Immunohistochemical panel of degenerated articular discs from patients with temporomandibular joint osteoarthritis.

BACKGROUND: Temporomandibular joint osteoarthritis (TMJOA) is a progressive degenerative disease caused by imbalance between anabolic and catabolic stimuli. OBJECTIVE: The aim of this study was to evaluate histopathological changes, collagen degeneration and the expression of eleven TMJOA biomarkers in articular discs. METHODS: Specimens were obtained from eight female patients submitted to discectomy. Discs were divided into anterior band (AB), intermediate zone (IZ) and posterior band (PB) for computerised histomorphometric analyses. Each was assigned a histopathological degeneration score (HDS). Collagen degeneration was assessed with Picrosirius-polarisation method. Biomarkers were evaluated through immunohistochemistry, including IGF-1, OPG, VEGF, TNF-α, FGF-23, IHH, MMP-3, MMP-9, TGF-ß1 , BMP-2 and WNT-3. Image processing software was used to calculate average immature collagen ratios and immunostained areas. Spearman rank tests were applied to verify correlations, with significance level of 0.05. RESULTS: The HDS showed negative correlation with expression of VEGF in IZ and PB (P < .05) and positive with TNF-α in AB (P < .01). Collagen degeneration correlated with TGF-ß1 (P < .05), BMP-2 (P < .01) and IHH (P < .05) immunostained areas in the IZ; TGF-ß1, BMP-2 and IHH expression correlated among each other in AB and IZ (P < .05). CONCLUSION: Angiogenesis and tissue fragmentation may result from aberrant physiologic responses mediated by VEGF and TNF-α, compromising TMJ discs during OA progression. The expression of TGF-ß1, BMP-2 and IHH could be related to collagen degeneration in displaced discs and may participate in TMJOA pathogenesis.

Six-Year Follow-Up of Immature Tooth Revascularization With Enamel Matrix Proteins.

Novel endodontic revascularization techniques have been considered as alternative options for treatment of immature teeth affected by apical periodontitis. The continuous development of the root canal has been recognized as a major advantage of these techniques over traditional apexification approaches. This article reports a case in which endodontic revascularization using extracellular matrix proteins (EMPs) as a scaffold was utilized to treat an immature maxillary lateral incisor with history of trauma and chronic apical periodontitis. The root canal was accessed and sequentially irrigated with sodium hypochlorite (NaOCl) (2 mL, 5.25%), saline solution (10 mL), and gluconate chlorhexidine (10 mL, 0.12%). The root canal was then dried, filled with an antibiotic paste (ciprofloxacin, metronidazole, and minocycline), and sealed for 3 weeks. The antibiotic paste was then removed by irrigating the canal with NaOCl (10 mL, 5.25%). The intracanal scaffold was obtained by injecting a commercially available enamel EMP into the newly formed intracanal blood clot. Mineral trioxide aggregate was used to seal the scaffold in place, and a composite resin restoration was then placed using a universal restorative. At 3 and 72 months, clinical and radiographic analyses demonstrated short- and long-term success of the technique presented. The authors' findings indicate revascularization techniques are promising in the treatment of immature teeth with apical periodontitis. Longitudinal clinical trials are necessary to confirm the findings reported herein.

Cirurgia plástica periodontal para correção de sorriso gengivoso / Periodontal plastic surgery for treatment of gummy smile. Reports of clinical

A necessidade de um sorriso perfeito e de tratamentos estéticos tem aumentado nos últimos anos. O sorriso é determinado por posição, forma, tamanho do dente, textura, cor e linha da gengiva e dos lábios e a forma da maxila. O objetivo do presente trabalho foi relatar dois casos clínicos de sorriso gengivoso e descrever os diferentes fatores etiológicos e as formas de tratamento.