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Kondo T, Kanayama K, Egusa H, Nishimura I. Current perspectives of residual ridge resorption: Pathological activation of oral barrier osteoclasts. J Prosthodont Res 2023; 67:12-22. [PMID: 35185111 DOI: 10.2186/jpr.jpr_d_21_00333] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE Tooth extraction is a last resort treatment for resolving pathological complications of dentition induced by infection and injury. Although the extraction wound generally heals uneventfully, resulting in the formation of an edentulous residual ridge, some patients experience long-term and severe residual ridge reduction. The objective of this review was to provide a contemporary understanding of the molecular and cellular mechanisms that may potentially cause edentulous jawbone resorption. STUDY SELECTION Clinical, in vivo, and in vitro studies related to the characterization of and cellular and molecular mechanisms leading to residual ridge resorption. RESULTS The alveolar processes of the maxillary and mandibular bones uniquely juxtapose the gingival tissue. The gingival oral mucosa is an active barrier tissue that maintains homeostasis of the internal organs through its unique barrier immunity. Tooth extraction not only generates a bony socket but also injures oral barrier tissue. In response to wounding, the alveolar bone socket initiates regeneration and remodeling through coupled bone formation and osteoclastic resorption. Osteoclasts are also found on the external surface of the alveolar bone, interfacing the oral barrier tissue. Osteoclasts in the oral barrier region are not coupled with osteoblastic bone formation and often remain active long after the completion of wound healing, leading to a net decrease in the alveolar bone structure. CONCLUSIONS The novel concept of oral barrier osteoclasts may provide important clues for future clinical strategies to maintain residual ridges for successful prosthodontic and restorative therapies.
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Affiliation(s)
- Takeru Kondo
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, CA, USA.,Division of Molecular and Regenerative Prosthodontics, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Keiichi Kanayama
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, CA, USA.,Department of Periodontology, Division of Oral Infections and Health Science, Asahi University School of Dentistry, Gifu, Japan
| | - Hiroshi Egusa
- Division of Molecular and Regenerative Prosthodontics, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Ichiro Nishimura
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, CA, USA
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Munhoz L, de Brito MAD, Arita ES, Sapienza MT. 18F-NaF uptake in dentomaxillofacial bones as a result of oral alterations: a positron emission tomography/computerized tomography scanning study. Oral Radiol 2021; 37:669-676. [PMID: 33428105 DOI: 10.1007/s11282-020-00509-z] [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: 10/24/2020] [Accepted: 12/22/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES 18F-NaF is a bone scanning radiotracer that reflects changes in bone metabolism, and it is applied in oncology to scan bone tumors or metastasis. Dentomaxillofacial alterations can lead to 18F-NaF uptake and could lead to false-positive results in PET/CT examinations. Hence, the objective of this research was to verify if the uptake of 18F-NaF in the mandible or maxilla is correlated to the presence of odontogenic alterations, which could lead to false-positive results in positron emission tomography/computerized tomography (PET/CT) examinations. METHODS 42 patients who underwent 18F-NaF PET/CT examinations and panoramic radiographs to detect bone metastasis and to assess oral conditions before oncologic treatment were included. Edentulous patients and patients with neoplasms in the maxillofacial area, and those whose imaging examinations had technical failures were excluded from the study. RESULTS A total of 252 areas from panoramic radiographs and PET/CT examinations were assessed. It was observed that the presence of periodontal bone loss resulted in a higher number of cases with false negatives. Accuracy, sensitivity, and specificity of 18F-NaF uptake-regardless of the type of odontogenic origin alteration-were 76.2%, 53.3%, and 89.4%, respectively. CONCLUSION 18F-NaF uptake in the maxilla or mandible could be influenced by oral alterations in the alveolar bones. The alterations in the oral cavity that lead to 18F-NaF accumulation should be recognized by medical radiologists to prevent false-positive results in PET/CT examinations using the tracer 18F-NaF.
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Affiliation(s)
- Luciana Munhoz
- Department of Stomatology, School of Dentistry, São Paulo University, 2227 Lineu Prestes Avenue, São Paulo, SP, 05508-000, Brazil.
| | - Mayara Aguilar Dias de Brito
- Radiology Institute, Hospital das Clínicas, Medicine School, São Paulo University, 75, Dr. Ovídio Pires de Campos Street, São Paulo, SP, 05403-010, Brazil
| | - Emiko Saito Arita
- Department of Stomatology, School of Dentistry, São Paulo University, 2227 Lineu Prestes Avenue, São Paulo, SP, 05508-000, Brazil
| | - Marcelo Taiti Sapienza
- Radiology Institute, Hospital das Clínicas, Medicine School, São Paulo University, 75, Dr. Ovídio Pires de Campos Street, São Paulo, SP, 05403-010, Brazil
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Abstract
The prevalence of prosthodontic treatment has been well recognized, and the need is continuously increasing with the ageing population. While the oral mucosa plays a critical role in the treatment outcome, the associated biomechanics is not yet fully understood. Using the literature available, this paper provides a critical review on four aspects of mucosal biomechanics, including static, dynamic, volumetric and interactive responses, which are interpreted by its elasticity, viscosity/permeability, apparent Poisson's ratio and friction coefficient, respectively. Both empirical studies and numerical models are analysed and compared to gain anatomical and physiological insights. Furthermore, the clinical applications of such biomechanical knowledge on the mucosa are explored to address some critical concerns, including stimuli for tissue remodelling (interstitial hydrostatic pressure), pressure–pain thresholds, tissue displaceability and residual bone resorption. Through this review, the state of the art in mucosal biomechanics and their clinical implications are discussed for future research interests, including clinical applications, computational modelling, design optimization and prosthetic fabrication.
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Affiliation(s)
- Junning Chen
- School of Aerospace, Mechanical and Mechatronic Engineering, University of Sydney, Sydney, New South Wales 2006, Australia
| | - Rohana Ahmad
- Unit of Prosthodontics, Faculty of Dentistry, Universiti Teknologi MARA, Shah Alam 40450, Malaysia
| | - Wei Li
- School of Aerospace, Mechanical and Mechatronic Engineering, University of Sydney, Sydney, New South Wales 2006, Australia
| | - Michael Swain
- Faculty of Dentistry, University of Sydney, Sydney, New South Wales 2006, Australia
| | - Qing Li
- School of Aerospace, Mechanical and Mechatronic Engineering, University of Sydney, Sydney, New South Wales 2006, Australia
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Suenaga H, Chen J, Yamaguchi K, Sugazaki M, Li W, Swain M, Li Q, Sasaki K. Bone metabolism induced by denture insertion in positron emission tomography. J Oral Rehabil 2015; 43:198-204. [PMID: 26431672 DOI: 10.1111/joor.12356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2015] [Indexed: 11/26/2022]
Abstract
18F-fluoride positron emission tomography (PET) can identify subtle functional variation prior to the major structural change detectable by X-ray. This study aims to investigate the mechanobiological bone reaction around the abutment tooth and in the residual ridge, induced by insertion of removable partial denture (RPD) within two different groups of patients: patients without denture experience (Group 1) and patients with denture experience before (Group 2), using 18F-fluoride PET imaging technique. 18F-fluoride PET/computerised tomography (CT) scan was performed to examine the bone metabolic change in mandible before and after the RPD treatment. Region of interests (ROIs) were placed in alveolar bone around abutment tooth and in residual bone beneath the RPD. Standardised uptake value (SUV), reflecting the accumulation of 18F-fluoride, was measured for each ROI. In all subjects of Group 1, SUVs after insertion were higher than before in both alveolar bone and residual bone, while there was less significant change in SUV in subjects of Group 2. This study demonstrated using longitudinal 18F-fluoride PET scans to effectively examine the bone metabolic change in mandible induced by occlusal loading after RPD insertion. Using this technique, within the six subjects in this study, it was shown that bone metabolism around abutment tooth and residual ridge increased after RPD insertion in case of first-time denture user, while there was no big change in the patient with experience of denture before. This study revealed the effectiveness of applying PET to evaluate bone metabolic activity as mechanobiological reaction.
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Affiliation(s)
- H Suenaga
- Division of Preventive Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - J Chen
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Sydney, Australia
| | - K Yamaguchi
- Department of Radiology, Sendai Kousei Hospital, Sendai, Japan
| | - M Sugazaki
- Division of Preventive Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - W Li
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Sydney, Australia
| | - M Swain
- Bio-clinical Sciences, Faculty of Dentistry, Kuwait University, Safat, Kuwait
| | - Q Li
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Sydney, Australia
| | - K Sasaki
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
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Valadares AA, Duarte PS, Woellner EB, Coura-Filho GB, Sapienza MT, Buchpiguel CA. Comparison of standardized uptake values measured on F-NaF PET/CT scans using three different tube current intensities. Radiol Bras 2015; 48:17-20. [PMID: 25798003 PMCID: PMC4366024 DOI: 10.1590/0100-3984.2014.0034] [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: 04/22/2014] [Accepted: 06/08/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze standardized uptake values (SUVs) using three different tube current intensities for attenuation correction on (18)FNaF PET/CT scans. MATERIALS AND METHODS A total of 254 (18)F-NaF PET/CT studies were analyzed using 10, 20 and 30 mAs. The SUVs were calculated in volumes of interest (VOIs) drawn on three skeletal regions, namely, right proximal humeral diaphysis (RH), right proximal femoral diaphysis (RF), and first lumbar vertebra (LV1) in a total of 712 VOIs. The analyses covered 675 regions classified as normal (236 RH, 232 RF, and 207 LV1). RESULTS Mean SUV for each skeletal region was 3.8, 5.4 and 14.4 for RH, RF, and LV1, respectively. As the studies were grouped according to mAs value, the mean SUV values were 3.8, 3.9 and 3.7 for 10, 20 and 30 mAs, respectively, in the RH region; 5.4, 5.5 and 5.4 for 10, 20 and 30 mAs, respectively, in the RF region; 13.8, 14.9 and 14.5 for 10, 20 and 30 mAs, respectively, in the LV1 region. CONCLUSION The three tube current values yielded similar results for SUV calculation.
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Affiliation(s)
- Agnes Araujo Valadares
- Nuclear Physicians, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, SP, Brazil
| | - Paulo Schiavom Duarte
- PhDs, Physicians Assistants, Instituto do Câncer do Estado de São Paulo Octavio Frias de Oliveira (Icesp), São Paulo, SP, Brazil
| | - Eduardo Bechtloff Woellner
- Nuclear Physicians, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, SP, Brazil
| | - George Barberio Coura-Filho
- PhDs, Physicians Assistants, Instituto do Câncer do Estado de São Paulo Octavio Frias de Oliveira (Icesp), São Paulo, SP, Brazil
| | - Marcelo Tatit Sapienza
- Private Docent, Professor, Department of Radiology and Oncology - Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
| | - Carlos Alberto Buchpiguel
- Private Docent, Full Professor, Department of Radiology and Oncology - Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
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Suenaga H, Chen J, Yamaguchi K, Li W, Sasaki K, Swain M, Li Q. Mechanobiological Bone Reaction Quantified by Positron Emission Tomography. J Dent Res 2015; 94:738-44. [DOI: 10.1177/0022034515573271] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
While nuclear medicine has been proven clinically effective for examination of the change in bone turnover as a result of stress injury, quantitative correlation between tracer uptake and mechanical stimulation in the human jawbone remains unclear. This study aimed to investigate the relationship between bone metabolism observed by 18F-fluoride positron emission tomography (PET) images and mechanical stimuli obtained by finite element analysis (FEA) in the residual ridge induced by the insertion of a removable partial denture (RPD). An 18F-fluoride PET/CT (computerized tomography) scan was performed to assess the change of bone metabolism in the residual ridge under the denture before and after RPD treatment. Corresponding patient-specific 3D finite element (FE) models were created from CT images. Boundary conditions were prescribed by the modeling of condylar contacts, and muscular forces were derived from the occlusal forces measured in vivo to generate mechanobiological reactions. Different mechanobiological stimuli, e.g., equivalent von Mises stress (VMS), equivalent strain (EQV), and strain energy density (SED), determined from nonlinear FEA, were quantified and compared with the standardized uptake values (SUVs) of PET. Application of increased occlusal force after RPD insertion induced higher mechanical stimuli in the residual bone. Accordingly, SUV increased in the region of residual ridge with higher mechanical stimuli. Thus, with SUV, a clear correlation was observed with VMS and SED in the cancellous bone, especially after RPD insertion (R2 > 0.8, P < 0.001). This study revealed a good correlation between bone metabolism and mechanical stimuli induced by RPD insertion. From this patient-specific study, it was shown that metabolic change detected by PET in the loaded bone, in a much shorter duration than conventional x-ray assessment, is associated with mechanical stimuli. The nondestructive nature of PET/CT scans and FEA could potentially provide a new method for clinical examination and monitoring of prosthetically driven bone remodeling.
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Affiliation(s)
- H. Suenaga
- Division of Preventive Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - J. Chen
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, NSW, Australia
| | - K. Yamaguchi
- Department of Radiology, Sendai Kousei Hospital, Sendai, Japan
| | - W. Li
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, NSW, Australia
| | - K. Sasaki
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry Sendai, Japan
| | - M. Swain
- Faculty of Dentistry, The University of Sydney, NSW, Australia
| | - Q. Li
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, NSW, Australia
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Matsui H, Fukuno N, Kanda Y, Kantoh Y, Chida T, Nagaura Y, Suzuki O, Nishitoh H, Takeda K, Ichijo H, Sawada Y, Sasaki K, Kobayashi T, Tamura S. The expression of Fn14 via mechanical stress-activated JNK contributes to apoptosis induction in osteoblasts. J Biol Chem 2014; 289:6438-6450. [PMID: 24446436 DOI: 10.1074/jbc.m113.536300] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Bone mass is maintained by the balance between the activities of bone-forming osteoblasts and bone-resorbing osteoclasts. It is well known that adequate mechanical stress is essential for the maintenance of bone mass, whereas excess mechanical stress induces bone resorption. However, it has not been clarified how osteoblasts respond to different magnitudes of mechanical stress. Here we report that large-magnitude (12%) cyclic stretch induced Ca(2+) influx, which activated reactive oxygen species generation in MC3T3-E1 osteoblasts. Reactive oxygen species then activated the ASK1-JNK/p38 pathways. The activated JNK led to transiently enhanced expression of FGF-inducible 14 (Fn14, a member of the TNF receptor superfamily) gene. Cells with enhanced expression of Fn14 subsequently acquired sensitivity to the ligand of Fn14, TNF-related weak inducer of apoptosis, and underwent apoptosis. On the other hand, the ASK1-p38 pathway induced expression of the monocyte chemoattractant protein 3 (MCP-3) gene, which promoted chemotaxis of preosteoclasts. In contrast, the ERK pathway was activated by small-magnitude stretching (1%) and induced expression of two osteogenic genes, collagen Ia (Col1a) and osteopontin (OPN). Moreover, activated JNK suppressed Col1a and OPN induction in large-magnitude mechanical stretch-loaded cells. The enhanced expression of Fn14 and MCP-3 by 12% stretch and the enhanced expression of Col1a and OPN by 1% stretch were also observed in mouse primary osteoblasts. These results suggest that differences in the response of osteoblasts to varying magnitudes of mechanical stress play a key role in switching the mode of bone metabolism between formation and resorption.
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Affiliation(s)
- Hiroyuki Matsui
- Department of Biochemistry, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Sendai 980-8575, Japan; Department of Advanced Prosthetic Dentistry, Tohoku University, 4-1 Seiryo-machi, Sendai 980-8575, Japan; Laboratory for Mechanical Medicine, Locomotive Syndrome Research Institute, Nadogaya Hospital, Nadogaya 687-4, Kashiwa 277-0032, Japan
| | - Naoto Fukuno
- Department of Biochemistry, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Sendai 980-8575, Japan; Department of Advanced Prosthetic Dentistry, Tohoku University, 4-1 Seiryo-machi, Sendai 980-8575, Japan
| | - Yoshiaki Kanda
- Department of Advanced Prosthetic Dentistry, Tohoku University, 4-1 Seiryo-machi, Sendai 980-8575, Japan
| | - Yusuke Kantoh
- Department of Biochemistry, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Sendai 980-8575, Japan; Department of Advanced Prosthetic Dentistry, Tohoku University, 4-1 Seiryo-machi, Sendai 980-8575, Japan
| | - Toko Chida
- Department of Biochemistry, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Sendai 980-8575, Japan
| | - Yuko Nagaura
- Department of Biochemistry, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Sendai 980-8575, Japan
| | - Osamu Suzuki
- Division of Craniofacial Function Engineering, Graduate School of Dentistry, Tohoku University, 4-1 Seiryo-machi, Sendai 980-8575, Japan
| | - Hideki Nishitoh
- Division of Biochemistry and Molecular Biology, Department of Medical Sciences, University of Miyazaki, 5200 Kihara, Kiyotake, 889-1692 Japan
| | - Kohsuke Takeda
- Division of Cell Regulation, Graduate School of Biomedical Sciences, Nagasaki University, 1-14 Bunkyo-machi, Nagasaki 852-8521, Japan
| | - Hidenori Ichijo
- Laboratory of Cell Signaling, Graduate School of Pharmaceutical Sciences, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Yasuhiro Sawada
- Laboratory for Mechanical Medicine, Locomotive Syndrome Research Institute, Nadogaya Hospital, Nadogaya 687-4, Kashiwa 277-0032, Japan; Mechanobiology Institute, National University of Singapore, 5A Engineering Drive 1, 117411 Singapore
| | - Keiichi Sasaki
- Department of Advanced Prosthetic Dentistry, Tohoku University, 4-1 Seiryo-machi, Sendai 980-8575, Japan
| | - Takayasu Kobayashi
- Department of Biochemistry, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Sendai 980-8575, Japan
| | - Shinri Tamura
- Department of Biochemistry, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Sendai 980-8575, Japan.
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Engstrand T, Kihlström L, Neovius E, Skogh ACD, Lundgren TK, Jacobsson H, Bohlin J, Åberg J, Engqvist H. Development of a bioactive implant for repair and potential healing of cranial defects. J Neurosurg 2013; 120:273-7. [PMID: 23909245 DOI: 10.3171/2013.6.jns1360] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The repair of complex craniofacial bone defects is challenging and a successful result is dependent on the size of the defect, quality of the soft tissue covering the defect, and choice of reconstruction method. The objective of this study was to develop a bioactive cranial implant that could provide a permanent reconstructive solution to the patient by stimulating bone healing of the defect. In this paper the authors report on the feasibility and clinical results of using such a newly developed device for the repair of a large traumatic and therapy-resistant cranial bone defect. The patient had undergone numerous attempts at repair, in which established methods had been tried without success. A mosaic-designed device was manufactured and implanted, comprising interconnected ceramic tiles with a defined calcium phosphate composition. The clinical outcome 30 months after surgery revealed a restored cranial vault without postoperative complications. Computed tomography demonstrated signs of bone ingrowth. Examination with combined (18)F-fluoride PET and CT provided further evidence of bone healing of the cranial defect.
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Affiliation(s)
- Thomas Engstrand
- Stockholm Craniofacial Centre, Department of Molecular Medicine and Surgery, Plastic Surgery Section
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