Bone Tissue Density Research Articles

A Novel Technique for Repairing Alveolar Clefts: Computer-Assisted Design With Posterior of Mandible Block Bone Grafts

Objective: Iliac cancellous bone graft is the gold standard for the treatment of alveolar clefts. However, the resorption rate of iliac cancellous bone is generally high. In this study, the authors propose a new method for repairing alveolar clefts using block bone grafts in the posterior region of the mandibular molar and the anterior margin of the ascending branch. Methods: Ten patients with a diagnosis of unilateral or bilateral alveolar cleft were collected. Block bone grafting between the posterior mandibular molar region and the inner and outer oblique lines of the anterior margin of the ascending branch was used to treat the alveolar synostosis. Preoperative, 1-week postoperative, and 6-month postoperative multislice spiral computed tomography scans of the patients were collected and analyzed for preoperative design and postoperative graft bone morphology using computer-assisted software tools, which were also required to measure the changes in the bone tissue density in the posterior mandibular bone extraction area. Results: At 6 months postoperatively, the mean bone resorption rate of the posterior mandibular bone grafts for cleft alveolar processes was 33.96% ± 11.23%. Bone tissue density in the posterior mandibular bone grafting area recovered to near preoperative levels at 6 months postoperatively. Conclusion: The novel method of bone grafting for the cleft alveolar process used in this paper is really effective. Postoperative posterior mandibular bone extraction did not cause sequelae such as mandibular bone defects or poor morphology in the patients. Computer-assisted design and three-dimensional printing technology helped to improve intraoperative bone grafting accuracy and postoperative assessment.

ОСТЕОПОРОЗ КАК ФАКТОР РИСКА СЕРДЕЧНО-СОСУДИСТЫХ ЗАБОЛЕВАНИЙ

Cardiovascular disease and bone fractures caused by osteoporosis are the leading causes of death in older adults. The purpose of this study was to demonstrate the correlation between overall risk of cardiovascular events and low bone density in postmenopausal women, and its impact on the incidence of major cardiovascular events. Our prospective study included 300 postmenopausal women. All those examined were divided into three groups depending on the measured bone tissue density: Group I – 84 examined with osteoporosis; Group II – 115 patients with osteopenia; and group III – 101 subjects with normal bone density. For all subjects, the overall ten-year risk of a fatal cardiovascular event was calculated using the SCORE system tables. Results. After 36 months of observation, cardiovascular diseases occurred in 19 (6.3%) subjects. Significant differences in the incidence of cardiovascular events were demonstrated between patients with osteoporosis, osteopenia and normal bone density (x2=28.7; p<0.001), as well as between patients with high and low cardiovascular risk (x2=22, 6; p). <0.001). Multivariate logistic regression analysis showed that smoking (2.23; 95% CI: 1.02–6.19; p=0.035) and an increase in total cardiovascular score (1.36; 95% CI: 1.17–1 .58; p<0.001) are related. with an increased risk of cardiovascular events, while an increase in T-score was associated with a decreased risk of cardiovascular events (0.42; 95% CI: 0.25 to 0.73; p=0.002). Measurement of bone density with a standardized assessment of overall cardiovascular risk may be useful in selecting women in need of intensive prevention and treatment of atherosclerosis.

ГИБРИДНОЕ ОРТОДОНТИЧЕСКОЕ ЛЕЧЕНИЕ С ПРИМЕНЕНИЕМ ТРИЛОН-Б ЭЛЕКТРОФОРЕЗА. КЛИНИЧЕСКИЙ СЛУЧАЙ

The purpose of the study is to optimize the treatment of patients with dentofacial anomalies and deformities using complex orthodontic treatment using Trilon-B electrophoresis. The article presents a clinical example of hybrid orthodontic treatment using Trilon-B electrophoresis of a patient aged 37 years with a diagnosis of “distal occlusion, skeletal class 2”. Materials and methods. A comprehensive diagnosis of the condition of the patient’s dental system was carried out: clinical examination; photometry; anthropometry of dentition on models obtained using 3D scanning; X-ray examination methods (OPTG, CBCT); measurement of bone tissue density before treatment in the Picasso Viewer program. The next stage was making a diagnosis and drawing up a treatment plan, consisting of pre-orthodontic preparation of bone structures using Trilon-B electrophoresis and direct orthodontic treatment. Results. After the combined treatment, an optimal functional and aesthetic result was achieved. The proposed method of orthodontic treatment using Trilon-B electrophoresis made it possible to shorten the active period of treatment and reduce the risk of possible complications due to short-term wearing of orthodontic equipment, and was also successfully used in the complex treatment of 23 patients with dentoalveolar anomalies and deformities.

A 3D micro-CT assessment of composition and structure of bone tissue after vertical and horizontal alveolar ridge augmentation using CAD/CAM-customized titanium mesh.

To date, no studies have exploited micro-CT in humans to evaluate bone morphology and structure after bone augmentation with CAD/CAM-customized titanium mesh, in mandible and maxilla. The aim of this study was to assess the composition and microstructure of bone biopsy through micro-CT analysis. Bone augmentation at both maxillary and mandible sites was performed on 30 patients randomly treated with customized mesh, either alone (M-) or covered with resorbable membrane (M+), in both cases filled 50:50 with autogenous bone and xenograft. After 6 months, biopsies were taken and micro-CT was performed on consecutive 1-mm-thick VOIs from coronal to apical side, measuring tissue volumes, trabecular thickness, spacing, and number. In both groups, irrespective of membrane use, bone tissue (M-: 29.76% vs. M+: 30.84%) and residual graft material (M-: 14.87% vs. M+: 13.11%) values were similar. Differences were site-related (maxillary vs. mandibular) with higher percentage of bone tissue and trabecular density of low-mineralized bone and overall bone in the mandible. The composition and structure of bone tissue, as assessed by micro-CT after alveolar ridge augmentation using CAD/CAM-customized titanium meshes, showed similar features regardless of whether a collagen membrane was applied.

Importance of local and systemic factors in preventing implant displacement in the mandibular body: a scoping review of existing literature

BackgroundThe aim of this research was to analyse the current literature on displaced dental implants in the mandibular body, including local and systemic variables related to their cause, and to identify the most frequent location.MethodsThe study conducted a search of three databases (Pubmed, Scopus, and Web of Science) using specific index terms such as ‘dental implant’, ‘displacement’, ‘dislocation’, ‘displaced’, and ‘mandible’. The analysis focused on the direction of displacement and the characteristics of the bone tissue (bone quality, density, and quantity) in cases where dental implants were displaced.ResultsA total of 371 articles were obtained. Thirteen of these articles were selected and read in full. To define bone quality, the Lekholm and Zarb classification, modified by Rosas et al., was used. The type II-B bone, which is characterized by thick cortical bone surrounding cancellous bone with extremely wide medullary spaces, presented the largest number of complications. Twenty-two cases were found in which the displacement direction was horizontal. Of these, four were displaced vestibularly, fourteen lingually, and four remained in the center. Additionally, 24 cases presented vertical displacement, with 12 displaced towards the inferior border of the mandible, 9 towards the middle or adjacent to the inferior dental nerve canal, and 3 above the inferior dental nerve canal.ConclusionThe accidental displacement of implants within the mandibular body is associated with various risk factors, including the characteristics of the bony trabeculum and the size of the medullary spaces. It is reasonable to suggest that only an adequate pre-surgical diagnostic evaluation, with the help of high-resolution tomographic images that allow a previous evaluation of these structures, will help to have better control over the other factors, thus minimizing the risk of displacement.

Evaluation of the elemental composition and radiological density of bone tissue when replacing a metaphyseal defect with bioceramic phosphate-silicate granules (experimental study)

Background: It is known that bioceramic implants containing various calcium or silicon compounds in isolation demonstrate osteoconductive effect in the replacement of post-traumatic bone defects. The combined use of these elements in single material should potentiate the organotypic filling of the bone cavity by creating favorable ion microenvironment and staged biodegradation. AIM: To identify the correlation of radiological indicators of the density of newly formed bone tissue and content of micro- and macronutrients in a bone defect when it is replaced by bioceramics with various mass ratio of calcium phosphate and silicate. MATERIALS AND METHODS: The study was performed on male rabbits of the “white giant” breed, which, after receiving a standardized delimited metaphysical bone defect, implants with variable ratio of calcium phosphate and calcium silicate (in proportions of 40/60, 50/50 and 60/40 wt. %) were used to replace it. The results were evaluated using multispiral computed tomography and scanning electron microscopy energy dispersive analysis with detection by the method of correlation analysis of possible connections between the obtained data. RESULTS: Quantitative indicators of calcium and phosphorus content in bone regenerate in all groups increased mainly in the period from 30 to 60 days, and silicon content, reaching maximum amounts by the 30th day of the experiment, subsequently decreased monotonously, which showed participation of this element in the starting regenerative processes, and its decrease served as a marker of organotypic restructuring. In the elemental analysis of newly formed bone tissue during implantation of bioceramics containing phosphate and calcium silicate in the proportion of 60/40 wt. %. The highest amounts of calcium, phosphorus and silicon and the highest density of newly formed bone tissue were noted, which had direct correlation, and this pattern was observed both in the early stages (30 days) and throughout the experimental study. CONCLUSION: Analyzing the data obtained, it can be concluded that it is advisable to study the features of the course of reparative osteogenesis depending on the ionic environment, as well as the high potential of using synthetic bioceramics in general and the prospects of using implants on the basis of phosphate-silicate composites for bone defects replacement.

Alendronate treatment rescues the effects of compressive loading of TMJ in osteogenesis imperfecta mice

BackgroundOsteogenesis imperfecta (OI) is a genetic disorder of connective tissue caused by mutations associated with type I collagen, which results in defective extracellular matrix in temporomandibular joint (TMJ) cartilage and subchondral bone. TMJ is a fibrocartilaginous joint expressing type I collagen both in the cartilage and the subchondral bone. In the present study the effects of alendronate and altered loading of the TMJ was analyzed both in male and female OI mice.Materials and methodsForty-eight, 10-weeks-old male and female OI mice were divided into 3 groups: (1) Control group: unloaded group, (2) Saline + Loaded: Saline was injected for 2 weeks and then TMJ of mice was loaded for 5 days, (3) alendronate + loaded: alendronate was injected for 2 weeks and then TMJ of mice was loaded for 5 days. Mice in all the groups were euthanized 24-h after the final loading.ResultsAlendronate pretreatment led to significant increase in bone volume and tissue density. Histomorphometrically, alendronate treatment led to increase in mineralization, cartilage thickness and proteoglycan distribution. Increased mineralization paralleled decreased osteoclastic activity. Our immunohistochemistry revealed decreased expression of matrix metallopeptidase 13 and ADAM metallopeptidase with thrombospondin type 1 motif 5.ConclusionThe findings of this research support that alendronate prevented the detrimental effects of loading on the extracellular matrix of the TMJ cartilage and subchondral bone.

Disparities in Osteoporosis Prevention and Care: Understanding Gender, Racial, and Ethnic Dynamics.

Osteoporosis, the most prevalent metabolic bone disease, significantly impacts global public health by increasing fracture risks, particularly among post-menopausal women and the elderly. Osteoporosis is characterized by decreased bone mineral density (BMD) and deterioration of bone tissue, which leads to enhanced fragility. The disease is predominantly diagnosed using dual X-ray absorptiometry (DXA) and is significantly influenced by demographic factors such as age and hormonal changes. This chapter delves into the condition's complex nature, emphasizing the pervasive gender and racial disparities in its screening, diagnosis, and treatment. Recent findings highlight a substantial gap in the management of osteoporosis, with many individuals remaining under-screened and under-treated. Factors contributing to this include the asymptomatic early stages of the disease, lack of awareness, economic barriers, and inconsistent screening practices, especially in under-resourced areas. These challenges are compounded by disparities that affect different genders and races unevenly, influencing both the prevalence of the disease and the likelihood of receiving adequate healthcare services. The summary of this chapter underscores the urgent need for targeted strategies to overcome these barriers and improve health equity in osteoporosis care. Proposed strategies include enhancing public and healthcare provider awareness of osteoporosis, broadening access to diagnostic screenings, and integrating personalized treatment approaches. These efforts aim to align with global health objectives to mitigate the impacts of osteoporosis and ensure equitable health outcomes across all demographic groups.

MSCT-semiotics of vertebrae in patients with cervical spine stenosis

Introduction The number of surgical interventions on the cervical spine for stenosis has been constantly increasing. This fact proves that there is a need for careful preoperative preparation that would consider the complexity of the intervention and the age of the patients.Purpose To substantiate the need to include the MSCT data processing algorithm of bone tissue density of vertebral bodies and arches to assess their quality for planning osteoplastic decompressive laminoplasty in patients with cervical spine stenosis due to degenerative changes.Material and methods This single-center retrospective study investigated qualitative and quantitative characteristics of the spine with radiography and multislice computed tomography (MSCT) in 82 patients with degenerative diseases of the cervical spine and associated spinal canal stenosis (CSS).Results and discussion The data obtained indicate a tendency for the total density of the cervical vertebrae to increase from C3 to C5 and to decrease caudally, with minimal density in C7 without signs of osteoporosis. A similar trend is characteristic of trabecular bone. The density of the osteon layer of the vertebral arch cortex differs significantly from the density of the outer and inner plates. The total density of the compact layer of the vertebral arch cortex exceeds 785.15 ± 38.4 HU.Conclusion The data obtained justify the need to include the study of the density of vertebral bodies, vertebral arches, and its thickness in the MSCT data processing algorithm to develop a plan for surgical intervention in patients with cervical spine stenosis in order to obtain objective data on the quality of the bone.

Changes in the Optical Density of the First Rib and the Coracoid Process of Scapula in Men Depending on Age and Chest Shape According to Computed Tomography

The purpose of the study was to evaluate the dynamics of changes in the optical density of bone tissue of the first rib and the base coracoid process of scapula in men of different ages without signs of osteoporosis depending on chest shape. Material and methods. The study was performed on tomograms of the chest of 191 men aged from 20 to 70 years. Measurements on tomograms were carried out in the axial plane using the RadiAnt program. The scans measured the optical density of the first rib tubercle, the distal bony part of the first rib, and the base of scapula coracoid process. All measurements were taken in men randomized by age and chest shape. The results of osteometry were processed by statistical methods. Results. The chest shape determines age-related changes in the optical density of bone tissue. In individuals with intermediate and transverse chest shapes, a decrease in the optical density of bone tissue at the base of scapula coracoid process begins to appear at the age of 30–50 years. These changes are most pronounced for the base of coracoid process, regardless of the chest shape, at the age of over 50 years. A decrease in the optical density of the first rib tubercle manifests over the age of 50 years in individuals with intermediate and transverse chest shape. In individuals with a gracile chest shape, the optical density of the bone structure is more stable. The tubercle of the first rib, along with the base of coracoid process, can serve as a prognostic area in the diagnosis of systemic osteoporosis in individuals with transverse and intermediate chest shape. Conclusion. A deterministic approach to the described indicators of changes in the optical density of bone tissue of the first rib and scapula in individuals with different chest shapes, according to SCT tomograms, objectively helps to predict and subsequently verify the manifestations of osteoporosis. The dependences we have identified on changes in bone tissue density and in the structure of correlations between the studied parameters of the first rib and the coracoid process indicate pronounced somatotypic variability, which must be taken into account when developing restorative treatment and predicting the course of orthopedic diseases in people of different age.

The Effect of Clopidogrel Treatment on Osseointegration of Titanium Implants: A Histomorphometric Study in Rabbits.

To evaluate the effect of continuous perioperative clopidogrel treatment on the osseointegration of titanium implants. A total of 32 New Zealand rabbits were randomly divided between two groups: a clopidogrel group (n = 16) and a control group (n = 16). For 1 week prior to the surgical placement of a titanium implant in their medial femoral condyle, rabbits in the clopidogrel group received 3 mg/kg of clopidogrel daily, and the control group received only the vehicle. This treatment was continued for another 6 weeks postoperatively. At 6 weeks, the rabbits were euthanized and postmortem histologic and histomorphometric evaluation of the implants was performed. The surgical procedures and postoperative period were uneventful and well tolerated by all animals without any surgical wound dehiscence, signs of infection, or other complication. No implant failure was observed in any of the groups. Histomorphometric analysis showed that bone-to-implant contact (BIC) was 48.77% for the clopidogrel group and 34.65% for the control group, with statistically significant difference between them (P < .001). Moreover, clopidogrel group had significantly greater bone tissue density (40.52% vs 28.74%, respectively; P <.001) and mean trabecular thickness (284.7 μm vs 180.7 μm, respectively; P < .001) in proximity to the implant surface than the control group, while the mean trabecular number had no difference between groups (1.56 vs 1.60, respectively; P = .961). The present study showed that continuous clopidogrel treatment does not negatively affect osseointegration, but rather promotes it in terms of BIC and bone density around the titanium implants. Further studies on the effect of the P2Y12 receptor and its antagonists on peri-implant bone homeostasis may provide useful information or applications for long-term success of dental implant therapy.

An evidence-based algorithmic approach to osteoporosis etiology verification on the example of a clinical case

Background. The importance of timely detection of osteoporosis in patients is conditioned by its severe consequences such as osteoporotic fractures. The disease can be both primary and related to the existing other pathology or to the therapy being carried out, i.e. secondary. In young patients, in most cases, osteoporosis is secondary in nature. Diagnosis verification requires doctor’s perseverance and knowledge. Purpose – is to demonstrate an algorithm of finding a possible cause of the osteoporosis development in a young person on the example of a clinical case. Materials and Methods. The medical history of a 32-year-old man is presented. The man was consulted a doctor with complaints of long-lasting aching pain in the back, stiffness in the morning in the thoracic spine and pain during movement, and was diagnosed with a compression fracture of the spine on the background of a decrease in bone mineral density. Results. The article describes the step-by-step algorithm of making a diagnosis by gradually excluding primary osteoporosis and possible causes of the secondary nature of the disease. Information about the possible mechanisms of osteoporosis formation in the most common conditions included to the differential diagnosis is given in the article. The described diagnostic search algorithm can be used in the practice of a doctor of any specialty. Conclusions. Making a diagnosis of osteoporosis must include a differential diagnosis of its forms with the establishment of the ethiology of this pathology. In young patients, in most cases, osteoporosis has secondary nature and requires a mandatory search for its cause by gradually and methodically excluding conditions that can lead to a decrease in the mineral density of bone tissue, including genetic ones. In practice, there are cases of idiopathic osteoporosis, when the examination does not allow to clearly establish the reasons that led to a decrease in bone density. Such cases require the special attention of doctors, because the diagnosis of the main disease that led to the development of osteoporosis in the future can be detected. In this case along with antiresorptive drugs, therapy of the condition, which is the root cause of the development of osteoporosis, is prescribed, if possible. The specified combined therapy will contribute to increasing the effectiveness of treatment and shortening its duration.

ANALYTICAL REVIEW OF PUBLICATIONS ON MACHINE LEARNING METHODS IN ONCOLOGY AND APPROACH TO EVALUATING THEIR QUALITY

The work includes an analytical review of publications on machine learning methods in oncology and an approach to evaluating their quality. An analysis of publications by year was conducted in the Web of Science and Scopus bibliometric databases. The highest number of authors, the number of publications among universities, the number of countries, and publication categories in the Scopus bibliometric database on machine learning methods in oncology are presented. A multifactor regression prediction model for bone tissue density in oncological pathology predicting four severity grades of the studied disease course was proposed. This model included the following factors with corresponding weights: gender (2.1), age (0.06), stage (0.9), absence/presence of B-symptoms (A/B) (0.9), international prognostic index (IPI-NCCN) ( 1.1), body mass index (BMI) (-0.2), number of chemotherapy courses (0.9), Charlson comorbidity index (СCI) (0.3), bone mineral density after completion of chemotherapy (HU C) (-0.08), β-2-microglobulin (B2M) level (0.0007), lactate dehydrogenase (LDH) (0.006), body surface area (BSA) (-3.3). To assess the level of confidence in the proposed model for predicting bone density disorders in oncological pathology, ROC analysis was performed to obtain the corresponding curves and the area under them was estimated. A conclusion was made about the quality of the classification and the sensitivity, specificity, prognostic value of positive and negative results, the ratio of the probability of positive and negative results, as well as the accuracy of the classification were determined. For each of the four degrees of severity of violations (1C, 2C, 3C, 4C), it is necessary to carry out appropriate calculations, the matrices of inconsistencies for which are given in four tables. Sensitivity was calculated for 1C (98.8%), 2C (97.5%), 3C (95.2%) and 4C (98.5%); specificity for 1C (90.4%), 2C (83.3%), 3C (90.9%) and 4C (95%); predictive value of a positive result for 1C (97.6%), 2C (95.2%), 3C (97.5%) and 4C (97%); predictive value of a negative result for 1C (95%), 2C (90.9%), 3C (83.3%) and 4C (97.4%); accuracy for 1C (97.1%), 2C (97.1%), 3C (97.1%), and 4C (97.1%). According to the results of the analysis of ROC curves, a high level of classification of 1C (AUC=0.869), 3C (AUC=0.869) and 4C (AUC=0.869) was established. The average level of classification of bone density disorders according to 2C (AUC=0.758).

Results of bone grafting using a xenogenic cortical plate BiOTECK

BACKGROUND: The fundamental condition that determines the effectiveness of treatment, with immediate and long-term positive results, is the amount of bone tissue in the jaws at the proposed implantation site. Defects in the dentition to a large extent and severe atrophy of the bone tissue of the jaws due to the loss of teeth significantly limit the use of dental implantation. It is reasonable to expand the indications for the use of dental implants in cases of atrophy of the jaw bone tissue in the installation site. This allows the optimization of surgical techniques aimed at increasing the volume of the jaw bone tissue, such as the use of new osteoplastic materials for guided bone regeneration.&#x0D; AIM: This study aimed to analyze the results of a jawbone graft using a BiOTECK xenogeneic cortical plate.&#x0D; MATERIALS AND METHODS: The test group consisted of 22 patients (11 men and 11 women) with jawbone atrophy. All patients underwent bone graft surgery using a BiOTECK xenogeneic cortical plate (BiOTECK, Italy).&#x0D; In the course of the study, all patients with jawbone loss underwent a dynamic clinical and X-ray examination during the following stages: during the dental implant surgery planning stage aimed at determining the volume of the bone tissue available and identifying the associated conditions and diseases (prior to conducting an osteoplastic procedure), prior to dental implant installation (6 months after osteoplastic surgery), and prior to the start of the orthopedic stage of treatment (12 months after osteoplastic surgery).&#x0D; RESULTS: The cone beam computed tomography data were analyzed and statistically processed to obtain the results. It was revealed that the values of the “bone densitometry” indicator increased 6 months after the bone graft using the BiOTECK xenogeneic cortical plate, and the values of the “densitometric density of jaw bone tissue” indicator increased.&#x0D; Immediately after bone grafting using the BiOTECK xenogeneic cortical plate, the thickness of the bone tissue of the upper jaw increased by an average of 5.0±0.1 mm and that of the lower jaw increased by an average of 3.9±0.1 mm. In the first stage of the dental implant surgery (6 months after osteoplastic procedure), due to resorption, the thickness of the bone tissue of the alveolar process of the upper jaw decreased by 1.1±0.1 mm and amounted to 6.8±0.1 mm (bone resorption rate: 13.9%), and the thickness of the bone tissue of the alveolar process of the lower jaw decreased by 0.8±0.2 mm and amounted to 6.6±0.3 mm (bone resorption rate: 10.3%).&#x0D; CONCLUSION: The clinical and X-ray results obtained 1 year after installing dental implants and performing bone graft surgery using the BiOTECK xenogeneic cortical plate indicate a stable volume of marginal bone tissue in the area of alveolar crest reconstruction.

Evaluation of Bone Density Changes Before and After One Year of Denosumab (Prolia) Administration in Osteoporosis Patients

Background: Osteoporosis, a widespread disease associated with aging, is characterized by a decrease in bone tissue density. With the global population aging, numerous studies aim to present methods for preventing or treating this disease to avoid pathological fractures by preserving bone density. Objectives: This study aimed to compare the changes in bone density in females with osteoporosis before and after receiving denosumab for at least one year. Methods: This clinical trial was conducted on 202 patients with osteoporosis who were referred to two private clinics in Tehran between 2019 and 2020. Each patient received two subcutaneous injections of 60 mg denosumab (Prolia) once every six months. Bone density was measured using the DXA method, and the T-score and the risk of bone fracture were calculated and compared using the FRAX instrument before drug administration and six months after the second dose injection. Results: The average age of the participants was 69.0 ± 8.0 years. Significant differences were observed in vertebral bone density (-2.55 ± 0.06 to -2.00 ± 0.07) and femur bone density (-2.10 ± 0.10 to -1.88 ± 0.06) before and after denosumab treatment (P &lt; 0.05). Furthermore, the risk of major fractures (23.0 ± 1.9 to 18.9 ± 1.5) and hip fractures (8.5 ± 1.3 to 5.7 ± 0.9) significantly decreased before and after treatment with denosumab (P &lt; 0.05). A significant improvement in bone density was observed across all age groups of patients before and after treatment with denosumab (P &lt; 0.05). Conclusions: Denosumab significantly reduces the risk of bone fractures and enhances bone density in postmenopausal women. It proves to be an effective medication for reducing the increased risk of fractures in postmenopausal women and for improving their bone density.

Icariin promotes bone marrow mesenchymal stem cells osteogenic differentiation via the mTOR/autophagy pathway to improve ketogenic diet-associated osteoporosis

BackgroundIcariin, a traditional Chinese medicine, has demonstrated anti-osteoporotic properties in ovariectomized mice. However, its effectiveness in preventing bone loss induced by ketogenic diet (KD), which mimics osteoporosis in human, remains unexplored. This study aims to investigate icariin’s impact on KD-induced bone loss in mice.MethodsThirty mice were divided into: sham, KD, and KD + icariin groups. Post a 12-week intervention, evaluation including bone microstructures, serum concentrations of tartrate-resistant acid phosphatase (TRAP) and bone-specific alkaline phosphatase (ALP), and femoral tissue expression levels of osteocalcin (OCN) and TRAP. The expression levels of mammalian target of rapamycin (mTOR), ALP, peroxisome proliferator-activated receptor gamma (PPAR-γ), phosphorylated mTOR (p-mTOR), and the autophagy adaptor protein (p62) were also analyzed. Alizarin granule deposition and cellular ALP levels were measured following the induction of bone marrow mesenchymal stem cells (BMSCs) into osteogenesis.ResultsThe study found that KD significantly impaired BMSCs' osteogenic differentiation, leading to bone loss. Icariin notably increased bone mass, stimulated osteogenesis, and reduced cancellous bone loss. In the KD + icariin group, measures such as bone tissue density (TMD), bone volume fraction (BV/TV), trabecular number (Tb.N), and trabecular thickness (Tb.Th) were significantly higher than in the KD group. Additionally, bone trabecular separation (Tb.Sp) was markedly lower in the KD + icariin group. Moreover, icariin increased OCN and ALP levels while suppressing PPAR-γ, TRAP, p62, and p-mTOR. In cellular studies, icariin encouraged osteogenic development in BMSCs under KD conditions.ConclusionsIcariin effectively counteracts bone thinning and improves bone microstructure. Its mechanism likely involves stimulating BMSCs osteogenic differentiation and inhibiting bone resorption, potentially through mTOR downregulation. These findings suggest icariin's potential as an alternative treatment for KD-induced bone loss.

Vascular and renal calcification as a consequence of high-dose calcium and vitamin D drugs

Calcium-containing drugs occupy an important place in the list of anti-osteoporotic agents. Their consumption, often in combination with high doses of vitamin D, has increased significantly over the last couple of decades. Cases of uncontrolled intake of the macronutrient have become more frequent. Aggressive advertising of high-dose calcium supplements with calciferol of foreign production on television played its role in this. Nowadays doctors of various specialties have to face more and more often the consequences of using such preparations. The article describes the mechanism of calcium deposits formation in vessels and kidneys against the background of calcium supplementation. The results of large-scale studies proving the close relationship between high intake of calcium and vitamin D with calcification of vessels, development of cardiovascular diseases and nephrolithiasis are presented. Doubts are raised about the validity and necessity of high-dose calcium supplements in the treatment of skeletal diseases. The possibilities of successful therapy of postmenopausal osteoporosis without the use of such agents are presented on the example of the preparation Osteo-Vit D3, which does not contain calcium and high doses of calciferol, but increases the mineral density of bone tissue and reduces the volume of calcificates in blood vessels and kidneys.

Особенности современных методов диагностики остеопороза (обзор литературы)

Abstract. Currently, osteoporosis is one of the most common diseases that significantly reduce the quality of life of patients, leading to their disability and death from related complications. The growing prevalence of osteoporosis in the population over the years, both among people over 60 years of age and among children under 18 years of age, as well as the high prevalence of osteoporotic fractures and their projected increase, requires improvement in the organization of care for patients, which primarily implies timely diagnosis with determination of the risk of low-energy fractures and timely treatment. Purpose: based on an analysis of the literature, to evaluate the current state of the problem and the effectiveness of modern methods for diagnosing osteoporosis. Materials and methods: a search was conducted in the open electronic scientific databases PubMed and the databases of the Russian scientific electronic library eLibrary using keywords and phrases: osteoporosis, osteodensitometry, bone mineral density, osteoporotic fracture. The results were obtained using the equipment of the Center for Collective Use of Scientific Equipment at Derzhavin Tambov State University. Results. The research presents data on risk factors for osteoporosis, possible clinical manifestations and existing methods for diagnosing this disease, indicating the advantages and disadvantages of each of the presented methods. The standard research method, if there is reason to assume a diagnosis, will be osteodensitometry. Ultrasound osteodensitometry serves as an indirect method for assessing bone tissue density. To determine bone mineral density it is recommended to use single energy X-ray absorptiometry (SXA), dual energy X-ray absorptiometry (DXA), radiographic absorptiometry (RA) and quantitative computed tomography. The standard radiographic method of radiation visualization of bone structures is the most accessible and widespread in the Russian Federation; however, for the purpose of diagnosing osteoporosis, this technique in most cases is not the method of choice, since radiographs can reveal reliable, but rather late signs of this disease. Conclusion. Each of the diagnostic methods has its own individual advantages, unique to it; to identify this disease in the early stages of its development, there is a need to use several methods for quantitative determination of bone density simultaneously.

Особливості фізичного і статевого розвитку та стан кісткової тканини у дівчат підліткового віку

In the period of puberty the reproductive system formation takes place, the physical development of adolescents body, the mineralization of bone tissue, and the accumulation of bone mass come to an end. Purpose - to assess the physical, sexual development and state of the bone tissue in adolescent girls with violation of the reproductive system formation. Materials and methods. A clinical examination of 87 girls of pubertal age was carried out, the study group included 47 girls with violation of the reproductive system formation. The comparison group consisted of 40 girls without such violation. Anthropometry was used to assess physical and sexual development, сonstitutional type, body mass index, sexual development, and mineral density of bone tissue were determined. Results. Secondary sexual characteristics were found to appear later and have a lower degree of expression in girls of the study group compared to the comparison group (10.2±1.0 points vs. 12.3±1.4 points, p&lt;0.05). Asthenic type of body structure was found 4 times more often, normosthenic type - 2.2 times less often than in girls of the comparison group (р&lt;0.01). Severe disorders of menstrual function occurred 2 times more often in girls with an asthenic body structure compared to girls with a normosthenic body structure. Deficit body weight in girls of the study group was determined 4.2 times more often in girls of the study group than in the comparison group (p&lt;0.01). In 80.8% of adolescent girls with a violation of the reproductive system formation, the mineral density of bone tissue was significantly lower than in the comparison group. In 55.3% of subjects of the main group, osteopenia of various degrees of severity was determined. Conclusions. Adolescent girls with disorders of the reproductive system formation were found a delay in physical development and puberty. The mineral density of bone tissue was significantly lower than in adolescents with a physiological puberty. The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local ethics committees of the institutions mentioned in the paper. An informed parental consent was obtained for the study in children. No conflict of interests was declared by the author.

Correlation of bone density of individual jaw sections according to Hounsfield with the length of the adentiary section in the cone-beam computer tomography program

Aim. To study the existence of a relationship between the density of bone tissue and the length of the edentulous part of the tooth row. Materials and methods. Evaluation of the density of the spongy substance of the jaws by the maximum and average value of HU. The density of cancellous bone was evaluated only in the areas available for implant placement. The groups consisted of the localization and extent of the dentition defect. Statistical methods included the estimation of the arithmetic mean (M), standard deviation (σ), error of the mean (m), confidence interval (95 % CI), estimation of the median (Me) and interquartile range ([Q1; Q2]), Student’s test (t criterion). Results. Maximum and average indicators of cancellous bone density in defects of the upper (562.4 [347.1; 777.8] and 301.5 [163.0; 439.9], respectively (р = 0.84) and lower (1379.0 [1116.2; 1641.9] HU and 848.6 [630.6; 1066.6] HU, respectively, p = 0.96) jaws in the areas of molars and premolars with “large” defects are significantly different from the indicators “small” defects (299.7 [176.9; 422.4] and 642.6 [470.4; 814.9], 1061.1 [866.5; 1255.7] and 608.3 [440.5; 776.1, respectively). The average bone density of the alveolar process of the upper jaw is almost the same in defects of different lengths. The average density of the cancellous bone of the alveolar part of the lower jaw in “large” defects has significant differences from “average” ones (p = 0.02) and “small” (p = 0.005) defects. Conclusions. The average density of cancellous bone of the alveolar part of the lower jaw in “large” defects has significant differences from “medium” (p = 0.02) and “small” (p = 0.005) defects, and regardless of the extent of the dentition defect corresponds to class D3 (350–850 HU) according to the Misch classification. The average density of cancellous bone of the alveolar process of the upper jaw in the areas of molars and premolars does not have significant differences depending on the extent of the dentition defect and corresponds to class D4 (150–350 HU) according to the Misch classification. Since one class includes a large range of values, the clinical classification of Misch does not allow taking into account individual bone density indicators that have statistically significant differences in different areas of the dentition.