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Ha JY, Eo MY, Sodnom-Ish B, Mustakim KR, Myoung H, Kim SM. Electron microscopic analysis of necrotic bone and failed implant surface in a patient with medication-related osteonecrosis of the jaw. Maxillofac Plast Reconstr Surg 2023; 45:34. [PMID: 37789223 PMCID: PMC10547673 DOI: 10.1186/s40902-023-00402-9] [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: 07/02/2023] [Accepted: 09/17/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Bisphosphonates (BP), a commonly used medication for various bone diseases, have been known to have severe complications such as bisphosphonate-related osteonecrosis of the jaw (BRONJ). Failure of dental implants has also been found in patients with medication-related osteonecrosis of the jaw (MRONJ). In this study, we analyzed the necrotic bone tissues and the surface of the failed implants removed from the jaw in patients treated with BPs and antiresorptive agents. RESULTS Chronic inflammatory cells with collagen and fibrous tissues and bone sequestrum were shown at 5.0 × , 10.0 × , 20.0 × , and 40.0 × magnified histologic sections in the bone and fibrotic scar tissues removed from patients with MRONJ due to osteonecrosis. Hardened bone tissues with microcracked bony resorbed lacunae were observed in SEM. Unlike the previously published comparative data where immune cells, such as dendritic cells, were found in the failed implant surface, these immune cells were not identified in the BRONJ-related peri-implantitis tissues through the TEM investigations. Furthermore, EDS revealed that in addition to the main titanium element, gold, carbon, oxygen, calcium, phosphorus, silicon, and sulfur elements were found. CONCLUSION Hardened bone tissues with microcracked bony resorbed lacunae were observed in the SEM findings, which were considered as the main characteristic of the osteonecrosis of the jaw. Immune cells, such as dendritic cells were not identified in the TEM. EDS showed that in addition to the main titanium element, gold, carbon, oxygen, calcium, phosphorus, and silicon elements were found. Furthermore, it was revealed that sulfur was found, which was considered to be one of the complicated causes of implant failure in patients with BRONJ.
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Affiliation(s)
- Ji Young Ha
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea
| | - Mi Young Eo
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea
| | - Buyanbileg Sodnom-Ish
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea
| | - Kezia Rachellea Mustakim
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea
| | - Hoon Myoung
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea
| | - Soung Min Kim
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea.
- Oral and Maxillofacial Microvascular Reconstruction Lab, Brong Ahafo Regional Hospital, Ghana Health Service, P.O. Box 27, Sunyani, Brong Ahafo, Ghana.
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Castro-Núñez J, Sifuentes-Cervantes JS, Alemán BO, Rivera I, Bustillo J, Guerrero LM. Histologic features of bone regenerated by means of negative pressure in the context of odontogenic keratocyst. Oral Maxillofac Surg 2023; 27:421-426. [PMID: 35643989 DOI: 10.1007/s10006-022-01080-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 05/24/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE The objective of the present research is to describe the histologic features of the bone regenerated by means of negative pressure (sugosteogenesis) in a group of patients diagnosed with odontogenic keratocyst (OKC) who underwent active decompression and distraction sugosteogenesis (ADDS) at our institution. MATERIALS AND METHODS The authors designed a retrospective case series study. The population included patients with a histologic diagnosis of odontogenic keratocyst in whom active decompression and distraction sugosteogenesis followed by enucleation was performed. All patients were seen and followed from July 2019 to January 2021. The investigation was approved by the Institutional Review Board, and it observed the Declaration of Helsinki on medical protocol. Variables of this study included age, gender, anatomic location (mandible or maxilla), and histologic characteristics of the bone regenerated by means of negative pressure. Histologic features were defined as being consistent or inconsistent with viable mature bone. RESULTS Bone biopsies of 6 patients were considered. In total, 83.33% of patients were males and 16.66% females. One hundred percent of the bone samples subjected to negative pressure showed features of viable mature bone. CONCLUSIONS In this study, the histological features of the bone subjected to negative pressure demonstrated the normal characteristics of the mature, normal bone.
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Affiliation(s)
- Jaime Castro-Núñez
- PGY 3Oral and Maxillofacial Surgery Residency ProgramSchool of Dental MedicineMedical Sciences Campus, University of Puerto Rico, Paseo Dr. José Celso Barbosa, San Juan, Puerto Rico, 00921.
| | - José S Sifuentes-Cervantes
- PGY 1, Oral and Maxillofacial Surgery Residency Program, School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Brayann O Alemán
- PGY 4, Oral and Maxillofacial Surgery Residency Program, School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Irelsy Rivera
- PGY 4, Oral and Maxillofacial Surgery Residency Program, School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Jairo Bustillo
- Oral and Maxillofacial Pathology Department, School of Dentistry, Universidad El Bosque, Bogotá, Colombia
| | - Lidia M Guerrero
- Oral and Maxillofacial Surgery Residency Program, School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
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Wang J, Zhang Y, Zhao C, Zhang Q. Femoral Head Necrosis Due to Brucella Infection in China: Case Series and Literature Review. Infect Drug Resist 2022; 15:5857-5865. [PMID: 36237293 PMCID: PMC9553233 DOI: 10.2147/idr.s383584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 09/28/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction The causes of femoral head necrosis mainly include trauma, corticosteroid, and alcohol, among which Brucella is highly unusual. Patients and Methods This paper reported three rare cases of femoral head necrosis due to Brucella, summarizing and analyzing the epidemiological history, clinical manifestations, laboratory examinations, imaging findings, individualized therapy, and biopsy results of patients with this disease. A literature review related to brucellosis and femoral head necrosis was conducted. Results All three patients had an epidemic history of brucellosis. They suffered from hip pain and limitation of movement for months, and femoral head necrosis was confirmed by magnetic resonance imaging (MRI). Pathological Giemsa staining or real-time polymerase chain reaction (real-time PCR) confirmed Brucella melitensis (B. melitensis) as the cause of osteonecrosis. Each patient received individualized therapy according to the degree of osteonecrosis, which was based on anti-brucellosis medications and hip puncture and irrigation decompression. They were followed up for more than two years and rehabilitated well. Conclusion Brucella infection should always be considered the cause of femoral head necrosis for patients with hip pain, especially for those with an epidemic history; early diagnosis and individual stepwise therapy can prevent the progression of osteonecrosis.
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Affiliation(s)
- Jie Wang
- Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People’s Republic of China
| | - Yao Zhang
- Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People’s Republic of China
| | - Changsong Zhao
- Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People’s Republic of China
| | - Qiang Zhang
- Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People’s Republic of China,Correspondence: Qiang Zhang, Email
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Odontogenic Keratocyst in the Masseter Muscle. J Craniofac Surg 2021; 33:e275-e276. [PMID: 34374673 DOI: 10.1097/scs.0000000000008079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Odontogenic keratocyst (OKC) arising from purely soft tissue other than the mucosa covering the jawbone is rare. A 57-year-old Korean female patient presented with a lump on her right cheek, which had been suspected as a fibrotic mass on the buccinator muscle by the local clinic. Magnetic resonance imaging showed an ovoid mass in the buccal space just before the right ramus with an enhancing component in the marginal area, and the interior of the mass revealed a fluid signal. Histopathologically, the lesion showed the typical features of OKC and the cyst wall contained some daughter cysts and the minor salivary gland, muscle, and fat tissues. The authors report a very unique case of OKC arising in the masseter muscle.
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Decompression effects on bone healing in rat mandible osteomyelitis. Sci Rep 2021; 11:11673. [PMID: 34083570 PMCID: PMC8175588 DOI: 10.1038/s41598-021-91104-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 05/20/2021] [Indexed: 12/22/2022] Open
Abstract
Osteomyelitis (OM) of the jaw is usually caused by a chronic odontogenic infection. Decompression is the release the intraluminal pressure in the cystic cavity allowing gradual bone growth from the periphery. The aim of this study was to analyze the effectiveness of decompression in an OM jaw model. A 4-mm-diameter defect was made on mandibles of fourteen Sprague-Dawley rats and inoculated with S. aureus (20 μl of 1 × 107 CFU/ml) injection. Two weeks later, four groups were made as non-treatment (C1), only curettage (C2), curettage and decompression (E1), and curettage and decompression with normal saline irrigation (E2). After four weeks, each group was analyzed. Most micro-CT parameters, including bone mineral density [0.87 (± 0.08) g/cm3] with bone volume [0.73 (± 0.08) mm3] was higher in E2 group than that of C1 group (p = 0.04, p = 0.05, respectively). E2 group in histology showed the highest number of osteocytes than those of control groups, 91.00 (± 9.90) (p = 0.002). OPN were expressed strongly in the E1 ("5": 76-100%) that those of other groups. Decompression drains induced advanced bone healing compared to that of curettage alone. Therefore, it could be recommended to use decompressive drain for enhancing the jaw OM management.
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