A 14-year-old boy presented with a swelling on the right side of his face and upper jaw caused by a large dentigerous cyst. The cyst involved the area where his impacted right maxillary canine and other teeth were located. The patient's buccal pad of fat was harvested and processed to isolate the stromal vascular fraction (SVF) stem cells. After removing the cyst surgically, the SVF cells were administered to the bone defect area to aid bone regeneration and support orthodontic tooth movement. At 16 months post-operatively, good bone regeneration was observed and the patient was undergoing orthodontic treatment to align the impacted canine.
L-PRF for increasing the width of keratinized mucosa around implants: A split...MD Abdul Haleem
This randomized controlled pilot clinical trial evaluated the use of L-PRF membranes for increasing the width of keratinized mucosa around dental implants compared to free gingival grafts. The results showed that both treatments significantly increased the width of keratinized mucosa by 6.0 mm for L-PRF and 7.3 mm for free gingival grafts. However, patients reported significantly less postoperative pain with L-PRF, and it required less surgery time than free gingival grafts. While both treatments were effective at creating keratinized tissue, L-PRF provided advantages of lower morbidity and shorter procedure time for patients.
Treatment of Endodontic –Periodontic lesion with combination therapy: PRF and...iosrjce
This document describes a case study of a patient with a primary endodontic and secondary periodontic lesion treated with a combination of platelet rich fibrin (PRF) and demineralized freeze dried bone allograft (DFDBA). The patient presented with bleeding gums and a 15mm periodontal pocket around tooth #46. Endodontic treatment was performed initially, followed by regenerative periodontal surgery 3 months later using DFDBA bone graft material and a PRF membrane. Follow up at 6 months found reduced pocket depth and increased bone fill on radiographs, indicating the combination therapy was effective at treating the combined endo-perio lesion.
Journal club on Connective tissue graft associated or not with low laser ther...Shilpa Shiv
Connective tissue graft associated or not with low laser therapy to treat gingival recession: randomized clinical trial, Fernandes-Dias SB, de Marco AC, Santamaria Junior M et al.
JCP 2015.
L-PRF for increasing the width of keratinized mucosa around implants: A split...MD Abdul Haleem
This randomized controlled pilot clinical trial evaluated the use of L-PRF membranes for increasing the width of keratinized mucosa around dental implants compared to free gingival grafts. The results showed that both treatments significantly increased the width of keratinized mucosa by 6.0 mm for L-PRF and 7.3 mm for free gingival grafts. However, patients reported significantly less postoperative pain with L-PRF, and it required less surgery time than free gingival grafts. While both treatments were effective at creating keratinized tissue, L-PRF provided advantages of lower morbidity and shorter procedure time for patients.
Treatment of Endodontic –Periodontic lesion with combination therapy: PRF and...iosrjce
This document describes a case study of a patient with a primary endodontic and secondary periodontic lesion treated with a combination of platelet rich fibrin (PRF) and demineralized freeze dried bone allograft (DFDBA). The patient presented with bleeding gums and a 15mm periodontal pocket around tooth #46. Endodontic treatment was performed initially, followed by regenerative periodontal surgery 3 months later using DFDBA bone graft material and a PRF membrane. Follow up at 6 months found reduced pocket depth and increased bone fill on radiographs, indicating the combination therapy was effective at treating the combined endo-perio lesion.
Journal club on Connective tissue graft associated or not with low laser ther...Shilpa Shiv
Connective tissue graft associated or not with low laser therapy to treat gingival recession: randomized clinical trial, Fernandes-Dias SB, de Marco AC, Santamaria Junior M et al.
JCP 2015.
LSTR 3mix MP important efficacy particularly antibacterial and periapical le...Dr.Aklaqur Rahman Chayon
Author:-
Dr Nurjahan Afsary
BDS(DU),Post graduation training in
Conservative dentistry.Dhaka dental College.
Consultant dental surgeon at AR DENTAL Maxillofacial care Research and training center ,N oral health and dental care.
Co-author:-
Dr Aklaqur Rahman BDS(Dhaka dental College)
LSTR 3mix MP important efficacy particularly antibacterial and periapical lesions during conservative treatment in the dentistry like RCT and other endodontics management;Case Studies
journal club on Progressive Root Resorption Associatedwith the Treatment of ...Shilpa Shiv
This case report describes progressive root resorption that occurred after treatment of a deep gingival recession using scaling and root planing, tetracycline root conditioning, and connective tissue grafting. At 20 months post-operatively, external root resorption was observed without symptoms. Root resorption is an uncommon complication that can occur despite initially achieving the desired outcome of treating recession and creating healthy periodontal tissues. Tetracycline root conditioning may cause late root resorption, so this risk should be considered when developing treatment plans.
An Assessment on the Clinical Performance of Non-carious Cervical Restorationsasclepiuspdfs
This study evaluated the clinical performance of non-carious cervical lesion restorations placed at a university dental clinic over a 7-year period. A total of 121 restorations in 34 patients were assessed based on materials used (glass ionomer cement, resin composite, resin-modified glass ionomer cement) and clinical handling technique (with vs without cavity preparation). Glass ionomer cement restorations showed significantly better retention and less secondary caries compared to the other materials, but there were no differences in marginal integrity, discoloration, or anatomic form based on material. The clinical performance did not differ based on whether cavity preparation was used.
This presentation is a review of MANDIBULAR MOLAR ROOT RESECTION VERSUS IMPLANT THERAPY A RETROSPECTIVE NONRANDOMIZED STUDYZ
afiropoulos GG, Hoffmann O, Kasaj A, Willershausen B, Deli G, Tatakis DN.Journal of Oral Implantology, 2009
The document discusses periodontal flaps, including their definition, historical background, objectives, indications and contraindications. It describes the advantages and disadvantages of flap surgery, as well as principles of flap design such as ensuring adequate blood supply. The document outlines different flap techniques and factors that can affect surgical outcomes. In summary:
- A periodontal flap involves surgically separating gingiva/mucosa to access bone and roots. Objectives include enabling root instrumentation and re-establishing periodontal health.
- Indications include deep pockets inaccessible to non-surgical treatment, while contraindications involve poor patient health/cooperation.
- Principles of flap design focus on blood supply to reduce
The document discusses various periodontal regenerative procedures. It describes techniques such as bone grafting using autogenous bone or other bone substitutes to regenerate alveolar bone defects. Bone grafts can aid regeneration through osteogenesis, osteoinduction and osteoconduction. Autogenous bone is often considered the best option but alternatives include allografts and synthetic grafts when autogenous bone is not feasible. The ideal properties and use of various graft materials are also discussed.
This document discusses periodontal regeneration techniques. It covers topics like guided tissue regeneration (GTR), bone grafts, growth factors and their role in treating periodontal defects. GTR uses barrier membranes to prevent epithelial down growth and help regenerate periodontal tissues. Studies show that GTR is effective in treating intra-bony defects and class II mandibular furcations, but has limited effects on maxillary furcations. GTR alone or with grafts can treat gingival recession. Long-term results of GTR are stable over many years.
This case series examines a new surgical technique for regenerating interimplant papillae using subepithelial connective tissue grafts. 10 patients with missing papillae between implant restorations received the new procedure involving buccal and palatal incisions made away from the papilla to preserve blood supply, and tunneling performed with a specialized instrument. The papillae scores improved on average from 0.8 to 2.4 after 16 months, demonstrating regeneration of the papillae over 11-30 months. However, long-term studies are still needed to validate the technique and outcomes.
This document provides an overview of guided tissue regeneration (GTR). It begins with definitions of periodontal regeneration and GTR. It then discusses the history and development of GTR from the 1970s onwards. The core concept of GTR is explained, which is based on Melcher's hypothesis that only periodontal ligament cells can regenerate the periodontal attachment apparatus. Indications, contraindications, design criteria and objectives of GTR barriers are covered. The document classifies and compares advantages and disadvantages of absorbable versus non-absorbable membranes. Key factors affecting GTR outcomes are discussed. Surgical techniques and the healing of GTR-treated defects are described. The document concludes with additional considerations like complications and the
The document describes a modified neutral zone technique for improving the stability of mandibular complete dentures. The technique involves making an acrylic resin base with posterior occlusal rims, applying a thermoplastic denture adhesive, and having patients wear it for 2 days to record the neutral zone. The base is then used to make an acrylic resin complete denture. Most patients reported improved denture stability and reduced pressure sores. However, the technique is complex and not recommended for routine use.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
JOURNAL CLUB: “Matching the Dimensions of Currently AvailableInstruments wit...Urvashi Sodvadiya
This micro-CT study investigated the largest original diameters of Vertucci type IV mandibular molar mesial root canals at 1-, 2-, 3-, and 4-mm levels short of the apical foramen. The diameters were then matched to currently available instrument sizes recommended for apical preparation. The study found that the original canal diameters were usually larger than recommended instrument sizes, making it impossible to fully shape most canals without risk of deviation, perforation, or root weakening. Approaches are needed to better determine optimal apical preparation size and address the problem of unprepared canal walls.
journal club on Combined Surgical Resective and Regenerative Therapy forAdva...Shilpa Shiv
JC on Combined Surgical Resective and Regenerative Therapy forAdvanced Peri-implantitis with Concomitant Soft Tissue Volume Augmentation: A Case Report. IJPRD 2014.
This document outlines the phases of periodontal therapy, including:
1) Preliminary phase focusing on emergencies and extractions.
2) Nonsurgical phase involving plaque control, non-surgical treatments like scaling and root planing.
3) Surgical phase using various periodontal surgeries and other treatments like implants and endodontics.
4) Restorative phase for final restorations and prosthodontics.
5) Maintenance phase for long-term supportive periodontal therapy.
Surgical periodontal therapy aims to eliminate pathologic changes, create a stable periodontium, and promote regeneration through techniques like pocket reduction surgeries and correction of anatomic defects
Journal Club On GENE DELIVERY TO PERIODONTAL TISSUE USING BUBBLE LIPOSOMES AN...Shilpa Shiv
This study examined using bubble liposomes and ultrasound to deliver genes into gingival tissues. The researchers found that:
1) Optimal ultrasound parameters for gene delivery into gingival tissue were an intensity of 2.0 W/cm2 and exposure time of 30 seconds.
2) Gene expression levels, as measured by luciferase activity, peaked 1 day after transfection then declined over 7 days.
3) Histological examination found enhanced green fluorescent protein was expressed in both gingival epithelium and connective tissue cells after bubble liposome and ultrasound mediated gene delivery.
Healing of Periapical Bone Lesion After Periradicular Surgery And Graft Place...QUESTJOURNAL
Objectives: 1.To clinically evaluate the healing process following periapical surgery with Chitra granules 2.To radiographically evaluate healing, following periapical surgery with Chitra granules. 3.To compare the bone healing in the study group, clinically and radiographically following the modalities of treatment, with that of the control group (without graft). Materials: 1.Chitra hydroxyapatite granules. 2. Gutta-percha — for root canal obturation by lateral condensation. 3. High Copper amalgam used as retrofilling materials. To evaluate healing after periapical surgery using Chitra granules, 22 patients were selected from out patient section of Department of Conservative Dentistry and Endodontics, Govt. Dental College, Kozhikode,based on clinical and radiographical evaluation. The study group consisted of 13 males and 9 females. All were of the age group 15-35 years. After selection they were randomly divided into two groups A and B. In group A the Chitra granule were placed in the bony defect and in group B the defect were left as such after surgery. Results: Clinical parameters showed better early symptom free condition in group A compared to group B. But data found statistically insignificant (t-7.27,df-1.8, P >0.05). Radiographical evaluation data analysis showed statistically significant difference among group A and group B. Conclusion: Biocompatible Chitra granule not only obliterates the cavity but act as a scaffold for bone growth and prevent scar tissue formation.It is osteoconductive. In comparison to the conventional periapical surgery, the placement of Chitra granules facilitates bone regeneration more easily. The material is found to be very cost effective, easily available, easy to manipulate and involves least complication to both clinicians and patients.
Light-Emitting Diode Irradiation Promotes Donor Site Wound Healing of the F...Shilpa Shiv
This document summarizes a study that investigated the effects of LED light irradiation on wound healing of free gingival grafts in rats. The study found that LED light irradiation at 10-20 J/cm2 promoted fibroblast viability and wound closure in vitro, and accelerated wound healing in vivo by promoting re-epithelialization, reducing inflammation and sequestrum formation, and increasing collagen deposition. LED light facilitated healing, likely by reducing reactive oxygen species and promoting angiogenesis and tissue remodeling, though additional research is still needed to validate the optimal LED conditions for clinical use.
Eight-year follow-up of successful intentional replantationAbu-Hussein Muhamad
This case report describes the endodontic retreatment and restoration of a structurally compromised maxillary second premolar. The tooth had undergone inadequate endodontic treatment 4 years prior and presented with a periapical lesion and perforation. Microscopic retreatment was performed using hand files, ultrasonics and irrigants. The canal and perforation were obturated with gutta-percha and MTA-based sealer. A direct composite build-up was placed to create a core, and an indirect composite onlay was adhesively cemented as the definitive restoration. At the 6-month recall, the tooth was asymptomatic and the patient was satisfied with the treatment outcome.
This study extracted mesenchymal stem cells from dental pulp tissue from a freshly extracted deciduous tooth. The cells were cultured and showed active growth over 35 days. Chromosome analysis of 25 and 100 cells at 20 and 35 days found no abnormalities. This establishes a method for extracting and culturing stem cells from deciduous teeth, a biological waste, for potential therapeutic applications. Further research with more samples and passage cultures is needed to validate producing these stem cells at larger scales.
5th publication -Dr Rahul VC Tiwari - Department of ral and Maxillofacial Surgery, SIBAR Institute of Dental Sciences, Takkellapadu,Guntur, Andhra Pradesh - 522509.
LSTR 3mix MP important efficacy particularly antibacterial and periapical le...Dr.Aklaqur Rahman Chayon
Author:-
Dr Nurjahan Afsary
BDS(DU),Post graduation training in
Conservative dentistry.Dhaka dental College.
Consultant dental surgeon at AR DENTAL Maxillofacial care Research and training center ,N oral health and dental care.
Co-author:-
Dr Aklaqur Rahman BDS(Dhaka dental College)
LSTR 3mix MP important efficacy particularly antibacterial and periapical lesions during conservative treatment in the dentistry like RCT and other endodontics management;Case Studies
journal club on Progressive Root Resorption Associatedwith the Treatment of ...Shilpa Shiv
This case report describes progressive root resorption that occurred after treatment of a deep gingival recession using scaling and root planing, tetracycline root conditioning, and connective tissue grafting. At 20 months post-operatively, external root resorption was observed without symptoms. Root resorption is an uncommon complication that can occur despite initially achieving the desired outcome of treating recession and creating healthy periodontal tissues. Tetracycline root conditioning may cause late root resorption, so this risk should be considered when developing treatment plans.
An Assessment on the Clinical Performance of Non-carious Cervical Restorationsasclepiuspdfs
This study evaluated the clinical performance of non-carious cervical lesion restorations placed at a university dental clinic over a 7-year period. A total of 121 restorations in 34 patients were assessed based on materials used (glass ionomer cement, resin composite, resin-modified glass ionomer cement) and clinical handling technique (with vs without cavity preparation). Glass ionomer cement restorations showed significantly better retention and less secondary caries compared to the other materials, but there were no differences in marginal integrity, discoloration, or anatomic form based on material. The clinical performance did not differ based on whether cavity preparation was used.
This presentation is a review of MANDIBULAR MOLAR ROOT RESECTION VERSUS IMPLANT THERAPY A RETROSPECTIVE NONRANDOMIZED STUDYZ
afiropoulos GG, Hoffmann O, Kasaj A, Willershausen B, Deli G, Tatakis DN.Journal of Oral Implantology, 2009
The document discusses periodontal flaps, including their definition, historical background, objectives, indications and contraindications. It describes the advantages and disadvantages of flap surgery, as well as principles of flap design such as ensuring adequate blood supply. The document outlines different flap techniques and factors that can affect surgical outcomes. In summary:
- A periodontal flap involves surgically separating gingiva/mucosa to access bone and roots. Objectives include enabling root instrumentation and re-establishing periodontal health.
- Indications include deep pockets inaccessible to non-surgical treatment, while contraindications involve poor patient health/cooperation.
- Principles of flap design focus on blood supply to reduce
The document discusses various periodontal regenerative procedures. It describes techniques such as bone grafting using autogenous bone or other bone substitutes to regenerate alveolar bone defects. Bone grafts can aid regeneration through osteogenesis, osteoinduction and osteoconduction. Autogenous bone is often considered the best option but alternatives include allografts and synthetic grafts when autogenous bone is not feasible. The ideal properties and use of various graft materials are also discussed.
This document discusses periodontal regeneration techniques. It covers topics like guided tissue regeneration (GTR), bone grafts, growth factors and their role in treating periodontal defects. GTR uses barrier membranes to prevent epithelial down growth and help regenerate periodontal tissues. Studies show that GTR is effective in treating intra-bony defects and class II mandibular furcations, but has limited effects on maxillary furcations. GTR alone or with grafts can treat gingival recession. Long-term results of GTR are stable over many years.
This case series examines a new surgical technique for regenerating interimplant papillae using subepithelial connective tissue grafts. 10 patients with missing papillae between implant restorations received the new procedure involving buccal and palatal incisions made away from the papilla to preserve blood supply, and tunneling performed with a specialized instrument. The papillae scores improved on average from 0.8 to 2.4 after 16 months, demonstrating regeneration of the papillae over 11-30 months. However, long-term studies are still needed to validate the technique and outcomes.
This document provides an overview of guided tissue regeneration (GTR). It begins with definitions of periodontal regeneration and GTR. It then discusses the history and development of GTR from the 1970s onwards. The core concept of GTR is explained, which is based on Melcher's hypothesis that only periodontal ligament cells can regenerate the periodontal attachment apparatus. Indications, contraindications, design criteria and objectives of GTR barriers are covered. The document classifies and compares advantages and disadvantages of absorbable versus non-absorbable membranes. Key factors affecting GTR outcomes are discussed. Surgical techniques and the healing of GTR-treated defects are described. The document concludes with additional considerations like complications and the
The document describes a modified neutral zone technique for improving the stability of mandibular complete dentures. The technique involves making an acrylic resin base with posterior occlusal rims, applying a thermoplastic denture adhesive, and having patients wear it for 2 days to record the neutral zone. The base is then used to make an acrylic resin complete denture. Most patients reported improved denture stability and reduced pressure sores. However, the technique is complex and not recommended for routine use.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
JOURNAL CLUB: “Matching the Dimensions of Currently AvailableInstruments wit...Urvashi Sodvadiya
This micro-CT study investigated the largest original diameters of Vertucci type IV mandibular molar mesial root canals at 1-, 2-, 3-, and 4-mm levels short of the apical foramen. The diameters were then matched to currently available instrument sizes recommended for apical preparation. The study found that the original canal diameters were usually larger than recommended instrument sizes, making it impossible to fully shape most canals without risk of deviation, perforation, or root weakening. Approaches are needed to better determine optimal apical preparation size and address the problem of unprepared canal walls.
journal club on Combined Surgical Resective and Regenerative Therapy forAdva...Shilpa Shiv
JC on Combined Surgical Resective and Regenerative Therapy forAdvanced Peri-implantitis with Concomitant Soft Tissue Volume Augmentation: A Case Report. IJPRD 2014.
This document outlines the phases of periodontal therapy, including:
1) Preliminary phase focusing on emergencies and extractions.
2) Nonsurgical phase involving plaque control, non-surgical treatments like scaling and root planing.
3) Surgical phase using various periodontal surgeries and other treatments like implants and endodontics.
4) Restorative phase for final restorations and prosthodontics.
5) Maintenance phase for long-term supportive periodontal therapy.
Surgical periodontal therapy aims to eliminate pathologic changes, create a stable periodontium, and promote regeneration through techniques like pocket reduction surgeries and correction of anatomic defects
Journal Club On GENE DELIVERY TO PERIODONTAL TISSUE USING BUBBLE LIPOSOMES AN...Shilpa Shiv
This study examined using bubble liposomes and ultrasound to deliver genes into gingival tissues. The researchers found that:
1) Optimal ultrasound parameters for gene delivery into gingival tissue were an intensity of 2.0 W/cm2 and exposure time of 30 seconds.
2) Gene expression levels, as measured by luciferase activity, peaked 1 day after transfection then declined over 7 days.
3) Histological examination found enhanced green fluorescent protein was expressed in both gingival epithelium and connective tissue cells after bubble liposome and ultrasound mediated gene delivery.
Healing of Periapical Bone Lesion After Periradicular Surgery And Graft Place...QUESTJOURNAL
Objectives: 1.To clinically evaluate the healing process following periapical surgery with Chitra granules 2.To radiographically evaluate healing, following periapical surgery with Chitra granules. 3.To compare the bone healing in the study group, clinically and radiographically following the modalities of treatment, with that of the control group (without graft). Materials: 1.Chitra hydroxyapatite granules. 2. Gutta-percha — for root canal obturation by lateral condensation. 3. High Copper amalgam used as retrofilling materials. To evaluate healing after periapical surgery using Chitra granules, 22 patients were selected from out patient section of Department of Conservative Dentistry and Endodontics, Govt. Dental College, Kozhikode,based on clinical and radiographical evaluation. The study group consisted of 13 males and 9 females. All were of the age group 15-35 years. After selection they were randomly divided into two groups A and B. In group A the Chitra granule were placed in the bony defect and in group B the defect were left as such after surgery. Results: Clinical parameters showed better early symptom free condition in group A compared to group B. But data found statistically insignificant (t-7.27,df-1.8, P >0.05). Radiographical evaluation data analysis showed statistically significant difference among group A and group B. Conclusion: Biocompatible Chitra granule not only obliterates the cavity but act as a scaffold for bone growth and prevent scar tissue formation.It is osteoconductive. In comparison to the conventional periapical surgery, the placement of Chitra granules facilitates bone regeneration more easily. The material is found to be very cost effective, easily available, easy to manipulate and involves least complication to both clinicians and patients.
Light-Emitting Diode Irradiation Promotes Donor Site Wound Healing of the F...Shilpa Shiv
This document summarizes a study that investigated the effects of LED light irradiation on wound healing of free gingival grafts in rats. The study found that LED light irradiation at 10-20 J/cm2 promoted fibroblast viability and wound closure in vitro, and accelerated wound healing in vivo by promoting re-epithelialization, reducing inflammation and sequestrum formation, and increasing collagen deposition. LED light facilitated healing, likely by reducing reactive oxygen species and promoting angiogenesis and tissue remodeling, though additional research is still needed to validate the optimal LED conditions for clinical use.
Eight-year follow-up of successful intentional replantationAbu-Hussein Muhamad
This case report describes the endodontic retreatment and restoration of a structurally compromised maxillary second premolar. The tooth had undergone inadequate endodontic treatment 4 years prior and presented with a periapical lesion and perforation. Microscopic retreatment was performed using hand files, ultrasonics and irrigants. The canal and perforation were obturated with gutta-percha and MTA-based sealer. A direct composite build-up was placed to create a core, and an indirect composite onlay was adhesively cemented as the definitive restoration. At the 6-month recall, the tooth was asymptomatic and the patient was satisfied with the treatment outcome.
This study extracted mesenchymal stem cells from dental pulp tissue from a freshly extracted deciduous tooth. The cells were cultured and showed active growth over 35 days. Chromosome analysis of 25 and 100 cells at 20 and 35 days found no abnormalities. This establishes a method for extracting and culturing stem cells from deciduous teeth, a biological waste, for potential therapeutic applications. Further research with more samples and passage cultures is needed to validate producing these stem cells at larger scales.
5th publication -Dr Rahul VC Tiwari - Department of ral and Maxillofacial Surgery, SIBAR Institute of Dental Sciences, Takkellapadu,Guntur, Andhra Pradesh - 522509.
3D reconstruction revealed features of carious hard tissues and soft tissues. Specifically, it showed strongly expressed amelogenin proteins in dentin tubules of carious teeth and increased glial markers GFAP and S100B in pulp components of carious teeth. 4D live cell imaging showed the diffusion patterns of fluorescent molecules in response to bacterial virulence factors and uptake of an antibiotic into epithelial cells to kill intracellular oral pathogens. 3D/4D imaging using confocal microscopy provides benefits for analyzing clinical dental specimens and studying drug development.
Treatment of gingival recession using coronally advanced flapShruti Maroo
This document describes a case study evaluating the efficacy of the coronally advanced flap technique for treating gingival recession. A 27-year old male patient presented with Miller's Class I gingival recession on teeth 22 and 23, along with sensitivity. The coronally advanced flap procedure was performed, involving incisions and elevation of a partial-thickness flap. One month and three months post-operatively, the patient showed uneventful healing and 100% root coverage, with reduction in sensitivity and no probing defects. The coronally advanced flap technique alone can successfully treat gingival recession when residual gingiva is thick and wide, resulting in good esthetic and functional outcomes.
This study evaluated the clinical outcomes and properties of periodontal ligament progenitor cells (PDLPs) for the treatment of periodontitis. Three patients with intrabony periodontal defects were treated by transplantation of autologous PDLPs cultured on a bone graft material. Clinical measurements over 32-72 months showed reduced probing depths and clinical attachment gains, indicating potential therapeutic benefits. In vitro analysis found that PDLPs showed characteristics similar to periodontal ligament stem cells (PDLSCs), including proliferation, mesenchymal surface marker expression, and multipotent differentiation, but lacked expression of the tendon marker scleraxis. This provides preliminary evidence that PDLP transplantation may be an effective and safe approach for periodontitis
Mahendra Azad et al. GAINT ODONTOGENIC KERATOCYST OF MANDIBLE OPERATED UNDER LOCAL ANESTHESIA- A CASE REPORT. JOURNAL OF DENTAL HEALTH & RESEARCH (VOL. 1, ISSUE 2, JUL - DEC 2020): 24-2
Two Way Approach For Enucleation Of Maxillary Radicular Cyst.iosrjce
This document describes a case study of a 39-year-old male patient who presented with pain and swelling in the left upper back tooth region. Clinical and radiographic examination revealed a large radicular cyst extending from the upper left canine to third molar region. The cyst was initially enucleated through an intraoral approach. Later, a functional endoscopic sinus surgery was performed through the maxillary antrum to inspect for any residual cyst lining, since the patient also had a deviated nasal septum requiring septoplasty. No residual cyst was observed during endoscopy. This case report demonstrates that large maxillary radicular cysts can be effectively treated through both conventional intraoral enucleation and an end
This case report describes the rehabilitation of an edentulous 63-year old female patient with an implant supported overdenture. The patient presented with a loose lower denture and difficulty with mastication and speech. Clinical examination and radiographs showed resorbed alveolar ridges. The treatment plan involved placing two implants in the mandible and four implants in the maxilla. After osseointegration, ball attachments were connected to the implants and incorporated into the overdenture. The patient was followed up for 6 months and showed improved function, retention, stability and satisfaction with the new overdenture. Implant supported overdentures can successfully rehabilitate edentulous ridges and provide superior outcomes compared to
This case report describes the rehabilitation of an edentulous 63-year old female patient with an implant supported overdenture. The patient presented with a loose lower denture and difficulty with mastication and speech. Clinical examination and radiographs revealed resorbed alveolar ridges. The treatment plan involved placing two implants in the mandible and four implants in the maxilla. Ball attachments were used to connect the overdentures to the implants. The surgical placement of the implants was described. After osseointegration, the ball attachments were connected to create an implant supported overdenture. The patient was satisfied with improved function and esthetics. The case report concluded implant supported overdentures are an effective treatment for
Dr. Rahul VC Tiwari - Fellowship In Orthognathic Surgery - Jubilee Mission Medical College Hospital and Research Center, Thrissur, Kerala - 20TH PUBLICATION - IJADS
recent advances in prosthodontics/dental lab technology courses by Indian den...Indian dental academy
This document summarizes several new developments in dental ceramics. It discusses materials like In-Ceram, Procera, and IPS Empress 2 which can be used for posterior dental restorations due to improvements in strength and toughness compared to conventional ceramics. In-Ceram cores are crystalline rather than glass-based, increasing strength. Procera uses a titanium substructure for strength while Empress 2 uses lithium disilicate glass ceramics with 60% crystal content for high strength without compromising translucency. These new materials allow for all-ceramic restorations in areas requiring more load bearing than previous ceramics.
1. The document discusses the management of non-vital immature permanent teeth with open apices through a revascularization procedure.
2. Revascularization involves inducing bleeding into the empty root canal to potentially trigger wound healing and regeneration of pulp tissue.
3. The procedure first disinfects the canal with irrigants and medicaments, then uses small files to induce bleeding up to 3mm into the canal, followed by placement of MTA and restoration to allow further development.
Osseo-integrated dental implants have been widely used for the rehabilitation of tooth loss. Although dental implants
are considered an available treatment in the paradigm shift from traditional dental therapies, such as fixed dental bridges and
removable dentures, the fundamental problems must be overcome prior to their clinical use in young patients who are still
undergoing jawbone growth. A bio-engineered functional bio-hybrid implant that is combined with adult-derived periodontal
tissue and attached with bone tissue can act as a substitute for cementum. This bio-hybrid implant was successfully engrafted
and it restored physiological function, including bone remodelling, regeneration and appropriate responsiveness to noxious
stimuli. Thus, this article reviews the functional bio-hybrid implant’s potential for clinical use as a next-generation dental
implant using adult-derived tissues.
Recent advances in prosthodontics / crown & bridge courses by indian dental a...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
This case report describes a 9-year-old male child who presented with a painless swelling on the inner aspect of his lower lip. The swelling had developed over the past 3 months and was diagnosed as a mucocele based on the reported history of trauma to the lip and clinical features of the lesion. The mucocele was surgically removed and microscopic examination confirmed the diagnosis. Mucoceles typically develop due to obstruction or trauma of minor salivary glands and are best treated with complete surgical excision to prevent recurrence.
Rapid canine retraction and orthodontic treatment with dentoalveolar distract...Dr Mujtaba Ashraf
This document presents a study on a new technique called dentoalveolar distraction (DAD) to rapidly retract canines during orthodontic treatment. The study involved 10 patients where the maxillary first premolars were extracted and a distractor device was used to move the canines into the extraction sites at a rate of 0.8 mm per day. Full canine retraction was achieved in an average of 10 days with minimal anchorage loss. The canines tipped and translated distally on average 13 degrees. No complications were observed. The DAD technique reduces orthodontic treatment time by nearly 50% with no adverse effects on surrounding structures.
This document discusses the management of diabetic foot ulcers from both modern and Ayurvedic perspectives. It presents the case of a 70-year-old man with a large abscess and cellulitis on his right foot. Using Paradadi churan and herbal oils like Jatayadi tail and Nirgundi tail, the wound size gradually decreased over several months with no infection or pain. This treatment aligned with Ayurvedic principles and avoided amputation, demonstrating Susruta's effective approach for managing diabetic foot ulcers.
Similar to Buccal pad fat for cyst Indian Jr SCT volume 2, issue 1, April 16 (20)
Buccal pad fat for cyst Indian Jr SCT volume 2, issue 1, April 16
1. Indian Journal of Stem Cell Therapy 43
Introduction
Cyst is a pathological cavity which may or may
not be lined by epithelium, contains fluid,
semisolid material or gas and present in bone or
soft tissue[1]. Dentigerous cyst is lesion attached
to the cervical region of an impacted tooth and
cystic fluid forms between reduced enamel
epithelium and enamel of the tooth crown.
Usually dentigerous cysts are more common in
mandible frequently in male and it is the second
most common cyst of the jaws comprising 14-
20% of jaw cyst. Mandibular 3rd molar followed
by maxillary canine and occasionally
supernumerary teeth or odontomas are involved
in cyst formation [2, 3]. Dentigerous is usually
associated with painless expansion, grow
considerably in size of the jaw and cause facial
asymmetry[4]. It occurs at any age group, but
more common in the second and third decades[5].
Small cysts are usually easy to treat surgically.
However, these are asymptomatic even when
reaching considerable size and impacted tooth
are displaced distance due to cystic pressure and
treatment is more difficult one. Surgeries may
results in removal of many teeth or tooth buds or
affect the vitality of adjacent teeth.
SVF from Buccal pad of fat
According to Hausman, Dodson [6] the word
adipocyte refers to the lipid filled cell, found in
high concentration in various body locals. Basic
adipose architecture contains some lipid filled
adipocytes, connective tissue, blood vessels, pre
adipocytes, monocytes and macrophages. A cell
fraction that serves as the precursor to majority
of adipocytes of the adult is called stromal
vascular cell fraction (SVF). The pioneering work
of Prunet-Marcassus et al. [7] suggested that
adipose tissue contains a number of progenitor
cells that gives rise to different phenotypes in
Autologous Buccal Pad of Fat Stromal Vascular Fraction Used
To Regenerate Larger Defect Due to Maxillary Dentigerous Cyst
K. Manimaran1
, K. Arunkumar3
, M. Chandramohan1
, S. Mahenderaperumal1
, S.
Sankaranarayanan2
, D Avinash Gandi2
, Rohini Sharma2
1- KSR Institute of Dental Science and Research. Department Of Oral and maxillofacial Surgery,
Tiruchengode, TN, India
2- Mother Cell Regenerative Center, Trichy, TN, India.
3- RVS dental college and hospital, Department of Oral medicine and radiology, Coimbatore, TN, India.
Corresponding author : Prof. Dr. S. Sankaranarayanan,
Director - Mother Cell Regenerative Centre (MCRC)
44GA - 1st Floor, Vishranti Surya Complex, Aruna Nagar, Vayalur Road, Puthur, Trichy - 620017
Mobile : 09443120843 E mail Id: stemcellsankar@gmail.com
Abstract
Cyst is a pathological cavity may or may not be lined by epithelium, contains fluid, semisolid
material or gas and present in bone or soft tissue. Sometimes the cyst may involve important
anatomical structure which requires careful enucleation and retaining anatomic integrity. Various
modalities of treatments can be advocated like enucleation, marsupialization and resection. To
bring the impacted canine by orthodontic movement good bone support is necessary in the osteolytic
region. Hence we attempted bone regeneration with stem cells from autologous stromal vascular
fractions SVF. We used SVF from buccal pad of fat with minimal manipulation to treat larger
defect involving right maxilla and maxillary sinus due to dentigerous cyst. Good bone regeneration
was achieved with 16 month of followup. Patient is now under orthodontic treatment to bring
down the impacted canine.
Key word: Dentigerous Cyst, Enucleation, Buccal pad of fat, SVF.
2. 44 Indian Journal of Stem Cell Therapy
addition to a large portion of macrophages and
hematopoietic progenitor cells.
The study was performed at the Department of
Oral and Maxillofacial Surgery, KSR Dental
College, Tiruchengode, Tamilnadu, India. This
study was performed with written informed
consent from his parents and after the approval
of Institutional Ethical Committee - KSR Institute
of Dental Science & Research (IEC-KSRIDSR)
and in full accordance with the World Medical
Association Declaration of Helsinki.
We took buccal pad of fat from right side of the
patient's cheek (malar region) intra orally before
surgery for dentigerous cyst under local
anesthesia. The fat tissue was processed into SVF
under Good Manufacturing practice (GMP) class
clean rooms according to standard operating
procedure at the Research Department of
Biotechnology of KSR institution campus. After
sending fat tissue for SVF isolation clinical
procedure of cyst removal was carried out.
Isolation of SVF Fromhuman buccal
pad fat [8]
The experimental protocol was approved by the
Institutional Review Board KSR institute of Dental
science and research ,Tiruchengode. The adipose
tissue was processed within 2 hours of sample
collection to retain the viability of the cells. The
fat was processed for isolation of Stromal
Vascular Fraction as previously described by
Gandi et al. [8] with few modifications. Briefly,
after rinsing in normal saline collected fat (6gms)
was placed in a sterile petri dish, and was minced
into small (4-5 mm) pieces with surgical scissors
and scalpel. After removal of connective tissue
the minced sample was transferred in centrifuge
tube containing 10 ml of Type I Collagenase -
Animal free origin (17100-Gibco® Life
Technologies™, NY, USA). The adipose tissue-
collagenase suspension was incubated at 37°C
30 to 60 mins with intermittent vigorous shaking
for every 10 minutes. After incubation the
suspension was neutralized by equal volume of
complete medium, consisting of Mesen PRO
medium supplemented with 20% of autologous
serum. Then the content was centrifuged at
4000g for 10 min to pellet the MSC-rich dense
stromal vascular fraction. After centrifugation
the adipocyte and fat appeared as a yellow oily
layer at the top of the tube. This supernatant
containing the oily layer and collagenase solution
was decanted with the help of a transfer pipette.
The pellet was suspended in 2 ml of sterile 160mM
NH4Cl and incubated at room temperature (RT)
for 10 min to lyse the red blood cells. The samples
were transferred to new centrifuge tube and
centrifuged at 300g for 10 min to pellet the RBC
free SVF. The SVF pellet was then resuspended
in HBSS and filtered through a 40 ?m strainer
(352340, Corning). The cell number & viability
of SVF was calculated by tryphan blue dye
exclusion assay as per the protocols of Darlington
[9]. Following that about 15 × 106SVF cells/ml,
was suspended in 4 ml of patients PRP prepared
and taken for administrating after the clinical
procedure of cyst removal.
Case Report:
14 year old boy reported to the department of
oral & maxillofacial surgery with complaints of
swelling in the right side of the face lateral to nose
and swelling in the anterior part of upper jaw.
On examination extra oral swelling 3 x 2 cm size
present in lateral to right side of nose and
obliteration of right nasolabial fold causing facial
asymmetry (Fig 1). Intra oral examination
revealed non-fluctuant swelling with obliteration
of right labial sulcus from midline to 1st premolar
region. Missing 13 and retained 53 (deciduous
canine). Grade II mobility in 11, 12 and both these
teeth are tilted towards the mid line. Duration of
swelling was 10 months. Patient treated
elsewhere for this complaint for the past 3 months
and root canal opened in 11 and 12 there. OPG
(Fig 2) I.O periapical X-Ray revealed larger cystic
lesion involving right maxillary region with
impacted 13, lying over 14, 15 region, also
impacted supernumerary tooth lying right to
lateral nasal aperture and roots of 11, 12 tilted
towards the distal side. Aspiration showed straw
colored fluid. Both clinical and radiographic
findings suggested the provisional diagnosis of
dentigerous cyst.
We discussed treatment plan with patient
regarding preserving 11 (Right central incisor),
12 (Right lateral incisor) and to bring the
impacted canine to normal anatomical position
by orthodontic treatment. To bring the teeth from
the impacted position which is very horizontally
3. 44 Indian Journal of Stem Cell Therapy
addition to a large portion of macrophages and
hematopoietic progenitor cells.
The study was performed at the Department of
Oral and Maxillofacial Surgery, KSR Dental
College, Tiruchengode, Tamilnadu, India. This
study was performed with written informed
consent from his parents and after the approval
of Institutional Ethical Committee - KSR Institute
of Dental Science & Research (IEC-KSRIDSR)
and in full accordance with the World Medical
Association Declaration of Helsinki.
We took buccal pad of fat from right side of the
patient's cheek (malar region) intra orally before
surgery for dentigerous cyst under local
anesthesia. The fat tissue was processed into SVF
under Good Manufacturing practice (GMP) class
clean rooms according to standard operating
procedure at the Research Department of
Biotechnology of KSR institution campus. After
sending fat tissue for SVF isolation clinical
procedure of cyst removal was carried out.
Isolation of SVF Fromhuman buccal
pad fat [8]
The experimental protocol was approved by the
Institutional Review Board KSR institute of Dental
science and research ,Tiruchengode. The adipose
tissue was processed within 2 hours of sample
collection to retain the viability of the cells. The
fat was processed for isolation of Stromal
Vascular Fraction as previously described by
Gandi et al. [8] with few modifications. Briefly,
after rinsing in normal saline collected fat (6gms)
was placed in a sterile petri dish, and was minced
into small (4-5 mm) pieces with surgical scissors
and scalpel. After removal of connective tissue
the minced sample was transferred in centrifuge
tube containing 10 ml of Type I Collagenase -
Animal free origin (17100-Gibco® Life
Technologies™, NY, USA). The adipose tissue-
collagenase suspension was incubated at 37°C
30 to 60 mins with intermittent vigorous shaking
for every 10 minutes. After incubation the
suspension was neutralized by equal volume of
complete medium, consisting of Mesen PRO
medium supplemented with 20% of autologous
serum. Then the content was centrifuged at
4000g for 10 min to pellet the MSC-rich dense
stromal vascular fraction. After centrifugation
the adipocyte and fat appeared as a yellow oily
layer at the top of the tube. This supernatant
containing the oily layer and collagenase solution
was decanted with the help of a transfer pipette.
The pellet was suspended in 2 ml of sterile 160mM
NH4Cl and incubated at room temperature (RT)
for 10 min to lyse the red blood cells. The samples
were transferred to new centrifuge tube and
centrifuged at 300g for 10 min to pellet the RBC
free SVF. The SVF pellet was then resuspended
in HBSS and filtered through a 40 ?m strainer
(352340, Corning). The cell number & viability
of SVF was calculated by tryphan blue dye
exclusion assay as per the protocols of Darlington
[9]. Following that about 15 × 106SVF cells/ml,
was suspended in 4 ml of patients PRP prepared
and taken for administrating after the clinical
procedure of cyst removal.
Case Report:
14 year old boy reported to the department of
oral & maxillofacial surgery with complaints of
swelling in the right side of the face lateral to nose
and swelling in the anterior part of upper jaw.
On examination extra oral swelling 3 x 2 cm size
present in lateral to right side of nose and
obliteration of right nasolabial fold causing facial
asymmetry (Fig 1). Intra oral examination
revealed non-fluctuant swelling with obliteration
of right labial sulcus from midline to 1st premolar
region. Missing 13 and retained 53 (deciduous
canine). Grade II mobility in 11, 12 and both these
teeth are tilted towards the mid line. Duration of
swelling was 10 months. Patient treated
elsewhere for this complaint for the past 3 months
and root canal opened in 11 and 12 there. OPG
(Fig 2) I.O periapical X-Ray revealed larger cystic
lesion involving right maxillary region with
impacted 13, lying over 14, 15 region, also
impacted supernumerary tooth lying right to
lateral nasal aperture and roots of 11, 12 tilted
towards the distal side. Aspiration showed straw
colored fluid. Both clinical and radiographic
findings suggested the provisional diagnosis of
dentigerous cyst.
We discussed treatment plan with patient
regarding preserving 11 (Right central incisor),
12 (Right lateral incisor) and to bring the
impacted canine to normal anatomical position
by orthodontic treatment. To bring the teeth from
the impacted position which is very horizontally
4. 44 Indian Journal of Stem Cell Therapy
addition to a large portion of macrophages and
hematopoietic progenitor cells.
The study was performed at the Department of
Oral and Maxillofacial Surgery, KSR Dental
College, Tiruchengode, Tamilnadu, India. This
study was performed with written informed
consent from his parents and after the approval
of Institutional Ethical Committee - KSR Institute
of Dental Science & Research (IEC-KSRIDSR)
and in full accordance with the World Medical
Association Declaration of Helsinki.
We took buccal pad of fat from right side of the
patient's cheek (malar region) intra orally before
surgery for dentigerous cyst under local
anesthesia. The fat tissue was processed into SVF
under Good Manufacturing practice (GMP) class
clean rooms according to standard operating
procedure at the Research Department of
Biotechnology of KSR institution campus. After
sending fat tissue for SVF isolation clinical
procedure of cyst removal was carried out.
Isolation of SVF Fromhuman buccal
pad fat [8]
The experimental protocol was approved by the
Institutional Review Board KSR institute of Dental
science and research ,Tiruchengode. The adipose
tissue was processed within 2 hours of sample
collection to retain the viability of the cells. The
fat was processed for isolation of Stromal
Vascular Fraction as previously described by
Gandi et al. [8] with few modifications. Briefly,
after rinsing in normal saline collected fat (6gms)
was placed in a sterile petri dish, and was minced
into small (4-5 mm) pieces with surgical scissors
and scalpel. After removal of connective tissue
the minced sample was transferred in centrifuge
tube containing 10 ml of Type I Collagenase -
Animal free origin (17100-Gibco® Life
Technologies™, NY, USA). The adipose tissue-
collagenase suspension was incubated at 37°C
30 to 60 mins with intermittent vigorous shaking
for every 10 minutes. After incubation the
suspension was neutralized by equal volume of
complete medium, consisting of Mesen PRO
medium supplemented with 20% of autologous
serum. Then the content was centrifuged at
4000g for 10 min to pellet the MSC-rich dense
stromal vascular fraction. After centrifugation
the adipocyte and fat appeared as a yellow oily
layer at the top of the tube. This supernatant
containing the oily layer and collagenase solution
was decanted with the help of a transfer pipette.
The pellet was suspended in 2 ml of sterile 160mM
NH4Cl and incubated at room temperature (RT)
for 10 min to lyse the red blood cells. The samples
were transferred to new centrifuge tube and
centrifuged at 300g for 10 min to pellet the RBC
free SVF. The SVF pellet was then resuspended
in HBSS and filtered through a 40 ?m strainer
(352340, Corning). The cell number & viability
of SVF was calculated by tryphan blue dye
exclusion assay as per the protocols of Darlington
[9]. Following that about 15 × 106SVF cells/ml,
was suspended in 4 ml of patients PRP prepared
and taken for administrating after the clinical
procedure of cyst removal.
Case Report:
14 year old boy reported to the department of
oral & maxillofacial surgery with complaints of
swelling in the right side of the face lateral to nose
and swelling in the anterior part of upper jaw.
On examination extra oral swelling 3 x 2 cm size
present in lateral to right side of nose and
obliteration of right nasolabial fold causing facial
asymmetry (Fig 1). Intra oral examination
revealed non-fluctuant swelling with obliteration
of right labial sulcus from midline to 1st premolar
region. Missing 13 and retained 53 (deciduous
canine). Grade II mobility in 11, 12 and both these
teeth are tilted towards the mid line. Duration of
swelling was 10 months. Patient treated
elsewhere for this complaint for the past 3 months
and root canal opened in 11 and 12 there. OPG
(Fig 2) I.O periapical X-Ray revealed larger cystic
lesion involving right maxillary region with
impacted 13, lying over 14, 15 region, also
impacted supernumerary tooth lying right to
lateral nasal aperture and roots of 11, 12 tilted
towards the distal side. Aspiration showed straw
colored fluid. Both clinical and radiographic
findings suggested the provisional diagnosis of
dentigerous cyst.
We discussed treatment plan with patient
regarding preserving 11 (Right central incisor),
12 (Right lateral incisor) and to bring the
impacted canine to normal anatomical position
by orthodontic treatment. To bring the teeth from
the impacted position which is very horizontally
5. 44 Indian Journal of Stem Cell Therapy
addition to a large portion of macrophages and
hematopoietic progenitor cells.
The study was performed at the Department of
Oral and Maxillofacial Surgery, KSR Dental
College, Tiruchengode, Tamilnadu, India. This
study was performed with written informed
consent from his parents and after the approval
of Institutional Ethical Committee - KSR Institute
of Dental Science & Research (IEC-KSRIDSR)
and in full accordance with the World Medical
Association Declaration of Helsinki.
We took buccal pad of fat from right side of the
patient's cheek (malar region) intra orally before
surgery for dentigerous cyst under local
anesthesia. The fat tissue was processed into SVF
under Good Manufacturing practice (GMP) class
clean rooms according to standard operating
procedure at the Research Department of
Biotechnology of KSR institution campus. After
sending fat tissue for SVF isolation clinical
procedure of cyst removal was carried out.
Isolation of SVF Fromhuman buccal
pad fat [8]
The experimental protocol was approved by the
Institutional Review Board KSR institute of Dental
science and research ,Tiruchengode. The adipose
tissue was processed within 2 hours of sample
collection to retain the viability of the cells. The
fat was processed for isolation of Stromal
Vascular Fraction as previously described by
Gandi et al. [8] with few modifications. Briefly,
after rinsing in normal saline collected fat (6gms)
was placed in a sterile petri dish, and was minced
into small (4-5 mm) pieces with surgical scissors
and scalpel. After removal of connective tissue
the minced sample was transferred in centrifuge
tube containing 10 ml of Type I Collagenase -
Animal free origin (17100-Gibco® Life
Technologies™, NY, USA). The adipose tissue-
collagenase suspension was incubated at 37°C
30 to 60 mins with intermittent vigorous shaking
for every 10 minutes. After incubation the
suspension was neutralized by equal volume of
complete medium, consisting of Mesen PRO
medium supplemented with 20% of autologous
serum. Then the content was centrifuged at
4000g for 10 min to pellet the MSC-rich dense
stromal vascular fraction. After centrifugation
the adipocyte and fat appeared as a yellow oily
layer at the top of the tube. This supernatant
containing the oily layer and collagenase solution
was decanted with the help of a transfer pipette.
The pellet was suspended in 2 ml of sterile 160mM
NH4Cl and incubated at room temperature (RT)
for 10 min to lyse the red blood cells. The samples
were transferred to new centrifuge tube and
centrifuged at 300g for 10 min to pellet the RBC
free SVF. The SVF pellet was then resuspended
in HBSS and filtered through a 40 ?m strainer
(352340, Corning). The cell number & viability
of SVF was calculated by tryphan blue dye
exclusion assay as per the protocols of Darlington
[9]. Following that about 15 × 106SVF cells/ml,
was suspended in 4 ml of patients PRP prepared
and taken for administrating after the clinical
procedure of cyst removal.
Case Report:
14 year old boy reported to the department of
oral & maxillofacial surgery with complaints of
swelling in the right side of the face lateral to nose
and swelling in the anterior part of upper jaw.
On examination extra oral swelling 3 x 2 cm size
present in lateral to right side of nose and
obliteration of right nasolabial fold causing facial
asymmetry (Fig 1). Intra oral examination
revealed non-fluctuant swelling with obliteration
of right labial sulcus from midline to 1st premolar
region. Missing 13 and retained 53 (deciduous
canine). Grade II mobility in 11, 12 and both these
teeth are tilted towards the mid line. Duration of
swelling was 10 months. Patient treated
elsewhere for this complaint for the past 3 months
and root canal opened in 11 and 12 there. OPG
(Fig 2) I.O periapical X-Ray revealed larger cystic
lesion involving right maxillary region with
impacted 13, lying over 14, 15 region, also
impacted supernumerary tooth lying right to
lateral nasal aperture and roots of 11, 12 tilted
towards the distal side. Aspiration showed straw
colored fluid. Both clinical and radiographic
findings suggested the provisional diagnosis of
dentigerous cyst.
We discussed treatment plan with patient
regarding preserving 11 (Right central incisor),
12 (Right lateral incisor) and to bring the
impacted canine to normal anatomical position
by orthodontic treatment. To bring the teeth from
the impacted position which is very horizontally
6. 44 Indian Journal of Stem Cell Therapy
addition to a large portion of macrophages and
hematopoietic progenitor cells.
The study was performed at the Department of
Oral and Maxillofacial Surgery, KSR Dental
College, Tiruchengode, Tamilnadu, India. This
study was performed with written informed
consent from his parents and after the approval
of Institutional Ethical Committee - KSR Institute
of Dental Science & Research (IEC-KSRIDSR)
and in full accordance with the World Medical
Association Declaration of Helsinki.
We took buccal pad of fat from right side of the
patient's cheek (malar region) intra orally before
surgery for dentigerous cyst under local
anesthesia. The fat tissue was processed into SVF
under Good Manufacturing practice (GMP) class
clean rooms according to standard operating
procedure at the Research Department of
Biotechnology of KSR institution campus. After
sending fat tissue for SVF isolation clinical
procedure of cyst removal was carried out.
Isolation of SVF Fromhuman buccal
pad fat [8]
The experimental protocol was approved by the
Institutional Review Board KSR institute of Dental
science and research ,Tiruchengode. The adipose
tissue was processed within 2 hours of sample
collection to retain the viability of the cells. The
fat was processed for isolation of Stromal
Vascular Fraction as previously described by
Gandi et al. [8] with few modifications. Briefly,
after rinsing in normal saline collected fat (6gms)
was placed in a sterile petri dish, and was minced
into small (4-5 mm) pieces with surgical scissors
and scalpel. After removal of connective tissue
the minced sample was transferred in centrifuge
tube containing 10 ml of Type I Collagenase -
Animal free origin (17100-Gibco® Life
Technologies™, NY, USA). The adipose tissue-
collagenase suspension was incubated at 37°C
30 to 60 mins with intermittent vigorous shaking
for every 10 minutes. After incubation the
suspension was neutralized by equal volume of
complete medium, consisting of Mesen PRO
medium supplemented with 20% of autologous
serum. Then the content was centrifuged at
4000g for 10 min to pellet the MSC-rich dense
stromal vascular fraction. After centrifugation
the adipocyte and fat appeared as a yellow oily
layer at the top of the tube. This supernatant
containing the oily layer and collagenase solution
was decanted with the help of a transfer pipette.
The pellet was suspended in 2 ml of sterile 160mM
NH4Cl and incubated at room temperature (RT)
for 10 min to lyse the red blood cells. The samples
were transferred to new centrifuge tube and
centrifuged at 300g for 10 min to pellet the RBC
free SVF. The SVF pellet was then resuspended
in HBSS and filtered through a 40 ?m strainer
(352340, Corning). The cell number & viability
of SVF was calculated by tryphan blue dye
exclusion assay as per the protocols of Darlington
[9]. Following that about 15 × 106SVF cells/ml,
was suspended in 4 ml of patients PRP prepared
and taken for administrating after the clinical
procedure of cyst removal.
Case Report:
14 year old boy reported to the department of
oral & maxillofacial surgery with complaints of
swelling in the right side of the face lateral to nose
and swelling in the anterior part of upper jaw.
On examination extra oral swelling 3 x 2 cm size
present in lateral to right side of nose and
obliteration of right nasolabial fold causing facial
asymmetry (Fig 1). Intra oral examination
revealed non-fluctuant swelling with obliteration
of right labial sulcus from midline to 1st premolar
region. Missing 13 and retained 53 (deciduous
canine). Grade II mobility in 11, 12 and both these
teeth are tilted towards the mid line. Duration of
swelling was 10 months. Patient treated
elsewhere for this complaint for the past 3 months
and root canal opened in 11 and 12 there. OPG
(Fig 2) I.O periapical X-Ray revealed larger cystic
lesion involving right maxillary region with
impacted 13, lying over 14, 15 region, also
impacted supernumerary tooth lying right to
lateral nasal aperture and roots of 11, 12 tilted
towards the distal side. Aspiration showed straw
colored fluid. Both clinical and radiographic
findings suggested the provisional diagnosis of
dentigerous cyst.
We discussed treatment plan with patient
regarding preserving 11 (Right central incisor),
12 (Right lateral incisor) and to bring the
impacted canine to normal anatomical position
by orthodontic treatment. To bring the teeth from
the impacted position which is very horizontally