ABSTRACT
Peri-implantitis is one of the most important biological complications in the field of oral implantology. Identifying the causative factors of peri-implant inflammation and osteolysis is crucial for the disease's prevention and treatment. The underlying risk factors and detailed pathogenesis of peri-implantitis remain to be elucidated. Titanium-based implants as the most widely used implant inevitably release titanium particles into the surrounding tissue. Notably, the concentration of titanium particles increases significantly at peri-implantitis sites, suggesting titanium particles as a potential risk factor for the condition. Previous studies have indicated that titanium particles can induce peripheral osteolysis and foster the development of aseptic osteoarthritis in orthopedic joint replacement. However, it remains unconfirmed whether this phenomenon also triggers inflammation and bone resorption in peri-implant tissues. This review summarizes the distribution of titanium particles around the implant, the potential roles in peri-implantitis and the prevalent prevention strategies, which expects to provide new directions for the study of the pathogenesis and treatment of peri-implantitis.
Subject(s)
Humans , Peri-Implantitis/pathology , Titanium/pharmacology , Dental Implants/adverse effects , Osteolysis/pathology , Inflammation/chemically inducedABSTRACT
Primary non-Hodgkin lymphoma of the bone (PLB) is a rare type of non-Hodgkin's lymphoma (NHL) that affects the skeletal system with or without regional lymph node involvement. We present the case of a 74-year-old female patient with pain due to multifocal osteolytic lesions. The diagnosis of diffuse large B-cells (non-GCB) phenotype was made by clinical, laboratory, histopathological examination accompanied by an extensive immunohistochemical profile of one of the skeletal lesions.
Subject(s)
Humans , Female , Aged , Osteolysis/pathology , Lymphoma, Non-Hodgkin/pathology , B-LymphocytesABSTRACT
Bone involvement of syphilis can be observed in tertiary and congenital syphilis. It is infrequent during the secondary stage. The skull is the most affected bone in secondary syphilis, and its most frequent form of presentation is proliferative osteitis. If the skull is affected, headache is usual and can be as intense as in meningitis. Osteolyitic lesions may be seen in complimentary imaging studies, with a moth eaten aspect. These lesions raise concern over a number of differential diagnoses, among which are infectious, inflammatory and neoplastic diseases. The definitive diagnosis is made by bone biopsy of the compromised bone. Molecular techniques in the affected tissues increases diagnostic performance. There is no standardized treatment protocol for syphilis since there are no guidelines available. We report a case of a 19 year old female, presenting with a unique osteolytic lesion in the skull due to secondary syphilis.
El compromiso óseo de la sífilis se observa predominantemente en la sífilis terciaria y en la sífilis congénita, siendo infrecuente durante el estadio secundario. El hueso más afectado durante la sífilis secundaria es el cráneo, siendo la osteítis proliferativa la forma más frecuente de presentación. Cuando afecta la calota, la cefalea es habitual y puede ser tan intensa que se confunde con un proceso meníngeo. En las imágenes se observan lesiones líticas de aspecto apolillado, planteando el diagnóstico diferencial con otras patologías infecciosas, inflamatorias y neoplásicas. El diagnóstico definitivo se realiza por estudio histológico del hueso comprometido. Las técnicas de biología molecular en los tejidos afectados aumentan el rendimiento diagnóstico. No existen protocolos estandarizados para el tratamiento de la sífilis con compromiso óseo. Presentamos el caso clínico de una mujer de 19 años de edad, con una lesión osteolítica única de calota debida a una sífilis secundaria.
Subject(s)
Humans , Female , Young Adult , Osteolysis/microbiology , Osteolysis/pathology , Skull/microbiology , Syphilis/complications , Syphilis/pathology , Osteolysis/drug therapy , Skull/pathology , Magnetic Resonance Imaging , Syphilis/drug therapy , Tomography, X-Ray Computed , Anti-Bacterial Agents/therapeutic useABSTRACT
Gorham's disease, also known as idiopathic massive osteolysis, is a rare pathological condition characterized by vascular proliferation that results in destruction and reabsorption of the bone matrix, of unknown etiology. It was first described by Jackson in 1838, but it was Gorham and Stout, in 1955, who defined this disease as a specific entity. It has variable clinical presentation and generally has progressive behavior. Controversy continues regarding the treatment and there is no standard treatment. This pathological condition generally presents a favorable prognosis. Here, a case of Gorham's disease with involvement of the left hip is presented, in a male patient without relevant antecedents.
A doença de Gorham, também conhecida por osteólise maciça idiopática, é uma patologia rara, caraterizada por uma proliferação vascular que resulta na destruição e reabsorção da matriz óssea, de etiologia desconhecida. Foi descrita pela primeira vez em 1838 por Jackson, mas foram Gorham e Stout, em 1955, que definiram a doença como uma entidade específica. Com uma apresentação clinica variável, geralmente tem um comportamento progressivo. O tratamento permanece controverso, não há um tratamento padrão. Essa patologia apresenta geralmente um prognóstico favorável. É apresentado um caso de doença de Gorham com envolvimento do quadril esquerdo, num doente do sexo masculino, sem antecedentes de relevo.
Subject(s)
Humans , Male , Middle Aged , Rare Diseases/etiology , Osteolysis/diagnosis , Osteolysis/pathologyABSTRACT
El granuloma reparativo central de células gigantes(GRCCG) es una lesión osteolítica poco frecuente, localizadageneralmente en los huesos maxilares. Aunquesu patogenia continúa siendo controversial, se creeque se origina tras una irritación o traumatismo crónico.Se manifiesta en forma de nódulo circunscripto rojo-púrpura,de crecimiento lento e histológicamente está constituidopor células gigantes multinucleadas inmersas enuna estroma de células ovaladas y fusiformes, planteandodiagnósticos diferenciales con otras lesiones de cé-lulas gigantes.A pesar de sus características histológicas benignas, elcomportamiento de esta lesión suele ser agresivo localmente.Mujer de 31 años de edad con una lesiónosteolítica en maxilar inferior, que resultó tener un componentepredominante de células gigantes que motivóun minucioso análisis anatomopatológico y clínico delesiones de células gigantes de los maxilares, llegándoseal diagnóstico de GRCCG.En nuestro caso la edad, el sexo y la localización de lalesión se correspondieron con la bibliografía consultada.También concordó la clínica, la presentación de lalesión como única, el hallazgo de células gigantesmultinucleadas en una estroma fibrocelularvascularizada y la observación de áreas hemorrágicas ypigmento hemosiderínico. No encontramos antecedentesde irritación o traumatismo en la zona tumoral.A pesar del gran número de lesiones de células gigantesmultinucleadas de los maxilares llegamos al diagnósticode GRCCG por la clínica y los hallazgos morfológicos.Nuestra paciente no presentó signos de recurrencia hastael momento de esta comunicación.Es nuestro objetivo indicar la importancia clínico-patoló-gica del GRCCG, que obliga a plantear diagnósticosdiferenciales con todas las lesiones que en esta localizaciónpresentan células gigantes...
The central reparative granuloma giant cell (GRCCG) isa rare osteolytic lesion, usually located on the jawbone.Although its pathogenesis remains controversial, isbelieved to have originated after irritation or chronic trauma.It manifests as red-purple nodule circumscribed, slowgrowing and histologically is composed of multinucleatedgiant cells embedded in a stroma of spindle and ovalcells, suggesting differential diagnosis with other giantcell lesions.Their benign histological features, the behavior of theselesions are usually locally aggressive. Case report 31 yearsof age with an osteolytic lesion in the mandible. Thehistopathological study showed the same predominantgiant cell component, arriving after a thorough differentialanalysis and clinical pathology of giant cell lesions of thejaws, the diagnosis of GRCCG.Discussion: In our case the age, sex and location of thelesion were consistent with the literature. They alsoagreed the presentation of the lesion as unique, the findingof multinucleated giant cells in a fibrocellular stroma vascularand hemorrhagic areas observing and hemosiderinpigment. No irritation or trauma to the tumor area.Our patient had no signs of recurrence. It is our objectiveto indicate the importance of GRCCG clinicopathological,which requires raising the differential diagnosisfor all lesions in this location have giant cells, takinginto account both clinical and morphology...
Subject(s)
Humans , Female , Granuloma, Giant Cell , Mandible , Maxillofacial Injuries , Osteolysis/pathologyABSTRACT
Tuberculosis of the spine (Pott' disease), is an uncommon evento of extrapulmonary tuberculosis and usually occurs in the absence of extraspinal infection. We report a 24 year-old-man assisted in Córdoba, City (Argentina). Patient arrived at the hospital with mild lumbar pain, thigh's hyperesthesia an patellar hyporreflexia, both in the right side, without general manifestations. X-ray and CT scanning showed severe structural domage of vertebral bodies of the fourth, an fifth lumbar (L4, L5) and first sacral (S1) vertebrae. In addition, paraspinal abscess with extension up to psoas muscle was observed. Mycobacterium tuberculosis was isolated by culture of specimens obtained by aspiration from affected area, fourty days after admission. Patient was treated for nine months with four drugs (Isoniazid, Rifampicine, Pyrazinamide and Ethambutol). Then, the spine was surgically stabilized. During a follw-up of ten years, patient improved progressively. We point out that Pott' disease should be suspected in all cases with vertebral osteomyelitis and negative bacteriological test for common bacteria.
Subject(s)
Humans , Male , Adult , Antitubercular Agents/therapeutic use , Diagnosis, Differential , Mycobacterium Infections/pathology , Orthopedic Fixation Devices , Osteolysis/pathology , Specimen Handling , Spinal Neoplasms , Tuberculosis, Spinal/pathology , Lumbar Vertebrae/pathology , Lumbar VertebraeABSTRACT
Arteriovenous fistulas of the extracranial vertebral artery are rare. The authors report a case of a spontaneous arteriovenous fistula of the extracranial vertebral artery presenting as an osteolytic lesion at the body of the axis. The patient presented with headache and posterior neck pain. The fistula was obliterated by an endovascular trapping.
Subject(s)
Adult , Humans , Male , Arteriovenous Fistula/pathology , Axis, Cervical Vertebra/pathology , Follow-Up Studies , Osteolysis/pathology , Vertebral Artery/pathologySubject(s)
Child, Preschool , Humans , Male , Osteolysis/pathology , Tuberculosis, Osteoarticular/pathologyABSTRACT
Progressive osteolysis is a significant cause for morbidity in patients with neoplasia affecting the skeleton. It gives rise to fractures, bone pain and hypercalcaemia. The mechanism for osteolysis is principally mediated by the activation of bone resorbing cells. The bisphosphonates are specific inhibitors of osteoclast mediated bone resorption and have been widely used in the management of osteolysis. Clodronate is one of the bisphosphonates that may be given by mouth or by parenteral injections. Both formulations lower serum calcium in the vast majority of affected patients due to the inhibition of bone resorption. Moreover, the agent also has significant effects on bone pain. There is increasing evidence that the long-term use of Clodronate decreases the incidence of intercurrent hypercalcaemia, bone pain and fracture and thereby improves the quality of life of affected patients