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Understanding the composition and function of cells constituting tissues and organs is vital for unraveling biological processes. Single-cell analysis has allowed us to move beyond traditional methods of categorizing cell types. This innovative technology allows the transcriptional and epigenetic profiling of numerous individual cells, leading to significant insights into the development, homeostasis, and pathology of various organs and tissues in both animal models and human samples. In this review, we delve into the outcomes of major investigations using single-cell transcriptomics to decipher the cellular composition of mammalian teeth and periodontal tissues. The recent single-cell transcriptome-based studies have traced in detail the dental epithelium-ameloblast lineage and dental mesenchyme lineages in the mouse incisors and the tooth germ of both mice and humans; unraveled the microenvironment, the identity of niche cells, and cellular intricacies in the dental pulp; shed light on the molecular mechanisms orchestrating root formation; and characterized cellular dynamics of the periodontal ligament. Additionally, cellular components in dental pulps were compared between healthy and carious teeth at a single-cell level. Each section of this review contributes to a comprehensive understanding of tooth biology, offering valuable insights into developmental processes, niche cell identification, and the molecular secrets of the dental environment.

Signal regulatory protein alpha (SIRPα) is mainly expressed by cells of myeloid origin. This membrane glycoprotein is shown to be involved in regulation of different inflammatory conditions, such as colitis and arthritis. However, SIRPα has not been investigated in relationship to periodontitis, an inflammatory condition affecting the tooth supporting tissues. We aim to investigate if resident cells in the periodontium express SIRPα and whether a possible expression is affected by inflammatory conditions. Primary human keratinocytes, fibroblasts, periodontal ligament cells, and osteoblasts were cultured with or without the pro-inflammatory cytokines tumor necrosis factor alpha (TNF-α) or interleukin-1-beta (IL-1β). All different periodontal cell types showed a basal mRNA expression of SIRPα. Pro-inflammatory cytokines induced a 2–3-fold significant increase in SIRPα expression in both cultured human gingival fibroblasts and osteoblasts but neither in keratinocytes nor in periodontal ligament cells. Tissue sections from human gingival tissue biopsies were histochemically stained for SIRPα. Epithelial keratinocytes and gingival fibroblasts stained positive in sections from periodontally healthy as well as in sections from periodontitis. In periodontitis sections, infiltrating leukocytes stained positive for SIRPα. We highlight our finding that oral keratinocytes, gingival fibroblasts, and periodontal ligament cells do express SIRPα, as this has not been presented before. The fact that inflammatory stimulation of gingival fibroblasts increased the expression of SIRPα, while an increased expression by gingival fibroblasts in periodontitis tissue in situ could not be detected, is indeed contradictory.

Objective To investigate the clinical characteristics, diagnosis and treatment of severe combined periodontal-endodontic lesions in a double-rooted maxillary lateral incisor with a palatal radicular groove and to provide a reference for clinical diagnosis and treatment. Methods A patient with a double-rooted left maxillary lateral incisor with a palatal radicular groove and severe combined periodontal-endodontic lesions underwent complete root canal therapy and intentional replantation, and a retrospective analysis of the management of this type of patient was performed based on the literature. Results The 3-year follow-up examination revealed no discomfort, good healing of the upper left lateral incisor, no pathological loosening, and a palatal gingival sulcus was found at a depth of approximately 1 mm. Review of the literature showed that the prognosis of the affected tooth and the choice of treatment plan were correlated with the length and depth of extension of the lingual groove toward the root, the periodontal condition and the pulpal status of the affected tooth. For minor PRGs or for affected teeth with no loss of pulpal viability, flap surgery and odontoplasty can be used to avoid endodontic treatment or retreatment. For deep or long lingual grooves that result in significant loss of periodontal tissue, endodontic treatment, odontoplasty, or closure of the grooves and guided tissue regeneration are needed. In the case of PRGs with double root formation, the affected tooth can be preserved via root canal therapy, removal of the small root and filling with apical restorative material, and intentional replantation. Conclusion In cases of severe combined periodontal-endodontic lesions due to palatal radicular grooves occurring in double-rooted maxillary lateral incisors, clinical presentation and imaging can prevent missed diagnoses, and appropriate treatment should be based on the length and depth of lingual grooves extending toward the roots, periodontal conditions, and pulpal status of the affected teeth.

Abstract Background The surgically facilitated orthodontic strategy has been a promising strategy for orthodontic treatment recently. Therefore, the present meta-analysis was conducted to assess the available scientific evidence regarding the clinical outcomes, including the potential detrimental effects associated with these surgical procedures, with the aim of providing much more evidence-based information for clinical practice. Methods An electronic search of three databases (PubMed, Cochrane, and Embase) and a manual search of relevant articles published up to May 2023 were carried out. Clinical trials (≥ 10 subjects) that utilized surgically facilitated orthodontic strategies with clinical and/or radiographic outcomes were included. Meta-analyses and sub-group analyses were performed to analyze the standardized mean difference (SMD) or weighted mean difference (WMD), and confidence interval (CI) for the recorded variables. Results Nineteen studies published from Oct 2012 to May 2023 met the inclusion criteria. Based on the analysis outcomes, corticotomy treatment significantly decreased the alignment duration (WMD: -1.08 months; 95% CI = -1.65, -0.51 months, P = 0.0002), and accelerated the canine movement (WMD: 0.72 mm; 95% CI = 0.63, 0.81 mm, P

Background/purpose: The ligature-induced periodontitis model is an effective approach to induce inflammation and bone loss similar to that of human periodontitis. Previous clinical and in vitro studies have shown the involvement of lymphocytes in periodontitis, while, the local and systemic profile of immune cells associated with periodontitis in the ligature-induced periodontitis model in mice remains unclear. Materials and methods: Experimental periodontitis was constructed in mice by ligating around the maxillary second molars for 14 and 28 days, respectively. Alveolar bone loss was assessed by micro-computed tomography (micro-CT). Hematoxylin and eosin (H&E) and tartrate-resistant acid phosphatase (TRAP) staining were used to evaluate the histological changes in the periodontal tissues. B and T cells in the cervical lymph nodes, spleen, and peripheral blood were analyzed by flow cytometry. Results: The 14-day ligation effectively induced significant periodontal inflammation and alveolar bone loss in C57BL/6J mice, which were progressive and maintained for a relatively long-term period until day 28. In addition, CD3+ T cells and CD19+ B cells were the dominant population in both health and disease, and the B cell population within the cervical lymph nodes (LN) increased significantly under periodontitis condition, while, no significant differences of the T and B cell population among the spleen and peripheral blood were observed. Conclusion: The ligature-induced periodontitis mice model was established to perform a longitudinal assessment of changes in periodontal tissues morphologically and histologically, meanwhile, explore the local and systemic changes of the predominant immune-associated cells.

Introduction: Periodontal disease is an infectious syndrome presenting inflammatory aspects. Radiographic evaluation is an essential complement to clinical assessment but has limitations such as the impossibility of assessing tissue inflammation. It seems essential to consider new exploration methods in clinical practice. Ultrasound of periodontal tissues could make it possible to visualize periodontal structures and detect periodontal diseases (periodontal pocket measurement and the presence of intra-tissue inflammation). Clinical Innovation Report: An ultrasound probe has been specially developed to explore periodontal tissues. The objective of this clinical innovation report is to present this device and expose its potential. Discussion: Various immediate advantages favor using ultrasound: no pain, no bleeding, faster execution time, and an image recording that can be replayed without having to probe the patient again. Ultrasound measurements of pocket depth appear to be as reliable and reproducible as those obtained by manual probing, as do tissue thickness measurements and the detection of intra-tissue inflammation. Conclusions: Ultrasound seems to have a broad spectrum of indications. Given the major advances offered by ultrasound imaging as a complementary aid to diagnosis, additional studies are necessary to validate these elements and clarify the potential field of application of ultrasound imaging in dentistry.

Abstract Orthodontic tooth movement relies on bone remodeling and periodontal tissue regeneration in response to the complicated mechanical cues on the compressive and tensive side. In general, mechanical stimulus regulates the expression of mechano-sensitive coding and non-coding genes, which in turn affects how cells are involved in bone remodeling. Growing numbers of non-coding RNAs, particularly mechano-sensitive non-coding RNA, have been verified to be essential for the regulation of osteogenesis and osteoclastogenesis and have revealed how they interact with signaling molecules to do so. This review summarizes recent findings of non-coding RNAs, including microRNAs and long non-coding RNAs, as crucial regulators of gene expression responding to mechanical stimulation, and outlines their roles in bone deposition and resorption. We focused on multiple mechano-sensitive miRNAs such as miR-21, - 29, -34, -103, -494-3p, -1246, -138-5p, -503-5p, and -3198 that play a critical role in osteogenesis function and bone resorption. The emerging roles of force-dependent regulation of lncRNAs in bone remodeling are also discussed extensively. We summarized mechano-sensitive lncRNA XIST, H19, and MALAT1 along with other lncRNAs involved in osteogenesis and osteoclastogenesis. Ultimately, we look forward to the prospects of the novel application of non-coding RNAs as potential therapeutics for tooth movement and periodontal tissue regeneration.

Periodontal tissue stem cells, which play a crucial role in maintaining the homeostasis of periodontal tissues, are found in the periodontal ligament (PDL). These cells have long been referred to as mesenchymal stem/stromal cells (MSCs), and their clinical applications have been extensively studied. However, tissue stem cells in the PDL have not been thoroughly investigated, and they may be different from MSCs. Recent advances in stem cell biology, such as genetic lineage tracing, identification of label-retaining cells, and single-cell transcriptome analysis, have made it possible to analyze tissue stem cells in the PDL in vivo. In this review, we summarize recent findings on these stem cell populations in PDL and discuss future research directions toward developing periodontal regenerative therapy.

The aesthetic constancy and functional stability of periodontium largely depend on the presence of healthy mucogingival tissue. Soft tissue management is crucial to the success of periodontal surgery. Recently, synthetic substitute materials have been proposed to be used for soft tissue augmentation, but the tissue compatibility of these materials needs to be further investigated. This study aims to assess the in vitro responses of human gingival mesenchymal stromal cells (hG-MSCs) cultured on a Gelatin/Polycaprolactone prototype (GPP) and volume-stable collagen matrix (VSCM). hG-MSCs were cultured onto the GPP, VSCM, or plastic for 3, 7, and 14 days. The proliferation and/or viability were measured by cell counting kit-8 assay and resazurin-based toxicity assay. Cell morphology and adhesion were evaluated by microscopy. The gene expression of collagen type I, alpha1 (COL1A1), α-smooth muscle actin (α-SMA), fibroblast growth factor (FGF-2), vascular endothelial growth factor A (VEGF-A), transforming growth factor beta-1 (TGF-β1), focal adhesion kinase (FAK), integrin beta-1 (ITG-β1), and interleukin 8 (IL-8) was investigated by RT-qPCR. The levels of VEGF-A, TGF-β1, and IL-8 proteins in conditioned media were tested by ELISA. GPP improved both cell proliferation and viability compared to VSCM. The cells grown on GPP exhibited a distinct morphology and attachment performance. COL1A1, α-SMA, VEGF-A, FGF-2, and FAK were positively modulated in hG-MSCs on GPP at different investigation times. GPP increased the gene expression of TGF-β1 but had no effect on protein production. The level of ITG-β1 had no significant changes in cells seeded on GPP at 7 days. At 3 days, notable differences in VEGF-A, TGF-β1, and α-SMA expression levels were observed between cells seeded on GPP and those on VSCM. Meanwhile, GPP showed higher COL1A1 expression compared to VSCM after 14 days, whereas VSCM demonstrated a more significant upregulation in the production of IL-8. Taken together, our data suggest that GPP electrospun nanofibers have great potential as substitutes for soft tissue regeneration in successful periodontal surgery.

Objective To analyze changes in proteoglycan and its correlation with alveolar bone resorption in periodontitis. Methods Twelve eight-week-old C57BL/6J male mice were selected, and the periodontitis model was established by ligating the right maxillary second molar with 6-0 silk thread. The nonligated part of the left maxilla was used as the control. The mice were killed 14 days after the operation. Micro-CT was used to assess alveolar bone resorption. HE staining was used to observe the alveolar bone profile, and TRAP staining was conducted to examine the positive rate of osteoclasts. The expression of proteoglycan-related genes, such as aggrecan (ACAN), biglycan (BGN), versican (VCAN), decorin (DCN), osteoclast-related genes, such as cathepsin K (CTSK), matrix metalloprotein-9 (MMP-9), and receptor activator of nuclear factor kappa-B ligand (RANKL), and inflammation-related genes, such as interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α), was detected by real-time quantitative PCR. Additionally, the correlation of the expression of proteoglycans with osteoclast-related genes and inflammation-related genes was evaluated by Pearson correlation analysis. Results The resorption of alveolar bone on the periodontitis side increased. TRAP staining showed that the number of osteoclasts was substantially increased in the maxilla with periodontitis. Real-time quantitative PCR demonstrated that compared with the control side, the expression of proteoglycan-related genes, such as ACAN, BGN, and DCN, was decreased, whereas the expression of the VCAN gene was significantly increased in the periodontitis side. Meanwhile, the expression of osteoclast-related genes, such as CTSK, MMP-9, and RANKL, and inflammation-related genes, such as IL-1β, IL-6, and TNF-α, was markedly increased in the periodontitis side (P

Abstract Background The biocompatibility of NeoMTA Plus® (Avlon BioMed Inc., Bradenton, Fl) as a furcal perforation repair material is not fully understood. This study compares the biocompatibility of Mineral Trioxide Aggregate (MTA Angelus) and NeoMTA Plus® as delayed furcation perforation repair materials. Methods Pulpotomy and root canal obturation were performed in 72 premolars in six mongrel dogs and then a standardized furcal perforation was performed. The coronal access was left open for three weeks. After curetting, cleaning and drying of the perforations, these teeth were divided into three equal groups (N = 24 teeth/ 2 dogs each) according to the material used for perforation repair; group I: NeoMTA Plus®, group II: MTA Angelus and group III: no material (positive control). The coronal access cavities were sealed with a filling material. The inflammatory cell count and qualitative pathology (presence of calcific bridge, configuration of fibrous tissue formed, examination of tissue surrounding the furcation area, histology of intraradicular bone and the inflammatory nature of tissues) were carried out after one week (subgroup A, N = 8 teeth), one month (subgroup B, N = 8 teeth) and three months (subgroup C, N = 8 teeth). The inflammatory cell count was expressed as mean ± SD and statistically analyzed. P-value 0.05). In contrast to group II, there was no significant differences in inflammatory cell count between the subgroups in groups I and III (P > 0.05). NeoMTA Plus® exhibited better qualitative pathological features than MTA Angelus after one week and nearly similar features after one month and three months of repair. Conclusion NeoMTA Plus® has a better early biocompatibility than MTA Angelus after one week of delayed furcation perforation repair and a similar late biocompatibility after one month and three months.

In the process of orthodontic treatment, the balance between the modeling of alveolar bone and the mechanical stress exerted by the appliance is key to the effective movement of orthodontic teeth. Alveolar bone modeling involves many regulatory factors, and microRNAs (miRNAs), as posttranscriptional regulatory factors, play an important role in the occurrence of bone modeling. As an important member of the miRNA family, miRNA-21 promotes the differentiation of periodontal ligament stem cells into osteoblasts and plays an important role in maintaining bone balance and preventing bone resorption as a regulator of osteoclast formation and a promoter of osteoclast differentiation. A literature review showed that miRNA-21 can regulate osteoclast function and promote bone resorption through programmed cell death 4 (PDCD4), phosphate and tension homology deleted on chromosome ten (PTEN), receptor activator of nuclear factor-κB ligand (RANKL) and osteoprotegerin (OPG). MiRNA-21 is highly sensitive to external mechanical stress in the process of orthodontic tooth movement. After orthodontic force is applied, miRNA-21 can promote osteoclast formation and accelerate orthodontic movement; through targeted regulation of periodontal ligament associated protein-1 (PLAP-1), it can regulate periodontal ligament remodeling in the late stage of tooth movement and improve the potential of tooth movement. In addition, miRNA-21 mediates orthodontic tooth movement (OTM) and alveolar bone remodeling in the periodontal inflammatory microenvironment. miRNA-21 can upregulate the expression of hypoxia-inducible factor-1α (HIF-1α) in periodontal ligament stem cells in a hypoxic environment. It can promote the expression of osteogenic markers, such as osteopontin (OPN), osteocalcin (OCN), alkaline phosphatase (ALP) and runt-related transcription factor 2 (Runx2), and promote osteogenic differentiation during orthodontic tooth movement.

The periodontal ligament is located between the bone (alveolar bone) and the cementum of the tooth, and it is connected by tough fibers called Sharpey’s fibers. To maintain healthy teeth, the foundation supporting the teeth must be healthy. Periodontal diseases, also known as tooth loss, cause the alveolar bone to dissolve. The alveolar bone, similar to the bones in other body parts, is repeatedly resorbed by osteoclasts and renewed by osteogenic cells. This means that an old bone is constantly being resorbed and replaced by a new bone. In periodontal diseases, the alveolar bone around the teeth is absorbed, and as the disease progresses, the alveolar bone shrinks gradually. In most cases, the resorbed alveolar bone does not return to its original form even after periodontal disease is cured. Gum covers the tooth surface so that it matches the shape of the resorbed alveolar bone, exposing more of the tooth surface than before, making the teeth look longer, leaving gaps between the teeth, and in some cases causing teeth to sting. Previously, the only treatment for periodontal diseases was to stop the disease from progressing further before the teeth fell out, and restoration to the original condition was almost impossible. However, a treatment method that can help in the regeneration of the supporting tissues of the teeth destroyed by periodontal diseases and the restoration of the teeth to their original healthy state as much as possible is introduced. Recently, with improvements in implant material properties, implant therapy has become an indispensable treatment method in dentistry and an important prosthetic option. Treatment methods and techniques, which are mainly based on experience, have gradually accumulated scientific evidence, and the number of indications for treatment has increased. The development of bone augmentation methods has contributed remarkably to the expansion of indications, and this has been made possible by various advances in materials science. The induced pluripotent stem cell (iPS) cell technology for regenerating periodontal tissues, including alveolar bone, is expected to be applied in the treatment of diseases, such as tooth loss and periodontitis. This review focuses on the alveolar bone and describes clinical practice, techniques, and the latest basic research.

Background. Determining what dentists know and believe about periodontal tissue properties is important to establish prevention practices. The present study aimed to investigate the knowledge, attitude, and practice of general dental practitioners about the properties of periodontal tissue around retainable teeth in Birjand, Northeast Iran. Methods. The knowledge, practice, and attitude of 91 dentists about periodontal tissue properties around retainable teeth were assessed by a validated researcher-made questionnaire. Results. The results showed that the mean score of dentists’ attitude, knowledge, and practice were 70.7, 88.2, and 77, respectively. The mean score of the attitude of male dentists was higher than females significantly (P = 0.014). Conclusion. It is highly recommended that continuing courses should be held to improve their knowledge.

Periodontitis is commonly observed and is an important concern in dental health. It is characterized by a multifactorial etiology, including imbalance of oral microbiota, mechanical stress, and systemic diseases such as diabetes mellitus. The current standard treatments for periodontitis include elimination of the microbial pathogen and application of biomaterials for treating bone defects. However, the periodontal tissue regeneration via a process consistent with the natural tissue formation process has not yet been achieved. Developmental biology studies state that periodontal tissue is composed of neural crest-derived ectomesenchyme. To elucidate the process of periodontal regeneration, it is essential to understand the developmental background and intercellular cross-talk. Several recent studies have reported the efficacy of transplantation of mesenchymal stem cells for periodontal tissue regeneration. In this review, we discuss the basic knowledge of periodontal tissue regeneration using mesenchymal stem cells and highlight the potential of stem cell-based periodontal regenerative medicine.

This systematic review aims to investigate the possibilities of ultrasound imaging in the field of periodontal tissues exploration to visualize periodontal anatomical structures and to assess reliability in clinical evaluation using the PRISMA guidelines. An electronic search through the MEDLINE database was realized to identify studies that have explored ultrasonography in the field of periodontal imaging published from 2000 to March 2022. The search resulted in 245 records; after exclusions, a total of 15 papers were included in the present review. Various publications have shown the possibility of using intraoral ultrasound for a precise exploration of intraoral tissues and to perform measurements of periodontal structures. Studies argue that ultrasounds open the prospect of a complete paradigm shift on the diagnosis and follow-up of periodontal disease. However, there is currently no clinical device dedicated to periodontal ultrasound. This field is still under-studied, and studies are needed to explore the large field of applications from periodontal assessment to treatment reassessment, including surgery. Researchers should focus their efforts to develop special intraoral ultrasound device and explore the possibilities of clinical periodontal applications.

This research aimed to evaluate Mask R-CNN and U-Net convolutional neural network models for pixel-level classification in order to perform the automatic segmentation of bi-dimensional images of US dental arches, identifying anatomical elements required for periodontal diagnosis. A secondary aim was to evaluate the efficiency of a correction method of the ground truth masks segmented by an operator, for improving the quality of the datasets used for training the neural network models, by 3D ultrasound reconstructions of the examined periodontal tissue. Methods: Ultrasound periodontal investigations were performed for 52 teeth of 11 patients using a 3D ultrasound scanner prototype. The original ultrasound images were segmented by a low experienced operator using region growing-based segmentation algorithms. Three-dimensional ultrasound reconstructions were used for the quality check and correction of the segmentation. Mask R-CNN and U-NET were trained and used for prediction of periodontal tissue’s elements identification. Results: The average Intersection over Union ranged between 10% for the periodontal pocket and 75.6% for gingiva. Even though the original dataset contained 3417 images from 11 patients, and the corrected dataset only 2135 images from 5 patients, the prediction’s accuracy is significantly better for the models trained with the corrected dataset. Conclusions: The proposed quality check and correction method by evaluating in the 3D space the operator’s ground truth segmentation had a positive impact on the quality of the datasets demonstrated through higher IoU after retraining the models using the corrected dataset.

Objective This study aimed to investigate the expression of autophagy-related factors microtubule-associated protein l light chain 3 (LC3) and the apoptosis-related factors BCL2-associated X protein (Bax) and B cell lymphoma-2 (Bcl-2) in the periodontal tissue of experimental diabetic rats. These data were used to explore the potential mechanism in diabetes-induced periodontal tissue lesions. Methods A total of 32 Sprague Dawley (SD) rats were randomly assigned into diabetes (group D, n = 16) and control groups (group N, n = 16). The diabetic group was induced by intraperitoneal injection of 1% streptozotocin (STZ, 60 mg/kg) and the control group was injected with citrate buffer (0.1mol/L). Rats were sacrificed after 4 and 8 weeks of feeding and collected as D1, N1 groups and D2, N2 groups, and the maxilla were retained for analysis. The changes in periodontal tissue structure were observed by hematoxylin-eosin (HE) staining. The expression and distribution of LC3, Bax and Bcl-2 in the periodontium of the rats was detected by immunohistochemical (SP) staining. Results Diabetic rats showed several changes compared to control animals including sparse alveolar bone trabecular structure, loss of the lamina dura and absorption of the local alveolar bone. The positive expression level of LC3 in the gingival epithelial, periodontal ligament and alveolar bone of group D1 was significantly higher than in the N1, N2 and D2 groups (P < 0.05). The level of Bax expression in the group D2 rats was significantly higher than those in the N1, N2 and D1 groups (P < 0.05), while the positive degree of Bcl-2 was significantly lower than those of other groups (P < 0.001). LC3 was negatively correlated with Bax and was irrelevant with Bcl-2; Bcl-2 was not correlated with Bax. Conclusions The expression of LC3, Bax and Bcl-2 changes in the periodontal tissue of diabetic rats may indicate that autophagy and apoptotic are involved in the process of periodontal tissue damage in diabetic rats. These changes may be one of the mechanisms of periodontal tissue lesions.

Extracellular Vesicles (EVs) are small lipid-enclosed particles containing biological molecules such as RNA and proteins that have emerged as vital modulators of intercellular communication. Increasingly, studies have shown that EVs play an essential role in the occurrence and prognosis of oral diseases. EVs are increasingly considered a research hotspot of oral diseases. In addition, the characteristics of carrying active molecules have also been studied in oral tissue regeneration. Evidence has shown that EVs regulate the homeostasis of the inflammatory microenvironment, promote angiogenesis, and repair damaged tissues. In this review, we summarized the characteristics of EVs and highlighted the role of EVs in oral tissue regeneration, including dental pulp, periodontal tissue, cartilage, and bone. We also discussed their deficiencies and prospects as a potential therapeutic role in the regeneration treatment of oral disease.

The application of periodontal tissue in regenerative medicine has gained increasing interest since it has a high potential to induce hard-tissue regeneration, and is easy to handle and graft to other areas of the oral cavity or tissues. Additionally, bone morphogenetic protein-2 (BMP-2) has a high potential to induce the differentiation of mesenchymal stem cells into osteogenic cells. We previously developed a system for a gene transfer to the periodontal tissues in animal models. In this study, we aimed to reveal the potential and efficiency of periodontal tissue as a biomaterial for hard-tissue regeneration following a bmp-2 gene transfer. A non-viral expression vector carrying bmp-2 was injected into the palate of the periodontal tissues of Wistar rats, followed by electroporation. The periodontal tissues were analyzed through bone morphometric analyses, including mineral apposition rate (MAR) determination and collagen micro-arrangement, which is a bone quality parameter, before and after a gene transfer. The MAR was significantly higher 3–6 d after the gene transfer than that before the gene transfer. Collagen orientation was normally maintained even after the bmp-2 gene transfer, suggesting that the bmp-2 gene transfer has no adverse effects on bone quality. Our results suggest that periodontal tissue electroporated with bmp-2 could be a novel biomaterial candidate for hard-tissue regeneration therapy.

Introduction, aim: Case report deals with the observation of a less common isolated periodontal damage of a permanent tooth in a young female, the cause of which was an unwanted and unconscious self-implantation of hair particles into the gingival sulcus of the permanent upper central incisor. Methods: Retrospective evaluation of the case report. Results: Causal therapy led to the rapid healing of the periodontal defect and preservation of her own tooth. Conclusion: The necessity of a regular and complex evaluation of every young individual with serious damage of the periodontal tissue including detailed history of the patient that could be rather difficult, was discussed. Correct diagnosis is a prerequisite for the adequate and successful treatment of all less common periodontal diseases.

As a new generation of autologous platelet concentrates, concentrated growth factors (CGF) have demon⁃ strated potential for promoting soft and hard tissue regeneration in vitro and in vivo, and this potential has also been demonstrated in clinical trials. CGF may be used alone or with bone graft materials in guided tissue regeneration (GTR), bone regeneration, internal sinus elevation, and reconstruction of bone defects after the removal of jaw cysts. As a rich source of growth factors, CGF have performed well in periodontal regeneration.

Periodontal disease is an inflammatory disease of the periodontium. It begins with the relatively benign gingivitis and becomes more established and destructive depending on the host, genetic, and environmental factors such as long-term plaque and calculus deposition. Subsequently, the connective tissue attachment to the root surface is lost causing bone resorption and formation of a periodontal pocket. We are in a new age of synthesis that demands vision, capabilities, logical reduction, and critical analysis for a constructive progress. In contrast to the conventional approaches of anti-inflammatory periodontal therapy, however, the regenerative procedures aimed at repairing lost periodontal tissues, including alveolar bone, periodontal ligament, and root cementum, remain more challenging and rapidly progressive periodontitis is attained.

The periodontal ligaments (PDLs) with specific orientations to tooth-root surfaces play a key role in generating biomechanical responses between the alveolar bone and cementum as a tooth-supporting tissue. However, control of angulations and regeneration of the ligamentous tissues within micron-scaled interfaces remains challenging. To overcome this limitation, this study investigated surface fabrications with microgroove patterns to control orientations of rat PDL cells in vitro and fibrous tissues in vivo. After being harvested, rat PDL cells were cultured and three different microgroove patterns (∠PDL groove = 0°, ∠PDL groove = 45°, and ∠PDL groove = 90°) were created by the digital slicing step in 3D printing. Cell-seeded scaffolds were subcutaneously transplanted at 3 and 6 weeks. In histology images, rat PDL cells were spatially controlled to angularly organize following the microgroove patterns and fibrous tissues were formed in scaffolds with specific angulations, which were reflected by additively manufactured microgroove topographies. Based on the results, specifically characterized surface topographies were significant to directly/indirectly organizing rat PDL cell alignments and fibrous tissue orientations. Therefore, interactions between surface topographies and tissue organizations could be one of the key moderators for the multiple tissue complex (bone-ligament-cementum) neogenesis in periodontal tissue engineering.

Background: Normal children had sensing capabilities to do oral health assessments. The inability to hear that was suffered by the deaf children caused obstacles to do oral health assessments. The dental and periodontal conditions were important for healthy life in general. The objective of this research was to know the difference Community Index Periodontal Treatment Needs (CPITN) between normal children in SD N 1 Tegaldowo Sragen with deaf children in SLB-B YPSLB Gemolong. Method: This research used observational method with Cross Sectional strategy. The subject of this research consist of 31 deaf children dan 83 normal children. Periodontal conditions from the two groups were measured by WHO probe. After the measurement, the CPITN index would be determined by looking at the highest score. The research was analyzed by using statistic non-parametric test from Mann-Whitney. Results: The result was 0.0003 (p

The initiation and progression of periodontal disease were reported to be the results of complicated inter⁃ actions between specific subgingival bacteria and host immuno⁃inflammatory response. As a part of the immune and de⁃ fense system mechanisms of the host, leptin may have a protective effect on periodontal tissues. We summarize the lat⁃ est progress in the relationship between leptin and periodontitis.

The prevalence of generalized periodontitis in different countries of the world is quite high. There are various systematizations and clinical and morphological forms of periodontitis, distinguished depending on the etiology, the nature of the process and the immune response. Polymorphic clinical manifestations of this nosology associated with different composition of subgingival microflora. A significant role is also played by factors that influence the antimicrobial response and the new metabolic status of adolescent organisms. The problem of early diagnosis of generalized periodontitis in adolescents, the development of effective measures for its prevention and treatment aimed at achieving positive long-term results, occupies one of the leading places among the priority areas of development of modern dentistry. Recent epidemiological and clinical studies show a relationship between pathology of the cardiovascular system and persistent bacterial infections or clinical conditions with generalized periodontitis. In addition, the current views and concepts do not fully explain the differences in identifying risk factors for the development and progression of periodontitis in adolescents, its course, and mixed results of treatment under the same conditions. The difference in the rate of progression of periodontitis known in the clinic in adolescents who received treatment according to standard generally accepted schemes suggests the biological heterogeneity of this disease and its possible complex causes. In this regard, studies are gaining particular importance, allowing to specify the effect on the possibility of developing periodontitis in healthy individuals and to predict the course in patients with this nosology. Therefore, the study of the relationship of this pathology with genetically determined factors should be attributed to a promising one. The latest data on the problem of metabolic disorders in the development of inflammation in periodontal tissues and, as a consequence, the etiopathogenesis of atherosclerosis demonstrate the main aspect of this leading form of pathology as an inflammatory disease. Recent large pathomorphological studies suggest that one of the places in atherogenesis is the inflammatory factor. High plasma cholesterol is an important factor in the development of atherosclerosis, makes it possible to consider it as a process associated with the accumulation of fats in the wall. According to some authors, granulocyte defects lead to a number of systemic diseases associated with periodontal tissue pathology: deficiency of adhesion of type 1 leukocytes; Chediak-Higashi syndrome; Down syndrome; PapillonLefebvre syndrome; diabetes; chronic granulomatosis; lazy white blood cell syndrome; Crohn’s disease. For the successful conduct of the surgical phase of treatment, a set of diagnostic methods is necessary, the results of which would allow predicting the final result of surgical interventions in periodontal tissues. However, traditional methods of diagnosing and predicting the development of various forms of rapidly progressive periodontitis in adolescents are not always effective and timely and do not completely solve the tasks set for clinicians due to the cyclical and unpredictable course of the pathological process, rapidly progressive destruction of periodontal tissues, toxic and allergic reactions. There are only a few achievements of foreign scientists regarding genetically determined prognostic risk factors and the clinical course of generalized periodontitis in adolescents. This necessitates the search for new, effective, highly specific techniques that would allow pathogenetic substantiation of the process from the standpoint of molecular genetics.

Wnt signaling plays a central role in many processes during embryonic development and adult homeostasis. At least 19 types of Wnt ligands, receptors, transducers, transcription factors, and antagonists have been identified in mammals. Two distinct Wnt signaling pathways, the canonical signaling pathway and the noncanonical signaling pathway, have been described. Some Wnt signaling pathway components are expressed in the dental epithelium and mesenchyme during tooth development in humans and mice. Functional studies and experimental analysis of relevant animal models confirm the effects of Wnt signaling pathway on the regulation of developing tooth formation and adult tooth homeostasis. Mutations in some Wnt signaling pathway components have been identified in syndromic and non-syndromic tooth agenesis. This review provides an overview of progress in elucidating the role of Wnt signaling pathway components in the tooth and the resulting possibilities for therapeutic development.

Periodontal disease is a chronic inflammatory disease caused by periodontal bacteria. Recently, periodontal phototherapy, treatment using various types of lasers, has attracted attention. Photobiomodulation, the biological effect of low-power laser irradiation, has been widely studied. Although many types of lasers are applied in periodontal phototherapy, molecular biological effects of laser irradiation on cells in periodontal tissues are unclear. Here, we have summarized the molecular biological effects of diode, Nd:YAG, Er:YAG, Er,Cr:YSGG, and CO2 lasers irradiation on cells in periodontal tissues. Photobiomodulation by laser irradiation enhanced cell proliferation and calcification in osteoblasts with altering gene expression. Positive effects were observed in fibroblasts on the proliferation, migration, and secretion of chemokines/cytokines. Laser irradiation suppressed gene expression related to inflammation in osteoblasts, fibroblasts, human periodontal ligament cells (hPDLCs), and endothelial cells. Furthermore, recent studies have revealed that laser irradiation affects cell differentiation in hPDLCs and stem cells. Additionally, some studies have also investigated the effects of laser irradiation on endothelial cells, cementoblasts, epithelial cells, osteoclasts, and osteocytes. The appropriate irradiation power was different for each laser apparatus and targeted cells. Thus, through this review, we tried to shed light on basic research that would ultimately lead to clinical application of periodontal phototherapy in the future.

The physicochemical properties, especially pH value of dental medicines, have significant influence on the health of oral cavity tissues. The pH of formulations should correspond to the value of saliva pH (5.5–8.0). For carbomer-based gels, the required pH value is obtained by neutralizing them with alkaline components, which leads to their structuring (thickening). This affects the physical properties of the gel, its residence time at the application site and the rate of release of active pharmaceutical ingredient. Therefore, the main purpose of this study is to evaluate the rheological, textural, and biopharmaceutical properties of Carbomer Polacril® 40P-based dental gel depending on the pH value. Evaluation of the rheological properties of gel preparations were performed by measuring the structural viscosity of the samples as a function of pH and temperature. The textural properties of the gel were evaluated by performing tests regarding back extrusion and spreadability. Carbomer Polacril® 40P-based gels haven’t shown noticeable thixotropic behavior, and were characterized by plastic flow in the whole studied pH range. The structural viscosity at the selected average pH value hasn’t differed at storage (25 °C) and application (37 °C) temperature. Texture studies of dental gels have shown a strong correlation with rheoparameters. Their rheological behavior and textural properties haven’t changed significantly between the pH range of 5.5–6.6. The relatively narrow range of working pH values does not affect the change in the viscosity of the preparation significantly and, consequently, does not affect the release of APIs from the developed Carbomer Polacril® 40P-based dental gel.

Background: The objective of this study was to digitally evaluate the effect of the cervical emergence of restorations in terms of gingival tissue volume. Materials and methods: In this study, 31 upper front teeth (from canine to canine) were selected and prepared using the biologically oriented preparation technique (BOPT). Each tooth had undergone a change in its provisional process with different emergence profile angles: 30° and 60°. Each sample was digitalised (STL file) using an intraoral scanner. By using various pieces of manipulation software for STL files, a volumetric analysis protocol was carried out. Changes in gingival thickness and position were measured at the buccal and the lingual positions. Results: By increasing the angulation of the emergence profile to 60°, the gingival thickness increased by 0.255 ± 0.381 mm (p = 0.001; t-test) at buccal and by 0.038 ± 0.381 mm at lingual (p = 0.600; t-test). In relation to the gingival height, at buccal, there is an apical displacement of 0.262 ± 0.246 mm (p = 0.001; t-test), and at lingual, there is an apical displacement of 0.390 ± 0.279 mm (p = 0.001; t-test). It was shown that an increase in the provisional emergence profile angle significantly diminishes the gingival height while significantly increasing gingival thickness. The Pearson’s correlation coefficient, r = 0.636, was moderately high and significant (p = 0.001; Pearson). Conclusions: The soft tissue surrounding the BOPT restored tooth evolved according to the prosthetic emergence angle of the provisional restoration, enabling us to plan for an apico-coronal and bucco-lingual displacement of the gingival tissue prior to the definitive restoration.

The objective. To study metabolic processes in connective tissue (CT) at different intensity of inflammation in parodontium. Materials and methods. The research is conducted on the sample of oxyproline, which is one of the indicators in the study of metabolic processes in the CT. This amino-acid presents in the blood in the free state, reflects the processes of collagen degradation in the form of protein-binding oxyproline and has no unambiguous interpretation. Results. At low intensity of the imflammation in the periodontium (stomatitis and alveolitis), the synthesis and collagen degradation are in relative equilibrium, and an increase in its intensity (gingivitis and especially periodontitis) leads to its violation. Conclusions. It has been established that the CT plays an important role in the development of pathological processes in periodontal tissues. The concentration of free and peptide-linked oxyproline in serum is higher in the groups of patients with more severe periodontal inflammation (periodontitis and gingivitis).

Inkjet printing technology has the potential to be used for seeding of viable cells for tissue engineering approaches. For this reason, a piezoelectrically actuated, drop-on-demand inkjet printing system was applied to deliver viable human dental follicle stem cells (hDFSC) of sizes of about 15 μm up to 20 μm in diameter. The purpose of these investigations was to verify the stability of the printing process and to evaluate cell viability post printing. Using a Nanoplotter 2.1 (Gesim, Germany) equipped with the piezoelectric printhead NanoTip HV (Gesim, Germany), a concentration of 6.6 ×106 cells ml−1 in DMEM with 10% fetal calf serum (FCS) could be dispensed. The piezoelectric printhead has a nominal droplet volume of ~ 400 pl and was set to a voltage of 75 V and a pulse of 50 μs while dosing 50 000 droplets over a time of 100 seconds. The volume and trajectory of the droplet were checked by a stroboscope test right before and after the printing process. It was found that the droplet volume decreases significantly by 35% during printing process, while the trajectory of the droplets remains stable with only an insignificant number of degrees deviation from the vertical line. It is highly probable that some cell sedimentations or agglomerations affect the printing performance. The cell viability post printing was assessed by using the Trypan Blue dye exclusion test. The printing process was found to have no significant influence on cell survival. In conclusion, drop-on-demand inkjet printing can be a potent tool for the seeding of viable cells.

An informative-evidence-based method for rapid assessment of periodontal tissue in miners is proposed. The efficiency of treatment-and-prophylactic complex with inclusion of “Biotrit C”, “Litcitin D3”, Vitamin Complex “Alphabet”is indicated. The complex mentioned allows to normalize functional reactions in the microcirculatory bed and simultaneously to increase the concentration of oxyhemoglobin and significantly reduce that of methemoglobin, improve the barrier function of the mucous membrane of the gum, which leads to reduction of inflammatory phenomena in the tissues of periodontium.

Over the past decades, periodontitis has become a rising health problem and caused various diseases. In the many studies shows that some extracts and compound to the prevention and treatment of periodontitis. This study focuses on the effects of inhibition of gingival damage and alveolar bone loss. The aim of this study was to evaluate the protective effects of Magnolia biondii extract (MBE) against ligature-induced periodontitis in rats. A ligature was placed around the molar teeth for 8 weeks, and MBE was administered for 8 weeks. Gingival tissue damage and alveolar bone loss were measured by microcomputed tomography (CT) analysis and histopathological examination. Serum Interluekin-1 β (IL-1β), tumor necrosis factor-α (TNF-α), cyclooxygenases-2 (COX-2), and receptor activator of nuclear factor−κB ligand (RANKL) levels were investigated using commercial kits to confirm the antiperiodontitis effects of MBE. We confirmed that ligature-induced periodontitis resulted in gingival tissue damage and alveolar bone loss. However, treatment for 8 weeks with MBE protected from periodontal tissue damage and downregulated serum inflammatory cytokine factors and RANKL levels. These results suggest that MBE exerts antiperiodontitis effects by inhibiting gingival tissue destruction and alveolar bone loss through regulation of anti-inflammatory cytokines in periodontitis-induced rats.

Introduction: A review of newer drugs for topical or systemic administration useful in contemporary dentistry in the therapy of diseases of periodontal tissue, oral mucous membrane, and salivary glands available in Czech Republic was given in this article. Objectives: There were discussed mouthrinses containing chlorhexidine in lower concentrations and/or oxidation agents associated with reduced dark discoloration of teeth and lingual mucosa. FotoSan 630 represents a system for photodynamic antimicrobial therapy using monochromatic light produced by light-emitting diods for the photoinitiation of the toluidine blue O as a photosensitizer. It is declared for the supportive topical treatment of plaque-induced periodontopathies, periimplant defects, dry socket, infected root canals and caries lesions. Hyaluronic acid contained in commercial gel products Aloclair and Gengigel, lubricative product Aequasyal, and gel product SineHerp are recommended in topical treatment of various less serious diseases of the oral mucosa and salivary glands. Drugs for systemic administration discussed here are antileukotriene immunomodulator montelucast, immunosuppressive and antiinflammatory drugs thalidomide and leflunomid. They are usable in the therapy of more serious mucosal diseases, mostly of autoimmune or uncertain origin. Caspofungin, micafungin and anidulafungin are modern echinocandin antimycotics for parenteral use indicated for treatment of severe mycotic infections, mostly candidiasis in altered individuals. Drugs for biological therapy declared as antitumorous and antiinflammatory agents already seldom used in dentistry are monoclonal antibodies rituximab, cetuximab, and erlotinib, potentially useful are also etanercept, infliximab and adalimumab. Botulotoxin is a neurotoxin of bacterial origin used at present in the therapy of various neurological disturbances in the head and neck area.

Introduction: There are many of drugs useful for topical or systemic treatment of diseases of periodontal tissue and oral mucous membrane. Their correct administration and efficacy depend strictly on adeqnate of information regarding their properties. Aim: The review deals with some drugs newly available in Czech Republic and related therapeutic procedures used in the treatment of periodontal and mucosal diseases. Therapeutic agents: For topical chemical inhibition of the dental plaque are dedicated octenidine, kationic antiseptic pyridine derivate, and combination of classic bis-biguanide derivate chlorhexidine with aromatic agent eugenol. As adjuvant chemotherapeutics in the treatment of periodontitis serve systems for targeted antimicrobial photodynamic therapy based on the use of photosensitizers as producers of the singlet oxygen, namely toluidine blue O and methylen blue. The source of monochromatic light for their pohotoactivation is laser device. Saturated alcohol docosanol with antiviral acitivity serves in topical therapy of labial herpes. Vanillinamide alkaloid capsaicine is selective agonist of vanilloid receptore TRPV 1 of sensitive nerves. Patch product Qutenza has been recently used for higly effective topical treatment of neuropatic pain. It could be potentially very useful agent in the treatment of some forms of atypical facial pain. Irradiation of salivary glands results in association with its dosis in the damage of various grade of the glandular parenchyma associated with postirradiative hyposialia. Cytoprotective prodrug amifostine releases active thiol after its dephosphorylation. It is recommended for the protection of the glandular parenchyma against adverse effects of antitumorous drugs and therapeutic irradiation in the region of the head and neck. Conclusion: Spectrum of therapeutic agents useful in the treatment of periodontal and mucosal diseases raises permanently. Efficacy of their application is connected with sufficient information of professionals and correct and early diagnosis of the disease, as well.

Background: Recently, various biostimulation′s effects of low energy laser irradiation have been reported. The present study was designed to examine the effects of low-energy laser irradiation on alveolar bone remodelling during orthodontic tooth movement and finally on formation of new keratinized gingiva. Materials and Methods: 22 patients and 27 teeth in vestibular mucosal without keratinized gingiva were selected. Every patient was treated with self ligating appliances. In every orthodontic session the patient was treated with Diode laser biostimulation. At the moment of debonding, 27 teeth involved in the research were evaluated in terms of quality and quantity of attached gingiva. BOP and CAL loss were investigated. Results: Every tooth considered at the end of orthodontic treatment showed an attached gingiva around the crown: The average of keratinized gingiva at the end of the study was 3.10 mm and the mean increasing at each month was 0,49 mm. Conclusions: The combination between self ligating appliances and laser′s biostimulation could improve the differentiation of periodontal ligaments stem cells in fibroblasts, able to promote attached gingiva around the crown of the teeth erupted in oral vestibular mucosa.

The loss of proper contact of the adjacent teeth, which usually occurs as a result of caries or tooth extraction, can lead to serious consequences on oral tissues health as well as on the function of complete oral system, unless timely repaired. It often happens that the irregular contact of the tooth due to inadequate filling remains unnoticed by the patient and dentist. Also, if the loss of contact caused by caries or after tooth extraction is not treated, it often leads to inclination of adjacent teeth and their traumatic contact in relation to the antagonists. If this situation remains for a long time, it can cause significant disorder for which rehabilitation, complex therapy and long period of time are required. The aim of this study was to point out the proper procedure for the treatment of complex lesions of teeth and adjacent tissues, caused by extraction of the second lower right premolar and impaired contact between the first molar and first premolar.

INTRODUCTION Periodontitis is an inflammatory disease of the supporting tissues of teeth and is a major cause of tooth loss in adults. The onset and progression of periodontal disease is attributed to the presence of elevated levels of a consortium of pathogenic bacteria. Gram negative bacteria, mainly strict anaerobes, play the major role. OBJECTIVE The present study aimed to assess the presence of the main types of microorganisms involved in the aetiopathogenesis of periodontal disease: Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Eikenella corrodens, Treponema denticola, Tanerella forsythia and Prevotella intermedia in different samples collected from the oral cavity of 90 patients diagnosed with periodontitis. METHOD Bacterial DNA detection was performed in diverse biological materials, namely in dental plaque, gingival tissue and saliva, by means of multiplex PCR, a technique that allows simultaneous identification of two different bacterial genomes. RESULTS In the dental plaque of the periodontitis patients, Treponema denticola dominated. In the gingival tissue, Tannerella forsythia and Treponema denticola were the microbiota most frequently detected, whilst in saliva Treponema denticola and Eikenella corrodens were found with the highest percentage. CONCLUSION The identification of microorganisms by multiplex PCR is specific and sensitive. Rapid and precise assessment of different types of periodontopathogens is extremely important for early detection of the infection and consequently for the prevention and treatment of periodontal disease. In everyday clinical practice, for routine bacterial evaluation in patients with periodontal disease, the dental plaque is the most suitable biological material, because it is the richest in periodontal bacteria.

Many epidemiological evidences have proven the association between smoking and periodontal disease. The causality can be further established by linking findings of traditional epidemiological studies with the developments in molecular techniques that occurred in the last decade. The present article reviews recent studies that address the effect of smoking on molecular and genetic factors in periodontal disease. Most findings support the fact that tobacco smoking modulates destruction of the periodontium through different pathways: microcirculatory and host immune systems, connective tissue, and bone metabolism. Although smokers experience an increased burden of inflammatory responses to microbial challenges compared to non-smokers, understanding the association between smoking and periodontal diseases involves substantial problems with respect to accuracy of measurements, and particularly, sampling of many subjects. It remains unclear whether genetic susceptibility to periodontal disease is influenced by exposure to smoking or the effect of smoking on periodontal disease is influenced by genetic susceptibility. Employment of molecular techniques may play a key role in further elucidation of mechanisms linking smoking and periodontal destruction, the direct relationship as environmental factors and indirect relationship through genetic factors.

This paper reviews the evidence for cigarette smoking as a risk factor for the development of severe destructive periodontal disease in young adults. A high prevalence of cigarette smoking has been identified among young individuals with aggressive periodontitis and tobacco usage increases the risk of periodontal destruction most significantly in young populations. The effect appears to be dose related and is independent of levels of plaque accumulation. Young smokers have more alveolar bone loss and attachment loss than non smoking equivalents. Prolonged and heavy smoking can reduce gingival bleeding and therefore mask the clinical marker of bleeding on probing often used by dentists to monitor periodontal health. This has implications for potential misdiagnosis and failure to detect periodontitis at an early stage. Nicotine metabolites concentrate in the periodontal tissues and can have local effects as well as the potential to affect the systemic host response. Dentists are well placed to assess the smoking status of their young patients and have a role to play in the delivery of smoking cessation advice especially as it pertains to periodontal health. In this way the dental profession can also make a significant contribution to the general health and well being of our youth and future generations.