ABSTRACT
Medical diciplines have been gradually differentiated and specialized during its developement, and problems due to deep specialization have been increasingly apparent. Its performance is as follows: dental specialists tends to focus on a certain narrow area and ignore neither the patients as a whole existence nor the role of the environmental factors. In this article, the author tries to show the holistic integrative medicine (HIM) from the point of view of periodontal specialty. In fact, the pathogenesis, the differential diagnosis and the treatment of periodontal diseases along with the role of preventive dentistry and basic medicine for periodontology must be considered as a whole using the philosophy of HIM. The future development of periodontal specialty should absorb the achievements of other medical and dental diciplines. Periodontist should pay more attention to HIM. The author also gives some thoughts and suggestions on how to practice HIM in the field of periodontics.
ABSTRACT
Objective:To compare the proliferative and periodontal specific differentiation abilities of induced pluripotent stem cells (iPSCs) at different passages,and to investigate whether long term culturing would have a negative influence on their proliferation and specific differentiation capacity,thus providing a theoretical basis for further in-depth research on periodontal regeneration and the possible clinical applications of iPSCs.Methods:IPSCs derived from human gingival fibroblasts at passages 5,10,15 and 20 were recovered and cultured in vitro.Their morphology and proliferation rates were observed respectively.We further induced the iPSCs at different passages toward periodontal tissue under the treatment of growth/differentiation factor-5 (GDF-5) for 14 days through the EB routine,then compared the periodontal differentiation propensities between the different passages of iPSCs by detecting their calcified nodules formation by Alizarin red staining and assaying their relative periodontal tissue related marker expressions by qRT-PCR and immunofluorescence staining,including bone related markers:osteocalcin (OCN),bone sialoprotein (BSP);periodontal ligament related markers:periostin,vimentin;and cementum related markers:cementum attachment protein (CAP),cementum protein 1 (CEMP1).The untreated spontaneous differentiation groups were set as negative controls respectively.Results:iPSCs at different passages all showed a high proliferative capacity when cultured in vitro and turned into a spindlelike shape similar to fibroblasts upon periodontal specific differentiation.All iPSCs formed typical calcified nodules upon GDF-5 induction by Alizarin red staining in comparison to their untreated controls.The relative calcium deposition at all passages had been significantly upgraded under the treatment of GDF-5 (P5:t =2.125,P =0.003;P10:t =2.246,P =0.021;P15:t =3.754,P =0.004;P20:t =3.933,P =0.002),but no significant difference in their calcium deposition were detected within passages 5,10,15 and 20 (periodontal differentiation:F =2.365,P =0.109;spontaneously differentiation:F =2.901,P =0.067).Periodontal tissue related marker expressions of iPSCs at all passages had also been significandy upgraded under the treatment of GDF-5 (P ＜ 0.05),but still,no significant difference in their expression levels of periodontal tissue related proteins were detected within passages (BSP:F =0.926 7,P=0.450;vimentin:F=0.917 1,P=0.455;CEMP1:F=2.129,P=0.1367).Conclusion:Our results preliminarily confirmed that long term culturing won't influence the proliferation capacity and periodontal specific differentiation propensity of iPSCs,as they can still proliferate and differentiate toward periodontal cells with high efficiency upon growth factor induction after continuous passaging.Therefore,iPSCs could be recognized as a promising cell source for future possible application in periodontal tissue regeneration.
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Objective:To analyze the plaque staining image by using image analysis software,to verify the maneuverability,practicability and repeatability of this technique,and to evaluate the influence of different plaque stains.Methods:In the study,30 volunteers were enrolled from the new dental students of Peking University Health Science Center in accordance with the inclusion criteria.The digital images of the anterior teeth were acquired after plaque stained according to filming standardization.The image analysis was performed using Image Pro Plus 7.0,and the Quigley-Hein plaque indexes of the anterior teeth were evaluated.Results:The plaque stain area percentage and the corresponding dental plaque in-dex were highly correlated,and the Spearman correlation coefficient was 0.776 (P<0.01 ).Intraclass correlation coefficients of the tooth area and plaque area which two researchers used the software to calcu-late were 0.956 and 0.930 (P<0.01).The Bland-Altman analysis chart showed only a few spots outside the 95%consistency boundaries.The different plaque stains image analysis results showed that the diffe-rence of the tooth area measurements was not significant,while the difference of the plaque area measure-ments significant (P<0.01).Conclusion:This method is easy in operation and control,highly related to the calculated percentage of plaque area and traditional plaque index,and has good reproducibility.The different plaque staining method has little effect on image segmentation results.The sensitive plaque stain for image analysis is suggested.
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Objective:To evaluate the effects of Er,Cr:YSGG laser on the root surface of periodontally involved teeth and healthy teeth,concerning the microstructure and the roughness.Methods:Eight freshly extracted teeth due to severe periodontitis and eight freshly extracted teeth due to orthodontic rea-sons or being third molar were chosen in this study.The root surface of each tooth was divided into four areas,and received four treatment methods:no treatment (control group );root planing with Gracey scaler for 30 seconds;irradiation by the lower power Er,Cr:YSGG laser;irradiation by the higher power Er,Cr:YSGG laser.Four periodontally involved teeth and four healthy teeth were used for the evaluation of microstructure using scanning electron microscope (SEM).The other four periodontitis teeth and four healthy teeth were used for the evaluation of roughness (Ra value )using 3 D profiler.Results:Smear layer was found on the teeth scaled by Gracey scaler,while the teeth irradiated by Er,Cr:YSGG laser demonstrated a melting surface with less smear layer.In the periodontitis teeth irradiated by the higher power,opening dentinal tubules could be observed.For the periodontally involved teeth,the Ra values of groups 1 to 4 were (237.4 ±20.0)nm,(1 35.7 ±1 1 .9)nm (P=0.01 ),(463.6 ±49.3)nm (P<0.001 )and (486.0 ±59.0)nm (P<0.001 )respectively.For the healthy teeth,the Ra values of groups 1 to 4 were (1 91 .4 ±44.5)nm,(1 31 .6 ±21 .5)nm (P=0.482),(463.7 ±34.6)nm (P<0.001 )and (470.3 ±1 21 .3)nm (P<0.001 )respectively.Conclusion:Er,Cr:YSGG laser can affect the microstructure of the cementum of the periodontitis teeth and healthy teeth.Irradiation by the Er,Cr:YSGG laser resulted in a melting surface with less smear layer and increased the roughness in the surface of root.
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SUMMARY This case report concerns a 23-year-old woman with chronic periodontitis who had been pre-viously diagnosed with Takayasu arteritis ( TA ) .Her erythrocyte sedimentation rate ( ESR ) and C-reactive protein ( CRP) level were decreased before and 3 months after non-surgical periodontal therapy with no change in her prescribed medications (ESR from 31.00 mm/h to 23.0 mm/h, CRP from 21.40 mg/L to 18.46 mm/h).Through the occasional findings , we raised a hypothetical analysis about the po-tential relationship between periodontitis and TA with respect to inflammatory factors , bacteria and medi-cation.Further studies of large samples are needed to verify the findings .