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Inorganic bovine bone matrix (IBBM) is a biomaterial with proven osteoconductive functionalities. The objective of this study was to assess the in vivo bone regeneration functionalities of IBBM modified or not by an experimental MOE in sheep. MOE synthesis was performed by suspending nacre particles (0.05 g, diameters < 0.01 mm) in anhydrous acetic acid (pH 7, 5 mL, 25°C, 72 hours) using magnetic stirring. Polyethylene carriers (d= 5.0 mm, l= 10.0 mm, open ends) of negative control (sham) or experimental groups (IBBM or MOE-modified IBBM) were placed (n=3 conditions /animal; intramuscularly) adjacent to the lower spine of adult sheep (8 animals, » 45 Kg, 2 years old). Tissues were harvested (at 3 or 6 months) after implantation in preparation for histological (H), morphometrical (MM) and immunohistochemical analyses (IH; Wnt-3a, CD34, Vimentin and PREF-1). MM data were tested for normality and variance homogeneity using the Shapiro-Wilk and Levene tests, and Mann Whitney and Kruskal-Wallis, respectively. IM data were analyzed using two-way ANOVA and Tukey tests. Differences (p < 0.05) were observed between experimental groups (IBBM and IBBM+MOE at both 3 and 6 months) and controls (sham) for total area; Differences were not found for presence of remnant particles among experimental groups. The highest formation of bone was observed with IBBM+MOE (6-months). No differences (p > 0.05) were found on IM analysis (CD34, Vimentin, PREF-1, Wnt3a). Results indicated that experimental materials (IBBM+MOE) display promising functionalities. Additional studies are necessary to define biomaterials’ longitudinal effects and long-term biocompatibility properties. Matriz ósea inorgánica bovina (IBBM) son biomateriales con características osteocoductoras comprobadas. El objetivo del presente fue evaluar las funcionalidades de regeneración ósea de IBBM modificado por MOE en ovinos. MOE fue sintetizado suspendiendo-se nácar (0.05 g, diámetros < 0.01 mm) en ácido acético anhidro (pH 7, 25° C, 72 horas) con agitación magnética. Tubos huecos de polietileno (d = 5.00 mm, l = 10.00 mm, extremos abiertos) del grupo control negativo (simulacro) o grupos experimentales (IBBM o IBBM modificado por MOE) fueran colocados (n = 3/condición/animal; intramuscular) adyacente a la parte distal de la columna de ovejas (8 animales, » 45 kg, 2 años). Tejidos fueron recogidos (3 o 6 meses) después implantación para análisis histológicos (H), morfométricos (MM) e inmunohistoquímicos (IH; Wnt-3a, CD34, Vimentin y PREF-1). Datos MM se analizaron utilizando las pruebas de Shapiro-Wilk y Levene, Mann Whitney y Kruskal Wallis. Datos IM se analizaron mediante ANOVA de medidas repetidas y Tukey. Diferencias (p < 0.05) ocurrieran entre grupos experimentales (IBBM y IBBM +MOE a los 3 y 6 meses) y controles (simulacro) para área total; no se encontraron diferencias para partículas remanentes entre grupos experimentales; hueso recién formado se produjo solo en la presencia de biomateriales. Maior cantidad de hueso fue observada con IBBM + MOE (6-meses). No hubo diferencias (p > 0.05) en IH (Wnt-3a, CD34, Vimentin y PREF-1). Resultados reportados indican que materiales experimentales (IBBM + MOE) tienen características prometedoras. Se necesitan estudios para definir efectos longitudinales y de biocompatibilidad de los biomateriales. A matriz óssea inorgânica bovina (IBBM) é um biomaterial com funcionalidades osteocondutoras comprovadas. Este estudo avaliou as funcionalidades ósseo-regenerativas do IBBM modificado ou não por MOE em ovinos. MOE foi sintetizado através da suspensão do nacre (0.05 g, diâmetros < 0.01 mm) em ácido acético anidro (pH 7, 25°C, 72 horas) usando agitação magnética. Tubos de polietileno (d = 5.00 mm, c = 10.0 mm, extremidades abertas) do controle negativo (sham) ou grupos experimentais (IBBM ou IBBM modificado por MOE) foram posicionados (n = 3/condição/animal; intramuscular) adjacentes á distal da coluna de ovelhas (8 animais, » 45 Kg, 2 anos). Tecidos foram colhidos (3 ou 6 meses) pós-implantação para análises histológicas (H), morfométricas (MM) e imunohistoquímicas (IH; Wnt-3a, CD34, Vimentin and PREF-1). Dados MM foram analisados utilizando os testes Shapiro-Wilk e Levene, Mann Whitney e Kruskal-Wallis. Dados IM foram analisados usando ANOVA de medidas repetidas e Tukey. Diferenças (p < 0.05) foram observadas entre of grupos experimentais (IBBM e IBBM + MOE aos 3 e 6 meses) e controles (sham) para área total; não foram encontradas diferenças para partículas remanescentes entre os grupos experimentais; osso neoformado ocorreu apenas na presença de biomateriais. Os maiores valores de osso neoformado foram observados com IBBM + MOE (6-meses). Diferenças estatísticas (p > 0.05) não encontradas na análise IM (Wnt-3a, CD34, Vimentin and PREF-1). Resultados indicam que materiais experimentais (IBBM + MOE) apresentam funcionalidades promissoras. Estudos adicionais são necessários para definir os efeitos longitudinais dos biomateriais e suas propriedades de biocompatibilidade de longo prazo.

Aim: In vitro evaluation of the influence of bovine xenogenic biomaterials on stem cells from human exfoliated deciduous teeth (SHEDs). The study was divided into three groups: 1) group C (control), containing only MSCs; 2) group BP, containing MSCs and Bonefill Porous®; 3) group BO, containing MSCs and Bio-Oss®. MSCs were derived from a deciduous tooth from a 7-year-old male donor. An aliquot of cells was subjected to immunophenotyping by flow cytometry. Cell viability (neutral red), cytotoxicity (MTT), and cell proliferation (crystal violet) assays were performed. All groups underwent morphological analysis by light microscopy (LM), and the biomaterial with superior performance was submitted to evaluation by scanning electron microscopy (SEM). Time points of 24, 48, and 72 h of culture were used. All results were evaluated with a significance level of 0.05. Results showed that both biomaterials maintained cell viability and cytotoxicity similar to the control. The BO group showed smaller cell proliferation compared to the other groups. In LM evaluation, the BP group showed more spread and adherent cells than the BO group. In SEM, cells of the BP group showed characteristics of more active cells than those of the control. Bovine xenogenic biomaterials positively influenced SHEDs, while the BP group seemed to present higher potential with SHEDs for future application within in vivo and/or clinical studies. Objetivo: Evaluación in vitro de la influencia de los biomateriales xenógenos bovinos en células madre de dientes caducifolios exfoliados (SHEDs) humanos. El estudio se dividió en tres grupos: 1) grupo C (control), que contiene sólo MSCs; 2) grupo BP, que contiene MSCs y Bonefill Porous®; 3) Grupo BO, que contiene MSCs y Bio-Oss®. Los MSC se derivaron de un diente caducifolio de un donante de 7 años. Un conjunto celular fue sometido a inmunofennotización por citometría de flujo. Se realizaron pruebas de viabilidad celular (rojo neutro), citotoxicidad (TM) y proliferación celular (cristal violeta). Todos los grupos fueron sometidos a análisis morfológicos por microscopía ligera (ML), y el biomaterial con rendimiento superior fue sometido a evaluación mediante microscopía electrónica de barrido (SEM). Se utilizaron puntos de tiempo de 24, 48 y 72 horas de cultura. Todos los resultados fueron evaluados con un nivel de significancia de 0,05. Los resultados mostraron que ambos biomateriales mantenían la viabilidad celular y la citotoxicidad similar al control. El grupo bo presentó una menor proliferación celular en comparación con los otros grupos. En la evaluación lm, el grupo BP presentó células más difundidas y adherentes que el grupo bo. En SEM, las células del grupo BP presentaron más características celulares activas que las del control. Los biomateriales xenógenos bovinos influyeron positivamente en los SHEDs, mientras que el grupo BP parecía presentar un mayor potencial con SHEDs para futuras aplicaciones en estudios clínicos y/o in vivo. Objetivo: Avaliação in vitro da influência de biomateriais xenogênicos bovinos sobre células-tronco de dentes decíduos esfoliados humanos (SHEDs). O estudo foi dividido em três grupos: 1) grupo C (controle), contendo apenas CTMs; 2) grupo BP, contendo MSCs e Bonefill Porous®; 3) grupo BO, contendo MSCs e Bio-Oss®. As CTMs foram derivadas de um dente decíduo de um doador de 7 anos de idade. Uma alíquota de células foi submetida à imunofenotipagem por citometria de fluxo. Foram realizados ensaios de viabilidade celular (vermelho neutro), citotoxicidade (MTT) e proliferação celular (cristal violeta). Todos os grupos foram submetidos à análise morfológica por microscopia de luz (ML), e o biomaterial com desempenho superior foi submetido à avaliação por microscopia eletrônica de varredura (MEV). Foram utilizados pontos temporais de 24, 48 e 72 horas de cultura. Todos os resultados foram avaliados com nível de significância de 0,05. Os resultados mostraram que ambos os biomateriais mantiveram a viabilidade celular e citotoxicidade semelhantes ao controle. O grupo BO apresentou proliferação celular menor em comparação aos demais grupos. Na avaliação LM, o grupo BP apresentou mais células disseminadas e aderentes do que o grupo BO. No MEV, as células do grupo BP apresentaram características de células mais ativas do que as do controle. Biomateriais xenogênicos bovinos influenciaram positivamente os SHEDs, enquanto o grupo BP pareceu apresentar maior potencial com SHEDs para futura aplicação em estudos in vivo e / ou clínicos.

Previous reports demonstrated the utility of systemic application of growth hormone (GH) in the treatment of bone defects. Very few studies correlated bone repair efficacy with hepatic and renal side effects promoted by locally-delivered GH. The objectives of this study were to assess the bone repair properties along with hepatic and renal adverse effects promoted by local application of GH in a rat model. Thirty-two rats were randomly divided (4 groups; n = 8/group), as follows: (i) AB (autogenous bone + local application of saline solution [SS]), (ii) AB+ (autogenous bone + SS local application + SS irrigation), (iii) AB/GH+ (autogenous bone + SS local application + GH irrigation) and (iv) AB/GHL+ (autogenous bone + GH local application + GH irrigation). Critical-sized defects (diameter = 5.0 mm) were surgically created by a single operator in the calvaria of rats. Defects were filled with ground autogenous bone. Defects pertaining to AB+ and AB/GH+ received a mixture of autogenous bone and a SS-saturated (0.02 mL) collagen sponge covered with bovine cortical membrane. Defects in group AB/GHL+, were filled with the same biomaterials saturated with GH (0.02 mL). SS (0.1 mL) or GH (0.1 mL, equivalent to 0.4 IU) were applied locally on alternate days (8 weeks) in animals in groups AB, AB+ and AB/GH+ or AB/GHL+, respectively. Bone repair properties was determined in hematoxylin/eosin-stained slices using traditional histologic and histomorphometric techniques along with optical microscopy and digital image analysis. Statistical differences among groups was determined using Kruskal-Wallis and Tukey post hoc tests (α = 0.05). Histology results indicated that AB and AB+ displayed greater presence of autogenous bone as compared to AB/GH+ and AB/GHL+. Histomorphometric results indicated significantly higher osteoid matrix formation in AB and AB+ when compared to AB/GHL+ (p = 0.009). Kidneys and livers were found to have their glomeruli preserved in AB and AB+. Strong glomeruli necrosis and large areas of protein deposition were found in AB/GH+. Abnormal small-sized glomeruli were found in AB/GHL+. The utilization of autogenous bone graft associated with local application and irrigation with GH was shown to not improve the bone repair in calvarial critical-sized defects in a rat model., Growth hormone, Rats, Osteogenesis, Wound healing, Materials application, Biomedical materials, Dentistry, Dental materials, Oral medicine

Background Alendronate (ALN) has direct action on bone metabolism, increasing osteogenesis and decreasing bone resorption. The study rated the effect of ALN on femoral fracture repair and the effect of different doses of the drug on the liver and kidneys. Methods Wistar rats were divided into groups: A1 (ALN 1 mg/kg), A2 (ALN 3 mg/kg), and C (saline solution). The drug/solution was applied intraperitoneally three times a week after femoral fracture until euthanasia 45 days later. Results Liver analysis from group A1 presented normal histological aspects, while hepatic steatosis was observed in group A2. In groups A1 and A2, kidneys showed amylocymile like cell degeneration. In femur bone callus, no difference was observed in collagens I and III or in number of trabeculae (p ≥ 0.05). Immunohistochemical evaluation showed positivity for the Transforming Grow Factor β-1 (TGFβ-1) marker in the control group, in spinal area and in small chondrocytes, but negativity for hypertrophy. In A1, an extensive area of cartilaginous expansion was observed, with positive hypertrophic TGFβ-1 cartilage, even in areas with bone matrix. A low positivity was observed in the medullar area, in contrast to the control. Group A2 presented a high number of chondroid matrices and a moderate number of TGFβ-1 cells, with little positivity in medullary area. Conclusions A dosage of ALN 1 mg/kg promotes cellular differentiation activity in the bone callus region, with mild damage in the liver and kidneys. A dosage of ALN 3 mg/kg became toxic without positive alterations in cell differentiation.

The aim of this case report was to describe a modified free gingival graft technique for gaining vertical and horizontal soft-tissue growth in the posterior region of the mandible before installation of dental implants. Patient A.A., a 38-year-old female, received a modified free gingival graft in the posterior region of the mandible. After 90 days, an increase, both horizontally and vertically, of the gingival tissue was observed, and the patient was satisfied with the result. The dental implant was installed, and a 3-mm of the vertical gain of keratinized gingiva was observed. Further research is needed to evaluate the effectiveness of this technique before prosthetic dental implantation.

As lesões pigmentadas na cavidade bucal têm diversas características clínicas, que podem variar desde uma pigmentação fisiológica, como as manchas melânicas, até algo mais grave, como o melanoma maligno. Pela grande diversidade de lesões pigmentadas, os tratamentos são variados e individualizados. Objetivo: Remover manchas melânicas por meio de uma técnica cirúrgica que associa instrumentos rotatórios e lâmina de bisturi. Relato de caso: Paciente de 34 anos, melanoderma, procurou atendimento na Universidade Positivo queixando-se das manchas escurecidas visíveis em sua gengiva e do incômodo que elas lhe causavam por se destacarem ao sorrir. Após o exame clínico, diagnosticou-se presença de pigmentações melânicas. O tratamento proposto foi a remoção cirúrgica das manchas com broca e lâmina de bisturi. No pós-cirúrgico imediato a paciente apresentou boa cicatrização e relatou apenas leve ardência nos três primeiros dias. Após 60 dias, a gengiva se apresentava cicatrizada, sem recidiva das manchas. Conclusão: A técnica escolhida mostrou-se efetiva pois houve cicatrização adequada sem recidiva da pigmentação no acompanhamento pós-operatório.

Zirconia has been presented as an alternative biomaterial to titanium, commercially presented as a single-body implant and/or as an abutment, demonstrating clinically biocompatible favorable results in white and rose esthetics. However, the number of long-term in vivo studies and mechanical tests evaluating the response of stress distribution compared with titanium implants is still limited. The aim of the study was to compare the principal peak stresses in the peri-implant bone around titanium and zirconia implants using the finite element method. Four groups of 3-dimensional models were constructed for the tests: G1, external hexagon titanium implant with a zirconia abutment; G2, zirconia implant with a zirconia abutment; G3, single-body titanium implant; and G4, single-body zirconia implant. Axial and oblique loads of 100 N at 45° were simulated in the prosthetic crown. The bone results showed that the peak stresses decreased by 12% in zirconia implants with 2 parts for axial load and 30% for the oblique load. In single-body implants, the peak stresses decreased 12% in the axial load and 34% in the oblique load when a zirconia implant was used compared with a titanium implant. Although the stress values in megapascals are similar, it can be concluded that the zirconia implants decrease the stress peaks at the peri-implant bone area around the implant platform when compared with titanium implants.

Purpose: Edentulism has been demonstrated to have negative social and psychological effects on individuals that include adverse impacts on facial and oral esthetics, masticatory function and speech abilities, that when combined, are translated into significant reductions in patients’ quality of lives. It is well-known that immediate placement of implants is a challenging surgical procedure that requires proper treatment planning and surgical techniques. Therefore, the present study describes a 4-year follow-up case report where short implants were placed in an atrophic mandibule and were loaded with the utilization of an all-on-four prosthetic protocol. Case report: A 54 year-old woman dissatisfied with her oral and facial esthetics, masticatory function and speech ability came to the implantology clinic of the Positivo University seeking for oral rehabilitation treatment. After detailed physical and clinical examination, a Computer Tomography scan (CT-scan) was performed to determine the patient’s bone ridge density, dimensions and eligibility for the placement of dental implants. The CT-scan results have indicated the presence of an extremely atrophic mandibular bone ridge. The CT-scan was also used as an aid during the final restoration treatment planning in terms of vertical dimension of occlusion, masticatory function, and stabilization of the lower denture. An all-on-four protocol supported by short implants was then treatment-planned to reduce time, costs and morbidity, and also to achieve superior immediate esthetic results and masticatory function. To reconstruct the patient’s atrophic edentulous mandibule, 4 short implants, including 2 distally tilted, were placed with a final torque of 45 Ncm. Results: Following the development and implementation of a complex treatment plan, the patient displayed stable soft and hard tissues at 4-year postoperative follow-up assessment, demonstrating the effectiveness of the all-on-four technique supported by short implants. Conclusion: Within the limits of this study, the present case report demonstrated that the all-on-four prosthetic protocol with immediate loading on short implant was effective in an atrophic mandible over a 4-year follow-up.

O objetivo deste trabalho foi descrever um método de controle de esterilização dos materiais utilizados pelos acadêmicos de Odontologia, bem como comparar a sua eficiência frente ao antigo método de controle. Um software foi criado pela Gestão de Tecnologia da Informação da Universidade Positivo, a partir de uma demanda interna do curso, a fim de aprimorar o controle da central de esterilização. O novo método permite que etiquetas com código de barras sejam colocadas externamente em todas as caixas dos alunos, controlando todo o fluxo de entrada e saída de materiais, gerando maior segurança e agilidade do processo de esterilização. Além disso, o sistema permite que o professor tenha acesso à lista de todo o material esterilizado pelo aluno, bem como a data, horário e número da autoclave na qual o material foi esterilizado. Para avaliar a satisfação com o método foram entregues questionários para os estudantes do último ano do curso de Odontologia, contendo perguntas subjetivas sobre o novo e sobre o antigo método de controle. De acordo com o questionário aplicado, demonstrou-se que novo método utilizado diminui os atrasos para atendimento e o número de materiais danificados e perdidos, aumenta a segurança e acelera o tempo para a colocação e retirada dos materiais (p

A osteonecrose induzida por medicamentos (ONIM) é uma grave complicação da terapia com drogas antirreabsortivas, como os bifosfonatos (BFs). Embora ocorra com mais frequência em pacientes oncológicos, os quais utilizam BFs endovenosos, pacientes usuários de BFs orais para tratamento de osteoporose também se encontram no grupo de risco, principalmente quando procedimentos odontológicos cirúrgicos como exodontias e implantes dentários são realizados. Objetivo: Relatar três casos de pacientes que fizeram uso de BFs no passado ou ainda utilizavam a medicação durante cirurgia para instalação de implantes dentários, abordando os principais fatores de risco para o desenvolvimento da ONIM. Conclusão: O conhecimento prévio pelo implantodontista dos efeitos adversos da terapia com drogas antirreabsortivas em pacientes que necessitam de reabilitação dentária é de extrema importância no manejo desses pacientes, uma vez que elas podem prejudicar a longevidade das reabilitações com implantes e induzir à osteonecrose dos maxilares, comprometendo não somente a saúde bucal como também interferindo negativamente na qualidade de vida dos pacientes.

A aparência estética é uma das preocupações do ser humano, o que leva a uma busca constante por uma estética que expresse harmonia, naturalidade e expressividade. Sendo assim, os procedimentos restauradores têm contribuído positivamente para a resolução dos desafios odontológicos estéticos. Objetivo e relato de caso: Relatar um caso clínico com associação de clareamento dental, confecção de pino intrarradicular e coroa indireta em dissilicato de lítio em que foi devolvida ao paciente a estética desejada. Paciente de 23 anos de idade fraturou o incisivo central superior direito na infância; insatisfeito com a instabilidade de cor do dente, buscou novas alternativas de tratamento. Conclusão: A associação de diferentes tratamentos na Odontologia estética pode apresentar resultados satisfatórios para o restabelecimento estético e funcional de dentes anteriores.

Introduction: The rehabilitation of atrophic anterior maxilla can be done by different techniques. Among the procedures for bone augmentation, we can use block grafting, guided bone regeneration, and split crest technique (SCT). SCT consists in bone crest osteotomy, followed by manual/mechanical expansion up to the splitting of the buccal plate from the lingual/palatal plate through greenstick fracture. SCT advantage is the possibility of simultaneously installing a dental implant. However, SCT planning should consider the remaining bone width and the the flap type to obtain success. Objective: To report a case of implant-supported rehabilitation of an atrophic anterior maxilla using the split crest technique with insertion of 4 immediate implants, showing the effectiveness of the technique.

TGF-β1 is a cytokine that may induce both osteoneogenesis through Runx-2 or fibrosis via the transcription of α-smooth muscle actin (α-SMA). Because it has been previously known that alendronate increases the level of TGF-β1 and that under the usual condition of bone metabolism the estrogen may prevent the fibrotic effect of TGF-β1, the aim of this study was to evaluate if alendronate alters the cellular differentiation process post calvarial surgery in estrogen-deficient specimens. A transosseous defect that was 5 mm in diameter was created on the calvarium of each of 32 female rats with previous ovarian-salpingo-oophorectomy. All defects were treated with autografts, and 16 rats received the administration of 1 mg/kg of alendronate three times a week until euthanasia on the 15th and 60th day post surgery. Histomorphometric and immunohistochemical analyses of the expression of TGF-β1, estrogen receptor alpha nuclear (α-ER), α-SMA, BMPR1B, and Runx-2 were performed, and ELISA was used to measure the level of estrogen. All animals demonstrated low levels of estrogen post ovarian-salpingo-oophorectomy. The histological results demonstrated larger bone matrix deposition in specimens treated with alendronate on the 15th day post surgery. The result was associated with a higher co-expression of TGF-β1, BMPR1B, and Runx-2 when compared with the control group. In addition, on the 60th day post surgery, the increase of bone matrix deposition from 15th to 60th day was discrete in specimens treated with alendronate compared with the control group. This result coincided with the intense simultaneous expression of TGF-β1, α-ER, and α-SMA, whereas the expression of BMPR1B and Runx-2 decreased. The prolonged administration of alendronate altered the cranial repair in ovarian-salpingo-oophorectomized specimens due to the simultaneous occurrence of low estrogen and the presence of TGF-β1+/α-ER+ inducing the presence of α-SMA+, whereas BMPR1B and Runx-2 were suppressed. The prolonged administration of alendronate alters osteoneogenesis and induces an unusual microenvironment in the bone that seems to imitate the physiological tissue damage that culminates in the loss of the functional layer of endometrium.

Objective To evaluate the effect of a single-dose local administration of PTH on bone healing in rat calvarial bone defects by means of micro-computed tomography, histological and histomorphometric analysis. Design Critical-size cranial osteotomy defects were created in 42 male rats. The animals were randomly divided into 3 groups. In the C Group, the bone defect was only filled with a blood clot. In the S Group, it was filled with a collagen sponge and covered with bovine cortical membrane. In the PTH Group, the defect was filled with a collagen sponge soaked with PTH and covered with bovine cortical membrane. The groups were further split in two for euthanasia 15 and 60 days post-surgery. Data was statistically analyzed with t-tests for independent samples or the nonparametric Mann-Whitney test when applicable. Intragroup comparisons were analyzed with paired t-tests (p Results Micro-CT analysis results did not demonstrate statistically significant intergroup differences. At 15 days post-surgery, the histomorphometric analysis showed that the PTH Group exhibited a significantly higher percentage of bone formation compared with the S Group. At 60 days post-surgery, a higher percentage of new bone was observed in the PTH group. Conclusion The results suggest that the local administration of PTH encouraged the bone healing in critical-size calvarial defects in rats.

The periodontal treatment of teeth with furcation defect is clinically challenging. In cases of class II furcation defects, the regenerative surgery shows low morbidity and good prognosis when correctly indicated. The aim of the present study is to report a treatment option for class II furcation defect through autogenous bone graft associated with the Bichat’s fat pad. Case report: A 59-year-old female patient was diagnosed with class II furcation defect in the left mandibular first molar. The treatment comprised surgical reconstruction of the defect with a combination of maxillary tuberosity bone graft and Bichat’s fat pad. The clinical and radiographic follow-up of 180 days showed bone formation in the furcation area and absence of probing depth. Conclusion: An association of autogenous graft form the maxillary tuberosity with a Bichat’s fat pad proved to be a safe, low cost, and effective therapy for the regenerative treatment of class II furcation.

There are various alternatives for correcting a gingival smile, ranging from techniques such as gingivectomy to more complex and invasive procedures such as orthognathic surgery. Gingival smile is one of the most common complaints of patients seeking an aesthetic smile. This article describes the alternative treatments available for lip repositioning and improving smile aesthetics, and presents the clinical course of a gingival smile patient after undergoing the surgical technique of gingival recontouring (GR) associated with lip repositioning with restorative aesthetic treatment. The surgery performed corrected altered passive eruption of the maxillary anterior teeth and lengthened the lateral beam of the elevator muscle of the upper lip and wing of the nose, and achieved containment with sutures, reducing the gingival smile. After surgery, it was apparent that the high smile line had been successfully corrected without compromising labial harmony. The patient expressed high satisfaction with the treatment. The surgical technique proposed in this study may be a therapeutic option for lip repositioning to achieve smile harmony.

Novel biomaterials capable of accelerating the healing process of skeletal tissues are urgently needed in dentistry. The present in vivo study assessed the osteoconductive and osteoinductive properties of experimental biphasic bioceramics (HA-TCP) modified or not by a nacre extract (marine organic extract, MOE) in a sheep model. Fabrication of MOE involved mixing ground nacre (0.05 g, particle sizes n = 8, age: 2 years, weight: 45 kg). Euthanization of animals was performed at 3 and 6 months after surgery. Tissues harvested were subjected to macroscopic and radiographic assessments. Specimens were then stained for histological analysis. Both control and experimental animals were capable of inducing the neoformation of fibrous connective tissue at both time points where superior amounts of tissue formation and mineralization were detected for experimental groups (unaltered (at 3 and 6 mos) and MOE-modified HA-TCP (at 3 mos)). Histological results, however, revealed that mature bone formation was only observed for specimens fabricated with MOE-modified HA-TCP in a time-dependent manner. The present study has successfully demonstrated the in vivo utility of experimental biphasic bioceramics modified by MOE in an ectopic grafting sheep model. Promising osteoconductive and osteoinductive properties must be further developed and confirmed by subsequent research.

Gingivitis is still considered a major risk factor for the occurrence and progression of periodontal disease. The aim of the present study was to compare the long-term (1, 12, and 18 weeks) antiplaque and antigingivitis efficacies of two commercially available toothpastes, Colgate Total® (CT) and BlueM® (BM), against attached supragingival dental plaque and gingival inflammation in an experimental gingivitis model. A parallel double-blinded randomized clinical trial including 39 dental students who refrained from all plaque control methods (manual or chemical) for 7 days was conducted. After the establishment of clinical gingivitis, participants were randomized into two experimental groups (CT and BM). Plaque index (PI) and gingival index (GI) were then calculated according to Turesky’s modified Quigley and Hein index. Participants were assessed in four time periods (preclinical trial phase (W −1), gingivitis phase (W0), one week (W1), twelve weeks (W12), and eighteen weeks (W18)). Participants’ stimulated saliva was collected and cultured (either aerobically or anaerobically, 37°C, 48 hours) in each time period (W −1, W0, W1, W12, and W18) for the count of viable colonies. Obtained data were analyzed using 2-way ANOVA and Tukey’s test (α = 0.05). No significant differences were found (p>0.05) between experimental groups at W −1. Significant differences between groups were observed at W0 (p<0.05) for the parameter time period, but not for the interaction between parameters (time period ∗ toothpastes). Lower bacterial counts were observed in both groups after one week of toothbrushing; however, no significant differences were found between investigated dentifrices. Intra- and intergroup comparisons revealed that significant differences were not found (p>0.05) between dentifrices at W1, W12, and W18 for both GI and PI. The present study demonstrated that toothpastes containing active oxygen and lactoferrin (BM) have comparable antiplaque and antigingivitis efficacies with triclosan-containing toothpastes (CT).

The objective of this systematic review was to compare the conical internal connection (IC) with the external hexagonal connection (EH) on the occurrence of marginal bone loss (ΔMBL). Different databases were used to carry out the selection of the elected studies. The studies were judged according to the risk of bias as “high”, “low” and “unclear” risk. For the meta-analysis we included only studies that could extract the data of ΔMBL, survival rate (SR) and probing depth (PD). No statistically significant differences were found for ΔMBL data at one, three- and five-year survival rates between implant connections (p

The scaffolds and their interaction with mesenchymal stem cells are objects of study in bioengineering and tissue repair. Mechanisms such as surface adhesion, proliferation, viability, and cytotoxicity are essential for the development of therapies. The present study analyzed the influence of platelet-rich fibrin (PRF) in viability, cytotoxicity, and proliferation of stem cells from human exfoliated deciduous teeth (SHED) exposed to bovine biomaterial surfaces. The studied groups were divided and analyzed as follows: (S) only SHED as control Group; (SB) SHED + biomaterial; (SBP) SHED + biomaterial + PRF. Analyses of cells seeded in 24-well plates were performed after 24, 48 and 72 hours. Individual groups were subjected to viability, cytotoxicity and cell proliferation tests using neutral red, MTT and crystal violet, respectively; and in the 72-hour group, scanning electron microscopy (SEM) was performed to record cell ultra-morphology. Data were submitted to statistical analysis by two-factor ANOVA with a significance level of 5%. The results demonstrated a better performance in the viability/cytotoxicity and proliferation of stem cells for the group (SBP) in comparison to the group (SB) and the group (S). The applied statistical tests showed that the biomaterial factor, time, and interaction between them gave rise to results with statistical significance. SHED submitted to bovine biomaterial were more viable, proliferative and with lower toxicity when associated with PRF. PRF seemed to activate the metabolism of stem cells in culture, indicating that such an association can bring an effective benefit in clinical outcome. El marco y su interacción con las células madres mesenquimales son objetos de estudio en bioingeniería y reparación de tejidos. Mecanismos como la adhesión superficial, la proliferación, la viabilidad y la citotoxicidad son fundamentales para el desarrollo de terapias. El presente estudio analizó la influencia de la fibrina rica en plaquetas (PRF) sobre la viabilidad, citotoxicidad y proliferación de células madre mesenquimales de dientes primarios humanos exfoliados (SHED) en contacto con biomateriales bovinos. Los grupos estudiados se dividieron y analizaron de la siguiente manera: (S) solo SHED como grupo de control; (SB) SHED + biomaterial; (SBP) SHED + biomaterial + PRF. Se realizaron análisis de células sembradas en placas de 24 pocillos después de 24, 48 y 72 horas. Los grupos individuales se sometieron a pruebas de viabilidad, citotoxicidad y proliferación celular utilizando rojo neutro, MTT y violeta cristal, respectivamente, y en el grupo de 72 horas, se realizó microscopía electrónica de barrido (SEM) para registrar la morfología celular. Los datos se sometieron a análisis estadístico mediante ANOVA de dos factores con un nivel de significancia del 5%. Los resultados demostraron un mejor desempeño en la viabilidad / citotoxicidad y proliferación de células madre para el grupo (SBP) en comparación con el grupo (SB) y el grupo (S). Las pruebas estadísticas aplicadas mostraron que el factor biomaterial, el tiempo y la interacción entre ellos dieron lugar a resultados con significación estadística, las SHED sometidas a biomaterial bovino fueron más viables, proliferativos y con menor toxicidad cuando se asociaron con PRF. PRF parecio activar el metabolismo de las células madres en cultivo, lo que indica que tal asociación puede aportar un beneficio efectivo en los resultados clínicos. O arcabouço e a sua interação com as células-tronco mesenquimais são objetos de estudo em bioengenharia e reparo de tecidos. Mecanismos como adesão superficial, proliferação, viabilidade e citotoxicidade são fundamentais para o desenvolvimento de terapias. O presente estudo analisou a influência da fibrina rica em plaquetas (PRF) na viabilidade, citotoxicidade e proliferação de células-tronco mesenquimais de dentes decíduos humanos esfoliados (SHED) em contato com biomaterial de origem bovina. Os grupos estudados foram divididos e analisados ​​da seguinte forma: (S) apenas SHED como Grupo controle; (SB) SHED + biomaterial; (SBP) SHED + biomaterial + PRF. As análises das células semeadas em placas de 24 poços foram realizadas após 24, 48 e 72 horas. Grupos individuais foram submetidos a testes de viabilidade, citotoxicidade e proliferação celular usando vermelho neutro, MTT e cristal violeta, respectivamente, e no grupo de 72 horas foi realizada a microscopia eletrônica de varredura (MEV) para registrar a ultra morfologia celular. Os dados foram submetidos à análise estatística por ANOVA de dois fatores com nível de significância de 5%. Os resultados demonstraram um melhor desempenho na viabilidade / citotoxicidade e proliferação de células-tronco para o grupo (SBP) em relação ao grupo (SB) e ao grupo (S). Os testes estatísticos aplicados mostraram que o fator biomaterial, o tempo e a interação entre eles deram origem a resultados com significância estatística. As SHED submetidas ao biomaterial bovino se apresentaram mais viáveis, proliferativas e com menor toxicidade quando associadas à PRF. A PRF pareceu ativar o metabolismo das células-tronco em cultivo, indicando que tal associação pode trazer um benefício efetivo nos desfechos clínicos.

Teeth with extraordinary length are a rare condition that complicates endodontic procedures due to the difficult in being reached the working length and making the adequate preparation of the root canal, once there are no endodontic instruments longer than 31 mm commercially available. This study presents a description of technical adaptations for endodontic preparation of a maxillary canine with 39.59 mm of length. The procedures adopted were based on the consultation of the literature regarding the treatment of long teeth, and included endodontic instrument adaptation and changing the reference point of the instrument. This study shows that extremely long teeth can be successfully instrumented endodontically using the described clinical techniques. Los dientes con longitud extraordinaria son una condición poco común que complica los procedimientos de endodoncia debido a la dificultad para alcanzar la longitud de trabajo y realizar la preparación adecuada del conducto radicular, una vez que no existen instrumentos de endodoncia de más de 31 mm disponibles comercialmente. Este estudio presenta una descripción de las adaptaciones técnicas para la preparación endodóntica de un canino maxilar de 39,59 mm de longitud. Los procedimientos adoptados se basaron en la consulta de la literatura sobre el tratamiento de dientes largos, incluida la adaptación del instrumento endodóntico y el cambio del punto de referencia del instrumento. Este estudio muestra que los dientes extremadamente largos pueden instrumentarse endodónticamente con éxito utilizando las técnicas clínicas descritas. Dentes com comprimento extraordinário são uma condição rara que complica os procedimentos endodônticos pela dificuldade em se atingir o comprimento de trabalho e fazer o preparo adequado do canal radicular, uma vez que não há instrumentos endodônticos maiores que 31 mm disponíveis comercialmente. Este estudo apresenta uma descrição de adaptações técnicas para o preparo endodôntico de um canino superior com 39,59 mm de comprimento. Os procedimentos adotados basearam-se em consulta à literatura a respeito do tratamento de dentes longos, e incluíram adaptação do instrumento endodôntico e alteração do ponto de referência do instrumento. Este estudo mostra que dentes extremamente longos podem ser instrumentados endodonticamente com sucesso usando as técnicas clínicas descritas.

A bichectomia é um procedimento que se constitui na remoção da porção anterior do corpo adiposo de Bichat (paCAB). O extrato celular obtido após o processamento por meio de digestão enzimática desse tecido é chamado de fração vascular estromal (FVE). A natureza das células que compõem a FVE qualifica esse produto para uma ampla gama de aplicações clínicas, especialmente em procedimentos de estímulo à renovação e à reparação tecidual, incluindo-se os fins estéticos de rejuvenescimento em face. Entretanto, o aproveitamento desse material biológico vivo está diretamente relacionado ao seu adequado manejo e transporte, desde sua coleta, processamento e envio para aplicação clínica. Este trabalho teve como objetivo caracterizar a FVE obtida a partir da paCAB, e também verificar se o plasma pobre em plaqueta (PPP) autólogo é eficiente na manutenção da viabilidade celular, podendo ser uma opção de meio para transporte até sua aplicação clínica mediata. Três pacientes com indicação da realização de bichectomia participaram da pesquisa. Antes da remoção da paCAB foi realizada a coleta sanguínea venosa para a obtenção do PPP. A paCAB bilateral coletada foi enviada para o Centro de Processamento Celular Curityba Biotech e submetida ao protocolo para desagregar as células da matriz extracelular. Ao final, a FVE foi fracionada em alíquotas que foram acondicionadas em seringas e em placas de cultivo, e impostas a ensaios para se avaliar a viabilidade celular nos tempos 0, 24 e 48 h. A viabilidade celular e a caracterização das células presentes na FVE foram avaliadas por microscopia de luz e imunofenotipagem por citometria de fluxo. Uma amostra foi mantida em garrafa de cultivo até atingir 7x106 células. Após, foram impostas a comprovação da presença de células-tronco mesenquimais (CTM) capazes de se manter em cultivo padrão. A amostra analisada por imunofenotipagem confirmou a existência das seguintes células: células-tronco mesenquimais e hematopoiéticas, células endoteliais e células T.

Devido à necessidade da reabilitação com implantes dentários, a cirurgia de levantamento do seio maxilar é descrita como uma técnica segura, neste relato de caso demonstramos uma técnica modificada de levantamento de seio maxilar, a técnica do travesseiro, na qual é confeccionado um travesseiro com uma membrana absorvível preenchida com enxerto ósseo. No momento cirúrgico é utilizada a técnica da janela lateral com deslocamento da membrana de Schneider e inserção do travesseiro. Como resultado clínico foi observado uma quantidade satisfatória de ganho ósseo no pós-operatório de 11 meses. Com essa técnica é possível obter um menor tempo cirúrgico devido à necessidade apenas da preparação do leito receptor, visto que o travesseiro é confeccionado previamente ao ato cirúrgico, além de uma nova manobra para a proteção do biomaterial em casos de perfurações da membrana de Schneider diminuindo a chance de complicações pós-operatórias.

Gingival recession occurs due to the migration of the gingiva in the apical direction, leading to compromising local aesthetics and root hypersensitivity. Connective tissue graft is the gold standard treatment in these cases improving both functional and aesthetics aspects.The purpose of this case is to report root coverage using the free connective tissue graftingtechnique (CTG) associated with topical application of active oxygen oral gel and mouthwash (blue®m). A 27-year-old female sought care with the main complaint of root hypersensitivity and the presence of gingival recession in the anterior region of the mandible. Clinical examination revealed the presence of type 1 gingival recession in the left mandibular central incisor. The treatment of choice was a modified graft (free connective graft). The graft and recipient bed received applications of blue®m oral gel. The patient was instructed to use blue®m mouthwash and blue®m oral gel after the surgery for 10 days. At 60 days, the patient showed satisfactory healing in the area of the free CTG, with gain of keratinized tissue and partial covering of the gingival recession. Free CTG with the support of the gel and the mouthwash with active oxygen release makes the technique viable, preventing graft necrosis and achieving root coverage and keratinized tissue. La recesión gingival se produce por la migración de la encía en dirección apical, lo que compromete la estética local y la hipersensibilidad radicular. El injerto de tejido conectivo es el tratamiento estándar de oro en estos casos mejorando tanto los aspectos funcionales como estéticos. El propósito de este caso es reportar la cobertura radicular utilizando la técnica de injerto de tejido conectivo libre (CTG) asociada a la aplicación tópica de gel oral de oxígeno activo y enjuague bucal (blue®m). Una mujer de 27 años solicitó atención con el síntoma principal de hipersensibilidad radicular y presencia de recesión gingival en la región anterior de la mandíbula. El examen clínico reveló la presencia de recesión gingival tipo 1 en el incisivo central mandibular izquierdo. El tratamiento de elección fue un injerto modificado (injerto conectivo libre). El injerto y el lecho receptor recibieron aplicaciones de gel oral blue®m. Se le indicó al paciente que usara enjuague bucal blue®m y gel oral blue®m después de la cirugía durante 10 días. A los 60 días, la paciente presentó cicatrización satisfactoria en la zona de la CTG libre, con ganancia de tejido queratinizado y recubrimiento parcial de la recesión gingival. El CTG libre con el apoyo del gel y el enjuague bucal con liberación activa de oxígeno hace viable la técnica, previniendo la necrosis del injerto y consiguiendo cobertura radicular y tejido queratinizado. A recessão gengival ocorre devido à migração da gengiva no sentido apical, levando ao comprometimento da estética local e à hipersensibilidade radicular. Enxerto de tecido conjuntivo é o tratamento padrão ouro nesses casos, melhorando os aspectos funcionais e estéticos. O objetivo deste caso é relatar a cobertura da raiz usando a técnica de enxerto de tecido conjuntivo (CTG) livre associada à aplicação tópica de gel de oxigênio ativo e enxaguatório bucal (blue®m). Uma mulher de 27 anos procurou atendimento com queixa principal de hipersensibilidade radicular e presença de recessão gengival na região anterior da mandíbula. O exame clínico revelou a presença de recessão gengival tipo 1 no incisivo central inferior esquerdo. O tratamento de escolha foi um enxerto modificado (enxerto conjuntivo livre). O enxerto e o leito receptor receberam aplicações de gel oral blue®m. O paciente foi orientado a usar enxaguatório bucal blue®m e gel oral blue®m após a cirurgia por 10 dias. Aos 60 dias, a paciente apresentava cicatrização satisfatória na área do CTG livre, com ganho de tecido queratinizado e cobertura parcial da recessão gengival. A CTG livre com o suporte do gel e o enxaguatório com liberação ativa de oxigênio tornam a técnica viável, evitando a necrose do enxerto, possibilitando o recobrimento radicular com tecido queratinizado.

Introduction: Today, the appreciation of aesthetic dentistry by society brought to the search for materials and techniques that improve the appearance of smile, which is essential in maintaining physical and mental health of the patient. Objective: This study aimed to report a case of gummy smile involving Periodontics and Restorative Dentistry. Case report: This case, despite other possible alternatives, was solved through periodontal surgery (clinical crown augmentation associated with osteotomy) and indirect restorations with porcelain crowns. Conclusion: In our experience this procedure is safe, predictable, with minimal risks or side effects, and it is a treatment option for these cases.

Gingival recession is the most common mucogingival defect, characterized by apical migration of the gingival margin from the cementoenamel junction and root exposure. Several surgical techniques are reported for the treatment of gingival recession. Here we present a comparison of the conventional (coronally advanced flap) and semilunar coronally positioned flap techniques for root coverage in teeth with cervical abrasion restored with pink resin that mimics the color of the gingiva. Although the conventional technique is more predictable, we found that both techniques were effective in achieving satisfactory and esthetic root coverage.

In recent years, there have been a growing number of procedures involving dental implants. Most cases, though, are characterized by bone atrophy, especially horizontal atrophy. This clinical case aims to report a technique for the expansion of the horizontal alveolar ridge. A longitudinal fracture was created in the alveolar ridge to expand the bone, followed by immediate insertion of dental implants along with a particulate allogeneic bone graft. Eight implants were placed in the maxilla, and after 12 months, a surgical reopening was performed, along with rehabilitation with a protocol-type prosthesis, for which a zirconia infrastructure was made. The patient was observed during a 10-month follow-up period in which an effective osseointegration of all implants was achieved as a result of such a technique. The split-crest technique followed by the immediate placement of implants and a particulate allogeneic bone graft proved to be effective, with a predictable osseointegration.

Fresh frozen allograft bone is routinely used in orthopedic surgery for the reconstruction of large bone defects, and its use in oral and maxillofacial surgery is increasing. The purpose of this case was to demonstrate the installation of dental implants and the use of fresh frozen bone for reconstruction of anterior maxilla in the same surgery. This case report presents the insertion of dental implants followed immediately by a placement of fresh frozen allograft in block and particle for a reconstruction of atrophic anterior maxillary in the same surgery. Ten months subsequent to this procedure, provisional fixed prosthesis was installed on the implants. Four months later (postoperative month 14), the final fixed prosthesis was installed and the clinical success was observed. The insertion of dental implants followed immediately by a placement of fresh frozen allograft is a safe and efficient process that results in the successful return of dental function and aesthetic rehabilitation for the patient.

To use scanning electron microscopy (SEM) and determine whether the surfaces of titanium implants are damaged when touched with a steel rongeur, titanium tweezers, or surgical gloves. Material and methods: Ten dental implants were divided into five groups: Control (C), Titanium Tweezers (T-T), Steel Rongeurs (S-R), Surgical Gloves (S-G), and Steel Support (S-S). The implants were assembled in a metallic base (stub) with the aid of copper strips. They were then imaged and their microstructures were characterized using SEM. Results: An analysis of the obtained images showed that the implants that had been handled with titanium tweezers or a steel rongeur suffered some damage to their physical structure; "scratches" and other small signs of damage were visible on their surfaces. The affected areas were very small compared to the total surface area of the implants. Small dark local stains were observed at the spots where some of the implants had rubbed against a steel support. The rubbing of the implants against the support did not cause any structural damage. The implants handled with surgical gloves exhibited many dark stains their surfaces. This suggested that the powder from the surgical gloves had contaminated the surfaces of the implants. Conclusion: Using SEM imaging, it was determined that the surfaces of dental implants suffer minor physical damage when handled with various pieces of dental equipment. However, the damage should not result in failure of the osseointegration process. In vivo studies are needed to confirm this hypothesis.

Oral rehabilitation with dental implants becomes limited in patients who make use of sodium bisphosphonate (BF), because this drug inhibits osteoclast activity and thus osteoblastic, fundamental steps to implant osseointegration. Furthermore, this drug can cause osteonecrosis of the jaw (OJ). The dentist has to fully know about this drug and its side effects, to differentiate it from other changes. Objective: This study aimed to review the literature on the influence of bisphosphonates on implant and to evaluate the possible complications resulting from prolonged use, providing subsidies to the dentist to prevent and recognize the patient with osteonecrosis of the jaws Literature review: The BPs are a class of drugs used for the treatment of bone diseases such as osteoporosis, because their mechanism of action inhibits the function of osteoclast. However, these drugs may cause some side effects known as the OJ. Patients undergoing intravenous therapy are more likely to develop these changes than those undergoing oral therapy. OJ is characterized by painful symptoms, leaving the exposed bone in the oral cavity. There are several treatment strategies according to the clinical stage that the patient presents. Conclusion: The installation of dental implants in patients who make use of BPs presents risks, since this drug can cause OJ.

Purpose This study evaluated the immunohistochemical presence of Indian Hedgehog (IHH), transforming growth factor-β (TGF-β), and parathyroid-1 receptor (PTH1R) in calvaria bone repair, and compared these results with the histological bone matrix features in defects treated with autograft in the presence or absence of L-PRP. Material and methods An artificial bone defect measuring 5 × 1 mm was produced in the calvaria of 28 Wistar rats. Randomly the defects were treated with autograft and autograft mixed with L-PRP. The animals were euthanized at 15 and 40 days post-surgery. Data were analyzed by Student–Newman–Keuls test (p ≤ .05) for immunohistochemical interpretation. Results The results revealed that the histological characteristic of bone matrix deposited in the defect was different in the defects treated with L-PRP. The group that received only the autograft demonstrated larger haversian bone matrix deposited, whereas the group that received autograft mixed with L-PRP revealed trabecular bone deposition. These results coincided with significantly higher immunopositivity for IHH, TGF-β1, and PTH1R in the L-PRP group. Conclusion These results suggest that L-PRP altered the biological characteristic of the autograft, increasing the bone cells IHH+ but inducing a trabecular bone associated with intense quantities of TGF-β and PTH1R.

Background: Novel multifunctional biomaterials were recently designed to allow for an optimized tissue regeneration process. Purpose: To comprehensively assess (photographic, radiographic and histological) the in vivo functionality of demineralized bovine bone matrix (DBM) associated with an experimental marine organic extract (MOE) from nacre in a sheep ectopic grafting model. Materials and methods: Synthesis of MOE was based on mixing powdered nacre (0.05 g, particles average size

This study aimed to evaluate the effect of two methods of local application of alendronate and parathyroid hormone (PTH) on bone repair and the systemic implications. A critically sized defect (5 mm) was created in the cranial region of twenty-five male Wistar rats, and the bone removed was particulated, and grafted back to the defect with different treatments. The animals were randomly divided into five groups: A1- bone graft immersion in alendronate solution (3 mg/kg) for 5 minutes; P1- bone graft immersion in PTH solution (20 µg); A2- weekly local applications of alendronate 1 mg/kg; P2- weekly local applications of PTH (20 µg); C- no drugs were used. The animals were euthanized 60 days after surgery. Cranial bone blocks were removed for histological, histomorphometric, and immunohistochemical analyses. MMP-2 and MMP-9 were used for immunolabeling. The kidneys, liver, and brain were also removed from all the rats for histological analysis. The data were submitted for statistical analysis with a level of significance of 0.05 (One-way ANOVA). The group C and group P2 presented a higher quantity of viable bone particles than the remaining groups. Groups A1, A2, and P1 presented with fewer viable bone particles than the control group, with a predominance of non-mineralized connective tissue. The histomorphometric analysis revealed no differences in relative bone area or MMP-2 or MMP-9 immunolabeling between the groups (p>0.05). Group A2 showed presence of fat in the liver consistent with hepatic steatosis. Changes in brain tissue were observed in groups A1 and P1.

The objective of the study is to evaluate bone repair in rats treated with different alendronate doses. Sixty female rats ovariectomized were randomly divided in three groups: group C (control group), group A1 (ALN/1 mg/kg), and A2 (ALN/ 3 mg/kg). Each animal received subcutaneous applications of sodium alendronate at a dose correspondent to group A1 or A2 three times a week, while the control group received 0.9% saline solution. After 4 weeks of application, a critical defect was created in the calvaria of animals of all groups. The defect was filled by particulate autogenous bone. The applications were maintained until euthanasia, which occurred 15 and 60 days after the surgical procedure. The pieces were sent for histological, histomorphometric and immunohistochemical analysis. The data were submitted to statistical analysis with significance level of 0.05. The descriptive histological analysis demonstrated an increase in bone neoformation in both groups treated with alendronate when compared to the control group. The histomorphometric analysis showed an increase in the amount of neoformed bone in A1 and A2 groups when compared to group C, both at 15 days (p = 0.0002) and at 60 days (p = 0.001). In the immunohistochemical analysis, it was possible to observe a difference in immunolabeling just for Mmp2 at the time of 60 days in A1 (p = 0.001) and A2 (p = 0.023) when compared to the control group. Systemic delivery of alendronate, regardless of the dose, increased the amount of bone neoformation. Prescription of sodium alendronate at 1 mg/kg for improvement of bone neoformation in bone graft procedures.

BACKGROUND Alendronate (ALN) is a nitrogen-bisphosphonate that may induce an anabolic effect on craniofacial bone repair when administrated in low doses. Based on this premise, this study analyzed the influence of prophylactic low doses of ALN on bone healing in defects created in rabbit mandible. METHODS A 5 × 2-mm diameter deep defect was created in the calvaria of 28 rabbits. Fourteen of these rabbits received previously 50 μg/kg of 1% sodium ALN for 4 weeks, while the other rabbits received only 0.9% physiological saline solution (control). Animals were euthanized at 15 and 60 days postsurgery (n = 7), and the data were analyzed using histomorphometry and immunohistochemistry using the anti-CD34, bone morphogenetic protein -2 (BMP-2), and transforming growth factor (TGF)-β1 antibodies. RESULTS On the 15th day postsurgery, the specimens that received previous treatment with ALN demonstrated large vascular lumen and intense positivity to CD34 either concentrated in endothelium or cells spread among the reparative tissue. These results coincided with intense positivity for BMP-2+ cells and TGF-β1 that was concentrated in both cells and perivascular area. In contrast, the control group revealed scarce cells that exhibited CD34, BMP-2+, and the TGF-β1 was restricted for perivascular area on well-formed granulation tissue. These patterns of immunohistochemical result, especially found on the 15th day of analysis, seem to be responsible for the development of larger quantities of bone matrix in the specimens that receive ALN on the 60th day postsurgery. CONCLUSION These preliminary results showed that the prophylactic administration of low doses of ALN might be an alternative to craniofacial bone craniofacial bone repair because it increases the immunopositivity for TGF-β1 and consequently improves the CD34+ and BMP-2+ cells on reparative sites.

Purpose: The aim of this randomized clinical trial was to radiographically compare peri-implant marginal bone level changes between immediately loaded implants without the removal of an abutment placed at the time of surgery (IL), delayed loaded nonsubmerged implants (NS), and delayed loaded submerged implants (SI). Materials and Methods: Patients' edentulous sites were randomly allocated to the three groups of implants so that each patient received one implant of each group. Digital periapical radiographs were obtained at baseline as well as three (T1), six (T2), and nine (T3) months after implant insertion. The mesial and distal bone crest levels adjacent to each implant were measured, and the mean values were calculated for each implant at each period. The data were statistically analyzed by repeated measures analysis of variance (ANOVA) and the Tukey test (P < .05). Results: The patient sample comprised 15 subjects (13 women and 2 men; mean age: 47.7 years) with partially edentulous sites in the mandibular posterior area. Forty-five implants were inserted (15 IL implants, 15 NS implants, and 15 SI implants). There was no statistically significant difference between the three groups with regard to changes in the marginal bone level during the follow-up period. The study achieved a 93.3% cumulative survival rate for both delayed loaded groups (NS and IS) and a 100% survival rate for the IL group. Conclusion: In the 9-month period following the implants, no statistically significant differences were found between immediately and delayed loaded implants or between submerged and nonsubmerged implants in bone level changes in patients with partial posterior mandibular edentulism.

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a serious complication of therapy with antiresorptive drugs, such as bisphosphonates (BFs). Although it occurs more often in oncology patients who use intravenous BFs, patients who use oral BFs for osteoporosis are also in the risk group, especially when surgical dental procedures such as dental extraction or dental implants are performed. We report 3 cases of patients who received BF therapy in the past or were still using the medication during dental implant surgery and developed BRONJ and loss of the implants. Prior knowledge by dentists of the adverse effects of BF therapy in patients requiring dental rehabilitation is extremely important in the management of these patients, since BFs may impair the longevity of the dental implant as well as induce osteonecrosis of the jaws, compromising not only oral health but also negatively interfering in the quality of life of these patients.

Introduction: The bichectomy has been increasingly sought in dental practice, whether due to functional or aesthetic complaints. It is considered an aesthetic and functional surgery, for improving both facial harmony and chewing. Objective: This study aimed to establish a quality of life profile of patients submitted to bichectomy surgery in a private service in Curitiba, PR, Brazil. Material and methods: The OHIP-14 was applied in a single moment in patients who underwent bichectomy in the last 6 to 18 months. Results: Thirty-six individuals of both sexes were evaluated, being 1 man and 35 women, with the median age of 31 (19-53) years. The median OHIP-14 scores were 0.00 (0-24) points. There was no association between OHIP-14 with age, postoperative complications, postoperative time or tobacco smoking (p > 0.05). Conclusion: The individuals were satisfied after performing the surgical procedure, presenting very low scores when compared to the literature.

Autologous bone is reported by scientific literature as the gold standard for the replacement of the bone loss in maxillary atrophic area. Notwithstanding, this grafting type shows several disadvantages as: The procedure morbidity, limited size of the graft and longer recovering time. Recombinant human bone morphogenetic protein type 2 (rhBMP-2) has been used as bone substitute for the reconstruction of large bone defects. The aim of this case was to report a clinical case exhibiting the reconstruction of the atrophic maxilla through using rhBMP-2 as grafting material associated with absorbable collagen sponge (ACS). At 8 months of following-up, osseointegrated implants were placed. After 2 years and 5 months of following-up, it could be observed an appropriate aesthetical and functional rehabilitation.

The containment of the elevator muscle of the upper lip and wing of nose was used for the treatment of patients with gummy smile. This technique had corrected esthetic alterations of smile, reducing the upper lip elevation, which results in a smaller gingival display. An upper lip lengthening as well as a reduction in the upper lip shortening when the patient smiled could be observed. The high smile line was corrected without compromising the labial harmony. This study presents an innovative and effective therapeutic option to obtain a natural and harmonious smile. The patient expressed a high degree of satisfaction.

This paper aims to report a literature review on the anatomy and morphology of the interproximal papilla and present the options of both surgical and nonsurgical treatment for the recovery of interdental papilla. Literature review: The loss of the interdental papilla because of the interproximal bone loss accounts for aesthetic, phonetic and functional problems of patients with periodontal disease. The interproximal tissue reconstruction has been reported in literature through both surgical procedures with the use of subepithelial connective tissue graft, restorative and orthodontic treatment. Conclusion: The etiology of gingival black space is multifactorial, therefore, it is important to diagnose properly the etiological factor to establish an appropriate treatment planing. However, the treatment approaches are not predictable and further studies are necessary to recommend the clinical practices available to date.