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1.
J Clin Med ; 10(5)2021 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-33801333

RESUMO

Since the announcement of the coronavirus 2019 (COVID-19) outbreak as a pandemic, several studies reported increased psychological distress among healthcare workers. In this investigation, we examined the association between psychological outcomes and various factors among German dentists. Dentists from all German federal states were invited to participate in this study through a self-administered online questionnaire between July and November 2020. This questionnaire collected information on demographics, Depression Anxiety Stress Scales (DASS-21), and the Impact of Events Scale-Revised (IES-R) instrument. The associations displayed between demographic and psychological outcomes of depression, anxiety, stress, intrusion, avoidance, and hyperarousal were evaluated. Seven-hundred-and-thirty-two dentists participated in the survey and reported overall scores of (4.88 ± 4.85), (2.88 ± 3.57), (7.08 ± 5.04), (9.12 ± 8.44), (10.68 ± 8.88) and (10.35 ± 8.68) for depression, anxiety, stress, intrusion, avoidance, and hyperarousal, respectively. For females, being between 50-59 years of age, being immune deficient or chronically ill, working at a dental practice, and considering the COVID-19 pandemic a financial hazard were reported as significant associated factors (p < 0.05) with higher DASS-21 and IES-R scores. These findings underline the aspects which need to be taken into attention to protect the mental wellbeing of dentists in Germany during the crisis.

2.
Artigo em Inglês | MEDLINE | ID: mdl-33066223

RESUMO

Currently, there is no standard treatment protocol for apical periodontitis (AP). Thus, restorable teeth might get extracted and replaced prosthetically. This study evaluated German dentists' preferred AP treatment decisions and the influencing factors for selecting tooth retention by initial/repeated surgical/non-surgical root-canal treatment (RCT) or extraction with/without prosthetic replacement. Through an online-survey, participants (n = 260) rated different treatment options for four case scenarios with AP in anterior/posterior teeth without/with previous RCT. Statistical analysis included the Friedman test for intra-case comparisons and Chi-squared test for factor-associations (p ≤ 0.05). Tooth retention using initial/repeated RCT was ranked first in all scenarios and rated as (very) appropriate by most participants, while implant-supported crowns (ISC) and apicoectomy had the second ratings. ISC were preferred more on posterior teeth or previous root-canal-treated teeth. Rating levels of treatment options displayed significant differences for all case scenarios. Posterior tooth retention by RCT demonstrated a significant association with work experience. Tooth retention with previous RCT displayed a significant correlation with dentists' privately insured patients. Most dentists preferred tooth preserving with initial/repeated RCT, while others selected non-evidence-based choices. This reflects a lack of consensus of AP treatment decisions in Germany. Fixed treatment guidelines and further evaluation of treatment-decision-correlated factors are recommended for correct treatment planning.

3.
Stem Cells Int ; 2020: 8897138, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32879629

RESUMO

Objective: Ascorbic acid (AA) and controlled inflammatory stimuli are postulated to possess the ability to independently exert positive effects on a variety of proliferative, pluripotency, and differentiation attributes of gingival mesenchymal stem/progenitor cells (G-MSCs). The current study's objective was to explore and compare for the first time the impact of the major inflammatory cytokines (IL-1ß/TNF-α/IFN-γ), AA, or their combination on multipotency/pluripotency, proliferative, and differentiation characteristics of G-MSCs. Design: Human G-MSCs (n = 5) were isolated and cultured in basic medium (control group), in basic medium with major inflammatory cytokines; 1 ng/ml IL-1ß, 10 ng/ml TNF-α, and 100 ng/ml IFN-γ (inflammatory group), in basic medium with 250 µmol/l AA (AA group) and in inflammatory medium supplemented by AA (inflammatory/AA group). All media were renewed three times per week. In stimulated G-MSCs intracellular ß-catenin at 1 hour, pluripotency gene expression at 1, 3, and 5 days, as well as colony-forming units (CFUs) ability and cellular proliferation over 14 days were examined. Following a five-days stimulation in the designated groups, multilineage differentiation was assessed via qualitative and quantitative histochemistry as well as mRNA expression. Results: ß-Catenin significantly decreased intracellularly in all experimental groups (p = 0.002, Friedman). AA group exhibited significantly higher cellular counts on days 3, 6, 7, and 13 (p < 0.05) and the highest CFUs at 14 days [median-CFUs (Q25/Q75); 40 (15/50), p = 0.043]. Significantly higher Nanog expression was noted in AA group [median gene-copies/PGK1 (Q25/Q75); 0.0006 (0.0002/0.0007), p < 0.01, Wilcoxon-signed-rank]. Significant multilineage differentiation abilities, especially into osteogenic and chondrogenic directions, were further evident in the AA group. Conclusions: AA stimulation enhances G-MSCs' stemness, proliferation, and differentiation properties, effects which are associated with a Wnt/ß-catenin signaling pathway activation. Apart from initially boosting cellular metabolism as well as Sox2 and Oct4A pluripotency marker expression, inflammation appeared to attenuate these AA-induced positive effects. Current results reveal that for AA to exert its beneficial effects on G-MSCs' cellular attributes, it requires to act in an inflammation-free microenvironment.

4.
J Endod ; 2020 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-32827509

RESUMO

INTRODUCTION: Stem/progenitor cells from the apical papilla (SCAPs) demonstrate remarkable regenerative and immunomodulatory properties. During their regenerative events, SCAPs, similar to other stem/progenitor cells, could interact with their local inflammatory microenvironment via their expressed toll-like receptors (TLRs). The present study aimed to describe for the first time the unique TLR expression profile of SCAPs. METHODS: Cells were isolated from the apical papilla of extracted wisdom teeth (n = 8), STRO-1 immunomagnetically sorted, and cultured to obtain single colony-forming units. The expression of CD14, 34, 45, 73, 90, and 105 were characterized on the SCAPs, and their multilineage differentiation potential was examined to prove their multipotent aptitude. After their incubation in basic or inflammatory medium (25 ng/mL interleukin 1 beta, 103 U/mL interferon gamma, 50 ng/mL tumor necrosis factor alpha, and 3 × 103 U/mL interferon alpha), a TLR expression profile for SCAPs under uninflamed as well as inflamed conditions was respectively generated. RESULTS: SCAPs demonstrated all predefined stem/progenitor cell characteristics. In basic medium, SCAPs expressed TLRs 1-10. The inflammatory microenvironment up-regulated the expression of TLR1, TLR2, TLR4, TLR5, TLR6, and TLR9 and down-regulated the expression of TLR3, TLR7, TLR8, and TLR10 in SCAPs under the inflamed condition. CONCLUSIONS: The present study defines for the first time a distinctive TLR expression profile for SCAPs under uninflamed and inflamed conditions. This profile could greatly impact SCAP responsiveness to their inflammatory microenvironmental agents under regenerative conditions in vivo.

5.
Periodontol 2000 ; 84(1): 35-44, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32844413

RESUMO

It is well established that dental plaque on teeth leads to gingivitis and periodontitis, and that several mechanical and chemical methods of plaque control can prevent gingivitis. The aim of the current review is to summarize and synthesize the available scientific evidence supporting practices for mechanical oral hygiene to prevent periodontal diseases. Evidence for contemporary practices of mechanical oral hygiene to prevent periodontal disease relies on studies of gingivitis patients. General recommendations concerning the ideal oral hygiene devices and procedures are still inconclusive. However, toothbrushing and interdental cleaning remain the mainstays of prevention of periodontal diseases. The primary approach requires individually tailored instruction for implementation of a systematic oral hygiene regimen.


Assuntos
Placa Dentária/prevenção & controle , Gengivite/prevenção & controle , Doenças Periodontais/prevenção & controle , Dispositivos para o Cuidado Bucal Domiciliar , Humanos , Higiene Bucal , Escovação Dentária
7.
Artigo em Inglês | MEDLINE | ID: mdl-32549206

RESUMO

Oral health care providers are expected to show good examples of oral health behaviours and attitudes to their community. Previous studies displayed the constructive effect of dental education on oral hygiene manners of undergraduate students. The aim of this survey was to assess and compare aspects of oral health attitudes and behaviours between preclinical and clinical dental students in German universities. The German-language version of the HU-DBI was distributed to preclinical and clinical students from different German universities. Dichotomized (agree/disagree) responses to 20 HU-DBI items were provided in this study, with a maximum possible score of 19. A quantitative estimate of oral health attitudes and behaviours was provided by the total of appropriate answers given to every statement by each group. Data were analysed statistically. The overall mean score of answers favouring good oral hygiene was marginally higher in preclinical (14.62) than clinical students (14.31) but showed no statistical significance. Similarly, the analysis of each item individually displayed no statistically significant differences between preclinical and clinical participants, except in a single item of the survey. This study showed no effective differences in oral hygiene attitudes and behaviour between preclinical and clinical students in German universities. This reveals a weak effect of dental education on improving students' oral health attitudes in Germany and might demand the introduction of more courses emphasizing the importance of correct oral health behaviour of health care providers.


Assuntos
Atitude Frente a Saúde , Higiene Bucal , Estudantes de Odontologia , Atitude do Pessoal de Saúde , Feminino , Alemanha , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Saúde Bucal , Inquéritos e Questionários
8.
Clin Oral Investig ; 2020 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-32474807

RESUMO

OBJECTIVES: Whereas the key role of subgingival instrumentation in periodontal therapy is well known, the influence of operators' experience/training with different devices on treatment results is yet uncertain. Therefore, we assessed untrained undergraduate students, working on manikins, as to how effectively they learn to use curettes (GRA) and sonic scalers (AIR); hypothesizing that AIR will result in higher relative cleaning efficacy (RCE) than GRA. MATERIAL AND METHODS: Before baseline evaluation (T0), 30 operators (9 males, 21 females) received a 2-h theoretical lesson for both instruments, followed by a 12-week period with a weekly digitized training program for 45 min. During three sessions (T1-T3), the operators had to instrument six equivalent test teeth with GRA and AIR. At T0-T3, treatment time, proportion of removed simulated biofilm (RCE-b), and hard deposits (RCE-d) were measured. RESULTS: At T0, RCE-b was in mean(SD) 64.18(25.74) % for GRA, 62.25(26.69) % for AIR; (p = 0.172) and RCE-d 85.48(12.32) %/ 65.71(15.27) % (p < 0.001). At T3, operators reached highest RCE-b in both groups (GRA/AIR 71.54(23.90) %/71.75(23.05)%; p = 0.864); RCE-d GRA/AIR: 84.68(16.84) %/77.85(13.98) %; p < 0.001). Both groups achieved shorter treatment times after training. At T3, using curettes was faster (GRA/AIR 16.67(3.31) min/19.80(4.52) min; p < 0.001). CONCLUSIONS: After systematic digitized training, untrained operators were able to clean 70% of the root surfaces with curettes and sonic scalers. CLINICAL RELEVANCE: It can be concluded that a systematic digitized and interactive training program in manikin heads is helpful in the training of root surface debridement.

9.
BMC Oral Health ; 20(1): 136, 2020 05 08.
Artigo em Inglês | MEDLINE | ID: mdl-32384897

RESUMO

BACKGROUND: Interdental rubber picks (IRP) have become a frequent and convenient alternative for interdental cleaning. However, only little evidence exists supporting the effectiveness of newer designs available on the market. Therefore, a new in vitro model was evaluated to measure the experimental cleaning efficacy (ECE), as well as the force needed for insertion and during the use of IRP, with high reproducibility. METHODS: Five different sizes of commercially marketed IRP with elastomeric fingers (IRP-F) (GUM SOFT-PICKS® Advanced, Sunstar Deutschland GmbH, Schönau, Germany) or slats (IRP-S) (TePe EasyPick™, TePe D-A-CH GmbH, Hamburg, Germany) were tested. Interdental tooth surfaces were reproduced by a 3D-printer (Form 2, Formlabs Sommerville, MA, USA) according to human teeth and matched to morphologically equivalent pairs (isosceles triangle, concave, convex) fitting to different gap sizes (1.0 mm, 1.1 mm, 1.3 mm). The pre-/post brushing situations at interdental areas (standardized cleaning, computer aided ten cycles) were photographically recorded and quantified by digital image subtraction to calculate ECE [%]. Forces were registered with a load cell [N]. RESULTS: IRP-F have to be inserted with significant higher forces of 3.2 ± 1.8 N compared to IRP-S (2.0 ± 1.6 N; p < 0.001) independent of the size and type of artificial interdental area. During cleaning process IRP-S showed significantly lower values for pushing/pulling (1.0 ± 0.8 N/0.5 ± 0.4 N) compared to IRP-F (1.6 ± 0.8 N/0.7 ± 0.3 N; p < 0.001) concomitant to significantly lower ECE (19.1 ± 9.8 vs. 21.7 ± 10.0%, p = 0.002). Highest ECE was measured with largest size of IRP-F/IRP-S independent the morphology of interdental area. CONCLUSIONS: New interdental cleaning aids can be tested by the new experimental setup supported by 3D printing technology. Within the limitations of an in vitro study, IRP-F cleaned more effectively at higher forces compared to IRP-S.


Assuntos
Dispositivos para o Cuidado Bucal Domiciliar , Placa Dentária/prevenção & controle , Escovação Dentária/instrumentação , Alemanha , Humanos , Fotografia Dentária , Pressão , Reprodutibilidade dos Testes , Escovação Dentária/métodos
10.
J Clin Periodontol ; 47(8): 991-1005, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32473038

RESUMO

AIM: Toll-like receptors are key players in mesenchymal stem/progenitor cells' micro-environmental crosstalk, endorsing various biological reactions. For the first time, this study investigates the effects of TLR3-ligation on gingival mesenchymal stem/progenitor cells (G-MSCs) stemness and differentiation properties. MATERIAL AND METHODS: G-MSCs (n = 5) were isolated, sorted using anti-STRO-1 antibodies,and sowed on culture dishes to generate colony-forming units (CFUs), and their stem/progenitor cells' features and TLR3 expression were characterized. Subsequently, TLR3 activation of G-MSCs via Poly (I:C) was done, followed by an analysis of the expression of pluripotency-related factors, mesenchymal stemness-associated surface markers, and the ability to form CFUs and multilineage differentiation, using qualitative and quantitative histochemistry and RT-PCR. RESULTS: G-MSCs demonstrated all predefined stem/progenitor cells' characteristics and TLR3 expression. TLR3-activated G-MSCs showed a significantly reduced ability to form CFUs and pluripotency transcriptional factors expression. Mesenchymal stem/progenitor cell-associated surface markers and multilinear differentiation potential were significantly higher following TLR3 ligation (p < .05, Wilcoxon signed rank test). CONCLUSIONS: TLR3-mediated activation maintains the mesenchymal stem/progenitor cells phenotype and drives G-MSCs' differentiation and commitment, with a shift away from an undifferentiated pluripotent cellular phenotype. This distinctive modulation could influence potential therapeutic applications of G-MSCs.

11.
Stem Cells Int ; 2020: 1941629, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32300365

RESUMO

Cell-based therapies currently represent the state of art for tissue regenerative treatment approaches for various diseases and disorders. Induced pluripotent stem cells (iPSCs), reprogrammed from adult somatic cells, using vectors carrying definite transcription factors, have manifested a breakthrough in regenerative medicine, relying on their pluripotent nature and ease of generation in large amounts from various dental and nondental tissues. In addition to their potential applications in regenerative medicine and dentistry, iPSCs can also be used in disease modeling and drug testing for personalized medicine. The current review discusses various techniques for the production of iPSC-derived osteogenic and odontogenic progenitors, the therapeutic applications of iPSCs, and their regenerative potential in vivo and in vitro. Through the present review, we aim to explore the potential applications of iPSCs in dental and nondental tissue regeneration and to highlight different protocols used for the generation of different tissues and cell lines from iPSCs.

12.
Stem Cells Int ; 2020: 5734539, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32184832

RESUMO

Stem/progenitor cells are undifferentiated cells characterized by their exclusive ability for self-renewal and multilineage differentiation potential. In recent years, researchers and investigations explored the prospect of employing stem/progenitor cell therapy in regenerative medicine, especially stem/progenitor cells originating from the oral tissues. In this context, the regeneration of the lost dental tissues including enamel, dentin, and the dental pulp are pivotal targets for stem/progenitor cell therapy. The present review elaborates on the different sources of stem/progenitor cells and their potential clinical applications to regenerate enamel, dentin, and the dental pulpal tissues.

13.
Stem Cells Int ; 2020: 7593402, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32089709

RESUMO

Regenerative medicine literature has proposed mesenchymal stem/progenitor cell- (MSC-) mediated therapeutic approaches for their great potential in managing various diseases and tissue defects. Dental MSCs represent promising alternatives to nondental MSCs, owing to their ease of harvesting with minimally invasive procedures. Their mechanism of action has been attributed to their cell-to-cell contacts as well as to the paracrine effect of their secreted factors, namely, secretome. In this context, dental MSC-derived secretome/conditioned medium could represent a unique cell-free regenerative and therapeutic approach, with fascinating advantages over parent cells. This article reviews the application of different populations of dental MSC secretome/conditioned medium in in vitro and in vivo animal models, highlights their significant implementation in treating different tissue' diseases, and clarifies the significant bioactive molecules involved in their regenerative potential. The analysis of these recent studies clearly indicate that dental MSCs' secretome/conditioned medium could be effective in treating neural injuries, for dental tissue regeneration, in repairing bone defects, and in managing cardiovascular diseases, diabetes mellitus, hepatic regeneration, and skin injuries, through regulating anti-inflammatory, antiapoptotic, angiogenic, osteogenic, and neurogenic mediators.

14.
PeerJ ; 8: e8495, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32030328

RESUMO

Background: The aim of this study was to assess the clinical impact of non-surgical root canal treatments (NSRCT) performed with different treatment protocols on the probability of tooth survival without untoward events and to identify predictors influencing the outcome. Methods: During the period from July 1999 to October 2016, 5,858 patients were identified in which 9,967 NSRCTs were performed. The treatments were followed up and divided into three groups. In Group 1 root canal treatment was performed with hand instruments, in Group 2 with multiple file rotary instruments and passive ultrasonic irrigation (PUI), and Group 3 was treated with Reciproc instruments and PUI. Untoward events were defined as orthograde retreatment, apicoectomy or extraction of the tooth after initial treatment. Weibull regression was used to analyse the data. Results: A total of 9,938 cases could be included into the analyses. The results showed 5-years predicted survival rates without untoward events of 73.9% (95% CI [71.7%-76.1%]), 75.1% (95% CI [71.7%-78.0%]) and 78.4% (95% CI [75.1%-81.4%]) for study group 1 (N = 5,580), 2 (N = 1,700) and 3 (N = 2,658), respectively. The differences between Group 1 and 3 were statistically significant (p < 0.006). Higher age of the patient (per year increase) and number of earlier NSRCTs (per unit increase) reduce the survival without untoward events statistically significant (both p < 0.02), while treatment of premolars had a statistically significant lower hazard ratio [0.89 (95% CI [0.79-0.99]; p = 0.030)] compared to treatment of molars and anterior teeth. A higher number of supportive periodontal treatments (per unit increase) improved tooth survival without untoward events highly significant (p < 0.0001). Discussion: More recent endodontic treatment protocols involving reciprocating instruments and PUI appear to be associated with higher tooth survival rates without untoward events compared to hand instruments.

15.
Clin Oral Investig ; 24(2): 607-617, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31111282

RESUMO

OBJECTIVES: There is uncertainty regarding the benefits of periodontal endoscopy (PE) for subgingival instrumentation. Moreover, the influence of operators' experience and training with such a device on treatment results is unclear. Therefore, we compared in an in vitro study the use of PE for scaling and root planing (SRP) with the conventional non-surgical therapy, hypothesizing that using a PE allows to remove more simulated hard deposits than without (nPE), influenced by the operators' experience and training. MATERIAL AND METHODS: A sonic device and Gracey curettes were utilized by 11 operators (six dentists, five dental hygienists) in periodontitis manikins heads. The time required for treatment and the proportion of removed simulated hard deposits by SRP were measured. RESULTS: Using the PE led to a significant difference in removal of simulated hard deposits (%) (mean ± SD) irrespective of operators' experience (PE 90.78 ± 12.10% (range 58.80-100%); nPE 79.98 ± 22.15% (range 38.10-100%, p < 0.001)), sub-analyses for different tooth types demonstrated a significant difference in favor of PE for front teeth (p < 0.001) and in the upper jaw independent of the tooth type (p < 0.001). Comparison of treatment times for two quadrants with and without PE showed a significantly longer treatment time with PE (∆22.27 ± 17.98 mins, p <0.001). CONCLUSIONS: Within the present pilot study, the use of PE led to more removal of simulated hard deposits but was concomitantly related to more time and financial effort. Using PE was most beneficial in the front area. CLINICAL RELEVANCE: PE may provide additional benefits for the removal of hard deposits compared to traditional SRP. The beneficial effect of PE seems not to be influenced by operators experience nor by pocket probing depth.


Assuntos
Endoscopia , Raspagem Dentária , Humanos , Periodontite , Projetos Piloto , Aplainamento Radicular
16.
Artigo em Inglês | MEDLINE | ID: mdl-33396877

RESUMO

Dentists should present to patients as good role models in their oral health behaviour. Previous studies have demonstrated how education can improve dental students' oral health. This pilot investigation aimed to compare and evaluate the features of the oral health behaviour and attitudes of preclinical and clinical dental students at Ain Shams University, a public Egyptian university. The Hiroshima University-Dental Behaviour Inventory (HU-DBI) survey was provided to 149 (78 female/71 male) dental students. Dichotomised (agree/disagree) answers to 20 HU-DBI items were possible, with a maximum conceivable score of 19. An estimation of oral health behaviour and attitudes was calculated by the sum of correct oral health answers to every item by the study groups and evaluated statistically. The score of oral health-favouring answers was higher in clinical (11.50) than preclinical students (10.63) and was statistically significant (p < 0.05). Single-item evaluations showed no statistical significance, except in one survey item. This survey exhibited weak differences in the improvement of oral hygiene behaviour and attitudes between participating preclinical and clinical students, as well as overall poor oral health behaviour in both groups. This inadequacy of Egyptian public dental education in terms of sufficient student oral health progress emphasises the necessity for supplementary courses and curricular reviews that accentuate the need for future dentists to display the correct oral health behaviour.


Assuntos
Atitude Frente a Saúde , Saúde Bucal , Estudantes de Odontologia , Egito , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Higiene Bucal , Projetos Piloto , Autoavaliação , Estudantes de Odontologia/psicologia , Estudantes de Odontologia/estatística & dados numéricos , Inquéritos e Questionários , Universidades
17.
Sci Rep ; 9(1): 8495, 2019 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-31186466

RESUMO

We applied deep convolutional neural networks (CNNs) to detect periodontal bone loss (PBL) on panoramic dental radiographs. We synthesized a set of 2001 image segments from panoramic radiographs. Our reference test was the measured % of PBL. A deep feed-forward CNN was trained and validated via 10-times repeated group shuffling. Model architectures and hyperparameters were tuned using grid search. The final model was a seven-layer deep neural network, parameterized by a total number of 4,299,651 weights. For comparison, six dentists assessed the image segments for PBL. Averaged over 10 validation folds the mean (SD) classification accuracy of the CNN was 0.81 (0.02). Mean (SD) sensitivity and specificity were 0.81 (0.04), 0.81 (0.05), respectively. The mean (SD) accuracy of the dentists was 0.76 (0.06), but the CNN was not statistically significant superior compared to the examiners (p = 0.067/t-test). Mean sensitivity and specificity of the dentists was 0.92 (0.02) and 0.63 (0.14), respectively. A CNN trained on a limited amount of radiographic image segments showed at least similar discrimination ability as dentists for assessing PBL on panoramic radiographs. Dentists' diagnostic efforts when using radiographs may be reduced by applying machine-learning based technologies.


Assuntos
Perda do Osso Alveolar/diagnóstico por imagem , Aprendizado Profundo , Radiografia , Bases de Dados como Assunto , Odontólogos , Humanos , Curva ROC , Reprodutibilidade dos Testes
18.
Tissue Eng Part B Rev ; 25(5): 445-460, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31179893

RESUMO

Relying on their ease of isolation and remarkable tissue reparative/regenerative potential, dental pulp stem/progenitor cells (DPSCs) gained pronounced importance in the field of regenerative dentistry. Though inflammation is classically considered the reason for the damage of the dentin-pulpal complex, it continues to be an essential stage of any dentin-pulpal tissue repair or regeneration procedures. During their performance of a pulpal tissue repair or regeneration actions, DPSCs interact with their inflammatory microenvironment locally, possibly influencing their fate and the result of any DPSCs-mediated dentin-pulpal reparative/regenerative endeavor. Hence, this review aims at comprehensively elaborating on these complex interactions of DPSCs with their local pulpal inflammatory microenvironment, particularizing on the inflammatory aspects, affecting DPSCs' stemness, homing/migration, proliferation, differentiation as well as immunomodulation characteristics, and the potentially fundamental intracellular processes involved and their anticipated association with the noncanonical as well as canonical Wnt/ß-Catenin intracellular signaling. Impact Statement This review particularizes on the current state of knowledge on the complex interrelation between dental pulp stem/progenitor cells and their pulpal inflammatory microenvironment; elaborates on inflammation aspects affecting their stemness, proliferation, migration/homing, differentiation and immunomodulation characteristics, and the fundamental intracellular processes involved and their anticipated association with the canonical and noncanonical Wnt pathways. All these aspects could significantly affect the dento-pulpal regenerative therapeutic approaches in vivo.


Assuntos
Polpa Dentária/citologia , Inflamação/terapia , Regeneração , Medicina Regenerativa , Células-Tronco/citologia , Cicatrização , Animais , Diferenciação Celular , Humanos , Imunomodulação , Tecidos Suporte
19.
J Periodontal Res ; 54(4): 413-423, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30830694

RESUMO

BACKGROUND AND OBJECTIVE: Inflammatory cytokines impact the course of periodontal disease, repair, and regeneration. Vitamin A and its metabolites are inflammation-modulatory biomolecules, affecting cellular pluripotency. The aim of this study was to investigate the effect of retinol and periodontal inflammatory cytokines (IL-1ß/TNF-α/IFN-γ) on pluripotency and proliferative properties of gingival mesenchymal stem/progenitor cells (G-MSCs), for the first time. MATERIAL AND METHODS: Human G-MSCs (n = 5) were STRO-1 immuno-magnetically sorted, characterized and expanded in basic medium (control group), in basic medium with IL-1ß (1 ng/mL), TNF-α (10 ng/mL), and IFN-γ (100 ng/mL) (inflammatory group), in basic medium with retinol (20 µmol/L) (retinol group) and with retinol added to the inflammatory group (inflammatory/retinol group). ß-catenin levels at 1 hour, cellular proliferation over 14 days, and colony-forming units (CFUs) at 14 days were investigated. Pluripotency gene expressions were examined at 1, 3, and 5 days via reverse transcription-polymerase chain reaction (RT-PCR). Multilineage differentiation potential was evaluated, following 5 days priming, using qualitative and quantitative histochemistry and RT-PCR. RESULTS: G-MSCs were CD14- , CD34- , CD45- , CD73+ , CD90+ , CD105+ , and showed mesenchymal stem/progenitor cells' hallmarks, CFUs, and multilineage differentiation potential. Intracellular ß-catenin significantly declined in the stimulated groups (P < 0.001, Friedman test). Cellular proliferation at 72 hours was most prominent in the control and inflammatory group [Median cell numbers (Q25/Q75); 6806 (4983/7312) and 5414 (4457/7230), respectively], followed by an upsurge in the retinol group. At 14 days, the retinol group exhibited the highest CFUs [Median CFUs (Q25/Q75); 35 (20/58), P = 0.043, Wilcoxon signed-rank]. Nanog was most expressed in the inflammatory and retinol group [Median gene expression/PGK1 (Q25/Q75); 0.0006 (0.0002/0.0014) and 0.0005 (0.0003/0.0008)]. Inflammation significantly upregulated Sox2 expression [0.0002 (0.0008/0.0005)], while its expression was diminished in the retinol and inflammatory/retinol group (P < 0.001, Friedman test). Inflammatory/retinol group exhibited the highest multilineage differentiation potential. CONCLUSION: Controlled short-term inflammatory/retinol stimuli activate the Wnt/ß-catenin pathway, affecting G-MSCs' pluripotency, proliferation, and differentiation. The present findings provide further insights into the inflammatory-regenerative interactions and their modulation potential for G-MSCs-mediated periodontal repair/regeneration.


Assuntos
Diferenciação Celular , Inflamação , Células-Tronco/citologia , Vitamina A/farmacologia , Via de Sinalização Wnt , Células Cultivadas , Citocinas/metabolismo , Humanos
20.
J Clin Periodontol ; 46(5): 522-528, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30762911

RESUMO

AIM: Recombinant secreted frizzled-related protein 5 (sFRP5) improved periodontal status in mice. Thus, this study aimed to investigate this finding in human periodontitis using an epidemiological approach. MATERIALS AND METHODS: sFRP5 and wnt5a concentrations were determined in human serum from the Food Chain Plus cohort using ELISAs. A total of 128 patients with periodontitis and tooth loss and 245 patients with periodontitis without tooth loss were compared to 373 sex-, smoker-, age- and BMI-matched individuals in a nested case-control design. RESULTS: Systemic sFRP5 serum levels were significantly lower in patients with periodontitis and tooth loss (2.5 [0.0-10.4] ng/ml, median [IQR]) compared to patients with periodontitis without tooth loss (6.0 [2.5-15.8] ng/ml, median [IQR], p = 0.04] and matched controls (7.0 [2.5-18.3] ng/ml, median [IQR], p = 0.02). No significant differences in sFRP5 serum levels were found among patients with periodontitis without tooth loss (6.0 [2.5-15.8] ng/ml, median [IQR]) and controls (3.1 [0.0-10.6] ng/ml, median [IQR], p = 0.06). CONCLUSIONS: sFRP5 might serve as a novel biomarker for periodontitis severity. Modulating the inflammatory background of severe forms of periodontitis, in the time of precision medicine, needs to be revealed in further studies.


Assuntos
Proteínas do Olho , Periodontite , Animais , Estudos de Casos e Controles , Humanos , Peptídeos e Proteínas de Sinalização Intracelular , Proteínas de Membrana , Camundongos
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