Biological Evaluation (In Vitro and In Vivo) of Bilayered Collagenous Coated (Nano Electrospun and Solid Wall) Chitosan Membrane for Periodontal Guided Bone Regeneration.

The application of barrier membranes in guided bone regeneration (GBR) has become a commonly used surgical technique in periodontal research. The objectives of this study were to evaluate the in vitro biocompatibility and osteogenic differentiation of mesenchymal stem cells (MSCs) on two different collagenous coatings (nano electrospun fibrous vs. solid wall) of bilayered collagen/chitosan membrane and their histological evaluation on bone regeneration in rabbit calvarial defects. It was found that chitosan-nano electrospun collagen (CNC) membranes had higher proliferation/metabolic activity compared to the chitosan-collagen (CC) and pristine chitosan membranes. The qRT-PCR analysis demonstrated the CNC membranes induced significant expression of osteogenic genes (Osteocalcin, RUNX2 and Col-α1) in MSCs. Moreover, higher calcium content and alkaline phosphatase activity of MSCs were observed compared to the other groups. Histologic and histomorphometric evaluations were performed on the uncovered (negative control) as well as covered calvarial defects of ten adult white rabbits with different membranes (CNC, CC, BioGide (BG, positive control)) at 1 and 2 months after surgery. More bone formation was detected in the defects covered with CNC and BG membranes than those covered by CC and the negative control. No inflammation and residual biomaterial particles were observed on the membrane surface or in the surrounding tissues in the surgical areas. These results suggest that bilayer CNC membrane can have the potential for use as a GBR membrane material facilitating bone formation.

A clinical and histologic evaluation of gingival fibroblasts seeding on a chitosan-based scaffold and its effect on the width of keratinized gingiva in dogs.

BACKGROUND: Finding biocompatible matrix materials capable of enhancing the procedures of gingival augmentation is a major concern in periodontal research. This has prompted the investigation of a safe grafting technique by means of synthetic or natural polymers. The objective of this study is to examine the effect of a gingival fibroblast cultured on a naturally derived (i.e., chitosan-based) scaffold on the width of keratinized gingiva in dogs. METHODS: Gingival fibroblasts were cultured from a small portion of hard palates of five dogs. A bilayered chitosan scaffold was seeded with the gingival fibroblasts and transferred to dogs. Surgery was performed bilaterally, and the regions were randomly divided into two groups: chitosan only (control site) and chitosan + fibroblast (test site). Periodontal parameters, including probing depth and width of keratinized and attached gingiva, were measured at baseline and 3 months after surgery. A histologic evaluation was also performed on the healed grafted sites. RESULTS: Comparison of width of keratinized and attached gingiva in control and test sites showed that the mean width of keratinized and attached gingiva increased in each group after surgery. However, the difference between control and test groups was not statistically significant. Concerning the existence of the keratinized epithelium, exocytosis, and epithelium thickness, no significant difference was observed in test and control sites. The difference was significant in relation to rete ridge formation. CONCLUSION: The tissue-engineered graft consisting of chitosan + fibroblast was applied to gingival augmentation procedures and generated keratinized tissue without any complications usually associated with donor-site surgery.

Oral self-care and use of dental services among adults with diabetes mellitus.

PURPOSE: To investigate the oral health behaviour and the smoking habits among diabetic adults with regard to diabetes-related factors and their background information. MATERIALS AND METHODS: In 2005, a questionnaire was conducted among diabetic adults (N = 299) in Tehran, Iran. The subjects were invited to the dental clinic and were asked to complete a self-administered questionnaire. In addition to their background information, the questionnaire requested information on smoking, oral self-care, dental attendance, year of onset of diabetes and organ complications related to diabetes. The data related to the type of diabetes and the latest value of glycosylated haemoglobin level (HbA1c) were obtained from the patient records at the diabetic clinic. Chi-square test and binary logistic regression model were used for statistical analyses. RESULTS: Of all the subjects, 29% reported brushing their teeth on a twice-daily basis. Women (P = 0.05) reported higher frequencies of twice-daily tooth brushing. Subjects with moderate diabetic control (HbA1c = 7.6-8.5%) showed the highest rate for twice-daily tooth brushing (P < 0.001). Of all the subjects, 47% reported having visited a clinician within the past 12 months; this rate was the highest among those without diabetes-related complications (52% versus 41%; P = 0.05). Subjects who had a physician referral were more likely to report having had a dental visit within the past 12 months (OR = 4.4; CI = 1.9-10.2). CONCLUSIONS: The present results call for improvement in the level of oral self-care and the regularity of dental checkups among diabetic adults to compensate for their increased risk for oral diseases.

Periodontal treatment needs of diabetic adults.

AIM: The aim of this study was to investigate diabetes-related factors in relation to periodontal treatment needs. MATERIAL AND METHODS: A cross-sectional study was conducted among 299 dentate diabetics attending a diabetic clinic in Tehran, Iran. A self-administered questionnaire was administered during a dental appointment in order to gather information about year of birth, year of onset of diabetes, education and organ complications related to diabetes. Number of teeth, the Community Periodontal Index of Treatment Needs and visible plaque were recorded. RESULTS: None of the subjects had a healthy periodontium. Shallow periodontal pockets were the most prevalent finding. Periodontal pockets exceeding 5 mm and a higher number of missing teeth were associated with a low level of education. The sum of plaque scores [odds ratio (OR)=1.3; 95% confidence interval (CI) 1.1-1.5] was related to the presence of deepened pockets when controlling for other factors. Among diabetes-related factors, the only significant association with CPITN > or =3 was by HbA1c (OR=0.7; 95% CI 0.6-0.9); for CPITN=4, no associations with the diabetes-related factors appeared. CONCLUSIONS: The poor periodontal status of our diabetic patients indicates a need to establish a comprehensive oral health promotion programme for diabetics based on collaboration between dental and general health care professionals involved in diabetic care.