Could implant position influence the peri-implant parameters in edentulous mandibles of diabetics rehabilitated with overdentures? A split-mouth randomized study.

This randomized controlled trial assessed the impact of crestal level position of implants installed in type 2 diabetes mellitus (T2DM) patients rehabilitated with overdentures. Twenty-two mandibular edentulous T2DM patients were submitted to implant placement for retention of an overdenture. By means of a split-mouth design, two implants were installed: one at supracrestal level (SL) and one at crestal level (CL). Clinical, immunoenzymatic and tomographic analyses were performed at prosthesis placement (baseline) and after 6, 12 and 24 months following implant loading. Increased peri-implant probing depths were detected in CL implants when compared with SL implants at all time-points (baseline P=0.047; 6 months P=0.014; 12 months P=0.027; 24 months P=0.036). Indeed, augmented clinical attachment levels were also detected in CL implants when compared with SL implants at all time-points (baseline P=003; 6 months P=0.045; 12 months P=0.029; 24 months P=0.026). CL implants demonstrated increased amounts of interleukin-6 (IL-6) at 6 months (P=0.043) and higher IL-17 (P=0.021), IL-21 (P=0.034) and tumour necrosis factor alpha (TNF-α) concentrations (P=0.030) at 24 months in comparison with SL implants. CL group revealed enhanced bone loss from baseline to 6 (P=0.032), 12 (P=0.043) and 24 months (P=0.028) when compared with SL. In conclusion, this study showed that implants placed supracrestally in T2DM patients rehabilitated with overdentures demonstrated lower bone loss and better clinical parameters with beneficial modulation of peri-implant immunoinflammatory biomarkers when compared with implants positioned at crestal level.

Lumbar Myelopathy Caused by Multiple Cartilaginous Exostoses in a Dog.

A 6-months-old male mixed-breed dog was admitted to the veterinary hospital with lameness in the right pelvic limb, proprioceptive ataxia, and suspected spinal cord injury in the lumbosacral segment. Upon palpation, firm nodules were noted on the bony surface of the thoracic and pelvic limbs, ribs, vertebrae, and tail. The radiographic study showed nodules of low radiopacity with well-defined limits and smooth contours, one of which was overlapping the fifth lumbar vertebra. Given the clinical presentation indicative of spinal cord injury, the animal was subjected to hemilaminectomy for nodular resection. Histopathological examination of the biopsy enabled the diagnosis of osteochondroma. The clinical follow up after surgery showed improvement in walking, despite persistent monoparesis in the right pelvic limb. The radiographic study in association with clinical and histopathological exams allowed the diagnosis and monitoring of the lesions.

Brain teratoma in a free-ranging mallard (Anas platyrhynchos) - case report / [Teratoma cerebral em um pato-real (Anas platyrhynchos) de vida livre - relato de caso]

Teratoma is a rare neoplasia with differentiation in two or three germ cell lines. Intracranial teratoma in birds has rarely been reported, especially affecting the brain. This is the first report of a brain teratoma in a mallard with neurological clinical signs. The neoplasm was characterized as a mature brain teratoma, extending from the cerebellum to the brainstem, and with one nodule in the cortex.(AU)

O teratoma é uma neoplasia rara, com diferenciação em duas ou três linhagens de células germinativas. Teratomas intracranianos, em aves, são raramente relatados, principalmente, com localização cerebral. Este é o primeiro relato de teratoma cerebral em um pato-real com sinais clínicos neurológicos. A neoplasia foi caracterizada como um teratoma cerebral maduro, estendendo do cerebelo ao tronco encefálico e com um nódulo no córtex.(AU)

Tumor carcinoide na vesícula biliar em cão / Carcinoid gallbladder tumor in a dog

Carcinoid is a neoplasia that arises from dispersed cells of the neuroendocrine system. This tumor is uncommon in animals, and its occurrence in the gallbladder is rare. A male Basset Hound dog's corpse was taken to the Univerdade Federal de Minas Gerais to be analyzed by the Veterinary Pathology sector, without a description of its previous history. Necropsy revealed the presence of pale oral, ocular and penile mucous membranes. The gallbladder had a thickened wall and a dilated lumen, which was filled with dark and lumpy bile. Its mucosa had a whitish-red nodule, with solid and friable areas. Microscopically, there was a focal neoplastic proliferation, which wasn't encapsulated and had imprecise limits, which cells were distributed in a solid pattern and separated by a delicate fibrovascular stroma. The neoplastic cells presented oval or round shaped nucleus, which had a chromatin predominantly loose, and one or two nucleoli. Their cytoplasm was moderately abundant, and in most of the cells it was eosinophilic, granular, and had well-defined limits. Using the Grimelius coloration, neoplastic cells' cytoplasmic granules stained brownish or black, confirming the neuroendocrine origin of the neoplasia. Based on the macroscopic and microscopic findings, the diagnosis of a gallbladder carcinoid was established.(AU)

Subgingival Host-Microbial Interactions in Hyperglycemic Individuals.

Type 2 diabetes mellitus (T2DM) is an established risk factor for periodontitis, yet its contribution to creating host-bacterial disequilibrium in the subgingival crevice is poorly understood. The present investigation aimed to quantify the impact of hyperglycemia on host-bacterial interactions in established periodontitis and to map shifts in these dynamics following mechanical nonsurgical therapy. Seventeen T2DM and 17 non-T2DM subjects with generalized severe chronic periodontitis were recruited along with 20 periodontally healthy individuals. Subjects with periodontitis were treated with scaling and root planing (SRP). Samples of subgingival biofilm and gingival crevicular fluid were collected at baseline and at 1-, 3-, and 6 mo postoperatively. Correlations were generated between 13.7 million 16S ribosomal DNA sequences and 8 immune mediators. Intermicrobial and host-microbial interactions were modeled using differential network analysis. Periodontal health was characterized by a sparse interbacterial and highly connected cytokine-bacterial network, while both normoglycemics and T2DM subjects with periodontitis demonstrated robust congeneric and intergeneric hubs but significantly fewer cytokine-bacterial connections. Following SRP, the cytokine-bacterial edges demonstrated a 2-fold increase 1 mo postoperatively and a 10-fold increase at 6 mo in normoglycemics. In hyperglycemics, there was a doubling at 1 mo but no further changes thereafter. These shifts accompanied an increasingly sparse interbacterial network. In normoglycemics, the nodes anchored by interleukin (IL)-4, IL-6, and IL-10 demonstrated greatest rewiring, while in hyperglycemics, IL-1ß, IL-6, INF-γ, and IL-17 exhibited progressive rewiring. Thus, the present investigation points to a breakdown in host-bacterial mutualism in periodontitis, with interbacterial interactions rather than host-bacterial interactions primarily determining community assembly. Hyperglycemia further exacerbates this uncoupled mutualism. Our data also demonstrate that while nonsurgical therapy might not consistently alter microbial abundances or lower proinflammatory molecules, it "reboots" the interaction between the immunoinflammatory system and the newly colonizing microbiome, restoring a role for the immune system in determining bacterial colonization. However, this outcome is lower and delayed in hyperglycemics.

Bilateral Primary Obstructive Giant Megaureter in an Adult Dog.

A rare case of bilateral, primary, obstructive, giant megaureter was found during necropsy examination of an 11-year-old female German shepherd dog. On ultrasound examination and at necropsy examination, both ureters were tortuous and extensively dilated with diameter ranging from 1.86 to 4.8 cm. Both vesicoureteral junctions were obstructed by uroliths. A diagnosis of giant megaureter was established using human parameters since these values are not recognized in animals. The classification of obstructive and primary megaureter was determined because the obstruction was due to uroliths at the vesicoureteral junctions.

The impact of implant abutment surface treatment with TiO2 on peri-implant levels of angiogenesis and bone-related markers: a randomized clinical trial.

The goal of this randomized, blinded, split-mouth controlled clinical trial was to assess the influence of abutment surface treatment on tissue healing. Fifteen patients received two implants distributed randomly to two groups: test (TiO2 abutment surface), control (standard abutment surface). Levels of epidermal growth factor (EGF), bone morphogenetic protein 9 (BMP-9), endothelin 1 (ET-1), fibroblast growth factor (FGF), placental growth factor (PlGF), and vascular endothelial growth factor (VEGF) were quantified in the peri-implant fluid after 3, 14, 30, and 60 days. Inter-group comparisons indicated higher levels of EGF, BMP-9, ET-1, FGF, and PlGF in the test group after 30days (P<0.05). PlGF levels were also higher in the test group after 60 days. In the test group, intra-group analysis revealed different levels of ET-1 and FGF between days 3 and 30, and days 3 and 60 (P<0.05); furthermore, VEGF levels were significantly higher on day 60 than on day 3 (P <0.05). In the control group, intra-group analysis demonstrated significantly different levels of ET-1, FGF, and PlGF between days 3 and 60 and of PlGF between days 14 and 60 (P<0.05). In conclusion, abutment surfaces treated with TiO2 influenced the levels of angiogenesis and bone-related markers.

Effect of curcumin on bone tissue in the diabetic rat: repair of peri-implant and critical-sized defects.

This study determined the effect of curcumin on bone healing in animals with diabetes mellitus (DM). One hundred rats were divided into five groups: DM+PLAC, DM+CURC, DM+INS, DM+CURC+INS, and non-DM (CURC, curcumin; PLAC, placebo; INS, insulin). Critical calvarial defects were created and titanium implants were inserted into the tibiae. Calvarial defects were analyzed histometrically, and BMP-2, OPN, OPG, RANKL, Runx2, Osx, ß-catenin, Lrp-5, and Dkk1 mRNA levels were quantified by PCR. The implants were removed for a torque evaluation, the peri-implant tissue was collected for mRNA quantification of the same bone-related markers, and the tibiae were submitted to micro-computed tomography. The DM+CURC+INS and non-DM groups exhibited greater closure of the calvaria when compared to the DM+PLAC group (P<0.05). Increased retention of implants was observed in the DM+CURC, DM+CURC+INS, and non-DM groups when compared to the DM+PLAC group (P<0.05). CURC improved bone volume and increased bone-implant contact when compared to DM+PLAC (P<0.05). In calvarial samples, CURC favourably modulated RANKL/OPG and Dkk1 and improved ß-catenin levels when compared to DM+PLAC (P<0.05). In peri-implant samples, Dkk1 and RANKL/OPG were down-regulated and BMP-2 up-regulated by CURC when compared to DM+PLAC (P<0.05). CURC reverses the harmful effects of DM in bone healing, contributing to the modulation of bone-related markers.

The impact of different torques for the insertion of immediately loaded implants on the peri-implant levels of angiogenesis- and bone-related markers.

The aim of this split-mouth, randomized, double-blind, controlled clinical trial was to evaluate the influence of different insertion torque values for dental implants on bone- and angiogenesis-related marker profiles. Eighteen edentulous patients received dental implants and fixed complete-arch mandibular prostheses. The implants (n=36) were assigned randomly to two groups: reduced torque (n=18), with insertion torque <30Ncm; and conventional torque (n=18), with insertion torque ≥30Ncm. Levels of vascular endothelial growth factor (VEGF), placental growth factor, bone morphogenetic protein 9 (BMP-9), periostin, osteoprotegerin (OPG), and tartrate-resistant acid phosphatase (TRAP) in the peri-implant fluid were quantified at 7, 14, 30, and 120days after implant placement. Inter-group comparisons showed that VEGF and OPG levels were higher in the low-level torque group than in the conventional torque group on days 7 and 30, respectively (P<0.05). BMP-9 and periostin levels were higher in the conventional group than in the low-level torque group on day 120, and TRAP was up-regulated around implants inserted with conventional torque when compared to those inserted with lower-level torque at all time points evaluated (P<0.05). In conclusion, the use of different levels of torque for implantation of immediately loaded implants significantly influenced the levels of bone- and angiogenesis-related markers during early peri-implant repair.

Impact of type 2 diabetes on the gene expression of bone-related factors at sites receiving dental implants.

This study evaluated the influence of type 2 diabetes mellitus (T2DM) on the gene expression of bone-related factors in alveolar bone tissue from sites designated to receive dental implants. Bone biopsies were harvested from sites of planned implants for 19 systemically healthy patients and 35 patients with T2DM (17 with better-controlled T2DM (glycated haemoglobin (HbA1c) levels ≤8%) and 18 with poorly controlled T2DM (HbA1c levels >8%)). The mRNA levels of tumour necrosis factor alpha, transforming growth factor beta, receptor activator of the nuclear factor kappa B ligand (RANKL), osteoprotegerin (OPG), runt-related transcription factor 2, alkaline phosphatase, bone sialoprotein (BSP), type I collagen (COL-I), and osteocalcin were evaluated by quantitative real-time polymerase chain reaction. T2DM up-regulates RANKL levels and the ratio of RANKL/OPG, whereas it down-regulates COL-I and BSP expression (P<0.05). Higher mRNA levels of RANKL/OPG were observed in the poorly controlled T2DM patients compared to those with better-controlled T2DM and systemically healthy patients (P<0.05). A lower amount of COL-I and BSP was detected in the biopsies from individuals with poorly controlled T2DM compared to systemically healthy patients (P<0.05). In conclusion, RANKL, RANKL/OPG, COL-I, and BSP are negatively affected in diabetics. Additionally, the patient's glycaemic status appears to modulate bone-related genes in a different manner.

Resveratrol improves bone repair by modulation of bone morphogenetic proteins and osteopontin gene expression in rats.

This study investigated the effect of resveratrol on bone healing and its influence on the gene expression of osteogenic markers. Two calvarial defects were created and one screw-shaped titanium implant was inserted in the tibia of rats that were assigned to daily administration of placebo (control group, n=15) or 10mg/kg of resveratrol (RESV group, n=15) for 30 days. The animals were then sacrificed. One of the calvarial defects was processed for histomorphometric analysis and the tissue relative to the other was collected for mRNA quantification of bone morphogenetic protein (BMP)-2, BMP-7, osteopontin (OPN), bone sialoprotein (BSP), osteoprotegrin (OPG), and receptor activator of NF-κB ligand (RANKL). Implants were removed by applying a counter-torque force. Histomorphometric analysis revealed higher remaining defect in the calvarial defects of the control group than the RESV group (P=0.026). Resveratrol increased the counter-torque values of implant removal when compared to control therapy (P=0.031). Gene expression analysis showed a higher expression of BMP-2 (P=0.011), BMP-7 (P=0.049), and OPN (P=0.002) genes in the RESV group than in the control group. In conclusion, resveratrol improved the repair of critical-sized bone defects and the biomechanical retention of implants. Indeed, this natural agent may up-regulate the gene expression of important osteogenic markers.

Release of bone markers in immediately loaded and nonloaded dental implants: a randomized clinical trial.

The aim of this study was to compare the release of bone markers during osseointegration of immediately loaded and nonloaded implants. Forty patients who were indicated for rehabilitation with dental implants randomly received either implant and prosthesis placement within 72 hours (group IM) or implant insertion and no prosthesis placement (group NL). Peri-implant crevicular fluid was collected immediately after implant insertion and 7, 15, 30, 60, 90, and 120 days after surgery and levels of osteoprotegerin, transforming growth factors, osteocalcin, osteopontin, and parathyroid hormone were evaluated using Luminex assay. Bleeding index and peri-implantar sulcus depth were also evaluated. The data were compared using statistical tests (α = 5%). No statistical difference was found regarding demographic and clinical parameters (p > .05). Transforming growth factors, osteoprotegerin, osteopontin, and parathyroid hormone presented an earlier release peak in group IM than in NL group (p < .05). Osteocalcin achieved higher levels in group IM versus group NL between 7 and 30 days of evaluation (p < .05). It may be concluded that earlier loading positively modulates bone mediators release around immediately loaded implants when compared with nonloaded dental implants.

Perinatal periodontal disease reduces social behavior in male offspring.

OBJECTIVE: Our objective was to verify whether prenatal maternal periodontitis is a risk factor for the development of central nervous system disorders in rats. METHODS: Periodontitis was induced by placing a ligature around the upper and lower first molars in 9 female Wistar rats (experimental group); 9 rats were left unligated (control group). The maternal general activity in an open field was observed on gestational day (GD) 0, GD 4, and GD 14, and the maternal performance was assessed on the second day after birth. The pups' play behavior was assessed on postnatal day 30. The relative level of reelin was measured in the frontal cortex by real-time PCR analysis. RESULTS: The results showed that, compared with the control group, (1) the general activity in female rats with periodontitis was decreased, (2) the maternal performance of these rats was not modified by periodontitis, (3) the play behavior of pups from dams with periodontitis was decreased, and (4) there were no differences in the frontal cortex reelin levels of pups from dams with periodontitis. CONCLUSIONS: We conclude that pre- and postnatal periodontitis induces maternal sickness behavior and reduces the pups' play behavior without interference with frontal cortex reelin expression.

Platelet-rich plasma does not improve bone regeneration around peri-implant bone defects--a pilot study in dogs.

The purpose of the present study was to evaluate the influence of platelet-rich plasma (PRP) on bone regeneration in dehiscence-type bone defects around dental implants. Ten male adult mongrel dogs were used. Three months after teeth extractions, an osteotomie for implantation and a buccal dehiscence defect were prepared on both sides of the jaws. Two dental implants with machined surfaces were placed on each implant site of the mandible. Dehiscences were randomly assigned to the following groups: (1) test (PRP) and (2) control. After 3 months animals were sacrificed; implants and adjacent hard tissues were processed for undecalcified sections. Bone-to-implant contact (BIC), bone density (BD) within the limits of implant threads, bone density (BO) and new bone area (NB) in a zone lateral to the implant, corresponding to bone defects, were obtained and measured. Inter group analysis (paired Student's t-test, alpha = 5%) demonstrated no statistically significant differences for any of the parameters when PRP was used (P > 0.05). Within the limits of the present study, it was concluded that platelet-rich plasma alone did not enhance bone regeneration for peri-implant defects.

Effect of two different approaches for root decontamination on new cementum formation following guided tissue regeneration: a histomorphometric study in dogs.

BACKGROUND AND OBJECTIVE: The aim of the present study was to evaluate comparatively the effect of two different approaches for root decontamination on new cementum formation following guided tissue regeneration (GTR). MATERIAL AND METHODS: Nine mongrel dogs were used to obtain bilateral chronic class III furcation defects by placing cotton ligatures around both third mandibular premolars. The teeth were randomly assigned to receive one of the following treatments: scaling and root planing, by means of hand and rotatory instruments, in order to remove soft and hard deposits as well as all root cementum (group A); or removal of only soft microbial deposits, by polishing the root surface with rubber cups and polishing paste, aiming for maximum root cementum preservation (group B). Both groups were treated with GTR, with the use of resorbable polyglycolic-lactic acid membranes (RESOLUT XT). RESULTS: Four months later, data analysis showed that a superior length (mm) (3.59 +/- 1.67 and 6.20 +/- 2.26 for groups A and B, respectively; p = 0.004) and a thicker layer (microm) (18.89 +/- 9.47 and 52.29 +/- 22.48 for groups A and B, respectively; p = 0.001) of new cementum was achieved by keeping the root cementum in place during root decontamination (group B). Regardless of the treatment modality, the new cementum was predominantly of a reparative, cellular extrinsic and intrinsic fiber type. CONCLUSION: Within the limits of the present study, it may be concluded that root cementum preservation may affect the new cementum formation following GTR in class III furcation defects, and the treatment modality did not influence the type of newly formed cementum.