RESUMO
IMPACT STATEMENT: The various roles played by brain-derived neurotrophic factor (BDNF) in a multitude of tissues and at different scenarios have rendered BDNF a favorable candidate for improving tissue regeneration. Although the tested formulations of BDNF quantitatively regenerate tissue to a level similar to control groups, it resulted in significantly more instances of full regeneration.
Assuntos
Fator Neurotrófico Derivado do Encéfalo/farmacologia , Colágeno/farmacologia , Periodonto/fisiologia , Regeneração/fisiologia , Animais , Regeneração Óssea/efeitos dos fármacos , Cemento Dentário/efeitos dos fármacos , Cemento Dentário/fisiologia , Cães , Epitélio/efeitos dos fármacos , Feminino , Imageamento Tridimensional , Periodonto/diagnóstico por imagem , Periodonto/efeitos dos fármacos , Microtomografia por Raio-XRESUMO
To evaluate the impact of the GaAlAs diode laser with energy densities of 160 J/cm2, 320 J/cm2, and 640 J/cm2 on the periodontal tissues under continuous orthodontic force application and on the rate of orthodontic tooth movement in rats with type-2 diabetes mellitus. The intensity of primary alveolar bone formation was also investigated through the immune-positive osteocytes for OPN antibody. Forty adult male Wistar rats were divided into eight groups of 5 rats: normoglycemic (N), 160 J-laser-normoglycemic (160 J-LN), 320 J-laser-normoglycemic (320 J-LN), 640 J-laser-normoglycemic (640 J-LN), diabetic (D), 160 J-laser-diabetic (160 J-LD), 320 J-laser-diabetic (320 J-LD), and 640 J-laser-diabetic (640 J-LD) rats. Diabetes mellitus was induced by a single intravenous injection of 40 mg/kg monohydrated-alloxan. An orthodontic force magnitude of 20cN was applied. The laser parameters were continuous emission of 780-nm wavelength, output power of 20mW, and fiber probe with a spot size of 0.04 cm in diameter. Radiographic, histomorphological, and immunohistochemical analysis were performed after a period of 21 days. The photobiomodulation using the energy density of 640 J/cm2 strongly stimulated the alveolar bone formation and contributed the reorganization of the soft periodontal tissues, followed by the 320 J/cm2. Extensive alveolar bone loss, intense infiltration of inflammatory cells, and degradation of the PDJ tissue were mainly found in the D and 160 J-LD groups. The rate of orthodontic tooth movement was represented by the interdental distance between the cementoenamel junctions of the right mandibular first and second molars . This distance was larger in the diabetic groups (D: 39.98±1.97, 160 J-LD: 34.84±6.01, 320 J-LD: 29.82±1.73, and 640 J-LD: 35.47±4.56) than in the normoglycemic groups (N: 21.13±1.19; 160 J-LN: 22.69±0.72, 320 J-LN: 22.28±0.78, and 640 J-LN: 24.56±2.11). The number of osteopontin-positive osteocytes was significantly greater in the 640 J-LD (14.72 ± 0.82; p < 0.01) and 640 J-LN (13.62 ± 1.33; p < 0.05) groups than with D (9.82 ± 1.17) and 160 J-LD (9.77 ± 1.10) groups. Therefore, the energy density of 640 J/cm2 provided the best maintenance and integrity of the periodontal tissue microarchitecture under continuous orthodontic force when compared with the other dosages, mainly in the uncontrolled diabetic rats. The interdental distance was greater in the D and 160 J-LD groups due to presence of severe periodontitis caused by diabetes plus the mechanical stress generated by continuous orthodontic forces, implying, thus, an insufficient biostimulatory effect for the dosage of 160 J/cm2.
Assuntos
Diabetes Mellitus Tipo 2/fisiopatologia , Terapia com Luz de Baixa Intensidade/métodos , Periodonto/efeitos da radiação , Técnicas de Movimentação Dentária/métodos , Perda do Osso Alveolar/patologia , Animais , Diabetes Mellitus Experimental , Imuno-Histoquímica , Lasers Semicondutores/uso terapêutico , Masculino , Aparelhos Ortodônticos , Osteoclastos/efeitos da radiação , Osteócitos/efeitos da radiação , Osteogênese/efeitos da radiação , Osteopontina/análise , Periodonto/diagnóstico por imagem , Periodonto/patologia , Doses de Radiação , Radiografia , Distribuição Aleatória , Ratos Wistar , Valores de Referência , Reprodutibilidade dos TestesRESUMO
Abstract To evaluate the impact of the GaAlAs diode laser with energy densities of 160 J/cm2, 320 J/cm2, and 640 J/cm2 on the periodontal tissues under continuous orthodontic force application and on the rate of orthodontic tooth movement in rats with type-2 diabetes mellitus. The intensity of primary alveolar bone formation was also investigated through the immune-positive osteocytes for OPN antibody. Forty adult male Wistar rats were divided into eight groups of 5 rats: normoglycemic (N), 160 J-laser-normoglycemic (160 J-LN), 320 J-laser-normoglycemic (320 J-LN), 640 J-laser-normoglycemic (640 J-LN), diabetic (D), 160 J-laser-diabetic (160 J-LD), 320 J-laser-diabetic (320 J-LD), and 640 J-laser-diabetic (640 J-LD) rats. Diabetes mellitus was induced by a single intravenous injection of 40 mg/kg monohydrated-alloxan. An orthodontic force magnitude of 20cN was applied. The laser parameters were continuous emission of 780-nm wavelength, output power of 20mW, and fiber probe with a spot size of 0.04 cm in diameter. Radiographic, histomorphological, and immunohistochemical analysis were performed after a period of 21 days. The photobiomodulation using the energy density of 640 J/cm2 strongly stimulated the alveolar bone formation and contributed the reorganization of the soft periodontal tissues, followed by the 320 J/cm2. Extensive alveolar bone loss, intense infiltration of inflammatory cells, and degradation of the PDJ tissue were mainly found in the D and 160 J-LD groups. The rate of orthodontic tooth movement was represented by the interdental distance between the cementoenamel junctions of the right mandibular first and second molars . This distance was larger in the diabetic groups (D: 39.98±1.97, 160 J-LD: 34.84±6.01, 320 J-LD: 29.82±1.73, and 640 J-LD: 35.47±4.56) than in the normoglycemic groups (N: 21.13±1.19; 160 J-LN: 22.69±0.72, 320 J-LN: 22.28±0.78, and 640 J-LN: 24.56±2.11). The number of osteopontin-positive osteocytes was significantly greater in the 640 J-LD (14.72 ± 0.82; p < 0.01) and 640 J-LN (13.62 ± 1.33; p < 0.05) groups than with D (9.82 ± 1.17) and 160 J-LD (9.77 ± 1.10) groups. Therefore, the energy density of 640 J/cm2 provided the best maintenance and integrity of the periodontal tissue microarchitecture under continuous orthodontic force when compared with the other dosages, mainly in the uncontrolled diabetic rats. The interdental distance was greater in the D and 160 J-LD groups due to presence of severe periodontitis caused by diabetes plus the mechanical stress generated by continuous orthodontic forces, implying, thus, an insufficient biostimulatory effect for the dosage of 160 J/cm2.
Assuntos
Animais , Masculino , Técnicas de Movimentação Dentária/métodos , Periodonto/efeitos da radiação , Terapia com Luz de Baixa Intensidade/métodos , Diabetes Mellitus Tipo 2/fisiopatologia , Aparelhos Ortodônticos , Osteoclastos/efeitos da radiação , Osteócitos/efeitos da radiação , Osteogênese/efeitos da radiação , Doses de Radiação , Valores de Referência , Periodonto/patologia , Periodonto/diagnóstico por imagem , Imuno-Histoquímica , Radiografia , Distribuição Aleatória , Reprodutibilidade dos Testes , Perda do Osso Alveolar/patologia , Ratos Wistar , Diabetes Mellitus Experimental , Osteopontina/análise , Lasers Semicondutores/uso terapêuticoRESUMO
Aim: the present study aimed to examine the influence of the quality of root canal fillings and coronal restorations on the prevalence of periapical lesions. Materials and Methods: Two hundred digital panoramic radiographs were obtained from the archive of Al‑HamziDental Center in Sanaa, Yemen. The final sample consisted of 120 radiographs, and 675 root filled teeth.The quality of root canal fillings was scored according to criteria of length, homogeneity and taper. Coronal status (type of restoration, signs of marginal leakage or decay) was also evaluated. The periapical status was categorized on the basis of presence or absence of radiographical signs of apical periodontitis. Chi-square test was used to determine statistical significance between different parameters. Results: We found that 93.6 percent of root filled teeth were associated with apical periodontitis. Only 9.2 percent of root filled teeth were found to have an acceptable standard of root canal fillings, of which 32.3 percent was also associated to signs of periapical disease. In roots with an unacceptable root canal filling, 95.4 percent had periapical disease. Teeth with good (14.4 percent) and poor (32.9 percent) intra-coronal restorations had apical periodontitis in 93.8 percent and 97.7 percent of cases, respectively. Crown restorations were present in 52.7 percent of root filled teeth, of which 91.0 percent were associated with periapical lesions. Conclusion: The poor technical quality of root canal fillings and coronal restorations is consistent with a high prevalence of apical periodontitis.
Assuntos
Humanos , Periodontite Periapical/terapia , Periodonto/diagnóstico por imagem , Tratamento do Canal Radicular/métodos , Estudos Transversais , Prevalência , Periodontite Periapical/epidemiologia , Controle de Qualidade , Radiografia Panorâmica , Obturação do Canal Radicular , IêmenRESUMO
OBJECTIVE: This study evaluated alveolar bone loss around mandibular incisors, induced by the Herbst appliance. METHODS: The sample consisted of 23 patients (11 men, 12 women; mean age of 15.76 ± 1.75 years), Class II, Division 1 malocclusion, treated with the Herbst appliance. CBCT scans were obtained before treatment (T0) and after Herbst treatment (T1). Vertical alveolar bone level and alveolar bone thickness of mandibular incisors were assessed. Buccal (B), lingual (L) and total (T) bone thicknesses were assessed at crestal (1), midroot (2) and apical (3) levels of mandibular incisors. Student's t-test and Wilcoxon t-test were used to compare dependent samples in parametric and nonparametric cases, respectively. Pearson's and Spearman's rank correlation analyses were performed to determine the relationship of changes in alveolar bone thickness. Results were considered at a significance level of 5%. RESULTS: Mandibular incisors showed no statistical significance for vertical alveolar bone level. Alveolar bone thickness of mandibular incisors significantly reduced after treatment at B1, B2, B3, T1 and significantly increased at L2. The magnitude of the statistically significant changes was less than 0.2 mm. The changes in alveolar bone thickness showed no statistical significance with incisor inclination degree. CONCLUSIONS: CBCT scans showed an association between the Herbst appliance and alveolar bone loss on the buccal surface of mandibular incisors; however, without clinical significance.
Assuntos
Perda do Osso Alveolar/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Má Oclusão Classe II de Angle/diagnóstico por imagem , Má Oclusão Classe II de Angle/terapia , Desenho de Aparelho Ortodôntico , Aparelhos Ortodônticos Funcionais , Adolescente , Brasil , Feminino , Seguimentos , Gengiva/diagnóstico por imagem , Humanos , Incisivo/diagnóstico por imagem , Masculino , Mandíbula/diagnóstico por imagem , Periodonto/diagnóstico por imagem , Estudos Retrospectivos , Técnicas de Movimentação DentáriaRESUMO
ABSTRACT Objective: This study evaluated alveolar bone loss around mandibular incisors, induced by the Herbst appliance. Methods: The sample consisted of 23 patients (11 men, 12 women; mean age of 15.76 ± 1.75 years), Class II, Division 1 malocclusion, treated with the Herbst appliance. CBCT scans were obtained before treatment (T0) and after Herbst treatment (T1). Vertical alveolar bone level and alveolar bone thickness of mandibular incisors were assessed. Buccal (B), lingual (L) and total (T) bone thicknesses were assessed at crestal (1), midroot (2) and apical (3) levels of mandibular incisors. Student's t-test and Wilcoxon t-test were used to compare dependent samples in parametric and nonparametric cases, respectively. Pearson's and Spearman's rank correlation analyses were performed to determine the relationship of changes in alveolar bone thickness. Results were considered at a significance level of 5%. Results: Mandibular incisors showed no statistical significance for vertical alveolar bone level. Alveolar bone thickness of mandibular incisors significantly reduced after treatment at B1, B2, B3, T1 and significantly increased at L2. The magnitude of the statistically significant changes was less than 0.2 mm. The changes in alveolar bone thickness showed no statistical significance with incisor inclination degree. Conclusions: CBCT scans showed an association between the Herbst appliance and alveolar bone loss on the buccal surface of mandibular incisors; however, without clinical significance.
RESUMO Introdução: este estudo avaliou a perda óssea alveolar ao redor dos incisivos inferiores induzida pelo aparelho de Herbst. Métodos: a amostra foi composta por 23 pacientes (11 homens e 12 mulheres; média de idade 15,76 ± 1,75 anos), má oclusão de Classe II, divisão 1, tratados com aparelho de Herbst. TCFCs foram realizadas antes do tratamento (T0) e após o tratamento (T1) com o Herbst. A altura e a espessura óssea alveolar dos incisivos inferiores foram avaliadas. As espessuras ósseas vestibular (V), lingual (L) e total (T) foram mensuradas nos terços cervical (1), médio (2) e apical (3) dos incisivos inferiores. O teste t de Student e o teste t de Wilcoxon compararam as amostras dependentes nos casos paramétricos e não paramétricos, respectivamente. As análises de Pearson e Spearman determinaram a correlação entre as alterações na espessura do osso alveolar. Os resultados foram considerados para um nível de significância de 5%. Resultados: os incisivos inferiores não apresentaram significância estatística para a altura óssea alveolar. Após o tratamento, a espessura óssea alveolar dos incisivos inferiores reduziu-se significativamente em V1, V2, V3 e T1 e aumentou significativamente em L2. A quantidade da alteração óssea significativa foi menor que 0,2mm. As alterações na espessura óssea alveolar não apresentam correlação estatisticamente significativa com o grau de inclinação do incisivo. Conclusões: as imagens de TCFC demonstram associação entre o uso do aparelho de Herbst e a perda óssea alveolar no lado vestibular dos incisivos inferiores; entretanto, sem significância clínica.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Perda do Osso Alveolar/diagnóstico por imagem , Aparelhos Ortodônticos Funcionais , Tomografia Computadorizada de Feixe Cônico , Má Oclusão Classe II de Angle/terapia , Má Oclusão Classe II de Angle/diagnóstico por imagem , Técnicas de Movimentação Dentária , Brasil , Periodonto/diagnóstico por imagem , Estudos Retrospectivos , Seguimentos , Desenho de Aparelho Ortodôntico , Gengiva/diagnóstico por imagem , Incisivo/diagnóstico por imagem , Mandíbula/diagnóstico por imagemRESUMO
O diagnóstico por imagem é um exame complementar importante para o diagnóstico e acompanhamento da doença periodontal e peri-implantar e atualmente a tomografia computadorizada de feixe cônico (TCFC) substitui o uso das tomografias convencionais odontológicas e da tomografia computadorizada médica. No entanto, artefatos ocorrem principalmente, próximos de estruturas de alta densidade como o metal, sendo que essa alteração pode interferir na interpretação das imagens e no diagnóstico. Sendo assim, o presente estudo tem como objetivo realizar uma revisão de literatura relacionada ao efeito do artefato de "beam hardening" na capacidade de identificação das alterações periodontais e peri-implantares. Conclui-se que a TCFC promove uma avaliação tridimensional de doença periodontal e da peri-implantite, mas na presença de artefatos metálicos pode haver uma limitação da qualidade da imagem do nível ósseo ao redor dos dentes e implantes.(AU)
Diagnostic imaging is an important complementary method for the diagnosis and follow up of periodontal disease and peri-implant and nowadays cone-beam computed tomography (CBCT) replaces the use of conventional dental CT scans and medical CT scan. However, artifacts occur mainly near high-density structures such as metal, and this change may interfere interpretation of the images and diagnosis. Therefore, this study aims to conduct a literature review on the effect of "beam hardening" artifact in identifying capacity of periodontal and peri-implant changes. We conclude that CBCT promote three-dimensional evaluation of periodontal disease and peri-implantitis, but presence of metal artifacts could be a limitation of the image quality of bone level around the teeth and implants.(AU)
Assuntos
Humanos , Artefatos , Tomografia Computadorizada de Feixe Cônico/normas , Doenças Periodontais/diagnóstico por imagem , Periodonto/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico/instrumentação , Reprodutibilidade dos TestesRESUMO
Although osteonecrosis of the jaws (ONJ), a serious complication of antiresorptive medications, was reported a decade ago, the exact mechanisms of disease pathophysiology remain elusive. ONJ-like lesions can be induced in animals after antiresorptive treatment and experimental interventions such as tooth extraction or periapical or periodontal disease. However, experimental induction and manipulation of disease progression does not always reflect clinical reality. Interestingly, naturally occurring maxillofacial abscesses, inducing aggressive inflammation of the peri-radicular mucosa with significant osteolysis and alveolar bone expansion, have been reported in mice. Here, we aimed to explore whether osteonecrotic lesions would develop in areas of maxillary peri-radicular infections, in mice on antiresorptive medications with distinct pharmacologic action, thus establishing a novel ONJ animal model. Mice were treated with RANK-Fc or OPG-Fc that bind to RANKL or with the potent bisphosphonate zoledronic acid (ZA). Maxillae were assessed radiographically and histologically. µCT imaging of vehicle mice revealed several maxillae with altered alveolar bone morphology, significant ridge expansion and large lytic areas. However, in RANK-Fc, OPG-Fc and ZA treated animals the extent of bone loss was significantly less, but exuberant bone deposition was noted at the ridge periphery. BV and BV/TV were increased in the diseased site of antiresorptive vs. veh animals. Histologically, extensive inflammation, bone resorption and marginal gingival epithelium migration were seen in the diseased site of vehicle animals. Rank-Fc, OPG-Fc and ZA reduced alveolar bone loss, increased periosteal bone formation, and induced areas of osteonecrosis, and bone exposure that in many animals covered significant part of the alveolar bone. Collectively, our data demonstrate ONJ-like lesions at sites of maxillary peri-radicular infection, indistinguishable in mice treated with RAKL inhibitors vs. zoledronate. This novel mouse model of spontaneous ONJ supports a central role of osteoclast inhibition and infection/inflammation in ONJ pathogenesis and validates and complements existing animal models employing experimental interventions.
Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/patologia , Reabsorção Óssea/tratamento farmacológico , Difosfonatos/efeitos adversos , Imidazóis/efeitos adversos , Maxila/patologia , Fosfatase Ácida/metabolismo , Processo Alveolar/diagnóstico por imagem , Processo Alveolar/efeitos dos fármacos , Processo Alveolar/patologia , Animais , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/diagnóstico por imagem , Reabsorção Óssea/patologia , Difosfonatos/uso terapêutico , Modelos Animais de Doenças , Imidazóis/uso terapêutico , Isoenzimas/metabolismo , Masculino , Maxila/efeitos dos fármacos , Camundongos Endogâmicos C57BL , Periodonto/diagnóstico por imagem , Periodonto/efeitos dos fármacos , Periodonto/patologia , Radiografia , Proteínas Recombinantes de Fusão/farmacologia , Proteínas Recombinantes de Fusão/uso terapêutico , Fosfatase Ácida Resistente a Tartarato , Ácido ZoledrônicoRESUMO
The rat model is widely used in periodontal research and the quality of histological sections is essential. The purpose of this study was to evaluate the histological characteristics of periodontal tissues in Wistar rat maxillae, with different times of fixation and decalcified by nitric acid or formic acid (Anna Morse Solution). Fifteen rats were used. Fixation was performed for 24, 48 and 72 hours. The maxillae were hemi-sectioned and each part was decalcified either in nitric acid for 7 days or in Anna Morse solution for 35 days. Two trained and blinded examiners performed the evaluation. Fourty eight hours of fixation and decalcification with Anna Morse solution showed more clear characteristics of the epithelium-connective tissue interface and of the periodontal structures. Mean measurements between the cementum-enamel junction and the bone crest varied in the different experimental times from 176.5 (+/- 60.45) to 210.94 (+/- 39.33) pixels on the buccal aspect, and from 199.69 (+/- 38.33) to 298.55 (+/-70.81) pixels on the palatal aspect, with no statistically significant differences (ANOVA, p > 0.05). In the same fixation period, decalcification with nitric acid or Anna Morse solution did not display any statistically significant differences. It may be concluded that for a qualitative histological analysis, fixation should preferably be for 48 hours and the demineralization should be made by Anna Morse solution. For a histomorphometric analysis, the decalcification solution does not interfere in the results.
Assuntos
Formiatos/farmacologia , Ácido Nítrico/farmacologia , Doenças Periodontais/patologia , Ligamento Periodontal/patologia , Periodonto/patologia , Fixação de Tecidos/métodos , Análise de Variância , Animais , Técnica de Descalcificação , Modelos Animais de Doenças , Masculino , Maxila , Microscopia Eletrônica , Ligamento Periodontal/ultraestrutura , Periodonto/diagnóstico por imagem , Periodonto/efeitos dos fármacos , Ratos , Ratos Wistar , Estatísticas não Paramétricas , Fatores de Tempo , UltrassonografiaRESUMO
En el presente trabajo se trata de ampliar, mediante un método de filtración localizada en sectores precisos de la película radiográfica, un medio que facilite la visualización de estructuras con bajo porcentaje mineral, las que por su condición de baja densidad, frente a valores de radiación corrientes, pierden su posibilidad de impresionar la película radiográfica surgiendo como consecuencia, la falta de información al respecto (AU)