
Topics: Animals; Dental Cementum; History of Dentistry; History, 17th Century; History, 18th Century; History, 19th Century; History, 20th Century; Humans
PubMed: 28261800
DOI: 10.1111/jre.12444 -
Dental Clinics of North America Jan 2022Successful periodontal regeneration requires the hierarchical reorganization of multiple tissues including periodontal ligament, cementum, alveolar bone, and gingiva.... (Review)
Review
Successful periodontal regeneration requires the hierarchical reorganization of multiple tissues including periodontal ligament, cementum, alveolar bone, and gingiva. The limitation of conventional regenerative therapies has been attracting research interest in tissue engineering-based periodontal therapies where progenitor cells, scaffolds, and bioactive molecules are delivered. Scaffolds offer not only structural support but also provide geometrical clue to guide cell fate. Additionally, functionalization improves bioactive properties to the scaffold. Various scaffold designs have been proposed for periodontal regeneration. These include the fabrication of biomimetic periodontal extracellular matrix, multiphasic scaffolds with tissue-specific layers, and personalized 3D printed scaffolds. This review summarizes the basic concept as well as the recent advancement of scaffold designing and fabrication for periodontal regeneration and provides an insight of future clinical translation.
Topics: Dental Cementum; Humans; Periodontal Ligament; Tissue Engineering; Tissue Scaffolds
PubMed: 34794550
DOI: 10.1016/j.cden.2021.06.004 -
The Chinese Journal of Dental Research Jun 2022The ultimate goal of periodontal treatments is the regeneration of all lost periodontal tissues including bone, cementum and the periodontal ligament (PDL). Until now,... (Review)
Review
The ultimate goal of periodontal treatments is the regeneration of all lost periodontal tissues including bone, cementum and the periodontal ligament (PDL). Until now, the clinical methods for periodontal regeneration have been associated with significant failure or incomplete success. Various studies have reported the promising effects of growth factors/cytokines on periodontal regeneration. Growth factors/cytokines include proteins or steroid hormones that bind to cellular receptors, known as signalling molecules, and that trigger cellular responses that eventually stimulate cell proliferation and differentiation. The present review aims to provide an overview of the main growth factors that play an important role in and have been used in the regeneration of periodontal components.
Topics: Cementogenesis; Cytokines; Dental Cementum; Periodontal Ligament; Periodontium
PubMed: 35686588
DOI: 10.3290/j.cjdr.b3086335 -
Swiss Dental Journal Apr 2021
Topics: Dental Cementum; Tooth Root
PubMed: 33789419
DOI: No ID Found -
Journal of Dental Research Jul 2016Cementum is a mineralized tissue covering the tooth root that functions in tooth attachment and posteruptive adjustment of tooth position. During formation of the... (Review)
Review
Cementum is a mineralized tissue covering the tooth root that functions in tooth attachment and posteruptive adjustment of tooth position. During formation of the apically located cellular cementum, some cementoblasts become embedded in the cementoid matrix and become cementocytes. As apparently terminally differentiated cells embedded in a mineralized extracellular matrix, cementocytes are part of a select group of specialized cells, also including osteocytes, hypertrophic chondrocytes, and odontoblasts. The differentiation and potential function(s) of cementocytes are virtually unknown, and the question may be posed whether the cementocyte is a dynamic actor in cementum in comparable fashion with the osteocyte in the skeleton, responding to changing tooth functions and endocrine signals and actively directing local cementum metabolism. This review summarizes the literature with regard to cementocytes, comparing them to their closest "cousins," the osteocytes, where insights gained from osteocyte studies serve to inform the critical examination of cementocytes. The review identifies important unanswered questions about these cells regarding their origins, differentiation, morphology and lacuno-canalicular system, selective markers, and potential functions.
Topics: Animals; Dental Cementum; Humans; Microscopy, Electron, Scanning; Osteocytes; Tooth Root
PubMed: 27029548
DOI: 10.1177/0022034516641898