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Ciobanu P, Danciu M, Pascu A, Gardikiotis I, Forna N, Sirbu MT, Calistru AE, Puha B, Veliceasa B, Sirbu PD. Experimental Study on Rats with Critical-Size Bone Defects Comparing Effects of Autologous Bone Graft, Equine Bone Substitute Bio-Gen ® Alone or in Association with Platelet-Rich Fibrin (PRF). Polymers (Basel) 2024; 16:1502. [PMID: 38891449 PMCID: PMC11175103 DOI: 10.3390/polym16111502] [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: 04/11/2024] [Revised: 05/17/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND A critical-sized bone defect (CsBD) is considered one that will not heal spontaneously and requires reconstruction. This study aims to compare the results of using different bone reconstructive techniques and to study the potential of platelet-rich fibrin (PRF) to enhance the healing properties of a bone substitute (BS). METHODS In this experimental study on rats, the treatment of critical-sized bone defects was carried out by analysing four groups: a control group in which the bone defect was left empty; a group treated with Bio-Gen®; another group in which the defect was treated with PRF in combination with Bio-Gen®; and the last that was treated with autologous bone graft (ABG). The defects were evaluated by microcomputed tomography (µCT) and then histomorphometrically. RESULTS From both the histological and imagistic point of view, the best results were registered in the ABG group, followed by the group treated with Bio-Gen® with PRF, Bio-Gen® group, and control group, with statistically significant differences. CONCLUSIONS A 5 mm defect in the rat radius can be considered critical. ABG showed the best results in treating the bone defect. PRF significantly enhanced the efficacy of Bio-Gen®.
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Affiliation(s)
- Petru Ciobanu
- Department of Surgery II—Orthopedics and Traumatology, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700454 Iasi, Romania
| | - Mihai Danciu
- Department of Morphofunctional Sciences I—Morphopathology, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700454 Iasi, Romania
| | - Andrei Pascu
- Department of Morphofunctional Sciences I—Morphopathology, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700454 Iasi, Romania
| | - Ioannis Gardikiotis
- Advanced Center for Research and Development in Experimental Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700454 Iasi, Romania
| | - Norin Forna
- Department of Surgery II—Orthopedics and Traumatology, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700454 Iasi, Romania
| | - Mihnea Theodor Sirbu
- Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700454 Iasi, Romania
| | - Anca-Elena Calistru
- Research Institute for Agriculture and Environment, Iasi University of Life Science, 700490 Iasi, Romania
| | - Bogdan Puha
- Department of Surgery II—Orthopedics and Traumatology, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700454 Iasi, Romania
| | - Bogdan Veliceasa
- Department of Surgery II—Orthopedics and Traumatology, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700454 Iasi, Romania
| | - Paul-Dan Sirbu
- Department of Surgery II—Orthopedics and Traumatology, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700454 Iasi, Romania
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Su D, Wu Y, Yang S, Ma D, Zhang H, Ma Y, Liu J, Wang C, Liu H, Yang X. Dual-energy computed tomography and micro-computed tomography for assessing bone regeneration in a rabbit tibia model. Sci Rep 2024; 14:5967. [PMID: 38472263 DOI: 10.1038/s41598-024-56199-8] [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: 10/08/2023] [Accepted: 03/04/2024] [Indexed: 03/14/2024] Open
Abstract
To gain a more meaningful understanding of bone regeneration, it is essential to select an appropriate assessment method. Micro-computed tomography (Micro-CT) is widely used for bone regeneration because it provides a substantially higher spatial resolution. Dual-energy computed tomography (DECT) ensure shorter scan time and lower radiation doses during quantitative evaluation. Therefore, in this study, DECT and Micro-CT were used to evaluate bone regeneration. We created 18 defects in the tibial plateau of the rabbits and filled them with porous polyetheretherketone implants to promote bone regeneration. At 4, 8, and 12 weeks, Micro-CT and DECT were used to assess the bone repair in the defect region. In comparison to Micro-CT (152 ± 54 mg/cm3), the calcium density values and hydroxyapatite density values obtained by DECT [DECT(Ca) and DECT(HAP)] consistently achieved lower values (59 ± 25 mg/cm3, 126 ± 53 mg/cm3). In addition, there was a good association between DECT and Micro-CT (R = 0.98; R2 = 0.96; DECT(Ca): y = 0.45x-8.31; DECT(HAP): y = 0.95x-17.60). This study highlights the need to use two different imaging methods, each with its advantages and disadvantages, to better understand the bone regeneration process.
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Affiliation(s)
- Danyang Su
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yan Wu
- Department of 3D Printing Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shenyu Yang
- Department of 3D Printing Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Duoshan Ma
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Haoran Zhang
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuanbo Ma
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jinlong Liu
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Chunyu Wang
- Department of 3D Printing Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Huilong Liu
- Department of 3D Printing Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaopeng Yang
- Department of Medical Equipment, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
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Bissinger O, Von den Hoff A, Maier E, Obermeier KT, Stimmer H, Kolk A, Wolff KD, Götz C. The Value of Surveillance Imaging of Oral Squamous Cell Carcinoma. Cancers (Basel) 2024; 16:207. [PMID: 38201635 PMCID: PMC10778242 DOI: 10.3390/cancers16010207] [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: 09/18/2023] [Revised: 11/15/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
The evaluation of surveillance imaging of OSCC patients is a difficult task physicians have to face daily. Multiple patients experience a recurrence of this disease, which underlines the importance of regular patient monitoring programs. Our study analysed the value of surveillance imaging, such as computed tomography (CT) and nuclear magnetic resonance imaging (NMRI), as a patient monitoring programme and its effectiveness in achieving improvement in early recurrence detection. The study comprised 125 patients, out of which 56 (n = 56) showed radiological and 69 (n = 69) showed clinical and radiological conspicuous patterns in domestic follow-ups, respectively. The use of CT and NMRI showed a significant dependence on the histological result (p = 0.03). However, the different groups showed no significant dependence on the histological result (p = 0.96). The distribution of the histological biopsies, which were taken due to radiological changes, were prone to wrong positive diagnoses (false positives) in 71 percent. To conclude, imaging modalities should be chosen for each patient individually to reduce false positives, improve the early detection of recurrence, and increase the cure rate.
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Affiliation(s)
- Oliver Bissinger
- Department of Oral and Maxillofacial Surgery, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria (C.G.)
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Klinikum Rechts der Isar, Ismaninger Str. 22, 81675 Munich, Germany
| | - Anne Von den Hoff
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Klinikum Rechts der Isar, Ismaninger Str. 22, 81675 Munich, Germany
| | - Elisabeth Maier
- Department of Oral and Maxillofacial Surgery, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria (C.G.)
| | - Katharina Theresa Obermeier
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital LMU Munich, Lindwurmstraße 2A, 80337 Munich, Germany
| | - Herbert Stimmer
- Department of Radiology, School of Medicine, Technical University of Munich, Klinikum Rechts der Isar, Ismaninger Str. 22, 81675 Munich, Germany
| | - Andreas Kolk
- Department of Oral and Maxillofacial Surgery, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria (C.G.)
| | - Klaus-Dietrich Wolff
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Klinikum Rechts der Isar, Ismaninger Str. 22, 81675 Munich, Germany
| | - Carolin Götz
- Department of Oral and Maxillofacial Surgery, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria (C.G.)
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Klinikum Rechts der Isar, Ismaninger Str. 22, 81675 Munich, Germany
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Abdelwahab D, Ezz AlArab A, El Nahass H. Soft tissue esthetics around immediately provisionalized delayed implants with and without connective tissue graft: A randomized clinical trial pilot study. Clin Implant Dent Relat Res 2023; 25:11-22. [PMID: 36579756 DOI: 10.1111/cid.13168] [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: 06/03/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Evaluate the peri-implant soft tissue esthetics following a single, immediately provisionalized, delayed implant with/-out subepithelial connective tissue graft (SCTG). MATERIAL AND METHODS The eligible patients were randomized into two groups. Immediate provisionalization was performed with (test group: SCTGG) or without SCTG (control group: NGG). The soft tissue esthetics was assessed by Pink Esthetic Score (PES) and Mucosal Scarring Index (MSI), at 6 and 12 months, following final implant restoration. RESULTS The SCTGG, compared to NGG, yielded a 0.2 increased PES at 12 months (95% confidence interval (CI): -1, 1.4) and a 0.2 decreased MSI score (95% CI -0.9, 0.5) with no statistically significant differences in PES and MSI between both groups (p > 0.05). CONCLUSION Soft tissue grafting around immediately provisionalized delayed implants could exhibit comparable results to immediate provisionalization alone in terms of peri-implant soft tissue esthetics using PES and MSI (ClinicalTrials.gov Identifier: NCT03770975).
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Affiliation(s)
- Dina Abdelwahab
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Azza Ezz AlArab
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Hani El Nahass
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Effective Spatial Resolution of Photon Counting CT for Imaging of Trabecular Structures is Superior to Conventional Clinical CT and Similar to High Resolution Peripheral CT. Invest Radiol 2022; 57:620-626. [PMID: 35318968 DOI: 10.1097/rli.0000000000000873] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Photon counting computed tomography (PCCT) might offer an effective spatial resolution that is significantly improved compared with conventional state-of-the-art computed tomography (CT) and even provide a microstructural level of detail similar to high-resolution peripheral CT (HR-pQCT). The aim of this study was to evaluate the volumetric effective spatial resolution of clinically approved PCCT as an alternative to HR-pQCT for ex vivo or preclinical high-resolution imaging of bone microstructure. MATERIALS AND METHODS The experiment contained 5 human vertebrae embedded in epoxy resin, which were scanned 3 times each, and on 3 different clinical CT scanners: a PCCT (Naeotom Alpha), a dual-energy CT (Somatom Force [SF]), and a single-energy CT (Somatom Sensation 40 [S40]), all manufactured by Siemens Healthineers (Erlangen, Germany). Scans were performed with a tube voltage of 120 kVp and, to provide maximum scan performance and minimum noise deterioration, with exposures of 1500 mAs (SF), 2400 mAs (S40), and 4500 mAs (PCCT) and low slice increments of 0.1 (PCCT) and 0.3 mm (SF, S40). Images were reconstructed with sharp and very sharp bone kernels, Br68 and Br76 (PCCT), Br64 (SF), and B65s and B75h (S40). Ground truth information was obtained from an XtremeCT scanner (Scanco, Brüttisellen, Switzerland). Voxel-wise comparison was performed after registration, calibration, and resampling of the volumes to isotropic voxel size of 0.164 mm. Three-dimensional point spread- and modulation-transfer functions were calculated with Wiener's deconvolution in the anatomical trabecular structure, allowing optimum estimation of device- and kernel-specific smoothing properties as well as specimen-related diffraction effects on the measurement. RESULTS At high contrast (modulation transfer function [MTF] of 10%), radial effective resolutions of PCCT were 10.5 lp/cm (minimum resolvable object size 476 μm) for kernel Br68 and 16.9 lp/cm (295 μm) for kernel Br76. At low contrast (MTF 5%), radial effective spatial resolutions were 10.8 lp/cm (464 μm) for kernel Br68 and 30.5 lp/cm (164 μm) for kernel Br76. Axial effective resolutions of PCCT for both kernels were between 27.0 (185 μm) and 29.9 lp/cm (167 μm). Spatial resolutions with kernel Br76 might possibly be still higher but were technically limited by the isotropic voxel size of 164 μm. The effective volumetric resolutions of PCCT with kernel Br76 ranged between 61.9 (MTF 10%) and 222.4 (MTF 5%) elements per cubic mm. Photon counting CT improved the effective volumetric resolution by factor 5.5 (MTF 10%) and 18 (MTF 5%) compared with SF and by a factor of 8.7 (MTF 10%) and 20 (MTF 5%) compared with S40. Photon counting CT allowed obtaining similar structural information as HR-pQCT. CONCLUSIONS The effective spatial resolution of PCCT in trabecular bone imaging was comparable with that of HR-pQCT and more than 5 times higher compared with conventional CT. For ex vivo samples and when patient radiation dose can be neglected, PCCT allows imaging bone microstructure at a preclinical level of detail.
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Jing X, Ding Q, Wu Q, Su W, Yu K, Su Y, Ye B, Gao Q, Sun T, Guo X. Magnesium-based materials in orthopaedics: material properties and animal models. BIOMATERIALS TRANSLATIONAL 2021; 2:197-213. [PMID: 35836647 PMCID: PMC9255805 DOI: 10.12336/biomatertransl.2021.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/16/2021] [Accepted: 09/10/2021] [Indexed: 11/29/2022]
Abstract
As a new generation of medical metal materials, degradable magnesium-based materials have excellent mechanical properties and osteogenic promoting ability, making them promising materials for the treatment of refractory bone diseases. Animal models can be used to understand and evaluate the performance of materials in complex physiological environments, providing relevant data for preclinical evaluation of implants and laying the foundation for subsequent clinical studies. To date, many researchers have studied the biocompatibility, degradability and osteogenesis of magnesium-based materials, but there is a lack of review regarding the effects of magnesium-based materials in vivo. In view of the growing interest in these materials, this review briefly describes the properties of magnesium-based materials and focuses on the safety and efficacy of magnesium-based materials in vivo. Various animal models including rats, rabbits, dogs and pigs are covered to better understand and evaluate the progress and future of magnesium-based materials. This literature analysis reveals that the magnesium-based materials have good biocompatibility and osteogenic activity, thus causing no adverse reaction around the implants in vivo, and that they exhibit a beneficial effect in the process of bone repair. In addition, the degradation rate in vivo can also be improved by means of alloying and coating. These encouraging results show a promising future for the use of magnesium-based materials in musculoskeletal disorders.
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Affiliation(s)
- Xirui Jing
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Qiuyue Ding
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Qinxue Wu
- Department of Clinical Medicine, Hubei Enshi College, Enshi, Hubei Province, China
| | - Weijie Su
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Keda Yu
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Yanlin Su
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Bing Ye
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Qing Gao
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Tingfang Sun
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Xiaodong Guo
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China,Corresponding author: Xiaodong Guo,
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Dual-energy X-ray Absorptiometry Does Not Represent Bone Structure in Patients with Osteoporosis: A Comparison of Lumbar Dual-Energy X-Ray Absorptiometry with Vertebral Biopsies. Spine (Phila Pa 1976) 2021; 46:861-866. [PMID: 34100839 DOI: 10.1097/brs.0000000000003917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Prospective cross-sectional exploratory study. OBJECTIVE To evaluate the correlation between in vivo lumbar dual-energy x-ray absorptiometry (DXA) and parameters of bone architecture in micro-computed tomography (micro-CT) in patients with osteoporosis. SUMMARY OF BACKGROUND DATA DXA is the current diagnostic standard for evaluating osteoporosis. However, there are various concerns regarding its validity, especially in the spine. No study has so far investigated whether in vivo DXA correlates with the actual lumbar bone architecture. METHODS Lumbar DXA scans were compared with micro-CT analysis of vertebral biopsies in patients with osteoporotic vertebral fractures (fracture group) and those without (control group). Preoperatively, all patients underwent a DXA scan (L1-L4). Intraoperative biopsies from nonfractured vertebrae (preferably L3) were analyzed by micro-CT regarding bone quantity and quality. The groups were compared regarding differences in DXA and micro-CT results. In each group, a correlation analysis was performed between DXA and micro-CT. RESULTS The study included 66 patients (33 per group). Preoperative DXA results were worse in the fracture group than the control group (areal bone mineral density [aBMD] 0.95 vs. 1.31, T-score -1.97 vs. 0.92, each P < 0.001). Micro-CT analysis confirmed differences regarding quantitative parameters (bone/total volume: 0.09 vs. 0.12, P < 0.001) and qualitative parameters (connectivity index: 15.73 vs. 26.67, P < 0.001; structure model index: 2.66 vs. 2.27, P < 0.001; trabecular number: 2.11 vs. 2.28, P = 0.014) of bone architecture between both groups. The DXA results did not correlate with micro-CT parameters in the fracture group. In the control group, correlations were found for some parameters (bone/total volume vs. aBMD: r = 0.51, P = 0.005; trabecular number vs. aBMD: r = 0.56, P = 0.001). CONCLUSION These data constitute the first comparison of DXA measurements with microstructural analysis of vertebral biopsies in patients with osteoporosis. Our results indicate that lumbar DXA neither qualitatively nor quantitatively represents microstructural bone architecture and is therefore not a reliable tool for the evaluation of bone quality in the spine.Level of Evidence: 3.
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Postl L, Mücke T, Hunger S, Bissinger O, Malek M, Holberg S, Burgkart R, Krennmair S. In-house 3D-printed surgical guides for osseous lesions of the lower jaw: an experimental study. Eur J Med Res 2021; 26:25. [PMID: 33722284 PMCID: PMC7958719 DOI: 10.1186/s40001-021-00495-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/02/2021] [Indexed: 11/30/2022] Open
Abstract
Background The accuracy of computer-assisted biopsies at the lower jaw was compared to the accuracy of freehand biopsies. Methods Patients with a bony lesion of the lower jaw with an indication for biopsy were prospectively enrolled. Two customized bone models per patient were produced using a 3D printer. The models of the lower jaw were fitted into a phantom head model to simulate operation room conditions. Biopsies for the study group were taken by means of surgical guides and freehand biopsies were performed for the control group. Results The deviation of the biopsy axes from the planning was significantly less when using templates. It turned out to be 1.3 ± 0.6 mm for the biopsies with a surgical guide and 3.9 ± 1.1 mm for the freehand biopsies. Conclusions Surgical guides allow significantly higher accuracy of biopsies. The preliminary results are promising, but clinical evaluation is necessary.
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Affiliation(s)
- Lukas Postl
- Department of Oral and Maxillofacial Surgery, Kepler University Hospital GmbH, Johannes Kepler University Linz, Krankenhausstr. 9, 4021, Linz, Austria. .,NumBioLab, Ludwig-Maximilians University of Munich, Munich, Germany. .,Department of Oral and Maxillo-Facial Surgery, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany.
| | - Thomas Mücke
- Department of Oral and Maxillo-Facial Surgery, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany
| | - Stefan Hunger
- Department of Oral and Maxillofacial Surgery, Kepler University Hospital GmbH, Johannes Kepler University Linz, Krankenhausstr. 9, 4021, Linz, Austria
| | - Oliver Bissinger
- Department of Oral and Maxillofacial Surgery, Medizinische Universitaet Innsbruck, Innsbruck, Austria
| | - Michael Malek
- Department of Oral and Maxillofacial Surgery, Kepler University Hospital GmbH, Johannes Kepler University Linz, Krankenhausstr. 9, 4021, Linz, Austria
| | - Svenia Holberg
- NumBioLab, Ludwig-Maximilians University of Munich, Munich, Germany
| | - Rainer Burgkart
- Department of Orthopaedics and Sports Orthopedics, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany
| | - Stefan Krennmair
- Department of Oral and Maxillofacial Surgery, Kepler University Hospital GmbH, Johannes Kepler University Linz, Krankenhausstr. 9, 4021, Linz, Austria.,NumBioLab, Ludwig-Maximilians University of Munich, Munich, Germany
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Pumberger M, Issever AS, Diekhoff T, Schwemmer C, Berg S, Palmowski Y, Putzier M. Bone structure determined by HR-MDCT does not correlate with micro-CT of lumbar vertebral biopsies: a prospective cross-sectional human in vivo study. J Orthop Surg Res 2020; 15:398. [PMID: 32912263 PMCID: PMC7488144 DOI: 10.1186/s13018-020-01895-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/16/2020] [Indexed: 01/22/2023] Open
Abstract
Background Osteoporosis is characterized by a deterioration of bone structure and quantity that leads to an increased risk of fractures. The primary diagnostic tool for the assessment of the bone quality is currently the dual-energy X-ray absorptiometry (DXA), which however only measures bone quantity. High-resolution multidetector computed tomography (HR-MDCT) offers an alternative approach to assess bone structure, but still lacks evidence for its validity in vivo. The objective of this study was to assess the validity of HR-MDCT for the evaluation of bone architecture in the lumbar spine. Methods We conducted a prospective cross-sectional study to compare the results of preoperative lumbar HR-MDCT scans with those from microcomputed tomography (μCT) analysis of transpedicular vertebral body biopsies. For this purpose, we included patients undergoing spinal surgery in our orthopedic department. Each patient underwent preoperative HR-MDCT scanning (L1-L4). Intraoperatively, transpedicular biopsies were obtained from intact vertebrae. Micro-CT analysis of these biopsies was used as a reference method to assess the actual bone architecture. HR-MDCT results were statistically analyzed regarding the correlation with results from μCT. Results Thirty-four patients with a mean age of 69.09 years (± 10.07) were included in the study. There was no significant correlation for any of the parameters (bone volume/total volume, trabecular separation, trabecular thickness) between μCT and HR-MDCT (bone volume/total volume: r = − 0.026 and p = 0.872; trabecular thickness: r = 0.074 and r = 6.42; and trabecular separation: r = − 0.18 and p = 0.254). Conclusion To our knowledge, this is the first study comparing in vivo HR-MDCT with μCT analysis of vertebral biopsies in human patients. Our findings suggest that lumbar HR-MDCT is not valid for the in vivo evaluation of bone architecture in the lumbar spine. New diagnostic tools for the evaluation of osteoporosis and preoperative orthopedic planning are urgently needed.
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Affiliation(s)
- Matthias Pumberger
- Spine Department, Center for Musculoskeletal Surgery, Charité University Medicine Berlin, Chariteplatz 1, 10117, Berlin, Germany
| | - Ahi Sema Issever
- Department of Radiology, Charité University Medicine Berlin, Chariteplatz 1, 10117, Berlin, Germany
| | - Torsten Diekhoff
- Department of Radiology, Charité University Medicine Berlin, Chariteplatz 1, 10117, Berlin, Germany
| | - Christin Schwemmer
- Charité University Medicine Berlin, Chariteplatz 1, 10117, Berlin, Germany
| | - Susanne Berg
- Charité University Medicine Berlin, Chariteplatz 1, 10117, Berlin, Germany
| | - Yannick Palmowski
- Spine Department, Center for Musculoskeletal Surgery, Charité University Medicine Berlin, Chariteplatz 1, 10117, Berlin, Germany.
| | - Michael Putzier
- Spine Department, Center for Musculoskeletal Surgery, Charité University Medicine Berlin, Chariteplatz 1, 10117, Berlin, Germany
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Bamba J, Ishida H, Araki K. A NEWLY DEVELOPED PHANTOM FOR PHYSICAL QUALITY ASSURANCE OF DENTAL CONE-BEAM COMPUTED TOMOGRAPHY. RADIATION PROTECTION DOSIMETRY 2019; 183:303-311. [PMID: 30053200 DOI: 10.1093/rpd/ncy116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 06/12/2018] [Accepted: 07/03/2018] [Indexed: 06/08/2023]
Abstract
Two phantoms for a performance evaluation of cone-beam computed tomography (CBCT) were developed and their efficiency was tested. The first phantom, for low-contrast resolution, consisted of an acrylic circular plate with three 0.5-1.0 mm diameter rods. These rods enable the user to visually evaluate the limit of observation. The second phantom, for geometric distortion, especially focused on the z-axis and consisted of two tabular acryl plates crossed perpendicularly with 1.0 mm-wide grooves in a grating form every 10.0 mm. The distances between the grooves on the axial and coronal images were evaluated. Five CBCT modalities were assessed using these phantoms. The contrast resolutions differed for each apparatus and set of exposure parameters. In terms of geometric distortion, some distortion was observed at the periphery of the field of view for both the axial and z-axis planes. These results suggest that our new phantoms can be used to evaluate CBCT.
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Affiliation(s)
- Junko Bamba
- Division of Radiology, Department of Oral Diagnostic Sciences, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ota-ku, Tokyo, Japan
| | - Hideki Ishida
- Division of Radiology, Department of Oral Diagnostic Sciences, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ota-ku, Tokyo, Japan
| | - Kazuyuki Araki
- Division of Radiology, Department of Oral Diagnostic Sciences, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ota-ku, Tokyo, Japan
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Impacts of dynamic degradation on the morphological and mechanical characterisation of porous magnesium scaffold. Biomech Model Mechanobiol 2019; 18:797-811. [DOI: 10.1007/s10237-018-01115-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 12/26/2018] [Indexed: 01/27/2023]
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Kustro T, Kiss T, Chernohorskyi D, Chepurnyi Y, Helyes Z, Kopchak A. Quantification of the mandibular defect healing by micro-CT morphometric analysis in rats. J Craniomaxillofac Surg 2018; 46:2203-2213. [PMID: 30343871 DOI: 10.1016/j.jcms.2018.09.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 07/29/2018] [Accepted: 09/19/2018] [Indexed: 12/17/2022] Open
Abstract
PURPOSE The goal of this study was the evaluation of the bone tissue structural characteristics over the time course of mandibular defect healing using micro-CT technique, as well as determination of the inter-relationships between different micro-CT parameters used for assessment of the bone regeneration process and the patterns of their dynamic changes. MATERIALS AND METHODS The body and ramus of the mandible was exposed in 24 Wistar rats. A 2-mm full thickness bony defect was created. Animals were randomized into four groups, which were ended 3, 6, 12 and 24 weeks after operation. The mandible was excised and underwent micro-CT analysis. For statistical evaluation, the Mann-Whitney U test, polynomial or exponential regression and Spearman analysis were applied. RESULTS The absolute volume of the bone regenerate increased from 1.69 ± 0.53 mm3 (3 weeks) to 3.36 mm3 ± 0.56 (6 months), as well as percentage of bone volume, increased significantly from 12.5 ± 2.3% at the 3-week term to 26.4 ± 8.7% at the 3-month term or 23.1 ± 8.7% at the 6-month term. Structural (trabecular) thickness gradually increased from 0.13 ± 0.007 mm at the 3-week term to 0.3 ± 0.11 mm at the 6-month term. The structural model index was 0.79 ± 0.46 in the early phase after trauma and then decreased to negative values. CONCLUSION The bone regeneration process was characterized by a significant increase (p < 0.05) in bone volume, percentage of bone volume, structural thickness and bone mineral density, and a decrease in bone surface-to-volume ratio and volume of pore space from the 3-week term to the 6-month term. These changes can be mathematically described by nonlinear exponential regression models.
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Affiliation(s)
- T Kustro
- Department of Stomatology, Bogomolets National Medical University, 13, T. Shevchenko blvd, 01601, Kyiv, Ukraine
| | - T Kiss
- János Szentágothai Research Centre & Department of Pharmacology and Pharmacotherapy, Medical School, University of Pecs, Ifjúság útja 20, Pécs, H-7624, Hungary
| | - D Chernohorskyi
- Department of Stomatology, Bogomolets National Medical University, 13, T. Shevchenko blvd, 01601, Kyiv, Ukraine
| | - Y Chepurnyi
- Department of Stomatology, Bogomolets National Medical University, 13, T. Shevchenko blvd, 01601, Kyiv, Ukraine.
| | - Z Helyes
- János Szentágothai Research Centre & Department of Pharmacology and Pharmacotherapy, Medical School, University of Pecs, Ifjúság útja 20, Pécs, H-7624, Hungary; PharmInVivo Ltd., Szondi Gy. u. 7, H-7629, Pécs, Hungary
| | - A Kopchak
- Department of Stomatology, Bogomolets National Medical University, 13, T. Shevchenko blvd, 01601, Kyiv, Ukraine
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Sanz-Martín I, Permuy M, Vignoletti F, Nuñez J, Muñoz F, Sanz M. A novel methodological approach using superimposed Micro-CT and STL images to analyze hard and soft tissue volume in immediate and delayed implants with different cervical designs. Clin Oral Implants Res 2018; 29:986-995. [PMID: 30246362 DOI: 10.1111/clr.13365] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 05/14/2018] [Accepted: 08/09/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To study the hard and soft tissue volume after placing immediate (IMI) or delayed implants (DLI) with a triangular coronal macro-design (Test/T) or a conventional cylindrical design (Control/C). MATERIAL AND METHODS T/C implants were inserted in healed ridges or in fresh extraction sockets of eight beagle dogs. Biopsies were processed for Micro-CT analysis and dental stone casts were optically scanned to obtain STL files revealing the soft tissue contours at 12 weeks. Image analysis software was utilized to match common landmarks superimposing the two sets of data. Three distinct volumes were calculated; buccal bone volume (B-BV), soft tissue volume below the implant shoulder (EC-STV), and the soft tissue volume above the implant shoulder (SC-STV). Using linear measurements, the soft tissue height (STH), the mucosal thickness (MT-IS), and the distance from the implant shoulder to the bone crest (I-BC) were assessed in the digital images and in conventional histology to assess the concordance, reproducibility, and reliability. RESULTS There were no significant differences between test and control implants regarding the buccal bone volume, although test implants had greater B-BV in all locations except for PM2. The soft tissue volume was similar at T/C implants. The surgical approach influenced the distribution of the total tissue volume. In the IMI, a low position of the bone crest was correlated with low values of B-BV, SC-STV, MT-IS, and STH. Linear measurements showed a high correlation between the histology and digital measurements and high inter and intra examiner agreement. CONCLUSION The superimposition of Micro-CT/STL allowed the analysis of soft and hard tissue volumes. Reduction of the implant buccal aspect resulted in nonsignificant higher bone volume although similar soft tissue volume while the surgical approach influenced soft tissue response.
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Affiliation(s)
- Ignacio Sanz-Martín
- Section of Periodontology, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - María Permuy
- Faculty of Veterinary Lugo, University of Santiago de Compostela, Lugo, Spain
| | - Fabio Vignoletti
- Section of Periodontology, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Javier Nuñez
- Section of Periodontology, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Fernando Muñoz
- Faculty of Veterinary Lugo, University of Santiago de Compostela, Lugo, Spain
| | - Mariano Sanz
- Section of Periodontology, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
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