Effects of low-level laser therapy and platelet concentrate on bone repair: Histological, histomorphometric, immunohistochemical, and radiographic study.

PURPOSE: Low-level laser therapy (LLLT) can increase bone metabolism, cell proliferation, and maturation, and reduce inflammation, while platelet concentrate (PC) assists bone healing process by releasing proteins and growth factors. Here, we evaluated the efficacy of combined LLLT and PC therapy in the healing of critical-size bone defects. MATERIALS AND METHODS: Calvarial critical-size defects 5 mm in diameter were made in 48 Wistar rats. Bones were removed, milled, and used as autogenous bone grafts. Animals were randomized into four groups: LP (LLLT + PC), PC, L (LLLT), and C (control, autogenous graft only). Animals were sacrificed at day 30 and 60 post-surgery. Specimens were submitted to radiographic (digital and conventional), histological, histomorphometric, and immunohistochemical analyses. RESULTS: Digital radiography was shown to be a better image analysis method compared with conventional radiography. Histological analysis demonstrated a significant difference in bone formation between animals in group L (p = 0.049) at day 60 than in other groups. Higher rates of inflammatory infiltrates and fibrosis were observed in the LP and PC groups at days 30 and 60, whereas the groups not receiving PC showed a higher rate of bone maturity. The inflammatory processes were reduced in the animals in the L group, together with new bone formation and maturation. Groups L and C had higher scores of positive osteocalcin immunostaining in bone and extracellular matrix. CONCLUSIONS: LLLT reduces inflammation and contributes to increased bone formation. PC treatment was shown to maintain connective tissue and to induce fibrosis during bone repair. Combined LLLT and PC treatment did not improve bone repair.

Análise da expressão de citocinas e dos receptores RAGE no periodonto de ratos diabéticos / Cytokine and RAGE receptor expression analyses in periodontium of diabetic rats

As doenças periodontais (DPs) são alterações inflamatórias crônicas que acometem os tecidos de sustentação do órgão dental. A presença do diabetes é refletida em maior severidade e prevalência das DPs tanto em humanos quanto em modelos experimentais. Contudo, os mecanismos biológicos envolvidos no aumento da prevalência e da severidade permanecem pouco conhecidos. Desta forma, o objetivo deste estudo foi avaliar o número de células marcadas por imunohistoquímica para TNF- , IL-1 , IL-6, RANKL, MMP-2, MMP-9 e para os receptores RAGE na doença periodontal experimental decorrente da indução do diabetes em ratos. Inicialmente, os ratos (n=25) foram submetidos à indução do diabetes através de administração endovenosa de aloxana (42mg/kg) e, juntamente com o grupo controle (n=25), acompanhados por 1, 3, 6, 9 e 12 meses. Em seguida, as hemimandíbulas foram coletadas e submetidas aos procedimentos de imunohistoquímica. Os resultados revelam que a presença do diabetes resulta em alterações significativas no número de células imunomarcadas para diferentes mediadores do processo inflamatório. Nos animais diabéticos, foi observado aumento estatisticamente significativo (p<0,05 ANOVA) no número de células imunomarcadas para TNF- (6 e12 meses), IL-1 (12 meses), IL-6 (9 e 12 meses), RANKL (9 meses) e para os receptores RAGE (6, 9 e 12 meses). Não foram observadas diferenças em relação ao número de células imunomarcadas para MMP-2 e MMP-9 entre os grupos controle e experimental, apesar da tendência a aumento no número de células MMP-9+ nos ratos após 12 meses da indução do diabetes (p>0,05 ANOVA). Assim, a desregulação na expressão de citocinas inflamatórias e fatores osteoclastogênicos parece ser um dos mecanismos biológicos envolvidos no aumento da prevalência e da severidade das doenças periodontais em decorrência do diabetes.

Periodontal diseases (PD) are chronic inflammatory diseases leading the destruction of connective tissue and alveolar bone supporting the teeth. The establishment of diabetes increases PD prevalence and severity in humans and experimental model. However, biological mechanisms regarding to increase of prevalence and severity remains poorly known. The aim of this study was to evaluate the number of immuno-staining cells to TNF- IL-1 , IL-6, MMP-2, MMP-9, RANKL and RAGE receptors in experimental periodontal disease in diabetic rats. Diabetes was induced in Wistar rats (n=25) by endovenous administration of 42 mg/kg of alloxan, and together with control animals (n=25), were analyzed at 1, 3, 6, 9 and 12 months after diabetes induction. The animals were sacrificed and the jaws were removed and submitted to immunohistochemistry procedures. Our data demonstrated that diabetes induction and progression resulted in significant alterations in number of immuno-staining cells to different mediators of inflammatory process. In diabetic rats, we observed an increased number of immuno-staining cells to TNF- (6 and 12 months), IL-1 (12 months), IL-6 (9 e 12 months), RANKL (9 months) and RAGE receptors (6, 9 and 12 months) (p<0,05 ANOVA). Regarding to MMP-2+ and MMP-9+ cells, we did not found differences between control and experimental groups. However, we found a trend of towards in MMP-9+ cells in diabetic rats after 12 months of diabetes induction (p>0,05 ANOVA). Then, our data demonstrated that diabetes establishment and progression resulted in an increase of immuno-staining cells to TNF- , IL-1 IL-6, RANKL and RAGE receptors. Taken together, desregulation of inflammatory cytokines and osteoclastogenic factor expression seems to be one of biological mechanisms involved in the increase of periodontal disease prevalence and severity associated with diabetes.

Análise da expressão de citocinas e dos receptores RAGE no periodonto de ratos diabéticos / Cytokine and RAGE receptor expression analyses in periodontium of diabetic rats

As doenças periodontais (DPs) são alterações inflamatórias crônicas que acometem os tecidos de sustentação do órgão dental. A presença do diabetes é refletida em maior severidade e prevalência das DPs tanto em humanos quanto em modelos experimentais. Contudo, os mecanismos biológicos envolvidos no aumento da prevalência e da severidade permanecem pouco conhecidos. Desta forma, o objetivo deste estudo foi avaliar o número de células marcadas por imunohistoquímica para TNF- , IL-1 , IL-6, RANKL, MMP-2, MMP-9 e para os receptores RAGE na doença periodontal experimental decorrente da indução do diabetes em ratos. Inicialmente, os ratos (n=25) foram submetidos à indução do diabetes através de administração endovenosa de aloxana (42mg/kg) e, juntamente com o grupo controle (n=25), acompanhados por 1, 3, 6, 9 e 12 meses. Em seguida, as hemimandíbulas foram coletadas e submetidas aos procedimentos de imunohistoquímica. Os resultados revelam que a presença do diabetes resulta em alterações significativas no número de células imunomarcadas para diferentes mediadores do processo inflamatório. Nos animais diabéticos, foi observado aumento estatisticamente significativo (p<0,05 ANOVA) no número de células imunomarcadas para TNF- (6 e12 meses), IL-1 (12 meses), IL-6 (9 e 12 meses), RANKL (9 meses) e para os receptores RAGE (6, 9 e 12 meses). Não foram observadas diferenças em relação ao número de células imunomarcadas para MMP-2 e MMP-9 entre os grupos controle e experimental, apesar da tendência a aumento no número de células MMP-9+ nos ratos após 12 meses da indução do diabetes (p>0,05 ANOVA). Assim, a desregulação na expressão de citocinas inflamatórias e fatores osteoclastogênicos parece ser um dos mecanismos biológicos envolvidos no aumento da prevalência e da severidade das doenças periodontais em decorrência do diabetes.

Periodontal diseases (PD) are chronic inflammatory diseases leading the destruction of connective tissue and alveolar bone supporting the teeth. The establishment of diabetes increases PD prevalence and severity in humans and experimental model. However, biological mechanisms regarding to increase of prevalence and severity remains poorly known. The aim of this study was to evaluate the number of immuno-staining cells to TNF- IL-1 , IL-6, MMP-2, MMP-9, RANKL and RAGE receptors in experimental periodontal disease in diabetic rats. Diabetes was induced in Wistar rats (n=25) by endovenous administration of 42 mg/kg of alloxan, and together with control animals (n=25), were analyzed at 1, 3, 6, 9 and 12 months after diabetes induction. The animals were sacrificed and the jaws were removed and submitted to immunohistochemistry procedures. Our data demonstrated that diabetes induction and progression resulted in significant alterations in number of immuno-staining cells to different mediators of inflammatory process. In diabetic rats, we observed an increased number of immuno-staining cells to TNF- (6 and 12 months), IL-1 (12 months), IL-6 (9 e 12 months), RANKL (9 months) and RAGE receptors (6, 9 and 12 months) (p<0,05 ANOVA). Regarding to MMP-2+ and MMP-9+ cells, we did not found differences between control and experimental groups. However, we found a trend of towards in MMP-9+ cells in diabetic rats after 12 months of diabetes induction (p>0,05 ANOVA). Then, our data demonstrated that diabetes establishment and progression resulted in an increase of immuno-staining cells to TNF- , IL-1 IL-6, RANKL and RAGE receptors. Taken together, desregulation of inflammatory cytokines and osteoclastogenic factor expression seems to be one of biological mechanisms involved in the increase of periodontal disease prevalence and severity associated with diabetes.