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This study evaluated the bone incorporation process of a screw-shaped internal fixation device made of poly (L-lactide-co-D, L-lactide) (PLDLLA). Thirty-two male Wistar rats received 32 fixation devices (2 mm × 6 mm) randomly assigned to either the right or left tibia and one implant in each animal. After 7, 14, 28, and 42 days, the rats were euthanized and the specimens were subjected to microtomographic computed tomography (microCT) and histomorphometric analyses to evaluate bone interface contact (BIC%) and new bone formation (NBF%) in cortical and cancellous bone areas. The animals euthanized on days 28 and 42 were treated with calcein and alizarin red, and confocal LASER microscopy was performed to determine the mineral apposition rate (MAR). Micro-CT revealed a higher percentage of bone volume (p < 0.006), trabecular separation (p < 0.001), and BIC in the cortical (p < 0.001) and cancellous (p = 0.003) areas at 28 and 42 days than at 7 and 14 days. The cortical NBF at 42 days was greater than that at 7 and 14 days (p = 0.022). No statistically significant differences were observed in cancellous NBF or MAR at 28 and 42 days. Based on these results, it can be seen that the PLDLLA internal fixation device is biocompatible and allows new bone formation around the screw thread.
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(1) Objective: The aim of this study was to assess the biological behavior of bone tissue on a machined surface (MS) and modifications made by a laser beam (LS) and by a laser beam incorporated with hydroxyapatite (HA) using a biomimetic method without thermic treatment (LHS). (2) Methods: Scanning electron microscopy coupled with energy-dispersive X-ray spectrometry (SEM/EDX) was performed before and after installation in the rabbit tibiae. A total of 20 Albinus rabbits randomly received 30 implants of 3.75 × 10 mm in the right and left tibias, with two implants on each surface in each tibia. In the animals belonging to the 4-week euthanasia period group, intramuscular application of the fluorochromes calcein and alizarin was performed. In implants placed mesially in the tibiofemoral joint, biomechanical analysis was performed by means of a removal torque (N/cm). The tibias with the implants located distally to the joint were submitted for analysis by confocal laser microscopy (mineral apposition rate) and for histometric analysis by bone contact implant (%BIC) and newly formed bone area (%NBA). (3) Results: The SEM showed differences between the surfaces. The biomechanical analysis revealed significant differences in removal torque values between the MSs and LHSs over a 2-week period. Over a 4-week period, both the LSs and LHSs demonstrated removal torque values statistically higher than the MSs. BIC of the LHS implants were statistically superior to MS at the 2-week period and LHS and LS surfaces were statistically superior to MS at the 4-week period. Statistical analysis of the NBA of the implants showed difference between the LHS and MS in the period of 2 weeks. (4) Conclusions: The modifications of the LSs and LHSs provided important physicochemical modifications that favored the deposition of bone tissue on the surface of the implants.
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BACKGROUND: Current clinical approaches to regenerate temporomandibular joint (TMJ) articulating cartilage defects only treat the symptoms (i.e. pain and dysfunction) and do not seek to restore joint integrity for long-term relief. Therefore, we investigated a novel self-assembling tissue-engineered cartilage to overcome this significant clinical issue for TMJ regenerative purposes. OBJECTIVES: Examine the maturation of dynamic self-regenerating cartilage (dSRC) using auricular chondrocytes and evaluate a novel combinatorial approach with fractional laser treatment and dSRC implantation for TMJ cartilage repair. MATERIALS AND METHODS: A suspension of 107 freshly harvested rabbit ear chondrocytes was cultured under a continuous reciprocating motion to form the dSRC. After 2, 4 and 8 weeks of culture, dSRC samples were stained with H&E, Safranin-O and Toluidine Blue. Immunohistochemistry (IHC) was performed for collagens type I and II. Channels (300-500 µm diameter and 1.2-1.5 mm depth) were created in six freshly harvested condyles using a fractional Erbium laser. Two groups were tested: dSRC in a laser-ablated lesion (experimental) and an empty laser-ablated channel (control). TMJ condyles were cultured for up to 8 weeks and analysed as described above. RESULTS: H&E staining showed a high cell density in dSRC compared to native cartilage. All dSRC groups demonstrated intense Safranin-O staining, indicating high glycosaminoglycan (GAG) production and intense Toluidine Blue staining showed high proteoglycan content. IHC confirmed that dSRC consisted predominantly of collagen type II. The experimental group showed improved cartilage repair at both time points compared to the empty channels. CONCLUSION: dSRC viability and successful matrix formation were demonstrated in vitro. The combination of fractional laser ablation and dSRC implantation enhanced cartilage repair.
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Cartílago Articular , Condrocitos , Regeneración , Articulación Temporomandibular , Ingeniería de Tejidos , Animales , Conejos , Condrocitos/trasplante , Ingeniería de Tejidos/métodos , Articulación Temporomandibular/cirugía , Articulación Temporomandibular/patología , Regeneración/fisiología , Cartílago Articular/cirugía , Cartílago Articular/patología , Trastornos de la Articulación Temporomandibular/cirugía , Trastornos de la Articulación Temporomandibular/fisiopatología , Trastornos de la Articulación Temporomandibular/terapia , Células Cultivadas , Cartílago Auricular/fisiología , Técnicas In VitroRESUMEN
Background: Fracture healing poses a significant challenge in orthopedics. Successful regeneration of bone is provided by mechanical stability and a favorable biological microenvironment. This systematic review aims to explore the clinical application of orthobiologics in treating aseptic delayed union and non-union of long bones in adults. Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Three databases were explored, with no date restrictions, using keywords related to orthobiologics and delayed union and non-union. Eligible studies included human clinical studies in English, with available full texts, examining orthobiologics such as platelet-rich plasma (PRP), mesenchymal stem cells (MSCs), and bone morphogenetic protein (BMPs) for treating aseptic delayed unions and non-unions in adults. Animal studies, in vitro research, and studies on non-unions due to congenital defects, tumors or infections were excluded. Results: The initial search identified 9417 studies, with 20 ultimately included in the review. These studies involved 493 patients affected by non-union and 256 patients affected by delayed union, with an average age respectively of 40.62 years and 41.7 years. The mean follow-up period was 15.55 months for non-unions and 8.07 months for delayed unions. PRP was the most used orthobiologic, and outcomes were evaluated through time to union, functional scores, and clinical examinations. The results indicated that orthobiologics, especially PRP, tended to yield better outcomes compared to surgical procedures without biological factors. Conclusion: This systematic review suggests that orthobiologics, such as PRP, BMPs, and MSCs, can be effective and safe in the management of delayed union and non-union fractures. These biological treatments have the potential to improve union rates, reduce healing times, and enhance functional outcomes in patients with non-union fractures. Further research is essential to refine treatment protocols and determine the most suitable orthobiologic for specific patient populations and fracture types.
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The aim of this split-mouth randomized clinical trial was to evaluate the clinical outcomes (operative time, edema, trismus, and pain), the immediate histological effects, the alveolar repair (2 and 4 months), and the quality of life after the extraction of impacted third molars using high-speed pneumatic and electrical rotation. Sixteen patients underwent extraction of the two mandibular third molars with a minimum interval of 15 days. On one side of the participant's mouth, high-speed pneumatic rotation was used (Control Group-CG) while for the other side, high-speed electrical rotation was used (Study Group-SG). Statistical analysis included ANOVA repeated measures and Pearson correlations. SG group showed: shorter operative time (p = 0.019), less pain (p = 0.034), swelling (p < 0.001) and trismus (p = 0.025) on the 1st postoperative day; less pain (p = 0.034) and trismus (p = 0.010) on the 3rd postoperative day; less trismus (p = 0.032) on the 7th postoperative day; and better quality of life (p = 0.007). No differences were observed for peripheral bone damage or bone density of alveolar repair at 2 and 4 months between groups. Electric high-speed rotation provided better postoperative clinical parameters of pain, edema and trismus when compared with pneumatic high-speed rotation for mandibular third molar surgery.Trial registration: Brazilian Registry of Clinical Trials registration number RBR-4xyqhqm ( https://ensaiosclinicos.gov.br/rg/RBR-4xyqhqm ).
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Tercer Molar , Trismo , Humanos , Tercer Molar/cirugía , Rotación , Estudios Prospectivos , Calidad de Vida , Dolor Postoperatorio , Extracción Dental , Boca , EdemaRESUMEN
OBJECTIVE: This study aimed to evaluate the efficacy of ozone therapy in the preoperative (prevention) and/or postoperative (treatment) of MRONJ. MATERIAL AND METHODS: Forty male Wistar rats were caudally treated with zoledronic acid (ZOL) and to ozone therapy before extraction (prevention, POG), after extraction (treatment, TOG), or both (prevention and treatment, TPOG), and treated with saline (SAL). The animals received intramuscular fluorochrome (calcein and alizarin), and 28 days postoperatively, they were euthanized, and the tissues were subjected to microtomographic computed tomography (microCT), LASER confocal, and histomorphometric analyses. RESULTS: Micro-CT showed a higher bone volume fraction average in all groups than that in the ZOL group (P < 0.001), the ZOL group showed high porosity (P = 0.03), and trabecular separation was greater in the TOG group than in the POG group (P < 0.05). The mineral apposition rate of the POG group was high (20.46 ± 6.31) (P < 0.001), followed by the TOG group (20.32 ± 7.4). The TOG group presented the highest mean newly formed bone area (68.322 ± 25.296) compared with the ZOL group (P < 0.05), followed by the SAL group (66.039 ± 28.379) and ZOL groups (60.856 ± 28.425). CONCLUSIONS: Ozone therapy modulated alveolar bone repair in animals treated with ZOL, mainly after surgery trauma, leading to bone formation as healing tissue. CLINICAL RELEVANCE: Osteonecrosis has been a challenge in dentistry, and owing to the lack of a consensus regarding therapy, studies presenting new therapies are important, and ozone has been one of the therapies explored empirically.
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Osteonecrosis de los Maxilares Asociada a Difosfonatos , Conservadores de la Densidad Ósea , Osteonecrosis , Ratas , Animales , Masculino , Difosfonatos , Imidazoles/farmacología , Extracción Dental , Ratas Wistar , Ácido Zoledrónico , Microtomografía por Rayos X , Osteonecrosis de los Maxilares Asociada a Difosfonatos/diagnóstico por imagen , Osteonecrosis de los Maxilares Asociada a Difosfonatos/prevención & control , Osteonecrosis de los Maxilares Asociada a Difosfonatos/tratamiento farmacológicoRESUMEN
OBJECTIVE: To assess the outcomes of several rodent animal models for studying tooth extraction-related medication-related osteonecrosis of the jaw (MRONJ). DESIGN: After a search of the databases, 2004 articles were located, and 118 corroborated the inclusion factors (in vivo studies in rodents evaluating tooth extraction as a risk factor for the development of MRONJ). RESULTS: Numerous studies attempting to establish an optimal protocol to induce MRONJ were found. Zoledronic acid (ZA) was the most used drug, followed by alendronate (ALN). Even when ZA did not lead to the development of MRONJ, its effect compromised the homeostasis of the bone and soft tissue. The association of other risk factors (dexamethasone, diabetes, and tooth-related inflammatory dental disease) besides tooth extraction also played a role in the development of MRONJ. In addition, studies demonstrated a relationship between cumulative dose and MRONJ. CONCLUSIONS: Both ZA and ALN can lead to MRONJ in rodents when equivalent human doses (in osteoporosis or cancer treatment) are used. Local oral risk factors and tooth-related inflammatory dental disease increase the incidence of MRONJ in a tooth extraction-related rodent model.
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Osteonecrosis de los Maxilares Asociada a Difosfonatos , Conservadores de la Densidad Ósea , Animales , Humanos , Difosfonatos/efectos adversos , Conservadores de la Densidad Ósea/efectos adversos , Osteonecrosis de los Maxilares Asociada a Difosfonatos/etiología , Roedores , Ácido Zoledrónico/efectos adversos , Extracción Dental/efectos adversos , Modelos Animales , Alendronato/efectos adversosRESUMEN
Recent studies have shown that bisphosphonates can also impact osteoblasts besides osteoclasts. This study aimed to evaluate the effects of different concentrations of Zoledronic acid (ZA) during the osteogenic differentiation of human Bone Marrow Stem Cells (hBMSCs) in vitro. Thus, osteogenic differentiation of hBMSCs was conducted with different concentrations of Zoledronic Acid (ZA) (0, 0.1, 1.0, and 5.0 µM) for the first 3 days. Cell metabolism was quantified at 1-, 3-, 7-, and 14 days. At 7- and 14-days, the following analyses were performed: 1) mineralization nodule assay, 2) LIVE/DEAD™, 3) cell adhesion and spreading, 4) alkaline phosphatase (ALP) activity, and 5) qPCR analysis for RUNX-2), ALPL, and COL1 A1. Data were analyzed by ANOVA 2-way, followed by Tukey's post hoc test (p < 0.05). Cell metabolism (3-, 7-, and 14-days) (p < 0.001), mineralization (7-, 14-days) (p < 0.001), and ALP activity (14-days) (p < 0.001) were reduced in ZA 5.0 µM when compared to control (no ZA). Also, ZA 5.0 µM downregulated the expression of RUNX2 at 7- and 14-days (p < 0.001). It is possible to conclude that ZA (5.0 µM) can impair hBMSC differentiation into osteoblasts and interferes with its mineralization phase.
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Difosfonatos , Osteogénesis , Humanos , Ácido Zoledrónico/farmacología , Difosfonatos/farmacología , Diferenciación Celular , Células de la Médula ÓseaRESUMEN
Critical-sized bone defects (CSBDs) represent a significant clinical challenge, stimulating researchers to seek new methods for successful bone reconstruction. The aim of this systematic review is to assess whether bone marrow stem cells (BMSCs) combined with tissue-engineered scaffolds have demonstrated improved bone regeneration in the treatment of CSBD in large preclinical animal models. A search of electronic databases (PubMed, Embase, Web of Science, and Cochrane Library) focused on in vivo large animal studies identified 10 articles according to the following inclusion criteria: (1) in vivo large animal models with segmental bone defects; (2) treatment with tissue-engineered scaffolds combined with BMSCs; (3) the presence of a control group; and (4) a minimum of a histological analysis outcome. Animal research: reporting of in Vivo Experiments guidelines were used for quality assessment, and Systematic Review Center for Laboratory animal Experimentation's risk of bias tool was used to define internal validity. The results demonstrated that tissue-engineered scaffolds, either from autografts or allografts, when combined with BMSCs provide improved bone mineralization and bone formation, including a critical role in the remodeling phase of bone healing. BMSC-seeded scaffolds showed improved biomechanical properties and microarchitecture properties of the regenerated bone when compared with untreated and scaffold-alone groups. This review highlights the efficacy of tissue engineering strategies for the repair of extensive bone defects in preclinical large-animal models. In particular, the use of mesenchymal stem cells, combined with bioscaffolds, seems to be a successful method in comparison to cell-free scaffolds.
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OBJECTIVE: Synovial chondromatosis (SC) of the temporomandibular joint (TMJ) is a synovial membrane disease characterized by the formation of cartilaginous nodules (CN), that may erode the skull base. Historically, cases with skull base involvement have been treated with open surgery. We report a case of TMJ SC with skull base perforation treated and repaired via minimally invasive TMJ arthroscopy and describe the advanced endoscopic operative maneuvers performed. CASE REPORT: A 34-year-old male presented with a 4-year history of malocclusion and right TMJ arthralgia. Clinical examination demonstrated malocclusion and direct pressure loading pain. Advanced imaging revealed glenoid fossa erosion and numerous homogenous hypointense lesions within an effusion. The initial surgical plan included diagnostic TMJ arthroscopy followed by conversion to open arthroplasty. Endoscopic operative maneuvers allowed for the accomplishment of the surgical goals, completely arthroscopically. Histopathology confirmed SC, and the patient remains on observation, with relief of symptoms. CONCLUSION: Advanced arthroscopy is a viable treatment option for select cases of TMJ SC with skull base involvement that allowed for access to the joint space, retrieval of biopsy specimens and CN, and repair of the skull defect.
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Condromatosis Sinovial , Trastornos de la Articulación Temporomandibular , Masculino , Humanos , Adulto , Condromatosis Sinovial/diagnóstico por imagen , Condromatosis Sinovial/cirugía , Condromatosis Sinovial/patología , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/cirugía , Trastornos de la Articulación Temporomandibular/patología , Tomografía Computarizada por Rayos X , Articulación Temporomandibular/patología , Base del Cráneo/patología , Base del Cráneo/cirugíaRESUMEN
BACKGROUND: Tissue engineering of skin and mucosa is essential for the esthetic and functional reconstruction of individuals disfigured by trauma, resection surgery, or severe burns while overcoming the limited amount of autograft and donor site morbidity. PURPOSE: We aimed to determine whether a combination of Gelatin-methacryloyl (GelMA) hydrogel scaffold alone or loaded with either dental pulp stem cells (DPSCs) and/or vascular endothelial growth factor (VEGF) could improve skin wound healing in rats. MATERIALS AND METHODS: Four 10 mm full-thickness skin defects were created on the dorsum of 15 Sprague-Dawley rats. The wounds were treated with GelMA alone, GelMA+DPSCs, or GelMA+DPSCs+VEGF. Unprotected wounds were used as controls. Animals were euthanized at 1-, 2-, and 4 weeks post-surgery, and the healing wounds were harvested for clinical, histological, and RT-PCR analysis. RESULTS: No signs of clinical inflammation were observed among all groups. Few and sparse mononuclear inflammatory cells were observed in GelMA+DPSCs and GelMA+DPSCs+VEGF groups at 2 weeks, with complete epithelialization of the wounds. At 4 weeks, the epidermis in GelMA+DPSCs and GelMA+DPSCs+VEGF groups was indistinguishable from the empty defect and GelMA groups. The decrease in cellularity and increase in density of collagen fibers were observed over time in both GelMA+DPSCs and GelMA+DPSCs+VEGF groups but were more evident in the GelMA+DPSCs+VEGF group. The GelMA+DPSCs+VEGF group showed a higher expression of the KER 10 gene at all time points compared with the other groups. Expression of Col1 A1 and TGFß-1 were not statistically different over time neither among the groups. CONCLUSION: GelMA scaffolds loaded with DPSCs, and VEGF accelerated the re-epithelialization of skin wounds.
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Gelatina , Factor A de Crecimiento Endotelial Vascular , Ratas , Animales , Humanos , Factor A de Crecimiento Endotelial Vascular/metabolismo , Ratas Sprague-Dawley , Pulpa Dental/metabolismo , Células MadreRESUMEN
To evaluate the osteoconductive potential of inorganic biomaterials of bovine origin submitted to different temperatures in the bone repair of critical defects in rat calvaria. Forty-eight rats were divided into four groups according to the material used to fill the defect: control group (GC), the defect was filled only with blood clot (n = 12); GBO, defect filled with Bio-Oss®, deproteinzed at 300°C (n = 12); GOX, defect filled with Inorganic GenOx®, deproteinzed from 850 to 1200°C (n = 12) and G700, defect filled with Inorganic GenOx 700, deproteinzed at 700°C (n = 12). In each animal's calvaria, a trephine bur with 5 mm internal diameter was used to produce a 6 mm-diameter central defect. Gen Derm® resorbable bovine membrane was superimposed over all defects. Subsequently, animals were euthanized at 30 and 60 days after surgery. The pieces were sent for histological and histometric analysis to evaluate the following variables: bone neoformation, presence of biomaterial, mononuclear and polymorphonuclear leukocytes, presence of other tissues (granulation and medullary) and maturation of collagen fibers. The most representative group for bone neoformation was GC. At 30 days, there was a higher mean of mature bone tissue (75.8). At 60 days, there was no statistical difference between the GC (64.9), GBO (32.9), GOX (45.3), and G700 (26.6) groups. GBO presented the highest amount of biomaterial after 30 days (115.9) and 60 days (118.5). All bovine biomaterials were biocompatible and osteoconductive. GOX promoted the best bone repair of the studied materials.
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Materiales Biocompatibles , Cráneo , Ratas , Animales , Bovinos , Ratas Wistar , Temperatura , Materiales Biocompatibles/farmacología , Cráneo/cirugía , Cráneo/patología , Regeneración ÓseaRESUMEN
AIM: The aim of this study was to evaluate the profile of patients undergoing dental treatment in relation to cannabis use. MATERIALS AND METHODS: A comprehensive questionnaire was used to address the type of cannabis preparations, route of intake, frequency of usage, and potential reasoning for use (recreational vs medical use) of patients from the MGH Dental Group. RESULTS: Seventy-six adult patients completed the survey. Sixty-one percent of the participants were female, with the majority (59%) of the participants being ≥51 years or older. Twelve of the 76 participants (16%) were 18-30 years old. The remaining 19 patients (25%) who participated in the study were 31-50 years old. The sample included participants who were predominately non-Hispanic (63 patients, 83%) and White (59 patients, 78%). The majority of patients either had their first use of cannabis prior to 18 years of age (36%) or did not respond to this question (34%) at all. The predominant age at consistent cannabis use was 18-30 years (13%). The most common method of cannabis intake in the preceding year for participants was smoking, followed by ingesting, using cannabidiol (CBD), and vaping (least common). Recreational cannabis use was reported in 47% of the participants vs 28% of participants who reported cannabis intake for medical use. CONCLUSION: This preliminary study characterized the profile of patients undergoing dental treatment in relation to marijuana use. Diminishing restraints to cannabis use may affect the dental profession. CLINICAL SIGNIFICANCE: It is important for dentists to understand cannabis-related oral health conditions to provide customized patient treatments.
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Cannabidiol , Cannabis , Fumar Marihuana , Marihuana Medicinal , Adulto , Humanos , Femenino , Masculino , Adolescente , Adulto Joven , Persona de Mediana Edad , Marihuana Medicinal/uso terapéutico , Hospitales Generales , Fumar Marihuana/efectos adversos , AnalgésicosRESUMEN
Surgical trauma in those under a prolonged use of bisphosphonates, can lead to mediation-related osteonecrosis of the jaw (MRONJ). This study aimed to evaluate the preventive therapies for MRONJ. Following four cycles of zoledronic acid administration, Wistar rats had their molar extracted, and were organized into nine treatment groups: negative control group (NCG), treated with saline solution and blood-clot in the alveolus; positive control group (PCG), with blood-clot in the alveolus; BG, ß-tricalcium phosphate-based biomaterial; DG, 10% doxycycline gel; aG, antimicrobial photodynamic therapy; and DBG, aBG, aDG, and aDBG, using combination therapy. After 28 days, the lowest bone volume (BV/TV) was reported in PCG (42.17% ± 2.65), and the highest in aDBG (69.85% ± 6.25) (p < 0.05). The higher values of daily mineral apposition rate were recorded in aDBG (2.64 ± 0.48) and DBG (2.30 ± 0.37) (p < 0.001). Moreover, aDBG presented with the highest neoformed bone area (82.44% ± 2.69) (p < 0.05). Non-vital bone was reported only in the PCG (37.94 ± 18.70%). Owing to the key role of the biomaterial, the combination approach (aDBG) was the most effective in preventing MRONJ following tooth extraction.
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Osteonecrosis de los Maxilares Asociada a Difosfonatos , Conservadores de la Densidad Ósea , Fotoquimioterapia , Animales , Antibacterianos , Materiales Biocompatibles , Osteonecrosis de los Maxilares Asociada a Difosfonatos/tratamiento farmacológico , Osteonecrosis de los Maxilares Asociada a Difosfonatos/etiología , Osteonecrosis de los Maxilares Asociada a Difosfonatos/prevención & control , Fosfatos de Calcio , Difosfonatos , Doxiciclina , Fotoquimioterapia/efectos adversos , Ratas , Ratas Wistar , Solución Salina , Extracción Dental/efectos adversos , Ácido ZoledrónicoRESUMEN
OBJECTIVE: This study aimed to evaluate 4 methods of osteosynthesis in the maxilla after a linear advance of 11âmm. METHODOLOGY: Le Fort I osteotomies were performed on 24 resin models and different osteosynthesis were applied in the anterior region. Group I received Lindorf plates; group II, modified Lindorf plates; group III, inverted "T" plates; and group IV, "L" plates. All groups received "L" plates in the posterior region. Analysis were performed through universal mechanical testing machine with an axial linear load until 5-mm displacement. The data obtained about the force and the amount of deformation were computed, thus the energy required for displacement and stiffness was calculated. Statistical analysis was performed using 2-way analysis (Shapiro-Wilk, followed by Holm-Sidak) (Pâ <â0.05). RESULTS: Groups I and II showed greater resistance to displacement (Pâ<â0.05) than the other groups. The largest amount of maximum force exerted for the 5-mm displacement was in group II (91.73âN), followed by group I (87.46âN), presenting the best values in comparison with the other groups (Pâ<â0.001). Group III had less stiffness (Pâ<â0.001) than the other groups. CONCLUSIONS: The use of preclinical methodologies to verify the mechanical stability of fixation models allows a prediction in the choice of greater resistance systems. The fixation type with greater resistance to deformation was achieved with modified Linford plates followed by Linford plates in the anterior region and plate "L" bilaterally in the posterior region.
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Fijación Interna de Fracturas , Osteotomía Le Fort , Placas Óseas , Fijación Interna de Fracturas/métodos , Humanos , Maxilar/cirugía , Osteotomía Le Fort/métodosRESUMEN
(1) Background: This study evaluates the effects of photobiomodulation (PBM) therapy on the peri-implant bone healing of implants with a machined surface (MS) and treated surface (TS). (2) Methods: Topographic characterization of the surfaces (scanning electron microscopy [SEM]- energy dispersive X-ray spectroscopy [EDX]) was performed before and after implant removal. Twenty rabbits were randomly divided into four groups: MS and TS groups (without PBM therapy) and LMS and LTS groups (with PBM therapy). After implant placement, the stability coefficient (ISQ) was measured. In the periods of 21 and 42 days, the ISQ was measured again, followed by biomechanical analysis. (3) Results: The surfaces of the TS implants showed topographic differences compared with MS implants. The ISQ values of the LMS were statistically significant when compared with those of the MS at 42 days (p < 0.001). The removal torque values of the LMS were statistically significant when compared with those of the MS at 21 days (p = 0.023) and 42 days (p = 0.023). For SEM, in general, the LMS, TS and LTS presented high bone tissue coverage when compared to MS. (4) Conclusions: The PBM therapy modulated the osseointegration process and was evidenced mainly on the machined surface.
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BACKGROUND: Implant placement is a common part of dental rehabilitation in older individuals. The role of diminished bone mineral density on the healing of dental implants remains to be elucidated. OBJECTIVE: The aim of this study was to assess the implant survival rate in postmenopausal women with osteopenia/osteoporosis. METHODS: A retrospective cohort study was conducted of postmenopausal women treated with dental implants and stratified into two groups: those receiving antiresorptive therapy (W ≥ 50 years S) or those not receiving treatment (W ≥ 50 years U). The predictor variable was osteopenia/osteoporosis treatment. The outcome variable was implant failure rate at stage two uncovering. Other study variables included: age, implant location, and bone graft placement. T-test, chi-square test, and univariate and multivariate logistic regression were computed. A p-value<0.05 was considered statistically significant. RESULTS: The sample was composed of 93 W ≥ 50 years U (197 implants) and 114 W ≥ 50 years S (189 implants). W ≥ 50 years U showed a statistically higher implant failure rate with chi-square testing compared to W ≥ 50 years S (p=0.022). However, univariate, and multivariate logistic regression between age, location, bone grafting, and implant failure did not demonstrate significant associations. CONCLUSION: Both groups integrated dental implants successfully, with a low failure rate. Implant location, bone grafting, and osteopenia/osteoporosis treatment did not significantly affect osseointegration at uncovering.
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Enfermedades Óseas Metabólicas , Implantes Dentales , Osteoporosis , Femenino , Humanos , Anciano , Estudios Retrospectivos , Proyectos Piloto , Posmenopausia , Tasa de Supervivencia , Enfermedades Óseas Metabólicas/epidemiologíaRESUMEN
PURPOSE: The aim of this study was to investigate the association of hypertension and antihypertensive drugs with the failure of osseointegrated dental implants. MATERIALS AND METHODS: This study conformed to STROBE Guidelines regarding retrospective studies. Data from 602 medical records of patients who received rehabilitation treatment with osseointegrated implants between 2000 and 2017, completed at least 6 months before the study, were analyzed. Data on age, sex, presence or absence of hypertension, use or not of antihypertensive drugs, number of placed and lost implants, and type of prosthetic rehabilitation were collected. Statistical chi-square tests and the Fisher exact test were used to analyze the variables with implant loss, using a significance level of P < .05. RESULTS: One thousand eight hundred eighty-seven implants were placed with a success rate of 97.51% (47 implants lost in 41 patients). Of the 602 patients, 71.43% (432) were normotensive and 28.36% (171) were hypertensive. The success rate of implants in the normotensive group was 93.28%, and in the hypertensive group, it was 92.99%, with no statistical difference between the groups (P = .958). Of these patients, the success rate among the hypertensive group was similar for medication users (92.5%) and for nonusers (94.1%), with no statistically significant difference (P = .939). CONCLUSION: The presence of hypertension, as well as the use of antihypertensives, could not be associated with the failure of osseointegrated implants.
Asunto(s)
Prótesis Anclada al Hueso , Implantes Dentales , Hipertensión , Antihipertensivos/uso terapéutico , Implantación Dental Endoósea , Fracaso de la Restauración Dental , Humanos , Hipertensión/complicaciones , Estudios RetrospectivosRESUMEN
Introdução: As limitações das terapias atuais para doenças degenerativas da articulação temporomandibular (ATM) levaram ao aumento do interesse em estratégias regenerativas. A engenharia de tecidos (ET), combinando células-tronco, arcabouços e fatores de crescimento, pode fornecer uma substituição biológica funcional e permanente das estruturas da ATM, além de prevenir o avanço de doenças degenerativas. Objetivo: Este artigo descreve as perspectivas atuais da ET das estruturas da ATM em modelos animais. Metodologia: As abordagens da ET foram categorizadas de acordo com as estruturas primárias da ATM: 1) o disco articular, 2) o côndilo mandibular e 3) a fossa glenóide e eminência articular. Resultados: As áreas com a maior quantidade de estudos são o côndilo mandibular e disco articular, em estudos que abordam o uso de arcabouços tridimensionais, de origem sintética e/ou natural, podendo ou não estar associados a células tronco (diferenciadas ou não) e a fatores de crescimento. Conclusão: A ET da ATM ainda é uma área relativamente nova, em desenvolvimento e em constante avanço. Os avanços tecnológicos desenvolvidos nessa área têm o potencial de auxiliar no desenvolvimento de terapias mais eficientes e menos invasivos... (AU)
Introducción: Las limitaciones de las terapias actuales para las enfermedades degenerativas de la articulación temporomandibular (ATM) han llevado a un mayor interés en las estrategias regenerativas. La ingeniería de tejidos, que combina células, andamios y factores de crecimiento, puede proporcionar un reemplazo biológico funcional y permanente de las estructuras de la ATM, además de prevenir el avance de enfermedades degenerativas. Objetivo: Este artículo describe las perspectivas actuales de la ingeniería de tecidos de las estructuras de la ATM en modelos animales. Metodología: Los enfoques de ingeniería de tejidos se clasificaron según las estructuras primarias de la ATM: 1) el disco articular, 2) el cóndilo mandibular y 3) la fosa glenoidea y la eminencia articular. Resultados: Las áreas con mayor número de estudios son el cóndilo mandibular y el disco articular, en estudios que abordan el uso de estructuras tridimensionales, de origen sintético y/o natural, que pueden o no estar asociadas a células (diferenciadas o no) y con factores de crecimiento. Conclusión: La ingeniería de tejidos de la ATM es todavía un área relativamente nueva, en desarrollo y em constante avance. Los avances tecnológicos desarrollados en esta área tienen el potencial de ayudar en el desarrollo de terapias más eficientes y menos invasivas... (AU)
Introduction: The limitations of current therapies for degenerative diseases of the temporomandibular joint (TMJ) have led to increased interest in regenerative strategies. Tissue engineering (TE), combining stem cells, scaffolds, and growth factors, can provide a functional and permanent biological replacement of TMJ structures, in addition to preventing the advancement of degenerative diseases. Aim: This article describes current TE perspectives of TMJ structures in animal models. Methods: TE approaches were categorized according to the primary TMJ structures: 1) the articular disc, 2) the mandibular condyle, and 3) the glenoid fossa and articular eminence. Results: The areas with the greatest number of studies are the mandibular condyle and articular disc, in studies that address the use of three-dimensional scaffolds, of synthetic and/or natural origin, which may or may not be associated with stem cells (differentiated or not) and with growth factors. Conclusion: TE of the TMJ is still a relatively new, developing, and constantly advancing area. The technological advances developed in this area have the potential to assist in the development of more efficient and less invasive therapies... (AU)
Asunto(s)
Humanos , Masculino , Femenino , Células Madre , Articulación Temporomandibular/cirugía , Ingeniería de Tejidos , Cóndilo Mandibular , Desarrollo TecnológicoRESUMEN
Introdução: As limitações das terapias atuais para doenças degenerativas da articulação temporomandibular (ATM) levaram ao aumento do interesse em estratégias regenerativas. A engenharia de tecidos (ET), combinando células-tronco, arcabouços e fatores de crescimento, pode fornecer uma substituição biológica funcional e permanente das estruturas da ATM, além de prevenir o avanço de doenças degenerativas. Objetivo: Este artigo descreve as perspectivas atuais da ET das estruturas da ATM em modelos animais. Metodologia: As abordagens da ET foram categorizadas de acordo com as estruturas primárias da ATM: 1) o disco articular, 2) o côndilo mandibular e 3) a fossa glenóide e eminência articular. Resultados: As áreas com a maior quantidade de estudos são o côndilo mandibular e disco articular, em estudos que abordam o uso de arcabouços tridimensionais, de origem sintética e/ou natural, podendo ou não estar associados a células tronco (diferenciadas ou não) e a fatores de crescimento. Conclusão: A ET da ATM ainda é uma área relativamente nova, em desenvolvimento e em constante avanço. Os avanços tecnológicos desenvolvidos nessa área têm o potencial de auxiliar no desenvolvimento de terapias mais eficientes e menos invasivos... (AU)
Introducción: Las limitaciones de las terapias actuales para las enfermedades degenerativas de la articulación temporomandibular (ATM) han llevado a un mayor interés en las estrategias regenerativas. La ingeniería de tejidos, que combina células, andamios y factores de crecimiento, puede proporcionar un reemplazo biológico funcional y permanente de las estructuras de la ATM, además de prevenir el avance de enfermedades degenerativas. Objetivo: Este artículo describe las perspectivas actuales de la ingeniería de tecidos de las estructuras de la ATM en modelos animales. Metodología: Los enfoques de ingeniería de tejidos se clasificaron según las estructuras primarias de la ATM: 1) el disco articular, 2) el cóndilo mandibular y 3) la fosa glenoidea y la eminencia articular. Resultados: Las áreas con mayor número de estudios son el cóndilo mandibular y el disco articular, en estudios que abordan el uso de estructuras tridimensionales, de origen sintético y/o natural, que pueden o no estar asociadas a células (diferenciadas o no) y con factores de crecimiento. Conclusión: La ingeniería de tejidos de la ATM es todavía un área relativamente nueva, en desarrollo y en constante avance. Los avances tecnológicos desarrollados en esta área tienen el potencial de ayudar en el desarrollo de terapias más eficientes y menos invasivas... (AU)
Introduction: The limitations of current therapies for degenerative diseases of the temporomandibular joint (TMJ) have led to increased interest in regenerative strategies. Tissue engineering (TE), combining stem cells, scaffolds, and growth factors, can provide a functional and permanent biological replacement of TMJ structures, in addition to preventing the advancement of degenerative diseases. Aim: This article describes current TE perspectives of TMJ structures in animal models. Methods: TE approaches were categorized according to the primary TMJ structures: 1) the articular disc, 2) the mandibular condyle, and 3) the glenoid fossa and articular eminence. Results: The areas with the greatest number of studies are the mandibular condyle and articular disc, in studies that address the use of three-dimensional scaffolds, of synthetic and/ or natural origin, which may or may not be associated with stem cells (differentiated or not) and with growth factors. Conclusion: TE of the TMJ is still a relatively new, developing, and constantly advancing area. The technological advances developed in this area have the potential to assist in the development of more efficient and less invasive therapies... (AU)