The new bone formation in human maxillary sinuses using two bone substitutes with different resorption types associated or not with autogenous bone graft: a comparative histomorphometric, immunohistochemical and randomized clinical study

Abstract Objective The aim of this study is to evaluate the new bone and connective tissue formation and the biomaterial remaining after maxillary sinus bone augmentation using 5 different bone substitutes. The osteocalcin immunolabeling was performed to demonstrate their calcification and the possibility of receiving dental implants. Methodology 40 patients underwent maxillary sinus bone augmentation and were divided in 5 groups: Group 1 with 8 maxillary sinuses were grafted with autogenous bone graft (AB); Group 2 with 8 maxillary sinuses grafted with bioactive glass (BG); Group 3 with 8 maxillary sinuses grafted with bioactive glass added to autogenous bone graft (BG + AB) 1:1; Group 4 with 8 maxillary sinuses grafted with Bio-Oss (BO) and Group 5 with 8 maxillary sinuses grafted with Bio-Oss added to autogenous bone graft (BO + AB) 1:1. Results In group AB, 37.8% of bone was formed in the pristine bone region, 38.1% in the intermediate and 44.5% in the apical region. In group BG, 43.6% was formed in the pristine bone, 37% in the intermediate and 49.3% in the apical region. In group BG + AB 1:1, 39.0% was formed in the pristine bone region, 34.8% in the intermediate and 36.8% in apical region. In group BO, 33.4% was formed in the pristine bone, 32.5% in the intermediate and 34.3% in the apical region. In group BO + AB 1:1, 32.8% was formed in the pristine bone, 36.1% in intermediate and 27.8% in the apical regions. The immunolabeling for osteocalcin showed an intensive staining for all groups, which could demonstrate the calcification of the bone formed. Conclusion This study showed that the groups evaluated formed a suitable lamellar bone in the maxillary sinus reconstruction after six months of bone healing, thus being indicated to receive dental implants.

Losartan improves alveolar bone dynamics in normotensive rats but not in hypertensive rats

Abstract Hypertension is one of the main causes of premature death in the world; also, it is associated with several bone alterations. Preclinical studies have demonstrated delayed alveolar bone healing in hypertensive rats. However, losartan has been favorable for consolidation of bone grafts and reduction in active periodontitis. Therefore, losartan is suggested to be effective in bone formation stages, as well as in the synthesis of matrix proteins and mineralization. Objectives: To evaluate the alveolar bone dynamics in hypertensive rats treated with losartan by laser confocal microscopy and histological analysis. Methodology: Thirty-two rats, 16 spontaneously hypertensive rats (SHR) and 16 Wistar albinus rats, treated or not with losartan (30 mg/kg/day) were used. Calcein fluorochrome at 21 days and alizarin red fluorochrome at 49 days were injected in rats (both 20 mg/kg). The animals were submitted to euthanasia 67 days after treatment, and then the right maxilla was removed for laser confocal microscopy analysis and the left maxilla for histological analysis. Results: This study showed a greater calcium marking in normotensive animals treated with losartan in relation to the other groups. Laser confocal microscopy parameters showed higher values of bone volume formed, mineralized surface, active surface of mineralization and bone formation rate in normotensive animals treated with losartan. However, a smaller mineralized surface was observed in all hypertensive animals. Conclusion: Losartan can improve bone mineralization parameters under normal physiological conditions, but the same anabolic effect does not occur under hypertension.

Bioactive glass added to autogenous bone graft in maxillary sinus augmentation: a prospective histomorphometric, immunohistochemical, and bone graft resorption assessment

Abstract Objective The aim of this study was to compare the bone resorption rate, histomorphometry and immunohistochemical findings of bioactive glass (Biogran; Biomet, Warsaw, IN, USA) mixed with autogenous bone grafts (1:1) and autogenous bone graft isolate in maxillary sinus elevation surgery. Material and Methods A total of 9 maxillary sinuses were grafted with Biogran with autogenous bone graft (group 1) and 12 were mixed with autogenous bone graft (group 2). Postoperative cone beam computed tomography (CBCT) was used to measure the initial graft volume after 15 days (T1), and 6 months later, another CBCT scan was performed to evaluate the final graft volume (T2) and determine the graft resorption rate. The resorption outcomes were 37.9%±18.9% in group 1 and 45.7%±18.5% in group 2 (P=0.82). After 6 months, biopsies were obtained concurrent with the placement of dental implants; these implants were subjected to histomorphometric analysis and immunohistochemical analysis for tartrate-resistant acid phosphatase (TRAP). Results The average bone formation in group 1 was 36.6%±12.9 in the pristine bone region, 33.2%±13.3 in the intermediate region, and 45.8%±13.8 in the apical region; in group 2, the values were 34.4%±14.4, 35.0%±13.9, and 42.0%±16.6 of new bone formation in the pristine bone, intermediate, and apical regions, respectively. Immunostaining for TRAP showed poor clastic activity in both groups, which can indicate that those were in the remodeling phase. Conclusions The similarity between the groups in the formation and maintenance of the graft volume after 6 months suggests that the bioactive glass mixed with autogenous bone (1:1) can be used safely as a bone substitute for the maxillary sinus lift.

Alveolar bone healing in rats: micro-CT, immunohistochemical and molecular analysis

Abstract Alveolar bone healing after upper incisor extraction in rats is a classical model of preclinical studies. The underlying morphometric, cellular and molecular mechanism, however, remains imprecise in a unique study. Objectives The aim of this study was therefore to characterize the alveolar bone healing after upper incisor extraction in rats by micro computed tomographic (Micro-CT), immunohistochemical and real-time polymerase chain reaction (RT-PCR) analysis. Material and Methods Thirty animals (Rattus norvegicus, Albinus Wistar) were divided into three groups after upper incisors extraction at 7, 14, and 28 days. Micro-CT was evaluated based on the morphometric parameters. Subsequently, the histological analyses and immunostaining of osteoprotegerin (OPG), receptor activator of nuclear kappa B ligand (RANKL) and tartrate resistant acid phosphate (TRAP) was performed. In addition, RT-PCR analyses of OPG, RANKL, the runt-related transcription factor 2 (RUNX2), osteocalcin (OC), osteopontin (OPN), osterix (OST) and receptor activator of nuclear kappa B (RANK) were performed to determine the expression of these proteins in the alveolar bone healing. Results Micro-CT: The morphometric parameters of bone volume and trabecular thickness progressively increased over time. Consequently, a gradual decrease in trabecular separation, trabecular space and total bone porosity was observed. Immunohistochemical: There were no differences statistically significant between the positive labeling for OPG, RANKL and TRAP in the different periods. RT-PCR: At 28 days, there was a significant increase in OPG expression, while RANKL expression and the RANKL/OPG ratio both decreased over time. Conclusion Micro-CT showed the newly formed bone had favorable morphometric characteristics of quality and quantity. Beyond the RUNX2, OC, OPN, OST, and RANK proteins expressed in the alveolar bone healing, OPG and RANKL activity showed to be essential for activation of basic multicellular units during the alveolar bone healing.

Daily melatonin administration improves osseointegration in pinealectomized rats

Abstract The hypothesis of this study was that the peri-implant bone healing of the group of pinealectomized rats would differ from the control group. The samples were subjected to immunohistochemical, microtomographic (total porosity and connectivity density), and fluorochrome (mineralized surface) analyses. Objectives The goal of this study was to investigate the cellular changes and bone remodeling dynamics along the bone/implant interface in pinealectomized rats. Material and Methods The total of 18 adult male rats (Rattus norvegicus albinus, Wistar) was divided into three groups (n=6): control (CO), pinealectomized without melatonin (PNX) and pinealectomized with melatonin (PNXm). All animals were submitted to the first surgery (pinealectomy), except the CO group. Thirty days after the pinealectomy without melatonin, the second surgery was conducted, in which all animals received an implant in each tibia (36 titanium implants with surface treatment were installed - Implalife® São Paulo, SP, Brazil). By gavage, the rats of the PNX group received the vehicle solution, and the procedure. Results Immunohistochemical analysis for runt-related transcription factor 2 (RUNX2), alkaline phosphatase (ALP), osteopontin (OP) and osteocalcin (OC) showed that the bone repair process in the PNXm group was similar to that of the CO group, whereas the PNX group showed a delay. The microtomographic parameters of total porosity [Po(tot)] and bone surface (BS) showed no statistically significant differences, whereas for the connective density (Conn.Dn) a statistical difference was found between the CO and PNXm groups. Fluorochrome analysis of the active mineralized surface showed statistically significant difference between the CO and PNX and between the CO and PNXm groups. Conclusion The absence of the pineal gland impaired the bone repair process during osseointegration, however the daily melatonin replacement was able to restore this response.

Bone repair access of BoneCeramic™ in 5-mm defects: study on rat calvaria

Abstract Objective: The aim of this study was to evaluate the osteoconductive potential of BoneCeramic™ on bone healing in rat calvaria 5-mm defects. Material and Methods: A 5-mm calvaria bone defect was induced in three groups and the defect was not filled with biomaterial [Clot Group (CG)], autogenous bone (AG), or Bone Ceramic Group (BCG). Animals were euthanized after 14 or 28 days and the bone tissue within the central area of the bone defect was evaluated. Results were compared using ANOVA and Tukey test (p<0.05). Immunohistochemistry was performed using primary antibodies against osteocalcin, RUNX-2, TRAP, VEGF proteins, and 3-dimensional images of the defects in μCT were obtained to calculate bone mineral density (BMD). Results: In BCG, the defect was completely filled with biomaterial and new bone formation, which was statistically superior to that in the GC group, at both time-points (p<0.001 for 14 days; p=0.002 for 28 days). TRAP protein showed weak, RUNX-2 showed a greater immunolabeling when compared with other groups, VEGF showed moderate immunostaining, while osteocalcin was present at all time-points analyzed. The μCT images showed filling defect by BCG (BMD= 1337 HU at 28 days). Conclusion: Therefore, the biomaterial tested was found to be favorable to fill bone defects for the reporting period analyzed.

A SERM increasing the expression of the osteoblastogenesis and mineralization-related proteins and improving quality of bone tissue in an experimental model of osteoporosis

Abstract Raloxifene is an antiresorptive drug, selective estrogen receptor modulator (SERM) used in the treatment of osteoporosis. Objective To evaluate proteins related to bone repair at the peri-implant bone in a rat model of osteoporosis treated with raloxifene. Material and Methods 72 rats were divided into three groups: SHAM (healthy animals), OVX (ovariectomized animals), and RLX (ovariectomized animals treated with raloxifene). Raloxifene was administered by gavage (1 mg/kg/day). Tibial implantation was performed 30 days after ovariectomy, and animals were euthanized at 14, 42, and 60 days postoperatively. Samples were collected and analyzed by immunohistochemical reactions, molecular analysis, and microtomographic parameters. Results RLX showed intense staining of all investigated proteins at both time points except for RUNX2. These results were similar to SHAM and opposite to OVX, showing mild staining. The PCR gene expression of OC and ALP values for RLX (P<0.05) followed by SHAM and OVX groups. For BSP data, the highest expression was observed in the RLX groups and the lowest expression was observed in the OVX groups (P<0.05). For RUNX2 data, RLX and SHAM groups showed greater values compared to OVX (P<0.05). At 60 days postoperatively, microtomography parameters, related to closed porosity, showed higher values for (Po.N), (Po.V), and (Po) in RLX and SHAM groups, whereas OVX groups showed lower results (P<0.05); (BV) values (P=0.009); regarding total porosity (Po.tot), RLX group had statistically significant lower values than OVX and SHAM groups (P=0.009). Regarding the open porosity (Po.V and Po), the SHAM group presented the highest values, followed by OVX and RLX groups (P<0.05). The Structural Model Index (SMI), RLX group showed a value closer to zero than SHAM group (P<0.05). Conclusions Raloxifene had a positive effect on the expression of osteoblastogenesis/mineralization-related proteins and on micro-CT parameters related to peri-implant bone healing.

Polylactic/polyglycolic acid copolymer is a good carrier for bmp-2 on bone regeneration? / Copolímero do ácido polilático/poliglicólico é um bom carreador para bmp-2 na regeneração óssea?

The aim of this work was to evaluate the role of polylactic /polyglycolic acid copolymer as carrier for BMP-2 on bone regeneration in rat calvarium. Forty five adult male rats underwent 5-mm critical defects in bone calvaria to be divided into three groups according to the filling materials: Control-blood clot; PLGA-polylactic acid Polyglycolic/copolymer; PLGA + BMP-2 -polylactic acid Polyglycolic/copolymer associated with BMP-2. Sacrifice of animals occurred at 5, 15 and 30 days after surgery The evaluation of new bone formation was obtained by histomorphometry, while OPG and RANKL proteins were observed by immunohistochemistry. Statistical analysis was performed by means of nonparametric tests based on quantitative variables of independent samples. Considering the amount of newly formed bone, significant difference was detected between PGLA (178,2±137,5µm) and the other groups, at day 30. In PLGA + BMP-2 and control groups, the expression of RANKL was prevalent on the OPG in the periods of 15 and 30 days, suggesting a favorable condition for bone reabsorption in these periods. Therefore, immunoexpression of RANKL and OPG and bone formation observed in different groups and periods of analysis showed that the polylactic/polyglycolic acid copolymer does not act as a good carrier for BMP-2.

O objetivo deste estudo foi avaliar o copolímero do ácido polilático/poliglicólico como carreador para BMP-2 na regeneração óssea da calvária de ratos. Foram utilizados 45 ratos adultos machos. Defeitos ósseos críticos de 5mm de diâmetro foram realizados com uma broca trefina na calvária dos animais. Os animais foram divididos em três grupos, de acordo com o material de notas para preenchimento dos defeitos: Controle - coágulo; PLGA - copolímero ácido polilático/poliglicólico; PLGA + BMP-2 - copolímero do ácido polilático/poliglicólico associado a BMP-2. O sacrifício ocorreu aos 5, 15 e 30 dias após a cirurgia. A avaliação da neoformação óssea foi obtida por histomorfometria, enquanto a análise de marcação para as proteínas OPG e RANKL foi observada por imunohistoquímica. Análises estatísticas foram realizadas por meio de testes não paramétricos de variáveis quantitativas em amostras independentes. Com relação à quantidade de tecido ósseo neoformado, observou-se diferença estatística significante entre o grupo PLGA (178,2±137,5µm) e os demais, no período de 30 dias. Nos grupos PLGA+BMP-2 e Controle, a marcação de RANKL foi predominante sobre a marcação de OPG nos períodos de 15 e 30 dias, evidenciado uma condição favorável para a reabsorção óssea nestes períodos. Portanto, a marcação de RANKL e OPG, e a formação óssea observada nos diferentes grupos e tempos de análise mostrou que o copolímero de ácido polilático/poliglicólico não atua como um bom carreador para BMP-2.

Short term sodium alendronate administration improves the peri-implant bone quality in osteoporotic animals

Abstract Sodium alendronate is a bisphosphonate drug that exerts antiresorptive action and is used to treat osteoporosis. Objective The aim of this study was to evaluate the bone repair process at the bone/implant interface of osteoporotic rats treated with sodium alendronate through the analysis of microtomography, real time polymerase chain reactions and immunohistochemistry (RUNX2 protein, bone sialoprotein (BSP), alkaline phosphatase, osteopontin and osteocalcin). Material and Methods A total of 42 rats were used and divided in to the following experimental groups: CTL: control group (rats submitted to fictitious surgery and fed with a balanced diet), OST: osteoporosis group (rats submitted to a bilateral ovariectomy and fed with a low calcium diet) and ALE: alendronate group (rats submitted to a bilateral ovariectomy, fed with a low calcium diet and treated with sodium alendronate). A surface treated implant was installed in both tibial metaphyses of each rat. Euthanasia of the animals was conducted at 14 (immunhostochemistry) and 42 days (immunohistochemistry, micro CT and PCR). Data were subjected to statistical analysis with a 5% significance level. Results Bone volume (BV) and total pore volume were higher for ALE group (P<0.05). Molecular data for RUNX2 and BSP proteins were significantly expressed in the ALE group (P<0.05), in comparison with the other groups. ALP expression was higher in the CTL group (P<0.05). The immunostaining for RUNX2 and osteopontin was positive in the osteoblastic lineage cells of neoformed bone for the CTL and ALE groups in both periods (14 and 42 days). Alkaline phosphatase presented a lower staining area in the OST group compared to the CTL in both periods and the ALE at 42 days. Conclusion There was a decrease of osteocalcin precipitation at 42 days for the ALE and OST groups. Therefore, treatment with short-term sodium alendronate improved bone repair around the implants installed in the tibia of osteoporotic rats.

Evaluation of biomaterials with and without platelet-rich plasma: a histometric study using beagle dogs

Aim: To compare the alveolar bone repair process using biomaterial in dogs with and without the incorporation of platelet-rich plasma. Methods: Six beagles were used. Bilateral extractions of the three mandibular premolars were performed. Bio-Gen® was applied in the first alveolus, the clotwas maintained in the second alveolus and Genox® was applied to the third alveolus. PRP wasadded to all alveoli on the left side only. The dogs were submitted to euthanasia after 30, 60 and90 days and submitted to histological analysis for the determination of mean area of new boneformation. Tukey’s post test was used in the statistical analysis. Results: Significant increase inbone formation occurred in Bio-Gen® + PRP when compared with the other groups at 30 and 90days. In the evaluation at 60 days, no statistically significant differences among the groups were found. Conclusions: The Bio-Gen® biomaterial led to the best bone repair and the combinationof platelet-rich plasma accelerated the repair process.

A New Anionic Bovine Tendon as Scaffold for the Repair of Bone Defects: A Morphological, Histomorphometric and Immunohistochemical Study.

Aim: The process of bone repair is of evident importance in both the clinical and functional spheres. For this reason, the field of bioengineering has taken it as an object of study, seeking to perfect the implantation of materials that allow for adequate bone neoformation. This study investigated the process of bone repair after anionic bovine tendon grafting in rat tibias by conducting a morphological, histomorphometric and immunohistochemical study. Methodology: The experimental model consisted of 36 rats randomly divided into two groups: a control group (CG, n=18), in which a surgical cavity in the tibia was filled with blood clots; and an experimental group (EG, n=18), in which a surgical cavity in the tibia was filled with an anionic bovine tendon graft. In the experimental group, the major axis of the collagen fiber bundle was placed perpendicularly to the long axis of the tibia. Microscopic, morphometric and immunohistochemical evaluations were conducted at 7, 15, and 30 days postoperative. Results: The analyzes showed an increase in bone neoformation in the experimental group during the assessed periods. There was a significant difference between day 7 and day 30 and evident vascular proliferation was detected by the immunohistochemical analysis. Conclusion: It can be concluded that the anionic bovine tendon collagen proved to be an adequate and biocompatible material for bone regeneration, with osteogenic capabilities that allow it to be used as a scaffold for bone repair.

Acesso subciliar para fraturas do complexo zigomático-orbitário / Subciliar approach for zygomatic-orbital complex fractures

Diversos acessos cirúrgicos podem ser utilizados no tratamentode fraturas do complexo zigomático-orbitário. A incisão subciliarpromove uma excelente exposição do rebordo infraorbitário,assoalho e parede lateral de órbita com localização que a tornaimperceptível após a reparação tecidual. Contudo, o aumentoda exposição da esclera e o ectrópio são possíveis sequelasassociadas a este tipo de acesso. Este trabalho tem por objetivoapresentar caso clínico de fratura de complexo zigomáticoorbitárioe discutir aspectos relativos a variações da técnicacirúrgica que elucidam a evolução da mesma, minimizandopossíveis sequelas pós-operatórias.

Alveolar bone healing process in spontaneously hypertensive rats (SHR): A radiographic densitometry study

Hypertension is one of the most important public health problems worldwide. If undiagnosed or untreated, this pathology represents a systemic risk factor and offers unfavorable conditions for dental treatments, especially those requiring bone healing. Objectives: The purpose of this study was to demonstrate, by analysis of bone mineral density (BMD), that the alveolar bone healing process is altered in spontaneously hypertensive rats (SHRs). Material and Methods: Wistar rats and SHRs were submitted to extraction of the upper right incisor and were euthanized 7, 14, 21, 28 and 42 days after surgery. Right maxillae were collected, radiographed and analyzed using Digora software. BMD was expressed as minimum (min), middle (med) and maximum (max) in the medium (MT) and apical (AT) thirds of the dental alveolus. Results: The results were compared across days and groups. Wistar showed difference in med and max BMD in the MT between 7 and 28 and also between 14 and 28 days. The AT exhibited significant difference in med and min BMD between 7 and 28 days, as well as difference in min BMD between 28 and 42 days. SHRs showed lower med BMD in the MT at 28 days when compared to 21 and 42 days. Differences were observed across groups in med and min BMD at day 28 in the MT and AT; and in max BMD at 14, 21 and 42 days in the MT. Conclusions: These results suggest that the alveolar bone healing process is delayed in SHRs comparing with Wistar rats.

Particularities in the surgical technique of calvaria graft / Particularidades en la técnica quirúrgica de injerto de calota

Calvaria grafts provide good bone quantity for the reconstruction of the atrophic maxilla, and have lower morbidity and resorption rates when compared to iliac crest. The aim of this paper is to present the technique for obtaining a graft of the skull. Initially, the depth of the osteotomy is determined by a manually conducted bur, which establishes the limits of the structures of the skull (outer table, diploe and inner table), making the removal of bone blocks easier and safer. Thus, osteotomies of the blocks are made with greater security, avoiding the complications inherent to surgical technique. The case that will be presented it is from a male patient of 65 years who refused to submit to the iliac crest graft, opting for the calvaria, despite being bald, that is a contraindication for this treatment modality. A delicate suture associated with placement of titanium mesh to maintain the conformation of the patient's skull in the region of the bone defect, created after removal of the graft, provided a good cosmetic result at the donor site. The use of titanium mesh for re-anatomization of bone defects created in the grafts is well indicated for bald patients...

Los injertos de calvaria proporcionan una buena cantidad de hueso para la reconstrucción del maxilar atrófico, y tienen menores tasas de morbilidad y reabsorción en comparación con la cresta ilíaca. El objetivo de este trabajo es presentar la técnica para la obtención de un injerto del cráneo. Inicialmente, la profundidad de la osteotomía se determina mediante una fresa manualmente, lo que establece los límites de las estructuras del cráneo (tabla externa, diploe y tabla interna), lo que hace la eliminación de bloques óseos más fácil y segura. Por lo tanto, las osteotomías de los bloques se hacen con mayor seguridad, evitando las complicaciones inherentes a la técnica quirúrgica. Se presenta el caso de un paciente hombre de 65 años que se negó a ser sometido a injerto de cresta ilíaca, optando por la bóveda craneal, a pesar de ser calvo, que es una contraindicación para esta modalidad de tratamiento. Una sutura cuidadosa asociada con la colocación de malla de titanio para mantener la conformación del cráneo del paciente en la región del defecto óseo creado después de obtención del injerto, deja un buen resultado cosmético en el sitio donante. El uso de malla de titanio para la re-anatomización de defectos óseos creados en los injertos está bien indicada para pacientes calvos...

Avaliação da incorporação de enxerto ósseo homógeno fresco congelado em humanos. Análises histológica e imuno-histoquímica / Evaluation of the allograft fresh frozen incorporation in humans. Histological and immunohistochemistry analysis

O osso homógeno fresco congelado tem sido utilizado no intuito de substituir o osso autógeno. No entanto, as suas propriedades de osseoindução e até mesmo osseocondução não estão bem conceituadas na literatura científica. Esse trabalho teve por objetivo avaliar amostras de tecido ósseo homógeno enxertados em humanos através das análises qualitativas histológica e imuno-histoquímica. Para tal, dez pacientes previamente selecionados foram submetidos à cirurgia de reconstrução de defeitos ósseos em espessura, usando enxerto ósseo homógeno em bloco fresco congelado estabilizado e fixado por meio de parafusos bicorticais. Após período de integração de seis meses foi realizado procedimento de reabertura para instalação dos implantes osseointegráveis. Neste momento cirúrgico, amostras do enxerto ósseo foram removidas por meio de broca trefina. As amostras foram fixadas em formol 10%, levadas ao processamento para corte descalcificado em parafina e coradas por hematoxilina e eosina. Realizou-se processamento imuno-histoquímico para a expressão da enzima Caspase 3. As lâminas foram levadas à microscopia óptica para realização das análises histológica e imuno-histoquímica qualitativas. Os resultados mostraram tecido ósseo não vital, com poucas áreas de deposição de osso neoformado sobre a matriz amorfa, presença de infiltrado inflamatório com áreas de osteomielite e imunomarcação expressiva da enzima Caspase 3. Diante da metodologia empregada e dos resultados obtidos concluiu-se que o enxerto homógeno fresco congelado em bloco não incorporou ao leito receptor após período de reparação de seis meses.

Allogeneic, fresh-frozen bone has been used in order to replace bone autografts. However, its osteoinduction and osteoconduction properties are not well-defined in the scientific literature. This work aimed to evaluate samples of homogenous bone grafts in humans by qualitative histological and immunohistochemical analysis. For this, ten pre-selected patients underwent surgical augmentation of bone defects. The homogenous fresh frozen block bone graft was stabilized and fixed by bicortical screws. After six months, the reopening procedure was performed for installation of osseointegrated implants. At this time surgical bone graft samples were removed by means of drill trephine. The samples were fixed in 10% formalin, processed with decalcified paraffin, and stained with hematoxylin and eosin. Immunohistochemistry was performed for the expression of Caspase 3 enzyme. The slides were brought to light microscopy for qualitative histology and immunohistochemistry. The results showed non-vital bone tissue, with few areas of deposition of new bone formation on the amorphous matrix, presence of chronic inflammatory infiltrate with areas of osteomyelitis, and expressive immunolabeling of Caspase 3. Given the methods employed and the results it was concluded that the allograft fresh-frozen block is not incorporated into the recipient bed after a healing period of six months

Implantes osseointegrados: evolução e sucesso / Osseointegrated implants: evoluation and success

Introdução: A reabilitação com implantes osseointegrados é hoje,uma alternativa de tratamento extremamente vantajosa aos pacientes. Deste a descoberta da osseointegração, a odontologia atingiu alta previsibilidade em seus tratamentos. Para tanto diversos princípios, desde os protocolos cirúrgicos, a escolha do material e até a técnica para confecção das próteses implantossuportadas ou implantorretidas, influenciam num bom prognóstico de caso. Objetivo: Sendo assim, é proposta deste trabalho é realizar uma revisão da literatura no tocante aos fundamentos da osseointegração, parâmetros históricos e técnicos da implantodontia. Conclusões: Técnicas bem conduzidas promovem a maior previsibilidade de sucesso na implantodontia. As superfícies rugosas apresentam maior área de contato osso-implante e melhores resultados mecânicos. A qualidade óssea é fundamental na previsibilidade do tratamento.

Introduction: The oral rehabilitation with dental implants is a very viable treatment modality for patients. Therefore the discovery of osseointegration, dentistry has reached the trigger with respect to treatment with a high predictability of success. For this various principles, since the surgical protocols, the choice of material and even the technique for the manufacture of implant-supported prosthesis influence a good prognosis for treatment. Objective: Therefore, it is proposed this study a literature review of the fundamentals of osseointegration, explaining the historical and technical parameters of implantology, focusing in what the literature currently is studying with more intensity, the acceleration of osseointegration. Conclusion: well conducted procedures promotes the best aimed success in implantology. Rough surfaces shows great are for implant-bone contact and better mechanical results. The bone quality is fundamental in results foresigh.

Bone regeneration in surgically created defects filled with autogenous bone: an epifluorescence microscopy analysis in rats

Although the search for the ideal bone substitute has been the focus of a large number of studies, autogenous bone is still the gold standard for the filling of defects caused by pathologies and traumas, and mainly, for alveolar ridge reconstruction, allowing the titanium implants installation. OBJECTIVES: The aim of this study was to evaluate the dynamics of autogenous bone graft incorporation process to surgically created defects in rat calvaria, using epifluorescence microscopy. MATERIAL AND METHODS: Five adult male rats weighing 200-300 g were used. The animals received two 5-mm-diameter bone defects bilaterally in each parietal bone with a trephine bur under general anesthesia. Two groups of defects were formed: a control group (n=5), in which the defects were filled with blood clot, and a graft group (n=5), in which the defects were filled with autogenous bone block, removed from the contralateral defect. The fluorochromes calcein and alizarin were applied at the 7th and 30th postoperative days, respectively. The animals were killed at 35 days. RESULTS: The mineralization process was more intense in the graft group (32.09 percent) and occurred mainly between 7 and 30 days, the period labeled by calcein (24.66 percent). CONCLUSIONS: The fluorochromes showed to be appropriate to label mineralization areas. The interfacial areas between fluorochrome labels are important sources of information about the bone regeneration dynamics.

Consumo de medicamentos pelos pacientes submetidos a procedimentos odontológicos na Faculdade de Ciências da Saúde da Universidade de Marília (UNIMAR) - SP em 2003 / Drug´s consume in patients thar received dentistry treatment in the Health Science Fculty of Marilia University (UNIMAR) - SP em 2003

O propósito do presente estudo foi conhecer, por meio de levantamento em prontuários, o consumo de medicamentos sistêmicos pelos pacientes, no ano de 2003, que foram atendidos nas clínicas das disciplinas de Cirurgia, Periodontia e Clínica Integrada do Curso de Odontologia da Faculdade de Ciências da Saúde da Universidade de Marília, UNIMAR, SP. Para o seu desenvolvimento foi realizada uma coleta de dados dos 668 prontuários utilizados, seguindo-se um instrumento, na forma de ficha de coleta, elaborado com base nos itens que o compõem. O tipo de estudo empregado foi transversal, caracteristicamente não direcional, que consiste em observar eventos e fatores em estudo ao mesmo tempo. Com base na metodologia utilizada e nos dados obtidos, tabulados e expressados em números e porcentuais, concluiu-se que: 1) é prevalente a amostra dos pacientes que tomavam medicamentos sistêmicos; 2) eram bem diversificados os medicamentos consumidos, com ênfase nos anti-hipertensivos e contraceptivos; 3) a faixa etária prevalente dos pacientes que referiram tomar medicamentos foi de 40 a 49 anos; 4) os pacientes do gênero feminino, na sua maioria, foram os que mais referiram tomar medicamentos; 5) dentre os grupos dos idosos, acima de 60 anos, quase a metade referiu tomar medicamentos, sendo a maioria do sexo masculino, e 6) no grupo de idosos, os medicamentos mais referidos foram os anti-hipertensivos, anti-arritímicos, antidepressivos e analgésicos.

The aim of the present study was to evaluate, through a prompt analysis, the use of systemic drugs of the patients that received dentistry treatment in the year of 2003 and that were attended in Surgery, Periodontics and Integrative Clinical Clinics of the Health Science Faculty of Marilia University (UNIMAR - SP). The data was collected from 668 prompts, following a collect file, elaborated based on the questions answered in the own prompts. The kind of study was the transversal one, not directional, that consists in the observance of events and factors that are studied at the same time. According to the used methodology and the obtained data that were organized in tables and expressed in numbers and percentages, it was concluded that: 1) the sample of patients that use systemic drugs is prevalent; 2) the consumed drugs were very diversified, primarily anti-hipertensive and contraceptives; 3) prevalent age of the patients that related the use of drugs was between 40 and 49 years old; 4) female patients related greater use of drugs; 5) regarding the older groups, above 60 years, almost half of them related using drugs and most of them are of male gender and 6) in the older groups, the most consumed drugs were the anti-hipertensive, anti-arritmics, anti depressive and analgesics.

Effects of Tissucol™ and epsilon aminocaproic acid in the healing process following dental extraction in dehydrated rats

Foi estudada histologicamente a reparação do alvéolo dental de ratos desidratados, após o implante de adesivo fibrínico (TISSUCOL®) associado à irrigação prévia da ferida com solução a 5% de ácido épsilon-aminocapróico. Foram empregados 72 ratos, divididos em três grupos, que receberam diferentes tratamentos após o procedimento cirúrgico. No Grupo I, após a extração do incisivo superior direito, a mucosa gengival foi suturada. Nos Grupos II e III foi provocada a desidratação crônica pela privação de ingestão de líquidos durante 09 dias (3 dias no pré-operatório e 6 dias no pós-operatório), sendo que, no Grupo II, após a extração dental, a mucosa gengival foi suturada de forma semelhante à do Grupo I; no Grupo III, logo após a exodontia, o alvéolo foi irrigado com a solução de ácido épsilon-aminocapróico a 5%, seguida de implante de adesivo fibrínico (TISSUCOL®) e foi feita sutura da mucosa de forma semelhante à dos demais grupos. Decorridos 3, 7, 15 e 21 dias após o ato operatório, os animais foram sacrificados em número de 6 para cada grupo. A seguir, as peças contendo o alvéolo dental foram removidas e fixadas em formalina a 10% e descalcificadas em solução de ácido fórmico e citrato de sódio em partes iguais. Após processamento laboratorial de rotina, foram incluídas em parafina para microtomia. Foram obtidos cortes semi-seriados com 6 micrômetros de espessura, seguidos de coloração em hematoxilina e eosina para estudo microscópico. Os resultados obtidos mostram que a hidroprivação no pré e pós-operatório ocasiona profundo retardo no processo de reparo em feridas de extração dental. O emprego de adesivo fibrínico (TISSUCOL®) melhora o quadro fibrinolítico provocado pela desidratação.

Reação do tecido conjuntivo subcutâneo de ratos aos fios de sutura poliglecaprone 25 (monocryl) e poliglactina 910(vicryl) / Reaction of rat subcutaneous tissue to the sutures Poliglecaprone 25 (Monocryl) and Polyglactin 910 (Vicryl)

Dentro do procedimento cirúrgico, a síntese constitui um passo muito importante, despertando interesse dos pesquisadores e fabricantes na busca de um material com melhor comportamento. Recentemente foi lançado no mercado, um fio sintético, absorvível, monofilamentar a base de poliglecaprone 25, obtido da copolime -rização de epsilon-caprolactone e glicólico que apresenta boa flexibilidade e fácil manuseio. O propósito deste trabalho foi compará-lo ao fio de poliglactina 910, sintético, multifilamentar, absorvível, obtido da copolimerização de lactídeo e glicídio em avaliação após implante ao nível do tecido conjuntivo subcutâneo de rato. Utilizou-se neste estudo, 20 ratos machos, com peso aproximado de 250 gramas. Cada animal, após anestesia, recebeu tricotomia do dorso, incisão linear de 2cm de comprimento atingindo o tecido subcutâneo e divulsão com tesoura romba. No lado direito foi realizado implante de 1 cm de comprimento de fio de poliglecaprone 25 (Monocryl), e, no lado esquerdo de fio de poliglactina 910(Vicryl). Decorridos 5, 10 e 20 dias após o ato operatório, os animais foram sacrificados para obtenção das peças com o material de sutura. Após o processamento laboratorial de rotina, essas peças foram incluídas em parafina para microtomia. Os cortes obtidos foram corados pela técnica da hematoxilina e eosina para estudo microscópico. Os resultados obtidos mostraram que o fio de poliglecaprone 25 apresentou melhor resposta biológica com reação inflamatória mais discreta e organização do tecido conjuntivo mais precoce.

In surgical procedure, sutures are a very important step and have caused a lot of interest for researchers and manufacturers in the searching for better materials. Recently, it was released a synthetic, absorbable, monofilament, poliglecaprone 25, prepared from the copolymer of the glycolide and epsilon caprolactone. This suture material presents good flexibility and handling qualities. In this present study, we compared the responses of rat subcutaneous tissue after the use of poliglecaprone 25 and polyglactin 910, a synthetic, multifilament polymer of polyglact acid, the study was performedon twenty male rats, weighing 250g approximately. A 2 cm longitudinal incision was made in the dorsal subcutaneous tissue. In the right side, the animal received poliglecaprone 25 suture (Monocryl) measuring 1 cm size, and, the left side received polyglactin 910 suture (Vicryl). After 5, 10 and 20 days, the animals were sacrificedand the sutures and the subcutaneous tissue were removed. The pieces received routine histotechnical processing and were stained with haematoxylin and eosin for histological analysis. Results showed that poliglecaprone 25 suture, presented better biological results, with less inflammation and better connective tissue growth.