Preclinical evaluation of the potential of fibrin biopolymer alveolar preservation after tooth extraction. Microtomographic, histomorphometric and immunohistochemical evaluation

• Autor(a) principal: Bighetti, Ana Carolina Cestari
• Data de Publicação: 2022
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Biblioteca Digital de Teses e Dissertações da USP
• Texto Completo: https://www.teses.usp.br/teses/disponiveis/25/25149/tde-18112022-182855/
• topic: Adesivo tecidual de fibrina; Alvéolo dental; Bone resorption; Extração dentária; Fibrin tissue adhesive; Microtomografia por raio-X; Reabsorção óssea; Tooth extraction; Tooth socket; X-Ray microtomography

Tooth extraction results in significant ridge resorption, leading to alveolar bone and soft tissue changes that can compromise esthetics and complicate functional rehabilitation. The heterologous fibrin biopolymer (HFB) is a low-cost national biopharmaceutical resulting from the combination of a serine protease extracted from the venom of Crotalus durissus terrificus and a cryoprecipitate rich in fibrinogen obtained from the blood of Bubalus bubalis. Has hemostatic, adhesive, sealant and scaffolding properties. In clinical trials I/II it was shown to be safe, non-immunogenic and effective in the treatment of chronic venous ulcers. The objective of the current study was to evaluate the use of HFB in the alveolar healing process after tooth extraction. The right upper incisor of 48 rats (Rattus norvegicus, Wistar) were extracted and filled by blood clot group CS (BCG, n=24) and HFB (HFBG, n=24). After 0, 7, 14 and 42 days (n=6 per group/experimental period) the pieces with the alveoli were submitted to volumetric analysis of the microtomographic images, histomorphometric of the sections stained with hematoxylin and eosin, of the bone collagen fibers by the picrocirius method. red/quantitative polarized light of macrophages and osteoclasts in sections immunostained by tartrate-resistant acid phosphatase (TRAP). Data were submitted to ANOVA/Tukey(HSD) and Student\'s t test for comparison between periods and groups, respectively, with significance p<0.5%. In the microtomographic evaluations, the total volume of the alveolus (TV) was similar between 0 and 14 days (p>0.05; mean of 64±5.4 mm3) except in the BCG at 14 days, which was 12% lower (57±3.2 mm3). At 42 days, TV reduced an average of 15.7±8.14% (11% in the cervical third, 16% in the medial and 20% in the apical third) in the HFBG, while in the BCG the reduction was on average 29±6.67% (18% cervical, 29% medial and 40% apical). In this period, bone volume (BV) was higher in HFBG (46±5.4mm3) compared to BCG (37±5.8mm3). However, a higher bone density was observed in the BCG group and with an organic matrix composed of thicker collagen fibers than in the HFBG group. Histologically, at 14 days, greater vascularization and osteoclastic activity was observed in the BCG group than in the HFBG, associated with greater resorption of alveolar bone walls. Preclinical results showed that HFBG modulates local vascularization and reduces bone resorption/remodeling leading to greater preservation of the alveolar ridge after tooth extraction.