Comprehensive Development of a Cellulose Acetate and Soy Protein-Based Scaffold for Nerve Regeneration.

BACKGROUND: The elaboration of biocompatible nerve guide conduits (NGCs) has been studied in recent years as a treatment for total nerve rupture lesions (axonotmesis). Different natural polymers have been used in these studies, including cellulose associated with soy protein. The purpose of this report was to describe manufacturing NGCs suitable for nerve regeneration using the method of dip coating and evaporation of solvent with cellulose acetate (CA) functionalized with soy protein acid hydrolysate (SPAH). METHODS: The manufacturing method and bacterial control precautions for the CA/SPAH NGCs were described. The structure of the NGCs was analyzed under a scanning electron microscope (SEM); porosity was analyzed with a degassing method using a porosimeter. Schwann cell (SCL 4.1/F7) biocompatibility of cell-seeded nerve guide conduits was evaluated with the MTT assay. RESULTS: The method employed allowed an easy elaboration and customization of NGCs, free of bacteria, with pores in the internal surface, and the uniform wall thickness allowed manipulation, which showed flexibility; additionally, the sample was suturable. The NGCs showed initial biocompatibility with Schwann cells, revealing cells adhered to the NGC structure after 5 days. CONCLUSIONS: The fabricated CA/SPAH NGCs showed adequate features to be used for peripheral nerve regeneration studies. Future reports are necessary to discuss the ideal concentration of CA and SPAH and the mechanical and physicochemical properties of this biomaterial.

Exploring Schwann Cell Behavior on Electrospun Polyhydroxybutyrate Scaffolds with Varied Pore Sizes and Fiber Thicknesses: Implications for Neural Tissue Engineering.

The placement of a polymeric electrospun scaffold is among the most promising strategies to improve nerve regeneration after critical neurotmesis. It is of great interest to investigate the effect of these structures on Schwann cells (SCs), as these cells lead nerve regeneration and functional recovery. The aim of this study was to assess SC viability and morphology when cultured on polyhydroxybutyrate (PHB) electrospun scaffolds with varied microfiber thicknesses and pore sizes. Six electrospun scaffolds were obtained using different PHB solutions and electrospinning parameters. All the scaffolds were morphologically characterized in terms of fiber thickness, pore size, and overall appearance by analyzing their SEM images. SCs seeded onto the scaffolds were analyzed in terms of viability and morphology throughout the culture period through MTT assay and SEM imaging. The SCs were cultured on three scaffolds with homogeneous smooth fibers (fiber thicknesses: 2.4 µm, 3.1 µm, and 4.3 µm; pore sizes: 16.7 µm, 22.4 µm, and 27.8 µm). SC infiltration and adhesion resulted in the formation of a three-dimensional network composed of intertwined fibers and cells. The SCs attached to the scaffolds maintained their characteristic shape and size throughout the culture period. Bigger pores and thicker fibers resulted in higher SC viability.

Effects of Low-Level Laser Therapy and Purified Natural Latex (Hevea brasiliensis) Protein on Injured Sciatic Nerve in Rodents: Morpho-Functional Analysis.

The present study analyzed the effects of low-level laser therapy (LLLT) and the purified natural latex protein (Hevea brasiliensis, F1 protein) on the morpho-function of sciatic nerve crush injuries in rats. One-hundred and eight male Wistar rats were randomly allocated to six groups (n = 18): 1. Control; 2. Exposed (nerve exposed); 3. Injury (injured nerve without treatment); 4. LLLT (injured nerve irradiated with LLLT (15 J/cm2, 780 nm)); 5. F1 (injured nerve treated with F1 protein (0.1%)); and 6. LLLT + F1 (injured nerve treated with LLLT and F1). On the 1st, 7th, 14th, and 56th days after injury, a functional sensory analysis of mechanical allodynia and mechanical hyperalgesia and a motor analysis of grip strength and gait were performed. After 3, 15, and 57 days, the animals were euthanized for morphometric/ultrastructural analyses. The treatments applied revealed improvements in morphometric/ultrastructural parameters compared to the injured group. Sensory analyses suggested that the improvements observed were associated with time progression and not influenced by the treatments. Motor analyses revealed significant improvements in grip strength from the 7th day in the LLLT group and in gait from the 56th day in all treated groups. We concluded that even though the morphological analyses showed improvements with the treatments, they did not influence sensory recovery, and LLLT improved motor recovery.

Brainstem Modulates Parkinsonism-Induced Orofacial Sensorimotor Dysfunctions.

Parkinson's Disease (PD), treated with the dopamine precursor l-3,4-dihydroxyphenylalanine (L-DOPA), displays motor and non-motor orofacial manifestations. We investigated the pathophysiologic mechanisms of the lateral pterygoid muscles (LPMs) and the trigeminal system related to PD-induced orofacial manifestations. A PD rat model was produced by unilateral injection of 6-hydroxydopamine into the medial forebrain bundle. Abnormal involuntary movements (dyskinesia) and nociceptive responses were determined. We analyzed the immunodetection of Fos-B and microglia/astrocytes in trigeminal and facial nuclei and morphological markers in the LPMs. Hyperalgesia response was increased in hemiparkinsonian and dyskinetic rats. Hemiparkinsonism increased slow skeletal myosin fibers in the LPMs, while in the dyskinetic ones, these fibers decreased in the contralateral side of the lesion. Bilateral increased glycolytic metabolism and an inflammatory muscle profile were detected in dyskinetic rats. There was increased Fos-B expression in the spinal nucleus of lesioned rats and in the motor and facial nucleus in L-DOPA-induced dyskinetic rats in the contralateral side of the lesion. Glial cells were increased in the facial nucleus on the contralateral side of the lesion. Overall, spinal trigeminal nucleus activation may be associated with orofacial sensorial impairment in Parkinsonian rats, while a fatigue profile on LPMs is suggested in L-DOPA-induced dyskinesia when the motor and facial nucleus are activated.

Carrier systems for bone morphogenetic proteins: An overview of biomaterials used for dentoalveolar and maxillofacial bone regeneration.

Different types of biomaterials have been used to fabricate carriers to deliver bone morphogenetic proteins (BMPs) in both dentoalveolar and maxillofacial bone regeneration procedures. Despite that absorbable collagen sponge (ACS) is considered the gold standard for BMP delivery, there is still some concerns regarding its use mainly due to its poor mechanical properties. To overcome this, novel systems are being developed, however, due to the wide variety of biomaterial combination, the heterogeneous assessment of newly formed tissue, and the intended clinical applications, there is still no consensus regarding which is more efficient in a particular clinical scenario. The combination of two or more biomaterials in different topological configurations has allowed specific controlled-release patterns for BMPs, improving their biological and mechanical properties compared with classical single-material carriers. However, more basic research is needed. Since the BMPs can be used in multiple clinical scenarios having different biological and mechanical needs, novel carriers should be developed in a context-specific manner. Thus, the purpose of this review is to gather current knowledge about biomaterials used to fabricate delivery systems for BMPs in both dentoalveolar and maxillofacial contexts. Aspects related with the biological, physical and mechanical characteristics of each biomaterial are also presented and discussed.

Analysis of the Chemical Composition and Morphological Characterization of Tissue Osseointegrated to a Dental Implant after 5 Years of Function.

Osseointegration implies the coexistence of a biocompatible implant subjected to masticatory loads and living bone tissue adhered to its surface; this interaction is a critical process for the success of implants. The objective of this work is to analyze the osseoformation and osseointegration of a dental implant in operation for 5 years microscopically through morphological analysis of the surface and chemical composition through a variable pressure scanning electron microscope (VP-SEM) and energy dispersive X-ray spectrometry (EDX). The chemical composition and general characteristics of the structural morphology of random areas of the surfaces of an osseointegrated dental implant from an ex vivo sample were analyzed. On the surface of the implant free of bone tissue, titanium (TI) was mainly identified in the area of the implant threads and carbon (C) in the depth of the implant threads. Phosphorus (P), calcium (Ca), oxygen (O), carbon (C), with dense and homogeneous distribution, and, to a lesser extent, sodium (Na) were detected on the bone surface around the contour of the implant. Regarding the morphological characteristics of the implant surface, a rough structure with some irregularities and detachments of the implant lodged in the bone tissue was observed. Microscopic analysis showed calcified bone tissue distributed in an orderly manner on the coronal and medial surface and sinuous and irregular in the apical area, with the presence of red blood cells. The composition of the implant allows a dynamic process of bone remodeling and regeneration subject to the biological and mechanical needs of the operation. Dental implants are shown to have exceptional and long-lasting biocompatibility that enables the formation of mature peri-implant bone tissue.

Polyhydroxybutyrate (PHB) Scaffolds for Peripheral Nerve Regeneration: A Systematic Review of Animal Models.

In the last two decades, artificial scaffolds for nerve regeneration have been produced using a variety of polymers. Polyhydroxybutyrate (PHB) is a natural polyester that can be easily processed and offer several advantages; hence, the purpose of this review is to provide a better understanding of the efficacy of therapeutic approaches involving PHB scaffolds in promoting peripheral nerve regeneration following nerve dissection in animal models. A systematic literature review was performed following the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" (PRISMA) criteria. The revised databases were: Pub-Med/MEDLINE, Web of Science, Science Direct, EMBASE, and SCOPUS. Sixteen studies were included in this review. Different animal models and nerves were studied. Extension of nerve gaps reconnected by PHB scaffolds and the time periods of analysis were varied. The additives included in the scaffolds, if any, were growth factors, neurotrophins, other biopolymers, and neural progenitor cells. The analysis of the quality of the studies revealed good quality in general, with some aspects that could be improved. The analysis of the risk of bias revealed several weaknesses in all studies. The use of PHB as a biomaterial to prepare tubular scaffolds for nerve regeneration was shown to be promising. The incorporation of additives appears to be a trend that improves nerve regeneration. One of the main weaknesses of the reviewed articles was the lack of standardized experimentation on animals. It is recommended to follow the currently available guidelines to improve the design, avoid the risk of bias, maximize the quality of studies, and enhance translationality.

Optimal Morphometric Characteristics of a Tubular Polymeric Scaffold to Promote Peripheral Nerve Regeneration: A Scoping Review.

Cellular behavior in nerve regeneration is affected by the architecture of the polymeric nerve guide conduits (NGCs); therefore, design features of polymeric NGCs are critical for neural tissue engineering. Hence, the purpose of this scoping review is to summarize the adequate quantitative/morphometric parameters of the characteristics of NGC that provide a supportive environment for nerve regeneration, enhancing the understanding of a previous study. 394 studies were found, of which 29 studies were selected. The selected studies revealed four morphometric characteristics for promoting nerve regeneration: wall thickness, fiber size, pore size, and porosity. An NGC with a wall thickness between 250-400 µm and porosity of 60-80%, with a small pore on the inner surface and a large pore on the outer surface, significantly favored nerve regeneration; resulting in an increase in nutrient permeability, retention of neurotrophic factors, and optimal mechanical properties. On the other hand, the superiority of electrospun fibers is described; however, the size of the fiber is controversial in the literature, obtaining optimal results in the range of 300 nm to 30 µm. The incorporation of these optimal morphometric characteristics will encourage nerve regeneration and help reduce the number of experimental studies as it will provide the initial morphometric parameters for the preparation of an NGC.

Methods to Characterize Electrospun Scaffold Morphology: A Critical Review.

Electrospun scaffolds can imitate the hierarchical structures present in the extracellular matrix, representing one of the main concerns of modern tissue engineering. They are characterized in order to evaluate their capability to support cells or to provide guidelines for reproducibility. The issues with widely used methods for morphological characterization are discussed in order to provide insight into a desirable methodology for electrospun scaffold characterization. Reported methods include imaging and physical measurements. Characterization methods harbor inherent limitations and benefits, and these are discussed and presented in a comprehensive selection matrix to provide researchers with the adequate tools and insights required to characterize their electrospun scaffolds. It is shown that imaging methods present the most benefits, with drawbacks being limited to required costs and expertise. By making use of more appropriate characterization, researchers will avoid measurements that do not represent their scaffolds and perhaps might discover that they can extract more characteristics from their scaffold at no further cost.

How Fiber Surface Topography Affects Interactions between Cells and Electrospun Scaffolds: A Systematic Review.

Electrospun scaffolds have a 3D fibrous structure that attempts to imitate the extracellular matrix in order to be able to host cells. It has been reported in the literature that controlling fiber surface topography produces varying results regarding cell-scaffold interactions. This review analyzes the relevant literature concerning in vitro studies to provide a better understanding of the effect that controlling fiber surface topography has on cell-scaffold interactions. A systematic approach following PRISMA, GRADE, PICO, and other standard methodological frameworks for systematic reviews was used. Different topographic interventions and their effects on cell-scaffold interactions were analyzed. Results indicate that nanopores and roughness on fiber surfaces seem to improve proliferation and adhesion of cells. The quality of the evidence is different for each studied cell-scaffold interaction, and for each studied morphological attribute. The evidence points to improvements in cell-scaffold interactions on most morphologically complex fiber surfaces. The discussion includes an in-depth evaluation of the indirectness of the evidence, as well as the potentially involved publication bias. Insights and suggestions about dose-dependency relationship, as well as the effect on particular cell and polymer types, are presented. It is concluded that topographical alterations to the fiber surface should be further studied, since results so far are promising.

Transcutaneous Electrical Nerve Stimulation in Nerve Regeneration: A Systematic Review of In Vivo Animal Model Studies.

OBJECTIVE: Transcutaneous electrical nerve stimulation (TENS) is a noninvasive electrical stimulation therapy indicated for pain control that has been applied for the regeneration of nerves. This systematic review aimed to analyze the evidence on TENS effectiveness on nerve regeneration. MATERIALS AND METHODS: A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria: PubMed/MEDLINE, Web of Science, ScienceDirect, and SciELO data bases. Primary research that evaluated TENS on nerve regeneration was considered. RESULTS: Several studies have investigated the use of TENS for pain treatment. A total of six animal studies analyzed TENS for nerve regeneration. The selected articles showed high quality (Animal Research: Reporting of In Vivo Experiments guidelines), with many unclear points related to bias opportunities (Systematic Review Center for Laboratory Animal Experimentation Risk of Bias tool). In general, TENS accelerated functional and motor recovery and increased axon quantity and diameter. More specifically, the application of low-frequency TENS resulted in a continuous basal lamina; a higher density of fibers with normal diameters, indicating normal myelination, showed signs of deterioration and delayed nerve regeneration. In contrast, the high-frequency TENS application stimulated motor regeneration and increased the diameter of the regenerated axons but revealed a small number of axons, demyelination, dark axoplasm, and an increase in the predisposition of neuropathic pain. CONCLUSIONS: Although there is some heterogeneous evidence in animal research, TENS seems to be a promising treatment for nerve injury that should be better explored. It is still necessary to improve the analysis of its application parameters, which can lead to the most satisfactory regeneration results and improve the understanding of its mechanisms on peripheral nerve regeneration.

Clinical evaluation of single 4-mm implants in the posterior mandible: A 3-year follow-up pilot study.

STATEMENT OF PROBLEM: Extra-short implants in the posterior mandible can increase the functional surface area and reduce the risk of implant overload. However, reports of treatment using single extra-short implants in the posterior mandible with a midterm follow-up are lacking. PURPOSE: The purpose of this prospective pilot study was to evaluate the clinical behavior of single extra-short 4-mm implants placed in the posterior mandible during a follow-up of 3 years from implant restoration. MATERIAL AND METHODS: A total of 18 participants with a single extra-short 4-mm-long implant placed in the area of the mandibular first molars participated in this pilot study. The survival and success rates of implants, as well as biologic and prosthetic variables, were evaluated during a follow-up of 3 years from implant restoration. RESULTS: The survival rate of the implants was 100%, with no implant or biologic complications recorded. One prosthetic complication (loosening of 1 screw) was observed. CONCLUSIONS: Single extra-short (4 mm) implants in the posterior mandible showed favorable clinical behavior during the first 3-years of follow-up.

Main Morphological Characteristics of Tubular Polymeric Scaffolds to Promote Peripheral Nerve Regeneration-A Scoping Review.

The "nerve guide conduits" (NGC) used in nerve regeneration must mimic the natural environment for proper cell behavior. OBJECTIVE: To describe the main morphological characteristics of polymeric NGC to promote nerve regeneration. METHODS: A scoping review was performed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) criteria in the PubMed, Web of Science, Science Direct, and Scientific Electronic Library Online (SciELO) databases. Primary studies that considered/evaluated morphological characteristics of NGC to promote nerve regeneration were included. RESULT: A total of 704 studies were found, of which 52 were selected. The NGC main morphological characteristics found in the literature were: (I) NGC diameter affects the mechanical properties of the scaffold. (II) Wall thickness of NGC determines the exchange of nutrients, molecules, and neurotrophins between the internal and external environment; and influences the mechanical properties and biodegradation, similarly to NGC (III) porosity, (IV) pore size, and (V) pore distribution. The (VI) alignment of the NGC fibers influences the phenotype of cells involved in nerve regeneration. In addition, the (VII) thickness of the polymeric fiber influences neurite extension and orientation. CONCLUSIONS: An NGC should have its diameter adjusted to the nerve with wall thickness, porosity, pore size, and distribution of pores, to favor vascularization, permeability, and exchange of nutrients, and retention of neurotrophic factors, also favoring its mechanical properties and biodegradability.

Symmetry of mandibular movements: A 3D electromagnetic articulography technique applied on asymptomatic participants.

STATEMENT OF PROBLEM: Asymmetries in mandibular movements (MMs) can be found in patients with some temporomandibular joint disorders, condylar fracture, or after orthognathic or orthodontic surgery. Quality and symmetry of the MMs should be recorded and analyzed. However, methods for this purpose are limited. PURPOSE: The purpose of this clinical study was to determine the symmetry of MMs on asymptomatic participants by applying an innovative technique based on 3D electromagnetic articulography. MATERIAL AND METHODS: The symmetry of MMs was studied in 16 fully dentate participants (8 men and 8 women). A 3D electromagnetic articulograph was used to register MM by placing a sensor on the interincisal midline of the mandible. The border movements related to the frontal (FP), sagittal (SP), and horizontal (HP) polygons of the Posselt envelope of motion were recorded, as well as masticatory movements. Digital data processing was applied to calculate the trajectory and ranges of mandible displacement, area of the right and left sectors of FP and HP, similarity index between the right and left sectors of FP and HP, and orientation of the individualized masticatory cycles. The Shapiro-Wilk statistical test was used to determine the normality of the sample. To compare the characteristics of the right and left sectors of the polygons, a paired-samples t test (normal distributions) and Wilcoxon test for paired samples (non-normal distributions) were applied (α=.05). RESULTS: No statistically significant differences were found between the right and left sectors of the frontal and horizontal polygons in terms of trajectory (FP, P=.408; HP, P=.417), ranges of movement (FP, P=.736; HP, P=.650), areas (FP, P=.736; HP, P=.233), or orientation of the cycles (P=.506). The similarity index between the morphology of the right and left sectors of the polygons was 68 ±12% for the FP and 67 ±11% for the HP. The areas, trajectories, and ranges had similar values, but they had a different morphology on each side of the polygons. Regarding masticatory cycles, a balanced distribution was observed in terms of their orientation. CONCLUSIONS: The technique used allowed the assessment of symmetry of MM on asymptomatic participants. The evaluated parameters maintain similar values at both left and right sides; however, a different morphology of the trajectories and areas was observed.

Mandibular border movements: The two envelopes of motion.

BACKGROUND: The envelope of motion is a diagrammatic representation of the mandibular border movements. Classically, those movements are carried out eccentrically; starting from the position of maximal intercuspation, the mandible describes an excursion movement until reaching maximal mouth opening. Reverse movements would describe a different path, but up to now concentric development of mandibular border movements has not been considered. Literature states that beyond mandibular border movements limits, no movement is possible. Therefore, it is of great interest to compare both paths-both envelopes of motion-and define the actual limits of mandibular movement. OBJECTIVE: The aim of this study was to compare the geometric characteristics of mandibular border movements carried out eccentrically and concentrically by healthy subjects. METHODS: Sixteen individuals aged between 18 and 27 years, molar class I and with no temporomandibular disorders, participated in the study. Eccentric and concentric mandibular movements were recorded using a 3D electromagnetic articulograph. Data were processed with computational scripts developed in MATLAB. Maximum mouth opening, trajectories, displacement ranges, polygon areas and chewing cycle area/ mandibular border movements area ratio were analysed. RESULTS: The frontal plane showed significant differences in all the parameters evaluated. Higher values were registered in the concentric area of the border movement envelope (P = .008) and in the trajectories on both sides. Statistical differences were observed in polygon areas (P = .006) in the sagittal plane and right ranges (P = .046) in the horizontal plane. CONCLUSION: Concentric mandibular movements revealed significant differences in three-dimensional trajectories in the frontal plane.

A new insight of Platelet-Rich Fibrin clots morphology and their elemental composition.

This study analyzed the architecture of Platelet-Rich Fibrin (PRF) clots and assessed their elemental composition in order to provide new insight into this biomaterial. Five surplus PRF clots (2,700 RPM, 12 min.) donated by patients (63.6 ±â€¯12.3 years old) were prepared for use in dental clinical procedures. The internal three-dimensional morphology of the red zones and the thirds of the yellow zones of the clots were analyzed by Variable Pressure Scanning Electron Microscope (VPSEM) after sample preparation by two methods: 1. Fixation (2.5% gluataraldehyde); and 2. Fixation with subsequent partial removal of extracellular elements (8 N, HCl). Semi-quantitative elemental analysis was performed by energy-dispersive X-ray spectrometry (EDX). VPSEM analysis showed erythrocytes in both the red zone and the yellow zone, which consisted mainly of fibrin. Removal of extracellular elements enriched the morphology of both zones; the organization of the fibrin was observed to differ in the thirds of the yellow zone, with increasing density and organization to distal. The elements that compose organic substances (C-Carbon, N-Nitrogen, O-Oxygen, Na-Sodium and P-Phosphorus) and halogens (Cl-Chloride and S-Sulfur) were detected; the highest concentrations were of C, followed by O (p < 0.05), in the proximal region of the fibrin. The results of the present study suggest organization of fibrin in the PRF clot, and also reveal the distribution of the elements present in the different regions of the clot. Improved understanding of these characteristics may favor the use of this biomaterial by increasing its efficiency and functionality.

Prevalence and morphometric analysis of double mental foramen and double mandibular foramen from digital panoramic radiographs / Prevalencia y análisis morfométrico de foramen mental y foramen mandibular dobles a través de radiografías panorámicas digitales

The morphological variations of the mental foramen (MF) and mandibular foramen (MBF) have been studied for several years, and the prevalence and morphometric characteristics of double and triple foramina have been reported. The objective of this study was to establish the prevalence of variations in the MF and MBF, and to carry out a morphometric analysis of a Chilean population using digital panoramic radiographs. The study included 927 radiographs; the observed prevalence of double MF was 2.58 %, while the prevalence of double MBF was 1.51 %. No cases of triple foramina were found. In men, double MF was found more frequently in the left hemiarch (64.28 % of cases), while in women it was more frequent in the right hemiarch (80 %). Double MBF was found more frequently in the right hemiarch in women (80 % of cases), while the distribution between left and right in men was even. The mean area, width and height of the double MF were 5.46 mm2, 2.77 mm and 2.57 mm respectively. The means of the same morphometric measurements in double MBF were 6.37 mm2, 2.27 mm and 3.19 mm respectively. In both foramina, statistically significant differences were only found between the height of the foramen and the age of the subjects, with the observation that the greater the subject's age, the smaller the height. Dental surgeons must take these anatomical variants into consideration in clinical and surgical actions; timely diagnosis by radiograph is important to avoid possible complications.

Las variaciones morfológicas del foramen mental (FM) y mandibular (FMB) han sido estudiadas durante varios años, reportándose su prevalencia y las características morfométricas de forámenes dobles y triples. El objetivo de este estudio fue establecer la prevalencia de variaciones de los FM y FMB y realizar un análisis morfométrico a través de radiografías panorámicas digitales de una muestra de población chilena. En el estudio se incluyeron 927 radiografías y se observó una prevalencia de FM doble de 2,58 %, mientras que la prevalencia de FMB doble fue de 1,51 %. No se encontraron casos de forámenes triples. En hombres, el FM doble se encontró mayoritariamente en la hemiarcada izquierda (64,28 % de los casos), mientras que en mujeres fue en la hemiarcada derecha (80% de los casos). Para el caso de los FMB dobles, en mujeres se presentó mayoritariamente en la hemiarcada derecha (80 % de los casos), mientras que en hombres fue equitativo en ambos lados. El promedio del área, ancho y alto de los FM dobles fue de 5,46 mm2, 2,77 mm y 2,57 mm, respectivamente. Asimismo, los promedios de estas medidas morfométricas para el FMB doble fueron 6,37 mm2, 2,27 mm y 3,19 mm, respectivamente. Para ambos forámenes sólo se encontraron diferencias estadísticamente significativas entre el alto y la edad de los sujetos, observando que, a mayor edad menor era el alto del foramen. Los cirujanos dentistas deben tener en consideración estas variantes anatómicas para la realización de distintas acciones clínicas y quirúrgicas, su diagnóstico radiográfico oportuno es importante para prevenir posibles complicaciones.

Description of tongue movements on swallowing patterns.

OBJECTIVE: The purpose of this study was to compare the different swallowing patterns regarding tongue movement during saliva swallowing in healthy participants. DESIGN: Seventeen participants (23.0 ± 3.6 years old) were included in this cross-sectional study. The movement of the tongue (anterior, middle and posterior portions) on the three axes of space (inferior-superior, anterior-posterior and medial-lateral) was recorded using a 3D electromagnetic articulograph. The tongue movement patterns registered during saliva swallowing were classified according to Bourdiol et al. (2014) into Type I, II or III. RESULTS: Three swallowing patterns were identified (Type I, 64.7 %; Type II, 5.9 %; and Type III, 29.4 %). On the anterior-posterior axis, the displacement of the three portions of the tongue was significantly higher in Type III pattern compared with the Type I pattern. Furthermore, on the superior-inferior axis, the displacement of the anterior portion was significantly higher in Type III pattern compared with Type I pattern. In Type I pattern, on the inferior-superior axis, the smallest range of displacement occurred in the anterior portion of the tongue, followed by the middle and, finally, the posterior portion. In the analysis of Type III swallowing pattern, no significant differences were found on the range of displacement of the tongue portions on the three axes. CONCLUSION: Statistical differences were found between swallowing patterns Type I and III regarding tongue movement. The frequency of pattern II found in the participants of this study was not high enough to compare the three patterns. However, the results obtained indicate that the methodology applied could be used to identify the patterns based on quantitative data.

Characteristics of Mandibular Movement and Mastication in Older Adults with Removable Dental Prostheses: Three-Dimensional Analysis / Características de Movimientos Mandibulares y Masticación en Adultos Mayores con Prótesis Dental Removible: un Análisis Tridimensional

ABSTRACT: Aging is a dynamic process that includes various alterations in the oral cavity, with tooth loss being the most frequent. Rehabilitative treatment may include removable or fixed prostheses and implants. The aim of this study was to describe the geometric (trajectory, ranges, areas) and kinematic (speed) characteristics of the mandibular and masticatory movements threedimensionally in participants with dental prostheses. A sample of 10 participants with removable prosthetic rehabilitation was divided into three groups (complete, atypical and overdenture) the characteristics of mandibular movements bordering and chewing with 3D Electromagnetic Articulography were measured. The Posselt polygonin was obtained, the frontal and sagittal plans, its areas, trajectories and ranges are analyzed. The masticatory movements were analyzed in the area of each cycle, the frequency, the speed and the reason between the masticatory cycle and the bordering movements, no significant differences between the groups. Subjects with dental prostheses, regardless of the type, they showed low of motion (border and functional) compared to dentate subjects with no functional alterations whose values have been reported in the literature. The subjects with overdenture have values closer to what is described for young dentate subjects.

RESUMEN: El envejecimiento es un proceso dinámico que incluye varias alteraciones en la cavidad oral, siendo la pérdida de dientes la más frecuente. El tratamiento de rehabilitación puede incluir prótesis fijas o removibles y/o implantes. El objetivo de este estudio fue describir las características geométricas (trayectoria, rangos, áreas) y cinemáticas (velocidad) de los movimientos mandibulares y masticatorios en participantes con prótesis dentales realizando un análisis en tres dimensiones. Se consideró una muestra de 10 participantes con rehabilitación protésica y se dividió en tres grupos (prótesis total, atípica e implantosoportada), se midieron las características de los movimientos mandibulares bordeantes y masticatorios con articulografía electromagnética 3D. Se obtuvo el polígono Posselt en los planos frontal y sagital, se analizaron sus áreas, trayectorias y rangos. Se analizaron los movimientos masticatorios en cuanto al área de cada ciclo, la frecuencia, la velocidad y la razón entre el área el ciclo masticatorio y los movimientos bordeantes, sin diferencias significativas entre los grupos. Los sujetos con prótesis dentales, independientemente del tipo, mostraron disminución de movimiento (bordeante y funcional) en comparación con los sujetos dentados sin alteraciones funcionales cuyos valores se han informado en la literatura. Los sujetos con prótesis implantosoportada tienen valores más cercanos a lo que se describe para sujetos jóvenes dentados.

Comparison of morphological quantitative characteristics of the newly formed alveolar bone after the application of demineralized bone matrix and cortical bone allografts / Comparación de las características morfológicas cuantitativas del hueso alveolar recién formado después de la aplicación de matriz ósea desmineralizada y aloinjertos de hueso cortical

The allografts were used to obtain sufficient alveolar bone tissue for proper dental implant placement. The objective of the present study was to evaluate the morphological and quantitative characteristics (cellular and collagen densities) of the newly formed alveolar bone with the application of cortical bone (CB) and demineralized bone matrix (DBM) allografts. Six samples of alveolar bone tissue from 5 patients (50 ± 6.3 years) were obtained after 6 months of application of the allografts and immediately before the placement of the dental implants. The samples were fixed (buffered formaldehyde, pH7.2), decalcified (EDTA 10 %) and histologically processed (HE and Picro-Sirius) for histologic analysis. Morphological analysis revealed presence of osteocytes and trabeculae in neoformed bone tissue near the allografts and absence of inflammatory and allergic cells; the remnants of CB were located mainly in the periphery of the bone tissue and the remnants of DBM were more incorporated into the tissue. Osteogenitor cells were observed around the remaining material. The cell density was not modified in newly formed bone tissue with the application of both allografts as compared to mature bone tissue. The density of the type I and III collagens present in the osteoids interspersed with the remainder of the materials showed a tendency to increase in the samples treated with DBM. It was concluded that by the histological characteristics observed both grafts were biocompatible, however the bone treated with DBM presented better incorporation and a tendency of increase of the collagen content in the remnant region of the allografts.

Los aloinjertos son utilizados para obtener tejido óseo alveolar apropiado para la colocación correcta del implante dental. El objetivo de este trabajo fue evaluar las características morfológicas y cuantitativas (densidades celulares y de colágeno) del hueso alveolar recién formado con la aplicación de aloinjertos de hueso cortical (CB) y matriz desmineralizada de hueso (DBM). Seis muestras de tejido óseo alveolar fueron obtenidas de 5 pacientes (50 ± 6,3 años) después de 6 meses de aplicación de los aloinjertos e inmediatamente antes de la colocación de los implantes dentales. Las muestras fueron fijadas (formaldehído tamponado, pH 7,2), descalcificadas (EDTA al 10%) y procesadas histológicamente (HE y Picro-Sirius) para el análisis histológico. El análisis morfológico reveló la presencia de osteocitos y trabéculas en el tejido óseo neoformado cerca de los aloinjertos y la ausencia de células inflamatorias y alérgicas; los remanentes de CB se ubicaron principalmente en la periferia del tejido óseo y los remanentes de DBM se incorporaron más en el tejido. Se observaron células osteogenitoras alrededor del material restante. La densidad celular no se modificó en el tejido óseo recién formado con la aplicación de ambos aloinjertos en comparación con el tejido óseo maduro. La densidad de los colágenos de tipo I y III presentes en los osteoides intercalados con el resto de los materiales mostró una tendencia a aumentar en las muestras tratadas con DBM. Se concluyó que, debido a las características histológicas observadas, ambos injertos fueron biocompatibles, sin embargo, el hueso tratado con DBM presentó una mejor incorporación y una tendencia al aumento del contenido de colágeno en la región remanente de los aloinjertos.