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BACKGROUND:Studies have shown that there are significant differences in the geometric morphology of the distal femur of different races and genders,and there are more short female patients in southern China,so the phenomenon of overhanging or insufficient coverage of imported knee prostheses often occurs during surgery. OBJECTIVE:To investigate the characteristics of distal femur bones in southern Chinese women and compare them with imported joint prostheses by simulating the three-dimensional reconstruction of the distal femur bone and matching the femoral side after osteotomy with common imported joint prostheses. METHODS:From January to December 2021,120 female volunteers underwent a CT scan of knee joints.The images were imported into Mimics 20.0 software in Dicom format for three-dimensional reconstruction and then imported into Magic 22.0 software to simulate osteotomy by posterior cruciate ligament preserved total knee arthroplasty and to conduct a matching study with a normal imported joint prosthesis. RESULTS AND CONCLUSION:(1)The functional anteroposterior dimension(fAP)of the distal femur and Persona matched prosthesis had a total overhang rate of 25%(30/120).The fAP≤47 mm group had an overhang than the other groups(P<0.05).The poor coverage rate of Triathlon prosthesis was 12.5%(15/120),and poor coverage was more likely in fAP>53 mm group than in fAP≤53 mm group(P<0.05).(2)The total poor coverage rate of femoral intercondylar width matching with Triathlon prosthesis was 27.5%(33/120).Therefore,the poor coverage rate of bone surface in the central region of the distal femur was more likely in the fAP≤47 mm group than in other groups(P<0.05).The overhang rate of Journey II was 21.6%(26/120),and the overhang rate was higher in the fAP>53 mm group than in the fAP≤53 mm group(P<0.05).(3)Journey II CR prosthesis had the largest difference with the length of the anterior mediolateral diameter of the femur,which was easy to hang out on the anterolateral side of the femoral prosthesis.The Persona CR prosthesis has the largest difference with the length of the posterior mediolateral diameter of the femur,which is easy to be poorly covered in the posterior medial part of the prosthesis.It is recommended to increase the femoral prosthesis with reduced mediolateral diameter in the fAP≤47 mm group and add wider and narrower sizes than the conventional size of intercondylar width,and optimize the anterolateral angular arc design of the femoral prosthesis to improve the matching of posterior cruciate ligament reserved knee prosthesis.
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BACKGROUND:Artificial intelligence planning system can automatically establish a three-dimensional model and generate planning schemes,but its accuracy in predicting the prosthesis size has not been fully verified. OBJECTIVE:To investigate the accuracy of artificial intelligence planning system in predicting prosthesis size before total hip arthroplasty and its influence on clinical prognosis,and further analyze the risk factors affecting the accuracy of planning. METHODS:Clinical data of patients with unilateral initial total hip arthroplasty who were admitted to the Department of Orthopedics of Affiliated Hospital of Xuzhou Medical University from January 2021 to June 2022 were prospectively collected.The patients were randomly divided into the artificial intelligence planning system group(n=80)and the conventional template group(n=79).Intraoperative use of prostheses and preoperative planning of prosthesis matching were compared between the two groups.Postoperative follow-up Harris scores and the occurrence of complications such as leg length discrepancy,dislocation and prosthesis loosening were recorded in both groups.The effects of demographic indicators,preoperative diagnosis,and Dorr typing on the accuracy of femoral stem planning were explored using univariate and multivariate Logistic regression analyses. RESULTS AND CONCLUSION:(1)The prediction of the prosthesis size on the acetabular side and femoral side was 50%(40/80)and 55%(44/80)in the artificial intelligence planning system group,compared to 34%(27/79)and 37%(29/79)in the conventional template group,with statistically significant differences(P＜0.05).(2)The artificial intelligence planning system group had an accuracy rate within one size difference for the acetabular and femoral side prostheses of 91%(73/80)and 86%(69/80),compared to 82%(65/79)and 72%(58/79)in the conventional template group,with differences statistically different only on the femoral side(P＜0.05).(3)No dislocation or prosthesis loosening occurred in the two groups during postoperative follow-up.The difference in lower limb length between the artificial intelligence planning system and conventional template groups was(3.56±2.32)mm and(3.52±2.41)mm.At the last follow-up,the Harris scores of the artificial intelligence planning system and conventional template groups were(92.74±3.08)and(91.81±3.52),respectively;there was no significant difference in the above differences(P＞0.05).(4)Univariate analysis results showed that preoperative diagnosis as developmental dysplasia of the hip and osteonecrosis of the femoral head,and Dorr type B and C femurs had a significant effect on the accuracy of predicted prosthesis size using an artificial intelligence planning system(P＜0.05).(5)Multivariate logistic regression analysis showed that preoperative diagnosis of developmental dysplasia of the hip(OR=18.233,95%CI:2.662-124.888)was an independent risk factor for the prediction of femoral stem size by artificial intelligence planning system.(6)The artificial intelligence planning system has a higher accuracy in predicting prosthetic size than traditional two-dimensional templates,and there is not a significant difference in the risk of postoperative complications or joint function.The accuracy of the artificial intelligence planning system in patients with developmental dysplasia of the hip was low due to anatomical deformities and acetabular anatomical position reconstruction.
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@#Alveolar bone is an important anatomic basis for implant-supported denture restoration, and its different degrees of defects determine the choices of bone augmentation surgeries. Therefore, the reconstruction of alveolar bone defects is an important technology in the clinical practice of implant restoration. However, the final reconstructive effect of bone quality, bone quantity and bone morphology is affected by many factors. Clinicians need to master the standardized diagnosis and treatment principles and methods to improve the treatment effect and achieve the goal of both aesthetic and functional reconstruction of both jaws. Based on the current clinical experience of domestic experts and the relevant academic guidelines of foreign counterparts, this expert consensus systematically and comprehensively summarized the augmentation strategies of alveolar bone defects from two aspects: the classification of alveolar bone defects and the appropriate selection of bone augmentation surgeries. The following consensus are reached: alveolar bone defects can be divided into five types (Ⅰ-0, Ⅰ-Ⅰ, Ⅱ-0, Ⅱ-Ⅰ and Ⅱ-Ⅱ) according to the relationship between alveolar bone defects and the expected position of dental implants. A typeⅠ-0 bone defect is a bone defect on one side of the alveolar bone that does not exceed 50% of the expected implant length, and there is no obvious defect on the other side; guided bone regeneration with simultaneous implant implantation is preferred. Type Ⅰ-Ⅰ bone defects refer to bone defects on both sides of alveolar bone those do not exceed 50% of the expected implant length; the first choice is autologous bone block onlay grafting for bone increments with staged implant placement or transcrestal sinus floor elevation with simultaneous implant implantation. Type Ⅱ-0 bone defects show that the bone defect on one side of alveolar bone exceeds 50% of the expected implant length, and there’s no obvious defect on the other side; autologous bone block onlay grafting (thickness ≤ 4 mm) or alveolar ridge splitting (thickness > 4 mm) is preferred for bone augmentation with staged implant placement. Type Ⅱ-Ⅰ bone defects indicate that the bone plate defect on one side exceeds 50% of the expected implant length and the bone defect on the other side does not exceed 50% of the expected implant length; autologous bone block onlay grafting or tenting techniques is preferred for bone increments with staged implant implantation. Type Ⅱ-Ⅱ bone defects are bone plates on both sides of alveolar bone those exceed 50% of the expected implant length; guided bone regeneration with rigid mesh or maxillary sinus floor elevation or cortical autologous bone tenting is preferred for bone increments with staged implant implantation. This consensus will provide clinical physicians with appropriate augmentation strategies for alveolar bone defects.
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Objective@#To investigate the features of alveolar bone morphology of mandibular central incisors in high-angle adult females using cone-beam computed tomography (CBCT) and evaluate the influence of aging in these patients.@*Methods@# CBCT and lateral cephalometric images of 142 untreated adult female patients were selected and grouped by facial growth pattern. The number of high-angle cases was increased to 164 to further explore the difference within high-angle adult females who were divided into two groups according to age. The indexes of alveolar bone height and thickness in the lower incisor region and inclination of the lower incisors were measured by Dolphin software. The data was statistically analyzed.@*Results@#Compared with the average-angle group, the high-angle group had a lower alveolar bone attachment level (P < 0.05) and less bone thickness at the root apex level (P < 0.05). The thickness of lingual alveolar bone decreased with labial inclination of the lower incisors in both the high-angle and average-angle groups (r = -0.251, P = 0.025; r = -0.428, P = 0.001, respectively). In hyperdivergent female patients, the middle-aged group had a lower attachment level of alveolar bone than the young group (P < 0.05), but no significant difference in bone thickness at the root apex level (P > 0.05) was found between the two groups@*Conclusion @# High-angle adult females had thinner mandibular anterior alveolar bone with significantly lower attachment levels. Aging and inclination of lower incisors influenced bone morphology and should be taken into careful consideration.
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BACKGROUND: Some studies have shown that Erzhi Pill can improve the bone density, bone shadow area, bone mineral content and serum estradiol level of ovariectomized rats, but the possible mechanism has not been explored. OBJECTIVE: To investigate the effect of Erzhi Pill on bone remodeling in an ovariectomized rat model of osteoporosis. METHODS: A rat model of post-menopausal osteoporosis was established, and the extracts of Erzhi Pills of 6, 9, and 12 g/kg per day were administered intragastrically. Administration in each group began at the 13th week after surgery, and the samples were taken at 16, 20, and 24 weeks after surgery. The bone tissue morphology was observed by hematoxylin-eosin staining, the percentage of trabecular bone was measured by Motic 6.0 system, and the bone density of the rat right tibial bone was detected by a bone densitometer. Expressions of osteoprotegerin, nuclear factor κB receptor activating factor ligand (RANKL), tartrate-resistant acid phosphatase (TRAP) and osteocalcin mRNAs in the first lumbar vertebrae were detected by qPCR. RESULTS AND CONCLUSION: The trabecular bone had a better morphological structure, and the number of trabeculae, bone miner density, and bone tissue osteoprotegerin level were significantly increased in a dose-depended manner after treatment with Erzhi Pill, whereas the mRNA levels of RANKL and TRAP decreased in a dose-depended manner after treatment with Erzhi Pill (P < 0.05). Therefore, the alcohol extract of Erzhi Pill can improve the status of hightransformation osteoporosis in ovariectomized rats, promote the expression of osteoprotegerin and inhibit the expression of RANKL, so as to inhibit the activity of osteoclasts and ultimately improve the bone remodeling in female osteoporotic rats.
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Sex steroids play an important role in the growth, development, and maintenance of the bone. Sex differences are observed in bone mass growth. Bone structure and strength in young males are stronger than young females, which are results of the fully utilization of androgen containing testosterone, its aromatization and its reduction products. As male and female growing older, the reduction in bone mass of males happens later than that of females, which are result of the more moderate decrease of estrogen in males. Our review is to summarize the effects of bone metabolism differences between males and females based on several clinical pathological models and to review the latest researches in this field.
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Objective·To compare the difference of the first molar and alveolar morphology between the deviated side and non-deviated side in skeletal class Ⅲ patients with mandibular deviation by using cone-beam computed tomography (CBCT) image combined with three-dimensional reconstruction measurement technology. Methods·Fifty-six asymmetric CBCT data were evaluated by Mimics 10.0 and 3-Matic software. Some measures were analyzed by t-test including the buccolingual angle, the mesiodistal angle, crown root ratio of first molar and the thickness of alveolar or cancellous bone. Results·The buccolingual angle and crown root ratio of mandibular first molar were significantly larger on the deviated side than on the non-deviated side (P=0.021, P=0.004). Compared with the non-deviated side, the buccal and total cancellous bone thickness of mandibular first molar were significantly smaller on the deviated side (P=0.043, P=0.048). There was no significant difference in the ratio of buccal and total cancellous bone thickness on mandibular first molar (both P=0.118). The measurements of maxillary first molar and maxillary alveolar bone morphology were not significantly different between two sides (all P>0.05). Conclusion·In skeletal class Ⅲ patients with mandibular deviation, although the buccolingual compensation of first molar is found, the position of first molar in the alveolar bone is symmetrical. The asymmetry of alveolar bone morphology are mainly manifested in the reduction of the buccal and total cancellous bone thickness on the mandibular deviated side.
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Objective: To compare the difference of the first molar and alveolar morphology between the deviated side and non-deviated side in skeletal class III patients with mandibular deviation by using cone-beam computed tomography (CBCT) image combined with three-dimensional reconstruction measurement technology. Methods: Fifty-six asymmetric CBCT data were evaluated by Mimics 10.0 and 3-Matic software. Some measures were analyzed by t-test including the buccolingual angle, the mesiodistal angle, crown root ratio of first molar and the thickness of alveolar or cancellous bone. Results: The buccolingual angle and crown root ratio of mandibular first molar were significantly larger on the deviated side than on the non-deviated side (P=0.021, P=0.004). Compared with the non-deviated side, the buccal and total cancellous bone thickness of mandibular first molar were significantly smaller on the deviated side (P=0.043, P=0.048). There was no significant difference in the ratio of buccal and total cancellous bone thickness on mandibular first molar (both P=0.118). The measurements of maxillary first molar and maxillary alveolar bone morphology were not significantly different between two sides (all P>0.05). Conclusion: In skeletal class III patients with mandibular deviation, although the buccolingual compensation of first molar is found, the position of first molar in the alveolar bone is symmetrical. The asymmetry of alveolar bone morphology are mainly manifested in the reduction of the buccal and total cancellous bone thickness on the mandibular deviated side.
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Objectives:To investigate the effects of amylin on bone minernal density and structure parameters of bone tissue in glucocorticoid induced osteoporosis rats. Methods:Four groups of female Wistar rats (3 months old) were treated for 12 weeks as follows: ⅠNormal Control, ⅡDXM, Ⅲ DXM+AMY;Ⅳ DXM+Vitamin Da 3. By intramuscular injection of dexamethasone(XM)1mg/kg twice a week during the first 8 weeks, the animal model of Glucocorticoid induced osteopoprosis was established. After 12 weeks, BMD of the lumbar vertebrae and the femural bone were measured by DEXA. The bone morphology of the lumbar vertebrae was also determined. Results:①After the treatment with AMY, bone mineral density (BMD) was significantly increased at the lumbar spine and the femural bone. ( vs. DXM group, P
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Objective The effect of oral L-Dopa on healing of the experimental mandibular defect of rabbits was studied.Method 52 rabbits were assigned randomly to experimental group and control group.After bone defect being made on mandible,rabbits had been given with L-Dopa in experimental group.Healing bone samples were adopted at 14,21,30,42,49 days after operation,observed x-ray and histological changes and calculated out the bone histomorphometric parameters.Results X-ray inspection indicated that bone defect of the experimental group had completed callus union from 30th day.But,a part of the defect of control group did not appear callus union radiologically.Histological examination had the same result.Bone histormorphometry examination exhibited that there was a significant difference between TBV of the experimental and the control group(P
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OBJECTIVE:To study the effects of bone-tonifying capsule on bone morphology and serum TNF-?level of the osteoporosis(OP)model rats.METHODS:The rats were divided into sham operation group,model group and treatment group.OP model were established by removing ovaries of both sides in both the model group and the treatment group by o-variectomy,then the bone density of each group was determined;the bone morphology was observed in the decalcified section of bone tissue;the concentration of serum estradiol(E 2 )and TNF-?level were determined by radioimimunoassay.RESULTS:Compared with the sham group,the bone density and serum E 2 level lowed yet the TNF-?level increased in the model group(P
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This study has been performed to determine whether significant differences in the maxillary basal bone pattern exist between skeletal Class ill malocclusion and normal occlusion. Mterials for the skeletal Class ill sample consisted of lateral cephalometric roentgenograms and maxillary cast models of 29 adult individuals, 15 males and 14 females. The average age was 19.75 years with a range from 16.4 to 29.1 years. A normal control sample consisted of lateral cephalometric roentgenograms and maxillary cast models of 24 adult individuals, 13 males and 11 females. The average age was 24.25 years with a range from 20.8 to 29.4 years. The results of this study can be summarized and concluded as like follows. 1. In comparing sexual difference of maxillary basal bone morphology in skeletal Class III malocclusion, the following parameters of males were found to be significally larger than those of females : inter first premolar width, inter molar width, oblique canine height, oblique molar height and maxillary basal bone perimeter. 2. In comparing sexual difference of maxillary basal bone morphology in normal occlusion, the following parameters of males were found to be significally larger than those of females : inter canine width, inter first and second premolar width, inter molar width, oblique canine height and oblique molar height. 3. In comparing maxillary basal bone morphologic difference between skeletal Class III malocclusion and normal occlusion in males, the following parameters were found to be significally larger in normal occlusion : inter canine width, inter canine height, inter molar height, oblique canine height and oblique molar height. 4. In comparing maxillary basal bone morphologic difference between skeletal Class III malocclusion and normal occlusion in females, the following parameters were found to be significally larger in normal occlusion : inter canine height, inter molar height, oblique canine height, oblique molar height and maxillary basal bone perimeter.
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Adult , Female , Humans , Male , Bicuspid , Malocclusion , Molar , Orthognathic SurgeryABSTRACT
Objective To observe the anti-osteoporosis effect of Gusongbao capsule (GC).Methods Osteoporosis rat models were induced by gastric infusion of vitamin A acid at a dose of 70 mg/kg for 14 days. The bone morphological and blood biochemical indexes and the amount of calcium and phosphorus in urine excreted every day were determined in both treatment group (treated with Gusongbao) and model control group.Results In the treatment group,the average width of bone trabecula,relative bone volume,average thickness of bone cortex,bone calcium,cell number in per unit area of bone trabecula,and the average gray degree of caput femoris and femoral shaft were higher than those in the moderate group. High dose (0.8 g/kg) and middle dose (0.4 g/kg) of GC increased bone phosphorus level and decreased urine calcium level markedly and high dose of GC also increased serum level of CT (P
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AIM: To assess the therapeutic effects and mechanisms of Shenhuang Jinkang Tablet(Radix et rhi-zoma salviae miltiorrhizae,Radix astragali,Rhizoma atractylodis macrocephalae,Rhizoma curcumae longae,Radix angelicae sinensis,Concha ostreae,Concha ostreae praeparatum) on cervical spondylosis in the rat model.METH-ODS: Sprague-Dawley rats were divided into 6 groups at random.The cervical spondylosis rat model was induced,and then administered with normal saline,Shenhuang Jingkang Tablet(500 mg/kg,1 000 mg/kg,2 000 mg/kg) and Jingfukang,respectively.To observe the movement,sensation and morphological change in rat model.The contents of SOD,MDA,IL-6 in serum were tested.RESULTS: As compared with the control group,the activity of cervical part was significantly improved,the oppression was relieved.The average functional angle increased in Shenhuang Jingkang Tablet groups.Difference was significant(P