Thesis (M.S.)--University of Alabama at Birmingham, 2007. / Title from first page of PDF file (viewed Oct. 30, 2007). Includes bibliographical references (p. 61-66).

A periodontite é uma doença inflamatória crônica, multifatorial, altamente prevalente na população que compromete os tecidos de suporte dos dentes gerando sequelas de difícil resolução, mesmo com as mais modernas técnicas regenerativas. A terapia tecidual parece ser uma alternativa promissora e as células indiferenciadas do ligamento periodontal (PDL) tem demonstrado grande potencial terapêutico. No entanto, o PDL necessita de estímulos adequados de biomodificadores para que a diferenciação ocorra de forma coordenada. As proteínas da matriz do esmalte (EMD) é um tipo de biomodificador que promove formação de novo cemento. Apesar de ser utilizada clinicamente, a sua associação com células frescas do PDL ainda não foi explorada. Este é um estudo da expressão gênica e proteica do PDL com finalidade de reaproveitamento do tecido recém-extraído, estimulado por EMD, tendo em vista a regeneração periodontal. Os resultados da expressão gênica apresentam VEGF (p=0.5194) com diferença entre medianas de -0.201 e FGF-2 (p = 0,0059) com diferença entre medianas de -0.4167. No estudo de citocinas, VEGF-A (p<0,0001) com diferença entre medianas de 60,93, enquanto VEGF-D (p=0.0049) com entre medianas de 2,45. Através dos resultados da expressão gênica baseada em FGF-2 e proteica baseada em VEGF-A, foi possível observar que as EMD modularam a resposta tecidual ex-vivo no período de 10 minutos tendo em vista o padrão angiogênico. Essa combinação poderá servir como uma proposta terapêutica, visando a aplicação clínica futura de tecidos comumente descartados após exodontia, como o PDL. / Periodontitis is a chronic inflammatory disease, multifactorial and highly prevalent in the world population that affects the teeth of the supporting tissues, generating sequels difficult to solve even with the most modern regenerative techniques. Tissue therapy appears to be a promising alternative and undifferentiated cells of the periodontal ligament (PDL) have shown great therapeutic potential. However, the PDL needs to appropriate stimuli biomodificatores that differentiation occurs in a coordinated fashion. The enamel matrix proteins (EMP) are a type of biomodificator that promotes new cementum formation. Despite being used clinically, its association with PDL fresh cells has not yet been explored. This is a study of gene and protein expression of PDL with reuse purpose of the newly extracted tissue stimulated by EMD, with a view to periodontal regeneration. The results show VEGF gene expression (p = 0.5194) difference in median -001 and FGF-2 (p = 0.0059) difference in medians of -0.4167. In the study of cytokines, VEGF-A (p <0.0001) with the difference between medians of 60.93, whereas VEGF-D (p = 0.0049) with from 2.45 medians. Through the results of the FGF-2-based gene expression and protein-based VEGF-A, it was observed that the EMD modulated the tissue response ex vivo in the 10-minute period considertingthe standard angiogenic. This combination may serve as a therapeutic approach aimed at future clinical application of tissues commonly discarded after extraction, such as the PDL.

A periodontite é uma doença inflamatória crônica, multifatorial, altamente prevalente na população que compromete os tecidos de suporte dos dentes gerando sequelas de difícil resolução, mesmo com as mais modernas técnicas regenerativas. A terapia tecidual parece ser uma alternativa promissora e as células indiferenciadas do ligamento periodontal (PDL) tem demonstrado grande potencial terapêutico. No entanto, o PDL necessita de estímulos adequados de biomodificadores para que a diferenciação ocorra de forma coordenada. As proteínas da matriz do esmalte (EMD) é um tipo de biomodificador que promove formação de novo cemento. Apesar de ser utilizada clinicamente, a sua associação com células frescas do PDL ainda não foi explorada. Este é um estudo da expressão gênica e proteica do PDL com finalidade de reaproveitamento do tecido recém-extraído, estimulado por EMD, tendo em vista a regeneração periodontal. Os resultados da expressão gênica apresentam VEGF (p=0.5194) com diferença entre medianas de -0.201 e FGF-2 (p = 0,0059) com diferença entre medianas de -0.4167. No estudo de citocinas, VEGF-A (p<0,0001) com diferença entre medianas de 60,93, enquanto VEGF-D (p=0.0049) com entre medianas de 2,45. Através dos resultados da expressão gênica baseada em FGF-2 e proteica baseada em VEGF-A, foi possível observar que as EMD modularam a resposta tecidual ex-vivo no período de 10 minutos tendo em vista o padrão angiogênico. Essa combinação poderá servir como uma proposta terapêutica, visando a aplicação clínica futura de tecidos comumente descartados após exodontia, como o PDL. / Periodontitis is a chronic inflammatory disease, multifactorial and highly prevalent in the world population that affects the teeth of the supporting tissues, generating sequels difficult to solve even with the most modern regenerative techniques. Tissue therapy appears to be a promising alternative and undifferentiated cells of the periodontal ligament (PDL) have shown great therapeutic potential. However, the PDL needs to appropriate stimuli biomodificatores that differentiation occurs in a coordinated fashion. The enamel matrix proteins (EMP) are a type of biomodificator that promotes new cementum formation. Despite being used clinically, its association with PDL fresh cells has not yet been explored. This is a study of gene and protein expression of PDL with reuse purpose of the newly extracted tissue stimulated by EMD, with a view to periodontal regeneration. The results show VEGF gene expression (p = 0.5194) difference in median -001 and FGF-2 (p = 0.0059) difference in medians of -0.4167. In the study of cytokines, VEGF-A (p <0.0001) with the difference between medians of 60.93, whereas VEGF-D (p = 0.0049) with from 2.45 medians. Through the results of the FGF-2-based gene expression and protein-based VEGF-A, it was observed that the EMD modulated the tissue response ex vivo in the 10-minute period considertingthe standard angiogenic. This combination may serve as a therapeutic approach aimed at future clinical application of tissues commonly discarded after extraction, such as the PDL.

There are more than 150,000 anterior cruciate ligament reconstructions each year with the goal of recovering the balance between knee stability and mobility. As many as 25 percent of these procedures will end in joint instability that can cause further damage. The risk of developing degenerative joint disease (DJD) increases in patients with previous knee injury, resulting in a higher instance of total knee arthroplasty (TKA). There are more than 400,000 TKA procedures each year, but the waiting lists for this surgery shows that many more patients are hoping to undergo this procedure. TKA provides improved knee function and pain relief for patients suffering from DJD. Although this procedure is considered successful, as younger patients undergo this treatment, the long-term performance must be improved. Major mechanisms of failure include component loosening from stress-shielding, poor integration of the implant with native tissue, and ion release from the implant. TiNb alloys are more biocompatible than currently used alloys, such as NiTi, and have mechanical properties closer to bone, so they would reduce the instance of stress shielding. TiNb can be made porous for better integration with the native bone and has superior corrosion resistance than NiTi. Engineered ligaments have generally failed to achieve mechanical properties sufficiently similar to their native counterparts, but also lack the osteochondral interface critical to the transfer of load between ligament and bone. The osteochondral interface could be incorporated through a gradient of inorganic content toward the bony insertion ends of the ligament graft, as we showed that in increase of inorganic content resulted in the transdifferentiation of osteoblasts toward chondrocyte-like cells (bone to cartilage-like). A composite scaffold composed of an electrospun mesh with either a hydrogel component or extracellular matrix (ECM) produced by the cells may be a suitable tissue engineered ligament graft. The non-linear stress-strain behavior seen in native ligament is exhibited by both of these systems, and the ECM produced by these systems is consistent with ligament tissue. The ECM-electrospun mesh composite exhibited higher elastic modulus than the fibrin-electrospun mesh composite, but required extensive pre culture while the fibrin-electrospun mesh composite could be fabricated in situ.