Search Results (3,940)

Background: Older adults with cancer are surviving longer due to earlier detection and more effective treatments for advanced stages. This population is at an elevated risk of osteoporosis due to age-related changes in bone density as well as the impact of cancer and cancer treatments on the skeletal system. Main Body: Cancer treatments are associated with increased bone loss and fracture risk via a variety of mechanisms. International guidelines recommend screening for cancer treatment-induced bone loss and provide treatment algorithms for pharmacological agents for those on hormonal therapy. There is a paucity of guidelines on bone health protection for those receiving intermittent glucocorticoid and newer immunotherapy regimes. Results: All patients receiving cancer treatment should undergo an individualised fracture risk assessment to optimise their bone health with regular review and reassessment of their risk profile. Dedicated bone health guidelines in cancer populations should be expanded to consider the impact of newer treatment modalities. All patients should receive education around non-pharmacological management and undergo a shared decision-making approach where there are indications for bone-targeted agents. Conclusions: Bone health assessment is an integral part of comprehensive geriatric assessment for older people with cancer. Strategies to minimise bone density loss and reduce fracture risk are an important consideration for cancer survivorship programmes for the majority of people and require a standardised approach. Full article

Background: Autologous osteochondral transplantation (AOT)—the transfer of hyaline cartilage with its underlying subchondral bone—is well established for focal osteochondral lesions, yet evidence for larger (>200 mm²) defects is limited. We assessed clinical and functional outcomes of AOT in patients with osteochondral knee lesions exceeding 200 mm². Methods: In this retrospective cohort study, 52 patients underwent AOT for full-thickness osteochondral defects of the femoral condyles or patellofemoral joint. All lesions were ≥200 mm² and treated with a standardized press-fit technique using one to four overlapping cylindrical grafts. Pain and knee function were evaluated preoperatively and at 3, 6, and 12 months postoperatively with the Visual Analogue Scale (VAS), Tegner–Lysholm Knee Score (TLKS), and Knee Society Score (KSS). Results: Mean defect size was 224.4 ± 84.5 mm². The VAS improved from 6.32 ± 1.1 preoperatively to 0.72 ± 0.6 at 12 months (p < 0.001). The TLKS rose from 58.6 ± 11.4 to 95.0 ± 6.8 and the KSS from 63.8 ± 12.2 to 97.4 ± 4.9 during the same period (both p < 0.001). Most gains occurred within the first 3–6 months and were sustained at 12 months. No major surgical complications were observed, and outcomes were unaffected by age, sex, or graft number/size. Conclusions: AOT is a safe, effective option for large osteochondral knee defects (>200 mm²), offering rapid, durable pain relief and excellent functional recovery while preserving native joint structures. Accurate donor site reconstruction and precise graft placement in the weight-bearing zone appear critical for optimal results. Longer-term prospective studies are needed to confirm durability and refine patient-selection criteria. Full article

Background: Cardiovascular diseases (CVDs) are linked with poor oral health outcomes, yet data on oral health status, behaviors, and awareness among CVD patients in Odisha remain scarce. This study aimed to assess the self-reported oral health status, behaviors, and knowledge among patients with CVD and associated risk factors. Methods: A cross-sectional survey was conducted among 391 patients aged 40–80 years attending dental and cardiology OPDs at a tertiary care center in Bhubaneswar. Participants were grouped into control, at-risk, and established CVD categories. A 24-item questionnaire and panoramic radiographic examination were used to assess oral health. Data were analyzed using the chi-squared test and Kappa statistics. Results: Patients with established CVD reported significantly higher prevalence of oral health problems, poor oral hygiene behaviors, and lower awareness compared to controls. Clinical findings revealed higher rates of periodontal bone loss, caries, and periapical radiolucency in the CVD group. Agreement between radiographic examiners was high. Conclusions: There is a substantial burden of oral disease and poor oral health awareness among patients with CVD in Odisha. These findings emphasize the need for integrated oral health education and care protocols in cardiovascular patient management. Full article

Purpose: We previously reported that the systemic administration of preprogrammed mouse hematopoietic bone marrow-derived progenitor cells (HSPCs) improved visual function and restored a functional retinal pigment epithelial (RPE) layer. Here, we investigated the potential impact of donor vs. host age on systemic cellular therapy in a murine model of retinal degeneration. Methods: HSPCs from young (8 weeks) and old (15 months) mice were programmed ex vivo with a lentiviral vector expressing the RPE65 gene (LV-RPE65) and systemically administering into young or old SOD2 KD mice. Visual loss and pathological changes were evaluated by electroretinogram (ERG), optical coherence tomography (OCT), histology, and immunohistochemistry. Results: Old donor HSPCs administered to old manganese superoxide dismutase (SOD2) knockdown (KD) recipient mice offered the least benefit. This was exemplified by the reduced recruitment and incorporation of LV-RPE65 HSPC into the RPE layer, as well as decreased improvement in visual function, retinal thinning, and limited reduction in oxidative damage and microglial activation. LV-RPE65 HSPC from young mice incorporated into the RPE layer of old SOD2 KD mice, though to a lesser extent than young cells administered to young hosts, offered some level of protection. By contrast, LV-RPE65 HSPCs from old mice, located to the subretinal space of young host mice, reduced visual loss, although some retinal pathology was observed. Conclusions: The administration of LV-RPE65 HSPC from old donors to old SOD2 KD mice offered the least improvement. Translational Relevance: Our findings highlight how both donor and recipient age impact the success of HSPC-based retinal therapy and using cells from aged donors for AMD treatment may have some limitations. Full article

Osteoporosis is a skeletal disorder characterized by decreased bone strength, which leads to an increased risk of developing fractures. Interestingly, this metabolic disorder is often related to sarcopenia, defined as decreased muscle mass, strength, and function. These two conditions appear to be closely connected, leading to a clinical condition named osteosarcopenia (OS). Aging may explain the link between muscle and bone loss through genetic, mechanical, endocrine, and nutritional factors. Further, aging increases the amount of adipose tissue, often due to sedentary behavior and unbalanced nutritional pattern, leading to a clinical condition defined as osteosarcopenic obesity, characterized by concurrent obesity, sarcopenia, and osteoporosis, where each condition exacerbates the others. Moreover, sarcopenia leads to decreased physical (PA) activity, worsening skeletal homeostasis, and creating a vicious cycle, which increases falls, fracture risk, and disability. This review underscores the importance of a systemic approach, focusing on nutritional therapy integrated with PA and, eventually, pharmacological interventions to efficiently manage (OS). Full article

Background: The craniofacial region is functionally unique, with close interaction between muscles and bones during mastication, speech, and facial expression. Although myokines, muscle-derived signaling molecules, are increasingly being studied in relation to bone metabolism, most studies have focused on limb muscles and long bones. Given the developmental and functional specificity of craniofacial structures, this article aims to map the current evidence on myokines involved in craniofacial bone metabolism and to identify gaps in order to guide future research. Methods: We conducted a literature search in PubMed and Scopus (January 2000–July 2025), combining both free-text keywords and MeSH terms to ensure comprehensive retrieval of relevant articles. Results: Nine articles from the extensive search were included in this review that adhered to the eligibility criteria. The myokines that were reported include interleukin-6, insulin like growth factor-1, and myostatin and irisin. Conclusions: Further research is required into the mechanism by which craniofacial muscle-derived myokines regulate local bone metabolism, as this knowledge could pave the way for novel therapeutic strategies that leverage myokine signaling, which could be applied in the context of orthodontic and orthognathic treatments, maxillofacial reconstruction, or age-related bone loss. Full article

Wound healing in oral surgery is influenced by systemic conditions (aging, diabetes) and habits (smoking, alcoholism), which can hinder the natural regenerative capacity of the oral mucosa. The human amniotic membrane (hAM), long recognized for its wound-healing properties, has gained attention as a valuable biomaterial in regenerative dentistry. Its biological composition—including epithelial and mesenchymal stem cells, collagen, growth factors, cytokines, and proteins with anti-inflammatory and antimicrobial properties—supports anti-inflammatory, angiogenic, immunomodulatory, and pro-epithelializing effects. These elements work synergistically to enhance tissue repair, reduce scarring, and promote rapid healing. The hAM can be preserved through cryopreservation, dehydration, or freeze-drying, maintaining its structural and functional integrity for diverse clinical uses. In oral surgery, the hAM has been applied with significant success to surgical wound coverage, treatment of periodontal and bone defects, and implant site regeneration, as well as management of complex conditions like medication-related osteonecrosis of the jaw (MRONJ). Clinical studies and meta-analyses support its safety, efficacy, and adaptability. Despite its proven therapeutic benefits, the hAM remains underutilized in dentistry due to challenges related to its preparation and storage. This review aims to highlight its potential and encourage broader clinical adoption in regenerative oral surgical practices. Full article

Introduction: The aim of this study was to investigate the spatial relationship between the incisive canal (IC) and apical region of the maxillary central incisors in the Korean population, using cone-beam computed tomography (CBCT) imaging. The findings are intended to inform and improve the planning and execution of immediate implant placement in the maxillary esthetic zone. Materials and methods: CBCT data were collected from 94 patients (48 men, 46 women) aged 20–79 years at Gangnam Dental Clinic, Seoul, South Korea. The sample was divided according to age into three groups: 20–39 years, 40–59 years, and 60–79 years. Exclusion criteria included missing maxillary anterior teeth, severe crowding, periodontitis, pathology, and image artifacts. Measurements of the distance from the root apex to the incisive canal (RIC-11-P, RIC-21-P) and from the root apex to the buccal bone (RBB-11-B, RBB-21-B) were taken from CBCT images. Statistical analyses were conducted using Welch’s t-test, ANOVA, and Pearson correlation, with significance set at p < 0.05. Results: The mean distances from the root apex to the incisive canal were 3.77 mm (RIC-11-P) and 3.62 mm (RIC-21-P), while the mean distances to the buccal bone were 0.86 mm and 0.94 mm, respectively. Males exhibited significantly greater distances compared to females, both in the NPC-to-root apex and buccal bone measurements. Age-related variations were observed, with younger individuals showing shorter distances from the IC to the root apex. However, ANOVA tests and Pearson correlation analysis indicated no statistically significant correlation in these distances across different age groups. The study highlights significant gender differences in maxillary central incisor anatomy, with males having larger distances from the root apex to both the IC and buccal bone, which has implications for implant placement. While age-related changes were observed, they did not significantly affect the mean distances in a statistically meaningful way. Conclusions: These findings underscore the need for personalized treatment planning in immediate implant placement, particularly in relation to gender and age. Comparisons with other population studies suggest that these anatomical differences may be consistent across various ethnic groups, though individual variance factors should still be considered. Full article

Background/Objectives: Dairy and soybean are important potential dietary sources of bone health. However, their comparative effectiveness and the role of specific components remain unclear. In this network meta-analysis (NMA), we aimed to compare the effects of various dairy and soy products (food level) and their key bioactive components (component level) on bone health in healthy women. Methods: We systematically searched PubMed, Embase, Cochrane Library, and Web of Science (up to 28 February 2025) for randomized controlled trials. A frequentist random-effects NMA was used to compare interventions for lumbar spine (LS) and total body (TB) bone mineral density (BMD) and bone turnover markers [osteocalcin (OC), deoxypyridinoline (DPD)]. Mean differences (MDs) and 95% confidence intervals were pooled. Interventions were ranked using the surface under the cumulative ranking curve (SUCRA). Results: Sixty RCTs involving 6284 participants (mean age: 54.2 years) were included. At the food level, no dairy or soy interventions significantly improved outcomes versus control, although milk + yogurt ranked numerically highest based on SUCRA values. At the bioactive-component level, the combination of casein + whey protein (MD 0.04 g/cm², 95% CI 0.01–0.06) and soybean protein (MD: 0.03 g/cm², 95% CI: 0.01–0.05) significantly increased TB BMD. Whey protein alone (SUCRA 74.4% for LS BMD) and casein + whey protein (SUCRA 86.3% for TB BMD and 75.9% for DPD) were among the highest-ranked interventions for bone health. Conclusions: The combination of milk and yogurt may be relatively promising among dairy products for bone health. Whey protein appears to be a key bioactive component beneficial for women’s bone health. Full article

The growing challenge of biofilm-associated infections in dentistry necessitates advanced solutions. This review highlights the potential of smart bioactive and antibacterial materials—bioactive glass ceramics (BGCs), silver nanoparticle (AgNP)-doped polymers, and pH-responsive chitosan coatings—in transforming restorative dentistry. BGCs reduce biofilms by >90% while promoting bone integration. AgNP-polymers effectively combat S. mutans and C. albicans but require controlled dosing (<0.3 wt% in PMMA) to avoid cytotoxicity. Chitosan coatings enable pH-triggered drug release, disrupting acidic biofilms. Emerging innovations like quaternary ammonium compounds, graphene oxide hybrids, and 4D-printed hydrogels offer on-demand antimicrobial and regenerative functions. However, clinical translation depends on addressing cytotoxicity, standardizing antibiofilm testing (≥3-log CFU/mL reduction), and ensuring long-term efficacy. These smart materials pave the way for self-defending restorations, merging infection control with tissue regeneration. Future advancements may integrate AI-driven design for multifunctional, immunomodulatory dental solutions. Full article

Background/Objectives: Bruxism is a prevalent parafunctional activity that induces masticatory muscle hypertrophy and physiological mandibular bone alterations. While botulinum toxin type A (BTX-A) injections effectively reduce muscle hyperactivity, objective radiological assessment of their skeletal effects remains limited. This study aimed to quantitatively evaluate the impact of BTX-A on mandibular trabecular bone structure by assessing potential reductions in fractal dimension (FD) in bruxism patients compared to controls. Methods: This retrospective matched-pair study included 42 bruxism patients (39 females, 3 males) receiving 50 U of BTX-A in masseter muscles and 32 age-matched non-bruxism controls (30 females, 2 males). Pre- and 6-month post-treatment panoramic radiographs were analyzed. FD values were calculated from bilateral condylar neck, ramus, and angulus regions. Results: Statistically significant reductions in FD values were observed in the angulus regions post-treatment (Right: 1.3856 to 1.2995; Left: 1.3718 to 1.2529, p < 0.001). Postoperative FD values in the BTX-A group showed no significant differences when compared to the control group (p > 0.05). Conclusions: BTX-A administration leads to measurable, region-specific reductions in mandibular trabecular bone fractal dimension, particularly in the angulus. The postoperative similarity to the control group suggests a potential normalization of bone structure following treatment. These findings highlight the clinical utility of fractal analysis for monitoring osseous adaptations in neuromuscular interventions. Full article

Background and objectives: Patient-specific components (PSC) represent an innovative option for total knee arthroplasty (TKA) in advanced osteoarthritis. Their effectiveness, however, closely relies on accurate positioning. Our study investigates the accuracy achieved by means of an inertial-based extramedullary cutting guide and the postoperative clinical and radiographic outcomes. Methods and materials: This was a prospective, single-arm, pilot study involving patients undergoing primary TKA with YourKnee^TM PSC. Femoral and tibial bone resections were performed using the Perseus inertial-based extramedullary cutting guide. Postoperative mechanical alignment and component positioning were assessed by computed tomography. Clinical outcomes were evaluated preoperatively and at 1, 3, 6, and 12 months postoperatively by main knee function and clinical outcome measures. Results: The study population included a small cohort (n= 12, four females/eight males, mean age 69 ± 5.65 years, mean BMI 25.7 ± 3.8 kg/m², KL grade > 3) with no control group. The mean absolute error between the planned and obtained Hip–Knee–Ankle angle was 1.36° ± 1.06 and within ±3° of all cases. Mean coronal alignment error was 1.87° ± 0.87 and 1.67° ± 0.75 for the femoral and tibial components, respectively. The mean sagittal alignment error was 1.89° ± 1.24 and 2.45° ± 0.87 for the femoral and the tibial components, respectively. Patients showed significant improvement in clinical and functional scores within the first 6 months: OKS increased from 20.64 ± 2.77 at the preoperative screening to 42.27 ± 4.34 (p < 0.0001), total KSS rose from 90.64 ± 17.25 to 169.36 ± 23.57 (p < 0.0001), and FJS reached 85.09 ± 17.14 at 6 months (p = 0.0031), indicating excellent functional recovery and forgotten joint effect. Knee ROM improved from 90.91° ± 11.14 to 110.36° ± 8.44 (p < 0.0001). After 6 months, outcome scores plateaued, suggesting an early stabilization of clinical benefits. No signs of radiolucency were detected on X-rays at 3- and 12-month follow-ups. Conclusions: The Perseus inertial-based extramedullary cutting guide used in combination with the YourKnee^TM PSCs resulted in accurate intraoperative prosthesis positioning and significant improvements in clinical and functional outcomes at 6 months after surgery. Despite the small sample size and absence of a control group, the results suggest that such combination represents a viable option to conventional surgical instrumentation and current off-the-shelf prosthetic designs. Full article

Purpose: Gradenigo syndrome is a rare complication of acute otitis media (AOM) in children, characterized by suppurative otitis media, unilateral facial pain, and ipsilateral abducens nerve palsy. This review summarizes pediatric data on the presentation, diagnostics, treatment, and outcomes. Methods: A literature research was conducted using the terms “Gradenigo syndrome,” “petrous apicitis,” and “complications otitis media.” Pediatric cases were analyzed for demographics, symptoms, diagnostic findings, therapeutic strategies, and clinical outcomes. Results: Sixty-three articles described 65 patients (mean age: 8.0 years). The classic triad occurred in 22% of cases; 74% showed incomplete presentations. Imaging revealed petrous apex inflammation (84%) and petrous bone tip obliteration (49%). Antibiotics were administered in 88% of cases, most commonly third-generation cephalosporins. Surgery was performed in 72%, mainly myringotomy, tympanostomy tube insertion, and mastoidectomy; no direct petrous apex approaches were reported. Pathogens were identified in 41% of cases, most commonly Fusobacterium necrophorum. Clinical improvement occurred in 98%, with 75% achieving a complete resolution; complications were reported in 29%, including one fatality (2%). Conclusions: Given its variable presentation, comprehensive diagnostic imaging is essential for the diagnosis of Gradenigo syndrome. Early broad-spectrum antibiotic therapy is essential. Surgical intervention is required in severe cases. Long-term targeted antibiotic therapy may help prevent recurrence. Full article

Background: Vitamin D3 is an important factor for bone metabolism, and its deficiency may affect dental implantation results. Materials and methods: 384 patients with a diagnosis of tooth loss and vitamin D deficiency were examined and treated with dental implants. Vitamin D3 supplements were prescribed by the endocrinologist for all patients in the individual dose. The patients were divided into two equal study groups (n = 192) depending on the dental implantation period: Group 1—operation after blood serum vitamin D3 level normalization; group 2—before reaching the reference level of vitamin D3. Follow-up examinations were performed on the day of dental implantation, 7 days later, 1, 3, 6, and 12 months later, and every 1 year after treatment (up to 10 years). Implant stability and peri-implant tissue condition were assessed with clinical and X-ray diagnostics. Patients also visited an endocrinologist 2 months after the start of the treatment, then every 6 months. Results: The target vitamin D3 level (30–60 ng/mL) (p < 0.001) was achieved in all patients after treatment. At the control examinations, peri-implantitis was diagnosed in 10 patients (2.6%). It was detected in the group of patients with severe vitamin D deficiency and vitamin D deficiency—2 (25%) and 8 (3.4%) patients; respectively (p < 0.05). There was no significant difference between groups for risk of complications or bone quality after treatment. Conclusions: Timely screening of vitamin D3 levels and the appropriate treatment by an endocrinologist in young and middle-aged patients allow for achieving 97.4% dental implantation success for a ten-year period. Full article

Primary ovarian insufficiency (POI) in adolescents and young women is a rare but serious endocrine disorder with far-reaching reproductive, metabolic, and psychological implications. This study aimed to evaluate diagnostic timelines, treatment patterns, and psychosocial outcomes among affected individuals in a secondary care setting in Saudi Arabia. A retrospective observational analysis was conducted on 96 patients aged 13–39 years diagnosed with POI between 2018 and 2024. Data were extracted from electronic medical records and assessed using validated clinical and psychological tools, including the MENQOL and HADS. The mean age at diagnosis was 22.9 years, with one-third of patients experiencing diagnostic delays exceeding 18 months. Hormone replacement therapy was initiated in 69.8% of cases, while fertility counselling and bone mineral density screening were provided to 61.5% and 74.0% of patients, respectively. Over 60% exhibited clinically significant symptoms of anxiety or depression. Multivariate analysis revealed that delayed diagnosis, absence of hormone therapy, and lack of fertility counselling significantly increased the risk of psychological distress. These findings underscore the importance of timely diagnosis, multidisciplinary intervention, and integrated mental health support in the management of POI. Comprehensive, culturally responsive care models are essential to improving quality of life and long-term outcomes in this vulnerable population. Full article