ABSTRACT
Resumen Introducción: La fascia lata es la parte más externa de la aponeurosis del muslo. Se trata de una membrana gruesa y resistente que posee elasticidad, flexibilidad y memoria. Actualmente es utilizada en el área médica para el tratamiento de defectos abdominales, incontinencia urinaria, ptosis palpebral y, en odontología, se utiliza para regeneración tisular guiada, coberturas radiculares, aumento de reborde y preservación de alveolo. Método: Se ha realizado una búsqueda electrónica en las bases de datos de Medline, PubMed y SciELO con el término fascia lata. Fueron incluidos textos compie-tos en idioma español e inglés que abarcan desde 1983 hasta 2015. La característica principal de estos textos es que exploran el uso de fascia lata en el área médica y odontológica. Discusión: Durante la realización de este trabajo surgieron situaciones limitantes debido a la escasa cantidad de artículos, investigaciones y casos clínicos documentados enfocados al uso de la fascia lata en el área odontológica. Conclusiones: La fascia lata es un material reabsorbible. biocompatible, que es bien tolerado por el lecho receptor, goza de características de seguridad y larga duración en su uso dentro de las especialidades medicas y odontológicas.
Abstract Introduction: Fascia lata is the most extreme section of the thigh's aponeurosis. It is a thick and resistant membrane possessing elasticity, flexibility and memory. It is presently used in the medical world to treat abdominal defects, urinary incontinence, and palpebral ptosis. In dentistry it is used in guided tissue regeneration, root coverage, ridge increase and socket (alveolus) preservation. Method: An electronic search was conducted in the following databases: Medline, PubMed and Sei ELO, with the term fascia lata. Full texts in English and Spanish were included in timeline spanning from 1983 to 2015. Main characteristic selected for these texts was they explored use of fascia lata and medical and dental areas. Discussion: Limiting situations arose during the execution of this project due to the scarcity found in articles and research papers and documented clinical cases targeting use of fascia lata ion dental areas. Conclusions: Fascia lata is a resorbable, biocompatible material, well tolerated by the recipient bed; when used in medical and dental specialties it exhibits characteristics of accuracy (security) and long duration.
ABSTRACT
Objetivo: comparar injertos de tejido blando autólogos y alógenos para el tratamiento de defectos clase I de Seibert. Métodos: se seleccionaron 18 sitios quirúrgicos, de 14 pacientes, y se asignaron aleatoriamente. Fueron asignados ocho sitios quirúrgicos para recibir injerto autólogo de tejido conectivo, y nueve para recibir injerto alógeno de fascia muscular. Se tomaron cuatro modelos diagnósticos para las mediciones, uno al inicio, y luego al primero, al segundo y al cuarto mes después de la cirugía. Adicionalmente, se realizaron seis biopsias del grupo de fascia. Resultados: el grupo control presentó una profundidad inicial promedio de 2,29 ± 0,55 mm, y el experimental, 3,50 ± 0,85 mm. La ganancia en espesor al primero, al segundo y al cuarto mes fue de 71,2, 46,52 y 28,5% en la fascia, y de 56,53, 38,31 y 38,1% en el tejido conectivo, respectivamente. La fascia se reabsorbió 28,8, 53,48 y 71,5%, al primero, al segundo y al cuarto mes, y el tejido conectivo se reabsorbió 43,47, 61,69 y 61,69%, respectivamente. No hubo diferencias significativas entre los dos grupos (p>0,05). El análisis histológico mostró presencia de tejido colágeno denso, poco celular, entremezclado con el tejido conectivo del huésped. La fascia tuvo una mayor tendencia a la reabsorción que el tejido conectivo, y la ganancia al cuarto mes en ambos fue similar. Sin embargo, el tejido conectivo fue más estable en el tiempo. La fascia mostró menor morbilidad,e histológicamente se observó presencia de este injerto después de 20 semanas. Conclusiones: la fascia humana constituye una alternativa de tratamiento para corregir defectos de reborde en el sector anterior.
Aim: Compare tissue grafting from autologous and allogenous sources for the treatment of Seibert Class I border defects. Methods: 18 surgical sites from 14 patients were selected and randomly assigned. 8 surgical sites received connective tissue grafts from autologous donor sites, and 9 surgical sites received allogenous muscular fascia grafts. 4 diagnostic casts were taken for comparative study (baseline, 1 month, 2nd month and 4th month postsurgical). In addition, 6 tissue punch biopsies were taken from the fascia group to determine presence of fascia tissue. ResultsThe control group showed an average tissue depth of 2.29 ± 0.55 mm and the experimental group showed 3.5 ± 0.85 mm, at baseline. Tissue gain for the fascia group was 71.2%, 46.52% y 28.5% for the 1st, 2nd and 4th months respectively, and the control group presented 56.53%, 38.31% y 38.1% respectively. There were not statistically significant differences between the two treatments (p>0,05). Histological analysis of the fasciagroup showed dense collagen tissue and host connective tissue at the 4th month. Fascia tissue grafts seemed to reabsorb faster than the connective tissue from the control group and the gain in tissue size at the 4th month was similar in both groups. The fascia tissue group, however, seemed to present less morbidity and was found in the histological samples at the 20 week postsurgical measurements. The connective tissue grafts were more stable in the treatment of Seibert I border defects. Conclusions: Human muscular fascia tissue could be an alternative treatment for the correction of Seibert class I border defects.
Subject(s)
Guided Tissue Regeneration, Periodontal , Bone Transplantation , Fascia , Connective TissueABSTRACT
A incompetência glótica ainda representa um desafio para a laringologia. Implantes de biomateriais no espaço de Reinke ou no espaço paraglótico estão entre as opções de tratamento, e suturas e confecção de bolsões subepiteliais são normalmente utilizados para fixação desses implantes. Alternativamente, a cola biológica pode ser usada como adesivo nesses casos. A cola de fibrina (CF) é produto da reação de dois componentes do sistema de coagulação: o fibrinogênio e a trombina, que formam uma rede de fibrina, responsável, entre outros, pela adesão dos tecidos. Entretanto, além do efeito adesivo, a CF e seus componentes podem interferir no processo cicatricial, atuando sobre citocinas como o fator de crescimento transformador-beta (TGF-beta). O objetivo deste estudo é avaliar o efeito da cola de fibrina na deposição de colágeno após enxertia de fáscia em pregas vocais de coelhos. Dezoito coelhos foram submetidos a enxerto de fáscia em ambas as pregas vocais, sendo o lado esquerdo fixado com CF. Os coelhos foram sacrificados após 7, 30 e 90 dias. As laringes foram removidas e as pregas vocais preparadas para estudo histomorfométrico através da coloração picrossirius, a fim de avaliar a deposição de colágeno total em torno do enxerto. Foi observado um aumento estatisticamente significativo na densidade de colágeno em torno dos enxertos de fáscia nas pregas vocais que receberam a CF (p=0,0102) após 90 dias, em comparação com as pregas vocais controles. A aplicação da CF interferiu na deposição de colágeno em torno dos enxertos de fáscia, resultando em um aumento significativo na densidade de colágeno após 90 dias, possivelmente em decorrência da interação de seus componentes com citocinas e células envolvidas no processo de cicatrização.
The glottal incompetence is still a challenge in Laryngology. Implants of biomaterials in Reinkes space or paraglottic space are among the treatment options, and sutures and pockets dissections are usually used to set these implants. Alternatively, biological glue can be used as adhesive in these cases. Fibrin glue (FG) is the product reaction of two components of the coagulation system: the fibrinogen and thrombin that form a fibrin net, responsible for the tissues adhesion, among other functions. However, the FG and its components may interfere in wound healing, interacting with cytokines as the transforming growth factor-beta (TGF-beta). The objective is to study the effect of fibrin glue on collagen deposition after fascia grafting on the rabbits vocal folds. Eighteen rabbits were submitted to the fascia graft on both vocal folds, being the left side fixed with FG. The rabbits were sacrificed after 7, 30 and 90 days. The larynx were removed and vocal folds prepared for histomorphometric study through Picrosirius Red stain, in order to evaluate the collagen deposition around the graft. There was a significant increase in collagen density around the grafts on the vocal folds that received FG (p=0.0102) after 90 days, compared with the control. FG application interfered in collagen deposition around fascia grafts, resulting in a significantly increase of collagen density after 90 days, which possibly resulted from the interaction of FG and its components with the cytokines and cells involved in the wound healing.