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Objective To investigate the early clinical efficacy of bone cement modified with mineralized collagen in the treatment of osteoporotic vertebral compression fractures with percutaneous vertebroplasty(PVP). Methods All 98 cases of sin?gle vertebral osteoporotic compression fracture from June 2017 to August 2018 were studied. Forty?eight cases were treated with bone cement modified with mineralized collagen (modified group) and 50 cases were treated with traditional bone cement (traditional group). The basic clinical information including age, sex and bone mineral density of all patients were analyzed. The injectable time, volume, distribution (bone cement in the vertebra showing a whole mass without interruption or loss is known as type O while bone cement in the vertebra showing two masses with a small amount or none in the middle is known as type H) and leakage of bone cement during operation, visual analogue score(VAS), Oswestry disability index (ODI), height of anterior, middle and posterior columns of injured vertebrae and the incidence of adjacent vertebral fractures were compared between the two groups. Results There were no significant differences in age, sex, bone mineral density T value and bone ce?ment injection volume between the two groups. VSA score, ODI, anterior and middle column heights were significantly improved on the first day and 6 months after operation (P<0.05), but there was no significant difference between the two groups (P>0.05). In?traoperative cement injectable time was shorter in the traditional group than the modified group,and there was significant different between the two groups (t=3.428, P=0.002). The incidence of adjacent vertebral re?fracture was 12% in the traditional group and 2% in the modified group. There was significant different between the two groups (χ2=7.061, P=0.029). The leakage rate of bone cement was 10% in the traditional group and 6% in the modified group, andthere was significant difference between the two groups (χ2=7.963, P=0.019). The distribution of bone cement (O/H) in the traditional group was 20/30 and that in the modified group was 19/29, and there was significant difference between the two groups (χ2=38.992, P<0.001). Conclusion Modified bone cement has the same clinical effect as traditional bone cement in relieving pain and restoring the height of injured vertebra in the treat?ment of osteoporotic vertebral compression fractures with PVP. However, the injectable time of modified bone cement is longer. The leakage rate and the incidence of re?fracture of adjacent vertebrae are significantly reduced.
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Objective@#To investigate the early clinical efficacy of bone cement modified with mineralized collagen in the treatment of osteoporotic vertebral compression fractures with percutaneous vertebroplasty(PVP).@*Methods@#All 98 cases of sin-gle vertebral osteoporotic compression fracture from June 2017 to August 2018 were studied. Forty-eight cases were treated with bone cement modified with mineralized collagen (modified group) and 50 cases were treated with traditional bone cement (traditional group). The basic clinical information including age, sex and bone mineral density of all patients were analyzed. The injectable time, volume, distribution (bone cement in the vertebra showing a whole mass without interruption or loss is known as type O while bone cement in the vertebra showing two masses with a small amount or none in the middle is known as type H) and leakage of bone cement during operation, visual analogue score(VAS), Oswestry disability index (ODI), height of anterior, middle and posterior columns of injured vertebrae and the incidence of adjacent vertebral fractures were compared between the two groups.@*Results@#There were no significant differences in age, sex, bone mineral density T value and bone ce-ment injection volume between the two groups. VSA score, ODI, anterior and middle column heights were significantly improved on the first day and 6 months after operation (P<0.05), but there was no significant difference between the two groups (P>0.05). In-traoperative cement injectable time was shorter in the traditional group than the modified group,and there was significant different between the two groups (t=3.428, P=0.002). The incidence of adjacent vertebral re-fracture was 12% in the traditional group and 2% in the modified group. There was significant different between the two groups (χ2=7.061, P=0.029). The leakage rate of bone cement was 10% in the traditional group and 6% in the modified group, andthere was significant difference between the two groups (χ2=7.963, P=0.019). The distribution of bone cement (O/H) in the traditional group was 20/30 and that in the modified group was 19/29, and there was significant difference between the two groups (χ2=38.992, P<0.001).@*Conclusion@#Modified bone cement has the same clinical effect as traditional bone cement in relieving pain and restoring the height of injured vertebra in the treat-ment of osteoporotic vertebral compression fractures with PVP. However, the injectable time of modified bone cement is longer. The leakage rate and the incidence of re-fracture of adjacent vertebrae are significantly reduced.
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BACKGROUND:Hydrophilic acrylic materials with good biocompatibility have been widely used in clinic. However, there are some problems about the biocompatibility and safety of hydrophilic acrylic intraocular lens after long-term clinical application. OBJECTIVE:To discuss the biocompatibility and stability issues and corresponding processing methods after hydrophilic acrylic intraocular lens implantation. METHODS:A computer-based search of Wanfang and PubMed database was performed for articles related to clinical application of hydrophilic acrylic intraocular lens published from 2005 to 2014. The keywords were “hydrophilic acrylic,intraocular lens” in Chinese and English, respectively. A total of 618 articles were initialy retrieved, and finaly 35 articles were included in result analysis. RESULTS AND CONCLUSION:As the hydrophilic acrylic intraocular lens is foldable, a smal incision is required for implantation and the operation is simple that cause less damage to the patients. In addition, the hydrophilic acrylic intraocular lens has poor bacterial and inflammatory cel adhesion, which leads to a low probability of infective endophthalmitis after implantation. But there is a high incidence of posterior capsule opacification as wel as some refractive errors and visual quality problems after implantation. Taken together, to solve these problems depends on the continuous improvements and updates of intraocular lens materials and designs.
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BACKGROUND:Percutaneous vertebroplasty with bone cement injection for osteoporotic vertebral compression fractures can quickly relieve pain and increase vertebral strength, but vertebral re-fractures often occur because of osteoporosis. OBJECTIVE:To investigate the therapeutic effect of percutaneous vertebroplasty with bone cement injection combined with zoledronic acid in the treatment of osteoporotic vertebral compression fractures. METHODS:Six patients with osteoporotic vertebral compression fractures were enrol ed, including two males and four females, aged 60-86 years. These patients with T12-L4 vertebral fractures underwent percutaneous vertebroplasty with polymethyl methacrylate acrylate bone cement treatment. At 4 weeks after bone cement injection, al patients were administrated with intravenous injection of zoledronic acid (100 mL:5 mg) as anti-osteoporosis treatment, 30 drops per minute, once a year, for consecutive 2 years. The 2-year periodic imaging was performed to observe the clinical efficacy on vertebral compression fractures, bone density and adjacent vertebral fractures. RESULTS AND CONCLUSION:At 48 hours after bone cement injection, pain symptoms were relieved in the six cases. At the end of 2-year fol ow-up, fractures healed in al the six cases without delayed union or nonunion, and there was no bone cement leakage, nerve root compression, dural involvement, needle opening or wound infection and pulmonary embolism;the bone density was significantly higher than that before treatment (P<0.05), and no adjacent vertebral fractures occurred. These findings indicate that the percutaneous vertebroplasty with bone cement injection combined with zoledronic acid can significantly relieve pain, improve vertebral stability and bone density, and reduce the incidence of adjacent vertebral fractures in patients with osteoporotic vertebral compression fractures.
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BACKGROUND:By using the bone filing mesh container, a smal amount of bone cement can be penetrated to the trabecular space to form a microscopic twist, thereby strengthening the vertebral body. But there is no report about bone filing mesh container for treatment of osteoporotic vertebral compression fractures. OBJECTIVE:To compare the vertebral uplift and cement leakage of bone filing mesh container, percutaneous vertebroplasty and percutaneous kyphoplasty for the treatment of wedge-shaped osteoporotic vertebral compression fractures. METHODS:Ninety patients with wedge-shaped osteoporotic vertebral compression fractures were randomly divided into three groups. Polymethylmethyl acrylic bone cement type II was perfused into these three groups by bone filing mesh container, percutaneous vertebroplasty and percutaneous kyphoplasty, respectively. Bone cement type, vertebral uplift, leakage rate, visual analogue scale score, Oswestry disability index and Cobb’s angle were calculated and compared among the three groups. RESULTS AND CONCLUSION:The operation was successful in al patients. The success rate of puncture was 100%. There were 2 cases of bone cement leakage for percutaneous vertebroplasty and one case for percutaneous kyphoplasty. The vertebral uplift, visual analog scale score, Oswestry disability index and Cobb’s angle were improved significantly in the three groups after treatment (P 0.05). No difference in pain relief and action recovery was found among the three groups. These findings demonstrate that the bone filing mesh container with polymethylmethyl acrylic bone cement for treatment of osteoporotic vertebral compression fractures can have a promising result in relieving the pain, lifting the injured vertebral height, and the correction of kyphosis, which can also reduce the leakage rate of bone cement.
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BACKGROUND:The hardened acrylic resin bone cement composite after implantation into human body can resist an intensity of 78-93 MPa. But a large amount of heat energy is released by bone cement during the process of solidification and it wil kil normal cel s, leading to peripheral tissue necrosis. OBJECTIVE:To investigate the characteristics of induced knee joint osteoarthritis after application of acrylic resin bone cement composite as a bone substitute for subchondral bone. METHODS:Thirty male Japanese big ear rabbits were randomly and equal y divided into four experimental groups (A, B, C, D) and a blank control group. After removal of subchondral bone on the right medial tibial plateau, polymethyl methacrylate powder/hydroxyapatite composite materials were implanted in rabbits in the experimental groups A, B, C, and D. Rabbits in the blank control group were only subjected to exposure of periosteum on the left medial tibial plateau. At 3, 6, 9 and 12 weeks after removal of subchondral bone, rabbits in the experimental groups A, B, C and D were sacrificed, and subchondral bone specimens were taken for hematoxylin-eosin staining and matrix metal oproteinase expression analysis. At the same time, interleukin-1βand tumor necrosis factor-ɑ levels in the synovial fluid were determined. RESULTS AND CONCLUSION:Mankin score in the experimental group C was significantly higher than in the blank control group and experimental group A (P<0.05). Mankin score in the experimental group D was significantly higher than in the experimental group B (P<0.05). The gray scale of matrix metal oproteinase-1 was highest in the blank control group, fol owed by experimental groups A, B, C, and the last in the experimental group D (P<0.05). Interleukin-1β and tumor necrosis factor-ɑ levels in the synovial fluid were highest in the experimental group D, fol owed by experimental groups C, B, A and the last in the blank control group (P<0.05). These findings suggest that acrylic resin bone cement composite as a bone substitute for subchondral bone induces knee joint osteoarthritis and leads to increases in matrix metal oproteinase-1 and tumor necrosis factor-ɑ levels in the synovial fluid.
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BACKGROUND:Percutaneous kyphoplasty for the treatment of vertebral compression fractures has gained good clinical results and it is characterized as smal trauma, less bleeding and very low rate of complications. The vast majority of elderly patients can tolerate it, but this method cannot prevent fracture replase in the elderly. OBJECTIVE:To evaluate clinical outcomes of percutaneous kyphoplasty combined with anti-osteoporosis drug for the treatment of acute osteoporotic vertebral compression fractures METHODS:According to strict inclusion and exclusion criteria, 137 patients, including 26 males and 111 females, mean age of (75.55±6.96) years, with a total of 198 acute osteoporotic vertebral compression fractures treated by kyphoplasty that involves injection of polymethyl methacrylate cement under radiologic control into a treated vertebral body were conducted in this study. Al patients were asked to take anti-osteoporosis drugs for 3 post-treatment months. The primary outcomes were visual analogue scale, ertebral restoring rate, Oswestry disability index, Cobb angle at different time (pre-operation, 1 week and 3 months after operation). In addition, the rate of complications and the replase rate of vertebral compression fractures after operation were recorded. RESULTS AND CONCLUSION:There were significant differences in the mean visual analog scale scores, vertebral restoring rate, Oswestry disability index, Cobb angle at pre-procedure and post-procedure (at 1 week and 3 months) (P<0.001). In addition, the rate of postoperative complications was 0.7%and there were no vertebral compression fractures during 3-month fol ow-up period. Our study suggests that percutaneous kyphoplasty combined with anti-osteoporosis drug for the treatment of acute osteoporotic vertebral compression fractures can gain good clinical results.
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Objective To explore the effects of polymethylmethacrylate(PMMA)-induced autophagy osteoclasts on bone disso-lution animal models ,and study the mechanism of PMMA particle-induced pyrophosphate osteolysis .Methods 30 8-week-old BALB / c mice were randomly divided into two groups ,sterile air with back injection on mice to form airbag and homologous skulls were implanted into experimental group mice were injected with PMMA particles ,the control group were injected with physiological saline .After 14 d ,the mice were killed ,osteoclast activation related gene (RANK / RANKL ) and autophagy morphological exami-nation of the the airbags tissue and the skull were detect .Results The tartrate-resistant enzyme staining (TRAP)-positive osteo-clasts(21 .31 ± 6 .32)s of experiment group is significantly higher than that of the control group (7 .45 ± 3 .23) ,immunohisto-chemistry showed that autophytic protein microtubule-associated protein 1 light chain 3(LC3) and Beclin 1 antibody staining score level in experimental group was significantly higher than that of control group .RT-PCR showed that the RANK mRNA level(1 .35 ± 0 .05) of experimental group was significantly increased(P< 0 .05) .Conclusion The autophagy induce by PMMA is involved in the formation of osteolysis .
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Objective To evaluate biomechanical effect of bone cement distribution on lumbar vertebral body with osteoporotic fracture.Methods Forty nine lumbar vertebrae (L1-L5) specimens were collected from 12 old cadavers.After exerting axial pressure load on every specimen,the initial intensity and stiffness were measured,and then vertebral body crush fracture models were established.According to zones where bone cement was injected in vertebrae,the specimens were divided into one control group and six experimental groups:A,B,C,D,E,F groups,i.e.unilateral anterior 2/3 group,unilateral posterior 2/3 group,unilateral whole group,bilateral anterior 2/3 group,bilateral posterior 2/3 group,and bilateral whole group,respectively,including 7 specimens in each group.In A,B,C groups,unipedicular balloon kyphoplasty was done,while in D,E,F groups,bipedicular balloon kyphoplasty was done.Then the maximum compressive strength and stiffness were measured.Results After percutaneous kyphoplasty,the maximum strength in all experimental groups was significantly greater than that in the control group.There were no significant differences in strength between A and B groups,between C,D and E groups.For the maximum strength,the results of comparison were:F group ＞ C group,D and C groups ＞ A and B groups.Except for F group,the stiffness in other 5 experimental groups was significantly lower than its initial value.There were no significant differences in stiffness between A,B,and C groups,between D and E groups.However,the stiffness in F group was greater than those in D and E groups,and it was greater in bilateral groups than those in unilateral groups.Conclusion Bone cement distribution in lumbar vertebral body can affect biomechanical property of vertebral body,and the bilateral distribution can cause better biomechanical effect than unilateral distribution.The ideal distribution zone of bone cement is in the anterior 2/3 of the vertebral body.
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STATEMENT OF THE PROBLEM: The cold-cured resins used in fabrication of the provisional crown and fixed partial dentures could cause pulpal damage by heat generated during exothermic polymerization reactions. PURPOSE: In this in vitro study investigates the how external conditions such as material of the matrix, thickness of the matrix and thickness of dentin affect the temperature of the tooth during polymerization reaction of the cold-cured resins. MATERIAL AND METHODS: To measure the temperature of the resin, metal die was maintained to the temperature of 37 degrees C with water bath to simulate the temperature of thetooth and thermocouple was placed in the center of the metal die. Acrylic pipe was cut in height of 1, 2, 3, 6, 10 mm and placed on the metal die and mixed resin was pored in the acrylic pipe. As the resin polymerized temperature was recorded with the thermometer. Temperature of the resin using matrix was recorded by using the individual tray relieved in different thickness 2, 5, 7, 10 mm. The material of the matrix was irreversible hydrocolloid impression material, vinyl polysilloxane impression material and vacuum-formed template. Temperature rise of the resin using different thickness of tooth section was recorded by placing tooth section on the metal die and placing resin over the tooth section. RESULTS: [Table]. CONCLUSION: 1. Temperature rise increased as the thickness of the resin increased but there was no significant differences over 3 mm thickness of the resin. 2. The lowest temperature rise was showed in irreversible hydrocolloid impression material and vinyl polysilloxane impression material, vacuum-formed template as in orders. 3. Temperature rise of the resin decreased regardless of the thickness of the matrix when vinyl polysilloxane impression material was used as the matrix. 4. When irreversible hydrocolloid impressionmaterial was used as matrix, the temperature rise of the resin decreased as the thickness of the matrix increased and there was no temperature rise when thickness of the matrix reached 10 mm. 5. The temperature rise of the resin did not decreased when Polypropylene vacuum-formed template was used as the matrix. 6. The temperature of the resin increased as the thickness of the dentin decreased.