Alendronato de sódio tópico associado ao osso bovino liofilizado no reparo ósseo / Topical alendronate associated with lyophilized bovine bone in bone repair

Introdução: O osso bovino inorgânico é o enxerto mais utilizado na Odontologia, tendo como desvantagem longo tempo de integração ao leito receptor. Os bifosfonatos têm sido utilizados para modular a quantidade e a qualidade do osso regenerado e diminuir o tempo de integração do enxerto. Objetivo: Avaliar o efeito do bifosfonato alendronato de sódio (ALN) 0,5%, associado ou não ao osso bovino inorgânico, na reparação de defeitos ósseos. Material e método: Dois defeitos ósseos foram confeccionados na calvária de 12 coelhos, sendo a cavidade esquerda/experimental preenchida com: GI = osso bovino inorgânico (Bio-Oss®); GII = Bio-Oss® + ALN 0,5%; GIII = ALN 0,5%; e a cavidade direita por coágulo sanguíneo (controle). Os animais foram mortos aos 60 dias pós-operatórios. Por meio de análise histomorfométrica calculou-se o percentual de osso neoformado e remanescente do biomaterial em relação à área total do defeito. Resultado: Osso neoformado: GI = 38,16 ± 15,44%; GII = 55,77 ± 16,75%; GII I = 60,28 ± 11,45%. Controle = 45,11 ± 11,09%. Remanescente do enxerto: GI = 7,02 ± 5,36% e GII = 16,59 ± 9,56%. Não houve diferença quanto ao percentual de osso neoformado entre os grupos (ANOVA p = 0,15512; teste de Tukey F = 2,089). O percentual de remanescente do enxerto também foi estatisticamente semelhante entre os grupos GI e GII (teste de Tukey F = 5,019). Conclusão: O uso tópico da solução de ALN 0,5% isoladamente ou associado ao osso bovino liofilizado não alterou o percentual de neoformação óssea nem a degradação dos grânulos do enxerto.

Introduction: Inorganic bovine bone is the most used graft in dentistry, with the disadvantage of long integration time into the receptor bed. Bisphosphonates have been used to modulate the quantity and quality of regenerated bone and decrease graft integration time. Objective: To evaluate the effect of alendronate sodium bisphosphonate (ALN) 0.5%, associated or not with Inorganic bovine bone, in the repair of bone defects. Material and method Two bone defects were made in the calvaria of 12 rabbits, and the left/experimental cavity was filled with: GI = Inorganic bovine bone (Bio-Oss®); GII = Bio-Oss® + 0.5% ALN; GIII = 0.5% ALN; and the right cavity/blood clot control. The animals were killed at 60 days after surgery. Through histomorphometric analysis, the percentage of newly formed bone and remnant biomaterial relative to the total area of the defect was calculated. Result: Neoformed bone: GI = 38.16 ± 15.44%, GII = 55.77 ± 16.75%; GIII= 60.28 ± 11.45%; Control=45,11 ± 11,09%. Graft remnant: GI = 7.02 ± 5.36% and GII = 16.59 ± 9.56%. There was no difference in the percentage of newly formed bone between the groups (ANOVA p = 0.15512; Tukey's test F = 2.089). The percentage of graft remnant was also statistically similar between groups GI and GII (Tukey's test F = 5019). Conclusion: Topical use of 0.5% ALN solution alone or associated with lyophilized bovine bone did not change the percentage of bone neoformation, nor the degradation of graft granules.

Low-level laser therapy and anesthetic infiltration for orofacial pain in patients with fibromyalgia: a randomized clinical trial

Background: To compare the analgesic effect of anesthetic infiltration of lidocaine 2% and low-level laser therapy (LLLT) by GaAlAs into tender points of patients with orofacial pain and fibromyalgia (FM). Material and Methods: A randomized clinical trial was performed with adults (N=66) that were allocated into two groups (1:1): Group A received LLLT irradiation by Diode Laser GaAlAs (780nm) with expositions twice a week during six weeks and Group B was treated with anesthetic infiltration of lidocaine 2% without vasoconstrictor once a week for four weeks. The pain assessment included the Visual Analogic Scale (VAS) and tenderness to palpation. Results: No dropout and adverse effect was observed during the study. The pain decreased significantly in each group after the treatment (p=0.0001, β=1.0), even though no statistical difference was found between both treatments (p=0.46, β= 0.82). The presence of tender points decreased after both treatments, with responsively in some types of masticatory muscles (p<0.05) except posterior temporalis muscle. The patients' perception showed that both treatments were effective and a few patients reported that the treatment did not improve welfare. Conclusions: The LLLT by GaAlAs and anesthetic infiltration of lidocaine 2% were equally effective to control orofacial pain in FM individuals (AU)

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Graded changes in enamel component volumes resulted from a short tooth bleaching procedure.

AIM: To test the hypothesis that changes in enamel component volumes (mineral, organic, and water volumes, and permeability) are graded from outer to inner enamel after a short bleaching procedure. MATERIALS AND METHODS: Extracted unerupted human third molars had half of their crowns bleached (single bleaching session, 3 × 15 min), and tooth shade changes in bleached parts were analyzed with a spectrophotometer. Ground sections were prepared, component volumes and permeability were quantified at histological points located at varying distances from the enamel surface (n=10 points/location), representing conditions before and after bleaching. RESULTS: Tooth shade changes were significant (p<0.001; 95% CI=-1/-8; power=99%), and most of the enamel layer was unaffected after bleaching, except at the outer layers. Multiple analysis of covariances revealed that most of the variance of the change in enamel composition after bleaching was explained by the combination of the set of types of component volume (in decreasing order of relevance: mineral loss, organic gain, water gain, and decrease in permeability) with the set of distances from the enamel surface (graded from the enamel surface inward) (canonical R(2)=0.97; p<0.0001; power>99%). CONCLUSIONS: Changes in enamel composition after a short bleaching procedure followed a gradient within component volumes (mineral loss>organic gain>water gain>decrease in permeability) and decreased from the enamel surface inward.

Analysis of the healing process of the wounds occurring in rats using laser therapy in association with hydrocolloid.

PURPOSE: To evaluate wound healing in rats by using low-level laser therapy (LLLT) associated with hydrocolloid occlusive dressing. METHODS: Forty male, adult, Wistar rats were used, distributed into four groups: LG (received 2 J/cm² of laser therapy); HG (treated with hydrocolloid); LHG (treated with 2 J/cm² of laser therapy and hydrocolloid); and the CG (treated with 1 mL of 0.9% saline). The wound was evaluated at pre-determined periods 3rd and 7th days, considering the macroscopic and histological parameters (inflammatory cells, capillary neoformation, fibroblasts, collagen formation and reepithelialization). RESULTS: The LG group at seven days showed increased collagen formation, the LHG group at 3 days showed mild collagen formation. The HG group and the CG at 7 days showed complete reepithelialization. CONCLUSION: Low-level laser therapy as well as the hydrocolloid dressing have favored the wound-healing process in rats.

Analysis of the healing process of the wounds occurring in rats using lasertherapy in association with hydrocolloid

PURPOSE: To evaluate wound healing in rats by using low-level laser therapy (LLLT) associated with hydrocolloid occlusive dressing. METHODS: Forty male, adult, Wistar rats were used, distributed into four groups: LG (received 2 J/cm² of laser therapy); HG (treated with hydrocolloid); LHG (treated with 2 J/cm² of laser therapy and hydrocolloid); and the CG (treated with 1 mL of 0.9% saline). The wound was evaluated at pre-determined periods 3rd and 7th days, considering the macroscopic and histological parameters (inflammatory cells, capillary neoformation, fibroblasts, collagen formation and reepithelialization).RESULTS: The LG group at seven days showed increased collagen formation, the LHG group at 3 days showed mild collagen formation. The HG group and the CG at 7 days showed complete reepithelialization.CONCLUSION: Low-level laser therapy as well as the hydrocolloid dressing have favored the wound-healing process in rats.

Histomorphometric evaluation of calcium phosphate bone grafts on bone repair / Avaliação histomorfométrica de enxertos ósseos de cimento fosfato de cálcio no processo de reparo ósseo

Because of its biocompatibility and osteoconductive properties, calcium-phosphate cement has been used as bone surrogate. OBJECTIVE: The purpose of this study was to do a histomorphometric comparison of bone regeneration using hydroxyapatite biphasic ceramic, calcium-phosphate cement and autogenous bone graft. STUDY DESIGN: Prospective and laboratorial experiment. MATERIALS AND METHODS: Two 5mm in diameter cavities (left and right - test and control) were made in the parietal bone of 72 rats. The GI, GII, GIII and GIV test cavities were filled with calcium-phosphate cement, biphasic ceramic hydroxyapatite, autogenous bone graft and blood. The animals were killed at 30, 60 and 90 days and the specimens underwent histomorphometric analysis. RESULTS: The results showed that autogenous bone graft treated defects had significantly more new bone at 30 days compared to other test groups. Within 60 and 90 days, bone formation was more significant in the test groups GI, GII and GIII; GI and GII encompassed larger areas. Throughout the evaluation periods, GII tests showed more bone formation when compared to GI. CONCLUSIONS: Biomaterials depicted a significantly increase in bone content, when compared to autogenous bone graft, concerning bone regeneration.

Os materiais de fosfato de cálcio, pelas características de biocompatibilidade e osteocondução, estão sendo estudados como substitutos ósseos. OBJETIVO: Comparar histomorfometricamente o reparo ósseo promovido pela cerâmica bifásica de hidroxiapatita, cimento fosfato de cálcio e enxerto ósseo autógeno. FORMA DE ESTUDO: Prospectivo e experimental em laboratório. MATERIAL E MÉTODO: Foram criadas duas cavidades (esquerda e direita - teste e controle) de 5mm de diâmetro nos ossos parietais de 72 ratos Wistar. As cavidades testes GI, GII, GIII e GIV foram preenchidas com cimento fosfato de cálcio, cerâmica bifásica de hidroxiapatita, enxerto ósseo autógeno e coágulo sanguíneo. Os animais foram sacrificados aos 30, 60 e 90 dias e os espécimes avaliados histomorfometricamente. RESULTADOS: Os resultados mostraram maior formação óssea no período de 30 dias para o GIII quando comparado aos outros grupos testes. Nos períodos de 60 e 90 dias, a neoformação óssea foi mais acentuada nos grupos testes GI, GII e GIII, alcançando maiores áreas em GI e GII. Em todos os períodos de avaliação, as cavidades testes GII apresentaram maiores áreas frente às GI. CONCLUSÃO: Os biomateriais foram superiores ao enxerto autógeno no reparo ósseo.

Utilização dos lasers de Er:YAG e Nd:YAG na desinfecção do sistema de canais radiculares: revisão de literatura / Use of Er:YAG and Nd:YAG lasers in the desinfection of root canals system: a literature review

A sanificação do sistema de canais radiculares cujo objetivo é promover a eliminação de microrganismos é considerada um dos principais objetivos e determinantes para o sucesso da terapia endodôntica. Neste sentido, novos instrumentos, equipamentos e materiais estão constantemente sendo desenvolvidos, destacando-se os aparelhos de Lasers que podem ser utilizados em vários procedimentos odontológicos. O objetivo deste artigo foi esclarecer aos clínicos e especialistas, através de uma revisão de literatura sobre a utilização dos lasers de Er:YAG e Nd:YAG na eliminação dos microrganismos que colonizamo sistema de canais radiculares.

Assessment of bone repair associated with the use of organic bovine bone and membrane irradiated at 830 nm.

OBJECTIVE: The aim of the present investigation was to assess histologically the effect of LLLT (GaAIAs, 830 nm, 40 mW, CW, (Phi) approximately 0.6 mm, 16 J/cm(2) per session) on the repair of surgical defects created in the femur of the Wistar Albinus rat. The defects were filled to lyophilized bovine bone (Gen-ox), organic matrix) associated or not to GTR (Gen-derm). BACKGROUND DATA: A major problem on modern Dentistry is the recovery of bone defects caused by trauma, surgical procedures or pathologies. Several types of biomaterials have been used in order to improve the repair of these defects. These materials are often associated to procedures of GTR. Previous studies have shown positive effects of LLLT on the repair of soft tissue wounds, but there are a few on its effects on bone healing. METHODS: Surgical bone defects were created in 42 animals divided into five groups: Group I (control, 6 animals); Group II (Gen-ox, 9 animals); Group III (Gen-ox + Laser, 9 animals); Group IV (Gen-ox + Gen-derm, 9 animals); Group V (Gen-ox + Gen-derm + Laser, 9 animals). The animals on the irradiated group received 16 J/cm(2) per session divided into four points around the defect (4 J/cm(2)) being the first irradiation immediately after surgery and repeated seven times at every 48 h. The animals were humanly killed after 15, 21, and 30 days. RESULTS: The results of the present investigation showed histological evidence of improved amount of collagen fibers at early stages of the bone healing (15 days) and increased amount of well organized bone trabeculae at the end of the experimental period (30 days) on irradiated animals compared to non irradiated ones. CONCLUSIONS: It is concluded that a positive biomodulative effect on the healing process of one defect associated or not to the use of organic lyophilized bone and biological bovine lyophilized membrane on the femur of the rat.

Estudo do reparo de defeitos ósseos irradiados com laser λ 830 nm submetidos ou não a implante de hidroxiapatita sintética e/ou membrana de osso bovino / Study of the repair of bone´s defects radiated with laser λ 830 nm submitted or not it implantation of synthetic hydroxyapatite and/or membrane of bovine bone

Este trabalho teve como objetivo estudar a influência da Laserterapia (GaAIAs À830nm, 40mW, CW) sobre o processo de reparo de defeitos ósseos padronizados em fêmur de ratos Wistar albinus submetidos ou não a implante de hidroxiapatita sintética microgranular (HA) e/ou membrana de cortical óssea bovina descalcificada. Foram estabelecidos oito grupos de animais: Grupo IA (Controle - n=09); Grupo 18 (Laser - n=12); Grupo lIA (HA - n=12); Grupo IIB (HA + Laser - n=12); Grupo IIIA (Membrana - n=12); Grupo IIIB(Membrana + Laser - n=12); Grupo IVA (HA + Membrana - n=12) e Grupo IVB (HA + Membrana + Laser - n=12). Os animais foram irradiados a cada 48 horas, sendo a primeira irradiação realizada imediatamente após a cirurgia. As irradiações foram aplicadas transcutaneamente em quatro pontos em torno da ferida. Cada ponto recebeu uma dose de 4J/cm2 ®p-0,60mm, 40mW) e a dose total por sessão foi de 16J/cm2. Os sacrifícios foram realizados após 15, 21 e 30 dias, e os espécimes removidos foram processados para posterior inclusão em parafina. Depois de corados pelas Técnicas de HE e de Picrosirius, foram analisados em Microscopia de Luz. Os resultados mostraram que todos os grupos experimentais apresentaram um incremento no reparo dos defeitos ósseos em todos os períodos de observação quando comparados com o grupo controle, sobretudo nos grupos com membrana elou irradiados. Ao comparar-se os grupos irradiados com implante de HA e/ou membrana, observou-se que o reparo dos defeitos submetidos a Laserterapia também se processou de forma mais rápida, a partir dos períodos de 15 e 21 dias, uma vez que aos 30 dias, o nível de reparo dos defeitos foi muito semelhante nos grupos irradiados ou não. Evidenciou-se neoformação óssea dentro da cavidade pela osteocondução do implante de HA, sendo que nos grupos irradiados houve incremento desta neoformação. Conclui-se que a Laserterapia produziu um efeito de biomodulação positiva sobre o reparo dos defeitos ósseos submetidos ou não a i...

Effect of 830-nm laser light on the repair of bone defects grafted with inorganic bovine bone and decalcified cortical osseus membrane.

OBJECTIVE: The aim of this study was to histologically assess the effect of low-level laser therapy (LLLT) (lambda830 nm) on the repair of standardized bone defects of the femur of Wistar albinus rats grafted with inorganic bovine bone and associated (or not) with decalcified bovine cortical bone membrane. BACKGROUND DATA: Bone loss may be a result of pathology, trauma, or surgical procedure. Extensive studies on the process of bone repair have been undertaken, and several techniques for the correction of bone defects have been proposed. Amongst them is the use of several types of grafts, the use of membranes, and the combination of both techniques. There is evidence in the literature of the positive effect of LLLT on the healing of soft tissue wounds. However, its effect on bone healing is not completely understood. MATERIALS AND METHODS: Five randomized groups were studied: group I (control); group IIA (Gen-ox); group IIB (Gen-ox + LLLT); group IIIA (Gen-ox + Gen-derm); and group IIIB (Gen-ox + Gen-derm + LLLT). Bone defects were created at the femur and were treated according to the group. The animals of irradiated groups were irradiated every 48 h for 15 days; the first irradiation was performed immediately after the procedure. The animals were irradiated transcutaneuosly at four points around the defect. At each point, a dose of 4 J/cm2 was given (phi approximately equal to 0.6 mm, 40 mW), and the total dose per session was 16 J/cm2. The animals were humanely killed at 15, 21, and 30 days after surgery. The specimens were routinely processed to wax, serially cut, stained with H&E and Picrosirius stains, and analyzed under light microscopy. RESULTS: The results showed more advanced repair of the irradiated groups when compared to the non-irradiated ones. The repair of the irradiated group was characterized by both increased bone formation and on the amount of collagen fibers around the graft within the cavity, as early as the 15th day after surgery, considering the osteoconductive capacity of the Gen-ox and the increment of the cortical repair in specimens with Gen-derm membrane. CONCLUSION: It is concluded that LLLT had a positive effect on the repair of bone defect by graft associated or not with the use of biological membrane.

Effect of low level laser therapy on the repair of bone defects grafted with inorganic bovine bone.

The aim of this study was to assess histologically the effect of LLLT (lambda 830 nm) on the repair of standardized bone defects on the femur of Wistar albinus rats which were grafted with inorganic bovine bone Gen-ox(R). Three randomized groups were studied: group I (control, n=6); group II (Gen-ox, n=9) and group III (Gen-ox + LLLT, n=9). The animals were irradiated every 48 h during 15 days; the first irradiation was performed immediately after the procedure. The animals were irradiated transcutaneuosly at four points around the defect. At each point a dose of 4 J/cm(2) was given (Ø approximately 0.6 mm, 40 mW) and the total dose per session was 16 J/cm(2). The animals were killed by an overdose of general anesthetic 15, 21 and 30 days after surgery. The specimens were routinely processed by embedding in paraffin, serially cut and stained with H&E and Picrosirius and analyzed under light microscopy. The results showed evidence of a more advanced repair in the irradiated group when compared to the non-irradiated groups. The repair of the irradiated group was characterized by both increased bone formation and amount of collagen fibers around the graft within the cavity from the 15th day after surgery, also considering the osteoconductive capacity of the Gen-ox. We conclude that LLLT had a positive effect on the repair of bone defects implanted with inorganic bovine bone.

Effect of 830-nm laser light on the repair of bone defects grafted with inorganic bovine bone and decalcified cortical osseous membrane.

OBJECTIVE: The aim of this study was to assess histologically the effect of LLLT (lambda830 nm) on the repair of standardized bone defects on the femur of Wistar albinus rats grafted with inorganic bovine bone and associated or not to decalcified bovine cortical bone membrane. BACKGROUND DATA: Bone loss may be a result of several pathologies, trauma or a consequence of surgical procedures. This led to extensive studies on the process of bone repair and development of techniques for the correction of bone defects, including the use of several types of grafts, membranes and the association of both techniques. There is evidence in the literature of the positive effect of LLLT on the healing of soft tissue wounds. However, its effect on bone is not completely understood. MATERIALS AND METHODS: Five randomized groups were studied: Group I (Control); Group IIA (Gen-ox); Group IIB (Gen-ox + LLLT); Group IIIA (Gen-ox + Gen-derm) and Group IIIB (Gen-ox + Gen-derm + LLLT). Bone defects were created at the femur of the animals and were treated according to the group. The animals of the irradiated groups were irradiated every 48 h during 15 days; the first irradiation was performed immediately after the surgical procedure. The animals were irradiated transcutaneously in four points around the defect. At each point a dose of 4 J/cm2 was given (phi approximately 0.6 mm, 40 mW) and the total dose per session was 16 J/cm2. The animals were humanely killed 15, 21, and 30 days after surgery. The specimens were routinely processed to wax, serially cut, and stained with H&E and Picrosirius stains and analyzed under light microscopy. RESULTS: The results showed evidence of a more advanced repair on the irradiated groups when compared to non-irradiated ones. The repair of irradiated groups was characterized by both increased bone formation and amount of collagen fibers around the graft within the cavity since the 15th day after surgery, through analysis of the osteoconductive capacity of the Gen-ox and the increment of the cortical repair in specimens with Gen-derm membrane. CONCLUSION: It is concluded that LLLT had a positive effect on the repair of bone defect submitted the implantation of graft.

Effect of low level laser therapy on the repair of bone defects grafted with inorganic bovine bone

O objetivo deste trabalho foi avaliar histologicamente a influência da radiação laser não-cirúrgica (830 nm) sobre o reparo ósseo de defeitos padronizados em fêmur de ratos Wistar albinus e submetidos a implante de osso bovino inorgânico Gen-ox. Foram estabelecidos três grupos de animais: grupo I (controle, n=06); grupo II (Gen-ox, n=09) e grupo III (Gen-ox + LLLT, n=09). Os animais foram irradiados a cada 48 horas, sendo a primeira irradiação realizada imediatamente após a cirurgia. Os animais foram irradiados transcutaneamente em quatro pontos em torno da ferida. Cada ponto recebeu uma dose de 4 J/cm2 e a dose total por sessão foi de 16 J/cm2. Os sacrifícios foram realizados 15, 21 e 30 dias após a cirurgia. Os espécimes foram removidos e fixados para procedimento laboratorial, sendo corados com HeE e Picrosirius e analisados em microscopia de luz. Os resultados mostraram evidência de um reparo ósseo mais avançado nos espécimes irradiados em relação aos não irradiados. O reparo nos espécimes irradiados foi caracterizado por uma maior neoformação óssea, bem como por uma maior proliferação de fibras colágenas no interior do defeito já a partir de 15 dias após a cirurgia, também considerando a capacidade osteocondutiva do Gen-ox. Conclui-se que a LLLT resultou num efeito de biomodulação positiva sobre o reparo do defeito ósseo submetido a implante de osso bovino inorgânico.