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1.
Eur Cell Mater ; 34: 162-179, 2017 10 05.
Artículo en Inglés | MEDLINE | ID: mdl-28980278

RESUMEN

The aim of the present study was to evaluate the effect of different dosages of retarded vs. rapid release of bone morphogenic protein 2 (BMP2) at different recipient sites. Porous composite poly(D,L-lactic acid) (PDLLA)/CaCO3 scaffolds were loaded with three different dosages of rhBMP2 (24 µg, 48 µg and 96 µg) and implanted, together with blank controls, both into non-healing defects of the mandibles and into the gluteal muscles of 24 adult male Wistar rats. After 26 weeks, bone formation and expression of bone specific markers [alkaline phosphatase (AP) and Runx2] were evaluated by histomorphometry and immunohistochemistry. Results showed that the mode of delivery had no quantitative effect on bone formation in mandibular sites. Expression of AP and Runx2 showed significant differences among the three dosage groups. There were significant correlations between the expression of both AP and Runx2 as well as the extent of bone formation, with both retarded and rapid release of rhBMP2. In ectopic sites, retarded release significantly enhanced bone formation in the low and medium dosage groups, compared to rapid release. Expression of AP was significantly higher and Runx2 significantly lower in ectopic sites, compared to mandibular sites. Significant correlations between the expression of bone specific markers and bone formation occurred only in the retarded delivery groups, but not in the rapid release groups. Within the limitations of the experimental model, it was concluded that retarded delivery of BMP2 was effective, preferably in sites with low or non-existing pristine osteogenic activity. Expression of bone specific markers indicated that osteogenic pathways might be different in mandibular vs. ectopic sites.


Asunto(s)
Proteína Morfogenética Ósea 2/farmacología , Huesos Faciales/efectos de los fármacos , Mandíbula/efectos de los fármacos , Osteogénesis/efectos de los fármacos , Factor de Crecimiento Transformador beta/farmacología , Fosfatasa Alcalina/metabolismo , Animales , Huesos/efectos de los fármacos , Huesos/metabolismo , Carbonato de Calcio/química , Subunidad alfa 1 del Factor de Unión al Sitio Principal/metabolismo , Huesos Faciales/patología , Masculino , Mandíbula/patología , Poliésteres/química , Porosidad , Ratas Wistar , Proteínas Recombinantes/farmacología , Factores de Tiempo , Andamios del Tejido/química , Resultado del Tratamiento
2.
Eur Cell Mater ; 30: 28-40; discussion 40, 2015 Jul 27.
Artículo en Inglés | MEDLINE | ID: mdl-26214288

RESUMEN

The aim of the present study was to test the hypothesis that immobilisation of bone morphogenic proteins on the surface of titanium implants through nano-anchored oligonucleotides can enhance peri-implant bone formation. Non-coding 60-mer DNA oligonucleotides (ODN) were anchored to the surface of custom made sandblasted acid etched (SAE) titanium screw implants through anodic polarisation, gamma-sterilised with a standard dose of 25 kGy, and were hybridised with complementary 30-mer strands of DNA oligonucleotides conjugated to rhBMP2. Blank SAE implants, SAE implants with nano-anchored ODN and SAE implants with nano-anchored ODN and non-conjugated rhBMP2 served as controls. The implants were inserted into the tibiae of 36 Sprague Dawley rats. Perforations at the head and the tip of the implants allowed for bone ingrowth. Bone ingrowth into perforations and bone implant contact (BIC) as well as bone density (BD) at a distance of 200 µm from the implant surface were assessed after 1 , 4 and 13 weeks. Implants with nano-anchored ODN strands hybridised with conjugated rhBMP2 exhibited enhanced bone ingrowth into the perforations and increased BIC after 1 week as well as increased BIC after 4 weeks compared to controls. No difference was seen after 13 weeks. Bone density around the outer implant surface did not differ significantly at any of the intervals. It is concluded that rhBMP2 immobilised on the surface of titanium implants through nano-anchored oligonucleotide strands can enhance bone implant contact. The conditions of sterilisation tested allowed for handling under clinically relevant conditions.


Asunto(s)
Proteína Morfogenética Ósea 2/metabolismo , Tornillos Óseos , Oligonucleótidos/metabolismo , Osteogénesis/efectos de los fármacos , Titanio/farmacología , Animales , Densidad Ósea/efectos de los fármacos , Huesos/cirugía , Materiales Biocompatibles Revestidos/farmacología , Ratas Sprague-Dawley
3.
Clin Oral Investig ; 19(5): 1121-8, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-25346374

RESUMEN

OBJECTIVES: Cancer progression is influenced by tumor microenvironment and communication of stromal cells and tumor cells. Interactions may enhance epithelial-mesenchymal transition (EMT) of tumor cells through signaling proteins such as Wnt/beta-catenin and matrix metalloproteinases (MMP), as well as loss of cellular integrity, which affects invasion, progression, and metastasis of head and neck squamous cell carcinoma (HNSCC). In this study, we are testing the hypothesis that interactions of human mesenchymal stromal cells (MSCs) with HNSCC might influence the expression of markers of EMT and tumor progression by co-culturing human MSC with the PCI-13 HNSCC line. MATERIALS AND METHODS: Pooled MSCs were derived from the iliac bone marrow of seven patients and co-cultured in transwell permeable membrane wells with tumor cells of the established HNSCC cell line PCI-13 (UICC: T3, N1, M0). MSCs were characterized through fluorescence-activated cell sorting (FACS) analysis. Expression of Wnt3, E-cadherin, beta-catenin, MMP14, cathepsin b, and ETS1 was assessed by quantitative RT-PCR. RESULTS: We were able to show that co-culture of MSCs and PCI-13 leads to a significantly reduced expression of Wnt3, MMP14, and beta-catenin compared to controls, whereas the expression of cathepsin b and ETS1 was not significantly different between co-cultures and controls. CONCLUSION: Our results suggest that the interaction between MSCs and PCI-13 may suppress EMT in cancer cells. CLINICAL RELEVANCE: The influence of MSCs can suppress the onset of EMT in HNSCC, affecting tumor progression and therapy.


Asunto(s)
Carcinoma de Células Escamosas/patología , Transición Epitelial-Mesenquimal , Neoplasias de Cabeza y Cuello/patología , Células Madre Mesenquimatosas/fisiología , Adolescente , Adulto , Biomarcadores de Tumor/análisis , Línea Celular Tumoral , Niño , Técnicas de Cocultivo , Progresión de la Enfermedad , Citometría de Flujo , Humanos , Persona de Mediana Edad , Reacción en Cadena en Tiempo Real de la Polimerasa , Carcinoma de Células Escamosas de Cabeza y Cuello
4.
Int J Oral Maxillofac Surg ; 52(3): 371-378, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35835683

RESUMEN

The aim of this study was to assess the changes in occlusal patterns during combined surgical and orthodontic therapy in patients with vertical jaw malformations. Twenty-six orthognathic patients (18 female, eight male; median age 25 years, interquartile range 11.5 years) and 10 control patients (five female, five male; median age 29.8 years, interquartile range 13.5 years) recruited from neutral configured patients attending the Department of Orthodontics, were investigated. Based on cephalometry, the patients were grouped into vertical skeletal configurations of either open, deep, or natural bite cases. Registrations of the occlusal contacts were taken using a digital occlusal sensor immediately before surgery and at 9 months after the surgical intervention. Before the intervention, open and deep bite patients showed significantly less efficient occlusal patterns than the untreated controls regarding total tooth contact (P < 0.001), time of occlusion (P = 0.002), occlusal asymmetry (P = 0.001), anterior tooth contact (P < 0.001), and posterior tooth contact (P < 0.001). After surgery, the parameters in the deep bite patients were similar to those in the controls; however, in open bite patients, total tooth contact (P = 0.003), occlusal asymmetry (P = 0.011), and posterior tooth contact (P = 0.035) differed significantly. In conclusion, combined orthodontic and surgical correction of vertical malocclusions was found to improve occlusal function in patients with deep bite to the level of controls.


Asunto(s)
Maloclusión , Sobremordida , Diente , Humanos , Masculino , Femenino , Niño , Adolescente , Estudios Prospectivos , Oclusión Dental , Maloclusión/cirugía , Cefalometría
5.
Eur Cell Mater ; 23: 161-9; discussion 169, 2012 Mar 13.
Artículo en Inglés | MEDLINE | ID: mdl-22415802

RESUMEN

The aim of the present study was to test the hypothesis that sandblasted and acid etched titanium surfaces can be functionalised with vascular endothelial growth factor (VEGF) using oligonucleotides for anchorage and slow release. rhVEGF165 molecules were conjugated to strands of 30-mer non-coding DNA oligonucleotides (ODN) and hybridised to complementary ODN anchor strands which had been immobilised to the surface of sandblasted/acid etched (SAE) Ti specimens. Specimens with non-conjugated VEGF adsorbed to ODN anchor strands and to blank SAE surfaces served as controls. Specific binding of conjugated VEGF exhibited the highest percentage of immobilised VEGF (71.0 %), whereas non-conjugated VEGF only achieved 53.2 and 30.7 %, respectively. Cumulative release reached 54.0 % of the immobilised growth factor in the group of specifically bound VEGF after 4 weeks, whereas non-conjugated VEGF adsorbed to ODN strands released 78.9% and VEGF adsorbed to SAE Ti surfaces released 97.4 %. Proliferation of human umbilical vein endothelial cells (HUVECs) was significantly increased on the surfaces with specifically bound VEGF compared to the control surfaces and SAE Ti surfaces without VEGF. Moreover, the released conjugated VEGF exhibited biological activity by induction of von Willebrand Factor (vWF) in mesenchymal stem cells. It is concluded that the angiogenic functionalisation of SAE titanium surfaces can be achieved by conjugation of VEGF to ODN strands and hybridisation to complementary ODN strands that are anchored to the titanium surface. The angiogenic effect is exerted both through the immobilised and the released portion of the growth factor.


Asunto(s)
Neovascularización Fisiológica/efectos de los fármacos , Titanio/metabolismo , Factor A de Crecimiento Endotelial Vascular/administración & dosificación , Factor A de Crecimiento Endotelial Vascular/metabolismo , Proliferación Celular/efectos de los fármacos , Células Cultivadas , Preparaciones de Acción Retardada/administración & dosificación , Preparaciones de Acción Retardada/metabolismo , Células Endoteliales de la Vena Umbilical Humana/efectos de los fármacos , Células Endoteliales de la Vena Umbilical Humana/metabolismo , Humanos , Proteínas Inmovilizadas/metabolismo , Técnicas In Vitro , Células Madre Mesenquimatosas/efectos de los fármacos , Células Madre Mesenquimatosas/metabolismo , Oligonucleótidos/química , Oligonucleótidos/metabolismo , Proteínas Recombinantes/metabolismo , Propiedades de Superficie , Titanio/química , Factor de von Willebrand/efectos de los fármacos , Factor de von Willebrand/metabolismo
6.
Artículo en Alemán | MEDLINE | ID: mdl-21887614

RESUMEN

Guidelines and recommendations are increasingly impacting day-to-day clinical care in medicine and dentistry. Although guidelines are only meant to define a range of treatment measures that have been proven to be medically useful, they can have a significant impact on both health care politics and reimbursement strategies as well as be misused to direct particular treatment modalities into the hands of certain specialties. Because these effects tend to not only negatively influence the acceptance but also impair the implementation of guidelines, the process of guideline compilation has to be transparent and based on clearly defined methodology. The German Association of Dental and Craniomandibular Sciences ("Deutsche Gesellschaft für Zahn-, Mund- und Kieferheilkunde", DGZMK) is the umbrella organization of all scientific dental associations in Germany, and initiating new guideline projects as well as continuously updating existing guidelines is one of one of its major tasks. These activities are pursued in cooperation with the "Zahnärztliche Zentralstelle Qualitätssicherung" (ZZQ) and the "Arbeitsgemeinschaft wissenschaftlich medizinischer Fachgesellschaften" (AWMF).


Asunto(s)
Unión Europea , Programas Nacionales de Salud/normas , Guías de Práctica Clínica como Asunto/normas , Garantía de la Calidad de Atención de Salud/normas , Sociedades Odontológicas , Especialidades Odontológicas/normas , Conducta Cooperativa , Curriculum/normas , Atención a la Salud/normas , Educación Continua en Odontología/normas , Educación de Posgrado en Odontología/normas , Predicción , Alemania , Adhesión a Directriz , Comunicación Interdisciplinaria , Especialidades Odontológicas/educación , Cirugía Bucal/educación , Cirugía Bucal/normas
7.
Int J Oral Maxillofac Surg ; 49(10): 1303-1310, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32173246

RESUMEN

Incorrect registration of the condylar position in orthognathic surgery is supposed to cause postoperative relapse, condylar resorption and temporomandibular disorders. The aim of this prospective study was to evaluate the influence of general anaesthesia on centric relation (CR). Therefore, CR registered preoperatively in the awake patient and CR registered intraoperatively under general anaesthesia were recorded in 30 patients (14 men, 16 women) undergoing orthognathic surgery (skeletal class I: n=3, II: n=13, III: n=14; symmetric: n=20; asymmetric: n=10). CR records were digitized and, through superimposition on the preoperative cone beam computed tomography of the patient's skull, the superior, anterior and posterior joint space and the volumetric congruence of 120 condyles were analysed. The linear measurements of joint spaces did not demonstrate any clinically relevant discrepancy between the CR measured in the awake and anaesthetized patient. In contrast, volumetric analysis revealed statistically significant differences between both states, with an intraoperative condylar sag predominantly in the posterior-inferior direction. The patient's skeletal class or symmetry had no significant influence on the intraoperative condylar displacement. Thus, the risk of fixing the condyle in an unphysiological position supports the idea of using intraoperative condylar positioning devices to achieve predictable and stable outcomes.


Asunto(s)
Cirugía Ortognática , Anestesia General , Femenino , Humanos , Masculino , Cóndilo Mandibular/diagnóstico por imagen , Osteotomía Le Fort , Estudios Prospectivos
8.
Int J Oral Maxillofac Surg ; 49(2): 157-165, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31345665

RESUMEN

Tumour progression in head and neck squamous cell carcinoma (HNSCC) is influenced by the surrounding stroma and inflammatory cytokines such as tumour necrosis factor alpha (TNF-α). The aim of this study was to test the hypothesis that TNF-α modulates the interactions of HNSCC cell line PCI-13 and bone marrow mesenchymal stromal cells (BMSCs) and influences markers of epithelial-mesenchymal transition (EMT). Following induction with TNF-α, mono- and co-cultures of BMSCs and the established HNSCC cell line PCI-13 were analyzed; protein expression of E-cadherin and vimentin and qRT-PCR expression of Snail, Twist, MMP14, vimentin, E-cadherin, and ß-catenin were examined, and changes in cellular AKT signalling were analyzed. TNF-α induced a significant decrease in E-cadherin (64.5±6.0%, P=0.002) and vimentin (10.4±3.5%, P=0.04) protein expression in co-cultured PCI-13, while qRT-PCR showed a significant increase in ß-catenin (BMSCs P<0.0001; PCI-13 P=0.0005) and Snail (BMSCs P=0.009; PCI-13 P=0.01). TNF-α also resulted in a down-regulation of AKT downstream targets S6 (38.7±20.9%, P=0.01), p70S6 (16.7±12%, P=0.05), RSK1 (23.6±28.8%, P=0.02), and mTOR (27.4±17.5%, P=0.004) in BMSC co-cultures. In summary, while reducing the expression of vimentin and AKT-signalling in PCI-13 and BMSC, respectively, TNF-α introduced an inflammatory-driven tumour-stroma transition, marked by an increased expression of markers of EMT.


Asunto(s)
Carcinoma de Células Escamosas , Neoplasias de Cabeza y Cuello , Células Madre Mesenquimatosas , Neoplasias de la Boca , Intervención Coronaria Percutánea , Línea Celular Tumoral , Técnicas de Cocultivo , Transición Epitelial-Mesenquimal , Humanos , Factor de Necrosis Tumoral alfa
9.
Oral Oncol ; 103: 104615, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32120340

RESUMEN

BACKGROUND AND PURPOSE: Adenoid cystic carcinomas (ACC) are characterized by high rate of local recurrence and late distant metastasis. Chromosomal changes in the evolution from primary tumors to metastatic disease of ACC have not been appointed. Here we investigated the chromosomal alterations of 53 primary tumors from ACC patients with different progressive states by shallow whole genome sequencing to identify potential new markers for metastatic spread. METHODS: Illumina paired-end libraries were generated using DNA from the primary tumor of 53 ACC patients. Fragmented DNA was end-repaired, A-tailed and multiplex sequencing adapters were ligated. Sequence data were mapped to HG19 and a copy-number analysis was conducted using the QDNAseq R package (version 1.10.0). Outliers were removed and data was smoothed by applying the circular binary segmentation algorithm implemented in the R package copynumber version 1.22.0. A modified chromosomal instability (CNI) score was used to analyze deletions and amplifications. RESULTS: Cluster analysis of the whole genome sequencing revealed that the frequency of chromosomal aberrations were increased in ACC with local recurrence and distant metastases in comparison to ACC patients with no metastatic spread. Specifically, chromosome 6 and 12 and exclusively the entire chromosome 4 showed an increased frequency of chromosomal alterations with tumor progression. CONCLUSION: Our data show a molecular evolution from primary tumors to local recurrences and distant metastases and pinpoint the critical chromosomal regions involved in this process. These regions should be in the focus of the search for therapeutic targets of progressive ACC.


Asunto(s)
Carcinoma Adenoide Quístico/genética , Neoplasias de las Glándulas Salivales/genética , Secuenciación Completa del Genoma/métodos , Carcinoma Adenoide Quístico/patología , Aberraciones Cromosómicas , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Neoplasias de las Glándulas Salivales/patología
10.
Clin Oral Implants Res ; 20(1): 24-30, 2009 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-19126104

RESUMEN

OBJECTIVES: The present study was conducted to test the hypothesis that preshaped polylactic acid (PLA) implants loaded with recombinant human bone morphogenic protein 2 (rhBMP-2) can induce bone formation in a rat ectopic model. MATERIALS AND METHODS: Two groups of porous cylindrical poly-DL-lactic acid implants of 8-mm diameter were produced by gas foaming with CO(2), incorporating 48 and 96 microg rhBMP-2, respectively, into each implant. Blank PLA implants were used as controls. The release of BMPs and the induction of alkaline phosphatase were assessed in vitro. Osteoinduction in vivo was tested by insertion of 15 implants from each group into the gluteal muscles of Wistar rats. Five implants from each group were retrieved after 6, 13 and 26 weeks and assessed using flat panel volume detector computed tomography and light microscopy. RESULTS: Both groups of implants showed increased release of rhBMP-2 during the first 24-48 h, with a slightly higher amount being released from the implants with 48 microg. Release during subsequent intervals was <100 ng/72 h in the low-concentration group and >100 ng in the group with 96 microg rhBMP-2. Implants with 95 microg rhBMP-2 exhibited bone formation in vivo on the outside of the implants across the observation period of 26 weeks with invasion of bone into the pores, whereas implants with 48 microg rhBMP-2 failed to induce the formation of bone tissue. No bone formation was found in the control implants. CONCLUSIONS: The results suggest that release rates of rhBMP-2 for ectopic bone induction have to be >100 ng/72 h to maintain the osteoinductive activity of the tested porous PLA implants. This slow release system may have impact on alveolar bone augmentation procedures when used as individually preformed osteoinductive implants.


Asunto(s)
Implantes Absorbibles , Proteínas Morfogenéticas Óseas/farmacología , Portadores de Fármacos , Osteogénesis/efectos de los fármacos , Proteínas Recombinantes/farmacología , Factor de Crecimiento Transformador beta/farmacología , Animales , Proteína Morfogenética Ósea 2 , Nalgas , Preparaciones de Acción Retardada , Relación Dosis-Respuesta a Droga , Humanos , Ácido Láctico , Masculino , Osificación Heterotópica , Poliésteres , Polímeros , Ratas , Ratas Wistar
11.
Clin Oral Implants Res ; 20(1): 31-7, 2009 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-19126105

RESUMEN

OBJECTIVE: The aim of the present study was to test the hypothesis that peri-implant bone formation can be improved by modifying dual acid-etched (DAE) implant surfaces using organic coatings that enhance cell adhesion and osteogenic differentiation. MATERIAL AND METHODS: Ten adult female foxhounds received experimental titanium implants in the mandible 3 months after removal of all premolar teeth. Six types of implants were evaluated in each animal: (i) implants with a machined surface (MS), (ii) implants with a DAE surface topography, (iii) implants with an acid-etched surface coated with RGD peptides, (iv) implants with an acid-etched surface coated with collagen I, (v) implants with an acid-etched surface coated with collagen I and chondroitin sulphate (CS), (vi) implants with an acid-etched surface coated with collagen I and CS and recombinant human bone morphogenetic protein-2. Peri-implant bone regeneration was assessed by histomorphometry after 1 and 3 months in five dogs each by measuring bone implant contact (BIC) and the bone volume density (BVD) of the newly formed peri-implant bone. RESULTS: After 1 month, mean BIC was significantly higher in the coated implants group than in the MS group. There was no significant difference when mean BIC in the DAE group was compared with implants with any of the organic coatings, but the difference was significant when compared with the MS implants. Differences in mean BVD value did not reach significance between any of the surfaces. After 3 months, the same held true for the mean BIC of all the groups except for Coll I. Mean volume density of the newly formed bone was higher in all the surface modifications, albeit without statistical significance. CONCLUSIONS: It is concluded that with the exception of Coll I, the tested organic surface coatings on DAE surfaces did not improve peri-implant bone formation when compared with the DAE surfaces but enhanced BIC when compared with the MSs.


Asunto(s)
Sulfatos de Condroitina/farmacología , Materiales Biocompatibles Revestidos , Colágeno Tipo I/farmacología , Implantes Dentales , Oseointegración/efectos de los fármacos , Grabado Ácido Dental , Animales , Densidad Ósea , Proteína Morfogenética Ósea 2 , Proteínas Morfogenéticas Óseas/farmacología , Adhesión Celular , Perros , Femenino , Humanos , Implantes Experimentales , Oligopéptidos/farmacología , Proteínas Recombinantes/farmacología , Propiedades de Superficie , Factores de Tiempo , Titanio , Factor de Crecimiento Transformador beta/farmacología
12.
Clin Oral Implants Res ; 20(1): 38-44, 2009 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-19126106

RESUMEN

The aim of the present study was to test the hypothesis that calcium phosphate coatings of dual acid-etched surfaces (DAEs) can improve periimplant bone regeneration. Ten adult female foxhounds received experimental titanium screw implants in the mandible 3 months after removal of all premolar teeth. Five types of surface states were evaluated in each animal: (i) implants with a machined surface (MS) (Control 1); (ii) implants with a DAE (Control 2); (iii) implants with a DAE coated with collagen I (Control 3); (iv) implants with a DAE with mineralized collagen I; and (v) implants with a DAE with a hydroxylapatite (HA) coating. Periimplant bone regeneration was assessed by histomorphometry after 1 and 3 months in five dogs each by measuring bone implant contact (BIC) and the volume density of the newly formed periimplant bone (BVD). After 1 month, mean BIC of experimental implants did not differ significantly from implants with DAE and collagen-coated surfaces, but was significantly higher than the MS implants. BVD was enhanced significantly only in implants with mineralized collagen coating compared with DAE and collagen-coated controls. After 3 months, the mean values of BIC had increased significantly in the group of implants with HA and mineralized collagen coating but were not significantly different from implants with DAE and collagen-coated surfaces. The same held true for the mean BVD values. In conclusion, the present study could not verify the hypothesis that calcium phosphate coatings of DAEs in the present form enhanced periimplant bone formation compared with the DAE surface alone.


Asunto(s)
Materiales Biocompatibles Revestidos , Colágeno Tipo I/farmacología , Implantes Dentales , Durapatita/farmacología , Oseointegración/efectos de los fármacos , Grabado Ácido Dental , Animales , Densidad Ósea , Adhesión Celular , Perros , Femenino , Humanos , Implantes Experimentales , Propiedades de Superficie , Factores de Tiempo , Titanio
13.
Int J Oral Maxillofac Surg ; 48(3): 364-372, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30139710

RESUMEN

The aim of this study was to evaluate and compare the quality of systematic reviews of vertical bone regeneration techniques, using two quality-assessment tools (AMSTAR and ROBIS). An electronic literature search was conducted to identify systematic reviews or meta-analyses that would evaluate at least one of the following outcomes: implant survival, success rates, complications or bone gain after vertical ridge augmentation. Methodological quality assessment was performed by two independent evaluators. Results were compared between reviewers, and reliability measures were calculated using the Holsti's method® and Cohen's kappa. Seventeen systematic reviews were included, of which seven presented meta-analysis. Mean ±95% confidence interval AMSTAR score was 6.35 [4.74;7.97], with higher scores being correlated with a smaller risk of bias (Pearson's correlation coefficient=-0.84; P<0.01). Cohen's inter-examiner kappa showed substantial agreement for both checklists. From the available evidence, we ascertained that, regardless of the technique used, it is possible to obtain vertical bone gains. Implant success in regenerated areas was similar to implants placed in pristine bone with results equating between 61.5% and 100% with guided bone regeneration being considered the most predictable technique regarding bone stability, while distraction osteogenesis achieved the biggest bone gains with the highest risk of possible complications.


Asunto(s)
Aumento de la Cresta Alveolar/métodos , Regeneración Ósea/fisiología , Metaanálisis como Asunto , Revisiones Sistemáticas como Asunto , Humanos
14.
Int J Oral Maxillofac Surg ; 48(3): 347-354, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30220486

RESUMEN

Face-bow transfer is an essential step in articulator-based orthognathic surgery planning. However, it can be a source of inaccuracy. Virtual computer-based planning avoids this error through the use of direct patient-related three-dimensional imaging data. The aim of this prospective observational study was to determine the error of face-bow transfer three-dimensionally and correlate it to the different types of malocclusion. Orthognathic surgery performed on 38 patients (10 male, 28 female; mean (standard deviation) age 24.7 (6.9) years) was planned twice: first articulator-based with plaster models and second computer-based with surgery planning software. Both models were digitized and compared regarding the angle between the Frankfort horizontal plane and the occlusal plane. In most cases, the angle in the sagittal dimension was higher in the articulator-based model than in the computer-based model. The angle in the transverse dimension was as often under- as over-represented. The type of malocclusion, i.e. skeletal class, vertical relationship, and degree of asymmetry, had no significant impact on the amount of error. In conclusion, this study indicates that computer-based planning should be considered as an advantageous alternative in orthognathic surgery planning.


Asunto(s)
Maloclusión/cirugía , Procedimientos Quirúrgicos Ortognáticos/métodos , Cirugía Asistida por Computador/métodos , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Imagenología Tridimensional , Masculino , Maloclusión/diagnóstico por imagen , Modelos Dentales , Estudios Prospectivos , Programas Informáticos , Adulto Joven
15.
Eur J Med Res ; 13(6): 292-8, 2008 Jun 24.
Artículo en Inglés | MEDLINE | ID: mdl-18558556

RESUMEN

OBJECTIVE: Critical size defects (CSDs) of bone are defined as defects that do not heal spontaneously to new bone during the lifetime of an adult individual. In contrast, immature animals are capable to heal defects of identical size. It was our hypothesis that age-related paracrine effects are relevant for this difference in regeneration. METHODS: The pooled supernatant of primary rat calvarial osteoblast-like cell cultures (POBC) derived from prenatal or postnatal donors was concentrated and applied into CSDs of adult recipient organisms (n = 10). In addition, the supernatant of POBC derived from prenatal donors was pooled and purified by reverse-phase chromatography. Each pre-purified fraction was tested in a proliferation indicating bioassay. Peptide fractions containing proliferative activities were re-chromatographed and re-tested in a bioassay. Finally, a proliferative activity was purified, identified by sequence analysis and applied into CSDs of adult recipients. RESULTS: The application of POBC derived from prenatal donors resulted in osseous regeneration of a CSD in adult recipients, while the supernatant of postnatal donors had much smaller effects. The morphologic features resembled the spontaneous osseous healing of calvarial defects of the same size in immature organisms. The polypeptide "tissue inhibitor of metalloproteinases type II"(TIMP-2) was isolated from the supernatant of cultures of POBC derived from prenatal donors by measuring the induction of their proliferation. Additionally, the application of human TIMP-2 injected into calvarial CSDs of adult organisms resulted in osseous healing. CONCLUSION: We conclude that one component responsible for the healing effect of CSDs of POBC supernatants derived from prenatal donors is TIMP-2.


Asunto(s)
Huesos/metabolismo , Inhibidor Tisular de Metaloproteinasa-2/biosíntesis , Envejecimiento , Secuencia de Aminoácidos , Animales , Proliferación Celular , Células Cultivadas , Cromatografía/métodos , Modelos Biológicos , Datos de Secuencia Molecular , Osteoblastos/metabolismo , Péptidos/química , Ratas , Homología de Secuencia de Aminoácido , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción
16.
J Biomed Mater Res A ; 83(2): 455-62, 2007 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-17477390

RESUMEN

The aim of the present report was to test a system for controlled release of recombinant human bone morphogenic protein (rhBMP2) incorporated into polylactic acid (PLA) implants. Incorporation of rhBMP2 into the polymer was accomplished by mixing rhBMP2 solution with granular powder of amorphous poly-DL-lactic acid, subsequent lyophilization, and high pressure CO(2) treatment at 100 bar. Porous cylindrical implants of 8 mm diameter and 3 mm thickness were fabricated with 100, 200, 400, and 800 microg BMP2/g polymer and submitted to in vitro testing. Polymer degradation was assessed during immersion of PLA implants into PBS for 176 days by measuring the inherent viscosity at days 0, 99, and 131. BMP2 release was evaluated by immersion of both the lyophilized powder and the implants into cell culture medium for up to 27 days. BMP2 release was assessed using a custom made ELISA. The biological activity of the released growth factor was determined by measuring the induction of alkaline phosphatase (AP) in C2C12 cells. There was a significant retardation in the release of BMP2 from the implants compared to the granular powder. Detectable amounts of BMP2 were found for all concentrations of BMP2 until the end of the observation period. Significant induction of AP was detected by BMP released from the implants after 3, 6, and 9 days. The present in-vitro study has shown that incorporation of rhBMP2 into PLA implants with subsequent slow release of biologically active growth factor is possible.


Asunto(s)
Proteínas Morfogenéticas Óseas/metabolismo , Preparaciones de Acción Retardada/metabolismo , Ácido Láctico/metabolismo , Polímeros/metabolismo , Proteínas Recombinantes/metabolismo , Factor de Crecimiento Transformador beta/metabolismo , Implantes Absorbibles , Fosfatasa Alcalina/biosíntesis , Animales , Proteína Morfogenética Ósea 2 , Línea Celular , Inducción Enzimática , Gases , Humanos , Concentración de Iones de Hidrógeno , Péptidos y Proteínas de Señalización Intercelular/metabolismo , Ratones , Microscopía Electrónica de Rastreo , Poliésteres
17.
Int J Oral Maxillofac Surg ; 36(12): 1146-52, 2007 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-17822884

RESUMEN

Most parents are emotionally traumatized when confronted by the birth of a baby with an orofacial cleft (OFC). Affected families may have to compensate for increased financial, social and personal impacts before primary treatment is completed. This study was conducted to identify factors influencing the quality of life (QoL) of families having young children with OFC. A self-administered questionnaire containing the impact on family scale was applied in 130 consecutive families having children with OFC aged between 6 and 24 months. The results were related to the type of cleft and the time of initial diagnosis using non-parametric tests and multivariate correlation analysis (P<0.05). In families having children with isolated cleft lip, financial and social impacts were reduced, but problems in coping were increased when compared to families with children having cleft lip and palate or isolated cleft palate. Total impact was highest in families having children with isolated cleft palate, probably due to later surgery for reconstruction. Prenatal diagnosis of OFC did not reduce the general impact on affected families, but increased the social impact. The relation of certain impacts to distinct types of cleft might allow more tailored support of affected families and improve their QoL.


Asunto(s)
Labio Leporino/psicología , Fisura del Paladar/psicología , Familia/psicología , Calidad de Vida/psicología , Ultrasonografía Prenatal/psicología , Adulto , Preescolar , Labio Leporino/diagnóstico , Fisura del Paladar/diagnóstico , Métodos Epidemiológicos , Padre/psicología , Femenino , Humanos , Lactante , Masculino , Madres/psicología , Embarazo
18.
J Craniomaxillofac Surg ; 45(5): 731-740, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-28318921

RESUMEN

OBJECTIVES: TGF-ß1 signaling modulates epithelial mesenchymal transitions (EMT) of head and neck squamous cell carcinoma (HNSCC). Bone marrow mesenchymal stromal cells (BMSC) are able to exert a regulating influence on the expression of markers of EMT in HNSCC cells. It was thus the aim of this study to test the hypothesis that TGF-ß1 modulates the interactions of tumor transition between BMSCs and HNSCC, affecting the expression of E-cadherin, Vimentin, Snail, Twist, MMP14 and beta-catenin. Furthermore, we analyzed alterations in the AKT-signaling of tumor and stroma cells. MATERIALS AND METHODS: BMSCs were isolated from iliac bone marrow aspirates and co-cultured in trans-well permeable membrane wells with tumor cells of the established HNSCC cell line PCI-13. Following the induction with TGF-ß1 under serum free conditions the expression of Vimentin and E-Cadherin was assessed via immunofluorescence. A quantitative RT-PCR analysis of tumor transition markers E-cadherin, Vimentin, Snail, Twist, MMP14 and beta-catenin was performed. Changes in AKT-Signaling were identified via protein analysis. RESULTS: In non-induced co-cultures, BMSC were able to suppress Vimentin in PCI-13 as a marker of tumor transition. In TGF-ß1 induced co-cultures PCI-13 significantly increased the expression of Vimentin, Twist, Snail, MMP14, GSK3a, PRAS40, 4E-BP1, and AMPKa compared to monolayer controls. TGF-ß1 co-cultured BMSC demonstrated a significant increase of Snail, PRAS40, mTOR, GSK3a/b, Bad, PDK1 and 4E-BP1. CONCLUSIONS: TGF-ß1 was able to attenuate the modulating influence of BMSC in co-culture and drive the co-culture towards a progressive tumor transition, affecting the expression of markers of EMT, AKT-Signaling and proliferative checkpoints.


Asunto(s)
Transformación Celular Neoplásica/efectos de los fármacos , Células Madre Mesenquimatosas/citología , Neoplasias de la Boca/patología , Factor de Crecimiento Transformador beta1/farmacología , Adolescente , Adulto , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/patología , Niño , Técnicas de Cocultivo , Transición Epitelial-Mesenquimal/efectos de los fármacos , Neoplasias de Cabeza y Cuello/metabolismo , Neoplasias de Cabeza y Cuello/patología , Humanos , Persona de Mediana Edad , Neoplasias de la Boca/metabolismo , Reacción en Cadena en Tiempo Real de la Polimerasa , Adulto Joven
19.
Clin Hemorheol Microcirc ; 67(3-4): 453-457, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28885213

RESUMEN

The chorioallantoic membrane of fertilized chicken eggs in an early phase of breeding presents an approved test situation for the growth and treatment of human cancer cells.These models work due to the inoculation of cells into the membrane that stays within the egg shell during the time of investigation. In this study a modification of this model is presented. Samples of native tumors, rather than cell lines, are transplanted into the membrane and the body of the egg is taken out of the shell and placed in a plastic bowl. These modifications lead to an enhanced accessibility to the chorioallantoic membrane and the surrounding vessels thus facilitating intra venous access and application of pharmaceuticals and a focused radiotherapy. With the current modifications the embryo was kept alive and additionally, the vascularized tumor environment was preserved.


Asunto(s)
Carcinoma de Células Escamosas/terapia , Técnicas de Cultivo de Célula/métodos , Membrana Corioalantoides , Neoplasias Orofaríngeas/terapia , Animales , Carcinoma de Células Escamosas/patología , Línea Celular , Embrión de Pollo , Trasplante de Neoplasias , Neoplasias Experimentales , Neoplasias Orofaríngeas/patología
20.
Int J Oral Maxillofac Surg ; 35(10): 941-6, 2006 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-17027234

RESUMEN

The aim of the present study was to test the hypothesis that measurements of implant stability using resonance frequency analysis (RFA) correlate with histomorphometric data of bone anchorage. Ten adult female foxhounds received a total of 80 implants in their mandibles 3 months after removal of all premolar teeth. At the time of implant placement, torque required for bone tapping was registered as a measure of bone density and immediately after placement implant stability was assessed using RFA. RFA measurements were repeated at the time of implant retrieval after 1 month (5 dogs) and 3 months (5 dogs). Peri-implant bone regeneration was assessed histomorphometrically by measuring bone-implant contact (BIC) and the volume density of the newly formed peri-implant bone (BVD). RFA values at the time of implant placement did not correlate with the torque required to tap the bone for implant placement. After 1 and 3 months, RFA values were significantly increased compared with baseline values. BIC and BVD, however, had increased significantly during this interval. There was no correlation between bone-implant contact and RFA values nor between peri-implant bone density and RFA values. Thus, the hypothesis could not be verified. It is concluded that the validity of the individual measurement of implant stability using RFA should be considered with caution.


Asunto(s)
Densidad Ósea , Implantación Dental Endoósea/métodos , Implantes Dentales , Mandíbula/cirugía , Animales , Perros , Femenino , Modelos Animales , Estadística como Asunto , Torque , Vibración
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