Bone Structure Research Articles

Clinical Efficacy of Three-Dimensional-Printed Pure Titanium Fracture Plates with Locking Screw Systems in Distal Tibia Fractures

Background and Objectives: Distal tibia fractures are high-energy injuries characterized by a mismatch between standard plate designs and the patient’s specific anatomical bone structure, which can lead to severe soft tissue damage. Recent advancements have focused on the development of customized metal plates using three-dimensional (3D) printing technology. However, 3D-printed metal plates using titanium alloys have not incorporated a locking system due to the brittleness of these alloys. Therefore, this study aimed to determine whether a locking mechanism can be effectively implemented using 3D-printed pure titanium and further evaluate the clinical outcomes of such implants in patients with distal tibia fractures. Materials and Methods: Between March 2021 and June 2022, nine patients who underwent open reduction and internal fixation for distal tibia fractures using 3D-printed pure titanium plates were enrolled. Pure titanium powder (Ti Gr.2, Type A, 3D Systems, USA) was spread to a thickness of 30 μm and partially sintered using a 500 W laser to produce the 3D-printed metal plates. The locking screws were fabricated using a milling process. Open reduction and internal fixation were performed on the nine patients using 10 customized plates. The clinical efficacy was analyzed using the union rate, and complications, such as infection and skin irritation, were evaluated to ensure a comprehensive outcome assessment. Results: Surgical treatment was successfully performed on nine patients, with nine of ten plates remaining stable and undamaged. However, one patient with neurofibromatosis experienced a fractured metal plate, which necessitated revision surgery using a metal rod. No screw loosening or surgical wound complications occurred. Conclusions: This study showed that 3D-printed pure titanium plates with integrated locking screw systems provide a viable and effective solution for managing distal tibia fractures. Three-dimensional printing and pure titanium show promise for orthopedic advancements.

Influencing fracture healing by specific osteoporosis medications

Osteoporosis is a widespread disease defined by areduction in bone mass and structure, thereby increasing the risk of fragility fractures. Treatment typically involves specific medications, which either inhibit bone resorption (antiresorptive) or stimulate bone formation (anabolic) and may potentially influence the healing of osteoporotic fractures. On the other hand, metabolic disorders, immune system dysfunctions or circulatory problems can impair fracture healing. Therefore, the targeted use of osteoporosis medications could be astrategy to promote the healing of impaired fractures. The aim of this study is to provide acurrent overview of the effects of osteoporosis medications approved in Germany on fracture healing. The focus is on the potential influence of these medications in the context of osteoporosis treatment. Additionally, the current state of research is examined to explore to what extent the targeted use of these medications could improve fracture healing. Aliterature search was conducted in the PubMed database using topic-specific keywords. Preclinical studies, clinical trials, review articles and meta-analyses were considered to present the current scientific knowledge with clinical relevance. Preclinical and clinical studies suggest that specific osteoporosis medications do not have aclinically relevant negative impact on the healing of fragility fractures. Osteoanabolic substances even tend to have apositive effect on fracture healing in both normal and impaired healing processes; however, the available studies are limited and none of the medications have been approved for this specific use. Osteoporosis medications with antiresorptive or osteoanabolic effects are primarily used to treat osteoporosis, especially after fragility fractures, to reduce the risk of further fractures. There is no clinically relevant impairment of fracture healing due to these medications. Further studies would be required to obtain approval for these medications specifically to improve fracture healing.

Comparison of Resampling Methods and Radiomic Machine Learning Classifiers for Predicting Bone Quality Using Dual-Energy X-Ray Absorptiometry

Background/Objectives: This study presents a novel approach, based on a combination of radiomic feature extraction, data resampling techniques, and machine learning algorithms, for the detection of degraded bone structures in Dual X-ray Absorptiometry (DXA) images. This comprehensive approach, which addresses the critical aspects of the problem, distinguishes this work from previous studies, improving the performance achieved by the most similar studies. The primary aim is to provide clinicians with an accessible tool for quality bone assessment, which is currently limited. Methods: A dataset of 1531 spine DXA images was automatically segmented and labelled based on Trabecular Bone Score (TBS) values. Radiomic features were extracted using Pyradiomics, and various resampling techniques were employed to address class imbalance. Three machine learning classifiers (Logistic Regression, Support Vector Machine (SVM), and XGBoost) were trained and evaluated using standard performance metrics. Results: The SVM classifier outperformed the other classifiers. The highest F-score of 97.5% was achieved using the Grey Level Dependence Matrix and Grey Level Run Length Matrix feature combination with SMOTEENN resampling, which proved to be the most effective resampling technique, while the undersampling method yielded the lowest performance. Conclusions: This research demonstrates the potential of radiomic texture features, resampling techniques, and machine learning methods for classifying DXA images into healthy or degraded bone structures, which potentially leads to improved clinical diagnosis and treatment.

3D printing of different fibres towards HA/PCL scaffolding induces macrophage polarization and promotes osteogenic differentiation of BMSCs.

With the rise of bone tissue engineering (BET), 3D-printed HA/PCL scaffolds for bone defect repair have been extensively studied. However, little research has been conducted on the differences in osteogenic induction and regulation of macrophage (MPs) polarisation properties of HA/PCL scaffolds with different fibre orientations. Here, we applied 3D printing technology to prepare three sets of HA/PCL scaffolds with different fibre orientations (0-90, 0-90-135, and 0-90-45) to study the differences in physicochemical properties and to investigate the response effects of MPs and bone marrow mesenchymal stem cells (BMSCs) on scaffolds with different fibre orientations. The results showed that multi-angle staggered fibres affected the overall porosity and compressive strength of the scaffolds. Compared with the other two groups, the 0-90-45 scaffold induced osteogenic differentiation of BMSCs more significantly, while promoting the polarisation of MPs towards the M2 phenotype to form an osteogenic-friendly immune microenvironment. Unexpectedly, the 0-90-45 scaffold significantly upregulated the expression of angiogenic genes (PDGF, VEGF). Therefore, we conclude that the multi-angle interlaced fibres better mimic the physiological structure of cancellous bone, and that the excellent biomimetic properties reflect the best in vitro osteogenic, immunomodulatory and angiogenic effects. In conclusion, this study is a step forward in the exploration of BET scaffolds and provides a very promising bone filling material.

Nrf2 Activation as a Therapeutic Target for Flavonoids in Aging-Related Osteoporosis

Biological aging is a substantial change that leads to different diseases, including osteoporosis (OP), a condition involved in loss of bone density, deterioration of bone structure, and increased fracture risk. In old people, there is a natural decline in bone mineral density (BMD), exacerbated by hormonal changes, particularly during menopause, and it continues in the early postmenopausal years. During this transition time, hormonal alterations are linked to elevated oxidative stress (OS) and decreased antioxidant defenses, leading to a significant increase in OP. Aging is significantly associated with an abnormal ratio of oxidant/antioxidant and modified nuclear factor erythroid-derived two related factor2 (Nrf2)/Kelch-like ECH-associated protein 1 (Keap1) pathway. OS adversely affects bone health by promoting osteoclastic (bone resorbing) activity and impairing osteoblastic (bone-forming cells). Nrf2 is critical in controlling OS and various cellular processes. The expression of Nrf2 is linked to multiple age-related diseases, including OP, and Nrf2 deficiency leads to unbalanced bone formation/resorption and a consequent decline in bone mass. Various drugs are available for treating OP; however, long-term uses of these medicines are implicated in diverse illnesses such as cancer, cardiovascular, and stroke. At the same time, multiple categories of natural products, in particular flavonoids, were proposed as safe alternatives with antioxidant activity and substantial anti-osteoporotic effects.

Optimising surgical efficiency by designing lightweight skull-PSI assemblies and curved fixture plates for cranial reconstruction using FEA

Cranial reconstruction using implants is critical for protecting intracranial structures and restoring cerebral hemodynamics in cases of cranial defects caused by accidents, diseases or cancer. Patient-specific implants (PSIs) made from materials such as polyether-ether-ketone (PEEK), are required to be lightweight, high in strength and capable of mimicking the natural bone structure. Effective fastening mechanisms using the required number of fixture plates are essential for seamless integration between the PSI and the cavity of a defected skull for successful cranial reconstruction. This study explores the optimal number and shape of fixture plates required to join a Skull-PSI assembly, such that the overall weight of the PSI remains minimal, and to ensure that these assemblies do not fail when subjected to heavy external loads of 950 N. PEEK material was used for PSI, natural bone for the defected skull and Titanium Alloy (Ti-6Al-4 V) for the fixture plates. Conventional straight shaped fixture plates often require manual bending for correct fitment on the Skull-PSI curved surface, which increases a surgeon's time and effort. Curved shaped fixture plates were designed, to save on this time and effort and enhance the contact surface area with the Skull-PSI surface. Four, three and two numbered, straight and curved shaped fixture plates were investigated using Finite Element Analysis (FEA) techniques. Three numbered, curved shaped fixture plates were found to be optimal, to generate a 7-gram lightweight PSI that could successfully sustain external loads up-to 950 N without failure. Ultimately, these design improvements would benefit both patient and surgeon in aspects of surgery time and patient comfort.

PENERAPAN TERAPI PROGRESSIVE MUSCLE RELAXATION TERHADAP NYERI AKUT PRE OPERASI FRACTURE NECK FEMUR

Fractures or breaks in the continuity of bone structure are a major problem in the health sector. Tissue damage causes several typical clinical manifestations, namely pain. If not treated immediately, it can cause immobilization of the individual to carry out self-care activities. This study aims to determine the application of progressive muscle relaxation therapy to acute pain in preoperative patients with left femoral neck fractures in the Agung Wilis Accident Surgery Room, Blambangan Hospital. The research design used a case study of nursing care for femoral neck fracture patients with acute pain and carried out assessment, diagnosis, action planning, implementation and evaluation. Data collection methods through interviews and direct observation. The results of Mrs. N complained of pain from a femoral neck fracture, pain like being stabbed in the thigh area radiating to the pelvis on a scale of 7, the pain seemed to come and go. Interventions are given to reduce pain levels with progressive muscle relaxation. The evaluation revealed a change in the scale before therapy was given, namely a pain scale of 7 to 5. It can be concluded that the application of progressive muscle relaxation can be an alternative in treating pain in fracture sufferers.

Anatomic Variations Important for Dental Implantation in the Mandible—A Systematic Review

Background: This is a systematic review on the subject of anatomic landmarks and variations in the mandible that influence implantation placement. With this systematic review, we would like to summarize the results from different studies that are relevant to this subject and that are up to date, presenting their main findings, the measurements of mentioned landmarks, and giving clinical implications that will be helpful to practitioners in their better understanding of this topic. Methods: This study followed all of the elements of PRISMA. The criteria for inclusion and exclusion are described in detail. The following bibliographic databases were searched: PubMed (MEDLINE), The Cochrane Library, Wiley Online Library, EMBASE, and, additionally, Google Scholar. The search of articles was carried out using a combination of different keywords with a Boolean operator for each keyword. A total of 30 studies were included in this review and the risk of bias for each study was assessed. This review was registered with the PROSPERO ID number CRD42024609308. Results: The structure “SPIDER“ was used to present the findings in the summation table, followed by a detailed description of the quantitative findings and overall mean values of the most commonly used measured points. The morphometric measurements of anatomic details and variations in the mandible, such as the mandibular canal, mental foramen, lingual foramina, lingual canal, incisive canal, and mandibular concavity, are of high significance for clinicians dealing with implantation where gender, ethnicity, age groups, the side of the mandible, or remaining teeth can influence implantation planning. Conclusions: The distances of the named anatomic landmarks to the surrounding bone structures that are used as a guide during planning are of huge importance, so proper and detailed measurements must be executed by experienced professionals using CBCT. Knowledge of the position and variation in these landmarks may be used for any bone-guided augmentation, surgical transpositions of anatomic landmarks, and surgery intervention planning. The results of this study can aid in choosing appropriate measurement points and give the gross picture, for clinicians, in therapy planning, considering all the landmarks of significance in the mandible.

Multifunctional electrospinning periosteum: Development status and prospect.

In the repair of large bone defects, loss of the periosteum can result in diminished osteoinductive activity, nonunion, and incomplete regeneration of the bone structure, ultimately compromising the efficiency of bone regeneration. Therefore, the research and development of tissue-engineered periosteum which can replace the periosteum function has become the focus of current research. The functionalized electrospinning periosteum is expected to mimic the natural periosteum and enhance bone repair processes more effectively. This review explores the construction strategies for functionalized electrospun periosteum from the following perspectives: ⅰ) bioactive factor modification (bone morphogenetic protein-2 (BMP-2), vascular endothelial growth factor (VEGF) etc.), ⅱ) inorganic compound modification, ⅲ) drug modification, ⅳ) artificial periosteum in response to physical stimuli. Furthermore, the construction of artificial periosteum through electrospinning, in conjunction with other strategies, is also analyzed. Finally, the current challenges and prospects for the development of electrospinning periosteum are also discussed.

Investigating the Molecular Mechanisms of Jiangu Decoction in Treating Type 2 Diabetic Osteoporosis.

Type 2 diabetic osteoporosis (T2DOP) is a metabolic bone disease characterized by impaired bone structure and decreased bone strength in diabetic patients. Jiangu Decoction (JGD), a traditional Chinese poly-herbal formulation, has shown efficacy in mitigating osteoporosis (OP) and fractures caused by osteoporosis in diabetic patients in clinical trials. In addition, JGD has been proven to promote the proliferation of osteoblasts. However, the specific mechanisms underlying these effects remain unclear. This study aimed to elucidate the molecular mechanisms underlying the therapeutic effects of JGD in treating T2DOP. Liquid chromatography-mass spectrometry (LC-MS) was utilized to elucidate the chemical profile of JGD. A T2DOP mouse model (C57BL/6) was established by combining a high-fat diet with streptozotocin (STZ). Micro-computed tomography (micro-CT) imaging, three-point bending tests, and histological staining were utilized to assess alterations in bone mass, bone quality, and bone strength in mice. Mouse Calvaria 3T3-E1 (MC3T3-E1) cells were treated with 33 mmol/L D-glucose (HG), and the protective effect of JGD on the high glucose injury model was observed. Western blotting and qRT-PCR were employed to analyze alterations in biomarkers associated with the Keap1/Nrf2/HO-1 signaling pathway, both in vivo and in vitro. A total of 909 compounds were identified in JGD using LC-MS. Subsequently, the function of JGD was evaluated both in vitro and in vivo. The findings indicated that JGD promoted bone formation, enhanced bone microstructure, and ameliorated diabetic symptoms in T2DOP mice. Additionally, JGD increased alkaline phosphatase (ALP) activity, facilitated bone mineralization, and upregulated the expression levels of osteogenic marker genes such as runt-related transcription factor 2 (Runx2), osteocalcin (Ocn), and collagen type 1 alpha (Col1a1). Importantly, JGD reduced oxidative stress levels and decreased the accumulation of reactive oxygen species by modulating the Keap1/Nrf2/HO-1 axis both in vivo and in vitro. Our study suggests that JGD could alleviate T2DOP impairment, closely linked to the Keap1/Nrf2/HO-1 signaling pathway.

Methylglyoxal compromises callus mineralization and impairs fracture healing through suppression of osteoblast terminal differentiation.

Impaired fracture healing in diabetic patients leads to prolonged morbidity and increased healthcare costs. Methylglyoxal (MG), a reactive metabolite elevated in diabetes, is implicated in various complications, but its direct impact on bone healing remains unclear. Here, using a non-diabetic murine tibial fracture model, we demonstrate that MG directly impairs fracture healing. Micro-computed tomography revealed decreased volumetric bone mineral density in the callus, while callus volume remained unchanged, resulting in a brittle bone structure. This was accompanied by reduced expression of osteocalcin and bone sialoprotein, both critical for mineralization. Biomechanical analysis indicated that MG reduced the mechanical resilience of the fracture site without altering its elastic strength, suggesting that the impairment was not primarily due to the accumulation of advanced glycation end-products in the bone extracellular matrix. In vitro studies confirmed that non-cytotoxic concentrations of MG inhibited osteoblast maturation and mineralization. Transcriptomic analysis identified downregulation of Osterix, a key transcription factor for osteoblast maturation, without altering Runx2 levels, leading to decreased expression of key mineralization-related factors like osteocalcin. These findings align with clinical observations of reduced circulating osteocalcin levels in diabetic patients, suggesting that the detrimental effects of MG on osteoblasts may extend beyond bone metabolism. Our study highlights MG and MG-sensitive pathways as potential therapeutic targets for improving bone repair in individuals with diabetes and other conditions characterized by elevated MG levels.

Combination of Vascularized and Non-vascularized Fibula Free Flap With Dermofat Graft for Maxilla and Mandibula Reconstruction After Malignant Spindle Cell Tumor Resection.

The spindle cell tumor is a variant of sarcomatoid carcinoma that mostly affects the oral cavity. Bone involvement in this tumor leads to a wide excision, which sometimes requires resection of both the maxilla and mandible. The maxilla and mandible are important bones that function to form the 3-dimensional dimensions of the facial bones. The fibular bone can be selected to replace the facial bone because of its strong structure with a skin paddle, long pedicle, and proper bone shape. The authors present the case of a 24-year-old female who underwent maxillectomy and total hemimandibulectomy after a spindle cell tumor resection. The free fibular flap was harvested and divided into several segments to close the mandible and maxilla. However, the vascularized bone was insufficient; thus, non-vascularized bone was used in combination to reconstruct the maxilla. Six months after bone reconstruction, a dermofat graft was placed to fill the cheek structure. During the 6 months of follow-up, the vascularized and non-vascularized fibular bones were well arranged. Intraoral placement of a skin paddle covering the maxilla and mandible was viable. Both functional and esthetic outcomes were attained in patients with high satisfaction rates. Although there are many reconstruction options for patients with post-wide tumor excision, the fibula free flap remains the main choice as a replacement for facial bones because it has a strong and firm bone structure that can resemble facial bones; thus, a non-vascularized bone graft can be used in combination to cover the defects.

A retrospective comparative fractal and radiomorphometric analysis of the effect of bisphosphonate use pattern and duration on the mandible.

The aim of this study was to investigate the effect of two different bisphosphonate types on bone using dental panoramic radiographs (DPRs) and to compare these findings with a healthy cohort. Panoramic dental radiographs of bisphosphonate users (30) and healthy individuals (30) were retrospectively evaluated for the study. Regarding FA, standardized 50 × 50 pixel regions of interest (ROI) were identified for each patient. Moreover, the assessment encompassed Mandibular Cortical Width (MCW), Panoramic Mandibular Index (PMI), and Mandibular Cortical Index (MCI). A significance level of p < 0.05 was deemed to be statistically significant. The case group showed significantly higher MCW and PMI measurements than the control group (p < 0.001). Right and left MCI measurements differed depending on the type of drug used (p = 0.008 and p = 0.019, respectively). No discernible correlation was found between the time elapsed since the last dose and any measurement values (p > 0.05). This study showed that bisphosphonate type and duration of drug use have a significant effect on changes in cortical bone structure. The persistence of these effects, unaffected by the time since the previous dose, suggests that bisphosphonates have a long-lasting effect on bone.

The Treatment and Monitoring of Osteoporosis using Bone Turnover Markers.

Osteoporosis is a degenerative bone disease that causes the weakening of bone structure. Since bone structure is dynamic throughout a person's lifespan, bones are under constant growth and destruction in a process known as bone turnover or bone remodeling. Osteoporosis involves the disruption of this growth/destruction equilibrium towards the destructive side. An increase in bone turnover leads to a lower bone density and therefore a greater risk of fracture or injury of higher severity. Bone turnover markers serve as indicators of the process of bone turnover. These markers are split into two groups: formation (building up) markers and resorption (breaking down) markers. Using biochemical techniques and assays, these markers can be measured to monitor the activity of the markers as well as determine treatment options and efficacy based on this activity. The use of biomarkers in osteoporosis can pave the way for their use in other diseases such as cancer.

A Prospective Observational Cohort Study Comparing High-Complexity Against Conventional Pelvic Exenteration Surgery.

Background: Conventional pelvic exenteration (PE) comprises the removal of all or most central pelvic organs and is established in clinical practise. Previously, tumours involving bone or lateral sidewall structures were deemed inoperable due to associated morbidity, mortality, and poor oncological outcomes. Recently however high-complexity PE is increasingly described and is defined as encompassing conventional PE with the additional resection of bone or pelvic sidewall structures. This observational cohort study aimed to assess surgical outcomes, health-related quality of life (HrQoL), decision regret, and costs of high-complexity PE for more advanced tumours not treatable with conventional PE. Methods: High-complexity PE data were retrieved from a prospectively maintained quaternary database. The primary outcome was overall survival. Secondary outcomes were perioperative mortality, disease control, major morbidity, HrQoL, and health resource use. For cost-utility analysis, a no-PE group was extrapolated from the literature. Results: In total, 319 cases were included, with 64 conventional and 255 high-complexity PE, and the overall survival was equivalent, with medians of 10.5 and 9.8 years (p = 0.52), respectively. Local control (p = 0.30); 90-day mortality (0.0% vs. 1.2%, p = 1.00); R0-resection rate (87% vs. 83%, p = 0.08); 12-month HrQoL (p = 0.51); and decision regret (p = 0.90) were comparable. High-complexity PE significantly increased overall major morbidity (16% vs. 31%, p = 0.02); and perioperative costs (GBP 37,271 vs. GBP 45,733, p < 0.001). When modelled against no surgery, both groups appeared cost-effective with incremental cost-effectiveness ratios of GBP 2446 and GBP 5061. Conclusions: High-complexity PE is safe and feasible, offering comparable survival outcomes and HrQoL to conventional PE, but with greater morbidity and resource use. Despite this, it appears cost-effective when compared to no surgery and palliation.

Pemigatinib suppresses liver fibrosis and subsequent osteodystrophy in mice.

Liver fibrosis could lead to serious secondary diseases, including osteodystrophy. The interaction between liver and bone has not been fully elucidated, thus existing therapies for osteodystrophy secondary to liver fibrosis are often ineffective. FGF23 was initially found as an endocrine regulator of phosphate homeostasis, but recently, its involvement in fibrosis has been suggested. In this study, we hypothesized that the FGF23 level increases with liver injury, which in turn induces liver fibrosis and osteodystrophy. Liver fibrosis model mice were generated via carbon tetrachloride administration and bile duct ligation. Fibrosis was assessed using Masson trichrome staining and hydroxyproline assay. The bone structure was evaluated using dual-energy x-ray absorptiometry and microcomputed tomography. Human HSC lines LX-2 and primary rat HSCs were used for in vitro analyses. Carbon tetrachloride-induced and bile duct ligation-induced liver injury increased the serum FGF23 level compared with that in control mice. RNA sequencing analysis of FGF23-treated LX-2 showed that FGF23 promotes the production of matrisome, which helps in forming the extracellular matrix. The FGF receptor antagonist pemigatinib alleviated carbon tetrachloride-induced and bile duct ligation-induced liver fibrosis and the deleterious alterations in bone density and microstructure in mice. The serum FGF23 level increased with liver injury, and FGF23 promoted liver fibrosis. Moreover, pemigatinib alleviated liver fibrosis and hepatic osteodystrophy. These findings suggest that FGF23 mediates the communication between the liver and bone and that FGF23 may be a new therapeutic target for liver fibrosis and subsequent osteodystrophy.

Efficacy and Mechanism of Highly Active Umbilical Cord Mesenchymal Stem Cells in the Treatment of Osteoporosis in Rats.

A rat model of osteoporosis was induced with dexamethasone sodium phosphate. Highly active umbilical cord mesenchymal stem cells (HA-UCMSCs) and UCMSCs were isolated, cultured, identified, and infused intravenously once at a dose of 2.29 × 106 cells/kg. In the 4th week of treatment, bone mineral density (BMD) was evaluated via cross-micro-CT, tibial structure was observed via HE staining, osteogenic differentiation of bone marrow mesenchymal stem cells (BMMSCs) was examined via alizarin red staining, and carboxy-terminal cross-linked telopeptide (CTX), nuclear factor-κβ ligand (RANKL), procollagen type 1 N-terminal propeptide (PINP) and osteoprotegerin (OPG) levels were investigated via enzyme-linked immunosorbent assays (ELISAs). BMMSCs were treated with 10-6 mol/L dexamethasone and cocultured with HA-UCMSCs and UCMSCs in transwells. The osteogenic and adipogenic differentiation of BMMSCs was subsequently examined through directional induction culture. The protein expression levels of WNT, β-catenin, RUNX2, IFN-γ and IL-17 in the bone tissue were measured via Western blotting. The BMD in the healthy group was higher than that in the model group. Both UCMSCs and HA-UCMSCs exhibited a fusiform morphology; swirling growth; high expression of CD73, CD90 and CD105; and low expression of CD34 and CD45 and could differentiate into adipocytes, osteoblasts and chondrocytes, while HA-UCMSCs were smaller in size; had a higher nuclear percentage; and higher differentiation efficiency. Compared with those in the model group, the BMD increased, the bone structure improved, the trabecular area, number, and perimeter increased, the osteogenic differentiation of BMMSCs increased, RANKL expression decreased, and PINP expression increased after UCMSC and HA-UCMSC treatment for 4 weeks. Furthermore, the BMD, trabecular area, number and perimeter, calcareous nodule counts, and OPG/RANKL ratio were higher in the HA-UCMSC treatment group than in the UCMSC treatment group. The osteogenic and adipogenic differentiation of dexamethasone-treated BMMSCs was enhanced after the coculture of UCMSCs and HA-UCMSCs, and the HA-UCMSC group exhibited better effects than the UCMSC coculture group. The protein expression of WNT, β-catenin, and runx2 was upregulated, and IFN-γ and IL-17 expression was downregulated after UCMSC and HA-UCMSC treatment. HA-UCMSCs have a stronger therapeutic effect on osteoporosis compared with that of UCMSCs. These effects include an improved bone structure, increased BMD, an increased number and perimeter of trabeculae, and enhanced osteogenic differentiation of BMMSCs via activation of the WNT/β-catenin pathway and inhibition of inflammation.</p>.

Microcomputed tomographic analysis of the trabecular and cortical architecture of the proximal femur and hip bone of cats and small breed dogs.

This study aims to provide an initial database to gain more detailed knowledge of the trabecular and cortical bone structure of pelvic and femur bones in cats and smaller dogs. Additionally, the bony microarchitecture between cats and smaller dogs was compared to identify possible differences between those species. These findings could potentially improve the development of non-cemented total hip replacement (THR). To determine the bony microarchitecture, a total of 48 pelvises and thus 96 acetabuli and femora of smaller dogs (n=21) and cats (n=27) were analysed using microcomputed tomography. The parameters bone volume (BV/TV), bone surface (BS/BV), trabecular thickness (Tb.Th), number of trabeculae (Tb.N), trabecular spacing (Tb.Sp), degree of anisotropy (DA), connectivity density (Conn. D) and mean bone density were measured and compared between the species. In addition, the femoral angle of antetorsion was determined on both sides of the body. Overall, cats had fewer but thicker trabeculae than the small dogs in the analysed areas of the pelvis and femur. This resulted in a greater trabecular distance in cats than in small dogs. Together with a higher cortical bone density at the femoral shaft in cats, it could be determined that cats have a more stable bone architecture in the measured areas than smaller dogs. The angle of antetorsion did not differ significantly between the cats and the dogs examined.

Septal extensor 2024 with costal cartilage: total fusion of architecture and engineering in primary rhinoplasty. An advanced surgical technique of the nasal tip

Adjusting the lower third of the nose can be considered the most complicated part of nose surgery. The caudal septal edge is usually located behind the nasal spine without direct contact; Additionally, thick skin contributes to limited definition of the nose, especially at the nasal tip. Repairing these problems and their consequences represents a genuine challenge for the cosmetic surgery surgeon, especially considering the importance of correcting imperfections in the bone and cartilaginous structure of the nose, including alterations in the nasal cartilages themselves, such as the partial or complete lack of the same, which may be the result of a process of absorption or necrosis of the tissues. The purpose of this document is to explain the implants used in the nasal tip during a primary rhinoplasty as part of aesthetic surgery of the nose, with the purpose of supporting an innovative technique called Septal Extender 2024. A novel surgical technique is presented and also carried out a retrospective descriptive analysis by reviewing medical records, surgical procedures for primary nasal tip rhinoplasty with septal extender.

Evaluation of the C-reactive protein serum levels in periodontitis patients with or without atherosclerosis – A clinical study

Background: Periodontitis is a bacterial infection that can originate in the gums and progress to damage the bone and other structures supporting the teeth. One indicator of systemic inflammation caused by various triggers such as injuries, infections, and hypoxia is the highly potent C-reactive protein (CRP). Atherosclerosis is a progressive arterial disease that is characterized by the thickening of subintimal layers in muscular and elastic arteries of intermediate-to-large size due to the accumulation of athermanous plaque. Therefore, our objective in this research is to evaluate CRP levels in individuals with periodontitis, with or without atherosclerosis, after diagnosis. It is important to determine if there is a correlation between periodontitis, a common inflammatory condition of the gums, and elevated CRP levels, which could potentially contribute to the development of atherosclerosis. Methodology: The Department of Periodontics and Implantology at Bhabha College of Dental Sciences conducted the study, which involved the random assignment of 60 participants of both sexes, aged between 30 and 60 years, using a cross-sectional design. The participants were selected from the Department of Periodontics and Implantology, and venous blood samples were taken before and after nonsurgical periodontal treatment to evaluate serum CRP and complete blood count levels. Results: Higher blood CRP levels were seen in individuals with chronic periodontitis, regardless of the presence or absence of atherosclerosis. When comparing the groups of people with and without atherosclerosis and chronic periodontitis, the rise in blood CRP levels was almost double in the group with atherosclerosis. To prevent the progression of atherosclerotic lesions, chronic periodontitis must be treated aggressively. Conclusion: Chronic periodontitis, with or without atherosclerosis, leads to high CRP levels in the blood. Those with both conditions have almost twice the CRP levels compared to those without atherosclerosis. Proper treatment is necessary due to chronic periodontitis’ association with atherosclerotic lesions.