Rogério Belle de Oliveira

Effects of human aging on periodontal tissues

Loss of teeth is frequently associated with periodontal disease in older adults. The aim of this review was to present the effects of aging on the periodontal tissues. Aging alone does not lead to critical loss of periodontal attachment in healthy elderly persons. The effects of aging on periodontal tissues are based on molecular changes in the periodontal cells, which intensify bone loss in elderly patients with periodontitis. These effects may be associated with (1) alterations in differentiation and proliferation of osteoblasts and osteoclasts; (2) an increase in periodontal cell response to the oral microbiota and mechanical stress leading to the secretion of cytokines involved in osseous resorption; and (3) systemic endocrine alterations in the elderly people.

Pharyngeal Airway Changes in Class III Patients Treated With Double Jaw Orthognathic Surgery—Maxillary Advancement and Mandibular Setback

PURPOSE The pharyngeal airway may change after skeletal movement in patients who have undergone orthognathic surgery. The aim of this study was to evaluate the skeletal and pharyngeal airway changes in subjects with a Class III facial pattern who underwent double-jaw surgery (maxillary advancement and mandibular setback). MATERIALS AND METHODS The present retrospective study assessed preoperative (T0), 2- to 4-month postoperative (T1), and 6- to 12-month postoperative (T2) radiographs of subjects with a Class III facial pattern treated at São Lucas Hospital (Porto Alegre, Brazil) using imaging software (Dolphin Imaging 3D 11.5). Five measurements of the pharyngeal airway space (nasopharynx; upper, middle, and lower oropharynges; hypopharynx) were evaluated and correlated with the skeletal movement of the jaws (lines perpendicular to the Frankfurt horizontal plane passing through the nasion point to points A and B). The Student t test for paired samples was used to assess the presence of significant differences between the intervals, and the Spearman correlation coefficient was used to assess the significant correlation existing between the skeletal movement and the pharyngeal airway changes. The results were considered at a maximum level of significance of 5% (P < .05). RESULTS In the sample of 58 subjects (38 female and 20 male, 18 to 48 years old), measurements of the nasopharynx, upper oropharynx, and middle oropharynx increased, whereas measurements of the lower oropharynx and hypopharynx decreased during these periods (T0 to T1, T0 to T2). Decreases from T1 to T2 in the measurements of the nasopharynx and upper oropharynx were also identified. A correlation between the jaw movements and the change in airway measurement was found between the line perpendicular to the Frankfurt horizontal plane passing through the nasion point to point A and the nasopharynx and between the line perpendicular to the Frankfurt horizontal plane passing through the nasion point to point B and the lower oropharynx for T0 to T1 and T0 to T2. CONCLUSIONS A correlation between skeletal movements and changes in the measurements of pharyngeal airway was found between maxillary advancement and the nasopharynx, with proportions of 102.8% and 85.5% in the short and medium terms, respectively, and between mandibular setback and the low oropharynx, with proportions of 44.8% and 43.5% in the short and medium terms. A correlation for pharyngeal airway measurements was found between those located anatomically near each other, showing the importance of the pharyngeal muscles in this relation.

Use of autologous fat graft for correction of facial asymmetry stemming from Parry-Romberg syndrome.

Facial hemiatrophy is a typical manifestation of Parry-Romberg syndrome, characterized by a slow progressive atrophy that appears in early stages of life, primarily affecting the subcutaneous tissue and subjacent fat on 1 side of the face. We describe the case of a 42-year-old female patient with stabilized moderate facial hemiatrophy on the left side of the face, successfully treated with a 2-stage autologous fat transplant and the use of subcutaneous tunnels among the musculature for the placement of the graft. We also describe the principal forms of correcting facial asymmetry in patients with Parry-Romberg syndrome and demonstrate that an autologous fat graft provides good results in the correction of this deformity, with improved esthetics and patient satisfaction.

Embolization of pseudoaneurysm of the internal maxillary artery after orthognathic surgery.

In orthognathic surgery, Le Fort I osteotomy is one of the most often used methods for the correction of dental-facial deformities and is considered technically safe. However, this procedure may lead to diverse complications, including uncommon vascular complications. A clinical case is described of late development of pseudoaneurysm in one of the branches of the maxillary artery in a 20-year-old patient who had undergone Le Fort I osteotomy, bilateral sagittal osteotomy of mandibular branch, and mentoplasty and subsequently treated with embolization. The main forms of treating vascular injuries are reviewed, and embolization is demonstrated to be a technically safe procedure with few complications.

Assessment of the oral and maxillofacial surgery service in a teaching hospital in Brazil.

Objective:The purpose of this study was to determine an epidemiologic profile of the patients hospitalized and/or operated on by an oral and maxillofacial surgery service in Brazil. Materials and Methods:A retrospective and descriptive epidemiologic survey of the Oral and Maxillofacial Surgery Service from Saint Lucas Hospital at the Pontifical Catholic University, Porto Alegre, Brazil, from January 2000 to December 2005, was performed. Data related to the number, sex, age, service year, as well as surgical modalities performed, instituted treatments, and length of stay, were collected from the hospitals handbooks. Results:A total of 1117 patients were attended during the 6 years of study, with a decreasing tendency throughout the years (P = 0.022). There was female predominance (54%), between 10 and 40 years old, and attended via public health system (56%). Among surgical modalities performed, dentoalveolar surgery was the most prevalent (22.9%), followed by the orthognathic surgeries (21.4%), facial fractures (18%), pathologic condition surgeries (16.7%), and dental implants and grafts (13.7%). Surgeries of patients with cleft lip and/or palate (3.4%), treatment of maxillofacial infections (2.95%), and temporomandibular joint surgeries (1%) were less frequent. Conclusions:The information presented in this research elicited data to clarify the type of attendance performed by the service, being a cornerstone for planning, organization, and attention improvement of these patients. In addition, this information can compare with data among services, specialty acting fields, as well as, its impact in hospital activities.

Poly(L-lactic acid) membranes: Absence of genotoxic hazard and potential for drug delivery

The use of poly(L-lactic acid) (PLA) has been considered an important alternative for medical devices once this polyester presents biomechanical, optical and biodegradable properties. Moreover, the use of PLA results in less inflammatory reactions and more recently it has been proposed its application in drug delivery systems. Genotoxicological evaluations are considered part of the battery assays in toxicological analysis. Considering the wide applications of PLA, the present work evaluated the potential cytotoxic and genotoxic effects of PLA in CHO-K1 cells, as well as its physicochemical properties. No cytotoxic effects of PLA were detected by colorimetric tetrazolium assay (XTT) analysis, and the clonogenic survival assay showed that PLA did not disrupt the replicative cell homeostasis, neither exhibited genotoxic effects as evidenced by comet and micronucleus assays. Thermogravimetric properties of PLA were not altered after contact with cells and this film exhibited ability in absorb and release Europium(III) complex. All these data suggest genotoxicological safety of PLA for further applications in drug delivery systems.

Osseointegration of atmospheric plasma‐sprayed titanium implants: Influence of the native oxide layer

The aim of this study was to evaluate in vivo the influence of the native oxide layer on osseointegration and new bone formation on the surface of atmospheric plasma-sprayed porous titanium coatings. Porous titanium coatings were deposited on all implant surfaces, and half of the samples were subsequently submitted to oxide layer removal treatment. Samples were implanted onto the cortical bone of sheep (tibia) and evaluated at 30 and 60 days. Implants were removed en bloc and the attachment of bone to implants was examined by tensile pull-out test (osseointegration assessment), light microscopy, scanning electron microscopy (histological analysis), and instrumented hardness tests (mechanical properties of mature and newly formed bone tissue). Coatings submitted to oxide layer treatment presented higher osseointegration values at both healing periods and showed more mature and mineralized bone tissue when compared with nontreated coatings. Our findings showed that the use of acid-etching in association with atmospheric plasma spraying techniques improves osseointegration of titanium implants.

Evaluation of tissue response and genotoxicity of poly(L/D-lactic acid) disks implanted in rat calvarium

The aim of the present study was to evaluate local and cytotoxicity systemic tissue reaction in the skull of rats using the implantation of disks of poly (lactic L/D-acid) and evaluate its genotoxicity. 25 males Wistar rats were used, 20 animals underwent surgical procedures and had the discs implanted in the parietal bone, and 5 animals received postoperative medication in the same way, serving as a control group for genotoxicity. The results were subjected to statistical evaluation by analysis of variance (ANOVA). In histological evaluation, between periods of 90 and 120 days in the control group, a new formation at the edges of the defect was noticed. In the experimental group, there was new bone formation at the edges of the defect, migrating below the site occupied by the disk, an absence of inflammatory infiltrate. Regarding the evaluation of genotoxicity, a significant reduction in the frequency of polychromatic erythrocytes in relation to negative control or significant increase in the polychromatic erythrocytes with micronuclei was not detected. So, the material used in this study is biocompatible and well tolerated by the tissues studied, and found to be negative for chromosomal mutagenicity.

Kinin B1 Receptor Deletion Affects Bone Healing in Type 1 Diabetic Mice

The effects of kinin B1 receptor (B1R) deletion were examined on femur bone regeneration in streptozotocin (STZ)‐type 1 diabetes. Diabetes induction in wild‐type C57/BL6 (WTC57BL6) mice led to decrease in body weight and hyperglycemia, compared to the non‐diabetic group of the same strain. The lack of B1R did not affect STZ‐elicited body weight loss, but partially prevented hyperglycemia. Diabetic mice had a clear delay in bone regeneration, and displayed large areas of loose connective tissue within the defects, with a reduced expression of the mineralization‐related protein osteonectin, when compared to the non‐diabetic WTC57/BL6. The non‐diabetic and diabetic B1R knockout (B1RKO) mice had bone regeneration levels and osteonectin expression comparable to that seen in control WTC57/BL6 mice. WTC57/BL6 STZ‐diabetic mice also showed a marked reduction of collagen contents, with increased immunolabeling for the apoptosis marker caspase‐3, whereas diabetic B1RKO had collagen levels and caspase‐3 activity comparable to those observed in non‐diabetic WTC57/BL6 or B1RKO mice. No significant difference was detected in the number of tartrate‐resistant acid phosphatase (TRAP)‐stained cells, or in RANK/RANKL/OPG system immunolabeling throughout the experimental groups. Data bring novel evidence on the relevance of kinin B1R under type 1 diabetes with regards to its role in bone regeneration. J. Cell. Physiol. 230: 3019–3028, 2015.

Submandibular myofibroma: a case report

PurposeMyofibroma is a rare benign spindle cell neoplasm, and the aim of the present study was to carry out a literature review and present a clinical case of a patient with a myofibroma in the submandibular region and its management.ConclusionsDiagnosis of myofibroma can be reached by a histopathologic and immunohistochemical analysis and surgical excision is the treatment of choice.