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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 Clinics of North America Oct 2022As a widespread chronical disease, periodontitis progressively destroys tooth-supporting structures (periodontium) and eventually leads to tooth loss. Therefore,... (Review)
Review
As a widespread chronical disease, periodontitis progressively destroys tooth-supporting structures (periodontium) and eventually leads to tooth loss. Therefore, regeneration of damaged/lost periodontal tissues has been a major subject in periodontal research. During periodontal tissue regeneration, biomaterials play pivotal roles in improving the outcome of the periodontal therapy. With the advancement of biomaterial science and engineering in recent years, new biomimetic materials and scaffolding fabrication technologies have been proposed for periodontal tissue regeneration. This article summarizes recent progress in periodontal tissue regeneration from a biomaterial perspective. First, various guide tissue regeneration/guide bone regeneration membranes and grafting biomaterials for periodontal tissue regeneration are overviewed. Next, the recent development of multifunctional scaffolding biomaterials for alveolar bone/periodontal ligament/cementum regeneration is summarized. Finally, clinical care points and perspectives on the use of biomimetic scaffolding materials to reconstruct the hierarchical periodontal tissues are provided.
Topics: Biocompatible Materials; Guided Tissue Regeneration, Periodontal; Humans; Periodontal Ligament; Periodontium; Tissue Engineering
PubMed: 36216452
DOI: 10.1016/j.cden.2022.05.011 -
The Kaohsiung Journal of Medical... Apr 2018Orthodontic tooth movement relies on coordinated tissue resorption and formation in the surrounding bone and periodontal ligament. Tooth loading causes local hypoxia and... (Review)
Review
Orthodontic tooth movement relies on coordinated tissue resorption and formation in the surrounding bone and periodontal ligament. Tooth loading causes local hypoxia and fluid flow, initiating an aseptic inflammatory cascade culminating in osteoclast resorption in areas of compression and osteoblast deposition in areas of tension. Compression and tension are associated with particular signaling factors, establishing local gradients to regulate remodeling of the bone and periodontal ligament for tooth displacement. Key regulators of inflammation and tissue turnover include secreted factors like RANK ligand and osteoprotegerin, transcription factors such as RUNX2 and hypoxia-inducible factor, cytokines, prostaglandins, tissue necrosis factors, and proteases, among others. Inflammation occurred during tooth movement needs to be well controlled, as dysregulated inflammation leads to tissue destruction manifested in orthodontic-induced root resorption and periodontal disease. Understanding the biology has profound clinical implications especially in the area of accelerating orthodontic tooth movement. Surgical, pharmacological, and physical interventions are being tested to move teeth faster to reduce treatment times and time-dependent adverse outcomes. Future developments in acceleratory technology and custom appliances will allow orthodontic tooth movement to occur more efficiently and safely.
Topics: Biomechanical Phenomena; Bone Resorption; Core Binding Factor Alpha 1 Subunit; Cytokines; Gene Expression Regulation; Humans; Hypoxia-Inducible Factor 1, alpha Subunit; Mechanotransduction, Cellular; Osteoblasts; Osteoclasts; Osteogenesis; Osteoprotegerin; Periodontal Ligament; RANK Ligand; Tooth; Tooth Movement Techniques
PubMed: 29655409
DOI: 10.1016/j.kjms.2018.01.007 -
International Journal of Oral Science Jun 2021Nowadays, orthodontic treatment has become increasingly popular. However, the biological mechanisms of orthodontic tooth movement (OTM) have not been fully elucidated.... (Review)
Review
Nowadays, orthodontic treatment has become increasingly popular. However, the biological mechanisms of orthodontic tooth movement (OTM) have not been fully elucidated. We were aiming to summarize the evidences regarding the mechanisms of OTM. Firstly, we introduced the research models as a basis for further discussion of mechanisms. Secondly, we proposed a new hypothesis regarding the primary roles of periodontal ligament cells (PDLCs) and osteocytes involved in OTM mechanisms and summarized the biomechanical and biological responses of the periodontium in OTM through four steps, basically in OTM temporal sequences, as follows: (1) Extracellular mechanobiology of periodontium: biological, mechanical, and material changes of acellular components in periodontium under orthodontic forces were introduced. (2) Cell strain: the sensing, transduction, and regulation of mechanical stimuli in PDLCs and osteocytes. (3) Cell activation and differentiation: the activation and differentiation mechanisms of osteoblast and osteoclast, the force-induced sterile inflammation, and the communication networks consisting of sensors and effectors. (4) Tissue remodeling: the remodeling of bone and periodontal ligament (PDL) in the compression side and tension side responding to mechanical stimuli and root resorption. Lastly, we talked about the clinical implications of the updated OTM mechanisms, regarding optimal orthodontic force (OOF), acceleration of OTM, and prevention of root resorption.
Topics: Humans; Osteoblasts; Osteoclasts; Periodontal Ligament; Periodontium; Root Resorption; Tooth Movement Techniques
PubMed: 34183652
DOI: 10.1038/s41368-021-00125-5 -
Indian Journal of Dental Research :... 2010The interrelationship between periodontal and endodontic disease has aroused confusion, queries and controversy. Differentiating between periodontal and endodontic... (Review)
Review
The interrelationship between periodontal and endodontic disease has aroused confusion, queries and controversy. Differentiating between periodontal and endodontic problems can be difficult. A symptomatic tooth may have pain of periodontal and/or pulpal origin. The nature of that pain is often the first clue in determining the etiology of such a problem. Radiographic and clinical evaluation can help clarify the nature of the problem. In some cases, the influence of pulpal pathology may create periodontal involvement. In others, periodontal pathology may create pulpal pathology. This review article discusses the various clinical aspects to be considered for accurately diagnosing and treating endo-perio lesions.
Topics: Clinical Protocols; Dental Fistula; Dental Pulp Diseases; Diagnosis, Differential; Humans; Periodontal Diseases; Periodontal Ligament; Tooth Apex; Toothache
PubMed: 21187629
DOI: 10.4103/0970-9290.74238 -
Stem Cells Translational Medicine Apr 2019Periodontitis is a widespread disease characterized by inflammation-induced progressive damage to the tooth-supporting structures until tooth loss occurs. The... (Review)
Review
Periodontitis is a widespread disease characterized by inflammation-induced progressive damage to the tooth-supporting structures until tooth loss occurs. The regeneration of lost/damaged support tissue in the periodontium, including the alveolar bone, periodontal ligament, and cementum, is an ambitious purpose of periodontal regenerative therapy and might effectively reduce periodontitis-caused tooth loss. The use of stem cells for periodontal regeneration is a hot field in translational research and an emerging potential treatment for periodontitis. This concise review summarizes the regenerative approaches using either culture-expanded or host-mobilized stem cells that are currently being investigated in the laboratory and with preclinical models for periodontal tissue regeneration and highlights the most recent evidence supporting their translational potential toward a widespread use in the clinic for combating highly prevalent periodontal disease. We conclude that in addition to in vitro cell-biomaterial design and transplantation, the engineering of biomaterial devices to encourage the innate regenerative capabilities of the periodontium warrants further investigation. In comparison to cell-based therapies, the use of biomaterials is comparatively simple and sufficiently reliable to support high levels of endogenous tissue regeneration. Thus, endogenous regenerative technology is a more economical and effective as well as safer method for the treatment of clinical patients. Stem Cells Translational Medicine 2019;8:392-403.
Topics: Animals; Biocompatible Materials; Humans; Periodontal Ligament; Periodontitis; Periodontium; Regeneration; Stem Cells; Tissue Engineering; Wound Healing
PubMed: 30585445
DOI: 10.1002/sctm.18-0181 -
Clinical Oral Investigations Jan 2022The aim of this in vitro and in vivo study was to investigate the interaction of periodontitis and orthodontic tooth movement on interleukin (IL)-6 and C-X-C motif...
OBJECTIVES
The aim of this in vitro and in vivo study was to investigate the interaction of periodontitis and orthodontic tooth movement on interleukin (IL)-6 and C-X-C motif chemokine 2 (CXCL2).
MATERIALS AND METHODS
The effect of periodontitis and/or orthodontic tooth movement (OTM) on alveolar bone and gingival IL-6 and CXCL2 expressions was studied in rats by histology and RT-PCR, respectively. The animals were assigned to four groups (control, periodontitis, OTM, and combination of periodontitis and OTM). The IL-6 and CXCL2 levels were also studied in human gingival biopsies from periodontally healthy and periodontitis subjects by RT-PCR and immunohistochemistry. Additionally, the synthesis of IL-6 and CXCL2 in response to the periodontopathogen Fusobacterium nucleatum and/or mechanical strain was studied in periodontal fibroblasts by RT-PCR and ELISA.
RESULTS
Periodontitis caused an increase in gingival levels of IL-6 and CXCL2 in the animal model. Moreover, orthodontic tooth movement further enhanced the bacteria-induced periodontal destruction and gingival IL-6 gene expression. Elevated IL-6 and CXCL2 gingival levels were also found in human periodontitis. Furthermore, mechanical strain increased the stimulatory effect of F. nucleatum on IL-6 protein in vitro.
CONCLUSIONS
Our study suggests that orthodontic tooth movement can enhance bacteria-induced periodontal inflammation and thus destruction and that IL-6 may play a pivotal role in this process.
CLINICAL RELEVANCE
Orthodontic tooth movement should only be performed after periodontal therapy. In case of periodontitis relapse, orthodontic therapy should be suspended until the periodontal inflammation has been successfully treated and thus the periodontal disease is controlled again.
Topics: Animals; Fusobacterium nucleatum; Gingiva; Periodontal Ligament; Periodontitis; Rats; Tooth Movement Techniques
PubMed: 34024010
DOI: 10.1007/s00784-021-03988-4 -
Scientific Reports Jun 2020To evaluate tooth behaviours under various maxillary incisor retraction protocols for clear aligner therapy. A three-dimensional finite element model of maxillary...
To evaluate tooth behaviours under various maxillary incisor retraction protocols for clear aligner therapy. A three-dimensional finite element model of maxillary dentition was constructed for first premolar extraction. A loading method was developed to mimic the mode of action of clear aligners for incisor en masse retraction. Three protocols with different amounts of retraction and intrusion on incisors were designed. Initial tooth displacements and stresses on periodontal ligaments were analysed with ANSYS software. The central (U) and lateral (U) incisors exhibited uncontrolled lingual tipping and extrusion upon 0.25 mm retraction. U1 exhibited translation movement, while U underwent less tipping during 0.2 mm retraction and 0.15 mm intrusion. Labial tipping and intrusion of U and bodily intrusion of U were observed during 0.1 mm of retraction and 0.23 mm of intrusion. With the additional intrusion on incisors, canine showed extrusion movement, and higher stresses on periodontal ligaments were shifted from U to canines. Incisors also exhibited different mesial-distal angulation in the three simulations, while posterior teeth all suffered mesial inclination. Incorporating intrusion displacement in clear aligners led to a tendency of lingual root movement during incisor retraction. The complexity of tooth movement should be recognized regarding clear aligner therapy.
Topics: Bicuspid; Biomechanical Phenomena; Dentition; Finite Element Analysis; Humans; Incisor; Maxilla; Orthodontic Appliances, Removable; Periodontal Ligament; Printing, Three-Dimensional; Software; Stress, Mechanical; Tooth Mobility; Tooth Movement Techniques
PubMed: 32576935
DOI: 10.1038/s41598-020-67273-2 -
Biomaterials Jun 2019The regeneration of lost periodontal apparatus in periodontitis treatment remains a clinical challenge due to the limited regenerative capacity of cementum, periodontal...
The regeneration of lost periodontal apparatus in periodontitis treatment remains a clinical challenge due to the limited regenerative capacity of cementum, periodontal ligament and alveolar bone in periodontitis condition. For periodontal tissue regeneration, it is essential to regulate the inflammatory response and the subsequent differentiation of periodontal cells under the condition due to the infectious nature of the disease. In this study, it was noted that 45 nm gold nanoparticles (AuNPs) could exhibit significant anti-inflammatory effect and improve the periodontal inflammatory microenvironment via regulating inflammatory and regenerative cytokine production and modulating macrophage polarization, subsequently affect the differentiation of human periodontal ligament cells (hPDLCs). With the addition of direct effects of AuNPs on hPDLCs, the periodontal tissue differentiation capacity of hPDLCs in LPS-activated inflammatory macrophage-hPDLCs coculture system was significantly enhanced by the interaction between AuNPs-conditioned macrophage and AuNPs-stimulated hPDLCs. The potential therapeutic application of AuNPs in periodontal tissue regeneration and periodontitis treatment was investigated using both rat fenestration and ligature-induced periodontitis models. It was found that the treatment of 45 AuNPs showed significantly increased newly-formed periodontal attachment, bone and cementum in periodontal defect and less tissue destruction in the progression of periodontitis. This study demonstrated that 45 nm AuNPs could not only directly modulate hPDLCs, but also regulate the early inflammatory response of periodontal tissues via the regulation of macrophage phenotypes, therefore, generate a microenvironment with constraint inflammatory cytokine levels and reparative cytokines such as bone morphogenetic protein-2 (BMP-2), leading to PDLC differentiation, periodontal tissue regeneration and the prevention of periodontitis progression.
Topics: Animals; Bone Morphogenetic Protein 2; Cell Differentiation; Cell Polarity; Cell Survival; Gold; Humans; Inflammation; Lipopolysaccharides; Macrophages; Metal Nanoparticles; Mice; Periodontal Ligament; Periodontitis; RAW 264.7 Cells; Regeneration
PubMed: 30933774
DOI: 10.1016/j.biomaterials.2019.03.039 -
BMC Oral Health Dec 2022The effects of upper-molar distalization using clear aligners in combination with Class II elastics for anchorage reinforcement have not been fully investigated yet. The...
INTRODUCTION
The effects of upper-molar distalization using clear aligners in combination with Class II elastics for anchorage reinforcement have not been fully investigated yet. The objective of this study is to analyze the movement and stress of the whole dentition and further explore guidelines for the selection of traction methods.
METHODS
Three-dimensional (3D) finite element models are established to simulate the sequential molar distalization process, including the initial distalization of the 2 molar (Set I) and the initial distalization of the 1 molar (Set II). Each group set features three models: a control model without Class II elastics (model A), Class II elastics attached to the tooth by buttons (model B), and Class II elastics attached to the aligner by precision cutting (model C). The 3D displacements, proclination angles, periodontal ligament (PDL) hydrostatic stress and alveolar bone von Mises stress in the anterior area are recorded.
RESULTS
In all of the models, the maxillary anterior teeth are labial and mesial proclined, whereas the distal moving molars exhibit distal buccal inclination with an extrusion tendency. With the combination of Class II elastics, the anchorage was effectively reinforced; model C demonstrates superior anchorage reinforcement with lower stress distribution in comparison with model B. The upper canines in model B present an extrusion tendency. Meanwhile, the mandibular dentition in models B and C experience undesired movement tendencies with little discrepancy from each other.
CONCLUSIONS
Class II elastics are generally effective for anchorage reinforcement as the upper-molar distalization is performed with clear aligners. Class II elastics attached to an aligner by precision cutting is a superior alternative for maxillary anchorage control in cases that the proclination of upper incisors and extrusion of upper canines are unwanted.
Topics: Finite Element Analysis; Molar; Incisor; Periodontal Ligament; Orthodontic Appliances, Removable
PubMed: 36456944
DOI: 10.1186/s12903-022-02526-2