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1.
Int. j. med. surg. sci. (Print) ; 8(3): 1-9, sept. 2021. ilus
Article in English | LILACS | ID: biblio-1292570

ABSTRACT

Ossifying Fibroma is a gingival mass in which calcified foci are found. It is a nodular lesion that involves the inserted and interdental gum. There is a predilection for the female sex and for the anterior region of the maxilla. This work aims to report the surgical management of a Ossifying Fibroma in the maxilla and the immediate reconstructive with autogenous graft. Female patient, in the third decade of life, presenting Ossifying Fibroma in the region between maxillary incisors and premolars. She was treated surgically by means of marginal resection of the lesion under general anesthesia and immediate reconstruction with autologous iliac crest graft. Followed up for 12 months with no signs of recurrence.


El Fibroma osificante es una masa gingival en la que se encuentran focos calcificados. Es una lesión nodular que involucra la encía adherida e interdentaria. Hay una predilección por el sexo femenino y por la región anterior del maxilar. Este trabajo tiene como objetivo informar sobre el manejo quirúrgico de un fibroma osificante periférico en el maxilar y su reconstrucción inmediata con injerto autógeno. Paciente de sexo femenino, en la tercera década de vida, presenta un Fibroma osificante en la región entre incisivos maxilares y premolares. Fue tratada quirúrgicamente por medio de una resección marginal de la lesión bajo anestesia general y reconstrucción inmediata con injerto de cresta ilíaca autóloga. Seguimiento durante 12 meses sin signos de recurrencia.


Subject(s)
Humans , Adult , Cementoma/surgery , Radiography, Panoramic , Cementoma/diagnostic imaging , Bone Transplantation/methods , Cone-Beam Computed Tomography
2.
Artrosc. (B. Aires) ; 28(1): 62-68, 2021.
Article in Spanish | LILACS, BINACIS | ID: biblio-1252448

ABSTRACT

Introducción: El objetivo de nuestro trabajo es evaluar la evolución clínica, la condroprotección y la reacción inmunológica del trasplante de menisco (TM) con aloinjerto gama irradiado (GI) versus fresco congelado (FC) a veinticuatro meses. Materiales y métodos: veinte TM mediales en veinte pacientes, se evaluaron escalas de rodilla, Mapeo-T2 y segunda vista artroscópica, así como identificación de reacciones inmunológicas con la medición de citocinas inflamatorias por PCR en sangre y líquido sinovial. Trece trasplantes con injerto FC y siete GI, edad promedio de treinta y dos años. Resultados: mejoría significativa en escalas a veinticuatro meses: KOOS (dolor 67.80/79.30; síntomas 60.80/82.10; AVD 8.05/92.40; deportes 37/63.35; CV 28.90/71.30), Lysholm (62.20/85.80), IKDCs (50.17/72.12), EVA (3.35/0.4). El cartílago del compartimento trasplantado se mantuvo dentro de valores normales, sin diferencia a los veinticuatro meses (fémur: 33.43 versus 33.50 ms, p = 0.16) (tibia: 33.57 versus 34.35 ms, p = 0.21). Todos los pacientes mostraron integridad del injerto a los doce meses en la segunda vista artroscópica. Solo se observó aumento en las citoquinas plasmáticas IL-6 e IL-17 en un paciente del grupo GI, sin repercusión clínica. Conclusiones: mejoría clínica, adecuada integración y condroprotección significativa a veinticuatro meses en ambos tipos de injertos


Introduction: Our objective is to evaluate the clinical course, chondroprotection and immunological reaction of meniscus transplantation (TM) with gamma irradiated (GI) versus fresh frozen (FC) allograft at twenty-four months. Materials and methods: twenty medial TMs in twenty patients, knee scales, T2-mapping and second arthroscopic view were evaluated, as well as identification of immunological reactions with the measurement of inflammatory cytokines by PCR in blood and synovial fluid. Thirteen transplants with FC graft and seven GI grafts, average age of thirty-two years. Results: significant improvement on scales at twenty-four months: KOOS (pain 67.80 / 79.30; symptoms 60.80 / 82.10; AVD 8.05 / 92.40; sports 37 / 63.35; CV 28.90 / 71.30), Lysholm (62.20 / 85.80), IKDCs (50.17 / 72.12), EVA (3.35 / 0.4). The cartilage of the transplanted compartment remained within normal values, with no difference at twenty-four months (femur: 33.43 versus 33.50 ms, p = 0.16) (tibia: 33.57 versus 34.35 ms, p = 0.21). Conclusions: all patients showed integrity of the graft at twelve months in the second arthroscopic view. An increase in plasma cytokines IL-6 and IL-17 was only observed in one patient in the GI group, without clinical repercussion. Clinical improvement, adequate integration and significant chondroprotection at twenty-four months in both types of grafts


Subject(s)
Adult , Cartilage, Articular , Bone Transplantation/methods , Allografts , Tibial Meniscus Injuries/surgery , Knee Joint/surgery
3.
Int. j. odontostomatol. (Print) ; 14(4): 678-684, dic. 2020. graf
Article in English | LILACS | ID: biblio-1134557

ABSTRACT

ABSTRACT: The present study aims to describe, through a case report, the functioning of bone grafts, where they are obtained including bone banks and the different dental areas in which it is used. A 50-year.old female patient HMR, sought the postgraduate college of dentistry CECAPE for oral rehabilitation. The initial clinical examination revealed the absence of several dental elements in both the maxilla and mandi ble, bone resorption in the entire maxillary extension where there was an absence of elements in the anterior region and the presence of a torus in the palatal region. Initial tomographic examinations of the maxilla and mandible were performed, looking for the best conduct regarding the diagnosis and planning of the case. After the clinical and radiographic examinations was performed, and the diagnosis was reached, it was determined as a treatment for oral rehabilitation of the maxilla, bone grafting and an Implant-supported Removable Partial Prosthesis and for the mandible a Dento-muco-supported Removable Partial Prosthesis. Dental treatments and oral rehabilitation from the use of bone tissues and bone grafting have become commonly used. Procedures that would normally lead to failure started to increase the percentage of successes due to the use of these biomaterials. The use of bone grafts in dentistry has been shown to be a very effective and useful resource, considering its great applicability in bone reconstructions in different areas of dentistry.


RESUMEN: El presente estudio tiene como objetivo describir a través de un informe de caso, el funcionamiento de los injertos óseos, donde se obtienen, incluidos los bancos de huesos y las diferentes áreas dentales en las que se emplea. Una paciente HMR, de 50 años de edad, asistió el centro universitario de posgrado CECAPE para rehabilitación oral. El examen clínico inicial reveló la ausencia de varios dientes tanto en el maxilar como en la mandíbula, la resorción ósea en toda la extensión maxilar donde había ausencia de dientes en la región anterior y la presencia de un torus en la región palatina. Se realizaron exámenes tomográficos iniciales del maxilar y mandíbula, buscando la mejor conducta con respecto al diagnóstico y la planificación del caso. Después de los exámenes clínicos y radiográficos realizados y el diagnóstico listo, se determinó como un tratamiento para la rehabilitación oral del maxilar, el injerto óseo y una prótesis removible implantosoportada y para la mandíbula una prótesis parcial removible dento-muco-soportada. Los tratamientos dentales y la rehabilitación oral a partir del uso de tejidos óseos y el injerto óseo se han utilizado comúnmente. Los procedimientos que normalmente conducirían al fracaso comenzaron a aumentar el porcentaje de éxitos debido al uso de estos biomateriales. Se ha demostrado que el uso de injertos óseos en odontología es un recurso muy eficaz y útil, considerando su gran aplicabilidad en las reconstrucciones óseas en diferentes áreas de la odontología.


Subject(s)
Humans , Female , Middle Aged , Bone Transplantation/methods , Dental Implantation, Endosseous/methods , Bone-Implant Interface/diagnostic imaging , Tomography, X-Ray Computed , Mandible/diagnostic imaging , Mouth Rehabilitation
4.
Rev. cuba. ortop. traumatol ; 34(2): e295, jul.-dic. 2020. tab, ilus
Article in Spanish | LILACS, CUMED | ID: biblio-1156591

ABSTRACT

RESUMEN Introducción: Las pseudoartrosis diafisarias de cúbito y radio constituyen un desafío terapéutico para el cirujano ortopédico, a causa de la dificultad para lograr y mantener la reducción de dos huesos paralelos en presencia de músculos pronadores y supinadores que ejercen influencias angulares y rotacionales. Objetivo: Evaluar la eficacia de la aplicación del minifijador externo combinado con el injerto óseo homólogo en esta afección. Métodos: Se realizó un estudio longitudinal, retrospectivo de corte transversal en 74 pacientes operados de pseudoartrosis diafisaria de cúbito y radio desde enero de 2000 hasta diciembre de 2014, en el Complejo Científico Ortopédico Internacional Frank País, en los que se utilizó el modelo de minifijación externa RALCA® e injerto óseo homólogo del Banco de Tejidos ORTOP. Resultados: La pseudoartrosis fue más frecuente en hombres (73 por ciento) y en las edades comprendidas entre 30 y 39 años. La localización más frecuente fue en el cúbito, en su tercio superior (52 por ciento). La mayoría de los pacientes presentaron una pseudoartrosis no viable (56 por ciento). Se consolidó en 66 por ciento de los pacientes antes de las 18 semanas y en solo uno no se obtuvo la consolidación. El hueso que menos tiempo requirió para consolidar fue el radio. En la evaluación de la eficacia de la técnica quirúrgica se obtuvo 62 por ciento de resultados buenos, 33 por ciento regulares y 5 por ciento malos. Conclusiones: La asociación de la minifijación externa modelo RALCA® e injerto óseo homólogo de banco mostró buenos resultados en el tratamiento de la pseudoartrosis de cúbito y radio(AU)


ABSTRACT Introduction: Diaphyseal pseudoarthroses of the ulna and radius constitute a therapeutic challenge for the orthopedic surgeon, due to the difficulty to achieve and maintain the reduction of two parallel bones in the presence of pronator and supinator muscles that exert angular and rotational influences. Objective: To evaluate the effectiveness of using external minifixator combined with homologous bone graft in the treatment of this condition. Method: A longitudinal, retrospective and cross-sectional study was carried out with 74 patients operated on, from January 2000 to December 2014, for diaphyseal pseudoarthrosis of the ulna or radius at Frank País International Orthopedic Scientific Complex, cases in which RALCA® external minifixation and homologous bone graft from the ORTOP Tissue Bank were used. Results: Pseudoarthrosis was more frequent in men (73 percent) and at ages 30-39 years. The most frequent location was the ulna, in its upper third (52 percent). Most of the patients had nonviable pseudoarthrosis (56 percent). The condition was consolidated in 66 percent of the patients within 18 weeks, and only one did not achieve consolidation. The bone that took the least time to heal was the radius. In the evaluation of the effectiveness of the surgical technique, 62% obtained good outcomes; 33 percent fair outcomes; and 5 percent, poor outcomes. Conclusions: The association of the RALCA® model miniexternal fixation and homologous bone graft from the Bank showed good outcomes in the treatment of ulna and radius pseudoarthrosis(AU)


Subject(s)
Humans , Male , Female , Pseudarthrosis/surgery , Radius Fractures/surgery , Ulna Fractures/surgery , Bone Transplantation/methods , Allografts/transplantation , Cross-Sectional Studies , Retrospective Studies , Longitudinal Studies
5.
Int. j. morphol ; 38(5): 1426-1433, oct. 2020. graf
Article in English | LILACS | ID: biblio-1134459

ABSTRACT

SUMMARY: Bone morphogenetic protein (rhBMP-2) is a powerful osteo-inductive growth factor widely used in bone reconstruction and both the vehicle used to administer it and the scaffold substrate could determine its success in clinical situations. The aim was to analyse the clinical behaviour of dental implants placed in single alveolar ridges with a horizontal deficiency in the maxillary anterior region that were reconstructed horizontally with rhBMP-2 and porous hydroxyapatite (HA). Inclusion criteria were both males and females, between the ages of 18 and 29 with single tooth loss of one upper incisor. Cone Beam Computed Tomography (CBCT) was used to take measurements prior to bone augmentation and again prior to the implant insertion. Surgery was carried out under local anaesthetic. In the primary procedure, bone substitute was introduced using porous HA and rhBMP-2; after 4 to 5 months, dental implant surgery was carried out and the implant placed; after 3 months of consolidation the provisional prosthesis was placed and then a definitive restoration was placed. Variables were analysed using the t-test with a p-value of < 0.05 in order to assess statistical significance. Thirteen subjects were included (6 females and 7 males). Bone augmentation resulted in a bone gain of 4.15mm (p=0.023), which was shown to be statistically significant. All of the grafts placed were successful and 13 implants were placed, using torques between 30 and 70N, without complications. For the final prostheses, 11 were screw retained and 2 were cemented in place. The horizontal bone augmentation using HA and rhBMP-2 is an efficient technique for single bone defects in the anterior maxillary area; clinical trials on a larger scale are needed to confirm these results.


RESUMEN: La proteína ósea morfogenética (BMP-2) es un potente osteoinductor utilizado ampliamente en técnicas reconstructivas; el vehículo de instalación es determinante en su evolución. El objetivo fue analizar el comportamiento clínico de implantes dentales instalados en rebordes alveolares únicos con deficiencia horizontal del sector anterior reconstruida horizontalmente con BMP-2 e hidroxiapatita (HA) porosa. Fueron incluidos sujetos de ambos sexos de entre 18 y 29 años, con pérdida dentaria unitaria a nivel de incisivos superiores. Se utilizó tomografía computadorizada para realizar mediciones en las etapas previa a la instalación del injerto y previo a la instalación del implante. Las cirugías fueron realizadas bajo anestesia local. En la primera intervención se realizó la instalación del injerto óseo utilizando HA porosa y BMP-2; después de 4 a 5 meses se realizó la instalación del implante dental; 3 meses después se realizó la conexión protésica y rehabilitación final. Las variables fueron estudiadas con la prueba t test considerando el valor de p< 0,05 para considerar significancia estadística. Trece sujetos fueron incluidos (6 mujeres y 7 hombres); con la reconstrucción ósea se obtuvo una ganancia ósea de 4,15mm (p=0.023) que fue estadísticamente significativo. No existió pérdida en ningún injerto realizado; se instalaron 13 implantes con torques entre 30 y 70N sin complicaciones; se realizaron prótesis fijas atornilladas en 11 casos y cementadas en 2 casos. La técnica con HA y BMP- 2 es eficiente para reconstruir defectos horizontales en perdidas unitarias del sector anterior maxilar; ensayos clínicos de mayor escala son necesarios para confirmar estos resultados.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Bone Morphogenetic Protein 2/therapeutic use , Alveolar Ridge Augmentation/methods , Hydroxyapatites/therapeutic use , Maxilla/surgery , Bone Regeneration , Tomography, X-Ray Computed , Dental Implants , Longitudinal Studies , Bone Transplantation/methods , Bone Substitutes , Alveolar Process/diagnostic imaging , Maxilla/diagnostic imaging
6.
J. appl. oral sci ; 28: e20190435, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1056593

ABSTRACT

Abstract Objective To quantify the bone volume that can be safely withdrawn from 3 donor sites: (1) the mandibular symphysis, (2) the oblique mandibular line and (3) the skullcap. Methodology For the symphysis, 200 tomographic exams were evaluated by the extension of the anterior loop of mental foramen, by the nerve, by the distance of the foramens, by the distance between the vestibular cortical and the lingual plates and by the distance between the apexes, or lower anterior teeth, and the mandibular base, using the "distance" tool of the I-CAT Vision, in the panoramic and parasagittal reformations. For the oblique line, 70 TCFC exams were analyzed retrospectively in panoramic and parasagittal reformations, evaluating the thickness of the vestibular cortical and the distance between the cortical and the mandibular canal. For the cranial bone, a hexagonal donor site located in parietal area was considered. Results The average dimensions of the bone blocks that can be safely removed from the region of the mandibular symphysis are: 32.27 mm in length, 4.87 mm in height and 4 mm in thickness, providing a volume of 628.61 mm3 available for grafting. In the oblique line, the available bone volume for grafting was 859.61 mm3. In the region of the cranial vault, multiplying the average bone thickness by the area of the hexagon, an average volume of 2,499 mm3 was obtained. Conclusions Comparing the donor sites, the bone availability in the cranial vault is 3 times greater than in the mandibular posterior region, and at least 2 times greater than in the mandibular symphysis.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Skull/transplantation , Bone Transplantation/methods , Cone-Beam Computed Tomography/methods , Transplant Donor Site , Mandible/transplantation , Skull/diagnostic imaging , Retrospective Studies , Anatomic Landmarks , Transplant Donor Site/diagnostic imaging , Cortical Bone/transplantation , Cortical Bone/diagnostic imaging , Mandible/diagnostic imaging , Medical Illustration
7.
Artrosc. (B. Aires) ; 27(1): 26-35, 2020.
Article in Spanish | LILACS, BINACIS | ID: biblio-1118180

ABSTRACT

El trasplante meniscal autólogo (TMA) es el tratamiento de elección en el síndrome postmeniscectomía, sin embargo, sigue siendo un procedimiento limitado, existiendo controversias en la literatura. No se encontraron reportes de TMA en pacientes y centros latinoamericanos, lo que imposibilita sustentar una conducta en base a literatura local. El objetivo de este estudio es revisar los aspectos más importantes del TMA, detallar una de las técnicas quirúrgicas más utilizadas y describir y discutir los resultados de una serie de casos consecutivos de pacientes tratados con TMA en un país latinoamericano. Se describe la técnica quirúrgica para un TMA lateral con fijación ósea a través de canal trapezoidal ("Keyhole") que ofrece ventajas para los TMA laterales, pues las raíces son muy cercanas entre ellas y el canal tiene una fijación "pressfit" disminuyendo el stress en las suturas sin la necesidad de realizar túneles óseos, que podrían interferir con procedimientos asociados.Se incluyen los resultados demográficos, clínicos, funcionales y de satisfacción de una serie retrospectiva de 16 pacientes [18 trasplantes (12 laterales y 6 mediales)] consecutivos [mediana de edad 20,5 (15-37)], operados de TMA por un mismo cirujano, entre 2004-2019, con mediana de seguimiento de 3,3 (0,5-14,8) años. No se excluyeron pacientes. Los datos fueron obtenidos a través de revisión de fichas clínicas y encuestas telefónicas. Se realizó un análisis estadístico que incluyó un test multivariado buscando asociaciones entre las variables, Wilcoxon para resultados funcionales y Kaplan-Meier para sobrevida del trasplante (reintervenciones) (p<0,05). Los resultados de esta primera serie de TMA en Latinoamérica son discutidos y se comparan con la literatura, encontrándose resultados similares a lo reportado en otras regiones y concuerdan con lo esperado para un procedimiento de salvataje


Meniscal allograft transplantation (MAT) is the gold standard treatment for post meniscectomy syndrome. However, it is still considered a limited procedure, existing controversies in the reported literature. No reports in Latin American centers and patients were found, hindering the generalization of results with this treatment. This study aims to review the critical aspects of MAT, describe a technical note for a commonly used MAT procedure, and report and discuss the results of a consecutive series of patients treated with MAT in a Latin American country.The technical note for a lateral MAT with the Keyhole bone fixation is described. This technique offers advantages in lateral MAT, where meniscal roots are close together. The keyhole is press-fit fixed into the tibial plateau, decreasing the stress of the holding sutures, and without interfering with associated procedures.The review includes the demographic, clinical, functional, and satisfaction results of a consecutive retrospective series of 16 patients [18 MAT (12 lateral and 6 medial)] with a median age of 20.5 (15-37) years. All patients were operated by the same surgeon between 2004-2019, and the median follow-up was 3.3 (0.5-14.8) years. The data was obtained through the revision of clinical files and telephonic surveys. The statistical analysis included a multivariate analysis for the association between variables, Wilcoxon for functional tests, and Kaplan-Meier for survival rate (reinterventions) (p<0.05).The results of the first Latin American MAT series are discussed and compared to the reported literature, finding similar results and are consistent with a salvage procedure


Subject(s)
Menisci, Tibial/surgery , Bone Transplantation/methods , Knee Joint/surgery , Retrospective Studies
8.
Actual. osteol ; 15(3): 225-236, Sept-Dic. 2019. ilus
Article in English | LILACS | ID: biblio-1116171

ABSTRACT

Bone grafting is important to preserve the alveolar bone ridge height and volume for dental implant placement. Even though implant-supported overdentures present highly successful outcomes, it seems that a great number of edentulous individuals have not pursued implant-based rehabilitation. The cost of the treatment is one of the reasons of discrepancy between highly successful therapy and its acceptance. Therefore, the development of biomaterials for bone grafting with comparable characteristics and biological effects than those renowned internationally, is necessary. In addition, domestic manufacture would reduce the high costs in public health arising from the application of these biomaterials in the dental feld. The purpose of this clinical case report is to provide preliminary clinical evidence of the efficacy of a new bovine bone graft in the bone healing process when used for sinus floor elevation. (AU)


El uso de injertos óseos es importante para preservar la altura y el volumen de la cresta alveolar para la colocación de implantes dentales. Si bien las sobredentaduras implanto-soportadas presentan resultados altamente exitosos, la mayoría de las personas desdentadas no han sido rehabilitadas mediante implantes dentales. Uno de los principales motivos por los cuales los pacientes no aceptan este tipo de tratamiento, altamente exitoso, es el elevado costo del mismo. Por ello, es necesario el desarrollo de biomateriales de injerto óseo con características y efectos biológicos comparables a los reconocidos internacionalmente. Asimismo, la fabricación nacional reduciría los altos costos en Salud Pública derivados de la aplicación de estos biomateriales en el campo dental. El objetivo de esta comunicación es presentar un caso clínico a fin de proporcionar evidencia preliminar acerca de la eficacia de un nuevo injerto de hueso bovino en el proceso de cicatrización ósea en el levantamiento del piso del seno maxilar. (AU)


Subject(s)
Humans , Animals , Female , Middle Aged , Cattle , Rats , Bone Transplantation/methods , Jaw, Edentulous, Partially/rehabilitation , Sinus Floor Augmentation/methods , Osteogenesis , Argentina , Biocompatible Materials , Cattle/physiology , Carticaine/administration & dosage , Chlorhexidine/administration & dosage , Naproxen/administration & dosage , Public Health/economics , Osseointegration , Dentures , Bone Transplantation/trends , Jaw, Edentulous, Partially/pathology , Jaw, Edentulous, Partially/therapy , Durapatite/therapeutic use , Amoxicillin-Potassium Clavulanate Combination/administration & dosage , Dental Implantation, Endosseous/methods , Sinus Floor Augmentation/trends , Allografts/immunology , Allografts/transplantation
9.
Int. j. odontostomatol. (Print) ; 13(4): 433-436, dic. 2019. graf
Article in English | LILACS | ID: biblio-1056480

ABSTRACT

ABSTRACT: Periapical cyst originates from an inflammatory reaction in the body that occurs due to a long-term endodontic aggression. It is more prevalent in caucasian male, during the third decade of life, in the anterior portion of the maxilla. They are commonly radiographic findings, due to their asymptomatic aspect. This study reports a Periapical Cyst in the portion corresponding to teeth 21, 22 and 23, which was treated by enucleation of the cyst, apicoectomy and retrograde root filling with Mineral trioxide aggregate (M.T.A) of teeth 21 and 22, filling of the cyst cavity with xenogeneic bone graft GenOx and a collagen membrane Gen-Derm. Observations after three months show good and rapid bone regeneration, periodontal and periapical health of the teeth involved.


RESUMEN: El quiste periapical se origina de una reacción inflamatoria que ocurre debido a una agresión endodóntica a largo plazo. Es más frecuente en el varón caucásico, durante la tercera década de la vida, en la porción anterior del maxilar. Son comúnmente hallazgos radiográficos, debido a su aspecto asintomático. En este estudio informamos acerca de un quiste periapical, en la porción correspondiente a los dientes 21, 22 y 23, que se trató mediante enucleación, apicectomía y relleno de raíz retrógrada con agregado de trióxido mineral (MTA) de los dientes 21 y 22, relleno de la cavidad del quiste con injerto óseo xenogénico Gen-Ox y una membrana de colágeno GenDerm. Las observaciones después de tres meses mostraron una buena y rápida regeneración ósea, con conservación de la salud periodontal y periapical de los dientes involucrados.


Subject(s)
Humans , Male , Middle Aged , Mandibular Diseases/pathology , Mandibular Diseases/diagnostic imaging , Maxillary Diseases/pathology , Maxillary Diseases/diagnostic imaging , Odontogenic Cysts/pathology , Odontogenic Cysts/diagnostic imaging , Bone Transplantation/methods , Radicular Cyst/diagnostic imaging , Bone Substitutes/therapeutic use , Oral Surgical Procedures
10.
Rev. Asoc. Odontol. Argent ; 107(2): 54-62, abr.-jun. 2019. ilus
Article in Spanish | LILACS | ID: biblio-1015871

ABSTRACT

Objetivo: Presentar una técnica quirúrgica de disyunción con bisturí piezoeléctrico y expansión de rebordes delgados en maxilar inferior que permita la colocación de implantes en la posición tridimensional correcta en el mismo acto quirúrgico. Casos clínicos: Se presenta la resolución de dos casos clínicos de pacientes que acudieron a la Cátedra de Odontología Integral Adultos de la Facultad de Odontología de la Universidad de Buenos Aires. Ambos requerían la colocación de implantes en sectores posteroinferiores. Las imágenes tomográficas mostraban adecuada altura del reborde alveolar pero deficiente espesor para la colocación de implantes en la posición tridimensional correcta. Se decidió realizar una técnica de disyunción horizontal del reborde alveolar con bisturí piezoeléctrico, expansión del reborde y colocación de implantes e injerto óseo particulado de forma simultánea. Luego de 3 meses, se efectuó la segunda cirugía para iniciar la rehabilitación protésica. Conclusión: La técnica de disyunción horizontal del reborde alveolar mediante el uso del bisturí piezoeléctrico permitió ubicar al implante en la posición tridimensional correcta dentro del tejido óseo nativo sin la necesidad de realizar regeneraciones complejas en rebordes alveolares delgados (AU)


Aim: Present the horizontal split crest technique with a piezoelectric scalpel and the immediate implant placement in the correct tridimensional position, in thin mandibular alveolar ridges. Cases report: The surgical resolutions of 2 clinical cases of patients who attended the Adult Integral Dentistry Chair of the Faculty of Dentistry of the UBA, are presented. Both patients required implant placement in posterior madibular residual ridge. The tomographic images showed adequate height of the alveolar ridge but poor thickness for implants placement in a correct three-dimensional position. It was decided to perform a horizontal split crest technique of the alveolar ridge with piezoelectric scalpel, ridge expansion, and immediate implant placement with xenograft. After 3 months, the second surgery was performed to start with the prosthetic rehabilitation. Conclusion: The horizontal split crest technique using a piezoelectric scalpel, allowed immediate implant placement in the correct tridimensional position within native bone tissue, avoiding a guided bone regeneration technique, in these cases with thin alveolar ridges (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Palatal Expansion Technique , Dental Implantation, Endosseous , Piezosurgery/methods , Argentina , Schools, Dental , Osseointegration , Bone Transplantation/methods , Alveolar Process/surgery , Mouth Rehabilitation
11.
Rio de Janeiro; s.n; 2019. 98 p.
Thesis in Portuguese | ColecionaSUS, LILACS, ColecionaSUS | ID: biblio-1222428

ABSTRACT

Doença degenerativa da coluna vertebral, sobretudo, o acometimento do disco intervertebral, é frequente na população mundial. O tratamento cirúrgico apresenta indicações precisas constituindo o padrão-ouro, a artrodese. Esta modalidade, entretanto, altera a mobilidade e a biomecânica do segmento funcional. A criopreservação de disco intervertebral em banco de tecidos e sua posterior utilização como substituto do disco degenerado objetivam manter a fisiologia local. Propor técnica cirúrgica de ressecção de bloco de coluna lombar e avaliar a possibilidade da manutenção das características histológicas dos discos intervertebrais submetidos ao congelamento com criopreservante. Foram obtidos espécimes de 6 doadores cadáveres humanos após avaliação e autorização de captação de tecido musculoesquelético de acordo com as normas do Sistema Nacional de Transplantes por meio da Portaria nº 2600 de 21 de outubro de 2009 do Ministério da Saúde. Após a realização de uma técnica de ressecção no bloco da coluna lombar, o material foi transportado para o banco de tecidos do Instituto Nacional de Traumatologia e Ortopedia Jamil Haddad em um recipiente específico com soro fisiológico 0,9% à temperatura de 4°C. Cada bloco de coluna lombar gerou, após o processamento do tecido realizado até 8 horas da captação, 3 discos intervertebrais. Dois discos foram armazenados em meio crioprotetor e congelados de forma gradual até -80°C. Cada disco foi descongelado no 7° e 15° dia, seccionados longitudinal e transversalmente e então, confeccionadas lâminas coradas com hematoxilina-eosina para análise histológica; Um disco controle, não-congelado, foi preservado em formol 10% e sofreu o mesmo processo de secção e preparo de lâminas, coloração. O estudo histológico das lâminas observou a presença ou não de alterações morfoestruturais (ânulo fibroso, núcleo pulposo) e celularidade, pontuada e classificada em muito alterada (0-3 pontos), moderadamente alterada (4-7 pontos) e inalterada (8-10 pontos). A técnica cirúrgica de ressecção en bloc da coluna vertebral foi reproduzida em todos os doadores cadáveres. A análise histológica revelou que poucas alterações foram observadas após 7 dias de congelamento do disco em meio criopreservante. Observamos que, embora tecnicamente demandante, a ressecção de bloco de coluna lombar é reprodutível. A preservação das propriedades do disco intervertebral por, no mínimo, 7 dias é possível e torna-se uma possibilidade de material para transplantação em futuras artroplastias biológicas


Degenerative disease of the vertebral column, especially the involvement of the intervertebral disc, is frequent in the world population. The surgical treatment presents precise indications constituting the gold standard, the arthrodesis. This modality, however, alters the mobility and biomechanics of the functional segment. The cryopreservation of intervertebral disk in a tissue bank and its posterior use as a substitute for the degenerate disc aim to maintain the local physiology. To propose surgical technique of lumbar spine block resection and to evaluate the possibility of maintaining the histological characteristics of the intervertebral discs submitted to the freezing with cryopreservant. Specimens of 6 human cadaveric donors were obtained after evaluation and authorization of the capture of musculo-skeletal tissue in accordance with the norms of the National System of Transplants through Ordinance No. 2600 of October 21, 2009 of the Ministry of Health. After performing a resection technique in the lumbar spine block, the material was transported to the tissue bank of Jamil Haddad National Institute of Traumatology and Orthopedics in a specific container with 0.9% saline solution at 4 ° C. Each lumbar spine block generated, after processing the tissue performed up to 8 hours of the capture, 3 intervertebral discs. Two discs were stored in cryopreservation and frozen gradually to -80 ° C. Each disc was thawed on day 7 and day 15, sectioned longitudinally and transversely, and then, blades stained with hematoxylin-eosin for histological analysis; One disc control, non-frozen, was preserved in 10% formaldehyde and underwent the same process of sectioning and preparation of blades staining. The histological study of the slides observed the presence or absence of morphostructural alterations (fibrous annulus, nucleus pulposus) and cellularity, scored and classified as highly altered (0-3 points), moderately altered (4-7 points) and unchanged (8-10 points). The surgical technique of en bloc resection of the spine was reproduced in all cadaveric donors. Histological analysis revealed that few changes were observed after 7 days of cryopreservant disk freezing. We observed that, although technically demanding, lumbar spine block resection is reproducible. The preservation of the intervertebral disc properties for at least 7 days is possible and becomes a possibility of material for transplantation in future biological arthroplasties


Subject(s)
Cryopreservation/methods , Bone Transplantation/methods , Intervertebral Disc/transplantation
12.
Rev. Col. Bras. Cir ; 46(4): e2225, 2019. graf
Article in Portuguese | LILACS | ID: biblio-1041129

ABSTRACT

RESUMO A remoção de enxerto da crista ilíaca anterior é uma boa opção para a reconstrução de defeitos mandibulares após ressecções por trauma ou outras doenças. Para obtenção de resultados clínicos de excelência em cirurgias reconstrutivas com enxertos ósseos, um planejamento pré-operatório preciso e uma refinada técnica cirúrgica são essenciais. Portanto, este artigo descreve o uso de um template customizável, que é indicado para obter bloco de osso ilíaco livre para reconstruções mandibulares imediatas ou tardias após defeitos marginais ou segmentares. O template é baseado em um fragmento de metal maleável obtido de uma lata de bebida de alumínio. Ele é utilizado no transoperatório para demarcar o sítio doador do enxerto ósseo e é especialmente útil devido ao acesso limitado à cortical interna da crista ilíaca. O template customizável tem se mostrado uma ferramenta de fácil aplicação para determinar o tamanho do bloco de enxerto a ser coletado da região ilíaca, otimizando o tempo cirúrgico e evitando a remoção insuficiente de enxerto ósseo.


ABSTRACT Bone graft harvesting from the anterior iliac crest is a good option for reconstructing mandibular defects after trauma or other diseases. In order to achieve optimal clinical results in reconstructive surgeries with bone grafts, accurate preoperative planning and prestigious surgical technique are paramount. Therefore, this paper describes the use of a customizable template that is indicated for obtaining free iliac bone block for immediate or late mandibular reconstructions following marginal or segmental defects. The template is based on a piece of malleable metal obtained from an aluminum beverage can. It is used transoperatively to demarcate the bone graft donor site, being especially useful because of the limited access to the inner table of the anterior ilium. The described customizable template has been shown as a useful tool to easily determine the size of the bone block to be harvested from the iliac region, improving surgical time and preventing removal of insufficient bone graft.


Subject(s)
Humans , Female , Young Adult , Bone Transplantation/methods , Mandibular Reconstruction/methods , Mandible/surgery , Stereolithography , Ilium/transplantation , Models, Anatomic
13.
Int. j. morphol ; 37(1): 82-86, 2019. tab, graf
Article in English | LILACS | ID: biblio-990009

ABSTRACT

SUMMARY: The aim of this study was to characterize a commercial beta tricalcium phosphate (β-TCP) block allograft for use in maxillofacial reconstruction, evaluating its homogeneity, porosity and mineralization. Two commercial 5 x 5 x10 mm chronOS Vivify β-TCP blocks were used, which were evaluated by a STEM SU-3500 variable pressure scanning electron microscope (SEM-STEM) (Hitachi, Japan). For the semi-quantitative microanalysis of elements, the QUANTAX 100 energy dispersive x-ray spectrometer detector (EDX) (Bruker, Germany) was used. The homogeneity of the structural morphology, macropore and micropore size and component homogeneity were evaluated. The microscopic analysis showed micropores of 164.92 mm (± 35.032 mm) in diameter in the outer area and micropores in the inner area of 54.44 mm (± 17.676 mm). The formation of porosities and irregularities present in the block was heterogeneous between the outer and inner surfaces. The mineral content of the blocks presented homogeneity with the presence of carbon (2.02 %), oxygen (44.33 %), phosphate (16.62 %) and calcium (37.87 %). The β-TCP block can be used in bone reconstruction but the presence of reduced macropore and micropore sizes could limit efficiency in the substitution and bone regeneration phase.


RESUMEN: El objetivo de este estudio fue caracterizar un aloinjerto de bloqueo de fosfato tricálcico (β-TCP) comercial para su uso en la reconstrucción maxilofacial, evaluando su homogeneidad, porosidad y mineralización. Se utilizaron dos bloques comerciales de 5 x 5 x 10 mm de vivify β-TCP de chronOS, que se evaluaron mediante un microscopio electrónico de barrido de presión variable STEM SU-3500 (SEM-STEM) (Hitachi, Japón). Para el microanálisis de elementos semicuantitativo, se utilizó el detector de espectrómetro de rayos X de dispersión de energía QUANTAX 100 (EDX) (Bruker, Alemania). Se evaluó la homogeneidad de la morfología estructural, el tamaño del macroporo y microporo y la homogeneidad de los componentes. El análisis microscópico mostró microporos de 164,92 mm (± 35,032 mm) de diámetro en el área externa y microporos en el área interna de 54,44 mm (± 17,676 mm). La formación de porosidades e irregularidades presentes en el bloque fue heterogénea entre las superficies externas e internas. El contenido mineral de los bloques presentó homogeneidad con la presencia de carbono (2,02 %), oxígeno (44,33 %), fosfato (16,62 %) y calcio (37,87 %). El bloque β-TCP se puede utilizar en la reconstrucción ósea, pero la presencia de macroporos y tamaños de microporos reducidos podría limitar la eficacia en la fase de sustitución y regeneración ósea.


Subject(s)
Humans , Calcium Phosphates/therapeutic use , Bone Transplantation/methods , Bone Substitutes/therapeutic use , Reconstructive Surgical Procedures/methods , Bone Regeneration , Microscopy, Electron, Scanning , Face/surgery , Tissue Scaffolds , Allografts , Maxilla/surgery
14.
Acta cir. bras ; 34(7): e201900704, 2019. tab, graf
Article in English | LILACS | ID: biblio-1038112

ABSTRACT

Abstract Purpose: The effects of resveratrol administration on calvarial bone defects with alloplastic graft material was investigated for osteoinductive reaction and bone development in rats. Methods: Healthy male rats were randomly divided into 3 groups consisting of 10 rats. Groups were as follows: control (defect) group, defect + graft group, and defect + graft + resveratrol group. A calvarial bone defect was created in all groups, alloplastic bone grafts were applied to the defect in the 2nd and 3rd group, resveratrol (5 mg/kg/day) was added to the drinking water of the animals following graft application for 28 days in the 3rd group. Results: Increase in osteoclasts and necrotic changes were observed histopathologically in the control group. In the 2nd group, reduction of inflammation, congestion of blood vessels, increased osteblastic activity, osteoinductive effect, progression of osteocyte development and increased collagen fibers in connective tissue were observed. In the 3rd group, osteoblasts seemed to secrete bone matrix and accelerate osteoinductive effect with increased osteopregenitor activity and positive osteopontin and osteonectin expressions. Conclusion: Resveratrol treatment was thought to be an alternative and supportive drug for implant application by inducing new bone formation in the calvaral defect region as a result of short-term treatment.


Subject(s)
Animals , Male , Rats , Skull/surgery , Bone Regeneration/drug effects , Bone Transplantation/methods , Bone Substitutes/administration & dosage , Resveratrol/administration & dosage , Osteoblasts/drug effects , Osteogenesis/drug effects , Skull/drug effects , Drug Administration Schedule , Osteonectin/administration & dosage , Osseointegration/drug effects , Bone Substitutes/therapeutic use , Disease Models, Animal , Osteopontin/administration & dosage
15.
Pesqui. vet. bras ; 38(12): 2246-2253, dez. 2018. tab, ilus
Article in English | LILACS, VETINDEX | ID: biblio-976424

ABSTRACT

Cranial cruciate ligament is the main responsible for knee stability by preventing cranial tibial displacement regarding the femur. Deficiency in this ligament (CCLD) may cause subluxation of the tibia and dysfunction of the pelvic member due to overloading. Tibial osteotomies are among the more current surgical techniques for treating CCLD in dogs and they proportionate the dynamic stability by means of modifying bone geometry and the distribution of forces acting on the articulation. The objective of this work is to describe the use of the allogeneic cortical bone graft conserved in glycerin as a spacer on the tibial tuberosity advancement (TTA) for treating the CCLD. In order to do that, 34 dogs submitted to TTA surgery correction were evaluated, being 23 males (67.35%) and 11 females (32.35%). Surgical procedures happened from May 2011 to October 2015. Regarding the surgical procedure after osteotomy of the tibial tuberosity, a disk of allogeneic cortical disk, sawn wedge-hapsed, conserved in glycerin, proportions of 2x1mm was applied as spacer, enabling TTA. Advancements from 3 to 12 mm were executed, depending on the need of the patient. For animals with patella dislocation, trochleoplasty and TTA were executed in order to correct the deviation. The mean ± SD age of animals was 6.67±3.58 and weight was 15.16±12.97 kg. Mongrel dogs, Poodles and Yorkshire terriers were the most affected ones. From the 36 evaluated knees, 11 (30.56%) were associated with some traumatic process and in 25 (69.44%) there was no relation with previous trauma. From those wounds, 20 (55.56%) happened in the right limb and 16 (44.44%) in the left limb and two animals had CCLD bilaterally. Animals had continuous support, discreet drawer movement and negative tibial compression 15 days after surgery. At 30 days, 26 cases (72.22%) had firm support (FS); at 45 days, 24 cases (66 test at 7 and 67%) had FS and eight cases (22.22%) without claudication (WC). During subsequent radiographic evaluations the progressive incorporation of the graft and osteotomy union were observed. In this study, most of the diagnosed CCLD occurred in males diverging from results obtained by other authors that found greater frequency in females. Support without claudication it was observed in most of the cases of implants at 60 days. We concluded that the conserved allogeneic cortical bone graft was able to promote bone union in TTA of dogs with CCLD. None of the animals had signs of contamination, infection of the surgical wound or rejection related with the presence of the graft, demonstrated by the complete graft-bone incorporation observed early at 45 days in some animals. The glycerin was a good conservation medium for those fragments intended for grafting because, besides being of low cost, it kept bone fragments free of contamination, reducing antigenicity and preserving the functions of osteoinduction and osteoconduction. The possibility of molding the graft to the animal need is a characteristic favorable to executing the modified technique that could be molded according to the size of the animal, allowing perfect adaptation to the osteotomized local in different breeds. Intercurrences commonly observed in TTA with patellar dislocation, meniscal lesions, tibial crest fracture and displacement were not found in the animals of this study, probably due to the better distribution of forces between the pass screw in TT and the TTA plate confirming that it has good adaptation to the technique conferring to the modified TTA advantages regarding the conventional TTA.(AU)


O ligamento cruzado cranial é o principal responsável pela estabilidade do joelho, impedindo o deslocamento da tíbia cranial em relação ao fêmur. A deficiência neste ligamento (CCLD) pode causar subluxação da tíbia e disfunção do membro pélvico devido à sobrecarga. As osteotomias tibiais estão entre as técnicas cirúrgicas mais atuais para o tratamento de CCLD em cães e proporcionam a estabilidade dinâmica por meio da modificação da geometria óssea da distribuição das forças que atuam sobre a articulação. O objetivo desse estudo é descrever o uso do enxerto ósseo cortical alogênico conservado em glicerina como espaçador no avanço da tuberosidade tibial (TTA) para o tratamento do CCLD. Para isso, 34 cães submetidos à cirurgia de TTA foram avaliados, sendo 23 machos (67,35%) e 11 fêmeas (32,35%). Os procedimentos curúrgicos aconteceram entre maio de 2011 e outubro de 2015. Com relação ao procedimento cirúrgico após a osteotomia da tuberosidade tibial, um disco alogênico cortical, em forma de cunha serrada, conservado em glicerina com proporções de 2 x 1mm foi aplicado como espaçador possibilitando a TTA. Avanços de 3 a 12mm foram executados, dependendo da necessidade do paciente. Para animais com luxação da patela, realizou-se a trocleoplastia e a TTA para a correção do desvio. A idade média dos animais foi de 6,67±3,58 anos e pesos médios de 15,16±12,97kg. Cães sem raça definida, Poodles e Yorkshire Terriers foram os mais afetados. Dos 36 joelhos avaliados, 11 (30,56%) foram associados a algum processo traumático e em 25 (69,44%) não havia nenhuma relação com um trauma prévio. Dos ferimentos, 20 (55,56%) aconteceram no membro direito e 16 (44,44%) no esquerdo, sendo que dois animais apresentavam CCLD bilateralmente. Os animais tiveram suporte contínuo, discreto movimento de gaveta e compressão tibial negativa 15 dias após a cirurgia. Aos 30 dias, 26 casos tinham suporte firme (FS); aos 45 dias, 24 casos tinham FS e oito casos sem claudicação (WC). Durante avaliações radiográficas subsequentes, observou-se a incorporação progressiva da união do enxerto e da osteotomia. Neste estudo, a maior parte do CCLD diagnosticado ocorreu em machos, divergindo dos resultados obtidos por outros autores que encontraram maior frequência em fêmeas. Suporte sem claudicação foi observado na maioria dos casos de implantes aos 60 dias. Foi concluído que o enxerto ósseo cortical alogênico conservado foi capaz de promover a união óssea na TTA de cães com CCLD. Nenhum dos animais apresentou sinais de contaminação, infecção da ferida cirúrgica ou rejeição relacionada à presença do enxerto, demonstrada pela incorporação completa do enxerto ósseo observada precocemente aos 45 dias em alguns animais. A glicerina foi um bom meio de conservação para os fragmentos destinados à enxertia porque, além do menor custo, manteve os fragmentos ósseos livres de contaminação, reduzindo a antigenicidade e preservando as funções de osteoindução e osteocondução. A possibilidade de moldagem do enxerto à necessidade do animal é uma característica favorável à execução da técnica modificada que pode ser moldada de acordo com o tamanho do animal, possibilitando perfeita adaptação ao local osteotomizado em diferentes raças. Intercorrências comumente observadas na TTA com luxação patelar, lesões meniscais, fratura da crista tibial e deslocamento não foram encontradas nos animais deste estudo, provavelmente devido à melhor distribuição de forças entre a passagem do parafuso no TT e a placa do TTA, confirmando que tem boa adaptação à técnica conferindo às vantagens da TTA modificada em relação à TTA convencional.(AU)


Subject(s)
Animals , Dogs , Stifle/surgery , Stifle/physiopathology , Stifle/injuries , Bone Transplantation/methods , Bone Transplantation/veterinary , Glycerol/pharmacology
16.
Braz. dent. j ; 29(5): 435-445, Sept.-Oct. 2018. tab, graf
Article in English | LILACS | ID: biblio-974183

ABSTRACT

Abstract This study aimed to evaluate the effect of two methods of local application of alendronate and parathyroid hormone (PTH) on bone repair and the systemic implications. A critically sized defect (5 mm) was created in the cranial region of twenty-five male Wistar rats, and the bone removed was particulated, and grafted back to the defect with different treatments. The animals were randomly divided into five groups: A1- bone graft immersion in alendronate solution (3 mg/kg) for 5 minutes; P1- bone graft immersion in PTH solution (20 µg); A2- weekly local applications of alendronate 1 mg/kg; P2- weekly local applications of PTH (20 µg); C- no drugs were used. The animals were euthanized 60 days after surgery. Cranial bone blocks were removed for histological, histomorphometric, and immunohistochemical analyses. MMP-2 and MMP-9 were used for immunolabeling. The kidneys, liver, and brain were also removed from all the rats for histological analysis. The data were submitted for statistical analysis with a level of significance of 0.05 (One-way ANOVA). The group C and group P2 presented a higher quantity of viable bone particles than the remaining groups. Groups A1, A2, and P1 presented with fewer viable bone particles than the control group, with a predominance of non-mineralized connective tissue. The histomorphometric analysis revealed no differences in relative bone area or MMP-2 or MMP-9 immunolabeling between the groups (p>0.05). Group A2 showed presence of fat in the liver consistent with hepatic steatosis. Changes in brain tissue were observed in groups A1 and P1.


Resumo Este estudo visou avaliar o efeito de dois métodos de aplicação local de alendronato e de paratormônio (PTH) no reparo ósseo e avaliar as implicações sistêmicas. Um defeito de tamanho crítico (5 mm) foi criado na calota craniana de vinte e cinco ratos Wistar machos, e o osso removido foi particulado e enxertado de volta no defeito com diferentes tratamentos. Os animais foram divididos aleatoriamente em cinco grupos: A1: imersão do enxerto ósseo em solução de alendronato (3 mg/kg) durante 5 min; P1- imersão do osso em solução de PTH (20 μg); A2- aplicações locais semanais de alendronato 1 mg/kg; P2- aplicações locais semanais de PTH 20 μg; C: não foram utilizados medicamentos. Os animais foram eutanasiados 60 dias após a cirurgia. Foram removidos os blocos ósseos envolvendo a região do defeito para realização das análises histológica, histomorfométrica e imuno-histoquímica. MMP2 e MMP9 foram as imunomarcações utilizadas. Os rins, fígado e cérebro também foram removidos de todos os ratos para análise histológica. Os dados foram submetidos à análise estatística com um nível de significância de 0,05 (One-way ANOVA). A análise histológica revelou que o grupo C e o grupo P2 apresentaram maior quantidade de partículas ósseas viáveis do que as apresentadas pelos demais grupos. Os grupos A1, A2 e P1 apresentaram menos partículas ósseas viáveis em comparação com o grupo controle com predominância de tecido conjuntivo não mineralizado. A análise histomorfométrica não revelou diferenças entres os grupos na área óssea relativa ou em MMP2 e MMP9 (p>0,05). O grupo A2 mostrou presença de gordura no fígado consistente com esteatose hepática. Alterações no tecido cerebral foram observadas nos grupos A1 e P1.


Subject(s)
Animals , Male , Rats , Osteogenesis/drug effects , Parathyroid Hormone/pharmacology , Skull/surgery , Skull/drug effects , Bone Regeneration/drug effects , Alendronate/pharmacology , Wound Healing/drug effects , Bone Resorption , Brain/drug effects , Immunohistochemistry , Bone Transplantation/methods , Alendronate/administration & dosage , Kidney/drug effects , Liver/drug effects
17.
Int. j. morphol ; 36(3): 1143-1148, Sept. 2018. tab, graf
Article in English | LILACS | ID: biblio-954243

ABSTRACT

The aim was to describe the star volume analysis in ridge preservation using different grafting materials. Bilateral extraction of the first mandibular molars of sixteen male rabbits was performed, divided at random into four groups (n= 4 in each group) according to graft, using: blood clot (G1), xenograft (G2), pure phase beta-tricalcium phosphate (G3) and biphasic calcium phosphate (60 % HA / 40 % beta-TCP) (G4). Rabbits were euthanized at 4, 6, or 8 wk post-extraction; the trabecular bone structures was evaluated by star volume analysis. The Levene test was used to analyze variance, as was the independent sample t-test. A P-value of < 0.001 was used to establish a statistically significant. The star volume analysis of the mandibular trabecula shows that the marrow space star volume (V*m.space) was higher than the trabecular star volume (V*tr). At 6-week post-extraction, new trabecular bone was evident. At 8-week post-extraction V*tr increase in all groups and the V*m.space diminish, suggesting coarsening of the internal architecture. In G2, some trabecular bone was observed in the central region. In G3, most of the socket regions were occupied by newly formed and loose trabecular bone and in the G4, the sockets were almost entirely filled with trabecular bone. Star volume analysis is adequate to analysis of bone patterns formation using bone substitutes.


El objetivo de esta investigación fue describir el volumen estrella en preservación alveolar utilizando diferentes injertos óseos. La exodoncia bilateral del primer molar mandibular de 16 conejos machos fue realizada, dividiéndolos en 4 grupos (n= 4 en cada grupo) de acuerdo al injerto utilizado, siendo: coágulo sanguíneo (G1), xenoinjerto (G2), beta-tricalcio fosfato puro (G3) y fosfato de calcio bifásico (60 % HA / 40 % beta-TCP) (G4). Los conejos fueron sometidos a eutanasia a las 4, 6 u 8 semanas post exodoncia; el trabeculado óseo fue evaluado por medio del volumen estrella. La prueba de Levene fue utilizado para el análisis de varianza y luego la prueba t-test para muestras independientes. El valor de P menor a 0.001 fue establecido como significancia estadística. El análisis del volumen estrella del trabeculado mostró que el espacio medular de volumen estrella (V*m.space) fue mayor que trabeculado (V*tr). A 6 semanas post exodoncia, nuevo trabeculado óseo fue evidente. A las 8 semanas post exodoncia V*tr aumenta en todos los grupos y el V*m.space disminuye, sugiriendo un engrosamiento de la arquitectura interna. En el grupo G2, algún trabeculado óseo fue observado en la región central. En el G3, la mayoría del alveolo fue ocupado por nuevo hueso y perdió trabeculado óseo y en G4, el alveolo fue ocupado casi enteramente por hueso trabecular. El análisis de volumen estrella es adecuado para analizar el modelo de formación ósea utilizando sustitutos óseos.


Subject(s)
Animals , Rabbits , Bone Transplantation/methods , Tooth Socket/anatomy & histology , Tooth Socket/surgery , Alveolar Ridge Augmentation , Tooth Extraction , Wound Healing , Bone Substitutes , Mandible/anatomy & histology
18.
Braz. dent. j ; 29(4): 325-334, July-Aug. 2018. tab, graf
Article in English | LILACS | ID: biblio-974170

ABSTRACT

Abstract Several techniques have been proposed for vertical bone regeneration, and many of them use bone autogenous and allogeneic grafts. The purpose of this study was to compare demineralised freeze-dried bone allografts (DFDBA), fresh-frozen (FF) allografts, autogenous bone grafts to find differences between volumetric and histological quantity of bone formation and vertical bone growth dynamic. A vertical tissue regeneration bone model was performed in rabbit calvarias under general anaesthesia. Four hollow cylinders of pure titanium were screwed onto external cortical bone calvarias in eight rabbits. Each one of the cylinders was randomly filled with one intervention: DFDBA, FF, autogenous bone, or left to be filled with blood clot (BC) as control. Allogeneic grafts were obtained from a ninth animal following international standardised protocols for the harvesting, processing, and cryopreservation of allografts. Autogenous graft was obtained from the host femur scraping before adapting hollow cylinders. Animals were euthanized at 13 weeks. Vertical volume was calculated after probe device measurements of the new formed tissue inside the cylinders and after titanium cylinders were removed. Histomorphometry and fluorochrome staining were used to analyse quantity and dynamic of bone formation, respectively. Results showed that DFDBA and fresh-frozen bone improved the velocity and the quantity of bone deposition in distant portions of the basal plane of grafting. Remaining material in allograft groups was more intense than in autogenous group. Both allografts can be indicated as reliable alternatives for volume gain and vertical bone augmentation.


Resumo Várias técnicas foram propostas para regeneração óssea vertical, e muitas delas usam enxertos ósseos e alogênicos ósseos. O objetivo deste estudo foi comparar os aloenxertos ósseos congelados desmineralizados (DFDBA), os aloenxertos congelados frescos (FF) com os enxertos ósseos autógenos para encontrar diferenças entre o volume, a histologia da formação óssea e a dinâmica do crescimento ósseo vertical. Um modelo ósseo de regeneração tecidual vertical foi realizado em calvarias de coelho sob anestesia geral. Quatro cilindros ocos de titânio puro foram parafusados nas calvarias de osso cortical externo em oito coelhos. Cada um dos cilindros foi preenchido aleatoriamente com uma intervenção: DFDBA, FF, osso autógeno ou com coágulo sanguíneo (BC) como controle. Os enxertos alogênicos foram obtidos a partir de um nono animal seguindo protocolos internacionais padronizados para a coleta, processamento e criopreservação de aloenxertos. O enxerto autógeno foi obtido da raspagem do fêmur do hospedeiro antes de adaptar os cilindros ocos. Os animais foram eutanasiados após 13 semanas. O volume vertical foi calculado após a medição, por meio de sonda milimetrada, do novo tecido formado dentro dos cilindros e após a remoção dos cilindros de titânio. Histomorfometria e coloração com fluorocromios foram utilizados para analisar a quantidade e a dinâmica da formação óssea. Os resultados mostraram que DFDBA e osso fresco congelado melhoraram a velocidade e a quantidade de deposição óssea em porções distantes do plano basal de enxerto. O material remanescente nos grupos de aloenxerto foi mais intenso do que em grupo autógeno. Ambos os aloenxertos podem ser indicados como alternativas confiáveis para ganho de volume e aumento ósseo vertical.


Subject(s)
Animals , Male , Rabbits , Bone Regeneration , Bone Transplantation/methods , Models, Biological , Transplantation, Autologous , Transplantation, Homologous , Bone Screws , Fluorescent Dyes/chemistry , Freeze Drying , Microscopy, Fluorescence
19.
ImplantNewsPerio ; 3(3): 463-472, mai.-jun. 2018. ilus, tab
Article in Portuguese | LILACS, BBO | ID: biblio-905505

ABSTRACT

Objetivos: avaliar o aumento ósseo com um biomaterial aloplástico no seio maxilar. Materiais e métodos: foram selecionados seis pacientes, totalizando nove seios maxilares, que realizaram cirurgia de reconstrução óssea em região posterior de maxila. Todas as cirurgias de elevação do seio maxilar traumáticas utilizaram o biomaterial sintético Straumann Bone Ceramic. Os pacientes realizaram uma tomografia pré-operatória, e uma após seis meses do ato cirúrgico, em que foram obtidas medidas lineares horizontais e verticais na imagem panorâmica da tomografia e medidas lineares horizontais e verticais no corte sagital da tomografia, ambas no centro das imagens. Resultados: identificou-se 100% de sucesso nas cirurgias de elevação de seio maxilar, em que verticalmente obteve-se diferença estatística significante (p < 0,05) e horizontalmente sem significância estatística (p > 0,05). Em média, obteve-se ganho vertical ósseo de 14,73 mm na imagem panorâmica e 16,05 mm no corte sagital, e espessura 20,82 mm na imagem panorâmica e 11,37 mm no corte sagital. Conclusão: o biomaterial sintético Straumann Bone Ceramic demonstrou-se excelente para a reconstrução de seios maxilares.


Objectives: to evaluate bone augmentation using an alloplastic material. Material and methods: six patients (9 maxillary sinuses) underwent surgical bone reconstruction at the posterior maxillary region. All surgeries were performed after atraumatic sinus membrane lifting and packing of Straumann BoneCeramic. Also, CBCTs were made at baseline and 6 months later to generate horizontal and vertical measurements at the panoramic and sagittal view modes both at the center of the images. Results: operative procedures were considered 100% successful. At the vertical dimension, statistical differences were obtained (p<0.05) but no significant differences were seen in the horizontal dimension (p>0.05). Overall, the vertical mean gain was 14.73mm at the panoramic and 16.05mm at the sagittal sections, being the observed thicknesses of 20.82mm and 11.37mm, respectively. Conclusion: the Straumann BoneCeramic biomaterial provided excellent results for maxillary sinus reconstructions.


Subject(s)
Humans , Biocompatible Materials/therapeutic use , Bone Regeneration , Bone Substitutes/therapeutic use , Bone Transplantation/methods , Cone-Beam Computed Tomography , Maxillary Sinus/surgery , Sinus Floor Augmentation
20.
ImplantNewsPerio ; 3(3): 527-535, mai.-jun. 2018. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-905522

ABSTRACT

Os enxertos ósseos autógenos são considerados como padrão-ouro para reabilitações de defeitos ósseos, e a região intrabucal constitui um excelente sítio doador para a resolução de defeitos ósseos pequenos e moderados. Este relato de caso clínico teve como objetivo descrever uma técnica cirúrgica para a obtenção de enxerto ósseo autógeno proveniente do tórus palatino para a reabilitação de altura e de espessura do rebordo ósseo alveolar remanescente referente ao elemento 11. Paciente do gênero feminino, 25 anos, procurou a clínica odontológica tendo como queixa principal a ausência do dente 11, perdido devido ao insucesso de um tratamento endodôntico. Radiograficamente, observou-se defeito ósseo horizontal na região do dente 11, e clinicamente, observou-se deficiência em espessura óssea vestibulolingual que impossibilitaria a instalação imediata de implante. Ao exame físico intrabucal, notou-se a presença de tórus palatino pronunciado, que apresentava 20 mm de comprimento, localizado na região central do palato e que, como sítio doador, mostrou-se de fácil acesso para a remoção do enxerto ósseo autógeno, mostrando-se suficiente em volume para a reconstrução do rebordo envolvendo um elemento unitário. Os blocos obtidos foram fixados com parafusos corticais medindo 1,5 mm. O acompanhamento clínico mostrou que a técnica proposta para reabilitação de rebordo alveolar para posterior inserção do implante unitário mostrou-se previsível e as dimensões de altura e de espessura de osso no sítio receptor, apesar da remodelação óssea sofrida, foi aceitável após sete meses, permitindo, de forma satisfatória, a reabilitação.


Autogenous bone grafts are considered as gold standard for rehabilitation of bone defects and the intrabucal region constitutes an excellent donor site for the resolution of small and moderate bone defects. This clinical case report aimed to describe a surgical technique to obtain an autogenous bone graft from the palatine torus for rehabilitation of height and thickness of the remaining alveolar bone ridge referring to element 11. A 25-year-old female patient sought the dental clinics having as main complaint the absence of tooth 11, lost due to failure of an endodontic treatment. Radiographically, a horizontal bone defect was observed in the region of the tooth 11 and clinically a bucco-lingual bone thickness defi ciency was observed that would make it impossible to insert the implant immediately. The presence of a pronounced palatine torus that was 20 mm long, located in the central region of the palate and which, as a donor site, was easily accessible for removal of the autogenous bone graft. Sufficient volume for rebuilding the collar involving a single element. The obtained blocks were fixed with cortical screws measuring 1.5 mm. Clinical follow-up showed that the proposed technique for alveolar ridge rehabilitation for posterior implant insertion was predictable and the dimensions of height and bone thickness at the recipient site, despite the bone remodeling suffered, were acceptable after 7 months allowing the oral rehabilitation.


Subject(s)
Humans , Female , Adult , Alveolar Bone Loss , Bone Transplantation/methods , Exostoses , Oral Surgical Procedures , Palatal Neoplasms , Palate/abnormalities , Transplantation, Autologous
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