Osseointegração de implantes de titânio com modificação da superfície por ablação a laser e recobrimento por hidroxiapatita biomimética: estudo biomecânico e histomorfométrico em tíbia de coelhos

O sucesso dos sistemas modernos de implantes dentais tem sido relacionado ao desenvolvimento do design e das características de superfícies dos implantes. O propósito do presente estudo foi avaliar duas novas superfícies de implantes (modificada por laser - LMS e recoberta por hidroxiapatita biomimética - HA), comparando-as a outro implante comercial, (superfície usinada – MS). Um total de 144 implantes (3,75 x 10mm), 48 de cada superfície, foram instalados na tíbia de coelhos e avaliados após 4, 8 e 12 semanas. Após os períodos de cicatrização os animais foram sacrificados, um dos implantes expostos e a força necessária para derosquea-los foi aferida por um torquímetro analógico. O outro implante foi removido com o tecido ósseo peri-implantar e processado por corte histológico calcificado para análise histomorfométrica do contato osso-implante (BIC%) e da área óssea entre espiras (BBT%). Em 4 e 8 semanas, os implantes HA apresentaram valor de torque de remoção estatisticamente superior (p<0,05) quando comparado aos demais, sendo o mesmo observado para os implantes LMS quando comparados aos MS. Após 12 semanas, os implantes HA e LMS foram estatisticamente superiores aos implantes MS. Por outro lado, a análise do contato osso-implante mostrou que na região cortical, os implantes LMS e HA foram estatisticamente superiores ao MS para todos os períodos de cicatrização, sem diferença estatística entre LMS e HA. A análise histomorfométrica mostrou que, quando comparados na região endosteal, os implantes LMS e HA foram estatisticamente superiores ao MS no período inicial de cicatrização. Embora os implantes LMS e HA não apresentassem diferenças estatísticas entre eles, uma tendência de maiores valores de BIC% para HA na região endosteal foi observada em todos os períodos do estudo.Os resultados deste estudo mostram que apesar de não haver diferença...Purpose: Considering the great biological potential of the association between laser ablation and hydroxyapatite thin layer coatings to create an interesting bioactive environment on titanium dental implants, the aim of the present study was to investigate, by histomorphometrical and removal torque analysis, the histological effects of a surface treatment created by laser-ablation (Nd:YAG) and, later, thin deposition of HA particles by a chemical process compared to implants with only laser-ablation and implants with machined surfaces. Materials and Methods: Forty-eight rabbits received two implant by tibiae of the following surfaces: Machined surface (MS), laser-modified surface (LMS) and biomimetic hydroxiapatite coated surface (HA). After 4, 8 and 12 weeks of healing, one implant was exposed, and the needed force to unscrew measured using an analogical torque gauge. The other implant and surrounding bone was removed and prepared by a calcified histological process. The percentage of bone-to-implant contact (BIC) and the bone area formed between the threads (BBT) were evaluated separately to the cortical and endosteal region. Results: The difference was statistically significant (P < .05) between the LMSMS and HA-MS surfaces in all periods of evaluation, and between LMS-HA to 4 and 8 weeks of healing. The surface characterization showed a deep, rough, and regular topography provided by the laser conditioning, that was followed by the HA coating. Average BIC percentage in the cortical region was significantly higher (P<0.001) on the LMS and HA implants, compared with MS ones for all periods of healing, having no statistical differences between LMS and HA. When compared in the endosteal area, the LMS and HA implants showed statistically higher (P<0.01) BIC percentage values than MS at the initial periods of healing (LMS after 4 weeks and HA after 4 and 8 weeks, respectively)... (Complete abstract click electronic access below)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Avaliação de implantes de titânio com modificação da superfície por abrasão a laser ou recobrimento por hidroxiapatita biomimétrica. Estudo biomecânico em tíbia de coelhos

O sucesso dos sistemas modernos de implantes dentais tem sido relacionado ao desenvolvimento do design e das características de superfícies dos implantes. O propósito do presente estudo foi avaliar duas novas superfícies de implantes (modificada por laser - SML e recoberta por hidroxiapatita biomimética - HA), comparando-as a outros dois implantes comerciais, (superfície usinada - SU e modificada por jateamento e ataque ácido - SMC). Um total de 96 implantes (3,75 x 10mm), 24 de cada superfície, foram instalados na tíbia de coelhos e avaliados após 4, 8 e 12 semanas. Após os períodos de cicatrização os animais foram sacrificados, os implantes expostos e a força necessária para derosquea-los foi aferida por um torquímetro analógico. Em 4 e 8 semanas, os implantes HA apresentaram valor de torque de remoção estatisticamente superior (p<0,05) quando comparado aos demais, sendo o mesmo observado para os implantes SML quando comparados aos SU. Após 12 semanas, os implantes HA e SML foram estatisticamente superiores aos implantes SU. Os resultados deste estudo sugerem que os implantes HA foram superiores aos demais nos períodos iniciais, obtendo uma estabilidade satisfatória com 4 semanas de implantação. Os implantes SML foram superiores aos SU em todos os períodos avaliados, porém não apresentando diferenças quando com parados aos SMC.The success of modern dental implant systems has been associated with the development of implant designs and surface characteristic. The purpose of this study was to evaluate two new implant surfaces (laser-modified - LSM and biomimetic-hydroxyapatite coating - HA) comparing them with two other commercial implants (machined surface -MS and modified by sandblasted and acid etched - MCS). A total of 96 implants (3,75 x 10mm), 24 of each surface, were placed in rabbit tibia being evaluated after 4, 8 and 12 weeks. After the healing periods, the animals were sacrificed, the implants sites were exposed, and the needed force to unscrew the implants was measured using an analogical torque gauge. At 4 and 8 weeks, the HA implants removal torque was statistically greater (p<0,05) in comparison with the others, being the same observed to LSM when compared with MS. After 12 weeks, the HA and LSM implants were statistically greater just when compared with MS. The results of this study suggest that the HA implants were superior to the other at the initial periods, having a satisfactory stability with 4 weeks post-implantation. The LSM implants were superior to MS at all periods evaluated, but having no difference when compared with MCS.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Evaluation of titanium implants with surface modification by laser beam. Biomechanical study in rabbit tibias

The purpose of the present study was to evaluate, using a biomechanical test, the force needed to remove implants with surface modification by laser (Nd:YAG) in comparison with implants with machined surfaces. Twenty-four rabbits received one implant with each surface treatment in the tibia, machined surface (MS) and laser-modified surface (LMS). After 4, 8 and 12 weeks of healing, the removal torque was measured by a torque gauge. The surfaces studied were analyzed according to their topography, chemical composition and roughness. The average removal torque in each period was 23.28, 24.0 and 33.85 Ncm for MS, and 33.0, 39.87 and 54.57 Ncm for LMS, respectively. The difference between the surfaces in all periods of evaluation was statistically significant (p < 0.05). Surface characterization showed that a deep and regular topography was provided by the laser conditioning, with a great quantity of oxygen ions when compared to the MS. The surface micro-topography analysis showed a statistical difference (p < 0.01) between the roughness of the LMS (R a = 1.38 ± 0.23 μm) when compared to that of the MS (R a = 0.33 ± 0.06 μm). Based on these results, it was possible to conclude that the LMS implants' physical-chemical properties increased bone-implant interaction when compared to the MS implants. © 2009 Sociedade Brasileira de Pesquisa Odontológica

Laser ablation in titanium implants followed by biomimetic hydroxyapatite coating: Histomorphometric study in rabbits

Titanium surface texture and chemistry modification successfully improves the host response and consequently the bone-to-implant contact surrounding dental implants. The aim of the present study was to investigate, using histomorphometrical-analysis, the effects of titanium surface modification by laser-ablation (Nd:YAG) followed by thin chemical deposition of HA. Forty-eight rabbits received one implant by tibiae of AS-machined (MS), laser-modified (LMS), or biomimetic hydroxyapatite-coated (HA) surface. Bone-to-implant contact (BIC) and bone area (BBT) were evaluated after 4, 8, and 12 weeks, at cortical and cancellous regions. Average BIC in the cortical region was higher (P < 0.001) on the LMS and HA implants for all periods, with no differences between LMS and HA. For the cancellous area, the LMS and HA implants showed higher (P < 0.01) BIC than MS at the initial periods. The LMS and HA showed similar values in the cortical region, but a tendency of higher values for HA in the cancellous region was observed in all periods. For the BBT, the differences were found only between HA and MS after 4 weeks in the cortical region (P < 0.05), and after 12 weeks in the cancellous area (P < 0.05). Our results showed that HA biomimetic coating preceded by laser treatment induced the contact osteogenesis and allowed the formation of a more stable boneimplant interface, even in earlier periods. Microsc. Res. Tech., 2012. (C) 2012 Wiley Periodicals, Inc

Model for the Evaluation of Root Wear by Histometric Analysis

Background: Knowledge of the wear to the root surface caused by different instruments is essential in the choice of the type of tool used in relation to the phase of periodontal treatment which the patient is undergoing. Purpose: The objective of this study was to present a new methodology for evaluating tooth wear produced by the instrumentation of the root surface. Study Design: The present study used five teeth, the proximals of which were divided in three regions: coronal, median, and an apical. The coronal region was scaled with a curette, the apical region was irradiated with the Erbium, Chromium: Yttrium-Scandium-Gallium-Garnet laser (Er,Cr:YSGG laser) and the medial region was left untreated, which served as control. The teeth underwent a histological process and were analyzed histometrically. The t test (P < 0.05) was used to analyze the root wear. Results: The regions that were irradiated with the Er, Cr: YSGG laser presented less wear (113.37 +/- 32.94 mu m) in comparison to the regions that were scaled with manual curettes (169.83 +/- 24.76 mu m) (P < 0.05). Conclusions: The methodology proposed was efficient in the measurement of the wear caused by the root instrumentation and proved easy to execute, easy to reproduce, and of low cost and with high calibration accuracy. Microsc. Res. Tech. 74:920-924, 2011. (C) 2010 Wiley-Liss, Inc.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

The Labor Signal

Weekly journal from Oklahoma City, Oklahoma "devoted to the interest of organized labor." The paper includes labor news and articles, along with advertising

Gengivite Plasmocitária induzida por uso de pimenta

The aim of this case report is present a case in which the patient had plasma cell gingivitis induced by consumption of pepper. Patient A.M.S., male, 23 years, presented himself at the Clinic of Periodontology, complaining of severe pain, bleeding gums and tooth mobility. Interview was conducted not observing anything relevant. In oral evaluation, we observed in the anterior swollen gums, bleeding, suppuration and great touch, and tooth mobility. Being an aggressive framework in relation to patient age, we performed the following laboratory tests: complete blood count, blood sugar, and coagulation, and biopsy in the anterior inferior, because a diagnosis of lymphoma. At the end of antibiotic therapy, a significant improvement of clinical symptoms, pain relief, less swollen gums and reduce the suppuration and mobility. Laboratory tests showed no change. Fifteen days later, the patient returned with worsening of clinical status. The pathological diagnosis was plasma cell gingivitis and then performed a new history by placing greater emphasis on dietary habits, and the patient reported consumption of pepper in their meals, and relate this to clinical presentation. After elimination of pepper diet the patient showed remission of clinical data.O objetivo desse estudo foi de apresentar um relato de caso em que o paciente apresentava gengivite plasmocitária induzida por consumo de pimenta. Paciente AMS, sexo masculino, 23 anos, apresentou-se na Clínica de Periodontia, queixando-se de dor intensa, sangramento gengival e mobilidade dental. Foi realizada anamnese não observando-se nada relevante. Na avaliação bucal, observou-se na região anterior gengival edemaciada, sangramento ao toque e grande supuração, além de mobilidade dental. Tratando-se de um quadro agressivo em relação à idade do paciente, foram realizados os seguintes exames complementares: hemograma completo, taxa de glicemia e coagulograma, bem como biópsia, na região anterior inferior, devido a suspeita diagnóstica de linfoma. Ao final da antibioticoterapia, houve melhora significativa do quadro clínico, alívio da dor, gengiva menos edemaciada e redução da supuração e mobilidade. Os exames laboratoriais não apresentaram nenhuma alteração; 15 dias após, o paciente retornou com piora do quadro clínico. O diagnóstico histopatológico foi de gengivite plasmocitária e, então, foi realizada nova anamnese dando maior importância aos hábitos alimentares, sendo que o paciente relatou consumo de pimenta em suas refeições, fato relacionado ao quadro clínico apresentado. Após a eliminação da pimenta da dieta, o paciente apresentou remissão dos dados clínicos

Impact of diabetes mellitus and metabolic control on bone healing around osseointegrated implants: Removal torque and histomorphometric analysis in rats

Objectives: To evaluate bone healing around dental implants with established osseointegration in experimental diabetes mellitus (DM) and insulin therapy by histomorphometric and removal torque analysis in a rat model. Materials and methods: A total of 80 male Wistar rats received a titanium implant in the tibiae proximal methaphysis. After a healing period of 60 days, the rats were divided into four groups of 20 animals each: a 2-month control group, sacrificed at time (group A), a diabetic group (group D), an insulin group (group I), and a 4-month control group (group C), subdivided half for removal torque and half for histomorphometric analysis. In the D and I groups the DM was induced by a single injection of 40 mg/kg body weight streptozotocin (STZ). Two days after DM induction, group I received subcutaneous doses of insulin twice a day, during 2 months. Groups C and D received only saline. Two months after induction of DM, the animals of groups D, C and I were sacrificed. The plasmatic levels of glucose (GPL) were monitored throughout the experiment. Evaluation of the percentages of bone-to-implant contact and bone area within the limits of the implant threads was done by histomorphometric and mechanical torque analysis. Data were analyzed by anova at significant level of 5%. Results: The GPL were within normal range for groups A, C and I and higher for group D. The means and standard deviations (SD) for histomorphometric bone area showed significant difference between group D (69.34 ± 5.00%) and groups C (78.20 ± 4.88%) and I (79.63 ± 4.97%). Related to bone-to-implant contact there were no significant difference between the groups D (60.81 + 6.83%), C (63.37 + 5.88%) and I (66.97 + 4.13%). The means and SD for removal torque showed that group D (12.91 ± 2.51 Ncm) was statistically lower than group I (17.10 ± 3.06 Ncm) and C (16.95 ± 5.39 Ncm). Conclusions: Diabetes mellitus impaired the bone healing around dental implants with established osseointegration because the results presented a lower percentage of bone area in group D in relation to groups C and I resulting in a lowest torque values for implant removal. Moreover, insulin therapy prevents the occurrence of bone abnormalities found in diabetic animals and osseointegration was not compromised. © 2012 John Wiley & Sons A/S

Graft incorporation and implant osseointegration following the use of autologous and fresh-frozen allogeneic block bone grafts for lateral ridge augmentation

OBJECTIVES: To compare autogenous bone (AT) and fresh-frozen allogeneic bone (AL) in terms of histomorphometrical graft incorporation and implant osseointegration after grafting for lateral ridge augmentation in humans. MATERIALS AND METHODS: Thirty-four patients were treated with either AL (20 patients) or AT (14 patients) onlay grafts. During implant installation surgery 6 months after grafting, cylindrical biopsies were harvested perpendicularly to the lateral aspect of the augmented alveolar ridge. Additionally, titanium mini-implants were installed in the grafted regions, also perpendicularly to the ridge; these were biopsied during second-stage surgery. Histological/histomorphometric analysis was performed using decalcified and non-decalcified sections. RESULTS: Histological analysis revealed areas of necrotic bone (NcB) occasionally in contact with or completely engulfed by newly formed vital bone (VB) in both AT and AL groups (55.9 ± 27.6 vs. 43.1 ± 20.3, respectively; P = 0.19). Statistically significant larger amounts of VB (27.6 ± 17.5 vs. 8.4 ± 4.9, respectively; P = 0.0002) and less soft connective tissue (ST) (16.4 ± 15.6 vs. 48.4 ± 18.1, respectively; P ≤ 0.0001) were seen for AT compared with AL. No significant differences were observed between the groups regarding both bone-to-implant contact (BIC) and the bone area between implant threads (BA) on the mini-implant biopsies. CONCLUSION: Allogeneic bone block grafts may be an option in cases where a limited amount of augmentation is needed, and the future implant can be expected confined within the inner aspect of the bone block. However, the clinical impact of the relatively poor graft incorporation on the long-term performance of oral implants placed in AL grafts remains obscure