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1.
Rev. Círc. Argent. Odontol ; 79(230): 17-20, dic. 2021. ilus, graf
Article in Spanish | LILACS | ID: biblio-1358178

ABSTRACT

Luego de una extracción dental ocurren inevitablemente procesos de reabsorción y remodelación ósea, donde la dimensión y morfología de la cresta alveolar se ve modificada, representando un problema para la rehabilitación de la zona. Estudios clínicos han documentado un promedio de 4,0 a 4,5 mm de reabsorción ósea horizontal luego de una exodoncia, como así también cambios dimensionales significativos en los alrededores del hueso alveolar. El propósito fue evaluar y comparar clínica y tomográficamente los procesos de reparación y conservación del reborde alveolar post-extracción de paredes intactas, con y sin la utilización de esponjas de colágeno intraalveolar como relleno y placa termoformada como barrera física, durante el proceso de cicatrización. Se seleccionaron pacientes con indicación de exodoncia de elementos dentarios normalmente implantados y clínicamente aceptables, aplicando los criterios de exclusión, se realiza toma de impresión del terreno para la confección de una placa de protección rígida 0,8 termoformada para ser colocada posterior a la extracción durante la masticación por un período de 30 días. Se indica tomografía cone-beam post operatoria inmediata y a los tres meses para analizar, medir y comparar alto y ancho de crestas alveolares residuales. En la evaluación clínica y tomográfica de los casos estudiados, el grupo control donde se usó únicamente placa de protección alveolar arrojó mejores resultados que el grupo donde se colocaron esponja de colágeno en el interior del alvéolo. Palabras clave: Regeneración ósea, esponja de colágeno, cicatrización ósea, alvéolo postextracción, placa de protección alveolar (AU)


After a tooth extraction, bone resorption and remodeling processes inevitably occurs, where size and morphology of the alveolar crest is modified, representing a problem for the rehabilitation of the area. Clinical studies have documented an average of 4.0 to 4.5 mm of horizontal bone resorption after an extraction, us well us substantial dimensional changes around the alveolar bone. The purpose was to evaluate and compare clinical and tomographically both repair and preservation of post extraction alveolar ridge of intact walls processes, with and without the use of intraalveolar collagen sponges as filler and a thermoformed protective plaque, us physica? barrier, during healing process. Patients with normally implanted and clinically acceptable tooth with extraction indication were selected, applying the exclusion criteria, impression of the field is taken to build a 0.8 rigid thermoformed protective plaque in order to be placed after extraction and used during chewing for a period of 30 days. Immediate and three months post-operative cone beam tomography are indicated to analyze, measure and compare height and width of residual alveolar crests. In the clinical and tomographic evaluation of the cases treated, control group where only alveolar protective plaque was used, showed better results than the group with intraalveolar collagen sponge (AU)


Subject(s)
Humans , Male , Female , Bone Regeneration , Alveolar Bone Loss , Collagen , Argentina , Schools, Dental , Tooth Extraction , Wound Healing , Tomography, X-Ray Computed , Statistical Analysis , Cone-Beam Computed Tomography
2.
Braz. dent. j ; 32(4): 83-95, July-Aug. 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1345517

ABSTRACT

Abstract This study evaluated the bone repair in surgical defects of rats treated with hyaluronic acid (HA) associated or not with Hevea brasiliensis fraction protein (F-1). Bone defect were created in 15 albino Wistar rats divided into 3 groups (n=5): Control group (1) - blood clot; HA group (2) - 0.5% hyaluronic acid; HAF1 group (3) - 0.1% F-1 protein fraction dissolved in 0.5% hyaluronic acid. After 4 weeks, the animals were euthanized and the bone repair was evaluated through histomorphometric analysis, zymography and immunohistochemistry. The neoformed bone area did not show a significant difference (p = 0.757), but there was a tendency for bone trabeculation to increase in the groups HA and HAF1. For immunohistochemically analysis, there was a difference in vascular endothelial growth factor (VEGF) labeling (p = 0.023), being higher in the groups HA and HAF1 than the control group. No significant difference in bone sialoprotein (BSP) (p = 0.681), osteocalcin (p = 0.954), however, significant difference in platelet endothelial cell adhesion molecule-1 (CD-31) (p = 0.040), with HAF1 group being significantly lower than the control. For zymographic analysis, there was no significant difference for metalloproteinase-2 (MMP-2) (p = 0.068), but there was a tendency to increase MMP-2 in the HA group. Despite the influence on angiogenic factors and the apparent tendency for greater trabeculation in the HA and HAF1 groups, there was no significant difference in the area of ​​newly formed bone tissue in the analyzed period.


Resumo Este estudo avaliou o reparo ósseo em defeitos cirúrgicos de ratos tratados com ácido hialurônico (AH) associado ou não à fração proteica de Hevea brasiliensis (F-1). Foram criados defeitos ósseos em 15 ratos albinos Wistar divididos em 3 grupos (n = 5): Grupo controle (1) - coágulo sanguíneo; Grupo HA (2) - ácido hialurônico 0,5%; Grupo HAF1 (3) - fração proteica F-1 0,1% dissolvida em ácido hialurônico a 0,5%. Após 4 semanas, os animais foram submetidos à eutanásia e o reparo ósseo avaliado por meio de análise histomorfométrica, zimografia e imunohistoquímica. A área óssea neoformada não apresentou diferença significativa (p = 0,757), mas houve tendência de aumento da trabeculação óssea nos grupos HA e HAF1. Para a análise imunoistoquímica, houve diferença na marcação do fator de crescimento endotelial vascular (VEGF) (p = 0,023), sendo maior nos grupos HA e HAF1 do que no grupo controle. Nenhuma diferença significativa na sialoproteína óssea (BSP) (p = 0,681), osteocalcina (p = 0,954), no entanto, diferenças significativas foram encontradas para a molécula de adesão de células endoteliais plaquetárias-1 (CD-31) (p = 0,040), com o grupo HAF1 sendo significativamente inferior ao controle. Para a análise zimográfica, não houve diferença significativa para metaloproteinase-2 (MMP-2) (p = 0,068), mas houve tendência de aumento da MMP-2 no grupo HA. Apesar da influência sobre os fatores angiogênicos e da aparente tendência de maior trabeculação nos grupos HA e HAF1, não houve diferença significativa na área de tecido ósseo neoformado no período analisado.


Subject(s)
Animals , Rats , Hyaluronic Acid , Latex , Bone Regeneration , Matrix Metalloproteinase 2 , Vascular Endothelial Growth Factor A
3.
Odontol. Clín.-Cient ; 20(1): 46-54, jan.-mar. 2021. ilus, tab
Article in Portuguese | LILACS, BBO | ID: biblio-1367843

ABSTRACT

Introdução: As alterações dimensionais do processo alveolar após extração dentária é uma conse quência natural e fisiológica indesejável, podendo dificultar a colocação de um implante dentário na posição desejada. Portanto, a Regeneração Óssea Guiada (ROG) tem um papel relevante na pre venção da perda óssea. Objetivo: Compreender a eficácia do uso de membranas não absorvíveis na ROG de alvéolos pós extração. Metodologia: A pesquisa foi realizada nas bases de dados Pubmed, Scielo e BVS (Biblioteca Virtual em Saúde), além da busca no Google Acadêmico. Não foi aplicado nenhum limite temporal, nem restrição de idioma, como forma de abranger a maioria quantidade de trabalhos sobre o tema. Foram excluídos estudos que se distanciavam do objetivo desta revi são, bem como estudos de casos. Resultados e discussão: A ROG se consolida como uma técnica de preservação óssea e o seu princípio se relaciona com a osteopromoção. A fim de melhorar a capacidade de formação de osso, as membranas têm sido utilizadas como barreiras que guiam a cicatrização óssea e auxiliando na preservação do osso alveolar. Considerações finais: O uso da membrana não reabsorvível é muito viável e promissor na ROG em alvéolos pós-extração, com evidência em sua vantagem de preservação alveolar significativa... (AU)


Introduction: Dimensional changes in the alveolar process after tooth extraction is an undesirable natural and physiological consequence, which may make it difficult to place a dental implant in the desired posi tion. Therefore, Guided Bone Regeneration (ROG) has an important role in preventing bone loss. Objective: To understand the effectiveness of the use of non-absorbable membranes in the ROG of extraction sock ets. Methodology: The research was carried out in the databases Pubmed, Scielo and BVS (Virtual Health Library), in addition to the Google Scholar search. No time limit or language restriction was applied, as a way to cover the majority of works on the topic. Studies that differed from the objective of this review were excluded, as well as case studies. Results and discussion: ROG consolidates itself as a bone preservation technique and its principle is related to osteopromotion. In order to improve bone formation capacity, membranes have been used as barriers that guide bone healing and assist in the preservation of alveolar bone. Final considerations: The use of the non-resorbable membrane is very feasible and promising in ROG in post-extraction sockets, with evidence of its significant alveolar preservation advantage... (AU)


Subject(s)
Bone Regeneration , Guided Tissue Regeneration , Membranes
4.
Medisan ; 25(2)mar.-abr. 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1250340

ABSTRACT

Introducción: El uso de plasma rico en plaquetas para la regeneración de defectos óseos periodontales constituye una terapéutica eficaz. Objetivo: Identificar la evolución de pacientes con lesiones endoperiodontales tratados con plasma rico en plaquetas. Métodos: Se realizó un estudio observacional, descriptivo y longitudinal de 11 adultos con enfermedad endoperiodontal y tratamiento endodóntico finalizado, atendidos en la consulta de Periodoncia y Medicina Regenerativa del Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, desde febrero del 2018 hasta diciembre del 2019, quienes requerían intervención quirúrgica periodontal y cumplían los criterios para recibir plasma rico en plaquetas. A tal efecto, se analizaron variables sociodemográficas, clínicas, radiográficas y de respuesta terapéutica, las que fueron expresadas estadísticamente por medio de frecuencias absolutas y relativas y de la media aritmética. Resultados: En la serie resultaron más frecuentes, antes de la terapia, el sangrado al sondaje (81,8 %), las características alteradas de las encías (72,7 %), la movilidad dentaria (72,7 %) y las bolsas periodontales de 7 a 9 milímetros, con pérdida ósea en el tercio apical (63,6 %); todo lo cual se revirtió a menores porcentajes luego de 6 meses de tratamiento. Conclusiones: La evolución de los pacientes afectados por lesiones periodontales fue satisfactoria con el empleo del plasma rico en plaquetas, lo que se evidenció clínica y radiográficamente.


Introduction: The use of platelets rich-plasm for the regeneration of periodontal bony defects constitutes an effective therapy. Objective: To identify the clinical course of patients with endoperiodontal lesions treated with platelets rich-plasm. Methods: An observational, descriptive and longitudinal study of 11 adults with endoperiodontal disease and concluded endodontics treatment was carried out. They were assisted in the Periodontics and Regenerative Medicine Service of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba, from February, 2018 to December, 2019; who required periodontal surgical intervention and fulfilled the approaches to receive platelets rich-plasm. To such an effect, sociodemographic, clinical, radiographic and of therapeutic response variables were analyzed, which were statistically expressed by means of absolute and relative frequencies and of mean arithmetic. Results: In the series, bleeding on probing (81.8 %), altered characteristics of the gums (72.7 %), dental mobility (72.7 %) and 7 to 9 millimeters periodontal bags, with bony loss in the third apical (63.6 %) were more frequent before therapy; all of which was reverted to lower percentages after 6 months of treatment. Conclusions: The clinical course of the patients affected by periodontal lesions was satisfactory with the use of platelets rich-plasm, which was clinical and radiographically evidenced.


Subject(s)
Periodontal Diseases/therapy , Bone Regeneration , Platelet-Rich Plasma , Periodontics , Adult , Endodontics , Prolotherapy
5.
Braz. dent. j ; 32(1): 26-33, Jan.-Feb. 2021. graf
Article in English | LILACS, BBO | ID: biblio-1180720

ABSTRACT

Abstract The limited options for bone repair have led to an extensive research of the field and the development of alloplastic and xenogeneic grafts. The purpose of this study was to evaluate bone repair with two bone substitutes: deproteinized bovine bone (DBB) and biphasic calcium phosphate ceramic (BCP) in critical-size defect. A total of 8-mm defects were made in the parietal bones of rabbits (n=12). The animals were divided into three experimental groups: sham (defect filled with a blood clot), DBB (defect filled with DBB), and BCP (defect filled with BCP). After the experimental periods of 15 and 45 days, the animals were euthanized and submitted to histomorphometric analysis. The total defect area, mineralized tissue area, biomaterial area, and soft tissue area were evaluated. A greater amount of immature bone tissue and biomaterial particles were observed in the BCP group compared to DBB and sham at 45 days (p<0.05). There was no difference in the qualitative pattern of bone deposition between DBB and BCP. However, the sham group did not show osteoid islands along with the defect, presenting a greater amount of collagen fibers as well in relation to the DBB and BCP groups. There was a greater number of inflammatory cells in the DBB at 45 days compared to BCP and sham groups. In conclusion, BCP and DBB are options for optimizing the use of bone grafts for maxillofacial rehabilitation. Bone defects treated with BCP showed greater deposition of bone tissue at 45 days.


Resumo As opções limitadas para reparo ósseo levaram ao desenvolvimento de abrangente pesquisa na área de enxertos aloplásticos e xenogênicos. O objetivo deste estudo foi avaliar o reparo ósseo com dois substitutos ósseos: osso bovino desproteinizado (DBB) e cerâmica fosfática de cálcio bifásica (BCP) em defeito de tamanho crítico. Material e métodos: defeitos críticos de 8 mm foram feitos nos ossos parietais de coelhos (n=12). Os animais foram divididos em três grupos experimentais: sham (defeito preenchido com coágulo sanguíneo), DBB (defeito preenchido com DBB) e BCP (defeito preenchido com BCP). Após os períodos experimentais de 15 e 45 dias, os animais foram sacrificados e submetidos à análise histomorfométrica. Foram avaliadas a área total de defeitos, área de tecidos mineralizados, área de biomateriais e área de tecidos moles. Resultados: maior quantidade de tecido ósseo imaturo e de partículas de biomaterial foram observados no grupo BCP em comparação aos grupos DBB e sham aos 45 dias (p<0,05). Não houve diferença no padrão qualitativo de deposição óssea entre DBB e BCP. Ainda, o grupo sham não apresentou ilhas osteóides ao longo do defeito, apresentando maior quantidade de fibras colágenas em relação aos grupos DBB e BCP. Houve maior quantidade de células inflamatórias no DBB aos 45 dias em comparação aos grupos BCP e sham. Conclusões: BCP e DBB são opções para otimizar o uso de enxertos ósseos na reabilitação de pacientes. Defeitos ósseos tratados com BCP mostraram maior deposição de tecido ósseo aos 45 dias.


Subject(s)
Animals , Rabbits , Bone Substitutes , Hydroxyapatites , Osteogenesis , Bone Matrix , Bone Regeneration , Calcium Phosphates , Cattle , Ceramics
6.
Braz. j. biol ; 81(1): 53-61, Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1153329

ABSTRACT

Abstract The aim of this study was to analyze the biological behavior and osteogenic potential of magnesium (Mg) substituted hydroxyapatite (HA) microspheres, implanted in a critical bone defect, considering that this ion is of great clinical interest, since it is closely associated with homeostasis and bone mineralization. For the purpose of this study, 30 rats were used to compose three experimental groups: GI - bone defect filled with HA microspheres; GII - bone defect filled with HA microspheres replaced with Mg; GIII - empty bone defect; evaluated at biological points of 15 and 45 days. The histological results, at 15 days, showed, in all the groups, a discrete chronic inflammatory infiltrate; biomaterials intact and surrounded by connective tissue; and bone neoformation restricted to the borders. At 45 days, in the GI and GII groups, an inflammatory response of discrete granulomatous chronic type was observed, and in the GIII there was a scarce presence of mononuclear inflammatory cells; in GI and GII, the microspheres were seen to be either intact or fragmented, surrounded by fibrous connective tissue rich in blood vessels; and discrete bone neoformation near the edges and surrounding some microspheres. In GIII, the mineralization was limited to the borders and the remaining area was filled by fibrous connective tissue. It was concluded that the biomaterials were biocompatible and osteoconductive, and the percentage of Mg used as replacement ion in the HA did not favor a greater bone neoformation in relation to the HA without the metal.


Resumo O objetivo deste estudo foi analisar o comportamento biológico de microesferas de hidroxiapatita (HA) substituída com magnésio (Mg) durante o reparo de defeito ósseo crítico, tendo em vista que este íon é de grande interesse clínico, pois está intimamente associado à homeostasia e à mineralização óssea. Para tanto, utilizou-se 30 ratos para compor três grupos experimentais: GI - defeito ósseo preenchido com microesferas de HA; GII - defeito ósseo preenchido com microesferas de HA substituída com Mg; GIII (controle) - defeito ósseo vazio; avaliados nos pontos biológicos de 15 e 45 dias. Os resultados histológicos evidenciaram, aos 15 dias, discreto infiltrado inflamatório crônico e neoformação óssea restrita às bordas, em todos os grupos. Nos grupos GI e GII, os biomateriais mantiveram-se íntegros e circundados por tecido conjuntivo frouxo. Aos 45 dias, notou-se resposta inflamatória do tipo crônica granulomatosa discreta nos grupos GI e GII, e no GIII presença escassa de células inflamatórias mononucleares. As microesferas implantadas no GI e GII mantiveram-se, em sua maioria, íntegras e envolvidas por tecido conjuntivo fibroso. Notou-se discreta neoformação óssea próxima às bordas e circunjacente a algumas microesferas. No GIII, a mineralização limitou-se às bordas e a área remanescente foi preenchida por tecido conjuntivo fibroso. Conclui-se que os biomateriais foram biocompatíveis, bioativos, osteocondutores e apresentaram biodegradação lenta, indicando seu grande potencial para em aplicações clínica como biomaterial de preenchimento.


Subject(s)
Animals , Rats , Durapatite , Magnesium , Osteogenesis , Biocompatible Materials , Bone Regeneration
7.
Arq. bras. med. vet. zootec. (Online) ; 73(1): 132-140, Jan.-Feb. 2021. ilus
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1153043

ABSTRACT

Defeitos ósseos constituem um problema de saúde global. O sistema Rigenera permite a extração de microenxertos ricos em células-tronco mesenquimais (CTMs). Objetivou-se avaliar o processo de regeneração óssea por enxertos obtidos pelo sistema Rigenera em defeitos críticos na calvária de ratos. Foram utilizados 18 ratos Wistar, machos, pesando 285±29g, distribuídos em três grupos (n=6), sendo cada animal controle de si mesmo, denominados G15-Controle e G15-Tratado (15 dias); G30-Controle e G30-Tratado (30 dias) e G60-Controle e G60-Tratado (60 dias). Foram realizadas duas lesões de 5mm de diâmetro em cada antímero da calvária. Nos grupos tratados, foram utilizados microenxertos autólogos de cartilagem xifoide, obtidos pelo sistema Rigenera. O defeito contralateral serviu como controle em todos os animais. Os animais foram eutanasiados aos 15, 30 e 60 dias após a cirurgia, e as amostras foram processadas para a histoquímica. Nos grupos controle, não foram observados sinais de regeneração óssea, enquanto nos grupos tratamento foram verificadas áreas de formação óssea e tecido mesenquimal ativado. O sistema Rigenera foi eficiente na obtenção de microenxertos autólogos, para terapia celular em defeito crítico de calvária de ratos. Com o aprimoramento do protocolo, o sistema Rigenera poderá ser amplamente utilizado no tratamento de lesões ósseas.(AU)


Bone defects are a global health problem. The Rigenera system allows the extraction of micro grafts rich in mesenchymal stem cells (MSCs). The objective of this study was to evaluate the bone regeneration process by grafts obtained by the Rigenera system in defects in the rats calvarian. Eighteen male Wistar rats were used, weighing 285 ± 29g, distributed in three groups (n = 6), where each animal was treatment and control, called G15-Control and G15-Treated (15 days); G30-Control and G30-Treated (30 days) and G60-Control and G60-Treated (60 days). Two 5mm diameter lesions were performed on each calvaria side. In the treated groups, autologous micrograft from xiphoid cartilage, obtained by the Rigenera system, were used. The other defect served as a control in all animals. The animals were euthanized at 15, 30 and 60 days after the surgery and the samples were processed for histochemistry. In the control groups, no signs of bone regeneration were observed, while in the treatment groups, areas of bone formation and activated mesenchymal tissue were verified. The Rigenera system was efficient in obtaining autologous micrograft for cell therapy in a critical calvaria defect in rats. Rigenera system can be widely used in the treatment of bone injuries.(AU)


Subject(s)
Animals , Rats , Skull/injuries , Bone Regeneration , Mesenchymal Stem Cells , Craniocerebral Trauma/therapy , Craniocerebral Trauma/veterinary , Rats, Wistar/injuries , Autografts
8.
Braz. dent. sci ; 24(4, suppl 1): 1-9, 2021. ilus, tab
Article in English | LILACS, BBO | ID: biblio-1352592

ABSTRACT

Objective: Glucocorticoids induced osteoporosis and its related fragility fractures represent a costly human and socioeconomic load worldwide. All the current pharmacological therapies possess multiple adverse effects and high cost. Thus, the pesent study aimed to evaluate the bone healing ability of Moringa oleifera (MO) on glucocorticoids induced osteoporosis in the jawbone of Albino rats. Material and Methods: Osteoporosis was prompted by a daily intraperitoneal injection of 200 µg/ 100 g dexamethasone for 30 days. Next,the animals were randomly divided into 2 groups; osteoporotic and MO treated group. The treated group receivd a daily oral dose of 200mg/kg of MO. Rats from the MO group were sacrificed after 4 weeks from the beginning of treatment, and the same sacrifice date was used for the osteoporotic group. Bone regeneration was evaluated by dual energy x-ray absorptiometry (DEXA), real time polymerase chain reaction (RT-PCR), histopathological and histomorphometric examination. Results: After the sacrifice, the DEXA analysis revealed a significant upregulation in the BMD in the MO treated group (p <0.001). The RT-PCR test showed a significant decline in RANKL gene expression and a significant rise in OPG gene expression in the MO group (p < 0.001, p = 0.002, respectively). The histopathological examination of the MO group displayed a marked healing of the jawbone micro-anatomy. The histomorphometric analysis also showed that the bone area percentage increased significantly in the MO group (p <0.05). Conclusion: A cheap, easy to get, yet a powerful plant like MO leaves, can be cosidered an effective treatment for osteoporosis (AU).


Objetivos: A osteoporose induzida por glicocorticóides e suas fraturas por fragilidade relacionadas representam um custo humano caro e carga socioeconômica em todo o mundo. Todas as terapias farmacológicas atuais possuem múltiplos efeitos adversos e alto custo. Assim, o presente estudo teve como objetivo avaliar a capacidade de cicatrização óssea de Moringa oleifera (MO) em osteoporose induzida na mandíbula de ratos albinos. Material e Métodos: A osteoporose foi induzida por uma injeção intraperitoneal diária de 200 µg / 100 g de dexametasona por 30 dias. A seguir, os animais foram divididos aleatoriamente em 2 grupos; grupo tratado com osteoporose e MO. O grupo tratado recebeu uma diária dose oral de 200 mg / kg de MO. Os ratos do grupo MO foram eutanasiados após 4 semanas do início do tratamento, e a mesma data de eutanásia foi usada para o grupo osteoporótico. A regeneração óssea foi avaliada por espectrometria de raio-x de energia dupla (DEXA), reação em cadeia da polimerase em tempo real (RT-PCR), análise histopatológica e histomorfométrica. Resultados: Após a eutanásia, a análise DEXA revelou uma regulação positiva significativa na DMO no grupo tratado com MO (p <0,001). O teste RT-PCR mostrou um declínio significativo na expressão do gene RANKL e um aumento significativo na expressão do gene OPG no grupo MO (p <0,001, p = 0,002, respectivamente). O exame histopatológico do grupo MO revelou uma cicatrização acentuada da microanatomia do maxilar. A análise histomorfométrica também mostrou aumento significativo na porcentagem de área óssea no grupo MO (p <0,05). Conclusão: A MO é uma planta barata, de fácil obtenção, e suas folhas ainda podem ser consideradas poderosas como tratamento eficaz para a osteoporose. (AU)


Subject(s)
Animals , Rats , Osteoporosis , Bone Regeneration , Moringa oleifera , Glucocorticoids
9.
J. appl. oral sci ; 29: e20201092, 2021. tab, graf
Article in English | LILACS | ID: biblio-1340095

ABSTRACT

Abstract Objective This study sought to compare the biocompatibility of a three-dimensional (3D)-printed titanium implant with a conventional machined titanium product, as well as the effect of such implant applied with recombinant human Bone Morphogenetic Protein Type 2 (rhBMP-2) for guided bone regeneration. Methodology Disk-shaped titanium specimens fabricated either by the conventional machining technique or by the 3D-printing technique were compared by MC3T3-E1 cells cytotoxicity assay. New bone formation was evaluated using a rapid prototype titanium cap applied to the calvaria of 10 rabbits, which were divided into two groups: one including an atelopeptide collagen plug on one side of the cap (group I) and the other including a plug with rhBMP-2 on the other side (group II). At six and 12 weeks after euthanasia, rabbits calvaria underwent morphometric analysis through radiological and histological examination. Results Through the cytotoxicity assay, we identified a significantly higher number of MC3T3-E1 cells in the 3D-printed specimen when compared to the machined specimen after 48 hours of culture. Moreover, morphometric analysis indicated significantly greater bone formation at week 12 on the side where rhBMP-2 was applied when evaluating the upper portion immediately below the cap. Conclusion The results suggest that 3D-printed titanium implant applied with rhBMP-2 enables new bone formation.


Subject(s)
Animals , Osteogenesis , Titanium , Rabbits , Skull/surgery , Bone Regeneration , Recombinant Proteins , Transforming Growth Factor beta , Bone Morphogenetic Protein 2 , Printing, Three-Dimensional
10.
São José dos Campos; s.n; 2021. 82 p. ilus, graf, tab.
Thesis in Portuguese | LILACS, BBO | ID: biblio-1362109

ABSTRACT

Os materiais biocerâmicos são promissores em cirurgias de substituição óssea, tanto para aplicações odontológicas quanto ortopédicas. Estes materiais apresentam excelente compatibilidade biológica, osteocondutividade, degradação, além de exibirem atividade antimicrobiana. Neste presente trabalho, o objetivo foi avaliar in vitro a efetividade de scaffolds ß-fosfato tricálcico (ß-TCP) incorporado com biovidro (S53P4), produzidos por meio do processo de gel casting, na atividade celular, diferenciação osteoblástica e ação antibacteriana sobre biofilmes monotípicos, e avaliar in vivo seu efeito sobre a neoformação óssea. Os scaffolds foram confeccionados com diferentes materiais: a) ß-TCP; b) ß-TCP incorporado com biovidro. Na etapa in vitro, foram realizados os testes de MTT, proteína total, atividade de fosfatase alcalina, nódulos de mineralização, interação celular e expressão dos genes relacionados à osteogênese por RT-PCR. Na etapa in vivo, dois scaffolds de cada biomaterial foram implantados nas tíbias direita e esquerda de coelhos. Após 21 dias, os animais foram eutanasiados e a neoformação óssea foi avaliada por meio de análise histológica e análise histomorfométrica. Por fim, avaliou a formação de biofilmes em cepas de Candida albicans, Pseudomonas aeruginosa e Staphylococcus aureus. Os resultados in vitro, mostraram que os scaffolds ß-TCP/S53P4 não apresentaram efeito citotóxico e permitiram a interação de células de aspecto alongado sobre os scaffolds. Na avaliação da proteína total os scaffolds ß-TCP/S53P4 apresentaram valores mais altos, sendo significativamente maior em comparação ao ß-TCP (p<0,05) no período de 7 dias. Na atividade de fosfatase alcalina, os scaffolds foram semelhantes estatisticamente (p>0,05). Na quantificação de nódulos de mineralização, os scaffolds ß-TCP/S53P4 expressaram maior quantidade de nódulos de mineralização com diferença estatística significativa (p<0,05) com os scaffolds ß-TCP. No período de 7 dias, os genes osteopontina (Osp), fator relacionado ao Runt (Runx2), osteocalcina (Bglap), fator estimulador de colônias de macrófagos (M-csf), prostaglandina E2 (PgE2), osteonectina (Osn) e fator de crescimento de transformador Beta (Tgf-ß1) foram expressos em todos os scaffolds, sem diferença estatística entre os grupos (p>0,05). Contudo a expressão de integrina ß1 (Itg ß1) no scaffold ß-TCP foi maior do que no scaffold ß-TCP/S53P4, diferindo estatisticamente (p<0,05), houve maior expressão de colágeno I (Col-1) em ß-TCP/S53P4 com diferença estatística (p<0,05). Os defeitos preenchidos por ß-TCP/S53P4 tiveram maior formação e preenchimento por tecido ósseo neoformado (p<0,05) conforme a análise histomorfométrica. ß-TCP/S53P4 inibiu o crescimento bacteriano e fúngico em comparação ao ß-TCP (p<0,05). Desse modo, os resultados confirmam a capacidade osteogênica da cerâmica ß-TCP e sugere que após a incorporação do biovidro S53P4, pode reduzir infecções microbianas. O novo biomaterial demonstrou-se um excelente material para aplicação na engenharia de tecido ósseo.


Bioceramic materials are promising in bone replacement surgeries, both for dental and orthopedic applications. These materials have excellent biological compatibility, osteoconductivity, degradation, in addition to exhibiting antimicrobial activity. The objective of this study was to investigate the effects of bioglass (S53P4) incorporated into ß-tricalcium phosphate (ß-TCP) scaffolds on cell activity, osteoblast differentiation and antibacterial activity in monotypic biofilms in vitro, and to evaluate the influence of this new biomaterial on in vivo bone neoformation. The scaffolds were made with different materials: a) ß-TCP; b) ß-TCP incorporated with bioglass. MTT test, total protein, alkaline phosphatase activity, mineralization nodules, cell interaction and expression of genes related to osteogenesis by RT-PCR were performed. Two scaffolds of each biomaterial were implanted in the right and left tibiae of rabbits. After 21 days, the animals were euthanized and bone neoformation was evaluated through histological and histomorphometric analysis. Finally, the formation of biofilms in Candida albicans, Pseudomonas aeruginosa and Staphylococcus aureus strains. The in vitro results showed that the ß-TCP/S53P4 scaffolds did not show cytotoxic effect and allowed the interaction of elongated cells on the scaffolds. In the evaluation of total protein, the ß-TCP/S53P4 scaffolds showed better results, being significantly higher compared to ß-TCP (p<0.05) in the 7-day period. In alkaline phosphatase activity, the scaffolds were statistically similar (p>0.05). In the quantification of mineralization nodules, the ß-TCP/S53P4 scaffolds expressed a greater amount of mineralization nodules with a significant difference (p<0.05) with the ß-TCP scaffolds. Within 7 days, genes Osp, Runx2, Bglap, M-csf, PgE2, Osn and Tgf-ß1 were expressed in all scaffolds, with no significant difference between groups (p>0.05). The expression of Itg ß1 in the ß-TCP scaffold was higher than in the ß-TCP/S53P4 scaffold, differing statistically (p<0.05), but there was a higher expression of Col-1 in ß-TCP/S53P4 with statistical difference (p<0.05). In the histological analysis, neoformed bone tissue filling the defect was observed in both scaffolds, but greater formation was observed in ß-TCP/S53P4 (p<0.05). ßTCP/S53P4 inhibited bacterial and fungal growth compared to ß-TCP (p<0.05). Thus, the results confirm the osteogenic capacity of the ß-TCP ceramic and suggest that after its incorporation into the S53P4 bioglass, it can prevent microbial infections. An excellent biomaterial for application in bone tissue engineering


Subject(s)
Animals , Rabbits , Osteogenesis , Biocompatible Materials , Bone Regeneration
11.
Braz. dent. sci ; 24(3): 1-8, 2021. tab
Article in English | LILACS, BBO | ID: biblio-1281176

ABSTRACT

Objetivo: Avaliar os efeitos bioquímicos e histopatológicos da administração de diclofenaco e cetoprofeno na regeneração óssea em modelo de defeito calvarial em ratos. Material e Métodos: A amostra foi composta por 108 ratos Wistar que foram distribuídos aleatoriamente em três grupos, aos quais foi realizada osteotomia de 6 mm de diâmetro na calvária. O grupo A (controle) recebeu solução salina; O Grupo B recebeu 2 mg / kg de cetoprofeno e o Grupo C recebeu 2 mg / kg de diclofenaco. Todos os tratamentos foram administrados intraperitonealmente a cada 12 horas durante 3 dias. A regeneração óssea foi avaliada pelas características bioquímicas (fosfatase alcalina e cálcio sérico) e histopatológicas (contagem de osteócitos e células de osteoblastos) aos 15 e 30 dias. Resultados:Na avaliação bioquímica, os níveis de fosfatase alcalina no grupo cetoprofeno foram significativamente menores em comparação com o grupo diclofenaco em 15 e 30 dias (p= 0.015 e p= 0.001; respectivamente). No entanto, os níveis séricos de cálcio não mostraram diferença entre os grupos de estudo aos 15 e 30 dias (p= 0.42 p= 0.81; respectivamente). Na análise histopatológica, a contagem de osteoblastos e osteócitos foi significativamente menor no grupo cetoprofeno em comparação ao grupo diclofenaco aos 15 e 30 dias (p< 0,05). Conclusão: A administração de cetoprofeno tem efeitos bioquímicos e histopatológicos negativos de maior intensidade na regeneração óssea em comparação com a administração de diclofenaco. (AU)


Objective: To evaluate the biochemical and histopathological effects of diclofenac and ketoprofen administration on bone regeneration in a calvarial defect model in rats. Material and Methods: The sample consisted of 108 Wistar rats that were randomly distributed in three groups, to which an osteotomy of 6 mm in diameter was performed in the calvaria. Group A (control) was given saline solution; Group B received ketoprofen 2 mg/kg and Group C received diclofenac 2 mg/kg. All treatments were administered intraperitoneally every 12 hours for 3 days. Bone regeneration was evaluated by biochemical (alkaline phosphatase and serum calcium) and histopathological (osteocyte and osteoblast cell count) characteristics at 15 and 30 days. Results: In the biochemical evaluation, alkaline phosphatase levels in the ketoprofen group were significantly lower compared to the diclofenac group at 15 and 30 days (p= 0.015 and p= 0.001; respectively). However, serum calcium levels did not show the difference between the study groups at 15 and 30 days (p= 0.42 and p= 0.81; respectively). In the histopathological analysis, the count of osteoblasts and osteocytes was significantly lower in the ketoprofen group compared to the diclofenac group at 15 and 30 days (p< 0.05). Conclusion: The administration of ketoprofen has negative biochemical and histopathological effects of greater intensity on bone regeneration compared to the administration of diclofenac (AU)


Subject(s)
Animals , Rats , Rats , Bone Regeneration , Anti-Inflammatory Agents, Non-Steroidal , Diclofenac , Ketoprofen
12.
Braz. dent. sci ; 24(3): 1-7, 2021. ilus
Article in English | LILACS, BBO | ID: biblio-1281929

ABSTRACT

Objective: To test the ability of platelet-rich plasma clinically and radiologically for pulp regeneration of immature teeth with apical periodontitis. Material and Methods: An experimental study was conducted From (March/2018-July/2020) 12 upper central immature incisors with acute apical periodontitis and necrotic pulp from six patients receiving regenerative endodontic treatment using concentrated platelets rich plasma were performed by the same endodontist at Mediclinic Middle East Hospitals. Informed consent, including explanation of risks and alternative treatments or no treatment were prepared and filled by the patient parents. The therapeutic protocol was involved accessing the pulp chamber; irrigation copiously with sodium hypochlorite; applying calcium hydroxide as intracanal medicament and a provisionally sealing it after 4 weeks. The canal was cleaned, dried and injected with concentrated platelets rich plasma which serve as a scaffold for pulp regeneration. MTA was used to seal the chamber before final filling with composite. Evaluations: All teeth were monitored clinically (mobility, palpation, percussion, and sensitivity cold test) and radiographically. Results: Twenty months follow-up all teeth showed resolution of periapical radiolucencies, continued root development with positive response to sensitivity cold test and no discoloration. Conclusion: The results of this study confirmed the previous finding that pulp regeneration can be gained by using cPRP successfully. (AU)


Objetivo: Testar a capacidade do plasma rico em plaquetas clinicamente e radiograficamente para a regeneração pulpar em dentes imaturos com periodontite apical. Material e Métodos: O estudo experimental foi realizado em Março/2018 e Julho/2020, 12 incisivos centrais imaturos com periodontite apical aguda e necrose pulpar em 6 pacientes recebendo tratamento endodôntico regenerativo usando concentrado de plasma ricas em plaquetas. Foram realizadas pelo mesmo endodontista no Hospital Mediclinic Middle East. O consentimento informado incluindo explicação do risco e tratamentos alternativos ou de nenhum tratamento foi preenchido pelos responsáveis do paciente. O protocolo terapêutico envolveu acesso à câmara pulpar, irrigação abundante com hipoclorito de sódio, aplicação de hidróxido de cálcio como medicação intracanal e selado intracanal por 4 semanas. O canal foi limpo, seco e injetado concentrado de plasma rico em plaquetas que servem como um scaffold para a regeneração pulpar. Usou-se MTA para selar a câmara antes do preenchimento final com compósitos. Avaliações: Todos os dentes foram monitorados clinicamente (mobilidade, palpação, percussão e teste de sensibilidade com frio) e radiograficamente. Resultados: Após 20 meses de acompanhamento, todos os dentes apresentaram a resolução das radioluscências periapicais, desenvolvimento contínuo da raiz com resposta positiva ao teste de sensibilidade ao frio e sem descoloração. Conclusão: O resultado do estudo confirmou descobertas anteriores que a regeneração pulpar pode ser obtida usando cPRP com sucesso. (AU)


Subject(s)
Humans , Periodontitis , Bone Regeneration , Platelet-Rich Plasma
13.
Braz. j. med. biol. res ; 54(9): e11055, 2021. tab, graf
Article in English | LILACS | ID: biblio-1278585

ABSTRACT

Because bone-associated diseases are increasing, a variety of tissue engineering approaches with bone regeneration purposes have been proposed over the last years. Bone tissue provides a number of important physiological and structural functions in the human body, being essential for hematopoietic maintenance and for providing support and protection of vital organs. Therefore, efforts to develop the ideal scaffold which is able to guide the bone regeneration processes is a relevant target for tissue engineering researchers. Several techniques have been used for scaffolding approaches, such as diverse types of biomaterials. On the other hand, metallic biomaterials are widely used as support devices in dentistry and orthopedics, constituting an important complement for the scaffolds. Hence, the aim of this review is to provide an overview of the degradable biomaterials and metal biomaterials proposed for bone regeneration in the orthopedic and dentistry fields in the last years.


Subject(s)
Humans , Orthopedics , Biocompatible Materials , Bone Regeneration , Tissue Engineering , Dentistry , Tissue Scaffolds
14.
Braz. dent. sci ; 24(1): 1-7, 2021. ilus
Article in English | LILACS, BBO | ID: biblio-1145574

ABSTRACT

Generalized stage IV, grade C periodontitis results in rapid bone destruction in the periodontium and can lead to early tooth loss. Scaling and root planing (SRP) complemented by systemic antibiotics, access surgery, regenerative techniques and implant placement are among the treatments used for patients with this condition. The aim of this article is to report a comprehensive periodontal treatment in a 23-year-old male who was referred to the periodontology department due to complaints of tooth mobility and gum infections diagnosed with generalized stage IV, grade C periodontitis according to the clinical, systemic, and family history features observed. Thorough non-surgical periodontal treatment consisting of scaling and root planing was provided, followed by a series of regenerative periodontal surgeries including guided tissue regeneration (GTR) and guided bone regeneration(GBR) to manage advanced bone defects. Six months after periodontal therapy, all implants were inserted using a one-stage approach and Six months later, they were restored with porcelain fused to metal crowns. During the one and two-year follow-ups, the teeth and implants did not show any signs of instability, attachment loss or bone loss. This case report shows that within the limitations of this study a successful outcome can be achieved with an early diagnosis and treatment involving elimination of infectious microorganisms and meticulous long-term maintenance combined with regenerative techniques and implant placement to restore the masticatory function and improve the quality of life for the patient. However further investigation and clinical studies are required to confirm these results (AU)


A periodontite generalizada estágio IV, grau C resulta em rápida destruição óssea do periodonto, podendo levar à perda dentária precoce. Raspagem e aplainamento radicular (SRP) complementada com antibióticos sistêmicos, acessos cirúrgicos, técnicas regenerativas e colocação de implantes estão entre os tratamentos usados para essa condição. O objetivo deste artigo é relatar o tratamento periodontal abrangente de um paciente de 23 anos, que foi encaminhado ao departamento de periodontia com queixas de mobilidade dentária e infecções gengivais, diagnosticado com periodontite generalizada estágio IV, grau C de acordo com as características clínicas, sistêmicas e de histórico familiar observadas. O tratamento periodontal não cirúrgico completo de raspagem e aplainamento radicular foi realizado, seguido por cirurgias periodontais regenerativas, incluindo regeneração tecidual guiada (GTR) e regeneração óssea guiada (GBR) para tratar defeitos ósseos avançados. Seis meses após a terapia periodontal, todos os implantes foram inseridos através de abordagem de estágio único e, seis meses depois, foram restaurados com porcelana fundida às coroas de metal. Durante os acompanhamentos de um e dois anos, os dentes e implantes não mostraram quaisquer sinais de instabilidade, perda de inserção ou perda óssea. Este relato mostra que, dentro das limitações deste estudo, um resultado bem-sucedido pode ser alcançado a partir de diagnóstico precoce e tratamento envolvendo a eliminação de microrganismos e manutenção meticulosa à longo prazo, combinada com técnicas regenerativas e colocação de implantes para restaurar a função mastigatória e melhorar a qualidade de vida do paciente. No entanto, mais investigações e estudos clínicos são necessários para confirmar esses resultados (AU)


Subject(s)
Humans , Adult , Periodontitis , Aggressive Periodontitis , Bone Regeneration , Dental Implants
15.
Article in English | WPRIM | ID: wpr-922463

ABSTRACT

Guided bone regeneration (GBR) uses resorbable and non-resorbable membranes as biological barriers. This study compared the differences in hard tissue stability between GBR using evidence-based digital titanium mesh and resorbable collagen membranes during implant placement. A total of 40 patients (65 implant sites) were enrolled and divided into two groups: resorbable membrane and digital titanium mesh groups. The alveolar bone was analyzed at two- and three-dimensional levels using cone-beam computed tomography and by reconstructing and superimposing the hard tissues at four time points: preoperatively, postoperatively, before second-stage surgery, and 1 year after loading. The use of digital titanium mesh showed less alveolar bone resorption in vertical and horizontal directions two-dimensionally before the second-stage surgery and 1 year after loading. Regarding volumetric stability, the percentage of resorption after 6 months of healing with resorbable membrane coverage reached 37.5%. However, it was only 23.4% with titanium mesh. Although postoperative bone volume was greater at all labial sites with resorbable membrane than with digital titanium mesh, after substantial bone resorption within 1 year of loading, the labial bone thickness at the upper part of implants was thinner with resorbable membrane than with digital titanium mesh. Furthermore, digital titanium meshes made according to ideal bone arch contour reduced soft tissue irritation, and the exposure rate was only 10%. Therefore, although both resorbable membrane and digital titanium mesh in GBR were able to successfully reconstruct the bone defect, digital titanium meshes were better at maintaining the hard tissue volume in the osteogenic space.


Subject(s)
Bone Regeneration , Bone Resorption , Humans , Osteogenesis , Surgical Mesh , Titanium
16.
Article in English | WPRIM | ID: wpr-921386

ABSTRACT

OBJECTIVES@#To observe the effect of type 2 diabetes mellitus (T2DM) on mandibular bone regeneration and the expression of factors related to T helper cell 17 (Th17 cell) and regulatory T cell (Treg cell) in mice.@*METHODS@#Thirty-six 6-week-old C57BL/6J male mice were randomly divided into normal control (NC) and T2DM groups. Fasting blood glucose levels were detected 0 d, 7 d, 14 d, and 28 d after surgery for mandibular defects. Hematoxylin-eosin (HE) staining was used in observing the bone after 7 d, 14 d, and 28 d of the healing process. Immunohistochemical staining was used in observing the expression of alkaline phosphatase (ALP), Runt-related transcription factor 2 (RUNX2), forkhead box protein P3 (Foxp3), retinoic acid related orphan receptor gamma T (RORγt), and protein tyrosine phosphatase non-receptor type 2 (PTPN2) after 7 d, 14 d, and 28 d of healing.@*RESULTS@#HE staining showed that the area with new bones in the T2DM group was significantly smaller than that in the NC group. Immunohistochemical staining showed that the expression of osteogenesis related proteins ALP and RUNX2 were significantly reduced in the T2DM group. In addition, the number of RORγt positive cells increased, whereas the number of Foxp3 positive cells and the expression PTPN2 decreased significantly in the mandibular bone defect in mice with T2DM.@*CONCLUSIONS@#T2DM significantly inhibit mandibular bone regeneration in mice. Decline in PTPN2 expression and the transition of Treg and Th17 may be the underlying molecular mechanisms.


Subject(s)
Animals , Bone Regeneration , Diabetes Mellitus, Type 2 , Forkhead Transcription Factors , Male , Mice , Mice, Inbred C57BL , TCF Transcription Factors , Th17 Cells
17.
Article in English | WPRIM | ID: wpr-921384

ABSTRACT

Framework nucleic acid (FNA) is a set of DNA nanostructures characterized by the framework morphology. It can design rational DNA sequences and follow the principle of complementary base pairing to construct FNA. The recent discovery of FNA constructed by DNA nanotechnology has great application potential in the field of bone regene-ration. It plays a positive role in the osteogenic differentiation of stem cells, bone regeneration, vascular regeneration, neuromodulation, immune regulation, and drug delivery. Here, we reviewed the current study findings on FNA in the field of bone regeneration.


Subject(s)
Bone Regeneration , Nanostructures , Nanotechnology , Nucleic Acids , Osteogenesis , Tissue Engineering
18.
Article in English | WPRIM | ID: wpr-888704

ABSTRACT

Nanomaterial-based drug sustainable release systems have been tentatively applied to bone regeneration. They, however, still face disadvantages of high toxicity, low biocompatibility, and low drug-load capacity. In view of the low toxicity and high biocompatibility of polymer nanomaterials and the excellent load capacity of hollow nanomaterials with high specific surface area, we evaluated the hollow polydopamine nanoparticles (HPDA NPs), in order to find an optimal system to effectively deliver the osteogenic drugs to improve treatment of bone defect. Data demonstrated that the HPDA NPs synthesized herein could efficiently load four types of osteogenic drugs and the drugs can effectively release from the HPDA NPs for a relatively longer time in vitro and in vivo with low toxicity and high biocompatibility. Results of qRT-PCR, ALP, and alizarin red S staining showed that drugs released from the HPDA NPs could promote osteogenic differentiation and proliferation of rat bone marrow mesenchymal stem cells (rBMSCs) in vitro. Image data from micro-CT and H&E staining showed that all four osteogenic drugs released from the HPDA NPs effectively promoted bone regeneration in the defect of tooth extraction fossa in vivo, especially tacrolimus. These results suggest that the HPDA NPs, the biodegradable hollow polymer nanoparticles with high drug load rate and sustainable release ability, have good prospect to treat the bone defect in future clinical practice.


Subject(s)
Animals , Bone Regeneration , Indoles , Nanoparticles , Osteogenesis , Pharmaceutical Preparations , Polymers , Rats
19.
Article in English | WPRIM | ID: wpr-887763

ABSTRACT

Long-term missing teeth can lead to alveolar bone loss in the edentulous area. Guided bone regeneration (GBR) is a bone augmentation method. It is widely used in clinical practice and broadens the indications of orthodontic treatment to a certain extent. This article reports a case of an adult patient with edentulous space in the maxillary central incisor, which was successfully closed through orthodontic treatment combined with GBR. This study will provide a re-ference for future clinical work.


Subject(s)
Adult , Alveolar Bone Loss , Anodontia , Bone Regeneration , Humans , Incisor , Maxilla , Orthodontic Space Closure
20.
Article in Chinese | WPRIM | ID: wpr-878420

ABSTRACT

Oromaxillofacial hard tissue defects is still a difficult problem in clinical treatment. Regeneration of oromaxillofacial hard tissue based on tissue engineering technology has a good clinical application prospect. The functional modification of scaffolds is one of key factors that influence the outcome of tissue regeneration. The biomimetic design of biomaterials through simulating the natural structure and composition of oromaxillofacial hard tissue has gradually become a research hotspot due to its advantages of simplicity and efficiency. In this article, the biomimetic modification of biomaterials for oromaxillofacial hard tissue regeneration is reviewed, expecting to provide a new idea for the treatment of oromaxillofacial hard tissue defect.


Subject(s)
Biocompatible Materials , Biomimetics , Bone Regeneration , Dental Implants , Tissue Engineering , Tissue Scaffolds
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