Mesenchymal Stromal Cells from Healthy and Inflamed Human Gingiva Respond Differently to Porphyromonas gingivalis.

Gingiva-Derived Mesenchymal Stromal Cells (GMSCs) have been shown to play an important role in periodontitis. However, how P. gingivalis, one of the key etiological agents of the disease, affects healthy (H)- and periodontitis (P)-GMSCs is unknown. To address this problem, we established 10 H-GMSC and 12 P-GMSC lines. No significant differences in morphology, differentiation into chondroblasts and adipocytes, expression of characteristic MSCS markers, including pericyte antigens NG2 and PDGFR, were observed between H- and P-GMSC lines. However, proliferation, cell size and osteogenic potential were higher in P-GMSCs, in contrast to their lower ability to suppress mononuclear cell proliferation. P. gingivalis up-regulated the mRNA expression of IL-6, IL-8, MCP-1, GRO-α, RANTES, TLR-2, HIF-1α, OPG, MMP-3, SDF-1, HGF and IP-10 in P-GMSCs, whereas only IL-6, MCP-1 and GRO-α were up-regulated in H-GMSCs. The expression of MCP-1, RANTES, IP-10 and HGF was significantly higher in P-GMSCs compared to H-GMSCs, but IDO1 was lower. No significant changes in the expression of TLR-3, TLR-4, TGF-ß, LAP, IGFBP4 and TIMP-1 were observed in both types of GMSCs. In conclusion, our results suggest that P-GMSCs retain their pro-inflammatory properties in culture, exhibit lower immunosuppressive potential than their healthy counterparts, and impaired regeneration-associated gene induction in culture. All these functions are potentiated significantly by P. gingivalis treatment.

Production of Soluble Receptor Activator of Nuclear Factor Kappa-Β Ligand and Osteoprotegerin by Apical Periodontitis Cells in Culture and Their Modulation by Cytokines.

RANKL, a bone-destructive cytokine, and OPG, its osteoprotective counterpart, are expressed in periapical lesions (PLs), which represent hystopatological manifestations of apical periodontitis. However, their regulation in PLs has not been elucidated yet. Therefore, our aim was to study the production of RANKL and OPG and their modulation by pro- and anti-inflammatory cytokines in PL cell cultures. Isolated PL cells were cultured alone or with addition of TNF-α, IFN-ϒ, IL-17, IL-4, IL-10, and IL- 33, respectively. The levels of RANKL and OPG in supernatants were measured by ELISA. The proportion of CD3+ (T cells) and CD19+/CD138+ (B cells/plasma cells) within isolated PLs was determined by immunocytochemistry. The levels of RANKL were higher in cultures of symptomatic PLs compared to asymptomatic PLs and PLs with the dominance of T cells (T-type lesions) over B cells/plasma cells (B-type lesions). A higher proportion of osteodestructive processes (RANKL/OPG ratio > 1.0) were detected in symptomatic PLs. The production of RANKL was upregulated by IFN-ϒ and IL-17 and higher concentrations of IL-33. IL-10 and lower concentrations of IL-33 augmented the production of OPG. The addition of either RANKL or anti-RANKL antibody to the cultures did not modify significantly the production of OPG. In conclusion, this original PL cell culture model suggests that increased bone destruction through upregulated production of RANKL could be associated with exacerbation of inflammation in PLs with the predominance of Th1 and Th17 responses and increased secretion of IL-33. In contrast, IL-10 and lower levels of IL-33, through upregulation of OPG, may suppress osteolytic processes.

[Analysis of variation of sagittal position of the jaw bones in skeletal Class III malocclusion].

BACKGROUND/AIM: Skeletal Class III malocclusion is a discrepancy in the sagittal jaw relationship, due to imbalances in their development and/or position, resulting in the dominant appearance of the lower jaw in facial profile. The aim of this study was to determine variations in the sagittal position of the jaw bones to the cranial base in subjects with skeletal Class III, for the earliest possible diagnosis of malocclusion. METHODS: Fifty children and as many adults with skeletal Class III, both sexes, were examined and selected, based on the findings of sagittal interjaw relationship (ANB) < or = 0 degrees from the cephalometric analysis of tele-x-ray profile head shots. The subjects were grouped according to age. The first group consisted of children aged 6-12 years, and another group, of adults aged 18-26 years. We measured the angles of maxillary prognathism (SNA), mandibular prognathism (SNB) and ANB. Based on these results, within the respective groups subclassification into the subgroups was done, among which a significant difference measured values was evaluated. In both groups a significant correlation of the determined values was evaluated. RESULTS: An average SNA angle ranged 77.36 +/- 3.58 in children and 77.32 +/- 4.88 in adults, while an average SNB angle was 79.46 +/- 3.91 in the group of children and 81.12 +/- 3.76 in adults. An average ANB angle was -2.10 +/- 2.07 in children, and -4.00 +/- 2.34 in adults. In both groups, a significant correlation between the measured values and a significant difference in the values of all the measured parameters were found between patients from different subgroups (p < 0.01). CONCLUSION: The most common morphological variation of sagittal position of the upper jaw is its retrognatism, which is equally present in both children and adults. Sagittal position of the lower jaw in most of the adults was prognathic, while mandible prognathism in the children was less present.

Study of molecular and granular layer of dentate gyrus of female rats neonatally treated with estrogen.

The proliferation of hippocampal dentate gyrus granule cells was investigated using (3)H-thymidine incorporation in control and estrogen-treated rats. Newborn 3-day old female Wistar rats were treated with a single dose of 1 mg of estradiol and 30 microCi (3)H-thymidine, and were sacrificed when 10 days old. The total number of neurons and the number of labeled granule cells in the granular layer and its subdivisions of both suprapyramidal and infrapyramidal limbs were analyzed using a stereological method. In both limbs, the total number of neurons as well as the total number of labeled granule cells in the granular layer were significantly increased in treated rats compared to corresponding controls. The thicknesses of the molecular and the granular layers and their subdivisions of both suprapyramidal and infrapyramidal limbs were analyzed using a stereological method. In treated female rats the molecular layer (ML) in both limbs was significantly decreased, and the granular layer (GL) was significantly increased in suprapyramidal limb. However, in the infrapyramidal limb an increased number of labeled cells in treated animals were significant in all particular zones of the granular layer. In the suprapyramidal limb's granular layer a significant increase in labeled cells was observed in subgranular zone (SGZ). Our results suggest a differential effect of estradiol on thicknesses of the ML and the GL, and dentate gyrus granule cells proliferation through the early rat life.

[Evaluation of telemedicine systems for impacted third molars diagnosis].

UNLABELLED: BACKGROUND/AIM. In the last twenty years significant advances have been made in the fields of information and telecommunication technology in health care applications, with a positive impact on the health care practice. The need for remote diagnosis and planning of interventions is of special importance in military health care, and health management of immobile persons, and those with special needs. In cases such as these, availability of specialist health care is mainly limited by geographic and financial factors. The aim of this study was to investigate practical usability of telemedicine approaches in everyday management of oral surgery patients in terms of reliability of established diagnosis and indications for oral surgery treatment of the third molars. METHODS: Our experimental randomized study enrolled 432 randomly selected patients of both genders, aged 20 to 87 years, undergoing panoramic radiography for some reason in the Centre for Dental Radiography in Belgrade. In addition to radiography, photographs of the face and mouth cavity were taken. These images were uploaded to the web server specially dedicated to the study purposes, and then transmitted to teledentists, i.e. oral surgeons, who made remote diagnoses. Diagnostic agreement was determined by way of the Cohen's kappa coefficient, and diagnostic sensitivity (SE), specificity (SP), and effectiveness (EFF) were also established. Statistical significance was determined and comparisons performed by using the z-test, and testing of non-parametric characteristics by using the McNemar's chi2 test for p = 0.05 significance cut-off. RESULTS: The results obtained by analyzed images and diagnostic assessment of the clinical diagnosis (kappa = 0.99, SE = 99%, SP = 99%, EFF = 99%, for 95% CI) indicate an almost complete diagnostic agreement. The differences in diagnosis were not statistically significant. CONCLUSION: Diagnostic assessment of the clinical diagnosis of impacted or semi-impacted third molars assisted by the telemedicine approach was equal to the real-time assessment of clinical diagnosis. Telemedicine, and teledentistry as its branch, represent the present and even more the future of this field of health care.

[Effect of local administration of platelet-rich plasma and guided tissue regeneration on the level of bone resorption in early dental implant insertion].

BACKGROUND/AIM: Osseointegration is a result of cellular migration, differentiation, bone formation, and bone remodeling on the surface of an implant. Each of these processes depends on platelets and blood coagulum. Platelet-rich plasma (PRP) is used to improve osseointegration and stability of implants. The aim of the research was to test the influence that PRP and guided tissue regeneration in bone defects have on bone defect filling and the level of bone resorption in early implant insertion. METHODS: This experimental study included 10 dogs. A total of 40 BCT implants were inserted, 4 in each dog (two on the left side and two on the right side), with guided tissue regeneration. Radiologic analyses were done immediately after the insertion and 10 weeks after the insertion. Bone defect filling was measured by a graduated probe 10 weeks after the implant insertion. The following protocols were tested: I - PRP in combination with bovine deproteinized bone (BDB) and resorptive membrane of bovine origin (RBDM), II - BDB + RBDM, III - PRP + RBDM and IV - RBDM. RESULTS: The applied protocols affected differently the bone defect filling and the level of bone resorption. Significantly better results (the lowest bone resorption) were achieved with protocol I (PRP + BDB + RBDM) in comparison with protocols III (PRP + RBDM) and IV (RBDM), but not with protocol II (BDB + RBDM). On the other hand, no significant difference was found among protocols II (BDB + RBDM), III (PRP + RBDM) and IV (RBDM) in the level of bone tissue resorption. CONCLUSION: The bone defect filling was largest and the level of bone resorption was lowest in the protocol with PRP applied in combination with BDB and RBDM.

Clinical parameters of the local anesthetic effects of bupivacaine applied with and without a vasoconstrictor in oral implantology.

BACKGROUND/AIM: Bupivacaine (Marcaine), homologue of mepivacaine, chemically related to lidocaine, is used as a local anesthetic for local infiltration, peripheral nerve block, retrobulbar block, symphathetic block, and caudal and epidural anesthesia. The aim of this investigation was to determine and to compare clinical parameters of the local anesthetic effects of bupivacaine applied with and without a vasoconstrictor. METHODS: This investigation included a total of 30 randomly selected patients, who ranged in age from 30-60 years, with partial or total anodontia in the molar region of the mandible. These patients with total or partial edentulous molar part of the mandible, scheduled for dental implantation placement, were asked to participate in the study. In the first phase of the investigation, the patients were subjected to local anesthesia with 3.5 cm3 of 0.5% bupivacaine with a vasoconstrictor (adrenalin, 1: 200,000) in the right side of the mandible. After administering local anesthesia, the placement of blade, cylindrical, transdental (B.C.T.) implants was performed. In the second stage of the investigation, in 7-10 days period after the first oral surgery, the patients were subjected to local anesthesia with 3.5 cm3 of 0.5% bupivacaine, but without a vasoconstrictor, in the left side of the mandible. After administering local anesthesia, the placement of B.C.T. implants was performed. During the performance of both oral surgery procedures, the following clinical parameters of the local anesthetic effects were monitored: latent period, duration and the potency of anesthesia, and the evaluation of the postoperative pain level. RESULTS: The latent period under local anesthesia with 3.5 cm3 of 0.5% bupivacaine and vasoconstrictor was statistically significantly shorter than without vasoconstrictor. The duration of local anesthesia was longer without vasoconstrictor. There was no difference in the potency of anesthesia with or without a vasoconstrictor, while the lowest level of postoperative pain was found after administering bupivacaine without a vasoconstrictor use. CONCLUSION: The results of this investigation show that bupivacaine without a vasoconstrictor is efficient when used for local anesthesia in placing dental implants since it provides better blood circulation required for good dental implant osseointegration.