Development of collagenous scaffolds for wound healing: characterization and in vivo analysis.

The development of wound dressings from biomaterials has been the subject of research due to their unique structural and functional characteristics. Proteins from animal origin, such as collagen and chitosan, act as promising materials for applications in injuries and chronic wounds, functioning as a repairing agent. This study aims to evaluate in vitro effects of scaffolds with different formulations containing bioactive compounds such as collagen, chitosan, N-acetylcysteine (NAC) and ε-poly-lysine (ε-PL). We manufactured a scaffold made of a collagen hydrogel bioconjugated with chitosan by crosslinking and addition of NAC and ε-PL. Cell viability was verified by resazurin and live/dead assays and the ultrastructure of biomaterials was evaluated by SEM. Antimicrobial sensitivity was assessed by antibiogram. The healing potential of the biomaterial was evaluated in vivo, in a model of healing of excisional wounds in mice. On the 7th day after the injury, the wounds and surrounding skin were processed for evaluation of biochemical and histological parameters associated with the inflammatory process. The results showed great cell viability and increase in porosity after crosslinking while antimicrobial action was observed in scaffolds containing NAC and ε-PL. Chitosan scaffolds bioconjugated with NAC/ε-PL showed improvement in tissue healing, with reduced lesion size and reduced inflammation. It is concluded that scaffolds crosslinked with chitosan-NAC-ε-PL have the desirable characteristics for tissue repair at low cost and could be considered promising biomaterials in the practice of regenerative medicine.

Efficacy of sonic and ultrasonic activation during endodontic treatment: a Meta-analysis of in vitro studies.

OBJECTIVE: To ensure a successful endodontic treatment, it is important to have a proper disinfection of the root canal. The current study compares the root canal cleanliness and smear layer score between sonic and ultrasonic activation. METHOD: Systematic literature review was implemented, using 12 databases. All in vitro studies comparing the efficacy of sonic and ultrasonic activation and reporting at least one outcome of interest were included. RESULTS: At the apical level, pooling the data in the random-effects model (I2=64%, p = .1) revealed a statistically significant lower smear layer score within the sonic activation group (MD-0.48; 95% CI-0.92, -0.04; p = .03). Furthermore, there was a statistically significant lower push-out bond strength value among the sonic group, in contrast to the ultrasonic group at the middle (MD-0.69; 95% CI-1.13, -0.25; p = .002) and at the apical levels (MD-0.78; 95% CI-1.09, -0.46; p < .0001) of the root canal. CONCLUSIONS: Sonic activation accomplished advancement relative to ultrasonic agitation in removing the smear layer, while ultrasonic activation resulted in significant cohesion between the sealers and the dentine tubules, decreasing the vulnerability of apical leakage and tooth fracture.

Oral and cranio-maxillofacial trauma in children and adolescents in an emergency setting at a Brazilian hospital.

BACKGROUND/AIMS: Very few studies have been performed to evaluate cranio-maxillofacial trauma diagnosed in hospitals in children and adolescents. The aim of this study was to perform an analysis of oral and cranio-maxillofacial trauma in the aforementioned population. MATERIALS AND METHODS: A hospital-based retrospective study, which reviewed 1438 patient records, was conducted at the "Teresina Emergency Hospital", Brazil. Data regarding demographics, day of the week on which trauma occurred, type of injury, etiology, anatomic trauma site, time of hospital admission, and associated comorbidities (or injuries) were collected. RESULTS: There were 1092 (75.9%) males and 346 (24.1%) females. The largest group was adolescents aged between 13 and 18 years (956, 66.5%). The majority lived in urban areas (69%). Trauma occurred most frequently during the week. The most prevalent etiology was road traffic accidents involving motorcycles (771, 53.6%) causing facial and skull fractures (598, 41%). The most prevalent soft tissue lesions were facial abrasions (49%), followed by injuries to the cheek (16.7%). Comorbidities associated with craniofacial trauma were present in 82%, with complications from traumatic brain injuries being the most prevalent (65.6%) Dental trauma was recorded in only 81 cases (5.6%). CONCLUSION: Male adolescents living in urban areas were most affected by craniofacial trauma. The most common cause was road traffic accidents involving motorcycles, resulting in facial and skull fractures. Complications from traumatic brain injuries were the most common associated injuries.

Behaviour of co-cultured human osteoclastic and osteoblastic cells exposed to endodontic sealers' extracts.

OBJECTIVES: Bone tissue is constantly being moulded and shaped by the coordinated action of bone-resorbing osteoclasts and bone-synthesizing osteoblasts. This study addresses the long-term effects of endodontic sealers' extracts (AH Plus™, GuttaFlow™, Tubliseal™, Sealapex™ and RealSeal™) on co-cultures of human osteoclastic and osteoblastic cells. METHODS: The sealers were mixed according to the manufacturer's instructions, freshly extracted with culture medium (1.3 cm(2)/ml; 24 h; 37 °C, 5% CO2/air) and diluted (1:20-1:2,500). Co-cultures of osteoclastic and osteoblastic cells, established from precursors present in human peripheral blood mononuclear cells and bone marrow cells, respectively, were exposed to the extracts for 21 days. Co-cultures were characterized for the osteoclastic and osteoblastic response. RESULTS: The sealers caused a dose-dependent decrease on TRAP and ALP activities, respectively, an osteoclastic and an osteoblastic marker. The resorbing ability of the osteoclastic cells and the expression of osteoclastic and osteoblastic genes were also decreased; in addition, the extracts affected several intracellular signalling pathways. Inhibition was higher during the two first weeks, followed by adaptive cell responses. Osteoblastic response was more sensitive to the extracts' toxicity and showed lower adaptive ability. SIGNIFICANCE: A correlation to the clinical situation cannot be predicted; however, the results suggest that the sealers' eluents might disrupt the highly regulated interaction between osteoblastic and osteoclastic cells, compromising the local bone metabolism. Also, the higher susceptibility of the osteoblastic response might be particularly relevant in the initial stages of the healing of periapical lesions, due to the significant role of the bone formation events.

Comparative Evaluation of the Canal Shaping Ability, Pericervical Dentin Preservation, and Smear Layer Removal of TruNatomy, WaveOne Gold, and ProTaper Ultimate-An Ex Vivo Study in Human Teeth.

INTRODUCTION: Innovative file systems have been recently introduced, claiming improved effectiveness and superior ability to preserve the tooth structure, still allowing an efficient preparation and disinfection up to the apical region. Regardless, few data are available on the comparative effectiveness of the most recently developed systems. Thus, this ex vivo study aimed to comparatively evaluate, for the first time, the functionality of WaveOne Gold (WOG), TruNatomy (TN), and ProTaper Ultimate (PU) file systems regarding canal shaping, dentin preservation, and smear layer removal ability. METHODS: Human maxillary incisors were randomly divided for instrumentation with one of the assayed systems. Canal shaping ability and pericervical dentin preservation were characterized through microtomographic evaluation and morphometric assessment (n = 15). Smear layer removal ability was evaluated by scanning electron microscopy (SEM) (n = 6). RESULTS: TN and PU presented the lowest canal volume variation upon instrumentation, found to be significantly lower than that attained with WOG (P < .05). Pericervical dentin was reduced in all groups upon instrumentation, with TN evidencing the highest preservation, quantitatively similar to PU, and significantly higher than that attained with WOG (P < .05). SEM imaging revealed the presence of scattered remnants of the smear layer and partially opened dentinal tubules at the apical portion, with no significant differences between systems. CONCLUSIONS: TN and PU allowed for the highest tissue preservation, reporting the lowest volume variation and the highest preservation of the pericervical dentin. None of the assessed systems provided a complete removal of the smear layer in the apical region.

Fast-Setting Calcium Silicate-Based Pulp Capping Cements-Integrated Antibacterial, Irritation and Cytocompatibility Assessment.

Calcium silicate-based cements (CSCs) are endodontic materials widely used in vital pulp-capping approaches. Concerning the clinical application, the reduced set time and pre-mixed formulations are relevant characteristics during the operative management of pulpal exposure, aiming to optimise the work time and improve cross-infection/asepsis control. Additionally, clinical success seems to be greatly dependent on the biological performance of the materials that directly contact the living pulp. As such, this work approaches an integrative biological characterisation (i.e., antibacterial, irritation, and cytocompatibility assays) of three fast-setting CSCs-BiodentineTM, TotalFill® BC RRM™ Fast Putty, and Theracal LC®. These cements, after setting for 24 h, presented the expected topography and elemental composition (assessed by scanning electron microscopy, coupled with EDS analysis), in accordance with the information of the manufacturer. The set cements displayed a significant and similar antibiofilm activity against S. mutans, in a direct contact assay. Twenty-four-hour eluates were not irritant in the standardised CAM assay, but elicited distinct dose- and time-dependent cytotoxicity profiles on fibroblastic cells-i.e., Biodentine was devoid of toxicity, TotalFill presented a slight dose-dependent initial toxicity that was easily overcome, and Theracal LC was deleterious at high concentrations. When compared to long-setting ProRoot MTA cement, which highlighted the pursued integrative approach, Biodentine presented a similar profile, but TotalFill and Theracal LC displayed a poorer performance regarding antibiofilm activity/cytocompatibility features, and Theracal LC suggested eventual safety concerns.

Long-term dose- and time-dependent effects of endodontic sealers in human in vitro osteoclastogenesis.

INTRODUCTION: This study evaluates the concentration and time-dependent effects of endodontic sealers' extracts (AH Plus [Dentsply DeTrey, Konstanz, Germany], GuttaFlow [Roeko, Colténe/Whaledent, Germany], Tubliseal [Kerr/Sybron, Romulus, MI], Sealapex [Kerr/Sybron, Romulus, MI], and RealSeal [SybronEndo, Orange, CA]) in the differentiation and function of both unstimulated and stimulated osteoclast precursors, simulating, respectively, immature/undifferentiated precursors and cells undergoing osteoclastogenesis. METHODS: The sealers were mixed according to the manufacturers' instructions, freshly extracted with culture medium (1.3 cm(2)/mL, 24 hours, 37°C, 5% CO2/air), and diluted (1:20, 1:100, 1:500, and 1:2500). Human peripheral blood mononuclear cells were used as osteoclast precursor cells. After overnight attachment, peripheral blood mononuclear cell cultures were exposed to the sealers' extracts during 21 days in the absence (unstimulated) or presence (stimulated) of recombinant macrophage colony-stimulating factor and receptor for the activation of nuclear factor-κB ligand. Cultures performed in the absence of the extracts were used as the control. Cultures were characterized for osteoclastic differentiation and function. RESULTS: Extracts caused mostly inhibitory effects on osteoclastic cells, both in unstimulated and stimulated conditions, which were reflected by a decrease in tartrate-resistant acid phosphatase activity, the presence of actin rings, vitronectin and calcitonin receptors, the calcium phosphate resorbing ability, and the expression of osteoclastic genes. Also, the extracts induced alterations in the relative contribution of some intracellular signaling pathways involved in osteoclastogenic events. The sealers differed in the dose- and time-dependent profile. An adaptive cell response was noticed for the inhibitory effects after long-term exposure. CONCLUSIONS: Endodontic sealers affect the osteoclastic differentiation and activity, which is followed by an adaptive cell response. Our results suggest that the deleterious effect in the bone periapical tissues observed with the root canal sealers might involve, at least partially, a direct effect on the osteoclastic cells.

Status protético e alterações bucais dos pacientes do Programa Interdisciplinar de Geriatria e Gerontologia da UFF / Prosthetic status and oral manifestations of patients included in the Interdisciplinary Program of Geriatrics and Gerontology at UFF

O presente trabalho verificou a necessidade do uso e da troca de próteses (parcial e total) de 103 pacientes com idade acima de 60 anos envolvidos no Programa Interdisciplinar de Geriatria e Gerontologia da UFF. No que diz respeito à necessidade de utilização de próteses tanto parciais como totais, verificou-se que, em relação aos homens, as mulheres tinham a menor probabilidade de permanecer sem os dentes (p<0,05). Entretanto, com relação à necessidade de troca das próteses, não foi observada diferença estatística entre os sexos. As alterações vasculares da cavidade bucal foram significativas nos pacientes com faixa etária maior

Saúde bucal dos pacientes do programa interdisciplinar de Geriatria e Gerontologia da UFF / Oral health status of Geriatric patients from a multidisciplinary program at UFF

O presente estudo verificou o estado de saúde bucal de 103 pacientes com idade superior a 60 anos do Programa Interdisciplinar de Geriatria e Gerontologia da UFF. Realizou-se o exame clínico intrabucal dos idosos, visando averiguar o índice CPO-D e utilizaçäo de próteses total e parcial

Patologias e processos dento-maxilares em remanescentes esqueletais de dois sítios pré-históricos no Brasil: o cemitério de Furna do Estrago (PE) e o Sambaqui de Cabeçuda (SC) / Pathologies and process dental-maxillary in remnants skeletal of two siegues prehistorics in Brazil

O estudo de procesos dento-patológicos com uma perspectiva biocultural vem se tornando mais importante na paleopatologia brasileira, nos últimos anos. O objetivo deste trabalho foi detalhar perfis dento-patológicos para duas séries esqueletais, remanescentes de grupos distintos quanto a suas estratégias de subsistência e pertencentes a contextos geográficos e ambientais diferentes. As séries pertencem ao cemitério da Furna do Estrago, utilizado por um grupo que habitou uma regiäo do Agreste do Estado de Pernambuco, e ao Sambaqui de Cabeçuda, utilizado por um grupo que viveu em ambiente lagunar, no Estado de Santa Catarina. As análises efetuadas, procuraram inventariar e interpretar lesöes cariosas, desgaste dentário, abcessos, cálculos, reaçöes periodontais e perda em vida. Foi constatada a existência de maior severidade de patologias dentárias e complicaçöes orais na Furna do Estrago que exibe pequenas diferenças entre os padröes de patologias dentárias de mulheres e homens, e reduçäo destas, nos esqueletos que ocupam os níveis estratigráficos mais recentes do sítio. O Sambaqui de Cabeçuda, por outro lado, exibe baixos índices de patologias, completa ausência de cáries e diferenças inexpressivas entre os níveis estratigráficos, porém com maior comprometimento da saúde oral entre os homens, acompanhando, também, de perda significativa dos incisivos mandibulares, o que sugere o uso de adornos labiais. Estes resultados permitem propor modelos bioculturais coerentes para a subsistência dos grupos, passíveis de serem testados em outras populaçöes pré-históricas brasileiras.