Search Results (144)

Mesenchymal stem cells (MSCs) are multipotent adult cells that are highly valued for their immunomodulatory potential and intrinsic ability to home to inflamed sites. This study specifically utilized human dental pulp stem cells (hDPSCs), a unique MSC subtype derived from the neural crest, due to their reported superior anti-inflammatory capacity. To rigorously test their efficacy, we employed the AIRmax murine model, which exhibits a genetically determined high-inflammatory phenotype. Acute inflammation was induced by subcutaneous injection of the polyacrylamide suspension Biogel P-100. Two hours post-induction, AIRmax mice were treated intravenously with hDPSCs. Our results demonstrate that hDPSC treatment produced significant anti-inflammatory effects evident at 24 h. The treated group showed a pronounced reduction in leukocyte migration and decreased protein extravasation in the inflammatory exudate. Crucially, hDPSCs also modulated molecular mediators, significantly decreasing the pro-inflammatory cytokine TNF-alpha and reactive oxygen species (ROS) production. Furthermore, while hDPSCs efficiently and rapidly homed to the inflammation site within 2 h, their maximal therapeutic benefits only manifested after 24 h. This suggests that their robust capacity to modulate acute inflammatory responses relies not only on rapid migration but also on a paracrine “hit-and-run” mechanism that suppresses cellular infiltration and oxidative stress over time. This study reinforces the potential of hDPSCs as a powerful, multi-target therapeutic agent for inflammatory conditions, supporting further investigation into their precise mechanisms and clinical application. Full article

Periodontal disease is a progressive inflammatory condition frequently diagnosed in dogs, particularly in small breeds such as Yorkshire Terriers, Toy Terriers, Spitz, Toy Poodles and other breeds predisposed to rapid plaque and tartar accumulation. As the field of regenerative medicine becomes more popular, more and more attention is being paid to substances that promote tissue regeneration, one of which is platelet-rich plasma (PRP). PRP is an autologous blood-derived product rich in growth factors that stimulate tissue regeneration and modulate inflammation. This study aimed to evaluate the clinical effectiveness of PRP injections without additional activating agents in the management of stage 2–3 periodontitis in small-breed dogs. Forty-two adult dogs (Yorkshire Terriers, Toy Terriers, Pomeranians, Toy Poodles, and Havanese) were enrolled and divided into two groups: PRP (n = 30) and control (n = 12). Following standard dental prophylaxis, the PRP group received gingival, submucosal, and periodontal pocket injections of PRP (0.1 mL per site). Periodontitis stage, gingival index, periodontal pocket depth, and horizontal bone loss were evaluated at baseline and 30 days post-treatment. PRP therapy significantly improved all evaluated parameters (p < 0.05). The gingival index decreased threefold, periodontal pocket depth was reduced twofold, and horizontal bone loss decreased by more than twofold compared with baseline and controls. No adverse reactions, discomfort, or postoperative complications were observed. The administration of non-activated PRP as an adjunct to dental cleaning significantly enhances soft and hard tissue regeneration in small-breed dogs with stage 2–3 periodontitis. PRP therapy represents a safe, minimally invasive, and effective regenerative approach for improving periodontal health in routine veterinary dentistry. Full article

Background: Chronic maxillary sinusitis is most often linked to dental, allergic, or anatomical etiologies, with foreign body-induced forms remaining rare. This case report describes a unique occurrence of chronic maxillary sinusitis resulting from misplaced hyaluronic filler due to a facial esthetic procedure. Case presentation: A 60-year-old woman experienced right-sided maxillary sinusitis symptoms for three years after hyaluronic filler injections. Multi-slice computed tomography showed total sinus opacification, a vermicular foreign body, and a small anterior wall perforation. The patient underwent Caldwell-Luc surgery for foreign body removal and mucosal excision, followed by histopathological analysis. Results: The procedure was successful, with complete extraction of the foreign body compatible with hyaluronic filler. Postoperative recovery was uneventful, and symptoms resolved. This rare complication likely resulted from accidental filler penetration into the maxillary sinus during the injection. Conclusions: To the best of our knowledge, after a detailed search of the available literature, this is the first reported case of chronic maxillary sinusitis caused by material that is compatible with misplaced hyaluronic filler. It stresses the critical need to minimize serious complications in the facial esthetic procedures through detailed anatomical knowledge, technical skill, and a strict credentialing protocol of practitioners. Further awareness and regulations could improve patient safety. Full article

Vital pulp therapy (VPT) seeks to preserve pulp vitality by using biocompatible with regenerative potential. This study tested the hypothesis that an injectable gelatin methacryloyl (GelMA) hydrogel containing piezoelectric barium titanate promotes odontogenic differentiation of dental pulp stem cells (DPSC) significantly better than a commercially available tricalcium silicate material used for vital pulp therapy. First, the light-curable, injectable piezoelectric hydrogel was engineered and characterized for its physicomechanical, piezoelectric properties and biocompatibility to DPSCs. The effect of this gel on the odontogenic differentiation of DPSCs was determined by measuring the expression level of key genes, compared to Biodentine XP. The hydrogel exhibited excellent injectability (<1 kgf of force), mechanical stability, and generated physiologically relevant voltages under cyclic loading mimicking mastication. MTT and ROS assays show no cytotoxic or damaging oxidative stress effects. When DPSCs were cultured over the materials under cyclic loading, the piezoelectric hydrogel significantly enhanced cell viability and upregulated COL1A1, DSPP, and DMP1 expression compared to Biodentine XP and non-piezoelectric hydrogel controls. These findings establish piezoelectric hydrogel as a self-powered, bioactive platform that converts physiological forces into regenerative bioelectric cues, offering a promising next-generation material for vital pulp therapy. Full article

This pilot study evaluated the feasibility and preliminary outcomes of computer-guided intraosseous anesthesia for oral surgery and dental implantology. Background/Objectives: The inferior alveolar nerve block (IANB) is widely used for dental anesthesia; however, issues such as anatomical variation and inflammation can hinder effective pain control. Alternatives have been studied primarily in irreversible pulpitis, with limited data available for other procedures. Methods: In a retrospective analysis, data from 85 patients who underwent implantation, root resection, or osteotomy using QuickSleeper^® intraosseous anesthesia (IO), infiltration (INF), or IANB were assessed. Results: IO, IANB, and INF produced similar pain levels during administration, procedure, and recovery; blood pressure and heart rate were comparable. IO and INF led to less lip numbness after 15 min and required less anesthetic. IO had a significantly shorter latency than IANB, allowing earlier surgery. Conclusions: Computer-guided IO is a viable alternative to IANB for implantation, root resection, and osteotomy, offering equal pain control, shorter latency, earlier surgery, and reduced injection volume. Within the limitations of this pilot study, the findings should be considered preliminary and require confirmation in larger prospective studies. Given the exploratory pilot design, no formal sample size calculation was performed; the sample size was defined by feasibility considerations. Full article

This study investigated bite force changes after botulinum toxin type A (BoNT-A) injection into different masticatory muscles. Thirty-five male participants were divided into three groups: masseter only (M), masseter and temporalis (MT), and masseter, temporalis, and medial pterygoid (MTP). Bite force was measured before and up to 6 months after injection with the Dental Prescale II system. Baseline values showed no significant group differences. Group M exhibited significant reduction at 1 and 2 weeks, with recovery within 1 month. Group MT showed a similar transient decrease, also recovering after 1 month. In contrast, Group MTP demonstrated a more pronounced and prolonged reduction, persisting up to 4 months before recovery. These results indicate that the extent and duration of BoNT-A effects depend on the number of muscles injected. Multi-muscle injections, including the medial pterygoid, provide more durable suppression. However, further research involving patient populations is needed to clarify whether multi-muscle injection strategies provide therapeutic benefits in clinical conditions such as temporomandibular disorders or oromandibular dystonia. Full article

Background/Objectives: Lidocaine hydrochloride (LD-HCl) is the most commonly used local anesthetic in dentistry, often administered with epinephrine to extend its duration and reduce systemic absorption. However, its relatively short duration of action, the need for repeated injections, and the unpleasant taste may limit patient compliance and procedural efficiency. This study aimed to develop and evaluate a novel injectable nanoemulsion-based in situ gel depot system of LD to provide prolonged anesthetic activity. Methods: LD-loaded nanoemulsions were formulated by high-shear homogenization followed by probe sonication, employing Miglyol 812 N (oil phase), a combination of Tween 80 and soy lecithin (surfactant–co-surfactant), glycerin, and deionized water (aqueous phase). The selected nanoemulsion (S1) was dispersed in a thermoreversible poloxamer solution to form a nanoemulgel. The preparation was evaluated for globule diameter and uniformity, zeta potential, surface morphology, pH, drug content, stability, rheological behavior, injectability, and in vitro drug release. Analgesic efficacy was assessed via tail-flick and thermal paw withdrawal latency tests in Wistar rats. Cardiovascular safety was monitored using non-invasive electrocardiography and blood pressure measurements. Results: The developed nanoemulsions demonstrated a spherical shape, nanometer size (206 nm), high zeta-potential (−66.67 mV) and uniform size distribution, with a polydispersity index of approximately 0.40, while the nanoemulgel demonstrated appropriate thixotropic properties for parenteral administration. In vitro release profiles showed steady LD release (5 h), following the Higuchi model. In vivo studies showed significantly prolonged analgesic effects lasting up to 150 min (2.5 h) compared to standard LD-HCl injection (p < 0.001), with no adverse cardiovascular effects observed. Conclusions: The developed injectable LD in situ nanoemulgel offers a promising, patient-friendly alternative for prolonged anesthetic delivery in dental and operative procedures, potentially reducing the need for repeated injections and enhancing procedural comfort. Full article

As life expectancy continues to increase, age-related disorders are becoming more prevalent. Among these, vascular complications resulting from chronic inflammation are particularly concerning, as they impair angiogenesis and hinder tissue repair, both processes that heavily rely on a well-structured extracellular matrix (ECM). In this context, MicroMatrix^® UBM Particulate, a skin substitute composed of collagen, laminin, and proteoglycans, appears to offer properties conducive to tissue regeneration. The aim of this study was to evaluate the regenerative potential of MicroMatrix^® combined with the Secretome of human Dental Pulp Stem Cells (hDPSC-S), using the medicinal leech Hirudo verbana, a well-established model for studying wound healing, angiogenesis, and tissue regeneration. Adult leeches were injected with MicroMatrix^® either suspended in FBS-free medium (CTRL) or supplemented with hDPSC-S. 1-week post-treatment, the animals were sacrificed and subjected to morphological and immunohistochemical analyses. Our findings revealed that MicroMatrix^® successfully integrated into the leech body wall. Notably, when supplemented with hDPSC-S, there was a marked increase in cell infiltration, including telocytes and Hematopoietic Precursor Stem Cells, along with a significantly higher vessel density compared to CTRL. These results support the effectiveness of the cell-free device composed of MicroMatrix^® and hDPSC-S, highlighting its potential as a promising strategy for regenerative therapies aimed at treating complex wounds with poor vascularization. Full article

Background and Objectives: Dental anxiety can hinder both treatment delivery and dental education. Few studies have examined this issue among Romanian dental students. This study assessed the prevalence, intensity, and main procedural triggers of dental anxiety, with a focus on experiences related to local anesthesia. Methods: A cross-sectional survey was conducted (January–May 2024) among 122 fourth-year students using the validated Romanian version of the Modified Dental Anxiety Scale (MDAS) and additional items on demographics, prior anesthesia and perceived complications. Data analysis included descriptive statistics, chi-square tests, and t-tests. Results: Overall, 21.3% of respondents scored in the low anxiety range, 75.4% in the moderate range, and 3.3% in the severe range (MDAS ≥ 19). No significant gender differences were identified (p > 0.05). Injections with local anesthetic were rated as the most distressing procedure, followed by drilling, whereas scaling was reported as least stressful. The majority (86.9%) had undergone previous local anesthesia, with very few adverse events recalled. Conclusions: Romanian dental students reported moderate dental anxiety overall, with local anesthesia injections as the main trigger. The lack of gender differences points to a potential buffering effect of clinical exposure. Incorporating structured anxiety management into dental curricula may enhance both student well-being and patient care. Full article

Background: Local anesthesia is essential for most dental procedures, but its parenteral administration is often painful. Topical anesthetics are commonly used to minimize local anesthesia pain; however, commercial formulations fail to fully prevent the discomfort of local anesthetic injection. Methods: We developed and characterized a novel lidocaine and epinephrine co-loaded liquid crystalline precursor system (LCPS) for topical anesthesia. The formulation was structurally characterized using polarized light microscopy (PLM) and small-angle X-ray scattering (SAXS). Rheological behavior was assessed through continuous and oscillatory rheological analyses. Texture profile analysis, in vitro mucoadhesive force evaluation, in vitro drug release and permeation studies, and an in vivo toxicity assay using the chicken chorioallantoic membrane (CAM) model were also conducted. Results: PLM and SAXS confirmed the transition of the LCPS from a microemulsion to a lamellar liquid crystalline structure upon contact with artificial saliva. This transition enhanced formulation consistency by over 100 times and tripled mucoadhesion strength. The LCPS also provided controlled drug release, reducing permeation flow by 93% compared to the commercial formulation. Importantly, the CAM assay indicated that the LCPS exhibited similar toxicity to the commercial product. Conclusions: The developed LCPS demonstrated promising physicochemical and biological properties for topical anesthesia, including enhanced mucoadhesion, controlled drug delivery, and acceptable biocompatibility. These findings support its potential for in vivo application and future clinical use to reduce pain during dental anesthesia procedures. Full article

Dental caries can cause premature loss of deciduous teeth, affecting children’s growth and development. Endodontic treatment using polymer posts is an effective solution. This study explores biodegradable root canal posts made from Polylactic Acid (PLA), Polycaprolactone (PCL), and amorphous calcium phosphate (ACP), aiming to enhance mechanical properties, minimize polymer degradation acidity, and prevent inflammation. A root canal post with a spherical head and serrated structure was designed and produced via micromolding and optimized using the Taguchi experimental method. The melt temperature, injection speed, and holding speed were analyzed for their influence on shrinkage, revealing an optimal rate of 2.575%, representing the sum of axial and radial shrinkage. The melt temperature had the highest impact (55.932%), followed by holding speed (33.575%), with there being minimal effect from injection speed. The composite exhibited a flexural strength of 21.936 MPa, a modulus of 2.083 GPa, and a hydrophilic contact angle of 73.73 degrees. Cell survival tests confirmed biocompatibility, with a survival rate exceeding 70% and no toxicity. These findings highlight the potential of PLA/PCL/ACP composites, combined with injection molding, for developing biodegradable root canal posts in primary teeth. Full article

Objective: Successful local anesthesia reduces patient pain and anxiety, facilitates the procedure, and enhances overall comfort; however, in children, it may also increase the risk of parafunctional activities in anesthetized areas. This retrospective study aimed to evaluate the factors influencing the risk of self-inflicted injuries. Methods: A study was conducted from January to December 2023 using the records of 4285 pediatric patients aged 4–12 years who underwent dental treatment under local anesthesia. Among 1161 cases at Poznan University (Poland), 73 (6.3%) of self-inflicted injuries were reported. At Rome University (Italy), 823 cases were reviewed, with 522 involving local anesthesia and 23 cases (4.4%) of trauma. Results: The overall prevalence of trauma following local anesthesia was 5.9%, indicating significant clinical concern. The lips were the most commonly affected (69.9%), followed by the cheeks (15.1%) and tongue (15.1%). The study confirmed a positive correlation between younger age and higher trauma incidence, with no significant differences in sex or ethnicity. Longer anesthesia duration and higher anesthetic doses were associated with increased lesion severity. The type of anesthetic also played a role, with articaine showing a higher risk compared to lidocaine. Furthermore, the type of injection influenced trauma incidence, due to the distribution of numbness and exploratory behaviors. Conclusions: Local anesthesia remains an indispensable tool in pain management in pediatric dentistry. However, the risk of self-inflicted injuries is not limited to the youngest patient. Proper education on post-anesthetic care is essential for minimizing complications and ensuring safe and effective dental treatment. Full article

Polymers are essential materials in the fabrication of partial and complete dentures, where their mechanical properties directly impact durability, comfort, and clinical performance. This study examines the influence of different manufacturing temperatures on the surface hardness of polymeric materials used in dental applications. A total of 60 experimental samples with a rectangular shape of Vertex ThermoSens polymer (Vertex Dental, 3D Systems, Soesterberg, The Netherlands) were fabricated through injection molding at 280 °C and 300 °C and analyzed over time to assess changes in their properties. Hardness measurements, conducted using the EQUOTIP Shore D hardness tester (Proceq SA, Schwerzenbach, Canton of Zürich, Switzerland), indicated increased hardness over time, with higher values observed in samples fabricated at 300 °C. A two-way ANOVA was performed to evaluate the statistical significance of temperature and time on hardness, revealing a significant effect (F = 14.73, p = 0.0185). These findings suggest that processing polymers at elevated temperatures improves surface hardness, significant for denture longevity and patient comfort. Increased hardness contributes to greater wear resistance. Optimizing polymer manufacturing conditions can thus lead to improved clinical outcomes, ensuring more durable and biocompatible dental prostheses. Full article

Background/Objectives: Temporomandibular disorders (TMDs) are the most common cause of non-dental pain in the orofacial region. Due to the complex and multifactorial nature of TMD, a multidisciplinary approach is often required. The objective of this narrative review is to evaluate the effectiveness of multimodal therapies in the management of TMD. Methods: A literature search was performed using a combination of keywords: “TMD”, “TMJ”, “disorders”, “manual therapy”, “physical therapy”, “dry needling”, “botulinum toxin”, “Botox”, “splint”, and “psychotherapy”. The search was conducted in the PubMed, Google Scholar, and Scopus databases, focusing on studies involving human subjects. Results: The included studies reported that the use of multimodal approaches—such as physiotherapy, botulinum toxin injections, occlusal splints, and/or psychotherapy—led to symptom improvement or complete resolution in patients with TMD. Conclusions: Temporomandibular disorders are complex conditions with a multifactorial etiology involving both somatic and psychological components. Given the wide range of symptoms and the functional connections of the temporomandibular joint with the nervous, muscular, and skeletal systems—including the cervical spine—effective treatment of TMD requires a multidisciplinary strategy. Full article

Background and Clinical Significance: Local anesthetic injections, routine in dental practice, ensure pain control during procedures like root canal treatments. Though generally safe, they can occasionally cause hematomas, localized blood accumulations in tissue planes. Rapidly expanding hematomas in the head and neck are exceptionally rare but dangerous due to anatomical complexity, potentially threatening the airway. This case report emphasizes the critical need for the prompt recognition and management of such complications to prevent life-threatening outcomes, highlighting vigilance in routine dental procedures. Case Presentation: A 63-year-old male presented with rapidly enlarging right buccal swelling four hours post-local anesthetic injection for a root canal on a right maxillary molar. Examination showed warm, erythematous edema and buccal ecchymosis; a CT scan confirmed a 3.8 cm × 8.4 cm × 5.5 cm buccal space hematoma. His medical history revealed controlled type 2 diabetes and hyperlipidemia, and his coagulation was normal. Conservative management failed as the hematoma progressed, limiting mouth and eye opening. Urgent surgical decompression under general anesthesia evacuated clots and ligated facial and angular arteries. ICU monitoring ensured airway stability, with discharge on day three with antibiotics and follow-up. Conclusions: This case highlights the rare potential for dental anesthetic injections to cause rapidly progressive hematomas, requiring urgent surgical intervention and multidisciplinary care to prevent airway compromise. Early recognition, imaging, and decisive management are vital in achieving favorable outcomes in such serious complications. Full article