4. Chester (1991): São materiais destinados a estar em contacto com os tecidos vivos e/ou fluidos biológicos para avaliar, tratar, e modificar as formas ou substituir todo um tecido, orgão ou função do corpo.
6. Biomateriais Para que são usados? Para a regeneração de um tecidolesadoouemfalta e com fimestético e/oufuncional Se o tecido a regenerar é osso o tratamento é definidocomoregeneraçãoósseaguiada (ROG) . Se for necessárioregenerar, paraalém de osso, a estutura de suporte periodontal (osso, cemento e ligamento periodontal) então define-se comoregeneraçãotecidualguiada (RTG)
7. Biomateriais Definição do biomaterial ideal O biomaterial idealdevecumprir as seguintesfunções: preencher o espaço do defeitoósseo criar o “ambiente” favorávelpara a regeneraçãoóssea(biocompatível) estimular a regeneraçãoóssea(substrato) Reabsorverem tempo semelhanteao tempo necessáriopara a neo formaçãoósseafisiológica(tipo de material , granulometria e processoproductivo) Manter o volume original do enxerto 100% 80% 60% 40% 20% 0% 1° mês 2° mês 3° mês 4° mês enxerto
11. Colagéneo: o substrato ideal Afinidade natural pelas BMPs Protege BMPs de proteólisenãoespecifica Previne a difusãoprematura das BMPs É completamentereabsorvido É substituidopor novo tecidoósseoformado Excelentesubstratopara o recrutamento, ancoragem e diferenciação de célulasprogenitoras de osso
12. Bibliografia sobre colagéneo Bruce E, Steven P, Louis M. Use of microcristalline collagen for hemostasis after oral surgery in a hemophylic. J Oral Surg 1979 37(2): 126-128 Capuano A, Bargelli F, Fadda GM, Parrini S. Collagene eterologo in chirurgia odontostomatologica. Il dentista moderno. Dicembre 2002 Centrella M, McCarthy TL, Canalis E. Trasforming growth factor beta is a bifunctional regular of replication and collagen synthesis in osteoblast-enriched cell cultures from fetal rat bone. J Biol Chem, 1987; 262: 2869-2874 Charulatha V, Rajaram A. Influence of different crosslinking treatments on the physical properties of collagen membranes. Biomater, 2003; 24: 759-767 Hsu FY, Chueh SC, Wang YJ. Microspheres of hydroxyapatite/reconstituted collagen as supports for osteoblast cell growth. Biomater, 1999; 20: 1931-1936 Kadler KE, Holmes DF, Trotter JA, Chapman JA. Collagen fibril formation. Biochem J, 1996; 316: 1-11 Liu LS, Thomson AY, Heidaran MA, et al. An osteoconductive collagen/hyaluronate matrix for bone regeneration. Biomater, 1999; 12: 1097-1108 Lucas PA, Syftestad GT, Goldberg VM, Caplan AI. Ectopic induction of cartilage and bone by water soluble proteins from bovine bone using a collagenous delivery vehicle. J Biomed Mater Res, 1989; 23(A1): 23-29 Meyer U et al. Microstructural investigations of strain-related collagen mineralization. British J Oral Maxillofacial Surgery, 2001; 39: 381-389 Patino MG, Neiders ME, Andreana S, Noble B, Cohen RE. Collagen as an implantable material in medicine and dentistry. J Oral Implantology, 2002; 28(5): 220-225 Stein MD, Salkin LM, Freedman AL, Glushko V. Collagen sponge as a topical hemostatic agent in mucogingival surgery. J Periodontol 1985; 56: 35-38 Salasznyk RM, Williams WA, Boskey A, Batorsky A,, Plopper GE. Adhesion to vitronectin and collagen I promotes osteogenic differentiation of human mesenchymal stem cells. Journal of Biomedicine and Biotechnology, 2004; 1: 24-34 Wallace DG, Rhee W, et al. Injectable cross-linked collagen with imporved flow properties. J Biomed Mater Res, 1989; 23: 931-945 Werkmeister JA, Tebb TA, White JF, Ramshaw JAM. Collagenous tissue formation in association with medical implants. Current Opinion in Solid State and Materials Science, 2001; 5: 185-191
13. Int J Oral Maxillofac Implants. 2004 Mar-Apr;19(2):199-207 Histomorphometric analysis of natural bone mineral for maxillary sinus augmentation. John HD, Wenz B. PURPOSE: Lack of bone height in the posterior maxilla often necessitates augmentation prior to or simultaneously with dental implant placement. The purpose of this clinical study was to evaluate the use of the natural bone mineral Bio-Oss alone or in combination with autogenous bone in sinus floor elevations performed as 1- or 2-step procedures. MATERIALS AND METHODS: Thirty-eight patients required sinus augmentation. Natural bone mineral alone was used in sinus floor augmentation in 21 patients. In 13 patients, a mixture of the bone substitute and autogenous bone was used, and in 4 patients autogenous bone alone was used. In all of the patients, samples were taken for biopsy 3 to 8 months postoperatively, and bone regeneration was evaluated histologically and histomorphometrically. RESULTS: In all patients, the amount of new bone significantly increased over the observation time, while marrow areas decreased. There was no statistically significant difference in the amount of new bone formation between the Bio-Oss group (new bone 29.52% +/- 7.43%) and the Bio-Oss/autogenous bone group (new bone 32.23% +/- 6.86%). In the 4 patients treated with autogenous bone alone, a greater amount of newly formed bone was found; however, in these cases the area volume filled was smaller than in the other 2 groups. DISCUSSION: The data showed that new bone formation takes place up to 8 months after sinus floor elevation and that there is no difference in the amount of bone formation between procedures done with the bone substitute alone or with the mixture of the substitute and autogenous bone. CONCLUSION: These data suggest that predictable bone formation can be achieved with the use of Bio-Oss.
19. Regeneração Periodontal Rx peri-apical: defeitoprofundonaraizmesial do 3.6 Imagem per op: Defeito infra ósseo Cortesia Drs. Giuseppe Corrente e Roberto Abundo
72. IMPLANTES ZIGOMÁTICOS INDICAÇÕES Maxilar Edéntulo com Grande Reabsorção óssea Pneumatização do Seio Maxilar Status Pós-Maxilectomia Fenda Lábio-Palatina