Bone Regeneration with Mesenchymal Stem Cells in Scaffolds: Systematic Review of Human Clinical Trials.

The aim of the study is to determine the effectiveness of stem cells in scaffolds in the treatment of bone deficits, in regard of bone regeneration, safety, rehabilitation and quality of life in humans. The systematic review was conducted in accordance with PRISMA 2020. A systematic search was conducted in three search engines and two registries lastly in 29-9-2022.for studies of the last 15 years. The risk of bias was assessed with RoB-2, ROBINS- I and NIH Quality of Before-After (Pre-Post) Studies with no Control group. The certainty of the results was assessed with the GRADE assessment tool. Due to heterogeneity, the results were reported in tables, graphs and narratively. The study protocol was published in PROSPERO with registration number CRD42022359049. Of the 10,091 studies retrieved, 14 were meeting the inclusion criteria, and were qualitatively analyzed. 138 patients were treated with mesenchymal stem cells in scaffolds, showing bone healing in all cases, and even with better results than the standard care. The adverse events were mild in most cases and in accordance with the surgery received. When assessed, there was a rehabilitation of the deficit and a gain in quality of life was detected. Although the heterogeneity between the studies and the small number of patients, the administration of mesenchymal stem cells in scaffolds seems safe and effective in the regeneration of bone defects. These results pave the way for the conduction of more clinical trials, with greater number of participants, with more standardized procedures.

Mandibular Melanotic Neuroectodermal Tumor of Infancy: Interdisciplinary Treatment from 2 Months to 19 Years of Age.

Melanotic neuroectodermal tumor of infancy (MNTI) is a clinically distinctive, benign neoplasm of neural crest origin. The tumor develops usually in the anterior maxilla and rarely in the skull and mandible. This is a report of the interdisciplinary treatment of a rare case of MNTI occurring in the mandible. The patient was initially addressed for examination at the age of 2 months with a rapidly growing tumor of the mandible that had increased double in size in a week. A well-defined lesion in the left mandible shown on MRI and high urine vanillylmandelic acid (VMA) level determined the diagnosis. The complete interdisciplinary treatment included four interventions. Surgery with enucleation and curettage, performed as first intervention, at the age of 2 months. The second intervention lasted from age 7 to age 15 and included a first phase of Orthodontic treatment to monitor normal growth, followed by interceptive Orthodontic treatment and Prosthodontic intervention with interim dentures. The third intervention accomplished after competition of growth and included the pre-prosthetic surgery with an augmentation of the height of the edentulous atrophic mandible and placement of 4 implants. In the fourth intervention the permanent prosthodontic restoration supported by implants was applied.

Effectiveness of Denture Cleansers on Removal of Adherent Candida albicans Cells from Denture Base Acrylics of Various Roughness.

PURPOSE: To experimentally examine the effectiveness of a small sample of commercial denture cleansers in removing Candida albicans cells from denture surfaces. MATERIALS AND METHODS: A total of 216 specimens from three brands of denture base resins (72 for each acrylic resin) were divided into three groups of 24 specimens that each received a different surface treatment (Ra1, Ra2, and Ra3). The specimens were contaminated by the Candida albicans strain ATCC 90028, immersed for 15 minutes in one of two experimental denture cleanser solutions or in tap water, and placed in Petri dishes with culture medium. RESULTS: Candida albicans colonies were measured after 24-hour incubation at 37ÆC. There was a statistically significant difference in the cleansing result depending on the denture cleanser used. CONCLUSION: The use of commercial denture cleansers may under certain conditions be effective in the removal of Candida albicans from denture bases.

Comparative Assessment of a New Holistic-Oriented and an Old Specialty-Specific Undergraduate Curriculum in Removable Prosthodontics: A Study Based on Senior Students' Perceptions.

PURPOSE: A survey was conducted in the Dental School, Aristotle University, Thessaloniki, Greece, (i) to assess the perceptions and experiences of senior dental students, Classes of 2014 and 2015, toward the old, specialty-specific (OC) and new, holistic-oriented (NC) undergraduate curriculum, respectively, in removable prosthodontics and (ii) to identify areas of improvement in prosthodontic training. MATERIALS AND METHODS: Structural components of both curricula were collected, including the total number of (i) laboratory/lecture/clinical training hours, (ii) written examinations, (iii) mandatory clinical cases, and (iv) European Credit Transfer and Accumulation System (ECTS) credits. A 20-item closed-type questionnaire using a five-point Likert scale was distributed in two consecutive groups of seniors, Classes of 2014 (n = 54) and 2015 (n = 57); 54 OC and 57 NC senior students filled out the questionnaire. RESULTS: A greater percentage of NC students stated that (i) they felt less confident to carry out jaw relation recording and removable partial denture metal framework design and (ii) the time allocated for clinical training was less sufficient. Students of both curricula reported that the laboratory courses and lectures contributed little to their clinical performance. Implant restorations and prosthetic management of patients with craniomandibular disorders were the most popular treatment options that the respondents felt that should be incorporated in the undergraduate curriculum. CONCLUSIONS: As a general trend, students completing the revised curriculum reported more difficulties during their training and felt more insecure about their clinical competences. To enhance students' self-confidence in prosthodontics, more effective preclinical training methods, introduction of additional treatment options, and alternative educational methods should be considered.

Implant-assisted removable partial dentures as an alternative treatment for partial edentulism: a review of the literature.

This study reviewed the current literature concerning implant-assisted removable partial dentures (RPDs) in order to present the existing knowledge about performance issues. An electronic search was conducted on the PubMed database for published English-language articles that contained information about implant-assisted RPDs. A review of these articles indicated that the combination of dental implants with RPDs constitutes a cost-efficient prosthetic protocol that can offer solutions to problematic aspects of treatment with removable partial dentures. Well-designed studies are still needed to provide robust evidence on critical issues, such as design guidelines, long-term survival of implants associated with RPDs, and their effect on patients' quality of life.

Interim prosthodontic management of surgery-induced dental agenesis: a clinical report of 8 years of treatment.

The prosthodontic management of a 7-year-old girl with induced dental agenesis is described. The mandibular posterior tooth germs had been removed during surgical excision of a melanotic neuroectodermal tumor of infancy, at the age of 2 months. The ongoing prosthodontic treatment, now in its eighth year, was implemented by regular follow-up of the operation outcome and by targeted orthodontic intervention. The treatment plan included the provision of four successive interim removable partial dentures. Care was taken to preserve the oral structures, adapt to the morphological changes, and satisfy the needs of the child. Due to the unfavorable biomechanical conditions, retention and stability problems were encountered. These were resolved by engaging the mechanism of neuromuscular adaptation through optimization of the shape of the denture base. For children and adolescents with extensive dental agenesis, prosthodontic management with interim removable dentures supports function, restores esthetics, and provides a solid basis for the definitive treatment.

Polishing of denture base acrylic resin with chairside polishing kits: an SEM and surface roughness study.

Heat-cured acrylic resin specimens were polished using either conventional laboratory polishing, sandpaper, or three commercial chairside kits. The surface roughness of the polished specimens was measured with a contact profilometer. Scanning electron microscopy was used to obtain microphotographs of the polished surfaces. Laboratory polishing produced the smoothest surfaces in all cases, while sandpaper application produced the roughest. Use of the chairside polishing kits resulted in significantly rougher surfaces compared to those produced by laboratory polishing. Nonetheless, polishing of trimmed denture bases using chairside polishing kits is an effective alternative procedure for cases in which the laboratory procedure is not applicable.

Effective treatment of self-injurious oral trauma in Lesch-Nyhan syndrome: a case report.

Lesch-Nyhan syndrome (LNS) is an X-linked disorder originating from deficiency of the enzyme hypoxanthine guanine phosphoribosyl transferase. It is characterized by neurological manifestations, including the dramatic symptom of compulsive self-mutilation, which results in destruction of oral and perioral tissues. Several drug trials have been administered to improve the severe self-destructive behaviour, with questionable effectiveness. Invasive treatment approaches, such as extraction of teeth and orthognathic surgery, have been suggested with variable success. A conservative treatment with an intraoral appliance serving to prevent oral and peri-oral self-injury is presented in this report. The patient was a 14-year-old boy demonstrating the typical LNS behaviour, including compulsive self-biting, significant loss of lip and tongue tissue, spasticity and involuntary movements. An acrylic maxillary appliance was designed and constructed with an occlusal plate raising the bite. The appliance was retained by two Adams' clasps on the first premolars, along with three ball clasps between the incisors. Fabrication, insertion, and maintenance were uncomplicated and non-stressful to the patient. Periodic recall over 3-year period has confirmed the effective healing of the oral lesions and a high level of tolerance of the appliance.

The contribution of orthodontics to the prosthodontic treatment of ectodermal dysplasia: a long-term clinical report.

BACKGROUND: The long-term management of hypohidrotic ectodermal dysplasia (HED) from prepuberty to adulthood often necessitates orthodontic and orthopedic treatment in conjunction with prosthodontic care. CASE DESCRIPTION: The authors present a report regarding the combined orthodontic and prosthodontic treatment of a child with HED-associated oligodontia from the ages of 10 to 18 years. The authors fabricated successive maxillary removable partial dentures, equipped with midline jackscrews, at different phases of the treatment and planned treatment to close the patient's midline diastema. After completion of the orthodontic therapy, three-dimensional analysis of the final dental casts showed a measurable increase in the transverse dimensions of the maxillary dental arch, and posttreatment cephalometric analysis revealed the face to have normal vertical dimensions and a mild retroposition of the maxilla. CONCLUSIONS: and CLINICAL IMPLICATIONS: Orthodontic and orthopedic treatment in coordination with prosthetic restoration at the appropriate time may benefit the stomatognathic function, normal growth, esthetics and emotional well-being of young people with HED.

An alternative impression technique for individuals with special care needs.

Impression making may be complicated in individuals with limited ability to cooperate with caregivers. An alternative technique for obtaining full-arch casts from sectional preliminary impressions is described. The technique is a modification of the procedure advocated for impression making in subjects with limited mouth opening. A pair of partial stock trays is selected to fit the right and left side of the arch. Two sectional irreversible hydrocolloid impressions are made separately. The first cast is placed into the second impression prior to pouring, to obtain a cast of the complete arch. The procedure was used during the treatment of an uncooperative young patient with Lesch-Nyhan Syndrome and provided a simple and reliable means to obtain the diagnostic cast of the mandibular teeth. It is recommended not only for uncooperative patients, but also for patients with special needs; such as those with anatomical restrictions, functional impairment, and movement disorders.

Oligodontia and associated characteristics: assessment in view of prosthodontic rehabilitation.

Bibliographic evidence regarding oligodontia was reviewed to extract information necessary for a systematic review for a prosthodontic approach to management. Syndromic oligodontia, appearing as a symptom of many syndromes, was distinguished from isolated, or non-syndromic, which is an independent trait. Although a rare disorder, oligodontia has always been considerably researched, especially concerning its prevalence and genetic background. Non-syndromic oligodontia has been associated with the presence of small and misshapen natural teeth, orofacial clefting and reduced saliva secretion. A typical maxillofacial morphology has also been reported, which seems to result from the lack of dental and functional compensation and not from an altered growth pattern. Syndromic oligodontias also exhibit the above basic features but are complicated by each syndrome's specific characteristics. Prosthodontic treatment of individuals with oligodontia must anticipate the dental and oral clinical characteristics and provide with continuing support and preservation of proper maxillofacial relationships.