Histomorphometric evaluation of different graft associations for maxillary sinus elevation in wide antral cavities: a randomized controlled clinical trial.

OBJECTIVES: Pneumatization of the maxillary sinus can make it difficult, if not impossible, to install osseointegrated implants, and undertake their eventual functional rehabilitation, which may ultimately require regenerative techniques to achieve. This randomized controlled study proposed conducting a histological evaluation of the behavior of different graft materials in wide maxillary sinuses, at a height of 8 to 10 mm from the alveolar ridge, combined with bone remnants less than 3mm. MATERIALS AND METHODS: Thirty-six patients underwent a sinus elevation procedure through the lateral window. The sinuses were randomly filled with the following materials (n=12/group): group 1, xenogenic bone + autogenous bone (ratio 70:30, respectively); group 2, xenogenic bone + L-PRF; and group 3, xenogenic bone. At 8 months, bone biopsies of engrafted sites were harvested and analyzed histomorphometrically in order to quantify newly formed bone tissue. RESULTS: The results showed a greater area of newly formed bone for G1, averaging 2678.37 (1116.40) µm2, compared with G2 at 984.87 (784.27) µm2, and G3 at 480.66 (384.76) µm2 (p < 0.05). Additionally, fewer xenogenic bone particles and a large amount of connective tissue were observed in G2. CONCLUSIONS: In maxillary sinuses with large antral cavities, autogenous bone combined with xenogenic bone seems to demonstrate better graft remodeling and improve bone formation, compared with the addition of L-PRF. CLINICAL RELEVANCE: L-PRF produces few advantages regarding new bone formation in the wide maxillary sinuses. TRIAL REGISTRATION: Brazilian Clinical Trials Registry (REBEC) number RBR-2pbbrvg.

Histological and histomorphometric evaluation of efficacy of a polypropylene barrier in guided bone regeneration and modified guided bone regeneration in critical defects in rodent cranial vaults.

BACKGROUND: The last few years have detailed a number of surgical materials and techniques to stimulate guided bone regeneration (GBR). Polypropylene has been used as a mechanical barrier, intentionally designed to be exposed to the oral environment, isolating the regeneration area, and allowing the blood clot to remain protected in a confined space while pluripotent mesenchymal cells regenerate the alveolar bone tissue. AIM: Due to the lack of studies on polypropylene barriers (PB) (Bone Heal- Bone heal ind. e Com. LTDA - São Paulo, Brazil), this study aimed to evaluate the histological repair process of critical defects (7 mm) made in the rodent cranial vaults comparing its efficacy in GBR and modified GBR. MATERIALS AND METHODS: A total of 30 rats were divided into three groups. The control group consisted of 10 rats, wounds covered with just a blood clot. The second group consisted of an exposed/uncoated PB at the edges of the wound, and it was removed after 3 days. The third group used submerged PB with coaptation of the wound edges, and it was not removed. Five animals of each group were euthanized at 30 and 90 days postoperative and submitted to microscopic analysis and histomorphometric evaluation. RESULTS: Modified GBR (membrane exposed to the oral medium) provided earlier tissue organization at 30 days; however, the third group presented better bone neoformation at 90 days. CONCLUSION: Modified GBR provided earlier tissue organization compared with the control group, as well as promoting improved bone neoformation, while regeneration with the submerged membrane presented better bone neoformation in the long term.

Dietary supplementation with procyanidin-rich Pinus pinaster extract is associated with attenuated Ehrlich tumor development in mice.

Inflammation and oxidative stress are related to cancer initiation and progression. We hypothesized that dietary supplementation with a procyanidin-rich Pinus pinaster extract (Pyc) with known antioxidant and anti-inflammatory effects could induce systemic protection, thereby attenuating tumor development. To test our hypothesis, mice were subjected to long-term supplementation (20 days, every 24 h) with saline, 25 mg/kg resveratrol or 100 mg/kg Pyc. Pyc was administered at a maximum tolerated oral dose, previously determined using toxicity indicators. Ten days after Ehrlich ascites tumor induction, weight gain and abdominal circumference increase were calculated. Ascitic fluid from six mice/group was evaluated by determining total volume; tumor packed cell volume; cell viability; tumor cell death type; inflammatory infiltrate; and levels of tumor necrosis factor alpha (TNF-α), interleukin 1 beta (IL-1ß), carbonyl proteins, lipid peroxidation, cyclooxigenase-2 (COX-2) expression and Akt phosphorylation (p-Akt). Ten mice/group were monitored to evaluate survival. Pyc and resveratrol were associated with reduced weight gain (>30%), abdominal circumference and ascitic volume. Tumor packed cell volume was reduced in Pyc-supplemented mice (26%), which had the largest tumor cell count reduction (>35%), increased ascitic fluid apoptosis rates (20%) and the longest survival (>2-fold). Pyc and resveratrol treatment both reduced inflammatory infiltrate and levels of TNF-α, IL-1ß, carbonyl proteins, lipid peroxidation (~ 30%) and p-Akt (up to 4-fold). Only Pyc significantly inhibited COX-2. Pyc attenuated oxidative and inflammation mediators and impaired tumor development, supporting our hypothesis and suggesting Pyc as a candidate for future studies in multitargeted dietary-based cancer prevention approaches.