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Kildal D, Riether T, Blasenbrey T, Turhani D, Antoch G, Beer M, Geibel MA. Thickness of the hard palate : A new criterion for the diagnosis of osteoporosis? RADIOLOGIE (HEIDELBERG, GERMANY) 2024:10.1007/s00117-024-01318-9. [PMID: 38842551 DOI: 10.1007/s00117-024-01318-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 04/23/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND We were looking for an osteoporosis screening in computed tomography (CT) exams, simple and without additional examinations. We hypothesized that the criterion of "decreasing cortical thickness", may have an influence on the hard palate. Therefore, we investigated whether thickness of the hard palate (HPT) may serve as an indicator of osteoporosis for patients imaged for other reasons. METHODS Patients with dual-energy x-ray absorptiometry (DXA) and CT were identified by a radiology information system (RIS)-based, full-text search. Measurement of thickness of hard palate done in existing CT image by radiologist and dentist and compared with available findings and DXA measurements. RESULTS We identified a "test group": 57 patients with DXA and CT available out of 449 patient population and we selected further 70 patients without bone diseases as "control groups". The measurements showed that HPT correlated with age and bone density. The mean HPT was 2.4 mm in normal, 0.9 mm in osteopenia, 0.8 mm in osteoporosis and 5.3 mm in osteopetrosis case. No bone "healthy" patient fell below 1 mm. The relationship between bone density and HPT has not been described previously. HPT was highest in the bone-healthy group and decreased with age, osteopenia, and osteoporosis. Osteopetrosis, as a disease with increased bone density showed an increase in HPT. CONCLUSIONS HPT correlates with bone disease. We propose a new criterion for assessment on CT and digital volume tomography (DVT) or cone beam computed tomography (CBCT). A threshold of 1.0 mm when applying a simple measurement of HPT on Head CT or DVT may serve as an indicator for potential osteopenia or osteoporosis as incidental finding without extra imaging further diagnosis and treatment leading to early notice of Osteoporosis.
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Affiliation(s)
- Daniela Kildal
- Upper Valais Hospital Center Visp (SZO), Radiology, Hôpital du Valais, 3930, Visp, Switzerland.
- Diagnostic and Interventional Radiology, University Hospital Ulm, 89070, Ulm, Germany.
- Spitalzentrum Oberwallis, Klinik Radiologie, Pflanzettastrasse 8, 3930, Visp, Switzerland.
| | - Tobias Riether
- Dento- and Maxillofacial Surgery, University Hospital Ulm, 89070, Ulm, Germany
| | | | - Dritan Turhani
- Center for Oral and Maxillofacial Surgery, Danbue University, 3500, Krems an der Donau, Austria
| | - Gerald Antoch
- Institute for Diagnostic and Interventional Radiology, University Hospital Düsseldorf, 40225, Düsseldorf, Germany
| | - Meinrad Beer
- Diagnostic and Interventional Radiology, University Hospital Ulm, 89070, Ulm, Germany
| | - Margrit-Ann Geibel
- Dento- and Maxillofacial Surgery, University Hospital Ulm, 89070, Ulm, Germany
- Department of Dentistry, Danbue University, 3500, Krems an der Donau, Austria
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Anandan R, C.L K, Ganesan A, Aniyan K. Y. Strut and radio-morphometric analysis of mandibular trabecular structure in pre-and post-menopausal women to aid in the diagnosis of osteoporosis. J Oral Biol Craniofac Res 2024; 14:273-279. [PMID: 38559588 PMCID: PMC10979266 DOI: 10.1016/j.jobcr.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 02/10/2024] [Accepted: 03/08/2024] [Indexed: 04/04/2024] Open
Abstract
Purpose The purpose of the study is to evaluate the mandibular trabecular pattern in pre- and postmenopausal age women. By analysing the strut, fractal, grey level co-occurrence matrix, and radio-morphometric indices in the panoramic radiograph. Method Panoramic radiographs from 2019 to 2022 were used to assess pre- and postmenopausal women's bone mineral density. A total of 272 panoramic radiographs, which exhibited clear visibility of the mental foramen on both sides without any blurring, motion artefacts, surgical errors, overlapping hyoid bone, or inferior mandibular cortex, were divided into two groups. Group A (136 premenopausal women) and Group B (136 postmenopausal women). It is a retrospective study that is non-interventional/observational in design. Strut features, fractal dimensions, a grey-level co-occurrence matrix, and radio morphometric indices were used to investigate bone texture in an image processing program. The mean difference between group variables was calculated using an independent sample t-test/unpaired t-test. Results Pre-menopausal women had a mean age of 38.83 ± 6.01 years, while postmenopausal women had a mean age of 68.26 ± 8.31 In the postmenopausal group Four regions of interest exhibited fractal dimensions with a P value of less than 0.01 and GLCM features including contrast (0.812), correlation (0.230), energy (0.215), and homogeneity (0.322). Strut features of the four regions showed that 15 of 19 characteristics were significantly different. Conclusion Orthopantomogram is useful in screening for osteoporosis. Strut, radio-morphometric indices, and fractal analysis can assess bone texture and quality. Future research incorporating artificial intelligence can revolutionize image analysis and support clinical decision-making.
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Affiliation(s)
- Ragavendiran Anandan
- Department of Oral Medicine and Radiology, SRM Dental College, no.1 Bharathi Salai, Ramapuram, Chennai-600089, India
| | - Krithika C.L
- Department of Oral Medicine and Radiology, SRM Dental College, no.1 Bharathi Salai, Ramapuram, Chennai-600089, India
| | - Anuradha Ganesan
- Department of Oral Medicine and Radiology, SRM Dental College, no.1 Bharathi Salai, Ramapuram, Chennai-600089, India
| | - Yesoda Aniyan K.
- Department of Oral Medicine and Radiology, SRM Dental College, no.1 Bharathi Salai, Ramapuram, Chennai-600089, India
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Ersan N, Özel B. Fractal dimension analysis of different mandibular regions in familial Mediterranean fever patients: A cross-sectional retrospective study. PLoS One 2023; 18:e0288170. [PMID: 37390096 PMCID: PMC10313079 DOI: 10.1371/journal.pone.0288170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 06/20/2023] [Indexed: 07/02/2023] Open
Abstract
Familial Mediterranean fever (FMF) is a genetic condition that may cause loss of bone mineral density (BMD) due to chronic inflammation. Previously, fractal dimension (FD) analysis values of mandibular cortical bone were shown to be lower in osteoporosis. Therefore, FD might be considered as an auxiliary tool to refer patients for dual-energy x-ray absorptiometry (DXA), which is the gold standard for BMD measurement. The purpose of this cross-sectional retrospective study was to evaluate trabecular and cortical microarchitecture of the mandible with FD analysis on panoramic radiographs in a subpopulation of FMF. Also, the effect of colchicine use was investigated. Forty-three FMF patients, aged between 10.8 and 71.2 years, and age- and gender-matched control group consisting of patients, who had no systemic diseases, were included. Demographic information such as age and gender, and colchicine use were recorded. In terms of age, the patients were classified as <30 and 30< years. On each panoramic radiographs five regions of interest were selected on the mandible as: 1- premolar, 2- molar, 3- angular, 4- condylar, and 5- basal cortical bone regions on right (R) and left (L) sides. Statistical significance was accepted at p<0.05 level. Intra- and inter-observer agreements demonstrated good to excellent consistency. In FMF patients, L3 and L4 values were higher, whereas L5 values were lower (p<0.05) than the control group. In terms of age, the difference between groups was insignificant in FMF patients (p>0.05), whereas in control group R3 and L4 values were higher in the 30< age group (p<0.05). Regarding gender and colchicine use, the difference between groups was insignificant (p>0.05). FMF disease might be a candidate for referral to DXA examination based on decreased bone density in the mandibular cortex detected by FD measurements on routine panoramic radiographs. Further studies are warranted to ascertain this relationship.
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Affiliation(s)
- Nilüfer Ersan
- Yeditepe University Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Istanbul, Turkiye
| | - Beliz Özel
- Yeditepe University Faculty of Dentistry, Department of Endodontics, Istanbul, Turkiye
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4
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Gullberg J, Al-Okshi A, Homar Asan D, Zainea A, Sundh D, Lorentzon M, Lindh C. The challenge of applying digital image processing software on intraoral radiographs for osteoporosis risk assessment. Dentomaxillofac Radiol 2022; 51:20210175. [PMID: 34324394 PMCID: PMC8693323 DOI: 10.1259/dmfr.20210175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES The purpose of this study was to evaluate rater agreement and the accuracy of a semi-automated software and its fully automated tool for osteoporosis risk assessment in intraoral radiographs. METHODS A total of 567 intraoral radiographs was selected retrospectively from women aged 75-80 years participating in a large population-based study (SUPERB) based in Gothenburg, Sweden. Five raters assessed participants' risk of osteoporosis in the intraoral radiographs using a semi-automated software. Assessments were repeated after 4 weeks on 121 radiographs (20%) randomly selected from the original 567. Radiographs were also assessed by the softwares' fully automated tool for analysis. RESULTS Overall interrater agreement for the five raters was 0.37 (95% CI 0.32-0.41), and for the five raters with the fully automated tool included as 'sixth rater' the overall Kappa was 0.34 (0.30-0.38). Intrarater agreement varied from moderate to substantial according to the Landis and Koch interpretation scale. Diagnostic accuracy was calculated in relation to reference standard for osteoporosis diagnosis which is T-score values for spine, total hip and femoral neck and presented in form of sensitivities, specificities, predictive values, likelihood ratios and odds ratios. All raters' mean sensitivity, including the fully automated tool, was 40,4% (range 14,3%-57,6%). Corresponding values for specificity was 69,5% (range 59,7%-90,4%). The diagnostic odds ratios ranged between 1 and 2.7. CONCLUSION The low diagnostic odds ratio and agreement between raters in osteoporosis risk assessment using the software for analysis of the trabecular pattern in intraoral radiographs shows that more work needs to be done to optimise the automation of trabecular pattern analysis in intraoral radiographs.
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Affiliation(s)
| | - Ayman Al-Okshi
- Department of Oral Medicine and Radiology, Faculty of Dentistry, Sebha University, Sebha, Libya
| | | | - Anita Zainea
- Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Daniel Sundh
- Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
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Cavalcante DDS, Silva PGDB, Carvalho FSR, Quidute ARP, Kurita LM, Cid AMPL, Ribeiro TR, Gurgel ML, Kurita BM, Costa FWG. Is jaw fractal dimension a reliable biomarker for osteoporosis screening? A systematic review and meta-analysis of diagnostic test accuracy studies. Dentomaxillofac Radiol 2021; 51:20210365. [PMID: 34767466 PMCID: PMC9499197 DOI: 10.1259/dmfr.20210365] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To summarize the evidence on the feasibility of maxillomandibular imaging exams-related fractal dimension (FD) in screening patients with osteoporosis. METHODS This registered systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses of Diagnostic Test Accuracy statement. High sensitivity search strategies were developed for six primary databases and grey literature. Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) items evaluated the risk of bias, and the GRADE approach assessed the evidence certainty. RESULTS From 1034 records initially identified through database searching, four studies were included (total sample of 747 patients [osteoporosis, 136; control group, 611]). The meta-analysis showed that the overall sensitivity and specificity of the FD were 86.17 and 72.68%, respectively. In general, all studies showed low RoB and applicability concern. The certainty of the evidence was very low to moderate. CONCLUSIONS This systematic review showed that the jaw-related FD presented sensitivity and specificity values higher than 70%, and its sensitivity in osteoporosis screening was a better parameter than specificity.
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Affiliation(s)
- Davi de Sá Cavalcante
- Division of Radiology, Postgraduate Program in Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | | | | | - Ana Rosa Pinto Quidute
- Division of Endocrinology and Diabetology, Walter Cantídio University Hospital, Fortaleza, Ceará, Brazil
| | - Lúcio Mitsuo Kurita
- Division of Radiology, Postgraduate Program in Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | | | - Thyciana Rodrigues Ribeiro
- Division of Patient with Special Needs, Postgraduate Program in Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Marcela Lima Gurgel
- Division of Radiology, Postgraduate Program in Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Bianca Moreira Kurita
- Division of Pharmacology, Maurício de Nassau Center University, Fortaleza, Ceará, Brazil
| | - Fábio Wildson Gurgel Costa
- Division of Radiology, Postgraduate Program in Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
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Johanen A, Jonasson G, Lund H, Bernhardsson S, Hagman J, Hange D, Liljegren A, Persson C, Stadig I, Wartenberg C, Sjögren P, Hakeberg M. Trabecular bone patterns as a fracture risk predictor: a systematic review. Acta Odontol Scand 2021; 79:482-491. [PMID: 33650459 DOI: 10.1080/00016357.2021.1886322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND The aim of this systematic review was to evaluate the assessment of trabecular bone patterns in dental radiographs, for fracture risk prediction, compared with the current diagnostic methods. METHODS The PRISMA guidelines were followed. According to predefined inclusion criteria (PICO), literature searches were focussed on published studies with analyses of trabecular bone patterns on intraoral and/or in panoramic radiographs, compared with Dual X-ray Absorptiometry (DXA) and/or Fracture Risk Assessment Tool (FRAX), with the outcomes; fracture and/or sensitivity and specificity for osteoporosis prediction. The included studies were quality-assessed using the QUADAS-2 tool and the certainties of evidence was assessed using the GRADE approach. RESULTS The literature searches identified 2913 articles, whereas three were found to meet the inclusion criteria. Two longitudinal cohort studies evaluated the use of trabecular bone patterns to predict bone fractures. In one of the studies, the relative risk of fracture was significantly higher for women with sparse bone pattern, identified by visual assessment of dental radiographs, and in the other study by digital software assessment. Visual assessment in the second study did not show significant results. The cross-sectional study of digital analyses of trabecular bone patterns in relation to osteoporosis reported a sensitivity of 0.70 and a specificity of 0.69. CONCLUSION Based on low certainty of evidence, trabecular bone evaluation on dental radiographs may predict fractures in adults without a prior diagnosis of osteoporosis, and based on very low certainty of evidence, it is uncertain whether digital image analyses of trabecular bone can predict osteoporosis.
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Affiliation(s)
- Astera Johanen
- Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Clinic of Oral and Maxillofacial Radiology, Public Dental Service, Gothenburg, Sweden
| | - Grethe Jonasson
- Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research and Development Primary Health Care, Research and Development Center Södra Älvsborg, Region Västra Götaland, Sweden
| | - Henrik Lund
- Department of Oral and Maxillofacial Radiology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Susanne Bernhardsson
- HTA-centre of Region Västra Götaland, Gothenburg, Sweden
- Research and Development Primary Health Care, Gothenburg, Sweden
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jennie Hagman
- Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Clinic of Oral Medicine, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden
| | - Dominique Hange
- Research and Development Primary Health Care, Research and Development Center Södra Älvsborg, Region Västra Götaland, Sweden
- Department of Public Health and Community Medicine/Primary Health Care, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ann Liljegren
- Medical Library, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Cecilia Persson
- Clinic of Oral and Maxillofacial Radiology, Public Dental Service, Gothenburg, Sweden
| | - Ida Stadig
- Medical Library, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | | | - Magnus Hakeberg
- Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Clinic of Oral Medicine, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden
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Is the Jaw Bone Micro-Structure Altered in Response to Osteoporosis and Bisphosphonate Treatment? A Micro-CT Analysis. Int J Mol Sci 2021; 22:ijms22126559. [PMID: 34207275 PMCID: PMC8234121 DOI: 10.3390/ijms22126559] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/26/2021] [Accepted: 06/08/2021] [Indexed: 12/23/2022] Open
Abstract
The aim of the study was to quantify the micro-architectural changes of the jaw bone in response to ovariectomy, exposed or not to bisphosphonate treatment. A total of 47 Wistar rats were ovariectomized (OVX) or sham-operated (shOVX) and exposed to osteoporosis preventive treatment for eight weeks either with bisphosphonates (alendronate, ALN; group OVX-ALN) three days/week at a dose of 2 mg/kg or with saline solution (untreated control condition; group OVX). The bone morphometric parameters of the trabecular jaw bone were assessed using ex vivo micro-computed tomography. The regions of interest investigated in the maxilla were the inter-radicular septum of the second molar and the tuber. The regions quantified in the mandible included the three molar regions and the condyle. A one-way analysis of variance followed by pairwise comparison using Tukey’s HSD and the Games–Howell test was conducted to explore significant differences between the groups. In the maxilla, OVX decreased the bone volume in the inter-radicular septum of the second molar. Bisphosphonate treatment was able to prevent this deterioration of the jaw bone. The other investigated maxillary regions were not affected by (un)treated ovariectomy. In the mandible, OVX had a significant negative impact on the jaw bone in the buccal region of the first molar and the inter-radicular region of the third molar. Treatment with ALN was able to prevent this jaw bone loss. At the condyle site, OVX significantly deteriorated the trabecular connectivity and shape, whereas preventive bisphosphonate treatment showed a positive effect on this trabecular bone region. No significant results between the groups were observed for the remaining regions of interest. In summary, our results showed that the effects of ovariectomy-induced osteoporosis are manifested at selected jaw bone regions and that bisphosphonate treatment is capable to prevent these oral bone changes.
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Li Y, Ling J, Jiang Q. Inflammasomes in Alveolar Bone Loss. Front Immunol 2021; 12:691013. [PMID: 34177950 PMCID: PMC8221428 DOI: 10.3389/fimmu.2021.691013] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 05/18/2021] [Indexed: 12/18/2022] Open
Abstract
Bone remodeling is tightly controlled by osteoclast-mediated bone resorption and osteoblast-mediated bone formation. Fine tuning of the osteoclast-osteoblast balance results in strict synchronization of bone resorption and formation, which maintains structural integrity and bone tissue homeostasis; in contrast, dysregulated bone remodeling may cause pathological osteolysis, in which inflammation plays a vital role in promoting bone destruction. The alveolar bone presents high turnover rate, complex associations with the tooth and periodontium, and susceptibility to oral pathogenic insults and mechanical stress, which enhance its complexity in host defense and bone remodeling. Alveolar bone loss is also involved in systemic bone destruction and is affected by medication or systemic pathological factors. Therefore, it is essential to investigate the osteoimmunological mechanisms involved in the dysregulation of alveolar bone remodeling. The inflammasome is a supramolecular protein complex assembled in response to pattern recognition receptors and damage-associated molecular patterns, leading to the maturation and secretion of pro-inflammatory cytokines and activation of inflammatory responses. Pyroptosis downstream of inflammasome activation also facilitates the clearance of intracellular pathogens and irritants. However, inadequate or excessive activity of the inflammasome may allow for persistent infection and infection spreading or uncontrolled destruction of the alveolar bone, as commonly observed in periodontitis, periapical periodontitis, peri-implantitis, orthodontic tooth movement, medication-related osteonecrosis of the jaw, nonsterile or sterile osteomyelitis of the jaw, and osteoporosis. In this review, we present a framework for understanding the role and mechanism of canonical and noncanonical inflammasomes in the pathogenesis and development of etiologically diverse diseases associated with alveolar bone loss. Inappropriate inflammasome activation may drive alveolar osteolysis by regulating cellular players, including osteoclasts, osteoblasts, osteocytes, periodontal ligament cells, macrophages, monocytes, neutrophils, and adaptive immune cells, such as T helper 17 cells, causing increased osteoclast activity, decreased osteoblast activity, and enhanced periodontium inflammation by creating a pro-inflammatory milieu in a context- and cell type-dependent manner. We also discuss promising therapeutic strategies targeting inappropriate inflammasome activity in the treatment of alveolar bone loss. Novel strategies for inhibiting inflammasome signaling may facilitate the development of versatile drugs that carefully balance the beneficial contributions of inflammasomes to host defense.
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Affiliation(s)
- Yang Li
- Department of Endodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, China
| | - Junqi Ling
- Department of Endodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, China.,Guangdong Province Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Qianzhou Jiang
- Department of Endodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, China
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Elleby C, Skott P, Jonasson G, Theobald H, Nyrén S, Salminen H. Two methods of evaluating mandibular trabecular pattern in intraoral radiographs and the association to fragility fractures during a 47-year follow up. Eur J Oral Sci 2021; 129:e12801. [PMID: 34101266 DOI: 10.1111/eos.12801] [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: 01/05/2021] [Revised: 04/30/2021] [Accepted: 05/03/2021] [Indexed: 11/28/2022]
Abstract
In this longitudinal cohort study, we explored the association of fragility fractures to sparse trabecular bone pattern in intraoral radiographs using two methods, a visual and a semi-automated. Our aim was to study both sexes and to include younger age-groups, during a follow-up time of 47 years. The cohort consisted of 837 men and women aged 18-65 years, with intraoral radiographs from 1970-1971. The trabecular pattern was assessed in the mandibular premolar region with a visual and a semi-automated method. Data on fragility fractures were acquired from the Swedish National Patient Register for 47 years of follow-up time. Sparse trabecular pattern was found in 2.2% of the cohort using the visual method, and 18% were deemed at 'risk of osteoporosis' using the semi-automated method. A total of 132 individuals suffered at least one fragility fracture during the follow-up period. We found no significant association between fractures and sparse trabecular pattern using either method. This study shows that visual assessment, as a predictor of future fractures, may not be a suitable method for individuals of all ages and sexes. As for the semi-automated method, there is still very limited evidence for its fracture predictive ability.
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Affiliation(s)
- Charlotta Elleby
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.,Academic Centre for Geriatric Dentistry, Stockholm, Sweden.,Folktandvården Stockholms län AB, Stockholm, Sweden
| | - Pia Skott
- Academic Centre for Geriatric Dentistry, Stockholm, Sweden.,Folktandvården Stockholms län AB, Stockholm, Sweden.,Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Grethe Jonasson
- Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Holger Theobald
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.,Academic Primary Care Health Centre, Region Stockholm, Stockholm, Sweden
| | - Sven Nyrén
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden
| | - Helena Salminen
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
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Delayed Diagnosis of Unilateral Mandibular Condylar Fracture in a Posterior Edentulous Patient. Case Rep Dent 2021; 2021:5579236. [PMID: 34055422 PMCID: PMC8147526 DOI: 10.1155/2021/5579236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 05/01/2021] [Accepted: 05/05/2021] [Indexed: 11/18/2022] Open
Abstract
Background Fractures of the mandible are common in elderly patients, and among them, condylar fractures are the most frequent type. A change in occlusion is the most common physical finding in patients with fractures of the mandible. Therefore, it is challenging to identify mandibular fractures in posterior edentulous patients due to the lack of posterior occlusal contacts. It is crucial to do radiological investigations in such patients to exclude fractures. Case Presentation. This article describes a case of delayed diagnosis of a unilateral mandibular condylar fracture for a week's duration and treating the condition as temporomandibular pathology in a posterior edentulous, 52-year-old patient. Conclusion This clinical case highlights the importance of radiological investigations and occlusal analysis for early diagnosis of condylar fractures, particularly in posterior edentulous patients, lacking posterior occlusal contacts.
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11
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Mohammed AO, Kaklamanos EG. Effect of ovariectomy-induced osteoporosis on the amount of orthodontic tooth movement: a systematic review of animal studies. Eur J Orthod 2021; 43:672-681. [PMID: 33866368 DOI: 10.1093/ejo/cjab013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Understanding the impact of osteopenia and osteoporosis on orthodontic tooth movement could be of benefit to the orthodontist, but research in humans presents practical and ethical problems. The ovariectomized animal model could provide useful information on osteoporosis. OBJECTIVE To compare the amount of tooth movement during or after the application of orthodontic forces between ovariectomized animals and control or sham-operated subjects. SEARCH METHODS Unrestricted searches in seven databases and manual searching of the reference lists in relevant studies were performed up to February 2021 (PubMed, Central, Cochrane Database of Systematic Reviews, Scopus, Web of Science, Arab World Research Source, ProQuest Dissertations, and Theses Global). SELECTION CRITERIA We searched for studies quantitatively comparing the amount of tooth movement during or after the application of orthodontic forces between ovariectomized animals and control or sham-operated subjects. DATA COLLECTION AND ANALYSIS Following study retrieval and selection, relevant data were extracted, and the risk of bias was assessed using the SYRCLE's Risk of Bias Tool. Exploratory synthesis and meta-regression were carried out using the random effects model. RESULTS Thirteen studies were finally selected and no specific concerns regarding bias were identified. During the active period, ovariectomy was associated with a statistically significant acceleratory effect on the rate of orthodontic tooth movement compared to non-treated rats (3 weeks; 4 studies, 0.15 mm more movement in the ovariectomized rats; 95 per cent confidence interval: 0.10-0.19; P = 0.000). Exploratory meta-regression showed that this difference could increase over time. Following force discontinuation, no statistically significant differences were observed [3 weeks; 1 study (median ± SE), Ovariectomy group: 0.30 ± 0.04 mm; Sham operation group: 0.18 ± 0.03; P = 0.1558]. CONCLUSIONS Ovariectomy-induced osteoporosis may affect the rate of orthodontic tooth movement. Although animal studies should be approached with caution regarding their translational potential, the safe practice would suggest that one should consider potential implications. REGISTRATION PROSPERO (CRD42018118003).
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Affiliation(s)
- Ayesha O Mohammed
- Dubai Health Authority, Dubai, United Arab Emirates.,Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Eleftherios G Kaklamanos
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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Barr C, Sharafieh R, Schwarz G, Wu R, Klueh U, Kreutzer D. Noninflammatory Stress-Induced Remodeling of Mandibular Bone: Impact of Age and Pregnancy. J Oral Maxillofac Surg 2020; 79:1147-1155. [PMID: 33412113 DOI: 10.1016/j.joms.2020.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 12/02/2020] [Accepted: 12/02/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE The impact of noninflammatory stress, such as aging and pregnancy, on human long bone remodeling is well-established, but little is known about the impact of these stressors on oral bones, including the mandibular bone. To begin to fill this gap in our knowledge, we utilized a mouse mandibular model to evaluate the impact of noninflammatory simple stressors, ie, aging and pregnancy, on bone mandibular architecture and bone density in the mandible using micro-CT. MATERIALS AND METHODS For the present study, mandibles were obtained from both aged and pregnant C57BL/6 mice and analyzed using micro-CT technology. Micro-CT metrics included bone volume fraction (BVF), total volume (TV), tissue density, and apparent density in the mandible on the mandibular area of compact and trabecular bone, in which the teeth are embedded. All bone-related metrics data from aged and pregnant mice were analyzed using ANOVA analysis and visualized in boxplots. RESULTS Age-dependent bone remodeling occurred over 4 to 18 weeks of age, ie, increases in BVF, TV, BV/TV, as well as tissue and bone density. Evaluation of bone remodeling in breeder mice (repeated pregnancy model) and virgin mice (age-matched controls) at 37 weeks of age demonstrated that breeder mice had a dramatic decline in all bone metrics measured. CONCLUSIONS This study underscores the need for more research on noninflammatory stress-related mandibular bone remodeling (eg, age and pregnancy), which compromises bone strength and tooth anchoring. The data also underscores loss of alveolar bone height, as in periodontitis, is an important metric for a more complete assessment of bone loss. This report on mice provides essential data that can be applied for oral-maxillofacial surgeons and periodontists when planning for dental implants in patients with such stressors. Periodontitis related bone loss occurs independent of skeletal homeostasis, although osteoporosis may adversely affect alveolar bone height in humans.
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Affiliation(s)
- Charles Barr
- Former Professor, Department of Oral Health and Diagnostic Sciences. School of Dental Medicine, University of Connecticut, Farmington, CT
| | - Roshanak Sharafieh
- Assistant Professor, Department of Surgery, School of Medicine, University of Connecticut, Farmington, CT
| | - Gregory Schwarz
- Graduate Student, Department of Surgery, School of Medicine, University of Connecticut, Farmington, CT
| | - Rong Wu
- Research Associate II and Statistician, Connecticut Institute for Clinical and Translational Science, University of Connecticut, Farmington, CT
| | - Ulrike Klueh
- Associate Professor, Department of Biomedical Engineering, School of Engineering, Wayne State University, Detroit, MI
| | - Don Kreutzer
- Professor, Former Chair and Head of Immunology, Department of Surgery, School of Medicine, University of Connecticut, Farmington, CT.
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Geraets WG, Jonasson G, Hakeberg M. Changing trabecular patterns in panoramic radiographs of Swedish women during 25 years of follow-up. Dentomaxillofac Radiol 2020; 49:20190494. [PMID: 32207990 DOI: 10.1259/dmfr.20190494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The radiographic trabecular pattern on dental radiographs may be used to predict fractures. The aim of this study was to analyze longitudinal changes in the mandibles of 145 females between 1980 and 2005. METHODS Panoramic radiographs were obtained in 1980 and 2005. On 290 radiographs, regions of interest (ROIs) were selected in the ramus, angle and body. In all ROIs, the orientation was measured in 36 directions with the line frequency deviation method. The effects of ageing were analyzed for the fracture and the non-fracture groups separately. RESULTS During the follow-up, 61 females suffered fractures of the hip, wrist, spine, leg or arm. The fracture and non-fracture groups displayed dissimilar age changes in each investigated ROI. All significant changes pertained to increasing values of line frequency deviation. With increasing age, the trabecular network in the mandible lost details and the trabeculae became more aligned in their main direction. In the "ramus", the alignment was to the 110-120˚ axis, parallel to the posterior and anterior ramus border. In the "angle", the alignment was to the 135-150˚ axis, parallel to the oblique line, and in the "body" ROI to the 150-175˚ direction, approximately parallel to the occlusal plane and inferior cortex. CONCLUSION Most changes were consistent with the notion that the bone aged less severely in the non-fracture group. In the fracture group, the findings indicate that bone loss leads to redistribution of the remaining bone tissue in such a way that the trabeculae are accentuated perpendicular to the principal loading.
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Affiliation(s)
- Wil Gm Geraets
- Department of Oral Radiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands
| | - Grethe Jonasson
- Research & Development Unit in Southern Ӓlvsborg County, Sven Eriksonplatsen 4, SE-50338 Borås, Sweden.,Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Box 450, 405 30 Gothenburg, Sweden
| | - Magnus Hakeberg
- Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Box 450, 405 30 Gothenburg, Sweden
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Guo Z, Du X, Wang L, Li K, Jiao J, Guglielmi G, Zhurakivska K, Lo Muzio L, Blake GM, Cheng X. Measurements of volumetric bone mineral density in the mandible do not predict spinal osteoporosis. Dentomaxillofac Radiol 2020; 49:20190280. [PMID: 31718273 PMCID: PMC7068080 DOI: 10.1259/dmfr.20190280] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 09/15/2019] [Accepted: 11/06/2019] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE The objective of this study was to determine whether the trabecular volumetric Bone Mineral Density (vBMD) of the middle, body and angle of the mandible correlates with vBMD of the cervical and lumbar vertebrae in a Chinese population. METHODS AND MATERIALS 661 subjects (270 males, 391 females), ranging from 20 to 59 years of age, were recruited for vBMD measurements by quantitative CT (QCT). Basic information (age, height and weight), vBMD of the mandible (middle, body and angle sites), and vBMD of the cervical and lumbar vertebrae were recorded. Spearman's rank correlation test was used to investigate the association of mandibular with vertebral vBMD. RESULTS The study cohort comprised 661 subjects: 270 (41%) males, 391 (59%) females. Median age in males was 40 (range, 21-59) years. Median age in females was 41 (range, 20-59) years. Values of the Spearman correlation coefficient between mandibular and vertebral vBMD ranged from R = 0.048 to 0.141. In males, the three correlation coefficients between mandibular and cervical vBMD (middle: R = 0.138; body: R = 0.126; angle: R = 0.122) were all statistically significant (p < 0.05). In females, the correlation between the middle mandibular site and cervical site was statistically significant (R = 0.141, p < 0.01). None of the other correlations examined were statistically significant. CONCLUSION In this study population, mandibular vBMD was at best weakly correlated with cervical and lumbar vertebral vBMD, indicating that mandibular vBMD should be measured independently for the assessment of mandibular bone status.
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Affiliation(s)
- Zhe Guo
- Department of Radiology, Beijing Jishuitan Hospital, Xicheng District, Beijing, China
| | - Xia Du
- Department of Radiology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Ling Wang
- Department of Radiology, Beijing Jishuitan Hospital, Xicheng District, Beijing, China
| | - Kai Li
- Department of Radiology, Beijing Jishuitan Hospital, Xicheng District, Beijing, China
| | - Jun Jiao
- Department of Radiology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Giuseppe Guglielmi
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Khrystyna Zhurakivska
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Glen M Blake
- School of Biomedical Engineering & Imaging Sciences, King's College London, St Thomas' Hospital, London, United Kingdom
| | - Xiaoguang Cheng
- Department of Radiology, Beijing Jishuitan Hospital, Xicheng District, Beijing, China
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Zuchuat J, Manzano A, Decco O. Image-based analysis of trabecular bone in osteoporotic rabbits: correlation of morphological features and bone mineral density profile. Biomed Phys Eng Express 2019; 6:015005. [PMID: 33438593 DOI: 10.1088/2057-1976/ab575f] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To analyse a set of morphological features from digital radiographs (RX) and bone mineral density (BMD) values estimated from quantitative computerized tomography scans (QCT scans) of the knee joint of an osteoporotic rabbits, and to determine the relationship and correlation of these variables to be considered as an alternative diagnosis method. METHODS The knee joint of rabbits (N = 9 ovariectomized and injected with of methylprednisolone sodium succinate (OVX + MPSS) and 3 sham operated healthy controls) were subjected to radiographic examination before the beginning of the study and after 6 weeks; after sacrifice, they were immediately scanned with a 64-channel CT. A set of morphological features was extracted from RX images and then subjected to Principal Component Analysis (PCA); BMD-values were calculated at different depths from the articular surface of the femur and the tibia. The selected morphological variables and the BMD values were correlated in order to determine useful information in medical diagnostics. RESULTS Ten morphological variables explained 80.39% of the total variability, but only some of them demonstrated significant differences between baseline and OVX + SSMP states and between OVX + SSMP and control. Spearman analysis showed higher positive and negative correlation of these parameters among them (r = 0.67, 0.81, 0.83 and 1); and a moderate correlation with the BMD values (r = 0.50, 0.52, 0.52 and 0.55) during the progression of osteoporosis (OP). CONCLUSION The Spearman's rank test supported the overall significant correlation between both, the morphological features and BMD values, making them as a reliable alternative option to the diagnosis of osteoporosis.
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Affiliation(s)
- Jésica Zuchuat
- Bioimplants Laboratory, Faculty of Engineering-National University of Entre Rios, Oro Verde-Entre Rios, Argentina
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de Sá Cavalcante D, da Silva Castro MG, Quidute ARP, Martins MRA, Cid AMPL, de Barros Silva PG, Cadwell Williams J, Neves FS, Ribeiro TR, Costa FWG. Evaluation of bone texture imaging parameters on panoramic radiographs of patients with Sheehan's syndrome: a STROBE-compliant case-control study. Osteoporos Int 2019; 30:2257-2269. [PMID: 31372710 DOI: 10.1007/s00198-019-05086-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 07/09/2019] [Indexed: 10/26/2022]
Abstract
UNLABELLED Sheehan's syndrome (SHS) is a rare condition related to the risk of osteoporosis and evaluation of bone texture imaging features on panoramic radiographs would be suitable for this condition, which was the aim of the present study. Fractal dimension, lacunarity, and trabecular morphologic aspects were significantly altered in these patients. INTRODUCTION SHS is an important public health problem particularly in developing countries. It is characterized as postpartum hypopituitarism secondary to obstetric complications-related ischemic pituitary necrosis that shows significant systemic metabolic repercussions. Thus, this study aimed to evaluate bone texture parameters in digital panoramic radiographs of patients with SHS. METHODS A case-control study was conducted with 30 SHS patients from an Endocrinology and Diabetology Service of reference in Brazil, and 30 age- and sex-matched healthy controls. A custom computer program measured fractal dimension, lacunarity, and some morphologic features in the following mandibular regions of interest (50 × 50 pixels): below the mental foramen (F1), between the first and second molars (M1), and at the center of the mandibular ramus (R1). RESULTS The fractal analysis showed a statistically significant difference between the studied groups in all regions of interest. The fractal dimension in F1 (p = 0.016), M1 (p = 0.043), and R1 (p = 0.028) was significantly lower in SHS group, as well as lacunarity in R1 (p = 0.008). Additionally, several morphologic features were statistically significant in the SHS group (p < 0.05). CONCLUSION Therefore, individuals with SHS showed altered imaging texture parameters on panoramic radiographs, which reflect a smaller spatial organization of the bone trabeculae and, possibly, a state of reduced mineral bone density.
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Affiliation(s)
- D de Sá Cavalcante
- Department of Clinical Dentistry, Postgraduate Program in Dentistry, Federal University of Ceará, Alexandre Baraúna St 949, Rodolfo Teofilo, Fortaleza, Ceará, 60430-160, Brazil
| | - M G da Silva Castro
- Realistic Simulation Center, Univeristy Center UNICHRISTUS, R. João Adolfo Gurgel St 133, Cocó, Fortaleza, Ceará, 60190-060, Brazil
| | - A R P Quidute
- Division of Endocrinology and Diabetology, Walter Cantídio University Hospital, Alexandre Baraúna St 949, Rodolfo Teofilo, Fortaleza, Ceará, 60430-160, Brazil
| | - M R A Martins
- Division of Endocrinology and Diabetology, Walter Cantídio University Hospital, Alexandre Baraúna St 949, Rodolfo Teofilo, Fortaleza, Ceará, 60430-160, Brazil
| | - A M P L Cid
- Department of Clinical Dentistry, Postgraduate Program in Dentistry, Federal University of Ceará, Alexandre Baraúna St 949, Rodolfo Teofilo, Fortaleza, Ceará, 60430-160, Brazil
| | - P G de Barros Silva
- Department of Clinical Dentistry, Postgraduate Program in Dentistry, Federal University of Ceará, Alexandre Baraúna St 949, Rodolfo Teofilo, Fortaleza, Ceará, 60430-160, Brazil
| | - J Cadwell Williams
- Department of Anatomy and Cell Biology, Indiana School of Medicine, 635 Barnhill Dr, Indianapolis, IN, 46202, USA
| | - F S Neves
- Division of Oral Radiology, School of Dentistry, Federal University of Bahia, Araújo Pinho ave 62, Canela, Salvador, Bahia, 40110-040, Brazil
| | - T R Ribeiro
- Department of Clinical Dentistry, Postgraduate Program in Dentistry, Federal University of Ceará, Alexandre Baraúna St 949, Rodolfo Teofilo, Fortaleza, Ceará, 60430-160, Brazil
| | - F W G Costa
- Department of Clinical Dentistry, Postgraduate Program in Dentistry, Federal University of Ceará, Alexandre Baraúna St 949, Rodolfo Teofilo, Fortaleza, Ceará, 60430-160, Brazil.
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Engler-Pinto A, Siéssere S, Calefi A, Oliveira L, Ervolino E, de Souza S, Furlaneto F, Messora MR. Effects of leukocyte- and platelet-rich fibrin associated or not with bovine bone graft on the healing of bone defects in rats with osteoporosis induced by ovariectomy. Clin Oral Implants Res 2019; 30:962-976. [PMID: 31287918 DOI: 10.1111/clr.13503] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 06/03/2019] [Accepted: 06/18/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To evaluate the healing of critical size defects (CSDs) in calvaria of rats with osteoporosis induced by ovariectomy and treated with leukocyte- and platelet-rich fibrin (L-PRF) associated or not with bovine bone graft (XENO). MATERIAL AND METHODS A total of 32 rats underwent a bilateral ovariectomy procedure. After 3 months, one 5 mm in diameter CSD was created in the middle of the calvaria of each animal. In group C, defect was filled with blood clot only. In PRF, XENO, and PRF-XENO groups, defects were filled with 0.1 ml of L-PRF, 0.1 ml of XENO, and a mixture of 0.1 ml of L-PRF plus 0.1 ml of XENO, respectively. L-PRF compressed clots were used to cover the defects in PRF and PRF-XENO groups. Animals were submitted to euthanasia at 30 postoperative days. Histomorphometric, microtomographic, and immunohistochemical analyses were performed. RESULTS PRF-XENO group presented greater amount of neoformed bone (NB) when compared with XENO group, as well as higher expression of vascular endothelial growth factor (VEGF), osteocalcin (OCN), and bone morphogenetic protein (BMP-2/4) (p < .05). PRF group presented increased amount of NB and higher expression of VEGF, OCN, BMP-2/4, and Runt-related transcription factor 2 (RUNX-2) when compared with group C (p < .05). CONCLUSIONS (a) The isolated use of L-PRF clot can improve bone neoformation in CSDs in rats with osteoporosis induced by ovariectomy, but seems to lead to decreased amount of bone neoformation when compared to the isolated use of XENO; (b) L-PRF potentiates the healing of XENO in rats with osteoporosis induced by ovariectomy.
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Affiliation(s)
- Ana Engler-Pinto
- Department of Morphology, Physiology and Basic Pathology - DMFPB, School of Dentistry, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Selma Siéssere
- Department of Morphology, Physiology and Basic Pathology - DMFPB, School of Dentistry, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Ana Calefi
- Department of Morphology, Physiology and Basic Pathology - DMFPB, School of Dentistry, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Luiz Oliveira
- Department of Oral and Maxillofacial Surgery and Periodontology - DCTBMF, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Edilson Ervolino
- Department of Basic Sciences, School of Dentistry, São Paulo State University, Araçatuba, SP, Brazil
| | - Sérgio de Souza
- Department of Oral and Maxillofacial Surgery and Periodontology - DCTBMF, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Flávia Furlaneto
- Department of Oral and Maxillofacial Surgery and Periodontology - DCTBMF, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Michel Reis Messora
- Department of Oral and Maxillofacial Surgery and Periodontology - DCTBMF, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
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Pachêco‐Pereira C, Almeida FT, Chavda S, Major PW, Leite A, Guerra EN. Dental imaging of trabecular bone structure for systemic disorder screening: A systematic review. Oral Dis 2018; 25:1009-1026. [DOI: 10.1111/odi.12950] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 07/25/2018] [Accepted: 07/30/2018] [Indexed: 01/02/2023]
Affiliation(s)
- Camila Pachêco‐Pereira
- School of Dentistry, Faculty of Medicine and DentistryUniversity of Alberta Edmonton Alberta Canada
- Health Sciences Faculty University of Brasília Brasília Brazil
| | - Fabiana T. Almeida
- School of Dentistry, Faculty of Medicine and DentistryUniversity of Alberta Edmonton Alberta Canada
| | - Suraj Chavda
- School of Dentistry, Faculty of Medicine and DentistryUniversity of Alberta Edmonton Alberta Canada
| | - Paul W. Major
- School of Dentistry, Faculty of Medicine and DentistryUniversity of Alberta Edmonton Alberta Canada
| | - Andre Leite
- Health Sciences Faculty University of Brasília Brasília Brazil
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Trabecular structural changes in the mandibular condyle caused by degenerative osteoarthritis: a comparative study by cone-beam computed tomography imaging. Oral Radiol 2018; 35:51-58. [DOI: 10.1007/s11282-018-0324-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 01/27/2018] [Indexed: 10/17/2022]
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Zhang ZG, Chen YJ, Xiang LH, Pan JH, Wang Z, Xiao GG, Ju DH. Protective effect of Rhizoma Dioscoreae extract against alveolar bone loss in ovariectomized rats via regulation of IL-6/STAT3 signaling. Int J Mol Med 2017; 40:1602-1610. [PMID: 28901385 DOI: 10.3892/ijmm.2017.3130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 09/07/2017] [Indexed: 11/05/2022] Open
Abstract
The aim of the present study was to assess the effectiveness of Rhizoma Dioscoreae extract (RDE) on preventing rat alveolar bone loss induced by ovariectomy (OVX), and to determine the role of interleukin-6 (IL-6)/signal transducer and activator of transcription 3 (STAT3) signaling pathway in this effect. Female Wistar rats were subjected to OVX or sham surgery. The rats that had undergone OVX were treated with RDE (RDE group), vehicle (OVX group) or 17β-estradiol subcutaneous injection (E2 group). Subsequently, bone metabolic activity was assessed by analyzing 3-D alveolar bone construction, bone mineral density, as well as the plasma biomarkers of bone turnover. The gene expression of alveolar bone in the OVX and RDE groups was evaluated by IL-6/STAT3 signaling pathway polymerase chain reaction (PCR) arrays, and differentially expressed genes were determined through reverse transcription-quantitative PCR. The inhibitory effect of RDE on alveolar bone loss in the OVX group was demonstrated in the study. In comparison with the OVX group, the RDE group exhibited 19 downregulated genes and 1 upregulated gene associated with the IL-6/STAT3 signaling pathway in alveolar bone. Thus, RDE was shown to relieve OVX-induced alveolar bone loss in rats, an effect which was likely associated with decreased abnormal bone remodeling via regulation of the IL-6/STAT3 signaling pathway.
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Affiliation(s)
- Zhi-Guo Zhang
- Institute of Basic Theory, China Academy of Chinese Medical Sciences, Beijing 100700, P.R. China
| | - Yan-Jing Chen
- Institute of Basic Theory, China Academy of Chinese Medical Sciences, Beijing 100700, P.R. China
| | - Li-Hua Xiang
- Institute of Basic Theory, China Academy of Chinese Medical Sciences, Beijing 100700, P.R. China
| | - Jing-Hua Pan
- Institute of Basic Theory, China Academy of Chinese Medical Sciences, Beijing 100700, P.R. China
| | - Zhen Wang
- Institute of Basic Theory, China Academy of Chinese Medical Sciences, Beijing 100700, P.R. China
| | - Gary Guishan Xiao
- School of Pharmaceutical Science, Dalian University of Technology, Dalian, Liaoning 116024, P.R. China
| | - Da-Hong Ju
- Institute of Basic Theory, China Academy of Chinese Medical Sciences, Beijing 100700, P.R. China
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Hwang JJ, Lee JH, Han SS, Kim YH, Jeong HG, Choi YJ, Park W. Strut analysis for osteoporosis detection model using dental panoramic radiography. Dentomaxillofac Radiol 2017; 46:20170006. [PMID: 28707523 DOI: 10.1259/dmfr.20170006] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES The aim of this study was to identify variables that can be used for osteoporosis detection using strut analysis, fractal dimension (FD) and the gray level co-occurrence matrix (GLCM) using multiple regions of interest and to develop an osteoporosis detection model based on panoramic radiography. METHODS A total of 454 panoramic radiographs from oral examinations in our dental hospital from 2012 to 2015 were randomly selected, equally distributed among osteoporotic and non-osteoporotic patients (n = 227 in each group). The radiographs were classified by bone mineral density (T-score). After 3 marrow regions and the endosteal margin area were selected, strut features, FD and GLCM were analysed using a customized image processing program. Image upsampling was used to obtain the optimal binarization for calculating strut features and FD. The independent-samples t-test was used to assess statistical differences between the 2 groups. A decision tree and support vector machine were used to create and verify an osteoporosis detection model. RESULTS The endosteal margin area showed statistically significant differences in FD, GLCM and strut variables between the osteoporotic and non-osteoporotic patients, whereas the medullary portions showed few distinguishing features. The sensitivity, specificity, and accuracy of the strut variables in the endosteal margin area were 97.1%, 95.7 and 96.25 using the decision tree and 97.2%, 97.1 and 96.9% using support vector machine, and these were the best results obtained among the 3 methods. Strut variables with FD and/or GLCM did not increase the diagnostic accuracy. CONCLUSION The analysis of strut features in the endosteal margin area showed potential for the development of an osteoporosis detection model based on panoramic radiography.
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Affiliation(s)
- Jae Joon Hwang
- 1 Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Jeong-Hee Lee
- 1 Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Sang-Sun Han
- 1 Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Young Hyun Kim
- 1 Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Ho-Gul Jeong
- 1 Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Yoon Jeong Choi
- 2 Department of Orthodontics, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Wonse Park
- 3 Department of Advanced General Dentistry, Yonsei University College of Dentistry, Seoul, Republic of Korea
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Geraets W, Jonasson G, Hakeberg M. Predicting fractures using trabecular patterns on panoramic radiographs. Clin Oral Investig 2017; 22:377-384. [PMID: 28567531 PMCID: PMC5748394 DOI: 10.1007/s00784-017-2122-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 05/05/2017] [Indexed: 01/04/2023]
Abstract
OBJECTIVES The observer score of the trabecular pattern on panoramic radiographs is known to be a strong predictor of bone fractures. The aim of this study was to enhance the predictive power of panoramic radiographs by means of texture analysis methods. MATERIAL AND METHODS The study followed 304 postmenopausal women during 26 years. At the beginning of the study, panoramic radiographs were obtained. One observer assessed the trabecular pattern in the premolar region as dense, sparse, or alternating dense and sparse. In addition, on each radiograph, a region of interest was selected in the molar/premolar region and analyzed with texture analysis procedures. During 26 years of follow-up, 115 women suffered a fracture of the hip, spine, leg, or arm. Logistic regression was applied to test the predictive power of various variables with respect to fractures. RESULTS Of all variables, the observer score of the trabecular pattern correlated strongest with the occurrence of fractures. By itself, the score yielded an ROC curve with an area of 0.80 under the curve. Combining the observer score with the texture analysis features increased the area under the ROC curve to 0.85. CONCLUSIONS The trabecular pattern on panoramic radiographs provides a strong predictor of fractures, at least for postmenopausal women. The assessment by an observer combined with texture analysis procedures yields a predictive power that parallels best known predictions in literature. CLINICAL RELEVANCE This study illustrates that panoramic radiographs are state of the art predictors of postcranial fractures.
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Affiliation(s)
- Wil Geraets
- Department of Oral and Maxillofacial Radiology, Academic Centre for Dentistry Amsterdam (ACTA), Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands.
| | - Grethe Jonasson
- Research & Development Unit in Southern Älvsborg County, Sven Eriksonplatsen 4, 50338, Borås, Sweden
- Department of Behavioral and Community Dentistry, Institute of Odontology, University of Gothenburg, Medicinaregatan 12E, Gothenburg, Sweden
| | - Magnus Hakeberg
- Department of Behavioral and Community Dentistry, Institute of Odontology, University of Gothenburg, Medicinaregatan 12E, Gothenburg, Sweden
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Chen YJ, Wang SP, Cheng FC, Hsu PY, Li YF, Wu J, Huang HL, Tsai MT, Hsu JT. Intermittent parathyroid hormone improve bone microarchitecture of the mandible and femoral head in ovariectomized rats. BMC Musculoskelet Disord 2017; 18:171. [PMID: 28438150 PMCID: PMC5404672 DOI: 10.1186/s12891-017-1530-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 04/16/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Intermittent parathyroid hormone (PTH) can be used to treat osteoporosis of the spine and hip. However, whether it can be used to treat osteoporosis of the mandible is unclear. The purpose of this study was to explore the influence of applying intermittent PTH to ovariectomized rats on the trabecular bone microarchitecture of the mandible and femoral head. METHODS Eighteen female rats were divided into three groups: the healthy group, ovariectomized (OVX) group, and OVX + PTH group. The OVX group and OVX + PTH group had an OVX at 8 weeks of age. The OVX + PTH group received intermittent PTH therapy for 12 weeks. The mandibles and femurs of all rats were removed at 20 weeks and were then scanned using microcomputed tomography (micro-CT). RESULTS From the micro-CT analysis, the trabecular bone microarchitecture of the mandible and femoral head are offered as follows: (1) The bone volume fraction and trabecular thickness in the OVX group were lower than those in the healthy group. (2) The bone volume fraction and trabecular thickness in the OVX + PTH group approximated those in the healthy group. CONCLUSION The conclusions of this study regarding the trabecular bone microarchitecture of the mandible and femoral head are offered as follows: (1) The BV/TV and TbTh in the OVX group were lower than those in the healthy group. (2) The BV/TV and TbTh in the OVX + PTH group approximated those in the healthy group, therefore, intermittent PTH displayed high efficacy for treating femoral or mandibular deterioration of bone microstructure resulting from loss of ovarian function. Osteoporosis of the femur or mandible in the rats was ameliorated by intermittent PTH therapy.
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Affiliation(s)
- Ying-Ju Chen
- Department of Food and Nutrition, Providence University, Taichung, 433, Taiwan
| | - Shun-Ping Wang
- Department of Orthopaedics, Taichung Veterans General Hospital, Taichung, 407, Taiwan
| | - Fu-Chou Cheng
- Stem Cell Medical Research Center, Department of Medical Research, Taichung Veterans General Hospital, Taichung, 407, Taiwan
| | - Pei-Yu Hsu
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, 404, Taiwan
| | - Yu-Fen Li
- Institute of Biostatistics, China Medical University, Taichung, 404, Taiwan
| | - Jay Wu
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, 112, Taiwan
| | - Heng-Li Huang
- School of Dentistry, College of Medicine, China Medical University, 91 Hsueh-Shih Road, Taichung, 40402, Taiwan.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, 413, Taiwan
| | - Ming-Tzu Tsai
- Department of Biomedical Engineering, Hungkuang University, Taichung, 433, Taiwan
| | - Jui-Ting Hsu
- School of Dentistry, College of Medicine, China Medical University, 91 Hsueh-Shih Road, Taichung, 40402, Taiwan. .,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, 413, Taiwan.
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Abstract
BACKGROUND Osteoporosis is still underdiagnosed in Germany. OBJECTIVES Is it possible to detect osteoporosis on the basis of a cone-beam computed tomography image of the mandible and several measuring methods? MATERIALS AND METHODS Sixteen cone-beam computed tomography (CBCT) images from patients of the dental clinic at the University of Ulm were reinvestigated. When the CBCT images were processed the subjects were at least 55 years old, and the mandible was completely mapped on the image. Furthermore, a dual-energy X‑ray absorptiometry scan or a CT bone mineral density test was required for every subject. The subjects were divided into an osteoporosis group and a control group. The computed tomography mental index (CTMI), the computed tomography mandibular index superior (CTI[S]) and the computed tomography mandibular index inferior (CTI[I]) were deployed for comparison of the groups. In the first instance a comparison of the osteoporosis and control groups was made for both male and female subjects. Subsequently, only the images of the female subjects were compared to each other. RESULTS A possibility for osteoporosis can be expressed at CTMI values located < 3.0 mm. As well for CTI(S) < 0.18 and CTI(I) < 0.23. There arises a 66.7 % sensitivity and 70 % specificity for the mixed subject group and an 80 % sensitivity and 57.1 % specificity for the female subject group for CTMI and CTI(S). Furthermore, there are 50.0 % sensitivity and 70 % specificity for the mixed subject group and 60.0 % sensitivity and 57.1 % specificity for the female subject group for the CTI(I). CONCLUSION CTMI, CTI(S) and CTI(I) are only suitable for osteoporosis detection to a limited extent.
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Barngkgei I, Halboub E, Almashraqi AA, Khattab R, Al Haffar I. IDIOS: An innovative index for evaluating dental imaging-based osteoporosis screening indices. Imaging Sci Dent 2016; 46:185-202. [PMID: 27672615 PMCID: PMC5035724 DOI: 10.5624/isd.2016.46.3.185] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 10/13/2015] [Accepted: 12/11/2015] [Indexed: 01/10/2023] Open
Abstract
Purpose The goal of this study was to develop a new index as an objective reference for evaluating current and newly developed indices used for osteoporosis screening based on dental images. Its name; IDIOS, stands for Index of Dental-imaging Indices of Osteoporosis Screening. Materials and Methods A comprehensive PubMed search was conducted to retrieve studies on dental imaging-based indices for osteoporosis screening. The results of the eligible studies, along with other relevant criteria, were used to develop IDIOS, which has scores ranging from 0 (0%) to 15 (100%). The indices presented in the studies we included were then evaluated using IDIOS. Results The 104 studies that were included utilized 24, 4, and 9 indices derived from panoramic, periapical, and computed tomographic/cone-beam computed tomographic techniques, respectively. The IDIOS scores for these indices ranged from 0 (0%) to 11.75 (78.32%). Conclusion IDIOS is a valuable reference index that facilitates the evaluation of other dental imaging-based osteoporosis screening indices. Furthermore, IDIOS can be utilized to evaluate the accuracy of newly developed indices.
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Affiliation(s)
- Imad Barngkgei
- Department of Oral Medicine, Faculty of Dentistry, Damascus University, Damascus, Syria.; Department of Oral Medicine, Faculty of Dentistry, Syrian Private University, Damascus, Syria
| | - Esam Halboub
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Abeer Abdulkareem Almashraqi
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia.; Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ibb University, Ibb, Yemen
| | - Razan Khattab
- Department of Periodontology, Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Iyad Al Haffar
- Department of Oral Medicine, Faculty of Dentistry, Damascus University, Damascus, Syria
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Matsunaga S, Maki H, Noguchi T, Odaka K, Kasahara M, Yamamoto M, Abe S. Effect of Ovariectomy on the Tibia and Alveolar Bone in a Senescence-Accelerated Mouse-Prone 6 (SAMP6) Model. J HARD TISSUE BIOL 2016. [DOI: 10.2485/jhtb.25.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lin PL, Huang PW, Huang PY, Hsu HC. Alveolar bone-loss area localization in periodontitis radiographs based on threshold segmentation with a hybrid feature fused of intensity and the H-value of fractional Brownian motion model. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2015; 121:117-126. [PMID: 26078207 DOI: 10.1016/j.cmpb.2015.05.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 05/11/2015] [Accepted: 05/19/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND AND OBJECTIVE Periodontitis involves progressive loss of alveolar bone around the teeth. Hence, automatic alveolar bone-loss (ABL) measurement in periapical radiographs can assist dentists in diagnosing such disease. In this paper, we propose an effective method for ABL area localization and denote it as ABLIfBm. METHOD ABLIfBm is a threshold segmentation method that uses a hybrid feature fused of both intensity and texture measured by the H-value of fractional Brownian motion (fBm) model, where the H-value is the Hurst coefficient in the expectation function of a fBm curve (intensity change) and is directly related to the value of fractal dimension. Adopting leave-one-out cross validation training and testing mechanism, ABLIfBm trains weights for both features using Bayesian classifier and transforms the radiograph image into a feature image obtained from a weighted average of both features. Finally, by Otsu's thresholding, it segments the feature image into normal and bone-loss regions. RESULTS Experimental results on 31 periodontitis radiograph images in terms of mean true positive fraction and false positive fraction are about 92.5% and 14.0%, respectively, where the ground truth is provided by a dentist. The results also demonstrate that ABLIfBm outperforms (a) the threshold segmentation method using either feature alone or a weighted average of the same two features but with weights trained differently; (b) a level set segmentation method presented earlier in literature; and (c) segmentation methods based on Bayesian, K-NN, or SVM classifier using the same two features. CONCLUSION Our results suggest that the proposed method can effectively localize alveolar bone-loss areas in periodontitis radiograph images and hence would be useful for dentists in evaluating degree of bone-loss for periodontitis patients.
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Affiliation(s)
- P L Lin
- Department of Computer Science and Information Engineering, Providence University, Shalu, Taichung 43301, Taiwan.
| | - P W Huang
- Department of Computer Science and Engineering, National Chung Hsing University, Taichung 40227, Taiwan.
| | - P Y Huang
- Department of Computer Science and Engineering, National Chung Hsing University, Taichung 40227, Taiwan.
| | - H C Hsu
- College of Oral Medicine, Chung Shan Medical University and Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
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Abstract
Osteoporosis is a major health problem affecting one in three women over the age of 50 and may not be detected until fractures occur. Since osteoporotic fractures are a health burden worldwide, identifying subjects with a high risk of osteoporosis and preventing osteoporosis-related mortality and morbidity are a very important health strategy. Women show an estrogen-related bone loss starting at menopause, predominantly occurring in trabecular bone. Diagnosis of osteoporosis is usually based on the bone mineral density measurement, but this is not a practical and economical technique for early detection. Therefore, investigators are interested in the possibility of detecting osteoporosis from the panoramic radiographs. Mandibular cortical bone undergoes resorptive activity in osteoporotic patients, leading to a decreased thickness and more porous inferior border. Therefore, studies have demonstrated the usefulness of cortical width and shape, determined from panoramic radiographs, in identifying elderly individuals with undetected osteoporosis, especially postmenopausal women. In conclusion, postmenopausal women with C3 category, Mental Index (MI) <3 mm, and panoramic mandibular index (PMI) <0.3 may be considered for further osteoporosis investigation.
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Affiliation(s)
- Ayse Gulsahi
- Department of Dentomaxillofacial Radiology, Baskent University, Ankara, Turkey
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Bozdag G, Sener S. The evaluation of MCI, MI, PMI and GT on both genders with different age and dental status. Dentomaxillofac Radiol 2015; 44:20140435. [PMID: 26133366 DOI: 10.1259/dmfr.20140435] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of this study was to measure the mandibular cortical index (MCI), mental index (MI), panoramic mandibular index (PMI) and cortical bone thickness in the zone of the gonial angle (GT) in panoramic radiographies from a large sample of males and females and to determine how they relate to patients' age, gender and dental status. METHODS 910 panoramic radiographs were obtained and grouped into age, dental status and gender. The MCI, MI, PMI and GT were analysed. RESULTS Remarkable differences were observed for MCI and GT regarding gender, age groups and dental status on both sides (p < 0.05). While age and dental status had an effect on the MI and PMI in females, dental status had an effect on the MI and PMI in males (p < 0.05). Also, gender had an effect on the MI and PMI (p < 0.05). CONCLUSIONS The effects of age and tooth loss are different in females and males. In females, the harmful effects of tooth loss and age are more prominent according to the PMI and MI measurements. The effects of age and tooth loss in the GT and MCI measurements are similar, and these indices can be accepted as more reliable in studies including both genders.
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Affiliation(s)
- G Bozdag
- Department of Oral Radiology, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
| | - S Sener
- Department of Oral Radiology, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
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Calciolari E, Donos N, Park JC, Petrie A, Mardas N. A systematic review on the correlation between skeletal and jawbone mineral density in osteoporotic subjects. Clin Oral Implants Res 2015; 27:433-42. [DOI: 10.1111/clr.12597] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Elena Calciolari
- Periodontology Unit; UCL Eastman Dental Institute; London UK
- Section of Periodontology, Implantology and Gnathology; Centre of Dentistry; University of Parma; Parma Italy
| | - Nikolaos Donos
- Periodontology Unit; UCL Eastman Dental Institute; London UK
| | - Jung-Chul Park
- Department of Periodontology; College of Dentistry; Dankook University; Cheonan South Korea
| | - Aviva Petrie
- Biostatistics Unit; UCL Eastman Dental Institute; London UK
| | - Nikos Mardas
- Periodontology Unit; UCL Eastman Dental Institute; London UK
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31
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Rhizoma Dioscoreae extract protects against alveolar bone loss in ovariectomized rats via microRNAs regulation. Nutrients 2015; 7:1333-51. [PMID: 25690421 PMCID: PMC4344591 DOI: 10.3390/nu7021333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 02/05/2015] [Accepted: 02/09/2015] [Indexed: 01/08/2023] Open
Abstract
The aim of this study was to evaluate the osteoprotective effect of aqueous Rhizoma Dioscoreae extract (RDE) on the alveolar bone of rats with ovariectomy-induced bone loss. Female Wistar rats underwent either ovariectomy or sham operation (SHAM). The ovariectomized (OVX) rats were treated with vehicle (OVX), estradiol valerate (EV), or RDE. After treatments, the bone mineral density (BMD) and the three-dimensional microarchitecture of the alveolar bone were analyzed to assess bone mass. Microarrays were used to evaluate microRNA expression profiles in alveolar bone from RDE-treated and OVX rats. The differential expression of microRNAs was validated using real-time quantitative RT-PCR (qRT-PCR), and the target genes of validated microRNAs were predicted and further analyzed using Ingenuity Pathway Analysis (IPA). The key findings were verified using qRT-PCR. Our results show that RDE inhibits alveolar bone loss in OVX rats. Compared to the OVX rats, the RDE-treated rats showed upregulated expression levels of 8 microRNAs and downregulated expression levels of 8 microRNAs in the alveolar bone in the microarray analysis. qRT-PCR helped validate 13 of 16 differentially expressed microRNAs, and 114 putative target genes of the validated microRNAs were retrieved. The IPA showed that these putative target genes had the potential to code for proteins that were involved in the transforming growth factor (TGF)-β/bone morphogenetic proteins (BMPs)/Smad signaling pathway (Tgfbr2/Bmpr2, Smad3/4/5, and Bcl-2) and interleukin (IL)-6/oncostatin M (OSM)/Jak1/STAT3 signaling pathway (Jak1, STAT3, and Il6r). These experiments revealed that RDE could inhibit ovariectomy-induced alveolar bone loss in rats. The mechanism of this anti-osteopenic effect in alveolar bone may involve the simultaneous inhibition of bone formation and bone resorption, which is associated with modulation of the TGF-β/BMPs/Smad and the IL-6/OSM/Jak1/STAT3 signaling pathways via microRNA regulation.
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The protective effect of Rhizoma Dioscoreae extract against alveolar bone loss in ovariectomized rats via regulating Wnt and p38 MAPK signaling. Nutrients 2014; 6:5853-70. [PMID: 25514564 PMCID: PMC4277003 DOI: 10.3390/nu6125853] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 11/28/2014] [Accepted: 12/02/2014] [Indexed: 11/17/2022] Open
Abstract
AIM The aim of this study was to evaluate the osteoprotective effect of aqueous Rhizoma Dioscoreae extract (RDE) on the alveolar bone of rats with ovariectomy-induced bone loss. METHODS Female Wistar rats were subjected to either ovariectomy or a sham operation (SHAM). The ovariectomized (OVX) rats were treated with vehicle (OVX) or RDE by oral gavage or with 17β-estradiol (E2) subcutaneously. After treatments, the bone mineral density (BMD), the three-dimensional bone architecture of the alveolar bone and the plasma biomarkers of bone turnover were analyzed to assess bone metabolism, and the histomorphometry of the alveolar bone was observed. Microarrays were used to evaluate gene expression profiles in alveolar bone from RDE-treated and OVX rats. The differential expression of genes was further analyzed using Ingenuity Pathway Analysis (IPA). The key findings were verified using real-time quantitative RT-PCR (qRT-PCR). RESULTS Our results showed that RDE inhibited alveolar bone loss in OVX rats. Compared to the OVX rats, the RDE-treated rats showed upregulated expression levels of 207 genes and downregulated expression levels of 176 genes in the alveolar bone. The IPA showed that several genes had the potential to code for proteins that were involved in the Wnt/β-catenin signaling pathway (Wnt7a, Fzd2, Tcf3, Spp1, Frzb, Sfrp2 and Sfrp4) and the p38 MAPK signaling pathway (Il1rn and Mapk14). CONCLUSION These experiments revealed that RDE could inhibit ovariectomy-induced alveolar bone loss in rats. The mechanism of this anti-osteopenic effect in alveolar bone may be involved in the reduced abnormal bone remodeling, which is associated with the modulation of the Wnt/β-catenin and the p38 MAPK signaling pathways via gene regulation.
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Gamsjaeger S, Srivastava AK, Wergedal JE, Zwerina J, Klaushofer K, Paschalis EP, Tatakis DN. Altered bone material properties in HLA-B27 rats include reduced mineral to matrix ratio and altered collagen cross-links. J Bone Miner Res 2014; 29:2382-91. [PMID: 24771481 DOI: 10.1002/jbmr.2268] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 04/22/2014] [Accepted: 04/23/2014] [Indexed: 01/17/2023]
Abstract
Spondyloarthropathy and inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are often associated with severe osteopenia/osteoporosis in both children and adults. HLA-B27 transgenic rats present a phenotype that includes severe colitis and severely accelerated alveolar bone loss. The purpose of this study was to evaluate long bone density status, systemic bone metabolic markers, and intrinsic bone material properties in HLA-B27 transgenic (TG) rats, and compare them with those of age- and sex-matched wild-type (WT) animals. The results indicate that in the HLA-B27 rat, an animal susceptible to both alveolar bone loss (ABL) and long bone osteopenia, there is a statistically significant negative correlation between ABL and long bone bone mineral density (BMD), as well as mineral/matrix ratio at active bone-forming trabecular surfaces. The TG animals had a lower mineral/matrix ratio and higher relative proteoglycan and advanced glycation end product (ϵ-N-Carboxymethyl-L-lysine) content and pyridinoline/divalent collagen cross-link ratio compared with WT. These results may provide better understanding of the interrelationship between osteoporosis and oral bone loss, the underlying causes of the inferior bone strength in the HLA-B27 transgenic animals, and could prove to be a useful model in the elucidation of the pathophysiology of spondyloarthropathy and IBD-associated osteopenia/osteoporosis and in the evaluation of pharmacological intervention(s) against such conditions.
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Affiliation(s)
- Sonja Gamsjaeger
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Vienna, Austria
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Chong BS, Quinn A, Pawar RR, Makdissi J, Sidhu SK. The anatomical relationship between the roots of mandibular second molars and the inferior alveolar nerve. Int Endod J 2014; 48:549-55. [DOI: 10.1111/iej.12348] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 07/26/2014] [Indexed: 11/26/2022]
Affiliation(s)
- B. S. Chong
- Institute of Dentistry; Barts & The London School of Medicine & Dentistry; Queen Mary University of London; London UK
| | - A. Quinn
- Institute of Dentistry; Barts & The London School of Medicine & Dentistry; Queen Mary University of London; London UK
| | - R. R. Pawar
- Institute of Dentistry; Barts & The London School of Medicine & Dentistry; Queen Mary University of London; London UK
| | - J. Makdissi
- Institute of Dentistry; Barts & The London School of Medicine & Dentistry; Queen Mary University of London; London UK
| | - S. K. Sidhu
- Institute of Dentistry; Barts & The London School of Medicine & Dentistry; Queen Mary University of London; London UK
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Kathirvelu D, Anburajan M. Prediction of low bone mass using a combinational approach of cortical and trabecular bone measures from dental panoramic radiographs. Proc Inst Mech Eng H 2014; 228:890-8. [PMID: 25179243 DOI: 10.1177/0954411914548700] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study is to extract cortical and trabecular features of the mandible and to develop a novel combinational model of mandibular cortical thickness, trabecular bone area and age in order to predict low bone mineral density or osteoporosis from a dental panoramic radiograph. The study involved 64 south Indian women (age = 52.5 ± 12.7 years) categorised into two groups (normal and low bone mineral density) based on total femur bone mineral density. The dental panoramic radiographs were obtained by a digital scanner, and measurement of total bone mineral density at the right femur was performed by a dual-energy X-ray absorptiometry scanner. The mandibular cortical thickness and panoramic mandibular index were measured bilaterally, and the mean values were considered. The region of interest of 128 × 128 pixels around the mental foramen region was manually cropped and subjected to pre-processing, normalisation and average threshold-based segmentation to determine trabecular bone area. Multiple linear regression analyses of cortical and trabecular measures along with age were performed to develop a combinational model to classify subjects as normal and low bone mineral density. The proposed approach demonstrated strong correlation (r = 0.76; p < 0.01) against the total bone mineral density and resulted in accuracy, sensitivity and positive predictive values of 0.84, 0.92 and 0.85, respectively; the receiver operating characteristic outcomes disclosed that the area under the curve was 0.89.Our results suggest that the proposed combinational model could be useful to diagnose subjects with low bone mineral density.
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Affiliation(s)
- D Kathirvelu
- Department of Biomedical Engineering, SRM University, Kattankulathur, Tamil Nadu, India
| | - M Anburajan
- Department of Biomedical Engineering, SRM University, Kattankulathur, Tamil Nadu, India
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36
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Liu X, Zhang R, Zhou Y, Yang Y, Si H, Li X, Liu L. The effect of Astragalus extractive on alveolar bone rebuilding progress of tooth extracted socket of ovariectomied rats. AFRICAN JOURNAL OF TRADITIONAL, COMPLEMENTARY, AND ALTERNATIVE MEDICINES : AJTCAM 2014; 11:91-8. [PMID: 25395711 PMCID: PMC4202524 DOI: 10.4314/ajtcam.v11i5.15] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Postmenopausal osteoporosis (PMO) is an estrogen deficiency condition that causes severe loss of bone mass in the vertebrae and long bones. We explored the effect and the possible underlying mechanism of the extracts of Astragalus (AE) on the tooth alveolar bone rebuilding progress of postmenopausal osteoporosis of PMO animal models. MATERIAL AND METHODS The PMO models were acquired by ovariectomy. After 8 weeks the first left maxillary molars of the rats were extracted and AE was administered orally for 8 weeks. Then the histological morphology and the transcription and expression of TGF-β1 and TNF-α in the tooth extracted socket were detected by HE dying, QRT-PCR and ELISA. RESULTS The results showed that the new bone volume and TGF-β1 was significantly lower in PMO group than the control group and AE group at the observing period. At the same time TNF-α in PMO group was significantly higher than the other two groups. Moreover AE group had no significant differences with the control group in all data at the observing period. CONCLUSION AE has positive effect on alveolar bone rebuilding progress of tooth extracted socket of PMO rats. AE also has the potential to enhance the expression of TGF-β1 and decrease the expression of TNF-α of the rebuilding tooth extracted socket.
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Affiliation(s)
- Xiaochen Liu
- Stomatology Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Runju Zhang
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yi Zhou
- Stomatology Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yanli Yang
- Stomatology Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Hongling Si
- Stomatology Hospital?Xian Jiaotong University, Xian, Shaanxi, China
| | - Xiaohong Li
- Stomatology Hospital?Xian Jiaotong University, Xian, Shaanxi, China
| | - Li Liu
- Stomatology Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
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Systemic Diseases. Oral Radiol 2014. [DOI: 10.1016/b978-0-323-09633-1.00025-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Scheibel PC, Ramos AL, Iwaki LCV. Is there correlation between alveolar and systemic bone density? Dental Press J Orthod 2013; 18:78-83. [DOI: 10.1590/s2176-94512013000500014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE: The present study assessed the correlation between maxillomandibular alveolar bone density and systemic bone mineral density (BMD). METHODS: Dual-energy X-ray absorptiometry of the anterior and posterior maxillomandibular alveolar bone, of the standard sites for the measurement of BMD (lumbar spine and femur) and the third cervical vertebra was performed on 23 middle-aged women. Periapical radiographs were also obtained, with an aluminum step-wedge as reference for the digital reading of apical bone density of the upper incisors. RESULTS: Spearman's correlations coefficients revealed that density in the apical region was correlated with that of the femoral neck (r = 0.433; p < 0.05); BMDs of the posterior regions of the mandible and maxilla were significantly correlated with that of the cervical vertebra (r = 0.554, p < 0.01 and r = 0.423, p < 0.05, respectively); and the anterior maxilla was correlated with the posterior mandible (r = 0.488, p < 0.05). CONCLUSION: Bone density of the maxillary alveolar bone was significantly correlated with that of the femoral neck. Among the bone densities of the alveolar regions, only the anterior maxilla and the posterior mandible were significantly correlated. The findings suggested that bone densitometry might be individually and locally evaluated.
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Dai QG, Zhang P, Wu YQ, Ma XH, Pang J, Jiang LY, Fang B. Ovariectomy induces osteoporosis in the maxillary alveolar bone: an in vivo micro-CT and histomorphometric analysis in rats. Oral Dis 2013; 20:514-20. [PMID: 23919414 DOI: 10.1111/odi.12166] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Revised: 07/09/2013] [Accepted: 07/14/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate whether porotic changes occur in maxillary alveolar bone in ovariectomized rats. METHODS Thirty-two 6-week-old female Sprague-Dawley rats were divided into an ovariectomy group (OVX) and a sham-ovariectomy group (sham). Twelve weeks after surgery, maxillae of 16 rats (eight OVX and eight sham) were analyzed by micro-CT. Inter-radicular alveolar bone of the maxillary first molar was reconstructed and analyzed. The remaining 16 maxillae were used for histochemistry, including hematoxylin-eosin staining and tartrate-resistant acid phosphatase enzyme staining. RESULTS Three-dimensional reconstructed images of the irregular alveolar bone showed an intuitive view of porotic changes in the OVX group. The alveolar bone in OVX rats had a porous microarchitecture including lower bone mass and a looser structure of more widely separated trabeculae. Bone mineral density (BMD), bone volume fraction (BV/TV), and trabecular thickness (Tb.Th.) were significantly lower in the OVX group than those in the sham group (P < 0.05). Trabecular separation (Tb.Sp.) increased significantly in the OVX rats compared to the sham rats (P < 0.05). Histomorphometric analysis of alveolar bone also revealed porotic changes in the OVX rats. Bone area ratio significantly decreased in the OVX group compared with the sham group (P < 0.01). There were also more osteoclasts present in the alveolar bone of OVX rats compared to sham rats (P < 0.05). CONCLUSION Ovariectomy induces osteoporosis in maxillary alveolar bone in rats, which may be related to the increased number of osteoclasts.
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Affiliation(s)
- Q-G Dai
- Department of Oral and Cranio-maxillofacial Science, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Stomatology, Shanghai, China
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Noguchi T, Matsunaga S, Kinoshita H, Fukuda M, Saka H, Ide Y, Abe S. A Site-Specific Comparison of the Trabecular Structure in Senescence-Accelerated Mice^|^mdash;Evaluation of Time-Course Changes in Bone Architecture using in Vivo Micro-CT^|^mdash;. J HARD TISSUE BIOL 2013. [DOI: 10.2485/jhtb.22.171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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41
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Is smoking a predictor of apical periodontitis? Clin Oral Investig 2012; 17:1947-55. [DOI: 10.1007/s00784-012-0893-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Accepted: 11/21/2012] [Indexed: 10/27/2022]
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Mijares D, Kulkarni A, Lewis K, Yao F, Xi Q, Tannous S, Dias R, LeGeros RZ. Oral bone loss induced by mineral deficiency in a rat model: Effect of a synthetic bone mineral (SBM) preparation. Arch Oral Biol 2012; 57:1264-73. [DOI: 10.1016/j.archoralbio.2012.02.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Revised: 02/10/2012] [Accepted: 02/23/2012] [Indexed: 11/16/2022]
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Geraets WGM, Lindh C, Verheij H. Sparseness of the trabecular pattern on dental radiographs: visual assessment compared with semi-automated measurements. Br J Radiol 2012; 85:e455-60. [PMID: 22374281 DOI: 10.1259/bjr/32962542] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE In diagnostic imaging; human perception is the most prominent, yet least studied, source of error. A better understanding of image perception will help to improve diagnostic performance. This study focuses on the perception of coarseness of trabecular patterns on dental radiographs. Comparison of human vision with machine vision should yield knowledge on human perception. METHOD In a study on identifying osteoporotic patients, dental radiographs were made from 505 post-menopausal women aged 45-70 years. Intra-oral radiographs of the lower and upper jaws were made. Five observers graded the trabecular pattern as dense, sparse or mixed. The five gradings were combined into a single averaged observer score per jaw. The radiographs were scanned and a region of interest (ROI) was indicated on each. The ROIs were processed with image analysis software measuring 25 image features. Pearson correlation and multiple linear regression were used to compare the averaged observer score with the image features. RESULTS 14 image features correlated significantly with the observer judgement for both jaws. The strongest correlation was found for the average grey value in the ROI. Other features, describing that osteoporotic patients have fewer but bigger marrow spaces than controls, correlated less with the sparseness of the trabecular pattern than a rather crude measure for structure such as the average grey value. CONCLUSION Human perception of the sparseness of trabecular patterns is based more on average grey values of the ROI than on geometric details within the ROI.
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Affiliation(s)
- W G M Geraets
- Department of Oral and Maxillofacial Radiology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, Netherlands.
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Widmer A, Fürst A, Bettschart R, Makara M, Geyer H, Kummer M. Bilateral iatrogenic [corrected] maxillary fractures after dental treatment in two aged horses. J Vet Dent 2010; 27:160-2. [PMID: 21038833 DOI: 10.1177/089875641002700303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This clinical report describes two horses with bilateral maxillary fractures following dental treatment. The fractures occurred during dental treatment by a veterinarian, and both had rostral, transverse, and complete bilateral maxillary fractures with instability and minimal displacement. The fractures were repaired using bilateral intraoral wiring with the patients under general anesthesia. The postoperative period was without complications and the fractures healed as expected. Maxillary fractures during or after routine dental treatment are rare, but can occur, especially in older horses. Appropriate sedation and, if necessary, regional nerve blocks might reduce the risk of iatrogenic fractures of the maxilla. General anesthesia must be considered for tooth extraction in horses that are difficult to restrain.
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Affiliation(s)
- A Widmer
- Department Vetsuisse, Faculty Zurich, Section Surgery, University of Zurich, Switzerland.
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Dagistan S, Bilge OM. Comparison of antegonial index, mental index, panoramic mandibular index and mandibular cortical index values in the panoramic radiographs of normal males and male patients with osteoporosis. Dentomaxillofac Radiol 2010; 39:290-4. [PMID: 20587653 DOI: 10.1259/dmfr/46589325] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The aim of the study was to compare the values of the antegonial index (AI), mental index (MI), panoramic mandibular index (PMI) and mandibular cortical index (MCI) in the panoramic radiographs of normal males and male patients with osteoporosis. METHODS In panoramic radiographs obtained from 40 male individuals (20 normal and 20 with osteoporosis), the mean was calculated for MI, AI, PMI and MCI index values measured in the right and left mandibles. The MI, AI and PMI index values were evaluated using the paired t-test, and MCI values were analysed using the chi(2) test. RESULTS MI (P < 0.001), AI (P < 0.01) and PMI (P < 0.05) values were significantly smaller in the group with osteoporosis; however, MCI (P > 0.05) was not significantly different. CONCLUSION MI, PMI and AI values, as radiomorphometric indices, were found to be smaller among male patients with osteoporosis, compared with normal patients in this study. It is suggested that these indices, used as an ancillary method in the diagnosis of osteoporosis in women, could also be useful for male patients. Further studies, of larger groups are needed on this subject, including of the MCI, which in this study showed no significant difference.
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Affiliation(s)
- S Dagistan
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, Ataturk University, Erzurum 25240, Turkey.
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Licks R, Licks V, Ourique F, Radke Bittencourt H, Fontanella V. Development of a prediction tool for low bone mass based on clinical data and periapical radiography. Dentomaxillofac Radiol 2010; 39:224-30. [PMID: 20395463 PMCID: PMC3520227 DOI: 10.1259/dmfr/23760876] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2009] [Revised: 05/24/2009] [Accepted: 06/11/2009] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES This study aimed to develop and test a tool for low bone mass pre-screening by combining periapical radiographs with clinical risk factors. METHODS The study sample consisted of 60 post-menopausal women over 40 years of age who were referred for dental radiographs. These patients also had their bone mineral density measured at the lumbar spine and proximal femur using dual-energy X-ray absorptiometry. Radiographic density measurements and 14 morphological features were obtained from each dental radiograph using digital image processing software. The clinical variables considered were age and bone mass index. Classification and regression tree analysis (CART) was used to test the predictive power of clinical and radiographic risk factors for classifying individuals. RESULTS CART indicated that the most important variables for classifying patients were age, number of terminal points/periphery, periphery/trabecular area, radiographic density and bone mass index. CONCLUSION A combination of clinical and radiographic factors can be used to identify individuals with low bone mineral density, with higher accuracy than any one of these factors taken individually.
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Affiliation(s)
- R Licks
- School of Dentistry, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil
| | - V Licks
- School of Mechatronic Engineering, Pontifical Catholic University of Rio Grande do Sul (PUCRS)Porto Alegre, Rio Grande do SulBrazil
| | - F Ourique
- School of Electrical Engineering, Pontifical Catholic University of Rio Grande do Sul (PUCRS)Porto Alegre, Rio Grande do SulBrazil
| | - H Radke Bittencourt
- Department of Statistics, Pontifical Catholic University of Rio Grande do Sul (PUCRS)Porto Alegre, Rio Grande do SulBrazil
| | - V Fontanella
- School of Dentistry, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil
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The relationship between panoramic radiomorphometric indices and the femoral bone mineral density of edentulous patients. Oral Radiol 2009. [DOI: 10.1007/s11282-009-0015-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gulsahi A, Yüzügüllü B, Imirzalioglu P, Genç Y. Assessment of panoramic radiomorphometric indices in Turkish patients of different age groups, gender and dental status. Dentomaxillofac Radiol 2008; 37:288-92. [PMID: 18606751 DOI: 10.1259/dmfr/19491030] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of the study was to determine the distribution of the appearance of the inferior mandibular cortex (Mandibular Cortical Index (MCI)) in a large Turkish population group and to assess a range of values for cortical width at the mental foramen region (Mental Index (MI)) and the ratio of the thickness of the mandibular cortex to the distance between the inferior margin of the mental foramen and the inferior mandibular cortex (Panoramic Mandibular Index (PMI)) according to the MCI. In addition, we assess how age, sex and dental status affected the MCI. METHODS Panoramic radiographs of 1,863 patients, 698 (37.5%) men and 1,165 (62.5%) women over 20 years old, were assessed during 2005-2006 from the files of Baskent University. Gender, age and dental status were recorded for each patient. MCI classifications, MI and PMI values in the MCI groups were evaluated and comparisons were made using logistic regression analysis. RESULTS Compared with patients aged 20-49 years, the likelihood of MCI C3 category in patients over 70 years of age and in patients aged 50-69 years of age was 79.14 and 9.17 times higher. The likelihood of the C3 category in edentulous and partially dentate patients was 27.30 and 2.68 times higher than in fully dentate patients, respectively. The likelihood of C3 category in patients with MI <3 mm was 14.86 times higher than in patients with MI >or=3 mm; also, in patients with a PMI of <0.30 this likelihood was 9.78 times higher than in patients with a PMI of >or=0.30. CONCLUSION Without respect to gender, edentulous patients with C3 category, MI <3 mm and PMI <0.30 may be seen as high-risk patients for osteoporosis and therefore should be referred for further osteoporosis investigation.
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Affiliation(s)
- A Gulsahi
- Başkent University, Faculty of Dentistry, Department of Oral Diagnosis and Radiology, 11 sok no. 26 06490, Bahçelievler, Ankara, Turkey.
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Glowacki J. Impact of postmenopausal osteoporosis on the oral and maxillofacial surgery patient. Oral Maxillofac Surg Clin North Am 2008; 19:187-98, vi. [PMID: 18088877 DOI: 10.1016/j.coms.2007.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
With aging, there is a loss of skeletal mass in women and men, but the rate of loss accelerates in perimenopausal women. With the loss of bone mass there is increased risk for fracture in the axial and appendicular skeleton. The mandible and maxilla also experience age-related declines in some parameters of architecture and trabecular pattern, but those do not seem to be directly associated with fracture risk. Although the literature is controversial regarding the generalizability of the impact of systemic osteoporosis on the oral/maxillofacial patient, it is prudent to give consideration to an individual patient's osteoporosis status, risk, and anti-osteoporosis therapies when planning oral and maxillofacial surgical procedures.
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Buyukkaplan US, Akkaya A, Yildiz M, Bircan A, Aksoy Dogan A, Ozturk O. Mineral Status of COPD Patients under Long-Term Inhaled Corticosteroid Therapy. J Prosthodont 2008; 17:462-7. [PMID: 18573148 DOI: 10.1111/j.1532-849x.2008.00334.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- U Sebnem Buyukkaplan
- Department of Prosthetic Dentistry, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey
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