Predifferentiated Gingival Stem Cell-Induced Bone Regeneration in Rat Alveolar Bone Defect Model.

Cleft alveolus, a common birth defect of the maxillary bone, affects one in 700 live births every year. This defect is traditionally restored by autogenous bone grafts or allografts, which may possibly cause complications. Cell-based therapies using the mesenchymal stem cells (MSCs) derived from human gingiva (gingiva-derived mesenchymal stem cells [GMSCs]) is attracting the research interest due to their highly proliferative and multilineage differentiation capacity. Undifferentiated GMSCs expressed high level of MSC-distinctive surface antigens, including CD73, CD105, CD90, and CD166. Importantly, GMSCs induced with osteogenic medium for a week increased the surface markers of osteogenic phenotypes, such as CD10, CD92, and CD140b, indicating their osteogenic potential. The objective of this study was to assess the bone regenerative efficacy of predifferentiated GMSCs (dGMSCs) toward an osteogenic lineage in combination with a self-assembling hydrogel scaffold PuraMatrix™ (PM) and/or bone morphogenetic protein 2 (BMP2), on a rodent model of maxillary alveolar bone defect. A critical size maxillary alveolar defect of 7 mm × 1 mm × 1 mm was surgically created in athymic nude rats. The defect was filled with either PM/BMP2 or PM/dGMSCs or the combination of three (PM/dGMSCs/BMP2) and the bone regeneration was evaluated at 4 and 8 weeks postsurgery. New bone formation was evaluated by microcomputed tomography and histology using Hematoxylin and Eosin staining. The results demonstrated the absence of spontaneous bone healing, either at 4 or 8 weeks postsurgery in the defect group. However, the PM/dGMSCs/BMP2 group showed significant enhancement in bone regeneration at 4 and 8 weeks postsurgery, compared with the transplantation of individual material/cells alone. Apart from developing the smallest critical size defect, results showed that PM/dGMSCs/BMP2 could serve as a promising option for the regeneration of bone in the cranio/maxillofacial region in humans.

Managing the untoward anesthetic event in an oral and maxillofacial surgery practice.

The safe and efficient use of outpatient surgical anesthesia modalities is a significant part of the training and expertise of the oral and maxillofacial surgeon. Although adverse outcomes are rare, they can have considerable traumatic psychological and professional consequences for the surgeon involved. The goal of this article is to develop guidelines to educate the doctor, the second victim, on how to manage a bad outcome and how to navigate through a difficult and arduous process.

Dental treatment of the pregnant patient: literature review and guidelines for the practicing clinician.

The purpose of this review article is to assist the practicing clinician by categorizing and packaging useful clinical information into a format that will assist with the treatment of pregnant patients. Our goal is to offer the scientific foundations that lead to current practice guidelines, specifically those that are of particular relevance to today's dental professional.

Virtual rounding via videoconference-enabled smartphones: a case for multifacility rounds.

Telemedicine is defined as the use of medical information exchanged from one site to another via electronic communications to improve delivery of care. This improvement in delivery of care is evident by more-efficient consults, triaging, and real-time communication between patient and surgeon. Internet-capable smartphones are capable of transferring radiographs and other images. Aziz and Ziccardi in 2009 demonstrated using smartphones for downloading images from the hospital archiving system to the resident's phone and then e-mailing or texting them to the attending for immediate review. Here we build on the work of Aziz and Ziccardi as we describe a novel use of smartphones for virtual rounding between residents and faculty based on improvements in technology, specifically video capability and increased accessibility of compatible devices.

Odontogenic carcinoma differentiation into rhabdomyosarcoma: report of a rare case.

To the authors' knowledge, this is the first reported case of an odontogenic carcinoma with documented skeletal muscle differentiation (rhabdomyosarcoma). The histology and clinical features of this aggressive odontogenic neoplasm are described. Within the English-language literature, only 2 cases are reported of an odontogenic tumor with muscle differentiation: a benign odontogenic tumor (ameloblastoma) with differentiation into a rhabdomyosarcoma and an odontogenic sarcoma with smooth-muscle differentiation. The general practitioner should be aware that odontogenic lesions may be malignant, even though this is extremely rare, and all tissue removed from the oral cavity should be submitted for biopsy.

Treatment of patients who have type 1 diabetes mellitus: physiological misconceptions and infusion pump therapy.

BACKGROUND: This article reviews the unique physiology of patients who have type 1 diabetes mellitus (insulin-dependent diabetes mellitus, or IDDM); allays some common physiological misconceptions; and updates dental practitioners on the emerging technology of insulin infusion pump therapy, now available to patients who have type 1 diabetes mellitus. DESCRIPTION: The authors review the physiology of stress and describe the dawn phenomenon. They also describe insulin infusion pump therapy, as well as its advantages and disadvantages, to familiarize dentists with new technologies in caring for patients who have diabetes. Emergencies that may present themselves as a result of these advances in biotechnology are discussed. CLINICAL IMPLICATIONS: Dental practitioners who treat patients who have IDDM need to have a solid foundation in the basic medical sciences and emerging biomedical technology as they each relate to diabetes. Practitioners must become familiar with infusion pump therapy, not only for cases of medical emergencies, but also to customize treatment for patients who have diabetes. Practitioners also need to remain up to date in the rapidly changing realm of caring for people who have diabetes.