Intentional tooth replantation(ITR)is an advanced treatment modality and the procedure of last resort for preserving teeth with inaccessible endodontic or resorptive lesions.ITR is defined as the deliberate extraction...Intentional tooth replantation(ITR)is an advanced treatment modality and the procedure of last resort for preserving teeth with inaccessible endodontic or resorptive lesions.ITR is defined as the deliberate extraction of a tooth;evaluation of the root surface,endodontic manipulation,and repair;and placement of the tooth back into its original socket.Case reports,case series,cohort studies,and randomized controlled trials have demonstrated the efficacy of ITR in the retention of natural teeth that are untreatable or difficult to manage with root canal treatment or endodontic microsurgery.However,variations in clinical protocols for ITR exist due to the empirical nature of the original protocols and rapid advancements in the field of oral biology and dental materials.This heterogeneity in protocols may cause confusion among dental practitioners;therefore,guidelines and considerations for ITR should be explicated.This expert consensus discusses the biological foundation of ITR,the available clinical protocols and current status of ITR in treating teeth with refractory apical periodontitis or anatomical aberration,and the main complications of this treatment,aiming to refine the clinical management of ITR in accordance with the progress of basic research and clinical studies;the findings suggest that ITR may become a more consistent evidence-based option in dental treatment.展开更多
The repair of the periodontal membrane is essential for the successful management of periodontal disease and dental trauma.Emdogain®(EMD)is widely used in periodontal therapy due to its ability to promote repair....The repair of the periodontal membrane is essential for the successful management of periodontal disease and dental trauma.Emdogain®(EMD)is widely used in periodontal therapy due to its ability to promote repair.Despite substantial research,the cellular and molecular mechanisms underlying EMD’s effects,particularly at the single-cell resolution,remain incompletely understood.This study established a delayed tooth replantation model in rats to investigate these aspects.Tooth loss rate and degree of loosening were evaluated at 4 and 8 weeks.Micro-CT,HE staining,TRAP staining,and immunofluorescence staining were evaluated to assess EMD’s efficacy.Single-cell sequencing analyses generated single-cell maps that explored enrichment pathways,cell communication,and potential repair mechanisms.Findings indicated that EMD could reduce the rate of tooth loss,promote periodontal membrane repair,and reduce root and bone resorption.Single-cell analysis revealed that EMD promotes the importance of Vtn+fibroblasts,enhancing matrix and tissue regeneration functions.Additionally,EMD stimulated osteogenic pathways,reduced osteoclastic activity,and promoted angiogenesis-related pathways,particularly bone-related H-type vessel expression in endothelial cells.Gene modules associated with angiogenesis,osteogenesis,and odontoblast differentiation were identified,suggesting EMD might facilitate osteogenesis and odontoblast differentiation by upregulating endothelium-related genes.Immune cell analysis indicated that EMD did not elicit a significant immune response.Cell communication analysis suggested that EMD fostered pro-regenerative networks driven by interactions between mesenchymal stem cells,fibroblasts,and endothelial cells.In conclusion,EMD proves to be an effective root surface therapy agent that supports the restoration of delayed replantation teeth.展开更多
文摘Intentional tooth replantation(ITR)is an advanced treatment modality and the procedure of last resort for preserving teeth with inaccessible endodontic or resorptive lesions.ITR is defined as the deliberate extraction of a tooth;evaluation of the root surface,endodontic manipulation,and repair;and placement of the tooth back into its original socket.Case reports,case series,cohort studies,and randomized controlled trials have demonstrated the efficacy of ITR in the retention of natural teeth that are untreatable or difficult to manage with root canal treatment or endodontic microsurgery.However,variations in clinical protocols for ITR exist due to the empirical nature of the original protocols and rapid advancements in the field of oral biology and dental materials.This heterogeneity in protocols may cause confusion among dental practitioners;therefore,guidelines and considerations for ITR should be explicated.This expert consensus discusses the biological foundation of ITR,the available clinical protocols and current status of ITR in treating teeth with refractory apical periodontitis or anatomical aberration,and the main complications of this treatment,aiming to refine the clinical management of ITR in accordance with the progress of basic research and clinical studies;the findings suggest that ITR may become a more consistent evidence-based option in dental treatment.
基金the National Natural Science Foundation of China(U22A20314,82470988,32070826)National Key R&D of Program of China(2022YFC2504201)+2 种基金Outstanding Youth Fund of Chongqing Natural Science Foundation(CSTB2023NSCQJQX0006)Science and Technology Research Project of Chongqing Education Commission(KJQN202200471)CQMU Program for Youth Innovation in Future Medicine(W0075).
文摘The repair of the periodontal membrane is essential for the successful management of periodontal disease and dental trauma.Emdogain®(EMD)is widely used in periodontal therapy due to its ability to promote repair.Despite substantial research,the cellular and molecular mechanisms underlying EMD’s effects,particularly at the single-cell resolution,remain incompletely understood.This study established a delayed tooth replantation model in rats to investigate these aspects.Tooth loss rate and degree of loosening were evaluated at 4 and 8 weeks.Micro-CT,HE staining,TRAP staining,and immunofluorescence staining were evaluated to assess EMD’s efficacy.Single-cell sequencing analyses generated single-cell maps that explored enrichment pathways,cell communication,and potential repair mechanisms.Findings indicated that EMD could reduce the rate of tooth loss,promote periodontal membrane repair,and reduce root and bone resorption.Single-cell analysis revealed that EMD promotes the importance of Vtn+fibroblasts,enhancing matrix and tissue regeneration functions.Additionally,EMD stimulated osteogenic pathways,reduced osteoclastic activity,and promoted angiogenesis-related pathways,particularly bone-related H-type vessel expression in endothelial cells.Gene modules associated with angiogenesis,osteogenesis,and odontoblast differentiation were identified,suggesting EMD might facilitate osteogenesis and odontoblast differentiation by upregulating endothelium-related genes.Immune cell analysis indicated that EMD did not elicit a significant immune response.Cell communication analysis suggested that EMD fostered pro-regenerative networks driven by interactions between mesenchymal stem cells,fibroblasts,and endothelial cells.In conclusion,EMD proves to be an effective root surface therapy agent that supports the restoration of delayed replantation teeth.
