RESUMO
BACKGROUND: Tooth autotransplantation (TAT) is a surgical procedure involving the extraction of a tooth from one location and its subsequent transplantation into another alveolar socket within the same individual. This innovative treatment approach holds significant promise. Nonetheless, the potential recipients exhibit a limited level of awareness and understanding of this procedure. This study investigated the knowledge, attitudes, and practices (KAP) among patients with combined dentition defects and non-functional impacted teeth toward TAT. METHODS: This web-based cross-sectional study was conducted between December 2022 and February 2023 at one hospital. A self-designed questionnaire was developed to collect demographic information of the patients and assess their knowledge, attitudes, and practices toward TAT. RESULTS: A total of 533 valid questionnaires were collected. The mean knowledge, attitude, and practice scores were 5.55 ± 2.38 (possible range: 0-10), 26.82 ± 2.46 (possible range, 8-40), and 27.45 ± 7.40 (possible range, 9-45), respectively. CONCLUSION: The participants had insufficient knowledge, negative attitudes, and passive practices toward TAT. Targeted interventions should be implemented to improve the understanding and practice of TAT among patients with dentition defects.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Dente Impactado , Transplante Autólogo , Humanos , Dente Impactado/cirurgia , Estudos Transversais , Feminino , Masculino , Adulto , Inquéritos e Questionários , Pessoa de Meia-Idade , Adolescente , Adulto Jovem , Idoso , Dente/transplanteRESUMO
The stages of preoperative planning and surgical treatment of compromised teeth by the method of autotransplantation of a tooth are presented on the example of two clinical cases. The autotransplantation method can be considered an alternative to dental implantation when strictly adhering to the surgical protocol and careful selection of patients.
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Implantação Dentária , Dente , Transplante Autólogo , Humanos , Implantação Dentária/métodos , Dente/transplante , Masculino , Feminino , AdultoRESUMO
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Tooth autotransplantation: an umbrella review. Tan BL, Tong HJ, Narashimhan S, Banihani A, Nazzal H, Duggal MS. Dent Traumatol 2023;39(Suppl 1):2-29. SOURCE OF FUNDING: Open access funding provided by the Qatar National Library TYPE OF STUDY/DESIGN: Umbrella review.
Assuntos
Dente , Transplante Autólogo , Humanos , Dente/transplante , Revisões Sistemáticas como AssuntoRESUMO
DESIGN: An umbrella review of systematic reviews and meta-analyses on dental autotransplantation (DAT). AIM: To provide a comprehensive overview of the current state of knowledge on prognostic factors, outcomes, and complications of DAT by synthesizing the evidence. METHODS: A comprehensive search of six databases was conducted for systematic reviews and meta-analyses published up to June 30, 2022. Two authors independently performed study selection, data extraction, and quality assessment using the AMSTAR 2 tool. Raw data from primary studies were analyzed using a random effects meta-analysis, and meta-regression was performed to investigate the effect of open and closed apices on the outcomes. RESULTS: Ten systematic reviews, of which nine included meta-analyses, were examined. The overall success rate of the studies was 89.4%, and the survival rate was 96.1%. The main complications were ankylosis (4.6%) and root resorption (7.4%). The analysis showed that a closed apex increased the proportion of ankylosis, resorption, and reduced survival but had no effect on success. The quality of the systematic reviews included varied, with 20% scoring moderate, 60% scoring low, and 20% scoring critically low on the AMSTAR 2 scale. CONCLUSIONS: Dental implant therapy is a reliable solution for replacing lost or damaged teeth, with high success and survival rates. However, it is a procedure that requires precision and attention to detail, along with careful selection of suitable candidates, comprehensive planning, and consideration of factors that may impact outcomes. To improve results and reduce potential complications, it is essential to establish standard clinical guidelines and conduct further extensive research.
Assuntos
Saúde Bucal , Transplante Autólogo , Humanos , Transplante Autólogo/métodos , Dente/transplante , Revisões Sistemáticas como AssuntoRESUMO
BACKGROUND: Tooth autotransplantation (AT) involves the surgical relocation of a tooth from 1 site in the mouth to another site within the same patient. This approach is a good option in a growing patient when dental implant placements or fixed bridges are not suitable and when preserving natural teeth is a priority. Tooth AT is a complex procedure that requires specialized skills from a multidisciplinary team with careful patient and tooth selection and treatment planning. TYPES OF STUDIES REVIEWED: The authors provided a review of the state of knowledge and research on tooth AT and presented a case scenario and barriers to adoption, with a focus on the United States. RESULTS: Success rates for tooth AT can vary depending on several factors, including the patient's overall health, specific tooth involved, skill of the dental surgeon, and postoperative care provided. Long-term outcomes of autotransplanted teeth have been cited in the literature with impressive longitudinal follow-up spanning up to 26 years. Results of several systematic reviews showed survival rates from 75% through 98%. CONCLUSIONS AND PRACTICAL IMPLICATIONS: Adoption of tooth AT has grown over the years, owing to advancements in dental techniques, improved patient outcomes, and increased awareness among both dentists and patients. Increasing awareness and availability of tooth AT to replace missing teeth can provide a natural and functional alternative to traditional prosthetic options. Tooth AT helps preserve the alveolar bone in growing patients and can offer excellent esthetic and functional outcomes.
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Dente , Transplante Autólogo , Humanos , Dente/transplante , FemininoRESUMO
INTRODUCTION: This retrospective study aimed to identify which patient-, donor tooth-, recipient site-, and surgical procedure-related variables may influence the outcome of tooth autotransplantation. METHODS: The sample included 128 autotransplants performed in 122 patients. Single-visit clinical/imaging examinations were used to define the outcome as successful, survival, or failure. The association of potential indicators with the survival or failure categories was analyzed individually and adjusted for confounders through multivariate logistic regression models. RESULTS: After a follow-up period of 1 to 30.11 years, success was achieved in 71.8% of autotransplants, whereas the survival and failure groups had rates of 14.1% each, and the grouped success/survival rate reached 85.9%. An extraoral time >15 minutes and difficult handling/placement were strong/independent risk covariates for survival and failure categories (odds ratio >1, P < .05). Additionally, unerupted/partially erupted status of the donor tooth was a significant indicator for survival, whereas deficient bone level at the recipient site, surgical extraction, poor initial stability, and lack of prophylactic antibiotics were independently linked to failure (odds ratio > 1, P < .05). The root morphology and socket status acted as modifiers of the effect of the recipient site location on the survival group (P > .05). CONCLUSION: Based on the results of this study, unerupted/partially erupted status of the donor tooth, surgical extraction, total extraoral time >15 minutes, deficient recipient's bone level, difficult handling/placement of the autotransplant, poor initial stability, and lack of prophylactic antibiotics during the surgical procedure must be considered with caution when performing autotransplantation because of their deleterious influence on the outcome.
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Dente , Transplante Autólogo , Humanos , Estudos Retrospectivos , Feminino , Masculino , Adulto , Seguimentos , Dente/transplante , Resultado do Tratamento , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , Fatores de RiscoRESUMO
INTRODUCTION: As personalized medicine advances, there is an escalating need for sophisticated tools to understand complex biomechanical phenomena in clinical research. Recognizing a significant gap, this study pioneers the development of patient-specific in silico models for tooth autotransplantation (TAT), setting a new standard for predictive accuracy and reliability in evaluating TAT outcomes. METHODS: Development of the models relied on 6 consecutive cases of young patients (mean age 11.66 years ± 0.79), all undergoing TAT procedures. The development process involved creating detailed in silico replicas of patient oral structures, focusing on transplanting upper premolars to central incisors. These models underpinned finite element analysis simulations, testing various masticatory and traumatic scenarios. RESULTS: The models highlighted critical biomechanical insights. The finite element models indicated homogeneous stress distribution in control teeth, contrasted by shape-dependent stress patterns in transplanted teeth. The surface deviation in the postoperative year for the transplanted elements showed a mean deviation of 0.33 mm (±0.28), significantly higher than their contralateral counterparts at 0.05 mm (±0.04). CONCLUSIONS: By developing advanced patient-specific in silico models, we are ushering in a transformative era in TAT research and practice. These models are not just analytical tools; they are predictive instruments capturing patient uniqueness, including anatomical, masticatory, and tissue variables, essential for understanding biomechanical responses in TAT. This foundational work paves the way for future studies, where applying these models to larger cohorts will further validate their predictive capabilities and influence on TAT success parameters.
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Simulação por Computador , Análise de Elementos Finitos , Transplante Autólogo , Humanos , Fenômenos Biomecânicos , Criança , Feminino , Masculino , Dente/transplante , Dente Pré-Molar , IncisivoRESUMO
Autologous tooth grafting is a dental restorative modality based on periodontal ligament healing.Human periodontal ligament stem cells(PDLSCs) are involved in the formation and remodeling of periodontal tissue.Based on previous findings, the proliferation and differentiation of processing cryopreserved periodontal ligament stem cells (PDLSCs) exhibit similarities to those of fresh cells. However, there is evident absorption in the transplanted frozen tooth's roots and bones, with the underlying cause remaining unknown. Granulocyte macrophage colony-stimulating factor(GM-CSF) is named for its produce granulocyte and macrophage precursors from bone marrow precursors, and it also serves as one of the regulatory factors in inflammatory and osteoclast formation. This study aimed to investigate changes in GM-CSF expression in frozen PDLSCs (fhPDLSCs) and evaluate the impact of GM-CSF on PDLSCs with respect to cellular activity and osteogenic ability. The role of GM-CSF in periodontal absorption was further speculated by comparing with IL-1ß. The results revealed a significant increase in GM-CSF levels from fhPDLSCs compared to fresh cells, which exhibited an equivalent inflammatory stimulation effect as 1 ng/ml IL-1ß. Cell viability also increased with increasing concentrations of GM-CSF; however, the GM-CSF from fhPDLSCs was not sufficient to significantly trigger osteoclastic factors. Considering its interaction with IL-1ß and positive feedback mechanism, environments with high doses of GM-CSF derived from fhPDLSCs are more likely to activate osteoclastic responses.Therefore, for frozen tooth replantation, great attention should be paid to anti-inflammation and anti-infection.GM-CSF may serve as a potential therapeutic target for inhibiting periodontal resorption in delayed grafts.
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Perda do Osso Alveolar , Fator Estimulador de Colônias de Granulócitos e Macrófagos , Dente , Humanos , Perda do Osso Alveolar/metabolismo , Perda do Osso Alveolar/terapia , Diferenciação Celular , Células Cultivadas , Fator Estimulador de Colônias de Granulócitos e Macrófagos/metabolismo , Macrófagos , Osteoclastos , Dente/transplante , Transplante AutólogoRESUMO
Objetivo: apresentar o relato de duas pacientes com agenesias dentárias em que cinco dentes autotransplantados foram utilizados como modalidade de tratamento. Além disso, objetiva-se mostrar questões sobre a técnica cirúrgica, suas indicações e previsibilidade. Relato de caso: Neste estudo, foram relatados 5 casos de autotransplante dentário em duas pacientes jovens, em que a equipe realizou os procedimentos e o acompanhamento clínico e radiográfico por 5 e 7 anos. Devido à alta sensibilidade da técnica, foram seguidos princípios previamente estabelecidos na literatura envolvendo o autotransplante dentário. Durante o período de acompanhamento, os dentes se mantiveram em posição e em função e as pacientes não apresentavam queixas associadas. Considerações finais: a técnica do autotransplante dentário, quando bem indicada e executada, é capaz de promover resultados bastante satisfatórios, sendo uma ótima alternativa reabilitadora, com taxas de sucesso elevadas e custos reduzidos. No entanto, critérios em relação aos sítios doadores e receptores e a habilidade do cirurgião devem ser levados em conta para o sucesso do técnica.
Objective: presenting the report of two patients with tooth agenesis in which five autotransplanted teeth were used as a treatment modality. Furthermore, the aim is to show questions about the surgical technique and its indications and predictability. Case report: In this study, 5 cases of dental autotransplantation were reported in two young patients, in which the team performed procedures and had clinical and radiographic follow-up for 5 and 7 years. Due to the high sensitivity of the technique, principles previously established in the literature involving dental autotransplantation were followed. During the follow-up period, the teeth remained in position and function and the patients had no associated complaints. Final considerations: the dental autotransplantation technique, when well indicated and executed, is capable of achieving very satisfactory results, being a great rehabilitative alternative, with high success rates and reduced costs. However, criteria regarding donor and receptor sites and the surgeon's skill must be taken into account for the success of the technique.
Assuntos
Humanos , Feminino , Adolescente , Adulto , Dente/transplante , Reimplante Dentário/métodos , Anodontia/cirurgia , Transplante Autólogo/métodos , Seguimentos , Resultado do TratamentoRESUMO
Tooth autotransplantation is a versatile procedure with several clinical applications among patients across different age groups. The success of this procedure depends on multiple factors. Despite the wealth of studies available, no single primary study or systematic review is able to report on every factor affecting the outcomes of autotransplantation. The aims of this umbrella review were to evaluate treatment-related and patient-related outcomes of autotransplantation and to assess the pre-, peri- or post-operative factors that could affect these. An umbrella review was conducted according to the PRISMA statement. A literature search of five databases was performed up to 25 September 2022. Systematic Reviews (SR) with and without meta-analysis evaluating autotransplantation were included. Calibration among reviewers was carried out prior to study selection, data extraction and Risk of Bias (RoB) assessment. Study overlap was calculated using corrected covered area. Meta-meta-analysis (MMA) was performed for suitable SRs. The AMSTAR 2 critical appraisal tool was used to evaluate the quality of evidence. Seventeen SRs met the inclusion criteria. Only two SRs were suitable for conduct of MMA on autotransplantation of open apex teeth. The 5-year and 10-year survival rates were >95%. A narrative summary on factors that could affect autotransplantation outcomes and comparisons of autotransplantation to other treatment options were reported. Five SRs were rated as 'low quality' and 12 SRs were rated as 'critically low quality' in the AMSTAR 2 RoB assessment. In order to facilitate a more homogenous pool of data for subsequent meta-analysis, an Autotransplantation Outcome Index was also proposed to standardise the definition of outcomes. Autotransplantation of teeth with open apices have a high survival rate. Future studies should standardise the reporting of clinical and radiographic findings, as well as the definition of outcomes.
Assuntos
Dente , Humanos , Transplante Autólogo , Dente/transplanteRESUMO
BACKGROUND/AIM: Variability in the outcome measures used to assess the success of tooth autotransplantation presents challenges for combining data to examine the success of the technique. Reaching agreement on the most important outcomes will enable routine procedural and follow-up data to be collected in a standardised way. In turn this will promote greater data synthesis to evaluate outcomes and examine which procedural techniques influence outcome. The aim of this study was to identify which prognostic factors and outcomes are most important to clinicians with experience in autotransplantation of developing teeth. METHODS: The Delphi method was used to build consensus on the most important prognostic factors and outcomes. Item identification involved a systematic literature review and review of current clinical datasets in use. A two-round Delphi questionnaire was undertaken with clinicians providing tooth autotransplantation, followed by a consensus meeting to finalise the most important items. RESULTS: Outcomes and prognostic factors were identified from the systematic review (82 studies and eight reviews), one guideline and three existing clinical datasets. Patient interviews and a clinician survey added a number of items that would not have been identified from the literature only. A total of 56 outcomes and 93 prognostic factors were included for rating in the Delphi questionnaire. The Delphi questionnaire was completed by 15 respondents in round one and 13 respondents in round two. The consensus meeting was attended by nine participants. The final items that were judged to be most important included 29 outcomes (25 clinical, three patient-reported and one service delivery) and 49 prognostic factors (18 patient characteristics, four presurgical, 17 surgical and 10 postsurgical). Clinical outcomes were consistently rated higher than patient-reported outcomes. CONCLUSIONS: The clinical outcomes rated as the most important were transplant survival and reason for failure, outcomes relating to pulp health, different types of resorption and evidence of infection (suppuration). Important patient-reported outcomes were satisfaction with overall treatment experience, and outcome and quality of life related to function of the transplanted tooth. Procedural information rated as being the most important related to the donor tooth: stage of root development, method for surgical removal and storage and condition of the donor tooth root surface following removal.
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Qualidade de Vida , Dente , Humanos , Prognóstico , Transplante Autólogo , Dente/transplante , Raiz DentáriaRESUMO
Repositioning of impacted teeth in the dental arch through en-bloc autotransplantation showed short-term efficacy of 89%. The objective of this study was to evaluate the technique for long-term efficacy. The analysis involved 23 teeth transplanted to the alveolar ridge through harvesting the tooth with the adjacent bone tissue. Development of the root was completed and the apical foramen was closed in all the teeth. The teeth were examined clinically and radiologically (CBCT) and compared to contralateral ones. The obtained data were analysed statistically. The efficacy of the procedure amounted to 81% including two teeth lost at an early stage and another two lost during follow-up. The mean age of patients upon performing the procedure was 29.8. The long-term follow-up amounted to the mean of 34.3 months. In the study group recession of 1-2 mm as well as 3-5 mm was found, which was not noted on the control group. In 11.1% of the study group teeth the external root resorption was observed. No transplanted tooth underwent root canal treatment, no periapical changes were observed at CBCT and 77.8% of those showed positive reaction to ethyl chloride. One case of ankylosis was observed in tooth 11 and in two cases increased mobility of the transplanted tooth was found. Regeneration of nerves as well as revascularization in the en-bloc autotransplantation proceeded with high predictability and the risk of ankylosis of the treated tooth seemed to be negligible. Gingival recession was observed more often in case of en-bloc transplantation compared to the control group. The long-term follow-up suggested that this the technique does not prevent external resorption in 100%.
Assuntos
Anquilose , Reabsorção da Raiz , Dente Impactado , Dente , Humanos , Transplante Autólogo , Dente Canino/transplante , Raiz Dentária , Dente/transplante , SeguimentosRESUMO
Background and Objectives: The purpose of this study is to observe the usefulness of autogenous tooth transplantation by examining the cumulative survival rate according to the period of auto-transplanted teeth as pre-implant treatment. Materials and Methods: This study was conducted on 111 patients who visited Kyungpook National University Dental Hospital and underwent autogenous tooth transplantation between November 2008 and January 2021 (about 13 years). The cumulative survival rate of autogenous tooth transplantation according to the causes of extraction of the recipient tooth (caries, periapical lesion, crack, crown fracture, periodontitis) and condition of opposing teeth (natural teeth vs. fixed prosthesis). The cumulative survival rate of autogenous tooth transplantation according to the age (under 30 vs. over 30) was also investigated and it was examined whether there were any differences in each factor. Results: The average follow-up period was 12 months, followed by a maximum of 162 months. The 24-month cumulative survival rate of all auto-transplanted teeth was 91.7%, 83.1% at 60 months and the 162-month cumulative survival rate was 30.1%. There were no statistical differences between the causes of extraction of the recipient's teeth, differences in the condition of the opposing teeth, and differences under and over the age of 30. Conclusions: The survival rate of autogenous tooth transplantation appears to be influenced by the conditions of the donor tooth rather than the conditions of the recipient tooth. Although autogenous tooth transplantation cannot completely replace implant treatment, it is meaningful in that it can slightly delay or at least earn the time until implant placement is possible.
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Fraturas dos Dentes , Dente , Humanos , Taxa de Sobrevida , Dente/transplante , Transplante Autólogo , Extração Dentária , Seguimentos , Resultado do TratamentoRESUMO
Objective: To screen and analyze the factors affecting the prognosis of replacing single missing tooth by autograft tooth, so as to provide reference for clinical judgment of surgical prognosis. Methods: A total of 176 patients (188 teeth) underwent autotransplantation of teeth in the Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University from January 2017 to December 2019, including 85 teeth of males and 103 teeth of females were involved. The age was (33.0±9.8) years (16-65 years). The possible factors affecting the prognosis of replacing single missing tooth by autograft tooth were summarized and grouped, and the clinical and imaging data were recorded and judged. The surgical records and photographic data from the patients' previous medical records were retrospectively analyzed. The survival analysis method was used for statistical analysis to screen out the factors affecting the cumulative survival rate of transplanted teeth. Results: The 5-year cumulative survival rate of 188 transplanted teeth was 88.4%. Univariate Log-Rank analysis showed that age (P<0.001), sex (P=0.008), smoking (P<0.001), position of recipient area (P<0.001), height of alveolar bone in recipient area (P<0.001), time of donor tooth in vitro (P<0.001), use of donor model (P<0.001) and initial stability (P<0.001) were significantly correlated with cumulative survival rate of transplanted teeth. Multivariate Cox proportional hazard regression analysis showed that smoking (ß=-2.812, P=0.049), alveolar bone height (ß=1.521, P=0.020), donor time (ß=-2.001, P=0.019), use of donor model (ß=1.666, P=0.034) and initial stability (ß=-1.417, P=0.033) were significantly correlated with the cumulative survival rate of transplanted teeth. Conclusions: The prognosis of autogenous tooth transplantation can be predicted by smoking, height of alveolar bone in recipient area, time of donor teeth in vitro, use of donor model and initial stability. Good prognosis of transplanted teeth can be obtained by using donor model during operation, reducing the time of donor teeth in vitro, taking effective methods to restore alveolar bone height, maintaining good initial stability, and good oral health education after operation.
Assuntos
Perda de Dente , Dente , Adulto , Feminino , Humanos , Masculino , Prognóstico , Estudos Retrospectivos , Dente/transplante , Transplante Autólogo , Resultado do Tratamento , Adulto JovemRESUMO
OBJECTIVES: To determine the survival of intentional autotransplantation of developing teeth. MATERIAL AND METHODS: An electronic search was carried out in the MEDLINE database, Web of Science, and Cochrane Library. The criteria used are the ones described in the PRISMA Declaration. The following MeSH terms were used: ("tooth" [MeSH Terms] OR "tooth" [All Fields]) AND ("transplantation, autologous" [MeSH Terms] OR ("transplantation" [All Fields] AND "autologous" [All Fields]) OR "autologous transplantation" [All Fields] OR "autotransplantation" [All Fields]) AND ("humans" [MeSH Terms]. Randomised clinical trials and prospective and retrospective clinical studies were included. RESULTS: The meta-analytic study of overall survival included a total of 14 studies, yielding an overall survival rate of 97.9%. In studies with 1-year follow-ups, survival was 98%. The resulting 2-year follow-up rate was 97%, while the 5- and 10-year survival rates were 95.9% and 96.9%, respectively. CONCLUSIONS: The autotransplantation technique performed in a single-phase and on teeth that have not completed their development is a predictable technique, with a described survival rate at a 2-year follow-up of more than 97%. CLINICAL RELEVANCE: The technique of dental autotransplantation is considered an important resource for the resolution and rehabilitation of tooth loss in patients, especially in those who are still in a growth period. Moreover, this technique has a low complication rate and a 10-year survival rate of 96.9%. It should therefore be considered a safe and reliable procedure.
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Dente , Humanos , Estudos Prospectivos , Estudos Retrospectivos , Dente/transplante , Transplante Autólogo , Resultado do TratamentoRESUMO
OBJECTIVES: Cryopreservation is discussed as a viable method of preserving teeth for determined autogenous tooth transplantation. Unchanged physical properties of hard tooth tissues are crucial for functional healing. Due to different thermal expansion coefficients of enamel and dentin or the crystallization process, the freezing process may lead to crack formation, which could adversely impact the long-term prognosis of the teeth. MATERIAL AND METHODS: Twenty third molars (n = 20) were frozen slowly using a conservative cryopreservation protocol and stored at -80°C (group 1) and -196°C (group 2). After a storage time of 2 weeks, the samples were thawed to a temperature of +36°C and embedded in polymethyl methacrylate blocks. Cyclic loading was carried out using a spherical steel test specimen with 50,000 mechanical load cycles, followed by load to failure testing for determination of critical load. RESULTS: No significant difference in the first load drop could be detected during the load to failure test under different storage conditions. The values until fracture correlated very closely in contralateral tooth pairs, which emphasizes the importance of crown geometry in load to failure tests. CONCLUSIONS: Conclusions: Cryopreservation, specifically the storage temperature, does not appear to have a significant effect on the physical properties of tooth transplants.
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Criopreservação/métodos , Preservação de Órgãos/métodos , Manejo de Espécimes/métodos , Fraturas dos Dentes/prevenção & controle , Dente/transplante , Adolescente , Adulto , Feminino , Humanos , Técnicas In Vitro , Masculino , Adulto JovemRESUMO
OBJECTIVE: This study investigated the effects of poly lactic-co-glycolic acid (PLGA) loaded with plasmid DNA encoding fibroblast growth factor-2 (pFGF-2) on human periodontal ligament cells (hPDLCs) in vitro and evaluated the ability of the PLGA/pFGF-2 scaffold to promote periodontal ligament (PDL) regeneration in a beagle dog teeth avulsion animal model. BACKGROUND: Growth factor and scaffold play important roles in PDL regeneration. PLGA is a kind of biodegradable and biocompatible polymer that can be used as a carrier to deliver growth factors or genes. FGF-2 can induce potent proliferative responses, promote cell migration and regulate the production of extracellular matrix. Therefore, a gene-activated matrix composed of scaffold and genes is supposed to be a superior approach for promoting tissue regeneration. METHODS: In this study, PLGA and PLGA/pFGF-2 scaffolds were fabricated using electrospinning. The characterization of scaffolds was shown by scanning electron microscope (SEM) and transmission electron microscope (TEM). dsDNA HS was used to test the plasmid release of PLGA/pFGF-2 scaffold. The viability and proliferation of hPDLCs on the two kinds of scaffolds were evaluated by the CCK-8 assay, and the expression of collagen I and scleraxis were analysed by RT-qPCR. The roots of avulsed teeth were covered by the two types of scaffolds and replanted into the alveolar pockets in beagles. Haematoxylin-eosin and Masson staining were used to evaluate the effects of PLGA/pFGF-2 scaffold on promoting PDL regeneration. RESULTS: The smooth and uniform fibres can be observed in both scaffolds, and the plasmids were randomly distributed in the PLGA/pFGF-2 scaffold. dsDNA HS analysis demonstrated that the PLGA/pFGF-2 scaffold released up to 123 ng pFGF-2 over 21 days in a sustained manner without any obvious burst release. The PLGA/pFGF-2 scaffold promoted the proliferation of hPDLCs and increased the expression levels of collagen I and scleraxis compared with PLGA scaffold. Animal experiments showed that more regular PDL-like tissues and less root surface resorption occurred in the PLGA/pFGF-2 scaffold group compared with the PLGA scaffold group. CONCLUSIONS: The PLGA/pFGF-2 scaffold promoted hPDLCs proliferation and facilitated periodontal ligament-related differentiation. The PLGA/pFGF-2 scaffold possesses excellent biological characteristics and could be used as a promising biomaterial for improving the treatment prognosis of replanted tooth.
Assuntos
Fator 2 de Crescimento de Fibroblastos , Ligamento Periodontal , Animais , Cães , Fator 2 de Crescimento de Fibroblastos/genética , Fator 2 de Crescimento de Fibroblastos/farmacologia , Glicolatos , Glicóis , Ligamento Periodontal/efeitos dos fármacos , Plasmídeos/genética , Alicerces Teciduais , Dente/transplanteRESUMO
The aim of autotransplantation of teeth (ATT) is to replace a lost tooth with a functional tooth within the same patient. Although it has recently become more of a recognized and viable treatment approach in dentistry, the long-term outcomes are still not well-documented. The principal author (M.T.) has performed more than 1000 ATTs for reasons such as treating missing teeth, deep caries, poor endodontic results, and periodontitis over the past 30 years in private practice. During the course of private practice, 2 separate analyses were performed on a total of 319 cases with follow-up ranging from 2-26 years. The results showed a tendency toward higher success rates in younger patients; the success rate was highest in ATTs performed on immature teeth (about 95%), about 90% in patients younger than 30 years of age and approximately 80% in patients older than 30. The failures were most often caused by replacement resorption (ie, ankylosis-related resorption). The purpose of this case series was to show successful long-term outcomes of ATT as well as to provide clinical insights and describe tendencies noted over the course of 30 years of performing ATTs.