Imaging findings of acute calcific periarthritis, with emphasis on magnetic resonance imaging: pictorial essay / Achados de imagem da periartrite cálcica aguda, com ênfase na ressonância magnética: ensaio iconográfico

Abstract Acute calcific periarthritis (ACP) is defined as periarticular inflammation associated with intra-articular deposits of hydroxyapatite and other basic calcium phosphate crystals. Patients with ACP present with a sudden onset of pain, together with localized swelling, as well as erythema, tenderness, and reduced range of motion. Familiarity with the clinical and radiological manifestations of ACP aids in the diagnosis and helps differentiate it from other conditions, particularly infectious or inflammatory pathologies such as septic arthritis and gout, thereby reducing the number of unnecessary diagnostic and therapeutic procedures. The objective of this pictorial essay is to illustrate the imaging findings of ACP in various joints, with an emphasis on the findings obtained by magnetic resonance imaging.

Resumo A periartrite cálcica aguda (PCA) é uma inflamação periarticular aguda associada a depósitos justa-articulares de hidroxiapatita e outros cristais básicos de fosfato de cálcio. Os pacientes apresentam início súbito de dor, edema localizado, eritema, sensibilidade e redução da amplitude de movimentos. A familiaridade com as manifestações clínicas e radiológicas da PCA facilita o diagnóstico e permite diferenciá-la de outras entidades, em particular, com doenças infecciosas ou inflamatórias, como artrite séptica e gota, reduzindo procedimentos diagnósticos e terapêuticos desnecessários. O objetivo deste ensaio iconográfico é ilustrar os achados de imagem de PCA em algumas articulações, com ênfase na ressonância magnética.

Influence of bioactive particles and onium salt on the physicochemical properties of experimental infiltrants

Abstract This study evaluated physicochemical properties of experimental infiltrants after addition of hydroxyapatite nanoparticles (HAp) or 58S bioactive glass (BAG) and diphenyliodonium hexafluorophosphate (DPI). The resin matrix was composed of TEGDMA/Bis-EMA (3:1), 0.5 mol% CQ, and 1 mol% EDAB. The blends received or not 0.5 mol% DPI and 10% wt BAG or HAp. Icon was used as commercial control. The groups were characterized by XRD, FT-IR spectrometry, and SEM before and after simulated body fluid (SBF) immersion for up to 7 days. Polymerization kinetics (n =3 ), water sorption and solubility (n=10), and viscosity (n = 3) were surveyed. For polymerization kinetics, the samples were polymerized for 5 min and the data were obtained from 40 s and 5 min. Statistical analysis was made using ANOVA and Tukey's test (a = 0.05). After 7 days of SBF immersion, XRD and FT-IR showed that the HAp crystalline phase was present only in the HAp groups. A lower degree of conversion (DC) and polymerization rate were observed for the Icon and BAG groups, whereas HAp showed higher values. For the BAG group, DPI increased polymerization rate and DC in 40 s. After 5 min, all groups presented DC above 80%. In groups with particles, the HAp groups exhibited higher viscosity, whereas DPI groups showed a decrease in viscosity. Icon had the highest water sorption. To conclude, BAG neither improved the physicochemical properties studied, nor did it show bioactive properties. The addition of DPI reduced viscosity caused by particle addition and also attenuated the DC decrease caused by BAG addition. The addition of bioactive particles to infiltrants should be seen with caution because they increase viscosity and may not bring major clinical improvements that justify their use. DPI might be indicated only if any component is added to the infiltrant to act as a compensation mechanism.

The effect of scaffold hydroxyapatite derived from portunus pelagicus shell on the expression of fibroblast growth factor-2 (fgf-2) and bone morphogenetic proteins-2 (bmp -2) in the extraction sockets of cavia cobaya / El efecto del scaffold de hidroxiapatita derivada de portunus pelagicus sobre la expresión del factor de crecimiento de fibroblastos-2 (FGF-2) y las proteínas morfogenéticas óseas-2 (BMP-2) en los alvéolos dentarios de cavia cobaya

Objetive: To determine the expression of Fibroblast Growth Factor (FGF)-2 and Bone Morphogenetic Protein (BMP)-2 after application of scaffold hydroxyapatite from Rajungan crab shell (Portunus pelagicus) in the tooth extraction socket of Cavia cobaya. Material and Methods: This study used a post-test only control group design with 28 Cavia cobaya separated into two groups, control and treatment group. The left mandibular incisor was extracted, and socket preservation was conducted. A hydroxyapatite graft derived from crab shells was mixed with gelatin and eventually turned into a scaffold, which was afterward put into the extraction socket. After 7 days and 14 days, each group was terminated and examined using immunohistochemical staining to observe the expression of FGF-2 and BMP-2. One-Way Anova and Tukey HSD were used to examine the research data. Results: FGF-2 and BMP-2 expressions were observed higher in the group that received hydroxyapatite scaffold at the post-extraction socket than those in the group that did not receive hydroxyapatite scaffold. Conclusion: The application of a hydroxyapatite scaffold from Rajungan crab shell (Portunus pelagicus) to the tooth extraction socket can increase FGF-2 and BMP-2 expression.

Objetivo: Determinar la expresión del factor de crecimiento de fibroblastos (FGF)-2 y la proteína morfogenética ósea (BMP)-2 después de la aplicación de hidroxiapatita de andamio de caparazón de cangrejo Rajungan (Portunus pelagicus) en el alvéolo de extracción dental de Cavia cobaya. Material y Métodos: Este estudio utilizó un diseño de grupo de control solo posterior a la prueba con 28 Cavia cobaya separados en dos grupos, grupo de control y grupo de tratamiento. Se extrajo el incisivo mandibular izquierdo y se realizó la preservación del alvéolo. Un injerto de hidroxiapatita derivado de caparazones de cangrejo se mezcló con gelatina y se convirtió en un andamio, que luego se colocó en el alvéolo de extracción. Después de 7 días y 14 días, se terminó cada grupo y se examinó mediante tinción inmunohistoquímica para observar la expresión de FGF-2 y BMP-2. Se utilizaron One-Way Anova y Tukey HSD para examinar los datos de la investigación. Resultados: Las expresiones de FGF-2 y BMP-2 se observaron más altas en el grupo que recibió la estructura de hidroxiapatita en el alvéolo posterior a la extracción que en el grupo que no recibió la estructura de hidroxiapatita. Conclusión: La aplicación de un andamio de hidroxiapatita de caparazón de cangrejo Rajungan (Portunus pelagicus) al alvéolo de extracción dental puede aumentar la expresión de FGF-2 y BMP-2.

Hancornia speciosa Gomes Latex Increases Bone Mineralization in Rats: A Preclinical Study / Látex de Hancornia speciosa Gomes aumenta a mineralização óssea em ratos: Um estudo pré-clínico

Abstract Objective To evaluate the systemic effect of Hancornia speciosa latex on bone neoformation and mineralization in rats. Methods For that, the latex was first collected, and its composition was analyzed. A total of 30 male Wistar rats were used, which were simultaneously submitted to two surgical procedures: extraction of an incisor and creation of a defect with 2 mm in diameter in the parietal bone. The rats were divided into two groups: systemic control (SC) systemic latex (SX) which were administered, orally and daily, 1.5 mL of water or a solution containing 50% of water and 50% of latex by gavage, respectively. After 15 days of the treatment, the animals were euthanized and their samples were collected. Results The results were statistically analyzed, and the level of significance was set at 0.05. We showed that H. speciosa latex contained calcium. The oral and daily administration of the latex for 15 days increased the contents of calcium and phosphorus in the basal bone and newly-formed bone in the mandibular alveolus of rats. Conclusion The present was a pioneer study demonstrating the potential of H. speciosa latex in increasing bone mineralization. Our results may aid in the conception and development of a natural drug.

Resumo Objetivo Avaliar o efeito sistêmico do látex de Hancornia especiosa na neoformação óssea e mineralização em ratos. Métodos Para isso, primeiro o látex foi coletado, e sua composição foi analisada. No estudo, foram utilizados 30 ratos Wistar machos submetidos simultaneamente a dois procedimentos cirúrgicos: extração de incisivo e criação de um defeito de 2 mm de diâmetro no osso parietal. Os ratos foram divididos em dois grupos: controle sistêmico (CS) e látex sistêmico (XS), aos quais foi administrado, oral e diariamente, 1,5 mL de água ou uma solução contendo 50% de água e 50% de látex por gavagem, respectivamente. Após 15 dias do tratamento, os animais foram eutanizados, e suas amostras, coletadas. Resultados Os resultados foram analisados estatisticamente, e o nível de significância foi fixado em 0,05. Mostramos que o látex de H. speciosa continha cálcio. A administração oral e diária deste látex por 15 dias aumentou o conteúdo de cálcio e fósforo de osso basal e de osso recém-formado no alvéolo mandibular de ratos. Conclusão Este foi um estudo pioneiro, que demonstrou o potencial do látex de H. speciosa no aumento da mineralização óssea. Nossos resultados podem ajudar na concepção e no desenvolvimento de uma droga natural.

Perda de definição do contorno do submento: correto diagnóstico e algoritmo de tratamento / Loss of definition of the submental contouring: correct diagnosis and treatment algorithm

A busca por procedimentos estéticos voltados para a perda de definição do submento é crescente. Um correto diagnóstico é imperativo para o sucesso do tratamento e redução das complicações. Adiposidade localizada, flacidez cutânea e perda da estrutura óssea são os principais achados. Um algoritmo de tratamento foi discutido nesta revisão, lembrando-se, claro, da possibilidade de tratamentos combinados e sequenciais para melhores resultados

The search for aesthetic procedures aimed at the loss of submental definition is increasing. A correct diagnosis is imperative for successful treatment and the reduction of complications. Localized adiposity, skin flaccidity, and loss of bone structure are the main findings. A treatment algorithm was discussed in this review, remembering, of course, the possibility of combined and sequential treatments for better results.

Grafting biomaterials associated to topical glucocorticoid: effects on pre-osteoblastic cells (MC3T3-E1)

Abstract The topical glucocorticoid budesonide has been prescribed before and after sinus lift surgery as adjuvant drug treatment for maxillary sinus membrane inflammation. However, there is no study on the effects of budesonide on the regenerative process of bone grafting biomaterials. We investigated the effect of the association of budesonide with some biomaterials on the growth and differentiation capacity of pre-osteoblastic cells (MC3T3-E1 subclone 4). Xenogeneic (Bio-Oss and Bio-Gen) and synthetic hydroxyapatites (Osteogen, Bonesynth, and HAP-91) were tested in conditioned medium (1% w/v). The conditioned medium was then supplemented with budesonide (0.5% v/v). Cell viability was assessed using the MTT assay (48, 96, and 144 h), and mineralized nodules were quantified after 14 days of culture using the Alizarin Red Staining. Alkaline phosphatase activity was assessed through the release of thymolphthalein at day seven. All biomaterials showed little or no cytotoxicity. The Bio-Gen allowed significantly less growth than the control group regardless of the experimental time. Regarding differentiation potential of MC3T3-E1, the HAP-91-conditioned medium showed remarkable osteoinductive properties. In osteodifferentiation, the addition of budesonide favored the formation of mineral nodules when cells were cultured in medium conditioned with synthetic materials, whereas it weakened the mineralization potential of cells cultured in xenogeneic medium. Regardless of whether budesonide was added or not, Osteogen and Bio-Oss showed higher alkaline phosphatase activity than the other groups. Budesonide may improve bone formation when associated with synthetic biomaterials. Conversely, the presence of this glucocorticoid weakens the mineralization potential of pre-osteoblastic cells cultured with xenogeneic hydroxyapatites.

Clinical observation of accordion technique in promoting bone transport and prolonging newborn bone mineralization / 中国骨伤

OBJECTIVE@#To analyze effect of accordion technique on bone mineralization of extended bone segment in treating tibial bone defect with bone transport.@*METHODS@#From May 2017 to October 2019, 22 patients with tibial bone defects were treated with Ilizarov bone-transport technique, and divided into two groups after bone-transport was completed, 11 patients in each group. In observation group, there were 9 males and 2 females aged from 20 to 60 years old with an average of (42.6± 13.3) years old;the length of bone defect ranged from 3 to 13 cm with an average of(6.4±2.6) cm;2 patients were suffered from upper tibial bone defects, 3 patients were middle and 6 patients were lower;patients were treated with accordion technique for 35 days. In control group, there were 10 males and 1 female aged from 41 to 60 years old with an average of (51.6±6.4) years old;the length of bone defect ranged from 3 to 10.7 cm with an average of (6.6±2.5) cm;1 patient was suffered from upper tibial bone defects, 3 patients were middle and 7 patients were lower;patients were treated with lock external fixator to waiting bone mineralization. The content of hydroxyapatite (HAP) extended bone segment was measured after bone-transport completed immediately, 35, 65 and 95 days after bone-transport was completed, respectively, then the mineralization time and healing time were compared between two groups, and the therapeutic effect of bone defect was evaluated by using Paley scoring criteria.@*RESULTS@#Twenty-two patients were followed up from 18 to 36 months with an average of (27.0±6.3) months. The wounds on the bone defects healed spontaneously during bone transport, and there were no wound complications such as skin infection or skin necrosis occurred. There were statisticaldifference in the content of HAP of the extended bone segments at 35, 65 and 95 days after bone-transport between two groups (@*CONCLUSION@#Accordion technique and locking external fixator mineralization in prolonging bone segment healing after bone-transport have the equal clinical effect, while the accordion technique could significantly accelerate the growth rate of HAP and shorten the mineralization time and healing time.

Padronização da aplicação corporal de hidroxiapatita de cálcio com a técnica de figuras vetorizadas / Standardization of the body vectoring technique with calcium hydroxyapatite

Introdução: a hidroxiapatita de cálcio em gel carreador de carboximetilcelulose apresenta resultados inequívocos para a melhora cutânea facial, estimulando a produção de colágeno e elastina. Seu uso para tratamento corporal tornou-se on- label apenas recentemente, após comprovações científicas de seu benefício em maior diluição. O objetivo deste trabalho foi demonstrar uma padronização técnica para racionalização da aplicação corporal. Neste estudo foram idealizadas figuras vetorizadas para aplicação da hidroxiapatita de cálcio com diluição intermediária. Com a técnica proposta, é possível calcular, com exatidão, o volume de produto necessário para cada paciente em função do tamanho da unidade anatômica a ser tratada e das características topográficas da região. A racionalidade desta técnica permite ainda distribuição homogênea, minimização das complicações por acúmulo de produto, boa tolerabilidade pela paciente e otimização dos resultados. Conclusões: a simplicidade técnica das figuras vetorizadas facilita a aplicação da hidroxiapatita de cálcio, e as customizações devem ser feitas com a maior experiência do injetor.

Introduction: Calcium hydroxyapatite in a carboxymethylcellulose carrier gel presents unequivocal results for facial skin improvement, stimulating the collagen and elastin production. Regulatory agencies recently approved its use after scientific proof of its benefit in greater dilution. Objective: This study aimed to demonstrate a technical standardization to rationalize body application. Methods: This study idealized vectorized figures to apply calcium hydroxyapatite with intermediate dilution (1:4). Results and discussion: The proposed technique makes it possible to accurately calculate the required for each patient, depending on the anatomical unit's size to be treated and the region's topographic characteristics. This technique's rationale also allows homogeneous distribution, minimization of complications due to product accumulation, good tolerability by the patient and optimization of results. Conclusions: The vectorized figures' technical simplicity facilitates calcium hydroxyapatite application, and customizations must be made with the injector's greatest experience

Evaluation of Bone Repair in the Mandible of Rabbits Using Biphasic Calcium Phosphate Micro-Macroporous Hydroxyapatite Bioceramics and Beta-Tricalcium Phosphate

Objective: To perform a clinical and histological evaluation, characterizing and proving the feasibility of the use of beta tricalcium phosphate (HA/ßTCP) bioceramics as a bone defect repair material, comparing it with autogenous bone and blood clot in terms of osteoinductive, conductive, and genic capacities. Material and Methods: The experiment was based on 3 critical defects in the mandible of 11 New Zealand rabbits. The defects were filled with HA/ßTCP bioceramics and autogenous bone, respectively, collected and ground during the development of defects and blood clots. The animals were euthanized after the 90-day experiment and samples were collected for histomorphological examination. To evaluate differences between the groups, a one-way analysis of variance (ANOVA) was performed with Tukey's post hoc test. An α value lower than 0.05 was considered statistically significant. Results: Microscopy revealed the presence of osteoblasts, osteoclasts, and osteocytes associated or not associated with the presence of mature or immature bone. All the studied materials presented bone neoformation in all cases, with the presence of mature and immature bone. Regarding the presence of HA/ßTCP bioceramic residual material, the same was found in 7 of 11 slides. Conclusion: HA/ßTCP bioceramics were shown to be a biocompatible bone substitute, with osteoinductive and osteoconductive characteristics, accelerating the process of new bone formation when compared with autogenous and blood clotted bone, thereby showing promise for bone defect repair with safety and efficacy.

Clinical courses and degradation patterns of absorbable plates in facial bone fracture patients

BACKGROUND: Absorbable plates are widely used in open reduction and internal fixation surgeries for facial bone fractures. Absorbable plates are made of polyglycolic acid (PGA), polylactic acid (PLA), polydioxane (PDS), or various combinations of these polymers. The degradation patterns of absorbable plates made from different polymers and clinical courses of patients treated with such plates have not been fully identified. This study aimed to confirm the clinical courses of facial bone fracture patients using absorbable plates and compare the degradation patterns of the plates. METHODS: A retrospective chart review was conducted for 47 cases in 46 patients who underwent open reduction and internal fixation surgery using absorbable plates to repair facial bone fractures. All surgeries used either PLA/PGA composite-based or poly-L-lactic acid (PLLA)/hydroxyapatite (HA) composite-based absorbable plates and screws. Clinical courses were confirmed and comparisons were conducted based on direct observation. RESULTS: There were no naturally occurring foreign body reactions. Post-traumatic inflammatory responses occurred in eight patients (nine cases), in which six recovered naturally with conservative treatment. The absorbable plates were removed from two patients. PLA/PGA composite-based absorbable plates degraded into fragments with non-uniform, sharp surfaces whereas PLLA/HA composite-based absorbable plates degraded into a soft powder. CONCLUSION: PLA/PGA composite-based and PLLA/HA composite-based absorbable plates showed no naturally occurring foreign body reactions and showed different degradation patterns. The absorbable plate used for facial bone fracture surgery needs to be selected in consideration of its degradation patterns.

Fabrication and biocompatibility assessment of the scaffold with biomimetic interconnected macropore structure / 中国组织工程研究

BACKGROUND: Development of bone tissue engineering provides a new method to solve bone defect repair. Scaffold material and structure construction are issues of concern. OBJECTIVE: To fabricate a silk fibroin and hydroxyapatite scaffold with biomimetic interconnected macropores structure using the paraffin-sphere leaching technology and to evaluate its possibility of cytocompatibility. METHODS: The scaffold with biomimetic interconnected macropores structure was made by the paraffin-sphere leaching technology. The structure of scaffold was observed by the stereomicroscope and scanning electron microscope. The pore size and elasticity modulus were calculated. Passage 3 rabbit adipose-derived mesenchymal stem cells were seeded into the scaffold. The cell viability was detected by live/dead staining at 48 hours after culture. The cell adhesion was observed by hematoxylin-eosin staining at 1 week of culture. The scaffold-cell composite was observed under scanning electron microscope at 3 days of culture. The cell proliferation was detected by the cell counting-kit 8 assay at 1, 3, 5 and 7 days of culture. Those cells cultured alone were considered as control group. RESULTS AND CONCLUSION: (1) Stereomicroscope showed the ivory silk fibroin/hydroxyapatite scaffold. Scanning electron microscope revealed pore structures in cross-section and longitudinal-section with good connectivity. The scaffold pore size was (362.23±26.52) μm and the elasticity modulus was (54.93±5.44) kPa. (2) Scanning electron microscope showed that adipose-derived mesenchymal stem cells adhered and stretched well in the pore wall and connected pore, secreted abundant extracellular matrix, and filled in the pores of silk fibroin/hydroxyapatite scaffold. (3) Hematoxylin-eosin staining results found that adipose-derived mesenchymal stem cells evenly adhered onto the inner wall of silk fibroin/hydroxyapatite scaffold, and proliferated well. (4) Live/dead staining revealed a good viability of adipose-derived mesenchymal stem cells. (5) Cell counting-kit 8 assay results showed the good proliferation of adipose-derived mesenchymal stem cells on the scaffold. (6) To conclude, the silk fibroin/hydroxyapatite scaffold possesses good pore size and cytocompatibility.

Preparation and characterization of sustained-release levofloxacin bone tissue-engineered three-dimensional silk fibroin/chitosan/nano-hydroxyapatite scaffold / 中国组织工程研究

BACKGROUND: Preliminary study has prepared the three-dimensional silk fibroin/chitosan/nano-hydroxyapatite scaffold successfully.OBJECTIVE: To explore the mechanical properties, physical characteristics, chemical composition and antibiotic sustained-release ability of three-dimensional silk fibroin/chitosan/nano-hydroxyapatite scaffold loaded with levofloxacin. METHODS: Levofloxacin/chitosan (3:1) microspheres were constructed by emulsion settlement filter method. 5, 7.5 and 10 g of microspheres were added into 2％ of silk fibroin/chitosan/nano-hydroxyapatite mixed solution through freeze drying and chemical cross-linking to obtain the scaffolds loaded with antibiotics. The scaffolds loaded with antibiotics underwent scanning electron microscope observation, and chemical composition analysis. The sustained release, mechanical properties, porosity, water absorption expansion rate and hot water soluble loss rate were detected. RESULTS AND CONCLUSION: (1) Scanning electron microscope observed that there were drug microspheres at the inner wall of the scaffold, and the voidage was decreased with mass of microspheres increasing. (2) Energy spectrum analysis showed that the three kinds of scaffolds were rich in calcium and phosphonium ions. (3) The three kinds of scaffolds showed the same releasing trend, which presented with sudden-release effect at the former 3 days (release> 50％) , and then tended to be stable. The release rate was the slowest in the scaffold loaded with 10 g of microscopes, and the rapidest in the scaffold loaded with 5 g of microscopes. (4) With the mass of microspheres increasing, there was an increase in the compressive and tension abilities and hot water soluble loss rate, and a decrease in the porosity, mean pore size and water absorption expansion rate. (5) These results indicate that the three-dimensional tissue-engineered scaffold loaded with levofloxacin is constructed successfully by freeze drying and chemical cross-linking method, which holds good sustained-release effect and compressive ability, water absorption expansion rate and hot water soluble loss rate.

Experimental study on osteogenic differentiation of adipose-derived mesenchymal stem cells induced by hydroxyapatite / 天津医药

@#Objective Toinvestigatetheeffectofhydroxyapatite(HA)ontheosteogenicdifferentiationpotencyof adipose-derivedmesenchymalstemcells(ADSCs).Methods ADSCswereisolatedandpurifiedfromC57BL/6mice.Toxic effectsofhydroxyapatiteonADSCsweredetectedbycellproliferationassay.Alkalinephosphatase(ALP)assaywasusedto detecttheeffectsofdifferentconcentrationsofHAonosteogenicdifferentiationofADSCs.RelativemRNAexpressionlevels ofosteogenicgenes(BGLAP, ALP, COL1A1, OPNandRunx2)weremeasuredbyRT-PCR.Results Thelowconcentration ofHA(≤20mg/L)showedlesseffectonproliferationofADSCs.WiththeincreaseofHAconcentration,thecellproliferation decreased.Theco-cultureof20mg/LHAwithADSCssignificantlyincreasedtheALPactivity,andpromotedtheexpression ofosteoblast-relatedgenes(P＜0.01).Conclusion Hydroxyapatitehavetheabilitytoinducetheosteogenicdifferentiation ofADSCs,whichprovideatheoreticalbasisforcombinatingHAandADSCsintoanewboneengineeringscaffold.

Comparison of removal torque of saline-soaking RBM implants and RBM implants in rabbit tibias / 대한치과보철학회지

PURPOSE: The purpose of this study is to investigate the effect of the titanium implant soaked in saline after RBM surface treatment on the initial osseointegration by comparing the removal torque and the surface analysis compared to the titanium implant with only RBM surface treatment. MATERIALS AND METHODS: The control group was RBM surface treated implants (RBM), and the test group was implants soaked in saline for 2 weeks after RBM surface treatment (RBM+Sal). The control and test group implants were placed in the left and right tibiae of 10 rabbits, respectively, and at the same time, the insertion torque (ITQ) was measured. After 10 days, the removal torque (RTQ) was measured by exposing the implant site. FE-SEM, EDS, Surface roughness and Raman spectroscopy were performed for the surface analysis of the new implant specimens used in the experiments. RESULTS: There was no significant difference in insertion torque and removal torque between RBM surface treated titanium implants and saline-soaked titanium implants after RBM surface treatment. CONCLUSION: Saline soaking after RBM surface treatment of titanium implants did not positively affect the initial osseointegration as compared to titanium implants with only RBM surface treatment.

Dentinal Tubules Occluding Effect Using Nonthermal Atmospheric Plasma

Nonthermal atmospheric plasma has been studied for its many biomedical effects, such as tooth bleaching, wound healing, and coagulation. In this study, the effects of dentinal tubules occlusion were investigated using fluoride-carboxymethyl cellulose (F-CMC) gel, nano-sized hydroxyapatite (n-HA), and nonthermal atmospheric plasma. Human dentin specimens were divided to 5 groups (group C, HA, HAF, HAP, and HAFP). Group HA was treated with n-HA, group HAF was treated with n-HA after a F-CMC gel application, group HAP was treated with n-HA after a plasma treatment and group HAFP was treated with n-HA after a plasma and F-CMC gel treatment. The occlusion of dentinal tubules was investigated using scanning electron microscopy (SEM) and energy dispersive x-ray spectroscopy (EDS), which shows Ca/P ratio. In the EDS results, a higher Ca/P ratio was shown in the groups including n-HA than in the control group. The specimens of group HAP and HAFP had a higher Ca/P ratio in retentivity. In the SEM results, there was not a significant difference in the amount of times applied. Therefore, this study suggests F-CMC gel and n-HA treatment using nonthermal atmospheric plasma will be a new treatment method for decreasing hypersensitivity.

On the effect of saline immersion to the removal torque for resorbable blasting media and acid treated implants

PURPOSE: The purpose of this study is to investigate the effect of the titanium implant soaked in saline after RBM and acid etched surface treatment on the initial osseointegration by comparing the removal torque and the surface analysis compared to the titanium implant with only RBM and acid etched surface treatment. MATERIALS AND METHODS: The control group was RBM and acid etched surface treated implants (RBM + HCl), and the test group was implants soaked in saline for 2 weeks after RBM and acid etched surface treatment (RBM + HCl + Sal). The control and test group implants were placed in the left and right tibiae of 10 rabbits, respectively, and at the same time, the insertion torque (ITQ) was measured. After 10 days, the removal torque (RTQ) was measured by exposing the implant site. FE-SEM, EDS, Surface roughness and Raman spectroscopy were performed for the surface analysis of the new implant specimens used in the experiments. RESULTS: There was significant difference in insertion torque and removal torque between control group and experimental group (P = 0.014 < 0.05). Surface roughness of experimental group is higher than control group. CONCLUSION: Saline soaking after RBM and acid etched surface treatment of titanium implants were positively affect the initial osseointegration as compared to titanium implants with only RBM and acid etched surface treatment.

Unsintered Hydroxyapatite and Poly-L-Lactide Composite Screws/Plates for Stabilizing β-Tricalcium Phosphate Bone Implants

Unsintered hydroxyapatite (u-HA) and poly-L-lactide (PLLA) composites (u-HA/PLLA) are osteoconductive and biodegradable. Screw (Super-Fixsorb MX30) and plate (Super-Fixsorb MX40 Mesh) systems made of u-HA/PLLA are typically used in small bones in maxillofacial surgeries. After the resection of bone tumors in larger bones, reconstructions with β-tricalcium phosphate (β-TCP) implants of strong compression resistance have been reported. After a resection, when the cavity is hemispheric- or concave-shaped, stabilization of the implanted β-TCP block is necessary. In the current series, u-HA/PLLA were used to stabilize the mechanically strong implanted low-porous β-TCP blocks in six bone tumor cases, including three giant cell tumors of bone, and one case each of chondroblastoma, chondrosarcoma, and parosteal osteosarcoma. The mean age of patients at the time of surgery was 31.3 years (range, 19 to 48 years). The bones involved were two ilia (posterior), a femur (diaphysis to distal metaphysis), and three tibias (proximal epiphysis, proximal metaphysis to epiphysis, and distal metaphysis to epiphysis). Neither displacement of the implanted β-TCP block nor any u-HA/PLLA-related complications were observed. The radiolucent character of the u-HA/PLLA did not hinder radiological examinations for potential signs of tumor recurrence. The method of using u-HA/PLLA components for the stabilization of β-TCP blocks makes the procedure easy to perform and reliable. It can extend the application of β-TCP blocks in reconstruction surgery.

In vitro effects of alcohol-containing mouthwashes on human enamel and restorative materials

Abstract The objective of this study was to evaluate the in vitro effects, including surface morphological characteristics and chemical elemental properties, of different mouthwash formulations on enamel and dental restorative materials, simulating up to 6 months of daily use. Human enamel samples, hydroxyapatite, composite resin, and ceramic surfaces were exposed to 3 different mouthwashes according to label directions — Listerine® Cool Mint®, Listerine® Total Care, and Listerine® Whitening — versus control (hydroalcohol solution) to simulate daily use for up to 6 months. The samples were analyzed using scanning electron microscopy (SEM), infrared spectrophotometry (µ-Fourier transform infrared microscopy), energy-dispersive X-ray (EDX) spectroscopy, and color analysis before and after exposure. No relevant changes were observed in the morphological characteristics of the surfaces using SEM techniques. The physical and chemical aspects of the enamel surfaces were evaluated using mid-infrared spectroscopy, and EDX fluorescence was used to evaluate the elemental aspects of each surface. There was no variation in the relative concentrations of calcium and phosphorus in enamel, silicon and barium in composite resin, and silicon and aluminum in the ceramic material before and after treatment. No relevant changes were detected in the biochemical and color properties of any specimen, except with Listerine® Whitening mouthwash, which demonstrated a whitening effect on enamel surfaces. Long-term exposure to low pH, alcohol-containing, and peroxide-containing mouthwash formulations caused no ultra-structural or chemical elemental changes in human enamel or dental restorative materials in vitro.

A comparison of different bone graft materials in peri-implant guided bone regeneration

Abstract The aim of this study was to compare the effects of hydroxyapatite (HA), deproteinized bovine bone (DPB), human-derived allogenic bone (HALG), and calcium sulfate (CAP) graft biomaterials used with titanium barriers for bone augmentation to treat peri-implant defects in rat calvarium treated by guided bone regeneration (GBR). Thirty-two female Sprague-Dawley rats were divided into four groups: DPB, HALG, HA, and CAP. One titanium barrier was fixed to each rat's calvarium after the titanium implants had been fixed. In total, 32 titanium implants and barriers were used. Ninety days after the surgical procedure, all the barriers were removed. After decalcification of bone tissue, the titanium implants were removed gently, and new bone regeneration in the peri-implant area was analyzed histologically. Immunohistochemical staining of vascular endothelial growth factor (VEGF) was also performed. There were no statistically significant between-group differences in new bone regeneration or VEGF expression after 3 months. According to the results of the histological and immunohistochemical analyses, none of the grafts used in this study showed superiority with respect to new bone formation.

Avaliação de duas formas de hidroxiapatita e beta-tricálcio fosfato em enxertos sinusais com concomitante instalação de implantes em coelhos / Evaluation of two formulations of hydroxyapatite and beta-tricalcium phosphate in rabbit sinus grafts with concomitant implant placement

Este trabalho teve por objetivo avaliar o tecido ósseo periimplantar formado após o enxerto sinusal com hidroxiapatita e beta-tricálcio fosfato (HA + ß-TCP), nas apresentações em grânulos e em pasta, concomitante à instalação de implantes em coelhos. Trinta e quatro seios maxilares de coelhos foram enxertados com HA + ß-TCP, sendo metade do grupo grânulos e metade do grupo pasta. Concomitantemente, foi realizada a instalação de implantes. Aos 7 e 40 dias pósoperatórios, realizou-se a eutanásia dos animais, e as amostras foram preparadas para as análises tomográfica, microtomográfica, histológica (coloração por hematoxilina e eosina - HE), imunoistoquímica (marcação de fator de transcrição Runt-2 ­ RUNX2 ­, fator de crescimento endotelial vascular ­ VEGF ­, osteocalcina ­ OCN ­ e fosfatase ácida resistente ao tartarato ­ TRAP) e de torque de remoção dos implantes. Na tomografia, foi observada a manutenção da integridade da membrana sinusal, sem extravasamento de material, nos dois grupos e períodos. Parâmetros morfométricos de volume ósseo, porcentagem do volume ósseo e número de trabéculas foram significativamente superiores para o grupo pasta do que para o grupo grânulos aos 7 dias, enquanto que a porosidade foi maior para o grupo grânulos nesse mesmo período. Aos 40 dias, não houve diferença significativa entre os grupos para a maioria dos parâmetros microtomográficos estudados. Nos cortes histológicos corados por HE, observou-se que em ambos os grupos ocorreu a formação de tecido ósseo junto às espiras do implante aos 40 dias, favorecendo a osseointegração. Imunomarcações positivas semelhantes foram encontradas tanto para o fator de diferenciação osteoblástica RUNX2 quanto para o fator de mineralização OCN no osso neoformado nos dois grupos experimentais. A atividade osteoclástica evidenciada pela TRAP mostrou-se semelhante nos dois grupos, com discreto predomínio para o grupo grânulos. Já a marcação positiva para o VEGF mostrou-se aumentada no grupo grânulos, caracterizando um potencial osteocondutor superior nessa apresentação do biomaterial. Ademais, não houve diferenças nos valores de torque de remoção do implante entre ambos os grupos. Logo, as duas apresentações da HA + ß-TCP mostraram resultados favoráveis à osseointegração a longo prazo, com formação de tecido ósseo em quantidade e qualidade semelhantes junto aos implantes(AU)

This work aimed to evaluate the peri-implant bone tissue after maxillary sinus grafting with hydroxyapatite and beta-tricalcium phosphate (HA + ß-TCP), in granular and paste formulations, concomitant with implant placement in rabbits. Thirty four rabbit maxillary sinuses were grafted with HA + ß-TCP, being half of the granular group and half of the paste group. Concomitantly, the implant placement was performed. At 7 and 40 postoperative days, animals were euthanized, and the samples were prepared for tomographic, microtomographic, histological (hematoxylin and eosin staining), immunohistochemical (Runt-related transcription factor 2 ­ RUNX2, vascular endothelial growth factor ­ VEGF ­, osteocalcin ­ OCN ­ and tartrate-resistant acid phosphatase ­ TRAP ­ staining) and implant torque removal analyses. In computed tomography, the maintenance of sinus membrane integrity, with no material extravasation, was observed in both groups and periods. Morphometric parameters of bone volume, percentage of bone volume and trabecular number were significantly higher for paste than granular group at day 7, while the porosity was higher for granular group in this period. At day 40, there were no significant differences between both groups for the majority of the microtomographic parameters studied. In the HE-stained histological sections, it was observed that bone healing around implant threads occurred for both groups at day 40, enhancing osseointegration. Similar positive immunostainings were observed for both the RUNX2 osteoblastic differentiation factor and the OCN mineralization factor in the neoformed bone in the two experimental groups. The osteoclast activity evidenced by TRAP was similar in both groups, with a slight predominance for the granular group. Positive staining for VEGF growth factor was increased in the granular group, characterizing a superior osteoconductive potential for this biomaterial formulation. Besides, there were no differences in the values of implant removal torque between both groups. Thus, the two formulations o H + ß-TCP showed favorable osseointegration results in the long term, with similar amount and quality of bone tissue formation around the implants(AU)