Connective Tissue Attachment Research Articles

Determining biologic width and its relevance in periodontics – a review

The length from the root surface of a tooth to the junctional epithelium and connective tissue attachment is termed as biological width (BW). It protects the tooth from diseases and infections by acting as a natural seal. On an average it is 2.04 mm. In clinical practice the BW is determined by periodontal probe. The calculation of BW can be done by several methods. An identification of BW breach is confirmed when the length is observed to be less than 2 mm at multiple locations or at a single location. When we are considering the prolonged health benefits of any restoration or a natural tooth, the health of the gingiva is of prime importance. An excess of BW breach leads to innumerable adverse effects, which are talked about in this review article. The article sheds light on BW in association to implants and conservative procedures and its evaluation clinically, and also a discussion about the procedures that can be used to rectify BW breaches in routine practice.

Investigation of periodontal tissue regeneration using octacalcium phosphate and collagen composite

ObjectiveThis study aimed to investigate periodontal tissue regenerative potential of octacalcium phosphate (OCP) and collagen composite (OCPcol), recognized as excellent bone-regenerative materials, in artificial bone defect models using beagle dogs. This study specifically assessed the efficacy of OCPcol in periodontal soft-tissue regeneration. MethodsOCPcol was implanted in bone defects adjacent to the roots of the left mandibular third and fourth premolars in six beagle dogs (OCP group), while five dogs did not receive OCPcol (control group). The dogs were observed for 3 months. The specimens were evaluated radiologically and histologically. ResultsMicrocomputed tomography revealed bone regeneration originating from the lateral cortical bone surface adjacent to the created defect. The superficial layer of the regenerated bone was cortical bone-like and continuous with the upper and lower alveolar bone. The bone was regenerated by maintaining a continuous void in the periodontal ligament space above and below the dentinal defect. Dental defects of roots were not regenerated. The control group did not exhibit sufficient bone regeneration. Histologically, in the OCP group, formation of new cementum was observed on the outer surface of the root dentin, with connective tissue attachment and an oblique-running periodontal ligament in the space between the new bone and dentin. However, the dentinal defects were not regenerated． ConclusionsAlveolar bone and periodontal ligament regenerated when OCPcol was implanted into a bone and dentinal defect created around a natural tooth root. These results suggest that OCPcol effectively regenerates periodontal tissue, without ankylosis.

Clinical Features, Etiopathogenesis, and Therapeutic Approaches of Acute Gingival Lesions: A Narrative Review.

A bacterial infection is typically the source of gingivitis, a non-destructive condition that produces gum inflammation. Unlike chronic lesions, which have well-defined features and a gradual onset, acute lesions are unpleasant. Usually, the first symptoms are bleeding, swollen, and red gums. If gingivitis is not treated, it can lead to periodontitis, a more serious condition where the gums separate from the teeth. It seems that gingival disease-induced inflammation is a necessary condition for the breakdown of connective tissue attachment apical to the cementoenamel junction (CEJ). This may result in damage to the bone and soft tissue that support the teeth, leading to loosening and unstable teeth, andif the infection worsens, eventual tooth loss may occur. While one of the most prevalent inflammatory diseases in humans is plaque-induced gingivitis, there are several less common but frequently very significant non-plaque-induced gingival illnesses. Maintaining regular dental hygiene can help prevent gingivitis and make it reversible. Non-plaque-induced gingival lesions might be pathologic alterations restricted to gingival tissues, but they are also frequent signs of systemic disorders. Diagnosing patients with these lesions and creating treatment regimens for them must be the aim of the therapy.

COMBINATION OF REGENERATIVE THERAPY AND FREE GINGIVAL GRAFT IN STAGE IV PERIODONTITIS: CASE REPORT

Introduction: Periodontal regenerative therapy can be used to repair damaged periodontal tissues caused by periodontitis. The combination of regenerative periodontal surgery and FGG (Free Gingival Graft) is expected to accelerate the regeneration of periodontal tissue. Case : A 37-year-old woman came with complaints of loose lower front teeth, frequent bleeding and pain when eating and drinking. The complaint was felt since 1 year ago. Clinical examination obtained an average pocket depth of 6 mm and an average second degree of tooth mobility. On radiographic examination found bone damage horizontally. Case Management: The patient received root planing scaling and occlusion adjustment, followed by dental periodontal surgery 42,41,31,32. Stage II surgery for recession closure therapy with FGG was carried out three months after stage 1 surgery was performed. Discussion: Regenerative periodontal surgery is performed to produce new periodontal tissue growth and restore connective tissue attachment to the teeth. Free Gingival Graft is performed to increase gingival keratinization and improve patient esthetics. Conclusion and Suggestions: The combination of regenerative periodontal surgery and FGG for the treatment of periodontitis cases involving severe bone destruction gives good results of periodontal tissue healing by alveolar bone healing and regeneration and quite good aesthetics.

Effect of TiO2 Abutment Coatings on Peri-Implant Soft Tissue Behavior: A Systematic Review of In Vivo Studies.

Establishing a proper soft tissue adhesion around the implant abutment is essential to prevent microbial invasion, inhibit epithelial downgrowth, and obtain an optimal healing process. This systematic review aims to evaluate the real potential of TiO2 coating on the behavior of peri-implant soft tissue health and maintenance. A specific aim was to evaluate clinically and histologically the effect of TiO2 abutment coating on epithelial and connective tissue attachment. Electronic database searches were conducted from 1990 to 2023 in MEDLINE/PubMed and the Web of Science databases. In total, 15 out of 485 publications were included. Eight studies involved humans, and seven were animal studies. Exposure time ranges from 2 days to 5 years. The peri-implant soft tissue evaluations included clinical assessment (plaque index (PI), peri-implant probing pocket depth (PPD), and bleeding on probing (BoP)), histological as well as histomorphometric analysis. The Office of Health Assessment and Translation (OHAT) Risk of Bias Rating Tool for Human and Animal Studies was used to evaluate the overall quality of the studies included in the review. The results showed some variation but remained within acceptable limits. Within the limitations of this systematic review, the present findings suggest that TiO2 coatings seem to influence soft tissue healing. TiO2-coated abutments with a roughness value between 0.2 and 0.5 μm enhance soft tissue health. Sol-gel-derived TiO2 coatings induced better soft tissue attachment than noncoated machined abutment surfaces. The anodized titanium abutments demonstrate comparable clinical and histological outcomes to conventional machined abutments. However, there was variation among the included studies concerning TiO2 coating characteristics and the measured outcomes used to evaluate the soft tissue response, and therefore, quantitative analysis was not feasible. Long-term in vivo studies with standardized soft tissue analysis and coating surface parameters are necessary before a definitive conclusion can be drawn. OSF Registration No.: 10.17605/OSF.IO/E5RQV.

Next-generation antibacterial nanopolymers for treating oral chronic inflammatory diseases of bacterial origin.

'Periodontitis' refers to periodontal destruction of connective tissue attachment and bone, in response to microorganisms forming subgingival biofilms on the root surface, while 'apical periodontitis' refers to periapical inflammatory processes occurring in response to microorganisms within the root canal system. The treatment of both diseases is based on the elimination of the bacterial challenge, though its predictability depends on the ability of disrupting these biofilms, what may need adjunctive antibacterial strategies, such as the next-generation antibacterial strategies (NGAS). From all the newly developed NGAS, the use of polymeric nanotechnology may pose a potential effective approach. Although some of these strategies have only been tested invitro and in preclinical invivo models, their use holds a great potential, and therefore, it is relevant to understand their mechanism of action and evaluate their scientific evidence of efficacy. To explore NGAS based on polymeric nanotechnology used for the potential treatment of periodontitis and apical periodontitis. A systemic search of scientific publications of adjunctive antimicrobial strategies using nanopolymers to treat periodontal and periapical diseases was conducted using The National Library of Medicine (MEDLINE by PubMed), The Cochrane Oral Health Group Trials Register, EMBASE and Web of Science. Different polymeric nanoparticles, nanofibres and nanostructured hydrogels combined with antimicrobial substances have been identified in the periodontal literature, being the most commonly used nanopolymers of polycaprolactone, poly(lactic-co-glycolic acid) and chitosan. As antimicrobials, the most frequently used have been antibiotics, though other antimicrobial substances, such as metallic ions, peptides and naturally derived products, have also been added to the nanopolymers. Polymeric nanomaterials containing antimicrobial compounds may be considered as a potential NGAS. Its relative efficacy, however, is not well understood since most of the existing evidence is derived from invitro or preclinical invivo studies.

Synergistic Effect of Nano Strontium Titanate Coating and Ultraviolet C Photofunctionalization on Osteogenic Performance and Soft Tissue Sealing of poly(ether-ether-ketone).

This study aimed to evaluate the bioactivity of poly(ether ether ketone) (PEEK) after surface modification by persistent photoconductive strontium titanate (SrTiO3) magnetron sputtering and ultraviolet (UV) C irradiation. According to the different modifications, the PEEK specimens were randomly divided into five groups (n = 38/group): PEEK, Sr100-PEEK, Sr200-PEEK, UV/PEEK, and UV/Sr200-PEEK. Then, the specimens of Sr100-PEEK and Sr200-PEEK groups were, respectively, coated with 100 and 200 nm thickness photocatalyst SrTiO3 on the PEEK surface by magnetron sputtering. Subsequently, UV-C light photofunctionalized the specimens of PEEK and Sr200-PEEK groups to form UV/PEEK and UV/Sr200-PEEK groups. The specimens were characterized by a step meter, scanning electron microscopy (SEM), atomic force microscopy (AFM), energy dispersive X-ray spectroscopy (EDX), and a water contact angle meter. The release test of the Sr ion was performed by inductively coupled plasma mass spectrometry (ICP-MS). In vitro study, osteogenic activity (MC3T3-E1 osteoblast-like cells) and epithelial and connective tissue attachment (gingival epithelial cells GE1 and fibroblasts NIH3T3) were analyzed in five groups. Surface morphology of the specimens was changed after coating, and the Sr content on the Sr-PEEK surface was increased with increasing coating thickness. In addition, the contact angle was increased significantly after magnetron sputtering. After UV-C photofunctionalization, the content of surface elements changed and the contact angle was decreased. The release of Sr ion was sustained, and the final cumulative release amount did not exceed the safety limit. In vitro experiments showed that SrTiO3 improved the cell activity of MC3T3-E1 and UV-C irradiation further enhanced the osteogenic performance of PEEK. Besides, UV-C irradiation also significantly promoted the cell viability, development, and expression of adhesion proteins of GE1 and NIH3T3 on PEEK. The present investigation demonstrated that nano SrTiO3 coating with UV-C photofunctionalization synergistically enhanced the osteogenic properties and soft tissue sealing function of PEEK in vitro.

Regenerativna parodontalna terapija - II deo

Introduction: The periodontal diseases lead to the morphological and functional disintegration of the tooth-supporting apparatus, and a basic concept of surgical periodontal therapy is the elimination of periodontal pockets with the bone remodelling and creating the physiological architecture at a more apical level, thereby achieving better conditions for dental plaque control. The progenitor cell population in the periodontal ligament is served for the reconstruction of lost epithelial attachment. Guided Tissue Regeneration (GTR) is a procedure that allows for the repair of a periodontal defect by cells capable of creating new connective tissue attachment and alveolar bone, and the aim is a minimization of postoperative gingival recession. The objectives of GTR are the creation of a new epithelial attachment, an increase in the bone level, and the minimization of postoperative gingival recession. Aim: Presentation of modern approaches, materials, prognostic factors as well as complications of periodontal therapy that are focused on attachment regeneration and complete reconstruction of periodontal tissue. Conclusion: The difference in terms of outcomes of regenerative periodontal therapy relates to the degree of patient's cooperation with the therapist, the level of oral hygiene, the selection of an appropriate bone defect, as well as the methods of surgery. The high level of dental plaque control, elimination of pathogenic microflora and intensive antimicrobial periodontal therapy improve the outcome of periodontal regenerative therapy.

Adjunctive effect of 470-nm and 630-nm light-emitting diode irradiation in experimental periodontitis treatment: a preclinical study.

This study investigated the adjunctive effect of light-emitting diodes (LEDs) in the treatment of experimental periodontitis. Experimental periodontitis was induced by placing ligatures around the mandibular second, third, and fourth premolars of 6 beagles for 3 months. After ligature removal, periodontitis progressed spontaneously for 2 months. The animals' hemimandibles were allocated among the following 3 groups: 1) no treatment (control), 2) scaling and root planing (SRP), and 3) SRP with LED irradiation at 470-nm and 630-nm wavelengths (SRP/LED). The probing pocket depth (PPD) and gingival recession (GR) were measured at baseline, 6 weeks, and 12 weeks. The clinical attachment level (CAL) was calculated. After 12 weeks, histological and histomorphometric assessments were performed. The distances from the gingival margin to the apical extent of the junctional epithelium (E) and to the connective tissue (CT) attachment were measured, as was the total length of soft tissue (ST). PPD and CAL increased at 12 weeks compared with baseline in the control group (6.31±0.43 mm to 6.93±0.50 mm, and 6.46±0.60 mm to 7.61±0.78 mm, respectively). PPD and CAL decreased at 12 weeks compared with baseline in the SRP group (6.01±0.59 to 4.81±0.65 mm, and 6.51±0.98 to 5.39±0.93 mm, respectively). PPD and CAL decreased at 12 weeks compared with baseline in the SRP/LED group (6.03±0.39 to 4.46±0.47 mm, and 6.11±0.47 to 4.78±0.57 mm, respectively). The E/ST and CT/ST ratios significantly differed among the 3 groups (P<0.05). The clinical parameters and histologic findings demonstrated that 470-nm and 630-nm wavelength LED irradiation accompanying SRP could improve treatment results. Within the study limitations, 470 nm and 630 nm wavelength LED irradiation might provide additional benefits for periodontitis treatment.

The effects of direct polymethylmethacrylate and zirconia-on-Ti-base abutments on peri-implant soft tissue integration: A study in minipigs.

To assess two types of abutment materials routinely used in daily prac-tice-direct polymethyl methacrylate (PMMA) and a zirconia-on-Ti-base abut-ment-and their effects on peri-implant soft tissues and bone remodeling in a mini-pig model. A total of 40 implants were placed in five mini-pigs in a single-stage surgery. Four different types of abutment materials (n = 10 per group) were used: (1) titanium (control); (2) zirconia (control); (3) PMMA (test 1); and (4) Ti-base (zirconia bonded to a titanium framework; test 2). After 3 months of healing, the samples were collected and subjected to nondecalcified histology. The soft tissue dimensions (sulcus, junctional epithelium, and connective tissue attach-ment) were assessed on each abutment mesially and distally, and the distance from the implant margin to the first bone-to-implant contact (BIC) was measured. No statistically significant differences were found among the four groups regarding soft tissue dimensions (P = .21), and a long junctional epithelium (mean: 4.1 mm) and a short connective tissue attachment (mean: 0.3 mm) were found in the majority of abutments. In some samples, the junctional epithelium extended all the way to the bone level. The measured peri-implant bone remodeling was similar in all four groups (P = .25). The present findings indicate that both di-rect PMMA and zirconia-on-Ti-base abutments seem to allow soft tissue integration similar to that of titanium and zirconia abutments. However, clinical studies are war-ranted to either confirm or refute the observed findings and to further investigate the influence of different materials on mucointegration.

A New Way to Model Periodontitis in Laboratory Animals.

to develop a new method of accelerated modeling of experimental periodontitis on laboratory animals. The study was carried out on 22 female rats. A wire ligature was applied to the cervical area of the incisors of the animals in an eight-shaped manner. Plaque obtained from a patient with periodontitis was placed under the wire, and nicotine and ethyl alcohol solutions were injected under the gingival mucosa. A complex index has been proposed to assess inflammation. At the end of the experiment the animals were euthanized, their jaws were dissected into dentoalveolar blocks and further descriptive histologic analysis was performed. On the second day the gingiva of the rats acquired a cyanotic-pink color, on the fourth day the consistency of the gingiva became friable, mobility appeared in the lower incisors. Complex index of inflammation in animals of the main group: before the study-9, on the 7th day-195. Gingival preparations showed signs of exudative inflammation. In alveolar processes-irreversible resorption of bone structures. The difference of indicators in animals before and after the experiment was statistically significant (p < 0.05). The new experimental model of periodontitis is reproduced in a short period of time, provides intensive development of inflammation, leads to disruption of the integrity of epithelial and connective tissue attachment, destruction of alveolar bone.

Coffee consumption and periodontitis: a Mendelian Randomization study

BackgroundCoffee is one of the most consumed beverages in the world, coffee consumption has been growing in the United States over the past 20 years. Periodontitis is defined by the pathologic loss of the periodontal ligament and destruction of the connective tissue attachment and alveolar bone loss and is related to different systemic diseases and conditions. However, the causality has remained unclarified, thus we regarded discovering the causal relationship between coffee consumption and the liability to periodontitis as the objective of the study.MethodsCoffee consumption was subdivided into binary coffee consumption and continuous coffee consumption to refine the study design. Genetic instruments were stretched from the MRC-IEU’s (MRC Integrative Epidemiology Unit) output from the GWAS pipeline using phesant-derived variables based on the UK Biobank, the Gene-Lifestyle Interactions in Dental Endpoints (GLIDE) project, and the joint meta-analysis of a recent GWAS. The IVW (Inverse Variance Weighted) was regarded as the primary method to estimate the causality, a scatter plot revealed the intuitive result, and tests for stability were also carried out.ResultsAn effect of continuous coffee consumption on the risk of periodontitis was found, with per SD of coffee consumed increases, the risk of periodontitis rises by 1.04% (Odds Ratio of IVW is 1.0104), while the effect of binary coffee consumption on periodontitis did not meet the requirement of indicating a strong causal association, neither were the reverse causality analyses.ConclusionsThe study indicated the causality of continuous coffee consumption to the risk of periodontitis with a relatively small scale of effect estimate and no strong evidence for an effect of binary coffee-consuming behavior on periodontitis. There was also no intensive evidence suggesting reverse causality.

Surgical Anatomy of the Ligamentous Attachments in the Superoposterior Scalp Region.

Hairline-lowering surgery has become increasingly popular in recent years, but little investigation into the surgical anatomy of the scalp has been performed. The aim of this study was to describe findings based on clinical observation and anatomic study of ligamentous attachments in the superoposterior region of the scalp. Six fresh cadaveric heads were dissected to identify connective tissue structures in the superoposterior scalp region. The areas of interest were along the sagittal suture towards the lambda, the obelion, and around the lambdoid suture. The location and dimensions of identified connective tissue attachments were documented with reference to described skeletal landmarks. Three distinct structures could be identified: (1) a cylindrical structure that sits at the posterior end of the sagittal suture with the parietal foramina in its base. This ligamentous structure extends from the pericranium into the galea, causes dimpling in the skin, and contains emissary veins. As this fulfills the criteria for an osseocutaneous retaining ligament, the term "cranial retaining ligament" is proposed. (2) Anterior to this ligament a connective tissue thickening was identified running along the sagittal suture and blending into the ligament, for which the term "sagittal adhesion" is proposed. (3) Another adhesion was identified just superior to the lambdoid suture, posterior to the retaining ligament, for which the term "supralambdoid adhesion" is proposed. Identification and better understanding of ligamentous structures in the superoposterior scalp allows for a safer and more effective advancement of the scalp in hairline-lowering surgery, which is a benefit to both patients and surgeons.

Differences in levels of bone morphogenetic protein-2 in periodontitis patients with and without type 2 diabetes mellitus

Periodontitis is characterized by gingival bleeding, periodontal pocket formation, damage to the connective tissue attachment, and alveolar bone resorption. One of the risk factors that can increase the occurrence of periodontitis is diabetes mellitus (DM). In Indonesia, the incidence and prevalence of periodontitis are higher in patients with type 2 DM. In the present study, BMP-2 expression in periodontitis patients with and without type 2 DM was evaluated. We performed a descriptive analytical cross-sectional study in 40 respondents with stages II-III grades B-C chronic periodontitis. They were divided into a chronic periodontitis group with type 2 DM and a chronic periodontitis group without DM. Crevicular fluid of the gingival sulcus of the central maxillary anterior teeth from each respondent was taken using paper points for 5 minutes and placed in an Eppendorf tube. Each tube was labelled according to its group. All of the samples were examined by BMP-2 ELISA kit and measured by BioRad microplate reader with a wavelength of 450 nm. Data were analysed using SPSS 16.0 program. The independent sample t-test was used to compare the BMP-2 among two groups. The results of the study revealed the BMP-2 level in periodontitis patients with type 2 DM was 63.1 pg/ml, while in periodontitis patients without DM was 66.8 pg/ml. BMP-2 levels in periodontitis patients with type 2 DM were significantly lower than those in periodontitis patients without DM (p &lt; 0.05).

Exploring the Biological Width in Dentistry: A Comprehensive Narrative Review.

Biological width (BW) is the distance established from the junctional epithelium and connective tissue attachment to the root surface of a tooth. It acts as a natural seal protecting the tooth from infections and diseases. The normal dimension of it is 2.04 mm on average. A periodontal probe is used to determine BW in routine clinical practice. Various methods are available for the determination of BW. A diagnosis of BW violation is asserted when the distance is found to be less than 2 mm at single or multiple locations. Gingival health is of utmost importance when considering the long-term health of the tooth as well as any restoration. A plethora of BW violations can lead to a myriad of complications, which are discussed briefly in this article. The article also aims to highlight BW in relation to restorative margins and implantsand its clinical assessment as well as shed light on the procedure that can be employed to correct BW violations in dental practice.

Scanning electron microscopy study to evaluate and compare fibrin clot adhesion over the root surface treated with tetracycline, doxycycline and minocycline.

Periodontitis is an inflammatory disease caused by a group of specific microorganisms that provoke the destruction of the periodontal ligament and the alveolar bone, along with pocket formation or recession, or both. The present study aimed to compare the efficacy of tetracycline, doxycycline and minocycline in improving fibrin clot adhesion over manually instrumented periodontally affected root surfaces with the use of scanning electron microscopy (SEM). A total of 45 single-rooted extracted teeth were sectioned into 45 dentinal blocks and divided into 3 groups: tetracycline (group I); doxycycline (group II); and minocycline (group III). A drop of blood was added over the dentinal blocks, allowed to clot, and later rinsed with phosphatebuffered saline (PBS),1% formaldehyde, and 0.02% glycine. Then, the surfaces were post-fixed in 2.5% glutaraldehyde and dehydrated in a graded ethanol series of 30%, 50%, 75%, 90%, 95%, and 100%. Afterward, the samples were examined under a SEM to assess fibrin clot adhesion and the number of blood cells. Minocycline demonstrated better fibrin clot adhesion, followed by tetracycline and doxycycline. Statistical significance was observed at ×2,000 magnification (p = 0.021), whereas no significance was noted at ×5,000 magnification. Dentinal blocks treated with minocycline had a better fibrin network and a greater number of entrapped erythrocytes, which is vital in the early wound-healing process leading to the formation of connective tissue attachment.

Ligaplants: A Natural Implant: Myth or Hope?: A Literature Review

The aim of this study was to gain knowledge about ligaplants which is a recent advancement in the field of implant dentistry. Dental implants are being increasingly used to replace missing teeth among individuals. Regeneration of periodontal ligament (PDL) attachment around implants is under consideration to overcome the shortcomings of osseointegrated implants, and it is now emerging as a new beneficial method for replacing missing teeth. In the last few years, tissue engineering has led to the formation of a PDL around the dental implant called “ligaplants.” Various studies have been carried out in vitro and on test animals. These studies have shown that PDL cells have great potential for regeneration and re-establish connective tissue attachment. The various cells contained in the PDL play a crucial role in the optimal functionality of the tooth bone apparatus. This review article features the advantages and benefits of dental implants when combined with the PDL in comparison with conventional osseointegrated implants. Ligaplants are prepared by combining the biomaterial used in conventional implants with the PDL cells, which provides better biological performance and increases the lifespan of the prosthesis.

Regenerative Potential of Bone Morphogenetic Protein 7-Engineered Mesenchymal Stem Cells in Ligature-Induced Periodontitis.

Periodontitis is an oral disease caused by bacterial infection that has stages according to the severity of tissue destruction. The advanced stage of periodontitis presents irreversible destruction of soft and hard tissues, which finally results in loss of teeth. When conventional treatment modalities show limited results, tissue regeneration therapy is required in patients with advanced periodontitis. In the present study, we aimed to evaluate the effect of bone marrow-derived mesenchymal stem cells (BM-MSCs) delivering bone morphogenetic protein 7 (BMP7) on tissue regeneration in a periodontitis model. BMP7 is a member of the BMP family that shows bone-forming ability; however, BMPs rapid clearing and degradation and unproven efficacy make it difficult to apply it in clinical dentistry. To overcome this, we established BMP7-expressing engineered BM-MSCs (BMP7-eBMSCs) that showed superior osteogenic differentiation potential when subcutaneously transplanted with a biphasic calcium phosphate scaffold into immunocompromised mice. Furthermore, the efficacy of BMP7-eBMSC transplantation for periodontal tissue regeneration was evaluated in a rat ligature-induced periodontitis model. Upon measuring two-dimensional and three-dimensional amounts of regenerated alveolar bone using microcomputed tomography, the amounts were found to be significantly higher in the BMP7-eBMSC transplantation group than in the eBMSC transplantation group. Most importantly, fibrous periodontal ligament (PDL) tissue regeneration was also achieved upon BMP7-eBMSC transplantation, which was evaluated by calculating the modified relative connective tissue attachment. The amount of connective tissue attachment in the BMP7-eBMSC transplantation group was significantly higher than that in the ligature-induced periodontitis group, although the increase was comparable between the BMP7-eBMSC and human PDL stem cell transplantation groups. Taken together, our results suggested that sustainable release of BMP7 induces periodontal tissue regeneration and that transplantation of BMP7-eBMSCs is a feasible treatment option for periodontal regeneration. Impact Statement Periodontitis is the second most common human dental disease affecting chronic systemic diseases. Despite the tremendous efforts trying to cure the damaged periodontal tissues using tissue engineering technologies, a definitive regenerative method has not been in consensus. Researchers are seeking more feasible and abundant source of mesenchymal stem cells (MSCs), and furthermore, how to use reliable growth factors under more efficient control are the issues to be solved. In this study, we aimed to evaluate the effect of bone morphogenetic protein 7 (BMP7) gene delivering bone marrow-derived MSCs on periodontal tissue regeneration to evaluate the efficacy of BMP7 and engineered BMSCs for periodontal tissue regeneration.

An Overview of Gingival Diseases in Childhood

The restoration of GH post-treatment for gingivitis or periodontitis is critical, and specific diagnostic criteria are outlined for these conditions. Importantly, even patients with a history of well-managed periodontitis remain at risk for recurrence, necessitating vigilant monitoring and management. Gingivitis, commonly observed in children and teenagers, is a reversible inflammatory condition of the gingival tissue (GT) that does not involve clinical attachment loss (CAL). It serves as a precursor to more severe periodontal diseases characterized by the loss of connective tissue attachment and bone. Controlling gingival inflammation is key to preventing periodontitis and its recurrence. The etiology of childhood gingival diseases is multifactorial, with factors like poor oral hygiene, sugary diets, limited dental care access, and systemic conditions such as diabetes and immunodeficiency playing significant roles. Clinicians must effectively manage gingivitis across all age groups, recognizing the broad categories of gingival diseases: dental plaque biofilm-induced gingivitis and non-dental-plaque-induced gingival diseases.

Quantifying red complex bacteria, oral hygiene condition, and inflammation status in elderly: A pilot study

IntroductionPeriodontitis is an inflammation of the periodontal apparatus leads to destruction of connective tissue attachment and tooth loss. Red complex bacteria may contribute to disease initiation. Bacterial infection in periodontitis leads to a low-grade chronic infection and inflammation in distant organs. Notably, aging can affect the immune response. ObjectivesThe aim of this study was to analyze the effect of aging on oral hygiene and inflammation condition. Moreover, to evaluate the correlation between the oral hygiene condition and red complex bacterial load in subgingival plaque. Materials and methodsIn this cross-sectional study, we examined 20 adult and 20 elderly subjects with periodontitis. Clinical parameters included Oral Hygiene Index Simplified (OHI-S) and Papillary Bleeding Index (PBI) were recorded. Subgingival plaque was collected from the tooth with a probing depth of 5–7 mm and analyzed with a reverse transcription polymerase chain reaction (RT-PCR) for red complex bacteria quantification. Statistical analysis was performed, respectively. ResultsBoth groups had poor oral hygiene conditions, reflected by high OHI-S and PBI. The quantity of red complex bacteria (P. gingivalis, T. denticola, T. forsythia) in the elderly group was significantly higher in comparison to the adult group. There was significant strong linear relationship between OHI-S and red complex bacteria (r < 1, p < 0.05). Only P. gingivalis bacteria with PBI values had a strong linear relationship and statistically significant. (r < 1, p < 0.05). P. gingivalisload was significantly higher than T. denticola and T. forsythia load, and it correlated with poor oral hygiene in the adult and elderly groups and with PBI in the elderly group. ConclusionsAging affects to the red complex bacterial load and oral hygiene condition, but not the inflammation. These findings contribute to the development of novel treatment strategies focusing on bacterial aspect for periodontitis in the elderly.