Stem cells in regenerative dentistry: Current understanding and future directions.

BACKGROUND: Regenerative dentistry aims to enhance the structure and function of oral tissues and organs. Modern tissue engineering harnesses cell and gene-based therapies to advance traditional treatment approaches. Studies have demonstrated the potential of mesenchymal stem cells (MSCs) in regenerative dentistry, with some progressing to clinical trials. This review comprehensively examines animal studies that have utilized MSCs for various therapeutic applications. Additionally, it seeks to bridge the gap between related findings and the practical implementation of MSC therapies, offering insights into the challenges and translational aspects involved in transitioning from preclinical research to clinical applications. HIGHLIGHTS: To achieve this objective, we have focused on the protocols and achievements related to pulp-dentin, alveolar bone, and periodontal regeneration using dental-derived MSCs in both animal and clinical studies. Various types of MSCs, including dental-derived cells, bone-marrow stem cells, and umbilical cord stem cells, have been employed in root canals, periodontal defects, socket preservation, and sinus lift procedures. Results of such include significant hard tissue reconstruction, functional pulp regeneration, root elongation, periodontal ligament formation, and cementum deposition. However, cell-based treatments for tooth and periodontium regeneration are still in early stages. The increasing demand for stem cell therapies in personalized medicine underscores the need for scientists and responsible organizations to develop standardized treatment protocols that adhere to good manufacturing practices, ensuring high reproducibility, safety, and cost-efficiency. CONCLUSION: Cell therapy in regenerative dentistry represents a growing industry with substantial benefits and unique challenges as it strives to establish sustainable, long-term, and effective oral tissue regeneration solutions.

Odontología sostenible y sustentable / Sustainable dentistry

Introducción: la periodontitis es una enfermedad infecciosa multifactorial asociada a un biofilm de microorganismos patógenos. Objetivo: el objetivo del trabajo fue establecer la prevalencia de Porphyromonas gingivalis en pacientes con periodontitis y relacionarla con la severidad de la enfermedad. Material y métodos: participaron 45 pacientes, sistémicamente saludables, con edades entre 35 y 65 años. El grado de periodontitis se definió según los criterios de Papapanou y colaboradores. Como grupo control, se incluyeron 20 sujetos de ambos sexos sin periodontitis y sin enfermedades sistémicas. Se tomaron muestras de fluido gingival en dos sitios más profundos. Porphyromonas gingivalis se detectó por PCR (reacción en cadena de la polimerasa). Resultados: la frecuencia relativa de periodontitis fue de 13.3% grado I, 46.7% grado II y 40% grado III. El sexo masculino presentó periodontitis grado III 72.2% y grado II 52.3%. El grado I se registró con mayor frecuencia en el sexo femenino, 66.7%. La prevalencia de Porphyromonas gingivalis en la población con periodontitis fue de 44.4%. Se obtuvieron diferencias estadísticamente significativas entre los grados de severidad de periodontitis y la presencia de Porphyromonas gingivalis (p = 0.0002, α = 5%). Conclusión: la periodontitis predominó en el sexo masculino. La prevalencia de Porphyromonas gingivalis en la población con periodontitis crónica fue de 44.4% y su presencia está relacionada con la severidad (AU)

Introduction: periodontitis is a multifactorial infectious disease associated with a biofilm of pathogenic microorganisms. Objective: the objective of the work was to establish the prevalence of Porphyromonas gingivalis in patients with periodontitis and relate it to the severity of the disease. Material and methods: 45 systemically healthy patients, aged between 35 and 65 years old, participated. The degree of periodontitis was defined according to the criteria of Papapanou et al. As a control group, 20 patients of both sexes without periodontitis and without systemic diseases were included. Gingival fluid samples were taken from two deeper sites. Porphyromonas gingivalis was detected by PCR (polymerase chain reaction). Results: the relative frequency of periodontitis was 13.3% grade I, 46.7% grade II and 40% grade III. The male sex presented periodontitis grade III 72.2% and grade II 52.3%. Grade I was recorded more frequently in the female sex, 66.7%. The prevalence of Porphyromonas gingivalis in the population with periodontitis was 44.4%. Statistically significant differences were obtained between the degrees of severity of periodontitis and the presence of Porphyromonas gingivalis (p = 0.0002, α = 5%). Conclusion: periodontitis predominated in males. The prevalence of Porphyromonas gingivalis in the population with chronic periodontitis was 44.4% and its presence is related to severity (AU)

La odontología verde / Green dentistry

El propósito del presente trabajo está orientado a generar una reflexión entre el gremio odontológico profesional y los estudiantes de las licenciaturas en Odontología respecto a la contaminación global que estamos generando y a la crítica situación del planeta, así como sus consecuencias ambientales y climatológicas, sobre lo importante que es educar bajo la perspectiva de una Odontología Verde y Sostenible a través de la ambientalización curricular en las escuelas y facultades de Odontología para generar un tipo de cultura y conciencia proambiental. De igual forma para señalar lo sencillo que es ambientalizar agradable y relajantemente nuestro entorno educativo y laboral, así como realizar algunas prácticas odontológicas ecológicas y ambientales en la práctica privada que cuestan poco o nada y que, por el contrario, el gran efecto positivo que éstas tendrán en el medio ambiente y la reducción de los niveles de contaminación actuales. Si realmente logramos generar una nueva cultura y conciencia que se preocupe por el medio ambiente en el campo de la Odontología, los resultados para todos se verán reflejados en un mejor ambiente social, educativo de trabajo y de salud (AU)

The purpose of this work is aimed at generating a reflection between the professional dental guild and the students of the Bachelor's Degrees in Dentistry regarding the global pollution that we are generating and the critical situation of the planet and its environmental and climatological consequences, on how important it is educate under the perspective of a Green and Sustainable Dentistry through the greening of the curriculum in the Schools and Faculties of Dentistry to generate a type of culture and pro-environmental awareness. Likewise, point out how simple it is to pleasantly and relaxingly green our educational and work environment, as well as perform some ecological and environment, as well perform some ecological and environment, dental practices in private practice that cost little or nothing and that, on the contrary, the great positive effect that these will have on the environment and the reduction of current pollution levels. If we truly manage to generate a new culture and awareness that cares about the environment in the field of Dentistry, the results for all will be reflected in a better social, educational, work and health environment (AU)

Reflexionando sobre la odontología en escenarios de hoy y de mañana / Reflecting on dentistry in current and future scenarios

Esta reflexión plantea una auto interpelación e instala a la odontología ­mi odontología­ en el escenario global de la salud. Cada pregunta formulada reproduce una certeza con- templada o vivida; cada hipótesis representa una duda espe- ranzada. Los actores de la odontología deberemos dar res- puestas a las preguntas que nos formula el siglo XXI porque "la salud global se construye mediante un préstamo que nos está haciendo el mañana" (AU)

In this reflection, I ask myself questions and situate den- tistry ­my dentistry­ in the global health scenario. Each ques- tion replicates a certainty that has been considered or expe- rienced, and each hypothesis expresses a hopeful doubt. As actors involved in dentistry, we will have to provide answers to the questions posed by the 21st century, because "global health is constructed based on time being loaned to us by the future" (AU)

Artificial Intelligence Techniques: Analysis, Application, and Outcome in Dentistry-A Systematic Review.

OBJECTIVE: The objective of this systematic review was to investigate the quality and outcome of studies into artificial intelligence techniques, analysis, and effect in dentistry. MATERIALS AND METHODS: Using the MeSH keywords: artificial intelligence (AI), dentistry, AI in dentistry, neural networks and dentistry, machine learning, AI dental imaging, and AI treatment recommendations and dentistry. Two investigators performed an electronic search in 5 databases: PubMed/MEDLINE (National Library of Medicine), Scopus (Elsevier), ScienceDirect databases (Elsevier), Web of Science (Clarivate Analytics), and the Cochrane Collaboration (Wiley). The English language articles reporting on AI in different dental specialties were screened for eligibility. Thirty-two full-text articles were selected and systematically analyzed according to a predefined inclusion criterion. These articles were analyzed as per a specific research question, and the relevant data based on article general characteristics, study and control groups, assessment methods, outcomes, and quality assessment were extracted. RESULTS: The initial search identified 175 articles related to AI in dentistry based on the title and abstracts. The full text of 38 articles was assessed for eligibility to exclude studies not fulfilling the inclusion criteria. Six articles not related to AI in dentistry were excluded. Thirty-two articles were included in the systematic review. It was revealed that AI provides accurate patient management, dental diagnosis, prediction, and decision making. Artificial intelligence appeared as a reliable modality to enhance future implications in the various fields of dentistry, i.e., diagnostic dentistry, patient management, head and neck cancer, restorative dentistry, prosthetic dental sciences, orthodontics, radiology, and periodontics. CONCLUSION: The included studies describe that AI is a reliable tool to make dental care smooth, better, time-saving, and economical for practitioners. AI benefits them in fulfilling patient demand and expectations. The dentists can use AI to ensure quality treatment, better oral health care outcome, and achieve precision. AI can help to predict failures in clinical scenarios and depict reliable solutions. However, AI is increasing the scope of state-of-the-art models in dentistry but is still under development. Further studies are required to assess the clinical performance of AI techniques in dentistry.

O ensino da saúde pública na graduação em Odontologia no Brasil: uma revisão de literatura / Public health teaching in undergraduation courses in Dentistry in Brazil: a literature review

O Cirurgião-Dentista, no passado, era capacitado a trabalhar apenas com técnicas tradicionais e individualistas, em consultórios particulares. Na atualidade, as Instituições de Ensino Superior juntamente com as Diretrizes Curriculares Nacionais (DCNs) permitem que esses profissionais tenham a integração do ensino-serviço em Saúde Pública durante a sua formação acadêmica. O aprendizado da Saúde Pública a partir dos estágios supervisionados no Sistema Único de Saúde visa a qualidade da formação profissional. O objetivo deste estudo é relatar a importância do aprendizado de Saúde Pública na graduação em Odontologia. Trata-se de uma revisão bibliográfica baseada na literatura especializada, realizada através de consultas a artigos científicos selecionados, utilizando os bancos de dados online daPubMed, Lilacs e Bireme. Estudos evidenciam que as DCNs em Odontologia foram responsáveis pela elaboração de orientações sobre as políticas educacionais brasileiras, as quais se integraram com o sistema de Saúde Pública. As modificações ocorridas ao longo do processo histórico da formação dos Cirurgiões-Dentistas são benéficas, entretanto, ainda é considerada uma dificuldade para Instituições de Ensino Superior. O ensino-aprendizado da Saúde Pública para os alunos de graduação em Odontologia permite a formação do profissional com visão abrangente, possibilitando a construção do senso crítico, habilidades humanas e éticas sobre suas atividades profissionais na rede de serviço de saúde.

The Dental Surgeon, in the past, was able to work only with traditional and individualistic techniques in private offices. Currently, Higher Education Institutions and the National Curriculum Guidelines allow these professionals to integrate teaching-service in Public Health into their academic training. The learning of Public Health in the supervised intern-ships in the Unified Health System aims at elevating the quality of professional training. The objective is to report the importance of Public Health learning in undergraduate den-tistry courses. This is a bibliographic review based on specialized literature and carried out through consultations of selected scientific articles using the online databases PubMed, Li-lacs, and Bireme. Studies show that the National Curricular Guidelines in Dentistry were responsible for elaborating guidelines on Brazilian educational policies integrated with the Public Health System. Changes that occurred during the historical process of the Dental Surgeons formation are beneficial; however, it is still considered a difficulty for Higher Education Institutions. Teaching-learning of Public Health for undergraduate students in Dentistry allows the training of professionals with an in-depth view, enabling the construc-tion of a critical sense and human and ethical skills about their professional activities in the health service network.

Dental Challenges and the Needs of the Population during the Covid-19 Pandemic Period. Real-Time Surveillance Using Google Trends.

BACKGROUND: The outbreak of the COVID-19 pandemic may lead to changes in the dental needs of the population and new challenges concerning oral health care. METHODS: The Google Trends tool was used to collect data on the Internet search interest. The investigated material was collected from 1 January 2020 to 23 August 2020. Search terms "toothache", "dentist" and "stay at home" were retrieved for the whole world as well as for the US, the UK, Poland, Italy and Sweden. RESULTS: During the lockdown, correlation analysis indicates the lowest public interest in the word "dentist" one week preceding the peak for "toothache", followed by an increase in the word search for "dentist". On 12 April, worldwide, the maximum of Google Trends Relative Search Volume (RSV) for "toothache" was observed. CONCLUSION: Decrease in "dentist" queries during lockdown followed by an increase in "toothache" search predicts greater dental needs in the post-pandemic period. The surveillance shows significant changes in queries for dental-related terms during the course of the COVID-19 pandemic. In order to prepare for future pandemic outbreaks teledentistry programs should be taken into consideration.

Legislación y Normas Atingentes a la Atención Odontológica y el COVID-19. Una Perspectiva Desde las Clínicas Universitarias / Lesgislation and Norms Related to Dental Care and the COVID-19. A Perspective from University Clinics

RESUMEN: La enfermedad por coronavirus 2019 (COVID-19) es una enfermedad infecciosa causada por el Coronavirus 2 del Síndrome Respiratorio Agudo Grave (SARS-CoV-2). La mayoría de los pacientes infectados con SARS-CoV-2 tiene una evolución asintomática o leve. Sin embargo, una parte de los infectados presentará un deterioro en su condición de salud, desarrollando una neumonía aguda grave, que puede producir la muerte. Las personas vinculadas a las clínicas odontológicas están en riesgo de infección por SARS-CoV-2, pues la saliva es un importante método de transmisión del virus. Por su naturaleza, la atención odontológica se realiza a corta distancia del paciente, con constante exposición a saliva, sangre y otros fluidos corporales, y es frecuente el manejo de instrumentos cortopunzantes. Por consiguiente, los elementos de protección personal cobran gran importancia y las reglamentaciones de la autoridad sanitaria en el contexto de la pandemia que actualmente se vive deben cumplirse a cabalidad, debido a obligaciones éticas y legales. En esta revisión narrativa se revisa y discute la reglamentación de la autoridad sanitaria que involucra las prestaciones odontológicas en el contexto del COVID-19, cómo se aplicará en las clínicas universitarias y cómo complementar la normativa con la evidencia científica disponible.

ABSTRACT: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by Coronavirus 2 of Severe Acute Respiratory Syndrome (SARS-CoV-2). The majority of patients infected with SARS-CoV-2 have an asymptomatic or mild evolution. However, a part of those infected will present a deterioration in their health condition, developing severe acute pneumonia, which can lead to death. People linked to dental clinics are at risk of SARS-CoV-2 infection, since saliva is an important method of transmission of the virus. Due to its nature, dental care is performed at a short distance from the patient, with constant exposure to saliva, blood and other body fluids, and the use of sharp instruments is frequent. Consequently, the elements of personal protection are very important and the regulations of the health authority in the context of the current pandemic must be fully complied with, due to ethical and legalobligations. This narrative review reviews and discusses the regulation of the health authority that involves dental services in the context of COVID-19, how it will be applied in university clinics and how to complement the regulations with the available scientific evidence.

Perception of Dental Students of COMS-TH regarding Future of Dentistry in Nepal amid COVID-19 Pandemic.

INTRODUCTION: There is a global crisis which has been led by COVID-19. The patients undergoingdental procedures and dental professionals are at higher risk of contracting this disease owing toaerosols generated and a lot of face to face contact during the procedures. The aim of this study was to know the perceptions of dental students of COMS-TH regarding future of dentistry in Nepal amidCOVID-19 pandemic. METHODS: The present cross-sectional descriptive study was conducted at COMS-TH, Bharatpur by sending an online e-survey questionnaire to 146 dental students out of which 99 responded. The e-survey questionnaire consisted of three parts which consisted of questions about demographics, knowledge about COVID-19 and their perceptions about future of dentistry. RESULTS: The results of the study depicted that most of the students thought dentistry is good and noble profession and will recommend it to young medical aspirants. Most of them wanted to pursue post graduation courses in future giving preference to Oral and Maxillofacial Surgery. CONCLUSIONS: The study concluded that most of the dental students were satisfied with dentistry as their profession and wanted National Dental Association to fix the minimum charges of each dental procedure. Also there is a need to start more post graduation courses in existing institutions providing dental education as most of the students want to pursue it in future.

Current herbal medicine as an alternative treatment in dentistry: In vitro, in vivo and clinical studies.

Since the time that human population comprehended the importance of general health maintenance and the burden of disease, there has been a search for healing properties in the natural environment. Herbal medicine is the use of plants with medical properties for prevention and treatment of conditions that can affect general health. Recently, a growing interest has been observed toward the use of traditional herbal medicine alongside synthetic modern drugs. Around 80% of the population, especially in developing countries relies on it for healthcare. Oral healthcare is considered a major part of general health. According to the world health organization (WHO), oral health is considered an important part of general health and quality of life. The utilization of natural medications for the management of pathologic oro-dental conditions can be a logical alternative to pharmaceutical methods due to their availability, low costs, and lower side effects. The current literature review aimed at exploration of the variety and extent of herbal products application in oral health maintenance including different fields of oral healthcare such as dental caries, periodontal maintenance, microbial infections, oral cancers, and inflammatory conditions.

The ways of using machine learning in dentistry.

Innovative computer techniques are starting to be employed not only in academic research, but also in commercial production, finding use in many areas of dentistry. This is conducive to the digitalization of dentistry and its increasing treatment and diagnostic demands. In many areas of dentistry, such as orthodontics and maxillofacial surgery, but also periodontics or prosthetics, only a correct diagnosis ensures the correct treatment plan, which is the only way to restore the patient's health. The diagnosis and treatment plan is based on the specialist's knowledge, but is subject to a large, multi-factorial risk of error. Therefore, the introduction of multiparametric pattern recognition methods (statistics, machine learning and artificial intelligence (AI)) is a great hope for both the physicians and the patients. However, the general use of clinical decision support systems (CDSS) in a dental clinic is not yet realistic and requires work in many aspects - methodical, technological and business. The article presents a review of the latest attempts to apply AI, such as CDSS or genetic algorithms (GAs) in research and clinical dentistry, taking under consideration all of the main dental specialties. Work on the introduction of public CDSS has been continued for years. The article presents the latest achievements in this field, analyzing their real-life application and credibility.

Aplicação de práticas integrativas e complementares na odontologia / Application of complementary and integrative practices in dentistry

A incorporação de novas tecnologias e métodos para proporcionar um atendimento odontológico mais confortável, humano e menos invasivo, propiciou o uso de terapias alternativas e complementares em Odontologia. Objetivo: revisar a literatura e assim fornecer ao cirurgião-dentista maiores informações a respeito dos recursos alternativos e complementares utilizados no consultório odontológico. Materiais e Métodos: A pesquisa foi realizada utilizando termos Decs e operadores boleanos. As bases de dados consultadas foram Pubmed, Lilacs, Scielo e Google Scholar, no ano de 2020, e após aplicação dos critérios de elegibilidade, foram selecionados 65 estudos, dentre estudos clínicos randomizados e não-randomizados, estudos observacionais, revisões sistemáticas e não ­ sistemáticas. Resultados e Discussão: Destaca-se as terapias: Acupuntura, Crioterapia, Fitoterapia, Hipnose, Homeopatia, Laserterapia, Massoterapia, Musicoterapia, Ozonioterapia, Terapia fotodinâmica e Toxina Botulínica, nas suas diversas pluralidades de aplicação, não somente para a área odontológica, mas na integralização com diversos campos, atuando no físico e psíquico. Conclusão: Diante dos achados, pode-se concluir que grande parte das terapias complementares são bem empregadas em Odontologia. Entretanto, mais evidências científicas são essenciais para o desempenho de tais práticas. Isto as tornará eficazes e seguras, tanto na atenção à saúde em âmbito público, quanto privado, permitindo à população brasileira beneficiar-se das terapias como alternativas eficientes e de baixo custo.

The incorporation of new technologies and methods to provide a more comfortable, humane and less invasive dental care, favored the use of alternative and complementary therapies in Dentistry. Objective: to review the literature and thus provide the dentist with more information about alternative and complementary resources used in the dental office. Materials and Methods: The research was carried out using terms Decs and Boolean operators. The databases consulted were Pubmed, Lilacs, Scielo and Google Scholar, in 2020, and after applying the eligibility criteria, 65 studies were selected, among randomized and non-randomized clinical studies, observational studies, systematic reviews and non- systematic. Results and Discussion: Therapies stand out: Acupuncture, Cryotherapy, Phytotherapy, Hypnosis, Homeopathy, Laser Therapy, Massage Therapy, Music Therapy, Ozone Therapy, Photodynamic Therapy and Botulinum Toxin, in their diverse application areas, not only in the dental field, but in integration with several fields, working in the physical and psychic. Conclusion: Given the findings, it can be concluded that most complementary therapies are well used in dentistry. However, more scientific evidence is essential for the performance of such practices. This will make them effective and safe, both in public and private health care, allowing the Brazilian population to benefit from therapies as efficient and low-cost alternatives.

Regeneración ósea como un ejemplo de ingeniería tisular en odontología, con énfasis en el desarrollo de los andamios / Regeneração óssea como exemplo de engenharia de tecidos em odontologia, com ênfase no desenvolvimento de andaimes / Bone regeneration as an example of tissue engineering in dentistry, with an emphasis on the development of scaffolds

Resumen La ingeniería tisular es un área científica multidisciplinaria la cual tiene como finalidad terapéutica restaurar, sustituir o incrementar las actividades funcionales de los tejidos orgánicos. Objetivos: Realizar una revisión de la literatura sobre la ingeniería tisular a nivel del área bucomaxilofacial. Métodos: Se realizó una búsqueda bibliográfica mediante los portales PubMed MEDLINE, Google Scholar, y LILACS, usando los términos "células madre, regeneración ósea y factores de crecimiento tisular". Resultados: Se obtuvieron 193 resultados positivos, de los cuales 24 se utilizaron para el desarrollo del presente trabajo. Discusión: Han sido expuestos varios biomateriales capaces de propiciar la neoformación ósea, siendo esencial su correcta manipulación, la conformación de una arquitectura adecuada y la sinergia de las diversas propiedades. Conclusiones: Los andamios son los que brindan mayor oferta para su uso y la elección de cada uno de ellos no depende del material en sí mismo.

Resumo: A engenharia de tecidos é uma área científica multidisciplinar cujo objetivo é restaurar, substituir e aumentar as atividades funcionais dos tecidos orgânicos. Objetivos: O objetivo deste trabalho é revisar a literatura sobre engenharia de tecidos no nível da área bucomaxilofacial. Métodos: Foi realizada uma pesquisa bibliográfica no portals PubMed MEDLINE, Google Scholar, e LILACS, utilizando os termos "células-tronco, regeneração óssea e fatores de crescimento tecidual". Resultados: foram obtidos 193 resultados positivos, dos quais 24 foram utilizados para o desenvolvimento deste trabalho. Discussão: Vários biomateriais capazes de promover a neoformação óssea foram expostos, sendo sua manipulação correta, a conformação de uma arquitetura adequada e a sinergia das várias propriedades. Conclusões: são os andaimes que oferecem a melhor oferta para seu uso e a escolha de cada um não depende do material propriamente dito.

Abstract Tissue engineering is a multidisciplinary scientific area that has the therapeutic purpose of restoring, replacing, or increasing the functional activities of organic tissues. Objective: This work aims to review the literature on tissue engineering in oral and maxillofacial procedures. Methods: A bibliographic search was conducted in PubMed MEDLINE, Google Scholar, and LILACS, using the terms "stem cells," "bone regeneration," and "tissue growth factors." Results: In total, 193 positive results were obtained, of which 24 were used for this paper. Discussion: Several biomaterials capable of promoting bone neoformation have been described. They need to be adequately manipulated and have the right architecture and achieve the synergy of the various properties. Conclusions: Scaffolds have the widest uses, and selecting one does not depend on the material itself.

COVID-19: a new turning point for dental practice

Abstract Recent new zoonotic respiratory viruses have infected humans and led to severe acute respiratory syndrome: severe acute respiratory syndrome coronavirus (SARS-CoV), influenza A H5N1, influenza A H1N1 and Middle East respiratory syndrome coronavirus (MERS-CoV). The first SARS-CoV outbreak took place in 2003, in Guangdong, China. A decade later, another pathogenic coronavirus, MERS-CoV caused an endemic in Middle Eastern countries. The latest pandemic coronavirus infectious disease (COVID-19) has been related to the newly isolated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). For the first time since the acquired immunodeficiency syndrome (AIDS) in the 1980s. Dentistry is facing a new turning point. This critical review aims to discuss the impact of COVID-19 infection on oral health care. In dental practice COVID-19 patients are the main source of infection and symptomatic patients are more contagious. Dentists can be first line of diagnosis of the disease, as they work in close contact with patients and are at the risk of being affected by COVID-19 and all respiratory infections. Several guidelines for dental practice environments have been published by dental associations and regulatory boards. It is already evident that biological, psychological and social effects of the COVID-19 pandemic have present and future impacts on dental practice. Dental schools, regulatory boards, scientific associations, government authorities, and public and private health care services must join efforts to design enduring answers for severe and long-standing viral challenges.

Small molecule GSK-3 antagonists play a pivotal role in reducing the local inflammatory response, in promoting resident stem cell activation and in improving tissue repairing in regenerative dentistry.

Regenerative dentistry is attracting growing interest in the scientific community, mainly because of its translational and promising therapeutic approach. The latest research carried out by the scientific community are aimed at triggering the local cellular response, in order to induce a physiological self-repairing of damaged oral tissues. Such physiological processes mainly involve the activation of local stem cell populations: mesenchymal stem cells, in fact, retain the ability to proliferate and to differentiate towards functional mature elements, thus leading towards healing of damaged tissues. Glycogen Synthase Kinase-3 (GSK-3) is a key-regulator of the Wnt/ß-catenin pathway; it phosphorylates ß-catenin, that then is degraded in the cytosol. The activation of such signalling, mediated by Wnt ligand/receptor association, inhibits GSK-3, leading to translocation of ß-catenin to the nucleus and to gene transcription. Selective inhibitors of GSK-3 have been linked to the activity of Wnt signalling and to the regeneration of injured tissues, including complex dental and oral structures. Small Molecule GSK-3 Antagonists are the most interesting class of molecules acting with a "Bystander effect": reducing local inflammation and local bone resorption and triggering the activity and differentiation of resident "sleeping" MSCs. The aim of this narrative topical review is to describe the current knowledge on the role of small molecule GSK-3 antagonists in regenerative dentistry, with strategic insights towards the translational applications in nanomaterials in dentistry and in dental repairing.

Matrix metalloproteinases and inhibitors in dentistry.

OBJECTIVES: Matrix metalloproteinase (MMP) expression has been associated with tissue development, invasive cancer cell behavior, and inflammation. The associations of increased expression of MMPs with diseases have led to intensive research activities to develop MMP inhibitors. Here, the questions are addressed which associations between increased levels of any MMP with dental diseases may be cause or consequence, whether MMP levels may be of diagnostic value and whether and which MMP inhibitors need further investigations for use in dental diseases. METHODS: To study the role of MMPs and to discriminate between cause or consequence, the literature about measurements of MMPs and about the use of inhibitory drugs and genetic knockout animal models in dentistry was compared. RESULTS: The only FDA-approved treatment with MMP inhibitors is tetracyclines for periodontitis, whereas a diagnostic test for activated MMP-8 in oral fluids is valued in practical periodontology. The MMP literature in dentistry is artificially skewed to the gelatinases MMP-2 and MMP-9 and to enamelysin, alias MMP-20. The basis for this observation is, respectively, the widely used and sensitive technique of gelatin zymography and enamel proteins as substrates of MMP-20. Studies on additional MMPs are gaining interest in dentistry and MMP inhibitors may provide new applications. In addition, drugs with proven effects for the treatment of dental diseases may be found to act through MMP inhibition. CONCLUSION AND RELEVANCE: In conclusion, research on MMPs and inhibitors may provide practical applications beyond diagnosis and treatment of periodontitis and will be, directly or indirectly, beneficial for patients with dental or periodontal diseases.

Stem Cells for the Oromaxillofacial Area: Could they be a promising source for regeneration in dentistry?

Oromaxillofacial tissues (OMT) are composed of tooth and bone, together with nerves and blood vessels. Such a composite material is a huge source for mesenchymal stem cells (MSCs) that can be obtained with ease from extracted teeth, teeth structures and socket blood, flapped gingiva tissue, and mandibular/maxillar bone marrow. They offer a biological answer for restoring damaged dental tissues such as the regeneration of alveolar bone, prevention of pulp tissue defects, and dental structures. Dental tissue-derived mesenchymal stem cells share properties with bone marrow-derived mesenchymal stem cells and there is a considerable potential for these cells to be used in different stem cell-based therapies, such as bone and nerve regeneration. Dental pulp tissue might be a very good source for neurological disorders whereas gingiva-derived mesenchymal stem cells could be a good immune modulatory/suppressive mediators. OMT-MSCs is also promising candidates for regeneration of orofacial tissues from the perspective of developmental fate. Here, we review the fundamental biology and potential for future regeneration strategies of MSCs in oromaxillofacial research.