The influence of root surface distance to alveolar bone and periodontal ligament on periodontal wound healing

Objective : Biomodification of the root surface plays a major role in periodontal wound healing. Root surface modification with bone morphogenetic protein (BMP) stimulates bone and cementum-like tissue formation; however, severe ankylosis is simultaneously observed. Bio-safe collagen hydrogel scaffolds may therefore be useful for supplying periodontal ligament cells and preventing ankylosis. We examined the effects of BMP modification in conjunction with collagen hydrogel scaffold implantation on periodontal wound healing in dogs. Material and Methods: The collagen hydrogel scaffold was composed of type I collagen sponge and collagen hydrogel. One-wall infrabony defects (5 mm in depth, 3 mm in width) were surgically created in six beagle dogs. In the BMP/Col group, BMP-2 was applied to the root surface (loading dose; 1 µg/µl), and the defects were filled with collagen hydrogel scaffold. In the BMP or Col group, BMP-2 coating or scaffold implantation was performed. Histometric parameters were evaluated at 4 weeks after surgery. Results: Single use of BMP stimulated formation of alveolar bone and ankylosis. In contrast, the BMP/Col group frequently enhanced reconstruction of periodontal attachment including cementum-like tissue, periodontal ligament and alveolar bone. The amount of new periodontal ligament in the BMP/Col group was significantly greater when compared to all other groups. In addition, ankylosis was rarely observed in the BMP/Col group. Conclusion: The combination method using root surface modification with BMP and collagen hydrogel scaffold implantation facilitated the reestablishment of periodontal attachment. BMP-related ankylosis was suppressed by implantation of collagen hydrogel.

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Analysis of Stress in the Periodontal Ligament and Alveolar Bone of the Maxillary First Molars during Intrusion with Microscrew Implants: A 3D Finite Element Study

World Journal of Dentistry ◽

10.5005/jp-journals-10015-1250 ◽

2014 ◽

Vol 5 (1) ◽

pp. 11-16 ◽

Cited By ~ 1

Author(s):

AS Pavithra ◽

GS Prashanth ◽

SE Shekar

Keyword(s):

Finite Element ◽

Periodontal Ligament ◽

Maximum Stress ◽

Alveolar Bone ◽

Root Surface ◽

3D Finite Element ◽

Finite Element Study ◽

Palatal Implant ◽

Transpalatal Arch ◽

Element Study

ABSTRACT Objectives The objective of this study was to graphically display the pattern and magnitude of stress distribution along the periodontal ligament and the alveolar bone of upper first molars on application of intrusive forces using microscrew implants. Materials and methods A computer simulation of threedimensional model of maxillary first molars and second molars bilaterally with their periodontal ligament and alveolar bone, with microscrew implants, force element and a transpalatal arch were constructed on the basis of average anatomic morphology. Finite element analysis was done to evaluate the amount of stress and its distribution during orthodontic intrusive force. Results Overall maximum stress in this study was seen in the alveolar bone in the implant insertion area of 7.155 N/mm2. Maximum stress in the periodontal ligament was seen in middle third distocervical palatal root surface of the first molar (0.008993 N/mm2). Maximum stress in the enamel was seen in the distal aspect of the cementoenamel junction (0.423 N/mm2). Maximum stress in the dentin was observed in apical one-third of the mesiobuccal root surface of first molar (0.1785 N/mm2). Conclusion In this study with the use of palatal implant and transpalatal arch, we found that there was no tipping observed during intrusion. This study demonstrates that significant true intrusion of maxillary molars could be obtained in a wellcontrolled manner by using fixed appliances with microscrew implant as bony anchorage. How to cite this article Pavithra AS, Prashanth GS, Mathew S, Shekar SE. Analysis of Stress in the Periodontal Ligament and Alveolar Bone of the Maxillary First Molars during Intrusion with Microscrew Implants: A 3D Finite Element Study. World J Dent 2014;5(1):11-16.

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Gingival and Periodontal Problems in Children

PEDIATRICS ◽

10.1542/peds.54.2.190 ◽

1974 ◽

Vol 54 (2) ◽

pp. 190-195

Author(s):

Alan M. Polson

Keyword(s):

Periodontal Ligament ◽

Alveolar Bone ◽

Root Surface ◽

Potential Space ◽

Alveolar Process ◽

Clinical Appearance ◽

Know How ◽

Pale Pink ◽

Child Patient ◽

Blunt Probe

This review will concentrate on the gingival and periodontal problems which the pediatrician may see as part of his care of the child patient. The age period covered is from the time of first tooth erruption to the middle teens. In considering specific conditions, the clinical appearance will be described, together with etiology and recommended management. Although the majority of gingival and periodontal problems are chronic in nature, a section is included on acute conditions. The periodontium is the investing and supporting structure of the tooth. It comprises the gingiva, periodontal ligament, alveolar bone and cementum. The tooth is suspended in the alveolar bone socket through the periodontal ligament fibers which are embedded at one end in the cementum covering the root surface and in the alveolar bone at the other end. The gingiva is that portion of the oral masticatory mucosa which surrounds the teeth and is attached to the alveolar process of the jaws. In order to recognize pathological changes in the gingiva it is necessary to know how the normal appears (Fig. 1). The gingival tissues which extend into and fill the interdental or interproximal area form the gingival papillae. The gingiva has a thin edge where it meets and surrounds the tooth in a collar-like fashion. There is a potential space between the tooth and the marginal gingiva into which a blunt probe may be passed to a depth of 1 to 2 mm. The gingiva in health is pale pink and firm, and does not bleed on probing, brushing, mastication or spontaneously.

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Periodontal Wound Healing in the Absence of Periodontal Ligament Cells

Journal of Periodontology ◽

10.1902/jop.1987.58.2.71 ◽

1987 ◽

Vol 58 (2) ◽

pp. 71-77 ◽

Cited By ~ 13

Author(s):

I. Aukhil ◽

E. Pettersson ◽

C. Suggs

Keyword(s):

Wound Healing ◽

Periodontal Ligament ◽

Periodontal Ligament Cells ◽

Periodontal Wound Healing

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Fibroblast Growth Factor (FGF): A Review

Dental Journal of Advance Studies ◽

10.1055/s-0038-1671960 ◽

2013 ◽

Vol 01 (02) ◽

pp. 091-094

Author(s):

Ram Gupta ◽

Manu Gupta ◽

Avnika Garg

Keyword(s):

Wound Healing ◽

Growth Factors ◽

Periodontal Regeneration ◽

Fibroblast Growth Factors ◽

Root Surface ◽

Matrix Proteins ◽

Fibroblast Growth ◽

Polypeptide Growth Factors ◽

Naturally Occurring ◽

Periodontal Wound Healing

AbstractIn order for periodontal regeneration to occur, progenitor cells must migrate to the denuded root surface, attach to it, proliferate and mature into an organized and functional fibrous attachment apparatus. Significant advances have been made during the last decade in understanding the factors controlling the migration, attachment and proliferation of cells. A group of naturally occurring molecules known as polypeptide growth factors in conjunction with certain matrix proteins, are key regulators of these biological events. Of these, the fibroblast growth factors (FGFs) appear to have an important role in periodontal wound healing. The purpose of this review is to summarize current information on these growth factors with emphasis on their potential implications in periodontal wound healing and regeneration.

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Platelet Rich Fibrin - A Saviour for Replanted Teeth – A Review

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/574 ◽

2021 ◽

Vol 10 (33) ◽

pp. 2816-2823

Author(s):

Sanjana Mall ◽

Rajmohan Shetty ◽

Amitha Hegde ◽

Kavita Rai

Keyword(s):

Periodontal Ligament ◽

Alveolar Bone ◽

Treatment Success ◽

Periodontal Regeneration ◽

Root Surface ◽

Periodontal Ligament Cells ◽

Platelet Concentrates ◽

Soft Tissue Healing ◽

Platelet Rich Fibrin ◽

Tissue Healing

The periodontal ligament is a unique specialised connective tissue between the cementum covering the tooth root and the alveolar bone. It is believed that periodontal ligament cells are responsible for not only osteogenesis and osteoclasia of the alveolar bone but also for fibrogenesis and fibroplasia of the ligament itself, as well as cementogenesis and the presence of cementoblasts on the root surface. Injury to the periodontal ligament (PDL) and its compromised healing (external inflammatory resorption and replacement resorption) has been cited as one of the major reasons for the failure of transplantation and replantation procedures. The necessity of having a healthy PDL so that the tooth can re-attach and be retained in the socket determines the prognosis of replanted teeth. Thus, the importance of maintaining the periodontal viability has led to an increased interest in the development of platelet concentrates, which have been considered as autologous biomaterials having the ability to potentiate healing, repair, and regenerate. PRF (platelet rich fibrin) is a living biomaterial derived from human blood containing fibrin, platelets, growth factors, leukocytes and stem cells entrapped in a fibrin-based scaffold / matrix, which has been documented to promote bone and soft tissue healing and regeneration. PRF technology has grabbed the attention of clinicians because it is readily available, is easy to prepare, can be produced immediately at the chairside, is easy to use, and widely applicable in dentistry, while being financially realistic for the patient and the clinician. Thus, the purpose of this review is to enumerate the biologic, chemical and physical properties of PRF and highlight the essential role it plays in periodontal regeneration and repair, which can be highly beneficial in improving the treatment success rate of transplantation and replantation procedures. KEY WORDS Platelet Rich Fibrin, Replantation, Transplantation, Periodontal Ligament, Periodontal Regeneration

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Are Cementoblasts a Subpopulation of Osteoblasts or a Unique Phenotype?

Journal of Dental Research ◽

10.1177/154405910508400501 ◽

2005 ◽

Vol 84 (5) ◽

pp. 390-406 ◽

Cited By ~ 229

Author(s):

D.D. Bosshardt

Keyword(s):

Periodontal Ligament ◽

Alveolar Bone ◽

Experimental Studies ◽

Periodontal Regeneration ◽

Root Surface ◽

Precursor Cell ◽

Enamel Matrix Proteins ◽

Periodontal Ligament Fibroblasts ◽

Precursor Cell Line ◽

Cell Diversity

Experimental studies have shown a great potential for periodontal regeneration. The limitations of periodontal regeneration largely depend on the regenerative potential at the root surface. Cellular intrinsic fiber cementum (CIFC), so-called bone-like tissue, may form instead of the desired acellular extrinsic fiber cementum (AEFC), and the interfacial tissue bonding may be weak. The periodontal ligament harbors progenitor cells that can differentiate into periodontal ligament fibroblasts, osteoblasts, and cementoblasts, but their precise location is unknown. It is also not known whether osteoblasts and cementoblasts arise from a common precursor cell line, or whether distinct precursor cell lines exist. Thus, there is limited knowledge about how cell diversity evolves in the space between the developing root and the alveolar bone. This review supports the hypothesis that AEFC is a unique tissue, while CIFC and bone share some similarities. Morphologically, functionally, and biochemically, however, CIFC is distinctly different from any bone type. There are several lines of evidence to propose that cementoblasts that produce both AEFC and CIFC are unique phenotypes that are unrelated to osteoblasts. Cementum attachment protein appears to be cementum-specific, and the expression of two proteoglycans, fibromodulin and lumican, appears to be stronger in CIFC than in bone. A theory is presented that may help explain how cell diversity evolves in the periodontal ligament. It proposes that Hertwig’s epithelial root sheath and cells derived from it play an essential role in the development and maintenance of the periodontium. The role of enamel matrix proteins in cementoblast and osteoblast differentiation and their potential use for tissue engineering are discussed.

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Periodontal Wound Healing and Tissue Regeneration: A Narrative Review

Pharmaceuticals ◽

10.3390/ph14050456 ◽

2021 ◽

Vol 14 (5) ◽

pp. 456

Author(s):

Young-Dan Cho ◽

Kyoung-Hwa Kim ◽

Yong-Moo Lee ◽

Young Ku ◽

Yang-Jo Seol

Keyword(s):

Wound Healing ◽

Tissue Regeneration ◽

Alveolar Bone ◽

Healing Process ◽

Complex Structure ◽

Limiting Factors ◽

Public Health Issue ◽

Wound Healing Process ◽

Periodontal Tissues ◽

Periodontal Wound Healing

Periodontal disease is a major public health issue, and various periodontal therapies have been performed to regenerate periodontal tissues. The periodontium is a complex structure composed of specialized tissues that support the teeth, and most periodontal surgeries are invasive procedures, including a resection of the gingiva or the alveolar bone. The periodontal wound healing process is slightly different from cutaneous wound healing and is similar to fetal healing, being almost scar-free. The aim of this review article is to provide an overview of periodontal wound healing and discuss various surgical and pharmaceutical approaches to achieve stable wound healing and improve the treatment outcomes. In addition, detrimental and limiting factors that induce a compromised prognosis are discussed, along with the perspective and future direction for successful periodontal tissue regeneration.

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