Areas Of New Bone Formation Research Articles

Determination of critical-sized defect of mandible in a rabbit model: Micro-computed tomography, and histological evaluation

ObjectiveTo evaluate a rabbit model of mandibular box-shaped defects created through an intraoral approach and determine the minimum size defect that would not spontaneously heal during the rabbit's natural life (or critical-sized defect, CSD). MethodsForty-five 6-month-old rabbits were randomly divided into five defect size groups (nine each). Mandibular box-shaped defects of different sizes (4, 5, 6, 8, and 10 mm) were created in each hemimandible, with the same width and depth (3 and 2 mm, respectively). Four, 8, and 12 weeks post-surgery, three animals per group were euthanized. New bone formation was assessed using micro-computed tomography (MCT) and histomorphometric analyses. ResultsBox-shaped defects were successfully created in the buccal region between the incisor area and the anterior part of the mental foramen in rabbit mandibles. Twelve weeks post-surgery, MCT analysis showed that the defects in the 4, 5, and 6 mm groups were filled with new bone, while those in the 8 and 10 mm groups remained underfilled. Quantitative analysis revealed that the bone mass recovery percentage in the 8 and 10 mm groups was significantly lower than that in the other groups (p < 0.05). There was no significant difference in the bone mass recovery percentage between the 8 and 10 mm groups (p > 0.05). Histomorphometric analysis indicated that the area of new bone formation in the 8 and 10 mm groups was significantly lower than that in the remaining groups (p < 0.05). There was no significant difference in the new bone area between the 8 and 10 mm groups (p > 0.05). ConclusionsThe dimensions of box-shaped CSD created in the rabbit mandible through an intraoral approach were 8 mm × 3 mm × 2 mm. This model may provide a clinically relevant base for future tissue engineering efforts in the mandible.

Functionalizing Collagen Membranes with MSC-Conditioned Media Promotes Guided Bone Regeneration in Rat Calvarial Defects.

Functionalizing biomaterials with conditioned media (CM) from mesenchymal stromal cells (MSC) is a promising strategy for enhancing the outcomes of guided bone regeneration (GBR). This study aimed to evaluate the bone regenerative potential of collagen membranes (MEM) functionalized with CM from human bone marrow MSC (MEM-CM) in critical size rat calvarial defects. MEM-CM prepared via soaking (CM-SOAK) or soaking followed by lyophilization (CM-LYO) were applied to critical size rat calvarial defects. Control treatments included native MEM, MEM with rat MSC (CEL) and no treatment. New bone formation was analyzed via micro-CT (2 and 4 weeks) and histology (4 weeks). Greater radiographic new bone formation occurred at 2 weeks in the CM-LYO group vs. all other groups. After 4 weeks, only the CM-LYO group was superior to the untreated control group, whereas the CM-SOAK, CEL and native MEM groups were similar. Histologically, the regenerated tissues showed a combination of regular new bone and hybrid new bone, which formed within the membrane compartment and was characterized by the incorporation of mineralized MEM fibers. Areas of new bone formation and MEM mineralization were greatest in the CM-LYO group. Proteomic analysis of lyophilized CM revealed the enrichment of several proteins and biological processes related to bone formation. In summary, lyophilized MEM-CM enhanced new bone formation in rat calvarial defects, thus representing a novel 'off-the-shelf' strategy for GBR.

Application of bone morphogenetic protein 2 derived peptide loaded onto nano hydroxyapatite for periodontal bone regeneration

To explore the feasibility of utilizing a nano drug delivery system for the promotion of periodontal bone regeneration, we constructed a hydroxyapatite-bone morphogenetic protein-2 (HA-BMP-2) nanocomposite. Through characterization by X-ray diffraction and Fourier transform infrared spectroscopy, the synthesized nanocomposite was confirmed to be HA, and nano HA (nHA) could prolong the half-life of BMP-2 by 10 times. In the cell test, we found that compared with nHA, nHA-BMP-2 improved the activity and migration of human periodontal ligament stem cells (HPLSCs) to promote the reconstruction of bone defects. Moreover, nHA-BMP-2 could improve the mineralization of HPLSCs, including increased levels of alkaline phosphatase, collagen I, and osteocalcin, thus enhancing osteogenesis. In the animal experiments, nHA-BPM-2 was further confirmed to effectively improve the area of new bone formation, bone density, bone volume percentage, and trabecular number in periodontal bone defect areas and reduce the repair time. Therefore, nHA-BMP-2 shows great potential for periodontal bone regeneration.

Characterization of a nanocomposite scaffold and assessment of its osteogenic influence in a rabbit mandibular bone defect model

ObjectiveBone is a complex tissue with a multifactorial healing process. Different scaffold materials have been tested for efficacy in bone regeneration. Polycaprolactone (PCL), alginate (Alg), and hydroxyapatite (HA) are materials with different properties that make them good candidates for scaffold fabrication for bone tissue engineering purposes. Composite scaffolds achieve better properties because they combine high mechanical strength of synthetic materials with biocompatibility and hydrophilicity of natural materials. This study was conducted to achieve in vitro and in vivo characterization of a composite nanofibrous material and test its osteogenic effect on mandibular bone defects. MethodsScaffolds were fabricated through electrospinning technique and coated through casting method. Characterization was conducted using scanning electron microscope (SEM), energy-dispersive X-ray (EDX), and Fourier transform infrared (FTIR). Mechanical tests were done. Weight loss and water absorption percentages were calculated in vitro. For in vivo tests, male New Zealand white rabbits were divided into two groups. Both groups had bilateral circular mandibular defects. The control group was left without further intervention while the experimental group had scaffolds implanted in the defects. After different time intervals, animals were euthanized, and histological evaluations with histomorphometric analyses were conducted. ResultsThe fabricated material showed proper biocompatibility and morphological, physical, chemical, and mechanical properties. The experimental group showed enhanced bone healing with more arranged and mature bone trabeculae. The area of new bone formation was significantly higher in the experimental than the control group. ConclusionsElectrospun nanocomposite [PCL/Alg/nano-HA (nHA)] represents a highly qualified material that can efficiently enhance bone regeneration.

Effect of Low-intensity Pulsed Ultrasound on Healing of Bone Defects in Rat Tibia as Measured by Reconstructed Three-dimensional Analysis of Micro CT Images.

The aim of this study was to evaluate the effect of low-intensity pulsed ultrasound (LIPUS) on bone metabolism during the healing period in rat tibiae bone defects using micro-computed tomography (micro CT) imaging for three-dimensional morphological evaluation. The right tibia received ultrasound exposure (US group) every day, whereas the opposite side served as a control (Control group). At 1, 2, and 3 weeks after the operation, micro CT was performed, and the volume and surface area of new bone formation in the bone defects was evaluated three-dimensionally. Bone volume (BV) and bone surface (BS) in the tibiae of both the US and Control groups demonstrated the highest values 1 week after the operation, with no significant differences between the groups. At 2 weeks after the operation, the BV and BS values in both groups had decreased, but the decrease was smaller in the US group than the Control group. At 3 weeks after the operation, the BV and BS values in the Control group were significantly lower than those in the US group. LIPUS stimulation can prevent bone loss during the healing of bone defects.

The use of rhBMP2 for augmentation of established horizontal/vertical defects may require additional use of rhVEGF to achieve significant bone regeneration: An in vivo experimental study.

To test the hypothesis that the use of rhBMP2 in established defects requires additional growth factors such as rhVEGF to accomplish effective bone repair. Horizontal/vertical defects of 2cm length and 1cm height were created bilaterally in the alveolar crest of the maxillae of 18 minipigs together with the extraction of all premolar teeth and one molar tooth on both sides. After 3months of healing, defects were augmented with 0.5g particulate PDLLA/CaCO3 composite loaded with 400µg rhBMP2/50µg rhVEGF165 on one side and 800µg rhBMP2 on the other in 12 test animals, whereas defects in six control animals were sham operated and left unfilled on one side and augmented with blank carriers on the other. After 4 and 13weeks, the animals were evaluated each for area of new bone formation (mm²) and bone density (area %). Augmentations with carriers loaded with 800g µrhBMP2 failed to induce significantly more bone than in the augmentations with unloaded carrier after 4 and 13weeks (p=.1000, p=.381). Augmentations with carriers loaded with 400µg rhBMP2 and 50µg erhVEGF165 resulted in significantly increased bone formation after 13weeks (p=.024) compared to blank carriers. Soft tissue in augmentations with combined rhBMP2/rhVEGF165 loading exhibited numerous microvessels compared to soft tissue in augmentations with rhBMP2. It is concluded that effective bone regeneration in augmentations of established alveolar ridge defects may require the application of rhVEGF additionally to rhBMP2.

The Effect of Systemic Administration of Co-enzyme Q10 on Orthodontic Relapse in a rabbit model

ABSTRACT Introduction: Several pharmacological agents have been investigated for their ability to reduce orthodontic relapse. Objective: The current research was performed to test the short term influence of systemic Co-enzyme Q10 administration on post-orthodontic relapse in rabbits. Materials and methods : Thirty New Zealand rabbits were randomly divided into 2 groups (n=15) : Experimental receiving Co-enzyme Q10 and control receiving control vehicle. Orthodontic tooth movement was performed using NiTi coil spring for 21 days for both groups, then this coil spring was detached, and teeth were allowed to relapse for another 21 days. Amounts and percentages of relapse were assessed on three-dimensional models of the experimental and control groups at two time points (T2: 1 week of relapse) and (T3: three weeks of relapse). Animals were sacrificed after 3 weeks of relapse for histological examination using H&E stain. Also, histomorphometric analysis was performed. Statistical analysis was computed. Significance was judged at the 5% level. Results: The amount and percentage of relapse showed insignificant difference among experimental and control groups, although relapse in the experimental group was less. However, the histological analysis showed that Co-enzyme Q10 resulted in significant reduction in osteoclast count with the area of new bone formation being significantly increased. Signs of bone resorption were more evident in the control group. Conclusions: From the present results, it could be concluded that Co-enzyme Q10 is capable of altering bone resorption pattern favorably in spite of its short term ineffectiveness in minimizing relapse.

Effects of the technique and drill design used during the osteotomy on the thermal and histological stimulation

The objective of our in vivo study was to compare the effects of the osteotomy on the thermal alterations, the bone healing and count of polymorphonuclear cells, comparing the drill design (cylindrical or conical) using continuous or intermittent movement. Twelve rabbits were used, which were made four osteotomies (n = 2 per tibia) to simulate the surgical drilling sequence for the installation of a dental implant at 8 mm of length and regular diameter. Four groups were proposed: group G1, cylindrical drill with continuous movement; group G2, cylindrical drill with intermittent movement; group G3, conical drill with continuous movement; and, group G4, conical drill with intermittent movement. Thermal mean variation was 6.91 ± 1.4 °C in group 1, 4.30 ± 1.3 °C in group 2, 2.78 ± 0.6 °C in group 3, and 2.77 ± 0.7 °C in group 4. Whereas the mean area of new bone formation was 1.00 ± 0.3 mm2 in group 1, 1.48 ± 0.3 mm2 in group 2, 2.20 ± 0.4 mm2 in group 3, and 2.43 ± 0.4 mm2in group 4. The mean count of polymorphonuclear cells, in the group 1 was 62.4 ± 5.9 cells, group 2 was 50.7 ± 4.2 cells, group 3 was 44.4 ± 3.7 cells, and group 4 was 42.4 ± 3.7 cells. The conical drill sequence produced a significantly smaller increase in temperature during both techniques (continuous and intermittent), more effective new bone formation and a smaller number of polymorphonuclear cells. During the osteotomy for the installation of implants, the professional must take to consider the drill design to perform a less traumatic surgical technique, which can improve and facilitate the healing of peri-implant tissues.

Immediate versus delayed application of bone morphogenetic protein-2 solution in damaged extraction sockets: a preclinical in vivo investigation

To compare the clinical, radiographic, and histological healing patterns between the immediate and delayed applications of bone morphogenetic protein-2 (BMP-2) in damaged extraction sockets in dogs. The distal roots of the fourth premolars of the mandible were extracted bilaterally in five beagle dogs, and buccal bone defects (4mm wide and 9mm high) were surgically created. Collagenated biphasic calcium phosphate (CBCP) soaked for 10min in 100μL of BMP-2 solution was applied immediately to the defect site in the control group. In the test group, the BMP-2 solution of same dose was injected into the grafted site 2weeks after grafting with a saline-soaked CBCP. The dogs were sacrificed 2weeks later. Clinical, histological, and radiographic analyses were followed. Swelling and inflammatory reactions were predominantly observed in the control group at 2weeks. The area of new bone formation was significantly larger in the control group compared with the test group (10.8 ± 7.0 mm2 [mean ± SD] and 6.3 ± 3.1 mm2, respectively; p = 0.043). No significant difference was found in ridge width at 2mm, 4mm and 6mm below the lingual bone crest between the control (2.6 ± 1.0mm, 3.2 ± 0.9mm and 4.5 ± 0.5mm, respectively) and test group (3.3 ± 1.0mm, 3.7 ± 1.3mm and 4.2 ± 1.0mm; all p > 0.05). Delayed application of BMP-2 2weeks after surgery did not show any advantage over immediate application of BMP-2 in terms of new bone formation. This study suggests that it might be better to apply BMP-2 immediately in alveolar ridge preservation, instead of delayed application, in order to enhance new bone formation.

Transplant chimerism in porcine structural vascularized bone allotransplants

BackgroundBone allotransplant viability can be maintained long-term by implanting arteriovenous (AV) bundles and creating an autogenous neoangiogenic circulation. Only short-term immunosuppression is required. This study investigates the origin of viable osteocytes observed in areas of active bone remodeling in orthotopically transplanted tibiae in a Yucatan mini-pig model. MethodsSegmental tibial defects created in female Yucatan minipigs (N = 14) were reconstructed with a matched vascularized composite allotransplant from a male donor. The circulation was microsurgically restored, with simultaneous autogenous AV-bundle implantation in group 1 (N = 7). A ligated AV-bundle was implanted as a no-angiogenesis control in group 2 (N = 7). After 20-weeks, repopulation of the allotransplant was assessed by real-time qPCR measurement of relative copy numbers of a Y chromosome-specific gene (SRY) and an autosomal housekeeping gene, ribosomal protein L4 (RPL4). A lower SRY/RPL4 ratio demonstrates replacement of male allogeneic cells with female, autogenous cells in the sample. Genomic DNA was extracted from cross-sections of the allotransplant, liver and spleen. Additionally, areas of new bone formation within the allotransplant were sampled by laser capture microdissection. A comparison was made between groups as well as male control samples. RNA was extracted from bone as well, as a measure of metabolically active cells. ResultsLaser-captured areas of new bone formation in animals with both normal and ligated AV-bundles were found to have significantly lower relative copy numbers of SRY (p = 0.03) than control specimens from male bone, indicating replacement by female (autogenous) bone-forming cells. Analysis of an entire segment of the allotransplant from Group 1 was similarly reduced (p = 0.04), unlike that from Group 2. RNA expression of SRY was observed in both groups. No chimerism could be found in non-bone tissues (liver and spleen). ConclusionWe observed a significant level of transplant chimerism in areas of new bone formation sampled by laser capture microdissection. The migration of autogenous cells including osteocytes was seen in both groups. Survival of some allogeneic (male) cells was also demonstrable. No microchimerism was found in liver and spleen.

Available Findings Fail to Provide Strong Evidence of the Role of Bone Morphogenic Protein-2 in Femoral Head Osteonecrosis.

Despite widespread research on non-traumatic femoral head osteonecrosis (FHON), there is no consensus about preventative treatment options. Insufficient blood supply and increased intra-osseous pressure are the initiating events in the majority of cases. BMPs are growth factors that belong to the transforming growth factor β (TGFβ) superfamily. Two specific formulations of BMPs have already been approved by the FDA: 1. BMP-2 (Infused, Medtronic) for the treatment of tibial open fractures and spinal fusion; 2. BMP-7 (OP-1, Stryker) in the setting of long bone non-unions. To our knowledge there is no published work reviewing the utility of BMP-2 in the setting of FHON. Online databases (EMBASE, Cochrane, MEDLINE and PubMed) for literature relating to the use of BMP-2 in the treatment of FHON on 2nd June 2017. Animal studies: A total of 169 animal subjects with induced FHON were treated with BMP-2 in all the included in vivo studies. Improved histological parameters, areas of revascularization, areas of new bone formation and osteoid deposition were seen in all studies. The number of osteoclasts decreased post operatively, in the ibandronate and BMP-2 group. Human studies: In combination, 96 human hips were treated in two studies utilizing BMP-2 and mean follow-up was at least five years. Success rate of BMP-2 was above 80 % (based on Harris score and WOMAC score) in both studies. Both are level III studies. The present review of animal and clinical studies could not find well-designed prospective comparable studies with large sample size and preliminary evidence is not sufficient to supports the utilization of BMP-2, and its impact on the midterm outcomes of FHON.

Effects of Erythropoietin on The Healing of Calvarial Bone Defect

Objectives To evaluate the effect of a single-dose local administration versus the systemic administration of Erythropoietin on bone healing in calvarial bone defectsMaterial & Methods Critical-size cranial osteotomy defects were created in 30 rabbits. The animals were randomly divided into 3 groups. The animals were randomly divided into 3 groups (n= 10 animals in each group). In the Group I, the bone defect was only filled with a collagen sponge soaked with erythropoietin. In the Group II, it was filled with a collagen sponge and erythropoietin injected systemically. While in the Group III, the defect was filled with a collagen sponge. The groups were further split in two for euthanasia 10- and 21-days post-surgery. New bone formation and neovascularization were evaluated by hematoxylin-eosin. For the 10-days samples, all the groups analyzed for area percent of blood vessels while on the 21- day samples, the area of new bone formation was calculated. Differences between groups were analyzed by one-way ANOVA.Results At 10 days post-surgery, the histological analysis showed that the erythropoietin Groups exhibited a significantly higher percentage of bone formation compared with the other Group. At 21 days post-surgery, a higher percentage of new bone was observed in the erythropoietin group.Conclusions The results suggest that both local and systemic administration of erythropoietin hormone encouraged the bone healing in critical-size calvarial defects in Rabbits.

Microgrooves and Microrugosities in Titanium Implant Surfaces: An In Vitro and In Vivo Evaluation.

The physical characteristics of an implant surface can determine and/or facilitate osseointegration processes. In this sense, a new implant surface with microgrooves associated with plus double acid treatment to generate roughness was evaluated and compared in vitro and in vivo with a non-treated (smooth) and double acid surface treatment. Thirty disks and thirty-six conical implants manufactured from commercially pure titanium (grade IV) were prepared for this study. Three groups were determined, as described below: Group 1 (G1), where the samples were only machined; group 2 (G2), where the samples were machined and had their surface treated to generate roughness; and test group 3 (G3), where the samples were machined with microgrooves and the surface was treated to generate the roughness. For the in vitro analysis, the samples were submitted to scanning microscopy (SEM), surface profilometry, the atomic force microscope (MFA) and the surface energy test. For the in vivo analyses, thirty-six implants were placed in the tibia of 9 New Zealand rabbits in a randomized manner, after histological and histomorphometric analysis, to determine the level of contact between the bone and implant (BIC%) and the bone area fraction occupancy (BAFO%) inside of the threads. The data collected were statistically analyzed between groups (p < 0.05). The in vitro evaluations showed different roughness patterns between the groups, and the G3 group had the highest values. In vivo evaluations of the BIC% showed 50.45 ± 9.57% for the G1 group, 55.32 ± 10.31% for the G2 group and 68.65 ± 9.98% for the G3 group, with significant statistical difference between the groups (p < 0.0001). In the BAFO% values, the G1 group presented 54.97 ± 9.56%, the G2 group 59.09 ± 10.13% and the G3 group 70.12 ± 11.07%, with statistical difference between the groups (p < 0.001). The results obtained in the evaluations show that the surface with microgrooves stimulates the process of osseointegration, accelerating the healing process, increasing the contact between the bone and the implant and the area of new bone formation.

Effects of transplantation of FGF-2-transfected MSCs and XACB on TNF-α expression with avascular necrosis of the femoral head in rabbits.

Objective: The present study aimed to investigate the effect of the transplantation of basic fibroblast growth factor (FGF-2) gene-transfected mesenchymal stem cells (MSCs) and xenogeneic antigen-cancellous bone (XACB) on tumor necrosis factor-α (TNF-α) expression with avascular necrosis of the femoral head (ANFH) in rabbits. Methods: The models of steroid-induced osteonecrosis in rabbits were randomly divided into five groups: A (model), B (XACB), C (XACB + MSCs), D (XACB + MSCs + LV), and E (XACB + MSCs + LV-FGF-2) groups. The therapeutic effect was evaluated by Hematoxylin and Eosin (H&E) staining. Immunohistochemical and RT-PCR assays were used to detect the protein and mRNA expression of TNF-α in the femoral head, respectively. Results: At 12 weeks after the operation, the defect in rabbits in group E was completely repaired, while defects in rabbits in the other groups were not completely repaired, and the area of new bone formation was higher, when compared with the other groups (P<0.05). Furthermore, the protein and mRNA expression TNF-α was lower at 3, 6, and 12 weeks after surgery, when compared with the other groups, and the difference was statistically significant (P<0.05). Conclusion: FGF-2/MSCs/XACB could promote the repair of ANFH, and may be correlated to the inhibition of TNF-α expression.

A 3D-printed polycaprolactone/β-tricalcium phosphate mandibular prosthesis: A pilot animal study.

In this study, we assessed the effectiveness of a tonsil-derived mesenchymal stem cell (TMSC)-transplanted polycaprolactone/beta-tricalcium phosphate prosthesis (specifically designed for easier fixing and grafting with a single scaffold) on rabbit mandible osteogenesis. The mandibles of 18 rabbits were exposed, and 10 × 8-mm bone defects were made. Two rabbits did not receive implants; four were reconstructed with the scaffold control (SC) (SC group); four were reconstructed with scaffolds soaked in peripheral blood (PB) (PB group); four were reconstructed with TMSC-transplanted scaffolds (TMSC group); and four were reconstructed with differentiated osteocyte-transplanted scaffolds (DOC) (DOC group). Each rabbit was sacrificed 12 weeks after surgery, and the area of new bone formation was investigated by mechanical testing, histology, and micro-computed tomography. More extended and denser new bone masses were observed in the TMSC and DOC groups, although fibrosis and vascular formation levels were similar in all groups, suggesting that the dual-structured scaffold alone provides a good environment for bone attachment and regeneration. The bone volumes of representative scaffolds from the SC, PB, TMSC, and DOC groups were 43.12, 48.35, 53.10, and 57.44% of the total volumes, respectively. The design of the scaffold resulted in effective osteogenesis, and TMSCs showed osteogenic potency, indicating that their combination could enable effective bone regeneration. NA Laryngoscope, 130:358-366, 2020.

Buccal fat pad-derived stem cells with anorganic bovine bone mineral scaffold for augmentation of atrophic posterior mandible: An exploratory prospective clinical study.

Application of adipose-derived stem cells originated from buccal fat pad (BFP) can simplify surgical procedures and diminish clinical risks compared to large autograft harvesting. This study sought to evaluate and compare the efficacy of buccal fat pad-derived stem cells (BFPSCs) in combination with anorganic bovine bone mineral (ABBM) for vertical and horizontal augmentation of atrophic posterior mandibles. Fourteen patients with atrophic posterior mandible were elected for this prospective exploratory study. BFP (3-5 mL) was harvested and BFPSCs were isolated and combined with ABBM at 50% ratio. The vertical and horizontal alveolar deficiencies were augmented by 50% mixture of ABBM with either BFPSCs (group 1) or particulated autologous bone (group 2). Titanium mesh was contoured to the desired 3D shape of the alveolar ridge and fixated to the host sites over the graft material of the two groups. At first, the amount of new bone areas was calculated by quantitative analysis of cone beam computed tomography (CBCT) images that were taken 6 months postoperatively according to regenerative techniques (group 1 vs group 2 without considering the type of bone defects). Second, these amounts were calculated in each group based on the type of defects. Quantitative analysis of CBCT images revealed the areas of new bone formation were 169.5 ± 5.90 mm2 and 166.75 ± 10.05 mm2 in groups 1 and 2, respectively. The area of new bone formation for vertical defects were 164.91 ± 3.74 mm2 and 169.36 ± 12.09 mm2 in groups 1 and 2, respectively. The area of new bone formation for horizontal deficiencies were 170.51 ± 4.54 mm2 and 166.98 ± 9.36 mm2 in groups 1 and 2, respectively. There were no statistically significant differences between the two groups in any of the pair-wise comparisons (P > 0.05). The findings of the present study demonstrated lack of difference in bone volume formation between BFPSCs and autologous particulate bone in combination with ABBM. If confirmed by future large-scale clinical trial, BFPSCs may provide an alternative to autogenous bone for reconstruction of alveolar ridge defects.

Leukemia in Ancient Egypt: Earliest case and state‐of‐the‐art techniques for diagnosing generalized osteolytic lesions

AbstractMalignant bone tumors are uncommon among archaeological skeletal remains, and the general skeletal involvement is even less frequent. Multiple myelomas along with metastases are the most common conditions in paleopathology, whereas malignant myeloproliferative diseases have only been described in a handful of cases.We present a probable case of acute lymphocytic leukemia in a skeleton of an individual from Ancient Egypt, dated to the end of the First Intermediate Period and the beginning of the Middle Kingdom (c 2160–2000 bc). The excavation of the Temple of Millions of Years of Thutmosis III located in el‐Assasif (Luxor, Upper Egypt) recovered a total of 41 complete individual from an associated grave‐Necropolis placed close to the north enclosure wall. The individual, a 16 to 21‐year‐old male, showed a severe disease affecting all the skeleton with, predominantly, osteolytic lesions and areas of new bone formation. Gross examination under magnification and X‐ray in field were performed.We review the paleopathological literature to compare the cases previously reported of malignant disease. The morphology and distribution of the lesions of the individual are discussed to make an adequate differential diagnosis in the individual. Several criteria suggest that the disease was most likely acute lymphocytic leukemia: The individual died before the age of 21, the patterns of the bone lesions as well as its distribution below the elbow and knee joints, the presence of a gap in the coronal suture, and the mandible involvement.If this is the case, it would be the oldest case of leukemia described in Ancient Egypt and could help to understand the evolution patterns of cancer in the history.

Evaluation of Osteoconduction of Biphasic Calcium Phosphate Ceramic in the Calvaria of Rats: Microscopic and Histometric Analysis.

(1) Background: Evaluate the osteoconduction capability of a biphasic calcium phosphate (BCP) ceramic composed of hydroxyapatite and β-tricalcium phosphate 60%/40% in a rat model. (2) Methods: In the calvarial bone of 54 adult male rats, 7-mm diameter critical size defects were performed. The animals were randomly allocated to three experimental groups according to the type of material: blood clot (BCG), blood clot covered with a bovine-derived collagen membrane (MBCG), and BCP ceramic covered with a bovine-derived collagen membrane (BCPG). In each group, 6 animals were euthanatized at post-operative days 7, 30, and 60 for histological and histometric analysis. (3) Results: The qualitative analysis revealed the persistence of the collagen membrane at seven days, with no relevant newly bone formation in all groups. At 30 days, centripetal bone formation was observed residual particles of the biomaterial surrounded by fibroblasts noted in the BCPG. At 60 days, while BCG and MBCG showed a partial maturation with the central part of the defect populated by a fibrous connective tissue, in the BCPG the critical area was entirely occupied by newly formed bone. In the intra groups analysis was noted a significant increase in new bone formation during the experimental period (p < 0.05). At 60 days, BCPG showed a higher percentage area of new bone formation (p < 0.05). (4) Conclusion: BCP promoted a new bone formation by osteoconduction and might be considered a valid alternative in bone regeneration procedures.

Temporomandibular arthropathies: A retrospective study with histopathological characteristics.

BackgroundTo investigate the incidence of temporomandibular arthropathies diagnosed in a university center and to describe their histopathological characteristics.Material and MethodsTemporomandibular arthropathy cases with corresponding slides were selected from an oral and maxillofacial surgical pathology service. Cases of exclusively articular disc disease were not included.ResultsThe mean age was 31.3 years with a predominance of females (69.7%). Of these diagnoses, 53.6% were unilateral condylar hyperplasia, 17.8% were bony ankylosis, 14.3% were degenerative joint disease, 10.7% were osteochondroma, and 3.6% were synovial chondromatosis. Condylar hyperplasia presented as thick fibrocartilage and cartilage nests in the cancellous bone. Bony ankylosis exhibited lamellar bone and nests of chondrocytes. Degenerative joint disease presented as an irregular layer of fibrocartilage with areas of clustered chondrocytes and calcified cartilage. Osteochondroma of the condyle exhibited hyaline cartilage and areas of new bone formation. Synovial chondromatosis presented as immature cartilaginous tissue and randomly arranged chondrocytes.ConclusionsThe pathological alterations verified in these arthropathies involved diseases that were predominantly proliferative, i.e., unilateral condylar hyperplasia, osteochondroma and synovial chondromatosis of the tumor or pseudotumor type and bony ankylosis associated with callus formation of the reparative type, and less frequent degenerative changes for which the disease is so named. Key words:Temporomandibular joint, pathology, ankylosis, pathology, arthritis, degenerative, osteochondroma, chondromatosis, synovial.

Treatment of intrabony defects with modified perforated membranes in aggressive periodontitis: subtraction radiography outcomes, prognostic variables, and patient morbidity

ObjectivesThe main objectives of this study were (1) to evaluate bone/graft density alterations by digital subtraction radiography; (2) to determine factors associated with favorable clinical and radiographic outcomes, and (3) to report on patient morbidity after guided tissue regeneration (GTR) in aggressive periodontitis (AgP) patients.Materials and methodsAdapting a split-mouth design, 30 comparative intrabony defects in 15 patients were randomly treated with xenogenic graft plus modified perforated membranes (MPM, tests) or xenogenic graft plus standard collagen membranes (CM, controls). The time period of observation was 12 months.ResultsThere were significant improvements in clinical and radiographic parameters within each group, without intergroup differences. However, higher PPD reduction for three-wall defects was noted in MPM sites (5.22 versus 3.62 mm; p = 0.033). Moreover, a significant gain in bone/graft density of 4.9% from 6 to 12 months post-operatively was observed in test sites. Multivariate analysis demonstrated that morphology of intrabony defects was a predictor of CAL gain (p = 0.06), while independent prognostic variables effecting changes in bone/graft density were radiographic defect depth (p = 0.025) and radiographic angle (p = 0.033). The majority of patients reported some discomfort, pain, and edema with mild intensity without any significant differences between treatment modalities.ConclusionsThis study demonstrated enhanced bone/graft density gain after GTR with MPM, which may indicate greater area of new bone formation. Independent variables effecting treatment outcomes were intrabony defect morphology, radiographic defect depth, and radiographic angle.Clinical relevanceThis study supports the regenerative treatment of intrabony defects in AgP patients and identifies some variables with prognostic value.