Desordem temporomandibular e a influência do polimorfismo genético

A desordem temporomandibular (DTM) é uma doença multifatorial que afeta a articulação temporomandibular (ATM), músculos mastigatórios e tecidos adjacentes, ocasionando dor crônica na maioria dos pacientes. Apesar da DTM ter origem inicial não inflamatória, a progressão da doença é acompanhada por alterações inflamatórias secundárias, determinadas pela interação entre moléculas e células, tais como interleucinas, via Wnt, metaloproteinases e fator de necrose tumoral tipo- α.  Alterações nos níveis dessas moléculas podem interferir nessa resposta, oferecendo maior proteção ou susceptibilidade ao desenvolvimento da doença. Essa resposta inflamatória é coordenada pela característica genética, por isso, estudos recentes tentam explorar o padrão genético individual como forma de justificar a etiologia das DTM. Polimorfismos nos genes responsáveis pela resposta inflamatória tem mostrado serem potenciais para futuros procedimentos clínicos em odontologia. Sendo assim, o objetivo desta revisão de literatura foi analisar a correlação entre a característica genética individual e o desenvolvimento de DTM. Baseando-se nos artigos revisados, este estudo demonstrou que a característica genética pode ter correlação com o desenvolvimento de DTM. No entanto, estudos incluindo maior número de pacientes e diagnóstico mais preciso da DTM ainda são necessários para confirmar esta correlação. Acredita-se que futuros métodos diagnósticos e terapêuticos poderão ter como base a característica genética do indivíduo de acordo com a identificação das regiões polimórficas. Tais métodos poderão propiciar o desenvolvimento de tratamentos padronizados para cada tipo de paciente, identificação de pacientes de risco e protocolos de proservação

Is bleeding on probing a differential diagnosis between periimplant health and disease?

As far as the periimplant anatomy is considered, the question raised is whether or not healthy periimplant tissues present bleeding on probing (BOP). Aim: To assess if the criterion BOP is strictly related to periimplant disease (PID). Methods: 134 patients were included in this study. All periimplant regions were clinically and radiographically evaluated. Patients were assigned to 3 groups based on radiographic and clinical aspects in the periimplant region: Group A (healthysites) - no signs of mucosal inflammation or bone loss; Group B (mucositis) - red and swollen mucosa, but no radiographic bone loss; Group C (periimplantitis) - radiographically confirmed pathological bone loss. After this classification, all periimplant sulci were probed at 4 sites (mesial, distal, buccal, lingual/palatal). Patients’ mean age was 51.7±12.4 years, 77 women and 57 men, with a total of 486 osseointegrated endosseous implants. Results: Groups A and C showed significant difference in age and implant region distribution (p=0.009 and p=0.008, respectively). After initial clinical and radiographic diagnosis of periimplant status, 33 (20.1%) regions showed BOP in group A. All regions in Group B presented BOP. In Group C, 41 (19.9%) regions showed no BOP. All groups differed significantly considering BOP as diagnosis parameter (p<0.0001). Conclusions: BOP was always present in inflamed mucosa, but it was not always absent in healthy mucosa. Not all periimplantitis regions showed BOP. Clinical and radiographic aspects must always be considered together for diagnosis of PID, even if BOP is absent

Is bleeding on probing a differential diagnosis between periimplant health and disease?

as the periimplant anatomy is considered, the question raised is whether or not healthy periimplant tissues present bleeding on probing (BOP). Aim: To assess if the criterion BOP is strictly related to periimplant disease (PID). Methods: 134 patients were included in this study. All periimplant regions were clinically and radiographically evaluated. Patients were assigned to 3 groups based on radiographic and clinical aspects in the periimplant region: Group A (healthysites) - no signs of mucosal inflammation or bone loss; Group B (mucositis) - red and swollen mucosa, but no radiographic bone loss; Group C (periimplantitis) - radiographically confirmed pathological bone loss. After this classification, all periimplant sulci were probed at 4 sites (mesial, distal, buccal, lingual/palatal). Patients mean age was 51.7±12.4 years, 77 women and 57 men, with a total of 486 osseointegrated endosseous implants. Results: Groups A and C showed significant difference in age and implant region distribution (p=0.009 and p=0.008, respectively). After initial clinical and radiographic diagnosis of periimplant status, 33 (20.1%) regions showed BOP in group A. All regions in Group B presented BOP. In Group C, 41 (19.9%) regions showed no BOP. All groups differed significantly considering BOP as diagnosis parameter (p<0.0001). Conclusions: BOP was always present in inflamed mucosa, but it was not always absent in healthy mucosa. Not all periimplantitis regions showed BOP. Clinical and radiographic aspects must always be considered together for diagnosis of PID, even if BOP is absent

Mesenchymal stromal cells from bone marrow treated with bovine tendon extract acquire the phenotype of mature tenocytes

ABSTRACT OBJECTIVE: This study evaluated in vitro differentiation of mesenchymal stromal cells isolated from bone marrow, in tenocytes after treatment with bovine tendon extract. METHODS: Bovine tendons were used for preparation of the extract and were stored at -80 °C. Mesenchymal stromal cells from the bone marrow of three donors were used for cytotoxicity tests by means of MTT and cell differentiation by means of qPCR. RESULTS: The data showed that mesenchymal stromal cells from bone marrow treated for up to 21 days in the presence of bovine tendon extract diluted at diminishing concentrations (1:10, 1:50 and 1:250) promoted activation of biglycan, collagen type I and fibromodulin expression. CONCLUSION: Our results show that bovine tendon extract is capable of promoting differentiation of bone marrow stromal cells in tenocytes

RESULTS OF THE USE OF PEEK CAGES IN THE TREATMENT OF BASILAR INVAGINATION BY GOEL TECHNIQUE

ABSTRACT Objective: Analysis of the use of polyetheretherketone (PEEK) cages for atlantoaxial facet realignment and distraction for treatment of basilar invagination by Goel technique. Method: Retrospective descriptive statistical analysis of the neurological status, pain, presence of subsidence and bone fusion with the use of PEEK cages in 8 atlantoaxial joints of 4 patients with basilar invagination. All patients were treated with atlantoaxial facet distraction and realignment and subsequent arthrodesis C1-C2 by the technique of Goel modified by the use of PEEK cage. Results: All patients showed improvement in Nurick neurological assessment scale and Visual Analogue Scale (VAS) of pain. There were no cases of subsidence, migration, or damage to the vertebral artery during the insertion of the cage. All joints evolved with bone fusion, assessed by dynamic radiographs, and computed tomography. Two patients developed neuropathic pain in dermatome of C2 and one patient had unilateral vertebral artery injury during C2 instrumentation treated with insertion of pedicle screw to control the bleeding. Conclusion: The results of the treatment of basilar invagination by the Goel technique with the use of PEEK cages shown to be effective and safe although further studies are needed to confirm this use

Late Adherent Human Bone Marrow Stromal Cells Form Bone and Restore the Hematopoietic Microenvironment In Vivo

Bone marrow stromal cells (BMSCs) are a valuable resource for skeletal regenerative medicine because of their osteogenic potential. In spite of the very general term “stem cell,” this population of cells is far from homogeneous, and different BMSCs clones have greatly different phenotypic properties and, therefore, potentially different therapeutic potential. Adherence to a culture flask surface is a primary defining characteristic of BMSCs. We hypothesized that based on the adherence time we could obtain an enriched population of cells with a greater therapeutic potential. We characterized two populations of bone marrow-derived cells, those that adhered by three days (R-cells) and those that did not adhere by three days but did by six days (L-cells). Clones derived from L-cells could be induced into adipogenic, chondrogenic, and osteogenic differentiation in vitro. L-cells appeared to have greater proliferative capacity, as manifested by larger colony diameter and clones with higher CD146 expression. Only clones from L-cells developed bone marrow stroma in vivo. We conclude that the use of late adherence of BMSCs is one parameter that can be used to enrich for cells that will constitute a superior final product for cell therapy in orthopedics