Carlos Fernando de Almeida Barros Mourão

Obtention of injectable platelets rich-fibrin (i-PRF) and its polymerization with bone graft: technical note

The use of autologous platelet concentrates, represent a promising and innovator tools in the medicine and dentistry today. The goal is to accelerate hard and soft tissue healing. Among them, the platelet-rich plasma (PRP) is the main alternative for use in liquid form (injectable). These injectable form of platelet concentrates are often used in regenerative procedures and demonstrate good results. The aim of this study is to present an alternative to these platelet concentrates using the platelet-rich fibrin in liquid form (injectable) and its use with particulated bone graft materials in the polymerized form.

Maxillary Sinus Augmentation with a New Xenograft: A Randomized Controlled Clinical Trial.

BACKGROUND Insufficient residual alveolar bone height is a common deterrent in the placement of dental implants in the posterior maxilla. The use of autografts, xenografts, allografts and alloplasts or a combination between them has been demonstrated to be effective for increasing bone height and bone volume in the deficient posterior maxilla. PURPOSE The aim of this clinical trial is to comparatively determine the density of newly formed in sinus floor augmentation bone after a 24-week healing period treatment with a new bovine xenograft. MATERIALS AND METHODS The sinus floor was grafted with Bio-Oss® (n = 10) and Osseous® (n = 10). Histological sections were examined with a focus on the presence of connective tissue (CT) and newly formed bone (NFB). The sections were histomorphometrically evaluated and the definitive crown was inserted after 3 months. RESULTS After 6 months, the mean value of new bone formation was 24.60 (±2.503), the CT was 42.60 (±4.006) and the remaining biomaterial was 25.40 (±2.547) in Bio-Oss group. In Osseous group, the mean value of new bone formation was 24.90 (±3.542), the CT was 45.70 (±7.040) and the remaining biomaterial was 22.90 (±3.247). CONCLUSIONS Both biomaterials afforded a favorable implant position and the prosthetic rehabilitation.

The in vitro release of cytokines and growth factors from fibrin membranes produced through horizontal centrifugation: CHARACTERIZATION OF L-PRF-LIKE FIBRIN MEMBRANES

Platelet-rich fibrin membranes are biomaterials widely used for therapeutic purposes, and canonically produced through the processing of peripheral blood with fixed-angle rotor centrifuges. In this work, we evaluate the in vitro stability and release of cytokines and growth factors when these biomaterials are produced with a horizontal swing-out clinical centrifuge. Membranes produced from the blood of 14 donors were morphologically evaluated by scanning electron microscopy and fluorescence microscopy, and their stability was assessed by photographic recording after incubation in culture medium for up to 28 days. The release of 27 cytokines and growth factors was monitored for three weeks through a multiparametric immunoassay. The fibrin membranes presented complex three-dimensional structure with a high density of nucleated cells. A large release of growth factors [platelet derived growth factor, fibroblastic growth factor (bFGF), and vascular endothelial growth factor] was detected in the first 24 h, followed by time-dependent decay, maintaining significant concentrations after three weeks. Both anti-inflammatory and pro-inflammatory cytokines presented different release peaks, maintaining high rates of elution for up to 21 days. Chemokines of relevance in tissue repair [RANTES, granulocyte colony-stimulating factor (G-CSF)] were also produced in large quantities throughout the experimental period. The present results demonstrate that blood-derived fibrin membranes with high structural stability and cell content can be generated by horizontal centrifugation, being able of a prolonged production/release of growth factors and pro- and anti-inflammatory cytokines.

Tratamento cirúrgico da fratura de mandibula atrófica pela técnica AO: relato de caso

As fraturas das mandibulas atroficas sao de dificil tratamento, pois necessitam de um vasto conhecimento por parte do cirurgiao maxilofacial. Como e uma injuria incomum, muitos profissionais nao possuem a experiencia necessaria para trata-las. O objetivo deste artigo e demonstrar um caso clinico onde foi empregada a tecnica cirurgica errada para tratar uma fratura de mandibula atrofica bilateral e seu retratamento atraves da filosofia preconizada pela AO Foundation empregando uma placa de reconstrucao 2.4 mm e enxertia com osso autogeno particulado da crista iliaca anterior. Apos 1 e 7 meses conclui-se que, apesar de ser uma tecnica mais agressiva, proporciona os resultados mais satisfatorios e previsiveis. Descritores: Fixacao Interna de Fraturas; Tecnicas de Fixacao da Arcada Osseodentaria; Arcada Edentula.

Treatment of frontal bone fracture sequelae through inversion of the bone fragment

Treatment of frontal sinus fractures depends on the structures involved: the anterior wall, the posterior wall and the nasofrontal duct. It may vary from the correction of the defect in the anterior wall to the cranialization with obliteration of the nasofrontal duct. The inversion of the frontal sinuss anterior wall to correct the defect in the fractured region is a good treatment option for sequelae, since this technique eliminates or reduces the use of biomaterial in the area, and allows direct assessment of the permeability of the nasofrontal duct. This work describes the technique of fractured segment inversion for the treatment of frontal sinus fracture sequelae in a motorcycle accident victim.