Matriz dérmica acelular na regeneração óssea guiada de áreas tratadas com implante imediato / A cellular dermal matrix for guided bone regeneration around immediate implants

A exposição prematura e a contaminação de membranas podem prejudicar a regeneração óssea guiada ao redor de implantes imediatos. Para tanto, este trabalho apresenta a matriz dérmica acelular como uma opção para obtenção de formação óssea aliada a uma melhora da relação mucogengival.

Bioactive glass efficacy in the periodontal healing of intrabony defects in monkeys.

The purpose of this study was the histomorphologic analysis of the efficacy of bioactive glass particles with a narrow size range (Biogran) in the periodontal healing of 2-wall intrabony defects in monkeys. The 2-wall defects were made in the mesial area of the left and right second premolars of four monkeys, filled with gutta-percha and, after 15 days, they were debrided and either naturally filled with coagulum (control) or implanted with bioactive glass (test). In the control sites, the junctional epithelium migrated up to the base of the defect. The presence of newly formed cementum was more significant in the test defects. Both control and test sites showed newly formed bone at the base of the defect. The test defects presented foci of newly formed bone around and within the glass particles localized in the middle third, distant from the defect walls. Histologic analysis showed that the 300- to 355-microm bioactive glass particles aided new periodontal insertion. In conclusion, the tested bioactive glass had better healing potential than debridement only. The graft material showed a promising inhibition of apical migration of the junctional epithelium and greater cementum deposition on the radicular surface of the intrabony defects. The replacement of bioactive glass particles by new bone occurred due not only to an osteoconductive property, but also to an osteostimulatory capacity. Future investigations should evaluate this potential comparatively or together with other grafting materials, regenerative techniques and biological modifiers, as well as assess the longitudinal stability of the new attachment.

Bioactive Glass Efficacy in the Periodontal Healing of Intrabony Defects in Monkeys

A proposta desse estudo foi avaliar histologicamente a eficácia de um vidro bioativo com pequena variação de tamanho de partículas (Biogran) na cicatrização periodontal de defeitos infra-ósseos de 2 paredes em macacos. Os defeitos foram feitos na mesial dos segundos pré-molares direito e esquerdo de 4 macacos, a seguir foram preenchidos com guta-percha e, após 15 dias, foram debridados e preenchidos naturalmente com coágulo (controle) ou com vidro bioativo (teste). Nos sítios-controle, o epitélio juncional migrou até a base do defeito. A formação de novo cemento foi mais significante nos defeitos-teste. Ambos os tipos de defeitos, controle e teste, apresentaram formação de novo osso na área da base dos defeitos. Os defeitos-teste apresentaram deposição de novo osso ao redor e dentro de partículas de vidro bioativo localizadas no terço médio, distantes das paredes do defeito. A análise histológica demonstrou que o vidro bioativo com partículas de 300 a 355 µm favoreceu nova inserção periodontal. Concluiu-se que o vidro bioativo testado teve melhor potencial de cura que o debridamento. O material enxertado mostrou promissora inibição da migração apical do epitélio junctional e maior deposição de cemento na superfície radicular em defeitos infra-ósseos A substituição das partículas de vidro bioativo por novo osso ocorreu devido não apenas a uma atividade osteo-condutora, mas também a uma capacidade osteo-estimuladora. Futuras investigações devem avaliar esse potencial comparativamente a outros materiais de enxerto, técnicas regenerativas e modificadores biológicos, assim como, avaliar longitudinalmente a estabilidade dessa nova inserção.

A Aids e suas manifestações orais e periodontais: revisão de literatura / AIDS and its oral and periodontal manifestations: a literature review

As manifestações orais podem ser o primeiro sinal clínico da infecção pelo HIV. Embora a microbiota subgengival da doença periodontal no paciente portador de HIV/Aids seja semelhante àquela encontrada no indivíduo soronegativo, ela pode ser acrescida de alguns microrganismos oportunistas. As bolsas periodontais têm sido consideradas reservatórios para patógenos oportunistas como a Candida albicans em indivíduos com Aids. A presença, em altos níveis, de citocinas inflamatórias no fluido do sulco gengival desses pacientes pode resultar em uma maior destruição periodontal. As novas terapias de combate à Aids têm diminuído a incidência das manifestações orais e a mortalidade. No entanto, longitudi nalmente, a perda da efetividade da terapia em alguns pacientes pode levar à recorrência dessas manifestações

Root trunk concavities as a risk factor for regenerative procedures of class II furcation lesions in humans.

BACKGROUND: The purpose of this study was to evaluate the influence of root trunk concavities on guided tissue regeneration in humans and to determine if a modification in membrane design could improve the results. METHODS: Ten patients who provided 10 pairs of similar Class II furcation defects were recruited for the study. Each defect was randomly assigned to treatment with either a normal expanded polytetrafluoroethylene (ePTFE) membrane (NM) or a modified ePTFE membrane (MM). The MM were made by removing the collar from an NM, cutting it into 2 mm segments, and suturing each of the segments to the collar of each MM. Following basic therapy, baseline clinical measurements were recorded using an acrylic stent, including probing depth (PD) and clinical attachment level (CAL). Full flaps were elevated, the defects were carefully debrided, and the root surfaces were decontaminated with manual and ultrasonic instruments. Hard tissue measurements were performed during surgery to determine vertical (VD) and horizontal defect (HD) depths. Then, NM and MM were sutured to their corresponding tooth and the flaps sutured. Membranes remained in position for 6 weeks. After 1 year, all sites were re-entered and soft and hard tissue measurements were recorded. RESULTS: After 1 year, there were no statistically significant differences (Mann-Whitney test) between NM and MM groups in percentages of PD reduction (P= 0.27), CAL change (P= 0.26), or VD resolution (P = 0.13). However, percentage of HD resolution (NM: 24.3+/-11.8; MM: 44.8+/-16.0) was significantly different between groups (P= 0.008). CONCLUSIONS: The modified membranes resulted in greater horizontal resolution of Class II furcation defects. The collars of the membranes should be modified to improve results when root trunk concavities are present.