Avances en el tratamiento de la osteoporosis secundaria

Osteoporosis is being increasingly recognised in paediatric practice as a consequence of the increasing life expectancy of children who suffer from chronic diseases and other factors.There are many non-pharmacological measures that can improve children’ bone health, for example, avoiding inflammatory activity and osteotoxic treatments; increasing sun exposure and weight-bearing exercise, and maintaining an adequate nutritional status.Vitamin D and calcium supplements have been proposed as a measure to increase bone mass, but their effect and therapeutic indications are not completely clear.On the other hand, bisphosphonates are currently the only pharmacological alternative for the patients with infantile secondary osteoporosis. However, more studies are required on the therapeutic indications, posology, and long term secondary effects of biphosphonates.The aim of this article is to analyze the scientific evidence of the effectiveness of the therapeutic alternatives for childhood secondary osteoporosis and their safety in children.     

Measurement of three-dimensional perioral soft tissue changes in dentoalveolar protrusion patients after orthodontic treatment using a structured light scanner

Objective:To evaluate the three-dimensional (3D) perioral soft tissue changes after orthodontic treatment in patients with dentoalveolar protrusion using structured light–based scanners.Materials and Methods:Forty-four Korean adults (19 men and 25 women, 21.4 ± 3.4 years) with dentoalveolar protrusion treated by extraction of all four first premolars and then en masse retraction with maximum anchorage were evaluated. Lateral cephalograms and 3D facial scans were obtained before treatment (T1) and immediately after debonding (T2). Superimposition was performed, and 27 perioral landmarks were identified. The 3D changes in the landmarks and ratio of movement of the soft tissue relative to the horizontal incisal tip were evaluated. A paired t-test and one-way analysis of variance were performed.Results:The upper incisors were retracted 5.76 mm and the lower incisors were retracted 4.62 mm (P < .001). The upper lip moved inferoposteriorly, and the lower lip moved superoposteriorly. In the lower lip, upward movement was greater than backward movement (P < .001). The most prominent changes appeared at the greatest bulge area. The relative ratios were 42%–53% in the upper lip area and 22%–82% in the lower lip area. The lip corners moved superoposteriorly (P < .001). Subnasale moved downward (P < .05) and posteriorly (P < .001), while the landmarks under the nostrils moved upward and posteriorly (P < .001).Conclusion:Facial scans from white structured light scanners efficiently evaluated 3D perioral soft tissue in dentoalveolar protrusion patients. Backward movement and significant vertical movement of the lip were observed. The nasal and lip angle areas showed considerable changes.     

Reliability and validity of measurements of facial swelling with a stereophotogrammetry optical three-dimensional scanner

Volume changes in facial morphology can be assessed using the 3dMD DSP400® stereo-optical 3-dimensional scanner, which uses visible light and has a short scanning time. Its reliability and validity have not to our knowledge been investigated for the assessment of facial swelling. Our aim therefore was to assess them for measuring changes in facial contour, in vivo and in vitro. Twenty-four healthy volunteers with and without an artificial swelling of the cheek were scanned, twice in the morning and twice in the afternoon (in vivo measurements). A mannequin head was scanned 4 times with and without various externally applied artificial swellings (in vitro measurements). The changes in facial contour caused by the artificial swelling were measured as the change in volume of the cheek (with and without artificial swelling in place) using 3dMD Vultus® software. In vivo and in vitro reliability expressed in intraclass correlations were 0.89 and 0.99, respectively. In vivo and in vitro repeatability coefficients were 5.9 and 1.3 ml, respectively. The scanner underestimated the volume by 1.2 ml (95% CI -0.9 to 3.4) in vivo and 0.2 ml (95% CI 0.02 to 0.4) in vitro.     

A new posture measurement method for measuring intrinsic standing posture

Aims: Although body posture in relation to the dental condition has been of great interest in the dental profession, rumination bias has been a substantial obstacle to achieving a reliable objective evaluation of the intrinsic body posture. The aim of this study was to establish a posture control protocol that would minimize the effect of bias.

Methodology: Fifteen healthy male volunteers (23–33 years of age) participated in this study. The posture movement was recorded for 10 seconds by a three-dimensional motion capture system. The experiment was performed on four different days.

Results: The posture was most stable at 4–5 seconds after the start of the front bulb gaze (the mean coefficient of variation ranged from 0·1 to 44·1). The intraclass correlation coefficients for four days were 0·871–0·975 (P≤0·001).

Conclusions: It was concluded that the use of this measurement method helped in producing a reliable intrinsic standing posture where unbiased evaluation of the effect of any intervention on the body posture is researched.     

Differences in three-dimensional soft tissue changes after upper,lower, or both jaw orthognathic surgery in skeletal class III patients

The decision is not always straightforward as to which orthognathic procedure is best for a good aesthetic result; three-dimensional imaging has brought new insight into this topic. The aim of this prospective study was to verify objectively whether postoperative changes occur within those regions not directly affected by surgical movements of the underlying jaw bones. The study included 83 young adults with skeletal class III deformities. They were classified into three groups according to the type of surgery: bilateral sagittal split osteotomy set-back of the mandible (BSSO), Le Fort I advancement of the maxilla, or a combination of both. Pre- and postoperative optical scans were registered as regional best-fits on the areas of the foreheads and both orbits. The shell to shell differences were measured and the average distances between the observed regions were calculated. As expected, changes were greatest in the regions where the underlying bones had been moved, but regardless of the operation performed, changes were found over the whole face. Changes in the nose, cheek, and upper lip regions in the BSSO group and in the lower lip and chin region in the Le Fort I group confirmed the concept of the facial soft tissue mask acting as one unit.     

Virtual medical plant modeling based on L-system

Background

Searching the drug molecules from the medicinal plants become more and more popular given that herbal components have been widely considered to be safe.In medical virtual plant studies, development rules are difficult to be extracted, the construction of plant organs is highly dependent on equipment and the process is complicated.

Aim

To establish three-dimensional structural virtual plant growth model.

Methods

The quasi-binary tree structure and its properties were obtained through the research of theory on binary tree, then the relationship between quasi-binary tree structure and plant three-dimensional branching structure model was analyzed, and the three-dimensional morphology of plants was described.

Results

A three-dimensional plant branch structure pattern extracting algorithm based on quasi-binary tree structure. By using 3-D L-system method, the extracted rules were systematized, and standardized. Further more, we built a comprehensive L-model system. With the aid of graphics and PlantVR, we implemented the plant shape and 3-D structure''s reconstruction.

Conclusion

Three-dimensional structure virtual plant growth model based on time-controlled L-system has been successfully established.     

The role of intratumoral lymphovascular density in distinguishing primary from secondary mucinous ovarian tumors

OBJECTIVE:

Ovarian mucinous metastases commonly present as the first sign of the disease and are capable of simulating primary tumors. Our aim was to investigate the role of intratumoral lymphatic vascular density together with other surgical-pathological features in distinguishing primary from secondary mucinous ovarian tumors.

METHODS:

A total of 124 cases of mucinous tumors in the ovary (63 primary and 61 metastatic) were compared according to their clinicopathological features and immunohistochemical profiles. The intratumoral lymphatic vascular density was quantified by counting the number of vessels stained by the D2-40 antibody.

RESULTS:

Metastases occurred in older patients and were associated with a higher proportion of tumors smaller than 10.0 cm; bilaterality; extensive necrosis; extraovarian extension; increased expression of cytokeratin 20, CDX2, CA19.9 and MUC2; and decreased expression of cytokeratin 7, CA125 and MUC5AC. The lymphatic vascular density was increased among primary tumors. However, after multivariate analysis, the best predictors of a secondary tumor were a size of 10.0 cm or less, bilaterality and cytokeratin 7 negativity. Lack of MUC2 expression was an important factor excluding metastasis.

CONCLUSIONS:

The higher intratumoral lymphatic vascular density in primary tumors when compared with secondary lesions suggests differences in the microenvironment. However, considering the differential diagnosis, the best discriminator of a secondary tumor is the combination of tumor size, laterality and the pattern of expression of cytokeratin 7 and MUC2.