Peri-Implant Mucosal Fenestration and Histologic Observation of Bone Xenograft Material 7-Years After Implant Installation: A Case Report.

Bone augmentation is often required before the installation of dental implants. Here, we report a case for a patient who previously received bone augmentation at the upper right jaw using a xenogenic graft, followed by successful implant installation. Seven years later, the patient presented with mucosal fenestration with bone exposure at the area and gave a history of a recent diagnosis of cutaneous lichen planus. Several attempts were made to manage the situation, and finally, we resorted to connective tissue graft placement at the site. A piece of bone was sent for histologic evaluation, where the results indicated the presence of un-resorbed graft material surrounded by inflammatory cells, with no evidence of bone formation in the area. The case presents histologic evidence for the lack of new bone formation using xenograft over the evaluation period. The case also shows lichen planus, a possible cause for oral complication for patients undergoing augmentation and implant installation.

Maxillary root amputation: Case report with a 14-year-follow-up and updated mini review.

Root resection is performed to create a maintainable furcation area in teeth with advanced periodontitis. However, the long-term feasibility of this treatment remains controversial. We present a case in which distal root resection in a maxillary molar successfully preserved the form and function of the dentition for approximately 14 years.

Incidence of maxillary sinus septa in the saudi population.

BACKGROUND: The variability in the maxillary sinus anatomy makes dental implant planning challenging. One of the anatomical landmarks that could affect the decision for implant placement around the maxillary sinus is the sinus septa. This study aimed to retrospectively determine the prevalence, anatomical distribution, and morphology of the maxillary sinus septa. MATERIALS AND METHODS: This study included 309 CBCT images that were analyzed to determine the prevalence, height, location, and orientation of the maxillary sinus septa. Descriptive statistics, Mann‒Whitney U tests, and Kruskal‒Wallis tests were used for data analysis. RESULTS: A total of 618 maxillary sinuses were analyzed. Maxillary septa were present in 30% (n = 188) of the sinuses and in approximately 45% of the analyzed images. The mean height of the septa was 5.09 mm. The presence of bilateral septa was evident in 49 subjects (35.25%). Female subjects were significantly more likely to have only one septum (n = 67, 53.6%, p < 0.05). CONCLUSION: The presence of septa is very common, found in one-third to approximately half of the evaluated cases, which warrants careful examination before any surgical interventions to avoid possible complications.

Clinical and Radiographic Peri-Implant Parameters and Whole Salivary Interleukin-1ß and Interleukin-6 Levels among Type-2 Diabetic and Nondiabetic Patients with and without Peri-Implantitis.

OBJECTIVE: The aim was to assess the peri-implant clinical and radiographic parameters and whole salivary levels of interleukin (IL)-1ß and IL-6 among type 2 diabetic and nondiabetic patients with and without peri-implantitis. MATERIAL AND METHODS: Ninety-one implants were placed in patients without type 2 diabetes mellitus (39 patients with and 52 patients without peri-implantitis; group 1). Eighty implants were placed in patients with diabetes (35 patients with and 45 patients without peri-implantitis; group 2). Peri-implant plaque index, bleeding on probing, probing depth, and marginal bone loss were measured. Unstimulated whole saliva samples were collected and IL-1ß and IL-6 levels were measured using standard techniques. p < 0.05 was considered statistically significant. RESULTS: In group 1, plaque index (p < 0.001), bleeding on probing (p < 0.001), probing depth (p < 0.001), and whole salivary IL-1ß (p < 0.001) and IL-6 (p < 0.001) levels were significantly higher in patients with peri-implantitis than in those without peri-implantitis. Plaque index, bleeding on probing, probing depth, and marginal bone loss were comparable among all of the patients in group 2. Among patients with peri-implantitis, plaque index (p < 0.001), bleeding on probing (p < 0.001), probing depth (p < 0.001), marginal bone loss (p < 0.001), and whole salivary IL-1ß (p < 0.001) and IL-6 (p < 0.001) levels were significantly higher in those with diabetes than in those without diabetes. CONCLUSION: Among individuals without diabetes, peri-implant plaque index, bleeding on probing, probing depth, marginal bone loss, and whole salivary IL-1 ß and IL-6 levels were higher among patients with peri-implantitis compared to patients without peri-implantitis. Among patients with diabetes, the severity of the measured parameters appears to be influenced by the glycemic status rather than by peri-implantitis.

Isolation of dental pulp stem cells from a single donor and characterization of their ability to differentiate after 2 years of cryopreservation.

OBJECTIVES: To investigate the viability and differentiation capacity of dental pulp stem cells (DPSCs) isolated from single donors after 2 years of cryopreservation.   METHODS: This prospective study was conducted between October 2010 and February 2014 in the Stem Unit, College of Medicine, King Saud University, Riyadh, Saudi Arabia. Seventeen teeth extracted from 11 participants were processed separately to assess the minimum tissue weight needed to yield cells for culturing in vitro. Cell stemness was evaluated before passage 4 using the colony forming unit assay, immunofluorescence staining, and bi-lineage differentiation. Dental pulp stem cells  were cryopreserved for 2 years. Post-thaw DPSCs were cultured until senescence and differentiated toward osteogenic, odontogenic, adipogenic, and chondrogenic lineages.   RESULTS: Viable cells were isolated successfully from 6 of the 11 participants. Three of these 6 cultured cell lines were identified as DPSCs. A minimum of 0.2 g of dental pulp tissue was required for successful isolation of viable cells from a single donor. Post-thaw  DPSCs successfully differentiated towards osteogenic, odontogenic, chondrogenic, and adipogenic lineages. The post-thaw DPSCs were viable in vitro up to 70 days before senescence. There was no significant difference between the cells.   CONCLUSION: Within the limitations of this investigation, viable cells from dental pulp tissue were isolated successfully from the same donor using a minimum of 2 extracted teeth. Not all isolated cells from harvested dental pulp tissue had the characteristics of DPSCs. Post-thaw DPSCs maintained their multi-lineage differentiation capacity.

Dental pulp stem cells. Biology and use for periodontal tissue engineering.

Inflammatory periodontal disease is a major cause of loss of tooth-supporting structures. Novel approaches for regeneration of periodontal apparatus is an area of intensive research. Periodontal tissue engineering implies the use of appropriate regenerative cells, delivered through a suitable scaffold, and guided through signaling molecules. Dental pulp stem cells have been used in an increasing number of studies in dental tissue engineering. Those cells show mesenchymal (stromal) stem cell-like properties including self-renewal and multilineage differentiation potentials, aside from their relative accessibility and pleasant handling properties. The purpose of this article is to review the biological principles of periodontal tissue engineering, along with the challenges facing the development of a consistent and clinically relevant tissue regeneration platform. This article includes an updated review on dental pulp stem cells and their applications in periodontal regeneration, in combination with different scaffolds and growth factors.

Osteogenic differentiation of dental pulp stem cells under the influence of three different materials.

BACKGROUND: Regeneration of periodontal tissues is a major goal of periodontal therapy. Dental pulp stem cells (DPSCs) show mesenchymal cell properties with the potential for dental tissue engineering. Enamel matrix derivative (EMD) and platelet-derived growth factor (PDGF) are examples of materials that act as signaling molecules to enhance periodontal regeneration. Mineral trioxide aggregate (MTA) has been proven to be biocompatible and appears to have some osteoconductive properties. The objective of this study was to evaluate the effects of EMD, MTA, and PDGF on DPSC osteogenic differentiation. METHODS: Human DPSCs were cultured in medium containing EMD, MTA, or PDGF. Control groups were also established. Evaluation of the achieved osteogenesis was carried out by computer analysis of alkaline phosphatase (ALP)-stained chambers, and spectrophotometric analysis of alizarin red S-stained mineralized nodules. RESULTS: EMD significantly increased the amounts of ALP expression and mineralization compared with all other groups (P < 0.05). Meanwhile, MTA gave variable results with slight increases in certain differentiation parameters, and PDGF showed no significant increase in the achieved differentiation. CONCLUSIONS: EMD showed a very strong osteogenic ability compared with PDGF and MTA, and the present results provide support for its use in periodontal regeneration.

Congenital adrenal hyperplasia with localized aggressive periodontitis and amelogenesis imperfecta.

Congenital adrenal hyperplasia (CAH) is an inherited medical condition that implies defects in steroid biosynthesis. The dental findings of a female patient with CAH are reported. The patient suffered from severe periodontal tissue destruction, obvious enamel defects, as well as some occlusal problems. The management approach is presented and the possibility of interrelation of her dental findings with her medical condition is discussed.