Dental Soft Tissues Research Articles

Preparation and characterization of nano-emulsion formulations of Asparagus densiflorus root and aerial parts extracts: evaluation of in-vitro antibacterial and anticancer activities of nano-emulsion versus pure plant extract

Objective Preparation and characterization of nano-emulsion formulations for Asparagus densiflorus aerial and root parts extracts. Significance Genus Asparagus is known for its antimicrobial and anticancer activities, however, freeze dried powder of aqueous – alcoholic extract prepared in this study, exhibited a limited water solubility, limiting its therapeutic application. Thus, encapsulation of its phytochemicals into nano-emulsion is proposed as a solution to improve water solubility, and facilitate its clinical translation. Methods the composition of extracts for both aerial and root parts of Asparagus densiflorus was identified by HPLC and LC-MS analysis. Nano-emulsion was prepared via homogenization where a mixture of Castor oil: phosphate buffered saline (10 mM, pH 7.4): Tween 80: PEG 600 in a ratio of 10: 5: 2.5: 2.5, respectively. Nano-emulsion formulations were characterized for particle size, polydispersity index (PDI), zeta potential, TEM, viscosity and pH. Then, the antibacterial and anticancer activities of nano-emulsion formulations versus their pure plant counterparts was assessed. Results The analysis of extracts identified several flavonoids, phenolics, and saponins which were reported to have antimicrobial and anticancer activities. Nano-emulsion formulations were monodispersed with droplet sizes ranging from 80.27 ± 2.05 to 111.16 ± 1.97 nm, and polydispersity index ≤0.3. Nano-emulsion formulations enhanced significantly the antibacterial (multidrug resistant bacteria causing skin and dental soft tissues infections) and anticancer (HuH7, HEPG2, H460 and HCT116) activities compared to their pure plant extract counterparts. Conclusion Employing a nano-delivery system as a carrier for phytochemicals might be an effective strategy to enhance their pharmacological activity, overcome their limitations, and ultimately increase their potential for clinical applications.

Dental Soft Tissues and Palatal Masticatory Mucosa from the Periodontal and Radiographic Perspectives: A Review Article

This review article delves into the advancements in the assessment and management of palatal masticatory mucosa, with a particular emphasis on the thickness of the palatal mucosa and its implications for periodontal and peri-implant surgeries. It highlights the pivotal role of cone beam computed tomography (CBCT) in evaluating Thickening of the palatal mucosa, despite its inherent limitations in soft tissue visualization. The paper discusses the evolution of mucogingival surgery, including the classification of marginal tissue recession and soft tissue grafts, and examines the histology of palatal mucosa. It also evaluates the indications, predictability, and clinical as well as aesthetic outcomes of free gingival graft (FGG) & connective tissue graft (CTG) procedures. Various methodologies to measure palatal mucosa thickness are explored, alongside strategies to overcome CBCT's limitations in soft tissue assessment. The review underscores the significance of a comprehensive understanding of palatal masticatory mucosa's anatomy and histology, alongside the surgical techniques available for managing mucogingival deficiencies. It aims to enhance the predictability and aesthetics of periodontal and peri-implant surgeries through advancements in diagnostic and surgical techniques, coupled with a deeper understanding of tissue biology.

Extracellular matrix remodelling in dental pulp tissue of carious human teeth through the prism of single-cell RNA sequencing

Carious lesions are bacteria-caused destructions of the mineralised dental tissues, marked by the simultaneous activation of immune responses and regenerative events within the soft dental pulp tissue. While major molecular players in tooth decay have been uncovered during the past years, a detailed map of the molecular and cellular landscape of the diseased pulp is still missing. In this study we used single-cell RNA sequencing analysis, supplemented with immunostaining, to generate a comprehensive single-cell atlas of the pulp of carious human teeth. Our data demonstrated modifications in the various cell clusters within the pulp of carious teeth, such as immune cells, mesenchymal stem cells (MSC) and fibroblasts, when compared to the pulp of healthy human teeth. Active immune response in the carious pulp tissue is accompanied by specific changes in the fibroblast and MSC clusters. These changes include the upregulation of genes encoding extracellular matrix (ECM) components, including COL1A1 and Fibronectin (FN1), and the enrichment of the fibroblast cluster with myofibroblasts. The incremental changes in the ECM composition of carious pulp tissues were further confirmed by immunostaining analyses. Assessment of the Fibronectin fibres under mechanical strain conditions showed a significant tension reduction in carious pulp tissues, compared to the healthy ones. The present data demonstrate molecular, cellular and biomechanical alterations in the pulp of human carious teeth, indicative of extensive ECM remodelling, reminiscent of fibrosis observed in other organs. This comprehensive atlas of carious human teeth can facilitate future studies of dental pathologies and enable comparative analyses across diseased organs.

Go Micro Aesthetics: A Cross-Sectional Study to Assess Anterior Hard and Soft Tissue Parameters in Young Adults of Bhopal City.

Background In the maxillary aesthetic zone, the symmetry and proportions of hard and soft dental tissue play a crucial role. A dental practitioner should have a thorough knowledge of parameters such as crown length (CL), crown width (CW), zenith point, and gingival angle (GA) to perform teeth restorations. This study aims to assess the anterior hard and soft tissue parameters and determine the crown shape and its correlation with the gingival parameters of young adults' anterior teeth. Methods In the study, 110 patients were assessed and divided into two groups: Group I with 55 females and Group II with 55 males. Using a calibrated vernier caliper, the following parameters were calculated: crown width (CW)/crown length (CL) ratio, gingival angle (GA), distance from the lateral incisor (LI) to the gingival aesthetic line (GAL), interdental papilla height (PH) between the two central incisors (CI), distance between the central incisor (CI) and the lateral incisor (LI), and distance between LI and canine. Results Statistical analysis of data was performed using the independent samples t-test (P<0.05). The mean value of CW, CL, CW/CL ratio, and GA, along with the distance from LIs to GALs and PHs of the anterior teeth, were lower in females than in males. The correlation between the GA and the CW/CL ratio indicated that higher GAs and CW/CL ratios give teeth a square appearance. Moreover, a lower GA and CW/CL ratio will make teeth appear round ornarrow. Conclusion The present study concluded that the mean values of hard and soft dental tissue parameters are higher in males than in females. These values can be used to restore functional aesthetics in accordance with the results of a local population and could help form restorative, aesthetic, and cosmetic procedures while maintaining focus on the size and shape of teeth and the level of gingiva at various significant treatment stages.

Laser in Dentistry During COVID-19 Pandemic: A Brief Review of Literature

The novel coronavirus causing severe acute respiratory syndrome (SARS-CoV-2) induced a pandemic influencing several countries worldwide; it has also caused serious concerns in dentistry due to its routes of transmission. As compared to the beginning of dental operations, the total microbial load suspended in the air rises more than three times during dental procedures due to the aerosols contained in the saliva, blood, organic tooth particles, bacteria, or viruses. Various types of dental lasers are recognized to be already produced and used in the treatment of hard and soft dental and oral tissues. One of the benefits of the dental laser is its ability to decontaminate surfaces and destroy germs. Dental lasers produce substantially less aerosols and droplets in comparison to high-speed dental headpieces and ultrasonic devices. Therefore, it is beneficial to indicate its influence in reducing the COVID-19 contamination risk, especially in dentistry.

Wnt Signalling in Regenerative Dentistry

Teeth are complex structures where a soft dental pulp tissue is enriched with nerves, vasculature and connective tissue and encased by the cushioning effect of dentin and the protection of a hard enamel in the crown and cementum in the root. Injuries such as trauma or caries can jeopardise these layers of protection and result in pulp exposure, inflammation and infection. Provision of most suitable materials for tooth repair upon injury has been the motivation of dentistry for many decades. Wnt signalling, an evolutionarily conserved pathway, plays key roles during pre- and post-natal development of many organs including the tooth. Mutations in the components of this pathway gives rise to various types of developmental tooth anomalies. Wnt signalling is also fundamental in the response of odontoblasts to injury and repair processes. The complexity of tooth structure has resulted in diverse studies looking at specific compartments or cell types of this organ. This review looks at the current advances in the field of tooth development and regeneration. The objective of the present review is to provide an updated vision on dental biomaterials research, focusing on their biological properties and interactions to act as evidence for their potential use in vital pulp treatment procedures. We discuss the outstanding questions and future directions to make this knowledge more translatable to the clinics.

Perbandingan Intensitas Pewarnaan Ekstrak Buah Terung Belanda (Solanum betaceum Cav) dengan Disclosing Solution Sebagai Bahan Identifikasi Plak Gigi

Background: The dental plaque becomes the main etiology of many hard and soft dental tissue’s problem. The dental plaque has a similar color with the teeth, it can not be seen without a coloring agent. There are two types of coloring used, namely synthetic dyes and natural dyes. Anthocyanin is a natural coloring found in tamarillo that can be used to identify the dental plaque. Methods: This study used a quasi-experimental method with post-test only one group design with independent t-test. The study was conducted in February 2019. Twelve samples were selected based on the inclusion and exclusion criteria. The samples were given two times plaque examination, then the result were recorded in RKP (Plaque Control Record) form. The data analyzed by using SPSS. Results: The average score of plaque control with disclosing solution was 26.93%, while the plaque control score with tamarillo extract was 20.02%. Bivariate test results obtained p=0.037 (p&lt;0.05) which means there is a significant difference between the plaque control scores using disclosing solution and plaque control with tamarillo extract. Conclusion: Tamarillo extract can not be used in the identification of dental plaque, because the color intensity is not as good as the use of disclosing solution.&#x0D; &#x0D; Keywords: dental plaque, disclosing solution, tamarillo extract&#x0D;

Perbandingan Intensitas Pewarnaan Ekstrak Buah Terung Belanda (Solanum betaceum Cav) dengan Disclosing Solution Sebagai Bahan Identifikasi Plak Gigi

Background: The dental plaque becomes the main etiology of many hard and soft dental tissue’s problem. The dental plaque has a similar color with the teeth, it cannot be seen without a coloring agent. There are two types of coloring used, namely synthetic dyes and natural dyes. Anthocyanin is a natural coloring found in tamarillo that can be used to identify the dental plaque. Methods: This study used a quasi-experimental method with post-test only one group design with independent t-test. The study was conducted in February 2019. Twelve samples were selected based on the inclusion and exclusion criteria. The samples were given two times plaque examination, then the result were recorded in RKP (Plaque Control Record) form. The data analyzed by using SPSS. Results: The average score of plaque control with disclosing solution was 26.93%, while the plaque control score with tamarillo extract was 20.02%. Bivariate test results obtained p=0.037 (p&lt;0.05) which means there is a significant difference between the plaque control scores using disclosing solution and plaque control with tamarillo extract. Conclusion: Tamarillo extract cannot be used in the identification of dental plaque, because the color intensity is not as good as the use of disclosing solution.

Contrast-enhanced nano-CT reveals soft dental tissues and cellular layers.

To introduce a methodology designed to simultaneously visualize dental ultrastructures, including cellular and soft tissue components, by utilizing phosphotungstic acid (PTA) as a contrast-enhancement agent. Sound third molars were collected from healthy human adults and fixed in 4% buffered paraformaldehyde. To evaluate the impact of PTA in concentrations of 0.3%, 0.7% and 1% on dental soft and hard tissues for CT imaging, cementum and dentine-pulp sections were cut, dehydrated and stained with immersion periods of 12, 24h, 2days or 5days. The samples were scanned in a high-resolution nano-CT device using pixel sizes down to 0.5µm to examine both the cementum and pulpal regions. Dental cementum and periodontium as well as odontoblasts and predentine were made visible through PTA staining in high-resolution three-dimensional nano-CT scans. Different segments of the tooth required different staining protocols. The thickness of the cementum could be computed over the length of the tooth once it was made visible by the PTA-enhanced contrast, and the attached soft tissue components of the interior of the tooth could be shown on the dentine-pulp interface in greater detail. Three-dimensional illustrations allowed a histology-like visualization of the sections in all orientations with a single scan and easy sample preparation. The segmentation of the sigmoidal dentinal tubules and the surrounding dentine allowed a three-dimensional investigation and quantitative of the dentine composition, such as the tubular lumen or the ratio of the tubular lumen area to the dentinal surface. The staining protocol made it possible to visualize hard tissues along with cellular layers and soft tissues in teeth using a laboratory-based nano-CT technique. The protocol depended on both tissue type and size. This methodology offers enhanced possibilities for the concomitant visualization of soft and hard dental tissues.

Mechanical Removal of the Biofilm: Is the Curette Still the Gold Standard?

The goal of modern periodontal therapy, both during the initial stages and during maintenance, is to create biologically acceptable tooth surfaces through sub- and supragingival cleaning, which enables binding of the connective tissue to the greatest extent possible. In past centuries, the focus of periodontal treatment was on the removal of the supposed cause of periodontal disease, the supra- and supragingival calculus and "infected" root cementum. The findings on the importance of biofilm<A51_FootRef>1</A51_FootRef> (plaque) and the endogenous responses to biofilm metabolism have shifted the therapeutic focus to elimination of the biofilm. The importance of avoiding injury to the hard and soft dental tissue is nowadays of upmost importance. For classical scaling and root planing to remove mineralized deposits and "infected" cementum, only hand instruments were available in the past. The regular, long-term use of these tools is associated with changes in the hard and soft tooth tissues, and with pain and sensitivity experienced by the patient during and after treatment. Modern root-surface debridement primarily uses ultrasound systems to remove hard mineralized deposits. For biofilm management, air polishing devices with low-abrasive powders are increasingly gaining acceptance. With this new technology, biofilm management can now be performed much more effectively and efficiently, using materials more sparingly; this also causes less pain and discomfort for patients during and after treatment, and less fatigue for practitioners. The modern systems allow gentle, optimal biofilm management, whereas the traditional hand instruments (curettes, scalers) and classic rotating instruments used for polishing do not. Current knowledge suggests that these instruments are not best suited for biofilm management.

Resurrection of antibiotics that methicillin-resistant Staphylococcus aureus resists by silver-doped bioactive glass-ceramic microparticles

This work describes a novel strategy to combat methicillin-resistant Staphylococcus aureus (MRSA) via the reactivation of inert antibiotics. This strategy exploits a multifunctional system consisting of bioactive glass–ceramic microparticles with antibacterial properties combined with various antibiotics to kill MRSA. Specifically, sol–gel derived silver-doped bioactive glass–ceramic microparticles (Ag-BG) combined with antibiotics that MRSA resists such as oxacillin or fosfomycin, significantly decreased the viability of MRSA. Ag-BG also potentiated the activity of vancomycin on static bacteria, which are typically resistant to this antibiotic. Notably, the synergistic activity is restricted to cell-envelope acting antibiotics as Ag-BG supplementation did not increase the efficacy of gentamicin. Bacteria viability assays and electron microscopy images demonstrate that Ag-BG synergizes to restore antibacterial activity to antibiotics that MRSA resists. The low cytotoxicity previously studied against oral bacteria, together with the known regenerative properties presented in previous studies, and the unique antibacterial properties observed in this work when they are combined with antibiotics, make this multifunctional system a promising approach for healing infected tissue. Statement of SignificanceThis study addresses a very significant issue in the field of antibiotic resistance presenting an innovative way to clear MRSA, by utilizing bioactive glass–ceramic microparticles in combination with antibiotics. Multifunctional glass–ceramic microparticles doped with silver ions (Ag-BG) have been previously observed to exhibit bioactive and antibacterial properties. In this study Ag-BG microparticles were observed to synergize with antibiotics restoring their sensitivity against MRSA. This research work presents a novel approach to resurrect ineffective antibiotics and render them effective against MRSA. Cytotoxicity to eukaryotic cells is not anticipated, as it has been previously observed that these microparticles can trigger hard and soft dental tissue regeneration, when they are utilized in certain concentrations. This study opens a new avenue in the treatment of multidrug resistance bacteria.

Analysis of The Gingival Biotype Based on The Measurement of Hard and Soft Dental Tissue Dimensions

ABSTRACT Aim: It is to determine the relationship between gingival thickness and (buccal bone thickness, crown length, crown width, papillary height and papillary width) at upper central incisors teeth by means of a noninvasive and relatively accurate digital registration method. Subjects and Methods: In 100 periodontally healthy subjects, cone-beam computed tomographic images were obtained. Measurements of buccal bone thickness and gingival thickness at the central incisors was performed at points 1 mm from the alveolar crest. Correlation coefficient was calculated to assess the correlation between gingival thickness and buccal bone thickness. Results: The mean and standard deviation values were calculated for each group. Pearson correlation was used to find the correlation between Gingival thickness and each of Bone thickness, Crown length, Crown width, Papillary height and Papillary width. Independent sample t-test was used to compare between females and males’ results in each variable. The significance level was set at p ≤ 0.05A statistically significant difference was found between females and males in all variables Gingival thickness, Bone thickness, Crown length, Crown width, Papillary height and Papillary width where (p<0.001), (p<0.001), (p=0.001), (p=0.027), (p=0.036) and (p<0.001) respectively, where females always showed thin type. There was a significant positive relationship between gingival thickness and Bone thickness, which states that increasing gingival thickness will be accompanied by increasing in bone thickness and vice versa. Conclusion: there are significant correlation between the gingival biotype, bone thickness, Crown length, crown width and papilla of anterior incisor crowns and respectively were females always showed thin biotype than males.

Root Resorption Classifications: A Narrative Review and a Clinical Aid Proposal for Routine Assessment.

Root resorption (RR) refers to noninfectious damage related to the loss of hard and soft dental tissue that results from clastic cell activity. It is observed as a pathologic process that is predominantly asymptomatic in the permanent dentition and physiological during the shedding of primary teeth. Roots are protected by unmineralized organic cementoid and predentine. RR occurs because of the inability of the clastic cells to adhere to unmineralized surfaces. Since the first RR classification was described by Andreasen in the 1970s, several classifications have been proposed with diverse terminology. A narrative literature review was undertaken on the current classification, diagnosis, pathophysiology, and treatment of RR. A bibliographic search resulted in 434 titles and abstracts, and from those, 17 articles were obtained that alluded to 15 RR classifications. A total of 28 articles that met the inclusion criteria were included. Results showed that Andreasen’s classification is the most widely used for classifying RR. In terms of epidemiologic data, studies are scarce, although RR pathophysiology is well described in the literature. Overall clinical guidelines are summarized in a new RR classification diagram. The choice of RR treatment application should be in line with the RR type and the dentist’s experience. However, an earlier and correct diagnosis will significantly improve final outcomes and long-term prognosis, especially with the current evolution of advanced imaging techniques, such as cone-beam computed tomography and bioceramic-based endodontic sealers.

Immediate implant placement and loading using fractured lateral incisor and surgirest template

This clinical case report presents a novel laboratory technique to place an angulated implant fixture and fabricate an immediate provisional-fixed implant prosthesis using the patient's own extracted tooth. Preservation of the local hard and soft dental tissues with the immediate prosthesis assists predictability when the clinical situation permits.

Developing a mobile application to better inform patients and enable effective consultation in implant dentistry

The field of dentistry lacks satisfactory tools to help visualize planned procedures and their potential results to patients. Dentists struggle to provide an effective image in their patient's mind of the end results of the planned treatment only through verbal explanations. Thus, verbal explanations alone often cannot adequately help the patients make a treatment decision. Inadequate attempts are frequently made by dentists to sketch the procedure for the patient in an effort to depict the treatment. These attempts however require an artistic ability not all dentists have. Real case photographs are sometimes of help in explaining and illustrating treatments. However, particularly in implant cases, real case photographs are often ineffective and inadequate. The purpose of this study is to develop a mobile application with an effective user interface design to support the dentist–patient interaction by providing the patient with illustrative descriptions of the procedures and the end result. Sketching, paper prototyping, and wire framing were carried out with the actual user's participation. Hard and soft dental tissues were modeled using three dimensional (3D) modeling programs and real cases. The application enhances the presentation to the patients of potential implants and implant supported prosthetic treatments with rich 3D illustrative content. The application was evaluated in terms of perceived ease of use and perceived usefulness through an online survey. The application helps improve the information sharing behavior of dentists to enhance the patients' right to make informed decisions. The paper clearly demonstrates the relevance of interactive communication technologies for dentist–patient communication.

Human tooth and root canal morphology reconstruction using magnetic resonance imaging.

Background and aimsVisualization of the internal and external root canal morphology is very important for a successful endodontic treatment; however, it seems to be difficult considering the small size of the tooth and the complexity of the root canal system. Film-based or digital conventional radiographic techniques as well as cone beam computed tomography provide limited information on the dental pulp anatomy or have harmful effects. A new non-invasive diagnosis tool is magnetic resonance imaging, due to its ability of imaging both hard and soft tissues. The aim of this study was to demonstrate magnetic resonance imaging to be a useful tool for imaging the anatomic conditions of the external and internal root canal morphology for endodontic purposes.MethodsThe endodontic system of one freshly extracted wisdom tooth, chosen for its well-known anatomical variations, was mechanically shaped using a hybrid technique. After its preparation, the tooth was immersed into a recipient with saline solution and magnetic resonance imaged immediately. A Bruker Biospec magnetic resonance imaging scanner operated at 7.04 Tesla and based on Avance III radio frequency technology was used. InVesalius software was employed for the 3D reconstruction of the tooth scanned volume.ResultsThe current ex-vivo experiment shows the accurate 3D volume rendered reconstruction of the internal and external morphology of a human extracted and endodontically treated tooth using a dataset of images acquired by magnetic resonance imaging. The external lingual and vestibular views of the tooth as well as the occlusal view of the pulp chamber, the access cavity, the distal canal opening on the pulp chamber floor, the coronal third of the root canals, the degree of root separation and the apical fusion of the two mesial roots, details of the apical region, root canal curvatures, furcal region and interradicular root grooves could be clearly bordered.ConclusionsMagnetic resonance imaging offers 3D image datasets with more information than the conventional radiographic techniques. Due to its ability of imaging both hard and soft dental tissues, magnetic resonance imaging can be successfully used as a 3D diagnostic imaging technique in dentistry. When choosing the imaging method, dental clinicians should weight the benefit-risk ratio, taking into account the costs associated to magnetic resonance imaging and the harmful effects of ionizing radiations when cone beam computed tomography or conventional x-ray are used.

Stem Cells, Inflammation, and Fibrosis.

Stem Cells, Inflammation, and Fibrosis.

Dental Care in the Frail Older Adult: Special Considerations and Recommendations

Frail older adults disproportionately suffer from untreated dental problems. Age-related biological changes to hard and soft dental tissues, existing medical conditions, polypharmacy, diet and uncontrolled plaque exacerbate the problem. All of these factors increase the complexity of treatment and will differ greatly from standard treatment of younger adults. This article discusses the key considerations and suggestions for risk assessment, disease management, treatment planning and palliative care to maintain the patient's comfort and quality of life.

Applications of X-ray fluorescence analysis (XRF) to dental and medical specimens

Summary Human tissues contain many kinds of minerals and trace essential elements that act as catalytic or structural components of large biochemical molecules. In addition, various metallic and inorganic materials are used in dental and medical materials and devices. In the dental and medical fields, specimens that are wet and/or have low heat resistance are often requested for elemental analysis. Therefore, a rapid and non-destructive method of elemental analysis is required. X-ray fluorescence analysis (XRF) provides useful elemental information about specimens without causing specimen damage or requiring extra specimen preparations. In this paper, an outline of the XRF apparatus and applications of XRF to hard and soft dental and medical specimen tissues are presented, and dental materials are reviewed.

Dental stem cells--characteristics and potential.

Soft dental tissues have been identified as easily accessible sources of multipotent postnatal stem cells. Dental stem cells are mesenchymal stem cells (MSC) capable of differentiating into at least three distinct cell lineages: osteo/odontogenic, adipogenic and neurogenic. They express various markers including those specific for MSC, embryonic stem cells and neural cells. Five different types of dental stem cells have been isolated from mature and immature teeth: dental pulp stem cells, stem cells from exfoliated deciduous teeth, periodontal ligament stem cells, stem cells from apical papilla and dental follicle progenitor cells. Dental stem cells may be used in dental tissue engineering including dental, enamel and periodontal tissue regeneration. They could also be used as a promising tool in potential treatment of neurodegenerative, ischemic and immune diseases.