Recurrent Aphthous Stomatitis Akintoye, Sunday O., BDS, DDS, MS; Greenberg, Martin S., DDS, FDSRCS
The Dental clinics of North America
58, Številka:
2
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Recurrent aphthous stomatitis (RAS) is the most common ulcerative disease affecting the oral mucosa. RAS occurs mostly in healthy individuals and has an atypical clinical presentation in ...immunocompromised individuals. The etiology of RAS is still unknown, but several local, systemic, immunologic, genetic, allergic, nutritional, and microbial factors, as well as immunosuppressive drugs, have been proposed as causative agents. Clinical management of RAS using topical and systemic therapies is based on severity of symptoms and the frequency, size, and number of lesions. The goals of therapy are to decrease pain and ulcer size, promote healing, and decrease the frequency of recurrence.
Objectives Mesenchymal stem cells (MSCs) offer a promising therapy in dentistry because of their multipotent properties. Selecting donor MSCs is crucial because Beagle dogs (canines) commonly used in ...preclinical studies have shown variable outcomes, and it is unclear whether canine MSCs (cMSCs) are skeletal site specific. This study tested whether jaw and long bone cMSCs have disparate in vitro and in vivo multilineage differentiation capabilities. Study Design Primary cMSCs were isolated from the mandible (M-cMSCs) and femur (F-cMSCs) of four healthy Beagle dogs. The femur served as the non-oral control. Clonogenic and proliferative abilities were assessed. In vitro osteogenic, chondrogenic, adipogenic, and neural multilineage differentiation were correlated with in vivo bone regeneration and potential for clinical applications. Results M-cMSCs displayed two-fold increase in clonogenic and proliferative capacities relative to F-cMSCs ( P = .006). M-cMSCs in vitro osteogenesis based on alkaline phosphatase ( P = .04), bone sialoprotein ( P = .05), and osteocalcin ( P = .03), as well as adipogenesis ( P = .007) and chondrogenesis ( P = .009), were relatively higher and correlated with enhanced M-cMSC bone regenerative capacity. Neural expression markers, nestin and βIII-tubulin, were not significantly different. Conclusions The enhanced differentiation and bone regenerative capacity of mandible MSCs may make them favorable donor graft materials for site-specific jaw bone regeneration.
Abstract Introduction Human orofacial bone mesenchymal stem cells (OFMSCs) from maxilla and mandible have robust osteogenic regenerative properties on the basis of our previous reports that ...demonstrate phenotypic and functional differences between jaw and axial bone mesenchymal stem cells in same individuals. Furthermore, a combination of OFMSCs with bioactive calcium-releasing cements can potentially improve OFMSC multilineage differentiation capacity, but biocompatibility of calcium-silicate cements with OFMSCs is still unclear. We tested the hypothesis that material extracts of calcium-releasing calcium-silicate cements support biomimetic microenvironment for survival and differentiation of human OFMSCs. Methods Two experimental calcium-silicate cements, (1) calcium-silicate mineral powder (wTC) containing dicalcium and tricalcium-silicate, calcium sulfate, and calcium chloride and (2) wTC doped with alpha-tricalcium phosphate (wTC-αTCP), were designed and prepared. Cement setting times were assessed by Gilmore needles, ability to release calcium and hydroxyl ions was assessed by potentiometric methods, and OFMSC attachment to calcium-silicate discs was assessed. Calcium-silicate material extracts were tested for ability to support OFMSC survival and in vitro/in vivo differentiation. Results Fewer OFMSCs attached to calcium-silicate discs relative to tissue culture plastic ( P = .001). Extracts of calcium-silicate cements sustained OFMSC survival, maintained steady state levels of vascular cell adhesion molecule-1, alkaline phosphatase, and bone sialoprotein while up-regulating their respective gene transcripts. Adipogenic and in vivo bone regenerative capacities of OFMSCs were also unaffected by calcium-silicate extracts. Conclusions Ion-releasing calcium-silicate cements support a biomimetic microenvironment conducive to survival and differentiation of OFMSCs. Combination of OFMSCs and calcium-silicate cement can potentially promote tissue regeneration in periapical bone defects.
Chemical and Radiation-Associated Jaw Lesions Omolehinwa, Temitope T., BDS; Akintoye, Sunday O., BDS, DDS, MS
The Dental clinics of North America,
2016, January 2016, 2016-Jan, 2016-01-00, 20160101, Letnik:
60, Številka:
1
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Osteonecrosis of the jaw is a major public health concern throughout the world. Use of radiotherapy for head and neck cancer and bone antiresorptives and antiangiogenic agents have increased its ...incidence. Medication-related osteonecrosis of the jaw is more common relative to other types of osteonecrosis. Osteoradionecrosis occurs despite better treatment planning and shielding to minimize collateral damage to bone. Other related necrotic lesions are secondary to usage of recreational drugs and steroids. This article provides comprehensive information about these different types of bone necrosis; provides the readers with radiographic diagnostic criteria and updates on current theories on pathophysiology of osteonecrosis.
McCune–Albright syndrome (MAS) is a rare multisystem disorder characterized by the triad of polyostotic fibrous dysplasia (FD), endocrine disorders, and café-au-lait skin pigmentation. Ninety percent ...of MAS patients have FD lesions in the craniofacial area, resulting in significant orofacial deformity, dental disorders, bone pain, and compromised oral health. Maxillomandibular FD is also associated with dental developmental disorders, malocclusion, and high caries index. There are limited data on the outcomes of dental treatments in maxillomandibular FD/MAS patients, because clinicians and researchers have limited access to patients, and there are concerns that dental surgery may activate quiescent jaw FD lesions to grow aggressively. This report highlights current perspectives on dental management issues associated with maxillomandibular FD within the context of MAS.
Objectives Osteoradionecrosis (ORN) is common in the jaws after radiotherapy. We hypothesized that the mandible is more susceptible to ORN than the tibia, based on site disparity in hypoxic, ...hypocellular, and hypovascular tissue breakdown. Study Design Twelve rats received 50 Gy irradiation to mandible or tibia; 4 of the rats further received minor surgical trauma to the irradiated sites. Structural and cellular skeletal changes were assessed with computerized tomography, histology, and immunostaining. Results Mandible developed ORN with 70% mean bone loss 10 weeks after irradiation ( P < .05), whereas tibia was structurally and radiologically intact 20 weeks after irradiation. Hypocellularity, hypoxia, and oxidative stress were higher in irradiated mandible ( P < .001) than tibia ( P < .01) but vascular damage was similar at both skeletal sites. Combined effects of radiation and minor trauma promoted mandibular alveolar bone loss and tibial fracture. Conclusions ORN has a more rapid onset in mandible than in tibia in the rat.
Article Title and Bibliographic Information Association between oral bisphosphonate use and dental implant failure among middle-aged women. Yip JK, Borrell LN, Cho SC, Francisco H, Tarnow DP. J Clin ...Periodontol 2012;39:408-14. Reviewer Sunday O. Akintoye, BDS, DDS, MS Purpose/Question To determine whether dental implant failure is associated with history of oral bisphosphonate therapy Source of Funding Authors' institution provided support Type of Study/Design Case-control study Level of Evidence Level 2: Limited-quality, patient-oriented evidence Strength of Recommendation Grade Not applicable
Article Title and Bibliographic Information Risk factors for osteonecrosis of the jaws: a case-control study from the CONDOR dental PBRN. Barasch A, Cunha-Cruz J, Curro FA, Hujoel P, Sung AH, Vena D, ...Voinea-Griffin AE; CONDOR Collaborative Group, Beadnell S, et al. J Dent Res 2011;90(4):439-44. Reviewers Sunday O. Akintoye, BDS, DDS, MS, Elliot V. Hersh, DMD, MS, PhD Purpose/Question To determine risks associated with bisphosphonate therapy and identify other risk factors for osteonecrosis of the jaw (ONJ) Source of Funding National Institute of Dental and Craniofacial Research grants U01DE016747, U01DE016755, U01DE016750, U01DE016746, U01DE016754, and U01DE016752 Type of Study/Design Multicenter case-control study Level of Evidence Level 2: Limited-quality, patient-oriented evidence Strength of Recommendation Grade Not applicable
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