Differences In Bone Density Research Articles

Platelet-rich fibrin did not affect autologous bone graft in repairing alveolar clefts

ObjectiveTo investigate effect of platelet-rich fibrin (PRF) on bone regeneration in repairing alveolar clefts with autologous particulate cancellous bone and marrow (PCBM) from iliac crest. MethodsAlveolar cleft patients were randomly divided into the PRF group (mixing PCBM with liquid PRF and covering the graft with PRF membranes) or control group (PCBM only). After bone graft, the regenerated bone volume was assessed by cone beam computed tomography (CBCT) at 6 months, the bone density was evaluated by CBCT at 6 months and periapical radiographs at 1, 3, and 6 months. The position of the regenerated bone at 6-months was classified using the Chelsea scale. The Mann-Whitney U test was used to analyze differences in bone volume and density between groups. ResultsFifteen alveolar cleft sites (13 patients, aged 8–14 years old) were analyzed. The PRF and control group consisted of 8 and 7 cleft sites, respectively. The regenerated bone volume and density were not significantly different between both groups. The Chelsea scale results were similar in both groups. All clefts healed uneventfully. ConclusionsPRF did not affect bone regeneration when repairing alveolar clefts with autologous PCBM.

The comparative Micro-CT analysis on trabecular bone density between hydroxyapatite gypsum puger scaffold application and bovine hydroxyapatite scaffold application

Background: Generally, after tooth extraction, trauma is caused by bone damage, which leads to a decreased bone density. Bone damage repair should be conducted using a bone graft containing hydroxyapatite (HA). HA can be synthesised from gypsum puger powder, which is abundant and easy to obtain. Hydroxyapatite gypsum puger (HAGP) was successful with 100% hydroxyapatite purity level. Purpose: To compare the ratio of trabecular bone density in Wistar rats between HAGP scaffold application and bovine hydroxyapatite (BHA) scaffold application. Methods: This study is a laboratory experiment using 6 treatment groups, namely K (-) polyethylene glycol (PEG) 7, K (-) PEG 28, HAGP + PEG 7, HAGP + PEG 28, BHA + PEG 7, and BHA + PEG 28. HAGP scaffold freeze-drying. The rats were anaesthetised intramuscularly, and their left mandibular incisor was removed. The scaffold was applied to the mouse socket, followed by tissue decapitation after 7 and 28 days. The examination was carried out with micro-computed tomography (Micro-CT). Next, statistical analysis using a one-way analysis of variance (ANOVA) test was conducted (p <0.05). Results: The ANOVA test result showed a difference in bone density between the treatment and control groups on days 7 and 28. The Least Significant Difference (LSD) test result revealed that there was no significant difference between K (-) PEG 28 and HAGP + PEG 7 (p=0.133). Nevertheless, there were significant differences between the other groups. Conclusion: Based on the Micro-CT analysis, the trabecular bone density in Wistar rats following HAGP scaffold application is higher than that of BHA scaffold application.

Effect of Platelet-Rich Plasma on Bone Healing in Immediate Implants Analyzed by Cone Beam Computerized Tomography: A Randomized Controlled Trial.

The possibility of platelet-rich plasma (PRP) on the improvement of bone and adjacent tissue recovery has previously been validated. However, there is insufficient data supporting the use of platelet-rich plasma to improve the healing of bone and adjacent tissues around an implant in the oral cavity. The purpose of this randomized controlled trial was to observe the effect of platelet-rich plasma (PRP) concentrate on marginal bone loss and bone density around immediate implant placement using Cone Beam Computerized Tomography (CBCT). This clinical study was conducted over a period of six months on 12 subjects, who were equally categorized into two groups. Group I was the control, whereas the subjects in Group II received PRP therapy at the surgical site. All subjects were given a standard treatment with a single implant system (DIO UFII hybrid sandblasted acid-etched implants). Inserted implants were analyzed through CBCT, and records were registered at baseline, at the 12th week before functional loading and the 26th week after functional loading. The bone loss was calculated at the proximal (mesial and distal) side of the implant and bone density at baseline, 12th week, and 26th week after implant placement. SPSS version 23.0 was used for statistical analysis of data. The changes in bone levels were measured and compared between the two groups using the Mann–Whitney U test, with no significant difference. Bone density was analyzed by an independent sample t-test, p value ≤ 0.05 was considered statistically significant. Again, no significant difference in bone density was observed between both groups at all three instances. Therefore, it can be concluded that local injection of PRP after immediate implant placement did not show any decrease in marginal bone loss or improvement in bone density. This trial is registered with NCT04650763.

Comparison of Single and Multiple Low-Level Laser Applications After Rapid Palatal Expansion on Bone Regeneration in Rats

Introduction: This study was performed to compare the effects of single and multiple irradiations of low-level laser therapy (LLLT) on bone regeneration in a mid-palatal suture following rapid palatal expansion (RPE). Methods: In this animal study, 40 male Wistar rats underwent RPE for 7 days and were divided into 4 groups including A: single LLLT on day 7, B: Multiple LLLT on days 7, 9, 11, 13 and 15, C: control (no LLLT), and D: sacrificed on day 7. Animals in group D were used to determine the amount of suture expansion. LLLT was done by a diode laser set at an 808 nm wavelength with a useful power output of 100 mW and duration of 0.1 ms. LLLT was applied to three points. After three weeks of retention, the rats were sacrificed and beheaded and the maxilla was evaluated by occlusal radiography, µ-CT, and histomorphometric analyses. A comparison of the mean measurements between the groups was performed using ANOVA and the Tukey post hoc test. Results: Based on occlusal radiography and µCT, bone density in group B was significantly higher than group A and group C (P<0.05). There was no significant difference in bone density between group A and group C (P>0.05). Mean suture width (MSW) in group B was significantly lesser than the control group (P=0.027) while there was no significant difference between MSWnin groups A and B (P=0.116) and groups A and C (P=0.317). Conclusion: It may be concluded that multiple low-power laser irradiation improves bone regeneration after RPE while single irradiation does not have a positive effect.

Mechanical and morphological characterization of PMMA/bone composites in human femoral heads

PMMA bone cement has gained an important place in a variety of orthopaedic applications in the femur. However, appropriate data on the mechanical properties of bone-cement composites from the human femur are lacking. Therefore, the goal of this study was to determine the morphological and quasi-static compressive properties of proximal femoral bone-cement composites. Thirty trabecular bone specimens were extracted from fifteen pairs of human femoral heads using specimen-specific cutting guides to ensure an accurate alignment with the main trabecular direction (MTD). One specimen from each pair was augmented with PMMA bone cement, while the other one was left untreated. Specimens were scanned with μCT to determine morphological parameters and tested in quasi-static compression until failure. We found that the long axis of the specimens was highly aligned with the MTD (mean error < 5°). A higher compressive modulus and ultimate strength were observed for the bone-cement composite specimens (E = 5.7 ± 0.4 GPa; σu = 77.9 ± 5.1 MPa) compared to the bone only specimens (E = 2.9 ± 0.7 GPa; σu = 19.0 ± 5.8 MPa). Furthermore, the composites had a higher modulus, but lower strength than cement itself (E = 5.0 ± 0.3 GPa; σu = 85.9 ± 2.7 MPa) and the composite modulus was significantly correlated with the bone volume fraction (BV/TV). These results are in contrast to previous findings on human vertebral bone, where the composite was more compliant than cement and no correlation was found between BV/TV and the composite modulus. Thus, properties of bone-cement composites cannot simply be applied across different anatomical sites; the site-specific differences in bone density and trabecular alignment should be taken into account. Collectively, the present results suggest that at low BV/TV, cement dominates the composite properties, while at high BV/TV, the contribution of bone becomes apparent, revealing a positive relationship between BV/TV and the on-axis modulus.

DXA and pQCT derived parameters in Indian children with beta thalassemia major - A case controlled study.

Children with beta thalassemia major (BTM) are known to have reduced bone mass which increases incidence of non-traumatic fractures. Few studies have assessed prevalence of fractures and bone health in underprivileged children with BTM. Our objectives were to 1) determine prevalence of fractures in underprivileged Indian children with BTM, 2) assess size corrected bone density and bone geometry using Dual x-ray absorptiometry (DXA) and peripheral quantitative computerized tomography (pQCT) in these children and healthy controls 3) determine predictors of fractures in children with BTM 4) compare differences in bone density between children with BMT with and without fractures. Bone mineral content and areal bone mineral density (aBMD) of lumbar spine and whole body and vertebral fracture assessment (VFA) was performed by DXA in 334 children (3-18years, 167 BTM+167 controls). Volumetric BMD (vBMD) and bone geometry were assessed by pQCT (subset, 70 BTM, 70 healthy) at distal radius. Children with BTM had higher prevalence of vertebral and long bone fractures (p<0.05). DXA aBMD was lower in children with BTM (p<0.05), whereas, lumbar spine bone mineral apparent density (LSBMAD) was higher (p>0.05). Children with BTM had lower total distal radial vBMD, cortical vBMD and strength strain index (SSI) at 66% site whereas, distal radial trabecular vBMD at 4% was higher (p<0.05). On height adjustment, children with BTM had lower muscle area and cortical thickness and higher marrow area (p<0.05) at 66% site. Age, body size, total body less head (TBLH) aBMD and strength strain index (SSI) were important predictors of fractures in children with BTM. Thus, children with BTM had higher prevalence of non-traumatic fractures. Despite lower areal and volumetric densities, they had higher LSBMAD and trabecular densities which may be attributed to erythroid hyperplasia and iron deposition due to inadequate transfusion and chelation. As LSBMAD is raised in these children, it is unlikely to identify BTM subjects at risk of fracture; VFA thus maybe useful in identifying asymptomatic vertebral fractures.

Microstructure of the hyoid bone based on micro-computed tomography findings.

In this study, micro-CT was used to observe the microscopic anatomy of the hyoid bone, examine the variation of the trabecular bone inside the hyoid bone, and investigate the internal structure of the hyoid bone.A total of 22 hyoid bones were scanned using micro-CT. The changes in the internal bone trabeculae were assessed with 3D reconstructions, and the fine anatomical structure of the hyoid bone was further analyzed.Micro-CT images showed the microstructure of various parts of the hyoid bone. There were significant differences in total volume, bone volume, bone area, bone density, and volume fraction between the body and greater horns of the hyoid bone (P < .05), but no significant differences in the ratio of bone area/volume and bone surface density were found between the body and greater horns of the hyoid bone (P > .05). In addition, significant differences in the trabecular bone measurements, bone trabecular connectivity, and Euler number were found between the body and greater horns of the hyoid bone (P < .05). Other parameters, including bone trabecular thickness, number of trabecular bones, bone trabecular structure model index, and anisotropy of bone trabeculae, did not differ between the body and greater horns of the hyoid bone (P > .05). There was noticeably ossified healing at the joint between the body and greater horns of the hyoid bone.Micro-CT can adequately display the internal structure of the hyoid bone. The identified bone structure may help clarify the physiological function of the hyoid bone. The present findings provide a theoretical basis for further studies aimed at pathological changes due to hyoid injury in clinical and forensic medicine.

Posterior pelvic ring bone density with implications for percutaneous screw fixation

Although the second (S2) and third (S3) sacral segments have been established as potential osseous fixation pathways for screw fixation, the S2 body has been demonstrated to have inferior bone density when compared to the body of the first (S1) sacral segment. Caution regarding the use of iliosacral screws at this level has been advised as a result. As transiliac-transsacral screws traverse the lateral cortices of the posterior pelvis, they may be relying on bone with superior density for purchase, which could obviate this concern. The objective of this study was to compare the bone density of the posterior ilium and sacroiliac joint to that of the sacral body at the first (S1), second (S2), and third (S3) sacral levels. A retrospective case series was performed, reviewing the CT scans of 100 patients without prior pelvic trauma. Each CT was confirmed to have available osseous fixation pathways at the first (S1), second (S2), and third (S3) sacral segments. The bone density of the posterior ilium/sacroiliac joint (PISJ) and sacral body (SB) was measured using the embedded standardized Hounsfield units (HU) tool at each sacral level. The average S2 PISJ bone density (320.1) was significantly higher than the S1 (286.5) and S3 (278.9) PISJ (p < 0.0001) and S1 and S3 PISJ was not statistically different. The S1 sacral body bone density (231.1) was significantly higher than the S2 (182.1) and S3 (126.8) bone density (p < 0.0001). The PISJ bone density is greater than the sacral body at every sacral level (p < 0.0001). The S2 PISJ bone density is significantly greater than S1. The S1, S2, and S3 PISJ bone density is greater than the sacral body at all sacral levels, and the S1 body has higher bone density than the S2 and S3 bodies. These differences in bone density may have implications for the stability of posterior pelvic ring fixation constructs with regard to screw purchase. Level III-Case cohort series.

A Retrospective CBCT Study of the Relationship between Mandibular Symphysis Bone Density and Mandibular Growth Direction

The objective of this retrospective study was to investigate the relationship between mandibular symphysis bone density (BD) and mandibular growth direction in adolescent patients by facilitating the measurement of cortical and cancellous BDs at the mandibular symphysis using cone beam computed tomography (CBCT). 224 adolescent patients (98 males and 126 females) were categorized by sex, age, and mandibular growth direction. Cortical and cancellous BDs were measured along with a sagittal slice at multiple locations. Females exhibited higher cortical BD than males at menton (Me, P =0.002). Patients with a posterior growth direction exhibited a higher cortical BD than those with anterior and normal growth direction at Me (P <0.021, P <0.001, respectively), pogonion (Pog, P =0.037, P =0.037, respectively) and genion (Ge, P =0.007, P =0.008, respectively). Patients with a posterior growth direction exhibited a higher cortical BD than those with anterior growth direction at B point (P =0.009). Significant differences in BD were identified across anthropometric categories. These findings may be useful in determining mandibular growth direction in adolescents.

Correlation of Implant Stability Between Two Noninvasive Methods Using Submerged and Nonsubmerged Healing Protocols: A Randomized Clinical Trial.

Various invasive and noninvasive methods have been used for measuring primary implant stability. Periotest damping device and resonance frequency analysis with the Osstell device have been classified as noninvasive methods. Primary and secondary implant stability measurements using both devices have given reproducible quantitative values. In this clinical randomized trial, a general correlation was evaluated between the implant stability recorded using both Osstell and Periotest devices on the day of implant installation and 3 months after healing for the submerged and nonsubmerged loading protocols. The present study also investigated whether the difference in gender of the included patients would have an effect on the correlation between the two devices. Eighty completely edentulous patients were recruited, and all patients ranged from 50 to 69 years of age. Overall, 56 men and 24 women were included, with a mean age of 62.5 years for men and 59.6 years for women. A single implant was installed in the midline of the completely edentulous mandible to improve retention of the patient's lower denture. After implant installation, one implant stability quotient (ISQ) value at the buccal surface was recorded, and then the Periotest M device was used to measure the damping effect (Periotest value [PTV]) of the installed implant using the smart peg screwed to the implant. Patients were then randomized into 2 groups using sealed envelopes: the submerged and nonsubmerged groups. For both groups, all ISQ and Periotest readings were recorded in the patient's case report file on the day of implant installation and 3 months after healing. When the ISQ of the buccal surface was correlated to the PTV, there was a moderate negative statistically significant correlation between the 2 readings (correlation coefficient = -.466, P = .000). There tended to be a weak negative correlation between the 2 devices in the male group (correlation coefficient = .395, P = .046) during implant installation, although there tended to be no correlation between the 2 devices in the female group (correlation coefficient = -.367, P = .342). After 3 months of healing, when correlating the readings of the buccal surface of the Osstell with that of the Periotest within each group (submerged and nonsubmerged), there was no statistically significant correlation between the readings within each group (correlation coefficient = -.014, -.430, P = .942, P = .052, respectively). However, there was a strong negative statistically significant correlation between the 2 devices for the female group for both the nonsubmerged group (correlation coefficient = -.823, P = .003) and submerged group (correlation coefficient = -.857, P = .014), whereas there was no statistically significant correlation within the male group for both the nonsubmerged group (correlation coefficient = -.377, P = .123) and submerged group (correlation coefficient = -.022, P = .940). The correlation between the Osstel and Periotest device remains controversial. The present study concluded that there is a significant negative correlation between the 2 devices when recording primary implant stability, although this significance is lost after 3 months of loading when recording secondary implant stability. Gender also affects the implant stability recording, which is mainly due to the difference in bone density between men and women.

Categorizing 10 Sports According to Bone and Soft Tissue Profiles in Adolescents.

Considering the different loading and training characteristics of the sports practiced during growth, it is important to specify and categorize the bone and soft tissue adaptations in adolescent athletes. This study aimed to categorize 10 different loading sports and a nonsport group and identify the differences in bone density and soft tissues. The sample included 625 adolescents (10 to 17 yr of age) of 10 sports (soccer, basketball, volleyball, track and field, judo, karate, kung fu, gymnastics, baseball, and swimming) and a nonsport group. Dual-energy x-ray absorptiometry assessed areal bone mineral density (aBMD), bone mineral apparent density (BMAD), and soft tissues (lean soft tissue and fat mass). The results were adjusted for sex, peak height velocity status, lean soft tissue, fat mass, and weekly training volume. The comparisons among groups showed that soccer had the highest whole-body aBMD (mean ± SEM: 1.082 ± 0.007 g·cm) and lower limb aBMD (1.302 ± 0.010 g·cm). Gymnastics presented the highest upper limb aBMD (0.868 ± 0.012 g·cm) and whole-body BMAD (0.094 ± 0.001 g·cm). Swimming presented the lowest aBMD values in all skeletal sites (except at the upper limbs) and whole-body BMAD. The soft tissue comparisons showed that soccer players had the highest lean soft tissue (43.8 ± 0.7 kg). The lowest fat mass was found in gymnasts (8.04 ± 1.0 kg). The present study investigated and categorized for the first time 10 different sports according to bone density and soft tissue profiles. Soccer and gymnastics sport groups were found to have the highest bone density in most body segments, and both sports were among the groups with the lowest fat mass.

Measurement of Scaphoid Bone Microarchitecture: A Computed Tomography Imaging Study and Implications for Screw Placement

High bone density and quality is associated with improved screw fixation in fracture fixation. The objective of this study was to assess bone density and quality in the proximal and distal scaphoid to determine optimum sites for placement of 2 screws in scaphoid fracture fixation. Twenty-nine cadaveric human scaphoid specimens were harvested and scanned using micro-computed tomography. Bone density (bone volume fraction) and bone quality (relative bone surface area, trabecular number, and trabecular thickness) were evaluated in 4 quadrants within each of the proximal and distal scaphoid. The proximal radial quadrant of the scaphoid had significantly greater bone volume than the distal ulnar (mean difference, 33.2%) and distal volar quadrants (mean difference, 32.3%). There was a significantly greater trabecular number in the proximal radial quadrant than in the distal ulnar (mean difference, 16.7%) and in the distal volar quadrants (mean difference, 15.9%) and between the proximal ulnar and the distal ulnar quadrants (mean difference, 12%). There was a significantly greater bone surface area in the proximal radial and distal radial quadrants than in the distal ulnar and distal volar quadrants. There were no significant differences in trabecular thickness between the 8 analyzed quadrants CONCLUSIONS: Although there are differences in bone volume, trabecular number, and bone surface area between the proximal pole of the scaphoid and that of the distal pole, there were no significant differences in the bone quality (trabecular thickness, trabecular number, and relative bone surface area) and density (bone volume fraction) between the 4 quadrants of the proximal or distal pole of the cadaveric scaphoids studied. Insertion of 2 headless compression screws can be determined by ease of surgical access and ease of screw positioning and not by differences in bone quality or density of the proximal or distal scaphoid.

Bone Geometry, Density, and Microarchitecture in the Distal Radius and Tibia in Adults With Marfan Syndrome Assessed by HR-pQCT.

Marfan syndrome (MFS) is a hereditary disorder of connective tissue caused by mutations in the fibrillin-1 gene. Studies have shown that patients with MFS have lower bone mass, but little is known about the other constituents of bone strength. We hypothesize that patients with MFS will have larger bone area and compromised cortical microarchitecture compared with non-MFS individuals. A total of 74 adult patients with MFS and 145 age- and sex-matched non-MFS reference individuals were included in this study. High-resolution peripheral quantitative computed tomography (HR-pQCT) at the distal radius and distal tibia and dual-energy X-ray absorptiometry of total hip and the lumbar spine were performed, and bone turnover and sex hormones were measured. Patients with MFS had significantly lower areal bone mineral density (BMD) at the total spine (-13%) and total hip (-7%) when compared with the reference group. Patients with MFS had significantly larger total bone area at both the radius (+27%) and tibia (+34%). Volumetric BMD at both measured sites showed significantly reduced total, trabecular, and cortical volumetric BMD in patients with MFS compared with the reference group. The microarchitectural parameters at the radius and tibia were compromised in patients with MFS with significantly reduced trabecular number and thickness, leading to a higher trabecular separation and significantly reduced cortical thickness and increased cortical porosity compared with the reference group. The differences in bone density, geometry, or microarchitecture were not explained by increased bone turnover markers or circulating levels of sex hormones. We conclude patients with MFS have altered bone geometry, altered bone microstructure, and lower bone mass (lower areal BMD and volumetric BMD at all sites) compared with healthy reference individuals. Future studies should focus on fracture rates and fracture risk in adult and aging patients with MFS. © 2020 American Society for Bone and Mineral Research (ASBMR).

Evaluating mandibular symphysis bone density according to various skeletal patterns with CBCT.

The aim of this retrospective study was to evaluate the bone density (BD) at the mandibular symphysis according to horizontal and vertical patterns using cone-beam computed tomography (CBCT). Three hundred nineteen untreated adults with a mean age of 24years. CBCT images were converted into the lateral cephalometric images, and tracings were performed for categorizing the patients based on skeletal features. Cortical BDs at B point, pogonion (Pog), genion (Ge) and menton (Me), and cancellous BDs of the mandibular symphysis were measured using CBCT images. Statistical analyses were performed to evaluate the effects of horizontal and vertical skeletal patterns on BDs. Females exhibited higher BD than males at the Me, Pog, Ge (P<.001). Hyperdivergent skeletal pattern showed significantly higher cortical BD than normovergent and hypodivergent skeletal patterns at Me (P<.001). Normovergent skeletal pattern showed significantly higher cortical BD than hypodivergent skeletal patterns at Me (P=.001). Class II skeletal pattern showed significantly higher cortical BD than Class I and III skeletal patterns at Me (P<.001) and Ge (P<.05). Class I skeletal pattern showed significantly higher mean cortical BD than Class III skeletal pattern at B point (P=.025). Cancellous BD was higher in Class III and hypodivergent skeletal patterns than others but showed no statistical significance. Significant differences were identified across various skeletal patterns. Several mandibular symphyseal landmarks showed statistically significant differences in BD at Me, B point and Ge, with Me having the most statistically significant findings.

Ultrasonic examination of differences in bone density of chronic obstructive pulmonary disease (COPD) rats constructed by different methods.

Osteoporosis is one of the main complications of chronic obstructive pulmonary disease (COPD) patients. We investigated the bone density in rat model of COPD induced by different method. We developed seven distinct groups to evaluate the differences in bone density. Based on these seven different ways, rats were categorized into distinct groups in which simple cigarette inhalation, sulfur dioxide inhalation, lipopolysaccharide intubation, protease induction, bacterial nasal injection, smoking combined with endotoxin, smoking combined bacterial infection, and smoking combined with protease were tested. The results from the male Sprague-Dawley (SD) rats were used to construct the COPD model, and then the bone density of the rats' right femurs was examined by the ultrasonic bone density testing. The compound factor-induced COPD rat model provides a better simulation of the clinical characteristics and pathophysiological processes of COPD. Smoking combined with bacterial infection method has the most apparent effect on reducing bone density, with statistical differences (P<0.05). The COPD rat model constructed by the combination of smoking and bacterial infection method has a much lower bone density.

Rehabilitation of traumatic spinal cord injury with lower limb exoskeleton

In recent years, several technological innovations have emerged to improve the rehabilitation of traumatic spinal cord injury (SCI). Among them, robotic orthosis, also known as human exoskeletons, are prominent devices for lower limb therapy. Since the early 2000s, numerous clinical studies have begun to investigate the efficacy of these devices, demonstrating the beneficial effects of exoskeletons regarding the prevention and deceleration of the progression of complications following spinal cord injury and subsequent immobilization. Previous works also deal with physiological, psycho-social and social effects, and presents possible risk factors following SCI. In this paper, the main results of the relevant international research is reviewed, the structure and operation of the first devices (ReWalkTM P6.0) in Hungary are presented, also, the main modalities of robotic assisted rehabilitation activity at international level are demonstrated. Based on the international results, the training protocol for a multicentre controlled clinical trial, involving the University of Pécs and the National Institute for Medical Rehabilitation is presented in this work. According to our hypothesis, high intensity exoskeleton-assisted complex rehabilitation induces positive changes in bone density, in the urogenital and gastrointestinal tract. Changes are quantified by objective urodynamic and defecative parameters. The difference in bone density is assessed with DEXA scan, and the effects on mental status are evaluated by questionnaires. The aim of this research is to promote a complementary therapeutic procedure based on validated results for SCI patients with paraplegia, also to establish recommendations for home use of the robotic exoskeletons, and to conceivably join to international scientific research projects. Orv Hetil. 2020; 161(29): 1200-1207.

Bone Mineral Density of Femur and Lumbar and the Relation between Fat Mass and Lean Mass of Adolescents: Based on Korea National Health and Nutrition Examination Survey (KNHNES) from 2008 to 2011.

It is most important to reach the maximum bone density in the childhood period to prevent developing osteoporosis; it is widely known that increased body weight has a positive correlation with bone density and that even though both the fat mass and lean mass have a significant impact on bone density, the latter mass has more importance for adults. Therefore, the study analyzed to identify the relationship between bone density and both fat mass and lean mass of Korean adolescents. Subjects were chosen among 21,303 people from the Korea National Health and Nutrition Examination Survey (KNHNES) between 2008 and 2011 that took a bone density checkup; as a result, 1454 teenagers aged between 12 and 18 were selected. Data analysis was performed in SAS ver. 9.4 (SAS Institute Inc., Cary, NC, USA) following the KNHNES and the weighted complex sample analysis was conducted; body fat mass and lean mass were divided into quintile groups, and to figure out the differences in bone density that were analyzed in six models adjusted by body weight (kg) and walking (yes/no), muscle strengthening exercises (yes/no), nutrition (intake of ca (g), and serum vitamin D (ng/mL)). Then, the generalized linear model (GLM) and trend test were conducted for each gender with a significance level of 0.05. The bone density differences of fat mass and lean mass were analyzed. The result of Model 6 considering all correction variables is as follows; in the case of male adolescents, the total femur and lumbar spine showed a significant difference (F = 13.120, p < 0.001; F = 12.900, p < 0.001) for fat mass, and the trend test showed that the figures significantly decreased (β = −0.030, p < 0.001; −0.035, p < 0.001). Meanwhile, for lean mass, the total femur and lumbar spine had a significant difference (F = 16.740, p < 0.001; F = 20.590, p < 0.001) too, but the trend test showed a significant increase (β = 0.054, p < 0.001; 0.057, p < 0.001). In the case of female adolescents, the lumbar spine (F = 3.600, p < 0.05) for lean mass showed a significant difference, and it also significantly rose in the trend test too (β = 0.020, p < 0.01). To sum up the results, for male adolescents, the bone density differences for fat mass (FM) and lean mass (LM) all had significant differences, but for female adolescents, only the lumbar spine for LM showed such a result. Meanwhile, both genders showed that LM had a more positive impact on bone density than FM.

Assessment of bone density changes following two-jaw surgery using multidetector computed tomography: A pilot study.

ObjectiveThe aim of this retrospective study was to evaluate the pre- and postsurgical bone densities at alveolar and extra-alveolar sites following two-jaw orthognathic surgery.MethodsThe sample consisted of 10 patients (mean age, 23.2 years; range, 18.0–27.8 years; 8 males, 2 females) who underwent two-jaw orthognathic surgery. A three-dimensional imaging program (Invivo 5) was used with multidetector computed tomography images taken pre- and postoperatively (obtained 32.3 ± 6.0 days before surgery and 5.8 ± 2.6 days after surgery, respectively) for the measurement of bone densities at the following sites: (1) alveolar bone in the maxilla and mandible, (2) extra-alveolar sites, such as the top of the head, menton (Me), condyle, and the fourth cervical vertebrae (C4).ResultsWhen pre- and postsurgical bone densities were compared, an overall tendency of decrease in bone density was noted. Statistically significant reductions were observed in the densities of cancellous bone at several areas of the maxillary alveolar bone; cortical and cancellous bone in most areas of the mandibular alveolar bone; cortical bone in Me; and cancellous bone in C4. There was no statistically significant difference in bone density in relation to the depth of the alveolar bone. In a comparison of the bone densities between groups with and without genioplasty, there was almost no statistically significant difference.ConclusionsAccelerated tooth movement following orthognathic surgery may be confirmed with reduced bone density. In addition, this study could offer insights into bone metabolism changes following orthognathic surgery, providing direction for further investigations in this field.

Can Ellipsoid Sign be One of the Earliest Findings of the Medial Femoral Condyle Chondromalacia of Knee Antero Posterior X-Ray?

Aim of the study was to investigate whether ellipsoid sign (ES) in the region corresponding to the cartilaginous facet of the medial femoral condyle (MFC) indicates early cartilage lesion. The finding has not been defined in the literature yet. The study was performed retrospectively with 50 patients who underwent articular cartilage examination and arthroscopy between 2015 and 2018. Patients were divided into two according to the presence or absence of ES. There were 24 patients in case group (Group A) and 26 patients in controls (Group B). Weight-bearing cartilage areas of MFC in the region where ES was found in both groups were classified according to arthroscopic Outerbridge classification (OC) and compared statistically with each other. There was no significant difference in terms of age, gender and alignment between Group A and Group B (p > 0.05). All OC grades were higher in Group A (p < 0.001). Positive correlation between ES and MFC chondromalacia grade was detected (r: 0.671, t: 6.266, p < 0.05). ES, which refers to the difference in bone density in MFC seen in antero-posterior (AP) X-Ray, is a result of changes in subchondral bone due to chronic cartilage loss. ES detected on AP X-Ray may help in early diagnosis of medial femoral articular cartilage chondromalacia, even at grade 0 or 1. We recommend searching for ES, as the earliest symptom of chondromalacia, which occurs even before MRI lesions. Future studies may reveal additional information about ES.

PD26-11 DIFFERENTIAL EFFECTS OF TESTOSTERONE TREATMENT ON BONE DENSITY AND BODY COMPOSITION IN MEN WITH CLASSICAL VS FUNCTIONAL HYPOGONADISM

INTRODUCTION AND OBJECTIVE: There are limited data on Testosterone (T) therapy in men with functional hypogonadism (FH) compared to those with classical forms (primary/secondary hypogonadism, PH/SH) regarding bone density and body composition METHODS: Registry data of 2-5 years comprising 189 patients including 67 men with PH (mean age 32.0±10.1 years), 49 with SH (mean age 30.4±9.4 years) and 73 with FH (mean age 44.8±11.6 years) all receiving uniform treatment using intramuscular T undecanoate (1000 mg). All patients received annual assessments of bone density and body composition using dual-energy X-ray absorptiometry RESULTS: Serum T concentrations increased from 6.8±2.7 nmol/L to 18.1±2.9 nmol/L in men with PH/SH and from 7.9±2.5 nmol/L to 17.3±3.2 nmol/L in men with FH. There was an initial difference in bone density between patient groups (T-Score lumbar spine, PH: -1.8±0.3, SH: -2.3±0.4, FH: -1.2±0.3, all p<0.001 vs each other) and (T-Score hip, PH: -1.4±0.3, SH: -1.7±0.4, FH: -1.1±0.3, all p<0.001 vs each other). Body fat content was higher (p<0.001) in FH (38%±10) than in PH (28%±6) and SH (30%±5). Lean body mass was lower in FH compared to PH/SH (p<0.001), respectively. Changes over time using Kaplan-Meier models revealed fundamental differences in inter-individual effects: men with FH were more likely to lose body fat and gain lean mass compared to men with PH/SH (hazard ratio 1.4 [1.2-1.6], p=0.006 and hazard ratio 1.3 [1.1-1.6], p=0.009). A significant increase in bone density was observed for all patient groups (lumbar spine and hip, both p<0.001), albeit the effect was least pronounced in FH and strongest in SH (lumbar spine: p=0.008 and hip: p=0.01, post-hoc tests). Stepwise multiple Cox regression models could attribute these differences to the different baseline characteristics between groups including age and delta T levels. There was no difference between groups for the overall increase in hematocrit. Changes in PSA levels were more likely to occur in FH (hazard ratio 1.4 [1.2-1.6], p=0.004) CONCLUSIONS: This study provides major new findings regarding effects T therapy in different groups of hypogonadal men. Patients with FH experience greater benefits in losing fat mass and gaining lean mass than men with classical forms of hypogonadism, while these have a more pronounced increase in bone density than patients with FH Source of Funding: none