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Statement of problem Strontium has been validated for potent bone-seeking and antiosteoporotic properties and elicits a potentially beneficial impact on implant osseointegration in patients with osteoporosis. However, the efficacy of strontium supplementation on improving new bone formation and implant osseointegration in the presence of osteoporotic bone is still unclear. Purpose The purpose of this systematic review was to comprehensively assess the efficacy of strontium supplementation, encompassing oral intake and local delivery of strontium, on implant osseointegration in patients with osteoporosis. Material and methods Searches on electronic databases (MEDLINE or PubMed, Web of Science, EBSCO, Embase, and Clinicaltrials.gov ) and manual searches were conducted to identify relevant preclinical animal trials up to June 2020. The primary outcomes were the percentage of bone-implant contact and bone area; the secondary outcomes were quantitative parameters of biomechanical tests and microcomputed tomography (μCT). Results Fourteen preclinical trials (1 rabbit, 1 sheep, and 12 rat), with a total of 404 ovariectomized animals and 798 implants, were eligible for analysis. The results revealed a significant 17.1% increase in bone-implant contact and 13.5% increase in bone area, favoring strontium supplementation despite considerable heterogeneity. Subgroup analyses of both bone-implant contact and bone area exhibited similar outcomes with low to moderate heterogeneity. Results of biomechanical and μCT tests showed that strontium-enriched implantation tended to optimize the mechanical strength and microarchitecture of newly formed bone despite moderate to generally high heterogeneity. Conclusions Based on the available preclinical evidence, strontium supplementation, including local and systemic delivery, showed promising results for enhancing implant osseointegration in the presence of osteoporosis during 4 to 12 weeks of healing. Future well-designed standardized studies are necessary to validate the efficacy and safety of strontium supplementation and to establish a standard methodology for incorporating Sr into implant surfaces in a clinical setting.

The spectrum of bone lesions in axial spondyloarthritis is of great interest. With inflammation and mechanical influence concurrence in the background, both tissue gain and tissue loss in a particular bone area can occur simultaneously. Moreover, if vertebral bone mass loss, perhaps, can be easily explained by chronic systemic inflammation, the reason of its gain, observed in axial spondyloarthritis remains a mystery. It is unclear whether it is a consequence of enhanced recovery processes after injury, adaptation to altered mechanical stress, response to inflammatory cells activation or cytokines, produced by them, or changes in Wnt signaling pathways (for example). Whether these factors act individually or collectively is also unclear.

OBJECTIVES The present study was performed to compare the effectiveness of Ankaferd Blood Stopper® (ABS) with enamel matrix derivatives (EMD) for treating fenestration defects in rats. MATERIALS AND METHODS Forty-eight male Wistar rats were randomly divided into six groups (each n = 8). Fenestration defects were created in all rats, to which ABS, EMD, or saline (S) was then applied. The rats were grouped and sacrificed at one of two different time points, as follows: ABS-10-group, ABS-treatment/sacrifice on day 10; EMD-10-group, EMD-treatment/sacrifice on day 10; S-10-group, S-treatment/sacrifice on day 10; ABS-38-group, ABS-treatment/sacrifice on day 38; EMD-38-group, EMD-treatment/sacrifice on day 38; and S-38-group, S-treatment/sacrifice on day 38. Then, histomorphometric analysis including measurements of new bone area (NBA) and new bone ratio (NBR), and immunohistochemical analysis including the determination of osteopontin (OPN) and type-III-collagen (C-III) expression were performed. RESULTS The NBA and NBR were significantly higher in the ABS-10-group and EMD-10-group compared to the S-10-group (p

Objective:The current study aimed to assess the relationship between protein intake and bone parameters among dynapenic-obese older adults.Design:The current study is a secondary analysis with an a posteriori and exploratory design.Setting:Subjects were recruited from the community via social communication (flyers and meetings in community centres) in the Great Montreal area.Participants:Twenty-six subjects were divided a posteriori into two groups according to their usual protein intake: PROT−: < 1 g/kg per d (n 13; women: 53·8 %; 66·5 (sd 3·3) years) and PROT+: > 1·2 g/kg per d (n 13; women: 61·5 %; 67·2 (sd 2·7) years).Results:Both groups were comparable for age (PROT−: 66·5 (sd 3·3) v. PROT+: 67·2 (sd 2·7) years, P = 0·61) and gender (women: PROT−: n 7; 53·8 % v. PROT+: n 8; 61·5 %, P = 0·69). The PROT− group had a higher marrow area (P = 0·049), a greater bone compressive strength (P = 0·048) and a larger total bone area (P = 0·045) than the PROT+ group. However, no significant difference between the two groups was observed regarding body composition (fat and lean masses) or muscle composition.Conclusions:A lower protein intake seems to be associated with bone sizes, which influence bone strength, but do not influence bone density among dynapenic-obese older people.

Background. The aim of this study was to assess the volumetric stability and bone formation in grafts with Bio-Oss and autogenous bone at different proportions in rabbit calvaria. Material and Methods. Ten rabbits received four titanium cylinders in their calvaria and randomly divided into the following groups: Group I: Bio-Oss (100%), Group II: Bio-Oss (75%) + autogenous bone (25%), Group III: Bio-Oss (50%) + autogenous bone (50%), and Group IV: autogenous bone (100%). After twelve weeks, the animals were euthanized, and samples were collected for clinical and histological analysis. Results. Clinical analysis showed that Groups I (90.43 ± 8.99) and II (90.87 ± 7.43) had greater dimensional stability compared to Group IV (P=0.0005). Histologically, Groups I, II, and III showed areas of bone formation with particles of biomaterial remaining in close contact with the newly formed bone. However, there were no significant differences between the groups regarding the newly formed bone area. Conclusion. It was concluded that the use of Bio-Oss either alone or associated with the autogenous bone at a proportion of 25% showed superior dimensional stability compared to the use of autogenous bone in the proposed experimental model.

PURPOSE This study represents a systematic review of the literature to assess the effectiveness of strontium-coated titanium surfaces on osseointegration in experimental assays with healthy, nonosteoporotic and/or nonosteopenic animals. MATERIALS AND METHODS An electronic search was conducted of the databases MEDLINE/PubMed, Wiley Library, and Web of Science through 2018, with the aim of identifying studies on the osseointegration of titanium implants modified with strontium. RESULTS A total of 255 papers were found, of which 11 were included in this systematic review. The primary result was the percentage of bone-to-implant contact (BIC) around the titanium implants with or without a strontium-coated surface. The different techniques used to coat titanium surfaces with strontium recorded significant results in terms of the improvement in the implant's quality, as they increased its contact with the bone, bone area, and bone formation, as well as enhanced its biomechanical properties. CONCLUSION Nine of 11 studies reported that titanium implants coated with strontium showed significantly higher BIC (P < .001 to P < .05). This coating also improved the implants' biomechanical properties.

Objective: The aim of this study was to evaluate the effect of teriparatide (PTH 1-34, rhPTH) on a rabbit defect model with local xenogen grafts histomorphometrically and radiologically. Methods: For this purpose, two 10 mm diameter critical-size defects were created in the calvaria of 16 rabbits. In the control group, the defect area was filled with a xenogen graft, while in the teriparatide group (PTH 1-34), a xenogen graft combination with 20 mcg teriparatide was used. For both 4 – week and 8 – week study groups, new bone, residual graft, and soft tissue areas were evaluated as well as bone volume histomorphometrically and radiologically. Results: Histomorphometrically, there was a significant difference in new bone area values at the 8th week (p 0.05). There was no statistically significant difference between the groups at both 4 and 8 weeks (p > 0.05). In the radiologically measured total bone volume values, PTH1-34 group values were found to be significantly higher for both 4 – and 8 – weeks values compared to the control groups (p

Objectives The aim of this study was to assess the influence of transgingival compared with submerged healing on peri-implant bone maintenance around a novel, fully tapered implant in a healed crestal ridge in minipigs. Materials and methods In each of 12 minipigs, two implants (Straumann® BLX, Roxolid® SLActive®, Ø 3.75 × 8 mm) were placed. Implants were either left for submerged or for transgingival healing for 12 weeks. Measurements performed were bone-to-implant contact (BIC), first bone-to-implant contact (fBIC), bone area to total area (BATA), perpendicular bone crest to implant shoulder (pCIS), bone height change from placement, and bone overgrowth (for submerged implants). Results No significant differences were found between transgingival and submerged healing in any of the measured parameters, except for BATA on the buccal aspect in which significantly more bone formation was found for the transgingival healing group. For both groups, there was a gain in crestal bone height during the 12-week healing period. Conclusions Loaded compared with unloaded implants displayed comparable levels of osseointegration and equivalent marginal bone levels. This qualifies the implant placement protocol with respect to the osteotomy dimensions and subcrestal placement protocol for immediate loading. Clinical relevance The here presented results related to osseointegration and crestal bone maintenance after submerged or transgingival healing have demonstrated a high level of consistency in the used in vivo translational model. The obtained results support the translation of the novel implant type in conjunction with the developed surgical workflow and placement protocol into further clinical investigation and use.

The multi-spiked connecting scaffold (MSC-Scaffold) prototype is the essential innovation in the fixation of components of resurfacing total hip arthroplasty (THRA) endoprostheses in the subchondral trabecular bone. We conducted the computed micro-tomography (micro-CT) assessment of the subchondral trabecular bone microarchitecture before and after the MSC-Scaffold embedding in femoral heads removed during long-stem endoprosthesis total hip arthroplasty (THA) of different bone densities from 4 patients with hip osteoarthritis (OA). The embedding of the MSC-Scaffold in subchondral trabecular bone causes the change in its relative area (BA/TA, bone area/total area ratio) ranged from 18.2% to 24.7% (translating to the calculated density ρB relative change 11.1–14.4%, and the compressive strength S relative change 75.3–122.7%) regardless of its initial density (before the MSC-Scaffold embedding). The densification of the trabecular microarchitecture of subchondral trabecular bone due to the MSC-Scaffold initial embedding gradually decreases with the increasing distance from the apexes of the MSC-Scaffold’s spikes while the spatial extent of this subchondral trabecular bone densification ranged from 1.5 to 2.5 mm (which is about half the height of the MSC-Scaffold’s spikes). It may be suggested, despite the limited number of examined femoral heads, that: (1) the magnitude of the effect of the MSC-Scaffold embedding on subchondral trabecular bone densification may be a factor contributing to the maintenance of the MSC-Scaffold also for decreased initial bone density values, (2) the deeper this effect of the subchondral trabecular bone densification, the better strength of subchondral trabecular bone, and as consequence, the better post-operative embedding of the MSC-Scaffold in the bone should be expected.

Objective To compare the outcome after extensive lateral guided bone regeneration using deproteinized bovine bone mineral (DBBM) with or without autogenous bone chips in a canine model of chronic horizontal alveolar ridge defect. Materials and methods The second, third and fourth lower premolars of both sides were extracted, and the buccal bone walls were completely removed in five beagle dogs. After 4 weeks, DBBM particles mixed with autogenous bone chips at a ratio of 1:1 were grafted at one side (DBBM/Auto group), while DBBM particles alone were grafted at the contralateral side (DBBM group). The graft materials on both sides were covered by a resorbable collagen membrane and fixation pins. Microcomputed tomographic volume and histomorphometric analyses were performed at 16 weeks post-surgery. Results The ridges of both groups were recovered horizontally, but new bone formation beyond the original ridge contour at the defect site was not found. The DBBM group exhibited a larger total radiographic augmented volume and new bone volume compared with the DBBM/Auto group, but the differences were minimal (p > 0.05). Histologically, the regenerated area and new bone area were also slightly larger without any statistical significance in the DBBM group than in the DBBM/Auto group (p > 0.05). Conclusion The addition of autogenous bone chips to DBBM for lateral ridge augmentation may confer no advantage over grafting DBBM alone with respect to both space maintenance and de novo bone formation in dogs.

3D printing technology has been gradually applied to various areas. In the present study, 3D-printed implants were fabricated with direct metal laser sintering technique for a dental single root with titanium. The 3D implants were allocated into following groups: not treated (3D-None), sandblasted with a large grit and acid-etched (3D-SLA), and target-ion-induced plasma-sputtered surface (3D-TIPS). Two holes were drilled in each tibia of rabbit, and the three groups of implants were randomly placed with a mallet. Rabbits were sacrificed at two, four, and twelve weeks after the surgery. Histologic and histomorphometric analyses were performed for the evaluation of mineralized bone-to-implant contact (mBIC), osteoid-to-implant contact (OIC), total bone-to-implant contact (tBIC), mineralized bone area fraction occupancy (mBAFO), osteoid area fraction occupancy (OAFO), and total bone area fraction occupancy (tBAFO) in the inner and outer areas of lattice structure. At two weeks, 3D-TIPS showed significantly higher inner and outer tBIC and inner tBAFO compared with other groups. At four weeks, 3D-TIPS showed significantly higher outer OIC than 3D-SLA, but there were no significant differences in other variables. At twelve weeks, there were no significant differences. The surface treatment with TIPS in 3D-printed implants could enhance the osseointegration process in the rabbit tibia model, meaning that earlier osseointegration could be achieved.

Distraction osteogenesis (DO) is a physiological process that generates new bone tissue formation, using progressively separated bone fragments. Recently, several techniques have been investigated to develop the maturation of the new bone tissue. Bisphosphonates was an effective material for the acceleration of bone formation in DO procedures. The purpose of this study was to evaluate the effects of the systemic zoledronic acid application at the beginning of the consolidation period on new bone genesis in a DO model of rat femurs. The rats were divided randomly into 3 groups, as follows: Control group (CNT group) (n = 10), zoledronic acid dosage-1 (n = 10), and dosage-2 (n = 10) groups (ZA-D-1 and ZA-D-2). No treatment was administered in controls, but DO was applied to the rat femurs. A single dose of 0.1 mg/kg and 0.2 mg/kg of zoledronic acid was administered systematically at the beginning of the consolidation period after the distraction in treatment groups, respectively. Histomorphometric analyses were performed on the original distracted bone area and the surrounding bone tissue. Osteoblasts, new bone formation, and fibrosis were scored. New bone formation in the ZA-D-1 and ZA-D-2 groups, when compared with the control group, was detected highly (P

We examined the effect of jump exercise on bone parameters in young female rats under food restriction. Seven-week-old female rats were divided into four groups: a sedentary and ad libitum feeding group (n = 10), a jump exercise and ad libitum feeding group (n = 9), a sedentary and 30% food restriction group (n = 9), and a jump exercise and 30% food restriction group (n = 10). The jump groups jumped 20 times/day, 5 times/week. The experiment lasted for 13 weeks. There were no interactions of jump exercise and food restriction on bone. Jump exercise under food restriction conditions induced higher bone strength, bone mineral content, bone area, bone mineral density (BMD), and cortical bone volume in young female rats, similar to rats under ad libitum feeding conditions. Bone strength parameters were not significantly different between ad libitum intake and food restriction with jump exercise training; however, BMD, bone size, and bone mass in the food restriction groups did not reach the levels of those in the ad libitum conditions group with jump exercise training. Neither jump exercise nor food restriction had a significant effect on serum estradiol or IGF-1. Our study reveals jump exercise attenuates loss of biomechanical properties and some bone sites with food restriction in young female rats.

Implant placement in severely atrophic jaws is especially challenging because of the poor quality and quantity of the future implant bed. Although various bone augmentation procedure like ridge augmentation, sinus lift these procedures are possible today but it may lead to surgical morbidity they increase the risks and costs of dental implant treatment as well as the number of necessary operations. Also sometimes the patient is not agreeing for such extensive surgical procedures, according to the well-known implantological rules for dental restorations, crestal implants are indicated in situations when an adequate vertical bone supply is given but single piece dental implant (basal implants) is a viable treatment option derives support from the basal bone area which usually remains free from the infection and less prone to resorption.

Background: Osteoarthritis is one of the chronic debilitating disease affecting the temporomandibular joint (TMJ). Even though there are several therapeutic approaches to treat osteoarthritic joints, intra-articular injection provides local drug delivery to the joint with instant pain relief. Purpose: The aim of this study was to investigate the regenerative potential of intraarticular injections of Platelet-Rich Plasma (PRP), Botox and Botox + PRP (combined) in treating induced temporomandibular joint (TMJ) osteoarthritis in Albino rats.Design: 42 male adult Wister albino rats were used in this study. All rats were anesthetized and injected with 2mg MIA in both sides of TMJ to induce osteoarthritis. After confirmation of osteoarthritis by enzyme-linked immunosorbent assay (ELISA), the rats were randomly divided to three groups. The right side acted as the experimentally treated group and was injected weekly with either Botox (5 IU/kg diluted in 50 µL saline), 50 µL PRP, or their combination, while the left side acted as control. Tissues were assessed at two and four weeks post-treatment histologically, radiographically and biochemically (using qRT-PCR and ELISA).Results: The treated sides showed statistically significantly higher mean bone area percentages, in addition to lower statistically significantly mean IL-1β and MMP13 levels than the untreated sides. The highest mean bone area % was recorded in the PRP group followed by the combined group of Botox+ PRP. The treated sides recorded a higher mean joint space than the untreated sides that is statistically significant in the Botox group (p < 0.001) and statistically non-significant in the PRP and Botox+ PRP group. Conclusion: This study confirms the regenerative potential of PRP alone and in combination with Botox, which implies that the use of PRP alone or combined with Botox can enhance the healing of conditions as TMJ osteoarthritis.

Osteoid osteoma is a benign bone tumor, found in young subjects with typical intense focal pain, nocturnal exacerbation and favorable response to salicylates. Painless osteoid osteomas are rare and their diagnosis is difficult, especially whether their imaging appearance is not typical. We report the case of a 13-year-old boy with a spontaneous painless lesion of the distal phalanx of a toe. The main symptom was a swelling of the distal portion of the toe with an enlargement of its nail. The radiological aspect was not typical. A computed tomography showed a small lucent bone area within a focal hypertrophy of the phalangeal tuft and an osteoid osteoma was proposed as main diagnosis. The tumor was completely removed and the histopathological examination confirmed the diagnosis of osteoid osteoma. This clinical case shows that painless swelling of a toe may be indicative of an osteoid osteoma.

The osteotome procedure, the crestal system regarding sinus lifting, is a lesser invasive procedure to raise the alveolar bone height efficiently under the right circumstances. The site-specific sinus lift procedures and the scope for vertical bone augmentation are the features of the crestal method with negligible distress post-surgery. Summers’ osteotome method is known to preserve the bone at the specific region, elevate the sinus membrane, and move it upward based on the distinct needs of the patient. There is a minimal rise in the bone area that results in negligible variations to the sinus morphology. This is the purpose of this method than the lateral window surgery.

Context In a cross-sectional study, we found an association between type 2 diabetes mellitus (T2DM) and smaller bone area together with greater bone mineral density (BMD) at the total hip. Objective This work aims to investigate these associations longitudinally, by studying T2DM status (no T2DM n = 1521, incident T2DM n = 119, or prevalent T2DM n = 106) in relation to changes in total hip bone area and BMD. Methods In 3 cohorts, the Swedish Mammography Cohort Clinical (SMCC; n = 1060), Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS; n = 483), and Uppsala Longitudinal Study of Adult Men (ULSAM; n = 203), with repeat assessment of T2DM status and dual energy x-ray absorptiometry (DXA) measurements of total hip bone area and BMD on average 8 years apart, a linear regression model was used to assess the effect of T2DM status on change in bone area and BMD at the total hip. Results After meta-analysis, the change in bone area at the total hip was 0.5% lower among those with incident T2DM compared to those without T2DM (–0.18 cm2; 95% CI, –0.30 to –0.06). The change in bone area was similar among those with prevalent T2DM compared to those without (0.00 cm2; 95% CI, –0.13 to 0.13). For BMD, the combined estimate was 0.004 g/cm2 (95% CI, –0.006 to 0.014) among those with incident T2DM and 0.010 g/cm2 (95% CI, –0.000 to 0.020) among those with prevalent T2DM, compared to those without T2DM. Conclusion Those with incident T2DM have a lower expansion in bone area at the total hip compared to those without T2DM.

Purpose The aim of the present study was to systematically analyze how a multifactorial surgical instrumentation approach affects osseointegration on both narrow-diameter and wide-diameter short implants. Materials and Methods Twelve skeletally mature female sheep were used in the study along with 144 plateau-root-form healing chamber titanium (Ti-6Al-4V) implants (Bicon LLC, Boston, MA), evenly distributed between narrow (3.5 mm) and wide (6.0 mm) diameters. The presence or the absence of irrigation, different drilling speeds, and 2 time points quantifying bone-implant contact (BIC) and bone area fraction occupancy (BAFO) to evaluate the osteogenic parameters around the implants. Results There were no signs of inflammation, infection, or failure of the implants observed at either healing period. The narrow 3.5-mm implant, at 6 weeks, yielded significant differences in terms of BIC at a drilling speed of 50 rotations per minute (RPM), with higher values of the samples using irrigation (30.6 ± 6.1%) compared with those without (19.7 ± 6.1%). No statistical differences were detected for 500 and 1,000 RPM with or without irrigation. The wide 6-mm diameter implant showed differences with respect to drilling speed, 500 and 1,000 RPM, with higher values associated with samples subjected to irrigation. BAFO results, for both diameters, only detected statistical differences between the 2 times (3 vs 6 weeks); no statistical differences were detected when evaluating as a function of time, drilling speed, and irrigation. Conclusions Surgical instrumentation variables (ie, drilling speed [RPM] and irrigation) yielded to be more of an effect for BIC at longer healing time (6 weeks) for the wider implants. Furthermore, deploying narrow or wide plateau-root-form implants, where conditions allow, has shown to be a safe alternative, considering the high BIC and BAFO values observed, independent of irrigation.

High tibial osteotomy (HTO) and knee joint distraction (KJD) are joint-preserving treatments that unload the more affected compartment (MAC) in knee osteoarthritis. This post-hoc study compares two-year cartilage-thickness changes after treatment with KJD vs. HTO, and identifies factors predicting cartilage restoration. Patients indicated for HTO were randomized to KJD (KJDHTO) or HTO treatment. Patients indicated for total knee arthroplasty received KJD (KJDTKA). Outcomes were the MRI mean MAC cartilage thickness and percentage of denuded bone area (dABp) change two years after treatment, using radiographic joint space width (JSW) as the reference. Cohen&rsquo, s d was used for between-group effect sizes. Post-treatment, KJDHTO patients (n = 18) did not show significant changes. HTO patients (n = 33) displayed a decrease in MAC cartilage thickness and an increase in dABp, but an increase in JSW. KJDTKA (n = 18) showed an increase in MAC cartilage thickness and JSW, and a decrease in dABp. Osteoarthritis severity was the strongest predictor of cartilage restoration. Kellgren&ndash, Lawrence grade &ge, 3 showed significant restoration (p &lt, 0.01) after KJD, grade &le, 2 did not. Effect sizes between severe KJD and HTO patients were large for MAC MRI cartilage thickness (d = 1.09, p = 0.005) and dABp (d = 1.13, p = 0.003), but not radiographic JSW (d = 0.28, p = 0.521). This suggests that in knee osteoarthritis patients with high disease severity, KJD may be more efficient in restoring cartilage thickness.

Aims/hypothesis Observational studies indicate that type 2 diabetes mellitus and fasting glucose levels are associated with a greater risk for hip fracture, smaller bone area and higher bone mineral density (BMD). However, these findings may be biased by residual confounding and reverse causation. Mendelian randomisation (MR) utilises genetic variants as instruments for exposures in an attempt to address these biases. Thus, we implemented MR to determine whether fasting glucose levels in individuals without diabetes are causally associated with bone area and BMD at the total hip. Methods We selected 35 SNPs strongly associated with fasting glucose (p −8) in a non-diabetic European-descent population from the Meta-Analyses of Glucose and Insulin-related traits Consortium (MAGIC) (n = 133,010). MR was used to assess the associations of genetically predicted fasting glucose concentrations with total hip bone area and BMD in 4966 men and women without diabetes from the Swedish Mammography Cohort, Prospective Investigation of Vasculature in Uppsala Seniors and Uppsala Longitudinal Study of Adult Men. Results In a meta-analysis of the three cohorts, a genetically predicted 1 mmol/l increment of fasting glucose was associated with a 2% smaller total hip bone area (−0.67 cm2 [95% CI −1.30, −0.03; p = 0.039]), yet was also associated, albeit without reaching statistical significance, with a 4% higher total hip BMD (0.040 g/cm2 [95% CI −0.00, 0.07; p = 0.060]). Conclusions/interpretation Fasting glucose may be a causal risk factor for smaller bone area at the hip, yet possibly for greater BMD. Further MR studies with larger sample sizes are required to corroborate these findings. Graphical abstract

The aim of this study was to evaluate the combined effects of recombinant human bone morphogenetic protein - 9 (rhBMP-9) loaded onto absorbable collagen sponges (ACS) and low-intensity pulsed ultrasound (LIPUS) on bone formation in rat calvarial defects. Circular calvarial defects were surgically created in 18 Wistar rats, which were divided into LIPUS-applied (+) and LIPUS-non-applied (−) groups. The 36 defects in each group received ACS implantation (ACS group), ACS with rhBMP-9 (rhBMP-9/ACS group), or surgical control (control group), yielding the following six groups: ACS (+/−), rhBMP-9/ACS (+/−), and control (+/−). The LIPUS-applied groups received daily LIPUS exposure starting immediately after surgery. At 4 weeks, animals were sacrificed and their defects were investigated histologically and by microcomputed tomography. Postoperative clinical healing was uneventful at all sites. More new bone was observed in the LIPUS-applied groups compared with the LIPUS-non-applied groups. Newly formed bone area (NBA)/total defect area (TA) in the ACS (+) group (46.49 ± 7.56%) was significantly greater than that observed in the ACS (−) (34.31 ± 5.68%) and control (−) (31.13 ± 6.74%) groups (p < 0.05). The rhBMP-9/ACS (+) group exhibited significantly greater bone volume, NBA, and NBA/TA than the rhBMP-9/ACS (−) group (2.46 ± 0.65 mm3 vs. 1.76 ± 0.44 mm3, 1.25 ± 0.31 mm2 vs. 0.88 ± 0.22 mm2, and 62.80 ± 11.87% vs. 42.66 ± 7.03%, respectively) (p < 0.05). Furthermore, the rhBMP-9/ ACS (+) group showed the highest level of bone formation among all groups. Within their limits, it can be concluded that LIPUS had osteopromotive potential and enhanced rhBMP-9-induced bone formation in calvarial defects of rats. The use of rhBMP-9 with LIPUS stimulation can be a potential bone regenerative therapy for craniofacial/peri-implant bone defects.

Objectives/hypothesis PENTOCLO treatment, associating pentoxifylline, tocopherol, and clodronate, resolves radiation-induced fibrosis. The main aim of the present study was to prospectively assess efficacy in mandibular osteoradionecrosis (ORN). Study design Prospective cohort study. Methods Twenty-seven patients with mandibular ORN were included in the Pentoclauvergne Study between January 2014 and February 2016. After an initial 28-day phase of antibiotic, antifungal, and corticosteroid therapy, they received the PENTOCLO association daily until cure or a maximum of 24 months. The main assessment criterion was exposed bone area (EBA); secondary criteria comprised the Subjective, objective, management, and analytic (SOMA) score. Results Under PENTOCLO, EBA decreased by 28% at 2 months, 55% at 6 months, and 92% at 24 months; the SOMA score decreased by 23%, 38%, and 50%, respectively. A complete treatment course cured 76.5% of patients at a mean 9.6 months. Conclusions PENTOCLO is a simple, well-tolerated, and effective treatment for mandibular ORN. Level of evidence 4 Laryngoscope, 130:E559-E566, 2020.

In this study, micro-CT was used to observe the microscopic anatomy of the hyoid bone, examine the variation of the trabecular bone inside the hyoid bone, and investigate the internal structure of the hyoid bone. A total of 22 hyoid bones were scanned using micro-CT. The changes in the internal bone trabeculae were assessed with 3D reconstructions, and the fine anatomical structure of the hyoid bone was further analyzed. Micro-CT images showed the microstructure of various parts of the hyoid bone. There were significant differences in total volume, bone volume, bone area, bone density, and volume fraction between the body and greater horns of the hyoid bone (P .05). In addition, significant differences in the trabecular bone measurements, bone trabecular connectivity, and Euler number were found between the body and greater horns of the hyoid bone (P .05). There was noticeably ossified healing at the joint between the body and greater horns of the hyoid bone. Micro-CT can adequately display the internal structure of the hyoid bone. The identified bone structure may help clarify the physiological function of the hyoid bone. The present findings provide a theoretical basis for further studies aimed at pathological changes due to hyoid injury in clinical and forensic medicine.

Made available in DSpace on 2020-12-12T02:46:55Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-10-01 To overcome the morbidity of autogenous graft removal and limitations of allogeneic and xenogeneic grafts, a great interest exists in the development of biomaterials of synthetic origin. Objective: The aim of this study was to evaluate the biological behavior of a novel bioactive glass (60% SiO2- 36% CaO-4% P2O5) as bone substitute in critical calvaria defects of rats, in comparison to hydroxyapatite. Methods: Sixty male Wistar rats were divided in three groups, according to the treatment: Control Group (C) - blood clot; Hydroxyapatite (HA) - particulate hydroxyapatite (≤0,5 mm); and Bioactive Glass (BG) - particulate bioactive glass (0.04–1 mm). Results: From the intergroup analysis, it was observed that Group C presented a greater newly formed bone area (NBA) when compared to Groups HA and BG. In addition, Group HA showed higher NBA when compared to Group BG at 30 and 60 days (P < 0.05). Immunohistochemistry revealed that groups HA and BG presented high and moderate osteocalcin immunolabeling respectively. Group HA displayed a greater number of TRAP-positive cells compared to Groups C and BG at 30 and 60 days (p < 0.05). Conclusion: From these results, we can conclude that the resorption rate of hydroxyapatite is higher than the novel bioactive glass, which maintained significant higher volume until the last experimental period. Both of the tested biomaterials acted as osteoconductors during bone repair, and their physical characteristics importantly influenced this process. Doctorating Student in Periodontics – São Paulo State University “Júlio de Mesquita Filho” (UNESP) Undergraduate Student in Dentistry - Federal University of Alfenas (UNIFAL-MG) Doctorating Student in Periodontics Federal University of Minas Gerais (UFMG) Doctor in Cell Biology Adjunct Professor - Federal University of Alfenas (UNIFAL-MG) Professor of Integral Dedication to the Doctrine and Research - São Paulo State University “Júlio de Mesquita Filho” (UNESP) Doctor in Public Health Adjunct Professor IV - Federal University of Alfenas (UNIFAL-MG) Doctor in Periodontics Adjunct Professor IV - Federal University of Alfenas (UNIFAL-MG) Doctorating Student in Periodontics – São Paulo State University “Júlio de Mesquita Filho” (UNESP) Professor of Integral Dedication to the Doctrine and Research - São Paulo State University “Júlio de Mesquita Filho” (UNESP)

Background Treating a titanium or titanium alloy implant with ultraviolet (UV) light is known to improve its associated cell growth and osseointegration. However, little is known about the effect of UV irradiation on hydroxyapatite (HA), which is also used frequently in orthopaedic and dental surgery. Here we examined the effect of UV irradiation on the hydrophilicity of HA, and on its osteoconduction ability in rats. Methods HA implants of low and high porosity were treated with UV light, and photofunctionalisation was assessed by the contact angle of a water drop on the surface. HA implants were also inserted into rat femurs, and the rats were killed 2 or 4 weeks later. The bone volume and bone area ratio were calculated from microcomputed tomography and histological data. Results The contact angle of a water drop on HA implants of both porosities was significantly reduced after UV irradiation. In the rat femurs, there was no significant difference in the bone volume between the UV light-treated and control implants at 2 or 4 weeks. The bone area ratio for the UV light-treated versus control implants was significantly increased at 2 weeks, but there was no significant difference at 4 weeks. Conclusions The surface of UV-irradiated HA disks was hydrophilic, in contrast to that of non-irradiated HA disks. Photofunctionalisation accelerated the increase in the bone area ratio in the early healing stage. This technology can be applied to surgical cases requiring the early fusion of bone and HA.

The aim of the present study was to evaluate the effects of a single dose of locally administered teriparatide (TP) on healing critical-sized defects in rat mandibles through histomorphometric and microcomputed tomography (micro-CT) analyses. In this study, 48 Sprague–Dawley rats were used. The experimental animals were divided into 4 groups as follows: Group 1 had empty defects, Group 2 received autografts, Group 3 received allografts, and Group 4 received allografts combined with 40 μg of TP. Eight weeks after the surgical procedure, all rats were sacrificed, and all specimens were evaluated using micro-CT and histomorphometric analyses. The results of the histomorphometric analysis showed that Group 4 had the most new bone area (0.85 mm2 ± 0.13 mm2) (p = 0.002) and the highest number of osteoblasts (86.61 ± 4.86) (p = 0.001). In addition, the results of the micro-CT analysis showed that Group 4 had the highest bone volume/total volume (23.27% ± 0.15%) (p = 0.001). The histomorphometric and micro-CT values of Group 2 were higher than those of Group 1 but lower than those of Group 3 and Group 4. The results of the study show that a single dose of locally administered TP has a positive effect on the integration of allografts. However, further studies are necessary to identify the mechanism of action and the effective minimum and maximum doses of locally administered TP.

This study estimated upper and lower limb bone mineral content (BMC) and bone area (BA) in 48 children tennis players (24 boys, 24 girls) aged 7-13 years. The sample comprised four age groups (8.2 ± 0.44, 9.5 ± 0.13, 10.5 ± 0.33, 12.2 ± 0.58). BMC and BA were measured via DXA, and sexual maturity by the Tanner scale, then used as a binary: prepubertal vs peripubertal. Total training time (TTT) included all playing years. Arms were asymmetric and legs symmetric. Boys were more asymmetric than girls in BMC (18% vs 13%) and BA (11% vs 8%). Pre-pubertal children were less asymmetric than peri-pubertal in BMC (14% vs 18%) and in BA (9.4% vs 10%). Bone growth changed with age and TTT markedly better in the dominant arm. The linear combination of TTT, sex, and maturity binary extracted 59% of BMC asymmetry and only 21% of BA asymmetry. For both bone parameters the sex effect was significant only for the pre-pubertal children. Training time constitutes the best predictor of bone asymmetry compared to age, sex, and maturity; when adequate, playing arm bone hypertrophy may be detectable at the age of 7-8 years. These results have health and performance implications.

Osseodensification, a counterclockwise drilling technique for the placement of endosseous implants is a popular clinical technique. However, the effect of the osseodensification technique on primary implant stability, bone-implant contact, and bone area frequency occupancy is unclear.The purpose of this systematic review and meta-analysis was to investigate the biomechanical and histomorphometric outcomes of endosteal implants placed by using the osseodensification technique in animal models.An electronic search through Medline/PubMed, Lilacs, and Science Direct databases, and an additional manual search of the reference list of included articles was conducted by using specific keywords and Medical Subject Headings (MeSH) terms for articles in the English language and published up to April 31, 2020. Only animal studies comparing the biomechanical and histomorphometric outcomes of endosteal implants placed by using the osseodensification and conventional drilling protocol were included. The SYstematic Review Center for Laboratory animal Experimentation (SYRCLE) tool was used to determine the risk of bias assessment, and the quality of included studies was assessed by using Animal Research: Reporting in Vivo Experiments (ARRIVE) guidelines.Nine studies were included. The results of the meta-analysis showed that the pooled weighted mean difference of the insertion torque value for the primary implant stability of endosseous dental implants placed by using the osseodensification technique was 2.270 (95% confidence interval [CI]=1.147 to 3.393; P.001), the weighted mean difference of the percentage of bone-implant contact at 3 weeks was 0.487 (95% CI=0.220 to 0.754; P=.114), the weighted mean difference of the percentage of bone-implant contact at 6 weeks was 0.565 (95% CI=0.219 to 0.911; P=.448), the weighted mean difference of the percentage of bone area frequency occupancy at 3 weeks was 0.679 (95% CI=0.265 to 1.093; P=.073), and the weighted mean difference of the percentage of bone area frequency occupancy at 6 weeks was 0.391 (95% CI=-0.204 to 0.986; P=.027).Limited data from animal studies suggest that the primary implant stability, bone-implant contact, and bone area frequency occupancy significantly improved for the endosteal implants placed by using the osseodensification technique compared with conventional drilling protocol. However, additional laboratory and clinical studies are recommended to provide stronger evidence.

(1) Background: While decreasing bone mineral density (BMD) with age in living people has been well documented, a correlation between age and bone mineral density in deceased people has only been reported in a few studies. A correlation between age and BMD in deceased people was investigated as an objective tool for age estimation of unidentified remains. (2) Methods: The Bone Area Ratio (BAR) was measured in 402 autopsy cases (143 females and 259 males over the age of 20). (3) Results: The correlation coefficient in the females was r = &minus, 0.5476, and the correlation coefficient in the males was r = &minus, 0.2166, indicating a stronger correlation in females than in males. A comparison of the BAR values in the deceased females for each age group with that in live females found no significant differences in the BAR values. BAR values in the deceased were similar to in live individuals, and this did not change with duration of the postmortem interval. (4) Conclusions: Measuring the BAR value based on bone mass using ultrasonic waves is rapid and easy, even for those lacking forensic training, and may be used to estimate the age of an individual and the likelihood of fracture due to trauma.

BackgroundInvestigating the effects of 405-nm, 532-nm, 650-nm, and 950-nm wavelengths of LLLTs (low-level laser therapies) on the orthodontic tooth movement in rats by using histological and immunohistochemical methods. Forty-five Wistar albino rats were randomly divided into 5 groups: control group (positive control: the left maxillary 1st molar side; negative control: the right maxillary 1st molar side), 405 nm LLLT group (Realpoo), 532 nm LLLT group (Realpoo), 650 nm LLLT group (Realpoo), and 940 nm LLLT group (Biolase). The left maxillary 1st molar teeth of all rats were applied mesially 50-g force. Starting from the 1st day, 48 h intervals, LLLT was applied in continuous wave mode and in contact with the tissue. The application area was approximately 1 cm2. The lasers were performed for 3 min on each surface (buccal, palatal, mesial), totally 9 min (total dose 54 J/cm2). The amount of the molar mesialization, the bone area between the roots, PDL (periodontal ligament) measurements, TRAP (tartrate-resistant acid phosphatase), and ALP (alkaline phosphatase) immunoreactivity intensity were calculated.ResultsThe amount of the molar mesialization was significantly higher in the 650 nm LLLT group (mean 0.878 ± 0.201 mm; 95% CI (confidence interval) 0.724 and 1.032) than in the groups of positive control (mean 0.467 ± 0.357 mm; 95% CI 0.192 and 0.741) and 405 nm LLLT (mean 0.644 ± 0.261 mm; 95% CI 0.443 and 0.845) (p< 0.001). There were significant differences in the PDL-mesial (p= 0.042) and PDL-distal (p= 0.007) regions between the groups. The immunoreactivity intensity for TRAP-mesial was significantly higher in the positive control group (mean 109,420.33 ± 8769.17; 95% CI 100,217.65 and 118,623.02) than in the 405 nm (mean 91,678.83 ± 7313.39; 95% CI 84,003.9 and 99,353.77) and the 650 nm LLLT (mean 87,169.17 ± 4934.65; 95% CI 81,990.56 and 92,347.77) groups (p= 0.002). There was no statistically significant difference between the groups on immunoreactivity intensity with ALP staining.ConclusionsThe results of this study show that LLLT with 650-nm wavelength increases orthodontic tooth movement more than 405-nm, 532-nm, and 940-nm LLLTs. The 940-nm and 650-nm LLLTs also increase the bone area between the roots by more than 405-nm and 532-nm wavelengths.

Objectives Intermittent injection of parathyroid hormone (PTH) is used to treat osteoporosis. The concept of bone quality was updated 20 years ago; however, these updates have not been adopted in implant dentistry. This study aimed to investigate the effects of intermittent administration of PTH on bone quality around implants in rat tibiae. Methods Grade IV-titanium-threaded implants that were 3.5 mm long and 2.0 mm wide were placed in a randomly selected side of the proximal tibiae of 12-week-old female Wistar rats. Three weeks after implant placement, the rats were randomly divided into PTH-administration and saline-injection groups (PTH and VC, respectively; n = 7 per group). Micro-computed tomographical, histomorphometric, and immunohistochemical analyses were performed to evaluate bone quality and quantity surrounding the implants. Results PTH significantly increased bone volume and bone mineral density in bones not associated with the implants as compared to these values in the VC group. PTH significantly increased bone area and the amount of collagen within the total inside areas of all implant threads compared to that observed in VC. Moreover, PTH significantly increased the number of osteoblasts, osteocytes, and osteoclasts in the total inside and/or outside areas of all implant threads and altered the ratio of type I and III collagen to total collagen fibers. Conclusions Within the limitations of this study, intermittent administration of PTH improved both bone quantity and bone quality based on the types and numbers of bone cells and the types of collagen fibers surrounding implants placed into rat tibiae.

Objectives: The aim of this study was to compare autogenous and allograft bone rings in surgically created vertical bone defects. Material and methods: Four male, 1-year-old sheep were used in this study. In each sheep, eight vertical bone defects 7 mm in diameter were created using trephine drill in the iliac wing. Autogenous and allograft bone rings 5 mm in height and 7 mm in diameter were used for vertical augmentation around implants. The study consisted of four groups according to the bone ring type and amount of vertical augmentation, autogenous 2 mm, allograft 2 mm, autogenous 4 mm, and allograft 4 mm. Two of the animals were sacrificed after 4 months, and the remaining two animals were sacrificed after 8 months. Undecalcified sections were prepared from harvested samples. Histological assessment and histomorphometric analysis were performed. Results: Autogenous 2 mm group showed higher values than allograft 2 mm group, and autogenous 4 mm group showed higher values than allograft 4 mm group in terms of bone area and bone-to-implant contact (BIC) after 4 months. However, allograft 2 mm group showed higher bone area and BIC values than autogenous 2 mm group after 8 months. Also, autogenous 4 mm and allograft 4 mm groups showed comparable results after 8 months. Allograft 2 mm and allograft 4 mm groups showed higher bone area and BIC values at 8 months compared with 4 months. Conclusions: Allograft bone ring looks promising in augmentation of surgically created vertical bone defects around implants after 8 months of healing. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Infection associated with an implant is a complication feared in surgery, as it leads to loosening and dysfunction. This report documents an unexpected good bony integration of a porous tantalum shoulder prosthesis despite infection. A shoulder prosthesis with a porous tantalum glenoidal base plate was retrieved after 3 years of ongoing infection with Staphylococcus spp. Methyl-methacrylate embedded sections of the retrieved glenoidal component were analyzed by optical and scanning electron beam microscopy (SEM). Bone ongrowth and ingrowth were quantified. Bone had formed at the implant surface and within the open cell structure of the porous tantalum. The bone implant contact index was 32%. The bone ingrowth or relative bone area within the open structure was 8.2%, respectively 11.9% in the outer 50% of the thickness. Due to the section thickness, bone ongrowth could best be documented in SEM. Despite long-lasting and ongoing infection, the glenoidal base plate of the prosthesis showed good bony integration upon removal. The bone ingrowth into the porous tantalum was comparable to the values previously reported for the undersurface of retrieved proximal humerus resurfacing implants. Good integration of the implant however did not solve the problem of infection, and related morbidity. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2924-2931, 2018.

Improved osseointegration of dental implants is imperative in clinic. Effect of doxycycline on promoting bone formation after implant placement was expected due to its inhibitory properties on inflammation and osteoclastogenesis. To evaluate new bone formation on the hydroxyapatite (HA)-coated implant surface, which was treated with doxycycline, in comparison with the untreated HA surface, half of the HA-coated implants were soaked in doxycycline solution (DOX group) whereas the other HA-coated implants were untreated (HA group). Eight weeks after extracting the maxillary first molars of 4-week-old male mice, the implants of both groups were placed at the extracted site. 4 and 8 weeks after surgery, the samples were evaluated radiologically and histomorphometrically. Bone-implant contact of DOX group was statistically higher than the one of HA group at 4 and 8 weeks. New bone area between the threads of the implants also statistically increased at 8 weeks in DOX group compared to HA group.

Age estimation from radiographs is common when age is not documented, such as in forensic, refugee and asylum seeker cases. The methods currently used are outdated and not applicable to all human groups due to variations between populations and secular changes in growth. This study aims to use the ossification of the carpus in a modern sample of New South Wales children to produce an age estimation formula that can be applied to cases of undocumented age. Hand radiographs (n = 400; 194 left and 206 right) from the Sydney children’s hospital, aged from birth to 17 years (256 males and 144 females) were analysed. Bone area (BO) and carpal area (CA) were measured, and a carpus ossification ratio (BO/CA) was calculated for each individual. Linear regression analysis was used to produce a formula for age estimation. Analysis demonstrated no significant difference in the ossification ratio (95% CI) between wrists of left and right sides and a regression formula for age was determined to be [−0.972 + 1.403 g + 21.758 (BO/CA)] ± 1.40 (g is 1 for males and 0 for females). This regression formula accounted for 88% of total variance. The median of the absolute values of residual (MAR) and the standard error of estimate (SEE) were −0.03 years, 1.40 years respectively. Using the ossification ratio of the carpus, an age estimation formula with a relatively high degree of reliability and accuracy was generated for a modern sample of New South Wales Children.

Purpose: The placement of immediate implants has become a routine treatment modality for the replacement of missing teeth. The aim of the present study was to evaluate dimensional changes of hard tissues following tooth extraction, implant bed preparation, and the subsequent integration of titanium implants placed immediately or following an 8-week healing period. Materials and Methods: All mandibular premolars were extracted and used as experimental sites in five beagle dogs. The left quadrant was used to compare the healing of alveolar bone following regular tooth extraction or surgical implant bed preparation. The right quadrant was used to compare immediate with delayed implant placement (3.3 mm, Bone Level SLActive, Roxolid, Straumann) after an 8-week healing period. All samples were assessed histologically for new bone area/total area (BATA), bone-to-implant contact (BIC), and bone height changes from the buccal and lingual midlines. Results: Implant bed preparation led to significantly lower BATA values and bone height loss compared with regular extraction sockets (-2.46 mm vs -1.44 mm, respectively; P = .0007). Placement of immediate implants demonstrated buccal and lingual bone height loss of 1.51 mm and 0.91 mm, respectively, whereas only 0.12 mm and 0.12 mm of bone height loss was observed during delayed implant placement. A significantly higher BIC was observed for implants placed immediately compared with delayed placement (52% vs 35%, P < .05). Conclusion: Implant bed preparation further increased dimensional changes when compared with routine extraction sockets. Although immediate implant placement produced better BIC than did delayed placement, a significantly higher bone height loss at both the buccal and lingual midlines was reported. Further investigation is underway to minimize dimensional changes following immediate implant placement.

The impact of adult bone traits on changes in bone structure and mass during aging is not well understood. Having shown that intracortical remodeling correlates with external size of adult long bones led us to hypothesize that age-related changes in bone traits also depend on external bone size. We analyzed hip dual-energy X-ray absorptiometry images acquired longitudinally over 14 years for 198 midlife women transitioning through menopause. The 14-year change in bone mineral content (BMC, R2 = 0.03, p = 0.015) and bone area (R2 = 0.13, p = 0.001), but not areal bone mineral density (aBMD, R2 = 0.00, p = 0.931) correlated negatively with baseline femoral neck external size, adjusted for body size using the residuals from a linear regression between baseline bone area and height. The dependence of the 14-year changes in BMC and bone area on baseline bone area remained significant after adjusting for race/ethnicity, postmenopausal hormone use, the 14-year change in weight, and baseline aBMD, weight, height, and age. Women were sorted into tertiles using the baseline bone area-height residuals. The 14-year change in BMC (p = 0.009) and bone area (p = 0.001) but not aBMD (p = 0.788) differed across the tertiles. This suggested that women showed similar changes in aBMD for different structural and biological reasons: women with narrow femoral necks showed smaller changes in BMC but greater increases in bone area compared to women with wide femoral necks who showed greater losses in BMC but without large compensatory increases in bone area. This finding is opposite to expectations that periosteal expansion acts to mechanically offset bone loss. Thus, changes in femoral neck structure and mass during menopause vary widely among women and are predicted by baseline external bone size but not aBMD. How these different structural and mass changes affect individual strength-decline trajectories remains to be determined. © 2017 American Society for Bone and Mineral Research.

The objective of this in vivo study was to compare bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) values of a new implant, designed to be inserted without bone preparation, using two different preparation protocols: no site preparation and prior limited cortical perforation, versus the values of a control implant using a conventional drilling protocol. Forty-one implants were inserted in 13 rabbits. Thirteen test implants with a new thread design were inserted using no bone preparation (NP), 14 test implants were inserted with limited cortical perforation (CP), and 14 conventional implants served as control. Five animals were sacrificed after 21 days and eight animals after 42 days. Histomorphometric analysis was performed and percentage of BIC and BAFO values were measured. ANOVA with Tukey post hoc and Mann–Whitney nonparametric tests were calculated to compare between the groups. Statistical analysis showed no significant difference in the measured values between any of the groups, neither compered by implant nor by compered day. The results demonstrated that biological osseointegration parameters of implant that was inserted without any bone preparation was non-inferior compared to conventional preparation. The clinical relevance is that novel implant designs may not require bone preparation prior to placement.

Made available in DSpace on 2020-12-10T19:36:45Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-09-25 Background Fracture of an implant is a quite rare event but represents an important opportunity to evaluate the peri-implant bone tissue response to implant overload in human beings. This study aimed to evaluate bone tissue around three fractured titanium implants retrieved from a human maxilla, by histomorphometric and birefringence analyses. Case report For this, the implants and the surrounding bone were removed after having been united to a tooth in function for 45 months, by a 4-mm internal diameter trephine bur, following an undecalcified section was obtained. The results showed a rate of 77.3% of bone-to-implant contact (BIC) and 80.3% of bone area filling within the limits of the implant threads. Under circularly polarized light microscopy investigation, the amount of the transverse collagen fibers was of 48.11%, and the amount of the longitudinal collagen fibers was of 51.89%. Conclusion Within the limitation of this study, the possible cause of the implant fracture could be the association of overload, inadequate implant diameter, and fragile internal hexagon connection. Univ Araraquara UNIARA, Dent Sch, Dept Hlth Sci, Postgrad Program Implantol, Rua Carlos Gomes 1338, BR-14801340 Araraquara, SP, Brazil Univ Araraquara UNIARA, Dept Hlth Sci, Araraquara, SP, Brazil Sao Paulo State Univ UNESP, Sch Dent Araraquara, Dept Diag & Surg, Araraquara, SP, Brazil Sao Paulo State Univ UNESP, Sch Dent Araraquara, Dept Diag & Surg, Araraquara, SP, Brazil

This study reported that the transitional zones in older adults were enlarged at the expense of the compact-appearing cortex with a greater porosity in all cortical sub-compartments. The magnitude of differences in areal and volumetric bone mineral density (aBMD, vBMD) between older and younger groups was similar. Aging is strongly associated with bone loss, but little is known about magnitudes of differences in bone microarchitectures, aBMD, and vBMD from peak bone mass (PBM) to senescence. We aimed to describe differences in aBMD, vBMD, and bone microarchitecture parameters at the distal radius between older and young adults. We compared 201 participants, aged 62–89 years (female 47%) and 196 participants, aged 24–28 years (female 38%). Bone microarchitecture parameters at distal radius were measured using high-resolution peripheral computed tomography (HRpQCT). aBMD was measured using dual-energy X-ray absorptiometry (DXA). Unpaired t tests and chi-square tests were used to compare differences in means and proportions as appropriate. Older adults had thinner compact-appearing cortices with larger (cross-sectional area: outer 30.96 mm2 vs. 28.38 mm2, inner 36.34 mm2 vs. 32.93 mm2) and thicker (outer 0.57 mm vs. 0.54 mm, inner 0.71 mm vs. 0.65 mm) transitional zones compared with young adults (all p

Objective. This study aims to investigate the effect of systemically administrated zoledronate on bone-implant fixation in animal models. Methods. We searched MEDLINE, Embase, and EBSCO for studies that explore the role of systemic or local zoledronate delivery in implant osseointegration in animal models. The Review Manager software was used to analyze selected studies by using the weighted mean difference random-effects model. Analytical data are mainly about bone ingrowth, such as bone-to-implant contact (BIC), bone volume/total volume (BV/TV), and bone area. Results. Twenty studies were selected from 182 publications. The mean quality score was 18/20 for all of the 20 studies (κ = 0.9). Despite differences in protocols, these studies showed consistent improvement of implant osseointegration with zoledronate administration. In addition, the osteoporotic animal model, systemic or local administration, sufficient drug dosage, and sample follow-up time were correlated with improved outcomes. Conclusion. Systematic administration of zoledronate could improve the osseointegration of orthopedic implant in animal models. Results of this meta-analysis should be interpreted cautiously because of the inherent differences between preclinical and clinical subjects. For the local administration, there is a similar trend as well, but the results need to be confirmed and complemented with further analyses.

Background: The intraosseous temperature during implant installation has never been evaluated in an in vivo controlled setup. The aims were to investigate the influence of a drilling protocol and implant surface on the intraosseous temperature during implant installation, to evaluate the influence of temperature increase on osseointegration and to calculate the heat distribution in cortical bone. Methods: Forty Br&aring, nemark implants were installed into the metatarsal bone of Finnish Dorset crossbred sheep according to two different drilling protocols (undersized/non-undersized) and two surfaces (moderately rough/turned). The intraosseous temperature was recorded, and Finite Element Model (FEM) was generated to understand the thermal behavior. Non-decalcified histology was carried out after five weeks of healing. The following osseointegration parameters were calculated: Bone-to-implant contact (BIC), Bone Area Fraction Occupancy (BAFO), and Bone Area Fraction Occupancy up to 1.5 mm (BA1.5). A multiple regression model was used to identify the influencing variables on the histomorphometric parameters. Results: The temperature was affected by the drilling protocol, while no influence was demonstrated by the implant surface. BIC was positively influenced by the undersized drilling protocol and rough surface, BAFO was negatively influenced by the temperature rise, and BA1.5 was negatively influenced by the undersized drilling protocol. FEM showed that the temperature at the implant interface might exceed the limit for bone necrosis. Conclusion: The intraosseous temperature is greatly increased by an undersized drilling protocol but not from the implant surface. The temperature increase negatively affects the bone healing in the proximity of the implant. The undersized drilling protocol for Br&aring, nemark implant systems increases the amount of bone at the interface, but it negatively impacts the bone far from the implant.

Evaluate the effects of ionizing radiation on microarchitecture, the osteocyte lacunar network, and collagen maturity in a bone repair site. Bone defects were created on tibias of 20 New Zealand rabbits. After 2 weeks, the animals were randomly divided into (n = 10) NoIr (nonirradiated group) and Ir (irradiated group). In the Ir, the animals received single-dose irradiation of 30 Gy on the tibia and were euthanized after 2 weeks. Bone microarchitecture parameters were analyzed by using micro-CT, and the osteocyte lacunar network, bone matrix, and collagen maturation by histomorphometric analysis. The data were analyzed using unpaired Student’s t test (α = 0.05). Trabecular thickness in Ir was lower than that in NoIr (P = 0.028). No difference was found for bone volume fraction and bone area. Lacunae filled with osteocytes were more numerous (P

The recently introduced technique of osseodensification for dental implant involves the use of special drills (Densah) run in a counter-clockwise direction at the osteotomy site. It is claimed that this causes expansion of the osteotomy site, and increases density of the bone in immediate vicinity of the osteotomy. We reviewed published papers on the primary stability attained using this drilling technique. As a secondary finding, the bone to implant contact (BIC) and the bone area fraction occupancy (BAF) was also compared between the conventional drilling protocol and the osseodensification protocol, among these articles. A Systematic search was performed in PubMed-Medline, Embase and Google Scholar for clinical/animal studies up to November 2018. A total of 12 articles, from a database of 132 articles, consisting of 8 animal histologic studies, 2 human based clinical studies, 1 case series and 1 case report were assessed. 10/12 articles measured the insertion torque values, 7/12 articles measured the BIC and 6/12 articles estimated the BAF between the two techniques. Quality assessment of 8 studies performed using ARRIVE guidelines showed that 6/8 studies had a high score. An average increase in the insertion torque, BIC and BAF was noted in the osseodensification group as compared to the conventional drilling group. Since most of these studies are non-clinical, it can be inferred that osseodensification is an efficient way to enhance primary stability of implants in low density bone in an animal model. However, extrapolation to long term clinical success cannot be ascertained until further evidence becomes available.

The relationship between bone mineral density and tooth loss in men is unclear. The aim of this retrospective cohort study was to determine if relative metacarpal bone area (MCA) predicts tooth loss in a cohort of 273 male participants in the Dental Longitudinal Study and Normative Aging Study of the Department of Veterans Affairs. Outer and inner cortical bone widths of the middle metacarpal of the nondominant hand were measured on anteroposterior hand radiographs approximately 11 y apart. Baseline MCA was computed and categorized into quartiles. The men were followed from 1971 to 2015. Incident tooth loss during 2 intervals was examined: concurrent with the MCA measurements and long term over the total follow-up (17 ± 7 y). Radiographic alveolar bone loss (ABL) was measured on periapical radiographs as a percentage of the distance from the cementoenamel junction to root apex, and the number of teeth with ABL >40% was computed. Negative binomial generalized linear regression models estimated the mean number of teeth with ABL >40% and the number lost (concurrent and total), controlling for age, smoking, number of teeth at baseline, percentage teeth with ≥1 decayed/filled surface, and years of follow-up. At baseline, MCA was inversely related to number of teeth with >40% ABL. Men in the lowest MCA quartile (Q1) lost the most teeth, both concurrent with MCA measurements and long term, but the association differed by caries level (≤55% or >55% decayed/filled teeth). At the low caries level, the numbers lost in Q1 were 29% greater than in the highest MCA quartile (Q4). At the high caries level, the numbers lost in Q1 were more than twice those in Q4. Associations were attenuated when further controlled for number of teeth with ABL>40%. These findings suggest that systemic bone status plays a role in tooth loss and that the association may be mediated by alveolar bone loss. Knowledge Transfer Statement: Low relative metacarpal bone area was related to loss of alveolar bone and incident tooth loss in men. This information extends previous research, primarily studies of women, showing that osteoporosis adversely affects oral health. Knowledge of a patient’s systemic bone status may be important for managing his or her periodontal disease. Tooth loss in the absence of periodontal inflammation may signify systemic bone loss. Interprofessional communication is central to maintaining optimal oral and bone health.

Background: Bone mass acquisition in childhood is directly linked to adult bone mineral density (BMD) and fracture risk. BMD is a heritable trait, more than 70% of its variability among a population is affected by genetic factors. Objectives: In the present study, we wanted to investigate the association between estrogen receptor alpha (ESR1) polymorphisms, PvuII (rs2234693) and XbaI (rs9340799), and bone area, bone mineral content (BMC), and BMD of the lumbar spine, femoral neck, and also of the total body less the head in Iranian children. Methods: The ESR1 gene PvuII and XbaI genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism. Bone area, BMC, BMD, and bone mineral apparent density (BMAD) were assessed by dual-energy X-ray absorptiometry (DEXA). Linear regression was carried out to examine the effects of the ESR1 (PvuII and XbaI) polymorphisms on DEXA outputs when adjusted for confounding factors (i.e., age, sex, BMI, and pubertal stage) in 3 models. Results: ESR1 (PvuII) gene polymorphisms (CT vs. CC) showed significant effects on the BMC of the total body less the head in all 3 models. For ESR1 (XbaI), individuals with the AG genotype had higher lumbar spine BMD and lumbar spine BMAD compared to other genotypes. Conclusions: It seems that the PvuII and XbaI polymorphisms of ESR1 could be associated with BMC and BMD variation in Iranian children and adolescents.

The aim of this study was to examine the effect of volleyball and basketball practice on bone acquisition and to determine which of these 2 high-impact sports is more osteogenic in prepubertal period. We investigated 170 boys (aged 10-12 yr, Tanner stage I): 50 volleyball players (VB), 50 basketball players (BB), and 70 controls. Bone mineral content (BMC, g) and bone area (BA, cm(2)) were measured by dual-energy X-ray absorptiometry at different sites. We found that, both VB and BB have a higher BMC at whole body and most weight-bearing and nonweight-bearing sites than controls, except the BMC in head which was lower in VB and BB than controls. Moreover, only VB exhibited greater BMC in right and left ultra-distal radius than controls. No significant differences were observed between the 3 groups in lumbar spine, femoral neck, and left third D radius BMC. Athletes also exhibited a higher BA in whole body, limbs, lumbar spine, and femoral region than controls. In addition, they have a similar BA in head and left third D radius with controls. The VB exhibited a greater BA in most radius region than controls and a greater femoral neck BA than BB. A significant positive correlation was reported between total lean mass and both BMC and BA in whole body, lumbar spine, total hip, and right whole radius among VB and BB. In summary, we suggest that volleyball and basketball have an osteogenic effect BMC and BA in loaded sites in prepubescent boys. The increased bone mass induced by both volleyball and basketball training in the stressed sites was associated to a decreased skull BMC. Moreover, volleyball practice produces a more sensitive mechanical stress in loaded bones than basketball. This effect seems translated by femoral neck expansion.

SummaryObjectives: The purposes of this study were to determine: 1) the efficacy of polycaprolac-tone-g-polyethylene glycol (PCL-g-PEG) and polylactic-co-glycolic acid (PLGA-g-PEG) hydrogels and an absorbable collagen sponge (ACS) as carriers for lysophosphatidic acid (LPA), 2) the effect of LPA on bone healing in dogs, and 3) the ideal dose of LPA to maximally stimulate bone healing.Methods: Bilateral ulnar ostectomies were performed on purpose bred dogs. Control defects were filled with a PCL-g-PEG or PLGA-g-PEG hydrogel, or a saline soaked ACS. Contralateral defects were filled with a PCL-g-PEG or PLGA-g-PEG hydrogel, or an ACS with each carrying differing concentrations of an LPA solution. Dual-energy X-ray absorptiometry (DXA) was performed. Total bone area (TBA), mineral density (BMD), and mineral content (BMC) were determined at each time point. Relationships between the effect of treatment over time on TBA, BMC and BMD were determined.Results: Phase 1 - There was no significant difference in DXA-based TBA (p = 0.09), BMC (p = 0.33), or BMD (p = 0.74) over time between LPA treatments, or between the LPA treated and control groups TBA (p = 0.95), BMC (p = 0.99), or BMD (p = 0.46). Phase 2 - There was no significant difference over time between LPA treatments in DXA-based TBA (p = 0.33), BMC (p = 0.45), or BMD (p = 0.43), or between the LPA treated and control groups TBA (p = 0.94), BMC (p = 0.38), or BMD (p = 0.17). Phase 3 - There was no significant difference over time between LPA treatments in DXA-based TBA (p = 0.78), BMC (p = 0.88), or BMD (p = 0.35), or between the LPA treated and control groups TBA (p = 0.07), BMC (p = 0.85), or BMD (p = 0.06). There was a significant increase in TBA (p Clinical significance: Although LPA has shown promise as an osteoinductive agent in research, its performance as a bone graft substitute, as utilized in this study, is unsupported. Further studies are necessary to determine the incorporation and elution kinetics of LPA from the PLGA-g-PEG hydrogel and from an ACS. Hydrogels may have clinical applications for delaying or preventing bone formation.