Regenerating the periodontal ligament (PDL) is a crucial factor for periodontal tissue regeneration in the presence of traumatized and periodontally damaged teeth. Various methods have been applied for periodontal regeneration, including tissue substitutes, bioactive materials, and synthetic scaffolds. However, all of these treatments have had limited success in structural and functional periodontal tissue regeneration. To achieve the goal of complete periodontal regeneration, many studies have evaluated the effectiveness of decellularized scaffolds fabricated via tissue engineering. The aim of this study was to fabricate a decellularized periodontal scaffold of human tooth slices and determine its regeneration potential. We evaluated two different protocols applied to tooth slices obtained from human healthy third molars. The extracellular matrix scaffold decellularized using sodium dodecyl sulfate and Triton X-100, which are effective in removing nuclear components, was demonstrated to preserve an intact structure and composition. Furthermore, the decellularized scaffold could support repopulation of PDL stem cells near the cementum and expressed cementum and periodontal-ligament-related genes. These results show that decellularized PDL scaffolds of human teeth are capable of inducing the proliferation and differentiation of mesenchymal stem cells, thus having regeneration potential for use in future periodontal regenerative tissue engineering.
13-year old boy with spastic quadriplegia cerebral palsy visited dental clinic with chief complaints of mouth breathing and malocclusion. His mouth was constantly open at the resting position, with his mandible and tongue displaced downward. He breathed through his mouth, making a constant gurgling sound, a sign of upper airway obstruction. To enhance his mandible position, vertical chin cap was first considered, but it was not sufficient to reduce the gurgling sound or ease breathing. Then, cervical splint was considered, which effectively decreased the gurgling sound by repositioning his mandible to the anterior-superior position. Oxygen saturation was increased when the cervical splint was used. Cervical splint can effectively assist breathing in patients with cerebral palsy, but it should be carefully applied as long-term use can result in unexpected complications. Under instruction by a physician regarding proper usage, a cervical splint can be applied to assist breathing in patients with cerebral palsy.
Local and general factors have been attributed to root resorption occurred by injuries such as trauma and dental caries that affect periodontal ligament or dental pulp tissue. Pathologic root resorption is different from physiologic root resorption in terms of resorption pattern such as micromorphology of resorption fossae and types of observed cells. Microscopic morphologies and histologic features of physiologic and pathologic root resorption surface of maxillary primary central incisors resulting from trauma and periapical inflammation were observed by scanning electron microscope and light microscope. The morphology of physiologic resorption lacunae was small and oval or circular shape with regularities. The morphology of pathologic resorption lacunae was large and polygonal shape with irregularities compared with the physiologic resorption lacunae. Multinucleated giant cells and mononuclear cells were closely attached to the physiologic and pathologic resorption lacunae, whereas several kinds of mesenchymal cells with numerous inflammatory cells were found in the areas adjacent to the pathologic resorption surface. Compensating cementum formation took place along some of the areas of physiologic and pathologic resorption area resulting from trauma, but could not be observed on pathologic resorption area resulting from periapical inflammation.
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