Abstract Reduction of morbidity in osseous reconstruction of cranio-maxillofacial bony defects could come from development of less invasive bone graft harvesting techniques or by elimination of bone graft donor sites using a bone graft substitute. This work studies outcomes and morbidity associated with these two approaches. A power-driven trephine was used to harvest bone from the anterior iliac crest using a minimally invasive surgical technique. Initially the safety of the technique was evaluated in a cadaver model. Twenty-five freshly preserved adult cadavers had a total of 250 cancellous cores of bone harvested from 50 anterior iliac crest sites. Twenty intentional perforations were made to the maximum depth possible with the instrumentation tested. No encroachment upon the peritoneum was found. A total of 84 patients had 333 cores of cancellous bone harvested using the same approach with a complication rate of 3.6% and a patient satisfaction rate of 98.8%. In a further 76 patients the motorized trephine method was compared to traditional open iliac crest corticocancellous block harvesting. The trephine group ambulated earlier, required fewer days of hospital stay and had significantly lower pain scores than the open iliac crest group. Coral-derived granules were used as a xenograft bone graft substitute to treat bony defects in the cranio-maxillofacial skeletons of 36 patients with 54 sites and followed for 12 to 36 months. The augmentations produced satisfactory results with the following complications noted: overt wound infection 1.8%, wound irritation 3.8% and clinically evident resorption in 9.3% of augmented sites. Coral-derived granules were then used to treat 48 dento-alveolar defects in 21 growing patients with trauma induced tooth-loss in the anterior maxilla and elective ankylosed tooth removal in the posterior maxilla and mandible. Coral granules were significantly more efficacious in reconstructing alveolar defects in the posterior maxilla or mandible (93.5%), than the anterior maxilla (17.6%). The minimally invasive technique using a power driven trephine was successful at reducing morbidity from bone graft harvesting at the anterior iliac crest. Coral-derived granules can be used in selected situations as a bone graft substitute and minimize post surgical morbidity by eliminating the bone graft donor site.

Estudos sugerem que a cafeína atua sobre o osso promovendo aumento da excreção de cálcio e inibição da proliferação de osteoblastos, aumentando o risco de fraturas, osteoporose e doença periodontal. Os efeitos da cafeína sobre o tecido ósseo dificultam a aplicação de implantes dentários devido à presença de grandes defeitos ósseos ou volume ósseo insuficiente. Vários métodos são propostos para a regeneração de defeitos ósseos, entre eles, o uso de diferentes tipos de enxertos, os quais demonstram capacidade em promover a formação óssea A despeito das desvantagens, o osso autógeno ainda é considerado a referência padrão como enxerto ósseo, devido ao seu potencial osteogênico, osteoindutor e osteocondutor. A engenharia tecidual óssea tem sido utilizada como uma estratégia para a regeneração óssea. As células tronco mesenquimais são consideradas multipotentes e podem replicar como células indiferenciadas, possuindo potencial para se diferenciarem em linhagens de osso, cartilagem, gordura e cartilagem. O objetivo deste estudo foi quantificar histomorfometricamente a reparação óssea pelo enxerto de uma associação de osso autógeno obtido da calota craniana e células osteoblásticas em defeitos ósseos produzidos pela extração dental de ratos submetidos à administração diária de cafeína. Os animais foram divididos em: Controle (c), osso autógeno (oa) e osso autógeno + células osteoblásticas (oa+co) e receberam injeções diárias intraperitonealmente de 30 mg/kg/dia de cafeína durante trinta dias, os homólogos receberam de solução salina. Os ratos foram sacrificados nos períodos de 7, 21 e 42 dias pós-cirurgia e as amostras teciduais foram processadas para a obtenção de secções finas (5 m) e coradas com HE. Através de um sistema de análise de imagens se estimou a fração de volume de osso, conjuntivo e coágulo, no defeito ósseo. Os resultados histológicos e histométricos mostraram que nos animais sob tratamento com cafeína houve uma menor formação óssea estatisticamente significante a 1%, e um retardo na reabsorção do coágulo sanguíneo quando comparado aos alvéolos dos animais sob tratamento com soro fisiológico. A análise qualitativa do fragmento de osso autógeno isoladamente ou associado às células osteoblásticas mostrou uma osteointegração progressiva e sem reação de corpo estranho nos animais tratados com soro fisiológico e, as células implantadas não propiciaram reações imunogênicas nem a formação tumoral, possibilitando um aumento (25%) na reparação óssea dos animais tratados com a cafeína. Conclui-se que o enxerto/implante das células osteoblásticas associadas ao osso autógeno da calota craniana foi capaz de compensar, nos períodos tardios, os efeitos deletérios da cafeína na reparação óssea alveolar. / Studies suggest that caffeine acts on the bone for increasing the excretion of calcium and inhibition of osteoblasts proliferation, increasing the risk of fractures, osteoporosis and periodontal disease. The effects of caffeine on bone difficult the application of dental implants due to large bone defects and insufficient bone volume. Several methods are proposed for the regeneration of bone defects, including the use of different types of grafts, which show ability to promote bone formation. Despite the disadvantages, the autogenous bone is still considered the gold standard as bone graft because the potential osteogenic, osteoinductive and osteoconductive. The bone tissue engineering has been used as a strategy for bone regeneration. The mesenchymal stem cells are considered multipotent and can replicate as undifferentiated cells, with potential to differentiate into lineages of bone, cartilage, fat and cartilage. This study aimed to quantify histomorphometrycally bone repair by grafts of a combination of autogenous bone obtained from the skull and osteoblastic cells in bone defects produced by dental extraction in rats subjected to daily administration of caffeine. The animals were divided into: Control (c), autogenous bone (ab) and autogenous bone + osteoblastic cells (ab + oc) and received daily injections intraperitoneally of 30 mg/kg/day of caffeine for thirty days, the counterparts received saline solution. The rats were sacrificed at times of 7th, 21st and 42nd days post-surgery and tissue samples were processed to obtain thin sections (5 m) and stained with HE. Through an image analysis system was estimated the fraction of volume of bone, collagen and blood clot in the bone defect. The histological and histometric results showed that in animals under treatment with caffeine had a lower bone formation statistically significant at 1%, and a delay in the resorption of blood clots when compared to the alveoli of animals under treatment with saline. The qualitative analysis of the fragment of autogenous bone alone or associated with osteoblastic cells showed a progressive osteointegration and no foreign body reaction in animals treated with saline, and implanted the cells not provided immunogenic reactions or tumor formation, allowing an increase (25%) on bone repair in animals treated with caffeine. It was concluded that the graft/implant of osteoblastic cells associated with autogenous bone from the skull was able to compensate in later periods, the deleterious effects of caffeine on alveolar boné repair.

Submitted by JOÃO PAULO BONARDI null (joao_bonardi@hotmail.com) on 2017-03-06T16:15:16Z No. of bitstreams: 1 Dissertação João Paulo corrigido.pdf: 3605304 bytes, checksum: d85c867eef7490b5298db3147e3a1be1 (MD5) / Approved for entry into archive by LUIZA DE MENEZES ROMANETTO (luizamenezes@reitoria.unesp.br) on 2017-03-09T20:16:15Z (GMT) No. of bitstreams: 1 bonardi_jp_me_araca.pdf: 3605304 bytes, checksum: d85c867eef7490b5298db3147e3a1be1 (MD5) / Made available in DSpace on 2017-03-09T20:16:15Z (GMT). No. of bitstreams: 1 bonardi_jp_me_araca.pdf: 3605304 bytes, checksum: d85c867eef7490b5298db3147e3a1be1 (MD5) Previous issue date: 2017-02-21 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Objetivos: Comparar através de análise hitométrica e imunoistoquimica o comportamento do ChronOs® (β-TCP) e do Bio-Oss® (Osso bovino inorgânico ) puros e misturados ao osso autógeno na proporção 1:1 em seios maxilares de humanos. Metodologia: 30 pacientes foram convidados para participar deste trabalho, resultando em 30 seios enxertados com osso autógeno puro (grupo A (controle)), ChronOs® puro (grupo C), ChronOs® em adição de osso autógeno na proporção 1:1(grupo CA), Bio-Oss® puro (grupo B) e Bio-Oss® em adição de osso autógeno na proporção de 1:1 (grupo BA), onde foram realizadas biopsias 6 meses após a realização desses enxertos e analisadas através de histometria (analisadas através do software ImageJ) e imunoistoquimica (RUNX2, VEGF e Osteocalcina). Os resultados foram tabulados, o teste de Shapiro-Wilk foi aplicado para avaliação da normalidade, em seguida foram aplicado os testes Kruskal-Wallis e Anova 1 fator para os dados paramétricos e não paramétricos sucetivamente e o teste de Tukey como pós teste. Resultados: Para neoformação óssea o grupo A foi maior que os grupos B e BA e o grupo CA foi maior que o grupo BA (p<0,05). Para os remanescentes de biomateriais o grupo BA apresentou um número maior que os grupos Chronos C, CA e A (p<0,05). Para tecido mole o grupo C foi maior que o grupo B (p<0,05). O resultado das imunomarcações mostrou marcação fraca para RUNX 2 nos grupos A, C, B e BA e marcação moderada para o grupo CA. Marcação intensa para VEGF nos grupos B e CA, moderada nos grupos A e C e fraca no grupo BA. Para a Osteocalcina houve uma marcação intensa em todos os grupos. Conclusão: Conclui-se que o Chronos puro ou misturado apresentam comportamento mais próximo ao osso autógeno em termos de quantidade de tecido ósseo neoformado e remanescentes de biomateriais que o Bio Oss puro ou associado ao osso autógeno. / Objectives: To compare the performance of ChronOs® (β-TCP) and Bio-Oss® (Inorganic bovine bone) pure and mixed with autogenous bone in a 1: 1 ratio in maxillary sinuses of humans through histometric and immunohistochemical analysis. Metodology: 30 patients were invited to participate of this study, resulting in 30 grafted sinuses with pure autogenous bone (group A (control)), pure ChronOs® (group C), ChronOs® in addition 1: 1 autogenous bone (group CA), pure Bio-Oss®(group B) and Bio-Oss® in addition1: 1 (group BA), which biopsies were performed 6 months after the grafting and analyzed by histology (analyzed using ImageJ software) and immunohistochemistry (RUNX2, VEGF and Osteocalcin). The results were tabulated, the Shapiro-Wilk test was applied to evaluate the normality, then the Kruskal-Wallis and Anova 1 tests were applied for the parametric and non-parametric data and Tukey test as post test was applied. Results: The group A was higher than B and BA groups, and the group CA was higher than the BA group (P <0.05). For the remainder of biomaterials, BA group presented a higher number than Chronos C, CA and A groups (P <0.05). For soft tissue, group C was greater than group B (P <0.05). The immunolabeling results showed poor labeling for RUNX 2 in groups A, C, B and BA and moderate labeling for CA group. Intense labeling for VEGF in B and CA groups, moderate in groups A and C and weak in BA group. For Osteocalcin, there was an intense marking in all groups. Conclusion: It was concluded that pure or mixed Chronos present behavior closer to the autogenous bone in terms of amount of neoformed bone tissue and biomaterial remnants than the pure or mixed Bio Oss.

Orientador: Idelmo Rangel Garcia Júnior / Resumo: Foi realizado um estudo histomorfométrico para avaliar o reparo ósseo em cavidades experimentais criadas na tíbia de coelhos, preenchidas com dois tipos de partículas de osso autógeno. Foram utilizados 12 coelhos, nos quais foram realizadas 3 cavidades unicorticais de 7 mm de diâmetro, com uma broca trefina, na face lateral da tíbia direita. Os defeitos ósseos foram preenchidos respectivamente com partículas de osso autógeno obtidas com um triturador manual, com partículas de osso autógeno recolhidas com um coletor ósseo durante o preparo de cavidades com a seqüência de brocas de implantes e com coagulo sangüíneo servindo como controle. Os animais foram igualmente distribuídos em 3 grupos e sacrificados nos períodos de 7, 15 e 30 dias. De acordo com os resultados obtidos, aos 7 dias todos os grupos apresentaram-se preenchidos por coágulo sangüíneo, sendo observada a presença de partículas ósseas autógenas nos grupos triturado ( 44,75% ) e coletado ( 24% ). No período de 15 dias, notou-se a diferenciação conjuntiva em todos os grupos, com ausência de neoformação óssea no grupo controle ( 0% ), presença de partículas ósseas e início de formação óssea nos grupos coletado (38,88%) e triturado (46%). No período de 30 dias observou-se a neoformação óssea nos grupos controle (50%), coletado (64,63%) e triturado (66%) com a presença de um trabeculado ósseo imaturo. De acordo com a metodologia utilizada, concluiu-se que: a diferença entre a neoformação óssea nas cavidades dos grupos triturado e coletado não foi estatisticamente significante, porem mostrou-se superior a do grupo controle no aspecto quantitativo e qualitativo. As partículas ósseas do grupo triturado não foram totalmente reabsorvidas nos períodos analisados, enquanto que no grupo coletado houve uma reabsorção das partículas ósseas e neoformação óssea superiores aos do grupo triturado. / Abstract: A histomorphometric study was carried out to evaluate the bone repair in experimental cavities created in rabbits tibiae and filled with two types of particulate autogenous bone grafts. Twelve rabbits were used. In each tibia, on the right lateral face, three 7 mm diameter unicortical cavities were performed with a trephine bur. The bone defects were respectively filled with particles of autogenous bone obtained with manual bone mill, with autogenous bone particles collected with a bone collector during the cavities preparation with implant burs, and with the blood clot serving as a control group. The animals were equally divided in three groups and sacrificed on 7, 15 and 30 days. According to the obtained results, on the seventh day all the groups showed to be filled with blood clots with the presence of autogenous bone particles observed on the triturated group (44,75%) and collected group (24%). At the fifteenth day period it was noted connective tissue differentiation in all the groups, with no bone neoformation noted on the control group (0%). Presence of bone particles and beginning of osteogenesis was noted in the collected (38,88%) and triturated (46%) groups. On the thirtieth day bone neoformation was observed in the control (50%), collected (64,63%) and triturated (66,63%) groups as well as the presence of immature trabecular bone. According to the methodology utilized, it was concluded that the bone formation occurred in the cavities of the triturated and collected groups did not show statistical significance, however being superior to the control group as to the quantitative and qualitative aspect. The bone particles of the triturated group were not totally reabsorbed in the analyzed periods, while in the collected group there was a bone particles resorption and bone neoformation in a higher degree than in the triturated group. / Mestre

Objectives: The purpose of this study was to evaluate whether the effects of hyperbaric oxygen (HBO) therapy could alter the critical size defect (CSD) diameter and to evaluate the effect of HBO on the repair of CSD in the presence and absence of a non-vascularized autogenous bone graft (ABG). Study Design: Twenty rabbits were divided in two groups of ten animals each. CSD were created in the parietal bones bilaterally. Defects were critical-sized, 15 mm on one side and supracritical-sized, 18 mm on the contralateral side. Group 1 received a 90-min HBO treatment sessions at 2.4 absolute atmospheric pressure (ATA) for 90 minutes per day for 20 days. Group 2 served as a normobaric roomair control (NBO). Additional ten animals were divided into 2 groups of 5 animals each. Bilateral CSD were created. ABG were allocated to one side of each calvarium. Group 1 received HBO treatments. Group 2 served as NBO. After sacrifice, data were collected including qualitative assessment, radiographic analysis, Micro CT bone analysis and histomorphometric analysis. ANOVA and paired sample t test were used for statistical analysis. Results: Both radiographic analysis and histomorphometric analysis demonstrated more new bone in the HBO CSD (p<.001). Micro CT analysis indicated a higher bone mineral content (BMC) in ABG CSD (p<.05). Histologically, complete bridging of the defect was observed in ABG defects. Histomorphometric analysis showed that HBO treatment increased new bone and marrow and reduced fibrous tissue in the defects (p<.01 for all). Conclusion: Bone regeneration was significantly greater in the HBO animals regardless of the defect size. HBO may have changed the accepted diameter of CSD to more than 18 mm. HBO enhances bony healing in non-grafted CSD.

Objectives: The purpose of this study was to evaluate whether the effects of hyperbaric oxygen (HBO) therapy could alter the critical size defect (CSD) diameter and to evaluate the effect of HBO on the repair of CSD in the presence and absence of a non-vascularized autogenous bone graft (ABG). Study Design: Twenty rabbits were divided in two groups of ten animals each. CSD were created in the parietal bones bilaterally. Defects were critical-sized, 15 mm on one side and supracritical-sized, 18 mm on the contralateral side. Group 1 received a 90-min HBO treatment sessions at 2.4 absolute atmospheric pressure (ATA) for 90 minutes per day for 20 days. Group 2 served as a normobaric roomair control (NBO). Additional ten animals were divided into 2 groups of 5 animals each. Bilateral CSD were created. ABG were allocated to one side of each calvarium. Group 1 received HBO treatments. Group 2 served as NBO. After sacrifice, data were collected including qualitative assessment, radiographic analysis, Micro CT bone analysis and histomorphometric analysis. ANOVA and paired sample t test were used for statistical analysis. Results: Both radiographic analysis and histomorphometric analysis demonstrated more new bone in the HBO CSD (p<.001). Micro CT analysis indicated a higher bone mineral content (BMC) in ABG CSD (p<.05). Histologically, complete bridging of the defect was observed in ABG defects. Histomorphometric analysis showed that HBO treatment increased new bone and marrow and reduced fibrous tissue in the defects (p<.01 for all). Conclusion: Bone regeneration was significantly greater in the HBO animals regardless of the defect size. HBO may have changed the accepted diameter of CSD to more than 18 mm. HBO enhances bony healing in non-grafted CSD.

Made available in DSpace on 2014-06-11T19:23:41Z (GMT). No. of bitstreams: 0 Previous issue date: 2003Bitstream added on 2014-06-13T20:50:52Z : No. of bitstreams: 1 coradazzi_lf_me_araca.pdf: 2222457 bytes, checksum: d4df3c1b61fe6c5d468f78b6582caafb (MD5) / Foi realizado um estudo histomorfométrico para avaliar o reparo ósseo em cavidades experimentais criadas na tíbia de coelhos, preenchidas com dois tipos de partículas de osso autógeno. Foram utilizados 12 coelhos, nos quais foram realizadas 3 cavidades unicorticais de 7 mm de diâmetro, com uma broca trefina, na face lateral da tíbia direita. Os defeitos ósseos foram preenchidos respectivamente com partículas de osso autógeno obtidas com um triturador manual, com partículas de osso autógeno recolhidas com um coletor ósseo durante o preparo de cavidades com a seqüência de brocas de implantes e com coagulo sangüíneo servindo como controle. Os animais foram igualmente distribuídos em 3 grupos e sacrificados nos períodos de 7, 15 e 30 dias. De acordo com os resultados obtidos, aos 7 dias todos os grupos apresentaram-se preenchidos por coágulo sangüíneo, sendo observada a presença de partículas ósseas autógenas nos grupos triturado ( 44,75% ) e coletado ( 24% ). No período de 15 dias, notou-se a diferenciação conjuntiva em todos os grupos, com ausência de neoformação óssea no grupo controle ( 0% ), presença de partículas ósseas e início de formação óssea nos grupos coletado (38,88%) e triturado (46%). No período de 30 dias observou-se a neoformação óssea nos grupos controle (50%), coletado (64,63%) e triturado (66%) com a presença de um trabeculado ósseo imaturo. De acordo com a metodologia utilizada, concluiu-se que: a diferença entre a neoformação óssea nas cavidades dos grupos triturado e coletado não foi estatisticamente significante, porem mostrou-se superior a do grupo controle no aspecto quantitativo e qualitativo. As partículas ósseas do grupo triturado não foram totalmente reabsorvidas nos períodos analisados, enquanto que no grupo coletado houve uma reabsorção das partículas ósseas e neoformação óssea superiores aos do grupo triturado. / A histomorphometric study was carried out to evaluate the bone repair in experimental cavities created in rabbits tibiae and filled with two types of particulate autogenous bone grafts. Twelve rabbits were used. In each tibia, on the right lateral face, three 7 mm diameter unicortical cavities were performed with a trephine bur. The bone defects were respectively filled with particles of autogenous bone obtained with manual bone mill, with autogenous bone particles collected with a bone collector during the cavities preparation with implant burs, and with the blood clot serving as a control group. The animals were equally divided in three groups and sacrificed on 7, 15 and 30 days. According to the obtained results, on the seventh day all the groups showed to be filled with blood clots with the presence of autogenous bone particles observed on the triturated group (44,75%) and collected group (24%). At the fifteenth day period it was noted connective tissue differentiation in all the groups, with no bone neoformation noted on the control group (0%). Presence of bone particles and beginning of osteogenesis was noted in the collected (38,88%) and triturated (46%) groups. On the thirtieth day bone neoformation was observed in the control (50%), collected (64,63%) and triturated (66,63%) groups as well as the presence of immature trabecular bone. According to the methodology utilized, it was concluded that the bone formation occurred in the cavities of the triturated and collected groups did not show statistical significance, however being superior to the control group as to the quantitative and qualitative aspect. The bone particles of the triturated group were not totally reabsorbed in the analyzed periods, while in the collected group there was a bone particles resorption and bone neoformation in a higher degree than in the triturated group.

Estudos sugerem que a cafeína atua sobre o osso promovendo aumento da excreção de cálcio e inibição da proliferação de osteoblastos, aumentando o risco de fraturas, osteoporose e doença periodontal. Os efeitos da cafeína sobre o tecido ósseo dificultam a aplicação de implantes dentários devido à presença de grandes defeitos ósseos ou volume ósseo insuficiente. Vários métodos são propostos para a regeneração de defeitos ósseos, entre eles, o uso de diferentes tipos de enxertos, os quais demonstram capacidade em promover a formação óssea A despeito das desvantagens, o osso autógeno ainda é considerado a referência padrão como enxerto ósseo, devido ao seu potencial osteogênico, osteoindutor e osteocondutor. A engenharia tecidual óssea tem sido utilizada como uma estratégia para a regeneração óssea. As células tronco mesenquimais são consideradas multipotentes e podem replicar como células indiferenciadas, possuindo potencial para se diferenciarem em linhagens de osso, cartilagem, gordura e cartilagem. O objetivo deste estudo foi quantificar histomorfometricamente a reparação óssea pelo enxerto de uma associação de osso autógeno obtido da calota craniana e células osteoblásticas em defeitos ósseos produzidos pela extração dental de ratos submetidos à administração diária de cafeína. Os animais foram divididos em: Controle (c), osso autógeno (oa) e osso autógeno + células osteoblásticas (oa+co) e receberam injeções diárias intraperitonealmente de 30 mg/kg/dia de cafeína durante trinta dias, os homólogos receberam de solução salina. Os ratos foram sacrificados nos períodos de 7, 21 e 42 dias pós-cirurgia e as amostras teciduais foram processadas para a obtenção de secções finas (5 m) e coradas com HE. Através de um sistema de análise de imagens se estimou a fração de volume de osso, conjuntivo e coágulo, no defeito ósseo. Os resultados histológicos e histométricos mostraram que nos animais sob tratamento com cafeína houve uma menor formação óssea estatisticamente significante a 1%, e um retardo na reabsorção do coágulo sanguíneo quando comparado aos alvéolos dos animais sob tratamento com soro fisiológico. A análise qualitativa do fragmento de osso autógeno isoladamente ou associado às células osteoblásticas mostrou uma osteointegração progressiva e sem reação de corpo estranho nos animais tratados com soro fisiológico e, as células implantadas não propiciaram reações imunogênicas nem a formação tumoral, possibilitando um aumento (25%) na reparação óssea dos animais tratados com a cafeína. Conclui-se que o enxerto/implante das células osteoblásticas associadas ao osso autógeno da calota craniana foi capaz de compensar, nos períodos tardios, os efeitos deletérios da cafeína na reparação óssea alveolar. / Studies suggest that caffeine acts on the bone for increasing the excretion of calcium and inhibition of osteoblasts proliferation, increasing the risk of fractures, osteoporosis and periodontal disease. The effects of caffeine on bone difficult the application of dental implants due to large bone defects and insufficient bone volume. Several methods are proposed for the regeneration of bone defects, including the use of different types of grafts, which show ability to promote bone formation. Despite the disadvantages, the autogenous bone is still considered the gold standard as bone graft because the potential osteogenic, osteoinductive and osteoconductive. The bone tissue engineering has been used as a strategy for bone regeneration. The mesenchymal stem cells are considered multipotent and can replicate as undifferentiated cells, with potential to differentiate into lineages of bone, cartilage, fat and cartilage. This study aimed to quantify histomorphometrycally bone repair by grafts of a combination of autogenous bone obtained from the skull and osteoblastic cells in bone defects produced by dental extraction in rats subjected to daily administration of caffeine. The animals were divided into: Control (c), autogenous bone (ab) and autogenous bone + osteoblastic cells (ab + oc) and received daily injections intraperitoneally of 30 mg/kg/day of caffeine for thirty days, the counterparts received saline solution. The rats were sacrificed at times of 7th, 21st and 42nd days post-surgery and tissue samples were processed to obtain thin sections (5 m) and stained with HE. Through an image analysis system was estimated the fraction of volume of bone, collagen and blood clot in the bone defect. The histological and histometric results showed that in animals under treatment with caffeine had a lower bone formation statistically significant at 1%, and a delay in the resorption of blood clots when compared to the alveoli of animals under treatment with saline. The qualitative analysis of the fragment of autogenous bone alone or associated with osteoblastic cells showed a progressive osteointegration and no foreign body reaction in animals treated with saline, and implanted the cells not provided immunogenic reactions or tumor formation, allowing an increase (25%) on bone repair in animals treated with caffeine. It was concluded that the graft/implant of osteoblastic cells associated with autogenous bone from the skull was able to compensate in later periods, the deleterious effects of caffeine on alveolar boné repair.

Abstract This study focuses on the development of a bone collecting device for intra-oral bone harvesting and on the introduction of a new bone graft donor site, zygomatic bone. A bone collector was constructed and tested in vitro. This bone collector is suitable and efficient in dental implant related bone grafting surgery. It was also found to be more efficient and with a larger capacity in bone harvesting when compared to the two commercially available bone collectors. A zygomatic bone harvesting technique is introduced in this study. The safety and morbidity of the method was assessed in a cadaver and a prospective clinical study. In the cadaver study, 40 procedures were performed. The complications during the cadaver harvesting included 15 perforations into the maxillary sinus and 7 perforations into the infratemporal fossa. The only intra-operative complication in 32 clinical operations was perforation of the maxillary sinus in 33% of the zygomatic sites. None of these patients experienced any post-operative problems related to the perforation. Patients needed pain medication for a mean time of four days and they did not demonstrate any paresthesias or altered sensations in the donor area. The yield of the bone graft from zygomatic bone was quantified in cadaver and clinical studies. In the cadaver study, the average yield of the graft was 0.59 ml. In the clinical study the average graft volume was 0.90 ml. The required reconstructions were accomplished in all clinical cases. In the prospective clinical study, the bone grafts from the zygomatic bone were used simultaneously with one-stage dental implants placement. Bone grafting was employed at 72 of the 82 implant sites. Two of the bone grafted implants failed, yielding a survival rate of 97.2% for bone grafted implants and 97.6% for the whole study group. Grafted sites healed remarkably well, and no obvious signs of graft resorption were noted during the 26.9 months follow-up period. The bone collector developed in this study is an effective instrument in intra-oral bone harvesting. The zygomatic bone can be regarded as a safe bone harvesting donor site and the yield of bone graft from this area is sufficient for moderate defects in resorbed alveolar ridges.

Magister Scientiae Dentium - MSc(Dent) / Autologous bone grafting in conjunction with dental implant therapy is a well-accepted procedure in oral and maxillofacial rehabilitation. A variety of intraoral donor sites, such as the mandibular symphysis, the mandibular ramus and the maxillary tuberosity have been used in oral and maxillofacial reconstruction. However these sites are associated with complications. In order to reduce these complications, the anterior palate has been proposed as a potential donor site. However, the scientific literature in this regard is sparse, and larger studies are required to investigate the clinical potential of this proposed site. Aim: To determine the volume and density of available bone in the anterior palate that may be used for bone harvesting using cone-beam computed tomography (CBCT) in a select South African population. Materials and methods: One hundred previously acquired CBCT scans taken at the Diagnostic and Radiology Department of Tygerberg Oral Health Centre were analyzed for the required data. These were all acquired from a single CBCT machine (Newtom VGI®, Verona, Italy). The study sample included 52 females and 48 males ranging from ages 20 years to 80 years. The CBCT scans were divided into 3 different age groups. The first age group was between the ages of 20 and 39 years, the second age group was from 40 to 59 years and the third age group was ≥ 60 years. The volume and density of the anterior palate of the different age groups were analyzed using specific criterion. CBCT specific software (Simplant Pro Crystal®) Dentsply implants, Mannheim, Germany was used to standardize the data collection. All data was stored in a Microsoft Excel spreadsheet (Microsoft Corporation, Washington, USA). Results: The mean volume of the anterior palate in this study was 2.11 ± 0.55 cm3, with a minimum volume of 1.04 cm3 and a maximum volume of 3.82 cm3. There was no significant difference in the volume and density of the anterior palate between different age groups and no significant difference in the volume between males and females (p value = 0.227). Conclusions: The anterior palate affords a considerable amount of bone volume which is similar or even more than other intraoral donor sites. The anterior palate is a potential donor site for bone harvesting and CBCT may be regarded as an ideal tool to analyze the amount of bone available for harvesting.