Assessing bone formation on hydrophilic and hydrophobic implant surfaces in a murine model treated with bisphosphonates.

OBJECTIVE: To evaluate the osseointegration of implants with hydrophobic (HFB) and hydrophilic (HFL) surfaces in a murine model of high-dose bisphosphonates (BPs). MATERIALS AND METHODS: Sixty-four rats were randomly allocated into four groups: control group with HFB implants (CG-HFB), control group with HFL implants (CG-HFL), BP group with HFB implants (BP-HFB), and BP group with HFL implants (BP-HFL). Animals were euthanized after 15 and 45 days (n=8). The dependent variables assessed were the removal torque (biomechanical analysis), the bone volume around the implants (%BV/TV) (microtomographic analysis), the bone-implant contact (%BIC), the bone between the threads (%BBT) (histomorphometric analysis), and the expression of bone metabolism markers (immunohistochemistry analysis). RESULTS: The CG-HFL and BP-HFL groups presented higher removal torque than the CG-HFB and BP-HFB implants. The %BIC of the CG-HFL surfaces was slightly higher than that of the CG-HFB implants. The BP-HFB and BP-HFL groups presented a higher %BIC than that of the CG-HFB and CG-HFL groups (p<0.001). BP therapy also increased the %BBT at both implant surfaces. Higher levels of ALP were observed in the matrix region of bone tissue on the HFL surfaces than on the HFB surfaces. CONCLUSION: Both surfaces enable osseointegration in rats under BP therapy. CLINICAL RELEVANCE: The study demonstrates that hydrophobic (HFB) and hydrophilic (HFL) implant surfaces can promote osseointegration in rats undergoing bisphosphonate therapy. The HFL surfaces exhibited improved biomechanical performance, higher bone-implant contact, and increased bone volume, suggesting their potential clinical relevance for implant success in individuals on bisphosphonate treatment.

Fresh-frozen allogeneic bone blocks grafts for alveolar ridge augmentation: Biological and clinical aspects.

The possibilities for oral bone regeneration procedures vary depending on the type of bone defect to be treated, which in turn dictate the type of graft to be used. Atrophic alveolar ridges are non-contained defects and pose a challenging defect morphology for bone regeneration/augmentation. Successful results are regularly obtained with the use of particulate grafts in combination with barrier membranes. In cases of very narrow ridges with need of larger amount of bone augmentation, block grafts are often used. Fresh-frozen allogeneic bone block grafts have been proposed as an alternative to autogenous (AT) bone blocks. Based on a systematic appraisal of pre-clinical in vivo studies and clinical trials including a direct comparison of fresh-frozen bone (FFB) blocks versus AT bone blocks it can be concluded that a FFB block graft: (a) cannot be considered as a reliable replacement of a AT bone block, and (b) should only be considered in cases where the amount of necessary augmentation-in a lateral direction-is relatively limited, so that the main portion of the body of the implant lies within the inner (i.e., the vital) aspect of the block.

Effect of a gel containing green tea extract and hyaluronic acid on palate pain scores and wound healing after free gingival graft: a quasi-randomized controlled clinical trial.

OBJECTIVES: The aim of this study was to evaluate the effect of a gel containing green tea extract and hyaluronic acid (HA) on pain scores and wound healing in donor sites after free gingival graft (FGG). MATERIALS AND METHODS: Forty-two patients requiring FGG were included in three groups: (1) control group (n = 14), no material was placed in the donor area; only the clot was kept in position by sutures; (2) placebo group (n = 14), vehicle gel applied 3 times a day for 7 days; and (3) test group (n = 14), gel containing green tea extract and HA applied 3 times a day for 7 days. The wound size by clinical measurement (WS-CM) and photographic image (WS-PI), complete wound epithelialization (CWE), and palatal mucosa color were evaluated after 3 days and 1, 2, and 4 weeks postoperatively. The visual analog scale (VAS) for pain and analgesic consumption were used to assess participant's perception in the same postoperative periods. RESULTS: A similar progressive reduction in the wound size, associated with an improvement in the color pattern, was observed in all groups (p > 0.05). No significant differences were found for CWE and pain assessment between the examined groups (p > 0.05). CONCLUSION: The gel containing green tea extract and HA application in palatal wounds after FGG removal does not provide clinical healing benefits using this investigated protocol. CLINICAL RELEVANCE: This is the first clinical study evaluating the effect of gel containing green tea extract and HA on the palate postoperative pain control and wound healing after FGG. TRIAL REGISTRATION: http://clinicaltrials.gov : NCT05270161.

Digital planning and guided dual technique in esthetic crown lengthening: a randomized controlled clinical trial.

OBJECTIVES: The present study aimed to compare the guided dual technique with the conventional technique in esthetic crown lengthening (ECL). MATERIALS AND METHODS: The trial registration number is NCT04922086. Twenty-four participants diagnosed with altered passive eruption (APE) type I subcategory B were selected and allocated into two groups. In the control group (n = 12), the ECL procedure was planned by clinical examination and transgingival probing; in the test group (n = 12), the ECL procedure was carried out using digital planning and a double guide. Clinical parameters were assessed at baseline, immediately after the intervention (IAI), and at 4, 8, and 12 months of follow-up. RESULTS: The clinical crown length (CCL) mean at baseline was 8.09 mm (± 0.77) and increased significantly to 9.92 mm (± 0.62) IAI, with minimal significant reduction after 12 months (9.47 mm [± 0.60]) in the control group. Similarly, in the test group, the mean CCL at baseline was 8.04 mm (± 0.69) and increased significantly to 9.94 mm (± 0.57) IAI, with minimal reduction after 12 months (9.35 mm [± 0.80]). No differences were found between the mean CCL determined in the digital planning and after 12 months. No correlation was found between gingival thickness and gingival margin stability. High esthetic satisfaction was demonstrated by participants/specialists without differences between groups. CONCLUSIONS: In conclusion, the guided dual technique was as effective as the conventional technique for treatment of APE, with stable results after 12 months of follow-up. CLINICAL RELEVANCE: The guided dual technique aims to transfer both the gingival and bone resection planned position to facilitate the ECL surgical procedure and increase treatment predictability.

Effect of Antibiotic Prophylaxis on Early Loss of Implants Installed by Unexperienced Operators.

Routine use of antibiotics for dental implant installation is widely applied in dental practice to prevent postoperative infection and implant loss. However, the effectiveness and necessity of such protocols have not been consensual in the literature. This study aimed to evaluate the effect of antibiotic prophylaxis on survival of dental implants placed in clinically healthy patients by unexperienced operators. A double-blind, randomized, placebo-controlled trial was conducted. Ninety patients who received between 2 and 4 dental implants by unexperienced operators were enrolled in this study. Patients were randomly allocated in 2 groups. For the antibiotic group (n = 47), patients received 1 g of preoperative amoxicillin; in the placebo group (n = 43), patients received preoperative placebo administration. Each patient was evaluated preoperatively, 2 days, and 7 days postoperatively. Factors evaluated were mouth opening amplitude, assessment of referred pain through a visual analogue scale, and characteristic signs of infection (presence of fistula, ulceration in the surgical wound, tissue necrosis at the edges of the wound, dehiscence of the surgical flap, and presence of purulent exudate in the surgical wound). Implant survival was evaluated until 90 days postsurgical procedure. Results showed that there were no statistically significant differences in postoperative healing, swelling, and pain. However, more loss of dental implants was observed in the placebo group (14.9% vs 2.3%). Use of antibiotic prophylaxis reduced implant loss that was previously placed by unexperienced operators.

Effect of the association of infra-red and red wavelength photobiomodulation therapy on the healing of post-extraction sockets of third lower molars: a split-mouth randomized clinical trial.

The aim of this study was to evaluate the effect of photobiomodulation therapy (PBMT) with the association of red and infra-red laser therapy in the healing of the post-extraction sockets of third lower molars. Twenty patients were submitted to extraction of lower third molars and the post-extraction sockets were treated using two different approaches in a randomized split-mouth design: The test side received the PBMT with red (λ 660 nm) and infra-red laser therapy (λ 808 nm) and the control side was not irradiated. The PBMT was applied immediately and 3 and 7 days after the surgical procedure. Post-extraction socket healing was assessed by the bone repair score, bone density, and fractal dimension analysis 7 and 90 days after the surgical procedure, using cone-beam computed tomography images. Additionally, clinical analyses were performed 3, 7, 14, 30, and 90 days after the surgical procedure, considering the occurrence of pain, edema, and bleeding, as well as the quality of the oral mucosa repair, assessed using a visual analogue scale. The clinical analysis showed that PBMT reduced edema and improved the repair of oral mucosa at 7 days after surgery, while the tomographic analysis showed no significant differences between groups. Dual-wavelength PBMT improved the post-operative clinical course in patients undergoing lower third molar extraction, without altering bone repair.

Strontium ranelate improves post-extraction socket healing in rats submitted to the administration of bisphosphonates.

The aim of this study was to evaluate the effect of strontium ranelate (Sr) on post-extraction socket healing in rats submitted to the administration of bisphosphonates. Sixty rats were submitted to the tooth extraction of the first lower molar after 60 days of the daily administration of saline solution (SS) or alendronate (ALN). Then, the animals were allocated into six groups namely CTR: administration of SS during the whole experiment, ALN: administration of ALN during the whole experiment, ALN/SS: application of SS for 30 days after extraction in animals previously treated with ALN, ALN/Sr: application of Sr for 30 days after extraction in animals previously treated with ALN, ALN/S60: ALN therapy interruption 30 days before the extraction followed by the application of SS for 60 days, and ALN/Sr60: ALN therapy interruption 30 days before the tooth extraction followed by the application of Sr for 60 days. The healing of the post-extraction sockets was evaluated by microCT and histomorphometry. The use of ALN induced partial bone necrosis, inflammatory infiltration, and a delay in soft tissue healing; the use of Sr improved the connective tissue organization. Sr has subtle positive effects on the post-extraction healing in animals submitted to the administration of bisphosphonate.

Osseointegration of different implant surfaces in areas grafted with deproteinized bovine bone associated or not with fresh bone marrow-Preclinical study in rabbits.

OBJECTIVES: To assess the influence of two different implant surfaces on osseointegration in maxillary sinuses of rabbits previously grafted with deproteinized bovine bone (DBB) associated or not with fresh bone marrow (BM). MATERIAL AND METHODS: Sixteen New Zealand albino rabbits (males, 3.5/4.5 kg and 9-12 months old) were randomly divided into two groups with 8 rabbits each, according to the type of association of biomaterials used to fill the animals' maxillary sinuses: DBB (Deproteinized Bovine Bone) and DBB/BM (Deproteinized bovine bone associated with fresh autologous bone marrow). Ninety (90) days following the grafting procedure, the animals received implants in the area with two different microstructures (SA-Sandblasting + acid attack and SA-H-Sandblasting + acid attack + immersion in 0.9% sodium chloride isotonic solution). All rabbits were euthanized 90 days after implant placement. The microtomographic analysis was performed to verify the number of mineralized tissues around the implants throughout their length (%BV/TV), while the histomorphometric analysis was performed to verify the percentage of bone-implant contact around the implants throughout their length (%BIC). RESULTS: We observed no differences in the quantity for %BV/TV (DBB-SA:33.25 ± 19.67; DBB-SA-H:35.15 ± 22.17; DBB/BM-SA:39.71 ± 24.21; DBB/BM-SA-H:36.40 ± 23.07) and %BIC (DBB-SA:58.94 ± 24.37; DBB-SA-H:52.52 ± 24.36; DBB/BM-SA: 61.66 ± 14.60; DBB/BM-SA-H: 64.06 ± 23.30) between the groups assessed. CONCLUSIONS: The addition of BM and the type of surface did not influence the osseointegration of implants installed in areas grafted with sintered deproteinized bovine bone at high temperatures in the late period assessed.

Remodelling of sinus bone grafts according to the distance from the native bone: A histomorphometric analysis.

OBJECTIVES: To evaluate graft remodelling according to the distance from the native bone in maxillary sinuses grafted with anorganic bovine bone (ABB). MATERIAL AND METHODS: Bilateral sinus grafting was performed in twenty patients with residual bone height <5 mm before implant placement. After 8 months, biopsy samples were harvested, and histomorphometric analysis was performed to examine bone formation according to the distance (in mm) from the native bone (sinus floor). In the grafted area, the percentages of new bone (NB), residual graft material (rABB), and soft tissue (ST) were evaluated. RESULTS: A total of 103 biopsy samples were evaluated, and the percentages of NB, rABB, and ST were 31.62 ± 9.85%, 18.94 ± 7.88%, and 49.41 ± 9.52%, respectively, in the 1st mm; 27.15 ± 9.83%, 23.33 ± 9.45%, and 49.53 ± 11.73%, respectively, in the 2nd mm; 23.61 ± 13.02%, 21.35 ± 11.08%, and 55.03 ± 16.14%, respectively, in the 3rd mm; and 21.67 ± 12.29%, 19.67 ± 10.28%, and 58.66 ± 12.46%, respectively, in the 4th mm. The 1st millimetre of the grafted area (closer to the native bone) presented a larger amount of NB than the other portions of the grafted areas and a smaller amount of rABB than the 2nd mm of the grafted area (p < .05). The amount of ST was larger in the 3rd and 4th mm of the grafted area than in the first 2 millimetres (p < .05). CONCLUSION: The distance from the native bone influences bone formation following maxillary sinus augmentation.

Low-level laser therapy (LLLT) in sites grafted with osteoconductive bone substitutes improves osseointegration.

The aim of this study was to evaluate the osseointegration of implants placed in areas grafted with different osteoconductive bone substitutes irradiated with infrared low-level laser therapy (LLLT). Fifty-six rats were randomly allocated into 4 groups: DBB, bone defects filled with deproteinized bovine bone graft (DBB); HA/TCP, bone defects filled with biphasic ceramic made of hydroxyapatite and ß-tricalcium phosphate (HA/TCP); DBB-L, bone defects filled with DBB and treated by LLLT; HA/TCP-L, bone defects filled with HA/TCP and treated by LLLT. Bone defects were performed in the tibia of each animal and filled with the different biomaterials. The grafted areas were treated with LLLT (λ 808 nm, 100 mW, ϕ ∼ 0.60 mm) in 7 sessions with 48 h between the irradiations. After the 60-day period, the implants were placed, and the animals were euthanized after 15 and 45 days. The osseointegration and bone repair in the grafted area were evaluated by biomechanical, microtomographic and histometric analyses, and the expression of some bone biomarkers was evaluated by immunohistochemistry analysis. LLLT induced higher degree of osseointegration, which was associated with the greater expression of BMP2 and OCN. LLLT performed in areas grafted with osteoconductive bone substitutes prior to implant placement improves osseointegration.

Loading deproteinized bovine bone with strontium enhances bone regeneration in rat calvarial critical size defects.

OBJECTIVE: To evaluate the effect of grafting with strontium (Sr)-loaded deproteinized bovine bone (DBB) on bone healing in calvarial critical size defects (CSD) in rats. MATERIAL AND METHODS: Two circular bone defects (5 mm in diameter) were created in the calvaria of 42 rats. One of the defects, randomly chosen, was grafted with (a) DBB, (b) DBB loaded with 19.6 µg/g of Sr (DBB/Sr1), or (c) DBB loaded with 98.1 µg/g of Sr (DBB/Sr2). The other defect was left empty as negative control. Groups of seven animals from each of the groups were euthanized 15 and 60 days post-op. Bone healing in the CSD was evaluated by micro-CT and histology/histomorphometry and immunohistochemistry. RESULTS: DBB/Sr2-grafted sites showed statistically significantly shorter radiographic residual defect length compared with DBB/Sr1- and DBB-grafted sites, and with empty controls at 60 days. Further, the amount of new bone formation in the DBB/Sr1- and DBB/Sr2-grafted sites was significantly higher compared with that in the DBB-grafted sites at 60 days. A larger number of DBB/Sr1- and DBB/Sr2-grafted sites presented with no- or only limited to mild inflammation, compared with the DBB-grafted sites, especially at 60 days. Higher expression of osteocalcin was observed in DBB/Sr1- and DBB/Sr2-grafted sites as compared to DBB-grafted sites. CONCLUSION: Grafting with Sr-loaded DBB enhanced bone formation in CSD in rats, when compared with grafting with non-loaded DBB. CLINICAL RELEVANCE: Grafting with Sr-loaded DBB may enhance bone formation in bone defects.

Evaluation of bone turnover after bisphosphonate withdrawal and its influence on implant osseointegration: an in vivo study in rats.

OBJECTIVES: The aim of this study was to investigate bone turnover alterations after alendronate (ALD) withdrawal and its influence on dental implants osseointegration. MATERIALS AND METHODS: Seventy female Wistar rats were randomly divided in 2 groups that received on day 0 either placebo (control group-CTL; n = 10) or 1 mg/kg sodium alendronate (ALD; n = 60) once a week for 4 months. At day 120, ALD treatment was suspended for 50 animals. Then, a titanium implant was placed in the left tibia of each rat that were randomly allocated in five subgroups of ten animals each, according to the period of evaluation: day 0 (INT-0), day 7 (INT-7), day 14 (INT-14), day 28 (INT-28), and day 45 (INT-45) after ALD withdrawal. CTL group and a group that received ALD until the end of the experimental period (non-interrupted group-non-INT; n = 10) underwent implant placement on day 120. Animals were euthanized 28 days after implant surgery. Bone mineral density (BMD) of femur and lumbar vertebrae were evaluated by DXA, biochemical markers of bone turnover were analyzed by ELISA, and bone histomorphometry was performed to measure bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO). RESULTS: All groups receiving ALD showed higher BMD values when compared to CTL group, which were maintained after its withdrawal. Decreased concentrations in all bone turnover markers were observed in the non-INT group, and in the groups in which ALD was discontinued compared to the CTL group. The non-INT group showed lower %BIC and notably changes in bone quality, which was persistent after drug withdrawal. CONCLUSION: Collectively, the findings of this study demonstrated that ALD therapy decreased bone turnover and impaired bone quality and quantity around dental implants, and that its discontinuation did not reverse these findings. CLINICAL RELEVANCE: The severe suppression of bone turnover caused by the prolonged use of ALD may alter the capacity of bone tissue to integrate with the implant threads impairing the osseointegration process.

Analysis of Linear and Angular Deviations of Implants Installed With a Tomographic-Guided Surgery Technique: A Prospective Cohort Study.

The aim of this study was to evaluate the linear and angular deviations of the implants installed by the computerized tomography (CT)-guided surgery technique. Eighteen patients who underwent implant insertion by means of CT-guided surgery participated in this study. Ten of these patients had a fully edentulous maxilla, and 8 had a fully edentulous mandible. The patients received a total of 115 implants, of which 81 implants were installed in the maxilla and 34 installed in the mandible. Tomographic guides were made for tomographic examination in both the upper and lower jaws. After the image acquisition, the virtual planning of the positioning of the implants was performed in relation to the previously made prosthesis. The measurement of the linear and angular deviations between the virtual planning and the final position of the implants was performed with the overlap of the planning and postoperative tomography. There were no differences in the linear and angular deviations of the implants installed in the maxilla and mandible. Compared with the coronal region, there was a trend of greater linear deviations in the apical regions of the implants and a greater tendency toward deviations in the posterior regions than in the anterior regions of both arches. The CT-guided surgery promoted the installation of implants with high accuracy and allowed the installation of straight pillars in all cases evaluated. The linear deviations were not different in the different regions of the mouth or in the different portions of the implants.

Analysis of osseointegration of implants with hydrophilic surfaces in grafted areas: A Preclinical study.

OBJECTIVES: The aim of this study was to evaluate the effect of a hydrophilic surface on the osseointegration in grafted areas with deproteinized bovine bone (DBB) and with biphasic ceramics of hydroxyapatite/ß-tricalcium phosphate (HA/TCP). MATERIAL AND METHODS: Fifty-six rats were randomly allocated to four groups with 14 animals each: DBB: DBB+Machined surface; HA/TCP: HA/TCP+Machined surface; DBB-H: DBB+Hydrophilic surface; HA/TCP-H: HA/TCP+Hydrophilic surface. The bone defects were performed at the proximal epiphysis of the tibia. Then, the defects were filled with the biomaterials. After 60 days, the implants were placed in the grafted areas. The animals were submitted to euthanasia at periods of 15 and 45 days after the implants' placement. The osseointegration was assessed by biomechanical, microtomographic, and histometric analyses. In addition, the expression of bone morphogenetic protein-2 (BMP-2), alkaline phosphatase (ALP), and osteocalcin (OCN) was evaluated by immunohistochemistry. RESULTS: The HA/TCP-H group presented higher removal torque values and more mineralized tissue in the vicinity of the implants compared with the HA/TCP group. The DBB-H and HA/TCP-H groups presented higher values of bone-implant contact (at 15 and 45 days), of bone between the threads (45 days), and expression of BMP-2 (45 days) than the DBB and HA/TCP groups. Furthermore, the DBB-H group presented a higher expression of ALP than the DBB group (15 days). CONCLUSION: In conclusion, implants with a hydrophilic surface improve osseointegration in grafted areas compared to implants with machined surfaces in a rat tibia model.

Glycemic control protects against trabecular bone microarchitectural damage in a juvenile male rat model of streptozotocin-induced diabetes.

PURPOSE: To determine which features of the bone microarchitecture are affected by established diabetes mellitus (DM) and the effectiveness of glycemic control in the protection of bone tissue. MATERIAL AND METHODS: Sixty juvenile Wistar male rats were divided into three groups of 20 animals: a control group (C) that included healthy animals, a diabetic group (D) that included animals with induced diabetes, and a controlled diabetic group (CD) that included animals with induced diabetes that were treated with insulin. The animals were euthanized at the periods of 6 and 8 weeks after the induction of diabetes (10 animals per group/period). Vertebral L4 specimens were submitted to µCT analysis to assess the following parameters of the bone microarchitecture: bone volume fraction (BV/TV), trabecular thickness (Tb.Th), trabecular number (Tb.N), and trabecular spacing (Tb.Sp). RESULTS: The D group exhibited lower values of BV/TV (%) and numbers of trabeculae compared with the C group at 6 and 8 weeks and compared with the CD group at 8 weeks. The CD group exhibited higher trabecular thickness values compared with the D group at 8 weeks. There were no differences between the groups regarding the spaces between the trabeculae. CONCLUSION: Induced diabetes affected the microarchitecture of the trabecular bone of the vertebrae by reducing the values of the majority of the parameters in relation to those of the control group. Glycemic control with insulin appears to protect bones from the effects of the hyperglycemia.

Tomographic Evaluation of Prevalence, Position, and Diameter of the Intraosseous Branch of the Posterior Superior Alveolar Artery in Fully Edentulous Individuals.

The objective of this study was to evaluate the presence, position, and diameter of the intraosseous branch (IObr) of the posterior superior alveolar artery in fully edentulous patients. Two-hundred five computed tomography scans of fully edentulous patients were analyzed. The presence of the IObr was investigated in the coronal plane at the lateral wall of the maxillary sinus. In patients in whom the IObr was detected, the artery diameter was measured, and the distance from the artery to the bone crest of the alveolar ridge, the maxillary sinus floor, and the distance of the maxillary sinus floor to the bone crest of the alveolar ridge were measured as well. A descriptive statistical analysis of these parameters was conducted. The IObr was identified in the maxillary sinus in 105 tomography images (51.2%), and its diameter varied between 0.8 and 3.3 mm (1.29 ±â€Š0.49 mm). The IObr presented with an artery diameter less than 1 mm in 29% of the patients, between 1 and 2 mm diameter in 61% of the patients and with a diameter larger than 2 mm in 10% of patients. Regarding the IObr topography, the distance from the artery to the floor of the maxillary sinus was 9.62 ±â€Š4.59 mm, and the distance from the artery to the top of crestal bone was 15.15 ±â€Š4.47 mm. At least 10% of edentulous patients are at risk of bleeding complications during interventions in the maxillary sinus.

Treatment of periodontal disease with an Er,Cr:YSGG laser in rats exposed to cigarette smoke inhalation.

The purpose of this study was to evaluate the erbium, chromium:yttrium-scandiumgallium-garnet (Er,Cr:YSGG) laser irradiation in the treatment of periodontitis in rats exposed to cigarette smoke inhalation (CSI). Ligatures were placed in the maxillary second molars. After a 15-day period, the ligatures were removed and 180 animals were randomly divided into six groups: (1) CSRP group--CSI and manual scaling and root planing (SRP) treatment; (2) CL group--CSI and Er,Cr:YSGG laser irradiation; (3) CSRP + L group-CSI, SRP, and Er,Cr:YSGG irradiation; (4) SRP group-manual SRP; (5) L group--Er,Cr:YSGG irradiation; (6) SRP + L group--SRP and Er,Cr:YSGG irradiation. At 7, 15, and 30 days after treatments, animals were euthanized and histologic, histometric, immunohistochemistry, and real-time PCR analyses were performed. Histometrically, no differences were observed in the SRP, L, and SRP + L groups exposed to CSI. The CSRP group showed more bone formation at 30 days than at 15 days (p < 0.01) but less bone at 30 days than the CL group at 30 days (p < 0.05). Immunohistochemical staining was positive for osteoblasts, fibroblasts, and osteoclasts. Real-time PCR showed more (vascular endothelial growth factor) VEGF expression in the L (p < 0.05) and SRP + L (p < 0.01) groups at 30 days than at 15 days and less VEGF expression in the CSRP group at 30 days than at 15 days (p < 0.05). There was no difference in fibroblast growth factor (FGF) expression. The Er,Cr:YSGG laser irradiation promotes favorable conditions for tissue repair even in animals exposed to CSI, with similar results as those achieved from manual scaling and root planing.

Effect of Er,Cr:YSGG laser application in the treatment of experimental periodontitis.

The purpose of this study was to evaluate the influence of an erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser in the absence or presence of manual scaling and root planning (SRP) for the treatment of induced periodontitis in rats. Ligatures were placed in the subgingival region of the maxillary first molar. After a 7-day period, the ligatures were removed, and 40 rats were randomly divided into four groups (G), as follows: (GI) no treatment, (GII) scaling and root planning (SRP) with curettes, (GIII) Er,Cr:YSGG laser irradiation and (GIV) SRP with curettes followed by Er,Cr:YSGG laser irradiation. Seven and 30 days after the treatment, the animals were sacrificed and histologic, histometric and immunohistochemistry analyses were performed. All groups showed similar histopathological characteristics during the evaluation period. The histometric analysis was confirmed using Bonferroni and paired t tests. At 7 and 30 days, groups II, III and IV exhibited greater bone formation in the furcation area when compared to group I (p < 0.0001; p < 0.05). During the 7-day period, the groups irradiated with the laser (III and IV) showed a statistically larger new bone area than the group treated with SRP (II) (p < 0.01). Immunohistochemistry analysis revealed that the control group exhibited a higher expression of tartrate-resistant acid phosphatase (TRAP) and the receptor activator of nuclear factor κΒ ligand (RANKL) when compared to groups II, III and IV (p < 0.05). All treatments were able to reduce the inflammatory processes, consequently enabling the repair of periodontal tissues. The results achieved with the application of the Er,Cr:YSGG laser suggest that this laser can stimulate greater bone formation, especially over a shorter period of time.

Survival analysis of dental implants placed in horizontally severely resorbed maxillae after reconstruction with xenogeneic graft: a case series.

PURPOSE: To evaluate the survival rates of dental implants with a hybrid macrostructure and the surface biomimetically coated with nanohydroxyapatite, placed in horizontally atrophic maxillae previously submitted to the guided bone regeneration (GBR) procedure, associated with the use of a deproteinized bovine bone graft (DBB). METHODS: Twenty-five patients who received 196 implants were involved in this study. First, these patients were submitted to GBR procedures and maxillary sinus lift, where DBB was used as the grafting material. The dental implants were placed after a minimum period of 6 months of the grafting procedures. The patients were followed up every six months and clinical/radiographic examinations were performed to assess the implants, using the following indicators as a reference: (1) Absence of mobility; (2) Absence of pain. Data about the age, surgery time, smoking status, implant size, and time between the grafting procedure and implant placement were correlated with implant failures. RESULTS: Twelve implants failed, generating a survival rate of 94.23%. None of the variables analysed correlated with the implant failures. CONCLUSION: Implants with a hybrid macrostructure and surface biomimetically coated with nanohydroxyapatite present good survival rates in horizontally atrophic maxillae grafted with DBB.

Comparison of different dual-wavelength photobiomodulation protocols application in third molar extractions. A split-mouth randomized controlled trial.

OBJECTIVE: To compare the use of PBMT in the soft tissue and bone healing after third molar extraction using the dual-wavelength laser directly into the post-extraction alveoli (PBMT-I), or PBMT with a red laser directly into the alveoli and with an infrared laser externally on the patient's face (PBMT-IE). METHODS: Twenty patients underwent extraction of four third molars were involved in this split-mouth double-blind randomized controlled trial. The Post-extraction alveoli were treated with the following protocols: PBMT-IE: Application of a red laser directly into the alveolus, and infrared laser irradiation transcutaneously and PBMT-I: Application of dual-wavelength laser intraorally. Patients were clinically evaluated 3, 7, 14, 30, and 90 days after the surgical procedure. The analyses in this study were divided into qualitative (centered on the patient's report and on the evaluators' analysis), and quantitative analyses (measurement of the vertical and horizontal dimensions of the face with the objective of measuring post-surgical edema and radiographic analyses for evaluation of the density and structure of the newly formed bone). RESULTS: A progressive improvement was observed in all parameters evaluated in this study, however, this improvement was time dependent, with no distinct effect observed between the PBMT treatments applied. CONCLUSION: The different dual-wavelength PBMT protocols induced a similar postoperative clinical course in third molar extraction surgeries, with a reduced occurrence of complications and a good healing pattern of hard and soft tissues.