Reconstructive periodontal therapy with simultaneous ridge augmentation. A clinical and histological case series report

Treatment of intrabony periodontal defects with a combination of a natural bone mineral (NBM) and guided tissue regeneration (GTR) has been shown to promote periodontal regeneration in intrabony defects. In certain clinical situations, the teeth presenting intrabony defects are located at close vicinity of the resorbed alveolar ridge. In these particular cases, it is of clinical interest to simultaneously reconstruct both the intrabony periodontal defect and the resorbed alveolar ridge, thus allowing insertion of endosseous dental implants. The aim of the present study was to present the clinical and histological results obtained with a new surgical technique designed to simultaneously reconstruct the intrabony defect and the adjacently located resorbed alveolar ridge. Eight patients with chronic advanced periodontitis displaying intrabony defects located in the close vicinity of resorbed alveolar ridges were consecutively enrolled in the study. After local anesthesia, mucoperiosteal flaps were raised, the granulation tissue removed, and the roots meticulously scaled and planed. A subepithelial connective tissue graft was harvested from the palate and sutured to the oral flap. The intrabony defect and the adjacent alveolar ridge were filled with a NBM and subsequently covered with a bioresorbable collagen membrane (GTR). At 11–20 months (mean, 13.9 ± 3.9 months) after surgery, implants were placed, core biopsies retrieved, and histologically evaluated. Mean pocket depth reduction measured 3.8 ± 1.7 mm and mean clinical attachment level gain 4.3 ± 2.2 mm, respectively. Reentry revealed in all cases a complete fill of the intrabony component and a mean additional vertical hard tissue gain of 1.8 ± 1.8 mm. The histologic evaluation indicated that most NBM particles were surrounded by bone. Mean new bone and mean graft area measured 17.8 ± 2.8% and 32.1 ± 8.3%, respectively. Within their limits, the present findings indicate that the described surgical approach may be successfully used in certain clinical cases to simultaneously treat intrabony defects and to reconstruct the resorbed alveolar ridge

Filling of extraction sockets of feline maxillary canine teeth with autogenous bone or bioactive glass

PURPOSE: To evaluate bone healing in the extraction socket of the feline maxillary canine tooth after grafting.METHODS: Eighteen adult cats were submitted to unilateral extraction of maxillary canine tooth and divided into three groups. In group 1 (n=6), control, the extraction socket was left empty. In group 2 (n=6), the extraction socket was filled with autogenous cancellous bone from the iliac crest and in group 3 (n=6), with bioactive glass particulate material. Cats were euthanized at four weeks postoperative.RESULTS: The radiographic examinations performed four weeks after surgery showed that in all groups the healing process converged to a radiopacity similar to that observed in the surrounding bones. Histological examination showed formation of woven bone within the extraction socket. The percentage of newly formed bone within the extraction socket, measured by the histometry, showed no statistically significant difference among the values of the three groups (Kruskal-Wallis'test p>0.05) (group 1: 63.96 +/- 5.85, group 2: 66.84 +/- 11.67, group 3: 59.28 +/- 15.50).CONCLUSION: The bone regeneration observed in the extraction sockets filled with autogenous cancellous bone or bioactive glass was similar to that observed in the control sites, given an observation period of four weeks after extraction of the maxillary canine tooth.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação para o Desenvolvimento da UNESP (FUNDUNESP)Sao Paulo State Univ, Dept Clin Surg & Anim Reprod, UNESP, Aracatuba, SP, BrazilUNESP, Dept Clin Surg & Anim Reprod, Aracatuba, SP, BrazilUNESP, Dept Biosci Prod & Anim Hlth, Aracatuba, SP, BrazilSao Paulo State Univ, Dept Clin Surg & Anim Reprod, UNESP, Aracatuba, SP, BrazilUNESP, Dept Clin Surg & Anim Reprod, Aracatuba, SP, BrazilUNESP, Dept Biosci Prod & Anim Hlth, Aracatuba, SP, Brazi

Track D Social Science, Human Rights and Political Science

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138414/1/jia218442.pd

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival

Bone augmentation in rabbit calvariae: comparative study between Bio-Oss® and a novel B-TCP/DCPD granulate

Aim: In the present in vivo study, we compare the bone regeneration capacity of a novel brushite cement synthesized in our laboratory (DTG) with Bio-Oss® using rabbits as an animal model. Methods: The study was performed in a group of 14 adult New Zealand rabbits using the bone conduction model. Two titanium cylinders were fixed into perforated slits made on the parietal cortical bone of each rabbit. One cylinder was left empty (negative control) and the other was filled with either Bio-Oss® or brushite set cement granules (test cylinder). Four weeks after the intervention, the animals were sacrified and biopsies were taken. The following parameters were analysed: bone tissue augmentation, bone mineral density and biomaterials resorption. The comparison of data between the different groups was performed using the Mann-Whitney test with a significance level of p<0.05. Results: The mean bone mineral density and augmented mineral tissue inside the test cylinders were similar but higher than those of negative controls. Material resorption and bone tissue augmentation were significantly higher in the defects treated with the brushite-based set cement (p<0.05). Conclusions: Brushite cement granules were more resorbable and generated more bone tissue than Bio-Oss® inside the titanium cylinders placed in the rabbit calvaria