Outcomes of Arteriotomy Closure Technique for Carotid Endarterectomy: Bovine Pericardial Patch Closure versus Primary Closure

ABSTRACT Introduction: The aim of our study was to compare the primary closure (PRC) and patch angioplasty closure (PAC) of carotid artery following carotid endarterectomy (CEA). Methods: Data of patients who underwent CEA in the period from January 2005 to June 2020 were reviewed through files. Demographic characteristics, information about the operation, and postoperative follow-up outcomes of the patients were compared. Results: Of the 144 CEA cases included in the study, PRC and PAC were applied to 62 (43.7%) and 82 (56.3%) patients, respectively, for the carotid artery closure. Duration of surgery and carotid artery clamping time were not different between the PRC and PAC groups (106.73±17.13 minutes vs. 110.48±20.67 minutes, P=0.635; 24.25±11.56 minutes vs. 25.19±8.99 minutes, P=0.351, respectively). Postoperative respiratory impairment was more common in the PRC group (P=0.012); however, nerve injuries (P=0.254), surgical wound hematomas (P=0.605), surgical site infections (P=0.679), and mortality (P=0.812) were not significantly different between the groups. During the mean patient follow-up time of 26.13±19.32 months, restenosis was more common in the PRC group than in the PAC group (n=26, 41.9% vs. n=4, 4.9%, respectively; P=0.003). Frequencies of stroke (n=4, 2.8% vs. n=2, 2.4%, respectively; P=0.679), transient ischemic attacks (n=2, 1.4% vs. n=0, 0%, respectively; P=0.431), and mortality (n=4, 6.5% vs. n=4, 4.9%, respectively; P=0.580) were not significantly different between the PRC and PAC groups. Conclusion: We are of the opinion that the PAC method is effective and safe for carotid artery closure in patients undergoing CEA.

Comparison of the effectiveness and safety between autologous bone grafts and xenografts for the treatment of alveolar bone defects: overview of systematic reviews using frisbee methodology / Comparación sobre la efectividad y seguridad entre los injertos óseos autólogos y xenoinjertos para el tratamiento de defectos óseos alveolares: overview de revisiones sistemáticas con metodología frisbee

Introduction: Due to the extensive number of studies developed on periodontal pathologies and the clinical need generated to correct bonvze defects, we have carried out an Overview of systematic reviews using the FRISBEE methodology. Material and Methods: Through this study we expect to bridge the knowledge gap generated regarding the clinical question on the effectiveness of autologous bone substitutes and xenografts in maxillary and mandibular bone defects. Results: For this study, we carried out a systematic search in Epistemonikos and PubMed, we included 3 systematic reviews and 5 primary studies included in these reviews to extract their data. We analyzed data using RevMan 5.4. and GRADEpro. Assessed outcomes included: bone gain [MD 0.06 mm lower (0.26 lower to 0.14 higher)] and bone resorption [MD 0.03 mm higher (0.12 lower to 0.18 higher)], where no significant differences were found between the study groups. The certainty of the evidence was moderate for both outcomes. Bone length and bone density outcomes were not measured or reported in the included studies. Conclusion: We concluded that there are no significant clinical differences between the application of autologous bone grafts and xenografts for bone defects correction for the assessed outcomes, therefore, these biomaterials should be applied at the discretion of the clinician and according to the needs and preferences of patients.

Introducción: Debido al extenso número de estudios desarrollados sobre patologías periodontales y a la necesidad clínica generada para corregir defectos óseos, hemos realizado un Overview de revisiones sistemáticas tipo FRISBEE para acortar la brecha de conocimiento generada respecto a la pregunta clínica sobre la efectividad de sustitutos óseos tipo autólogo y xenoinjertos en defectos óseos a nivel maxilar y mandibular. Material y Métodos: Para este estudio realizamos una búsqueda sistemática en Epistemonikos y PubMed, de los cuales incluimos 3 revisiones sistemáticas y 5 estudios primarios incluidos en estas revisiones para extraer sus datos. Los datos fueron analizados a través de RevMan 5.4. Y GRADEpro. Resultados: Los estudios analizaron los desenlaces propuestos: ganancia ósea posterior a la aplicación del injerto óseo [MD 0.06 mm menos (0.26 menos a 0.14 más)] y reabsorción ósea posterior a la aplicación del injerto óseo [MD 0.03 mm más (0.12 menos a 0.18 más)], donde no se encontraron diferencias significativas entre los grupos de estudio. La certeza de la evidencia fue moderada para ambos desenlaces. Los desenlaces longitud ósea y densidad ósea no fueron medidos o reportados en los estudios incluidos. Conclusión: Se concluyó que no hay diferencias que sean clínicamente significativas entre la aplicación de injertos óseos autólogos y xenoinjertos para la corrección de defectos óseos para los desenlaces analizados, por lo que, la aplicación de estos biomateriales queda a criterio del clínico, y de acuerdo a las necesidades y preferencias de los pacientes.

Gingival Recession Treatment with the Use of Xenogeneic Matrix: Optimization of Patient-Centered Outcomes by the Digital Soft Tissue Design

Abstract Objective: To evaluate the impact of the originally-developed approach aimed at pre-treatment graphical modelling of soft-tissue changes (digital soft tissue design) for the optimization of patient-centered outcomes after Class I and Class II single gingival recessions treatment with the use of a xenogeneic dermal matrix. Material and Methods: Patients enrolled in the study group received single gingival recession treatment via CAF+XDM method supported by pre-treatment graphical modelling of potential soft-tissue changes (digital soft tissue design), while patients enrolled in the control group received single gingival recession treatment via CAF+CTG method with no pre-treatment graphical modeling of gingival level changes. Patient-centered outcomes were measured by visual analogue scale, OHIP-14, and Mahajan's scales. Results: Realization of pre-treatment graphical modelling of soft-tissue changes supported the achievement of better patient-centered outcomes, such as root coverage (p<0.05), surgical phase (p<0.05), post-surgical phase (p<0.05), cost-effectiveness (p<0.05) and diagnostics and patient-orientation (p<0.05) based on patient's personal perception grades. Conclusion: Patient-centered results were found to be more successful within the group using the xenogeneic type of graft accompanied with the implementation of pre-treatment graphical modeling of soft tissue changes, which helped to balance patients' pre-operative expectations and post-operative satisfaction with the received results, reduce post-operative morbidity and improve oral health-related quality of life (AU).

A importância do uso de pericárdio bovino para reconstruções cirúrgicas: uma revisão sistemática / The importance of the use of bovine pericardium for surgical reconstructions: a systematic review

Introdução: O uso de pericárdio bovino teve início em 1972 nas cirurgias cardiovasculares. A partir da evolução da engenharia de tecidos com os cuidados na preparação do material, minimizando os riscos de rejeição e facilitando a utilização para diversos tipos de cirurgias, o pericárdio bovino tornou-se ferramenta importante em procedimentos cirúrgicos reconstrutivos. Objetivos: Nessa casuística, o presente estudo propõe avaliar o atual cenário da utilização do pericárdio bovino em procedimentos cirúrgicos de diversas especialidades e os resultados pósoperatórios encontrados. Métodos: Assim, foi realizada uma revisão sistemática da literatura e a base de dados consultada foi a MEDLINE, utilizando a palavra-chave "bovine pericardium", elencando estudos publicados nos últimos cinco anos em inglês e português, e que não utilizavam outro tipo de "patch". Resultados: Foram selecionados 14 artigos que totalizam 507 pacientes, submetidos a cirurgias em diversas áreas, tais quais, cardiologia, neurologia, vascular, pediatria, urologia e oftalmologia. Conclusão: Depreende-se que o uso de pericárdio bovino como remendo cirúrgico é seguro, tendo em vista que existem poucos casos de rejeição do hospedeiro, além de fácil e rápido de ser manuseado, possuindo benefícios frente a próteses mecânicas. Faz-se relevante, portanto, ampliar o número de estudos sobre o tema, visando o grande potencial que esse tipo de material possui para a medicina regenerativa.

Introduction: The use of bovine pericardium started in 1972 in cardiovascular surgeries. From the evolution of tissue engineering with care in the preparation of the material, minimizing the risk of rejection and facilitating the use for various types of surgeries, the bovine pericardium has become an important tool in reconstructive surgical procedures. Purpose: In this series, the present study proposes to evaluate the current scenario of the use of bovine pericardium in surgical procedures of different specialties, and the postoperative results found. Methods: Thus, a systematic literature review was carried out and the database consulted was MEDLINE, using the keywords "bovine pericardium", listing studies published in the last five years in English and Portuguese and that did not use another type of patch. Results: 14 articles were selected, totaling 507 patients, who underwent surgery in several areas, such as cardiology, neurology, vascular, pediatrics, urology, and ophthalmology. Conclusion: It appears that the use of bovine pericardium as a surgical patch is safe, given that there are few cases of host rejection, in addition to being easy and quick to handle, with benefits compared to mechanical prostheses. It is relevant, therefore, to expand the number of studies on the subject, aiming at the great potential that this type of material has for regenerative medicine.

Expression of CD44 in previously grafted alveolar bone / Expresión del marcador óseo CD44 en hueso alveolar previamente injertado

Objetive: To determine the expressions of the bone surface marker CD44 in samples of alveolar bone previously regenerated with allograft, xenograft, and mixed, using the technique of guided bone regeneration. Material and Methods: This exploratory study was approved by the institutional research and ethics committee. By means of intentional sampling and after obtaining informed consent for tissue donation, 20 samples of alveolar bone previously regenerated with guided bone regeneration therapy with particulate bone graft and membrane were taken during implant placement. The samples were stained with hematoxylin-eosin for histological analysis, and by immunohistochemistry for the detection of CD44. Results: Sections with hematoxylin-eosin showed bone tissue with the presence of osteoid matrix and mature bone matrix of usual appearance. Of the CD44+ samples, 80% were allograft and 20% xenograft. The samples with allograft-xenograft were negative. There were no differences in the intensity of CD44 expression between the positive samples. The marker was expressed in osteocytes, stromal cells, mononuclear infiltrate, and some histiocytes. Eighty percent of the CD44+ samples and 100% of the samples in which 60 or more cells were labelled corresponded to allografts (p=0.000). A total of 67% of the samples from the anterior sector, and 40% from the posterior sector were CD44+ (p=0.689). Conclusion: This study shows for the first time that guided bone regeneration using allografts is more efficient for the generation of mature bone determined by the expression of CD44, compared to the use of xenografts and mixed allograft-xenograft, regardless of the regenerated anatomical area.

Objetivo: Determinar la expresión del marcador de membrana óseo CD44 en muestras de hueso alveolar previamente regenerado con aloinjerto, xenoinjerto y mezcla mediante la técnica de regeneración ósea guiada. Material y Métodos: Con aval del Comité de Investigación y Ética, se realizó un estudio exploratorio. Por muestreo intencional y firma de consentimiento informado de donación, se tomaron durante la colocación del implante, 20 muestras de hueso alveolar previamente regenerado con terapia de regeneración ósea guiada con injerto óseo particulado y membrana. Las muestras fueron teñidas con hematoxilina-eosina para el análisis histológico y por inmunohistoquímica para la detección del CD44. Resultados: : Los cortes con hematoxilina-eosina mostraron tejido óseo con presencia de matriz osteoide y matriz ósea madura de aspecto usual. De las muestras CD44+, 80% fueron de aloinjerto y 20% de xenoinjerto. Las muestras con aloinjerto-xeoninjerto fueron negativas. No hubo diferencias en la intensidad de la expresión del CD44 entre las muestras positivas. El marcador se expresó en osteocitos, células estromales, infiltrado mononuclear y algunos histiocitos. El 80% de las muestras CD44+ y el 100% de las muestras con marcación de 60 o más células correspondían a aloinjertos (p=0,000). El 67% de las muestras del sector anterior y el 40% del sector posterior fueron CD44+ (p=0,689). Conclusión: Este estudio muestra por primera vez que la regeneración ósea guiada usando aloinjertos, es más eficiente para la generación de hueso maduro determinado por la expresión de CD44, comparado con el uso de xenoinjertos y mezcla de aloinjerto-xenoinjerto, independientemente del sector anatómico regenerado.

Surgical options for aortic root replacement in destructive endocarditis

Abstract Objective: To analyze patients' preoperative characteristics, surgical data, postoperative courses, and short- and long-term outcomes after implantation of different full-root prostheses for destructive aortic valve endocarditis. Methods: Between 1999 and 2018, 80 patients underwent aortic root replacement due to infective endocarditis in our institution. We analyzed the abovementioned data with standard statistical methods. Results: The Freestyle stentless porcine prostheses were implanted in 53 (66.25%) patients, biological valve conduits in 13 (16.25%), aortic root homografts in nine (11.25%), and mechanical valve conduits in five (6.25%). There were no significant preoperative differences between the groups. The incidence of postoperative complications and intensive care unit length of stay did not differ significantly between the groups. The 30-day mortality rate was low among Freestyle patients (n=8, 15.1%) and high in the mechanical conduit cohort (n=3, 60%), though with borderline statistical significance (P=0.055). The best mean survival rates were observed after homograft (13.7 years) and stentless prosthesis (8.1 years) implantation, followed by biological (2.8 years) and mechanical (1.4 years) conduits (P=0.014). The incidence of reoperations was low in the mechanical conduit group (0) and stentless bioroot group (n=1, 1.9%), but two (15.4%) patients with biological conduits and three (33.3%) patients with homografts required reoperations in the investigated follow-up period (P=0.005). Conclusion: In patients with the destructive form of aortic valve endocarditis, homografts and stentless porcine xenografts offer better survival rates than stented valve conduits; however, the reoperation rate among patients who received homograft valves is high.

Chorioallantoic urothelial tumor avatar. A clinical tool for phenotype-based therapy

Abstract In the muscle invasive bladder cancer (MIBC) standard of care treatment only patients presenting a major pathological tumor response are more likely to show the established modest 5% absolute survival benefit at 5 years after cisplatin-based neoadjuvant chemotherapy (NAC). To overcome the drawbacks of a blind NAC (i.e. late cystectomy with unnecessary NAC adverse events) with potential to survival improvements, preclinical models of urothelial carcinoma have arisen in this generation as a way to pre-determine drug resistance even before therapy is targeted. The implantation of tumor specimens in the chorioallantoic membrane (MCA) of the chicken embryo results in a high-efficiency graft, thus allowing large-scale studies of patient-derived "tumor avatar". This article discusses a novel approach that exploits cancer multidrug resistance to provide personalized phenotype-based therapy utilizing the MIBC NAC dilemma.

Reconstrucción cervico torácica y reconstrucción axilar: Relato de caso / Thoracic cervical and axilar reconstruction: Case story / Reconstrução cervical torácica e reconstrução axilar: Relato de caso

Objetivo: Detallar el tratamiento propuesto y la reproductividad de la reconstrucción en deformidad incapacitante de paciente gran quemado, que presenta compromiso de regiones: cervical, torácica, mandibular, facial y axilar; demostrando el uso de dispositivos biotecnológicos; así mismo describir el uso de colgajo dorsal ancho para reconstrucción región axilar. Método: Paciente con graves secuelas de quemadura, cérvico torácica y facial al cual se realiza reconstrucción con uso de matriz dérmica acelular bicapa y unicapa, piel heteróloga e injerto fino mallado. Dos años posteriores al primer tratamiento, se realiza reconstrucción compleja de la región axilar izquierda con colgajo dorsal ancho con isla de piel y matriz dérmica acelular unicapa mallada, más colocación de piel mallada. Resultados: Resolución de secuelas funcionales limitantes descritas, con retracción secundaria mínima. Mejora postural y funcional de áreas tratadas. Conclusiones: La matriz dérmica acelular es una herramienta útil ya que: proporciona cierre inmediato a la herida evitando pérdidas de líquidos y electrolitos,disminuye la reacción inflamatoria, permite cambios indoloros de vendajes. El beneficio que de ella se obtiene, supera notoriamente el coste del mismo. La matriz dérmica puede ser usada cuantas veces sea necesaria, sin prejuicio significativo en la morbilidad. El injerto autólogo usado, debe ser muy fino lo que ayuda a la regeneración de la piel, tanto funcionalmente como de forma cosmética. El tratamiento axilar propuesto de rotación avance de colgajo muscular con isla de piel, fue realizado de acuerdo a la clasificación de la lesión, mismo que permitió una cobertura adecuada con poca morbimortalidad.

Objective: To detail the proposed treatment and the reproduce of reconstruction in incapacitating deformity of a large burned patient, presenting regional involvement: cervical, thoracic, facial and axillary; demonstrating the use of biotechnological devices; likewise describe the use of dorsal flap for axillary region reconstruction. Methods: Patient with serious cervical and facial burn sequela, which reconstruction is performed with use of acellular bilayer and single layer dermal matrix, heterologous skin and fine mesh graft. Two years after the first treatment, a complex reconstruction of the left axillary region was performed with dorsal flap with a skin island using acellular single-layer dermal matrix, and meshed skin graft. Results: Resolution of limiting functional sequela described, with minimal secondary retraction. Postural and functional improvement of treated areas. Conclusions: The acellular dermal matrix is a useful tool: provides immediate closure of wound avoiding losses of fluids and electrolytes, decreases inflammatory reaction, allows painless changes of bandages. The benefit obtained from it greatly exceeds the cost of it. The dermal matrix can be used as many times as necessary, without significant prejudice in morbidity. The autologous graft used must be very thin which helps the regeneration of the skin, both functionally and cosmetically. The axillary treatment proposed rotation advance of muscle flap with skin island was performed according to the classification of the lesion, which allowed adequate coverage with little morbidity and mortality.

Objetivo: Detalhar o tratamento proposto e reprodutividade na reconstrução da deformidade incapacitante do grande queimado, que teve comprometimento das regiões cervical, torácica, mandibular, facial e nas axilas, demonstrando o uso de dispositivos biotecnológicos; descrever também o uso do retalho grande dorsal para reconstrução da região axilar. Método: Paciente com sequelas graves de queimadura, na região torácica e facial, reconstrução com matriz dérmica acelular de dupla camada e com uma matriz de camada simples, mais pele heteróloga e enxerto de malha fina. Dois anos após o primeiro tratamento, a reconstrução complexa da axila esquerda é realizada com retalho do grande dorsal com ilha de pele e matriz dérmica de camada simples, mais colocação de pele fina malhada. Resultados: Resolução de sequelas funcionais limitantes descritas, com mínima retração secundária. Melhoria postural e funcional das áreas tratadas. Conclusões: A matriz dérmica acelular é uma ferramenta útil, fornecendo fechamento imediato para a ferida, evitando perdas de fluidos e eletrólitos, diminuindo a reação inflamatória e permitindo trocas indolores. O benefício obtido excede em muito o seu custo. A matriz dérmica pode ser utilizada quantas vezes forem necessárias, sem prejuízo significativo na morbidade. O enxerto autólogo utilizado deve ser muito fino, o que ajuda a regeneração da pele, tanto funcional como cosmética. O tratamento axilar proposto para avanço da rotação do retalho muscular com ilha de pele foi realizado de acordo com a classificação da lesão, o que permitiu cobertura adequada, com pouca morbimortalidade.

Action of a deproteinized xenogenic biomaterial in the process of bone repair in rats submitted to inhalation of cigarette smoke

Abstract Purpose: To investigate if the inorganic bovine bone matrix changes the bone formation in rats submitted to inhalation of cigarette smoke. Methods: Twenty Wistar rats were divided into two groups: Cigarette Clot Group (CCG), which in the inhalation chamber received the smoke of 10 cigarettes, 3 times a day, 10 minutes, for 30 days and had the surgical cavity filled by clot; Cigarette Biomaterial Group (CBG), submitted to the same inhalation technique but with the cavity filled by biomaterial. Results: In CCG there was a significant difference of new bone tissue in the analyzed periods (15 and 45 days), and in 15 days, there was 4.8 ± 0.42 of bone formed and 11.73 ± 0.59 (p <0.05) in 45 days. The CBG also showed a significant difference between the periods of 15 to 45 days, being respectively 6.16 ± 0.30 and 11.60 ± 0.61. However, when the groups were compared, within the same analyzed periods, a significant difference was observed only in the period of 15 days, with the new bone percentage being greater in the CBG. Conclusion: The bone matrix acted as an osteoinductive biomaterial, biocompatible and aided in the repair process, mainly in the initial period of recovery.

Tomographic late evaluation of xenogeneic bone grafts in sockets of impacted third molars

Abstract It is necessary to preserve height and thickness of the alveolar bone to facilitate rehabilitation with osteointegratable implants or simply to maintain bone integrity after extraction. Biomaterials associated with resorbable or non-resorbable membranes, when placed in the region of the socket, may contribute to avoid this unwanted reabsorption. Objective The objective of this study was to evaluate the distance of the crest of alveolar ridge to the cementoenamel junction (CEJ) of the lower second molars and the bone density of the third molar socket filled with Gen-Tech®, 5 years after an exodontia using cone beam computed tomography (CBCT) to visualize the central region of the sockets, without overlapping of the buccal and lingual cortical bones. Material and Methods A total of 12 individuals from an initial group of 39 patients submitted to extraction of the unruptured lower third molars and grafting of an association of inorganic bovine bone matrix, organic bovine bone matrix, collagen and bone morphogenetic proteins (BMP) (Gen-Tech®) on one side and the contralateral sockets filled only by clot, returned to control after 5 years, and were submitted to CBCT. The distance from the crest of alveolar bone to the CEJ and the bone density (BD) were measured using the i-CAT Vision Software. Results The results showed that the distance from the crest of alveolar bone to the CEJ in the control group was similar to that observed before the exodontia; in the experimental group, this distance was smaller. Considering the BD measurement, a significantly higher density was observed in the experimental group (p<0.05). Conclusion Part of the biomaterial was not absorbed and allowed the stability of the evaluated parameters after 5 years, being able to be used as a bone substitute in the socket.

Preservação de alvéolo com uso de materiais xenógenos em área estética da maxila: relato de caso / Ridge preservation using xenografts in an aesthetic area of the maxilla: Case Report

INTRODUÇÃO: Para manter as dimensões ósseas e gengivais do alvéolo até a instalação de implantes tardios o cirurgião dentista pode lançar mão de diversas técnicas de regeneração óssea guiada, dentre estas existentes a associação de um substituto ósseo com um selador do alvéolo vem apresentando resultados clínicos satisfatórios. OBJETIVO: O objetivo do presente trabalho é relatar um caso clínico onde a preservação alveolar em área estética maxilar foi realizada com materiais xenógenos. RELATO DE CASO: Paciente gênero feminino com 50 anos, melanoderma, não fumante e sem alterações sistêmicas apresentou-se a pós-graduação em periodontia da Faculdade de Odontologia de Ribeirão Preto devido a incômodo estético nos elementos 11 e 21. No exame clínico verificou comprometimento periodontal extenso nos dentes 11 e 21 sendo indicada a exodontia com reabilitação oral via implantes dentários. O tratamento proposto foram as exodontias seguidas de preservação alveolar com materiais xenógenos para posterior instalação de implantes na área enxertada. Porém a pedido da paciente e por conta das condições periodontais e estéticas as exodontia foram realizadas em momentos diferentes demonstrando um planejamento diferenciado e individualizado. CONCLUSÃO: Podemos concluir que a associação entre o substituto ósseo com a membrana substituta de tecido mucoso conseguiu obter resultados satisfatórios na preservação e manutenção das dimensões ósseas e teciduais no caso apresentado (AU)

INTRODUCTION: To maintain the bone and gingival dimensions of the ridge until the installation of implants the dental surgeon can use several techniques of guided bone regeneration, among these the association of a bone substitute with a ridge's sealant has shown satisfactory clinical results. OBJECTIVE: The objective of this study is to report a clinical case where ridge preservation in maxillary aesthetic area was performed with xenogenic materials. CASE REPORT: A 50-year-old female patient, melanoderma, non-smoker and no systemic conditions presented at post-graduation in periodontics from the Faculty of Dentistry of Ribeirão Preto due to aesthetic discomfort in elements 11 and 21. At the clinical examination it was verified that there was extensive periodontal impairment on teeth 11 and 21, that why it was indicated an oral rehabilitation with dental implants. The proposed treatment was the exodontia followed by ridge preservation with xenogenic materials for posterior implant installation in the grafted area. However, at the request of the patient and due to the periodontal and aesthetic conditions, the exodontia were performed at different times, demonstrating a different and individualized treatment planning. CONCLUSION: We can conclude that the association between the bone substitute and the mucosal tissue replacement membrane was able to obtain satisfactory results in the preservation and maintenance of the bone and tissue dimensions in the presented case.tissue (AU)

The effects of ozone therapy as an adjunct to the surgical treatment of peri-implantitis

PURPOSE: The decontamination procedure is a challenging aspect of surgical regenerative therapy (SRT) of peri-implantitis that affects its success. The purpose of the present study was to determine the impact of additional topical gaseous ozone therapy on the decontamination of implant surfaces in SRT of peri-implantitis. METHODS: A total of 41 patients (22 males, 19 females; mean age, 53.55±8.98 years) with moderate or advanced peri-implantitis were randomly allocated to the test group (ozone group) with the use of sterile saline with additional ozone therapy or the control group with sterile saline alone for decontamination of the implant surfaces in SRT of peri-implantitis. Clinical and radiographic outcomes were evaluated over a period of 12 months. RESULTS: At the 12-month follow-up, the plaque and gingival index values were significantly better in the ozone group (P < 0.05). Probing depth decreased from 6.27±1.42 mm and 5.73±1.11 mm at baseline to 2.75±0.7 mm and 3.34±0.85 mm at the end of the 12-month observation period in the ozone and control groups, respectively. Similarly, the clinical attachment level values changed from 6.39±1.23 mm and 5.89±1.23 mm at baseline to 3.23±1.24 mm and 3.91±1.36 mm at the 12-month follow-up in the ozone and control groups, respectively. According to the radiographic evidence, the defect fill between baseline and 12 months postoperatively was 2.32±1.28 mm in the ozone group and 1.17±0.77 mm in the control group, which was a statistically significant between-group difference (P < 0.05). CONCLUSIONS: Implant surface decontamination with the additional use of ozone therapy in SRT of peri-implantitis showed clinically and radiographically significant. Trial registry at ClinicalTrials.gov, NCT03018795.

Preservação e aumento de rebordo alveolar após perda de implante osseointegrado / Ridge preservation and augmentation after dental implant failure ­ a case report

Este relato de caso objetivou descrever as técnicas de preservação e aumento de rebordo alveolar após perda de um implante osseointegrado. Paciente com 54 anos de idade, do sexo feminino, procurou o serviço odontológico da Faculdade de Odontologia da Universidade Federal do Rio Grande do Sul, pois um implante instalado há cincos anos na região do dente 25 encontrava-se com mobilidade. Ao exame clínico e radiográfico, constatou-se perda da osseointegração e extensa perda óssea da região vestibular. Realizou-se a remoção do implante, preservação e aumento de rebordo alveolar com enxerto de osso bovino desproteinizado e membrana de colágeno. Além do aumento da densidade óssea da região, observou-se aumento em espessura gengival, o que favoreceu a estética da área. Nove meses após esses procedimentos, um implante do tipo hexágono externo foi instalado. Posteriormente, uma nova prótese foi confeccionada. Concluiu-se que a preservação de rebordo alveolar é uma técnica de fundamental importância para a adequada instalação de implantes osseointegrados, pois favorece aspectos funcionais e estéticos, podendo ser aplicada em casos de perda de implantes e de dentes.

This case report aimed to describe a case of ridge preservation after loss of an osseointegrated implant. A 54 years-old female sought the dental service of the Federal University of Rio Grande do Sul because her implant, installed five years prior the initial exam, in the region of the element 25, presented mobility. Clinical and tomographic exams showed loss of osseointegration and extensive bone loss in the buccal surface. The implant was removed and the ridge preservation and augmentation was performed with deproteinized bovine bone graft and collagen membrane. In addition to the increased bone density in the region, the gingival thickness were increased in the region, favoring the aesthetics. After nine months, an external hexagon implant was installed. Aftwerwards, a new prosthesis was placed. It was concluded that the ridge preservation is extremely important for proper installation of osseointegrated dental implants, providing better functional and aesthetics aspects and can be applicable to cases where dental implants or tooth were lost.

Anti-cancer Effects of a Novel Quinoline Derivative 83b1 on Human Esophageal Squamous Cell Carcinoma through Down-Regulation of COX-2 mRNA and PGE₂ / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: 83b1 is a novel quinoline derivative that has been shown to inhibit cancer growth in human esophageal squamous cell carcinoma (ESCC). This study was conducted to comprehensively evaluate the cytotoxic effects of 83b1 on a series of ESCC cell lines and investigate the mechanisms by which 83b1 suppresses cancer growth based on molecular docking analysis. MATERIALS AND METHODS: A series of ESCC and nontumor immortalized cell lines were exposed to 83b1 and cisplatin (CDDP) in a dose-dependent manner, and the cytotoxicity was examined by a MTS assay kit. Prediction of the molecular targets of 83b1 was conducted by molecular docking analysis. Expression of cyclooxygenase 2 (COX-2) mRNA and COX-2–derived prostaglandin E₂ (PGE₂) were measured by quantitative real-time polymerase chain reaction and enzymelinked immuno-sorbent assay, respectively. In vivo anti-tumor effect was determined using a nude mice xenografted model transplanted with an ESCC cell line, KYSE-450. RESULTS: 83b1 showed the significant anti-cancer effects on all ESCC cell lines compared to CDDP; however, 83b1 revealed much lower toxic effects on non-tumor cell lines than CDDP. The predicted molecular target of 83b1 is peroxisome proliferator-activated receptor delta (PPARδ), which is a widely known oncoprotein. Additionally the expression of COX-2 mRNA and COX-2–derived PGE2 were down-regulated by 83b1 in a dose-dependent manner in ESCC cell lines. Furthermore, 83b1 was shown to significantly reduce the tumor size in nude mice xenograft. CONCLUSION: The results of this study suggest that the potential anti-cancer effects of 83b1 on human esophageal cancers occur through the possible oncotarget, PPARδ, and down-regulation of the cancer related genes and molecules.

Physicochemical characterization of porcine bone-derived grafting material and comparison with bovine xenografts for dental applications

PURPOSE: The physicochemical properties of a xenograft are very important because they strongly influence the bone regeneration capabilities of the graft material. Even though porcine xenografts have many advantages, only a few porcine xenografts are commercially available, and most of their physicochemical characteristics have yet to be reported. Thus, in this work we aimed to investigate the physicochemical characteristics of a porcine bone grafting material and compare them with those of 2 commercially available bovine xenografts to assess the potential of xenogenic porcine bone graft materials for dental applications. METHODS: We used various characterization techniques, such as scanning electron microscopy, the Brunauer-Emmett-Teller adsorption method, atomic force microscopy, Fourier-transform infrared spectroscopy, X-ray diffraction, and others, to compare the physicochemical properties of xenografts of different origins. RESULTS: The porcine bone grafting material had relatively high porosity (78.4%) and a large average specific surface area (SSA; 69.9 m²/g), with high surface roughness (10-point average roughness, 4.47 µm) and sub-100-nm hydroxyapatite crystals on the surface. Moreover, this material presented a significant fraction of sub-100-nm pores, with negligible amounts of residual organic substances. Apart from some minor differences, the overall characteristics of the porcine bone grafting material were very similar to those of one of the bovine bone grafting material. However, many of these morphostructural properties were significantly different from the other bovine bone grafting material, which exhibited relatively smooth surface morphology with a porosity of 62.0% and an average SSA of 0.5 m²/g. CONCLUSIONS: Considering that both bovine bone grafting materials have been successfully used in oral surgery applications in the last few decades, this work shows that the porcine-derived grafting material possesses most of the key physiochemical characteristics required for its application as a highly efficient xenograft material for bone replacement.

Withaferin-A Inhibits Colon Cancer Cell Growth by Blocking STAT3 Transcriptional Activity

BACKGROUND: Withania somnifera (known as Ashwagandha) is a medicinal plant used in the ayurvedic medicines in India. Withaferin-A, a withanolide derived from the leaf extract of W. somnifera, has been reported to exhibit anti-tumor activity against various cancer cells, such as leukemia, breast cancer and colon cancer cells. METHODS: We investigated the anti-cancer effects of withaferin-A on the proliferation and migration of human colorectal cancer (HCT116) cells. And we evaluated the effects of withaferin-A on the transcriptional activity of STAT3 and the growth of HCT116 cells in xenograft mouse tumor model. RESULTS: In the present study, we found that withaferin-A inhibited the proliferation and migration of HCT116 cells in a concentration-dependent manner. Treatment of HCT116 cells with withaferin-A attenuated interleukin-6-induced activation of STAT3, which has been implicated in the development and progression of colon cancer. To examine the effect of withaferin-A on HCT116 cells proliferation in vivo, we generated HCT116 cells xenograft tumors in Balb/c nude mice and treated the tumor bearing mice with or without withaferin-A intraperitoneally. Treatment with withaferin-A exhibited significant decrease in the volume and weight of tumors as compared to untreated controls. CONCLUSIONS: The present study suggests that withaferin-A holds the potential to be developed as a small molecule inhibitor of STAT3 for the treatment of HCT116.

The influence of PI-88 on heparanase protein expression of human esophageal cancer cell and xenograft of nude mice / 天津医药

Objective To explore the inhibitory effects of sulfated oligosaccharides PI-88 on the heparanase protein expression of human esophageal squamous cancer cell (ESCC) line TE-13, and to explore the effects of growth, angiogenesis and heparanase protein expression on ESCC xenografts of nude mice. Methods TE-13 cells were cultured and divided into three groups:group A (control group), group B (15 mg/L PI-88) and group C (30 mg/L PI-88). Heparanase protein expression of TE-13 cells was measured by Western blot assay after being cultured for 36 h. The ESCC suspension was injected subcutaneously in 10 BALB/c/nu mice to build up ESCC xenograft model. The model mice were divided randomly into observation group and control group (5 mice per group). The mice in observation group received 40 mg/(kg·d) PI-88. The mice in control group only received the same volume of saline at the same time. Both PI-88 and saline were daily administrated for 14 days. Every 2 days,the volume of xeongrafts were measured and the mice were executed at the 14th day. CD34 immunohistochemical staining was used to detect the micro vessel density (MVD) of xenografts. Western blot assay and immunohistochemical staining were used to detect the heparanase protein expression of xenografts. Results The heparanase protein expressions of TE-13 cells were significantly decreased in group B and group C than those of group A (P<0.001), with a kind of PI-88 dose-dependent manner. The volume, MVD and heparanase protein expression of xenografts were significantly lower in observation group than those of control group (P<0.05). Conclusion The heparanase protein expression in TE-13 cells can be inhibited by PI-88 in vitro and vivo. Furthermore, the growth and angiogenesis of ESCC xenografts were also inhibited by PI-88.