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Previous issue date: 2014-01-10 / Bisphosphonates are drugs widelly used to treat diseases characterized by intense bone resorption. Although very efficacious, they are also associated with cases of osteonecrosis in jaw bones called bisphosphonate-related osteonecrosis of the jaws (BRONJ). The disease is difficult to treat and its etiology is considered multifactorial but it has not yet been completely understood. Among other etiologic factors, the major or secondary role of microorganisms in BRONJ has been discussed. The aim of this work was to evaluate by means of histomorphometry in Gram, Gomori-Grocott and immunohistochemistry (IHC) the microorganisms found in surgically induced wounds in maxillae of rats subjected to bisphosphonate therapy. Thirty-four rats were allocated into three groups according to the treatment received: (1) zoledronic acid group (n=12); (2) clodronate group (n=12); and (3) control group (n=10, normal saline). Sixty days after started the treatment, tooth extractions and surgical wounds in soft tissue were performed. Forty-two days after surgeries, rats were euthanized, the specimens were processed and histological analysis performed. At the tooth extraction site, the zoledronic acid group had higher prevalence of Actinomyces than the clodronate and control, whereas at the soft tissue wound, both test groups showed higher values than control. Candida occurrence did not significantly differ between the groups. At the tooth extraction site, single Gram-positive cocci were more prevalent in the zoledronic acid, whereas at the soft tissue wound, they were more prevalent in both test groups than controls. Single Gram-negative cocci did not show any significant difference between the groups at the tooth extraction site; at the soft tissue wound, they were more prevalent in the zoledronic acid group. At the tooth extraction site, bacilli did not differ between the groups, whereas at the soft tissue wound site, they were significantly higher in the test groups. Diplococci, streptococci and staphylococci were rarely found, without significant difference between the groups. Actinomyces was the most prevalent microorganism, followed by single cocci and bacilli. Streptococci, staphylococci, Candida and diplococci do not seem to play a significant role in such lesions whereas the anatomical site seems to be a determinant of the microorganisms involved. / Bisfosfonatos s?o f?rmacos amplamente empregados no tratamento de doen?as caracterizadas por intensa reabsor??o ?ssea e t?m sido associados a quadros de osteonecrose maxilar (BRONJ). A BRONJ ? uma condi??o de dif?cil tratamento, cuja etiologia, embora considerada multifatorial, n?o foi completamente esclarecida. Entre outros fatores etiol?gicos, a participa??o dos microrganismos como fator principal ou secund?rio tem sido discutida na literatura. O presente estudo teve por objetivo avaliar, por meio de histomorfometria nas t?cnicas de Gram, Gomori-Grocott e imunoistoqu?mica (IHQ), os microrganismos de feridas cir?rgicas induzidas em maxilas de ratos sob terapia com bisfosfonatos. Trinta e quatro ratos foram distribu?dos em tr?s grupos de acordo com o tratamento administrado: (1) grupo ?cido zoledr?nico (n=12); (2) grupo clodronato (n=12); e (3) grupo-controle (n=10, solu??o salina). Sessenta dias ap?s iniciado o tratamento, os animais foram submetidos a exodontias e indu??o cir?rgica de les?o de tecido mole. Decorridos 42 dias dos procedimentos cir?rgicos, foi realizada a eutan?sia, e os esp?cimes foram submetidos a processamento histol?gico. No s?tio das exodontias, o grupo ?cido zoledr?nico teve maior preval?ncia de Actinomyces que o clodronato e o controle, enquanto no s?tio da ferida de tecido mole, ambos os grupos-teste exibiram maiores valores que o controle. A ocorr?ncia de Candida n?o diferiu significativamente entre os grupos. No s?tio de exodontia, cocos Gram-positivos isolados foram mais prevalentes no grupo ?cido zoledr?nico, ao passo que, na regi?o de ferida de tecido mole, eles foram mais prevalentes nos grupos-teste que no controle. A preval?ncia de cocos Gram-negativos isolados n?o exibiu diferen?a significativa entre os grupos no s?tio das exodontias; entretanto, no s?tio da ferida de tecido mole, foi maior no grupo ?cido zoledr?nico. Os bacilos n?o diferiram entre os grupos no s?tio de exodontia, mas na ?rea de ferida de tecido mole, foram mais prevalentes nos grupos-teste. A ocorr?ncia de diplococos, estreptococos e estafilococos foi rara e n?o exibiu diferen?a significativa entre os grupos. Tanto em s?tio de exodontia, quanto de ferida de tecido mole, o Actinomyces foi o microrganismo mais prevalente seguido pelos cocos isolados e bacilos. Estreptococos, estafilococos, Candida e diplococos n?o exercem papel significativo no desenvolvimento das les?es. O s?tio anat?mico parece ser fator determinante dos microrganismos envolvidos.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/1243 |
| Date | 10 January 2014 |
| Creators | Boff, Renata Chiapinotto |
| Contributors | Cherubini, Karen |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Odontologia, PUCRS, BR, Faculdade de Odontologia |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | -8096554818733665164, 500, 600, 4673435736271820140 |
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