Update in Imaging Evaluation of Bone and Soft Tissue Sarcomas / Atualização na avaliação por imagens dos sarcomas ósseos e das partes moles

Abstract The evolution in imaging evaluation of musculoskeletal sarcomas contributed to a significant improvement in the prognosis and survival of patients with these neoplasms. The precise characterization of these lesions, using the most appropriate imaging modalities to each clinical condition presented, is of paramount importance in the design of the therapeutic approach to be instituted, with a direct impact on clinical outcomes. The present article seeks to update the reader regarding imaging methodologies in the context of local and systemic evaluation of bone sarcomas and soft tissues.

Resumo A evolução na avaliação por imagens dos sarcomas musculoesqueléticos contribuiu para melhora significativa no prognóstico e na sobrevida dos portadores destas neoplasias. A caracterização precisa destas lesões, mediante utilização das modalidades de imagem mais adequadas a cada condição clínica apresentada, é de suma importância no delineamento da abordagem terapêutica a ser instituída, com impacto direto sobre os desfechos clínicos. O presente artigo busca atualizar o leitor a propósito das metodologias de imagem no contexto da avaliação local e sistêmica dos sarcomas ósseos e das partes moles.

Preparation and Performance of Three-Dimensional Silk FibroinScaffolds with Different Matrix Stiffness / 医用生物力学

Objective After hydrogen bonding between collagen ( COL) and silk fibroin ( SF ) at different concentrations, a composite scaffold with adjustable stiffness was prepared by combining with gel system, and its physical and chemical properties were characterized. Methods SF with different qualities was dissolved in sodium alginate (SA) solution, then COL solution at different concentration and calcium carbonate ( CaCO3 ) powder were added. The hydrogels of SC1, SC2, and SC3 groups were obtained by taking out the mixed solution and adding some gluconic acid lactone ( GDL) powder, and different SF scaffolds were obtained after freeze drying. Results The SF scaffolds with adjustable stiffness were successfully prepared. The compression moduli of SC1, SC2, and SC3 groups were (17. 31±2. 73), (24. 12±1. 81), (32. 54±1. 81) kPa, respectively. The innerstructure of the scaffolds was observed. From SC1 group to SC3 group, pores of the scaffolds were smaller and fewer, and hydrophilicity of the materials become better and better. Conclusions Three-dimensional ( 3D) porous scaffolds with different matrix stiffness can be prepared by changing the concentration of SF and COL solution. The concentration of SF and COL is proportional to the compression modulus, water absorption, water retention and swelling rate of SF scaffolds, while inversely proportional to porosity. The findings of this study are expected to provide theoretical guidance for construction of scaffolds with appropriate matrix stiffness for inducing osteogenic differentiation of mesenchymal stem cells

Progress of research on application of chondroitin sulfate in osteogenic repair materials / 口腔医学

@#Chondroitin sulfate is an important component of extracellular matrix (ECM) in animal and human body. In recent years, chondroitin sulfate has been proven to have potential efficacy in biomedical application and has been widely used in bone regeneration and osteogenesis, especially in craniofacial reconstruction and dental medicine. Research shows that chondroitin sulfate derivatives and chondroitin sulfate composite scaffolds have great potential in promoting osteogenesis and biomineralization. However, due to the variety of chondroitin sulfate and various application forms, study on its mechanism of osteogenic repair is still insufficient. In this paper, biological characteristics, bone regeneration and osteogenesis of chondroitin sulfate, its application in different biomaterial design and future prospect are discussed.

Multi-disciplinary treatment of severe palatal radicular groove of maxillary lateral incisor: A case report and literature review / 中南大学学报(医学版)

Palatal radicular groove is a developmental malformation of maxillary incisors, lateral incisors in particular, which often causes periodontal destruction. This paper reports a case of combined periodontal-endodontic lesions induced by palatal radicular groove, which was initially misdiagnosed as a simple periapical cyst. After root canal therapy and periapical cyst curettage, the course of disease was prolonged, resulting in the absence of buccal and maxillary bone plates in the affected tooth area. After the etiology was determined, the affected tooth was extracted and guide bone tissue regeneration was performed at the same time, followed by implantation and restoration at the later stage, leading to clinical cure. The palatal radicular groove is highly occult, and the clinical symptoms are not typical. If the abscess of the maxillary lateral incisor occurs repeatedly, and the abscess of the maxillary lateral incisor has not been cured after periodontal and root canal treatment, cone-beam computed tomographic and periodontal flap surgery should be considered.

Ankle arthrodesis with intramedullary retrograde nail for bone tumors. preliminary results and surgical technique / Artrodese do tornozelo com cavilha intramedular retrógrada para tumores ósseos. resultados preliminares e técnica cirúrgica

ABSTRACT Objective Present the preliminary results of a case series using the surgical ankle arthrodesis technique with an intramedullary retrograde nail for bone tumors. Methods We present the preliminary data of 4 patients, 3 males and 1 female, with a mean age of 46,2 (range 32 to 58) years, with histology proven Giant Cell Tumour of bone in 3 and osteosarcoma in 1. The mean resection length of distal tibia was 11,75 (range 9 to 16) cm, and all the patients underwent reconstruction with a tibiotalocalcaneal arthrodesis with an intercalary allograft fixed by a retrograde intramedullary nail. Results Oncological follow-up evolved without evidence of local recurrence or disease progression in all patients. After a mean time of 69.5 (range 32 to 98 months), patients had a mean MSTS12 functional score of 82.5% (range 75 to 90). All tibial arthrodesis and diaphyseal osteotomy sites were fused within 6 months with a return to activities without complications related to coverage skin or infection. Conclusion No complications were recorded; all arthrodesis and diaphysial tibial osteotomy sites fused by 6 months, and the mean follow-up of those patients was 69,5 (range 32 to 988) months, with a mean functional MSTS score of 82,5% (range 75-90). Level of Evidence: IV; Retrospective Case Series.

RESUMO Objetivo Apresentar os resultados preliminares de uma série de casos utilizando a técnica cirúrgica de artrodese do tornozelo com haste intramedular retrógada para tumores ósseos. Métodos Apresentamos os dados preliminares de quatro pacientes, três homens e uma mulher, com idade média de 46,2 (variação de 32 a 58) anos, com histologia comprovada de tumor de células gigantes em três e osteossarcoma em um. O comprimento médio de ressecção da tíbia distal foi de 11,75 (variação de 9 a 16) cm, e todos os pacientes foram submetidos à reconstrução com uma artrodese tibiotalocalcaneana com um aloenxerto intercalar fixado por uma haste intramedular retrógrada. Resultados O acompanhamento oncológico evoluiu sem evidências de recidiva local ou progressão da doença, em todos os pacientes. Após um tempo médio de 69,5 (variação de 32 a 98 meses), os pacientes tiveram uma pontuação média funcional MSTS12 de 82,5% (variação de 75 a 90). Todos os locais de artrodese e osteotomia diafisária tibiais foram fundidos em 6 meses com retorno às atividades de vida diária sem complicações relacionadas à cobertura ou infecção. Conclusão Não foram registradas complicações; todos os locais de artrodese e osteotomia diafisária da tíbia fundiram-se em 6 meses, e o acompanhamento médio desses pacientes foi de 69,5 (variação de 32 a 988) meses, com uma pontuação média funcional MSTS de 82,5% (variação de 75-90). Nível de Evidência IV; Série de Casos Retrospectivos.

Tumores óseos de la rótula

Introducción: Los tumores alrededor de la rodilla son frecuentes, a excepción de la rótula donde su localización es ocasional. En esta estructura anatómica existen características clínicas y epidemiológicas muy específicas según el tipo de tumor. Objetivo: Actualizar y brindar información sobre los tumores de la rótula. Métodos: La búsqueda y análisis de la información se realizó en un periodo de 62 días (primero de noviembre al 31 de diciembre de 2022) y se emplearon las siguientes palabras: patellar bone tumors, bone tumor AND patella, knee bone tumors a partir de la información obtenida se realizó una revisión bibliográfica de un total de 153 artículos publicados en las bases de datos: PubMed, Hinari, SciELO y Medline mediante el gestor de búsqueda y administrador de referencias EndNote, de ellos se utilizaron 30 citas seleccionadas para realizar la revisión, 28 de los últimos cinco años. Resultados: Se menciona la incidencia de los tumores benignos más frecuentes que afectan esta estructura anatómica, como el tumor de células gigantes. Se hace referencia a los tumores óseos malignos más reportados y su comportamiento clínico e imagenológico en especial el osteosarcoma. Se abordaron las metástasis de la rótula en particular las provenientes del pulmón. Conclusiones: Los tumores óseos de la rótula son lesiones infrecuentes, al comparar su incidencia con otros tumores de la rodilla. La presentación depende del tipo histológico y grado de afección ósea.

Introduction: Tumors around the knee are frequent, except for the patella, where its location is occasional. In this anatomical structure there are very specific clinical and epidemiological characteristics depending on the type of condition. Objective: To update and provide information on patella tumors. Methods: The search and analysis of the information was carried out in a period of 62 days (November 1st to December 31st, 2022) and the following words were used: patellar bone tumors, bone tumor AND patella, knee bone tumors. From the information obtained a bibliographic review was carried out, a total of 153 articles published in the PubMed, Hinari, SciELO and Medline databases through the EndNote search manager and reference manager were found, of which 30 selected citations were used to carry out the review, 28 of the last five years. Results: The incidence of the most frequent benign tumors that affect this anatomical structure, such as the Giant Cell Tumor, is mentioned. Reference is made to the most reported malignant bone tumors and their clinical and imaging behavior, especially Osteosarcoma. Metastases of the patella were addressed, particularly those of the lung. Conclusions: Bone tumors of the patella are infrequent lesions, when comparing their incidence with tumors from the rest of the knee joint. Presentation depends on the histological type and degree of bone involvement.

Devascularized bone surface culture for identification of microorganisms for osteomyelitis / 中华创伤骨科杂志

Objective:To evaluate devascularized bone surface culture for identification of microorganisms for osteomyelitis.Methods:A prospective study was conducted to include the eligible patients who were diagnosed with osteomyelitis and treated at Division of Orthopaedics and Traumatology, Department of Orthopaedics and Traumatology, Nanfang Hospital from December 2021 to January 2023. Their infected bone tissues were collected for both bone sample culture (BSC) and general sample culture (GSC). For BSC, the devascularized bone fragments, harvested intraoperatively, were put flat on sterile culture plates with solidified agar, their surface was gently covered with cooled and molten tryptone soy agar, and then the plates with bone samples were incubated at 37 ℃ with 5% CO 2. Meanwhile, 5 suspected samples of infected bone tissue were randomly harvested by 5 independent instruments for laboratory GSC. The culture time, bacterial species, and bacterial positive rate were compared between the 2 culture methods. Results:Included were a total of 73 patients [59 males and 14 females with an age of 49.0(31.0, 58.5) years]. The culture time for BSC [1 (1, 1) d] was significantly shorter than that for GSC [3 (2, 3) d], and the total positive rate of BSC [78.1% (57/73)] was significantly higher than that of GSC [61.6% (45/73)] ( P<0.05). The bacterial species cultured by GSC were consistent with those cultured by BSC. Conclusion:In identification of microorganisms for osteomyelitis, since BSC may be quicker and lead to a higher positive rate of bacterial culture than GSC, it can be used as an optional choice besides GCS.

Estrés agudo y crónico en la reparación ósea: un enfoque actualizado desde las neurociencias / Acute and chronic stress in bone repair: an updated approach from the neurosciences

Los mecanismos moleculares fisiológicos asociados a la respuesta ante el estrés agudo y crónico permiten entender los cambios que éstos pueden producir en los diversos tejidos del cuerpo. Diversas investigaciones resaltan el papel del estrés crónico en el desarrollo de disfunciones que afectan el equilibrio corporal; sin embargo, hay que considerar que los mecanismos relacionados con el estrés agudo, también pueden influir en el desarrollo de patologías y de la progresión de las manifestaciones deletéreas del estrés crónico. Por otro lado, uno de los tejidos más estudiados en los últimos años ha sido el tejido óseo, ya que éste se encuentra influenciado por factores nerviosos, endocrinos e inmunológicos. Esta revisión busca analizar las bases neurocientíficas de los mecanismos moleculares del estrés y su relación en el proceso de reparación ósea. Para esto, se realizó una búsqueda de la literatura en las bases de datos de Pubmed, Scopus y ScienceDirect, concluyendo que el estrés modifica la liberación de neurotransmisores, la acción del sistema nervioso autónomo, la liberación de hormonas corticotrópicas y la actividad de diversas citocinas; lo que conlleva al desequilibrio de los procesos de regulación y reparación del tejido óseo sometido a carga o lesión.

The physiological molecular mechanisms associated with the response to acute and chronic stress allow us to understand the changes that these can produce in the various tissues of the body. Various investigations highlight the role of chronic stress in the development of dysfunctions that affect body balance; However, it must be considered that the mechanisms related to acute stress can also influence the development of pathologies and the progression of the deleterious manifestations of chronic stress. On the other hand, one of the most studied tissues in recent years has been bone tissue, since it is influenced by nervous, endocrine and immunological factors. This paper seeks to analyze the neuroscientific bases of the molecular mechanisms of stress and their relationship in the bone repair process. Therefore, a literature search was carried out in the Pubmed, Scopus and ScienceDirect databases. Concluding that stress modifies the release of neurotransmitters, the action of the autonomic nervous system, the release of corticotropic hormones and the activity of various cytokines; which leads to the imbalance of the regulation and repair processes of the bone tissue subjected to load or injury.

Efeitos do laser de baixa intensidade em osteoblastos cultivados em arcabouços nanofibrosos de ácido polilático / Effects of low-intensity laser on osteoblasts cultured on polylactic acid nanofibrous scaffolds

A engenharia de tecidos ósseos é um ramo importante da medicina regenerativa e envolve o desenvolvimento de arcabouços com composição e arquitetura favoráveis à integração celular, além do estudo de fatores capazes de promover a adesão e proliferação celular, incluindo estímulos químicos e biofísicos. O objetivo do estudo foi avaliar a utilização do laser de baixa intensidade (LBI) como uma ferramenta para promover a bioestimulação in vitro de células osteoblásticas cultivadas em arcabouços nanofibrosos de ácido polilático (PLA). Os arcabouços foram produzidos pela técnica de eletrofiação e caracterizados quanto à molhabilidade, composição pela espectroscopia no infravermelho por transformada de Fourier (FTIR), morfologia da superfície por microscópica eletrônica de varredura (MEV), caracterização termogravimétrica (TGA), calorimetria diferencial exploratória (DSC) e cristalinidade por difração de raios-X (DRX). Os ensaios biológicos foram conduzidos com osteoblastos da linhagem OFCOL II cultivados na superfície dos arcabouços e submetidos ou não (grupo controle) a irradiação com laser diodo InGaAIP na potência de 30 mW, nas doses de 1, 4 e 6 J/cm² e nos comprimentos de onda de 660 nm (grupos V1, V4, V6, respectivo as doses) e 780 nm (grupos I1, I4 e I6, respectivo as doses). Os efeitos do LBI na proliferação dos osteoblastos foram avaliados através do método bioquímico Alamar Blue, nos intervalos de 24, 48 e 72h, enquanto a viabilidade e a morfologia celular foram analisadas no intervalo de 72h, através do ensaio Live/Dead e da microscopia eletrônica de varredura (MEV), respectivamente. Os dados do ensaio bioquímico de Alamar Blue mostraram uma maior proliferação celular nos grupos V6 em todos os intervalos analíticos em comparação ao grupo controle (p<0,05). Outras diferenças entre o grupo controle e irradiados foram encontradas apenas nos intervalos de 48h e 72h para V1, e para o grupo IV6 em 72h. O ensaio Live/Dead revelou um aumento na viabilidade celular nos grupos trados com LBI, sendo significativamente maior no grupo V1 quando comparado ao grupo controle. A análise por MEV mostrou adequada interação dos osteoblastos aos arcabouços, com o corpo celular se espalhando ao longo do eixo da nanofibra e a presença de contatos físicos mais evidentes, através da formação de ligação por meio de filopódios e lamelipódios, nos grupos V1, V6 e I6. Em conjunto, os dados do presente trabalho mostraram que o LBI promove a bioestimulação de osteoblastos cultivados sobre nanofibras de PLA, o que aponta para o seu uso potencial nas técnicas de engenharia tecidual óssea, sobretudo no que se refere ao uso do comprimento de onda de 660 nm, a qual apresentou grupos com mais resultados significativos (AU).

Bone tissue engineering is a relevant branch of regenerative medicine and involves the development of scaffolds with composition and architecture favorable to cell integration, in addition to studying factors capable of promoting cell adhesion and proliferation, including chemical and biophysical stimuli. The study aimed to evaluate the use of low-level laser irradiation (LLLI) to promote in vitro biostimulation of osteoblastic cells cultured on polylactic acid (PLA) nanofibrous scaffolds. The scaffolds were produced by the electrospinning technique and characterized in terms of wettability, composition by Fourier transform infrared spectroscopy (FTIR), surface morphology by scanning electron microscopy (SEM), thermogravimetric characterization (TGA), differential scanning calorimetry (DSC) and crystallinity by Xray diffraction (XRD). The biological assays were conducted with osteoblasts of the OFCOL II lineage cultured on the surface of the scaffolds and submitted or not (control group) to irradiation with InGaAIP diode laser, power of 30 mW, with doses of 1, 4 and 6 J/cm² and wavelengths of 660 nm (groups V1, V4, V6, respectively doses) and 780 nm (groups I1, I4 and I6, respectively doses). The effects of LLLT from the perspective of osteoblasts were evaluated using the biochemical method Alamar Blue assay, at intervals of 24, 48 and 72h, while cell viability and morphology were observed at 72h, using the Live/Dead assay and electron microscopy. scan (SEM), respectively. The Alamar Blue assay data showed more significant cell proliferation in groups in the V6 groups at all analytical intervals compared to the control group (p<0.05). Other differences between the control and irradiated groups were found only at intervals of 48h and 72h for V1, and for group IV6 at 72h. The Live/Dead assay revealed an increase in cell viability in the groups treated with LLLT, being significantly higher in the V1 group when compared to the control group. SEM analysis showed adequate interaction between osteoblasts and scaffolds, with the cell body spreading along the nanofiber axis and the presence of more evident physical contacts, through the formation of bonds through filopodia and lamellipodia, in groups V1, V6 and I6. Together, the data from the present study observed that LLLT promotes the biostimulation of osteoblasts cultured on PLA nanofibers, which pointed to its potential use in bone tissue engineering techniques, especially with regard to the use of the wavelength of 660 nm, which presented groups with more significant results (AU).

3D spheroid cell cultures and their role in bone regeneration: a systematic review / Cultivos de esferoides 3D y su papel en la regeneración ósea: una revisión sistemática

Abstract Recently, the 3D spheroid cell culture application has been extensively used in the treatment of bone defects. A wide variety of methodologies have been used, which has made the comparison of results complex. Therefore, this systematic review has two aims: (i) to perform an analysis focused on the role of 3D spheroid cell culture in bone regeneration strategies; and (ii) address the main challenges in clinical application. A search of the following keywords "3D cell culture", "spheroid", and "bone regeneration" was carried out in the PubMed, Scopus, and ScienceDirect databases and limited to the years 2010-2020. Studies were included if their primary objective was the behavior of cell aggregates to formed spheroids structures by different 3D cell culture techniques focused on the regeneration of bone tissue. To address the risk of bias for in vitro studies, the United States national toxicology program tool was applied, and descriptive statistics of the data were performed, with the SPSS V.22 program. A total of 16 studies were included, which met the established criteria corresponding to in vitro and in vitro/in vivo studies; most of these studies used stem cells for the 3D cell spheroids. The most often methods used for the 3D formation were low adherence surface and rotational methods, moreover, mesenchymal stem cells were the cell line most frequently used because of their regenerative potential in the field of bone tissue engineering. Although the advances in research on the potential use of 3D spheroids in bone regeneration have made great strides, the constant innovation in cell spheroid formation methodologies means that clinical application remains in the future as strategy for 3D tissue bioprinting.

Resumen Recientemente, la aplicación del cultivo 3D de esferoides se ha utilizado ampliamente en el tratamiento de defectos óseos. La variedad de metodologías para lograr los cultivos 3D de esferoides ha hecho compleja la comparación de resultados. Por tanto, esta revisión sistemática tiene dos objetivos: (i) realizar un análisis centrado en el papel de los cultivos 3D de esferoides en las estrategias de regeneración ósea; y (ii) abordar los principales desafíos en la aplicación clínica. Se realizó una búsqueda de las siguientes palabras clave "cultivo celular 3D", "esferoide" y "regeneración ósea" en las bases de datos PubMed, Scopus y ScienceDirect y se limitó a los años 2010-2020. Se incluyeron los estudios si su principal objetivo era el comportamiento de agregados celulares para generar las estructuras esferoidales desarrollados por diferentes técnicas de cultivo celular 3D enfocadas a la regeneración del tejido óseo. Para abordar el riesgo de sesgo de los estudios in vitro, se aplicó la herramienta del programa nacional de toxicología de Estados Unidos y se realizaron estadísticas descriptivas de los datos, con el programa SPSS V.22. Se incluyeron un total de 16 estudios, que cumplieron con los criterios establecidos correspondientes a estudios in vitro e in vitro/in vivo; la mayoría de estos estudios utilizaron células troncales para generar los esferoides celulares 3D. Los métodos más utilizados para la formación de los esferoides 3D fueron la superficie de baja adherencia y los métodos de rotación, asimismo, la línea celular de células troncales mesenquimales fueron las más utilizadas debido a su gran potencial regenerativo en el campo de la ingeniería de tejidos óseos. Aunque los avances en la investigación sobre el uso potencial de los cultivos celulares de esferoides 3D en la regeneración ósea han logrado grandes avances, la constante innovación en las metodologías de la generación de esferoides 3D deja claro que la aplicación clínica de estos permanecerá en el futuro como estrategia en la bioimpresión tisular.

Reference standard thickness for bone plates of upper teeth: an ultra-high-resolution study using tomographic mapping / Padrão de referência de espessura para cristas ósseas de dentes superiores: um estudo de ultra-alta resolução usando mapeamento tomográfico

Objective: it is important to know the thicknesses of the alveolar bone plates (ABPs) based on the current literature for the planning and success of orthodontic treatment. However, studies have scientific limitations regarding ABPs as the image resolution is not adequate and is restricted to a few teeth or buccal face only. This study was aimed at reporting a reference standard for bone plates of upper teeth, in which 15 patients (mean age of 21.79 years) with balanced occlusion and a harmonious facial profile were evaluated using cone-beam computed tomography at a voxel size of 0.1 mm. Material and Methods: bone tissues of the cervical, middle, and apical thirds of the root (buccal and palatal), the distance between cement-enamel junction (CEJ) and alveolar bone crest (ABC), and inclination of the teeth to the palatal plane were evaluated. Paired t-test, Spearman's correlation tests, and linear regression tests were used (P < 0.05). Results: the buccal distance between the CEJ and ABC was greater than the palatal one in all pairs of teeth. Most of the bone tissues had a thickness ≤ 1 mm in the buccal face, whereas in the cervical-apical direction, the thickness was ≥ 2 mm. There is no equivalence between genders in the sample. Conclusion: the reduced buccal bone architecture around the first premolars was indicative of local gingival recessions, and the lack of gender uniformity was suggestive of individual evaluation. References of normal bone tissue determining the orthodontic limits were provided to assist in the treatment planning. (AU)

Objetivo: é importante conhecer as espessuras das cristas ósseas alveolares (COAs) com base na literatura atual para o planejamento e sucesso do tratamento ortodôntico. No entanto, os estudos apresentam limitações científicas em relação às COAs, pois a resolução da imagem não é adequada e está restrita apenas a alguns dentes ou face vestibular. Este estudo teve como objetivo descrever um padrão de referência para corticais ósseas de dentes superiores, no qual 15 pacientes (idade média de 21,79 anos) com oclusão equilibrada e perfil facial harmonioso foram avaliados por meio de tomografia computadorizada de feixe cônico no tamanho de voxel de 0,1 mm. Material e Métodos: os tecidos ósseos dos terços cervical, médio e apical da raiz (vestibular e palatina), a distância entre a junção cemento-esmalte (JCE) e a crista óssea alveolar (COA) e a inclinação dos dentes ao plano palatino foram avaliados. Foram utilizados o teste t pareado, os testes de correlação de Spearman e os testes de regressão linear (P < 0,05). Resultados: a distância vestibular entre a JEC e a COA foi maior que a palatina em todos os pares de dentes. A maioria dos tecidos ósseos apresentou espessura ≤ 1 mm na face vestibular, enquanto no sentido cérvico-apical a espessura foi ≥ 2 mm. Não há equivalência entre os gêneros na amostra. Conclusão: a arquitetura óssea vestibular reduzida ao redor dos primeiros pré-molares foi indicativa de recessões gengivais locais, e a falta de uniformidade de gênero foi sugestiva de avaliação individual. Referências de tecido ósseo normal determinando os limites ortodônticos foram fornecidas para auxiliar no planejamento do tratamento. (AU)

Psammomatoid juvenile ossifying fibroma of frontal sinus - surgical and reconstructive approach

ABSTRACT Psammomatoid juvenile ossifying fibroma (PJOF) is a benign fibro-osseous lesion that mainly affects the paranasal sinuses and periorbital bones. It may cause significant esthetic and functional impairment. Herein, we describe the diagnosis and surgical approach of an extensive PJOF arising in the frontal sinus of a young male. After complete lesion removal and histopathological confirmation, the bone defect was repaired with a customized polymethylmethacrylate implant. PJOF may present aggressive clinical behavior. The excision of extensive PJOF in the orbitofrontal area can result in significant esthetic defects. Polymethacrylate implants restore functionally and esthetically the involved area.

CircularRNA CDR1as promotes osteogenic differentiation and angiogenesis related genes expression in mouse bone marrow mesenchymal stem cells / 口腔疾病防治

Objective@# To investigate the effects of over expression and low expression of antisense transcripts of circular RNA cerebellar degeneration associated protein 1 (CDR1as) in Balb/C mouse bone marrow mesenchymal stem cells (BMSCs) on factors related to osteogenesis and angiogenesis.@*Methods@#BMSCs were cultured and identified in vitro. The lentiviral (LV) vector containing the overexpressed and silenced circRNA CDR1as genes and the control lentivirus were respectively transfected into mouse BMSCs, and stable cell lines were screened. The cells were divided into the circRNACDR1as over expression group and the over expression control group, and the CircRNACDR1as low expression group and the low expression control group. The components were stained with Alizarin Red S and alkaline phosphatase after 14 and 21 days of osteoinduction; qRT-PCR was used to detect the target genes circRNA CDR1as, osteogenic differentiation markers alkaline phosphatase (ALP), runt- related transcription factor 2 (RUNX2), osteocalcin (OCN), osteopontin (OPN), osterix(Osx), collagen I (COL-1), and the mRNA expression levels of vascular endothelial grown factor (VEGF) and angiogenin-1 (Ang-1). @*Results@# The results of alizarin red staining and alkaline phosphatase staining showed that the extracellular matrix calcium precipitation and ALP staining area of the over expression experimental group was greater than its control group, and those of the low expression experimental group was less than its control group. As the number of days of osteogenic induction increased, the calcium precipitation and ALP staining in each group also increased. RT-PCR results showed that the mRNA expression levels of circRNA CDR1as, ALP, RUNX2, OCN, OPN, OSX, COL-1, VEGF and Ang-1 in the over expression experimental group BMSCs were significantly increased (P<0.001). In the low expression experimental group, the mRNA expression levels of circRNA CDR1as, ALP, RUNX2, OCN, OPN, OSX, COL-1, VEGF and Ang-1 in BMSCs were significantly reduced (P<0.001). @*Conclusion@# Over expression of the circRNA CDR1as gene promotes the osteogenic differentiation and angiogenesis of BMSCs. Low expression of the circRNA CDR1as gene inhibits the osteogenic differentiation and angiogenesis of BMSCs.

CBCT study on the safe location of palatal microscrew implant anchorage nail between maxillary first and second molars / 口腔疾病防治

Objective@#Conebeam CT (CBCT) was used to measure the palatine between the maxillary first and second molars. The proximal and distal palatal widths of the maxillary first and second molar and the palatal mucosal thickness and bone tissue thickness when microscrew implant anchorage nail were implanted at different angles provided a reference for the clinical selection of microscrew implant placement.@* Methods@#The image data of 90 adult patients were selected as the research object, and the jaw bone was reconstructed by scanning. In maxillary palatine, selection of distances at 12 mm, 14 mm, 16 mm, and 18 mm from the palatal apex of maxillary first molar between the maxillary first and second molar were used as measurement, measured the proximal and distal palatal widths of maxillary first and second molar and the palatal mucosal thickness and bone tissue thickness when microscrew implant anchorage nails were implanted at 30 °, 45 °, 60 °, and 90 °. SPSS 26.0 software was used for one-way ANOVA and LSD pair comparison. @*Results@#The larger the angle of the microscrew implant anchorage nail was, the smaller the proximal and distal medial widths between the maxillary first and second molar, and the difference was statistically significant (P < 0.05). Compared with the 90° direction, the proximal and distal medial widths of the microscrew implant anchorage nail were larger in the 60° direction. The greater the angle of implantation, the smaller the mucosal thickness and the greater the bone tissue thickness, and the results showed a significant difference (P < 0.001). Compared with the direction of 30° and 45°, the mucosal thickness at the direction of 60° was smaller, and the bone tissue thickness was larger. The higher the position of the microscrew implant anchorage nail, the greater the width of the proximal and distal medial, and the difference was statistically significant (P < 0.05). Compared with the positions 12 and 14 mm from the palatal tip, the proximal and distal medial widths of the microscrew implant anchorage nail were larger. The higher the implant position was, the greater the mucosal thickness and the smaller the bone tissue thickness. The results showed a significant difference (P < 0.001). Compared with the position of 18 mm from the palatal tip of the maxillary first molar, the mucosal thickness was smaller and the bone tissue thickness was larger.@*Conclusion@#It is most appropriate to implant microscrew implant anchorage nail at least 10 mm in length in the direction of 60° at the palatal apex 16 mm from the maxillary first molar in palatine between the first and second molar.

Updating on Bone and Soft Tissue Sarcomas Staging / Atualização no estadiamento dos sarcomas ósseos e das partes moles

Abstract Bone and soft tissue sarcomas consist of a heterogeneous group of malignant tumors of mesenchymal origin that can affect patients from any age. The precise staging of these lesions determines the best therapeutic strategies and prognosis estimates. Two staging systems are the most frequently used: the system proposed by the University of Florida group, led by Dr. William F. Enneking (1980) and adopted by the Musculoskeletal Tumor Society (MSTS), and the system developed by the American Joint Committee on Cancer (AJCC) (1977), currently in its 8th edition (2017). This paper updates the reader on the staging of bone and soft tissue sarcomas affecting the musculoskeletal system.

Resumo Os sarcomas ósseos e das partes moles consistem em grupo heterogêneo de neoplasias malignas de origem mesenquimal que podem ocorrer em qualquer faixa etária. O estadiamento preciso destas lesões determina as melhores estratégias terapêuticas e estimativas de prognóstico. Dois sistemas de estadiamento são os mais frequentemente empregados no manejo destas neoplasias: o sistema proposto pelo grupo da Universidade da Flórida, liderado pelo Dr. William F. Enneking (1980), adotado pela Musculoskeletal Tumor Society (MSTS) e o sistema desenvolvido pela American Joint Committee on Cancer (AJCC) (1977) que se encontra em sua 8a edição (2017). O presente artigo busca atualizar o leitor a respeito do estadiamento dos sarcomas ósseos e das partes moles que acometem o sistema musculoesquelético.

Extremities Soft Tissue Sarcomas, more Common and as Dangerous as Bone Sarcomas / Sarcomas de partes moles nos membros, mais comuns e tão graves quanto os sarcomas ósseos

Abstract Musculoskeletal sarcomas are rare diseases that require attention. They often present high degree of malignancy at diagnosis and, if underestimated, they can evolve aggressively locally and systemically. They present as soft tissues arcoma and bone sarcomas, with soft tissue being four to five times more common. Most soft tissue sarcomas occur in the extremities. The most common subtypes in children and adolescents are rhabdomyosarcoma and synovial sarcoma; in adults, undifferentiated pleomorphic sarcoma, liposarcoma, leiomyosarcoma, myxofibrosarcoma and synovial sarcoma; all with a high degree of histological malignancy. Many soft tissue sarcomas are confused with benign soft tissue tumors, 100 times more common, so they are resected without the necessary planning, resulting in amputation of a limb that could have been preserved. As in all cancers, the most important prognostic factor is metastatic disease. When it is present, the overall survival rate falls around 20 to 30%. Survival rates are generally similar between bone and soft tissue sarcomas. So soft tissue sarcomas, in addition to being more prevalent, are as aggressive as bones arcomas, deserving a lot of attention from orthopedic surgeons, who are often the first line of care of carriers of these tumors.

Resumo Os sarcomas musculoesqueléticos são doenças raras que exigem atenção. Frequentemente, apresentam alto grau de malignidade ao diagnóstico e se subestimados podem evoluir de forma agressiva local e sistemicamente. Apresentam-se como sarcoma de partes moles e sarcomas ósseos, sendo os de partes moles quatro a cinco vezes mais comuns. A maioria dos sarcomas de partes moles ocorre nos membros. Os subtipos mais comuns nas crianças e adolescentes são o rabdomiossarcoma e o sarcoma sinovial, nos adultos o sarcoma pleomórfico indiferenciado, lipossarcoma, leiomiossarcoma, mixofibrossarcoma e sarcoma sinovial; todos de alto grau de malignidade histológica. Muitos sarcomas de partes moles são confundidos com tumores benignos de partes moles, 100 vezes mais comuns, por isso são ressecados sem o planejamento necessário, acarretando em amputação de um membro que poderia ter sido preservado. Como em todos os cânceres, o fator prognóstico mais importante é a doença metastática. Na sua vigência, a taxa de sobrevida global cai em torno de 20 a 30%. As taxas de sobrevida no geral são parecidas entre os sarcomas ósseos e de partes moles, portanto o sarcoma de partes moles, além de mais prevalente, mostra-se tão agressivo quanto os sarcomas ósseos, por isso merece muita atenção dos ortopedistas que frequentemente são a primeira linha de atendimento dos portadores destes tumores.

Effect of selected metals on bone tissue of the masticatory apparatus / Efectos de metales en el tejido óseo del aparato masticatorio

The masticatory apparatus is a functional unit of the human body, which is mainly responsible for speech, chewing, and swallowing. It is built of bones, joints, ligaments, teeth, and muscles. In addition, the oral cavity and its hard tissues are the first ones to be exposed to exogenous factors during feeding and breathing. The aim of the work was to review the literature of recent years on the toxicology of metals and their possible negative and sometimes positive effects on the metabolism of bones of the masticatory apparatus. In summary, metals commonly found in the environment affect the bones of the masticatory apparatus to varying degrees. Attention should be paid to the sources of individual metals in the environment and to prevent their excessive, unwanted effects on the bones of the masticatory apparatus. (AU)

El aparato masticatorio constituye una unidad funcional del cuerpo humano especializada en la regulación y coordinación de los procesos del habla, la masticación y la deglución. Está constituida por huesos, ligamentos, articulaciones, músculos y dientes. El tejido óseo de la cavidad bucal es el primero en estar expuesto a factores exógenos durante la alimentación y la respiración. El objetivo del presente trabajo es realizar una revisión de lo reportado en la literatura en los últimos años, con respecto a los efectos beneficiosos o nocivos de los metales pesados sobre el metabolismo de los huesos del aparato masticatorio. En resumen, se evidencia que los metales presentes en el medioambiente afectan a estos huesos en diferentes grados. Se debe prestar especial atención a identificar las fuentes de donde provienen estos metales, para prevenir los efectos no deseados sobre el tejido óseo masticatorio generados por una excesiva exposición a ellos. (AU)

Therapeutic effects of percutaneous vertebroplasty and kyphoplasty on osteoporotic vertebral compression fracture / 中国组织工程研究

BACKGROUND: Percutaneous vertebral body stenting system (VBS) can alleviate patient's pain, recover the height of vertebral body, and correct local kyphosis, but there is no definite clinical study to show that It has obvious advantages over percutaneous kyphoplasty (PKP). OBJECTIVE: To compare the short-term effect of VBS versus PKP in the treatment of osteoporotic vertebral compression fracture. METHODS: Forty patients with osteoporotic vertebral compression fracture who received VBS or PKP between January 2017 and December 2018 In the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine were included in this study. They were divided into a VBS group (n=15) and a PKP group (n=25) according to surgery method. According to whether fluoroscopic operation was performed in retroextension position, two subgroups were designated: VBS retroextension group (n=7) and PKP retroextension group (n=14). RESULTS AND CONCLUSION: Compared with the PKP group, the amount of bone cement injected Into the vertebra was greater in the VBS group (P 0.05). Compared with preoperative situations, Visual Analogue Scale score was significantly decreased after surgery In both VBS and PKP groups, and further decreased at the last follow-up (P 0.05). These results suggest that VBS and PKP are effective in the treatment of osteoporotic vertebral compression fractures. VBS can better correct compression kyphosis deformity when more bone cement Is injected. The difference of therapeutic efficacy between two surgical approaches can be reduced with proper surgical position, keeping the surgical segment In the retroextension position.

Role and mechanism of hierarchical microchanneled bone scaffolds in promoting osteogenesis and angiogenesis / 中国组织工程研究

BACKGROUND: How to recruit endogenous seed cells to promote osteogenesis, provide appropriate bone regeneration microenvironment for cells and ensure the vascularization process of new bone are the difficulties of bone tissue engineering research. OBJECTIVE: To review the osteogenesis and vasculogenesis from the aspects of hierarchical microchanneled bone scaffold. METHODS: The first author searched relevant literature on the promoting effect of hierarchical microchanneled bone scaffold on osteogenesis and angiogenesis from China National Knowledge Infrastructure, Wanfang, PubMed and Web of Science databases from 1950 to 2020. The key words were “hierarchical microchanneled scaffolds, osteogenesis, and angiogenesis” in Chinese and English. Finally, a total of 52 articles meeting the inclusion criteria were selected. RESULTS AND CONCLUSION: Hierarchical microchanneled bone scaffold has a good role in promoting osteogenesis and vascularization, and has a good application prospect in bone tissue engineering. At present, hierarchical microchanneled bone scaffold is mature in the theory of bone tissue engineering. In vitro experiments have confirmed that the hierarchical microchanneled bone scaffold can promote the adhesion and differentiation of mesenchymal stem cells into osteoblasts, but the osteogenic effect in vivo is still poor, and it is still possible to further improve the osteogenic effect. In the future, we should focus on the construction of hierarchical microchanneled bone scaffold complexes, such as chemokines or cytokines, which can further improve the osteogenic efficiency in vivo.

Three-dimensional printing technology and bone tissue engineering research: Literature metrology and visual analysis of research hotspots / 中国组织工程研究

BACKGROUND: With the continuous development of three-dimensional (3D) printing technology and bone tissue engineering, more and more studies have applied 3D printing technology to bone tissue engineering, but the main research status, hot spots and development trend are not clear enough. OBJECTIVE: To explore the current research status, hotspots and development trends of this field through the literature metrology and visual analysis of research hotspots of 3D printing and bone tissue engineering. METHODS: The CNKI database was searched under the theme of “3D printing and bone tissue engineering research”. Based on the quantitative visual analysis method of CNKI literature, the author made a statistical analysis on the trend of the number of publications, publishing institutions and journals of the application of 3D printing technology in bone tissue engineering. VOSviewer software was used to analyze the author collaboration and keyword co-occurrence network of the literature, and the hot research topic was interpreted based on the literature. RESULTS AND CONCLUSION: (1) A total of 469 effective articles related to 3D printing and bone tissue engineering were retrieved. Since 2014, the research on 3D printing and bone tissue engineering has shown a steady growth trend. Chinese Journal of Tissue Engineering Research and Jilin University are the most published journal and institution in this field, respectively. The authors of the literature form five major groups, but there is very little cooperation between the groups. (2) Keywords co-occurrence network shows that the contents revealed by keywords commonly clustering into four research topics (bone tissue engineering scaffold material, 3D printing technology and its application in orthopedics, 3D printing and joint replacement, and others) and the top 10 keywords (3D printing technology, computer aided technology, bone tissue engineering, tissue engineering, fracture, bone defect, hydroxyapatite, three-dimensional, replacement, titanium alloy) really reflect the present situation and the hotspots of current 3D printing and the bone tissue engineering research, which can provide a reference for researchers in this field when choosing a research direction.