The regenerative dentistry: current approaches and future insights

Regenerative medicine typically aims to promote and improve the healing of tissues and organs of the human body, to restore the physiological architecture and the main functions lost.The combination of several scientific fields, including tissue engineering and cell biology, has led to the development of novel regenerative therapies that claim to obtain a better repairing, regenerating and replacing of tissues and organs damaged by chronic and acute diseases, or by severe traumatic injuries. In this landscape, the mesenchymal stem cells (MSCs) have been widely reported to self-regenerate and differentiate towards different tissues, under specific conditions and stimuli. Nowadays, MSCs are routinely used in autologous transplantation: the use of specific molecular effectors and biomimetic scaffolds populated with such MSCs has shown promising results both in vitro and in vivo experiments aimed to achieve a time-effective tissue reconstruction and a functional regeneration of complex organs

Stem Cells from Dental Sources:Translational Applications in Medicine and Novel Approaches

Recently, regenerative medicine has been attracting interest from scientific groups working on translational applications of applied medical sciences [...]

Tailored Brushing Method (TBM): an innovative simple protocol to improve the oral care

Background. The objective of this study is to describe and assess the effectiveness and acceptability of a modern tailored protocol of oral hygiene, based on the concordance between professionals and patients, and based on the proper choice of best tools for oral hygiene regardless of the technique used. This new method has been called Tailored Brushing Method (TBM). Material and methods. Two groups of adult patients (n=200) were involved in this research, according to specific inclusion criteria. Test group followed the indications of the new Tailored Brushing Method, while control group was involved in a standard protocol of oral hygiene with the suggestions of a brushing technique and the typical approach based on the compliance. Plaque Index, bleeding on Probing index and patients' acceptability of the methods (Visual Analog Scale) were assessed at different time points. Descriptive and statistical analyses were performed. Results and conclusions. Test group had statistically lower Plaque Index and Bleeding on Probing after 30 days, in comparison with control group. Test group expressed a better acceptance of the new tailored method. This research suggests to use a tailored approach to oral hygiene, overcoming the need of patient's compliance, often affected by bias such as alteration of the protocols and wrong brushing maneuvers

Retrospective analysis of the correlation between the facial biotype and the inclination of the upper canine cusp axis to the occlusal plane

Permanent maxillary canines are the second most frequently impacted teeth and the prevalence of this clinical condition is estimated to be 1-2% in the general population. The diagnosis of maxillary canine impaction should be based on both clinical and radiographic examinations. The aim of this study was to evaluate the presence of a correlation between the facial biotype and the inclination of the upper cusp axis. A correlation between the total radicular length of the lateral incisors was also evaluated, by comparing the side of impaction with the healthy side. Twenty three patients with a diagnosis of unilateral upper cusp impaction were recruited. For each patient, dental casts and radiographic material (panoramic radiographs and lateral cephalograms) were examined. Statistical analyses were done with Spearman's rank correlation coefficient or Spearman's rho (V). X-ray examinations demonstrated that canine impaction was associated to other dental anomalies (32% of the sample). The mean S angle measurements were 22.9° ± 4.1°, and mean values of the T angle were 34.7°± 4.0°. The mean distance “d” value was 14.6 mm ± 1.2 mm. The mean values of the angle between the upper cusp axis and the perpendicular-to-Fh plane were 20.8 °± 2.6°. Among the 23 subjects recruited, 5 showed values included in the range 25°-45° and 1 an inclination > 45°. The results obtained in the present study demonstrate a significant inverse correlation between the MM angle and the inclination of the upper cusp axis to the perpendicular-to-Fh plan

Cells isolated from human periapical cysts express mesenchymal stem cell-like properties

We provide a detailed description of mesenchymal stem cells (MSCs) isolated from human periapical cysts, which we have termed hPCy-MSCs. These cells have a fibroblast-like shape and adhere to tissue culture plastic surfaces. hPCy-MSCs possess high proliferative potential and self-renewal capacity properties. We characterised the immunophenotype of hPCy-MSCs (CD73+, CD90+, CD105+, CD13+, CD29+, CD44+, CD45-, STRO-1+, CD146+) by flow cytometry and immunofluorescence. hPCy-MSCs possess the potential to differentiate into osteoblast- and adipocyte-like cells in vitro. Multi-potentiality was evaluated with culture-specific staining and quantitative reverse transcription-polymerase chain reaction (qRT-PCR) analysis for osteo/odontogenic and adipogenic markers. This is the first report to indicate that human periapical cysts contain cells with MSC-like properties. Taken together, our findings indicate that human periapical cysts could be a rich source of MSCs. © Ivyspring International Publisher

Potential use of human periapical cyst-mesenchymal stem cells (hPCy-MSCs) as a novel stem cell source for regenerative medicine applications

Mesenchymal stem cells (MSCs) are attracting growing interest by the scientific community due to their huge regenerative potential. Thus, the plasticity of MSCs strongly suggests the utilization of these cells for regenerative medicine applications. The main issue about the clinical use of MSCs is related to the complex way to obtain them from healthy tissues; this topic has encouraged scientists to search for novel and more advantageous sources of these cells in easily accessible tissues. The oral cavity hosts several cell populations expressing mesenchymal stem cell like-features, furthermore, the access to oral and dental tissues is simple and isolation of cells is very efficient. Thus, oral-derived stem cells are highly attractive for clinical purposes. In this context, human periapical cyst mesenchymal stem cells (hPCy-MSCs) exhibit characteristics similar to other dental-derived MSCs, including their extensive proliferative potential, cell surface marker profile and the ability to differentiate into various cell types such as osteoblasts, adipocytes and neurons. Importantly, hPCy-MSCs are easily collected from the surgically removed periapical cysts; this reusing of biological waste guarantees a smart source of stem cells without any impact on the surrounding healthy tissues. In this review, we report the most interesting research topics related to hPCy-MSCs with a newsworthy discussion about the future insights. This newly discovered cell population exhibits interesting and valuable potentialities that could be of high impact in the future regenerative medicine applications

Highly Efficient in Vitro Reparative Behaviour of Dental Pulp Stem Cells Cultured with Standardised Platelet Lysate Supplementation

Dental pulp is an accessible source of multipotent mesenchymal stromal cells (MSCs). The perspective role of dental pulp stem cells (DPSCs) in regenerative medicine demands an in vitro expansion and in vivo delivery which must deal with the safety issues about animal serum, usually required in cell culture practice. Human platelet lysate (PL) contains autologous growth factors and has been considered as valuable alternative to fetal bovine serum (FBS) in cell cultures. The optimum concentration to be added of such supplement is highly dependent on its preparation whose variability limits comparability of results. By in vitro experiments, we aimed to evaluate a standardised formulation of pooled PL. A low selected concentration of PL (1%) was able to support the growth and maintain the viability of the DPSCs. The use of PL in cell cultures did not impair cell surface signature typically expressed by MSCs and even upregulated the transcription of Sox2. Interestingly, DPSCs cultured in presence of PL exhibited a higher healing rate after injury and are less susceptible to toxicity mediated by exogenous H2O2 than those cultured with FBS. Moreover, PL addition was shown as a suitable option for protocols promoting osteogenic and chondrogenic differentiation of DPSCs. Taken together, our results indicated that PL is a valid substitute of FBS to culture and differentiate DPSCs for clinical-grade use