Special Issue "Applied Biomaterials in Oral Surgery and Personalized Dentistry"

A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Applied Dentistry".

Deadline for manuscript submissions: closed (20 May 2021).

Special Issue Editor

Prof. Dr. Gaetano Isola
E-Mail Website
Guest Editor
Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
Interests: periodontitis; oral surgery; oral pathology; oral health-systemic health; bone biology
Special Issues and Collections in MDPI journals

Special Issue Information

Dear Colleagues,

The development of new biocompatible materials and/or existing material composition and progressing techniques is expected to broaden the diversity of applications of biomaterials in the dentistry field in the coming years. The progress in materials research clearly requires an improved understanding in multiple disciplines, as well as the development of new design methodologies in order to obtain better properties in biologic performance and better biocompatibility. The objectives of all these biomaterials and technologies are not only to replace missing or damaged tooth tissues but now also to promote tissue regeneration and protect healthy tooth tissue.

Comprehension of recent advances in biomaterials of dentistry would lead to appropriate applications of these biomaterials in clinical cases and successful strategies to improve dental treatment outcomes to better serve patients. It is important to choose the most appropriate material for the regeneration of tooth structures via biomimetic processes. In other words, choosing the appropriate dental materials and their successful clinical use directly affect treatment outcome and long-term results.

Biomaterials and technologies are not only replacing missing or damaged tissues but also promoting tissue regeneration. In this Special Issue, research related to application techniques in dentistry will be analyzed and updated.

Specific areas of current research activity are discussed and some of the required technical advances highlighted.

We especially welcome interventional studies aiming at improving the knowledge of the imaging functional biomaterials and technologies in dentistry. Review studies including those that use conceptual frameworks on any of the aforementioned topics will also be welcomed.

Prof. Dr. Gaetano Isola
Guest Editor

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Keywords

  • applied dentistry
  • periodontology
  • oral surgery
  • orthodontics
  • temporomandibular joint
  • quality of life
  • teeth
  • biomaterials
  • software
  • bone
  • periodontal ligament
  • periodontal medicine
  • dental materials
  • oral medicine

Published Papers (11 papers)

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Research

Jump to: Review

Article
Antibacterial and Anti-Inflammatory Potential of Mouthwash Composition Based on Natural Extracts
Appl. Sci. 2021, 11(9), 4227; https://doi.org/10.3390/app11094227 - 06 May 2021
Viewed by 499
Abstract
Mouthwash contains chlorhexidine, triclosan, cetylpyridinium chloride, benzethonium chloride, and fluoride. However, continuous use of these chemical substance affects both pathogenic and nonpathogenic oral bacteria and causes an imbalance in the oral environment, which is known to affect not only oral diseases but also [...] Read more.
Mouthwash contains chlorhexidine, triclosan, cetylpyridinium chloride, benzethonium chloride, and fluoride. However, continuous use of these chemical substance affects both pathogenic and nonpathogenic oral bacteria and causes an imbalance in the oral environment, which is known to affect not only oral diseases but also systemic diseases. Therefore, in this study, we observed the possibility of replacing the composition of chemical compound mouthwash with a natural extract. Platycodon grandiflorum (PG), Chaenomeles sinensis Koehne (CSK), and Siraitia grosvenorii (SG) were used as natural extracts, and a mixture of enzyme salt, xylitol, mint, green tea, lemon, and propolis were used as the natural extract mixture series (M1–M5). The natural extracts and natural mixture series were evaluated for the antibacterial effect, anti-inflammatory effect, cell viability, and nitric oxide (NO) assay using eleven types of pathogenic oral bacteria, two types of nonpathogenic oral bacteria, and macrophages RAW 264.7 cells. Cell viability was measured as about 35.9–46.7% for the control group (GA and LIS), about 36.3–57.7% for the natural extract group (PG, CSK, SG), and about 95.8–97.9% for the natural extract mixture series group (M1–M5). In the NO assay tested with lipopolysaccharide (LPS)-stimulated inflammatory responses, the control group was measured at about 89%, the natural extracts group were measured at 84–88%, and the natural extract mixture series group at about 54–82%. It was observed that some natural extracts (PG, SG) and natural extract mixtures (M4, M5) inhibited LPS-induced NO production, which meant that natural extracts had anti-inflammation potential. In conclusion, it was observed that natural extracts mixed in proper proportions affect pathogenic oral bacteria and not nonpathogenic oral bacteria. It is considered that appropriately formulated natural extracts can maintain a healthy oral environment and further replace commercial mouthwash based on chemical compound mixtures. Full article
(This article belongs to the Special Issue Applied Biomaterials in Oral Surgery and Personalized Dentistry)
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Article
Torque Requirements and the Influence of Pilot Holes on Orthodontic Miniscrew Microdamage
Appl. Sci. 2021, 11(8), 3564; https://doi.org/10.3390/app11083564 - 15 Apr 2021
Viewed by 372
Abstract
This study aimed to quantify the microdamage to cortical bone of different thickness and the maximum insertion torque during orthodontic miniscrew implant (OMI) placement with and without a pilot hole. Forty-five porcine bone specimens were prepared with thicknesses of 1.5, 2 and 2.5 [...] Read more.
This study aimed to quantify the microdamage to cortical bone of different thickness and the maximum insertion torque during orthodontic miniscrew implant (OMI) placement with and without a pilot hole. Forty-five porcine bone specimens were prepared with thicknesses of 1.5, 2 and 2.5 mm. Ten bone specimens per thickness had a pilot hole drilled prior to the insertion of an OMI, and the remaining 15 bone specimens had an OMI without a pilot hole inserted. Sequential staining was used to identify damage caused by bone preparation and surface microdamage from OMI insertion and confocal laser microscopy images were used to quantify damage characteristics. Of the five damage characteristics, only one decreased when a pilot hole was used for all bone specimens (p = 0.025), while two increased as cortical bone thickness increased (p = 0.0064, p = 0.0003). There was no evidence that maximum insertion torque differed according to pilot hole status (p = 0.1144) and increased as cortical bone thickness increased (p = 0.0001). The presence of a pilot hole had minimal effect on microdamage characteristics and no effect on maximum insertion torque. As cortical bone thickness increased, an increase in microdamage and in maximum insertion torque was observed. Full article
(This article belongs to the Special Issue Applied Biomaterials in Oral Surgery and Personalized Dentistry)
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Article
Behavior of Primary Human Oral Keratinocytes Grown on Invisalign® SmartTrack® Material
Appl. Sci. 2021, 11(6), 2826; https://doi.org/10.3390/app11062826 - 22 Mar 2021
Viewed by 619
Abstract
Orthodontic clear aligner treatment is gaining tremendous popularity. The world market leader is Align Technology® and its product Invisalign®. Although numerous patients are treated with Invisalign® aligners, only little is known about the cellular effects of aligner material on [...] Read more.
Orthodontic clear aligner treatment is gaining tremendous popularity. The world market leader is Align Technology® and its product Invisalign®. Although numerous patients are treated with Invisalign® aligners, only little is known about the cellular effects of aligner material on oral epithelial cells. In the present study, we aimed to investigate the effects of SmartTrack® clear aligner material on directly cultured primary human oral keratinocytes (HOKs). Cell morphology and behavior were investigated by scanning electron microscopy and bright field microscopy. Aligner effects on viability were detected by cell-counting-kit (CCK)-8 and live/dead staining. Gene expression of several inflammatory and barrier proteins was assessed by qPCR. Cells cultured on tissue culture plastic served as control. Cell proliferation/viability was significantly lower in cells cultured on aligner material (p < 0.05) in comparison to control. Live/dead staining did not reveal an increase in the number of dead cells on aligner surfaces. After two and seven days of incubation, interleukin (IL)-6 expression decreased, and IL-8 expression increased in HOKs cultured on aligner surfaces. The expression of intercellular adhesion molecule 1 (ICAM-1) significantly decreased after seven days. Gene expression of epithelial barrier markers showed that integrin (ITG)-α6 significantly decreased after two and seven days. A significant decrease in ITG-β4 and E-cadherin expression levels compared to control could only be seen after seven days. We did not find any cytotoxic effect, but alterations in the cell’s barrier functions and inflammatory reaction were obvious. Clinical studies are required to give further insights into clinical reactions on the underlying aligner material of this quickly expanding orthodontic appliance. Full article
(This article belongs to the Special Issue Applied Biomaterials in Oral Surgery and Personalized Dentistry)
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Article
Inhibitory Potential of Mangiferin on Glucansucrase Producing Streptococcus mutans Biofilm in Dental Plaque
Appl. Sci. 2020, 10(22), 8297; https://doi.org/10.3390/app10228297 - 23 Nov 2020
Cited by 1 | Viewed by 554
Abstract
Glucansucrase secreted by Streptococcus mutans and composed of virulence genes alters oral microbiota, creating adherent environment for structural bacteria colony forming dental biofilm. The present investigation studied the inhibitory and binding potentials of mangiferin against S. mutans and its enzyme glucansucrase implicated in [...] Read more.
Glucansucrase secreted by Streptococcus mutans and composed of virulence genes alters oral microbiota, creating adherent environment for structural bacteria colony forming dental biofilm. The present investigation studied the inhibitory and binding potentials of mangiferin against S. mutans and its enzyme glucansucrase implicated in biofilm formation. Antibacterial activity against planktonic S. mutans was carried out. Using reverse transcription PCR, the expression of crucial virulence genes, gtfB, gtfC, gtfD, gbpB, and comDE were determined. The effect of mangiferin on teeth surfaces biofilm was ascertained by scanning electron microscopy (SEM). Docking analysis of S. mutans glucansucrase and mangiferin revealed the binding energy of −7.35 and ten hydrogen interactions. Antibacterial study revealed that mangiferin was not lethal to planktonic S. mutans, but a concentration-dependent inhibition of glucansucrase activity was observed. The inhibitory effect of water-insoluble glucan synthesis was apparently more marked relative to water-soluble glucan synthesis attenuation. Mangiferin significantly downregulated the expression of the virulence genes, indicating a mechanism involving glucanotranferases, specifically inhibiting colony formation by attenuating bacterial adherence. SEM images revealed that S. mutans biofilm density was scanty in mangiferin treated teeth compared to non-treated control teeth. Our data therefore suggest that mangiferin inhibited S. mutans biofilms formation by attenuating glucansucrase activities without affecting bacteria growth. Full article
(This article belongs to the Special Issue Applied Biomaterials in Oral Surgery and Personalized Dentistry)
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Article
Load Transfer during Magnetic Mucoperiosteal Distraction in Newborns with Complete Unilateral and Bilateral Orofacial Clefts: A Three-Dimensional Finite Element Analysis
Appl. Sci. 2020, 10(21), 7728; https://doi.org/10.3390/app10217728 - 31 Oct 2020
Viewed by 506
Abstract
The primary correction of congenital complete unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) is challenging due to inherent lack of palatal tissue and small extent of the palatal shelves at birth. The tissue deficiency affects the nasal [...] Read more.
The primary correction of congenital complete unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) is challenging due to inherent lack of palatal tissue and small extent of the palatal shelves at birth. The tissue deficiency affects the nasal mucosa, maxillary bone and palatal mucosa. This condition has driven the evolution of several surgical and non-surgical techniques for mitigating the inherent problem of anatomical deficits. These techniques share the common principle of altering the neighboring tissues around the defect area in order to form a functional seal between the oral and nasal cavity. However, there is currently no option for rectifying the tissue deficiency itself. Investigations have repeatedly shown that despite the structural tissue deficiency of the cleft, craniofacial growth proceeds normal if the clefts remain untreated, but the cleft remains wide. Conversely, craniofacial growth is reduced after surgical repair and the related alteration of the tissues. Therefore, numerous attempts have been made to change the surgical technique and timing so as to reduce the effects of surgical repairs on craniofacial growth, but they have been only minimally effective so far. We have determined whether the intrinsic structural soft and hard tissue deficiency can be ameliorated before surgical repair using the principles of periosteal distraction by means of magnetic traction. Two three-dimensional maxillary finite element models, with cleft patterns of UCLP and BCLP, respectively, were created from computed tomography slice data using dedicated image analysis software. A virtual dental magnet was positioned on either side of the cleft at the mucoperiosteal borders, and an incremental magnetic attraction force of up to 5 N was applied to simulate periosteal distraction. The stresses and strains in the periosteal tissue induced by the magnet were calculated using finite element analysis. For a 1 N attraction force the maximum strains did not exceed 1500 µstrain suggesting that adaptive remodeling will not take place for attraction forces lower than 1 N. At 5 N the regions subject to remodeling differed between the UCLP and BCLP models. Stresses and strains at the periosteum of the palatal shelf ridges in the absence of compressive forces at the alveolar borders were greater in the UCLP model than the BCLP model. The findings suggest that in newborns with UCLP and BCLP, periosteal distraction by means of a magnetic 5 N attraction force can promote the generation of soft and hard tissues along the cleft edges and rectify the tissue deficiency associated with the malformation. Full article
(This article belongs to the Special Issue Applied Biomaterials in Oral Surgery and Personalized Dentistry)
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Article
Digital Models for the Analysis of Little’s Irregularity Index in Subjects with a Different Degree of Crowding: A Reproducibility Study
Appl. Sci. 2020, 10(20), 7108; https://doi.org/10.3390/app10207108 - 13 Oct 2020
Viewed by 567
Abstract
Background: To investigate the accuracy and reproducibility of digital measurements of Little’s Irregularity Index and to evaluate if different degrees of dental crowding could influence these measurements. Methods: The study included 40 dental models and 5 sub-groups were created according to [...] Read more.
Background: To investigate the accuracy and reproducibility of digital measurements of Little’s Irregularity Index and to evaluate if different degrees of dental crowding could influence these measurements. Methods: The study included 40 dental models and 5 sub-groups were created according to the severity of the crowding. In both the digital models and the study cast, Little’s Irregularity Index was recorded by measuring (1) the mesiodistal width of each tooth and (2) the arch lengths in both the maxillary and mandibular jaw. Two operators performed measurements on plaster and digital models using, respectively, a digital caliper and OrthoAnalyzerTM 3D software (3Shape A/S, Copenhagen, Denmark). Statistical analysis was performed to assess intra- and inter-operator variability, the accuracy between manual and digital measurements and if the amount of crowding could affect the accuracy of the digital measurements. Results: Concerning intra-examiner reliability, no statistically significant differences were detected (p > 0.05). In the maxillary and mandibular arch, the Intraclass Correlation Coefficient (ICC) value was 0.996 and 0.997 for the analogic measurements and 0.998 and 0.978 for the digital measurements. For the maxillary arch, the mean difference between the analogic and digital Little’s Irregularity Index (LII) measurements was 0.43 mm while for the mandibular arch the mean difference was 0.24 mm, showing some overestimation of the digital measurements (p < 0.05). No differences were found according to crowding subgroups (p > 0.05). Conclusions: Digital measurements of LII could be considered as a valid substitute of the gold standard analogical measurement. Full article
(This article belongs to the Special Issue Applied Biomaterials in Oral Surgery and Personalized Dentistry)
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Article
Tongue Posture, Tongue Movements, Swallowing, and Cerebral Areas Activation: A Functional Magnetic Resonance Imaging Study
Appl. Sci. 2020, 10(17), 6027; https://doi.org/10.3390/app10176027 - 31 Aug 2020
Cited by 1 | Viewed by 918
Abstract
The aim of this study was to pinpoint the cerebral regions implicated during swallowing by comparing the brain activation areas associated with two different volitional movements: tongue protrusion and tongue elevation. Twenty-four healthy subjects (11—males 22 ± 2.9 y; 13—females 23 ± 4.1 [...] Read more.
The aim of this study was to pinpoint the cerebral regions implicated during swallowing by comparing the brain activation areas associated with two different volitional movements: tongue protrusion and tongue elevation. Twenty-four healthy subjects (11—males 22 ± 2.9 y; 13—females 23 ± 4.1 y; were examined through functional magnetic resonance imaging (fMRI) while performing two different swallowing tasks: with tongue protrusion and with tongue elevation. The study was carried out with the help of fMRI imaging which assesses brain signals caused by changes in neuronal activity in response to sensory, motor or cognitive tasks. The precentral gyrus and the cerebellum were activated during both swallowing tasks while the postcentral gyrus, thalamus, and superior parietal lobule could be identified as large activation foci only during the protrusion task. During protrusion tasks, increased activations were also seen in the left-middle and medial frontal gyrus, right thalamus, inferior parietal lobule, and the superior temporal gyrus (15,592-voxels; Z-score 5.49 ± 0.90). Tongue elevation activated a large volume of cortex portions within the left sub-gyral cortex and minor activations in both right and left inferior parietal lobules, right postcentral gyrus, lentiform nucleus, subcortical structures, the anterior cingulate, and left insular cortex (3601-voxels; Z-score 5.23 ± 0.52). However, the overall activation during swallowing tasks with tongue elevation, was significantly less than swallowing tasks with tongue protrusion. These results suggest that tongue protrusion (on inferior incisors) during swallowing activates a widely distributed network of cortical and subcortical areas than tongue elevation (on incisor papilla), suggesting a less economic and physiologically more complex movement. These neuromuscular patterns of the tongue confirm the different purpose of elevation and protrusion during swallowing and might help professionals manage malocclusions and orofacial myofunctional disorders. Full article
(This article belongs to the Special Issue Applied Biomaterials in Oral Surgery and Personalized Dentistry)
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Article
Bite and Sight: Is There a Correlation? Clinical Association between Dental Malocclusion and Visual Disturbances in Pediatric Patients
Appl. Sci. 2020, 10(17), 5913; https://doi.org/10.3390/app10175913 - 26 Aug 2020
Viewed by 1537
Abstract
Aim: The aim of this study was to evaluate the correlation between malocclusions and visual defects. This is a case-control study evaluating the prevalence of visual defects in patients with different types of malocclusions. Methods: One-hundred and sixty patients aged from 5 to [...] Read more.
Aim: The aim of this study was to evaluate the correlation between malocclusions and visual defects. This is a case-control study evaluating the prevalence of visual defects in patients with different types of malocclusions. Methods: One-hundred and sixty patients aged from 5 to 14 were evaluated using the ROMA index to detect malocclusion; the ones with the lowest scores were used as the control group. They were also submitted to visual-capacity inspection for motility and refractive disorders. Results: Our work showed an enhanced prevalence of refractive defects or fusional vergence defects and alteration of eye movements (especially the saccades) in almost all dental malocclusions. Statistics: The Kappa test values for ROMA index were between 0.643 and 1.00 for the intraoperator agreement (0.00 < p < 0.002) and between 0.773 and 1.00 for the agreement between operators (p = 0 < 0.001). The statistically significance level for the correlation malocclusion/visual defects was set at p < 0.05. Statistical analyses were performed with the STATA software (version 15.0, Stata Corp LP, College Station, TX, USA). Conclusion: Considering the high level of the statistical analysis and the accuracy of the methodology used, these data allows the establishment of a huge correlation between sagittal, transversal and vertical malocclusions with ocular disorders (myopia, hyperopia, astigmatism and ocular motility defects). Full article
(This article belongs to the Special Issue Applied Biomaterials in Oral Surgery and Personalized Dentistry)
Article
The Combination of Diode Laser and Ozonated Water in the Treatment of Complicated Pulp Gangrene
Appl. Sci. 2020, 10(12), 4203; https://doi.org/10.3390/app10124203 - 19 Jun 2020
Cited by 3 | Viewed by 890
Abstract
The study aimed to investigate the effects of endodontic space decontamination using a laser combined with ozonated water in the therapy of complicated pulp gangrene. The subject of this in vivo study was a 12-year-old patient diagnosed with extensive periapical periodontitis on the [...] Read more.
The study aimed to investigate the effects of endodontic space decontamination using a laser combined with ozonated water in the therapy of complicated pulp gangrene. The subject of this in vivo study was a 12-year-old patient diagnosed with extensive periapical periodontitis on the mandibular right first molar. Biological samples were initially collected to identify the active pathogen—Enterococcus faecalis, then the nonsurgical endodontic treatment was performed in a single visit, according to the active disinfection guidelines of the identified pathogen. Two-month postoperative, clinical and radiological examination revealed a complete healing of the periapical lesion. The correct diagnosis of this endodontic–periodontal pathology, and the unconventional treatment of the complex system of infected root canals, allowed a favorable treatment result without any surgical intervention. This unconventional approach, which combines a laser technique with ozonated water, allows for predictable results in periapical lesion treatment. Full article
(This article belongs to the Special Issue Applied Biomaterials in Oral Surgery and Personalized Dentistry)
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Review

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Review
Efficacy of Rapid Maxillary Expansion with or without Previous Adenotonsillectomy for Pediatric Obstructive Sleep Apnea Syndrome Based on Polysomnographic Data: A Systematic Review and Meta-Analysis
Appl. Sci. 2020, 10(18), 6485; https://doi.org/10.3390/app10186485 - 17 Sep 2020
Cited by 3 | Viewed by 843
Abstract
Aim: To systematically review international literature related to rapid maxillary expansion (RME) as the treatment for obstructive sleep apnea syndrome (OSAS) in children less than 18 years-old, followed by a meta-analysis of the apnea-hypopnea index (AHI) before and after RME, with or without [...] Read more.
Aim: To systematically review international literature related to rapid maxillary expansion (RME) as the treatment for obstructive sleep apnea syndrome (OSAS) in children less than 18 years-old, followed by a meta-analysis of the apnea-hypopnea index (AHI) before and after RME, with or without a previous adenotonsillectomy (AT). Methods: Literature on databases from PubMed, Wiley online library, Cochrane Clinical Trials Register, Springer link, and Science Direct were analyzed up to March 2020. Two independent reviewers (S.G. and R.J.M.) screened, assessed, and extracted the quality of the publications. A meta-analysis was performed to compare AHI values before and after the treatment with RME. Results: Six studies reported outcomes for 102 children with a narrow maxillary arch suffering from OSAS with a mean age of 6.7 ± 1.3. AHI improved from a M ± SD of 7.5 ± 3.2/h to 2.5 ± 2.6/h. A higher AHI change in patients with no tonsils (83.4%) and small tonsils (97.7%) was detected when compared to children with large tonsils (56.4%). Data was analyzed based on a follow-up duration of ≤3 year in 79 children and >3 years in 23 children. Conclusion: Reduction in the AHI was detected in all 102 children with OSAS that underwent RME treatment, with or without an adenotonsillectomy. Additionally, a larger reduction in the AHI was observed in children with small tonsils or no tonsils. A general improvement on the daytime and nighttime symptoms of OSAS after RME therapy was noted in all the studies, demonstrating the efficacy of this therapy. Full article
(This article belongs to the Special Issue Applied Biomaterials in Oral Surgery and Personalized Dentistry)
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Review
Rigenera® Autologous Micrografts in Oral Regeneration: Clinical, Histological, and Radiographical Evaluations
Appl. Sci. 2020, 10(15), 5084; https://doi.org/10.3390/app10155084 - 23 Jul 2020
Cited by 4 | Viewed by 710
Abstract
Tissue engineering represents a novel approach that aims to exploit the use of biomaterials composed mainly of scaffolds, cells (or grafts), and growth factors capable of restoring a specific tissue. Biomaterials represent the future of dental and oral regeneration due to their biocompatibility [...] Read more.
Tissue engineering represents a novel approach that aims to exploit the use of biomaterials composed mainly of scaffolds, cells (or grafts), and growth factors capable of restoring a specific tissue. Biomaterials represent the future of dental and oral regeneration due to their biocompatibility and affinity with the receiving site. The aim of this review was to collect results and considerations about a new type of biomaterial based on the use of micrografts in combination with different scaffolds. Micrografts are tissue particles enriched with progenitor cells (PCs), which are defined as descendants of stem cells that can differentiate into specialized cells belonging to the same tissue. PCs in the oral cavity might be extracted from various tissues such as dental pulp, periosteum, or periodontal ligament. Moreover, these cells are easy to isolate through a mechanical process that allows for the filtration of cells with a diameter of 80 μm, in contrast with enzymatic procedures where reagents are used and various culture periods are needed. The aim of this review was to collect data regarding the use of micrografts, developed by a Rigenera® chair-side machine, in oral regeneration evaluating the clinical, histological, and radiographical outcomes. There have been encouraging results for the application of micrografts in bone and periodontal regeneration, but further randomized clinical trials are needed to validate this promising outcome. Full article
(This article belongs to the Special Issue Applied Biomaterials in Oral Surgery and Personalized Dentistry)
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