Tomographic late evaluation of xenogeneic bone grafts in sockets of impacted third molars

It is necessary to preserve height and thickness of the alveolar bone to facilitate rehabilitation with osteointegratable implants or simply to maintain bone integrity after extraction. Biomaterials associated with resorbable or non-resorbable membranes, when placed in the region of the socket, may contribute to avoid this unwanted reabsorption. Objective: The objective of this study was to evaluate the distance of the crest of alveolar ridge to the cementoenamel junction (CEJ) of the lower second molars and the bone density of the third molar socket filled with Gen-Tech®, 5 years after an exodontia using cone beam computed tomography (CBCT) to visualize the central region of the sockets, without overlapping of the buccal and lingual cortical bones. Material and Methods: A total of 12 individuals from an initial group of 39 patients submitted to extraction of the unruptured lower third molars and grafting of an association of inorganic bovine bone matrix, organic bovine bone matrix, collagen and bone morphogenetic proteins (BMP) (Gen-Tech®) on one side and the contralateral sockets filled only by clot, returned to control after 5 years, and were submitted to CBCT. The distance from the crest of alveolar bone to the CEJ and the bone density (BD) were measured using the i-CAT Vision Software. Results: The results showed that the distance from the crest of alveolar bone to the CEJ in the control group was similar to that observed before the exodontia; in the experimental group, this distance was smaller. Considering the BD measurement, a significantly higher density was observed in the experimental group (p<0.05). Conclusion: Part of the biomaterial was not absorbed and allowed the stability of the evaluated parameters after 5 years, being able to be used as a bone substitute in the socket

Characterization and in vitro cytocompatibility of an acid-etched titanium surface

The aims of this study were to characterize the microstructure of a commercially pure titanium (cpTi) surface etched with HCl/H2SO4 (AE-cpTi) and to investigate its in vitro cytocompatibility compared to turned cpTi (T-cpTi). T-cpTi showed a grooved surface and AE-cpTi revealed a surface characterized by the presence of micropits. Surface parameters indicated that the AE-cpTi surface is more isotropic and present a greater area compared to T-cpTi. The oxide film thickness was similar between both surfaces; however, AE-cpTi presented more Ti and O and less C. Osteoblastic cell proliferation, alkaline phosphatase activity, and bone-like nodule formation were greater on T-cpTi than on AE-cpTi. These results show that acid etching treatment produced a surface with different topographical and chemical features compared to the turned one, and such surface modification affected negatively the in vitro cytocompatibility of cpTi as demonstrated by decreasing culture growth and expression of osteoblastic phenotype.O objetivo deste estudo foi caracterizar a microestrutura de uma superfície de titânio comercialmente puro (cpTi) condicionada com HCl/H2SO4 (acid etched) (AE-cpTi) e investigar sua citocompatibilidade in vitro, comparada à do cpTi usinado (turned) (T-cpTi). O T-cpTi apresentou uma superfície com sulcos e o AE-cpTi exibiu uma superfície caracterizada pela presença de micro-vales. Os parâmetros de superfície indicaram que a superfície AE-cpTi é mais isotrópica e apresenta uma área maior quando comparada à superfície T-cpTi. A espessura da camada de óxido foi similar para as duas superfícies; no entanto, a AE-cpTi apresentou maiores quantidades de Ti e O e menor, de C. A proliferação de células osteoblásticas, a atividade de fosfatase alcalina e a formação de matriz mineralizada foram maiores na superfície T-cpTi que na AE-cpTi. Esses resultados mostram que o condicionamento ácido produziu uma superfície com características topográficas e químicas diferentes quando comparadas às da superfície usinada. Além disso, observou-se que essas modificações de superfície afetaram de forma negativa a citocompatibilidade in vitro do cpTi como demonstrado pela inibição da proliferação celular e da expressão do fenótipo osteoblástico

Experimental alveolitis in rats: microbiological, acute phase response and histometric characterization of delayed alveolar healing

The pathogenesis of alveolitis is not well known and therefore experimental situations that mimic some features of this disease should be developed. OBJECTIVE: In this study, the evolution of the experimentally induced infection in rat sockets is characterized, which leads to clinical signs of suppurative alveolitis with remarkable wound healing disturbs. MATERIAL AND METHODS: Non-infected (Group I) and experimentally infected sockets in Rattus novergicus (Group II) were histometrically evaluated regarding the kinetics of alveolar healing. In addition, the characterization of the present bacteria in inoculation material and the serum levels of C-reactive protein (CRP) were performed. The detected species were Capnocytophaga ochracea, Fusobacterium nucleatum ss nucleatum, Prevotella melaninogenica, Streptococcus anginosus, Treponema socranskii and Streptococcus sanguis. RESULTS: All experimentally infected rats developed suppurative alveolitis, showing higher levels of CRP in comparison to those non-infected ones. Furthermore, infected rats presented a significant delayed wound healing as measured by the histometric analysis (higher persistent polymorphonuclear infiltrate and lower density of newly formed bone). CONCLUSION: These findings indicate that rat sockets with experimentally induced infection produced higher levels of serum CRP, showing the potential of disseminated infection and a disturb in the alveolar repair process in an interesting experimental model for alveolitis studies

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

Systemic Trans- and Postoperative Evaluations of Patients Undergoing Dental Implant Surgery

OBJECTIVE: The aims of this study were to examine the trans- and postoperative systemic characteristics of patients undergoing dental implant surgery and to investigate the relationship between pre- and post- surgery anxiety levels. MATERIAL AND METHODS: Thirty-nine patients were analyzed in 3 call centers to determine anxiety levels, pain levels, and preoperative and postoperative histories using the State-Trait (STAI) questionnaire. RESULTS: A total of 93 dental implants were installed, with a success rate of 100%. The most frequently reported systemic disease was hypertension. There was a significantly higher rate of effective clamping (torque) to the mandibular bone than to the maxillary bone. The association between postoperative surgical complications and longer operative time was not significant, but there was a significant correlation between the alteration of mouth opening and daily routine activities and a significant decrease in anxiety levels between the day of surgery and the postoperative time point (p =0.006). CONCLUSION: A longer surgical time was associated with surgery-related complications and with a higher anxiety index on the preoperative evaluation

Repair of bone cavities in dog's mandible filled with inorganic bovine bone and bioactive glass associated with platelet rich plasma

The aim of this study was to evaluate the effect of platelet rich plasma (PRP) associated to bovine inorganic bone (Bio-Oss®; Geistlich) or bioactive glass (Bio-Gran®; Orthovita, Implant Innovations) on bone healing. Bone cavities were prepared in both sides of the mandible of 4 adult male dogs. The cavities were divided into 4 groups according to the filling material as follows: control, PRP, PRP/Bio-Oss, PRP/Bio-Gran. The animals were sacrificed after 120 days and histological and histomorphometrical analysis was performed. The control group showed 80.6% of bone formation in the longitudinal sections at 6 mm depth and 83.7% at 13 mm depth. The transverse sections displayed 74.2% at both 6 and 13 mm depths. The PRP group showed 21.1% of bone formation in the longitudinal sections at 6 mm depth, and 23.1% at 13 mm depth. The transverse sections presented 28.98% of bone formation at 6 mm depth and 41.2% at 13 mm depth. The PRP/Bio-Gran group showed 25.1% of bone formation in the longitudinal sections at 6 mm depth and 30.4% at 13 mm depth. In the transverse sections, the bone formation was 43.0% at 6 mm depth and 39.7% at 13 mm depth. The PRP/Bio-Oss group showed 35.5% of bone formation in the longitudinal sections at 6 mm depth and 42% at 13 mm depth. In the transversal sections, the bone formation was 26.8% and 31.2% at the depths of 6 and 13 mm, respectively. PRP alone or associated with bovine inorganic bone or bioglass had no significant effect in bone healing

Cutaneous healing after topical application of nebacetin and gingilone to infected wounds. Clinical and histological study in rats

It was performed a study to examine the cutaneous cicatrization of infected wound of skin after daily topic application of Nebacetin and Gingilone. Following clinical observations the animals were sacrificed after 4, 10 and 17 post-operative days. The pieces were treated, analyzed, in an optical microscope. The topic application of Nebacetin showed to be more efficient in the epithelial reparation comparatively to the Gingilone and control group

Reconstruction of alveolar bone defect with autogenous bone particles and osseointegrated implants: histologic analysis and 10 years monitoring

Maintaining the volume of the alveolar process after extraction can be achieved by immediate implant placement and guided bone regeneration, with or without the use of biomaterials. The authors present a case report with a 10 years follow-up, rehabilitation using osseointegrated implants in the extraction area and maintenance of the volume of the alveolar process with autogenous cortical bone shavings