Efficacy of treatment of class II furcation lesions using membrane associated with bone grafting in mandibular molars compared to membrane only: a systematic review and meta-analysis / Eficacia del tratamiento de lesiones de furca grado II utilizando membrana asociada con injerto óseo en molares mandibulares en comparación con solamente membrana: revisión sistemática y metanálisis

Objective: The objective of the present systematic review and meta-analysis was to compare treatment with membrane associated with bone grafting and treatment exclusively with membrane in the approach of Class II furcation defects in mandibular molars. Materials and Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses statement was followed. Searches were conducted in five databases (PubMed, Web of Science, Scopus, Ovid, and Lilacs), in Septem-ber 2021, without restriction regarding publication year or language. Studies comparing membranes associated with bone grafting and membranes exclusively in the treatment of Class II furcation lesions were included. Cross-sectional, case-control studies, and reviews were excluded. Study selection, data extraction, and risk of bias assessment (MINORS) were performed by two review authors. The certainty of the evidence (GRADE) was evaluated and meta-analysis was performed. Mean difference (MD) and 95% confidence interval (CI) were provided. Results: Four hundred eighty-six references were iden-tified and four studies were included. Greater reduction in probing depth [MD = 0.32 (CI = 0.09, 0.56)] and greater clinical attachment level gain [MD = 0.41 (CI = 0.24, 0.57)] were observed when membrane and bone grafting were used. The risk of bias of included studies was low. Conclusions: This present systematic review and meta-analysis demonstrated that treatment of Class II furcation defects in mandibular molars using membrane and bone grafing is significantly more efficacious than treatment with the exclusive use of membrane.

Objetivo: El objetivo de la presente revisión sistemática y metanálisis fue comparar el tratamiento con membrana asociado a injerto óseo y el tratamiento exclusivamente con membrana en el abordaje de lesiones de furca grado II en molares mandibulares. Materiales y Métodos: Se siguió la declaración de elementos de informe preferidos para revisiones sistemáticas y metanálisis (PRISMA). Las búsquedas se realizaron en cinco bases de datos (PubMed, Web of Science, Scopus, Ovid y Lilacs), en septiembre de 2021, sin restricción de año de publicación o idioma. Se incluyeron estudios que compararon membranas asociadas con injertos óseos y membranas exclusivamente en el tratamiento de lesiones de furca de grado II. Se excluyeron los estudios transversales, de casos y controles y las revisiones. Dos revisores realizaron la selección de estudios, la extracción de datos y la evaluación del riesgo de sesgo (MINORS). Se evaluó la certeza de la evidencia (GRADE) y se realizó un metanálisis. Se proporcionaron la diferencia de medias (DM) y el intervalo de confianza (IC) del 95%. Resultados: Se identificaron 486 referencias y se incluyeron cuatro estudios. Se observó una mayor reducción en la profundidad de sondaje [DM = 0,32 (IC = 0,09, 0,56)] y una mayor ganancia en el nivel de inserción clínica [DM = 0,41 (IC= 0,24, 0,57)] cuando se utilizaron injertos de membrana y hueso. El riesgo de sesgo de los estudios incluidos fue bajo. Conclusión: La presente revisión sistemática y metanálisis demostró que el tratamiento de los defectos de furca de grado II en molares mandibulares utilizando membrana e injertos de hueso es significativamente más eficaz que el tratamiento con el uso exclusivo de membrana.

Uso de membrana de celulosa oxidada post-gingivectomía en hiperplasia gingival inducida por fenitoína / Use of oxidized cellulose regenerated post-gingivectomy on ginigival hyperplasia induced by phenytoin

Introducción: La hiperplasia gingival es una condición benigna caracterizada por el aumento de volumen de la encía. Algunos fármacos, factores genéticos, aparatología y placa dentobacteriana son factores que pueden inducir esta condición. Objetivo: Devolver la anatomía a la encía brindando una mejor estética y permitiendo una óptima higiene oral. Material y métodos: Paciente masculino de 20 años de edad con antecedentes de fenitoína presenta aumento de volumen en la encía. Resultados: Se obtuvieron resultados estéticos y funcionales satisfactorios con el tratamiento quirúrgico y el uso de membrana de celulosa oxidada. Conclusión: En el manejo de la hiperplasia gingival es importante el enfoque no quirúrgico como control de placa dentobacteriana y medidas de higiene del mismo paciente (AU)

Introduction: Gingival hyperplasia is a benign condition characterized for the grown on the gingival volume. Some drugs, genetic, orthodontic and dental plaque are some factors that can induce this condition. Objective: To return the gingival anatomy, providing a better aesthetic allowing also good oral hygiene. Material and methods: A male 20 years of age with medical history of phenytoin display grown on the gingival volume. Results: Aesthetic and functional results were achieved with the surgical treatment and the oxidized cellulose membrane. Conclusion: In the gingival hyperplasia management is important de non-surgical approach, as dental plaque control and oral hygiene of the patient (AU)

Disruptive technologies for hemodialysis: medium and high cutoff membranes. Is the future now? / Tecnologias disruptivas para hemodiálise: membranas de ponto de corte médio e alto. O futuro é agora?

Abstract In the past decade, a new class of hemodialysis (HD) membranes (high retention onset class) became available for clinical use. The high cutoff (HCO) and the medium cutoff (MCO) membranes have wider pores and more uniformity in pore size, allowing an increased clearance of uremic toxins. Owing to the mechanism of backfiltration/internal filtration, middle molecules are dragged by the convective forces, and no substitution solution is needed. The HCO dialyzer is applied in septic patients with acute kidney injury requiring continuous kidney replacement therapy. The immune response is modulated thanks to the removal of inflammatory mediators. Another current application for the HCO dialyzer is in hematology, for patients on HD secondary to myeloma-kidney, since free light chains are more efficiently removed with the HCO membrane, reducing their deleterious effect on the renal tubules. In its turn, the MCO dialyzer is used for maintenance HD patients. A myriad of clinical trials published in the last three years consistently demonstrates the ability of this membrane to remove uremic toxins more efficiently than the high-flux membrane, an evolutionary disruption in the HD standard of care. Safety concerns regarding albumin loss as well as blood contamination from pyrogens in the dialysate have been overcome. In this update article, we explore the rise of new dialysis membranes in the light of the scientific evidence that supports their use in clinical practice.

Resumo Na última década, uma nova classe de membranas de hemodiálise (HD) (classe de início de alta retenção) tornou-se disponível para uso clínico. As membranas de ponto de corte alto (HCO) e ponto de corte médio (MCO) têm poros mais largos e maior uniformidade no tamanho dos poros, permitindo uma maior depuração de toxinas urêmicas. Devido ao mecanismo de retrofiltração/filtração interna, as moléculas médias são arrastadas pelas forças convectivas, não sendo necessária uma solução de substituição. O dialisador de HCO é aplicado em pacientes sépticos com lesão renal aguda que requerem terapia renal substitutiva contínua. A resposta imunológica é modulada graças à remoção de mediadores inflamatórios. Outra aplicação atual para o dialisador de HCO é em hematologia, para pacientes em HD secundária ao rim do mieloma, uma vez que as cadeias leves livres são removidas mais eficientemente com a membrana de HCO, reduzindo seu efeito deletério sobre os túbulos renais. Por sua vez, o dialisador de MCO é utilizado para pacientes em HD de manutenção. Uma miríade de ensaios clínicos publicados nos últimos três anos demonstra consistentemente a capacidade desta membrana de remover toxinas urêmicas de forma mais eficiente do que a membrana de alto fluxo, uma ruptura evolutiva no padrão de cuidado em HD. As preocupações de segurança em relação à perda de albumina, bem como a contaminação do sangue por pirogênios no dialisato foram superadas. Neste artigo de atualização, exploramos o surgimento de novas membranas de diálise à luz das evidências científicas que apoiam seu uso na prática clínica.

Efficacy of two barrier membranes and deproteinized bovine bone mineral on bone regeneration in extraction sockets: A microcomputed tomographic study in dogs / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the effect of two barrier membranes [multilaminated small intestinal submucosa (mSIS) and bioresorable collagen membrane (Bio-Gide)] combined with deproteinized bovine bone mineral Bio-Oss on guided bone regeneration through a canine extraction sockets model.@*METHODS@#The distal roots of 18 premolars of the Beagle' s bilateral maxillary and mandibular were removed, and 18 extraction sockets were obtained. They were randomly divided into 3 groups, and the following procedures were performed on the sockets: (1) filled with Bio-Oss and covered by mSIS (mSIS group), (2) filled with Bio-Oss and covered by Bio-Gide (BG group), (3) natural healing (blank control group). Micro-computed tomograph (Micro-CT) was performed 4 and 12 weeks after surgery to eva-luate the new bone regeneration in the sockets of each group.@*RESULTS@#The postoperative healing was uneventful in all the animals, and no complications were observed through the whole study period. Micro-CT analysis showed that the new bone fraction in the mSIS group and the BG group was significantly higher than that in the blank control group at the end of 4 weeks and 12 weeks (P < 0.05), and more new bone fraction was observed in the mSIS group than in the BG group, but the difference was not statistically significant (P>0.05). The new bone fraction of coronal third part of the socket in the mSIS group and BG group at the end of 4 weeks were significantly higher than that of the middle and apical third part of each group (P < 0.05). The values of bone mineral density were similar at 4 weeks in all the groups (P>0.05), but were significantly higher than that in the control group at the end of 12 weeks (P < 0.05). The bone morphometric analysis showed that the trabecular number and trabecular spacing were significantly better in the mSIS group and the BG group than in the control group at the end of 4 weeks and 12 weeks (P < 0.05), while the value in the mSIS group was slightly higher than in the BG group, but the difference was not statistically significant (P>0.05). The difference in trabecular thickness between all the groups was not statistically significant (P>0.05).@*CONCLUSION@#mSIS membrane as a barrier membrane combined with deproteinized bovine bone mineral can enhance new bone formation in canine extraction sockets, similar to Bio-Gide collagen membrane.

Effect of sulfonated block copolymer on the equilibrium and thermal properties of sulfonated fluoroblock copolymer blend membrane / Efecto del copolímero en bloque sulfonado sobre las propiedades térmicas y de equilibrio de una membrana sulfonada mezclada con un fluoropolímero en bloque

Polymeric membrane technologies demand the synthesis of new polymers to enhance their equilibrium, thermal, and transport properties. Therefore, the focus of this investigation was the evaluation of the equilibrium and thermal properties of a sulfonated fluoroblock copolymer blend membrane composed of sulfonated poly(styre-ne-isobutylene-styrene) (SIBS SO3H) and a novel sulfonated fluoroblock copolymer composed of poly(4-fluo-rostyrene) (P4FS), poly(styrene) (PS) and poly(isobutylene) (PIB). The fluoroblock copolymer was synthesized using Atom Transfer Radical Polymerization (ATRP) and cationic polymerization. First, the molecular weight and the thermal stability of the block copolymer were determined using Gel Permeation Chromatography (GPC) and Thermogravimetric Analysis (TGA). Second, the chemical composition was monitored utilizing Fourier Transform Infrared spectroscopy (FTIR) and Nuclear Magnetic Resonance (NMR) spectroscopy. The molecular weight of P4FS-b-PS was Mn ~ 36,100; this value increased 8% after the cationic polymerization. The equilibrium properties of the membrane were evaluated using the water uptake and Ion-Exchange Capacity. The degradation behavior and the thermal transitions were determined using TGA and Differential Scanning Calorimetry (DSC), respectively. This newly membrane exhibited water uptake higher than 608% related to the improvement of 36% in the ion-exchange capacity and the increment of 25.31% and 25.24% in the energy required to produce the thermal transitions induced by the addition of the sulfonated fluoroblock copolymer.

La tecnología de membranas poliméricas requiere de la síntesis de nuevos polímeros que mejoren sus propiedades de equilibrio, térmicas y de transporte. Esta investigación tuvo como objetivo determinar las pro-piedades de equilibrio y térmicas de una membrana compuesta de poli(estireno-isobutileno-estireno) sulfonado (SIBS SO3H) y un fluoropolímero en bloque sulfonado compuesto de poli(4-fluorostireno) (P4FS), poli(estireno) (PS) y poli(isobutileno) (PIB). El fluoropolímero en bloque se sintetizó utilizando la técnica de polimerización radical por transferencia atómica (ATRP por sus siglas en inglés) y polimerización catiónica. El peso molecular y la estabilidad térmica del fluoropolímero en bloque fueron determinadas por medio de Cromatografía de Permeación en Gel (GPC) y un análisis termogravimétrico (TGA). La composición química se monitorizó utilizando espectroscopía infrarroja por transformada de Fourier (FTIR) y espectroscopía de Resonancia Magnética Nuclear (RMN). El peso molecular de P4FS-b-PS fue Mn ~ 36,100; este valor aumentó un 8% después de la polimerización catiónica. Las propiedades de equilibrio de la membrana fueron evaluadas por medio de la absorción de agua y la capacidad de intercambio iónico. El comportamiento de degradación y las transiciones térmicas se determinaron utilizando TGA y Calorimetría Diferencial de Barrido (DSC). Esta nueva membrana exhibió una absorción de agua mayor del 608% relacionada con la mejora del 36% en la capacidad de intercambio iónico y el incremento en 25.31% y 25.24% en la energía requerida para producir las transiciones termales inducidas por la adición del fluoropolímero sulfonado en bloque.

Agrandamiento gingival inducido por fenitoínas / Phenytoin induced gingival enlargement

Se entiende por agrandamiento gingival el incremento en masa y volumen del tejido gingival. Se considera una condición benigna de la cavidad oral, por lo general de manejo rutinario, que logra regularse con medidas simples de control del biofilm microbiano. El agrandamiento gingival puede ser producido por diversas condiciones clínicas, hereditarias, deficiente higiene oral o fármacos. La epilepsia afecta a 1% de la población mundial y requiere el uso de fármacos antiepilépticos o anticonvulsivantes para lograr su control, dentro de éstos la fenitoína actúa como un bloqueador selectivo de los canales de sodio sensibles al voltaje y constituye uno de los fármacos más empleados por su capacidad en el control de crisis focales y generalizadas. La fenitoína se ha relacionado con los agrandamientos gingivales como uno de sus efectos adversos, los cuales se incluyen dentro de las enfermedades por fármaco inducidas en la cavidad oral. El objetivo de este artículo es brindar la información necesaria sobre el manejo correcto de pacientes con agrandamiento gingival producido por fenitoínas y a la vez poder conocer las consecuencias de estos fármacos en la cavidad oral (AU)

Gingival enlargement means the increase in mass and volumen of the gingival tissue. It is considered a benign condition of the oral cavity, usually of routine management, wich can be regulated with simple measures of biofilm control. The gingival enlargement can be produced by diverse clinical conditions, hereditary deficient oral higiene or drugs. Epilepsy affects 1% of the world population and requires the use of antiepileptic or anticonvulsant drugs to achieve its control, within these phenytoin acts as selective blocker or voltage ­ sensitive sodium channels and is one of the most used grugs for its ability to control focal and generalized crises. Phenytoin has been linked to gingival enlargement as one of its adverse effects which is included within the drug diseases induced in the oral cavity. The objective of this article is to provide the necessary information on the correct managment of patients with gingival enlargemen produced by phenytoins and at the same time to know the consequences of these drugs in the oral cavity (AU)

Membranas e barreiras para regeneração óssea guiada / Membranes and barriers for guided bone regeneration

Introdução: a evolução das técnicas de reconstrução alveolar e dos biomateriais na regeneração óssea guiada (ROG), vêm trazendo consigo o desenvolvimento de novas membranas com diferentes características e propriedades. Objetivo: este trabalho tem como objetivo reunir dados das membranas utilizadas em procedimentos de ROG, presentes no mercado nacional, para facilitar ao clínico a escolha de um biomaterial que seja adequado ao procedimento planejado e com um desempenho favorável para a regeneração. Metodologia: foram incluídas 30 membranas para ROG registradas e regulamentadas pela Agência Nacional de Vigilância Sanitária (ANVISA). As empresas fabricantes foram contatadas para fornecer as informações dos seus respectivos produtos. Resultados: 30 membranas foram encontradas e tabuladas. Após a análise das informações obtidas pelos fabricantes, as mesmas foram classificadas nos seguintes itens: nome, empresa fabricante, origem, tempo de bioreabsorção, possibilidade de exposição ao meio bucal, diâmetro dos orifícios e apresentação. Discussão: as propriedades e características específicas de cada membrana podem determinar diferentes resultados, sendo importante para o profissional conhecer essas diferenças para selecionar os materiais mais indicados aos procedimentos de ROG de acordo com os objetivos de cada caso. Dessa forma, os resultados podem ser previsíveis e atender da melhor forma possível as expectativas do tratamento com embasamento científico. Conclusão: o presente estudo tabulou 30 membranas quanto as suas principais características, visando orientar os profissionais da saúde na seleção da membrana mais adequada para alcançar seus objetivos no tratamento da ROG.

Introduction: the evolution of alveolar reconstruction techniques and biomaterials in guided bone regeneration (GBR), have brought with it the development of new membranes with different characteristics and properties. Objective: this study aims to gather data from the membranes used for ROG procedures present in the national market, to facilitate the clinician to choose a biomaterial that is suitable for the planned procedure and with a favorable performance for regeneration. Metodology: 30 membranes were included, registered and regulated by ANVISA. The manufacturing companies were contacted to provide information on their respective products. Results: 30 membranes were found and tabulated after analyzing the information obtained by the manufacturers, they were classified in the following items: name, manufacturer company, origin, time of resorption, possibility of exposure to the oral environment, diameter of the holes and presentation. Discussion: the specific properties and characteristics of each membrane can determine different results and, therefore, it is important for the professional to know these differences in order to select the most suitable materials for the GBR procedures according to the objectives of each case. In this way, the results can be predictable and best meet the expectations of the treatment with a correct scientific basis. Conclusion: the present study tabulated 30 membranes as to their main characteristics, aiming to guide health professionals in the selection of the most appropriate membrane to achieve their goals in the treatment of GBR.

Biodegradation properties of multi-laminated small intestinal submucosa / 北京大学学报(医学版)

OBJECTIVE@#To study the biodegradation properties of multi-laminated small intestinal submucosa (mSIS) through in vitro and in vivo experiments, comparing with Bio-Gide, the most widely used collagen membrane in guided bone regeneration (GBR) technique, for the purpose of providing basis to investigate whether mSIS meets the requirements of GBR in dental clinics.@*METHODS@#The degradation properties were evaluated in vitro and in vivo. In vitro degradation was performed using prepared collagenase solution. Morphology of mSIS and Bio-Gide in degradation solution were observed and the degradation rate was calculated at different time points. In in vivo experiments, nine New Zealand rabbits were used for subcutaneous implantation and were divided into three groups according to observation intervals. Six unconnected subcutaneous pouches were made on the back of each animal and were embedded with mSIS and Bio-Gide respectively. At the end of weeks 4, 8, and 12 after operation, gross observation and HE staining were used to evaluate the degree of degradation and histocompatibility.@*RESULTS@#In vitro degradation experiments showed that mSIS membrane was completely degraded at the end of 12 days, while Bio-Gide was degraded at the end of 7 days. Besides, mSIS maintained its shape for longer time in the degradation solution than Bio-Gide, indicating that mSIS possessed longer degradation time, and had better ability to maintain space than Bio-Gide. In vivo biodegradation indicated that after 4 weeks of implantation, mSIS remained intact. Microscopic observation showed that collagen fibers were continuous with a few inflammatory cells that infiltrated around the membrane. Bio-Gide was basically intact and partially adhered with the surrounding tissues. HE staining showed that collagen fibers were partly fused with surrounding tissues with a small amount of inflammatory cells that infiltrated as well. Eight weeks after operation, mSIS was still intact, and was partly integrated with connective tissues, whereas Bio-Gide membrane was mostly broken and only a few residual fibers could be found under microscope. Only a small amount of mSIS debris could be observed 12 weeks after surgery, and Bio-Gide could hardly be found by naked eye and microscopic observation at the same time.@*CONCLUSION@#In vitro degradation time of mSIS is longer than that of Bio-Gide, and the space-maintenance ability of mSIS is better. The in vivo biodegradation time of subcutaneous implantation of mSIS is about 12 weeks and Bio-Gide is about 8 weeks, both of which possess good biocompatibility.

Poly (Lactic Acid) membrane and Sedum dendroideum extract favors the repair of burns in rats

Abstract Purpose: To evaluate the healing potential of the electrospinning membranes of Poly (Lactic Acid) (PLA) associated with Sedum dendroideum extract in burn injuries in rats. Methods: Seventy-five rats were submitted to burn injury on their back skin: (C) untreated; (F) with daily topical application of S. dendroideum extract; (M) with electrospinning membranes of PLA; (MF10) with electrospinning membranes of PLA with 10% S. dendroideum extract; (MF25) with electrospinning membranes of PLA with 25% S. dendroideum extract. Tissue samples were taken after 2, 6 and 14 days of the burn injury and were subjected to histomorfometric analysis of quantification of fibroblasts, collagen fibers, blood vessels, and inflammatory infiltrate Results: The histomorphometric analysis showed an increase in the number of fibroblasts, collagen fibers and blood vessels in the burns treated with membranes of PLA, associated or not with the 10% and 25% extract. The extract of S. dendroideum promoted the increase of collagen fibers. Conclusion: The electrospinning PLA membrane, isolated or associated with the S. dendrodeum extract, favored the healing of burn injuries in this experimental model, with an increase of fibroblasts, collagen fibers, and blood vessels. S. dendroideum isolated only stimulated the collagenesis.

Therapy for patients with burns - an integrating review

SUMMARY OBJECTIVE: to identify, through an integrative review, national studies published over the last ten years highlighting products and therapies used in burns. METHODS: integrative research with studies published in the last ten years. Including clinical studies describing the use of the already established or innovative therapies in burns and the results obtained, published in national journals in the last ten years. Excluding articles published before 2007 and those that did not present results regarding the use of products in burns. RESULTS: ten articles that met the inclusion criteria were selected. Collagenase, 1% silver sulfadiazine, and porous cellulose membrane were some of the therapies cited. CONCLUSION: the casuistry was low; however, the good results obtained with porous cellulose membrane and silver nanocrystalline dressing are highlighted, since they were used in a larger number of patients in the studies evaluated.

RESUMO OBJETIVO: Identificar, por meio de revisão integrativa, estudos nacionais publicados nos últimos dez anos que destaquem produtos e terapêuticas utilizados nas queimaduras. MÉTODOS: Pesquisa integrativa com estudos publicados nos últimos dez anos. Incluídos os estudos clínicos que descreveram a utilização de terapias já consagradas ou inovadoras em queimaduras e os resultados obtidos e publicados em periódicos nacionais nos últimos dez anos. Excluídos os artigos publicados antes de 2007 e os que não apresentaram resultados quanto ao uso de produtos nas queimaduras. RESULTADOS: Selecionados dez artigos que atenderam aos critérios de inclusão, sendo colagenase, sulfadiazina de prata 1% e membrana celulósica porosa algumas das terapias descritas. CONCLUSÕES: A casuística foi baixa, porém, ressaltam-se os bons resultados obtidos com a membrana celulósica porosa e o curativo com prata nanocristalina, em virtude de terem sido utilizados em um maior número de pacientes nos estudos avaliados.

Research progress on the modification of guided bone regeneration membranes / 华西口腔医学杂志

Guided bone regeneration (GBR) is an important technique to solve bone defect problems. In this technique, GBR barrier membranes play an irreplaceable role. GBR membranes can act as a barrier protecting fibroblasts from bone defects and promote osteoblast adhesion and proliferation, leading to bone regeneration. GBR barrier membranes should be enhanced because of the disadvantages of collagen membranes, which are extensively applied to the field of GBR. Therefore, various efforts have been devoted to modifying the antibacterial and osteogenic properties of GBR barrier membranes and developing novel materials. This article reviews the research advancements on the modification of GBR barrier membranes and discover future directions for the development of GBR barrier membranes to provide a reference for bone tissue engi-neering and repair.

Advanced applications of membrane technology in biological detection / 生物工程学报

Membrane creates the functions of protection, supporting, dispersion and separation. More functions can be designed by modifying membrane surface and grafting/loading selective ligands or catalysts on the membrane, thus membrane technology has been widely applied in biological detection, and its application approaches becomes diverse. Rational design of functional membranes can meet the demands in different steps of biological detection process, including sample pretreatment, preparation, response and sensing. This review summarized the functionalization methods of filtration membranes, applications of membrane technology in sample preparation and detection process, as well as the research on the integration of functional membranes. By revisiting the research progress on functional membrane design, preparation and applications for biological detection, it is expected to take better advantage of membrane materials structure and performance for constructing efficient and stable detection platform, which is more "adapted" to the detection environment.

Aplicaciones del cianoacrilato en periodoncia: serie de casos / Applications of cyanoacrylate in periodontics: a series of cases

Introducción: Actualmente el uso de adhesivos tisulares como el cianoacrilato ha sido beneficioso en el área odontológica, reduciendo el tiempo del acto quirúrgico, disminuyendo el tiempo de cicatrización y la cicatriz postoperatoria, así también el dolor postoperatorio. Objetivo: El objetivo de este artículo es reportar diversas aplicaciones del cianoacrilato en tratamientos quirúrgicos periodontales, como recontorneo estético, gingivectomía, colgajo posicionado apical y preservación alveolar. Materiales y métodos/Presentación de casos: Los protocolos de tratamiento utilizados fueron los tradicionales para cada caso en particular más la adición de tres capas de cianoacrilato, con lapso de aplicación de 30 segundos entre cada capa. Conclusión: Los resultados clínicos de los casos presentados muestran una eficacia en la cicatrización al utilizar cianoacrilato, sin embargo, no sustituye los métodos tradicionales de los protocolos de cada tratamiento (AU)

Introduction: Currently, the use of tissue adhesives such as cyanoacrylate has been beneficial in the dental area, reducing the time of the surgical act, decreasing the time of healing and the postoperative scar, as well as the postoperative pain. Objective: The objective of this article is to report various applications of cyanoacrylate in periodontal surgical treatments, such as aesthetic crown lengthening, gingivectomy, apically positioned flap, and alveolar preservation. Materials and methods/Case presentation: The treatment protocols were the traditional ones for each particular case plus the addition of three layers of cyanoacrylate, with application time of 30 seconds between each layer. Conclusion: The clinical results of the presented cases show an efficacy in the cicatrization when using cyanoacrylate adhesives, nevertheless it does not substitute the traditional methods of the protocols of each treatment (AU)

Poly(3-hydroxybutyrate) graft copolymer dense membranes for human mesenchymal stem cell growth

Background: The use of novel materials as an artificial extracellular matrix for stem cell growth is a current strategy of increasing interest for regenerative medicine. Here, we prepare thermal-remolded membrane scaffolds from poly(3-hydroxybutyrate) grafted with 2-amino-ethyl methacrylate hydrochloride. However, it is unclear whether these membranes are useful for tissue engineering. Results: The mechanical properties, tribology, and morphology of the dense membranes were assessed. The results show that tensile strain at break and roughness of the compressed membrane decrease with increasing graft degree. Moreover, graft copolymer membranes showed lower resistance to scratching, greater degree of swelling and higher brittleness than un-grafted P(3HB) films. Thus, it effectively supports the growth of dermal fibroblast, as demonstrated by epifluorescence microscopy. Conclusions: It is concluded that the developed membrane can be properly used in is the restoration of skin tissue. How to cite: González-Torres M, Sánchez-Sánchez R, Solís-Rosales SG, et al. Poly(3-hydroxybutyrate) graft copolymer dense membranes for human mesenchymal stem cell growth.

Cierre de comunicación oroantral mediante el uso de membrana de plasma: revisión de la literatura y reporte de un caso clínico / Closure of oroantral communication using a plasma membrane: review of the literature and report of a clinical case

Una comunicación oroantral es el espacio creado entre el seno maxilar y la cavidad oral, si ésta no es tratada a tiempo puede desencadenar una fístula e inclusive la presencia de sinusitis crónica. La comunicación oroantral es una de las complicaciones con mayor prevalencia que puede presentarse durante los procedimientos quirúrgicos cercanos a la zona donde se vea involucrado el seno maxilar. Con mayor incidencia encontramos los primeros molares, seguidos de los segundos molares y por último los terceros molares. El manejo convencional de una comunicación oroantral va desde su cierre espontáneo hasta el manejo quirúrgico; esto dependerá del tamaño de la lesión y el tiempo transcurrido de ésta. El caso clínico se trata de un paciente de 42 años de edad con antecedente de extracción del O.D. 16 por facultativo particular, desarrollando posteriormente un cuadro de sinusitis, por lo que acude al Servicio de Urgencias del Hospital Regional 1o de Octubre, I.S.S.S.T.E. en la CDMX, siendo valorado por nuestro servicio, donde se observa una comunicación franca entre la cavidad bucal y el seno maxilar, realizándose cierre de la misma con una membrana de plasma rico en factores de crecimiento plaquetario (AU)

Oroantral communication is the space created between the maxillary sinus and the oral cavity, if the communication is not treated on time, it would progress to oroantral fi stula or chronic sinus disease. An oroantral communication is the most common complication during surgical procedures closer to the maxillary sinus. With greater incidence we found sites of upper fi rst molar, followed by the second molar and fi nally third molars. The conventional handling of an oroantral communication goes between spontaneously closure or surgical closure management, it will depend in the size of the lesion and the time elapsed. The present article shows a clinical case, is a male patient of 42 years old with a previous extraction of tooth 16, by a private doctor, later developing a picture of sinusitis. Then he goes to the emergency department of the Hospital 1o of October, ISSSTE in the CDMX, being evaluated by our service, where there is a frank communication between the oral cavity and the maxillary sinus, closing it with a plasma membrane rich in growth factors (AU)

Técnica de ortodoncia osteogénica periodontalmente acelerada: principios biológicos y etapa quirúrgica / Periodontally accelerated orthodontic and osteogenic technique: biological principles and surgical stage

La integración de la cirugía bucomaxilofacial con la ortodoncia, ya no sólo se limita al trabajo en equipo sobre pacentes con malformaciones bucomaxilofaciales (asociando ortodoncia y cirugía ortognática), sino también en otros múltiples procedimientos. El ortodoncista posee mayores opciones a la hora de planificar y el paciente mejores resultados estéticos y funcionales a mediano y largo plazo. Los pacientes adultos jóvenes demandan tratamientos funcionales y estéticos en el menor tiempo posible. La ortodoncia osteogénica periodontalmente acelerada permite: movimientos dentales acelerados, reducir el tiempo de tratamiento y mejorar el estado periodontal y biotipo gingival. En el presente trabajo analizamos las bases biológicas de la técnica y su etapa quirúrgica, junto con la presentación de un caso (AU)

The integration of oral and maxillofacial surgery with orthodontics is no longer limited to team work on patients with oral and maxillofacial malformations (associating orthodontics and orthognathic surgery), but also in other multiple procedures. The orthodontist has greater options when planning and the patient, better aesthetic and functional results in the medium and long term. Young adult patients demand functional and aesthetic treatments in the shortest possible time. Periodontally accelerated osteogenic orthodontics allow: accelerated dental movements, reduced treatment time and improve periodontal status and gingival biotype. In the present work, we analyze the biological bases of the technique and its surgical stage, together with the presentation of a case (AU)

The study of the use of a latex biomembrane and conjunctival autograft in rabbit conjunctiva wound healing / Estudo do implante de biomembrana de látex e auto-enxerto conjuntival em cicatrização de ferida conjuntiva de coelho

RESUMO Objetivo: Estudar o uso da biomembrana de látex e o transplante conjuntival autólogo na cicatrização conjuntival em coelhos. Métodos: Em nove coelhos albinos, neo-zelandeses, machos foram removidas áreas retangulares idênticas, do quadrante supero nasal, adjacente ao limbo, de ambos os olhos. As áreas desnudas da camada esclerótica nos olhos direitos foram recobertas com biomembrana de látex e a dos olhos esquerdos com enxerto conjuntival autólogo. Os animais foram sacrificados em grupos de três, aos 7, 14 e 21 dias após a cirurgia. Os tecidos do local cirúrgico, incluindo a córnea, foram fixados em formaldeído, antes de serem processados em parafina e corados com hematoxilina e eosina. A natureza e a intensidade da resposta inflamatória e o padrão de epitelização da superfície conjuntival foram avaliados sob microscopia óptica, em seções histológicas longitudinais, passando pelo centro dos espécimes anatômicos. Resultados: Até o décimo quarto dia pós-operatório, o grupo que recebeu a biomembrana apresentou reação inflamatória mais intensa do que o grupo com auto enxerto conjuntival. Aos 14 dias, os olhos com biomembrana apresentavam-se menos inflamados e com estroma mais espesso do que aos 7 dias. Aos 21 dias, a reparação conjuntival de ambos os grupos apresentavam características semelhantes. Conclusão: Apesar de apresentar uma cicatrização mais lenta, a biomembrana de látex se mostrou tão eficaz quanto o auto enxerto conjuntival na reconstrução da superfície ocular após três semanas de cicatrização pós-operatória. Devido as suas baixas toxicidade e alergenicidade, este material parece ser uma opção terapêutica promissora na reconstrução da conjuntiva.

ABSTRACT Purpose: To study a latex biomembrane and conjunctival autograft with regard to the promotion of conjunctival healing in rabbits. Methods: The study included nine male albino rabbits. In these rabbits, a rectangular area of the conjunctiva was surgically removed from the superonasal quadrant adjacent to the limbus in both eyes. The bare area of the sclerotic coat of the right eye was reconstructed with a latex biomembrane, and the corresponding site of the left eye was reconstructed with a conjunctival autograft. The animals were killed in groups of three at 7, 14, and 21 days after surgery. The tissues from the surgical site, including the cornea, were fixed in formaldehyde, and were then processed in paraffin and stained with hematoxylin and eosin. The nature and intensity of the inflammatory response and the epithelial pattern at the conjunctival surface were evaluated under optical microscopy with longitudinal histological sections through the center of the anatomical specimens. Results: Until the 14th postoperative day, the inflammatory reaction was greater in the biomembrane group than in the conjunctival autograft group. In the latex biomembrane group, inflammation was less intense and the stroma was thicker on the 14th postoperative day than on the 7th postoperative day. After three weeks, conjunctival healing in both groups showed similar characteristics. Conclusion: Although healing was slower with a latex biomembrane, tissue reconstitution was almost the same as that with a conjunctival autograft by three weeks. A latex biomembrane is as effective as a conjunctival autograft for the reconstruction of the ocular surface. Owing to the lack of toxicity and allergenicity, a latex biomembrane appears to be a promising therapeutic option for conjunctival reconstruction.

Effects of Paclitaxel-conjugated N-Succinyl-Hydroxyethyl Chitosan Film for Proliferative Cholangitis in Rabbit Biliary Stricture Model / 中华医学杂志(英文版)

<p><b>Background</b>Paclitaxel (PTX) could inhibit the growth of fibroblasts, which occurs in proliferative cholangitis and leads to biliary stricture. However, its use has been limited due to poor bioavailability and local administration for short time. This study designed and synthesized a new PTX-conjugated chitosan film (N-succinyl-hydroxyethyl chitosan containing PTX [PTX-SHEC]) and evaluated its safety and efficiency using in vivo and in vitro experiments.</p><p><b>Methods:</b>The SHEC conjugated with PTX was confirmed by nuclear magnetic resonance (NMR) and Fourier-transform infrared spectroscopy (FT-IR) measurements. Drug releases in vitro and in vivo were determined using high-performance liquid chromatography. Cell viability in vitro was measured using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide. Rabbit biliary stricture model was constructed. All rabbits randomly divided into five groups (n = 8 in each group): the sham-operated rabbits were used as control (Group A), Groups B received laparotomies and suture, Group C received laparotomies and covered SHEC suture without the PTX coating, Group D received laparotomies and covered PTX-SHEC suture, and Group E received laparotomies and 1000 μmol/L PTX administration. Liver function tests and residual dosage of PTX from each group were measured by enzyme-linked immunosorbent assay. Histological data and α-smooth muscle actin (SMA) immunohistochemical staining of common bile duct were examined.</p><p><b>Results:</b>NMR and FT-IR indicated that PTX was successfully introduced, based on the appearance of signals at 7.41-7.99 ppm, 1.50 ppm, and 1.03 ppm, due to the presence of aromatic protons, methylene protons, and methyl protons of PTX, respectively. No bile leak was observed. The PTX-conjugated film could slowly release PTX for 4 weeks (8.89 ± 0.03 μg at day 30). The in vitro cell viability test revealed significantly different levels of toxicity between films with and without PTX (111.7 ± 4.0% vs. 68.1 ± 6.0%, P < 0.001), whereas no statistically significant difference was observed among the three sets of PTX-contained films (67.7 ± 5.4%, 67.2 ± 3.4%, and 59.1 ± 6.0%, P > 0.05). Histological examinations revealed that after 28 days of implantment, Groups D and E (but not Group C) had less granulation tissue and glandular hyperplasia in the site of biliary duct injury than Group B. The pattern was more obvious in Group D than Group E. Less α-SMA-positive cells were found in tissue from Groups D and E. Comparing with Group E, the liver function was improved significantly in Group D, including total bilirubin (2.69 ± 1.03 μmol/L vs. 0.81 ± 0.54 μmol/L, P = 0.014), alanine aminotransferase (87.13 ± 17.51 U/L vs. 42.12 ± 15.76 U/L, P = 0.012), and alkaline phosphatase (60.61 ± 12.31 U/L vs. 40.59 ± 8.78 U/L, P < 0.001).</p><p><b>Conclusions</b>PTX-SHEC film effectively inhibites the myofibroblast proliferation and extracellular matrix over-deposition during the healing process of biliary reconstruction. This original film might offer a new way for reducing the occurrence of the benign biliary stricture.</p>

Repair of Bone Defects with Chitosan-Collagen Biomembrane and Scaffold Containing Calcium Aluminate Cement

Abstract Innovative biomaterials can provide a promising new direction for the treatment of bone defects, stimulating a proper repair process, with no damage to adjacent tissues. The purpose of this in vivo study was to evaluate the biocompatibility and the osteoinductive capacity of chitosan-collagen biomembrane and scaffold containing calcium aluminate cement. Eighteen New Zealand white rabbits (Oryctolagus cuniculus) were distributed according to the experimental times of analysis (7, 15 and 30 days). Four bone defects were created in the rabbits calvaria, which were individually filled with the biomembrane, scaffold, blood clot (negative control) and autologous bone (positive control). Histopathological analysis was performed using optical microscope at 32´, 64´, 125´ and 320´ magnifications. Cell response to inflammation and new bone tissue formation was quantified using a score system. The biomembrane group presented greater inflammatory response at 15 days, with significant difference to autologous bone group (p<0.05). There was no statistically significant difference for foreign body type reaction among groups (p>0.05). Concerning new bone formation, linear closure of the defect area was observed more evidently in the group with autologous bone. The scaffold group presented similar results compared with the autologous bone group at 30 days (p>0.05). Both tested biomaterials presented similar biocompatibility compared with the control groups. In addition, the biomembrane and scaffold presented similar osteoinductive capacity, stimulating bone repair process in the course of the experimental time intervals.

Resumo Biomateriais inovadores podem fornecer uma promissora nova direção para o tratamento de defeitos ósseos, estimulando um processo de reparo adequado, sem danos aos tecidos adjacentes. O objetivo deste estudo in vivo foi avaliar a biocompatibilidade e a capacidade osteoindutora de uma biomembrana e um scaffold compostos por colágeno e quitosana, contendo cimento de aluminato de cálcio. Dezoito coelhos (New Zealand White, Oryctolagus cuniculus) foram distribuídos de acordo com os períodos experimentais de análise (7, 15 e 30 dias). Quatro defeitos foram criados na calvaria dos coelhos, que foram individualmente preenchidos com a biomembrana, scaffold, coágulo (controle negativo) e osso autólogo (controle positivo). A avaliação histopatológica foi realizada em microscópio óptico em aumentos de 32´, 64´, 125´ e 320´. A resposta celular à inflamação e à formação de novo tecido ósseo foi quantificada utilizando um sistema de escore. O grupo da biomembrana apresentou maior resposta inflamatória no período de 15 dias, com diferença significativa para o grupo do osso autólogo (p<0,05). Não houve diferença estatística significante para a reação do tipo corpo estranho entre os grupos (p>0,05). Em relação à neoformação óssea, observou-se fechamento linear da área do defeito, que foi mais evidente no grupo em que se utilizou o osso autólogo. O grupo scaffold apresentou resultados semelhantes ao grupo do osso autólogo no período de 30 dias (p>0,05). Ambos os biomateriais testados apresentaram biocompatibilidade similar em comparação com os grupos controle. Além disso, a biomembrana e o scaffold apresentaram capacidade osteoindutora similar, estimulando o reparo ósseo ao longo dos intervalos de tempo experimentais.