JIDAM “An Official Journal of IDA - Madras Branch” ©2022. Available
online

ISSN No: 2582-0559

Volume No: 9, Issue No: 1

SHORT COMMUNICATION

FREEZE-DRIED UMBILICAL CORD ALLOGRAFT- THE NEW

BIOMATERIAL

“CORD TO THE RESCUE..!”

Dr. Dhwani K Dedhia, Dr. Burnice Nalina Kumari C, Dr. Jaideep Mahendra,

Dr.Vijayalakshmi Rajaram

Department of Periodontology, Meenakshi Ammal Dental College, Meenakshi Academy of Higher Education and

Research, Chennai, Tamilnadu, India

DOI: 10.37841/jidam_2022_V9_I1_06

Address for Correspondence

Dr. C.Burnice Nalina Kumari, MDS

No:142, 9th street,M.G.Chakrapani nagar,

Maduravoyal, Chennai-95, Tamilnadu, India

Mail id: drburnice.perio@madch.edu.in

Received : 09.01.2022

Accepted : 04.02.2022

First Published: 10.02.2022 Published : 30.03.2022

ABSTRACT

The  world  of  dentistry  has  always  been  evolved  at  its
best. In the recent years, enormous treatment modalities
with  novel  biomaterials  have  been  discovered  in
regenerative  dentistry.  Despite  all  the  advancements,
however  there  are  few  limitations  with  certain
biomaterials.  The  most  recent  potential  alternative
biomaterial and the first to be used in India is the freeze
dried  umbilical  cord  allograft  (FDUCA).  FDUCA  is
prepared  from  the  placenta  along  with  the  umbilical
cord from a potential donor after parturition. FDUCA is
10 times thicker than the amnion and chorion membrane
and  is  found  to  contain  enormous  amount  of  growth
factors and immunomodulatory factors owing to a great
potential  in  regenerative  dentistry.      The  superior
properties  of  this  novel  biomaterial  in  regenerative
dentistry  brings  in  an  evolution  of  biomaterials  and  a
boon to dentistry.

KEYWORDS

: Regenerative dentistry; Tooth loss;

Aesthetics; Freeze-dried Umbilical Cord Allograft

Volume No: 9, Issue No: 1

Dhwani et al: Freeze-dried umbilical cord allograft- A new biomaterial

INTRODUCTION

Dentistry has evolved through the years with enormous
treatment modalities and various biomaterials to treat hard
and soft tissue defects in the oral cavity. Yet, gingival
recession, tooth loss and aesthetics remains a major problem
for many patients. This is due to high level of patient
discomfort as these result in tooth hypersensitivity, pain,
cervical abrasion and increased risk of root caries.

There are several treatment modalities to manage the above
problems addressed by the patients. Few of them include
pedicle grafts, autogenous free gingival grafts, subepithelial
connective tissue grafts with or without the use of
biomaterials, after endodontic management of painful,
carious and abraded teeth. However, there are limitations
with soft tissue grafts such as patient morbidity, two surgical
sites and limited blood supply.

Hence to every dentist, an

evolution becomes utmost necessary in order to explore,
solve and overcome the above limitations.

One of the potential recent alternative novel biomaterial is
the Freeze-dried Umbilical Cord Allograft. It is known to
contain essential growth and immunomodulatory factors that
promote an anti-inflammatory environment. This new
allograft can be used as a treatment modality for various
defects in the oral cavity and is the first to be procured and
used in India.

Different regenerative materials have been used in dentistry
from the advent of Millipore to GTR and various other
collagen membranes. Non-resorbable membranes were
replaced with resorbable membranes to avoid second
surgical procedure. Recent advances include the amnion and
the chorion membrane which were derived from the
placenta. The most recent regenerative material and the first
to be used in India is the freeze-dried umbilical cord allograft
which is derived from the umbilical cord of the foetus. It is
known to contain immunomodulatory factors thus promoting
an anti-inflammatory environment resulting in periodontal
regeneration.

MATERIALS AND METHODS

Freeze-dried  umbilical  cord  allograft  is  prepared  at  the
TISSUE  BANK,  TATA  MEMORIAL  HOSPITAL  -
MUMBAI  using  standard  protocol.  Placenta  with  umbilical
cord is received from potential donor (which is expelled out
after the delivery of baby) and a written informed consent is
taken  from  them.  Before  processing  the  umbilical  cord
tissue,  donor  is  screened  for  medical  and  social  history  and
other  blood  investigations  included  tests  for  HIV,  HBV,
HCV  and  syphilis  antigens.  After  screening,  if  donor  is
suitable  for  processing,  the  umbilical  cord  tissue  is
processed,  freeze-dried,  cut  into  appropriate  sizes,  packed
and gamma sterilized. (Fig 1)

Fig 1: Freeze-dried umbilical cord allograft

RESULTS

Increased gingival thickness, no patient morbidity or post-
operative complications along with almost complete root
coverage is seen when used in root coverage procedures,
since this allograft contains essential growth factors and
immune-modulatory properties. Another added advantage of
freeze-dried umbilical cord allograft is that, it is about 10
times thicker than amniotic membrane, easier to handle and
is comprised of higher concentrations of biologic
components.

More specifically, it is shown to induce apoptosis of
activated neutrophils and macrophages, decrease fibroblast
proliferation, downregulate TGF-β (transforming growth
factor beta) signalling, increase the expression of anti-
inflammatory cytokines, thereby reducing the expression of
proinflammatory cytokines.

One such complex active

biologic component in freeze dried umbilical cord allograft
is HC-HA/PTX3 (heavy chain– hyaluronin/pentraxin 3) is
responsible for promoting regenerative healing by exerting
anti-inflammatory and ant scarring actions.

DISCUSSION

This new novel biomaterial can be used in guided tissue
regenerative procedures, socket preservation procedures, to
treat intrabony defects, in various oral and maxillofacial
procedures, implant-related procedures (treatment of
periimplantitis), as a bandage after procurement of palatal
grafts or from various other donor sites and root coverage
procedures. Freeze-dried umbilical cord allograft is known to
achieve almost complete root coverage in the treatment of
gingival recession. Hence the aesthetic concern of the patient
is also satisfied. Thus this new allograft is of use in various
fields of dentistry and especially in the field of
Periodontology.

CONCLUSION

Collectively, the above properties of freeze-dried umbilical

cord allograft help to promote the healing and regeneration

of various tissues in the oral cavity. Thus all these

applications bring in an evolution of biomaterials in the field

of dentistry. This novel biomaterial is a recent boon in the

field of regenerative dentistry with more applicability, ease

with superior properties replacing other regenerative

materials in times to come.

Volume No: 9, Issue No: 1

Dhwani et al: Freeze-dried umbilical cord allograft- A new biomaterial

FINANCIAL SUPPORT AND

SPONSORSHIP:
Nil

CONFLICTS OF INTEREST:

There are no conflicts of interest.

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