The Morpho-Functional Three-Dimensional Analysis for Zygomatic Implants: A Clinical Tool With Surgical Implications.

ABSTRACT: Zygomatic implants (ZIs) have been used successfully for the rehabilitation of jaws with severe atrophy for the past 2 decades. The development of computed tomography, three-dimensional (3D) analysis software, and stereolithographic models has positively impacted the development of preoperative planning. This article describes the protocol developed by the Department of Oral and Maxillofacial Surgery of El Bosque University, Bogotá, Colombia, through 10 years of experience, for the installation of ZIs, covering from the times when the implants were placed through intraoperative guidance, until now, in which drilling guides developed by computer-aided design and computer-aided manufacturing are used, without neglecting in their design multiple factors that must be considered. To date, this protocol for the treatment of patients with atrophic jaws through ZIs includes a detailed clinical examination, in which variables such as bone and dental relationship between the jaws, oral opening and dynamic interaction between soft cervicofacial tissues are considered. It also includes a 3D computed tomography planning for the design and preparation of surgical guides whose insertion patterns must be executable during surgery. Together, clinical and imaging analysis converge in what it has been called morpho-functional 3D planning.

Critical-sized mandibular defect reconstruction using human dental pulp stem cells in a xenograft model-clinical, radiological, and histological evaluation.

PURPOSE: This research evaluated clinical, histological, and radiological osseous regeneration in a critical-sized bilateral cortico-medullary osseous defect in model rabbits from New Zealand after receiving a hydroxyapatite matrix and polylactic polyglycolic acid (HA/PLGA) implanted with human dental pulp stem cells (DPSCs). METHODS: Eight New Zealand rabbits with bilateral mandibular critical-sized defects were performed where one side was treated with an HA/PLGA/DPSC matrix and the other side only with an HA/PLGA matrix for 4 weeks. RESULTS: An osseointegration was clinically observed as well as a reduction of 70% of the surgical lumen on one side and a 35% on the other. Histologically, there was neo-bone formation in HA/PLGA/DPSC scaffold and angiogenesis. A bone radiodensity (RD) of 80% was radiologically observed achieving density levels similar to mandibular bone, while the treatment with HA/PLGA matrix achieves RD levels of 40% on its highest peaks. CONCLUSIONS: HA/PLGA/DPSC scaffold was an effective in vivo method for mandibular bone regeneration in critical-sized defects induced on rabbit models.

Marcadores candidatos, estrategias de cultivo y perspectivas de las DPSCs como terapia celular en odontología / Candidate markers, culture strategies and DPSC perspectives used as cellular therapy in dentistry

La ingeniería tisular basada en las células troncales de pulpa dental se considera como un enfoque prometedor para la odontología regenerativa, con el objetivo final de reemplazar morfológica y funcionalmente los tejidos periodontales y/o los dientes perdidos a través de la síntesis in vitro de sustitutos análogos tisulares o, incluso, de un diente humano denominado biodiente. Las células troncales de la pulpa dental representan una colonia de células adultas que tienen la capacidad de autorrenovación y diferenciación en diferentes linajes. El origen exacto de las células troncales de la pulpa dental no ha sido completamente determinado y estas células troncales parecen ser la fuente de los odontoblastos que contribuyen a la formación del complejo dentinopulpar. Recientemente, los logros obtenidos a partir de la investigación de las células troncales nos han permitido contemplar las posibles aplicaciones terapéuticas de las células troncales de la pulpa dental. Algunos estudios han demostrado que las células troncales de la pulpa dental son capaces de producir tejidos dentales in vivo, incluyendo la dentina, la pulpa dental y las estructuras de la corona. Mientras que otras investigaciones han demostrado que estas células troncales se diferencian in vitro e in vivo, por ejemplo, en osteoblastos, neuroblastos, condrocitos, fibroblastos y endotelio. En teoría, un biodiente sintetizado a partir de las células troncales de la pulpa dental debe ser la mejor opción para recuperar la totalidad de la estructura y función de un diente humano. El objetivo de este artículo de revisión es hacer una breve descripción de la localización, origen, aislamiento y marcadores candidatos de células troncales de pulpa dental, para así plantear las perspectivas de aplicación en la clínica odontológica.

Tissue engineering based on dental pulp stem cells is considered as a promising approach for regenerative dentistry. It purports the final target of morphologically and functionally replacing periodontal tissues and/or lost teeth by means of the in vitro synthesis of tissue-analog substitutes, or even a human tooth (called bio-tooth). Dental pulp stem cells represent a colony of adult cells which have the ability to auto-renovate and differentiate in different lineages. Dental pulp stem cells exact origin has yet to be fully determined; these stem cells seem to be the source of odontoblasts, which contribute to the formation of the dentin-pulp complex. Recently, achievements obtained through research conducted on stem cells, have allowed us to contemplate the possible therapeutic applications of dental pulp stem cells. Some studies have shown that dental pulp stem cells are able to produce in vivo dental tissues, including dental pulp and crown structures. Other research has demonstrated that these stem cells differentiate in vivo and in vitro into osteoblasts, neuroblasts, chondrocytes fibroblasts, and endothelium. In theory, a bio-tooth synthesized from autogenic dental pulp stem cells should be the best option to recover the whole structure and function of a human tooth. The aim of the present review article was to undertake a brief description of the location, origin, isolation and candidate markers of dental pulp stem cells in order to thus present application perspectives to be used in the dental clinic.