Use of adipose derived stem cells in Treacher Collins syndrome

Objective: Treacher Collins syndrome (TCS) is a rare congenital disorder of craniofacial development. TCS occurs with an incidence of 1:50,000, and more than 60% of TCS cases have no previous family history and arise as the result of de novo mutations. The high rate of de novo mutations, together with the extreme variability in the degree to which individuals can be affected, makes the provision of genetic counseling extremely complicated. Consequently, every case of TCS is unique and needs to be assessed individually. Patients with TCS frequently undergo multiple reconstructive surgeries from birth through adulthood, which rarely are fully corrective in the long-term. The nascent field of regenerative medicine offers the promise to improve some of these treatments. In particular, structural fat grafting (SFG) seems to be a good strategy not only to restore the normal volume and contour of the face, but also to provide a source of adipose-derived stem cells (ADSCs) with a multilineage differentiation potential. In this work, we present genetical analyses of ADSC affected by TCS. Materials and methods: ADSCs from were analyzed for their stemness properties and shared many characteristics with those of a healthy subject. Screening of the genome of the TCS patient using array-Comparative Genomic Hybridization allowed us to identify some chromosomal imbalances that are probably associated with TCS. Results: We found that some alterations, involving the TIMELESS gene, were usually associated with embryonic stem cells. Conclusions: With the aim to improve the final results, we need to consider combining knowledge of genetic alterations and expression profiles as a fundamental step before starting with surgical procedures

Mesh-tissue integration of synthetic and biologic meshes in wall surgery: brief state of art

Many studies show that surgical hernia repair with the use of prosthetic meshes can result in pain, hernia recurrence, contraction and mesh rupture. Numerous experimental studies have been conducted to understand the effect of mesh stiffness, pore size and mesh patterns on mesh biocompatibility. The purpose of this mini review is to present an overview of the contracture, adhesion, tissue regrowth and histological response characteristics of permanent and absorbable mesh. Indeed, the mechanics of mesh-human tissue interaction is poorly understood in the literature. It has been shown that early integration of biological meshes is critical for sustained hernia repair. One of the emerging experimental approaches is to combine cell-based regenerative medicine with mesh materials. Studies in preclinical models show that the use of synthetic and biological meshes with autologous cell implantation improves the biocompatibility of biomaterials, promoting key tissue regeneration processes such as adhesion and vascularisation

In vitro comparative study on the mechanical behavior of Zirconia and Polyetheretherketone in applied dental sciences

OBJECTIVE: Recently, Zirconia and polyaryletherketone (PEEK) have attracted increasing interest as reliable and safe materials in dental applications, mainly because of their good biomechanical characteristics. The aim of this study was to investigate the response to different loads by prosthetic frameworks for supported fixed partial dentures (FPDs), thus simulating osseointegrated implants. MATERIALS AND METHODS: The specimens were divided into two groups (n= 5 each). Group A: FDPs in zirconia-ceramic; Group B: FDPs in PEEK-composite. These 2 groups were subjected to vertical loads so to evaluate structural deformation; then, they have been analyzed by scanning electron microscopy (SEM) at different magnifications. RESULTS: In tested samples, different types of mechanical failures have been observed. In Zirconia-specimens, chipping is the main failure noticed in this study, mostly in distal margins of the structure. Also, peek-specimens show failure and fracture. CONCLUSIONS: Zirconia and PEEK could be considered both good materials, but several investigations are needed to use these materials as an alternative to metals for fixed partial dentures

Clinical outcomes of fully and partially threaded zygomatic implants in a cohort of patients with minimum 7.5-year follow-up

OBJECTIVE: The aim of this retrospective case series report was to evaluate the results of oral rehabilitation with extra-sinus zygomatic implant surgery with a minimum follow-up of 7.5 years. PATIENTS AND METHODS: A total of 35 patients with 87 zygomatic implants were included. The mean follow-up period of the patients was 93 months. The zygomatic implant survival and complications were evaluated as criteria for success. RESULTS: There were no implant failures. Overall success rate without complications for zygomatic implant was 88.5%. Complications developed in 4 patients (1 cutaneous fistula and 3 mucositis). According to the results on an implant basis, patients with previously failed conventional implants had greater probability of complications. Patients with quad zygomatic implants had higher incidence of complications than those with two zygomatic implants. Fully threaded implant design was associated with higher incidence of mucositis than partially threaded design. No relation was found between implant success and smoking, prosthesis type, and antagonist dentition. When conducting the analysis using the patient as unit, only the antagonist dentition showed significant difference, the worst outcome being associated with the Toronto resin prosthesis. CONCLUSIONS: Zygomatic implants can be considered as a safe alternative to conventional implant insertions and bone grafting procedures in oral rehabilitation of patients with severely atrophic maxillary bone

Oral rehabilitation of oncology patients with dental implants after reconstruction surgery with autogenous flaps

OBJECTIVE: Reconstruction after radical cancer surgery in terms of function and esthetics can be quite demanding. The aim of this study was to evaluate oral rehabilitation with autogenous flaps and dental implants for maxillofacial reconstruction in oncologic patients after implant insertions. MATERIALS AND METHODS: The study consisted of 19 patients diagnosed with either squamous cell carcinoma, fusocellular carcinoma, or mucoepidermoid carcinoma. The reconstruction of the maxillofacial defects was done with autogenous flaps (free fibular flap, antero-lateral thigh flap, radial forearm flap, or rotational pedicled temporal muscle flap). Implants were inserted on the average 32.03±19.51 months after reconstructive operations. A total of 82 implants were inserted. Mean follow-up after maxillo-facial surgery was 7.2 years (mean 86.56±22.04 months). Mean follow-up after implant insertions was 4.5 years (mean 54.6±21.82). Primary outcome was implant survival. Secondary outcome was evaluation of post-surgical complications. RESULTS: There were surgical revisions in seven patients after reconstructive surgery with flaps, mainly due to tumor relapse. Complications were seen in 11 patients. There was one implant failure. Overall implant survival rate was 98.8%. No relations were found between implant survival rate and gender, type of tumor, type of microvascular free flap, radiation therapy, chemotherapy, and prosthesis type. CONCLUSIONS: According to the results of this study, oral rehabilitation with dental implants inserted in free flaps for maxillofacial reconstruction after ablative oncologic surgery can be considered as a safe treatment modality with successful outcomes

In vitro comparative study on the mechanical behavior of Zirconia and Polyetheretherketone in applied dental sciences

OBJECTIVE: Recently, Zirconia and polyaryletherketone (PEEK) have attracted increasing interest as reliable and safe materials in dental applications, mainly because of their good biomechanical characteristics. The aim of this study was to investigate the response to different loads by prosthetic frameworks for supported fixed partial dentures (FPDs), thus simulating osseointegrated implants. MATERIALS AND METHODS: The specimens were divided into two groups (n= 5 each). Group A: FDPs in zirconia-ceramic; Group B: FDPs in PEEK-composite. These 2 groups were subjected to vertical loads so to evaluate structural deformation; then, they have been analyzed by scanning electron microscopy (SEM) at different magnifications. RESULTS: In tested samples, different types of mechanical failures have been observed. In Zirconia-specimens, chipping is the main failure noticed in this study, mostly in distal margins of the structure. Also, peek-specimens show failure and fracture. CONCLUSIONS: Zirconia and PEEK could be considered both good materials, but several investigations are needed to use these materials as an alternative to metals for fixed partial dentures