Publications by authors named "Mônica Diuana Calasans-Maia"

53 Publications

Osseodensification enables bone healing chambers with improved low-density bone site primary stability: an in vivo study.

Sci Rep 2021 Jul 29;11(1):15436. Epub 2021 Jul 29.

Clinical Research Laboratory, Dentistry School, Universidade Federal Fluminense, Rua Mario Santos Braga, 28/4 Floor, Niterói, RJ, Brazil.

Primary implant stability is a prerequisite for successful implant osseointegration. The osseodensification technique (OD) is a non-subtractive drilling technique that preserves the bone tissue, increases osteotomy wall density, and improves the primary stability. This study aimed to investigate the hypothesis that OD, through a wider osteotomy, produces healing chambers (HCs) at the implant-bone interface without impacting low-density bone primary stability. Twenty implants (3.5 × 10 mm) with a nanohydroxyapatite (nHA) surface were inserted in the ilium of ten sheep. Implant beds were prepared as follows: (i) 2.7-mm-wide using subtractive conventional drilling (SCD) technique (n = 10); (ii) 3.8-mm-wide using an OD bur system (n = 10). The sheep were randomized to two groups, with samples collected at either 14-(n = 5) or 28-days (n = 5) post-surgery and processed for histological and histomorphometric evaluation of bone-implant contact (BIC) and bone area fraction occupancy (BAFO). No significant group differences were found with respect to final insertion torque and implant stability quotient (p > 0.050). BIC values were higher for SCD after 14 and 28 days (p < 0.050); however, BAFO values were similar (p > 0.050). It was possible to conclude that the OD technique allowed a wider implant bed preparation without prejudice on primary stability and bone remodeling.
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http://dx.doi.org/10.1038/s41598-021-94886-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8322171PMC
July 2021

The role of antiresorptive drugs and medication-related osteonecrosis of the jaw in nononcologic immunosuppressed patients: A systematic review.

J Res Med Sci 2021 31;26:23. Epub 2021 Mar 31.

Guy's Dental Hospital, Oral Surgery Department, London, UK.

Medication related osteonecrosis of the jaw (MRONJ) is a severe condition affecting the jaws of patients exposed to specific drugs, and is primarily described in patients receiving bisphosphonate (BP) therapy. However, more recently it has been observed in patients taking other medications, such as the RANK ligand inhibitor (denosumab) and antiangiogenic drugs. It has been proposed that the existence of other concomitant medical conditions may increase the incidence of MRONJ. The primary aim of this research was to analyze all available evidence and evaluate the reported outcomes of osteonecrosis of the jaws (ONJ) due to antiresorptive drugs in immunosuppressed patients. A multi-database (PubMed, MEDLINE, EMBASE and CINAHL) systematic search was performed. The search generated twenty-seven studies eligible for the analysis. The total number of patients included in the analysis was two hundred and six. All patients were deemed to have some form of immunosuppression, with some patients having more than one disorder contributing to their immunosuppression. Within this cohort the commonest trigger for MRONJ was a dental extraction (n=197). MRONJ complications and recurrence after treatment was sparsely reported in the literature, however a total of fourteen cases were observed. The data reviewed have confirmed that an invasive procedure is the commonest trigger of MRONJ with relatively high frequency of post-operative complications or recurrence following management. However, due to low-quality research available in the literature it is difficult to draw a definitive conclusion on the outcomes analysed in this systematic review.
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http://dx.doi.org/10.4103/jrms.JRMS_794_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8240545PMC
March 2021

Does the Coronectomy a Feasible and Safe Procedure to Avoid the Inferior Alveolar Nerve Injury during Third Molars Extractions? A Systematic Review.

Healthcare (Basel) 2021 Jun 18;9(6). Epub 2021 Jun 18.

Oral Surgery Department, Universidade Federal Fluminense, Niteroi 24020-140, Brazil.

This systematic review aimed to review the literature on the coronectomy technique and evaluate the incidence of success and complications as a surgical approach for inferior third molars. Online databases were searched for data on the frequency of inferior alveolar nerve damage, lingual nerve damage, root migration, pain, infection, dry socket, and extraction of the remaining root, and data on the necessity of reintervention were also extracted. Randomized clinical trials, controlled clinical trials, prospective cohort studies, and prospective and retrospective studies with or without the control group were intercepted. This systematic review was registered in PROSPERO (CDR 42020135485). Sixteen papers analyzed 2176 coronectomies in total, and only five of them were judged as appropriate according to methodological quality assessment. The incidence of inferior alveolar nerve injury was documented in 0.59% of the procedures, lingual nerve injury in 0.22%, infection 3.95%, dry socket 1.12%, extraction of the root 5.28%, and reintervention 1.13%. The pain was the most reported, in 22.04% of the population. This study provides an overview of the clinical success and complications of coronectomy, and their prevalence. A coronectomy may be considered a low-risk procedure and an option for treatment to avoid potential damage to nervous structures. However, patients should still undergo a full screening and evaluation of postsurgical procedures.
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http://dx.doi.org/10.3390/healthcare9060750DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8234010PMC
June 2021

Prevalence of anosmia and ageusia symptoms among long-term effects of COVID-19.

Oral Dis 2021 May 18. Epub 2021 May 18.

Department of Oral Surgery, School of Dentistry, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.

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http://dx.doi.org/10.1111/odi.13919DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8242542PMC
May 2021

Clinical Comparation of Extra-Short (4 mm) and Long (>8 mm) Dental Implants Placed in Mandibular Bone: A Systematic Review and Metanalysis.

Healthcare (Basel) 2021 Mar 12;9(3). Epub 2021 Mar 12.

Oral Surgery Department, Universidade Federal Fluminense, Niteroi 24020-140, Brazil.

This systematic review (SR) aimed to evaluate implant survival rate, marginal bone loss (MBL), and biological/prosthetic complications of extra-short 4 mm dental implants. An electronic search without language or date restrictions was performed in five databases and in gray literature for articles published until August 2020. Prospective cohort studies and randomized clinical trials (RCTs) that evaluated the clinical performance of extra-short 4 mm dental implants were included. Studies were independently assessed for risk of bias using the Cochrane Collaboration's tool. The protocol of this SR was registered in the PROSPERO database under number CRD42019139709. Four studies were included in the present SR. There was no significant difference in implant survival rate ( = 0.75) between extra-short 4 mm and long implants. After 12 months of function, the extra-short implants had a significantly ( = 0.003) lower marginal bone loss (MBL) rate when compared to long implants. Extra-short implants had a lower number of biological and prosthetic complications when compared to long implants. After 12 months of follow-up, extra-short 4 mm dental implants placed in the mandible exhibit satisfactory clinical outcomes concerning implant survival rate and MBL when compared to longer implants, with a low number of biological and prosthetic complications. A higher number of RCTs with longer follow-up is necessary for the future.
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http://dx.doi.org/10.3390/healthcare9030315DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7998998PMC
March 2021

Clinical efficacy of simvastatin gel combined with polypropylene membrane on the healing of extraction sockets: A triple-blind, randomized clinical trial.

Clin Oral Implants Res 2021 Jun 27;32(6):711-720. Epub 2021 Mar 27.

Department of Dental Technics, School of Dentistry, Fluminense Federal University, Niterói, Brazil.

Objectives: This study aimed to evaluate dimensional changes, level of soft tissue healing, and pain/discomfort perception in post-extraction sockets filling with 1.2% simvastatin (SIM) gel covered with polypropylene membranes (PPPM).

Material And Methods: Twenty-six post-extraction sockets of posterior teeth were randomly allocated in two groups: (a) socket filling with 1.2% SIM gel and covered with PPPM (n = 13) and (b) socket filling with placebo gel and covered with PPPM (n = 13). Cone-beam computed tomography (CBCT) images before and 90 days after the extraction enabled alveolar bone dimensional changes calculation using horizontal and vertical measurements. The measurements occurred at three different levels for thickness located 1, 3, and 5 mm from the top of the bone crest. The vertical (depth) measure was assessed from the most apical portion of the socket to the bone crest's most coronal portion. Seven days after the extractions, the level of soft tissue healing and pain perception were also analyzed.

Results: After 90 days of extractions, the dimensional changes in thickness in the test group were significantly smaller in sections A (p = .044), B (p = .036) and C (p = .048) when compared to the control group. The test group showed a significantly lower height-dimensional change than the control group (p < .0001). Soft tissue healing index (p = .63), perception of pain (p = .23), and number of analgesics consumed (p = .25) were similar between groups.

Conclusions: Simvastatin at 1.2% compared with placebo effectively reduced the dimensional changes in post-extraction sockets covered with PPPM. There was no significant difference in the level of soft tissue healing and postoperative pain between the test and control groups.
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http://dx.doi.org/10.1111/clr.13740DOI Listing
June 2021

Use of platelet-rich fibrin for the treatment of periodontal intrabony defects: a systematic review and meta-analysis.

Clin Oral Investig 2021 May 20;25(5):2461-2478. Epub 2021 Feb 20.

Department of Periodontology, University of Bern, Bern, Switzerland.

Objectives: This study aims to compare the treatment outcomes of periodontal intrabony defects by using platelet-rich fibrin (PRF) with other commonly utilized modalities.

Materials And Methods: The eligibility criteria comprised randomized controlled trials (RCTs) comparing the clinical outcomes of PRF with that of other modalities. Studies were classified into 10 categories as follows: (1) open flap debridement (OFD) alone versus OFD/PRF; (2) OFD/bone graft (OFD/BG) versus OFD/PRF; (3) OFD/BG versus OFD/BG/PRF; (4-6) OFD/barrier membrane (BM), OFD/PRP, or OFD/enamel matrix derivative (EMD) versus OFD/PRF; (7) OFD/EMD versus OFD/EMD/PRF; (8-10) OFD/PRF versus OFD/PRF/metformin, OFD/PRF/bisphosphonates, or OFD/PRF/statins. Weighted means and forest plots were calculated for probing depth (PD), clinical attachment level (CAL), and radiographic bone fill (RBF).

Results: From 551 articles identified, 27 RCTs were included. The use of OFD/PRF statistically significantly reduced PD and improved CAL and RBF when compared to OFD. No clinically significant differences were reported when OFD/BG was compared to OFD/PRF. The addition of PRF to OFD/BG led to significant improvements in CAL and RBF. No differences were reported between any of the following groups (OFD/BM, OFD/PRP, and OFD/EMD) when compared to OFD/PRF. No improvements were also reported when PRF was added to OFD/EMD. The addition of all three of the following biomolecules (metformin, bisphosphonates, and statins) to OFD/PRF led to statistically significant improvements of PD, CAL, and RBF.

Conclusions: The use of PRF significantly improved clinical outcomes in intrabony defects when compared to OFD alone with similar levels being observed between OFD/BG and OFD/PRF. Future research geared toward better understanding potential ways to enhance the regenerative properties of PRF with various small biomolecules may prove valuable for future clinical applications. Future research investigating PRF at histological level is also needed.

Clinical Relevance: The use of PRF in conjunction with OFD statistically significantly improved PD, CAL, and RBF values, yielding to comparable outcomes to OFD/BG. The combination of PRF with bone grafts or small biomolecules may offer certain clinical advantages, thus warranting further investigations.
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http://dx.doi.org/10.1007/s00784-021-03825-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8060184PMC
May 2021

A systematic review of metastatic cancer presenting in osteonecrosis of the jaws (MC-ONJ) in patients undergoing antiresorptive and/or antiangiogenic therapy for skeletal-related adverse events.

Oral Surg Oral Med Oral Pathol Oral Radiol 2021 06 8;131(6):650-659. Epub 2021 Jan 8.

Oral Surgery Consultant, Guys Dental Hospital, Oral Surgery Department, London, UK.

Introduction: Osteonecrosis of the jaw (ONJ) is reported to be primarily associated with patients receiving bisphosphonate therapies but has been found in patients taking a number of other medications. A number of recent reports have noted the presence of metastatic cancers in the histologic analysis of osteonecrotic lesions from the jaw. The aim of the present review is to estimate the frequency and the type of metastatic cancer most commonly found in ONJ specimens in patients undergoing antiresorptive and/or antiangiogenic drug therapy.

Material And Methods: A multidatabase (PubMed, MEDLINE, EMBASE, and CINAHL) systematic search was performed. Any studies involving human participants treated with antiresorptive and antiangiogenic drugs were considered. Where study patients presented with malignant cells within osteonecrotic specimens, further data were collected. Data are presented using descriptive statistics.

Results: A total of 13 studies met the inclusion criteria for this systematic review. Thirty-seven study patients had histologic evidence of malignant cells within medication-related osteonecrosis of the jaw (MRONJ) specimens. The most frequent phenotype of malignant cells found within MRONJ specimens were breast cancer variants (n = 15). The frequency of malignant tumor cells found within the MRONJ specimens was calculated using 4 studies. Out of 604 patients, the frequency was 4.64% (n = 28).

Conclusions: Based on the limited data available in the literature, it is plausible that not histologically analyzing all ONJ specimens could result in a small number of undiagnosed and untreated malignant diseases. Additional data based on a larger cohort of study patients is necessary to understand the role of MRONJ in metastatic spread and the influence of surgical treatment and reoccurrence.
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http://dx.doi.org/10.1016/j.oooo.2021.01.001DOI Listing
June 2021

The risk of osteonecrosis of the jaw and adverse outcomes in patients using antiresorptive drugs undergoing orthodontic treatment: A systematic review.

Heliyon 2021 Jan 13;7(1):e05914. Epub 2021 Jan 13.

King's College Dental Hospital, Oral Surgery Department, London, UK.

Objectives: Medication-related osteonecrosis of the jaw (MRONJ) is rare. It is a serious adverse effect of certain drugs, of which bisphosphonates (BPs) are the most widely known. The aim of this systematic review was to analyze all published evidence for the reported adverse outcomes as a result of orthodontic treatment in patients undergoing antiresorptive therapy.

Data: All types of studies involving patients undergoing orthodontic treatment and treated with antiresorptive drugs were considered. A meta-analysis was not conducted due to the high amount of variability and heterogeneity in the reporting and presentation of data among the studies meeting the inclusion criteria.

Sources: A systematic search was performed using 4 databases (PubMed, MEDLINE, EMBASE and CINAHL).

Study Selection: Seven studies matched the inclusion criteria for this review, reporting a total of 29 patients. MRONJ was only reported in 1 patient. The adverse outcomes following orthodontic treatment included difficulty achieving root parallelism ( = 4), difficulty achieving complete space closure ( = 3), exaggerated tooth mobility post-debond ( = 2), increased duration of orthodontic treatment beyond expected completion ( = 1), sclerotic alveolar bone changes seen on post-op radiographic images ( = 2), and an increased amount of root resorption ( = 1).

Conclusions: The high amount of heterogeneity and limited evidence precluded a valid interpretation and analysis of the results through pooling of data. Additional data with sufficient quality, a reduction of bias, and a greater prospective cohort of patients is crucial to assess adverse effects, mechanisms of action, and associated risk factors in at-risk patients.

Clinical Significance: Based on the limited evidence available in the literature, it is unclear whether orthodontic treatment alone can precipitate MRONJ. However, antiresorptive drug therapy may be associated with a sub-optimal treatment outcome.
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http://dx.doi.org/10.1016/j.heliyon.2021.e05914DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7810783PMC
January 2021

A prospective study of resolution of post-traumatic orbital complications using PRECLUDE® MVP: A randomized controlled trial.

Ann Med Surg (Lond) 2021 Jan 29;61:139-144. Epub 2020 Dec 29.

Oral & Maxillofacial Surgery, Federal Fluminense University, Rio de Janeiro, Brazil.

Orbital fractures alone represent 10% up to 25% of all facial fractures, but when they are associated with other fractures of the middle-third of the face, their incidence can increase up to 55%. This study aimed to identify whether the size of the orbital defect based on the classification by Jaquiéry et al. influenced the resolution of post-traumatic complications after orbital wall reconstruction using PRECLUDE®MVP alone or in combination with a titanium mesh or autogenous bone graft. Thirty-five orbits were categorized into four groups on the basis of the size of the defect and the operative techniques: group 1 contained 16 Jaquiéry class I orbits treated only with PRECLUDE®MVP; group 2 included eight class II orbits treated with PRECLUDE®MVP along with autogenous bone graft harvested from the calvaria or a titanium mesh; group 3 included five class III orbits and group 4 included six class IV orbits that were treated the same way as those in group 2. Spearman correlation showed that the use PRECLUDE®MVP didn't improve the post traumatic complications for big orbital defects due to the three-dimensional anatomical changes that occurred by neurologic lesions and lipolysis of the orbital contents.
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http://dx.doi.org/10.1016/j.amsu.2020.12.021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7797472PMC
January 2021

In Vivo Comparative Evaluation of Biocompatibility and Biodegradation of Bovine and Porcine Collagen Membranes.

Membranes (Basel) 2020 Dec 15;10(12). Epub 2020 Dec 15.

Clinical Research Laboratory in Dentistry, Universidade Federal Fluminense, Niteroi 24020-140, RJ, Brazil.

Mechanical barriers prevent the invasion of the surrounding soft tissues within the bone defects. This concept is known as Guided Bone Regeneration (GBR). The knowledge about the local tissue reaction and the time of degradation of absorbable membranes favors the correct clinical indication. This study aimed to evaluate the biocompatibility and biodegradation of a bovine collagen membrane (Lyostypt, São Gonçalo, Brazil) and compare it to a porcine collagen membrane (Bio-Gide) implanted in the subcutaneous tissue of mice, following ISO 10993-6:2016. Thirty Balb-C mice were randomly divided into three experimental groups, LT (Lyostypt), BG (Bio-Gide), and Sham (without implantation), and subdivided according to the experimental periods (7, 21, and 63 days). The BG was considered non-irritant at seven days and slight and moderate irritant at 21 and 63 days, respectively. The LT presented a small irritant reaction at seven days, a mild reaction after 21, and a reduction in the inflammatory response at 63 days. The biodegradation of the LT occurred more rapidly compared to the BG after 63 days. This study concluded that both membranes were considered biocompatible since their tissue reactions were compatible with the physiological inflammatory process; however, the Bio-Gide was less degraded during the experimental periods, favoring the guided bone regeneration process.
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http://dx.doi.org/10.3390/membranes10120423DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7765348PMC
December 2020

Nanostructured Carbonated Hydroxyapatite Associated to rhBMP-2 Improves Bone Repair in Rat Calvaria.

J Funct Biomater 2020 Dec 4;11(4). Epub 2020 Dec 4.

Oral Surgery Department, Dentistry School, Universidade Federal Fluminense, Rio de Janeiro 24020-140, Brazil.

Many biomaterials are used for Bone Morphogenetic Proteins (BMPs) delivery in bone tissue engineering. The BMP carrier system's primary function is to hold these growth factors at the wound's site for a prolonged time and provide initial support for cells to attach and elaborate the extracellular matrix for bone regeneration. This study aimed to evaluate the nanostructured carbonated hydroxyapatite microspheres (nCHA) as an rhBMP-2 carrier on rats calvaria. A total of fifteen male Wistar rats were randomly divided into three groups ( = 5): clot (control group), rhBMP-2 associated with collagen membrane (COL/rhBMP-2) or associated with the microspheres (nCHA/rhBMP-2). After 45 days, the calvaria defect samples were evaluated through histological, histomorphometric, and SR-µCT analyses to investigate new-formed bone and connective tissue volume densities. The descriptive histological analysis showed that nCHA/rhBMP-2 improved bone formation compared to other groups. These results were confirmed by histomorphometric and SR-µCT analysis that showed substantially defect area filling with a higher percentage of newly formed (36.24 ± 6.68) bone than those with the COL/rhBMP-2 (0.42 ± 0.40) and Clot (3.84 ± 4.57) ( < 0.05). The results showed that nCHA is an effective carrier for rhBMP-2 encouraging bone healing and an efficient alternative to collagen membrane for rhBMP-2 delivery.
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http://dx.doi.org/10.3390/jfb11040087DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7768361PMC
December 2020

IN VIVO EVALUATION OF BOVINE XENOGRAFT ASSOCIATED WITH OXYGEN THERAPY IN ALVEOLAR BONE REPAIR.

J Oral Implantol 2020 Dec 3. Epub 2020 Dec 3.

Orthodontic Department and Clinical Research Laboratory in Dentistry, Universidade Federal Fluminense, Niteroi, RJ, Brazil.

In order to preserve alveolar bone thickness and width after extraction, clinical strategies have been adopted to reduce or eliminate the need for future surgical interventions to increase the alveolar ridge. The use of xenogeneic biomaterials has been increasing for such application. The association of bone substitutes with active oxygen-based materials, which is essential in the wound healing process, could accelerate the bone repair, optimizing the maintenance of alveolar architecture after extraction. However, the truth of this hypothesis is not clear. The present study aimed to compare the biological response to inorganic bovine bone graft Bonefill® (BF), associated or not with active oxygen-based gel Oral gel Blue ® m (BF+BM), in alveolar bone repair. Twenty female Wistar rats were randomly distributed, the left upper central incisor was extracted and the dental sockets were filled with BF in the control group (n=10), and with BF+BM in the experimental group (n=10). After 7- and 42-days' post implantation (n=5), the animals were euthanized, and the samples were processed for descriptive histological and histomorphometric evaluations. The results showed no significant difference between the groups (p>0.05). Both groups presented a time-dependent increase of new formed bone and biosorption biomaterial (p=0.0001). While the biomaterial analyzed was considered compatible and osteoconductive, the association with Blue ® m gel did not improve or interfere with the bone repair after the experimental periods.
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http://dx.doi.org/10.1563/aaid-joi-D-20-00110DOI Listing
December 2020

The Influence of Nanostructured Hydroxyapatite Surface in the Early Stages of Osseointegration: A Multiparameter Animal Study in Low-Density Bone.

Int J Nanomedicine 2020 10;15:8803-8817. Epub 2020 Nov 10.

Clinical Research Laboratory, Dentistry School, Universidade Federal Fluminense, Niteroi, RJ, Brazil.

Background And Objective: The success rates of dental implants in low-density bone have been reported as a challenge, especially for early or immediate loading in the maxilla posterior area. Nanoscale architecture affects the roughness, surface area, surface energy of the implant and can enhance osseointegration. This study aimed to evaluate the implant-surface topography and biomechanical, histomorphometric, and histological bone responses to a new nanostructured hydroxyapatite surface placed in the iliac crest of sheep.

Methods: Ten female sheep (2-4 years) received 30 implants (n=10/group): HAnano coated (Epikut Plus, S.I.N. Implant System, Sao Paulo, SP, Brazil), SLActive (BLX, Straumann, Basel, Switzerland), and TiUnite (NobelActive, Nobel Biocare, Göteborg, Sweden) surfaces. Scanning electron microscopy with energy-dispersive spectroscopy evaluated the implant surface topography, the insertion torque value, and resonance frequency analysis evaluated the primary stability, bone-implant contact, and bone-area fraction occupancy were evaluated after 14 and 28 days after implant placement.

Results: The surface morphology was considerably comparable between the implant groups'; however, the TiUnite group presented a remarkable different surface. The SLActive and TiUnite groups presented an insertion torque average of 74 (±8.9) N/cm that was similar to that of HAnano 72 (±8.3) N/cm (p >0.05). The resonance frequency evaluated with Osstell/SmartPeg or Penguin/MulTipeg showed similar results when assessing implants from the same group. BIC and BAFO significantly increased (p<0.05) throughout the experimental periods to all groups, but BIC and BAFO values were similar among the implants at the same time point. After 4 weeks, bone-implant contact was higher than 80% of the total length analyzed. New bone occupies around 60% of analyzed area around the implants.

Conclusion: HAnano coated surface promoted comparable osseointegration as SLActive and TiUnite in the sheep model. The three tested surfaces showed comparable osseointegration at the early stages of low-density bone repair in the sheep model.
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http://dx.doi.org/10.2147/IJN.S280957DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7667590PMC
December 2020

A completely digital approach to replicating functional and esthetic parameters in mandibular implant-supported complete-arch prostheses.

J Prosthet Dent 2020 Oct 14. Epub 2020 Oct 14.

Professor, Department of Periodontology, School of Dentistry, Veiga de Almeida University (UVA), Rio de Janeiro, Brazil. Electronic address:

Making an intraoral digital scan for fixed mandibular implant-supported complete-arch prostheses is a clinical challenge. The absence of references in the mandibular arch for precise scan alignment may complicate the correct digital design of the prosthesis framework. This article presents a straightforward method that allows a completely digital approach to digital scanning for fixed mandibular implant-supported prostheses.
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http://dx.doi.org/10.1016/j.prosdent.2020.05.041DOI Listing
October 2020

Is THP-1 viability affected by the crystallinity of nanostructured carbonated hydroxyapatites?

J Biomed Mater Res A 2021 07 28;109(7):1266-1274. Epub 2020 Oct 28.

Bioengineering Laboratory, National Institute of Metrology, Quality and Technology, Duque de Caxias, Brazil.

In daily clinical practice, there is a notable variety of synthetic bone substitute, with various resorption rates, different chemical and structural characteristics that influence on bone regeneration and are not suitable for every clinical use. New biomaterials based on nanotechnology have been developed to be bioabsorbable as new bone is formed. This study intends to evaluate THP-1 cell viability when exposed to extracts of unsintered nanostructured carbonated hydroxyapatite (cHA) microspheres processed at 5 and 37°C compared to sintered hydroxyapatite processed at 90°C. cHA shows, in previous studies, biocompatibility, and better bioabsorption rates, consequently, improve the deposition of new bone and tissue repair. The results demonstrated that the tested biomaterials did not activate inflammatory role through THP-1 cells and did not affect activated macrophages independently of their crystallinities, suggesting their safety and biocompatibility. These results are of fundamental importance for the advancement of research on smart materials, especially in what controls the effect of nanostructured cHA microspheres in the biological environment, seems to be a promising biomaterial in clinical application on regenerative medicine.
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http://dx.doi.org/10.1002/jbm.a.37120DOI Listing
July 2021

Effectiveness of connective tissue graft substitutes for the treatment of gingival recessions compared with coronally advanced flap: a network meta-analysis.

Clin Oral Investig 2020 Oct 26;24(10):3395-3406. Epub 2020 Aug 26.

Department of Periodontology and Oral Implantology, Dental Research Division, University of Guarulhos, São Paulo, Brazil.

Objectives: This study aimed to conduct a network comparison of the clinical effect of connective tissue graft (CTG) substitutes on the treatment of gingival recessions using coronally advanced flap.

Materials And Methods: An electronic search without language or dates restrictions was performed in five databases and in Grey literature for articles published until May, 2020. The eligibility criteria comprised randomized controlled trials (RCTs) that analyzed the clinical outcomes of CTG substitutes when compared with coronally advanced flap (CAF) for the treatment of Miller class I and II (Cairo RT I) gingival recessions. A pairwise and network meta-analysis were conducted for each periodontal parameters to assess and compare the outcomes among different treatment arms for the primary and secondary outcomes. This systematic review (SR) was registered in INPLASY under number INPLASY202060075.

Results: Twenty-seven studies were included in the present SR. All analyzed CTG substitutes showed superior results when comparing with CAF alone for all periodontal parameters. However, when compared in a network, the acellular dermal matrix (ADM) demonstrated the best treatment ranking of probability results, followed by platelet-rich fibrin (PRF), enamel matrix derivative (EMD), and xenogeneic collagen matrix (XCM) for root coverage (RC).

Conclusion: This SR observed that the association of biomaterials increases the effectiveness of RC in comparison with CAF alone. Based on the treatment ranking, although all the biomaterials analyzed showed a positive effect for RC, the ADM demonstrated the best results.

Clinical Relevance: To know the effectiveness of CTG substitutes for the treatment of gingival recessions.
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http://dx.doi.org/10.1007/s00784-020-03547-3DOI Listing
October 2020

In Vivo Biological Evaluation of Orthodontically Moved Incisors after Replantation.

Medicina (Kaunas) 2020 Aug 20;56(9). Epub 2020 Aug 20.

Orthodontics Department, Dentistry School, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-617, Brazil.

There is still considerable controversy regarding the possibility of submitting replanted teeth to orthodontic movement (OM). The purpose of the present study was to evaluate the tissue response after orthodontic movement on replanted teeth. Sixty Wistar rats were randomly assigned to four groups ( = 15): G1, replantation without OM after 30 days; G2, replantation with OM after 30 days; G3, replantation without OM after 60 days, and G4, replantation with OM after 60 days. The maxillary left central incisors were extracted and the teeth were stored in milk media. After 30 min, the teeth were replanted and fixed with non-rigid immobilization. All specimens were observed after 30 and 60 days of replantation and then subdivided into two subgroups (with OM or without OM). The animals were euthanized after seven days of the OM started, and the maxillary bone blocks were processed for histological evaluation. The histological results showed periodontal ligament repair in both periods studied without OM; however, ankylosis and root resorption was seen in all orthodontically moved teeth. The orthodontic movement did not favor tissue response in all replanted teeth, regardless of the experimental periods.
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http://dx.doi.org/10.3390/medicina56090421DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7558910PMC
August 2020

Determining the setting of root canal sealers using an in vivo animal experimental model.

Clin Oral Investig 2021 Apr 13;25(4):1899-1906. Epub 2020 Aug 13.

Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.

Objectives: To present and explore the potential of an animal-based experimental model developed to determine the set of root canal sealers in vivo. The setting of AH Plus, BioC Sealer, TotalFill BC Sealer, and Sealapex was determined using either ISO 6876 or the novel in vivo method proposed in this study.

Material And Methods: The in vitro setting time of the sealers tested was determined in accordance with ISO 6876:2012. In determining the in vivo set, 24 adult Wistar rats were followed up for two evaluation periods: 1 and 4 weeks. Their upper-right incisor was extracted, and its pulp tissue was removed. The root canal was then filled from retrograde with one of the 4 sealers, and the tooth was re-implanted and fixed with a layer of a flowable composite resin. After 1 or 4 weeks of the surgical procedures, the animals were euthanized, and their incisors were extracted. Two-mm-thick slices of the middle third of the tooth root were obtained and assessed with a Gillmore device, to determine whether or not the sealer had set.

Results: The following in vitro results were obtained by using ISO 6876 methodology: AH Plus set after a mean time of 423 ± 20 min and 476 ± 35 min, in metal and plaster molds, respectively. BioC Sealer set after 7 days (in dental plaster molds), whereas TotalFill BC Sealer and Sealapex did not set even after 25 days in both tested conditions (metal or dental plaster molds). Using the novel in vivo methodology, AH Plus, BioC Sealer, and TotalFill BC Sealer set after both 7 and 30 days. In contrast, Sealapex did not set at either time point.

Conclusions: AH Plus and BioC Sealer set under both in vitro and in vivo test conditions. TotalFill BC Sealer did not set under in vitro conditions but did after 1 week under in vivo conditions. Sealapex did not set under either in vitro or in vivo conditions.

Clinical Relevance: The influence of the testing conditions on the setting results is a clear indication that new in vivo experimental models should be useful in future studies on Bioceramics root canal sealers.
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http://dx.doi.org/10.1007/s00784-020-03496-xDOI Listing
April 2021

Weak evidence for the management of medication-related osteonecrosis of the jaw: An overview of systematic reviews and meta-analyses.

J Oral Pathol Med 2021 Jan 12;50(1):10-21. Epub 2020 Jul 12.

Department of Orthodontic, School of Dentistry, Fluminense Federal University, Niterói, Brazil.

Background: Although several therapies are proposed for medication-related osteonecrosis of the jaw (MRONJ), to date there is no consensus or treatment protocol for MRONJ. This overview aims to summarize the available evidence on the management and outcomes of MRONJ.

Methods: An electronic search without language or date restrictions occurred in five databases and gray literature for articles published until March 2020. This overview was performed according to the PICO format. The eligibility criteria comprised systematic reviews (RS) with or without meta-analyses that analyzed treatments outcomes for MRONJ. The methodological quality of each SR was evaluated using AMSTAR 2.

Results: Fifteen studies published between 2014 and 2020 were included in this overview. The summary of the evidence showed that conservative treatment and low level laser therapy can yield favorable results for early stages of MRONJ whereas surgical treatment seems to be better for advanced stages. However, qualitative assessment of the SRs highlighted a global low level of quality.

Conclusions: There is weak evidence to support treatment protocols for MRONJ. Because of the low quality of the SRs, highlighted by this overview, no insightful therapeutic recommendations can be issued for any intervention for MRONJ.
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http://dx.doi.org/10.1111/jop.13083DOI Listing
January 2021

Calcium Phosphate Carrying Simvastatin Enhances Bone Regeneration: A Systematic Review.

Braz Dent J 2020 Mar-Apr;31(2):93-102

Laboratory of Dental Clinical Research, Dentistry school, UFF - Universidade Federal Fluminense, Niterói, RJ, Brazil.

Several studies have aimed to develop alternative therapeutic biomaterials for bone repair. The purpose of this systematic review was to evaluate how statins carried by calcium phosphate affect the formation and regeneration of bone tissue in animal models when compared to other biomaterials or spontaneous healing. This systematic review followed the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions, the PRISMA guidelines, and the Preclinical Systematic Review & Meta-analysis Facility (SyRF). The protocol of this systematic review was registered in PROSPERO (CRD42018091112) and in CAMARADES. In addition, ARRIVE checklists were followed in order to increase the quality and transparency of the search. An electronic search was performed using the MEDLINE/PubMed, Scopus, SciELO, and PROSPERO library databases. The authors used a specific search strategy for each database, and they also conducted a search in the grey literature and cross-references. The eligibility criteria were animal studies, which evaluated bone repair treated with calcium phosphate as a simvastatin carrier. The selection process yielded 8 studies from the 657 retrieved. All manuscripts concluded that locally applied simvastatin carried by calcium phosphate is biocompatible, enhanced bone repair and induced statistically greater bone formation than cloth or calcium phosphate alone. In conclusion, the pertinent pre-clinical studies evidenced the calcium phosphate biocompatibility and its effectiveness in delivering SIM to improve the repair of bone defects. So, clinical trials are encouraged to investigate the impact of SIM associated with calcium phosphate bone graft in repairing bone defect in humans.
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http://dx.doi.org/10.1590/0103-6440202002971DOI Listing
June 2020

Clinical efficacy of xenogeneic collagen matrix in augmenting keratinized mucosa round dental implants: a systematic review and meta-analysis.

Clin Oral Investig 2020 Jul 19;24(7):2163-2174. Epub 2020 May 19.

Department of Oral Surgery, School of Dentistry, Fluminense Federal University, Rua Mario dos Santos Braga, 30, Centro, Niterói, Rio de Janeiro, 24020-140, Brazil.

Objectives: This study aimed to evaluate the clinical effects of xenogeneic collagen matrix (XCM) in augmenting keratinized mucosa width (KMW) around dental implants.

Materials And Methods: Articles that were published before or during April 2020 were electronically searched in four databases without any date or language restrictions and manually searched in regular journals and grey literature. The eligibility criteria comprised randomized controlled trials (RCTs) or prospective studies that analysed the clinical efficacy of XCM for augmenting KMW around dental implants. This systematic review (SR) was registered in PROSPERO under number CRD42018115399.

Results: Eleven studies published between 2009 and 2019 were included in this SR. There was no significant difference in KMW increase (p = 0.14), probing depth (PD) decrease (p = 0.17) or participants' aesthetic satisfaction (PAS) (p = 0.32) when XCM was compared to connective tissue graft (CTG). However, the increase in gingival thickness (GT) was significantly higher (p = 0.001) with the use of CTG.

Conclusions: The use of XCM improved KMW and PD with rates comparable to those for CTG. XCM showed lower results for GT when compared to CTG. XCM presented similar results in terms of PAS when compared to CTG.

Clinical Relevance: The presence of a KMW around dental implants is associated with better peri-implant tissue health.
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http://dx.doi.org/10.1007/s00784-020-03321-5DOI Listing
July 2020

Ineffectiveness of ozone therapy in nonsurgical periodontal treatment: a systematic review and metaanalysis of randomized clinical trials.

Clin Oral Investig 2020 Jun 12;24(6):1877-1888. Epub 2020 May 12.

Department of Dental Technics, School of Dentistry, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.

Objective: This systematic review (SR) aimed at assessing the adjunctive clinical effect of ozone therapy (OT) on nonsurgical periodontal treatment.

Materials And Methods: Articles published prior to September 2019 were electronically searched in four databases without any other date or language restrictions and manually searched in regular journals and in gray literature. This review was performed according to the PICO format. The eligibility criteria comprised randomized controlled trials (RCTs) that analyzed the adjunctive effect of OT on nonsurgical periodontal treatment.

Results: Twelve studies published between 2010 and 2019 were included in this SR. A metaanalysis of ten reports showed that there was no statistically significant difference in the periodontal parameters analyzed when scaling and root planing (SRP) plus sulcus irrigation with ozonated water or sulcus insertion of ozonated gas were used when compared to SRP alone. Additionally, there was no significant difference when the effect of SRP plus ozonated water was compared with SRP plus 2% chlorhexidine gluconate (CLX). No studies reported significant microbiological differences when the use of ozone was compared with SRP alone.

Conclusions: The results of this SR do not support the use of OT for nonsurgical periodontal treatment. However, due to the potential heterogeneity across the studies, the presence of confounding factors, and the short follow-up of some included RCTs, these results should not be considered definitive.

Clinical Relevance: The current evidence indicates that ozone has antimicrobial activity and good biocompatibility with periodontal cells and gingival fibroblasts. However, no evidence was found for a positive effect of OT as an adjunct to scaling and root planing.
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http://dx.doi.org/10.1007/s00784-020-03289-2DOI Listing
June 2020

Immunological response of allogeneic bone grafting: A systematic review of prospective studies.

J Oral Pathol Med 2020 May 7;49(5):395-403. Epub 2020 Feb 7.

Department of Dental Technics, School of Dentistry, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.

Background: Although widely used, the potential for immunological sensitization of allogeneic bone grafts is still controversial in the literature. This systematic review aimed to evaluate the immune response of allogeneic bone graft procedures in humans.

Methods: An electronic search without language or date restrictions occurred in four databases for articles published until July 2019. Eligibility criteria included prospective cohort studies, controlled clinical trials, and randomized clinical trials that evaluated the potential of allogeneic bone grafts in sensitized immune system in humans through immunological or biological analysis. The protocol number of this SR registered in PROSPERO is CDR42019135491.

Results: The search and selection process yielded eight prospective cohort studies published between 1984 and 2019. The percentage of patients' sensitization analyzed by human leukocyte antigens ranged from 21% to 67%, with a cumulative mean of 48 ± 17.3%. Bone soluble protein analysis demonstrates the sensitization of 55% of patients after allograft bone grafts. Also, a high level of circulating cell-free DNA took place in the immediate postoperative period.

Conclusion: Although studies report a low incidence of local complications, an average of 48% of the patients remain with the immune system sensitized after receiving allogeneic bone grafts. Future studies should better address the local and systemic consequences of such sensitization.
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http://dx.doi.org/10.1111/jop.12998DOI Listing
May 2020

Microspheres of alginate encapsulated minocycline-loaded nanocrystalline carbonated hydroxyapatite: therapeutic potential and effects on bone regeneration.

Int J Nanomedicine 2019 24;14:4559-4571. Epub 2019 Jun 24.

Department of Condensed Matter, Applied Physics and Nanoscience, Brazilian Center for Research in Physics, Rio de Janeiro, Brazil.

Tetracycline and its derivatives, combined with calcium phosphates, have been proposed as a delivery system to control inflammatory processes and chronic infections. The objective of this study was to evaluate the microspheres of alginate encapsulated minocycline-loaded nanocrystalline carbonated hydroxyapatite (CHAMINO) as a biomimetic device to carry out target-controlled drug delivery for alveolar bone repair. CHAMINO microspheres were implanted in a rat central incisor socket after 7 and 42 days. New bone was formed in both groups between 7 and 42 days of implantation. However, the bone growth was significantly higher for the CHAMINO microspheres. The minocycline (MINO) loading capacity of the nanocrystaline carbonated hydroxyapatite (CHA) nanoparticles was 25.1±2.2 µg MINO/mg CHA for adsorption over 24 hrs. The alginate microspheres containing minocycline-loaded CHA were biologically active and inhibited the culture growth for up to seven days of the MINO release. An osteoblastic cell viability assay based on the resazurin reduction was conducted after the cells were exposed to the CHAMINO powder and CHAMINO microspheres. Thus, it was found that the alginate extracts encapsulated the minocycline-loaded CHA microspheres and did not affect the osteoblastic cell viability, while the minocycline-doped CHA powder reduced the cell viability by 90%. This study concluded that the alginate microspheres encapsulating the minocycline-loaded nanocrystalline carbonated hydroxyapatite exhibited combined antibacterial activity against with cytocompatibility and osteoconduction properties. The significant improvement in the new bone formation after 42 days of implantation suggests that the CHAMINO microsphere has potential in clinical applications of bone regeneration.
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http://dx.doi.org/10.2147/IJN.S201631DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6600321PMC
October 2019

Usefulness of platelet-rich fibrin as a hemostatic agent after dental extractions in patients receiving anticoagulant therapy with factor Xa inhibitors: a case series.

Oral Maxillofac Surg 2019 Sep 17;23(3):381-386. Epub 2019 May 17.

Department of Oral Surgery, Dentistry School, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.

Purpose: To evaluate the clinical outcomes of platelet-rich fibrin (PRF) application for hemostasis after dental extraction in patients receiving anticoagulant therapy with factor Xa inhibitors.

Methods: In total, 25 patients receiving anticoagulant therapy with rivaroxaban or apixaban who required routine dental extraction were evaluated. In all patients, PRF was used for hemostasis in addition to adapting sutures. Bleeding was subjectively assessed using a sterilize gauze pad at 24, 48, and 72 h after the procedure.

Results: All invited participants (n = 25) consented to participate. The PRF clots successfully arrested bleeding after extraction in all patients, with no complications at any time point after the procedure. Favorable soft tissue healing was observed during suture removal at 10 days after the procedure in all patients, with no signs of infection or late healing.

Conclusions: The results of this case series indicate that PRF is a promising natural hemostatic agent for the management of bleeding after dental extraction in patients receiving factor Xa inhibitor therapy. Further controlled clinical studies with larger patient samples are necessary to clarify the findings of this case series.
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http://dx.doi.org/10.1007/s10006-019-00769-yDOI Listing
September 2019

In Vitro Physico-Chemical Characterization and Standardized In Vivo Evaluation of Biocompatibility of a New Synthetic Membrane for Guided Bone Regeneration.

Materials (Basel) 2019 Apr 11;12(7). Epub 2019 Apr 11.

Oral Surgery Department, Dentistry School, Universidade Federal Fluminense, Niterói, Rio de Janeiro 24.020-140, Brazil.

This study's aim was to evaluate the biocompatibility and bioabsorption of a new membrane for guided bone regeneration ( associated with hydroxyapatite and β-) with three thicknesses (200, 500, and 700 µm) implanted in mice subcutaneously. Scanning electron microscopy, X-ray diffraction, Fourier transform infrared spectroscopy, and the quantification of carbon, hydrogen and nitrogen were used to characterize the physico-chemical properties. One hundred Balb-C mice were divided into 5 experimental groups: Group 1-Sham (without implantation); Group 2-200 μm; Group 3-500 μm; Group 4-700 μm; and Group 5-Pratix. Each group was subdivided into four experimental periods (7, 30, 60 and 90 days). Samples were collected and processed for histological and histomorphometrical evaluation. The membranes showed no moderate or severe tissue reactions during the experimental periods studied. The 500-μm membrane showed no tissue reaction during any experimental period. The 200-μm membrane began to exhibit fragmentation after 30 days, while the 500-μm and 700-µm membranes began fragmentation at 90 days. All membranes studied were biocompatible and the 500 µm membrane showed the best results for absorption and tissue reaction, indicating its potential for clinical guided bone regeneration.
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http://dx.doi.org/10.3390/ma12071186DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6479290PMC
April 2019

Association between biomarkers and medication-related osteonecrosis of the jaws: a systematic review.

Oral Surg Oral Med Oral Pathol Oral Radiol 2019 Jun 26;127(6):504-515. Epub 2019 Feb 26.

Department of Oral Surgery, School of Dentistry, Fluminense Federal University, Rio de Janeiro, Brazil.

Objectives: Our aim was to conduct a systematic review (SR) of the literature assessing the role of human biomarkers in the diagnosis or prognostication of medication-related osteonecrosis of the jaws (MRONJ).

Study Design: An electronic search without date or language restriction was carried out in PubMed/MEDLINE, the Cochrane Central Register of Controlled Trials, Web of Science, and LILACS for publications until March 2018. In addition, a manual search in the gray literature was conducted. The search process was performed by 2 independent reviewing authors. Eligibility criteria included randomized and nonrandomized clinical trials, prospective or retrospective cohorts, case controls, and case series evaluating the association between biomarkers and MRONJ. The protocol of this SR was registered in PROSPERO under number CRD42018095886.

Results: The search and selection process yielded 19 studies (2 case series, 6 case-control studies, 9 prospective cohort studies, and 2 retrospective studies) published between 2008 and 2018. Twenty-four biomarkers collected from serum, saliva, and urine were investigated by these studies. Eleven biomarkers were possibly related to MRONJ; however, no consensus is observed in the literature with regard to the sensitivity and clinical effectiveness of these biomarkers.

Conclusions: Although many biomarkers have been associated with MRONJ, the present SR found scarce clinical evidence supporting the use of these biomarkers for the diagnosis and prognosis of MRONJ.
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http://dx.doi.org/10.1016/j.oooo.2019.02.014DOI Listing
June 2019

Clinical efficacy of xenogeneic collagen matrix in the treatment of gingival recession: a systematic review and meta-analysis.

Acta Odontol Scand 2019 Aug 21;77(6):457-467. Epub 2019 Mar 21.

c Department of Oral Surgery, School of Dentistry , Fluminense Federal University , Rio de Janeiro , Brazil.

The aim of this systematic review (SR) was to evaluate the effects of xenogenic collagen matrix (XCM) on the outcomes of clinical treatments of patients with Miller class-I or -II gingival recessions. Articles that were published before March 2018 were electronically searched in four databases without any date or language restrictions and manually searched in regular journals and gray literature. The eligibility criteria comprised randomized controlled trials (RCTs) and prospective controlled trials with follow-up periods of 6 months or more that compared the performance of XCM in the treatment of Miller class-I or -II gingival recessions. This SR was registered in PROSPERO under number CRD42018106118. Nine RCTs published between 2010 and 2018 were included in this SR. The percentage of root coverage (RC) was significantly higher ( = .0003) when gingival recessions were treated with XCM when compared to coronally advanced flap (CAF) alone. In addition, the parameters of keratinized mucosa width (KMW) ( = .006) and gingival thickness (GT) ( = .0003) were also improved when the XCM was used in comparison to the CAF alone. There was not a statistically significant difference ( = .22) between the clinical attachment level (CAL) achieved with the use of XCM and that achieved with CAF alone. RC with the use of XCM, when compared to connective tissue grafts (CTGs) ( = .09) and enamel matrix derivative (EMD) ( = .62), there was no significant difference; however, XCM yielded lower RC than CTG in the treatment of Miller class-I or -II gingival recessions. Based on both the individual studies' outcomes and the pooled estimates, it can be concluded that the use of XCM improves the RC, KMW and GT in the treatment of gingival recessions when compared to CAF alone and may be a viable alternative to use of CTG.
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http://dx.doi.org/10.1080/00016357.2019.1588372DOI Listing
August 2019

Effects of methods of hydration of a biphasic ceramic graft on bone regeneration of extraction socket defects.

J Periodontol 2019 04 29;90(4):425-432. Epub 2018 Nov 29.

Department of Periodontology, School of Dentistry, Federal Fluminense University, Rua São Paulo 28, Niterói, Rio de Janeiro, 24000-000, Brazil.

Background: Alveolar volumetric changes are inherent to the healing process after tooth extraction and filling of the extraction site with biomaterials can reduce these volumetric changes and provide a more favorable environment for the future prosthetic restoration with implants. Among the biomaterials available, biphasic ceramic compounds have shown promissing clinical results, however, histologic evaluation of bone tissue response to different hydration and incorporation methods are limited. The objective of this study was to comparatively evaluate in vivo the osteoconductive potential of the biphasic ceramic bone substitute (SBC) composed of beta-tricalcium phosphate and hydroxyapatite after different hydration methodologies in rat extraction sockets.

Methods: Wistar rats (n = 20) were randomly distributed in two subgroups (G1, G2) according to the hydration methods used. After extraction of the right upper central incisor the alveoli were filled with SBC hydrated by two different methods. Group 1: biomaterial hydrated in blood; Group 2: biomaterial hydrated in physiologic saline. The animals were euthanized after 1 and 6 weeks for removal of the bone blocks containing the biomaterial and were submitted to histologic processing. Five-μm-thick demineralized sections of the samples were stained with hematoxylin and eosin (HE) and subjected to histomorphometric analysis.

Results: Bone formation was limited 7 days after the extraction procedure and increased in both groups between 7 and 42 days from surgery, demonstrating a time dependent increase of bone volume throughtout the experimental period (p < 0.05).

Conclusions: The hydration of SBC with saline significantly increased new bone formation and reduced connective tissue volume after 42 days demonstrating that hydration method may significantly influence bone healing in such defects, and, thus should be carefully performed.
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http://dx.doi.org/10.1002/JPER.18-0209DOI Listing
April 2019
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