RESUMO
The efficacy of the local application of recombinant human fibroblast growth factor-2 (FGF-2) in periodontal regeneration has been investigated. In this study, a randomized, double-blind, placebo-controlled clinical trial was conducted in 253 adult patients with periodontitis. Modified Widman periodontal surgery was performed, during which 200 µL of the investigational formulation containing 0% (vehicle alone), 0.2%, 0.3%, or 0.4% FGF-2 was administered to 2- or 3-walled vertical bone defects. Each dose of FGF-2 showed significant superiority over vehicle alone (p < 0.01) for the percentage of bone fill at 36 wks after administration, and the percentage peaked in the 0.3% FGF-2 group. No significant differences among groups were observed in clinical attachment regained, scoring approximately 2 mm. No clinical safety problems, including an abnormal increase in alveolar bone or ankylosis, were identified. These results strongly suggest that topical application of FGF-2 can be efficacious in the regeneration of human periodontal tissue that has been destroyed by periodontitis.
Assuntos
Fator 2 de Crescimento de Fibroblastos/uso terapêutico , Regeneração Tecidual Guiada Periodontal/métodos , Periodontite/cirurgia , Adulto , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/cirurgia , Processo Alveolar/efeitos dos fármacos , Índice de Placa Dentária , Método Duplo-Cego , Feminino , Fator 2 de Crescimento de Fibroblastos/administração & dosagem , Seguimentos , Gengiva/patologia , Hemorragia Gengival/classificação , Retração Gengival/classificação , Humanos , Masculino , Pessoa de Meia-Idade , Perda da Inserção Periodontal/classificação , Índice Periodontal , Ligamento Periodontal/efeitos dos fármacos , Bolsa Periodontal/classificação , Placebos , Radiografia , Proteínas Recombinantes , Retalhos Cirúrgicos , Mobilidade Dentária/classificação , Resultado do TratamentoRESUMO
To evaluate the effects of epinephrine (E) and norepinephrine (NE) administered during local anesthesia on left ventricular diastolic function, we examined transmitral inflow patterns with pulsed Doppler echocardiography. Arterial blood pressure, heart rate, and transmitral inflow patterns were measured in 10 healthy volunteers when 3.6 mL of 2% lidocaine containing 1:80,000 E or 1:25,000 NE was injected supraperiosteally in the maxilla. The dosage of drug administered was 45 micrograms for E and 144 micrograms for NE. After the administration of E, heart rate was increased, but blood pressure was unchanged. Peak early velocity (R), peak atrial velocity (A), the ratio of A to R (A/R), and the deceleration rate (Dc) were increased, whereas the isovolumic relaxation time (IVRT) was shortened. The increase of R and Dc and the shortening of IVRT indicated an activation of left ventricular relaxation. After the administration of NE, blood pressure was increased and heart rate was decreased. A decrease in Dc, shortening of the acceleration half-time (AcT), and prolongation of IVRT were observed. These changes reflect impeded myocardial relaxation. We conclude that E activates left ventricular diastolic function and that NE, in contrast, impairs it.
