Search

Simple Summary: Computer tomography (CT)-guided percutaneous core biopsies are currently the gold standard in diagnostic procedures for patients with bone lesions of unknown kind. Morphologic targeting can be challenging, especially for small and/or heterogeneous lesions. Hereby, targeting inaccuracies may lead to misdiagnosis or inconclusive histopathology. This increases the need for repeat biopsies, which is associated with an accompanying increase in healthcare costs, delay in diagnosis and treatment, and decrease in quality of life. Interventional molecular image guidance has the potential to refine lesion localization and personalize the biopsy strategy. By using 2-deoxy-2-18F-fluoro-D-glucose-positron emission tomography (18F-FDG-PET)/CT to support the identification of heterogeneous lesions or lesions without radiographic substrate, we show that molecular image guidance helps to increase the procedural success rate by 16%. Computer tomography (CT)-guided percutaneous core biopsies are currently the gold standard in diagnostic procedures for patients with bone lesions of unknown kind. CT-guided biopsies can lead to misdiagnosis or repetition of biopsies in case of small or heterogeneous lesions. We hypothesize that molecular image guidance could be used to optimize the biopsy strategy, by supporting the detection of heterogeneous lesions or lesions without radiographic substrate. To evaluate this hypothesis, we investigated if and how the addition of 2-deoxy-2-18F-fluoro-D-glucose-positron emission tomography (18F-FDG-PET)/CT could augment routine CT-guided bone biopsies. To this end, 106 patients who underwent a CT-guided bone biopsy between April 2019 and April 2020, obtained from either a vertebral or peripheral bone, were included. Patients were divided into 2 groups: 36 patients received an 18F-FDG-PET/CT scan prior to their CT-guided bone biopsy (PET group), while 70 patients only had a morphological CT scan (CT group). Histopathology was used to categorize biopsies into five subgroups (inconclusive, benign, malignant or infectious disease, or normal tissue). In the PET group, the number of conclusive biopsies was significantly higher compared to the CT group (N = 33/36 (92%) versus N = 53/70 (76%); p < 0.05). Furthermore, the number of first-try biopsies was lower in the PET group compared to the CT group (1.9 vs. 2.54, p = 0.051). In conclusion, 18F-FDG-PET/CT imaging significantly increased the success rate of first-try CT-guided bone biopsies by showing less inconclusive biopsies and misdiagnosis. [ABSTRACT FROM AUTHOR]

Tarsal coalition occurs in 1% of the population and represents a congenital failure of segmentation in two or more tarsal bones. It most commonly occurs at the talocalcaneal and calcaneonavicular joint. Although commonly asymptomatic, it may present with pain, rigidity, and pes planus. Cubonavicular, multiple synchronous, and bilateral coalitions are rare but an awareness is required to ensure accurate diagnosis and management. In this article, we presented the first reported case (to the best of our knowledge) of bilateral cubonavicular coalition with synchronous talocalcaneal coalition and stress response within the intermediate cuneiform. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Prevention & Treatment For Stomatological Diseases is the property of Journal of Prevention & Treatment For Stomatological Diseases Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The patient is a 22-year-old female basketball player initially diagnosed with a calcaneal fracture. Five months after the pain began, the patient was referred to a foot and ankle surgeon and diagnosed with middle facet tarsal coalition. The patient received one X-ray-guided subtalar steroid injection and two platelet-rich plasma injections to aid in pain relief while completing her senior year of collegiate basketball. She elected to end her senior season early to have the recommended subtalar fusion surgery. The surgery ended her basketball career but provided pain-free activities of daily living. This case presents unique components compared with available literature on how injury presentation in adult populations can complicate a timely and accurate initial diagnosis. This case is also unique because despite conservative efforts, a surgical fusion was required to optimize pain and function during activities of daily living. [ABSTRACT FROM AUTHOR]

Background: After injuries, infections, or tumor removal, endogenous healing depends on bone repair. Disorders of bone healing are difficult to treat in clinical settings. There are numerous induced methods for correcting bone abnormalities, such as the induced membrane technique, allogenic bone grafting, synthetic bone grafting, artificial joint replacement, and autologous bone grafting. However, the delivery of the bone graft and bone filling materials necessitates surgical implantation at the fracture site, which could cause edema, infection, and the development of heterotopic bone locally. Therefore, systemically administered osteogenic drugs will provide an excellent method for bone lesion healing. Aim of the study: to evaluate the systemic effect of metformin on bone healing after surgical induction of bony defect and to determine the amount of newly formed bone using histological, histomorphometric analysis, and the surface area measurement of newly formed bone. Also to study the safety of metformin administration at the administered dose for this purpose. Materials and Methods: Twenty mature male New Zealand rabbits were separated into two groups, each including ten rabbits for the study. The same surgical procedure was performed on all rabbits. Two holes were made at the femur (3 mm in diameter and 3 mm in depth) and left empty. Metformin tablets were ground into a fine powder and the resultant powder was dissolved in 10ml of water to prepare a liquid dosage containing 50 mg/1ml of metformin. Metformin is administered orally to the rabbits through a feeding tube at a dose of 50 mg/kg body weight. Animals were euthanized at two-time intervals, 14 and 28 days. The femur was separated, sectioned preserved, and sent for histological analysis and histomorphometry. Results: The results revealed that there is an increase in new bone formation and bone-forming cells in the metformin-treated group. Conclusion: Metformin increases bone healing by increasing the number of bone-forming cells and the surface area of newly formed bone tissues and causes less inflammatory response at the site of a bone lesion. So it possesses an osteogenic effect. [ABSTRACT FROM AUTHOR]

Background: Calcaneonavicular (CNC) and talocalcaneal (TCC) coalitions are the most common cause of rigid flatfoot in children. After resection, correction of the most frequent valgus-hindfoot deformity usually requires a second-step surgery. We report results of a retrospective study of patients treated with a one-step correction. Methods: Between 2008 and 2019, data were collected on 26 patients (19 male, 7 female) affected by CNC (n = 18) and TCC (n = 13), all with rigid symptomatic flatfeet. Average age at surgery was 12.5 ± 1.1 (SD) years (range, 9.8-15.2). All patients (26/26) underwent resection, 20 of 26 underwent at the same time subtalar extraarticular screw arthroereisis (SESA) for correction of residual hindfoot valgus deformity. Pre- and postoperative talocalcaneal angle according to Costa Bartani and Talar inclination angle in weightbearing were measured. Twenty-five of 26 patients had postoperative American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score. Results: Pre- and postoperative talocalcaneal average angle for CNC was respectively 141.5 ± 7.7 degrees and 130.5 ± 5.2 degrees (P < .0001) and 143.7 ± 7.7 degrees and 129.7 ± 7.0 degrees (P < .0001) for TCC. Talar inclination average angle for CNC was 29.2 ± 5.3 degrees and 19.3 ± 1.6 degrees (P < .0001) and 31.2 ± 6.4 degrees and 21.4 ± 3.4 degrees (P < .0001) for TCC. Average follow-up (FU) was 4.7 ± 3.0 years (range, 6 months-11.9 years, median 4.9 years), with a mean age at FU of 17.2 ± 5.8 (SD) years (min 12.1, max 25.3, median 16.8 years). The mean AOFAS ankle-hindfoot score for CNC and for TCC was 96.6 (range 83-100) for resection and valgus correction as one-step procedure with no statistical difference (P = .5) between CNC and TCC. No patients had additional surgery for complications or recurrence. Conclusion: Symptomatic rigid flatfeet affected by CNC and TCC treated with coalition resection and minimally invasive subtalar arthroereisis (SESA) for residual hindfoot valgus correction in one step in adolescent age achieved good to excellent results in all cases. Further surgery to correct malalignment was avoided. [ABSTRACT FROM AUTHOR]

This pilot study aimed to assess the diagnostic accuracy of CBCT in identifying peri-implantitis-like bone defects in cadavers. Three cadaver dental arches treated with the Thiel embalming method were used. Three different types of peri-implant bone defects (buccal dehiscence, two- to three-wall defects, and circumferential defects) were prepared on 15 implants. Defect depths and lengths were identified clinically using a periodontal probe, radiologically by means of CBCT images, and histologically with a micrometer using an optic microscope. Peri-implant bone defect morphology evaluated using CBCT images matched the clinical defect configuration (100% accuracy). CBCT assessment demonstrated lower values in defect depth and defect length when compared with the clinical evaluation. A statistically significant difference in defect depth (0.35 ± 0.45 mm; P = .037) was recorded between the clinical and CBCT data. Regarding defect length, a statistically significant mean difference of 0.81 ± 0.83 mm (P = .003) was noted between the clinical and CBCT data. Similarly, a mean difference of 1.09 ± 1.52 mm was recorded between the defect length assessed histologically and the CBCT data (P = .031). No statistically significant differences were observed between the other evaluated variables. CBCT is a reliable tool for peri-implantitis diagnosis and treatment planning, though the underestimation of defect severity may affect the prognosis and clinical decision-making. Clinicians need to be flexible in establishing prognoses and treatment based on CBCT assessment. [ABSTRACT FROM AUTHOR]

Despite the widespread use of cone beam computed tomography (CBCT), few articles have been published to assess the accuracy in detecting alveolar bone defects using different CBCT exposure settings. A human cadaver with rounded bone defects in various locations was scanned using a CBCT scanner at different settings. Four examiners twice studied 1,500 crosssectional digital and printed slices for defect presence, location, and size. High-resolution zoom mode achieved the highest overall accuracy. Moreover, apical location of the defects significantly affected overall accuracy. Bone defect detection depends upon exposure settings of CBCT scans. Exposure settings and field of view dimensions should be individualized per case. [ABSTRACT FROM AUTHOR]

TBCK syndrome is an autosomal recessive disorder primarily characterized by global developmental delay, hypotonia, abnormal magnetic resonance imaging (MRI), and distinctive craniofacial phenotypes. High variability is observed among affected individuals and their corresponding variants, making clinical diagnosis challenging. Here, we discuss recent breakthroughs in clinical considerations, TBCK function, and therapeutic development. [ABSTRACT FROM AUTHOR]

A case study of a 19-year-old young man, dealing with a foot pain condition, and spondyloarthritis, a group of chronic inflammatory rheumatic diseases on the association of Haglund's disease,. Topics include posing a problem of differential diagnosis and medical therapy; and symptoms of enthesitic peripheral spondyloarthritis retained according to the criteria of the Assessment of Spondylo-Arthritis International Society (ASAS).

Background. CKD-MBD is a mineral and bone metabolism syndrome caused by chronic kidney disease. FGF23 is an important factor regulating phosphorus and is the main influencer in the CKD-MBD process. In this study, we observed the correlation among serum FGF23 and calcium, phosphorus and parathyroid hormone, and the correlation between FGF23 levels and cardiac structural changes in MHD patients. Methods. We examined serum FGF23 concentrations in 107 cases of MHD patients using the ELISA method, recorded demographic information and biochemical data, and analyzed the correlation between serum FGF23 levels and blood calcium and blood phosphorus and PTH levels. All patients were evaluated by cardiac color ultrasound, and we finally analyzed the association between the FGF23 level and cardiac structural changes. Results. In 107 cases of MHD patients, serum FGF23 levels were linearly associated with serum calcium (r = 0.27 P < 0.01) and parathyroid hormone levels (r = 0.25, P < 0.05). FGF 23 was negatively correlated with age (r = −0.44, P < 0.01).Serum FGF23 levels were correlated with right atrial hypertrophy in HD patients (P < 0.05). No correlation was found among FGF23, left ventricular hypertrophy/enlargement, and valve calcification stenosis (P > 0.05). Conclusion. Serum FGF23 showed a positive correlation among blood calcium levels and PTH levels in hemodialysis patients, and FGF23 levels can affect the incidence of right atrial hypertrophy in MHD patients. [ABSTRACT FROM AUTHOR]

Purpose of Review: Describe the potential contribution of disorganized tissue to the pathogenesis of bone abnormalities and fractures. Especially, fractures that are unexplained by bone loss (osteoporosis) or structural deterioration. Recent Findings: Currently, bone fragility is primarily viewed as due to loss, or decay (osteoporosis). However, it is also acknowledged that this view is limited because it does not explain many fractures or abnormalities such as necrosis, sclerosis, or infarcts. Atypical femoral fractures (AFFs) during antiresorptive therapy are an example. Hence, it is proposed that another distinct mechanism is responsible for bone diseases. A remarkable bone property distinct from mass and decay is the organization (arrangement) of its components. Components must be perfectly assembled or well-stacked to ensure "the right amount of bone, at the right place". Disorganization is an aberration that is conspicuous in many diseases, more so in conditions poorly associated with bone mass and decay such as osteogenesis imperfecta, hypophosphatasia, and AFFs. However, despite the likely critical role of disorganization, this feature has received limited clinical attention. Summary: This review focuses on the potential contribution of disorganization to bone in health and diseases. Particularly, we propose that disorganization, by causing ineffective transfer of loads, may produce not only bone abnormalities (pain, necrosis, infarct, sclerosis, delayed healing) but also fractures, especially AFFs or stress fractures. A disorganized element is one that is where it shouldn't be (improperly stacked elements). Hence, disorganization can be measured by quantifying the extent to which a tissue (pixel within an image) is at an incorrect location. [ABSTRACT FROM AUTHOR]

Tarsal coalitions are anomalous connections between two or more bones in the hindfoot or midfoot secondary to embryonic failure of segmentation and differentiation of the mesenchyme. Calcaneonavicular and talocalcaneal coalitions are the most common. Although it is a congenital deformity, presentation is usually in adolescence which coincides with ossification of the coalition. Patients typically present with diffuse foot pain, calf muscle pain, recurrent ankle ligament sprains and a rigid hindfoot valgus deformity. Initial management is non-operative and may involve activity reduction, a trial of immobilization in a walking boot or cast, physiotherapy, corticosteroid injections and regular analgesia. Close to a third of patients experience symptom relief but the remaining patients with persistent symptoms will require operative intervention. Patients without degenerative joint disease undergo resection of the coalition. It is now established that an associated severe hindfoot valgus foot should be addressed at this stage to prevent inevitable future joint degeneration. The indications for joint fusion remain unclear and the tendency is to postpone this when possible until a later age. In recent years, arthroscopic resection of talocalcaneal coalitions has gained popularity, despite being technically demanding. It gives good visualization of the coalition, better postoperative pain relief and quicker improvement of the hindfoot stiffness. [ABSTRACT FROM AUTHOR]

The therapy of bone defects based on advanced biological scaffolds offers the most promising therapeutic strategy for bone reconstruction. It is still challenging to develop scaffolds with the mechanical, osteogenic, angiogenic, and antibacterial properties required for bone defect reconstruction. Here, a novel organic/inorganic composite scaffold (zinc-whitlockite (ZnWH)/G/H) was synthesized using gellan gum (GG), human-like collagen (HLC), and ZnWH nanoparticles. The scaffold had excellent mechanical properties, adjustable swelling ratio, and interconnected pore structure. In addition to its excellent biocompatibility, it could promote osteogenic differentiation by releasing ZnWH nanoparticles to stimulate human bone marrow mesenchymal stem cells (hBMSCs) to upregulate the levels of alkaline phosphatase (ALP), osteocalcin (OCN), and osteopontin (OPN). In addition, this study showed that ZnWH nanoparticles could also promote angiogenesis by upregulating the paracrine secretion of vascular endothelial growth factor (VEGF) in hBMSCs. At the same time, the scaffold could inhibit the proliferation of bacteria. After 12 weeks of treatment in the rabbit femoral defect model, the ZnWH/G/H scaffold significantly accelerated the process of bone reconstruction. Therefore, these results demonstrate that the prepared novel nanocomposite scaffold, ZnWH/G/H, offers a promising candidate for bone regeneration. [ABSTRACT FROM AUTHOR]

Tarsal coalitions are abnormal fibrous or bony connections between the tarsal bones of the foot. While not always symptomatic, coalitions can cause pain, alterations in forefoot and hindfoot morphology, and alterations in foot and ankle biomechanics. Previous research has described the association of tarsal coalitions with fractures of the lower extremity. Multiple reports of acute fracture in the presence of tarsal coalition have been presented, as have reports of stress fractures of the foot and ankle with concomitant coalition, insidious in onset and thought to be related to aberrancies in foot and ankle biomechanics. The purpose of this review is to discuss the biomechanics seen in tarsal coalitions and to describe reports of fracture occurring concomitantly with tarsal coalitions. We will discuss diagnostic options and treatment approaches in the setting of fracture with preexisting tarsal coalition. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this clinical study was to evaluate the long-term outcome of the split bone block (SBB) technique for vertical bone augmentation in the posterior maxilla in combination with sinus floor elevation using a tunneling approach. Materials and Methods: Patients were treated for extensive vertical and horizontal alveolar bone defects without simultaneous implant placement and followed up for at least 10 years postoperatively. Autogenous bone blocks were harvested from the mandibular retromolar area following the MicroSaw protocol. The harvested bone blocks were split longitudinally according to the SBB technique. Implants were inserted and exposed after every 3 months, and prosthetic restoration was performed. Results: One hundred forty-two consecutively treated patients, 154 grafted sites, and 356 inserted implants were documented. Minimal graft exposure (1 to 3 mm) 4 to 8 weeks postoperatively was documented in two sites; infection of the grafted area occurred in one other case. The mean preoperative clinical vertical defect was 7.8 ± 3.9 mm, and the mean horizontal width was 3.1 ± 2.2 mm. Postoperatively, the mean vertical gained dimension was 7.6 ± 3.4 mm (maximum: 13 mm), and the mean width was 8.3 ± 1.8 mm. Implants could be inserted in all sites, with additional local small augmentation in 21 cases. The amount of maximum vertical bone resorption was 0.21 ± 0.18 mm after 1 year, 0.26 ± 0.21 mm after 3 years, 0.32 ± 0.19 mm after 5 years, and 0.63 ± 0.32 mm after 10 years. As part of a total patient dropout of 16.9%, four implants were lost within 10 years. The mean vertically gained bone was stable at 6.82 ± 0.28 mm (maximum: 12 mm). The resorption rate after 10 years was 8.3%. Conclusion: The described tunneling flap approach allows a hermetic soft tissue closure, characterized by a reduction of dehiscence and a secure bone graft healing. The combination of thin autogenous bone blocks and bone particles according to the SBB technique allows an acceleration of transplant revascularization, and thus, of graft regeneration, allowing a shortening of the patient treatment time as well as long-term three-dimensional volumetric bone stability. [ABSTRACT FROM AUTHOR]

Background: Resection of tarsal coalitions provides good patient satisfaction scores, reduced pain, and improved long-term function in both athletic and non-athletic populations. This study aimed to determine when athletic patients undergoing resection of a tarsal coalition were able to return to their desired activity, and whether they experienced a decreased desired activity level (DDA). Methods: Data on a total of 78 patients who underwent 97 tarsal coalition resections (49 talocalcaneal coalitions, 47 calcaneo-navicular, 14 cuboid-navicular, and three cuneo-navicular; some patients had more than one coalition) operated between January 2001 and June 2020 were prospectively collected. To subjectively assess outcomes, the Roles and Maudsley score (RM) was utilized. Results: At an average follow-up from the index procedure of 33.6 ± 41.5 months, return to activity for the entire cohort was 18.3 ± 9.6 weeks. Post-RM was 1.3 ± 0.6. Conclusion: Surgical excision of tarsal coalitions produced favorable results, with most patients able to return to their desired activity level. Level of evidence: IV. [ABSTRACT FROM AUTHOR]

Background: Middle phalanx physeal fractures in children are rare, and proper treatment gives good results. Despite treatment, these fractures may lead to physeal arrest and growth disturbances leading to severe angulation deformities. Closed wedge osteotomy with internal fixation efficiently corrects the angulation deformities in children. Methods: We did a retrospective study analyzing 11 children with middle phalanx physeal injuries and severe angulation. Closed wedge osteotomy and internal fixation with plate and screw were done. We interpreted the pre- and postoperative correction of angles, middle phalanx length discrepancy, technical aspects, range of movement, grip strength, pain, and functional outcomes. Results: The mean age of the patients was 10.5 years. The mean follow-up was 28 months (range 24–30 months). Ten of the 11 patients achieved good radiological union, range of motion, and good outcome. None of the patients had growth plate deformity in the follow-up. All patients had a significant correction of angulation/deformity, length, and improvement of grip strength in the postoperative period (p < 0.05). None had physeal disturbances/abnormalities in the follow-up. Conclusions: Though middle phalanx physeal fractures are rare and innocuous, adequate treatment is essential to prevent angulation and growth disturbances. Close wedge corrective osteotomy and internal fixation with plates and screws provide stable and rigid fixation. Greater attention is needed to follow-up them until skeletal maturity. Level of evidence: IV. [ABSTRACT FROM AUTHOR]

The present study was performed to evaluate the impact of smoking status on 6-month clinical outcomes of a regenerative procedure based on enamel matrix derivative and deproteinized bovine bone mineral in the treatment of intraosseous defects accessed with buccal single flap approach. A total of 22 defects were selected in smoking (n = 11) and nonsmoking (n = 11) patients. Regenerative treatment resulted in similar clinical attachment level (CAL) gain in both smokers and nonsmokers. A trend toward lower 6-month CAL gain and probing depth reduction was observed in patients smoking 11 to 20 cigarettes per day compared to those smoking 1 to 10 cigarettes per day. [ABSTRACT FROM AUTHOR]

Unlike long bones, jawbone development is mainly accomplished by intramembranous ossification resulting from the differentiation of periosteal progenitor cells. However, the spatiotemporal ontogeny of periosteal progenitor cells during jawbone development and repair remains elusive. In this study, we mapped the transcriptional landscape of the human jawbone periosteum at single-cell resolution and identified a cathepsin K (Ctsk)+ periosteal subset. Lineage tracing analysis indicated that Ctsk-Cre–labeled periosteal cells could make contributions to jawbone development. However, different from the periosteal-specific location of Ctsk+ cells in long bone, we also identified Ctsk+ stromal cells in jawbone marrow and implied the heterogeneity of jawbone Ctsk+ hierarchy. In further analysis of the periosteal progenitor cell subset of heterogeneous Ctsk+ hierarchy, we identified a unique Ctsk+Ly6a+ subset of cells. The additional marker Ly6a helped to further confine the progenitor subset to the jawbone periosteum and was nearly undetectable in the bone marrow. Defects in the jawbone could activate the migration and osteogenic differentiation of Ctsk+Ly6a+ cells. Local ablation of Ctsk+ cells by diphtheria reduced the number of Ctsk+Ly6a+ cells and delayed the repair of the bone defect. Taken together, we identify a novel periosteal osteogenic progenitor subset that is active in jawbone osteogenesis and healing. [ABSTRACT FROM AUTHOR]

A case study of female baby is presented who was born at a gestational age of 35 weeks, AGA, to a 25-year-old mother with a history of type I diabetes for several years, chronic hypertension, and a known history of 2 previous spontaneous abortions (G3P1). Topics include examines the pregnancy was complicated by maternal COVID infection two months before delivery.

Summary: This study describes the clinical, radiological, and molecular data of four new patients with osteoporosis-pseudoglioma syndrome and assesses their response to bisphosphonate therapy. Introduction: Osteoporosis-pseudoglioma syndrome (OPPG) is a very rare disorder characterized mainly by severe juvenile osteoporosis and congenital blindness. OPPG is caused by biallelic mutations in the gene encoding low-density lipoprotein receptor-related protein 5 (LRP5). Methods: We present the clinical, radiological, and molecular findings of four new patients with OPPG from Egypt. We also assessed patients' response to oral and intravenous bisphosphonate therapy. Results: All patients had reduced bone mineral density (BMD) with variable number of fractures per year, in addition to bone abnormalities and the characteristic eye phenotype associated with OPPG. Mutation analyses of LRP5 gene revealed three different homozygous variants including two novel ones, c.7delG (p.A3Qfs*80) and c.3280G > A (p.E1094K). The c.3280G > A (p.E1094K) was recurrent in two unrelated patients who shared a unique haplotype suggesting a possible founder effect. The use of bisphosphonate therapy was beneficial; however, intravenous bisphosphonate administration led to a more favorable response. Conclusion: Our study described the phenotypic and genetic features of four patients with OPPG and identified two new LRP5 variants, thus expanding the mutational spectrum of OPPG. In addition, our study reinforces the efficiency of using intravenous bisphosphonates in the management of patients with OPPG. [ABSTRACT FROM AUTHOR]

Introduction: The styloid process (SP) is a cylindrical bony structure emerging from the lower surface of the petrous temporal bone, its normal length is from 20 mm to 30 mm and those with more than 30 mm length are considered elongated. Calcification in stylohyoid ligament or calcification of SP is termed Eagle's syndrome. The aim of this study is to conduct an epidemiological survey of SP on digital orthopantomogram (OPG) in the Saurashtra population with an age range of 5--90 years. Materials and Methods: This is a retrospective study of 1088 OPG radiographs randomly selected from the database of 2019--2020 from the oral medicine and radiology department of our institute, which was taken on the OPG model CS 8100 Carestream digital panoramic system. Measurements of SP were done from the temporal bone to the tip. Those with more than 30 mm in length were considered to be elongated. The study sample was divided into four different age groups and was compared according to gender and sides. The Chi-square test and t-test were performed. Results: Elongated SP was noted in 354 (32.53%) out of 1088 subjects. Among age groups, subjects of more than 50 years showed a maximum number of elongated SPs. Conclusion: Subjects showing elongated SP and their mean length are increased with age, which indicates chronic development of calcification. No statistical significance was found in the elongation of SP in correlation with the cohort's gender and sides (bilateral or unilateral). [ABSTRACT FROM AUTHOR]

Snyder-Robinson syndrome is an extremely rare genetic disorder, caused by mutations of the spermine synthase gene. We report a novel case of Snyder-Robinson syndrome, caused by a de novo mutation and first misdiagnosed with osteogenesis imperfecta. Clinical features, course, and genetic analysis are presented. The patient was treated with bisphosphonates for a decade, until developing an atypical femoral fracture. Teriparatide was then administered for 2 years and then changed to denosumab every 6 months, improving his bone density mass and preventing further fractures. [ABSTRACT FROM AUTHOR]

Background: Sutural bones or wormian bones (an unusual anatomical variant associated with inadequate closure of suture) are extra intrasutural irregular isolated bones that occur additionally at the center of ossification of the skull; along sutures, around sutures or between the cranial sutures formed by bones of the skull vault. Case Presentation: This report displays a case of the presence of an unusual sutural bone at the bregma of the skull of a cadaver during maceration; hence revealing and supporting the possibility of variations in ossification centers and skull matrix which could aid neurosurgeons, orthopedics, and radiologists in their practices. Conclusion: The human bregmatic sutural bone presented in this report is a rare occurrence. Considering its location in the skull, it is the first kind reported in Nigeria and Africa as well as one of the few cases reported across the Globe. [ABSTRACT FROM AUTHOR]

The morphology of the proximal carpals (scaphoid, lunate, triquetrum) are linked to the range of motion (ROM) at the radiocarpal and midcarpal joints. While the relationship between ROM and habitual locomotor mode is well established, it has yet to be investigated whether relative patterns of internal bone architecture reflect the kinematics and kinetics at the proximal row. As internal bone is known to model its structure to habitually incurred forces, internal architecture has the potential to provide insight into how joints have been loaded during the lifetime of an individual. Using a broad sample of extant great apes and humans (n = 177 total bones), this study investigates whether relative differences in the bone volume to total volume (BV/TV) and degree of anisotropy (DA) across the scaphoid, lunate and triquetrum correlate with the presumed force transfer and biomechanics of the hominoid wrist. Results reveal that broad patterns in BV/TV and DA differentiate hominoids by their predominant locomotor mode. The human pattern suggests the lunate may be the most highly strained bone within the proximal row. Both knuckle‐walking taxa (Gorilla, Pan) exhibited similar architectural patterns suggesting they are adapted to resist similar forces in this region of the wrist. The relatively high DA across all Pongo carpals suggests it may have more stereotypical wrist loading than commonly assumed. Finally, the distinctly low DA in the triquetrum across all taxa suggests force transfer via the synapomorphic triangular fibrocartilage complex may leave a distinctive signature in the internal bone architecture that requires further investigation. Objectives: Functional adaptation in the trabecular and cortical bone of individual wrist bones has been investigated across hominoid species but functional conclusions remain limited. This study examines whether relative patterns in internal bone architecture across multiple carpal bones can be correlated to the known or assumed kinetics and kinematics of the wrist joint in extant hominoids. Materials and Methods: This study applied a whole‐bone methodology to quantify the internal architecture (cortical and trabecular bone) of the scaphoid, lunate, and triquetrum of suspensory (Pongo sp.), knuckle‐walking (Pan paniscus, Pan troglodytes, Gorilla sp.) and bipedal (Homo sapiens) hominoids (n = 177 total bones). Results: H. sapiens showed unique patterns in both measured parameters: a decrease in degree of anisotropy (DA) from the scaphoid to the triquetrum with higher bone volume to total volume (BV/TV) in the lunate relative to the other bones. Knuckle‐walking taxa had similar patterns in both parameters: highest mean DA in the lunate and lowest in the triquetrum while significantly higher BV/TV was recorded the triquetrum. Pongo exhibited the same DA pattern as knuckle‐walking taxa but a distinct pattern of continual decrease in BV/TV from scaphoid to triquetrum. Discussion Relative differences in the internal bone structure across multiple carpals differentiated locomotor modes in extant hominoids. The triquetrum and lunate are particularly understudied but their importance to differentiating locomotor mode indicates further research is warranted. Establishing patterns across more carpal joints in primates should be a research priority as they will provide critical context to interpreting fossil species represented by single or few carpal elements. [ABSTRACT FROM AUTHOR]

Articular facet morphology plays a fundamental role in subtalar joint biomechanics and stability, and likely influences the development of hindfoot osteoarthritis. While multiple anatomical studies have shown wide variation in articular facet configuration, the clinico-radiological findings are rarely presented. We illustrate a case of bilateral subtalar joint middle facet agenesis in a 45-year-old woman, which was missed despite several presentations. We demonstrate the imaging findings to enable clinicians to distinguish this from the more common middle facet coalition. We summarise the developmental anatomy and discuss the potential implications on biomechanical function. Recognition of middle facet agenesis within the complex subtalar joint is important to prevent misdiagnosis and unnecessary surgery. [ABSTRACT FROM AUTHOR]

Heart failure (HF) is a prevalent clinical syndrome that causes significant physical limitations. Osteoporosis is also an important cause of loss of functionality, and it mainly affects women. There are several reports linking HF and osteoporosis, and both share risk factors. Most of the data available so far point to bone fragility as a consequence of HF, and several mechanisms have been identified to explain this relationship. Among the proposed pathophysiological mechanisms are the hyperactivation of the renin–angiotensin–aldosterone system and the increase in parathyroid hormone, functional limitation, production of inflammatory mediators and the use of drugs for HF. The role of osteoprotegerin has gained attention owing to its cardiovascular and skeletal effects, its observed deficiency during the postmenopausal period along with its compensatory increases in HF and severe osteoporosis. The objective of this review was to perform a literature search for the main evidence on skeletal impairment in HF, with emphasis on women. As for epidemiological studies, we selected data from 3 meta-analyses and 20 individual observational studies, which together showed the interrelationship between the two clinical conditions in terms of both decreased bone density and increased fracture risk. In conclusion, HF and osteoporosis are interrelated conditions mediated by complex pathophysiological mechanisms which may be more relevant for postmenopausal women, considered to be a vulnerable population for both cardiovascular diseases and bone fragility. [ABSTRACT FROM AUTHOR]

Objective: This study describes the radiographic diagnosis and nonoperative chiropractic management for a case of a chronic calcaneonavicular coalition in an adult patient. Background: Calcaneonavicular coalition is a congenital/acquired condition of the tarsal bones often diagnosed in individuals 8-12 years old. Considering its rare presentation (less than 1% of the population), there remains little literature on the conservative management of this condition. Case presentation: Chronic calcaneonavicular coalition in a 35-year-old recreational athlete is presented. Management/outcome: Following radiographic diagnosis, the patient was placed in a walking boot for four-weeks. After removal of the boot, the patient was managed nonoperatively. They reported a full resolution of symptoms with noted return to all pre-injury activities. Summary: Presentation of calcaneonavicular coalition may be dependent on many factors, including age, medical history, and chronicity of the condition. Previous medical background may include recurrent inversion ankle sprains, aggravated with activity, and alleviated with rest. Nonoperative management of calcaneonavicular coalition may be considered as a viable intervention. [ABSTRACT FROM AUTHOR]

Tricho-dento-osseous syndrome (TDO) is a rare autosomal dominant disorder with complete penetrance. Common clinical features include abnormalities of hair, teeth, and skull. Dental management of TDO patients is quite challenging in terms of existing dental and skeletal problems. The current article presents a 12-year-old girl suffering TDO, followed by a review on the published literature pertaining to the dental management of TDO patients. Patient history included, rejected corneal transplantation, stone-forming kidneys, and several previous dental treatments. She was noted to have signs of mandibular prognatia, frontal bossing of the skull, mild bilateral tibial bowing, microstomia, and labial fissures. Dental findings included severe generalized enamel defects, discolored teeth, microdontia, anterior open-bite, posterior cross-bite, deep periodontal pockets, hyperplastic inflamed gingiva, taurodontism of permanent molars, dental periapical radiolucencies, and missing teeth. She was the only child of healthy, nonconsanguineous parents with no familial history of similar congenital syndrome or dental abnormalities. A treatment plan was established based on medical/dental history and findings, using a team-based approach. This article emphasizes the importance of a multidisciplinary approach for the dental management of patients suffering TDO. [ABSTRACT FROM AUTHOR]

The reconstruction of long-bone segmental defects remains challenging, with the three common methods of treatment being bone transport, vascularized bone transfer, and the induced membrane technique (IMT). Because of its simplicity, replicability, and reliability, usage of IMT has spread all over the world in the last decade, with more than 300 papers published in the PubMed literature database on this subject so far. Most of the clinical studies have reported high rates of bone union, yet some also include more controversial results with frequent complications and revision surgeries. At the same time, various experimental research efforts have been designed to understand and improve the biological properties of the induced membrane. This literature review aims to provide an overview of IMT clinical results in terms of bone union and complications and to compare them with those of other reconstructive procedures. In light of our findings, we then propose an original classification scheme of IMT failures distinguishing between preventable and nonpreventable failures. [ABSTRACT FROM AUTHOR]

Tissue engineering principles allow the generation of functional tissues for biomedical applications. Reconstruction of large-scale bone defects with tissue-engineered bone has still not entered the clinical routine. In the present study, a bone substitute in combination with mesenchymal stem cells (MSC) and endothelial progenitor cells (EPC) with or without growth factors BMP-2 and VEGF-A was prevascularized by an arteriovenous (AV) loop and transplanted into a critical-size tibia defect in the sheep model. With 3D imaging and immunohistochemistry, we could show that this approach is a feasible and simple alternative to the current clinical therapeutic option. This study serves as proof of concept for using large-scale transplantable, vascularized, and customizable bone, generated in a living organism for the reconstruction of load-bearing bone defects, individually tailored to the patient's needs. With this approach in personalized medicine for the reconstruction of critical-size bone defects, regeneration of parts of the human body will become possible in the near future. [ABSTRACT FROM AUTHOR]

Objective: To reveal the proportion of concomitant extragenital malformations in a large cohort of Chinese patients with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome.Study Design: Retrospective study.Setting: Tertiary teaching hospitals in China.Patient(s): A total of 1,055 Chinese Han women with MRKH syndrome diagnosed and treated at 11 Chinese tertiary teaching hospitals from January 2015 to January 2020.Intervention(s): Karyotype analysis, hormone profiling, pelvic ultrasonography, spinal roentgenograms, urologic ultrasonography, and Chinese female reproductive tract malformation registry platform (https://ecrf.linklab.com/).Main Outcome Measure(s): Patients' demographic and clinical characteristics, concurrent malformations, and family histories.Result(s): Of the 1,055 Chinese Han patients with MRKH, 69.6% had type I MRKH syndrome and the remaining 30.4% had type II MRKH syndrome. Among the type II patients, 12.6% had müllerian duct aplasia, unilateral renal aplasia/ectopic kidney, and cervicothoracic somite dysplasia association. Skeletal malformations were the most common associated extragenital malformations in the study (22.0%, 232/1,055), of which idiopathic scoliosis and congenital vertebral malformations were the 2 main skeletal malformations (80.6% and 14.2%, respectively). Renal malformations were the second-highest associated extragenital malformations (9.7%, 102/1,055), with unilateral renal agenesis and ectopic kidney being the most common renal malformations (48.0% and 22.5%, respectively).Conclusion(s): Type II disease was less common among Chinese patients with MRKH syndrome compared with European patients. Skeletal malformations were more common extragenital malformations than renal malformations in our cohort. [ABSTRACT FROM AUTHOR]

Background: Intercalary bone defects are challenging for both surgeon and patient. The Masquelet's induced membrane technique saves bone consolidation time is less technically demanding than other techniques and achieves good results in the reconstruction of large extra-articular intercalary bone defects. Patients and Methods: This prospective study reviewed 60 patients treated with the induced membrane technique. Patients with femoral or tibial extra-articular intercalary bone defects >5 cm long, occurring either posttraumatically or after debridement of infected bone, were included in the study. Patients with bone defects <5 cm long were excluded from the study. The male-to-female ratio was 17:3. Patient age ranged from 10 to 50 years. Recorded outcomes included union, infection, residual deformity, soft-tissue healing, persistent pain, return to previous occupation, permanent joint contracture, and patient satisfaction. Results: Mean follow-up was 3.1 years (range, 2.2-4 years). Mean intercalary bone defect measured 7.5 cm (range, 5-13 cm) in length. Forty-five of 60 patients had open fractures. Thirty-nine underwent Ilizarov fixation, 12 with locked plates, and nine with a limb reconstruction system. The mean interval between the first and second stages was 56 days (range, 42-84 days). Bony union was achieved in 51 patients (85%). Twelve patients experienced relapsed infection during treatment, three because of flap failure, and nine because of inadequate debridement. Three were treated with repeat debridement and free vascularized flap after gastrocnemius flap, six underwent bone transport, and three required amputation. Conclusion: The Masquelet's induced membrane technique was highly effective in achieving the union of large femoral intercalary bone defects, with mixed results in the tibia. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the behavior of a demineralized bone matrix membrane and a polytetrafluoroethylene (PTFE) membrane in the process of bone repair of surgical defects filled with autogenous bone in rats. Materials and Methods: Sixty rats weighing approximately 250 g each were selected and separated into three groups: control group without membrane, demineralized bone matrix membrane group, and PTFE membrane group. Bilaterally, surgical defects of 2 mm in diameter were prepared in the tibiae. The defect in the left tibia was filled with particulate autogenous bone collected during the creation of the two defects and was left uncovered (control) or was covered with the membranes investigated by the present study. At 10 or 60 days postoperatively, the rats were euthanized and the left tibiae were submitted to routine laboratory processing for histomorphometric analysis. All groups were evaluated separately on the 10th and 60th days after surgery. The Kruskal-Wallis test was used for group comparison. Results: The membrane-treated defects showed a delay in healing. Sites treated with demineralized bone matrix membrane showed, as early as day 10, more newly formed bone and slow replacement until day 60. At day 60, the sites covered with demineralized bone matrix membrane and with synthetic membrane showed statistically significant results. Conclusion: The demineralized bone matrix membrane proved to be biocompatible. In terms of newly formed bone area, both membranes showed similar performance. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated the retrospective outcomes of implant-borne dental rehabilitation in patients with mandibular defects reconstructed with a fibula free flap. Materials and Methods: Patients with segmental mandibular defects were enrolled in this cohort study. Defects in these patients were caused by oral neoplasm, trauma, and osteoradionecrosis. The patients were treated with a fibula free flap procedure and dental implant–borne prostheses between 1988 and 2010. Clinical and radiographic data were evaluated; Kaplan-Meier survival analysis and Poisson regression analysis were used to evaluate implant survival parameters. The statistical significance (α = .05) of the results was determined. Results: Seventy-four patients were selected in this study. All patients were available for continuous follow-up. Nine patients (12.1%) developed fibular graft complications postoperatively: 3 in donor sites and 6 in recipient sites. One hundred ninety-two implants were inserted, and 18 implants failed (9.3%). Overall implant survival in patients was 90.1%, 83.1%, and 69.3% after 5, 10, and 20 years, respectively. In 152 implants, probing depth (PD) ranged from 2 to 3 mm. In 31 implants, PD was greater than 5 mm. In 9 implants, PD was greater than 7 mm. The highest implant failure rates were expected for men (odds ratio [OR] = 2.948; 95% confidence interval [CI], 1.10 to 7.85; P = .031), patients receiving primary fibula free flap reconstruction (OR = 3.696; 95% CI, 1.16 to 11.73; P = .027), and patients receiving radiotherapy (OR = 5.269; 95% CI, 1.40 to 19.7; P = .014). Conclusion: Fibula free flap procedures and implant-borne prostheses proved to be reliable approaches for rehabilitation of mandibular defects and oral function. The overall postoperative fibula free flap and peri-implant complication rates proved to be low. Regular follow-up visits and proper oral hygiene maintenance contributed to the long-term successful treatments. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to assess the effect of characterized uncultured omental adipose–derived stromal vascular fraction (SVF) on bone regeneration in a circular mandibular bone defect. A chitosan scaffold was used to maintain the cells in situ. Materials and Methods: Seventy-five healthy male white Wistar rats were randomized into three experimental groups. In the control group, a surgical bone defect was created in the body of the mandible. In the scaffold group, a chitosan scaffold was placed into the defect. In the scaffold/SVF group, a scaffold was implanted and seeded with 10-µL SVF aliquots (2.19 ± 0.43 × 107 cells). Results: Microscopic and histomorphometric analyses showed improved and earlier regeneration of bone defects in the scaffold/SVF group compared to the scaffold-only group. Conclusion: In this animal model, the use of a chitosan scaffold with SVF aliquots resulted in significantly earlier regeneration of bone than the use of the scaffold alone. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this systematic review was to identify studies in which either orthodontic extrusion or bone grafting was used prior to single implant placement in the maxillary esthetic zone and to compare the biologic, functional, and esthetic outcomes of these two approaches. Materials and Methods: An electronic MEDLINE search was conducted by three independent reviewers to identify English-language articles, published in dental journals between January 1992 and August 2013, reporting on single-implant site development accomplished by orthodontic forced eruption of nonrestorable teeth or by bone grafting procedures. The search terms were categorized into four groups comprising a PICO (problem, intervention, comparison, outcome) question. Supplementary manual searches of published full-text articles and related reviews were also performed. Results: The initial database search produced 301 relevant titles. After careful examination and discussion, 32 studies were selected for inclusion. No study directly comparing the two implant site development methods was identified. The observation periods of the available studies were either short or not stated Conclusion: There is a substantial lack of evidence to determine which method for implant site development is better. Definitive conclusions cannot be drawn, since no clinical trials have directly compared these two methods. All included studies reported separately on the two implant site– development methods and used different protocols. According to the literature reviewed, it seems that both methods of implant site development are effective and neither method is superior. Multicenter studies and randomized clinical trials should be performed to evaluate the efficacy of these two methods. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate bone healing after the use of a xenograft scaffold enriched with bone marrow mesenchymal stem cells (BM-MSCs), an autogenous bone graft, or the scaffold without BM-MSCs. Materials and Methods: Eighteen rabbits were used for this study; bilateral 12-mm-diameter defects were created in the animals’ parietal bones. The bilateral defects were filled with a xenograft enriched with BM-MSCs (test group [TG]), with autogenous bone graft (positive control group [PCG]), or with a xenograft alone (negative control group [NCG]). In all groups, randomly, one defect was covered with a collagen membrane. The rabbits were sacrificed 8 weeks after surgery, and their parietal bones were harvested and analyzed histomorphometrically. Results: Within the PCG and the NCG, the defects covered with the barrier membrane showed better bone healing. In the TG, the defects covered with the barrier membrane did not show better bone healing (intragroup comparisons by Wilcoxon and Friedman tests for paired data). TG showed percentage of mineralized tissue (MT) of 56.03% ± 3.49% with membrane and 57.71% ± 5.31% without membrane. PCG showed MT of 55.13% ± 4.83% and 49.69% ± 3.81% with and without membrane, respectively, and NCG showed MT of 26.77% ± 7.29% and 19.67% ± 2.66% with and without membrane, respectively. Conclusion: Both autogenous bone graft and a xenograft enriched with BM-MSCs were equally effective for bone reconstruction and better than the xenograft alone. The use of a barrier membrane seemed to have a synergistic effect on bone healing in PCG and NCG but not in TG. [ABSTRACT FROM AUTHOR]

Patients missing portions or all of the maxillary alveolar bone who are restored with zygomatic implants frequently have threads exposed that can be a mucosal irritant. If such irritation is reported, covering the threads with a highly polished titanium sleeve is recommended. The technique of placing said custom sleeve is described. This adjunctive treatment method has eliminated mucosal irritation. [ABSTRACT FROM AUTHOR]

Neurofibromatosis type 1 (NF1) is a genetic multisystem disorder. Clinicians must be aware of the diverse clinical features of this disorder in order to provide optimal care for it. We have set up an NF1 in-hospital medical care network of specialists regardless of patient age, launching a multidisciplinary approach to the disease for the first time in Japan. From January 2014 to December 2020, 246 patients were enrolled in the NF1 patient list and medical records. Mean age was 26.0 years ranging from 3 months to 80 years. The number of patients was higher as age at first visit was lower. There were 107 males (41%) and 139 females. After 2011, the number of patients has increased since the year when the medical care network was started. Regarding orthopedic signs, scoliosis was present in 60 cases (26%), and bone abnormalities in the upper arm, forearm, and tibia in 8 cases (3.5%). Neurofibromas other than cutaneous neurofibromas were present in 90 cases (39%), and MPNST in 17 cases (7.4%). We launched a multidisciplinary NF1 clinic system for the first time in Japan. For patients with NF1, which is a hereditary and systemic disease associated with a high incidence of malignant tumors, it will be of great benefit when the number of such clinics in Japan and the rest of Asia is increased. [ABSTRACT FROM AUTHOR]

The repair of large bone defects is lengthy and complex. Both biomaterials and phototherapy have been used to improve bone repair. We aimed to describe histologically the repair of tibial fractures treated by wiring (W), irradiated or not, with laser (λ780 nm, 70 mW, CW, spot area of 0.5 cm2, 20.4 J/cm2 (4 × 5.1 J/cm2, Twin Flex Evolution®, MM Optics, Sao Carlos, SP, Brazil) per session, 300 s, 142.8 J/cm2 per treatment) or LED (λ850 ± 10 nm, 150 mW, spot area of 0.5 cm2, 20.4 J/cm2 per session, 64 s, 142.8 J/cm2 per treatment, Fisioled®, MM Optics, Sao Carlos, Sao Paulo, Brazil) and associated or not to the use of mineral trioxide aggregate (MTA, Angelus®, Londrina, PR, Brazil). Inflammation was discrete on groups W and W + LEDPT and absent on the others. Phototherapy protocols started immediately before suturing and repeated at every other day for 15 days. Collagen deposition intense on groups W + LEDPT, W + BIO-MTA + LaserPT and W + BIO-MTA + LEDPT and discrete or moderate on the other groups. Reabsorption was discrete on groups W and W + LEDPT and absent on the other groups. Neoformation varied greatly between groups. Most groups were partial and moderately filed with new-formed bone (W, W + LaserPT, W + LEDPT, W + BIO-MTA + LEDPT). On groups W + BIO-MTA and W + BIO-MTA + LaserPT bone, neoformation was intense and complete. Our results are indicative that the association of MTA and PBMT (λ = 780 nm) improves the repair of complete tibial fracture treated with wire osteosynthesis in a rodent model more efficiently than LED (λ = 850 ± 10 nm). [ABSTRACT FROM AUTHOR]

Extra-short implants, of which clinical outcomes remain controversial, are becoming a potential option rather than long implants with bone augmentation in atrophic partially or totally edentulous jaws. The aim of this study was to compare the clinical outcomes and complications between extra-short implants (≤ 6 mm) and longer implants (≥ 8 mm), with and without bone augmentation procedures. Electronic (via PubMed, Web of Science, EMBASE, Cochrane Library) and manual searches were performed for articles published prior to November 2020. Only randomized controlled trials (RCTs) comparing extra-short implants and longer implants in the same study reporting survival rate with an observation period at least 1 year were selected. Data extraction and methodological quality (AMSTAR-2) was assessed by 2 authors independently. A quantitative meta-analysis was performed to compare the survival rate, marginal bone loss (MBL), biological and prosthesis complication rate. Risk of bias was assessed with the Cochrane risk of bias tool 2 and the quality of evidence was determined with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. 21 RCTs were included, among which two were prior registered and 14 adhered to the CONSORT statement. No significant difference was found in the survival rate between extra-short and longer implant at 1- and 3-years follow-up (RR: 1.002, CI 0.981 to 1.024, P = 0.856 at 1 year; RR: 0.996, CI 0.968 to 1.025, P = 0.772 at 3 years, moderate quality), while longer implants had significantly higher survival rate than extra-short implants (RR: 0.970, CI 0.944 to 0.997, P < 0.05) at 5 years. Interestingly, no significant difference was observed when bone augmentations were performed at 5 years (RR: 0.977, CI 0.945 to 1.010, P = 0.171 for reconstructed bone; RR: 0.955, CI 0.912 to 0.999, P < 0.05 for native bone). Both the MBL (from implant placement) (WMD: − 0.22, CI − 0.277 to − 0.164, P < 0.01, low quality) and biological complications rate (RR: 0.321, CI 0.243 to 0.422, P < 0.01, moderate quality) preferred extra-short implants. However, there was no significant difference in terms of MBL (from prosthesis restoration) (WMD: 0.016, CI − 0.036 to 0.068, P = 0.555, moderate quality) or prosthesis complications rate (RR: 1.308, CI 0.893 to 1.915, P = 0.168, moderate quality). The placement of extra-short implants could be an acceptable alternative to longer implants in atrophic posterior arch. Further high-quality RCTs with a long follow-up period are required to corroborate the present outcomes. Registration number The review protocol was registered with PROSPERO (CRD42020155342). [ABSTRACT FROM AUTHOR]

Background: Temporomandibular joint osteoarthritis (TMJOA) is a degenerative disease that gradually affects the articular cartilage, synovium, and bone structure. To date, the molecular mechanism of TMJOA pathogenesis remains unclear. The aim of this study was to explore the biological function of the micro‐ribonucleic acid 101a‐3p (miR‐101a‐3p) and its role in TMJOA. Methods: We detected the effect of interleukin‐1β (IL‐1β) on chondrocyte proliferation using Cell Counting Kit‐8 (CCK‐8) technology. Using quantitative polymerase chain reaction (qPCR), we detected transcription levels of miR‐101a‐3p in a rat model with TMJOA and inflamed chondrocytes, as well as in a group of normal rats. The effect of miR‐101a‐3p on apoptosis was examined in vitro using flow cytometry (FCM). We then analyzed the target of miR‐101a‐3p via bioinformatics and confirmed it using a luciferase reporter assay (LRA). Results: We showed that IL‐1β could inhibit proliferation of chondrocytes. We found that miR‐101a‐3p levels were significantly lower in the rat inflammation model with TMJOA and inflamed chondrocytes than in the normal group. Additionally, miR‐101a‐3p substantially promoted apoptosis of chondrocytes, and both bioinformatic analyses and LRA found that this miRNA targeted the genes ubiquitin‐conjugating enzyme 2D1 (UBE2D1) and Frizzled class receptor 4 (FZD4). Conclusion: Our results suggested that miR‐101a‐3p was involved in the pathogenesis of TMJOA and that its mechanism was probably interaction with its target genes UBE2D1 and FZD4. [ABSTRACT FROM AUTHOR]

Copyright of Ciencia e Innovación en Salud is the property of Universidad Simon Bolivar (USB) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Arterial thoracic outlet syndrome (aTOS) is rarely diagnosed in children. A 15-year-old boy with recent-onset claudication was found to have aTOS on investigation. Bony abnormality other than the cervical rib might also cause aTOS. Enhanced awareness of aTOS as a cause of vascular symptoms in children is warranted. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the present randomized, controlled clinical multicenter trial was to compare a polyethylene glycol (PEG) and a native collagen membrane (BG) for simultaneous guided bone regeneration at bony dehiscence‐type defects around bone level titanium implants. Material and methods: The study enrolled 117 patients requiring implant treatment in the posterior maxilla or mandible with expected buccal bony dehiscence‐type defects at the placed titanium implants. According to a parallel groups design, defects were filled with a synthetic bone filler and randomly assigned to either PEG or BG membrane. As primary parameter, the relative vertical bone fill was assessed at baseline and at re‐entry after 6 months of healing. As secondary parameters, the marginal bone level (MBL) was assessed radiographically and soft tissue conditions were recorded up to 18 months postloading. Results: Both groups showed comparable vertical bone fill revealing a relative change in defect height of 59.7% (PEG) and 64.4% (BG). The absolute mean reduction in defect size was 2.5 mm in the PEG group and 3.2 mm in the BG group. Although both groups revealed a statistically significant mean defect reduction (p <.001), a comparison between the two groups did not show statistical significances. The non‐inferiority test with inferiority limit of −5% could not be rejected, based on the 90% confidence interval of the differences of the two means with lower limit −15.4%. After 18 months, an MBL increase of 0.45 ± 0.43 mm in the PEG group and 0.41 ± 0.81 mm in the BG group was detected (p <.001). Soft tissue complications were observed in both groups without showing statistical significance. Conclusions: Both membranes supported bone regeneration at dehiscence‐type defects and obtained vertical bone fill with a relative change in defect height of 59.7% (PEG) and 64.4% (BG); however, the non‐inferiority of PEG could not be shown. [ABSTRACT FROM AUTHOR]

Tricho–dento–osseous (TDO) syndrome is a multisystem congenital disorder that is known by bone, skin, and hair abnormalities. Primitive studies show different varieties of manifestations related to this disorder, which involve sclerotic bones, nail involvement, enamel hypoplasia, mandibular prognathism, and taurodontism. Although exploring different TDO cases revealed genetic mutations in all of them, they have many variations in phenotypic view. In this study, we report a case whose primary diagnosis was alopecia and came for extraction of her third molars, but after clinical and radiographic examination, it was found that the cause of her disease was something different. [ABSTRACT FROM AUTHOR]