Platelet rich fibrin as a gingival tissue regeneration enhancer.

Tissue regenerative procedures aim to enhance regeneration of altered tissue. Extensive research has been carried out in this area and all proposed procedures present limitations. In this context the area of platelet-rich fibrin (PRF) research has gained tremendous awareness in the latest years. PRF is a low-cost regenerative modality that facilitates soft tissue regeneration derived from 100% autologous sources. It forms a fibrin mesh that liberates growth factors in a slow and prolonged manner and also contains supra-physiological concentrations of leukocytes. Reports from the literature have suggested that these leukocyte-rich blood-preparations are capable of improving wound healing, diminishing post-operative pain, and additionally minimizing the risk of infection. In our article we present the first clinical case where PRF was used as a wound healing accelerator of gingival lesions in a chemical soft tissue burn after teeth whitening

Clinical features and management of oral lichen planus (OLP) with emphasis on the management of hepatitis C virus (HCV)-related OLP

Oral lichen planus (OLP) is a chronic inflammatory disease characterized by the occurrence of multiple, symmetrical lesions in the oral cavity. Hepatitis C virus (HCV) infection has been suggested as an etiological factor in OLP. The purpose of this review was to summarize the current literature regarding the treatment of OLP in patients with HCV infection. An electronic search of the PubMed database was conducted until January 2018, using the following keywords: OLP, HCV, corticosteroids, retinoids, immunomodulatory agents, surgical interventions, photochemotherapy, laser therapy, interferon, ribavirin, and direct-acting antivirals. We selected the articles focusing on the clinical features and treatment management of OLP in patients with/without HCV infection. Topical corticosteroids are considered the first-line treatment in OLP. Calcineurin inhibitors or retinoids can be beneficial for recalcitrant OLP lesions. Systemic therapy should be used in the case of extensive and refractory lesions that involve extraoral sites. Surgical intervention is recommended for isolated lesions. In patients with HCV, monotherapy with interferon (IFN)-α may either improve, aggravate or trigger OLP lesions, while combined IFN-α and ribavirin therapy does not significantly influence the progression of lesions. Direct-acting antiviral (DAA) therapy appears to be a promising approach in patients with HCV-related OLP, as it can improve symptoms of both liver disease and OLP, with fewer side effects. Nevertheless, for clinical utility of DAAs in OLP patients, further studies with larger sample sizes, adequate treatment duration, and long term follow-up are required

The Presence of Periodontitis in Patients with Von Willebrand Disease: A Systematic Review

The aim of this systematic review and meta-analysis was to analyze the available evidence on the assessment of periodontal disease in patients with von Willebrand disease (VWD). An electronic search in three databases (PubMed, Web of Science, and Scopus) was conducted by three independent reviewers to identify cross-sectional, cohort, and clinical trial studies. Studies considered eligible for this review were evaluated according to the quality and risk assessment tool proposed by the CLARITY Group at McMaster University. In order to analyze the possible correlation of VWD patients and periodontitis and their susceptibility to bleeding during the periodontal screening phase, periodontal parameters evaluated were probing pocket depth (PPD), bleeding on probing (BOP), gingival bleeding index (GBI), and periodontal inflamed surface area (PISA). After a screening of 562 articles, three articles were selected for the qualitative analysis. Within the limitation of our review, VWD patients are not more susceptible to periodontitis as compared with non-VWD patients. Nevertheless, bleeding on probing and gingival index needs to be carefully taken into consideration during periodontal screening of VWD due to the possible presence of false positives

The Applicability of Nanostructured Materials in Regenerating Soft and Bone Tissue in the Oral Cavity—A Review

Background and Objectives: Two of the most exciting new technologies are biotechnology and nanotechnology. The science of nanostructures, or nanotechnology, is concerned with the development, testing, and use of structures and molecules with nanoscale dimensions ranging from 1 to 100 nm. The development of materials and tools with high specificity that interact directly at the subcellular level is what makes nanotechnology valuable in the medical sciences. At the cellular or tissue level, this might be converted into focused clinical applications with the greatest possible therapeutic benefits and the fewest possible side effects. The purpose of the present study was to review the literature and explore the applicability of the nanostructured materials in the process of the regeneration of the soft and hard tissues of the oral cavity. Materials and Methods: An electronic search of articles was conducted in several databases, such as PubMed, Embase, and Web of Science, to conduct this study, and the 183 articles that were discovered were chosen and examined, and only 22 articles met the inclusion criteria in this review. Results: The findings of this study demonstrate that using nanoparticles can improve the mechanical properties, biocompatibility, and osteoinductivity of biomaterials. Conclusions: Most recently, breakthroughs in tissue engineering and nanotechnology have led to significant advancements in the design and production of bone graft substitutes and hold tremendous promise for the treatment of bone abnormalities. The creation of intelligent nanostructured materials is essential for various applications and therapies, as it allows for the precise and long-term delivery of medication, which yields better results

Romanian Dentists’ Perception of Legal Liability Related to COVID-19 Infection during Dental Treatments in Times of the Pandemic Outbreak

Our study aimed to describe and assess the impact of legal aspects on dentists’ practices during the COVID-19 pandemic. The objectives were: (a) to explore dentists’ and dental managers’ knowledge about dental liability during the COVID-19 pandemic; (b) to inquire about the respondents’ perceptions of immunity for prejudices resulting from non-urgent dental procedures during the COVID-19 pandemic; and (c) to assess respondents’ “good faith” in handling challenges in the pandemic context. We conducted an observational, cross-sectional, exploratory study based on a survey. The target population was represented by active dentists in Romania from 11 March 2020 to 31 January 2022. An email, professional groups on WhatsApp, and Facebook invitation to participate were sent at the end of January 2022. Data were collected using a self-administrated electronic questionnaire. The responses of sixty-one participants, the majority younger than 41 years (82%) and women (77%), were analyzed. Most respondents (72%) appropriately thought that patients could complain about being infected with COVID-19 during their visits for dental treatment. Most respondents agreed that all dental personnel should benefit from legal immunity (72%). The respondents indicated that clinic or office management is responsible for failing to implement/respect the safety measures and protocols specific to the COVID-19 pandemic (83%). Outcomes showed that the respondents are aware of the possibility of being sued and would not be surprised to see COVID-19 raised in litigation, while the state’s immunity is expected for all dental care personnel, not only dentists

Comparative assessment of bone regeneration by histometry and a histological scoring system / Evaluarea comparativă a regenerării osoase utilizând histometria și un scor de vindecare histologică

Obiective: Scopul studiului de față a constat în evaluarea valorii scorului de vindecare histologică, comparativ cu histometria în monitorizarea vindecării osose la nivelul calotei. Material și metodă: Am realizat un studiu cazcontrol cu un lot control și unul de studiu. La un număr de 60 de șoareci CD1 incluși în lotul de studiu am indus chirurgical un defect osos la nivelul calotei și am realizat reconstrucția defectului utilizând grefe obținute prin inginerie tisulară. Ingineria tisulară a grefonului osos s-a realizat utilizând celule stem embrionare poziționate pe suport matriceal -corn caduc de cerb, iar ca inductor al diferențierii am utilizat mediu osteogenetic bazal și complex. La cei 30 de șoareci CD1 incluși în lotul control am indus chirurgical același defect osos la nivelul calotei, dar nu am realizat reconstrucția osoasă a acestuia. Procesul de regenerare osoasă a fost evaluat la 2 și respectiv la 4 luni utilizând scorul de vindecare și histometria. Rezultate: Scorul de vindecare histologică s-a corelat statistic semnificativ cu dimeniunea defectului obtinută la histometrie (p<0.001). Evaluarea parametrilor în baza cărora s-a stabilit scorul de vindecare histologică indică regenerarea cea mai avansată la subiecții din lotul de studiu sacrificați la 4 luni, la care s-a utilizat pentru ingineria grefonului osos celule stem embrionare, suport matriceal corn caduc de cerb și mediu osteogenetic complex ca inductor. Concluzii: scorul de vindecare histologică este o metoda valoroasă de cuantificare a procesului de regenerare osoasă. Relevanță clinică: Acest studiu demonstrează că scorul de vindecare histologică prezentat este un instrument util pentru clinician în procesul de evaluare a regenerării osoase

Atelo-collagen type I bovine bone substitute and membrane in guided bone regeneration: a series of clinical cases and histopathological assessments

Absorbable atelo-collagen type 1 represents a new approach for guided bone regeneration with several reported advantages such as: osteoblast attachment, proliferation, mineralization potential, absorption of growth factors and inhibition of bacterial pathogen colonization. The aim of this study was to assess the clinical, radiological (preoperative width, re-entry width, gain), Periotest measurements and histologic benefits of atelo-collagen-derived bovine bone grafts (ImploBone) in combination with an atelo-collagen type I barrier membrane (ImploSorb) for guided bone regeneration (GBR) of atrophic alveolar crest in thirteen patients. Eleven patients underwent simultaneous GBR with implant insertion, two had initial GBR procedure followed by implant placement after 6 months of healing. Ridge augmentation was performed using an atelo-collagen membrane (ImploSorb, Bioimplon, Germany) and a combination of 50% ABBM (ImploBone, granule size 0.5-1mm, BioImplon Germany) mixed with 50% autologous bone. It was found that simultaneous GBR with implant placement resulted in a 35% gain at bone defect level (preoperative width 5.03±1.25 mm, re-entry width 6.81±0.98 mm, gain 1.78±1.71 mm). Implant placement performed in a 2 stage surgery 6 months following GBR was linked with a 63.9% gain at bone defect level (preoperative width 3.79±1.10 mm, re-entry width 6.22±1.41 mm, gain 2.43±1.43 mm). The total gain in both groups was 41.9% utilizing these novel biomaterials (preoperative width 4.68±1.32 mm, re-entry width 6.65±1.12 mm, gain 1.96±1.64 mm). This case series study presents a protocol where GBR can be performed either simultaneously to implant placement or delayed with this innovative biomaterial to favor bone regrowth. Future randomized controlled clinical trials are needed to further validate the bonepromoting potential of atelo-collagen-based biomaterials for bone regeneration

The World of Oral Cancer and Its Risk Factors Viewed from the Aspect of MicroRNA Expression Patterns

Oral cancer is one of the leading causes of death worldwide, with a reported 5-year survival rate of around 50% after treatment. Epigenetic modifications are considered to have a key role in oral carcinogenesis due to histone modifications, aberrant DNA methylation, and altered expression of miRNAs. MicroRNAs (miRNAs) are small non-coding RNAs that have a key role in cancer development by regulating signaling pathways involved in carcinogenesis. MiRNA deregulation identified in oral cancer has led to the idea of using them as potential biomarkers for early diagnosis, prognosis, and the development of novel therapeutic strategies. In recent years, a key role has been observed for risk factors in preventing and treating this malignancy. The purpose of this review is to summarize the recent knowledge about the altered mechanisms of oral cancer due to risk factors and the role of miRNAs in these mechanisms