Estudio anatómico de la hiperostosis porótica en órbitas oculares: cribra orbitalia en la población arqueológica de Tutuquén, región del Maule, Chile / Anatomical study of porotic hyperostosis in the eye orbits: cribra orbitalia in the archaeological population of Tutuquén, Maule region, Chile

RESUMEN: La cribra orbitalia o hiperostosis porótica del techo orbitario es considerada una manifestación ósea microperforativa de condiciones patológicas hematológicas, especialmente la anemia ferropénica. Este hallazgo, se enmarca de manera casi exclusiva a estudios en poblaciones arqueológicas. El propósito de este estudio fue describir la expresión de cribra orbitalia en una población arqueológica de Chile central. Restos óseos de 32 individuos fueron analizados, los cuales fueron obtenidos de la población del Monumento Arqueológico Cementerio Tutuquén, los que están depositados en el Museo Regional de Rancagua. En cada una de la muestras incluidas, se evaluaron períodos de datación, sexo, rango etáreo, presencia v/s ausencia de cribra orbitalia y en los casos en que ésta estuvo presente, se determinó su intensidad mediante visión directa con lente de aumento. Un 59,38 % de los individuos presentó cribra orbitalia. De éstos, 26,32 % fueron de sexo femenino, 31,58 % de sexo masculino y 42,10 % indeterminado. De los individuos del período 10.000 AP, 33,33 % presentó cribra orbitalia; de los individuos del período 7.000 AP un 50 % y de los individuos pertenecientes al período 1.000 AP, un 68,4 %. Al clasificar la severidad de la cribra orbitalia se observó que 31,57 % de los individuos presentaron Cribra orbitalia tipo I; 36,84 % tipo II; 10,52 % tipo III; 10,52 % tipo IV y 10,52 % tipo V. Los datos aportados complementarán el conocimiento morfopatológico de la órbita ocular humana desde el estudio de poblaciones arqueológicas.

SUMMARY: The cribra orbitalia or porotic hyperostosis of the orbital roof is considered a microperforative bone manifestation of hematological pathological conditions, especially iron deficiency anemia. This finding is almost exclusively part of studies in archaeological populations. The purpose of this study was to describe the expression of cribra orbitalia in an archaeological population of central Chile. Bone remains of 32 individuals were analyzed, which were obtained from the population of the Tutuquén Cemetery Archaeological Monument, which are deposited in the Regional Museum of Rancagua. In each of the included samples, dating periods, sex, age range, presence v / s absence of cribra orbitalia were evaluated and in the cases in which it was present, its intensity was determined by direct vision with a magnifying lens. The 59.38 % of the individuals presented cribra orbitalia. Of these, 26.32 % were female, 31.58 % male, and 42.10 % undetermined. Of the individuals in the period 10,000 BP, 33.33 % presented cribra orbitalia; of the individuals of the period 7,000 AP, 50% and of the individuals belonging to the period 1,000 AP, 68.4 %. When classifying the severity of the cribra orbitalia, it was observed that 31.57 % of the individuals had type I; 36.84 % type II; 10.52 % type III; 10.52 % type IV and 10.52 % type V. The data provided will complement the morpho-pathological knowledge of the human eye orbit from the study of archaeological populations.

Cyclosporine A impairs bone repair in critical defects filled with different osteoconductive bone substitutes

Abstract The aim of this study was to assess the influence of cyclosporine administration on the repair of critical-sized calvaria defects (CSDs) in rat calvaria filled with diverse biomaterials. Sixty animals were divided into two groups: the control (CTR) group (saline solution) and the cyclosporine (CCP) group (cyclosporine, 10 mg/kg/day). These medications were administered daily by gavage, beginning 15 days before the surgical procedure and lasting until the day the animals were euthanized. A CSD (5 mm Ø) was made in the calvaria of each animal, which was allocated to one of 3 subgroups, according to the biomaterial used to fill the defect: coagulum (COA), deproteinized bovine bone (DBB), or biphasic calcium phosphate ceramics of hydroxyapatite and β-phosphate tricalcium (HA/TCP). Euthanasia of the animals was performed 15 and 60 days after the surgical procedure (n = 5 animals/period/subgroup). Bone repair (formation) assessment was performed through microtomography and histometry, while the analyses of the expression of the BMP2, Osteocalcin, and TGFβ1 proteins were performed using immunohistochemistry. The CSDs not filled with biomaterials demonstrated lower bone formation in the CCP group. At 15 days, less bone formation was observed in the CSDs filled with DBB, a smaller volume of mineralized tissue was observed in the CSDs filled with HA/TCP, and the expression levels of BMP2 and osteocalcin were lower in the CCP group compared to the CTR group. The use of cyclosporine impaired bone repair in CSD, and this effect can be partially explained by the suppression of BMP2 and osteocalcin expression.

Cyclosporine A impairs bone repair in critical defects filled with different osteoconductive bone substitutes

Abstract The aim of this study was to assess the influence of cyclosporine administration on the repair of critical-sized calvaria defects (CSDs) in rat calvaria filled with diverse biomaterials. Sixty animals were divided into two groups: the control (CTR) group (saline solution) and the cyclosporine (CCP) group (cyclosporine, 10 mg/kg/day). These medications were administered daily by gavage, beginning 15 days before the surgical procedure and lasting until the day the animals were euthanized. A CSD (5 mm Ø) was made in the calvaria of each animal, which was allocated to one of 3 subgroups, according to the biomaterial used to fill the defect: coagulum (COA), deproteinized bovine bone (DBB), or biphasic calcium phosphate ceramics of hydroxyapatite and β-phosphate tricalcium (HA/TCP). Euthanasia of the animals was performed 15 and 60 days after the surgical procedure (n = 5 animals/period/subgroup). Bone repair (formation) assessment was performed through microtomography and histometry, while the analyses of the expression of the BMP2, Osteocalcin, and TGFβ1 proteins were performed using immunohistochemistry. The CSDs not filled with biomaterials demonstrated lower bone formation in the CCP group. At 15 days, less bone formation was observed in the CSDs filled with DBB, a smaller volume of mineralized tissue was observed in the CSDs filled with HA/TCP, and the expression levels of BMP2 and osteocalcin were lower in the CCP group compared to the CTR group. The use of cyclosporine impaired bone repair in CSD, and this effect can be partially explained by the suppression of BMP2 and osteocalcin expression.

Estrategias para el empleo optimizado de la neuroimagenología en pacientes con traumatismo encéfalo craneano: puesta al día / Strategies for the optimized use of neuroimaging in patients with head trauma cranial: update

INTRODUCTION: Introduction of current neuroimaging technologies has been essential for the agile and effective diagnosis of cranial brain injuries. However, for various reasons there is a tendency to indiscriminate use. A review of the topic was made aimed at providing an update on the recommended strategies for the optimized use of these technologies. Material and method: A review of the topic of the last five years was made, using the Medline / Pubmed and SciELO platforms of complete articles, in English and Spanish. We also included relevant articles, published in previous years, located in previous bibliographic reviews carried out by the authors. CONCLUSIONS: Routine study with CT scan in all patients with head trauma is not cost effective, should be used in patients with Glasgow less than 15 points or in those with Glasgow of 15 points and risk factors of intracranial injury. Its use as a form of neuromonitoring is similarly useful, but on a selective basis. Magnetic Resonance Imaging is especially useful in the mediate or late periods of cranial trauma, in patients with clinical tomographic incongruences, very useful to establish prognosis in diffuse traumas and intracranial complications. Neurosonology is a useful tool for therapeutic decision.

The influence of LLLT applied on applied on calvarial defect in rats under effect of cigarette smoke

Abstract Objective Considering the global public health problem of smoking, which can negatively influence bone tissue repair, the aim of this study is to analyze the influence of photobiomodulation therapy (PBM) on calvaria defects created surgically in specimens under the effect of cigarette smoke and analyzed with use of histomorphometric and immunohistochemistry techniques. Methodology Calvaria defects 4.1 mm in diameter were surgically created in the calvaria of 90-day-old rats (n=60) that were randomly divided into 4 experimental groups containing 15 animals each: control group (C), smoking group (S), laser group (L), and smoke associated with laser group (S+L). The animals were subjected to surgery for calvaria defects and underwent PBM, being evaluated at 21, 45, and 60 days post-surgery. The specimens were then processed for histomorphometric and immunohistochemistry analyses. The area of bone neoformation (ABN), percentage of bone neoformation (PBNF), and the remaining distance between the edges of the defects (D) were analyzed histometrically. Quantitative analysis of the TRAP immunolabeled cells was also performed. The data were subjected to analysis of variance (ANOVA) in conjunction with Tukey's test to verify the statistical differences between groups (p<0.05). Results The smoking group showed less ABN compared to the other experimental groups in all periods, and it also showed more D at 21 days compared to the remaining groups and at 45 days compared to the laser group. The smoking group showed a lower PNBF compared to the laser group in all experimental periods and compared to smoking combined with LLLT group at 21 days. Conclusions PBM acted on bone biomodulation, thus stimulating new bone formation and compensating for the negative factor of smoking, which can be used as a supportive therapy during bone repair processes.

Presentation of the trepanned skull labelled MO-90, found in the Avar cemetery on the territory of settlements Ómoravica-Kopláló in Serbia / Presentación de cráneo trepanado etiquetado MO-90, encontrado en el cementerio de Avar en territorio de los asentamientos Ómoravica-Kopláló en Serbia

SUMMARY: The most prominent issues in paleopathology concerning skull lesions are skull trepanation and artificial deformation of the skull. From the very beginnings of this scientific field, these two groups of alterations have been the focus of interest. Since the second half of the 19th century, countless pathologists, surgeons and ethnologist have dealt with this issue. The interest is still great. Nevertheless, numerous questions regarding skull trepanation and artificial deformation are yet to be answered. The first trepanned skull finds were discovered in France and Hungary. The finds in Hungary are interesting because a large number of trepanned skulls were found in a relatively small area. On the skull remains found in the grave discovered in the Òmoravica-Koplaló cemetery and labelled MO-90, left of the Sutura sagittalis there is a hole about 1cm in diameter. There are no pathological lesions along the edge or around the hole.

RESUMEN: Los temas más destacados en la paleopatología con respecto a las lesiones del cráneo son la trepanación y la deformación artificial éste. Desde los comienzos en esta área científica, estos dos grupos de alteraciones han sido el foco de interés. Desde la segunda mitad del siglo XIX, un número importante de patólogos, cirujanos y etnologistas se han enfocado e interesado en este tema. Sin embargo, aún existen preguntas y numerosas dudas sobre la trepanación del cráneo y la deformación artificial. Los primeros hallazgos de cráneos trepanados se descubrieron en Francia y Hungría. Los hallazgos en Hungría son interesantes debido a que es un área relativamente pequeña, pero fueron encontrados una gran cantidad de cráneos trepanados. En los restos de cráneos encontrados en la tumba del cementerio Òmoravica-Koplaló y etiquetados como MO-90, a la izquierda de la sutura sagital se observó un foramen de aproximadamente 1 cm de diámetro. No hay lesiones patológicas a lo largo del margen, tampoco alrededor del foramen.

Bone repair access of BoneCeramic™ in 5-mm defects: study on rat calvaria

Abstract Objective: The aim of this study was to evaluate the osteoconductive potential of BoneCeramic™ on bone healing in rat calvaria 5-mm defects. Material and Methods: A 5-mm calvaria bone defect was induced in three groups and the defect was not filled with biomaterial [Clot Group (CG)], autogenous bone (AG), or Bone Ceramic Group (BCG). Animals were euthanized after 14 or 28 days and the bone tissue within the central area of the bone defect was evaluated. Results were compared using ANOVA and Tukey test (p<0.05). Immunohistochemistry was performed using primary antibodies against osteocalcin, RUNX-2, TRAP, VEGF proteins, and 3-dimensional images of the defects in μCT were obtained to calculate bone mineral density (BMD). Results: In BCG, the defect was completely filled with biomaterial and new bone formation, which was statistically superior to that in the GC group, at both time-points (p<0.001 for 14 days; p=0.002 for 28 days). TRAP protein showed weak, RUNX-2 showed a greater immunolabeling when compared with other groups, VEGF showed moderate immunostaining, while osteocalcin was present at all time-points analyzed. The μCT images showed filling defect by BCG (BMD= 1337 HU at 28 days). Conclusion: Therefore, the biomaterial tested was found to be favorable to fill bone defects for the reporting period analyzed.

Effects of vacuum sealing drainage on the treatment of cranial bone-exposed wounds in rabbits

This study was designed to assess the efficacy of vacuum sealing drainage (VSD) on skull exposure wounds in rabbits and to investigate the underlying mechanism of the process. Full-thickness excisional circular wounds 2×2 cm with or without periosteum involvement were created in 88 New Zealand white rabbits (mean body weight: 3.0±0.65 kg). Animals were randomly divided into 4 groups: periosteum-intact wounds treated with traditional dressing (p+control), periosteum-intact wounds treated with VSD (p+VSD), periosteum-lacking wounds treated with traditional dressing (p-control) and periosteum-lacking wounds treated with VSD (p-VSD). The wounds treated with traditional dressing were covered with Vaseline gauze, while VSD treatment was accompanied with continuous -120 mmHg pressure. Finally, wound tissues were harvested for analysis of hydroxyproline content and histologic detection. VSD hastened the wound healing process significantly (P<0.05) compared to the corresponding control groups. VSD alleviated the inflammation reaction, accelerated re-epithelialization and facilitated the organization of collagen fibers into neat rows. During the wound healing process, the hydroxyproline content increased overtime [i.e., postoperative days (POD) 7, POD 10 and POD 15] in all four groups, and it peaked in the p+VSD group. VSD also promoted angiogenesis via increasing number and quality of collagen. We concluded that VSD can promote healing in bone-exposed wounds via increasing hydroxyproline content and vessel density, reducing inflammatory responses and generating ordered collagen arrangement.

Is the combination of fat grafts and platelet rich plasma effective in rats?

ABSTRACT PURPOSE: To investigate if the association of fat grafts and platelet-rich plasma (PRP) improves graft viability in female rats. METHODS: This is an experimental, randomized and blinded study, which involved 47 rats. Fat was harvested from the inguinal region and grafted to the cranial region. The experimental group consisted of PRP-enriched fat grafts (n=22) whilst the control group consisted of fat graft only (n=25). After a 100-day period, the animals were euthanised and the fat grafts were analyzed using scores from 0 (absent) to 4 (abundant), in optical microscopy by two independent and blinded pathologists. RESULTS: Regarding fat graft cell viability, the PRP group scored moderate/abundant in 63% of cases and the fat graft only group scored absent/slight in 72% of cases (p=0.03). The PRP group also presented lower fat necrosis scores when compared to the fat graft only group (p=0.03). Tumors (dermoid cysts) within the fat grafts were observed in three animals in which the grafts were mixed with PRP. CONCLUSION: Platelet-rich plasma improves the viability and integration of fat grafts in rats, but more studies are needed to fully understand the exact mechanisms that lead to this improvement and assess the safety of the method for use in humans.

Simvastatin and biphasic calcium phosphate affects bone formation in critical-sized rat calvarial defects

ABSTRACT PURPOSE: To investigate the effects of locally applied simvastatin plus biphasic calcium phosphate (BoneCeramic(r)) or collagen sponge on bone formation in critical-sized bone defects. METHODS: Thirty defects of 5mm in diameter were created bilaterally with a trephine bur in the calvariae of fifteen Wistar rats. The defects were divided into five groups: group 1 - control, no treatment; group 2 (BoneCeramic(r)); group 3 (BoneCeramic(r) + 0.1mg simvastatin); group 4 (collagen sponge); and group 5 (collagen sponge + 0.1mg simvastatin). After eight weeks the animals were euthanized and their calvariae were histologically processed. Hematoxylin and eosin-stained sections were subjected to histological and histomorphometrical analyses. The area of newly formed bone was calculated and compared between groups. RESULTS: The greater amount of a bone-like tissue was formed around the carrier in group 3 (BoneCeramic(r) + 0.1mg simvastatin) followed by group 2 (BoneCeramic(r)), and almost no bone was formed in the other groups. Group 3 was significantly different compared to group 2, and both groups were significantly different compared to the other groups. CONCLUSION: Simvastatin combined with BoneCeramic(r) induced significantly greater amounts of newly formed bone and has great potential for the healing of bone defects.

Lesión osteolítica de calota por sífilis secundaria / Injury by skull osteolytic secundary syphilis

Bone involvement of syphilis can be observed in tertiary and congenital syphilis. It is infrequent during the secondary stage. The skull is the most affected bone in secondary syphilis, and its most frequent form of presentation is proliferative osteitis. If the skull is affected, headache is usual and can be as intense as in meningitis. Osteolyitic lesions may be seen in complimentary imaging studies, with a moth eaten aspect. These lesions raise concern over a number of differential diagnoses, among which are infectious, inflammatory and neoplastic diseases. The definitive diagnosis is made by bone biopsy of the compromised bone. Molecular techniques in the affected tissues increases diagnostic performance. There is no standardized treatment protocol for syphilis since there are no guidelines available. We report a case of a 19 year old female, presenting with a unique osteolytic lesion in the skull due to secondary syphilis.

El compromiso óseo de la sífilis se observa predominantemente en la sífilis terciaria y en la sífilis congénita, siendo infrecuente durante el estadio secundario. El hueso más afectado durante la sífilis secundaria es el cráneo, siendo la osteítis proliferativa la forma más frecuente de presentación. Cuando afecta la calota, la cefalea es habitual y puede ser tan intensa que se confunde con un proceso meníngeo. En las imágenes se observan lesiones líticas de aspecto apolillado, planteando el diagnóstico diferencial con otras patologías infecciosas, inflamatorias y neoplásicas. El diagnóstico definitivo se realiza por estudio histológico del hueso comprometido. Las técnicas de biología molecular en los tejidos afectados aumentan el rendimiento diagnóstico. No existen protocolos estandarizados para el tratamiento de la sífilis con compromiso óseo. Presentamos el caso clínico de una mujer de 19 años de edad, con una lesión osteolítica única de calota debida a una sífilis secundaria.

The biopolymer sugarcane as filling material of critical defects in rats

PURPOSE: To evaluate the effects of particulate (granule-shaped) SCB on bone repair relating it to its biocompatibility and bone neoformation. METHODS: Thirty Wistar rats were submitted to a one 7-mm-diameter defect and divided equally into three experimental groups, with two different postoperative times of evaluation, 90 and 120 days. Each calvaria defect was filled up with clot (control group), particulated autogenous bone or granulated SCB. Five animals of each group were assessed at 90 and 120 days after surgery. In these two periods, histological and histometric analysis were obtained. RESULTS: The clot group showed a bone resorption trend while the autogenous bone group a bone repair trend. However in the SCB group, the critical defect filled up only with fibrous connective tissue and presented none bone neoformation. CONCLUSION : The sugarcane biopolymer when used in critical size defects was a biocompatible material and proved to be a good material to fill bone cavities, keeping them as uniform areas filled with soft tissue and avoiding the tissue shrinkage.

Determination of a Newborn with Lethal Type II Osteogenesis Imperfecta and Other Anomalies Using Autopsy and Postmortem MSCT--A Case Report / 法医学杂志

A case of a stillbirth with lethal type II osteogenesis imperfecta (OI) was reported. The fetus had skull fractures and craniocerebral injuries during pregnancy. Postmortem multi-sliced computed tomography (MSCT) and 3D-reconstruction were performed, followed by a medico-legal autopsy. The autopsic findings showed the typical features of type II OI, including a soft calvarium, deformed extremities, flexed and abducted hips, and uncommon features, such as white sclera, coxa vara, absence of several bones and organs, a cleft lip, and asymmetric ears. The radiologic images revealed such anomalies and variations as a cleft palate, mandibular dysplasia, spina bifida, costa cervicalis, and fusion of the ribs and vertebrae, which were difficult to detect during conventional autopsy. The paper investigated the classification, causative mutation, cause of death, and the differentiation of OI from child abuse, coming to a conclusion that OI knowledge can be of great importance to forensic pathologists and that the merits of postmortem MSCT should be emphasized in forensic pathologic examinations.

Research Progress on Biomechanics of Craniocerebral Injury in Children / 法医学杂志

In the researches of biomechanics for child craniocerebral injury, the research progress of performance parameter detection for brain, skull, cranial suture and dura mater, and the finite element model construction for child's head were reviewed. Meanwhile, the shortcomings of the established finite element model construction of child's head were analyzed. Thus, it is necessary to strengthen the material properties parameter detection of child's head, and establish the relevant database, so as to lay the foundation for establishing an accurate finite element model of child's head.

Avaliação microtomográfica e histomorfométrica do processo de reparo de defeitos ósseos em calvária de coelhos tratados com diferentes materiais de enxerto / Microtomographic and histomorphometric evaluation of bone repair in rabbit cranial defects treated with different graft materials

Um dos grandes desafios para o tratamento de defeitos ósseos extensos na região bucomaxilofacial têm sido o desenvolvimento de um biomaterial substituto ósseo ao enxerto autógeno. No presente trabalho avaliou-se a formação óssea e a biodegrabilidade do osso desproteinizado bovino Bio-Oss® e do seu similar GenOx Inorg® e da cerâmica bifásica GenPhos® XP no processo de reparo de defeitos ósseos cranianos em coelhos, comparativamente ao osso autógeno (controle positivo) e coágulo sanguíneo (controle negativo). Foram realizados cirurgicamente defeitos bilaterais de 8-mm de diâmetro nos ossos parietais de 39 coelhos. A seguir os defeitos foram preenchidos aleatoriamente com 0,1cm3 de material ou coágulo conforme cada grupo de tratamento. Após os períodos de 4, 8 e 24 semanas os crânios foram coletados, analisados no microtomógrafo e processados histologicamente. O percentual de volume do defeito ocupado pelo material e osso neoformado foi avaliado pela microtomografia e histomorfometria, enquanto que, para a medula óssea, tegumento e tecido conjuntivo, apenas pela análise histomorfométrica. Os resultados quantitativos obtidos foram comparados estatisticamente pela ANOVA a dois critérios (período e tratamento) e teste de Tukey com p<0,05. A intensidade da associação linear dos dados microtomográficos e histomorfométricos avaliada pelo coeficiente de correlação de Pearson, mostraram correlação moderada a forte. Nos períodos iniciais de reparo (30 e 60 dias), os defeitos tratados com Bio-Oss®, GenOx® Inorg e GenPhos® XP apresentaram manutenção do volume do material enxertado (Vvi médio de 34% ) e formação óssea menor e mais imatura em relação grupo autógeno (Vvi = 22% vs. 32% no grupo autógeno). No período mais tardio (180 dias) a quantidade de formação óssea foi estatisticamente similar nos grupos Bio-Oss® (Vvi = 27%), GenOx® Inorg (Vvi = 26%) e GenPhos® XP (Vvi = 20%) porém, o GenOx® Inorg promoveu a formação de um tecido ósseo mais organizado e com maior acúmulo de biomaterial+osso+medula óssea (Vvi = 67,9%) comparado ao GenPhos® XP (Vvi =58,9%) e Bio Oss (Vvi = 55,6%) mas, inferior ao do enxerto autógeno (Vvi = 78%). Os resultados aqui obtidos permitem concluir que o osso autógeno promove rápida formação e maturação óssea, porém não consegue promover o reestabelecimento completo da díploe removida cirurgicamente. Os materiais BioOss, GenOx® Inorg e GenPhos® XP são excelentes materiais osteocondutores levando a formação óssea em toda extensão do defeito, sendo o GenOx® Inorg o que apresenta menor grau de reabsorção e maior e melhor preenchimento do defeito.(AU)

One major challenge for treatment of critical size defects in maxillofacial region has been the development of a substitute biomaterial to the autogenous bone grafts. In present study we evaluated the bone formation and biodegradability of deproteinized bovine bone Bio-Oss® and GenOx® Inorg, and biphasic calcium phosphate GenPhos XP® during bone repair process in rabbits cranial defects compared to autogenous bone (positive control) and blood clot (negative control). In parietal bone of 39 rabbits were made bilateral 8-mm diameter defects, which were filled randomly with 0,1cm3 material or clot as each treatment group. After periods of 4, 8 and 24 weeks skulls of animals were collected, analyzed the MicroCT scanner and histologically processed. The percentage of defect volume occupied by biomaterial and new-formed bone were assessed by histomorphometry and microtomography, while the bone marrow, connective tissue and tegument only by first analysis. The quantitative data were compared by two-way ANOVA analysis (time and treatment) and Tukey's test at p <0.05. The intensity of the linear association of MicroCT and morphometric data evaluated by the Pearson correlation coefficient, showed moderate to strong correlation. In the early repair periods (30 and 60 days), the defects treated with Bio- Oss, GenOx® Inorg and GenPhos® XP showed maintenance of the graft material volume (average Vvi of 34%) and lower and more immature bone compared autograft group (Vvi = 22% vs. 32% in the autograft group). In the later period (180 days) the amount of bone formation was statistically similar to the groups Bio-Oss® (Vvi = 27 %), GenOx® Inorg (Vvi = 26%) and GenPhos® XP (Vvi = 20%) however, the bone formation in GenOx® Inorg was more organized and with greater accumulation of particles + bone tissue + bone marrow (Vvi = 67.9%), when compared to GenPhos® XP (Vvi = 58.9%) and Bio-Oss® (Vvi = 55.6%) but lower than the autograft (Vvi = 78%). It was concluded that the autogenous bone promotes rapid bone formation and maturation, but cannot promote the complete reestablishment of diploe surgically removed. The Bio-Oss®, GenOx® Inorg and GenPhos® XP are excellent osteoconductive materials leading to bone formation in the full extent of the defects, and the GenOx® Inorg showing less absorption promotes more and better defect filling.(AU)

Electrical stimulation in the bone repair of defects created in rabbit skulls / Estimulación eléctrica en la reparación ósea de defectos creados en cráneos de conejos

Electrical stimulation has been used in different conditions for tissue regeneration. The aim of this study was to analyze the tissue response of defects created in rabbit skulls to electrical stimulation. Two groups were formed, each with 9 New Zealand rabbits; two 5 mm defects were made, one in each parietal, with one being randomly filled with autogenous bone extracted as particles and the other maintained only with blood clotting. The rabbits were euthanized at 8 weeks and 15 weeks to then study the samples collected histologically. In the 8-week analysis bone formation was observed in the defects in the test and control filled with bone graft, whereas the defects with clotting presented a very early stage of bone formation with abundant connective tissue. At 15 weeks an advanced stage of bone regeneration was identified in the defects with bone graft, whereas no significant differences were found in the electrically stimulated defects. In conclusion, electrical stimulus does not alter the sequence of bone formation; new studies could help establish patterns and influences of the stimulus on bone regeneration.

La estimulación eléctrica ha sido empleada en diferentes condiciones para la regeneración de tejidos. El objetivo de esta investigación es analizar la respuesta tisular de defectos creados en cráneo de conejos a la estimulación eléctrica. Se formaron 2 grupos con 9 conejos de raza New Zealand cada uno; en ellos se realizaron dos defectos de 5 mm, uno en cada parietal, siendo aleatoriamente uno rellenado con el propio hueso autógeno extraído en forma de partículas y el otro mantenido solo con coagulo sanguíneo; se realizó la eutanasia a las 8 semanas y a las 15 semanas para luego estudiar histológicamente las muestras recolectadas. En el análisis de 8 semanas se observó formación ósea en los defectos test y control rellenados con injerto óseo mientras que los defectos con coagulo presentaron un estado muy precoz de formación ósea, observándose abundante tejido conectivo. A las 15 semanas se identificó un estado avanzado de regeneración ósea en los defectos con injerto óseo, donde no se apreció diferencias importantes en los defectos estimulados eléctricamente. Se concluye que el estimulo eléctrico no altera la secuencia de formación ósea; nuevos estudios podrían contribuir a establecer patrones e influencias del estimulo eléctrico en la regeneración ósea.

Avaliação de diferentes protocolos de aplicação do laser de baixa intensidade associado ou não ao osso bovino inorgânico (Bio-Oss®) na cicatrização de defeitos ósseos criados cirurgicamente em calvárias de ratos: estudo histológico e histométrico / Evaluation of different protocols of low-level laser (LLL) application combined or not with inorganic bovine bone (Bio-Oss®) in the healing of surgically created bone defects in rat calvaria: histological and histometric study

O propósito deste estudo foi avaliar diferentes protocolos de aplicação do laser de baixa intensidade (LBI) associados ou não ao osso bovino inorgânico (Bio-Oss®) na cicatrização de defeitos ósseos de tamanho crítico (DTC) em calvárias de ratos. Foram utilizados 90 ratos machos adultos (Rattus norvegicus, albinus, Wistar). Um defeito de tamanho crítico (DTC) de 5 mm de diâmetro foi criado cirurgicamente na calvária de cada animal. Os animais foram divididos igualmente (n=10) e aleatoriamente em 9 gruposexperimentais: 1) grupo C (controle), 2) grupo LBI (4J) (laser de baixa intensidade GaAlAs, 730 nm, 100 mW, 4J, 140 J/cm2), 3) Grupo LBI (6J) (laser de baixa intensidade GaAlAs, 730 nm, 100 mW, 6J, 210 J/cm2), 4) Grupo BO (osso bovino inorgânico), 5) Grupo BO + LBI (4J) (osso bovino inorgânico + laser de baixa intensidade 4J), 6) Grupo BO + LBI (6J) (osso bovino inorgânico + laser de baixa intensidade 6J), 7) Grupo OA (osso autógeno), 8) Grupo OA + LBI (4J) (osso autógeno + laser de baixa intensidade 4J), 9) Grupo OA + LBI (6J) (osso autógeno + laser de baixa intensidade 6J). Os animais foram submetidos à eutanásia aos 30 dias pós-operatórios. Foram avaliadas a área de osso neoformado (AON), extensão linear de osso (ELO) e área de partículas remanescentes (APR). Os dados foram submetidos ao teste paramétrico ANOVA, seguido pelo teste de Tukey (p<0,05). O grupo BO+LBI (6J) demonstrou maior média (48,57 ± 28,22%) de AON e o grupo C a menor média (9,96 ± 4,49%) de AON. Os grupos LBI (6J), OA+LBI (6J) e BO+LBI (6J) demonstraram diferenças estatisticamente significativas de AON em relação ao grupo C. Em relação a ELO, apenas os grupos BO e BO+LBI (4J) não demonstraram diferenças estatisticamente significativas quando comparados ao grupo C, e a maior diferença entre as médias de ELO foram nas comparações do grupo LBI (6J) (76,55 ± 15,54%) com o grupo C (16,00 ± 9,86%. Maior APR foi observada nos grupos em que BO não foi irradiado pelo LBI. Porém, quando...

The purpose of this study was to evaluate different protocols of low-level laser (LLL) application combined or not with inorganic bovine bone (Bio-Oss®) in the healing process of bone defects of critical size (CSD) in rat calvaria. 90 male adult rats (Rattusnorvegicus, albinus, Wistar) were used. A critical size defect (CSD) of 5 mm in diameter was surgically created in the calvaria of each rat. The rats were then divided equally (n=10) and randomly into 9 experimental groups: 1) Group C (control) 2) Group LBI (4J) (low-level laser - GaAlAs, 730 nm, 100 mW, 4J, 140 J/cm2), 3) Group LBI (6) (low- level laser - GaAlAs, 730 nm, 100 mW, 6J, 210 J/cm2), 4) Group BO (inorganic bovine bone), 5) Group BO + LBI (4J) (inorganic bovine bone + low-level laser 4J), 6) Group BO LBI (6J) (inorganic bovine bone + low-level laser 6J), 7) Group OA (autogenous bone), 8) Group OA + LBI (4J) (autogenous bone + low-level laser 4J), 9 Group OA + LBI (6J) (autogenous bone + low-level laser 6J). The rats utilized were euthanized 30 days post-operation. The areas of new bone formation (ANB), linear extension bone (LEB), and areas of remaining particles (ARP) were evaluated. The data underwent the parametric ANOVA test, followed by the Tukey test (p<0,05). Group BO+LBI (6J) presented the greatest average (48,57 ± 28,22%) of ANB and Group C presented the lowest average (9,96 ± 4,49%) of ANB. The groups LBI (6J), OA+LBI (6J), and BO+LBI (6J) presented statistically significant differences of ANB in comparison to Group C. Regarding the LEB, only the groups BO and BO+LBI (4J) did not present differences statistically significant in comparison to Group C. The largest difference between the averages of LEB were in the comparison of Group LBI (6J) (76,55 ± 15,54%) with Group C (16,00 ± 9,86%). The largest ARP was observed in the groups where the inorganic bovine bone was not irradiated by the LLL. However, when comparing Group BO+LBI (6J) to Group OA+LBI (4J) and...

Avaliação de diferentes protocolos de aplicação do laser de baixa intensidade associado ou não ao osso bovino inorgânico (Bio-Oss®) na cicatrização de defeitos ósseos criados cirurgicamente em calvárias de ratos: estudo histológico e histométrico / Evaluation of different protocols of low-level laser (LLL) application combined or not with inorganic bovine bone (Bio-Oss®) in the healing of surgically created bone defects in rat calvaria: histological and histometric study

O propósito deste estudo foi avaliar diferentes protocolos de aplicação do laser de baixa intensidade (LBI) associados ou não ao osso bovino inorgânico (Bio-Oss®) na cicatrização de defeitos ósseos de tamanho crítico (DTC) em calvárias de ratos. Foram utilizados 90 ratos machos adultos (Rattus norvegicus, albinus, Wistar). Um defeito de tamanho crítico (DTC) de 5 mm de diâmetro foi criado cirurgicamente na calvária de cada animal. Os animais foram divididos igualmente (n=10) e aleatoriamente em 9 gruposexperimentais: 1) grupo C (controle), 2) grupo LBI (4J) (laser de baixa intensidade GaAlAs, 730 nm, 100 mW, 4J, 140 J/cm2), 3) Grupo LBI (6J) (laser de baixa intensidade GaAlAs, 730 nm, 100 mW, 6J, 210 J/cm2), 4) Grupo BO (osso bovino inorgânico), 5) Grupo BO + LBI (4J) (osso bovino inorgânico + laser de baixa intensidade 4J), 6) Grupo BO + LBI (6J) (osso bovino inorgânico + laser de baixa intensidade 6J), 7) Grupo OA (osso autógeno), 8) Grupo OA + LBI (4J) (osso autógeno + laser de baixa intensidade 4J), 9) Grupo OA + LBI (6J) (osso autógeno + laser de baixa intensidade 6J). Os animais foram submetidos à eutanásia aos 30 dias pós-operatórios. Foram avaliadas a área de osso neoformado (AON), extensão linear de osso (ELO) e área de partículas remanescentes (APR). Os dados foram submetidos ao teste paramétrico ANOVA, seguido pelo teste de Tukey (p<0,05). O grupo BO+LBI (6J) demonstrou maior média (48,57 ± 28,22%) de AON e o grupo C a menor média (9,96 ± 4,49%) de AON. Os grupos LBI (6J), OA+LBI (6J) e BO+LBI (6J) demonstraram diferenças estatisticamente significativas de AON em relação ao grupo C. Em relação a ELO, apenas os grupos BO e BO+LBI (4J) não demonstraram diferenças estatisticamente significativas quando comparados ao grupo C, e a maior diferença entre as médias de ELO foram nas comparações do grupo LBI (6J) (76,55 ± 15,54%) com o grupo C (16,00 ± 9,86%. Maior APR foi observada nos grupos em que BO não foi irradiado pelo LBI. Porém, quando...

The purpose of this study was to evaluate different protocols of low-level laser (LLL) application combined or not with inorganic bovine bone (Bio-Oss®) in the healing process of bone defects of critical size (CSD) in rat calvaria. 90 male adult rats (Rattusnorvegicus, albinus, Wistar) were used. A critical size defect (CSD) of 5 mm in diameter was surgically created in the calvaria of each rat. The rats were then divided equally (n=10) and randomly into 9 experimental groups: 1) Group C (control) 2) Group LBI (4J) (low-level laser - GaAlAs, 730 nm, 100 mW, 4J, 140 J/cm2), 3) Group LBI (6) (low- level laser - GaAlAs, 730 nm, 100 mW, 6J, 210 J/cm2), 4) Group BO (inorganic bovine bone), 5) Group BO + LBI (4J) (inorganic bovine bone + low-level laser 4J), 6) Group BO LBI (6J) (inorganic bovine bone + low-level laser 6J), 7) Group OA (autogenous bone), 8) Group OA + LBI (4J) (autogenous bone + low-level laser 4J), 9 Group OA + LBI (6J) (autogenous bone + low-level laser 6J). The rats utilized were euthanized 30 days post-operation. The areas of new bone formation (ANB), linear extension bone (LEB), and areas of remaining particles (ARP) were evaluated. The data underwent the parametric ANOVA test, followed by the Tukey test (p<0,05). Group BO+LBI (6J) presented the greatest average (48,57 ± 28,22%) of ANB and Group C presented the lowest average (9,96 ± 4,49%) of ANB. The groups LBI (6J), OA+LBI (6J), and BO+LBI (6J) presented statistically significant differences of ANB in comparison to Group C. Regarding the LEB, only the groups BO and BO+LBI (4J) did not present differences statistically significant in comparison to Group C. The largest difference between the averages of LEB were in the comparison of Group LBI (6J) (76,55 ± 15,54%) with Group C (16,00 ± 9,86%). The largest ARP was observed in the groups where the inorganic bovine bone was not irradiated by the LLL. However, when comparing Group BO+LBI (6J) to Group OA+LBI (4J) and...

Cranial vault reconstruction with bone morphogenetic protein, calcium phosphate, acellular dermal matrix, and calcium alginate in mice

PURPOSE: To evaluate experimental cranial vault reconstructions, by combining bone morphogenetic protein type 2 (BMP-2) and different matrices. METHODS: Fourty-nine animals were initially included (seven per group). We designed an experimental, open, prospective and comparative study, divided in seven groups: 1 - BMP-2+calcium phosphate (BT); 2 - BMP-2+acellular dermal matrix (BM); 3 - BMP-2+calcium alginate (BA); 4 - TCP; 5 - MDM; 6 - ALG; 7 - Bone autograft (BAG). A bone failure was created in left parietal bone of adult male mice. At the same procedure reconstruction was performed. After five weeks, animals were sacrificed, and reconstruction area was removed to histological analysis. After exclusion due to death or infection, thirty-eight animals were evaluated (BT=5; BM=6; BA=6; TCP=7; MDM=3; ALG=6; BAG=5). RESULTS: A higher incidence of infection has occurred in MDM group (57%, P=0.037). In cortical fusion, groups BAG, TCP, and BMP-2+TCP (BT) obtained the best scores, comparing to the others (P=0.00846). In new bone formation, groups BT, BAG, and TCP have presented the best scores (P=0.00835). When neovascularization was considered, best groups were BMP-2+MDM (BM), BMP-2+ALG (BA), TCP, and MDM (P=0.001695). BAG group was the best in bone marrow formation, followed by groups BT and TCP (P=0.008317). CONCLUSIONS: Bone morphogenetic protein type 2 increased bone regeneration in experimental skull reconstruction, especially when combined to calcium phosphate. Such association was even comparable to bone autograft, the gold-standard treatment, in some histological criteria. .

Histiocitosis dendrocítica (histiocitosis de células de langerhans), manifestaciones orales y craneofaciales: reporte de tres casos / Dendrocitic histiocytosis (langerhans cell histiocytosis), oral and craniofacial manifestations: report of three cases

La Histiocitosis de células de Langerhans (HCL) corresponde a una proliferación anormal de células dendríticas, de tipo clonal, cuyo espectro clínico general incluye compromiso de la piel y las mucosas, las uñas, el hueso, la médula ósea, el hígado, el bazo, linfonodos, el pulmón, el tracto gastrointestinal inferior, el sistema endocrino y el sistema nervioso central. En este trabajo presentamos tres casos de la enfermedad, con manifestaciones orales y craneofaciales, analizadas desde el punto de vista clínico (examen extra e intra oral), imagenológico (tomografías computadas) e histopatológico (expresión de marcador específico CD1a). Dos casos fueron clasificados como HCL de presentación aguda diseminada y uno como presentación crónica. Los pacientes fueron tratados oportunamente con quimioterapia según el protocolo del Programa Infantil Nacional de Drogas Antineoplásicas.

The Langerhans cell histiocytosis (LCH) corresponds to an abnormal proliferation of dendritic cells, clonal type, which usually involves compromise of skin and mucous membranes, nails, bone, bone marrow, liver, spleen, lymph nodes, lung, lower gastrointestinal tract, endocrine system and the central nervous system. We present three cases of the disease, with oral and craniofacial manifestations, analyzed from the clinical perspective (intra and extra oral exam), imaging (CT scans) and histopathological (specific marker CD1a expression). Two cases were classified as acute disseminated LCH presentation and one as a chronic disease. Patients were treated with chemotherapy timely according to the protocol of the National Child Program of Antineoplastic Drugs.