Reabsorción radicular en premolares, posterior a ortodoncia de autoligado, utilizando tomografía computarizada

Este Estudio tuvo por objetivo determinar la incidencia de reabsorción radicular externa en premolares superiores e inferiores permanentes al finalizar el tratamiento de ortodoncia. Esta investigación fue realizada en pacientes entre 18 y 35 años que recibieron tratamiento de ortodoncia, sin extracciones, con técnica de autoligado en la ciudad de Guadalajara. Se consideraron 120 premolares, realizando mediciones longitudinales en las tomografías computarizadas de haz cónico al inicio y término del tratamiento. Utilizando el software Implant Viewer 3. Los valores registrados en el primer y segundo premolar superior tanto del lado derecho como izquierdo al inicio y término del tratamiento fluctuaron entre -4.946 y -7.801; p ≤ 0.0005 encontrándose diferencias estadísticas significativas. Mientras que en el primer y segundo premolar inferior tanto del lado derecho como izquierdo, fluctuaron entre -4.864 y -5.28; p ≤ 0.0005 encontrándose diferencias estadísticas significativas. Se concluye en este estudio que los dientes sometidos a movimientos durante el tratamiento de ortodoncia sufren modificaciones en el contorno de la raíz, cambios con consecuencias mínimas que no comprometen la funcionalidad del diente. Los premolares superiores presentaron mayores rangos de reabsorción radicular que los premolares inferiores.

The aim of this study is to determine the incidence of root resorption in permanent upper and lower premolars at the end of an orthodontic treatment. This research was carried out in patients aged between 18 and 35 years old who received orthodontic treatment, without extractions, with a self-ligating technique in the city of Guadalajara, Mexico. In this study, 120 premolars were considered, making longitudinal measurements with cone beam computed tomography at the beginning and the end of the treatment, using the Implant Viewer 3 software. The values recorded in the upper first and second premolars on both the right and left sides at the beginning and the end of the treatment fluctuated between -4.946 and -7.801; p ≤ 0.0005, finding statistically significant differences. In the lower first and second premolars on both the right and left sides, they fluctuated between -4.864 and -5.28; p ≤ 0.0005, also finding statistically significant differences. It is concluded that teeth subjected to movements during orthodontic treatment suffer modifications in the contour of the root, changes with minimal consequences that do not compromise their functionality. The upper premolars showed higher ranges of root resorption than the lower premolars.

Características clínicas y radiográficas de reabsorciones radiculares externas / Clinical and radiographic characterization of external root resorption

Introducción La siguiente revisión bibliográfica se realizó con el propósito de reconocer las características clínicas y radiográficas que deben ser evaluadas para el diagnóstico de las reabsorciones radiculares externas incluyendo también sus tratamientos. Metodología Se llevó a cabo una búsqueda en las bases de datos MEDLINE/PubMed, Cochrane Library y Google Scholar bajo el término , incluyendo estudios experimentales y revisiones bibliográficas desde 2010 a 2022 en español e inglés, incluyendo finalmente 17 artículos. Resultados Los resultados obtenidos señalaron que cada tipo de reabsorción radicular externa presenta características clínicas específicas que las diferencian. Estas diferencias son: para la reabsorción externa inflamatoria la vitalidad pulpar negativa; para la reabsorción externa de reemplazo la ausencia de movilidad y percusión metálica; para la reabsorción externa cervical una coloración rosada de la corona; la reabsorción externa superficial no presenta ningún tipo de sintomatología clínica y la reabsorción de colapso apical transitorio presenta un cambio de coloración transitorio. Conclusión Las reabsorciones radiculares externas requieren un diagnóstico preciso y temprano. Se debe realizar un examen clínico con énfasis en sondaje, coloración, movilidad y pruebas de vitalidad.

Introduction The following bibliographic review was carried out with the purpose of recognizing the clinical and radiographic characteristics that must be considered in the diagnosis of external root resorption, including treatments. Methods A bibliographic search was carried out in PubMed/Medline, Cochrane Library and Google Scholar databases under the term "external root resorption", from 2010 to 2022 in Spanish and English. Experimental studies and bibliographic reviews were selected, and finally 17 articles were included. Results The results obtained indicated that each type of resorption presents specific clinical characteristics that differentiate them, these are: for external inflammatory resorption a negative pulp vitality; for replacement external resorption the absence of mobility and metallic percussion; for cervical external resorption a pink coloration of the crown; superficial external resorption does not present any type of clinical symptoms and transient apical collapse presents a transient change in color. Conclusion External root resorptions require accurate and early diagnosis. A clinical examination should be performed with emphasis on the following: probing, coloration, mobility, and vitality tests.

Research progress on invasive cervical resorption / 口腔疾病防治

@#Tooth absorption can be divided into physiological absorption and pathological absorption. Root absorption of mature deciduous teeth is physiological absorption. Pathological absorption includes internal absorption and external absorption. Internal absorption, also known as intramedullary absorption, includes inflammatory absorption and alternative absorption. External tooth absorption originates from the outer surface of the root or the neck of the tooth and can be divided into inflammatory absorption, alternative absorption, pressure resorption and invasive cervical resorption. Invasive cervical resorption (ICR) is pathological damage caused by many factors, which usually begins in the cemento-enamel junction and extends peripherally or horizontally in the dentin. It hardly invades the pulp. Orthodontic devices, trauma, bleaching, systemic diseases, and the use of certain medications can all lead to invasive cervical resorption. The clinical manifestations of ICR are usually asymptomatic or not obvious, and most of which are found in imaging examinations. Because caries and internal absorption are often misdiagnosed through plain apical radiography, cone beam computed tomography (CBCT) can help to better understand the situation of invasive cervical resorption. Because the pathogenesis and etiology of invasive cervical resorption are not fully understood, clinical negligence and inadequate treatment of invasive cervical resorption can even cause unnecessary tooth loss. This article reviews the latest research progress on the histopathologic features, pathogenic mechanism, susceptibility factors, diagnosis and treatment of ICR, with special emphasis on susceptibility factors and their mechanisms.

Research progress on applications and mechanisms of osteogenesis effect of magnetic fields in oral field / 口腔疾病防治

@#Magnetic fields are safe and used in noninvasive physical therapies. Numerous studies have confirmed that magnetic fields have good osteogenic effects and certain value for clinical application in accelerating orthodontic tooth movement, promoting bone-implant integration, promoting fracture healing and improving the effects of distraction osteogenesis. Magnetic fields are expected to become applied as effective auxiliary methods for treating oral diseases. To support the clinical application of magnetic fields, this article reviews the applications of magnetic fields in the oral cavity, the biological effects on bone cells and the molecular mechanisms through which magnetic fields regulate bone metabolism. The biological effects of magnetic fields on bone cells include promoting osteogenesis by osteoblasts and mesenchymal stem cells and inhibiting bone resorption by osteoclasts. At the molecular level, bone cells sense and respond to magnetic stimulation, and through various mechanisms, such as displacement currents, Lorentz forces, and free radical pair effects, stimuli are transformed into biologically recognizable electrical signals that activate complex downstream signaling pathways, such as the P2 purinergic receptor signaling pathway, adenosine receptor signaling pathway, transforming growth factor-β receptor signaling pathway, mammalian target of rapamycin (mTOR) pathway, and Notch pathway. In addition, magnetic parameters, which are the factors affecting the osteogenic effects of magnetic fields, are discussed. However, the mechanisms of the osteogenic effects of magnetic fields are unclear, and further studies of these mechanisms could provide effective strategies for bone regeneration and periodontal tissue regeneration. In addition, considering the target of magnetic field therapies, combination with other drugs could lead to new strategies for the treatment of oral diseases.

Partial extraction therapies (PET): a review of the literature / Terapias de extração parcial (TEP): uma revisão da literatura

ABSTRACT One of the most common dental procedures is tooth extraction; however, the bone defect resulting from the process is only partially restored, leading to considerable bone loss. To rehabilitate a fully or partially edentulous patient, we must handle these sites with delicate surgical procedures. There is a large literature presenting attempts to overcome the negative effects of a dental extraction, with the aim of reducing tissue volume loss or restoring the alveolar architecture. In this context, Partial Extraction Therapy (PET) represents a subgroup of interventions to prevent bone loss after extraction using the tooth itself to prevent alveolar bone loss. This literature review aims to make a survey of the published articles on PET, with an emphasis on socket shield technique, and to explain the other techniques such as root burial, pontic-shield and proximal socket-shield, their indications and counter indications in order to deepen the knowledge of these techniques. To identify the included or considered studies, we adopted a detailed search strategy for MEDLINE and Cochrane Library focused in the last 31 years, whose language was English, Spanish or Portuguese. This text presents an analysis of current data regarding the alternatives for alveolar preservation and the installation of immediate implants in these areas, presenting the possibility of a different surgical technique. However, due to the immaturity and lack of conclusive scientific evidence regarding the predictability of the procedures, it is considered that the use of the socket shield technique must be done in an extremely cautious way.

RESUMO Um dos procedimentos odontológicos mais comuns é a extração dentária, contudo, , o defeito ósseo decorrente do processo é apenas parcialmente restaurado, levando a uma perda ossea volumétrica consideravel. Para reabilitar um paciente totalmente ou parcialmente desdentado, devemos manusear estes sitios com intervenções cirúrgicas delicadas. Há uma vasta literatura apresentando tentativas de transpor os efeitos negativos de uma extração dentária, com o objetivo de diminuir a perda volumétrica tecidual ou restaurar a arquitetura alveolar. Neste contexto, a Terapia de Extração Parcial (TEP) representa um subgrupo de intervenções para prevenir a perda óssea após exodontia, usando o próprio dente para prevenir a perda óssea alveolar. Essa revisão de literatura tem por objetivo fazer um levantamento dos artigos publicados sobre as TEP, com ênfase na técnica de socket shield, e explanar a cerca das demais técnicas como sepultamento radicular, pontic-shield e proximal socket-shield, suas indicações e contra-indicações, a fim de aprofundar o conhecimento dessas técnicas. Para a identificação dos estudos inclui?dos ou considerados, adotamos a estrate?gia de busca detalhada para os bancos MEDLINE e Biblioteca Cochrane nos u?ltimos 31 anos, cujo idioma fosse o ingle?s, espanhol ou o portugue?s. Este texto, apresenta uma análise de dados atuais a respeito das alternativas para a preservação alveolar e instalação de implantes imediatos nestas áreas, apresentando a possibilidade de uma técnica cirúrgica diferenciada. No entanto, devido a imaturidade e falta de comprovação cientifica contundente a respeito da previsibilidade dos procedimentos, considera-se que o emprego da técnica de socket shield deve ser feito de forma cautelosa.

Reporte de caso: reabsorción cervical externa / Case report: external cervical resorption

La reabsorción cervical externa es una patología poco frecuente y difícil de detectar, lo que complica el diagnóstico y pronóstico. El proceso destructivo provoca pérdida progresiva de tejido, comenzando en la superficie radicular y avanzando hacia la pulpa. Este tipo de reabsorción ocurre principalmente en la región cervical de la raíz dental pudiendo confundirse con lesión de caries radicular. El objetivo del reporte de caso es ilustrar al equipo de salud la existencia de esta condición y destacar la importancia del diagnóstico temprano y diferencial para evitar llegar a la pérdida del diente afectado.

External cervical resorption is a rare and difficult-to-detect condition, which complicates diagnosis and prognosis. The destructive process causes progressive loss of tissue, starting at the root surface and advancing towards the pulp. This type of resorption primarily occurs in the cervical region of the dental root and can be confused with root caries. The case report aims to inform the healthcare team about the presence of this condition and emphasizes the significance of early and differential diagnosis to prevent the loss of the affected tooth.

Abordagem de incisivos centrais superiores traumatizados: relato de caso / Approach to traumati zed maxillary central incisors: case report

Introdução: O traumatismo dentário é uma ocorrência frequente durante a infância e adolescência. Geralmente, o diagnóstico acontece de forma tardia, devido à falta de conhecimento da população. Cada tipo de trauma necessita de uma conduta única e especializada. Nos casos de comprometimento pulpar, é necessário cuidado quanto à escolha da técnica a ser empregada, bem como a seleção da medicação intracanal que, por sua vez, apresenta grande interferência no sucesso do tratamento. Não obstante o avanço das técnicas de instrumentação, a troca da medicação entre as sessões nesses casos é mandatória. Relato de caso: Um paciente, sexo masculino, em idade escolar (15 anos) apresentou-se ao serviço de saúde bucal com relato de escurecimento e dores na mastigação após trauma dentário durante a infância. Os testes de vitalidade pulpar revelaram necrose pulpar, com resultado negativo no teste térmico e positivo na percussão. O exame radiológico evidenciou uma lesão apical, juntamente com reabsorção externa no elemento 21, confirmado em tomografia. O paciente foi submetido a um tratamento endodôntico. Resultado: Após o tratamento, foi solicitado novo exame tomográfico, em que se evidenciou um processo de cicatrização óssea no periápice e reabsorção por substituição na lesão cervical. Conclusão: A partir deste caso clínico, pôde-se evidenciar a importância do diagnóstico adequado, do manejo e da técnica endodôntica eficaz na resolução de problemas decorrentes de traumas dentários em pacientes jovens.

Introduction: Dental trauma is a frequent occurrence during childhood and adolescence. Generally, diagnosis happens late, due to lack of knowledge among the population. Each type of trauma requires a unique and specialized approach. In cases of pulp involvement, care must be taken when choosing the technique to be used, as well as the selection of intracanal medication, which, in turn, has a major impact on the success of the treatment. Despite advances in instrumentation techniques, changing medication between sessions in these cases is mandatory. Case report: A male patient of school age (15 years old) presented to the oral health service with reports of darkening and pain when chewing following dental trauma during childhood. Pulp vitality tests revealed pulp necrosis, with a negative result in the thermal test and positive in percussion. The radiological examination showed an apical lesion, together with external resorption in element 21, confirmed on tomography. The patient underwent endodontic treatment. Result: After treatment, a new tomographic examination was requested, which showed a process of bone healing in the periapex and resorption by replacement in the cervical lesion. Conclusion: From this clinical case, it was possible to highlight the importance of adequate diagnosis, management, and effective endodontic technique in solving problems arising from dental trauma in young patients.

Radiolucência intracoronal pré-eruptiva (PECR) de um segundo molar permanente. relato de caso / Pre-eruptive intracoronal radiolucency (PECR) of a permanent second molar. case report

Introdução: A Radiolucência intracoronal pré eruptiva (PECR) é um achado radiográfico, com aspecto de lesão radiolúcida na dentina coronária, adjacente a junção amelodentinária, em dentes não irrompidos. Objetivo: Relatar um caso de possível reabsorção intracoronal pré-eruptiva com destruição extensa de dentina e envolvimento pulpar de um segundo molar permanente recém-erupcionado. Método: Após definição do diagnóstico, optou-se por um tratamento conservador, com a realização de capeamento pulpar direto com a finalidade de manutenção da vitalidade pulpar e término de formação das raízes. Resultado: Após o tratamento, paciente permaneceu assintomática no controle de quinze dias, com teste de vitalidade normal e sem sinais de inflamação. Conclusão: A interpretação cuidadosa do exame radiográfico é crucial para a detecção precoce e manejo adequado dessas lesões.

Pre-eruptive intracoronal radiolucency (PECR) is a radiographic finding, with the appearance of a radiolucent lesion in the coronary dentin, adjacent to the dentinal-enamel junction, in unerupted teeth. Objective: To report a case of possible pre-eruptive intracoronal resorption with extensive dentin destruction and pulpal involvement of a newly erupted second permanent molar. Method: After defining the diagnosis, a conservative treatment was chosen, with direct pulp capping in order to maintain pulp vitality and end root formation. Result: After treatment, the patient remained asymptomatic in the fifteen-day control, with normal vitality test and no signs of inflammation. Conclusion: Careful interpretation of the radiographic examination is crucial for early detection and proper management of these lesions.

Resorción intracoronal preeruptiva: reportes radiográficos y tomográficos de cuatro casos / Preeruptive Intracoronal Resorption: X-Ray and Tomographic Reports of Four Cases

RESUMEN La resorción intracoronal preeruptiva (RIPE) se presenta como un defecto ubicado en la dentina coronal próxima a la unión amelodentinaria en la corona de un germen dentario. Este defecto de profundidad y ubicación anteroposterior variables solo puede ser diagnosticado mediante radiografías extraorales, intraorales y tomografías dentales. La etiología no ha sido determinada, pero los estudios de histopatología sugieren que este defecto sería una secuela de resorción dentaria. En el presente manuscrito, se presentan radiografías panorámicas y tomografías de haz cónico (THC) de cuatro pacientes con dicha afección, en las que encontramos los defectos dentinarios y discontinuidades en el esmalte adyacente, por lo que se discutirá la utilidad de la THC en el diagnóstico y la planificación de tratamiento de los casos con RIPE.

ABSTRACT Preeruptive Intracoronal Resorption (PIR) manifests as a defect located in the dentin of a dental germ, adjacent to the amelodentinal junction in the crown. This defect, which varies in depth and anteroposterior location, can only be diagnosed through extraoral and intraoral x-rays, as well as dental tomography. The etiology of PIR remains undetermined, although histopathological studies suggest it could be a consequence of dental resorption. In this paper, panoramic x-rays and cone beam computed tomography (CBCT) scans of four patients with PIR are presented. The dental defects and enamel discontinuities adjacent to them are identified, highlighting the usefulness of CBCT in diagnosing and planning treatment for PIR cases.

Diferencia en la expresión del ligando de receptor activador para el factor nuclear K B, en tejido tumoral frente a la infección por diferentes patógenos periodontales / Difference in receptor activator of nuclear factor K B expression in tumoral tissue by different periodontal pathogens

La enfermedad periodontal es una de las principales causas de pérdida dentaria. Clínicamente, esta patología, mediada por la desregulación del sistema inmune producto de una disbiosis ocurrida en el surco gingival, inicia con la inflamación de la encía y evoluciona con el daño irreversible de los tejidos que rodean el diente. El hueso alveolar es uno de los tejidos afectados esta patología, esto debido a la activación de osteoclastos por la sobreexpresión de la proteína RANKL en el huésped. El propósito de este trabajo es determinar el nivel de sobreexpresión de RANKL, en un modelo de células tumorales U2OS, frente a la infección con Porphyromonas gingivalis y Prevotella intermedia. Para identificar el nivel de RANKL, se definieron cuatro grupos: Un grupo control, no tratado; Grupo PG, tratado con P. gingivalis; Grupo PI, tratado con P. Intermedia; y un grupo PG+PI, tratado con ambas bacterias. El nivel relativo de la proteína RANKL fue determinado en el sobrenadante y en los extractos celulares de manera independiente, mediante la técnica Western blot. En sobrenadantes, el grupo PG mostró mayores niveles de RANKL comparados con PI (p < 0,05). En extractos celulares los niveles fueron mayores en el grupo PG+PI (p < 0,05). El grupo PI mostró los niveles más bajos de RANKL. La infección polimicrobiana resulta en una mayor expresión de RANKL en células tumorales U2OS, mientras que frente a la infección P. gingivalis, se observó mayor cantidad de RANKL soluble.

SUMMARY: Periodontal disease is one of the main causes of tooth loss. Clinically, this pathology, mediated by the deregulation of the immune system due to a dysbiosis occurred in the gingival sulcus, begins with the inflammation of the gum and evolves with the irreversible damage of the tissues that surround the tooth. Alveolar bone is one of the most affected tissues by this disease, due to the activation of osteoclasts by the upregulation of RANKL in the host. The aim of this study is to determine the increase of RANKL, in a U2OS tumor cells model, inoculated with Porphyromonas gingivalis and Prevotella intermedia. To identify the level of RANKL, four groups were defined: A control group, not treated; PG group, treated with P.gingivalis; PI group, treated with P. intermedia; and a PG+PI group, treated with both bacteria. The relative level of RANKL was determined in the supernatant and cell extracts independently, using the Western blot technique. In supernatants, the PG group showed higher RANKL levels compared to PI (p < 0.05). In cell extracts the levels were higher in the PG+PI group (p < 0.05.). The PI group showed the lowest levels of RANKL.Polymicrobial infection results in a greater expression of of soluble RANKL was observed.

Retrospective analysis of survival of avulsed and replanted permanent teeth according to 2012 or 2020 IADT Guidelines

Abstract This study aimed to compare the survival of replanted teeth that followed the 2012 or the 2020 International Association of Dental Traumatology (IADT) guidelines. Sixty-two permanent replanted teeth were retrospectively assessed (IADT 2012, n = 45; IADT 2020, n = 17). Five years after replantation (from January 2017 to December 2021), clinical and radiographic examinations were performed. A significance level of 95% was considered to evaluate the outcomes. Thirty-one teeth (50.0%) remained in their sockets and 31 (50.0%) were lost due to external root resorption. Of the 25 (40.3%) teeth replanted within one hour, 16 (64.0%) remained in their sockets, and 9 (36.0%) were lost. Twenty-two (71.0%) of all 31 lost teeth had an extra-alveolar time of more than one hour. Twelve teeth remained in their sockets without resorption: 8 (66.7%) were replanted within one hour, 2 (16.7%) followed the 2012 IADT, and 2 (16.7%) the 2020 IADT guidelines for late replantation. There was a significant difference (p <0.05) in the extra-alveolar time (< one hour), but without difference between the guidelines in late replantation (p > 0.05). Replanted teeth following both, 2012 or 2020 IADT guidelines, have similar clinical outcomes. The extra-alveolar time of less than one hour was demonstrated to be important to keep the permanent tooth in its socket.

Resumo Este estudo teve como objetivo comparar a sobrevida, por cinco anos, de dentes reimplantados que seguiram as diretrizes de 2012 ou 2020 da International Association of Dental Traumatology (IADT). Sessenta e dois dentes permanentes reimplantados foram avaliados retrospectivamente (IADT 2012, n = 45; IADT 2020, n = 17). Cinco anos após o reimplante, foram realizados exames clínicos e radiográficos. Foi considerado um nível de significância de 95% para avaliar os desfechos. Trinta e um dentes (50,0%) permaneceram em seus alvéolos e 31 (50,0%) foram perdidos por reabsorção radicular externa. Dos 25 (40,3%) dentes reimplantados em uma hora, 16 (64,0%) permaneceram em seus alvéolos e 9 (36,0%) foram perdidos. Vinte e dois (71,0%) de todos os 31 dentes perdidos tiveram um tempo extra-alveolar superior a uma hora. Doze dentes permaneceram em seus alvéolos sem reabsorção: 8 (66,7%) foram reimplantados em uma hora, 2 (16,7%) seguiram a IADT de 2012 e 2 (16,7%) as diretrizes da IADT de 2020 para reimplante tardio. Houve diferença significativa (p<0,05) no tempo extra-alveolar (< uma hora), mas sem diferença entre as diretrizes no reimplante tardio (p > 0,05). Dentes reimplantados seguindo as diretrizes de 2012 ou 2020 da IADT, tiveram taxas de sucesso semelhantes. O tempo extra-alveolar inferior a uma hora demonstrou ser importante para manter o dente permanente em seu alvéolo.

Mechanism of Zhibai Dihuang decotion in treating postmenopausal osteoporosis / 药学学报

In this study, the ovarian surgery (ovariectomy, OVX) was used to establish the osteoporosis mice model of primary menstruation, in order to evaluate the protective effects and mechanisms of Zhibai Dihuang decotion on postmenopausal osteoporosis (PMOP). The animal experimental protocol has been reviewed and approved by Laboratory Animal Ethics Committee of Jinan University (number: 20210315-03), in compliance with the Institutional Animal Care Guidelines. C57BL/6 mice were divided into five groups, including Sham group, OVX group, low (32 g·kg-1·day-1) and high dose (64 g·kg-1·day-1) of Zhibai Dihuang decotion groups, positive drug group (alendronate, 9.9 mg·kg-1·q3d). After modeling, mice were given medication intervention for 8 weeks, and then femoral and tibial tissues were taken to detect indicators such as bone microstructure, bone resorption, and oxidative stress. The experimental results showed that after Zhibai Dihuang decotion administration, the bone microstructure damage caused by OVX surgery was alleviated, and the relevant parameters bone mineral density (BMD), bone volume/total volume (BV/TV), trabecular number (Tb. N) and connectivity density (Conn. D) both significantly increased. At the same time, the number of TRAP positive osteoclasts decreased significantly, and the levels of proteins and genes related to osteoclast differentiation decreased, indicating that Zhibai Dihuang decoction could inhibit the increased activity of osteoclast caused by OVX. Afterwards, network pharmacology was used to construct the active compound action target network of Zhibai Dihuang decotion, and it was found that the target genes of its active ingredients were closely related to the oxidative stress pathway. Finally, the detection results of oxidative stress levels in bone tissues showed that after treatment with Zhibai Dihuang decotion, the levels of oxidative stress products 4-hydroxynonenal (4-HNE) and malondialdehyde (MDA) in bone tissues of mice significantly decreased, while the levels of antioxidant stress substance L-glutathione (GSH) increased. These above results indicated that Zhibai Dihuang decotion can regulate the level of oxidative stress in the body and inhibit osteoclast activity, which played a therapeutic role in PMOP, as well as provided theoretical basis for the prevention and treatment of PMOP with traditional Chinese medicine.

Research progress of bone graft resorption after Latarjet procedure for treatment of recurrent anterior shoulder dislocation / 中国修复重建外科杂志

OBJECTIVE@#To review the research progress of bone graft resorption after Latarjet procedure for the treatment of recurrent anterior shoulder dislocation, and provide a guide for further research on bone graft resorption.@*METHODS@#The relevant literature in recent years was extensively reviewed. The pathogenesis, classification, risk factors, clinical function impact, and management of bone graft resorption after Latarjet procedure for the treatment of recurrent anterior shoulder dislocation were summarized.@*RESULTS@#Bone graft resorption is the common complication after Latarjet procedure for the treatment of recurrent anterior shoulder dislocation. Stress shielding and poor blood supply may contribute to the occurrence of bone graft resorption. The absence of significant preoperative glenoid bone loss, open procedure, earlier graft healing may to be the risk factors for bone graft resorption. Various assessment methods and classification systems are used to evaluate the region and severity of bone graft resorption. Partial resorption may be considered as a natural glenoid remodeling process after the surgery, but severe and complete resorption is proved to be one of the reasons for failed procedures and there is no effective measure to prevent it, except for accepting revision surgery.@*CONCLUSION@#The pathogenesis, risk factors, clinical function impact of bone graft resorption after Latarjet procedure for the treatment of recurrent anterior shoulder dislocation has not been fully elucidated and there is a lack of effective management strategies, so further clinical and basic researches are needed.

Research progress on an autophagy-mediating AMPK pathway involving bone metabolism-related cells that regulate bone homeostasis in periodontitis / 口腔疾病防治

@#Osteoclasts are the only cells responsible for bone resorption in the body, and osteoblasts are the main cells responsible for bone regeneration in the body. Under physiological conditions, these cells maintain a dynamic balance to maintain bone homeostasis. It was widely believed that the imbalance of bone metabolism is mainly affected by the expression of related inflammatory factors. However, with the gradual expansion of related studies in recent years, autophagy has been shown to be closely related to the differentiation, apoptosis and functions of osteoclasts and osteoblasts. AMP-activated protein kinase (AMPK) is an important regulator of energy metabolism in vivo and is involved in the regulation of autophagy and bone homeostasis in bone metabolism-related cells. Periodontitis is a chronic infectious disease, and its typical symptoms are alveolar bone resorption. At present, controlling the level of periodontal inflammation and alveolar bone resorption more effectively in clinical practice remains a challenge. The detection of AMPK and autophagy levels in bone metabolism-related cells shows certain prospects for the clinical prevention and treatment of periodontitis in the future. Therefore, this article reviews the regulation of periodontal inflammation levels and bone homeostasis through cell autophagy related to AMPK-mediated bone metabolism.

Autosomal dominant osteopetrosis type Ⅱ: 2 cases report and literature review / 中华内分泌代谢杂志

Osteosclerosis is a rare hereditary bone metabolic disease, characterized by increased bone mass and density caused by bone resorption disorders, and any abnormal mutation involving osteoclast maturation or function will lead to the occurrence of osteopetrosis. Clinically, the prevalence of autosomal dominant osteopetrosis type Ⅱ(ADO-Ⅱ) is higher than that of other types of osteopetrosis, which involves multiple systems such as endocrine, bone, blood, nerve, ear-nose-throat, and oral cavity. Disease progression is insidious and easily overlooked, and there is no standard treatment. This article summarizes the clinical characteristics, examination data, diagnosis and treatment process of the two patients, analyzes multi-system symptoms, pathogenesis and treatment principles of the disease to improve the management of patients with ADO-Ⅱ.

Melatonin attenuates bone resorption induced by acute sleep deprivation in growing rats / 中华内分泌代谢杂志

Objective:To explore the changes of bone turnover markers induced by sleep deprivation (SD) and the effect of melatonin supplementation on the bone turnover status.Methods:Six-week-old Wistar male rats were divided into SD, normal control (NC), and melatonin supplementation (SD+ MT) groups. Acute SD model was established using a modified multi-level bench method. The bone turnover markers, corticosterone, and melatonin in serum as well as Cathepsin K(CTSK) mRNA expression in bone tissue were tested.Results:Acute SD disrupted the balance between bone formation and bone absorption evidenced by rapid decreased serum procollagen type Ⅰ N-terminal propeptide (PⅠNP) levels and increased β cross-linked C-telopeptide of type Ⅰ collagen (β-CTX) levels ( P=0.003) from 24 h to 72 h. The exogenous melatonin treatment decreased β-CTX [(512.4±95.8) ng/mL vs (696.0±76.5) ng/mL, P=0.004] and the osteoclast-related gene CTSK mRNA level after 72 h SD. Conclusions:Acute SD accelerates bone resorption, which could be partially alleviated by melatonin supplementation.

Application of the "three-in-one" bone repair strategy in the treatment of osteoporotic fractures / 中华创伤杂志

Osteoporotic fractures secondary to osteoporosis increase very rapidly in incidence, and have become a major cause of disability and mortality in the elderly population. Currently, there have no standard guidelines for perioperative management, surgery and postoperative rehabilitation, causing multiple complications and poor therapeutic outcome. The authors previously proposed bone repair strategies including active anti-osteoporosis, adequate bone grafting and bone healing acceleration, namely "three-in-one" bone repair strategy. The care steps in osteoporotic fracture surgery inluded perioperative management, operative precaution, and postoperative prevention of secondary fractures. With this in mind, the authors further discussed the detailed application of "three-in-one" bone repair strategy including perioperative active anti-osteoporosis treatment, early rehabilitation training, standardized internal fixation selection, standard bone grafting methods and prevention of secondary complications, so as to promote the standardized treatment of osteoporotic fractures and improve the prognosis.

Association of bone resorption marker β-CTX with hypercalcemia in patients with Graves′ disease / 中国医师杂志

Objective:To explore the association of bone resorption marker β carboxyterminal peptide of collagen Ⅰ (β-CTX) with hypercalcemia in patients with Graves′ disease (GD).Methods:287 patients with GD who were hospitalized in the endocrinology department of Fuyang People′s Hospital from January 2021 to December 2021 were divided into control group ( n=251) and hypercalcemia group ( n=36) according to the corrected blood calcium level. The clinical data and serum β-CTX level of the two groups were compared. Logistic regression model was used to analyze the risk factors of hypercalcemia in GD patients. Pearson correlation was used to analyze the correlation between serum β-CTX level and other indexes. Results:Of the 287 GD patients, 36 were diagnosed as hypercalcemia, and the incidence of hypercalcemia was 12.54%. The levels of free triiodothyronine (FT3), free thyroxine (FT4), blood phosphorus (P) and β-CTX in hypercalcemia group were higher than those in control group, and the total parathyroid hormone (iPTH) in hypercalcemia group were lower than those in control group (all P<0.05). Multivariate Logistic regression analysis showed that FT3 ( OR=1.283, 95% CI: 1.049-1.570, P<0.05), iPTH ( OR=0.924, 95% CI: 0.863-0.989, P<0.05), β-CTX ( OR=2.488, 95% CI: 1.193-5.189, P<0.05) were the influencing factors for hypercalcemia in GD patients. Pearson correlation analysis showed that β-CTX was positively correlated with FT3, FT4, blood calcium, P, alkaline phosphatase (ALP), total procollagen type I amino end terminal peptide (PINP), N-bone-gamma-carboxyglutamic-acid-containing proteins (N-MID) and 25(OH)D, and negatively correlated with iPTH (all P<0.05). Conclusions:β-CTX is highly expressed in the serum of GD patients with hypercalcemia, which is a risk factor for the occurrence of hypercalcemia in GD patients.

Multiple idiopathic root resorption: a case report and literature review / 口腔疾病防治

Objective @#To explore the etiology, clinical manifestations, diagnosis and treatment of multiple idiopathic root resorption to provide a reference for clinical diagnosis and treatment. @*Methods@# The clinical data of a case of multiple idiopathic root resorption were analyzed retrospectively, and the related literature was reviewed.@*Results@#The patient had no history of orthodontic correction, occlusal trauma, trauma history or other causes of root resorption. Clinical examination revealed full-mouth gingival congestion, redness, a loose texture, and variable degrees of destruction of the alveolar bone. Imaging examination showed that teeth 13, 16, 26, 36, 46 had idiopathic root resorption. The diagnoses were multiple idiopathic root resorption and periodontitis. The pathology tests showed that a large number of osteoclasts were present in the soft tissue surrounding the teeth. Whole-exome sequencing showed that there was a strong correlation between gene mutations (WNT7a and HSPG2) and the present phenotype. Root resorption of teeth without periodontitis was stopped after periodontal treatment during the 19-month follow-up. Tooth 13 was removed, and extraction socket preservation was performed. The etiology of idiopathic root resorption may be related to gene mutations, but it is not clear. At present, there is no effective treatment. @* Conclusion @#Multiple idiopathic root resorption has an unknown etiology, but it may be related to WNT7A and HSPG2 gene mutations. The rate of root resorption can be slowed by controlling periodontal inflammation.

The role of E3 ubiquitin ligases in bone homeostasis and related diseases

The ubiquitin-proteasome system (UPS) dedicates to degrade intracellular proteins to modulate demic homeostasis and functions of organisms. These enzymatic cascades mark and modifies target proteins diversly through covalently binding ubiquitin molecules. In the UPS, E3 ubiquitin ligases are the crucial constituents by the advantage of recognizing and presenting proteins to proteasomes for proteolysis. As the major regulators of protein homeostasis, E3 ligases are indispensable to proper cell manners in diverse systems, and they are well described in physiological bone growth and bone metabolism. Pathologically, classic bone-related diseases such as metabolic bone diseases, arthritis, bone neoplasms and bone metastasis of the tumor, etc., were also depicted in a UPS-dependent manner. Therefore, skeletal system is versatilely regulated by UPS and it is worthy to summarize the underlying mechanism. Furthermore, based on the current status of treatment, normal or pathological osteogenesis and tumorigenesis elaborated in this review highlight the clinical significance of UPS research. As a strategy possibly remedies the limitations of UPS treatment, emerging PROTAC was described comprehensively to illustrate its potential in clinical application. Altogether, the purpose of this review aims to provide more evidence for exploiting novel therapeutic strategies based on UPS for bone associated diseases.