Home About us Contact
|
Home About us Contact | ||
|
|
||
Healing Process (healing + process)
Kinds of Healing Process Selected AbstractsHealing process induced by three composite prostheses in the repair of abdominal wall defectsJOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 2 2002Juan M. Bellón Abstract The present study compared the performance of three composite prostheses used to repair abdominal wall defects in rabbits. Two of them [Parietex Composite® (PC) and Composix® (CS)] are commonly used in clinical practice and one was designed by the present team (PL-PU99). At 14 and 90 days postimplant, specimens were obtained for morphological, macrophage response (RAM-11) and morphometric and biomechanical analysis. The prosthetic area covered by adhesions was significantly greater (p < 0.05) in the CS group (6.83 ± 2.31 cm2) than in PC (0.11 ± 0.02 cm2) or PL-PU99 (0.10 ± 0.07 cm2). At 14 days, it was observed a homogeneous, organized, well-vascularized neoperitoneum that was significantly thicker (p < 0.05) in PL-PU99. Except in the CS implants, this layer was covered by a continuous mesothelium. All three composites achieved good recipient tissue integration. Highest macrophage levels were recorded at 14 days with significantly higher values in the PL-PU99 prosthesis. Biomechanical strength was significantly greater (p < 0.05) in CS at two weeks postimplant, but it was similar at 90 days. These findings suggest that the three composites show ideal integration with host tissue, along with similar biomechanical strength at 90 days, and significantly higher adhesion formation is induced by the CS prosthesis, possibly due to incomplete mesothelialization of the lower prosthetic surface. © 2002 John Wiley & Sons, Inc. J Biomed Mater Res (Appl Biomater) 63: 182,190, 2002; DOI 10.002/jbm.10123 [source] Rationale for esthetic tissue preservation of a fresh extraction socket by an implant treatment concept simulating a tooth replantationDENTAL TRAUMATOLOGY, Issue 1 2010Georgia Trimpou A soft-tissue recession must be avoided, whether it is due to a compression of the peri-implant soft-tissue caused by an over-dimensioned restoration in the cervical collar of the provisional crown or to a too small dimensioned sulcus former. A simulation of the exact dimension of the lost tooth , especially on the cervical part of the new provisional restoration , is expected to preserve all relevant information and allows the design of a naturally looking emergence profile. Based on theoretical considerations and a case report, the authors intend to demonstrate that a near-naturally dimensioned sealing of the dento-gingival soft-tissue collar may initiate a tissue-maintaining healing process, similar to a tooth replantation. The natural dental crown, connected to an implant instead of the root, is applied for a tight sealing of the wound. If due to traumatic impact the tooth is no longer available, a naturally dimensioned crown restoration will serve as an alternative wound sealant. [source] Effect of root surface treatment with propolis and fluoride in delayed tooth replantation in ratsDENTAL TRAUMATOLOGY, Issue 6 2008Jéssica Lemos Gulinelli Nevertheless, an extended extraoral period damages the periodontal ligament and results in external root resorption. The purpose of this study was to assess by histologic and histometric analysis, the influence of propolis 15% (natural resinous substance collected by Apis mellifera bees from various plants) and the fluoride solution used as root surface treatment on the healing process after delayed tooth replantation. Thirty Wistar (Rattus norvegicus albinus) rats were submitted to extraction of their upper right incisor. The teeth were maintained in a dry environment for 60 min. After this, the pulp was extirpated and the papilla, enamel organ and periodontal ligament were removed with scalpel. The teeth were divided into three experimental groups: Group I , teeth immersed in 20 ml of physiologic saline; Group II , teeth immersed in 20 ml of 2% acidulated phosphate sodium fluoride; Group III , teeth immersed in 20 ml of 15% propolis. After 10 min of immersion in the solutions, the root canals were dried and filled with calcium hydroxide paste and the teeth were replanted. The animals were euthanized 60 days after replantation. The results showed that similar external root resorption was seen in the propolis and fluoride groups. Teeth treated with physiologic saline tended to have more inflammatory root resorption compared with those treated with fluoride or propolis. However, the comparative analysis did not reveal statistically significant differences (P > 0.05) between the treatment modalities when used for delayed tooth replantation. [source] Recurrent trauma histories of two ,unlucky teeth': 42-month follow-upDENTAL TRAUMATOLOGY, Issue 5 2008Zuhal K The fracture type, severity of dislocation, mobility of fragments and diastasis have negative influence on the healing process. The aim of this study was to describe the treatment and the 42-month follow-up period of three trauma histories in a 12-year-old patient in 1 year and to emphasize the negative effects of recurrent traumas on the healing pattern and prognosis of root fractures. [source] Hypertrophic Scars and Keloids,A Review of Their Pathophysiology, Risk Factors, and Therapeutic ManagementDERMATOLOGIC SURGERY, Issue 2 2009DOLORES WOLFRAM MD BACKGROUND Hypertrophic scars and keloids result from an abnormal fibrous wound healing process in which tissue repair and regeneration-regulating mechanism control is lost. These abnormal fibrous growths present a major therapeutic dilemma and challenge to the plastic surgeon because they are disfiguring and frequently recur. OBJECTIVE To provide updated clinical and experimental information on hypertrophic scars and keloids so that physicians can better understand and properly treat such lesions. METHODS A Medline literature search was performed for relevant publications and for diverse strategies for management of hypertrophic scars and keloids. CONCLUSION The growing understanding of the molecular processes of normal and abnormal wound healing is promising for discovery of novel approaches for the management of hypertrophic scars and keloids. Although optimal treatment of these lesions remains undefined, successful healing can be achieved only with combined multidisciplinary therapeutic regimens. [source] LARGE HYPERPLASTIC POLYP DEVELOPING AFTER ENDOSCOPIC MUCOSAL RESECTION OF GASTRIC ADENOMA IN A PATIENT RECEIVING IMMUNOSUPPRESSIVE THERAPYDIGESTIVE ENDOSCOPY, Issue 2 2006Geum-Youn Gwak A 59-year-old man underwent endoscopic mucosal resection (EMR) for gastric adenoma. He had suffered from end-stage renal disease for several years and had received renal transplantation some 5 months before EMR. Subsequently, he took immunosuppressive agents. Follow-up gastrofiberscopy 6 months after EMR showed a sessile polyp at the resection site twice as large as the original adenoma; biopsy specimens revealed a hyperplastic nature. At the time of writing, this hyperplastic polyp has neither increased in size nor developed adenomatous or carcinomatous changes by histological examinations over the past 5 years. Therefore, this is a case of hyperplastic polyp occurring at the gastric adenoma resection site, and suggests the possible effect of immunosuppressive therapy on the post-EMR healing process and hyperplastic polyp development. [source] Effects of oestrogen agonists on human dermal fibroblasts in an in vitro wounding assayEXPERIMENTAL DERMATOLOGY, Issue 11 2009Susan Stevenson Abstract:, Oestrogen and dehydroepiandrosterone (DHEA) improve wound healing, but circulating levels decline significantly with age. Recently, the selective oestrogen receptor modulators (SERMs) tamoxifen and raloxifene have been shown to improve age-associated impaired wound healing. Therefore, we have evaluated the effects of 17,-oestradiol, ER, and ER, agonists, tamoxifen, raloxifene and DHEA on human dermal fibroblasts using an in vitro wound assay. An ER, agonist, 17,-oestradiol and DHEA all significantly accelerated cell migration; the DHEA effect was blocked with an aromatase inhibitor. Tamoxifen, raloxifene and DHEA all significantly increased DNA synthesis; the DHEA stimulatory effect was reversed by an aromatase inhibitor. This study demonstrates that 17,-oestradiol, an ER, agonist, tamoxifen, raloxifene and DHEA (following conversion to oestrogen) all have significant effects on human fibroblasts, the key mesenchymal cell involved in the wound healing process. Further understanding of the mechanisms involved may have important implications for the management of age-related impaired wound healing. [source] Serum-free cultured keratinocytes fail to organize fibronectin matrix and possess different distribution of beta-1 integrinsEXPERIMENTAL DERMATOLOGY, Issue 2 2001G. Altankov Abstract: The development of serum free medium formulation for culturing keratinocytes was a breakthrough in achieving a high number of epidermal cells for experimental and therapeutic studies, in particular to support the wound healing process. It is not clear, however, if switching the cells to highly proliferative phenotype may reflect change in other cellular functions important for the wound repair as their adhesive interactions with the extracellular matrix components. Remodelling of the extracellular matrix, particularly of fibronectin plays an essential role for guiding the cells during wound healing. The molecular mechanisms for organization of this provisional fibronectin matrix, however, are still not clear. We found that keratinocytes in serum containing medium, although in fewer numbers than fibroblasts, were able to remove adsorbed fluorescent labelled fibronectin from the substratum and reorganize it in a fibrilar pattern along the cell periphery. After 3 days the secreted fibronectin had also been organized as matrix-like fibers and as clusters deposited on the substratum after migrating cells. In contrast, serum free cultured keratinocytes fail to organize pre-adsorbed fluorescent labelled fibronectin, as well as the secreted fibronectin, although they grow very well under these conditions. Switching the cells to serum containing medium initiates the removal of fluorescent labelled fibronectin from the substratum, however without reorganization in fibrillar pattern. Most likely, these keratinocytes remove fluorescent labelled fibronectin by the expression of proteolytic activity, rather than with the mechanical function of ,1 integrins. The latter were diffusely dispersed in serum containing conditions and tend to organize in focal adhesions in serum free cultured cells. We assumed their transient expression and different affinity state might be important for the keratinocyte migration and matrix assembly mechanism. [source] Inflammation-associated remodelling and fibrosis in the lung , a process and an end pointINTERNATIONAL JOURNAL OF EXPERIMENTAL PATHOLOGY, Issue 2 2007William A.H. Wallace Summary Fibrosis by common usage in the pathological and clinical literature is the end result of a healing process and synonymous with scarring. We would argue that its use to describe a dynamic series of events which may be reversible is unhelpful and that the term ,lung remodelling' is a better description for this process as it reflects changes in tissue organization that may or may not progress to ,fibrosis' as a final fixed point. Resolution, through reversal of active lung remodelling, by therapeutic intervention is possible providing the alveolar architecture remains intact. If the lung architecture is lost then healing by permanent fibrosis with loss of organ function is inevitable. [source] Pimecrolimus versus placebo in genital aphthous ulcers of Behcet's disease: a randomized double-blind controlled trialINTERNATIONAL JOURNAL OF RHEUMATIC DISEASES, Issue 3 2010Cheyda CHAMS-DAVATCHI Abstract Background:, Genital aphthous ulcers of Behcet's disease (BD) are painful and usually resistant to local treatments. Pimecrolimus is an ascomycin macrolactam, used in inflammatory skin diseases. Objective:, To discover if pimecrolimus can accelerate the healing of BD genital aphthous ulcers. Methods:, Ninety patients with genital aphthous ulcers were enrolled. Only patients treated with colchicine alone were selected. All patients signed a written consent form. Patients were randomly assigned to pimecrolimus or placebo cream, applied twice daily for 1 week. The primary outcome was the healing period. Up to 7 days, it was considered as a positive result. Results were compared by chi-square test. The mean healing time was compared by analysis of variance. Analyses were done both by the ,intention-to-treat' and ,treatment-completed' methods. Results:, Both groups were similar at the entry (gender, age, ulcer size, pain intensity and treatment delay). By intention-to-treat analysis, in the pimecrolimus group, 18 patients had positive and 27 negative results. In the control group, four had positive and 41 negative results. The difference was significant (,2 = 10.167, P = 0.001). By treatment-completed analysis, with pimecrolimus, 18 patients had positive and 22 negative results. With placebo, four had positive, and 41 negative results. The difference was significant (,2 = 12.574, P = 0.0004). Comparison of mean healing time in the pimecrolimus versus placebo group, demonstrated a significant acceleration both in intention-to-treat analysis (10.7 vs. 20.7 days, F = 17.466, P < 0.0001) and treatment-completed analysis (8.3 vs. 20.7 days, F = 29.289, P < 0.0001). Conclusion:, Pimecrolimus is safe and efficient in the treatment of BD genital ulcers, by accelerating the healing process. [source] Introduction: between cultures and naturesINTERNATIONAL SOCIAL SCIENCE JOURNAL, Issue 187 2006Marie Roué How can indigenous peoples react to a situation of change that has a particularly strong effect on their youth? This article attempts to understand whether young Crees, who today find themselves all too often in a situation of double social exclusion, can complete their schooling, thus qualifying for work in the dominant society, while at the same time gaining command of the knowledge and know-how of their own society. Among the James Bay Cree Indians, some elders welcome youngsters after a period of delinquency and who are having problems into their hunting camps, and by initiating them to life "on the land" succeed in restoring their relationship with the world. This exemplary experience makes it possible to imagine solutions for helping indigenous youth fully to benefit from the two worlds in which they have roots. The elders, by inventing a healing process based on an initiation to the natural and cultural environment, offer a modern-day shamanism. [source] Healing the wounds of school by returning to the land: Cree elders come to the rescue of a lost generationINTERNATIONAL SOCIAL SCIENCE JOURNAL, Issue 187 2006Marie Roué How can indigenous peoples react to a situation of change that has a particularly strong effect on their youth? This article attempts to understand whether young Crees, who today find themselves all too often in a situation of double social exclusion, can complete their schooling, thus qualifying for work in the dominant society, while at the same time gaining command of the knowledge and know-how of their own society. Among the James Bay Cree Indians, some elders welcome youngsters after a period of delinquency and who are having problems into their hunting camps, and by initiating them to life "on the land" succeed in restoring their relationship with the world. This exemplary experience makes it possible to imagine solutions for helping indigenous youth fully to benefit from the two worlds in which they have roots. The elders, by inventing a healing process based on an initiation to the natural and cultural environment, offer a modern-day shamanism. [source] Physiological changes in tissues denervated by spinal cord injury tissues and possible effects on wound healingINTERNATIONAL WOUND JOURNAL, Issue 3 2008Laurie M Rappl Abstract There are many metabolic and physiological changes that happen to the tissues below the level of a spinal cord injury. These deficits are examined in relation to the series of events that has to take place for wound healing , the "wound healing cascade". The conclusion is that every step of the wound healing process is impaired by the physiological deficits inherent post-spinal cord injury. This may explain, in part, why pressure ulcers on these patients are so difficult to close and to maintain closed. [source] Perfusion, oxygenation and warmingINTERNATIONAL WOUND JOURNAL, Issue 2007David Leaper Abstract Perfusion, oxygenation and warming are three elements which have a significant effect on wound healing both with respect to speed and quality of healing. The effects include infection control, increased blood flow and improved quality of granulation tissue. The importance of these elements are outlined and discussed to provide and introduce the importance of oxygen in the healing process. [source] OASIS® wound matrix versus Hyaloskin® in the treatment of difficult-to-heal wounds of mixed arterial/venous aetiologyINTERNATIONAL WOUND JOURNAL, Issue 1 2007Marco Romanelli Abstract Mixed arterial/venous (A/V) ulcers are difficult to treat and slow to heal likely as a result of deficiencies in molecular and cellular elements in the wound bed. Recently, biomaterials have been developed that replace extracellular matrix (ECM) molecules and growth factors critical to the normal healing process. In this study, the effects of OASIS® and Hyaloskin® were evaluated to compare the effectiveness of these two ECM-based products in their ability to achieve complete wound healing of mixed A/V ulcers. After 16 weeks of treatment, patients in each group were evaluated on four criteria: complete wound healing, time to dressing change, pain and comfort. Complete wound closure was achieved in 82·6% of OASIS® -treated ulcers compared with 46·2% of Hyaloskin® -treated ulcers (P < 0·001). Statistically significant differences favouring the OASIS® treatment group were also reported for time to dressing change (P < 0·05), pain (P < 0·05) and patient comfort (P < 0·01). Overall, OASIS® was superior to Hyaloskin® for the treatment of patients with mixed A/V ulcers, a population in which standard treatment options largely consist of moist wound dressings and compression therapy is typically not an option. OASIS® is a useful and well-tolerated treatment for mixed A/V ulcers that has the potential to improve quality of life and reduce costs associated with standard of care. [source] A biodegradable copolymer for the slow release of growth hormone expedites scarring in diabetic ratsJOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 2 2007Francisco García-Esteo Abstract In many diseases wound healing is impaired. This study was designed to establish whether the healing process in diabetes could be improved using a site-specific polymer delivery system containing hGH. The system was first optimized in in vitro experiments performed on cultured fibroblasts taken from healthy and diabetic rats and then tested in an incisional wound model created in the diabetic Wistar rat. In the in vitro experiments using cultured fibroblasts, cell viability, growth, and proliferation were determined, along with polymer degradation, hormone release rates and the expression of TGF,1 in the culture medium. For the in vivo experiments, polymer discs with/without GH were inserted through 3 cm incisions made on the backs of the animals. Wound specimens were obtained 7 and 30 days after surgery to evaluate inflammatory/apoptotic cells, metalloprotease expression and neoangiogenesis using microscopy and immunohistochemical techniques. The local administration of GH using a polymer delivery system did not affect the normal wound healing process. Conversely, when used in diabetic animals, epidermal and dermal repair was expedited. Our findings indicate that GH induces cell proliferation, enhances CD4+ infiltration; increases extracellular matrix protein deposition; stimulates angiogenesis; and diminishes apoptosis at the diabetic wound site. These effects give rise to a comparable wound healing process to that observed in healthy animals. © 2006 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2006 [source] Expression of Dishevelled-1 in wound healing after acute myocardial infarction: possible involvement in myofibroblast proliferation and migrationJOURNAL OF CELLULAR AND MOLECULAR MEDICINE, Issue 2 2004Lijun Chen Abstract One of our previous studies indicated that the expression of ,-catenin, which is the key factor of wnt-frizzled pathway, increased significantly in the ischemic area of the rat heart 7 days after myocardial infarction (MI). Together with the results of other recent studies, we made an assumption that wnt-frizzled pathway may be involved in the controlled cell proliferation and migration during repair processes after MI. To verify this assumption we tried to investigate the expression of another signal transduction molecule called Dishevelled in wnt-frizzled pathway during the wound healing process after MI. The left descending coronary arteries of rats were ligated to induce MI. Immunohistochemistry SABC method and in situ hybridization were performed to detect the expression of Dishevelled-1. The results showed, that one day after MI, Dishevelled-1 mRNA but not protein expression was detected in the cells at the border zone of the infarction area; 4 days after MI the expression of Dishevelled-1 increased exclusively and cytoplasmic Dishevelled-1 was observed not only at the border zone but also in the infarct area; 7 days after MI, it seems that the expression reached its peak, the positive staining even spread into the endothelial and smooth muscle cells of the newly formed and pre-existing blood vessels in the infarction area; after that the Dishevelled-1 expression decreased abruptly and could hardly be detected 28 days after MI. Thus cytoplasmic Dishevelled-1 may be involved in the controlled proliferation and migration of myofibroblasts and vascular endothelial cells, hence play a role during the wound healing process after MI. [source] Nicotine inhibits myofibroblast differentiation in human gingival fibroblastsJOURNAL OF CELLULAR BIOCHEMISTRY, Issue 6 2005Yiyu Fang Abstract Cigarette smoking has been suggested as a risk factor for several periodontal diseases. It has also been found that smokers respond less favorably than non-smokers to periodontal therapy. Previous work in our lab has shown that nicotine inhibits human gingival cell migration. Since myofibroblasts play an important role in wound closure, we asked if nicotine affects gingival wound healing process by regulating myofibroblast differentiation. Human gingival fibroblasts (HGFs) from two patients were cultured in 10% fetal bovine serum cell culture medium. Cells were pretreated with different doses of nicotine (0, 0.01, 0.1, and 1 mM) for 2 h, and then incubated with transforming growth factor beta (TGF-,1) (0, 0.25, 0.5, and 1 ng/ml) with or without nicotine for 30 h. The expression level of ,-smooth muscle actin (,-SMA), a specific marker for myofibroblasts, was analyzed by Western blots, immunocytochemistry, and real-time polymerase chain reaction (real-time PCR). Phosphorylated p38 mitogen-activated protein kinase (Phospho-p38 MAPK) activity was analyzed by Western blots. TGF-,1 induced an increase of ,-SMA protein and mRNA expression, while nicotine (1 mM) inhibited the TGF-,1-induced expression of ,-SMA but not ,-actin. Nicotine treatment down-regulated TGF-,1-induced p38 MAPK phosphorylation. Our results demonstrated for the first time that nicotine inhibits myofibroblast differentiation in human gingival fibroblasts in vitro; supporting the hypothesis that delayed wound healing in smokers may be due to decreased wound contraction by myofibroblasts. © 2005 Wiley-Liss, Inc. [source] Nicotine inhibits human gingival fibroblast migration via modulation of Rac signalling pathwaysJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 12 2005Yiyu Fang Abstract Aim: Cigarette smoking is a risk factor in the development of periodontal diseases. In addition, a delayed healing process has been shown in smokers compared with non-smokers after periodontal treatment. Cell migration is a key process of wound healing and it is highly regulated by a variety of signalling pathways. The small G protein, Rac, is necessary for cell migration. Our aim was to determine if nicotine disrupted Rac and its downstream signalling proteins, p21-activated kinase 1/2 (PAK1/2), and p44/42 mitogen-activated protein kinase (MAPK) (extracellular regulated kinase 1/2). Material and Methods: Primary human fibroblasts from healthy gingival tissues were cultured and grown to confluence. Cells were serum starved for 24 h, and then treated with nicotine (0 or 0.5 ,M) prior to in vitro wounding. Cell migration was analysed in live cell assays following in vitro wounds. Rac activity, phosphorylation levels of PAK1/2, and p44/42 MAPK were assessed in cultures treated with or without nicotine after multiple wounds. Results: Nicotine decreased cell migration rates by 50% compared with controls. In addition, nicotine altered the activation patterns of Rac and PAK 1/2 and up-regulated p44/42 MAPK. Conclusion: Decreased cell migration in periodontal wounds exposed to nicotine may be mediated through the Rac and PAK1/2 signalling pathways. [source] Effect of enamel matrix proteins (Emdogain®) on healing after re-implantation of "periodontally compromised" rootsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2003An experimental study in the dog Abstract Objective: The present experiment was performed to assess whether Emdogain® applied on the root surface of extracted teeth or teeth previously exposed to root planning can protect the tooth from ankylosis following re-implantation. Material and Methods: The experiment included two groups of dogs, including five animals each. The root canals of all mandibular third premolars (3 P 3) were reamed and filled with gutta-percha. A crestal incision was placed from the area of the second to the fourth premolar. Buccal and lingual full thickness flaps were elevated. With the use of a fissure bur, the crown and furcation area of 3 P 3 were severed in an apico-coronal cut. The distal and mesial tooth segments were luxated with an elevator and extracted with forceps. Group A: The mesial and distal segments of 3 P 3 were air dried on a glass surface for 60 min. The roots from the right side were conditioned and exposed to Emdogain® application. The roots from the left side received the same treatment with the exception of Emdogain® application. The mesial and distal tooth segments were re-implanted and the crown portions were severed with a horizontal cut and removed. The buccal and lingual flaps were mobilized and sutured to obtain complete coverage of the submerged roots. Group B: A notch was prepared in each root, 4,5 mm apical of the cemento-enamel junction. The area of the root that was located coronal to the notch was scaled and planned. The roots in the right side of the mandible were treated with Emdogain®, while the roots in the left side served as controls. After 6 months of healing, the dogs were killed and blocks containing one root with surrounding tissues were harvested, and prepared for histological examination, which also included morphometric assessments. Thus, the proportions of the roots that exhibited signs of (i) replacement (ii) inflammatory and (iii) surface resorption were calculated. Results and Conclusion: It was demonstrated that healing of a re-implanted root that had been extracted and deprived of vital cementoblasts was characterized by processes that included root resorption, ankylosis and new attachment formation. It was also demonstrated that Emdogain® treatment, i.e. conditioning with EDTA and placement of enamel matrix proteins on the detached root surface, failed to interfere with the healing process. Zusammenfassung Zielsetzung: Untersuchung, ob Emdogain®, wenn es auf die Wurzeloberfläche extrahierter Zähne oder von Zähnen, die zuvor eine Wurzelglättung bekommen haben, appliziert wird, die Zähne nach Reimplantation vor Ankylose schützen kann. Material und Methoden: Die Studie wurde bei 2 Gruppen von Hunden durchgeführt, die je 5 Tiere umfasste. Die Wurzelkanäle aller 3. Prämolaren des Unterkiefers (3 P 3) wurden aufbereitet und mit Guttapercha gefüllt. Ein Schnitt auf dem Limbus alveolaris wurde vom 2. zum 4 Prämolaren geführt. Bukkal und lingual wurde ein Vollschichtlappen mobilisiert. Mit einem Fissurenbohrer wurden die 3 P 3 mit einem Schnitt in koronoapikaler Richtung im Bereich der Krone und der Furkation geteilt. Die distalen und mesialen Zahnsegmente wurden mit einem Elevator luxiert und mit einer Zange extrahiert. Gruppe A: Die mesialen und distalen Segmente von 3 P 3 wurden auf einer Glasoberfläche 60 min lang luftgetrocknet. Die Wurzeln der rechten Seite wurden konditioniert und mit Emdogain® beschickt. Die Wurzeln der linken Seite erhielten die gleiche Behandlung mit der Ausnahme, dass keine Applikation von Emdogain® erfolgte. Die mesialen und distalen Wurzeln wurden reimplantiert und die Kronenanteile durch einen horizontalen Schnitt getrennt und entfernt. Die bukkalen und lingualen Lappen wurden mobilisiert und durch Naht ein vollständiger Verschluss der reimplantierten Wurzeln erreicht. Gruppe B: In jede Wurzel wurde 4,5 mm apikal der Schmelz-Zement-Grenze eine Kerbe präpariert. Der Bereich der Wurzel, der koronal dieser Kerbe lag, wurde gescalt und wurzelgeglättet. Die Wurzeln der rechten Unterkieferseite wurden mit Emdogain® behandelt, während die Wurzeln der linken Seite als Kontrolle dienten. Nach einer Heilung von 6 Monaten wurden die Hunde getötet und Blöcke, die eine Wurzel und das umgebende Gewebe enthielten, gewonnen und für die histologische Untersuchung präpariert, die auch morphometrische Befunde einschloss. Es wurden also die Anteile der Wurzeln berechnet, die Zeichen von (i) Ersatz- (ii) entzündlicher und (iii) Oberflächenresorption zeigten. Ergebnisse und Schlussfolgerungen: Es wurde gezeigt, dass die Heilung von reimplantierten Wurzeln, die extrahiert und von vitalen Zementoblasten befreit worden waren, durch Prozesse charakterisiert war, die Wurzelresorption, Ankylose und die Bildung neuen Attachments umfassten. Es wurde gezeigt, dass die Behandlung mit Emdogain®, d.h. Konditionierung mit EDTA und Applikation des Schmelz-Matrix-Proteins auf die freie Wurzeloberfläche diesen Heilungsprozess nicht beeinflussen konnte. Résumé Objectif: Cette expérimentation fut réalisée pour déterminer si Emdogain® appliqué sur la surface radiculaire de dents extraites ou de dents préalablement soumises à un surfaçage radiculaire pouvait protéger la dent de l'ankylose après réimplantation. Matériel et Méthodes: L'expérience comprenait 2 groupes de 5 chiens. Les canaux radiculaires de toutes les troisièmes premolaires mandibulaires (3 P 3) furent alésés et bouchés à la gutta-percha. Une incision crestale de la deuxième à la quatrième prémolaire permit de soulever un lambeau de pleine épaisseur vestibulaire et lingual. La couronne et la zone de furcation de 3 P 3 furent découpées à l'aide d'une fraise fissure d'apical en coronaire. Les segments distaux et mésiaux furent luxés avec un élévateur et extraits avec un davier. Groupe A: Les segments mésiaux et distaux de 3 P 3 furent séchés à l'air sur une plaque de verre pendant 60 min. Les racines du coté droit furent préparées et imprégnées d' Emdogain®. Les racines gauches reçurent le même traitement sans application d'Emdogain ®. Les segments mésiaux et distaux furent alors réimplantés et les couronnes découpées par un trait horizontal et éliminées. Les lambeaux vestibulaires et linguaux furent déplacés et suturés pour obtenir un recouvrement complet des racines enfouies. Groupe B: Une entaille a été préparée sur chaque racine, à 4,5 mm en apical de la jonction amélo-cémentaire. La surface de racine située coronairement à cette entaille fut alors détartrée et surfacée. Les racines du coté droit furent traitées par Emdogain® alors que les racines du coté gauche firent office de contrôle. Après 6 mois de cicatrisation, les chiens furent sacrifiés et des blocs contenant une racine et les tissus environnant furent prélevés pour un examen histologique et morphométrique. Ainsi, les proportions de racine présentant des signes de (i) remplacement (ii) d'inflammation et (iii) de résorption furent calculées. Résultats et conclusion: Nous avons démontré que la cicatrisation de racine réimplantées après extraction et élimination des cémentoblastes se caractérisait par un processus qui comprenait résorption radiculaire, ankylose et formation d'une nouvelle attache. Nous avons aussi démontré que le traitement par Emdogain®, c'est à dire conditionnement à l'EDTA et mise en place de protéines de la matrice améllaire sur la surface radiculaire, ne pouvait pas interférer avec le processus de cicatrisation. [source] Enamel matrix derivative exhibits angiogenic effect in vitro and in a murine modelJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2003Kuo Yuan Abstract Objectives: Angiogenesis is one of the most critical events in the wound healing process. Any increase in angiogenesis could result in more rapid and complete healing. A recent study found that enamel matrix derivative (EMD) could accelerate early periodontal wound healing. We wanted to clarify whether EMD caused an angiogenic effect and, thus, possibly enhanced wound healing. Methods: We performed in vitro proliferation and chemotaxis assays on human umbilical vein endothelial cell (HUVEC) cultures, and a tissue culture assay using blood vessel fragments in fibrin gel. Collagen membranes soaked with EMD were implanted subcutaneously in mice to test the in vivo angiogenic effect. Results: While there were no significant differences between the negative control and EMD groups in the proliferation assay, EMD treatment did exhibit a significantly greater dose-dependent chemotactic effect on HUVEC than control group treatments. The tissue culture in fibrin gel showed new blood vessel outgrowths in the EMD groups, but none in the negative control group. In the animal studies, significantly more endothelial cells were detected in the EMD group of mice. Conclusions: Our findings show that EMD does exhibit some angiogenic effects. However, the underlying molecules and mechanisms are still unidentified. We discuss several possibilities. Zusammenfassung Ziele: Die Angiogenese gehört zu den kritischsten Ereignissen bei der Wundheilung. Eine Erhöhung der Angiogenese könnte zu einer rascheren und kompletteren Wundheilung führen. Kürzlich zeigte eine Studie, dass Schmelzmatrixderivate (EMD) die frühe parodontale Wundheilung beschleunigen könnte. Wir wollten klären, ob EMD einen angiogenetischen Effekt verursacht und dies möglicherweise die Wundheilung verbessert. Methoden: Wir führten in vitro Proliferations- und Chemotaxis-Assays an menschlichen Umbilicalvenen-Endothelzellen (HUVEC)Kulturen durch und studierten eine Gewebekultur unter Nutzung von Blutgefäßfragmenten in Fibringel. Kollagenmembranen mit EMD getränkt wurden subkutan in Mäuse implantiert, um den angiogenetischen Effekt in vivo zu testen. Ergebnisse: Während es keine signifikanten Differenzen zwischen den negativen Kontrollen und den EMD Gruppen in dem Proliferationsassay gab, zeigte die EMD Behandlung einen signifikant größeren, dosisabhängigen chemotaktischen Effekt auf HUVEC verglichen mit den Kontrollen. Die Gewebekultur im Fibringel zeigte neue Blutgefäßbildungen in den EMD-Gruppen, aber keine bei den Negativkontrollen. Bei den Tierstudien wurden signifikant mehr Endothelzellen in den EMD Mäusegruppen entdeckt. Schlussfolgerungen: Unsere Ergebnisse zeigen, dass EMD einige angiogenetische Effekte zeigt. Jedoch sind die zugrunde liegenden Moleküle und die Mechanismen noch nicht geklärt. Wir diskutieren verschiedene Möglichkeiten. Résumé Objectifs: L'Angiogenèse est un des plus critiques éléments lors du processus de cicatrisation. La moindre augmentation de l'angiogenèse peut entraîner une cicatrisation plus rapide et plus complète. Une récente étude a montré que les dérivés de la matrice amellaire (EMD) pouvait accélérer plus tôt la cicatrisation parodontale. Nous voulions clarifier la possible responsabilité de l'EMD dans l'angiogenèse et si oui, l'amélioration de la cicatrisation. Méthodes: Nous avons réalisé in vitro la prolifération et un essai de chimiotactisme sur des cultures de cellules endothéliales de la veine ombilicale humaine (HUVEC), et un essai de culture tissulaire en utilisant des fragments de vaisseaux sanguins dans un gel de fibrine. Des membranes de collagène gorgées d'EMD furent implantées en sous-cutanée chez des souris pour tester l'effet angiogénique in vivo. Résultats: Bien qu'il n'y eut pas de différences significatives entre le contrôle négatif et le groupe EMD pour le test de prolifération, le traitement par EMD présentait un effet chimiotactique dose- dépendant significativement plus élevé sur les HUVEC. La culture tissulaire sur gel de fibrine présentait une surcroissance de nouveaux vaisseaux sanguins pour le groupe EMD, mais pas dans le groupe contrôle. Plus de cellules endothéliales furent en outre détectées lors de l'étude animale, pour le groupe de souris traitées par EMD. Conclusions: Nos données montrent que l'EMD présente quelques effets angiogéniques. Cependant, les molécules et les mécanismes responsables ne sont toujours pas identifiés. Nous discutons quelques possibilités. [source] The challenge of using the low back pain guidelines: a qualitative researchJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 4 2007Rachel Dahan MD MClSc Abstract Purpose, Current low back pain (LBP) clinical guidelines have helped to summarize the scientific evidence and research, but have failed to provide tools and guide family physicians (FPs). The purpose of this study is to identify barriers and facilitators for the implementation of LBP guidelines from family FPs' perspective. Methods, A qualitative focus group study of FPs in the north of Israel. Purposeful sampling was used to recruit participants, all of them board-certified FPs. Four focus groups were created, and discussions were taped, transcribed and analysed for major themes. Results, Focus groups findings have expanded the understanding of the intellectual and mental challenges faced by Israeli FPs caring for LBP patients and highlighted the many obstacles to implementing LBP guidelines. Physicians' decision-making, pertaining to LBP, functions on three levels simultaneously: the physicians' agenda based on familiarity with the guidelines; their need to remain grounded in the context of the specific patient,doctor relationship; and the constraints and demands of the physician's workplace, medical system and environment. Conclusions, Despite an overall positive attitude towards LBP guideline implementation, FPs found it hard to come to terms with the conflicting dimensions of LBP patient care. The patient,doctor interaction determined the outcome of the encounter, whether it complied with the guidelines and whether the encounter leads to a healing process or to a vicious circle of unnecessary utilization of services. [source] Diazoxide, a KATP opener, accelerates restitution of ethanol or indomethacin-induced gastric ulceration in rats independent of polyaminesJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 3 2001M Rahgozar Abstract Background and Aims: Experimental acute gastric ulcerations (EAGU) are healed very rapidly. This healing process has two steps; mucosal restitution and delayed repair. Adenosine 5,-triphosphate (ATP)-dependent potassium channels (KATP) have a regulatory role in the gastrointestinal physiology. In the present study, the effects of KATP channel modulators; diazoxide (channel opener) and glibenclamide (channel antagonist) on the healing of EAGU were investigated. The effect of polyamine (mediators presumably responsible for restitution) biosynthesis by difluoromethylornithine (DFMO) on diazoxide-induced alterations, and the effects of acid secretion inhibitors (cimetidine, omeprazole and atropine) on the mucosal restitution of EAGU were also studied. Methods: Groups of 10 male rats were starved for 24 h and EAGU was induced by oral administration of 1 mL 60% ethanol or a subcutaneous injection of 30 mg/kg indomethacin. Different groups were subjected to various doses of diazoxide (5, 15, 45 mg/kg) and/or glibenclamide (2, 6, 18 mg/kg) administered intraperitoneally (i.p.) after EAGU induction. Polyamine biosynthesis was inhibited by a single i.p. injection of DFMO (500 mg/kg), administered 10 min before EAGU induction. Cimetidine, omeprazole or atropine were administered intraperitoneally at doses of 200, 5 and 1 mg/kg, respectively, after EAGU induction. Animals were killed and their gastric mucosa was examined for ulcerations. Results: Diazoxide accelerated the healing of EAGU, whereas glibenclamide aggravated EAGU. The concomitant administration of glibenclamide antagonized the diaoxide effect. Diazoxide-induced acceleration of mucosal restitution was not abolished by DFMO. Cimetidine, omeprazole and atropine had no effect on the healing of EAGU. Conclusion: The KATP channels may play an important role in the gastric mucosal restitution independent of polyamines. Acid inhibition cannot reverse EAGU. [source] Meal patterns and meal quality in patients with leg ulcersJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 1 2000U. Wissing Background Wound healing is a complex process, which requires adequate energy sources, proteins, and specific minerals and vitamins. If an individual is unable to get or to eat the nutrients required, the wound healing process might be disrupted. The aim of this study was to investigate food-related factors, meal patterns and meal quality in relation to nutritional status in elderly out-patients with leg ulcers. Methods Nutritional status was assessed by use of the Mini Nutritional Assessment in 70 patients living in their own homes. Fifty-six of the patients recorded actual meals and snacks over four consecutive days. Meal patterns and meal quality were evaluated with the help of a qualitative classification system, the Food Based Concept for Classification of Eating Episodes. Results Thirty-six patients were classified as well-nourished, 32 were at risk of malnutrition and two were malnourished. More patients in the risk group for malnutrition did not buy their own food, and usually ate alone. Incomplete Meals and Low Quality Snacks were the most common eating types. The patients at risk of malnutrition had significantly fewer prepared Complete Meals than the well-nourished patients. Conclusion The results show a diet and meal quality which hardly meets the requirements for nutrients that are important in wound healing, especially for those patients assessed at risk of malnutrition. [source] Study of order and dynamic processes in tendon by NMR and MRIJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 2 2007G. Navon PhD Abstract Tendons are composed of a parallel arrangement of densely packed collagen fibrils that results in unique biomechanical properties of strength and flexibility. In the present review we discuss several advanced magnetic resonance spectroscopy (MRS) and imaging (MRI) techniques that have allowed us to better understand the biophysical properties of tendons and ligaments. The methods include multiple quantum and T2 filtering combined with NMR and MRI techniques. It is shown in detail how these techniques can be used to extract a number of useful parameters: 1) the 1H- 1H and 1H- 2H dipolar interactions; 2) the proton exchange rates between water and collagen, and between water molecules; 3) the distribution of fibril orientations; and 4) the anisotropy of diffusion. It is shown that relaxation data as a function of angular dependence can be obtained in vivo using mobile NMR sensors. Finally, this article describes how double quantum filtered (DQF) MRI can be used to image and monitor the healing process in injured tendons. J. Magn. Reson. Imaging 2007. © 2007 Wiley-Liss, Inc. [source] Compression therapy promotes proliferative repair during rat Achilles tendon immobilizationJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 7 2010Nikos Schizas Abstract Achilles tendon ruptures are treated with an initial period of immobilization, which obstructs the healing process partly by a reduction of blood circulation. Intermittent pneumatic compression (IPC) has been proposed to enhance tendon repair by stimulation of blood flow. We hypothesized that daily IPC treatment can counteract the deficits caused by 2 weeks of immobilization post tendon rupture. Forty-eight Sprague-Dawley SD) rats, all subjected to blunt Achilles tendon transection, were divided in three equal groups. Group A was allowed free cage activity, whereas groups B,C were immobilized at the operated hindleg. Group C received daily IPC treatment. Two weeks postrupture the rats were euthanatized and the tendons analyzed with tensile testing and histological assessments of collagen organization and collagen III-LI occurrence. Immobilization significantly reduced maximum force, energy uptake, stiffness, tendon length, transverse area, stress, organized collagen diameter and collagen III-LI occurrence by respectively 80, 75, 77, 22, 47, 65, 49, and 83% compared to free mobilization. IPC treatment improved maximum force 65%, energy 168%, organized collagen diameter 50%, tendon length 25%, and collagen III-LI occurrence 150% compared to immobilization only. The results confirm that immobilization impairs healing after tendon rupture and furthermore demonstrate that IPC-treatment can enhance proliferative tendon repair by counteracting biomechanical and morphological deficits caused by immobilization. © 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 28:852,858, 2010 [source] BMP-7,induced ectopic bone formation and fracture healing is impaired by systemic NSAID application in C57BL/6-mice,JOURNAL OF ORTHOPAEDIC RESEARCH, Issue 6 2010Alexander S. Spiro Abstract Nonsteroidal antiinflammatory drugs (NSAIDs) are known to potentially impair the fracture healing process. The aim of the present study was to determine if the impairment of bone healing by systemic NSAID application is, at least in part, due to an interaction of NSAIDs with the bone anabolic BMP-7 pathway. Therefore, we first analyzed fracture healing in control and diclofenac-treated mice, where we not only found a significant impairment of fracture healing due to diclofenac treatment as assessed by biomechanical testing and µCT imaging, but also found high coexpression of bone morphogenetic protein-7 (BMP-7) and cyclooxygenase-2 (COX-2) within the fracture callus of both groups. To experimentally address the possible interaction between BMP-7 and COX-2, we then induced ectopic bone formation in control (n,=,10) and diclofenac-treated mice (n,=,10) by application of BMP-7 (recombinant human OP-1, rhOP-1) into the hamstring muscles. After 20 days of treatment, each ectopic bone nodule was analyzed by contact-radiography, µCT, histology, and histomorphometry. Diclofenac application decreased the trabecular number and bone mass in the ectopic bone nodules significantly due to reduced osteoblast number and activity. These data demonstrate that the bone anabolic effect of BMP-7 and fracture healing is impaired by diclofenac application, and suggest that the potential negative impact of NSAIDs on fracture healing is, at least in part, due to interference with BMP-7 signaling. © 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 28:785,791, 2010 [source] Smoking delays chondrogenesis in a mouse model of closed tibial fracture healingJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 12 2006Hossam B. El-Zawawy Abstract Smoking delays the healing process and increases morbidity associated with many common musculoskeletal disorders, including long bone fracture. In the current study, a murine model of tibial fracture healing was used to test the hypothesis that smoking delays chondrogenesis after fracture. Mice were divided into two groups, a nonsmoking control group and a group exposed to cigarette smoke for 1 month prior to surgical tibial fracture. Mice were euthanized at 7, 14, and 28 days after surgery. The outcomes measured were immunohistochemical staining for type II collagen protein expression as a marker of cartilage matrix and proliferating cell nuclear antigen (PCNA) staining to measure proliferation at the site of injury. Toluidine blue staining and histomorphometry were used to quantify areas of cartilaginous and noncartilaginous fracture callus. Radiographs were analyzed for evidence of remodeling after injury. At day 7 after injury, mice exposed to cigarette smoke had a smaller fracture callus with less cartilage matrix compared to controls. Proliferation was present at high levels in both groups at this time point, but proliferating cells had a more immature morphology in the smoking group. At day 14, chondrogenesis was more active in smokers compared to controls, while a higher percentage of bone was present in the control animals. At day 28, X-ray analysis revealed a larger fracture callus remaining in the smoking animals. Together, these findings show that the chondrogenic phase of tibial fracture healing is delayed by smoking. This study represents, to our knowledge, the first analysis of molecular and cellular mechanisms of healing in a smoking mouse fracture model. © 2006 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res [source] Intact fibula improves fracture healing in a rat tibia osteotomy modelJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 2 2005Sandra J. Shefelbine Abstract Rat tibia fractures are often used in fracture healing studies. Usually the fracture is stabilized with an intramedullary pin, which provides bending stiffness, but little torsional stiffness. The objective of this research was to determine the in vitro torsional rigidity of an osteotomized tibia with and without the fibula, and to determine if this difference influences the healing process in vivo. In vitro eleven rat tibias received an osteotomy, were stabilized with an intramedullary pin, and were tested in internal rotation to determine the torsional rigidity. The fibula was then manually broken and the torsional rigidity measured again. In vivo 18 rats received a tibial osteotomy, eight of which had an additional fractured fibula. After three weeks, the rats were sacrificed and the tibias were analyzed. Bone density in the fracture callus was measured with qCT. Bending rigidity and maximum breaking moment were determined in three-point bending. In vitro testing demonstrated that the torsional rigidity with an intact fibula was nearly two times higher than when the fibula was fractured. Though the torsional rigidity was still small in comparison with an intact bone, it resulted in a significantly different healing process in vivo. Rats with intact fibulas had significantly higher bone mineral density, bending rigidity, and maximum breaking moment compared to rats with a fractured fibula. These results indicate that torsional stability considerably affects the healing process. In a fracture model, it is critical to characterize the mechanical environment of the fracture. © 2004 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved. [source] Temporal expression of growth factors and matrix molecules in healing tendon lesionsJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 1 2005Linda A. Dahlgren Abstract Overuse tendon injuries are common among elite and recreational athletes. Tendon healing may be enhanced at the cellular level through the use of exogenous growth factors; however, little is known about the endogenous expression of growth factors in healing tendon. This study describes the temporal expression of insulin-like growth factor-I (IGF-I), transforming growth factor-,1 (TGF-,1), and collagen types I and III in healing tendon lesions. Collagenase-induced lesions were created in the tensile region of the flexor digitorum superficialis tendon of both forelimbs of 14 horses. Tendons were harvested from euthanatized horses 1, 2, 4, 8 or 24 weeks following injury. Gene expression was evaluated using Northern blot analysis (collagen types I and III), real time PCR (IGF-I and TGF-,1), and in situ hybridization. Protein content was assayed by dye-binding assay (collagen types I and III), radioimmunoassay (IGF-I), ELISA (TGF-,1), and immunohistochemistry. Samples were also processed for differential collagen typing. DNA and glycosaminoglycan content, and routine H&E staining. Microscopically, lesions progressed from an amorphous, acellular lesion soon after injury to scar tissue filled with collagen fibers and mature fibroblasts organized along lines of tension. Early lesions were characterized by immediate increases in expression of growth factors and collagen. Message levels for TGF-,1 peaked early in the wound healing process (1 week), while IGF-I peaked later (4 weeks), as the regenerative phase of healing was progressing. In the first 2 weeks after lesion induction, tissue levels of IGF-I protein actually decreased approximately 40% compared to normal tendon. By 4 weeks, these levels had exceeded those of normal tendon and remained elevated through 8 weeks. Message expression for collagen types I and III increased by 1 week following injury and remained elevated throughout the course of the study. Collagen type I represented the major type of collagen in healing tendon at all time points of the study. Based on these results, IGF-I, administered exogenously during the first 2 weeks following injury, may provide a therapeutic advantage by bolstering low endogenous tissue levels and enhancing the metabolic response of individual tendon fibroblasts. © 2004 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved. [source] | ||||||||||||||||||||||||||||||||||||||||