Comparison of Biomaterial Implants in the Dental Socket: Histological Analysis in Dogs

Background:Bone graft procedures have been used commonly in buco-maxillo-facial surgery. For this reason, many researchers have evaluated the bone substitutes.Purpose:The present study evaluated soft and hard tissue reactions to two different hydroxyapatites HAs (synthetic HA and natural HA) and bioactive glass implanted into the sockets immediately after extraction.Materials and Methods:First and third upper and lower premolars, on both sides, were extracted from six female dogs. The alveolar sockets were randomly assigned to four groups: Group 1 - control (unfilled), Group 2 - filled with synthetic hydroxyapatite, Group 3 - filled with bovine bone mineral (natural HA), and Group 4 - filled with bioactive glass. The animals were euthanized at 4 weeks (n = 2), 8 weeks (n = 2), and 28 weeks (n = 2) after extraction. The mandible and maxilla of each animal were removed for histological analysis to determine soft tissue reactions, newly formed bone, bone characteristics, and presence or absence of implanted materials.Results:Most particles of synthetic hydroxyapatite had bone formation on their surface, although some particles showed a layer of fibrous connective tissue. The bovine bone mineral group exhibited particles partially replaced with bone formation. The bioactive glass group showed particles with a thin layer of calcified tissue, but was absent in some specimens, suggesting complete resorption.Conclusion:All biomaterials had similar behavior. Bovine bone mineral, compared to synthetic hydroxyapatite and bioactive glass, showed a larger number of particles covered with osseous tissue. All biomaterials interfered with the socket repair process.

Development and application of methods for determination of residual monomer in dental acrylic resins using high performance liquid chromatography

Two high-performance liquid chromatographic methods for determination of residual monomer in dental acrylic resins are described. Monomers were detected by their UV absorbance at 230 nm, on a Nucleosil((R)) C-18 (5 mu m particle size, 100 angstrom pore size, 15 x 0.46 cm i.d.) column. The separation was performed using acetonitrile-water (55:45 v/v) containing 0.01% triethylamine (TEA) for methyl methacrylate and butyl methacrylate, and acetonitrile-water (60:40 v/v) containing 0.01% TEA for isobutyl methacrylate and 1,6-hexanediol dimethacrylate as mobile phases, at a flow rate of 0.8 mL/min. Good linear relationships were obtained in the concentration range 5.0-80.0 mu g/mL for methyl methacrylate, 10.0-160.0 mu g/mL for butyl methacrylate, 50.0-500.0 mu g/mL for isobutyl methacrylate and 2.5-180.0 mu g/mL for 1,6-hexanediol dimethacrylate. Adequate assay for intra- and inter-day precision and accuracy was observed during the validation process. An extraction procedure to remove residual monomer from the acrylic resins was also established. Residual monomer was obtained from broken specimens of acrylic disks using methanol as extraction solvent for 2 h in an ice-bath. The developed methods and the extraction procedure were applied to dental acrylic resins, tested with or without post-polymerization treatments, and proved to be accurate and precise for the determination of residual monomer content of the materials evaluated. Copyright (c) 2005 John Wiley & Sons, Ltd.

Filling of extraction sockets with autogenous bone in cats

OBJETIVO: Avaliar a regeneração óssea de alvéolos dentais de gatos após enxertia. MÉTODOS: Dezoito gatos adultos, distribuídos em três grupos de 6 animais cada, foram submetidos a extração do canino mandibular direito ou esquerdo. No grupo 1, controle, o alvéolo foi deixado vazio. No grupo 2, o alvéolo foi preenchido com osso esponjoso autógeno do osso ilíaco e no grupo 3, com raspa de osso cortical do osso ilíaco. Os animais foram submetidos à eutanásia 6 semanas após a cirurgia. RESULTADOS: Nas radiografias realizadas no pós-operatório imediato na projeção ventrodorsal observou-se uma área de radiolucência correspondente ao local da alveolectomia e extração dentária. Diminuição da radiolucência foi verificada nas radiografias realizadas seis semanas após a cirurgia. Nos cortes histológicos verificou-se a presença de trabéculas ósseas. A porcentagem de tecido ósseo esponjoso presente nos alvéolos dentais foi quantificada por exames histométricos. Não houve diferença estatisticamente significante entre os grupos (Teste de Kruskal-Wallis p > 0.05) (grupo 1: 52,54 ± 15,4; grupo 2: 50,51 ± 5,01; grupo 3: 51,85 ± 9,52). CONCLUSÃO: Os alvéolos dentais de gatos preenchidos com osso esponjoso autógeno ou raspa de osso cortical autógeno apresentaram regeneração óssea similar àquela observada no grupo controle, após um período de observação de seis semanas.

Histologic study of use of microfibrillar collagen hemostat in rat dental sockets

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Response of human dental pulp to dentin adhesive systems

Many in vivo studies have stated that the response of the dentin/pulp complex does not depend on the dental material used as the liner or pulp-capping agent. However, several in vitro studies have reported the metabolic cytotoxic effects of resin components applied to fibroblast and odontoblast cell lines. The aim of this study was to evaluate the human pulp response following direct pulp capping with current bonding agents and calcium hydroxide (CH). Sound premolars scheduled for orthodontic extraction had their pulp tissue mechanically exposed. After hemorrhage control and total acid conditioning, the experimental bonding agents, including All Bond 2, Scotchbond MP-Plus, Clearfil Liner Bond 2, and Prime & Bond 2.1 were applied on the pulp exposure site. CH saline paste was used as the control pulp-capping agent. All cavities were restored with Z-100 resin composite according to the manufacturer's instructions. Following extractions, the teeth were processed for microscopic evaluation. In the short term, the bonding agents elicited a moderate inflammatory pulp response with associated dilated and congested blood vessels adjacent to the pulp exposure site. A mild inflammatory pulp response was observed when Clearfil Liner Bond 2 or CH was applied on the pulp exposures. With time, macrophages and giant cells engulfing globules and components of all experimental bonding agents displaced into the pulp space were seen. This chronic inflammatory response did not allow complete pulp repair, which interfered with the dentin bridge formation. Pulp exposures capped with CH exhibited an initial organization of elongated pulp cells underneath the coagulation necrosis. CH stimulated early pulp repair and dentin bridging that extended into the longest period. The bonding agents evaluated in the present study cannot be recommended for pulp therapy on sound human teeth.

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)

Application of propolis to dental sockets and skin wounds.

The purpose of this study was to examine histologically the effects of propolis topical application to dental sockets and skin wounds. After topical application of either a 10% hydro-alcoholic solution of propolis or 10% hydro-alcoholic solution alone, cutaneous wound healing and the socket wound after tooth extraction were examined. The rats were sacrificed at 3, 6, 9, 15 and 21 days after the operation. The specimens were subjected to routine laboratory studies after staining with hematoxylin and eosin. It was concluded that topical application of propolis hydro-alcoholic solution accelerated epithelial repair after tooth extraction but had no effect on socket wound healing.

Influence of different types of non-resorbable suture material on the healing of extraction wounds--a histological study in rats.

The influence of different non-resorbable suture materials on the healing of tooth extraction wounds was examined in 120 adult male albino rats. Nylon gave the best biological results for healing of the mucosa and dental socket. Silk and cotton produced considerable delay of socket healing. Healing was only mildly delayed by polyester suture, with a short moderate inflammatory reaction at the initial stage.

Efeitos da estimulação ultra-sônica sobre o processo de reparo em ferida de extração dental: estudo histológico em ratos.

The effects of ultrasound on the wound healing process after teeth extractions were studied histologically. The right upper incisor was extracted in 56 rats. They were divided into 2 groups, one control (I) and one experimental (II). Group II received ultrasound stimulation that was applied with the frequency of repetition of 1,000 Hz and pulse length of 2,000 us continuously, during five minutes daily since the extraction day until 24 hours before the death. The rats were sacrificed at 3, 6, 9, 12, 15, 18, and 21 postoperative days. The results showed a precocious granulation tissue formation, faster remodeling of osseous ridges, and consequently acceleration of the alveolar wound healing process.

Loss of space and dental arch length after the loss of the lower first primary molar: A longitudinal study

The premature loss of primary teeth may harm the normal occlusal development, although there are debates relating to the necessity of using space maintainer appliances. The aim of the study is to evaluate the changes in the dental arch perimeter and the space reduction after the premature loss of the lower first primary molar in the mixed dentition stage. The sample consists of 4 lower arch plaster models of 31 patients, within the period of pre-extraction, 6, 12 and 18 months after the lower first primary molar extraction. A reduction of space was noted with the cuspid dislocation and the permanent incisors moving toward the space of the extraction site. It was concluded that the lower first molar primary premature loss, during the mixed dentition, implicates an immediate placement of a space maintainer.

Experimental peri-implant tissue breakdown around different dental implant surfaces: Clinical and radiographic evaluation in dogs

Purpose: Tissue reactions to 4 different implant surfaces were evaluated in regard to the development and progression of ligature-induced peri-implantitis. Materials and Methods: In 6 male mongrel dogs, a total of 36 dental implants with different surfaces (9 titanium plasma-sprayed, 9 hydroxyapatite-coated, 9 acid-etched, and 9 commercially pure titanium) were placed 3 months after mandibular premolar extraction. After 3 months with optimal plaque control, abutment connection was performed. Forty-five days later, cotton ligatures were placed around the implants to induce peri-implantitis. At baseline and 20, 40, and 60 days after placement, the presence of plaque, peri-implant mucosal redness, bleeding on probing, probing depth, clinical attachment loss, mobility, vertical bone loss, and horizontal bone loss were assessed. Results: The results did not show significant differences among the surfaces for any parameter during the study (P > .05). All surfaces were equally susceptible to ligature-induced peri-implantitis over time (P < .001). Correlation analysis revealed a statistically significant relationship between width of keratinized tissue and vertical bone loss (r 2 = 0.81; P = .014) and between mobility and vertical bone loss (r 2 = 0.66; P = .04), both for the titanium plasma-sprayed surface. Discussion and Conclusions: The present data suggest that all surfaces were equally susceptible to experimental peri-implantitis after a 60-day period.

Densitometric analysis of the autogenous demineralized dentin matrix on the dental socket wound healing process in humans

The aim of this study was to evaluate the effects of the autogenous demineralized dentin matrix (ADDM) on the third molar socket wound healing process in humans, using the guided bone regeneration technique and a polytetrafluoroethylene barrier (PTFE). Twenty-seven dental sockets were divided into three groups: dental socket (Control), dental socket with PTFE barrier (PTFE), and dental socket with ADDM slices associated to PTFE banier (ADDM + PTFE). The dental sockets were submitted to radiographic bone densitometry analysis and statistical analysis on the 15th, 30th, 60th and 90th days using analysis of variance (ANOVA) and Tukey's test (p ≤ 0.05). The radiographic analysis of the ADDM + PTFE group showed greater homogeneity of bone radiopacity than the Control group and the PTFE group, during all the observation times. The dentin matrix gradually disappeared from the dental socket during the course of the repair process, suggesting its resorption during the bone remodeling process. It was concluded that the radiographic bone density of the dental sockets treated with ADDM was similar to that of the surrounding normal bone on the 90th day. The ADDM was biocompatible with the bone tissue of the surgical wounds of human dental sockets. The radiographic analysis revealed that the repair process was discreetly faster in the ADDM + PTFE group than in the Control and PTFE groups, although the difference was not statistically significant. In addition, the radiographic image of the ADDM + PTFE group suggested that its bone architecture was better than that of the Control and PFTE groups.

Oral myofunctional and electromyographic evaluation of the anterior suprahyoid muscles and tongue thrust in patients with class II/1 malocclusion submitted to first premolar extraction

Objective: The aim of this study was to assess the existence of myofunctional alterations before and after first premolar extraction in Class II/1 malocclusion patients that could endanger the long-term dental arch stability. Materials and Methods: The study was performed by means of morphological, functional and electromyographic analyses in 17 Class II/1 malocclusion patients (group T) and 17 Class I malocclusion patients (group C), both groups with 12-30-year age range (mean age: 20.93 ± 4.94 years). Results: Data analyzed statistically by Student's t-test showed a significant decrease in the maxillary and mandibular dental arch perimeters after orthodontic treatment (p<0.05). The Kruskal-Wallis test analyzed data from tongue posture at rest and during swallowing, not showing significant differences after treatment (groups Tb and Ta) (p>0.05). However, group T differed significantly from group C (p<0.05). The electromyographic data showed that the anterior right and left suprahyoid muscles acted synergistically in both groups, while having a lower myoelectric activity in group T during swallowing. Conclusions: Myofunctional alterations observed after the orthodontic treatment in Class II/1 malocclusion seemed to jeopardize the long-term orthodontic stability, making recurrence possible. Further research should be conducted to compare electromyographic data before and after orthodontic treatment in order to corroborate the results of the present investigation.