Guideline on therapeutic dentistry for the 5-th term

РУКОВОДСТВАСТОМАТОЛОГИЯ ЛЕЧЕБНО-ВОССТАНОВИТЕЛЬНАЯСТОМАТОЛОГИЯ ТЕРАПЕВТИЧЕСКАЯИНОСТРАННЫЕ СТУДЕНТЫУЧЕБНО-МЕТОДИЧЕСКИЕ ПОСОБИЯПособие составлено в соответствии с учебной программой для медицинских вузов по терапевтической стоматологии. Предназначено для внутреннего использования

Hydrogels and Dentin-Pulp Complex Regeneration: From the Benchtop to Clinical Translation

Dentin-pulp complex is a term which refers to the dental pulp (DP) surrounded by dentin along its peripheries. Dentin and dental pulp are highly specialized tissues, which can be affected by various insults, primarily by dental caries. Regeneration of the dentin-pulp complex is of paramount importance to regain tooth vitality. The regenerative endodontic procedure (REP) is a relatively current approach, which aims to regenerate the dentin-pulp complex through stimulating the differentiation of resident or transplanted stem/progenitor cells. Hydrogel-based scaffolds are a unique category of three dimensional polymeric networks with high water content. They are hydrophilic, biocompatible, with tunable degradation patterns and mechanical properties, in addition to the ability to be loaded with various bioactive molecules. Furthermore, hydrogels have a considerable degree of flexibility and elasticity, mimicking the cell extracellular matrix (ECM), particularly that of the DP. The current review presents how for dentin-pulp complex regeneration, the application of injectable hydrogels combined with stem/progenitor cells could represent a promising approach. According to the source of the polymeric chain forming the hydrogel, they can be classified into natural, synthetic or hybrid hydrogels, combining natural and synthetic ones. Natural polymers are bioactive, highly biocompatible, and biodegradable by naturally occurring enzymes or via hydrolysis. On the other hand, synthetic polymers offer tunable mechanical properties, thermostability and durability as compared to natural hydrogels. Hybrid hydrogels combine the benefits of synthetic and natural polymers. Hydrogels can be biofunctionalized with cell-binding sequences as arginine-glycine-aspartic acid (RGD), can be used for local delivery of bioactive molecules and cellularized with stem cells for dentin-pulp regeneration. Formulating a hydrogel scaffold material fulfilling the required criteria in regenerative endodontics is still an area of active research, which shows promising potential for replacing conventional endodontic treatments in the near future

Therapeutic Dentistry for the 4th year students

УЧЕБНО-МЕТОДИЧЕСКИЕ ПОСОБИЯСТОМАТОЛОГИЯ ЛЕЧЕБНО-ВОССТАНОВИТЕЛЬНАЯСТОМАТОЛОГИЯПЕРИОДОНТА БОЛЕЗНИСТОМАТОЛОГИЯ ТЕРАПЕВТИЧЕСКАЯИНОСТРАННЫЕ СТУДЕНТЫTHERAPEUTIC DENTISTRYПособие рассматривает один из важнейших разделов терапевтической стоматологии - периодонтологию. Изложены основные аспекты этиологии и патогенеза заболеваний периодонта, их клиническая картина. Представлена классификация заболеваний периодонта, основные и дополнительные методы диагностики, профилактики и лечения заболеваний периодонта. Предназначено для студентов 4 курса стоматологического факультета, обучающихся на английском языке

Early angiogenic change in dental pulp stromal cells cultured on biomimetic matrices

Revascularisation of the devitalised root canal is the Holy Grail of Endodontics and is being hotly pursued by many teams of clinicians but has yet to be achieved. The overall aim of this work was to attempt to induce early angiogenesis in human dental pulp stromal cells (DPSCS) in vitro and in vivo using a biomimetic approach based on combining scaffolds comprised of ECM components with DPSCs as a first step towards a tissue engineering strategy for dental pulp regeneration. After isolating DPSCs using collagenase digest, they were cultured on 1% hyaluronic acid (HyA) or Types I and III collagen matrices used either singly or in combination to determine the ability of these scaffolds to support/induce early angiogenic change in DPSCs both in vitro and in vivo. Angiogenic change was determined using a combined approach of DNA quantification, histology, immunohistochemistry to detect the angiogenic markers CD31 and CD34 and quantitative RT-PCR. DPSCs were shown to attach and proliferate on Type I and III collagen membranes in vitro but early angiogenic change in vitro was evidenced only when 1% HyA gel was used, including in the absence of the morphogen rhVEGF165 as shown immunohistochemically. PCR at two and five days post-seeding showed an up-regulation of CD31 and CD34 genes dependant on culture conditions, with CD31 being upregulated early and CD34 later in the culture period. A modified tooth slice model containing a combination of HyA/collagen scaffold/DPSC constructs within its lumen also showed positive early angiogenic change in vitro. SEM examination further confirmed that DPSCs could attach, colonise and proliferate to/on the combined scaffold. The same combined scaffold-tooth slice model ± DPSCs used in vivo in nude mice showed cellular ingress into the lumen with a soft tissue closely resembling dental pulp-like tissues in its appearance with new tubule-like material grown on from the dentinal tubules of the tooth slice. There was a defined demarcation line between this latter material and the dentinal tubules of the tooth slice and the new material closely resembled predentine or dentine-like matrix in appearance and stained strongly for CD31 and CD34 markers. It also had a layer of cells adjacent to and in intimate contact with its deposition front, whose cell processes transited the new tubule-like material and continued into the dentine tubules of the tooth slice for some distance. Interestingly, this neo-tissue was independent of the addition of DPSCs to the construct. The results suggest that biomimetic scaffolds based upon components of the pulp extracellular matrix may provide a useful platform for future engineering of a vascularised replacement dental pulp

Therapeutic Dentistry for the 3rd year student

УЧЕБНО-МЕТОДИЧЕСКИЕ ПОСОБИЯСТОМАТОЛОГИЯ ЛЕЧЕБНО-ВОССТАНОВИТЕЛЬНАЯСТОМАТОЛОГИЯ ТЕРАПЕВТИЧЕСКАЯКАРИЕС ЗУБОВ /ТЕРАПИЯЗУБНЫЕ ЦЕМЕНТЫ ПЛОМБИРОВОЧНЫЕПЕРИОДОНТА БОЛЕЗНИАНТИСЕПТИКИСТЕРИЛИЗАЦИЯDENTAL CARIESTHERAPEUTIC DENTISTRYИНОСТРАННЫЕ СТУДЕНТЫУчебный материал состоит из 19 уроков. Обсуждаются вопросы применения антисептиков и стерилизации в стоматологии, индивидуальной и профессиональной гигиены, кариесологии, некариозных поражений. Содержатся такие темы, как "Методы исследования деструктивного процесса тканей пародонта", "Возможности выбора пломбировочного материала в различных случаях", "Малоинвазивные методы оперативного лечения кариеса зубов". The 5th semester contains educational material for 19 lessons. This section discusses the issues of antiseptics and sterilization in dentistry, individual and professional hygiene, cariesology, non-carious lesions. Added topics as "Methods of investigation characterized destructive process of periodontal tissues", "Possibilities of filling material choice in different cases", "Minimal invasive methods of operative treatment of dental caries"

Advanced Materials for Oral Application

This book consists of one editorial, 12 original research articles and two review papers from scientists across the world, with expertise in materials for dental application. The main subjects covered are: biomaterials and techniques for oral tissue engineering and regeneration; biomaterials for surgical reconstruction; CAD/CAM technologies and dedicated materials; novel restorative and endodontic materials and instruments

EDENTULISM PROBLEM: USE OF STEM CELLS FOR BONE REGENERATION AND BONE INFLAMMATION

In this study we have started from a real odontoiatric clinic problem, which affects a high percentage of patients: edentulism. Implant therapy, started by Prof. Branemark in the seventies thanks to the discovery of osseointegration, has developed in the last 15 years. This therapy represents a valid solution for edentulous patients, although it cannot always be used. Severe osseous resorption or anatomical limitations hinder the use of implant and force the employ of biomaterials and/or autologous bone, which, according to the latest scientific research, represents the gold standard. However, intraoral bone graft is not always well tolerated by patients and, in cases of severe atrophy, the quantity of bone that can be taken from the oral cavity is not enough for complete regeneration. Although implant therapy represents the best solution for edentulous patients, in the latest years a biological complication has become more and more frequent: peri-implantitis. It represents a serious problem since it begins with an inflammation of peri-implant hard tissues that clinically leads to a loss of peri-implant alveolar bone and, eventually, to the loss of the implant as a whole. According to the most recent literature, this serious problem affects 10% of the patients and 4% of the implant sites after 10 years of follow-up. To make this pathology even more serious is the little knowledge that clinicians and researchers have about early diagnosis, etiopathogenesis and therapy. The purpose of this study is to address both edentulism and consequent osseous regeneration, as well as the problem of peri-implantitis from a biological point of view and with the help of tissue engineering. In particular, we wanted to test the ability of stem cells taken from adult tissue to favor - in shorter time - osseous regeneration and implant osseointegration both in vitro and on small and large animals. Furthermore, we have tested the anti-inflammatory ability of stem cells in bone tissue. Finally, with regard to the problem of peri-implantitis, we have searched for predictive genetic factors in order to possibly identify patients at risk. Preliminary results of studies performed both in vitro and on animal enable us to state that: -- It is possible to isolate stem cells from different adult tissues (adipose tissue, dental pulp) and test their genetic stability. -- For the cells isolated from dental pulp, we could identify an important connection between patient’s age and ability to differentiate and proliferate. -- Stem cells combined with different scaffolds are able to foster osseous regeneration faster. -- It has been recognized an actual anti-inflammatory ability of stem cells in bone tissue. -- Preliminary results on the use of CGH as genetic predictive technique for peri-implantitis are encouraging since they foreground a correlation between the genetic alteration of some chromosomal tracts and clinical onset of the disease