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1.
Artículo en Inglés | MEDLINE | ID: mdl-32037368

RESUMEN

The human body is comprised of hundreds of bones, which are constantly regenerated through the interactions of two cell types: osteoblasts and osteoclasts. Given the difficulty of analyzing their intravital dynamics, we have developed a system for intravital imaging of the bone marrow cavity using two-photon microscopy, to visualize the dynamic behaviors of living bone cells without sectioning. Combined with the newly developed chemical fluorescent probes to detect localized acidification caused by osteoclasts, we identified two distinct functional states of mature osteoclasts, i.e., "bone-resorptive" and "non-resorptive". Here, we focus on the dynamics and functions of bone cells within the bone marrow cavity and discuss how this novel approach has been applied to evaluate the mechanisms of action of drugs currently in clinical use. We further introduce our recent study that identified arthritis-associated osteoclastogenic macrophages in inflamed synovium and revealed their differentiation trajectory into the pathological osteoclasts, which together represent to a new paradigm in bone research.


Asunto(s)
Médula Ósea/diagnóstico por imagen , Resorción Ósea/diagnóstico por imagen , Osteoclastos/metabolismo , Animales , Artritis/metabolismo , Médula Ósea/metabolismo , Resorción Ósea/metabolismo , Diferenciación Celular , Colorantes Fluorescentes/química , Homeostasis , Humanos , Macrófagos/metabolismo , Microscopía de Fluorescencia por Excitación Multifotónica/métodos , Imagen Óptica/métodos
2.
PLoS One ; 15(1): e0228009, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31999739

RESUMEN

OBJECTIVE: One of the common complications occurring after cranioplasty (CP) is aseptic bone-flap resorption (ABFR). Reoperation necessary because of the development of ABFR can lead to unfavorable complications during subsequent surgery using a synthetic skull implant, and also necessarily leads to higher costs. The aim of this study is to identify prognostic factors that may help to predict the development of ABFR. METHODS: In this study, 303 CP surgeries performed between 2002 and 2017 were examined retrospectively to identify factors predicting the occurrence of ABFR. A number of these factors (e.g., time lapse between decompressive craniectomy (DC) and CP, bone-flap size, specific laboratory signs, and the reason for the original DC) were analyzed as possibly influencing the risk of developing ABFR. RESULTS: ABFR of an autologous bone flap that subsequently required a CP with synthetic skull implants occurred in 10 of 303 patients (3.0%). CP timing and patients' Karnofsky Performance Scores (KPS) (p = 0.008; p = 0.012) were identified as significant factors with an impact on the development of ABRF. Age did not reveal a significant value, but statistical analysis shows a clear trend. The younger the age, the more likely it was that an ABFR would develop. CONCLUSION: The risk of ABFR lessens the longer the period of time elapsed between DC and CP. Age does not reveal a significant value, but statistical analysis shows that there is a clear trend.


Asunto(s)
Resorción Ósea/epidemiología , Resorción Ósea/etiología , Colgajos Quirúrgicos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Resorción Ósea/diagnóstico por imagen , Niño , Preescolar , Descompresión Quirúrgica , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Factores de Riesgo , Tomografía Computarizada por Rayos X , Adulto Joven
3.
Acta Orthop ; 91(1): 115-120, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31762353

RESUMEN

Background and purpose - Insufficient initial fixation or early micromotion of an implant is associated with a thin layer of fibrous tissue at the peri-implant interface. It is unknown if bone loss is induced by the fibrous tissue interface acting as an active biological membrane, or as a membrane that will produce supraphysiologic fluid flow conditions during gait, which activates the mechanosensitive osteocytes to mediate osteoclast differentiation. We investigated whether mechanically induced osteolysis is dependent on the fibrous tissue interface as a biologically active scaffold, or if it merely acts as a conduit for fluid flow, affecting the mechanosensitive osteocytes in the peri-prosthetic bone.Methods - Using a rat model of mechanically instability-induced aseptic loosening, we assessed whether the induction of osteoclast differentiation was dependent on the presence of a peri-implant fibrous interface. We analyzed the amount of osteoclast differentiation, osteocyte apoptosis, pro-resorptive cytokine expression and bone loss using immunohistochemistry, mRNA expression and micro-CT.Results - Osteoclast differentiation and bone loss were induced by mechanical instability but were not affected by the presence of the fibrous tissue membrane or associated with osteocyte apoptosis. There was no increased mRNA expression of any of the cytokines in the fibrous tissue membrane compared with the peri-implant bone.Interpretation - Our data show that the fibrous tissue membrane in the interface plays a minor role in inducing bone loss. This indicates that the peri-implant bone adjacent to loose bone implants might play an important role for osteoclast differentiation.


Asunto(s)
Apoptosis , Diferenciación Celular , Citocinas/metabolismo , Inestabilidad de la Articulación/metabolismo , Osteoclastos/metabolismo , Osteocitos/metabolismo , Falla de Prótesis , Tibia/metabolismo , Animales , Resorción Ósea/diagnóstico por imagen , Resorción Ósea/genética , Resorción Ósea/metabolismo , Interfase Hueso-Implante/diagnóstico por imagen , Citocinas/genética , Modelos Animales de Enfermedad , Inmunohistoquímica , Inestabilidad de la Articulación/diagnóstico por imagen , Inestabilidad de la Articulación/genética , Osteoclastos/citología , Osteocitos/citología , ARN Mensajero/metabolismo , Ratas , Tibia/diagnóstico por imagen , Microtomografía por Rayos X
4.
Dentomaxillofac Radiol ; 49(1): 20190253, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31559846

RESUMEN

Uremic leontiasis ossea (ULO), which occurs in the craniomaxillofacial region, is a sign of terminal stage osteitis fibrosa cystica or brown tumors and primarily caused by secondary hyperparathyroidism induced by renal failure. Pathophysiological changes include osteoclasts or osteoblasts proliferation, bone resorption, bone decalcification, and connective tissue proliferation. In this paper, we report a case of a 24-year-old female patient, who was diagnosed with ULO and presented with multiple facial swellings. Imaging features included zonal patterns with alternating rings of hypo- and hyperattenuated craniomaxillofacial bones, and diffused mixed sclerotic tissues with lytic changes in CT imaging. T1 weighted image and T2 weighted image in MRI were characterized by alternating rings of low and intermediate signal intensity patterns. To the best of our knowledge, this case is the first example of pathologically proved ULO with maxillofacial MRI.


Asunto(s)
Hiperostosis Frontal Interna , Imagen por Resonancia Magnética , Adulto , Resorción Ósea/diagnóstico por imagen , Femenino , Humanos , Hiperostosis Frontal Interna/diagnóstico por imagen , Hiperostosis Frontal Interna/etiología , Hiperparatiroidismo Secundario/complicaciones , Adulto Joven
5.
Orthop Clin North Am ; 51(1): 87-95, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31739883

RESUMEN

Proximal humeral bone loss in revision shoulder arthroplasty poses a significant obstacle to achieving stable and reliable fixation of the humeral stem. It is important to identify and classify this bone loss preoperatively, which can range from epiphyseal to substantial diaphyseal bone loss. There are several reconstructive options that can address the varying levels of bone loss, including cemented long-stem fixation, a composite construct using proximal humeral allograft or femoral allograft, proximal humeral endoprosthetic replacement, or total humeral replacement. All of these are viable reconstructive options that have demonstrated adequate to good outcomes.


Asunto(s)
Artroplastía de Reemplazo de Hombro/efectos adversos , Artroplastia de Reemplazo/efectos adversos , Húmero/patología , Aloinjertos/trasplante , Artroplastia de Reemplazo/métodos , Cementos para Huesos , Resorción Ósea/clasificación , Resorción Ósea/diagnóstico por imagen , Resorción Ósea/patología , Epífisis/patología , Epífisis/cirugía , Humanos , Húmero/diagnóstico por imagen , Húmero/cirugía , Prótesis Articulares , Complicaciones Posoperatorias/cirugía , Periodo Preoperatorio , Prótesis e Implantes , Radiografía , Rango del Movimiento Articular/fisiología , Resultado del Tratamiento
6.
Int J Mol Sci ; 20(23)2019 Nov 30.
Artículo en Inglés | MEDLINE | ID: mdl-31801223

RESUMEN

Matrix metalloproteinase (MMP)-2 and MMP-9 are well-known gelatinases that disrupt the extracellular matrix, including gelatin. However, the advantages of modulating MMP expression in gelatin-based materials for applications in bone regenerative medicine have not been fully clarified. In this study, we examined the effects of epigallocatechin gallate (EGCG), a major polyphenol catechin isolated from green tea, on MMP expression in gelatin sponges and its association with bone formation. Four gelatin sponges with or without EGCG were prepared and implanted into bone defects for up to 4 weeks. Histological and immunohistological staining were performed. Micro-computed tomography was used to estimate the bone-forming capacity of each sponge. Our results showed that EGCG integration attenuated MMP-2 (70.6%) and -9 expression (69.1%) in the 1 week group, increased residual gelatin (118.7%), and augmented bone formation (101.8%) in the 4 weeks group in critical-sized bone defects of rat calvaria compared with vacuum-heated gelatin sponges without EGCG. Moreover, vacuum-heated gelatin sponges with EGCG showed superior bone formation compared with other sponges. The results indicated that integration of EGCG in gelatin-based materials modulated the production and activity of MMP-2 and -9 in vivo, thereby enhancing bone-forming capacity.


Asunto(s)
Materiales Biocompatibles/síntesis química , Regeneración Ósea/efectos de los fármacos , Resorción Ósea/prevención & control , Catequina/análogos & derivados , Gelatina/química , Inhibidores de la Metaloproteinasa de la Matriz/farmacología , Ingeniería de Tejidos/métodos , Implantes Absorbibles , Aldehídos/antagonistas & inhibidores , Aldehídos/metabolismo , Animales , Resorción Ósea/diagnóstico por imagen , Catequina/farmacología , Línea Celular , Proliferación Celular/efectos de los fármacos , Masculino , Metaloproteinasa 2 de la Matriz/metabolismo , Metaloproteinasa 9 de la Matriz/metabolismo , Osteoblastos/citología , Osteoblastos/efectos de los fármacos , Osteoblastos/fisiología , Ratas , Ratas Sprague-Dawley , Cráneo/diagnóstico por imagen , Cráneo/efectos de los fármacos , Cráneo/lesiones , Cráneo/fisiología , Andamios del Tejido , Microtomografía por Rayos X
7.
Yonsei Med J ; 60(11): 1067-1073, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31637889

RESUMEN

PURPOSE: Bone flap resorption (BFR) after cranioplasty with an autologous bone flap (ABF) is well known. However, the prevalences and degrees of BFR remain unclear. This study aimed to evaluate changes in ABFs following cranioplasty and to investigate factors related with BFR. MATERIALS AND METHODS: We retrospectively reviewed 97 patients who underwent cranioplasty with frozen ABF between January 2007 and December 2016. Brain CT images of these patients were reconstructed to form three-dimensional (3D) images, and 3D images of ABF were separated using medical image editing software. ABF volumes on images were measured using 3D image editing software and were compared between images in the immediate postoperative period and at postoperative 12 months. Risk factors related with BFR were also analyzed. RESULTS: The volumes of bone flaps calculated from CT images immediately after cranioplasty ranged from 55.3 cm³ to 175 cm³. Remnant bone flap volumes at postoperative 12 months ranged from 14.2% to 102.5% of the original volume. Seventy-five patients (77.3%) had a BFR rate exceeding 10% at 12 months after cranioplasty, and 26 patients (26.8%) presented severe BFR over 40%. Ten patients (10.3%) underwent repeated cranioplasty due to severe BFR. The use of a 5-mm burr for central tack-up sutures was significantly associated with BFR (p<0.001). CONCLUSION: Most ABFs after cranioplasty are absorbed. Thus, when using frozen ABF, patients should be adequately informed. To prevent BFR, making holes must be kept to a minimum during ABF grafting.


Asunto(s)
Trasplante Óseo , Craneotomía , Congelación , Imagenología Tridimensional , Colgajos Quirúrgicos , Adolescente , Adulto , Resorción Ósea/diagnóstico por imagen , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pacientes , Estudios Retrospectivos , Cráneo/diagnóstico por imagen , Cráneo/cirugía , Programas Informáticos , Cirujanos , Trasplante Autólogo , Adulto Joven
8.
Int J Mol Sci ; 20(20)2019 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-31618828

RESUMEN

Exercise therapy inhibits joint destruction by suppressing pro-inflammatory cytokines. The efficacy of pharmacotherapy for rheumatoid arthritis differs depending on the phase of the disease, but that of exercise therapy for each phase is unknown. We assessed the differences in the efficacy of treadmill running on rheumatoid arthritis at various phases, using rat rheumatoid arthritis models. Rats with collagen-induced arthritis were used as rheumatoid arthritis models, and the phase after immunization was divided as pre-arthritis and established phases. Histologically, the groups with forced treadmill running in the established phase had significantly inhibited joint destruction compared with the other groups. The group with forced treadmill running in only the established phase had significantly better bone morphometry and reduced expression of connexin 43 and tumor necrosis factor α in the synovial membranes compared with the no treadmill group. Furthermore, few cells were positive for cathepsin K immunostaining in the groups with forced treadmill running in the established phase. Our results suggest that the efficacy of exercise therapy may differ depending on rheumatoid arthritis disease activity. Active exercise during phases of decreased disease activity may effectively inhibit arthritis and joint destruction.


Asunto(s)
Artritis Reumatoide/etiología , Artritis Reumatoide/patología , Cartílago Articular/patología , Condicionamiento Físico Animal , Animales , Artritis Experimental , Artritis Reumatoide/diagnóstico por imagen , Artritis Reumatoide/metabolismo , Biomarcadores , Peso Corporal , Resorción Ósea/diagnóstico por imagen , Resorción Ósea/metabolismo , Cartílago Articular/diagnóstico por imagen , Cartílago Articular/metabolismo , Conexina 43/metabolismo , Citocinas/metabolismo , Modelos Animales de Enfermedad , Mediadores de Inflamación/metabolismo , Ratas , Membrana Sinovial/metabolismo , Membrana Sinovial/patología , Factor de Necrosis Tumoral alfa/metabolismo
9.
Am J Orthod Dentofacial Orthop ; 156(4): 531-544, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31582125

RESUMEN

Progressive condylar resorption, also known as idiopathic condylar resorption, is an uncommon, aggressive, degenerative disease of the temporomandibular joint (TMJ) seen mostly in adolescent girls and young women. This condition leads to loss of condylar bone mass, decrease of mandibular ramal height, steep mandibular and occlusal plane angles, and an anterior open bite. In 3 case reports, we review the pathogenesis of TMJ degenerative disease and the clinical management of TMJ arthrosis. We emphasize that TMJ arthritic disease should be discussed in dental circles as a pathologic entity in the same way that orthodontists discuss arthritic disease in orthopedic circles. Regarding the degenerative pathology of the TMJ, treatment goals include restored function and pain reduction. The treatment methods used to achieve these goals can range from noninvasive therapy to minimally invasive and invasive surgery. Most patients can be treated noninvasively, and the importance of disease prevention and conservative management in the overall treatment of TMJ disease must be acknowledged. The decision to manage TMJ osteoarthrosis surgically must be based on evaluation of the patient's response to noninvasive treatments, mandibular form and function, and effect of the condition on his or her quality of life.


Asunto(s)
Resorción Ósea/diagnóstico por imagen , Resorción Ósea/cirugía , Ortodoncia Correctiva/métodos , Procedimientos Quirúrgicos Ortognáticos/métodos , Osteoartritis/diagnóstico por imagen , Osteoartritis/cirugía , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/terapia , Adulto , Resorción Ósea/patología , Niño , Terapia Combinada , Progresión de la Enfermedad , Femenino , Humanos , Cóndilo Mandibular/patología , Cóndilo Mandibular/cirugía , Osteoartritis/patología , Calidad de Vida , Trastornos de la Articulación Temporomandibular/patología , Resultado del Tratamiento
10.
Am J Orthod Dentofacial Orthop ; 156(4): 555-565, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31582127

RESUMEN

A common dilemma when treating anterior open bite is understanding its etiology. Idiopathic condylar resorption (ICR) can cause open bite in affected individuals. Although it is prudent to not treat patients with ICR until active resorption has ceased, orthodontists may begin treating them because anterior open bite from ICR may not appear before or during their orthodontic treatment. This article reports a 12-year-old female who was diagnosed with ICR 10 months after completion of her orthodontic treatment for a Class II Division 1 malocclusion. When a young patient with a high mandibular angle and previous skeletal or dental Class II malocclusion returns with an open bite during the retention phase, the patient's condyles must be carefully examined to determine whether any temporomandibular joint disorder, such as ICR, is present. Currently, the controversy over the cause and the cure for ICR is continuing to challenge orthodontists in diagnoses and treatments. Orthodontists should closely monitor and offer informed treatment options to patients with risk factors for ICR or signs of its pathology that might develop at any stage of orthodontic treatment, including the retention period.


Asunto(s)
Resorción Ósea/complicaciones , Resorción Ósea/terapia , Maloclusión de Angle Clase II/terapia , Cóndilo Mandibular/patología , Enfermedades Mandibulares/patología , Enfermedades Mandibulares/terapia , Mordida Abierta/etiología , Mordida Abierta/terapia , Ortodoncia Correctiva/métodos , Trastornos de la Articulación Temporomandibular/terapia , Resorción Ósea/diagnóstico por imagen , Cefalometría , Niño , Terapia Combinada , Estética Dental , Femenino , Humanos , Maloclusión de Angle Clase II/diagnóstico por imagen , Enfermedades Mandibulares/diagnóstico por imagen , Mordida Abierta/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Resultado del Tratamiento
11.
Int J Mol Sci ; 20(17)2019 Aug 30.
Artículo en Inglés | MEDLINE | ID: mdl-31480285

RESUMEN

Compared to other materials such as 45S5 bioactive glass (BG), ß-tricalcium phosphate (ß-TCP)-based bone substitutes such as Vitoss show limited material-driven stimulation of osteogenesis and/or angiogenesis. The unfavorable degradation kinetics of ß-TCP-based bone substitutes may result in an imbalance between resorption and osseous regeneration. Composite materials like Vitoss BA (Vitoss supplemented with 20 wt % 45S5-BG particles) might help to overcome these limitations. However, the influence of BG particles in Vitoss BA compared to unsupplemented Vitoss on osteogenesis, resorption behavior, and angiogenesis is not yet described. In this study, Vitoss and Vitoss BA scaffolds were seeded with human mesenchymal stromal cells before subcutaneous implantation in immunodeficient mice for 10 weeks. Scaffold resorption was monitored by micro-computed tomography, while osteoid formation and vascularization were assessed by histomorphometry and gene expression analysis. Whilst slightly more osteoid and improved angiogenesis were found in Vitoss BA, maturation of the osteoid was more advanced in Vitoss scaffolds. The volume of Vitoss implants decreased significantly, combined with a significantly increased presence of resorbing cells, whilst the volume remained stable in Vitoss BA scaffolds. Future studies should evaluate the interaction of 45S5-BG with resorbing cells and bone precursor cells in greater detail to improve the understanding and application of ß-TCP/45S5-BG composite bone substitute materials.


Asunto(s)
Resorción Ósea/tratamiento farmacológico , Sustitutos de Huesos/uso terapéutico , Fosfatos de Calcio/uso terapéutico , Cerámica/uso terapéutico , Silicatos/uso terapéutico , Adulto , Animales , Resorción Ósea/diagnóstico por imagen , Diferenciación Celular/efectos de los fármacos , Cerámica/farmacología , Femenino , Vidrio , Humanos , Cinética , Masculino , Ratones SCID , Persona de Mediana Edad , Neovascularización Fisiológica/efectos de los fármacos , Osteogénesis/efectos de los fármacos , Andamios del Tejido/química , Microtomografía por Rayos X , Adulto Joven
12.
J Craniofac Surg ; 30(7): 2211-2213, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31369506

RESUMEN

In this report, the authors introduce a rare complication after reduction malarplasty in 2 patients. One patient underwent temporal rhytidectomy and malar osteotomy. The other patient underwent zygoma grinding without osteotomy. Both patients presented malar depression and cheek ptosis after surgery and visited the clinic. Physical examination, cephalometric radiographs, and facial 3-dimensional computed tomography were conducted, which indicated total zygomatic arch bone resorption. After examining the possible causes of the complication, the authors concluded that preserving enough blood supply and performing adequate rigid fixation of the separated zygoma bone are key prevention for bone resorption. This is the first report of total zygomatic arch bone resorption after reduction malarplasty.


Asunto(s)
Resorción Ósea/diagnóstico por imagen , Procedimientos Quirúrgicos Reconstructivos/efectos adversos , Cigoma/diagnóstico por imagen , Adulto , Blefaroptosis/diagnóstico por imagen , Blefaroptosis/etiología , Resorción Ósea/etiología , Craneotomía/efectos adversos , Cara/cirugía , Huesos Faciales/cirugía , Femenino , Humanos , Osteotomía , Examen Físico , Radiografía , Ritidoplastia , Tomografía Computarizada por Rayos X/métodos
13.
J Shoulder Elbow Surg ; 28(11): 2128-2138, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31272889

RESUMEN

BACKGROUND: The incidence of medial calcar resorption has been shown to be common after uncemented total shoulder arthroplasty (TSA). With etiologies including stress shielding, debris-induced osteolysis, and infection, the clinical impact of medial calcar resorption has not been specifically examined. The purpose of this study was to determine whether resorption is associated with inferior outcomes or higher rates of radiographic loosening in TSA patients. METHODS: We conducted a retrospective review of TSA patients with minimum 2-year clinical follow-up. Patient-reported and functional outcome measures were recorded preoperatively and postoperatively. Postoperative radiographs were evaluated for glenoid and humeral component loosening. A new calcar resorption grading system was introduced to quantify the degree of resorption and assess the progression. RESULTS: A total of 171 patients met the inclusion criteria, with average clinical and radiographic follow-up periods of 50 and 46 months, respectively. Calcar resorption was identified in 110 patients (64.3%). No significant overall differences were observed between the patients with and without calcar resorption. Subgroup analysis showed that patients with grade 3 resorption had a higher incidence of glenoid radiolucencies (50%, P = .001) and patients with a progression from grade 1 to grade 3 had higher incidences of glenoid (50%, P = .003) and humeral (9%, P = .039) radiolucencies. CONCLUSION: Medial calcar resorption following TSA with a standard-length press-fit humeral component is common. Overall, no differences in patient-reported outcome measures or radiographic loosening were found compared with patients without calcar resorption. However, grade 3 calcar resorption and more dramatic progression of resorption should raise the suspicion of prosthetic loosening.


Asunto(s)
Artroplastía de Reemplazo de Hombro/efectos adversos , Resorción Ósea/complicaciones , Resorción Ósea/diagnóstico por imagen , Húmero/diagnóstico por imagen , Falla de Prótesis/etiología , Anciano , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Medición de Resultados Informados por el Paciente , Radiografía , Estudios Retrospectivos , Escápula/diagnóstico por imagen , Índice de Severidad de la Enfermedad , Articulación del Hombro/diagnóstico por imagen , Articulación del Hombro/fisiopatología , Articulación del Hombro/cirugía , Prótesis de Hombro
14.
Am J Orthod Dentofacial Orthop ; 156(1): 125-136, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31256825

RESUMEN

This case report describes the successful treatment of a 14-year-old girl with severe bilateral idiopathic condylar resorption and resultant mandibular retrusion, increased overjet, and anterior open bite. The nonextraction treatment plan included (1) aligning and leveling the teeth in both arches, (2) performing Le Fort I maxillary osteotomy, bilateral condylectomy, and mandibular joint replacement, and (3) postsurgical correction of the malocclusion. The orthodontic treatment was initiated with the use of custom lingual appliances followed by orthognathic surgery planned with virtual surgical planning. Patient-fitted and customized temporomandibular joint implants were designed and manufactured based on the patient's stereolithic bone anatomic model. Treatment was concluded with detailed orthodontic finishing. Optimum esthetic and functional results were achieved with the cooperation of 2 specialties and the use of state-of-the-art technology.


Asunto(s)
Tirantes , Prótesis Articulares , Cóndilo Mandibular/cirugía , Mordida Abierta/cirugía , Mordida Abierta/terapia , Ortodoncia Correctiva/métodos , Procedimientos Quirúrgicos Ortognáticos/métodos , Trastornos de la Articulación Temporomandibular/terapia , Adolescente , Puntos Anatómicos de Referencia , Resorción Ósea/complicaciones , Resorción Ósea/diagnóstico por imagen , Resorción Ósea/cirugía , Resorción Ósea/terapia , Cefalometría , Estética Dental , Femenino , Humanos , Imagenología Tridimensional , Mandíbula/cirugía , Cóndilo Mandibular/diagnóstico por imagen , Maxilar/cirugía , Mordida Abierta/diagnóstico por imagen , Aparatos Ortodóncicos , Aparatos Ortodóncicos Fijos , Ortodoncia Correctiva/instrumentación , Osteotomía , Planificación de Atención al Paciente , Radiografía Panorámica , Articulación Temporomandibular/diagnóstico por imagen , Articulación Temporomandibular/cirugía , Trastornos de la Articulación Temporomandibular/complicaciones , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/cirugía , Resultado del Tratamiento
15.
Am J Orthod Dentofacial Orthop ; 156(1): 75-86, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31256844

RESUMEN

INTRODUCTION: Maintaining tooth anchorage during orthodontic treatment has challenged orthodontists and threatening the success of some orthodontic therapy. The objective of this study was to evaluate the effect of local administration of simvastatin on orthodontic tooth movement. METHODS: Nickel-titanium coil springs were used to induce orthodontic tooth movement in 10 white New Zealand rabbits for 21 days. A split-mouth design was implemented where one mandibular quadrant received local administration of simvastatin and the corresponding mandibular quadrant received control vehicle solution on a weekly basis. Magnitudes of tooth movement were measured on 3-dimensional models of the experimental teeth. Animals were killed at the end of the experimental period to allow histomorphometric analysis of alveolar bone modeling. RESULTS: The total magnitude of tooth movement in the quadrant receiving simvastatin was significantly less than that in the quadrant receiving control vehicle solution. Local administration of simvastatin resulted in a significant percentage of inhibition of tooth movement of 39.8 ± 22.6%. Histomorphometric analysis revealed a significant reduction in the numbers of osteoclasts and areas of active bone-resorptive lacunae hindering bone resorption processes in the quadrant receiving simvastatin. CONCLUSIONS: Local administration of simvastatin can reduce the rate and magnitude of orthodontic tooth movement. Moreover, local administration of simvastatin diminishes bone resorption processes associated with orthodontic tooth movement reducing the number of osteoclasts and the subsequent area of active bone resorption.


Asunto(s)
Resorción Ósea/patología , Osteoclastos/efectos de los fármacos , Simvastatina/administración & dosificación , Simvastatina/antagonistas & inhibidores , Técnicas de Movimiento Dental/métodos , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/patología , Animales , Remodelación Ósea/efectos de los fármacos , Resorción Ósea/diagnóstico por imagen , Masculino , Mandíbula/irrigación sanguínea , Mandíbula/efectos de los fármacos , Mandíbula/patología , Modelos Animales , Níquel/química , Aparatos Ortodóncicos , Alambres para Ortodoncia , Osteoclastos/patología , Conejos , Titanio/química , Técnicas de Movimiento Dental/instrumentación
16.
EBioMedicine ; 44: 452-466, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31151929

RESUMEN

BACKGROUND: Cancer-associated bone disease is a serious complication in bone sarcomas and metastatic carcinomas of breast and prostate origin. Monoacylglycerol lipase (MAGL) is an enzyme of the endocannabinoid system, and is responsible for the degradation of the most abundant endocannabinoid in bone, 2-arachidonoyl glycerol (2AG). METHODS: The effects of the verified MAGL inhibitor on bone remodelling were assessed in healthy mice and in mouse models of bone disease caused by prostate and breast cancers and osteosarcoma. FINDINGS: JZL184 reduced osteolytic bone metastasis in mouse models of breast and prostate cancers, and inhibited skeletal tumour growth, metastasis and the formation of ectopic bone in models of osteosarcoma. Additionally, JZL184 suppressed cachexia and prolonged survival in mice injected with metastatic osteosarcoma and osteotropic cancer cells. Functional and histological analysis revealed that the osteoprotective action of JZL184 in cancer models is predominately due to inhibition of tumour growth and metastasis. In the absence of cancer, however, exposure to JZL184 exerts a paradoxical reduction of bone volume via an effect that is mediated by both Cnr1 and Cnr2 cannabinoid receptors. INTERPRETATION: MAGL inhibitors such as JZL184, or its novel analogues, may be of value in the treatment of bone disease caused by primary bone cancer and bone metastasis, however, activation of the skeletal endocannabinoid system may limit their usefulness as osteoprotective agents.


Asunto(s)
Benzodioxoles/farmacología , Remodelación Ósea/efectos de los fármacos , Huesos/efectos de los fármacos , Huesos/metabolismo , Inhibidores Enzimáticos/farmacología , Monoacilglicerol Lipasas/antagonistas & inhibidores , Piperidinas/farmacología , Animales , Neoplasias Óseas/diagnóstico , Neoplasias Óseas/tratamiento farmacológico , Neoplasias Óseas/metabolismo , Neoplasias Óseas/secundario , Resorción Ósea/diagnóstico por imagen , Resorción Ósea/tratamiento farmacológico , Resorción Ósea/metabolismo , Resorción Ósea/patología , Huesos/diagnóstico por imagen , Huesos/patología , Comunicación Celular/efectos de los fármacos , Modelos Animales de Enfermedad , Femenino , Xenoinjertos , Humanos , Ratones , Osteoclastos/efectos de los fármacos , Osteoclastos/metabolismo , Osteólisis/tratamiento farmacológico , Osteólisis/etiología , Osteólisis/metabolismo , Osteólisis/patología , Receptores de Cannabinoides/metabolismo
17.
Biomed Pharmacother ; 116: 109017, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31158803

RESUMEN

BACKGROUNDS: Osteoporosis prevailing in elderly involves a marked increase in bone resorption showing an initial fall in bone mineral density leading to a significant reduction in bone formation. AIM: The present study aimed to investigate the effect of Heamatococcus pluvialis microalgae on osteoporosis in D-galactose-treated rats. The underlying mechanism was tracked targeting the osteoprotegerin (OPG)/ nuclear factor-κß ligand (RANKL) pathway using micro-computed tomography scanning. METHODS: Osteoporosis was induced in rats by intraperitoneal injection of D-galactose (200 mg/kg/day) for eight consecutive weeks. Osteoporotic rats were orally treated with H. pluvialis biomass (BHP; 450 mg/kg), its polar (PHP; 30 mg/kg) and carotenoid (CHP; 30 mg/kg) fractions for the last 2 weeks of D-Gal injection. Twenty four hours after the last dose of the treatments, tibia bones of the rats were scanned using micro-computed tomography scanning for bone mineral density (BMD), bone volume fraction (BV/TV), trabecular thickness/separation/number (Tb.Th, Tb.Sp, Tb.N) evaluation, blood samples were withdrawn and sera were used for biochemical assessment. Moreover, femur bones were examined histopathologically using several stains. RESULTS: Induction of osteoporosis was associated with a marked reduction in BMD, BV/TV, Tb.Th, Tb.Sp, Tb.N and in serum levels of phosphorus and catalase. On the other hand, a significant elevation in serum levels of calcium, bone alkaline phosphatase (BALP) and interleukin-6 was observed. Moreover, up-regulation of OPG was detected in osteoporotic rats. Oral treatment with BHP, and PHP incremented tibia BMD and serum phosphorus level along with the decrease in serum levels of calcium, BALP, interleukin-6, OPG and RANKL. However, treatment with CHP almost restored all the fore mentioned parameters to normal values. Furthermore, the histopathological evaluation emphasized the biochemical outcomes. CONCLUSION: H. pluvialis fractions rich in astaxanthin ameliorated bone loss in experimentally-induced osteoporosis in rats probably through the down-regulation of serum OPG in concurrence with up-regulation of serum RANKL.


Asunto(s)
Resorción Ósea/etiología , Microalgas/fisiología , Osteoporosis/complicaciones , Osteoprotegerina/metabolismo , Ligando RANK/metabolismo , Transducción de Señal , Fosfatasa Alcalina/sangre , Animales , Resorción Ósea/sangre , Resorción Ósea/diagnóstico por imagen , Resorción Ósea/patología , Calcio/sangre , Catalasa/sangre , Glucosa , Interleucina-6/sangre , Masculino , Modelos Biológicos , Simulación del Acoplamiento Molecular , FN-kappa B/sangre , Osteoporosis/sangre , Osteoporosis/diagnóstico por imagen , Osteoporosis/patología , Osteoprotegerina/sangre , Ratas , Tibia/diagnóstico por imagen , Tibia/patología , Microtomografía por Rayos X
18.
Arthritis Rheumatol ; 71(11): 1801-1811, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31162832

RESUMEN

OBJECTIVE: The severity of rheumatoid arthritis (RA) correlates directly with bone erosions arising from osteoclast (OC) hyperactivity. Despite the fact that inflammation may be controlled in patients with RA, those in a state of sustained clinical remission or low disease activity may continue to accrue erosions, which supports the need for treatments that would be suitable for long-lasting inhibition of OC activity without altering the physiologic function of OCs in bone remodeling. Autotaxin (ATX) contributes to inflammation, but its role in bone erosion is unknown. METHODS: ATX was targeted by inhibitory treatment with pharmacologic drugs and also by conditional inactivation of the ATX gene Ennp2 in murine OCs (ΔATXC tsk ). Arthritic and erosive diseases were studied in human tumor necrosis factor-transgenic (hTNF+/- ) mice and mice with K/BxN serum transfer-induced arthritis. Systemic bone loss was also analyzed in mice with lipopolysaccharide (LPS)-induced inflammation and estrogen deprivation. Joint inflammation and bone erosion were assessed by histology and micro-computed tomography. The role of ATX in RA was also examined in OC differentiation and activity assays. RESULTS: OCs present at sites of inflammation overexpressed ATX. Pharmacologic inhibition of ATX in hTNF+/- mice, as compared to vehicle-treated controls, significantly mitigated focal bone erosion (36% decrease; P < 0.05) and systemic bone loss (43% decrease; P < 0.05), without affecting synovial inflammation. OC-derived ATX was revealed to be instrumental in OC bone resorptive activity and was up-regulated by the inflammation elicited in the presence of TNF or LPS. Specific loss of ATX in OCs from mice subjected to ovariectomy significantly protected against the systemic bone loss and erosion that had been induced with LPS and K/BxN serum treatments (30% reversal of systemic bone loss [P < 0.01]; 55% reversal of erosion [P < 0.001]), without conferring bone-protective properties. CONCLUSION: Our results identify ATX as a novel OC factor that specifically controls inflammation-induced bone erosions and systemic bone loss. Therefore, ATX inhibition offers a novel therapeutic approach for potentially preventing bone erosion in patients with RA.


Asunto(s)
Artritis Experimental/metabolismo , Artritis Reumatoide/metabolismo , Resorción Ósea/metabolismo , Osteoclastos/metabolismo , Hidrolasas Diéster Fosfóricas/metabolismo , Animales , Artritis Experimental/inmunología , Artritis Experimental/patología , Artritis Reumatoide/inmunología , Artritis Reumatoide/patología , Resorción Ósea/diagnóstico por imagen , Resorción Ósea/inmunología , Calcáneo/diagnóstico por imagen , Femenino , Fémur/diagnóstico por imagen , Técnicas de Silenciamiento del Gen , Humanos , Masculino , Ratones , Ratones Transgénicos , Ovariectomía , Astrágalo/diagnóstico por imagen , Factor de Necrosis Tumoral alfa/genética , Microtomografía por Rayos X
19.
Hand Clin ; 35(3): 241-257, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-31178083

RESUMEN

The scaphoid is the most commonly fractured bone in the wrist but 20% to 40% of scaphoid fractures are radiographically occult. Delayed or misdiagnosis can have significant consequences with late complications such as nonunion, malunion, or the development of avascular necrosis in the proximal pole. After initial negative radiographs, advanced cross-sectional imaging, including CT and MRI, ultimately may provide more accurate and rapid diagnosis than conventional radiography. With chronic fractures, the preferred modality depends on the clinical question. New techniques are evolving that will further advance imaging for diagnosis and treatment of scaphoid fractures.


Asunto(s)
Fracturas Óseas/diagnóstico por imagen , Hueso Escafoides/diagnóstico por imagen , Resorción Ósea/diagnóstico por imagen , Simulación por Computador , Diagnóstico por Imagen/métodos , Fijación Interna de Fracturas , Curación de Fractura , Fracturas Óseas/cirugía , Humanos , Imagenología Tridimensional , Impresión Tridimensional , Hueso Escafoides/lesiones , Hueso Escafoides/cirugía
20.
Int J Pediatr Otorhinolaryngol ; 123: 168-174, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31112840

RESUMEN

OBJECTIVE: This study aimed to explore and make an understanding of absorption existed in children with intracapsular fractures. METHODS: The sample was composed of all children (less than 12 years) who presented with intracapsular fractures within a 5-year period (January 2011 to April 2016). Data about age, gender, date of injury, dates of admission and discharge, transfer and/or referral by other clinics or local facilities, mechanism of trauma, location and pattern of fracture, associated injuries, centimeter of mouth opening, treatment methods, image date of pre- and post-treatment (including time of review), position of condylar head in pre-treatment or post-treatment, and absorption of condylar head in pre-treatment or post-treatment were recorded and analyzed. Data analysis included the Chi-Square test, the Fisher exact test, and the t-test. Logistic regression analysis was utilized to control the confounding variables. Probabilities of p less than 0.05 were considered statistically significantly different. RESULTS: In the 5 years records retrieved during this study, 93 children patients sustained a total of 140 condylar head fractures. Statistical analysis revealed that abduction of condylar process in post-treatment was highly related to the condylar absorption. Patients associated with other mandibular fractures were highly related to abduction of condylar process. Patients with condylar head fractures, the closer to the medial of the condylar process, the higher the risk of abduction of the condyle. No matter what kind of treatment method is used, it is very difficult to reverse the abduction of condylar process in children patients with intracapsular fractures efficaciously. CONCLUSION: Abduction of condylar process in post-treatment was highly related to the condylar absorption. Patients associated with other mandibular fractures were highly related to abduction of condylar process. Children patients who presented with condylar head fractures, the closer to the medial of the condylar process the higher the risk of abduction of the condyle. Neither surgery nor conservative treatment can recover the abduction of condylar process efficaciously.


Asunto(s)
Resorción Ósea/diagnóstico por imagen , Cóndilo Mandibular/lesiones , Fracturas Mandibulares/diagnóstico por imagen , Fracturas Mandibulares/terapia , Resorción Ósea/epidemiología , Niño , Preescolar , Estudios de Cohortes , Tratamiento Conservador , Femenino , Humanos , Masculino , Fracturas Mandibulares/complicaciones , Tomografía Computarizada por Rayos X
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