ABSTRACT
The objective of this systematic review was to identify the available scientific evidence on bone substitutes (BSs) compared with autogenous bone grafts (ABGs) for regeneration of horizontal bone resorption in the anterior maxillary alveolar process, aiming at rehabilitation with endosseous implants. This review was performed according to the PRISMA guidelines (2020) and registered in the database PROSPERO (CRD: 42017070574). The databases searched were PUBMED/MEDLINE, EMBASE, SCOPUS, SCIENCE DIRECT, WEB OF SCIENCE, and CENTRAL COCHRANE, in the English language. The Australian National Health and Medical Research Council (NHMRC) and Cochrane Risk of Bias Tool were used to assess the study's quality and risk of bias. A total of 524 papers were found. After the selection process, 6 studies were selected for review. A total of 182 patients were followed for a period of 6 to 48 months. The mean age of patients was 46.46 years, and 152 implants were installed in the anterior region. Two studies achieved a reduced graft and implant failure rate, whereas the remaining 4 studies had no losses. It may be concluded that the use of ABGs and some BSs is a viable alternative for the rehabilitation with implants in individuals with anterior horizontal bone loss. However, additional randomized controlled trials are warranted due to the limited number of papers.
Subject(s)
Alveolar Ridge Augmentation , Bone Substitutes , Dental Implants , Humans , Middle Aged , Bone Substitutes/therapeutic use , Australia , Dental Implantation, Endosseous , Bone TransplantationABSTRACT
BACKGROUND/AIM: An adequate storage medium can help preserve the viability of periodontal ligament cells, favoring the periodontal ligament repair process. The aim of this study was to evaluate the repair process following the delayed replantation of teeth stored in soy milk and whole milk. MATERIAL AND METHODS: The maxillary right incisors of 27 rats were divided into three equally sized groups: Group SM (delayed replantation with storage in soy milk), whose teeth were immersed in 50 mL of soy milk for 60 minutes; Group WM (delayed replantation with whole milk), teeth were kept for 60 minutes in 50 mL of whole milk; and Group D (delayed replantation with dry storage), teeth were kept in dry conditions for the same period (negative control). Next, the teeth of the animals of all groups were replanted into their sockets. Systemic antibiotics were given to all the animals, and then, they were euthanized after 60 days. Sections were obtained and stained with hematoxylin and eosin for histomorphometric study. The presence and location of acute and chronic inflammatory processes in the epithelial insertion of the protective and insertion periodontium were evaluated, as well as the presence, extension, depth, and repair of root resorption, and the resorption and ankylosis with bone. Statistical differences between groups were analyzed using the Dunn test. RESULTS: Groups SM and WM showed similar patterns in the repair of the periodontal ligament following delayed replantation, in relation to the inflammatory process in the proximities of the epithelial insertion, inflammation and organization of the periodontal ligament, plus root and bone resorption. However, in group WM, more ankylosis was observed than in group SM. CONCLUSION: The teeth stored in soy milk and whole milk had similar periodontal repair, which shows the potential of soy milk as a storage medium before tooth replantation.
Subject(s)
Root Resorption , Tooth Ankylosis , Tooth Avulsion , Animals , Periodontal Ligament , Rats , Tooth ReplantationABSTRACT
Traumatic dental intrusion is a serious injury and results in significant damage to the periodontal ligament, dentin-pulp complex, and alveolar bone. This article presents a case of severe intrusion of the two upper permanent central incisors where the treatment option was the combination of the surgical and orthodontic technique. The difficulty of accessing the crowns of these teeth to bond the brackets was solved by lifting a full thickness flap. To disengage the teeth from the alveolus, a careful dislocation motion was performed. After suturing the flap, a removable orthodontic appliance was installed and an extrusive force was applied for 8 weeks. After 10 weeks, the endodontic treatment was performed and the crowns were restored. The 10-year clinical control showed normal mobility. Radiographically, minor losses of the cervical alveolar cortical bone and integrity of the periodontal ligament were observed.
ABSTRACT
The aim of this study was to evaluate and compare, clinically, the efficiency of the subepithelial connective tissue graft (SCTG) and platelet-rich fibrin (L-PRF) using the tunnel technique to cover the multiple gingival recessions on anterior teeth, in the same patient. Within the limits of this study, we conclude that both SCTG and L-PRF proved to be reliable options for the treatment of gingival recessions, efficiently supporting the biological and aesthetic demand, stimulating the periodontal tissues' health, and bringing reliable and highly predictable results.
ABSTRACT
Este estudo avaliou a influência do aspirado de medula óssea (AMO) e do plasma rico em plaquetas (PRP) associados ou não ao enxerto de osso autógeno (OA) no reparo ósseo de defeitos de tamanho crítico (DTC), criados cirurgicamente em calvárias de ratos. 96 ratos foram divididos em 6 grupos: C, PRP, AMO, OA, PRP/OA e AMO/OA. Um DTC de 5 mm de diâmetro foi criado na calvária de cada animal. No grupo C, o defeito foi preenchido com coágulo sanguíneo somente. Nos grupos PRP e AMO, o defeito foi preenchido com PRP e AMO, respectivamente. No Grupo OA, o defeito foi preenchido com enxerto de OA. Nos grupos PRP/OA e AMO/OA, o defeito foi preenchido com enxerto de OA combinado com PRP ou AMO, respectivamente. Os animais foram submetidos à eutanásia aos 10 ou 30 dias pós-operatórios. Foram realizadas análises histomorfométrica e imunoistoquímica. A área de osso (AO) foi calculada como porcentagem da área total do defeito original. Foram realizadas reações imunoistoquímicas para detecção do antígeno nuclear de proliferação celular (PCNA), proteínas morfogenéticas ósseas 2/4 (BMP-2/4) e osteocalcina (OCN). As células PCNApositivas, BMP-2/4-positivas e OCN-positivas foram quantificadas. Os dados foram analisados estatisticamente. Aos 10 dias, os grupos OA, PRP/OA e AMO/OA apresentaram AO significativamente maior que o controle; e o grupo PRP/OA apresentou maior AO, bem como números significativamente maiores de células PCNA-positivas e BMP-2/4-positivas, que o grupo OA. Aos 30 dias, os resultados favoráveis dos grupos OA, PRP/OA e AMO/OA no reparo ósseoo foram também observados, e o grupo AMO/OA apresentou maior AO, bem como número significativamente maior de células OCN-positivas que o grupo OA. Além disso, o grupo AMO apresentou AO significativamente maior que o controle e similar a dos grupos OA e PRP/OA, mas menor que a do grupo AMO/OA. O grupo AMO apresentou números significativamente maiores de células PCNA-positivas, BMP-2/4-positivas e OCNpositivas que os grupos controle e PRP/OA. Pode-se concluir que, aos 10 dias, a associação PRP/OA proporcionou maior AO em DTC em calvárias de ratos quando comparada ao controle ou a cada terapia única; enquanto que, aos 30 dias, a associação AMO/OA foi a que promoveu maior AO que o controle ou cada terapia única. A terapia única com AMO promoveu AO semelhante àquela obtida com a terapia única com enxerto de OA aos 30 dias. Diferenças significativas na AO não foram observadas entre os grupos tratados com PRP/OA ou com AMO/OA em ambos os períodos de análise; contudo, um reparo ósseo mais avançado foi observado no grupo AMO/OA aos 30 dias(AU)
This study evaluated the influence of bone marrow aspirate (BMA) and platelet-rich plasma (PRP) combined or not with the autogenous bone (AB) graft on bone healing in surgically created critical-size defects (CSD) in rat calvaria. 96 rats were divided into 6 groups: C, PRP, BMA, AB, PRP/AB and BMA/AB. A 5 mm diameter CSD was created in the calvarium of each animal. In Group C, the defect was filled by blood clot only. In groups PRP and BMA, the defects were filled with PRP and BMA, respectively. In Group AB, the defect was filled with AB graft. In groups PRP/AB and BMA/AB, the defect was filled with AB graft combined with PRP or BMA, respectively. Animals were euthanized at either 10 or 30 days postoperative. Histomorphometric and immunohistochemical analyses were performed. Bone area (BA) was calculated as a percentage of the total area of the original defect. Proliferating cell nuclear antigen (PCNA), bone morphogenetic protein 2/4 (BMP-2/4) and osteocalcin (OCN) immunohistochemical staining were performed. PCNA-positive, BMP-2/4-positive and OCN-positive cells were quantified. Data were statistically analyzed. At 10 days, groups AB, PRP/AB and BMA/AB presented significantly greater BA than control; and group PRP/AB presented greater BA, as well as significantly higher numbers of PCNA-positive and BMP-2/4-positive cells than group AB. At 30 days, the favorable results of groups AB, PRP/AB and BMA/AB on bone healing were also observed; and group BMA/AB presented greater BA, as well as significantly higher number of OCN-positive cells than group AB. In addition, group BMA presented significantly greater BA than control and similar to groups AB and PRP/AB but lower than group BMA/AB. Group BMA presented significantly higher numbers of PCNA-positive, BMP-2/4-positive, and OCN-positive cells than control and PRP/AB. It can be concluded that, at 10 days, the combination of PRP/AB promoted greater BA in CSD in rat calvaria when compared to control or either treatment alone; while, at 30 days, the combination of BMA/AB promoted greater BA than control or either treatment alone. The treatment with BMA only yielded BA similar to that obtained with the treatment with AB graft only at 30 days. Significantly differences in BA were not observed between groups treated with PRP/AB or BMA/AB at both periods of analysis; however, a more advanced bone healing process was observed in group BMA/AB at 30 days(AU)
