Objective:To investigate the clinical effect of the guided bone regeneration(GBR)technique combined with temporary bridgework-guided gingival contouring in treating upper anterior tooth loss with labial bone defects.M...Objective:To investigate the clinical effect of the guided bone regeneration(GBR)technique combined with temporary bridgework-guided gingival contouring in treating upper anterior tooth loss with labial bone defects.Methods:From July 2023 to April 2024,80 patients with upper anterior tooth loss and labial bone defects were admitted to the hospital and selected as evaluation samples.They were divided into an observation group(n=40)and a control group(n=40)using a numerical table lottery scheme.The control group received treatment with the GBR technique,while the observation group received treatment with the GBR technique combined with temporary bridges to guide gingival contouring.The two groups were compared in terms of clinical red aesthetic scores(PES),labial alveolar bone density,labial bone wall thickness,gingival papillae,gingival margin levels,and patient satisfaction.Results:The PES scores of patients in the observation group were higher than those in the control group after surgery(P<0.05).The bone density of the labial alveolar bone and the thickness of the labial bone wall in the observation group were higher than those in the control group.The levels of gingival papillae and gingival margins were lower in the observation group after surgery(P<0.05).Additionally,patient satisfaction in the observation group was higher than in the control group(P<0.05).Conclusion:The GBR technique combined with temporary bridge-guided gingival contouring for treating upper anterior tooth loss with labial bone defects can improve the aesthetic effect of gingival soft tissue,increase alveolar bone density and the thickness of the labial bone wall,and enhance patient satisfaction.This approach is suitable for widespread application in healthcare institutions.展开更多
This study aimed to characterize and identify calcium-chelating peptides from rabbit bone collagen and explore the underlying chelating mechanism.Collagen peptides and calcium were extracted from rabbit bone by instan...This study aimed to characterize and identify calcium-chelating peptides from rabbit bone collagen and explore the underlying chelating mechanism.Collagen peptides and calcium were extracted from rabbit bone by instant ejection steam explosion(ICSE)combined with enzymatic hydrolysis,followed by chelation reaction to prepare rabbit bone peptide-calcium chelate(RBCP-Ca).The chelating sites were further analyzed by liquid chromatography-tandem mass(LC-MS/MS)spectrometry while the chelating mechanism and binding modes were investigated.The structural characterization revealed that RBCP successfully chelated with calcium ions.Furthermore,LC-MS/MS analysis indicated that the binding sites included both acidic amino acids(Asp and Glu)and basic amino acids(Lys and Arg),Interestingly,three binding modes,namely Inter-Linking,Loop-Linking and Mono-Linking were for the first time found,while Inter-Linking mode accounted for the highest proportion(75.1%),suggesting that chelation of calcium ions frequently occurred between two peptides.Overall,this study provides a theoretical basis for the elucidation of chelation mechanism of calcium-chelating peptides.展开更多
Hyperuricemia(HUA)is a vital risk factor for chronic kidney diseases(CKD)and development of functional foods capable of protecting CKD is of importance.This paper aimed to explore the amelioration effects and mechanis...Hyperuricemia(HUA)is a vital risk factor for chronic kidney diseases(CKD)and development of functional foods capable of protecting CKD is of importance.This paper aimed to explore the amelioration effects and mechanism of Andrias davidianus bone peptides(ADBP)on HUA-induced kidney damage.In the present study,we generated the standard ADBP which contained high hydrophobic amino acid and low molecular peptide contents.In vitro results found that ADBP protected uric acid(UA)-induced HK-2 cells from damage by modulating urate transporters and antioxidant defense.In vivo results indicated that ADBP effectively ameliorated renal injury in HUA-induced CKD mice,evidenced by a remarkable decrease in serum UA,creatinine and blood urea nitrogen,improving kidney UA excretion,antioxidant defense and histological kidney deterioration.Metabolomic analysis highlighted 14 metabolites that could be selected as potential biomarkers and attributed to the amelioration effects of ADBP on CKD mice kidney dysfunction.Intriguingly,ADBP restored the gut microbiome homeostasis in CKD mice,especially with respect to the elevated helpful microbial abundance,and the decreased harmful bacterial abundance.This study demonstrated that ADBP displayed great nephroprotective effects,and has great promise as a food or functional food ingredient for the prevention and treatment of HUA-induced CKD.展开更多
Limited cells and factors,inadequate mechanical properties,and necrosis of defects center have hindered the wide clinical application of bone-tissue engineering scaffolds.Herein,we construct a self-oxygenated 3D print...Limited cells and factors,inadequate mechanical properties,and necrosis of defects center have hindered the wide clinical application of bone-tissue engineering scaffolds.Herein,we construct a self-oxygenated 3D printed bioactive hydrogel scaffold by integrating oxygen-generating nanoparticles and hybrid double network hydrogel structure.The hydrogel scaffold possesses the characteristics of extracellular matrix;Meanwhile,the fabricated hybrid double network structure by polyacrylamide and CaCl2-crosslinked sodium carboxymethylcellulose endows the hydrogel favorable compressive strength and 3D printability.Furthermore,the O2 generated by CaO2 nanoparticles encapsulated in ZIF-8 releases steadily and sustainably because of the well-developed microporous structure of ZIF-8,which can significantly promote cell viability and proliferation in vitro,as well as angiogenesis and osteogenic differentiation with the assistance of Zn2+.More significantly,the synergy of O2 and 3D printed pore structure can prevent necrosis of defects center and facilitate cell infiltration by providing cells the nutrients and space they need,which can further induce vascular network ingrowth and accelerate bone regeneration in all areas of the defect in vivo.Overall,this work provides a new avenue for preparing cell/factor-free bone-tissue engineered scaffolds that possess great potential for tissue regeneration and clinical alternative.展开更多
Effective management of malignant tumor-induced bone defects remains challenging due to severe systemic side effects,substantial tumor recurrence,and long-lasting bone reconstruction post tumor resection.Magnesium and...Effective management of malignant tumor-induced bone defects remains challenging due to severe systemic side effects,substantial tumor recurrence,and long-lasting bone reconstruction post tumor resection.Magnesium and its alloys have recently emerged in clinics as orthopedics implantable metals but mostly restricted to mechanical devices.Here,by deposition of calcium-based bilayer coating on the surface,a Mg-based composite implant platform is developed with tailored degradation characteristics,simultaneously integrated with chemotherapeutic(Taxol)loading capacity.The delicate modulation of Mg degradation occurring in aqueous environment is observed to play dual roles,not only in eliciting desirable osteoinductivity,but allows for modification of tumor microenvironment(TME)owing to the continuous release of degradation products.Specifically,the sustainable H2 evolution and Ca2+from the implant is distinguished to cooperate with local Taxol delivery to achieve superior antineoplastic activity through activating Cyt-c pathway to induce mitochondrial dysfunction,which in turn leads to significant tumor-growth inhibition in vivo.In addition,the local chemotherapeutic delivery of the implant minimizes toxicity and side effects,but markedly fosters osteogenesis and bone repair with appropriate structure degradation in rat femoral defect model.Taken together,a promising intraosseous administration strategy with biodegradable Mg-based implants to facilitate tumor-associated bone defect is proposed.展开更多
Introduction: Pseudarthrosis (PSA) of the diaphysis of long bones still remains a current problem, despite improvements in the treatment of these fractures. Our study aims to study the epidemiological and therapeutic ...Introduction: Pseudarthrosis (PSA) of the diaphysis of long bones still remains a current problem, despite improvements in the treatment of these fractures. Our study aims to study the epidemiological and therapeutic aspects of PSA of the diaphysis of long bones. Method: This retrospective work concerns 30 cases of non-union of the diaphysis of long bones treated in the orthopedic and trauma surgery department at Donka National Hospital, during a period of 18 months from January 1, 2019 to June 30, 2020. Results: We recruited 30 patients, 80% of whom were male, with an average age of 39.9 years. Public road accidents (AVP) represented the main cause of fractures of the diaphysis of long bones 87%, they were open in 25 cases or 83%. The fractures were located in the middle 1/3 of the diaphysis of the long bones in 50% of cases. Treatment of initial fractures was traditional in 21 cases, orthopedic in 2 cases and surgical in 7 cases. It was aseptic nonunion in 28 cases (93%) and septic nonunion in 2 cases. They were hypertrophic in 7 cases, slightly hypertrophic in 5 cases, oligotrophic in 11 cases, atrophic in 6 cases and with bone defect in 1 case. The treatment was based on osteosynthesis including 16 cases of screwed “PV” plate: 7 cases of centromedullary “ECM” nailing, 2 cases of external fixator, 1 case of broaching and 4 cases of Plastering. The results according to ASAMI criteria on an anatomical level were excellent in 19 cases, good in 3 cases and poor in 3 cases, with a union rate of 76%. And 5 patients undergoing consolidation. Conclusion: Based on the literature data and the experience of our department, the true treatment of PSA requires correct management of the initial fracture without forgetting the interest in preventing AVP which appears to be an element essential, making it possible to reduce the incidence of fractures of the diaphysis.展开更多
Introduction: While autograft bone is the gold standard for multilevel posterolateral lumbar fusion, bone substitutes and graft extenders such as allograft bone, ceramics and demineralized bone matrix (DBM) have been ...Introduction: While autograft bone is the gold standard for multilevel posterolateral lumbar fusion, bone substitutes and graft extenders such as allograft bone, ceramics and demineralized bone matrix (DBM) have been used to avoid the morbidity and insufficient quantity associated with harvesting autologous bone. The primary objective of this retrospective study was to determine whether, in patients with increased risk of operative nonunion related to multilevel fusion, adding DBM fibers to mineralized bone allograft resulted in better fusion than using allograft alone. The secondary objectives were to evaluate how adding DBM fibers affects functional disability, low back pain, intraoperative blood loss and the nonunion rate. Methods: This retrospective study involved a chart review of consecutive patients who underwent multilevel lumbar spinal fusion and were operated on by a single surgeon. The patients were divided into two groups: 14 patients received mineralized bone allograft (control group) and 14 patients received a combination of mineralized bone allograft and DBM (experimental group). Patients were reviewed at a mean of 16.4 ± 2.2 months after surgery at which point CT scans were analyzed to determine whether fusion had occurred;Oswestry disability index (ODI) and pain were also evaluated. Results: A mean of 5 levels [min 2, max 13] were fused in these patients. Posterolateral fusion as defined by the Lenke classification was not significantly different between groups. The experimental DBM group had a significantly better composite fusion score than the control group (P Discussion: Adding DBM fibers to allograft bone during multilevel posterolateral spinal fusion was safe and produced better composite fusion than using allograft only as an autograft extender.展开更多
BACKGROUND Aneurysmal bone cyst(ABC)is a benign cystic of unknown etiology,characterized by multiple chambers and a high recurrence rate.Current treatment options include vascular embolization,surgical excision,curett...BACKGROUND Aneurysmal bone cyst(ABC)is a benign cystic of unknown etiology,characterized by multiple chambers and a high recurrence rate.Current treatment options include vascular embolization,surgical excision,curettage with cavity filling,sclerosing agent injection into the cavity,radiotherapy,and systemic drug therapy.Among these,surgical excision and curettage are the preferred treatment modalities.However,when the cyst reaches a large size,extensive removal of diseased tissue during surgery can hinder bone healing.In our department,we treated a case of a large ABC at the distal end of the femur in a child using the Ilizarov technique.The tumor was completely excised,and reconstruction was achieved through autologous femoral bone transfer.The follow-up at two years post-surgery indicated good results without tumor recurrence,and the growth and development of the child were essentially unaffected.CASE SUMMARY An 11-year-old boy was presented with an accidental fracture of his right leg.Despite having been examined at other hospitals,he had not received treatment.Given the potential for significant bone defects and the difficulty of the surgery,our doctors opted to use the Ilizarov technique to minimize harm to the patient.Upon admission,the patient underwent a needle biopsy and complete tumor resection-the Ilizarov technique assisted in the transport and reconstruction of the autologous femoral bone.Postoperatively,the patient exhibited regular followups,during which bone transport was gradually performed,and the external fixation frame was removed on time.Follow-up X-rays of the right lower limb displayed no tumor recurrence,with a normal appearance.Bone formation at the cutting site was satisfactory,and the union of the bone ends indicated good healing.After two years of follow-up,the patient had essentially returned to normal.CONCLUSION We successfully applied the Ilizarov technique to treat ABC,reducing the financial burden of patients and the pain of multiple surgeries.In cases where significant bone defects occur,the Ilizarov technique has demonstrated satisfactory therapeutic outcomes.展开更多
Background: When applied to trabecular bone X-ray images, the anisotropic properties of trabeculae located at ultra-distal radius were investigated by using the trabecular bone scores (TBS) calculated along directions...Background: When applied to trabecular bone X-ray images, the anisotropic properties of trabeculae located at ultra-distal radius were investigated by using the trabecular bone scores (TBS) calculated along directions parallel and perpendicular to the forearm. Methodology: Data from more than two hundred subjects were studied retrospectively. A DXA (GE Lunar Prodigy) scan of the forearm was performed on each subject to measure the bone mineral density (BMD) value at the location of ultra-distal radius, and an X-ray digital image of the same forearm was taken on the same day. The values of trabecular bone score along the direction perpendicular to the forearm, TBS<sub>x</sub>, and along the direction parallel to the forearm, TBS<sub>y</sub>, were calculated respectively. The statistics of TBS<sub>x</sub> and TBS<sub>y</sub> were calculated, and the anisotropy of the trabecular bone, which was defined as the ratio of TBS<sub>y</sub> to TBS<sub>x</sub> and changed with subjects’ BMD and age, was reported and analyzed. Results: The results show that the correlation coefficient between TBS<sub>x</sub> and TBS<sub>y</sub> was 0.72 (p BMD and age was reported. The results showed that decreased trabecular bone anisotropy was associated with deceased BMD and increased age in the subject group. Conclusions: This study shows that decreased trabecular bone anisotropy was associated with decreased BMD and increased age.展开更多
Particulate bone plays a crucial role in various oral and maxillofacial surgical procedures,including reconstruction,implantation,and craniofacial surgery.Autologous bone and deproteinized bovine bone xenografts are t...Particulate bone plays a crucial role in various oral and maxillofacial surgical procedures,including reconstruction,implantation,and craniofacial surgery.Autologous bone and deproteinized bovine bone xenografts are the two primary resources used for such procedures,with the former demonstrating superior cost-effectiveness and reduced comorbidity rates,particularly in cases involving donor zones.However,a significant challenge lies in acquiring uniformly sized autologous particulate bone specimens,with existing tools often yielding coarse particles at a high cost.Consequently,commercial bone xenograft solutions are frequently favored despite lower standards.This technical note introduces a novel technique for swiftly,safely,and efficiently obtaining autologous particulate bone specimens.The procedure involves the use of a motor handpiece fitted with a micro drill and surgical spoon to collect the bone particles.The continuous irrigation with saline maintains a clear surgical field during the milling process.The collected bone particles are then transferred to a metal capsule for further use.This technique offers a promising solution to the challenge of inconsistent particle size associated with harvesting using traditional methods,providing surgeons with a reliable and efficient method of obtaining autologous particulate bone samples.展开更多
BACKGROUND In the medical and dental fields,there is a need for studies of new therapeutic approaches for the treatment of bone defects that cause extensive bone loss.Melatonin may be an important endogenous biologica...BACKGROUND In the medical and dental fields,there is a need for studies of new therapeutic approaches for the treatment of bone defects that cause extensive bone loss.Melatonin may be an important endogenous biological factor for bone remodeling,and growth factors may enhance the repair process.AIM To evaluate the gene expression of cytokines(IL-1β,IL-6,IL-10 and TNF-α),markers of osteoclastogenesis(RANK,RANKL and OPG)and MMPs(MMP-1,MMP-2,MMP-8 and MMP-13)from the treatment of melatonin associated with an osteogenic membrane and rhBMP-2 on the recovery of a bone injury.METHODS Sixty-four rats were used and divided into 9 experimental groups and were formed according to the treatment carried out in the region of the bone lesion,which varied between the combination of 1,10 and 100μmol/L of melatonin.Gene Expression analysis was performed using real time-PCR by reading the concentration of total RNA and reverse transcription.RESULTS There were differences between groups when compared with clot or scaffold control,and improvement with a higher concentration of melatonin or rhBMP-2.The combination melatonin(1μg)with 5μg of rhBMP-2,using the guided bone regeneration technique,demonstrated some effects,albeit mild,on bone repair of critical bone defects.CONCLUSION This indicates that the approach for administering these substances needs to be reassessed,with the goal of ensuring their direct application to the affected area.Therefore,future research must be carried out,seeking to produce materials with these ideal characteristics.展开更多
This cohort study was designed to explore the relationship between maternal dietary patterns(DPs)and bone health in Chinese lactating mothers and infants.We recruited 150 lactating women at 1-month postpartum.The esti...This cohort study was designed to explore the relationship between maternal dietary patterns(DPs)and bone health in Chinese lactating mothers and infants.We recruited 150 lactating women at 1-month postpartum.The estimated bone mineral density(eBMD)of subjects’calcanei and the information on dietary intake were collected.After 5-month follow-up,the eBMD of mothers and their infants were measured again.Factor analysis was applied to determine maternal DPs.General linear models were used to evaluate the association between maternal DPs and maternal eBMD loss or infants’eBMD.With all potential covariates adjusted,Factor 2(high intake of whole grains,tubers,mixed beans,soybeans and soybean products,seaweeds,and nuts)showed a positive association with the changes of maternal eBMD(β=0.16,95%CI:0.005,0.310).Factor 3(high intake of soft drinks,fried foods,and puffed foods)was inversely correlated with the changes of maternal eBMD(β=-0.22,95%CI:-0.44,0.00).The changes of maternal eBMD were positively associated with 6-month infants’eBMD(β=0.34,95%CI:0.017,0.652).In conclusion,Factor 2 might contribute to the maintenance of eBMD in lactating women,while Factor 3 could exacerbate maternal eBMD loss.Additionally,the changes of maternal eBMD presented a positive correlation with 6-month infants’eBMD.展开更多
Irregular bone defects,characterized by unpredictable size,shape,and depth,pose a major challenge to clinical treatment.Although various bone grafts are available,none can fully meet the repair needs of the defective ...Irregular bone defects,characterized by unpredictable size,shape,and depth,pose a major challenge to clinical treatment.Although various bone grafts are available,none can fully meet the repair needs of the defective area.Here,this study fabricates a dough-type hydrogel(DR-Net),in which the first dynamic network is generated by coordination between thiol groups and silver ions,thereby possessing kneadability to adapt to various irregular bone defects.The second rigid covalent network is formed through photocrosslinking,maintaining the osteogenic space under external forces and achieving a better match with the bone regeneration process.In vitro,an irregular alveolar bone defect is established in the fresh porcine mandible,and the dough-type hydrogel exhibits outstanding shape adaptability,perfectly matching the morphology of the bone defect.After photocuring,the storage modulus of the hydrogel increases 8.6 times,from 3.7 kPa(before irradiation)to 32 kPa(after irradiation).Furthermore,this hydrogel enables effective loading of P24 peptide,which potently accelerates bone repair in Sprague–Dawley(SD)rats with critical calvarial defects.Overall,the dough-type hydrogel with kneadability,space-maintaining capability,and osteogenic activity exhibits exceptional potential for clinical translation in treating irregular bone defects.展开更多
To analyse the effectiveness of performing a transverse tibial bone graft in the treatment of patients with diabetic foot. We retrospectively analysed the clinical details of 51 diabetic foot patients in our hospital ...To analyse the effectiveness of performing a transverse tibial bone graft in the treatment of patients with diabetic foot. We retrospectively analysed the clinical details of 51 diabetic foot patients in our hospital from February 2023 to February 2024 and divided them into two groups according to the different treatment modalities, in which the control group received open debridement and the treatment group received transverse tibial bone transfer and compared the differences between the two groups. There were large differences in VAS score, Toronto Clinical Symptom Score, quality of life score, internal lumen diameter, blood flow velocity in the affected limb, perfusion volume, vascular endothelial growth factor, epidermal growth factor and CRP between the two groups after surgery (P < 0.05). Patients with diabetic foot should be treated with transverse tibial bone grafting, which is safer and more effective and can have a significant impact on improving the status of the affected limb, the inflammation and the patient’s quality of life.展开更多
Bone,renowned for its elegant hierarchical structure and unique mechanical properties,serves as a constant source of inspiration for the development of synthetic materials.However,achieving accurate replication of bon...Bone,renowned for its elegant hierarchical structure and unique mechanical properties,serves as a constant source of inspiration for the development of synthetic materials.However,achieving accurate replication of bone features in artificial materials with remarkable structural and mechanical similarity remains a significant challenge.In this study,we employed a cascade of continuous fabrication processes,including biomimetic mineralization of collagen,bidirectional freeze-casting,and pressure-driven fusion,to successfully fabricate a macroscopic bulk material known as artificial compact bone(ACB).The ACB material closely replicates the composition,hierarchical structures,and mechanical properties of natural bone.It demonstrates a lamellated alignment of mineralized collagen(MC)microfibrils,similar to those found in natural bone.Moreover,the ACB exhibits a similar high mineral content(70.9%)and density(2.2 g/cm3)as natural cortical bone,leading to exceptional mechanical properties such as high stiffness,hardness,and flexural strength that are comparable to those of natural bone.Importantly,the ACB also demonstrates excellent mechanical properties in wet,outstanding biocompatibility,and osteogenic properties in vivo,rendering it suitable for a broad spectrum of biomedical applications,including orthopedic,stomatological,and craniofacial surgeries.展开更多
With its main features of cartilage degeneration, subchondral bone sclerosis and osteophyte formation, osteoarthritisrepresents a multifactorial disease with no effective treatment options. As biomechanical shift in t...With its main features of cartilage degeneration, subchondral bone sclerosis and osteophyte formation, osteoarthritisrepresents a multifactorial disease with no effective treatment options. As biomechanical shift in thetrabecular network may be a driver for further cartilage degeneration, bone enhancement could possibly delayOA progression. Magnesium is known to be osteoconductive and already showed positive effects in OA models.We aimed to use magnesium cylinders to enhance subchondral bone quality, condition of cartilage and painsensation compared to sole drilling in vivo. After eight weeks of implantation in rabbits, significant increase insubchondral bone volume and trabecular thickness with constant bone mineral density was found indicatingfavored biomechanics. As representative for pain, a higher number of CD271+ vessels were present in controlsamples without magnesium. However, this result could not be confirmed by sensitive, objective lamenessevaluation using a pressure sensing mat and no positive effect could be shown on either cartilage degenerationevaluated by OARSI score nor the presence of regenerative cells in CD271-stained samples. The presented resultsshow a relevant impact of implanted magnesium on key structures in OA pain with missing clinical relevanceregarding pain. Further studies with shifted focus should examine additional structures as joint capsule orosteophytes.展开更多
Additive manufacturing(AM)has revolutionized the design and manufacturing of patient-specific,three-dimensional(3D),complex porous structures known as scaffolds for tissue engineering applications.The use of advanced ...Additive manufacturing(AM)has revolutionized the design and manufacturing of patient-specific,three-dimensional(3D),complex porous structures known as scaffolds for tissue engineering applications.The use of advanced image acquisition techniques,image processing,and computer-aided design methods has enabled the precise design and additive manufacturing of anatomically correct and patient-specific implants and scaffolds.However,these sophisticated techniques can be timeconsuming,labor-intensive,and expensive.Moreover,the necessary imaging and manufacturing equipment may not be readily available when urgent treatment is needed for trauma patients.In this study,a novel design and AM methods are proposed for the development of modular and customizable scaffold blocks that can be adapted to fit the bone defect area of a patient.These modular scaffold blocks can be combined to quickly form any patient-specific scaffold directly from two-dimensional(2D)medical images when the surgeon lacks access to a 3D printer or cannot wait for lengthy 3D imaging,modeling,and 3D printing during surgery.The proposed method begins with developing a bone surface-modeling algorithm that reconstructs a model of the patient’s bone from 2D medical image measurements without the need for expensive 3D medical imaging or segmentation.This algorithm can generate both patient-specific and average bone models.Additionally,a biomimetic continuous path planning method is developed for the additive manufacturing of scaffolds,allowing porous scaffold blocks with the desired biomechanical properties to be manufactured directly from 2D data or images.The algorithms are implemented,and the designed scaffold blocks are 3D printed using an extrusion-based AM process.Guidelines and instructions are also provided to assist surgeons in assembling scaffold blocks for the self-repair of patient-specific large bone defects.展开更多
BACKGROUND Lateral window approach for sinus floor lift is commonly used for vertical bone augmentation in cases when the residual bone height is less than 5 mm.However,managing cases becomes more challenging when a m...BACKGROUND Lateral window approach for sinus floor lift is commonly used for vertical bone augmentation in cases when the residual bone height is less than 5 mm.However,managing cases becomes more challenging when a maxillary sinus pseudocyst is present or when there is insufficient bone width.In this case,we utilized the bone window prepared during the lateral window sinus lift as a shell for horizontal bone augmentation.This allowed for simultaneous horizontal and vertical bone augmentation immediately after the removal of the maxillary sinus pseudocyst.CASE SUMMARY A 28-year-old female presented to our clinic with the chief complaint of missing upper left posterior teeth.Intraoral examination showed a horizontal deficiency of the alveolar ridge contour.The height of the alveolar bone was approximately 3.6 mm on cone beam computed tomography(CBCT).And a typical well-defined'dome-shaped'lesion in maxillary sinus was observed on CBCT imaging.The lateral bony window was prepared using a piezo-ultrasonic device,then the bony window was fixed to the buccal side of the 26 alveolar ridge using a titanium screw with a length of 10 mm and a diameter of 1.5 mm.The space between the bony window and the alveolar ridge was filled with Bio-Oss,covered with a Bio-Gide collagen membrane,and subsequently sutured.Nine months later,the patient’s bone width increased from 4.8 to 10.5 mm,and the bone height increased from 3.6 to 15.6 mm.Subsequently,a Straumann^(■)4.1 mm×10 mm implant was placed.The final all-ceramic crown restoration was completed four months later,and both clinical and radiographic examinations showed that the implant was successful,and the patient was satisfied with the results.CONCLUSION The bone block harvested from the lateral window sinus lift can be used for simultaneous horizontal bone augmentation acting as a shell for good two-dimensional bone augmentation.展开更多
Ankylosing spondylitis(AS)has a very high disability rate.How to effectively inhibit the formation of new bones has become a difficult point in clinical treatment.In recent years,research has shown that different trea...Ankylosing spondylitis(AS)has a very high disability rate.How to effectively inhibit the formation of new bones has become a difficult point in clinical treatment.In recent years,research has shown that different treatment plans can have an impact on inhibiting new bone formation.In this paper,the different effects of new bone formation in the treatment of AS with traditional Chinese and Western medicine are systematically listed.展开更多
In order to enhance the performance of the CNN-based segmentation models for bone metastases, this study proposes a segmentation method that integrates dual-pooling, DAC, and RMP modules. The network consists of disti...In order to enhance the performance of the CNN-based segmentation models for bone metastases, this study proposes a segmentation method that integrates dual-pooling, DAC, and RMP modules. The network consists of distinct feature encoding and decoding stages, with dual-pooling modules employed in encoding stages to maintain the background information needed for bone scintigrams diagnosis. Both the DAC and RMP modules are utilized in the bottleneck layer to address the multi-scale problem of metastatic lesions. Experimental evaluations on 306 clinical SPECT data have demonstrated that the proposed method showcases a substantial improvement in both DSC and Recall scores by 3.28% and 6.55% compared the baseline. Exhaustive case studies illustrate the superiority of the methodology.展开更多
文摘Objective:To investigate the clinical effect of the guided bone regeneration(GBR)technique combined with temporary bridgework-guided gingival contouring in treating upper anterior tooth loss with labial bone defects.Methods:From July 2023 to April 2024,80 patients with upper anterior tooth loss and labial bone defects were admitted to the hospital and selected as evaluation samples.They were divided into an observation group(n=40)and a control group(n=40)using a numerical table lottery scheme.The control group received treatment with the GBR technique,while the observation group received treatment with the GBR technique combined with temporary bridges to guide gingival contouring.The two groups were compared in terms of clinical red aesthetic scores(PES),labial alveolar bone density,labial bone wall thickness,gingival papillae,gingival margin levels,and patient satisfaction.Results:The PES scores of patients in the observation group were higher than those in the control group after surgery(P<0.05).The bone density of the labial alveolar bone and the thickness of the labial bone wall in the observation group were higher than those in the control group.The levels of gingival papillae and gingival margins were lower in the observation group after surgery(P<0.05).Additionally,patient satisfaction in the observation group was higher than in the control group(P<0.05).Conclusion:The GBR technique combined with temporary bridge-guided gingival contouring for treating upper anterior tooth loss with labial bone defects can improve the aesthetic effect of gingival soft tissue,increase alveolar bone density and the thickness of the labial bone wall,and enhance patient satisfaction.This approach is suitable for widespread application in healthcare institutions.
基金granted by the National Key R&D Program of China (2021YFD21001005)National Natural Science Foundation of China (31972102,32101980)+1 种基金Special key project of Chongqing technology innovation and application development (cstc2021jscx-cylhX0014)Chongqing Technology Innovation and Application Development Special Project (cstc2021jscx-tpyzxX0014)。
文摘This study aimed to characterize and identify calcium-chelating peptides from rabbit bone collagen and explore the underlying chelating mechanism.Collagen peptides and calcium were extracted from rabbit bone by instant ejection steam explosion(ICSE)combined with enzymatic hydrolysis,followed by chelation reaction to prepare rabbit bone peptide-calcium chelate(RBCP-Ca).The chelating sites were further analyzed by liquid chromatography-tandem mass(LC-MS/MS)spectrometry while the chelating mechanism and binding modes were investigated.The structural characterization revealed that RBCP successfully chelated with calcium ions.Furthermore,LC-MS/MS analysis indicated that the binding sites included both acidic amino acids(Asp and Glu)and basic amino acids(Lys and Arg),Interestingly,three binding modes,namely Inter-Linking,Loop-Linking and Mono-Linking were for the first time found,while Inter-Linking mode accounted for the highest proportion(75.1%),suggesting that chelation of calcium ions frequently occurred between two peptides.Overall,this study provides a theoretical basis for the elucidation of chelation mechanism of calcium-chelating peptides.
基金financially supported by Shenzhen Agricultural Development Special Fund(Fishery)Agricultural High-Tech Project([2021]735)the Shenzhen Science and Technology Innovation Commission(KCXFZ20201221173207022)Youth Science Foundation Project(32101936)。
文摘Hyperuricemia(HUA)is a vital risk factor for chronic kidney diseases(CKD)and development of functional foods capable of protecting CKD is of importance.This paper aimed to explore the amelioration effects and mechanism of Andrias davidianus bone peptides(ADBP)on HUA-induced kidney damage.In the present study,we generated the standard ADBP which contained high hydrophobic amino acid and low molecular peptide contents.In vitro results found that ADBP protected uric acid(UA)-induced HK-2 cells from damage by modulating urate transporters and antioxidant defense.In vivo results indicated that ADBP effectively ameliorated renal injury in HUA-induced CKD mice,evidenced by a remarkable decrease in serum UA,creatinine and blood urea nitrogen,improving kidney UA excretion,antioxidant defense and histological kidney deterioration.Metabolomic analysis highlighted 14 metabolites that could be selected as potential biomarkers and attributed to the amelioration effects of ADBP on CKD mice kidney dysfunction.Intriguingly,ADBP restored the gut microbiome homeostasis in CKD mice,especially with respect to the elevated helpful microbial abundance,and the decreased harmful bacterial abundance.This study demonstrated that ADBP displayed great nephroprotective effects,and has great promise as a food or functional food ingredient for the prevention and treatment of HUA-induced CKD.
基金supported by the National Natural Science Foundation of China(NSFC,22172082)NCC Fund(NCC2020FH05)+1 种基金Fundamental Research Funds for the Central Universities,Natural Science Foundation of Tianjin Municipal Science and Technology Commission(2022KJ208)Tianjin Health Science and Technology Project(TJWJ2021QN041).
文摘Limited cells and factors,inadequate mechanical properties,and necrosis of defects center have hindered the wide clinical application of bone-tissue engineering scaffolds.Herein,we construct a self-oxygenated 3D printed bioactive hydrogel scaffold by integrating oxygen-generating nanoparticles and hybrid double network hydrogel structure.The hydrogel scaffold possesses the characteristics of extracellular matrix;Meanwhile,the fabricated hybrid double network structure by polyacrylamide and CaCl2-crosslinked sodium carboxymethylcellulose endows the hydrogel favorable compressive strength and 3D printability.Furthermore,the O2 generated by CaO2 nanoparticles encapsulated in ZIF-8 releases steadily and sustainably because of the well-developed microporous structure of ZIF-8,which can significantly promote cell viability and proliferation in vitro,as well as angiogenesis and osteogenic differentiation with the assistance of Zn2+.More significantly,the synergy of O2 and 3D printed pore structure can prevent necrosis of defects center and facilitate cell infiltration by providing cells the nutrients and space they need,which can further induce vascular network ingrowth and accelerate bone regeneration in all areas of the defect in vivo.Overall,this work provides a new avenue for preparing cell/factor-free bone-tissue engineered scaffolds that possess great potential for tissue regeneration and clinical alternative.
基金supported by the National Key Research&Development Program of China(2021YFE0204900)the National Natural Science Foundation of China(52222108)Science and Technology Commission of Shanghai Municipality(22ZR1432000,23JC1402400).
文摘Effective management of malignant tumor-induced bone defects remains challenging due to severe systemic side effects,substantial tumor recurrence,and long-lasting bone reconstruction post tumor resection.Magnesium and its alloys have recently emerged in clinics as orthopedics implantable metals but mostly restricted to mechanical devices.Here,by deposition of calcium-based bilayer coating on the surface,a Mg-based composite implant platform is developed with tailored degradation characteristics,simultaneously integrated with chemotherapeutic(Taxol)loading capacity.The delicate modulation of Mg degradation occurring in aqueous environment is observed to play dual roles,not only in eliciting desirable osteoinductivity,but allows for modification of tumor microenvironment(TME)owing to the continuous release of degradation products.Specifically,the sustainable H2 evolution and Ca2+from the implant is distinguished to cooperate with local Taxol delivery to achieve superior antineoplastic activity through activating Cyt-c pathway to induce mitochondrial dysfunction,which in turn leads to significant tumor-growth inhibition in vivo.In addition,the local chemotherapeutic delivery of the implant minimizes toxicity and side effects,but markedly fosters osteogenesis and bone repair with appropriate structure degradation in rat femoral defect model.Taken together,a promising intraosseous administration strategy with biodegradable Mg-based implants to facilitate tumor-associated bone defect is proposed.
文摘Introduction: Pseudarthrosis (PSA) of the diaphysis of long bones still remains a current problem, despite improvements in the treatment of these fractures. Our study aims to study the epidemiological and therapeutic aspects of PSA of the diaphysis of long bones. Method: This retrospective work concerns 30 cases of non-union of the diaphysis of long bones treated in the orthopedic and trauma surgery department at Donka National Hospital, during a period of 18 months from January 1, 2019 to June 30, 2020. Results: We recruited 30 patients, 80% of whom were male, with an average age of 39.9 years. Public road accidents (AVP) represented the main cause of fractures of the diaphysis of long bones 87%, they were open in 25 cases or 83%. The fractures were located in the middle 1/3 of the diaphysis of the long bones in 50% of cases. Treatment of initial fractures was traditional in 21 cases, orthopedic in 2 cases and surgical in 7 cases. It was aseptic nonunion in 28 cases (93%) and septic nonunion in 2 cases. They were hypertrophic in 7 cases, slightly hypertrophic in 5 cases, oligotrophic in 11 cases, atrophic in 6 cases and with bone defect in 1 case. The treatment was based on osteosynthesis including 16 cases of screwed “PV” plate: 7 cases of centromedullary “ECM” nailing, 2 cases of external fixator, 1 case of broaching and 4 cases of Plastering. The results according to ASAMI criteria on an anatomical level were excellent in 19 cases, good in 3 cases and poor in 3 cases, with a union rate of 76%. And 5 patients undergoing consolidation. Conclusion: Based on the literature data and the experience of our department, the true treatment of PSA requires correct management of the initial fracture without forgetting the interest in preventing AVP which appears to be an element essential, making it possible to reduce the incidence of fractures of the diaphysis.
文摘Introduction: While autograft bone is the gold standard for multilevel posterolateral lumbar fusion, bone substitutes and graft extenders such as allograft bone, ceramics and demineralized bone matrix (DBM) have been used to avoid the morbidity and insufficient quantity associated with harvesting autologous bone. The primary objective of this retrospective study was to determine whether, in patients with increased risk of operative nonunion related to multilevel fusion, adding DBM fibers to mineralized bone allograft resulted in better fusion than using allograft alone. The secondary objectives were to evaluate how adding DBM fibers affects functional disability, low back pain, intraoperative blood loss and the nonunion rate. Methods: This retrospective study involved a chart review of consecutive patients who underwent multilevel lumbar spinal fusion and were operated on by a single surgeon. The patients were divided into two groups: 14 patients received mineralized bone allograft (control group) and 14 patients received a combination of mineralized bone allograft and DBM (experimental group). Patients were reviewed at a mean of 16.4 ± 2.2 months after surgery at which point CT scans were analyzed to determine whether fusion had occurred;Oswestry disability index (ODI) and pain were also evaluated. Results: A mean of 5 levels [min 2, max 13] were fused in these patients. Posterolateral fusion as defined by the Lenke classification was not significantly different between groups. The experimental DBM group had a significantly better composite fusion score than the control group (P Discussion: Adding DBM fibers to allograft bone during multilevel posterolateral spinal fusion was safe and produced better composite fusion than using allograft only as an autograft extender.
文摘BACKGROUND Aneurysmal bone cyst(ABC)is a benign cystic of unknown etiology,characterized by multiple chambers and a high recurrence rate.Current treatment options include vascular embolization,surgical excision,curettage with cavity filling,sclerosing agent injection into the cavity,radiotherapy,and systemic drug therapy.Among these,surgical excision and curettage are the preferred treatment modalities.However,when the cyst reaches a large size,extensive removal of diseased tissue during surgery can hinder bone healing.In our department,we treated a case of a large ABC at the distal end of the femur in a child using the Ilizarov technique.The tumor was completely excised,and reconstruction was achieved through autologous femoral bone transfer.The follow-up at two years post-surgery indicated good results without tumor recurrence,and the growth and development of the child were essentially unaffected.CASE SUMMARY An 11-year-old boy was presented with an accidental fracture of his right leg.Despite having been examined at other hospitals,he had not received treatment.Given the potential for significant bone defects and the difficulty of the surgery,our doctors opted to use the Ilizarov technique to minimize harm to the patient.Upon admission,the patient underwent a needle biopsy and complete tumor resection-the Ilizarov technique assisted in the transport and reconstruction of the autologous femoral bone.Postoperatively,the patient exhibited regular followups,during which bone transport was gradually performed,and the external fixation frame was removed on time.Follow-up X-rays of the right lower limb displayed no tumor recurrence,with a normal appearance.Bone formation at the cutting site was satisfactory,and the union of the bone ends indicated good healing.After two years of follow-up,the patient had essentially returned to normal.CONCLUSION We successfully applied the Ilizarov technique to treat ABC,reducing the financial burden of patients and the pain of multiple surgeries.In cases where significant bone defects occur,the Ilizarov technique has demonstrated satisfactory therapeutic outcomes.
文摘Background: When applied to trabecular bone X-ray images, the anisotropic properties of trabeculae located at ultra-distal radius were investigated by using the trabecular bone scores (TBS) calculated along directions parallel and perpendicular to the forearm. Methodology: Data from more than two hundred subjects were studied retrospectively. A DXA (GE Lunar Prodigy) scan of the forearm was performed on each subject to measure the bone mineral density (BMD) value at the location of ultra-distal radius, and an X-ray digital image of the same forearm was taken on the same day. The values of trabecular bone score along the direction perpendicular to the forearm, TBS<sub>x</sub>, and along the direction parallel to the forearm, TBS<sub>y</sub>, were calculated respectively. The statistics of TBS<sub>x</sub> and TBS<sub>y</sub> were calculated, and the anisotropy of the trabecular bone, which was defined as the ratio of TBS<sub>y</sub> to TBS<sub>x</sub> and changed with subjects’ BMD and age, was reported and analyzed. Results: The results show that the correlation coefficient between TBS<sub>x</sub> and TBS<sub>y</sub> was 0.72 (p BMD and age was reported. The results showed that decreased trabecular bone anisotropy was associated with deceased BMD and increased age in the subject group. Conclusions: This study shows that decreased trabecular bone anisotropy was associated with decreased BMD and increased age.
文摘Particulate bone plays a crucial role in various oral and maxillofacial surgical procedures,including reconstruction,implantation,and craniofacial surgery.Autologous bone and deproteinized bovine bone xenografts are the two primary resources used for such procedures,with the former demonstrating superior cost-effectiveness and reduced comorbidity rates,particularly in cases involving donor zones.However,a significant challenge lies in acquiring uniformly sized autologous particulate bone specimens,with existing tools often yielding coarse particles at a high cost.Consequently,commercial bone xenograft solutions are frequently favored despite lower standards.This technical note introduces a novel technique for swiftly,safely,and efficiently obtaining autologous particulate bone specimens.The procedure involves the use of a motor handpiece fitted with a micro drill and surgical spoon to collect the bone particles.The continuous irrigation with saline maintains a clear surgical field during the milling process.The collected bone particles are then transferred to a metal capsule for further use.This technique offers a promising solution to the challenge of inconsistent particle size associated with harvesting using traditional methods,providing surgeons with a reliable and efficient method of obtaining autologous particulate bone samples.
文摘BACKGROUND In the medical and dental fields,there is a need for studies of new therapeutic approaches for the treatment of bone defects that cause extensive bone loss.Melatonin may be an important endogenous biological factor for bone remodeling,and growth factors may enhance the repair process.AIM To evaluate the gene expression of cytokines(IL-1β,IL-6,IL-10 and TNF-α),markers of osteoclastogenesis(RANK,RANKL and OPG)and MMPs(MMP-1,MMP-2,MMP-8 and MMP-13)from the treatment of melatonin associated with an osteogenic membrane and rhBMP-2 on the recovery of a bone injury.METHODS Sixty-four rats were used and divided into 9 experimental groups and were formed according to the treatment carried out in the region of the bone lesion,which varied between the combination of 1,10 and 100μmol/L of melatonin.Gene Expression analysis was performed using real time-PCR by reading the concentration of total RNA and reverse transcription.RESULTS There were differences between groups when compared with clot or scaffold control,and improvement with a higher concentration of melatonin or rhBMP-2.The combination melatonin(1μg)with 5μg of rhBMP-2,using the guided bone regeneration technique,demonstrated some effects,albeit mild,on bone repair of critical bone defects.CONCLUSION This indicates that the approach for administering these substances needs to be reassessed,with the goal of ensuring their direct application to the affected area.Therefore,future research must be carried out,seeking to produce materials with these ideal characteristics.
基金NSFC and CNS for funding the projectfunded by the National Natural Science Foundation of China(NSFC,82173500)“CNS-ZD Tizhi and Health Fund”(CNS-ZD2020-163).
文摘This cohort study was designed to explore the relationship between maternal dietary patterns(DPs)and bone health in Chinese lactating mothers and infants.We recruited 150 lactating women at 1-month postpartum.The estimated bone mineral density(eBMD)of subjects’calcanei and the information on dietary intake were collected.After 5-month follow-up,the eBMD of mothers and their infants were measured again.Factor analysis was applied to determine maternal DPs.General linear models were used to evaluate the association between maternal DPs and maternal eBMD loss or infants’eBMD.With all potential covariates adjusted,Factor 2(high intake of whole grains,tubers,mixed beans,soybeans and soybean products,seaweeds,and nuts)showed a positive association with the changes of maternal eBMD(β=0.16,95%CI:0.005,0.310).Factor 3(high intake of soft drinks,fried foods,and puffed foods)was inversely correlated with the changes of maternal eBMD(β=-0.22,95%CI:-0.44,0.00).The changes of maternal eBMD were positively associated with 6-month infants’eBMD(β=0.34,95%CI:0.017,0.652).In conclusion,Factor 2 might contribute to the maintenance of eBMD in lactating women,while Factor 3 could exacerbate maternal eBMD loss.Additionally,the changes of maternal eBMD presented a positive correlation with 6-month infants’eBMD.
基金supported by the National Natural Science Foundation of China(82071104/32101104/82202663)Science and Technology Commission of Shanghai Municipality(23XD1434200/22Y21901000)+2 种基金Program of Shanghai Academic/Technology Research Leader(22XD1422600)Shanghai Municipal Health Planning Commission(202140127)Shanghai Hospital Development Center(SHDC12022120).
文摘Irregular bone defects,characterized by unpredictable size,shape,and depth,pose a major challenge to clinical treatment.Although various bone grafts are available,none can fully meet the repair needs of the defective area.Here,this study fabricates a dough-type hydrogel(DR-Net),in which the first dynamic network is generated by coordination between thiol groups and silver ions,thereby possessing kneadability to adapt to various irregular bone defects.The second rigid covalent network is formed through photocrosslinking,maintaining the osteogenic space under external forces and achieving a better match with the bone regeneration process.In vitro,an irregular alveolar bone defect is established in the fresh porcine mandible,and the dough-type hydrogel exhibits outstanding shape adaptability,perfectly matching the morphology of the bone defect.After photocuring,the storage modulus of the hydrogel increases 8.6 times,from 3.7 kPa(before irradiation)to 32 kPa(after irradiation).Furthermore,this hydrogel enables effective loading of P24 peptide,which potently accelerates bone repair in Sprague–Dawley(SD)rats with critical calvarial defects.Overall,the dough-type hydrogel with kneadability,space-maintaining capability,and osteogenic activity exhibits exceptional potential for clinical translation in treating irregular bone defects.
文摘To analyse the effectiveness of performing a transverse tibial bone graft in the treatment of patients with diabetic foot. We retrospectively analysed the clinical details of 51 diabetic foot patients in our hospital from February 2023 to February 2024 and divided them into two groups according to the different treatment modalities, in which the control group received open debridement and the treatment group received transverse tibial bone transfer and compared the differences between the two groups. There were large differences in VAS score, Toronto Clinical Symptom Score, quality of life score, internal lumen diameter, blood flow velocity in the affected limb, perfusion volume, vascular endothelial growth factor, epidermal growth factor and CRP between the two groups after surgery (P < 0.05). Patients with diabetic foot should be treated with transverse tibial bone grafting, which is safer and more effective and can have a significant impact on improving the status of the affected limb, the inflammation and the patient’s quality of life.
基金supported by the National Key R&D Program of China(No.2023YFC2412300 and 2020YFC1107600)the Key R&D Program in Shandong Province(No.2019JZZY011106)the Foshan-Tsinghua Industry-University-Research Cooperation Collaborative Innovation Project.
文摘Bone,renowned for its elegant hierarchical structure and unique mechanical properties,serves as a constant source of inspiration for the development of synthetic materials.However,achieving accurate replication of bone features in artificial materials with remarkable structural and mechanical similarity remains a significant challenge.In this study,we employed a cascade of continuous fabrication processes,including biomimetic mineralization of collagen,bidirectional freeze-casting,and pressure-driven fusion,to successfully fabricate a macroscopic bulk material known as artificial compact bone(ACB).The ACB material closely replicates the composition,hierarchical structures,and mechanical properties of natural bone.It demonstrates a lamellated alignment of mineralized collagen(MC)microfibrils,similar to those found in natural bone.Moreover,the ACB exhibits a similar high mineral content(70.9%)and density(2.2 g/cm3)as natural cortical bone,leading to exceptional mechanical properties such as high stiffness,hardness,and flexural strength that are comparable to those of natural bone.Importantly,the ACB also demonstrates excellent mechanical properties in wet,outstanding biocompatibility,and osteogenic properties in vivo,rendering it suitable for a broad spectrum of biomedical applications,including orthopedic,stomatological,and craniofacial surgeries.
基金funded by the German Research Foundation(Deutsche Forschungsgesellschaft,DFG,grant numbers 404534760).
文摘With its main features of cartilage degeneration, subchondral bone sclerosis and osteophyte formation, osteoarthritisrepresents a multifactorial disease with no effective treatment options. As biomechanical shift in thetrabecular network may be a driver for further cartilage degeneration, bone enhancement could possibly delayOA progression. Magnesium is known to be osteoconductive and already showed positive effects in OA models.We aimed to use magnesium cylinders to enhance subchondral bone quality, condition of cartilage and painsensation compared to sole drilling in vivo. After eight weeks of implantation in rabbits, significant increase insubchondral bone volume and trabecular thickness with constant bone mineral density was found indicatingfavored biomechanics. As representative for pain, a higher number of CD271+ vessels were present in controlsamples without magnesium. However, this result could not be confirmed by sensitive, objective lamenessevaluation using a pressure sensing mat and no positive effect could be shown on either cartilage degenerationevaluated by OARSI score nor the presence of regenerative cells in CD271-stained samples. The presented resultsshow a relevant impact of implanted magnesium on key structures in OA pain with missing clinical relevanceregarding pain. Further studies with shifted focus should examine additional structures as joint capsule orosteophytes.
文摘Additive manufacturing(AM)has revolutionized the design and manufacturing of patient-specific,three-dimensional(3D),complex porous structures known as scaffolds for tissue engineering applications.The use of advanced image acquisition techniques,image processing,and computer-aided design methods has enabled the precise design and additive manufacturing of anatomically correct and patient-specific implants and scaffolds.However,these sophisticated techniques can be timeconsuming,labor-intensive,and expensive.Moreover,the necessary imaging and manufacturing equipment may not be readily available when urgent treatment is needed for trauma patients.In this study,a novel design and AM methods are proposed for the development of modular and customizable scaffold blocks that can be adapted to fit the bone defect area of a patient.These modular scaffold blocks can be combined to quickly form any patient-specific scaffold directly from two-dimensional(2D)medical images when the surgeon lacks access to a 3D printer or cannot wait for lengthy 3D imaging,modeling,and 3D printing during surgery.The proposed method begins with developing a bone surface-modeling algorithm that reconstructs a model of the patient’s bone from 2D medical image measurements without the need for expensive 3D medical imaging or segmentation.This algorithm can generate both patient-specific and average bone models.Additionally,a biomimetic continuous path planning method is developed for the additive manufacturing of scaffolds,allowing porous scaffold blocks with the desired biomechanical properties to be manufactured directly from 2D data or images.The algorithms are implemented,and the designed scaffold blocks are 3D printed using an extrusion-based AM process.Guidelines and instructions are also provided to assist surgeons in assembling scaffold blocks for the self-repair of patient-specific large bone defects.
文摘BACKGROUND Lateral window approach for sinus floor lift is commonly used for vertical bone augmentation in cases when the residual bone height is less than 5 mm.However,managing cases becomes more challenging when a maxillary sinus pseudocyst is present or when there is insufficient bone width.In this case,we utilized the bone window prepared during the lateral window sinus lift as a shell for horizontal bone augmentation.This allowed for simultaneous horizontal and vertical bone augmentation immediately after the removal of the maxillary sinus pseudocyst.CASE SUMMARY A 28-year-old female presented to our clinic with the chief complaint of missing upper left posterior teeth.Intraoral examination showed a horizontal deficiency of the alveolar ridge contour.The height of the alveolar bone was approximately 3.6 mm on cone beam computed tomography(CBCT).And a typical well-defined'dome-shaped'lesion in maxillary sinus was observed on CBCT imaging.The lateral bony window was prepared using a piezo-ultrasonic device,then the bony window was fixed to the buccal side of the 26 alveolar ridge using a titanium screw with a length of 10 mm and a diameter of 1.5 mm.The space between the bony window and the alveolar ridge was filled with Bio-Oss,covered with a Bio-Gide collagen membrane,and subsequently sutured.Nine months later,the patient’s bone width increased from 4.8 to 10.5 mm,and the bone height increased from 3.6 to 15.6 mm.Subsequently,a Straumann^(■)4.1 mm×10 mm implant was placed.The final all-ceramic crown restoration was completed four months later,and both clinical and radiographic examinations showed that the implant was successful,and the patient was satisfied with the results.CONCLUSION The bone block harvested from the lateral window sinus lift can be used for simultaneous horizontal bone augmentation acting as a shell for good two-dimensional bone augmentation.
基金Supported by the National Natural Science Foundation of China(82205105).
文摘Ankylosing spondylitis(AS)has a very high disability rate.How to effectively inhibit the formation of new bones has become a difficult point in clinical treatment.In recent years,research has shown that different treatment plans can have an impact on inhibiting new bone formation.In this paper,the different effects of new bone formation in the treatment of AS with traditional Chinese and Western medicine are systematically listed.
文摘In order to enhance the performance of the CNN-based segmentation models for bone metastases, this study proposes a segmentation method that integrates dual-pooling, DAC, and RMP modules. The network consists of distinct feature encoding and decoding stages, with dual-pooling modules employed in encoding stages to maintain the background information needed for bone scintigrams diagnosis. Both the DAC and RMP modules are utilized in the bottleneck layer to address the multi-scale problem of metastatic lesions. Experimental evaluations on 306 clinical SPECT data have demonstrated that the proposed method showcases a substantial improvement in both DSC and Recall scores by 3.28% and 6.55% compared the baseline. Exhaustive case studies illustrate the superiority of the methodology.