Critical Defect Healing Assessment in Rat Calvaria Filled with Injectable Calcium Phosphate Cement.

(1) Background: The tissue engineering field has been working to find biomaterials that mimic the biological properties of autogenous bone grafts. (2) Aim: To evaluate the osteoconduction potential of injectable calcium phosphate cement implanted in critical defects in rat calvaria. (3) Methods: In the calvarial bone of 36 rats, 7-mm diameter critical size defects were performed. Afterwards, the animals were randomly divided into three groups according to filler material: a blood clot group (BC), blood clot membrane group (BCM), and an injectable ß-tricalcium phosphate group (HBS) cement group. After periods of 30 and 60 days, the animals were euthanized, the calvaria was isolated, and submitted to a decalcification process for later blades confection. Qualitative and quantitative analysis of the neoformed bone tissue were conducted, and histometric data were statistically analyzed. (4) Results: Sixty days post-surgery, the percentages of neoformed bone were 10.67 ± 5.57 in group BC, 16.71 ± 5.0 in group BCM, and 55.11 ± 13.20 in group HBS. The bone formation values in group HBS were significantly higher (p < 0.05) than in groups BC and BCM. (5) Conclusions: Based on these results, it can be concluded that injectable calcium phosphate cement is an osteoconductive material that can be used to fill bone cavities.

Evaluation of Osteoconduction of Biphasic Calcium Phosphate Ceramic in the Calvaria of Rats: Microscopic and Histometric Analysis.

(1) Background: Evaluate the osteoconduction capability of a biphasic calcium phosphate (BCP) ceramic composed of hydroxyapatite and ß-tricalcium phosphate 60%/40% in a rat model. (2) Methods: In the calvarial bone of 54 adult male rats, 7-mm diameter critical size defects were performed. The animals were randomly allocated to three experimental groups according to the type of material: blood clot (BCG), blood clot covered with a bovine-derived collagen membrane (MBCG), and BCP ceramic covered with a bovine-derived collagen membrane (BCPG). In each group, 6 animals were euthanatized at post-operative days 7, 30, and 60 for histological and histometric analysis. (3) Results: The qualitative analysis revealed the persistence of the collagen membrane at seven days, with no relevant newly bone formation in all groups. At 30 days, centripetal bone formation was observed residual particles of the biomaterial surrounded by fibroblasts noted in the BCPG. At 60 days, while BCG and MBCG showed a partial maturation with the central part of the defect populated by a fibrous connective tissue, in the BCPG the critical area was entirely occupied by newly formed bone. In the intra groups analysis was noted a significant increase in new bone formation during the experimental period (p < 0.05). At 60 days, BCPG showed a higher percentage area of new bone formation (p < 0.05). (4) Conclusion: BCP promoted a new bone formation by osteoconduction and might be considered a valid alternative in bone regeneration procedures.

Estudo comparativo in vivo da osseointegração em duas diferentes superfícies de implantes em liga TiAlV: caracterização topográfica, análise de frequência por ressonância e histométrica / Comparative study in vivo of osseointegration on two different surfaces of TiAlV alloy implants: topographic characterization, resonance frequency and histometric analyzes

Objetivo: Avaliar o comportamento biológico do tecido ósseo ao redor de implantes manufaturados em liga Ti-6Al-4V diante das superfícies modificadas por jateamento de óxido de alumínio seguido condicionamento ácido (SBAS) e a superfície usinada (MS). Material e Métodos: Dez coelhos receberam aleatoriamente 20 implantes de hexágono externo com dimensões de 4,0 mm de diâmetro e 10 mm de comprimento em suas tíbias direita e esquerda, sendo um implante de cada superfície em cada tíbia. Os implantes de ambos os grupos foram analisados através de microscopia eletrônica de varredura (MEV-EDX) e microscopia de força atômica (AFM). Discos com as mesmas superfícies foram submetidos à análise de rugosidade média (Ra) e secção transversal. Nos períodos de 3 e 6 semanas foi mensurado o coeficiente de estabilidade primária por meio da análise de frequência por ressonância (ISQ), seguido da eutanásia dos animais. As peças obtidas foram submetidas ao processamento de inclusão em resina fotopolimerizável e levadas ao micrótomo para corte calcificado. Foi mensurada em porcentagem a extensão linear de contato entre tecido ósseo mineralizado e implante (ELCOMI) e área óssea neoformada (AON). Os dados foram submetidos à análise de variância e ao teste t de Tukey. Resultados: MEV e AFM mostraram diferenças na topografia das superfícies. Os valores médios obtidos pelas análises de frequência por ressonância, Ra e secção transversal para SBAS foram estatisticamente superiores (p<0,05) quando comparados a MS. Os valores médios em porcentagem de ELCOMI para SBAS foram de 69,65 e 71,56 respectivamente para 3 e 6 semanas, enquanto para MS os valores médios foram de 54,06 e 55,99 respectivamente para os mesmos períodos. Os valores médios de AO no grupo SBAS foram de 69,85 e 79,60 para os períodos de 3 e 6 semanas, enquanto para MS os valores médios foram de 59,59 e 74,32 respectivamente nos mesmos grupos. Houve diferenças estatisticamente superiores (p<0,05) nos implantes SBAS para a ELCOMI nos períodos de 3 e 6 semanas e AON no período de 3 semanas. Conclusão: A modificação na superfície nos implantes SBAS proporcionou alterações na topografia dos implantes, promovendo um maior contato entre tecido ósseo e a liga de titânio, permitindo melhores níveis de osseointegração. Relevância clínica: Implantes manufaturados em liga de Ti-6Al-4V modificados por jateamento de óxido de alumínio seguido condicionamento ácido (SBAS) apresentam bons níveis de osseointegração e podem ser usados com segurança para reabilitação protética de pacientes(AU)

Objective: Evaluate the biological behavior of bone tissue around implants manufactured in Ti-6Al-4V alloy before surfaces modified by aluminum oxide blasting followed by acid etching (SBAS) and machined surface (MS). Material and Methods: Ten rabbits randomly received 20 external hexagon implants with dimensions of 4.0 mm in diameter and 10 mm in length on their right and left tibiae, one implant of each surface on each tibia. The implants of both groups were analyzed by scanning electron microscopy (SEM-EDX) and atomic force microscopy (AFM). Disks with the same surfaces were submitted to analysis of average roughness (Ra) and cross section. In the periods of 3 and 6 weeks, the primary stability coefficient was measured by means of resonance frequency analysis (ISQ), followed by euthanasia of the animals. The obtained pieces were submitted to the inclusion processing in photopolymerizable resin and taken to the microtome for cutting without decalcification. The bone interface contact (BIC) and neoformed bone area (NBA) was measured in percentage. Data were submitted to analysis of variance and Tukey t test. Results: SEM and AFM showed differences in surface topography. The mean values obtained by the resonance, Ra and cross section analyzes for SBAS were statistically higher (p <0.05) when compared to MS. The mean values in percentage of BIC for SBAS were 69.65 and 71.56 respectively for 3 and 6 weeks, while for MS the mean values were 54.06 and 55.99 respectively for the same periods. The mean values of NBA in the SBAS group were 69.86 and 79.59 for the 3 and 6 week periods, while for MS the mean values were 59.59 and 74.32, respectively, in the same groups. There were statistically superior differences (p <0.05) in SBAS implants for BIC in the 3 and 6 week periods and AON in the 3 week period. Conclusion: The surface modification of the SBAS implants provided changes in the topography of the implants, promoting a better contact between bone tissue and titanium alloy, allowing better levels of osseointegration. Clinical Relevance: Implants manufactured in Ti-6Al-4V alloy modified by aluminum oxide etching followed by acid etching (SBAS) present good levels of osseointegration and can be safely used for prosthetic rehabilitation of patients(AU)

Upper Airway Obstruction in a Panfacial Fracture.

Panfacial fractures are considered the most aggressive and complex facial fracture, and most of them are the results of a high energy trauma. Therefore, a clinical report of a male patient with a panfacial fracture and Richards type 3 fracture resulting in an airway obstruction is presented. This type of fracture can promote an upper airway obstruction, which needs a correct and fast diagnosis to the life support of the patient.

Immediate Treatment of Complex Mandible Fracture in a Pediatric Patient.

The facial fractures in pediatric patients are rare, and they can need an immediate treatment to recover the function and aesthetic to the young patients. However, the open reduction internal fixation is controversial in pediatrics; it can be effectiveness to treat complex mandible fractures. Therefore, we present a case of a pediatric patient with a complex mandible fracture caused by an auto accident. The immediate treatment was successful with the use of open reduction internal fixation.

Short-Blunt Injury in Child Resulting From Pet Bite.

The frequency of accidents due to dog bite in children is high, and in the most cases, the child already knows the aggressor dog. Patient, 3 years, female, melanoderm, victim of pet dog attack on the right side of the face region. After the physical examination, conscious sedation was performed with the supplementation of oxygen by pediatrics and the suture by oral and maxillofacial surgeon, under local anesthesia with adrenergic vasoconstrictor, with internal points in the muscles using vicryl 4-0 and in the skin with 5-0 nylon; the lesser number of stitches were performed in the lower region of the wound, allowing spontaneous drainage spaces. The immediate wounds closure of dog bites on the face is safe, even in cases after several hours of the injury.