Thesis (M. Sc.)--McGill University, 1998. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis (doctoral)--University of Göteborg, 1994. / Added t.p. with thesis statement inserted. Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 1997. / Includes bibliographical references.

Thesis (doctoral)--University of Göteborg, 1994. / Added t.p. with thesis statement inserted. Includes bibliographical references.

Thesis (M. Sc.)--McGill University, 1998. / Includes bibliographical references.

Thesis (D.P.H.)--University of Michigan, 1991. / Includes bibliographical references.

Made available in DSpace on 2014-06-11T19:26:42Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-02-25Bitstream added on 2014-06-13T19:13:52Z : No. of bitstreams: 1 carvalho_bm_me_araca.pdf: 630383 bytes, checksum: 44d117faacb1722e5bf9a5e9bdee6d51 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Devido à oferta limitada e morbidade associadas ao uso de enxertos autógenos, substitutos ósseos têm sido desenvolvidos e estudados. Implantes homógenos de matriz óssea desmineralizada (MOD) têm sido utilizados como material clínico de enxerto devido à sua suposta capacidade de osseoindução e osseocondução. Este estudo teve por objetivo comparar os resultados histológicos da utilização da matriz óssea homógena conservada em glicerina a 98% e em glutaraldeído 4% em defeitos ósseos cirurgicamente criados em tíbias de rato. Foram selecionados 18 ratos machos, destes, seis como grupo doador de matriz óssea (MOD). Os doze animais restantes foram operados, recebendo a matriz óssea desmineralizada em defeitos cirúrgicos criados em suas tíbias, onde, na direita foi implantado MOD armazenada em glicerina a 98% e na tíbia esquerda MOD armazenada em glutaraldeído a 4%. Foram sacrificados seis animais em cada tempo pós-operatório de 30 e 60 dias. Para análise microscópica, as lâminas foram coradas pelos métodos da hematoxilina e eosina e tricrômio de Masson. Após análise microscópica das peças, foi constatado áreas da implantação da MOD claramente visíveis e constituídas em ambas as amostras, contudo os implantes conservados em glutaraldeído induziram um tecido conjuntivo de uma forma mais desorganizada e fragmentada, quando comparados com os tratados com glicerina, que mostraram maior quantidade de áreas de neoformação óssea em sua periferia. Este estudo mostrou que a glicerina a 98% foi um meio de conservação mais favorável à neoformação óssea da MOD, quando comparado ao glutaraldeído a 4% / This study compared the histological results of allogeneic demineralized bone matrix (DBM) preserved in 98% glycerin and 4% glutaraldehyde in experimental bone defects. We selected 18 male rats, of these, six were used as donor of DBM. The remaining twelve animals received in the right tibia DBM stored in 98% glycerin and DBM in 4% glutaraldehyde in the left tibia. Six animals were sacrificed at each postoperative time of 30 and 60 days. For microscopic analysis, slides were stained by the methods of hematoxylin and eosin and Masson Tricomium. Microscopic analysis found areas of deployment of MOD in both samples, but the implants preserved by glutaraldehyde presented themselves in a more disorganized and fragmented compared to those treated with glycerin, which showed a larger amount of bone formation. This study showed that 98% glycerin was a more favorable medium of preservation for bone formation when compared to 4% glutaraldehyde

Orientador: Idelmo Rangel Garcia Júnior / Banca: Marco Antonio Brandão Pontual / Banca: Martha Alayde Alcântara Salim / Resumo: Devido à oferta limitada e morbidade associadas ao uso de enxertos autógenos, substitutos ósseos têm sido desenvolvidos e estudados. Implantes homógenos de matriz óssea desmineralizada (MOD) têm sido utilizados como material clínico de enxerto devido à sua suposta capacidade de osseoindução e osseocondução. Este estudo teve por objetivo comparar os resultados histológicos da utilização da matriz óssea homógena conservada em glicerina a 98% e em glutaraldeído 4% em defeitos ósseos cirurgicamente criados em tíbias de rato. Foram selecionados 18 ratos machos, destes, seis como grupo doador de matriz óssea (MOD). Os doze animais restantes foram operados, recebendo a matriz óssea desmineralizada em defeitos cirúrgicos criados em suas tíbias, onde, na direita foi implantado MOD armazenada em glicerina a 98% e na tíbia esquerda MOD armazenada em glutaraldeído a 4%. Foram sacrificados seis animais em cada tempo pós-operatório de 30 e 60 dias. Para análise microscópica, as lâminas foram coradas pelos métodos da hematoxilina e eosina e tricrômio de Masson. Após análise microscópica das peças, foi constatado áreas da implantação da MOD claramente visíveis e constituídas em ambas as amostras, contudo os implantes conservados em glutaraldeído induziram um tecido conjuntivo de uma forma mais desorganizada e fragmentada, quando comparados com os tratados com glicerina, que mostraram maior quantidade de áreas de neoformação óssea em sua periferia. Este estudo mostrou que a glicerina a 98% foi um meio de conservação mais favorável à neoformação óssea da MOD, quando comparado ao glutaraldeído a 4% / Abstract: This study compared the histological results of allogeneic demineralized bone matrix (DBM) preserved in 98% glycerin and 4% glutaraldehyde in experimental bone defects. We selected 18 male rats, of these, six were used as donor of DBM. The remaining twelve animals received in the right tibia DBM stored in 98% glycerin and DBM in 4% glutaraldehyde in the left tibia. Six animals were sacrificed at each postoperative time of 30 and 60 days. For microscopic analysis, slides were stained by the methods of hematoxylin and eosin and Masson Tricomium. Microscopic analysis found areas of deployment of MOD in both samples, but the implants preserved by glutaraldehyde presented themselves in a more disorganized and fragmented compared to those treated with glycerin, which showed a larger amount of bone formation. This study showed that 98% glycerin was a more favorable medium of preservation for bone formation when compared to 4% glutaraldehyde / Mestre

Purpose: We conducted a systematic review and meta-analysis evaluating dental implant failure and osteonecrosis related to antiresorptive therapy for osteoporosis. Methods: We searched 5 databases between 1946 and January 2022. We included interventional and non-interventional studies reporting rates of dental implant failure or osteonecrosis in those with osteoporosis or osteopenia. Two reviewers independently screened all titles and abstracts, and full-texts. Risk of bias was assessed using the modified Ottawa-Newcastle scale, and the evidence was assessed using the GRADE framework. We adhered to PRISMA 2020 and MOOSE reporting standards. Results: Our search revealed 793 unique citations that underwent title and abstract screening. We included 112 studies for full text screening, 33 underwent data abstraction, and ultimately nine (n=655) were included for the implant failure analysis. Random effects meta-analysis revealed a point estimate suggesting a decrease in relative risk of implant failure in those exposed to antiresorptives (RR 0.82, 95% CI 0.52 – 1.28, p = 0.38, very low certainty). We identified 128 cases of MRONJ in implant recipients. The rate of MRONJ following implantation in those exposed to antiresorptive therapy is 0.40% pooled from 20 cohorts. A single comparative study assessed risk adjusted MRONJ in osteoporotic patients undergoing dental implant placement and found use of bisphosphonates increased osteonecrosis of the jaw by 3 cases per 1000 patients (adjusted HR 4.09, 95% CI 2.75 – 6.09, p<0.001, moderate certainty). Conclusions: The limited evidence does not suggest an association between antiresorptive therapy for osteoporosis and dental implant failure. The certainty of evidence is very low due to serious methodologic concerns. Antiresorptive therapy likely causes MRONJ in osteoporotic patients receiving dental implants with moderate certainty evidence. / Thesis / Master of Science (MSc) / We sought to generate an up-to-date and comprehensive analysis of whether standard treatment for osteoporosis with anti-resorptives increases the risk of adverse outcomes when receiving dental implants. We conducted a search of all studies published on this between 1946 and 2022, and found 793 studies. Nine studies provided numbers related to dental implant outcomes. We are very uncertain whether anti-resorptive increase or reduce the absolute risk of dental implant failure. The estimated worst case scenario is that anti-resorptives cause 3 more implant failures per 100 patients. We also looked at the rare outcome where there’s death of the jaw bone (osteonecrosis). We found this occurs 0.4% of time in patients undergoing implant when exposed to anti-resorptive drugs. We estimate that exposure to anti-resorptives increases the risk of osteonecrosis of the jaw by 3 per 1000 patients. The evidence supporting this is from one moderate quality study.

Indiana University-Purdue University Indianapolis (IUPUI) / Endosseous implants have been accepted as a viable dental and medical adjunct and are now used for multiple dental applications. The majority are placed in patients of relatively advanced age, and, as such, the increased use of implants has raised questions in the areas of bone healing and metabolism associated with their placement. This study evaluated the mechanical and histological aspects of the bone/metal interface of endosseous titanium implants in compact and trabecular bone. Two implants were placed: one in the distal metaphysis (M) and one 2.0 cm proximal in the diaphysis (D). Right side limbs were subjected to a sham surgery and served as controls. The rabbits were sacrificed at six, 12, and 24 weeks healing time. Multiple fluorochrome labels were given to mark sites of bone formation. At sacrifice, all implants were tested for interface torque strength. Microradiography and fluorescent light microscopy were used to determine percent volume of bone and marrow space, bone/implant interface characteristics, percent labeled bone surface area, and percent labeled bone volume. D implants required about 20 percent more torque to mechanically disrupt the bone/implant interface than M implants. Values were M (combined groups) 33.4 N-cm ±15.5 N-cm, and D (combined groups) 41.5 N-cm ±16.0 N-cm (Mean ±SD, n = 8, p<.07). The percent of bone in direct contact with the implant surface appeared to increase only slightly with time. Direct contact occurred on 11.2%, 9.5% ±8.5% and 13.9% ±6.6% of the M implant surface in six, 12, and 24 week specimens, respectively. Direct contact occured on 11.7%, 10.2% ±2.4% and 19.5% ±0.35% of the D implant surface in six, 12, and 24 week specimens, respectively. Total bone volume in implanted D specimens was less [Exp.= 91.1% ± 3.1%, Cont. = 95.5% ± 0.73% (Mean ±SD)] and marrow space volume was greater [Exp. = 8.9% ±3.02%, Cont. = 4.6% ±0.73% (Mean ±SD)] than in controls (p<.02). The percent labeled bone volume was greater in the implanted specimens than in their controls (p<.001). This difference decreased over time. Implanted D specimens also showed significantly more (p<.001) labeled bone surface area than controls. These findings suggest that when implants are placed in elderly subjects, normally inactive bone becomes very active. Also, it seems that bone quality, not quantity, determines interface strength.