Vanessa Machado

Dental stem cells: recent progresses in tissue engineering and regenerative medicine

Abstract Since the disclosure of adult mesenchymal stem cells (MSCs), there have been an intense investigation on the characteristics of these cells and their potentialities. Dental stem cells (DSCs) are MSC-like populations with self-renewal capacity and multidifferentiation potential. Currently, there are five main DSCs, dental pulp stem cells (DPSCs), stem cells from exfoliated deciduous teeth (SHED), stem cells from apical papilla (SCAP), periodontal ligament stem cells (PDLSCs) and dental follicle precursor cells (DFPCs). These cells are extremely accessible, prevail during all life and own an amazing multipotency. In the past decade, DPSCs and SHED have been thoroughly studied in regenerative medicine and tissue engineering as autologous stem cells therapies and have shown amazing therapeutic abilities in oro-facial, neurologic, corneal, cardiovascular, hepatic, diabetic, renal, muscular dystrophy and auto-immune conditions, in both animal and human models, and most recently some of them in human clinical trials. In this review, we focus the characteristics, the multiple roles of DSCs and its potential translation to clinical settings. These new insights of the apparently regenerative aptitude of these DSCs seems quite promising to investigate these cells abilities in a wide variety of pathologies. Key messages Dental stem cells (DSCs) have a remarkable self-renewal capacity and multidifferentiation potential; DSCs are extremely accessible and prevail during all life; DSCs, as stem cells therapies, have shown amazing therapeutic abilities in oro-facial, neurologic, corneal, cardiovascular, hepatic, diabetic, renal, muscular dystrophy and autoimmune conditions; DSCs are becoming extremely relevant in tissue engineering and regenerative medicine.

Tooth Reattachment and Palatal Veneer on a Multidisciplinary Approach of Crown Fractures in Upper Central Incisors

Dental trauma is more common in young patients and its sequelae may have great impact on the esthetics, functions, and phonetics. This paper reports a case of trauma in both central incisors in a young 17-year-old patient who was treated using adhesive tooth fragment reattachment on tooth 2.1 and a palatal indirect composite veneer on tooth 1.1. Regarding the available literature and fracture extension, the treatment approach proposed for this case provided good functional and esthetic outcomes. Clinical and radiographic results after 1 year were successful. This case demonstrates the importance of establishing a multidisciplinary approach for successful dental trauma management.

Prevalence and extent of chronic periodontitis and its risk factors in a Portuguese subpopulation: a retrospective cross-sectional study and analysis of Clinical Attachment Loss

Objectives To assess the prevalence and extent of chronic periodontitis, and its risk factors in a Portuguese subpopulation referred to periodontal examination. Methods This retrospective cross-sectional study used a subset of data from patients who sought dental treatment in a university dental clinic in the Lisbon metropolitan area. The sample consisted of 405 individuals (225 females/180 males), aged 20–90 years. All patients underwent a full-mouth periodontal examination and chronic periodontitis was defined as Clinical Attachment Loss (CAL) ≥ 3 mm affecting two or more teeth. Aggressive periodontitis cases were excluded from the analysis. Results Prevalence of chronic periodontitis was 83.5% (95% CI [80.4–86.6%]). For these subjects, CAL ≥ 3 mm affected 86.0% (95% CI [84.7–87.2]) of sites and 83.7% (95% CI [81.7–85.6]) of teeth, respectively. Mean CAL ranged from 3.6 to 4.3 mm, according to age. In the multivariate logistic regression model, smoking (OR = 3.55, 95% CI [1.80–7.02]) and older age (OR = 8.70, 95% CI [3.66–20.69] and OR = 4.85, 95% CI [2.57–9.16]), for 65+ and 45–64 years old, respectively, were identified as risk indicators for CAL ≥ 3 mm. Conclusions This particular Portuguese adult subpopulation had a high prevalence of chronic periodontitis, with severe and generalized clinical attachment loss, and its presence was significantly associated with age and smoking. This data should serve to prepare future detailed epidemiological studies and appropriate public health programs.

IL-6 and TNF-α salivary levels according to the periodontal status in Portuguese pregnant women

Background Periodontitis is associated with increased concentration of inflammatory markers and saliva has been proposed as a non-invasive diagnostic fluid in oral and systemic diseases. The levels of salivary biomarkers, such as cytokines, could potentially be used to distinguish periodontal healthy individuals from subjects with periodontal disease. The purpose of this study was to characterize the salivary levels of two inflammatory biomarkers associated with periodontitis, interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-α), in order to assess whether these cytokines salivary levels could potentially be used to complement periodontitis pregnant women diagnose. Methods Forty-four pregnant women were distributed into three groups, according to their periodontal status: healthy, mild/moderate periodontitis and severe periodontitis. Unstimulated saliva was collected and analysis of TNF-α and IL-6 salivary levels were performed with Immulite®. Results Women with periodontitis exhibited significantly higher levels (p = 0.001) of salivary IL-6 and TNF-α compared with the healthy group: 25.1 (±11.2) pg/mL vs. 16.3 (±5.0) pg/mL and 29.7 (±17.2) pg/mL vs. 16.2 (±7.6) pg/mL, approximately 1.5 and 1.8 times more, respectively. Additionally, cytokines were significantly increased (p < 0.05) in severe periodontitis compared to periodontal healthy pregnant women. Conclusions These results revealed that IL-6 and TNF-α salivary biomarkers provide high discriminatory capacity for distinguishing periodontal disease from periodontal health in pregnant women.

Stress, salivary cortisol and periodontitis: A systematic review and meta-analysis of observational studies

OBJECTIVE This meta-analysis aims to systematically assess whether periodontitis has a meaningful effect on salivary cortisol, reflecting changes on free blood cortisol levels. DESIGN The Cochrane Handbook and the PRISMA statement were used as reporting guidelines. The MEDLINE-PubMed, Google Scholar, EMBASE, and CENTRAL databases were searched until September 2017 to identify eligible studies, screened by seven independent authors and verified by an eighth. Studies comparing salivary cortisol level of periodontitis cases to controls were included. Data were extracted using a predefined table and since all papers were non-randomized clinical trials they were appraised using Downs and Black tool. DerSimonian random effects meta-analysis was performed using OpenMetaAnalyst. RESULTS Six cross-sectional studies were included, with 258 participants with chronic periodontitis and 72 with aggressive periodontitis, in a total of 573 participants. Overall results showed that aggressive periodontitis patients have, on average, 53% higher salivary cortisol levels than healthy controls 1.53 (1.11-2.12). Meta-regression exploring the relationship among salivary cortisol levels and periodontal measures, i.e., periodontitis severity, showed a global neutral effect, although this result requires future confirmation due to the low power of the model. CONCLUSION Observational studies results suggest that subjects with aggressive periodontitis have higher salivary cortisol levels than healthy ones or patients with chronic periodontitis. Such salivary cortisol response difference may have a negative impact on the periodontium, contributing to worse the burden of aggressive periodontitis disease. In the future, wide and well-designed longitudinal studies should be carried out in order to extensively confirm this possible effect, considering the complex nature of periodontitis and its many confounders factors that may contribute to this outcome.

Corrigendum to “Tooth Reattachment and Palatal Veneer on a Multidisciplinary Approach of Crown Fractures in Upper Central Incisors”

[This corrects the article DOI: 10.1155/2017/4702635.].