Personalized Cell Therapy for Pulpitis Using Autologous Dental Pulp Stem Cells and Leukocyte Platelet-rich Fibrin: A Case Report

Introduction

Regenerative endodontic procedures have emerged as a new treatment. The aim of this case report was to describe a regenerative autologous cellular therapy using mesenchymal stem cells from inflamed dental pulp and leukocyte platelet-rich fibrin (L-PRF) in a mature tooth.

Cervical impalement injury

Impacted injuries of the head and neck are uncommon. Associated injuries can be present and can be a serious problem. We present an unusual clinical case and discuss the management of this complex injury. Head and neck injuries deserve special attention because of their enormous functional and esthetic significance. Contusion, abrasion, retained foreign bodies, laceration, and avulsion are some of the most frequent injuries. Impalement injuries are not so common. These lesions combine aspects of blunt and penetrating trauma and usually result from penetration by a large, rigid, blunt-tipped object that traverses a certain body area in a through-and-through fashion and often remains in situ at the time of presentation. There have been many case reports describing these injuries in the trunk and extremities; however, cases of head and neck impalement are still lacking in number. A case of an unusual cervical impalement is presented, together with a discussion of the management of this complex injury.     

Sinus floor augmentation with simultaneous placement of dental implants in the presence of platelet-rich plasma or recombinant human bone morphogenetic protein-7

The aim of the present study was to evaluate the possible benefit of platelet-rich plasma (PRP) in sinus grafting as compared with recombinant human bone morphogenetic protein-7 (rhBMP-7). For this purpose, we performed a bilateral sinus augmentation with anorganic bovine bone and simultaneous insertion of a titanium screw implant in five miniature pigs. Six hundred microliters of PRP and 15%-vol. autologous bone, which was collected with a trap during preparation of the implant recipient site, were added to the right sinus and 420 microl rhBMP-7 to the left sinus. A polychrome sequential labeling was performed. The animals were sacrificed 6 weeks after surgery. Undecalcified ground sections were evaluated by microradiography, digitized histomorphometry and under fluorescent light. The mean bone-implant contact using rhBMP-7 was 45.8% and 5.7% under PRP (P=0.002). The mean height of newly mineralized bone in the augmented area using rhBMP-7 amounted to 8.3 mm as opposed to 3.6 mm under PRP (P=0.013). Using PRP, the mean area of the newly formed bone was enhanced (51.3%) as compared with rhBMP-7 (33.1%); however, this difference was not statistically significant (P=0.081). In conclusion, under the selected experimental conditions the use of rhBMP-7 led to superior outcomes with regard to the osseointegration of dental implants and the height of new bone as compared with the use of PRP.     

The effect of the surface morphology of Ti-implants on the proliferation activity of fibroblasts and osteoblasts

It is known that surface morphology greatly influences the osseointegration of dental implants. The goal of the experiments conducted by the authors was to study in vitro the effect of various surface modifications on the activity of bone and connective tissue cells. In the experiments they introduced NIH3T3 fibroblast and MCH3T3 osteoblast cells were cultured the surface of ten titanium disks with various morphology in 24-multiwell plates. The cells were let grow on the surface of the disks for two days in a culture medium. One group of the disks underwent scanning electronmicroscopy and the changes in the number and form of cells on the surfaces were studied under various magnifications. From the surface of the second group the cells were lysed and were counted in a Bürker's chamber. After counting the cells they were lysed in a lysis buffer and their protein concentrations were measured with the help of a spectrophotometer. The authors found that only a morphological study of the cells is possible under SEM, they could not detect a quantitative difference in the number or activity of the cells. Upon counting the cells and determining their protein concentration the best result were yielded by the surface roughened by aluminium oxide. In growing fibroblasts the titanium oxide treated surfaces provided good results, while in the case of the osteoblasts the laser treated disks were more successful.