The prevalence of osteoporosis has been increasing globally. Recently surgical indications for elderly patients with osteoporosis have been increasing. However, only few strategies are available for osteoporotic patients who need spinal fusion. Osteoporosis is a result of negative bone remodeling from enhanced function of the osteoclasts. Because bone formation is the result of coupling between osteoblasts and osteoclasts, anti-resorptive agents that induce osteoclast apoptosis may not be effective in spinal fusion surgery, necessitating new bone formation. Therefore, anabolic agents may be more suitable for osteoporotic patients who undergo spinal fusion surgery. The instrumentations and techniques with increased pullout strength may increase fusion rate through rigid fixation. Studies on new osteoinductive materials, methods to increase osteogenic cells, strengthened and biocompatible osteoconductive scaffolds are necessary to enable osteoporotic patients to undergo spinal fusion. When osteoporotic patients undergo spinal fusion, surgeons should consider appropriate osteoporosis medication, instrumentation and technique.
Mohammed El Sallah Zagane;Abdelmadjid Moulgada;Murat Yaylaci;Sahli Abderahmen;Mehmet Emin Ozdemir;Ecren Uzun Yaylaci
Structural Engineering and Mechanics
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v.86
no.5
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pp.635-645
/
2023
This study aims to simulate the mechanical behavior of the total prosthesis model of Charnley (CMK3) by the 3D finite element method and to determine the state of the stresses in the femoral components (prosthesis, cement, and bone). The components are subjected to a dynamic load due to three activities (normal walking, climbing stairs, and standing up a chair). Static loading is by selecting the maximum load for the same activities mentioned. The results show that the maximum stresses in the proximal part of the cement are very important. Moreover, new results obtained for different parameters were discussed in detail. It is understood that current research provides important lessons for the surgeon to contribute to the clinical diagnosis of durable implantations and a better understanding of the process of bone remodeling and bone prosthesis.
Purpose: The aim of this study was to evaluate the preclinical results of 2 types of commercially available deproteinized bovine bone mineral (DBBM) when applied to alveolar bone defects in dogs. Methods: This study was conducted using 6 beagles. Alveolar defects in the mandible were formed and filled with 2 DBBMs produced by a similar procedure. Defects were randomly assigned to be filled using DBBM 1 or 2. All defects were covered with a collagen membrane and had a healing period of 12 weeks. After the dogs were sacrificed, histological, histomorphometric, and linear/volumetric analyses were performed. Results: Both DBBM groups showed similar histological findings, demonstrating that bone remodeling had occurred and new bone had formed. The residual bone particles were surrounded by newly formed vital bone. In the histomorphometric analysis, the ratio of the area of vital bone and residual bone substitute in DBBM 2 (38.18% and 3.47%, respectively) was higher than that of DBBM 1 (33.74% and 3.41%, respectively), although the difference was not statistically significant. There were also no statistically significant differences between both groups in linear and volumetric analyses using micro-computed tomography scans and digitized images of dental casts. Conclusions: In the present study, DBBM 1and 2, which were produced by similar processes, showed similar results in histological, histomorphometric, and volumetric analyses. Further studies are needed to identify more specific differences between the 2 DBBMs.
Despite high interests on microenvironmental regulation of leukemic cells, little is known for bone marrow (BM) niche in leukemia patients. Our recent study on BMs of acute myeloid leukemia (AML) patients showed that the mesenchymal stromal cells (MSCs) are altered during leukemic conditions in a clinical course-dependent manner. Leukemic blasts caused reprogramming of transcriptomes in MSCs and remodeling of niche cross-talk, selectively suppressing normal primitive hematopoietic cells while supporting leukemogenesis and chemo-resistance. Notably, differences in BM stromal remodeling were correlated to heterogeneity in subsequent clinical courses of AML, i.e., low numbers of mesenchymal progenitors at initial diagnosis were correlated to complete remission for 5-8 years, and high contents of mesenchymal progenitor or MSCs correlated to early or late relapse, respectively. Thus, stromal remodeling by leukemic cell is an intrinsic part of leukemogenesis that can contribute to the clonal dominance of leukemic cells over normal hematopoietic cells, and can serve as a biomarker for prediction of prognosis. [BMB Reports 2015; 48(8): 427-428]
Effects of several cytokines($IL-1{\beta},\;TNF_{\alpha},\;and\;IFN_{\gamma}$) have been examined on fetal rat osteoblast-like cells. To investigate whether cytokines play direct causal roles in production of lysosomal enzyme, fetal rat osteoblast-like cells were treated with $IL-1{\beta},\;TNF_{\alpha},\;and\;IFN_{\gamma}$, respectively or combined. And acid phosphatase was determined by biochemical method. Alkaline phosphatase was assayed to determine the effects of $IL-1{\beta},\;TNF_{\alpha},\;and\;IFN_{\gamma}$ on the expression of this enzyme. And also experiment of calcified nodule formation was performed to assess the effects of cytokines on the bone-forming activity of osteoblast-like cells in vitro. Acid phosphatase activity was significantly increased by the addition of $IL-1{\beta}\;and\;TNF_{\alpha}$, whereas decreased by $IFN_{\gamma}$. However, no significant change:: in alkaline phosphatase activity was observed when the osteoblast-like cells were treated with $IL-1{\beta}\;and\;TNF_{\alpha}$. Interestingly, $IFN_{\gamma}$ showed stimulatory effect on alkaline phosphatase activity. The number of calcified nodules was decreased by treatment of cultures with 1 ng/ml $IL-1{\beta},\;20\;ng/ml\;TNF_{\alpha}$, and 500 u/ml $IFN_{\gamma}$ continuously for 21 days, while considerable number of calcified nodules were formed in control group of osteoblast-like cell in culture for 21 days. These results seem to suggest that cytokines may play crucial roles in bone remodeling through the direct action on the osteoblast-like cell.
Yang, So Jin;Chung, Nam Hyung;Kim, Jong Ghee;Jeon, Young-Mi
The korean journal of orthodontics
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v.50
no.3
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pp.206-215
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2020
Osteochondroma is a common benign tumor of bones, but it is rare in the mandibular condyle. With its outgrowth it manifests clinically as deviation of the mandible limitation of mouth opening, and facial asymmetry. After the tumor is diagnosed on the basis of clinical symptoms and radiographic examination including cone-beam computed tomography (CBCT) analysis, an appropriate surgery and treatment plan should be formulated. Herein, we present the case of a 44-year-old female patient who visited our dental hospital because her chin point had been deviating to the left side slowly but progressively over the last 3 years and she had difficulty masticating. Based on CBCT, she was diagnosed with skeletal Class III malocclusion accompanied by osteochondroma of the right mandibular condyle. Maxillary occlusal cant with the right side down was observed, but it was confirmed to be an extrusion of the molars associated with dental compensation. Therefore, after intrusion of the right molars with the use of temporary anchorage devices, sagittal split ramus osteotomy was used to remove the tumor and perform orthognathic surgery simultaneously. During 6 months after the surgery, continuous bone resorption and remodeling were observed in the condyle of the affected side, which led to a change in occlusion. During the postoperative orthodontic treatment, intrusive force and buccal torque were applied to the molars on the affected side, and a proper buccal overjet was created. After 18 months, CBCT revealed that the rate of bone absorption was continuously reduced, bone corticalization appeared, and good occlusion and a satisfying facial profile were achieved.
Purpose: The purpose of this study was to evaluate the effectiveness of autogenous tooth graft materials after maxillary sinus bone grafts. Methods: The study involved 23 implants in 22 patients who visited the Department of Oral and Maxillofacial Surgery and the Department of Periodontics, Chosun University Dental Hospital, in 2008 and received autogenous tooth graft materials for maxillary sinus bone grafts. Results: For eight patients with maxillary bone graft materials prior to implant placement, the healing period averaged five months. For eleven patients with simultaneous maxillary bone graft and implant placement, eight patients received a second surgery, with an average healing time of six months. Three patients had a longer observation period with only a fixture implanted. Three patients who received only a bone graft required more time to implant placement because of the lack of residual bone and also for personal reasons. Only 5 patients had biopsies performed and complications such as infection and dehiscence healed well. The application of autogenous graft materials to the maxillary bone graft sites did not exert any significant effects on the success rates. When a mixture of graft materials was used, the post-surgical bone resorption rate was reduced. Histological analysis showed that new bone formation and remodeling were initiated during the three-to-six month healing period. Bone formation capacity increased continuously up to six months after the maxillary bone graft. Conclusion: According to this analysis, excellent stability and bone-forming capacity were seen in cases where autogenous materials were used alone or mixed with other materials. Autogenous tooth graft materials may be substituted instead of autogenous bones.
The purpose of this study was to compare the bone formation, maturation around HA-and titaniumcoated dental implants in dog. 5 hydroxyapatite coated IMZ implants and 5 titanium coated IMZ implants were placed into the previously extracted site in the mandible of 5 adults dogs. All dogs were injected intravenously Tetracycline, Alizalin red S, and Calcein for bone fluorescent labelling, After the experimental period of 16weeks, the dogs were sacrificed and tissue samples around the implants were obtained. Microscopic observations(ligth, polariged and fluorescence microscope), morphometric analysis, line profile with EPMA, and quantitative analysis for Ca,P, and Ti were performed. The results were as follows ; 1. Bone maturations around the implants were relatively lower than those of natural teeth. No significant differences in bone maturation and remodeling patterns were observed between the two implants groups. 2. Calcification of bone surrounding the implants was initiated in 8-11 weeks for HA-coated implants, while it took 11 weeks or more for Ti-coated implants. 3. Bone-to-implants contact ratio of 82.63% was recorded for HA-coated group and 72.25% for titanium coated group, with no significant difference between the two groups. 4. Bone around the implants exhibited reduced quantity of Ca and P in the $100{\mu}m$ region relative to natural teeth, while the rest of the regions showed no statistical differences. No significant differences were found between the two implant groups. 5. There was a separation of HA layer from the implant core and subsequent infiltration of inflammatory cells into the resulting space in the HA-coated implants, and evidences of phagocytosis of HA particles by macrophages. Bone calcification was more rapid around HA-coated implants compared to titanium-coated implants, but HA coated implants did not show any significant differences either in the degree of calcification or the bone-to-implant contact ratio over Ti coated implants. HA coated implants may have complications associated with HA absorption and separation of HA layer from the implant core.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.30
no.5
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pp.380-390
/
2004
Bone healing plays an important role in orthognathic and craniofacial surgery. Bone tissue repair and regeneration are regulated by an array of growth and morphogenetic factors. Bone formation and remodeling require continuous generation of osteoprogenitor cells from bone marrow stromal cells, which generate and respond to a variety of growth factors with putative roles in hematopoiesis and mesenchymal differentiation. In this study, the efficacy of a single application of hepatocyte growth factor to promote bone regeneration in 5-mm experimental calvarial defects of adult male rats was assessed histologically and immunohistochemically. The result of the experimental site were compared with those of the contralateral contral side. None of the control and experimental bone defects demonstrated complete bone closure. Bone regeneration was found close th the margine and central part of the defects. At 1, 2 weeks, there were found much significant cellural mitotic activity and many inflammatory cells and osteoblasts on the experimental site than control site. At 4, 6 weeks, new bone apposition was founded in both site but, more apposition was seen at experimental site. At 8, 12 weeks, also, some differences was found that more apposition of new bone and collagen fiber was seen on experimental site. Our results have some possibility that HGF do a early positive role to repair the bone defect. More study will be needed.
Purpose: The aim of the present study was to evaluate the effectiveness of using a mineralized bone cortical allograft (MBCA), with or without a resorbable collagenous membrane derived from bovine pericardium, on alveolar bone remodeling after immediate implant placement in a dog model. Methods: Six mongrel dogs were included. The test and control sites were randomly selected. Four biradicular premolars were extracted from the mandible. In control sites, implants without an allograft or membrane were placed immediately in the fresh extraction sockets. In the test sites, an MBCA was placed to fill the gap between the bone socket wall and implant, with or without a resorbable collagenous membrane. Specimens were collected after 1 and 3 months. The amount of residual particles and new bone quality were evaluated by histomorphometry. Results: Few residual graft particles were observed to be closely embedded in the new bone without any contact with the implant surface. The allograft combined with a resorbable collagen membrane limited the resorption of the buccal wall in height and width. The histological quality of the new bone was equivalent to that of the original bone. The MBCA improved the quality of new bone formation, with few residual particles observed at 3 months. Conclusions: The preliminary results of this animal study indicate a real benefit in obtaining new bone as well as in enhancing osseointegration due to the high resorbability of cortical allograft particles, in comparison to the results of xenografts or other biomaterials (mineralized or demineralized cancellous allografts) that have been presented in the literature. Furthermore, the use of an MBCA combined with a collagen membrane in extraction and immediate implant placement limited the extent of post-extraction resorption.
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