Luciana armada dias
@estacio.br
Professor of Graduate and PostGraduate Program Faculty of Dentistry
Estacio de Sá University
RESEARCH INTERESTS
Endodontics, Dentistry
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Scopus Publications
Renata C.V. Rodrigues, Mariana T.M. Porpino, Nilton Dessaune-Neto, Henrique S. Antunes, Karina M.M.C. Pinto, José C. Provenzano, Fábio R. Pires, José F. Siqueira Jr., and Luciana Armada
Elsevier BV
Karoline Magalhães de Paula, Cinthya Cristina Gomes, Maria Isabel Bastos Valente, Fabio Ramoa Pires, Katherine Azevedo Batistela Rodrigues Thuller, Letícia Salles, and Luciana Armada
Elsevier BV
Rodolfo de Souza Rocha Júnior, Bruno de Oliveira Bergamin, Adriana Gomes Rocha Bastos, Alexandre Marques Paes da Silva, Fábio Ramôa Pires, Dennis de Carvalho Ferreira, and Luciana Armada
Wiley
AbstractObjectiveTo compare the expression of IL‐17 in periapical lesions (cysts and granulomas) among elderly individuals and adults. We selected 20 periapical lesions of the elderly (12 granulomas and eight cysts) and 20 periapical lesions of adults (12 granulomas and eight cysts).Materials and MethodsImmunohistochemistry was performed using a specific antibody for IL‐17. The slides were subdivided into five high magnification fields and then the images were observed through an optical microscope. According to the number of positive markings for the antibody, grades were given, ranging from 0 to 2.ResultsThe results demonstrate that there was no statistical difference when comparing the expression of IL‐17 between cysts and granulomas of both groups (study group: cysts 0.7 ± 0.21 × granulomas 0.96 ± 0.58, p = .61; control group: cysts 0.37 ± 0.16 × granulomas 0.31 ± 0.23, p = .27). The comparison between adult (control group) and elderly patients (study group) showed a statistical difference both in cysts (study group: 0.7 ± 0.21 × control group: 0.37 ± 0.16, p = .007) and in granulomas (study group: 0.96 ± 0.58 × control group: 0.31 ± 0.23, p = .0009), in which elderly patients had a higher expression of interleukin 17, in relation to adult patients.ConclusionWe concluded that elderly patients have a higher expression of IL‐17 in both cysts and granulomas, when compared to adult patients.
Estéfano Borgo Sarmento, Rosana Helena Teixeira de Lima Ribeiro Andrade, Cinthya Cristina Gomes, Fábio Ramôa Pires, Maria Isabel Bastos Valente, Adalgiza Mafra Moreno, Marco Orsini, Dennis Carvalho Ferreira, Lucio Souza Gonçalves, and Luciana Armada
Hindawi Limited
Diabetes mellitus has been regarded as a condition capable of influencing the evolution of periapical lesions. Therefore, this study evaluated the immunoexpression of IL-1β, TNF-α, and IL-17 in apical periodontitis from type 2 diabetic patients through immunohistochemistry. Twenty-six periapical lesions were selected, and the images obtained through immunohistochemistry reactions were analyzed. The statistical significance was set at p < 0.05 . IL-1β expression was considered focal (54%), weak to moderate (38%), and strong (8%) in diabetics, and focal (46%), weak to moderate (31%), and strong (23%), in controls. TNF-α was focal (85%) and weak to moderate (15%) in diabetics, and focal (92%) and weak to moderate (8%), in controls. IL-17 was focal (8%), weak to moderate (46%), and strong (46%) in diabetics, and focal (62%), weak to moderate (8%), and strong (30%), in controls. The quantitative analysis revealed greater expression of IL-17, with a significant difference between IL-17 × IL-1β × TNF-α p = 0.0009 in the diabetic group. The cytokines IL-1β and TNF-α did not express statistical differences between the tested groups. The IL-17 showed higher immunoexpression in the diabetic group p = 0.047 , which may suggest higher bone resorption activity in chronic apical periodontitis in this group of patients.
G. Soimu, Jd. Netto, ÁM. Miranda, DE. Perez, L. Armada, and FR. Pires
Medicina Oral, S.L.
Background Ameloblastomas are benign odontogenic tumors that can eventually mimic the clinical and radiological features of apical periodontitis. The aim of the present study was to evaluate the clinical, radiological and histological characteristics from a series of ameloblastomas mimicking apical periodontitis diagnosed in a 14-year period. Material and Methods all cases histologically diagnosed as ameloblastomas from 2005 to 2018 presenting a clinical diagnosis of periapical lesion of endodontic origin were selected for the study. Clinical, radiological and histological characteristics from all cases were tabulated and descriptively and comparatively analyzed. Results Twenty cases composed the final sample, including 18 solid and 2 unicystic ameloblastomas. Mean age of the affected patients was in the fifth decade with predilection for males (72%). The most common anatomical location was the posterior mandible (55%) and most cases presented a radiolucent unilocular (80%) well-defined (95%) image. Most cases were asymptomatic, but the presence of local swelling and bone cortical rupture were common. Conclusions Ameloblastomas mimicking periapical lesions of endodontic origin are mostly diagnosed in adult males as well-defined radiolucent unilocular lesions producing local swelling and bone cortical rupture. Key words:Ameloblastoma, apical periodontitis, cyst, differencial diagnosis, granuloma, periapical lesion.
Walter Arthur Silva Valente, Déborah Barrocas, Luciana Armada, and Fábio Ramôa Pires
FapUNIFESP (SciELO)
Abstract The mechanisms that stimulate the proliferation of epithelial cells in inflammatory periapical lesions are not completely understood and the literature suggests that changes in the balance between apoptosis and immunity regulation appear to influence this process. Objective: To evaluate the expression of the epidermal growth factor (EGF), its receptor (EGFR) and of the keratinocyte growth factor (KGF), the presence of CD57+ cells, the epithelial cell proliferation index, and the expression of the Bcl-2 protein in inflammatory periapical lesions (IPL) at different stages of development. Methodology: Our sample was composed of 52 IPLs (22 periapical granulomas - PG - and 30 periapical cysts - PC), divided into three groups: PGs, small PCs, and large PCs. Specimens were processed for histopathologic and immunohistochemical analyses. Sections were evaluated according to the amount of positive staining for each antibody. Results: We found no significant differences among the groups regarding Bcl-2 (p=0.328) and Ki-67 (p>0.05) expression or the presence of CD57+ cells (p=0.748). EGF (p=0.0001) and KGF (p=0.0001) expression was more frequent in PCs than in PGs, and CD57+ cells were more frequent in IPLs with intense inflammatory infiltrates (p=0.0001). We found no significant differences in KGF (p=0.423), Bcl-2 (p=0.943), and EGF (p=0.53) expression in relation to inflammatory infiltrates or to the type of PC epithelial lining, but observed greater KGF expression (p=0.0001) in initial PCs. EGFR expression was similar among the groups (p>0.05). Conclusion: More frequent EGF and KGF expression in PCs and the greater presence of CD57+ cells in lesions with intense inflammatory infiltrates suggest that these factors influence IPL development. The greater KGF expression in initial PCs suggests its importance for the initial stages of PC formation.
Quésia Euclides Teixeira, Dennis de Carvalho Ferreira, Alexandre Marques Paes da Silva, Lucio Souza Gonçalves, Fabio Ramoa Pires, Florence Carrouel, Denis Bourgeois, Irna Sufiawati, and Luciana Armada
MDPI AG
Persistent inflammatory responses in the elderly may act as modifiers on the progression and repair of chronic apical periodontitis lesions (CAPLs). While the involvement of IL-1β, IL-6 and TNF-α in inflammatory responses and, particularly, in CAPL has been documented, their expression in elderly patients needs to be further characterized. Therefore, the purpose of this study was to evaluate and compare the expressions of pro-inflammatory cytokines in CAPL from elderly individuals with young/middle-aged individuals. Thirty CAPL (15 cysts and 15 granulomas) from elderly patients (>60 years) and 30 CAPL (15 cysts and 15 granuloma) from young/middle-aged individuals (20–56 years) were selected. Immunohistochemical reactions were performed against IL-1β, IL-6 and TNF-α. The slides were subdivided into five high-magnification fields and analyzed. The number of positive stains was evaluated for each antibody. There was no significant difference between the cytokines when the cysts and granuloma were compared in the two groups. In the young/middle-aged, only IL-1β showed a difference and was significantly higher in granulomas (p = 0.019). CAPL pro-inflammatory cytokine levels in the elderly were significantly higher than in young/middle-aged individuals (p < 0.05). The pro-inflammatory cytokines IL-1β, IL-6 and TNF-α were significantly higher in CAPL in the elderly compared with the young/middle-aged group. Further elaborate research studies/analyses to elucidate the reasons for and consequences of inflammation in the elderly are recommended.
Katherine A.B.R. Thuller, Luciana Armada, Maria Isabel Valente, Fábio Ramoa Pires, Cristiano M.M. Vilaça, and Cinthya Cristina Gomes
Elsevier BV
Sabrina C. Brasil, Rachel M.M. Santos, Arlete Fernandes, Renan S. Lima, Carlos Alberto S. Costa, Karina Mara Martins Da Costa Pinto, Fábio R. Pires, Marcia de Deus Santos, José F. Siqueira, and Luciana Armada
Elsevier BV
Marcio Francisco Pereira, Fabio Ramoa Pires, Luciana Armada, Dennis Carvalho Ferreira, Florence Carrouel, Denis Bourgeois, and Lucio Souza Gonçalves
MDPI AG
To compare the expression of the receptor activator of nuclear factor-kappa B (RANK), matrix metalloproteinase 9 (MMP-9) and parathyroid hormone-related protein (PTHrP) in primary chronic apical periodontitis lesions (CAPLs) between people living with HIV (PLWHIV) undergoing antiretroviral therapy (ART) and HIV- individuals, 32 CAPLs (16 lesions from each group) were submitted to histopathological and immunohistochemical analyses and compared between groups. The majority of the PLWHIV group had undetectable plasma viral loads (n = 13; 81.3%). The means of TCD4+ lymphocytes, exposure to HIV-1 and the time of the use of ART were 542.1 cells/mm3 (SD = 256.4), 6.3 years (SD = 2.9) and 5.0 years (SD = 2.5), respectively. Of all variables studied, only histopathological diagnosis showed a significant difference between groups (LWHIV: granuloma n = 11 (68.0%); cyst n = 5 (31.2%); HIV-: granuloma n = 15 (93.8%); cyst n = 1 (6.2%); p = 0.015). When comparing the expressions of the three inflammatory markers between the groups, no significant differences were seen. There was no difference in the expression of RANK, PTHrP and MMP-9 in primary chronic apical periodontitis lesions between PLWHIV under ART and HIV- individuals.
E. B. Sarmento, C. C. Gomes, F. R. Pires, L. C. Pinto, L. A. A. Antunes, and L. Armada
Wiley
AIM
To compare the immunoexpression of RANK, MMP-9, and PTHrP in apical periodontitis lesions of diabetic and normoglycemic individuals.
METHODOLOGY
Primary chronic apical periodontitis lesions associated with teeth indicated for extraction in 13 type 2 diabetic individuals and 13 normoglycemic individuals who were screened for the glycemic index and glycated hemoglobin (HbA1c) were analysed. Individuals with other systemic diseases and users of anti-inflammatories and/or antibiotics in the previous 3 months, were excluded. Silanized slides with paraffin sections were used for immunohistochemical reactions and stained with haematoxylin and eosin for histopathological classification. The images were analyzed with an optical microscope and the slides were subdivided into 5 large fields assigning scores (0-2), according to the number of positive markings for each antibody. Fisher's exact test evaluated the parameters: gender, type of lesion, location, and position in the arch. Non-parametric Mann-Whitney test was used for age, HbA1c values, and comparison of marker expression. The Chi-square test was used to associate the expression of the markers. And the Spearman´s coefficient correlated the markers with the size of the periapical lesion.
RESULTS
The samples consisted of 69% periapical granulomas and 31% periapical cysts in each group. RANK expression was considered weak/moderate and strong in, respectively, 62% and 38% of the cases in both groups. MMP-9 expression was weak/moderate and strong in, respectively, 38% and 62% of the cases from the diabetic group, in comparison to 38% and 38% in the normoglycemics (24% cases from this group were negative). In contrast, PTHrP expression was negative, weak/moderate, and strong in, respectively, 46%, 46%, and 8% of the cases from the diabetic group, in comparison to 38% negative and 62% weak/moderate in normoglycemics. Quantitative analysis revealed that there were no significant differences in the immunoexpression of RANK (p=0.26), MMP-9 (p=0.17), and PTHrP (p=0.43) between the groups. There was no significant correlation between the expression of bone resorption markers and the macroscopic size of the periapical lesions (p>0.05).
CONCLUSIONS
The bone resorption mediators analyzed had similar immunoexpression in the periapical lesions of diabetic and normoglycemic individuals.
W. Gomes-Silva, DL. Pereira, ER. Fregnani, OP Almeida, L. Armada, and FR Ramôa Pires
Medicina Oral, S.L.
Background The aim of the present study was to analyze the clinicopathological and the ultrastructural features of periapical actinomycosis (PA) cases. Material and Methods Data from the files of an oral pathology laboratory were retrieved and the findings of histopathological analysis were evaluated. Hematoxylin–eosin (HE), a modified Brown & Brenn, and Grocott stains as well as ultrastructural analysis using scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDX) were utilized. Results Six cases were obtained, 4 females and 2 males, with a mean age of 34 year-old. Two cases were symptomatic, lower teeth and the anterior region were more commonly affected, and all cases were characterized by periapical radiolucencies. All cases presented sulfur granules with a ray-fungus or club-shaped pattern of the Splendore-Hoeppli phenomenon in HE-stained sections, with filamentous gram-positive bacteria aggregates highlighted by the modified Brown & Brenn stain. SEM analysis revealed abundant packed rod-like and filamentous bacteria associated with an extracellular amorphous material. EDX analysis showed predominant picks of calcium and sulfur in actinomycotic colonies. Conclusions Our findings suggest that PA manifests either clinically and radiologically as a non-specific and heterogeneous condition and that the actinomycotic colonies consist in a calcium- and sulfur-rich matrix. Furthermore, the results highlight the importance of submitting periapical specimens after surgical removal to histopathological analysis. Key words:Actinomyces, actinomycosis, periapical diseases.
Juan Pacheco‐Yanes, Isbelia Gazzaneo, Alejandro R. Pérez, Luciana Armada, and Mônica A. S. Neves
Wiley
AIM
In the present study, we compared the transportation of three different instrumentation systems in different levels of standardized artificial curved canals.
METHODS
Sixty epoxy resin blocks containing simulated canals were divided into three groups (n = 20) according to the instrument used for canal preparation: Reciproc (REC), Reciproc Blue (REC Blue), and XP-endo Shaper (XPS). Pre- and post-instrumentation digital images of each specimen were superimposed by Photoshop software to evaluate the different amount of transportation. The Kruskal-Wallis and Wilcoxon were the non-parametric tests applied for the intergroup and intragroup analyses, respectively. The significance level was set at 5%.
RESULTS
The XPS showed significantly less canal transportation than REC Blue at five levels (P < 0.05) and significantly less canal transportation at seven evaluated levels when compared with the REC (P < 0.05). REC Blue showed significant less canal transportation than REC at four of the eight evaluated levels (P < 0.05). All evaluated instruments showed a significantly higher amount of resin removal toward the inner wall compared to the outer wall of the curvature (P < 0.001).
CONCLUSION
Although the XPS showed significantly less canal transportation than REC and REC Blue, all systems produced transportation from the original canal anatomy.
Cristiane Barbosa Lopes, Luciana Armada, and Fábio Ramôa Pires
Elsevier BV
Luciana Armada, Sabrina de Castro Brasil, Luci Armada-Dias, Juciléia Bezerra, Rosa M. R. Pereira, Lilian Takayama, Rachel Moreira Morais dos Santos, Lucio S. Gonçalves, and Celly C. A. Nascimento-Saba
Wiley
AIM
The aim of the present study was to evaluate how aging, sex, and hypogonadism influence mandibular bone density with and without the benefits of hormone treatment.
METHODS
Three-month old Wistar rats were randomly assigned to three experimental groups, with eights animals per group: controls, castrated (orchiectomized [ORX], ovariectomized [OVX]) and castrated with hormonal treatment (ORX + testosterone, OVX + estradiol benzoate). Females were previously evaluated by vaginal cytology. The corporal mass was verified weekly, and after three experimental periods (90, 120, and 150 days), the animals were killed. Blood was collected, and bones underwent densitometric and biomechanical analyses.
RESULTS
After castration, the male rats demonstrated low gain in body weight compared to females (P < .05). Male and female castrated animals presented serum concentrations of sex steroid hormones lower than the control group (P < .05). Bone mineral density and biomechanical properties of the L4 vertebrae and femur were reduced earlier in females than in males (P < .05). However, mandibles were affected only in the male rats at the most chronic experimental period.
CONCLUSION
Hypogonadism promotes alterations in the mandible over chronic periods, especially in males, and these alterations could be minimized by hormone treatment.
Nilton Dessaune Neto, Mariana Teixeira Maneschy Porpino, Henrique dos Santos Antunes, Renata Costa Val Rodrigues, Alejandro Ron Perez, Fábio Ramôa Pires, José Freitas Siqueira Jr, and Luciana Armada
FapUNIFESP (SciELO)
Abstract Objective: This study evaluated the expression of pro-inflammatory (IL-1β, IL-6, IFN-γ and TNF-α) and anti-inflammatory (IL-4 and TGF-β) cytokines in apical periodontitis lesions. Correlations between these cytokines and clinical and cone-beam computed tomographic (CBCT) data were also assessed. Material and Methods: Apical periodontitis lesions’ data were obtained from 27 patients subjected to periradicular surgery. Specimens were processed for histopathologic and immunohistochemical analysis. Sections were evaluated according to the amount of positive staining for each antibody. Expression levels of the target mediators were compared with clinical and CBCT data. Results: Twenty lesions were diagnosed as granuloma and 7 as cyst. In granulomas, IL-4 expression was significantly higher than IL-6 (p=0.001) and TNF-α (p=0.001). There was a significant relationship between high levels of TNF-α and lesions <5 mm (p=0.017). In cysts, IL-6 expression was significant lower than IL-4 (p=0.001) and IFN-γ (p=0.004). There was a significant relationship between high levels of TGF-β and endodontic treatment performed ≤4 years before (p=0.045). In general, IL-4 was the most expressed mediator in both cysts and granulomas. Conclusions: There was a balance between the expression of pro-inflammatory and anti-inflammatory cytokines associated with the chronic periradicular inflammatory process. TNF-α and TGF-β were related to some clinical and CBCT data.
Natália Santos Carneiro, Luciana Armada, Débora Lima Pereira, Pablo Agustin Vargas, Márcio Ajudarte Lopes, and Fábio Ramôa Pires
Elsevier BV
Janderson Teixeira Rodrigues, Henrique dos Santos Antunes, Luciana Armada, and Fábio Ramôa Pires
Elsevier BV
Natália Freire de Almeida, Sabrina de Castro Brasil, Dennis de Carvalho Ferreira, and Luciana Armada
Wiley
OBJECTIVES
To evaluate the CD68 immunoexpression in post-treatment apical periodontitis lesions of older patients and compare them with lesions of younger/middle age adults.
METHODS
Biopsy specimens from 21 apical periodontitis lesions (12 granulomas and 9 cysts) were selected from older patients and 25 apical periodontitis lesions from younger/middle age adults (12 cysts and 13 granulomas) were selected and analyzed by immunohistochemistry using silanized slides with anti-CD68 antibody. The slides were subdivided in five high-power fields and the images were observed under an optical microscope to evaluate the epithelial and connective tissues.
RESULTS
The results showed that there was no statistical difference for the CD68 expression in epithelial tissue of cysts between younger/middle age adults and older patients. However, for the connective tissue of both cysts and granulomas, there was a statistical difference between the two age groups. There was a statistical difference between the epithelial and the connective tissues in cysts of younger/middle age adults, and also when the epithelial tissue of the cysts was compared with connective tissue of the granuloma. In the group of older patients, there was no statistical difference between the connective tissue of the cysts and granulomas.
CONCLUSION
The intensity of the macrophage staining was greater in the connective tissue of cysts and granulomas alike in the younger/middle age adult patients, suggesting that these cells participate actively in this tissue. Immune responses in older patients may be compromised, suggesting that there is a greater tendency for the endodontic treatment of these patients to fail.
SV Azeredo, SC Brasil, H Antunes, FV Marques, FR Pires, and L Armada
Medicina Oral, S.L.
Background Macrophages and plasma cells play a key role in the regulation of innate and adaptive immunity. The aim of this study was to assess the presence of these cells in apical periodontitis and their distribution comparing with clinical and image data. Material and Methods Thirty-three lesions were selected and divided in two groups (17 periapical cysts and 16 periapical granulomas). Immunoreactions using anti-CD68 and anti-CD138 antibodies were carried out; image analysis was performed with an optical microscope and 5 high-power fields from each slide were evaluated leading to an average score of immunoexpression. This mean score was compared between the two groups and correlated with the clinical and image data. Results There was no statistically significant difference (p >0.05) for the mean average score of CD68+ macrophages and CD138+ plasma cells when comparing the two groups (cysts x granulomas) and the specimens included in each specific group. No statistically significant differences (p >0.05) were also observed when comparing the average scores with clinical and image data. Conclusions The presence of CD68+ macrophages and CD138+ plasma cells was similar in periapical cysts and granulomas and the presence of these cells did not correlate with clinical and image data from both groups. Key words:Macrophages, plasma cells, apical periodontitis, periapical granuloma, periapical cyst.
CVA Junior, ND Neto, RCV Rodrigues, HS Antunes, MTM Porpino, JCA Carvalhal, and L Armada
Medicina Oral, S.L.
Background This study compared the incidence of deviation along curved canals after preparation with two nickel-titanium (NiTi) rotary systems, Twisted File Adaptive and BT-RaCe. Material and Methods Forty resin training blocks with curved canals were filled with ink and divided into two groups according to the instrumentation technique. Preinstrumentation images were acquired by using a stereomicroscope. The canals were up to an instrument #35/0.04. Postinstrumentation images were captured using the same conditions, and the images were superimposed. The amount of resin removed was measured at 8 different points, beginning at the apical terminus of the canal. Differences in the mesial and distal aspects were measured to evaluate the occurrence of deviation. The Student’s-t test was used for comparison of the intragroup deviation. Intergroup analysis was performed by using one-way ANOVA for each level. For multiple comparisons, the Bonferroni test was used and a cutoff for significance was set at 5%. Results Intragroup analysis showed that both instrumentation techniques promoted some deviation at all levels. BT-RaCe showed significantly lower deviation at 0 and 4-mm levels than Group Twisted File Adaptive (p<0.05). On the other hand BT-RaCe showed worse performance at level 6. Conclusions The results of this study demonstrated that none of the NiTi tested systems was able to instrument curved canals simulated in resin blocks without some deviation during the preparation. There is still need for improvement in the instruments manufacturing aiming the better performance of endodontic files in curved root canals. Key words:BT-RaCe, Curved root canals, Deviation, Twisted File Adaptive.
T Galvão, B Camargo, L Armada, and F Alves
Medicina Oral, S.L.
Background To compare the quality of calcium hydroxide paste fillings performed by three different techniques. Material and Methods Sixty extracted maxillary central incisors, with previous root canal treatment, were decoronated and the gutta-percha was completely removed from the root canals. Subsequently, the canals were filled with a calcium hydroxide-based paste composed of calcium hydroxide, bismuth carbonate, and glycerin. The study samples were divided into the following three groups on the basis of three insertion techniques (n = 20, each): conventional technique using a hand instrument (MAN), rotary Lentulo spiral (LEN) technique, and a combined technique combining conventional hand files with sonic activation through the EndoActivator device (EA). The quality of fillings was evaluated radiographically by two examiners on the basis of the amount of voids and the apical limit. Results The canals filled with LEN or MAN had less void volume compared to the EA technique (P >0.01), with no significant differences between them. Considering the apical limits, the three tested techniques showed comparable results (P >0.05). Conclusions A combined approach utilizing hand files with sonic activation showed no enhancements over the LEN or MAN techniques on the quality of intracanal placement of calcium hydroxide paste. Key words:Calcium hydroxide placement, EndoActivator, Lentulo spirals, intracanal medication, root canal treatment.
Daniel Deluiz, Luciano Santos Oliveira, Fábio Ramôa Pires, Teresita Reiner, Luciana Armada, Marcus A. Nunes, and Eduardo Muniz Barretto Tinoco
Wiley
BACKGROUND
Severe alveolar atrophy often presents a challenge for the implant surgery. The significant lack of bone in the alveolar ridges may compromise the final restorations both from the aesthetic and functional standpoints.
OBJECTIVES
To evaluate the behavior of bone block allografts for the maxillary augmentation and to investigate its incorporation, remodeling, and implant survival rates in two different healing time points.
MATERIAL AND METHODS
Sixty-six consecutive patients (52 female/14 male, mean age: 57.95 ± 9.06 years old), presenting 113 atrophic alveolar ridges underwent maxillary augmentation with fresh-frozen allogeneic bone blocks from tibia. Patients were randomly assigned in two groups: Group 1-patients who would wait 4 months for implant placement after grafting, and Group 2-patients who would wait 6 months. Events of infection, suture dehiscence or mucosal perforation were recorded. Cone-beam computed tomography scans were compared volumetrically between the time of the grafting surgery and reentry procedure after incorporation. Biopsies were collected and subjected to histological, histomorphometric and immunehistochemical analysis.
RESULTS
A total of 305 implants were placed in the reconstructed sites. The mean resorption rate in Group 1 (13.98% ± 5.59) was significantly lower than Group 2 (31.52% ± 6.31). The amount of calcified tissue, newly formed bone and remaining graft particles demonstrated no difference between groups. The samples showed evident immunolabeling for the podoplanin protein in both groups. The implants cumulative survival rate was 94.76%.
CONCLUSIONS
The findings of the present study indicate that there is a significant difference regarding the resorption of the grafts when waiting 4 or 6 months before placing the implants, even though no difference was found in the histological, histomorphometric, and immunohistochemical features. Both 4-month and 6-months healing times are suitable for the implant placement.
S. C. Brasil, R. M. M. Santos, A. Fernandes, F. R. F. Alves, F. R. Pires, J. F. Siqueira, and L. Armada
Wiley
AIM
To evaluate the effects of a long period of oestrogen deficiency on the development of apical periodontitis in rats.
METHODOLOGY
Wistar rats (n = 24), 3 months old, evaluated by vaginal cytology, were included in the study. Twelve animals were ovariectomized (OVX group) and the other 12 were sham operated (control group). One hundred and twenty days after castration, the pulps of the left mandibular first molars were exposed to induce the development of apical periodontitis. Body mass was verified on a weekly basis. Following 21 and 40 days of lesion induction, the animals were sacrificed. Blood was collected for biochemical analysis, and mandibles were removed for radiographic analysis. Comparative analysis of the data was performed by the nonparametric Kruskal-Wallis and Dunn's multiple-comparisons tests. The t-test was applied to compare the oestrogen levels between control and OVX groups.
RESULTS
Radiographs revealed that apical periodontitis lesions were significantly larger in the 40-day OVX group when compared with both 40-day (P < 0.05) and 21-day (P < 0.001) control groups. Serum oestrogen levels were significantly lower in the OVX group (P < 0.01), confirming the efficacy of castration. Oestrogen deficiency resulted in significantly greater body mass gain (P < 0.01) in 40-day OVX group when compared with 40-day control group. Serum concentrations of calcium were similar between groups (P > 0.05). Alkaline phosphatase levels, although higher in the OVX groups (21 and 40 days), were not significantly different.
CONCLUSIONS
Ovariectomized rats had significantly larger apical periodontitis lesions after 40 days of pulp exposure when compared with controls. These findings suggest that bone alterations as a result of long periods of oestrogen deficiency can influence the progression of apical periodontitis.