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Nanopharmaceuticals in Alveolar Bone and Periodontal Regeneration
Published in Harishkumar Madhyastha, Durgesh Nandini Chauhan, Nanopharmaceuticals in Regenerative Medicine, 2022
Mark A. Reynolds, Zeqing Zhao, Michael D. Weir, Tao Ma, Jin Liu, Hockin H. K. Xu, Abraham Schneider
In another study, a biomimetic electrospun fish collagen/bioactiveglass/chitosan (Col/BG/CS) composite nanofibre membrane was developed for periodontal regeneration (Zhou et al. 2017). The morphology of the membrane was examined using SEM, with a fibre diameter of 159 ± 59 nm. hPDLCs were able to attach firmly and spread well on the membrane (Figure 15.5F). This nanomembrane exhibited a biomimetic structure with a high hydrophilicity and a relatively high tensile strength. The nanomembrane promoted cell growth with high expressions of osteogenic genes for hPDLSCs, including RUNX2 and OPN. This nanocomposite membrane was found to promote PDL and bone formation in a canine class II (Glickman’s) furcation defect model (Zhou et al. 2017). Compared to the control group, the composite membrane formed greater amounts of new bone with less inflammation (Figure 15.5G). New bone formation percentage by Col/BG/CS group was 69%, higher than the control group’s 45%, at 60 days after treatment. The novel nanofibre membrane exhibited more macroporosity and greater surface area to induce cell–cell and cell–matrix interactions, thus promoting osteogenesis and periodontal regeneration.
Dental magnetic resonance imaging for periodontal indication – a new approach of imaging residual periodontal bone support
Published in Acta Odontologica Scandinavica, 2019
Maurice Ruetters, Alexander Juerchott, Nihad El Sayed, Sabine Heiland, Martin Bendszus, Ti-Sun Kim
PA radiographing, not clinical measurements, was the reference technique in this study because none of the routine clinical measurements, PD or CAL, can be transferred into the DMRI datasets used in this study. The anatomic landmarks margin of the gingiva (PD) or CEJ (CAL) cannot be identified on DMRI due to artifacts by the tongue. PA radiographs have previously been shown not to differ statistically in terms of linear measurements of residual periodontal bone support compared to intraoperative measurements. [17] Thus, PA radiographing was chosen as a reference. The measurements applied in our study represented measurements of soft tissue (distance a) as well as of hard tissue (distance b). They demonstrate the accuracy of DMRI as a matter of principle concerning periodontal structures. Three-dimensional visualization of a periodontal defect, such as a furcation defect or a vertical defect, can be of prognostic value for the clinician. In the future, the morphology of periodontal defects may be illustrated and calculated by DMRI similar to CBCT but without radiation. This could be enabled using novel DMRI techniques that allow for three-dimensional imaging of periodontal tissue [18–21]. Secondly, the resolution of the DMRI sequence used in this study may be questioned. However, the DMRI sequence used in this study had an in-plane resolution of 0.469 × 0.469 mm which was one of the highest achievable resolutions available at the time of this study. Although DMRI cannot yet equal the resolution of PA radiographs, the achieved resolution is within the clinical tolerance level of 0.5 mm. Future technological developments may improve resolution capabilities [22,23], and subpixel algorithms enable a more precise imaging than the actual resolution would allow [24]. Thirdly, in practice, not all patients are suitable to receive DMRI, but most of them can receive a PA; for example, patients with cardiac pacemakers, insulin pumps, metallic implants and claustrophobia. Furthermore, there are materials used in dentistry that cause artifacts in DMRI, such as stainless steel orthodontic appliances and CoCr alloys [11]. A relative disadvantage of this study may be the use of contrast agent for DMRI. Although evidence shows that the use of the contrast agent Dotarem® is safe [25,26], it takes more time to apply the agent. Adverse reactions may occur and, moreover, patients treated with the contrast agent have a tendency to feel discomfort compared with patients on whom this agent was not used. In this study population, none of the patients showed adverse reactions after the use of Dotarem®. Fourth, DMRI devices are currently relatively expensive and not as widely accessible to dentists compared with X-ray methods. MRI scanners are operated by qualified radiologists and not by dentists. Therefore, more manpower is required to conduct a DMRI. Acquisition time is much longer for DMRI compared with a PA. Taking a PA represents a fast imaging method, which can be conducted by a dentist. However, DMRI is a relatively new technique and technical improvements may result in faster acquisition times, and more affordable equipment, suitable for use in a dental office. Similarly to CBCT, which was very expensive when first introduced, but is now quite affordable.