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Regenerative Endodontics
Regenerative endodontic procedures is defined as biologically based procedures designed to replace damaged structures such as dentin, root structures, and cells of the pulp-dentin complex. This new treatment modality aims to promote normal function of the pulp. It has become an alternative to heal apical periodontitis. Regenerative endodontics is the extension of root canal therapy. Conventional root canal therapy cleans and fills the pulp chamber with biologically inert material after destruction of the dental pulp, pulp due to dental caries, congenital deformity or trauma. Regenerative endodontics instead seeks to replace live tissue in the pulp chamber. The ultimate goal of regenerative endodontic procedures is to regenerate the tissues and the normal function of the dentin-pulp complex. Before this treatment modality is introduced, apexification procedures using either immediate placement of mineral trioxide aggregate apical plug or long term-calcium hydroxide treatment were t ...
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Endodontic
Endodontics () is the dental specialty concerned with the study and treatment of the dental pulp. Overview Endodontics encompasses the study (practice) of the basic and clinical sciences of normal dental pulp, the etiology, diagnosis, prevention, and treatment of diseases and injuries of the dental pulp along with associated periradicular conditions. In clinical terms, endodontics involves either preserving part, or all of the dental pulp in health, or removing all of the pulp in irreversible disease. This includes teeth with irreversibly inflamed and infected pulpal tissue. Not only does endodontics involve treatment when a dental pulp is present, but also includes preserving teeth which have failed to respond to non-surgical endodontic treatment, or for teeth that have developed new lesions, e.g., when root canal re-treatment is required, or periradicular surgery. Endodontic treatment is one of the most common procedures. If the dental pulp (containing nerves, arterioles, ...
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Dentin
Dentin ( ) (American English) or dentine ( or ) (British English) () is a calcified tissue (biology), tissue of the body and, along with tooth enamel, enamel, cementum, and pulp (tooth), pulp, is one of the four major components of teeth. It is usually covered by enamel on the crown and cementum on the root and surrounds the entire pulp. By volume, 45% of dentin consists of the mineral hydroxyapatite, 33% is organic material, and 22% is water. Yellow in appearance, it greatly affects the color of a tooth due to the translucency of enamel. Dentin, which is less mineralized and less brittle than enamel, is necessary for the support of enamel. Dentin rates approximately 3 on the Mohs scale of mineral hardness. There are two main characteristics which distinguish dentin from enamel: firstly, dentin forms throughout life; secondly, dentin is sensitive and can become hypersensitive to changes in temperature due to the sensory function of odontoblasts, especially when enamel recedes an ...
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Toothache
Toothaches, also known as dental pain or tooth pain,Segen JC. (2002). ''McGraw-Hill Concise Dictionary of Modern Medicine''. The McGraw-Hill Companies. is pain in the teeth or their supporting structures, caused by dental diseases or referred pain, pain referred to the teeth by non-dental diseases. When severe it may impact sleep, eating, and other daily activities. Common causes include pulpitis, inflammation of the pulp, (usually in response to dental caries, tooth decay, dental trauma, or other factors), dentin hypersensitivity, apical periodontitis (inflammation of the periodontal ligament and alveolar bone around the Root apex (dental), root apex), dental abscesses (localized collections of pus), alveolar osteitis ("dry socket", a possible complication of dental extraction, tooth extraction), acute necrotizing ulcerative gingivitis (a gum infection), and temporomandibular disorder. Pulpitis is reversible when the pain is mild to moderate and lasts for a short time afte ...
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Dental Pulp Stem Cells
Dental pulp stem cells (DPSCs) are stem cells present in the dental pulp, which is the soft living tissue within teeth. DPSCs can be collected from dental pulp by means of a non-invasive practice. It can be performed with an adult after simple extraction or to the young after surgical extraction of wisdom teeth. They are pluripotent, as they can form embryoid body-like structures (EBs) ''in vitro'' and teratoma-like structures that contained tissues derived from all three embryonic germ layers when injected in nude mice. DPSCs can differentiate ''in vitro'' into tissues that have similar characteristics to mesoderm, endoderm and ectoderm layers. They can differentiate into many cell types, such as odontoblasts, neural progenitors, osteoblasts, chondrocytes, and adipocytes. DPSCs were found to be able to differentiate into adipocytes and neural-like cells. DPSC differentiation into osteogenic lines is enhanced in 3D condition and hypoxia. These cells can be obtained from postnatal t ...
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GSK-3
Glycogen synthase kinase 3 (GSK-3) is a serine/threonine protein kinase that mediates the addition of phosphate molecules onto serine and threonine amino acid residues. First discovered in 1980 as a regulatory kinase for its namesake, glycogen synthase (GS), GSK-3 has since been identified as a protein kinase for over 100 different proteins in a variety of different pathways. In mammals, including humans, GSK-3 exists in two isozymes encoded by two homologous genes GSK-3α (GSK3A) and GSK-3β (GSK3B). GSK-3 has been the subject of much research since it has been implicated in a number of diseases, including type 2 diabetes, Alzheimer's disease, inflammation, cancer, addiction and bipolar disorder. GSK-3 is a serine/threonine protein kinase that phosphorylate either threonine or serine, and this phosphorylation controls a variety of biological activities, such as glycogen metabolism, cell signaling, cellular transport, and others. GS inhibition by GSK-3β leads to a decrease in ...
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King's College London
King's College London (informally King's or KCL) is a public university, public research university in London, England. King's was established by royal charter in 1829 under the patronage of George IV of the United Kingdom, King George IV and the Arthur Wellesley, 1st Duke of Wellington, Duke of Wellington. In 1836, King's became one of the two founding colleges of the University of London. It is one of the Third-oldest university in England debate, oldest university-level institutions in England. In the late 20th century, King's grew through a series of mergers, including with Queen Elizabeth College and Chelsea College of Science and Technology (1985), the Institute of Psychiatry (1997), the United Medical and Dental Schools of Guy's and St Thomas' Hospitals and the Florence Nightingale School of Nursing and Midwifery (in 1998). King's operates across five main campuses: the historic Strand Campus in central London, three other Thames-side campuses (Guy's, St Thomas' an ...
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Human Tooth Development
Tooth development or odontogenesis is the complex process by which teeth form from embryonic cells, grow, and erupt into the mouth. For human teeth to have a healthy oral environment, all parts of the tooth must develop during appropriate stages of fetal development. Primary (baby) teeth start to form between the sixth and eighth week of prenatal development, and permanent teeth begin to form in the twentieth week.Ten Cate's Oral Histology, Nanci, Elsevier, 2013, pages 70-94 If teeth do not start to develop at or near these times, they will not develop at all, resulting in hypodontia or anodontia. A significant amount of research has focused on determining the processes that initiate tooth development. It is widely accepted that there is a factor within the tissues of the first pharyngeal arch that is necessary for the development of teeth. Overview The tooth germ is an aggregation of cells that eventually forms a tooth.University of Texas Medical Branch. These cells are ...
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Dens Invaginatus
Dens invaginatus (DI), also known as tooth within a tooth, is a rare dental malformation and a developmental anomaly where there is an infolding of enamel into dentin. The prevalence of this condition is 0.3 - 10%, affecting males more frequently than females. The condition presents in two forms, coronal involving tooth crown and radicular involving tooth root, with the former being more common. DI is a malformation of teeth most likely resulting from an infolding of the dental papilla during tooth development or invagination of all layers of the enamel organ in dental papillae. Affected teeth show a deep infolding of enamel and dentin starting from the foramen coecum or even the tip of the cusps and which may extend deep into the root. Teeth most affected are maxillary lateral incisors Incisors (from Latin ''incidere'', "to cut") are the front teeth present in most mammals. They are located in the premaxilla above and on the mandible below. Humans have a total of eight (two ...
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Dens Evaginatus
Dens evaginatus is a rare odontogenic developmental anomaly that is found in teeth where the outer surface appears to form an extra bump or cusp. Premolars are more likely to be affected than any other tooth. It could occur unilaterally or bilaterally. Dens evaginatus (DE) typically occurs bilaterally and symmetrically. This may be seen more frequently in Asians (including Chinese, Malay, Thai, Japanese, Filipino and Indian populations). The prevalence of DE ranges from 0.06% to 7.7% depending on the race. It is more common in men than in women, more frequent in the mandibular teeth than the maxillary teeth. Patients with Ellis-van Creveld syndrome, incontinentia pigmenti achromians, Mohr syndrome, Rubinstein-Taybi syndrome and Sturge Weber syndrome are at a higher risk of having DE. Signs and symptoms It is important to diagnose DE early and provide appropriate treatment to help prevent periodontal disease, caries, pulpal complications and malocclusion. It occurs ...
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Platelet Rich Fibrin
Platelet-rich fibrin (PRF) or leukocyte- and platelet-rich fibrin (L-PRF) is a derivative of PRP where autologous platelets and leukocytes are present in a complex fibrin matrix to accelerate the healing of soft and hard tissue and is used as a tissue-engineering scaffold in oral and maxillofacial surgeries. PRF falls under FDA Product Code KST, labeling it as a blood draw/Hematology product classifying it as 510(k) exempt. To obtain PRF, the required quantity of blood is drawn into test tubes without an anticoagulant and centrifuged immediately. Blood can be centrifuged using a tabletop centrifuge from 3-8 minutes for 1300 revolutions per minute. The resultant product consists of the following three layers: the topmost layer consisting of platelet poor plasma, the PRF clot in the middle, and the red blood cells (RBC) at the bottom. The PRF clot can be removed from the test tube using a pickup instrument (such as Gerald tissue forceps). The RBC layer attached to the PRF clot can be ...
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Human Tooth
Humans (''Homo sapiens'') or modern humans are the most common and widespread species of primate, and the last surviving species of the genus ''Homo''. They are great apes characterized by their hairlessness, bipedalism, and high intelligence. Humans have large brains, enabling more advanced cognitive skills that facilitate successful adaptation to varied environments, development of sophisticated tools, and formation of complex social structures and civilizations. Humans are highly social, with individual humans tending to belong to a multi-layered network of distinct social groups — from families and peer groups to corporations and political states. As such, social interactions between humans have established a wide variety of values, social norms, languages, and traditions (collectively termed institutions), each of which bolsters human society. Humans are also highly curious: the desire to understand and influence phenomena has motivated humanity' ...
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Root Canal Therapy
Root canal treatment (also known as endodontic therapy, endodontic treatment, or root canal therapy) is a treatment sequence for the infected pulp of a tooth that is intended to result in the elimination of infection and the protection of the decontaminated tooth from future microbial invasion. It is generally done when the cavity is too big for a normal filling. Root canals, and their associated pulp chamber, are the physical hollows within a tooth that are naturally inhabited by nerve tissue, blood vessels and other cellular entities. Endodontic therapy involves the removal of these structures, disinfection and the subsequent shaping, cleaning, and decontamination of the hollows with small files and irrigating solutions, and the obturation (filling) of the decontaminated canals. Filling of the cleaned and decontaminated canals is done with an inert filling such as gutta-percha and typically a zinc oxide eugenol-based cement. Epoxy resin is employed to bind gutta-percha ...
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