O-HEALTH-EDU: A scoping review on the reporting of oral health professional education in Europe.

INTRODUCTION: The variability in oral health professional education is likely to impact on the management of oral health needs across Europe. This scoping review forms the initial part of a larger EU-funded collaborative Erasmus + project, 'O-Health-Edu'. The aim of this scoping review is to investigate how oral health professional education in Europe is reported. METHODS: The PRISMA and Arksey & O'Malley methodological frameworks for scoping reviews were used to guide reviewers in answering the research question "How is oral health professional education reported in Europe?". The search strategy encompassed published literature searches, internet searches and further searching of relevant documents from educational organisations, regulators and professional bodies. Once the search strategy was developed, it was sent to key stakeholders for consultation. Sources were reviewed by two authors (JD, JF) and included in the review if they reported on oral health professional education in Europe. RESULTS: A total of 508 sources were retrieved from all of the searches. A total of 405 sources were excluded as they did not report on the topic of interest, leaving 103 sources that reported on oral health professional education in Europe. Handsearching the references of published sources lead to a further 41 sources being screened, of which, 15 were included. In total, 33 duplications were removed and the final number of included sources was 85. The average year of publication for the included sources was 2007, with sources most commonly published in journals dedicated to dental education. Surveys represented the most common form of reporting. From the data obtained, four broad themes of reporting were evident: dental education at a programme level, dental education at a discipline level, other oral health professional education, and postgraduate education and continuous professional development. CONCLUSION: The reporting of dental and oral health professional education in Europe is limited. Whilst there are many useful documents that provide guidelines on dental education, there is limited knowledge on how education is implemented and delivered. There is a greater need for comprehensive educationally driven programme-level data on oral health professional education across Europe.

A Regenerative Endodontic Approach in Mature Ferret Teeth Using Rodent Preameloblast-conditioned Medium.

BACKGROUND: This study evaluated the effectiveness of a regenerative endodontic approach to regenerate the pulp tissue in mature teeth of ferret. The presence of odontoblast-like cells in the newly-formed tissue of teeth treated with or without preameloblast-conditioned medium was evaluated based on morphological criteria. MATERIALS AND METHODS: Twenty-four canines from six ferrets were treated. The pulp was removed, and the apical foramen was enlarged. After inducing the formation of a blood clot, a collagen sponge with or without preameloblast-conditioned medium was placed underneath the cementoenamel junction. The samples were analyzed at the eighth week of follow-up. RESULTS: Vascularized connective tissue was observed in 50% of teeth, without differences between groups. The tissue occupied the apical third of the root canals. Odontoblast-like cells were not observed in any group. CONCLUSION: Revitalization of mature teeth is possible, at least in the apical third of the root canal. Further experimental research is needed to produce more reliable outcomes.

Enlargement of the apical foramen of mature teeth by instrumentation and apicoectomy. A study of effectiveness and the formation of dentinal cracks.

OBJECTIVE: In the last few years there have been attempts to revascularize mature necrotic teeth instead of performing a standard root canal treatment. Apical foramen enlargement (AFE) would be necessary for regenerative treatments of mature teeth. In the literature, AFE has been made through apicoectomy and instrumentation. However, no standardized methods have been described yet, which may affect the success of the therapy. Our aim was to describe the effectiveness and damage to dental structures of five methods for AFE. METHODS: Two hundred and ten human teeth were assigned to one control group (n = 10) and four treatment groups (n = 50 each): instrumentation was up to file #80 0.5 mm coronal to the apex (I), at apex level (II), 0.5 mm beyond the apex (III) and apicoectomy at 2 and 4 mm from the apex (IV). The apical foramen diameter was measured before and after treatment. The formation of clinically visible fractures (CVF) and microcracks was analysed clinically and with ESEM, respectively. Thirty-two in situ sheep's teeth were also instrumented, to compare damage in in situ and ex vivo teeth. RESULTS: The foramen diameter was augmented by 0.15, 0.47, 0.54 0.06 and 0.32 mm in human teeth of groups I, II, III, apicoectomy at 2 and 4 mm, respectively. CVF were more frequent as the working length was augmented. No statistical differences were found for microcrack formation. In situ teeth showed significantly less damage. CONCLUSIONS: Instrumentation at apex level seems to be the most effective and least harmful technique for AFE, while apicoectomy is not a useful method.

The p38α MAPK function in osteoprecursors is required for bone formation and bone homeostasis in adult mice.

BACKGROUND: p38 MAPK activity plays an important role in several steps of the osteoblast lineage progression through activation of osteoblast-specific transcription factors and it is also essential for the acquisition of the osteoblast phenotype in early development. Although reports indicate p38 signalling plays a role in early skeletal development, its specific contributions to adult bone remodelling are still to be clarified. METHODOLOGY/PRINCIPAL FINDINGS: We evaluated osteoblast-specific deletion of p38α to determine its significance in early skeletogenesis, as well as for bone homeostasis in adult skeleton. Early p38α deletion resulted in defective intramembranous and endochondral ossification in both calvaria and long bones. Mutant mice showed reduction of trabecular bone volume in distal femurs, associated with low trabecular thickness. In addition, knockout mice also displayed decreased femoral cortical bone volume and thickness. Deletion of p38α did not affect osteoclast function. Yet it impaired osteoblastogenesis and osteoblast maturation and activity through decreased expression of osteoblast-specific transcription factors and their targets. Furthermore, the inducible Cre system allowed us to control the onset of p38α disruption after birth by removal of doxycycline. Deletion of p38α at three or eight weeks postnatally led to significantly lower trabecular and cortical bone volume after 6 or 12 months. CONCLUSIONS: Our data demonstrates that, in addition to early skeletogenesis, p38α is essential for osteoblasts to maintain their function in mineralized adult bone, as bone anabolism should be sustained throughout life. Moreover, our data also emphasizes that clinical development of p38 inhibitors should take into account their potential bone effects.

Conserved regulatory motifs in osteogenic gene promoters integrate cooperative effects of canonical Wnt and BMP pathways.

Osteoblast differentiation depends on the coordinated network of evolutionary conserved transcription factors during bone formation and homeostasis. Evidence indicates that bone morphogenetic protein (BMP) and Wnt proteins regulate several steps of skeletal development. Here, we provide a molecular description of the cooperative effects of BMP and Wnt canonical pathway on the expression of the early osteogenic genes Dlx5, Msx2, and Runx2 in C2C12 cells, primary cultures of bone marrow-mesenchymal stem cells, and organotypic calvarial cultures. Coordinated regulation of these genes leads to the cooperative activation of their downstream osteogenic target gene osterix. Induction of these genes is mediated through enhancer regions with an evolutionary conserved structure encompassing both Smad and TCF/LEF1 DNA-binding sites. Formation of a cooperative complex is mediated through DNA binding of Smads and TCF4/ß-catenin to their cognate sequences, as well as protein-protein interactions between them. The formation of these cooperative transcriptional complexes results in a more efficient recruitment of coactivators such as p300. We propose that evolutionary conserved regulatory regions in specific osteogenic master genes are key integrative modules during osteogenesis.

Estudio histomorfológico de la capacidad de regeneración ósea del plasma rico en plaquetas, médula ósea y fosfato tricálcico: estudio experimental en cerdos "regeneración ósea en cirugía experimental en cerdos" / Histomorphological study of the bone regeneration capacity of platelet-rich plasma, bone marrow and tricalcium phosphate experimental study on pigs

Objetivo: Se valora histomorfológicamente la capacidad de regeneración ósea del plasma rico en plaquetas, a distintas concentraciones,y el extracto de médula ósea rico en plaquetas, en comparación con -fosfato tricálcico. Material y Metodo: Se realiza un trabajo experimental en 8 cerdos, a los que se les practican trepanaciones mandibulares para colocar los materiales a estudio. Las muestras obtenidas se observan mediante microscopio electrónico y se realizan fotografías sistemáticas para analizarlas mediante un sistema de histograma de grises. Resultados: Los fenómenos de osificación se aprecian en el 96% de los defectos practicados, con independencia del material empleado para rellenarlo. Se aprecia que el plasma rico en plaquetas (PRP) y la médula ósea (M) muestran un grado de osteogénesis equivalente, 12,3 y 13,4 respectivamente más potencia que el control. El plasma pobre en plaquetas (PPP) presenta una capacidad semejante a los controles (C) con una media de sustracción de 14,03 y 14,12 respectivamente. El fosfato tricálcico (FT) se muestra efectivo como elemento inductor de osificación, 3,03 veces más potente que el control. Conclusiones: La osificación se presenta en la mayor parte de los defectos practicados. El PRP y la M son los elementos con máscapacidad osteogénica y el PPP no se muestra más efectivo que el control.

Objetive: On numerous occasions after the oral surgery bone defects occur which may be difficult to repair. Objective: We assessed the histomorphologic bone regeneration capacity of platelet-rich plasma at different concentrations, and extract bone marrow platelet-rich, compared with -tricalcium phosphate. Material and Methods: We performed an experimental study in 8 pigs, who are practicing trepanaciones jaw to move the materials to study. The samples obtained were observed through electronic microscope and systematic photographs were made to analyse them through a system of gray histogram. Results: Ossification Phenomena were seen in 96% of the defaults practiced with independance of the material used to fill them. It is appreciated that the platelet-rich plasma (PRP) and bone marrow (M) show an equivalent degree of osteogenesis, 12.3 and 13.4 respectively, more power than the control. The platelet-poor plasma (PPP) provides a capability similar to controls (C) with an average of 14.03 and 14.12 abduction respectively. Tricalcium phosphate (FT) is effective as an inducer of ossification, 3.03 times more potent than the control. Conclusions: The ossification occurs in most of the charged defects. The PRP and the M are the most osteogenic capacity and the PPP is no more effective than control.

Histomorphological study of the bone regeneration capacity of platelet-richplasma, bone marrow and tricalcium phosphate Experimental study on pigs

Introduction: Bone defects are rather common after oral surgery and may prove difficult to repair. Objective: Weprovide a histomorphological analysis of the bone regenerative capacity of platelet-rich plasma at different concentrationsand the extraction of platelet-rich bone marrow, compared with &bgr;-tricalcium phosphate. Methodology:We performed an experimental study on 8 pigs, in which we performed trepanations of the mandible inorder to place the materials to be studied. Using an electron microscope, we observed the samples obtained andtook a series of photographs in order to analyze the samples through a gray-scale histogram system.Results: Ossification phenomena were present in 96% of the charged defects, regardless of the material used to fillit. Platelet-rich plasma (PRP) and the bone marrow (M) showed an equivalent degree of osteogenesis, 12.3 and 13.4respectively, which is greater in than the control group. The platelet-poor plasma (PPP) shows a capacity similarto the control groups (C), with an average count of 14.03 and 14.12 respectively. Tricalcium phosphate (TP) wasshown to be effective as an ossification inducer, 3.03 times stronger than the control group. Conclusions: Ossificationoccurs in most of the charged defects. PRP and M had the greatest osteogenic capacity but PPP was nomore effective than the control (AU)

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Histomorphological study of the bone regeneration capacity of platelet-rich plasma, bone marrow and tricalcium phosphate: Experimental study on pigs.

INTRODUCTION: Bone defects are rather common after oral surgery and may prove difficult to repair. OBJECTIVE: We provide a histomorphological analysis of the bone regenerative capacity of platelet-rich plasma at different concentrations and the extraction of platelet-rich bone marrow, compared with beta-tricalcium phosphate. METHODOLOGY: We performed an experimental study on 8 pigs, in which we performed trepanations of the mandible in order to place the materials to be studied. Using an electron microscope, we observed the samples obtained and took a series of photographs in order to analyze the samples through a gray-scale histogram system. RESULTS: Ossification phenomena were present in 96% of the charged defects, regardless of the material used to fill it. Platelet-rich plasma (PRP) and the bone marrow (M) showed an equivalent degree of osteogenesis, 12.3 and 13.4 respectively, which is greater in than the control group. The platelet-poor plasma (PPP) shows a capacity similar to the control groups (C), with an average count of 14.03 and 14.12 respectively. Tricalcium phosphate (TP) was shown to be effective as an ossification inducer, 3.03 times stronger than the control group. CONCLUSIONS: Ossification occurs in most of the charged defects. PRP and M had the greatest osteogenic capacity but PPP was no more effective than the control .