Artigos - Diagnóstico e Cirurgia - FOAR

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Effects of red and infrared laser on post extraction socket repair in rats subjected to alendronate therapy
(2023-01-01) Gonçalves, Fernanda Castanheira [UNESP]; Mascaro, Bruno Arruda [UNESP]; Oliveira, Guilherme José Pimentel Lopes de; Spolidório, Luis Carlos [UNESP]; Marcantonio, Rosemary Adriana Chiérici [UNESP]; Universidade Estadual Paulista (UNESP); Universidade Federal de Uberlândia (UFU)
This study evaluated the effect of photobiomodulation therapy (PBMT) with a red or infrared laser on the repair of post extraction sockets in rats administered alendronate (ALN). Forty male rats were randomly allocated into four groups: Control Group (CTR): subcutaneous administration of saline solution throughout the experimental period; Alendronate Group (ALN): subcutaneous administration of alendronate during the entire experimental period; Alendronate/Red Laser Group (ALN/RL): administration of ALN and irradiation with a GaAlAs laser (λ 660 nm); and Alendronate/Infrared Laser Group (ALN/IRL): administration of ALN and irradiation with a GaAlAs laser (λ 830 nm). The first lower molars were extracted 60 days after the beginning of the administration of the drugs. The PBMT was applied after tooth extraction (7 sessions with intervals of 48 hours between sessions). Thirty days after tooth extraction, the animals were euthanized. Micro-CT and histometric analysis were performed to assess the bone healing and soft tissue repair of the tooth socket. The ALN group presented with more bone than the CTR; however, most of this bone was necrotic. ALN does not affect the bone microarchitecture. On the other hand, PBMT with IRL enhances the bone density due to the increase in the number and reduction in the spacing of the trabeculae. The amount of vital bone and connective tissue matrix was higher in the ALN/RL and ALN/IRL groups than in the ALN and CTR groups. PBMT enhanced the healing of the post extraction sockets in rats subjected to ALN administration. Furthermore, IRL improved the new bone microarchitecture.
Chlorin-based photosensitizer under blue or red-light irradiation against multi-species biofilms related to periodontitis
(2023-03-01) Garcia de Carvalho, Gabriel [UNESP]; Pacheco Mateo, Rafaela [UNESP]; Costa e Silva, Rodrigo; Maquera Huacho, Patricia Milagros [UNESP]; de Souza Rastelli, Alessandra Nara [UNESP]; de Oliveira, Kleber Thiago; Chierici Marcantonio, Rosemary Adriana [UNESP]; Zandim-Barcelos, Daniela Leal [UNESP]; Palomari Spolidorio, Denise Madalena [UNESP]; Universidade Estadual Paulista (UNESP); Universidade Federal de São Carlos (UFSCar)
In our previous study, Chlorin-e6 (Ce6) demonstrated a significant reduction of microorganisms’ viability against single-species biofilm related to periodontitis once irradiated by red light (660 nm). Also, higher bacteria elimination was observed under blue light (450 nm) irradiation. However, the use of blue light irradiation of Ce6 for antimicrobial administration is poorly explored. This study evaluated the effect of chlorin-e6-mediated antimicrobial photodynamic therapy (aPDT) using different wavelengths (450 or 660 nm) against multi-species biofilms related to periodontitis. Streptococcus oralis, Fusobacterium nucleatum, Porphyromonas gingivalis, and Aggregatibacter actinomycetemcomitans composed the mature biofilm developed under proper conditions for five days. aPDT was performed using different concentrations of Ce6 (100 and 200 μM), wavelengths (450 or 660 nm), and comparisons were made after qPCR assay and confocal laser scanning microscopy (CLSM) analysis. The greatest bacterial elimination was observed in the groups where Ce6 was used with blue light, for S. orallis (2.05 Log10 GeQ mL-1, p < 0.0001) and P. gingivalis (1.4 Log10 GeQ mL-1, p < 0.0001), aPDT with red light showed significant bacteria reduction only for S. orallis. aPDT with blue light demonstrated statistically higher elimination in comparison with aPDT with red light. The aPDT did not show a statistically significant effect when tested against A. actinomycetemcomitans and F. nucleatum (p=0.776 and 0.988, respectively). The aPDT using blue light showed a promising higher photobiological effect, encouraging researchers to consider it in the irradiation of Ce6 for further investigations.
Implants with hydrophilic surfaces equalize the osseointegration of implants in normo- and hyperglycaemic rats
(2022-01-01) Pinotti, Felipe Eduardo [UNESP]; Aron, Mauricio Andrés Tinajero; Lopes de Oliveira, Guilherme José Pimentel; Marcantonio, Elcio [UNESP]; Chiérici Marcantonio, Rosemarv Adriana [UNESP]; Universidade Estadual Paulista (UNESP); Universidade Federal de Sergipe (UFS); Universidade Federal de Uberlândia (UFU)
The purpose of this study was to evaluate the effect of a surface modified by blasting and acid attack and maintained in an isotonic solution compared to a machined surface on osseointegration in normo- and hyperglycaemic animals. Sixty-four animals were allocated into 4 groups with 16 animals each, and they were subdivided into two experimental periods (15 and 45 days), with 8 animals in each group. The groups were divided according to the type of implant that was installed in the animals' tibia and the animals' systemic condition: CM - Machined implants placed in Healthy animals; CH - Hydrophilic implants placed in Healthy animals, HM - Machined implants placed in animals with hyperglycaemia; HH- Hydrophilic implants installed in animals with hyperglycaemia. The following analyses were performed: biomechanical (removal torque), microtomographic (evaluation of the bone volume around the implants- BV/TV), and histomorphometric (evaluation of bone-implant contact BIC% and of the bone formation area between the threads BBT%). It was found that the implants with hydrophilic surfaces presented higher removal torques and quantities of BV/TV% and higher BIC% and BBT% values in normo- and hyperglycaemic animals. The results of this study indicated that the hydrophilic surface accelerates the osseointegration process (~ 15% BIC/BBT at 15-day period), especially in animals with hyperglycaemia. The hydrophilic surface equaled the osseointegration between normo- and hyperglycaemic animals, reversing the negative potential of hyperglycaemia on the osseointegration process.
Beta tricalcium phosphate, either alone or in combination with antimicrobial photodynamic therapy or doxycycline, prevents medication-related osteonecrosis of the jaw
(2022-12-01) Hadad, Henrique [UNESP]; Kawamata de Jesus, Laís [UNESP]; Piquera Santos, Ana Flávia [UNESP]; Rinaldi Matheus, Henrique [UNESP]; de Souza Rodrigues, Letícia Gabriella [UNESP]; Paolo Poli, Pier; Marcantonio Junior, Elcio [UNESP]; Pozzi Semeghini Guastaldi, Fernando; Maiorana, Carlo; Milanezi de Almeida, Juliano [UNESP]; Okamoto, Roberta [UNESP]; Ávila Souza, Francisley [UNESP]; Universidade Estadual Paulista (UNESP); University of Milan; Harvard School of Dental Medicine
Surgical trauma in those under a prolonged use of bisphosphonates, can lead to mediation-related osteonecrosis of the jaw (MRONJ). This study aimed to evaluate the preventive therapies for MRONJ. Following four cycles of zoledronic acid administration, Wistar rats had their molar extracted, and were organized into nine treatment groups: negative control group (NCG), treated with saline solution and blood-clot in the alveolus; positive control group (PCG), with blood-clot in the alveolus; BG, β-tricalcium phosphate-based biomaterial; DG, 10% doxycycline gel; aG, antimicrobial photodynamic therapy; and DBG, aBG, aDG, and aDBG, using combination therapy. After 28 days, the lowest bone volume (BV/TV) was reported in PCG (42.17% ± 2.65), and the highest in aDBG (69.85% ± 6.25) (p < 0.05). The higher values of daily mineral apposition rate were recorded in aDBG (2.64 ± 0.48) and DBG (2.30 ± 0.37) (p < 0.001). Moreover, aDBG presented with the highest neoformed bone area (82.44% ± 2.69) (p < 0.05). Non-vital bone was reported only in the PCG (37.94 ± 18.70%). Owing to the key role of the biomaterial, the combination approach (aDBG) was the most effective in preventing MRONJ following tooth extraction.
Accuracy of Manual and Virtual Predictive Tracings in Patients Submitted to Orthognathic Surgery
(2023-06-01) Gorla, Luís Fernando De Oliveira [UNESP]; Dos Santos, José Cleveilton; Carvalho, Pedro Henrique De Azambuja; Hochuli-Vieira, Eduardo; Gabrielli, Marisa Aparecida Cabrini; Universidade Estadual Paulista (UNESP)
Cephalometric tracing done manually was considered gold standard for the cephalometric analysis in the last decades. The digital radiographs began to be commonly used in order to make that in a digital way. The objective was to define the accuracy of the predictive and final cephalometric tracings performed manually and virtually. The authors selected 20 patients submitted to bimaxillary orthognathic surgery. The data were collected from lateral cephalometric radiographs, in the preoperative and postoperative periods. The interest were: points, angles (Sella-Nasion to A point angle; Sella-Nasion to B point angle; Frankfurt plane to Mandibular plane angle; Frankfurt plane to occlusal plane angle; Upper and lower central incisors long axes angle; Incisor to Mandibular plane angle; Upper incisor axis to Sella-Nasion plane angle) distances (Co-A; Co-Gn). Data were submitted to the Shapiro-Wilk, analysis of variance, and Kruskal-Wallis tests. The measurement differences were compared using a t test. Descriptive statistics were performed in Excel 2013 and SPSS software, P<0.05 being considered significant. No statistically significant difference was found between the mean values predictive and postoperative of the angles and distances within the manual and digital groups. When comparing the means of the differences between the predictive values and the final values, only the 1:1 angle presented a statistically significant difference, indicating a greater accuracy of the digital predictive tracing for this measure. In conclusion, both methods for obtaining predictive tracings are accurate, which shows that clinical results can be successfully simulated by the most accessible technique.
Chalcone T4 Inhibits RANKL-Induced Osteoclastogenesis and Stimulates Osteogenesis In Vitro
(2023-04-01) de Matos, Iolanda Augusta Fernandes [UNESP]; Fernandes, Natalie Aparecida Rodrigues [UNESP]; Cirelli, Giovani [UNESP]; de Godoi, Mariely Araújo [UNESP]; de Assis, Letícia Ribeiro [UNESP]; Regasini, Luis Octávio [UNESP]; Rossa Junior, Carlos [UNESP]; Guimarães-Stabili, Morgana Rodrigues [UNESP]; Universidade Estadual Paulista (UNESP)
Chalcones are phenolic compounds produced during the biosynthesis of flavonoids that have numerous biological activities, including anti-inflammatory, antioxidant and anticancer. In this in vitro study, we investigate a newly synthesized chalcone (Chalcone T4) in the context of bone turnover, specifically on the modulation of osteoclast differentiation and activity and osteoblast differentiation. Murine macrophages (RAW 264.7) and pre-osteoblasts (MC3T3-E1) were used as models of osteoclasts and osteoblasts, respectively. Differentiation and activity osteoclasts were induced by RANKL in the presence and absence of non-cytotoxic concentrations of Chalcone T4, added in different periods during osteoclastogenesis. Osteoclast differentiation and activity were assessed by actin ring formation and resorption pit assay, respectively. Expression of osteoclast-specific markers (Nfatc1, Oscar, Acp5, Mmp-9 and Ctsk) was determined by RT-qPCR, and the activation status of relevant intracellular signaling pathways (MAPK, AKT and NF-kB) by Western blot. Osteoblast differentiation and activity was induced by osteogenic culture medium in the presence and absence of the same concentrations of Chalcone T4. Outcomes assessed were the formation of mineralization nodules via alizarin red staining and the expression of osteoblast-related genes (Alp e Runx2) by RT-qPCR. Chalcone T4 reduced RANKL-induced osteoclast differentiation and activity, suppressed Oscar, Acp5 and Mmp-9 expression, and decreased ERK and AKT activation in a dose-dependent manner. Nfact1 expression and NF-kB phosphorylation were not modulated by the compound. Mineralized matrix formation and the expression of Alp and Runx2 by MC3T3-E1 cells were markedly stimulated by Chalcone T4. Collectively, these results demonstrate that Chalcone T4 inhibits in osteoclast differentiation and activity and stimulates osteogenesis, which indicates a promising therapeutic potential in osteolytic diseases.
Anti-Inflammatory Benefits of Food Ingredients in Periodontal Diseases
(2023-04-01) Papathanasiou, Evangelos; Alreshaid, Reem; Araujo de Godoi, Mariely [UNESP]; Tufts University School of Dental Medicine; Universidade Estadual Paulista (UNESP)
Periodontitis is a multi-faceted inflammatory disease that impacts the gingiva and the structures that support our teeth, and may eventually increase tooth mobility and the risk of tooth loss. Inflammation is a viable therapeutic target of periodontitis for both biologic (dietary) and host modulatory agents/drugs. Conventional therapeutic approaches for periodontitis, including nonsurgical or surgical periodontal therapy as well as occasional adjunctive antimicrobial therapy, have been only marginally effective. Malnutrition, or at least poor dietary habits, can be highly prevalent among patients with periodontal diseases. As several food nutrients can aid in periodontal healing and regeneration, there is a critical need to evaluate natural dietary sources and supplement ingredients that can counterbalance the inflammatory processes and improve the periodontal status of our patients. Here, we reviewed the current state of knowledge (search period: 2010 to 2022; PubMed and Web of Science) on the anti-inflammatory actions of food ingredients and supplements in clinical studies of patients with periodontal diseases. A diet that includes fruits and vegetables, omega-3 polyunsaturated fatty acids, and supplements of vitamins and plant-derived compounds seems to counteract gingival inflammation and has a promising therapeutic impact in patients with periodontal diseases. Despite the positive indications that several nutrients can be used as an adjunct to periodontal therapy, additional studies with bigger sample sizes and longer follow-up periods are needed to elucidate their therapeutic benefits and the most effective doses and administration.
Lymphomatoid Papulosis Type E Affecting the Palate: A Detailed Case Report and Review of Literature
(2023-05-01) Silveira, Heitor Albergoni [UNESP]; Ragusa Silva, Paula Verona [UNESP]; Pimentel, Bruna Gonçalves; Nogueira, Gustavo Milhomens; Chahud, Fernando; Brunaldi, Mariângela Ottoboni; León, Jorge Esquiche; Universidade Estadual Paulista (UNESP); Universidade de São Paulo (USP)
Lymphomatoid papulosis (LyP) belongs to the spectrum of primary cutaneous CD30+lymphoproliferative disorders, characterized by chronic, recurrent, self-healing papules, small nodules, or ulcers. The clinicopathological features of LyP can mimic overt lymphomas. To date, about 27 intraoral LyP cases have been reported. Of them, only 2 cases were diagnosed as angioinvasive LyP (type E). Herein, we report a 24-year-old Brazilian man who presented a large ulcerated lesion on the hard palate with rapid evolution. Remarkably, there was no involvement of the skin or other mucous membranes. Microscopy revealed a lymphoid infiltrate constituted by medium-sized to large atypical cells, with angiocentric and angiodestructive features. The atypical cells showed immunopositivity for CD3, CD8, CD30, CD56, granzyme B, perforin, and focally for MUM1/IRF4. Ki-67 highlighted almost all atypical lymphoid cells, whereas EBER1/2 was negative. After 2 months of follow-up, the lesion healed completely. Although rare, LyP type E should be included in the differential diagnosis of oral ulcers.
Evidence Linking PPARG Genetic Variants with Periodontitis and Type 2 Diabetes Mellitus in a Brazilian Population
(2023-04-01) Cirelli, Thamiris [UNESP]; Nicchio, Ingra G. [UNESP]; Bussaneli, Diego G. [UNESP]; Silva, Bárbara R. [UNESP]; Nepomuceno, Rafael [UNESP]; Orrico, Silvana R. P. [UNESP]; Cirelli, Joni A. [UNESP]; Theodoro, Letícia H. [UNESP]; Barros, Silvana P.; Scarel-Caminaga, Raquel M. [UNESP]; University Center—UNIFAE; Universidade Estadual Paulista (UNESP); Union of the Colleges of the Great Lakes—UNILAGO; University of North Carolina at Chapel Hill—UNC
The peroxisome proliferator-activated receptor gamma (PPARG) gene encodes a transcription factor involved in the regulation of complex metabolic and inflammatory diseases. We investigated whether single nucleotide polymorphisms (SNPs) and haplotypes of the PPARG gene could contribute with susceptibility to develop periodontitis alone or together with type 2 diabetes mellitus (T2DM). Moreover, we evaluated the gene–phenotype association by assessing the subjects’ biochemical and periodontal parameters, and the expression of PPARG and other immune response–related genes. We examined 345 subjects with a healthy periodontium and without T2DM, 349 subjects with moderate or severe periodontitis but without T2DM, and 202 subjects with moderate or severe periodontitis and T2DM. PPARG SNPs rs12495364, rs1801282, rs1373640, and rs1151999 were investigated. Multiple logistic regressions adjusted for age, sex, and smoking status showed that individuals carrying rs1151999-GG had a 64% lower chance of developing periodontitis together with T2DM. The CCGT haplotype increased the risk of developing periodontitis together with T2DM. The rs1151999-GG and rs12495364-TC were associated with reduced risk of obesity, periodontitis, elevated triglycerides, and elevated glycated hemoglobin, but there was no association with gene expression. Polymorphisms of the PPARG gene were associated with developing periodontitis together with T2DM, and with obesity, lipid, glycemic, and periodontal characteristics.
Dental implants in large animal models with experimental systemic diseases: A systematic review
(2023-01-01) Matos, Flávia Gomes; Stremel, Anna Clara Abreu; Lipinski, Leandro Cavalcante; Cirelli, Joni Augusto [UNESP]; dos Santos, Fábio André; State University of Ponta Grossa; Universidade Estadual Paulista (UNESP)
This systematic review aims to identify and discuss the most used methodologies in pre-clinical studies for the evaluation of the implementation of dental implants in systemically compromised pigs and sheep. This study provides support and guidance for future research, as well as for the prevention of unnecessary animal wastage and sacrifice. Preferred Reporting for Systematic Reviews and Meta-Analyses (PRISMA) was used as a guideline; electronic searches were performed in PubMed, Scopus, Scielo, Web of Science, Embase, Science Direct, Brazilian Bibliography of Dentistry, Latin American and Caribbean Literature in Health Sciences, Directory of Open Access Journals, Database of Abstracts of Reviews of Effects, and gray literature until January 2022 (PROSPERO/CRD42021270119). Sixty-eight articles were chosen from the 2439 results. Most studies were conducted in pigs, mainly the Göttinger and Domesticus breeds. Healthy animals with implants installed in the jaws were predominant among the pig studies. Of the studies evaluating the effect of systemic diseases on osseointegration, 42% were performed in osteoporotic sheep, 32% in diabetic sheep, and 26% in diabetic pigs. Osteoporosis was primarily induced by bilateral ovariectomy and mainly assessed by X-ray densitometry. Diabetes was induced predominantly by intravenous streptozotocin and was confirmed by blood glucose analysis. Histological and histomorphometric analyses were the most frequently employed in the evaluation of osseointegration. The animal models presented unique methodologies for each species in the studies that evaluated dental implants in the context of systemic diseases. Understanding the most commonly used techniques will help methodological choices and the performance of future studies in implantology.
Chronology of permanent teeth mineralization in Brazilian individuals: age estimation tables
(2023-12-01) Kuhnen, Barbara [UNESP]; Fernandes, Clemente Maia da Silva [UNESP]; Barros, Franciéllen de [UNESP]; Scarso Filho, José [UNESP]; Gonçalves, Marcelo [UNESP]; Serra, Mônica da Costa [UNESP]; Universidade Estadual Paulista (UNESP)
Background: Age is important in forming the uniqueness of individuals. When chronological age is not available, age estimation is required, particularly in court cases. The mineralization chronology of permanent teeth is a valuable tool for age estimation of subadults. This study aimed to evaluate the mineralization stages of permanent teeth of Brazilian subjects from imaging exams, using the classification by Moorrees et al. modified by the authors, to verify the existence of correlation between the chronology of mineralization stages and sex and to prepare numerical tables of the chronology of dental mineralization stages for Brazilian individuals. Methods: Digital panoramic radiographs of 1100 living Brazilian individuals of both sexes, aged between 2 and 25 years, born between 1990 and 2018, from the image bank of a Dental Radiographs and Documentations clinic located in the city of Araraquara, SP, Brazil. The images were evaluated according to the level of crown and root development and classified according to the stages proposed by Moorrees et al. (Am J Phys Anthropol 21: 205–213, 1963) adapted by the authors. All analyses were performed in the R software. Descriptive and exploratory analyses were performed on all data. For intra- and inter-examiner analyses, the rate of agreement and Kappa statistics at a 95% confidence interval were used. Kappa was interpreted according to Landis and Koch. Results: Only upper and lower canines showed significant differences between the sexes (p < 0.05), with higher average ages for men. The findings were presented in tables, as well as age estimates with 95% confidence intervals for each mineralization stage and each tooth. Conclusion: In the present study, we evaluated the mineralization stages of permanent teeth of Brazilian subjects from digital panoramic radiographs and found no correlation between the chronology of mineralization stages and sex, except for canines. From the obtained results, numerical tables of the chronology of dental mineralization stages were prepared.
Apelin Enhances the Effects of Fusobacterium nucleatum on Periodontal Ligament Cells In Vitro
(2023-03-01) Cores Ziskoven, Pablo; Nogueira, Andressa V. B.; Gutierrez, Lorena S. [UNESP]; Weusmann, Jens; Eick, Sigrun; Buduneli, Nurcan; Deschner, James; University Medical Center of the Johannes Gutenberg University; Universidade Estadual Paulista (UNESP); University of Bern; Ege University
This study aimed to explore effects of Fusobacterium nucleatum with or without apelin on periodontal ligament (PDL) cells to better understand pathomechanistic links between periodontitis and obesity. First, the actions of F. nucleatum on COX2, CCL2, and MMP1 expressions were assessed. Subsequently, PDL cells were incubated with F. nucleatum in the presence and absence of apelin to study the modulatory effects of this adipokine on molecules related to inflammation and hard and soft tissue turnover. Regulation of apelin and its receptor (APJ) by F. nucleatum was also studied. F. nucleatum resulted in elevated COX2, CCL2, and MMP1 expressions in a dose- and time-dependent manner. Combination of F. nucleatum and apelin led to the highest (p < 0.05) expression levels of COX2, CCL2, CXCL8, TNF-α, and MMP1 at 48 h. The effects of F. nucleatum and/or apelin on CCL2 and MMP1 were MEK1/2- and partially NF-κB-dependent. The combined effects of F. nucleatum and apelin on CCL2 and MMP1 were also observed at protein level. Moreover, F. nucleatum downregulated (p < 0.05) the apelin and APJ expressions. In conclusion, obesity could contribute to periodontitis through apelin. The local production of apelin/APJ in PDL cells also suggests a role of these molecules in the pathogenesis of periodontitis.
Non-Ulcerated and Ulcerated Necrotizing Sialometaplasia: Report of an Additional Case and Literature Review
(2023-01-01) Silva, Evânio Vilela [UNESP]; Silveira, Heitor Albergoni [UNESP]; Moreira, Thales Peres Candido; Augusto, Jefferson; Silva, Paula Verona Ragusa [UNESP]; Bufalino, Andreia [UNESP]; León, Jorge Esquiche; Universidade Estadual Paulista (UNESP); Universidade de São Paulo (USP)
Necrotizing sialometaplasia (NS) is a rare, self-limiting, necrotizing inflammatory lesion, often involving the minor salivary glands of the palate. NS occurs often in men (60%) older than 45 years. Commonly, it presents as an ulcerative lesion, measuring 1 to 3 cm in diameter, with an evolution time of a few weeks or days, simulating malignancy. However, in some instances, the mucosal surface is intact, thus emphasizing the importance of considering NS in the differential diagnosis of oral ulcerative and non-ulcerative lesions. To date, 12 cases of non-ulcerated NS in the palate have been reported. Here, we report a 50-year-old male patient who presented a non-ulcerated, asymptomatic, nodular swelling 3 months ago, located on the hard palate, clinically suggesting salivary gland tumor or lymphoproliferative disorder. After biopsy, a diagnosis of non-ulcerated NS was established. After 4 weeks, the lesion evolved with complete resolution. After literature review, notably, unlike ulcerated NS, the non-ulcerated NS affected patients a decade younger (33 years vs. 45 years), with marked female predilection (83% vs. 40%) and not uncommon bilateral presentation (33% vs. 10%). NS should be considered in the differential diagnosis of ulcerative and non-ulcerative lesions affecting the palate.
Clinical Assessment of Biphasic Calcium Phosphate in Granules and Paste Forms in Human Maxillary Sinus Bone Augmentation: A Randomized, Split-Mouth Clinical Trial
(2023-02-01) Bonardi, João Paulo [UNESP]; Pereira, Rodrigo dos Santos; Mourão, Carlos F.; Coelho Mendes, Bruno [UNESP]; Lowenstein, Adam; Montemezzi, Pietro; Giubilato, Flavio [UNESP]; Okamoto, Roberta [UNESP]; Hochuli-Vieira, Eduardo [UNESP]; Universidade Estadual Paulista (UNESP); University of Grande Rio-UNIGRANRIO; Tufts University School of Dental Medicine; San Raffaele Hospital
The aim of the present study is to compare the biphasic calcium phosphate (BCP) using two different forms—(1) granules and (2) paste—in human maxillary sinus bone reconstruction as a split-mouth study using histomorphometric and immunolabeling for osteocalcin. Ten patients with bilateral maxillary posterior partial edentulism were selected in order to reconstruct bone height. They were divided into two groups: BCPG and BCP-P. After six months of bone healing, biopsies were harvested to assess the new bone formation and immunostaining for osteocalcin. The BCP g group had the following results: mean of bone formation in pristine bone 49.4 ± 21.6%, intermediate 49.4 ± 16.2%, and apical 55.3 ± 21.4%. The group BCP-P had a mean of 41.9 ± 17.3% in the pristine bone region, 37.5 ± 7.8% for intermediate, and 39.0 ± 13.5% for apical. The osteocalcin immunolabeling was high for both groups, demonstrating bone calcification. Thus, the two biomaterials present suitable results for the placement of dental implants.
Antimicrobial effectiveness of ultrasonic irrigation in root canal treatment: a systematic review of randomized clinical trials and meta-analysis
(2023-04-01) Chalub, Lucas Orbolato [UNESP]; Nunes, Gabriel Pereira [UNESP]; Strazzi-Sahyon, Henrico Badaoui [UNESP]; Ferrisse, Túlio Morandin [UNESP]; dos Santos, Paulo Henrique [UNESP]; Gomes-Filho, João Eduardo [UNESP]; Cintra, Luciano Tavares Angelo [UNESP]; Sivieri-Araujo, Gustavo [UNESP]; Universidade Estadual Paulista (UNESP)
Objective: The objective of this systematic review and meta-analysis (SRM) was to answer the question as to whether the use of ultrasonic irrigation (UI) results in better antimicrobial activity in root canal disinfection compared to conventional irrigation (CI). Methods: A literature search was performed in the main scientific databases, carried out until October 2021. The eligibility criteria were randomized clinical trials (RCTs). Two meta-analyses were conducted using R software with the “META” package. The mean difference (MD) and odds ratio (OR) measure of effect were calculated. The fixed effect model was applied with a 95% confidence interval. The Cochrane collaboration scale was used to assess risk of bias and the GRADE tool to assess the quality of evidence. Results: A total of 1782 records were screened, and 12 studies meeting the criteria were included in this review. A low risk of bias was observed for most domains, except allocation concealment that was considered unclear. The certainty of evidence was classified as moderate in the OR meta-analyses and low in the MD meta-analyses. Ultrasonic irrigation resulted in a better antimicrobial effect in both meta-analyses, MD 1.42 [1.60; 1.23] p < 0.0001, I2 = 80%; and OR 3.86 [1.98; 7.53] p< 0.0001, I2 = 28.7%. Conclusion: Within the limitations of this SRM, UI presented better antimicrobial efficacy than CI. Clinical Relevance: UI should be used by clinicians as it promotes better antimicrobial efficacy in patients undergoing endodontic treatment.
Stress induced phosphoprotein 1 overexpression controls proliferation, migration and invasion and is associated with poor survival in oral squamous cell carcinoma
(2023-01-11) Dourado, Mauricio Rocha; Elseragy, Amr; da Costa, Bruno Cesar; Téo, Fábio Haach; Guimarães, Gustavo Narvaes; Machado, Renato Assis; Risteli, Maija; Wahbi, Wafa; Gurgel Rocha, Clarissa Araujo; Paranaíba, Lívia Máris Ribeiro; González-Arriagada, Wilfredo Alejandro; da Silva, Sabrina Daniela; Rangel, Ana Lucia Carrinho Ayroza; Marques, Marcelo Rocha; Rossa Junior, Carlos [UNESP]; Salo, Tuula; Coletta, Ricardo D.; Universidade Estadual de Campinas (UNICAMP); University of Oulu; Universidade de São Paulo (USP); University of Helsinki; Oswaldo Cruz Foundation; Universidade Federal da Bahia (UFBA); D’Or Institute for Research and Education (IDOR); Federal University of Alfenas; Universidad de los Andes; McGill University; Western Paranaí State University; Universidade Estadual Paulista (UNESP)
Objective: Although there have been remarkable achievements in the molecular landscape of oral squamous cell carcinoma (OSCC) in recent years, bringing advances in the understanding of its pathogenesis, development and progression, little has been applied in the prognosis and choosing the optimal treatment. In this study, we explored the influence of the stress induced phosphoprotein 1 (STIP1), which is frequently reported to be highly expressed in many cancers, in OSCCs. Methods: STIP1 expression was assessed in the TCGA database and in two independent cohorts by immunohistochemistry. Knockdown strategy was applied in OSCC cell lines to determine the impact of STIP1 on viability, proliferation, migration and invasion. The zebrafish model was applied for studying tumor formation and metastasis in vivo. The association of STIP1 and miR-218-5p was explored by bioinformatics and mimics transfection. Results: STIP1 was highly expressed in OSCCs and significantly associated with shortened survival and higher risk of recurrence. STIP1 down-regulation decreased proliferation, migration and invasion of tumor cells, and reduced the number of metastases in the Zebrafish model. STIP1 and miR-218-5p were inversely expressed, and the transfection of miR-218-5p mimics into OSCC cells decreased STIP1 levels as well as proliferation, migration and invasion. Conclusion: Our findings show that STIP1 overexpression, which is inversely associated with miR-218-5p levels, contributes to OSCC aggressiveness by controlling proliferation, migration and invasion and is a determinant of poor prognosis.
The Role of Dyslipidemia in Periodontitis
(2023-01-01) Bitencourt, Fernando Valentim; Nascimento, Gustavo G.; Costa, Susilena Arouche; Orrico, Silvana Regina Perez [UNESP]; Ribeiro, Cecilia Claudia Costa; Leite, Fábio Renato Manzolli; Aarhus University; Steno Diabetes Center Aarhus; National Dental Research Institute Singapore; Duke-NUS Medical School; Federal University of Maranhão; Universidade Estadual Paulista (UNESP); Union of the Colleges of the Great Lakes (UNILAGO)
Studies have suggested an important role of dyslipidemia, a condition with alterations in blood lipid levels, in promoting an additional effect on periodontal breakdown. Thus, this study aimed to explore the theoretical pathways associated with dyslipidemia and periodontitis. We used data from 11,917 US adults with complete periodontal examinations participating in the Third National Health and Nutrition Examination Survey (NHANES III). Our hypothesis was tested using structural equation modelling (SEM). Dyslipidemia was defined according to the National Cholesterol Education Program (NCEP-ATP III) and periodontitis as a latent variable reflecting the shared variance of the number of surfaces with periodontal pocket depth [PPD] = 4 mm, PPD = 5 mm, PPD ≥ 6 mm, clinical attachment level [CAL] = 4 mm, CAL = 5mm, CAL ≥ 6 mm, and furcation involvement. The model also considered distal determinants (age, sex, and socioeconomic status) and proximal determinants (HbA1c, smoking and alcohol consumption, and obesity). The model showed sufficient global fit (Root Mean Squared Error of Approximation = 0.04, 90%CI = 0.04–0.05, Tucker–Lewis Index = 0.93, Comparative Fit Index = 0.95). Age, sex, socioeconomic status, obesity, and smoking were directly associated with periodontitis (p < 0.01). Dyslipidemia revealed a significant direct effect on periodontitis (standardized coefficient [SC] = 0.086, SE 0.027; p < 0.01), also mediated via an indirect pathway through HbA1c (SC = 0.021; SE 0.010; p = 0.02) and obesity (SC = 0.036; SE 0.012; p < 0.01) and resulted in a total effect on periodontitis. Dyslipidemia was associated with periodontitis through a direct pathway and indirectly through HbA1c and obesity in the US population. These results support the need for a multi-professional approach to tackling oral and noncommunicable diseases (NCDs), directed at their common risk factors.
Obesity Modifies the Proteomic Profile of the Periodontal Ligament
(2023-01-01) Nogueira, Andressa V. B. [UNESP]; Lopes, Maria Eduarda S. [UNESP]; Marcantonio, Camila C. [UNESP]; Salmon, Cristiane R.; Mofatto, Luciana S.; Deschner, James; Nociti-Junior, Francisco H.; Cirelli, Joni A. [UNESP]; University Medical Center of the Johannes Gutenberg University; Universidade Estadual Paulista (UNESP); Universidade Estadual de Campinas (UNICAMP); São Leopoldo Mandic Research Center
This study aimed to assess the obesity effects on the proteomic profile of the periodontal ligament of rats submitted to obesity induction by a high-fat diet. Eight Holtzman rats were divided into control (n = 3) and obese (n = 5) groups. The maxillae were histologically processed for laser capture microdissection of the periodontal ligament of the first maxillary molars. Peptide mixtures were analyzed by LC-MS/MS. A total of 1379 proteins were identified in all groups. Among them, 335 (24.30%) were exclusively detected in the obese group, while 129 (9.35%) proteins were uniquely found in the control group. Out of the 110 (7.98%) differentially abundant proteins, 10 were more abundant and 100 had decreased abundance in the obese group. A gene ontology analysis showed some proteins related to obesity in the “extracellular exosome” term among differentially identified proteins in the gene ontology cellular component terms Prelp, Sec13, and Sod2. These three proteins were upregulated in the obese group (p < 0.05), as shown by proteomic and immunohistochemistry analyses. In summary, our study presents novel evidence that the proteomic profile of the periodontal ligament is altered in experimental obesity induction, providing a list of differentially abundant proteins associated with obesity, which indicates that the periodontal ligament is responsive to obesity.
Accuracy of partially and fully guided surgical techniques for immediate implant placement: An in vitro assessment
(2023-02-01) Nicchio, Nicolas [UNESP]; Gonçalves, Victor [UNESP]; Mendonça, Gustavo; Sales e Pessoa, Roberto; Frizzera, Fausto; Zandim-Barcelos, Daniela Leal [UNESP]; Universidade Estadual Paulista (UNESP); University of Michigan School of Dentistry; Unitri School of Dentistry (UFTM); FAESA University Center (FAESA)
Statement of problem: Optimal implant positioning is essential to achieving predictable results. Computer-guided surgery has been reported to be an accurate technique for implant placement in healed sites, but the accuracy of guided techniques for immediate implant placement into fresh sockets is still unclear. Purpose: The purpose of this experimental randomized split-mouth study in pig jaws was to determine the accuracy of partially and fully guided surgical techniques for immediate implant placement into fresh sockets and to compare 2 different methods of implant position deviations analysis. Material and methods: Twenty implants were installed in 10 pig jaws using 2 different techniques: partially guided (n=10) and fully guided (n=10). Cone beam computed tomography and digital scanning were performed before and after the surgical procedure to plan the virtual implant position and fabricate the surgical guide, as well as to determine implant position deviations. Two methods were used to evaluate implant deviations: tomographic and digital scanning. The Shapiro-Wilk test of normality was used. Deviation comparisons were carried out by using paired t tests (α=.05), and intraclass correlation coefficient (ICC) was computed to assess the agreement between the 2 methods of implant deviation analysis. Results: In the tomographic analysis, the partially guided technique resulted in significantly higher global apical and lateral coronal deviations (2.25 ±0.59 mm; 0.96 ±0.55 mm) than fully guided (1.52 ±0.89 mm; 0.75 ±0.52 mm) (P<.01 and P<.05, respectively). The analysis performed using digital scanning showed significantly higher angular, global apical, and lateral apical deviations in the partially guided (6 ±3.28 degrees; 2.49 ±1.03 mm; 2.16 ±1.07 mm) technique than in the fully guided (3.32 ±1.84 degrees; 1.5 ±0.58 mm; 0.98 ±0.67 mm) (P<.05). An ICC of 0.522 between the 2 methods of implant deviation analysis was obtained. Conclusions: The partially guided technique was less accurate than the fully guided technique for immediate implant placement into fresh sockets. A moderate concordance was observed between cone beam computed tomography and digital scanning analyses, suggesting that more studies are required to validate and to define the most reliable method of measuring implant deviation.
Protein-based salivary biomarkers for the diagnosis of periodontal diseases: Systematic review and meta-analysis
(2023-08-01) Arroyo, Esteban [UNESP]; Oliveira-Alves, Mónica G.; Chamorro-Petronacci, Cintia M.; Marichalar-Mendia, Xabier; Bravo-López, Susana B.; Blanco-Carrión, Juan; Pérez-Sayáns, Mario; Universidade Estadual Paulista (UNESP); Universidade Mogi das Cruzes; Anhembi Morumbi University; University of Santiago de Compostela; ORALRES Group Instituto de Investigación de Santiago (IDIS); University of the Basque Country (UPV/EHU); Barakaldo; Health Research Institute; Health Research Institute of Santiago de Compostela (IDIS)
Objective: This systematic review and meta-analysis was aimed at determining differentially expressed protein-based biomarkers detectable in the saliva for the diagnosis of major periodontal diseases. Methods: A literature review was conducted through January 31, 2022. The methodological quality and risk of bias were assessed with the Newcastle–Ottawa scale for case-control studies. Heterogeneity among studies was analysed with the Q statistical test and the I2 test. p-values lower than 0.10 and I2 values higher than 50% indicated high heterogeneity among studies; therefore, the random-effects model was used. The analysis of biological pathways associated with the differentially expressed protein markers was performed with the STITCH integration analysis tool and was limited to interactions with high confidence levels (0.7). Results: Of all protein-based biomarkers detected, 12 were suitable for meta-analysis: IL-1β, MIP-1α, albumin, TNF-α, ICTP, Ig-A, lactoferrin, MMP-8, IL-6, IL-8, IL-17 and PGE2. The salivary markers with high applicability were IL-1β for differentiating patients with chronic periodontal disease from patients with gingivitis with an OE = 73.5 pg/mL; ICTP for differentiating patients with chronic periodontal disease from healthy control patients with an OE = 0.091 ng/mL; and PGE2 for differentiating patients with chronic periodontal disease from healthy control patients with an OE = 36.3 pg/mL. Conclusions: The biomarkers with the highest differential expression and the greatest potential for clinical applicability are IL-1β for differentiating periodontitis from gingivitis, and ICTP and PGE2 for differentiating periodontitis from healthy status.

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