Induced pluripotent stem cells in periodontal reconstructive therapy: A narrative review of pre-clinical studies

Background: Regenerative periodontal surgical therapy faces significant challenges due to the limited ability of the body to regenerate damaged periodontal tissue. One of the primary goals in regenerative periodontal therapy is regaining periodontal tissue attachment after destruction by periodontal disease. Currently, stem cells, harnessing three pivotal components—cells, biomaterials, and growth factors—are widely used in periodontal regeneration. Stem cells can be obtained from various sources, either by isolating cells from bone marrow, teeth, and muscles or through the somatic cell programming method (reprogramming) known as induced pluripotent stem cells (iPSCs). Purpose: This review aims to describe the potential use of iPSCs in the treatment of periodontal defects. Review: Search strategies were developed using the PubMed, LILACS, Scielo, and Wiley online databases during the period of 2012–2022. Ten articles met the inclusion criteria. iPSCs were obtained by inducing somatic cells from both dental and non-dental sources with factors Oct3/4, Sox2, Klf4, and c-Myc. Periodontal tissue regeneration procedures can be augmented with iPSCs. Unlike tooth-based stem cells, iPSCs offer several advantages, such as unlimited cell sources and the capability to differentiate into any cell type, including periodontal tissue. The potential of iPSCs extends to correcting periodontal bone defects and forming new periodontal tissues, such as alveolar bone, cementum, and periodontal ligament. However, iPSCs do have limitations, including the need for clinical trials, cell programming production facilities, and optimization of differentiated-cell functionality. Conclusion: The combined use of iPSCs in cell-based tissue engineering holds vast potential for future periodontal treatment strategies

Clinical resolution of periodontitis among diabetic patients with chronic periodontitis co-morbidity under medical-dental coordinated care: a preliminary study in Kuantan

Clinical resolution of periodontitis (CRP) of type-2 diabetic patients with chronic periodontitis (T2DM-PD) after receiving non-surgical periodontal treatment (NSPT) has been reported in the previous studies. This study aimed to evaluate CRP of T2DM-PD under medicaldental coordinated care (M-DCC). Materials and Methods: A 6-months follow-up quasi-experimental study was conducted among 20 subjects who received M-DCC in 2016. M-DCC included standard diabetic care provided by medical professional from 3 health clinics and NSPT provided by periodontal specialists from two periodontal specialist clinics. Target glycemic control achievement (TGCA) HbA1c 6.5% was assessed at baseline and 6 months after NSPT. Clinical resolution of PD was measured in terms of BPE, BOP %, CAL(mm), PPD(mm), PPD 4mm, PPD =4 mm and PPD 6mm at baseline, 3 and 6 months. Paired simple t test and ANOVA F test were applied to infer clinical resolution of periodontitis and its relation to TGCA. Results: Mean (SD) of average BPE at baseline, 3- and 6-months were 3.52(0.34), 3.12(0.33) and 3(0.45) with (p<0.05); average PPD(mm) were 3.33(0.5), 3.23(0.75) and 2.73(0.57) with (p<0.05); PPD(%) 4mm were 71.03(12.33), 82.77(9.9) and 85.85 (8.9) with (p<0.05); PPD(%) =4 mm were 27.94(11.9), 16.97(10.01) and 13.71(9.1) with (p<0.05) ; PPD(%) 6mm were 8.04(4.32), 2.66(2.3) and 1.87(2.32) with (p<0.05). Significant resolution of BPE, CAL(mm) and PPD(mm) was noticed among two subjects who has changed from uncontrolled TGCA to controlled TGCA. Conclusion(s): CRP and TGCA results have verified the effectiveness of M-DCC. A further clinical control trial with adequate sample size needs to confirm the results of the present study

The expression of BMP4 and FGF2 in Wistar rats (Rattus norvegicus) post application of gourami fish (Osphronemus goramy) collagen

Background: Periodontitis is a chronic inflammatory disease of the periodontal tissue that is characterized by alveolar bone resorption. This occurs due to an imbalance of osteoblast and osteoclast during the bone formation and resorption processes. In order to obtain complete regeneration of periodontal tissue, bone grafting is frequently used in periodontal surgical therapy. Although each material has disadvantages, safe graft materials derived from animal sources can be employed as an alternative to bone graft materials. Osteoblast, osteoclast, calcified bone matrix, type I collagen, osteonectin, and hydroxyapatite can all be found in gourami scales, a form of food waste. BMP4 has osteoinduction functions, which are important in bone metabolism. Through angiogenic activity, FGF2 also contributes to periodontal regeneration. Purpose: The aim of the study was to assess the expression of BMP4 and FGF2 after the treatment group had been given gourami fish scale extract. Methods: Thirty-two experimental three-month-old male Wistar rats (150-200g) were randomly divided into four groups: a seven-day control group, a seven-day treatment group, a 14-day control group, and a 14-day treatment group. One mandibular incisor was extracted from each Wistar rat. The post-extraction socket was filled with blood for the control group and collagen extract for the treatment. Results: The one-way ANOVA test showed a significance level of 0.000 (p = <0.05). Conclusion: The expression of BMP4 and FGF2 increased after the application of collagen extract from gourami scales

Complex impedance analyses of n-BaTiO3 ceramics showing positive temperature coefficient of resistance

The influence was studied of grain boundary layer modifiers on the impedance spectra of semiconducting BaTiO3 ceramics processed in various atmospheres. Ceramic samples of undoped BaTiO3 annealed in an N-2 + H-2 atmosphere showed a single semicircle in the Cole-Cole plot when ohmic Ni electrodes were used. Impedance spectra of donor-doped specimens sintered in air showed overlapping semicircles which may indicate relaxational processes within the grains, e.g. electron trapping and detrapping at the deep traps. This is strongly supported by the minima shown by the grain resistance (R(g)) around the Curie point (T-c), whereas the behaviour of the grain boundary resistance (R(gb)) with temperature is similar to the d.c. resistance, i.e. a positive temperature coefficient of resistance (PTCR). Electron paramagnetic resonance (EPR) results indicate that the charge trapping is caused by the redistribution of electrons at native and extrinsic acceptor states during phase transitions. Thus, the neutral barium vacancies (V-Ba(X)) present in the tetragonal and orthorhombic phases change into singly ionized barium vacancies (V-Ba') in the cubic and rhombohedral phases. From the correlation between the resistivity changes and the charge redistribution at the trap states, it is envisaged that the PTCR effect is related to charge trapping at the acceptor states having higher concentration in the regions of the grain boundary layer. The impedance spectral data support this conclusion

Application of bioelectric effect to reduce the antibiotic resistance of subgingival plaque biofilm: An in vitro study

Context: Biofilms are known for their antimicrobial resistance, and so is the subgingival plaque biofilm, the primary etiologic factor for periodontal infections. Aims: The objective of this study is to investigate if the subgingival plaque biofilm resistance can be reduced using doxycycline in the presence of low-intensity electric field (bioelectric effect). Settings and Design: The study was an in vitro microbiological study. Materials and Methods: Subgingival plaque samples from chronic periodontitis patients were collected to grow subgingival plaque biofilms on hydroxyapatite disks. Hydroxyapatite disks with the plaque biofilms from each patient were divided into four groups: (i) No intervention – control, (ii) current alone – CU; (iii) doxycycline – AB, and (iv) combined treatment – CU + AB. After respective treatments, the disks were anaerobically incubated for 48 h, the biofilm was dispersed and subcultured and colony-forming unit/mL was estimated in all the four groups. Statistical Analysis: Statistical analysis was done using Mann–Whitney and Kruskal–Wallis tests for intergroup comparisons. T-test was done to assess the difference in current flow between the groups CU and CU + AB. Results: All the three treatment modalities showed antibacterial effect. Application of current alone resulted in reduced bacterial growth than control group. Doxycycline alone resulted in reduction in bacterial counts better than control and current alone groups. The combination treatment showed greatest inhibition of bacterial colonies. Conclusion: The ability of doxycycline antibiotic in inhibiting plaque biofilm was significantly enhanced by application of a weak electric field (5 volts for 2 min)

Color Stability of a New Rice Husk Composite in Comparison with Conventional Composites after Exposure to Commonly Consumed Beverages in Malaysia

Objective. To evaluate the color stability of a new organic rice husk nanocomposite as compared to four conventional composites after exposure to commonly consumed beverages in Malaysia. Methods. One hundred and twenty-five disk samples were prepared from a new rice husk-based composite and four other conventional methacrylate-based light-cured composites of shade A2. The samples were immersed in four commonly consumed beverages: coco-based drink, kopi, Chinese tea, and teh tarik for four weeks. The color measurements were carried out every week using the reflectance spectrophotometer according to the CIE L∗a∗b∗ color system. Color changes of samples (ΔE) in each week were calculated. Statistical analysis was carried out by performing a mixed ANOVA and Tukey’s post hoc test in order to analyse the differences in ΔE. Results. The findings revealed a statistically significant difference of ΔE reading (p<0.05) among all composites immersed in all four beverages after four weeks. Rice husk composites exhibited lesser color stability as compared to Ceram.X One Universal (p<0.001) and G-aenial Universal Flo (p<0.001) but showed higher color stability compared to Solare-X (p<0.001) and Neofil (p<0.001). Coffee and Chinese tea had the most significant impact on color changes (p<0.05) observed in all composites over four weeks of study. Conclusion. Rice husk composite showed acceptable color stability. It can be considered as an alternative to conventional composites due to its eco-friendly properties

Airway vascular reactivity and vascularisation in human chronic airway disease

Altered bronchial vascular reactivity and remodelling including angiogenesis are documented features of asthma and other chronic inflammatory airway diseases. Expansion of the bronchial vasculature under these conditions involves both functional (vasodilation, hyperperfusion, increased microvascular permeability, oedema formation, and inflammatory cell recruitment) and structural changes (tissue and vascular remodelling) in the airways. These changes in airway vascular reactivity and vascularisation have significant pathophysiological consequences, which are manifest in the clinical symptoms of airway disease. Airway vascular reactivity is regulated by a wide variety of neurotransmitters and inflammatory mediators. Similarly, multiple growth factors are implicated in airway angiogenesis, with vascular endothelial growth factor amongst the most important. Increasing attention is focused on the complex interplay between angiogenic growth factors, airway smooth muscle and the various collagen-derived fragments that exhibit anti-angiogenic properties. The balance of these dynamic influences in airway neovascularisation processes and their therapeutic implications is just beginning to be elucidated. In this review article, we provide an account of recent developments in the areas of vascular reactivity and airway angiogenesis in chronic airway diseases

Effectiveness of non-surgical periodontal therapy on glycemic control of Type 2 diabetic patients with periodontitis in public primary care clinics, Kuantan, Pahang

Introduction : Diabetes mellitus (DM) patients who achieved treatment target HbA1c ≤ 6.5% was 17.4% in Malaysia1,2. Prevalence of DM patients with periodontitis co-morbidity (DM-P) in Malaysia was 53.3%3. Effectiveness of non-surgical periodontal therapy (NSPT) on glycemic control of DM-P patients has been reported in previous studies4,5,6 Objective : To evaluate the effectiveness of NSPT on achieving target HbA1c ≤ 6.5% in type-2DM patients with periodontitis (T2DM-P) from public primary care clinic

Clinical resolution of periodontitis among diabetic patients under medical-dental coordinated care: a preliminary study in Kuantan

The literature had reported the clinical resolution of periodontitis (CRP) in type-2 diabetic patients (T2DM-P) following non-surgical periodontal treatment (NSPT). However, the changes in glycemic control status during NSPT have not been presented clearly. Hence, this study was aimed to evaluate the CRP of T2DM-P under medical- and dental-coordinated care (M-DCC). A 6-month follow-up quasi-experimental study was conducted on 20 T2DM-P patients who underwent M-DCC in Kuantan. M-DCC, which included the standard diabetic care was administered by medical professionals at three health clinics, while NSPT by two periodontal specialists at their respective clinics. The target glycemic control achievement (TGCA), HbA1c ≤ 6.5% – was assessed at 0 and 6 months post-NSPT. Clinical resolution of PD was measured in terms of the following parameters: (1) full mouth bleeding score (FMBS); (2) clinical attachment level (CAL) (mm); (3) probing pocket depth (PPD) (mm); as well as (4) PPDs of 0.05). NSPT, under M-DCC, gave rise to significant changes in the periodontal health of diabetic patients 6 months post-treatment. The effects of NSPT on HbA1c level were inconclusive. (WC:251)