Cathepsin K inhibitor causes changes in crystallinity and crystal structure of newly-formed mandibular bone in rats

Cathepsin K inhibitors are new drugs with the potential for the treatment of osteoporosis because they sustain bony remodelling better than bone resorption inhibitors such as bisphosphonates. The treatment of osteoporosis with inhibitors of bony resorption is associated with osteonecrosis of the jaw, as the deterioration in bony quality that they induce is thought to be one of its causes. The quality of bone is delineated by structural and material characteristics (which include the degree and quality of mineralisation, and depends on the content of proteoglycan and the structural integrity of the bony collagen).^1,2 Animal and clinical studies have shown that cathepsin K inhibitors improve the mineral density and structural characteristics of bone, but their effect on the rest remains unknown. We therefore hypothesised that these inhibitors will affect the material characteristics of newly-formed mandibular bone. To verify our hypothesis, we used Raman microspectroscopy to examine such bone in rats that were given a cathepsin K inhibitor, and found unusual crystallinity and an increased substitution of carbonate (CO₃^2?) in its crystal structure.     

Gelfoam haemostatic agent with or without autologous bone marrow-derived stem cells for the regeneration of critical-size mandibular defects in the rabbit

This study evaluated the effect of Gelfoam sponge with and without autologous bone marrow-derived stem cells (BMSCs) on bone regeneration in critical-size mandibular defects. The study involved 56 New Zealand rabbits assigned to four groups (14 in each). The osseous defects in group I were irrigated with normal saline, those in group II were grafted with autogenous tibial bone, and those in group III were filled with Gelfoam sponge. Group IV defects were treated as for group III, but the interface between the Gelfoam sponge and bone surface was injected with BMSCs. At the end of 4 weeks, seven rabbits in each group were euthanized; the remaining animals were euthanized at the end of the experiment, at 8 weeks postoperative. The percentage area of newly formed bone was significantly higher in group IV at week 4 (0.030 ± 0.01%) and week 8 (0.060 ± 0.03%) than in group I (0.01 ± 0.00% and 0.02 ± 0.00%, respectively) and group III (0.08 ± 0.01% and 0.015 ± 0.02%, respectively), but was lower than that in group II (0.038 ± 0.02% and 0.082 ± 0.01%, respectively). Thus, the combination of Gelfoam and autologous BMSCs promoted the regeneration of mandibular critical-size defects better than the use of Gelfoam alone. However, the amount of newly generated bone was lower than in defects grafted with autogenous bone.     

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??Objective    To evaluate the biomechanical influence of the relationship between implant tip and sinus ?oor cortical bone on posterior maxilla implantation by means of 3-dimensional??3-D??finite element??FE??analysis. Methods        Six 3-D FE models ??M1 to M6?? of standard implants and posterior maxillary region were constructed using CAD software. The thickness of both crestal cortical bone and sinus floor cortical bone were 1mm??according to different heights of the alveolar bone??the relationship between implant tip and sinus floor cortical bone was as follows. M1??the implant tip just broke through sinus cortical bone??the upper surface of sinus cortical bone and the apical surface of the implant were at the same level????M2??the implant tip broke through half the thickness of sinus ?oor cortical bone??M3??the implant tip just made contact with the lower surface of sinus ?oor cortical bone??for the remaining models??the implant tips were 1mm??2mm and 3mm apart from sinus floor??respectively. An inclined force of 129N was applied under immediate loading and conventional loading. The maximum von Mises stress??stress distribution??implant displacement and resonance frequencies were calculated using CAD software. Results    Except the M1 under immediate loading??the maximum von Mises stress of all models were concentrated on the surface of the crestal cortical bone around the implant neck. When the implant tip broke into or through sinus floor cortical bone??the maximum von Mises stress of crestal cortical bone reduced while that of sinus cortical bone increased??and the occlusional resonance frequencies of implants increased significantly while horizontal frequencies decreased??whether under immediate loading or conventional loading. Under immediate laoding??the maximum displacement of implant??especially the maximum displacement of the implant tip??was lower than the other models when the implant tip broke into or through the sinus cortical bone. However??the maximum displacements of both implant neck and tip were  hardly affected by the association between implant tip or sinus floor cortical bone under conventional loading. Conclusion    The association between implant tip and sinus floor cortical bone has effects both on stress distribution of the bone tissues around implant and on the maximum displacement and resonance frequencies of implants. Making the implant tip break into or through the sinus floor cortical bone??bi-cortical anchorage??is beneficial to improve the stress distribution and reduce the maximum displacement of implant??increasing the stability of the implant??especially under immediate loading.