Differences In Bone Density Research Articles

Influence of Extra Virgin Olive Oil Supplement and Combined Exercise on Health-Related Physical Fitness, Cardiovascular Disease Risk Factors, and Bone Density in Obese Elementary Students

PURPOSE: The purpose of this study was to investigate the influence of combined exercise and extra virgin olive oil supplement on health-related physical fitness, cardiovascular disease risk factors, and bone density in obese elementary school students.METHODS: The participants were 40 obese elementary students over 25 kg/m<sup>2</sup> to BMI, 10 combined exercise with high olive oil supplement group (HO+CE), 10 combined exercise with low olive oil supplement group (LO+CE), 10 combined exercise with placebo group (PL+CE), and 10 placebo group (PL). The participants have performed the exercise program for 70 minutes a day and 3 times a week with aerobic and resistance exercise during 12 weeks. Also, high and low olive oil supplement group took in 25 g and 10 g respectively at the same time and place.RESULTS: There were significant decreases in body fat to HO+CE compared with PL+CE (<i>p</i><.05) and significant increase in muscle mass and muscular endurance compared with PL+CE (<i>p</i><.05). However, there were no significant differences in body weight, BMI, muscular strength, and flexibility between groups. For cardiovascular disease risk factors, there is a significant difference to triglyceride, LDL-C, total cholesterol in HO+CE compared with PL+CE (<i>p</i><.05) and there were significant differences to HDL-C significantly decreased in HO+CE compared with PL+CE (<i>p</i><.05). There is no significant difference in bone density between groups (<i>p</i>>.05).CONCLUSIONS: In conclusion, there were positive responses for body composition and cardiovascular disease risk factors for the twofold cases through combined exercise and high extra virgin olive oil supplement, but not for bone density.

Effect of sandwich bone augmentation using hydroxyapatite and demineralized freeze- dried bone on infrabony pocket treatment

Periodontitis is periodontal inflammation in response to plaque bacterial antigens, causing damage to periodontal ligament and alveolar bone resorption. Bone graft material combination i.e. demineralized freeze-dried bone allograft (DFDBA) and hydroxyapatite (HA) using sandwich bone augmentation (SBA) method will support each other and will be beneficial to be used as a scaffold. The body takes long time to resorb HA so this could complement DFDBA which is more easily dissolved. This study aimed to reveal the effect of bone graft addition using SBA method on the treatment of infrabony pocket with open flap debridement in terms of probing depth, relative attachment loss, alveolar bone height, and density. This study was carried out to 20 infrabony pockets, where 10 of them were treated using open flap debridement with HA addition, while the other 10 groups were treated using open flap debridement with DFDBA and HA using SBA method. Probing depth and relative attachment loss were measured on days 0, 30 and 90. Bone height and density were measured using cone-beam computed tomography (images on day 0 and 90). The study showed that probing depth reduction on SBA group was greater than HA group. There were significant differences in probing depth and relative attachment loss examinations. However, bone height and bone density reduction did not show any significant difference. The conclusion from this study is open flap debridement using SBA method yields better regeneration in terms of probing depth and relative attachment loss than open flap debridement with HA addition. There is no difference in bone height and bone density between the two groups.

Degradation and Biocompatibility of AZ31 Magnesium Alloy Implants In Vitro and In Vivo: A Micro-Computed Tomography Study in Rats.

In current orthodontic practice, miniscrew implants (MSIs) for anchorage and bone fixation plates (BFPs) for surgical orthodontic treatment are commonly used. MSIs and BFPs that are made of bioabsorbable material would avoid the need for removal surgery. We investigated the mechanical, degradation and osseointegration properties and the bone-implant interface strength of the AZ31 bioabsorbable magnesium alloy to assess its suitability for MSIs and BFPs. The mechanical properties of a Ti alloy (TiA), AZ31 Mg alloy (MgA), pure Mg and poly-L-lactic acid (PLA) were investigated using a nanoindentation test. Also, pH changes in the solution and degradation rates were determined using immersion tests. Three-dimensional, high-resolution, micro-computed tomography (CT) of implants in the rat femur was performed. Biomechanical push-out testing was conducted to calculate the maximum shear strength of the bone-implant interface. Scanning electron microscopy (SEM), histological analysis and an evaluation of systemic inflammation were performed. MgA has mechanical properties similar to those of bone, and is suitable for implants. The degradation rate of MgA was significantly lower than that of Mg. MgA achieved a significantly higher bone-implant bond strength than TiA. Micro-CT revealed no significant differences in bone density or bone-implant contact between TiA and MgA. In conclusion, the AZ31 Mg alloy is suitable for both MSIs and BFPs.

Under-Drilling versus Hybrid Osseodensification Technique: Differences in Implant Primary Stability and Bone Density of the Implant Bed Walls.

The goal of this study was to evaluate the effects of two implant bed preparation techniques on the implant primary stability (IPS) and the bone density of the implant site. We completed 40 implant bed osteotomies in pig ribs using two techniques: osseodensification (OD) plus under-drilling (UD) with universal osseodensification drills (Test A), and under-drilling alone with drills of the same implant system (Test B). Implants with a 4.1 mm diameter and 10 mm length were inserted, and the IPS was evaluated with three methods: (insertion torque (IT), periotest (PTV), and resonance frequency analysis (RFA). The bone density was evaluated using micro-computed tomography. ANOVA and Tukey’s post-hoc test were used for comparison of the IPS values, and Kruskal–Wallis was used to evaluate the bone density. Statistical significance was set at p < 0.05. The tested B technique (UD) achieved a higher IPS compared to the Test A technique (OD + UD) for all the evaluation methods (p < 0.05). Bone density was higher at the apical and middle region in Test A compared to Test B and control sites (p < 0.05). We concluded that although the bone density increased with the hybrid OD technique with universal drills, implant beds prepared with UD using drills with geometry similar to that of the implant are more efficient at increasing IPS values.

High-resolution Peripheral Quantitative Computed Tomography for the Assessment of Bone Strength and Structure in Obstructive Sleep Apnea Patients

Objective To evaluate the bone strength and structure of patients with obstructive sleep apnea(OSA)by the high-resolution peripheral quantitative computed tomography(HR-pQCT)and to explore the relationship between OSA and osteoporosis. Methods Male patients who visited the Sleep Respiratory Center of our hospital from August 2017 to January 2019 were consecutively recruited.Clinical data including the results of Epworth sleep scale(ESS)scoring and overnight polysomnography were collected.HR-pQCT was used to compare the differences in bone geometry,density,and microstructure between OSA patients and non-OSA people;also,the radius and tibia on the non-dominant side were measured to explore the relationship between OSA and osteoporosis. Results A total of 83 subjects were enrolled in the study.The number of patients in the mild,moderate,and severe OSA groups and non-OSA group were 21,18,34,and 10,respectively.There was no significant difference in age,blood pressure,ESS score,sleep stage,and sleep efficiency among these four groups(P>0.05).Body mass index(BMI)and neck circumference were significantly different among these groups(F=4.234,P=0.008;F=3.100,P=0.031).There was no significant difference in the radius indicators(P>0.05).For tibia,there were significant differences among the four groups in the cortical area(Ct.Ar)(F=3.937,P=0.011).There were also significant differences in the bone microstructural indicators including trabecular thickness(Tb.Th)and cortical thickness(Ct.Th)(F=6.247,P=0.001;F=3.746,P=0.014),which were significantly lower in the three OSA groups than in the control group.Pairwise comparisons showed that the Ct.Ar in the severe OSA group was significantly higher than that in the mild OSA group(P=0.019)and Tb.Th in the control group was significantly higher than those in the mild and moderate OSA groups(P=0.006,P=0.001).Correlation analysis showed that,within a certain range,total volumetric bone mineral density(Tt.vBMD)and Tb.Th of radius and tibia were negatively correlated with age(r=-0.312,P=0.004;r=-0.328,P=0.002;r=-0.265,P=0.015;r=-0.280,P=0.010)and positively correlated with BMI(r=0.240,P=0.029;r=0.369,P=0.004;r=0.299,P=0.006;r=0.416,P=0.010).Stepwise multiple regression analysis showed that Tb.Th of radius and tibia were mostly correlated with BMI(β=0.262,P=0.008,R 2=0.243,F=6.270,P=0.000;β=0.494,P=0.000,R 2=0.186,F=7.243,P=0.000)and age(β=-0.216,P=0.030,R 2=0.243,F=6.270,P=0.000;β=-0.306,P=0.003,R 2=0.186,F=7.243,P=0.000).Tt.vBMD of radius had a certain correlation with sleep efficiency and with the decreasing nocturnal mean oxygen saturation caused by OSA(β=0.312,P=0.002, β=-0.249,P=0.012,R 2=0.327,F=7.482,P=0.000). Conclusions In non-elderly male populations,OSA mainly causes a decrease in Tb.Th and Ct.Th of the tibia.The changes in bone strength and structure are mainly related with age and body size and also have certain correlations with sleep efficiency and with the decreasing nocturnal mean oxygen saturation caused by OSA.

Effect of percutaneous kyphoplasty on lumbar-pelvic correlation in osteoporotic vertebral compressive fractures

To explore the effect of percutaneous kyphoplasty (PKP) on lumbar-pelvic correlation in osteoporotic vertebral compressive fracture (OVCF). According to the inclusion criteria, 63 patients with primary osteoporosis between January 2012 and June 2017 were selected as the control group and 67 patients with single-segment lumbar OVCF receiving PKP and complete clinical data were included as the observation group. There was no significant difference in gender, age, and lumbar spine bone density between the two groups ( P>0.05). The visual analogue scale (VAS) score and Oswestry Disability Index (ODI) score were used to assess lumbar pain and function before operation and at 3 days after operation in the observation group; lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS) were measured in lumbar lateral X-ray films which were taken before PKP and at 1 month after PKP. The same parameters were measured in the lumbar lateral X-ray films which were taken at the time of initial diagnosis in the control group. All patients were followed up 3-24 months with an average of 5.8 months in the observation group. The VAS score decreased from 5.6±1.8 before PKP to 2.8±1.3 at 3 days after PKP ( t=14.082, P=0.000); ODI decreased from 50.1%±5.0% before PKP to 18.2%±1.8% ( t=47.011, P=0.000). Compared with the control group, the LL, PI, and SS decreased and the PT increased in the observation group, and only the difference in LL between the two groups was significant ( P<0.05). In the observation group, the LL and SS significantly increased ( P<0.05) and PT significantly decreased ( P<0.05) at 1 month after operation when compared with preoperative ones, and PI decreased, but the difference was not significant ( P>0.05). In the control group, LL was positively correlated with PI and SS ( P<0.05); PI was positively correlated with PT and SS ( P<0.05). In the observation group, PI was positively correlated with SS ( P<0.05) before and after PKP. OVCF patients lost the specific lumbar-pelvic correlation. PKP can restore lumbar lordosis, but it still can not restore the normal physiological fitting.

Paravertebral Muscle Training in Patients with Unstable Spinal Metastases Receiving Palliative Radiotherapy: An Exploratory Randomized Feasibility Trial.

Background: Isometric paravertebral muscle training (IPMT) may improve mobility, pain, and quality of life (QOL) in cancer patients with spinal metastases. However, this regimen remains unproven in patients with unstable spinal metastases (USM), a population at high risk for clinical exacerbation with such interventions. Thus, we conducted this exploratory, non-blinded, randomized controlled trial (NCT02847754) to evaluate the safety/feasibility of IPMT and secondarily assess pain, bone density, pathologic fracture rate, and QOL. Methods: All patients had histologically/radiologically confirmed USM (per Taneichi score) and underwent non-operative management with 5–10 fractions of palliative radiotherapy (RT). Randomization (1:1) groups were IPMT (intervention, INT) or muscle relaxation (control, CON); both lasted 15 min/day and started concurrently with radiotherapy. The primary endpoint was feasibility (completion of training programs three months post-RT). Secondary endpoints were pain response (Visual Analog Scale) and opioid consumption, bone density and pathologic fracture rate, and QOL (European Organization for Research and Treatment of Cancer, EORTC questionnaires). Results: Sixty patients were randomized and 56 received protocol therapy. Mean survival in both groups was 4.4 months. There were no adverse events with either training regimen. Altogether, ≥80% of the planned sessions were completed by 55% (n = 16/29) in CON and 67% (n = 18/27) in INT. Regarding the post-radiotherapy home-based training, ≥80% of planned sessions were completed by 64% (n = 9/14) of the INT cohort. There were no differences in pain scores, opioid consumption, or bone density between arms (p > 0.05 for all). No difference was observed between groups regarding new pathological fractures (INT: n = 1 vs. CON: n = 3) after three months (p = 0.419). There were no QOL differences between arms (all parameters p > 0.05). Conclusions: IPMT is potentially feasible for high-risk USM patients. Future trials adequately powered for relevant endpoints are thus recommended.

Imaging and histomorphometric evaluation of mandible and tibia of rats treated with bisphosphonates.

To evaluate the mandible and tibia of rats treated with bisphosphonates (BPs) by imaging and histomorphometric analysis. Thirty-four rat specimens (Rattus norvegicus, Wistar strain) were distributed into 3 groups: (1) 12 rats treated with zoledronic acid; (2) 12 rats treated with clodronate; and (3) the control group, containing 10 rats that received saline. All bones were exposed to cone beam computed tomography (CBCT). The images were analyzed to determine bone density (BD), using the software OsiriX 7.0. Histological slides were prepared from the specimens and the proportion of bone volume (BV) was quantified using the software Adobe Photoshop CC. There was no statistically significant difference in BD either between the drug groups or between mandible and tibia. BV between BPs and control group did not show a significant difference. However, comparing the two bones, the mandibles in the control group displayed higher BV than did the tibiae in the same group. According to our results, we conclude that (1) BD was not altered by bone type or by type of BP administered, and (2) treatment with zoledronic acid or clodronate did not affect BV in the mandible or tibia of test groups.

Gender interactions between vertebral bone mineral density and fat content in the elderly: Assessment using fat-water MRI.

Adipose tissue is closely related to bone mass, bone quality, and bone fractures, but the connection between fat and bone is complex and gender-related. Fat-water magnetic resonance imaging (MRI) and MR spectroscopy (MRS) are very useful tools for identifying tissue fat. To assess gender interactions between bone mineral density (BMD), bone marrow fat, and body mass index (BMI) in the elderly using fat-water MRI and MRS. Prospective/cohort. Sixty-six women and 38 men (mean age, 62.3 years; range, 50-75 years), Asian. A 1.5T MR equipped with a body and spine array coil. STEAM MRS and T2 * Dixon were performed. Vertebral bone marrow fat ratio (MFR), BMI, and BMD were measured. Correlations between these variables and differences in bone density in MFR were assessed between participants, divided into three groups based on bone density. Multiple regression; Pearson tests; analysis of covariance; analysis of variance. Multiple regression analysis identified gender, vertebral bone MFR, and BMI as significant predictors of vertebral BMD (P < 0.001). Among the women, vertebral BMD was negatively correlated with vertebral MFR (P = 0.011), but among the men, it was positively correlated with BMI (P = 0.048), although this relationship was confounded by age and MFR. Moreover, vertebral bone marrow fat and BMI were indeed statistically uncorrelated in the elderly (P = 0.357 in women; P = 0.961 in men). We found gender interactions between fat and bone in the elderly. Higher bone marrow fat was correlated with lower trabecular BMD in older women but not in men. On the other hand, the positive correlation between BMI and BMD was more pronounced in men than in women. 2 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2020;51:1382-1389.

Comparison of Tibial and Talar Bone Density as a Function of Resection Level in Patients Undergoing Total Ankle Replacement vs Demographic-Matched Controls

Category:Ankle ArthritisIntroduction/Purpose:Initial implant fixation is critical for long-term success of total ankle replacement (TAR). One important factor which contributes to implant stability is the quality of the surrounding bone. Previous studies characterized a decrease in bone density with increasing distance from the level of the joint in the tibia and talus in non-arthritic ankles. However, ankle arthritis affects bone density remains unclear. The objective of this study is to compare the bone density in patients with and without ankle arthritis as a function of resection level from the joint. We hypothesized that there would be no difference in bone densities at each resection level between groups and bone density would decrease with greater distance from articular surface in both groups.Methods:We retrospectively reviewed 93 end-stage ankle arthritis patients with available preoperative non-weight bearing ankle computed tomography scans (CT)(Group A) and identified another cohort of 83 patients with non-arthritic ankles as a demographic-matched control group(Group B). Patients with retained ankle hardware, history of osteomyelitis, osteoporosis, and cysts greater than 1 cm in diameter at the ankle were excluded. There was no difference in term of gender, age and body mass index (BMI) between the groups(Table 1). The ROI tool in Sectra IDS7 picture archiving and communication system (PACS) was used to calculate Hounsfield Unit (HU) values in the cancellous region of the tibia and talus around the ankle joint. Measurements were obtained on axial CTs from 6 mm to 12 mm above the distal tibial plafond, and from 1 mm to 4 mm below the talar dome. The HU measurements and percentage decrease of HU values at each level were compared between groups.Results:Patients with ankle arthritis demonstrated significantly greater bone density than the control group between 6 mm and 10 mm from the joint in the tibia. There was no significant difference in bone density between 10 mm and 12 mm from the joint on the tibia, and at all levels in the talus between groups (Table 1). In both groups, bone density decreased significantly at each successive level from the joint for the tibia and talus. In addition, the percentage decrease of HU values at each relative level was the same in both groups.Conclusion:Patients with ankle arthritis demonstrated greater bone density at 6 mm to 10 mm from the joint in the tibia compared to demographic-matched controls. The increased bone density close to the joint may stem from bone eburnation that occurs as part of the arthritic process. In TAR, a tibial bone resection between 6 mm and 10 mm may provide improved initial stability of the implant. Contrary to traditional thinking, fixation into the talus may be of less concern.

Bone geometry and lower extremity bone stress injuries in male runners

Bone stress injuries (BSI) are common among distance runners and research investigations examining risk factors for BSI among men are limited. Therefore, investigations are needed to determine if men with a history of BSI have skeletal properties that may heighten BSI incidence. ObjectivesTo analyze differences in bone density, bone geometry, and estimates of bone strength in male runners with and without a BSI history. DesignCross-sectional. MethodsWe recruited 36 male distance runners ages 18–41 for this study. We used peripheral quantitative computed tomography (pQCT) to assess volumetric bone mineral density (vBMD, mg/mm3), bone geometry (total and cortical bone area, mm2), tibia robustness (total area/tibia length, mm) and estimates of bone strength (section modulus and polar strength-strain index, mm3) at 5 tibial sites. ResultsAfter adjusting for age, the BSI group had more slender tibias (9%), lower stress strain indices (−16%), lower section moduli (−17%) and smaller total cross-sectional (−11%) and cortical areas (−12%) at the 66% site of the tibia compared with controls (P < 0.05 for all). Similar differences were found at all other measurement sites. After adjusting for body size, differences in bone outcomes remained significant at the 66% site. ConclusionsThese results indicate that men with a history of BSI have lower estimated bending strength compared to controls because of narrower tibias. However, differences are largely attenuated in the distal ½ of the tibia after adjusting for body size. Thus, smaller tibia size, particularly at the mid-diaphysis, may be an important indicator for BSI incidence.

Differences in bone density on chest CT according to smoking status in males without chronic obstructive lung disease

The goals of this study were to determine whether bone density measured using CT (CTBD) can show significant differences in bone loss according to smoking status and pack-years, and to examine the correlation between CTBD and bone mineral density when measured by dual-energy X-ray absorptiometry (DEXA-BMD) in males without chronic obstructive pulmonary disease (COPD). In this cross-sectional study, 1,011 males without airflow obstruction ≥50 years old were included. CTBD and DEXA-BMD were compared among groups with different smoking statuses. The correlation between CTBD and DEXA-BMD and the association of CTBD with pack-years were also investigated. CTBD of all vertebral bodies (VBs) and DEXA-BMD of all VBs without L1 showed significant differences among never, former, and current smokers. CTBD was significantly lowest in ≥30-pack-year smokers and was significantly lower in ≥30-pack-year smokers than in <15-pack-year smokers (all P < 0.05). There were significant correlations between DEXA-BMD and CTBD at all VB levels (correlation coefficient [r], 0.448~0.640; all P < 0.01). A lower CTBD had a significant association with a 15 ≤ x < 30-pack-year smoking history and ≥30-pack-year smoking history, while there was no association with never-smokers. In conclusion, CTBD demonstrated significant differences in bone quality according to smoking status and pack-years in males without COPD.

Effects of inferior alveolar nerve rupture on bone remodeling of the mandible

Although various animal studies have indicated that sensory nerves played an important role in bone metabolism and nerve injury could impair the process of bone remodeling, the actual effect of sensory nerve rupture on human bones remains unclear. The aim of this preliminary study was to investigate the effect of inferior alveolar nerve (IAN) rupture on mandibular bone remodeling of patients underwent bilateral sagittal split ramus osteotomy (BSSRO).Ten patients with unilateral IAN rupture during BSSRO were involved in this study. Neurosensory examinations were employed to assess the sensory function of bilateral IAN. The remodeling process of the post-operational mandible was evaluated by panoramic radiographs and computed tomography (CT) scans.Neurosensory examinations indicated that nerve rupture resulted in significant hypoesthesia at the IAN-rupture side. Assessment of panoramic radiographs showed no evident alterations of bone structure at the IAN-rupture side of mandible. Evaluation of CT images also indicated no statistical difference in bone density and thickness between IAN-rupture side and contralateral side.Accordingly, our study indicated that IAN rupture may not significantly impair the short-term bone remodeling process of human mandible.

Bone adaptation impact of stemless shoulder implants: a computational analysis

Despite stemless implants showing promising functional and radiologic clinical outcomes, concerning signs of complications, such as bone resorption, have been reported. The aim of this study was to investigate the influence of 5 stemless designs on the bone adaptation process of the humerus. Three-dimensional finite element models of shoulder arthroplasties were developed considering stemless designs based on the Eclipse, Global Icon, SMR, Simpliciti, and Sidus stemless systems. For the designs not possessing a collar that covers the entire resected surface of the humerus, conditions of contact and no contact were simulated between the humeral head components and the bone surface. By use of a bone remodeling model, computational simulations were performed considering 6 load cases of standard shoulder movements. The bone adaptation process was evaluated by comparing differences in bone density between the implanted models and the intact model of the humerus. Overall, the design of the stemless implants had a relevant impact on the bone adaptation process of the humerus. The Eclipse-based design caused the largest bone mass loss, whereas the SMR-based design caused the least. When contact was simulated between the humeral head components of the SMR-, Simpliciti-, and Sidus-based designs and the resected bone surface, bone resorption increased. Considering only the bone adaptation process, the results suggest that the SMR-based implant presents the best performance and that contact between the humeral head component and the resected bone surface should be avoided. However, because other factors must be considered, further investigation is necessary to allow definite recommendations.

CT bone density analysis of low-impact proximal femur fractures using Hounsfield units

AimTo quantify and compare changes in bone mineral density (BMD) via CT analysis in patients with and without spontaneous femoral fractures. Materials and methodsConsecutive series of patients with CT imaging for spontaneous femoral fractures were compared to the age and gender matched controls. Bone density fixed region of interest measurements were obtained at the site of the fracture, proximally at the femoral head, and distally at the lesser trochanter in fracture patients and controls. Inter- and intrapatient comparisons were performed, including Chi-square and t-test analyses. Results24 spontaneous fractures and 25 controls were analyzed with no significant differences in mean age, gender, or body mass index. There were differences in the bone density between the fracture and contralateral non-fracture sides at (p = 0.0001) and distal (p < 0.0001) to the fracture. Proximal and distal bone density differences existed between case fracture and control non-fracture sites (p < 0.0001, p = 0.0001), and between the case non-fracture and control non-fracture sites (p < 0.0001, p < 0.0001). The reliability for measurements was good to excellent proximally (ICC = 0.63–0.87), moderate to excellent at the fracture site (ICC = 0.43–0.78), and fair to good distal (ICC = 0.24–0.68) to the fracture site. ConclusionPatients with spontaneous femoral fractures exhibit lower bone density than the asymptomatic controls. Bone insufficiency is best demonstrated proximal or distal to, rather than at the fracture site.

Evaluation of The Bio-Stimulatory Effect of Platelet Rich Fibrin Augmented by Diode LASER Compared to Platelet Rich Fibrin Alone on Dental Implant Replacing Posterior Mandibular Teeth. Randomised Clinical Trial: Split Mouth Study.

BACKGROUND:Restoring masticatory function and replacing missing teeth with minimal pain and discomfort are the most important issues for the patient and clinician. Nowadays dental implants became the most popular line of treatment to replace missing teeth; offering a comfortable long lasting prosthesis. Osseo-integration reflects the long term success of a dental implant. Many bio-modulators are used aiming to improve the osseointegration and healing around dental implants such as Low-Level Laser treatment (LLLT) and Platelet Rich Fibrin (PRF). PRF has been proven to improve bone repair process around the dental implant. LLLT is considered a noninvasive, safe technique that stimulates osteogenesis and alleviates post-operative pain.AIM:Evaluation of the bio-stimulatory effect of LLLT on a dental implant with PRF compared to PRF alone clinically and radiographically.METHODS:A randomised clinical trial with the split-mouth design was conducted on nine patients with bilaterally missing lower posterior tooth. All patients received one dental implant on each side with PRF. LASER application was performed to one side twice weekly for one month starting on the day of insertion. Post-operative pain was assessed daily through the first week using numerical rating pain scale (NRS) as the primary outcome. Relative peri-implant bone density was measured using direct digital intraoral radiography immediately after insertion, one, four and nine months postoperatively. Implants stability were measured using radio frequency assessment immediately after insertion, four and nine months post-operative as secondary outcomes.RESULTS:The NRS for pain was significantly decreased by the end of the first-week postoperatively in the intervention and control group with a mean of (2.22 ± 1.56) (2.11 ± 1.83) respectively. However, there was no statistically significant difference between the test groups at P-Value (0.892). The relative bone density values were decreased by the end of the ninth month of follow-up in the intervention and control group with a mean of (134.42 ± 16.13) (128.77 ± 33.54) respectively. No statistically significant difference was observed between the two test groups at P-value (0.863). The radiofrequency values for implant stability showed no statically significant difference after nine months of follow up when compared to the initial stability values at the day of insertion in the intervention and control group. The mean radiofrequency values were (67.24 ± 1.79) and (66.9 ± 2.57) respectively, and no statistically significant difference was observed between the two test groups at P-value (0.793)CONCLUSION:There are no statistically significant differences in post-operative pain values, implant stability and bone density between the implant sites treated with PRF augmented by Diode laser compared to implant sites treated by PRF alone.

Determining condylar bone density in adolescents: An inconclusive cone-beam computed tomographic study

In an article in the September issue of the journal, Kim et al attempted to determine the condylar bone density in different age groups and various skeletal patterns. (Kim KJ, Park JH, Bay RC, Lee MY, Chang NY, Chae JM. Mandibular condyle bone density in adolescents with varying skeletal patterns evaluated using cone-beam computed tomography: A potential predictive tool. Am J Orthod Dentofacial Orthop 2018;154:382-9). We appreciate the efforts of the authors and thought it was a great attempt to explore some unknown findings about condylar bone density, but certain points need to be addressed. As mentioned in the text, “The bone density of the mandibular condyle is affected by the functional pressure generated by the occlusion and the mandibular movements that are, in turn, influenced by the properties of the masticatory muscles and age.” Also, “Skeletal pattern is thought to be closely related to occlusal force.” Thus, the authors mentioned that age, sex, and occlusion type (Class I, II, III) affects the condylar bone density. But they do not mention confounding factors, which could alter the results of the study. For example, they did not mention the number of hyperdivergent, hypodivergent, or normovergent cases when the subjects were divided into Classes I, II, and III; the number of cases of hypodivergent subjects in Classes I and II might vary. Facial height ratio (which might be the actual factor responsible for variation of condylar bone density) acts as a confounding factor and can give us biased results. Also, the numbers of boys and girls in the Class I, II, and III groups were not the same, so sex as a confounding factor affects the result. Similarly, when the authors divided the subjects into hypodivergent, normovergent, and hyperdivergent groups, the number of Class I, II, and III cases and the sex of the subjects can act as confounding factors.1Jain S. Debbarma S. Jain D. Bias in dental research/dentistry.Ann Int Med Dent Res. 2016; 2: 2395-2814Google Scholar Nor did the authors mention the different adolescent age groups in the hyperdivergent and Class II groups versus other groups. It is quite possible that the results, which showed higher condylar bone density in Class II and hyperdivergent groups, might be due to a greater number of late adolescent subjects in these groups. Another important point to be noted in the study is that the standard deviation is more than the difference between bone density in different groups.2Jain S. Sharma N. Jain D. Basic fundamentals of designing a quality research.J Adv Med Dent Sci Res. 2015; 3: 88-95Google Scholar The authors did not mention the 95% CIs. P value and CIs are common statistical measures that provide complementary information about probability and conclusions regarding the clinical significance of the study.3Gupta A. Interpreting research findings with confidence interval.J Orthod. 2015; 1: 8Google Scholar Therefore, if we calculate the CIs, the values of the bone density would overlap within different groups and make the results less clinically significant. The value of difference in bone density of the different groups are very close to each other. For example, as mentioned in Table IV, total bone density difference in Class 1 and Class II is just 13 HU; when the samples are improperly distributed in terms of sex or age, that raises questions about clinical significance. Similarly, in Table III, normovergent and hyperdivergent groups have a difference of 21 HU in total bone density. The authors described the results to be statistically significant, but clinical significance of the results is doubtful. Thus, the results can not be held as conclusive as stated in the conclusion of the article. These might be factors causing different bone densities, but again, the results can not be held as conclusive. Mandibular condyle bone density in adolescents with varying skeletal patterns evaluated using cone-beam computed tomography: A potential predictive toolAmerican Journal of Orthodontics and Dentofacial OrthopedicsVol. 154Issue 3PreviewThe aim of this study was to evaluate the bone density of mandibular condyles in adolescents with varying skeletal patterns using cone-beam computed tomography. The null hypothesis was that there is no difference in the bone density of mandibular condyles in adolescents across various facial height ratios, ANB angle classifications, sexes, and age categories. Full-Text PDF Authors' responseAmerican Journal of Orthodontics and Dentofacial OrthopedicsVol. 155Issue 3PreviewThank you very much for your interest in our article. We truly appreciate your insightful questions and valuable suggestions. We agree that all of the factors listed can influence condylar bone density, and that they may interact with one another in doing so. Optimally, a full factorial analysis would be conducted on these data. Unfortunately, this type of analysis requires a very large data set. When we attempted to combine predictors, the matrices contained a number of very small groups, and even some empty cells. Full-Text PDF

Stability of two self-drilling Orthodontic Temporary Anchorage Devices (TAD) assessed by Histomorphometric Changes

Aims: This work was aimed to evaluate bone density around two types of self-drilling orthodontic miniscrews in mongrel dogs. Materials and methods: two groups of TADs were inserted in the maxillae of six mongrel dogs. Group 1: six tapered self-drilling miniscrews, each of which was inserted in the right buccal side between the roots of the maxillary third premolar (P3). Group 2: Six cylindrical self-drilling miniscrews, each of which was inserted in the right buccal side between the roots of the maxillary first molar (M1 ). All of the TADs were inserted parallel to the occlusal plane. Occlusal radiographic views were taken at different time intervals: pre-insertion, just after insertion (T0), after 4 weeks (T1), after 8 weeks (T2) and after 12 weeks (T3). Using IDRISI Kilimanjaro computer software, the peri-implant area surrounding the apical one third of miniscrew was studied measuring the amount of grey shade. Bone density was measure in five areas (zone1 through zone 5) around the apical 1/3 of the TADs. Paired t- test was used to compare the measurements of the bone density pre-insertion of TADs between roots of M1 and P3, and the bone density post-insertion of TADs in the cylindrical and tapered TAD. The unpaired t-test was used to evaluate the difference in bone density of each zone around the tapered TAD and it correspondent zone around the cylindrical TAD. Results: the significance of the scheduled differences between means of bone density around group1 and group 2 were variable, indicating that the bone density depends on several factors. Conclusion: TAD design has an influence on the bone density. Cylindrical TADs have more bone density around than tapered TADs.

Safety and efficacy of a novel, gradually anodized dental implant surface: A study in Yucatan mini pigs.

A newly developed dental implant system combining advancements in surface chemistry, topography, nanostructure, color, and surface energy aims to address biological challenges and expand clinical applications. To assess the short- and long-term safety and efficacy of a novel, gradually anodized dental implant surface/anodized abutment. Twenty-four Yucatan mini pigs (20-24 months old) received two dental implants in each jaw quadrant. Each site was randomized to receive either a commercially available anodized implant/machined abutment or a gradually anodized implant/anodized abutment with a protective layer. Animals were euthanized at 3, 6, and 13 weeks. Microcomputed tomography and histological analyses were performed. No significant histological differences in inflammation scores, epithelium length, bone-to-implant contact, or bone density were observed between groups for any healing time. Mucosal height was significantly higher at 3 weeks for controls (Δ = 0.2 mm); no differences were observed at 6 and 13 weeks. No significant differences in radiographic bone volume, bone-to-implant contact, trabecular thickness, and crestal bone levels were observed, irrespective of healing time. Trabecular spacing was borderline significant at 3 weeks in favor of the test implant sites; no differences were observed at 6 weeks. No significant differences were observed between experimental groups at 13 weeks. The new implant system yielded results comparable to a commercially available predicate device.

Density of bone metastatic lesions increases after radiotherapy in patients with breast cancer

The aim of this study was to assess local response to radiotherapy (RT) in a quantitative manner by evaluating the bone density of metastases. Spinal and pelvic bone metastases in 44 patients with breast cancer who were treated between May 2010 and December 2016 were retrospectively assessed. Bone density values of irradiated and unirradiated bone metastases before, 1–3 months after, 4–6 months after, and 7–9 months after RT were compared. At each time point, mean bone density ± standard deviation values were measured in Hounsfield units (HU) from computed tomography (CT) scans. Student’s t-test was used for statistical analyses of the differences in bone density and for univariate analysis of the prognostic factors for differences in bone density at various time points after RT. Mean bone densities in irradiated and unirradiated bone metastases before RT were 297.31 ± 211.93 HU and 326.29 ± 228.61 HU, respectively. At the subsequent three time points examined, the mean bone density values in the irradiated and unirradiated bone metastases were: 61.97 ± 78.58 HU (P = 0.000) and 36.93 ± 52.49 HU (P = 0.001); 149.07 ± 133.27 HU (P = 0.000) and 68.40 ± 101.10 HU (P = 0.000); and 183.94 ± 168.30 HU (P = 0.000) and 88.21 ± 159.49 HU (P = 0.004), respectively, in each case. Patients receiving bisphosphonates exhibited greater increases in bone density in their metastases 1–3 months after RT (83.04 ± 82.18 HU vs 26.86 ± 60.55 HU, respectively; P = 0.044), whereas chemotherapy before RT was associated with significantly lower increases in bone density at the subsequent three time points [(37.53 ± 67.66 HU vs 93.63 ± 80.36 HU, P = 0.027), (99.30 ± 107.92 HU vs 180.24 ± 127.85 HU, P = 0.030), and (126.07 ± 141.77 HU vs 236.28 ± 158.22 HU, P = 0.024), respectively, in each case]. Comparing bone density values determined from CT scans appears to be a practicable and reproducible method for assessing local response to RT for bone metastasis of breast cancer. Increased bone density was also observed in the irradiated bone metastases.