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Huang P, Jiang RX, Wang F, Qiao WW, Ji YT, Meng LY, Bian Z. PIEZO1 Promotes Odontoblast-Mediated Reactionary Dentinogenesis via SEMA3A. J Dent Res 2024:220345241257866. [PMID: 38910430 DOI: 10.1177/00220345241257866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2024] Open
Abstract
Located at the interface of the dentin-pulp complex, the odontoblasts are specialized cells responsible for dentin synthesis and nociceptive signal detection in response to external stimuli. Recent studies have shown that the mechanosensitive ion channel PIEZO1 is involved in bone formation and remodeling through the influx of calcium ions, and it is abundantly expressed in odontoblasts. However, the specific role of PIEZO1 in reactionary dentinogenesis and the underlying mechanisms remain elusive. In this study, we found intense PIEZO1 expression in the plasma membrane and cytoplasm of odontoblasts in healthy human third molars, mouse mandibular molars, and human odontoblast-like cells (hOBLCs). In hOBLCs, PIEZO1 positively regulated DSPP, DMP1, and COL1A1 expression through the Ca2+/PI3K-Akt/SEMA3A signaling pathway. In addition, exogenous SEMA3A supplementation effectively reversed reduced mineralization capacity in PIEZO1-knockdown hOBLCs. In vivo, Piezo1 expression peaked at day 7 and returned to baseline at day 21 in a wild-type mice dentin injury model, with Sema3a presenting a similar expression pattern. To investigate the specific role of PIEZO1 in odontoblast-mediated reactionary dentinogenesis, mice with a conditional knockout of Piezo1 in odontoblasts were generated, and no significant differences in teeth phenotypes were observed between the control and conditional knockout (cKO) mice. Nevertheless, cKO mice exhibited reduced reactionary dentin formation and decreased Sema3a and Dsp positive staining after dentin injury, indicating impaired dental pulp repair by odontoblasts. In summary, these findings suggest that PIEZO1 enhances the mineralization capacity of hOBLCs in vitro via the Ca2+/PI3K-Akt/SEMA3A signaling pathway and contributes to reactionary dentinogenesis in vivo.
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Affiliation(s)
- P Huang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - R X Jiang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - F Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - W W Qiao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Y T Ji
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - L Y Meng
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Z Bian
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
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Fu X, Kim HS. Dentin Mechanobiology: Bridging the Gap between Architecture and Function. Int J Mol Sci 2024; 25:5642. [PMID: 38891829 PMCID: PMC11171917 DOI: 10.3390/ijms25115642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/20/2024] [Accepted: 05/20/2024] [Indexed: 06/21/2024] Open
Abstract
It is remarkable how teeth maintain their healthy condition under exceptionally high levels of mechanical loading. This suggests the presence of inherent mechanical adaptation mechanisms within their structure to counter constant stress. Dentin, situated between enamel and pulp, plays a crucial role in mechanically supporting tooth function. Its intermediate stiffness and viscoelastic properties, attributed to its mineralized, nanofibrous extracellular matrix, provide flexibility, strength, and rigidity, enabling it to withstand mechanical loading without fracturing. Moreover, dentin's unique architectural features, such as odontoblast processes within dentinal tubules and spatial compartmentalization between odontoblasts in dentin and sensory neurons in pulp, contribute to a distinctive sensory perception of external stimuli while acting as a defensive barrier for the dentin-pulp complex. Since dentin's architecture governs its functions in nociception and repair in response to mechanical stimuli, understanding dentin mechanobiology is crucial for developing treatments for pain management in dentin-associated diseases and dentin-pulp regeneration. This review discusses how dentin's physical features regulate mechano-sensing, focusing on mechano-sensitive ion channels. Additionally, we explore advanced in vitro platforms that mimic dentin's physical features, providing deeper insights into fundamental mechanobiological phenomena and laying the groundwork for effective mechano-therapeutic strategies for dentinal diseases.
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Affiliation(s)
- Xiangting Fu
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan 31116, Republic of Korea;
- Mechanobiology Dental Medicine Research Center, Cheonan 31116, Republic of Korea
- Department of Nanobiomedical Science and BK21 NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan 31116, Republic of Korea
| | - Hye Sung Kim
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan 31116, Republic of Korea;
- Mechanobiology Dental Medicine Research Center, Cheonan 31116, Republic of Korea
- Department of Nanobiomedical Science and BK21 NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan 31116, Republic of Korea
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Human Primary Odontoblast-like Cell Cultures—A Focused Review Regarding Cell Characterization. J Clin Med 2022; 11:jcm11185296. [PMID: 36142943 PMCID: PMC9501234 DOI: 10.3390/jcm11185296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 11/17/2022] Open
Abstract
Cell cultures can provide useful in vitro models. Since odontoblasts are postmitotic cells, they cannot be expanded in cell cultures. Due to their extension into the dentin, injuries are inevitable during isolation. Therefore, “odontoblast-like” cell culture models have been established. Nowadays, there is no accepted definition of odontoblast-like cell cultures, i.e., isolation, induction, and characterization of cells are not standardized. Furthermore, no quality-control procedures are defined yet. Thus, the aim of this review was to evaluate both the methods used for establishment of cell cultures and the validity of molecular methods used for their characterization. An electronic search was performed in February 2022 using the Medline, Scopus, and Web of Science database identifying publications that used human primary odontoblast-like cell cultures as models and were published between 2016 and 2022. Data related to (I) cell culture conditions, (II) stem cell screening, (III) induction media, (IV) mineralization, and (V) cell characterization were analyzed. The included publications were not able to confirm an odontoblast-like nature of their cell cultures. For their characterization, not only a similarity to dentin but also a distinction from bone must be demonstrated. This is challenging, due to the developmental and evolutionary proximity of these two tissue types.
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Son YB, Kang YH, Lee HJ, Jang SJ, Bharti D, Lee SL, Jeon BG, Park BW, Rho GJ. Evaluation of odonto/osteogenic differentiation potential from different regions derived dental tissue stem cells and effect of 17β-estradiol on efficiency. BMC Oral Health 2021; 21:15. [PMID: 33413268 PMCID: PMC7792121 DOI: 10.1186/s12903-020-01366-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/15/2020] [Indexed: 12/12/2022] Open
Abstract
Background The dentin is a tissue, which is formed by odontoblasts at the pulp interface of the teeth that supports the enamel. Odontoblasts, the cranial neural crest cells are derived from ectodermal mesenchymal stem cells (MSCs) and are long and polarized cells. They are present at the outer surface of dentin and play a prominent role about dentin formation. Recently, attention has been focused on induction of odontoblast using various type of MSCs and effects of the 17ß-estradiol supplementation. In this study, we establish an efficient odonto/osteoblast differentiation protocol using 17ß-estradiol supplementation while comparing the odonto/osteoblast ability of various dental MSCs. Methods Same donor derived four types of dental MSCs namely dental pulp stem cells (DPSCs), stem cells from apical papilla (SCAP), dental follicle stem cells (DFSCs), and periodontal ligament stem cells (PDLSCs) were evaluated for their stemness characteristics and potency towards odonto/osteoblast (Induced odonto/osteoblast) differentiation.
Then 17ß-estradiol supplementation of 0 and 10 µM was applied to the odonto/osteoblast differentiation media for 14 days respectively. Furthermore, mRNA and protein levels of odonto/osteoblast markers were evaluated. Results All of the experimental groups displayed stemness characteristics by showing adipocyte and chondrocyte differentiation abilities, expression for cell surface markers and cell proliferation capacity without any significant differences. Moreover, all dental derived MSCs were shown to have odonto/osteoblast differentiation ability when cultured under specific conditions and also showed positive expression for odontoblast markers at both mRNA and protein level. Among all, DPSCs revealed the higher differentiation potential than other dental MSCs. Furthermore, odonto/osteoblast differentiation potential was enhanced by supplementing the differentiation media with 17ß-estradiol (E2). Conclusions Thus, DPSCs possess higher odonto/osteogenic potential than the SCAPs, DFSCs, PDLSCs and their differentiation capacity can by further enhanced under E2 supplementation.
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Affiliation(s)
- Young-Bum Son
- Department of Theriogenology and Biotechnology, College of Veterinary Medicine and Research Institute of Life Science, Gyeongsang National University, 501 Jinju-daero, Jinju, GN, 660-701, Republic of Korea
| | - Young-Hoon Kang
- Department of Oral and Maxillofacial Surgery, Changwon Gyeongsang National University Hospital, Changwon, Republic of Korea.,Department of Oral and Maxillofacial Surgery, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - Hyeon-Jeong Lee
- Department of Theriogenology and Biotechnology, College of Veterinary Medicine and Research Institute of Life Science, Gyeongsang National University, 501 Jinju-daero, Jinju, GN, 660-701, Republic of Korea
| | - Si-Jung Jang
- Department of Theriogenology and Biotechnology, College of Veterinary Medicine and Research Institute of Life Science, Gyeongsang National University, 501 Jinju-daero, Jinju, GN, 660-701, Republic of Korea
| | - Dinesh Bharti
- Department of Theriogenology and Biotechnology, College of Veterinary Medicine and Research Institute of Life Science, Gyeongsang National University, 501 Jinju-daero, Jinju, GN, 660-701, Republic of Korea
| | - Sung-Lim Lee
- Department of Theriogenology and Biotechnology, College of Veterinary Medicine and Research Institute of Life Science, Gyeongsang National University, 501 Jinju-daero, Jinju, GN, 660-701, Republic of Korea
| | - Byeong-Gyun Jeon
- Department of Biology Education, Gyeongsang National University, Jinju, Republic of Korea
| | - Bong-Wook Park
- Department of Oral and Maxillofacial Surgery, Changwon Gyeongsang National University Hospital, Changwon, Republic of Korea. .,Department of Oral and Maxillofacial Surgery, Gyeongsang National University School of Medicine, Jinju, Republic of Korea. .,Department of Dentistry, Hanil Hospital, Jinju, Republic of Korea.
| | - Gyu-Jin Rho
- Department of Theriogenology and Biotechnology, College of Veterinary Medicine and Research Institute of Life Science, Gyeongsang National University, 501 Jinju-daero, Jinju, GN, 660-701, Republic of Korea.
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Gallorini M, Krifka S, Widbiller M, Schröder A, Brochhausen C, Cataldi A, Hiller KA, Buchalla W, Schweikl H. Distinguished properties of cells isolated from the dentin-pulp interface. Ann Anat 2020; 234:151628. [PMID: 33212174 DOI: 10.1016/j.aanat.2020.151628] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/28/2020] [Accepted: 10/16/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Dental odontoblasts produce dentin mineralized matrix, trigger immune responses and act as sensory cells. The understanding of the mechanisms of these functions has been particularly restricted due to the lack of odontoblasts being cultivable in vitro. Because of the lack of specific markers to identify cells of the odontoblastic lineage, properties of the cells isolated from the dentin-pulp interface were compared to dental pulp cells, periodontal ligament cells, osteoblasts, skin fibroblasts, epithelial cells (A549) and HeLa in the present study. METHODS After surgical procedures, the pulp tissue was removed from the tooth crown, and cells were scrapped off the dentin-pulp interface. Explants from teeth of three patients were routinely cultivated, and cells were harvested after several weeks. Cell morphology and ultrastructure was studied by light microscopy (LM), scanning (SEM) or transmission electron microscopy (TEM). Expression of dentin sialophosphoprotein (DSPP), dentin matrix protein 1 (DMP1), TRPV4, and S100 calcium binding protein A4 (S100A4) were analyzed at the protein level by sodium dodecylsulfate polyacrylamide gel electrophoresis (SDS-PAGE) and Western blotting using specific antibodies. The differential expression of S100A4 in the various cell lines was further investigated at the gene level by semiquantitative real-time PCR. Mineralization in the various cell types was observed after alizarin red staining after a 28 days incubation period. The immunophenotype of the cells was examined by flow cytometry using monoclonal anti-human antibodies CD90-FITC, CD73-PE, CD105-PE, CD29-PE, CD140a-FITC, CD144-PE, CD45-FITC or CD34-FITC. Differences between median values were statistically analyzed (Mann-Whitney U-test). RESULTS Cells from the dentin-pulp interface retain the polarity of odontoblast morphology in culture with an elongated, rounded cell body, and an extended cellular process. Ultrastructural analysis of the cells indicates high secretory activity including the extracellular deposition of fibrillar collagen. An extended rough endoplasmic reticulum is lined by a large number of ribosomes, and a vast number of secretory granules merges with the cell membrane. Protein expression of DSPP, DMP1, and TRPV4 as a transient receptor potential cation was detected in all cell lines. S100A4 was found differentially expressed in cultures of cells from tooth tissues. High expression of S100A4 was observed at the protein and gene level in two fractions of cells isolated from the dentin-pulp interface, but was absent or only weakly expressed in pulp cells. S100A4 expression in cells from the dentin-pulp interface and pulp cells is consistent with the intensity of the formation of mineralized nodules detected by alizarin red staining. Immunophenotyping revealed that a high percentage of CD73 (ecto-5-nucleotidase), an enzyme active on the surface of immune-competent cells, was expressed in cells of the dentin-pulp interface. While 72%-78% of positive cells were detected in dentin-pulp interface fractions, only 28-64% of the cells in pulp cell cultures were stained. CONCLUSIONS The present findings obtained with a variety of cells of different origin provide experimental evidence that cells isolated from the dentin-pulp interface express unique properties different from dental pulp cells in particular. The differential expression of S100A4 is a relevant marker candidate for differentiating between dental pulp cells and cells of the odontoblast lineage.
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Affiliation(s)
- Marialucia Gallorini
- Department of Pharmacy, University "G. d'Annunzio" Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy
| | - Stephanie Krifka
- Department of Prosthetic Dentistry, University Hospital Regensburg, D-93042 Regensburg, Germany
| | - Matthias Widbiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, D-93042 Regensburg, Germany
| | - Agnes Schröder
- Department of Orthodontics, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, D-93042 Regensburg, Germany
| | - Christoph Brochhausen
- Institute of Pathology, University of Regensburg, Franz-Josef-Strauss Allee 11, D-93042 Regensburg, Germany
| | - Amelia Cataldi
- Department of Pharmacy, University "G. d'Annunzio" Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy
| | - Karl-Anton Hiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, D-93042 Regensburg, Germany
| | - Wolfgang Buchalla
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, D-93042 Regensburg, Germany
| | - Helmut Schweikl
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, D-93042 Regensburg, Germany.
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Widbiller M, Bucchi C, Rosendahl A, Spanier G, Buchalla W, Galler KM. Isolation of primary odontoblasts: Expectations and limitations. AUST ENDOD J 2019; 45:378-387. [DOI: 10.1111/aej.12335] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2019] [Indexed: 01/06/2023]
Affiliation(s)
- Matthias Widbiller
- Department of Conservative Dentistry and Periodontology University Hospital Regensburg Regensburg Germany
| | - Cristina Bucchi
- Department of Pathology and Experimental Therapy Universitat de Barcelona Barcelona Spain
- Department of Integral Adult Dentistry Research Centre for Dental Sciences Universidad de La Frontera Temuco Chile
| | - Andreas Rosendahl
- Department of Conservative Dentistry and Periodontology University Hospital Regensburg Regensburg Germany
| | - Gerrit Spanier
- Department of Oral‐ and Maxillofacial Surgery University Hospital Regensburg Regensburg Germany
| | - Wolfgang Buchalla
- Department of Conservative Dentistry and Periodontology University Hospital Regensburg Regensburg Germany
| | - Kerstin M. Galler
- Department of Conservative Dentistry and Periodontology University Hospital Regensburg Regensburg Germany
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Ma C, Chang B, Jing Y, Kim H, Liu X. Bio-Inspired Micropatterned Platforms Recapitulate 3D Physiological Morphologies of Bone and Dentinal Cells. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2018; 5:1801037. [PMID: 30581705 PMCID: PMC6299721 DOI: 10.1002/advs.201801037] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 08/02/2018] [Indexed: 05/09/2023]
Abstract
Cells exhibit distinct 3D morphologies in vivo, and recapitulation of physiological cell morphologies in vitro is pivotal not only to elucidate many fundamental biological questions, but also to develop new approaches for tissue regeneration and drug screening. However, conventional cell culture methods in either a 2D petri dish or a 3D scaffold often lead to the loss of the physiological morphologies for many cells, such as bone cells (osteocytes) and dentinal cells (odontoblasts). Herein, a unique approach in developing a 3D extracellular matrix (ECM)-like micropatterned synthetic matrix as a physiologically relevant 3D platform is reported to recapitulate the morphologies of osteocytes and odontoblasts in vitro. The bio-inspired micropatterned matrix precisely mimics the hierarchic 3D nanofibrous tubular/canaliculi architecture as well as the compositions of the ECM of mineralized tissues, and is capable of controlling one single cell in a microisland of the matrix. Using this bio-inspired 3D platform, individual bone and dental stem cells are successfully manipulated to recapitulate the physiological morphologies of osteocytes and odontoblasts in vitro, respectively. This work provides an excellent platform for an in-depth understanding of cell-matrix interactions in 3D environments, paving the way for designing next-generation biomaterials for tissue regeneration.
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Affiliation(s)
- Chi Ma
- Department of Biomedical SciencesTexas A&M University College of DentistryDallasTX75246USA
| | - Bei Chang
- Department of Biomedical SciencesTexas A&M University College of DentistryDallasTX75246USA
| | - Yan Jing
- Department of OrthodonticsTexas A&M University College of DentistryDallasTX75246USA
| | - Harry Kim
- Department of OrthopaedicsTexas Scottish Rite Hospital for ChildrenUniversity of Texas Southwestern Medical CenterTX75219USA
| | - Xiaohua Liu
- Department of Biomedical SciencesTexas A&M University College of DentistryDallasTX75246USA
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Botelho J, Cavacas MA, Borrecho G, Polido M, Oliveira P, Martins Dos Santos J. Human ex vivo dentin-pulp complex preservation in a full crown model. J Oral Biol Craniofac Res 2017; 7:19-22. [PMID: 28316916 DOI: 10.1016/j.jobcr.2016.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 12/11/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Currently, there is lack of human in vitro full tooth models that hold the odontoblast layer with pulp tissue in their native environment. The appearance of new in vitro and in vivo models has provided new understanding of the potential of tissue engineering in dental pulp regeneration. However, the development of new in vitro full tooth models will allow us to get closer to in vivo conditions. Thus, the aim of this study is to preserve a living dentin-pulp complex, in a novel in vitro full crown model, after tooth extraction. METHODS Twenty intact third molars, after preparation, were divided into four groups, with five samples each. We placed the negative control samples (C) in saline, and the tested groups were placed (T) in supplemented DMEM, at two different times: 1 and 7 days. The specimens were processed for light microscopy observation. RESULTS Contrary to C-groups, T-groups showed a functional dentin-pulp complex. The treated dentin-pulp complex presents normal histological appearance. CONCLUSIONS This study showed that it is possible to preserve a living dentin-pulp complex after tooth extraction during 7 days.
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Affiliation(s)
- João Botelho
- Instituto Superior de Ciências da Saúde Egas Moniz, Anatomy Department, Campus Universitário, Quinta da Granja, Caparica, Setúbal, Portugal
| | - Maria Alzira Cavacas
- Instituto Superior de Ciências da Saúde Egas Moniz, Anatomy Department, Campus Universitário, Quinta da Granja, Caparica, Setúbal, Portugal
| | - Gonçalo Borrecho
- Instituto Superior de Ciências da Saúde Egas Moniz, Anatomy Department, Campus Universitário, Quinta da Granja, Caparica, Setúbal, Portugal
| | - Mário Polido
- Instituto Superior de Ciências da Saúde Egas Moniz, Dental Materials Department, Campus Universitário, Quinta da Granja, Caparica, Setúbal, Portugal
| | - Pedro Oliveira
- Instituto Superior de Ciências da Saúde Egas Moniz, Anatomy Department, Campus Universitário, Quinta da Granja, Caparica, Setúbal, Portugal
| | - José Martins Dos Santos
- Instituto Superior de Ciências da Saúde Egas Moniz, Anatomy Department, Campus Universitário, Quinta da Granja, Caparica, Setúbal, Portugal
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