Preventive and therapeutic effects of relaxin on bisphosphonate related osteonecrosis of the jaw: an experimental study in rats / Efeitos preventivos e terapêuticos da relaxina na osteonecrose da mandíbula relacionada a bisfosfonatos: um estudo experimental em ratos

Objective: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a challenging complication of chronic bisphosphonate (BP) use. The hormone relaxin is able to induce the multistep differentiation process of human osteoclastogenesis, exhibits antifibrotic and anti-inflammatory actions, and promotes vasodilatation, wound healing, and angiogenesis. The present study aimed to evaluate the effects of relaxin in the prevention and management of BRONJ. Material and Methods: Thirty-six male Sprague Dawley rats were randomly divided into four groups. Rats in group 1 (n = 10) received relaxin and BP simultaneously for 12 weeks. Rats in group 2 (n = 10) received injections of BP for 12 weeks, followed by relaxin for another 12 weeks. Rats in group 3 (n = 10) received only BP injections, and those in group 4 (control, n = 6) received only saline. Necrosis and inflammation in the rats' mandibles were evaluated as indicators of BRONJ. Results: Necrosis and inflammation were not detected in group 1 (BP + relaxin). In group 3 (BP only), incidence rates of necrosis and inflammation were 90% and 60%, respectively. Conclusions: Our findings suggest that relaxin may be potently effective in preventing BRONJ and have some benefit in the treatment of existing BRONJ (AU)

Objetivo: A osteonecrose da mandíbula relacionada ao bisfosfonato (BRONJ) é uma desafiadora complicação do uso crônico de bisfosfonato (BP). O hormônio relaxina é capaz de induzir o processo múltiplo de diferenciação da osteoclastogênese humana, exibe ações anti-fibróticas e anti-inflamatórias e promove vasodilatação, cicatrização de feridas e angiogênese. O presente estudo teve como objetivo avaliar os efeitos da relaxina na prevenção e tratamento do BRONJ. Material e Métodos: Trinta e seis ratos Sprague Dawley machos foram divididos aleatoriamente em quatro grupos. Os ratos do grupo 1 (n = 10) receberam relaxina e BP simultaneamente por 12 semanas. Os ratos do grupo 2 (n = 10) receberam injeções de BP por 12 semanas, seguidos de relaxina por mais 12 semanas. Os ratos do grupo 3 (n = 10) receberam apenas injeções de BP e os do grupo 4 (controle, n = 6) receberam apenas solução salina. Necrose e inflamação nas mandíbulas dos ratos foram avaliadas como indicadores de BRONJ. Resultados: Necrose e inflamação não foram detectadas no grupo 1 (BP + relaxina). No grupo 3 (somente BP), as taxas de incidência de necrose e inflamação foram de 90% e 60%, respectivamente. Conclusões: Nossos resultados sugerem que a relaxina pode ser potentemente eficaz na prevenção do BRONJ e ter algum benefício no tratamento do BRONJ existente.(AU)

Vestibular-evoked myogenic potentials before and after dental implant surgery.

OBJECTIVES: This study aims to examine the effects of dental implant surgery on vestibular-evoked myogenic potential (VEMP) responses. PATIENTS AND METHODS: Between October 2012 and October 2014, a total of 60 consecutive patients undergoing dental implant surgery at Baskent University Hospital, Department of Otorhinolaryngology were included in the study. The control group consisted of 40 healthy subjects undergoing routine clinical examination. The VEMP response was evaluated at baseline, second and seventh days. Positional tests and Dix-Hallpike testing for vertigo were performed at baseline, second and seventh days. RESULTS: Hundred-eight dental implants were placed in 60 patients. There was no significant difference in the p1 and n1 latencies in the control group at baseline, second day, and seventh day (p>0.05). However, there was a significant increase at the second day for p1 latencies in the study group, compared to the baseline and seventh day (p=0.038). There was a significant increase at the second day for n1 compared to the baseline (p=0.016) and seventh day in the study group (p=0.005). There was a significant increase at the seventh day for n1 compared to the baseline in the study group (p=0.016). CONCLUSION: The present study revealed a significant difference in the cervical VEMP response on the second postoperative day for p1 and n1 latencies compared to the baseline and seventh postoperative day in dental implantation patients. Dental implant patients should be informed of such possible temporary problems as dizziness and vestibular problems.

Is the incidence of temporomandibular disorder increased in polycystic ovary syndrome?

The prevalence of temporomandibular disorders is higher among women than men (ratio 3:1 -9:1). Polycystic ovary syndrome(PCOS) is the most common endocrine disorder in women, which is characterised by chronic low-grade inflammation and excess of androgenic hormones that lead to metabolic aberrations and ovarian dysfunction. Increased activities of various matrix metalloproteinases (particularly MMP-2 and 9) in the serum of these patients has been reported, and it has been hypothesised that high activities of MMP may contribute to loss of matrix and chronic inflammation of the fibrocartilage in temporomandibular disorders. Our aim was to evaluate the incidence of temopormandibular dysfunction in women with PCOS compared with an age-matched, disease-free, control group. We studied 50 patients with previously diagnosed PCOS and 50 volunteers who had normal menstrual cycles. We made a comprehensive clinical examination of the temporomandibular joint (TMJ) and muscles of mastication in both groups and recorded the Visual Analogue Scores (VAS) for pain. There were significant differences (p<0.001) in the incidence of temporomandibular disorders (n=43 (86%) in the PCOS group compared with n=12 24% in the control group), muscle tenderness(n=32 (64%) in the PCOS group compared with n=14 (28%) in the control group) and pain in the TMJ (mean (SD) VAS 2.9 (2.61) compared with 0.3 (1.56). We confirm the higher incidence and severity of disorders of the TMJ in patients with PCOS and suspect that chronic low-grade inflammation may play a part in the aetiology of the disease.

Survival rates of implants inserted in the maxillary sinus area by internal or external approach.

OBJECTIVE: There are 2 surgical techniques to elevate the sinus floor: sinus lift with crestal approach (internal sinus lift [ISL]) and sinus lift with lateral wall approach (external sinus lift [ESL]). The aim of this study was to evaluate and compare the survival rates of implants placed in the posterior maxilla with ESL or ISL. PATIENTS AND METHODS: Ninety sinus lifts with lateral wall approach were performed in 82 patients, and 147 implants were inserted in these augmented sinuses in ESL group. Forty-five implants were inserted in maxilla in 33 patients with sinus lift with crestal approach in ISL group. The follow-up time was 33.8 and 15.6 months for ESL and ISL groups, respectively. RESULTS: One implant failure was observed in ESL group, and there was no implant failure in ISL group. All other implants were functioning well without any significant clinical finding. Implant survival was 99.2% in ESL group and 100% in ISL group. CONCLUSION: The sinus lift with lateral wall approach and crestal approach were reliable methods for implant insertion in the posterior maxilla. Survival rates of the ISL were slightly higher than ESL group. However, follow-up time of the ISL was shorter.

Early implant survival in posterior maxilla with or without beta-tricalcium phosphate sinus floor graft.

PURPOSE: The sinus lift procedure provides a way to increase the amount of available bone and the placement of longer implants. The aim of this study was to evaluate and compare the survival rates of implants inserted in the posterior maxilla (without sinus lift) to simultaneous implant insertion with sinus lift. PATIENTS AND METHODS: Seventy maxillary sinuses in 62 patients were augmented by beta-tricalcium phosphate and 121 implants were inserted into these augmented sinuses (study group) and 136 implants were inserted in the posterior maxilla in 65 patients (control group). Follow-up times were 29.8 and 32.3 months for the study and control groups, respectively. RESULTS: One implant in the study group and 1 implant in the control group failed. All other implants in both groups were functioning well without any significant clinical finding. Implant survivals were 99.17% in the study group and 99.26% in the control group. CONCLUSION: Simultaneous implant insertion and sinus lift with beta-tricalcium phosphate is a safe surgical procedure, and survival rates of implants inserted in the augmented sinus were similar to those of implants inserted in the posterior maxilla without sinus lift.