Bone Biopsy Specimens Research Articles

ОЦЕНКА ИММУНО-МОРФОЛОГИЧЕСКИХ ПАРАМЕТРОВ ЛОКАЛЬНОГО ОЧАГА ХРОНИЧЕСКОГО ПЕРИАПИКАЛЬНОГО ВОСПАЛЕНИЯ ПРИ ПРОВЕДЕНИИ ДЕНТАЛЬНОЙ ВНУТРИКОСТНОЙ ИМПЛАНТАЦИИ

Subject of study. In the current period, complex rehabilitation of patients with orthopedic structures supported by intraosseous dental implants is the leading method. Clinical situations of implant placement in areas of chronic periapical inflammation aren’t uncommon, while destructive forms of chronic periodontitis are characterized by processes that affect innate immunological reactions, which, in turn, affects osteoreparative processes, contributing to bone loss and complications. To minimize bone loss in the area of the extracted tooth, various methods of alveolar ridge preservation are currently proposed, however, there is a shortage of studies that study the quality of bone tissue and the inflammatory component. The purpose of the study is to analyze and evaluate the morphological and immunological indicators of the focus of chronic periapical inflammation in various forms of chronic periodontitis for dental intraosseous implantation using a delayed protocol. Methodology. The study, characterized by a two-component design, included a clinical and laboratory examination of 60 dental patients. The first stage was a study of the indicators of phagocytosis of neutrophils in the separated tooth socket and a histological study of trephine biopsy specimens of the alveolar bone with calculation of the inflammation index in various forms of chronic periodontitis; at the second stage, 12–14 weeks after tooth extraction, before implant installation, the morphological characteristics of the bone biomaterial were studied, conducting a comparative analysis of the indicators of patients with socket preservation using the generally accepted method and without preservation. Results. Based on the results of the study, it was concluded that predictors of inflammatory complications were found in patients. regardless of the form of chronic periodontitis: significantly increased rates of wound neutrophil phagocytosis, and a histological index of bone tissue inflammation higher than the control data. The study of morphological parameters before the installation of intraosseous dental implants in patients with conservation of the socket of extracted teeth with chronic periodontal foci according to the generally accepted method made it possible to register histological signs of chronic intraosseous inflammation that persisted after 12–14 weeks.

Prostate cancer–induced endothelial-cell-to-osteoblast transition drives immunosuppression in the bone–tumor microenvironment through Wnt pathway–induced M2 macrophage polarization

Immune checkpoint therapy has limited efficacy for patients with bone-metastatic castration-resistant prostate cancer (bmCRPC). To improve immunotherapy for bmCRPC, we aimed to identify the mechanism of bmCRPC-induced changes in the immune microenvironment. Among bmCRPC patients, higher levels of a 32-gene M2-like macrophage signature in bone metastasis samples correlated with shorter overall survival. Immunohistochemistry showed that CD206-positive (CD206+) macrophages were enriched in bmCRPC bone biopsy specimens compared with primary tumors or lymph node metastases. In preclinical osteogenic prostate cancer (Pca) xenograft models, CD206+ macrophages were recruited to areas with tumor-induced bone. RNA sequencing (RNAseq) analysis showed higher expression of an M2-like gene signature, with activated canonical and noncanonical Wnt pathways, in tumor-associated macrophages isolated from osteogenic tumors (bone-TAMs) than in TAMs isolated from nonosteogenic tumors (ctrl-TAMs). Mechanistic studies showed that endothelial cells (ECs) that had undergone EC-to-osteoblast (EC-to-OSB) transition, the precursors of tumor-induced OSBs, produced paracrine factors, including Wnts, CXCL14, and lysyl oxidase, which induced M2 polarization and recruited M2-like TAMs to the bone-tumor microenvironment (bone-TME). Bone-TAMs suppressed CD8+ T cells' proliferation and cytolytic activity, and these effects were partially reversed by treating bone-TAMs with Wnt inhibitors. Genetic or pharmacological inhibition of Pca-induced EC-to-OSB transition reduced the levels of M2-like macrophages in osteogenic tumors. Our study demonstrates that Pca-induced EC-to-OSB transition drives immunosuppression in the bone-TME, suggesting that therapies that reduce Pca-induced bone formation may improve immunotherapeutic outcomes for bmCRPC.

Anti-IL12p40 autoantibodies in a teenage girl with multiple recurrent abscesses

More frequent among adults, phenocopies may be caused by somatic mutations or anti-cytokine autoantibodies, mimicking the phenotypes of primary immunodeficiencies. A fourteen-year-old girl was referred for a two-year history of weight loss and multiple recurrent abscesses, complicated recurrent pneumonia, pyelonephritis, osteomyelitis, and septic shock, without fever. She had started with nausea, hyporexia, and weight loss, then with abscesses in her hands, knee, ankle, and spleen. She also developed a rib fracture and left thoracic herpes zoster. The patient was cachectic, with normal vital signs, bilateral crackles on chest auscultation, tumefaction of the knee joint, and poorly healed wounds in hands and chest, oozing a yellowish fluid. Chest computed tomography revealed multiple bilateral bronchiectases. Laboratory workup reported chronic anemia, leukocytosis, neutrophilia, mild lymphopenia, thrombocytosis, pan-hypergammaglobulinemia, and elevated acute serum reactants. Lymphocyte subsets were low but present. Mycobacterium tuberculosis was detected via polymerase chain reaction in a bone biopsy specimen from ankle osteomyelitis. Whole-exome sequencing failed to identify a monogenic defect. Interleukin-12 was found markedly elevated in the serum of the patient. Phosphorylation of STAT4, induced by increasing doses of IL-12, was neutralized by patient serum, confirming the presence of anti-IL12 autoantibodies. IL-12 and IL-23 are crucial cytokines in the defense against intracellular microorganisms, the induction of interferon-gamma production by lymphocytes, and other inflammatory functions. Patients who develop neutralizing serum autoantibodies against IL12 manifest late in life with weight loss, multiple recurrent abscesses, poor wound healing, and fistulae. Treatment with anti-CD20 monoclonal antibodies was effective.

Differences in tissue-level properties as assessed by nano-scratching in patients with and without atypical femur fractures on long-term bisphosphonate therapy: a proof-of-concept pilot study.

Atypical femur fractures (AFFs) are a well-established complication of long-term bisphosphonate (BP) therapy, but their pathogenesis is not fully understood. Although many patients on long-term BP therapy have severe suppression of bone turnover (SSBT), not all such patients experience AFF, even though SSBT is a major contributor to AFF. Accordingly, we evaluated tissue level properties using nano-scratch testing of trans-iliac bone biopsy specimens in 12 women (6 with and 6 without AFF matched for age and race). Nano-scratch data were analyzed using a mixed-model ANOVA with volume-normalized scratch energy as a function of AFF (Yes or No), region (periosteal or endosteal), and a first-order interaction between region and AFF. Tukey post hoc analyses of the differences of least squared means of scratch energy were performed and reported as significant if p<.05. The volume-normalized scratch energy was 10.6% higher in AFF than in non-AFF patients (p=.003) and 17.9 % higher in the periosteal than in the endosteal region (p=.004). The differences in normalized scratch energy are suggestive of a higher hardness of the bone tissue after long-term BP therapy. The results of this study are consistent with other studies in the literature and demonstrate the efficacy of using Nano-Scratch technique to evaluate bone tissue that exhibits SSBT and AFF. Further studies using nano-scratch may help quantify and elucidate underlying mechanisms for the pathogenesis of AFF.

Cladribine in the Treatment of Multifocal Multisystem Langerhans Cell Histiocytosis in a Patient with a Poor Prognosis. A Case Report

Langerhans cell histiocytosis is a hematologic clonal disease. The treatment of localized histiocytosis includes local methods such as radiotherapy or surgery. In cases of disseminated lesions with multiple system damage, chemotherapy is administered, which provides recovery in some patients. The present paper is a case report of multifocal multisystem Langerhans cell histiocytosis with bone, liver, spleen, abdominal lymph node and pituitary lesions in a 40-year-old patient. The diagnosis was verified by histology and immunohistochemistry of bone biopsy specimens. Polymerase chain reaction revealed no V600E mutation in the BRAF gene in tumor tissue. Persistent antitumor response was achieved after 6 chemotherapy cycles with cladribine monoregimen. This drug was well tolerated by the patient. By the time of this publication, the patient had preserved the persistent response for 38 months.

Retrospective Characterization of Bone Histomorphometric Findings in Clinical Patient Specimens.

Bone histomorphometry provides comprehensive information on bone metabolism and microstructure. In this retrospective study, we aimed to obtain an overview of the typical indications, referring hospitals, and histomorphometric quantification-based diagnoses of the bone tissue in our histomorphometry laboratory, the only laboratory in Finland carrying out histomorphometric examination of clinical bone biopsies. Between January 1, 2005 and December 31, 2020, 553 clinical bone biopsies were sent to our histomorphometry laboratory for histomorphometric examination. The median age of the patients was 55 years (range, 0.2-89.9 years), 51% of them were males, and 18% comprised pediatric patients. We received bone biopsy specimens from 23 hospitals or healthcare units. The majority of the samples we sent by nephrologists. The most common bone biopsy indications were suspicion of renal osteodystrophy (ROD), unknown bone turnover status in osteoporosis, and several or untypical fractures. The most common quantitative bone histomorphometry-based diagnosis was ROD. This study provides information on the clinical application of bone histomorphometry in Finland. Precise and quantitative ROD evaluation is the most common indication for bone histomorphometry, being crucial in clinical decision-making and targeted treatment of this patient group.

Obtaining a bone biopsy in acute hematogenous osteomyelitis using a new surgical instrument: A technical note

Acute hematogenous osteomyelitis is an infectious and inflammatory tubular bone disease involving the bone marrow. The final diagnosis is made based on a morphological study obtained from a bone biopsy. We have developed and patented a surgical instrument (Patent RU No 176629) for one-stage osteoperforation and trepan biopsy. Bone biopsy specimens obtained have been tested for their suitability for morphological examination, namely light and electron microscopy. It has a diagnostic and therapeutic function. This report aimed to describe a new bone biopsy tool that allows obtaining specimens suitable for morphological studies.

Characterization of Microarchitectures, Stiffness and Strength of Human Trabecular Bone Using Micro-Computed Tomography (Micro-CT) Scans

The present work presents evaluation and experimental verification of the use of X-ray computed tomographic microscopy (micro-CT) for accurate characterization of geometry, microarchitecture, and stiffness properties of bones. These properties are crucial for designing and building optimized implants for joint and dental reconstruction applications. High-resolution micro-CT scans would provide more detailed and accurate information about the microarchitecture and density distribution across patient bones. Nevertheless, micro-CT applications on live patients require invasive procedures involving small bone biopsy specimens. Alternatively, micro-CT could be used on samples collected from selected cadavers of different age, gender, and race groups to establish a database that could be used for providing useful microarchitecture information. The micro-CT scans of investigated bone samples reveal that the trabecular bone is anisotropic and heterogeneous. The results also showed considerable degree of parametric variability and uncertainty on microarchitecture and stiffness properties of patient’s trabecular bone.

Osteosarcoma.

Osteosarcoma is the most common primary malignant tumour of the bone. Osteosarcoma incidence is bimodal, peaking at 18 and 60 years of age, and is slightly more common in males. The key pathophysiological mechanism involves several possible genetic drivers of disease linked to bone formation, causing malignant progression and metastasis. While there have been significant improvements in the outcome of patients with localized disease, with event-free survival outcomes exceeding 60%, in patients with metastatic disease, event-free survival outcomes remain poor at less than 30%. The suspicion of osteosarcoma based on radiographs still requires pathological evaluation of a bone biopsy specimen for definitive diagnosis and CT imaging of the chest should be performed to identify lung nodules. So far, population-based screening and surveillance strategies have not been implemented due to the rarity of osteosarcoma and the lack of reliable markers. Current screening focuses only on groups at high risk such as patients with genetic cancer predisposition syndromes. Management of osteosarcoma requires a multidisciplinary team of paediatric and medical oncologists, orthopaedic and general surgeons, pathologists, radiologists and specialist nurses. Survivors of osteosarcoma require specialized medical follow-up, as curative treatment consisting of chemotherapy and surgery has long-term adverse effects, which also affect the quality of life of patients. The development of osteosarcoma model systems and related research as well as the evaluation of new treatment approaches are ongoing to improve disease outcomes, especially for patients with metastases.

Abstract #1323306: Establishing the Prevalence of Osteomalacia in Arab Adolescents Using Nutritional Biomarkers of Bone Health

The gold standard for osteomalacia diagnosis remains obtaining a bone biopsy specimen, an invasive procedure that most patients would not agree to. Establishing less invasive diagnostic criteria for this underdiagnosed entity is essential. This study was designed to assess the prevalence of biochemical osteomalacia in Saudi adolescents.

ODP450 A Case of Metastatic Medullary Thyroid Cancer Presenting with Pathologic Hip Fracture

Abstract Introduction Medullary thyroid cancer accounts for less than 5% of thyroid malignancies. Distant metastatic disease typically presents in lymph nodes, lung, liver and bone. We present a patient who initially presented with a pathologic hip fracture with bone biopsy revealing medullary thyroid carcinoma. Case Description A 44-year-old male with no past medical history presented to the emergency department for right hip pain following a mechanical fall. Imaging showed a right femoral neck pathologic fracture as well as lytic lesions within the right femoral neck and right ilium. Family history was significant for pancreatic cancer and breast cancer. The patient underwent bone biopsy of the right femur followed by total hip arthroplasty. Bone biopsy revealed metastatic medullary thyroid carcinoma. Thyroid ultrasound showed a 1.2 centimeter right solid hypoechoic nodule along with extensive cervical lymphadenopathy. Further imaging revealed metastatic disease throughout the thoracic spine, mediastinal lymphadenopathy, and a left 2.2 centimeter adrenal lesion with peripheral enhancement and possible necrosis. Carcinoembryonic antigen (CEA) level was 551 ng/mL (normal &amp;lt;4.7), calcitonin was 2,498 pg/mL (normal &amp;lt;10), and calcium levels were normal. Plasma free metanephrines were normal and plasma normetanephrines were less than two times the upper limit of normal. Genetic testing on the bone biopsy specimen revealed a RET p. C618S variant. Germline RET testing was collected. The patient was discharged with close follow-up with oncology to initiate systemic therapy and follow-up with endocrinology for the adrenal mass. Discussion Majority of cases of medullary thyroid carcinoma are sporadic. Patients typically present with a thyroid nodule with many having cervical lymph node involvement at diagnosis and 5-10% having distant metastatic disease. Our patient's initial presentation was unique in that he presented with a pathologic fracture. Bone metastases can be seen in about 30% of cases of metastatic medullary thyroid carcinoma. Calcitonin levels greater than 500 pg/mL require additional imaging to exclude metastatic disease. If RET mutational status is unknown, patients should be screened for primary hyperparathyroidism and pheochromocytoma. Screening for pheochromocytoma is critical in preoperative management of these patients. Treatment for patients with metastatic disease involves surgery, external beam radiotherapy, and kinase inhibitors. Presentation: No date and time listed

Method of Tissue Acquisition Affects Success of Comprehensive Genomic Profiling in Lung Cancer.

Multiple procedural techniques can be used to obtain tissue to create a formalin-fixed, paraffin-embedded specimen for comprehensive genomic profiling (CGP) in lung cancer. The literature is mixed on whether the procedure affects CGP success. To examine whether biopsy procedure affects lung cancer CGP success. This was a cross-sectional study of all patients with lung cancer whose specimens were submitted for CGP between January and February 2020. Multiple quality control metrics were used to determine whether cases were successfully profiled. In all, 3312 samples were identified. Overall, 67.5% (2236 of 3312) of samples were obtained from biopsies, 13.0% (432 of 3312) from fine-needle aspirations (FNAs), 9.7% (321 of 3312) from resections, 5.3% (174 of 3312) from fluid cytology cell blocks, and 4.5% (149 of 3312) from bone biopsies. Overall, 70.1% (2321 of 3312) of cases passed CGP, 15.4% (510 of 3312) of cases were released as qualified reports, and 14.5% (481 of 3312) of cases failed CGP. Resection samples were the most likely to be successfully sequenced, failing in only 2.8% (9 of 321) of instances, while fluid cytology specimens were the least likely, failing in 23.0% (40 of 174) of instances. Biopsy (14.5% [324 of 2236]), FNA (18.5% [80 of 432]), and bone biopsy (18.8% [28 of 149]) specimens failed at intermediate frequencies. On multivariate logistic regression analysis of CGP success on specimen type, fluid cytology (odds ratio [OR], 0.08; 95% CI, 0.03-0.19), biopsy (OR, 0.25; 95% CI, 0.11-0.52), FNA (OR, 0.14; 95% CI, 0.06-0.32), and bone biopsy (OR, 0.07; 95% CI, 0.03-0.17) specimens had decreased odds of CGP success relative to resection samples. Among patients with successfully sequenced samples, 48.0% were eligible for at least 1 therapy, based on a companion diagnostic or National Comprehensive Cancer Network biomarker. The method of tissue acquisition was an important preanalytic factor that determined whether a sample would be successfully sequenced and whether a clinically actionable genomic alteration would be detected.

Performance of an alloplastic material versus a mineralized allograft in alveolar ridge preservation: Clinical, micro-CT and histological analyses

Socket graft materials function as scaffolds for bone formation to preserve the alveolar ridge. The study aimed to evaluate alveolar ridge change and socket healing after grafting with an alloplast or allograft at 3 months post-extraction. In sixteen patients, 20 extracted sockets were grafted with biphasic calcium phosphate (BCP) or freeze-dried bone allograft (FDBA) and sealed with a platelet-rich fibrin. Alveolar ridge dimensions were assessed at immediate, 2, 6, 8, and 12 weeks postoperatively using cast-based measurements. After 12-week, ridge reduction was assessed by Cone-Beam CT (CBCT), the percentage of bone, and residual graft volumes and areas were assessed by using micro-CT and histomorphometry of bone biopsy specimens . Socket orifice of both groups was completely healed from 6 to 8 weeks. FDBA particles were blended with the surrounding bone better than BCP significantly ( P = 0.001). At a 12-week, the width and height reduction from cast-based of BCP (1.70 ± 1.10 mm , 0.72 ± 0.38 mm ) and FDBA (1.97 ± 0.83 mm , 0.66 ± 0.21 mm ) were agreed with CBCT (width: BCP 0.92 ± 0.34 mm , FDBA 0.98 ± 0.15 mm, buccal height: 0.49 ± 0.25 mm , 0.34 ± 0.25 mm , palatal height: 0.42 ± 0.13 mm , 0.35 ± 0.12 mm ) without significant difference. The bone volume and area of BCP (16.89 ± 7.46%, 18.40 ± 7.20%) were less than FDBA (22.37 ± 9.61%, 20.17 ± 4.59%) without statistical difference. The residual graft area of BCP (29.38 ± 7.96%) was higher than FDBA (22.50 ± 2.64%) significantly ( P < 0.05). The alloplast, BCP promoted less bone formation than the allograft, FDBA, but similarly preserved the alveolar ridge with minimal ridge reduction.

Effects of urolithin A on osteoclast differentiation induced by receptor activator of nuclear factor-κB ligand via bone morphogenic protein 2

ABSTRACT Urolithin A (UA) is an intestinal microbial metabolite derived from ellagitannins and a promising agent for treating osteoarthritis. However, its effects on osteoporosis are unclear. This study explored the effects of urolithin A (UA) on receptor activator of nuclear factor-κB ligand (RANKL)-induced osteoclasts and its underlying molecular mechanisms. RANKL treatment significantly increased tartrate-resistant acid phosphatase (TRACP) or osteoclast marker levels (P < 0.05), while adding UA decreased the RANKL-induced levels (P < 0.05) in RAW264.7 cells. Total RNA isolated from RANKL- or RANKL + UA-treated cells was sequenced, and the obtained transcriptome dataset revealed 2,399 differentially expressed genes. They were enriched in multiple pathways involved in rheumatoid arthritis, ERK1 and ERK2 cascade, regulation of inflammatory response, ECM-receptor interactions, and TNF signaling. Scanning electron microscopy showed that RANKL promoted bone resorption pits in bone biopsy specimens, whereas UA inhibited their formation. When bone morphogenic protein 2 (BMP2) was shRNA-silenced, the bone resorption pits were restored. Moreover, while RANKL significantly enhanced the levels of p-ERK2/ERK2, p-p38/p38, p-Akt1/Akt1, p-ERK1/ERK1, and osteoclast-related proteins (P < 0.05), UA reduced them. BMP2 silencing also reversed the UA inhibitory effect. Thus, UA represses the RANKL-induced osteoclast differentiation of RAW264.7 cells by regulating Akt1, p38, and ERK1/2 signaling, and BMP2 likely reverses the UA inhibitory effect via these pathways. We propose BMP2 as a potential drug target for treating bone metabolic diseases, such as osteoporosis.

Specific Characteristic of Hyperplastic Callus in a Larger Cohort of Osteogenesis Imperfecta Type V.

Hyperplastic callus (HPC) is the most conspicuous features of osteogenesis imperfecta (OI) type V, of which accurate diagnosis and treatment are facing challenges. We investigate the clinical features, and impact factors of HPC in OI type V patients. In this retrospective single-center study, a total of 21 patients with type V OI confirmed by IFITM5 mutation were included. Radiological characteristics of bone were evaluated by X-rays, dual-energy X-ray absorptiometry, and computed tomography scan. Bone biopsy specimens were performed and stained by routine hematoxylin-eosin. The effects of bisphosphonates on HPC were investigated. Eleven patients (52.3%) had HPCs at 19 skeletal sites, 11 of which affected the femur. Three patients developed four (21.1%) HPCs after fractures, and 15 (78.9%) HPCs occurred in absence of bone fracture. The progress of HPCs was variable, of which most HPCs enlarged in the initial phase and remained stable, and only one HPC dwindled in size. One patient had a rapidly growing mass on the right humerus, and biopsy showed irregular trabeculae of woven bone and immature bone and cartilage in the loose and edematous collagenous network without signs of tumor. Bisphosphonates treatment had no significant effects on HPC of OI patients. HPC is the specific characteristic of OI type V patients, and its location, shape, size, and progression are variable, and the femur is the most frequently involved site. It is very important to make a diagnosis of HPC through detecting IFITM5 mutation and completing pathological diagnosis if necessary. The treatment of HPC is worth further exploration.

Clinical Prediction of High-Turnover Bone Disease After Kidney Transplantation

Bone histomorphometric analysis is the most accurate method for the evaluation of bone turnover, but non-invasive tools are also required. We studied whether bone biomarkers can predict high bone turnover determined by bone histomorphometry after kidney transplantation. We retrospectively evaluated the results of bone biopsy specimens obtained from kidney transplant recipients due to the clinical suspicion of high bone turnover between 2000 and 2015. Bone biomarkers were acquired concurrently. Of 813 kidney transplant recipients, 154 (19%) biopsies were taken at a median of 28 (interquartile range, 18–70) months after engraftment. Of 114 patients included in the statistical analysis, 80 (70%) presented with high bone turnover. Normal or low bone turnover was detected in 34 patients (30%). For discriminating high bone turnover from non-high, alkaline phosphatase, parathyroid hormone, and ionized calcium had the areas under the receiver operating characteristic curve (AUCs) of 0.704, 0.661, and 0.619, respectively. The combination of these markers performed better with an AUC of 0.775. The positive predictive value for high turnover at a predicted probability cutoff of 90% was 95% while the negative predictive value was 35%. This study concurs with previous observations that hyperparathyroidism with or without hypercalcemia does not necessarily imply high bone turnover in kidney transplant recipients. The prediction of high bone turnover can be improved by considering alkaline phosphatase levels, as presented in the logistic regression model. If bone biopsy is not readily available, this model may serve as clinically available tool in recognizing high turnover after engraftment.

The Impact of Bone Mineral Density on Bone Metabolism and the Fracture Healing Process in Elderly Chinese Patients With Osteoporotic Vertebral Compression Fractures

Background: The aim of this study was to investigate the effect of bone mineral density (BMD) on bone histomorphological parameters and bone turnover markers (BTMs) following osteoporotic vertebral compression fracture (OVCF) and to determine the correlation between BMD and the percentage of middle height compression during the healing process. Methods: A total of 206 patients with OVCFs were included in this study. Bone biopsy specimens were acquired during surgery. Blood samples were obtained to determine the serum concentrations of BTMs. The patients were divided into 2 groups according to BMD.Results: The concentrations of N-terminal propeptide of type I collagen (PINP) in the T-score ≤ −2.5 group (50.92 ± 12.78 ng/ml) were significantly lower than those in the T-score > −2.5 group (68.75 ± 28.66 ng/ml, p = 0.025) 3–6 mo after fracture. Moreover, the volume of necrotic bone in the T-score ≤ −2.5 group (15.15 ± 5.44%) was higher than that (1.67 ± 0.79%, p < 0.001) in the T-score > −2.5 group during the same period. BMD was statistically correlated with cancellous bone content (RS = 0.761, p <0.001), PMHC (RS = 0.85, p < 0.001), fibrous tissue volume (RS = −0.376, p < 0.001), and necrotic bone content (RS = −0.487, p < 0.001).Conclusions: The healing process of OVCFs in the setting of low bone mass frequently occurs in the presence of decreased bone formation abilities, severe vertebral body height loss and a large amount of necrotic bone.

Division of an Iliac Crest Bone Biopsy Specimen to Allow Histomorphometry, Immunohistochemical, Molecular Analysis, and Tissue Banking: Technical Aspect and Applications.

ABSTRACTThe evaluation of bone complications in chronic kidney disease (CKD) often requires a bone biopsy, the analysis of which can refine the diagnosis of bone defects. Bone histomorphometry performed on sections of the iliac crest biopsy remains the reference procedure for the quantitative assessment of bone health in CKD patients, whereas immunohistochemistry and other molecular biology analyses are indispensable tools for studying the disrupted signaling pathways. Traditionally, the whole iliac crest biopsy was included in methyl‐methacrylate (MMA) and was exclusively used for bone histomorphometry to describe static, dynamic, and structural parameters. Therefore, further molecular analysis of the bone tissue or the need for tissue banking would require a second biopsy to be made, because inclusion in MMA prevents the extraction of good‐quality nucleic acids. In this work, we describe a simple approach to divide a single iliac crest bone biopsy into multiple parts. This allows for simultaneous assessments of histology, immunohistochemistry, biomolecular analysis, and tissue banking while preserving the same bone surface area for histomorphometry. © 2020 American Society for Bone and Mineral Research © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

Bone regeneration in the sockets of extracted teeth using an autologous dentin matrix

Dental implantation in the area of previously lost teeth is a modern way to rehabilitate edentulous patients. The search for osteoplastic materials and methods of preimplantation osteoplasty remains topical. One of these materials is an autogenous dentin matrix (ADM), which is based on a crushed extracted tooth. ADM production and application technologies are different and insufficiently tested. Nevertheless, the application of this technique may open up new clinical possibilities. The study on the use of ADM involved 20 patients from 18 to 65 years old. The patients underwent complex surgical and orthopedic treatment to restore chewing function. At the first stage, the extraction of teeth was performed with the simultaneous preservation of the socket of the extracted tooth ADM. The second stage was carried out 3-4 months later, which included the collection of bone biopsy specimen and subsequent dental implantation in the area of the previously extracted tooth. 42 specimens obtained 12-17 weeks after removal were subjected to histological examination. According to its structure, the bone tissue formed in the hole is reticulofibrous bone. Which allows us to conclude that by the time of 15-17 weeks, the processes of active reparative bone formation in the hole are completed, and the necessary local conditions for dental implantation have been created.

Sinus Floor Elevation with Biphasic Calcium Phosphate or Deproteinized Bovine Bone Mineral: Clinical and Histomorphometric Outcomes of a Randomized Controlled Clinical Trial.

To clinically and histomorphometrically compare a biphasic calcium phosphate (BCP) and deproteinized bovine bone mineral (DBBM) for sinus floor elevation. Sinus floor elevation procedures (lateral window) were performed randomly applying either BCP (test) or DBBM (control). At 6 months, bone biopsy specimens were harvested and dental implants were placed. The proportions of new bone, residual grafting material, and nonmineralized soft tissue were calculated. Four months after implant placement, the prosthetic reconstructions were inserted and the implant survival was assessed. Fifty-one patients were treated; 25 were randomly allocated to the BCP group and 26 to the DBBM group. After 6 months in 50 patients, bone biopsy specimens could be harvested, and a total of 121 implants could be placed subsequently. The histomorphometric analysis revealed a comparable percentage of new bone in both groups (BCP 35.9%, DBBM 35.4%; P > .05). The remaining grafting material was significantly lower with BCP (25.3%) compared with DBBM (45.9%; P < .001). Nonmineralized tissue was significantly higher for the BCP group (38.1%) compared with the DBBM group (18.2%; P < .001). The implant survival rate at loading was assessed at the level of the patients (96.0% for BCP and 88.8% for DBBM; P > .05) and at the level of the implants (96.9% for BCP and 94.7% for DBBM; P > .05). Grafting with DBBM or BCP showed similar percentages of new bone 6 months after sinus floor elevation. Implant survival presented no significant difference until loading.