Fracture Susceptibility Research Articles

Mutational Screening of Skeletal Genes in 14 Chinese Children with Osteogenesis Imperfecta Using Targeted Sequencing.

Background As a heterogeneous hereditary connective tissue disorder, osteogenesis imperfecta (OI) is clinically characterized by increased fracture susceptibility. Analysis of genetic pathogenic variants in patients with OI provides a basis for genetic counseling and prenatal diagnosis. Methods In this study, 14 diagnosed OI patients from sporadic Chinese families were enrolled to be screened for potential mutations from these patients by next-generation sequencing technology. Results 34 different variants were identified. 18 variants were from 4 OI-related genes including COL1A1, COL1A2, P3H1, and WNT1, and 10 variants are novel. Most OI patients (11 out of 14, 78%) harbor variants in type I collagen genes. Conclusions Our results support previously established estimates of the distribution and prevalence of OI mutations and highlight both phenotype and genetic heterogeneity among and within families. We report several novel variants of OI, which expands the clinical spectrum of OI. In summary, our data provides disease-causing genes information for genetic counseling towards OI patients and families and also provides a reference for clinicians in the diagnosis of OI, also in prenatal diagnosis of this disease.

Enhanced Risk of Osteoporotic Fracture in Patients with Sarcopenia: A National Population-Based Study in Taiwan.

Sarcopenia is a progressive and generalized skeletal muscle disorder associated with poor health outcomes in older adults. However, its association with the risk of fracture risk is yet to be clarified. Therefore, this study aimed to assess the incidence and consequence of osteoporosis-related fractures among patients with sarcopenia in Taiwan. A retrospective, population-based study on 616 patients with sarcopenia, aged >40 years, and 1232 individuals without sarcopenia was conducted to evaluate claims data from Taiwan’s National Health Insurance Research Database collected in the period January 2000–December 2013. The incidence rate of osteoporosis-related fracture was 18.13 and 14.61 per 1000 person years in the patients with sarcopenia and comparison cohort, respectively. Patients with sarcopenia had a greater osteoporotic fracture risk (adjusted hazard ratio [HR] 2.11; 95% confidence interval [CI] 1.47–3.04) after correcting for possible confounding. Additionally, females showed statistically significant correlations of sarcopenia with osteoporosis-related fracture risk (HR 1.53; CI 0.83–2.8 for males and HR 2.40, CI 1.51–3.81 for females). During this retrospective study on the fracture risk in Taiwan, an adverse impact of sarcopenia was observed, which substantiates the need to work toward sarcopenia prevention and interventions to reverse fracture susceptibility in patients with sarcopenia.

The Brown Algae Ishige sinicola Extract Ameliorates Ovariectomy-Induced Bone Loss in Rats and Suppresses Osteoclastogenesis through Downregulation of NFATc1/c-Fos.

Osteoporosis is characterized by reduction in bone mass and microarchitectural deterioration of the bone, which causes bone fragility and fracture susceptibility. Ishige sinicola, a brown alga, reportedly affects osteoblast differentiation. However, its protective effect on estrogen deficiency-induced bone loss has not been elucidated. This study aimed to investigate the effect of I. sinicola extract (ISE) on ovariectomy (OVX)-induced bone loss in vivo and osteoclastogenesis in vitro. Female Sprague-Dawley rats were randomly assigned to the sham-operated (SHAM) group and four OVX subgroups: SHAM, OVX, ISE20 (20 mg/kg), ISE200 (200 mg/kg), and estradiol (10 μg/kg). After 6 weeks of treatment, the bone mineral density (BMD), femur indices, and serum biomarker levels were measured. Furthermore, the effects of ISE on osteoclastogenesis and the expression of osteoclast-specific markers were measured. ISE administration improved the trabecular bone structure, bone biomechanical properties, BMD, and bone mineralization degree. In addition, the levels of serum bone turnover markers were decreased in the ISE group compared with those in the OVX group. Moreover, ISE inhibited osteoclast formation by downregulating NFATc1, TRAP, c-Src, c-Fos, and cathepsin K without any cytotoxic effects on RANKL-induced osteoclast formation. Therefore, we suggest that ISE has therapeutic potential in postmenopausal osteoporosis.

The Mechanism of Bone Remodeling After Bone Aging.

Senescence mainly manifests as a series of degenerative changes in the morphological structure and function of the body. Osteoporosis is a systemic bone metabolic disease characterized by destruction of bone microstructure, low bone mineral content, decreased bone strength, and increased brittleness and fracture susceptibility. Osteoblasts, osteoclasts and osteocytes are the main cellular components of bones. However, in the process of aging, due to various self or environmental factors, the body’s function and metabolism are disordered, and osteoporosis will appear in the bones. Here, we summarize the mechanism of aging, and focus on the impact of aging on bone remodeling homeostasis, including the mechanism of ion channels on bone remodeling. Finally, we summarized the current clinical medications, targets and defects for the treatment of osteoporosis.

Cortical porosity development and progression is mitigated after etelcalcetide treatment in an animal model of chronic kidney disease.

Chronic kidney disease (CKD) leads to increased bone fragility and risk of fracture. Cortical deteriorations, including cortical porosity, are key factors in fracture susceptibility in CKD. Since secondary hyperparathyroidism is common in CKD individuals and contributes to cortical deterioration, we hypothesized that reducing parathyroid hormone (PTH) may modulate CKD-induced cortical porosity. The goal of this pilot study was to assess the effects of lowering PTH, via the preclinical analogue of the FDA-approved calcimimetic etelcalcetide (KP-2326), on the development and progression of cortical pores in the setting of CKD. Male Cy/+ Sprague Dawley rats with clinical biochemistries consistent with CKD (N=8) were assigned to the study. At 30-32weeks of age, cortical bone was assessed via In vivo μCT and blood collected for biochemistries to create baseline measures. Calcimimetic treatment with KP-2326 (KP) was then administered 3× weekly for 2-4weeks. Cortical bone and biochemical parameters were repeated at study endpoint (33-37 wks of age). A group of age- and cohort-matched CKD rats (N=4) were utilized as untreated controls. Untreated CKD rats had significantly increased cortical porosity over time, while porosity in KP-treated CKD rats was not significantly changed over time. Individual pore analysis revealed that pore area was significantly higher for expanding pores in untreated CKD rats compared to KP-treated CKD rats. Mechanical properties of KP-treated animal femora were similar to historical values of age-matched CKD animals and lower than those of age-matched non-diseased animals. Our pilot preclinical study demonstrates that etelcalcetide treatment can mitigate the progression of cortical bone changes in an animal model of CKD through suppression of pre-existing cortical pore expansion and limiting the size of new pore development. While stabilization of porosity is beneficial it remains likely that infilling of porosity will be needed to positively affect mechanical properties of bones in the setting of CKD.

Frequency of Impacted Third Molar in Mandibular Angle Fractures in Patients Presenting to Ayub Teaching Hospital

Mandibular fractures are one of the commonest maxillofacial injury. Fractures take place at various locations. Mandibular angle fracture susceptibility in addition to being associated to the type and direction of impact is also associated with impacted 3rd molar.The objective of the study is to determine the frequency of impacted third molar in mandibular angle fracture.This descriptive cross-sectional study was performed for a period of six months on one hundred and twenty-two patients with mandibular. OPG was done to determine the state of 3rd molar tooth. The states of 3rd molar tooth along with its inclination were noted on a proforma.The frequency of 3rd molar impaction in fractures of angle of mandible was 36.1%. Young age (less than 31 years in this study) was significantly associated with development of impacted 3rd molar tooth (p < 0.05).Individuals with impacted 3rd molar should be educated about the possibility of the fracture of mandibular angle so that preventive measures can be adopted.

Micro-mechanical investigation about degradation of grain boundary cohesive strength of neutron-irradiated stainless steels

ABSTRACT Degradation of grain boundary (GB) cohesive strength due to neutron irradiation is a possible factor causing IASCC. In order to clarify the dose dependence and degradation factors of GB cohesive strength of neutron-irradiated stainless steels, micro-tensile testing and microstructural analysis by transmission electron microscopy were conducted on individual GBs of neutron-irradiated stainless steels that were harvested from flux thimble tubes (FTTs) irradiated up to 73 dpa and a baffle former bolt (BFB) irradiated to 19 dpa. The micro-tensile specimens fabricated from the FTTs that included a GB showed higher intergranular fracture susceptibility at higher doses, while the change in susceptibility was small at intermediate doses. On the other hand, the micro-tensile specimen that was fabricated from the BFB had less intergranular fracture susceptibility than the FTT specimen of a similar dose. Fine cavities were confirmed both in matrix and on GBs of the FTTs, whereas they were not found on GBs of the BFB. Considering the present results and those from a previous study investigating effects of helium on GB fracture, it was concluded that the GB cavities degraded GB cohesive strength. However, other factors were possibly promoting intergranular fracture of neutron-irradiated stainless steels such as GB segregation.

Durability evaluation of surface softened steel bar for prestressed concrete

The effects of Si addition and surface softening on delayed fracture susceptibility were evaluated in tempered martensitic steels with tensile strength of 1450 MPa. The delayed fracture susceptibility was reduced when Si content was increased from 0.2 mass% to 1.88 mass%. The delayed fracture susceptibility of steel containing 1.88 mass% Si was reduced further when the tensile strength of its surface was lowered to around 1150MPa. Based on above results, the durability of these steel bars was evaluated by exposure test of prestressed concrete poles (CP). The bending load of the PC pole was 1.3 times of the design load. As a result of dismantling investigation after 10 years exposure test, there were no breakage of the steel bars in the PC poles and the soundness was maintained. In this paper, we will also introduce some comparison results of exposure tests and acceleration tests with aiming to establish the evaluation methods for the long-term durability.

Influence of instrument taper on the fracture susceptibility of endodontically treated maxillary premolars

Influence of instrument taper on the fracture susceptibility of endodontically treated maxillary premolars

An Immature Traumatic Teeth Management With Apical Pathology Using the Novel Biodentine™ Obturation: A Case Report

Pulpal and periapical pathosis in an immature anterior tooth following traumatic injury is a frequent occurrence, and management of open apices in such cases poses a constant challenge to endodontists. This is due to the absence of apical constriction that would result in poor three-dimensional seal/adaptation of the obturated material within the canal system. Treatment of immature pulpless teeth with long-term calcium hydroxide may consequently weaken the dentin and increase the fracture susceptibility. Obturating the root canals completely with bioactive agents like Biodentine/mineral trioxide aggregate (MTA) has benefits like increased fracture resistance when compared to apexification. When used for obturation, Biodentine™, a new calcium silicate-based cement, performs superior to other Portland cement derivatives. This case report demonstrates a six-month follow-up result of an open apex and a periapical lesion involving maxillary right central incisor #11 with the Biodentine obturation that was previously subjected to triple antibiotic paste as an intra-canal medicament for three weeks. The satisfactory healing rate of tooth 11 with the reduction in the size of periapical radiolucency at the end of the six-month follow-up in this current article is highly considerable.

An examination of two different approaches for the study of femoral neck fracture: Towards a more relevant rodent model.

Femoral neck fractures are a massive personal and health programme burden. Methods to study femoral neck strength, across its combined trabecular and cortical components are therefore essential. Rodent ovariectomy-induced osteoporosis models are commonly coupled with ex vivo 3-/4-point bending methods to measure changes in femoral cortical diaphysis. The loading direction used to assess these properties are often non-physiologic and, moreover, these ovariectomy models are linked to marked weight gain that can influence the biomechanical properties. Herein, we explore whether more physiological axial ex vivo loading protocols applied to femoral neck samples of ovariectomised (OVX) rodents provide anatomically-relevant models for the assessment of strength. We examine the use of mouse and rat femurs, loaded in constrained and unconstrained configuration, respectively, and explore whether weight-correction increases their utility. Accordingly, the mid-shaft of the proximal half of femurs from OVX and sham-operated (Sham) mice was methacrylate-anchored and the head loaded parallel to the diaphysis (constrained). Alternatively, femurs from OVX and Sham rats were isolated intact and axially-loaded through hip and knee joint articular surfaces (unconstrained). Yield displacement, stiffness, maximum load and resilience were measured and fracture pattern classified; effects of body weight-correction via a linear regression method or simple division were assessed. Our data reveal significant deficiencies in biomechanical properties in OVX mouse femurs loaded in constrained configuration, only after weight-correction by linear regression. In addition, evaluation of rat femur biomechanics in unconstrained loading demonstrated greater variation and that weight-correction by simple division improved scope to reveal significant OVX impact. We conclude that greater femoral neck fracture susceptibility can indeed be measured in OVX rodents as long as multiple biomechanical parameters are reported, care is taken in choosing the method for assessing load-bearing strength and weight-correction applied. These studies advance the establishment of more relevant rodent models for the study of femoral neck fracture.

Review of Residual Stress Impingement Methods to Mitigate Environmental Fracture Susceptibility

Environmental cracking- and fatigue-related failures threaten all major industries and, to combat such degradation, numerous residual stress impingement (RSI) methods have been developed with varying levels of efficacy and ease of use. Some of the most commonly used RSI methods, such as shot peening, laser shock peening, and low plasticity burnishing, as well as new methods, such as ultrasonic nanocrystal surface modification, are reviewed in the context of corrosion, corrosion fatigue, and environmental cracking mitigation. The successes and limitations of these treatments are discussed, with a focus on their efficacy against these three damage modes based on the available literature. Case studies are reviewed that demonstrate how these treatments have been adopted and advanced by industry, and application-specific research efforts are explored with a focus on future opportunities. Research is identified that illustrates how the utility of these surface treatments may vary between alloy systems, and where the benefits must be weighed against the risks to a component’s service performance.

P129 Predictors of low bone mineral density in rheumatoid arthritis

Abstract Background/Aims Osteoporosis (OP) is an extra-articular manifestation of rheumatoid arthritis (RA) that leads to increased fracture susceptibility due to a variety of reasons including immobility and cytokine driven bone loss. Bone loss in other populations has well documented risk factors. It is unknown whether bone loss in RA predominantly affects the femoral neck or the spine. This study aimed to identify independent predictors of low bone mineral density (BMD) in patients RA at the lumbar spine and the femoral neck. Methods This was a retrospective observational cohort study using patients with Rheumatoid arthritis attending for a regional dual X-ray absorptiometry (DEXA) scan at the Royal Lancaster Infirmary between 2004 and 2014. BMD in L1-L4 in the spine and in the femoral neck were recorded. The risk factors investigated were steroid use, family history of osteoporosis, smoking, alcohol abuse, BMI, gender, previous fragility fracture, number of FRAX(tm) risk factors and age. Univariate and Multivariate regression analysis models were fitted to explore bone loss at these sites using BMD in g/cm2 as a dependant variable. . Results 1,527 patients were included in the analysis, 1,207 (79%) were female. Mean age was 64.34 years (SD11.6). mean BMI was 27.32kg/cm2 (SD 5.570) 858 (56.2%) had some steroid exposure . 169(11.1%) had family history of osteoporosis. fragility fracture history found in 406 (26.6%). 621 (40.7%) were current or ex smokers . There was a median of 3 OP risk factors (IQR 1,3) The performance of the models is shown in table one below. Different risk factors appeared to influence the BMD at different sites and the cumulative risk factors influenced BMD in the spine. None of the traditional risk factors predicted poor bone loss well in this cohort. P129 Table 1:result of the regression modelsCharacteristicB femoral neck95% CIpB spine95%CIpAge at scan-0.004-0.005,-0.003<0.01-0.0005-0.002,0.00050.292Sex-0.094-0.113,-0.075<0.01-0.101-0.129,-0.072<0.01BMI (mg/m2)0.0080.008,0.0101<0.010.01130.019,0.013<0.01Fragility fracture-0.024-0.055,0.0060.12-0.0138-0.060,0.0320.559Smoking0.007-0.022,0.0350.650.0286-0.015,0.0720.20Alcohol0.011-0.033,0.0 5560.620.0544-0.013,0.1120.11Family history of OP0.012-0.021,0.0450.470.0158-0.034,0.0650.53Number of risk factors-0.015-0.039,0.0080.21-0.039-0.075,-0.0030.03steroids0.004-0.023,0.0320.030.027-0.015,0.0690.21 Conclusion This study has shown that predictors of low BMD in the spine and hip are different and less influential than expected in this cohort with RA . As the FRAX(tm) tool only uses the femoral neck, this might underestimate the fracture risk in this population. Further work looking at individual areas is ongoing. Disclosure M.A. Swar: None. M. Bukhari: None.

Euthanasia Through Cervical Dislocation or CO2 Might Affect Keel Bone Fracture Prevalence in 30-Week-Old Laying Hens

Laying hens are susceptible to keel bone fractures due to continuous endogenous calcium resorption for eggshell formation. Although it is assumed that external trauma to the keel bone, e.g., due to collisions, is the main cause for fractures, accumulated forces or asymmetric load on a weakened bone might contribute to the high keel bone fracture prevalence found in commercial laying hens. The objective of this study was to investigate whether forces applied to the keel due to involuntary convulsions and uncontrolled wing flapping during euthanasia have the potential to cause keel bone fractures. Two hundred and seventy Dekalb White laying hens were euthanized at 30 weeks of age using cervical dislocation (n= 60) or CO2(n= 210). All hens were radiographed immediately before and after euthanasia. Radiographs were compared side by side to detect new fractures. Four out of the 270 hens (1.5%) obtained a fracture during euthanasia. Specifically, 0.95% of hens euthanized with CO2(2 out of 210) and 3.3% of hens euthanized through cervical dislocation (2 out of 60) obtained a euthanasia-induced fracture. All four hens with a euthanasia-induced fracture had signs of damage to the keel before euthanasia, indicating that pre-existing fractures could affect fracture susceptibility. Based on our results, we cannot rule out that convulsions during euthanasia can cause keel bone fractures in laying hens. In studies investigating keel bone integrity in birds euthanized with CO2or cervical dislocation, fracture prevalence might be overestimated. Future research is needed to assess whether euthanasia might be more likely to cause keel bone fractures in older birds and to quantify the frequency and strength of convulsions as a potential cause of fractures.

Identifying Fracture-Filling Material in Oil-Based Mud with Dielectric Borehole Imaging

Natural fractures maintain a significant role in many hydrocarbon plays, in both conventional and unconventional reservoirs. In exploration and development scenarios, specific fracture properties, such as orientation and density, are important. However, more critical is their internal architecture: are the fractures open to fluid flow or filled with minerals? Borehole microresistivity imaging tools are widely used to determine these fracture characteristics. In wells drilled with water-based muds, open fractures are filled with conductive borehole fluid that enables distinguishing open, water-filled fractures from resistive, mineral-filled fractures and the surrounding rock. However, many wells today are drilled with oil-based muds. In this case, mineral-filled fractures and oil-based-mud-filled fractures are equally highly resistive and cannot be directly distinguished using resistivity images only. The latest-generation wireline oil-based-mud microresistivity imagers operate in the megahertz frequency range, radiating the electrical current capacitively through the nonconductive mud column and delivering photorealistic borehole images. Both electrical conductivity and dielectric permittivity components constitute the measured signal, from which button standoff, formation resistivity, and dielectric permittivity are inverted. Our example case shows highly resistive, high-angle fractures from the resistivity images with their orientation and density. The standoff image determines if the mud column penetrates the fracture plane, showing an apparently high standoff compared with the surrounding rock. If the standoff appears high in the fracture plane, the fracture is classified as open to fluid flow. However, are these fractures indeed fully dilated and open, or are they filled with different materials—are they partially mineralized with calcite and partially open, filled with mud? To further determine the fracture fill and susceptibility to fluid flow, a new workflow employs the material dependency of the relative dielectric permittivity. The relative permittivity is estimated as a function of resistivity and frequency pixel by pixel on the resistivity image. The estimate formula is based on several hundred laboratory measurements on core plugs with different fluid saturations and salinities. The resulting borehole image enables distinguishing materials in the volume of investigation, where low values correspond to mud-dominated oil in open fracture planes, medium values correspond to rock-forming minerals, and high values are attributed to shales and other clay-rich rocks. Fracture planes filled with patches of both low- and medium-permittivity values are classified as partially open.

A Whole-Genome Sequencing Association Study of Low Bone Mineral Density Identifies New Susceptibility Loci in the Phase I Qatar Biobank Cohort.

Bone density disorders are characterized by a reduction in bone mass density and strength, which lead to an increase in the susceptibility to sudden and unexpected fractures. Despite the serious consequences of low bone mineral density (BMD) and its significant impact on human health, most affected individuals may not know that they have the disease because it is asymptomatic. Therefore, understanding the genetic basis of low BMD and osteoporosis is essential to fully elucidate its pathobiology and devise preventative or therapeutic approaches. Here we sequenced the whole genomes of 3000 individuals from the Qatar Biobank and conducted genome-wide association analyses to identify genetic risk factors associated with low BMD in the Qatari population. Fifteen variants were significantly associated with total body BMD (p < 5 × 10−8). Of these, five variants had previously been reported by and were directionally consistent with previous genome-wide association study data. Ten variants were new: six intronic variants located at six gene loci (MALAT1/TALAM1, FASLG, LSAMP, SAG, FAM189A2, and LOC101928063) and four intergenic variants. This first such study in Qatar provides a new insight into the genetic architecture of low BMD in the Qatari population. Nevertheless, more studies are needed to validate these findings and to elucidate the functional effects of these variants on low BMD and bone fracture susceptibility.

Incidence and treatment of adult femoral fractures with osteogenesis imperfecta: An analysis of a center of 72 patients in Taiwan.

Background: Osteogenesis imperfecta (OI) is a rare disease characterized by increased bone fragility and susceptibility for fractures. Only few studies have compared the management for femoral fractures in children with OI. Nevertheless, no cohort studies have described the treatment for femoral fractures in adults with OI in Taiwan. This study aimed to investigate and compare the incidence of union and non-union femoral fractures and the best treatment options to avoid non-union fractures.Methods: We enrolled 72 patients with OI who were older than 18 years at MacKay Memorial Hospital between January 2010 and December 2018. Femoral fracture incidence, non-union rate, and treatment modality were analyzed.Results: Of 72 patients with OI, 11 patients had femoral fractures and 4 patients of them had >1 femoral fracture. The incidence for all types of femoral fractures was 651 fractures per 100,000 person-years annually. In 15 total fractures, 4 fractures resulted in non-union, and patients with type 4 OI mostly had shaft fractures. The best outcomes for non-union shaft fracture is achieved by surgical treatment.Conclusion: Adults with OI tended to develop femoral fractures and non-unions. Adults with type 4 OI were particularly at high risk for non-unions in shaft fractures with conservative treatment.

Effects of Extended Aqueous Processing on Structure, Chemistry, and Performance of Polycrystalline LiNixMnyCozO2 Cathode Powders.

The prospect of aqueous processing of LiNixMnyCozO2 (NMC) cathodes has significant appeal to battery manufacturers for the reduction in materials cost, toxicological risk, and environmental impact compared to conventional N-methyl-2-pyrrolidone (NMP)-based processing. However, the effects of aqueous processing of NMC powders at industrial timescales are not well studied, with prior studies mostly focusing on relatively brief water washing processes. In this work, we investigate the bulk and surface impacts of extended aqueous processing of polycrystalline NMC powders with different compositions. We demonstrate that at timescales of several hours, polycrystalline NMC is susceptible to intergranular fracture, with the severity of fracture scaling with the NMC nickel content. While bulk crystallinity and composition are unchanged, surface sensitive techniques such as X-ray photoelectron spectroscopy (XPS) and transmission electron microscopy (TEM) indicate that the exposure of water leads to a level of delithiation, nickel reduction, and reconstruction from the layered to rock-salt structure at the surface of individual grains. Dynamic single NMC microparticle compression testing suggests that the resulting mechanical stresses weaken the integrity of the polycrystalline particle and increases susceptibility of intergranular fracture. The initially degraded surfaces along with the increased surface area lead to faster capacity fade and impedance growth during electrochemical cycling. From this work, it is demonstrated that NMC powders require surface or grain boundary modifications to make industrial-scale aqueous cathode processing viable, especially for next-generation nickel-rich NMC chemistries.

Critical Review of Asthikshaya and its Management: Ayurvedic Perspective

The state of equilibrium of Dosha, Dhatus, Malas is health and its disequilibrium is known as disease. Thisdisequilibrium may either be Vriddhi or Kshaya. Asthiis thefifth Dhatu among the seven Dhatus .It is theseat of vatadosha and carrying the function of dehadharana. Asthikshayais one of the condition described byAcharya Charak under 18 types Kshaya in which there is kshayaof Asthi Dhatu. According to the principle ofAshraya-ashrayee Bhava, Asthi &amp; Vata are inversely proportional to each other regarding Vriddhi and Kshaya.Vriddhvata leads to Kshaya of Asthi Dhatu. The symptoms of Asthikshaya resemble to Osteoporosis which ismajor health problem of ageing population. It is a skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility tofracture. Fracture is the most common complication of Osteoporosis which increases the risk of morbidityas well as mortality. Vatais the major factor in the Samprapti of Asthikshaya, Sampraptiof Asthikshayaoccurs in two ways- Dhatukshayajanya and Srotorodhajanya. In Srotorodhajanya, the obstruction can becleared by the use of Deepana and Pachana Dravyas. Nidanparivarjana, Shodhanachikitsa including Basti,Shamana Chikitsa including use of Swayoni Dravyas, Sudha Vargiya Dravyas, Guggulukalapa are the majortreatment modalities for Asthikshaya. They help in Vatashamana and as well as improving the bone health.By following Dincharya, Rutucharya and diet regulation, this disease can be prevented. This review articlehighlights on etiopathogenesis of Asthikshaya and its measures as per Ayurvedic perspective.

Influence of glass fiber posts on the fracture susceptibility of endodontically treated maxillary anterior teeth with direct veneers: Preliminary results of a randomized clinical trial.

The purpose of this randomized clinical trial was to evaluate the influence of glass fiber posts on fracture susceptibility of endodontically treated maxillary anterior teeth with direct veneers. Fifty participants had 1 maxillary anterior tooth restored with a direct veneer. They were divided into 2 groups (n=25) according to the use of intraradicular glass fiber posts. Clinical evaluation was performed at baseline, 6 and 12 months. The treatment success was determined by the absence of tooth fracture. If there was fracture, it was classified according to its extent. Fischer exact test was performed to analyze the criteria among the groups at each evaluation time. Friedman repeated analysis of variance assessed the difference in the performance of each group at three recall times (α=0.5). For control group, at the 6-month follow-up, one tooth had suffered a catastrophic failure, which resulted in tooth extraction. Fisher statistical analysis showed no significant difference between the cumulative success rate of the groups for the 6 (P > .999) and the 12-month (P > .999) period. Friedman test showed no significant difference among the periods of evaluation (P > .999). Both groups had a similar success rate for maxillary anterior endodontically treated teeth with direct veneers after 12 months. Glass fiber post use does not influence the fracture susceptibility of maxillary anterior endodontically treated teeth with direct veneers in the short term.