Formation Of New Bone Research Articles

Static and dynamic guided bone regeneration using a shape-memory polyethylene terephthalate membrane: An experimental study in rabbit mandible.

Periosteal expansion (PEO) results in the formation of new bone in the space created between existing bone by expanding the periosteum. PEO has already been performed on rabbit parietal bone and effective new bone formation has been demonstrated. In this study, the utility of a polyethylene terephthalate (PET) membrane as an activator was evaluated in the more complex morphology of the mandible. A PET membrane coated with hydroxyapatite (HA)/gelatine was placed in the rabbit mandibular bone at lower margin of mandibular molar region underneath periosteum, and screw-fixed. In the experimental group, the membrane was bent and screw-fixed along the lateral surface of the bone, with removal of the outer screw after 7 days followed by activation of the membrane. The experimental group was divided into two subgroups: with and without a waiting period for activation. Three animals were euthanized at 3 weeks and another three at 5 weeks postoperatively. Bone formation was assessed using micro-CT as well as histomorphometric and histological methods. No PET membrane-related complications were observed. The area of newly formed bone and the percentage of new bone in the space created by the stretched periosteum did not significantly differ between the control and experimental groups. However, in the experimental group a greater volume was present after 5 weeks than after 3 weeks. Histologically, bone formation occurred close to the site of cortical bone perforation, with many sinusoidal vessels extending through the perforations in the new bone into the overlying fibrous tissue. Inflammatory cells were not seen in the bone.

Disease-specific definitions of new bone formation on spine radiographs: a systematic literature review.

We aimed to explore the radiographic definitions of types of New Bone formation (NBF) by focusing on the terminology, description and location of the findings. Three systematic literature reviews were conducted in parallel to identify the radiographic spinal NBF definitions for spondyloarthritis (SpA), Diffuse Idiopathic Skeletal Hyperostosis (DISH) and Osteorathritis (OA). Study characteristics and definitions were extracted independently by two reviewers. Definitions were analysed and collated based on whether they were unique, modified or established from previous research. We identified 33 studies that indicated a definition for the NBF in SpA, 10 for DISH and 7 for spinal OA. In SpA, the variations in syndesmophytes included the description as well as the subtypes and locations. The differentiation of syndesmophytes from osteophytes were included in 12 articles, based on the origin and the angle of the NBF and associated findings. The definitions of DISH varied in the number of vertebrae, level and laterality. For OA, five articles indicated that osteophytes arose from the anterior or lateral aspects of the vertebral bodies, and two studies required a size cut-off. Our ultimate aim is to create formal NBF definitions for SpA, DISH and OA guided by an atlas, through a Delphi exercise with international experts. The improved ability to differentiate these conditions radiographically will not only allow the clinicians to accurately approach patients but also will help the researchers to better classify patient phenotypes and focus on accurate radiographic outcomes.

MRI-based synthetic CT: a new method for structural damage assessment in the spine in patients with axial spondyloarthritis – a comparison with low-dose CT and radiography

ObjectiveTo investigate the ability of MRI-based synthetic CT (sCT), low-dose CT (ldCT) and radiography to detect spinal new bone formation (NBF) in patients with axial spondyloarthritis (axSpA).MethodsRadiography of lumbar and...

Long-term Follow-up of Implant Installation Following Multiple Distraction Osteogenesis in Maxillofacial Gunshot Wounds.

Distraction osteogenesis (DO) is a reconstruction technique developed in the fields of oral and maxillofacial surgery and plastic surgery, addressing both vertical and horizontal bone deficiencies and enhancing soft tissue volume to facilitate subsequent dental implant placement. In this treatment method, devices are placed to stretch the bone gradually to stimulate the formation of new bone, effectively filling the existing defect to treat maxillofacial deformities or repair posttraumatic injuries. This case report presents an almost 20-year long-term follow-up of jaw defect reconstruction resulting from a gunshot injury, using DO with multiple distractors. Details on the frequency, period of DO, and subsequent implant installation in the distracted anterior jaw area are outlined. This case exhibits DO treatments that reconstructed effectively severe bone defects in the jaws. The quality of bone generated during the DO process was both functionally and esthetically satisfactory for subsequent implant rehabilitation.

Cobalt-containing calcium silicate nanowires incorporated scaffolds for the repair of osteochondral defect induced by chondrosarcoma

Considering the difficulty in the treatment of chondrosarcoma in clinic, multifunctional composite hydrogel scaffolds were designed with excellent photothermal ability for the regeneration of damaged bone and cartilage tissue. The chitosan solution/polyvinyl alcohol (CP) hydrogels with different contents of cobalt doped calcium silicate (Co-CSH) nanowires were prepared via 3D printing method. Attributing to the excellent photothermal performance of Co-CSH nanowires, the average survival rate of human chondrosarcoma cells in the CP-5Co-13.4 % and CP-5Co-16.2 % scaffolds with near infrared laser irradiation was about 10.5 % and 9.9 %, respectively. At the same time, the prepared composite hydrogel scaffolds possessed satisfactory biocompatibility and could support the adhesion and spread of rabbit bone mesenchymal stem cells (rBMSCs) and rabbit chondrocytes in the hydrogel scaffolds, and further promoted the formation of new bone and cartilage tissue in vivo, on account of the stimulation effect of released bioactive ions. Therefore, the prepared composite hydrogel scaffolds is expected to provide a new therapeutic strategy for the postoperative adjuvant treatment of chondrosarcoma.

EFFECT OF ULTRASOUND THERAPY AND MUSCLE ENERGY TECHNIQUE ON CHANGING THE ROM IN THE CASE GENU OSTEOARTHRITIS AT IMMANUEL HOSPITAL BANDUNG

Osteoarthritis is a chronic condition that develops slowly, characterized by weakening and wear of the cartilage itself and the formation of new bone on the joint surfaces. In cases of knee osteoarthritis, the clinical diagnosis is generally made in individuals aged 45 years and over or in older people who experience pain in the knee area related to activity and stiffness in the knee joint. The aim of this study was to evaluate the impact of providing Ultrasound Therapy and Muscle Energy Technique on changes in Range of Motion (ROM) in cases of Osteoarthritis Genu at the medical rehabilitation clinic at Immanuel Hospital Bandung.This research uses a quasi-experimental design with the design used is One-Group Pretest-Posttest. This study used 20 Osteorthritis Genu patients, using the Shapiro Wilk Test normality test method and using Paired Sample T-test analysis. Based on the research results, it can be concluded: 1. The average ROM value before being given Ultrasound Therapy and Muscle Energy Technique was 120, with a minimum value of 110 and a maximum value of 128 and a standard deviation value of 4.42. 2. The average ROM value after being given Ultrasound Therapy and Muscle Energy Technique was 123.05, with a minimum value of 113 and a maximum value of 132 and a standard deviation value of 4.39. 3. There is an effect of giving Ultrasound Therapy and Muscle Energy Technique on changes in ROM values, it can be shown that the significance value of the Paired sample t-test is 0.000.

Importance of bone health in bone lengthening

Distraction osteogenesis describes the process of growing new bone (“regenerate”) to correct limb length discrepancies or limb deformities. Whether pure lengthening or a combination of lengthening and straightening is involved, this represents one of the highest anabolic demands on bone in orthopedic surgery. Because distraction osteogenesis requires the formation of new bone, often in large amounts, it is critically important to evaluate the bone health of any potential surgical patient. Patients undergoing limb lengthening, therefore, would be expected to be especially sensitive to poor bone health. This article will review opportunities to assess and potentially improve bone health for limb lengthening patients. Key Concepts-Many potential limb lengthening patients may be Vitamin D deficient or insufficient.-Other simple nutraceuticals such as Boron, Magnesium, Calcium, Silicon, Vitamin K, L-arginine, and Inositol should be considered as adjuncts to bone health.- Intra-operative technique such as minimally invasive incisions that protect the blood supply and periosteum combined with osteotomies that maximize the bone surface area are recommended.- Numerous proposed pharmacological and mechanical interventions to improve and accelerate the healing of the regenerate bone look promising but are still investigational.

The Effects of Local Treatment of PTH(1-34) and Whitlockite and Hydroxyapatite Graft to the Calvarial Defect in a Rat Osteoporosis Model.

With the aging population, there is a rising incidence of senile diseases, notably osteoporosis, marked by fractures, prolonged recovery, and elevated mortality rates, underscoring the urgency for effective treatments. In this study, we applied the method of absorbing parathyroid hormone (PTH), a treatment for osteoporosis, into graft materials. Two types of graft materials with different properties, whitlockite (WH) and hydroxyapatite (HAP), were used. After forming calvarial defects in osteoporotic rats, WH and HAP grafts were implanted, with PTH applied directly to the graft sites. Micro-CT analysis was employed to assess bone regeneration, while tissue sections were stained to elucidate the regeneration process and bone cell dynamics. The results showed that bone regeneration was higher in the grafts that were actively degraded by osteoclasts in the early stage of regeneration. When PTH was applied, osteoclast activity increased, leading to enhanced bone regeneration. Furthermore, the activation of osteoclasts resulted in the penetration and formation of new bone within the degraded graft, which exhibited higher osseointegration. Therefore, for osteoporotic bone defects, bone grafts that can be easily degraded by osteoclasts are more suitable. Additionally, treatment with PTH can activate osteoclasts around the bone graft in the early stages of regeneration, inducing higher bone regeneration and improving osseointegration.

Use of Plant Extracts in Polymeric Scaffolds in the Regeneration of Mandibular Injuries.

Severe loss of bone mass may require grafting, and, among the alternatives available, there are natural biomaterials that can act as scaffolds for the cell growth necessary for tissue regeneration. Collagen and elastin polymers are a good alternative due to their biomimetic properties of bone tissue, and their characteristics can be improved with the addition of polysaccharides such as chitosan and bioactive compounds such as jatoba resin and pomegranate extract due to their antigenic actions. The aim of this experimental protocol was to evaluate bone neoformation in experimentally made defects in the mandible of rats using polymeric scaffolds with plant extracts added. Thirty rats were divided into group 1, with a mandibular defect filled with a clot from the lesion and no graft implant (G1-C, n = 10); group 2, filled with collagen/chitosan/jatoba resin scaffolds (G2-CCJ, n = 10); and group 3, with collagen/nanohydroxyapatite/elastin/pomegranate extract scaffolds (G3-CHER, n = 10). Six weeks after surgery, the animals were euthanized and samples from the surgical areas were submitted to macroscopic, radiological, histological, and morphometric analysis of the mandibular lesion repair process. The results showed no inflammatory infiltrates in the surgical area, indicating good acceptance of the scaffolds in the microenvironment of the host area. In the control group (G1), there was a predominance of reactive connective tissue, while in the grafted groups (G2 and G3), there was bone formation from the margins of the lesion, but it was still insufficient for total bone repair of the defect within the experimental period standardized in this study. The histomorphometric analysis showed that the mean percentage of bone volume formed in the surgical area of groups G1, G2, and G3 was 17.17 ± 2.68, 27.45 ± 1.65, and 34.07 ± 0.64 (mean ± standard deviation), respectively. It can be concluded that these scaffolds with plant extracts added can be a viable alternative for bone repair, as they are easily manipulated, have a low production cost, and stimulate the formation of new bone by osteoconduction.

Enhanced bone formation of rat mandibular bone defects with collagen membranes loaded on bone morphogenetic protein-9

Background/purposeBone morphogenetic protein-9 (BMP-9) has demonstrated multiple advantages in promoting osteogenesis. Our previous findings have indicated that the use of an absorbable collagen membrane (ACM) as a carrier for growth factors is effective in stimulating bone regeneration. The objective of this study was to assess the synergistic impact of BMP-9 incorporated into ACM (ACM/BMP-9) on bone formation within rat mandibular bone defects. Materials and methodsCircular bone defects of critical size were surgically induced on both sides of the rat mandibular bone, with subsequent random allocation into distinct groups: control, ACM alone, and ACM loaded with low (0.5 μg) or high (2.0 μg) concentrations of BMP-9. We conducted real-time in vivo micro-computerized tomography scans at the baseline and at 2, 4, and 6 weeks, and measured the volume of newly formed bone (NFB), bone mineral density (BMD) of NFB, and the closure percentage of the NFB area. Histological and histomorphometric analyses were performed at 6 weeks. ResultsReal-time assessment revealed notably higher levels of bone volume, BMD, and closure percentage in the NFB area for the groups treated with ACM/BMP-9 compared to the control and ACM groups. Within the high concentration of BMP-9 group, the volume and BMD of NFB exhibited a significant increase at 6 weeks compared to baseline. Histological examination confirmed the existence of osteoblasts, osteocytes, and blood vessels within the NFB. ConclusionConsidering the limitations of this research, the real-time evaluation finding indicates that ACM/BMP-9 effectively promotes bone formation in critical-size mandibular defects in rats.

Functionalized microporous sulfonated polyetheretherketone: Osteogenesis and anti-osteoclastogenesis effects via ROS and NLRP3-mediated pyroptosis in macrophages

The treatment of osteoporotic implant failures tends to be challenging due to an imbalance in bone homeostasis. Recently, the accumulation of intracellular reactive oxygen species (ROS) and activation of the inflammasome containing nucleotide-binding oligomerization domain-like-receptor family pyrin domain-containing 3 (NLRP3) protein have been shown to indirectly affect osteogenesis and osteoclastogenesis. Owing to the release of multi-metal ions from laponite (LAP), we fabricated a multifunctional LAP coating on a three-dimensional microporous sulfonated polyetheretherketone (SPEEK) surface via polydopamine (PDA) modification (SPEEK@PDA-LAP). The balance between osteogenesis and osteoclastogenesis was examined using macrophages in an osteo-immune microenvironment. Employing in vitro assays, we showed that the SPEEK@PDA-LAP alleviated intracellular ROS accumulation and inhibited the activation of NLRP3 inflammasome-mediated pyroptosis in macrophages, creating an osteoimmunomodulatory microenvironment to stimulate osteogenesis and inhibit osteoclastogenesis. The micro-computed tomography and histological results of in vivo experiments indicated that SPEEK@PDA-LAP implants reversed the balance between osteogenesis and osteoclastogenesis to promote the formation of new bone around the implant even under osteoporotic conditions. The results indicate that inhibiting the NLRP3 inflammasome and regulating intracellular ROS in macrophages can be an effective therapy for osteoporosis. These results highlight the potential of functional PEEK materials for bone regeneration in patients with osteoporosis.

Diagnosis and classification of axial spondyloarthritis (axSpA) - the current status

Axial spondyloarthritis (axSpA) is an inflammatory rheumatic disease typically characterized by inflammatory back pain (IBP). The term axSpA has largely replaced the long-used term ankylosing spondylitis (AS). IBP is caused by inflammation in the axial skeleton, with the sacroiliac joints (SIJ) being particularly frequently affected initially. The spine is usually added in later stages, which is then increasingly characterized structurally by the formation of new bone. The overall concept of spondyloarthritis includes other disease manifestations such as uveitis, psoriasis and colitis and comorbidities such as cardiovascular disease and osteoporosis.The ASAS classification criteria for axSpA, in place since 2009, have replaced the 1984 modified New York criteria. In the former, in addition to conventional X-rays, changes in the SIJ detected by magnetic resonance imaging (MRI) and also the detection of HLA B27 have, for the first time, played a role. It is important to note that these are not diagnostic criteria, as they do not exist. This paper outlines 10 points that should be considered when making a diagnosis.

Radiographic and histologic assessment of osseointegration for surface-treated titanium dental implants: An experimental study in dogs.

Modifying the dental implant's surface texture enhances its biological response to the bone and implant‒tissue interface, resulting in the successful support of forces. This study assessed the impact of sandblasting, sandblasting plus acid etching, Er,Cr:YSGG laser, and propolis implant surface treatments and occlusal load on the osseointegration of titanium dental implants in dogs. Seventy-two titanium dental implants with a diameter of 4 mm and a length of 10 mm were divided into four groups according to implant surface modifications (n=18 for each group): group A: sandblasting plus acid etching, group B: sandblasting with Al2 O3, group C: Er,Cr:YSGG laser, group D: propolis coating. Twenty-four local breed male dogs were used. Premolar teeth (P1, P2, and P3) were extracted on the left side of the mandible, and after 12 weeks of bone healing, implants were unilaterally installed. The osseointegration at three study times from implant installation (14, 90, and 180 days) was evaluated. The dog jaws were scanned using an intraoral scanner for the virtual design of screw-retained three-unit crowns after 90 days of osseointegration. Final radiographs were taken before the animals were sacrificed at 14, 90, and 180 days, and the histological analysis was performed. Radiographic analysis showed new bone formation (NBF) along and in contact with the implant surface of the treated groups. The histological analysis after 14 days in groups A and B revealed a uniform and ongoing pattern of bone growth and many osteoblasts with few osteocytes within lacunae in new bone trabeculae. Group C showed an increase in the number of osteoblasts lining thin bone trabeculae. Group D showed a generative power concerning bone. At 90 days, there was increased bone ingrowth, and the new bone matured in all the treated implant groups. At 180 days, dense mature bone apposition was in direct contact with delayed-loaded implant surfaces. A radiographic examination revealed that surface modification significantly impacted osseointegration, with a strong bond between the implant surface and the surrounding bone. The histological sections at the 14-day interval revealed obvious bone remodeling activity, especially in sandblasting plus acid etching and sandblasting-modified implant surface groups. At the 90-day interval, bone ingrowth had increased, and the new bone became mature, especially in sandblasting and propolis surface modification groups. After 180 days of the delayed-loaded implant osseointegration, differences were observed between different implant-treated groups with a remarkable remodeling of the bone, especially in the propolis coating group.

Annealing-temperature dependence of adhesion strength of hydroxyapatite layers coated on zirconia substrates by droplet elimination pulsed-laser deposition scheme

High-purity, high-crystallinity hydroxyapatite coatings on zirconia substrates were successfully fabricated at annealing temperatures >360 °C. The coatings did not dissolve in vivo within a short period and enhanced the formation of new bone. If the coating layer physically adheres to the zirconia substrate, strong bonding is expected on the coating layer. The adhesion strength of the coating layer was measured using an oscillation-type micro-scratch test. The adhesion strength was found to increase with increasing substrate surface temperature during deposition, irrespective of whether an in situ annealing process or a post-annealing process was used. These results indicated that the proposed coating layer will survive for a prolonged period in vivo and enable strong bone bonding with medical implants.

Regeneration of alveolar bone defects in the experimental pig model: A systematic review and meta-analysis.

Pigs are emerging as a preferred experimental invivo model for bone regeneration. The study objective was to answer the focused PEO question: in the pig model (P), what is the capacity of experimental alveolar bone defects (E) for spontaneous regeneration in terms of new bone formation (O)? Following PRISMA guidelines, electronic databases were searched for studies reporting experimental bone defects or extraction socket healing in the maxillae or mandibles of pigs. The main inclusion criteria were the presence of a control group of untreated defects/sockets and the assessment of regeneration via 3D tomography [radiographic defect fill (RDF)] or 2D histomorphometry [new bone formation (NBF)]. Random effects meta-analyses were performed for the outcomes RDF and NBF. Overall, 45 studies were included reporting on alveolar bone defects or extraction sockets, most frequently in the mandibles of minipigs. Based on morphology, defects were broadly classified as 'box-defects' (BD) or 'cylinder-defects' (CD) with a wide range of healing times (10 days to 52 weeks). Meta-analyses revealed pooled estimates (with 95% confidence intervals) of 50% RDF (36.87%-63.15%) and 43.74% NBF (30.47%-57%) in BD, and 44% RDF (16.48%-71.61%) and 39.67% NBF (31.53%-47.81%) in CD, which were similar to estimates of socket-healing [48.74% RDF (40.35%-57.13%) and 38.73% NBF (28.57%-48.89%)]. Heterogeneity in the meta-analysis was high (I2 > 90%). A substantial body of literature revealed a high capacity for spontaneous regeneration in experimental alveolar bone defects of (mini)pigs, which should be considered in future studies of bone regeneration in this animal model.

In vivo study on osteogenic efficiency of nHA/ gel porous scaffold with nacre water-soluble matrix

Background/purposeNano-hydroxyapatite (nHA)/ gel porous scaffolds loaded with WSM carriers are promising bone replacement materials that can improve osseointegration ability. This investigation aimed to evaluate the osteoinductive activity by implanting the composition of nano-hydroxyapatite (nHA)/ Gel porous scaffolds as a carrier of WSM via an animal model. Materials and methods: WSM was extracted and nHA was added to the matrix to construct porous composite scaffolds. The dose-effect curve of WSM concentration and alkaline phosphatase (ALP) activity was made by culturing rat osteoblasts and examining the absorbance. Three different materials were implanted into critical size defects (CSD) in the skulls of rats, which were further divided into four groups: WSM nHA /Gel group, n-WSM nHA /Gel group, HA powder group, and control group. Results: WSM (150 μg/mL-250μg/mL) effectively improved the activity of ALP in rat osteoblasts. All rats in each group had normal healing. WSM-loaded nHA /Gel group showed better performance on newly-formed bone tissue of rat skull and back at 4th week and 8th week, respectively. At the 4th week, the network of woven bone formed in the WSM-loaded nHA/Gel scaffold material. At 8th week, the reticular trabecular bone in the WSM-loaded scaffold material became dense lamellar bone, and the defect was mature lamellar bone. In the subcutaneous implantation experiment, WSM-loaded nHA/Gel scaffold material showed a better performance of heterotopic ossification than the pure nHA/Gel scaffold material. Conclusion: WSM promotes osteoblast differentiation and bone mineralization. The results confirm that the nHA/ Gel Porous Scaffold with Nacre Water-Soluble Matrix has a significant bone promoting effect and can be used as a choice for tissue engineering to repair bone defects.

In vivo research on 3D-printed composite PLGA and PDLLA-HA absorbable scaffolds for repairing radius defects in rabbits.

Despite being an important research topic in oral biomaterials, few studies have demonstrated the differences between poly(d,l-lactide-co-glycolide)/hydroxyapatite (PLGA/HA) and poly(d,l-lactic acid)/hydroxyapatite (PDLLA/HA). In this study, PLGA/HA and PDLLA/HA scaffolds were prepared using three-dimensional (3D) printing technology and implanted into radius defects in rabbits to assess their effects on bone regeneration. In this study, 6 mm × 4 mm bone defects were generated in the bilateral radii of rabbits. 3D-printed PLGA/HA and PDLLA/HA scaffolds were implanted into the defects. X-ray imaging, micro-computed tomography, and hematoxylin-eosin staining were performed to observe the degradation of the materials, the presence of new bone, and bone remodeling in the bone defect area. The PLGA/HA scaffolds displayed complete degradation at 20 weeks, whereas PDLLA/HA scaffolds exhibited incomplete degradation. Active osteoblasts were detected in both groups. The formation of new bone, bone marrow cavity reconstruction, and cortical bone remodeling were better in the PLGA/HA group than in the PDLLA/HA group. PLGA/HA scaffolds performed better than PDLLA/HA scaffolds in repairing bone defects, making the former scaffolds more suitable as bone substitutes at the same high molecular weight.

Efficacy of allogenic bone block graft in maxillary alveolar ridge reconstruction: A systematic review.

The purpose of this systematic review was to assess the efficiency of allogenic bone block grafts for maxillary alveolar ridge reconstruction. An electronic literature search was conducted using the PubMed, Cochrane Library, and Google Scholar databases. In addition, manual searching was done. Randomized controlled trials (RCTs) and prospective clinical trials (non-RCTs) up to December 2022, presenting the outcomes of allogenic bone blocks in maxillary alveolar ridge reconstruction, were identified. The rate of resorption, survival rate of implants, and formation of new bone following ridge augmentation were the outcome parameters. The quality assessment of the studies included was done using Joanna Briggs Institute Critical Appraisal Tool. A total of 13 studies that matched the inclusion criteria were included. The average rate of bone resorption ranged from 0.2 to 29.2 mm, with an implant survival rate of 96.87% across the included investigations. On an average, 25.83 mm (18.6-33/mm) of new mature compact osseous tissue was discovered, including viable osteocytes in close contact with the remnant cancellous bone. According to the results of the current systematic review, using allogenic bone block graft for reconstruction of atrophic maxillae appears to be an effective and reliable bone substitute for reconstruction of atrophic maxillae.

Histologic wound healing in studies using different ridge preservation protocols: A review.

Alveolar ridge preservation (ARP) procedures are designed to lessen dimensional changes in the alveolar ridge after tooth extraction. Wound healing after ridge preservation involves the formation of new vital bone in the former socket, and this vital bone is important in the osseointegration of dental implants. A series of ARP studies have been performed to help clinicians better understand the wound-healing events that occur following tooth extraction and ridge preservation. Different protocols have been examined using various materials and periods of healing time prior to implant placement. The primary aim of these studies was to ascertain the relative percentage of vital bone formation, residual graft material, and connective tissue (CT)/other at the healing site using histomorphometric examination of bone core biopsies obtained during osteotomy preparation. For allografts, the use of demineralized bone alone or in combination with mineralized is associated with more vital bone formation than the use of mineralized allograft alone. For mineralized allografts, the use of cortical versus cancellous bone has only minimal impact on new bone formation. Xenografts from bovine and porcine sources appear to have similar vital bone formation. Longer healing times prior to implant placement are associated with increased vital bone formation and decreased residual graft material. The most stable component in most studies is the percentage of CT/other. The percentage of vital bone and residual graft at ARP sites is dependent on the materials used and the length of healing time prior to obtaining core biopsies. What factors may affect the amount of new bone at the ARP site? At a time point about 4 months after ARP, the type of graft material used for ARP plays a large role in new bone formation. Studies focus on means and standard deviations, but patients often do not "follow the mean." Even if a single ARP protocol is used for all patients, there is great interindividual variability in new bone formation, and there is often variability between sites within a single patient. How long after ARP with an allograft should I wait to place an implant? Longer healing times such as 4-5 months generally provide higher amounts of vital bone formation than shorter healing times like 2-3 months. Differences in vital bone formation between ARP protocols tend to decrease with longer healing time. FDBA that contains demineralized bone, either alone or combined with mineralized FDBA, often provides higher amounts of new bone formation than 100% mineralized allograft, especially at shorter healing periods. Even a year after ARP with an allograft, residual graft material is often still present at the ARP site.

Role of vosoritide drug on children's with achondroplasia

Achondroplasia is a genetic condition with an autosomal dominant inheritance pattern. It is caused by detrimental heterozygous FGFR3 gene mutations. Gain-of-function mutations in the FGFR3 gene impair chondrocyte differentiation and proliferation, which has a negative impact on the formation of new bone. Vosoritide, also known as voxzogo, is the first pharmacological intervention to receive approval for the treatment of achondroplasia. This therapeutic agent has been sanctioned for administration via at-home injections, which are to be performed under the supervision of a proficient nurse.