Recent developments in metabolic bone diseases: a gnathic perspective

Manifestations of hyperparathyroidism in the jaws: Concepts, mechanisms, and clinical aspects

Hyperparathyroidism is one of the most common endocrine disorders worldwide. In countries where routine biochemical screening is not common, symptomatic hyperparathyroidism predominates. Its manifestations include skeletal alterations, calcification of soft tissues, kidney stones, and functional alterations in other systems. Notably, jaw alterations can be the first clinical sign of hyperparathyroidism, including brown tumor, renal osteodystrophy, osteitis fibrosa, and leontiasis ossea, and knowing such conditions is of core importance for the multidisciplinary diagnosis and management of hyperparathyroidism. We aimed to perform a concise review, systematizing the concepts and mechanisms underlying hyperparathyroidism and associated gnathic alterations. In addition, a detailed description of the clinical aspects of the jaw manifestations is presented.

Transcriptomic profiling of tantalum metal implant osseointegration in osteopenic patients

OBJECTIVES

The long-term success of dental implants is established by literature. Although clinically well defined, the complex genetic pathways underlying osseointegration have not yet been fully elucidated. Furthermore, patients with osteopenia/osteoporosis are considered to present as higher risk for implant failure. Porous tantalum trabecular metal (PTTM), an open-cell porous biomaterial, is suggested to present enhanced biocompatibility and osteoconductivity. The goal of this study was to evaluate the expression patterns of a panel of genes closely associated with osteogenesis and wound healing in osteopenic patients receiving either traditional titanium (Ti) or PTTM cylinders to assess the pathway of genes activation in the early phases of osseointegration.

MATERIAL AND METHODS

Implant cylinders made of Ti and PTTM were placed in osteopenic volunteers. At 2- and 4 weeks of healing, one Ti and one PTTM cylinder were removed from each subject for RT-PCR analysis using osteogenesis PCR array.

RESULTS

Compared to Ti, PTTM-associated bone displayed upregulation of bone matrix proteins, BMP/TGF tisuperfamily, soluble ligand and integrin receptors, growth factors, and collagen genes at one or both time points. Histologically, PTTM implants displayed more robust osteogenesis deposition and maturity when compared to Ti implants from the same patient.

CONCLUSIONS

Our results indicate that PTTM properties could induce an earlier activation of genes associated with osteogenesis in osteopenic patients suggesting that PTTM implants may attenuate the relative risk of placing dental implants in this population.

Morphological, densitometric and mechanical properties of mandible in 5-month-old Polish Merino sheep

BACKGROUND

Among bones building the axial and appendicular skeleton, the mandible is characterized by unique morphological and functional traits. The aim of the study was to evaluate morphological, densitometric and mechanical properties of mandible in 5-month-old Polish Merino sheep. Using quantitative computed tomography, volumetric bone mineral density (vBMD) and calcium hydroxyapatite density of the cortical bone (CbCa-HA), mean vBMD (MvBMD) and total bone volume were determined. Using computed tomography cross-sectional scans of the mandible, cross-sectional area, second moment of inertia, mean relative wall thickness and cortical index were determined. Three-point bending test was applied to determine mechanical properties. Serum concentration of insulin-like growth factor I (IGF-I) and bone-specific alkaline phosphatase (BAP) was also measured.

RESULTS

All the investigated morphometric, densitometric and mechanical parameters of the right and left mandibular halves were not significantly different (P > 0.05). There was no correlation of final body weight, MvBMD, CbCa-HA, BAP and IGF-I with all the analyzed parameters of mandible (P > 0.05). However, positive correlations between the other investigated morphometric, densitometric and mechanical parameter of mandible were found (P < 0.05).

CONCLUSIONS

Relationships between morphological, densitometric and mechanical parameters of the mandible indicate that the elaborated experimental model may serve for further studies on metabolic responses of skeletal system to physiological, nutritional, pharmacological, toxicological and environmental factors.