RESUMEN

PURPOSE: Herein we evaluated the effects of platelet concentrate (PC) and platelet-poor plasma (PPP) on bone repair using noncritical defects in the calvaria of rabbits and compared them to the presence of TGF-ß1 and osteocalcin on reparative sites. METHODS: Five noncritical defects of 8.7 mm in diameter were created on the calvaria of 15 animals. Each defect was treated differently, using autograft (ABG), ABG associated with PC (ABG + PC), ABG with PPP (ABG + PPP), isolated PPP, and blood clot (control). The animals were submitted to euthanasia on the second, fourth and sixth week post-surgery. RESULTS: The defects that received ABG+PC or PPP demonstrated lower bone formation when compared to specimens that received ABG in the same period. These results coincided to significant higher immunopositivity for TGF-ß1 for specimens that received PC, and lower presence of cytokine in the group PPP. However, either higher or lower presence of TGF-ß1 were also correlated to lower presence of osteocalcin. Likewise, these results were similar to findings in specimens treated only with PPP when compared to control. CONCLUSIONS: PC and PPP were not effective when applied in association with ABG. Similarly, isolated use of PPP was not beneficial in optimizing the bone repair.

Asunto(s)

Osteogénesis , Factor de Crecimiento Transformador beta1 , Animales , Autoinjertos , Osteocalcina , Conejos , Cráneo/cirugía , Factor de Crecimiento Transformador beta1/metabolismo

RESUMEN

OBJECTIVE: To evaluate the correlation between metabolic bone activity measured by single photon emission computed tomography (SPECT) and the anatomic condylar characteristics acquired by computed tomography (CT), in patients with unilateral condylar hyperplasia (UCH). Method and Materials/Patients: Observational, descriptive study in a group of 71 patients with clinical diagnosis of UCH and indication of SPECT/CT. Bone SPECT images obtained in a gamma-camera GE Infina and processed in a station Xeleris 3 with the program Volumetrix MI Evolution for bone. CT images acquired in a PET/CT Biograph mcT20 equipment (Siemens) processed in a station Osirix V 7.5.1 (Pixmeo, Bomex, Switzerland). RESULTS: The sample included 24 men (33.8%) and 47 women (66.2%). Active state UCH was detected in 40 (56.3%) cases (over 55% uptake in the affected condyle) and 38 (53.5%) presented mandibular deviation to the right side. No significant differences related to sex, age, or mandibular deviation side were found. Mandibular deviation was the only morphologic feature related to active/inactive UCH (p = 0.003). The likelihood of active CH was significantly higher in patients with mandibular deviation higher than 6 mm compared with <6 mm (odds ratio (OR): 3.51, confidence interval (CI) 95%: 1.27-9.72). CONCLUSION: There is a significant correlation between the magnitude of mandibular deviation quantified on CT and metabolic findings obtained by SPECT in patients with UCH. The risk of active UCH is 3.5 times higher in patients with a mandibular deviation ≥6 mm.

RESUMEN

OBJECTIVE: Temporomandibular disorder (TMD) is a multifactorial condition and the most common cause of orofacial pain, affecting mostly women, which points to a female hormone predilection. Therefore, the aim of this study was to analyze the association between TMD and estrogen receptor alpha 1 expression in disks of patients with TMD and condyle fracture (CFx). STUDY DESIGN: Forty specimens (from 27 patients) included n = 8 CFx, n = 21 anterior disk displacement with reduction (ADDwR), and n = 11 anterior disk displacement without reduction (ADDwoR). Age, area, and intensity of immunostaining were statistically compared between CFx, ADDwR, and ADDwoR groups using analysis of variance and Kruskal-Wallis analysis (P < .05). RESULTS: No significant difference between CFx, ADDwR, and ADDwoR groups with respect to age and expression of estrogen receptor alpha 1 was observed on immunohistochemical examination. CONCLUSION: No association of estrogen receptor alpha 1 expression and age was found in the CFx, ADDwR, and ADDwoR groups.

Asunto(s)

Luxaciones Articulares , Trastornos de la Articulación Temporomandibular , Síndrome de la Disfunción de Articulación Temporomandibular , Receptor alfa de Estrógeno , Femenino , Humanos , Imagen por Resonancia Magnética , Proyectos Piloto , Articulación Temporomandibular , Disco de la Articulación Temporomandibular

RESUMEN

ABSTRACT Purpose Herein we evaluated the effects of platelet concentrate (PC) and platelet-poor plasma (PPP) on bone repair using noncritical defects in the calvaria of rabbits and compared them to the presence of TGF-β1 and osteocalcin on reparative sites. Methods Five noncritical defects of 8.7 mm in diameter were created on the calvaria of 15 animals. Each defect was treated differently, using autograft (ABG), ABG associated with PC (ABG + PC), ABG with PPP (ABG + PPP), isolated PPP, and blood clot (control). The animals were submitted to euthanasia on the second, fourth and sixth week post-surgery. Results The defects that received ABG+PC or PPP demonstrated lower bone formation when compared to specimens that received ABG in the same period. These results coincided to significant higher immunopositivity for TGF-β1 for specimens that received PC, and lower presence of cytokine in the group PPP. However, either higher or lower presence of TGF-β1 were also correlated to lower presence of osteocalcin. Likewise, these results were similar to findings in specimens treated only with PPP when compared to control. Conclusions PC and PPP were not effective when applied in association with ABG. Similarly, isolated use of PPP was not beneficial in optimizing the bone repair.

Asunto(s)

Animales , Osteogénesis , Factor de Crecimiento Transformador beta1/metabolismo , Conejos , Cráneo/cirugía , Osteocalcina , Autoinjertos

RESUMEN

Osteochondroma manifests as a benign tumor that occurs as an abnormal bony development. This tumor is commonly asymptomatic and presents an exophytic outgrowth on bone surfaces, near synovial joints, a condition that invariably induces evident facial deformities. Treatment for this type of tumor usually involves a surgical approach promoting a total or partial resection of the affected anatomical area associated to prosthetic reconstruction of the bone area extracted. We present a case report about a giant mandibular condyle osteochondroma in a 37-year-old female patient. Her treatment involved a total condylectomy without immediate condylar reconstruction, which would be performed in a posterior surgical approach. During the patient's follow-up (every 6 months of post operation), a spontaneous and rudimentary condyle-like formation was observed. Because the stomatognathic function and facial harmony were satisfactory, we observed the condyle-like development for 5 years of follow-up. Also, because both the aesthetic aspect and functional evolution of the maxillary bone were considered satisfactory, no complementary reconstruction surgical treatment was required for the giant osteochondroma of the mandibular condyle.

RESUMEN

OBJECTIVE: MMP-13 performs digestion of collagen, which is a primary component of the temporomandibular joint (TMJ) articular disc. This study evaluated the expression of MMP-13 in patients with anterior disc displacement with (ADDwR) and without reduction (ADDwoR), and in the presence of TMJ osteoarthrosis. METHODS: Thirty-nine human temporomandibular joint disc samples were collected and divided in two ways: ADDwR (21 samples), ADDwoR (10 samples), and a control group (8 samples); and with osteoarthrosis (10 samples) and without osteoarthrosis (29 samples). Immunostaining of the TMJ discs was statistically compared between the groups. RESULTS: There was no statistically significant difference for the area of MMP-13 immunostaining between the control group, ADDwR, and ADDwoR, nor between groups with and without osteoarthrosis. CONCLUSION: This study suggests MMP-13 is not significantly involved in collagen degradation in human TMJ disc displacement or osteoarthrosis.

Asunto(s)

Metaloproteinasa 13 de la Matriz/metabolismo , Osteoartritis/metabolismo , Trastornos de la Articulación Temporomandibular/metabolismo , Adolescente , Adulto , Progresión de la Enfermedad , Femenino , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Adulto Joven

RESUMEN

The inflammatory process is a coordinated response that protects host after infection or trauma, involving several molecular reactions. Once the inflammation is closely linked to the process of destruction of the temporomandibular joint, this study aims to examine, by immunohistochemistry, the expression of interleukin-6 (IL-6), an important inflammatory marker, in temporomandibular articular discs of patients with anterior disc displacement with (ADDwR) and without reduction (ADDwoR) and its association with osteoarthrosis (OA). Thirty-eight (n = 38) articular discs were divided into two cutoffs: 1) analysis 1: 4 control (acute pathology), 17 ADDwR, 17 ADDwoR; and 2) analysis 2: without OA (n = 21) and with OA (n = 17). The area of immunostaining was compared statistically between groups (p < 0.05). In the disc samples, no significant differences were observed between the groups ADDwR and ADDwoR, and with and without OA, in respect to the expression of IL-6 by immunohistochemical examination. Future studies should be conducted with a larger sample size, which could clarify the association of the inflammatory mediator IL-6 with temporomandibular joint dysfunction.

Asunto(s)

Interleucina-6/metabolismo , Osteoartritis/metabolismo , Disco de la Articulación Temporomandibular/metabolismo , Trastornos de la Articulación Temporomandibular/metabolismo , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Osteoartritis/patología , Osteoartritis/cirugía , Disco de la Articulación Temporomandibular/patología , Disco de la Articulación Temporomandibular/cirugía , Trastornos de la Articulación Temporomandibular/patología , Trastornos de la Articulación Temporomandibular/cirugía , Adulto Joven

RESUMEN

BACKGROUND: Apoptosis is a programme of cell death which does not induce an inflammatory response. Recent previous research has suggested a correlation between temporomandibular internal derangement and apoptosis. Fas ligand (FasL) is an apoptosis-inducing factor, known to trigger apoptosis through distinct signal pathways. This study aims to examine, by immunohistochemistry, the expression of FasL in temporomandibular joint (TMJ) articular discs of patients with anterior disc displacement with reduction (ADDwR) and without reduction (ADDwoR) in patients with and without osteoarthrosis (OA). METHODS: Forty-two (n = 42) TMJ articular discs were divided into two cut-offs: (i) 8 control, 17 ADDwR, 17 ADDwoR, and (ii) without OA (n = 25) and with OA (n = 17). The area of immunostaining was compared statistically between groups (P < 0.05). RESULTS: Statistically significant differences were found in the expression of FasL in TMJ discs between the three groups (P = 0.001). ADDwR presented significant higher FasL expression when compared with ADDwoR (P < 0.001). Significant higher FasL expression was observed in the group without OA (P = 0.001). All patients without OA presented ADDwR, while all the patients with OA presented ADDwoR. CONCLUSION: A higher area of in situ immunostaining of FasL was found in temporomandibular discs with reduction, which is the less severe condition. Moreover, a reduced expression of FasL in the discs of patients with osteoarthrosis was found, suggesting that some aspects of apoptosis might underlie the progression of TMJ disorders.

Asunto(s)

Cartílago Articular/química , Proteína Ligando Fas/análisis , Osteoartritis/metabolismo , Disco de la Articulación Temporomandibular/química , Disco de la Articulación Temporomandibular/patología , Trastornos de la Articulación Temporomandibular/metabolismo , Articulación Temporomandibular/patología , Adolescente , Adulto , Apoptosis/fisiología , Cartílago Articular/patología , Cartílago Articular/cirugía , Membrana Celular/patología , Condrocitos/patología , Colorantes , Progresión de la Enfermedad , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Inmunohistoquímica , Luxaciones Articulares/patología , Masculino , Persona de Mediana Edad , Osteoartritis/patología , Osteoartritis/cirugía , Disco de la Articulación Temporomandibular/cirugía , Trastornos de la Articulación Temporomandibular/patología , Trastornos de la Articulación Temporomandibular/cirugía , Adulto Joven

RESUMEN

Neste estudo avaliou-se o efeito do probiótico, Proenzime®, adicionado à mistura mineral no ganho de peso de bovinos em sistema de pastejo extensivo. Utilizaram-se 40 bovinos, machos inteiros da raça Nelore (Bos indicus) com idade de aproximadamente 12 meses, divididos randomicamente em 2 grupos (20 bovinos/grupo): o grupo controle (GC) recebeu somente mistura mineral e o grupo probiótico (GP) que se adicionou probiótico. Pesaram-se os bezerros nos dias 0 e 30 de 30 a 90 dias e 0 a 90 dias. Os resultados mostraram um aumento significativo no ganho de peso nos animais do GP somente nos primeiros 30 dias.

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This study evaluated the effect of probiotic proenzyme ®, added to the mineral mixture in a weight gain of cattle in extensive grazing system. We used 40 animals, Nelore bulls (Bos indicus) aged approximately 12 months, randomly divided into 2 groups (20 animals / group): control group (CG) received only mineral mixture and probiotic group (GP) with added probiotic. Calves were weighed on days 0 and 30 from 30 to 90 days and 00 to 90 days. The results showed a significant increase in weight gain in animals only GP in the first 30 days.

Asunto(s)

Masculino , Animales , Bovinos , Bovinos/crecimiento & desarrollo , Probióticos/administración & dosificación , Probióticos/efectos adversos

RESUMEN

Neste estudo avaliou-se o efeito do probiótico, Proenzime®, adicionado à mistura mineral no ganho de peso de bovinos em sistema de pastejo extensivo. Utilizaram-se 40 bovinos, machos inteiros da raça Nelore (Bos indicus) com idade de aproximadamente 12 meses, divididos randomicamente em 2 grupos (20 bovinos/grupo): o grupo controle (GC) recebeu somente mistura mineral e o grupo probiótico (GP) que se adicionou probiótico. Pesaram-se os bezerros nos dias 0 e 30 de 30 a 90 dias e 0 a 90 dias. Os resultados mostraram um aumento significativo no ganho de peso nos animais do GP somente nos primeiros 30 dias.(AU)

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This study evaluated the effect of probiotic proenzyme ®, added to the mineral mixture in a weight gain of cattle in extensive grazing system. We used 40 animals, Nelore bulls (Bos indicus) aged approximately 12 months, randomly divided into 2 groups (20 animals / group): control group (CG) received only mineral mixture and probiotic group (GP) with added probiotic. Calves were weighed on days 0 and 30 from 30 to 90 days and 00 to 90 days. The results showed a significant increase in weight gain in animals only GP in the first 30 days.(AU)

Asunto(s)

Animales , Masculino , Bovinos , Bovinos/crecimiento & desarrollo , Probióticos/administración & dosificación , Probióticos/efectos adversos

RESUMEN

This work describes the preparation and characterization of porous 3D-scaffolds based on chitosan (CHI), chitosan/silk fibroin (CHI/SF) and chitosan/silk fibroin/hydroxyapatite (CHI/SF/HA) by freeze drying. The biomaterials were characterized by X-ray diffraction, attenuated total reflection Fourier transform infrared spectroscopy, thermogravimetric analysis, differential scanning calorimetry, scanning electron microscopy and energy dispersive spectroscopy. In addition, studies of porosity, pore size, contact angle and biological response of SaOs-2osteoblastic cells were performed. The CHI scaffolds have a porosity of 94.2±0.9%, which is statistically higher than the one presented by CHI/SF/HA scaffolds, 89.7±2.6%. Although all scaffolds were able to promote adhesion, growth and maintenance of osteogenic differentiation of SaOs-2 cells, the new 3D-scaffold based on CHI/SF/HA showed a significantly higher cell growth at 7 days and 21 days and the level of alkaline phosphatase at 14 and 21 days was statistically superior compared to other tested materials.

Asunto(s)

Materiales Biocompatibles/química , Quitosano/química , Durapatita/química , Fibroínas/química , Materiales Biocompatibles/síntesis química , Materiales Biocompatibles/farmacología , Técnicas de Cultivo de Célula/instrumentación , Técnicas de Cultivo de Célula/métodos , Diferenciación Celular , Línea Celular Tumoral , Supervivencia Celular/efectos de los fármacos , Humanos , Microscopía Electrónica de Rastreo , Osteogénesis , Porosidad , Ingeniería de Tejidos , Andamios del Tejido

RESUMEN

Here we report the structural characterization, physicochemical study and molecular modeling of the inclusion complex of trimethoprim in randomly methylated beta-cyclodextrin. The phase-solubility diagram obtained at pH 7.0 exhibited a linear behavior for the RAMEB concentrations studied suggesting a 1:1 stoichiometry and absence of aggregation in solution. From stoichiometric determination by the continuous variation method we confirmed a 1:1 stoichiometry. To make a detailed characterization of the inclusion mode, spectroscopic measurements by infrared and 1D and 2D (1)H NMR spectroscopy provided evidence that the inclusion mode is characterized by inclusion of the trimethoxyphenyl ring in the cavity; interactions with methyl groups located in the border of the cavity were also detected. The structure proposed was also confirmed by semiempirical molecular modeling.

Asunto(s)

Portadores de Fármacos/química , Trimetoprim/química , beta-Ciclodextrinas/química , Química Farmacéutica , Estabilidad de Medicamentos , Espectroscopía de Resonancia Magnética , Metilación , Modelos Químicos , Solubilidad , Espectroscopía Infrarroja por Transformada de Fourier , Termodinámica , Temperatura de Transición

RESUMEN

Osteomas are benign tumors composed of mature compact or cancellous bone. They represent an uncommon lesion that occurs mainly in craniofacial complex bones. In jaws, they can appear on the bone surface as a polypoid or sessile mass, characterizing a peripheral osteoma (PO), or can be a lesion in the medullar space, then it is called central osteoma. In view of the scarcely reported cases about POs, this article presents a case of PO of the maxillofacial area that was surgically resected using hemicoronal approach.

Asunto(s)

Cóndilo Mandibular/patología , Neoplasias Mandibulares/cirugía , Osteoma/cirugía , Diagnóstico Diferencial , Humanos , Masculino , Neoplasias Mandibulares/diagnóstico por imagen , Neoplasias Mandibulares/patología , Persona de Mediana Edad , Osteoma/diagnóstico por imagen , Osteoma/patología , Tomografía Computarizada por Rayos X

RESUMEN

An inclusion complex between the dihydrofolate reductase inhibitor pyrimethamine (PYR) and alpha-cyclodextrin (alpha-CD) was prepared and characterized. From the phase-solubility diagram, a linear increase of PYR solubility was verified as a function of alpha-CD concentration, suggesting the formation of a soluble complex. A 1:1 host-guest stoichiometry can be proposed according to the Job's plot, obtained from the difference of PYR fluorescence intensity in the presence and absence of alpha-CD. Differential scanning calorimetry (DSC) measurements provided additional evidences of complexation such as the absence of the endothermic peak assigned to the melting of the drug. The inclusion mode characterized by two-dimensional (1)H NMR spectroscopy (ROESY) involves penetration of the p-chlorophenyl ring into the alpha-CD cavity, in agreement to the orientation optimized by molecular modeling methods.

Asunto(s)

Modelos Moleculares , Pirimetamina/química , alfa-Ciclodextrinas/química , Espectroscopía de Resonancia Magnética , Solubilidad , Termodinámica , Difracción de Rayos X

RESUMEN

RACIONAL: Muitas dúvidas ainda permanecem no que se refere às ações dos fatores de crescimento e do plasma rico em plaquetas sobre o mecanismo de reparação tissular. Há necessidade de serem esclarecidos pontos controversos ainda existentes. OBJETIVO: Obter o plasma rico em plaquetas em coelhos através de um método simplificado e ao mesmo tempo adequado, introduzindo um modelo experimental que possa ser utilizado em estudos posteriores. MÉTODOS: Foram utilizados 25 coelhas da raça Nova Zelândia e sem doenças prévias. Quinze mL de sangue de cada animal foi coletado, sendo 10 mL submetidos à dupla centrifugação. Para comprovar a efetividade do método proposto realizou-se contagem mecânica do sangue, bem como do produto final. RESULTADO: Obteve-se uma concentração média de plaquetas no plasma rico em plaquetas 687 por cento maior que a contagem inicial observada no sangue venoso periférico. Para as variáveis: contagem inicial de plaquetas, contagem de plaquetas no plasma rico em plaquetas e enriquecimento, foram obtidos os limites de 95 por cento de confiança para suas médias, sendo que, no que se refere ao percentual de enriquecimento, existe 95 por cento de chance de que o intervalo de (530-844) contenha a média real de enriquecimento de plaquetas. CONCLUSÃO: O método simplificado utilizado permite a obtenção de plasma rico em plaquetas adequado permitindo seu uso em estudos dos fatores de crescimento nos mecanismos de reparação tecidual.

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BACKGROUND: Multiple uncertainties still exist about the action of the growth factors and the platelet-rich plasma on the mechanism of repair. AIM: To obtain the platelet-rich plasma in rabbits through a simplified and suitable method, creating an experimental model. METHODS: Twenty-five female New Zealand rabbits without previous diseases were used. Fifteen mL of blood of each rabbit was collected and 10 mL of the collected blood were twice centrifugated. To check the effectiveness of the proposed method mechanical counting of the blood and of the final product were performed. RESULTS: The mean platelet concentration was 687 percent higher than the initial peripheral blood counting. Mean initial platelet counting, platelet-rich plasma platelet counting and enriched were obtained with 95 percent CI and in terms of enrichment percentage there is a chance that the interval 530 to 844 be the real mean platelet enrichment. CONCLUSION: This simplified method permits to get an effective platelet-rich plasma to be used in trials about growth factors in mechanisms of tissue repair.

RESUMEN

A sialolitíase é uma doença das glândulas salivares, caracterizada pela formação de cálculos ou sialolitos no interior dos ductos ou do próprio parênquima glandular. A maioria dos sialolitos tem tamanho pequeno e geralmente são menores que um centímetro. Cálculos com tamanho maior que três centímetros são extremamente raros. Este trabalho apresenta um caso de cálculo gigante localizado no parênquima/hilo da glândula submandibular e que apresentava como particularidade fístula cutânea localizada na região submandibular

Asunto(s)

Fístula Cutánea , Glándulas Salivales/patología , Cálculos de las Glándulas Salivales

RESUMEN

In this work we prepared and characterized an inclusion complex of the dihydropteroate synthase inhibitor sulfadiazine (SDZ) in 2-hydroxypropyl-beta-cyclodextrin (HPBCD). From the phase-solubility diagram we observed an increase in the water solubility of the drug, calculating a binding constant of 1879M(-1). The inclusion mode involves a NH(2)-in orientation of the drug in the HPBCD cavity, according to the 2D NMR (ROESY) data and confirmed by molecular modeling using the semiempirical PM6 and RM1 methods.

Asunto(s)

Inhibidores Enzimáticos/síntesis química , Sulfadiazina/química , beta-Ciclodextrinas/química , 2-Hidroxipropil-beta-Ciclodextrina , Fenómenos Químicos , Química Física , Dihidropteroato Sintasa/antagonistas & inhibidores , Portadores de Fármacos/química , Inhibidores Enzimáticos/química , Inhibidores Enzimáticos/farmacología , Espectroscopía de Resonancia Magnética/métodos , Modelos Moleculares , Estructura Molecular , Transición de Fase , Solubilidad , Relación Estructura-Actividad , Temperatura , Agua/química , Difracción de Rayos X

RESUMEN

OBJECTIVE: The aim of this study was to analyze histologic and histomorphometric features of the articular disc in groups with and without disc displacement. STUDY DESIGN: A sample of 39 temporomandibular joints TMJs (31 case specimens, 8 control specimens) from 28 patients (mean age 31.2 years) were recruited for this study. The patients were considered to be affected and treated surgically with disc repositioning when presenting painful clinical signs of disc displacement after unsuccessful nonsurgical treatment for at least 6 months. Of the control patients, 4 presented condyle fracture which required opening to be reduced for treatment, and 4 displayed active condyle hyperplasia. The posterior region of the disc was removed and sent for histologic and histomorphometric analysis. Histologic (hematoxylin-eosin) and histomorphometric (picro-Sirius red) analyses were performed. Statistically significant differences between the analyzed groups were accessed through the chi-squared test (P

Asunto(s)

Luxaciones Articulares/patología , Disco de la Articulación Temporomandibular/patología , Trastornos de la Articulación Temporomandibular/patología , Adolescente , Adulto , Métodos Epidemiológicos , Femenino , Colágenos Fibrilares/análisis , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Luxaciones Articulares/diagnóstico por imagen , Luxaciones Articulares/cirugía , Masculino , Cóndilo Mandibular/lesiones , Fracturas Mandibulares/complicaciones , Persona de Mediana Edad , Radiografía , Articulación Temporomandibular/diagnóstico por imagen , Articulación Temporomandibular/patología , Articulación Temporomandibular/cirugía , Disco de la Articulación Temporomandibular/diagnóstico por imagen , Disco de la Articulación Temporomandibular/cirugía , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/cirugía

RESUMEN

PURPOSE: The Vitrea 2 imaging software (Vital Images Inc, Minnetonka, MN) was used for the volume analysis of the proximal tibial metaphysis. MATERIALS AND METHODS: Eighteen computed tomography scans of the proximal tibia were processed through the software, and 3-dimensional imaging of the proximal tibia was reconstructed. RESULTS: The volume and area of the proximal tibia that were generated resulted in a mean area of 127 cm(2) and a mean volume of 77.2 cm(2). CONCLUSION: This study supports the use of the proximal tibial metaphysis as a source of low to moderate volume of autologous bone. When compared with the accepted average volume of 25 cm(2), the computed results showed that there could be up to 3 times the amount of bone available in the proximal tibial metaphysis. The reported volume of bone harvested from previous studies was based on need and not the total amount available; subsequently, the results showed the possibility of a larger resource of bone, which provides the surgeon with the volumetrical limits of the proximal tibia metaphysis.

Asunto(s)

Trasplante Óseo/métodos , Programas Informáticos , Tibia/trasplante , Recolección de Tejidos y Órganos/métodos , Adulto , Anciano , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador/instrumentación , Procesamiento de Imagen Asistido por Computador/métodos , Masculino , Persona de Mediana Edad , Factores Sexuales , Tibia/anatomía & histología , Tomografía Computarizada por Rayos X

RESUMEN

O trabalho apresenta uma breve revisão da literatura a respeito das formas de tratamento empregadas na reconstrução dos defeitos ósseos verticais a nível alveolar, e descreve um caso clínico de trauma facial, com perda óssea em região anterior de mandíbula. O paciente foi tratado em dois estágios na reconstrução mandibular: 1) reconstrução da parte basilar da mandíbula com o emprego de enxerto autógeno de crista do ilíaco e placa de reconstrução em titânio; 2) reconstrução da parte alveolar após 12 meses, também com o emprego de enxerto de ilíaco, com o mesmo sendo coberto com retalho labial, de acordo com o protocolo seguido pelos autores. Após seis meses observou-se uma perfeita integração do enxerto, com grau mínimo de reabsorção, permitindo a instalação de três implantes de 18mm de comprimento. Seis meses após a instalação dos implantes iniciou-se a fase de reabilitação protética, observando-se a manutenção da altura óssea alveolar. Conclui que o emprego de enxerto ósseo autógeno pode ser uma alternativa válida em casos de reconstruções extensas à nível basilar e alveolar.

Asunto(s)

Humanos , Masculino , Adulto , Trasplante Óseo , Fracturas Mandibulares/cirugía , Traumatismos Faciales/cirugía