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Tatullo M, Riccitiello F, Rengo S, Marrelli B, Valletta R, Spagnuolo G. Management of Endodontic and Periodontal Lesions: the Role of Regenerative Dentistry and Biomaterials. Dent J (Basel) 2020; 8:E32. [PMID: 32260114 PMCID: PMC7346003 DOI: 10.3390/dj8020032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 03/29/2020] [Accepted: 04/01/2020] [Indexed: 02/03/2023] Open
Abstract
Regenerative dentistry represents a novel interdisciplinary approach involving biomaterials, several molecules and mesenchymal stem cells (MSCs), preferably derived from oral tissues. The pivotal role of MSCs depends on the fact that they can differentiate into different cell lineages and have the strategic role to release bioactive substances that stimulate the renewal and regeneration of damaged tissues. The role of regenerative dentistry is promising in all the branches of dentistry: the most intriguing application is related to the management of endodontic and periodontal defects, overcoming the surgical approach and the implantology as a consequence of a poorly efficient therapeutic plan.
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Affiliation(s)
- Marco Tatullo
- Department of Medical Sciences, Neurosciences and Sense Organs, University of Bari, 70124 Bari, Italy
| | - Francesco Riccitiello
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Napoli Federico II, 80131 Naples, Italy; (F.R.); (R.V.); (G.S.)
| | - Sandro Rengo
- Department of Health Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy;
| | - Benedetta Marrelli
- Marrelli Health-Healthcare Center, St. Enrico Fermi, 88900 Crotone, Italy;
| | - Rosa Valletta
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Napoli Federico II, 80131 Naples, Italy; (F.R.); (R.V.); (G.S.)
| | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Napoli Federico II, 80131 Naples, Italy; (F.R.); (R.V.); (G.S.)
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Carvalho CR, Costa JB, Costa L, Silva-Correia J, Moay ZK, Ng KW, Reis RL, Oliveira JM. Enhanced performance of chitosan/keratin membranes with potential application in peripheral nerve repair. Biomater Sci 2020; 7:5451-5466. [PMID: 31642822 DOI: 10.1039/c9bm01098j] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Although surgical management of peripheral nerve injuries (PNIs) has improved over time, autografts are still the current "gold standard" treatment for PNIs, which presents numerous limitations. In an attempt to improve natural biomaterial-based nerve guidance conduits (NGCs), chitosan (CHT), a derivative of the naturally occurring biopolymer chitin, has been explored for peripheral nerve regeneration (PNR). In addition to CHT, keratin has gained enormous attention as a biomaterial and tissue engineering scaffolding. In this study, biomimetic CHT/keratin membranes were produced using a solvent casting technique. These membranes were broadly characterized in terms of their surface topography and physicochemical properties, with techniques such as Fourier Transform Infrared Spectroscopy (FTIR), Differential Scanning Calorimetry (DSC), contact angle, weight loss and water uptake measurements, Scanning Electron Microscopy (SEM) and Atomic Force Microscopy (AFM). Biological in vitro assays were also performed, where a preliminary cytotoxicity screening with the L929 fibroblast cell line revealed that the membranes and respective materials are suitable for cell culture. In addition, Schwann cells, fibroblasts and endothelial cells were directly seeded in the membranes. Quantitative and qualitative assays revealed that the addition of keratin enhanced cell viablity and adhesion. Based on the encouraging in vitro results, the in vivo angiogenic/antiangiogenic potential of CHT and CHT/keratin membranes was assessed, using an optimized chick embryo chorioallantoic membrane assay, where higher angiogenic responses were seen in keratin-enriched materials. Overall, the obtained results indicate the higher potential of CHT/keratin membranes for guided tissue regeneration applications in the field of PNR.
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Affiliation(s)
- Cristiana R Carvalho
- 3B's Research Group, I3Bs - Research Institute on Biomaterials, Biodegradables and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, University of Minho, Avepark - Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco, Guimarães, Portugal.
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Zimta AA, Baru O, Badea M, Buduru SD, Berindan-Neagoe I. The Role of Angiogenesis and Pro-Angiogenic Exosomes in Regenerative Dentistry. Int J Mol Sci 2019; 20:ijms20020406. [PMID: 30669338 PMCID: PMC6359271 DOI: 10.3390/ijms20020406] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 01/04/2019] [Accepted: 01/15/2019] [Indexed: 02/07/2023] Open
Abstract
Dental surgeries can result in traumatic wounds that provoke major discomfort and have a high risk of infection. In recent years, density research has taken a keen interest in finding answers to this problem by looking at the latest results made in regenerative medicine and adapting them to the specificities of oral tissue. One of the undertaken directions is the study of angiogenesis as an integrative part of oral tissue regeneration. The stimulation of this process is intended to enhance the local availability of stem cells, oxygen levels, nutrient supply, and evacuation of toxic waste. For a successful stimulation of local angiogenesis, two major cellular components must be considered: the stem cells and the vascular endothelial cells. The exosomes are extracellular vesicles, which mediate the communication between two cell types. In regenerative dentistry, the analysis of exosome miRNA content taps into the extended communication between these cell types with the purpose of improving the regenerative potential of oral tissue. This review analyzes the stem cells available for the dentistry, the molecular cargo of their exosomes, and the possible implications these may have for a future therapeutic induction of angiogenesis in the oral wounds.
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Affiliation(s)
- Alina-Andreea Zimta
- MEDFUTURE-Research Center for Advanced Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, 23 Marinescu Street, 400337 Cluj-Napoca, Romania.
| | - Oana Baru
- Department of Preventive Dentistry, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400083 Cluj-Napoca, Romania.
| | - Mandra Badea
- Department of Preventive Dentistry, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400083 Cluj-Napoca, Romania.
| | - Smaranda Dana Buduru
- Prosthetics and Dental materials, Faculty of Dental Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania.
- Stomestet Stomatology Clinic, Calea Manastur 68A Street, 400658 Cluj-Napoca, Romania.
| | - Ioana Berindan-Neagoe
- MEDFUTURE-Research Center for Advanced Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, 23 Marinescu Street, 400337 Cluj-Napoca, Romania.
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, 23 Marinescu Street, 400337 Cluj-Napoca, Romania.
- Department of Functional Genomics and Experimental Pathology, The Oncology Institute "Prof. Dr. Ion Chiricuta", Republicii 34th street, 400015 Cluj-Napoca, Romania.
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Herrera D, Retamal-Valdes B, Alonso B, Feres M. Acute periodontal lesions (periodontal abscesses and necrotizing periodontal diseases) and endo-periodontal lesions. J Periodontol 2018; 89 Suppl 1:S85-S102. [DOI: 10.1002/jper.16-0642] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 06/29/2017] [Accepted: 07/30/2017] [Indexed: 12/16/2022]
Affiliation(s)
- David Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - Belén Retamal-Valdes
- Department of Periodontology; Dental Research Division; Guarulhos University; Guarulhos São Paulo Brazil
| | - Bettina Alonso
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - Magda Feres
- Department of Periodontology; Dental Research Division; Guarulhos University; Guarulhos São Paulo Brazil
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Herrera D, Retamal-Valdes B, Alonso B, Feres M. Acute periodontal lesions (periodontal abscesses and necrotizing periodontal diseases) and endo-periodontal lesions. J Clin Periodontol 2018; 45 Suppl 20:S78-S94. [DOI: 10.1111/jcpe.12941] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 06/29/2017] [Accepted: 07/30/2017] [Indexed: 01/29/2023]
Affiliation(s)
- David Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - Belén Retamal-Valdes
- Department of Periodontology; Dental Research Division; Guarulhos University; Guarulhos São Paulo Brazil
| | - Bettina Alonso
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - Magda Feres
- Department of Periodontology; Dental Research Division; Guarulhos University; Guarulhos São Paulo Brazil
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Sharma R, Hegde V, Siddharth M, Hegde R, Manchanda G, Agarwal P. Endodontic-periodontal microsurgery for combined endodontic-periodontal lesions: An overview. J Conserv Dent 2014; 17:510-6. [PMID: 25506135 PMCID: PMC4252921 DOI: 10.4103/0972-0707.144571] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Revised: 08/24/2014] [Accepted: 09/19/2014] [Indexed: 12/28/2022] Open
Abstract
Endodontic and periodontal microsurgery has surpassed the success rates for traditional endodontic and periodontal surgical procedures. Excellent healing results are being attributed to both the techniques, when employed, for isolated endodontic or periodontal defects. Combined endodontic-periodontal lesions have been referred to as a true challenge, requiring not only endodontic microsurgical management but also concurrent bone grafting and membrane barriers techniques. The prevention of epithelial downgrowth and regeneration of periodontal cementum, fiber, and bone seals the fate of these cases. Achieving primary closure with submergence of grafts has a positive effect on GTR outcome. New techniques of periodontal microsurgery, such as minimally invasive papilla preserving flaps with passive internal mattress suturing, have managed to obtain 90% primary flap closure over grafted sites. Root surface treatment and conditioning has also shown to be beneficial for GTR. Endodontic microsurgery for the combined lesion has not integrated these advances yet. These advances, along with a recently suggested treatment strategy, are ushering in the level next in management of the combined lesions. This article offers an overview of the combined lesion, the disease, its classification, treatment strategy, regenerative tools, microsurgical recommendations, and outcome studies.
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Affiliation(s)
- Ritu Sharma
- Department of Conservative Dentistry and Endodontics, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Vivek Hegde
- Department of Conservative Dentistry and Endodontics, MA Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - M Siddharth
- Department of Periodontics, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Rashmi Hegde
- Department of Periodontics, MA Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - Gunsha Manchanda
- Department of Conservative Dentistry and Endodontics, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Pratul Agarwal
- Department of Conservative Dentistry and Endodontics, Sharda University, Greater Noida, Uttar Pradesh, India
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