Interrelationship between implant and orthognathic surgery for the rehabilitation of edentulous cleft palate patients: a case report

A 43-year-old woman with a unilateral cleft lip and palate, presenting a totally edentulous maxilla and mandible with marked maxillomandibular discrepancy, attended the Prosthodontics section of the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo for treatment. She could not close her mouth and was dissatisfied with her complete dentures. Treatment planning comprised placement of six implants in the maxilla, four in the mandible followed by prostheses installation and orthognathic surgery. The mandibular full arch prosthesis guided the occlusion for orthognathic positioning of the maxilla. The maxillary complete prosthesis was designed to assist the orthognathic surgery with a provisional prosthesis (no metal framework), allowing reverse treatment planning. Maxillary and mandibular realignment was performed. Three months later, a relapse in the position of the maxilla was observed, which was offset with a new maxillary prosthesis. This isa complex interdisciplinary treatment and two-year follow-up is presented and discussed. It should be considered that this type of treatment could also be applied in non-cleft patients.

Evaluation of protein undernourishment on the condylar process of the Wistar rat mandible correlation with insulin receptor expression

The mandible condylar process cartilage (CP) of Wistar rats is a secondary cartilage and acts as a mandibular growth site. This phenomenon depends on adequate proteins intake and hormone actions, including insulin. Objectives The present study evaluated the morphological aspects and the expression of the insulin receptor (IR) in the cartilage of the condylar process (CP) of rats subjected to protein undernourishment. Material and Methods The nourished group received a 20% casein diet, while the undernourished group (U) received a 5% casein diet. The re-nourished groups, R and RR, were used to assess the effects of re-nutrition during puberty and adulthood, respectively. CPs were processed and stained with picro-sirius red, safranin-O and azocarmine. Scanning electron microscopy and immunohistochemistry were also performed. Results The area of the CP cartilage and the number of cells in the chondroblastic layer decreased in the U group, as did the thickness of the CP layer in the joint and hypertrophic layer. Renourishment during the pubertal stage, but not during the adult phase, restored these parameters. The cell number was restored when re-nutrition occurred in the pubertal stage, but not in the adult phase. The extracellular matrix also decreased in the U group, but was restored by re-nutrition during the pubertal stage and further increased in the adult phase. IR expression was observed in all CPs, being higher in the chondroblastic and hypertrophic cartilage layers. The lowest expression was found in the U and RR groups. Conclusions Protein malnutrition altered the cellularity, the area, and the fibrous cartilage complex, as well as the expression of the IRs. .

Reposicionamento de fármacos no câncer de boca: Identificação de possíveis agentes / Drug repositioning for oral cancer: Identifying candidate therapeutic agents

Objetivos: O objetivo deste estudo foi o de identificar compostos seletivamente tóxicos ao carcinoma espinocelular de boca in vitro por meio do reposicionamento de fármacos. Material e Métodos: Por meio de um escaneamento baseado na viabilidade celular de 1.280 fármacos, nós selecionamos três princípios ativos (luteolin, metixene hydrochloride e nitazoxanide) letais às células de câncer de boca SCC-25 e pouco tóxicos às células de queratinócitos cutâneos imortalizados HaCaT. Os fármacos candidatos foram investigados quanto à sua dose- e tempo-resposta bem como comparados e combinados à agentes quimioterápicos padrão por meio do ensaio por colorimetria com brometo de tiazolil azul de tetrazolio (MTT). O impacto dos fármacos na motilidade do SCC-25 e do HaCaT foi verificado pelo ensaio de migração celular e seus mecanismos de ação também foram explorados por meio da verificação dos níveis das proteínas fosforiladas pelo western blotting. Todos os experimentos foram realizados em triplicata e, pelo menos, três vezes independentes. O teste t de student foi utilizado para confrontar as variáveis e nível de significância de 5% foi estabelecido para todos os testes. Resultados: O flavonoide natural luteolin exerceu citotoxicidade potente contra as células de câncer de boca in vitro, apresentando baixa toxicidade ao HaCaT e alta eficiência quando comparado a quimioterápicos como a cisplatina e o AG1478. Do ponto de vista molecular, a luteolin ativou a via de sinalização do dano do DNA e, combinada com um inibidor do Chk, apresentou efeitos potencializados. Além disso, nós demonstramos que a nitazoxanide e o metixene hydrochloride são capazes de destruir células SCC-25 porém não as HaCaT de maneira proporcional à dose e ao tempo de tratamento. As combinações entre os três fármacos hit e com a cisplatina ou o AG1478 potencializaram seus efeitos contra as células malignas. Conclusões: O presente estudo traz a luteolin, o metixene hydrochloride e a nitazoxanide como...

Objectives: Here we aimed at identifying and reposition approved drugs that could be selectively toxic towards oral squamous cell carcinoma cells. Materials and Methods: Through a cell-based drug screening of 1,280 chemical molecules, we selected 3 compounds (luteolin, metixene hydrochloride, and nitazoxanide) lethal to oral cancer SCC-25 cells, while sparing immortalized keratinocyte HaCaT cells. The drugs were then further challenged for their time- and dose-responses, as well as their comparison and combination to standard chemotherapeutic agents by colorimetric assay 1-(4,5-Dimethylthiazol-2-yl)-3,5-diphenylformazan, Thiazolyl blue formazan (MTT). The impact on SCC-25 and HaCaT motility as well as the mode of action of the drugs was then further explored by scratching assay and western blotting, respectively. All the experiments were performed in triplicated and, at least, three independent times. Students t test was performed to verify the differences among the variables and the level of significance was set at 5%. Results: The natural flavonoid luteolin was a potent cytotoxic agent against oral cancer cells in vitro, presenting low toxicity against HaCaT cells and high efficiency as compared to standard-of-care, such as cisplatin and AG1478. From a molecular standpoint, luteolin coopted the DNA-damage pathway and could be efficiently combined with Chk pharmacological inhibitor. Moreover, we demonstrated that nitazoxanide and metixene hydrochloride kill the SCC-25 but not the HaCaT cells in a dose- and time-dependent. The combinations among the three drugs hit and with cisplatin and AG1478 improved their effect against the malignant cells. Conclusions: Luteolin, metixene hydrochloride, and nitazoxanide emerge as strong cytotoxic and/or adjuvant therapy in oral cancer, as these compounds present higher efficiency and lower toxicity against oral cancer cells in vitro than conventional chemotherapeutic agents.

Apoptosis of human tongue squamous cell carcinoma cell (CAL-27) induced by Lactobacillus sp. A-2 metabolites

Objective: To study the effect of Lactobacillus sp. A-2 metabolites on viability of CAL-27 cells and apoptosis in CAL-27 cells. Methods: Lactobacillus sp. A-2 metabolites 1 and 2 (LM1 and LM2) were obtained by culturing Lactobacillus sp. A-2 in reconstituted whey medium and whey-inulin medium; the cultured CAL-27 cells were treated with different concentrations of LM1 and LM2 (0, 3, 6, 12, 24, 48 mg/mL) and assayed by methyl thiazolyltetrazolium (MTT) method; morphological changes of apoptotic cell were observed under fluorescence microscopy by acridine orange (Ao) fluorescent staining; flow cytometry method (FCM) and agarose gel electrophoresis were used to detect the apoptosis of CAL-27 cells treated LM1 and LM2. Results: The different concentrations of LM1 and LM2 could restrain the growth of CAL-27 cells, and in a dose-dependent manner; the apoptosis of CAL-27 cells was obviously induced and was time-dependent. Conclusions: Viability of CAL-27 cells was inhibited by Lactobacillus sp. A-2 metabolites; Lactobacillus sp. A-2 metabolites could induce CAL-27 cells apoptosis; study on the bioactive compounds in the Lactobacillus sp. A-2 metabolites and their molecular mechanism is in progress. .

Estudos dos efeitos de um anti-inflamatório não esteroidal seletivo para COX-2 na osteogênese e na expressão das proteínas COX-2 e RUNX-2 durante o reparo ósseo alveolar em ratos / Effect of a selective anti-infflamatory inhibitor of COX-3 in the osteogenesis and COX-2 and RUNX-2 proteins expression in the alveolar bone healing in rats

Objetivo: No atual trabalho propomo-nos a avaliar morfometricamente possíveis alterações na reparação óssea alveolar pós-exodontia de ratos tratados com Meloxicam, um anti-inflamatório inibidor preferencial da cicloxigenase 2 (COX-2) e correlacionar com a expressão temporal da COX-2 e do fator de transcrição 2 com domínio Runt (Runx-2) associada com a diferenciação de células da linhagem osteoblástica. Material e Métodos: A exodontia do incisivo superior direito foi realizada em 120 ratos Wistar, divididos em grupo controle (n = 60) - animais tratados com injeção intraperitoneal de 0,1 ml de solução salina 0,9% diariamente e grupo tratado (n = 60) animais tratados com injeção de Meloxicam na dose de 3mg/kg de massa corporal, diariamente, ambos durante 7 dias. O volume total do alvéolo (VtA) e do tecido ósseo (VtO), o número de células imunomarcadas/mm² (Nm) para COX-2 e Runx-2 e a expressão protéica por Western blotting (WB) da COX-2 e RUNX-2 foram avaliados nos períodos 3, 7, 10, 14, 21 e 30 dias póscirurgias. Resultados: No grupo tratado o VtA manteve-se constante até os 21 dias, enquanto que no controle foi 0,272 vezes menor em relação aos 3 dias decorrente da maior atividade osteoclástica. Porém, aos 14 dias, no grupo tratado o VtO foi 0,337 vezes menor em relação ao controle decorrente da inibição parcial da transmigração de células inflamatórias responsáveis pela degradação do coágulo e da angiogênese, ocasionando um retardo na formação dos tecidos de granulação/conjuntivo, na diferenciação das células osteoblásticas e na formação/remodelação do tecido ósseo, e consequentemente no reparo ósseo alveolar. A imunomarcação para COX-2 foi observada em diversos tipos celulares, como fibroblastos, células endoteliais, células inflamatórias, osteoblastos e osteócitos. O Nm para COX-2 não apresentou diferenças estatísticas significantes entre os grupos no intervalo de 3 e 21 dias pós-cirurgia, enquanto que, a expressão...

Objective: To evaluate morphometrically possible changes in post-extraction alveolar bone healing in rats treated with Meloxicam, a selective anti-inflammatory inhibitor of cyclooxygenase (COX-2) and to correlate it with the temporal expression of COX-2 and transcription factor 2 with Runt domain (Runx-2) associated with differentiation of osteoblastic lineage cells. Material and Methods: The extraction of the right upper incisor was made in 120 male Wistar rats, divided into control group (n=60) - animals treated with an intraperitoneal injection of 0,1 ml of 0,9% NaCl solution daily for 7 days and the treated group (n=60) - animals treated with injection of 3mg/kg of body weight of Meloxicam 0.9% NaCl solution daily for 7 days. The total alveolar volume (VtA), total bone tissue volume (VtO), number of immunohistochemically positive cells/mm² (Nm) for COX-2 and RUNX-2 and the Western blotting (WB) COX-2 and RUNX-2 protein expressions were evaluated after 3, 7, 10, 14, 21 and 30 days after the surgeries. Results: In the treated group the VtA remained constant until the 21st day, while in the control group at the same day the value was 0,272 times lower compared to the 3 days period, due to the higher osteoclastic activity. However, at 14 days the VtO was 0,337 times lower in the treated group compared to the control due to the partial inhibition of the transmigration of inflammatory cells responsible for the degradation of the clot and angiogenesis, causing a delay in the formation of granulation/connective tissues, differentiation of osteoblastic cells and in bone tissue formation/remodeling, and consequently in the alveolar bone repair. The immunostaining for COX-2 was observed in various cell types, such as fibroblasts, endothelial cells, inflammatory cells, osteoblasts and osteocytes. The Nm for COX-2 showed no statistical differences between groups from the 3rd to the 21st day, while the WB protein expression was on average 0,232 times lower in the...