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Liu F, Wang X, He Y, Han R, Wang T, Guo Y. Jaw osteoporosis: Challenges to oral health and emerging perspectives of treatment. Biomed Pharmacother 2024; 177:116995. [PMID: 38917761 DOI: 10.1016/j.biopha.2024.116995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 06/13/2024] [Accepted: 06/15/2024] [Indexed: 06/27/2024] Open
Abstract
Osteoporosis is a prevalent bone metabolic disease that poses a significant challenge to global human health. Jaw osteoporosis, characterized by microstructural damage of the jaw resulting from various factors, is one of the common manifestations of this condition. Recent studies have demonstrated that jaw osteoporosis has multifaceted effects on oral health and can negatively impact conditions such as periodontitis, oral implantation, orthodontic treatment, and wound healing. However, there are still some limitations in the conventional treatment of osteoporosis. For instance, while bisphosphonates can enhance bone quality, they may also lead to osteonecrosis of the jaw, which poses a potential safety hazard in oral diagnosis and treatment. In recent years, considerable attention has been focused on improving the pathological condition of jaw osteoporosis. Treatment strategies such as gut microbial regulation, extracellular vesicles, molecular targeted therapy, herbal medicine, mechanical stimulation are expected to enhance efficacy and minimize adverse reactions. Therefore, understanding these effects and exploring novel treatments for jaw osteoporosis may provide new insights for oral health maintenance and disease treatment. This article reviews the impact of jaw osteoporosis on oral health and describes the limitations associated with current methods. It also discusses emerging perspectives on treatment, offering a comprehensive overview of the challenges and future directions in managing jaw osteoporosis.
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Affiliation(s)
- Fushuang Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xuan Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yikai He
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Ruiying Han
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Tianyi Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yongwen Guo
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China.
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Shi LL, Pudney J, Brangman S, Parham K, Nuara M. Head & Neck Trauma in the Geriatric Population. Otolaryngol Clin North Am 2023; 56:1183-1201. [PMID: 37385861 DOI: 10.1016/j.otc.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Craniofacial trauma in the geriatric population is increasing as our population ages. Due to loss of bone quality and medical comorbidities, injuries for minor trauma can be severe. A more extensive medical evaluation is usually warranted in this population before proceeding with surgery. In addition, unique surgical considerations exist in the repair of atrophic and edentulous bony fractures. Some quality improvement measures have already been undertaken but more is needed to help standardize care in this vulnerable population.
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Affiliation(s)
- Lucy L Shi
- Division of Facial Plastic & Reconstructive Surgery, Virginia Mason Franciscan Health, 1201 Terry Avenue 9th Floor, Seattle, WA 98101, USA
| | - Jacey Pudney
- Department of Geriatrics, SUNY Upstate University Hospital, 750 East Adams Street, Syracuse, NY 13210, USA
| | - Sharon Brangman
- Department of Geriatrics, SUNY Upstate University Hospital, 750 East Adams Street, Syracuse, NY 13210, USA
| | - Kourosh Parham
- Department of Otolaryngology-Head & Neck Surgery, University of Connecticut, 263 Farmington Avenue, Farmington, CT 06030, USA
| | - Michael Nuara
- Division of Facial Plastic & Reconstructive Surgery, Virginia Mason Franciscan Health, 1201 Terry Avenue 9th Floor, Seattle, WA 98101, USA.
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Pruthi G, Mahajan R, Gupta A, Patil AN, Paramasivam V, Kaundal S. The Effects of Statins on Bone Formation Around Implants Placed in Animal Bones: A Systematic Review and Meta-Analysis. J Maxillofac Oral Surg 2023; 22:265-286. [PMID: 37122799 PMCID: PMC10130266 DOI: 10.1007/s12663-023-01873-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/11/2023] [Indexed: 03/02/2023] Open
Abstract
Background Implants are preferred for replacement of missing teeth by the clinicians as well as the patients. Lesser alveolar bone density doesn't preclude any individual for choosing this option but warrants for extra caution. Preclinical studies have explored the osteoinductive potential of statins, but results should be analyzed vigorously before implementing them in humans. There is no meta-analysis to document effect of statins on bone formation around implants in osteoporotic animals. Methods and material PubMed, Embase and Cochrane were searched for studies investigating the effect of statins on bone implant contact (BIC %), bone mineral density (BMD %) and bone volume (BV %) around implants at 2, 4 and 12 weeks. Meta-analysis was performed on subgroups with osteoporotic animals which were administered statins through different routes. Results Quantitative data from 12 studies showed favorable effect of statins on bone around implants. Positive difference was observed at 4 weeks in BIC (parenteral [SMD = 4.33 (2.89, 5.77); I 2 = 3%)], BMD (local [SMD = 1.33 (0.51, 2.15); I 2 = 0%] and BV (local [SMD = 1.58 (0.76, 2.40); I 2 = 0%]. BIC [SMD = 1.40 (0.89, 1.90); I 2 = 0%] and BV [SMD = 3.91 (2.33, 5.50); I 2 = 43%] were higher in experimental group after 12 weeks of oral administration. Conclusions Statins can be investigated as potential bone graft materials to increase the predictability of osseointegration especially in osteoporotic individuals. Future research should focus to reproduce homogeneous data and conclusive recommendations which can be applied in clinical trials. Supplementary Information The online version contains supplementary material available at 10.1007/s12663-023-01873-z.
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Affiliation(s)
- Gunjan Pruthi
- Prosthodontics, Oral Health Sciences Centre, PGIMER, Chandigarh, 160012 India
| | - Rhea Mahajan
- Prosthodontics, Oral Health Sciences Centre, PGIMER, Chandigarh, 160012 India
| | - Arpit Gupta
- Public Health Dentistry, Oral Health Sciences Centre, PGIMER, Chandigarh, India
| | | | - Vijayabharathi Paramasivam
- Prosthodontics, Oral Health Sciences Centre, PGIMER, Chandigarh, 160012 India
- Present Address: Prosthodontics, AIIMS, Raipur, India
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Døving M, Naess I, Galteland P, Ramm-Pettersen J, Dalby M, Utheim TP, Skaga NO, Helseth E, Sehic A. Anatomical distribution of mandibular fractures from severe bicycling accidents: A 12-year experience from a Norwegian level 1 trauma center. Dent Traumatol 2022; 38:424-430. [PMID: 35481880 PMCID: PMC9544727 DOI: 10.1111/edt.12756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/09/2022] [Accepted: 04/12/2022] [Indexed: 11/29/2022]
Abstract
Background/Aim The mandible makes up a substantial part of the lower face, and is susceptible to injury. Even in helmeted cyclists, accidents may lead to fractures of the mandible because conventional helmets provide little protection to the lower part of the face. In addition, some studies indicate that helmets may lead to an increased risk of mandibular fractures. Thus, the aim of this study was to examine the anatomic distribution of mandibular fractures in injured cyclists and to assess if helmet use influenced the fracture locations. Material and Methods Data from a Norwegian Level 1 trauma center were collected in the Oslo University Hospital Trauma Registry over a 12‐year period. Of 1543 injured cyclists, the electronic patient charts of 62 cyclists with fractures of the mandible were retrospectively evaluated in detail. Demographic data, helmet use, and fracture type were assessed. Results Sixty‐two patients (4%) had fractures of the mandible, and women had an increased risk (OR 2.49, 95% CI 1.49–4.16, p < .001). The most common fracture site was the mandibular body, followed by the condyle. Isolated mandibular fractures occurred in 45% of the patients and 55% had other concomitant facial fractures. There were 42% of the patients with fractures in multiple sites of the mandible, and 42% had a concomitant dentoalveolar injury. Half of the cyclists were wearing a helmet at the time of the accident and 39% were not. There was no significant difference in fracture distribution between the helmeted and non‐helmeted groups. Conclusions Fracture of the mandibular body was the most prevalent mandibular fracture type following bicycle accidents. Women had an increased risk of mandibular fractures compared with men, whereas helmet wearing did not affect the anatomical fracture site.
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Affiliation(s)
- Mats Døving
- Department of Maxillofacial Surgery, Oslo University Hospital Ullevål, Oslo, Norway.,Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Ingar Naess
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Pål Galteland
- Department of Maxillofacial Surgery, Oslo University Hospital Ullevål, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jon Ramm-Pettersen
- Department of Neurosurgery, Oslo University Hospital Ullevål, Oslo, Norway
| | - Marius Dalby
- Department of Ophtalmology, Oslo University Hospital Ullevål, Oslo, Norway
| | - Tor Paaske Utheim
- Department of Maxillofacial Surgery, Oslo University Hospital Ullevål, Oslo, Norway.,Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Nils Oddvar Skaga
- Department of Anaesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital Ullevål, Oslo, Norway.,Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital Ullevål, Oslo, Norway
| | - Eirik Helseth
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Neurosurgery, Oslo University Hospital Ullevål, Oslo, Norway
| | - Amer Sehic
- Department of Maxillofacial Surgery, Oslo University Hospital Ullevål, Oslo, Norway.,Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
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Stefos S, Kourtis S, Vrekoussis T, Augoulea A, Kalantaridou S. Quality of Life in Menopausal Women with Dental Restorations and Implants. Open Dent J 2022. [DOI: 10.2174/18742106-v16-e2203151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aim:
This multicenter study examined the relationship, possible interactions, and intermittent effects that dental implants and prostheses can have on menopausal women’s quality of life as well as provided information regarding the possible side effects of therapeutic regimens on menopause and osteoporosis or osteopenia.
Materials and Methods:
Questionnaires consisted of selected quality of life questions based on specific and additional medical and dental (mainly prosthodontic) questions, which were administered to 100 Greek menopausal/post-menopausal women (Age: Mean Value=63,62 years old) with osteopenia or with or without osteoporosis, with dental implants and implant restorations, or conventional prosthetic restorations visiting two University Hospitals. Menopausal/post-menopausal status was judged on the basis of either secondary, definitive amenorrhoea or based on follicular stimulation hormone (FSH) values, estradiol, and clinical risk factors.
Results:
Participants had a statistically significantly better “functional” and “psychological” feeling after prosthodontic rehabilitation with and without implants. Three out of four reported that their dentist informed them of the possible implant problems that might arise from osteoporosis and its treatment (medications). Moreover, osteopenia was found to be associated with a very lower problem percentage. The bisphosphonate treatment had the highest rate (80%) of reported implant problems than non-bisphosphonate treatment (30%). The hormone replacement therapy (HRT) for menopause was reported to be more associated with problems in implant placement (19%) than in those without treatment (27.3%).
Conclusion:
The questionnaires revealed a significant improvement concerning women’s life quality and well-documented information about the problems their dental implants and restorations may cause in association with menopause and/or osteoporosis.
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Dai Z, Wei G. Inhibition of miRNA-100 facilitates bone regeneration defects of mesenchymal stem cells in osteoporotic mice through the protein kinase B pathway. Bioengineered 2022; 13:963-973. [PMID: 35132915 PMCID: PMC8974201 DOI: 10.1080/21655979.2021.2015880] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Osteoporotic patients suffer from bone microstructure damage and are prone to fracture and bone defect. Due to the damage of bone healing ability, the bone repair of osteoporotic patients is usually slow. Here we aimed to explore the function and potential molecular mechanism of miR-100 in osteogenic differentiation ability of bone marrow stem cells (BMSCs). Ovariectomy was performed on mice to induce osteoporosis. BMSCs were extracted from normal and ovariectomized (OVX) mice to examine the effect of microRNA (miR)-100 on BMSC osteogenic differentiation. Hematoxylin and eosin (H&E) staining and safranin O-fast green staining assays were performed on femur tissues to reveal pathological changes. The osteogenic differentiation of BMSCs were determined by Alkaline Phosphatase and Alizarin red staining assays. The results showed that miR-100 expression was significantly upregulated in bone tissues and BMSCs from osteoporotic mice. MiR-100 knockdown partially improved osteogenic function of OVX mice-derived BMSCs. Next, mechanistic target of rapamycin kinase (MTOR) was identified as the target downstream miR-100. MiR-100 deficiency can activate the protein kinase B (AKT)/mTOR pathway. MiR-100 controlled the osteogenic function of BMSCs by the AKT/mTOR pathway. Collectively, our findings demonstrate that inhibition of miR-100 facilitates bone regeneration defects of BMSCs in osteoporotic mice through AKT pathway, indicating that miR-100 might be an effective target for the treatment of osteoporotic mandibular injury and bone defect diseases.
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Affiliation(s)
- Zhengqiu Dai
- Department of Orthopedic, Taizhou Second People's Hospital, Taizhou, Jiangsu, China
| | - Guoqiang Wei
- Department of Plastic Surgery, First Ward, Xi'an International Medical Center Plastic Surgery Hospital, Xi'an, Shanxi, China
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Is Decreased Local Bone Quality an Independent Risk Factor for Complications Following Fracture Fixation of Facial Bones. J Craniofac Surg 2021; 32:1385-1390. [PMID: 33427779 DOI: 10.1097/scs.0000000000007436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Although osteoporosis is associated with increased risks of complications of fracture fixation in the orthopedic literature, the association between local bone quality (LBQ) and complications of facial fracture fixation is unknown. The authors aim to identify that if decreased LBQ is an independent risk factor for complications following facial fracture fixation? METHODS The authors conducted a prospective cohort study on patients over age of 50 years who underwent open reduction and rigid internal fixation for facial fractures. The primary predictor was LBQ (low or normal), decided by a combination of 3 panoramic indices. Other predictors included age, gender, body mass index (BMI), comorbidities, trauma-related characteristics, etc. The outcome variable was the presence of hardware-related, fracture-healing, wound, or neurosensory complications during 2-year follow-up. Univariate and multivariate regressions were performed to identify any significant association between predictor and outcome variables. RESULTS The sample was composed of 69 patients (27 females) with an average age of 58.6 ± 8.6 years and BMI of 25 ± 3.8. Low-LBQ patients were significantly older, more females, had lower BMI, mainly injured from falls, had more complications compared to their normal-LBQ counterparts. However, multivariable logistic regressions demonstrated that only age (adjusted OR: 1.12, P = 0.031, 95% CI: 1.01, 1.23) and diabetes (adjusted OR: 12.63, P = 0.029, 95% CI: 1.3, 122.53) were significantly associated with overall complications after confounding adjustment. CONCLUSIONS The results of the present study indicate that reduced LBQ is not an independent risk factor for complications following facial fracture fixation. The increased risk of complications in low-LBQ patients is more likely to be attributed to other age-related comorbidities such as diabetes. Therefore, the authors recommend detailed workup and good control of comorbidities in elderly trauma patient.
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Kale P, Mani A, Anarthe R, Pendyala G, Thakkur P, Sekharamantri A. Management of surgical complication during dental implant placement. JOURNAL OF HEAD & NECK PHYSICIANS AND SURGEONS 2021. [DOI: 10.4103/jhnps.jhnps_65_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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de Medeiros FCFL, Kudo GAH, Leme BG, Saraiva PP, Verri FR, Honório HM, Pellizzer EP, Santiago Junior JF. Dental implants in patients with osteoporosis: a systematic review with meta-analysis. Int J Oral Maxillofac Surg 2017; 47:480-491. [PMID: 28651805 DOI: 10.1016/j.ijom.2017.05.021] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 05/09/2017] [Accepted: 05/24/2017] [Indexed: 11/16/2022]
Abstract
There is currently no consensus regarding the survival rate of osseointegrated implants in patients with osteoporosis. A systematic review with meta-analysis was performed to evaluate the survival rate of implants in such patients. The PubMed/MEDLINE, Web of Science, Cochrane Library, and SciELO databases were used to identify articles published up to September 2016. The systematic review was performed in accordance with PRISMA/PICO requirements and the risk of bias was assessed (Australian National Health and Medical Research Council scale). The relative risk (RR) of implant failure and mean marginal bone loss were analyzed within a 95% confidence interval (CI). Fifteen studies involving 8859 patients and 29,798 implants were included. The main outcome of the meta-analysis indicated that there was no difference in implant survival rate between patients with and without osteoporosis, either at the implant level (RR 1.39, 95% CI 0.93-2.08; P=0.11) or at the patient level (RR 0.98, 95% CI 0.50-1.89; P=0.94). However, the meta-analysis for the secondary outcome revealed a significant difference in marginal bone loss around implants between patients with and without osteoporosis (0.18mm, 95% CI 0.05-0.30, P=0.005). Data heterogeneity was low. An increase in peri-implant bone loss was observed in the osteoporosis group. Randomized and controlled clinical studies should be conducted to analyze possible biases.
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Affiliation(s)
- F C F L de Medeiros
- Pró-Reitoria de Pesquisa e Pós-graduação (PRPPG), Universidade do Sagrado Coração, Bauru, SP, Brazil
| | - G A H Kudo
- Pró-Reitoria de Pesquisa e Pós-graduação (PRPPG), Universidade do Sagrado Coração, Bauru, SP, Brazil
| | - B G Leme
- Pró-Reitoria de Pesquisa e Pós-graduação (PRPPG), Universidade do Sagrado Coração, Bauru, SP, Brazil
| | - P P Saraiva
- Pró-Reitoria de Pesquisa e Pós-graduação (PRPPG), Universidade do Sagrado Coração, Bauru, SP, Brazil
| | - F R Verri
- Dental School of Araçatuba, UNESP - Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - H M Honório
- Department of Scientific Methodology and Statistics, Bauru School of Dentistry, USP - University of São Paulo, São Paulo, Brazil
| | - E P Pellizzer
- Dental School of Araçatuba, UNESP - Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - J F Santiago Junior
- Pró-Reitoria de Pesquisa e Pós-graduação (PRPPG), Universidade do Sagrado Coração, Bauru, SP, Brazil.
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Shayesteh Moghaddam N, Jahadakbar A, Amerinatanzi A, Skoracki R, Miller M, Dean D, Elahinia M. Fixation Release and the Bone Bandaid: A New Bone Fixation Device Paradigm. Bioengineering (Basel) 2017; 4:bioengineering4010005. [PMID: 28952484 PMCID: PMC5590446 DOI: 10.3390/bioengineering4010005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 12/23/2016] [Accepted: 01/17/2017] [Indexed: 11/16/2022] Open
Abstract
The current gold standard of care for mandibular segmental defeat reconstruction is the use of Ti-6Al-4V immobilization hardware and fibular double barrel graft. This method is often successful immediately at restoring mandible function, however the highly stiff fixation hardware causes stress shielding of the grafted bone and stress concentration in the fixation device over time which can lead to fixation device failure and revision surgery. The purpose of reconstructive surgery could be to create normal stress trajectories in the mandible following engraftment. We investigate the use of a two stage mechanism which separates the immobilization/healing and regenerative phases of mandibular segmental defect treatment. The device includes the use of a very stiff, Ti-6Al-4V, releasable mechanism which assures bone healing. Therefore it could be released once the reconstructed boney tissue and any of its ligamentous attachments have completely healed. Underneath the released Ti-6Al-4V plate would be a pre-loaded nitinol (NiTi) wire-frame apparatus that facilitates the normal stress-strain trajectory through the engrafted bone after the graft is healed in place and the Ti-6Al-4V fixation device has been released. Due to the use of NiTi wires forming a netting that connects vascularized bone and possibly bone chips, bone grafts are also more likely to be incorporate rather than to resorb. We first evaluated a healthy adult mandible during normal mastication to obtain the normal stress-strain distribution. Then, we developed the finite element (FE) model of the mandibular reconstruction (in the M1-3 region) with the proposed fixation device during the healing (locked state) and post-healing (released state) periods. To recreate normal stress trajectory in the reconstructed mandible, we applied the Response Surface Methodology (RMS) to optimize the Bone Bandaid geometry (i.e., wire diameters and location). The results demonstrate that the proposed mechanism immobilizes the grafted bone in the locked state properly since the maximum resultant gap (21.54 micron) between the graft and host mandible surfaces are in the safe region (less than 300 micron). By considering the von Mises criteria for failure, FE analysis together with experimental studies (i.e., compressive and tensile testing on the inferior and superior fixation devices, respectively) confirm that the proposed fixation devices do not fail, showing safety factor of at least 10.3. Based on the Response Surface Methodology (RSM) technique, the optimal parameter values for the wires are achieved (0.65 mm and 1 mm for the superior and inferior wires, respectively) and the required level of preload on each wire are calculated (369.8 N and 229 N for the inferior and superior wires, respectively). The FE results for stress distribution on the reconstructed mandible during the released state closely match that of a healthy mandible.
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Affiliation(s)
| | - Ahmadreza Jahadakbar
- Dynamic and Smart Systems Laboratory, The University of Toledo, Toledo, OH 43606, USA.
| | | | - Roman Skoracki
- Department of Plastic Surgery, The Ohio State University, Columbus, OH 43210, USA.
| | - Michael Miller
- Department of Plastic Surgery, The Ohio State University, Columbus, OH 43210, USA.
| | - David Dean
- Department of Plastic Surgery, The Ohio State University, Columbus, OH 43210, USA.
| | - Mohammad Elahinia
- Dynamic and Smart Systems Laboratory, The University of Toledo, Toledo, OH 43606, USA.
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Effect of Osteoporosis on Bone Density of Orthognathic Osteotomy Sites in Maxillofacial Region. J Craniofac Surg 2016; 27:e678-e683. [DOI: 10.1097/scs.0000000000003064] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Multi-Elemental Profiling of Tibial and Maxillary Trabecular Bone in Ovariectomised Rats. Int J Mol Sci 2016; 17:ijms17060977. [PMID: 27338361 PMCID: PMC4926509 DOI: 10.3390/ijms17060977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 05/31/2016] [Accepted: 06/03/2016] [Indexed: 02/07/2023] Open
Abstract
Atomic minerals are the smallest components of bone and the content of Ca, being the most abundant mineral in bone, correlates strongly with the risk of osteoporosis. Postmenopausal women have a far greater risk of suffering from OP due to low Ca concentrations in their bones and this is associated with low bone mass and higher bone fracture rates. However, bone strength is determined not only by Ca level, but also a number of metallic and non-metallic elements in bone. Thus, in this study, the difference of metallic and non-metallic elements in ovariectomy-induced osteoporosis tibial and maxillary trabecular bone was investigated in comparison with sham operated normal bone by laser ablation inductively-coupled plasma mass spectrometry using a rat model. The results demonstrated that the average concentrations of 25Mg, 28Si, 39K, 47Ti, 56Fe, 59Co, 77Se, 88Sr, 137Ba, and 208Pb were generally higher in tibia than those in maxilla. Compared with the sham group, Ovariectomy induced more significant changes of these elements in tibia than maxilla, indicating tibial trabecular bones are more sensitive to changes of circulating estrogen. In addition, the concentrations of 28Si, 77Se, 208Pb, and Ca/P ratios were higher in tibia and maxilla in ovariectomised rats than those in normal bone at all time-points. The present study indicates that ovariectomy could significantly impact the element distribution and concentrations between tibia and maxilla.
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Afrooz PN, Bykowski MR, James IB, Daniali LN, Clavijo-Alvarez JA. The Epidemiology of Mandibular Fractures in the United States, Part 1: A Review of 13,142 Cases from the US National Trauma Data Bank. J Oral Maxillofac Surg 2015; 73:2361-6. [DOI: 10.1016/j.joms.2015.04.032] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 04/22/2015] [Accepted: 04/23/2015] [Indexed: 10/23/2022]
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Zhang Y, Wang L, Deng F, Qiu H, Wu X. Determination of a critical size calvarial defect in senile osteoporotic mice model based on in vivo micro-computed tomography and histological evaluation. Arch Gerontol Geriatr 2015; 61:44-55. [PMID: 25682535 DOI: 10.1016/j.archger.2015.01.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 01/20/2015] [Accepted: 01/28/2015] [Indexed: 01/13/2023]
Abstract
PURPOSE To evaluate differences in the spontaneous healing capacity of senescence-prone inbred strains (SAMP6) and senescence-resistant inbred strains (SAMR1) and determine the critical defect size in a mouse model of senescence-accelerated osteoporosis. METHODS Unilateral full-thickness calvarial defects 2 or 4mm in diameter were made in 6-month-old male SAMP6 and SAMR1. Defects were evaluated in vivo by micro-CT at day 0 and 6 and 12 weeks postoperatively. Calvarial specimens were harvested at 12 weeks for hematoxylin and eosin staining, Masson's trichrome staining, and tartrate-resistant-acid-phosphatase (TRAP) staining. RESULTS Less new bone was observed in defects in SAMP6 compared to SAMR1 at 12 weeks postsurgery, with <5% healing in SAMP6 for both 2- and 4-mm defects compared to >5% healing in 2-mm defects in SAMRI (P<0.05). Histological analysis revealed dense connective tissue but little bone healing in 2- and 4-mm defects in SAMP6 and 4-mm defects in SAMR1. New bone was observed at the periphery of the 2-mm defects in SAMR1. Masson's trichrome staining also supported these findings. No obvious TRAP-positive cells were observed at the defect margins, but SAMP6 exhibited greater osteoclast numbers and surface areas in the diploë of contralateral bone compared to smaller osteoblast numbers and surface areas at the defect sites in SAMR1. CONCLUSIONS Defects of 2mm or larger in the cranium was critical-size or nonhealing defects in both SAMP6 and SAMR1. The differential findings on micro-CT and histomorphometry for the calvarial defect sites between SAMP6 and SAMR1 may imply different regenerative abilities of intramembranous ossification in these two strains.
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Affiliation(s)
- Yufeng Zhang
- Department of Prosthodontics, Stomatological Hospital of Chongqing Medical University, No. 426 Songshibei Road, Yubei, Chongqing 401147, China; Chongqing key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, China
| | - Lu Wang
- Department of Prosthodontics, Stomatological Hospital of Chongqing Medical University, No. 426 Songshibei Road, Yubei, Chongqing 401147, China; Chongqing key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, China.
| | - Feng Deng
- Chongqing key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, China; Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, No. 426 Songshibei Road, Yubei, Chongqing 401147, China
| | - Hongmei Qiu
- Key Laboratory of Biochemistry and Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Chongqing Medical University, Yixueyuan Road, Yuzhong, Chongqing 400016, China
| | - Xiaohong Wu
- Department of Prosthodontics, Stomatological Hospital of Chongqing Medical University, No. 426 Songshibei Road, Yubei, Chongqing 401147, China; Chongqing key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, China.
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15
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Tripathi G, Raja N, Yun HS. Effect of direct loading of phytoestrogens into the calcium phosphate scaffold on osteoporotic bone tissue regeneration. J Mater Chem B 2015; 3:8694-8703. [DOI: 10.1039/c5tb01574j] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
3D porous calcium deficient hydroxyapatite scaffolds with phytoestrogens were fabricated for osteoporotic bone tissue regeneration through a combination of 3D printing techniques and cement chemistry as a room temperature process.
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Affiliation(s)
- G. Tripathi
- Powder & Ceramic Division
- Korea Institute of Materials Science (KIMS)
- Changwon 641-831
- Republic of Korea
| | - N. Raja
- Powder & Ceramic Division
- Korea Institute of Materials Science (KIMS)
- Changwon 641-831
- Republic of Korea
- Korea University of Science and Technology (UST)
| | - H. S. Yun
- Powder & Ceramic Division
- Korea Institute of Materials Science (KIMS)
- Changwon 641-831
- Republic of Korea
- Korea University of Science and Technology (UST)
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Du Z, Steck R, Doan N, Woodruff MA, Ivanovski S, Xiao Y. Estrogen Deficiency-Associated Bone Loss in the Maxilla: A Methodology to Quantify the Changes in the Maxillary Intra-radicular Alveolar Bone in an Ovariectomized Rat Osteoporosis Model. Tissue Eng Part C Methods 2014; 21:458-66. [PMID: 25315176 DOI: 10.1089/ten.tec.2014.0268] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The effects of estrogen deficiency on bone characteristics are site-dependent, with the most commonly studied sites being appendicular long bones (proximal femur and tibia) and axial bones (vertebra). The effect on the maxillary and mandibular bones is still inconsistent and requires further investigation. This study was designed to evaluate bone quality in the posterior maxilla of ovariectomized rats to validate this site as an appropriate model to study the effect of osteoporotic changes. Forty-eight 3-month-old female Sprague-Dawley rats were randomly divided into two groups: an ovariectomized (OVX) group (n=24) and Sham-operated (SHAM) group (n=24). Six rats were randomly sacrificed from both groups at time points 8, 12, 16, and 20 weeks. The samples from tibia and maxilla were collected for micro computed tomography (μCT) and histological analysis. For the maxilla, the volume of interest area focused on the furcation areas of the first and second molar. Trabecular bone volume fraction (BV/TV, %), trabecular thickness (Tb.Th.), trabecular number (Tb.N.), trabecular separation (Tb.Sp.), and connectivity density (Conn.Dens) were analyzed after Micro CT scanning. At 8 weeks the indices BV/TV, Tb.Sp., Tb.N., and Conn.Dens showed significant differences (p<0.05) between the OVX and SHAM groups in the tibia. Compared with the tibia, the maxilla developed osteoporosis at a later stage, with significant changes in maxillary bone density only occurring after 12 weeks. Compared with the SHAM group, both the first and second molars of the OVX group showed significantly decreased BV/TV values from 12 weeks, and these changes were sustained through 16 and 20 weeks. For Tb.Sp., there were significant increases in bone values for the OVX group compared with the SHAM group at 12, 16, and 20 weeks. Histological changes were highly consistent with Micro CT results. This study established a method to quantify the changes of intra-radicular alveolar bone in the posterior maxilla in an accepted rat osteoporosis model. The degree of the osteoporotic changes to trabecular bone architecture is site-dependent and at least 3 months are required for the osteoporotic effects to be apparent in the posterior maxilla following rat OVX.
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Affiliation(s)
- Zhibin Du
- 1 Institute of Health and Biomedical Innovation, Queensland University of Technology , Brisbane, Queensland, Australia
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17
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Alghamdi HS, Jansen JA. Bone Regeneration Associated with Nontherapeutic and Therapeutic Surface Coatings for Dental Implants in Osteoporosis. TISSUE ENGINEERING PART B-REVIEWS 2013; 19:233-53. [DOI: 10.1089/ten.teb.2012.0400] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Hamdan S. Alghamdi
- Department of Biomaterials, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - John A. Jansen
- Department of Biomaterials, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
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18
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Mariotti A, Mawhinney M. Endocrinology of sex steroid hormones and cell dynamics in the periodontium. Periodontol 2000 2012; 61:69-88. [DOI: 10.1111/j.1600-0757.2011.00424.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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19
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Orthognathic Surgery in Primary Myopathies: Severe Case of Congenital Fiber Type Disproportion With Long-Term Follow-Up and Review of the Literature. J Oral Maxillofac Surg 2012; 70:1636-42. [DOI: 10.1016/j.joms.2011.06.214] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2011] [Revised: 06/11/2011] [Accepted: 06/14/2011] [Indexed: 11/17/2022]
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20
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Hermund NU, Stavropoulos A, Donatsky O, Nielsen H, Clausen C, Reibel J, Pakkenberg B, Holmstrup P. Reimplantation of cultivated human bone cells from the posterior maxilla for sinus floor augmentation. Histological results from a randomized controlled clinical trial. Clin Oral Implants Res 2011; 23:1031-7. [DOI: 10.1111/j.1600-0501.2011.02251.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2011] [Indexed: 11/30/2022]
Affiliation(s)
- Niels Ulrich Hermund
- Department of Oral and Maxillofacial Surgery; Hilleroed Hospital/Rigshospitalet; Hilleroed; Denmark
| | | | - Ole Donatsky
- Department of Oral and Maxillofacial Surgery; Hilleroed Hospital/Rigshospitalet; Hilleroed; Denmark
| | - Henrik Nielsen
- Department of Oral and Maxillofacial Surgery; Hilleroed Hospital/Rigshospitalet; Hilleroed; Denmark
| | | | - Jesper Reibel
- Department of Oral Pathology and Medicine; School of Dentistry; University of Copenhagen; Copenhagen; Denmark
| | - Bente Pakkenberg
- Laboratory of Stereology; Bispebjerg University Hospital; Copenhagen; Denmark
| | - Palle Holmstrup
- Department of Periodontology; School of Dentistry; University of Copenhagen; Copenhagen; Denmark
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Hohlweg-Majert B, Pautke C, Deppe H, Metzger MC, Wagner K, Schulze D. Qualitative and quantitative evaluation of bony structures based on DICOM dataset. J Oral Maxillofac Surg 2011; 69:2763-70. [PMID: 21703745 DOI: 10.1016/j.joms.2011.02.076] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Revised: 01/14/2011] [Accepted: 02/12/2011] [Indexed: 10/18/2022]
Abstract
PURPOSE The aim of this study was to investigate bone mass using different cone-beam computed tomographies (CBCTs) combined with image analysis and to determine whether bone quantity or quality was detected. MATERIALS AND METHODS Different measurements recorded on mandible bones of pigs in the retromolar region were evaluated on ProMax 3D (Planmeca Oy, Finland) and the ILUMA™CT (IMTEC™ Imaging, Ardmore, OK) to calculate a calibration curve. The spatial relationships of pig mandible halves relative to adjacent defined anatomical structures were assessed by means of 3D visualization software. In addition to the screenshot, their bone quality was evaluated in accordance with the Lenkholm and Zarb classification. RESULTS The CBCT calibration curves based on the measurements taken from the ProMax and ILUMA CT showed linear correlation. Huge Hounsfield units intervals were found between the 2 CBCTs and there was no correlation with the computed tomography. Exact information on the micromorphology of the bone cylinders was not available. A subjective correlation according to Lenkholm and Zarb showed overlapping in all groups. CONCLUSIONS CBCT is a good choice for analyzing bone mass. However, it does not provide any information on bone quality. To obtain information on the microarchitecture of the spongiosa, it is necessary to use a computed tomography with finite element analysis.
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Affiliation(s)
- Bettina Hohlweg-Majert
- Department of Oral and Maxillofacial Surgery, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.
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22
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Veigel E, Moore RJ, Zarrinkalam MR, Schulze D, Sauerbier S, Schmelzeisen R, Voss PJ. Osteopenia in the maxillofacial area: a study in sheep. Osteoporos Int 2011; 22:1115-21. [PMID: 20503036 DOI: 10.1007/s00198-010-1289-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2009] [Accepted: 04/09/2010] [Indexed: 10/19/2022]
Abstract
UNLABELLED Osteoporosis is a major public health problem worldwide. Its significance in the fields of traumatology and implantology of the maxillofacial area requires investigation. A large animal model was used to assess bone loss in the lumbar spine and mandible. INTRODUCTION Osteoporosis is a prevalent disease characterized by low bone mass and microarchitectural deterioration of bone tissue. Osteoporosis-related fractures represent a major public health burden. The presence and relevance of osteoporosis in the maxillofacial area remain controversial. Research in humans is limited by difficulties in finding large homogenous study groups and, due to ethical considerations, numerous animal models have been used in osteoporosis research. The aim of this study was to assess a sheep model of generalized osteopenia for changes in the maxillofacial area. METHODS Bone loss was induced in ten Merino sheep by ovariectomy, intramuscular administration of glucocorticoids, and a calcium-reduced diet. Five untreated animals served as controls. Bone mineral density (BMD) was assessed by dual-energy X-ray absorptiometry at the lumbar spine at baseline and after 1, 3, 6, 9, and 12 months. Lumbar and mandibular bone biopsies were obtained and analyzed with microcomputed tomography. RESULTS Lumbar BMD decreased progressively in the intervention group and was most significantly low after 6 months (p < 0.001). Lumbar trabecular bone showed a significant decrease in bone volume (BV)/tissue volume (TV; p < 0.05) in the inducted group. Significant changes were found in both analyzed mandibular regions for BV/TV (p < 0.05). Regional variations were found for other parameters in the mandible. The cortical width was substantially reduced in the intervention group (p < 0.001). CONCLUSIONS Microstructural changes occurring in sheep as a result of induction seem to have a generalized nature. This sheep model meets the criteria for further investigation in the maxillofacial area.
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Affiliation(s)
- E Veigel
- Albert-Ludwigs-Universität, Hugstetterstrasse 55, 79106 Freiburg, Germany.
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23
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Rupp JD, Flannagan CAC, Hoff CN, Cunningham RM. Effects of osteoporosis on AIS 3+ injury risk in motor-vehicle crashes. ACCIDENT; ANALYSIS AND PREVENTION 2010; 42:2140-2143. [PMID: 20728673 DOI: 10.1016/j.aap.2010.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2010] [Revised: 06/18/2010] [Accepted: 07/10/2010] [Indexed: 05/29/2023]
Abstract
Older occupants in motor-vehicle crashes are more likely to experience injury than younger occupants. One possible reason for this is that increasing age is associated with increased prevalence of osteoporosis, which decreases bone strength. Crash-injury data were used with Bayes' Theorem to estimate the conditional probability of AIS 3+ skeletal injury given that an occupant is osteoporotic for the injury to the head, spine, thorax, lower extremities, and upper extremities. This requires the conditional probabilities of osteoporosis given AIS 3+ injury for each of the body regions, which were determined from analysis of the Crash Injury Research and Engineering Network database. It also requires information on probability of osteoporosis in the crash-involved population and the probabilities of AIS 3+ skeletal injury to different body regions in crashes. The latter probabilities were obtained from the National Automotive Sampling System-Crashworthiness Data System (NASS-CDS) database. The former was obtained by modeling the probability of osteoporosis in the US populations using data from the 2006 National Health Examination Nutrition Survey and applying this model to the estimate of the crash-involved population in NASS-CDS. To attempt to account for the effects of age on injury outcome that are independent of osteoporosis, only data from occupants who were 60 years of age or older were used in all analyses. Results indicate that the only body region that experiences a statistically significant change in fracture injury risk with osteoporosis is the spine, for which osteoporosis increases the risk of AIS 3+ fracture by 3.28 times, or from 0.41% to 1.34% (p<0.0001). This finding suggests that the increase in AIS 3+ injury risk with age for non-spine injuries is likely influenced by factors other than osteoporosis.
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Affiliation(s)
- Jonathan D Rupp
- University of Michigan Transportation Research Institute, 2901 Baxter Rd., Ann Arbor, MI 48109-2150, United States.
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24
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Hohlweg-Majert B, Metzger MC, Kummer T, Schulze D. Morphometric analysis - Cone beam computed tomography to predict bone quality and quantity. J Craniomaxillofac Surg 2010; 39:330-4. [PMID: 21030266 DOI: 10.1016/j.jcms.2010.10.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2010] [Revised: 08/24/2010] [Accepted: 10/04/2010] [Indexed: 10/18/2022] Open
Abstract
AIM Modified quantitative computed tomography is a method used to predict bone quality and quantify the bone mass of the jaw. The aim of this study was to determine whether bone quantity or quality was detected by cone beam computed tomography (CBCT) combined with image analysis. MATERIALS AND PROCEDURES: Different measurements recorded on two phantoms (Siemens phantom, Comac phantom) were evaluated on images taken with the Somatom VolumeZoom (Siemens Medical Solutions, Erlangen, Germany) and the NewTom 9000 (NIM s.r.l., Verona, Italy) in order to calculate a calibration curve. The spatial relationships of six sample cylinders and the repositioning from four pig skull halves relative to adjacent defined anatomical structures were assessed by means of three-dimensional visualization software. RESULTS The calibration curves for computer tomography (CT) and cone beam computer tomography (CBCT) using the Siemens phantom showed linear correlation in both modalities between the Hounsfield Units (HU) and bone morphology. A correction factor for CBCT was calculated. Exact information about the micromorphology of the bone cylinders was only available using of micro computer tomography. CONCLUSION Cone-beam computer tomography is a suitable choice for analysing bone mass, but, it does not give any information about bone quality.
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Affiliation(s)
- B Hohlweg-Majert
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum rechts der Isar, Ismaninger Str. 22, D-81675 München, Germany
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Başa O, Dilek OC. Assessment of the risk of perforation of the mandibular canal by implant drill using density and thickness parameters. Gerodontology 2010; 28:213-20. [PMID: 20236331 DOI: 10.1111/j.1741-2358.2009.00362.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective of this study was to investigate whether the resistance of the bone surrounding the mandibular canal had sufficient density and thickness to avoid perforation by drills when preparing the bed of the implant. BACKGROUND Damage to the inferior alveolar nerve (IAN) is more common than expected. This injury may lead to serious complications ranging from mild paresthesia to total anaesthesia of the lower jaw. MATERIALS AND METHODS The CT images of 99 patients, whose ages ranged between 20 and 79years, and who applied for an implant application to the posterior aspect of the mandible were included in this study. RESULTS The overall average bone thickness in the premolar and molar regions was 0.8717±0.1818 and 0.8556±0.1756mm, respectively, whereas the bone density in the premolar and molar regions was 649.18±241.42 and 584.44±222.73 Hounsfield Units (HU), respectively (p<0.001). CONCLUSION It was determined that the average density and thickness of the bone that surrounds the mandibular canal was not sufficient to resist the implant drill. It can be concluded that the risk of injury to the IAN may be minimised by accurately determining the bone mass on the canal prior to the implant procedure, and avoiding excessive force when approaching the canal.
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Affiliation(s)
- Onur Başa
- Department of Oral Implantology, Yeditepe University, Faculty of Dentistry, Istanbul, Turkey
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26
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Using vital statistics to estimate the population-level impact of osteoporotic fractures on mortality based on death certificates, with an application to France (2000-2004). BMC Public Health 2009; 9:344. [PMID: 19761614 PMCID: PMC2758869 DOI: 10.1186/1471-2458-9-344] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2009] [Accepted: 09/17/2009] [Indexed: 12/02/2022] Open
Abstract
Background We developed a methodology using vital statistics to estimate the impact of osteoporotic fractures on the mortality of an entire population, and applied it to France for the period 2000-2004. Methods Current definitions of osteoporotic fractures were reviewed and their components identified. We used the International Classification of Diseases with national vital statistics data for the French adult population and performed cross-classifications between various components: age, sex, I-code (site) and E-code (mechanism of fracture). This methodology allowed identification of appropriate thresholds and categorization for each pertinent component. Results 2,625,743 death certificates were analyzed, 2.2% of which carried a mention of fracture. Hip fractures represented 55% of all deaths from fracture. Both sexes showed a similar pattern of mortality rates for all fracture sites, the rate increased with age from the age of 70 years. The E-high-energy code (present in 12% of death certificates with fractures) was found to be useful to rule-out non-osteoporotic fractures, and to correct the overestimation of mortality rates. Using this methodology, the crude number of deaths associated with fractures was estimated to be 57,753 and the number associated with osteoporotic fractures 46,849 (1.85% and 1.78% of all deaths, respectively). Conclusion Osteoporotic fractures have a significant impact on overall population mortality.
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Ihde S, Kopp S, Maier T. Comparison of implant survival with implants placed in acceptable and compromised bone: a literature review. J Maxillofac Oral Surg 2009; 8:1-7. [PMID: 23139459 DOI: 10.1007/s12663-009-0001-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2007] [Accepted: 01/15/2009] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Survival rates for conventional dental implant systems are relatively high in normal healthy bone. However, there are subgroups of patients that are at an increased risk of implant failure. In particular, patients with compromised quantity or quality of bone present a significant challenge to the dental implantologist. OBJECTIVE To perform a review of the literature in an attempt to quantify the relative risk of implant failure in compromised bone compared to good or acceptable bone and to identify whether certain anatomical regions are at greater risk. SEARCH STRATEGY We conducted a systematic electronic database search of Medline, Cinhahl and the Cochrane Library through March 2006 identifying articles meeting the eligibility criteria. RESULTS We calculated an increased risk of implant failure in compromised bone compared to healthy bone in both the maxilla and the mandible using conventional dental implant systems. Relative risks ranged from 2 to 12 with the highest risk of failure in the maxilla. Conventional systems are often used in combination or after bone augmentation procedures or more innovative methods for stimulating bone growth in patients with compromised bone. These approaches do have their limitations including high costs, the accumulation of the surgical risks, and delayed time to loading. DISCUSSION Quantifying the risk of implant failure in patients with compromised bone should assist the implantologist in treatment decision making and patient counseling. Alternative methods for treating patients with compromised bone include zygomatic and lateral implants, neither of which typically require bone augmentation procedures. More studies are needed to evaluate their safety and efficacy.
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Affiliation(s)
- Stefan Ihde
- Lindenstr.68, CH-8738 Uetliburg, Switzerland
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Tsolaki IN, Madianos PN, Vrotsos JA. Outcomes of Dental Implants in Osteoporotic Patients. A Literature Review. J Prosthodont 2009; 18:309-23. [DOI: 10.1111/j.1532-849x.2008.00433.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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SEM analysis of dental enamel morphological structures on the basis of their replicas in patients with systemic calcium deficiency. Open Life Sci 2009. [DOI: 10.2478/s11535-009-0007-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AbstractThe aim of the present study is to examine microscopically the surface of dental enamel by using a scanning electron microscope (SEM), using their replicas formed in female patients with diagnosed periodontal diseases and systemic calcium deficiency. Replicas of dental enamel surfaces in patients referred for treatment of periodontal diseases were subjected to microscopic analysis. The replicas, after coating with platinum-palladium alloy, were examined under the scanning electron microscope at magnifications of 15–5000 x. Densitometric examinations of spine (L2 - L4 segment) revealed bone mineral density BMD T-score lower than −2.5 in 5 patients, in the range of −1.5 to −2.5 in 10 patients, and higher than −1.5 in the remaining patients. Non-homogenous images of surfaces in the form of light and dark areas were observed. Light areas corresponded to damaged surfaces of dental tissues. Patients with higher systemic calcium deficiency had areas lighter in color. More of these areas were found in patients with higher systemic calcium deficiency. It can be assumed that the calcium deficit is likely to appear in the selected dental tissues, particularly in the dental enamel.
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Devlin H, Allen PD, Graham J, Jacobs R, Karayianni K, Lindh C, van der Stelt PF, Harrison E, Adams JE, Pavitt S, Horner K. Automated osteoporosis risk assessment by dentists: a new pathway to diagnosis. Bone 2007; 40:835-42. [PMID: 17188590 DOI: 10.1016/j.bone.2006.10.024] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2006] [Revised: 09/29/2006] [Accepted: 10/29/2006] [Indexed: 10/23/2022]
Abstract
General dental practitioners use a vast amount of panoramic radiography in their routine clinical work, but valuable information about patients' osteoporotic status is not collected. There are many reasons for this, but one of the prime reasons must be the disruption involved in clinical routine with lengthy manual radiographic assessment. We have developed computer software, based on active shape modeling that will automatically detect the mandibular cortex on panoramic radiographs, and then measure its width. Automatic or semi-automatic measurement of the cortical width will indicate the osteoporotic risk of the patient. The aim of our work was to assess the computer search technique's ability to measure the mandibular cortical width and to assess its potential for detection of osteoporosis of the hip, spine and femoral neck. Mandibular cortical width was measured using the manually initialized (semi-automatic) method and, when assessed for diagnosing osteoporosis at one of the three measurement sites, gave an area under the ROC curve (A(z))=0.816 (95% CI=0.784 to 0.845) and for the automatically initialized searches, A(z)=0.759 (95% CI=0.724 to 0.791). The difference between areas=0.057 (95% Confidence interval=0.025 to 0.089), p<0.0001. For diagnosing osteoporosis at the femoral neck, mandibular cortical width derived from the manually initialized fit gave an area under the ROC curve (A(z))=0.835 (95% CI=0.805 to 0.863) and for the automatically initialized searches A(z)=0.805 (95% CI=0.773 to 0.835). The difference in A(z) values between active shape modeling search methods=0.030 (95% CI=-0.010 to 0.070), and this was not significant, p=0.138. We concluded that measurement of mandibular cortical width using active shape modeling is capable of diagnosing skeletal osteoporosis with good diagnostic ability and repeatability.
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Affiliation(s)
- H Devlin
- School of Dentistry, University Dental Hospital, Higher Cambridge Street, Manchester, M15 6FH, UK.
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