Propiedades osteoinductivas de la dentina en regeneración ósea. Estudio preliminar

Abstract

espanolIntroduccion: El concepto de preservacion alveolar esta relacionado con los procedimientos llevados a cabo tras realizar una exodoncia dentaria con el fin de reducir la reabsorcion dentro del alveolo. La dentina ha sido propuesta como un biomaterial para este fin. Este articulo tiene como proposito evaluar la efectividad de la dentina en la preservacion alveolar y contrastar sus propiedades. Material y Metodo: Se presentan como parte de un estudio en desarrollo los primeros casos tras realizar exodoncias multiples. Determinamos un alveolo de estudio preservado con dentina y un alveolo control en el que estabilizamos el coagulo. La estabilidad dimensional de ambos alveolos se valoro mediante CBCT pasadas 8 y 16 semanas. Tras este periodo colocamos dos implantes experimentales de superficie Bioecth®. A las 16 semanas fueron explantados con trefina y sustituidos por implantes convencionales. Estas muestras fueron analizadas histologica e histomorfometricamente. Resultados: En el analisis tomografico apreciamos mayor estabilidad dimensional en el lado estudio. Histologicamente observamos ausencia de celulas inflamatorias, o signos de reaccion a cuerpo extrano, ademas de particulas de dentina completamente rodeadas de hueso neoformado, y frentes osteogenicos partiendo de particulas de dentina. Discusion: Los resultados obtenidos a partir de este estudio en humanos estan en consonancia con lo que ha sido descrito en la literatura. Observamos a nivel tomografico menor variacion dimensional en los alveolos donde se llevo a cabo la preservacion con dentina particulada, estos resultados sumados al analisis histologico contrastan las propiedades descritas para injertos particulados de dentina no desmineralizada, biocompatibilidad, osteoconduccion y osteoinduccion. EnglishIntroduction: The concept of alveolar preservation is related to the procedures carried out after perfor-ming a tooth extraction in order to reduce resorption within the alveolus. Dentin has been proposed as a biomaterial for this purpose. The aim of this article is to evaluate the effectiveness of dentin in alveolar preservation and to contrast its properties. Material and Method: The first cases are presented as part of a work in progress study after multiple extractions. It is determined a study socket preserved with dentin and a control socket in which the clot is stabilized.The dimensional stability of both sockets was assessed by CBCT after 8 and 16 weeks. After this period, two experimental Bioecth® surface implants were placed. After 16 weeks these were explanted with trephine and replaced with conventional implants. The samples were analyzed histologically and histomorphometrically. Results: In the tomographic analysis it was observed greater dimensional stability on the study side. It was noted the absence of inflammatory cells, or signs of foreign body reaction in the histology. In addition, dentin particles were completely surrounded by newly formed bone, and appeared osteogenic fronts as-sociated with these particles. Discusion: The results obtained from this study in humans are in line with what has been described in scientific papers. At the tomographic level, it was observed less dimensional variation in sockets where the preservation with particulate dentin was carried out. These results added to the histological analisis, contrast the properties described for particulate grafts of non-demineralized dentin, biocompatibility, osteoconduction and osteoinduction