Treatment of gingival defects with gingival mesenchymal stem cells derived from human fetal gingival tissue in a rat model.

BACKGROUND: The study aimed to evaluate the efficacy and safety of gingival mesenchymal stem cells (GMSCs) from human fetal gingival tissue used for treating gingival defects in a rat model. METHODS: GMSCs were isolated from human fetal gingival tissue and identified by flow cytometry for nestin, Oct4, vimentin, NANOG, CD105, and CD90. The immunogenicity of GMSCs was analyzed by mixed lymphocyte reactions; the tumorigenicity of GMSCs was evaluated by xenotransplanting into nude mice. The gingival defect animal model was established by mechanical resection in rats. GMSCs were transplanted into the defective area, and the regeneration of gingival tissue was observed twice weekly. Four weeks after transplantation, the gingival tissue was surgically cut down, and the graft was analyzed by immunohistochemistry staining for human mitochondrial antigens and rat CD3 and CD20. RESULTS: GMSCs from human fetal gingival tissue positively expressed nestin, Oct4, vimentin, NANOG, CD105, and CD90. There was no cell aggregation after mixed lymphocyte reactions, and interleukin-2 did not increase. Inoculation of GMSCs into nude mice for 6 months showed no tumor formation. GMSCs were transplanted into the gingiva defects of rats. One week after transplantation, the defect area was reduced, and after 3 weeks the morphology and color of local gingival tissue was similar to normal gingival tissue, and gingival height was the same as the normal control group. CONCLUSIONS: Using GMSCs from human fetal gingival tissue to treat gingival defects is a safe and effective innovative treatment method.

Coronally advanced flap in conjunction with platelet-rich fibrin-assisted immediate management of residual gingival defect following surgical excision of recurrent pyogenic granuloma in the maxillary esthetic segment.

Exophytic gingival lesions are more frequently encountered intraorally, out of which few are reactive in nature. Pyogenic granuloma (PG) is one of the commonly occurring reactive benign mucocutaneous lesions; exact etiopathogenesis remains unclear. Although surgical excision is the treatment of choice, sometimes it may induce residual soft defect formation which further creates an esthetic problem, root sensitivity, etc., The present case report not only describes the diagnosis and treatment of PG but also the immediate successful management of residual gingival defect in the esthetic area (which was originated as a sequel of the excisional biopsy of recurrent PG) by utilizing platelet-rich fibrin in conjunction with coronally advanced flap in single-stage surgery. Clinical healing was uneventful and satisfactory at 2 weeks, and excellent coverage of residual mucogingival defect with gingival esthetic and normal sulcus depth was observed at 3 and 6 months postoperatively without any sign of a complication.

Colored Gingiva Composite Used for the Rehabilitation of Gingiva Recessions and Non-Carious Cervical Lesions.

In this case of extensive gingival recession (Miller's Class II) and mild physiologic pigmentation, an alternative method for the placement of Amaris Gingiva-Colored Composite was used to produce a non-invasive, aesthetic result acceptable to the patient. In restoring the defects in the entire maxilla of this patient, the opaquers were not mixed, but applied individually, directly to various areas of the teeth. Multiple opaquers were placed in a pattern mimicking the coloring of the patient's gingiva. These were then covered with the base shade for a more aesthetic result to the patient's satisfaction. The restorations resulting from the alternative method were highly aesthetic and at an eleven (11) month review showed no signs of failure giving rise to the conclusion that this method proposed for application of Amaris Gingiva-Colored Composite is viable for producing highly-aesthetic restorations in cases of gingival recession.