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

Osteopontin, osteocalcin, and osteoprotegerin expression in human tissue affected by cleft lip and palate

Cleft lip and palate (CLP) is a common congenital anomaly with a complex etiology which has not been elucidated yet. This study investigated whether expression of osteopontin (OPN), osteoprotegerin (OPG), and osteocalcin (OC), which are essential for the normal craniofacial bone remodelling, is not regulated in children with CLP. Alveolar bone tissue samples were obtained from patients with complete bilateral (CB) CLP (n= 14) during corrective plastic surgery and unaffected control subjects (n= 9). OPN, OPG, and OC expression was assessed by immunohistochemistry, and data were analyzed with the Mann-Whitney test. OPN expression was observed only sporadically in the alveolar bone of 3 patients, in contrast to the control group (z= - 2.962; P< 0.003). The number of OPG-positive bone cells varied from occasional to moderate, in contrast to the control group (z= - 2.247; P= 0.025). OC-positive osteocytes were present in moderate to numerous numbers in both patients and controls, with no significant difference between them (z= - 1.356; P< 0.175). The prominent expression of OC characteristic for CBCLP affected hard tissue indicates a high potential of bone mineralization. Few OPG-positive osteocytes in the bone tissue implicate the disregulation of osteoclast differentiation, maturation, and activity, but few OPN-containing cells may prove the common disregulation of bone remodelling during cleft morphopathogenesis.publishersversionPeer reviewe

Secondary Bone Grafting With Simultaneous Auto-Tooth Transplantation to the Alveolar Cleft

One of the most important purposes of secondary bone grafting of the alveolar cleft is to stabilize the maxillary alveolar arch with completion of the dental arch. We report a case of secondary bone grafting with simultaneous auto-tooth transplantation to the alveolar cleft, using particulate cancellous bone and marrow (PCBM) combined with platelet-rich plasma (PRP), which contains many growth factors. The patient was born with a bilateral cleft lip and left buccal-localized cleft alveolus. We performed bone grafting to the cleft using PCBM with PRP and transplantation of the supernumerary tooth under general anesthesia when the patient was aged 11 years, 10 months. The postoperative course was uneventful and without any complications. The orthodontic treatment was nearly complete 10 months after the operation. The transplanted tooth was stable, and a normal gingival contour was attained during the 2-year follow-up period. The case was successful in achieving a stable occlusal condition within a short period. We suggest secondary bone grafting with simultaneous auto-tooth transplantation as an option for alveolar cleft treatment

O efeito da BMP-2 sobre as propriedades osteocondutoras do beta-tricálcio fosfato em defeitos de calvária de ratos

A neoformação óssea em defeitos críticos em calvária de ratos depende fortemente das propriedades osteocondutoras dos enxertos e biomateriais. Ainda é controverso se os biomateriais podem substituir os enxertos de osso autógeno e se a suplementação dos biomateriais com Proteínas Ósseas Morfogenéticas (BMPs) é necessária para melhorar a formação óssea. Examinamos defeitos críticos em calvária de ratos (5 mm de diâmetro) tratados com β-tricálcio fosfato (TCP; Cerasorb ® M), gel de ácido polilático e poliglicólico (PLA/PGA; Fisiograft®) e cimento de fosfato de cálcio (CPC; Norian® CRS®), isoladamente ou na presença de 5μg de BMP-2 após 45 dias. Defeitos tratados com enxerto de osso autógeno particulado e defeitos não tratados serviram como controle. A formação óssea foi avaliada com base na análise de μCT, análise histomorfométrica e análise de fluorescência. Nós relatamos que o TCP apoia a formação óssea de forma mais eficiente do que o enxerto de osso autógeno particulado. A formação óssea na presença de TCP sozinho atingiu um nível máximo de neoformação óssea, enquanto que a suplementação de BMP-2 falhou em melhorar a neoformação óssea. Em contrapartida, não houve diferença significativa na formação óssea quando o PLA / PGA e o CPC foram comparados ao enxerto autógeno. Além disso, a presença de BMP-2 não alterou substancialmente as propriedades osteocondutoras de PLA/PGA ou de CPC. Conclui-se que as propriedades osteocondutoras do TCP são superiores aos dos enxertos autógenos e que o TCP não exige suplementação de BMP-2. Nossos resultados também mostram que a diminuição da capacidade osteocondutora do PLA/PGA e do CPC não podem ser superadas pela suplementação de BMP-2 em defeitos de calvária de ratosBone formation in critical-sized calvaria defects is strongly dependent on the osteoconductive properties of grafts. It remains a matter of controversy whether biomaterials can replace autografts and whether the supplementation of biomaterials with Bone Morphogenetic Proteins (BMPs) is necessary to enhance bone formation. We examined rat calvaria critical-sized defects (5mm diameter) treated with β-tricalcium phosphate (TCP; Cerasorb® M), polylactic and polyglycolic acid gel (PLA/PGA; Fisiograft®) and calcium phosphate cement (CPC; Norian® CRS®), either alone or in the presence of 5μg of BMP-2 after 45 days. Autografts and untreated defects served as controls. Bone formation was evaluated based on μCT analysis, histomorphometric analysis and fluorescence analysis. We report that TCP supported bone formation more efficiently than did autografts. Bone formation in the presence of TCP alone reached a maximal level, as BMP-2 supplementation failed to enhance bone formation. By contrast, no significant difference in bone formation was observed when PLA/PGA and CPC were compared to autografts. Moreover, the presence of BMP-2 did not substantially change the osteoconductive properties of PLA/PGA or CPC. We conclude that the osteoconductive properties of TCP are superior to those of autografts and that TCP does not require BMP-2 supplementation. Our findings also show that the decreased osteoconductive properties of PLA/PGA and CPC cannot be overcome by BMP-2 supplementation in rat calvaria defectsCoordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Co-localização de OPG e RANKL durante o processo de reparo alveolar em ratas ovariectomizadas tratadas com estrógeno ou com raloxifeno

Objetivos: Avaliar a interferência da ovariectomia (OVX) e seu tratamento com estrógeno (E2) ou com raloxifeno (RLX) no balanço entre RANKL/OPG na cronologia do processo de reparo alveolar em diferentes períodos (7, 14, 21 e 42 dias) através da imunofluorescência por co-localização e análise histomorfométrica. Materiais e Métodos: Os grupos estudados foram: sham, OVX, OVX+E2, OVX+RLX. Após obtenção dos cortes histológicos corados em hematoxilina e eosina e as reações de co-localização por imunofluorescência de RANKL/OPG, os resultados foram avaliados quantitativamente. Resultados:Aos 7 dias: menor neoformação de trabéculas ósseas,o grupo OVX+RLX apresentou menor valor médio. O grupo OVX apresentou o maior turnover ósseo representado pelas co-localizações de OPG e RANKL. Aos 14 dias o grupo OVX+RLX apresentou menor formação óssea. O grupo sham apresentou intensa atividade celular representada pela alta imunorreatividade à OPG e RANKL observada nas células. Aos 21 dias os grupos experimentais apresentaram maiores níveis de ossificação; não apresentaram diferença estatística. O grupo OVX apresentou o menor turnover ósseo. Aos 42 dias houve diferença estatística na quantidade de formação óssea entre o grupo sham comparado aos demais grupos (p<0,05) e o grupo OVX apresentou o maior turnover ósseo. Conclusão: A ovariectomia atrasou o processo de reparo alveolar e alterou o turnover ósseo. A reposição do estrógeno e o tratamento com raloxifeno melhoraram as respostas, mas não restabeleceram completamente os valores da histometria e da colocalização do grupo sham.Objectives: To evaluate the influence of the ovariectomy (OVX), and its treatments with estrogen (E2) or with raloxifene (RLX) on the RANKL/OPG balance during the periods in the chronology of the alveolar wound healing process (7, 14, 21 end 42 pos operative days) in female rats by means of immunocolocalization and histomorphometric analysis. Methods: The studied groups were: sham, OVX, OVX with E2 replacement, OVX with (RLX) treatment. After obtaining the histological tissue pieces colored in hematoxilin and eosin and the immunocolocalization reaction for RANKL and OPG, the results were quantitatively evaluated. Results: At 7 days, was observed lesser neoformed trabeculae bone, the smaller medium value was observed to the OVX+RLX group. The OPG and RANKL immunocolocalization showed larger bone tunover to OVX group. At 14 days there was a larger quantity of neoformed trabeculae bone, the smaller medium value was observed to the OVX+RLX group, the sham group presented an intense cellular activity. At 21 days the experimental groups had a greater ossification levels; no statistical significance was observed. The OVX group had the lowest bone turnover. At 42 days there were statistically differences on the quantity of ossification within sham group compared to the other groups (p<0.05). The OVX group showed the largest bone turnover. Conclusions: Ovariectomy delays the alveolar wound healing process and interferes with the bone turnover. The E2 replacement and the RLX treatment improved the healing but not enough to reach histomorphometric and immunocolocalization valours of the sham group

Functional Aesthetic Treatment of Patient With Phenytoin-Induced Gingival Overgrowth

Gingival overgrowth (GO) may be related to the frequent use of certain medications, such as cyclosporin, phenytoin (PHT), and nifedipine, and is therefore denominated drug-induced GO. This article reports a case of a patient who with chronic periodontitis made use of PHT and presented generalized GO. A 30-year-old man with GO was referred to the clinic of the Universidade Estadual Paulista, Brazil. The complaint was poor aesthetics because of the GO. The patient had a medical history of a controlled epileptic state, and PHT was administered as an anticonvulsant medication. The clinical examination showed generalized edematous gingival tissues and presence of bacterial plaque and calculus on the surfaces of the teeth. The diagnosis was GO associated with PHT because no other risk factors were identified. Treatment consisted of meticulous oral hygiene instruction, scaling, root surface instrumentation, prophylaxis, and daily chlorhexidine mouth rinses. After this stage, periodontal surgery was performed, and histopathologic evaluation was made. The patient has been under control for 3 years after the periodontal surgery, and up to the present time, there has been no recurrence. It can be concluded that PHT associated with the presence of irritants favored gingival growth and that the association of nonsurgical and surgical periodontal therapies was effective in the treatment of GO. Besides, motivating the patient to maintain oral hygiene is a prerequisite for the maintenance of periodontal health

Peripheral Ossifying Fibroma

The peripheral ossifying fibroma (POF) is a common gingival growth usually arising from the interdental papilla. The anterior maxilla is the most common location of involvement. The etiology and pathogenesis of POF remains unknown. Some investigators consider it a neoplastic process, whereas others argue that it is a reactive process; in either case, the lesion is thought to arise from cells in the periodontal ligament. Trauma or local irritants, such as dental plaque, calculus, microorganisms, masticatory force, ill-fitting dentures, and poor quality restorations, have been implicated in the etiology of POF. The recommended treatment is the excisional biopsy; however, it can leave a defect if the procedure is not followed by a subepithelial connective tissue graft. The main objective of this article was to present a clinical case of excisional biopsy of a POF followed by a subepithelial connective tissue graft to correct the defect caused by the biopsy. The biopsy defect was satisfactorily repaired, and the lesion has not recurred after 6 years of follow-up