Higher Bone Density Research Articles

Effect of Smoking on Healing Failure After Rotator Cuff Repair

Background: No study to date has directly evaluated rotator cuff repair results among smokers. Purpose: To evaluate whether smoking affects healing after arthroscopic rotator cuff repair through propensity score matching (PSM). Study Design: Cohort study; Level of evidence, 3. Methods: Among 249 patients who underwent arthroscopic repair of full-thickness rotator cuff tears, 34 current heavy smokers were selected with a smoking history >20 pack-years (mean ± SD pack-years, 33.91 ± 12.13). Characteristics between current heavy smokers and nonsmokers were compared. According to the PSM technique, 34 nonsmokers were selected after 1:1 matching for age, fatty infiltration, and tear size—the main prognostic factors of outcomes after rotator cuff repair. Each patient’s outcome evaluation was completed anatomically at a minimum of 6 months (magnetic resonance imaging or ultrasonography) and functionally at a minimum of 1 year (pain visual analog scale, range of motion, American Shoulder and Elbow Surgeons, Constant, University of California, Los Angeles, and Simple Shoulder Test scores), and every outcome was analyzed in the matched smoker and nonsmoker groups. Results: Current heavy smokers had a higher incidence of male sex (P < .001), heavy manual work (P = .025), high bone density (P = .036), and poor tendinosis grade (P = .028). After adjustment for the confounding variables by PSM, the matched smoker group showed a significantly higher healing failure rate than the matched nonsmoker group (29.4% vs 5.9%, P = .023). However, we failed to detect significant differences in the functional outcomes between the matched groups (P > .05). Conclusion: Smoking affected healing failure after arthroscopic rotator cuff repair. Attention should be paid to smokers, especially current heavy smokers, in cases of rotator cuff repair surgery.

PALATAL VERSUS BUCCAL ANTRAL APPROACH FOR MAXILLARY SINUS LIFTING AND IMPLANT PLACEMENT

INTRODUCTION: Implant placement in the maxillary posterior alveolar ridge is often complicated by post extraction bone resorption, pneumatization of maxillary sinuses, and poor quality of alveolar bone. In these situations, the residual vertical bone height is reduced making standard implant placement difficult. Elevation of the maxillary sinus floor using the lateral antral approach is one possible solution. Palatal window osteotomy approach for maxillary sinus floor lifting is a new surgical technique used to increase vertical bone height prior to implant placement. OBJECTIVES: This study was designed for clinical evaluation of the maxillary sinus lifting technique using a palatal approach versus buccal approach. MATERIALS AND METHODS: this study was carried out as a randomized controlled clinical trial, the study sample included 14 patients. The sample was selected conveniently to fulfill a list of inclusion and exclusion criteria. All patients were divided into two equal groups, had gone maxillary sinus lifting together with implant placement, group1 :( study group) seven patients had sinus lifting through the palatal approach technique simultaneously with implant insertion. In group2 (control group) seven patients had maxillary sinus lifting using buccal antral approach technique simultaneously with implant insertion. Clinical and radiographic evaluation was done through 6 months postoperatively. RESULTS: Regarding postoperative clinical evaluation, group 1 was superior to that of group 2 in tissue management, because the vestibular anatomy in this group was not altered neither postoperative swelling occurred consequently nor disharmonious soft tissue scarring. Regarding the postoperative radiographic evaluation, group 1 was significantly increased in bone density around dental implants and less marginal bone loss postoperatively, however group 2 had higher vertical amount of bone gained around implants postoperatively. CONCLUSIONS: The palatal sinus lifting approach permitted higher postoperative comfort, less postoperative edema, less marginal bone loss around implants, and higher bone density around implants postoperatively.

THE USE OF HERBERT CANNULATED BONE SCREW IN THE TREATMENT OF MANDIBULAR FRACTURES (A CLINICAL AND RADIOGRAPHIC STUDY)

INTRODUCTION: Maxillofacial trauma is in querulous expansion by clinical and biomechanical studies in order to enhance the wellestablished techniques and to utilize new materials, all are directed towards the reduction in the immobilization period and enhancement of the rigid fixation. Since 1984 the cannulated Herbert Bone Screw (HBS) proves to be a successful mean of fracture fixation in various fields of orthopaedic surgery, nonetheless with no sufficient evidence about its performance in the maxillofacial trauma field. OBJECTIVES:The aim of the study was to evaluate clinically and radiographically the performance of HBS in the treatment of mandibular fractures. MATERIALS AND METHODS: Eleven patients with non-comminuted recent mandibular fracture were treated using Herbert bone screw. Clinical follow up was conducted after 24-hours, one week, four weeks, six weeks and twelve weeks. Also, a radiographic investigation was performed immediately postoperative and after twelve weeks to estimate the mean bone density across the fracture line. RESULTS: By the end of the follow up period, all cases showed normal lower lip sensation, normal occlusal and intercuspal relation, a statistically significant (P value < 0.001) decrease in level of pain intensity score based on the Visual Analogue Scale (VAS) and an uneventful wound healing with no records of developed infection. Mean bone density after twelve weeks showed a statistically significant (p < 0.001) increase in its values when compared to the immediately postoperative values. CONCLUSIONS: This study deduced that the use of Herbert screws results in a predictable and satisfactory outcome, in terms of achieving uneventful wound healing and high postoperative mean bone density values.

Loss of the von-Hippel Lindau gene in osteocytes alters B lymphocyte development and immune response

Abstract The von-Hippel Lindau protein (VHL) regulates hypoxia-inducible factor (HIF) degradation. Conditional-deletion of VHL in osteoblasts and in hematopoietic progenitors have demonstrated a role for VHL in these cell types, but how changes in bone homeostasis affects immune development are not fully understood. Osteoblasts (OBs) support B cell development. OBs mature into osteocytes (OCYs) and to test if OCYs also support B cell development, we generated OCY-specific (Dmp-Cre) conditional VHL knockout (cKO) mice. cKO mice display dysregulated bone growth, high bone density, smaller bone marrow (BM) cavity volume, and overall decrease in BM cellularity compared to controls. In line with this, the frequencies and numbers of B cell precursors (B220+ IgM−), immature B (B220+ IgMint) and recirculating B (B220+ IgMhigh) cells in the bone marrow are significantly decreased. These data suggest that the change in bone homeostasis adversely affects B cell development in a cell-extrinsic manner. Although the absolute numbers of B cells in the spleens of cKOs were normal, we hypothesized that loss of VHL in OCYs could permanently and adversely affect B cell functional response. To test this, VHL cKO mice were immunized with a T-independent antigen (NP-Ficoll). IgM and IgG3 antigen-specific titers to NP-Ficoll in VHL cKOs were similar to WT mice. Testing of B cell responses to T-dependent antigens (NP-OVA) is ongoing. Taken together, our data suggest that OCY-specific VHL deletion might be helpful to increase bone density, but at the expense of B cell numbers. Further investigation is required to understand the molecular mechanisms by which VHL in OCYs contribute to its putative role as a B cell niche cell.

E06 High bone density: too much of a good thing?

e06 High bone density: too much of a good thing?

Diabetic serum from older women increases adipogenic differentiation in mesenchymal stem cells

ABSTRACTBackground: Paradoxically, elderly persons with type 2 diabetes mellitus (T2DM) fracture despite having higher bone density than nondiabetics. Systemic factors associated with aging and T2DM may have detrimental, local effects on the skeleton. One such factor could be by altering the microenvironment of the mesenchymal stem cells (MSCs), multipotent progenitors capable of differentiating into adipocytes or osteoblasts. Methods: Sera were obtained from four participant groups (n = 40 total, 10 per group): (1) young women with normal glucose tolerance (NGTY), (2) postmenopausal women with NGT), (3) postmenopausal women with impaired glucose tolerance (IGT), and (4) postmenopausal women with T2DM. Sera were incubated with human MSCs for 14 days. Cell proliferation and apoptosis were measured using EdU and TUNEL labeling assays, respectively. MSC differentiation for each group was determined using osteogenic and adipogenic gene expression markers quantified by qRT-PCR, as well as Alizarin Red and Oil Red O staining. Results: Expression of adipogenic genes was greater than twofold higher (P < 0.05) in MSCs cultured with T2DM sera compared to those incubated with NGTY, NGT, or IGT sera. The increase in adipogenic gene expression corresponded with increased Oil Red O staining. Despite the increased adipogenic differentiation of MSCs exposed to T2DM sera, cell proliferation and apoptosis rates as well as osteoblastic activity were not significantly different among the four conditions. Conclusions: Systemic, circulating factors in the serum of older women with T2DM may promote MSC differentiation into adipocytes versus osteoblasts. Increased differentiation of MSCs into adipocytes is one possible mechanism by which T2DM increases fracture risk.

The effect of interbody fusion cage design on the stability of the instrumented spine in response to cyclic loading: an experimental study

Background ContextIn the lumbar spine, end plate preparation for the interbody fusion cages may critically affect the cage's long-term performance. This study investigated the effect of the interbody cage design on the compliance and cage subsidence of instrumented spines under cyclic compression. PurposeWe aimed to quantify the role of cage geometry and bone density on the stability of the spinal construct in response to cyclic compressive loads. Study DesignChanges in the cage-bone interface and the effect of bone density on these changes were evaluated in a human cadaveric model for three intervertebral cage designs. MethodsThe intervertebral space of 27 functional cadaveric spinal units was instrumented with bilateral linear cages, single anterior conformal cages, or single unilateral oblique cages. Once augmented with a pedicle screw fixation system, the instrumented spine unit was tested under cyclic compression loads (400–1,200 N) to 20,000 cycles at a rate of 2 Hz. Compliance of the cage-bone interface and cage subsidence was computed. Two-way repeated multivariate analysis of variance was used to test the effects of cage design and bone density on the compliance and subsidence of the cages. ResultsThe anterior conformal shaped cage showed reduced interface stiffness (p<.01) and higher hysteresis (p<.01) and subsidence rate (10%–30%) than the bilateral linear and unilateral oblique-shaped cages. Bone density was not associated with the initial compliance of the cage-bone interface or the rate of cage subsidence. Higher bone density did decrease the rate of reduction in cage-bone interface stiffness under higher cyclic loads for the anterior conformal shaped and unilateral oblique cages. ConclusionsCage design and position significantly affected the degradation of the cage-bone interface under cyclic loading. Comparisons of subsidence rate between the different cage designs suggest the peripheral location of the cages, using the stronger peripheral subchondral bone of the apophyseal ring, to be advantageous in preventing the subsidence and failure of the cage-bone interface.

Author response: MRI-guided focused ultrasound thalamotomy in non-ET tremor syndromes

We thank Dr. Venketasubramanian for the interest in our article,1 and for highlighting the safety concerns of focused ultrasound (FUS) as well as the need for more studies, which we agree on. Temporal bone window applies to standard brain diagnostic ultrasound whereas FUS uses over 1,000 ultrasound beams directed towards a deep target from all directions surrounding the patient's head.2 Therefore, the problem of temporal bone window does not apply to FUS. However, it is estimated that roughly 15% of FUS candidates cannot receive the treatment due to the high bone density of their skull.3

Editors' note: MRI-guided focused ultrasound thalamotomy in non-ET tremor syndromes

In “MRI-guided focused ultrasound thalamotomy in non-ET tremor syndromes,” Fasano et al. studied unilateral thalamotomy with MRI-guided focused ultrasound (MRgFUS) in patients with tremors other than essential tremor (ET). They found that MRgFUS targeting the ventro-intermedius nucleus (Vim) of the dominant hemisphere improved the tremor of the contralateral hemibody at 6 months. Commenting on the article, Dr. Venketasubramanian is concerned about the potential side effect of the procedure, noting that 2 patients had persistent neurologic symptoms and deficits. He also mentions the absence of an adequate temporal bony window, seen in some individuals, which may limit use of MRgFUS. Authors Fasanol et al. agree with the safety concerns and that more studies are needed. They also explain that the problem of temporal bone window does not apply to focused ultrasound (FUS). However, they clarify that 15% of FUS candidates cannot receive the treatment due to the high bone density of their skull. In “MRI-guided focused ultrasound thalamotomy in non-ET tremor syndromes,” Fasano et al. studied unilateral thalamotomy with MRI-guided focused ultrasound (MRgFUS) in patients with tremors other than essential tremor (ET). They found that MRgFUS targeting the ventro-intermedius nucleus (Vim) of the dominant hemisphere improved the tremor of the contralateral hemibody at 6 months. Commenting on the article, Dr. Venketasubramanian is concerned about the potential side effect of the procedure, noting that 2 patients had persistent neurologic symptoms and deficits. He also mentions the absence of an adequate temporal bony window, seen in some individuals, which may limit use of MRgFUS. Authors Fasanol et al. agree with the safety concerns and that more studies are needed. They also explain that the problem of temporal bone window does not apply to focused ultrasound (FUS). However, they clarify that 15% of FUS candidates cannot receive the treatment due to the high bone density of their skull.

Implant Insertion into an Augmented Bone Region Using the Canine Mandible Augmented by the "Casing Method".

The purpose of this study was to examine the efficacy of bone augmentation using the "Casing Method," which enables large-scale osteogenesis, and the feasibility of using the augmented bone in dental implants. Three Beagle dogs were used. After tooth extraction, a polyethylene terephthalate case (20 mm × 5 mm × 10 mm) was placed on the buccal surface of the mandible. A mixture of hydroxyapatite and beta-tricalcium phosphate (volume ratio = 1:1) was infiltrated into a suspension of autologous superfine bone powder and plasma, and the resulting mixture was packed into the case. After 16 weeks, the implant was inserted into the augmented bone and the original bone. Specimens of the mandible were collected at 2, 4, 8, and 16 weeks after implant insertion, and undecalcified sections were prepared. The integration of the implant into the surrounding bone tissue was observed histologically. Favorable bone formation was observed in the regions where bone augmentation was performed. The space between the cut bone surface and the implant was filled with newly formed bone in both the augmented and original bone regions. In addition, there was higher bone density in the augmented bone than that in the original bone at the coronal half of the implant at 16 weeks. As a result, bone-to-implant contact was significantly higher in the augmented bone region than in the original bone region. These results suggest that bone augmentation surgery using the "Casing Method" is an effective technique for expanding the application of dental implants. Anat Rec, 301:892-901, 2018. © 2018 Wiley Periodicals, Inc.

Complex interplay among adiposity, insulin resistance and bone health.

Obesity and osteoporosis are common public health problems. Paradoxically, while obesity is associated with higher bone density, type 2 diabetic obese individuals have an increased fracture risk. Although obesity and insulin resistance co-exist, some obese individuals remain insulin-sensitive. We suggest that the apparent paradox relating obesity, bone density and fracture risk in type 2 diabetes may be at least partly influenced by differences in bone strength and quality between insulin-resistant and insulin-sensitive obese individuals. In this review, we focus on the complex interplay between, adiposity, insulin resistance and osteoporotic fracture risk and suggest that this is an important area of study that has implications for individually tailored and targeted treatment to prevent osteoporotic fracture in obese type 2 diabetic individuals.

An assessment of proximal humerus density with reference to stemless implants

Shoulder arthroplasty humeral components have undergone several generational changes, with systems now offering shorter stems and stemless options. The stemless humeral implants obtain fixation in the trabecular bone of the proximal humerus through elaborate fixation features. To optimize implant design, the regional variations in bone density within the proximal humerus should be determined. As such, the purpose of this computed tomography-based study was to map the regional variations in bone density of the proximal humerus. The trabecular-canal of the proximal humerus was extracted from computed tomography scans of 98 subjects and divided into 13 slices and 5 subsections (central, anterior, posterior, medial, and lateral). The average apparent density (ρAVG) was then quantified in each subsection of the trabecular-canal. Slice depth, subsection, and gender were all significant main effects, with additional significant interactions between slice depth, subsection, and osteoarthritic condition. The slices above the resection plane had the greatest ρAVG, with densities decreasing down the canal. The central subsection had significantly lower ρAVG than the peripheral sections, and the medial subsection tended to have the highest ρAVG (P < .001). Furthermore, the ρAVG of male subjects was significantly greater than that of female subjects (P < .001). The apparent density of the proximal humerus' trabecular-canal is nonuniform. This has implications for the design of stemless implants, indicating that implants seeking purchase in higher density bone should take advantage of the peripheral regions of the trabecular-canal within the first 15-20 mm beneath the humeral head resection plane.

Sports Participation in High School and College Leads to High Bone Density and Greater Rates of Bone Loss in Young Men: Results from a Population-Based Study.

Estimated lifetime risk of an osteoporotic fracture in men over the age of 50years is substantial and lifestyle factors such as physical activity may explain variation in bone mass and bone loss associated with aging. Men (n = 253) aged 20-66years were followed for 7.5years and factors that influence changes in means and rates of change in bone mass, density, and size using dual-energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT) were investigated; in particular, seasons of sports participation during high school and college. Men with greater sports participation had higher total hip bone mineral content (BMC) (48.4 ± 0.9 and 48.6 ± 0.9g for 7-12 and 13+ seasons vs. 45.6 ± 0.8 and 45.4 ± 0.7g for 0 and 1-6 seasons, respectively p < 0.05) and areal bone mineral density (aBMD) (1.082 ± 0.015 and 1.087 ± 0.015g/cm2 for 7-12 and 13+ seasons vs. 1.011 ± 0.015 and 1.029 ± 0.013g/cm2 for 0 and 1-6 seasons, respectively p < 0.05) than men who participated in less sport-seasons. However, men with higher sports participation also had greater rates of bone loss in their mid-twenties at the hip (BMC - 0.8 and - 1.2% and aBMD - 0.8 and - 0.9% for 7-12 and 13+ seasons of sport participation, respectively) compared to those with 0 seasons of sport participation (BMC - 0.6% and aBMD - 0.6%) (all p < 0.05). Similar results were observed for femoral neck aBMD. Men with 7+ seasons of sport participation had higher cross-sectional area at the 20% distal radius site than those with no sports participation (all p < 0.05). These findings support significant effects of high school and/or college sports participation on bone mass and geometry in men throughout adulthood.

Florid cemento-osseous dysplasia: a contraindication to orthodontic treatment in compromised areas.

ABSTRACTFlorid cemento-osseous dysplasia is a sclerosing disease that affects the mandible, especially the alveolar process, and that is, in most cases, bilateral; however, in some cases it affects up to three or even four quadrants. During the disease, normal bone is replaced with a thinly formed, irregularly distributed tissue peppered with radiolucent areas of soft tissue. Newly formed bone does not seem to invade periodontal space, but, in several images, it is confused with the roots, without, however, compromising pulp vitality or tooth position in the dental arch. There is no replacement resorption, not even when the images suggest dentoalveolar ankylosis. Orthodontists should make an accurate diagnosis when planning treatments, as this disease, when fully established, is one of the extremely rare situations in which orthodontic treatment is contraindicated. This contraindication is due to: (a) procedures such as the installment of mini-implants and mini-plaques, surgical maneuvers to apply traction to unerupted teeth and extractions should be avoided to prevent contamination of the affected bone with bacteria from the oral microbiota; and (b) tooth movement in the areas affected is practically impossible because of bone disorganization in the alveolar process, characterized by high bone density and the resulting cotton-wool appearance. Densely mineralized and disorganized bone is unable to remodel or develop in an organized way in the periodontal ligaments and the alveolar process. Organized bone remodeling is a fundamental phenomenon for tooth movement.

Osseointegration of ultrafine-grained titanium with a hydrophilic nano-patterned surface: an in vivo examination in miniature pigs.

Advances in biomaterials science and implant surface technology have made dental implants more predictable and implant therapy more attractive to patients. Surgical interventions are becoming less invasive, and patients heal faster and suffer less morbidity. In this preclinical in vivo study, we compared a new ultra-fine grained titanium (ufgTi) implant material with a hydrophilic nano-patterned surface to commercially pure titanium (cpTi) in a well-established animal model. CpTi grade 4 was subjected to Equal Channel Angular Pressing (ECAP), followed by a cold drawing process that provided ultra-fine-grained titanium (ufgTi) with a mean grain size of 300 nm. After metallographic assessment, the surface topography was characterized by laser confocal microscopy and atomic force microscopy. UfgTi and cpTi implants were inserted in the mandible and maxilla of miniature pigs that healed for 4 and for 8 weeks. Osseointegration was assessed by biomechanical torque out analysis, histomorphometric evaluation, and micro-CT analysis. The metallographic properties of UfgTi were significantly better than those of cpTi. Their surface topographies had similar hydrophilic nano-patterned characteristics, with no significant differences in the nanometre range. Histomorphometric and biomechanical torque out analysis revealed no significant differences between ufgTi and cpTi in environments of either low (maxilla) or high (mandible) bone density. We obtained high bone-to-implant contact values irrespective of the bony microarchitecture even when the bone mineral density was low. Overall, this investigation suggests that ufgTi forms a hydrophilic nano-patterned surface with superior metallographic properties compared to cpTi and high levels of osseointegration. Thus, ufgTi has therapeutic potential as a future strategy for the development of small diameter implants to enable less invasive treatment concepts, reduce patient morbidity and may also lower the costs of patient care.

Factors related to the clinical application of orthodontic mini-implants

Orthodontic mini-implants use has been increased. The purpose of this review was to analyze the factors related to the clinical application of orthodontic mini-implants. For the present study, the electronic databases PubMed, MEDLINE, Cochrane, and Google Scholar were searched for available data. The literature search was performed on the articles published from 2003 up to 2017. International peer-reviewed journal articles related to factors which are associated with the clinical application of orthodontic mini-implants were searched. Successful application of mini-implants depends on proper selection of insertion site, proper selection of mini-implant (length, diameter, tapering), proper insertion (site, predrilling, angle, primary stability, injury, and absence of adjacent anatomic structures), absence of inflammation, and proper orthodontic loading. Insertion site and mini-implant characteristics are selected based mainly on cortical bone thickness, bone density, available bone, adjacent anatomic structures, and soft-tissue thickness. Sites of high cortical bone thickness, high cancellous bone density, sufficient available bone, and thin attached gingiva are ideal for mini-implant insertion. Extremely thick cortical bone requires attention. In thick cortical bone, shorter mini-implants can be selected. For sites of low cortical bone thickness and low cancellous bone density, longer and wider mini-implants are indicated. Very thin cortical bone and very low cancellous bone density negatively affect the prognosis of mini-implants. Very narrow implants entail fracture risk. Predrilling is preferred at high bone quality sites, whereas it is used with caution or even be avoided at low bone quality sites. Angled placement might be considered to increase bone-to-implant contact and reduce root injury risk. Loading time depends on insertion torque. Successful application of mini-implants is based on proper insertion site and mini-implant characteristics selection, proper insertion, absence of inflammation, and proper orthodontic loading. Careful assessment of all the factors that might compromise mini-implant success is important for their clinical application.

"Omics" Signatures in Peripheral Monocytes from Women with Low BMD Condition.

Postmenopausal osteoporosis (PMO) is a result of increased bone resorption compared to formation. Osteoclasts are responsible for bone resorption, which are derived from circulating monocytes that undertake a journey from the blood to the bone for the process of osteoclastogenesis. In recent times, the use of high throughput technologies to explore monocytes from women with low versus high bone density has led to the identification of candidate molecules that may be deregulated in PMO. This review provides a list of molecules in monocytes relevant to bone density which have been identified by “omics” studies in the last decade or so. The molecules in monocytes that are deregulated in low BMD condition may contribute to processes such as monocyte survival, migration/chemotaxis, adhesion, transendothelial migration, and differentiation into the osteoclast lineage. Each of these processes may be crucial to the overall route of osteoclastogenesis and an increase in any/all of these processes can lead to increased bone resorption and subsequently low bone density. Whether these molecules are indeed the cause or effect is an arena currently unexplored.

In Vivo Evaluation of Dual Acid-Etched and Grit-Blasted/Acid-Etched Implants With Identical Macrogeometry in High-Density Bone.

Based on the current evidence, the effect of implant macrogeometry has a significant influence on osseointegration. Thus, this study evaluated histomorphometrically and histologically the bone response to acid-etched in comparison to grit-blasted/acid-etched (GB) and machined control (C) surfaced implants possessing identical macrogeometry placed in high-density bone. Implant surface topography of the 3 different surfaced implants has previously been characterized. The macrogeometry of the implants were conical, and healing chambers were created in the cortical regions. The 3 groups were placed in the external mandibular body of adult male sheep (n = 5). After 6 weeks in vivo, all samples were retrieved for histologic observation and histomorphometry (eg, bone-to-implant contact [BIC] and bone area fraction occupancy [BAFO]). No statistical difference was observed for BIC and for BAFO, although there was a tendency that the mean values for BAFO was higher for the textured surface groups. It is suggested that the effect of surface topography is minimal in high-density bone and osseointegration seemed to be macrogeometry dependent.

Use of Bone Allograft With or Without Bone Marrow Aspirate Concentrate in Appositional Reconstructions: A Tomographic and Histomorphometric Study.

To evaluate bone allograft associated to bone marrow aspirate concentrate (BMAC), in maxillary reconstructions. Ten patients with alveolar bone deficiency in the anterior maxilla were randomly divided into control group (CG) and test group (TG). A bone block allograft was placed in both groups, but the graft was impregnated with BMAC only in TG. Computed tomography was performed 7 days (T1) and 6 months (T2) after the grafting procedure, and volume and bone density measurements were carried out. Histomorphometric analysis was performed at T2. Bone volume loss from T1 to T2 was significant only in TG. The bone density in the buccal region of the graft was significantly higher in TG than in CG. There was no significant difference between the groups, in respect to mineralized tissue (MT) and nonmineralized tissue (NMT), in that MT values were 37.77% ± 15.19% and 43.85% ± 10.94%, and NMT values were 62.15% ± 14.90% and 56.30% ± 10.72%, respectively, for CG and TG. The intragroup difference for the MT/NMT ratio was statistically significant in CG but not significant in TG. The use of BMAC resulted in an improved pattern of bone formation, with higher bone density in the peripheral regions of the graft.

FOR SLAUGHTER QUALITIES OF THE OBROSHYNSKA WHITE AND GREY BREED GROUP

FOR SLAUGHTER QUALITIES OF THE OBROSHYNSKA WHITE AND GREY BREED GROUP