Successful Use of Lower-Level Laser Therapy in the Treatment of Medication-Related Osteonecrosis of the Jaw

Case Presentation: This study aimed to report a case of medication related osteonecrosis of the jaw (MRONJ) of a 65-year-old female patient referred to the Oral and Maxillofacial Surgery team from Araçatuba Dental School, complaining about mobility of a previously dental implant placed on the posterior maxillary region. Clinical examination revealed an extensive necrosis area around the implant region. The patient reported bisphosphonate therapy with sodium alendronate for prevention of osteoporosis 5 years ago. A diagnosis of MRONJ was reached and the treatment decided was to remove the dental implant damaged and use the lower-level laser therapy (LLLT) associated with antibiotic therapy with clindamycin 300 mg and mouth rinses with chlorhexidine 0.12%.Conclusion: Six months after the treatment with LLLT a complete healing of the affected area was observed and 12 months after treatment the patient was rehabilitated with fixed dental prosthesis and showed excellent tissue healing of the necrosis areas. It was concluded that the use of LLLT showed to be a good option in the treatment of MRONJ

Repair process of surgical defects filled with autogenous bone grafts in tibiae of diabetic rats

From a biological standpoint, the best material for reconstruction of bone defects is the autogenous bone graft. However, as tissue healing is affected under diabetic conditions, major changes might take place in the revascularization, incorporation, replacement and remodeling phases of the grafted area. The purpose of this study was to assess the bone healing process in surgical wounds prepared in tibiae of diabetic rats and filled with autogenous bone. Forty male rats (Rattus norvegicus albinus, Wistar) were randomly assigned to receive an endovenous injection (penile vein) of either citrate buffer solution (Group 1 - control; n=20) or streptozotocin dissolved in citrate buffer solution (35 mg/kg) to induce diabetes (Group 2 - diabetic; n=20). After determination of glycemia, the animals were anesthetized and the anterolateral regions of the tibiae of both limbs were shaved, antisepsis was performed and longitudinal incisions were made in each limb. The tibiae were exposed and two 2mm-diameter surgical cavities were prepared: one in the right limb, filled with particulate autogenous bone and the other in the left limb, filled with blood clot. The animals were euthanized at 10 and 30 postoperative days. The anatomic pieces were obtained, submitted to laboratory processing and sections were stained by hematoxylin and eosin and Masson's Trichrome for histomorphologic and histometric analyses. In both groups, the wounds filled with autogenous bone graft showed better results than those filled with blood clot. The control group showed higher new bone formation in wounds filled with autogenous bone graft at 30 days than the diabetic group, but without statistical significance. It may be concluded that, in general, the new bone formation occurred with autogenous graft was quantitatively similar between control and diabetic groups and qualitatively better in the control group

Bone regeneration in surgically created defects filled with autogenous bone: an epifluorescence microscopy analysis in rats

Although the search for the ideal bone substitute has been the focus of a large number of studies, autogenous bone is still the gold standard for the filling of defects caused by pathologies and traumas, and mainly, for alveolar ridge reconstruction, allowing the titanium implants installation. OBJECTIVES: The aim of this study was to evaluate the dynamics of autogenous bone graft incorporation process to surgically created defects in rat calvaria, using epifluorescence microscopy. MATERIAL AND METHODS: Five adult male rats weighing 200-300 g were used. The animals received two 5-mm-diameter bone defects bilaterally in each parietal bone with a trephine bur under general anesthesia. Two groups of defects were formed: a control group (n=5), in which the defects were filled with blood clot, and a graft group (n=5), in which the defects were filled with autogenous bone block, removed from the contralateral defect. The fluorochromes calcein and alizarin were applied at the 7th and 30th postoperative days, respectively. The animals were killed at 35 days. RESULTS: The mineralization process was more intense in the graft group (32.09%) and occurred mainly between 7 and 30 days, the period labeled by calcein (24.66%). CONCLUSIONS: The fluorochromes showed to be appropriate to label mineralization areas. The interfacial areas between fluorochrome labels are important sources of information about the bone regeneration dynamics

Rank Protein Immunolabeling during Bone-Implant Interface Healing Process

The purpose of this paper was to evaluate the expression of RANK protein during bone-healing process around machined surface implants. Twenty male Wistar rats, 90 days old, after having had a 2 mm diameter and 6 mm long implant inserted in their right tibias, were evaluated at 7, 14, 21, and 42 days after healing. After obtaining the histological samples, slides were subjected to RANK immunostaining reaction. Results were quantitatively evaluated. Results. Immunolabeling analysis showed expressions of RANK in osteoclast and osteoblast lineage cells. The statistical analysis showed an increase in the expression of RANK in osteoblasts at 7 postoperative days and a gradual decrease during the chronology of the healing process demonstrated by mild cellular activity in the final stage (P < .05). Conclusion. RANK immunolabeling was observed especially in osteoclast and osteoblast cells in primary bone during the initial periods of bone-healing/implant interface

Transformação Cística como Consequência de Terceiro Molar Inferior Incluso

ResumoA permanência de terceiros molares inclusos na arcada pode causar diversas alterações patológicas, dentre elas o aparecimento de cistos odontogénicos. O aparecimento de um cisto paradentário associado a um terceiro molar inferior incluso foi diagnosticado 6 anos após a realização de um exame radiográfico de rotina onde o dente se encontrava incluso sem sinais de quaisquer patologia associada. A evolução e tratamento cirúrgico de enucleação deste cisto estão descritos e discutidos os aspectos relacionados à remoção preventiva de terceiros molares inclusos. A instituição de um plano de tratamento baseados na história clínica e exame radiográfico são necessários, a fim de estabelecer um protocolo preventivo das alterações causadas por essas retenções dentárias. A indicação de extracção de terceiros molares inclusos pode ser uma forma de se evitar o aparecimento destas e outras patologias associadas a essas retenções.AbstractThe permanence of impacted third molar in the jaws can cause many pathological alterations, amongst them the appearance of odontogenic cysts. The paradental cyst appearance and evolution next to a mandibular included third molar was diagnosised in radiograph routine follow-up, and its evolution and treatment are described. Are discussed the aspects related with the preventive removal to the impacted third molars and the necessity to institution a plan of treatment based in clinical history and radiograph in order to establish a preventive protocol the alterations caused by these impactions. The indication of extraction of impacted third enclosed can be a way to preventing the appearance of these and others pathologies associates to these lesions

Surgical-Orthodontic Traction for Impacted Maxillary Canines: A Critical Review and Suggested Protocol

Maxillary canine impaction is a common occurrence, especially in the palate, despite sufficient space in the arch for tooth alignment. A proper approach requires knowledge of different specialties of dentistry, such as orthodontics, surgery, radiology, and periodontology, which are generally not centered on a single professional. The causes for canine impaction may be either generalized or localized, and the diagnosis should be made through specific clinical and radiographic examination. The prognosis of surgical-orthodontic treatment depends on the position of the canine in relation to the neighboring teeth and height of the alveolar process, in addition to careful surgical technique, considering that there are risks involved, such as ankylosis, loss of tooth vitality, root resorption of the involved tooth and adjacent teeth, and damage to supporting tissues. Given the important role played by impacted maxillary canines, their traction is the treatment of choice in orthodontically treated patients. The present study reviews the literature on important factors to be considered when approaching impacted canines, such as therapeutic possibilities, their advantages and disadvantages

The characterisation of the craniofacial morphology of infants born with Zika virus:Innovative approach for public health surveillance and broad clinical applications

Background: This study was carried out in response to the Zika virus epidemic which constituted a public health emergency and to the 2019 WHO calling for strengthened surveillance for the early detection of related microcephaly. The main aim of the study was to phenotype the craniofacial morphology of microcephaly using novel approach and new measurements, relate the characteristics to brain abnormalities in Zika infected infants in Brazil to improve clinical surveillance. Methods: We captured 3D images of the face and the cranial vault of 44 Zika infected infants and matched healthy controls using 3D camera. The CT scans of the brain of the infected infants were analysed. The Principal Component Analysis (PCA) was applied to characterise the craniofacial morphology. In addition to the head circumference (HC), we introduced a new measurement, head height (HH) to measure the cranial vault. The level of brain abnormality present in the CT scans was assessed, the severity of parenchymal volume loss and ventriculomegaly was quantified. Findings: The PCA identified a significant difference (p &lt;0.001) between the cranial vaults and the face of the Zika infants and that of the controls. Spearman's rank-order correlation coefficients show that the head height (HH) has a strong correlation (0.87 in Zika infants; 0.82 in Controls) with the morphology of the cranial vaults which are higher than the correlation with the routinely used head circumference (HC). Also, the head height (HH) has a moderate negative correlation (-0.48) with the brain abnormalities of parenchymal volume loss. Interpretation: We discovered that head height (HH), the most sensitive and discriminatory measure of the severity of cranial deformity which should be used for clinical surveillance of Zika syndrome, evaluation of other craniofacial syndromes and assessment of various treatment modalities

RANCANG BANGUN ANEMOMETER BERBASIS AKUISISI DATA

Data acquisition system is aimed to display value and graphic in real-time. It is designed on Anemometer to present value or graphic of wind speed on Personal Computer (PC) that furthermore, data is analyzed and stored automatically in Microsoft Excel. Equipment used is Wind Speed Air Velocity Anemometer in the form of fan to measure wind speed. It is designed by using Optocoupler as transducer connected to Arduino Uno ATmega328. This Optocoupler has integrated phototransistor and LED (Light Emitting Diode) components. Both components functioned as receiver and data transfer of wind speed from fan by 0 and 1 logic value. Obtained data by PC will be shown on table and graphic including complete time. The result of test shows accuracy specification of Anemometer in 96,149 % and 1,619 % precision with average deviation standard of 0,0475

Daily melatonin administration improves osseointegration in pinealectomized rats

The hypothesis of this study was that the peri-implant bone healing of the group of pinealectomized rats would differ from the control group. The samples were subjected to immunohistochemical, microtomographic (total porosity and connectivity density), and fluorochrome (mineralized surface) analyses. Objectives: The goal of this study was to investigate the cellular changes and bone remodeling dynamics along the bone/implant interface in pinealectomized rats. Material and Methods: The total of 18 adult male rats (Rattus norvegicus albinus, Wistar) was divided into three groups (n=6): control (CO), pinealectomized without melatonin (PNX) and pinealectomized with melatonin (PNXm). All animals were submitted to the first surgery (pinealectomy), except the CO group. Thirty days after the pinealectomy without melatonin, the second surgery was conducted, in which all animals received an implant in each tibia (36 titanium implants with surface treatment were installed – Implalife® São Paulo, SP, Brazil). By gavage, the rats of the PNX group received the vehicle solution, and the procedure. Results: Immunohistochemical analysis for runt-related transcription factor 2 (RUNX2), alkaline phosphatase (ALP), osteopontin (OP) and osteocalcin (OC) showed that the bone repair process in the PNXm group was similar to that of the CO group, whereas the PNX group showed a delay. The microtomographic parameters of total porosity [Po(tot)] and bone surface (BS) showed no statistically significant differences, whereas for the connective density (Conn.Dn) a statistical difference was found between the CO and PNXm groups. Fluorochrome analysis of the active mineralized surface showed statistically significant difference between the CO and PNX and between the CO and PNXm groups. Conclusion: The absence of the pineal gland impaired the bone repair process during osseointegration, however the daily melatonin replacement was able to restore this response