Pain Control and Molecular Mechanisms as Factors for Tissue Regeneration in Dentistry in Healthy and Diabetic Patients

Aims of the project are to investigate the contribution of VEGF, HIF-1, BMP-2, NO and NOS in impaired function and healing of different oral tissues (mucosal lesions, gingiva, regenerated bone defects, dental pulp, parotid gland, blood vessels, peri-implant tissue) induced by diabetes mellitus (DM) and oral surgical procedures in humans and animal models. The methods used for such analyses will be: ELISA, RT-PCR, pharmacological receptor study and histomorphometry. The control of the early stage of regenerative therapy will be evaluated using the measurement of blood flow of treated sites (Laser Doppler Flowmetry). Regarding the final regenerative treatment using dental implants, the measure of implant stability according to the regenerated sites of implant placement under the different loading protocols, will be performed by the resonance frequency analysis (Osstell mentor). All these surgical procedures represent painful conditions, which have to be properly controlled to avoid potential stress especially in diabetic patients. Focused on that, the project will include the study of newer local anaesthetics, more successful additional techniques of local anaesthesia, safer vasoconstrictors and more efficient control of postoperative pain. We expect that the results of this study could enable therapeutic use of growth factors in an increasingly important strategy to regenerate by DM damaged oral tissues and to reduce the potential surgical stress in diabetic patients.