Hydroxyapatite/beta-tricalcium phosphate and enamel matrix derivative for treatment of proximal class II furcation defects: a randomized clinical trial

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Objective To clinically evaluate proximal furcations treated with hydroxyapatite/-tricalcium phosphate (HA/-TCP) isolated or combined with enamel matrix derivative (EMD). Material and Methods Thirty patients, presenting at least one proximal class II furcation defect, probing pocket depth (PPD) 5mm and bleeding on probing, were included. The defects were assigned to the HA/-TCP group (n=15); open-flap debridement (OFD)+HA/-TCP filling, or, HA/-TCP-EMD group (n=15); OFD+HA/-TCP+EMD filling. Plaque (PI) and gingival index (GI), PPD, relative gingival margin position (RGMP), vertical and horizontal attachment level (RVAL and RHAL), vertical and horizontal bone level (RVBL and RHBL), and furcation diagnosis were evaluated at baseline and at 6months. Results Both groups presented improvements after therapies (p0.05). At 6months, the gains in rVCAL in the HA/-TCP and HA/-TCP-EMD groups were 1.47 +/- 0.99 and 2.10 +/- 0.87mm, while the RHCAL gains were 1.47 +/- 1.46 and 1.57 +/- 1.58mm (p>0.05). The RVBL and RHBL gains for the HA/-TCP and HA/-TCP-EMD group were 1.47 +/- 1.13 and 1.70 +/- 1.26mm, and 1.90 +/- 1.11 and 1.70 +/- 1.37mm respectively (p>0.05). The HA/-TCP-EMD group showed seven closed furcations versus four in the HA/-TCP group (p>0.05). Conclusion Both treatments lead to improvements in all clinical variables studied in the present trial. However, the closure of proximal class II furcation defects is still unpredictable.403252259Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)FAPESP [08/56358-2

Effect of autologous bone marrow-derived cells associated with guided bone regeneration or not in the treatment of pen-implant defects

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)This study investigated the effect of bone marrow-derived cells associated with guided bone regeneration in the treatment of dehiscence bone defects around dental implants. Iliac-derived bone marrow cells were harvested from dogs and phenotypically characterized with regard to their osteogenic properties. After teeth extraction, three implant sites were drilled, dehiscences created and implants placed. Dehiscences were randomly assigned to: bone marrow-derived cells, bone marrow-derived cells + guided bone regeneration, and control (no treatment). After 3 months, implants with adjacent tissues were processed histologically, bone-to-implant contact, bone fill within the threads, new bone area in a zone lateral to the implant, new bone height, and new bone weight at the bottom of the defect were determined. Phenotypic characterization demonstrated that bone marrow-derived cells presented osteogenic potential. Statistically higher bone fill within the threads was observed in both bone marrow-derived cells + guided bone regeneration bone marrow-derived cell groups compared with the control group (P 0.05). For the other parameters (new bone area, bone-to-implant contact, new bone height and new bone weight), only the bone marrow-derived cells + guided bone regeneration group presented higher values compared with the non-treated control (P < 0.05). Bone marrow-derived cells provided promising results for peri-implantar bone regeneration, although the combined approach seems to be relevant, especially to bone formation out of the implant threads.411121127Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)FAPESP [07/55596-4, 06/59431-7]CNPq [303693/2009-6

Peri-implant reconstruction using autologous periosteum-derived cells and guided bone regeneration

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)P>Aim This investigation evaluated the bone healing in peri-implant defects treated with periosteum-derived cells (PCs) and guided bone regeneration (GBR). Material and Methods PCs were harvested from six beagle dogs and characterized in vitro with regard to their osteogenic properties. The animals were subjected to teeth extraction in the mandible, and after 3 months of healing, implant sites were drilled, bone dehiscences were created and implants were placed. Dehiscences were randomly assigned to: PCs+GBR, GBR, PCs and non-treated defects. After 3 months, the implants/adjacent tissues were processed. Bone-to-implant contact (BIC) bone fill (BF) within implant threads, and bone area (BA) in a zone lateral to the implant were obtained. Results In vitro analyses confirmed the osteogenic potential of PCs. Histometrically, no statistically significant differences were observed among the PCs+GBR, GBR and PCs groups for both BF and BIC (p > 0.05), whereas these groups showed statistically higher values, as compared with the non-treated group (p < 0.05). With respect to BA, the PCs+GBR and GBR groups presented significantly higher means, as compared with the PCs and non-treated groups (p < 0.05). Conclusion Although successful outcomes have been promoted by using the combined approach, PCs in conjunction with membranes did not provide additional benefit during peri-implant bone regeneration, when compared with the therapeutic approaches used alone.371211281136Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)FAPESP [Proc. 07/55596-4, 06/59431-7

Periosteum-Derived Cells as an Alternative to Bone Marrow Cells for Bone Tissue Engineering Around Dental Implants. A Histomorphometric Study in Beagle Dogs

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Background: The aim of this study is to investigate the potential use of periosteum-derived cells (PCs) for tissue engineering in pen-implant defects. Methods: Bone marrow cells (BMCs) and PCs were harvested from seven adult beagle dogs, cultured in vitro, and phenotypically characterized with regard to their osteogenic properties. The animals were then subjected to teeth extraction, and 3 months later, two implant sites were drilled, bone dehiscences created, and dental implants placed. Dehiscences were randomly assigned to one of two groups: PCs (PCs + carrier) and BMCs (BMCs + carrier). After 3 months, the animals were sacrificed and the implants with adjacent hard tissues were processed for undecalcified sections. Bone-to-implant contact, bone fill within the limits of implant threads, and new bone area in a zone lateral to the implant were histometrically obtained. Results: In vitro, phenotypic characterization demonstrated that both cell populations presented osteogenic potential, as identified by the mineral nodule formation and the expression of bone markers. Histometrically, an intergroup analysis showed that both cell-treated defects had similar bone fill within the limits of implant threads and bone-to-implant contact (P>0.05), and although a trend toward higher new bone area values was found for the PC group, there was no significant difference between the experimental groups (P>0.05). Conclusions: Periosteal and bone marrow cells presented a similar potential for bone reconstruction. As such, periosteum may be considered as an alternative source of osteogenic cells in implant dentistry. J Periodontol 2010;81:907-916.816907916Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)FAPESP [07/55596-4, 06/59431-7