The aim of this study was to use a literature review to evaluate and compare the different biomaterials used in surgeries for the closure of the palatal and alveolar clefts as alternatives to isolated autografting. For the search strategy, the PubMed and Medline databases were used with the indexing terms “’cleft palate’ (Mesh), ‘biocompatible materials’ (Mesh), and ‘dentistry’ (Mesh).” There was no restriction on language or publication time. After the research, 26 articles were found, and then, only the filter for clinical trials was selected. With this methodology, five articles were selected. The full texts have been carefully evaluated. The main issue among the five selected articles was the closure of a cleft palate and/or alveolar bone with the use of different types of biomaterials (e.g. autogenous bone from the iliac crest and chin, deproteinized bovine bone (DBB), β-tricalcium phosphate (β-TCP), synthetic resorption based on calcium sulfate, and the engineering of bone tissue); they evaluated preoperative and postoperative clinically and through imaging tests. The autogenous bone associated with DBB or β-TCP significantly reduces the amount of autogenous bone harvested from the iliac crest, morbidity, and the hospitalization of the patient, and the isolated use of bovine hydroxyapatite resulted in lower bone density compared to that from autogenous bone.
Necrotizing fasciitis (NF) is a devastating disease that typically affects immunocompromised patients, chronically debilitated patients or drug users, but can also affect healthy patients. Necrotizing fasciitis can rapidly produce septic shock and requires immediate surgical management of the necrotic tissue. It is a bacterial infection that progresses rapidly and has a high mortality generally caused by aerobic and anaerobic bacteria. The patient was immunocompromised and drug user. During treatment, a combination of broad-spectrum antibiotic therapy with Ciprofloxacin and Metronidazole, besides the use of activated charcoal dressing composed of carbonized fabric and impregnated with 0.15% silver nitrate enveloped by layer of fabric without activated carbon, chemical-mechanical debridement with hydrogen peroxide, 0.9% saline, and povidone iodine. According to the patient presented, for the treatment of NF there is a need for broad-spectrum antibiotic therapy associated with surgical debridement, use of activated charcoal for antiseptic compression and general intensive care.
The present study aimed to evaluate the peri-implantar bone healing in the presence of genistein treatment in ovariectomized rats. Thirty female rats with 4 months old were divided into 3 groups according to the experimental condition and the drug treatment: SHAM (rats submitted to the fictional surgery and gavage with 0.9% saline solution); OVX (rats submitted to bilateral ovariectomy and gavage with 0.9% saline solution); OVX GEN (rats submitted to bilateral ovariectomy and gavage with 1mg/day of genistein). 60 implants were installed, with two implants in each animal. The calcified group was subjected microcomputerized tomography and the parameters analysed was bone volume per tissue volume (BV/TV) and connective density (Cnn.Dn). The decalcified samples were evaluated through immunolabeling analysis, in order to detect the presence of RUNX2, Alkaline Phosphatase, Osteocalcin, Osteopontin and TRAP. All the quantitative data were submitted to the normality curve to determine the most adequate test. The significance level of p<0.05 was considered for all tests. The morphometric analysis of the OVX GEN group showed higher percentage of bone volume and lower connective density when compared with OVX. Immunohistochemical analysis favors expression. For the markers that positively label osteoblastic activity. This study shows that genistein therapy improves peri-implant bone healing in ovariectomized rats.
The objective of this study was to evaluate the daily maxillary and tibial bone mineral apposition rate of ovariectomized rats and orchiectomized rats through confocal laser microscopy. Twenty-four animals were divided into 4 groups (SHAMF, OVX, SHAMM and ORQ). Six rats were distributed to the SHAMF group (submitted to fictitious surgery); six rats to the OVX group (submitted to bilateral ovariectomy); six rats to the SHAMM group (submitted to fictitious surgery) and six rats to the ORQ group (submitted to bilateral orchiectomy). On the 60th day after the surgical procedures the animals received 20 mg/kg of calcein and after 24 days 20 mg/kg of alizarin red was administered. The euthanasia was performed 18 days after the last fluorochrome administration. The histological slides obtained were submitted to confocal microscopy analysis and then dynamic histomorphometry was performed to obtain the daily mineral apposition rate (MAR). In the tibias, the values of MAR were higher for the SHAMF group (P<0.05) (mean: 37.1μm² / day) compared to the ORQ group (mean: 7.16 μm²). In the jaws, the values were higher for the SHAMF group (P<0.05) (mean: 5.175μm² / day) compared to the SHAMM group (mean: 1.84 μm²), OVX (mean: 3.027 μm²) and ORQ group (mean: 1.56 μm²). It can be concluded that the female gender, regarding the characteristics of the maxillary and tibial bones, presented a daily mineral bone apposition rate higher than the male gender, mainly in the maxillary bone, presenting a statistically significant difference between all groups studied.
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