Daniela B Palioto

Publications of Daniela B Palioto

• Acellular dermal matrix graft with or without enamel matrix derivative for root coverage in smokers: a randomized clinical study.

  Authors: Luciana B Alves, Priscila P Costa, Sérgio Luís Scombatti de Souza, Márcio F de Moraes Grisi, Daniela B Palioto, Mario Taba, Arthur B Novaes

  Journal of clinical periodontology. 04/2012; 39(4):393-9.

  The aim of this randomized controlled clinical study was to compare the use of an acellular dermal matrix graft (ADMG) with or without the enamel matrix derivative (EMD) in smokers to evaluate whichThe aim of this randomized controlled clinical study was to compare the use of an acellular dermal matrix graft (ADMG) with or without the enamel matrix derivative (EMD) in smokers to evaluate which procedure would provide better root coverage. Nineteen smokers with bilateral Miller Class I or II gingival recessions ≥3 mm were selected. The test group was treated with an association of ADMG and EMD, and the control group with ADMG alone. Probing depth, relative clinical attachment level, gingival recession height, gingival recession width, keratinized tissue width and keratinized tissue thickness were evaluated before the surgeries and after 6 months. Wilcoxon test was used for the statistical analysis at significance level of 5%. No significant differences were found between groups in all parameters at baseline. The mean gain recession height between baseline and 6 months and the complete root coverage favored the test group (p = 0.042, p = 0.019 respectively). Smoking may negatively affect the results achieved through periodontal plastic procedures; however, the association of ADMG and EMD is beneficial in the root coverage of gingival recessions in smokers, 6 months after the surgery.

• Treatment of gingival recessions in heavy smokers using two surgical techniques: a controlled clinical trial.

  Authors: Danilo M Reino, Arthur B Novaes, Luciana P Maia, Daniela B Palioto, Márcio F M Grisi, Mário Taba, Sérgio L S Souza

  Brazilian dental journal. 01/2012; 23(1):59-67.

  Smokers have small root coverage which is associated with bad vascularity of periodontal tissues. This study evaluated a technique that can increase the blood supply to the periodontal tissuesSmokers have small root coverage which is associated with bad vascularity of periodontal tissues. This study evaluated a technique that can increase the blood supply to the periodontal tissues compared with a traditional technique. Twenty heavy smokers (10 males and 10 females) with two bilateral Miller class I gingival recessions received coronally positioned flaps in one side (Control group)and extended flap technique in the other side (Test group). Clinical measurements (probing pocket depth, clinical attachment level, bleeding on probing, gingival recession height, gingival recession width, amount of keratinized tissue, and width and height of the papillae adjacent to the recession) were determined at baseline, 3 and 6 months postoperatively. Salivary cotinina samples were taken as an indicator of the nicotine exposure level. No statistically significant differences (p>0.05) were detected for the clinical measurements or smoke exposure. Both techniques promoted low root coverage (Control group: 43.18% and Test group: 44.52%). In conclusion, no difference was found in root coverage between the techniques. Root coverage is possible and uneventful even, if rather low, in heavy smoker patients with low plaque and bleeding indices.

• Effects of enamel matrix derivative and transforming growth factor-β1 on human osteoblastic cells.

  Authors: Daniela B Palioto, Thaisângela L Rodrigues, Julie T Marchesan, Márcio M Beloti, Paulo T de Oliveira, Adalberto L Rosa

  Head & face medicine. 07/2011; 7:13.

  Extracellular matrix proteins are key factors that influence the regenerative capacity of tissues. The objective of the present study was to evaluate the effects of enamel matrix derivative (EMD),Extracellular matrix proteins are key factors that influence the regenerative capacity of tissues. The objective of the present study was to evaluate the effects of enamel matrix derivative (EMD), TGF-β1, and the combination of both factors (EMD+TGF-β1) on human osteoblastic cell cultures. Cells were obtained from alveolar bone of three adult patients using enzymatic digestion. Effects of EMD, TGF-β1, or a combination of both were analyzed on cell proliferation, bone sialoprotein (BSP), osteopontin (OPN) and alkaline phosphatase (ALP) immunodetection, total protein synthesis, ALP activity and bone-like nodule formation. All treatments significantly increased cell proliferation compared to the control group at 24 h and 4 days. At day 7, EMD group showed higher cell proliferation compared to TGF-β1, EMD + TGF-β1 and the control group. OPN was detected in the majority of the cells for all groups, whereas fluorescence intensities for ALP labeling were greater in the control than in treated groups; BSP was not detected in all groups. All treatments decreased ALP levels at 7 and 14 days and bone-like nodule formation at 21 days compared to the control group. The exposure of human osteoblastic cells to EMD, TGF-β1 and the combination of factors in vitro supports the development of a less differentiated phenotype, with enhanced proliferative activity and total cell number, and reduced ALP activity levels and matrix mineralization.

• In vitro evaluation of acellular dermal matrix as a three-dimensional scaffold for gingival fibroblasts seeding.

  Authors: Luciana P Maia, Arthur B Novaes, Sérgio L S Souza, Márcio F M Grisi, Mário Taba, Daniela B Palioto

  Journal of periodontology. 02/2011; 82(2):293-301.

  Tissue engineering principles could improve the incorporation of acellular dermal matrix (ADM). The aim of this study is to verify if ADM is a suitable three-dimensional matrix for gingivalTissue engineering principles could improve the incorporation of acellular dermal matrix (ADM). The aim of this study is to verify if ADM is a suitable three-dimensional matrix for gingival fibroblasts and cancerous cells ingrowth, and also if cultured medium conditioned in ADM affect cellular behavior. Canine gingival fibroblasts (CGF), human gingival fibroblasts (HGF), and murine melanoma cell line (B16F10) were seeded on ADM for up to 14 days. The following parameters were assessed: morphology and distribution of CGF, HGF, and B16F10; CGF and HGF viability; and the effect of ADM conditioned medium (CM) on CGF viability. Epifluorescence revealed that CGF were unevenly distributed on the ADM surface, showing no increase in cell number over the periods of study; HGF formed a monolayer on the ADM surface in a higher number at 14 days (P <0.05); B16F10 exhibited an increase in cell number within 7 days (P <0.05), and were mainly arranged in cell aggregates on the ADM, forming a continuous layer at 14 days. A higher percentage of cells on the ADM surface (P <0.05) compared to inside was observed for all cell types. 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide (MTT) values indicated higher cell viability in samples cultured with HGF compared to CGF (P = 0.024). A significantly lower cell viability for CGF grown in CM compared to cells grown in non-CM was observed at 48 and 72 hours (P <0.05). ADM is not suitable as a three-dimensional matrix for gingival fibroblasts ingrowth. Gingival fibroblasts and highly proliferative cells as B16F10 can only be superficially located on ADM, and CGF are negatively affected by culture medium conditioned in ADM, reducing its viability.

• The effect of a single episode of antimicrobial photodynamic therapy in the treatment of experimental periodontitis. Microbiological profile and cytokine pattern in the dog mandible.

  Authors: Rafael Ramos de Oliveira, Arthur Belém Novaes, Gustavo P Garlet, Raphael F de Souza, Mário Taba, Sandra Sato, Sérgio L S de Souza, Daniela B Palioto, Márcio F M Grisi, Magda Feres

  Lasers in medical science. 11/2010; 26(3):359-67.

  The purpose of this study was to evaluate the effect of a single application of antimicrobial photodynamic therapy (aPDT) on microbiological profile and cytokine pattern in dogs. Periodontal diseaseThe purpose of this study was to evaluate the effect of a single application of antimicrobial photodynamic therapy (aPDT) on microbiological profile and cytokine pattern in dogs. Periodontal disease was induced by placing 3.0 silk ligatures around the mandibular pre-molars bilaterally during 8 weeks. The dogs were randomly treated with aPDT using a dye/laser system, scaling and root planning (SRP), or with the association of treatments (SRP + aPDT). Plaque samples were collected at baseline, 1, 3, and 4 weeks, and the mean counts of 40 species were determined using DNA-DNA hybridization. Gingival biopsies were removed and the expression of tumor necrosis factor alpha (TNF-α), receptor activator of NF-kB ligand (RANKL), osteoprotegerin (OPG), matrix metalloproteinase (MMP-1), interleukin (IL) 6, IL-10 and total bacterial load by analysis of 16 S rRNA gene were evaluated through real-time PCR. The results shows that the levels of the majority of the species were reduced 1 week post-therapy for all treatments, however, an increase in counts of Prevotella intermedia (p = 0.00), Prevotella. nigrescens (p = 0.00) and Tannerella forsythia (p = 0.00) was observed for aPDT and SRP + aPDT. After 4 weeks, a regrowth of Porphyromonas gingivalis (p = 0.00) and Treponema denticola (p = 0.00), was observed for all treatments. Also, a strikingly reduction of counts on counts of Aggregatibacter actinomycetemcomitans was observed for the aPDT (p = 0.00). For the cytokine pattern, the results were similar for all treatments, and a reduction in the expression of cytokines and bacterial load was observed throughout the study. Our results suggest that SRP, aPDT in a single application, and SRP + aPDT affects different bacterial species and have similar effects on the expression of cytokines evaluated during the treatment of ligature-induced periodontitis.

• Comparison between micro- and macrosurgical techniques for the treatment of localized gingival recessions using coronally positioned flaps and enamel matrix derivative.

  Authors: Patrícia F Andrade, Márcio F M Grisi, Andrea M Marcaccini, Patrícia G Fernandes, Danilo M Reino, Sérgio L S Souza, Mário Taba, Daniela B Palioto, Arthur B Novaes

  Journal of periodontology. 11/2010; 81(11):1572-9.

  The aim of this study is to compare the macro- and microsurgery techniques for root coverage using a coronally positioned flap (CPF) associated with enamel matrix derivative (EMD). Thirty patientsThe aim of this study is to compare the macro- and microsurgery techniques for root coverage using a coronally positioned flap (CPF) associated with enamel matrix derivative (EMD). Thirty patients were selected for the treatment of localized gingival recessions (GRs) using CPF associated to EMD. Fifteen patients were randomly assigned to the test group (TG), and 15 patients were randomly assigned to the control group (CG). The microsurgical approach was performed in the TG, and the conventional macrosurgical technique was performed in the CG. The clinical parameters evaluated before surgery and after 6 months were GR, probing depth, relative clinical attachment level, width of keratinized tissue (WKT), and thickness of keratinized tissue (TKT). The discomfort evaluation was performed 1 week postoperative. There were no statistically significant differences between groups for all parameters at baseline. At 6 months, there was no statistically significant difference between the techniques in achieving root coverage. The percentage of root coverage was 92% and 83% for TG and CG, respectively. After 6 months, there was a statistically significant increase of WKT and TKT in TG only. Both procedures were well tolerated by all patients. The macro- and microsurgery techniques provided a statistically significant reduction in GR height. After 6 months, there was no statistically significant difference between the techniques regarding root coverage, and the microsurgical technique demonstrated a statistically significant increase in WKT and TKT.

• The bone formation capabilities of the anorganic bone matrix-synthetic cell-binding peptide 15 grafts in an animal periodontal model: a histologic and histomorphometric study in dogs.

  Authors: Flávia A Suaid, Guilherme O Macedo, Arthur B Novaes, Germana J Borges, Sérgio L S Souza, Mário Taba, Daniela B Palioto, Márcio F M Grisi

  Journal of periodontology. 04/2010; 81(4):594-603.

  The aim of this study is to verify the regenerative potential of particulate anorganic bone matrix-synthetic peptide-15 (ABM-P-15) in class III furcation defects associated or not with expandedThe aim of this study is to verify the regenerative potential of particulate anorganic bone matrix-synthetic peptide-15 (ABM-P-15) in class III furcation defects associated or not with expanded polytetrafluoroethylene membranes. Class III furcation defects were produced in the mandibular premolars (P2, P3, and P4) of six dogs and filled with impression material. The membranes and the bone grafts were inserted into P3 and P4, which were randomized to form the test and control groups, respectively; P2 was the negative control group. The animals were sacrificed 3 months post-treatment. Histologically, the complete closure of class III furcation defects was not observed in any of the groups. Partial periodontal regeneration with similar morphologic characteristics among the groups was observed, however, through the formation of new cementum, periodontal ligament, and bone above the notch. Histologic analysis showed granules from the bone graft surrounded by immature bone matrix and encircled by newly formed tissue in the test group. The new bone formation area found in the negative control group was 2.28 + or - 2.49 mm(2) and in the test group it was 6.52 + or - 5.69 mm(2), which showed statistically significant differences for these groups considering this parameter (Friedman test P <0.05). There was no statistically significant difference among the negative control, control, and test groups for the other parameters. The regenerative potential of ABM-P-15 was demonstrated through new bone formation circumscribing and above the graft particles. The new bone also was accompanied by the formation of new cementum and periodontal ligament fibers.

• Salivary interleukin-6, matrix metalloproteinase-8, and osteoprotegerin in patients with periodontitis and diabetes.

  Authors: Priscila P Costa, Glauce L Trevisan, Guilherme O Macedo, Daniela B Palioto, Sergio L S Souza, Marcio F M Grisi, Arthur B Novaes, Mario Taba

  Journal of periodontology. 03/2010; 81(3):384-91.

  Diabetes and periodontitis produce a protein discharge that can be reflected in saliva. This study evaluates the salivary concentrations of interleukin (IL)-6, matrix metalloproteinase (MMP)-8, andDiabetes and periodontitis produce a protein discharge that can be reflected in saliva. This study evaluates the salivary concentrations of interleukin (IL)-6, matrix metalloproteinase (MMP)-8, and osteoprotegerin (OPG) in patients with periodontitis with type 2 diabetes. Whole saliva samples were obtained from 90 subjects who were divided into four groups: healthy (control; n = 22), untreated periodontitis (UPD; n = 24), diabetes mellitus (DM; n = 20), and UPD + DM (n = 24) groups. Clinical and metabolic data were recorded. Salivary IL-6, MMP-8, and OPG concentrations were determined by a standard enzyme-linked immunosorbent assay. The UPD and UPD + DM groups exhibited higher salivary IL-6 than the control and DM groups (P <0.01). The salivary MMP-8 concentrations in all diseased groups (UPD, DM, and UPD + DM) were higher than in the control group (P <0.01). The salivary OPG concentrations in the DM group were higher than in the UPD and control groups (P <0.05). In the UPD + DM group, salivary IL-6 was correlated with glycated hemoglobin (HbA1c) levels (r = 0.60; P <0.05). The regression analysis indicated that the number of remaining teeth, clinical attachment level, and IL-6 might have influenced the HbA1c levels in patients with diabetes. Salivary IL-6 concentrations were elevated in patients with periodontitis with or without diabetes. Salivary MMP-8 and OPG concentrations were elevated regardless of periodontal inflammation in patients with diabetes. Therefore, periodontitis and diabetes are conditions that may interfere with protein expression and should be considered when using saliva for diagnoses.

• Circulating matrix metalloproteinase-8 (MMP-8) and MMP-9 are increased in chronic periodontal disease and decrease after non-surgical periodontal therapy.

  Authors: Andrea M Marcaccini, Arthur B Novaes, Cesar A Meschiari, Sergio L Souza, Daniela B Palioto, Carlos A Sorgi, Lucia H Faccioli, Jose E Tanus-Santos, Raquel F Gerlach

  Clinica chimica acta; international journal of clinical chemistry. 09/2009;

  BACKGROUND: Periodontal disease shares risk factors with cardiovascular diseases and other systemic inflammatory diseases. The present study was designed to assess the circulating matrixBACKGROUND: Periodontal disease shares risk factors with cardiovascular diseases and other systemic inflammatory diseases. The present study was designed to assess the circulating matrix metalloproteinases (MMPs) from chronic periodontal disease patients and, subsequently, after periodontal therapy. METHODS: We compared the plasma concentrations of MMP-2, MMP-3, MMP-8, MMP-9, tissue inhibitor of metalloproteinase-1 (TIMP-1) and TIMP-2, and total gelatinolytic activity in patients with periodontal disease (n=28) with those of control subjects (n=22) before and 3months after non-surgical periodontal therapy. RESULTS: Higher plasma MMP-3, MMP-8, and MMP-9 concentrations were found in periodontal disease patients compared with healthy controls (all P<0.05), whereas MMP-2, TIMP-1, and TIMP-2 levels were not different. Treatment decreased plasma MMP-8 and MMP-9 concentrations by 35% and 39%, respectively (both P<0.02), while no changes were found in controls. MMP-2, MMP-3, TIMP-1, and TIMP-2 remained unaltered in both groups. Plasma gelatinolytic activity was higher in periodontal disease patients compared with controls (P<0.001) and decreased after periodontal therapy (P<0.05). CONCLUSIONS: This study showed increased circulating MMP-8 and MMP-9 levels and proteolytic activity in periodontal disease patients that decrease after periodontal therapy. The effects of periodontal therapy suggest that it may attenuate inflammatory chronic diseases.

• Potential of bioactive glass particles of different size ranges to affect bone formation in interproximal periodontal defects in dogs.

  Authors: Maria Emília M C Felipe, Patrícia F Andrade, Arthur B Novaes, Márcio F M Grisi, Sérgio L S Souza, Mário Taba, Daniela B Palioto

  Journal of periodontology. 05/2009; 80(5):808-15.

  Background: The aim of this study was to compare the potential of bioactive glass particles of different size ranges to affect bone formation in periodontal defects, using the guided tissueBackground: The aim of this study was to compare the potential of bioactive glass particles of different size ranges to affect bone formation in periodontal defects, using the guided tissue regeneration model in dogs. Methods: In six dogs, 2-wall intrabony periodontal defects were surgically created and chronified on the mesial surfaces of mandibular third premolars and first molars bilaterally. After 1 month, each defect was randomly assigned to treatment with bioabsorbable membrane in association with bioactive glass with particle sizes between 300 and 355 mum (group 1) or between 90 and 710 mum (group 2), membrane alone (group 3), or negative control (group 4). The dogs were sacrificed 12 weeks after surgeries, and histomorphometric measurements were made of the areas of newly formed bone, new mineralized bone, and bioactive glass particle remnants. Results: With regard to the area of bioactive glass particle remnants, there was a statistically significant difference between groups 1 and 2, favoring group 1. There were greater areas of mineralized bone in groups 1 and 2 compared to groups 3 and 4 (P <0.05). Conclusion: The bioactive glass particles of small size range underwent faster resorption and substitution by new bone than the larger particles, and the use of bioactive glass particles favored the formation of mineralized bone.

• Effect of biofunctionalized implant surface on osseointegration: a histomorphometric study in dogs.

  Authors: Raquel R M Barros, Arthur B Novaes, Vula Papalexiou, Sérgio L S Souza, Mário Taba, Daniela B Palioto, Márcio F M Grisi

  Brazilian dental journal. 02/2009; 20(2):91-8.

  Among the different properties that influence bone apposition around implants, the chemical or biochemical composition of implant surface may interfere on its acceptance by the surrounding bone. TheAmong the different properties that influence bone apposition around implants, the chemical or biochemical composition of implant surface may interfere on its acceptance by the surrounding bone. The aim of this study was to investigate if a biofunctionalization of implant surface influences the bone apposition in a dog model and to compare it with other surfaces, such as a microstructured created by the grit-blasting/acid-etching process. Eight young adult male mongrel dogs had the bilateral mandibular premolars extracted and each one received 6 implants after 12 weeks, totaling 48 implants in the experiment. Four groups of implants were formed with the same microrough topography with or without some kind of biofunctionalization treatment. After histomorphometric analysis, it was observed that the modified microstructured surface with a 'low concentration of the bioactive peptide' provided a higher adjacent bone density (54.6%) when compared to the other groups (microstructured + HA coating = 46.0%, microstructured only = 45.3% and microstructured + 'high concentration of the bioactive peptide' = 40.7%), but this difference was not statistically significant. In conclusion, biofunctionalization of the implant surface might interfere in the bone apposition around implants, especially in terms of bone density. Different concentrations of bioactive peptide lead to different results.

• Subepithelial connective tissue graft for root coverage in smokers and non-smokers: a clinical and histologic controlled study in humans.

  Authors: Sérgio L S Souza, Guilherme O Macedo, Roberta S Tunes, Adriana M M Silveira E Souza, Arthur B Novaes, Marcio F M Grisi, Mário Taba, Daniela B Palioto, Vani M A Correa

  Journal of periodontology. 07/2008; 79(6):1014-21.

  BACKGROUND: The aim of this study was to evaluate root coverage of gingival recessions and to compare graft vascularization in smokers and non-smokers. METHODS: Thirty subjects, 15 smokers and 15BACKGROUND: The aim of this study was to evaluate root coverage of gingival recessions and to compare graft vascularization in smokers and non-smokers. METHODS: Thirty subjects, 15 smokers and 15 non-smokers, were selected. Each subject had one Miller Class I or II recession in a non-molar tooth. Clinical measurements of probing depth (PD), relative clinical attachment level (CAL), gingival recession (GR), and width of keratinized tissue (KT) were determined at baseline and 3 and 6 months after surgery. The recessions were treated surgically with a coronally positioned flap associated with a subepithelial connective tissue graft. A small portion of this graft was prepared for immunohistochemistry. Blood vessels were identified and counted by expression of factor VIII-related antigen-stained endothelial cells. RESULTS: Intragroup analysis showed that after 6 months there a was gain in CAL, a decrease in GR, and an increase in KT for both groups (P <0.05), whereas changes in PD were not statistically significant. Smokers had less root coverage than non-smokers (58.02% +/- 19.75% versus 83.35% +/- 18.53%; P <0.05). Furthermore, the smokers had more GR (1.48 +/- 0.79 mm versus 0.52 +/- 0.60 mm) than the non-smokers (P <0.05). Histomorphometry of the donor tissue revealed a blood vessel density of 49.01 +/- 11.91 vessels/200x field for non-smokers and 36.53 +/- 10.23 vessels/200x field for smokers (P <0.05). CONCLUSION: Root coverage with subepithelial connective tissue graft was negatively affected by smoking, which limited and jeopardized treatment results.

• Effects of periodontal therapy on glycemic control and inflammatory markers.

  Authors: Patricia A A O'Connell, Mario Taba, Auro Nomizo, Maria C Foss Freitas, Flavia A Suaid, Sergio A Uyemura, Glauce L Trevisan, Arthur B Novaes, Sergio L S Souza, Daniela B Palioto, Marcio F M Grisi

  Journal of periodontology. 05/2008; 79(5):774-83.

  BACKGROUND: Periodontitis, a complication of diabetes mellitus (DM), can induce or perpetuate systemic conditions. This double-masked, placebo-controlled study evaluated the effects of periodontalBACKGROUND: Periodontitis, a complication of diabetes mellitus (DM), can induce or perpetuate systemic conditions. This double-masked, placebo-controlled study evaluated the effects of periodontal therapy (scaling and root planing [SRP]) on the serum levels of glycated hemoglobin (HbA1c) and on inflammatory biomarkers. METHODS: Thirty subjects with type 2 DM and periodontitis were treated with SRP + placebo (SRP; N = 15) or with SRP + doxycycline (SRP+Doxy; N = 15), 100 mg/day, for 14 days. Clinical and laboratory data were recorded at baseline and at 3 months after treatment. RESULTS: After 3 months, the reduction in probing depth was 0.8 mm for the SRP group (P <0.01) and 1.1 mm for the SRP+Doxy group (P <0.01) followed by a 0.9% (SRP; P = 0.17) and 1.5% (SRP+Doxy; P <0.01) reduction in HbA1c levels. A significant reduction in interleukin (IL)-6; interferon-inducible protein 10; soluble fas ligand; granulocyte colony-stimulating factor; RANTES; and IL-12 p70 serum levels were also verified (N = 30). To our knowledge, this is the first report on the effects of periodontal therapy on multiple systemic inflammatory markers in DM. CONCLUSIONS: Periodontal therapy may influence the systemic conditions of patients with type 2 DM, but no statistical difference was observed with the adjunctive systemic doxycycline therapy. Moreover, it is possible that the observed improvement in glycemic control and in the reduction of inflammatory markers could also be due to diet, which was not controlled in our study. Therefore, a confirmatory study with a larger sample size and controlled diet is necessary.

• Comparison between two surgical techniques for root coverage with an acellular dermal matrix graft.

  Authors: Patrícia F Andrade, Maria Emília M C Felipe, Arthur B Novaes, Sérgio L S Souza, Mário Taba, Daniela B Palioto, Márcio F M Grisi

  Journal of clinical periodontology. 04/2008; 35(3):263-9.

  AIM: The aim of this randomized, controlled, clinical study was to compare two surgical techniques with the acellular dermal matrix graft (ADMG) to evaluate which technique could provide better rootAIM: The aim of this randomized, controlled, clinical study was to compare two surgical techniques with the acellular dermal matrix graft (ADMG) to evaluate which technique could provide better root coverage. MATERIAL AND METHODS: Fifteen patients with bilateral Miller Class I gingival recession areas were selected. In each patient, one recession area was randomly assigned to the control group, while the contra-lateral recession area was assigned to the test group. The ADMG was used in both groups. The control group was treated with a broader flap and vertical-releasing incisions, and the test group was treated with the proposed surgical technique, without releasing incisions. The clinical parameters evaluated before the surgeries and after 12 months were: gingival recession height, probing depth, relative clinical attachment level and the width and thickness of keratinized tissue. RESULTS: There were no statistically significant differences between the groups for all parameters at baseline. After 12 months, there was a statistically significant reduction in recession height in both groups, and there was no statistically significant difference between the techniques with regard to root coverage. CONCLUSIONS: Both surgical techniques provided significant reduction in gingival recession height after 12 months, and similar results in relation to root coverage.

• Histologic analysis of the acellular dermal matrix graft incorporation process: a pilot study in dogs.

  Authors: Sonia M Luczyszyn, Márcio F M Grisi, Arthur B Novaes, Daniela B Palioto, Sérgio L S Souza, Mario Taba

  The International journal of periodontics & restorative dentistry. 09/2007; 27(4):341-7.

  Clinical results with acellular dermal matrix graft (ADMG) in periodontal surgeries suggest that the material is incorporated by the host tissues. However, histologic studies of the ADMGClinical results with acellular dermal matrix graft (ADMG) in periodontal surgeries suggest that the material is incorporated by the host tissues. However, histologic studies of the ADMG incorporation process are limited. The objective of this study was to evaluate the incorporation of ADMG into gingival tissues in a dog model. Gingival recession-type defects were created at the canines of six dogs. After 6 weeks, periodontal surgeries to repair the defects were performed using ADMG. Two animals each were sacrificed after 4, 8, and 12 weeks. At 4 weeks, thick collagen fibers from the ADMG were clearly seen in the connective tissue, and some blood vessels were penetrating into the ADMG. At 8 weeks, blood vessel penetration was enhanced, and collagen fiber bundles from the ADMG were seen sending branches into the connective tissue in all directions. After 12 weeks, the ADMG and the connective tissue seemed to be well integrated into a single highly vascularized structure, indicating almost complete incorporation of the ADMG.

• Comparison of two surgical procedures for use of the acellular dermal matrix graft in the treatment of gingival recessions: a randomized controlled clinical study.

  Authors: Maria Emília M C Felipe, Patrícia F Andrade, Marcio F M Grisi, Sérgio L S Souza, Mário Taba, Daniela B Palioto, Arthur B Novaes

  Journal of periodontology. 08/2007; 78(7):1209-17.

  BACKGROUND: The aim of this randomized, controlled, clinical investigation was to compare two surgical techniques for root coverage with the acellular dermal matrix graft to evaluate which techniqueBACKGROUND: The aim of this randomized, controlled, clinical investigation was to compare two surgical techniques for root coverage with the acellular dermal matrix graft to evaluate which technique provided better root coverage, a better esthetic result, and less postoperative discomfort. METHODS: Fifteen patients with bilateral Miller Class I or II gingival recessions were selected. Fifteen pairs of recessions were treated and assigned randomly to the test group, and the contralateral recessions were assigned to the control group. The control group was treated with a broader flap and vertical releasing incisions; the test group was treated with the proposed surgical technique, without vertical releasing incisions. The clinical parameters evaluated were probing depth, relative clinical attachment level, gingival recession (GR), width of keratinized tissue, thickness of keratinized tissue, esthetic result, and pain evaluation. The measurements were taken before the surgeries and after 6 months. RESULTS: At baseline, all parameters were similar for both groups. At 6 months, a statistically significant greater reduction in GR favored the control group. The percentage of root coverage was 68.98% and 84.81% for the test and control groups, respectively. The esthetic result was equivalent between the groups, and all patients tolerated both procedures well. CONCLUSIONS: Both techniques provided significant root coverage, good esthetic results, and similar levels of postoperative discomfort. However, the control technique had statistically significantly better results for root coverage of localized gingival recessions.

• Effects of enamel matrix derivative and transforming growth factor-beta1 on human periodontal ligament fibroblasts.

  Authors: Thaisângela L S Rodrigues, Julie T Marchesan, Ricardo D Coletta, Arthur B Novaes, Márcio F de M Grisi, Sérgio L S Souza, Mário Taba, Daniela B Palioto

  Journal of clinical periodontology. 06/2007; 34(6):514-22.

  AIM: The objective of this study was to evaluate the effects of enamel matrix derivative (EMD), transforming growth factor-beta1 (TGF-beta1), and a combination of both factors (EMD+TGF-beta1) onAIM: The objective of this study was to evaluate the effects of enamel matrix derivative (EMD), transforming growth factor-beta1 (TGF-beta1), and a combination of both factors (EMD+TGF-beta1) on periodontal ligament (PDL) fibroblasts. MATERIAL AND METHODS: Human PDL fibroblasts were obtained from three adult patients with a clinically healthy periodontium, using the explant technique. The effects of EMD, TGF-beta1, or a combination of both were analysed on PDL cell proliferation, adhesion, wound healing, and total protein synthesis, and on alkaline phosphatase (ALP) activity and bone-like nodule formation. RESULTS: Treatment with EMD for 4, 7, and 10 days increased cell proliferation significantly compared with the negative control (p<0.05). At day 10, EMD and EMD+TGF-beta1 showed a higher cell proliferation compared with TGF-beta1 (p<0.01). Cell adhesion was significantly up-regulated by TGF-beta1 compared with EMD and EMD+TGF-beta1 (p<0.01). EMD enhanced in vitro wound healing of PDL cells compared with the other treatments. Total protein synthesis was significantly increased in PDL cells cultured with EMD compared with PDL cells treated with TGF-beta1 or EMD+TGF-beta1 (p<0.05). EMD induced ALP activity in PDL fibroblasts, which was associated with an increase of bone-like nodules. CONCLUSION: These findings support the hypothesis that EMD and TGF-beta1 may play an important role in periodontal regeneration. EMD induced PDL fibroblast proliferation and migration, total protein synthesis, ALP activity, and mineralization, while TGF-beta1 increased cellular adhesion. However, the combination of both factors did not positively alter PDL fibroblast behaviour.

• Effect of in vitro gingival fibroblast seeding on the in vivo incorporation of acellular dermal matrix allografts in dogs.

  Authors: Arthur B Novaes, Julie Teresa Marchesan, Guilherme O Macedo, Daniela B Palioto

  Journal of periodontology. 02/2007; 78(2):296-303.

  BACKGROUND: Acellular dermal matrix allograft (ADMA) has been used in various periodontal procedures with successful results. Because ADMA has no blood vessels or cells, slower healing andBACKGROUND: Acellular dermal matrix allograft (ADMA) has been used in various periodontal procedures with successful results. Because ADMA has no blood vessels or cells, slower healing and incorporation are observed compared to a subepithelial connective tissue graft. Fibroblasts accelerate the healing process by regulation of matrix deposition and synthesis of a variety of growth factors. Thus, the objective of this study was to evaluate histologically if gingival fibroblasts affect healing and incorporation of ADMA in dogs when used as a subepithelial allograft. METHODS: Gingival fibroblasts were established from explant culture from the connective tissue of keratinized gingiva collected from the maxilla of seven mongrel dogs. ADMA was seeded with gingival fibroblasts and transferred to dogs. Surgery was performed bilaterally, and the regions were divided into two groups: ADMA+F (ADMA containing fibroblasts) and ADMA (ADMA only). Biopsies were performed after 2, 4, and 8 weeks of healing. RESULTS: The quantity of blood vessels was significantly higher in the ADMA+F group at 2 weeks of healing (Kruskal-Wallis; P <0.05). There was no statistical difference (P >0.05) in the number of cell layers, epithelial area, or inflammatory infiltrate between the two groups at any stage of healing. CONCLUSION: The enhanced vascularization in vivo in early stages supports the important role of fibroblasts in improving graft performance and wound healing of cultured graft substitutes.

• Effects of granule size on the osteoconductivity of bovine and synthetic hydroxyapatite: a histologic and histometric study in dogs.

  Authors: Alexandre L Carvalho, Paulo E P Faria, Marcio F M Grisi, Sergio L S Souza, Mario Júnior Taba, Daniela B Palioto, Arthur B Júnior Novaes, Alexandre F Fraga, L Sevgi Ozyegin, Faik N Oktar, Luiz A Salata

  The Journal of oral implantology. 02/2007; 33(5):267-76.

  Two bovine hydroxyapatites (BHAs), one with granule size of 150 to 200 microm and one with granule size of 300 to 329 micro, and 2 synthetic hydroxyapatites (SHAs), with granule size of 150 and 300Two bovine hydroxyapatites (BHAs), one with granule size of 150 to 200 microm and one with granule size of 300 to 329 micro, and 2 synthetic hydroxyapatites (SHAs), with granule size of 150 and 300 microm, respectively, were compared for effectiveness in repairing circumferential bone defects in dogs. The hydroxyapatites (HAs) were characterized through powder x-ray diffraction (XRD) analysis and scanning electron microscopy (SEM). Three trephined bone defects (5.0 mm wide x 4 mm long) were created in the humeruses of 8 dogs. In a random manner, the defects on each side were treated with either BHA with small granules (BHA[s]), BHA with large granules (BHA[L]), SHA with small granules (SHA[s]), SHA with large granules (SHA[L]), or left to heal unaided (bilateral control). Four dogs were sacrificed after 6 and 12 postoperative weeks, respectively. Ground sections of each defect were submitted to histologic and histomorphometric analysis (percentage of area occupied by bone, bone marrow, and biomaterial). As a rule, the HA granules exhibited direct bone contact, regardless of the origin and the size of the granules. Control sites were related and had an increased amount of connective tissue infiltration. At 12 weeks, BHA(s) exhibited improved bone formation compared with SHA(s) and SHA(L). The SHA(s) delivered reduced amounts of bone compared with the remaining groups (control included). The area of bone measured in BHA(s) sites was significantly higher at 12 weeks than 6 weeks. The XRD revealed the tested HA samples to be highly crystalline, while BHA appeared with rougher surface at SEM analysis. The BHA(s) performed better than the SHA(s) and SHA(L), as assessed by the amount of bone measured in both implantation sites at 12 weeks. The BHA's material characteristic itself rather than granules size accounted for the distinctive biological behavior. The increased roughness of the BHAs' surface, as assessed through SEM, seemed to benefit the osteoconduction process.

• Anorganic bovine matrix/p-15 "flow" in the treatment of periodontal defects: case series with 12 months of follow-up.

  Authors: Raquel R M Barros, Arthur B Novaes, Virgílio M Roriz, Rafael R Oliveira, Márcio F M Grisi, Sérgio L S Souza, Mário Taba, Daniela B Palioto

  Journal of periodontology. 08/2006; 77(7):1280-7.

  BACKGROUND: Nowadays there is a trend in developing biologic modalities that may enhance wound healing of specific sites. In this regard, a cell-binding activity of type I collagen provided by aBACKGROUND: Nowadays there is a trend in developing biologic modalities that may enhance wound healing of specific sites. In this regard, a cell-binding activity of type I collagen provided by a synthetic peptide (P-15) was incorporated in a scaffold (anorganic bovine matrix [ABM]) to facilitate the attachment, migration, and differentiation of cells. This case series describes a surgical protocol for the placement of ABM/P-15 "flow" during regenerative procedures. METHODS: Wide periodontal defects were treated with sulcular incisions preserving the papillae, full-thickness flap reflection, granulation tissue debridement, mechanical and chemical root surface treatment, placement of the ABM/P-15 "flow," and wound-closure sutures. Weekly, and then monthly, deplaquing was performed until the 12-month postoperative recall, in which the clinical parameters were reevaluated. RESULTS: Significant clinical changes, including probing depth reduction and relative clinical attachment level gain, were achieved after the 12-month period. The radiographs demonstrated increase in radiopacity when compared to those taken initially, suggesting hard tissue improvements. CONCLUSIONS: The topography of the defects described here could be understood as a challenge for regeneration, once the previous breakdown of the supporting tissues had diminished the source of cells for the healing process and reduced the number of residual walls to retain the graft material. Thus, it seems that the ABM/P-15 "flow" contributed to the clinical success achieved. Based on this result, ABM/P-15 "flow" could be a useful and beneficial material for the treatment of periodontal defects.