Marcio Z Casati

Publications of Marcio Z Casati

• Diabetes Mellitus May Increase Bone Loss After Occlusal Trauma and Experimental Periodontitis.

  Authors: Claudia Kelly de Oliveira Diniz, Mônica Grazieli Corrêa, Marcio Z Casati, Francisco H Nociti, Karina G Ruiz, Glaucia M Brosi Ambrosano, Enilson A Sallum

  Journal of periodontology. 02/2012;

  Background: Diabetes Mellitus (DM) involves metabolic changes that can negatively influence periodontal tissues resulting in more prevalent and severe periodontitis and impaired bone formation.Background: Diabetes Mellitus (DM) involves metabolic changes that can negatively influence periodontal tissues resulting in more prevalent and severe periodontitis and impaired bone formation. Occlusal trauma (OT) is an injury of the supportive periodontium that results in bone loss. It can be hypothesized that DM would increase bone loss after OT, mainly when associated with periodontitis. Thus, the aim of the present study was to evaluate the influence of DM on bone response in the furcation area of teeth subjected to OT in the presence or absence of experimental periodontitis (EP) in the rat model. Material and Methods: Thirty-two Wistar rats were assigned to four groups: Group 1 (G1), DM+OT+EP (n=08); Group 2 (G2), DM+OT (n=08); Group 3 (G3), OT+EP (n=08); Group 4 (G4), OT (n=08). The animals of G1 and G2 received a single intraperitoneal injection of streptozotocin (STZ). After ten days, the animals of G1 and G3 were subjected to EP by ligature placement. Fifteen days after the start of EP, OT was induced by the creation of a premature contact. The animals were euthanized 35 days after DM induction. Results: DM enhanced bone loss in the presence of OT combined with EP, but did not increase bone loss in teeth subjected to OT alone. EP caused greater bone loss when associated with OT. Conclusion: Within the limits of this animal study, it can be concluded that DM enhances bone loss in the presence of occlusal trauma associated to EP.

• Correction of Hypophosphatasia (Hpp) Associated Mineralization Deficiencies In vitro by Phosphate/Pyrophosphate Modulation in Periodontal Ligament Cells.

  Authors: Thaisângela L Rodrigues, Brian L Foster, Karina G Silverio, Luciane Martins, Marcio Z Casati, Enilson A Sallum, Martha J Somerman, Francisco H Nociti

  Journal of periodontology. 10/2011;

  Background: Mutations in the Alpl gene in hypophosphatasia (HPP) reduce the function of tissue nonspecific alkaline phosphatase (TNAP), resulting in increased pyrophosphate (PP(i)) and a severeBackground: Mutations in the Alpl gene in hypophosphatasia (HPP) reduce the function of tissue nonspecific alkaline phosphatase (TNAP), resulting in increased pyrophosphate (PP(i)) and a severe deficiency in acellular cementum. We hypothesized that exogenous phosphate (P(i)) would rescue the in vitro mineralization capacity of periodontal ligament (PDL) cells harvested from HPP-diagnosed subjects, by correcting P(i)/PP(i) ratio and modulating expression of genes involved with P(i)/PP(i) metabolism. Methods: Ex vivo and in vitro analyses were employed to identify mechanisms involved in HPP-associated PDL/tooth root deficiencies. Constitutive expression of PP(i)-associated genes was contrasted in PDL versus pulp tissues obtained from healthy subjects. Primary PDL cell cultures from HPP subjects (monozygotic twin males) were established to assay alkaline phosphatase activity (ALP), in vitro mineralization, and gene expression. Exogenous P(i) was provided to correct P(i)/PP(i) ratio. Results: PDL tissues obtained from healthy individuals featured higher basal expression of key PP(i) regulators, genes Alpl, progressive ankylosis protein (Ankh) and ectonucleotide pyrophosphatase/phosphodiesterase 1 (Enpp1), versus paired pulp tissues. A novel Alpl mutation was identified in the twin HPP subjects enrolled in this study. Compared to controls, HPP-PDL cells exhibited significantly reduced ALP and mineralizing capacity, which were rescued by addition of 1mM P(i). Dysregulated expression of PP(i) regulatory genes Alpl, Ankh, and Enpp1 was also corrected by adding P(i), though other matrix markers evaluated in our study remained down-regulated. Conclusions: These findings underscore the importance of controlling P(i)/PP(i) ratio toward development of a functional periodontal apparatus, and support P(i)/PP(i) imbalance as the etiology of HPP-associated cementum defects.

• The impact of cigarette smoke inhalation on the outcome of enamel matrix derivative treatment in rats: histometric analysis.

  Authors: Mônica G Corrêa, Mirella L Gomes Campos, Bruno Braga Benatti, Marcelo Rocha Marques, Marcio Z Casati, Francisco H Nociti, Enilson A Sallum

  Journal of periodontology. 12/2010; 81(12):1820-8.

  Tobacco use is the most significant risk factor of periodontal disease. Clinical evidence has demonstrated that tobacco may negatively influence the results after surgical and non-surgicalTobacco use is the most significant risk factor of periodontal disease. Clinical evidence has demonstrated that tobacco may negatively influence the results after surgical and non-surgical periodontal therapy. Enamel matrix derivative (EMD) have been used in periodontal regenerative procedures resulting in improvement of clinical parameters. The effect of EMD in the presence of tobacco compounds is unclear. Thus, the aim of the present study is to evaluate the impact of cigarette smoke inhalation (CSI) on the results of EMD treatment. Twenty-two Wistar rats were assigned to two groups: Group 1, CSI (n = 11); Group 2, non-exposed (n = 11). Thirty days after initiation of CSI, fenestration defects were created at the buccal aspect of the first mandibular molar. The study followed a split-mouth design. After the surgeries the defects were randomly assigned to two subgroups: non-treated control and treated with EMD. The animals were sacrificed 21 days later and the percentage of defect fill, density of newly formed bone, and new cementum formation were histometrically assessed. The number of osteoclasts was determined by tartrate-resistant acid phosphatase. CSI was associated with less bone density compared to the non-exposed group. EMD provided an increased defect fill and new cementum formation in both groups. The number of tartrate-resistant acid phosphatase-positive osteoclasts was significantly higher in the CSI non-treated control group compared to the non-treated control of the non-exposed animals. EMD may provide increased defect fill and cementum formation in the presence or absence of CSI. However, tobacco smoke produced a detrimental effect on bone healing when density of newly formed bone was considered.

• DNA methylation status of the IL8 gene promoter in aggressive periodontitis.

  Authors: Denise C Andia, Naila F P de Oliveira, Renato C V Casarin, Marcio Z Casati, Sergio R P Line, Ana P de Souza

  Journal of periodontology. 05/2010; 81(9):1336-41.

  Studies evaluating the methylation status of cytokine genes may have relevance for inflammatory diseases in which the expression of some cytokines is altered, such as periodontitis. This studyStudies evaluating the methylation status of cytokine genes may have relevance for inflammatory diseases in which the expression of some cytokines is altered, such as periodontitis. This study observes the DNA methylation status in the interleukin-8 (IL8) gene promoter in cells of the oral epithelium of subjects affected by generalized aggressive periodontitis (AgP) and compares it to those of control subjects. Genomic DNA from epithelial oral cells of 37 generalized AgP patients and 37 controls were purified and modified by sodium bisulphite. Modified DNA was submitted by methylation-specific polymerase chain reaction, electrophoresed on 10% polyacrylamide gels, and stained. Subjects who presented generalized AgP have a higher frequency of hypomethylation of the IL8 gene promoter in oral epithelium cells than that of controls (86.5% in the generalized AgP group versus 62% in the control group; P = 0.016; chi(2) test). A marked hypomethylated status is found in the oral epithelial cells of subjects presenting with generalized AgP, compared to controls, in the promoter region of the IL8 gene. This hypomethylated status may reflect a generalized condition of oral epithelial cells, including gingival epithelium, because gingival epithelial cells were also collected during mouthwash use.

• Histometric evaluation of bone around titanium implants with different surface treatments in rats exposed to cigarette smoke inhalation.

  Authors: Mônica G Correa, Mirella L Gomes Campos, João B César-Neto, Marcio Z Casati, Francisco H Nociti, Enilson A Sallum

  Clinical oral implants research. 03/2009;

  Abstract Objectives: There is a lack of histological information about the influence of cigarette smoke on bone around surface-treated implants. The aim of the present study was to test the influenceAbstract Objectives: There is a lack of histological information about the influence of cigarette smoke on bone around surface-treated implants. The aim of the present study was to test the influence of titanium surface treatment on osseointegration in animals that were exposed to intermittent cigarette smoke inhalation. Material and methods: Twenty-two male Wistar rats were used. One tibia, chosen at random, received a machined titanium implant (MI) while the other received an aluminum oxide-blasted surface implant (ABI). The animals were randomly assigned to one of the following groups: Group 1 - control (n=11) and Group 2 - intermittent cigarette smoke inhalation (n=11). Sixty days after surgery, the animals were sacrificed. The degree of bone-to-implant contact (BIC), bone filling (BF) within the limits of the threads of the implants and bone density (proportion of mineralized bone in a 500-mum-wide zone lateral to the implant - BD) were measured in the cortical (zone A) and cancellous bone (zone B) areas. Results: Data analysis showed significant differences when comparing the groups and implant surfaces in both zones for BIC (two-way ANOVA -P<0.05). The two groups presented higher BIC mean values for ABI, when compared with MI (P<0.05). In group 2, cigarette smoke inhalation negatively affected BF in both zones (P<0.05). Group 2 presented a significantly decreased BD in both zones (P<0.05). No statistically significant differences were observed between surfaces in any of the groups for BD. Conclusion: Within the limits of the present study, it can be concluded that the aluminum oxide blast surface treatment may increase the degree of BIC but cannot overcome the detrimental effect of tobacco smoke on bone around titanium implants. To cite this article: Correa MG, Campos MLG, César-Neto JB, Casati MZ, Nociti FH, Sallum EA. Histometric evaluation of bone around titanium implants with different surface treatments in rats exposed to cigarette smoke inhalation. Clin. Oral Impl. Res. xx, 2009; 000-000. doi: 10.1111/j.1600-0501.2008.01695.x.

• A two-year prospective study of coronally positioned flap with or without acellular dermal matrix graft.

  Authors: Antonieta De Queiroz Côrtes, Antonio Wilson Sallum, Marcio Z Casati, Francisco H Nociti, Enilson A Sallum

  Journal of clinical periodontology. 09/2006; 33(9):683-9.

  AIM: Evaluation of the treatment of gingival recessions with coronally positioned flap with or without acellular dermal matrix allograft (ADM) after a period of 24 months. METHODS: Thirteen patientsAIM: Evaluation of the treatment of gingival recessions with coronally positioned flap with or without acellular dermal matrix allograft (ADM) after a period of 24 months. METHODS: Thirteen patients with bilateral gingival recessions were included. The defects were randomly assigned to one of the treatments: coronally positioned flap plus ADM or coronally positioned flap alone. The clinical measurements were taken before the surgeries and after 6, 12 and 24 months. RESULTS: At baseline, the mean values for recession height were 3.46 and 3.58 mm for the defects treated with and without the graft, respectively (p>0.05). No significant differences between the groups were observed after 6 and 12 months in this parameter. However, after 24 months, the group treated with coronally positioned flap alone showed a greater recession height when compared with the group treated with ADM (1.62 and 1.15 mm, respectively--p<0.05). A significant increase in the thickness of keratinized tissue was observed in the group treated with ADM as compared with coronally positioned flap alone (p<0.05). CONCLUSIONS: ADM may reduce the residual gingival recession observed after 24 months in defects treated with coronally positioned flap. In addition, a greater gingival thickness may be achieved when the graft is used.

• Coronally positioned flap with or without acellular dermal matrix graft in gingival recessions: a histometric study.

  Authors: Enilson A Sallum, Getúlio R Nogueira-Filho, Marcio Z Casati, Suzana Peres Pimentel, Juliana Bezerra Saldanha, Francisco H Nociti

  American journal of dentistry. 05/2006; 19(2):128-32.

  PURPOSE: To evaluate, histometrically, the healing of gingival recession treated by coronally positioned flaps (CPF) with or without acellular dermal matrix (ADM) as a subepithelial graft. METHODS:PURPOSE: To evaluate, histometrically, the healing of gingival recession treated by coronally positioned flaps (CPF) with or without acellular dermal matrix (ADM) as a subepithelial graft. METHODS: Gingival recessions were created on the upper cuspids of six dogs and were randomly assigned to: CPF+ADM (ADM group) or CPF alone (CPF group). After 4 months, the dogs were sacrificed, and the histometric measurements were performed. RESULTS: The epithelial length was 2.28 + 0.92 mm and 2.10 + 0.46 mm for the ADM and CPF groups, respectively (P=0.74). The connective tissue adaptation was 0.05 + 0.08 mm for the ADM group and 0.06 + 0.08 mm for the CPF group (P=0.36). The new cementum was 2.35 + 1.55 mm and 2.90 + 0.96 mm in the ADM and CPF groups, respectively (P=0.53). The new bone was 0.60 + 1.36 mm for the ADM group and 0.35 + 0.82 mm for the CPF group (P=0.53). The gingival recession was -0.88 + 1.33 mm in the ADM group and -0.21 + 0.22 mm in the CPF group (P=0.21). The gingival thickness was 1.63 + 0.28 mm in the ADM group and 1.16 + 0.20 mm in the CPF group (P=0.002).

• Periodontal debridement with povidone-iodine in periodontal treatment: short-term clinical and biochemical observations.

  Authors: Guilherme M Zanatta, Sandro Bittencourt, Francisco H Nociti, Enilson A Sallum, Antonio W Sallum, Marcio Z Casati

  Journal of periodontology. 04/2006; 77(3):498-505.

  BACKGROUND: The aim of the present study was to evaluate the clinical effects of one-stage periodontal debridement with an ultrasonic instrument, associated with 0.5% povidone (pvp)-iodine irrigationBACKGROUND: The aim of the present study was to evaluate the clinical effects of one-stage periodontal debridement with an ultrasonic instrument, associated with 0.5% povidone (pvp)-iodine irrigation in patients with chronic periodontitis. METHODS: Forty-five patients were randomly assigned into three groups: the control group (CG) received quadrant root planing at 1-week intervals over four consecutive sessions; the periodontal debridement plus pvp-iodine group (PD-PIG) received a 45-minute full-mouth debridement with an ultrasonic instrument, associated with 0.5% pvp-iodine irrigation; and the periodontal debridement group (PDG) received a 45-minute full-mouth periodontal debridement with an ultrasonic instrument, associated with NaCl irrigation. RESULTS: At the 3-month evaluation, the mean probing depth (PD) reduction in CG was 2.51+/-0.52 mm, 2.53+/-0.50 mm in PD-PIG, and 2.58+/-0.60 mm in PDG (P<0.05). The clinical attachment level (CAL) analysis showed a statistically significant gain in all groups compared to baseline (1.87+/-0.56 mm [CG], 1.94+/-0.70 mm [PD-PIG], and 1.99+/-0.92 mm [PDG]). Intergroup analysis of PD and CAL at 1 and 3 months showed no differences (P>0.05). The N-benzoyl-L-arginine-p-nitroanilide (BAPNA) test showed a significant reduction in trypsin activity only during the first month (P<0.05); at 3 months there were no differences compared to baseline (P=0.80). CONCLUSION: This study provides no evidence that pvp-iodine is effective as an adjunct for one-stage periodontal debridement.

• Guided tissue regeneration in Class II furcation defects using a resorbable polylactic acid barrier.

  Authors: Laerte L Bremm, Antonio W Sallum, Marcio Z Casati, Francisco H Júnior Nociti, Enilson A Sallum

  American journal of dentistry. 01/2005; 17(6):443-6.

  PURPOSE: To evaluate, clinically, the use of guided tissue regeneration (GTR) with a resorbable polylactic acid membrane (Atrisorb) in the treatment of Class II furcation defects in humans. METHODS:PURPOSE: To evaluate, clinically, the use of guided tissue regeneration (GTR) with a resorbable polylactic acid membrane (Atrisorb) in the treatment of Class II furcation defects in humans. METHODS: The study included 10 patients with two comparable Class II furcations in lower molars. The lesions were randomly assigned to one of the treatments: GTR with an Atrisorb resorbable membrane (test) or open flap debridement (control). The following clinical parameters were recorded before the surgeries (baseline) and after a healing period of 6 months: relative vertical clinical attachment level, relative horizontal clinical attachment level, probing depths, position of the gingival margin and width of the keratinized tissue. RESULTS: After the intra-group comparison (baseline versus 6 months), statistically significant differences were found for the parameters: probing depth, relative vertical clinical attachment level and relative horizontal clinical attachment level, in both groups (P < 0.05). Comparing the two groups, a statistically significant difference was found in the probing depth reduction favoring the GTR group (P < 0.05). No significant differences were found in the other parameters.

• Enamel matrix derivative and guided tissue regeneration in the treatment of dehiscence-type defects: a histomorphometric study in dogs.

  Authors: Enilson A Sallum, Suzana P Pimentel, Juliana B Saldanha, Getúlio R Nogueira-Filho, Marcio Z Casati, Francisco H Júnior Nociti, Antonio Wilson Sallum

  Journal of periodontology. 10/2004; 75(10):1357-63.

  BACKGROUND: The goal of this investigation was to histologically and histometrically evaluate the healing process of dehiscence-type defects treated by enamel matrix derivative (EMD) and/or guidedBACKGROUND: The goal of this investigation was to histologically and histometrically evaluate the healing process of dehiscence-type defects treated by enamel matrix derivative (EMD) and/or guided tissue regeneration (GTR). METHODS: Seven mongrel dogs were used. Buccal osseous dehiscences were surgically created on the mesial roots of the mandibular third and fourth premolars. The defects were exposed to plaque accumulation for 3 months. After this period, the defects were randomly assigned to one of the treatments: open flap debridement (OFD), enamel matrix derivative (EMD), GTR with bioabsorbable membrane (GTR), and the combination of both procedures (EMD + GTR). After 4 months of healing, the dogs were sacrificed and the blocks were processed. The histometric parameters evaluated included gingival recession, epithelial length, connective tissue adaptation, new cementum, and new bone. RESULTS: A superior length of new cementum was observed in the sites treated by EMD (3.7 mm) and EMD + GTR (3.8 mm) in comparison with OFD (2.4 mm) (P < 0.05). No statistically significant differences were found in the remaining histometric parameters. CONCLUSIONS: Within the limits of this study, it can be concluded that EMD alone or in combination with GTR barriers may effectively promote new cementum formation. The combination of both therapies may not provide additional benefits.

• Coronally positioned flap with or without acellular dermal matrix graft in the treatment of Class I gingival recessions: a randomized controlled clinical study.

  Authors: Antonieta De Queiroz Côrtes, Angela Guimaräes Martins, Francisco H Nociti, Antonio Wilson Sallum, Marcio Z Casati, Enilson A Sallum

  Journal of periodontology. 08/2004; 75(8):1137-44.

  BACKGROUND: The aim of this study was to clinically evaluate the treatment of Class I gingival recessions by coronally positioned flap with or without acellular dermal matrix allograft (ADM).BACKGROUND: The aim of this study was to clinically evaluate the treatment of Class I gingival recessions by coronally positioned flap with or without acellular dermal matrix allograft (ADM). METHODS: Thirteen patients with comparable bilateral Miller Class I gingival recessions (> or = 3.0 mm) were selected. The defects were randomly assigned to one of the treatments: coronally positioned flap and acellular dermal matrix (ADM group) or coronally positioned flap alone (CPF group). The clinical parameters included: probing depth (PD), clinical attachment level (CAL), recession height (RH), recession width (RW), height of keratinized tissue (HKT), thickness of keratinized tissue (TKT), plaque index (PI), and gingival index (GI). The measurements were taken before the surgeries and after 6 months. RESULTS: The mean baseline recession was 3.4 mm and 3.5 mm for ADM group and CPF group, respectively. After 6 months, both treatments resulted in significant root coverage (P < 0.01), reaching an average of 2.6 mm (76%) in the ADM group and 2.5 mm (71%) in the CPF group. The difference in recession reduction between treatments was not statistically significant. There were no statistically significant differences between the treatments in PD, CAL, RH, RW, and HKT. However, the mean TKT gain was 0.7 mm for the ADM group and 0.2 mm for the CPF group (P < 0.01). CONCLUSION: It can be concluded that both techniques could provide significant root coverage in Class I gingival recessions; however, a greater keratinized tissue thickness can be expected with ADM.

• Guided bone regeneration may be negatively influenced by nicotine administration: a histologic study in dogs.

  Authors: Juliana B Saldanha, Suzana P Pimentel, Marcio Z Casati, Enilson A Sallum, Deise Barbieri, Heitor Júnior Moreno, Francisco H Júnior Nociti

  Journal of periodontology. 05/2004; 75(4):565-71.

  BACKGROUND: A series of animal and in vitro data confirms that nicotine impairs bone healing, diminishes osteoblast function, and causes autogenous bone graft morbidity. Therefore, this study aimedBACKGROUND: A series of animal and in vitro data confirms that nicotine impairs bone healing, diminishes osteoblast function, and causes autogenous bone graft morbidity. Therefore, this study aimed to investigate the impact of nicotine on the healing of bone defects treated by the guided bone regeneration (GBR) principle. METHODS: Sixteen mongrel dogs were used. One defect was surgically created bilaterally and randomly assigned as an expanded polytetrafluoroethylene (ePTFE) membrane site or a non-membrane control site. The animals were randomly assigned to one of the following groups: group 1, placebo (n = 8) and group 2, subcutaneous administration of nicotine (2 mg/kg) twice daily (n = 8). After 4 months, the animals were sacrificed and the specimens routinely processed for semi-serial decalcified sections. The evaluated parameters were bone height, bone width, bone density, and bone area of newly formed bone. RESULTS: Intergroup analysis (Kruskal-Wallis) showed that membrane-protected defects in the placebo group demonstrated an increased bone area when compared to membrane-protected defects in the nicotine group and non-membrane sites, regardless of nicotine administration (P < 0.05). In addition, nicotine administration significantly affected bone density in membrane- and non-membrane-protected sites (P < 0.05). CONCLUSIONS: Within the limits of the present study, nicotine might affect, but not prevent, bone healing in defects treated by guided bone regeneration. The mechanisms of this effect should be investigated further.

• Coronally positioned flap with or without enamel matrix protein derivative for the treatment of gingival recessions.

  Authors: Enilson A Sallum, Marcio Z Casati, Raul G Caffesse, Leticia Perecin Funis, Francisco H Nociti Júnior, Antônio W Sallum

  American journal of dentistry. 11/2003; 16(5):287-91.

  PURPOSE: To evaluate, histometrically, the healing of gingival recessions treated by coronally positioned flaps associated with enamel matrix protein derivative (EMD-Group) and to compare it to thatPURPOSE: To evaluate, histometrically, the healing of gingival recessions treated by coronally positioned flaps associated with enamel matrix protein derivative (EMD-Group) and to compare it to that obtained with coronally positioned flaps alone (CPF-Group). METHODS: Five mongrel dogs were used. Gingival recessions were surgically created on the buccal aspect of the upper cuspids. The defects (5 x 7 mm) were exposed to plaque accumulation for 3 months. After a preparation period, the contralateral defects were randomly assigned to each group. After 3 months of healing, the dogs were sacrificed and the blocks were processed. The histometric parameters evaluated included: gingival recession, length of epithelium, new connective tissue attachment and new bone. RESULTS: The gingival recession was -0.1 +/- 0.2 mm for the EMD-Group and -0.8 +/- 1.3 mm for the CPF-Group (P = 0.17). The extension of the epithelium was 1.2 +/- 1.0 mm for the EMD-Group and 1.3 +/- 0.7 mm for the CPF-Group (P = 0.89). The new connective tissue attachment was 4.8 +/- 0.7 in the EMD-Group and 4.0 +/- 1.4 in the CPF-Group (P = 0.22). The new bone was 0.1 +/- 1.8 mm and -0.5 +/- 1.4 mm in the EMD-Group and CPF-Group, respectively (P = 0.50). Histologically, the defect coverage observed was 98.2% for the EMD-Group and 85.8% for the CPF-Group.

• Enamel matrix derivative and bone healing after guided bone regeneration in dehiscence-type defects around implants. A histomorphometric study in dogs.

  Authors: Marcio Z Casati, Enilson A Sallum, Francisco H Nociti, Raul G Caffesse, Antonio Wilson Sallum

  Journal of periodontology. 07/2002; 73(7):789-96.

  BACKGROUND: The goal of this investigation was to histometrically evaluate the effect of enamel matrix derivative (EMD) on bone healing after guided bone regeneration (GBR) in dehiscence-type osseousBACKGROUND: The goal of this investigation was to histometrically evaluate the effect of enamel matrix derivative (EMD) on bone healing after guided bone regeneration (GBR) in dehiscence-type osseous defects around dental implants; i.e., in the absence of periodontal ligament cells. METHODS: Six mongrel dogs were used. The second, third, and fourth mandibular premolars (p2, p3, and p4) and first molars (ml) were extracted. After 3 months, 2 implant osteotomies were prepared in each side of the mandible, dehiscence-type defects were created on the buccal aspect of each implant osteotomy (3.5 mm x 5.0 mm), and titanium implants were placed (3.75 mm x 8.5 mm). The surgically-created defects were randomly assigned to one of the treatments: EMD, GBR, EMD+GBR, or control. After 2 months, 4 additional defects were created and treated. The animals were sacrificed 3 months after the placement of the first implants, thus allowing the healing periods of 1 and 3 months. Undecalcified sections were obtained for the histometric evaluation including the percentage of bone-to-implant contact and new bone area on the implant threads related to the defect. RESULTS: No statistically significant differences were observed among the groups in the evaluated parameters after 1 month of healing. After 3 months, no statistically significant differences were observed among the groups for the percentage of bone-to-implant contact. The values for the new bone area were: 55.5+/-11.8, 53.8+/-16.3, 62.1+/-18.4, and 36.9+/-25.1 for EMD, GBR, EMD+GBR, and control, respectively. The difference between EMD+GBR and control was statistically significant (P <0.05). CONCLUSIONS: Within the limits of this study, it can be concluded that EMD may positively influence bone healing after GBR around titanium implants. EMD alone, however, had no statistically significant effect.