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The faculty and PG students have almost 400 publications to their credit in various national and international journals of repute. The faculty has also authored many books of high repute and contributed chapters in many books.

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Over 300 research activity projects have been carried out and submitted to the University from various departments.

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Upcoming xvi th national pg convention of indian academy of oral pathologists in subharti dental college, 24-25th june 2017, latest news @ sdc, oral hygiene day celebrated, cde on integrating periodontics for accelerated orthodontics, world health day was celebrated in subharti dental college & hospital, subharti dental college celebrated annual cultural and sports week – impulse 2016 ., bls course organized for students and faculty, orientation programme for the new batch of bds 2015 was held on 1st of september 2015., teacher’s day celebrated in subharti dental college, dentist day, continuing dental education programme, bds students and interns won 8 gold medals, celebrated annual cultural and sports week, dr. nikhil srivastava elected as executive committee member, dr. nikhil srivastava awarded with the prestigious star pedodontist award, fresher's day, subharti students win medals.

All submitted articles undergo double peer review process and are selectively accepted upon approval of an Editor. Published articles are immediately made available for the readers to read and download without any restriction barriers under the terms of Creative Common Attribution License. Journal scope includes but not limit to blepharoplasty, cleft palate, cosmetic facial surgery, craniofacial surgery, cranio-maxillofacial trauma, dental implant, facial reconstruction, head and neck reconstruction, lip reconstruction, mandibular nerve surgery, neck liposuction, oro facial pain, orofacial surgery braces, orthogenetic surgery, osseo integration, plastic and reconstructive surgery, rhytidectomy, scalp surgery, upper jaw surgery, etc.

Journal Information

Title: Research Reports in Oral and Maxillofacial Surgery

ISSN: 2643-3907

Editor-in-chief: Zi-Jun Liu

NLM title abbreviation: Res Rep Oral Maxillofac Surg

ISO abbreviation: Res Rep Oral Maxillofac Surg

Other titles: IAOMS

Category: Oral/Maxillofacial

DOI: 10.23937/2643-3907

Peer review: Double blind

Review speed: 3 weeks

Fast-track review: 10 days

Publication format (s): Electronic and print

Publication policy: Open Access; COPE guide

Publication type(s): Periodicals

Publisher: ClinMed International Library

Country of publication: USA

Language: English

Contact email: [email protected]

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All articles are fully peer reviewed, free to access and can be downloaded from our ClinMed archive.

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ClinMed Journals Index Copernicus Values

Clinical Medical Image Library: 93.51

International Journal of Critical Care and Emergency Medicine: 92.83

International Journal of Sports and Exercise Medicine: 91.84

International Journal of Womens Health and Wellness: 91.79

Journal of Musculoskeletal Disorders and Treatment: 91.73

Journal of Geriatric Medicine and Gerontology: 91.55

Journal of Infectious Diseases and Epidemiology: 91.55

Clinical Medical Reviews and Case Reports: 91.40

International Archives of Nursing and Health Care: 90.87

International Journal of Ophthalmology and Clinical Research: 90.80

International Archives of Urology and Complications: 90.73

Journal of Clinical Nephrology and Renal Care: 90.33

Journal of Family Medicine and Disease Prevention: 89.99

Journal of Clinical Gastroenterology and Treatment: 89.54

Journal of Dermatology Research and Therapy: 89.34

International Journal of Clinical Cardiology: 89.24

International Journal of Radiology and Imaging Technology: 88.88

Obstetrics and Gynaecology Cases - Reviews: 88.42

International Journal of Blood Research and Disorders: 88.22

International Journal of Diabetes and Clinical Research: 87.97

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Home > Dentistry > dissertations

School of Dentistry Dissertations and Theses

The School of Dentistry Dissertations and Theses Series is comprised of dissertations and theses authored by Marquette University's School of Dentistry doctoral and master's students.

Theses/Dissertations from 2024 2024

IN VITRO COMPARISON OF CELLULAR CYTOXICITY OF CONVENTIONAL VS. CAD/CAM DENTURE BASE MATERIALS , Zainab Hill Albasry

A COMPUTATIONAL FLUID DYNAMICS ANALYSIS COMPARING IRRIGATION WITHIN COMPLEX ROOT CANAL ANATOMY , Madeleinne Fern

Impact of Learning-Style-Based Education on Student Performance and Perception in Preclinical Endodontics: Part II , Rebecca Flaugher

PREEMPTIVE ANALGESIA AND PAIN AFTER PERIODONTAL AND IMPLANT- RELATED PROCEDURES: A SYSTEMATIC REVIEW AND META-ANALYSIS , Christos Gousias

Sleeveless guides are more accurate than sleeved guides: An in vitro study , Jenna Hang

RELIABILITY OF THE CVMS METHOD TO ASSESS THE CRANIOFACIAL GROWTH SPURT , Holly Ingersoll

Morphology of the Cranial Base of Untreated Class I and Class II Subjects , Ethan Just

Performance and Preference of Rotary Files by Pre-Doctoral Dental Students at Marquette School of Dentistry , Morgan Elizabeth McCall

Contribution of Dentoalveolar Heights on Facial Heights in Class I and Class II Untreated Subjects , Mira Bharat Suvagia

ORTHODONTIC LOAD QUANTIFICATION LEVELING A DEEP CURVE OF SPEE WITH DIFFERENT ARCHWIRE DESIGNS , Ahmed Youssef

Theses/Dissertations from 2023 2023

Effects of Thermocycling and Hydrolytic Aging on The Flexural Strength of Additively Manufactured Restorative Materials , Steven Mustafa Abu Al Tamn

LONG-TERM ASSESSMENT OF SKELETAL AND DENTAL ASYMMETRY AFTER CONVENTIONAL AND MINI-SCREW ASSISTED RAPID PALATAL EXPANSION , Brett Barton

Maxillary and Mandibular Incisor and Molar Dentoalveolar Heights in Untreated Subjects Presenting Class I and Class II Malocclusion , Samantha Zavada Cardinal

Factors Associated with Extraction Versus Non-Extraction Treatment Among Orthodontic Patients at Marquette University , Kelley Dentino

Short and Long-Term Effects of Conventional and Miniscrew-Assisted Rapid Palatal Expansion on Hard Tissues Using Voxel-Based Superimposition of Serial CBCTs , Isaac R. Empson

The Effect of Endodontic Access Cavity Designs on Crack Propagation of Mandibular Molars , Colin Kodama

Alveolar Bone Remodeling In Response to Orthodontic Tooth Movement , Matthew Raymond McGrady

A Digital Assessment of Centric Relation Precision , Christine Roenitz

The Influence of the Digitization Method on the Assessment of Accuracy and Reliability of Implant Placements , Ajitesh Singh

Immediate Postoperative Dimensional Changes Following Implant Placement , Juan Felipe Valencia Rincon

The Influence of Peri-Cervical Dentin Conservation on the Propagation of Cracks in Mandibular Molars , Hassanain Zaheer

Theses/Dissertations from 2022 2022

Edge-Chipping and Translucency Comparison Among Lithium Silicate-Based Ceramics , Essa Abdullah Alghamdi

Associations Between the Movement of Hard and Soft Tissues After Orthodontic Proclination of Incisors , Scott Beard

Evaluation of Damon PSL and Conventional MBT Brackets in Leveling and Alignment Efficiency , Jacob Beckstrand

Activated Charcoal Versus a Chemical Whitening Agent: Effect on Human Enamel , Hien Thai Doan

Color Characterization of Color Changing Orthodontic Adhesives , Megan Fried

Influence of Free-End Distal Extension on the Accuracy of Guided Implant Placement: An In Vitro Study , Geoffrey Ganzman

Influence of Multiple Root-End Surgery or Root Amputation on Root Surface Stress Distribution , John Curtis Jurkas

Autoignition and Sooting Characteristics of Iso-Octane and Ethanol in an Optical Rapid Compression Machine , Richard John Kempf

The Effect of Tray Design and Impression Material Consistencies on Accuracy of Complete Arch Implant Supported Fixed Dental Prostheses Master Casts , lujain Kurdi

Immediate Postoperative Dimensional Changes Following Guided Bone Regeneration , Morvarid Monfaredzadeh

The Accuracy and Sensitivity of ABO Electronic Cast Radiographic Program ORTHOSHARE 360 Compared to Manual Measurements , Lisa Nguyen

Identifying Optimal Composite Resin Depth to Maximize Fracture Resistance when Restoring Immature Endodontically Treated Teeth , David Poe

Mechanism of Mechanical Vibration in Enhancing Orthodontic Retention- Analysis of Global Gene Expression , Shuwei Wang

Theses/Dissertations from 2021 2021

In Vitro Study to Analyze Reverse Torque Values of Prosthetic Screws with Multiple Loosening/Tightening Preload Cycles , Amira Alhameed

Effects of Cleaning Agents on the Properties of Two Different Thermoplastic Retainer Materials , Jennifer Brehove

Correction of Excessive Gingival Display: Lip Repositioning with/without Myotomy , Austin Michael Dodge

The Influence of the Operator Experience on the Accuracy of Implant Placement: An In Vitro Study , Jeffrey Garcia

Root-End Surgery or Nonsurgical Retreatment: Are There Differences in Long Term Outcome? , Enida Haxhia

Mechanism of Mechanical Vibration in Enhancing Orthodontic Retention , Brent A. Ito

The Incidence of Root Canal Therapy or Extraction after Orthodontic Treatment: A Ten-Year Retrospective Study , Thomas Korte

Outcomes of Nonsurgical Root Canal Therapy Completed in Children Aged 6-13 Years , Lauren M. Loney

Comparing Orthodontic Debonding Aerosol Production with Various High-Volume Evacuation Systems , Eric Moe

Bending and Phase Transformation Properties of a Force Gradient Nickel-Titanium Orthodontic Wire , Brinda Shah

Effects of Fluoride on Corrosion Properties of Orthodontic Retention Wires , John J. Simindinger

Shear Bond Strength Characteristics on Surface Treatment Modalities of CAD-CAM Resin Based Core Materials , Nikita Sinha

Theses/Dissertations from 2020 2020

Oral Health and Quality of Life: A Clinic-Based Sample , Kinan M. Al-Bitar

Peri-Implantitis Risk Prediction Using a Computer Based Periodontal Risk Calculator Tool: A Retrospective Study , Walaa AL Zaibak

Assessment of 3D Facial Scan Integration in 3D Digital Workflow Using Radiographic Markers and Iterative Closest Point Algorithm , Mohamed Elshewy

Outcomes of Primary Endodontic Therapy in Medicaid Enrollees , Timothy Gainey

Corrosion Properties of Various Orthodontic Fixed Retention Wires , Tara Lynn Groen

Anatomical Considerations for Miniplate-Anchored Maxillary Protraction in Children with Unilateral Cleft Lip and Palate , Jared Holloway

Efficacy of Invisalign: A Retrospective Case Series of Intrusion, Extrusion, and Rotation with Trend Analysis , Kirsten Karkow

The Effect of Mechanical Vibration on Alveolar Bone Following Experimental Periodontitis: A Time Course Study , Joshua Murphy

Accuracy of Merging Scans of Definitive Fixed Prosthodontic Impressions to Obtain Single, Accurate Digitized Master Casts , Ossama Raffa

Tensile Strength of Elastomeric Ligature Ties Stretched Over Large and Small Orthodontic Brackets , Golden Shiloh

Influence of Progressive vs. Minimal Canal Preparations on the Fracture Resistance of Mandibular Molars: A Finite Element Analysis , Michael Smoljan

Impact of Delayed Completion of Previously Initiated Therapy and Provider Type on Outcomes of Root Canal Treatment , Igor Sulim

Theses/Dissertations from 2019 2019

The Cytotoxicity Effect of Silver Solder Materials on Human Periodontal Ligament Fibroblast Cells , Joseph Jeffrey Curry

An in Vitro Study of Surface Alterations to PEEK and Titanium and Its Effect Upon Human Gingival Fibroblasts , Maryam Gheisarifar

Effect of Heat-Treatment Time on Bending Properties of Cobolt-Chromium Orthodontic Wires , Melanie Hammerbeck

The Design and Physical Properties of An Optimized Chitosan Hydrogel for Potential Use in Endodontics , Hunter Housley

Comparison of Power Versus Manual Toothbrush in Reducing Gingivitis , Keerthi Kamreddy

Efficacy of Invisalign Attachments: A Retrospective Study , Theresa Karras

Evaluation of Corrosion Mechanisms in Stainless Steel Orthodontic Retainer Wires , Jamie Martin

Injectable Gels with Potential Use in Endodontics , Maksim Montatskiy

Effect of Different Implant Abutment Materials on Optical Properties of Translucent Monolithic Zirconia Crowns , Nisha Patel

Evaluation of Accuracy of Static Computer-Guided Implant Placement Compared with Partially-Guided or Free-Hand Placement , Laxmi Sukhtankar

The Effect of Mechanical Vibration on Alveolar Bone Following Experimental Periodontitis - A Micro-CT Study , Andrei Dan Taut

The Influence of Full Coverage Restorations On Pulp Vitality: A Ten-Year Retrospective Study , Abby Yavorek

Theses/Dissertations from 2018 2018

Effect of Different Finish Line Designs on the Marginal and Internal Fit of Metal Copings Made by Selective Laser Melting Technology , Adel Al Maaz

Effect of Emergence Profile of a Single Implant Restoration on the Health of Peri-Implant Soft Tissue , Waleed Nasir Asiri

Application of Mechanical Vibration to Enhance the Stability After Orthodontic Treatment - A Micro - CT Study , Nicolas Branshaw

A Retrospective Analysis of Patient Medical and Dental Treatment Histories, and MRONJ-Related Events , Jon Irelan

Orthodontic Bond Strength Comparison Between Two Filled Resin Sealants , James Kolstad

Comparison of Immediate vs. Delayed Recall of Orthodontic Information Following an Electronic Reminder , Michael Lenz

Orthodontic Open-Coil Spring Deactivation Forces Differ with Varying Activation Levels , Ryan Lubinsky

Factors Effecting Survival of Teeth with Nonsurgical Root Canal Therapy Including a Multi-State Outcome Analysis , Alex Moore

Orthodontic Treatment Planning Using Direct Visual Approximation of Arch Length Discrepancy and Cephalometric Analyses , Kathleen Rouse Vaught

Comparison of Different Temperatures on Bending Properties of Six Niti Endodontic File Systems , Sukbum Yoo

Theses/Dissertations from 2017 2017

QMIX 2in1 and NaOCI Precipitate: Documentation, Identification, and Exothermic Reaction , Gordon L. Barkley III

Viability of Human Periodontal Ligament Fibroblasts After Time in Tooth Storage Media , Scott MacDonald

Effects of Palatal Expansion on Speech Production , Jason Milton Meinhardt

Reliability of Digital Dental Cast Measures as Compared to Cone-Beam Computed Tomography for Analyzing the Transverse Dimension , Brian Michel

Analysis of Flexural Strength and Monotonic Load to Failure Following Simulated Chairside Adjustments and Repair in a Lithium Disilicate Glass-Ceramic , Ali Ramadhan

The Effect of Heat Treatment on the Bending Properties of a Cobalt-Chromium Orthodontic Wire , Alex Schwab

Comparison of Anterior Denture Teeth Arrangements Made with the Tooth Mold Template and Definitive Computer-Aided Design & Computer-Aided Manufacturing Complete Removable Dental Prostheses , Jose Antonio Sierra

Thermal Properties of Commonly Used Clear Aligner Systems As-Received and After Clinical Use , Louis Wenger

Direct Visual Approximation of Arch Length Discrepancy and Cephalometric Measurements , Bradley J. Wurm

Survival Rates of Primary Endodontic Therapy Following Core/Post and Crown Placement , Kandace Yee

Theses/Dissertations from 2016 2016

Evaluation of Die Trim Morphology Made by CAD/CAM Technology , Pratiksha Agrawal

Outcomes of Primary Endodontic Therapy Provided by Endodontic Specialists Compared to Other Providers , Jacob Burry

The Effect of Mechanical Vibration on Human PDL Cell Differentiation and Response to Inflammation , Megan DesRoches

Color Change of Commercial Resin Composited with Different Photoinitiators , Feng Gao

The Effects of Mechanical Vibration on Human Chondrocytes In Vitro , Bradley J. Gauthier

Thermal Properties of Copper Nickel-Titanium Orthodontic Archwires , Joshua Gilbert

Torsion and Bending Properties of EdgeEndo Files , Chad Hansen

Mitigating Distortion of Light-Polymerized Composite Trial Bases , Jon Patrick Irelan

Viability of Human Periodontal Ligament Fibroblasts After Storage in Save-A-Tooth, EMT Toothsaver and Hank's Balanced Salt Solution , Wonhee Lee

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• v.12(1); 2015

The Regenerative Medicine in Oral and Maxillofacial Surgery: The Most Important Innovations in the Clinical Application of Mesenchymal Stem Cells

Marco tatullo.

1. Tecnologica Research Institute, Biomedical Section, Crotone, Italy

2. Calabrodental clinic, Biomaterials test unit, Crotone, Italy

Massimo Marrelli

Francesco paduano.

Regenerative medicine is an emerging field of biotechnology that combines various aspects of medicine, cell and molecular biology, materials science and bioengineering in order to regenerate, repair or replace tissues.

The oral surgery and maxillofacial surgery have a role in the treatment of traumatic or degenerative diseases that lead to a tissue loss: frequently, to rehabilitate these minuses, you should use techniques that have been improved over time. Since 1990, we started with the use of growth factors and platelet concentrates in oral and maxillofacial surgery; in the following period we start to use biomaterials, as well as several type of scaffolds and autologous tissues. The frontier of regenerative medicine nowadays is represented by the mesenchymal stem cells (MSCs): overcoming the ethical problems thanks to the use of mesenchymal stem cells from adult patient, and with the increasingly sophisticated technology to support their manipulation, MSCs are undoubtedly the future of medicine regenerative and they are showing perspectives unimaginable just a few years ago. Most recent studies are aimed to tissues regeneration using MSCs taken from sites that are even more accessible and rich in stem cells: the oral cavity turned out to be an important source of MSCs with the advantage to be easily accessible to the surgeon, thus avoiding to increase the morbidity of the patient.

The future is the regeneration of whole organs or biological systems consisting of many different tissues, starting from an initial stem cell line, perhaps using innovative scaffolds together with the nano-engineering of biological tissues.

Introduction

The oral surgery and maxillofacial surgery have a role in the treatment of traumatic or degenerative diseases that lead to a tissue loss: frequently, to rehabilitate these minuses, you should use techniques that have been improved over time. Since 1990, tissue engineering has developed protocols in which it has been proposed the use of platelet concentrates, which showed enormous benefits for the patient: they favored and accelerated the post-surgical and provided a support for tissue regeneration due to growth factors contained in them. Several authors 1 - 4 have described the importance of growth factors in tissue repair processes, in fact, they are important elements for new tissue production, moreover, they perform feedback controls on inflammatory processes within the tissue graft, in cases of regenerative surgery.

Whitman 5 and Marx 6 published the first studies on the use of growth factors contained in platelet gel, called Platelet-Rich Plasma (PRP).

Thanks to Marx's studies, it was possible to verify that the platelet concentrate is a very effective tool for the modulation of wound healing and tissue regeneration. However, the PRP showed a number of disadvantages, such as the need of having to run a complex and expensive protocol for its production. To overcome some of these problems, the PRGF (Plasma Rich in Growth Factors) was introduced in the list of platelet concentrates. The PRGF is considered an evolution of the PRP 7 , 8 and it allows a higher concentration of growth factors in platelet preparation. Among the advantages of the PRGF, we can cite the lesser amount of blood taken for the preparation and a procedure relatively faster, while, among the disadvantages we can mention the rapid clot formation, which require speed in its surgical use.

In 2001, Choukroun et coll. have instead proposed an alternative technique: the PRF (Platelet Rich Fibrin). PRF is derived from a simple preparation protocol that does not require alteration of the blood; it is a platelet concentrate rich in GFs that contains a three-dimensional matrix of autologous, elastic and flexible fibrin.

Dohan et al . have shown that platelet cytokines (PDGF, TGFbeta1 and IGF-1) are present in three-dimensional fibrin matrix derived from these platelet concentrates; moreover, PRF matrix traps glycosaminoglycans such as heparin and hyaluronic acid, which have considerable affinity with some peptides present in the bloodstream and therefore show strong ability of chemotaxis and diapedesis, useful for the healing of tissue damaged, for example, by trauma 9 . Moreover, it was shown that this matrix can be a valuable support for the transplantation of bone morphogenetic proteins (BMP) issued in a progressive manner to induce osteogenic differentiation, as demonstrated by recent studies on muscle preparations 10 , 11 ; about this, the results of Wiltfang et al . are encouraging, in fact, they show an improvement of osteoblast proliferation in cases in which it was used the PRF compared to PRP 12 .

Marrelli et al. described a case in which is documented the filling with PRF of a large osteolytic cavity and complete bone reformation 13 . Tatullo et al . have suggested that the osteoinductive potential of PRF is related to its neoangiogenic ability and concentration of GFs, in relation to the fibrin content and platelet cytokines present, all suitable for the totipotent cell migration and activation of pre-osteoblastic cells present in the surgical site, fundamental aspects for bone regeneration 14 .

Platelets concentrates are, thus, versatile products in surgery, with regard to their biological properties and their easy manipulation in the form of gel or membranes; these features allow the use of PRF as well as other platelet concentrates in cases, for example, of maxillary surgical sites or in the surgery of maxillary sinus 15 .

The frontier of regenerative medicine nowadays is represented by the mesenchymal stem cells (MSCs): overcoming the ethical problems thanks to the use of mesenchymal stem cells from adult patient, and with the increasingly sophisticated technology to support their manipulation, MSCs are undoubtedly the future of medicine regenerative and they are showing perspectives unimaginable just a few years ago. Most recent studies are aimed to tissues regeneration using MSCs taken from sites that are even more accessible and rich in stem cells: the oral cavity turned out to be an important source of MSCs with the advantage to be easily accessible to the surgeon, thus avoiding to increase the morbidity of the patient.

Mesenchymal stem cells of oral origin

The aim of the regenerative medicine and tissue engineering is to regenerate and repair the damaged cells and tissues in order to establish the normal functions 16 . The regenerative medicine involves the use of biomaterials, growth factors and stem cells 17 . Regeneration of the tissues exists naturally due to the presence of stem cells with the potential to self-regenerate and differentiate into one of more specialized cell types. However, this regenerative potential decreases with age and regeneration is not sufficient to repair the damages produced by degenerative, inflammatory or tumor based diseases 18 . Stem cells are immature and unspecialized cells with the ability to renew and divide themselves indefinitely through “self-renewal” and able to differentiate into multiple cell lineages 19 . The stem cells use for regenerative medicine should fit the following criteria: they can be: a) found in abundant numbers and can be differentiated in multiple cell lineages in a reproducible and controllable manner; b) isolated by minimally invasive procedure with minimal morbidity for patients, c) produced in accordance with GMP (Good manufacture Practice) and d) transplanted safely 20 , 21 . In the last decade, several improvements have been produced in the comprehension of stem cells properties in view of the fact that these cells have an important role in the repair of every organ and tissue.

In general, the stem cells are divided into three main types that can be utilized for tissue repair and regeneration: i) the embryonic stem cells derived from embryos (ES) 22 , 23 ; ii) the adult stem cells that are derived from adult tissue 24 ; and iii) the induced pluripotent stem (iPS) cells that have been produced artificially via genetic manipulation of the somatic cells 25 . ES and iPS cells are considered pluripotent stem cells because they can develop into all types of cells from all three germinal layers. Both stem cells have technical and moral obstacles, in addition these cells are not easy to control and they can form tumors after injection 22 . On the contrary, adult stem cells are multipotent because they can only differentiate into a restricted number of cell types. Adult stem cells, also termed postnatal stem cells or somatic stem cells, are discovered in a particular area of each tissue named “stem cell niche.”

Different type of postnatal stem cells resides in numerous mesenchymal tissues and these cells are at the same time referred to as mesenchymal stem cells (MSCs) 24 , 26 . MSCs were first isolated and characterized from bone marrow (BMSCs) by Friedenstein et al. in 1974 27 . Subsequently, different studies have showed that MSCs can be isolated from other tissues, such as peripheral blood, umbilical cord blood, amniotic membrane, adult connective, adipose and dental tissues 28 - 32 .

Recently, orofacial and dental tissues have acquired interest as a further accessible source of mesenchymal stem cells 33 due to the fact that the oral area is rich in MSCs ( Table ​ Table1 1 ). Today, every cell population which has the following characteristics independently of its tissue source, is usually referred as MSCs: i) they adhere to plastic and have a fibroblast-like morphology; ii) they have the capacity of self-renewal and could differentiate into cells of the mesenchymal lineage such as osteocytes, chondrocytes and adipocytes. In addition, MSCs also can also differentiate, under appropriate conditions, into cells of the endoderm and ectoderm lineages such as hepatocytes and neurons, respectively 34 , 35 . Phenotypically, MSCs express the CD13, CD29, CD44, CD59, CD73, CD90, CD105, CD146 and STRO-1 surface antigens, and they do not express CD45 (leukocyte marker), CD34 (the primitive hematopoietic progenitor and endothelial cell marker), CD14 and CD11 (the monocyte and macrophage markers), CD79 and CD19 (the B cell markers), or HLA class II 36 . Research related to MSC from oral origin began in 2000 37 and every year numerous investigations have demonstrated that oral tissues, which are simply available for dentists, are a rich source for mesenchymal stem cells 33 , 38 .

Mesenchymal Stem Cells from dental tissues

Today numerous types of MSCs have been isolated from teeth: in 2000 MSCs were first isolated by Gronthos et al. from dental pulp (DPSCs) 37 , 38 . These cells possess phenotypic characteristics similar to those of BMSCs 39 , and they have definitive stem cell properties such as self-renewal and multi- differentiation capacity, and can form the dentin-pulp structure when transplanted into immunocompromised mice 40 . Moreover, DPSCs participate in the regeneration of non-orofacial tissues, in fact, these cells have been differentiated into hair follicle-, hepatocyte-, neuron-, islet-, myocyte- and cardiomyocyte-like cells 41 - 46 . Subsequently, MSCs have been also isolated from dental pulp of human exfoliated deciduous teeth (SHEDs). These cells, like DPSCs, have the ability to differentiate in vitro in odontoblasts, osteoblasts, adipocytes and neuron-like cells. Also SHEDs were able to form dentin and bone when transplanted with HA/TCP in vivo 47 .

The periodontal ligament is another adult MSCs source in dental tissue, and periodontal ligament stem cells (PDLSCs) were isolated from extracted teeth 48 . PDLSCs have the ability to regenerate periodontal tissues such as the cementum, periodontal ligament and alveolar bone 49 . Moreover, MSCs have been also isolated from developing dental tissues such as the dental follicle (DFPCs) 50 and apical papilla (SCAPs) 51 . DFPCs have the ability to regenerate periodontal tissues whereas SCAPs demonstrate better proliferation and better regeneration of the dentin matrix when transplanted in immunocompromised mice with compared to DPSCs 50 , 52 , 53 . Zhang et al. have isolated mesenchymal stem cells from the gingiva, these MSCs exhibited higher clonogenicity, self-renewal and multipotent differentiation capacity similar to that of BMSCs 54 . Moreover, the salivary glands derived MSCs could differentiate into the salivary gland duct cells as well as mucin and amylase producing acinar cells in vitro 55 . In addition, De Bari et al. demonstrated that single-cell-derived clonal populations of adult human periosteal cells possess mesenchymal multipotency, as they differentiate to osteoblast, chondrocyte, adipocyte and skeletal myocyte lineages in vitro and in vivo . Therefore, expanded MSCs isolated from periosteum could be useful for functional tissue engineering, especially for bone regeneration 56 .

The MSCs contained within the bone marrow aspiration from the iliac crest, and liposuction from extra-oral tissue are not easily-accessible stem cells. On the contrary, the orofacial bone marrow, periosteum, salivary glands and dental tissues are the most accessible stem cell sources. Moreover, the isolation of MSCs from these sources may still not be convenient because it requires surgical methods or tooth or pulp extraction. In addition, even if impacted wisdom teeth could be a mesenchymal stem cell source, these MSCs are present in a low percentage and can, therefore, be difficult to isolate, purify and expand. Furthermore, not all adults need the extraction of the wisdom teeth. To overcome these limitations, recently, Marrelli et al. demonstrated that MSCs derived from periapical cysts (hPCy-MSCs) have a mesenchymal stem cell immunophenotype and the ability to differentiate into osteogenic and adipogenic lineages 57 . The periapical cyst, which is a tissue that is easily obtainable and whose cells can be simply expanded from patients with minimal discomfort, seems to be a promising source of adult stem cells in dentistry for regenerative medicine. In fact, a recent study of Marrelli et al. showed that hPCy-MSCs similarly to DPSCs have neural progenitor-like properties by expressing spontaneously neuron and astrocyte specific proteins and neural related genes before any differentiation. Furthermore, hPCy-MSCs, under appropriate neural stimulation, acquire neural morphology and significantly over-express several neural markers at both protein and transcriptional level (in press, not yet published research by Marrelli et al. ).

Mesenchymal stem cells in regenerative medicine

It was reported that MSCs isolated from whole bone marrow aspirates in combination with scaffolds and growth factors are able to repair cranial defects in several animal models 58 - 60 . These studies demonstrated that MSCs can alleviate the complications of craniofacial surgical procedures that required allogenic tissue grafts or extraction of autologous bone from secondary sites. This approach may alleviate donor site morbidity and allow a virtual unlimited source of cellular material derived from allogenic MSCs 61 .

The identification of MSC residing in the oral cavity tissues increases clinical interest in MSCs as a cell source for regeneration of other connective tissues such as cementum, dentin and periodontal ligament (PDL). Many research studies research have been performed to assess the capacity of dental derived MSCs to enhance periodontal regeneration. Seo et al . have demonstrated that human PDLSCs were able to generate a cementum/PDL-like structures when transplanted into immunocompromised mice, and consequently transplantation of PDLSCs could be considered as a therapeutic approach for regeneration of tissues damaged by periodontal diseases 48 . Moreover, Kim et al . compared the alveolar bone regeneration achieved from implantation of PDLSCs and BMSCs and identified no significant difference in regenerative potential in vivo between these MSCs 62 .

The three key elements in the field of tissue engineering are stem cells, scaffolds and growth factors 63 . Recently, researchers are trying to identify the ideal scaffold that facilitate growth, cell spreading, adhesion, integration and differentiation of MSCs. This scaffold should be biocompatible and biodegradable, should have optimal physical features and mechanical properties 64 . Different material have been designed and constructed for tissue engineering approaches, using natural or synthetic polymers or inorganic materials, which have been fabricated into porous scaffolds, nanofibrous material, hydrogels and microparticles. Natural materials include collagen, elastin, fibrin, silk, chitosan and glycosaminoglycans 65 . Recently, hydrogels have been investigated for tissue engineering applications because they offer numerous properties including biocompatibility and mechanical characteristics similar to those of native tissue 66,67. Synthetic poly lactic-co-glycolic acid (PLGA) and titanium provide excellent chemical and mechanical properties for bone tissue regeneration in vivo using DPSCs 68 . Furthermore, recent studies demonstrated that DPSCs loaded onto scaffolds of chitosan formed a dentine-pulp complex in vivo 69 whereas DPSCs cultured on hydroxyapatite (HA) and placed subcutaneously in nude mice formed bone 70 . A great number of investigations for evaluating the in vivo application of MSCs isolated from the oral cavity were carried out on animal models. A clinical study conducted by Papaccio's group gave evidence of the possibility to utilise DPSCs to repair bone defect in humans. In fact, they showed that DPSCs/collagen biocomplex completely restored human mandible bone defects subsequent to DPSCs transplantation 71 .

Conclusions

The future is the regeneration of whole organs and complex biological systems consisting of many different tissues, starting from an initial stem cell line, probably using innovative scaffolds together with the nano-engineering of biological tissues: this approach is already a research topic in several international research institutes, and the best way to merge the numerous skills needed to get a so ambitious result is the multicenter collaboration. The authors are closely collaborating together with high-level international Universities, to develop protocols aimed to control and lead the tissues regeneration. This goal could make born a new generation of stem-cells based therapies, so to open the door to a new highly-performing regenerative medicine.

Starting from 2000, in only fifteen years, researchers have changed the face of the tissues engineering and the expectation of quality of life in more than 2 billions of patients undergone to a regenerative surgery: the challenge is to continue to make the patient's life better, to make the surgery more predictable and to simply replace damaged or degenerated tissues with MSCs from dental and oral sources.

Acknowledgments

The present study was supported by “PROMETEO Project - Progettazione e Sviluppo di piattaforme tecnologiche innovative ed ottimizzazione di PROcessi per applicazioni in MEdicina rigenerativa in ambito oromaxillofaciale, emaTologico, nEurologico e cardiOlogico”. PON01_02834.

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Effect of Splinting Implant Scan Bodies Intraorally on The Trueness of Complete Arch Digital Impressions: A Clinical Study , Kawther Mahmoud Ali

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In-vitro Comparison of Retention Among Contemporary and Conventional Post-and- Cores , Hatem Alqarni

Three Dimensional Analysis of Intraoral Scanners Accuracy: An In-Vitro Study , Rami Ammoun

Complications associated with mandibular fixed complete arch prostheses based on implant distribution , Shivani Karre

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Are Bone Turnover Markers and Vitamin D levels associated with Frequency of Complete Denture Relines? , Shweta Puri

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Thesis Title: Metaanalysis of Etiology and its clinical and radiological correlation in cases of Craniomaxillofacial trauma Name of candidate: Dr.Ritesh kumar Supervisor: Prof. S.S .Ahmed Co-supervisors: Dr. G.S.Hashmi

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Comparative evaluation of two point fixation versus three point fixation of minipalates in zygomatic complex fracture Name of candidate: Dr. Aquib Ansari Supervisor: Dr. G. S. Hashmi Co-supervisors: Prof.S.S.Ahmad,dr.Adeeb Alam Khan

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Role of Conventional radiographs and 3D CT in the evaluation of maxillofacial trauma- A Comparative study.

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Role of MRI in evaluation of swellings of maxillofacial region.

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Evaluation of host factor and identification of bacterial species in patients suffering from odontogenic infection. Candidate: Dr Zavir Khan

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Dr S S Ahmed , Dr Asad U Khan

Mandibular osteosynthesis: Camparative evaluation of three indigenous fixation system using 2mm miniplates, locking plates and 3 D plates. Candidate: Dr Shaikh Amjad Khan Munir

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Comparative study of detection of bacteremia after oral surgical procedures. Candidate : Dr Tabishur rahman

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• Published: 31 August 2021

The OMFS training pathway explained

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BDJ Student volume  28 ,  pages 36–37 ( 2021 ) Cite this article

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Hitesh Bansal on how to get involved and why you shouldn't be deterred

I was a 4 th year medical student when I decided I wanted to pursue a career in OMFS. I am now a second-degree dental student at King's College London, and regional representative for The Junior Trainees Group (JTG) of The British Association of Oral and Maxillofacial Surgeons (BAOMS). When I speak to dental students who show an interest in OMFS, they often have little knowledge of the training pathway, and what they do know, they understandably find very daunting. So, what is the training pathway, and what can you do to get involved?

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Cameron M, Westcott L. Maxillofacial training is no longer than other surgical specialties. Ann R Coll Surg Eng 2008; 90 : 146-149.

Isaac R, Ramkumar D, Ban J, Kittur M. Can you afford to become an oral and maxillofacial surgeon? BMJ 2016; 352 : 164.

Royal College of Surgeons in England. Higher Specialist Training Documents and Curricula. Available online at: www.rcseng.ac.uk/dental-faculties/fds/careers-in-dental-surgery/postgraduate-training-jcptd/higher-specialist-training-documents-and-curricula/ (accessed July 2021).

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The areas of research mainly focuses on minor oral surgery, space infections of the head and neck region, maxillofacial trauma, orthognathic surgery and TMJ disorders.

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