Influência da inalação da fumaça de cigarro na regeneração óssea guiada em enxertos autógenos onlay em ratas com deficiência estrogênica: estudo histomorfométrico
Carregando...
Data
2016-04-15
Autores
Nunes, Camilla Magnoni Moretto [UNESP]
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
As perdas ósseas constituem um desafio comum na clínica diária da periodontia e implantodontia. Essas condições que podem ser resultado de doenças periodontais, traumas e fatores anatômicos ou congênitos e também do uso de próteses totais ou parciais removíveis promovem uma reabsorção contínua dos rebordos alveolares dificultando uma adequada reabilitação posterior. Os implantes osseointegrados surgiram como uma abordagem terapêutica segura e com altos índices de sucesso, no entanto, é necessária uma quantidade mínima de osso que pode ser adquirida através da Regeneração Óssea Guiada (ROG), e também devem ser observados os fatores sistêmicos e locais do paciente que podem interferir no processo de osseointegração comprometendo o tratamento. Dentre os principais exemplos desses fatores estão o tabagismo e a deficiência estrogênica. Dessa forma, o presente trabalho se propôs verificar o processo de osseointegração na regeneração óssea guiada em enxertos autógenos onlay em comparação com a influência da inalação de fumaça de cigarro na regeneração óssea guiada em ratas com deficiência estrogênica. Para isso, foram utilizadas 120 ratas adultas (Rattus norvegicus, variação albinus, Wistar) com 90 dias de idade, com peso em torno de 300 gramas divididas aleatoriamente em dois grupos experimentais (Controle e Teste) cada um contendo 60 animais e subdivididos em dois subgrupos experimentais e organizados da seguinte maneira: C+ (n=30) ratas SHAM (submetidas à simulação da cirurgia de ovariectomia) não expostas à fumaça de cigarro; OVZ (n=30) ratas ovariectomizadas não expostas à fumaça de cigarro; C+F (n=30) ratas SHAM (submetidas à simulação da cirurgia de ovariectomia) expostas à fumaça de cigarro e OVZ+F (n=30) ratas ovariectomizadas expostas à fumaça de cigarro. Todos os animais foram submetidos à cirurgia para a colocação de enxertos na hemi-mandíbula esquerda, recobertos por membrana de colágeno reabsorvível. Os animais foram eutanasiados por perfusão cardíaca nos períodos 21, 45 e 60 dias. Os resultados revelaram que em relação à integração do enxerto ao leito receptor e o parâmetro Tempo houve um aumento significativo na integração do enxerto entre os períodos 45 dias x 21 dias (P= 0,034) intra subgrupo C+F. Em relação à altura do enxerto ósseo, no parâmetro Condição observou-se que a condição do fumo promoveu uma redução significativa da altura do enxerto ósseo no subgrupo C+F (P= 0,002) no período de 21 dias. Em relação à largura do enxerto ósseo o parâmetro Condição no período de 45 dias houve diferença significante inter subgrupos C+ x C+F (P= 0,014). A análise histomorfométrica foi realizada e os dados obtidos foram submetidos à análise de variância (ANOVA) dois fatores e teste de Shapiro-Wilk, ambos com nível de significância convencional de 5%. Com os resultados pode-se concluir que o reparo da regeneração óssea guiada de enxertos ósseos autógenos onlay em modelo animal de inalação da fumaça de cigarro associado à ovariectomia, não foi prejudicado.
Bone loss are an usual challenge on daily periodontal and implantology practice. These conditions could be a result of periodontal diseases, traumas and anatomic or congenital factors and prosthesis that will promotes a continual resorption of alveolar ridge hindering a proper subsequent rehabilitation. The dental implants have arisen as a safe therapeutic approach and with high success rates; however, a minimal amount of bone is necessary that can be acquired through Guided Bone Regeneration (GBR), and patient’s systemic and local factors must be observed because they may interfere with the osseointegration process compromising treatment. Among these main examples are smoking and estrogen deficiency. The nicotine found in cigarettes has shown important influence on the biological events negatively affecting bone repair and osseointegration. The estrogen deficiency, as well as cigarette, has an impact on the bone metabolism resulting in bone fragility by reducing its mass. Therewith is possible to observe in the literature that each these conditions can cause some damage to bone tissue. Thus, the present study aimed to verify the osseointegration process on guided bone regeneration in autogenous onlay grafts compared to the influence of smoking cigarette inhalation on guided bone regeneration in rats with estrogen deficiency. For this, 120 adult female rats (Rattus norvegicus, Albinus variation, Wistar) ninety days old, weighing around 300 grams were randomized in two experimental groups (Control and Test) each with 60 animals and divided into two experimental and organized subgroups as follows: C (n=30) SHAM rats (subjected to simulated ovariectomy surgery) unexposed to cigarette smoking; OVZ (n=30) ovariectomized and unexposed to cigarette smoking rats; C+F (n=30) SHAM rats (subjected to simulated ovariectomy surgery) exposed to cigarette smoking and OVZ+F (n=30) ovariectomized rats exposed to cigarette smoking. All the animals were undergo surgery for the placement of onlay bone grafts in the jaw left and these were coated with resorbable collagen membrane. The rats were euthanized by cardiac perfusion in periods 21, 45 and 60 days. The results showed in relation to the integration of the graft and the recipient bed Time parameter was a significant increase in graft integration between periods x 45 days 21 days (P = 0.034) intra subgroup C + F. In relation to the height of the bone graft, the parameter Condition was observed that the smoke condition produced a significant reduction of bone graft height in subgroup C + F (P= 0.002) in 21 days. In relation to the width of the bone graft condition parameter in the 45 day period there was a significant difference inter subgroups C x + C + F (P= 0.014). Histomorphometric analysis was performed and the data were submitted to analysis of variance (ANOVA) two factors and Shapiro-Wilk test, both with conventional significance level of 5%. With the results we can conclude that guided bone regeneration repair on autogenous bone graft onlay in an animal model of cigarette smoke inhalation associated with ovariectomy, was not jeopardized.
Bone loss are an usual challenge on daily periodontal and implantology practice. These conditions could be a result of periodontal diseases, traumas and anatomic or congenital factors and prosthesis that will promotes a continual resorption of alveolar ridge hindering a proper subsequent rehabilitation. The dental implants have arisen as a safe therapeutic approach and with high success rates; however, a minimal amount of bone is necessary that can be acquired through Guided Bone Regeneration (GBR), and patient’s systemic and local factors must be observed because they may interfere with the osseointegration process compromising treatment. Among these main examples are smoking and estrogen deficiency. The nicotine found in cigarettes has shown important influence on the biological events negatively affecting bone repair and osseointegration. The estrogen deficiency, as well as cigarette, has an impact on the bone metabolism resulting in bone fragility by reducing its mass. Therewith is possible to observe in the literature that each these conditions can cause some damage to bone tissue. Thus, the present study aimed to verify the osseointegration process on guided bone regeneration in autogenous onlay grafts compared to the influence of smoking cigarette inhalation on guided bone regeneration in rats with estrogen deficiency. For this, 120 adult female rats (Rattus norvegicus, Albinus variation, Wistar) ninety days old, weighing around 300 grams were randomized in two experimental groups (Control and Test) each with 60 animals and divided into two experimental and organized subgroups as follows: C (n=30) SHAM rats (subjected to simulated ovariectomy surgery) unexposed to cigarette smoking; OVZ (n=30) ovariectomized and unexposed to cigarette smoking rats; C+F (n=30) SHAM rats (subjected to simulated ovariectomy surgery) exposed to cigarette smoking and OVZ+F (n=30) ovariectomized rats exposed to cigarette smoking. All the animals were undergo surgery for the placement of onlay bone grafts in the jaw left and these were coated with resorbable collagen membrane. The rats were euthanized by cardiac perfusion in periods 21, 45 and 60 days. The results showed in relation to the integration of the graft and the recipient bed Time parameter was a significant increase in graft integration between periods x 45 days 21 days (P = 0.034) intra subgroup C + F. In relation to the height of the bone graft, the parameter Condition was observed that the smoke condition produced a significant reduction of bone graft height in subgroup C + F (P= 0.002) in 21 days. In relation to the width of the bone graft condition parameter in the 45 day period there was a significant difference inter subgroups C x + C + F (P= 0.014). Histomorphometric analysis was performed and the data were submitted to analysis of variance (ANOVA) two factors and Shapiro-Wilk test, both with conventional significance level of 5%. With the results we can conclude that guided bone regeneration repair on autogenous bone graft onlay in an animal model of cigarette smoke inhalation associated with ovariectomy, was not jeopardized.
Descrição
Palavras-chave
Regeneração óssea, Doenças ósseas metabólicas, Tabagismo, Bone regeneration, Bone metabolic disease, Smoking