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Introduction. Hyperbaric oxygen therapy is a treatment option for an increasing number of conditions. The aim of this study was to assess its therapeutic effects in femoral condylar necrosis as well as in normal tissue using hyperspectral imaging. Material and method. A 47-year-old female patient diagnosed with avascular necrosis of the medial femoral condyle was included in this study. The patient received hyperbaric oxygen therapy for two consecutive days (the first day: three stages of 30 min each, separated by two breaks of 5 min at pO2 = 2 ATA; the second day: three stages of 30 min each, separated by two breaks of 5 min at pO2 = 2.4 ATA). The effects of hyperbaric oxygen therapy on the affected area (patient’s knee) and normal (patient’s hand) tissues oxygenation were assessed before and after each treatment session using hyperspectral imaging. Results and discussions. The results showed that hyperspectral imaging is quite good for monitoring the hyperbaric oxygen therapy efficacy in affected areas, even with deep tissue problems. Conclusions. In conclusion, the hyperspectral imaging-based approach for monitoring hyperbaric oxygen therapy could support physicians in extracting prognostic information and making the right treatment decisions. Keywords: bone necrosis, image analysis, maps, oxyhemoglobin, deoxyhemoglobin, oxygen saturation

Sodium hypochlorite (NaOCl) is a strong antiseptic agent that is usually used as endodontic irrigant for dissolving organic parts of pulp and dentin and neutralizing toxic products. However, the use of sodium hypochlorite may cause destruction of blood vessels, soft tissues and bone necrosis if extruded into the periapical region. Urgent treatment of the NaOCl accident should be oriented on pain relief, infection control and recovery. This paper shows a case of periradicular tissue necrosis after accidental extrusion on NaOCl through fausse route of right maxillary canine, and complete tissue regeneration after surgical debridement and bone augmentation with addition of platelet rich fibrin (PRF) that occurred in a 53-year old patient at the dental clinic of Faculty of Dentistry in Pancevo.

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Medication-related osteonecrosis of the jaw (MRONJ) is related to impaired bone healing conditions in the maxillomandibular bone region as a complication of bisphosphonate intake. Although there are several hypotheses for the onset of MRONJ symptoms, one of the possible causes is the inhibition of bone turnover and blood supply leading to bone necrosis. The optimal treatment strategy for MRONJ has not been established either. BMP-2, a member of the TGF-β superfamily, is well known for regulating bone remodeling and homeostasis prenatally and postnatally. Therefore, the objectives of this study were to evaluate whether cyclophosphamide/zoledronate (CY/ZA) induces necrosis of the bone surrounding the tooth extraction socket, and to examine the therapeutic potential of BMP-2 in combination with the hard osteoinductive biomaterial, β-tricalcium phosphate (β-TCP), in the prevention and treatment of alveolar bone loss around the tooth extraction socket in MRONJ-like mice models. First, CY/ZA was intraperitoneally administered for three weeks, and alveolar bone necrosis was evaluated before and after tooth extraction. Next, the effect of BMP-2/β-TCP was investigated in both MRONJ-like prevention and treatment models. In the prevention model, CY/ZA was continuously administered for four weeks after BMP-2/β-TCP transplantation. In the treatment model, CY/ZA administration was suspended after transplantation of BMP-2/β-TCP. The results showed that CY/ZA induced a significant decrease in the number of empty lacunae, a sign of bone necrosis, in the alveolar bone around the tooth extraction socket after tooth extraction. Histological analysis showed a significant decrease in the necrotic alveolar bone around tooth extraction sockets in the BMP-2/β-TCP transplantation group compared to the non-transplanted control group in both MRONJ-like prevention and treatment models. However, bone mineral density, determined by micro-CT analysis, was significantly higher in the BMP-2/β-TCP transplanted group than in the control group in the prevention model only. These results clarified that alveolar bone necrosis around tooth extraction sockets can be induced after surgical intervention under CY/ZA administration. In addition, transplantation of BMP-2/β-TCP reduced the necrotic alveolar bone around the tooth extraction socket. Therefore, a combination of BMP-2/β-TCP could be an alternative approach for both prevention and treatment of MRONJ-like symptoms.

Avascular necrosis, diagnosed on the basis of either a specific pathological modification of the articular surfaces of bone or its radiologic appearance in vertebral centra, has been recognized in many Mesozoic marine reptiles as well as in present-day marine mammals. Its presence in the zoological and paleontologic record is usually associated with decompression syndrome, a disease that affects secondarily aquatic vertebrates that could dive. Bone necrosis can also be caused by infectious processes, but it differs in appearance from decompression syndrome-associated aseptic necrosis. Herein, we report evidence of septic necrosis in the proximal articular surface of the femur of a marine reptile, Pistosaurus longaevus, from the Middle Triassic of Poland and Germany. This is the oldest recognition of septic necrosis associated with septic arthritis in the fossil record so far, and the mineralogical composition of pathologically altered bone is described herein in detail. The occurrence of septic necrosis is contrasted with decompression syndrome-associated avascular necrosis, also described in Pistosaurus longaevus bone from Middle Triassic of Germany.

Polymethylmethacrylate (PMMA) bone cement has been widely used in orthopedic surgery for fixing prostheses and stabilizing collapsed vertebral fractures. Although it is the most popular biomaterials in orthopedics, heat generation during polymerization may cause thermal injury to the surrounding cells. Bone cells exposed to the thermal injury would secret a number of biological factors, and then locally influence a balance of bone remodeling. However, thermal tolerance of bone cells is not well understood. The aim of this study was therefore to quantify in vitro thermal injury of bone-derived cells and to establish a model to predict accumulation of the cell damage. Osteocyte, osteoblast, and fibroblast cell lines were exposed to steady supraphysiological temperatures ranging 40-75°C, and change of cell mortality depending on heating time and temperature was determined by using a dye, propidium iodide. When the cells were exposed to thermal treatment, all cell lines exhibited approximately exponential increase of cell injury at the initial phase, and then gradual decline of the increasing rate as the cell mortality approached 1. This kinetics of cell injury was described well by a logistic curve with high correlation coefficient. By comparing the slope of the logistic curves and the time to reach 50% of cell mortality, it is found that thermal tolerance of osteocytes was significantly low among three cell lines. This result indicates that thermal injury of osteocytes would be induced by the heating at a temperature that is harmless to other cell types, and both necrotic and apoptotic responses of thermally injured osteocytes might stimulate osteoclastic bone resorption.

OBJECTIVES: The purpose of this study was to evaluate the temperature change during low-speed drilling using infrared thermography. MATERIAL AND METHODS: Pig ribs were used to provide cortical bone of a similar quality to human mandible. Heat production by three implant drill systems (two conventional drilling systems and one low-speed drilling system) was evaluated by measuring the bone temperature using infrared thermography. Each system had two different bur sizes. The drill systems used were twist drill (2.0 mm/2.5 mm), which establishes the direction of the implant, and finally a 3.0 mm-pilot drill. Thermal images were recorded using the IRI1001 system (Infrared Integrated Systems Ltd.). Baseline temperature was 31±1ºC. Measurements were repeated 10 times, and a static load of 10 kg was applied while drilling. Data were analyzed using descriptive statistics. Statistical analysis was conducted with two-way ANOVA. RESULTS AND CONCLUSIONS: Mean values (n=10 drill sequences) for maximum recorded temperature (Max TºC), change in temperature (ΔTºC) from baseline were as follows. The changes in temperature (ΔTºC) were 1.57ºC and 2.46ºC for the lowest and the highest values, respectively. Drilling at 50 rpm without irrigation did not produce overheating. There was no significant difference in heat production between the 3 implant drill systems (p>0.05). No implant drill system produced heat exceeding 47ºC, which is the critical temperature for bone necrosis during low-speed drilling. Low-speed drilling without irrigation could be used during implant site preparation.

Nowadays three quarters of adolescents with cancer are cured but half of them experience a late toxic effect of antineoplastic therapy that interferes with their physical and psychosocial health. This review recapitulates late effects associated with radiation therapy, chemotherapy and surgery, reviews risk factors and prognosis and suggests follow-up and management strategies, excluding fertility issues. Adolescents with cancer should be the focus of active clinical research for the optimisation of antineoplastic treatment as well as for breakthroughs in the follow-up, prevention and management of toxic effects. © 2007 Elsevier Ltd. All rights reserved. 33 7 656 663

PubMedID: 16260355 Donor site necrosis is a very rare complication of palatal rotational flaps. The aim of this case report is to present a 43-year-old female, Type I diabetic patient with a chronic oroantral fistula in the right second molar region. The patient had bony necrosis in the donor site following palatal rotational flap operation. The treatment approach and the alternative methods are discussed. © 2005 Elsevier Inc. All rights reserved.

Background: Cooling is one of the main processes in bone temperature decrement, while drilling. this experiment was conducted for examination of alcohol effect as cooler in prevention of thermal necrosis. Methods: Bovine femur bone was considered as specimen and inclusions criteria for this study were: femur bone, cortical area and without bone periosteum. Drilling process was conducted by two types of k-wire- Trocar and Diamond, three speeds and three feed rates and in the time of march, 2016 in the place of university of Isfahan, Iran. Two type of thermometer- K-thermocouple and infrared thermometer- were used for temperature measurement, and all data were logged by data logger. Drilling processes were conducted by milling machine with ability of table movement for feed rate parameter. Method of alcohol usage in cooling was in form of conducting alcoholic gauze with k-wire while rotating. Results: Totally in the cases of trocar and diamond wires, while were cooled by alcohol, the risk of bone necrosis decreased about 44.44% and 66.66%. All temperature data were logged by changing parameters. maximum temperature, 94.5 °C, belonged to trocar wire in a non-cooling condition and after usage of cooler it decreased to 75 °C. In the usage of diamond wires, the maximum temperature was recorded 71 °C and the temperature while using alcohol was 51 °C. Diamond wire had better result in both conditions of cooling and no cooling, and this is related to geometric differences between two types of wires. Conclusion: Due to obtained data from examination, utilization alcohol can have an important influence on final bone temperature decreasing. The way of using alcohol was in the style of attrition soaked gauze onto wire while insertion.