Developments in Alloplastic Bone Grafts and Barrier Membrane Biomaterials for Periodontal Guided Tissue and Bone Regeneration Therapy
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Abstract:
Periodontitis is a serious form of oral gum inflammation with recession of gingival soft tissue, destruction of the periodontal ligament, and absorption of alveolar bone. Management of periodontal tissue and bone destruction, along with the restoration of functionality and structural integrity, is not possible with conventional clinical therapy alone. Guided bone and tissue regeneration therapy employs an occlusive biodegradable barrier membrane and graft biomaterials to guide the formation of alveolar bone and tissues for periodontal restoration and regeneration. Amongst several grafting approaches, alloplastic grafts/biomaterials, either derived from natural sources, synthesization, or a combination of both, offer a wide variety of resources tailored to multiple needs. Examining several pertinent scientific databases (Web of Science, Scopus, PubMed, MEDLINE, and Cochrane Library) provided the foundation to cover the literature on synthetic graft materials and membranes, devoted to achieving periodontal tissue and bone regeneration. This discussion proceeds by highlighting potential grafting and barrier biomaterials, their characteristics, efficiency, regenerative ability, therapy outcomes, and advancements in periodontal guided regeneration therapy. Marketed and standardized quality products made of grafts and membrane biomaterials have been documented in this work. Conclusively, this paper illustrates the challenges, risk factors, and combination of biomaterials and drug delivery systems with which to reconstruct the hierarchical periodontium.Keywords:
Periodontium
Periodontal fiber
Bone grafting
The finite element method (FEM) is a powerful computational tool for solving stress-strain problems; its ability to handle material inhomogeneity and complex shapes makes the FEM, the most suitable method for the analysis of internal stress levels in the tooth, periodontium, and alveolar bone. This article intends to explain the steps involved in the generation of a three-dimensional finite element model of tooth, periodontal ligament (PDL) and alveolar bone, as the procedure of modeling is most important because the result is based on the nature of the modeling systems. Finite element analysis offers a means of determining strain-stress levels in the tooth, ligament, and bone structures for a broad range of orthodontic loading scenarios without producing tissue damage.
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Understanding of the structure and metabolism of connective tissue components in recent years has increased drastically.The support and attachment of the tooth in the bones of the jaw is provided by a complex comprising of four connectivetissues and is known as the Periodontium. It is attached to the dentine of the root by the cementum and to the bones ofthe jaw via the alveolar bone. Two of the connective tissues are mineralized and comprise of cementum and alveolarbone, while the other two are essentially fibrous in nature and are represented by the periodontal ligament (PDL) and thegingiva. This review article summarizes the current knowledge of the periodontium and will discuss the most importantvital structure in detail that is Periodontal ligament.
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Objective To establish iNOS for the study of molecular mechanism of the effect of bite force loss on periodontium remodeling. Methods Eighty-one male Wistar rats(weigh 250±20g)were chosed to establish rat models of different bite force for the study, and left maxillary molars of rats were extracted and left mandibular molar area was used as the model with bite force lost. The animals were sacrificed after 6 hours, 1,2,3 days and 1,2,3,4 weeks. The prepared tissue specimens were processed for the study of the change in the histologic morphology and the expression of iNOSmRNA in PDLC and osteoblasts with HE staining and RT-PCR techniques. Results In the group of lost biting force, the derangement of periodontal ligament and resorption of alveolar bone were observed in histologic study: the structure of periodontal ligament deranged .fibers and cells arrayed disorderly, there were many holes in the alveolar bone, occasionally occurred osteoclasts; the expression of iNOSmRNA was observed dramatically changed: the expression of iNOSmRNA in periodontal ligament fibroblasts and osteoblasts was higher than normal, especially at 2d and 3w. Conclusion Bite force lost induce the expression of iNOSmRNA enhanced apparently in PDLC and osteoblasts, it suggestes that iNOS may play important roles in the process of periodontium remodeling.
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The periodontium of old marmosets is characterized by a narrow, serrated cribriform plate of alveolar bone, a loss of tinctorial identification of Sharpey's fibers and a decrease in the cellular elements of the periodontal ligament. The attachment fibers are frequently calcified. In contrast to the blue periodontal ligament and pink alveolar bone in alcian blue‐PAS stained sections of adult marmosets, the periodontal ligament stains pink and the alveolar hone deep red in old animals. Aged marmosets also have degenerative changes in the periodontal vasculature not seen in younger adults. The changes are similar to those described in aged human periodontal tissues.
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To investigate the molecular mechanism of the effect of bite force loss on periodontium remodeling.For establishing a rat model of different bite forces for the study, the left maxillary molars of Wistar rats were extracted and the left mandibular molar area was used as the model of the bite force lost. The animals were sacrificed after 6 hours,1,2,3 days and 1,2,3,4weeks. The prepared tissue specimens were processed for the study of the change in the histologic morphology and the expression of iNOS protein in PDLC and osteoblasts with HE staining, immunohistochemistry and RT-PCR techniques, and the results were analyzed by one-way ANOVA,Dunnet t test and paired samples test.In the group of lost biting force, the derangement of periodontal ligament and resorption of alveolar bone were observed in histologic study: the structure of periodontal ligament deranged ,fibers and cells arrayed abnormally, there were many holes in the alveolar bone, even osteoclasts were present; the expression of iNOS was observed dramatically changed: the expression of iNOS in periodontal ligament fibroblasts and osteoblasts was higher than normal, especially at 2 days and 3 weeks,so as the results of RT-PCR.There was a significant correlation between bite force lost and the increased expression of iNOSmRNA.Bite force lost significantly increased the expression of iNOSmRNA in PDLC and osteoblasts, which suggests that iNOS may play an important role in the process of periodontium remodeling.
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To study the expression of interleukin-1beta(IL-1beta) in the fibroblasts and osteoblasts in the periodontal ligament cells(PDLC) of normal rats and rats with loss of bite force, to explain the molecular mechanism of periodontium remodeling.Rat models of lost bite force were established using Wistar rats. The changes in the histological morphology of the periodontium and the expression of IL-1beta in the PDLC and osteoblasts were observed in both normal rats and the rat models using HE staining and immunohistochemistry techniques.In rat models of lost bite force, the periodontal ligament structure appeared to be disorganized and absorption occurred in the alveolar bone. The expression level of IL-1beta in the PDLC and osteoblasts was significantly enhanced in comparison with that in the normal rats, as demonstrated by immunohistochemical study.Loss of bite force may induce structural disorganization of the periodontal ligament and absorption in the alveolar bone, and the expression level of IL-1beta in PDLC and osteoblasts show significant elevation, indicating that the changes in histological morphology is closely coordinated with the functional changes in the periodontium.
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The periodontium of old marmosets is characterized by a narrow, serrated cribriform plate of alveolar bone, a loss of tinctorial identification of Sharpey's fibers and a decrease in the cellular elements of the periodontal ligament. The attachment fibers are frequently calcified. In contrast to the blue periodontal ligament and pink alveolar bone in alcian blue‐PAS stained sections of adult marmosets, the periodontal ligament stains pink and the alveolar bone deep red in old animals. Aged marmosets also have degenerative changes in the periodontal vasculature not seen in younger adults. The changes are similar to those described in aged human periodontal tissues.
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