Morphofunctional Improvement of the Facial Nerve and Muscles with Repair Using Heterologous Fibrin Biopolymer and Photobiomodulation.

Peripheral nerve injuries impair the patient's functional capacity, including those occurring in the facial nerve, which require effective medical treatment. Thus, we investigated the use of heterologous fibrin biopolymer (HFB) in the repair of the buccal branch of the facial nerve (BBFN) associated with photobiomodulation (PBM), using a low-level laser (LLLT), analyzing the effects on axons, muscles facials, and functional recovery. This experimental study used twenty-one rats randomly divided into three groups of seven animals, using the BBFN bilaterally (the left nerve was used for LLLT): Control group-normal and laser (CGn and CGl); Denervated group-normal and laser (DGn and DGl); Experimental Repair Group-normal and laser (ERGn and ERGl). The photobiomodulation protocol began in the immediate postoperative period and continued for 5 weeks with a weekly application. After 6 weeks of the experiment, the BBFN and the perioral muscles were collected. A significant difference (p < 0.05) was observed in nerve fiber diameter (7.10 ± 0.25 µm and 8.00 ± 0.36 µm, respectively) and axon diameter (3.31 ± 0.19 µm and 4.07 ± 0.27 µm, respectively) between ERGn and ERGl. In the area of muscle fibers, ERGl was similar to GC. In the functional analysis, the ERGn and the ERGI (4.38 ± 0.10) and the ERGI (4.56 ± 0.11) showed parameters of normality. We show that HFB and PBM had positive effects on the morphological and functional stimulation of the buccal branch of the facial nerve, being an alternative and favorable for the regeneration of severe injuries.

Effects of a Biocomplex Formed by Two Scaffold Biomaterials, Hydroxyapatite/Tricalcium Phosphate Ceramic and Fibrin Biopolymer, with Photobiomodulation, on Bone Repair.

There are several treatment methods available for bone repair, although the effectiveness becomes limited in cases of large defects. The objective of this pre-clinical protocol was to evaluate the grafting of hydroxyapatite/tricalcium phosphate (BCP) ceramic biomaterial (B; QualyBone BCP®, QualyLive, Amadora, Portugal) together with the heterologous fibrin biopolymer (FB; CEVAP/UNESP Botucatu, Brazil) and with photobiomodulation (PBM; Laserpulse®, Ibramed, Amparo, Brazil) in the repair process of bone defects. Fifty-six rats were randomly divided into four groups of seven animals each: the biomaterial group (G1/B), the biomaterial plus FB group (G2/BFB); the biomaterial plus PBM group (G3/B + PBM), and the biomaterial plus FB plus PBM group (G4/BFB + PBM). After anesthesia, a critical defect was performed in the center of the rats' parietal bones, then filled and treated according to their respective groups. The rats were euthanized at 14 and 42 postoperative days. Histomorphologically, at 42 days, the G4/BFB + PBM group showed a more advanced maturation transition, with more organized and mature bone areas forming concentric lamellae. A birefringence analysis of collagen fibers also showed a more advanced degree of maturation for the G4/BFB + PBM group. In the comparison between the groups, in the two experimental periods (14 and 42 days), in relation to the percentage of formation of new bone tissue, a significant difference was found between all groups (G1/B (5.42 ± 1.12; 21.49 ± 4.74), G2/BFB (5.00 ± 0.94; 21.77 ± 2.83), G3/B + PBM (12.65 ± 1.78; 29.29 ± 2.93), and G4/BFB + PBM (12.65 ± 2.32; 31.38 ± 2.89)). It was concluded that the use of PBM with low-level laser therapy (LLLT) positively interfered in the repair process of bone defects previously filled with the biocomplex formed by the heterologous fibrin biopolymer associated with the synthetic ceramic of hydroxyapatite and tricalcium phosphate.

Biological Behavior of Xenogenic Scaffolds in Alcohol-Induced Rats: Histomorphometric and Picrosirius Red Staining Analysis.

In this experimental protocol, the objective was to evaluate the biological behavior of two xenogenic scaffolds in alcohol-induced rats through histomorphometric and Picrosirius Red staining analysis of non-critical defects in the tibia of rats submitted or not to alcohol ingestion at 25% v/v. Eighty male rats were randomly divided into four groups (n = 20 each): CG/B (water diet + Bio-Oss® graft, Geistlich Pharma AG, Wolhusen, Switzerland), CG/O (water diet + OrthoGen® graft, Baumer, Mogi Mirim, Brazil), AG/B (25% v/v alcohol diet + Bio-Oss® graft), and AG/O (25% v/v alcohol diet + OrthoGen® graft). After 90 days of liquid diet, the rats were surgically obtained, with a defect in the tibia proximal epiphysis; filled in according to their respective groups; and euthanized at 10, 20, 40 and 60 days. In two initial periods (10 and 20 days), all groups presented biomaterial particles surrounded by disorganized collagen fibrils. Alcoholic animals (AG/B and AG/O) presented, in the cortical and medullary regions, a reactive tissue with inflammatory infiltrate. In 60 days, in the superficial area of the surgical cavities, particles of biomaterials were observed in all groups, with new compact bone tissue around them, without complete closure of the lesion, except in non-alcoholic animals treated with Bio-Oss® xenograft (CG/B), where the new cortical interconnected the edges of the defect. Birefringence transition was observed in the histochemical analysis of collagen fibers by Picrosirius Red, in which all groups in periods of 10 and 20 days showed red-orange birefringence, and from 40 days onwards greenish-yellow birefringence, which demonstrates the characteristic transition from the formation of thin and disorganized collagen fibers initially to more organized and thicker later. In histomorphometric analysis, at 60 days, CG/B had the highest volume density of new bone (32.9 ± 1.15) and AG/O the lowest volume density of new bone (15.32 ± 1.71). It can be concluded that the bone neoformation occurred in the defects that received the two biomaterials, in all periods, but the Bio-Oss® was superior in the results, with its groups CG/B and AG/B displaying greater bone formation (32.9 ± 1.15 and 22.74 ± 1.15, respectively) compared to the OrthoGen® CG/O and AG/O groups (20.66 ± 2.12 and 15.32 ± 1.71, respectively), and that the alcoholic diet interfered negatively in the repair process and in the percentage of new bone formed.

Effects of Therapy with Fibrin Glue combined with Mesenchymal Stem Cells (MSCs) on Bone Regeneration: A Systematic Review.

Cell therapy strategies using mesenchymal stem cells (MSCs) carried in fibrin glue have shown promising results in regenerative medicine. MSCs are crucial for tissue healing because they have angiogenic, anti-apoptotic and immunomodulatory properties, in addition to the ability to differentiate into several specialized cell lines. Fibrin sealant or fibrin glue is a natural polymer involved in the coagulation process. Fibrin glue provides a temporary structure that favors angiogenesis, extracellular matrix deposition and cell-matrix interactions. Additionally, fibrin glue maintains the local and paracrine functions of MSCs, providing tissue regeneration through less invasive clinical procedures. Thus, the objective of this systematic review was to assess the potential of fibrin glue combined with MSCs in bone or cartilage regeneration. The bibliographic search was performed in the PubMed/MEDLINE, LILACS and Embase databases, using the descriptors ("fibrin sealant" OR "fibrin glue") AND "stem cells" AND "bone regeneration", considering articles published until 2021. In this case, 12 preclinical and five clinical studies were selected to compose this review, according to the eligibility criteria. In preclinical studies, fibrin glue loaded with MSCs, alone or associated with bone substitute, significantly favored bone defects regeneration compared to scaffold without cells. Similarly, fibrin glue loaded with MSCs presented considerable potential to regenerate joint cartilage injuries and multiple bone fractures, with significant improvement in clinical parameters and absence of postoperative complications. Therefore, there is clear evidence in the literature that fibrin glue loaded with MSCs, alone or combined with bone substitute, is a promising strategy for treating lesions in bone or cartilaginous tissue.

Evaluation of the Use of an Inorganic Bone Matrix in the Repair of Bone Defects in Rats Submitted to Experimental Alcoholism.

To assess the effects of chronic alcoholism on the repair of bone defects associated with xenograft. Forty male rats were distributed in: control group (CG, n = 20) and experimental group (EG, n = 20), which received 25% ethanol ad libitum after a period of adaptation. After 90 days of liquid diet, the rats were submitted to 5.0-mm bilateral craniotomy on the parietal bones, subdividing into groups: CCG (control group that received only water with liquid diet and the defect was filled with blood clot), BCG (control group that received only water with liquid diet and the defect was filled with biomaterial), CEG (alcoholic group that received only ethanol solution 25% v/v with liquid diet and the defect was filled with blood clot), and BEG (alcoholic group that received only ethanol solution 25% v/v with liquid diet and the defect was filled with biomaterial). In the analysis of body mass, the drunk animals presented the lowest averages in relation to non-drunk animals during the experimental period. Histomorphologically all groups presented bone formation restricted to the defect margins at 60 days, with bone islets adjacent to the BCG biomaterial particles. CEG showed significant difference compared to BEG only at 40 days (17.42 ± 2.78 vs. 9.59 ± 4.59, respectively). In the birefringence analysis, in early periods all groups showed red-orange birefringence turning greenish-yellow at the end of the experiment. The results provided that, regardless of clinical condition, i.e., alcoholic or non-alcoholic, in the final period of the experiment, the process of bone defect recomposition was similar with the use of xenograft or only clot.

Eficácia da estimulação elétrica com corrente russa após neurorrafia término-lateral do nervo fibular comum: análise eletroneuromiográfica e de força muscular / Eficacia de la estimulación eléctrica con la corriente rusa tras la neurorrafia término-lateral del nervio fibular común: análisis electroneuromiográfico y de fuerza muscular muscular / Efficacy of electrical Russian current stimulation after end-to-side neurorrhaphy of the common fibular nerve: electroneuromyography and muscle strength analysis

RESUMO Lesões de nervos periféricos levam a perda funcional elevada no tecido muscular. Assim, muitas pesquisas têm investigado técnicas cirúrgicas, como neurorrafias, e recursos terapêuticos, como eletroestimulação, para melhorar a funcionalidade de um músculo reinervado após lesão periférica. Este estudo tem como objetivo investigar os efeitos da eletroestimulação com corrente russa (2.500Hz, 4ms, 10 seg. de contração por 20 seg. de relaxamento, modulação de 10Hz e 100 Hz) na recuperação funcional após secção e neurorrafia término-lateral do coto distal do nervo fibular comum à face lateral do nervo tibial em ratos. Foram utilizados 25 ratos Wistar, machos, com 80 dias de vida, fornecidos pelo Biotério Central da Universidade Sagrado Coração (Bauru, SP, Brasil). Os animais foram divididos aleatoriamente em cinco grupos: grupo-controle Inicial (GCI), grupo-controle final (GCF), grupo experimental não tratado (GENT), grupo neurorrafia término-lateral com estimulação russa (GNTLER) e grupo-controle desnervado (GCD). A corrente russa foi iniciada cinco dias após neurorrafia e aplicada no músculo tibial cranial do GNTLER, 3 vezes por semana, totalizando 36 sessões. A estimulação elétrica foi eficaz para aumentar a amplitude e diminuir a latência do músculo reinervado, além de aumentar a força muscular em comparação ao GCD. Diante disso, conclui-se que a eletroestimulação de média frequência (corrente russa) foi eficiente na recuperação funcional do músculo tibial cranial após neurorrafia término-lateral do nervo fibular comum.

RESUMEN Las lesiones de los nervios periféricos ocasionan una elevada pérdida funcional en el tejido muscular. De esta manera, en muchos estudios se han investigado técnicas quirúrgicas, como neurorrafias, y recursos terapéuticos, como la electroestimulación, para mejorar la funcionalidad del músculo reinervado tras una lesión periférica. El presente estudio tiene como objetivo investigar los efectos de la electroestimulación con corrente rusa (2.500Hz, 4ms, 10 seg. de contracción por 20 seg. de relajación, modulación de 10Hz y 100Hz) en la recuperación funcional tras la sección y neurorrafia término-lateral del muñón distal del nervio fibular común en la parte lateral del nervio tibial en ratas. Se utilizaron 25 ratas Wistar, machos, con 80 días de vida, proporcionadas por el Biotério Central de la Universidade do Sagrado Coração (Bauru, SP, Brasil). Se dividieron aleatoriamente los animales en cinco grupos: grupo de control inicial (GCI), grupo de control final (GCF), grupo experimental no tratado (GENT), grupo de neurorrafia término-lateral con estimulación rusa (GNTLER) y grupo de control denervado (GCD). La corriente rusa se inició cinco días tras la neurorrafia, siendo que la aplicó al músculo tibial craneal del GNTLER 3 veces a la semana, con un total de 36 sesiones. La estimulación eléctrica se mostró efectiva para aumentar la amplitud y disminuir la latencia del músculo reinervado, además de aumentar la fuerza muscular en comparación con el GCD. Por lo tanto, se concluye que la estimulación eléctrica de frecuencia media (corriente rusa) fue eficaz en la recuperación funcional del músculo tibial craneal tras la neurorrafia término-lateral del nervio fibular común.

ABSTRACT Peripheral nerve injury leads to a high functional loss of muscle tissue. Thus, many studies have investigated surgical techniques, such as neurorraphies, and therapeutic resources, such as electrical stimulation, to improve the functionality of reinnervated muscle after peripheral injury. This study aims to investigate the effects of electrical stimulation with Russian Current (2,500Hz, 4ms, 10:20 sec contraction/relaxation, modulated at 10Hz and 100Hz) in the functional recovery after section and end-to-side neurorrhaphy of the peroneal nerve distal stump common to the lateral face of the tibial nerve in rats. In this study, 25 male Wistar rats with 80 days of life were used, provided by the Universidade Sagrado Coração (USC), Bauru, SP, Brazil. The animals were randomly divided into five groups: Initial Control Group (ICG), Final Control Group (FCG), Untreated Experimental Group (UEG), End-to-Side Neurorrhaphy with Russian Stimulation Group (ENRSG), and Denervated Control Group (DCG). The Russian Current was started 5 days after neurorrhaphy and applied to the cranial tibial muscle of the ENRSG, 3 times a week, totaling 36 sessions. We observed that the electrical stimulation with Russian Current (ENRSG) was effective to increase amplitude (mV) and to decrease the latency (ms) of the reinnervated muscle, besides increasing the muscle strength when compared with the denervated control group. Therefore, we concluded that the average frequency electrical stimulation (Russian current) was efficient in the functional recovery of the cranial tibial muscle after the end-lateral neurorrhaphy of the common fibular nerve.

Fibrin Sealant Derived from Human Plasma as a Scaffold for Bone Grafts Associated with Photobiomodulation Therapy.

Fibrin sealants derived from human blood can be used in tissue engineering to assist in the repair of bone defects. The objective of this study was to evaluate the support system formed by a xenograft fibrin sealant associated with photobiomodulation therapy of critical defects in rat calvaria. Thirty-six rats were divided into four groups: BC (n = 8), defect filled with blood clot; FSB (n = 10), filled with fibrin sealant and xenograft; BCPBMT (n = 8), blood clot and photobiomodulation; FSBPBMT (n = 10), fibrin sealant, xenograft, and photobiomodulation. The animals were killed after 14 and 42 days. In the histological and microtomographic analysis, new bone formation was observed in all groups, limited to the defect margins, and without complete wound closure. In the FSB group, bone formation increased between periods (4.3 ± 0.46 to 6.01 ± 0.32), yet with lower volume density when compared to the FSBPBMT (5.6 ± 0.45 to 10.64 ± 0.97) group. It was concluded that the support system formed by the xenograft fibrin sealant associated with the photobiomodulation therapy protocol had a positive effect on the bone repair process.

Stimulation of morphofunctional repair of the facial nerve with photobiomodulation, using the end-to-side technique or a new heterologous fibrin sealant.

This research evaluated the influence of Photobiomodulation Therapy (PBMT) on lesions of the facial nerve repaired with the end-to-side technique or coaptation with a new heterologous fibrin sealant. Thirty-two Wistar rats were separated into 5 groups: Control group (CG), where the buccal branch of the facial nerve was collected; Experimental Suture Group (ESG) and Experimental Fibrin Group (EFG), in which the buccal branch was end-to-side sutured to the zygomatic branch on the right side of the face or coaptated with fibrin sealant on the left side; Experimental Suture Laser Group (ESLG) and Experimental Fibrin Laser Group (EFLG), in which the same procedures were performed as the ESG and EFG, associated with PBMT (wavelength of 830nm, energy density 6.2J/cm2, power output 30mW, beam area of 0.116cm2, power density 0.26W/cm2, total energy per session 2.16J, cumulative dose of 34.56J). The laser was applied for 24s/site at 3 points on the skin's surface, for a total application time of 72s, performed immediately after surgery and 3 times a week for 5weeks. A statistically significant difference was observed in the fiber nerve area between the EFG and EFLG (57.49±3.13 and 62.52±3.56µm2, respectively). For the area of the axon, fiber diameter, axon diameter, myelin sheath area and myelin sheath thickness no statistically significant differences were found (p<0.05). The functional recovery of whisker movement occurred faster in the ESLG and EFLG, which were associated with PBMT, with results closer to the CG. Therefore, PBMT accelerated morphological and functional nerve repair in both techniques.

Inside-out and standard vein grafts associated with platelet-rich plasma (PRP) in sciatic nerve repair. A histomorphometric study

Abstract Purpose: To evaluated the tubulization technique with standard and inside-out vein, filled or not with platelet-rich plasma (PRP), in sciatic nerve repair. Methods: Seventy male Wistar rats were randomly divided into five groups: IOVNF (Inside-Out Vein with No Filling); IOVPRP (Inside-Out Vein filled with PRP); SVNF (Standard Vein with No Filling); SVPRP (Standard Vein filled with PRP); Sham (Control). The left external jugular vein was used as graft in a 10 mm nervous gap. Results: In the morphological analysis of all groups, myelinated nerve fibers with evident myelin sheath, neoformation of the epineurium and perineurium, organization of intraneural fascicles and blood vessels were observed. In the morphometry of the distal stump fibers, SVPRP group had the highest means regarding fiber diameter (3.63±0.42 μm), axon diameter (2.37±0.31 μm) and myelin sheath area (11.70±0.84 μm2). IOVPRP group had the highest means regarding axon area (4.39±1.16 μm2) and myelin sheath thickness (0.80±0.19 μm). As for values of the fiber area, IOVNF group shows highest means (15.54±0.67 μm2), but are still lower than the values of the Sham group. Conclusion: The graft filled with platelet-rich plasma, with use standard (SVPRP) or inside-out vein (IOVPRP), promoted the improvement in axonal regeneration on sciatic nerve injury.

Efficacy of Laser Photobiomodulation on Morphological and Functional Repair of the Facial Nerve.

OBJECTIVE: Evaluate the efficacy of low-level laser therapy (LLLT) on qualitative, quantitative, and functional aspects in the facial nerve regeneration process. MATERIALS AND METHODS: Forty-two male Wistar rats were used, randomly divided into a control group (CG; n = 10), in which the facial nerve without lesion was collected, and four experimental groups: (1) suture experimental group (SEG) and (2) fibrin experimental group (FEG), consisting of 16 animals in which the buccal branch of the facial nerve was sectioned on both sides of the face; an end-to-end epineural suture was performed on the right side, and a fibrin sealant was used on the left side for coaptation of the stumps; and (3) laser suture experimental group (LSEG) and (4) laser fibrin experimental group (LFEG), consisting of 16 animals that underwent the same surgical procedures as SEG and FEG with the addition of laser application at three different points along the surgical site (pulsed laser of 830 nm wavelength, optical output power of 30 mW, power density of 0.2586 W/cm2, energy density of 6.2 J/cm2, beam area of 0.116 cm2, exposure time of 24 sec per point, total energy per session of 2.16 J, and cumulative dose of 34.56 J). The animals were submitted to functional analysis (subjective observation of whisker movement) and the data obtained were compared using Fisher's exact test. Euthanasia was performed at 5 and 10 weeks postoperative. The total number and density of regenerated axons were analyzed using the unpaired t-test (p < 0.05). RESULTS: Laser therapy resulted in a significant increase in the number and density of regenerated axons. The LSEG and LFEG presented better scores in functional analysis in comparison with the SEG and FEG. CONCLUSIONS: LLLT enhanced axonal regeneration and accelerated functional recovery of the whiskers, and both repair techniques allowed the growth of axons.

Comparative study between standard and inside-out vein graft techniques on sciatic nerve repair of rats. Muscular and functional analysis

Abstract Purpose: To compare the functional result of standart vein grafts and inside-out vein graft technique on sciatic nerve repair. Methods: We used 24 male Wistar rats divided into 4 groups: control group (CG), standard vein graft group (SVG), Inside-out vein graft group (IOVG) and denervated Group (DG). SVG, IOVG and DG underwent total section of the sciatic nerve, SVG and IOVG however underwent nerve repair surgery using a graft with normal jugular vein and inside-out jugular vein, respectively. Histological analysis of the soleus and Extensor Digitorum Longus (EDL), and Sciatic Functional Index were used to compare the results after 6 weeks. Results: Both grafts acted favorably in muscle recovery and improved functionality; They were similar in all parameters, however, in more points SVG achieved similar to the CG, in the other hand IOVG more times was similar to DG. Fact that makes the graft with normal vein the most viable option between the two options. Conclusion: Both types of grafts acted beneficially wherein the graft normal vein has proved to be the best option

Electrical stimulation attenuates morphological alterations and prevents atrophy of the denervated cranial tibial muscle / Eletroestimulação atenua alterações morfológicas e previne atrofia do músculo tibial cranial desnervado

ABSTRACT Objective To investigate if electrical stimulation through Russian current is able to maintain morphology of the cranial tibial muscle of experimentally denervated rats. Methods Thirty-six Wistar rats were divided into four groups: the Initial Control Group, Final Control Group, Experimental Denervated and Treated Group, Experimental Denervated Group. The electrostimulation was performed with a protocol of Russian current applied three times per week, for 45 days. At the end, the animals were euthanized and histological and morphometric analyses were performed. Data were submitted to statistical analysis with a significance level of p<0.05. Results The Experimental Denervated Group and the Experimental Denervated and Treated Group had cross-sectional area of smaller fiber compared to the Final Control Group. However, there was significant difference between the Experimental Denervated Group and Experimental Denervated and Treated Group, showing that electrical stimulation minimized muscle atrophy. The Experimental Denervated and Treated Group and Initial Control Group showed similar results. Conclusion Electrical stimulation through Russian current acted favorably in maintaining morphology of the cranial tibial muscle that was experimentally denervated, minimizing muscle atrophy.

RESUMO Objetivo Investigar se a estimulação elétrica pela corrente russa é capaz de manter a morfologia do músculo tibial cranial de ratos desnervados experimentalmente. Métodos Foram utilizados 36 ratos Wistar, distribuídos em quatro grupos: Grupo Controle Inicial, Grupo Controle Final, Grupo Experimental Desnervado Tratado, Grupo Experimental Desnervado. A eletroestimulação foi realizada com um protocolo de corrente russa aplicada três vezes por semanas, durante 45 dias. Ao final, os animais foram eutanasiados e, em seguida, foram realizadas as análises histológica e morfométrica. Os dados foram submetidos à análise estatística, com nível de significância de p<0,05. Resultados Os Grupos Experimental Desnervado e o Grupo Experimental Desnervado Tratado apresentaram área de secção transversal da fibra menor quando comparados ao Grupo Controle Final. Entretanto, constatou-se diferença significativa entre o Grupo Experimental Desnervado e o Grupo Experimental Desnervado Tratado, mostrando que a estimulação elétrica minimizou atrofia muscular. Ainda, observou-se que o Grupo Experimental Desnervado Tratado apresentou resultados semelhantes ao Grupo Controle Inicial. Conclusão A estimulação elétrica por meio da corrente russa foi favorável na manutenção da morfologia do músculo tibial cranial desnervado experimentalmente, minimizando a atrofia muscular.

PPE tube filled with autologous fat in the repair of peripheral nerve: a new proposal / Tubo PPE relleno con grasa autóloga en la reparación de los nervios periféricos: una nueva propuesta

This study proposes the use of a porous polyethylene (PPE) tube as the conductive element in the regeneration in the sciatic nerve sectioning and evaluates the use of fill with autologous fat. The subject was divided randomly into five groups, 3 control and 2 experimental (PPE tube graft with/ without autologous fat). Each group was selected for functional, histological and morphometric evaluation of the sciatic nerve. Functional analysis of the sciatic nerve occurred through the "footprint" values near -100 refer sectioned sciatic nerve, near 0 (zero) refer to control group. On histological analysis of the experimental groups lots of dense connective tissue replacing nerve tissue was observed. In morphometric analysis the group EGPGf got higher performance in all of variables. The use of PPE has shown promise in nerve regeneration with favorable results when associate with fat as a trophic factor in the regeneration.

Este estudio propone el uso de un tubo de polietileno poroso (PPE) como elemento conductor en la regeneración del nervio ciático seccionado y evaluar el uso de relleno con grasa autóloga. Al azar se formaron cinco grupos, 3 y 2 de control experimental (PPE prótesis tubular con / sin grasa autóloga). Cada grupo fue seleccionado para estudiar la forma funcional, histológica y evaluación morfométrica del nervio ciático. Un análisis funcional del nervio ciático se produjo a través de los valores de "huella", cerca de -100 se refiere al nervio ciático seccionado; cerca de 0 (cero) se refiere al grupo control. En el análisis histológico de los grupos experimentales se observó una gran cantidad de tejido conjuntivo denso que sustituye el tejido nervioso. En el análisis morfométrico, el grupo experimental de injerto de polietileno lleno de grasa (EGPGf) obtuvo un mayor rendimiento en todas las variables. El uso de PPE ha mostrado ser prometedor en la regeneración del nervio, con resultados favorables cuando se asocia con la grasa como un factor trófico en la regeneración.

Efeito da associação da laserterapia com a natação no reparo morfológico do nervo isquiático e na recuperação funcional de ratos submetidos à axonotmese / Efecto de la asociación entre la laserterapia y la natación en la recuperación morfológica del nervio isquiático y en la recuperación funcional de ratas sometidas a axonotmesis / Effect of the laser therapy in association with swimming for a morphological nerve repair and functional recovery in rats submitted to sciatic axonotmesis

RESUMO As lesões de nervos periféricos ocorrem frequentemente e, de modo geral, causam perda funcional impactando de forma negativa na vida do paciente. O objetivo do estudo foi verificar a eficiência da associação da laserterapia e natação em ratos acometidos por axonotmeses. A amostra foi composta por 50 ratos da linhagem Wistar. Foram divididos em 5 grupos, sendo: grupo controle (GC); grupo controle cirúrgico (GCC); grupo experimental laser (GEL); grupo experimental natação (GEN) e grupo experimental laser associado à natação (GELAN). O nervo foi esmagado em um segmento de 5 mm de comprimento próximo a trifurcação do nervo isquiático, feito com uma pinça durante 60 segundos. Foi utilizado o laser infravermelho AsGa (904 nm) com energia irradiada de 0,4 J na primeira semana, 0,8 J na segunda semana e 1,2 J na terceira e quarta semana. Para avaliação funcional (IFC), os animais foram imobilizados, e a região plantar das patas foram pintadas com tinta de carimbo. Esse procedimento foi repetido duas vezes com cada animal. Foi realizada a morfometria (áreas, diâmetros e espessuras das fibras, axônios e bainha de mielina) dos nervos com mensuração de 220 fibras por animal de cada grupo. Pudemos observar que os grupos GEL e GEN, em todas as variáveis morfométricas estudadas, obtiveram os melhores resultados, quando comparados com os outros grupos (GC, GCC e GELAN), mas não apresentou diferença estatisticamente significante entre eles. Na análise funcional observou-se que o grupo GELAN obteve o melhor resultado quando comparado com os outros grupos (GCC, GEL e GEN) e quando comparados os grupos GEL e GEN entre eles não houve diferença estatisticamente significante. A conclusão foi que os grupos GEL e GEN obtiveram os melhores resultados morfométricos, enquanto o GELAN apresentou o melhor resultado funcional. Portanto, pode-se concluir que a associação destes recursos favoreceu a recuperação funcional desses animais.

RESUMEN Las lesiones de los nervios periféricos frecuentemente ocurren, y generalmente ocasionan pérdida funcional, lo que les causa daño a la vida de los pacientes. En este artículo se propone a verificar la eficacia de la asociación de la laserterapia y de la natación en ratas sometidas a axonotmesis. El muestro se compuso de 50 ratas Wistar. Se las dividieron en 5 grupos: grupo control (GC); grupo control quirúrgico (GCQ); grupo experimental láser (GEL); grupo experimental natación (GEN) y grupo experimental láser asociado con la natación (GELAN). Se aplastó con una pinza durante 60 segundos el nervio en un segmento de 5 mm de extensión cerca de la trifurcación del nervio isquiático. Se empleó el láser infrarrojo AsGa (904 nm) con energía irradiada de 0,4 J en la primera semana, 0,8 J en la segunda y 1,2 J en la tercera y cuarta semanas. Para la evaluación funcional (IFC), se los inmovilizaron los animales y se los pintó con tinta estampilla la región plantar de las patas. Se repitió dicho procedimiento dos veces en cada animal. Se realizó la morfometría (áreas, diámetros y espesuras de las fibras, axónios y vaina de mielina) de los nervios con mensuración de 220 fibras por cada animal de cada grupo. Se notó que los grupos GEL y GEN, en todas las variables morfométricas estudiadas, presentaron los mejores resultados, en comparación con los otros grupos (GC, GCQ y GELAN), sin embargo no presentó diferencia estadísticamente significativa entre ellos. En el análisis funcional se observó que el grupo GELAN tuvo el mejor resultado en comparación con otros grupos (GCQ, GEL y GEN), y al comparar los grupos GEL y GEN no presentaron diferencia estadísticamente significativa. Se concluyó que los grupos GEL y GEN tuvieron mejores resultados morfométricos, mientras que el GELAN presentó el mejor resultado funcional. Por lo que se concluye que la asociación de dichos recursos les favoreció la recuperación funcional de dichos animales.

ABSTRACT The peripheral nerve injuries occur frequently and generally cause functional loss impacting negatively on patient's life. The objective this study was to verify the efficiency of the combination of laser therapy and swimming in rats affected by axonotmesis. The sample was comprised of 50 Wistar rats and it was divided into 05 groups: Control Group; Surgical Control Group; Laser Experimental Group; Swimming Experimental Group and Laser Experimental combined with Swimming Group. The nerve was crushed into a 5 mm-long segment next to the sciatic nerve trifurcation with a pair of forceps for 60 seconds. The GaAs infrared laser (904nm) was used with energy radiated 0,4J the first week, the second week 0,8J and 1,2J in the third and fourth week. For functional (FCI) evaluation, the animals were immobilized and the plantar region of their paws were painted with ink stamp. The procedure was repeated twice to each animal. The nerve morphometry (areas, diameters and thicknesses of the fibers, axons and myelin sheath) was performed with the measurement of 220 fibers per animal in each group . We can see that the GEL and GEN groups , obtained the best results when compared with the other groups (GC, GCC and GELAN) in all morphometric variables studied, but no statistically significant difference was found between them. In functional analysis, it was observed that the gelan group obtained the best results when compared with the other groups (GCC , GEN and GEL) and when the GEL and GEN groups were compared, there was no statistically significant difference between them. Was conclued the GEL and GEN groups havd the best morphometric results, while the GELAN showed the best functional outcome. Therefore, it can be concluded that the combination of these features favoured the functional recovery of the animals.

Identification of the bony canal of the posterior superior alveolar nerve and artery in the maxillary sinus: tomographic, radiographic, and macroscopic analyses.

The aim of this study was to identify the shape and route of the bony canal of the posterior superior alveolar artery (PSAA) and posterior superior alveolar nerve (PSAN) using different identification methods, including computed tomography (CT), panoramic radiograph, and macroscopic evaluation (corpse and dry skull). Twenty-four patients were analyzed by CT and panoramic and posterior anterior (PA) radiographs; additionally, 90 dry skulls and 21 dissected anatomical specimens were examined. Three-dimensional-CT revealed that the lateral wall of the maxillary sinus resembled a tunnel format in 60% of the treated patients. Out of all 24 patients, the panoramic radiograph identified the bony canal in only one patient; whereas the PA radiograph identified it in 80% of the patients. The dry skulls showed tunnellike routes of the PSAA and PSAN in 65% of the cases. Moreover, the pathway was also visibly observed in the dissected anatomical specimens as a straight shape in 85% of the cases. Thus, our results demonstrated that the most common shape of the bony canal of the PSAA and PSAN is the tunnel format with a straight route by 3D-CT, posterior anterior radiography, and macroscopic evaluation. However, in the panoramic radiographs, it was difficult to identify this canal.

Effect of low-level laser therapy (LLLT) on peripheral nerve regeneration using fibrin glue derived from snake venom.

OBJECTIVES: The purpose of this study was to assess whether the adhesive permits the collateral repair of axons originating from a vagus nerve to the interior of a sural nerve graft, and whether low-level laser therapy (LLLT) assists in the regeneration process. MATERIALS AND METHODS: Study sample consisted of 32 rats randomly separated into three groups: Control Group (CG; n=8), from which the intact sural nerve was collected; Experimental Group (EG; n=12), in which one of the ends of the sural nerve graft was coapted to the vagus nerve using the fibrin glue; and Experimental Group Laser (EGL; n=12), in which the animals underwent the same procedures as those in EG with the addition of LLLT. Ten weeks after surgery, the animals were euthanized. Morphological analysis by means of optical and electron microscopy, and morphometry of the regenerated fibers were employed to evaluate the results. RESULTS: Collateral regeneration of axons was observed from the vagus nerve to the interior of the autologous graft in EG and EGL, and in CG all dimensions measured were greater and presented a significant difference in relation to EG and EGL, except for the area and thickness of the myelin sheath, that showed significant difference only in relation to the EG. CONCLUSIONS: The present study demonstrated that the fibrin glue makes axonal regeneration feasible and is an efficient method to recover injured peripheral nerves, and the use of low-level laser therapy enhances nerve regeneration.

Comparacao do efeito do treinamento físico de natação com carga e sem carga na musculatura estriada esquelética de ratos / Comparison of the effect of physical swimming training load and off load in the striated skeletal muscle of rats

O treinamento físico provoca diversas alterações fisiológicas e morfológicas no tecido muscular dos seres vivos. Objetivo: assim, o objetivo deste estudo foi verificar o efeito do treinamento aeróbio e de carga sobre a massa corporal de ratos. Método: a amostra foi composta por 40 ratos machos da linhagem Wistar, com 80 dias de vida, pesando aproximadamente 250g, fornecidos pelo Biotério Central da Universidade do Sagrado Coração (USC). Divididos em grupo controle (GC), grupo controle água (GCA), grupo de atividade sem carga (GASC) e grupo de atividade com carga (GACC). O GASC e o GACC realizaram seus respectivos treinamentos durante 13 semanas consecutivas e o GC será utilizado como grupo controle. Todos os animais foram sacrificados com 125 dias de vida. Foi realizada a análise morfométrica dos músculos Sóleo e EDL (Extensor Digitorum Longus) utilizando-se um microcomputador com o software de captura e análise de imagem para comparar o efeito do exercício físico com e sem carga sobre o tecido muscular. Resultado e discussão: na avaliação muscular, as variáveis de área e diâmetro menor da fibra muscular apresentaram resultados semelhantes nos músculos sóleos e EDL. O grupo com carga GACC apresentou resultados superiores quando comparado com o grupo GASC, comprovando a eficiência da atividade física na hipertrofia das fibras musculares. Conclusão: foi possível concluir, na presente pesquisa, que o exercício foi eficaz no aumento da área da fibra muscular dos músculos sóleo e EDL de ratos Wistar, potencializado pela carga associada a hidroginástica...

Physical training causes several physiological and morphological changes in the muscle tissue of living organisms. Objective: the aim of this study was to investigate the effect of aerobic training and workload on the body weight of rats. Methods: the sample consisted of 40 male Wistar rats, 80 days old, weighing approximately 250g, provided by the Central Animal Facility of the Universidade do Sagrado Coração (USC). Divided into control group (CG), water control group (GCA), group activity without load (GASC) and group activity to charge (GACC). The GASC and the GACC held their training for 13 consecutive weeks and the GC will be used as control group. All animals were sacrificed at 125 days of life. Morphometric analysis of the Soleus and EDL muscles (Extensor Digitorum Longus) using a microcomputer with the capture software and image analysis was performed to compare the effects of exercise with and without load on muscle tissue. Results and discussion: muscle evaluation variables area and smallest diameter fiber presented similar results muscle in soleus and EDL. The group charged GACC showed superior results when compared with the GASC group, proving the effectiveness of physical activity in hypertrophy of muscle fibers. Conclusion: one can conclude, in this study, that exercise was effective in increasing the area of the muscle fiber in the soleus and EDL muscles of Wistar rats, potentiated by charge associated water aerobics...

O efeito da laserterapia de baixa potência em aspectos histológicos em um modelo experimental de lesão muscular por estiramento controlado em ratos / The effect of low-level laser therapy in histological aspects in a model of experimental muscle injury in rat controlled muscle strain

Estiramento muscular e outras desordens musculoesqueléticas são as principais causas que desabilitam atletas e praticantes de atividades físicas. Seu tratamento inclui AINES que desencadeiam vários efeitos adversos. Objetivo: o objetivo do estudo foi avaliar o efeito dos tratamentos com Laserterapia de Baixa Potência e do anti-inflamatório diclofenaco, tanto individualmente quanto combinados (laser + aplicação por vias tópica ou intramuscular de diclofenaco) em aspectos histológicos no modelo experimental de lesão muscular por estiramento controlado em ratos. Materiais e Métodos: a lesão por estiramento foi induzida, por sobre carga, no músculo tibial anterior de ratos (n=6). O grupo controle não recebeu tratamento, grupos lesados receberam um único tratamento com diclofenaco através das vias tópica ou intramuscular, irradiação com laser (3 J, 830 nm, 100 mW) ou os dois tratamentos conjuntamente, laser e diclofenaco, totalizando seis grupos experimentais. Os tratamentos foram realizados 1 hora após a lesão. O músculo tibial foi removido para análise histológica, três horas após a indução da lesão e também seis horas após indução. Resultados e discussão: a avaliação histológica demonstrou uma melhor organização estrutural do tecido muscular, células bem delineadas e menor quantidade de fibras fragmentadas e menor descontinuidade de acidofilia nos grupos tratados com laser e diclofenaco, nas duas vias de aplicação, tanto no período de 3 horas quanto no de 6 horas após a lesão. Conclusão: a irradiação do laser de baixa potência conjuntamente ao diclofenaco tópico e intramuscular melhorou aspectos histológicos do tecido muscular, após lesão por estiramento, na fase aguda quando comparado com os demais tratamentos...

Muscle stretch and other musculoskeletal disorders are the main causes that disable athletes and fitness enthusiasts. His treatment includes NAIDs that trigger various adverse effects. Objective: the objective of the study the effect of treatments with Low Power Laser (LPL) Therapy and the anti-inflammatory diclofenac, both individually and combined (LPL + intramuscular or topical application of diclofenac pathways) in histological aspects in an experimental model was to evaluate muscle injury in rats controlled stretch. Materials and Methods: the injury was induced by muscle stretch, overload, the tibialis anterior muscle of rats (n = 6). The control group received no treatment, injured groups received a single treatment with diclofenac through the anti-inflammatory topical or intramuscular (AT and AIM), irradiation with LPL (3 J 830 nm, 100 mW), or the two treatments together, LPL and diclofenac (LPL/LPL or AT/AIM), totaling six experimental groups. All treatments were performed 1 hour after the injury. The right anterior tibial muscle was removed for histological analysis, within 3 hours after induction of the lesion and also 12 hours after induction. Results and discussion: histological evaluation in this study showed a better estructural organization of muscle tissue, cells and less well defined amount of fragmented fibers in the group treated with LPL and LPL AT + 3J 3J + AIM in both the 3-hour period and in 6 hours following injury. Conclusion: treatment with LPL jointly to the topic and intramuscular diclofenac improved the histological aspects of muscle tissue after stretch injury in the acute phase compared with the other treatments...

Multidisciplinary approach in the teaching of dental sculpture and anatomy / Enfoque multidisciplinario para la enseñanza de escultura y anatomía dental

The purpose of the Dental Sculpture and Anatomy discipline is to introduce undergraduate students to the study of the anatomic and morphological characteristics of permanent and primary human dentition, through classes, books and cognitive and psychomotor activities. This discipline supports the teaching of specific knowledge necessary for a more extensive education, involving interdisciplinarity as a means of knowledge exchange among several areas of dentistry, to achieve comprehensive professional education. Students must recognize the dental morphology from samples of preserved teeth, and reproduce the morphology through three-dimensional models made of stone or wax blocks. In this article, the authors describe the process for producing teeth collars and macro dental models made of stone, their importance and benefits of utilization. The purpose of the study was to encourage the teaching of Dental Sculpture and Anatomy toundergraduate students of the Bauru School of Dentistry, University of São Paulo, through activities that would associate theory, practice and the development of manual skills.

El propósito de la disciplina sobre escultura y anatomía de dientes es introducir a los estudiantes de pregrado para el estudio de las características anatómicas y morfológicas de la dentición humana permanente y primaria, a través de clases, libros y actividades cognitivas y psicomotoras. Esta disciplina se fundamenta en la enseñanza de conocimientos específicos necesarios para una educación más amplia, que implica la interdisciplinariedad como medio de intercambio de conocimientos entre diferentes áreas en odontología, y de esa forma, lograr una enseñanza profesional integral. Los estudiantes deben identificar la morfología dental a partir de dientes conservados, además de reproducir la morfología a través de modelos tridimensionales elaborados con bloques de yeso tipo piedra o cera. En este estudio, los autores describen el proceso para la producción de collares de dientes y macro modelos dentales hechos de yeso tipo piedra, su importancia y los beneficios de su utilización. El propósito del estudio fue incentivar la enseñanza de la escultura y anatomía dental a los estudiantes de pregrado de la Facultad de Odontología de Bauru, Universidad de São Paulo, a través de actividades que asocian la teoría, práctica y desarrollo de habilidades manuales.

Análise comparativa da marcha com três joelhos protéticos diferentes, em amputado transfemoral esquerdo / Comparative analysis of gait with three different prosthetic knees, in patient with left transfemoral amputation

O termo amputação é a retirada total ou parcial de um membro.A amputação transfemoral refere-se a amputações realizadas entrea desarticulação do joelho e a do quadril. O Instituto Nacional doSeguro Social (INSS) reabilita profissionalmente os beneficiáriosincapacitados para sua atividade profissional, como aqueles comsequelas de amputação. Os joelhos protéticos proporcionam estabilidadena fase de apoio e controle na fase de balanço durantea marcha. O objetivo foi analisar comparativamente a marcha empaciente amputado transfemoral esquerdo, utilizando três joelhosprotéticos diferentes (hidráulico rotativo, hidráulico monocêntricoe microprocessado). Foram afixados marcadores no paciente peloposicionamento Helen Hayes, depois o mesmo deambulou um trajetodeterminado para a captura dos movimentos, com os três joelhospropostos, para análises cinemática e observacional. A avaliaçãoobservacional mostrou características da marcha com os três joelhosmuito parecidas. Observou-se, na análise cinemática, parâmetrosespaços-temporais com valores menores que os referenciais nos trêsjoelhos, pela falta de segurança do indivíduo amputado no joelhoprotético. O joelho microprocessado apresentou um número maiorde parâmetros iguais nos dois membros devido à sua facilidade noalinhamento e regulagem. Concluiu-se que o joelho microprocessadoé o mais indicado para este paciente...

The term amputation is the partial or total removal of a limb. Thetransfemoral amputation refers to amputation performed betweenthe dislocation of the knee and hip. The National Social SecurityInstitute (INSS) professionally rehabilitates disabled beneficiaries,returning to their professional activity, for example, those withsequelae of amputation. The prosthetic knees provide stability inthe stance phase and control in the swing phase during gait. Theobjective was to analyze gait of a patient with left transfemoralamputation using three different prosthetic knees (rotary hidraulic,hydraulic and monocentric microprocessor). Helen Hayes markersset were used, after the patient walked a determined path to capturethe movements, with the three knees, so the kinematic andobservational analysis could be performed. The evaluation showedobservational gait characteristics with the three knees very similar.Was observed in the kinematic analysis parameters of spatiotemporalgait with smaller values than the references in the three knees, in consequenceof lack of security of the knee amputation prosthesis. Themicroprocessor knee showed a larger number of parameters in thetwo limbs due to ease alignment and adjustment. It was concludedthat the microprocessor knee is the most suitable for this patient...