BACKGROUND:The previous study of the research group confirmed that Bushen Zhuangjin Decoction can regulate bone metabolism and play an anti-osteoporosis role,and nanocrystalline collagen-based bone can assist in the repair of limb bone defects.OBJECTIVE:To explore the repair effect of nanocrystalline collagen-based bone combined with Bushen Zhuangjin Decoction on osteoporotic bone defects.METHODS:Totally 84 female SD rats were randomly divided into a sham operation group(n=6,no modeling)and a bilateral ovariectomy group(n=78).After 12 weeks of bilateral ovariectomy,the sham operation group(n=6)and the bilateral ovariectomy group(n=6)were selected for osteoporosis modeling verification.The remaining 72 rats in the bilateral ovariectomy group were randomly divided into 6 intervention groups,with 12 rats in each group:groups A-E had femoral defect models(diameter 3.5 mm,depth 4 mm)established 12 weeks after bilateral ovariectomy.Group A was given double distilled water by gavage(once a day)after surgery;group B was given Bushen Zhuangjin Decoction by gavage(once a day)after surgery;group C had nanocrystalline collagen-based bone filled in the bone defect and then given double distilled water by gavage(once a day);group D had nanocrystalline collagen-based bone filled in the bone defect and then given alendronate sodium by gavage(once a week);group E had nanocrystalline collagen-based bone filled in the bone defect and then given Bushen Zhuangjin Decoction by gavage(once a day);group F had femoral defect models established at the same time after bilateral ovariectomy,and bone defect sites were filled with nanocrystalline collagen-based bone and then given Bushen Zhuangjin Decoction by gavage(once a day).All drugs were given continuously for 12 weeks.12 hours after the last administration,serum levels of type Ⅰ procollagen amino-terminal propeptide,type Ⅰ collagen cross-linked C-terminal peptide,and estradiol were detected;bone volume in the bone defect area was detected by Micro-CT.The expression of type Ⅰ collagen and vascular endothelial growth factor in the bone defect area was detected by immunohistochemical staining.RESULTS AND CONCLUSION:(1)Compared with group A,the serum level of type Ⅰ procollagen amino-terminal propeptide in groups D and E was decreased(P＜0.05).Compared with groups A and C,the serum estradiol level in groups D,E,and F was increased(P＜0.05).There was no significant difference in the bone volume in the defect area between groups A-F(P＞0.05).(2)Immunohistochemical staining showed that compared with group A,the expression of typeⅠ collagen and vascular endothelial growth factor in groups B,D,and E increased(P＜0.05).Compared with group C,the expression of type Ⅰ collagen in groups B,D,E,and F increased(P＜0.05),and the expression of vascular endothelial growth factor in groups D,E,and F increased(P＜0.05).(3)The results show that nanocrystalline collagen-based bone combined with Bushen Zhuangjin Decoction may have the potential to repair bone defects in ovariectomized osteoporotic rats.

BACKGROUND:The previous study of the research group confirmed that Bushen Zhuangjin Decoction can regulate bone metabolism and play an anti-osteoporosis role,and nanocrystalline collagen-based bone can assist in the repair of limb bone defects.OBJECTIVE:To explore the repair effect of nanocrystalline collagen-based bone combined with Bushen Zhuangjin Decoction on osteoporotic bone defects.METHODS:Totally 84 female SD rats were randomly divided into a sham operation group(n=6,no modeling)and a bilateral ovariectomy group(n=78).After 12 weeks of bilateral ovariectomy,the sham operation group(n=6)and the bilateral ovariectomy group(n=6)were selected for osteoporosis modeling verification.The remaining 72 rats in the bilateral ovariectomy group were randomly divided into 6 intervention groups,with 12 rats in each group:groups A-E had femoral defect models(diameter 3.5 mm,depth 4 mm)established 12 weeks after bilateral ovariectomy.Group A was given double distilled water by gavage(once a day)after surgery;group B was given Bushen Zhuangjin Decoction by gavage(once a day)after surgery;group C had nanocrystalline collagen-based bone filled in the bone defect and then given double distilled water by gavage(once a day);group D had nanocrystalline collagen-based bone filled in the bone defect and then given alendronate sodium by gavage(once a week);group E had nanocrystalline collagen-based bone filled in the bone defect and then given Bushen Zhuangjin Decoction by gavage(once a day);group F had femoral defect models established at the same time after bilateral ovariectomy,and bone defect sites were filled with nanocrystalline collagen-based bone and then given Bushen Zhuangjin Decoction by gavage(once a day).All drugs were given continuously for 12 weeks.12 hours after the last administration,serum levels of type Ⅰ procollagen amino-terminal propeptide,type Ⅰ collagen cross-linked C-terminal peptide,and estradiol were detected;bone volume in the bone defect area was detected by Micro-CT.The expression of type Ⅰ collagen and vascular endothelial growth factor in the bone defect area was detected by immunohistochemical staining.RESULTS AND CONCLUSION:(1)Compared with group A,the serum level of type Ⅰ procollagen amino-terminal propeptide in groups D and E was decreased(P＜0.05).Compared with groups A and C,the serum estradiol level in groups D,E,and F was increased(P＜0.05).There was no significant difference in the bone volume in the defect area between groups A-F(P＞0.05).(2)Immunohistochemical staining showed that compared with group A,the expression of typeⅠ collagen and vascular endothelial growth factor in groups B,D,and E increased(P＜0.05).Compared with group C,the expression of type Ⅰ collagen in groups B,D,E,and F increased(P＜0.05),and the expression of vascular endothelial growth factor in groups D,E,and F increased(P＜0.05).(3)The results show that nanocrystalline collagen-based bone combined with Bushen Zhuangjin Decoction may have the potential to repair bone defects in ovariectomized osteoporotic rats.

OBJECTIVES: This study aims to evaluate the short- to medium-term clinical efficacy of demineralized dentin matrix (DDM) particles applied during the immediate implantation of alveolar bone defects in the posterior region. METHODS: A total of 76 patients with 110 simple taper retentive implants were included in the conducted study and divided into Groups A and B in accordance with the bone grafting materials. Cone beam computed tomography and panoramic radiographs were taken immediately after implant surgery, immediate crown repair, and final follow-up time. The average follow-up time for Groups A and B was recorded. The primary observed clinical indicators were overall survival rate of the implant, bone resorption of the mesial and distal margins of the implant, buccal bone width resorption at the platform level and 1 mm below the platform, and bone height of the implant. Implant complication was a secondary observed clinical indicator. RESULTS: During the 1-to-5-year follow-up observation period, the mean follow-up of Group A was 38.2 months while that of Group B was 39.9 months. In Group A, two implants failed, one of which fractured, and implant overall survival rate was 96.4%. Four implants failed in Group B due to peri-implantitis, and implant overall survival rate was 92.6%. No statistically significant difference in implant overall survival rate was found between the two groups (P>0.05). In Group A, the average bone resorption in the mesial and distal margins of the implants was (1.011±2.047) mm and (0.841±2.183) mm, respectively. In Group B, the average bone resorption of the mesial and distal margins of the implants was (1.546±1.778) mm and (1.431±1.909) mm, respectively. No statistically significant difference was noted between the two groups (P>0.05). In Group A, buccal bone width resorption at the platform level and 1 mm below the platform of the implant was (0.782±2.084) mm and (0.681±2.307) mm, respectively. In Group B, buccal bone width resorption at the platform level and 1 mm below the platform of implant was (1.071±1.474) mm and (0.949±1.909) mm, respectively. No statistically significant difference was found between the two groups (P>0.05). In Group A, the buccal bone height of resorption of the implant was (1.044±2.214) mm. In Group B, the buccal bone height of resorption of the implant was (1.075±1.456) mm. No statistically significant difference in bone height was observed between the two groups (P>0.05). CONCLUSIONS During the 1-to-5-year follow-up observation period, DDM particles can effectively increase the height and width of alveolar bone, and they can achieve the same effect of maintaining alveolar bone contour and bone augmentation compared with deproteinized inorganic calf bone. DDM particles can be used as a potential new bone grafting material for the treatment of bone defects in clinical practice.
Humans ; Follow-Up Studies ; Dentin ; Cone-Beam Computed Tomography ; Dental Implants ; Male ; Female ; Adult ; Alveolar Bone Loss/surgery* ; Middle Aged ; Bone Transplantation ; Radiography, Panoramic ; Dental Implantation, Endosseous/methods* ; Immediate Dental Implant Loading

OBJECTIVES: To explore the related risk factors of early failure of simple taper retentive implants, and to provide theoretical guidance for clinical work. METHODS: Collect cases of patients who visited the Department of Stomatology of the Fourth Affiliated Hospital of Nanchang University from January 2021 to June 2024, received simple taper retentive implants, and had complete medical records. Taking the implants as the unit, analyze the influence of patient-related factors (gender, age, smoking history, hypertension history, diabetes history), implant-related factors (implant length, implant diameter, implant surface treatment), and surgical-related factors (implant site, implant timing, simultaneous maxillary sinus floor elevation, simultaneous bone augmentation) on the early failure of implants. Univariate analysis and multivariate analysis were adopted to explore the potential risk factors for early failure of simple taper retentive implants. RESULTS: A total of 3,533 simple taper retentive from 1,681 patients were included during the study period. Among them, 53 implants from 49 patients experienced early failure, with an early failure rate of 2.9% at the patient le-vel and 1.5% at the implant level. Multivariate analysis revealed that smoking (OR=2.148, P=0.021), the anterior mandibular region (OR=3.669, P=0.006), and the posterior maxillary region (OR=2.191, P=0.033) were risk factors for early failure of simple taper retentive implants. In the univariate analysis, simultaneous maxillary sinus floor elevation had a higher risk of early failure, but this effects was no longer significant in the multivariate analysis (P>0.05). CONCLUSIONS Smoking, the anterior mandibular region, and the posterior maxillary region are risk factors for the early failure of simple taper retentive implants, and could be comprehensively considered in the preoperative treatment plan.
Humans ; Risk Factors ; Male ; Female ; Middle Aged ; Dental Implants ; Adult ; Smoking/adverse effects* ; Dental Restoration Failure ; Aged

Objective: To investigate the correlation between magnetic resonance imaging-based vertebral bone quality (VBQ) score and screw loosening after dynamic pedicle screw fixation with polyetheretherketone (PEEK) rods, and evaluate its predictive value. Methods: A retrospective analysis was conducted on the patients who underwent dynamic pedicle screw fixation with PEEK rods from March 2017 to June 2022. Data on age, sex, body mass index, hypertension, diabetes, hyperlipidemia history, long-term smoking, alcohol consumption, VBQ score, L1–4 average Hounsfield unit (HU) value, surgical fixation length, and the lowest instrumented vertebra were collected. Logistic regression analysis was employed to assess the relationship between VBQ score and pedicle screw loosening (PSL). Results: A total of 24 patients experienced PSL after surgery (20.5%). PSL group and non-PSL group showed statistical differences in age, number of fixed segments, fixation to the sacrum, L1–4 average HU value, and VBQ score (p < 0.05). The VBQ score in the PSL group was higher than that in the non-PSL group (3.56 ± 0.45 vs. 2.77 ± 0.31, p < 0.001). In logistic regression analysis, VBQ score (odds ratio, 3.425; 95% confidence interval, 1.552–8.279) were identified as independent risk factors for screw loosening. The area under the receiver operating characteristic curve for VBQ score predicting PSL was 0.819 (p < 0.05), with the optimal threshold of 3.15 (sensitivity, 83.1%; specificity, 80.5%). Conclusion The VBQ score can independently predict postoperative screw loosening in patients undergoing lumbar dynamic pedicle screw fixation with PEEK rods, and its predictive value is comparable to HU value.

Objective: To investigate the correlation between magnetic resonance imaging-based vertebral bone quality (VBQ) score and screw loosening after dynamic pedicle screw fixation with polyetheretherketone (PEEK) rods, and evaluate its predictive value. Methods: A retrospective analysis was conducted on the patients who underwent dynamic pedicle screw fixation with PEEK rods from March 2017 to June 2022. Data on age, sex, body mass index, hypertension, diabetes, hyperlipidemia history, long-term smoking, alcohol consumption, VBQ score, L1–4 average Hounsfield unit (HU) value, surgical fixation length, and the lowest instrumented vertebra were collected. Logistic regression analysis was employed to assess the relationship between VBQ score and pedicle screw loosening (PSL). Results: A total of 24 patients experienced PSL after surgery (20.5%). PSL group and non-PSL group showed statistical differences in age, number of fixed segments, fixation to the sacrum, L1–4 average HU value, and VBQ score (p < 0.05). The VBQ score in the PSL group was higher than that in the non-PSL group (3.56 ± 0.45 vs. 2.77 ± 0.31, p < 0.001). In logistic regression analysis, VBQ score (odds ratio, 3.425; 95% confidence interval, 1.552–8.279) were identified as independent risk factors for screw loosening. The area under the receiver operating characteristic curve for VBQ score predicting PSL was 0.819 (p < 0.05), with the optimal threshold of 3.15 (sensitivity, 83.1%; specificity, 80.5%). Conclusion The VBQ score can independently predict postoperative screw loosening in patients undergoing lumbar dynamic pedicle screw fixation with PEEK rods, and its predictive value is comparable to HU value.

BACKGROUND:Heterotopic ossification is a dynamic growth process.Diverse heterotopic ossification subtypes have diverse etiologies or induction factors,but they exhibit a similar clinical process in the intermediate and later phases of the disease.Acquired heterotopic ossification produced by trauma and other circumstances has a high incidence. OBJECTIVE:To summarize the molecular biological mechanisms linked to the occurrence and progression of acquired heterotopic ossification in recent years. METHODS:The keywords"molecular biology,heterotopic ossification,mechanisms"were searched in CNKI,Wanfang,PubMed,Embase,Web of Science,and Google Scholar databases for articles published from January 2016 to August 2022.Supplementary searches were conducted based on the obtained articles.After the collected literature was screened,131 articles were finally included and summarized. RESULTS AND CONCLUSION:(1)The occurrence and development of acquired heterotopic ossification is a dynamic process with certain concealment,making diagnosis and treatment of the disease difficult.(2)By reviewing relevant literature,it was found that acquired heterotopic ossification involves signaling pathways such as bone morphogenetic protein,transforming growth factor-β,Hedgehog,Wnt,and mTOR,as well as core factors such as Runx-2,vascular endothelial growth factor,hypoxia-inducing factor,fibroblast growth factor,and Sox9.The core mechanism may be the interaction between different signaling pathways,affecting the body's osteoblast precursor cells,osteoblast microenvironment,and related cytokines,thereby affecting the body's bone metabolism and leading to the occurrence of acquired heterotopic ossification.(3)In the future,it is possible to take the heterotopic ossification-related single-cell osteogenic homeostasis as the research direction,take the osteoblast precursor cells-osteogenic microenvironment-signaling pathways and cytokines as the research elements,explore the characteristics of each element under different temporal and spatial conditions,compare the similarities and differences of the osteogenic homeostasis of different types and individuals,observe the regulatory mechanism of the molecular signaling network of heterotopic ossification from a holistic perspective.It is beneficial to the exploration of new methods for the future clinical prevention and treatment of heterotopic ossification.(4)Meanwhile,the treatment methods represented by traditional Chinese medicine and targeted therapy have become research hotspots in recent years.How to link traditional Chinese medicine with the osteogenic homeostasis in the body and combine it with targeted therapy is also one of the future research directions.(5)At present,the research on acquired heterotopic ossification is still limited to basic experimental research and the clinical prevention and treatment methods still have defects such as uncertain efficacy and obvious side effects.The safety and effectiveness of relevant targeted prevention and treatment drugs in clinical application still need to be verified.Future research should focus on clinical prevention and treatment based on basic experimental research combined with the mechanism of occurrence and development.

Objective: To investigate the correlation between magnetic resonance imaging-based vertebral bone quality (VBQ) score and screw loosening after dynamic pedicle screw fixation with polyetheretherketone (PEEK) rods, and evaluate its predictive value. Methods: A retrospective analysis was conducted on the patients who underwent dynamic pedicle screw fixation with PEEK rods from March 2017 to June 2022. Data on age, sex, body mass index, hypertension, diabetes, hyperlipidemia history, long-term smoking, alcohol consumption, VBQ score, L1–4 average Hounsfield unit (HU) value, surgical fixation length, and the lowest instrumented vertebra were collected. Logistic regression analysis was employed to assess the relationship between VBQ score and pedicle screw loosening (PSL). Results: A total of 24 patients experienced PSL after surgery (20.5%). PSL group and non-PSL group showed statistical differences in age, number of fixed segments, fixation to the sacrum, L1–4 average HU value, and VBQ score (p < 0.05). The VBQ score in the PSL group was higher than that in the non-PSL group (3.56 ± 0.45 vs. 2.77 ± 0.31, p < 0.001). In logistic regression analysis, VBQ score (odds ratio, 3.425; 95% confidence interval, 1.552–8.279) were identified as independent risk factors for screw loosening. The area under the receiver operating characteristic curve for VBQ score predicting PSL was 0.819 (p < 0.05), with the optimal threshold of 3.15 (sensitivity, 83.1%; specificity, 80.5%). Conclusion The VBQ score can independently predict postoperative screw loosening in patients undergoing lumbar dynamic pedicle screw fixation with PEEK rods, and its predictive value is comparable to HU value.

Objective: To investigate the correlation between magnetic resonance imaging-based vertebral bone quality (VBQ) score and screw loosening after dynamic pedicle screw fixation with polyetheretherketone (PEEK) rods, and evaluate its predictive value. Methods: A retrospective analysis was conducted on the patients who underwent dynamic pedicle screw fixation with PEEK rods from March 2017 to June 2022. Data on age, sex, body mass index, hypertension, diabetes, hyperlipidemia history, long-term smoking, alcohol consumption, VBQ score, L1–4 average Hounsfield unit (HU) value, surgical fixation length, and the lowest instrumented vertebra were collected. Logistic regression analysis was employed to assess the relationship between VBQ score and pedicle screw loosening (PSL). Results: A total of 24 patients experienced PSL after surgery (20.5%). PSL group and non-PSL group showed statistical differences in age, number of fixed segments, fixation to the sacrum, L1–4 average HU value, and VBQ score (p < 0.05). The VBQ score in the PSL group was higher than that in the non-PSL group (3.56 ± 0.45 vs. 2.77 ± 0.31, p < 0.001). In logistic regression analysis, VBQ score (odds ratio, 3.425; 95% confidence interval, 1.552–8.279) were identified as independent risk factors for screw loosening. The area under the receiver operating characteristic curve for VBQ score predicting PSL was 0.819 (p < 0.05), with the optimal threshold of 3.15 (sensitivity, 83.1%; specificity, 80.5%). Conclusion The VBQ score can independently predict postoperative screw loosening in patients undergoing lumbar dynamic pedicle screw fixation with PEEK rods, and its predictive value is comparable to HU value.