Comparative study of bone regeneration in critical cranial bone defects using bone marrow adult stem cells and calcium phosphate / Estudio comparativo sobre regeneración ósea en defectos óseos craneales con células madre adultas de la médula ósea y fosfato cálcico (BoneSource(R))

Objective. To compare the use of Bone Marrow adult Stem Cells (BMSCs), differentiated in vitro into osteoblasts, associated to calcium phosphate versus autogenous bone graft, in the repair process of critical size bone defects. Materials and method. On 36 Wistar adult rats, bilateral full-thickness defects on parietal bone were created. The defects were either repaired with calcium phosphate (group I), calcium phosphate + (BMSCs) (group II) or autogenous bone graft (group III), and the opposite side with blood clot (Control Group). In all cases a collagen membrane was used. The animals were sacrificed at 30 and 60 days, and all specimens were collected for further histological and histomorfometric study. Results. At 30 days, group III (autogenous bone graft) evidences a statistical difference on bone formation when compared to the experimental and control groups (p ≤ 0.05). At 60 days group II (BS + BMSCs) and group III (autogenous bone) showed a similar bone formation and has only a statistical difference when compared to group I (BS) and control group. Conclusion. The use of calcium phosphate in conjunction with BMSCs resulted in a similar behavior in the process of bone repair in critical size defects, when compared with autogenous bone graft (AU)

Objetivo. Comparar el uso de células madre adultas de la médula ósea (CMMO), diferenciadas in vitro en osteoblastos, asociadas a fosfato cálcico, frente a injerto de hueso autólogo, en el proceso de reparación de defectos óseos de tamaño crítico. Material y Método. En 36 ratas adultas Wistar, se crearon defectos bilaterales de todo el grosor en el hueso parietal. Los defectos se repararon con fosfato de calcio (BoneSource®) (grupo I), fosfato de calcio (BoneSource®) + (CMMO) (grupo II) o injerto de hueso autólogo (grupo III), y en el lado contralateral con coágulo de sangre (grupo de control). En todos los casos se utilizó membrana de colágeno. Los animales fueron sacrificados a las 30 y 60 días y se obtuvieron todas las muestras para el estudio histológico y el análisis histomorfométrico. Resultados. A los 30 días, en el grupo III (injerto de hueso autólogo) se puso de manifiesto una diferencia estadísticamente significativa en la formación de hueso en comparación con el grupo experimental y el de control (p < 0,05). A los 60 días, en el grupo II (BoneSource®) + CMMO) y el grupo III (hueso autólogo) se demostró una formación ósea similar, y sólo se evidenció una diferencia estadísticamente significativa en comparación con el grupo I (BoneSource®) y el grupo de control. Conclusión. El uso de fosfato de calcio en combinación con CMMO indujo un comportamiento similar en el proceso de reparación ósea en defectos de tamaño crítico, en comparación con injerto de hueso autólogo (AU)

Patient’s perception of improvement after surgical assisted maxillary expansion(SAME): Pilot study

Objective: Clinicians often assume that changes following orthognathic surgery are both physically and psychologicallybeneficial to the patient. The present study investigates patient perception regarding improvement after surgicallyassisted rapid maxillary expansion.Study design: A survey with twenty-three patients was carried out to identify satisfaction with the surgical outcomeand assess whether the surgery met patient expectations. General information was also collected on schooling, age,gender, chief complaint and reasons for seeking treatment.Results: Most patients (n = 19; 82%) were advised to undergo surgery by a dentist. Twenty-two (95%) patients reportedbeing satisfied with the operation procedure. Twenty-one (91%) patients reported that the procedure met theirexpectations. Nineteen respondents would undergo the same operation again and would recommend treatment toothers with similar problems.Conclusion: The need for surgery associated with orthodontic appliances to correct a transverse maxillary deficiencyrequires a proper explanation to patients regarding the procedure and postoperative period in order to ensure realisticexpectations concerning the surgical goals (AU)

Clinical comparative study of the effectiveness of two dosages of Dexamethasone to control postoperative swelling, trismus and pain after the surgical extraction of mandibular impacted third molars

No disponible

Purpose: The aim of this study was to evaluate the effect of two different concentrations (4 and 8 mg) of dexamethasone to decrease the swelling and trismus after the surgical extraction of mandibular impacted third molars.Methods: This randomized clinical trial comprised thirty (30) adult patients of both genders with no local or systemic problems, with bilateral impacted lower third molars in similar position, where surgical extraction had been indicated. They were given 4 mg and 8 mg of dexamethasone 1 hour before the surgical procedure at the first or second surgery. The choice of which side to operate first and the amount of concentration of medication to use was made randomly and double-blindly. Postoperative pain was evaluated using a visual analog scale (VAS) and the degree of swelling was evaluated through facial reference points’ variation. The presence of trismus was analyzed through measurement of the interincisal distance (IID). These assessments were obtained before the operation and 24h and 48h after the surgery.Results: Based on statistic analysis (pared t-student and Wilcoxon tests), the results showed a significant difference in the measurements of the degree of swelling and trismus of the treated sample. 8 mg of dexamethasone promoted a greater reduction of symptoms than 4mg of dexamethasoneConclusions: The administration of 8 mg of the dexamethasone was more effective than 4mg of the dexamethasone to reduce the degree of swelling and trismus. However, it had no effect on pain control (AU)

Patient’s perception of the events during and after Osteogenic Alveolar Distraction

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Objective: The aim of the study was to evaluate the patient’s perception of the events during and after an osteogenic alveolar distraction (OAD) procedure Materials and Methods: A total of fifty-five (55) osteogenic alveolar distraction (OAD) procedures were performed in fifty (50) patients, who then were asked to answer ten (10) questions related to the treatment. Six (6) questions made reference to predefined values in a Visual Analogical Scale (VAS), three (3) questions could be answered by a predeter- mined answer, and only one (1) question had a free answer. Results: In 76% of cases, the patient’s description of the sensation felt during the surgery was good and bearable; 84% of the patients didn’t feel pain after surgery. 4% of the patients felt pain during the activation period and 58% of the patients described the sensation during the activation period as pressure, felt most commonly, at the end of the period, and for about 20 minutes (66.6 %). In these cases the most frequently used analgesic was Paracetamol. Also, 46% ex- pressed having had some difficulty to activate the device, with 10% of them in need of extra help. The presence of the activation rod caused discomfort in 52%. Finally, 78% of the patients treated with OAD would undergo this procedure again if it was necessary. A bone graft was performed in 27 out of the 50 treated patients, with 70% of them describing the bone graft surgery as more painful than the OAD. Conclusion: The OAD technique had a high degree of acceptance among the treated patients, however, some details as the interference of the activation rod continue to disturb them. The acceptance of the OAD technique is much better when compared with bone graft surgery technique as a second treatment

Expansión rápida del maxilar quirúrgicamente asistida, abordaje unilateral / Surgically assisted rapid maxillary expansion, unilateral approach

Una adecuada dimensión transversal del maxilar superior es un componente crítico para obtener una oclusión funcional estable. Aunque la expansión rápida del maxilar puede ser usada en pacientes jóvenes, con el pasar del tiempo y el envejecimiento del individuo, las suturas óseas van ínter digitándose y llegan a fundirse parcial o totalmente. La expansión rápida del maxilar quirúrgicamente asistida en pacientes que presentan una madurez esquelética avanzada es el procedimiento de preferencia para corregir las deficiencias transversales del maxilar. En el siguiente artículo, presentamos un relato de caso clínico de deficiencia transversa del maxilar superior tratada con Expansión Rápida Quirúrgicamente Asistida, de forma unilateral.

Uma adequada dimensão transversal da maxila e um componente crítico para obter uma oclusão funcional estável. A pesar da expansão rápida da maxila ser usada m pacientes jovens, com o decorrer do tempo e o envelhecimento do individuo, as suturas ósseas vão ínterdigitándose chegando a se fundir parcial o totalmente. A expansão rápida da maxila cirurgicamente assistida em pacientes que apresentam uma maturidade esquelética avançada é o procedimento de preferência para corrigir as deficiências transversais da maxila. No seguinte artículo, apresentamos um relato de caso clínico de deficiência transversa da maxila tratada com Expansão Rápida Cirurgicamente Assistida, de forma unilateral.

An adequate transverse maxillary dimension is a critical component to obtain a stable functional occlusion. Although the rapid palatal expansion of the jaw can be used in young patients, the facial suture lines become significantly more interdigitated and become either partially or totally fused as individual's age. The surgically assisted rapid maxillary expansion in patients with advanced skeletal maturity is the procedure of preference to correct the transverse deficiencies. In the following article, we present a clinic case of maxillary transverse deficiency, treated with surgically assisted rapid maxillary expansion, with unilateral approach.