Severe Alveolar Bone Resorption Research Articles

Neutral zone and alveolar relation consideration for fabricating complete denture in a patient with severe alveolar bone resorption: a case report

Neutral zone and alveolar relation consideration for fabricating complete denture in a patient with severe alveolar bone resorption: a case report

Prosthetic Treatment Strategies for Improving Denture Retention in Pediatric Patients with Hypohidrotic Ectodermal Dysplasia: a Report of Two Cases

This report presents two cases concerning strategies for improving denture retention in pediatric patients with oligodontia caused by hypohidrotic ectodermal dysplasia (HED). Both patients presented with multiple missing teeth, conical canines, alveolar bone atrophy, and a skeletal Class III tendency. In the first case, a modified form of conical-crown-retained denture was used to cover the canines. This approach was carried out without tooth extraction or coping. In the second case of severe alveolar bone resorption and a distally tilted lower left canine, the tooth was restored with a hybrid ceramic crown. It was subsequently converted into a clasp-retained removable partial denture, utilizing a suction mechanism. Both patients are currently receiving regular check-ups for the maintenance of their prosthetic appliances and the evaluation of their growth patterns. This study presents innovative prosthetic treatment methods for pediatric patients with HED who have inadequate denture retention.

Mice Lacking PLAP-1/Asporin Show Alteration of Periodontal Ligament Structures and Acceleration of Bone Loss in Periodontitis.

Periodontal ligament-associated protein 1 (PLAP-1), also known as Asporin, is an extracellular matrix protein expressed in the periodontal ligament and plays a crucial role in periodontal tissue homeostasis. Our previous research demonstrated that PLAP-1 may inhibit TLR2/4-mediated inflammatory responses, thereby exerting a protective function against periodontitis. However, the precise roles of PLAP-1 in the periodontal ligament (PDL) and its relationship to periodontitis have not been fully explored. In this study, we employed PLAP-1 knockout mice to investigate its roles and contributions to PDL tissue and function in a ligature-induced periodontitis model. Mandibular bone samples were collected from 10-week-old male C57BL/6 (WT) and PLAP-1 knockout (KO) mice. These samples were analyzed through micro-computed tomography (μCT) scanning, hematoxylin and eosin (HE) staining, picrosirius red staining, and fluorescence immunostaining using antibodies targeting extracellular matrix proteins. Additionally, the structure of the PDL collagen fibrils was examined using transmission electron microscopy (TEM). We also conducted tooth extraction and ligature-induced periodontitis models using both wild-type and PLAP-1 KO mice. PLAP-1 KO mice did not exhibit any changes in alveolar bone resorption up to the age of 10 weeks, but they did display an enlarged PDL space, as confirmed by μCT and histological analyses. Fluorescence immunostaining revealed increased expression of extracellular matrix proteins, including Col3, BGN, and DCN, in the PDL tissues of PLAP-1 KO mice. TEM analysis demonstrated an increase in collagen diameter within the PDL of PLAP-1 KO mice. In line with these findings, the maximum stress required for tooth extraction was significantly lower in PLAP-1 KO mice in the tooth extraction model compared to WT mice (13.89 N ± 1.34 and 16.51 N ± 1.31, respectively). In the ligature-induced periodontitis model, PLAP-1 knockout resulted in highly severe alveolar bone resorption, with a higher number of collagen fiber bundle tears and significantly more osteoclasts in the periodontium. Our results demonstrate that mice lacking PLAP-1/Asporin show alteration of periodontal ligament structures and acceleration of bone loss in periodontitis. This underscores the significant role of PLAP-1 in maintaining collagen fibrils in the PDL and suggests the potential of PLAP-1 as a therapeutic target for periodontal diseases.

Postoperative Outcomes in the Surgical Rehabilitation of Alveolar Bone in Implant-Prosthetic Therapy: A Review

Surgical rehabilitation of the muco-osseous support in edentulous patients with severe alveolar bone resorption is a challenging stage for the specialists in implant-prosthetics and oral surgery. Various biomaterials including autogenic, allogenic, xenografts, and synthetic biomaterials are considered on-the-board options for implant-prosthetic therapy. The selection of the bone graft must consider the systemic status, the osteogenic potential of the recipient site, and the available growth time of the new bone. A large range of alveolar bone reconstruction techniques is available to implantologist or oral surgeon: guided bone regeneration (GBR), vertical/horizontal augmentation by onlay blocks, distraction osteogenesis, alveolar ridge splitting techniques, bone expansion techniques) Various research groups reported the bone gain both in vertical and horizontal augmentation techniques by xenografts. Lateral bone augmentation techniques were recommended in post-extraction areas. The potential of the vertical augmentation procedures was highlighted but the long-term success depends on clinician’ experience level. Various factors that can influence the implant success/failure rate when implants were placed in alveolar bone areas after reconstruction by grafting materials. The main factor responsible for the absence of graft integration, its migration, and the absence of implant integration in the grafted area is represented by the poor execution of the surgical technique and graft migration because of poor vascularization in the grafted area.

MiR-27a-5p alleviates periodontal inflammation by targeting phosphatase and tensin homolog deleted on chromosome ten.

MicroRNAs (miRNAs), a type of non-coding RNA, have been demonstrated to be essential posttranscriptional modulators in oral diseases and inflammatory responses. However, the specific role of miR-27a-5p in periodontitis requires further investigation. In this study, we used both cellular and animal models to determine how miR-27a-5p affects the pathogenesis of periodontitis and its associated biological functions. Quantitative real-time polymerase chain reaction and western blotting were used to analyze the expression of cytokines, phosphatase and tensin homolog deleted on chromosome ten (PTEN), and miR-27a-5p transcription. Investigation of alveolar bone resorption and inflammation of the periodontium in ligature-induced periodontitis in mice was performed using micro-computed tomography (micro-CT), hematoxylin-eosin (HE) staining, and tartrate-resistant acid phosphatase (TRAP) staining. The binding of miR-27a-5p and PTEN was predicted using the TargetScan database and experimentally confirmed using dual luciferase reporter gene assays. The inflamed gingiva showed lower levels of miR-27a-5p. Macrophages from miR-27a-5p-/- mice produced much higher quantities of pro-inflammatory cytokines owing to the stimulation of Porphyromonas gingivalis lipopolysaccharide, and miR-27a-5p-/- mice with ligature-induced periodontitis also exhibited more severe alveolar bone resorption and damage to the periodontium. Target validation assays identified PTEN as a direct target of bona. Blocking PTEN expression partially reduced inflammation, both in vitro and in vivo. miR-27a-5p alleviated the inflammatory response in periodontitis by targeting PTEN.

Severe alveolar bone resorption in Felty syndrome: a case report

BackgroundFelty syndrome is defined by three conditions: neutropenia, rheumatoid arthritis, and splenomegaly. Neutropenia associated with pancytopenia may further affect the dental condition of a patient. Periodontal treatment and surgery in patients with Felty syndrome necessitates cooperation with a hematologist. Here we present a case of a patient with Felty syndrome who was initially referred to the oral surgery hospital attached to the School of Dentistry for extensive periodontitis. She was effectively treated in collaboration with the hematology department.Case presentationA 55-year-old Asian woman visited our department with concerns of worsening tooth mobility, discomfort, and spontaneous gingival bleeding. Initial periodontal examination revealed generalized severe periodontitis (Stage IV Grade C) resulting from leukopenia/neutropenia and poor oral hygiene. A thorough treatment strategy involving comprehensive dental procedures, such as multiple extractions and extensive prosthetic treatment, was implemented. Following the diagnosis of Felty syndrome, the patient was started on treatment with oral prednisolone 40 mg/day, which effectively controlled the disease. Furthermore, there was no recurrence of severe periodontitis after the periodontal treatment.ConclusionsDentists and physicians should be aware that immunocompromised individuals with pancytopenia and poor oral hygiene are at risk of developing extensive periodontitis. If their susceptibility to infection and pancytopenia-related bleeding can be managed, such patients can still receive comprehensive dental treatment, including teeth extractions and periodontal therapy. Cooperation among the dentist, hematologist, and patient is necessary to improve treatment outcomes and the patient’s quality of life.

Unloading of occlusal force aggravates alveolar bone loss in periodontitis.

Periodontitis (PD), a chronic infectious inflammatory disease initiated by bacteria, is associated with several local contributing factors including occlusal trauma. Previous studies have found that the traumatic occlusal force could aggravate alveolar bone loss during PD. However, the effect of reduced occlusal force during PD remains unclear. This study aimed to explore the effect of occlusal force unloading on PD onset and progression and its underlying mechanism as an effort to provide restoration suggestions for PD patients with dentition defect in clinic. This study might also propose occlusal force unloading could be a new local contributing factor for PD. C57BL/6 mice were used to establish a PD model by the ligation of 5-0 silk around the mandibular left first molar (PD group) and an unloading experiment model by the extraction of their left maxillary first molar (EX group). The THP-1-derived macrophages were used to verify in vivo results. Micro-CT scanning and H&E staining results consistently showed that PD + EX group experienced the most severe alveolar bone resorption as compared to PD group and control group. Further RNA-sequencing analysis suggested that occlusal force unloading significantly enhanced osteoclastic resorption, inhibited osteoblastic activity, and promotes M1 and M2 macrophages polarization. Immunofluorescence staining (IF) results showed that compared with the PD group, PD + EX group significantly increased the ratio of M1/M2 polarization. Similar results were observed by RT-qPCR and IF in vitro: removal of compressive force led to an increased ratio of M1/M2 polarization in LPS-stimulated THP-1-derived macrophages. Our study demonstrated that occlusal force unloading aggravates bone resorption by increasing the ratio of M1/M2 macrophages polarization during PD, suggesting a previously unknown local contributing factor for PD, and providinga novel insight for dentists to restore missing teeth as an effort to maintain remaining dentition.

TLR9 Mediates Periodontal Aging by Fostering Senescence and Inflammaging

TLR9 is a critical nucleic acid sensing receptor in mediating periodontitis and periodontitis-associated comorbidities. Emerging evidence implicates TLR9 as a key sensor during aging, although its participation in periodontal aging is unexplored. Here, we investigated whether TLR9-mediated host responses can promote key hallmarks of aging, inflammaging, and senescence, in the course of periodontitis using a multipronged approach comprising clinical and preclinical studies. In a case-control model, we found increased TLR9 gene expression in gingival tissues of older (≥55 y) subjects with periodontitis compared to older healthy subjects as well as those who are younger (<55 y old) with and without the disease. Mechanistically, this finding was supported by an in vivo model in which wild-type (WT) and TLR9–/– mice were followed for 8 to 10 wk (young) and 18 to 22 mo (aged). In this longitudinal model, aged WT mice developed severe alveolar bone resorption when compared to their younger counterpart, whereas aged TLR9–/– animals presented insignificant bone loss when compared to the younger groups. In parallel, a boosted inflammaging milieu exhibiting higher expression of inflammatory/osteoclast mediators (Il-6, Rankl, Cxcl8) and danger signals (S100A8, S100A9) was noted in gingival tissues of aged WT mice compared to the those of aged TLR9–/– mice. Consistently, WT aged mice displayed an increase in prosenescence balance as measured by p16 INK4a /p19 ARF ratio compared to the younger groups and aged TLR9–/– animals. Ex vivo experiments with bone marrow–derived macrophages primed by TLR9 ligand (ODN 1668) further corroborated in vivo and clinical data and showed enhanced inflammatory-senescence circuit followed by increased osteoclast differentiation. Together, these findings reveal first systematic evidence implicating TLR9 as one of the drivers of periodontitis during aging and functioning by boosting a deleterious inflammaging/senescence environment. This finding calls for further investigations to determine whether targeting TLR9 will improve periodontal health in an aging population.

Long-term Prognosis of Guided Implant Placement After Ridge Preservation using Platelet-rich Fibrin Membrane: A Case Report

In the case of tooth extraction due to severe alveolar bone resorption, extensive bone grafting is often required, making implant treatment difficult and increasing the overall treatment time. We report the long-term prognosis of two cases in which these issues were successfully resolved. To reduce the treatment period and difficulty of the procedure, we performed ridge preservation using xenograft materials and platelet-rich fibrin membranes at the time of extraction. After approximately 3 months, we performed implantation using guided implant surgery. This procedure allowed us to shorten the overall treatment period and place the implant in the ideal location with adequate torque, without extensive bone grafting. Furthermore, implants placed using this procedure showed a stable clinical and radiographic prognosis for more than 6 years.

Proposed protocol for treatment of severe periodontitis without platelet transfusion in patients with aplastic anemia: a case report

BackgroundAplastic anemia is an intractable disease characterized by pancytopenia, susceptibility to infection, and difficulty in achieving hemostasis. In patients with severe periodontal disease and aplastic anemia, spontaneous bleeding from the gingival tissue due to thrombocytopenia and during brushing is common, which may further exacerbate dental issues. Comprehensive periodontal treatment for patients with aplastic anemia is highly challenging and requires collaboration with a hematologist. Here, we discuss the case of a patient with aplastic anemia and severe periodontitis who was successfully treated in collaboration with our hematology department.Case presentationA 36-year-old Japanese woman with chief complaints of spontaneous gingival bleeding, pain, and increasing tooth mobility consulted our department. She had developed pancytopenia at age 11 years and was later diagnosed with aplastic anemia, making her susceptible to infection due to leukopenia. The results of the initial periodontal examination led to a diagnosis of severe generalized periodontitis (generalized stage IV grade C periodontitis) caused by leukopenia and poor oral hygiene. We adopted a comprehensive treatment plan, including invasive dental procedures. The patient exhibited no postoperative bleeding due to aplastic anemia-induced thrombocytopenia and experienced a good outcome.ConclusionsBoth physicians and dentists should be aware that immunocompromised patients with aplastic anemia are at risk of developing severe periodontitis with severe alveolar bone resorption if the condition is combined with poor oral hygiene. Even in the presence of aplastic anemia, patients with severe periodontitis can undergo comprehensive dental treatment, including dental extraction and periodontal surgery, if bleeding and susceptibility to infection are controlled. This requires the cooperation of the patient and hematologists and can ultimately contribute to improving the patient’s quality of life.

A fixed reconstruction of fully edentulous patients with immediate function using an apically tapered implant design: a retrospective clinical study

BackgroundImmediate function has become an accepted treatment modality for fixed restorations in completely edentulous jaws. It is known that implant microtopography (surface) may enhance osseointegration, while implant macrotopography (macrodesign) plays an important role in primary stability in the patient requiring an immediate loading. The aim of this retrospective study was to evaluate the clinical and radiographic outcomes of the edentulous subjects treated with narrow and/or regular diameter, which placed and loaded immediately.MethodsForty-two consecutive patients received 171 implants, including regular and narrow diameter implants (NDIs). Each jaw, 19 mandibles and 24 maxillae, was treated with a fixed-full arch prosthesis according to the Straumann® Pro Arch concept. The majority (95%) of the restorations were supported by four implants, of which the posterior two implants were tilted. A provisional functional acrylic prosthesis was delivered on the day of surgery. All patients were followed up to 55 months. Cumulative survival rate was determined using Kaplan-Meier analysis. Radiological measurement of marginal bone level was performed.ResultsThe overall follow-up time for survival rate was up to 55 months. Four implants (3 implants in maxilla, 1 implant in mandible) were lost, resulting in an overall cumulative implant survival rate of 97.7%. Implant survival rate in the axial and tilted implants was not statistically significant. The mean of interproximal marginal bone loss was 0.15 mm after 24 months. Good soft tissue health was observed in almost 99% of patients. The final prosthesis survival rate was 100%.ConclusionsThe results of this retrospective pilot study indicated that total edentulous patients requiring an immediate implant placement and loading can be successfully treated with this implant design. The improved mechanical properties of these implants might give a more conservative treatment option for the jaws showing a severe horizontal alveolar bone resorption.

Effectiveness of strontium-doped brushite, bovine-derived hydroxyapatite and synthetic hydroxyapatite in rabbit sinus augmentation with simultaneous implant installation.

Various bone substitutes have been applied in sinus augmentation (SA) to overcome insufficient bone height at the posterior maxilla region caused by pneumatized sinus and severe alveolar bone resorption after teeth loss. However, their effectiveness in SA needs to be further elucidated. In this study, strontium-doped brushite (Sr-DCPD), a new bone substitute, together with bovine-derived hydroxyapatite (bHA) and synthetic hydroxyapatite (sHA) was used in rabbit maxillary SA with simultaneous implant installation. The sinus space-keeping capacity, resorption rate, osteoconductivity, and mechanical properties of regenerated bone, were evaluated by micro-computed tomography (CT), histological analysis, and mechanical testing. Sr-DCPD exhibited the best osteoconductivity and new bone formation (<4 weeks), but its final bone regeneration and removal torque of implants at week 12 were the lowest, mainly due to its poor space-keeping capacity and fast resorption. bHA exhibited the best space-keeping capacity and slowest resorption rate, but relative lower final bone volume and mechanical properties, while sHA showed good space-keeping capacity, slower resorption rate, and the best final bone formation and mechanical properties. sHA was most effective for SA and bHA was also an acceptable bone substitute; however, Sr-DCPD was least effective and not suitable in SA by itself.

Cystathionine gamma-lyase aggravates periodontal damage in traumatic occlusion mouse models.

Though impacts of traumatic occlusion (TO) on periodontal tissues and roles of cystathionine γ-lyase (Cth) gene in the regulation of bone homeostasis have been studied by many, no consensus has been reached so far on whether TO deteriorates the periodontium and precise roles of Cth in occlusal trauma. Therefore, this study aims to investigate the impacts of TO on periodontal tissues and the involvement of Cth gene. Eighty C57BL/6 wild-type (WT) mice and Cth knockout (Cth-/- ) mice, 8weeks old, were used in this study. The TO model was established using composite resin bonding on the left maxillary molar for one, two, and three weeks, respectively. Morphological and histological changes in the periodontium were assessed by micro-computed tomography (micro-CT), hematoxylin and eosin (H&E) staining, and tartrate-resistant acid phosphatase (TRAP) staining. Osteoclast-related genes were analyzed by real-time polymerase chain reaction (qPCR). It was found that decreased alveolar bone height, expanded bone resorption area, and increased width of periodontal ligament (PDL) occurred in TO models, accompanied by an increased number of osteoclasts in a time-dependent manner by micro-CT and histological staining. Osteoclast-related genes including Ctsk, Mmp9, Rank, Trap, and Rankl/Opg were also up-regulated after one week of modeling. The up-regulated expressions of Cth gene and its protein CTH were observed in TO mouse models. After 1, 2, or 3weeks of modeling, WT mice showed more severe alveolar bone resorption, wider PDL, higher osteoclast count, and higher levels of osteoclast-related genes Ctsk, Rank, and Rankl/Opg than Cth-/- mice. TO causes a reduction in alveolar bone height and PDL morphological disorder with their severity increases in a time-dependent manner. Cth aggravates periodontal damage caused by TO.

One-step treatment of periodontitis based on a core-shell micelle-in-nanofiber membrane with time-programmed drug release

As a chronic inflammatory disease, periodontitis is responsible for irreversible soft tissue damage and severe alveolar bone resorption. However, curative effects of current therapies are largely confined by the difficulty to simultaneously achieve anti-inflammation and bone regeneration. Also, the dynamic environment in oral cavity easily causes the drugs swallowed or rinsed away by saliva. We report here a one-step treatment based on a core-shell nanofiber membrane fabricated by coaxial electrospinning. Polymeric micelles containing SP600125 were distributed in the shell, while BMP-2 was incorporated in the core. After crosslinking, the nanofiber membrane displayed a prolonged degradation and release period up to 4 weeks. The release of SP600125 was detected at beginning, whereas BMP-2 was not released until day 12. Such a time-programmed release behavior was proved desirable for suppressing the expression of pro-inflammatory factors and enhancing the osteogenic induction in vitro. Further in vivo investigation confirmed that, by simply covering the periodontitis site with our nanofiber membrane, alveolar destruction was largely avoided and bone defects recovered within 2 month. Taken together, we believe that the use of our membrane with sequential release of SP600125 and BMP-2 may become a convenient and highly comprehensive therapy for periodontitis.

Complete denture rehabilitation of edentulous patient with severe alveolar bone resorption and condyle fracture using gothic arch tracing and closed mouth impression technique: A case report

Complete denture rehabilitation of edentulous patient with severe alveolar bone resorption and condyle fracture using gothic arch tracing and closed mouth impression technique: A case report

Involvement of CCR5 in bone resorption associated to apical periodontitis

Abstract The involvement of Cysteine-cysteine chemokine receptor 5 (CCR5) in the protection or stimulation of bone resorption associated with apical periodontitis that occur as consequence of endodontic infection has not yet been elucidated. The present study proposes to characterize the involvement of CCR5 in the genesis and progression of apical periodontitis, using animals deficient for this molecule. Experimental induction of periapical lesions was performed in CCR5 −/− (knockout) or wild type transgenic mice through the coronary opening of the lower 1st molars and exposure of the root canals to the oral environment for their contamination. After the death of the animals (at 0, 7, 21 and 42 days), the samples obtained in different experimental periods were evaluated by conventional microscopy and fluorescence (morphometry and characterization of the lesions), histoenzimology (TRAP for osteoclasts), immunohistochemistry, immunofluorescence and real-time PCR, to characterize the inflammatory cell in the presence or absence of CCR5 (neutrophils, macrophages and CD4 and CD8 lymphocytes), expression of cytokines (IL-1±, TNF-±, IFN-³, IL 4, IL-6 and IL-10), their ligands (RANTES and MIP- 1±) and factors involved in bone formation and resorption (RUNX2, NFATc1, ALP, RANK, RANKL, OPG and cathepsin K) and infection of tissues. Our results shows that CCR5 knockout mice developed more extense and severe inflammation and alveolar bone destruction at periapical region at 21 and 42 days after endodontic infection. It was concluded that CCR5 deficiency results in development of more severe periapical alveolar bone resorption associated to endodontic infection.

Advanced glycation end-product 2 and Porphyromonas gingivalis lipopolysaccharide increase sclerostin expression in mouse osteocyte-like cells

Sclerostin is a secreted glycoprotein that is mainly expressed in osteocytes, exerts negative effects on bone formation, and is present at elevated levels in diabetes mellitus (DM). Periodontitis is an infectious disease caused by periodontopathic bacteria, a complication of DM, and sometimes associated with severe inflammation and alveolar bone resorption. Advanced glycation end-products (AGEs) are a major pathogen in DM complications and adversely influence periodontitis in DM patients. In the present study, the effects of AGE2 and Porphyromonas gingivalis lipopolysaccharide (P-LPS) on the expression of sclerostin in mouse osteocyte-like cells (MLO-Y4-A2 cells) and its function in osteoblast differentiation were investigated. AGE2 and P-LPS up-regulated the expressions of receptor of AGE (RAGE) and Toll-like receptor 2 (TLR2), respectively, and significantly up-regulated that of sclerostin and interleukin 6 (IL-6) in osteocytes. Sclerostin, RAGE and TLR2 levels were synergistically increased by AGE2 and P-LPS. The siRNAs of RAGE and TLR2 significantly inhibited AGE2- and P-LPS-induced sclerostin expression. AGE2 up-regulated sclerostin expression in osteocyte-like cells via the RAGE, ERK and JNK, and NF-κB signal pathways. On the other hand, P-LPS elevated sclerostin levels via the TLR2, JNK and p38, and NF-κB signal pathways. When osteocytes pre-treated with AGE2 and P-LPS and osteoblastic cells (MC3T3-E1) were co-cultured in the medium with a sclerostin-neutralizing antibody, AGE2- and P-LPS-induced decreases in alkaline phosphatase activity and Runx2 expression in osteoblastic cells were significantly inhibited by the sclerostin-neutralizing antibody. These results suggest that AGE2 and P-LPS influence bone metabolism and inflammation through the regulation of sclerostin expression, and may aggravate periodontitis with DM.

Capsular-defective Porphyromonas gingivalis mutant strains induce less alveolar bone resorption than W50 wild-type strain due to a decreased Th1/Th17 immune response and less osteoclast activity.

Encapsulation of Porphyromonas gingivalis has been demonstrated as responsible of several host immunological changes, which have been associated with the pathogenesis of periodontitis. Using a murine model of periodontitis and two isogenic non-capsulated mutants of P. gingivalis, this study aimed to analyze whether P. gingivalis encapsulation induces more severe alveolar bone resorption, and whether this bone loss is associated with a T-helper (Th)1 and Th17-pattern of immune response. Experimental periodontal infections were generated by oral inoculation with the encapsulated W50 wild-type strain or isogenic non-encapsulated ΔPG0116-PG0120 (GPA) and ΔPG0109-PG0118 (GPC) mutants of P. gingivalis. Periodontal infections induced with the encapsulated HG184 or non-encapsulated ATCC 33277 strains of P. gingivalis were used as controls. Alveolar bone resorption was analyzed using microcomputed tomography and scanning electron microscopy. The expression levels of Th1, Th2, Th17, or T regulatory-associated cytokines and RANKL, as well as the periodontal bacterial load, were quantified by quantitative polymerase chain reaction. The detection of Th1 and Th17 lymphocytes was analyzed by flow cytometry. In the periodontal lesions, both capsular-defective knockout mutant strains of P. gingivalis induced less alveolar bone resorption than the encapsulated W50 wild-type strain. This decreased bone loss was associated with a dismissed RANKL expression, decreased Th1- and Th17-type of cytokine expression, reduced Th1 and Th17 lymphocyte detection, and low osteoclast finding. These data demonstrate that encapsulation of P. gingivalis plays a key role in the alveolar bone resorption induced during periodontitis, and this bone loss is associated with a Th1- and Th17-pattern of immune response triggered in the periodontal lesions.

Complete denture rehabilitation of edentulous patient with severe alveolar bone resorption using mandibular suction denture with closed mouth technique: a clinical report

Complete denture rehabilitation of edentulous patient with severe alveolar bone resorption using mandibular suction denture with closed mouth technique: a clinical report

Autogenous bone harvesting from iliac crest and symphysis for implant reconstruction

Horizontal and vertical bone resorption may be seen after tooth loss in the maxilla and mandible. The deficient edentulous ridge may interfere with the insertion of implants of adequate length placed in the correct position and with the ideal inclination. The severe alveolar bone resorption or pneumatisation of the maxillary sinus makes it difficult to perform the conventional dental implantation procedure. Functional implant-supported oral rehabilitation is increasingly being used as a restoration strategy for fully and partially edentulous patients, whenever sufficient bone volume is available. Implant-supported restoration is possible even in severely resorbed jaws using a reconstruction technique with bone augmentation that includes vascularised or nonvascularised bone grafting and tissue regeneration techniques. Standard donor sites for free autogenous bone-graft techniques are: the chin or ramus mandible, the iliac crest, the tibia and the calvaria. Advantages of intraoral mandibular sources include easy access, low morbidity, short healing periods, minimal graft resorption, and maintenance of high bone density; side effects include possible postoperative sensory disturbances and discomfort. Calvaria and iliac crest donor areas are most commonly used in cases of extensive alveolar ridge augmentation. The iliac crest generally supplies large quantities of corticocancellous bone. In this report, we present autogenous bone graft harvesting of 48 patients (40 iliac anterior crest, 8 symphysis) for facial reconstructive surgery.