Influence of loading and grafting on hard- and soft-tissue healing at immediately placed implants: An experimental study in minipigs.

AIM: To histologically evaluate the influence of (1) loading and (2) grafting on osseointegration and peri-implant soft-tissue healing at immediately placed, self-cutting progressive tissue-level implants (TLX) in a minipig model. MATERIALS AND METHODS: TLX implants (n = 56) were immediately placed following the extraction of the mandibular first and second premolars, bilaterally, in a total of n = 14 minipigs. In each animal, the implant sites were allocated to the following four groups: (1) unloaded with simultaneous grafting using a bovine bone mineral; (2) unloaded without grafting; (3) loaded with simultaneous grafting; and (4) loaded without grafting. Histomorphometric assessments at 4 and 12 weeks (n = 7 animals each) included primary (i.e., bone-to-implant contact [BIC]) and secondary outcome measures (e.g., first BIC [fBIC], junctional epithelium length [JE], connective tissue contact length [CTC], biological width [BW = JE + CTC]). RESULTS: At 4 weeks, mean BIC values ranged from 74.5 ± 11.6% in Group 2 to 83.8 ± 13.3% in Group 1, and, at 12 weeks, from 75.5% ± 7.9% in Group 2 to 79.9 ± 8.6% in Group 1. Multivariate linear mixed regression did not reveal any associations between BIC and implant loading or grafting at 4 and 12 weeks. At 12 weeks, significantly higher fBIC values were noted in Group 2 when compared with Group 1. All groups showed comparable JE, CTC, and BW values. CONCLUSIONS: Implant loading and grafting had no major effects on osseointegration and peri-implant soft tissue healing at TLX implants.

Group 2 ITI Consensus Report: Prosthodontics and implant dentistry.

OBJECTIVES: Working Group 2 was convened to address topics relevant to prosthodontics and dental implants. Systematic reviews were developed according to focused questions addressing (a) the number of implants required to support fixed full-arch restorations, (b) the influence of intentionally tilted implants compared to axial positioned implants when supporting fixed dental prostheses (FDPs), (c) implant placement and loading protocols, (d) zirconia dental implants, (e) zirconia and metal ceramic implant supported single crowns and (f) zirconia and metal ceramic implant supported FDPs. MATERIALS AND METHODS: Group 2 considered and discussed information gathered in six systematic reviews. Group participants discussed statements developed by the authors and developed consensus. The group developed and found consensus for clinical recommendations based on both the statements and the experience of the group. The consensus statements and clinical recommendations were presented to the plenary (gathering of all conference attendees) and discussed. Final versions were developed after consensus was reached. RESULTS: A total of 27 consensus statements were developed from the systematic reviews. Additionally, the group developed 24 clinical recommendations based on the combined expertise of the participants and the developed consensus statements. CONCLUSIONS: The literature supports the use of various implant numbers to support full-arch fixed prostheses. The use of intentionally tilted dental implants is indicated when appropriate conditions exist. Implant placement and loading protocols should be considered together when planning and treating patients. One-piece zirconia dental implants can be recommended when appropriate clinical conditions exist although two-piece zirconia implants should be used with caution as a result of insufficient data. Clinical performance of zirconia and metal ceramic single implant supported crowns is similar and each demonstrates significant, though different, complications. Zirconia ceramic FDPs are less reliable than metal ceramic. Implant supported monolithic zirconia prostheses may be a future option with more supporting evidence.

Retalho deslocado coronalmente com a utilização de enxerto conjuntivo subepitelial e Emdogain para recobrimento radicular ­ controle clínico de cinco anos / Coronally repositioned flap with subepithelial connective tissue graft and Emdogain for root coverage ­ a 5 year follow-up case report

Uma situação desafiadora na Odontologia é a recessão gengival. Seu tratamento deve ser capaz de promover um completo recobrimento do defeito da recessão com mínima profundidade de sondagem pós-tratamento, além de promover resultados de cor e textura na área recoberta compatível com a dos tecidos moles adjacentes. Algumas situações clínicas prévias devem ser observadas quando do exame do paciente, dentre elas: a etiologia da lesão, o grau de classificação e a existência de lesões cariosas na raiz exposta. Uma abordagem previsível para o recobrimento radicular é o retalho deslocado coronalmente associado ao enxerto de tecido conjuntivo subepitelial. As proteínas derivadas da matriz do esmalte vêm sendo utilizadas associadas a técnicas de recobrimento com o intuito de aumentar o potencial regenerativo da região. Neste relato, com controle clínico de cinco anos, foi realizada a recuperação do tecido gengival perdido na região do dente 31, com o uso da técnica do retalho deslocado coronalmente associado ao enxerto de tecido conjuntivo subepitelial e ao Emdogain. Esta associação resultou em um importante ganho de inserção, além da melhora estética na região para o paciente.

A challenging situation in dentistry is gingival recession. Its treatment should be able to promote a complete coverage of the recession defect with minimum post-treatment probing depth, in addition to promoting color and texture results in the covered area compatible with the adjacent soft tissue. Some previous medical conditions must be observed when examining the patient, among them the etiology, the degree of classifi cation and the existence of caries on the exposed root. A predictable approach to root coverage is the coronally repositioned flap associated with subepithelial connective tissue grafting. The enamel derived matrix has been associated with coverage techniques in order to increase the regenerative potential. In this 5 year case report, the lost gingival tissue was recovered at the region of tooth 31 using a coronally advanced fl ap associated to STG and Emdogain. There were esthetic improvements and better attachment levels observed in the clinical results.

Expression of SOFAT by T- and B-lineage cells may contribute to bone loss.

A novel T cell-secreted cytokine, termed secreted osteoclastogenic factor of activated T cells (SOFAT) that induces osteoclastic bone resorption in a RANKL-independent manner, has been described. Our group have previously reported that SOFAT is highly expressed in gingival tissues of patients with chronic periodontitis suggesting a putative role in the bone loss associated with periodontal disease. The aim of the present study was to identify other potential cellular sources of SOFAT in the bone resorptive lesions of patients with periodontal disease. Gingival tissues were biopsied from systemically healthy subjects without periodontal disease (n=5) and patients with chronic periodontitis (n=5), and the presence of SOFAT was analyzed by immunohistochemistry and immunofluorescence staining. The present data demonstrated marked SOFAT staining in diseased periodontal tissues that was predominantly associated with the lymphocytic infiltration of gingival tissues. Notably, in addition to CD3+ T cells, B­lineage cells including plasma cells also exhibited strong staining for SOFAT. As SOFAT has not previously been reported in B­lineage cells, splenic T cells and B cells were further purified from BALB/c mice and activated using CD3/CD28 and lipopolysaccharide, respectively. SOFAT was quantified by reverse transcription­quantitative polymerase chain reaction and was shown to be significantly expressed (P<0.05) in both activated T cells and B cells compared with unstimulated cells. These data support a putative role of SOFAT in the bone loss associated with chronic periodontal disease. In addition, to the best of our knowledge, this study demonstrates for the first time that in addition to T cells, B-lineage cells may also be a significant source of SOFAT in inflammatory states.

Ligandless Palladium-Catalyzed Regioselective Direct C-H Arylation of Imidazo[1,2-a]imidazole Derivatives.

Herein a novel access to functionalizable 6-substituted imidazo[1,2-a]imidazole scaffolds is described. The reactivity of this heterobicyclic unit toward direct C-H arylation was studied, and conditions allowing regioselective arylation at position 3 were successfully developed. The practicability of this method is manifested by the ligandless conditions and low catalyst loading. The strategy is functional group tolerant and provides rapid access to a large variety of 3,6-di(hetero)arylated imidazo[1,2-a]imidazole derivatives. A second arylation at position 2 was then carried out, and a library of diversified 2,3,6-tri(hetero)arylated imidazo[1,2-a]imidazoles was generated in good yields. A one-pot, two-step procedure was finally developed.

In vitro evaluation of the biological effect of SOFAT on osteoblasts.

Osteoclastogenesis is regulated by osteoblasts especially through the production of receptor activator of nuclear factor kappa-B ligand (RANKL). Immune cells present in inflamed tissues markedly increase this process by upregulating RANKL directly or by secreting proinflammatory cytokines, which stimulate RANKL expression by osteoblasts. A novel T-cell-secreted cytokine, termed secreted osteoclastogenic factor of activated T cells (SOFAT) was recently described. To better understand how SOFAT affects bone metabolism, we investigated its effect on osteoblastic cells. We demonstrate here that SOFAT did not influence MC3T3 cells viability and proliferation, evaluated by trypan blue exclusion and MTT tests, respectively. SOFAT stimulated the secretion of IL-6, IL-10 and GM-CSF in MC3T3 cells, as shown by the analysis of an inflammatory cytokines ELISA array. The upregulation of the corresponding genes was checked by qPCR. Both RANKL mRNA and protein levels did not significantly change in the presence of SOFAT, evaluated by qPCR and western blotting, respectively. In addition, analysis of a PCR array for IL6/STAT3 pathway demonstrated that SOFAT induced the expression of BCL2, IL1B, IL10, IL22, IL2RA, IL4, IL6, TNFSF10 and PIAS3, while IL2, IL21, CD4, CSF3R and TNF were repressed. Our results confirm that the SOFAT mechanism of action is RANKL-independent and indicate that, by co-opting osteoblasts to increase the production of osteoclastogenic cytokines, SOFAT may exacerbate inflammation and support osteoclast formation and bone destruction.

Instalação e provisionalização imediata de implantes após exodontia em dentes com reabsorção externa / Immediate installation and provisionalization of implants after extraction of teeth with external resorption

Vários fatores podem levar à perda dentária, entre eles a reabsorção externa das raízes. Para este, entre outros casos, a reposição dos dentes perdidos com a instalação imediata de implantes e provisionalização imediata tem sido um procedimento com bom prognóstico. Fatores como extração minimamente traumática, manutenção das cristas ósseas proximais e das tábuas ósseas vestibular e lingual, estabilidade primária do implante e a confecção de provisório imediato livre de contatos oclusais são parâmetros importantes para a previsibilidade do caso. Esta técnica tem sido descrita por vários autores desde a década de 90 com alto índice de sucesso, otimizando a reabilitação dos pacientes com menor tempo de espera e a preservação da arquitetura dos tecidos gengival e ósseo. Este trabalho apresenta o relato de dois casos clínicos de exodontias de dentes com reabsorção externa, previamente submetidos ao tracionamento ortodôntico, seguidas de instalação imediata de implantes e provisionalização imediata, com acompanhamento clínico e radiográfico de 7 anos...

Several factors can lead to tooth loss, including external root resorption. In these cases, among others, the replacement of missing teeth with immediate implant placement and provisionalization has been a procedure with good prognosis. Factors including minimally traumatic extraction, maintenance of proximal bone crests and buccal and lingual bone plates, primary implant stability and immediate provisionalization free of occlusal contacts are strictly important for success and good long-term result. This technique has been described since the 90s with a high success rate. It can optimize the rehabilitation with a shorter waiting time maintaining of bone and gingival contours. This article describes a 7-year radiographic and clinical follow-up of two extraction cases of teeth with external root resorption followed by immediate implant placement and immediate provisionalization...

New imidazo[1,2-b]pyrazoles as anticancer agents: synthesis, biological evaluation and structure activity relationship analysis.

Synthesis and functionalization strategies of the imidazo[1,2-b]pyrazole core were developed giving a rapid access to three series of novel imidazo[1,2-b]pyrazole type derivatives: C-2/C-6/C-7 trisubstituted, C-2/C-3/C-6 tri(hetero)arylated and C-2/C-3/C-6/C-7 tetrasubstituted imidazo[1,2-b]pyrazoles. 39 of the synthetized products were evaluated for in vitro anticancer activity using the MTT colorimetric assay against 5 human and 1 murine cancer cell lines. Promising in vitro growth inhibitory activities were exhibited by some of the target compounds. Of the 39 evaluated products, 4 displayed an IC50 ≤ 10 µM in the 6 cell lines analyzed (compounds 4d, 4g, 9a, 11a). A structure activity relationship analysis is also reported in this paper.

Design of α7 nicotinic acetylcholine receptor ligands in quinuclidine, tropane and quinazoline series. Chemistry, molecular modeling, radiochemistry, in vitro and in rats evaluations of a [(18)F] quinuclidine derivative.

In this report, we describe the synthesis of a novel library of α7 nAChR ligands based on the modulation of the quinuclidine, quinazoline and tropane moieties. Spirane derivatives were newly synthesized under stereo specific 1,3 dipolar cylcoadditions. Only amide derivatives bonded efficiently to the receptor with Ki measured between 14 and 133 nM. The best fluorinated candidate was selected and radiolabeled. The potent [(18)F]4 PET tracer was evaluated in rats and its brain accumulation quantified.

Antitumor activity of semisynthetic derivatives of Aconitum alkaloids.

We recently synthesized from aconitine a series of drugs with in vitro and in vivo antitumor properties, among which bis[O-(14-benzoylaconine-8-yl)]suberate (BBAS) was the most active (Eur J Med Chem 2012; 54: 343). In the present work, we used the NCI panel of 60 human tumor cell lines to identify the most sensitive cell lines and drugs with comparable cytotoxicity profiles. GI50 values of BBAS ranged between 0.12 and 6.5 µM. Activity was higher than average for leukemia and melanoma cell lines, especially SK-MEL-5 and SK-MEL-28, for the COLO-205 and HT-29 (colorectal) and MDA-MB-468 (breast) cancer cell lines. We evaluated the correlation between the GI50 of BBAS and those of 125 antiproliferative compounds with various mechanisms of action, using Bonferroni correction for multiple testing, and we observed a highly significant correlation with the GI50s of nitrosoureas. Interestingly, BBAS cytotoxicity was inversely correlated with the expression levels of MGMT (p = 0.009), an enzyme involved in the repair of nitrosourea-induced DNA damage. However, no correlation was found with the expression of 102 other genes involved in DNA repair. Antitumor activity was tested on immunodeficient mice with subcutaneously xenografted COLO-205, HT-29, MDA-MB-468, SK-MEL-5 and SK-MEL-28 cell lines. At 10 mg/kg, there was a significant reduction in tumor size with T/C values of 41 % and 43 % for COLO-205 and SK-MEL-28 cell lines, respectively. The drug was less active on HT-29 and SK-MEL-5 and inactive on MDA-MB-468 xenografts. Cell cycle studies showed an accumulation of BBAS-treated cells in G2/M phase after treatment at 20 µM. Together, our results allowed the identification of a potentially new class of anticancer agent displaying a mechanism of action related to that of nitrosoureas.

Implante imediato com provisionalização e utilização da coroa natural do elemento extraído / Immediate dental implant after tooth extraction using the natural dental crown as a provisional restoration. A case report

A implantação imediata após a exodontia com a confecção de um elemento protético provisório tem se tornado uma proposta viável, amplamente documentada na literatura e que diminui consideravelmente o tempo de tratamento e a quantidade de intervenções, contribuindo para maior satisfação do paciente. A observação de fatores relevantes da estrutura óssea remanescente e do contorno gengival da região deve ser considerada, com o objetivo de otimizar o prognóstico. Outras considerações quanto ao desenho e superfície do implante, conduta cirúrgica e protética também devem ser criteriosamente analisadas. O objetivo deste trabalho foi demonstrar, por meio de um relato de caso clínico, a utilização de implante imediato após a exodontia de um dente perfurado endodonticamente, seguido de provisionalização imediata, utilizando-se da coroa do dente extraído como elemento provisório, com acompanhamento de seis meses.

Immediate implantation after extraction followed by a provisional prosthetic element has become a viable proposition, widely documented in the literature and which significantly reduces treatment time and number of interventions, contributing to greater patient satisfaction. The observation of relevant factors of the remaining bone structure and gingival contour of the region must be considered in order to optimize the prognosis. Other considerations such as implant design and surface, surgical and prosthetic protocols should also be carefully analyzed. The objective of this paper is to demonstrate through a clinical case report, the use of immediate implant after extraction of a tooth endodontically perforated, followed by immediate provisionalization, using the crown of the extracted tooth as provisional element representing the 6-month follow-up report.

Efficient metal-free synthesis of various pyrido[2',1':2,3]imidazo- [4,5-b]quinolines.

Dancing with diversity: The synthesis of diverse pyrido[2',1':2,3]imidazo[4,5-b]quinolines bearing several substitution patterns was developed based on combining a multicomponent reaction (Groebke-Blackburn-Bienaymé reaction) with an original cyclization as a secondary transformation (see scheme; DBU = 1,8-diazabicyclo[5.4.0]undec-7-ene).

Secreted osteoclastogenic factor of activated T cells (SOFAT), a novel osteoclast activator, in chronic periodontitis.

A novel activated human T cell-secreted cytokine, referred as secreted osteoclastogenic factor of activated T cells (SOFAT), that induce osteoclastogenesis in a RANKL-independent manner was recently described. This study evaluated the role of SOFAT in periodontal tissues and periodontitis. Gingival biopsies were harvested from systemically healthy non-periodontitis (n=15) and chronic periodontitis patients (n=15). The mRNA and protein levels of SOFAT were measured by qPCR and by enzyme-linked immunosorbent assay, respectively. Moreover, RAW 264.7 cells were cultured with SOFAT or Receptor activator of nuclear factor-kB ligand (RANKL) and stained for tartrate-resistant acid phosphatase (TRAP). Also, mice received a palatal injection between the first and second upper molar of SOFAT (100 ng/ml) or saline solution (0.9%). The upper jaw was removed, histologically processed and stained with hematoxilin and eosin to observe the presence of osteoclast-like cells. The mRNA and protein levels of SOFAT were significantly higher in the gingival tissue of the periodontitis group when compared to non-periodontitis one (p<0.05). In addition, SOFAT potently induced TRAP-positive multinucleated cell formation by RAW 264.7 cells as well as induced the formation of osteoclast-like cells in the periodontal ligament in mice. The present study demonstrated that SOFAT may play an important role in periodontitis.

Efficient synthesis and first regioselective C-3 direct arylation of imidazo[1,2-b]pyrazoles.

Highly regioselective: An efficient synthesis of the imidazo[1,2-b]pyrazole core has been developed, and the first regioselective palladium-catalyzed direct arylation of the C-3 position is described (see scheme). Good to excellent yields were obtained for a wide range of aryl partners with electron-rich and electron-poor substituents. This methodology allows rapid access to a large variety of imidazo[1,2-b]pyrazole products and could open the way to the design of new biologically active compounds.

Hemisynthesis and antiproliferative properties of mono-[O-(14-benzoylaconine-8-yl)]esters and bis-[O-(14-benzoylaconine-8-yl)]esters.

A series of mono- and bifunctional acyl compounds, build from the 8-O-azeloyl-14-benzoylaconine scaffold and differing by the length of the alkyl linker chain, were synthesised and evaluated against a panel of human tumour cell lines, A-549 (lung cancer), MCF-7 (breast cancer) and HCT-15 (colon cancer). None of the mono-[O-(14-benzoylaconine-8-yl)]esters displayed in vitro activity against tumour cells (IC(50) > 60 µM). However, three bis-[O-(14-benzoylaconine-8-yl)]esters presented a noticeable in vitro cytotoxic activity, those bearing 7, 8 and 9 carbon atoms between the two aconitine moieties, with IC(50)s ranging between 4 and 28 µM. The most active, bis[O-(14-benzoylaconine-8-yl)]suberate, was then evaluated in vivo in immunodeficient mice bearing human tumour xenografts originating from MCF-7 and HCT-15 cells. For MCF-7 cells, administration of five doses every 4 days, and weekly administration of 4 doses resulted in T/C percent values of 36% (p = 0.001) and 56% (p = 0.02) on day 45, respectively. For HCT-15 cells, administration of five doses every 3 days resulted in 49% tumour regression on the 25th day (p = 0.00001).

New ferrocenic pyrrolo[1,2-a]quinoxaline derivatives: synthesis, and in vitro antimalarial activity--Part II.

Following our search for antimalarial compounds, novel series of ferrocenyl-substituted pyrrolo[1,2-a]quinoxalines 1-2 were synthesized from ferrocene-carboxaldehyde and tested for their in vitro activity upon the erythrocytic development of Plasmodium falciparum strains with different chloroquine-resistance status. The ferrocenic pyrrolo[1,2-a]quinoxalines 1-2 were prepared in 6 or 9 steps through a Barton-Zard reaction. Promising pharmacological results against FcB1, K1 and F32 strains were obtained with ferrocenyl pyrrolo[1,2-a]quinoxalines 1j-l linked by a bis-(3-aminopropyl)piperazine linker substituted by a nitrobenzyl moiety.

Synthesis and evaluation of the antiproliferative activity of novel isoindolo[2,1-a]quinoxaline and indolo[1,2-a]quinoxaline derivatives.

A novel series of isoindolo[2,1-a]quinoxaline and indolo[1,2-a]quinoxaline derivatives was synthesized and evaluated in vitro against various human cancer cell lines for antiproliferative activity. These new compounds displayed activity against leukemia and breast cancer cell lines in the 3- to 18-µM concentration range.

Antiproliferative effect on HepaRG cell cultures of new calix[4]arenes. Part II.

Cell cycle progression is dependent on the intracellular iron level and chelators can lead to iron depletion and decrease cell proliferation. This antiproliferative effect can be inhibited by exogenous iron. In this work, we present the synthesis of some new synthetic calix[4]arene podands bearing diamino-tetraesters, diamino-tetraalcohols, diamino-tetraacid and tetraaryloxypentoxy groups at the lower rim, designed as potential iron chelators. We report their effect on cell proliferation, in comparison with the new oral chelator ICL670A (4-[3,5-bis-(2-hydroxyphenyl)-1,2,4-triazol-1-yl]-benzoic acid). The antiproliferative effect of these new compounds was studied in the human hepatocarcinoma HepaRG cell cultures using cell nuclei counting after staining with the DNA intercalating fluorescence dye, Hoechst 33342. Their cytotoxicity was evaluated by the extracellular LDH activity. Preliminary results indicated that their antiproliferative effect was mainly due to their cytotoxicity. The efficiency of these compounds, being comparable to that of ICL670, was independent of iron depletion. This effect remains to be further explored. Moreover, it also shows that the new substituted calix[4]arenes could open the way to valuable new approaches for medicinal chemistry scaffolding.

Efficient pallado-catalyzed C6-(het)arylation of Imidazo[1,2-b][1,2,4,5]tetrazines under microwave irradiations.

A versatile protocol for the preparation of a library of 5,6-(het)bisarylated imidazo[1,2-b][1,2,4,5]tetrazines is described. Target compounds were obtained in fairly good yields, starting from ethoxy-7-(4-methoxyphenyl)imidazo[1,2-b][1,2,4,5]tetrazine and a large panel of bromoaryl derivatives, using palladium catalysis under microwave irradiation. Compatibility with various chemical groups and heterocycles was proven. Steric and electronic effects do not have any effect on the efficiency of the reaction. Purifications were performed without any difficulties, and the structure of a final compound was proven by crystal X-ray diffraction studies.

Synthesis and evaluation of the antiproliferative activity of novel pyrrolo[1,2-a]quinoxaline derivatives, potential inhibitors of Akt kinase. Part II.

Attenuation of protein kinases by selective inhibitors is an extremely active field of activity in anticancer drug development. Therefore, Akt, a serine/threonine protein kinase, also known as protein kinase B (PKB), represents an attractive potential target for therapeutic intervention. Recent efforts in the development and biological evaluation of small molecule inhibitors of Akt have led to the identification of novel inhibitors with various heterocycle scaffolds. Based on previous results obtained on the antiproliferative activities of new pyrrolo[1,2-a]quinoxalines, a novel series was designed and synthesized from various substituted phenyl-1H-pyrrole-2-carboxylic acid alkyl esters via a multistep heterocyclization process. These new compounds were tested for their in vitro ability to inhibit the proliferation of the human leukemic cell lines K562, U937, and HL60, and the breast cancer cell line MCF7. The first biological evaluation of our new substituted pyrrolo[1,2-a]quinoxalines showed antiproliferative activity against the tested cell lines. From a general SAR point of view, these preliminary biological results highlight the importance of substitution at the C-4 position of the pyrroloquinoxaline scaffold by a benzylpiperidinyl fluorobenzimidazole group, and also the need for a functionalization on the pyrrole ring.