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Journal of Oral Biosciences Mar 2023Bone, platelet concentrate, and tooth-derived dentin/cementum have been used as autologous materials in regenerative medicine Dentin materials were first recycled in... (Review)
Review
OBJECTIVES
Bone, platelet concentrate, and tooth-derived dentin/cementum have been used as autologous materials in regenerative medicine Dentin materials were first recycled in 2002 for bone regeneration in humans, although bone autografts were noted in the 19th century, and auto-platelet concentrates were developed in 1998. Dentin/cementum-based material therapy has been applied as an innovative technique for minimally invasive bone surgery, while bone autografts are associated with donor site morbidity.
METHODS
In October 2021, PubMed, Google Scholar, Scopus, and the Cochrane Library databases from 1980 to 2020 were screened.
RESULTS
The demineralized dentin/cementum matrix (DDM) had better performance in bone induction and bone regeneration than mineralized dentin.
CONCLUSIONS
Unlike cell culture therapy, DDM is a matrix-based therapy that includes growth factors. A matrix-based system is a realistic and acceptable treatment, even in developing countries. The aim of this review was to summarize the evidence related to both animal studies and human clinical cases using human dentin materials with a patch of cementum, especially DDM.
Topics: Animals; Humans; Dentin; Bone Regeneration; Animals, Laboratory; Dental Cementum
PubMed: 36336319
DOI: 10.1016/j.job.2022.10.003 -
Advances in Dental Research Jul 2011Pulp regeneration is considered in cases where the dental pulp has been destroyed because of microbial irritation. Diverse oral and food-borne micro-organisms are able... (Review)
Review
Pulp regeneration is considered in cases where the dental pulp has been destroyed because of microbial irritation. Diverse oral and food-borne micro-organisms are able to invade the pulp space, form biofilm on canal walls, and infiltrate dentinal tubules. Prior to pulp regeneration procedures, the pulp space and dentinal walls need to be sufficiently disinfected to allow for and promote regeneration. The necessary level of disinfection is likely higher than that accepted for traditional endodontic therapy, because in traditional techniques the mere lowering of bacterial loads and prevention of bacterial access to periapical tissues is conducive to healing. Moreover, several of the non-specific antimicrobials used in traditional endodontic therapy may cause significant changes in remaining dentin that interfere with its inherent potential to mediate regeneration. Non-specific antimicrobials also suppress all microbial taxa, which may allow residual virulent micro-organisms to preferentially repopulate the pulp space. Therefore, it is important for endodontic pathogens to be studied by molecular methods that allow for a broad depth of coverage. It is then essential to determine the most effective protocols to disinfect the pulp space, with minimal disruption of remaining dentin. These protocols include the topical use of effective antibiotics, including newer agents that have demonstrated efficacy against endodontic pathogens.
Topics: Anti-Bacterial Agents; Dental Disinfectants; Dental Pulp; Dental Pulp Cavity; Dental Pulp Diseases; Dentin; Humans; Regeneration; Root Canal Preparation
PubMed: 21677080
DOI: 10.1177/0022034511405388 -
Stem Cell Research & Therapy Jun 2021The dentin-pulp complex is essential for the long-term integrity and viability of teeth but it is susceptible to damage caused by external factors. Because traditional... (Review)
Review
The dentin-pulp complex is essential for the long-term integrity and viability of teeth but it is susceptible to damage caused by external factors. Because traditional approaches for preserving the dentin-pulp complex have various limitations, there is a need for novel methods for dentin-pulp complex reconstruction. The development of stem cell-based tissue engineering has given rise to the possibility of combining dental stem cells with a tissue-reparative microenvironment to promote dentin-pulp complex regeneration. Concentrated growth factor, a platelet concentrate, is a promising scaffold for the treatment of dentin-pulp complex disorders. Given its characteristics of autogenesis, convenience, usability, and biodegradability, concentrated growth factor has gained popularity in medical and dental fields for repairing bone defects and promoting soft-tissue healing. Numerous in vitro studies have demonstrated that concentrated growth factor can promote the proliferation and migration of dental stem cells. Here, we review the current state of knowledge on the effects of concentrated growth factor on stem cells and its potential applications in dentin-pulp complex regeneration.
Topics: Dental Pulp; Dentin; Humans; Intercellular Signaling Peptides and Proteins; Stem Cells; Tissue Engineering; Tooth
PubMed: 34147130
DOI: 10.1186/s13287-021-02446-y -
International Journal of Environmental... Sep 2021Human dentin consists of a primary layer produced during tooth formation in early childhood and a second layer which first forms upon tooth eruption and continues...
Human dentin consists of a primary layer produced during tooth formation in early childhood and a second layer which first forms upon tooth eruption and continues throughout life, termed secondary dentin (SD). The effect of attrition on SD formation was considered to be confined to the area subjacent to attrition facets. However, due to a lack of three-dimensional methodologies to demonstrate the structure of the SD, this association could not be determined. Therefore, in the current study, we aimed to explore the thickening pattern of the SD in relation to the amount of occlusal and interproximal attrition. A total of 30 premolars (50-60 years of age) with varying attrition rates were evaluated using micro-computerized tomography. The results revealed thickening of the SD below the cementoenamel junction (CEJ), mostly in the mesial and distal aspects of the root ( < 0.05). The pattern of thickening under the tooth cervix, rather than in proximity to attrition facets, was consistent regardless of the attrition level. The amount of SD thickening mildly correlated with occlusal attrition ( = 0.577, < 0.05) and not with interproximal attrition. The thickening of the SD below the CEJ coincided with previous finite element models, suggesting that this area is mostly subjected to stress due to occlusal loadings. Therefore, we suggest that the SD formation might serve as a compensatory mechanism aimed to strengthen tooth structure against deflection caused by mechanical loading. Our study suggests that occlusal forces may play a significant role in SD formation.
Topics: Bicuspid; Bite Force; Child, Preschool; Dentin, Secondary; Female; Finite Element Analysis; Humans; Tooth Cervix
PubMed: 34639261
DOI: 10.3390/ijerph18199961 -
Regenerative Medicine Sep 2009Dental pulp tissue is vulnerable to infection. Entire pulp amputation followed by pulp-space disinfection and filling with an artificial rubber-like material is employed... (Review)
Review
Dental pulp tissue is vulnerable to infection. Entire pulp amputation followed by pulp-space disinfection and filling with an artificial rubber-like material is employed to treat the infection - commonly known as root-canal therapy. Regeneration of pulp tissue has been difficult as the tissue is encased in dentin without collateral blood supply except from the root apical end. However, with the advent of the concept of modern tissue engineering and the discovery of dental stem cells, regeneration of pulp and dentin has been tested. This article will review the early attempts to regenerate pulp tissue and the current endeavor of pulp and dentin tissue engineering, and regeneration. The prospective outcome of the current advancement in this line of research will be discussed.
Topics: Animals; Cell Differentiation; Dental Pulp; Dentin; Humans; Mesenchymal Stem Cells; Mice; Regeneration; Regenerative Medicine; Tissue Engineering
PubMed: 19761395
DOI: 10.2217/rme.09.45 -
Developmental Dynamics : An Official... May 2006Periodontal regeneration and tissue engineering has re-awakened interest in the role of Hertwig's Epithelial Root Sheath (HERS), an epithelial tissue layer first... (Review)
Review
Periodontal regeneration and tissue engineering has re-awakened interest in the role of Hertwig's Epithelial Root Sheath (HERS), an epithelial tissue layer first discovered in amphibians more than a century ago. Using developmental, evolutionary, and cell biological approaches, we have, therefore, performed a careful analysis of the role of HERS in root formation and compared our data with clinical findings. Our developmental studies revealed HERS as a transient structure assembled in the early period of root formation and elongation and, subsequently, fenestrated and reduced to epithelial rests of Malassez (ERM). Our comparative evolutionary studies indicated that HERS fenestration was closely associated with the presence of a periodontal ligament and a gomphosis-type attachment apparatus in crocodilians and mammals. Based on these studies, we are proposing that HERS plays an important role in the regulation and maintenance of periodontal ligament space and function. Additional support for this hypothesis was rendered by our meta-analysis of recent clinical reports related to HERS function.
Topics: Animals; Biological Evolution; Epithelium; Humans; Tooth Root
PubMed: 16450392
DOI: 10.1002/dvdy.20674 -
The Journal of Forensic... Dec 2021The purpose of this study was to assess the correlation between the known chronological age and the dental cementum thickness (DCT) in male and female subjects in...
UNLABELLED
The purpose of this study was to assess the correlation between the known chronological age and the dental cementum thickness (DCT) in male and female subjects in different age groups.
MATERIAL AND METHODS
The study sample consisted of 57 donor teeth of both sexes. Teeth were classified by donors' sex and divided into three age groups: 10-19, 30-39 and 60-69 years. Tooth roots were cut with transverse ground sections in the apical, middle, and cervical thirds. DCT measurements were made on photomicrographs of light microscope. The correlation between DCT and the chronological age was calculated using the Spearman correlation coefficient.
RESULTS
A positive correlation was found (r=0.47, p <0.001) between DCT and age of the donor. DCT decreased from apical to cervical ground section (median [IQR] apical section 216.72 [128.25-375.00] μm, middle section 158.44 [87.66-284.90] μm; cervical section 96.60 [70.05-165.59] µm). DCT variability was influenced by sex, number of tooth roots and the condition of the tooth crown. The influence differed depending on the location of the section, being most prominent cervically.
CONCLUSION
The present study showed correlation of DCT with age, with significant influence of sex, number of tooth roots, condition of the tooth crown and location of the root section.
Topics: Age Determination by Teeth; Child; Dental Cementum; Female; Humans; Male; Microscopy; Tooth; Tooth Crown; Tooth Root
PubMed: 34999579
DOI: No ID Found -
Scientific Reports Apr 2023Restorative and prosthetic considerations usually necessitates endodontic treatment of third molars in order to retain them as a functional component of the dental arch....
Restorative and prosthetic considerations usually necessitates endodontic treatment of third molars in order to retain them as a functional component of the dental arch. However, the anatomy of third molars has been described as unpredictable. To date, there has been little published work on root and canal morphology of third molars, with an adequate sample size. The aim of this study was to investigate root and canal morphology of third molars. Maxillary and mandibular third molars were gathered from dental surgeries within north Jordan. Following access cavity preparation, pulp tissue was removed and root canals stained. Teeth were subject to examination after rendering them clear by immersion in methyl salicylate, and the following features evaluated: (1) number of roots; (2) number and type of root canals; (3) number and position of lateral canals; and (4) presence of inter-canal communications. Out of the examined 592 maxillary third molars, 69.9% had three roots, 10.81% had one, 9.79% had two, 9.12% had four, and 0.34% had five roots. Most had three (52.36%) and four canals (28.2%) with less frequency of two (11.48%), one (5.91%) and five canals (2.03%). Of the 639 mandibular third molars, 89.76% had two roots, 7.35% had three, 2.5% had one, and 0.47% had four roots. Most had three (55.71%) and two canals (29.42%) with less frequency of four (13.61%), one (1.09%) and five canals (0.15%). The majority of maxillary third molars had 3 roots, while the majority of mandibular third molars had two. Overall, nearly half of the maxillary and mandibular third molars had three canals. New canal configurations, not previously described in the literature nor included in Vertucci's classifications, were identified in both maxillary and mandibular third molars.
Topics: Humans; Molar, Third; Tooth Root; Molar; Maxilla; Dental Pulp Cavity; Cone-Beam Computed Tomography
PubMed: 37106025
DOI: 10.1038/s41598-023-34134-7 -
Caries Research 2015Dentin organic matrix, with type I collagen as the main component, is exposed after demineralization in dentinal caries, erosion or acidic conditioning during adhesive... (Review)
Review
Dentin organic matrix, with type I collagen as the main component, is exposed after demineralization in dentinal caries, erosion or acidic conditioning during adhesive composite restorative treatment. This exposed matrix is prone to slow hydrolytic degradation by host collagenolytic enzymes, matrix metalloproteinases (MMPs) and cysteine cathepsins. Here we review the recent findings demonstrating that inhibition of salivary or dentin endogenous collagenolytic enzymes may provide preventive means against progression of caries or erosion, just as they have been shown to retain the integrity and improve the longevity of resin composite filling bonding to dentin. This paper also presents the case that the organic matrix in caries-affected dentin may not be preserved as intact as previously considered. In partially demineralized dentin, MMPs and cysteine cathepsins with the ability to cleave off the terminal non-helical ends of collagen molecules (telopeptides) may lead to the gradual loss of intramolecular gap areas. This would seriously compromise the matrix ability for intrafibrillar remineralization, which is considered essential in restoring the dentin's mechanical properties. More detailed data of the enzymes responsible and their detailed function in dentin-destructive conditions may not only help to find new and better preventive means, but better preservation of demineralized dentin collagenous matrix may also facilitate true biological remineralization for the better restoration of tooth structural and mechanical integrity and mechanical properties.
Topics: Cathepsins; Collagenases; Cysteine Proteases; Dental Bonding; Dental Caries; Dentin; Humans; Matrix Metalloproteinase Inhibitors; Matrix Metalloproteinases; Tooth Remineralization
PubMed: 25661522
DOI: 10.1159/000363582 -
Biomolecules Aug 2021Developing multifunctional systems for the biomimetic remineralization of human enamel is a challenging task, since hydroxyapatite (HAP) rod structures of tooth enamel...
Developing multifunctional systems for the biomimetic remineralization of human enamel is a challenging task, since hydroxyapatite (HAP) rod structures of tooth enamel are difficult to replicate artificially. The paper presents the first report on the simultaneous use of chitosan (CS) and agarose (A) in a biopolymer-based hydrogel for the biomimetic remineralization of an acid-etched native enamel surface during 4-10-day immersion in artificial saliva with or without (control group) fluoride. Scanning electron microscopy coupled with energy-dispersive X-ray spectrometry, Fourier transform infrared and Raman spectroscopies, X-ray diffraction, and microhardness tests were applied to investigate the properties of the acid-etched and remineralized dental enamel layers under A and CS-A hydrogels. The results show that all biomimetic epitaxial reconstructed layers consist mostly of a similar hierarchical HAP structure to the native enamel from nano- to microscale. An analogous Ca/P ratio (1.64) to natural tooth enamel and microhardness recovery of 77.4% of the enamel-like layer are obtained by a 7-day remineralization process in artificial saliva under CS-A hydrogels. The CS component reduced carbonation and moderated the formation of HAP nanorods in addition to providing an extracellular matrix to support growing enamel-like structures. Such activity lacked in samples exposed to A-hydrogel only. These data suggest the potential of the CS-A hydrogel in guiding the formation of hard tissues as dental enamel.
Topics: Acid Etching, Dental; Biomimetic Materials; Buffers; Chitosan; Dental Enamel; Durapatite; Humans; Hydrogels; Materials Testing; Molar; Saliva; Sepharose; Tooth Extraction; Tooth Remineralization
PubMed: 34439803
DOI: 10.3390/biom11081137