Application of dental chairside evidence-based medicine for the treatment temporomandibular osteoarthritis / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To obtain an evidence-based treatment for an adolescent patient with temporomandibular osteoarthritis.</p><p><b>METHODS</b>The detailed history of an adolescent patient with temporomandibular osteoarthritis was analysed. Clinical Evidence (to Dec 2010), National Guideline Clearinghouse (2000-Dec 2010), Cochrane Library (Issue 4, 2010), MEDLINE(OVID, 1950-Dec 2010) and China Biology Medicine Database (1978-Dec 2010) were searched to obtain evidence such as clinical guidelines, systematic reviews and randomized controlled trials related to surgery or conservative treatment to temporomandibular osteoarthritis to find a personal treatment strategy for the patient.</p><p><b>RESULTS</b>Five articles were finally included, i.e. 1 clinical guideline, 3 systematic reviews and 1 randomized controlled trials. These evidence showed that: Conservative treatment like intra-articular injection instead of surgery should be adopted for adolescent patient; hyaluronate is the drug with sufficient evidence in supporting its use in treating temporomandibular disorders; inferior temporomandibular joint cavity injection or both upper and lower cavity injection has better effect than that of superior cavity injection only; and there was some evidence to support the use of glucosamine to treat temporomandibular disorders. Considering the situation of the case and the clinical evidence, an individual treatment plan of hyaluronate injection into the upper and lower cavity and glucosamine take orally was established. A long-term follow-up of 6 months showed a good treatment outcome.</p><p><b>CONCLUSION</b>Through the evidence-based methods and the use of clinical evidence, an individual treatment plan could be established for each patient with temporomandibular disorders, and this will provide strong supporting to the treatment of temporomandibular disorders. Up to now, it is clear that hyaluronate injection into the upper and lower cavity with glucosamine administration is effective in treating temporomandibular osteoarthritis.</p>

Cloning culture of submandibular gland stem/progenitor cells in vitro isolated from damaged gland tissue / 中国组织工程研究

BACKGROUND: Seed cells with good proliferation and enough amounts are need in reconstructing artificial salivary gland in vitro. However, adult stem cells are difficult to be isolated from normal submandibular gland.OBJECTIVE: To in vitro isolate submandibular gland stem/progenitor cells for cloning culture using animal models of damaged gland tissue.DESIGN, TIME AND SETTING: Cytological in vitro experiment was performed at the Gu.izhou Provincial Key Laboratory of Cell Tissue Engineering, Zunyi Medical College from March 2006 to January 2007.MATERIALS: A total of 10 male Sprague Dawley rats aged 8 weeks were supplied by the Animal Center, Third Military Medical University of Chinese PLA.METHODS: The model of tissue damaged submandibular gland in 10 rats was made by deligation. One week later, the gland tissue was obtained to harvest submandibular gland stem/progenitor cells by enzyme digestion in vitro. Following 10-14 days of primary culture, small round cells were collected, purified and subcultured for monoclonal culture.MAIN OUTCOME MEASURES: Immunocytochemical staining and immunofluorescence staining results were measured in submandibular gland stem/progenitor cells. Growth curve was drawn to analyze the proliferation of submandibular gland stem/progenitor cells in vitro.RESULTS: Cells expressing laminin showed stem cell characteristics. Positive expression of CD29 suggested high-adherent and high-proliferative stem cell properties. Positive expression of keratin-19 indicated epithelium-derived submandibular gland stem/progenitor cells. Growth curve was near to "S" shape, and in vitro culture and proliferation was active.CONCLUSION: Submandibular gland stem/progenitor cells had the characteristics of tissue stem cells. They might be as a kind of seed cells for tissue engineered artificial salivary gland in further research.

Biocompatibility of acellular tracheae as scaffold for artificial salivary gland organoid / 中国组织工程研究

BACKGROUND: An important initial step in developing a tissue engineering artificial salivary gland organoid is to find an ideal scaffold. To find other new biomaterials should to be further studied.OBJECTIVE: To obtain an acellular matrix from tracheae of rabbits and SD rats, and to investigate its biocompatibility as a primary step toward developing a tissue engineering artificial salivary gland organoid.DESIGN, TIME AND SETTING: A randomized controlled animal study, which was performed at the Key Laboratory of Transplantation Engineering and Immunology of Ministry of Health, West China Hospital of Sichuan University from February 2003 to May 2005.MATERIALS: A modified detergent and enzyme link extraction procedure was performed to remove cells from SD rats and rabbits tracheae. The histology, topography of inner-surface and biocompatibility were studied on both acellular tracheae.METHODS: Eighteen SD rats were randomly divided into 2 groups. One group was planted acellular trachea of SD rats. Other group consisted of acellular trachea of rabbits. On the third generations, submandibular gland cells were inoculated on two acellular tracheae and cultured on PGA membrane; while, cells in the control group were inoculated on 12-well culture plate, and cell/scaffold complex was cultured at the same time.MAIN OUTCOME MEASURES: The structure and topography of inner-surface of the acellular tracheae matrixes were observed both by light and scanning electron microscopy. The inflammatory response of the tissue around acellular tracheae implanted under the skin of cheek was evaluated at 1, 4, 12 weeks. The numbers of cells grown on the acellular tracheae and PGA film were counted at 1, 2, 3, 4, 5, 6, 7 days. At 1, 3, 5, 7 days, the mean values of metabolic activity test and the amylase activities of supernatants of the cells/scaffold complexes were examined.RESULTS: The cells were completely removed from both tracheae. No evident inflammatory response was found in tissues around two kinds of acellular tracheae implanted under the skin of cheek. The number of submandibular gland cells (SSG) grown on the two kinds of naturally derived biomaterials was much more than grown on PGA (P<0.05). The mean values of metabolic activity test and the amylase activities of supernatants containing cell/acellular matrixes were much higher than that of cell/PGA (P<0.05).CONCLUSION: The acelhilar tracheae matrixes made by our laboratory can be used as scaffold in the study of tissue engineering artificial salivary gland organoid.