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Troiano G, Rapani A, Fanelli F, Berton F, Caroprese M, Lombardi T, Zhurakivska K, Stacchi C. Inter and intra-operator reliability of Lekholm and Zarb classification and proposal of a novel radiomic data-driven clustering for qualitative assessment of edentulous alveolar ridges. Clin Oral Implants Res 2024; 35:729-738. [PMID: 38629945 DOI: 10.1111/clr.14271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 03/10/2024] [Accepted: 04/02/2024] [Indexed: 07/11/2024]
Abstract
OBJECTIVES The present study was conducted to evaluate the reproducibility of Lekholm and Zarb classification system (L&Z) for bone quality assessment of edentulous alveolar ridges and to investigate the potential of a data-driven approach for bone quality classification. MATERIALS AND METHODS Twenty-six expert clinicians were asked to classify 110 CBCT cross-sections according to L&Z classification (T0). The same evaluation was repeated after one month with the images put in a different order (T1). Intra- and inter-examiner agreement analyses were performed using Cohen's kappa coefficient (CK) and Fleiss' kappa coefficient (FK), respectively. Additionally, radiomic features extraction was performed from 3D edentulous ridge blocks derived from the same 110 CBCTs, and unsupervised clustering using 3 different clustering methods was used to identify patterns in the obtained data. RESULTS Intra-examiner agreement between T0 and T1 was weak (CK 0.515). Inter-examiner agreement at both time points was minimal (FK at T0: 0.273; FK at T1: 0.243). The three different unsupervised clustering methods based on radiomic features aggregated the 110 CBCTs in three groups in the same way. CONCLUSIONS The results showed low agreement among clinicians when using L&Z classification, indicating that the system may not be as reliable as previously thought. The present study suggests the possible application of a reproducible data-driven approach based on radiomics for the classification of edentulous alveolar ridges, with potential implications for improving clinical outcomes. Further research is needed to determine the clinical significance of these findings and to develop more standardized and accurate methods for assessing bone quality of edentulous alveolar ridges.
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Affiliation(s)
- Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonio Rapani
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Francesco Fanelli
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Federico Berton
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Marino Caroprese
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Teresa Lombardi
- Department of Health Sciences, University "Magna Græcia", Catanzaro, Italy
| | - Khrystyna Zhurakivska
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Claudio Stacchi
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
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Vigliar MFR, Marega LF, Duarte MAH, Alcalde MP, Rosso MPDO, Ferreira Junior RS, Barraviera B, Reis CHB, Buchaim DV, Buchaim RL. Photobiomodulation Therapy Improves Repair of Bone Defects Filled by Inorganic Bone Matrix and Fibrin Heterologous Biopolymer. Bioengineering (Basel) 2024; 11:78. [PMID: 38247955 PMCID: PMC10813421 DOI: 10.3390/bioengineering11010078] [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: 11/14/2023] [Revised: 12/22/2023] [Accepted: 01/11/2024] [Indexed: 01/23/2024] Open
Abstract
Biomaterials are used extensively in graft procedures to correct bone defects, interacting with the body without causing adverse reactions. The aim of this pre-clinical study was to analyze the effects of photobiomodulation therapy (PBM) with the use of a low-level laser in the repair process of bone defects filled with inorganic matrix (IM) associated with heterologous fibrin biopolymer (FB). A circular osteotomy of 4 mm in the left tibia was performed in 30 Wistar male adult rats who were randomly divided into three groups: G1 = IM + PBM, G2 = IM + FB and G3 = IM + FB + PBM. PBM was applied at the time of the experimental surgery and three times a week, on alternate days, until euthanasia, with 830 nm wavelength, in two points of the operated site. Five animals from each group were euthanized 14 and 42 days after surgery. In the histomorphometric analysis, the percentage of neoformed bone tissue in G3 (28.4% ± 2.3%) was higher in relation to G1 (24.1% ± 2.91%) and G2 (22.2% ± 3.11%) at 14 days and at 42 days, the percentage in G3 (35.1% ± 2.55%) was also higher in relation to G1 (30.1% ± 2.9%) and G2 (31.8% ± 3.12%). In the analysis of the birefringence of collagen fibers, G3 showed a predominance of birefringence between greenish-yellow in the neoformed bone tissue after 42 days, differing from the other groups with a greater presence of red-orange fibers. Immunohistochemically, in all experimental groups, it was possible to observe immunostaining for osteocalcin (OCN) near the bone surface of the margins of the surgical defect and tartrate-resistant acid phosphatase (TRAP) bordering the newly formed bone tissue. Therefore, laser photobiomodulation therapy contributed to improving the bone repair process in tibial defects filled with bovine biomaterial associated with fibrin biopolymer derived from snake venom.
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Affiliation(s)
- Maria Fernanda Rossi Vigliar
- Graduate Program in Anatomy of Domestic and Wild Animals, Faculty of Veterinary Medicine and Animal Science, University of Sao Paulo (FMVZ/USP), Sao Paulo 05508-270, Brazil; (M.F.R.V.); (D.V.B.)
| | - Lais Furlaneto Marega
- Department of Biological Sciences, Bauru School of Dentistry, University of Sao Paulo (FOB/USP), Bauru 17012-901, Brazil; (L.F.M.); (M.P.d.O.R.); (C.H.B.R.)
| | - Marco Antonio Hungaro Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of Sao Paulo (FOB/USP), Bauru 17012-901, Brazil; (M.A.H.D.); (M.P.A.)
| | - Murilo Priori Alcalde
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of Sao Paulo (FOB/USP), Bauru 17012-901, Brazil; (M.A.H.D.); (M.P.A.)
| | - Marcelie Priscila de Oliveira Rosso
- Department of Biological Sciences, Bauru School of Dentistry, University of Sao Paulo (FOB/USP), Bauru 17012-901, Brazil; (L.F.M.); (M.P.d.O.R.); (C.H.B.R.)
| | - Rui Seabra Ferreira Junior
- Center for the Study of Venoms and Venomous Animals (CEVAP), Sao Paulo State University (University Estadual Paulista, UNESP), Botucatu 18610-307, Brazil; (R.S.F.J.); (B.B.)
- Graduate Programs in Tropical Diseases and Clinical Research, Botucatu Medical School (FMB), Sao Paulo State University (UNESP–University Estadual Paulista), Botucatu 18618-687, Brazil
| | - Benedito Barraviera
- Center for the Study of Venoms and Venomous Animals (CEVAP), Sao Paulo State University (University Estadual Paulista, UNESP), Botucatu 18610-307, Brazil; (R.S.F.J.); (B.B.)
- Graduate Programs in Tropical Diseases and Clinical Research, Botucatu Medical School (FMB), Sao Paulo State University (UNESP–University Estadual Paulista), Botucatu 18618-687, Brazil
| | - Carlos Henrique Bertoni Reis
- Department of Biological Sciences, Bauru School of Dentistry, University of Sao Paulo (FOB/USP), Bauru 17012-901, Brazil; (L.F.M.); (M.P.d.O.R.); (C.H.B.R.)
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, Postgraduate Department, University of Marilia (UNIMAR), Marilia 17525-902, Brazil
| | - Daniela Vieira Buchaim
- Graduate Program in Anatomy of Domestic and Wild Animals, Faculty of Veterinary Medicine and Animal Science, University of Sao Paulo (FMVZ/USP), Sao Paulo 05508-270, Brazil; (M.F.R.V.); (D.V.B.)
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, Postgraduate Department, University of Marilia (UNIMAR), Marilia 17525-902, Brazil
- Medical School, University Center of Adamantina (UNIFAI), Adamantina 17800-000, Brazil
| | - Rogerio Leone Buchaim
- Graduate Program in Anatomy of Domestic and Wild Animals, Faculty of Veterinary Medicine and Animal Science, University of Sao Paulo (FMVZ/USP), Sao Paulo 05508-270, Brazil; (M.F.R.V.); (D.V.B.)
- Department of Biological Sciences, Bauru School of Dentistry, University of Sao Paulo (FOB/USP), Bauru 17012-901, Brazil; (L.F.M.); (M.P.d.O.R.); (C.H.B.R.)
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