Comprehensive case in a periodontally compromised patient.

Objectives: The aim of the study was to evaluate in vitro the impact of bioengineered plant-derived Rhamnogalacturonan-I’s (RG-I) nanocoatings on osteogenic capacity and pro-inflammatory cytokine response of murine osteoblasts following Porphyromonas gingivalis (P. gingivalis) infection.Bioengineered RG-I’s from pectins are potential candidates for surface nanocoating of medical devices due to their physical, chemical, and biological properties. Methods: Murine osteoblast-like cells (MC3T3-E1) and isolated primary calvarial osteoblast from C57BL/6J (B6J osteoblasts) mice were infected with P. gingivalis and incubated on polystyrene tissue culture plates with or without nanocoatings of unmodified isolated RG-I's from potato pulps (PU) or dearabinanated RG-I's (PA). Cell proliferation, metabolic activity, mineralization and osteogenic and pro-inflammatory gene expression were examined at different time points and repeated six times each (n = 6). Results: Following P. gingivalis infection, MC3T3-E1 and B6J osteoblasts cell proliferation after 12, 24, 48 and 72 hours was significantly higher when cultured on PA but not PU coating as compared to cells cultured on control surface without nanocoating. Cell metabolic activity after 3, 7, 14 and 21 days was significantly enhanced in MC3T3-E1 and B6J osteoblasts cultures on surface coated with PA compared to control; on surface coated with PU in MC3T3 culture. Moreover, P. gingivalis infected MC3T3-E1 and B6J cells formed after 3, 7, 14 and 21 days significantly higher amount of calcium deposits on PA but not PU coating as compared to cells cultured on control surface. Finally, Il-1, Il-6, TNF-alpha and Rankl gene expression were down-regulated after 3, 7, 14 and 21 days in cells cultured on PU and to a higher extent on PA as compared to the corresponding control whereas Runx, Alpl, Col1a1, Bglap were up-regulated vice versa. Conclusion: Our data clearly show that pectin RG-I's nanocoating with high content of galactan (PA) reduces the osteoblastic response to P. gingivalis infection in vitro and may therefore reduce a risk of inflammation especially in immunocompromised patients with rheumatoid or periodontal disorders.

Tooth extraction, once a simple and straightforward surgical procedure, should be performed with the acknowledgement that ridge reduction will follow and that further clinical steps should be considered to compensate for it. Prof. Mauricio Araujo will provide you with detailed information on the basic principles anatomic changes after tooth extraction and of clinical aspects of ridge alterations after tooth extraction with and without implant placement.