The Addition of Hydroxyapatite Nanoparticles on Implant Surfaces Modified by Zirconia Blasting and Acid Etching to Enhance Peri-Implant Bone Healing.

This study investigated the impact of adding hydroxyapatite nanoparticles to implant surfaces treated with zirconia blasting and acid etching (ZiHa), focusing on structural changes and bone healing parameters in low-density bone sites. The topographical characterization of titanium discs with a ZiHa surface and a commercially modified zirconia-blasted and acid-etched surface (Zi) was performed using scanning electron microscopy, profilometry, and surface-free energy. For the in vivo assessment, 22 female rats were ovariectomized and kept for 90 days, after which one implant from each group was randomly placed in each tibial metaphysis of the animals. Histological and immunohistochemical analyses were performed at 14 and 28 days postoperatively (decalcified lab processing), reverse torque testing was performed at 28 days, and histometry from calcified lab processing was performed at 60 days The group ZiHa promoted changes in surface morphology, forming evenly distributed pores. For bone healing, ZiHa showed a greater reverse torque, newly formed bone area, and bone/implant contact values compared to group Zi (p < 0.05; t-test). Qualitative histological and immunohistochemical analyses showed higher features of bone maturation for ZiHa on days 14 and 28. This preclinical study demonstrated that adding hydroxyapatite to zirconia-blasted and acid-etched surfaces enhanced peri-implant bone healing in ovariectomized rats. These findings support the potential for improving osseointegration of dental implants, especially in patients with compromised bone metabolism.

Effect of Enterococcus faecalis Biofilm on Corrosion Kinetics in Titanium Grade 4 Alloys with Different Surface Treatments.

E. faecalis has been associated with bacteremia, sepsis, and bacterial endocarditis and peri-implantitis. This microorganism can remain in the alveolus even after extraction of the root remnant. This study aimed to evaluate the corrosion on different surfaces of commercially pure titanium (Ti) grade 4 (Ticp-G4) as a function of the bacterial biofilm effect of Enterococcus faecalis. A total of 57 discs were randomly divided according to their surface finish (n = 19). For microbiological analysis (n = 9), the discs were placed in 12-well plates containing E. faecalis culture and incubated at 37 °C for 7 days. The results show that for the intergroup analysis, considering the "electrolyte" factor, there was a difference between the groups. There was greater biofilm formation for the D.A.Zir group, with greater electrochemical exchange for Biofilm, and the presence of biofilm favored greater electrochemical exchange with the medium.

Mapping Bone Marrow Cell Response from Senile Female Rats on Ca-P-Doped Titanium Coating.

Chemical and topographical surface modifications on dental implants aim to increase the bone surface contact area of the implant and improve osseointegration. This study analyzed the cellular response of undifferentiated mesenchymal stem cells (MSC), derived from senile rats' femoral bone marrow, when cultured on a bioactive coating (by plasma electrolytic oxidation, PEO, with Ca2+ and P5+ ions), a sandblasting followed by acid-etching (SLA) surface, and a machined surface (MSU). A total of 102 Ti-6Al-4V discs were divided into three groups (n = 34). The surface chemistry was analyzed by energy dispersive spectroscopy (EDS). Cell viability assay, gene expression of osteoblastic markers, and mineralized matrix formation were investigated. The cell growth and viability results were higher for PEO vs. MSU surface (p = 0.001). An increase in cell proliferation from 3 to 7 days (p < 0.05) and from 7 to 10 days (p < 0.05) was noted for PEO and SLA surfaces. Gene expression for OSX, ALP, BSP, and OPN showed a statistical significance (p = 0.001) among groups. In addition, the PEO surface showed a higher mineralized matrix bone formation (p = 0.003). In conclusion, MSC from senile female rats cultured on SLA and PEO surfaces showed similar cellular responses and should be considered for future clinical investigations.

Materials Sealing Preventing Biofilm Formation in Implant/Abutment Joints: Which Is the Most Effective? A Systematic Review and Meta-Analysis.

The purpose of this systematic review was to evaluate the literature available for materials exhibiting the best efficacy in preventing biofilm formation in the interior of implants. We searched PubMed/MEDLINE, Scopus, and Cochrane databases. This review is registered with the PROSPERO database and followed the suitability of the PRISMA protocol. The initial search resulted in 326 articles from the databases. After they were read, 8 articles remained, and the inclusion and exclusion criteria were applied. Six of these 8 articles were classified as in vitro and 2 were classified as in situ. The regions of the implants evaluated ranged from the interface of the pieces to the occlusal upper access of the abutment. The implant connections evaluated the Morse taper, external connection, and internal connection. Meta-analysis of the quantitative data was performed at a significance level of .05. Cotton exhibited poor control of infiltration, even in combination with other materials. Isolated gutta-percha (GP) and polytetrafluoroethylene (PTFE) tape with composite resin (CR) or GP performed better as physical barriers. The best results for chemical barriers were observed by the application of 1% chlorhexidine gluconate (CG) gel, thymol varnish, and the deposition of Ag films onto the surface. The applied meta-analysis did not show a significant difference in comparison between the different types of implant connections (P > .05). The application of CG and thymol varnish antimicrobials was effective in preventing biofilm formation and easy clinical execution; these could be used in combination with CR, GP, and PTFE.

Sealing agent reduces formation of single and dual-species biofilms of Candida albicans and Enterococcus faecalis on screw joints at the abutment/implant interface.

The aim of this research was to evaluate the efficacy of a commercial sealing agent at the abutment/implant interface against microleakage of single and dual-species biofilms of Candida albicans and Enterococcus faecalis into external hexagon (EH) and Morse taper (MT) prosthetic connections. A total of 216 samples of implants and their abutments were tested. Six groups (n = 36) were evaluated based on biofilm and period of incubation (7 and 14 days). The implant connections EH and MT (n = 18) were divided according to the use of the material (n = 9) (EH-T and MT-T: with the sealing agent; EH-C and MT-C: control). The biofilms were analyzed by microbial counting (CFU/mL) and SEM analysis and photographs of the material in the screw joints were also taken. Data were analyzed by Student t test, two-way ANOVA and Bonferroni test. For the single-species biofilms, there was a significant reduction in the growth of E. faecalis when compared MT-C and MT-T or EH-C and EH-T at 7 and 14 days. The same was observed for C. albicans biofilms. For dual-species biofilms of E. faecalis and C. albicans, the sealing agent was more effective in preventing microbial infiltration into the MT connection at 14 days, while microbial infiltration did not occur into EH connections even in absence of the sealing agent for both periods of evaluation. Overall, these data suggest that the presence of the sealing agent reduces or eliminates the microleakage of E. faecalis and C. albicans biofilms into the implants regardless of the period of incubation.

Cementoblastoma: relato de caso / Cementoblastoma: case report / Cementoblastoma: reporte de caso

O cementoblastoma é uma neoplasia odontogênica benigna, rara, responsável por 1% dos tumores odontogênicos. A localização mais comum é a região do primeiro molar inferior. Ela afeta principalmente a segunda e terceira décadas de vida, com crescimento lento, pode causar abaulamento cortical. Radiograficamente apresenta-se como uma lesão radiopaca, circunscrita por uma fina área radiolúcida, envolvendo a raiz dentária. Histologicamente, pode-se observar uma massa mineralizada, com aspecto cementóide, aderida às raízes do dente. Casos que apresentam expansão da cortical óssea aos exames clínico e imaginológico requerem tratamento cirúrgico por meio da curetagem da lesão e remoção do elemento dentário associado. Paciente do sexo feminino, leucoderma, 30 anos, procurou atendimento sem queixa de dor, apresentando abaulamento do osso cortical na região inferior esquerda do primeiro molar. Exames de imagem mostraram lesão radiopaca associada à raiz do elemento dentário 36, circunscrita com halo radiolúcido. A tomografia computadorizada mostra uma massa radiopaca na região apical do elemento. Biópsia excisional e exodontia do dente 46 foram realizadas. Material foi enviado para análise histopatológica e o diagnóstico foi cementoblastoma. A paciente está em proservação(AU)

Cementoblastoma is a benign, rare odontogenic neoplasm responsible for 1% of odontogenic tumors. The most common location is the lower first molar region. It mainly affects the second and third decades of life, with slow growth, can cause cortical bulging. Radiographically it presents as a radiopaque lesion, circumscribed by a thin radiolucent area, surrounding the dental root. Histologically, one can observe a mineralized mass, with cementoid aspect, adhered to the roots of the tooth. Cases that present expansion of the cortical bone to the clinical and imaging exams require surgical treatment by means of curettage of the lesion and removal of the associated dental element. A 30-year-old female patient, leucoderma, sought care without complaint of pain, showing bulging of the cortical bone in the lower left region of the first molar. Imaging studies showed radiopaque lesion associated with the root of the dental element 36, circumscribed with radiolucent halo. Computed tomography shows a radiopaque mass in the apical region of the element. Excisional biopsy and tooth extraction 46 were performed. Material was sent for histopathological analysis and the diagnosis was cementoblastoma. The patient is in proservation(AU)

El cementoblastoma es una neoplasia odontogénica benigna, rara, responsable del 1% de los tumores odontogénicos. La ubicación más común es la región del primer molar inferior. Se afecta principalmente a la segunda y tercera décadas de vida, con un crecimiento lento, puede causar abombamiento cortical. Radiograficamente se presenta como una lesión radiopaca, circunscrita por una fina área radiolúcida, envolviendo la raíz dental. Histológicamente, se puede observar una masa mineralizada, con aspecto celoide, adherida a las raíces del diente. Los casos que presentan expansión de la cortical ósea a los exámenes clínicos e imaginológico requieren tratamiento quirúrgico por medio del curetaje de la lesión y remoción del elemento dental asociado. El paciente de sexo femenino, leucoderma, 30 años, buscó atención sin queja de dolor, presentando abombamiento del hueso cortical en la región inferior izquierda del primer molar. Los exámenes de imagen mostraron lesión radiopaca asociada a la raíz del elemento dental 36, circunscrita con halo radiolúcido. La tomografía computarizada muestra una masa radiopaca en la región apical del elemento. Se realizó la biopsia excisional y la exodoncia del diente 46. El material fue enviado para análisis histopatológicos y el diagnóstico fue cementoblastoma. El paciente está en reposo(AU)

In vitro evaluation of microbial adhesion on the different surface roughness of acrylic resin specific for ocular prosthesis.

OBJECTIVE: The purpose of this study was to evaluate the influence of surface roughness in biofilm formation of four microorganisms (Staphylococcus epidermidis, Staphylococcus aureus, Enterococcus faecalis, and Candida albicans) on acrylic resin surface of ocular prostheses. MATERIALS AND METHODS: Acrylic resin samples were divided into six groups according to polishing: Group 1200S (1200 grit + silica solution); Group 1200; Group 800; Group 400; Group 120 and Group unpolished. Surface roughness was measured using a profilometer and surface images obtained with atomic force microscopy. Microbial growth was evaluated after 4, 24, and 48 hours of incubation by counting colony-forming units. STATISTICAL ANALYSIS USED: For roughness, it was performed 1-way ANOVA and parametric Tukey test α5% (P ≤ 0.05). For CFU data found, it was applied Kruskal-Wallis and Mann-Whitney tests. RESULTS: Group 120 and 400 presented the highest roughness values. For S. epidermidis and S. aureus, Group 1200S presented the lowest values of microbial growth. For E. faecalis at 4 hour, microbial growth was not observed. C. albicans did not adhere to the acrylic resin. Except for Group 1200S, different surface roughnesses did not statistically interfere with microbial adhesion and growth on acrylic surfaces of ocular prostheses. CONCLUSIONS: The roughness did not interfere with the microbial adhesion of the microorganisms evaluated. The use of silica decreases significantly microbial growth.

Bone augmentation using autogenous bone versus biomaterial in the posterior region of atrophic mandibles: A systematic review and meta-analysis.

OBJECTIVES: This systematic review and meta-analysis aimed to answer the PICO question: "Do patients who have received bone grafts with bone substitute (biomaterials) present bone gain (before implant installation), complications, and implant survival rates similar to autogenous grafts when used in the posterior mandible region?". DATA: This review followed the PRISMA statement and has been registered at PROSPERO (CRD42016048471). Studies published in English, randomized controlled and/or prospective clinical trials with at least 10 patients, and studies that compared grafts with bone substitutes to autogenous bone grafts (split-mouth design) were included. SOURCES: An electronic search and a manual search were conducted in PubMed/MEDLINE, Scopus, and Cochrane databases up to April 2018. STUDY SELECTION: Our initial search yielded 640 articles; we selected four articles that met the inclusion criteria. All selected studies used a split-mouth design. RESULTS: Our analysis revealed no significant difference between the biomaterial and autogenous groups in terms of bone gain (P = 0.11; mean difference [MD]: 0.59; 95% confidence interval [CI]: -0.13-1.31) or complication rate (P = 0.72; risk ratio [RR]: 1.25; 95% CI: 0.37-4.23). Sixty-six implants were installed in the biomaterial group and 63 in the autogenous group; these showed no significant difference in implant survival rate (P = 0.50; RR: 1.57; 95% CI: 0.43-5.81). CONCLUSION: We conclude that biomaterials or autogenous bone are indicated for the reconstruction of the posterior mandibular atrophic region, without lowering implant survival.

Short-Blunt Injury in Child Resulting From Pet Bite.

The frequency of accidents due to dog bite in children is high, and in the most cases, the child already knows the aggressor dog. Patient, 3 years, female, melanoderm, victim of pet dog attack on the right side of the face region. After the physical examination, conscious sedation was performed with the supplementation of oxygen by pediatrics and the suture by oral and maxillofacial surgeon, under local anesthesia with adrenergic vasoconstrictor, with internal points in the muscles using vicryl 4-0 and in the skin with 5-0 nylon; the lesser number of stitches were performed in the lower region of the wound, allowing spontaneous drainage spaces. The immediate wounds closure of dog bites on the face is safe, even in cases after several hours of the injury.

Efeito da vedação da interface pilar/implante na formação de biofilmes isolados e mistos de Candida albicans e Enterococcus faecalis nas junções parafusadas / Effect of the interface of the abutment/implant interface on the formation of isolated and mixed biofilms of C. albicans and E. faecalis on screw joints

O objetivo desta pesquisa foi avaliar a eficácia do material Loctite 2400® como de agente de vedação no selamento da interface pilar/implante contra a infiltração e formação de biofilmes isolados e mistos de C. albicans e E. faecalis no interior de conexões protéticas HE e CM. Foram formados 216 conjuntos de implantes com seus pilares protéticos e parafusos de retenção. Deste total, foram formados 6 grupos (n=36) de acordo com cada biofilme em função do período de incubação (7 e 14 dias) e conexão de implantes HE e CM (n=18) divididos em função do uso do material (n=9). Os biofilmes foram analisados por meio da contagem UFC/ml. Para análise qualitativa do biofilme misto formado aos 7 dias, foi realizada MEV. A análise do agente de vedação nas junções parafusadas foi realizada por meio de fotografias de conjuntos secionados. Para comparar as médias dos dados de contagem das UFC/mL para os ensaios de biofilme isolado de E. faecalis e C. albicans, os dados foram analisados pelo teste de ANOVA a dois critérios seguida pelo teste de Bonferroni considerando (α=5%). E para biofilme misto, foi utilizado o teste t Student. A contagem UFC/ml isolado de E. faecalis e C. albicans, apresentou diferença estatística significante de todos os grupos teste em relação ao controle, em todos os períodos de tempo. Para biofilme misto, não houve crescimento microbiano nos grupos HE, independente do microrganismos e período de tempo avaliado. Nos grupos CM, para E. faecalis, houve diferença estatística entre os grupos CM-C e CM-T somente no período de 14 dias. Para C. albicans, observa-se diferença estatística significante entre os grupos CM-C e CMT independente do período avaliado. A análise de MEV, mostra a formação de biofilme espesso com grande quantidade de matriz extracelular para os grupos controle. E a análise visual do agente de vedação, mostra a presença do material na interface pilar/implante e nas roscas da junção parafusada. Conclui-se que a presença do agente de vedação interferiu positivamente na infiltração de biofilmes isolados de E. faecalis e C. albicans para o interior dos implantes independente do período de tempo avaliado. Para biofilmes mistos, a conexão hexagonal externa foi mais eficaz contra a infiltração microbiana, independente do microrganismo, tempo e uso do agente de vedação. Para a conexão cone Morse, o agente de vedação foi eficaz apenas no período de 14 dias(AU)

The aim of this research was to evaluate the efficacy of sealing agent in the interface abutment/implant against infiltration of isolated and mixed biofilms of C. albicans and E. faecalis inside EH and MT prosthetic connections. 216 sets of implants with their prosthetic abutments and retaining screws were formed. Of this total, were formed six groups (n = 36) in accordance with each biofilm as function of the incubation period (7 and 14 days) and implant connection EH and MT (n = 18) stratified by use of the material (n = 9). The biofilms were analyzed by counting UFC/mL. For qualitative analysis of the mixed biofilm the SEM analysis was performed at 7 days. The analysis of the sealing agent in the screw joints was performed by photographs of the sectioned sets. To compare the average UFC/mL count data of E. faecalis and C. albicans isolated biofilms, the data were analyzed by two-way ANOVA test followed by Bonferroni test (α = 5%). For mixed biofilms it was applied t Student test. The UFC/mL isolated count for E. faecalis and C. albicans presented statistically significant difference of all the test groups in relation to the control, in all time periods. For mixed biofilm, there was no microbial growth in EH groups, independent of microorganisms and time period evaluated. In MT groups, for E. faecalis, there was statistical difference between MT-C and MT-T groups only in the period of 14-days. For C. albicans, statistically significant difference was observed between the groups MT-C and MT-T independent of the period evaluated. The SEM analysis shows the formation of thick biofilm with a high amount of extracellular matrix for control groups. The visual analysis of the sealing agent shows the presence of the material at the abutment/implant interface and the threads of the screw joint. It was concluded that the presence of the sealing agent interfered positively in the infiltration of isolated biofilms of E. faecalis and C. albicans into the implants regardless of the time period evaluated. For mixed biofilms, the external hexagonal connection is more effective against microbial infiltration, regardless of the microorganism, time and use of the sealing agent. For Morse taper connection, the sealing agent was effective only over the 14 day period(AU)

Successful Use of Lower-Level Laser Therapy in the Treatment of Medication-Related Osteonecrosis of the Jaw.

Case Presentation: This study aimed to report a case of medication related osteonecrosis of the jaw (MRONJ) of a 65-year-old female patient referred to the Oral and Maxillofacial Surgery team from Araçatuba Dental School, complaining about mobility of a previously dental implant placed on the posterior maxillary region. Clinical examination revealed an extensive necrosis area around the implant region. The patient reported bisphosphonate therapy with sodium alendronate for prevention of osteoporosis 5 years ago. A diagnosis of MRONJ was reached and the treatment decided was to remove the dental implant damaged and use the lower-level laser therapy (LLLT) associated with antibiotic therapy with clindamycin 300 mg and mouth rinses with chlorhexidine 0.12%. Conclusion: Six months after the treatment with LLLT a complete healing of the affected area was observed and 12 months after treatment the patient was rehabilitated with fixed dental prosthesis and showed excellent tissue healing of the necrosis areas. It was concluded that the use of LLLT showed to be a good option in the treatment of MRONJ.