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Gao J, Ren J, Ye H, Chu W, Ding X, Ding L, Fu Y. Thymosin beta 10 loaded ZIF-8/sericin hydrogel promoting angiogenesis and osteogenesis for bone regeneration. Int J Biol Macromol 2024; 267:131562. [PMID: 38626832 DOI: 10.1016/j.ijbiomac.2024.131562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 04/04/2024] [Accepted: 04/10/2024] [Indexed: 04/20/2024]
Abstract
Angiogenesis is pivotal for osteogenesis during bone regeneration. A hydrogel that promotes both angiogenesis and osteogenesis is essential in bone tissue engineering. However, creating scaffolds with the ideal balance of biodegradability, osteogenic, and angiogenic properties poses a challenge. Thymosin beta 10 (TMSB10), known for its dual role in angiogenesis and osteogenesis differentiation, faces limitations due to protein activity preservation. To tackle this issue, ZIF-8 was engineered as a carrier for TMSB10 (TMSB10@ZIF-8), and subsequently integrated into the self-assembled sericin hydrogel. The efficacy of the composite hydrogel in bone repair was assessed using a rat cranial defect model. Characterization of the nanocomposites confirmed the successful synthesis of TMSB10@ZIF-8, with a TMSB10 encapsulation efficiency of 88.21 %. The sustained release of TMSB10 from TMSB10@ZIF-8 has significantly enhanced tube formation in human umbilical vein endothelial cells (HUVECs) in vitro and promoted angiogenesis in the chicken chorioallantoic membrane (CAM) model in vivo. It has markedly improved the osteogenic differentiation ability of MC 3 T3-E1 cells in vitro. 8 weeks post-implantation, the TMSB10@ZIF-8/ Sericin hydrogel group exhibited significant bone healing (86.77 ± 8.91 %), outperforming controls. Thus, the TMSB10@ZIF-8/Sericin hydrogel, leveraging ZIF-8 for TMSB10 delivery, emerges as a promising bone regeneration scaffold with substantial clinical application potential.
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Affiliation(s)
- Jia Gao
- Taizhou Key Laboratory of Biomass Functional Materials Development and Application, School of Life Science, Taizhou University, Taizhou, Zhejiang 318000, PR China; College of Life Science and Medicine, Zhejiang Sci-Tech University, Hangzhou, Zhejiang 310018, PR China
| | - Jing Ren
- Institute of Antler Science and Product Technology, Changchun Sci-Tech University, Changchun, Jilin 130000, PR China
| | - Hanjie Ye
- Taizhou Key Laboratory of Biomass Functional Materials Development and Application, School of Life Science, Taizhou University, Taizhou, Zhejiang 318000, PR China
| | - Wenhui Chu
- Taizhou Key Laboratory of Biomass Functional Materials Development and Application, School of Life Science, Taizhou University, Taizhou, Zhejiang 318000, PR China.
| | - Xuankai Ding
- Taizhou Key Laboratory of Biomass Functional Materials Development and Application, School of Life Science, Taizhou University, Taizhou, Zhejiang 318000, PR China; College of Life Science and Medicine, Zhejiang Sci-Tech University, Hangzhou, Zhejiang 310018, PR China
| | - Lingzhi Ding
- Taizhou Central Hospital, Taizhou University, Taizhou, Zhejiang 318000, PR China
| | - Yongqian Fu
- Taizhou Key Laboratory of Biomass Functional Materials Development and Application, School of Life Science, Taizhou University, Taizhou, Zhejiang 318000, PR China.
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Moura NB, Ferreira CL, Lima VCS, Nunes CMM, de Marco AC, Costa ALF, Lopes SLPC, Jardini MAN. Effect of the pulsed electromagnetic field in the repair of a calvaria critical bone defect in rats: cone beam computed tomographic and histomorphometric analysis.: PEMF in the repair of a calvaria critical bone defect: CBCT analyses. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101483. [PMID: 37100171 DOI: 10.1016/j.jormas.2023.101483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 04/18/2023] [Accepted: 04/21/2023] [Indexed: 04/28/2023]
Abstract
INTRODUCTION The present study evaluated the effect of two protocols of Pulsed Electromagnetic Field (PEMF) therapy on bone neoformation on calvaria critical defects in rats. MATERIAL & METHODS 96 rats were randomly divided into 3 groups: Control Group (CG; n=32); Test Group - PEMF 1 hour (TG1h; n=32) and Test Group - PEMF 3 hour (TG3h; n=32). A Critical-size Bone Defect (CSD) was surgically created in the calvaria of rats. The animals in the test groups were exposure to PEMF for 5 days a week. The animals were euthanized at 14, 21, 45 and 60 days. The specimens were processed for volume and texture (TAn) analysis, by Cone Beam Computed Tomography (CBCT) and histomorphometric analysis, RESULTS: Histomorphometric and volume analyses revealed that there was no statistically significant difference in the repair of bone defects between groups receiving PEMF therapy and CG. TAn revealed a statistically significant difference between the groups only for the entropy parameter, in which TG1h group presented a higher value compared to CG on 21 days. TG1h and TG3h did not accelerate bone repair in calvarial critical size defect and the parameters of PEMF should be considered. DISCUSSION This study showed that PEMF application on CSD in rats does not accelerate bone repair. Although literature showed a positive association in biostimulation on bone tissue with the parameters applied, studies with other PEMF parameters are essential to verify improving this study design.
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Affiliation(s)
- Nicole Bertonde Moura
- Graduate student of institute of Science and Technology of Sao Jose dos Campos, Universidade Estadual Paulista (Unesp), São José dos Campos, SP, Brazil
| | - Camila Lopes Ferreira
- Department of Diagnosis and Surgery, Institute of Science and Technology of Sao Jose dos Campos, Universidade Estadual Paulista (unesp), Sao Jose dos Campos, SP, Brazil
| | - Victória Clarada Silva Lima
- Graduate student of institute of Science and Technology of Sao Jose dos Campos, Universidade Estadual Paulista (Unesp), São José dos Campos, SP, Brazil
| | - Camilla Magnoni Moretto Nunes
- Department of Diagnosis and Surgery, Institute of Science and Technology of Sao Jose dos Campos, Universidade Estadual Paulista (unesp), Sao Jose dos Campos, SP, Brazil
| | - Andrea Carvalho de Marco
- Department of Diagnosis and Surgery, Institute of Science and Technology of Sao Jose dos Campos, Universidade Estadual Paulista (unesp), Sao Jose dos Campos, SP, Brazil
| | - André Luiz Ferreira Costa
- Postgraduate Program in Dentistry, Cruzeiro do Sul University (UNICSUL), Sao Paulo, Sao Paulo, Brazil
| | - Sérgio Lúcio Pereirade Castro Lopes
- Department of Diagnosis and Surgery, Institute of Science and Technology of Sao Jose dos Campos, Universidade Estadual Paulista (unesp), Sao Jose dos Campos, SP, Brazil
| | - Maria Aparecida Neves Jardini
- Department of Diagnosis and Surgery, Institute of Science and Technology of Sao Jose dos Campos, Universidade Estadual Paulista (unesp), Sao Jose dos Campos, SP, Brazil.
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Freitas NRD, Guerrini LB, Esper LA, Sbrana MC, Santos CCVD, Almeida ALPFD. Photobiomodulation and Inorganic Bovine Bone in Guided Bone Regeneration: Histomorphometric Analysis in Rats. J Funct Biomater 2023; 14:jfb14050281. [PMID: 37233392 DOI: 10.3390/jfb14050281] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/10/2023] [Accepted: 05/14/2023] [Indexed: 05/27/2023] Open
Abstract
The objective of this study was to evaluate the efficacy of photobiomodulation in the bone regeneration of critical-sized defects (CSD) filled with inorganic bovine bone associated or not with collagen membranes. The study has been conducted on 40 critical defects in the calvaria of male rats, divided into four experimental groups (n = 10): (1) DBBM (deproteinized bovine bone mineral); (2) GBR (DBBM+collagen membrane); (3) DBBM+P (DBBM+photobiomodulation); and (4) GBR+P (GBR+photobiomodulation). At 30 days postoperative, the animals were euthanized, and after the tissue had been processed, histological, histometric, and statistical analyses were performed. The analyses have taken into account newly formed bone area (NBA), linear bone extension (LBE), and residual particle area (RPA) as variables. The Kruskal-Wallis test has been performed, followed by the Dwass-Steel-Critchlow-Fligner test for comparison between groups (p < 0.05). When the DBBM+P group was compared to the DBBM group, it was possible to observe significant statistical differences in all the variables analyzed (p < 0.05). The application of photobiomodulation in guided bone regeneration (GBR+P) has shown a decrease in the median value for the RPA variable (26.8) when compared to the GBR group (32.4), with a significant statistical difference; however, for NBA and LBE, the therapy has not provided significant results.
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Affiliation(s)
- Nicole Rosa de Freitas
- Postgraduate Program, Bauru School of Dentistry, University of São Paulo, Bauru 17012-901, Brazil
| | - Luísa Belluco Guerrini
- Postgraduate Program, Bauru School of Dentistry, University of São Paulo, Bauru 17012-901, Brazil
| | - Luis Augusto Esper
- Periodontics Sector, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru 17012-900, Brazil
| | - Michyele Cristhiane Sbrana
- Periodontics Sector, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru 17012-900, Brazil
| | | | - Ana Lúcia Pompéia Fraga de Almeida
- Periodontics Sector, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru 17012-900, Brazil
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru 17012-901, Brazil
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Fekrazad S, Sohrabi M, Fekrazad R. Angiogenetic and anti-inflammatory effects of photobiomodulation on bone regeneration in rat: A histopathological, immunohistochemical, and molecular analysis. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2023; 238:112599. [PMID: 36493717 DOI: 10.1016/j.jphotobiol.2022.112599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 04/27/2022] [Accepted: 11/10/2022] [Indexed: 11/17/2022]
Abstract
Post-surgical bone defects require new alternative approaches for a better healing process. For this matter, photobiomodulation therapy (PBMT) has been used in order to improve the process of healing, pain, and inflammation reduction and tissue rejuvenation. This study is set to evaluate the effect of PBMT on angiogenic and inflammatory factors for bone regeneration in rat post-surgical cranial defects. Thirty male Wistar rats were distributed accidentally into two groups (Subdivided into 3 groups according to their follow-up durations). During operation, an 8-mm critical-sized calvarial defect was made in each rat. A continuous diode laser was used (power density 100 mW/cm2, wavelength 810 nm, the energy density of 4 J/cm2). Bone samples were assessed histomorphometrically and histologically after hematoxylin and eosin (H&E) staining. ALP, PTGIR, OCN, and IL-1 levels were measured by RT-PCR. VEGF expression was studied by immunohistochemistry analysis. The level of IL-1 expression decreased significantly in the PBMT group compared to the control after 7 days (p < 0.05), while, the PTGIR level was improved significantly compared to the control group after 7 days. Furthermore, levels of OCN and ALP improved after PBM use; however, the alterations were not statistically meaningful (p > 0.05). Evaluation with IHC displayed a significant rise in VEGF expression after 3 days in the PBMT group compared to the control (p > 0.05). In this study's conditions, the results showed a meaningful alteration in osteogenic, inflammatory, and angiogenic mediators in post-surgical calvarial defect following PBMT. It appears that PBM can accelerate angiogenesis in the bone healing procedure which can be helpful in bone tissue engineering.
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Affiliation(s)
- Sepehr Fekrazad
- Department of General Surgery, Subdivision of Surgical Oncology, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Mona Sohrabi
- Department of Pediatrics, Dental School, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Reza Fekrazad
- Radiation Sciences Research Center, AJA University of Medical Sciences - International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
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De Marco AC, Cavassini Torquato L, Camacho Ribeiro T, Moretto Nunes C, Vicensotto Bernardo A, Martins Maciel CC, Alberto Pereira K, Neves Jardini MA, Pedrine Santamaria M. Effect of Photobiomodulation Therapy Associated With Biphasic Phosphate Calcium on Bone Repair: A Histomorphometric Study in Rats. J Lasers Med Sci 2022; 13:e33. [PMID: 36743134 PMCID: PMC9841385 DOI: 10.34172/jlms.2022.33] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 06/30/2022] [Indexed: 01/27/2023]
Abstract
Introduction: This study aimed to investigate the effects of photobiomodulation (PBM) therapy associated with biphasic calcium phosphate on calvaria critical defects in rats. Methods: Forty-eight (90 days old) adult male rats (Rattus norvegicus, Albinus variation, Wistar) received critical defects of 5 mm in diameter, which were made on their skull, and they were randomly assigned into the following groups: C-blood clot, B-biphasic calcium phosphate, L-photobiomodulation therapy, and B + L-biphasic calcium phosphate + photobiomodulation therapy. A low-level a gallium aluminum arsenide (GaAlAs) laser was applied in a single dose during surgery, in a wavelength of 660 nm and total energy density of 45 J/cm2. On 30th and 60th days, the animals from each group were euthanized. Histological and histomorphometric analyses were performed. Results:In 30 days, almost all specimens (C, L, B and B + L) showed bone neoformation areas in regions near the borders of the surgical defect. In 60 days, in many specimens (C, L, B, B + L), it was possible to see a narrow neoformed bone structure along almost the whole extension of the surgical defect, though it was thinner than the original calvary bone. Data were recorded as mean ± standard deviation, and after normality was tested, a suitable statistical test was applied (α = 5%). On day 60, there was a statistically significant difference when comparing the proportion of neoformation area between group L (0.52%±0.13) and group B+L (0.20%±0.08). Group L showed a difference compared with all the groups when we compared the remaining distance between the edges of neoformed bone (C×L, P=0.0431; B × L, P=0.0386; L×B+L, P=0.0352), demonstrating a great defect closure. Conclusion: Our findings suggest that although biphasic calcium phosphate exerts some osteogenic activity during bone repair, PBM therapy is not able to modulate this process.
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Affiliation(s)
- Andréa Carvalho De Marco
- Assistant Professor, Department of Diagnosis and Surgery – Division of Periodontology, Sao Paulo State University (UNESP), Institute of Science and Technology, Campus Sao Jose dos Campos, Brazil,Correspondence to Andréa Carvalho De Marco, ,
| | - Letícia Cavassini Torquato
- Department of Diagnosis and Surgery – Division of Periodontology, Sao Paulo State University (UNESP), Institute of Science and Technology, Campus Sao Jose dos Campos, Brazil
| | | | - Camilla Moretto Nunes
- Professor, Division of Periodontology Pre-clinical, Faculdade Santo Antônio, Caçapava, Brazil
| | | | - Clarissa Carvalho Martins Maciel
- Department of Diagnosis and Surgery – Division of Periodontology, Sao Paulo State University (UNESP), Institute of Science and Technology, Campus Sao Jose dos Campos, Brazil
| | - Kauê Alberto Pereira
- Department of Diagnosis and Surgery – Division of Periodontology, Sao Paulo State University (UNESP), Institute of Science and Technology, Campus Sao Jose dos Campos, Brazil
| | - Maria Aparecida Neves Jardini
- Associated Professor, Department of Diagnosis and Surgery – Division of Periodontology, Sao Paulo State University UNESP, Institute of Science and Technology, Campus Sao Jose dos Campos, Brazil
| | - Mauro Pedrine Santamaria
- Associated Professor, Department of Diagnosis and Surgery – Division of Periodontology, Sao Paulo State University UNESP, Institute of Science and Technology, Campus Sao Jose dos Campos, Brazil
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De Marco AC, Torquato LC, Gonçalves PR, Ribeiro TC, Nunes CM, Bernardo DV, Gomes MF, Jardini MAN, Santamaria MP. The Effect of Photobiomodulation Therapy in Different Doses on Bone Repair of Critical Size Defects in Rats: A Histomorphometric Study. J Lasers Med Sci 2022; 12:e53. [PMID: 35155138 DOI: 10.34172/jlms.2021.53] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 04/25/2021] [Indexed: 12/19/2022]
Abstract
Introduction: Photobiomodulation therapy (PBM) appears to induce osteogenesis and stimulate fracture repair; because of its capacity, it is considered a promising treatment, but the characteristics of response to different radiation doses must be investigated through in vivo studies to establish their safety and effectiveness. Thus, this paper aims to analyze the effects of the PBM at different doses on the repair of critical bone defects through histological and histomorphometric analyses. Methods: Sixty 90-day-old adult rats (Rattus norvegicus, albinus, Wistar) weighing approximately 300 g were used. Critical bone defects of 5 mm in diameter were performed in their calvaria. The animals were randomly separated into 5 groups: C-Blood clot, L15-PBM 15J/cm2, L30-PBM 30 J/ cm2, L45-PBM 45 J/cm2, L60-PBM 60 J/cm2. Each group was subdivided according to observation periods of 30 and 60 days with 6 rats in each subgroup. Low-level gallium aluminum arsenide (GaAlAs) lasers were used at a 660 nm wavelength, 30 mW and 0.04 cm2 in area. The PBM was applied over 5 points; 4 points of application were distributed on the edges while one point of application was located in the center of the bone defect. PBM occurred right after the procedure. In 30 and 60 days, the animals were euthanized by anesthesia overdose and the analyses were performed. The data were analyzed statistically by the ANOVA, together with the Tukey test, whose significance level was 5%. Results: As regards the treatment factor, the highest percentage of bone neoformation was achieved by group L45-60. The group with the highest closure, despite not having a statistically significant difference with the other doses, was 45 J with only 0.49 mm between edges. Conclusion: Thus, the present study allowed concluding that the highest percentage of bone neoformation area was achieved at 45 J/cm2 in 60 days; that is, it was significantly effective in comparison with other doses.
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Affiliation(s)
- Andrea Carvalho De Marco
- Department of Diagnosis and Surgery - Division of Periodontology, São Paulo State University (UNESP), Institute of Science and Tecnology, Campus São José dos Campos, Sao Paulo, Brazil
| | - Letícia Cavassini Torquato
- Department of Diagnosis and Surgery - Division of Periodontology, São Paulo State University (UNESP), Institute of Science and Tecnology, Campus São José dos Campos, Sao Paulo, Brazil
| | | | | | - Camilla Moretto Nunes
- Department of Diagnosis and Surgery - Division of Periodontology, São Paulo State University (UNESP), Institute of Science and Tecnology, Campus São José dos Campos, Sao Paulo, Brazil
| | | | - Mônica Fernandes Gomes
- Department of Biosciences and Oral Diagnosis, São Paulo State University (UNESP), Institute of Science and Technology, Campus São José dos Campos, Sao Paulo, Brazil
| | - Maria Aparecida Neves Jardini
- Department of Diagnosis and Surgery - Division of Periodontology, São Paulo State University (UNESP), Institute of Science and Tecnology, Campus São José dos Campos, Sao Paulo, Brazil
| | - Mauro Pedrine Santamaria
- Department of Diagnosis and Surgery - Division of Periodontology, São Paulo State University (UNESP), Institute of Science and Tecnology, Campus São José dos Campos, Sao Paulo, Brazil
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Torquato LC, Suárez EAC, Bernardo DV, Pinto ILR, Mantovani LO, Silva TIL, Jardini MAN, Santamaria MP, De Marco AC. Bone repair assessment of critical size defects in rats treated with mineralized bovine bone (Bio-Oss®) and photobiomodulation therapy: a histomorphometric and immunohistochemical study. Lasers Med Sci 2021; 36:1515-1525. [PMID: 33400010 DOI: 10.1007/s10103-020-03234-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 12/22/2020] [Indexed: 10/22/2022]
Abstract
This study aimed to investigate the effects of administering photobiomodulation therapy (PBM) with bovine bone matrix on critical size defects in rats. Seventy-two adult male rats (albinus, Wistar), 90 days old, were used. Defect of 5 mm in diameter was made in their calvaria. The animals were divided into 4 groups: C-blood clot, B-Bio-Oss®, L-PBM, B+L-Bio-Oss®+PBM. Each group has been subdivided into 07, 30, and 60 days of observation. For PBM, a low GaAlAs energy of 660 nm was irradiated, total energy density of 45 J/cm2 . PBM was conducted in a trans-surgical form once only. For immunohistochemistry, a semi-quantitative analysis was made of expression of osteoprotegerin (OPG), nuclear kappa B-factor ligand receptor activator (RANKL), and tartrate-resistant acid phosphatase (TRAP). All histomorphometric data were statistically analyzed by ANOVA and Tukey test, significance level of 5%. The groups that showed the highest proportion of neoformation were L (0.39% ± 0.13) and C (0.37% ± 0.97), but groups B and B+L had larger defect size (C-1.75 mm2 ± 0.40, B-3.02 mm2 ± 0.63, L-2.45 mm2 ± 0.53, B+L-3.23 mm2 ± 1.01). In immunohistochemistry, groups B and B+L had higher immunostaining scores for OPG and RANKL at 60 days, and TRAP immunostaining increased in all groups at 30 days, but group L was the only one to present specimens with score 0. Although, at 60 days, groups L and C presented the highest proportion of bone neoformation, at 30 days group B+L had more than twice as much bone neoformation as group B, the choice of treatment application should depend on the aim of the treatment.
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Affiliation(s)
- Letícia Cavassini Torquato
- Department of Diagnosis and Surgery, São Paulo State University (UNESP), Institute of Science and Technology, Av. Eng. Francisco José Longo, n° 777 - Jardim São Dimas, São José dos Campos, SP, 12245-000, Brazil.
| | - Eduardo Antonio Chelin Suárez
- Department of Diagnosis and Surgery, São Paulo State University (UNESP), Institute of Science and Technology, Av. Eng. Francisco José Longo, n° 777 - Jardim São Dimas, São José dos Campos, SP, 12245-000, Brazil
| | - Daniella Viscensotto Bernardo
- Department of Diagnosis and Surgery, São Paulo State University (UNESP), Institute of Science and Technology, Av. Eng. Francisco José Longo, n° 777 - Jardim São Dimas, São José dos Campos, SP, 12245-000, Brazil
| | | | | | - Thiago Igor Lemes Silva
- São Paulo State University (UNESP), Institute of Science and Technology, São José dos Campos, SP, Brazil
| | - Maria Aparecida Neves Jardini
- Department of Diagnosis and Surgery - Division of Periodontology, São Paulo State University (UNESP), Institute of Science and Tecnology, São José dos Campos, SP, Brazil
| | - Mauro Pedrine Santamaria
- Department of Diagnosis and Surgery - Division of Periodontology, São Paulo State University (UNESP), Institute of Science and Tecnology, São José dos Campos, SP, Brazil
| | - Andrea Carvalho De Marco
- Department of Diagnosis and Surgery - Division of Periodontology, São Paulo State University (UNESP), Institute of Science and Tecnology, São José dos Campos, SP, Brazil
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