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Flanagan D. Horizontal Alveolar Ridge Splitting and Expansion. J ORAL IMPLANTOL 2024; 50:200-210. [PMID: 38624042 DOI: 10.1563/aaid-joi-d-23-00186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
When considering placing dental implants in atrophic edentulous sites, there may be inadequate site width and little or no vertical bone loss. Any of several surgical procedures can augment these sites. Extracortical augmentation is done by applying graft material against the cortical bone. This technique expects progenitor cells to migrate outside the bony ridge's confines and form new bone. Another method entails ridge splitting and expansion to create space for osteogenesis and, when possible, implant placement. This may be a better method for horizontal ridge augmentation. The ridge is split, separating the facial and lingual cortices for a complete bone fracture. The patient's osseous cells can then migrate into the created space from the exposed medullary bone to form bone. The technique can be preferably performed flapless so the intact periosteum maintains a blood supply to ensure appropriate healing.
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Brzezinski ET, Hubbe M, Hunter RL, Agnew AM. Sex differences in workload in medieval Poland: Patterns of asymmetry and biomechanical adaptation in the upper limb at Giecz. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2024; 183:e24886. [PMID: 38130087 DOI: 10.1002/ajpa.24886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/29/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVES This study characterizes sexual dimorphism in skeletal markers of upper limb mechanical loading due to lateralization as evidence of division of labor in medieval Giecz, Poland. METHODS Twenty-six dimensions for paired humeri, clavicles, and radii representing adult males (n = 89) and females (n = 53) were collected from a skeletal sample from the cemetery site Gz4. Percent directional asymmetry (DA) and absolute asymmetry (AA) for each dimension were compared among bones, osteometric subcategories, and sex. Additionally, side bias and sex differences were assessed in degenerative joint disease (DJD) and entheseal changes (ECs). RESULTS Nearly all measurements revealed significant asymmetry favoring the right side. Asymmetry was most pronounced in midshaft dimensions with few sex differences. There were more correlations among dimensions within elements than between elements, mainly in the midshaft. No laterality in DJD frequencies was noted for either sex, but females demonstrated significantly lower odds of having DJD than males in most joints. Most ECs demonstrated a right-bias and association with DA with no sex-specific patterns except the biceps brachii insertion, where females were ~5 times more likely to be scored "right" than males. DISCUSSION The general lack of sex differences in asymmetry and ECs suggests similarly demanding workloads for females and males, with the exception of sex-specific functional loading differences in the forearm. Further, DJD data suggest males engaged in more intensive activities involving the upper limb. These results enhance understanding of workload in this important historical period and provide a comparison for asymmetry in past populations.
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Affiliation(s)
- Emma T Brzezinski
- Department of Anthropology, The Ohio State University, Columbus, Ohio, USA
- Skeletal Biology Research Lab, The Ohio State University, Columbus, Ohio, USA
| | - Mark Hubbe
- Department of Anthropology, The Ohio State University, Columbus, Ohio, USA
| | - Randee L Hunter
- Department of Anthropology, The Ohio State University, Columbus, Ohio, USA
- Skeletal Biology Research Lab, The Ohio State University, Columbus, Ohio, USA
| | - Amanda M Agnew
- Department of Anthropology, The Ohio State University, Columbus, Ohio, USA
- Skeletal Biology Research Lab, The Ohio State University, Columbus, Ohio, USA
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Similarities and Differences in Bone Mineral Density between Multiple Sites in the Same Individual: An Elderly Cadaveric Study. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6094663. [PMID: 35711524 PMCID: PMC9197619 DOI: 10.1155/2022/6094663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/18/2022] [Indexed: 11/17/2022]
Abstract
Bone mineral density (BMD) is known to vary based on various factors, and the degree of variation is site-specific. However, few studies have investigated the relationship between bone density at trabecular bone-rich and cortical bone-rich sites in the same individual. In this study, we attempted to measure BMD at multiple sites using whole-body computed tomography images taken immediately after death and to clarify the similarities and differences between skeletal sites. Additionally, we aimed to examine the factors that influence changes in BMD, such as the loading environment, bone microstructure, and the ossification process of each skeletal region. A 3D model containing BMD data of the skull, clavicle, lumbar vertebrae, and femur (neck and diaphysis) was created using computed tomography images taken immediately after the death of 60 individuals (28 men and 32 women, average age: 84.0 years) who consented to participate in the study before death. Arbitrary measurement sites were defined, and bone density was measured at each site. We found that the BMDs of all regions were negatively correlated with age, but this correlation was weaker in the skull than in other regions. The negative correlation was especially pronounced in areas with more trabecular bones in men and in areas with more cortical bones in women. Furthermore, these findings suggest that factors, such as the loading environment, bone microstructure, and the ossification process of the skeletal sites, affect the BMD. Furthermore, our results suggest that it is important to assess the BMD of cortical bone in older women.
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Liang W, Wu X, Dong Y, Chen X, Zhou P, Xu F. Mechanical stimuli-mediated modulation of bone cell function-implications for bone remodeling and angiogenesis. Cell Tissue Res 2021; 386:445-454. [PMID: 34665321 DOI: 10.1007/s00441-021-03532-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 09/21/2021] [Indexed: 12/20/2022]
Abstract
Bone remodeling, expressed as bone formation and turnover, is a complex and dynamic process closely related to its form and function. Different events, such as development, aging, and function, play a critical role in bone remodeling and metabolism. The ability of the bone to adapt to new loads and forces has been well known and has proven useful in orthopedics and insightful for research in bone and cell biology. Mechanical stimulation is one of the most important drivers of bone metabolism. Interestingly, different types of forces will have specific consequences in bone remodeling, and their beneficial effects can be traced using different biomarkers. In this narrative review, we summarize the major mediators and events in bone remodeling, focusing on the effects of mechanical stimulation on bone metabolism, cell populations, and ultimately, bone health.
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Affiliation(s)
- Wenqing Liang
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, 355 Xinqiao Road, Dinghai District, Zhoushan 316000, Zhejiang Province, People's Republic of China.
| | - Xudong Wu
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, 355 Xinqiao Road, Dinghai District, Zhoushan 316000, Zhejiang Province, People's Republic of China
| | - Yongqiang Dong
- Department of Orthopaedics, Xinchang People's Hospital, Shaoxing, 312500, Zhejiang Province, People's Republic of China
| | - Xuerong Chen
- Department of Orthopaedics, Shaoxing People's Hospital, Shaoxing Hospital, Zhejiang University School of Medicine, Shaoxing, 312000, Zhejiang Province, People's Republic of China
| | - Ping Zhou
- Department of Orthopaedics, Shaoxing People's Hospital, Shaoxing Hospital, Zhejiang University School of Medicine, Shaoxing, 312000, Zhejiang Province, People's Republic of China
| | - Fangming Xu
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, 355 Xinqiao Road, Dinghai District, Zhoushan 316000, Zhejiang Province, People's Republic of China.
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Schmidutz F, Milz S, Schiuma D, Richards RG, Windolf M, Sprecher CM. Cortical parameters predict bone strength at the tibial diaphysis, but are underestimated by HR-pQCT and μCT compared to histomorphometry. J Anat 2020; 238:669-678. [PMID: 33084063 PMCID: PMC7855080 DOI: 10.1111/joa.13337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 09/05/2020] [Accepted: 09/28/2020] [Indexed: 12/16/2022] Open
Abstract
Cortical bone and its microstructure are crucial for bone strength, especially at the long bone diaphysis. However, it is still not well‐defined how imaging procedures can be used as predictive tools for mechanical bone properties. This study evaluated the capability of several high‐resolution imaging techniques to capture cortical bone morphology and assessed the correlation with the bone's mechanical properties. The microstructural properties (cortical thickness [Ct.Th], porosity [Ct.Po], area [Ct.Ar]) of 11 female tibial diaphysis (40–90 years) were evaluated by dual‐energy X‐ray absorptiometry (DXA), high‐resolution peripheral‐quantitative‐computed‐tomography (HR‐pQCT), micro‐CT (μCT) and histomorphometry. Stiffness and maximal torque to failure were determined by mechanical testing. T‐Scores determined by DXA ranged from 0.6 to −5.6 and a lower T‐Score was associated with a decrease in Ct.Th (p ≤ 0.001) while the Ct.Po (p ≤ 0.007) increased, and this relationship was independent of the imaging method. With decreasing T‐Score, histology showed an increase in Ct.Po from the endosteal to the periosteal side (p = 0.001) and an exponential increase in the ratio of osteons at rest to those after remodelling. However, compared to histomorphometry, HR‐pQCT and μCT underestimated Ct.Po and Ct.Th. A lower T‐Score was also associated with significantly reduced stiffness (p = 0.031) and maximal torque (p = 0.006). Improving the accuracy of Ct.Po and Ct.Th did not improve prediction of the mechanical properties, which was most closely related to geometry (Ct.Ar). The ex‐vivo evaluation of mechanical properties correlated with all imaging modalities, with Ct.Th and Ct.Po highly correlated with the T‐Score of the tibial diaphysis. Cortical microstructural changes were underestimated with the lower resolution of HR‐pQCT and μCT compared to the histological ‘gold standard’. The increased accuracy did not result in an improved prediction for local bone strength in this study, which however might be related to the limited number of specimens and thus needs to be evaluated in a larger collective.
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Affiliation(s)
- Florian Schmidutz
- AO Research Institute Davos, Davos, Switzerland.,Department of Orthopaedic Surgery, University of Munich (LMU), Munich, Germany.,University of Tübingen, BG Trauma Center, Tübingen, Germany
| | - Stefan Milz
- Department of Anatomy II, University of Munich (LMU), Munich, Germany
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Gutiérrez S. CORR Insights®: What Regions of the Distal Clavicle Have the Greatest Bone Mineral Density and Cortical Thickness? A Cadaveric Study. Clin Orthop Relat Res 2019; 477:2733-2734. [PMID: 31764343 PMCID: PMC6907306 DOI: 10.1097/corr.0000000000001021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 10/09/2019] [Indexed: 01/31/2023]
Affiliation(s)
- Sergio Gutiérrez
- S. Gutiérrez, Director, Innovation Department, Foundation for Orthopaedic Research and Education, Tampa, FL, USA
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