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Master's Dissertation
DOI
https://doi.org/10.11606/D.25.2022.tde-18112022-182855
Document
Author
Full name
Ana Carolina Cestari Bighetti
Institute/School/College
Knowledge Area
Date of Defense
Published
Bauru, 2022
Supervisor
Committee
Assis, Gerson Francisco de (President)
Garlet, Ana Paula Favaro Trombone
Gennaro, Gabriela
Oliveira, Rodrigo Cardoso de
Title in English
Preclinical evaluation of the potential of fibrin biopolymer alveolar preservation after tooth extraction. Microtomographic, histomorphometric and immunohistochemical evaluation
Keywords in English
Bone resorption
Fibrin tissue adhesive
Tooth extraction
Tooth socket
X-Ray microtomography
Abstract in English
Tooth extraction results in significant ridge resorption, leading to alveolar bone and soft tissue changes that can compromise esthetics and complicate functional rehabilitation. The heterologous fibrin biopolymer (HFB) is a low-cost national biopharmaceutical resulting from the combination of a serine protease extracted from the venom of Crotalus durissus terrificus and a cryoprecipitate rich in fibrinogen obtained from the blood of Bubalus bubalis. Has hemostatic, adhesive, sealant and scaffolding properties. In clinical trials I/II it was shown to be safe, non-immunogenic and effective in the treatment of chronic venous ulcers. The objective of the current study was to evaluate the use of HFB in the alveolar healing process after tooth extraction. The right upper incisor of 48 rats (Rattus norvegicus, Wistar) were extracted and filled by blood clot group CS (BCG, n=24) and HFB (HFBG, n=24). After 0, 7, 14 and 42 days (n=6 per group/experimental period) the pieces with the alveoli were submitted to volumetric analysis of the microtomographic images, histomorphometric of the sections stained with hematoxylin and eosin, of the bone collagen fibers by the picrocirius method. red/quantitative polarized light of macrophages and osteoclasts in sections immunostained by tartrate-resistant acid phosphatase (TRAP). Data were submitted to ANOVA/Tukey(HSD) and Student's t test for comparison between periods and groups, respectively, with significance p<0.5%. In the microtomographic evaluations, the total volume of the alveolus (TV) was similar between 0 and 14 days (p>0.05; mean of 64±5.4 mm3) except in the BCG at 14 days, which was 12% lower (57±3.2 mm3). At 42 days, TV reduced an average of 15.7±8.14% (11% in the cervical third, 16% in the medial and 20% in the apical third) in the HFBG, while in the BCG the reduction was on average 29±6.67% (18% cervical, 29% medial and 40% apical). In this period, bone volume (BV) was higher in HFBG (46±5.4mm3) compared to BCG (37±5.8mm3). However, a higher bone density was observed in the BCG group and with an organic matrix composed of thicker collagen fibers than in the HFBG group. Histologically, at 14 days, greater vascularization and osteoclastic activity was observed in the BCG group than in the HFBG, associated with greater resorption of alveolar bone walls. Preclinical results showed that HFBG modulates local vascularization and reduces bone resorption/remodeling leading to greater preservation of the alveolar ridge after tooth extraction.
Title in Portuguese
Avaliação pré-clínica do potencial do biopolímero de fibrina na preservação alveolar após extração dentária. Avaliação microtomográfica, histomorfométrica e imunohistoquímica
Keywords in Portuguese
Adesivo tecidual de fibrina
Alvéolo dental
Extração dentária
Microtomografia por raio-X
Reabsorção óssea
Abstract in Portuguese
A extração dentária resulta em reabsorção significativa do rebordo, levando a alterações ósseas alveolares e de tecidos moles que podem comprometer a estética e complicar a reabilitação funcional. O biopolímero heterologo de fibrina (BHF) é um biofármaco nacional de baixo custo resultante da combinação de uma serinoprotease extraída do veneno de Crotalus durissus terrificus e de um crioprecipitado rico em fibrinogênio obtido do sangue de búfalos Bubalus bubalis. BHF apresenta propriedades hemostática, adesiva, selante e serve de arcabouço. Nos ensaios clínicos I/II mostrou-se seguro, não imunogênico e eficaz no tratamento de úlceras venosas crônicas. O objetivo do atual trabalho foi avaliar o uso da BHF no processo de cicatrização alveolar pós-extração dentária. O incisivo superior direito de 48 ratos (Rattus norvegicus, Wistar) foram extraídos e preenchidos pelo coágulo sanguíneo (GCS, n=24) e BHF (GBHF, n=24). Após, 0, 7, 14 e 30 dias (n=6 por grupo/período experimental) as peças com os alvéolos foram submetidas à análise volumétrica das imagens microtomográfica, histomorfométrica dos cortes corados pela hematoxilina e eosina, das fibras colágenas ósseas pelo método picrocirius red/luz polarizada e quantitativa de macrófagos e osteoclastos em cortes imunomarcados pela fosfatase ácida resistente ao tartarato (TRAP). Os dados foram submetidos a ANOVA/Tukey(HSD) e teste t de student para comparação entre períodos e grupos, respectivamente, com p<0,5%. Nas avaliações microtomográficas, o volume total do alvéolo (TV) foi similar entre 0 e 14 dias (p>0,05; média de 64±5,4 mm3) exceto no GCS aos 14 dias que foi 12% menor (57±3,2 mm3). Aos 42 dias, o TV reduziu em média 15,7±8,14% (11% no terço cervical, 16% na medial e 20% na apical) no GBHF, enquanto que no GCS a redução foi em média de 29±6,67% (18% na cervical, 29% na medial e 40% na apical). Neste período, o volume ósseo (BV) foi maior no GBHF (46±5,4mm3) comparado ao GCS (37±5,8mm3). Porém, uma maior densidade óssea foi observada no grupo GCS e com uma matriz organica composta por fibras colágenas mais espessas que no grupo GBHF. Histologicamente, aos 14 dias, maior vascularização e atividade osteoclástica foi observado no grupo GCS que no GBHF, associado a grande reabsorção das paredes ósseas alveolares. Os resultados pré-clínicos mostraram que o BHF modula a vascularização local e reduz a reabsorção/remodelação óssea levando a maior preservação do rebordo alveolar pós extração dentaria.
 
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Release Date
2024-10-26
Publishing Date
2022-11-21
 
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