Improved brachial skin hydration and appearance with hyperdiluted calcium hydroxylapatite.

INTRODUCTION: The search for minimally invasive treatments for areas not covered by clothing, such as the arms, has increased, particularly to combat flaccidity resulting from factors such as aging and weight loss. This study evaluated the efficacy of calcium hydroxyapatite (CaHA), an injectable biostimulator, in improving flaccidity and hydration of the skin of the arms. MATERIALS AND METHODS: Six women between 40 and 50 years old with visible signs of brachial flaccidity were selected. Calcium hydroxyapatite was injected into the arms in a 1:4 dilution (1.5 mL per side), with subjective evaluation based on the GAIS score and objective hydration analysis using corneometry. RESULTS: After a single application of CaHA, there was a significant increase in skin hydration (12.2%), objectively assessed by corneometry. Patient and physician satisfaction was high, evidenced by visible improvements in photographs and by the GAIS score. No significant adverse events were reported, demonstrating the safety of the procedure. DISCUSSION: Our clinical observations confirm the ability of CaHA to visibly improve arm flaccidity. In addition, hydration measures support previous histological studies demonstrating increases in dermal proteoglycans. Compared to other studies, the increase in skin hydration with CaHA was similar to those obtained with hyaluronic acid, suggesting comparable results with a more comfortable and less invasive technique. CONCLUSION: This study demonstrates the efficacy of CaHA in improving hydration of brachial skin after a single treatment. Despite the limitations of the sample size, the research contributes to the medical literature, highlighting the utility of the 3 mL CaHA presentation for brachial treatment with objective results in skin hydration.

Clinical and Histological Effects of Calcium Hydroxyapatite Filler in the Orofacial Region: A Study in Rats.

BACKGROUND: Calcium hydroxyapatite (CaHA) dermal filler has been increasingly used in facial aesthetic procedures. OBJECTIVE: To investigate clinical and histological changes associated with calcium hydroxyapatite (CaHA) dermal filler in the orofacial region. MATERIALS AND METHODS: Forty-eight female Wistar rats were divided into CaHA and control groups. The material was applied in the ventral tongue and the submandibular region; the animals were euthanized after 7, 30, and 90 days. RESULTS: After 7 days, yellowish nodules with a firm consistency were observed on the tongue. In 2 animals, the material migrated to the base of the tongue. Histopathological examination revealed CaHA spheres surrounded by an infiltrate, predominantly composed of macrophages. In the CaHA group, the percentage of collagen in the tongue and dermis was higher compared with the control group ( p < .05) at both 30 and 90 days. The thickness of the epidermis/dermis was also higher in the CaHA group ( p < .05). In 5 submandibular glands containing material, areas of edema and hyperemia were observed, along with infiltrates of neutrophils, lymphocytes, and plasma cells. Changes in the morphology of ducts and acini in adjacent regions were evident. CONCLUSION: CaHA exhibits satisfactory properties for filling and collagen biostimulation in the tested regions. Further studies are required to explore the potential for migration and the glandular alterations.

Agentes de abultamiento en incontinencia de orina de esfuerzo femenina: una alternativa a las mallas suburetrales / Bulking agents in female stress urinary incontinence: an alternative to suburethral mesh

OBJETIVO: Presentar una serie de casos de agentes de abultamiento (AA) de nuestro centro. MATERIAL Y MÉTODOS: Estudio retrospectivo. Se evaluaron todos los casos operados con AA entre 2017 y 2022. La inyección de AA se realizó en quirófano, bajo sedación con anestesia local periuretral o raquídea. La inyección se realizó con uretroscopia, 0,5 cc en 4 puntos periuretrales (horas 2, 5, 7 y 10). Se analizaron datos demográficos, quirúrgicos y de seguimiento. RESULTADOS: 15 casos. 13/15 presentaron incontinencia urinaria mixta. Solo dos casos tenían incontinencia de orina de esfuerzo pura. El procedimiento fue ambulatorio. La mediana del tiempo operatorio fue 15 minutos (15-20). La mediana de seguimiento fue 5 meses (1-9). El índice de severidad preoperatorio promedio fue 10,6 y en el seguimiento fue 2,79. La Escala de Mejoría Global mostró mejoría en 12/15, y 12/15 estaban satisfechas con la cirugía con mejoría en la calidad de vida. CONCLUSIÓN: Los AA son una opción quirúrgica efectiva, con una tasa de éxito del 80% en otros reportes, siendo similar con nuestra casuística. Ofrecer esta opción es posible a la hora de hablar de terapias alternativas.

OBJECTIVE: To present a case series of bulking agents (BA) from our center. MATERIAL AND METHODS: Retrospective study. All cases operated with BA between 2017 and 2022 were evaluated. A BA injection was performed in the operating room, under periurethral local anesthesia sedation or spinal anesthesia. The injection was performed with urethroscopy, 0.5 cc in 4 periurethral points (hours 2, 5, 7 and 10). Demographic, surgical, and follow-up data were analyzed. RESULTS: 15 cases were reported. 13/15 patients presented with mixed urinary incontinence. Only 2 cases had pure stress urinary incontinence. The procedure was ambulatory. Median operative time was 15 minutes (15-20). Median follow-up was 5 months (1-9). The average preoperative Sandvik Severity Index was 10.6 and in follow-up was 2.79. The PGI showed improvement in 12/15, and 12/15 were satisfied with the surgery with quality-of-life improvement. CONCLUSION: BA are an effective surgical option, with a success rate of 80%, according to other reports, being similar with our casuistry. Offer this option is possible at the moment of discussing alternative therapies.

Production and Characterization of Chitooligosaccharides: Evaluation of Acute Toxicity, Healing, and Anti-Inflammatory Actions.

The search for promising biomolecules such as chitooligosaccharides (COS) has increased due to the need for healing products that act efficiently, avoiding complications resulting from exacerbated inflammation. Therefore, this study aimed to produce COS in two stages of hydrolysis using chitosanases derived from Bacillus toyonensis. Additionally, this study aimed to structurally characterize the COS via mass spectrometry, to analyze their biocompatibility in acute toxicity models in vivo, to evaluate their healing action in a cell migration model in vitro, to analyze the anti-inflammatory activity in in vivo models of xylol-induced ear edema and zymosan-induced air pouch, and to assess the wound repair action in vivo. The structural characterization process pointed out the presence of hexamers. The in vitro and in vivo biocompatibility of COS was reaffirmed. The COS stimulated the fibroblast migration. In the in vivo inflammatory assays, COS showed an antiedematogenic response and significant reductions in leukocyte migration, cytokine release, and protein exudate. The COS healing effect in vivo was confirmed by the significant wound reduction after seven days of the experiment. These results indicated that the presence of hexamers influences the COS biological properties, which have potential uses in the pharmaceutical field due to their healing and anti-inflammatory action.

Silk fibroin nanocomposites as tissue engineering scaffolds - A systematic review.

Silk fibroin is a protein with intrinsic characteristics that make it a good candidate as a scaffold for tissue engineering. Recent works have enhanced its benefits by adding inorganic phases that interact with silk fibroin in different ways. A systematic review was performed in four databases to study the physicochemical and biological performance of silk fibroin nanocomposites. In the last decade, only 51 articles contained either in vitro cell culture models or in vivo tests. The analysis of such works resulted in their classification into the following scaffold types: particles, mats and textiles, films, hydrogels, sponge-like structures, and mixed conformations. From the physicochemical perspective, the inorganic phase imbued in silk fibroin nanocomposites resulted in better stability and mechanical performance. This review revealed that the inorganic phase may be associated with specific biological responses, such as neovascularisation, cell differentiation, cell proliferation, and antimicrobial and immunomodulatory activity. The study of nanocomposites as tissue engineering scaffolds is a highly active area mostly focused on bone and cartilage regeneration with promising results. Nonetheless, there are still many challenges related to their application in other tissues, a better understanding of the interaction between the inorganic and organic phases, and the associated biological response.

Special Issue: Biopolymers in Drug Delivery and Regenerative Medicine.

Biopolymers and biocomposites have emerged as promising pathways to develop novel materials and substrates for biomedical applications [...].

Surface functionalized mesoporous silica nanoparticles for intravitreal application of tacrolimus.

Tacrolimus (TAC), a potent immunosuppressive macrolide, has been investigated for ocular diseases due to promising results in the treatment of anterior and posterior segments eye diseases. Mesoporous and functionalized silica nanoparticles show potential as TAC delivery platforms owing to their interesting characteristic as large surface area, uniform pore size distribution, high pore volume, and excellent biocompatibility. The purpose of this study was to incorporate TAC in functionalized silica nanoparticles with 3-aminopropyltriethoxysilane (MSNAPTES) and investigate the safety and biocompatibility of the systems. The MSNAPTES and MSNAPTES TAC nanoparticles were characterized. The in vitro cytotoxicity of MSNAPTES and MSNAPTES load with TAC (MSNAPTES-TAC) in retinal pigment epithelial cells (ARPE-19) was determined, chorioallantoic membrane (CAM) assay model was used to investigate the in vivo biocompatibility, and safety of intravitreal injection was evaluated using clinical examination (assessment of intraocular pressure and indirect fundus ophthalmoscopy), electroretinographic (ERG) and histologic studies in rats' eyes. The elemental analysis (CHN), thermogravimetric (TGA), photon correlation spectroscopy and Fourier transform infrared (FTIR) analysis confirmed the presence of functionalized agent and TAC in the MSNAPTES nanoparticles. TAC loading was estimated at 7% for the MSNAPTES TAC nanoparticles. MSNAPTES and MSNAPTES TAC did not present in vitro cytotoxicity. The drug delivery systems showed good biocompatibility on CAM. No retinal abnormalities, vitreous hemorrhage, neovascularization, retinal detachment, and optic nerve atrophy were observed during the in vivo study. Follow-up ERGs showed no changes in the function of the retina cells after 15 days of intravitreal injection, and histopathologic observations support these findings. In conclusion, MSNAPTES TAC was successfully synthesized, and physicochemical analyses confirmed the presence of TAC in the nanoparticles. In vitro and in vivo studies indicated that MSNAPTES TAC was safe to intravitreal administration. Taking into account the enormous potential of MSNAPTES to carry TAC, this platform could be a promising strategy for TAC ocular drug delivery in the treatment of eye diseases.

Influência de scaffolds à base de cimento de aluminato de cálcio incorporados com células mesenquimais na regeneração óssea: estudo in vivo / Influence of scaffolds based on calcium aluminate cement, incorporated with mesenchymal cells, in bone regeneration: an in vivo study

O cimento de aluminato de cálcio (CAC) tem se tornado um biomaterial de destaque para a neoformação óssea devido às suas propriedades físicas, mecânicas e biocompatibilidade, além de possuir coeficiente de expansão térmica similar ao osso humano. O objetivo neste trabalho foi avaliar o potencial de regeneração óssea de scaffolds à base de CAC, incorporados ou não com células mesenquimais (MSC) em defeitos ósseos realizados em fêmures de ratos. Foram produzidos 48 scaffolds de CAC e suas blendas fosfato tricálcico (FOSF), óxido de zinco (ZNO) e zircônia (ZIRC), sendo que metade destes foram incorporados com MSC. Vinte e três ratos Wistar foram utilizados, sendo 03 para isolamento das MSC e 20 para confecção de defeitos ósseos em ambos os fêmures. Estes, receberam scaffolds do mesmo material incorporados com MSC do lado esquerdo e não incorporados do lado direito (n=5); e foram eutanasiados 21 dias após o procedimento cirúrgico.Na análise dos scaffolds por microscopia eletrônica de varredura foram verificadas estruturas com poros abertos e interconectados, além de adesão celular em todos os grupos.Na análise histológica, foi observado que todos os grupos apresentaram trabéculas ósseas neoformadas, entremeadas por células da medula óssea e tecido conjuntivo. Na histomorfometria, para os scaffolds não incorporados com MSC, observou-se que o grupo ZIRC apresentou maior neoformação óssea e nos scaffolds incorporados com MSC, o grupo FOSF demonstrou melhores resultados, ambos exibindo diferença estatística para os demais grupos (p<0,05). Na análise intragrupos, todos os grupos exibiram maior neoformação óssea quando incorporados com MSC, exceto o grupo ZIRC, único que apresentou melhores resultados quando não incorporado com MSC. Concluiu-se que scaffolds da blenda ZIRC promovem maior neoformação óssea, porém, quando estes são incorporados com MSC, a blenda FOSF exibe os melhores resultados. A incorporação de MSC influenciou positivamente a neoformação óssea, exceto na blenda ZIRC. Concluiu-se ainda que, dentre todos os grupos, o ZIRC sem células e o FOSF com células mostraram-se mais promissores na neoformação óssea, sem diferença estatística entre eles (p<0,05)(AU)

Calcium aluminate cement (CAC) has become a prominent biomaterial for bone neoformation due to its physical, mechanical and biocompatibility properties, in addition to having a coefficient of thermal expansion similar to human bone. The objective of this work was to evaluate the bone regeneration potential of scaffolds based on CAC, incorporated or not with mesenchymal cells (MSC) in bone defects performed in rat femurs. 48 CAC scaffolds and their tricalcium phosphate (FOSF), zinc oxide (ZNO) and zirconia (ZIRC) blends were produced, half of which were incorporated with MSC.Twenty three Wistar rats were used, being 03 for isolation of MSC and 20 for making bone defects in both femurs. These received scaffolds of the same material incorporated with MSC on the left side and not incorporated on the right side (n = 5); and were euthanized 21 days after the surgical procedure. In the analysis of the scaffolds by scanning electron microscopy, structures with open and interconnected pores were verified, in addition to cell adhesion in all groups. In the histological analysis, it was observed that all groups presented bone trabeculae. neoformed, interspersed with bone marrow cells and connective tissue. In histomorphometry, for the scaffolds not incorporated with MSC, it was observed that the ZIRC group showed greater bone neoformation and in the scaffolds incorporated with MSC, the FOSF group demonstrated better results, both showing statistical difference for the other groups (p <0.05). In the intragroup analysis, all groups exhibited greater bone neoformation when incorporated with MSC, except for the ZIRC group, the only one that showed better results when not incorporated with MSC. It was concluded that scaffolds from the ZIRC blend promote greater bone neoformation, however, when these are incorporated with MSC, the FOSF blend exhibits the best results. The incorporation of MSC positively influenced bone neoformation, except in the ZIRC blend. It was also concluded that, among all groups, ZIRC without cells and FOSF with cells were more promising in bone neoformation, with no statistical difference between them (p <0.05)(AU)

New Insights for Red Propolis of Alagoas-Chemical Constituents, Topical Membrane Formulations and Their Physicochemical and Biological Properties.

The main objectives of this study were to evaluate the chemical constitution and allergenic potential of red propolis extract (RPE). They were evaluated, using high performance liquid chromatography (HPLC) and the release of ß-hexosaminidase, respectively. A plethora of biologically active polyphenols and the absence of allergic responses were evinced. RPE inhibited the release of ß-hexosaminidase, suggesting that the extract does not stimulate allergic responses. Additionally, the physicochemical properties and antibacterial activity of hydrogel membranes loaded with RPE were analyzed. Bio-polymeric hydrogel membranes (M) were obtained using 5% carboxymethylcellulose (M1 and M2), 1.0% of citric acid (M3) and 10% RPE (for all). Their characterization was performed using thermal analysis, Fourier transform infrared (FTIR), total phenolic content, phenol release test and, antioxidant activity through 2,2-diphenyl-1-picrylhydrazyl radical (DPPH) and Ferric Reducing Antioxidant Power (FRAP). The latter appointed to the similar antioxidant capacity of the M1, M2 and M3. The degradation profiles showed higher thermostability to M3, followed by M2 and M1. The incorporation of RPE into the matrices and the crosslinking of M3 were evinced by FTIR. There were differences in the release of phenolic compounds, with a higher release related to M1 and lower in the strongly crosslinked M3. The degradation profiles showed higher thermostability to M3, followed by M2 and M1. The antibacterial activity of the membranes was determined using the disc diffusion assay, in comparison with controls, obtained in the same way, without RPE. The membranes elicited antibacterial activity against Staphylococcus aureus and Staphylococcus epidermidis, with superior performance over M3. The hydrogel membranes loaded with RPE promote a physical barrier against bacterial skin infections and may be applied in the wound healing process.

Evaluation of in vitro and in vivo biocompatibility of iron produced by powder metallurgy.

Biodegradable metallic materials (BMMs) are expected to corrode gradually in vivo after providing the structural support to the tissue during its regeneration and healing processes. These characteristics make them promising candidates for use in stents. These endoprostheses are produced from metal alloys by casting and thermomechanical treatment. Since porous alloys and metals have less corrosion resistance than dense ones, the use of powder metallurgy becomes an option to produce them. Among the metals, iron has been proposed as a material in the manufacturing of stents because of its mechanical properties. However, even then it is unclear what toxicity threshold is safe to the body. Thus, the objective of this research was to verify the biocompatibility of sintered 99.95% and 99.5% pure iron by powder metallurgy in vitro with Adipose-derived mesenchymal stromal cells (ADSCs) and in vivo with a Wistar rat model. Herein, characterizations of iron powder samples produced by the powder metallurgy and the process parameters as compression pressure, atmosphere, sintering time and temperature were determined to evaluate the potential of production of biodegradable implants. The samples obtained from pure iron were submitted to tests of green and sintered density, porosity, microhardness, hardness and metallography. The biocompatibility study was performed by indirect and direct cell culture with iron. The effects of corrosion products of iron on morphology, viability, and proliferation of ADSCs were evaluated in vitro. Hemolysis assay was performed to verify the hemocompatibility of the samples. In vivo biocompatibility was evaluated after pure iron discs were implanted subcutaneously into the dorsal area of Wistar rats that were followed up to 6 months. The results presented in this paper validated the potential to produce biodegradable medical implants by powder metallurgy. Both iron samples were hemocompatible and biocompatible in vitro and in vivo, although the 99.95% iron had better performance in vitro than 99.5%.

Enhancement of cellular activity in hyperglycemic mice dermal wounds dressed with chitosan-alginate membranes

The use of specially designed wound dressings could be an important alternative to facilitate the healing process of wounds in the hyperglycemic state. Biocompatible dressings combining chitosan and alginate can speed up wound healing by modulating the inflammatory phase, stimulating fibroblast proliferation, and aiding in remodeling phases. However, this biomaterial has not yet been explored in chronic and acute lesions of diabetic patients. The aim of this study was to evaluate the effect of topical treatment with a chitosan-alginate membrane on acute skin wounds of hyperglycemic mice. Diabetes mellitus was induced by streptozotocin (60 mg · kg-1 · day-1 for 5 days, intraperitoneally) and the cutaneous wound was performed by removing the epidermis using a surgical punch. The results showed that after 10 days of treatment the chitosan and alginate membrane (CAM) group exhibited better organization of collagen fibers. High concentrations of interleukin (IL)-1α, IL-1β, granulocyte colony-stimulating factor (G-CSF), and tumor necrosis factor-alpha (TNF-α) were detected in the first and second days of treatment. G-CSF and TNF-α level decreased after 5 days, as well as the concentrations of TNF-α and IL-10 compared with the control group (CG). In this study, the inflammatory phase of cutaneous lesions of hyperglycemic mice was modulated by the use of CAM, mostly regarding the cytokines IL-1α, IL-1β, TNF-α, G-CSF, and IL-10, resulting in better collagen III deposition. However, further studies are needed to better understand the healing stages associated with CAM use.

The use of synthetic mesh in contaminated and infected abdominal wall repairs: challenging the dogma-A long-term prospective clinical trial.

BACKGROUND: Abdominal wall reconstruction in patients presenting with enteric fistulas and mesh infection is challenging. There is a consensus that synthetic mesh must be avoided in infected operations, and the alternatives to using synthetic mesh, such as component separation techniques and biologic mesh, present disappointing results with expressive wound infection and hernia recurrence rates. METHODS: A prospective clinical trial designed to evaluate the short- and long-term outcomes of 40 patients submitted to elective abdominal wall repair with synthetic mesh in the dirty-infected setting, and compared to a cohort of 40 patients submitted to clean ventral hernia repairs. Patients in both groups were submitted to a single-staged repair using onlay polypropylene mesh reinforcement. RESULTS: Groups' characteristics were similar. There were 13 (32.5%) surgical site occurrences in the infected mesh (IM) group, compared to 11 (27.5%) in the clean-control (CC) group, p = 0.626. The 30-day surgical site infection rate was 15% for the IM group vs. 10% for the CC cases, p = 0.499. One patient required a complete mesh removal in each group. The mean overall follow-up was 50.2 ± 14.8 months, with 36 patients in the IM group and 38 clean-controls completing a follow-up of 36 months. There was one hernia recurrence (4.2%) in the IM group and no recurrences in the CC group. CONCLUSION: We demonstrated that using polypropylene mesh in the infected setting presented similar outcomes to clean repairs. The use of synthetic mesh in the onlay position resulted in a safe and durable abdominal wall reconstruction. TRIAL REGISTRATION: Study registered at Plataforma Brasil (plataformabrasil.saude.gov.br), CAAE 30836614.7.0000.0068. Study registered at Clinical Trials (clinicaltrials.gov), Identifier NCT03702153.

Enhancement of cellular activity in hyperglycemic mice dermal wounds dressed with chitosan-alginate membranes.

The use of specially designed wound dressings could be an important alternative to facilitate the healing process of wounds in the hyperglycemic state. Biocompatible dressings combining chitosan and alginate can speed up wound healing by modulating the inflammatory phase, stimulating fibroblast proliferation, and aiding in remodeling phases. However, this biomaterial has not yet been explored in chronic and acute lesions of diabetic patients. The aim of this study was to evaluate the effect of topical treatment with a chitosan-alginate membrane on acute skin wounds of hyperglycemic mice. Diabetes mellitus was induced by streptozotocin (60 mg · kg-1 · day-1 for 5 days, intraperitoneally) and the cutaneous wound was performed by removing the epidermis using a surgical punch. The results showed that after 10 days of treatment the chitosan and alginate membrane (CAM) group exhibited better organization of collagen fibers. High concentrations of interleukin (IL)-1α, IL-1ß, granulocyte colony-stimulating factor (G-CSF), and tumor necrosis factor-alpha (TNF-α) were detected in the first and second days of treatment. G-CSF and TNF-α level decreased after 5 days, as well as the concentrations of TNF-α and IL-10 compared with the control group (CG). In this study, the inflammatory phase of cutaneous lesions of hyperglycemic mice was modulated by the use of CAM, mostly regarding the cytokines IL-1α, IL-1ß, TNF-α, G-CSF, and IL-10, resulting in better collagen III deposition. However, further studies are needed to better understand the healing stages associated with CAM use.

Avaliação do reparo ósseo de defeitos de tamanho crítico tratados com matriz óssea mineralizada de osso bovino (Bio-Oss®) / Assessment of bone repair of critical size defects treated with bovine bone mineral matrix (BioOss®) and low-level laser therapy: histomorphometric and immunohistochemical study in rats

Este estudo teve como objetivo investigar os efeitos da terapia com laser de baixa intensidade (LLLT) associada ao Bio-Oss® em defeitos de tamanho crítico de ratos. Foram utilizados 72 ratos machos adultos (Rattus norvegicus, variação albinus, Wistar), com 90 dias de idade. Foram realizados defeitos ósseos na calvária com 5 mm de diâmetro. Os animais foram divididos em 4 grupos: C-Coágulo sanguíneo, B- Bio-Oss®, L- LLLT, B+L- Bio-Oss® + LLLT. Cada grupo foi subdividido de acordo com os períodos de observação de 07, 30 e 60 dias, com 6 ratos em cada subgrupo. Para LLLT uma baixa energia GaAlAs com comprimento de onda de 660 nm, foi aplicada em 5 pontos. Foram distribuídos 4 pontos de aplicação ao longo das bordas da ferida e um ponto de aplicação localizado na região central da ferida cirúrgica. A irradiação foi liberada por 12 segundos por ponto, com uma densidade total de energia de 45 J/cm2. A irradiação com laser ocorreu de forma transcirurgica em única aplicação imediatamente após o procedimento. Em 07, 30 e em 60 dias, 6 animais de cada grupo foram eutanasiados pela aplicação de anestesia geral em dose triplicada, e após os testes de sensibilidade os animais foram decapitados. Em seguida a calvária foi removida para análises histomorfométrica e imunohistoquímica. Todos os dados histomorfométricos foram submetidos a análise por ANOVA, complementado pelo teste de Tukey. O nível de significância foi de 5%. Os resultados da imunohistoquímica foram representados por scores e porcentagem. Os grupos que apresentaram maior proporção de neoformação foram os grupos L (0,39±0,13) e C (0,37±0,97), porém os grupos B e B+L tiveram maior tamanho de defeito (C-1,75±0,40, B-3,02±0,63, L-2,45±0,53, B+L-3,23±1,01). Na imunohistoquímica, aos 60 dias, os grupos B (score 4-34%) e B+L (B+L score 4­50%) apresentaram maior scores de imunomarcação para OPG e RANKL, aos 30 dias a porcentagem de imunomarcação para TRAP aumentou em todos os grupos, sendo o L o único a apresentar espécimes com score 0 (16%). Os grupos que apresentaram maior proporção de neoformação foram os grupos L e C, no entanto, os maiores valores relacionados ao volume ósseo foram encontrados nos grupos B e B+L.Todos os grupos apresentaram menores valores referente a distância entre as bordas de osso neoformado no interior do defeito ao final do experimento.Os grupos B e B+L apresentaram os maiores scores de imunomarcação para OPG, as imunomarcações para TRAP apareceram mais tardiamente no grupo L(AU)

This study aimed to investigate the effects of low-level laser therapy (LLLT) associated with Bio-Oss® on critical size defects in rats. 72 adult male rats (Rattus norvegicus, variation albinus, Wistar), 90 days old, were used. Bone defects were made in the calvaria with a diameter of 5 mm. The animals were divided into 4 groups: C-blood clot, B-Bio-Oss®, L-LLLT, B + L- Bio-Oss® + LLLT. Each group was subdivided according to the observation periods of 07, 30 and 60 days, with 6 rats in each subgroup. For LLLT a low GaAlAs energy with a wavelength of 660 nm was applied at 5 points. 4 points of application were distributed along the edges of the wound and one point of application located in the central region of the surgical wound. The irradiation was released for 12 seconds per point, with a total energy density of 45 J/cm2. Laser irradiation occurred in a trans-surgical form in a single application immediately after the procedure. At 07, 30 and 60 days, 6 animals from each group were euthanized by applying triple dose of general anesthesia, after the sensitivity tests the animals were beheaded. Then the calvaria was removed for histomorphometric and immunohistochemistry analysis. All histomorphometric data were analyzed statistically by ANOVA, complemented by the Tukey test. The level of significance was 5%. The results of immunohistochemistry were represented by scores and percentage. The groups that showed the highest proportion of neoformation were groups L (0,39±0,13) and C (0,37±0,97), but groups B and B + L had a larger defect size (C-1,75±0,40, B-3,02±0,63, L-2,45±0,53, B+L-3,23±1,01). In immunohistochemistry, at 60 days, groups B (score 4- 34%) and B + L (B+L score 4 - 50%) had higher immunostaining scores for OPG and RANKL, at 30 days the percentage of immunomarking for TRAP increased in all groups, group L was the only one to present specimens with a score 0 (16%). The groups with the highest proportion of neoformation were groups L and C, however, the highest values related to bone volume were found in groups B and B+L. All groups had lower values regarding the distance between the edges of newly formed bone inside the defect at the end of the experiment. Groups B and B+L had the highest immunostaining scores for OPG, immunomarkings for TRAP appear later in group L(AU)

In Situ Endoscopic Analysis of Vascular Supply and Regenerated Alveolar Bone in ß-TCP Grafted and Ungrafted Postextraction Sites before Implant Placement: A Prospective Case Control Study.

BACKGROUND: Endoscopy has seen a significant development over recent years in various medical fields with its application expanding from the support of minimal invasive surgery to in situ imaging. In this context, the application of endoscopic techniques to assess the quality of the regenerated bone in situ in the drill hole before implant placement is an appealing approach. AIM: The aim of this study was to use short distance support immersion endoscopy (SD-SIE) to compare the quality of regenerated bone in healed postextraction sites, which are grafted with an in situ hardening ß-TCP, against ungrafted sites, before implant placement. This assessment was based on microscopic bone analysis in combination with the blood vessel count. METHOD: 13 spontaneously healed and 13 grafted postextraction sites in 3 men and 6 women, aged 26-83 years, were evaluated using SD-SIE after 4-6 months. SD-SIE was applied in drill holes before implant placement, and videos were taken from representative central buccal areas. The video recordings were analyzed using Image J software for (1) number of blood vessels per area (NBV), (2) relative area of vessels (VA), (3) relative area of mineralized bone (MBA), (4) relative area of unmineralized bone (UMBA), and (5) relative area of bone substitute (BSA). RESULTS: The grafted sites showed more (1) NBV as well as (2) VA (8.6 ± 1.1; 2.03 ± 0.28%) than the ungrafted sites (2.5 ± 0.6; 1.18 ± 0.36%) (independent t-test; p < 0.05); (3) MBA and (4) UMBA were similar to those in the grafted sites (86.3 ± 2.2 %; 13.7 ± 2.2 %) and to the ungrafted sites (89.5 ± 3.7%; 10.5 ± 3.6%) (independent t-test; p > 0.05); and (5) BSA in the grafted sites was 18.2 ± 5.4%. CONCLUSION: SD-SIE is an interesting new approach for in situ assessment of bone quality and blood supply before implant placement. The regenerated bone in ß-TCP grafted extraction sockets showed an increased vascularization compared to ungrafted sites providing a vital support for subsequent implant placement.

Sinus Floor Augmentation by Intraoral Endoscopic Approach for Biomaterial Study in a Rabbit Model.

AIM: To develop a new surgical model for sinus floor augmentation (SFA) in rabbit for experimental purposes. MATERIALS AND METHODS: Eight adult rabbits were used, two for a surgical design using the anatomical dissection study, and the other six for an endoscopically assisted intraoral approach of SFA unilaterally, creating a subantral space where an allograft biomaterial was deposited. SFA was verified through cone-beam computerized tomography. Healing, weight, food, feces, and behavior were evaluated for 4 weeks post-operatively. RESULTS: All animals survived. There was no bleeding or infection; inflammation was mild. No changes were observed in terms of feeding, weight, feces, or behavior. Tissue healing was normal. CONCLUSION: This model is a refinement of the experimental technique and is a real option for SFA, without compromising animal morbidity because of its conservative design. The minimally invasive approach with endoscopic assistance reduces bias and improves surgical predictability.

Electrospinning synthesis and assessment of physicochemical properties and biocompatibility of cobalt nitrate fibers for wound healing applications.

The aim of this study was to develop polyurethane (PU) wound dressing incorporated with cobalt nitrate using electrospinning technique. The morphology analysis revealed that the developed composites exhibited reduced fiber and pore diameter than the pristine PU. The electrospun membranes exhibited average porosity in the range of 67% - 71%. Energy-dispersive X-ray spectra (EDS) showed the presence of cobalt in the PU matrix. The interaction of cobalt nitrate with PU matrix was evident in Fourier transform infrared spectroscopy (FTIR) and thermogravimetric analysis (TGA). The contact angle results indicated the improved wettability of the prepared PU/cobalt nitrate composites (82° ± 2) than the pure PU (100° ± 1). The incorporation of cobalt nitrate into the PU matrix enhanced the surface roughness and mechanical strength as evident in the atomic force microscopy (AFM) and tensile test analysis. The blood compatibility assays revealed the anticoagulant nature of the prepared composites by displaying prolonged blood clotting time than the PU control. Further, the developed composite exhibited less toxicity nature as revealed in the hemolysis and cytotoxicity studies. It was observed that the PU wound dressing added with cobalt nitrate fibers exhibited enhanced physicochemical, better blood compatibility parameters and enhanced fibroblast proliferation rates which may serve as a potential candidate for wound dressings.

Bioceramic cement in the filling of bone defects in rats.

PURPOSE: To evaluate PBS®MCIMMO cement in the filling of bone defects. METHODS: Thirty-six adult male Wistar rats were divided into three groups of twelve individuals each (group 1, group 2 and group 3). In all groups, a bone failure in the femur was induced, 2.0 mm wide and 7.0 mm deep. In group 1, the PBS®MCIMMO cement was applied to the bone defect produced and a titanium implant (CONNECTION®) 1.5 mm thick and 6 mm long was installed. In group 2, only the PBS® CIMMO cement was installed. In group 3, only bone failure was performed. Kruskal Wallis tests were performed to compare the mean area among the three groups. RESULTS: In all comparisons, significance was observed for group 2 (p = 0.0014-0.0026). CONCLUSION: The PBS®CIMMO cement induced bone neoformation, and integration between the newly formed bone, cement, and implant was observed.

Steroid vs. antibiotic impregnated absorbable nasal packing for wound healing after endoscopic sinus surgery: a randomized, double blind, placebo-controlled study / Tampão nasal absorvível embebido em esteroides versus antibióticos para cicatrização de feridas após cirurgia endoscópica nasossinusal: estudo randomizado, duplo cego, placebo controlado

Abstract Introduction: Endoscopic sinus surgery can lead to crusting or synechiae formation, which can affect the healing process. Objective: The aim of our study was to compare the influence of steroid versus antibiotic versus saline solution impregnated absorbable nasal spacers on postoperative wound healing and patient satisfaction. Methods: Eighty patients, 33 women and 47 men, were enrolled in this study. At the end of the surgery, two pieces of 4 cm biodegradable material were applied in each ethmoid cavity. One of them was impregnated with saline solution, while the second one with steroid, or with antibiotic. Results: We observed statistically significant differences in the Lund-Kennedy score between the control and both treatment groups: for the Antibiotic-group on days 10 and 30 (p = 0.009; p = 0.009) and for the Steroid-group on day 90 (p = 0.008). The extended endoscopic appearance of nasal mucosa indicated statistically significant differences in crust formation on day 10 comparing the steroid and control dressing (p = 0.025), in secretion type on days 10 and 30 comparing the antibiotic and control dressing (p = 0.003; p = 0.016) and additionally for steroid and control on day 90 (p = 0.046). On Day 90 we observed statistically significant differences in the absence of mucosal edema in the S-group compared to controls (p = 0.007). Conclusions: The results of this study reveal the significant positive influence of steroid- and antibiotic-impregnated biodegradable nasal packing on the postoperative healing process and patient satisfaction compared to the saline soaked dressing.

Resumo Introdução: A cirurgia endoscópica nasossinusal pode levar à formação de crostas e sinéquias, o que pode afetar o processo de cicatrização. Objetivo: O objetivo do nosso estudo foi comparar a influência do espaçador nasal absorvível embebido em esteroide versus antibiótico versus solução salina na cicatrização de ferida pós-operatória e na satisfação do paciente. Método: Oitenta pacientes, 33 mulheres e 47 homens, foram incluídos neste estudo. Ao final da cirurgia, dois tampões de material biodegradável de 4 cm foram aplicados em cada cavidade etmoidal. Um deles foi embebido em solução salina, enquanto no segundo foi utilizado esteroide, ou antibiótico. Resultados: Observamos diferenças estatisticamente significantes no escore de Lund-Kennedy entre os grupos controle e ambos os grupos tratamentos: para o grupo antibiótico nos dias 10 e 30 (p = 0,009; p = 0,009) e para o grupo esteroide no dia 90 (p = 0,008). O aspecto endoscópico da mucosa nasal indicou diferenças estatisticamente significantes na formação de crostas no dia 10, na comparação do esteroide com o curativo controle (p = 0,025), no tipo de secreção nos dias 10 e 30, na comparação do antibiótico com o curativo controle (p = 0,003; p = 0,016) e adicionalmente para esteroide e controle no dia 90 (p = 0,046). No dia 90, observamos diferenças estatisticamente significantes na ausência de edema da mucosa no grupo E (esteroide) em relação aos controles (p = 0,007). Conclusões: Os resultados deste estudo revelam uma influência positiva significante no uso de tampão nasal biodegradável embebido em esteroides e antibióticos no processo de cicatrização pós-operatória e satisfação do paciente em comparação com o curativo embebido em solução salina.