The outcome of tooth autotransplantation depends mainly on the transplant tooth's anatomy-the type of donor tooth and the developmental stage of root formation. Mature teeth display a higher complication rate due to lower pulp revascularization potential, requiring root canal treatment (RCT) pre- or postoperatively to avoid postoperative complications, which extends treatment duration and cost. This report details a 39-year-old patient's autotransplantation of a mature wisdom tooth to replace the first molar after unsuccessful root canal retreatment. During the surgery, an extraoral root resection of the transplanted tooth was performed prior to placement to avoid the need to elevate the Schneiderian membrane, which displayed imperfect healing following the surgical removal of a cystic lesion in the maxillary sinus. RCT was not performed before nor after the procedure. At the 3-year follow-up, the tooth was asymptomatic. The vitality of the autotransplanted tooth was difficult to determine using standard vitality tests, which depend on patients' subjective responses, but the use of pulse oximetry objectively confirmed this. This case not only shows the possibility of a mature tooth transplant revascularization in an older patient but also gives a possible postoperative protocol of how to objectively confirm and measure the revascularization of the autotransplanted tooth.

• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

OBJECTIVE: Systematic review and meta-analysis on laboratory studies aimed to answer whether there is a difference in fracture resistance and fracture mode of structurally compromised teeth restored with direct composite restorations reinforced with short glass-fiber or bidirectional polyethylene fiber substructure, and between the two different fiber-reinforcement types. METHODS: An electronic literature search was conducted in Medline, Scopus, Web of Science, Lilacs, Google Scholar, Cochrane Library, and University Library databases. The last search was conducted on 16 November 2023. Only studies looking at Ribbond-reinforced restorations and/ or the use of EverX Posterior within restorations were included. Data were categorized and analyzed based on specific outcome measures including fracture resistance and fracture mode. Data from individual studies were divided into premolars and molars for each material category and then collated to compare the mean differences in fracture resistance between control groups (composite restorations) and intervention groups (fiber-reinforced composite restorations). RESULTS: From the initial 1266 articles identified, 23 laboratory-based studies were included for quantitative analysis. Twenty articles had an overall low risk of bias and 3 had an overall unclear risk of bias. The pooled estimate of the effect favored the intervention groups as having statistically significant higher fracture resistance when compared to control groups. CONCLUSIONS: Both fiber types improve fracture resistance and the fracture mode of structurally compromised teeth is equally efficient. Application technique deserves attention. Ribbond could be placed in a single layer at the cavity floor, whereas EverX Posterior should replace missing dentin in an anatomically shaped way.

• MeSH
• fraktury zubů * prevence a kontrola   MeSH
• lidé MeSH
• polyethyleny MeSH
• sklo chemie   MeSH
• složené pryskyřice * terapeutické užití   chemie   MeSH
• trvalá zubní náhrada * metody   MeSH
• zubní materiály chemie   MeSH
• zuby-sanace - selhání MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• práce podpořená grantem MeSH
• systematický přehled MeSH

Most tooth-bearing non-mammalian vertebrates have the capacity to replace their teeth throughout life. This capacity was lost in mammals, which replace their teeth only once at most. Not surprisingly, continuous tooth replacement has attracted much attention. Classical morphological studies (e.g. to analyse patterns of replacement) are now being complemented by molecular studies that investigate the expression of genes involved in tooth formation. This review focuses on ray-finned fish (actinopterygians), which have teeth often distributed throughout the mouth and pharynx, and more specifically on teleost fish, the largest group of extant vertebrates. First we highlight the diversity in tooth distribution and in tooth replacement patterns. Replacement tooth formation can start from a distinct (usually discontinuous and transient) dental lamina, but also in the absence of a successional lamina, e.g. from the surface epithelium of the oropharynx or from the outer dental epithelium of a predecessor tooth. The relationship of a replacement tooth to its predecessor is closely related to whether replacement is the result of a prepattern or occurs on demand. As replacement teeth do not necessarily have the same molecular signature as first-generation teeth, the question of the actual trigger for tooth replacement is discussed. Much emphasis has been laid in the past on the potential role of epithelial stem cells in initiating tooth replacement. The outcome of such studies has been equivocal, possibly related to the taxa investigated, and the permanent or transient nature of the dental lamina. Alternatively, replacement may result from local proliferation of undifferentiated progenitors, stimulated by hitherto unknown, perhaps mesenchymal, factors. So far, the role of the neurovascular link in continuous tooth replacement has been poorly investigated, despite the presence of a rich vascularisation surrounding actinopterygian (as well as chondrichthyan) teeth and despite a complete arrest of tooth replacement after nerve resection. Lastly, tooth replacement is possibly co-opted as a process to expand the number of teeth in a dentition ontogenetically whilst conserving features of the primary dentition. That neither a dental lamina, nor stem cells appear to be required for tooth replacement places teleosts in an advantageous position as models for tooth regeneration in humans, where the dental lamina regresses and epithelial stem cells are considered lost.

• MeSH
• biologická evoluce MeSH
• ryby * fyziologie   MeSH
• zuby * MeSH
• zvířata MeSH
• Check Tag
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

Úvod a cíl: V případě ztráty zubu u dospělého pacienta lze volit mezi dentálním implantátem a autotransplantací zubu s ukončeným vývojem kořene. Cílem této kazuistiky je prezentovat osobní zkušenosti pacienta, který podstoupil náhradu dvou zubů – jednoho pomocí dentálního implantátu a druhého autotransplantací třetího moláru. Popis případu: Pacient ve věku 49 let byl odeslán na specializované pracoviště k posouzení náhrady zubů 15 a 17. Hlavním problémem pacienta byla ztráta mastikační funkce po extrakci čtyř zubů na pravé straně. Vyšetření odhalilo, že zub 38 je indikován k extrakci, a proto byla pacientovi nabídnuta možnost nahradit zub 17 autotransplantací zubu 28, která byla provedena. Zub 15 byl nahrazen implantátem. Transplantovaný zub vyžadoval ošetření kořenových kanálků a následně byla doporučena protetická úprava jeho korunky. Výsledky hlášené pacientem, které byly zaznamenány prostřednictvím dotazníku, ukázaly, že byl spokojen s výsledky v obou případech. Autotransplantát poskytl rychlejší funkční rehabilitaci, ale byl spojen s vyšším počtem návštěv kvůli nutnosti ošetření kořenových kanálků. Závěr: Při plánování individualizovaného léčebného plánu je nezbytné zohlednit očekávání a hlavní obtíže pacienta. Autotransplantace zubu je možností náhrady při zohlednění všech nutných kroků, pokud je k dispozici vhodný donor. Dentální implantát je preferovanou volbou v případě dostatečné nabídky kosti.

Introduction and aim: For tooth loss in adult patients, treatment options include dental implants and autotransplantation of a tooth with complete root formation. This case report presents a patient’s experience undergoing both treatments – one tooth replaced with a dental implant and another with an autotransplanted third molar. Case description: A 49-year-old patient, concerned about masticatory function loss after the extraction of four teeth on the right side, was referred for evaluation. Examination indicated that tooth 38 required extraction, offering the opportunity to replace tooth 17 with an autotransplanted tooth 28. Tooth 15 was replaced with a dental implant. The transplanted tooth required root canal treatment (RCT) and prosthetic crown modification. Patient-reported outcomes, acquired through a questionnaire, showed satisfaction with both procedures. The autotransplant allowed for a quicker functional recovery but involved more visits due to the necessity of RCT. Conclusion: Individualized treatment planning must consider patient expectations and primary concerns. Autotransplantation is viable when a suitable donor tooth is available, but one must consider all steps including RCT and potential prosthodontic reconstruction. Dental implants are preferred when bone availability is sufficient.

• MeSH
• autologní transplantace * MeSH
• implantace zubů metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• moláry transplantace   MeSH
• zubní implantáty jednotlivých zubů * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

Získaná hemofilie A (AHA) je vzácné krvácivé onemocnění vyskytující se především ve vyšším věku. Je způsobená přítomností autoprotilátek proti koagulačnímu faktoru VIII (FVIII). Může být asociována s autoimunitním onemocněním, malignitou či po porodu nebo vzniká idiopaticky. Důležitá je včasná diagnóza a léčba, která spočívá v léčbě krvácení a imunosupresivní léčbě k navození remise onemocnění čili k eradikaci inhibitoru. Zmiňujeme případ pacientky s revmatoidní artritidou s krvácivými projevy z gastrointestinálního traktu (GIT), kožními sufuzemi a protrahovaným krvácením po extrakci zubu. U pacientky byla diagnostikována AHA a bylo nutné zahájit léčbu rekombinantním aktivovaným faktorem VII (rFVIIa). Vstupně zjištěn vysoký inhibitor, který po léčbě kombinované imunosuprese (kortikoidy, cyklofosfamid, rituximab) klesal velice pomalu. Pro nově zjištěné krvácení do musculus psoas byla navýšena substituce rFVIIa a byl indikován emicizumab, k prevenci dalšího krvácení u pacientky s přetrvávajícím inhibitorem. Díky jeho s. c. aplikaci mohla být pacientka propuštěna do ambulantní péče.

Acquired haemophilia A (AHA) is a rare bleeding disorder occurring particularly in the elderly. It is caused by the presence of autoantibodies against coagulation factor VIII (FVIII). It may be associated with an autoimmune disease, malignancy, occur after birth, or arise idiopathi­cally. Early diagnosis and treatment are important, which involves treatment of bleeding and immunosuppressive therapy to induce disease remission or eradicate the inhibitor. We report a case of a female patient with rheumatoid arthritis with bleeding manifestations from the gastrointestinal tract (GIT), skin suffusions, and prolonged bleeding after tooth extraction. The patient was diagnosed with AHA and had to be started on treatment with recombinant activated factor VII (rFVIIa). Initially, a high inhibitor level was found that decreased very slowly after treatment with combined immunosuppression (corticoids, cyclophosphamide, rituximab). Due to newly detected bleeding into the psoas muscle, rFVIIa replacement therapy was increased and emicizumab was indicated to prevent further bleeding in the patient with persistent inhibitor. Thanks to the subcutaneous route of administration, the patient could be discharged to outpatient care.

• Klíčová slova
• emicizumab,
• MeSH
• faktor VIII aplikace a dávkování   terapeutické užití   MeSH
• hemofilie A * etiologie   farmakoterapie   komplikace   MeSH
• humanizované monoklonální protilátky aplikace a dávkování   terapeutické užití   MeSH
• imunosupresivní léčba metody   MeSH
• krvácení etiologie   terapie   MeSH
• lidé MeSH
• protilátky bispecifické aplikace a dávkování   terapeutické užití   MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

The accuracy and quality of temporary dentures are important factors in dentistry, especially when bridging the time between tooth preparation and the placement of definitive dentures. The aim of this study is to determine the dimensional accuracy of temporary dental prostheses, specifically crowns and bridges, manufactured using different technologies. Three manufacturing methods were evaluated: stereolithography (SLA), digital light processing (DLP) and CNC milling. A total of 30 temporaries (n = 30) were fabricated, with an equal number fabricated using each technology. The fabricated samples were scanned with an S900 Arti 3D scanner (Zirkonzahn, Italy) and the scanned data was analyzed using GOM Inspect software (Zeiss, Germany) to detect deviations from the original model. The results showed that SLA technology showed the smallest deviations (0.025 ± 0.002 mm), indicating the highest accuracy among the tested technologies. DLP technology demonstrated medium accuracy (0.052 ± 0.011 mm), exceeding CNC milling, but not reaching SLA accuracy. Conversely, CNC milling showed the largest deviations (0.106 ± 0.009 mm) and the lowest accuracy in the production of temporary dentures. Based on the accuracy of the produced crowns and bridges, the SLA technology is therefore considered the most suitable for the creation of temporary dentures. These findings underscore the potential of SLA technology in achieving higher precision in dental applications, while offering a reliable method to produce quality temporary dental restorations.

Úvod a cíl: Autotransplantaci zubu můžeme v současné době pokládat za jeden z možných způsobů ošetření ztráty zubu. Tento způsob terapie se rozvíjí již více než 30 let a dostává se postupně do širšího povědomí zubních lékařů. Cílem této retrospektivní klinické studie bylo zpracovat a vyhodnotit výsledky zubní autotransplantace u dětí a dospělých pacientů s určením míry přežití autotransplantovaného zubu a míry úspěšnosti tohoto typu ošetření. Dalším cílem bylo určit specifika autotransplantací u jednotlivých věkových skupin se závěry důležitými pro klinickou praxi. Metodika: Zkoumaným souborem byli pacienti odeslaní konsekutivně k autotransplantaci zubů na specializované pracoviště v letech 2016–2021. Byla zaznamenána odbornost ošetřujícího lékaře, který pacienta k autotransplantaci indikoval, vhodnost a proveditelnost transplantace a donorová a příjmová oblast zubního transplantátu. Počátkem roku 2022 probíhalo klinické a rentgenologické hodnocení autotransplantovaných zubů. Pacienti byli rozděleni na dvě skupiny podle věku v době autotransplantace, a to do 18 let a více než 18 let. Výsledky: Celkově bylo k autotransplantaci delegováno 73 pacientů ve věkovém rozmezí 10–59 let. Věkový průměr byl 21,4 let s mediánem 17 let. U 12 pacientů nebyla autotransplantace doporučena. Celkově bylo provedeno 68 autotransplantací zubů, 12 jich však nesplňovalo minimální období sledování (šest měsíců po autotransplantaci). Celkově bylo tedy zhodnoceno 56 dentálních autotransplantátů. Ve skupině dětí se jednalo o 27 jedinců ve věku 10–17 let, u kterých byla provedena autotransplantace alespoň jednoho stálého zubu. Celkem bylo transplantováno 34 zubů. Vyhodnocení transplantovaných zubů proběhlo po 6 až 50 měsících od transplantace s průměrem 24 měsíců. Míra přežití dosahovala 100 %, míra úspěšnosti 91 %. Ve skupině dospělých se jednalo o 22 jedinců ve věku 18–59 let a celkem bylo transplantováno 22 zubů. Vyhodnocení transplantovaných zubů proběhlo po 6 až 72 měsících od transplantace s průměrem 33 měsíců. Míra přežití dosahovala 95 %, míra úspěšnosti 77 %. Závěr: Využití autotransplantátu k náhradě nezaloženého nebo ztraceného zubu nejčastěji indikovali ortodontisté. U pacientů ve věku do 18 let převažují jako donorová i příjmová oblast premoláry. U pacientů nad 18 let věku převažují jako donorová oblast třetí moláry a jako příjmová oblast moláry v dolní čelisti. U obou věkových skupin je vysoká míra přežití i úspěšnosti autotransplantátu, a proto lze tento postup považovat za spolehlivou metodu náhrady zubu.

Introduction, aim: At present, tooth autotransplantation is considered one of the therapeutic methods for the replacement of lost teeth. In the last 30 years, the method of tooth autotransplantation has been developed and refined and has become a basic knowledge of dental practitioners. The aim of this clinical retrospective study was to examine children and adult patients with tooth autotransplantation and obtain survival and success rates. Another aim was to determine other specifics of autotransplantation in each group with conclusions relevant for clinical practice. Methods: The study population consisted of the patients referred consecutively for tooth autotransplantation to a specialist department between years 2016 and 2021. The specialization of the reffering dentist, the suitability and feasibility of the transplantation, and the donor and recipient area of the tooth graft were recorded. In 2022, clinical and radiological evaluation of the autotransplanted teeth was performed. Patients were divided into two groups according to age in time of autotransplantation, namely under 18 years and over 18 years. Results: Overall, 73 patients in the age range of 10–59 years were referred for autotransplantation. The mean age was 21.43 years with a median age of 17 years. Autotransplantation was not recommended in 12 patients. A total of 68 autotransplantations were performed, but at the time of examination, 12 did not meet the minimum 6-month follow up, so they were excluded from the evaluation. A total of 56 autotransplants were evaluated. In the group of children, there were 27 patients aged 10–17 years who underwent autotransplantation of at least one permanent tooth. A total of 34 teeth were transplanted. The evaluation of the transplanted teeth was performed 6–50 months after the transplantation with a mean follow-up time of 24 months. The survival rate was 100% and the success rate was 91%. The adult group consisted of 22 patients aged 18–59 years and a total of 22 teeth were transplanted. The evaluation of the transplanted teeth was performed 6–72 months after transplantation with a mean of 33 months. The survival rate was 95%, the success rate 77%. Conclusion: The use of autograft to replace undeveloped or lost teeth was most often indicated by orthodontists. In the patients under 18 years of age, the premolars are the predominant donor area and recipient area. In patients over 18 years of age, the third molars are the predominant donor area and the mandibular molars the predominant recipient area. Both age groups have high survival and success rates of autograft and this procedure can be considered as a predictable method of tooth replacement.

• MeSH
• analýza přežití MeSH
• autologní štěp diagnostické zobrazování   statistika a číselné údaje   MeSH
• autologní transplantace * metody   statistika a číselné údaje   MeSH
• dospělí MeSH
• Kaplanův-Meierův odhad MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• pooperační období MeSH
• retrospektivní studie MeSH
• zubní kořen růst a vývoj   transplantace   MeSH
• zuby * diagnostické zobrazování   transplantace   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• klinická studie MeSH

PATIENTS: This case report presents a minimally invasive approach to replace a missing mandibular lateral incisor using a dual-injection molding technique with flowable composite resins. Integrated with a comprehensive digital workflow, this method achieves a structurally and esthetically biomimetic, bi-layered prosthetic solution. A 34-year-old woman with congenital absence of a mandibular lateral incisor was successfully rehabilitated using a direct composite resin-bonded fixed partial denture (RBFPD). DISCUSSION: Two specialized three-dimensional (3D)-printed flexible indices stabilized by a custom-designed 3D-printed rigid holder were employed to ensure the meticulous injection molding of flowable composite resins formulated to emulate the inherent chromatic gradations between dentin and enamel. The inherent flexibility of the indices, combined with the holder, facilitated accurate and seamless adaptation to the complex morphological features of the dental arch, thereby mitigating the challenges commonly associated with rigid 3D-printed resin indices. CONCLUSIONS: The bilayered direct composite RBFPD using 3D printed flexible indices prepared with a full digital workflow has several advantages over other dental prosthetic solutions, including noninvasiveness, cost-effectiveness, biomimetic esthetics, repairability, and shortened treatment times. Although the initial results are promising, further longitudinal studies with larger patient cohorts are required to confirm the long-term efficacy of this approach.

• MeSH
• 3D tisk * MeSH
• anodoncie rehabilitace   terapie   MeSH
• biomimetika MeSH
• dospělí MeSH
• lidé MeSH
• mandibula * MeSH
• řezáky * MeSH
• složené pryskyřice * MeSH
• zubní náhrady částečné pevné lepené pryskyřicí MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Bone regeneration after injury or after surgical bone removal due to disease is a serious medical challenge. A variety of materials are being tested to replace a missing bone or tooth. Regeneration requires cells capable of proliferation and differentiation in bone tissue. Although there are many possible human cell types available for use as a model for each phase of this process, no cell type is ideal for each phase. Osteosarcoma cells are preferred for initial adhesion assays due to their easy cultivation and fast proliferation, but they are not suitable for subsequent differentiation testing due to their cancer origin and genetic differences from normal bone tissue. Mesenchymal stem cells are more suitable for biocompatibility testing, because they mimic natural conditions in healthy bone, but they proliferate more slowly, soon undergo senescence, and some subpopulations may exhibit weak osteodifferentiation. Primary human osteoblasts provide relevant results in evaluating the effect of biomaterials on cellular activity; however, their resources are limited for the same reasons, like for mesenchymal stem cells. This review article provides an overview of cell models for biocompatibility testing of materials used in bone tissue research.

• MeSH
• biokompatibilní materiály farmakologie   MeSH
• buněčná diferenciace MeSH
• kosti a kostní tkáň * MeSH
• kultivované buňky MeSH
• lidé MeSH
• osteoblasty MeSH
• osteogeneze MeSH
• proliferace buněk MeSH
• tkáňové inženýrství * metody   MeSH
• tkáňové podpůrné struktury MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Recent years have improved our understanding of the plasticity of cell types behind inducing, building, and maintaining different types of teeth. The latest efforts were aided by progress in single-cell transcriptomics, which helped to define not only cell states with mathematical precision but also transitions between them. This includes new aspects of dental epithelial and mesenchymal stem cell niches and beyond. These recent efforts revealed continuous and fluid trajectories connecting cell states during dental development and exposed the natural plasticity of tooth-building progenitors. Such "developmental" plasticity seems to be employed for organizing stem cell niches in adult continuously growing teeth. Furthermore, transitions between mature cell types elicited by trauma might represent a replay of embryonic continuous cell states. Alternatively, they could constitute transitions that evolved de novo, not known from the developmental paradigm. In this review, we discuss and exemplify how dental cell types exhibit plasticity during dynamic processes such as development, self-renewal, repair, and dental replacement. Hypothetically, minor plasticity of cell phenotypes and greater plasticity of transitions between cell subtypes might provide a better response to lifetime challenges, such as damage or dental loss. This plasticity might be additionally harnessed by the evolutionary process during the elaboration of dental cell subtypes in different animal lineages. In turn, the diversification of cell subtypes building teeth brings a diversity of their shape, structural properties, and functions.

• MeSH
• regenerace fyziologie   MeSH
• zuby * MeSH
• zvířata MeSH
• Check Tag
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH