Polydioxanone Membrane Compared with Collagen Membrane for Bone Regeneration.

Guided bone regeneration (GBR) is an approach that induces osteopromotion through the regenerative membranes. These barriers exhibit bioactive behavior and mechanical function. Polydioxanone is a synthetic option, already used in medicine and dentistry, with good results in bone regeneration. This study aimed to evaluate bone repair in critical defects in rat calvaria using a polydioxanone membrane (Plenum® Guide) compared with a commercially available collagen-based membrane (Bio-Gide®). The bone defects were filled with Plenum® Osshp, a synthetic bone graft, hydroxyapatite:ß-tricalcium phosphate, 70:30%, Group PG (Plenum® Guide + Plenum® Osshp), and Group BG (Geistlich Bio-Gide® + Plenum® Osshp). The specimens were submitted to immunohistochemical (RUNX2 and OPN), gene expression (RUNX2, IBSP, and VEGF), histometric, and microtomography analyses after 07, 15, 30, and 60 days postoperative. PG group showed greater immunolabeling area for RUNX2 and OPN, higher gene expression of VEGF (3.15 ± 0.85), and IBSP (24.9 ± 0.59). However, there was no statistical difference between groups in the histometric analysis regarding the percentage of connective tissue PG (0.83 ± 0.45), BG (0.70 ± 0.34), neoformed bone PG (0.60 ± 0.4), BG (0.65 ± 0.51), and remaining biomaterial PG (0.84 ± 0.31), BG (0.91 ± 0.33). In addition, there was no statistical difference between groups by micro-CT analysis. The absorbable-synthetic membrane, Plenum® Guide, is an effective membrane for guided bone regeneration.

Tissue response to different incision tools in animal model.

PURPOSE: The aim of this study is to compare the repair of incisions performed with microdissection electrocautery tip, conventional electrocautery tip, high potency diode laser, and conventional scalpel blade in a in vivo model. METHODS: Different incisions were performed in adults Holtzman rats using the four types of instruments: microdissection electrocautery tip, conventional electrocautery tip, high potency diode laser, and conventional scalpel blade, in different periods of healing process. Thirty rats were divided into 5 groups, according to the period of euthanasia-24 h, 48 h, 72 h, 7 days, and 14 days. All animals received four incisions, each by a different method. Quantitative histological and histomorphometric analyses were performed using hematoxylin and eosin (HE) and Picrosirius Red staining. RESULTS: Inflammatory profile and tissue repair presented small statistically significance differences comparing conventional scalpel blade and microdissection tip; moreover, both presented quantitatively superior to the others. CONCLUSION: It is believed that the microdissection tip can perform a dynamic incision just as a common scalpel blade, but more effective. Furthermore, it can promote a better hemostatic control of the surgical field that is comparable to conventional electrocautery tip without affecting tissue repair.

Nasal Septal Deviation After Surgically Assisted Rapid Maxillary Expansion.

Background and Aim: Surgically assisted rapid maxillary expansion (SARME) is a surgical technique widely used to correct deficiency of the transverse maxillary dimension. Although some studies investigated the effect of SARME on nasal and facial alterations, there is no evidence that correlates nasal septal deviation (NSD) to SARME as a possible postoperative sequel. The aim of this study is to address and quantify possible variations in the position of the nasal bony septum after SARME and identify any NSD as a postoperative outcome of this surgical technique. Patients and Methods: This is a retrospective study, conducted at the Department of Oral and Maxillofacial Surgery of the University Hospital of Araraquara (Unesp, faculty of dentistry), SP, Brazil. Twenty-nine patients who underwent SARME were studied; every patient was evaluated by cone-beam computerized tomography (CBCT) before (T0) and six months after surgery (T1), and we collected the variation of nasal septal position by measuring the distance between the bony septum and the nasal lateral wall. Our measurements were carried out at the level of the head, midpoint and tail of the inferior turbinate. Results: A mean NSD ranging from 0.4 to 1.2 mm was measured, and it is more pronounced at the anterior part of the bony septum. Twenty-seven patients (93.1%) presented minor changes in bony septum position; in 2 cases (6.8%), a significant NSD was found (p < 0.05). Conclusion: A variation of bony nasal septum position can be expected in any direction after SARME, and it is more pronounced at anterior portion.

Cellular Response of Human Osteoblasts to Different Presentations of Deproteinized Bovine Bone.

Objectives: This study evaluated the cellular response of primary osteoblasts exposed to two different presentations of a low-temperature non-sintered deproteinized bovine bone matrix (DBBM). Materials and methods: Six different baths of a commercially available DBBM block (Bonefill® Porous Block) and one of DBBM granule (Bonefill® Porous) were evaluated to identify the mineral structure and organic or cellular remnants. Samples of the same baths were processed in TRIZOL for RNA extraction and quantification. For the immunologic cell reaction assay, primary human osteoblasts (pOB) were exposed to DBMM block (pOB + B) or granules (pOB + G), or none (control) for 1, 3, or 7 days of cell cultivation. Expression of proinflammatory cytokines by pOB was evaluated by crosslinked ELISA assay. In addition, total DNA amount, as well as cell viability via LDH evaluation, was assessed. Results: Organic remnants were present in DBBM blocks; 45.55% (±7.12) of osteocytes lacunae presented cellular remnants in blocks compared to 17.31% (±1.31) in granules. In three of five batches of blocks, it was possible to isolate bovine RNA. The highest concentration of TGF-ß1 was found in supernatants of pOB + G on day 7 (218.85 ± 234.62 pg/mL) (p < 0.05), whereas pOB + B presented the lowest amount of TGF-ß1 secretion at the end of evaluation (30.22 ± 14.94 pg/mL, p < 0.05). For IL-6 and OPG, there was no statistical difference between groups, while pOB + G induced more IL-8 secretion than the control (3.03 ± 3.38 ng/mL, p < 0.05). Considering the kinetics of cytokine release during the study period, all groups presented a similar pattern of cytokines, estimated as an increasing concentration for IL-6, IL-8, and OPG during cultivation. Adherent cells were observed on both material surfaces on day 7, according to H&E and OPN staining. Conclusion: Neither tested material induced a pronounced inflammatory response upon osteoblast cultivation. However, further studies are needed to elucidate the potential influence of organic remnants in bone substitute materials on the regeneration process.

Horizontal ridge augmentation using xenogenous bone graft-systematic review.

PURPOSE: This study aimed to perform a systematic review about the use of xenogenous bonegraft in horizontal ridge augmentation to answer the following question: In implant patients, treated with xenografts for horizontal ridge augmentation, what would be the outcomes in terms of bone gain, bone resorption, implant survival, and complication rates? METHODS: The main search was performed at PubMed, Cochrane, and Scopus databases, and found 2610 articles. After selection and duplicate removal, 29 studies were included in the final review. The collected data were sample size, number and type of graft, site, horizontal gain, resorption rate, and complications. RESULTS: A total of 610 patients were submitted to 853 bone grafts, both in the maxilla and mandible. Most studies (n = 26) used particulate grafts, isolated or associated with autogenous bone, and covered by collagen membrane or titanium mesh. The mean of horizontal bone gain was 4.44 mm. In addition, the augmented ridges allowed placement of 1325 successful dental implants. The complication rate was 7.85%, and membrane exposure was the most reported complication. CONCLUSIONS: Although the autogenous bone graft remains as the gold standard for alveolar reconstruction, this review suggests that xenogenous bone graft is a feasible alternative for horizontal bone augmentation.

Surgical Treatment of Fibroosseous Lesion in Young Patient with Reduced Mouth Opening.

Fibrous dysplasia is a benign fibroosseous disorder that can affect the maxillary bones, causing aesthetic deformity and functional impairment. This article reports the case of a 13-year-old male patient at the time of diagnosis. The patient showed increased facial volume with relevant asymmetry, having reported the onset of the condition 12 months before. Upon examination, the patient presented an 8-mm mouth opening and an acute inflammatory process associated with tooth 37 pericoronal hood. Upon imaging exam, exuberant bone growth in the left mandibular ramus area of ground glass aspect was observed. After incisional biopsy, fibrous dysplasia was diagnosed and sequentially treated with osteoplasty and coronoid process removal. The patient evolved to a 43-mm mouth opening and favorable aesthetics without recurrence in a 3-year follow-up period. In this case, coronoidectomy and bone plasty proved to be effective, returning aesthetics and function. The patient is supposed to be followed up in the long term.

Double unilateral, bilateral, and multiple mandibular fractures: an observational study.

PURPOSE: Double and multiple mandibular fractures are associated to high morbidity and functional damage. This study aimed to evaluate the characteristics and outcomes of double unilateral, bilateral, and multiple mandibular fractures. METHODS: A 7-year observational retrospective analysis was performed, and the injury-related data were collected from the medical records. Statistical analysis was performed using Fisher's exact test (p < 0.05). RESULTS: In this period, 283 patients showed mandibular fractures. Of them, 83 (29.7%) had double or multiple mandibular fractures and were included in the study. Double bilateral fractures were more prevalent than multiple or double unilateral. Multiple fractures presented significant association with the combination of load-bearing and load-sharing fixation protocols. Most cases (94.0%) applied at least one type of internal fixation system. However, there was a positive association between condylar fractures and non-surgical treatment (p < 0.01). Moreover, mandibular body fractures were associated with load-bearing fixation (p < 0.01). In 56 cases, no complications were observed (67.5%). Complications were divided into treatment failure (10.8%) and transitory or minor complications (21.7%). There was no statistical association between complications and fracture pattern, fracture-tooth relation, and treatment modality. CONCLUSION: Double and multiple mandibular fractures represented almost one third of all mandibular fractures, and regardless to treatment protocol, there was no difference about complications. Moreover, although a considerable complication rate was found, most of them were minor or transitory.

A 10-year retrospective study of dental trauma in permanent dentition / Estudio retrospectivo de 10 años sobre trauma dental en la dentición permanente

Objective. This study aims to identify the characteristics and factors associated with TDI treated at a referral service. Material and methods. A ten-year period cross-sectional retrospective analysis of medical records of patients with TDI in their permanent teeth was performed, and injury-related data were collected. Statistical analysis was performed using the chi-square association test and complex analysis (p<0.05). Results. Records of 545 patients, totaling 1438 traumatized teeth, were evaluated, and a male prevalence at a 2.4:1 ratio was found. The age group with highest incidence was 13-19 years. Central maxillary incisors and dislocations were the most affected teeth and TDI, respectively. Statistical analysis showed different TDI causes according to age: children are often victims of falls, traffic accidents, aggression and collisions, whereas adolescents are involved in sports accidents, and young adults in traffic accidents, falls and collisions. Conclusion. Considering the scope of this retrospective study at a single referral center, a profile of young male patients with TDI in superior central incisors due to falls, collisions, traffic accidents or sports could be detected

Objetivo. Identificar las características y los factores asociados con el traumatismo dentoalveolar (TD) atendido en un servicio de referencia. Material y métodos. Ha sido realizado un análisis retrospectivo de los pacientes con TD en dientes permanentes en un período de10 años. Fueron extraídos los datos relacionados con el TD. El análisis estadístico se realizó mediante el test de asociación chi-cuadrado y el análisis de los residuos (p<0,05). Resultados. Los registros de 545 pacientes con un total de 1.438 dientes traumatizados fueron incluidos. Se constata la prevalencia en el sexo masculino, con una proporción de 2,4:1. El grupo etario con mayor incidencia fue el de 13-19 años. Los incisivos centrales superiores fueron los dientes más afectados y el traumatismo dentario más diagnosticado fueron las luxaciones. El análisis estadístico ha mostrado una asociación de diferentes causas de TD con la edad: los niños son víctimas, con mayor probabilidad, de caídas, accidentes de tránsito, agresiones y colisiones, mientras que los adolescentes los son de accidentes deportivos, y los adultos jóvenes de accidentes de tráfico, caídas y colisiones. Conclusión. Considerando el alcance de este estudio retrospectivo en un único servicio de referencia, se detectó un perfil de jóvenes pacientes del sexo masculino con la presencia de TD en los incisivos centrales superiores por las caídas, colisiones, accidentes de tráfico o prácticas deportivas

(7-Chloroquinolin-4-yl)arylhydrazones: Candida albicans enzymatic repression and cytotoxicity evaluation, Part 2.

OBJECTIVE: This work describes the anti-enzymatic activity of (7-chloroquinolin-4-yl)arylhydrazones against Candida albicans and examines their cytotoxicity. MATERIAL AND METHODS: Ten C. albicans strains [nine isolates and one azole-resistant standard strain (ATCC 62342)] were used to assess the anti-enzymatic activity. Fifteen compounds at sub-antifungal concentrations ranging from 12.5 to 100 µg/ml were assessed after a 30-min exposure. The strains were seeded onto petri dishes with selective agar media for aspartyl proteases (Saps) and phospholipases (PLs). Enzymatic inhibition was measured by the reduction of the precipitation zone (Pz) against untreated strains (positive control). A colorimetric MTT assay was used with 3T3/NIH mouse fibroblasts to evaluate cytotoxicity. Cells were exposed to 15 compounds in concentrations from 6.25 to 100 µg/ml for 24 and 48 h. RESULTS: Four hydrazones showed enzymatic repression values over 40% to Pl and three over 20% to Saps. The cell viability was over 50% at hydrazone concentrations of 25-100 µg/ml. CONCLUSION: These results revealed that select (7-chloroquinolin-4-yl)arylhydrazones may be potential antifungal agents for the control of C. albicans infections.