Perimplantar repair in rats type 2 diabetics treated with the combination of antimicrobial photodynamic therapy and polyphenol compounds: biomechanical, histometric, microtomographic and molecular characterization

Abstract

Type 2 diabetes is a metabolic disease caused by the accumulation of blood glucose due to the inability of insulin to exert its effects on the body. With the advancement of dentistry, and with the increasing use of dental implants in the population, it is necessary each day more the search for alternatives that help in a better treatment for the population, such as photodynamic therapy (aPDT). The aim of this project is to search for alternatives that may aid in a non-invasive treatment, such as resveratrol action, photodynamic therapy (aPDT) or its association in non-diabetic rats and type 2 diabetic rats, through analysis of biomechanical, molecular, microtomography and by dynamic histometry 60 days after implant installation For this purpose, 128 rats will be divided into three groups: 1- Control (CO): where the animals will be normoglycemic; 2- Control + resveratrol (COR): where the animals will be normoglycemic and treated with oral resveratrol; 3- Diabetic type 2 (DM2): where the animals will be type 2 diabetics; and 4- Diabetics type 2 + resveratrol (DM2R): where the animals will be diabetic type 2 and treated with oral resveratrol. Within each group there will be four subgroups: ST- Without therapy, where the animals will not have any type of additional therapy; AM- Methylene blue, where the animals will only receive topical application of methylene blue (100 ¼g / mL) in the surgical area before the installation of the maxillary implants; FBM- photobiomodulation, where the surgical area will receive laser irradiation at low intensity; aPDT- Photodynamic antimicrobial therapy (aPDT), where the animals will receive the topical application of methylene blue (100 ¼g / mL) in the surgical area before implant installation and after 60 seconds, low intensity laser irradiation.Animals from the DM2 groups will have diabetes induced by a hyperlipidic diet for three weeks associated with a single application of streptozotocin (35mg.kg) dissolved in citrate buffer. After the verification of type 2 diabetes, all animals will undergo superior first molar extraction, and after 30 days, osseointegrated implants will be installed. At this time the therapy will be performed according to the groups. For the FBM and the aPDT, the indium-gallium-aluminum-phosphorus laser (InGaAlP, 660 nm) with 40 mW, exposure time of 60 seconds, energy of 2.4 J. The animals will undergo cardiac puncture for the ELISA test (IL-6, TNF± and TGF² kits) at 7 days after surgery and euthanized at 60 days after implanting the maxilla, respectively. In the maxillae removed after 60 days, a computerized microtomography (parameters of volume, porosity, and to characterize bone trabeculation), confocal microscopy analysis (analysis of bone dynamics peri-implant, active mineralization surface and daily bone deposition rate) and histometric analysis. The quantitative data will be submitted to the normality test and this will indicate a more adequate statistical test (parametric vs non-parametric). It will be adopted for all tests significance level of 5%. (AU)