Applicability of homologous fibrin composite in the bone repair process associated or not with laser photobiomodulation therapy

• Autor(a) principal: Rocha, Karina Torres Pomini
• Data de Publicação: 2020
• Tipo de documento: Tese
• 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-25102021-181138/
• topic: Adesivo tecidual de fibrina; Biocompatible materials; Bioestimulação a Laser; Bone regeneration; Bone substitutes; Fibrin tissue adhesive; Heterografts; Low-level light therapy; Materiais biocompatíveis; Regeneração óssea; Substitutos ósseos; Xenoenxertos

Aim: In the search for improvement in the results of reconstructive surgical interventions that require bone repair, several therapeutic modalities have been researched. However, studies that elucidate the combined use of three-dimensional composite scaffold and non-invasive extra-operative therapies are still scarce. Thus, the objective of the first article was to develop a systematic review to compile results of scientific studies with clinically relevant in vivo test models, in order to investigate the applicability of homologous fibrin sealant as a cellular support in the bone regeneration process. The second article sought to elucidate the effects of the association of the homologous fibrin sealant incorporated with the deproteinized bovine bone matrix and laser photobiomodulation therapy in a model of critical bone defect in rat calvaria. Material and methods: Article 1 - The studies were selected from the PubMed/Medline databases, according to the PRISMA statement, through a combination of keywords, fibrin sealant and bone repair. The search filters were built using the parameters: articles over 10 years old (n = 175); without access to the full text (n = 5); not english language (n = 4). Article 2 - Thirty-six rats were divided into four groups: BC (n = 8) defect filled with blood clot, BCPBMT (n = 8) defect filled with blood clot and laser photobiomodulation, FSB (n = 10) defect filled with deproteinized bovine bone matrix plus fibrin sealant, FSBPBMT (n = 10) defect filled with deproteinized bovine bone matrix plus fibrin sealant and laser photobiomodulation. The animals were killed after 14 and 42 days and the specimens subjected to microtomographic, histological and histomorphometric analyzes. Results: Article 1 - After selecting the inclusion and exclusion criteria, 12 articles were selected from 313 initially identified. Studies have reported that the fibrin sealant is capable of providing a favorable microenvironment for the proliferation and differentiation of osteoprogenitor cells and combined with other bone grafts form multifunctional scaffolds with greater mechanical resistance, greater graft stability in the surgical bed, and longer support time throughout the bone repair process. Article 2 - In the histological and microtomographic analysis, new bone formation was observed in all groups, limited to the defect margins, and without complete wound closure. In the FSB group, bone formation increased between periods (4.3±0.46 to 6.01±0.32), yet with lower volume density when compared to the FSBPBMT (5.6±0.45 to 10.64±0.97) group. Conclusion: Article 1 - The studies analyzed pointed out that homologous fibrin sealants are capable of building a three-dimensional framework that provides support for cell growth. Article 2 - It is concluded that the support system formed by fibrin sealant derived from human blood and the deproteinized bovine bone matrix associated with the proposed laser photobiomodulation protocol was able to promote greater speed in the deposition of mineralized bone matrix.