Management of bone defects with Bio-oss

Introduction: The defects in the alveolar bone might appear as a result of congenital malformations, traumatic injuries, periodontal disease, surgical traumas, chronic periapical changes and tumors from benign or malignant origin. The aim of this study was to provide solid and healthy area with application of Bio-Oss in the defect. Materials and methods: Based on the clinical diagnosisestablished by previously taken history, clinical examination and radiographic images oral-surgery interventions was made. To realize the aim of this work, augmentative material was implicated in the bone defects made in the patients after removal of follicular cyst, chronic periapical lesion, and parodontopathia. During the first and seventh day of the interventions, the patients have been followed through from aspect of possible development of local and general complications after the oral-surgery intervention. After period of one, three and six mount control x-ray was made. Results: Obtained results confirmed that: volume of the socket and defect of the bone was kept, fast revascularization was achieved, bone formation and slow resorption of the augmentative material was achieved, and period of normal healing without infection was also achieved. Conclusions: The augmentative materials used for treatment of bone defects besides their basic chemical and physical characteristics referring to their solubility in the body fluids, the transformation, modulation and resorption must be completely safe or secure, i.e. not to bring any risk of infection, immunological risk, physiological intolerance or inhibition of the process of restitutio ad integrum. In our study Bio-Oss was confirmed as augmentative material who had this characteristics. Keywords: bone defect, resorption of the bone, augmentative material, Bio-Os

SIPMO 2019

The biennial Congress of the Italian Society of Oral Pathology and Medicine (SIPMO) is an International meeting dedicated to the growing diagnostic challenges in the oral pathology and medicine field. The III International and XV National edition will be a chance to discuss clinical conditions which are unusual, rare, or difficult to define. Many consolidated national and international research groups will be involved in the debate and discussion through special guest lecturers, academic dissertations, single clinical case presentations, posters, and degree thesis discussions. The SIPMO Congress took place from the 17th to the 19th of October 2019 in Bari (Italy), and the enclosed copy of Proceedings is a non-exhaustive collection of abstracts from the SIPMO 2019 contributions

PRELIMINARY FINDINGS OF A POTENZIATED PIEZOSURGERGICAL DEVICE AT THE RABBIT SKULL

The number of available ultrasonic osteotomes has remarkably increased. In vitro and in vivo studies have revealed differences between conventional osteotomes, such as rotating or sawing devices, and ultrasound-supported osteotomes (Piezosurgery®) regarding the micromorphology and roughness values of osteotomized bone surfaces. Objective: the present study compares the micro-morphologies and roughness values of osteotomized bone surfaces after the application of rotating and sawing devices, Piezosurgery Medical® and Piezosurgery Medical New Generation Powerful Handpiece. Methods: Fresh, standard-sized bony samples were taken from a rabbit skull using the following osteotomes: rotating and sawing devices, Piezosurgery Medical® and a Piezosurgery Medical New Generation Powerful Handpiece. The required duration of time for each osteotomy was recorded. Micromorphologies and roughness values to characterize the bone surfaces following the different osteotomy methods were described. The prepared surfaces were examined via light microscopy, environmental surface electron microscopy (ESEM), transmission electron microscopy (TEM), confocal laser scanning microscopy (CLSM) and atomic force microscopy. The selective cutting of mineralized tissues while preserving adjacent soft tissue (dura mater and nervous tissue) was studied. Bone necrosis of the osteotomy sites and the vitality of the osteocytes near the sectional plane were investigated, as well as the proportion of apoptosis or cell degeneration. Results and Conclusions: The potential positive effects on bone healing and reossification associated with different devices were evaluated and the comparative analysis among the different devices used was performed, in order to determine the best osteotomes to be employed during cranio-facial surgery

Development of a 3D Model of Ameloblastoma

Introduction: Ameloblastoma is a benign yet aggressive tumour of the jawbones causing bone resorption and has a high rate of recurrence after surgery. The precise molecular mechanisms driving ameloblastoma remain unclear and it is critical to study the association between ameloblastoma and its native bone microenvironment if we are to develop new therapeutic interventions. Current 3D ameloblastoma in vitro models lack an active bone component and there is no 3D bone model which canß biomimetically recapitulate active bone formation. Methods: First, an in vitro 3D ameloblastoma model was established and characterised the ameloblastoma cell lines within. Then a novel active bone-forming stroma model (3D bone stroma model) was created, and fully characterised bone nodules produced therein. The ameloblastoma tumour mass was placed on top of active 3D bone stroma compartments and conducted gene work to understand the genetic alterations in bone cells as well as ameloblastoma cells. Results: 3D tumouroid model successfully mimicked the ameloblastoma tumour microenvironment and native subtype cell morphology and caused ameloblastoma cells to produce more bone resorption proteins in earlier days. Then, a novel active bone-forming model was developed by forming bone nodules in 3D stiff matrix with high collagen density. This model allowed detection of early and late bone formation markers. The compositional and structural characterisation of the bone nodules was completed. The 3D bone stroma was used as a compartment of 3D ameloblastoma tumouroid model. This compartmentalised model showed that ameloblastoma directly inhibits bone nodule formation by targeting osteoblast differentiation genes and bone matrix development genes. Conclusion: The development of the first 3D ameloblastoma tumouroid model with of active bone stroma provided novel information about ameloblastoma microenvironment and some of the mechanisms associated with bone damage. The genes involved in ameloblastoma-induced inhibition of bone formation were identified. Further work is ongoing in order to include osteoclast-like cells in the 3D model, with a view to increase its biomimetic complexity, study the interaction between ameloblastoma cells, active bone formation cells, and osteoclasts, and explore potential drug targets

Prediction of Multiple Basal Cell Carcinomas

Basal cell carcinoma (BCC) is the most common cancer in white-skinned individuals with increasing incidence rates worldwide. Patients with BCC place a large burden on healthcare systems, because of the high incidence and the increased risk of synchronous and metachronous BCCs and other ultraviolet radiation related skin cancers (i.e. field cancerization). In this thesis we have performed multiple studies to define who these patients who develop multiple BCCs are and created prediction models, using both non-genetic and genetic predictors

Development of two in vitro organotypic models for the oral tumour ameloblastoma

Ameloblastoma is the most common odontogenic tumour worldwide. It is a locally invasive yet benign tumour, with bone destructive capacity. Up to 70% of cases are estimated to recur and some of these form tumours in the soft tissues surrounding the original tumour sites. There are many unanswered questions around the cellular events leading up to the growth of an ameloblastoma tumour, how ameloblastoma cells invade the bone tissue surrounding it, how the disease progresses and if there are any suitable biomarkers to potentially be used for disease diagnosis and/or prevention. This study used tissue engineering techniques to create two distinct models for ameloblastoma tumours. The first involved the development of bone-like compressed collagen constructs, which were co-cultured with ameloblastoma cells from the AM-1 cell line. These constructs were examined for cell proliferation, invasion, cell-to-cell contacts and gene expression. The second construct involved modelling AM-1 cell behaviour together with an organotypic soft tissue model, so that recurrent ameloblastoma behaviour could be investigated. For this, co-cultures of gingival fibroblasts in compressed collagen scaffolds were developed. Using this construct, it was found that AM-1 cells upregulated matrix metalloproteinase (MMP-2) expression. It was found that AM-1 cells rapidly proliferated in both constructs, and cell-to-cell interactions and some invasion were also observed. Finally, based on gene expression data obtained for the two constructs, potential therapeutic agents were tested. Application of either Alendronate or Doxycycline was found to reduce AM-1 cell survival within the models. The models developed during this project are the first to provide an organotypic in vitro setting for the examination of ameloblastoma cells. They effectively mimic the in vivo tissue by providing appropriate extracellular matrix factors and cell types. The behaviour of AM-1 cells in these models was close to that observed in in vivo tumours