Tissue engineering in dentistry

Surgical reconstruction of large facial defects is not possible at times due to extensive loss of tissues that cannot be corrected by surgery alone. In these cases, prosthetic restoration of lost facial tissues can be done using maxillofacial prostheses. Introduction of new material which gives life-like appearance to such prosthetic restorations e.g. silicone and poly ether rubbers and use of implants to retain these prostheses have given a new dimension to rehabilitation of such patients. However, in certain clinical scenarios, conventional acrylic resin prostheses are still the recommended options. This report discuss clinical performance of two cases of prosthetic rehabilitation of the nasal component of the face secondary to resection due to malignancy and due to infections using external device retained maxillofacial prosthesis.

The science of tissue engineering aims at the repair of damaged tissues as well as creates replacement of the lost ones. This is becoming a major component of the regenerative medicine by combining the principles of transplantation, materials science and bioengineering to restore a diseased or a damaged tissue to normal function. The earliest attempts at tissue replacement thousands of years back involved teeth and even in modern times, dentistry has continued to place considerable emphasis on the study and use of biocompatible materials. For most of the general dental practitioners restoration of lost tooth tissue, whether from disease or trauma, represents a significant proportion of their daily routine. Considering the current prevalence of the dental diseases, it can be said that the challenge and resource burden of restoring lost tooth tissue will be with us for many years to come. Tissue engineering will have a considerable effect on dental practice during the next coming years. The greatest effects will likely be related to the repair and replacement of mineralized tissues, the promotion of oral wound healing, correction of craniofacial abnormalities, integration of biocompatible prosthetic implant materials with the oral tissues, the regeneration of dental hard and soft tissues and the use of gene transfer adjunctively. The purpose of this brief review is to provide the general dental practitioner a background of tissue engineering, its accomplishments in dentistry and its future promises to the profession in the form of regenerative dentistry.

Simplified treatment of severe dental erosion with ultrathin CAD-CAM composite occlusal veneers and anterior bilaminar veneers, 2016

sciencedirect.com Simplified treatment of severe dental erosion with ultrathin CAD-CAM composite occlusal veneers and anterior bilaminar veneers Luís Henrique Schlichting, Tayane Holz Resende, Kátia Rodrigues Reis, Pascal Magne The Journal of prosthetic dentistry 116 (4), 474-482, 2016 Restorative treatment for patients with dental erosion requires an analysis of the degree of structural damage. Patients affected by moderate to severe dental erosion are particularly challenging because complex occlusal reconstruction will be needed. Ultrathin bonded occlusal veneers represent a conservative alternative to traditional onlays and complete coverage crowns for the treatment of severe erosion. This article describes a complete mouth rehabilitation with ultrathin computer-aided design and computer-aided manufacturing (CAD-CAM) composite resin occlusal veneers in a patient with a severely eroded dentition. In the maxillary anterior teeth, the bilaminar approach was chosen with lingual composite resin veneers and labial porcelain veneers. The main benefit of this approach is the possibility of using additive adhesive techniques, allowing only strategic reduction of sound dental structure or no preparation.

Journal of the American Dental Association, 2000

Immediate implant placement and provisional restoration has become a popular and well-supported method of tooth replacement in the maxillary anterior dentition. Aside from achieving osseointegration, esthetic demands have grown with better understanding of the behavior of hard and soft tissues following this mode to therapy. Stability of gingival contours, texture of the surrounding tissues, and blending of prosthetic components with the natural dentition are critical for successful outcomes to be maintained long-term. Increasing soft tissue thickness at the time of therapy plays an important role in this regard. A technique combining the proven principles of immediate implant placement and provisional restoration with hard and soft tissue augmentation using nonautogenous materials is demonstrated with comparisons to nongrafted, temporized historical controls.

Nepal Medical College journal : NMCJ, 2009

One of the greatest assets a person can have is a smile that shows beautiful, natural teeth. The restoration of a smile is one of the most appreciated and gratifying services a dentist can render. The positive psychologic effects of improving a patient's smile often contribute to an improved self image and enhanced self esteem. Periodontal attachment loss in the maxillary anterior region can often lead to esthetic and functional clinical problems. Lifelong motivation is essential to the supportive therapy for these patients, and the maintenance of good esthetics, combined with conducive to maintaining long term dental and professional health. This paper aims to demonstrate an innovative treatment option for dealing with aesthetic challenges posed by a patient.

2012

Journal of Stomatology

Recent advances in removable prosthodontics include biofunctional prosthetic system (BPS), which closely replicates aesthetics, comfort, functional, and phonetic aspects of natural dentition. With this background in mind, we conducted a systematic review to critically evaluate application of BPS over conventional dentures in removable prosthodontics. A search for full text articles with keywords "biofunctional prosthetic system (BPS)", using PubMed search engine was carried out. Nine full text articles were eligible for final review and among them, three were of original research studies. All the original research articles were questionnaire-based studies. Six articles were reports of edentulous cases rehabilitated using BPS. The clinical findings and questionnaire responses of the studies revealed that the BPS performed better than the conventional dentures in most aspects of clinical evaluation. Moreover, the results showed that BPS systems outperformed conventional dentures in aesthetics, patient comfort, and function. Based on these findings, we concluded that the volume of literature available regarding the comparison of BPS to the conventional denture is insufficient to prove that it has a significant advantage over the conventional system. There is a definite need for larger number of clinical trials to establish the competitive superiority of BPS technique.

Several lesions or pathologies alter the symmetry, anatomical morphology and facial physiology of the patient affecting their quality of life; therefore they need to be adequately repaired. Customized prosthetic devices allow proper correction of these alterations through surgical interventions. Thus it is important to develop protocols aimed to design the prosthesis considering the anatomical parameters of the patient, its placement and the comprehensive approach to each case. Tissue engineering proposes new strategies for regeneration or replacement of tissues or organs, restoring the shape and function to the affected area. Many therapeutic approaches are based on stem cells since they could make the difference in promoting tissue acceleration and regeneration in clinical practice. With the prospect of being implemented in the field of oral-maxillofacial reconstruction, these developments could have positive effects on patient´s care, impacting on population health.