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1.
J Oral Maxillofac Surg ; 78(12): 2184-2194, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32961127

RESUMO

PURPOSE: The aim of this preclinical study was to evaluate the healing of critical-sized defects (CSDs) in the calvarial bone of rats grafted with deproteinized bovine bone graft (DBB) and with a combination of hydroxyapatite (HA) and ß-tricalcium phosphate (TCP) and bisphosphonate treatment. MATERIALS AND METHODS: Eighty-four animals were randomly divided into 2 groups according to the type of solution administered: the control group (CTR, saline solution) and the test group (alendronate [ALD]; sodium alendronate-50 µg/kg/day). Medications were administered via oral gavage starting 15 days before the surgical procedure until the end of the experiment. A CSD (5 mm in diameter) was made in the calvaria of each animal, and the rats were randomly allocated to 3 subgroups according to the biomaterial used to fill the defect: coagulum, DBB, and HA/TCP. The animals were sacrificed 15 and 60 days after the surgical procedure (n = 7 animals/period/subgroup). Microcomputed tomography was used to evaluate the percentage of mineralized tissues (volume). The amount of newly formed bone and remaining bone substitute material in the calvaria were analyzed by histomorphometry. RESULTS: There were no differences between the CTR and ALD groups with regard to the volume of mineralized tissues. The DBB and HA/TCP subgroups of CTR animals presented a significant increase in newly formed bone compared with these subgroups of ALD animals after 60 days of healing. CONCLUSIONS: Collectively, our findings indicate that the use of oral ALD reduced bone formation in CSD in the calvaria of rats grafted with DBB and HA/TCP.


Assuntos
Substitutos Ósseos , Transplantes , Alendronato/farmacologia , Animais , Regeneração Óssea , Substitutos Ósseos/uso terapêutico , Fosfatos de Cálcio , Bovinos , Ratos , Crânio/cirurgia , Microtomografia por Raio-X
2.
Clin Oral Implants Res ; 31(12): 1223-1231, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32979877

RESUMO

OBJECTIVES: The aim of this short-term double-blind, parallel, randomized clinical trial was to compare bone augmentation grafting with 100% autogenous bone (AB) or 50% deproteinized bovine bone matrix (DBBM)/ 50% autogenous bone (BOAB) using a guided bone regeneration procedure, the fence technique, in a two-stage implant placement. MATERIAL AND METHODS: Partially edentulous patients with extensive three-dimensional osseous defects were included in this study. The main outcome measure was the differences in bone volume from pre-surgery (T1) to 6 months post-surgery (T2). Bone height, chair-time, pain, functional limitation, and complications were also assessed. RESULTS: Fifteen patients were allocated to the AB group and 15 patients to the BOAB group. The difference in bone volume from T1 to T2 was 648 mm3 for the AB group and 869mm3 for the BOAB group (difference between groups 221 mm3 , 95% CI from -363 to 804, p = .442). The surgery pain VAS was 1.6 for the AB group and 2.3 for the BOAB group (difference between groups 0.8, 95% CI from 0.0 to 1.5, p = .045 favoring the AB group). The height difference in bone from T1 to T2 was 2.2 mm for the AB group and 3.7 mm for the BOAB group (difference between groups 1.5mm, 95% CI from 0.1 to 2.9, p = .038 favoring the BOAB group). For complications, chair-time, post-surgery pain, and functional limitation, there were no differences between AB and BOAB. CONCLUSIONS: No significant differences, except for surgery pain VAS and difference in bone height, were observed in this trial comparing grafting with AB or BOAB.


Assuntos
Aumento do Rebordo Alveolar , Substitutos Ósseos , Transplantes , Animais , Matriz Óssea , Substitutos Ósseos/uso terapêutico , Transplante Ósseo , Bovinos , Implantação Dentária Endo-Óssea , Humanos
3.
Knee ; 27(4): 1167-1175, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32711878

RESUMO

BACKGROUND: The aim of the present study was to confirm the effectiveness of adding nanohydroxyapatite (NHA) to a heterologous bone graft in open-wedge high tibial osteotomy (OWHTO) by measuring the bone density via multislice computed tomography (CT) of the tibial osteotomy gap in a mid-term follow-up (five years). METHODS: Twenty-six patients undergoing OWHTO were randomly assigned to two groups: a pure graft group (Group A), in which the osteotomy gap was filled with only heterologous bone graft, and an NHA group (Group B), in which the osteotomy gap was filled with heterologous bone graft and NHA. CT was performed within one week of the operation, after two months, after 12 months and after five years. CT volume acquired in Hounsfield units (HU) was measured on three planes. RESULTS: The normal bone density was 110.2 ± 11.7 HU. The value of mean density at five years in Group A was 296.8 ± 81.8 HU, while in Group B, it was 202.2 ± 45.1 HU, showing a density more similar to normal bone and greater bone uniformity inside the osteotomy. The difference between the two groups was statistically significant (p < 0.05). Furthermore, both groups showed excellent mid-term clinical outcomes without significant differences. CONCLUSIONS: This study revealed that absorbability and bone formation at the osteotomy site in the NHA group was significantly higher as compared with the pure graft group at five years postoperatively.


Assuntos
Substitutos Ósseos/uso terapêutico , Transplante Ósseo/métodos , Durapatita/uso terapêutico , Osteoartrite do Joelho/cirurgia , Osteotomia/métodos , Tíbia/cirurgia , Adulto , Densidade Óssea , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nanopartículas , Osteoartrite do Joelho/diagnóstico por imagem , Tomografia Computadorizada por Raios X
4.
Vasc Endovascular Surg ; 54(8): 734-740, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32729383

RESUMO

BACKGROUND: Arteriovenous malformations (AVMs) are rare, congenital vascular anomalies. Intraosseous AVMS most frequently arise in the head and neck, with only a small fraction occurring in the extremities. Herein, we report the findings of a combined soft tissue and intraosseous AVM involving the lower extremity of a 13-year-old child. This case highlights the necessity of an interdisciplinary approach for the effective treatment and management of these rare vascular anomalies. CASE DESCRIPTION: A 13-year-old female presented with a 4-year history of intermittent pain and swelling over her right lateral malleolus. The patient was evaluated with radiologic imaging revealing an AVM involving the right distal leg, ankle, and hindfoot with intraosseous involvement of the distal tibia and talus. She was then referred to Vascular and Plastic Surgery and an angiogram was performed demonstrating shunting from the anterior tibial, peroneal, and posterior tibial arteries to the AVM. Venous drainage was to the anterior tibial and greater saphenous veins. Three embolizations were performed over the course of 6 months. Following the third embolization, the patient was taken to the operating room where Plastic and Orthopedic Surgery performed total resection of the nidus and involved bone which was then grafted with injectable synthetic bone graft. RESULTS: Successful resection of the nidus was achieved, and the patient had an uncomplicated recovery. Within 6 months postoperatively, the patient demonstrated full range of lower extremity motion and was able to participate in age appropriate gross motor activities. Radiologic evaluation 7 months postoperatively showed no evidence of nidus recurrence. CONCLUSION: Intraosseous involvement of AVMS is rare and presents a therapeutic challenge due to its invasive potential and high incidence of recurrence. Wide local excision with bone grafting and interdisciplinary management are paramount for complete resection.


Assuntos
Malformações Arteriovenosas/diagnóstico por imagem , Malformações Arteriovenosas/terapia , Substitutos Ósseos/uso terapêutico , Embolização Terapêutica , Osteotomia , Tálus/irrigação sanguínea , Tíbia/irrigação sanguínea , Adolescente , Malformações Arteriovenosas/fisiopatologia , Feminino , Humanos , Resultado do Tratamento
5.
Ulus Travma Acil Cerrahi Derg ; 26(4): 538-544, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32589255

RESUMO

BACKGROUND: Trauma to the face caused by assault or impact may cause internal orbital fracture. Increased intraorbital pressure without disruption of soft tissue integrity or causing a fracture line in orbital rims or orbital floor fractures described as 'orbital blow-out fracture'. Such fractures have been categorized as 'pure blow-out fractures' in which only the orbital floor is affected, and 'impure blow-out fractures' in which other maxillofacial bones such as zygoma, maxilla and nasoethmoid are also affected. Physical examination reveals periorbital edema and ecchymosis, subconjunctival hemorrhage, limitation of eye globe movements, diplopia, enophthalmos, dystopia, and infraorbital hypoesthesia. Reconstruction of the orbital bony structures is the most important issue to preserve the standard orbital functions and providing an aesthetic view. Although many surgical approaches have been defined in the literature regarding the attitude and timing of treatment, no consensus exists. In literature; many autogenous and alloplastic biomaterials have been recommended to correct orbital bone defects. METHODS: This study aims to compare postoperative outcomes of patients presenting with pure and impure blow-out fractures repaired with cartilage, bone grafts, titanium mesh or porous polyethylene implant. Sixty-four orbital floor fractures of 62 cases were included in this research who admitted to our clinic with maxillofacial trauma between 2011 and 2018. All patients underwent maxillofacial radiological examination; Waters radiography and also axial-coronal plane maxillofacial and orbital computerized tomography. RESULTS: Permanent, post-operative, vertical diplopia in extreme gazes was detected in 3 of 14 patients in whom the orbital floor was reconstructed with an iliac bone graft. Two of nineteen cases who underwent reconstruction using auricular conchal cartilage graft had vertical diplopia in extreme gazes four months after the operation. The implant extruded and became palpable in 2 of 15 patients in the porous polyethylene implant group. None of the patients in the iliac bone and conchal cartilage autograft groups was presented late postoperative enophthalmos according to the graft resorption. In titanium mesh group, 1 of eleven patients had permanent, post-operative vertical diplopia in extreme gazes. None of the patients in this group developed any donor area complications, infection, or implant extrusion. CONCLUSION: Results show that the auricular conchal cartilage graft was the best biomaterial used to repair defects smaller than 4 cm², where as titanium mesh was a good option to repair defects larger than 4 cm². However, selection of the optimal biomaterial to be used to repair orbital blow-out fractures should be made according to patient characteristics and preoperative findings, the severity of the injury, the cost of the biomaterial to be used, and surgeon's expertise.


Assuntos
Substitutos Ósseos , Transplante Ósseo , Fraturas Orbitárias/cirurgia , Procedimentos Cirúrgicos Reconstrutivos , Substitutos Ósseos/efeitos adversos , Substitutos Ósseos/uso terapêutico , Diplopia/epidemiologia , Humanos , Complicações Pós-Operatórias/epidemiologia , Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos , Procedimentos Cirúrgicos Reconstrutivos/instrumentação , Resultado do Tratamento
6.
Sci Rep ; 10(1): 9141, 2020 06 04.
Artigo em Inglês | MEDLINE | ID: mdl-32499489

RESUMO

Bone replacement and osteosynthesis require materials which can at least temporarily bear high mechanical loads. Ideally, these materials would eventually degrade and would be replaced by bone deposited from the host organism. To date several metals, notably iron and iron-based alloys have been identified as suitable materials because they combine high strength at medium corrosion rates. However, currently, these materials do not degrade within an appropriate amount of time. Therefore, the aim of the present study is the development of an iron-based degradable sponge-like (i.e. cellular) implant for bone replacement with biomechanically tailored properties. We used a metal powder sintering approach to manufacture a cylindrical cellular implant which in addition contains phosphor as an alloying element. No corrosion inhibiting effects of phosphorus have been found, the degradation rate was not altered. Implant prototypes were tested in an animal model. Bone reaction was investigated at the bone-implant-interface and inside the cellular spaces of the implant. Newly formed bone was growing into the cellular spaces of the implant after 12 months. Signs of implant degradation were detected but after 12 months, no complete degradation could be observed. In conclusion, iron-based open-porous cellular biomaterials seem promising candidates for the development of self-degrading and high load bearing bone replacement materials.


Assuntos
Implantes Absorvíveis , Ferro/química , Teste de Materiais , Ligas/química , Animais , Doenças Ósseas/patologia , Doenças Ósseas/terapia , Doenças Ósseas/veterinária , Substitutos Ósseos/química , Substitutos Ósseos/uso terapêutico , Osso e Ossos/patologia , Feminino , Porosidade , Ovinos
7.
PLoS One ; 15(5): e0233530, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32437406

RESUMO

In animal studies on bone healing, the effect of housing space and physical activity are seldom taken into account. Bone formation was evaluated in New Zealand White rabbits (mean ± SEM BW: 3.9 ± 0.11 kg) with a critical bone defect after 12 weeks of rehabilitation in pair-housing in 3 m2 large floor pens (Floor, n = 10) or standard single housing in 0.43 m2 cages (Cage, n = 10). In the randomised full-factorial study, a bone replica of calcium phosphate cement (CPC, n = 10) or autologous bone (AB, n = 10) was implanted in the unilateral 20 mm radius defect. Post-mortem, the oxidative capacity was measured by citrate synthase (CS) activity in M. quadriceps and the defect filling volume and density evaluated by microcomputer tomography (µ-CT). Histology sections were evaluated by subjective scoring and histomorphometry. Fourteen rabbits remained until the end of the study. Group Floor (n = 7; 3 CPC + 4 AB) had a higher CS activity and a larger bone defect filling volume and lower density by µ-CT measurements than group Cage (n = 7; 3 CPC + 4 AB). Three out of four rabbits in AB-Floor presented fusion of the defect with reorganisation of trabecular bone, whereas three of four in AB-Cage showed areas of incomplete healing. Floor rabbits had a higher score of bony fusion between the radius and ulna than Cage rabbits. There were no differences between groups in histomorphometry. The study found that a larger housing space increased physical activity and promoted bone formation.


Assuntos
Osteogênese , Rádio (Anatomia)/lesões , Animais , Cimentos para Ossos/uso terapêutico , Substitutos Ósseos/uso terapêutico , Transplante Ósseo , Fosfatos de Cálcio/uso terapêutico , Feminino , Abrigo para Animais , Coelhos , Rádio (Anatomia)/patologia , Rádio (Anatomia)/fisiologia , Cicatrização
8.
Infection ; 48(3): 333-344, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32270441

RESUMO

INTRODUCTION: The current treatment concepts of fracture-related infection (FRI) [Consensus Conference (Anti-Infection Task Force (AITF)) on the definition of acute or chronic osteomyelitis (cOM)] are associated with unsolved challenges and problems, underlining the need for ongoing medical research. METHOD: Literature review of treatments for FRI and description of own cases. RESULTS: We could include eight papers with 394 patients reporting treatments and outcome in FRI. The infection was resolved in 92.9% (mean) of all treatments. The mean follow-up was 25 months with a persistent non-union in 7% of the patients. We diagnosed 35 (19f/16m; 56.4 ± 18.6 years) patients with bone infections anatomically allocated to the proximal and distal femur (12×), the pelvis (2×), distal tibia (3×), tibial diaphysis (11×), the ankle joint (4×) and calcaneus (3×). These 35 patients were treated (1) with surgical debridement; (2) with antibiotic-eluting ceramic bone substitutes; (3) bone stabilization (including nail fixation, arthrodesis nails, plates, or external ring fixation), (4) optionally negative pressure wound therapy (NPWT) and (5) optionally soft tissue closure with local or free flaps. The mean follow-up time was 14.9 ± 10.6 months (min/max: 2/40 month). The overall recurrence rate is low (8.5%, 3/35). Prolonged wound secretion was observed in six cases (17.1%, 6/35). The overall number of surgeries was a median of 2.5. CONCLUSION: The results in the literature and in our case series are explicitly promising regarding the treatment of posttraumatic fracture-related infection.


Assuntos
Antibacterianos/uso terapêutico , Substitutos Ósseos/uso terapêutico , Fraturas Ósseas/complicações , Infecções/terapia , Fraturas Ósseas/tratamento farmacológico , Fraturas Ósseas/cirurgia , Humanos , Infecções/tratamento farmacológico , Infecções/etiologia , Extremidade Inferior/lesões , Extremidade Inferior/cirurgia
9.
World J Surg Oncol ; 18(1): 47, 2020 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-32122388

RESUMO

BACKGROUND: Chondroblastoma (CB) is a rare locally aggressive bone tumor that commonly occurs in the epiphysis or apophysis of long bones. Although surgical treatment of CB carries potential risk for physeal or articular cartilage damage, risk factors for joint degeneration have not been well described. In addition, we have mainly used synthetic bone substitute (SBS) to fill the bone defect after intralesional curettage as treatment for CB. This study thus aimed to evaluate the incidence of and risk factors for adjacent-joint radiographic degeneration after SBS treatment for CB. METHODS: We retrospectively reviewed 48 patients treated for CB at our institutions between 1996 and 2017. Clinical data, radiographic images, treatments, and local recurrence were analyzed. RESULTS: We identified 40 patients [29 males and 11 females with a mean age of 19 years (range, 8-35 years)] who received SBS to fill the defect after curettage with a minimum follow-up of 1 year. The mean follow-up period was 71 months (range, 13-239 months). A total of 8 patients (20%) developed local recurrence. Radiographic analysis showed that 5 patients (16.7%) developed radiographic joint degeneration. Joint degeneration was significantly associated with the affected joint (p = 0.004). CONCLUSIONS: Curettage and SBS filling had been found to be a reasonable treatment method for CB, which commonly occurs in the epiphysis or apophysis. Radiographic joint degeneration was not uncommon after CB treatment, especially in the talus and proximal humerus.


Assuntos
Neoplasias Ósseas/cirurgia , Substitutos Ósseos/uso terapêutico , Condroblastoma/cirurgia , Articulações/patologia , Adolescente , Adulto , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/patologia , Criança , Condroblastoma/diagnóstico por imagem , Condroblastoma/patologia , Feminino , Humanos , Articulações/diagnóstico por imagem , Masculino , Recidiva Local de Neoplasia/etiologia , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
10.
J Periodontol ; 91(10): 1295-1306, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32052436

RESUMO

BACKGROUND: Recombinant human bone morphogenetic protein 2 (rhBMP-2) is an osteoinductor frequently used for bone regeneration in oral and maxillofacial surgery. There is no consensus about the ideal carrier for this growth factor. The aim of this study was to compare the bone augmentation, bone microarchitecture, and biodegradation rate of additional carriers to rhBMP-2/absorbable collagen sponge (ACS) in a vertical guided bone regeneration model. METHODS: Four titanium cylinders were fixed onto the calvaria of rabbits (n = 20) that received (n = 10) or not (n = 10) rhBMP-2/ACS in conjunction with one of the carriers: beta-tricalcium phosphate (ß-TCP), biphasic calcium phosphate (BCP), bovine bone mineral (BBM) or blood clot. The samples were analyzed by means of microcomputed tomography and histomorphology after 14 weeks. RESULTS: All the materials with rhBMP-2/ACS exhibited improvement on bone augmentation, mainly BCP (P = 0.033) and ß-TCP (P = 0.038), in the upper portion of the cylinder. Although trabecular anisotropy was improved in all the materials groups, trabecular connectivity was diminished when the biomaterials received rhBMP-2/ACS. Resorption rate of the remaining biomaterial was improved by rhBMP-2/ACS, mainly in BBM (P <0.01) and ß-TCP (P <0.01). BBM exhibited the highest osteoclast density compared with the other materials groups. CONCLUSIONS: BCP and ß-TCP biomaterials exhibited a synergic effect with rhBMP-2/ACS, acting as suitable and viable carriers for vertical bone augmentation. The addition of rhBMP-2 significantly affected the biodegradation of ß-TCP and BBM, accelerating the resorption of these materials.


Assuntos
Substitutos Ósseos , Animais , Proteína Morfogenética Óssea 2 , Proteínas Morfogenéticas Ósseas , Regeneração Óssea , Substitutos Ósseos/uso terapêutico , Bovinos , Colágeno , Humanos , Coelhos , Proteínas Recombinantes , Fator de Crescimento Transformador beta , Microtomografia por Raio-X
11.
J Hand Surg Asian Pac Vol ; 25(1): 59-66, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32000605

RESUMO

Background: A new beta-tricalcium phosphate with unidirectional pore structure (UDPTCP), Affinos® (Kurray, Okayama, Japan), has been in clinical use since 2015. To date, there have been only a few clinical studies using this material. We report here the first clinical study for distal radial fracture in the elderly population treated with UDPTCP. Methods: Consecutive patients aged 65 years or older with dorsally displaced unstable fracture of the distal radius (n = 36) were treated operatively in our department. Following reduction of the fracture site, a 7 mm size cube of UDPTCP was placed in the gap of the bony defect and the fracture stabilized with mono-axial or poly-axial type locking plates and screws. Remodeling of the UDPTCP was evaluated by plain radiograph and clinical outcomes were also assessed. Results: UDPTCP was significantly resorbed at 2 months after surgery, both at the center and periphery of the material. Complications were only observed in the post-operative period. Significant correction loss of radial alignment was seen in patients stabilized with poly-axial locking plate. The clinical outcome in all cases was excellent. Conclusions: Block UDPTCP is a safe and convenient material for the treatment of distal radius fracture and is replaced within a suitable time period after grafting into the fracture site. UDPTCP and stable internal fixation is therefore a reliable strategy for restoring and preserving anatomical position, especially in the elderly population.


Assuntos
Substitutos Ósseos/uso terapêutico , Fosfatos de Cálcio/uso terapêutico , Fraturas do Rádio/cirurgia , Idoso , Idoso de 80 Anos ou mais , Placas Ósseas , Remodelação Óssea , Reabsorção Óssea/diagnóstico por imagem , Parafusos Ósseos , Avaliação da Deficiência , Feminino , Fixação Interna de Fraturas , Humanos , Masculino , Redução Aberta , Radiografia , Fraturas do Rádio/diagnóstico por imagem
12.
Medicina (Kaunas) ; 56(2)2020 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-31972958

RESUMO

Background and Objectives: Maxillary bone defects related to post-extraction alveolar ridge resorption are usual. These defects may lead to failure in further surgical implant phases given the lack of bone volume to perform the dental implant. The objective of this clinical assay was to evaluate the safety and efficacy of an experimental synthetic bone substitute in the preservation of post-extraction maxillary alveoli. Materials and Methods: 33 voluntary patients who had at least one maxillary premolar tooth that was a candidate for exodontia (n = 39) and subsequent implant rehabilitation participated. The regenerated alveoli were monitored by means of periodic clinical examinations (days 9 ± 1, 21 ± 4, 42 ± 6, and 84 ± 6), measuring the height and width of the alveolar crest (days 0 and 180 ± 5), measurement of radiodensity using tomographic techniques (days 0-5 and 175 ± 5), and histological examination of biopsies collected at 180 ± 5 days. Results: No significant differences were observed during the entire follow-up period between the two groups with respect to the safety variables studied. A variation in width of -0.9 ± 1.3 mm and -0.6 ± 1.5 mm, and a variation in height of -0.1 ± 0.9 mm and -0.3 ± 0.7 mm was observed for experimental material Sil-Oss® and Bio-Oss®, respectively. The radiodensity of the alveoli regenerated with the experimental material was significantly lower than that corresponding to Bio-Oss®. However, the histological study showed greater osteoid matrix and replacement of the material with newformed bone in the implanted beds with the experimental material. Conclusions: Both materials can be used safely and proved equally effective in maintaining alveolar flange dimensions, they are also histologically biocompatible, bioactive and osteoconductive. The experimental material showed the advantage of being resorbable and replaced with newformed bone, in addition to promoting bone regeneration.


Assuntos
Perda do Osso Alveolar/tratamento farmacológico , Fosfatos de Cálcio/farmacologia , Durapatita/antagonistas & inibidores , Sílica Gel/farmacologia , Adulto , Perda do Osso Alveolar/prevenção & controle , Substitutos Ósseos/normas , Substitutos Ósseos/uso terapêutico , Fosfatos de Cálcio/uso terapêutico , Método Duplo-Cego , Combinação de Medicamentos , Durapatita/farmacologia , Durapatita/uso terapêutico , Feminino , Humanos , Masculino , Maxila/efeitos dos fármacos , Maxila/fisiopatologia , Pessoa de Meia-Idade , Sílica Gel/uso terapêutico
13.
Carbohydr Polym ; 230: 115640, 2020 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-31887895

RESUMO

Bone transplantations are still facing many serious challenges, hydrogel as a new kind of artificial bone substitutes has developed into a promising bone scaffold material. However, it is still a challenge to combine bioactive agents and hydrogel matrix to promote osteoinductivity. Herein, we developed a novel bioactive hydrogel based on arginine-based unsaturated poly (ester amide) (Arg-UPEA) and methacrylated hyaluronic acid (HA-MA) via photo-crosslinking. As the results indicated, we found that the introduction of Arg-UPEA into HA-MA hydrogels could finely modulate their compressive modulus, swelling level and porous structure. Besides, among groups of different feed ratio, groups of 10 % and 15 % of Arg-UPEA content effectively enhanced osteogenic differentiation in osteoblasts when compared with HA-MA hydrogel. Furthermore, better bone regeneration and expression of osteogenesis-related factors in vivo also verified the Arg-UPEA/HA-MA hybrid hydrogels as a promising scaffold material for bone tissue engineering.


Assuntos
Substitutos Ósseos/química , Hidrogéis/química , Engenharia Tecidual , Tecidos Suporte/química , Células 3T3 , Amidas/química , Amidas/farmacologia , Animais , Arginina/química , Arginina/farmacologia , Regeneração Óssea , Substitutos Ósseos/uso terapêutico , Osso e Ossos , Ácido Hialurônico/química , Ácido Hialurônico/farmacologia , Hidrogéis/uso terapêutico , Interações Hidrofóbicas e Hidrofílicas , Metacrilatos/química , Metacrilatos/farmacologia , Camundongos , Células NIH 3T3 , Osteogênese/fisiologia , Poliésteres/química , Poliésteres/farmacologia , Porosidade , Ratos Sprague-Dawley
14.
Curr Stem Cell Res Ther ; 15(2): 144-154, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31830895

RESUMO

The nasal septal cartilage plays an important role in the growth of midface and as a vertical strut preventing the collapse of the nasal bones. The repair of nasal cartilage defects remains a major challenge in reconstructive surgery. The tissue engineering strategy in the development of tissue has opened a new perspective to generate functional tissue for transplantation. Given the poor regenerative properties of cartilage and a limited amount of autologous cartilage availability, intense interest has evoked for tissue engineering approaches for cartilage development to provide better outcomes for patients who require nasal septal reconstruction. Despite numerous attempts to substitute the shapely hyaline cartilage in the nasal cartilages, many significant challenges remained unanswered. The aim of this research was to carry out a critical review of the literature on research work carried out on the development of septal cartilage using a tissue engineering approach, concerning different cell sources, scaffolds and growth factors, as well as its clinical pathway and trials have already been carried out.


Assuntos
Cartilagens Nasais/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Procedimentos Cirúrgicos Reconstrutivos/tendências , Engenharia Tecidual/tendências , Substitutos Ósseos/uso terapêutico , Condrócitos/citologia , Condrócitos/fisiologia , Condrócitos/transplante , Condrogênese/fisiologia , Regeneração Tecidual Guiada/métodos , Regeneração Tecidual Guiada/tendências , Humanos , Cartilagens Nasais/transplante , Regeneração/fisiologia , Engenharia Tecidual/métodos , Tecidos Suporte
15.
Clin Oral Investig ; 24(3): 1151-1160, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31292776

RESUMO

OBJECTIVES: The aim of this study was to describe the histological and clinical outcome of "dentin block" (a mixture of autologous particulate dentin, leukocyte- and platelet-rich fibrin (L-PRF), and liquid fibrinogen) in alveolar ridge preservation. MATERIAL AND METHODS: Ten extraction sockets were grafted with "dentin block," a mixture of particulate autologous dentin with chopped leukocyte-platelet-rich fibrin (L-PRF) membranes at a 1:1 ratio, and liquid fibrinogen as a binder. Two grafted sites were followed at 4 and 5 months, and 6 sites at 6 months. Biopsies were taken from the core of the grafted site for histologic and histo-morphometric analysis. RESULTS: All patients completed the study without any adverse event. The vertical and horizontal dimensions of the alveolar ridge were preserved or even increased after 4, 5, or 6 months and remained stable after 6 months of the implant placement. The histological examination revealed a median relative percentage of bone, dentin, and connective tissue of 57.0, 0.9, and 39.3%, respectively. A comparison of samples at different time points (4, 5, and 6 months) showed a progressive increase in the proportion of bone with a decrease in the proportion of dentin. The bone was compact with normal osteocytes and moderate osteoblastic activity. In 4 out of 10 samples, no dentin was observed; in the other samples, it represented 1-5% (with geometric fragments). CONCLUSIONS: Dentin block showed to be a suitable bone substitute in an alveolar ridges preservation model. CLINICAL RELEVANCE: The promising results of dentin block as a bone substitute in alveolar ridge preservation could have an important clinical impact considering this biomaterial brings together the regenerative potential of three autologous products with excellent biological and clinical behavior, low risk of adverse effects, and feasible acquisition.


Assuntos
Aumento do Rebordo Alveolar , Substitutos Ósseos/uso terapêutico , Dentina/química , Fibrinogênio/química , Fibrina Rica em Plaquetas/química , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Projetos Piloto , Extração Dentária , Alvéolo Dental
16.
Clin Oral Investig ; 24(5): 1637-1650, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31338633

RESUMO

OBJECTIVES: The effect of leucocyte- and platelet-rich fibrin (L-PRF), associated with DBBM (deproteinized bovine bone mineral; Bio-Oss®) was investigated and compared with autogenous bone graft as a standard material for filling bone defects. MATERIAL AND METHODS: A defect of 5 mm in diameter was performed in 40 calvaria of rats. The animals were divided into 5 groups and received blood clot (CO), autogenous bone (AUT), DBBM (BIO), L-PRF, or DBBM associated with L-PRF (BIO-LPRF). After 4 and 8 weeks, bone regeneration was assessed by histometric and immunohistochemical analyses. RESULTS: The highest mean percentage of bone formation found at 4 and 8 weeks was observed for the BIO-L-PRF group (54.0% ± 2.8 and 63.6% ± 2.2). The lowest mean percentage at 4 and 8 weeks was observed for the CO group (16.7% ± 2.5 and 20.5% ± 1.0). There was statistical similarity among the AUT, BIO, and L-PRF groups. The expressions OC, RUNX 2, and VEGF showed a favorable aspect in the formation of new bone for BIO-L-PRF. VEGF was the marker with the highest expression because it was related to the initial healing process, promoting the migration and proliferation of endothelial cells in the region of the defect. Even after weeks, VEGF maintained a moderate expression. CONCLUSIONS: The association of L-PRF with DBBM improved bone repair when these biomaterials were inserted into the defects of the calvaria of rats. CLINICAL RELEVANCE: This reinforces the good performance of bovine bone and L-PRF as filler materials, especially when associated.


Assuntos
Regeneração Óssea , Substitutos Ósseos/uso terapêutico , Minerais/uso terapêutico , Fibrina Rica em Plaquetas , Crânio/lesões , Animais , Bovinos , Células Endoteliais/citologia , Ratos
17.
J Pak Med Assoc ; 69(11): 1617-1622, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31740866

RESUMO

OBJECTIVE: To compare the performance of collagenated bone graft substances with different collagen ratios after sinus floor augmentation. METHODS: The cross-sectional study was conducted at Hacettepe University, Ankara, Turkey, from September 2011 to September 2013. Sinus floor augmentation was done with two different equinederived xenografts in patients before dental implant application. Of the two randomised groups, one was treated with 100% collagenated bone mix (Group A), and the other half with 90% collagenated bone mix + 10% collagen gel (Group B).Six months after sinus augmentation, prior to dental implant surgery, a specimen was taken from the implant socket with trephine drill for histopathological evaluation of new bone, connective tissue and residual graft material at each augmented site. SPSS 19 was used for data analysis. RESULTS: Of the 19 patients, 12(63%) were females and 7(37%) were males. The overall mean age was 51.68±11,96 years (range: 24-69 years). A total of 30 sinus floor augmentations were done. New bone formation was significantly better in Group A(15 sinus floor augmentation) than in Group B (the other 15 sinus floor augmentation) (p<0.05), but there was no significant difference in connective tissue formation and residual graft materials between the groups (p>0.05). CONCLUSIONS: Collagenated bone mix was found to be a suitable graft material for sinus floor augmentation, but increased collagen ratio did not improve new bone formation over the 6-month healing process.


Assuntos
Substitutos Ósseos , Osso e Ossos , Levantamento do Assoalho do Seio Maxilar/métodos , Transplante Heterólogo/métodos , Adulto , Idoso , Animais , Substitutos Ósseos/química , Substitutos Ósseos/uso terapêutico , Osso e Ossos/química , Osso e Ossos/patologia , Estudos Transversais , Feminino , Cavalos , Humanos , Masculino , Pessoa de Meia-Idade , Osseointegração/fisiologia , Turquia , Adulto Jovem
18.
Arch Osteoporos ; 14(1): 109, 2019 11 18.
Artigo em Inglês | MEDLINE | ID: mdl-31741066

RESUMO

Kümmell's disease (eponymous name for osteonecrosis and collapse of a vertebral body due to ischemia and non-union of anterior vertebral body wedge fractures after major trauma) cannot heal spontaneously. Bone-filling mesh container (BFMC) can significantly relieve pain, help the correction of kyphosis, and may prevent cement leakage. This pilot study may provide the basis for the design of future studies. PURPOSE: To compare the effectiveness and safety of BFMC and percutaneous kyphoplasty (PKP) for treatment of Kümmell's disease. METHODS: From August 2016 to May 2018, 40 patients with Kümmell's disease were admitted to Guizhou Provincial People's Hospital. Among them, 20 patients (20 vertebral bodies) received PKP (PKP group) and the other 20 received BFMC (BFMC group). Operation time, Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), Cobb's angle changes, and related complications were recorded. RESULTS: All patients underwent operations successfully. VAS scores and ODI of both groups at each postoperative time point were lower than preoperatively, with statistically significant difference (p < 0.05). Postoperative Cobb's angle of both groups postoperatively was lower than preoperatively (p < 0.05). Cement leakage occurred in eight vertebrae (8/20) in the PKP group and in one vertebra (1/20) in the BFMC group. No complications such as pulmonary embolism, paraplegia, or perioperative death occurred during operation in both groups. Adjacent vertebral refractures occurred in five patients (5/20) in the PKP group and in four patients (4/20) in the BFMC group, with no significant difference in the incidence rate of refractures in both groups but the material is too small to verify statistically. CONCLUSIONS: Both PKP and BFMC technologies can significantly relieve pain and help the correction of kyphosis while treating Kümmell's disease. Moreover, the BMFC may prevent cement leakage.


Assuntos
Fraturas por Compressão/cirurgia , Cifoplastia/métodos , Cifose/cirurgia , Fraturas da Coluna Vertebral/cirurgia , Telas Cirúrgicas , Idoso , Dor nas Costas/cirurgia , Cimentos para Ossos/efeitos adversos , Cimentos para Ossos/uso terapêutico , Substitutos Ósseos/uso terapêutico , Extravasamento de Materiais Terapêuticos e Diagnósticos/etiologia , Feminino , Humanos , Cifoplastia/efeitos adversos , Masculino , Pessoa de Meia-Idade , Osteonecrose/cirurgia , Medição da Dor/métodos , Projetos Piloto , Complicações Pós-Operatórias/etiologia , Próteses e Implantes/efeitos adversos , Resultado do Tratamento
19.
Georgian Med News ; (294): 145-150, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31687968

RESUMO

The main aim is to find out the mechanisms of reparative regeneration of bone tissue in artificially created transverse mandibular defects in rats when applying osteoplastic materials based on hydroxyapatite and polylactide with different component percentage. Experimental studies were carried out on 114 mature laboratory white male 180-220 g rats that were divided into groups: control group - animals whose bone defect was filled only with a blood clot; 1st experimental group - the entire defect volume was densely filled with a block with the ratio of component parts, hydroxyapatite 80% + polylactide 20%; 2nd experimental group was similar, but with the ratio of 50% + 50%. Morphological and morphometric research methods were carried out after the removed jaws had been decalcized in a 10% nitric acid solution. An x-ray study was performed using an Intra digital radiograph (Planmeca, Finland). Statistical analysis of the results was carried out according to the standard method of descriptive statistics using the software package "StatSoftStatistica 10". The use of osteoplastic material with a longer period of its biodegradation contributes to filling the defect with bone tissue, but slows down the processes of the final formation of a mature secondary bone scar, yet allows even with hypercorrection to restore the anatomical form of the lost area. Therefore, the use of this material is recommended for a defect in the alveolar ridge, mainly in extraction sockets, when one needs to avoid atrophy and to create conditions for prosthetic treatment. Osteoimplant with a faster biodegradation period allows structuring collagen fibers in the regenerate in the early stages of healing, which optimizes the formation of an organic bone matrix and promotes its faster mineralization. Therefore, such bone substitutes can be better used for insignificant defects or when the restoration of the anatomical form is not essential, mainly for defects of the body and mandibular branches.


Assuntos
Perda do Osso Alveolar/tratamento farmacológico , Materiais Biocompatíveis/uso terapêutico , Regeneração Óssea/efeitos dos fármacos , Substitutos Ósseos/farmacologia , Mandíbula/patologia , Poliésteres/farmacologia , Perda do Osso Alveolar/cirurgia , Animais , Substitutos Ósseos/uso terapêutico , Durapatita , Masculino , Mandíbula/cirurgia , Ratos , Cicatrização
20.
Int J Mol Sci ; 20(17)2019 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-31480285

RESUMO

Compared to other materials such as 45S5 bioactive glass (BG), ß-tricalcium phosphate (ß-TCP)-based bone substitutes such as Vitoss show limited material-driven stimulation of osteogenesis and/or angiogenesis. The unfavorable degradation kinetics of ß-TCP-based bone substitutes may result in an imbalance between resorption and osseous regeneration. Composite materials like Vitoss BA (Vitoss supplemented with 20 wt % 45S5-BG particles) might help to overcome these limitations. However, the influence of BG particles in Vitoss BA compared to unsupplemented Vitoss on osteogenesis, resorption behavior, and angiogenesis is not yet described. In this study, Vitoss and Vitoss BA scaffolds were seeded with human mesenchymal stromal cells before subcutaneous implantation in immunodeficient mice for 10 weeks. Scaffold resorption was monitored by micro-computed tomography, while osteoid formation and vascularization were assessed by histomorphometry and gene expression analysis. Whilst slightly more osteoid and improved angiogenesis were found in Vitoss BA, maturation of the osteoid was more advanced in Vitoss scaffolds. The volume of Vitoss implants decreased significantly, combined with a significantly increased presence of resorbing cells, whilst the volume remained stable in Vitoss BA scaffolds. Future studies should evaluate the interaction of 45S5-BG with resorbing cells and bone precursor cells in greater detail to improve the understanding and application of ß-TCP/45S5-BG composite bone substitute materials.


Assuntos
Reabsorção Óssea/tratamento farmacológico , Substitutos Ósseos/uso terapêutico , Fosfatos de Cálcio/uso terapêutico , Cerâmica/uso terapêutico , Silicatos/uso terapêutico , Adulto , Animais , Reabsorção Óssea/diagnóstico por imagem , Diferenciação Celular/efeitos dos fármacos , Cerâmica/farmacologia , Feminino , Vidro , Humanos , Cinética , Masculino , Camundongos SCID , Pessoa de Meia-Idade , Neovascularização Fisiológica/efeitos dos fármacos , Osteogênese/efeitos dos fármacos , Tecidos Suporte/química , Microtomografia por Raio-X , Adulto Jovem
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