Bone Density Values Research Articles

Feasibility study of opportunistic osteoporosis screening on chest CT using a multi-feature fusion DCNN model

SummaryA multi-feature fusion DCNN model for automated evaluation of lumbar vertebrae L1 on chest combined with clinical information and radiomics permits estimation of volumetric bone mineral density for evaluation of osteoporosis.PurposeTo develop a multi-feature deep learning model based on chest CT, combined with clinical information and radiomics to explore the feasibility in screening for osteoporosis based on estimation of volumetric bone mineral density.MethodsThe chest CT images of 1048 health check subjects were retrospectively collected as the master dataset, and the images of 637 subjects obtained from a different CT scanner were used for the external validation cohort. The subjects were divided into three categories according to the quantitative CT (QCT) examination, namely, normal group, osteopenia group, and osteoporosis group. Firstly, a deep learning–based segmentation model was constructed. Then, classification models were established and selected, and then, an optimal model to build bone density value prediction regression model was chosen.ResultsThe DSC value was 0.951 ± 0.030 in the testing dataset and 0.947 ± 0.060 in the external validation cohort. The multi-feature fusion model based on the lumbar 1 vertebra had the best performance in the diagnosis. The area under the curve (AUC) of diagnosing normal, osteopenia, and osteoporosis was 0.992, 0.973, and 0.989. The mean absolute errors (MAEs) of the bone density prediction regression model in the test set and external testing dataset are 8.20 mg/cm3 and 9.23 mg/cm3, respectively, and the root mean square errors (RMSEs) are 10.25 mg/cm3 and 11.91 mg/cm3, respectively. The R-squared values are 0.942 and 0.923, respectively. The Pearson correlation coefficients are 0.972 and 0.965.ConclusionThe multi-feature fusion DCNN model based on only the lumbar 1 vertebrae and clinical variables can perform bone density three-classification diagnosis and estimate volumetric bone mineral density. If confirmed in independent populations, this automated opportunistic chest CT evaluation can help clinical screening of large-sample populations to identify subjects at high risk of osteoporotic fracture.

Trabecular Attenuation of L1 in Adult Patients with Multiple Myeloma: An Observational Study on Low-Dose CT Images.

The aim of this study was to evaluate the impact of trabecular attenuation of the L1 vertebral body in low-dose CT in adult patients with multiple myeloma (MM), smoldering multiple myeloma (SMM), and monoclonal gammopathy of undetermined significance (MGUS). The study population consisted of 22 patients with MGUS and 51 consecutive patients with newly diagnosed MM (SMM, n = 21; symptomatic MM, n = 36). CT scans were conducted using a 128-slice CT scanner (Somatom go.Top, Siemens, Munich, Germany). Low-dose whole-body CT scans were performed at a single time point for each patient. Trabecular bone density values were obtained by defining regions of interest on non-contrast images at the level of L1 vertebra. A threshold of p = 0.05 was applied to determine statistical significance. The median Hounsfield unit (HU) value in patients with MGUS, SMM, and MM was 148 HU (range 81-190), 130 HU (range 93-193), and 92 HU (range 26-190), respectively, with a statistically significant difference between the groups (p = 0.0015). Patients with HU values ≤ 92 had lower progression-free survival with statistically significant differences compared to the group with HU values > 92 (p < 0.0499). This is the earliest evidence of the importance of evaluating L1 attenuation values in low-dose CT images in patients with MGUS, SMM, and MM. Further prospective studies could contribute to reinforcing these results and exploring the clinical applicability and generalization of L1 attenuation values in low-dose whole-body CT scans in routine clinical practice.

Evaluation of alveolar ridge values with autogenous tooth graft and the provocative venture of allogeneic tooth graft from family members

Background Preserving the structural integrity of the alveolar ridge is paramount in ensuring the success of dental implant procedures and optimizing both aesthetic and physiological outcomes. This study aims to evaluate the efficacy of autologous dental grafting and explore intriguing results achieved through the utilization of allogeneic dental grafts obtained from a familial participant within the study’s framework. Methods Eleven patients necessitating bilateral dental extractions were enrolled in the study. Ten patients underwent autologous dental grafting on one side, while the contralateral side remained untreated. In the eleventh case, one side received autogenous dental grafting, while the other side was augmented with an allogeneic graft sourced from the patient’s son. Outcomes were monitored over a four-month period. Results Autogenous dental grafting led to a significant enhancement in bone density values and a reduction in osseous absorption rates(P&lt;0.05) when compared to untreated sites among the ten patients who underwent the procedure. However, notable advancements were observed in patient 11 who received an allogeneic dental graft from a familial donor, suggesting potential superiority over autologous grafting in promoting bone regeneration. These findings underscore the promising prospects of employing allogeneic dental grafts sourced from family members to achieve optimal outcomes in alveolar ridge preservation. Conclusions The study underscores the significance of utilizing autologous dental grafts for preserving alveolar ridge dimensions. Importantly, the noteworthy improvement observed in patient outcomes resulting from the use of allogeneic dental grafts compared to autologous grafts raises several inquiries, particularly concerning the potential relationship between the patient and the donor. Trial registration The study is registered as a BRAZILIAN CLINICAL TEST RECORD (ReBEC): U1111-1305-2793 on 28-05-2024 ( https://ensaiosclinicos.gov.br/rg/RBR-65qchvs).

Exploring vertebral bone density changes in a trunk with adolescent idiopathic scoliosis: a mechanobiological modeling investigation of intact and unilaterally paralyzed muscles

This study aimed to elucidate the vertebral bone density variations associated with adolescent idiopathic scoliosis (AIS), specifically examining the impact of unilateral muscle paralysis using an integrated approach combining Frost’s Mechanostat theory, a three-dimensional subject-specific finite element model and a musculoskeletal model of the L2 vertebra. The findings revealed a spectrum of bone density values ranging from 0.29 to 0.31 g/cm3, along with vertebral micro-strain levels spanning from 300 to 2200, consistent with existing literature. Furthermore, the ratio of maximum von Mises stress between the concave and convex side in the AIS model with intact muscles was approximately 1.08, which decreased by 4% due following unilateral paralysis of longissimus thoracis pars thoracic muscle. Overall, this investigation contributes to a deeper understanding of AIS biomechanics and lays the groundwork for future research endeavors aimed at optimizing clinical management approaches for individuals with this condition.

Relationship Between Circummaxillary and Intramaxillary Suture Densities and Skeletal Effects of Rapid Maxillary Expansion.

This retrospective clinical study aimed to evaluate the maturation of intramaxillary and circummaxillary suture systems and cervical vertebral maturation as predictors of the skeletal response achieved by rapid maxillary expansion (RME). A Digital Imaging and Communication in Medicine dataset of 20 patients (mean age: 15.55 years) prior (T0) and after (T1: 3.5±0.5 months) to RME were retrieved from the archive and analyzed. Bone density values of midpalatal suture (MPS), zygomaticomaxillary suture (ZMS), zygomaticotemporal suture (ZTS), pterygopalatine suture (PPS), and transverse palatine suture (TPS) were measured. The cervical vertebral maturational stages (CVS) were examined. The linear distances between the most lateral points of the piriform apertures were measured as the anterior reference, and the medial margins of the greater palatine foramina on the axial slice were chosen as the posterior reference. The difference at T1-T0 was calculated as the skeletal response to RME at anterior and posterior skeletal references. Spearman's rho rank and Kruskal-Wallis tests were used. Mean density values of ZMS, PPS, ZTS, TPS, MPS-Anterior, and MPS-Posterior were 922.81, 807.44, 753.83, 640.77, 661.13, and 604.59 HU, respectively. Mean linear changes in anterior and posterior skeletal expansion were 2.93±1.78 and 1.93±2.52 mm. There was no significant relationship between maturation indicators and skeletal response. Significant relationships were found between CVS and MPS density and CVS and circummaxillary suture average density (p≤0.05). Sutural density showed significant variations among CVSs. Although there was no correlation between skeletal response and density measurements, sutural density was found to be a promising indicator for future studies.

Poster 218: Localized Acetabular Bone Density Distributions Are Altered in Unilateral Femoral Acetabular Impingement

Objectives: Femoral acetabular impingement (FAI) can lead to bony and cartilage changes at the joint, and it has been suggested that changes in bone mineral density in the acetabulum may correlate with osteoarthritic degeneration of the hip. In this study, we aimed to use opportunistic quantitative computed tomography (QCT) to map density distributions across the acetabular region in patients with unilateral FAI and determine if there were differences between the affected and unaffected side. Furthermore, we assessed if these differences in density distributions were associated with radiographic measures of FAI. Methods: Twenty patients (age 31.9 (SD 9.2), 13 female) who underwent surgery for unilateral FAI and had an associated CT scan of both hips were included in this retrospective study. Both sides of the pelvis were segmented, and 3D models were created. Estimated bone density values were mapped across the bone models via QCT. A thin-spline semi-landmarking approach was used to allow density values at equivalent anatomical points to be compared within patients and across the group. With the contralateral side used as the control, differences in bone density between sides were calculated. A mixed effect linear regression model was used to determine if there were associations between the localized bone density and radiographic measures of Tonnis grade, alpha angle, lateral center edge angle (LCEA), and cross over sign, while controlling for age and sex. To visualize the data, density changes and statistical results were color-mapped to the bone models. Results: Overall, several regions of the acetabulum were found to have increased bone density in the affected side compared to the contralateral (Figure 1). Specifically, the anterior-superior parts of the acetabular rim appeared to be most affected, along with the posterosuperior region (Figure 2). Limited associations were found between localized density and the clinical variables, with the most notable finding being a region of the superior rim that was found to be associated with the alpha angle (Figure 3). Conclusions: FAI leads to distinct patterns of bone density changes around the acetabulum, although there is still variability at the level of the individual patient. It is unclear whether these changes in bone density may be related to the underlying condition, alterations in the patient’s mechanics due to pain, or a combination of these factors. Providing detailed density maps of the bony anatomy may also assist surgical providers in planning interventions. Further research may elucidate the relationship between bone density changes and long-term degeneration of the joint.

Accuracy of Phantomless Calibration of Routine Computed Tomography Scans for Opportunistic Osteoporosis Screening in the Spine Clinic.

Diagnostic accuracy study. To establish a simple method of phantomless bone mineral density (BMD) measurement by using preoperative lumbar Computed Tomography (CT) scans, and compare the accuracy of reference tissue combinations to diagnose low BMD against uncalibrated Hounsfield units (HUs). HUs are used as a measure of BMD; however, associations between HU and T-scores vary widely. Quantitative CT (qCT) scans are more accurate, but they require density calibration with an object of known density (phantom), which limits feasibility. As an emerging technique, phantomless (internal) calibration of routine CT scans may provide a good opportunity for screening. Patients who were scheduled to undergo lumbar surgery, with a preoperative CT scan, and a dual-energy x-ray absorptiometry (DXA) scan within six months were included. Four tissues were selected for calibration: subcutaneous adipose (A), erector spinae (ES), psoas (P) and aortic blood (AB). The HUs of these tissues were used in linear regression against ground-truth values. Calibrations were performed by using two different internal tissues at a time to maintain simplicity and in-office applicability.Volumetric bone mineral densities (vBMD) derived from internally calibrated CT scans were analyzed for new threshold values for low bone density. Areas under the curve (AUC) were calculated with 95% confidence intervals (CI). 45 patients were included (M/F=10/35, mean age:63.3). Calibrated vBMDs had stronger correlations with DXA T-scores when compared with HUs, with L2 exhibiting the highest coefficients. Calibration by using A and ES with the threshold of 162mg/cm3 had a sensitivity of 90% in detecting low BMD (AUC=0.671). This novel method allows simple, in-office calibration of routine preoperative CT scans without the use of a phantom. Calibration using adipose and erector spinae with a threshold of 162mg/cm3 is proposed for low bone density screening with high sensitivity (90%). Level III.

Bone Density of the Midpalatal Suture After Surgically Assisted Rapid Maxillary Expansion: A Retrospective Cohort Study

Objectives: To evaluate the bone density in the midpalatal suture after 10 months of surgically assisted rapid maxillary expansion (SARME) with the separation of the maxilla into 2 segments. Methods: Sixty multislice computed tomography (MCT) from 20 patients undergoing SARME were analyzed in 3 periods of time (1 MCT per patient on each occasion): (1) 1 week before surgery, (2) postsurgery immediately after completing the expander activation, and (3) 10 months after the expander activation. On all occasions, the bone density was measured in Hounsfield units on MCT scans in axial and coronal sections, in the anterior (A1), middle (A2), and posterior (A3) regions of the midpalatal suture. Results: The mean percentage values of bone density in Hounsfield units, from the 10-month postactivation period to preoperative in the A1, A2, and A3 regions were 68.38%, 38.21%, and 55.90%, respectively, in the axial norm, and 64.06%, 36.81%, and 55.50% in coronal norm (A1 = A3&gt;A2), with no significant difference in the tomographic cuts (P &gt;0.05). There was no correlation between patient age or amount of expansion in the expander and bone density. Conclusions: The bone density in the midpalatal suture 10 months after SARME is lower than preexpansion. A denser new bone formation along the suture concentrates closer to the extremities rather than in the central region. Although the maturation of the new bone formation in the midpalatal suture is lower 10 months after SARME, it appears to be sufficient for satisfactory clinical results, regardless of patient age or the amount of expansion in the expander.

Implant Survival in Renal-Transplanted Patients: A Prospective Long-Term Study.

The present study aims to assess the feasibility of implant rehabilitation in kidney-transplanted patients. Patients with kidney transplantation included in periodontal supportive care and at least one year of dialysis with mono- or partial edentulism were eligible for this study. Histomorphometric evaluation of the harvested bone was matched with radiological bone assessment. Implant stability was also monitored with resonance frequency analysis and insertion torque value. Fixed cemented prostheses have been delivered after conventional loading protocol. Supportive periodontal therapy has been administered. Eleven patients (9 males and 2 females) were included. The mean age was 58.1 ± 9.9 years. A total of 17 implants were inserted and analyzed. Mean ITV was 39.3 ± 23.8 Ncm. The mean primary stability (implant stability quotient) at T0 was 71.7 ± 10.5, whereas the mean secondary stability at T1 was 73.0 ± 7.3. The minimum follow-up was 62 months, with a maximum of 84 months (7 years) reached by 4 patients. Fourteen out of 15 implants were in function at a 5-year follow-up (survival rate: 93.3%). Two implants showed peri-implantitis. Seventeen bone samples were collected (13 in the mandible and 4 in the maxilla). The mean percentage of marrow spaces and lamellar bone was 41.6% and 58.4%, respectively. Class 3, according to Misch classification, was found as the mean value of radiological bone density. It can be concluded that implant-supported rehabilitation in kidney-transplanted patients is possible. Adequate periodontal maintenance allows implant rehabilitation in kidney-transplanted patients with long-term sufficient survival rates.

Osseodensification vs. Conventional Osteotomy: A Case Series with Cone Beam Computed Tomography.

Introduction: Osseodensification is a non-extraction technique using specially designed drills to increase bone density while extending an osteotomy, allowing bone to be preserved and condensed by compacting autograft during osteotomy preparation, increasing bone density around implants, and improving mechanical stability. Aim: The objective of this study is to compare conventional osteotomy and osseodensification protocols in implant placement and analyze whether there are differences in bone density. Materials and Methods: Study variables were defined, namely, osseodensification technique, conventional osteotomy technique, bone density, sex, area of location, implant dimensions, implant dimensions, and implant stability. Eligibility and exclusion criteria were defined. A step-by-step surgical protocol was developed. The surgeon and radiologist underwent intra-examiner calibration. A total of 15 patients were selected according to the eligibility criteria, and a total of 41 implants were inserted, 20 implants by conventional osteotomy and 21 by osseodensification. A cone beam computed tomography was performed one year after prosthetic rehabilitation to estimate bone density. Data were collected and recorded, and in the analysis of the association of variables, non-parametric tests were applied. Results: Significant statistical results were found in bone density values, with higher values being obtained with the osseodensification technique, that is, median density values of 1020, and median density values of 732 for the bone drilling technique. The results of the correlation between bone density in both techniques and sex, primary implant stability, implant dimensions and location area were statistically non-significant. Conclusions: Within the limitations of this study, there are differences in bone density between conventional osteotomy and osseodensification protocols. Bone density is increased with osseodensification over a study period of one year.

Effect of early preventive supplementation with calcium and phosphorus on metabolic bone disease in premature infants

ObjectiveThe objective was to study the effect of early preventive calcium and phosphorus supplementation on metabolic bone disease in preterm infants.MethodsA retrospective analysis of 234 preterm infants with a gestational age < 32 weeks or birth weight < 1500 g who were hospitalized in the Neonatology Department of the Second Hospital of Shandong University from 01.2018 to 12.2020 was conducted. One hundred thirty-two premature infants hospitalized from 01.2018 to 06.2019 did not receive prophylactic calcium and phosphorus supplementation in the early postnatal period. These infants received calcium or phosphorus supplementation at the time of hypocalcaemia or hypophosphatemia diagnosis. One hundred two premature infants hospitalized from 07.2019 to 12.2020 received early preventive calcium and phosphorus supplementation after birth. The levels of serum calcium and phosphorus, alkaline phosphatase, 25-hydroxyvitamin D, calcitonin, and parathyroid hormone at different time points and growth indicators at six months of age were compared between the two groups of infants. The number of cases of metabolic bone disease and fracture between the two groups was compared.Results1) A total of 12 infants (5.13%) among the 234 preterm infants were diagnosed with metabolic bone disease, including 2 (1.96%) in the prophylactic supplementation group and 10 (7.58%) in the nonprophylactic supplementation group. Fractures occurred in 3 premature infants (25.0%) with metabolic bone disease, all of whom were in the group that did not receive prophylactic supplementation. 2) There was no significant difference in serum calcium and calcitonin levels between the two groups. The levels of serum phosphorus and 25 hydroxyvitamin D in the prophylactic supplementation group were higher than those in the nonprophylactic supplementation group (P < 0.05). In comparison, alkaline phosphatase and parathyroid hormone levels were lower in the prophylactic supplementation group than in the nonprophylactic supplementation group (P < 0.05). Preterm infants in the prophylactic supplementation group had higher weight, length, head circumference, and bone density values than those in the nonprophylactic supplementation group (P < 0.05).ConclusionPreventive supplementation with calcium and phosphorus after birth can effectively improve calcium and phosphorus metabolism, and reduce the incidence of metabolic bone disease and fractures in premature infants. This can be further publicized and used clinically.

Bone density of the cervical, thoracic and lumbar spine measured using Hounsfield units of computed tomography – results of 4350 vertebras

IntroductionThe assessment of bone density has gained significance in recent years due to the aging population. Accurate assessment of bone density is crucial when deciding on the appropriate treatment plan for spinal stabilization surgery. The objective of this work was to determine the trabecular bone density values of the subaxial cervical, thoracic and lumbar spine using Hounsfield units.Material and methodsData from 200 patients who underwent contrast-enhanced polytrauma computed tomography at a maximum care hospital over a two-year period were retrospectively analyzed. HUs were measured with an elliptical measurement field in three different locations within the vertebral body: below the upper plate, in the middle of the vertebral body, and above the base plate. The measured Hounsfield units were converted into bone density values using a validated formula.ResultsThe mean age of the patient collective was 47.05 years. Mean spinal bone density values decreased from cranial to caudal (C3: 231.79 mg/cm3; L5: 155.13 mg/cm3; p < 0.001), with the highest values in the upper cervical spine. Bone density values generally decreased with age in all spinal segments. There was a clear decrease in values after age 50 years (p < 0.001).ConclusionsIn our study, bone density decreased from cranial to caudal with higher values in the cervical spine. These data from the individual spinal segments may be helpful to comprehensively evaluate the status of the spine and to design a better preoperative plan before instrumentation.

Evaluation of the efficacy of using dental pulp graft in the healing of the alveolar bone after impacted canine extraction: a prospective cohort study.

The purpose of this study was to evaluate the radiographic density of the alveolar bone of the maxilla after extraction of the impacted canines and using the pulp tissue as an autogenous graft. This prospective cohort study recruited 14 patients (8 females and 6 males) between 2021 and 2023, with an average age of 35 years. All participants had palatally impacted maxillary canines. The impacted teeth were extracted surgically. The extracted teeth were then used for autogenous grafting. The pulp tissue was removed, cut into small pieces, and placed on an absorbable gelatin sponge before being inserted into the extraction socket. The wound was subsequently closed meticulously. After 4 months, the bone density was assessed radiographically using the Hounsfield Scale on cone beam computed tomography scans. After 4 months, the mean radiographic bone density value in the extraction area was (652.77 ± 56.13 HU), while the average density of the original bone was (659.7 ± 39.6 HU). Within the limits of this study, dental pulp tissue can be used to restore bony defects of the alveolar bone in the maxilla. However, further research is needed to confirm these findings.

Evaluation of Bone Thickness and Density Values in Resistance Regions in Rapid Maxillary Expansion Using Computed Tomography.

This study used computed tomography (CT) to compare the bone thickness and density values around the zygomaticomaxillary, zygomaticotemporal, and pterygomaxillary sutures that are resistant to rapid maxillary expansion (RME) treatment according to age, sex, and cervical vertebrae maturation (CVM) stage. The study included 200 paranasal sinus records obtained for medical diagnosis and examination in a radiology clinic. The records provided data on 110 males and 90 females aged between 4 and 28 years. Bone thickness and density values around the zygomaticomaxillary, zygomaticotemporal, and pterygomaxillary sutures were measured using CT imaging. The correlations of bone thickness and density values with the variables of age, sex, and CVM stage were evaluated. No statistically significant difference was revealed between the bone thickness values around the zygomaticomaxillary and zygomaticotemporal sutures and age, sex, CVM stage, and the right and left regions of the same individual ( P >0.05). A strong correlation was identified between Hounsfield units (Hu) values on bone density in all 3 regions and age and sex ( P <0.001). No correlation was found between the CVM stage and density values around the zygomaticomaxillary, zygomaticotemporal, and pterygomaxillary sutures ( P >0.05). The Hu values of the records from females were higher than those of males in all age groups. It was observed that with increasing age, bone density values increased in all 3 regions, and thus circummaxillary region's Hu value increased.

Correlation between bone density, bone metabolism markers with lipid metabolism markers and body mass index

PurposeWe aimed to explore the relationship between bone mineral density (BMD), bone metabolism markers, and blood lipid-related indicators, body mass index (BMI) in elderly individuals.MethodsA retrospective analysis was conducted on 710 patients. Patients’ gender, age, height, weight, bone density values, T-scores, bone metabolism markers (including serum N-terminal propeptide of type I collagen (s-PINP), serum C-terminal telopeptide of type I collagen (s-CTX) and 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) and lipid-related indicators (including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) and Castelli index 1 (TC/HDL-C index) and Castelli index 2 (LDL-C/HDL-C index) were recorded. Correlations between variables were analyzed, and patients were grouped according to gender and T-score for intergroup comparisons.ResultsHDL-C negatively correlates with BMD and s-CTX. TG, Castelli index, and BMI positively correlate with BMD. BMI negatively correlates with s-PINP. 1,25(OH)2D3 negatively correlates with TC, LDL-C, and Castelli index. LDL-C positively correlates with BMD in males, and TC negatively correlates with s-PINP. In females, HDL-C negatively correlates with BMD, and s-CTX positively correlates with Castelli index. 1,25(OH)2D3 negatively correlates with TC, LDL-C, and Castelli index. TG and Castelli index were higher in normal bone mass group, while HDL-C is higher in the osteoporosis group. TG and BMI positively predicted bone mass density, while HDL-C negatively predicted bone mass density.ConclusionsHDL-C may have a predictive role in osteoporosis, particularly in women. The likelihood of osteoporosis is lower in individuals with high BMI or hyperlipidemia. Some lipid metabolism markers can be used to predict osteoporosis, and further research is needed.

IMPLANT SURVIVAL IN RENAL-TRANSPLANTED PATIENTS: A PROSPECTIVE LONG-TERM STUDY.

The present study aims to assess the feasibility of implant rehabilitation in kidney-transplanted patients. Patients with kidney transplantation included in periodontal supportive care and at least one year of dialysis with mono- or partial edentulism were eligible for this study. Histomorphometric evaluation of the harvested bone was matched with radiological bone assessment. Implant stability was also monitored with RFA and ITV. Fixed cemented prostheses have been delivered after conventional loading protocol. Supportive periodontal therapy has been administered. Eleven patients (9 males and 2 females) were included. The mean age was 58.1 ± 9.9 years. A total of 17 implants were inserted and analyzed. Mean ITV was 39.3 ± 23.8 Ncm. The mean primary stability (ISQ) at T0 was 71.7 ± 10.5, whereas the mean secondary stability at T1 was 73.0 ± 7.3. The minimum follow-up was 62 months, with a maximum of 84 months (7 years) reached by four patients. Fourteen out of 15 implants were in function at a 5-year follow-up (survival rate 93.3%). Two implants showed peri-implantitis. Seventeen bone samples were collected (13 in the mandible and 4 in the maxilla). The mean percentage of marrow spaces and lamellar bone was 41.6% and 58.4%, respectively. Class 3, according to Misch classification, was found as the mean value of radiological bone density. It can be concluded that implant-supported rehabilitation in kidney-transplanted patients is possible. Adequate periodontal maintenance allows implant rehabilitation in kidney transplanted patients with long-term sufficient survival rates.

The Efficacy of Platelet-Rich Plasma as an Adjunct to Bone Grafting in Alveolar Ridge Preservation Following Tooth Extraction

ABSTRACT Background: Tooth extraction often results in bone loss in the alveolar ridge, which can complicate subsequent dental implant placement. Alveolar ridge preservation (ARP) techniques, such as bone grafting, aim to mitigate this bone loss. Platelet-rich plasma (PRP) has been proposed as an adjunct to bone grafting in ARP to enhance bone regeneration. Materials and Methods: A total of 60 patients requiring tooth extraction and ARP were included in this randomized controlled trial. Patients were divided into two groups: Group A received bone grafting alone, while Group B received bone grafting with PRP. Clinical and radiographic assessments were performed at baseline and 6-month postsurgery. Bone density and height were measured using arbitrary values. Results: At the 6-month follow-up, Group B demonstrated a statistically significant increase in bone density (P &lt; 0.05) and bone height (P &lt; 0.05) compared to Group A. The arbitrary values for bone density in Group B increased by 15% and bone height increased by 10% compared to baseline measurements. Group A showed minimal improvement. Conclusion: The incorporation of PRP as an adjunct to bone grafting in ARP following tooth extraction significantly enhances bone density and height, suggesting its efficacy in preserving the alveolar ridge.

DeepmdQCT: A multitask network with domain invariant features and comprehensive attention mechanism for quantitative computer tomography diagnosis of osteoporosis

In the medical field, the application of machine learning technology in the automatic diagnosis and monitoring of osteoporosis often faces challenges related to domain adaptation in drug therapy research. The existing neural networks used for the diagnosis of osteoporosis may experience a decrease in model performance when applied to new data domains due to changes in radiation dose and equipment. To address this issue, in this study, we propose a new method for multi domain diagnostic and quantitative computed tomography (QCT) images, called DeepmdQCT. This method adopts a domain invariant feature strategy and integrates a comprehensive attention mechanism to guide the fusion of global and local features, effectively improving the diagnostic performance of multi domain CT images. We conducted experimental evaluations on a self-created OQCT dataset, and the results showed that for dose domain images, the average accuracy reached 91%, while for device domain images, the accuracy reached 90.5%. our method successfully estimated bone density values, with a fit of 0.95 to the gold standard. Our method not only achieved high accuracy in CT images in the dose and equipment fields, but also successfully estimated key bone density values, which is crucial for evaluating the effectiveness of osteoporosis drug treatment. In addition, we validated the effectiveness of our architecture in feature extraction using three publicly available datasets. We also encourage the application of the DeepmdQCT method to a wider range of medical image analysis fields to improve the performance of multi-domain images.

A Comparative Study of Two Resonance Frequency Analysis Instruments

Primary implant stability (PIS) depends on the surgical technique, implant design, and the characteristics of the recipient bone, among other factors. This paper aims to study different parameters (recipient bone characteristics like bone density (BD) and mean alveolar crest width (MACW)) that may be related to implant primary stability outcomes. With that, it can be determined if they are reliable PIS methods and guide treatment decisions for successful implant outcomes. Thirty-five dental implants (25 BTI Interna® CORE and 10 Bioner Top DM) were placed in 10 patients in 2022 and 2023. All of them underwent Cone Beam Computed Tomography (CBCT) scans to obtain values for MACW and BD. PIS measurements used were implant stability quotient (ISQ) obtained through different resonance frequency analysis (RFA) methods (Osstell® ISQ and Penguin RFA®) and insertion torque (IT). The results for the following variables showed significance at p&lt;0.001 and p&lt;0.05. Highly significant relationships were observed between Osstell and Penguin RFA values (p&lt;0.001). Regarding IT, a direct proportional relationship with ISQ was observed (p&lt;0.05). PIS, as measured by ISQ and IT, did not show a significant correlation with the mean alveolar crest width of the edentulous ridge measured by CBCT, suggesting that wide or narrow alveolar crests did not have an effect on rotational or lateral PIS in both implant groups. The most significant predictor of lateral and rotational PIS in our patients was the Hounsfield Units (HU) value 0.5 mm away from the implant placement area (p&lt;0.001) and (p&lt;0.05), respectively. In conclusion, non-invasive PIS methods could be considered as a guide for clinicians in treatment decision-making and implant success. However, further research is needed to predict PIS.

Evaluation of multidetector CT Hounsfield unit measurements as a predictor of efficacy and complications in percutaneous vertebroplasty for osteoporotic vertebral compression fractures

IntroductionMore than 30 years after the initial experience of Galibert and Deramond with percutaneous vertebroplasty, the procedure has gone through countless refinements and clinical evaluations. Predictors for the success and failure of the procedure in the literature vary and are focused on the duration of complaints, type of fracture, presence of edema on MRI scans, etc. We propose using a quantitative method based on a standard CT examination of the thoracic or lumbar spine to assess the risks and potential success of performing vertebroplasty.Materials and methodsThis is a single-center prospective observational study on 139 patients treated with percutaneous vertebroplasty (pVPL) for a single symptomatic osteoporotic vertebral compression fracture (OVCF). We measured the levels of disability and pain preoperatively and again at the 3-, 6- and 12-month marks using the standardized VAS and ODI questionnaires. Every patient in the study was evaluated with postoperative multidetector CT (MDCT) to determine the presence, extent, and localization of vertebral cement leakage and to measure the adjacent vertebrae’s minimal and mean density in Hounsfield units (HUmin and HUmean, respectively).ResultsWe determined that a slight (r = −0.201) but statistically significant (p = 0.018) correlation existed between HU measurements taken from radiologically intact adjacent vertebrae and the procedure’s effect concerning the pain levels at the 3-month follow-up. This correlation failed to reach statistical significance at 12 months (p = 0.072). We found no statistically significant relationship between low vertebral cancellous bone density and cement leakage on postoperative scans (p = 0.6 for HUmin and p = 0.74 for HUmean).ConclusionWe have moderately strong data that show a negative correlation between the mean values of vertebral cancellous bone density in patients with OVCF and the effect of pVPL in reducing pain. Lower bone densities, measured this way, showed no increased risk of cement leakage.