RESUMEN
BACKGROUND AND OBJECTIVES: Hertwig's epithelial root sheath (HERS) plays a role in root dentin formation. It produces the epithelial rests of Malassez (ERM) for the induction of periodontal tissue development during root formation. Although ERM is thought to be caused by epithelial-mesenchymal transition (EMT), the mechanism by which HERS is maintained as epithelium is unknown. Here, we aimed to elucidate the molecular mechanisms regulating the relationship between HERS maintenance and ERM development. METHODS: To understand the relationship between HERS and ERM development during root formation, we observed the developing molar root using cytokeratin14 (CK14) Cre/tdTomato mice via stereomicroscopy. The relationship between semaphorin and transforming growth factor (TGF) signaling in the maintenance of HERS and ERM development was examined using CK14cre/R26-tdTomato mice and a HERS cell line. RESULTS: tdTomato-positive cells were observed on HERS and the migrating cells from HERS. The migrating cells showed reduced E-cadherin expression. In contrast, HERS cells expressed semaphorin receptors and active RhoA. Semaphorin signaling was associated with RhoA activation and cell-cell adhesion, while TGF-ß induced decreased E-cadherin and active RhoA expression, and consequently enhanced cell migration. CONCLUSION: HERS induces root formation by controlling epithelial maintenance and EMT through the opposing effects of semaphorin and TGF-ß signaling.
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Transición Epitelial-Mesenquimal , Factor de Crecimiento Transformador beta , Femenino , Ratones , Animales , Factor de Crecimiento Transformador beta/farmacología , Células Epiteliales , Raíz del Diente/fisiología , Cadherinas/metabolismoRESUMEN
In the course of a lifetime the crowns of teeth wear off, cementum thickens and the pulp closes-in or may stiffen. Little is known about how these changes affect the tooth response to load. Using a series of finite element models of teeth attached to the jawbone, and by comparing these to a validated model of a 'young' pig 3-rooted tooth, the effects of these structural changes were studied. Models of altered teeth show a stiffer response to mastication even when material properties used are identical to those found in 'young' teeth. This stiffening response to occlusal loads is mostly caused by the thicker cementum found in 'old' teeth. Tensile stresses associated with bending of dentine in the roots fall into a narrower distribution range with lower peak values. It is speculated that this is a possible protective adaptation mechanism of the aging tooth to avoid fracture. The greatest reduction in lateral motion was seen in the bucco-lingual direction. We propose that greater tooth motion during mastication is typical for the young growing animal. This motion is reduced in adulthood, favoring less off-axis loading, possibly to counteract natural bone resorption and consequent compromised anchoring.
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Envejecimiento/fisiología , Cemento Dental/fisiología , Masticación/fisiología , Movilidad Dentaria/fisiopatología , Raíz del Diente/fisiología , Animales , Simulación por Computador , Análisis de Elementos Finitos , Maxilares/fisiología , Modelos Biológicos , Diente Molar/fisiología , Porcinos , Raíz del Diente/fisiopatologíaRESUMEN
This study evaluated the outcome of partial exposure of dentin matrix to ethylenediaminetetraacetic acid (EDTA) and application of platelet-rich fibrin (PRF) scaffold on regeneration of necrotic immature permanent teeth in a dog model. The present study was carried out on 216 permanent immature roots in nine mongrel dogs aged 6-9 months. Pulp necrosis and periapical pathosis were induced in 180 roots. These roots were divided into five equal groups (36 roots each) according to the treatment protocol: group I: blood clot; group II: 17% EDTA solution and blood clot; group III: PRF; group IV: 17% EDTA solution and PRF; and group V: without treatment (positive control). The negative control group (group VI) represented 36 untouched normal roots for normal maturation. The groups were followed up for 1, 2 and 3 months (subgroups). Maturation of the roots was monitored by radiography and histopathology. All data were statistically analysed. Group IV exhibited the highest increase in root length and thickness, decrease in apical diameter, the highest score of vital tissue infiltration and least inflammatory scores. There was a significant difference regarding the increase in root length and thickness and decrease in apical diameter in all subgroups of the experimental and negative control groups (P ≤ .05). PRF has a better regenerative potential than the blood clot during treatment of immature permanent teeth with necrotic pulp. Inclusion of 17% EDTA solution as a final irrigation enhances the regenerative potential of both PRF and blood clot.
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Dentina/fisiología , Ácido Edético/farmacología , Andamios del Tejido , Animales , Pulpa Dental/fisiología , Necrosis de la Pulpa Dental , Modelos Animales de Enfermedad , Perros , Femenino , Humanos , Masculino , Odontoblastos/fisiología , Fibrina Rica en Plaquetas/fisiología , Regeneración , Ingeniería de Tejidos , Raíz del Diente/fisiologíaRESUMEN
BACKGROUND: This study evaluated the antibacterial efficiency and ability of propolis to promote regeneration of immature permanent non-vital dogs' teeth. METHODS: Ninety six immature permanent premolars teeth in 6 mongrel dogs were divided randomly into: experimental teeth (N = 72) and control teeth (N = 24). Periapical pathosis was induced in all experimental and positive control teeth. Experimental teeth were classified according to the used intra-canal medication into: group I (N = 36), propolis paste was used and group II (N = 36), triple antibiotic paste (TAP) was used. Bacteriologic samplings were collected before and after exposure to intra-canal medicaments. After the disinfection period (3 weeks), revascularization was induced in all experimental teeth. Each group was subdivided according to the root canal orifice plug into: subgroup A (N = 18), propolis paste was used and subgroup B (N = 18), mineral trioxide aggregates (MTA) was used. Each subgroup was further subdivided according to the evaluation period into 3 subdivisions (6 teeth each): subdivision 1; after 2 weeks, subdivision 2; after one month and subdivision 3; after 2 months. Positive control group had 12 teeth with induced untreated periapical pathosis. Negative control group had 12 untouched sound teeth. All teeth were evaluated with radiography and histology. The bacteriologic and radiographic data were analyzed using repeated measures ANOVA and post-hoc Tukey tests. The histologic data were analyzed using Kruskal-Wallis test, Mann-Whitney U test with Bonferroni's adjustment and Chi-square test. The significance level was set at P ≤ .05. RESULTS: There was no significant difference in the antibacterial effectiveness between TAP and propolis groups (P > .05). In all subdivisions, there was no significant difference between the experimental groups in terms of increase in root length and dentin thickness, decrease in apical closure, new hard tissue formation, vital tissue formation inside the pulp canal and apical closure scores (P > .05). CONCLUSION: Propolis can be comparable with TAP as a disinfection treatment option in regenerative endodontic. As a root canal orifice plug after revascularization of necrotic immature permanent teeth in dogs, propolis induces a progressive increase in root length and dentin thickness and a decrease in apical diameter similar to those of MTA.
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Antibacterianos/administración & dosificación , Necrosis de la Pulpa Dental/tratamiento farmacológico , Pulpa Dental/efectos de los fármacos , Dentina/efectos de los fármacos , Própolis/administración & dosificación , Endodoncia Regenerativa/métodos , Tratamiento del Conducto Radicular/métodos , Raíz del Diente/efectos de los fármacos , Animales , Antibacterianos/uso terapéutico , Pulpa Dental/irrigación sanguínea , Pulpa Dental/fisiología , Dentina/irrigación sanguínea , Dentina/fisiología , Perros , Tejido Periapical/irrigación sanguínea , Tejido Periapical/efectos de los fármacos , Tejido Periapical/fisiología , Própolis/uso terapéutico , Distribución Aleatoria , Irrigantes del Conducto Radicular/uso terapéutico , Ápice del Diente/patología , Raíz del Diente/irrigación sanguínea , Raíz del Diente/fisiología , Resultado del TratamientoRESUMEN
INTRODUCTION: This study evaluated free water loss-induced residual strain with and without axial compressive loading and assessed the mechanical effect of cyclic loading in fully hydrated and partially dehydrated root dentin. METHODS: Root dentin sections prepared from freshly extracted human premolars were used. Customized 3-dimensional digital image correlation was used to qualitatively and quantitatively analyze the residual strain induced by 2 hours of free water loss in different regions of root dentin. Residual strain in partially dehydrated root dentin during axial compressive loading was also analyzed using 3-dimensional digital image correlation. The effect of cyclic loading on load to fracture in fully hydrated and partially dehydrated dentin and their fractography were analyzed using micro-computed tomographic imaging. RESULTS: Free water loss resulted in a heterogeneous distribution of residual strain and an overall formation of residual compressive strain with areas of tensile strain localized to the root canal and outer dentin. More residual compressive strain was observed in the apical dentin compared with the cervical dentin (P < .05), and more residual shear strain was observed in outer dentin compared with inner dentin (P < .05). Axial loading resulted in an increase in the load-induced compressive strain in the direction perpendicular to dentinal tubules (P < .05). Fully hydrated roots displayed a higher mean (P < .05) and median (P < .05) number of cycles to fracture with microcracks characteristic of toughness. CONCLUSIONS: After free water loss, root dentin displayed an increased formation of heterogenous residual strain, which resulted in increased axial compressive load-induced strain and a decreased resistance to fatigue failure. The effect of free water loss in the loss of mechanical integrity of root-filled teeth needs further investigation.
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Tratamiento del Conducto Radicular , Raíz del Diente , Agua , Diente Premolar , Dentina , Humanos , Raíz del Diente/fisiología , Agua/fisiologíaRESUMEN
A stem cell-mediated bioengineered tooth root (bio-root) has proven to be a prospective tool for the treatment of tooth loss. As shown in our previous studies, dental follicle cells (DFCs) are suitable seeding cells for the construction of bio-roots. However, the DFCs which can only be obtained from unerupted tooth germ are restricted. Stem cells from human exfoliated deciduous teeth (SHEDs), which are harvested much more easily through a minimally invasive procedure, may be used as an alternative seeding cell. In this case, we compared the odontogenic characteristics of DFCs and SHEDs in bio-root regeneration. Methods: The biological characteristics of SHEDs and DFCs were determined in vitro. The cells were then induced to secrete abundant extracellular matrix (ECM) and form macroscopic cell sheets. We combined the cell sheets with treated dentin matrix (TDM) for subcutaneous transplantation into nude mice and orthotopic jaw bone implantation in Sprague-Dawley rats to further verify their regenerative potential. Results: DFCs exhibited a higher proliferation rate and stronger osteogenesis and adipogenesis capacities, while SHEDs displayed increased migration ability and excellent neurogenic potential. Both dental follicle cell sheets (DFCSs) and sheets of stem cells from human exfoliated deciduous teeth (SHEDSs) expressed not only ECM proteins but also osteogenic and odontogenic proteins. Importantly, similar to DFCSs/TDM, SHEDSs/TDM also successfully achieved the in vivo regeneration of the periodontal tissues, which consist of periodontal ligament fibers, blood vessels and new born alveolar bone. Conclusions: Both SHEDs and DFCs possessed a similar odontogenic differentiation capacity in vivo, and SHEDs were regarded as a prospective seeding cell for use in bio-root regeneration in the future.
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Tratamiento Basado en Trasplante de Células y Tejidos/métodos , Saco Dental/citología , Dentina/química , Osteogénesis/fisiología , Trasplante de Células Madre/métodos , Raíz del Diente/citología , Adolescente , Animales , Diferenciación Celular/efectos de los fármacos , Proliferación Celular/efectos de los fármacos , Niño , Coristoma , Mezclas Complejas/farmacología , Saco Dental/efectos de los fármacos , Saco Dental/fisiología , Matriz Extracelular/metabolismo , Femenino , Humanos , Masculino , Ratones , Ratones Desnudos , Osteogénesis/efectos de los fármacos , Ligamento Periodontal/citología , Ligamento Periodontal/efectos de los fármacos , Ligamento Periodontal/fisiología , Cultivo Primario de Células , Ratas , Ratas Sprague-Dawley , Regeneración/efectos de los fármacos , Regeneración/fisiología , Células Madre/citología , Células Madre/efectos de los fármacos , Células Madre/fisiología , Técnicas de Cultivo de Tejidos , Raíz del Diente/fisiología , Raíz del Diente/cirugía , Diente Primario/citología , Diente Primario/fisiología , Diente Primario/cirugía , Trasplante Heterólogo , Adulto JovenRESUMEN
INTRODUCTION: The aim of this study was to compare different corticotomy approaches and determine their biomechanical effects on rate of canine displacement when compared to conventional orthodontics. METHOD: Three-dimensional Finite Element Models with conventional non-corticotomy approach (model 1) and three corticotomy approaches ensuing buccal and palatal vertical cuts (model 2), interseptal bone reduction (model 3), buccal vertical cuts (model 4) were fabricated. Displacement of the canine and von Mises stresses in the canine and trabecular bone were calculated and compared under a distal retraction force of 1.5N. RESULTS: The maximum displacement of canine with minimum anchorage loss was seen in model 3 followed by model 2, model 4 and model 1. The maximum equivalent (von Mises) stress was concentrated mainly on the distal side of canine in model 3 and had a uniform distribution of stresses on entire root surface. CONCLUSIONS: Corticotomy approaches effectively accelerated maxillary canine retraction, exhibiting twice the rate of canine movement with minimum anchorage loss when compared to non-corticotomy approach. Corticotomy with interseptal bone reduction was most effective in terms of canine displacement and stress distribution.
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Diente Canino/fisiología , Análisis del Estrés Dental , Análisis de Elementos Finitos , Imagenología Tridimensional/métodos , Técnicas de Movimiento Dental/métodos , Proceso Alveolar/fisiología , Fenómenos Biomecánicos , Hueso Esponjoso , Simulación por Computador , Humanos , Maxilar , Modelos Dentales , Métodos de Anclaje en Ortodoncia , Diseño de Aparato Ortodóncico , Soportes Ortodóncicos , Cierre del Espacio Ortodóncico/métodos , Alambres para Ortodoncia , Osteotomía/métodos , Ligamento Periodontal , Estrés Mecánico , Técnicas de Movimiento Dental/instrumentación , Raíz del Diente/fisiologíaRESUMEN
INTRODUCTION: Histologic examination of teeth after regenerative endodontic treatment (RET) shows that the type, quality, and quantity of tissues formed in the root canal space are not predictable. The aim of this study was to examine clinically, radiographically, and histologically the outcome of RET in immature noninfected human teeth using SynOss Putty (Collagen Matrix Inc, Oakland, NJ) as a scaffold. METHODS: Three pairs of maxillary/mandibular first premolars in 3 patients scheduled for extraction were included. Sensibility tests confirmed the presence of vital pulps. After informed consent, anesthesia, and rubber dam isolation, the pulps were removed. RET was performed using the following scaffolds: SynOss Putty + blood in both teeth in patient #1, SynOss Putty with or without blood in patient #2, and SynOss Putty + blood or blood only in patient #3. After a follow-up period of 2.5-7.5 months, the teeth were clinically and radiographically evaluated, extracted, and examined histologically. RESULTS: Patients remained asymptomatic after treatment. Radiographic examination of the teeth showed signs of root development after treatment. In teeth treated with SynOss Putty + blood, histologic examination showed formation of intracanal mineralized tissue around the scaffold particles solidifying with newly formed cementumlike tissue on the dentinal walls. The tooth treated with SynOss Putty without blood showed the formation of a periapical lesion. The tooth treated with a blood clot only showed tissues of periodontal origin growing into the root canal space. CONCLUSIONS: SynOss Putty + blood showed a predictable pattern of tissue formation and mineralization when used as a scaffold for RET in human immature noninfected teeth. The newly formed mineralized tissue solidifies with newly formed cementum on the dentinal walls.
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Colágeno , Cavidad Pulpar/fisiología , Dentina/fisiología , Durapatita , Regeneración Tisular Guiada Periodontal/métodos , Radiografía Dental , Regeneración , Endodoncia Regenerativa/métodos , Andamios del Tejido , Raíz del Diente/fisiología , Diente no Vital/diagnóstico por imagen , Diente no Vital/patología , Niño , Cavidad Pulpar/diagnóstico por imagen , Dentina/diagnóstico por imagen , Femenino , Humanos , Masculino , Raíz del Diente/diagnóstico por imagen , Diente no Vital/fisiopatología , Resultado del TratamientoRESUMEN
BACKGROUND: Human dentin is a highly calcified tissue of mesenchymal origin with a heterogeneous structure. Its morphology is constantly remodelled throughout the life span of the tooth, as well as under the influence of external stimuli. OBJECTIVE: The aim of the present study was to obtain information about the thermal changes in the crown and root dentin specimens of vital and devitalized teeth. METHODS: The investigated samples were divided into 6 groups, depending on the patients' age and dentin location (crown, root). An additional group of endodontically treated teeth was created. The methods of choice were were combined thermal analysis (DTA-TG(DTG)-MS and gas chromatography-mass spectrometry. RESULTS: After heating up to 1200 °C, endo- and exothermal effects were observed. The effects' dynamic was the same for all samples. The differences were in the samples' weight after the experiment, with root dentin showing the greatest mass loss percentage. CONCLUSIONS: The observed mass loss differences could be attributed to the presence of impurities in the dentin, as well as alterations in the collagen matrix. Ageing and endodontic treatment could catalyse the accumulation of such changes and affect the microstructure of the mineralized tissue.
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Envejecimiento , Dentina/fisiología , Dentina/fisiopatología , Diente no Vital/fisiopatología , Adulto , Calor , Humanos , Corona del Diente/fisiología , Corona del Diente/fisiopatología , Raíz del Diente/fisiología , Raíz del Diente/fisiopatologíaRESUMEN
INTRODUCTION: The latest research concerns the use of platelet concentrates, which are introduced into the root canal. The aim of this study was to examine the effectiveness of platelet-rich fibrin and platelet-rich plasma in regenerative endodontics. METHODS: This literature review was developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The literature search included all publications without a year limit. The last search was performed on January 31, 2018. An electronic search was performed using MEDLINE (PubMed), Cochrane, and Scopus. Articles were selected that addressed the following research question: Is the use of platelet concentrates effective in regenerative endodontics? The necessary information was extracted by 2 authors independently using a standardized form. RESULTS: The search resulted in 426 titles from all databases, and 26 studies met the inclusion criteria. Five were randomized trials, and the others were case reports. All described cases were asymptomatic. Only 3 cases from randomized trials were unsuccessful. Ten of the case reports found positive results for pulp vitality. In randomized trials, the teeth treated with platelet concentrates showed better results for pulp vitality. In almost all cases, they also described thickening and lengthening of the root wall and closure of the apical foramen, which are important for successful treatment of permanent teeth. CONCLUSIONS: This review showed that procedures using autologous platelet concentrates were successful in treating permanent teeth with root development. However, more long-term clinical studies are needed.
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Cavidad Pulpar , Fibrina Rica en Plaquetas , Plasma Rico en Plaquetas , Endodoncia Regenerativa/métodos , Raíz del Diente/fisiología , Plaquetas , Bases de Datos Bibliográficas , Humanos , Tratamiento del Conducto Radicular/métodos , Resultado del TratamientoRESUMEN
INTRODUCTION: Regeneration of the pulp-dentin complex is the penultimate goal of regenerative endodontic procedures (REPs). Histological outcomes have demonstrated reparative tissue formation in human teeth extracted post-REPs. However, lack of accurate characterization has precluded identification of the true nature of tissues formed post-REP. METHODS: Here, we present 2 case reports of tooth #29 and #9 treated with REPs and demonstrate their clinical, radiographic, and histological outcomes. RESULTS: Clinical outcomes revealed healing of apical periodontitis in both teeth and re-establishment of vitality responses in tooth #29. Moreover, radiographic assessments using 2D and 3D-volumetric analyses demonstrate considerable increase in root development for both teeth. Further, histological outcomes evaluated using Hematoxylin and Eosin and immunohistochemical staining demonstrates presence of vascular and lymphatic structures as well as immune cell markers indicative of regeneration of an immunocompetent pulp. Lastly, examination of hard tissue deposition shows dentin-like tissue in parts of tooth #29 demonstrating for the first time, regeneration of a pulp-dentin complex post-REP. CONCLUSIONS: Collectively, this is the first study demonstrating recapitulation of several tissues commonly found as part of a pulp-dentin complex in teeth treated with REPs.
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Pulpa Dental/fisiología , Dentina/fisiología , Periodontitis Periapical , Regeneración , Endodoncia Regenerativa/métodos , Raíz del Diente/fisiología , Niño , Pulpa Dental/diagnóstico por imagen , Pulpa Dental/inmunología , Pulpa Dental/inervación , Necrosis de la Pulpa Dental/terapia , Dentina/diagnóstico por imagen , Dentina/inmunología , Dentina/inervación , Femenino , Humanos , Imagenología Tridimensional , Regeneración Nerviosa , Periodontitis Periapical/diagnóstico por imagen , Periodontitis Periapical/patología , Periodontitis Periapical/fisiopatología , Periodontitis Periapical/terapia , Radiografía Dental , Raíz del Diente/diagnóstico por imagen , Raíz del Diente/inmunología , Raíz del Diente/inervación , Resultado del Tratamiento , Cicatrización de HeridasRESUMEN
To investigate the cause of mandibular implant loss, we evaluated the stress distribution in the bone under bite force when the miniimplant was near the root using three-dimensional finite element analysis. Our analysis involved four finite element models with different distances between the implant and adjacent tooth root and three loading conditions. With loading of the tooth only or both the tooth and implant, the peak stress within the bone around the implant neck, displacement, and stress surrounding the bone near the root increased as the distance between the implant and root decreased. However, with separate loading of the implant, the stress did not correlate with the distance between the implant and root. Application of bite force increases stress within bones surrounding mini-implants near the roots of adjacent teeth and may threaten implant stability, but simple orthodontic loading has little effect on the stress distribution at the mini-implant-bone interface.
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Fuerza de la Mordida , Interfase Hueso-Implante/fisiología , Implantes Dentales , Análisis de Elementos Finitos , Raíz del Diente/fisiología , Fenómenos Biomecánicos , Análisis del Estrés Dental , Módulo de Elasticidad , Humanos , Masculino , Mandíbula/diagnóstico por imagen , Miniaturización , Estrés Mecánico , Tomografía Computarizada Espiral , Adulto JovenRESUMEN
Mandibular volume and tooth root volumes were shown to increase at different rates at locations containing the roots of the canine (C) and mesial and distal roots of the first molar (M1). Thirty-six dogs were included in this study. Data were generated using computed tomography at locations of the mandible involving the roots of the C and M1 teeth. Software was used to trace the external surface of the mandible, calculating the volume of the mandible at each location. Similar techniques were used to trace and calculate the volume of the C and M1 roots. Mandible volume, tooth root volume, and root percentage of mandible volume were analyzed and compared using the slopes of the best fit line. At the M1 mesial and distal roots, mandible volume ( P < .001) and root volume ( P < .001) were both noted to increase, with increasing weight at different rates. The rate of change in the root percentage by weight of M1 roots was not different ( P = .214). Each location demonstrated a different increasing rate of change for mandibular volume and increasing root volume. Results show that as patient's weight increases, the mandible and root volumes increase at different rates. Root percentage by volume at all three locations was noted to decrease by the same rate. Canine and M1 roots are proportionally larger than the supporting mandibular bone in smaller patients. Care should be taken to recommend periodontal disease prevention for owners of small dogs and consideration made when performing extractions or other surgery that may destabilize the mandible.
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Perros/anatomía & histología , Perros/fisiología , Raíz del Diente/anatomía & histología , Raíz del Diente/fisiología , Animales , Peso Corporal , Tomografía Computarizada de Haz Cónico/veterinaria , Diente Canino/anatomía & histología , Diente Canino/fisiología , Diente Molar/anatomía & histología , Diente Molar/fisiología , WisconsinRESUMEN
INTRODUCTION: Compelling evidence pinpoints that pulp tissue engineering after the transplantation of stem cells is possible. Although intriguing, severe problems regarding clinical feasibility remain. Cell homing has been proposed as a viable alternative in which dentin-derived growth factors in a conducive scaffold may attract resident cells to form pulplike tissue. In this study, an ectopic animal model for in situ dental pulp tissue engineering was developed to evaluate whether pulplike tissue formation in empty root canals after the attraction of stem cells was possible and whether this could be enhanced by dentin-derived growth factors. METHODS: Three types of fibrin (custom-made fibrin, fibrin sealant, and plasma rich in growth factors [PRGF]) as well as a self-assembling peptide were evaluated in vivo in a modified tooth root model using human teeth. Root canal dentin was conditioned with EDTA, tooth roots were filled with growth factor-laden scaffolds, and dental pulp stem cells in collagen were placed at the root tip. Constructs were implanted into immunocompromised mice for 4 weeks and subsequently analyzed histologically. Differential interference contrast and second harmonic generation imaging were performed for selected sections. RESULTS: For custom-made fibrin and fibrin sealant with dentin matrix proteins, migration into the roots and the formation of a pulplike tissue were observed, whereas the peptide-based scaffold appeared less suitable. PRGF supported tissue formation regardless of the addition of dentin matrix proteins. In the test groups with dentin matrix proteins and EDTA conditioning, differentiated odontoblastlike cells extended cellular processes into the dentinal tubules, which coincided with the deposition of the newly formed collagenous dentin matrix. CONCLUSIONS: This new cell homing model provides evidence that fibrin derivatives make applicable scaffolds and that dentin-derived proteins induce chemotaxis and pulplike tissue formation.
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Pulpa Dental/fisiología , Dentina/metabolismo , Proteínas de la Matriz Extracelular/uso terapéutico , Endodoncia Regenerativa/métodos , Ingeniería de Tejidos/métodos , Adulto , Animales , Movimiento Celular , Pulpa Dental/metabolismo , Femenino , Humanos , Masculino , Ratones , Ratones Endogámicos , Andamios del Tejido , Raíz del Diente/fisiologíaRESUMEN
Scanning electron microscopy evaluation of root surfaces after ultrasonic instrumentation was performed with 2 different metallic tips on piezoelectric devices. Fresh extracted teeth were collected for experimental observation and randomly divided into 2 groups: Test Group, where the root surfaces were treated using an iron, rough, double nano-structural coated (T-Black), corindone-treated tip, and Control Group where the root surfaces were treated with a conventional iron smooth tip. A scanning electronic microscope analysis was performed and the surface roughness and the amount of residual debris were evaluated. Descriptive and inferential statistics were performed. Twenty specimens were analyzed, 10 per group and a total of 21.4â×â10âµm has been observed. On treated area percentage of debris after ultrasonic scaling in Test Group was 1.9â±â1.8%, while in Control Group it was 5.7â±â4.3%. Within the limits of the study, it seems that the efficacy of the novel iron, rough, double nano-structural coated (T-Black), corindone-treated structure tip showed greater performance in terms of root surface debridement than the conventional iron smooth tip. The possibility to use a single tool (ultrasonic device with a specific tip) for the root planing procedure within the nonsurgical mechanical therapy may represent a significant advantage for the clinicians. The tested novel tip seems to be able to show the requested ideal characteristics. However, further clinical studies are needed to demonstrate the in vitro results.
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Raspado Dental , Microscopía Electrónica de Rastreo , Raíz del Diente , Raspado Dental/instrumentación , Raspado Dental/métodos , Humanos , Distribución Aleatoria , Propiedades de Superficie , Raíz del Diente/fisiología , Raíz del Diente/cirugía , Raíz del Diente/ultraestructuraRESUMEN
Three immature permanent teeth with pulp necrosis and apical periodontitis were treated with regenerative endodontic therapy (RET), which included root canal disinfection with sodium hypochlorite irrigation, intra-canal medication with calcium hydroxide paste, 17% EDTA rinse, induction of periapical bleeding into the canal, collagen matrix and MTA coronal seal, and composite resin restoration of access cavities. After different periods of follow-up, it was observed that continued root maturation, especially apical closure occurred despite persistent apical periodontitis of immature permanent teeth after failed RET. This finding is of interest as the secondary goal of further root maturation occurred despite failure of the primary goal of elimination of clinical symptom/sign and periapical inflammation. The possible biological mechanisms that could allow for further root maturation to occur in spite of persistent root canal infection of immature permanent teeth are discussed. Based on these observations, the biology of wound healing of immature permanent teeth after injury is not fully understood and should be further investigated. This case report demonstrates that whilst further root maturation is considered a successful outcome for teeth treated with RET, the primary objective must be the resolution of the signs and symptoms of apical periodontitis.
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Dentición Permanente , Periodontitis Periapical/terapia , Endodoncia Regenerativa/métodos , Raíz del Diente/fisiología , Niño , Estudios de Seguimiento , Humanos , Masculino , Periodontitis Periapical/diagnóstico por imagen , Radiografía Dental/métodos , MuestreoRESUMEN
Currently regeneration of tooth and periodontal damage still remains great challenge. Stem cell-based tissue engineering raised novel therapeutic strategies for tooth and periodontal repair. Stem cells for tooth and periodontal regeneration include dental pulp stem cells (DPSCs), periodontal ligament stem cells (PDLSCs), stem cells from the dental apical papilla (SCAPs), and stem cells from human exfoliated deciduous teeth (SHEDs), dental follicle stem cells (DFSCs), dental epithelial stem cells (DESCs), bone marrow mesenchymal stem cells (BMMSCs), adipose-derived stem cells (ADSCs), embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs). To date, substantial advances have been made in stem cell-based tooth and periodontal regeneration, including dentin-pulp, whole tooth, bioroot and periodontal regeneration. Translational investigations have been performed such as dental stem cell banking and clinical trials. In this review, we present strategies for stem cell-based tissue engineering for tooth and periodontal repair, and the translational studies.
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Pulpa Dental/fisiología , Dentina/fisiología , Periodoncio/fisiología , Regeneración , Células Madre , Raíz del Diente/fisiología , Diente/fisiología , HumanosRESUMEN
The aim of this study was to compare the rate of tooth displacement, quantity of root resorption, and alveolar bone changes in five groups: corticopuncture (CP), low-level laser therapy (LLLT), CP combined with LLLT (CP + LLLT), control (C), and negative control (NC). A total of 60 half-maxilla from 30 male Wistar rats (10 weeks old) were divided randomly into five groups: three (CP, LLLT, and CP + LLLT) test groups with different stimulation for accelerated-tooth-movement (ATM), one control (C) group, and one negative control (NC) group with no tooth movement. Nickel-titanium coil springs with 50 g of force were tied from the upper left and right first molars to micro-implants placed behind the maxillary incisors. For the CP and CP + LLLT groups, two perforations in the palate and one mesially to the molars were performed. For the LLLT and CP + LLLT groups, GaAlAs diode laser was applied every other day for 14 days (810 nm, 100 mW, 15 s). The tooth displacements were measured directly from the rat's mouth and indirectly from microcomputer (micro-CT) tomographic images. Bone responses at the tension and compression sites and root resorption were analyzed from micro-CT images. The resulting alveolar bone responses were evaluated by measuring bone mineral density (BMD), bone volume fraction (BV/TV), and trabecular thickness (TbTh). Root resorption crater volumes were measured on both compression and tension sides of mesial and distal buccal roots. The tooth displacement in the CP + LLLT group was the greatest when measured clinically, followed by the CP, LLLT, and control groups (C and NC), respectively (p <0.05). The tooth movements measured from micro-CT images showed statistically higher displacement in the CP and CP + LLLT groups compared to the LLLT and control groups. The BMD, BV/TV, and TbTh values were lower at the compression side and higher at the tension side for all three test groups compared to the control group. The root resorption crater volume of the distal buccal root was higher in the control group, followed by CP, LLLT, and CP + LLLT, mostly at the compression site. Combining corticopuncture and low-level laser therapy (CP + LLLT) produced more tooth displacement and less root resorption at the compression side. The combined technique also promoted higher alveolar bone formation at the tension side.
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Técnicas de Movimiento Dental/métodos , Animales , Láseres de Semiconductores , Terapia por Luz de Baja Intensidad , Masculino , Maxilar/diagnóstico por imagen , Maxilar/efectos de la radiación , Diente Molar/diagnóstico por imagen , Diente Molar/fisiología , Diente Molar/efectos de la radiación , Ratas , Ratas Wistar , Resorción Radicular , Movilidad Dentaria , Raíz del Diente/diagnóstico por imagen , Raíz del Diente/fisiología , Raíz del Diente/efectos de la radiación , Microtomografía por Rayos XRESUMEN
INTRODUCTION: The importance of an intact layer of cementum on the root surface in preventing bacterial penetration into radicular dentin has not been sufficiently investigated. The aim of this in vitro study was to determine the effect of the absence of cementum from the root surface and the length of the infection period (2 or 4 weeks) on the maximum depth of bacterial penetration and the percentage of sectors lined with bacteria. METHODS: Sound, single-rooted extracted teeth with closed apices were randomly assigned to either a control group (cementum present [CP]) or an experimental group (cementum removed [CR]). Each group was further divided randomly into 2 subgroups: 2-week infection (CP2 and CR2) and 4-week infection (CP4 and CR4). Teeth were then artificially infected with Enterococcus faecalis and prepared for histology. RESULTS: A total of 107 teeth were available for histologic examination, 25 teeth in CP2, 31 teeth in CP4, 27 teeth in CR2, and 24 teeth in CR4. Pairwise comparisons revealed statistically significant differences in the maximum depth of bacterial penetration for the following combinations: CP2-CR2, CP2-CR4, CP4-CR2, and CP4-CR4 (P < .001). Pairwise comparisons also revealed a statistically significant difference in the percentage of sectors lined with bacteria for CP2-CR2, CP2-CP4, and CP2-CR4 (P < .001). CONCLUSIONS: The results support the hypothesis that the absence of cementum facilitates bacterial penetration into dentinal tubules. Results also suggest that the process of radicular dentin infection is time dependent and highlight the importance of early treatment of infected teeth, especially in situations in which cementum discontinuity is suspected.
Asunto(s)
Cemento Dental/fisiología , Dentina/fisiología , Enterococcus faecalis/fisiología , Dentina/microbiología , Humanos , Técnicas In Vitro , Raíz del Diente/microbiología , Raíz del Diente/fisiologíaRESUMEN
OBJECTIVES: This analysis seeks to determine whether differences between real and estimated chronological age (CA) with biological age (BA) in skeletal individuals reflect variability in aging. MATERIAL AND METHODS: A total of 87 individuals of two samples, ranging from 20 to 94 years old, were analyzed. One, partially documented, belongs to a Mexican skeletal collection dating to the 20th century; the other is an assemblage of prehispanic individuals from different archaeological sites. In all specimens, the tooth annulation method (TCA) was applied to estimate CA, while-excluding individuals older than 80 years-auricular surface (AS) and pubic symphysis (PS) methods were used to estimate BA. Statistical analyses were conducted to identify correlations and significance of the differences between CA vs. TCA, CA vs. AS/PS, TCA vs. AS/PS. Sex of individuals was assessed for its influence in aging. RESULTS: The use of TCA to estimate CA was successful for most individuals. A strong correlation was found between CA vs. TCA, CA vs. AS/PS, TCA vs. AS/PS and their differences were significant but variation in these were found when assessed by separate age groups. Sex did not influence such differences. DISCUSSION: TCA can be used to estimate CA and its differences with BA, being less than 10 years, are similar to those found in living populations. Differences between CA and BA are due to intra-population variability, which could be the consequence of individual differences in aging. More research is needed to have confidence that under- and overestimations of BA are indicators of aging variability at the level of the individual.