Vital Bone Formation After Grafting of Autogenous Bone and Biphasic Calcium Phosphate Bioceramic in Extraction Sockets of Rats: Histological, Histometric, and Immunohistochemical Evaluation.

PURPOSE: The study aimed to investigate through histology, histometry, and immunohistochemistry the vital bone formation after grafting of biphasic calcium phosphate bioceramic (BC) in combination with calvarial autogenous bone into the dental sockets of rats. MATERIALS AND METHODS: Forty-five male rats were submitted to upper right incisor extraction and divided according to the grafted material in: control, bioceramic (BC), and bioceramic + autogenous bone (BC + AB). The animals were killed 7, 21, and 42 days after surgery for histological, histometric, and immunohistochemistry analysis. RESULTS: Histomorphometric results demonstrated, for BC + AB group, formation of trabecular bone between the particles of BCs and autogenous bone, connecting them, as well as higher percentage of vital bone in comparison with BC. Immunohistochemical reactions showed intense labeling for Runx2-positive cells in the group BC + AB. CONCLUSIONS: Autogenous bone was able to stimulate bone turnover enabling a larger amount of vital bone synthesis and can be recommended as a viable grafting material in combination with synthetic biphasic BC.

Effects of coffee intake and intraperitoneal caffeine on bone repair process--a histologic and histometric study.

Studies have suggested that caffeine acts on bone promoting an increase of calcium excretion, inhibition of osteoblast proliferation and delay in tissue repair process, raising the risk of fractures, osteoporosis, periodontal disease and affecting the success of bone reconstructive procedures. The aim of this study was to analyze histomorphometrically the process of alveolar bone healing after tooth extraction in rats subjected to daily intake of boiled coffee or intraperitoneal administration of caffeine. Forty-five male rats were divided according to the treatment in Control group (C); Coffee group (CO) - treated with coffee since birth; and Caffeine (CAF) - intraperitoneal injection of aqueous solution of caffeine 1.5% (0.2 mL/100g body weight) for 30 days. When weighing between 250-300 g they were anesthetized, subjected to extraction of the maxillary right incisor, and euthanized 7, 21 and 42 days after surgery for histological assessments of bone volume and the quality of formed bone in the dental socket. The qualitative results demonstrated larger amounts of blood clot and immature bone in animals under treatment of pure caffeine compared to coffee and control. Histometric analysis revealed that coffee treatment led to a 40% drop in bone formation, and caffeine a 60% drop in comparison to control animals (ANOVA p≤0.01). It was concluded that both the daily ingestion of coffee and the intraperitoneal administration of caffeine in rats delayed the alveolar bone reparative process after tooth extraction, and this effect was more aggressive when pure caffeine was used.

Effects of Coffee Intake and Intraperitoneal Caffeine on Bone Repair Process - A Histologic and Histometric Study

Studies have suggested that caffeine acts on bone promoting an increase of calcium excretion, inhibition of osteoblast proliferation and delay in tissue repair process, raising the risk of fractures, osteoporosis, periodontal disease and affecting the success of bone reconstructive procedures. The aim of this study was to analyze histomorphometrically the process of alveolar bone healing after tooth extraction in rats subjected to daily intake of boiled coffee or intraperitoneal administration of caffeine. Forty-five male rats were divided according to the treatment in Control group (C); Coffee group (CO) - treated with coffee since birth; and Caffeine (CAF) - intraperitoneal injection of aqueous solution of caffeine 1.5% (0.2 mL/100g body weight) for 30 days. When weighing between 250-300 g they were anesthetized, subjected to extraction of the maxillary right incisor, and euthanized 7, 21 and 42 days after surgery for histological assessments of bone volume and the quality of formed bone in the dental socket. The qualitative results demonstrated larger amounts of blood clot and immature bone in animals under treatment of pure caffeine compared to coffee and control. Histometric analysis revealed that coffee treatment led to a 40% drop in bone formation, and caffeine a 60% drop in comparison to control animals (ANOVA p≤0.01). It was concluded that both the daily ingestion of coffee and the intraperitoneal administration of caffeine in rats delayed the alveolar bone reparative process after tooth extraction, and this effect was more aggressive when pure caffeine was used.

Estudos têm sugerido que a cafeína age sobre o osso promovendo um aumento da excreção de cálcio, inibição da proliferação dos osteoblastos e retardo no processo de reparação tecidual, aumentando o risco de fraturas, osteoporose, doença periodontal, bem como afetando o sucesso de procedimentos de reconstrução óssea. O objetivo deste estudo foi analisar histomorfometricamente o processo de reparação óssea alveolar após extração dentária em ratos submetidos à ingestão diária de café fervido ou a administração intraperitoneal de cafeína. 45 ratos machos foram divididos de acordo com o tratamento, em controle (C); café (CO), tratados com café desde o nascimento; e cafeína (CAF), injeção intraperitoneal de solução aquosa de cafeína de 1,5 % (0,2 mL/100 g de peso corporal) durante 30 dias. Quando pesavam entre 250-300 g os animais foram anestesiados, submetidos à extração do incisivo superior direito, e sacrificados em 7, 21 e 42 dias após a cirurgia para análises histológicas quanto ao volume e à qualidade do osso formado no alvéolo dental. Os resultados qualitativos demonstraram grandes quantidades de coágulo sanguíneo e osso imaturo nos animais tratados com cafeína pura, em relação aos grupos café e controle. A avaliação histométrica mostrou que o tratamento com o café levou a uma queda na formação óssea de 40%, e com a cafeína de 60% em comparação ao grupo controle (ANOVA p≤0,01). Concluiu-se que tanto a ingestão diária de café quanto a administração intraperitoneal de cafeína em ratos retardou o processo de reparação do osso alveolar após extração dentária, e este efeito é mais agressivo quando do uso da cafeína pura.

Bone integration behavior of hydroxyapatite/ß-tricalcium phosphate graft implanted in dental alveoli: a histomorphometric and scanning electron microscopy study.

PURPOSE: This study investigated the bone integration ability of a biphasic calcium phosphate bioceramic implanted in dental alveolus of rats. MATERIALS AND METHODS: A total of 21 male rats were submitted to upper right incisor extraction and implanted with a synthetic bioceramic (Straumann Bone Ceramic). The animals were killed on 7th, 21st, and 42nd day after surgery for light and scanning electron microscopy (SEM) analysis of bone, bioceramic, and soft tissue volume as well as the quality of graft in its interface. RESULTS: Light histology results showed no persistent inflammatory and foreign body reactions, a newly formed bone adhered on the ceramic surface without interposition of soft tissue, which was confirmed by SEM analysis. Histometrically, reduction/resorption, between 7 and 42 days, in the percentage of bioceramic implanted (α = 1%) left gaps for a gradual increase in vital bone formation (α = 1%) around the particles. CONCLUSIONS: The bioceramic in question is biocompatible, has good bone integration, being gradually resorbed and replaced by it, featuring a viable bone substitute for grafting procedures.

Mucocele and Fibroma: Treatment and Clinical Features for Differential Diagnosis

Mucocele is a benign lesion occurring in the buccal mucosa as a result of the rupture of a salivary gland duct and consequent outpouring of mucin into soft tissue. It is usually caused by a local trauma, although in many cases the etiology is uncertain. Mucocele is more commonly found in children and young adults, and the most frequent site is the lower inner portion of the lips. Fibroma, on the other hand, is a benign tumor of fibrous connective tissue that can be considered a reactionary connective tissue hyperplasia in response to trauma and irritation. They usually present hard consistency, are nodular and asymptomatic, with a similar color to the mucosa, sessile base, smooth surface, located in the buccal mucosa along the line of occlusion, tongue and lip mucosa. Conventional treatment for both lesions is conservative surgical excision. Recurrence rate is low for fibroma and high for oral mucoceles. This report presents a series of cases of mucocele and fibroma treated by surgical excision or enucleation and the respective follow-up routine in the dental clinic and discusses the features to be considered in order to distinguish these lesions from each other.

Mucocele é uma lesão comum na mucosa bucal, que resulta da ruptura de um ducto de glândula salivar e consequente derramamento de mucina para o interior dos tecidos moles circunjacentes. Frequentemente este derrame resulta de trauma local, embora em muitos casos a etiologia seja indefinida. É uma lesão não infecciosa benigna, que frequentemente afeta a cavidade bucal de crianças e adultos jovens, localizando-se geralmente na porção interna dos lábios inferiores. Por outro lado, o fibroma é um tipo de tumor benigno do tecido conjuntivo fibroso que pode ser considerado uma hiperplasia reacional do tecido conjuntivo em resposta a traumas e irritação. Geralmente são nodulares, com consistência firme, assintomáticos, coloração semelhante à da mucosa, base séssil, superfície lisa, localizados na mucosa jugal ao longo da linha de oclusão, língua e mucosa labial. O tratamento convencional para ambas as lesões é a excisão cirúrgica conservadora, sendo que sua recorrência é rara para fibromas e alta para as mucoceles. Este trabalho relata casos clínicos de mucocele e fibroma, tratados pela técnica de excisão cirúrgica ou enucleação, bem como descreve a proservação no consultório odontológico. As características importantes para o diagnóstico diferencial dessas lesões são discutidas.

Mucocele and fibroma: treatment and clinical features for differential diagnosis.

Mucocele is a benign lesion occurring in the buccal mucosa as a result of the rupture of a salivary gland duct and consequent outpouring of mucin into soft tissue. It is usually caused by a local trauma, although in many cases the etiology is uncertain. Mucocele is more commonly found in children and young adults, and the most frequent site is the lower inner portion of the lips. Fibroma, on the other hand, is a benign tumor of fibrous connective tissue that can be considered a reactionary connective tissue hyperplasia in response to trauma and irritation. They usually present hard consistency, are nodular and asymptomatic, with a similar color to the mucosa, sessile base, smooth surface, located in the buccal mucosa along the line of occlusion, tongue and lip mucosa. Conventional treatment for both lesions is conservative surgical excision. Recurrence rate is low for fibroma and high for oral mucoceles. This report presents a series of cases of mucocele and fibroma treated by surgical excision or enucleation and the respective follow-up routine in the dental clinic and discusses the features to be considered in order to distinguish these lesions from each other.

A retrospective study of oral manifestations in patients with paracoccidioidomycosis.

South American blastomycosis, paracoccidioidomycosis (Pb mycosis) or Lutz disease is an endemically fungal infection in Latin America. It is caused by the dimorphic fungus Paracoccidioides brasiliensis and may cause oral mucosal lesions. The incidence of Pb mycosis oral lesions was evaluated in patients assisted at a Brazilian Dental School's Specialized Oral Diagnosis Service with special focus on the different clinical forms of these lesions, its location, patients' occupation, deleterious habits, and diagnosis methodology. Students' and professionals' initial diagnoses were compared with the definitive diagnosis. Lesions were detected 31 cases (18 patients). The results show that 88.8% of the patients were male with a mean age of 50 years and 39% work(ed) with activities related to agriculture. As much as 88.9% were smokers and 72.2% were alcohol users. Exfoliative cytology was performed in 66.6% of the patients. Oral mucosa (30%), gingiva (16.6%) and lips 16.6% were the most common sites of Pb mycosis oral lesions. Comparing the initial with the definitive diagnosis made by the professionals their accuracy was 33% (6 out of 18 patients). Students' diagnosis was more accurate demonstrating 72.5% of initial correct diagnosis (13 out of 18). Statistical analysis by ANOVA (α=0.05, SPSS WIN) demonstrated a significant difference between the diagnosis of Pb mycosis made by students and professionals when considering initial diagnosis and final diagnosis (after histopathological analysis) (p=0.25). Incisional biopsy and exfoliate cytology are efficient for an early diagnosis of this disease in mouth. Students' training in diagnosis of oral pathologies to recognize lesions is urgent to improve public health.

Eruption sequestrum--case report and histopathological findings.

Eruption sequestrum is an uncommon disturbance in eruption and consists of small fragments of calcified tissue overlying the crowns of erupting permanent molar teeth, especially at the time of eruption of the mandibular first molars. This paper reports a case of unilateral eruption sequestrum in a 7-year-old Brazilian boy and describes its histopathological findings. A white small fragment, 0.5 cm in diameter, with hard consistency, irregular shape and located on the occlusal surface of the erupting mandibular left first molar was excised. Microscopic examination revealed large trabeculae with empty lacunae and a minimal amount of existing spongy bone consisting of acute inflammatory cells (neutrophils). Signs of necrosis were found on the periphery. The histological analysis was consistent with non-vital bone and the diagnosis of eruption sequestrum was established. Clinical and radiographic follow-up visits scheduled at short intervals and then every 6 months revealed normal postoperative conditions.

Dental Findings and Management in a Mucopolysaccharidosis Type IIIB Patient.

Mucopolysaccharidosis type IIIB (MPS IIIB) is an autosomal recessive disorder caused by deficiency of the lysosomal enzyme a-N-acetylglucosaminidase. Affected subjects present developmental delay, attention deficit disorder, uncontrollable hyperactivity, and aggressive behavior, followed by progressive dementia and death in late adolescence. The purpose of this paper is to report the dental findings and treatment in a child with MPS IIIB. His primary molars and permanent mandibular incisors presented obliterated pulp chambers and root canals, which may be a clinical manifestation of this disorder.

A retrospective study of oral manifestations in patients with paracoccidioidomycosis

South American blastomycosis, paracoccidioidomycosis (Pb mycosis) or Lutz disease is an endemically fungal infection in Latin America. It is caused by the dimorphic fungus Paracoccidioides brasiliensis and may cause oral mucosal lesions. The incidence of Pb mycosis oral lesions was evaluated in patients assisted at a Brazilian Dental School's Specialized Oral Diagnosis Service with special focus on the different clinical forms of these lesions, its location, patients' occupation, deleterious habits, and diagnosis methodology. Students' and professionals' initial diagnoses were compared with the definitive diagnosis. Lesions were detected 31 cases (18 patients). The results show that 88.8% of the patients were male with a mean age of 50 years and 39% work(ed) with activities related to agriculture. As much as 88.9% were smokers and 72.2% were alcohol users. Exfoliative cytology was performed in 66.6% of the patients. Oral mucosa (30%), gingiva (16.6%) and lips 16.6% were the most common sites of Pb mycosis oral lesions. Comparing the initial with the definitive diagnosis made by the professionals their accuracy was 33% (6 out of 18 patients). Students' diagnosis was more accurate demonstrating 72.5% of initial correct diagnosis (13 out of 18). Statistical analysis by ANOVA (α=0.05, SPSS WIN) demonstrated a significant difference between the diagnosis of Pb mycosis made by students and professionals when considering initial diagnosis and final diagnosis (after histopathological analysis) (p=0.25). Incisional biopsy and exfoliate cytology are efficient for an early diagnosis of this disease in mouth. Students' training in diagnosis of oral pathologies to recognize lesions is urgent to improve public health.

A blastomicose sul americana, paracoccidiodomicose (Pb micose) ou doença de Lutz é uma infecção fúngica endêmica na América Latina. É causada pelo fungo dimórfico Paracoccidiodes brasiliensis, e pode causar lesões na mucosa oral. Nós avaliamos a incidência de lesões orais de Pb micose nos pacientes atendidos em um Centro Especializado em Diagnóstico Oral com foco principal nas diferentes formas clinicas das lesões, suas localidades, ocupação dos pacientes, hábitos deletérios e diagnóstico e metodologia, e foram detectados 31 casos (18 pacientes). Os resultados mostraram que 88,8% dos pacientes eram do sexo masculino com idade média de 50 anos de idade, e 39% trabalham, ou trabalhavam, com atividades relacionadas à agricultura. Observou-se que 88,9% eram fumantes e 72,2% ingeriam álcool. Citologia esfoliativa foi feita em 66,6%. Mucosa jugal foi acometida em 30%, gengiva, e lábios 16% (cada um) foram os locais mais comuns de lesões orais da Pb micose. Comparando o diagnóstico inicial com o definitivo feito pelos profissionais, a acurácia foi de 33%; o diagnóstico dos estudantes foi mais preciso demonstrando 72,5% do diagnóstico inicial correto com diferença estatística significante (p=0,25) através do teste ANOVA do SPSS WIN com nível de significância de 5%. Biópsia incisonal e citologia esfoliativa são eficientes para um diagnóstico precoce desta doença na boca; o treinamento dos estudantes em diagnóstico para reconhecer as patologias orais é urgente para melhorar a saúde pública.

Eruption sequestrum - case report and histopathological findings

Eruption sequestrum is an uncommon disturbance in eruption and consists of small fragments of calcified tissue overlying the crowns of erupting permanent molar teeth, especially at the time of eruption of the mandibular first molars. This paper reports a case of unilateral eruption sequestrum in a 7-year-old Brazilian boy and describes its histopathological findings. A white small fragment, 0.5 cm in diameter, with hard consistency, irregular shape and located on the occlusal surface of the erupting mandibular left first molar was excised. Microscopic examination revealed large trabeculae with empty lacunae and a minimal amount of existing spongy bone consisting of acute inflammatory cells (neutrophils). Signs of necrosis were found on the periphery. The histological analysis was consistent with non-vital bone and the diagnosis of eruption sequestrum was established. Clinical and radiographic follow-up visits scheduled at short intervals and then every 6 months revealed normal postoperative conditions.

Sequestro de erupção é um distúrbio raro da erupção e consiste de pequenos fragmentos de tecido calcificado que envolvem as coroas dos dentes molares permanentes em erupção, principalmente no momento da erupção dos primeiros molares inferiores. O objetivo deste trabalho é relatar um caso unilateral de sequestro de erupção em um menino brasileiro de 7 anos de idade e descrever seus achados histopatológicos. Um fragmento branco e pequeno, de 0,5 cm de diâmetro, com consistência dura, de forma irregular e localizado na superfície oclusal do primeiro molar inferior esquerdo em erupção foi excisado. O exame microscópico revelou trabéculas grandes com lacunas vazias e uma quantidade mínima de osso esponjoso existente consistindo de células inflamatórias agudas (neutrófilos). Na periferia, sinais de necrose foram evidenciados. A análise histológica foi consistente com osso não-vital e o diagnóstico de sequestro de erupção foi estabelecido. Exames clínicos e radiográficos em intervalos curtos e posteriormente semestrais revelaram condições pós-operatórias normais.

Osteointegration of autogenous bone graft associated with osteoblastic cells under treatment with caffeine.

PURPOSE: The present study investigated osteointegration of autogenous bone (AB) from calvaria graft associated with osteoblastic cells (OC) in bone defects in rats subjected to daily administration of caffeine. MATERIALS AND METHODS: Male rats received daily intraperitoneal injection of 1.5% caffeine (0.2 mL/100 g body weight) or saline solution for 30 days. Then they were anesthetized, submitted to the extraction of the upper right incisor, and implanted with AB only and AB + OC. The animals were killed on 7th, 21st, and 42nd days after surgery, and their maxilla were processed for obtaining semiserial sections (5 µm) stained with hematoxylin and eosin. Through image analysis system, the bone volume and the quality of graft in adjacent areas were estimated. RESULTS: The results showed that in caffeine treatment, the AB + OC graft showed no foreign body and acute inflammatory reactions inside the defect when compared to AB. The histometric results revealed that the association AB + OC produced significant increase (10%-15%) in bone volume in later experimental period (42 days) when compared with saline solution group (P ≤ 0.01). CONCLUSIONS: It was concluded that the association of AB from calvaria + OC demonstrated progressive osteointegration and accelerated the repair of bone defects in animals treated with daily caffeine.

Bone quality associated with daily intake of coffee: a biochemical, radiographic and histometric study.

Caffeine induces loss of calcium and influences the normal development of bone. This study investigated the effects of coffee on bone metabolism in rats by biochemical measurement of calcium, bone densitometry and histometry. Male rats, born of female treated daily with coffee and with coffee intake since born, were anesthetized, subjected to extraction of the upper right incisor, and sacrificed 7, 21 and 42 days after surgery. Blood and urine samples were taken, and their maxilla radiographed and processed to obtain 5-µm-thick semi-serial sections stained with hematoxylin and eosin. The volume and bone quality were estimated using an image-analysis software. The results showed significantly greater amount of calcium in the plasma (9.40 ± 1.73 versus 9.80 ± 2.05 mg%) and urine (1.00 ± 0.50 versus 1.25 ± 0.70 mg/24 h) and significantly less amount in bone (90.0 ± 1.94 versus 86.0 ± 2.12 mg/mg bone), reduced bone mineral density (1.05 ± 0.11 versus 0.65 ± 0.15 mmAL), and lower amount of bone (76.19 ± 1.6 versus 53.41 ± 2.1 %) (ANOVA; p≤0.01) in animals treated with coffee sacrificed after 42 days. It may be concluded that coffee/caffeine intake caused serious adverse effects on calcium metabolism in rats, including increased levels of calcium in the urine and plasma, decreased bone mineral density and lower volume of bone, thus delaying the bone repair process.

Bone quality associated with daily intake of coffee: a biochemical, radiographic and histometric study

Caffeine induces loss of calcium and influences the normal development of bone. This study investigated the effects of coffee on bone metabolism in rats by biochemical measurement of calcium, bone densitometry and histometry. Male rats, born of female treated daily with coffee and with coffee intake since born, were anesthetized, subjected to extraction of the upper right incisor, and sacrificed 7, 21 and 42 days after surgery. Blood and urine samples were taken, and their maxilla radiographed and processed to obtain 5-µm-thick semi-serial sections stained with hematoxylin and eosin. The volume and bone quality were estimated using an image-analysis software. The results showed significantly greater amount of calcium in the plasma (9.40 ± 1.73 versus 9.80 ± 2.05 mg percent) and urine (1.00 ± 0.50 versus 1.25 ± 0.70 mg/24 h) and significantly less amount in bone (90.0 ± 1.94 versus 86.0 ± 2.12 mg/mg bone), reduced bone mineral density (1.05 ± 0.11 versus 0.65 ± 0.15 mmAL), and lower amount of bone (76.19 ± 1.6 versus 53.41 ± 2.1 percent) (ANOVA; p≤0.01) in animals treated with coffee sacrificed after 42 days. It may be concluded that coffee/caffeine intake caused serious adverse effects on calcium metabolism in rats, including increased levels of calcium in the urine and plasma, decreased bone mineral density and lower volume of bone, thus delaying the bone repair process.

A cafeína induz perda de cálcio e influencia no desenvolvimento ósseo normal. Este estudo investiga os efeitos do café sobre o metabolismo ósseo em ratos através de avaliações bioquímicas do cálcio, densitometria e histometria óssea. Ratos machos, nascidos de fêmeas tratadas diariamente com café, e com ingestão de café desde o nascimento, foram anestesiados, submetidos à extração do incisivo superior direito e sacrificados 7, 21 e 42 dias após a cirurgia. Amostras de sangue e urina foram colhidas, suas maxilas radiografadas e processadas para se obter cortes semi seriados (5 µm) e corados pela hematoxilina-eosina. Através de um programa de análise de imagens, o volume e a qualidade do osso foram avaliados. Os resultados demonstraram maior quantidade de cálcio no sangue (9,40 ± 1,73 versus 9,80 ± 2,05 mg por cento) e urina (1,00 ± 0,50 versus 1,25 ± 0,70 mg/24 h) e menor no osso (90,0 ± 1,94 versus 86,0 ± 2,12 mg/mg osso), densidade mineral óssea menor (1,05 ± 0,11 versus 0,65 ± 0,15 mmAL), e menor quantidade de osso (76,19 ± 1,6 versus 53,41 ± 2,1 por cento) estatisticamente significante (ANOVA p≤0,01) nos animais tratados com café sacrificados após 42 dias. Conclui-se que a ingestão de café/cafeína causou sérios efeitos adversos no metabolismo de cálcio em ratos, incluindo aumento dos níveis de cálcio na urina e no plasma, diminuição da densidade mineral óssea e menor volume de osso atrasando o processo de reparo ósseo.

Osteogenic potential of autogenous bone associated with bone marrow osteoblastic cells in bony defects: a histomorphometric study.

PURPOSE: Because of limitations of autogenous grafts, allografts, xenografts, alloplasts, and hydroxyapatite as graft materials, researchers have been using bone tissue engineering as a strategy for bone regeneration. The aim of this work was to study the effect of bone tissue engineering, associating bone marrow osteoblastic cells, and autogenous bone in defects created by dental extraction in rats. MATERIALS AND METHODS: Eighty male rats from 250 to 300 g were anesthetized, submitted to the extraction of the superior incisor, and divided in control group (C), implanted with osteoblastic cells (OC), autogenous bone (AB), and osteoblastic cells + autogenous bone (OC + AB). The animals were killed on 10th and 20th days after surgery and their maxilla were processed for obtaining fine semiserial sections (5 mum), and then stained with hematoxylin-eosin. Through image analysis system, bone volume in areas adjacent to the implants was estimated. RESULTS: The histometric results revealed that the association OC + AB produced significant increase (10%-15%) of bone in both experimental periods when compared with the control group (P < or = 0.01). CONCLUSIONS: Osteoblastic cells associated with autogenous bone accelerated the repair of bone defect, and the action of the osteoblastic cells was more effective until the 10th day and of the autogenous bone after this period.

Clinical, microscopic and imaging findings associated to McCune-Albright syndrome: report of two cases.

McCune-Albright syndrome is characterized by the triad café-au-lait cutaneous spots, polyostotic fibrous dysplasia and endocrinopathies. This article presents two cases of McCune-Albright syndrome in a middle-aged woman and a young girl. Both patients presented café-au-lait spots on the face and other parts of the body and expansion of the mandible with radiopaque-radiolucent areas with ground-glass radiographic appearance, and were diagnosed as having fibrous dysplasia and endocrine disorders. The patient of Case 1 had fibrous dysplasia on the upper and lower limbs, thorax, face and cranium, early puberty, hyperglycemia, hyperthyroidism and high serum alkaline phosphatase levels. The patient of Case 2 presented lesions on the upper limbs and evident endocrine disorders. In both cases presented in this article, the initial exam was made because of the mandibular lesion. However, a diagnosis of fibrous dysplasia must lead to investigation of the involvement of other bones, characterizing polyostotic fibrous dysplasia, which is manifested in a number of diseases. An accurate differential diagnosis is mandatory to determine the best treatment approach for each case.

Trigeminal nitric oxide synthase expression correlates with new bone formation during distraction osteogenesis.

Nitric oxide synthase (NOS) has been reported to be involved with both bone healing and bone metabolism. The aim of this study was to test the null hypothesis that there is no correlation between new bone formation during mandibular distraction osteogenesis and NOS expression in the trigeminal ganglion of rats. Newly formed tissue during distraction osteogenesis and trigeminal NOS expression measured by the NADPH-diaphorase (NADPH-d) reaction were evaluated in 72 male Wistar rats by histomorphometric and histochemical methods. In animals submitted to 0.5 mm/day distraction osteogenesis, the percentage of bone tissue was higher in the basal area of the mandibles compared with the center and significantly increased through the experimental periods (P < 0.05). At the sixth postoperative week, the difference in bone formation between the continuous and acute distraction osteogenesis groups was the highest. Significant correlation between new bone formation by distraction osteogenesis and NADPH-d-reactive neurons was found, varying according to neuronal cell size (r = -0.6, P = 0.005, small cells strongly stained; r = 0.5, P = 0.018, large cells moderately stained). The results suggest that NOS may play a role in the bone healing process via neurogenic pathways, and the phenomenon seems to be neuronal cell morphotype-dependent. Further studies are now warranted to investigate the mechanistic link between the expression of trigeminal NOS and mandibular new bone formation by distraction osteogenesis.

Comparison of rat bone healing following intra-alveolar grafting with organic or inorganic bovine bone particles

Aim: This study compared, histometrically, the alveolar bone healing after grafting rats extraction socket with particles of organic or inorganic bovine bone. Method: The volume fraction of grafted materials and bone trabeculae was estimated in histologic images at the end of the 2nd and 9th weeks post-operatively by a differential point-counting method. Results: Particles of both materials were observed partially filling the cervical alveolar third and the volume fraction of inorganic graft was larger than that of organic graft 2 and 9 weeks following implantation. Although evoking neither a foreign-body reaction nor a persisting inflammatory response, both materials delayed bone healing. By the 2nd week, the delay was more pronounced in the animals grafted with inorganic than in those grafted with organic bone, but only in the animals whose inorganic graft occupied more than 50% of the cervical third. By the 9th week, despite the greater volume fraction of inorganic graft the percent of bone healing was similar to that observed in the animals grafted with organic bone. Conclusion: The degree of impairment of bone healing resulted from combination of factors such as type of material, its relative amount and the phase of the reparational process.

Clinical, microscopic and imaging findings associated to Mccune-Albright syndrome: report of two cases

McCune-Albright syndrome is characterized by the triad café-au-lait cutaneous spots, polyostotic fibrous dysplasia and endocrinopathies. This article presents two cases of McCune-Albright syndrome in a middle-aged woman and a young girl. Both patients presented café-au-lait spots on the face and other parts of the body and expansion of the mandible with radiopaque-radiolucent areas with ground-glass radiographic appearance, and were diagnosed as having fibrous dysplasia and endocrine disorders. The patient of Case 1 had fibrous dysplasia on the upper and lower limbs, thorax, face and cranium, early puberty, hyperglycemia, hyperthyroidism and high serum alkaline phosphatase levels. The patient of Case 2 presented lesions on the upper limbs and evident endocrine disorders. In both cases presented in this article, the initial exam was made because of the mandibular lesion. However, a diagnosis of fibrous dysplasia must lead to investigation of the involvement of other bones, characterizing polyostotic fibrous dysplasia, which is manifested in a number of diseases. An accurate differential diagnosis is mandatory to determine the best treatment approach for each case.

A Síndrome de McCune-Albright é caracterizada pela tríade manchas café-com-leite na pele, displasia fibrosa poliostótica e endocrinopatias. Este artigo apresenta dois casos de Síndrome de McCune-Albright em uma mulher de meia idade e em uma menina. Ambos apresentavam manchas café-com-leite na face e em outras partes do corpo, expansão da mandíbula com área radiopaca-radiolúcida com aspecto de vidro despolido na radiografia, com o diagnóstico de displasia fibrosa, e desordens endócrinas. O paciente do Caso 1 apresentava displasia fibrosa nos membros inferiores e superiores, tórax, face e crânio, puberdade precoce, hiperglicemia, hipertireoidismo e elevação da fosfatase alcalina no sangue. O paciente do Caso 2 apresentava lesões nos membros superiores e desordem endócrina evidente. Em ambos os casos apresentados neste artigo, o exame inicial foi realizado devido à lesão mandibular. Contudo, o diagnóstico de displasia fibrosa deve conduzir a pesquisa de envolvimento de outros ossos, caracterizando a displasia fibrosa poliostótica, que se manifesta em um grande número de doenças. O diagnóstico diferencial preciso é fundamental para determinar o tratamento adequado a cada caso.

Autogenous bone graft associated with enamel matrix proteins in bone repair.

PURPOSE: Autogenous bone has been used with success as implants in intrabony defects, because of its biological advantages and osteogenic potential. The objective of this study was to evaluate histological and histometrically the bony repair in intrabony defects after dental extractions in rats with graft of a combination of the enamel matrix protein (EMP) (Emdogain, Strauman USA, LLC, Andover, MA. Headquarters in Basel, Switzerland) and autogenous bone. MATERIALS AND METHODS: Male rats (Rattus norvegicus, Wistar variety) weighing from 250 to 300 g were anesthetized and submitted to the extraction of the superior incisive and divided in (a) group with autogenous bone (fragment of bone of the alveolar ridge was grafted inside the alveolus) and (b) group with autogenous bone associated with EMP. The animals were killed on the 7th, 21st, and 42nd day after the extraction. The maxillae were processed to obtain fine sections (5 microm) stained with hematoxylin-eosin. The percentual volume of bone tissue in contiguous areas of the graft was calculated through a counting point system of image. RESULTS: The results showed that the bone fragments grafted in the cervical third of the alveolus developed a progressive osseointegration without foreign-body reaction. The quantification of the bony repair in the areas adjacent to the graft showed that the autogenous bone associated with EMP produced a greater amount of bone (10%-15% by analysis of variance, P = 0.05) in all the studied periods. CONCLUSIONS: It was concluded that the autogenous bone associated with EMP grafted in bony defects, immediately after the dental extraction in rats, demonstrated biocompatibility and accelerated the repair of bone defect.