transforming-growth-factor-beta and Oral-Fistula

Ameloblastoma is a locally aggressive tumor most often found in posterior body and angle of the mandible. Although ameloblastoma has histological characteristics of benignity, they have a high percentage of local recurrence and possible malignant development if treated improperly.. This report presents a treatment of unusual mandibular sequelae after tumor resection using recombinant human bone morphogenetic protein-2 (rhBMP-2) associated with hydroxyapatite (HA) and calcium triphosphate (TCP).. Seven months after surgery, the patient was asymptomatic, with stable occlusion and class I, without signs of infection or rejection, and bone repair with rigidity compatible to an immature bone structure was observed. Reconstruction of large mandibular bone defect with a combination of rhBMP-2 and HA/TCP achieving a satisfactory result with less invasive and minimum morbidity has been demonstrated.

Topics: Adult; Ameloblastoma; Biocompatible Materials; Bone Morphogenetic Protein 2; Bone Plates; Bone Substitutes; Bone Transplantation; Calcium Phosphates; Collagen; Cutaneous Fistula; Device Removal; Drug Carriers; Durapatite; Equipment Failure; Female; Follow-Up Studies; Humans; Mandibular Neoplasms; Oral Fistula; Plastic Surgery Procedures; Recombinant Proteins; Surgical Mesh; Surgical Wound Dehiscence; Surgical Wound Infection; Transforming Growth Factor beta

Cysts and granulomas are chronic periapical lesions mediated by a set of inflammatory mediators that develop to contain a periapical infection. This study analyzed the nature of the inflammatory infiltrate, presence of mast cells, and in situ expression of cytokines (interleukin [IL]-17 and transforming growth factor [TGF]-beta), chemokines (macrophage inflammatory protein [MIP]-1beta and monocyte chemotactic protein [MCP]-1), and nuclear transcription factor (FoxP3) in human periapical granulomas and cysts compared with a control group.. Fifty-five lesions (25 periapical cysts, 25 periapical granulomas, and 5 controls) were analyzed. The type of inflammatory infiltrate was evaluated by hematoxylin-eosin staining, and the presence of mast cells was analyzed by toluidine blue staining. Indirect immunohistochemistry was used to evaluate the expression of cytokines, chemokines, and FoxP3.. The inflammatory infiltrate mainly consisted of mononuclear cells. In cysts, mononuclear infiltrates were significantly more frequent than mixed (polymorphonuclear/mononuclear) infiltrates (P = .04). Mixed inflammatory infiltrates were significantly more frequent in patients with sinus tract (P = .0001). The number of mast cells was significantly higher in granulomas than in cystic lesions (P = .02). A significant difference in the expression of IL-17 (P = .001) and TGF-beta (P = .003) was observed between cysts and granulomas and the control group. Significantly higher IL-17 levels were also observed in cases of patients with sinus tract (P = .03).. We observed that chronic periapical lesions might experience a reagudization process that is correlated with an increased leukocyte infiltration, with the predominance of neutrophils attracted by a chemokine milieu, as well as the increased presence of IL-17.

Topics: Adult; Cell Count; Chemokine CCL2; Chemokine CCL4; Chemotaxis, Leukocyte; Female; Forkhead Transcription Factors; Humans; Interleukin-17; Leukocyte Count; Leukocytes, Mononuclear; Male; Mast Cells; Neutrophil Infiltration; Neutrophils; Oral Fistula; Periapical Granuloma; Radicular Cyst; T-Lymphocyte Subsets; T-Lymphocytes, Helper-Inducer; T-Lymphocytes, Regulatory; Transforming Growth Factor beta

The purpose of this study is to evaluate the bony regeneration of premaxillary clefts in humans using recombinant human bone morphogenetic protein type 2 in a collagen sponge carrier.. Twelve patients with unilateral clefted premaxillas were evaluated preoperatively and 4 months postoperatively. Ten patients were repaired with recombinant human bone morphogenetic protein type 2 while 2 others were grafted with anterior iliac crest particulate marrow cancellous bone. Computed tomographic studies were used to evaluate preoperative alveolar cleft volumes, postoperative bone bridge volumes, and preoperative and postoperative volume ratios.. A preoperative and postoperative volume ratio for patients repaired with recombinant human bone morphogenetic protein type 2 ranged from 24.1% to 90.6% with a mean of 71.7%. Patients who were grafted with particulate marrow cancellous bone had similar preoperative and postoperative volume ratios ranging from 71.3% to 84.9% with a mean of 78.1%.. Clefts of the anterior maxilla can have complete osseous regeneration induced by recombinant human bone morphogenetic protein type 2 as an effective alternative to conventional anterior iliac particulate marrow cancellous bone grafts.

Topics: Absorbable Implants; Alveolar Process; Bone Morphogenetic Protein 2; Bone Morphogenetic Proteins; Bone Regeneration; Bone Transplantation; Child; Cleft Palate; Collagen Type I; Drug Carriers; Female; Follow-Up Studies; Humans; Image Processing, Computer-Assisted; Male; Maxilla; Nose Diseases; Oral Fistula; Osteogenesis; Recombinant Proteins; Retrospective Studies; Tomography, X-Ray Computed; Transforming Growth Factor beta