Platelet-rich fibrin improves the osteoneogenesis in non-critical defects in calvaria: a histological and histometric study.

PURPOSE: The aim of this study was to evaluate the effect of platelet-rich fibrin (PRF) and autograft on non-critical bone repair. METHODS: Four bone defects (8.3 × 2 mm) were produced on the calvarium of 15 rabbits. The surgical defects were treated with either autograft, autograft associated to PRF, PRF alone, and sham. Animals were euthanized on the second, fourth or sixth posteoperative week. Histological analyses for presence of bone development on deffect was evaluated comparing the groups treated with autograft and without the autograft separately within the same period. Mann-Whitney's tests were used to compare the percentage of bone repair in each post-operative period for autograft × autograft + PRF groups and also for control × PRF groups (α = 5%). RESULTS: No differences were observed between the groups that received autograft and autograft associated to PRF on the second and fourth postoperative week, but areas treated with PRF demonstrated significant osteogenesis when compared to sham group on the fourth and sixth weeks. The groups that received PRF (with autograft or alone) demonstrated an enlarged bone deposition when compared to their control group. CONCLUSIONS: The use of PRF may influence bone repair and improve the bone deposition in late period of repair demonstrating osteoconductive and osteogenic properties.

Platelet-rich fibrin improves the osteoneogenesis in non-critical defects in calvaria: a histological and histometric study

ABSTRACT Purpose: The aim of this study was to evaluate the effect of platelet-rich fibrin (PRF) and autograft on non-critical bone repair. Methods: Four bone defects (8.3 × 2 mm) were produced on the calvarium of 15 rabbits. The surgical defects were treated with either autograft, autograft associated to PRF, PRF alone, and sham. Animals were euthanized on the second, fourth or sixth posteoperative week. Histological analyses for presence of bone development on deffect was evaluated comparing the groups treated with autograft and without the autograft separately within the same period. Mann-Whitney's tests were used to compare the percentage of bone repair in each post-operative period for autograft × autograft + PRF groups and also for control × PRF groups (α = 5%). Results: No differences were observed between the groups that received autograft and autograft associated to PRF on the second and fourth postoperative week, but areas treated with PRF demonstrated significant osteogenesis when compared to sham group on the fourth and sixth weeks. The groups that received PRF (with autograft or alone) demonstrated an enlarged bone deposition when compared to their control group. Conclusions: The use of PRF may influence bone repair and improve the bone deposition in late period of repair demonstrating osteoconductive and osteogenic properties.

TISSUE RESPONSES AND HEALING PATTERN OF PERIOSTAL DEFECTS IN CALVARY BETWEEN TWO TYPES OF MEMBRANES PRODUCED THROUGH BIOENGINEERING: STUDY IN RABBITS / RESPOSTAS TECIDUAIS E PADRÃO DE CICATRIZAÇÃO DE DEFEITOS PERIOSTAIS NA CALVÁRIA ENTRE DOIS TIPOS DE MEMBRANAS PRODUZIDAS POR MEIO DE BIOENGENHARIA: ESTUDO EM COELHOS

Introduction: Simultaneously with the development of new biomaterials, numerous surgical modalities have been proposed, with the aim of promoting adequate regeneration of bone defects, without providing fenestrations or dehiscence. Among the regenerative techniques currently accepted for this purpose, guided tissue regeneration (GTR) stands out. Objective: To evaluate the healing pattern and the histological response of the organism to the insertion of a type A gelatin-based membrane, and to compare it with a commercial membrane. Methods: Fifteen adult rabbits were selected. In the parietal region of the calvaria, flaps were performed to create a supraperiosteal pouch and implantation of 2 types of resorbable membranes: Marquette membrane and Bio-Gide® membrane. After the surgical procedure, the animals were allocated into 3 randomly selected groups (n=5) for the period of euthanasia, which occurred at 2, 4 and 6 postoperative weeks. Subsequently, the calvaria areas were removed and stained by H&E and analyzed for periosteum formation, inflammatory infiltrate in the area of membrane insertion, membrane degradation/resorption, and perimembrane fibrosis. Results: A slight inflammatory infiltration occurred around the Bio-Gide® membrane and it underwent resorption during the postoperative period with periosteum reconstruction, predominantly of a fibrous nature. The Marquette membrane also did not trigger an important inflammatory reaction. However, there was no significant resorption during the period; there was also significant formation of fibrous capsule surrounding the entire membrane area. Conclusion: The Marquette membrane produces tissue isolation reaction, minimizing periosteal formation while not providing its degradation

Introdução: Simultaneamente ao desenvolvimento de novos biomateriais, abundantes modalidades cirúrgicas têm sido propostas, com a finalidade de promover adequada regeneração de defeitos ósseos, sem proporcionar 2 fenestrações ou deiscências. Entre as técnicas regenerativas atualmente aceitas para este propósito, destaca-se a regeneração tecidual guiada (RTG). Objetivo: Avaliar o padrão de cicatrização e a resposta histológica do organismo frente à inserção de uma membrana a base de gelatina tipo A, e compará-la com membrana comercial. Métodos: Foram selecionadas 15 coelhas adultas. Na região parietal da calvária foram realizados retalhos para criação de uma bolsa supraperiostal e implantação de 2 tipos de membranas reabsorvíveis: membrana Marquette e membrana Bio-Gide®. Após o procedimento cirúrgico os animais foram alocados em 3 grupos randomicamente selecionados (n=5) para o período de eutanásia, que ocorreu em 2, 4 e 6 semanas pós-operatórias. Posteriormente, as áreas da calvária foram removidas e coradas por H&E e analisadas para averiguar formação de periósteo, infiltrado inflamatório na área de inserção de membrana, degradação/reabsorção da membrana, e fibrose perimembranar. Resultados: Ao redor da membrana Bio-Gide® ocorreu discreta infiltração inflamatória e a membrana sofreu reabsorção ao decorrer do período pósoperatório com reconstrução de periósteo prevalentemente de caráter fibroso. A membrana Marquette também não desencadeou importante reação inflamatória. Contudo, não foi verificada reabsorção significativa durante o período, também ocorreu significante formação de cápsula fibrosa cerceando toda área membranar. Conclusão: A membrana Marquette produz reação de isolamento tecidual, minimizando a formação periostal ao mesmo tempo que não proporciona sua degradação.

BONE HEALING OF DEFECTS IN CALVARIA USING RICH FIBRIN IN PLATELETS AND LEUKOCYTES: STUDY IN RABBITS / CICATRIZAÇÃO ÓSSEA DE DEFEITOS EM CALVÁRIA UTILIZANDO FIBRINA RICA EM PLAQUETAS E LEUCÓCITOS: ESTUDO EM COELHOS

Introduction: L-PRF (platelet and leukocyte-rich fibrin) is a concentrate of platelets and leukocytes in a fibrin network, obtained by autologous centrifugation collected at the time of the operation. It offers the advantages of low cost, easy preparation, simple acquisition and ability to accelerate the healing of soft and hard tissues. Objective: To evaluate the bone repair of non-critical defects in rabbit calvaria using L-PRF alone and in association with particulate autogenous bone. Method: Fifteen rabbits were used with blood collected and immediately centrifuged. Four non-critical defects measuring 8 mm in diameter were performed and filled with: 1) particulate autogenous bone; 2) particulate autogenous bone + L-PRF; 3) L-PRF only; and 4) without graft. They were sacrificed after 2, 4 and 6 weeks with the samples analyzed histologically and histomorphometrically comparing the regenerated areas. Results: At 2 weeks there was a statistical difference between groups 1 and 3; at 4 weeks there was between groups 2 and 4; and at 6 weeks between groups 1 and 4 and between 3 and 4. There was significant bone and proportional gain between 2 and 6 weeks for the L-PRF group. Conclusion: L-PRF alone had a positive and proportional effect on bone formation over the weeks.

Introdução: O L-PRF (fibrina rica em plaquetas e leucócitos) é concentrado de plaquetas e leucócitos em uma rede de fibrina, obtido pela centrifugação autóloga coletada no momento da operação. Oferece como vantagens o baixo custo, fácil preparo, de simples obtenção e com capacidade de acelerar a cicatrização de tecidos moles e duros. Objetivo: Avaliar o reparo ósseo de defeitos não críticos em calvária de coelhos utilizando o L-PRF isoladamente e em associação com osso autógeno particulado. Método: Foram utilizados 15 coelhos com sangue coletado e imediatamente centrifugado. Foram realizados 4 defeitos não críticos de 8 mm de diâmetro e tratados com preenchimento por: 1) osso autógeno particulado; 2) osso autógeno particulado + L-PRF; 3) somente L-PRF; e 4) sem enxerto. Foram sacrificados após 2, 4 e 6 semanas com as amostras analisadas histologicamente e histomorfometricamente comparando as áreas regenerada. Resultados: Com 2 semanas houve diferença estatística entre os grupos 1 e 3; com 4 semanas entre os grupos 2 e 4; e com 6 semanas entre os grupos 1 e 4 e entre 3 e 4. Houve ganho ósseo e proporcional significativo entre 2 e 6 semanas para o grupo de L-PRF. Conclusão: O L-PRF isoladamente teve efeito positivo e proporcional na formação óssea no decorrer das semanas.

Platelet-concentrated and platelet poor-plasma promote different pattern on immunohistochemical expression of TGF-ß1, however they impairs the osteoneogensis in calvarial defects treated with autograft due suppression of osteocalcin.

PURPOSE: Herein we evaluated the effects of platelet concentrate (PC) and platelet-poor plasma (PPP) on bone repair using noncritical defects in the calvaria of rabbits and compared them to the presence of TGF-ß1 and osteocalcin on reparative sites. METHODS: Five noncritical defects of 8.7 mm in diameter were created on the calvaria of 15 animals. Each defect was treated differently, using autograft (ABG), ABG associated with PC (ABG + PC), ABG with PPP (ABG + PPP), isolated PPP, and blood clot (control). The animals were submitted to euthanasia on the second, fourth and sixth week post-surgery. RESULTS: The defects that received ABG+PC or PPP demonstrated lower bone formation when compared to specimens that received ABG in the same period. These results coincided to significant higher immunopositivity for TGF-ß1 for specimens that received PC, and lower presence of cytokine in the group PPP. However, either higher or lower presence of TGF-ß1 were also correlated to lower presence of osteocalcin. Likewise, these results were similar to findings in specimens treated only with PPP when compared to control. CONCLUSIONS: PC and PPP were not effective when applied in association with ABG. Similarly, isolated use of PPP was not beneficial in optimizing the bone repair.

Sleep Disturbance in Scleroderma.

INTRODUCTION: Sleep quality may be impaired in systemic scleroderma (SSc) patients and contribute to loss of life quality. AIM: The aims of this study were to study the prevalence of sleep disturbance in SSc patients and its possible association with epidemiological, clinical and laboratory data, treatment used, and depression, and to verify the association of sleep disturbance and quality of life in this group of patients. METHODS: This is a cross-sectional study including 60 SSc patients. Epidemiological, clinical, laboratory, and treatment data were extracted from the medical records. To evaluate sleep quality, the PSQI (Pittsburgh Sleep Quality Index) was used; to evaluate depression, the CES-D (Center for Epidemiological Scale-Depression) was used; and to evaluate quality of life, SF-12 (12-Item Short-Form Health Survey) was used. Disease severity was evaluated by the Medsger index and the degree of cutaneous involvement by the modified Rodnan index. RESULTS: The prevalence of patients with sleep disturbance was 73.3%. Sleep disturbance was associated with esophageal involvement (p = 0.03), Medsger index with higher disease severity (p = 0.01), and more depressive mood (p = 0.002). Patients with poor quality of sleep had worse quality of life by the SF-12 in mental (p = 0.001) and physical domains (p = 0.0008). No associations were found with epidemiological, serological, and treatment variables (all P's = nonsignificant). CONCLUSIONS: There is a high prevalence of sleep disturbance in patients with SSc that is associated with esophageal involvement, severity of disease, depression, and worse quality of life.

Platelet-concentrated and platelet poor-plasma promote different pattern on immunohistochemical expression of TGF-β1, however they impairs the osteoneogensis in calvarial defects treated with autograft due suppression of osteocalcin

ABSTRACT Purpose Herein we evaluated the effects of platelet concentrate (PC) and platelet-poor plasma (PPP) on bone repair using noncritical defects in the calvaria of rabbits and compared them to the presence of TGF-β1 and osteocalcin on reparative sites. Methods Five noncritical defects of 8.7 mm in diameter were created on the calvaria of 15 animals. Each defect was treated differently, using autograft (ABG), ABG associated with PC (ABG + PC), ABG with PPP (ABG + PPP), isolated PPP, and blood clot (control). The animals were submitted to euthanasia on the second, fourth and sixth week post-surgery. Results The defects that received ABG+PC or PPP demonstrated lower bone formation when compared to specimens that received ABG in the same period. These results coincided to significant higher immunopositivity for TGF-β1 for specimens that received PC, and lower presence of cytokine in the group PPP. However, either higher or lower presence of TGF-β1 were also correlated to lower presence of osteocalcin. Likewise, these results were similar to findings in specimens treated only with PPP when compared to control. Conclusions PC and PPP were not effective when applied in association with ABG. Similarly, isolated use of PPP was not beneficial in optimizing the bone repair.