Caracterização do tecido ósseo peri-implantar em ratas hipertensas e com deficiência de estrógeno, após ação sinérgica de losartan e alendronato de sódio / Characterization of peri-implant bone tissue in hypertensive and estrogen-deficient rats after the synergistic action of losartan and alendronate sodium

Introdução: Este estudo visou caracterizar morfológica e estruturalmente o tecido produzido na interface osso-implante em ratas espontaneamente hipertensas ovariectomizadas com implantes instalados em suas tíbias, e analisou como o tratamento associado de losartan sistêmico e alendronato de sódio local influenciou no reparo ósseo peri-implantar. Material e Métodos: Foram utilizadas ratas espontaneamente hipertensas (SHR) que receberam losartan (30 mg/kg, p.o.). Após uma semana, implantes de titânio tratados (Medens, Ribeirão Preto, São Paulo, Brazil) ou não com alendronato de sódio (ALE) foram instalados nas tíbias. Sessenta dias após a implantação, a estabilidade do implante foi avaliada pela medição de torque reverso, considerado como desfecho primário. A microtomografia computadorizada e a análise por confocal foram parâmetros secundários. Resultados: A ação sinérgica do losartan e do alendronato de sódio na superfície do implante aumentou o torque reverso no grupo SHR SHAM ALE. Enquanto a microtomografia também revelou maior extensão de contato entre osso e implante, volume ósseo e espessura trabecular nos animais SHR SHAM ALE. Por último, o losartan e o alendronato de sódio não alterou significativamente os parâmetros de osseointegração nas ratas ovariectomizadas. Conclusões: Os resultados apresentados sugerem que a ação sistêmica do losartan somada à atuação local do alendronato de sódio na superfície dos implantes melhoram os parâmetros de osseointegração em tíbias de ratas hipertensas e não ovariectomizadas(AU)

Background: This study aims to characterize morphologically and structurally the tissue produced at the bone-implant interface in spontaneously hypertensive ovariectomized rats that will have implants placed in their tibiae, and to analyze how the associated treatment of systemic losartan and local sodium alendronate might influence the peri-implant bone healing. Methods: They are used spontaneously hypertensive (SHR) rats that received losartan (30 mg/kg, p.o.). After one week, titanium implants treated (Medens, Ribeirão, São Paulo, Brazil) or not with sodium alendronate (ALE) were installed in the tibiae. Sixty days after implantation, implant stability was assessed by measuring the removal torque considered the primary end point. Computed tomography and confocal analysis were secondary parameters. Results: The synergistic action of losartan and sodium alendronate on the implant surface increased the reverse torque in the SHR SHAM ALE group. While microtomography also revealed a greater extent of contact between bone and implant, bone volume and trabecular thickness in SHR SHAM ALE animals. Finally, losartan and sodium alendronate did not significantly alter osseointegration parameters in ovariectomized rats. Conclusions: The results presented suggest that systemic losartan plus the local action of sodium alendronate on implants surface improves osseointegration parameters in tibias of hypertensives and non-ovariectomized rats(AU)

Use of audiovisual media to enhance patients' knowledge regarding the oral adverse effects of oncology treatment / Uso de mídia audiovisual para aprimorar o conhecimento dos pacientes sobre os efeitos adversos orais do tratamento oncológico

Objetivo: o presente estudo teve como objetivo avaliar a eficácia de alternativas didáticas, como a mídia audiovisual, na transmissão de informações sobre os efeitos adversos orais do tratamento oncológico em pacientes com câncer. Métodos: pacientes oncológicos foram divididos aleatoriamente em dois grupos: grupo controle (n = 40) e grupo audiovisual (n = 36). O grupo controle recebeu informações verbais sobre os efeitos colaterais orais do tratamento do câncer. Por outro lado, o grupo audiovisual recebeu a mesma informação verbal, juntamente com uma apresentação ilustrativa de mídia audiovisual. Além disso, foram aplicados questionários sobre o assunto antes e após a intervenção da equipe odontológica. Resultados: o presente estudo empregou o teste exato de Fisher para análise estatística, e os resultados mostraram similaridade estatística entre os dois grupos (P > 0,05). Ambas as abordagens educacionais alcançaram o objetivo pretendido. Conclusão: um diálogo bem conduzido pode criar uma compreensão adequada entre pacientes com câncer, melhorando a sua adaptação. Opcionalmente, o uso de técnicas inovadoras, como recursos audiovisuais, pode ser uma alternativa acessível e eficiente, que também pode ser usada na educação desses pacientes. Dessa forma, vídeos educacionais podem ser usados para melhorar a compreensão dos pacientes, a adesão a esquemas terapêuticos e a qualidade de vida, além de contribuir para um melhor prognóstico.(AU)

Objective: the present study aimed to evaluate the efficacy of didactic alternatives, namely the audiovisual media, in conveying information regarding the oral adverse effects of oncology treatment in cancer patients. Methods: cancer patients were randomly divided into two groups: control group (n = 40) and audiovisual group (n = 36). The control group received verbal information regarding the oral side effects of cancer treatment. Conversely, the audiovisual group received the same verbal information, along with an illustrative audiovisual media presentation. Additionally, questionnaires on the subject were administered before and after the intervention by the dental team. Results: the current study employed Fisher's exact test for statistical analysis, and the results showed statistical similarity between the two groups (P > 0.05). Both educational approaches achieved the intended objective. Conclusion: a well-conducted dialogue can create adequate awareness among cancer patients and improve adaptation. Optionally, the use of innovative techniques, such as audiovisual resources, was observed to be an accessible and efficient alternative that can also be used in patient education. Therefore, educational videos can be used to improve patients' understanding, adherence to therapeutic regimens, and quality of life and contribute to a better prognosis.(AU)

Evaluation of Osteoconduction of Biphasic Calcium Phosphate Ceramic in the Calvaria of Rats: Microscopic and Histometric Analysis.

(1) Background: Evaluate the osteoconduction capability of a biphasic calcium phosphate (BCP) ceramic composed of hydroxyapatite and ß-tricalcium phosphate 60%/40% in a rat model. (2) Methods: In the calvarial bone of 54 adult male rats, 7-mm diameter critical size defects were performed. The animals were randomly allocated to three experimental groups according to the type of material: blood clot (BCG), blood clot covered with a bovine-derived collagen membrane (MBCG), and BCP ceramic covered with a bovine-derived collagen membrane (BCPG). In each group, 6 animals were euthanatized at post-operative days 7, 30, and 60 for histological and histometric analysis. (3) Results: The qualitative analysis revealed the persistence of the collagen membrane at seven days, with no relevant newly bone formation in all groups. At 30 days, centripetal bone formation was observed residual particles of the biomaterial surrounded by fibroblasts noted in the BCPG. At 60 days, while BCG and MBCG showed a partial maturation with the central part of the defect populated by a fibrous connective tissue, in the BCPG the critical area was entirely occupied by newly formed bone. In the intra groups analysis was noted a significant increase in new bone formation during the experimental period (p < 0.05). At 60 days, BCPG showed a higher percentage area of new bone formation (p < 0.05). (4) Conclusion: BCP promoted a new bone formation by osteoconduction and might be considered a valid alternative in bone regeneration procedures.

Clear cell odontogenic carcinoma of the mandible: a treatment strategy.

Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic tumor of the jaws, histologically characterized by the presence of agglomerates of cells with eosinophilic cytoplasm. The patient, a 62-year-old Caucasian woman, presented an intraosseous lesion in the mandibular symphysis. A clinical examination revealed a discrete volumetric increase with a hard consistency, palpable to extraoral and intraoral examinations. Imaging studies revealed an extensive radiolucent area, without defined limits, extending from the region of the right second premolar to the left canine. Incisional biopsy analysis indicated a diagnosis of CCOC. The treatment proposed was segmental resection of the mandible with a safety margin. After six months without recurrence, definitive mandibular reconstruction was performed using an iliac crest graft, followed by rehabilitation with implant-supported denture after five months. After three years of post-resection follow-up, the patient has shown no evidence of recurrence or metastasis. She continues to be under follow-up. To conclude, CCOC must be considered a malignant tumor with aggressive behavior. Previous studies have shown that resection with free margins is a treatment with a lower rate of recurrence. Nevertheless, long-term follow-up is necessary for such patients.

Reparo ósseo peri-implantar em tíbias de ratos espontaneamente hipertensos (SHR) tratados com losartan: análise biomecânica, molecular, microtomográfica, dinâmica óssea por fluorocromos, imunoistoquímica e histológica / Peri-implant bone healing in the tibia of spontaneously hypertensive rats (SHR) treated with losartan: a biomechanical, molecular, microtomography, bone dynamics by fluorochromes, immunohistochemical and histological analysis

A hipertensão está associada a doenças cardiovasculares, mas também com alterações na qualidade óssea. A hipertensão, portanto, pode ser um fator de risco para a osseointegração. Estudos pré-clínicos sugerem que o Losartan, um bloqueador dos receptores da angiotensina II amplamente utilizado para tratara hipertensão, tem um efeito benéfico na consolidação do enxerto. No entanto, o efeito da hipertensão e do Losartan na osseointegração permanece desconhecido. Materiais e métodos: Aqui utilizamos ratas espontaneamente hipertensivos (SHR) e ratos Wistar albinus normotensos que receberam Losartan (30 mg/kg, p.o.) ou não tratados. Após uma semana, mini-implantes de titânio foram inseridos na tíbia. Sessenta dias após a implantação, a estabilidade do implante foi avaliada pela medição de torque de remoção considerada o ponto final primário. A tomografia computadorizada micro e a análise histomorfométrica foram parâmetros secundários. Resultados: o Losartan aumentou o torque de remoção no grupo SHR hipertenso para os níveis dos controles Wistar. Enquanto os parâmetros corticais da osseointegração permaneceram inalterados, Losartan aumentaram a formação do osso medular. A micro tomografia computadorizada revelou maior volume ósseo por volume de tecido e espessura trabecular nos ratos SHR tratados com Losartan. A análise histomorfométrica mostrou ainda que o Losartan aumentou significativamente a espessura do osso recém-formado na área medular em ratos SHR hipertensos. O Losartan não alterou significativamente os parâmetros de osseointegração em ratos normotensos. Conclusões: Os dados apresentados sugerem que o antagonista dos receptores da angiotensina II Losartan aumenta os parâmetros medulares da osseointegração no modelo da tíbia de ratos espontaneamente hipertensos(AU)

Background: Hypertension is associated with cardiovascular diseases but also with alterations in bone quality. Hypertension therefore might be a risk factor for osseointegration. Preclinical studies suggest that losartan, an angiotensin II receptor blocker widely used to treat hypertension, has a beneficial effect in graft consolidation. However, the effect of hypertension and losartan on osseointegration remains unknown. Methods: Here we used spontaneously hypertensive rats (SHR) and normotensive Wistar albinus rats receiving losartan (30 mg/kg, p.o.) or left untreated. After one week, titanium miniscrews were inserted into the tibia. Sixty days after implantation, implant stability was evaluated by removal torque measurement considered the primary endpoint. Micro computed tomography and histomorphometric analysis were secondary endpoints. Results: Losartan increased the removal torque in the hypertensive SHR group to levels of the Wistar controls. While the cortical parameters of osseointegration remained unchanged, losartan increased medullary bone formation. Micro computed tomography revealed a higher bone volume per tissue volume and trabecular thickness in the SHR rats treated with losartan. Histomorphometric analysis further showed that losartan significantly increased the thickness of newly formed bone in medullary area in hypertensive SHR rats. Losartan did not significantly alter the parameters of osseointegration in normotensive rats. Conclusions: The data presented suggest that the angiotensin II receptor antagonist losartan increases the medullary parameters of osseointegration in a tibia model of spontaneously hypertensive rats(AU)

Clear cell odontogenic carcinoma of the mandible: a treatment strategy

Abstract Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic tumor of the jaws, histologically characterized by the presence of agglomerates of cells with eosinophilic cytoplasm. The patient, a 62-year-old Caucasian woman, presented an intraosseous lesion in the mandibular symphysis. A clinical examination revealed a discrete volumetric increase with a hard consistency, palpable to extraoral and intraoral examinations. Imaging studies revealed an extensive radiolucent area, without defined limits, extending from the region of the right second premolar to the left canine. Incisional biopsy analysis indicated a diagnosis of CCOC. The treatment proposed was segmental resection of the mandible with a safety margin. After six months without recurrence, definitive mandibular reconstruction was performed using an iliac crest graft, followed by rehabilitation with implant-supported denture after five months. After three years of post-resection follow-up, the patient has shown no evidence of recurrence or metastasis. She continues to be under follow-up. To conclude, CCOC must be considered a malignant tumor with aggressive behavior. Previous studies have shown that resection with free margins is a treatment with a lower rate of recurrence. Nevertheless, long-term follow-up is necessary for such patients.