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1.
Arch. endocrinol. metab. (Online) ; 65(6): 801-810, Nov.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1349996

ABSTRACT

ABSTRACT Objective: To evaluate the prevalence of osteosarcopenia and the association of osteosarcopenia with trabecular bone score (TBS) in a group of patients with type 2 diabetes mellitus(T2DMG) compared with a paired control group (CG). Materials and methods: Cross-sectional study with men and women ≥ 50 years recruited by convenience. Patients in both groups answered questionnaires and underwent evaluation of bone mineral density (BMD), handgrip strength (HGS), and TBS. The T2DMG also underwent a gait speed (GS) test. Sarcopenia was defined as low lean mass plus low HGS or GS according to the Foundation for the National Institute of Health Sarcopenia Project, and osteosarcopenia was deemed present when sarcopenia was associated with osteopenia, osteoporosis, or low-energy trauma fractures. Results: The T2DMG (n = 177) and CG (n = 146) had, respectively, mean ages of 65.1 ± 8.2 years and 68.8 ± 11.0 years and 114 (64.4%) and 80 (54.7%) women. T2DMG versus the CG had higher rates of osteosarcopenia (11.9% versus 2.14%, respectively, p = 0.010), sarcopenia (12.9% versus 5.4%, respectively, p < 0.030), and fractures (29.9% versus 18.5%, respectively, p = 0.019), and lower HGS values (24.4 ± 10.3 kg versus 30.9 ± 9.15 kg, respectively, p < 0.001), but comparable BMD values. Mean TBS values were 1.272 ± 0.11 and 1.320 ± 0.12, respectively (p = 0.001). On multivariate analysis, age, greater waist circumference, fractures, and osteoporosis increased the risk of degraded TBS. Osteosarcopenia was associated with diabetes complications (p = 0.03), calcium and vitamin D supplementation (p = 0.01), and all components of osteosarcopenia diagnosis (p < 0.05). Conclusion: Compared with the CG, the T2DMG had a higher prevalence of osteosarcopenia, sarcopenia, and fractures and lower bone quality assessed by TBS.


Subject(s)
Humans , Male , Female , Aged , Osteoporosis/etiology , Osteoporosis/epidemiology , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Sarcopenia/etiology , Sarcopenia/epidemiology , Absorptiometry, Photon , Bone Density , Cross-Sectional Studies , Hand Strength , Cancellous Bone/diagnostic imaging , Middle Aged
2.
Article in Chinese | WPRIM | ID: wpr-880413

ABSTRACT

Osteoporosis is one of the common metabolic diseases, which can easily lead to osteoporotic fractures. Accurate prediction of bone biomechanical properties is of great significance for the early prevention and diagnosis of osteoporosis. Bone mineral density measurement is currently used clinically as the gold standard for assessing bone strength and diagnosing osteoporosis, but studies have shown that bone mineral density can only explain 60% to 70% of bone strength changes, and trabecular bone microstructure is an important factor affecting bone strength. In order to establish the connection between trabecular bone microstructure and bone strength, this paper proposes a prediction method of trabecular bone modulus based on SE-DenseVoxNet. This method takes three-dimensional binary images of trabecular bone as input and predicts its elastic modulus in the z-axis direction. Experiments show that the error and bias between the predicted value of the method and the true value of the sample are small and have good consistency.


Subject(s)
Biomechanical Phenomena , Bone Density , Cancellous Bone/diagnostic imaging , Elastic Modulus , Humans , Osteoporosis/diagnostic imaging
3.
Belo Horizonte; s.n; 2021. 128 p. ilus.
Thesis in Portuguese | LILACS, BBO | ID: biblio-1344193

ABSTRACT

Os inibidores de aromatase (IAs) são medicamentos mais comumente utilizados para tratamento para pacientes com câncer de mama. Os IAs atuam inibindo a enzima aromatase, que é responsável pela conversão de hormônios esteroidais. Vários estudos mostram a importância do estrógeno para a formação óssea. Acredita-se que a privação do estrógeno possa ter um efeito deletério no osso causando o aumento da reabsorção óssea, diminuição da densidade mineral óssea (DMO) e com isso o aumento do risco de osteoporose e fraturas. A osteoporose é uma doença sistêmica multifatorial caracterizada pela redução da massa óssea e desorganização estrutural do tecido ósseo. O diagnóstico da osteoporose é baseado em critérios densitométricos da Organização Mundial de Saúde (OMS) com referência na classificação do T-score, realizada pela técnica de absorciometria de energia dupla de raios X (DXA), cujo valor avalia a DMO. Por se tratar de uma doença sistêmica, a osteoporose também afeta os ossos maxilares. Desta forma, o trabalho tem como objetivo avaliar parâmetros imaginológicos em pacientes mulheres que fazem tratamento com; IAs e encaminhadas para investigação de perda de massa óssea em um hospital de referência no tratamento dessas pacientes. Foram avaliadas 40 mulheres sob terapia com IAs. Foram avaliados índices radiomorfométricos (IR) de tomografia computadorizada de feixe cônico (TCFC) e análise fractal (AF) para algumas regiões de interesse (RI), espessura da cortical mandibular (ECM) e índice cortical mandibular (ICM) em radiografias panorâmicas digitais (RPD). Todas as pacientes foram submetidas ao exame DXA para avaliar a condição de DMO e divididas nos grupos: normal e baixa DMO. Para cada IR e para as RI da dimensão fractal, foram estabelecidas a curva característica de operação do receptor (ROC), a área sob a curva (AUC), a sensibilidade e a especificidade com seus receptivos intervalos de confiança. Os valores de AUC para os índices de RPD variaram de 52,6%-75,8%. O índice com a maior AUC foi a ECM, apresentando sensibilidade de 38,1%-100,0% e especificidade de 36,8%-84,2%. Para a AF, a RI do trabeculado total teve a maior sensibilidade, enquanto a RI anterior ao forame mentual teve a maior especificidade. Na análise da TCFC, os valores de AUC variaram de 51,8%-62,0%. Os índices com a AUC mais elevada foram o índice molar (M), com sensibilidade 18,1%-61,6% e especificidade de 66,9%-98,7% e o índice anterior (A) com sensibidade de 25,7%- 70,2% e especificidade de 48,8%-90,9%. O índice da sínfise (S) apresentou a maior sensibilidade e o índice posterior (P) apreentou a maior especificidade. Os índices de tomografia computadorizada inferior (ITC I) apresentou sensibilidade e especificidade razoáveis. Assim a ECM, a AF das RI do ângulo da mandíbula e do trabeculado total da RPD, bem como os índices ITC (I), M, P e A na TCFC mostraram-se úteis para identificar mulheres na pós-menopausa que usavam AI com baixa DMO.


Aromatase inhibitors (AIs) are the most commonly used drugs to treat breast cancer patients. AIs work by inhibiting the aromatase enzyme, which is responsible for converting steroid hormones. Several studies show the importance of estrogen for bone formation. It is believed that estrogen deprivation can have a deleterious effect on bone, causing increased bone resorption, decreased bone mineral density (BMD) and thus an increased risk of osteoporosis and fractures. Osteoporosis is a multifactorial systemic disease characterized by reduced bone mass and structural disorganization of bone tissue. The diagnosis of osteoporosis is based on densitometric criteria of the World Health Organization (WHO) with reference to the T- score classification, performed by the dual energy X-ray absorptiometry (DXA) technique, whose value assesses the BMD. As it is a systemic disease, osteoporosis also affects the maxillary bones. Thus, the study aims to evaluate imaging parameters in female patients undergoing treatment with AIs and referred for investigation of bone mass loss in a reference hospital in the treatment of these patients. Forty women undergoing therapy with AIs were evaluated. Radiomorphometric indices (RI) of cone beam computed tomography (CBCT) and fractal dimension (FD) were evaluated for some regions of interest (ROI), mandibular cortical width (MCW) and mandibular cortical index (MCI) in digital panoramic radiographs (DPR). All patients underwent the DXA exam to assess the status of BMD and divided into groups: normal and low BMD. The AUC values for the DPR indices ranged from 52.6%-75.8%. The index with the highest AUC was the mandibular cortical width ([MCW]; sensitivity: 38.1%-100.0%; specificity: 36.8%-84.2%). For FD, the total trabecular index had the greatest sensitivity, while the index anterior to the mental foramen (MF) had the highest specificity. In CBCT analysis, the values of AUC ranged from 51.8%-62.0%. The indices with the highest AUC were the molar index (M, sensitivity: 18.1%-61.6% and specificity: 66.9%-98.7%) and anterior (A, sensitivity: 25.7%-70.2% and specificity 48.8%-90.9%). The symphysis (S) index had the highest sensitivity, and the posterior (P) index presented the highest specificity. Sensitivity and specificity reasonable were obtained to computed tomography index (Inferior) [CTI (I)]. The MCW, FD of ROI of the mandible angle and total mandibular in the DPR, as well as the CTI (I), M, P, and A indices in the CBCT are useful to identify postmenopausal women who were using AI with low BMD.


Subject(s)
Osteogenesis , Osteoporosis , Bone Density , Aromatase Inhibitors , Estrogens , Radiography, Panoramic , Cone-Beam Computed Tomography , Cancellous Bone , Cortical Bone
4.
Rev. argent. radiol ; 84(2): 47-54, abr. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1125855

ABSTRACT

Resumen Objetivo: La osteoporosis es una condición de relevancia a nivel epidemiológico en Argentina, así como en el resto del mundo. Si bien actualmente la herramienta diagnóstica más relevante es la densitometría ósea, los análisis radiológicos pueden aportar información, principalmente en lo referente a la calidad ósea. En ese sentido, nos proponemos evaluar la estructura trabecular calcánea de una población local. Métodos: El material para dicho estudio consistió en 91 calcáneos de esqueletos pertenecientes a una muestra esqueletal. Fueron analizados individuos adultos, de ambos sexos, mediante imágenes radiográficas, a fin de clasificar su estructura trabecular de acuerdo al índice propuesto por Jhamaria y col., en una escala de V (normal) a I (osteoporosis severa). Resultados: Las prevalencias estimadas fueron de 23,1% de osteoporosis (fases I y II), 16,5% de borderline (fase III) y 48,4% se clasificó como estructura trabecular normal (fases IV y V). En relación a la edad de los individuos, se encontró una correlación significativa negativa entre ella y la pérdida trabecular (tau-b = -0,524, p = 0,00). No se encontraron diferencias significativas en cuanto a la afección dimórfica de la patología. Discusión: La relación entre envejecimiento y osteoporosis hallada es coincidente con estudios nacionales e internacionales que reconocen una disminución en la densidad mineral ósea (DMO) y una mala calidad ósea en individuos adultos mayores. La ausencia de afección dimórfica podría deberse a la edad promedio de la muestra, sumada a la posible resistencia de la estructura esponjosa del calcáneo a los cambios generados por el déficit estrogénico en las mujeres, característica de la osteoporosis tipo I. Conclusión: Creemos que es necesario revalorizar el análisis óseo por medio de radiografías, puesto que pueden ser de utilidad tanto en la clínica como en la investigación básica, debido a la mayor disponibilidad de equipos y a que posibilitan el análisis de otras propiedades del tejido óseo.


Abstract Objective: Osteoporosis is an important condition in an epidemiologic level in Argentina as in the rest of the world. Even though nowadays the most relevant diagnostic technique is bone densitometry, radiological studies can provide useful information, mainly in relation to bone quality. For this purpose, we aim to evaluate the calcaneus trabecular structure in a contemporary local population. Methods: The sample for this study consisted of 91 calcaneus from skeletons belonging to the skeletal repository. Adult individuals from both sexes were analyzed, to classify their trabecular structure according to the index proposed by Jhamaria et al., on a scale of V (normal) to I (severe osteoporosis). Results: The estimated prevalence were 23,1% of osteoporosis (phase I and II), 16,5% of borderline (phase III) and 48,4% were classified as normal trabecular structure (phase IV and V). In relation to the age of the individuals, a significant negative correlation was found between the first and the trabecular loss (tau-b = -0.524, p = 0.00). No significant differences were found in relation to the sex prevalence of this pathology. Discussion: The association found between aging and osteoporosis matches with the results of national and international studies that recognize that a decrease in Bone Mineral Density (BMD) and a bad bone quality in older adults. Absence of differences between sexes in this condition could be due to age average of the sample, added to the possible resistance of the calcaneus spongy structure to changes generated by estrogen deficit in women, characteristic of osteoporosis type I. Conclusion: We believe that it is necessary to revalue bone analysis by radiographic means, since they can be of use both in clinic and in basic research, due to a greater equipment availability and because they allow the analysis of other properties of bone tissue.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Osteoporosis/diagnostic imaging , Calcaneus/diagnostic imaging , Cancellous Bone/diagnostic imaging , Bone and Bones , Radiography , Bone Density , Cross-Sectional Studies
5.
Braz. oral res. (Online) ; 34: e016, 2020. tab, graf
Article in English | LILACS | ID: biblio-1089394

ABSTRACT

Abstract Horizontal bone loss after tooth extraction is a common finding that demands bone reconstruction in various cases. The aim of this study was to assess the horizontal alveolar status in partially and completely edentulous patients using cone-beam computed tomography (CBCT). In total, 1516 CBCT scans of 1404 adult patients were analyzed. Assessment of the images was performed in accordance with the previously published horizontal alveolar change (HAC) classification, which categorizes horizontal bone defects into four classes: HAC 1, HAC 2, HAC 3 and HAC 4 (from the least severe to the most severe condition). Analysis of 1048 scans from partially edentulous patients presented a distribution of 63.55%, 22.14%, 13.36% and 0.95% in HAC 1, HAC 2, HAC 3 and HAC 4, respectively. Analysis of 468 scans from completely edentulous patient images presented a distribution of 19.87%, 28.63%, 41.67% and 9.83% in HAC 1, HAC 2, HAC 3 and HAC 4, respectively. Based on these results, as in HAC 4, no cancellous bone was found between the cortical buccal and lingual/palatal bone plates, it seems reasonable to state that the absence of cancellous bone is higher in completely edentulous patients than in partially edentulous patients. Therefore, the absence of cancellous bone seems to be higher in completely edentulous than in partially edentulous patients.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Aged , Young Adult , Alveolar Bone Loss/pathology , Alveolar Bone Loss/epidemiology , Mouth, Edentulous/pathology , Mouth, Edentulous/epidemiology , Alveolar Process/pathology , Brazil/epidemiology , Prevalence , Retrospective Studies , Alveolar Bone Loss/diagnostic imaging , Mouth, Edentulous/diagnostic imaging , Cone-Beam Computed Tomography/methods , Alveolar Process/diagnostic imaging , Alveolar Ridge Augmentation , Cancellous Bone/pathology , Cancellous Bone/diagnostic imaging , Middle Aged
6.
Int. j. morphol ; 37(4): 1387-1390, Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1040142

ABSTRACT

This study aimed to investigate the micro-anatomical morphology of ossicular chain in term fetus using micro-CT, in order to analyze the parameters of internal ossicular structure that may affect sound conduction.Four ossicular chains from two term fetuses were scanned by micro-CT. The related structural parameters of the trabeculae within the incus and malleus were calculated and compared. The fine anatomical structure of the auditory ossicles was analyzed.The microstructure of each auditory ossicles in term fetuses was clearly revealed by micro-CT. A marrow cavity was observed in the incus and malleus. In statistical analysis of the structural parameters of trabeculae in the incus and malleus, significant differences were found in BS/BV and Tb.Th (P < 0.05). Micro-CT enables the visualization of internal ossicular structure. The auditory ossicles in term fetus has good bone quality. The obtained bone structure data will help to clarify the physiological functions of normal fetal auditory ossicles.


Este estudio tuvo como objetivo investigar la morfología microanatómica de la cadena osicular en el feto a término con micro-CT, con el fin de analizar los parámetros de la estructura osicular interna que pueden afectar la conducción del sonido. Cuatro cadenas osiculares de dos fetos a término fueron examinadas por micro-CT. Se calcularon y compararon los parámetros estructurales relacionados de las trabéculas dentro de los incus y malleus. Se analizó la estructura anatómica fina de los osículos. Se observó claramente la microestructura de cada osículo en los fetos y la cavidad medular en el incus y el malleus. En el análisis estadístico de los parámetros estructurales de las trabéculas en el incus y el malleus, se encontraron diferencias significativas en BS / BV y Tb.Th (P <0,05). Micro-CT permite la visualización de la estructura osicular interna. Los osículos en el feto a término tienen buena calidad ósea. Los datos obtenidos de la estructura ósea ayudarán para aclarar las funciones fisiológicas de los osículos auditivos fetales normales.


Subject(s)
Humans , Ear Ossicles/anatomy & histology , X-Ray Microtomography/methods , Fetus , Image Processing, Computer-Assisted , Imaging, Three-Dimensional , Cancellous Bone/anatomy & histology
7.
Int. j. odontostomatol. (Print) ; 13(4): 402-410, dic. 2019. graf
Article in Spanish | LILACS | ID: biblio-1056476

ABSTRACT

RESUMEN: Los bisfosfonatos (BP) disminuyen la resorción ósea al frenar la actividad de los osteoclastos. La vitamina E es antioxidante y su efecto positivo en el hueso sería mediante la prevención del estrés oxidativo. Se estudió la administración infiltrativa de Alendronato y Vitamina E para determinar si favorecían la formación de hueso en la reparación ósea del alvéolo postexodoncia. Se utilizaron ratas machos Wistar (n=96), de 90 ± 15 g, se les realizó la exodoncia de los primeros molares inferiores. Fueron dividos en 4 grupos: Un grupo control (C) recibió solución salina. El grupo AL 0,5 mg/ Kg; grupo E recibió 20 mg/kg; y grupo con tratamiento combinado AL y E. Los animales se sacrificaron a los 0, 7, 15 y 30 días postextracción. Se realizó la resección de las mandíbulas; las muestras fueron descalcificadas con EDTA y luego se incluyeron en parafina. Se realizaron cortes histológicos y se colorearon con Hematoxilina/Eosina. Se realizó análisis histológico e histomorfométrico. Se utilizó análisis de Varianza (ANOVA). En el análisis histológico, a los 7 y 15 días el grupo E presentó mayor neoformación de tejido óseo que los otros grupos. A los 30 días se observó hueso maduro con presencia de osteonas en el grupo E. En el estudio histomorfométrico a los 15 y 30 días se evidencian diferencias significativas en el número de osteoblastos por mm lineal, entre el grupo AL + E y C (p<0,01) y a los 30 días se encontró diferencia entre el grupo E y C (p<0,01). Al medir espesor trabecular se observó a los 30 días diferencias significativas entre el grupo AL+E y C (p<0,01) y entre el grupo C y E (p<0,01). La Vitamina E demostró que administrada por vía infiltrativa favorece la remodelación ósea en los alvéolos post exodoncia.


ABSTRACT: Bisphosphonates (BP) decrease bone resorption to curb the activity of the osteoclasts. Vitamin E is an antioxidant and its positive effect on the bone would be by preventing oxidative stress. Infiltrative Alendronate and vitamin E administration wasstudied to determine if they favored the formation of bone in bone repair of the postextraction alveolus. Male Wistar rats were used (n = 96), 90 ± 15 g, underwent extraction of the lower first molars. They were divided into 4 groups: A control group (C) received saline. The Group at the 0.5 mg/Kg; Group E received 20 mg/kg; and combined treatment group to AL and E. The animals were sacrificed at days 0, 7, 15 and 30 post extraction. With the resection of the jaws; samples were decalcified with EDTA and then included in paraffin. Histological cuts were made and colored with Hematoxylin/ eosin. Histomorphometric and histological analysis was performed. We used analysis of variance (ANOVA). In the histological analysis, 7 to 15 days the Group E presented greater neoformation of bone tissue than other groups. At 30 days mature bone was observed, with presence of osteons in the Group E. Study shows significant differences in the number of osteoblast histomorphometric function to 15 to 30 days by linear mm, among the group to the + E and C (p < 0.01) and 30-day difference was found among the Group E and C (p < 0.01). When measuring thick trabecular, significant differences were observed at 30 days between the AL+E and C Group (p < 0.01) and between C and E (p < 0.01). Vitamin E showed that administered infiltrative favors the bone remodeling in post extraction sockets.


Subject(s)
Animals , Male , Rats , Osteogenesis/physiology , Vitamin E/therapeutic use , Alendronate/administration & dosage , Osteoblasts , Vitamin E/administration & dosage , Intervention Studies , Analysis of Variance , Histological Techniques , Rats, Wistar , Cancellous Bone
8.
Rev. cuba. reumatol ; 21(2): e90, mayo.-ago. 2019.
Article in Spanish | LILACS, CUMED | ID: biblio-1093809

ABSTRACT

Introducción: la osteomalacia se caracteriza por la falta de mineralización de la sustancia osteoide, que afecta al hueso cortical y al hueso esponjoso maduro. Es una enfermedad que se presenta en adultos y niños, aunque la causa es diferente en cada uno. Objetivo: exponer la generalidad de la osteomalacia por ser una enfermedad que produce serias afectaciones a la población que la padece, especialmente a los niños. Se enfatiza en el diagnóstico y su tratamiento. Desarrollo: a fin de resumir los elementos esenciales para establecer el diagnóstico de osteomalacia hay que plantear en primer lugar, la presencia de un trastorno de la mineralización ósea, de ahí que además de tener en cuenta las causas de la enfermedad, su curso clínico y la sintomatología. Conclusiones: una recomendación importante es no tener en cuenta la posibilidad de complicaciones en el curso de la enfermedad, como las fracturas, que, aunque sean parte del cuadro clínico, al producirse pueden ocasionar graves problemas, como el caso de las que aparecen en las costillas, que si se desplazan pueden interesar órganos vitales, de modo que en este tipo de pacientes no debe excluirse la posibilidad de emergencias o de urgencias reumatológicas tanto en los adultos como en los niños(AU)


Introduction: osteomalacia is characterized by the lack of mineralization of the osteoid substance, which affects cortical bone and mature cancellous bone. It is a disease that occurs in adults and children, although the cause is different in each. Objective: to expose the generality of osteomalacia for being a disease that causes serious affectations to the population that suffers it, especially to children. Emphasis is placed on the diagnosis and its treatment. Development: in order to summarize the essential elements to establish the diagnosis of osteomalacia, we must first consider the presence of a bone mineralization disorder, hence, in addition to taking into account the causes of the disease, its clinical course and the symptomatology. Conclusions: an important recommendation is not to take into account the possibility of complications in the course of the disease, such as fractures, which, although they are part of the clinical picture, can cause serious problems when they occur, as in the case of those that appear in the ribs, which if they move may involve vital organs, so that in this type of patients should not exclude the possibility of emergencies or rheumatological emergencies in both adults and children(AU)


Subject(s)
Humans , Osteomalacia/diagnosis , Vitamin D Deficiency/prevention & control , Calcification, Physiologic , Emergencies , Fractures, Bone , Cancellous Bone , Osteomalacia/drug therapy , Calcium, Dietary/therapeutic use , Early Diagnosis , Sunbathing/standards
9.
Belo Horizonte; s.n; 2019. 154 p. ilus, tab.
Thesis in English, Portuguese | LILACS, BBO | ID: biblio-1049734

ABSTRACT

As lesões fibro-ósseas (LFOs) caracterizam-se pela substituição do osso normal por tecido conjuntivo fibroso e material mineralizado. Displasia fibrosa, fibroma ossificante e displasia cemento-óssea (DCO) compõem este grupo, que além da semelhança histopatológica, pode sobrepor características radiográficas. A correlação de dados clínicos, radiográficos e histopatológicos é necessária para o diagnóstico definitivo. Este trabalho teve como objetivo descrever e avaliar exames odontológicos de imagem de indivíduos diagnosticados com LFOs. Foram desenvolvidos três estudos com metodologias independentes. O primeiro estudo avaliou os efeitos da displasia cemento-óssea em estruturas anatômicas adjacentes por meio de tomografia computadorizada de feixe cônico (TCFC). Foram avaliados 60 casos de DCO, com 244 áreas de lesão envolvendo 426 dentes. A maioria das lesões apresentou aproximadamente 10 mm de diâmetro. Afilamento (n=80) expansão (n=62) e perfuração (n=60) foram os efeitos comuns na cortical óssea. A lâmina dura e o espaço do ligamento periodontal foram descontínuos em todos os dentes. No segundo estudo, 50 radiografias panorâmicas de mulheres com diagnóstico de DCO foram pareadas por idade com 50 radiografias panorâmicas de mulheres sem DCO. Os grupos DCO e não-DCO foram comparados através do índice de espessura da cortical mandibular (ECM), a dimensão fractal (DF) da região de osso trabecular e cortical e o índice cortical mandibular (ICM). O índice de ECM do grupo DCO foi de 3,12 mm (2,15-4,55) e do grupo não-DCO foi 3,52 mm (1,90- 4,70) com diferença estatística entre os grupos (p=0,034). A DF do trabeculado ósseo alveolar normal foi semelhante nos dois grupos, enquanto que menores médias de DF no osso cortical foram encontradas no grupo DCO (p=0,046). A classificação C3 do ICM foi mais comum no grupo DCO (p=0,009). O terceiro foi um estudo preliminar que avaliou a DF em imagens bidimensionais e tridimensionais de TCFC de seis casos de displasia fibrosa e seis de fibroma ossificante. Cortes de reconstrução panorâmica, axial, coronal e sagital foram selecionados em quatro espessuras: 0,25; 5; 15 e 25 mm, e avaliados em 3 formatos de regiões de interesse (RI). Duas metodologias compararam quatro formatos de volumes do interior das lesões. A média de DF das imagens bidimensionais de reconstrução panorâmica e axiais, com 0,25 mm de espessura mostrou diferença significativa entre displasia fibrosa e fibroma ossificante (p<0.05), independente do formato da RI (p>0,05). A média da DF de imagens tridimensionais foi diferente entre os grupos de lesões para a maioria das comparações (p<0.05), independente da metodologia usada. Informações detalhadas sobre a lesão e o envolvimento de estruturas adjacentes podem ser visualizadas em TCFC. Métodos não invasivos como os índices radiomorfométricos e análise fractal podem ser úteis na detecção de baixa densidade mineral óssea, ou mesmo como possível ferramenta de estudo da complexidade de imagens de LFOs.


Fibro-osseous lesions (FOLs) are characterized by the replacement of normal bone with fibrous connective tissue and mineralized material. The group includes the fibrous dysplasia, ossifying fibroma and cemento-osseous dysplasia (COD). These three lesions show similar histopathological and radiographic features. Clinical, radiographic and histopathological data correlation is necessary for the definitive diagnosis. This study aimed to describe and to evaluate dental imaging exams of individuals diagnosed with FOLs. Three studies with independent methodologies were developed. The first study evaluated the effects of COD on the adjacent anatomical structures by means of cone beam computed tomography (CBCT). Sixty cases of COD were evaluated. The assessment of the 60 cases involved 244 lesion areas and 426 teeth. Most lesions presented nearly 10 millimeters (mm) of diameter. Thinning (n=80), expansion (n=62) and perforation (n=60) were common effects on the cortical bone. All 426 teeth presented discontinuation of the lamina dura and of the periodontal ligament space. In the second study, 50 panoramic radiographies of women diagnosed with COD were matched with 50 panoramic radiographies of women without COD according to the individuals' age. Comparisons between groups regarding the mandibular cortical width index (MCW), the fractal dimension (FD) of the region of the trabecular and the cortical bone and the mandibular cortical index (MCI) were carried out. The MCW of the COD group was 3.12 mm (2.15-4.55) and the MCW of the non-COD group was 3.52 mm (1.90-4.70). A significant difference between groups was observed (p=0.034). FD of the normal trabecular alveolar bone was similar in both groups. For the cortical bone, a lower mean FD was observed in the COD group (p=0.046). The MCI C3 was more common in the COD group (p=0.009). The third was a preliminary study, in which the FD was evaluated on twodimensional and three-dimensional CBCT images of six cases of fibrous dysplasia and six cases of ossifying fibroma. Panoramic reconstruction, axial, coronal and sagittal slices were selected in four thicknesses (0.25, 5, 15 and 25 mm) and evaluated in three shapes of regions of interest (ROI). Two methodologies compared four volume formats from inside the lesions. A significant difference between fibrous dysplasia and ossifying fibroma was observed for the mean FD of the twodimensional images of panoramic reconstruction and axial slices with a thickness of 0.25 mm (p<0.05), regardless of the ROI shape (p>0.05). The mean DF of threedimensional images was different between lesion groups for most comparisons (p <0.05), regardless of the methodology used. Detailed information on lesions and involvement of adjacent structures can be viewed in CBCT. Non-invasive methods, such as radiomorphometric indices and fractal analysis may be useful in the detection of low bone mineral density or as a helpful tool for the differentiation of distinct types of FOLs.


Subject(s)
Radiography, Panoramic , Cementoma , Fibroma, Ossifying , Cone-Beam Computed Tomography , Fibrous Dysplasia of Bone , Cancellous Bone , Cortical Bone , Image Processing, Computer-Assisted , Retrospective Studies
10.
Acta cir. bras ; 34(3): e201900301, 2019. tab, graf
Article in English | LILACS | ID: biblio-989070

ABSTRACT

Abstract Purpose: To investigate the effects of dietary restriction on the growth plate and long bone tissue in growing rats. Methods: Sixty male Wistar rats were randomly assigned to two groups: Control (Con) and Diet-restricted (Res). After weaning, the Res rats were offered 50% of the chow ingested by the control (ad libitum food intake). The animals were subdivided into two subgroups with follow-ups up to 56 or 70 days. After euthanasia, the growth plate of tibias was analyzed by histomorphometry, micro-computed tomography, and mechanical test. The trabecular and compact bones were evaluated by histomorphometry, dual-energy X-ray absorptiometry, and micro-computed tomography (μCT). Real-time PCR was used to analyze gene expression. Results: Although dietary restriction did not alter gene expression, several phenotypic changes were seen in the growth plate; i.e., decrease in volume, reduction in total area and height, decrease in the area ossified zones, mechanical weakening, reduction in mass of trabecular and cortical bone, lower bone density, deterioration of the trabecular and cortical microarchitecture, and trabeculae with lower collagen deposition. Conclusion: Dietary restriction had severe detrimental effects on the growth plate and trabecular and cortical bone.


Subject(s)
Animals , Male , Rats , Bone Density/physiology , Malnutrition/complications , Cancellous Bone/growth & development , Cortical Bone/growth & development , Growth Plate/growth & development , Random Allocation , Rats, Wistar , Models, Animal , Malnutrition/physiopathology , X-Ray Microtomography
11.
Clinics ; 74: e829, 2019. tab, graf
Article in English | LILACS | ID: biblio-1001830

ABSTRACT

OBJECTIVE: To test whether swimming training benefits femoral neck strength in young diabetic rats under insulin therapy. METHODS: A total of 60 male Wistar rats (age: 40 days) were divided equally into the following six groups: control sedentary, control exercise, diabetic sedentary, diabetic exercise, diabetic sedentary plus insulin and diabetic exercise plus insulin. Diabetes was induced with a unique intraperitoneal injection (60 mg/kg body weight) of streptozotocin. Seven days after the injection and after 12 hours of fasting, the animals with blood glucose levels ≥300 mg/dL were considered diabetic. Seven days after the induction of diabetes, the animals in the exercise groups were subjected to progressive swimming training (final week: 90 min/day; 5 days/week; 5% load) for eight weeks. The animals in the insulin groups received a daily dose of insulin (2-4 U/day) for the same period. RESULTS: Severe streptozotocin-induced diabetes reduced the structural properties of the femoral neck (trabecular bone volume, trabecular thickness and collagen fiber content). The femoral neck mechanical properties (maximum load and tenacity) were also impaired in the diabetic rats. Insulin therapy partially reversed the damage induced by diabetes on the structural properties of the bone and mitigated the reductions in the mechanical properties of the bone. The combination of therapies further increased the femoral neck trabecular bone volume (∼30%), trabecular thickness (∼24%), collagen type I (∼19%) and type III (∼13%) fiber contents, maximum load (∼25%) and tenacity (∼14%). CONCLUSIONS: Eight weeks of swimming training potentiates the recovery of femoral neck strength in young rats with severe streptozotocin-induced diabetes under insulin therapy.


Subject(s)
Animals , Male , Swimming/physiology , Diabetes Mellitus, Experimental/physiopathology , Diabetes Mellitus, Experimental/drug therapy , Exercise Therapy/methods , Femur Neck/physiopathology , Hypoglycemic Agents/therapeutic use , Insulin/therapeutic use , Physical Conditioning, Animal/physiology , Time Factors , Blood Glucose/analysis , Body Weight/physiology , Reproducibility of Results , Collagen/analysis , Rats, Wistar , Streptozocin , Fractures, Bone/physiopathology , Fractures, Bone/prevention & control , Cancellous Bone/physiopathology
12.
J. oral res. (Impresa) ; 7(9): 426-431, ene. 2, 2018. ilus, tab
Article in English | LILACS | ID: biblio-1121162

ABSTRACT

Introduction: Ostene is a new synthetic bone hemostatic wax-like inert and biocompatible material that dissolves within two days after application. bone wax is a well- known topical hemostatic agent, easy to use, and its application is very simple. wound healing is a complex biological process; bone is a dynamic tissue that is continuously resorbed, renewed, and remodeled. materials and methods: twenty domestic rabbits were divided into four groups (day 1, day 3, day 7, and day 14). each rabbit was anaesthetized and three holes were drilled in the mandible: one was filled with Ostene, another with bone wax, and the other was left unfilled as control. sites of intervention were assessed by histopathology. results and Discussion: Ostene and bone wax showed osteoinductive property in bone healing with no inflammatory reaction. our study revealed new bone formation within 14 days in Ostene group. after histopathological analysis and scoring was finished, analysis by SPSS 14 software showed a significant difference between the use of Ostene and bone wax. conclusion: Ostene showed superiority over bone wax in bone healing, and it can be used in the same way as bone wax with no interference with bone healing and osteogenesis. Ostene has no side effects following application.


Subject(s)
Animals , Rabbits , Waxes/pharmacology , Wound Healing/drug effects , Hemostatics/administration & dosage , Hemostatics/pharmacology , Osteogenesis , Cancellous Bone
13.
Braz. oral res. (Online) ; 32: e21, 2018. tab, graf
Article in English | LILACS | ID: biblio-889464

ABSTRACT

Abstract: The lack of guidelines for bone augmentation procedures might compromise decision making in implantology. The objective of this study was to perform a retrospective study to verify the outcomes of horizontal bone reconstruction in implant dentistry with different types of materials and amounts of native bone in the recipient bed to allow for a new guideline for horizontal bone reconstruction. One hundred preoperative CT scans were retrospectively evaluated and categorized in accordance to horizontal bone defects as presence (Group P) or absence (Group A) of cancellous bone in the recipient bed. Different approaches were used to treat the edentulous ridge and the outcomes were defined either as satisfactory or unsatisfactory regarding the possibility of implant placement. The percentage distribution of the patients according to the presence or absence of cancellous bone was 92% for Group P and 8% for Group A. In Group P, 98% of the patients had satisfactory outcomes, and the use of autografts had 100% of satisfactory outcomes in this group. In Group A, 37.5% of the patients had satisfactory outcomes, and the use of autografts also yielded 100% of satisfactory outcomes. The use of allografts and xenografts in Group A had 0% and 33.3% of satisfactory outcomes, respectively. Therefore, it seems reasonable to speculate that the presence of cancellous bone might be predictive and predictable when the decision includes bone substitutes. In cases of absence of cancellous bone in the recipient bed, the use of a vitalized graft seems to be mandatory.


Subject(s)
Humans , Alveolar Ridge Augmentation/methods , Bone Substitutes/therapeutic use , Bone Transplantation/methods , Mandible/transplantation , Maxilla/transplantation , Alveolar Bone Grafting/methods , Alveolar Bone Loss/surgery , Autografts/transplantation , Bone Regeneration/physiology , Cancellous Bone/surgery , Cone-Beam Computed Tomography , Jaw, Edentulous, Partially/surgery , Patient Satisfaction , Reproducibility of Results , Retrospective Studies , Treatment Outcome
14.
HU rev ; 44(1): 7-13, 2018.
Article in Portuguese | LILACS | ID: biblio-981853

ABSTRACT

Introdução: Diabetes mellitus é uma doença metabólica que afeta vários órgãos-alvo, incluindo os ossos. Objetivo: Avaliar pelo método de esqueletonização o efeito do Diabetes mellitus tipo I (DM1) na microarquitetura de osso esponjoso. Material e métodos: Quatorze ratos Wistar foram divididos em: Saudável (S, n=7) e Diabético (D, n=7). O DM1 foi induzido por meio de injeção endovenosa de estreptozotocina no grupo D, sendo a confirmação da condição realizada por checagem do nível glicêmico. Os animais foram sacrificados após 35 dias da indução no grupo D, juntamente com os do grupo S. As epífises femorais foram seccionadas, removidas, desmineralizadas e incluídas em parafina. Dois cortes (5 µm) foram obtidos, corados em Hematoxilina e Eosina, e analisados ao Microscópio de Luz. Foi realizada a delimitação interativa das trabéculas ósseas, seguido pelo processo de binarização utilizando threshold global, feita por dois operadores distintos. Depois, foi realizado o processo de esqueletonização para acesso às características das trabéculas e da rede de interconexão entre elas. Os parâmetros avaliados foram: Área óssea em micrômetros quadrados (B.Ar, seguido pela proporção em porcentagem BV/TV), Índice de Modelo estrutural (SMI), Dimensão Fractal (FD), Número de trabéculas (Tb.N), Número de ramos (B.N), Número total de junções (Junc.N), Média de pontos terminais (End.p), Média de extensão de cada ramo (R.Le) e Número de junções triplas (Triple.points.N). Resultados: Houve diferença significante apenas no parâmetro SMI para os diferentes operadores (p<0,0001), sendo o mesmo retirado da análise entre diabetes vs saudável. Houve diferença significante na quantidade óssea, sendo maior no grupo S (0,46±0,09) comparado ao grupo D (0,41±0,07) (p=0,0082). Os demais parâmetros não mostraram diferença significante. Conclusão: Conclui-se que a área óssea no grupo saudável é maior em comparação ao DM1. Dentro das limitações deste estudo, parece que a distribuição espacial das trabéculas e suas características de interconexão não são alteradas no diabetes.


Introduction: Diabetes is a metabolic disease that affects several target-organs, including bone. Objective: Analyze the effects of Diabetes Mellitus Type 1 (DM1) on the trabecular bone microarchitecture by using the skeletonization process. Material and methods: Fourteen Wistar rats were divided in two groups: Health (S, n=7) and Diabetic (D, n=7). DM1 was induced with streptozotocin in D group, and glycemic levels were tested on peripheral blood samples. After 35 days, the animals were euthanized and had their femurs removed. The epiphysis were decalcified and embedded in paraffin. Five microns sections were stained in Hematoxylin and Eosin, and analyzed at the light microscope. Bone trabeculae were manually delimited, and then the binarization process with a global threshold was performed for each image. The whole process were conducted by two operators separately. Skeletonization was applied to binary images in order to evaluate the trabeculae characteristics and their network. Bone area (B.Ar), Bone proportion (BV/TV) Strucutre Model Index (SMI), Fractal Dimension (FD), Trabeculae number (Tb.N), Mean branches (B.N), Mean junction points (Junc.N), Mean End-points (End.p), Mean branches length (B.Le), and Mean triple points (Triple.points.N) were evaluated. Results: There was a significant difference only for SMI between different operators (p<0.0001), being this parameter excluded for the evaluation between health and diabetic groups. There was a significant difference between S and D for bone area, with S (0.46±0.09) higher than D (0.41±0.07) (p=0.0082). The other parameters analyzed were not significantly different. Conclusion: Bone trabecular area was higher in health compared with diabetes. Within the limitations of this study, one could suggest that there are no alterations of the spatial distribution of the trabeculae with their network and their inner structural characteristics.


Subject(s)
Animals , Male , Rats , Image Processing, Computer-Assisted/methods , Diabetes Mellitus/pathology , Diabetes Mellitus, Experimental/pathology , Cancellous Bone/ultrastructure , Rats, Wistar
15.
J. appl. oral sci ; 26: e20170004, 2018. tab, graf
Article in English | LILACS, BBO | ID: biblio-893706

ABSTRACT

ABSTRACT Among the many graft materials that have been used for the treatment of bone defects in oral and maxillofacial regions is xenograft. To improve osteoconductive effects of xenografts, they have been combined with various biocompatible materials, such as hyaluronic acid and bone morphogenetic protein. Objective: To determine bone-healing capacity of high molecular weight hyaluronic acid (HA) combined with xenograft in rabbit calvarial bone defects. Material and methods: Ten adult male New Zealand rabbits (mean weight 3 kg) were included in the study. Three 6-mm-diameter bicortical cranial defects were created on calvarial bone of all rabbits. These defects were filled as follows: a) xenograft; b) HA+xenograft; c) autograft. One month after the first operation, rabbits were sacrificed. Specimens were evaluated histomorphometrically. Results: Considering multiple comparisons, differences regarding new bone were statistically significant between all groups (p<0.05). The volume of residual graft was significantly decreased in HA group compared to xenograft group (p=0.035). Marrow space, trabecular thickness (TbTh), trabecular width (TbWi), trabecular separation (TbSp), and number of node: number of terminus (NNd:NTm) in the autograft group were significantly better than xenograft and HA groups (p<0.05). However, regarding marrow space, TbTh, TbWi, TbSp, and NNd:NTm values, xenograft and HA groups showed similar results and the difference were not significant (p>0.05). Conclusion: These results support that high molecular weight hyaluronic acid could contribute to the healing of xenograft by improving the percentage of new bone formation and reducing the percentage of residual graft. However, HA did not significantly affect the quality of newly formed bone assessed by microarchitectural parameters.


Subject(s)
Humans , Animals , Male , Skull/transplantation , Wound Healing/drug effects , Bone Regeneration/drug effects , Heterografts/drug effects , Hyaluronic Acid/pharmacology , Rabbits , Skull/drug effects , Biocompatible Materials/pharmacology , Reproducibility of Results , Bone Transplantation/methods , Treatment Outcome , Disease Models, Animal , Autografts/drug effects , Cancellous Bone/drug effects , Hyaluronic Acid/chemistry , Molecular Weight
16.
Article in Chinese | WPRIM | ID: wpr-776176

ABSTRACT

OBJECTIVE@#To analyze the operative methods and clinical effects of autologous distal tibial cancellous bone graft with periosteum in treating cartilage injury of talus with Hepple III-IV type.@*METHODS@#From June 2014 to August 2017, 25 patients (25 feet) with Hepple III to IV cartilage injury of talus were treated with autogenous ipsilateral distal tibial cancellous bone graft. Including 14 males and 11 females, aged from 18 to 52 years with an average of (38.4±3.1) years; left foot was in 8 cases and right foot was in 17 cases. According to Hepple classification, type III of 9 cases, type IV of 16 cases. The curative effect was assessed by Amercian orthopedic foot and ankle society (AOFAS) and visual analogue scale (VAS) before operation and 12 months after operation.@*RESULTS@#All 25 patients were followed up for 12 to 28 months with an average of (14.2±2.5) months. AOFAS and VAS scores were improved from preoperative 53.02±10.06, 8.02±1.14 to 88.04±7.45, 1.26±1.74 at 12 months after operation (<0.05). According to AOFAS standard, 16 cases got excellent results, 6 good, 3 poor.@*CONCLUSIONS@#Autologous distal tibial cancellous bone graft with periosteum is an effective method for Hepple III-IV cartilage injury of talus. It can effectively relieve ankle pain and improve ankle joint function.


Subject(s)
Adolescent , Adult , Bone Transplantation , Cancellous Bone , Cartilage , Female , Humans , Male , Middle Aged , Periosteum , Talus , Transplantation, Autologous , Treatment Outcome , Young Adult
17.
Int. j. morphol ; 35(3): 1133-1139, Sept. 2017. ilus
Article in English | LILACS | ID: biblio-893105

ABSTRACT

The aim of this study was to quantify the presence of cortical and cancellous bone in the mandibular symphysis. A descriptive study was conducted using cone beam computed tomography where skeletal class I and class III subjects were included, defined according to characteristics detected on dental, clinical and dental occlusion x-rays. From the 3D reconstruction, sections were used in relation to the axial axis of the teeth of the anterior sector; the amount of buccal cortical, cortical, lingual, inferior cortical and cancellous bone as well as symphysis height were determined. The measurements were taken using routine methods and analyzed with ANOVA and Tukey's HSD test with p <0.05 for statistical significance. 20 skeletal class I subjects aged 23 years (± 4.5) and 20 class III subjects aged 22 years (± 5.2) were included. Symphysis height was significantly greater in skeletal class III subjects, exceeding by 0.8 mm the height of class I subjects; the buccal cortical bone presented on average 2 mm less at different dental levels, whereas the lingual cortical and inferior basal bones were significantly larger than the buccal cortical bone. The cancellous and cortical bones did not present any significant differences between the two groups (p=0.093). The buccal and basilar cortical bone is smaller than lingual cortical bone.


El objetivo fue determinar la presencia de hueso cortical y esponjoso en sínfisis mandibular. Se realizó un estudio descriptivo en tomografías computadorizadas cone beam donde se analizaron sujetos clase I y clase III esqueletal definidos según características dentales, clínicas y radiográficas de oclusión dental y características radiográficas. Desde la reconstrucción 3D se utilizaron cortes en relación al eje axial de los dientes del sector anterior; en ellos se determinó la cantidad de hueso cortical bucal, cortical, lingual, cortical inferior, hueso esponjoso y altura de sínfisis. Las mediciones fueron realizadas con métodos de rutina y fueron analizados con la prueba ANOVA y HDS Turkey considerando un valor de p <0.05 para considerar significancia estadística. 20 sujetos clase I esqueletal con 23 años (+ 4.5) y 20 sujetos clase III esqueletal con edad de 23 años (+ 4.5) fueron incluidos. La altura de sínfisis fue significativamente mayor en sujetos de clase III esqueletal, superando por 0.8 mm la altura de sujetos clase I; el hueso cortical bucal presento en promedio menor de 2 mm en diferentes niveles dentarios, mientras que la cortical lingual y basal inferior fueron significativamente mayor que la cortical bucal. El hueso esponjoso y hueso cortical no presentó diferencias significativas entre ambos grupos (p=0.093). La cortical bucal y basilar son menores que el hueso cortical lingual.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Chin/pathology , Cancellous Bone , Cortical Bone , Mandible/pathology , Malocclusion, Angle Class I/pathology , Malocclusion, Angle Class III/pathology
18.
Braz. dent. j ; 28(3): 281-286, May-June 2017. tab, graf
Article in English | LILACS | ID: biblio-888657

ABSTRACT

Abstract The aim of this study was to find the role of TLR2 signaling pathway in reducing osteoclast activity and promoting osteoblast growth by inducing a combination of Aloe vera and cancellous bovine xenograft (XCB) into dental extraction socket. Forty-eight Cavia cobayas were used. They were divided into eight groups (n=6). For control group, their mandibular incisors were extracted and filled with PEG. For treatment groups, they were extracted and filled with XCB, Aloe vera and the combination of Aloe vera and XCB. The first four groups were sacrificed after 7 days and the other groups after 30 days. Immunohistochemistry and histopathology examination were conducted to examine TLR2, TNFa, OPG, collagen-1, and the osteoblast and osteoclast expressions. The expressions of TLR2, OPG and Collagen-1, as well as the number of osteoblast were increased. Meanwhile, the expressions of TNFa and osteoclast were decreased. The study finding was that TLR2 signaling pathway influenced alveolar bone osteogenesis process by reducing osteoclast activity and stimulating osteoblast growth induced by the combination of Aloe vera and XCB.


Resumo O objetivo deste estudo foi investigar o papel da via de sinalização de TLR2 na redução da atividade osteoclástica e na promoção do crescimento de osteoblastos, induzindo uma combinação de Aloe vera e enxerto de osso esponjoso bovino (EOEB) em alvéolo de extração dentária. Quarenta e oito Cavia cobayas foram utilizados e divididos em 8 grupos (n = 6). Para o grupo de controle, seus incisivos mandibulares foram extraídos e preenchidos com polietilenoglicol (PEG). Para grupos de tratamento, os dentes foram extraídos e preenchidos com EOEB, Aloe vera e a combinação de Aloe vera e EOEB. Os primeiros quatro grupos foram sacrificados após 7 dias e os outros grupos após 30 dias. As análises de imunohistoquímica e histopatologia foram realizada para examinar TLR2, TNFa OPG, colágeno-1 e as expressões de osteoblastos e osteoclastos. Houve maior expressão de TLR2, FGF2, OPG e colágeno-1, bem como maior número de osteoblastos. Enquanto isso, a expressão de TNFa e osteoclastos estava diminuída. O principal achado do estudo foi que a via de sinalização de TLR2 influenciou o processo de osteogênese do osso alveolar, reduzindo a atividade dos osteoclastos e estimulando o crescimento de osteoblastos induzido pela combinação de Aloe vera e EOEB.


Subject(s)
Animals , Male , Cattle , Aloe , Alveolar Process/growth & development , Cancellous Bone/transplantation , Osteogenesis , Signal Transduction , Toll-Like Receptor 2/metabolism , Collagen Type I/metabolism , Guinea Pigs , Heterografts , Osteoprotegerin/metabolism , Tooth Socket , Tumor Necrosis Factor-alpha/metabolism
19.
Bauru; s.n; 2017. 89 p. ilus, tab, graf.
Thesis in Portuguese | LILACS, BBO | ID: biblio-883240

ABSTRACT

Os bisfosfonatos (BF) são amplamente utilizados no tratamento de doenças osteolíticas como metástases ósseas e osteoporose. A osteonecrose dos maxilares associada ao uso de BF (OMAB) é caracterizada pela presença de osso exposto ou que pode ser sondado através de uma fístula que persiste por mais de oito semanas em pacientes com história de terapia de BF e sem história de radioterapia na região de cabeça e pescoço e/ou sem doença metastática nos maxilares. A incidência de OMAB aumenta com a potência, duração do tratamento e dose de BF recebida. Até o presente momento, a fisiopatologia da OMAB não está clara, dificultando a prevenção e o tratamento. O objetivo deste estudo foi avaliar o efeito da administração de altas doses Ácido Zoledrônico (AZ) por período prolongado no osso esponjoso da mandíbula e da metáfise proximal do fêmur de ratos Wistar. Para relacionar as descobertas à fisiopatologia da OMAB, o regime de administração de BF de um modelo animal relevante desta lesão foi reproduzido. Seis animais receberam AZ (0,6 mg / kg) e seis receberam solução salina no mesmo volume (Controles). Os compostos foram administrados por via intraperitoneal em cinco doses a cada 28 dias. A eutanásia dos animais ocorreu após 150 dias de início da terapia. As hemimandíbulas e fêmures direitos foram escaneados usando Micro-tomografia computadorizada (Micro-CT) de alta resolução (14 m). Para a primeira análise realizada neste estudo, os dados morfométricos do osso esponjoso foram calculados na região do segundo e primeiro molar na mandíbula e na metáfise do fêmur usando CTAnalyzer (Bruker, Bélgica). Para a segunda análise, cinco amostras de hemimandíbulas de cada grupo foram cortadas em lâminas histológicas (5 m) e coradas com Hematoxilina e Eosina. Para comparar os parâmetros morfométricos na Micro-CT e histologia, as imagens de Micro-CT foram espacialmente alinhadas à histologia. Os dados morfométricos do osso alveolar foram calculados usando o software CTAnalyzer (Bruker, Bélgica) na região entre as raízes mesial e distal do primeiro molar. A densidade da área vascular (área vascular/área total; VA/TA) e os dados histomorfométricos ósseos foram estimados usando Axiovision na mesma região (entre as raízes mesial e distal do primeiro molar). Foi adotada significância estatística de 5% ( = 0,05). Os animais tratados com AZ apresentaram aumento significativo na porcentagem de volume ósseo (p <0,05) com trabéculas mais espessas, osso mais compacto com menor separação trabecular na mandíbula e no fêmur. Na mandíbula, o aumento da densidade óssea e diminuição da separação trabecular foram fortemente correlacionados com a diminuição da área vascular observada no grupo AZ (p <0,05). Em conclusão, o tratamento de longa duração com altas doses de AZ foi significativamente associado ao aumento na densidade óssea e à diminuição dos espaços medulares, canais nutritivos e vasculatura do osso alveolar. A análise com Micro-CT revelou alterações semelhantes na estrutura óssea tanto na mandíbula quanto no fêmur do grupo AZ.(AU)


Bisphosphonates (BFs) are widely used in the treatment of osteolytic diseases such as bone metastases and osteoporosis. The osteonecrosis of the jaws related to BF (ONB) is characterized by the presence of exposed bone or bone that can be probed through a fistula that persists for more than eight weeks in patients with a history of BF therapy and without history of head and neck radiotherapy and / or without metastatic disease in the jaws. The incidence of ONB increases with potency, duration of treatment and dose of BF received. Thus far, the pathophysiology of ONB is unclear, hampering prevention and treatment. The aim of this study was to objectively assess the effect of long-term high-dose Zoledronic Acid (ZA) on cancellous bone in the jaw and femur of Wistar rats. In order to link our findings to the physiopathology of ONB, the therapeutic regiment of a relevant ONB animal model was reproduced. Twelve Wistar rats were randomly divided in two groups: six received Zoledronic acid (ZA; 0.6 mg / kg) and six (Controls) received saline solution in the same volume. The compounds were administrated intraperitoneally in five doses each 28 days. The rats were killed after 150 days of the therapy onset. Mandibles and femurs were scanned using a high-resolution (14m) micro-computerized tomography (Micro-CT). For the first analysis carried in this study, cancellous bone morphometric data were calculates in the region of the second and first molar in the mandible and in the proximal femur using CTAnalyzer (Bruker, Belgium). For the second analysis five samples were cut into histological slices (5m) and stained with Hematoxylin and Eosin. In order to compare the same morphological structures in Micro-CT and histology, the Micro-CT images were aligned to histology. Alveolar bone morphometric data (Micro-CT) was calculated using CTAnalyzer (Bruker, Belgium) in the region between the mesial and distal roots of the first molar. Blood vessels density and bone histomorphometric data were calculated using Axiovision (Carl Zeiss, Germany) in the same region used for Micro-CT evaluation. Statistical significance of 5% (=0.05) was adopted. ZA treated rats presented significant increase in the percentage of bone volume (p<0.05) with thicker trabeculae and more compact bone with smaller marrow spaces in the mandible and femur. In the mandible, the increase in bone density and decrease of marrow spaces size was strongly correlated with the decrease in the vascular area noticed in the ZA group (p<0.05). In conclusion, long-term high-dose ZA treatment was significant associated with the increase of bone density and the diminution of medullary spaces and nutritive canals size as well as decrease in vascularity of the alveolar bone. Micro-CT investigation showed similar changes in bone structure in the mandible and femur in the ZA group.(AU)


Subject(s)
Animals , Rats , Bisphosphonate-Associated Osteonecrosis of the Jaw/drug therapy , Bone Density Conservation Agents/administration & dosage , Cancellous Bone/drug effects , Diphosphonates/administration & dosage , Femur/drug effects , Imidazoles/administration & dosage , Mandibular Diseases/drug therapy , Bisphosphonate-Associated Osteonecrosis of the Jaw/physiopathology , Bone Density , Random Allocation , Rats, Wistar , Reproducibility of Results , Time Factors , Treatment Outcome , X-Ray Microtomography
20.
Smile Dental Journal. 2017; 12 (2): 32-32
in English | IMEMR | ID: emr-189661

ABSTRACT

Purpose: The aim of this study was to evaluate volumetric and clinical outcomes of atrophic posterior mandibles treated with inlay or onlay bone grafting techniques


Materials And Methods: In posterior mandibles, alveolar ridges were treated either with interpositional equine cancellous bone block [inlay group] or with onlay autogenous bone block [onlay group]. Bone volumes at baseline and at 4 months after surgery were measured by computed tomography


Results: A total of 20 subjects were enrolled in the present study: 10 in the inlay group and 10 in the onlay group. After surgery, atrophic posterior mandibles showed a mean vertical augmentation height of 6.0 mm in the inlay group and 7.4 mm in the onlay group. No significant differences were recorded between the two groups regarding volume loss of the grafted bone or decrease in vertical bone height of the augmented site [29% and 1.9 mm for the onlay group, and 35% and 1.7 mm for the inlay group] during healing. Two complications [1 wound dehiscence and 1 mandibular fracture] occurred postoperatively in the inlay group; on the other hand, the onlay group had three complications [wound dehiscence]. A total of 80 dental implants were placed in augmented areas: 46 in the inlay group with a peri-implant marginal bone loss of 0.8 mm, and 34 in the onlay group with a peri-implant marginal bone loss of 1.3 mm [p = 0.0006]


Conclusions: Inlay xenogeneic grafts showed volumetric bone remodeling similar to that recorded for onlay autogenous bone. The success of the autogenous onlay blocks [82.4%] appeared to be lower than that registered for the inlay group [93.8%], but the difference was not significant


Subject(s)
Humans , Retrospective Studies , Bone Transplantation , Atrophy , Tooth , Cancellous Bone , Dental Implants , Inlays
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