Does the association of blood-derived growth factors to nanostructured carbonated hydroxyapatite contributes to the maxillary sinus floor elevation? A randomized clinical trial.

OBJECTIVE: The combination of calcium phosphate with blood-derived growth factors (BDGF) has been widely used in bone regeneration procedures although its benefits are still unclear. The purpose of this study was to evaluate whether or not BDGF improves the efficacy of a modified carbonated calcium phosphate biomaterial in sinus floor augmentation. MATERIAL AND METHODS: Ten patients underwent 20 sinus floor augmentation procedures using nanostructured carbonated hydroxyapatite (cHA) microspheres alone or associated with BDGF in a randomized controlled clinical trial. The in vitro release of growth factors was assessed by an elution assay. Bone grafts were randomly implanted in the right and left maxillary sinuses of each participant, associated either with a 0.9% saline solution or BDGF. Bone gain was evaluated through cone beam tomography after 180 days. RESULTS: Nine women and one man composed the sample. The blood-derived concentrates were able to release high levels of growth factors and cytokines. A significant clinical advantage was observed in the use of the BDGF after fibrin polymerization around the biomaterial microspheres, optimizing the surgical procedures, thereby reducing the time and displacement, and improving the adaptation of the biomaterial in the maxillary sinus. No synergistic effect was observed in bone formation when cHA was associated with BDGF (p > 0.05). CONCLUSION: Equivalent new bone formation was observed for cHA in the presence or absence of the BDGF concentrate in bilateral sinus floor elevation after 6 months. Blood-derived growth factors did not improve bone repair when associated with calcium phosphate in sinus lift procedures.

Aplicação do mapeamento genético molecular para o diagnóstico de Síndrome de Apert ­ uma abordagem multidisciplinar / Application of molecular genetic mapping for the diagnosis of Apert's Syndrome ­ a multidisciplinary approach

A Síndrome de Apert é uma doença congênita rara caracterizada por fusão prematura da sutura coronal e estenose (disfunção) craniofacial grave, mas também exibe muitos outros defeitos cardíacos e pulmonares, bem como malformações neurais que podem levar a problemas cognitivos, na maior parte dos casos a anomalia é resultante de uma mutação paternal, afetando 1 a cada 160.000 nascidos vivos, com elevada incidência em asiáticos. A literatura escreve que essa síndrome é consequência de mutações do gene do fator de crescimento receptor 2 (FGFR2), abrangendo dois aminoácidos adjacentes, que ocorrem durante o processo de formação. Concluiu-se que o paciente com esse tipo de comprometimento requer acompanhamento multidisciplinar de longo prazo pela maioria dos danos não serem aparentes nas fases iniciais de vida, pelas patologias dentoesqueléticas, necessitando de tratamento odontológico periodicamente (AU).

Apert Syndrome is a rare congenital disease characterized by premature fusion of the coronal suture and severe craniofacial stenosis (dysfunction), but also exhibits many other cardiac and pulmonary defects as well as neural malformations that can lead to cognitive problems, in most cases anomaly is the result of a paternal mutation, affecting 1 in 160,000 live births, with high incidence in Asian people. Literature writes that this syndrome is a consequence of mutations of the growth factor receptor 2 (FGFR2) gene encompassing two adjacent amino acids that occur during the formation process. It is concluded that the patient with this type of impairment requires long-term multidisciplinary follow-up because most of the damages are not apparent in the early stages of life due to dentoskeletal pathologies requiring dental treatment periodically (AU).