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1.
J Clin Exp Dent ; 16(3): e350-e357, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38600932

RESUMO

Background: In cases of tooth avulsion, in which the neurovascular bundle responsible for nourishing the dental pulp is break, endodontic treatment is necessary before proceeding with tooth replantation. In this process, various substances have been tested in combination with calcium hydroxide Ca(OH)2 in an attempt to improve its effectiveness. This study aimed to examine the effects of using a mixture of Ca(OH)2 and 10% propolis, with subsequent application of ultrasonic treatment, on the delayed replantation of teeth in rats. Material and Methods: Twenty-four rats underwent a surgical procedure to extract the upper right incisor, leaving it on a surface to dry for one hour. The pulp and periodontal ligament were removed and the teeth were submerged in a 2% sodium fluoride acidulated phosphate solution. The canals were dehydrated using paper cones and the teeth were divided into four groups, according to the type of intracanal dressing: Ca(OH)2 group, Ca(OH)2 group with ultrasonic agitation, Ca(OH)2 and propolis group, Ca(OH)2 and propolis group with ultrasonic agitation. The root canals were irrigated with saline solution and the teeth were reimplanted. Sixty days after reimplantation, the animals were euthanized. Results: With regard to the presence of acute and chronic inflammatory infiltrate in the periodontal ligament, there was no statistically significant difference among some of the groups. Root resorption was identified in all groups, and there was no significant difference between them. Conclusions: It is concluded that the application of intracanal dressing containing Ca(OH)2 associated with 10% propolis, followed by ultrasonic agitation, did not prove to be more effective than the use of Ca(OH)2 alone in the repair process in the delayed replantation of rat teeth. Key words:Tooth replantation, Calcium hydroxide, Propolis, Ultrasound, Intracanal dressing.

2.
Clin Oral Investig ; 28(2): 151, 2024 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-38360985

RESUMO

OBJECTIVE: This study aimed to evaluate the efficacy of ozone therapy in the preoperative (prevention) and/or postoperative (treatment) of MRONJ. MATERIAL AND METHODS: Forty male Wistar rats were caudally treated with zoledronic acid (ZOL) and to ozone therapy before extraction (prevention, POG), after extraction (treatment, TOG), or both (prevention and treatment, TPOG), and treated with saline (SAL). The animals received intramuscular fluorochrome (calcein and alizarin), and 28 days postoperatively, they were euthanized, and the tissues were subjected to microtomographic computed tomography (microCT), LASER confocal, and histomorphometric analyses. RESULTS: Micro-CT showed a higher bone volume fraction average in all groups than that in the ZOL group (P < 0.001), the ZOL group showed high porosity (P = 0.03), and trabecular separation was greater in the TOG group than in the POG group (P < 0.05). The mineral apposition rate of the POG group was high (20.46 ± 6.31) (P < 0.001), followed by the TOG group (20.32 ± 7.4). The TOG group presented the highest mean newly formed bone area (68.322 ± 25.296) compared with the ZOL group (P < 0.05), followed by the SAL group (66.039 ± 28.379) and ZOL groups (60.856 ± 28.425). CONCLUSIONS: Ozone therapy modulated alveolar bone repair in animals treated with ZOL, mainly after surgery trauma, leading to bone formation as healing tissue. CLINICAL RELEVANCE: Osteonecrosis has been a challenge in dentistry, and owing to the lack of a consensus regarding therapy, studies presenting new therapies are important, and ozone has been one of the therapies explored empirically.


Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos , Conservadores da Densidade Óssea , Osteonecrose , Ratos , Animais , Masculino , Difosfonatos , Imidazóis/farmacologia , Extração Dentária , Ratos Wistar , Ácido Zoledrônico , Microtomografia por Raio-X , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/diagnóstico por imagem , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/prevenção & controle , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/tratamento farmacológico
3.
J Stomatol Oral Maxillofac Surg ; 124(6): 101479, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37080358

RESUMO

Recent studies have shown that bisphosphonates can also impact osteoblasts besides osteoclasts. This study aimed to evaluate the effects of different concentrations of Zoledronic acid (ZA) during the osteogenic differentiation of human Bone Marrow Stem Cells (hBMSCs) in vitro. Thus, osteogenic differentiation of hBMSCs was conducted with different concentrations of Zoledronic Acid (ZA) (0, 0.1, 1.0, and 5.0 µM) for the first 3 days. Cell metabolism was quantified at 1-, 3-, 7-, and 14 days. At 7- and 14-days, the following analyses were performed: 1) mineralization nodule assay, 2) LIVE/DEAD™, 3) cell adhesion and spreading, 4) alkaline phosphatase (ALP) activity, and 5) qPCR analysis for RUNX-2), ALPL, and COL1 A1. Data were analyzed by ANOVA 2-way, followed by Tukey's post hoc test (p < 0.05). Cell metabolism (3-, 7-, and 14-days) (p < 0.001), mineralization (7-, 14-days) (p < 0.001), and ALP activity (14-days) (p < 0.001) were reduced in ZA 5.0 µM when compared to control (no ZA). Also, ZA 5.0 µM downregulated the expression of RUNX2 at 7- and 14-days (p < 0.001). It is possible to conclude that ZA (5.0 µM) can impair hBMSC differentiation into osteoblasts and interferes with its mineralization phase.


Assuntos
Difosfonatos , Osteogênese , Humanos , Ácido Zoledrônico/farmacologia , Difosfonatos/farmacologia , Diferenciação Celular , Células da Medula Óssea
4.
Int J Mol Sci ; 23(19)2022 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-36232340

RESUMO

Short-chain fatty acids (SCFAs) are potent immune modulators present in the gingival crevicular fluid. It is therefore likely that SCFAs exert a role in periodontal health and disease. To better understand how SCFAs can module inflammation, we screened acetic acid, propionic acid, and butyric acid for their potential ability to lower the inflammatory response of macrophages, gingival fibroblasts, and oral epithelial cells in vitro. To this end, RAW 264.7 and primary macrophages were exposed to LPSs from Porphyromonas gingivalis (P. gingivalis) with and without the SCFAs. Moreover, gingival fibroblasts and HSC2 oral epithelial cells were exposed to IL1ß and TNFα with and without the SCFAs. We report here that butyrate was effective in reducing the lipopolysaccharide (LPS)-induced expression of IL6 and chemokine (C-X-C motif) ligand 2 (CXCL2) in the RAW 264.7 and primary macrophages. Butyrate also reduced the IL1ß and TNFα-induced expression of IL8, chemokine (C-X-C motif) ligand 1 (CXCL1), and CXCL2 in gingival fibroblasts. Likewise, butyrate lowered the induced expression of CXCL1 and CXCL2, but not IL8, in HSC2 cells. Butyrate further caused a reduction of p65 nuclear translocation in RAW 264.7 macrophages, gingival fibroblasts, and HSC2 cells. Propionate and acetate partially lowered the inflammatory response in vitro but did not reach the level of significance. These findings suggest that not only macrophages, but also gingival fibroblasts and oral epithelial cells are susceptive to the anti-inflammatory activity of butyrate.


Assuntos
Propionatos , Fator de Necrose Tumoral alfa , Acetatos/farmacologia , Anti-Inflamatórios/farmacologia , Ácido Butírico/farmacologia , Quimiocina CXCL1 , Quimiocina CXCL2 , Ácidos Graxos Voláteis/metabolismo , Interleucina-6 , Lipopolissacarídeos/farmacologia , Propionatos/farmacologia
5.
Materials (Basel) ; 15(13)2022 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-35806496

RESUMO

(1) Background: This study evaluates the effects of photobiomodulation (PBM) therapy on the peri-implant bone healing of implants with a machined surface (MS) and treated surface (TS). (2) Methods: Topographic characterization of the surfaces (scanning electron microscopy [SEM]- energy dispersive X-ray spectroscopy [EDX]) was performed before and after implant removal. Twenty rabbits were randomly divided into four groups: MS and TS groups (without PBM therapy) and LMS and LTS groups (with PBM therapy). After implant placement, the stability coefficient (ISQ) was measured. In the periods of 21 and 42 days, the ISQ was measured again, followed by biomechanical analysis. (3) Results: The surfaces of the TS implants showed topographic differences compared with MS implants. The ISQ values of the LMS were statistically significant when compared with those of the MS at 42 days (p < 0.001). The removal torque values of the LMS were statistically significant when compared with those of the MS at 21 days (p = 0.023) and 42 days (p = 0.023). For SEM, in general, the LMS, TS and LTS presented high bone tissue coverage when compared to MS. (4) Conclusions: The PBM therapy modulated the osseointegration process and was evidenced mainly on the machined surface.

6.
Int J Oral Maxillofac Implants ; 37(2): 250-269, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35476854

RESUMO

PURPOSE: The exposure of nonresorbable membranes following alveolar bone augmentation is one of the most frequently occurring complications. This review aimed to investigate the treatments that can be adopted to manage the exposure of polytetrafluoroethylene-based membranes (PTFE-ms) and titanium meshes (TMs) and their outcomes. MATERIALS AND METHODS: Two independent reviewers electronically and manually searched the EMBASE, PubMed/MEDLINE, Scopus, and Cochrane bibliographic databases to retrieve pertinent articles available between January 2000 and March 2021. Only human studies describing the type of treatment and the soft tissue outcome following exposure of PTFE-ms or TMs were included. RESULTS: Overall, 11 articles in the PTFE-ms group and 24 in the TM group were included for data analysis. Results indicated that, in both groups, two distinct therapeutic strategies are mostly applied in case of exposure, namely, pharmacologic and mechanical treatments. Other options have been identified seldomly. Statistically significant evidence of an association between the type of barrier membrane and the exposure rate (28.7% vs 38.5% for TMs and PTFE-ms, respectively; P = .019) and between the type of exposed device and the treatment outcome in terms of removal rate following therapy (11.9% and 44.4% for TMs and PTFE-ms, respectively; P < .001) was noted. CONCLUSION: In both groups, chlorhexidine applications and meticulous plaque control may lead to improved healing conditions after exposure. Surgical removal of the exposed portion can be considered to promote secondary intention healing. The beneficial effects of systemic antibiotics could not be demonstrated in the management of the exposure but should be evaluated in case of graft infection.


Assuntos
Aumento do Rebordo Alveolar , Implantes Dentários , Aumento do Rebordo Alveolar/efeitos adversos , Aumento do Rebordo Alveolar/métodos , Regeneração Óssea , Humanos , Politetrafluoretileno , Telas Cirúrgicas/efeitos adversos , Titânio
7.
Photodiagnosis Photodyn Ther ; 37: 102598, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34699984

RESUMO

BACKGROUND: Antimicrobial photodynamic therapy (aPDT) is used in endodontics to improve orthograde root canal disinfection as an adjunct to standard treatments. Conversely, evidence concerning the application of aPDT in retrograde endodontic surgery is limited. Thus, the aim of the present study was to provide additional data regarding the use of aPDT in the surgical endodontic treatment of periapical lesions. METHODS: A total of 25 consecutive patients presenting teeth with periapical radiolucency eventually associated with clinical signs and symptoms of apical periodontitis were included. Following access flap completion, osteotomy, mechanical debridement, root apical third resection, and preparation of the root-end cavity, aPDT was applied to decontaminate the surgical site using phenothiazine chloride dye at a concentration of 10 mg/mL and irradiation with a hand-held 100-mW diode laser with a wavelength of 660 ± 10 nm. At the latest follow-up visit, healing was evaluated as successful, uncertain, or failure according to well-established clinical and radiological criteria. RESULTS: Overall, 31 periapical lesions were treated with aPDT. Healing proceeded uneventfully. The mean follow-up time was 36.19 months, with times ranging from 12 to 85 months. A total of 25 (80.65%) cases were classified as successful, 5 (16.13%) as uncertain, and only one (3.22%) as failure. Irrespective of the treatment outcome, all treated teeth were still functional, with no symptoms reported by the patients. CONCLUSION: aPDT as an adjunctive treatment modality in the surgical endodontic treatment of periapical lesions showed promising medium-term results associated with preservation of all diseased teeth.


Assuntos
Anti-Infecciosos , Periodontite Periapical , Fotoquimioterapia , Antibacterianos/uso terapêutico , Anti-Infecciosos/uso terapêutico , Humanos , Periodontite Periapical/tratamento farmacológico , Periodontite Periapical/cirurgia , Fotoquimioterapia/métodos , Tratamento do Canal Radicular/métodos
8.
J Oral Maxillofac Surg ; 80(1): 37.e1-37.e12, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34656515

RESUMO

PURPOSE: Laser light has biological effects that can modulate inflammatory processes. Thus, this study aimed to evaluate the effects of photobiomodulation (PBM) therapy on pain, edema, and trismus after the extraction of retained third molars. METHODS: A split-mouth, double-blind, randomized clinical trial (RCT) was conducted in 13 patients with similar bilateral third molars who received intraoral application PBM therapy at 4 points with a diode laser at 810 nm wavelength, 6 J (100 mW, 60 seconds/point) on 1 side (the PBM side); and laser irradiation simulation on the other side (SHAM side). The pain was assessed through visual analog scale (VAS) at 0, 12, 24, 48, and 72 hours, number of analgesic-relief (NAR), and mean time of first analgesic use; edema, through VAS, and linear facial measurements at 0, 24, 48, and 72 hours; and trismus, through the mouth opening measurements at 0, 24, 48, and 72 hours. The repeated-measures analysis was applied to assess the effect of the treatment, followed by Tukey's post hoc test for multiple comparisons (P < .05). RESULTS: Thirteen patients (61.77% male and 38.63% female) with age of 24.16 ± 2.06 participated in this research. VAS showed that PBM controlled pain better (7.56 ± 6.25) than SHAM (32.25 ± 22.78) at 24 hours (P < .001) and 48 hours (19.47 ± 9.27 and 39.87 ± 4.21, respectively) (P = .011). VAS also showed that PBM controlled edema better (19.7 ± 13.27) than SHAM (32.38 ± 15.28) at 24 hours (P = .037) and 48 hours (19.47 ± 13.11 and 39.87 ± 22.77, respectively) (P = .002). CONCLUSION: The PBM therapy in this study resulted in pain and edema reduction after third molar surgery and may be considered as adjuvant therapy after the surgical procedure.


Assuntos
Terapia com Luz de Baixa Intensidade , Dente Impactado , Método Duplo-Cego , Edema/etiologia , Edema/terapia , Feminino , Humanos , Masculino , Dente Serotino/cirurgia , Dor Pós-Operatória/terapia , Extração Dentária , Dente Impactado/cirurgia , Trismo/terapia
9.
Radiol Case Rep ; 16(8): 2280-2285, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34194591

RESUMO

The aspiration of objects and foreign bodies requires quick and systematic care. During emergent orotracheal intubation, accidental dental crown release can cause a threat to the patient's life. This paper aimed to report a case of foreign body (dental prosthetic crown) aspiration and its management and discuss alternative approaches. An 81-year-old male patient, who was admitted to the hospital's intensive care unit (ICU) for meningitis, presented with altered consciousness, and decreased oxygen saturation. He underwent emergent orotracheal intubation. After intubation, chest radiography was performed to check for proper orotracheal tube positioning and lung expansion. The resultant images revealed the presence of a foreign body within the right lower lobe bronchus in the shape of a dental crown. The foreign body, intubation cannula and basket clamp were successfully removed, followed by reintubation of the patient. The foreign body was a prosthetic upper premolar dental crown (24). While care should be taken to avoid complications, if a foreign body is aspirated during emergent orotracheal intubation, endoscopic removal appears safe and effective. Careful creation, placement, maintenance, and preservation of prosthetic crowns are critically important in elderly patients.

10.
J Dent Sci ; 16(1): 333-341, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33384817

RESUMO

BACKGROUND/PURPOSE: The existing literature lacks information regarding the use of digital workflows during pre-surgical planning of implant rehabilitations in resorbed edentulous ridges. Thus, the aim was to evaluate the effectiveness of computer-guided implant placement and simultaneous computer-aided guided bone regeneration (GBR) in the treatment of atrophic posterior alveolar ridges. MATERIALS AND METHODS: Partially edentulous patients requiring GBR simultaneously to implant insertion were enrolled. Implant positions and the augmented missing bone were planned with specific software. A stereolithographic model of the grafted jaw was produced to transfer the virtual bone augmentation to the surgical field. A tooth-supported stent was used to guide implant insertion according to the virtual project. Visual analogue scales (VASs) were used to self-register postoperative pain, swelling, bleeding, and perception of the operation. Post-operative cone-beam computed tomography scan was superimposed to the virtual project to evaluate the accuracy of implant positions. RESULTS: Overall, 10 implants were placed in 5 patients. Healing proceeded uneventfully in all except one patient that showed a dehiscence of the lingual flap as early surgical complication. Nevertheless, complete filling of the bone defects was observed clinically and radiographically in all patients. Pain scored exceptionally high with respect to the other variables. Deviations of 0.73 ±â€¯0.21 mm, 0.59 ±â€¯0.28 mm, and 3.05°â€¯±â€¯1.22° were found at implant head, apex, and long-axis respectively. Distal implants showed higher angular deviations compared to mesial implants (p = 0.008). CONCLUSION: Computer-guided approach provided encouraging results in terms of efficacy and accuracy. Conversely, patient-centered outcomes were below the expectations.

11.
J Prosthet Dent ; 125(2): 266-272, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32111393

RESUMO

STATEMENT OF PROBLEM: Correct implant placement by means of a pretreatment planning software program is still subject to deviations between the planned and achieved implant positions. Inaccuracy at this level may have drastic consequences, including neurovascular trauma. Further data are therefore needed to evaluate the accuracy of such computer-guided implant planning software programs. PURPOSE: The purpose of this clinical study was to evaluate the accuracy of computer-guided implant surgery associated with prototyped surgical guides. MATERIAL AND METHODS: Cone beam computed tomography (CBCT) scans were made of the participants with a tomographic guide to merge anatomic and prosthetic data. This allowed virtual planning with a prosthetically guided approach respecting the anatomy of the participant. A prototyped surgical guide was then fabricated from the virtual plan, determining the intrasurgical position of the implants. Flapless guided implant surgery was carried out according to the manufacturer's instructions. A second CBCT was made 30 days after the surgery, to enable overlapping of the data from before and after the implant placement. The angular, coronal, central, and apical deviations of the placed implants were measured and compared with those virtually planned. The data were submitted to descriptive statistic and intraclass correlation coefficient (ICC), analysis of variance, and the Student t test (α=.05). RESULTS: A total of 61 implants were analyzed. The mean angular deviation was 2.04 degrees. The mean coronal, central, and apical linear deviations were 0.68 mm, 0.72 mm, and 0.82 mm, respectively. No statistically significant difference was found between the virtual and the real position of the implants inserted. A tendency toward a greater absolute error was observed in the mandible than in the maxilla in terms of angular (P=.047), central (P=.043), and coronal error (P=.031). CONCLUSIONS: Flapless computer-guided implant surgery with virtual planning had some angular and linear deviations; nevertheless, this technique should be acceptably safe and accurate.


Assuntos
Implantes Dentários , Cirurgia Assistida por Computador , Desenho Assistido por Computador , Computadores , Tomografia Computadorizada de Feixe Cônico , Implantação Dentária Endóssea , Humanos , Imageamento Tridimensional , Planejamento de Assistência ao Paciente
12.
J Craniofac Surg ; 32(3): e238-e240, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32868718

RESUMO

ABSTRACT: Removal of the buccal fat pad (BFP) is an important topic of discussion in the literature. Several studies have reported improvements in facial esthetics as a result of this technique. The BFP is close to vital structures, such as the facial nerve, parotid duct, and vessels. Injuries related to these structures may occur during the surgical procedure. This manuscript aimed to report and discuss 2 clinical cases of the complications after removal of the BFP. Besides the case presentation, a comprehensive review of the literature was also provided. The reported cases were 2 patients aged 31 and 38 years who were attended by the oral and maxillofacial surgery teams after a complication in the BFP surgery. The first case involved swelling due to Stensen's duct injury, and the second involved uncontrolled bleeding from the internal maxillary artery. Removal of the BFP must have precise indications. Complications may occur during or after surgery; hence, anatomical knowledge is fundamental to appropriate patient management.


Assuntos
Boca , Ductos Salivares , Tecido Adiposo , Bochecha/cirurgia , Nervo Facial , Humanos
13.
Biology (Basel) ; 9(12)2020 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-33339217

RESUMO

The aim of this study was to analyze the stages of the alveolar bone repair in type 2 diabetic rats evaluating the mechanism of mineralization and bone remodeling processes after dental extraction. Forty-eight rats were divided into normoglycemic (NG) and type 2 diabetes (T2D) groups. The upper right incisor was extracted and after 3, 7, 14 and 42 days the animals were euthanized. The following analyses were performed: immunolabeling against antibodies TNFα, TGFß, IL6, WNT, OCN and TRAP, collagen fibers maturation, microtomography and confocal microscopy. Data were submitted to statistical analysis. The immunolabeling analysis showed that the T2D presented a more pronounced alveolar inflammation than NG. Labeling of proteins responsible for bone formation and mineralization was higher in NG than T2D, which presented greater resorptive activity characterized by TRAP labeling. Also, T2D group showed a decrease in the amount of collagen fibers. Micro-CT analysis showed that T2D causes a decrease in bone volume percentage due to deficient trabecular parameters and higher porosity. The T2D bone dynamics show a loss in bone remodeling process. T2D prolongs the local inflammatory process, which impairs the organization and maturation of collagen fibers, delaying bone formation that generates impact on mineralization and bone turnover.

14.
Materials (Basel) ; 13(21)2020 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-33142881

RESUMO

(1) Background: This study aimed to evaluate the incorporation of hydroxyapatite/ß-tricalcium phosphate blocks grafted in rabbit mandibles. (2) Methods: Topographic characterization of biomaterial was performed through scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy (SEM-EDX). Ten rabbits randomly received autogenous bone graft harvested from the tibia (Autogenous Group-AG) or synthetic biomaterial manufactured in ß-tricalcium phosphate (Biomaterial Group-BG) at their right and left mandibular angles. Euthanasia was performed at 30 and 60 postoperative days; (3) Results: SEM-EDX showed a surface with the formation of crystals clusters. Histological analyses in BG at 30 days showed a slower process of incorporation than AG. At 60 days, BG showed remnants of biomaterial enveloped by bone tissue in the anabolic modeling phase. Histometric analysis showed that mean values of newly formed bone-like tissue in the AG (6.56%/9.70%) were statistically higher compared to BG (3.14%/6.43%) in both periods, respectively. Immunohistochemical analysis demonstrated early bone formation and maturation in the AG with more intense osteopontin and osteocalcin staining. (4) Conclusions: The biomaterial proved to be a possible bone substitute, being incorporated into the receiving bed; however, it showed delayed bone incorporation compared to autogenous bone.

16.
J Craniofac Surg ; 31(2): 558-561, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31856129

RESUMO

The genioglossus advancement muscle is a technique used to treat obstructive sleep apnea and depends on the precise location of the muscle insertion into the geniotubercle. The aim of this article was to present a case report about a 38-year-old male patient with obstructive sleep apnea even after undergoing uvulopalatopharyngoplasty and mentoplasty. A maxillo-mandibular advancement and genioglossus was proposed, for this a virtual planning of the surgical guide was done using a specialized software. The great advantage is to reduce the osteotomy by focusing precisely on the insertion of the muscle. The cutting guide facilitated the surgical procedure in all aspects and brought safety.


Assuntos
Apneia Obstrutiva do Sono/cirurgia , Adulto , Músculos Faciais , Mentoplastia , Humanos , Masculino , Avanço Mandibular , Osteotomia , Faringe/cirurgia , Língua
18.
Photodiagnosis Photodyn Ther ; 27: 117-123, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31152878

RESUMO

BACKGROUND: Medication-related osteonecrosis of the jaw (MRONJ) is a debilitating complication strongly associated to antiresorptive agents. The present study aimed to describe the use of antimicrobial photodynamic therapy (aPDT) in the prevention of MRONJ. METHODS: The sample consisted of 11 non-oncologic osteoporotic subjects in therapy with non-intravenous antiresorptive agents, requiring tooth extractions and/or implant removal. After minimally invasive surgical extractions, each alveolar socket was debrided and bony edges were smoothened. At this point, aPDT was performed using methylene blue-based phenothiazine chloride dye irradiated with a hand-held 100 mW diode laser with a wavelength of 660 ±â€¯10 nm. Flaps were sutured to achieve first intention closure. Soft tissue healing was promoted with weekly applications of low-level laser therapy for 6 weeks. Recall visits were scheduled weekly for the first two months and monthly thereafter up to 6 months. At the 6-month appointment, healing was assessed clinically and radiographically. RESULTS: A total of 62 surgical extractions were performed in both jaws, including 51 natural elements and 11 dental implants. No intraoperative complications were observed. Immediate post-operative period was generally uneventful except for mild pain and ecchymosis that occurred rarely and resolved spontaneously. Healing proceeded uneventfully, with no clinical or radiological prodromal manifestations of MRONJ up to the latest follow-up visit. CONCLUSIONS: aPDT might constitute a promising preventive treatment to reduce the risk of MRONJ in non-oncologic osteoporotic patients treated with non-intravenous antiresorptive agents that underwent dentoalveolar surgery.


Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/tratamento farmacológico , Azul de Metileno/uso terapêutico , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Cicatrização/efeitos dos fármacos , Idoso , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/terapia , Desbridamento , Feminino , Humanos , Lasers Semicondutores , Masculino , Extração Dentária/métodos
19.
J Funct Biomater ; 10(2)2019 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-31085984

RESUMO

(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.

20.
Clin Oral Investig ; 23(12): 4383-4397, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30972600

RESUMO

OBJECTIVES: The purpose of this study was to evaluate the biomechanical behavior of the interface formed between bone and implants with machined surfaces (MS) and those modified by Al2O3 sandblasting and acid etching (SBAS). MATERIALS AND METHODS: Before surgery, topographic characterization was performed by SEM-EDX and by mean roughness measurements. Ten Albinus rabbits received randomly 20 Ti-6Al-4V implants on its right and left tibiae, with one implant placed in each tibia. After implant insertion, the implant stability quotient (ISQ) was measured by means of resonance frequency analysis (RFA). After 3 and 6 weeks, the ISQ was again measured, followed by torque removal measurements. Analysis of variance and Tukey tests were used to analyze the data. The surface of the implants removed was evaluated by SEM-EDX. Immunohistochemical analysis of osteopontin (OPN) and osteocalcin (OC) protein was performed in bone tissue. RESULTS: The topographic characterization showed differences between the analyzed surfaces, and the mean roughness values of SBAS group were statistically higher than MS. Overall, higher statistically significant ISQ values were observed in the SBAS group compared to the MS group (p = 0.012). The intra-group comparison of ISQ values in the SBAS group showed statistically significant differences between 0 and 3 weeks (p = 0.032) and 0 and 6 weeks (p = 0.003). The torque removal measurements of group SBAS were statistically higher when compared with the torque removal measurements of group MS in the time intervals of 3 weeks (p = 0.002) and 6 weeks (p < 0.001). SEM-EDX of the implant surfaces removed in SBAS group showed greater bone tissue covering and mean values atomic in percentage of Ca, P, and O statistically superior (p < 0.05) than MS group. Immunohistochemical reactions showed intense OC immunolabeling at 6 weeks postoperative for SBAS group. CONCLUSIONS: The topographical modifications made in group SBAS allowed a better mechanical interlocking between the implant and bone tissue.


Assuntos
Implantes Dentários , Osseointegração , Titânio , Ligas , Animais , Planejamento de Prótese Dentária , Coelhos , Distribuição Aleatória , Propriedades de Superfície , Torque
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