Efficiency analysis of commercial polymeric membranes for bone regeneration in rat cranial defects

Purpose: To evaluate the in vivo efficiency of commercial polymeric membranes for guided bone regeneration. Methods: Rat calvarial critical size defects was treated with LuminaCoat (LC), Surgitime PTFE (SP), GenDerm (GD), Pratix (PR), Techgraft (TG) or control (C-) and histomorphometric analysis determined the percentage of new bone, connective tissue and biomaterial at 1 or 3 months. Statistical analysis used ANOVA with Tukey's post-test for means at same experimental time and the paired Student's t test between the two periods, considering p < 0.05. Results: New bone at 1 month was higher for SP, TG and C-, at 3 months there were no differences, and between 1 and 3 months PR had greater increase growthing. Connective tissue at 1 month was higher for C-, at 3 months for PR, TG and C-, and between 1 and 3 months C- had sharp decline. Biomaterial at 1 month was higher for LC, in 3 months for SP and TG, and between 1 and 3 months, LC, GD and TG had more decreasing mean. Conclusion: SP had greater osteopromotive capacity and limitation of connective ingrowth, but did not exhibit degradation. PR and TG had favorable osteopromotion, LC less connective tissue and GD more accelerated biodegradation.

Enfraquecimento dentinário pelo uso do hidróxido de cálcio como medicação intracanal / Weakening of dentin by use of calcium hydroxide as intracanal medication

A resistência dentinária, após uso do hidróxido de cálcio como medicação intracanal, foi testada a curto e longo prazo. Corpos de prova de incisivos suínos foram submetidos a ensaio mecânico imediato (n = 3/padrão) ou vedados com cimento provisório, sem preenchimento/GI ou com Ca(OH)2/GII (n = 18 cada), imersos em solução salina por 30, 90, 120, 150 e 180 dias e submetidos a teste de resistência à compressão. Dados em triplicata foram analisados pelos testes de Anova e Tukey-Kramer (p < 0,05). Houve menor resistência em GI a partir de 90 dias e em GII a partir de 30 dias (p < 0,001). Tais resultados confirmam o enfraquecimento dentinário precoce pelo uso do Ca(OH)2.

The resistance of the dentin after the use of calcium hydroxide as an intracanal medication was tested in the short and long term. Bodies of proof of pig incisors were subjected to mechanical testing immediately (n = 3/standard) or sealed with temporary cement, without filling/GI or with Ca(OH)2/GII (n = 18 each), immersed in saline for 30, 90, 120, 150 and 180 days and tested for compressive strength. Data in triplicate were analyzed by ANOVA and Tukey-Kramer (p < 0.05). There was less resistence in GI after 90 days and in GII after 30 days (p < 0.001). These results confirm the early weakening of dentin by use of Ca(OH)2.

Apexification with white MTA in an immature permanent tooth with dens invaginatus

Dens invaginatus, also known as “dens in dente”, is a developmental dental anomaly resulting in an invagination of the enamel organ into the dental papilla. These cases present technical difficulties to the root canal treatment. Apexification using an apical plug of mineral trioxide aggregate (MTA) has been indicated as an alternative to long-term intracanal use of calcium hydroxide in immature permanent teeth. It is considered as a simple and rapid technique. This paper reports a case of Oehlers’ Type 1 dens invaginatus in an immature permanent maxillary right lateral incisor, which presented pulp necrosis secondary to dental trauma and was treated by apexification with white MTA apical plugging followed by conventional root canal therapy. The operative procedures are described and the technique is discussed. The physical and biological properties of MTA, associated with appropriate instrumentation and obturation techniques, make this material an excellent option in the endodontic therapy of immature permanent teeth with dens invaginatus.

Repair of critical-size defects with autogenous periosteum-derived cells combined with bovine anorganic apatite/collagen: an experimental study in rat calvaria

The aim of this study was to evaluate the bone repair using autogenous periosteum-derived cells (PDC) and bovine anorganic apatite and collagen (HA-COL). PDC from Wistar rats (n=10) were seeded on HA-COL discs and subjected to osteoinduction during 6 days. Critical-size defects in rat calvarias were treated with blood clot (G1), autogenous bone (G2), HA-COL (G3) and HA-COL combined with PDC (G4) (n=40), and then analyzed 1 and 3 months after surgeries. Radiographic analysis exhibited no significant temporal change. G1 and G2 had discrete new marginal bone, but the radiopacity of graft materials in G2, G3 and G4 impaired the detection of osteogenesis. At 3 months, histopathological analysis showed the presence of ossification islets in G1, which was more evident in G2, homogeneous new bone around HA-COL in G3 and heterogeneous new bone around HA-COL in G4 in addition to moderate presence of foreign body cells in G3 and G4. Histomorphometric analysis showed no change in the volume density of xenograft (p>0.05) and bone volume density in G2 was twice greater than in G1 and G4 after 3 months (p<0.05), but similar to G3. The PDC did not increase bone formation in vivo, although the biomaterial alone showed biocompatibility and osteoconduction capacity.

O objetivo deste estudo foi avaliar o reparo ósseo usando células derivadas de periósteo (PDC) e apatita inorgânica e colágeno bovinos (HA-COL). PDC de ratos Wistar (n=10) foram semeadas sobre discos de HA-COL e osteoinduzidas por 6 dias. Defeitos de tamanho crítico em calvárias de ratos foram tratados com coágulo sanguíneo (G1), osso autógeno (G2), HA-COL (G3) ou HA-COL associado a PDC (G4) (n=40) e analisados em 1 e 3 meses após as cirurgias. Análise radiográfica não exibiu mudança temporal significante, G1 e G2 tiveram aumento discreto de novo osso marginal, entretanto a radiopacidade dos materiais de enxerto em G2, G3 e G4 prejudicou a detecção de osteogênese. Análise histopatológica mostrou em 3 meses ilhotas de ossificação em G1 que foi maior em G2, novo osso homogêneo ao redor de HA-COL em G3 e novo osso heterogêneo ao redor de HA-COL em G4 além da presença moderada de células gigantes de corpo estranho em G3 e G4. Análise histomorfométrica mostrou a densidade de volume inalterada do xenoenxerto (p>0,05) e a densidade de volume de novo osso em G2 duas vezes maior que G1 e G4 após 3 meses (p<0,05), mas similar a G3. PDC não aumentaram a formação óssea in vivo apesar do biomaterial sozinho ter apresentado biocompatibilidade e capacidade osteocondutora.

Terapia de defeito crítico em crânio de ratos pela associação de xenoenxerto bovino e células derivadas de periósteo autógeno / Therapy for critical defect in rat calvaria by the association of veal xenograft and cells derived from periosteum autogenous

O objetivo deste estudo foi avaliar a associação de células derivadas de periósteo autógeno (CDPA) e xenoenxerto de hidroxiapatita e colágeno I (HA/Col) no reparo de defeito crítico de crânio de ratos. CDPA de 10 ratos Wistar foram semeadas na densidade de 1,0x106 células sobre discos de HA/Col (8x2mm) em DMEM:HAMF12 com 10% soro fetal bovino e dexametazona, ácido ascórbico e 􀈕-glicerofosfato por 6 dias. Ensaio funcional comparou efeito de coágulo sanguíneo (G1), osso autógeno (G2), HA/Col (G3) e HA/Col+CDPA (G4) preenchendo defeito de 8 mm de crânio de ratos (n=40) em 1 e 3 meses. A análise radiográf ica não exibiu variação temporal, tendo G1 e G2 discreto novo osso marginal; radiopacidade dos materiais em G2, G3 e G4 impediu conf irmar osteogênese central. A análise histológica dos grupos mostrou em G1 tecido conjuntivo denso e ilhas de ossif icação (1-3m), em G2 coalescência do material e osteogênese (1-3m), em G3 ossif icação intramembranosa (1m) e novo osso homogêneo ao redor e substituindo HA (3m) e em G4 abundante tecido conjuntivo f rouxo permeando material (1m) e novo osso heterogêneo (3m); não houve necrose, inf lamação crônica ou exuberância de células gigantes tipo corpo estranho. As análises histomorfométrica e estatística mostraram diferença signif icativa (p<0,05) para biomaterial (1m) de G2 (23,3%) com G3 (44,6%) e G4 (47,5%) e para ganho ósseo (3m) de G2 (10,9%) com G1 (4,6%) e G4 (5,1%), tendo G3 (8,5%) neoformação óssea próxima a G2. Conclui-se que CDPA não aumentam formação óssea se associadas a HA/Col.

The aim of this study was evaluate the association of autogenous periosteum derived cells (APDC) and xenograf t made up hydroxyapatite and collagen I (HA/Col) in repair of critical size defect in rat calvaria. APDC of 10 Wistar rats were seeded with density of 1,0x106 cells above discs of HA/Col (8x2mm) in DMEM:HAMF12 with 10% fetal bovine serum and dexamethasone, ascorbic acid and 􀈕-glicerophosphate until 6 days. Functional assay compared ef fect of blood clot (G1), autogenous bone (G2), HA/Col (G3) and HA/Col+CDPA (G4) f illing the 8mm-defect in rat skull (n=40) at 1 and 3 months. Radiographic analysis did´t have time variation, with G1 and G2 showing mild peripheral new bone; radiopacity of materials in G2, G3 and G4 didn’t enable to conf irm central osteogenesis. Histologic analysis of groups showed in G1 dense connective tissue and bone islets (1-3m), in G2 fusion of material and osteogenesis (1-3m), in G3 intramembranous ossification (1m) and homogeneous new bone around and substitute HA (3m) and in G4 abundant loose connective tissue permeating the material (1m) and heterogeneous new bone (3m); there is not necrosis, chronic inf lammation or exuberance of giant cell like foreign body reaction. Histomorphometric and statistic analysis showed signif icative dif ferences (p<0.05) for biomaterial (1m) f rom G2 (23,3%) to G3 (44,6%) and G4 (47,5%) and for bone gain (3m) f rom G2 (10,9%) to G1 (4,6%) and G4 (5,1%), with G3 (8,5%) showing new bone formation closer to G2. It’s possible to conclude that APDC don’t increase bone formation if associate to HA/Col.