Evaluation of DNA methylation of inflammatory genes following treatment of chronic periodontitis: A pilot case–control study

ObjectiveTo evaluate the influence of periodontal therapy on DNA methylation in patients with chronic periodontitis as compared to healthy individuals.Material and MethodsTwenty patients were enrolled into two groups: (i) 10 diagnosed as clinically healthy; and (ii) 10 diagnosed with chronic periodontitis. Clinical measures were recorded and gingival biopsies were harvested at baseline (both patient groups) and at 2 and 8 weeks post‐baseline for diseased individuals. Molecular DNA methylation analysis was performed by pyrosequencing for the putative inflammation‐associated genes LINE‐1, COX‐2, IFN‐γ and TNF‐α. Random‐intercept linear regression models were applied to evaluate methylation levels across groups at baseline and the methylation changes over time in the diseased and normal tissues.ResultsPeriodontal therapy did not influence gene expression methylation of TNF‐α, IFN‐γ and LINE‐1 levels at normal and periodontitis sites over time. However, it significantly reduced COX‐2 methylation levels comparable to healthy individuals at both 2 and 8 weeks post‐treatment (p < .05).ConclusionsPeriodontal therapy resets the DNA methylation status of inflammatory gene for COX‐2 in patients with periodontal disease. DNA methylation levels of TNF‐α, IFN‐γ and LINE‐1 were sustained in periodontitis sites despite therapy. Future studies should consider an expanded panel of inflammatory genes over time. (ClinicalTrials.gov NCT02835898).Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138219/1/jcpe12783.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138219/2/jcpe12783_am.pd

Micropatterned Scaffolds with Immobilized Growth Factor Genes Regenerate Bone and Periodontal Ligament‐Like Tissues

Periodontal disease destroys supporting structures of teeth. However, tissue engineering strategies offer potential to enhance regeneration. Here, the strategies of patterned topography, spatiotemporally controlled growth factor gene delivery, and cell‐based therapy to repair bone–periodontal ligament (PDL) interfaces are combined. Micropatterned scaffolds are fabricated for the ligament regions using polycaprolactone (PCL)/polylactic‐co‐glycolic acid and combined with amorphous PCL scaffolds for the bone region. Scaffolds are modified using chemical vapor deposition, followed by spatially controlled immobilization of vectors encoding either platelet‐derived growth factor‐BB or bone morphogenetic protein‐7, respectively. The scaffolds are seeded with human cells and delivered to large alveolar bone defects in athymic rats. The effects of dual and single gene delivery with and without micropatterning are assessed after 3, 6, and 9 weeks. Gene delivery results in greater bone formation at three weeks. Micropatterning results in regenerated ligamentous tissues similar to native PDL. The combination results in more mature expression of collagen III and periostin, and with elastic moduli of regenerated tissues that are statistically indistinguishable from those of native tissue, while controls are less stiff than native tissues. Thus, controlled scaffold microtopography combined with localized growth factor gene delivery improves the regeneration of periodontal bone–PDL interfaces.For bone–ligament tissue regeneration, a combined strategy of patterned polymeric scaffolds, spatiotemporally controlled growth factor gene delivery, and cell‐based therapy is used. Polycaprolactone (PCL)/polylactic‐co‐glycolic acid scaffolds with microtopography and amorphous PCL scaffolds, combined with chemical vapor deposition for immobilization of gene therapy vectors, improve the regeneration of periodontal bone–periodontal ligament interfaces.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146594/1/adhm201800750-sup-0001-S1.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146594/2/adhm201800750_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146594/3/adhm201800750.pd

Recent advances in additive manufacturing of patient-specific devices for dental and maxillofacial rehabilitation

ObjectivesCustomization and the production of patient-specific devices, tailoring the unique anatomy of each patient's jaw and facial structures, are the new frontiers in dentistry and maxillofacial surgery. As a technological advancement, additive manufacturing has been applied to produce customized objects based on 3D computerized models. Therefore, this paper presents advances in additive manufacturing strategies for patient-specific devices in diverse dental specialties.MethodsThis paper overviews current 3D printing techniques to fabricate dental and maxillofacial devices. Then, the most recent literature (2018–2023) available in scientific databases reporting advances in 3D-printed patient-specific devices for dental and maxillofacial applications is critically discussed, focusing on the major outcomes, material-related details, and potential clinical advantages.ResultsThe recent application of 3D-printed customized devices in oral prosthodontics, implantology and maxillofacial surgery, periodontics, orthodontics, and endodontics are presented. Moreover, the potential application of 4D printing as an advanced manufacturing technology and the challenges and future perspectives for additive manufacturing in the dental and maxillofacial area are reported.SignificanceAdditive manufacturing techniques have been designed to benefit several areas of dentistry, and the technologies, materials, and devices continue to be optimized. Image-based and accurately printed patient-specific devices to replace, repair, and regenerate dental and maxillofacial structures hold significant potential to maximize the standard of care in dentistry

Classifying Maxillary Sinuses of Polish Patients for Sinus Lift: A Pilot Study

To date, there is no systematic anatomical classification available that could help clinicians in choosing between the lateral and palatal approach in sinus lift procedures. The aim was to provide a simple-to-use and memorable classification of the maxillary sinus concerning the thickness of lateral and palatal walls to facilitate the most adequate choice for the window location during direct sinus floor elevation. Cone beam computed tomography scans were consecutively obtained for 200 maxillary sinuses of patients needing dental implant placement with potential maxillary sinus augmentation. The thickness and height of the alveolar bone of the lateral and palatal walls of the maxillary sinuses were assessed. Four variants were distinguished. Class 0: an adequate sub-sinus residual bone height; without the need for sinus floor augmentation. Classes 1–3 had a reduced sub-sinus residual bone height. Class 1: a thinner lateral than palatal sinus wall. Class 2 (the most frequent; 49%): the comparable thickness of both walls in which either lateral, palatal, or crestal window osteotomies can be applied. Class 3 (the least frequent; 3%): a thinner palatal sinus wall in comparison to the lateral wall. The presented anatomical classification simplifies the decision-making process of choosing the most adequate window location and osteotomy technique

The Role of Epigenetic Functionalization of Implants and Biomaterials in Osseointegration and Bone Regeneration—A Review

The contribution of epigenetic mechanisms as a potential treatment model has been observed in cancer and autoimmune/inflammatory diseases. This review aims to put forward the epigenetic mechanisms as a promising strategy in implant surface functionalization and modification of biomaterials, to promote better osseointegration and bone regeneration, and could be applicable for alveolar bone regeneration and osseointegration in the future. Materials and Methods: Electronic and manual searches of the literature in PubMed, MEDLINE, and EMBASE were conducted, using a specific search strategy limited to publications in the last 5 years to identify preclinical studies in order to address the following focused questions: (i) Which, if any, are the epigenetic mechanisms used to functionalize implant surfaces to achieve better osseointegration? (ii) Which, if any, are the epigenetic mechanisms used to functionalize biomaterials to achieve better bone regeneration? Results: Findings from several studies have emphasized the role of miRNAs in functionalizing implants surfaces and biomaterials to promote osseointegration and bone regeneration, respectively. However, there are scarce data on the role of DNA methylation and histone modifications for these specific applications, despite being commonly applied in cancer research. Conclusions: Studies over the past few years have demonstrated that biomaterials are immunomodulatory rather than inert materials. In this context, epigenetics can act as next generation of advanced treatment tools for future regenerative techniques. Yet, there is a need to evaluate the efficacy/cost effectiveness of these techniques in comparison to current standards of care

The Role of Epigenetics in Periodontal and Systemic Diseases and Smoking: A Systematic Review

The aims of this systematic review were to identify and synthesize the evidence for an association in DNA methylation/histone modifications between periodontal diseases and systemic diseases/smoking. Electronic database searches using relevant search terms in PubMed, Embase, MEDLINE, CINAHL, Web of Science, Scopus, and SciELO, and manual searches, were independently conducted to identify articles meeting the inclusion criteria. Nine studies of 1482 participants were included. Periodontitis was compared to metabolic disorders, rheumatoid arthritis (RA), cancer, and smokers, as well as healthy controls. Substantial variation regarding the reporting of sample sizes and patient characteristics, statistical analyses, and methodology was found. IL6 and TNF were modified similarly in RA and periodontitis. While TIMP-3 and GSTP-1 were significantly lower in periodontitis patients and controls than in cancer, SOCS-1, RMI2, CDH1, and COX2 were modified similarly in both cancer and periodontitis. While TLR4 in and CXCL8 were affected in periodontitis independent of smoking habit, smoking might change the transcription and methylation states of ECM organization-related genes, which exacerbated the periodontal condition. There was some evidence, albeit inconsistent, for an association between DNA methylation and periodontal diseases and systemic diseases or smokers compared to healthy patients or non-smokers