General consensus on multimodal functions and validation analysis of perinatal derivatives for regenerative medicine applications.

Perinatal tissues, such as placenta and umbilical cord contain a variety of somatic stem cell types, spanning from the largely used hematopoietic stem and progenitor cells to the most recently described broadly multipotent epithelial and stromal cells. As perinatal derivatives (PnD), several of these cell types and related products provide an interesting regenerative potential for a variety of diseases. Within COST SPRINT Action, we continue our review series, revising and summarizing the modalities of action and proposed medical approaches using PnD products: cells, secretome, extracellular vesicles, and decellularized tissues. Focusing on the brain, bone, skeletal muscle, heart, intestinal, liver, and lung pathologies, we discuss the importance of potency testing in validating PnD therapeutics, and critically evaluate the concept of PnD application in the field of tissue regeneration. Hereby we aim to shed light on the actual therapeutic properties of PnD, with an open eye for future clinical application. This review is part of a quadrinomial series on functional/potency assays for validation of PnD, spanning biological functions, such as immunomodulation, anti-microbial/anti-cancer, anti-inflammation, wound healing, angiogenesis, and regeneration

Surgical Application of Human Amniotic Membrane and Amnion-Chorion Membrane in the Oral Cavity and Efficacy Evaluation: Corollary With Ophthalmological and Wound Healing Experiences

Due to its intrinsic properties, there has been growing interest in human amniotic membrane (hAM) in recent years particularly for the treatment of ocular surface disorders and for wound healing. Herein, we investigate the potential use of hAM and amnion-chorion membrane (ACM) in oral surgery. Based on our analysis of the literature, it appears that their applications are very poorly defined. There are two options: implantation or use as a cover material graft. The oral cavity is submitted to various mechanical and biological stimulations that impair membrane stability and maintenance. Thus, some devices have been combined with the graft to secure its positioning and protect it in this location. This current opinion paper addresses in detail suitable procedures for hAM and ACM utilization in soft and hard tissue reconstruction in the oral cavity. We address their implantation and/or use as a covering, storage format, application side, size and number, multilayer use or folding, suture or use of additional protective covers, re-application and resorption/fate. We gathered evidence on pre- and post-surgical care and evaluation tools. Finally, we integrated ophthalmological and wound healing practices into the collected information. This review aims to help practitioners and researchers better understand the application of hAM and ACM in the oral cavity, a place less easily accessible than ocular or cutaneous surfaces. Additionally, it could be a useful reference in the generation of new ideas for the development of innovative protective covering, suturing or handling devices in this specific indication. Finally, this overview could be considered as a position paper to guide investigators to fulfill all the identified criteria in the future

Actinic cheilitis: guidance on monitoring and management in primary care

Actinic cheilitis is an oral potentially malignant disorder caused by UV radiation leading to damage to epithelial keratinocytes of the lips. It predominantly affects the vermillion border of the lower lip. Due to its association with chronic UV exposure, associated risk factors include geographic areas, outdoor occupations, and skin subtypes. A high proportion of lip squamous cell carcinomas arise from actinic cheilitis lesions, with histological examination usually showing a degree of dysplasia. This paper aims to review the existing literature regarding the clinical picture of actinic cheilitis, its prevalence, differential diagnoses, and consensus on management, for the education of the general dental practitioner in identifying and surveillance of this lesion

Indications chirurgicales des lésions iatrogènes du nerf infra-alvéolaire et du nerf lingual : revue de la littérature

Introduction : Les lésions nerveuses du nerf infra alvéolaire (NIA) et du nerf lingual (NL) représentent les lésions les plus fréquentes en chirurgie orale. L’objectif de cet article était de clarifier la conduite à tenir pour poser l’indication de prise en charge chirurgicale de ces lésions. Matériel et Méthodes : Les mots clés indexés dans le MeSH (“Iatrogenic Disease”[Mesh] OR “Trauma, Nervous System”[Mesh] OR “Medical Errors”[Mesh]) AND (“Lingual Nerve”[Mesh] OR “Lingual Nerve Injuries”[Mesh] OR “Mandibular Nerve”[Mesh]) ont été appliqué dans la base de données PubMed et Cochrane. Les articles publiés entre 2004 et 2014 ont été retenus s’ils traitaient de l’étiologie, du diagnostic ou du traitement de ces lésions. Résultats : Sur 256 références, 22 ont été retenues. Différents tests cliniques sont utilisées pour évaluer la symptomatologie mais aucune méthode consensuelle n’est objectivée. Les indications chirurgicales souffrent du même manque de consensus. Les données recueillies mettent en évidence une efficacité de la chirurgie avec une Récupération Fonctionnelle Sensorielle dans 80 à 90 % des cas. Ces lésions sont trop souvent simplement surveillées alors que dans certains cas, la chirurgie doit être la première intention. Conclusion : Cet article détaille la méthode la plus standardisée et applicable en pratique courante pour évaluer le niveau d’atteinte et poser lorsqu’elle s’impose l’indication chirurgicale

Branchio-oto-renal syndrome: a clinical case

Observation: A 19-week-old patient seen in an oral dermatology clinic had small labial commissures pits associated with auricular abnormalities. Similar clinical elements were found in the family medical history. A diagnosis of branchio-oto-renal syndrome (BOR) was quickly evoked. Commentary: BOR syndrome is a rare disease. This autosomal dominant pathology is characterized by facial lesions and renal abnormalities. Diagnosis is based on many clinical criteria. An optional genetic study can sometimes assist in diagnosis

Intravascular papillary endothelial hyperplasia: a case report

Case report: A 71-year-old patient, with no notable medical-surgical history, was referred for a specialized consultation with Oral Mucosal Pathology for tumefaction on the dorsal side of the tongue. It was a nodular lesion measuring one centimeter long, purplish, and painless. There was nothing found through palpation. Surgical excision with a laser diode was performed under local anesthesia. The postoperative follow-up was simple. The patient was seen 3 months later without any sign of recurrence. Histopathological analysis revealed a vegetative intravascular hemangioendothelioma. Comments: This case is rare because of the location of the tumor, and moreover because the subject is male. A laser diode was chosen to resect the lesion because of the purple color which could have resulted in a possible vascular lesion. Indeed, the limits of excision were coagulated, which facilitated the surgery time and any limited postoperative hemorrhagic complications that could have occurred

J Biomed Mater Res B Appl Biomater

The aim of this study was to perform a systematic review on the clinical applications where chorion membrane (CM) and amnion/chorion membrane (ACM) were used for oral tissue regeneration procedures. Selection of articles was carried out by two evaluators in Pubmed and Scopus databases, and Outcomes (PICO) method was used to select the relevant articles. Clinical studies reporting the use of CM or ACM for oral soft and hard tissue regeneration were included. The research involved 21 studies conducted on 375 human patients. Seven clinical applications of CM and ACM in oral and periodontal surgery were identified: gingival recession treatment, intrabony and furcation defect treatment, alveolar ridge preservation, keratinized gum width augmentation around dental implants, maxillary sinus membrane repair, and large bone defect reconstruction. CM and ACM were compared to negative controls (conventional surgeries without membrane) or to the following materials: collagen membranes, dense polytetrafluoroethylene membranes, platelet-rich fibrin membranes, amnion membranes, and to a bone substitute. Several studies support the use of CM and ACM as an efficient alternative to current techniques for periodontal and oral soft tissue regeneration procedures. However, further studies are necessary to increase the level of evidence and especially to demonstrate their role for bone regeneration

Drug-induced oral mucous membrane pemphigoid: a case report

Observation: An 82-year-old patient treated with the antihistamine ebastine (Kestin®) for allergic rhinitis presented for gingival pain. The diagnosis of mucous membrane pemphigoid was suspected after a positive pinch test. Blood examinations highlighted AC anti-PBGA2, and the gingival biopsy showed an epithelioconjunctival delamination and the presence of anti-IgA antibody and C3 deposition along the basal of the membrane. Topical corticosteroid administration was initiated. The symptoms improved but elevated IgA and C3 levels persisted. He underwent a complete remission on cessation of ebastine treatment. Commentary: Mucous membrane pemphigoid is an autoimmune disease whose origin remains unclear. The aim of the treatment is to decrease the symptoms, but full recovery of the patients is exceptional. We report here a clinical case with symptom resolution because of the ebastine withdrawal. Ebastine can thus be suspected as a cause if a patient presents with oral symptoms of mucous membrane pemphigoid

Recent Advances of Pullulan and/or Dextran-Based Materials for Bone Tissue Engineering Strategies in Preclinical Studies: A Systematic Review

International audienceBone tissue engineering (BTE) strategies are increasingly investigated to overcome the limitations of currently used bone substitutes and to improve the bone regeneration process. Among the natural polymers used for tissue engineering, dextran and pullulan appear as natural hydrophilic polysaccharides that became promising biomaterials for BTE. This systematic review aimed to present the different published applications of pullulan and dextran-based biomaterials for BTE. An electronic search in Pubmed, Scopus, and Web of Science databases was conducted. Selection of articles was performed following PRISMA guidelines. This systematic review led to the inclusion of 28 articles on the use of pullulan and/or dextran-based biomaterials to promote bone regeneration in preclinical models. Sixteen studies focused on dextran-based materials for bone regeneration, six on pullulan substitutes and six on the combination of pullulan and dextran. Several strategies have been developed to provide bone regeneration capacity, mainly through their fabrication processes (functionalization methods, cross-linking process), or the addition of bioactive elements. We have summarized here the strategies employed to use the polysaccharide scaffolds (fabrication process, composition, application usages, route of administration), and we highlighted their relevance and limitations for BTE applications