Changes In Bone Tissue Research Articles

Bone and periosteum protein analysis via tandem mass tag quantitative proteomics in pediatric patients with osteomyelitis.

Bone healing is crucial in managing osteomyelitis after fracture fixation. Understanding the mechanism of extensive callus formation in pediatric osteomyelitis is highly important. This study aims to analyze bone and periosteum samples from pediatric patients to elucidate the essential processes involved in callus formation during osteomyelitis. The study included eight patients from our hospital: four with positive microbial culture who underwent osteomyelitis debridement and four who had osteotomy surgery as contral. We used tandem mass tag quantitative proteomics to investigate proteomic changes in bone and periosteum tissues obtained from these patients. Differential expression proteins were analyzed for their pathways through Gene Ontology (GO) annotation, GO enrichment analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis, and protein-protein interaction networks. A total of 4737 proteins were successfully identified. About 2224 differentially expressed proteins were detected in the bone tissues group and periosteum tissues group. Among the differentially expressed proteins, 10 protein genes in the bone group were associated with inflammation and osteogenesis, while in the periosteum group were nine. Cytochrome b-245, beta polypeptide (CYBB), nicotinamide phosphoribosyltransferase (NAMPT), tissue inhibitor of metalloproteinases 1 (TIMP-1), Raf-1 proto-oncogene, serine/threonine kinase (RAF-1), RELA proto-oncogene, NF-KB subunit (RELA), and sphingomyelin synthase 2 (SGMS2) may play an important role in callus formation in patients with osteomyelitis. This study provides novel clues for understanding callus formation in pediatric patients with osteomyelitis.

Periodontal health in patients with type 1 diabetes mellitus: relationship and risk factors of periodontitis progression

The article presents the results of literary sources review, namely clinical and experimental studies, meta-analyses and systematic analyzes regarding the effect of type 1 diabetes (T1D) on the periodontal tissues. According to them, the prevalence of periodontitis in patients with T1D is probably higher compared to healthy people. However, there are conflicting data on the cause-and-effect relationship between T1D and periodontitis. The article analyzes the impact of metabolic control in patients with T1D on the severity of periodontal diseases and the clinical attachment loss. Most studies show that the level of metabolic control of diabetes is associated with a high risk of developing periodontitis. The authors provide data from the analysis of the literature on possible mechanisms of periodontitis development, such as pro-inflammatory reactions and microcirculation disorders, changes in the microbial biofilm. Pathophysiological changes in bone tissue in patients with T1D, which are associated with insulin deficiency and its anabolic effect on bone tissue, worsen the biomechanical and adaptive properties of bones and may contribute to the severity of periodontitis. The conducted analysis indicates the importance of further research to assess the oral health in children with T1D.

The Case for Bisphosphonate Use in Astronauts Flying Long-Duration Missions.

Changes in the structure of bone can occur in space as an adaptive response to microgravity and on Earth due to the adaptive effects to exercise, to the aging of bone cells, or to prolonged disuse. Knowledge of cell-mediated bone remodeling on Earth informs our understanding of bone tissue changes in space and whether these skeletal changes might increase the risk for fractures or premature osteoporosis in astronauts. Comparisons of skeletal health between astronauts and aging humans, however, may be both informative and misleading. Astronauts are screened for a high level of physical fitness and health, are launched with high bone mineral densities, and perform exercise daily in space to combat skeletal atrophy as an adaptive response to reduced weight-bearing function, while the elderly display cellular and tissue pathology as a response to senescence and disuse. Current clinical testing for age-related bone change, applied to astronauts, may not be sufficient for fully understanding risks associated with rare and uniquely induced bone changes. This review aims to (i) highlight cellular analogies between spaceflight-induced and age-related bone loss, which could aid in predicting fractures, (ii) discuss why overreliance on terrestrial clinical approaches may miss potentially irreversible disruptions in trabecular bone microarchitecture induced by spaceflight, and (iii) detail how the cellular effects of the bisphosphonate class of drugs offer a prophylactic countermeasure for suppressing the elevated bone resorption characteristically observed during long-duration spaceflights. Thus the use of the bisphosphonate will help protect the bone from structural changes while in microgravity either along with exercise or alone when exercise is not performed, e.g. after an injury or illness.

Prevention of chemotherapy-related bone loss with doxorubicin-loaded solid lipid nanoparticles.

Aim: Breast cancer and its metastases involve high mortality even with advances in chemotherapy. Solid lipid nanoparticles provide a platform for drug delivery, reducing side effects and treatment-induced bone loss. A solid nanoparticle containing doxorubicin was evaluated for its ability to prevent bone loss in a pre-clinical breast cancer model.Methods: We investigated the effects of SLNDox in an aggressive metastatic stage IV breast cancer model, which has some important features that are interesting for bone loss investigation. This study evaluates bone loss prevention potential from solid lipid nanoparticles containing doxorubicin breast cancer treatment, an evaluation of the attenuation of morphological changes in bone tissue caused by the treatment and the disease and an assessment of bone loss imaging using computed tomography and electron microscopy.Results: Chemotherapy-induced bone loss was also observed in tumor-free animals; a solid lipid nanoparticle containing doxorubicin prevented damage to the growth plate and to compact and cancellous bones in the femur of tumor-bearing and healthy animals.Conclusion: The association of solid lipid nanoparticles with chemotherapeutic drugs with proven efficacy promotes the prevention of serious consequences of chemotherapy, reducing tumor progression, increasing quality of life and improving prognosis and survival.

Imaging of bones dysbarogenic changes in navy divers

The number of diving descents in the world is steadily growing, as is the complexity of the work performed under conditions of increased environmental pressure. Also, in order to increase efficiency and expand the range of tasks performed, the intensity, depth of dives and the time divers spend in hyperbaric conditions are increasing. These factors contribute to an increase in the number of diving pathologies, including damage to the skeletal bones of dysbarogenic genesis. X-ray diagnostic methods used during annual medical examinations of divers do not always allow the detection of dysbarogenic changes in the bones; in addition, the clinical manifestations of this pathology do not have obvious specificity. In this regard, it can be assumed that the occurrence of this pathology among divers has not been reliably established to date. This article is devoted to a review of the literature on the possibilities of radiodiagnosis of dysbarogenic changes in skeletal bones in specialists whose work involves being in conditions of high environmental pressure. The article highlights the results of a literature review of English-language and Russian-language publications presented in the databases of PubMed and scientific electronic libraries of Russia (eLIBRARY.RU and CYBERLENINKA.RU). In order to determine the optimal methods of radiation diagnostics, the etiological and pathogenetic aspects of the development of dysbarogenic degenerative and necrotic changes in the bones of the skeleton, as well as the experience of scientists in determining the corresponding radiation semiotics, were analyzed. Considering that the worst manifestation of bone pathology of dysbarogenic origin is dysbaric (aseptic) osteonecrosis, we studied the literature on the issues of its clinical and instrumental diagnosis. One of the directions in scientific research was the work of authors exploring the possibilities of early instrumental diagnosis of changes in bone tissue, in particular the possibilities of magnetic resonance imaging in the diagnosis of dysbaric osteonecrosis. In addition, data on modern x-ray methods were analyzed, which may be promising as a screening diagnosis of dysbarogenic degenerative and necrotic changes in the bones of the skeleton.

Bone Tissue Changes in Individuals Living with HIV/AIDS: The Importance of a Hierarchical Approach in Investigating Bone Fragility.

Skeletal alterations and their complications can significantly impact the quality of life and overall prognosis of patients living with HIV (PLWHIV). Considering skeletal alterations are often asymptomatic and unapparent during routine clinical evaluation, these conditions are frequently overlooked in the clinical management of PLWHIV. However, since the use of combined antiretroviral therapy (cART) has increased life expectancy in PLWHIV effectively, osteopenia, osteoporosis, and bone fragility are now considered to have a major health impact, with a substantial increase in healthcare costs. This narrative literature review aimed to provide a comprehensive overview of the contemporary literature related to bone changes in PLWHIV, focusing on the importance of taking a multi-scale approach in the assessment of bone hierarchical organization. Even though a low bone mineral density is frequently reported in PLWHIV, numerous ambiguities still remain to be solved. Recent data suggest that assessment of other bone properties (on various levels of the bone structure) could contribute to our understanding of bone fragility determinants in these individuals. Special attention is needed for women living with HIV/AIDS since a postmenopausal status was described as an important factor that contributes to skeletal alterations in this population. Further research on complex etiopathogenetic mechanisms underlying bone alterations in PLWHIV may lead to the development of new therapeutic approaches specifically designed to reduce the health burden associated with skeletal disorders in this population. A major challenge in the clinical management of PLWHIV lies in the adverse skeletal effects of some frequently prescribed cART regimens (e.g., regimens containing tenofovir disoproxil fumarate), which may require a switch to other pharmacological approaches for maintained HIV infection (e.g., regimens containing tenofovir alafenamide). Taken together, the findings are indicative that the HIV/AIDS status should be taken into consideration when designing new guidelines and strategies for individualized prevention, diagnosis, and treatment of increased bone fragility.

Effect of Xanthohumol from Humulus lupulus L. Against Gouty Bone Damage in Arthritis of Rats Induced by Mono-sodium Urate.

Xanthohumol (XAN) is an isoprenyl flavonoid from Humulus lupulus L. known for beer brewing, and an osteoprotective agent due to its active improvement in bone loss of osteoporosis. This study was first time to investigate its effects on anti-gouty bone injury in rats of gouty arthritis (GA) induced by monosodium urate (MSU). Results showed that XAN could significantly exert anti-inflammatory activity by alleviating swelling degree of joints, reducing serum level of inflammatory factors, improving inflammatory injury and degrading the Markin's score in lesion joint. Meanwhile, XAN could also fight against gouty bone damage by improving pathological changes of bone tissue and parameters of bone micro-structure. Moreover, XAN could even promote bone formation by effectively enhancing expression of Runx2 and OPG, while inhibit bone resorption with depressing matrix metalloproteinase-9 (MMP-9), MMP-13 and CTSK expression, reducing RANKL secretion, and abating the ratio of RANKL/OPG. Therefore, it was the first time to reveal the mechanism of XAN against gouty bone injury via inhibiting RANKL/OPG/RANK signaling pathway. Above all, this study provided potential strategy for the treatment of GA, and further contributed to research and resource development for hops.

Diagnosing periprosthetic hip joint infection with new-generation 0.55 T MRI

PurposeTo assess the accuracy of 0.55 T MRI in diagnosing periprosthetic joint infection (PJI) in patients with symptomatic total hip arthroplasty (THA). Material and methods0.55 T MRI of patients with THA PJI (Group A) and noninfected THA (Group B), including aseptic loosening (Group C, subgroup of B) performed between May 2021 and July 2023 were analysed retrospectively.Two musculoskeletal fellowship-trained radiologists independently identified MRI bone and soft tissue changes including: marrow oedema, periosteal reaction, osteolysis, joint effusion, capsule oedema and thickening, fluid collections, muscle oedema, bursitis, inguinal adenopathy, and muscle tears. The diagnostic performance of MRI discriminators of PJI was evaluated using Fisher’s exact test (p < 0.05) and interrater reliability was determined. 61 MRI scans from 60 THA patients (34 female, median age 68, range 41–93 years) in Group A (n = 9; female 4; median age 69, range 56–82 years), B (n = 51; 30; 67.5, 41–93 years), and C (10; 6; 67; 41–82 years) were included. ResultsCapsule oedema (sensitivity 89 %, specificity 92 %,), intramuscular oedema (89 %, 82 %) and joint effusion (89 %, 73 %) were the best performing discriminators for PJI diagnosis (p ≤ 0.001), when viewed individually and had combined 70 % sensitivity and 100 % specificity for PJI diagnosis in parallel testing. For the differentiation between PJI and aseptic loosening, intramuscular oedema (89 %, 80 %) and capsule oedema (89 %, 80 %) were significant discriminators (p ≤ 0.001) with combined 64 % sensitivity and 96 % specificity for PJI. ConclusionsNew generation 0.55 T MRI may aid in the detection of PJI in symptomatic patients. Oedema of the joint capsule, adjacent muscles as well as joint effusion were indicative of the presence of PJI.

Human Mesenchymal Stem Cells Improve Angiogenesis and Bone Formation in Severed Finger Rats through SIRT1/Nrf2 Signaling.

This study employed a severed finger rat model to analyze the effects of human mesenchymal stem cells (MSCs) on angiogenesis, inflammatory response, apoptosis, and oxidative stress, to evaluate the possible mechanism of the repair effect of MSCs on severed finger (SF) rats. Sixty Sprague-Dawley (SD) rats were categorized into five groups (n = 12). The pathological changes of severed finger tissues were investigated by Hematoxylin and eosin (H&E) staining on day 14 after the rats were sacrificed. The levels of inflammatory factors and oxidative stress factors were detected by ELISA. Terminal Deoxynucleotidyl Transferase (TdT) dUTP Nick End Labeling (TUNEL) was employed to assess the apoptosis of chondrocytes in severed finger tissues. The expression of osteocalcin (OCN), osteopontin (OPN), Collagen I (Col-1), and CD31 were detected by immunohistochemistry or immunofluorescence assay, respectively. The expression levels of related proteins were determined by western blot. Our study presented evidence that MSCs treatment improved pathological changes of skin and bone tissue, diminished the inflammatory response, prevented oxidative stress injury, suppressed chondrocyte apoptosis, and promoted angiogenesis, and bone formation compared to the model group. In addition, EX527 treatment attenuated the effect of MSCs, SRT1720 and ML385 co-treatment also attenuated the effect of MSCs. Importantly, the MSCs treatment increased the expression of Sirtuin 1(SIRT1)/Nuclear factor erythroid2-related factor 2(Nrf2) relate proteins. Our study indicated that the mechanism of the effect of MSCs on a severed finger was related to the SIRT1/ Nrf2 signaling pathway.

Temporal evolution of postsurgical bone repair in a rabbit model: A [99mTc]Tc-MDP scintigraphic study.

Bone regeneration is crucial for repairing bone tissue following various injuries. Research techniques that enable the study of metabolic changes in bone tissue under different conditions are important for understanding bone repair and remodeling. This study used bone scintigraphy to evaluate osteogenesis secondary to osteotomy in a preclinical model of New Zealand rabbits. For this purpose, we conducted a longitudinal, prospective, case-control study in which scintigraphic variables were measured in both the right forearm (case-operated) and the left forearm (control - non-operated). The study sample consisted of 10 rabbits subjected to osteotomy, followed by a 12-week postoperative evaluation period, divided into six imaging stages at 1, 2, 3, 4, 8, and 12 weeks. We observed that the operated forearm showed significantly higher external radiation than the control side, using the pinhole collimator, denoting an increase in the biodistribution and tropism of the radiopharmaceutical to the operated forearm. Among the three evaluated time points, osteoblastic activity was highest in the second week and presented a significant decline in the 8th and 12th weeks, denoting regeneration and resolution of the surgical injury; the control forearm was also influenced by the inactivity imposed by the operated forearm. This fact was notably evidenced by the reduction in the metabolic activity of osteoblasts in the left forearm. Our study suggested that bone scintigraphy was sensitive enough to semi-quantitatively differentiate the metabolic activity of osteoblasts in the operated forearm in the three temporal landmarks evaluated in the study.

Feasibility of application in the practice of dental diseases of metabolic changes in bone tissue in examination of patients with chronic kidney disease

Feasibility of application in the practice of dental diseases of metabolic changes in bone tissue in examination of patients with chronic kidney disease

OSTEOPOROSIS IN PATIENTS WITH SYSTEMIC MASTOCYTOSIS

Mastocytosis is a disease characterized by abnormal proliferation and accumulation of clonal mast cells. One of the systems that may be affected in patients with mastocytosis is the skeletal system. Osteolysis, osteopenia, osteoporosis and osteosclerosis may occur as a result of skeletal system involvement. Osteoporosis is seen in more than 1/5 of these patients and the disease may even present with multiple fractures. Underlying factors of the deterioration of bone health in systemic mastocytosis include mast cell infiltration and systemic release of mast cell mediators, increased number of osteoclasts, and overproduction of proinflammatory cytokines. Taking preventive measures for bone health disorders in patients with systemic mastocytosis, implementing screening protocols and treating osteoporosis appropriately if it develops are extremely important in preventing fragility fractures. The aim of this review is to provide an insight to the changes in bone tissue in patients with mastocytosis.

HISTOMORPHOMETRIC ASSESSMENT OF CHANGES THE STRUCTURAL COMPONENTS OF THE BONE IN RATS WITH CHRONIC CHOLESTASIS WITH CORRECTION OF THE COMPLEX FROM HEPATOPROTECTOR AND SORBENT

Problem. The disruption of the gastric duct in cholestasis causes insufficient absorption in the small intestine of macro- and microelements and fat-rich vitamins (A, D, E, K), which are necessary for healthy processes, and remodeling of bone tissue. To reduce pathological changes in bone tissue diseases of the hepatobiliary system in rats statement in cholestasis, need a comprehensive approach [6]. In the core of the preventive complex one can see a hepatoprotector, which, due to its main components (lecithin, quercetin), possesses the liver protecting properties, as well as has anti-inflammatory and bile-diluting effects, and a sorbent. Aim. To conduct a histomorphometric research of the femur in rats with chronic cholestasis and evaluate the effectiveness of the prophylactic complex. Methods. The follow-up study was carried out on male rats, divided into three groups: 1st group – intact, 2nd group – rats with simulated chronic cholestasis, 3rd group – rats, who, in parallel with the development of chronic cholestasis pathology, carried out prevention. Cholestasis in rats was modeled by ligation of the biliary duct under thiopental anesthesia [9]. A hepatoprotector at a dose of 500 mg/kg and a sorbent at a dose of 1 g/kg were administered to group 3 of the animals once over a period of 4 months. Histological analysis and photography of sections of the stegnus cyst were carried out using an additional light microscope and a camera for an Olympus LC30 microscope (Japan). Morphometric studies of rat femur were carried out using the following parameters: volume (%) of the articular epiphyseal cartilage, volume (%) of the cartilage, volume (%) of the cerebrum and the number of osteoblasts per the particular area. The main results. Certain histological changes in the epiphysis of the femoral bone were found in rats with chronic cholestasis, namely, noticeable delamination of the periosteum was noted. In the deep layers of the cartilage, a decrease in the number of isogenic groups was noted, in addition, they contained a smaller number of chondrocytes. Desolation of individual lacunae, a decrease in the number of osteoblasts, and thinning of bone trabeculae were also observed, indicating certain pathological changes in bone tissue. Analysis of the morphometric parameters of the femur in rats with chronic cholestasis revealed a decrease in the specific volume of the cartilage of the articular surfaces by 25.8%, a decrease in the specific volume of the bone marrow and the number of osteoblasts by 14.4% and 39.4%, respectively, and as well as an increase of 33.1% in the specific volume of bone beams in relation to the control group. The introduction of the prophylactic complex contributed to a significant increase in the specific volume of the cartilage of the articular surfaces – by 17.2%, the specific volume of bone marrow by 42.9%, the average number of osteoblasts by 34.9%, and a decrease in the specific volume of bone beams by 31 .7% relative to the group of animals with chronic cholestasis. That is, the use of a prophylactic complex, which consisted of a hepatoprotector and a sorbent, effectively eliminated pathological changes in bone tissue that arose against the background of the development of chronic cholestasis. Conclusions. The formation of chronic cholestasis leads to pathological changes in the cartilaginous tissue of the epiphysis of the femur of the animals under study, and it itself changes the volume of cartilage of the subglobular surfaces and causes destruction of the main components in bone tissue (reduces the volume of bone marrow and the number of osteoblasts at the background of the growth the volume of bone beams). The effectiveness of prophylactic in the elimination of pathological changes in bone tissue at the background of chronic cholestasis has manifested itself as a hepatoprotective, antioxidant, anti-inflammatory and anti-inflammatory hepatoprotector and those combined with a sorbent.

Age-related variations in trunk composition and patterns of regional bone and soft tissue changes in adult Caucasian women by DXA.

We explored the regional variations in body composition with advancing age in healthy Caucasian females living in the Mediterranean area. The objectives of this study were to establish body composition values for the trunk in healthy women of a Greek origin and to evaluate the effects of aging on the distribution of truncal bone mass, fat mass (FM) and lean mass (LM). Body composition of the trunk and detailed analysis of its anatomical components-the ribs, the thoracic spine, the lumbar spine and the pelvis, and FM and LM ratios--were calculated in 330 women aged 20-85years, using DXA. Peak bone mineral density (BMD) of the trunk was attained between ages 30 and 33. The overall truncal BMD reduction with age was 20.7% (p < 0.001). Peak %LM of the trunk was achieved at age 20. The overall reduction of %LM with age for the trunk was 9.8% (p < 0.001). Peak %FM of the trunk was attained between ages 68 and 73, and the overall %FM reduction with age was 2.8% (p > 0.05). Multiple comparative analyses showed that the 51-60years age group was the landmark age for significant changes of truncal bone mass measures across all age groups (p = 0). For truncal LM and FM metrics, multigroup comparative analysis showed the turning point of significant changes in soft tissue was the 41-50 age bracket (p = 0 and p = 0, respectively). In Greek women, truncal %LM exceeded by far %FM across all ages (p = 0). Our results suggest that aging affects body composition of the trunk in ambulatory healthy women of a Greek origin differently, leading to menopausal loss of bone mass, senior adulthood loss of lean mass, and middle-age storage of fat mass. In adult women, these age-related associations between bone and soft tissue metrics on DXA exams carry implications for the attainment of optimal peak values and shifts in body composition overtime, impacting lifelong skeletal health.

Assessment of bone mineral density in epileptic patients with long-term antiepileptic therapy: pilot data

Currently, there are numerous anticonvulsants with a favorable pharmacological profile and high safety are available. However, there is still a risk of drug-induced adverse events during long-term administration of antiepileptic therapy. One of the most unfavorable changes in bone tissue associated with anticonvulsant use is osteoporotic disorders, which result in a loss of bone density, making the bones more fragile and prone to fractures. The problem of decreased bone mineral density and frequent fractures in patients with epilepsy is an important and understudied issue that significantly reduces quality of life and involves significant economic costs for the treatment and rehabilitation of epileptic patients. Studying the interaction between osteoporosis and epilepsy is of great importance for the development of effective methods for timely diagnosis, treatment and prevention of bone metabolism disorders. This article presents pilot results of a study to investigate the effect of antiepileptic therapy on mineral metabolism and bone density. The aim of the study: to evaluate bone mineral density in adult patients with epilepsy long-term receiving antiepileptic therapy. Materials and methods. Thirty-eight adult patients with epilepsy taking antiepileptic drugs for a long time were examined. All patients underwent general clinical, neurologic examination and densitometric study by quantitative computed tomography at three points (L1, L2 and femoral neck). Results. Decreased bone mineral density was found in 34.2% of the patients. Of them, 29% had osteopenia and 5.2% - osteoporosis. The change in mineral density was observed at a median duration of antiepileptic therapy of 8 years. ROC analysis showed that bone mineral density decreased statistically significantly with increasing duration of anitconvulsant therapy (SROC 0.929±0.052; 95% CI: 0.827-1.000). Correlation analysis revealed a markedly close association (ρ = -0.626, p &lt; 0.001) between bone mineral density and duration of antiepileptic therapy. Conclusion. The results of the study confirm the effect of antiepileptic therapy on bone mineral density. And show that the probability of developing osteopenia and osteoprosis with longer duration of anticonvulsant therapy is higher than in the general population. The study of the effects of antiepileptic drugs on bone metabolism has important clinical implications for effective strategies for prescribing antiepileptic therapy in epileptic patients and requires further research.

Clinical diagnostic approach in the treatment of chronic periodontitis in mandibular molars: Clinical cases

Background. Inflammatory process in periapical tissues causes tooth extraction in more than 50% of cases. The development of chronic apical periodontitis can be triggered by an intracanal infection in undetected/missed root canal of the mandibular molars. The morphology of mandibular molars is distinguished by additional canals in the mesial root in some cases. Different studies reveal the middle mesial canal in 4.5% to 26% of cases with quite high incidence in youth. The dental therapy has been searching for effective approaches to diagnosis and treatment of chronic periodontitis, enabling the focus of chronic inflammation to be eliminated and the tooth to be saved. Case descriptions. The paper presents clinical cases of patients with destructive changes in bone tissues in the periapical region of the mesial root in mandibular molars. The developing of this pathology is associated with missed anatomy in the mesial root during primary endodontic treatment. The patients underwent clinical examination consisting of basic methods (interview, examination) and additional techniques (intraoral radiography). An additional middle mesial canal in the root of the mandibular molar was identified taking into account the complex morphology of the root system of the tooth and verified by its careful analysis and radiography. The final clinical diagnosis, chronic apical periodontitis (K04.5), was made following the obtained diagnostic results and the ICD-10 classification. Diagnostic examination and endodontic retreatment were performed using a dental operating microscope. Conclusion. An operating dental microscope provides visualization of microscopic anatomotopographical details, promoting the efficiency of diagnosis and treatment of chronic apical periodontitis in mandibular molars. Using dental microscope facilitates systematization of the data obtained during the examination, making a final clinical diagnosis, and development of a reasonable personalized treatment plan focused on detecting an additional middle canal in the mesio-buccal canal of the mandibular molar. Due to the suggested approach, the long-term outcomes of endodontic treatment can be an objective assessed in dynamics, thereby improving the quality of treatment for chronic apical periodontitis in patients.

Остеодистрофія в умовах експериментальної інтоксикації алюмінієм як наслідок порушень у травному тракті щурів

Relevance. The growing level of aluminum content in the environment: in the atmosphere, soil, water causes concern due to its toxic properties. The central nervous system, bones, kidneys and other are the target-organs for excessive intake of aluminum in the body. The mechanism by which aluminum induces changes in bone tissue has not been fully deciphered and, according to the authors, can be carried out not only due to its antagonistic action in relation to calcium, but also indirectly – due to pathological changes in the digestive tract and inhibition of the absorption of essential substances, which are necessary for bone tissue remodeling. The aim of the work is an experimental study of the effect of long-term intoxication with aluminum chloride on the condition of the mucous membranes of the digestive tract and bone tissue of rats. Materials and methods. The experiment was conducted on 16 male white rats weighing 239–268 g, which were divided into groups: group 1 – intact animals (n=8); group 2 – injection of 0.5 ml of 12 % AlCl3×6H2O solution (80 mg Al/kg) (n=8). On the 60th day of the study, the rats were removed from the experiment, blood serum was collected, the mandible and mucous membranes of the oral cavity, stomach, small and large intestine were isolated. In the mucous membranes of the digestive tract of rats, the activity of acid phosphatase, elastase, urease, catalase and the content of malonic dialdehyde were determined, in the mandibles – atrophy of the alveolar process, the content of aluminum, calcium and biochemical indexes of bone tissue remodeling (activity of elastase, acid and alkaline phosphatase), in blood serum – «liver» markers and calcium content. Results and conclusions. Long-term intoxication with aluminum chloride caused increase the activity of elastase, acid phosphatase, urease and decrease the activity of catalase in the mucous membranes of the digestive tract of rats against the background of increase the level of malonic dialdehyde. The most significant pathological changes were registered in the mucous membranes of the small and large intestines. Enter of aluminum chloride to rats for two months caused a hepatotoxic effect: increased the activity of aminotransaminases, the content of bilirubin and cholesterol in the blood serum of animals. Increased atrophy of the alveolar process of the mandibles of rats simulated aluminum intoxication, accumulation of aluminum in bone tissue and simultaneous decreased calcium level, and increased activity of acid phosphatase against the background of decreased activity of elastase and alkaline phosphatase were established. The extremely wide range of toxic effects of aluminum on the body requires the development of effective approaches to the prevention of intoxication.

Ultrasound Guided Cryoablation of Morton’s Neuroma: Case Series Including Post-Ablation MRI Appearances

Category: Midfoot/Forefoot; Other Introduction/Purpose: Morton’s neuroma (MN) is a very common compressive neuropathy of the interdigital nerve. Non- operative management is recommended initially and many therapies have been described. Cryoablation has shown promising results, however there are limited published studies in the literature. The purpose of this study was to assess the safety and efficacy of Cryoablation in patients with MN. A secondary aim was to evaluate post-procedure MRI appearances. Methods: A retrospective analysis was completed for 24 MN treated between June 2021 and September 2022. All patients had refractory MN symptoms after previous US guided steroid and LA injection within the previous year. Three patients also had refractory symptoms after prior alcohol ablation. Cryoablation was performed as a single outpatient procedure under continuous US monitoring and local anesthesia with 1 cycle for average of 2 minutes. Telephone follow up by radiology department with a 0–10 visual analogue scale (VAS) score was performed at 6 weeks and 3 months post-ablation. The patients were also encouraged to submit patient reported outcomes to a British Foot and Ankle Society (BOFAS) online scoring database as facilitated by the surgical team. Post-ablation MRI was performed to evaluate for post-procedure appearances at various intervals between 3 to 14 months. Results: 24 MN were treated. The mean size of MN treated was 12.3mm. Technical success was 100% and all patients tolerated the procedure well under local anesthesia. Mean pre-procedure VAS pain score was 8, which reduced to 1 at 6 weeks, and 2 at 3 months follow up in the treated MN. There is high patient satisfaction with 20 cases (83%) very satisfied. Four cases had various persistent symptoms and would want to have it done again (17%). Post-ablation MRI showed various bone and soft tissue changes in the ablation zone. There were two cases of fibrosis in the intermetatarsal space and one residual neuroma observed on MRI, although the patients were asymptomatic in the ablation site. No complications occurred e.g. infection, fracture or thermal injury. Conclusion: In this small series, ultrasound guided Cryoablation was deemed safe and effective treatment for MN. Clinical advantages of the procedure are good patient tolerance, single outpatient procedure, high patient satisfaction and reduced risk of scarring or residual neuroma. Further controlled prospective studies would be beneficial.

Mechanical properties of trabeculae and osteocyte morphology change significantly in different areas of the necrotic femoral head.

Background: Osteonecrosis of the femoral head is a complex hip ailment. The precise changes in bone tissue during the disease's onset remain unclear. It is vital to assess both the quantity and quality of the trabecular state in a necrotic femoral head. Aim: This study aims to identify and compare the ultrastructural changes in osteocyte morphology and nanomechanical characteristics within various regions of necrotic femoral heads. Methods: Between December 2016 and May 2023, we gathered ten necrotic femoral heads from patients and five femoral heads from cadavers. The samples from the necrotic femoral heads were categorized into three areas: necrotic, sclerotic, and normal. Our assessment methods encompassed hematoxylin and eosin staining, sclerostin (SOST) immunohistochemistry, micro-computed tomography, nanoindentation, and acid-etched scanning electron microscopy. These techniques enabled us to examine the SOST expression, trabecular microstructure, micromechanical properties of trabeculae, and modifications in osteocyte morphology at the ultrastructural level. Results: The protein level of SOST was found to be lower in the sclerotic area. In the necrotic area, decreased values of bone volume fraction, trabecular thickness, and trabecular number and an increased value of trabecular separation were found. Conversely, in the sclerotic area, higher mean values of bone volume fraction, trabecular number, and trabecular thickness and lower trabecular separation indicated significant changes in the structural characteristics of trabeculae. Compared with the healthy area, the elastic modulus and hardness in the sclerotic area were significantly higher than those in the necrotic, normal, and control areas, while those in necrotic areas were significantly lower than those in the healthy area. The number of osteocytes tended to increase in the sclerotic area with more canalicular cells compared to the healthy area and control group. Conclusion: These results imply that the stress distribution within the sclerotic area could potentially lead to enhanced trabecular quality and quantity. This effect is also reflected in the increased count of osteocytes and their canaliculars. It is plausible that the sclerotic trabecular bone plays a pivotal role in the repair of necrotic femoral heads.

Bone Volume Assessment Around Immediate Dental Implant in the Esthetic Area with Immediate Tooth-Like Single Crown Provisionalization: A Laser and Computed Tomography 1-Year Retrospective Study.

To examine the remodeling process of both the soft and hard tissue components of the postextraction socket around immediately loaded dental implants after tooth extraction in maxillary esthetic areas. Subjects underwent immediate placement of single implants in postextraction sockets without bone grafting, and their immediate provisionalization with custom tooth-like interim crowns were fabricated using digital diagnostic impressions and a dental milling machine. Intraoperative and 1-year follow-up layered scans of the postextraction sockets after implantation were acquired using a 3D optical system. In the short term, subjects underwent computed tomographic scans. Digital impressions for gingival contours, originally stored as STL (standard tessellation language) files, were converted to DICOM (Digital Imaging and Communications in Medicine) files with the implant shoulder working as a referral point, which were then superimposed to 3D radiologic images. The observed volumetric and linear outcomes were measured using a program known as DentaScan. The width of the alveolar crest at the level of the implant shoulder and marginal bone levels were acquired. Nonparametric tests were applied with a level of significance set at P < .01. No failure was reported after a follow-up of 1 year. Little or no inflammation of the treated areas was registered, and there were practically no signs of suppuration. The areas showed a significant reduction in the overall volumes for both soft and bone tissue, with a P value < .0001 from the baseline (0.983 ± 0.172 cm3) to the 1-year survey (0.865 ± 0.156 cm3). If the soft and bone tissue changes were separately evaluated, a significant loss (with a P value < .0001) was registered for only the bone tissues (from 0.434 ± 0.075 to 0.355 ± 0.061 cm3). Moreover, changes in gingival tissue from baseline to the 1-year survey (-0.040 ± 0.067) appeared to be significantly different from the overall volume loss (-0.118 ± 0.083 cm3). A shrinkage in width (-0.5 ± 0.7 mm) was found from baseline (12.6 ± 0.6 mm) to the 1-year follow-up (12.1 ± 0.9 mm). Marginal bone levels were 0.97 ± 0.70 mm and 0.39 ± 0.78 mm, respectively, at the mesial and distal aspects of the implants. The present analysis suggested that immediately customized provisionalization was effective enough to prevent both volume loss and linear shrinkage at the layers of the treated areas. Moreover, the buccal aspects seemed to be the areas most affected by the loss of volume. The mean loss in width, which amounted to roughly 0.5 mm, appeared to be negligible when compared to the overall width measured before surgery.