Enzymatic Potential of Filamentous Fungi as a Biological Pretreatment for Acidogenic Fermentation of Coffee Waste.

Spent coffee grounds (SCGs) are a promising substrate that can be valorized by biotechnological processes, such as for short-chain organic acid (SCOA) production, but their complex structure implies the application of a pretreatment step to increase their biodegradability. Physicochemical pretreatments are widely studied but have multiple drawbacks. An alternative is the application of biological pretreatments that include using fungi Trametes versicolor and Paecilomyces variotii that naturally can degrade complex substrates such as SCGs. This study intended to compare acidic and basic hydrolysis and supercritical CO2 extraction with the application of these fungi. The highest concentration of SCOAs, 2.52 gCOD/L, was achieved after the acidification of SCGs pretreated with acid hydrolysis, but a very similar result, 2.44 gCOD/L, was obtained after submerged fermentation of SCGs by T. versicolor. This pretreatment also resulted in the best acidification degree, 48%, a very promising result compared to the 13% obtained with the control, untreated SCGs, highlighting the potential of biological pretreatments.

Impact of a Pretreatment Step on the Acidogenic Fermentation of Spent Coffee Grounds.

Acidogenic fermentation (AF) is often applied to wastes to produce short-chain organic acids (SCOAs)-molecules with applications in many industries. Spent coffee grounds (SCGs) are a residue from the coffee industry that is rich in carbohydrates, having the potential to be valorized by this process. However, given the recalcitrant nature of this waste, the addition of a pretreatment step can significantly improve AF. In this work, several pretreatment strategies were applied to SCGs (acidic hydrolysis, basic hydrolysis, hydrothermal, microwave, ultrasounds, and supercritical CO2 extraction), evaluated in terms of sugar and inhibitors release, and used in AF. Despite the low yields of sugar extracted, almost all pretreatments increased SCOAs production. Milder extraction conditions also resulted in lower concentrations of inhibitory compounds and, consequently, in a higher concentration of SCOAs. The best results were obtained with acidic hydrolysis of 5%, leading to a production of 1.33 gSCOAs/L, an increase of 185% compared with untreated SCGs.

Identification of a novel pathogenic variant in FBN1 associated with Marfan Syndrome.

Aortic diseases arising in Marfan Syndrome (MFS), such as in aneurysms and dissections of the thoracic aorta, are related to genetic alterations in the FBN1 gene. Databases, such as Universal Mutations-FBN1, ClinVar and The Human Gene Mutation, contain more than a thousand FBN1 mutations associated with MFS. The FBN1 gene, which encodes fibrillin-1, is responsible for the integral production of different protein domains. Possible genetic changes may lead to a weakening of blood vessels, leading to the development of aortopathies. In this study, we present the association of a novel FBN1 variant with MFS. The proband is a man who presented ascending aortic aneurysm and dissection (TAAD) at 42-yr-old, which was surgically treated. Clinical investigations were performed in all family members enrolled in the study. Marfan signs were observed in the proband, daughters and granddaughter. Direct sequencing of the FBN1 gene in the proband identified a novel truncation variant p.(Glu2019Ter) and a cascade screening were done. The variant was classified as pathogenic and causal for MFS according to the American College of Medical Genetics and Genomics (ACMG) criteria and revised Ghent nosology for MFS diagnosis, respectively. Proband's daughter and granddaughter harbor the variant, however without aortic alteration. This work reports for the first time a patient with the FBN1-p.(Glu2019Ter) variant and its association with MFS/TAAD.

Computational Fluid Dynamics to Assess the Future Risk of Ascending Aortic Aneurysms. / Fluidodinâmica Computacional na Avaliação do Risco Futuro de Aneurismas de Aorta Ascendente.

BACKGROUND: A methodology to identify patients with ascending aortic aneurysm (AsAA) under high risk for aortic growth is not completely defined. OBJETIVE: This research seeks to numerically characterize the aortic blood flow by relating the resulting mechanical stress distribution with AsAA growth. METHODS: Analytical, observational, single-center study in which a computational fluid dynamics (CFD) protocol was applied to aortic computed tomography angiogram (CTA) images of patients with AsAA. Two CTA exams taken at a minimum interval of one year were obtained. From the CTA-gathered images, three-dimensional models were built, and clinical data were registered. Study of velocity field and coherent structures (vortices) was performed aiming to relate them to the presence or absence of aneurysm growth, as well as comparing them to the patients' clinical data. The Kolmogorov-Smirnov test was used to evaluate the normality of the distribution, and the non-parametric Wilcoxon signed-rank test, for non-normal distribution, was used to compare the paired data of the aortic angles. Statistical significance was set at 5%. RESULTS: The incident jet in the aortic wall generated recirculation areas in the posterior region of the jet, inducing complex vortices formation in the group with aneurysm growth, leading to an average pressure increase in the ascending aortic wall between exams. In the group without aneurysm growth, the average pressure decreased. CONCLUSION: This pilot study showed that CFD based on CTA may in the near future be a tool to help identify flow patterns associated with AsAA remodeling process.

FUNDAMENTOS: Uma metodologia para identificação de pacientes portadores de aneurisma de aorta ascendente (AAAs) sob alto risco de remodelamento aórtico não está completamente definida. OBJETIVO: Esta pesquisa objetiva caracterizar numericamente o fluxo sanguíneo aórtico, relacionando a distribuição do estresse mecânico resultante com o crescimento de AAAs. MÉTODOS: Estudo analítico, observacional, unicêntrico, em que um protocolo de fluidodinâmica computacional (CFD - Computacional Fluid Dynamics) foi aplicado a imagens de angiotomografia computadorizada (ATC) de aorta de pacientes portadores de AAAs. Duas ATC de aorta com pelo menos um ano de intervalo foram obtidas. Dados clínicos dos pacientes foram registrados e, a partir das imagens de ATC, foram gerados modelos tridimensionais. Foram realizados estudos do campo de velocidade e estruturas coerentes (vórtices) com o objetivo de relacioná-los ao crescimento ou não do aneurisma e, posteriormente, compará-los com os dados clínicos dos pacientes. O teste de Kolmogorov-Smirnov foi utilizado para avaliar a normalidade da amostra e o teste não-paramétrico Wilcoxon signed-rank foi aplicado para comparações de dados pareados entre os ângulos aórticos. A significância estatística foi fixada em 5%. RESULTADOS: Para o grupo que apresentou crescimento do aneurisma, a incidência do jato na parede aórtica gerou áreas de recirculação posterior ao jato, induzindo à formação de vórtices complexos, ocasionando um incremento na pressão média no endotélio aórtico. O grupo sem crescimento do aneurisma apresentou diminuição na pressão média. CONCLUSÃO: Este estudo piloto mostrou que a CFD baseada em ATC pode, em um futuro próximo, ser uma ferramenta auxiliar na identificação dos padrões de fluxo associados ao processo de remodelamento de AAAs.

Uncovering the Bioactivity of Aurantiochytrium sp.: a Comparison of Extraction Methodologies.

Aurantiochytrium sp. is an emerging alternative source of polyunsaturated fatty acids (PUFAs), docosahexaenoic acid (DHA), and squalene, playing an important role in the phasing out of traditional fish sources for these compounds. Novel lipid extraction techniques with a focus on sustainability and low environmental footprint are being developed for this organism, but the exploration of other added-value compounds within it is still very limited. In this work, a combination of novel green extraction techniques (high hydrostatic pressure extraction (HPE) and supercritical fluid extraction (SFE)) and traditional techniques (organic solvent Soxhlet extraction and hydrodistillation (HD)) was used to obtain lipophilic extracts of Aurantiochytrium sp., which were then screened for antioxidant (DPPH radical reduction capacity and ferric-reducing antioxidant potential (FRAP) assays), lipid oxidation protection, antimicrobial, anti-aging enzyme inhibition (collagenase, elastase and hyaluronidase), and anti-inflammatory (inhibition of NO production) activities. The screening revealed promising extracts in nearly all categories of biological activity tested, with only the enzymatic inhibition being low in all extracts. Powerful lipid oxidation protection and anti-inflammatory activity were observed in most SFE samples. Ethanolic HPEs inhibited both lipid oxidation reactions and microbial growth. The HD extract demonstrated high antioxidant, antimicrobial, and anti-inflammatory activities making, it a major contender for further studies aiming at the valorization of Aurantiochytrium sp. Taken together, this study presents compelling evidence of the bioactive potential of Aurantiochytrium sp. and encourages further exploration of its composition and application.

Fluidodinâmica Computacional na Avaliação do Risco Futuro de Aneurismas de Aorta Ascendente / Computational Fluid Dynamics to Assess the Future Risk of Ascending Aortic Aneurysms

Resumo Fundamentos Uma metodologia para identificação de pacientes portadores de aneurisma de aorta ascendente (AAAs) sob alto risco de remodelamento aórtico não está completamente definida. Objetivo Esta pesquisa objetiva caracterizar numericamente o fluxo sanguíneo aórtico, relacionando a distribuição do estresse mecânico resultante com o crescimento de AAAs. Métodos Estudo analítico, observacional, unicêntrico, em que um protocolo de fluidodinâmica computacional (CFD - Computacional Fluid Dynamics) foi aplicado a imagens de angiotomografia computadorizada (ATC) de aorta de pacientes portadores de AAAs. Duas ATC de aorta com pelo menos um ano de intervalo foram obtidas. Dados clínicos dos pacientes foram registrados e, a partir das imagens de ATC, foram gerados modelos tridimensionais. Foram realizados estudos do campo de velocidade e estruturas coerentes (vórtices) com o objetivo de relacioná-los ao crescimento ou não do aneurisma e, posteriormente, compará-los com os dados clínicos dos pacientes. O teste de Kolmogorov-Smirnov foi utilizado para avaliar a normalidade da amostra e o teste não-paramétrico Wilcoxon signed-rank foi aplicado para comparações de dados pareados entre os ângulos aórticos. A significância estatística foi fixada em 5%. Resultados Para o grupo que apresentou crescimento do aneurisma, a incidência do jato na parede aórtica gerou áreas de recirculação posterior ao jato, induzindo à formação de vórtices complexos, ocasionando um incremento na pressão média no endotélio aórtico. O grupo sem crescimento do aneurisma apresentou diminuição na pressão média. Conclusão Este estudo piloto mostrou que a CFD baseada em ATC pode, em um futuro próximo, ser uma ferramenta auxiliar na identificação dos padrões de fluxo associados ao processo de remodelamento de AAAs.

Abstract Background A methodology to identify patients with ascending aortic aneurysm (AsAA) under high risk for aortic growth is not completely defined Objetive This research seeks to numerically characterize the aortic blood flow by relating the resulting mechanical stress distribution with AsAA growth. Methods Analytical, observational, single-center study in which a computational fluid dynamics (CFD) protocol was applied to aortic computed tomography angiogram (CTA) images of patients with AsAA. Two CTA exams taken at a minimum interval of one year were obtained. From the CTA-gathered images, three-dimensional models were built, and clinical data were registered. Study of velocity field and coherent structures (vortices) was performed aiming to relate them to the presence or absence of aneurysm growth, as well as comparing them to the patients' clinical data. The Kolmogorov-Smirnov test was used to evaluate the normality of the distribution, and the non-parametric Wilcoxon signed-rank test, for non-normal distribution, was used to compare the paired data of the aortic angles. Statistical significance was set at 5%. Results The incident jet in the aortic wall generated recirculation areas in the posterior region of the jet, inducing complex vortices formation in the group with aneurysm growth, leading to an average pressure increase in the ascending aortic wall between exams. In the group without aneurysm growth, the average pressure decreased. Conclusion This pilot study showed that CFD based on CTA may in the near future be a tool to help identify flow patterns associated with AsAA remodeling process.

Evaluating the Potential of the Defatted By-Product of Aurantiochytrium sp. Industrial Cultivation as a Functional Food.

While Aurantiochytrium sp. is an increasingly popular source of polyunsaturated fatty acids (PUFAs), its extraction generates high amounts of waste, including the spent, defatted residue. The composition and bioactivities of this by-product could prove to be a major part of the sustainable valorisation of this organism within the framework of a circular economy. In this study, the defatted biomass of commercial Aurantiochytrium sp. was nutritionally characterised, and its amino acid profile was detailed. Additionally, the antioxidant and prebiotic potentials of an enzymatically digested sample of defatted Aurantiochytrium sp. were evaluated under a set of miniaturised in vitro assays. The nutritional profile of the spent Aurantiochytrium biomass revealed a protein and dietary-fibre rich product, with values reaching 26.7% and 31.0% for each, respectively. It also held high concentrations of glutamic and aspartic acid, as well as a favourable lysine/arginine ratio of 3.73. The digested samples demonstrated significant Weissela cibaria and Bifidobacterium bifidum growth-enhancing potential. Residual ferric reducing antioxidant power (FRAP) activity was likely attributed to antioxidant amino acids or peptides. The study demonstrated that some of the nutritional and functional potential that reside in the defatted Aurantiochytrium sp. waste encourages additional studies and the development of food supplements employing this resource's by-products under a biorefinery framework.

Histomorphometric evaluation of human extraction sockets treated with autologous fibrin, sticky bone or biphasic calcium phosphate.

It is essential to maintain the alveolar bone ridge to ensure the success of implant therapy. Platelet-rich fibrin (PRF) may benefit bone repair, but its quantitative microscopic results are still inconclusive. The aim of this study was to histomorphometrically analyze human dental alveoli after extraction treated with autologous fibrin, biphasic calcium phosphate or sticky bone. The sample consisted of healthy adult volunteer patients, with clinical and tomographic indication for single post-extraction graft of upper premolars for maintenance of the alveolar ridge and subsequent implantation. The 10 remaining patients in the study were divided into three groups according to the type of filling used in the dental socket: autologous PRF plug covered by a PRF membrane (G1), PRF associated with an alloplastic graft based on hydroxyapatite with beta tricalcium phosphate covered by a collagen membrane (G2) or alloplastic graft based on beta tricalcium phosphate covered by collagen membrane (control). After 8 months, bone biopsies were performed at the grafted sites and the patients underwent implant-prosthetic rehabilitation. Paraffin-embedded tissue blocks were routinely processed and sectionsfrom different depths were mounted in 3 slides and stained with HE. The histomorphometric evaluation analyzed 30 photomicrographs per block, quantifying the percentage presence of newly formed bone, connective tissue and remaining biomaterial using the ImageJ software. Parametric data enabled intergroup comparisons using ANOVA and Tukey's post-hoc test for multiple comparison with statistical significance of 5% (p<0.05), with normality of the 3 groups by the Jarque-Bera test (p>0.05). There was a higher mean of newly formed bone in G1 (68.83%) compared to G2 (35.69%) and control (16.28%). There was greater presence of connective tissue in the control (61.56%). Remaining biomaterial was higher in G2 (15.75%), but did not differ statistically from the control. Bone regeneration obtained with PRF alone or sticky bone suggests the efficacy of these therapies, encouraging the clinical use of this blood concentrate in dental procedures.

A manutenção do rebordo ósseo alveolar é prerrogativa para o sucesso da terapia com implantes. A fibrina rica em plaquetas (PRF) poderia beneficiar o reparo ósseo, mas seus resultados microscópicos quantitativos são ainda inconclusivos. O objetivo deste trabalho foi analisar histomorfometricamente alvéolos dentários humanos pós-extração tratados com fibrina autóloga, fosfato de cálcio bifásico ou sua associação. A amostra consistiu de pacientes adultos voluntários saudáveis, com indicação clínica e tomográfica de enxerto unitário pós-exodontia de pré-molares superiores para manutenção de rebordo alveolar e posterior implante. Os 10 pacientes remanescentes no estudo foram divididos em 3 grupos de acordo com o tipo de preenchimento usado no alvéolo dentário: plug de PRF autóloga recoberto por membrana de PRF (G1), PRF associada a enxerto aloplástico de hidroxiapatita com beta fosfato tricálcio recoberto por membrana de colágeno (G2) ou enxerto aloplástico de beta fosfato tricálcio recoberto por membrana de colágeno (controle). Após 8 meses, foram realizadas biópsias ósseas nos locais enxertados e os pacientes seguiram a reabilitação implanto-protético. Blocos histológicos incluídos em parafina foram microtomizados para gerar 3 lâminas de secções em diferentes profundidades, que foram coradas em HE. A avaliação histomorfométrica analisou 30 fotomicrografias por bloco, quantificando a presença percentual de osso neoformado, tecido conjuntivo e biomaterial remanescente pelo programa ImageJ. Os dados paramétricos permitiram comparações intergrupos usando ANOVA e pós-teste de comparações múltiplas de Tukey com significância estatística de 5% (p<0,05), havendo normalidade dos 3 grupos pelo teste Jarque-Bera (p>0,05). Houve maior média de osso neoformado em G1 (68,83%) em comparação a G2 (35,69%) e controle (16,28%). Houve maior presença de tecido conjuntivo no controle (61,56 %). Biomaterial remanescente foi maior em G2 (15,75%), mas não diferiu estatisticamente para o controle. A regeneração óssea obtida com PRF isolada ou em associação sugere a eficácia destas terapias, encorajando o uso clínico deste concentrado sanguíneo em procedimentos odontológicos.

Histomorphometric evaluation of human extraction sockets treated with autologous fibrin, sticky bone or biphasic calcium phosphate / Avaliação histomorfométrica de alvéolos dentários humanos pós-extração tratados com fibrina autóloga, aglutinado ósseo ou fosfato de cálcio bifásico

ABSTRACT It is essential to maintain the alveolar bone ridge to ensure the success of implant therapy. Platelet-rich fibrin (PRF) may benefit bone repair, but its quantitative microscopic results are still inconclusive. The aim of this study was to histomorphometrically analyze human dental alveoli after extraction treated with autologous fibrin, biphasic calcium phosphate or sticky bone. The sample consisted of healthy adult volunteer patients, with clinical and tomographic indication for single post-extraction graft of upper premolars for maintenance of the alveolar ridge and subsequent implantation. The 10 remaining patients in the study were divided into three groups according to the type of filling used in the dental socket: autologous PRF plug covered by a PRF membrane (G1), PRF associated with an alloplastic graft based on hydroxyapatite with beta tricalcium phosphate covered by a collagen membrane (G2) or alloplastic graft based on beta tricalcium phosphate covered by collagen membrane (control). After 8 months, bone biopsies were performed at the grafted sites and the patients underwent implant-prosthetic rehabilitation. Paraffin-embedded tissue blocks were routinely processed and sectionsfrom different depths were mounted in 3 slides and stained with HE. The histomorphometric evaluation analyzed 30 photomicrographs per block, quantifying the percentage presence of newly formed bone, connective tissue and remaining biomaterial using the ImageJ software. Parametric data enabled intergroup comparisons using ANOVA and Tukey's post-hoc test for multiple comparison with statistical significance of 5% (p<0.05), with normality of the 3 groups by the Jarque-Bera test (p>0.05). There was a higher mean of newly formed bone in G1 (68.83%) compared to G2 (35.69%) and control (16.28%). There was greater presence of connective tissue in the control (61.56%). Remaining biomaterial was higher in G2 (15.75%), but did not differ statistically from the control. Bone regeneration obtained with PRF alone or sticky bone suggests the efficacy of these therapies, encouraging the clinical use of this blood concentrate in dental procedures.

RESUMO A manutenção do rebordo ósseo alveolar é prerrogativa para o sucesso da terapia com implantes. A fibrina rica em plaquetas (PRF) poderia beneficiar o reparo ósseo, mas seus resultados microscópicos quantitativos são ainda inconclusivos. O objetivo deste trabalho foi analisar histomorfometricamente alvéolos dentários humanos pós-extração tratados com fibrina autóloga, fosfato de cálcio bifásico ou sua associação. A amostra consistiu de pacientes adultos voluntários saudáveis, com indicação clínica e tomográfica de enxerto unitário pós-exodontia de pré-molares superiores para manutenção de rebordo alveolar e posterior implante. Os 10 pacientes remanescentes no estudo foram divididos em 3 grupos de acordo com o tipo de preenchimento usado no alvéolo dentário: plug de PRF autóloga recoberto por membrana de PRF (G1), PRF associada a enxerto aloplástico de hidroxiapatita com beta fosfato tricálcio recoberto por membrana de colágeno (G2) ou enxerto aloplástico de beta fosfato tricálcio recoberto por membrana de colágeno (controle). Após 8 meses, foram realizadas biópsias ósseas nos locais enxertados e os pacientes seguiram a reabilitação implanto-protético. Blocos histológicos incluídos em parafina foram microtomizados para gerar 3 lâminas de secções em diferentes profundidades, que foram coradas em HE. A avaliação histomorfométrica analisou 30 fotomicrografias por bloco, quantificando a presença percentual de osso neoformado, tecido conjuntivo e biomaterial remanescente pelo programa ImageJ. Os dados paramétricos permitiram comparações intergrupos usando ANOVA e pós-teste de comparações múltiplas de Tukey com significância estatística de 5% (p<0,05), havendo normalidade dos 3 grupos pelo teste Jarque-Bera (p>0,05). Houve maior média de osso neoformado em G1 (68,83%) em comparação a G2 (35,69%) e controle (16,28%). Houve maior presença de tecido conjuntivo no controle (61,56 %). Biomaterial remanescente foi maior em G2 (15,75%), mas não diferiu estatisticamente para o controle. A regeneração óssea obtida com PRF isolada ou em associação sugere a eficácia destas terapias, encorajando o uso clínico deste concentrado sanguíneo em procedimentos odontológicos.

Brazilian dentists' perceptions of using bone grafts: an inland survey / Uso de enxertos ósseos na percepção de cirurgiòes-dentistas do interior do Brasil

ABSTRACT Pre-clinical assessments of bone substitute materials are frequent in the literature, but research papers about the clinical situation of bone graft use and consumer market acceptance are rare. The aim of this study was to evaluate the dental use of bone grafts according to the perception of dentists in the city of Sobral, Brazil. We interviewed 183 professionals and analyzed their professional data, knowledge of the subject, specific use, and opinions on cost-effectiveness and biosafety. Most of the respondents had 10 years ' or less experience in the profession, and lacked specialization though they had been familiar with the subject since they graduated. The most frequently mentioned compositions were ceramics, followed by composites. Only a quarter of the respondents had performed bone grafts, generally with up to 50 cases, with the most frequent applications being using simultaneously with a dental implant, fresh dental sockets and maxillary sinus lifting. Autogenous and xenogeneic grafts were more frequent than alloplastic and allogeneic; ceramics were the most frequently used composition, and the association of bone graft with membrane was more frequent than bone graft alone or associated with autologous fibrin. Professional and patient satisfaction was high, cost was considered moderate, and differences were found regarding patient participation in the choice and country of origin of the product. Bone grafts were used more often in the private than public service. Dentists stated that they follow the instructions. Inflammatory or infectious complications were found to be related to the frequency of the procedure performed and safety regarding the origin. Opinions were favorable regarding the use of grafts derived from animals and unfavorable to grafts derived from cadavers. Very few respondents were registered in human bone tissue banks. The good level of acceptance for dental use of bone grafts in a Brazilian inland city provides a promising scenario for the development of the sector.

RESUMO Avaliações pré-clínicas sobre materiais osseosubstitutos sao frequentes na literatura, mas sao raras pesquisas sobre o panorama clínico de uso de enxertos ósseos e aceitação do mercado consumidor. O objetivo deste estudo foi avaliar o uso odontológico de enxertos ósseos na percepção de dentistas da cidade de Sobral, Brasil. Foram entrevistados 183 profissionais e analisados dados profissionais, conhecimento temático, uso específico, relação custo-efetividade e biosseguranga. A maioria dos cirurgioes-dentistas exibiu até 10 anos na profissao, ausencia de especialização, porém familiaridade com a temática desde a graduação. As cerámicas, seguidas de compósitos, compu-seram as composições mais citadas. Apenas um quarto dos ci-rurgioes-dentistas já realizaram enxertos ósseos, em geral com realização de até 50 casos, com maior tendencia de aplicação em alvéolo dentário fresco, simultánea a implante dentário e para levantamento de seio maxilar. As origens autógena e xenó-gena tiveram maior destaque do que aloplástica e alógena, as cerámicas foram a composição mais usada e a associação do enxerto ósseo com membrana foi mais frequente do que enxerto ósseo sozinho ou associado á fibrina autóloga. A satisfação do profissional e paciente foi alta, o custo considerado moderado, havendo diferengas quanto a participação do paciente na escol-ha e no país de origem do produto, com maior uso no servigo privado do que no público. Os dentistas afirmaram seguirem a bula, que as complicações inflamatórias ou infecciosas estao relacionadas com a frequencia de procedimento realizado e se-guranga quanto á origem. Houve opiniao favorável ao uso de enxertos derivados de animais e desfavorável ao de cadáveres, havendo raros profissionais cadastrados em bancos de tecidos ósseos humanos. A boa aceitação para uso odontológico de enxertos ósseos em cidade do interior do Brasil configura um cenário promissor para o desenvolvimento do setor.

Brazilian dentists' perceptions of using bone grafts: an inland survey.

Pre-clinical assessments of bone substitute materials are frequent in the literature, but research papers about the clinical situation of bone graft use and consumer market acceptance are rare. The aim of this study was to evaluate the dental use of bone grafts according to the perception of dentists in the city of Sobral, Brazil. We interviewed 183 professionals and analyzed their professional data, knowledge of the subject, specific use, and opinions on cost-effectiveness and biosafety. Most of the respondents had 10 years' or less experience in the profession, and lacked specialization though they had been familiar with the subject since they graduated. The most frequently mentioned compositions were ceramics, followed by composites. Only a quarter of the respondents had performed bone grafts, generally with up to 50 cases, with the most frequent applications being using simultaneously with a dental implant, fresh dental sockets and maxillary sinus lifting. Autogenous and xenogeneic grafts were more frequent than alloplastic and allogeneic; ceramics were the most frequently used composition, and the association of bone graft with membrane was more frequent than bone graft alone or associated with autologous fibrin. Professional and patient satisfaction was high, cost was considered moderate, and differences were found regarding patient participation in the choice and country of origin of the product. Bone grafts were used more often in the private than public service. Dentists stated that they follow the instructions. Inflammatory or infectious complications were found to be related to the frequency of the procedure performed and safety regarding the origin. Opinions were favorable regarding the use of grafts derived from animals and unfavorable to grafts derived from cadavers. Very few respondents were registered in human bone tissue banks. The good level of acceptance for dental use of bone grafts in a Brazilian inland city provides a promising scenario for the development of the sector.

Avaliações pré-clínicas sobre materiais osseosubstitutos são frequentes na literatura, mas são raras pesquisas sobre o panorama clínico de uso de enxertos ósseos e aceitação do mercado consumidor. O objetivo deste estudo foi avaliar o uso odontológico de enxertos ósseos na percepção de dentistas da cidade de Sobral, Brasil. Foram entrevistados 183 profissionais e analisados dados profissionais, conhecimento temático, uso específico, relação custo-efetividade e biossegurança. A maioria dos cirurgiões-dentistas exibiu até 10 anos na profissão, ausência de especialização, porém familiaridade com a temática desde a graduação. As cerâmicas, seguidas de compósitos, compuseram as composições mais citadas. Apenas um quarto dos cirurgiões- dentistas já realizaram enxertos ósseos, em geral com realização de até 50 casos, com maior tendência de aplicação em alvéolo dentário fresco, simultânea a implante dentário e para levantamento de seio maxilar. As origens autógena e xenógena tiveram maior destaque do que aloplástica e alógena, as cerâmicas foram a composição mais usada e a associação do enxerto ósseo com membrana foi mais frequente do que enxerto ósseo sozinho ou associado à fibrina autóloga. A satisfação do profissional e paciente foi alta, o custo considerado moderado, havendo diferenças quanto a participação do paciente na escolha e no país de origem do produto, com maior uso no serviço privado do que no público. Os dentistas afirmaram seguirem a bula, que as complicações inflamatórias ou infecciosas estão relacionadas com a frequência de procedimento realizado e segurança quanto à origem. Houve opinião favorável ao uso de enxertos derivados de animais e desfavorável ao de cadáveres, havendo raros profissionais cadastrados em bancos de tecidos ósseos humanos. A boa aceitação para uso odontológico de enxertos ósseos em cidade do interior do Brasil configura um cenário promissor para o desenvolvimento do setor.