Elna P. Chalisserry

Therapeutic potential of dental stem cells

Stem cell biology has become an important field in regenerative medicine and tissue engineering therapy since the discovery and characterization of mesenchymal stem cells. Stem cell populations have also been isolated from human dental tissues, including dental pulp stem cells, stem cells from human exfoliated deciduous teeth, stem cells from apical papilla, dental follicle progenitor cells, and periodontal ligament stem cells. Dental stem cells are relatively easily obtainable and exhibit high plasticity and multipotential capabilities. The dental stem cells represent a gold standard for neural-crest-derived bone reconstruction in humans and can be used for the repair of body defects in low-risk autologous therapeutic strategies. The bioengineering technologies developed for tooth regeneration will make substantial contributions to understand the developmental process and will encourage future organ replacement by regenerative therapies in a wide variety of organs such as the liver, kidney, and heart. The concept of developing tooth banking and preservation of dental stem cells is promising. Further research in the area has the potential to herald a new dawn in effective treatment of notoriously difficult diseases which could prove highly beneficial to mankind in the long run.

Isolation and Characterization of Nano-Hydroxyapatite from Salmon Fish Bone

Nano-Hydroxyapatite (nHA) was isolated from salmon bone by alkaline hydrolysis. The resulting nHA was characterized using several analytical tools, including thermogravimetric analysis (TGA), Fourier transform infrared spectroscopy (FT-IR), X-ray diffraction analysis (XRD), scanning electron microscopy (SEM) and transmission electron microscopy (TEM), to determine the purity of the nHA sample. The removal of organic matter from the raw fish was confirmed by TGA. FT-IR confirmed the presence of a carbonated group and the similarities to synthetic Sigma HA. XRD revealed that the isolated nHA was amorphous. Microscopy demonstrated that the isolated nHA possessed a nanostructure with a size range of 6–37 nm. The obtained nHA interacted with mesenchymal stem cells (MSCs) and was non-toxic. Increased mineralization was observed for nHA treated MSCs compared to the control group. These results suggest that nHA derived from salmon is a promising biomaterial in the field of bone tissue engineering.

Hepatocyte Growth Factor Levels in the Saliva and Gingival Crevicular Fluid in Smokers with Periodontitis

Hepatocyte growth factor (HGF) production by oral fibroblasts is enhanced by various molecules that are induced during inflammatory conditions including periodontitis. HGF plays an important role in the progression of periodontitis, by stimulating intense growth of epithelial cells and preventing regeneration of connective tissue attachments. Smokers have a greater risk factor in the pathogenesis and progression of periodontal disease. The objective of the study was to estimate the level of HGF in saliva and gingival crevicular fluid (GCF) in smokers with periodontitis and to compare these levels with that of nonsmokers with periodontitis and healthy controls. The HGF levels were found to be significantly high in the saliva and GCF of smokers with periodontitis compared to both never-smokers with periodontitis and the healthy control group. The elevated levels of HGF in the saliva and GCF in the study population could explain the intrinsic mechanism triggering the severity of the periodontitis in smokers. Further studies are necessary to validate the current observations and to establish a sensitive marker to predict periodontal disease activity.

Prevalence of anterior dental trauma and its associated factors among children aged 3-5 years in Jaipur City, India - A cross sectional study

Objective: To study the prevalence of anterior dental trauma and its associated factors among 800 preschool children aged 3 to 5 years in Jaipur City, Rajasthan, India. Materials and Methods: A cross-sectional survey was conducted among children aged 3-5 years, who were enrolled in various private and public schools in Jaipur. Parents were asked to fill a form addressing socio-demographic data and clinical examinations were performed by a single dentist. Traumatic dental injuries (TDI) were assessed and recorded based on Andreasen′s classification. Associated factors such as sex, socioeconomic status (SES), and the type of injury were also analyzed. The data were analyzed statistically using Statistical Package for the Social Sciences software (version 20). Results: An overall 10.2% prevalence of TDI was observed among the study population. TDI were reported to be more among male children (11.87%) compared to female children (8.14%). Enamel fractures (69%) were the most prevalent type of anterior dental trauma. Upper central incisors were the most frequently affected. The SES of the parents had little influence on the prevalence of TDI. Conclusions: The prevalence rate of dental trauma among children aged 3-5 years was 10.2%. Associated factors, such as SES, were observed to be not significantly correlated to dental trauma among the studied preschoolers.

Prevalence of Periodontitis in Patients Undergoing Hemodialysis: a Case Control Study

Objectives: To assess the prevalence of periodontal disease among patients undergoing renal dialysis. Methods: Sixty hemodialysis patients (30 males, 30 females) with a mean age of 44.4±9.5 years comprised the study group. Periodontal parameters such as plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD) and clinical attachment level (CAL) were measured in these patients and 60 age and sex-matched control subjects. The data was tabulated and analyzed. Results: The mean duration of dialysis was 5.50±3.02 years. The plaque index (PI) bleeding on probing (BOP), Periodontal probing depth (PPD) and clinical attachment level (CAL) were significantly higher in patients undergoing hemodialysis than in control subjects. The mean clinical attachment level was significantly higher among the dialysis patients (2.78±0.83 mm) than the control subjects (1.97±0.53 mm). The plaque index and bleeding on probing also showed a similar pattern in patients undergoing hemodialysis compared to control patients. The prevalence and severity of periodontal disease seems to be higher in patients undergoing dialysis. Conclusion: From the observations of this study, it can be concluded that patients undergoing hemodialysis are more prone to periodontal diseases. Further studies with a larger population and a comparison with the duration of dialysis may further substantiate the current findings.

Marine Sponges as Future Biomedical Models

Marine sponges are animals of the phylum Porifera and also excellent source of various biomaterials and organic compounds. In recent years, significant developments on marine sponges derived biomaterials have been explored for various biological and biomedical applications (tissue engineering, drug delivery and biosensor). Biosilica and collagen of marine sponge are important constituents and has huge potential application in regenerative medicine. In the present chapter, we have discussed about isolation procedure of biosilica and collagen from marine sponge. Furthermore, tissue engineering of biogenic silica toward bone tissue engineering is explained in details. Finally, sponge-derived compounds and its use in regenerative medicine and collagen in drug delivery are discussed. As a conclusion, marine sponges are promising source of future biomaterials for various biological and biomedical applications.

Papillon–Lefèvre syndrome: a series of five cases among siblings

BackgroundPapillon–Lefèvre syndrome is a rare autosomal recessive disorder characterized by palmoplantar hyperkeratosis and aggressively progressing periodontitis leading to premature loss of deciduous and permanent dentition. The etiopathogenesis of the syndrome is relatively obscure, and immunologic, genetic, or possible bacterial etiologies have been proposed.Case presentationA series of five cases of Papillon–Lefèvre syndrome among the siblings in a family is presented here: a 3-year-old Arab girl, a 4-year-old Arab boy, a 11-year-old Arab boy, a 12-year-old Arab boy, and a 14-year-old Arab boy. The patients presented with severe gingival inflammation and mobility of teeth. The clinical manifestations were typical of Papillon–Lefèvre syndrome and the degree of involvement of the oral and skin conditions varied among them.ConclusionsThis case series stresses the consanguinity in the family as an etiologic factor. All siblings in the family were affected with Papillon–Lefèvre syndrome which makes this a rare case. A multidisciplinary approach with the active participation of a dental surgeon, dermatologist, and pediatrician is essential for the management of cases of Papillon–Lefèvre syndrome.

Oral Health and Adverse Pregnancy Outcomes

Maternal health has long been recognized as an important determinant in reducing the risk for pregnancy-related complications such as preterm birth and preeclampsia. Preterm (PTB) delivery and low birth weight (LBW) are considered to be the most relevant biological determinants of newborn infant survival in both developed and developing countries. The oral changes that can occur in pregnancy have been a focus of interest for many years. Physiological changes that occur in pregnant women can adversely affect oral health. Eleva‐ tions in estrogen and progesterone enhance the inflammatory response and consequently alter the gingival tissue (Mascarenhas et al., 2003). During pregnancy, the incidences of gingivitis and periodontitis are increased, and many pregnant women suffer from bleeding and spongy gums.

Drug Delivery Systems in Bone Regeneration and Implant Dentistry

Bone regeneration is a complex, well-orchestrated physiological process involving a number of cell types and intracellular and extracellular molecular signaling pathways [1]. Bone grafts provide a structural framework for clot development, maturation and remodeling that supports bone formation in osseous defects. These materials must possess biocompatibility and osteoconductivity, as well as the properties that support osteogenesis. The ideal charac‐ teristics of a bone graft are that it must be nontoxic, non-antigenic, resistant to infection, easily adaptable, readily and sufficiently available to stimulate new attachment and able to trigger osteogenesis [2].