Modified Tunnel Procedure to Facilitate Ridge Reconstruction of an Extraction Socket Associated with Buccal Dehiscence and Gingival Recession: A Case Report with a 6-year Follow-Up.

Introduction: Extraction sockets associated with buccal dehiscences and gingival recessions pose particular surgical and restorative challenges. In these cases, unassisted healing following flapless tooth extraction results in severe bone and soft tissue deformities and an aesthetic compromise. Root coverage procedures prior to ridge reconstruction may enable predictable alveolar augmentation. Case Presentation. This is the first case report describing the utilisation of modified tunnel procedure to facilitate ridge reconstruction consisting of ovate pontic and xenograft, of tooth #25 in a 38-year-old-male. The 6 months and 1-year reviews showed optimal soft tissue aesthetics, 100% root coverage of the tooth #25, and bone augmentation, which enabled placement of 10.0 mm × 4.0 mm (3i) implant in a prosthetically driven position. The 6-year review continued to show favourable clinical outcomes. Conclusion: Compromised extraction sockets containing buccal dehiscence and associated with gingival recessions may benefit from soft tissue augmentation procedures to enhance the clinical outcome of ridge reconstruction.

Traditional Chinese Medicine and orthopedic biomaterials: Host of opportunities from herbal extracts.

The role of Traditional Chinese Medicine (TCM), especially herbs or herbal extracts, in treating diseases has received increasing attention. This review focuses on the use of herbal extracts as signaling molecules and functional materials in the field of orthopedics, biomaterial science and bone tissue engineering strategies. A literature review using both Chinese and English references on herbs and herbal extracts based on TCM theory used in orthopedics and biomaterial science was performed. We discuss the efficacy of herbs, the active extracts from these herbs, the combination of herbal extracts and biomaterials and, finally, the application of herbal extracts to the biomaterials specific to orthopedics. Only a few studies have confirmed the feasibility of applying herbal extracts to biomaterials to improve the role of biomaterials and/or optimize drug delivery and release in orthopedics. In this context, this review reveals a new and promising direction for herbal extracts, where the use of herbal extracts based on TCM systemic treatment, can change the limited modern medicine view of biomaterials as "only for local treatment" when considering its efficacy.

MicroRNA Profiling in Mesenchymal Stromal Cells: the Tissue Source as the Missing Piece in the Puzzle of Ageing.

Ageing is among the main risk factors for human disease onset and the identification of the hallmarks of senescence remains a challenge for the development of appropriate therapeutic target in the elderly. Here, we compare senescence-related changes in two cell populations of mesenchymal stromal cells by analysing their miRNA profiling: Human Dental Pulp Stromal Cells (hDPSCs) and human Periosteum-Derived Progenitor Cells (hPDPCs). After these cells were harvested, total RNA extraction and whole genome miRNA profiling was performed, and DIANA-miRPath analysis was applied to find the target/pathways. Only 69 microRNAs showed a significant differential expression between dental pulp and periosteum progenitor cells. Among these, 24 were up regulated, and 45 were downregulated in hDPSCs compared to hPDPCs. Our attention was centered on miRNAs (22 upregulated and 34 downregulated) involved in common pathways for cell senescence (i.e. p53, mTOR pathways), autophagy (i.e. mTOR and MAPK pathways) and cell cycle (i.e. MAPK pathway). The p53, mTOR and MAPK signaling pathways comprised 43, 37 and 112 genes targeted by all selected miRNAs, respectively. Our finding is consistent with the idea that the embryological origin influences cell behavior and the ageing process. Our study strengthens the hypothesis that ageing is driven by numerous mediators interacting through an intricate molecular network, which affects adult stem cells self-renewal capability. Graphical abstract.

Can Desensitizing Toothpastes Also Have an Effect on Gingival Inflammation? A Double-Blind, Three-Treatment Crossover Clinical Trial.

BACKGROUND: Many desensitizing toothpastes exist commercially; however, few clinical trials have investigated their anti-inflammatory effects. This study aimed to evaluate the anti-inflammatory effect and patient appreciation of two toothpastes containing desensitizing agents: (1) a zinc-carbonate-hydroxyapatite nanoparticle (CHA) and (2) a calcium sodium phosphosilicate bioactive glass (CSPS). METHODS: CHA and CSPS were compared with an anti-inflammatory and antibacterial herbal based toothpaste (HB). The aims were accomplished by comparing the following outcomes: (1) the reduction in plaque and bleeding score (Full Mouth Plaque Score (FMPS) and Full Mouth Bleeding Score (FMBS), respectively); (2) the antibacterial activity (AbA) of the toothpaste by saliva samples; (3) the patient appreciation score (Visual Analogue Scale; VAS). Clinical parameters were assessed at baseline and 14 days post-treatment. RESULTS: The final sample consisted of 25 subjects, aged between 20 and 58 years. Although no differences in FMPS were reported (p > 0.05), both desensitizing toothpastes showed an improvement in FMBS. CSPS and HB recorded more AbA compared to CHA (p < 0.05). Moreover, HB resulted in a higher VAS score than both desensitizing toothpastes (p < 0.05). CONCLUSION: In conclusion, only CSPS displayed a similar anti-inflammatory effect compared to HB. Despite the low VAS score, CSPS could be considered as a valid and effective toothpaste in subjects with both dentin hypersensitivity and inflamed gums, highlighting its utility in clinical practice.

Heterotopic ossification in a patient with diffuse idiopathic skeletal hyperostosis: Input from histological findings.

A high incidence of heterotopic ossification (HO) has been reported in patients with diffuse idiopathic skeletal hyperostosis (DISH), a metabolic disease characterized by calcifications of entheses at spine and peripheral sites. We performed histological and immunohistochemical analyses in five different HO sites in a patient with DISH to study a possible mutual interaction of bone morphogenetic protein 2 (BMP-2), transforming growth factor beta (TGF-ß), and decorin, crucial for bone mass increasing, matrix calcification, and endochondral bone formation. We speculated that the surgical trauma triggered HO, inducing TGF-ß release at the lesion site. TGF-ß recruits osteoblast precursor cells and determines the overexpression of BMP-2 in the surrounding skeletal muscle, inducing a further osteogenic differentiation, contributing to HO onset.

Efficacy of an All-Natural Polyherbal Mouthwash in Patients With Periodontitis: A Single-Blind Randomized Controlled Trial.

Aim: This study aimed to evaluate the anti-inflammatory effect and the incidence of adverse effects of an all-natural polyherbal mouthwash in patients with periodontitis, after 3 months of use. These aims were accomplished by using full mouth bleeding score (FMBS), full mouth plaque score (FMPS), probing depth (PD) clinical attachment level (CAL) and a questionnaire recording any adverse events. Methods: The present randomized controlled clinical study considered 40 patients with moderate or severe periodontitis, randomized in two groups: a test group (TG) and a control group (CG). TG was instructed to use a polyherbal mouthwash composed of Propolis resin extract, Plantago lanceolata, Salvia officinalis leaves extract, and 1.75% of essential oils and the CG was given a placebo mouthwash. Both groups were instructed to rinse for 2 min, twice daily after their routine oral home care with the different mouthwashes. Clinical measurements of FMBS, FMPS, PD and CAL were recorded at baseline (T0) and after 3 months (T1). The incidence of adverse outcomes was recorded at every follow-up. Mann-Whitney U test and Wilcoxon signed-rank test were used for the statistical analysis (p < 0.05). Results: The final study sample consisted of 34 healthy individuals, 17 individuals in each of the two groups. TG and CG showed a statistically significant reduction in FMBS (p = 0.001 TG; p = 0.002 CG), FMPS (p = 0.001 TG; p = 0.003 CG), PD (p = 0.001 TG; p = 0.011 CG) and CAL (p < 0.001 TG; p = 0.020 CG) values from baseline to 3 months. The TG showed a statistically significant decrease in FMBS and FMPS compared with the CG. No adverse events or side effects were reported or observed in both groups. Conclusion: The use of polyherbal mouthwash in patients with moderate or severe periodontitis has proved safe and effective in reducing bleeding score and plaque accumulation, after 3 months, compared with placebo, although no difference between the two groups were reported on PD and CAL (both improving at T1).