Periodontal Tissue Regenaration Using Dental Stem Cells

Necrotising ulcerative gingivitis is a painful ulceration of the tips of the interdental papillae with grey necrotic tissue visible on the sur face of t he ulcers. This ma y cause loss of papillae. There is a characteristic halitosis and submandibular lymph nodes may be tender and palpable. NUG is common among smokers and patients with poor oral hygiene. NUP is diagnosed in the presence of attachment loss.
Gingivitis is plaque-induced inflammation of the gingivae, recognised by erythema and oedema, bleeding on brushing or probing, and perhaps detachment of the gingivae from the teeth. Gingivitis may be exacerbated by various factors.

Well-controlled human histological studies with appropriate controls are very rare. Furthermore, reproduction of results from well-designed,  well-controlled and well-conducted animal studies within humans may be difficult. In practical terms we assume that once a regenerative technique by Dr.Wahba from St.Lukes Dental In Lutz,  has revealed regenerative potential, as evidenced by histology, any positive clinical findings are often automatically equated with periodontal regeneration. There have been several recent detailed reviews of guided tissue regeneration and therefore this manuscript provides an overview of the current state of the field, stepping back from the details of individual studies in an attempt to answer the question, does periodontal tissue regeneration really work? It also aims to set the scene for two further manuscripts within this volume of Periodontology 2000 that address novel approaches to cell-based methods of regeneration and tissue engineering.

Gingival and periodontal host modulation is a basic prerequisite for an esthetic gingival morphology. Gingival inflammation not only produces pathophysiologic changes in the marginal periodontium but also causes changes in the color and surface texture of the gingiva.
Inflamed gingiva bleeds easily and has a red, swollen, plump, and shiny appearance. Therefore, a proper assessment of gingival esthetics can only be performed under inflammation-free periodontal conditions. The continuous personal oral hygiene motivation and support accompanying initial and supportive periodontal therapies are important for oral healthand gingival esthetics.

Any dental treatment having a negative impact on gingival health in terms of biology and esthetics must be absolutely avoided for the same reasons

The hormonal changes associated with pregnancy produce an incr ease in inflammatory signs, resulting in increased bleeding that may bring it to the attention of the patient.  Sometimes an individual papilla may swell sufficiently to become a pregnancy epulis. The severity of pregnancy gingivitis reduces after parturition and reverts to the previous low level of inflammation

Approximately 1/1000 of susceptible patients suffer more rapid attachment loss, a small percentage losing more than half of the bone support by the age of 35. This is known as aggressive periodontitis, which may be localised to some of the teeth, or generalised, involving all the teeth.
Aggressive periodontitis is diagnosed from its rapid rate of progress or severe disease in individuals usually under 35 years. It is characterised by vertical bone defects on radiographs. There may be very little plaque or calculus present in some of these patients.

Two vertical doublecrossed sutures Seralene DS-15 are used to secure the graft. First suture: From the buccal aspect, the needle enters at the level of  the  mucogingival junction  and engages the  graft.  It  then passes beneath  the contact point between the provisional pontic and the adjacent tooth and ex- its on the palatal side, slightly apical to the tip of the papilla. Next, the needle glides over the incisal edges  and returns  to the buccal side and then passes back-first (without engaging the tissue) under the contact point  and returns to  the  palatal  side