Enxerto ósseo com rhBMP-2 em pacientes com fissuras labiopalatinas: análise histológica / rhBMP-2 alveolar bone graft in individuals with cleft lip and palate: histological analysis

Taylline das Mercês Gonçalves, Rafael Almeida Monteiro, Maria da Conceição Andrade de Freitas, Nilton Cesar Nogueira dos Santos, Adna Barros Ismerim, Daniela Gamba Garib, Roberta Martinelli Carvalho, Terumi Okada Ozawa

Abstract


Este estudo avaliou histologicamente os tecidos ósseos removidos da região da fissura alveolar enxertada com rhBMP-2 em pacientes com fissuras labiopalatinas, 6 a 46 meses após a cirurgia. O grupo experimental foi composto por 13 pacientes com caninos retidos na região alveolar enxertada com rhBMP-2 (Infuse®). O grupo controle foi composto por seis pacientes com caninos retidos na região alveolar contralateral ou próxima à fissura não enxertada e um com canino retido na área enxertada com osso autógeno da crista ilíaca. No ato da exposição cirúrgica do canino, 6 a 46 meses após o enxerto ósseo secundário, as biópsias dos tecidos ósseos foram retiradas e submetidas a análise histológica pela técnica hematoxilina e eosina. Os cortes microscópicos do grupo experimental (n=12) evidenciaram fragmentos de tecido ósseo viável, com osteócitos normais em lacunas, osteoblastos na superfície óssea e espaços medulares preenchidos por tecido conjuntivo fibroso e vasos sanguíneos. O quadro histológico das biópsias de tecido ósseo removidas num período de 6 a 9 meses de enxertia evidenciaram trabéculas ósseas mais desorganizadas, sem formações lamelares e com maior densidade de osteócitos por área, indicando menor grau de maturidade óssea. As do período 24 a 46 meses eram compostas somente por tecido ósseo maduro de arranjo lamelar contendo linhas de reversão/incrementais e lacunas de osteócitos. Os fragmentos de tecidos ósseos removidos da área da fissura enxertada com rhBMP-2 apresentaram morfologia histológica normal, assemelhando-se com as características teciduais do grupo controle.


Keywords


Fissura labiopalatina, Enxerto ósseo, rhBMP-2.

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DOI: https://doi.org/10.34119/bjhrv4n5-052

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