Physical, chemical, and biological properties of white MTA with additions of AlF3.

OBJECTIVES: Addition of aluminum fluoride (AlF3) to MTA was tested to inhibit dental discoloration. MATERIALS AND METHODS: MTA Angelus with 0, 5, 15, and 45% AlF3 were tested. The set cements were characterized using scanning electron microscopy, energy-dispersive spectroscopy, and X-ray diffraction. Radiopacity and setting time were analyzed according to ANSI/ADA 57 and ASTM C266-08. Volume change was evaluated using volumetric micro-CT analysis. The pH and calcium ion release were assessed after 3 and 24 h and 28 days. Dental discoloration in contact with the cements was assessed after 24 h and 28 and 90 days of contact with bovine and human dentine. Tissue reaction to subcutaneous implantation in rats was examined after 30 and 60 days. RESULTS: AlF3 altered the microstructure of MTA. The addition of 5% AlF3 did not significantly alter the radiopacity, setting time, and volume change (p > 0.05). pH and calcium ion release significantly increased with addition of AlF3 (p > 0.05). All the tested proportions of AlF3 prevented the dental darkening verified for MTA Angelus in bovine and human teeth. AlF3 did not interfere in inflammatory response of MTA in all periods of analysis; otherwise, lower amounts showed less intense inflammatory infiltrate. CLINICAL RELEVANCE: AlF3 prevents destabilization of bismuth oxide and consequent tooth darkening, frequently verified in clinical practice when using white MTA. CONCLUSIONS: The use of 5% of AlF3 in combination to MTA resulted in a cement that did not result in dental discoloration and did not affect significantly physical, chemical, and biological properties.

O uso das proteínas ósseas morfogenéticas na Implantodontia - revisão de literatura / The use of morphogenetic protein in Implantology - literature review

A descoberta de materiais de enxerto para auxiliar na regeneração óssea ampliou as perspectivas da reabilitação oral. As proteínas ósseas morfogenéticas (BMPs) têm sido amplamente estudadas para a regeneração de áreas com defeitos ósseos. As BMPs são fatores de crescimento derivados da matriz óssea e que induzem a diferenciação de células mesenquimais indiferenciadas em osteoblastos. Algumas aplicações das BMPs na Implantodontia incluem a correção de defeitos alveolares pós-extração, aumento de rebordo alveolar em pacientes edêntulos, levantamento de seio maxilar, entre outros. As BMPs apresentam vantagens como a ausência de um segundo sítio cirúrgico para obtenção de tecido ósseo, resultando em menor tempo de reparo e maior comodidade aos pacientes. Além disso, a utilização das BMPs não se limita pelo tamanho do defeito podendo ser utilizada em defeitos extensos. Uma limitação das BMPs está relacionada ao custo elevado, sendo por este motivo pouco utilizada pelos profissionais cotidianamente. Diversos estudos pré-clínicos e clínicos demonstram o sucesso da utilização das proteínas ósseas morfogenéticas na neoformação óssea. O objetivo da presente revisão foi analisar a literatura relacionada à utilização das BMPs nos diferentes procedimentos envolvidos na área da Implantodontia. Estudos em animais empregando as BMPs concomitantemente com implantes osseointegrados demonstram o sucesso da utilização das proteínas para a neoformação óssea. Inúmeros estudos clínicos comprovam a viabilidade e segurança da utilização das BMPs em procedimentos cirúrgicos. Dos resultados presentes na literatura, pode-se concluir que as proteínas ósseas morfogenéticas são uma alternativa viável e segura, com grande potencial para a regeneração óssea na Implantodontia.

Development of bone graft materials has improved the options of treatment in rehabilitation therapy. Bone morphogenetic proteins (BMPs) have been widely studied for regeneration of bone defects. Bone morphogenetic proteins are growth factors derived from bone matrix. These proteins induce mesenchymal cells to differentiate into osteoblast cells, producing new bone. Some applications of BMPs in Implantology include alveolar correction in extraction sites, alveolar ridge augmentation in edentulous patients, and sinus floor augmentation. The bone morphogenetic proteins present some advantages as the absence of a second surgical site. The procedure is less traumatic and result in lower time for repair, which is a desirable property for the patients. Furthermore, the use of BMPs is not limited by the size of the defect. The proteins can be used in large defects without any restriction. However, BMPs have a high cost, which limits its use by the professionals. Several laboratorial and clinical studies have shown the success of the use of BMPs on bone formation. The aim of the present review was to analyze the studies regarding the use of BMPs in different procedures in Implantolo¬gy. Studies in animals using BMPs with dental implants show the success of the therapy and further studies in humans demonstrate the possibility of bone formation in cases of defects.The BMPs are able to induce bone regeneration around dental implants. Furthermore, several clinical studies verified feasibility and safety when using BMPs in surgery procedures. Bone morphogenetic proteins can be considered a potential and safe alternative in bone regenera¬tion in Implantology.