Guided Bone Regeneration with Occlusive Titanium Barrier: A Case Report and Clinical Considerations.

The need to obtain adequate bone volumes for prosthetic rehabilitation supported by implants, using different techniques and materials, represents an urgent need in modern dentistry. We report a case regarding the management of implant-prosthetic rehabilitation of the first and second upper right molars, in which no less than 4 mm of crestal bone remained to insert two implants. Regeneration of the residual bone was previously performed using a customized titanium barrier and a filler of a blood clot with tricalcium beta phosphate. The bone gain (3 mm) was evaluated by comparing CBCT images, while the implant stability (mean 70) was assessed with the ISQ measurement. A regenerated bone sample was taken for histological analysis. Guided bone regeneration obtained with a titanium barrier and blood clot allowed for the insertion of stable implants in a mature bone without heterologous material

Candida-associated denture stomatitis

Candida albicans is a dimorphic yeast strongly gram positive able to live as normal commensal organism in the oral cavity of healthy people. It is the yeast more frequently isolated in the oral cavity. Under local and systemic factors related to the host conditions, it becomes virulent and responsible of oral diseases known as oral candidiasis. It has been shown that the presence of denture is a predisposing factor to the onset of pathologies related to C. albicans. Clinical studies have shown that C. albicans is not only able to adhere to the mucous surfaces, but also to stick to the acrylic resins of the dental prostheses. Both the plaque accumulated on the denture and the poor oral hygiene contribute to the virulence of Candida, offering the clinical picture of Candida-associated denture stomatitis. The therapeutic strategies currently adopted in the clinical practice to overcome these fungal infections provide for the use of topical and/or systemic antifungal and topical antiseptics and disinfectants, the irradiation with microwaves and the accurate mechanical removal of the bacterial plaque from the denture surfaces and from the underlying mucosa. A correct oral hygiene is important for the control of the bacterial biofilm present on the denture and on the oral mucosa and it is the fundamental base for the prophylaxis and the therapy of the Candidaassociated denture stomatitis

Guided Bone Regeneration with Occlusive Titanium Barrier: A Case Report and Clinical Considerations

The need to obtain adequate bone volumes for prosthetic rehabilitation supported by implants, using different techniques and materials, represents an urgent need in modern dentistry. We report a case regarding the management of implant-prosthetic rehabilitation of the first and second upper right molars, in which no less than 4 mm of crestal bone remained to insert two implants. Regeneration of the residual bone was previously performed using a customized titanium barrier and a filler of a blood clot with tricalcium beta phosphate. The bone gain (3 mm) was evaluated by comparing CBCT images, while the implant stability (mean 70) was assessed with the ISQ measurement. A regenerated bone sample was taken for histological analysis. Guided bone regeneration obtained with a titanium barrier and blood clot allowed for the insertion of stable implants in a mature bone without heterologous material

Dental fragment embedded in the lower lip after facial trauma: brief review literature and report of a case

Upper incisors are the most frequently involved teeth in traumatic dental injuries. Soft tissues (lips and/or oral mucosa) adjacent to incisal edge can receive direct and/or indirect traumas. Laceration of the lower lip is a not rare eventuality and teeth fragments could be embedded in labial soft tissue. The reattachment of these fragments, if possible, is the elective treatment choice, thanks to the modern adhesive and restorative techniques. The authors present a case of a white Caucasian 10‑year‑old child, who attended the dental clinic for the treatment of both upper central incisors’ crown fractures. The fragment of the left incisor was retrieved embedded in the lower lip. It was successfully surgically removed and reattached using a composite adhesive technique. A careful clinical and radiographic examination with the surgical removal of tooth fragments could prevent undesirable foreign body reaction, infection and scarring. The authors also reviewed the most relevant literature concerning tooth fragment reattachment after removal from oral soft tissues

Blood Clotting Dissolution in the Presence of a Magnetic Field and Preliminary Study with MG63 Osteoblast-like Cells—Further Developments for Guided Bone Regeneration?

Background: The influence of a magnetic field on the activation of bone cells and remodelling of alveolar bone is known to incite bone regeneration. Guided Bone Regeneration (GBR) aims to develop biomimetic scaffolds to allow for the functioning of the barrier and the precise succession of wound healing steps, including haemostasis. The effect of a magnetic field on blood clot dissolution has not been studied yet. Methods: We conducted a methodological study on the clot stability in the presence of a static magnetic field (SMF). Preformed whole blood (WB) clots were treated with either a broad proteolytic enzyme (trypsin) or a specific fibrinolytic agent, i.e., tissue-type plasminogen activator (t-PA). MG63 osteoblast-like cells were added to preformed WB clots to assess cell proliferation. Results: After having experienced a number of clotting and dissolution protocols, we obtained clot stability exerted by SMF when tissue factor (for clotting) and t-PA + plasminogen (for fibrinolysis) were used. WB clots allowed osteoblast-like cells to survive and proliferate, however no obvious effects of the magnetic field were noted. Conclusions: Paramagnetic properties of erythrocytes may have influenced the reduction in clot dissolution. Future studies are warranted to fully exploit the combination of magnetic forces, WB clot and cells in GBR applied to orthodontics and prosthodontics

Effect of Mother’s Age and Pathology on Functional Behavior of Amniotic Mesenchymal Stromal Cells—Hints for Bone Regeneration

Human amnion-derived mesenchymal stromal cells (hAMSCs) are used increasingly in regenerative medicine applications, including dentistry. The aim of this study was to evaluate if hAMSCs from aged and pathological mothers could be affected in their phenotype and functional behavior. hAMSCs were isolated from placentas of women aged younger than 40 years (Group 1, n = 7), older than 40 years (Group 2, n = 6), and with pre-eclampsia (Group 3, n = 5). Cell yield and viability were assessed at isolation (p0). Cell proliferation was evaluated from p0 to p5. Passage 2 was used to determine the phenotype, the differentiation capacity, and the adhesion to machined and sandblasted titanium disks. hAMSCs recovered from Group 3 were fewer than in Group 1. Viability and doubling time were not different among the three groups. Percentages of CD29+ cells were significantly lower in Group 3, while percentages of CD73+ cells were significantly lower in Groups 2 and 3 as compared with Group 1. hAMSCs from Group 2 showed a significant lower differentiation capacity towards chondrogenic and osteogenic lineages. hAMSCs from Group 3 adhered less to titanium surfaces. In conclusion, pathology can affect hAMSCs in phenotype and functional behavior and may alter bone regeneration capacities

Adhesion and growth of osteoblast-like cells on laserengineered porous titanium surface. Expression and localization of N-cadherin and β-catenin

Introduction. Response of different types of cells on biomaterials is crucial for the applications of tissue engineering and regenerative medicine. It is recognized that cell behaviours depend largely by material surface characteristics. Objectives. The purpose of this study was to define the biologic response of MG63 cells to an innovative patented surface SYNTHEGRA®. Material and Methods. The MG63 morphology and distribution on the three different titanium disks surface were evaluated by microscopy analysis after staining with hematoxylin and eosin. Cell adhesion was determined by crystal violet assay at 48 hours while proliferation and cytotoxicity were performed by MTT assay at 24, 48, 72 and 240 hours. The expression and localization of N-cadherin and b-catenin were studied by immunofluorescence and confocal microscopy. Results. At 48 h the adhesion was similar in all titanium surfaces, no cytotoxic difference in cell viability were observed in all titanium disks when compared with controls, while the cell growth on p30 disks was significantly higher at 240 h than at 72 and 24 h. Morphological analysis show that cells are aligned along the grooves and inside the cavities. b-catenin appeared more diffuse and localized underneath the cell membrane, while N-cadherin signal was fainter in cells grown onto SYNTHEGRA® surface. Conclusion. This work put in evidence the performance of newly designed laser-micromachined surface for adhesion, growth and distribution of human osteoblast- like cells. SYNTHEGRA® surface inducing modification of N-cadherin and b-catenin expression and localization, which are suggestive of cells undergoing differentiation towards osteocytes, could be particularly suited for immediate load implant procedures

Adhesion and growth of osteoblast-like cells on laserengineered porous titanium surface. Expression and localization of N-cadherin and β-catenin

Introduction. Response of different types of cells on biomaterials is crucial for the applications of tissue engineering and regenerative medicine. It is recognized that cell behaviours depend largely by material surface characteristics. Objectives. The purpose of this study was to define the biologic response of MG63 cells to an innovative patented surface SYNTHEGRA®. Material and Methods. The MG63 morphology and distribution on the three different titanium disks surface were evaluated by microscopy analysis after staining with hematoxylin and eosin. Cell adhesion was determined by crystal violet assay at 48 hours while proliferation and cytotoxicity were performed by MTT assay at 24, 48, 72 and 240 hours. The expression and localization of N-cadherin and b-catenin were studied by immunofluorescence and confocal microscopy. Results. At 48 h the adhesion was similar in all titanium surfaces, no cytotoxic difference in cell viability were observed in all titanium disks when compared with controls, while the cell growth on p30 disks was significantly higher at 240 h than at 72 and 24 h. Morphological analysis show that cells are aligned along the grooves and inside the cavities. b-catenin appeared more diffuse and localized underneath the cell membrane, while N-cadherin signal was fainter in cells grown onto SYNTHEGRA® surface. Conclusion. This work put in evidence the performance of newly designed laser-micromachined surface for adhesion, growth and distribution of human osteoblast- like cells. SYNTHEGRA® surface inducing modification of N-cadherin and b-catenin expression and localization, which are suggestive of cells undergoing differentiation towards osteocytes, could be particularly suited for immediate load implant procedures