Molar incisor hypomineralization and pre-eruptive intracoronal lesions in dentistry-diagnosis and treatment planning
BACKGROUND A key requirement for biomimetic regeneration of tissues is a 3 D scaffold. The gold standard scaffold for revascularization is the blood clot, however, an adequate blood clot cannot always be achieved in narrow canals or mature roots.Hereby, we document the effects of platelet-rich fibrin（PRF） for the regenerative endodontic treatment（RET） of two immature permanent teeth with necrotic pulps for up to 48 mo.CASES SUMMARY The first patient was a 22-year-old female with history of trauma in tooth #9 with a sinus tract and a large periapical lesion. The second was a 9-year-old male presenting with a badly decayed tooth #14. Both cases were treated with RET and PRF prepared from the patients’ blood. PRF and its extract were used as a scaffold for RET. Patients were followed-up to 9 and 48 mo（4 years）, respectively.Both patients, were asymptomatic after treatment. At the 9-mo-follow-up of case#1, there was radiographic evidence of periapical bone healing, however, the root apex was still open. In case #2, the roots exhibited apical closure and normal periapical bone architecture at 12-mo follow-up, while no root lengthening was observed. After 48 mo, case #2 showed extensive intracanal calcification in all root canals that complicated conventional root canal treatment.CONCLUSION RET with PRF and its extract could be used in revascularization of immature permanent teeth. However, proper case selection to comply with long-term follow-up is necessary and adverse events such as calcification and canal obliteration should be planned for.
The regeneration of peripheral nerves comprises complicated steps involving a set of cellular and molecular events in distal nerve stumps with axonal sprouting and remyelination. Stem cell isolation and expansion for peripheral nerve repair（PNR） can be achieved using a wide diversity of prenatal and adult tissues, such as bone marrow or brain tissues. The ability to obtain stem cells for cell-based therapy（CBT） is limited due to donor site morbidity and the invasive nature of the harvesting process. Dental pulp stem cells（DPSCs） can be relatively and simply isolated from the dental pulps of permanent teeth, extracted for surgical or orthodontic reasons. DPSCs are of neural crest origin with an outstanding ability to differentiate into multiple cell lineages. They have better potential to differentiate into neural and glial cells than other stem cell sources through the expression and secretion of certain markers and a range of neurotropic factors;thus, they should be considered a good choice for PNR using CBT. In addition,these cells have paracrine effects through the secretion of neurotrophic growth factors and extracellular vesicles, which can enhance axonal growth and remyelination by decreasing the number of dying cells and activating local inhabitant stem cell populations, thereby revitalizing dormant or blocked cells,modulating the immune system and regulating inflammatory responses. The use of DPSC-derived secretomes holds great promise for controllable and manageable therapy for peripheral nerve injury. In this review, up-to-date information about the neurotrophic and neurogenic properties of DPSCs and their secretomes is provided.
Minireview of the clinical efficacy of platelet-rich plasma, platelet-rich fibrin and blood-clot revascularization for the regeneration of immature permanent teeth
DNA sequencing is the method of identifying the precise order of DNA nucleotides within a molecule. The information of DNA sequencing is of prime requisite for basic biological research as well as in various clinical specialties.They can be used to determine the individual genetic sequence, larger genetic regions, chromosomes as well as to sequence RNA and proteins. Since the first DNA sequencing in 1970s, there has been tremendous advancements in the technologies aimed to determine the entire human genome. The need for rapid and accurate sequencing of human genome has resulted in the introduction of next generation sequencing（NGS） technology. NGS refers to the secondgeneration DNA sequencing technologies where millions of DNA can be sequenced simultaneously. Some of the next gen sequencing methods employed are Roche/454 life science, Illumina/Solexa, SOLiD system and HeliScope.Application of NGS in decoding the genomic database of various oral diseases may possess therapeutic and prognostic value. This presentation provides an overview of the basics of NGS and their potential applications in oral disease diagnostics.
With an increase in the number of cases of autism spectrum disorder（ASD）,dental professionals need to be aware of the different techniques required to ensure safe dental treatments for affected patients. The concerns and preferences of the parents and the medical and dental history of each patient should be considered. The aim of this article was to provide a comprehensive update on the medical and dental health of patients with ASD. A detailed search of the electronic database PubMed/Medline/Lilacs was performed for the terms"Autism", "Autistic", "Autism Spectrum Disorder", "ASD", "Dentistry" and"Dentist", in the period between 2006 and 2017. Systemic reviews, research articles, and literature reviews were included. Expert opinions, case series, and case reports were excluded from the search. A detailed family-centered approach based on the preferences and concerns of parents is an important foundation for appropriate individualized dental treatment of patients with ASD. In addition,the knowledge of disruptive behaviors and patient′s challenges may guide dental practitioners in improving treatment planning, oral management, and the overall oral health of patients with ASD.
The herpesviruses are ubiquitous, doubled-strandedDNA viruses that can reactivate under conditions such as immunosuppressive therapy, acquired immunodeficiency syndrome, malnutrition, and immunosenescence. There are eight types of herpesviruses: Human herpesvirus simplex（HSV） type I（HSV-1） and HSV type II（HSV-2）, varicella-zoster virus（VZV）, epstein-Barr virus（EBV）, cytomegalovirus, human herpesvirus（HHV）-6, HHV-7, and HHV-8 or Kaposi’s sarcoma herpesvirus. Some of these viruses can infect the oral cavity, leading to different types of lesions. Specifically, labial herpes（HSV-1 and less frequently HSV-2）, zoster（VZV）, infectious mononucleosis and oral hairy leukoplakia（EBV）, and Kaposi’s Sarcoma（HHV-8） are the most common viruses infecting the oral cavity. Some of these viruses can act in synergy with other herpesviruses or as distinct infectious agents. Other herpesviruses may have indirect effects in periodontal disease. The diagnosis is frequently based on signs and symptoms and depends on the experience of the examiner. Cytopathologic and/or histopathologic examination as well as immunological methods such as ELISA could help to elucidate cases. In addition, molecular techniques which can be sensitive and specific have been reported in the literature. These methods require low amounts of sample and could offer results faster than other traditional methods.
Sports and energy drinks are consumed by more peoplethan ever. Sports and energy drinks may enhance physical resistance, stimulate metabolism, prevent rehydration and replace electrolytes during high activity efforts. However, these drinks often have a low pH and are acidic, which can erode enamel and dentin, and increase dentine hypersensitivity. In addition to the adverse effects of sports and energy drinks on tooth structures, they often have the potential to damage restorative materials. These drinks often contain artificial colors which have potential to discolor resin composite materials and glass ionomers. The acidic nature of these drinks could also lead to a degradation, increase in wear, and roughening of the surface of the restorative materials. Many of the negative consequences of sport and energy drinks can be related to their overconsumption among children and teenagers. Patients should be advised to have a healthy diet, and consume soft and energy drinks in moderation, to avoid any negative dental or health consequences. The overconsumption of sports and energy drinks which are high in sugar and have the lowest pH are most likely to cause avoidable dental problems.
The loss of the post-extraction alveolar ridge vertical and horizontal volume constitutes an irreversible process and presents a considerable impact on the prosthetic rehabilitation, particularly when implantsupported. Therefore, alveolar ridge resorption has become a challenge in contemporary clinical dentistry and alveolar ridge preservation and augmentation are an interesting therapeutic approach. The employment of biomaterials, as a therapeutic alternative to preserve bone in height and volume, has been frequently studied over the years, due to its conceptual attractiveness and its simple technique. The purpose of this paper is to review and discuss current methods to optimize the alveolar bone repair while maintaining its horizontal and vertical dimensions. This paper is based on scientific studies published in English including systematic reviews and also animal and human studies that were searched using the keywords "alveolar ridge preservation," "bone substitute", "biomaterials", "bone graft" and "grafting". Either autogenous bone as xenogenic and alloplastic materials, platelet rich plasma and use of membrane are alternatives. It becomes fundamental to understand that alveolar bone loss is still a clinical challenge and alveolar ridge preservation techniques can minimize, but not completely, eliminate the resorption process. The goal of alveolar ridge preservation and augmentation is to use a combination of bone or biomaterials to create bone which is sufficient for dental implant placement. Freeze-dried bone is generally recognized as giving more predictable treatment outcomes than synthetic materials or platelet rich plasma, and membranes must always be used to separate hard and soft tissues to promote optimal tissue healing.
AIM: To analyze differences in prevalence and pattern of tooth agenesis and craniofacial morphology between non syndromic children with tooth agenesis with and without upper cervical spine morphological deviations and to analyze associations between craniofacial morphology and tooth agenesis in the two groups together. METHODS: One hundred and twenty-six pre-orthodontic children with tooth agenesis were divided into two groups with（19 children, mean age 11.9） and without（107 children, mean age 11.4） upper spine morphological deviations. Visual assessment of upper spine morphology and measurements of craniofacial morphology were performed on lateral cephalograms. Tooth agenesis was evaluated from orthopantomograms.RESULTS: No significant differences in tooth agenesis and craniofacial morphology were found between children with and without upper spine morphological deviations（2.2 ± 1.6 vs 1.94 ± 1.2, P ＞ 0.05） but a tendency to a different tooth agenesis pattern were seen in children with morphological deviations in the upper spine. In the total group tooth agenesis was associated with the cranial base angle（n-s-ba, r = 0.23,P ＜ 0.01）, jaw angle（ML/RLar, r = 0.19, P ＜ 0.05）, mandibular inclination（NSL/ML, r =-0.21, P ＜ 0.05）, mandibular prognathia（s-n-pg, r = 0.25, P ＜ 0.01）, sagittal jaw relationship（ss-n-pg, r =-0.23, P ＜ 0.5）, overjet（r =-0.23, P ＜ 0.05） and overbite（r =-0.25, P ＜ 0.01）. CONCLUSION: Etiology of tooth agenesis in children with upper spine morphological deviations was discussed. The results may be valuable for the early diagnosis and treatment planning of non syndromic children with tooth agenesis.
Effects of different root canal preparation methods on root fracture resistance: A systematic review of the literature
Over the years, the use of the laser within health field and more particularly dentistry has been increasing and improving. The application of laser in the periodontal treatment takes part of a non-surgical and surgical approaches, is used for the decontamination of periodontal pockets due to its bactericidal effect, and the removal of granulation tissues, inflamed and diseased epithelium lining, bacterial deposits and subgingival calculus. However in spite of all the marketing surrounding, the use of laser highlighting its beneficial effect, the capacity of laser to replace the conventional treatment for chronic periodontitis is still debatable. In fact there is no evidence that any laser system adds substantial clinical value above conventional treatments of chronic periodontitis. Some studies showed a significant positive effect on clinical attachment level gain and probing depth reduction. In the other hand, several articles demonstrated no evidence of the superior effectiveness of laser therapy compared to root planing and scaling. Our aims is to review the literature on the capacity of erbium:Yttrium-aluminum-garnet and neodymium:Yttrium-aluminium-garnet laser to either replace or complete conventional mechanical/surgical periodontal treatments.
Silver amalgam contains mercury leading to concerns about the potential toxic effects of amalgam on the health of dental patients. The debate over the toxicity of ilver amalgam restorations has divided the dental profession for over a century. The use of amalgam restorations for anterior teeth have been declining worldwide due to patient’s safety concerns and preference for tooth colored restorations. Nevertheless, amalgam has served the dental profession for decades and benefited hundreds of millions of patients because of its longevity as a dental restorative material. Amalgam is still the World’s most widely used restorative material for posterior teeth.
Many lesions of the oral region are treated with surgical methods such as curettage and resection. Chemotherapy and radiation therapy with or without surgical intervention can be used as an adjunct in some cases. Intralesional steroid injection is a conservative procedure which is already used in various regions of the body andjoints. This technique is used also for a number of mouth and jaw lesions. Localized langerhans cell histiocytosis, central giant cell granuloma, oral submucous fibrosis, oral lichen planus, lichen sclerosus of the oral mucosa, lymphatic malformations and orofacial granulomatosis can be considered among these diseases. The purpose of this review is to investigate the effects of intralesional steroid injections in the treatment of oral diseases.
Over the years, the use of the laser within health field and more particularly dentistry has been increasing and improving. The application of laser in the periodontal treatment takes part of a non-surgical and surgical approaches, is used for the decontamination of periodontal pockets due to its bactericidal effect, and the removal of granulation tissues, inflamed and diseased epithelium lining, bacterial deposits and subgingival calculus. However in spite of all the marketing surrounding, the use of laser highlighting its beneficial effect, the capacity of laser to replace the conventional treatment for chronic periodontitis is still debatable. In fact there is no evidence that any laser system adds substantial clinical value above conventional treatments of chronic periodontitis. Some studies showed a significant positive effect on clinical attachment level gain and probing depth reduction. In the other hand, several articles demonstrated no evidence of the superior effectiveness of laser therapy compared to root planing and scaling. Our aims is to review the literature on the capacity of erbium:Yttrium-aluminum-garnet and neodymium:Yttrium-aluminium-garnet laser to either replace or complete conventional mechanical/surgical periodontal treatments.
Periosteal pedicle graft for the treatment of gingival recession: A viable alternative to sub-epithelial connective tissue graft
