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Sclerotic bone: a sign of bone reaction in patients with medication related osteonecrosis of the jaw.

Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse reaction associated with antiresorptive drugs such as bisphosphonates and denosumab. When dealing with advanced and/or multiple MRONJ lesions undergoing surgical therapy, the extent of surgery is often a topic of discussion. The aim of this study was to identify the differences in bone density in and around the MRONJ lesion before and after surgical treatment to evaluate the needed surgical extend of the modelling osteotomy. In this retrospective study 26 patients with MRONJ lesions that were surgically treated in our dep

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… Meanwhile it has been shown that a moderate surgical treatment results in better healing since the periosteum and unaffected bone are preconserved 26 . … Necrotic bone was removed while protecting the periosteum; as a result the 1-year follow-up panoramic radiographs showed complete regeneration of the bone 27 . The radiographic features of MRONJ remain relatively unspecific. …

Denosumab in pediatric bone disorders and the role of RANKL blockade: a narrative review.

BACKGROUND AND OBJECTIVE: Denosumab is a valuable and safe therapy for skeletal disorders in adults and has received regulatory approval to treat osteoporosis and bone metastases. However, denosumab is not licensed for pediatric use due to a lack of high-quality prospective research on children. This study aimed to describe and discuss the benefits and disadvantages of denosumab in treating bone diseases in children and to summarize the current understanding of the role of denosumab therapy in children. METHODS: A narrative review was conducted using the literature retrieved from the PubMed,

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… Bone thickening and enlargement occur in the remodeling process of the periosteum and bone marrow cavity ( 36 , 37 ). … A relatively well-defined lytic “dilatative” lesion can be seen on plain radiographs and may rupture from the periosteum and have a soapy appearance ( 57 , 58 ). …

Extensile Anterior and Posterior Knee Exposure for Complete Synovectomy of Diffuse Tenosynovial Giant Cell Tumor (Pigmented Villonodular Synovitis).

UNLABELLED: Diffuse tenosynovial giant cell tumor (TGCT), also known as pigmented villonodular synovitis, is a benign, neoplastic disease of … is visualized, all tissue deep to the quadriceps muscle and tendon, extending around to the femoral periosteum, is excised en bloc. Attention is then turned to the undersurface of the patella, fat pad, distal aspect of the femur, and proximal aspect of the tibia. The tumor may be embedded within the fat pad and must be removed. Any tumor remnants within the …

VERTEBROPLASTY IN THE TREATMENT OF VERTEBRAL FRACTURES CAUSED BY PLASMACYTOMA.

The aim of this study was to compare and evaluate clinical results before and after vertebroplasty in the treatment of myeloma-induced vertebral fractures. Success of the surgery was defined by increased or reduced pain intensity before and after the treatment, as assessed using the visual analog scale (VAS). The study was designed as a retrospective-prospective study. The study included 26 patients, 14 women and 12 men. Data on patients treated for myeloma-induced vertebral fractures were collected at the Department of Orthopedics, Osijek University Hospital Centre. The following data were an

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… If the procedure was performed under local anesthesia, skin and subcutaneous tissue to the periosteum were anesthetized with 2% lidocaine. If the patient could not tolerate pain, the procedure was performed under general anesthesia. …

Extensive Bone Marrow Necrosis and Osteolytic Lesions in a Case of Acute Myeloid Leukemia Transformed from Polycythemia Vera.

Acute myeloid leukemia (AML) is the most common leukemia in adults. In rare cases, bone marrow necrosis (BMN) and osteolytic lesions are presenting features of AML. The following case describes a patient with known polycythemia vera (PV) that presented with signs of multiple myeloma, including hypercalcemia, anemia, and lytic lesions of the thoracic spine and skull. Laboratory workup was not indicative of myeloma. A bone marrow biopsy was performed, which revealed extensive BMN and initial pathology was consistent with metastatic carcinoma. However, no immunohistochemical stains could be perfo

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… Granulocytic sarcoma (GS), also referred to as chloroma, myeloblastoma, and myelosarcoma, is an extramedullary tumor of myeloid cells that most often presents in soft tissue, bones, periosteum, and lymph nodes. …

Percutaneous vertebroplasty in patients with osteoportic vertebral body fractures.

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… The skin, subcutaneous tissues, and periosteum over the pedicle to be punctured were anesthetized with 1% lidocaine hydrochloride (Abbott Laboratories, North Chicago, IL) and 0.25% bupivacaine hydrochloride (Abbott Laboratories, Abbott Laboratories, North Chicago, IL). …

Длинная и извилистая дорога: гомеостатические и беспорядочные микроэкологические ниши: обзор описательной части.

Микроэкологические ниши Haematopoiet были охарактеризованы как "приемники" крови и иммунной системы. Эти ниши меняются во время онтгении, при этом костный мозг становится доминирующим местом гематопоисиса в послеродовой жизни в стабильных условиях. Для определения структуры и функции различных микроэкологических ниш гематопоиета необходимо четко определить конкретные подмножества гематопоиетических стеблей и потомковых клеток во время офгении и понять их временной внешний вид и анатомическое позиционирование. Различные гематопоиетические и негематопоиетические клетки способствуют появлению гем

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… The long bones of adult mice comprise a central shaft, the diaphysis, linked to the metaphyses and epiphyses at each end of the bone ( Figure 2A ). 88 , 89 The diaphysis is primarily composed of cortical or compact bone, which separates the outer highly vascularised periosteum from the inner medullary … Murine skeletal stem cells, which are located in marrow-free regions such as near or in the avascular hypertrophic growth plates and periosteum of long bones, were identified in 2015 by Chan and colleagues. 192 , 196 , 200 using the differential expression of multiple cell surface biomarkers to enrich …

Clinical efficacy analysis of mucoperiosteal flap combined with perforation technique for tooth extraction in medication-related osteonecrosis of the jaw risk population: a retrospective study.

BACKGROUND: To analyze and summarize the clinical efficacy of mucoperiosteal flap combined with perforation technique for tooth extraction in medication-related osteonecrosis of the jaw risk (MRONJ) population, and to provide clinical treatment options for such patients. METHODS: This study included 51 patients receiving antiresorptive drug (ARD) treatment who underwent tooth extraction at the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology between November 2016 and February 2024. Preoperative clinical data were collected and analyzed. Based

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… Tooth was extracted after local anesthesia ( a , b ),and then trapezoidal or angular flap was performed in the proximal and distal mesial gingival papilla, and the flap was raised under the periosteum ( c ), the extraction socket was thoroughly scratched, and the bone perforations around the extraction … Tooth was extracted after local anesthesia ( a , b ),and then trapezoidal or angular flap was performed in the proximal and distal mesial gingival papilla, and the flap was raised under the periosteum ( c ), the extraction socket was thoroughly scratched, and the bone perforations around the extraction …

Exosomes in the Repair of Bone Defects: Next-Generation Therapeutic Tools for the Treatment of Nonunion.

Nonunion with bone defects, a common complication after long bone fracture, is a major challenge for orthopaedic surgeons worldwide because of the high incidence rate and difficulties in achieving successful treatment. Bone defects are the main complications of nonunion. The conventional biological treatments for nonunion with bone defects involve the use of autologous bone grafts or bone graft substitutes and cell-based therapy. Traditional nonunion treatments have always been associated with safety issues and various other complications. Bone grafts have limited autologous cancellous bone an

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… First, the injured bone forms a hematoma, which is a fibrin clot caused by periosteal blood vessel haemorrhage beneath the periosteum and the medullary canal [ 31 ] as a result of coagulation [ 32 ]. … In the periphery of the new cartilage tissue toward the fracture location, periosteum swelling and bone formation occur through intramembranous ossification [ 39 ]. …

Bilateral Proptosis in a Case of Recurring Multiple Myeloma: Uncommon Orbital Presentation of Plasmacytoma.

Multiple myeloma is a malignant plasma cell dyscrasia that may invade the orbits in extramedullary presentations. Common manifestations of orbital involvement include unilateral proptosis, injection, chemosis, diplopia, and occasionally pain. Additionally, the soft-tissue tumors associated with multiple myeloma typically cause bony destruction of adjacent structures. However, in certain patients, bilateral proptosis and a lack of bony destruction may occur. In these instances, it is important for physicians to consider patient history, presentation, and progression in order to ensure that a po

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… The definitive surgical plan was to enlarge the orbit via removal of one to four walls with incision into the periosteum, allowing for soft-tissue prolapse and possible anterior tumor debulking. …

Acute respiratory failure as initial manifestation of conventional osteosarcoma rich in giant cells: a case report.

BACKGROUND: Osteosarcoma is a malignant tumor of the bone. The giant cell-rich osteosarcoma (GCRO) is a rare histological variant of the conventional osteosarcoma, accounting for 3% of all osteosarcomas. It has a variable clinical presentation, ranging from asymptomatic to multiple pathological fractures, mainly involving long bones, and less frequently the axial skeleton and soft tissues. CASE PRESENTATION: We present the case of a 25-year-old Hispanic woman, previously healthy, with a 1-month history of dyspnea on exertion, intermittent dry cough, hyporexia, and intermittent unquantified fe

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… differentiation of GCRO from other benign and malignant giant cell tumors (GCTs) is problematic because the classical radiological appearance of conventional osteosarcomas (such as osteoblastic and osteolytic areas with ill-defined margins, strong periosteal reaction, “Codman’s triangle” due to the elevation of periosteum …

Inflammaging in periodontal, periapical, and malignancy-associated disease: drivers of alveolar bone loss and repair.

BACKGROUND: Aging significantly impacts bone metabolism through altered osteoblast/osteoclast dynamics, reduced stem cell regeneration, and chronic inflammaging. This narrative review explores how these age-related changes influence alveolar bone loss and regeneration in the oral cavity. METHODS: The review investigates key mechanisms-including immunosenescence and inflammasome activation-across three specific pathological contexts: (1) periodontitis, (2) periapical bone resorption, and (3) malignancy-associated osteolysis. Preclinical and clinical evidence were integrated to analyze the bone

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… Another factor is the regenerative properties of the periapical periosteum and endosteum. These tissues contain stem cells that form the bone. … In older patients, periosteal ossification tends to be less robust, and the periosteum itself may be less cellular. The growth factor levels that drive repair may be lower or less responsive in aged tissues. …

Важное значение акромагалоидных физических свойств для клинической практики.

Акромагали и гигантизм - это гормональные расстройства, которые возникают в результате гиперсекретирования хронического роста гормона. Псевдоним префикса используется для описания определенного клинического состояния без четко подтвержденной характеристики патофизиологического механизма и основных биохимических характеристик; псевдоакромегалы или акромигалоидизм соответствуют определению, приведенному выше. В данном случае мы попытаемся представить краткий обзор диагностической оценки акромигалоидной физической внешности при обсуждении two - случаи пациентов, которые имеют такие же клинические

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… From other significant image findings, a palmar radiograph showed a marked thickness of the periosteum, primarily of the proximal phalanges, with a marginal width of slightly more than 12 mm ( Figure 2 ), and magnetic resonance imaging (MRI) of the hypothalamic-pituitary area showed reduction of pituitary …

Vertebroplasty in the treatment of recalcitrant lower back pain attributed to Modic 1 changes.

Vertebroplasty is a recognised treatment for osteoporotic and pathological compression fractures. We present the case of TF, a 70-year-old male patient with a history of poor left ventricular function presenting with refractory lower back pain, thought to be secondary to Modic Type1 changes in the L2 and L3 vertebrae, accompanying L2-L3 degenerative disc disease. He was treated conservatively for approximately 9 months without success. Following recent suggestions that vertebroplasty may provide pain relief in patients with degenerative disc change and coexistent Modic 1 changes not responding

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… The skin was infiltrated with lignocaine 1%, and the periosteum with ropivicaine 10 mg ml −1 . …

Treatment of bisphosphonate-related osteonecrosis of the jaws - a report of seven cases.

AIM OF THE STUDY: The aim of the study was to report on seven cases of BRONJ treated with surgical debridement, oral antibiotics and gentamicin-collagen sponge (Collatamp EG) placed in the bone wound. MATERIAL AND METHODS: Seven patients with 9 sites of BRONJ stage 2 were included in the study. Perioperative oral antibiotics, surgical debridement and/or sequestrotomy and gentamicin-collagen sponge (Collatamp EG) were used. Postoperative monitoring was carried out for the next 3 months. RESULTS: Three weeks after the surgery, six sites of BRONJ in five patients were treated successfully. In t

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… Double-suture was used: continuous resorbable monofilament (Monosyn 4/0) was used to suture the periosteum, then simple detached stitching with non-resorbable monofilament (Dafilon 3/0) was performed to obtain a hermetic closure at the wound margins. …

Osteosarcoma of the appendicular skeleton in dogs: consensus and guidelines.

Osteosarcoma (OSA) in dogs poses a clinical challenge to veterinary practitioners across the globe. As knowledge evolves, so too do clinical practices. However, there remain uncertainties and controversies. There is value for the veterinary community at large in the generation of a contemporary wide-ranging guideline document. The aim of this project was therefore to assimilate the available published knowledge into a single accessible referenced resource and to provide expert clinical guidance to support professional colleagues as they navigate current OSA challenges and controversies. Primar

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… The vast majority of canine and human OSA arises within the medullary cavity, with tumors arising from the periosteum being rare in dogs [( 29 ) (LOE 5, OEG D)] and humans [( 30 ) (LOE 3a, OEG B)]. … On the cranial aspect, new bone formation is apparent where the periosteum has lifted (Codman’s triangle). When this new bone formation is rapid, bone fibers align perpendicular to the axis of the bone (Sharpey’s fibers) creating a sunburst appearance. …

The Importance of Closed Reduction and Internal Fixation done with Intramedullary Implants in Pathological Fractures - A Case Series.

INTRODUCTION: Pathological fractures resulting from metastatic bone involvement, multiple myeloma (MM), and atypical femoral fractures present complex therapeutic challenges. Intramedullary (IM) nailing offers a biomechanically stable solution that facilitates early mobilization and enhances functional outcomes. This case series aims to evaluate the clinical and radiological results of IM fixation in pathological fractures, emphasizing pain relief and early functional outcomes. CASE SERIES: We report a series of five patients with pathological fractures of long bones who underwent IM nailing,

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… IM nails offer several advantages: they protect a long segment of bone, the necessary dissection is relatively small, blood supply to the periosteum is preserved, and rigid fixation can be achieved by locking with proximal and distal interlocking screws [ 4 ]. …

Use of Platelet Rich Fibrin (PRF)-Based Autologous Membranes for Tooth Extraction in Patients under Bisphosphonate Therapy: A Case Report.

Tooth extraction in patients treated with bisphosphonates (BPs) for osteoporosis or cancer exposes the patient to the risk of osteonecrosis of the jaw. An autologous membrane using platelet-rich fibrin (PRF) is an innovative technique to promote wound healing, which allows obtaining a hermetic closure of the post-extractive surgical site without the need of mucoperiosteal flaps or periosteal releasing incisions. Here, we report the case of a 70-year-old woman, in therapy with alendronate for 12 years, requiring the upper right premolar extraction because of a crown fracture. After the tooth ex

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… The latter can be achieved without the need of performing mucoperiosteal flaps or releases of the periosteum that could increase the patient’s post-operative morbidity. The use of PRF, thus, reduces invasiveness of the surgical procedure, which is limited to the atraumatic extraction of the tooth. …

Safety and Feasibility of Steerable Radiofrequency Ablation in Combination with Cementoplasty for the Treatment of Large Extraspinal Bone Metastases.

Background: Radiofrequency ablation (RFA) and cementoplasty, individually and in concert, has been adopted as palliative interventional strategies to reduce pain caused by bone metastases and prevent skeletal related events. We aim to evaluate the feasibility and safety of a steerable RFA device with an articulating bipolar extensible electrode for the treatment of extraspinal bone metastases. Methods: All data were retrospectively reviewed. All the ablation procedures were performed using a steerable RFA device (STAR, Merit Medical Systems, Inc., South Jordan, UT, USA). The pain was assessed

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… The aim of minimally-invasive ablation treatment is addressing the biological pain due to the stretching and irritation of the periosteum secondary to tumor growth and due to osteoclast-mediated bone resorption with the release of neurostimulating cytokines. …

Эффективность неконцентрированных действий Координирующие Шоковые Волны в сочетании с ботулинумтоксином на спасти у пациентов с умом.

Спастичность — это обычное осложнение у пациентов с неврологическими расстройствами, возрастающей инвалидностью и ухудшающей качество жизни. Было продемонстрировано, что комбинированная обработка с сфокусированными ударными волнами (FESWT) и ботулиновым токсином (BONT-A) повышает эффективность и продолжительность воздействия BONT-A на спасти у пациентов с травмами мозга. Мы изучили эффективность сочетания неконцентрированных ударных волн (uESWT) и BONT-A по спастисти. Это перспективное исследование с систематической случайностью включает в себя 24 :: пациенты с травмой мозга, небольшой размер

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… This may be due to the fact that, unlike fESWT, uESWT facilitates a more homogeneous application of energy in the muscle, reaching a greater number of endplates and allowing us to select the depth of application, preventing the maximum energy from reaching the periosteum of the bones, making them more …