Efeito do estresse crônico e benzodiazepínicos no reparo ósseo: estudo histológico em ratos

Stress is an environmental factor that may predispose individuals to depression. Benzodiazepines have been prescribed as effective drugs in these situations. The purpose of this study was histological evaluate of the effect of chronic stress and benzodiazepine drugs on bone healing. Bone cavities were created in both tibias of 40 male rats were divided into two groups: Control and Treaty. In this, the stressor stimulus was applied 40 days pre-operative and all post-operative days until sacrifice in the morning for 2 hours, by immobilizing restraint. These animals also received diazepam benzodiazepine group, daily, at a concentration of 5mg/Kg/peso body within 15 days of preoperative. In groups of five animals were sacrificed at 7, 14, 30 and 60 days post-surgery. At 7 days postoperatively, while the control group exhibited tissue rich in fibroblasts, the treated group showed newly formed tissue with few fibroblasts and capillaries along with lymphocytes and macrophages. At 14 days postsurgery, the control group showed newly formed trabecular bone while the treated group progressed to thin trabecular bone with numerous osteoblasts on their borders. At 30 days post-operative bone healing is complete in both groups. At 60 days post-operative characteristics observed in the treated and control groups are similar to the previous period, but with more advanced osteogenesis.

Avaliação longitudinal de duas técnicas de sinus lift

The implant has high success rates and predictability in this decade. However, bone availability is a factor that may limit the installation technique of dental implants in subsequent rehabilitation of the maxillary arch has been proposed technique’s maxillary sinus lifting when it presents itself pneumatized, for installation of dental implants The aim of this paper is to present two clinical cases using the surgical technique and rehabilitation to the patient with surgery maxillary sinus lifting with the use of a biomaterial alone or in combination with autogenous bone and the prosthetic resolution radiographic and clinical follow-up of three years.

Solução estética para prótese sobre implante

Próteses sobre implantes esteticamente favoráveis estão diretamente relacionadas com a condição dos tecidos moles e duros que as envolvem. A preservação dos tecidos mucogengivais ao redor de implantes dentários instalados na maxila anterior propicia um sorriso harmonioso, com uma estética bastante agradável. No entanto, em alguns casos, isso não ocorre principalmente pela grande reabsorção tecidual na região, na qual deveria ter sido realizado enxerto ósseo, antes mesmo da instalação dos implantes. Desse modo, o objetivo deste trabalho foi apresentar uma solução reabilitadora estética para essas possíveis falhas durante o planejamento com reabilitações sobre implantes, por meio de gengiva artificial cerâmica.

O impacto das próteses implantosuportadas na harmonia facial

Many patients seeking dental care wish to improve facial and smile aesthetics to be accepted in modern day society. In denture wearers, the physiological resorption causes atrophy mainly in the maxilla, being necessary to carry out reconstruction techniques and sometimes orthognathic surgery to improve occlusal stability and facial harmony. The aim of this study is to discuss the features related to the rehabilitation of edentulous patients with indication for reconstruction of the maxilla using bone grafts and orthognathic surgery by means of a clinical case. In the present case, after the prosthetic rehabilitation, the patient was full satisfied with obtained results and dismissed the initially proposed surgical protocol. Therefore, professionals should provide therapeutic options but the patient’s opinion should prevail provided its clinical feasibility.

Efeito do ácido tranexâmico associado à cola de fibrina sobre o reparo ósseo: estudo histológico em ratos

The bone repair process is controlled by complex molecular mechanisms that involve systemic and local factors. Fibrin glue is derived from human plasma and mimics the final pathway of coagulation network. Tranexamic acid inhibits fibrinolysis and prevents or decreases the formation of degradation products of fibrin and fibrinogen. The purpose of this study was to evaluate histologically in rats the effect of tranexamic acid associated with the fibrin glue on bone healing. The experiment used 60 (n = 5) male rats in: GI: Control, GII: fibrin glue, GIII tranexamic acid and GIV /fibrin glue/tranexamic acid. Bone defect (2.5mm diameter) was created in right tibia. The animals were euthanized at 7,14 and 30 days postoperatively, and the pieces were processed with hematoxylin and eosin. The results showed at 7 days post-operative surgical cavity filled with dense connective tissue rich in fibroblasts, permeated by delicate neoformed bone trabeculae in percentage of 70-80% for GI, GII and GIII and GIV to 94.8%. At 14 days post-operative newly formed bone was found between 75-85% for GI, GII and GIII and percentage above 95% for GIV. At 30 days postoperative GI and GIV showed 95-100% of mature bone tissue; GII and GIII in percentage close to 80-90%. Based on the results and methodology is concluded that fibrin / tranexamic acid glue association has positive action on bone repair.

Granuloma periférico de células gigantes: relato de caso

The peripheral giant cell granuloma (GPCG) is defined as a benign disorder of uncertain etiopathogenesis and proliferative reaction of the fibrous connective tissue or periosteum, which is characterized histologically by the presence of multinucleated giant cells. The purpose of this study is to report a case of GPCG in a 56-year-old white woman presenting a bleeding nodule on palpation, a red color with small whitish ulcerated areas, defined limits, resilient consistency, a pedicled base 2.0 cm in diameter, asymptomatic, involving the permanent lower left third molar, which presented mobility. Radiographically there was significant bone loss in this tooth region, whose initial diagnosis was pyogenic granuloma. The definitive diagnosis was obtained after excisional biopsy the microscopic examination of which identified the presence of multinucleated giant cells. The clinical postoperative follow-up revealed a favorable cicatricial repair of the operated area with no recurrence after 9 months of monitoring.

Granuloma Periférico de Células Gigantes: Relato de caso com acompanhamento de 2 anos

The peripheral giant cell granuloma (GPCG) is defined as a benign disorder of uncertain etiopathogenesis, and proliferative reaction of the fibrous connective tissue or the periosteum, which is characterized histologically by the presence of multinucleated giant cells. The purpose of this study is report a case of GPCG in a white women, with 56 years old, presenting nodule bleeding to the touch, red and white with small ulcerated areas, defined limits, resilient consistency, pedicled base with 2.0 cm diameter, asymptomatic, involving the permanent lower left third molar, that it was presented with mobility. Radiographically there was significant bone loss in this tooth region, whose initial diagnosis was pyogenic granuloma. The definitive diagnosis was obtained after excisional biopsy in which microscopic examination it was identified e presence of multinucleated giant cells. The clinical postoperative presented favorable cicatricial repairing of the operated area without recurrence after two years of monitoring.

Root reconstructed with mineral trioxide aggregate and guided tissue regeneration in apical surgery: a 5-year follow-up

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Reação de tecido subcutâneo ao cimento Portland modificado (CPM)

Introdução: o objetivo do estudo foi avaliar a resposta do tecido subcutâneo de ratos a implantes de tubos de polietileno com cimento Portland modificado (CPM) (EGEO S.R.L., Buenos Aires, Argentina) comparado com o MTA Angelus® (Angelus, Londrina/PR). Métodos: esses materiais foram colocados em tubos de polietileno e implantados no tecido conjuntivo dorsal de ratos Wistar por 7, 15, 30, 60 e 90 dias. Os espécimes foram preparados e corados com hematoxilina e eosina ou Von Kossa, ou não corados por luz polarizada. Foram realizadas avaliações quantitativas e qualitativas das reações. Resultados: ambos os materiais causaram reações moderadas em 7 dias, decaindo com o tempo. O MTA Angelus causou reações leves em 15 dias, decaindo com o tempo. A resposta foi similar ao controle em 30, 60 e 90 dias com CPM e MTA Angelus. Foram observadas mineralização e granulações birrefringentes à luz polarizada em ambos os materiais. Conclusões: foi possível concluir que o CPM e o MTA Angelus foram biocompatíveis em modelo de rato e estimularam a mineralização.

Lymphoepithelial cyst in jugal mucosa

Mouth lymphoepithelial cyst is rare, with few cases reported in literature. The aim of this article is to describe a clinical case, focusing on clinical and diagnostic aspects, treatment and prognosis. The lesion was one year old and had developed as a fibrous nodule in the jugal mucosa of a 71-year-old leucoderma patient. Considering focal inflammatory fibrous hyperplasia, fibroma and mucocele as differential diagnosis, excisional biopsy was carried out. A cystic cavity limited by pseudostratified epithelium without projections into the conjunctive tissue, with lymphoid tissue within, was microscopically identified. Without postoperative adverse events, the one-year clinical followup confirmed the favorable prognosis of this kind of lesion.

Bone defect repair on the alveolar wall of the maxillary sinus using collagen membranes and temporal fascia: an experimental study in monkeys

Few studies has been done using guided bone regeneration in maxillary sinus defects. AIM: To assess the bone repair process in surgical defects on the alveolar wall of the monkey maxillary sinus, which communicates with the sinus cavity, by using collagen membranes: Gen-derm - Genius Baumer, Pro-tape - Proline and autologous temporal fascia. MATERIALS AND METHODS: In this prospective and experimental study, orosinusal communications were performed in four tufted capuchin monkeys (Cebus apella) and histologic analysis was carried out 180 days after. RESULTS: In the defects without a cover (control), bone proliferation predominated in two animals and fibrous connective tissue predominated in the other two. In defects repaired with a temporal fascia flap, fibrous connective tissue predominated in three animals and bone proliferation predominated in one. In the defects repaired with Gen-derm or Pro-tape collagen membranes there was complete bone proliferation in three animals and fibrous connective tissue in one. CONCLUSIONS: Surgical defect can be repaired with both bone tissue and fibrous connective tissue in all study groups; collagen membranes was more beneficial in the bone repair process than temporal fascia or absence of a barrier.

Avaliação clínica e radiográfica de pacientes submetidos ao levantamento da membrana do seio maxilar

Implant dentistry is a dental specialty which presents great predictability in the rehabilitation at posterior, partially edentulous maxillary areas. Early tooth loss results in significant jaw remodeling. The maxillary sinus lifting followed by implant placement is a predictable technique initially described in 1980. Since then, several different techniques have been investigated varying filling materials and the management of complications in order to provide effective guidance in the rehabilitation of these patients. The current study evaluated ten patients who underwent sinus lifting before implant placement and crown installation. First, a retrospective analysis of the medical records was conducted to obtain information about possible postoperative complications. Clinical and radiographic analyses were performed at baseline and 180 days after surgeries. The sinus lifting with immediate implant placement provided satisfactory outcomes and can be considered a safe procedure. Treatment predictability was demonstrated in 90% of patients and for 86.96% of implants placed. It is important to highlight knowledge of anatomical structures at this area, the use of delicate surgical techniques, and strict patient follow-up.

Reabilitação de maxila atrófica com tecido ósseo homógeno e prótese fixa implantossuportada

The techniques of bone reconstruction for atrophic maxillae have been improved in order to promote bone tissue growth in both height and thickness. The grafts performed with use of autogenous bone is considered the gold standard by most researchers, for demonstrating osteogenic capacity and not to promote antigenic response. However, this type of grafting is not possible to get bone tissue in large quantity for extensive renovations. In recent years, alternatives have been researched to overcome the limitations of autogenous bone. Several alternatives have been investigated to supply the disadvantages of autogenous bone grafts. In such studies, allogeneic bone grafts which are obtained from individuals with different genetic load, but from the same species have been extensively used. They can be indicated in cases of arthrosplasty, surgical knee reconstruction, and large bone defects as well as in oral and maxillofacial reconstruction. Besides showing great applicability and biocompatibility, this type of bone is available in unlimited quantities. To rehabilitate atrophic maxillae an option that has been performed with high success rate is the reconstruction with bone graft followed by osseointegrated dental implants to rehabilitate the patient aesthetics and functionally. This paper aims to show the feasibility of allogenic bone as material for reconstruction of atrophic maxilla, and subsequent rehabilitation with metal ceramic fixed prosthesis implant and dental restoration with accompanying three years through literature review and clinical case report.

O impacto das próteses implantossuportadas na harmonia facial

Many patients seeking dental care wish to improve facial and smile aesthetics to be accepted in modern day society. In denture wearers, the physiological resorption causes atrophy mainly in the maxilla, being necessary to carry out reconstruction techniques and sometimes orthognathic surgery to improve occlusal stability and facial harmony. The aim of this study is to discuss the features related to the rehabilitation of edentulous patients with indication for reconstruction of the maxilla using bone grafts and orthognathic surgery by means of a clinical case. In the present case, after the prosthetic rehabilitation, the patient was full satisfied with obtained results and dismissed the initially proposed surgical protocol. Therefore, professionals should provide therapeutic options but the patient’s opinion should prevail provided its clinical feasibility.

Estudo retrospectivo de implantes osseointegrados instalados imediatamente após exodontias

Objectives: to evaluate implant survival immediately placed after tooth extraction considering different sites, prosthodontic modalities, and the need for biomaterials. Material and methods: dental records of 500 patients treated with dental implants between 2004 and 2011 were screened. Results: only 200 records (20%) corresponded to immediate implants. Reasons for tooth extraction included extensive caries, bone loss, and root fractures. From the 197 immediate dental implants, 86 were placed in the maxilla with a survival rate of 93.9% and 111 in the mandible (survival rate of 99.1%). The overall survival rate was 97.46%. Prosthodontic modalities identified were: Brånemark classic complete denture screwed prostheses (36%), overdentures (5.6%), fixed partial denture (31%), and single-tooth prostheses (27.4%). Also, it was observed that in 33% of cases there was a need for the use of grafts and/or biomaterials. Conclusion: it can be concluded that, when correctly indicated, immediate implants are an excellent choice. The anterior mandibular region, screwed and overdenture-type prostheses presented higher success rates when associated to immediate implant placement. The need for bone graft/biomaterial does not affect the clinical results.