The Optical Coherence Tomography and Raman Spectroscopy for Sensing of the Bone Demineralization Process

The presented research was intended to seek new optical methods to investigate the demineralization process of bones. Optical examination of the bone condition could facilitate clinical trials and improve the safety of patients. The authors used a set of complementary methods: polarization-sensitive optical coherence tomography (PS-OCT) and Raman spectroscopy. Chicken bone samples were used in this research. To stimulate in laboratory conditions the process of demineralization and gradual removal of the hydroxyapatite, the test samples of bones were placed into 10% acetic acid. Measurements were carried out in two series. The first one took two weeks with data acquired every day. In the second series, the measurements were made during one day at an hourly interval (after 1, 2, 3, 5, 7, 10, and 24 h). The relation between the content of hydroxyapatite and images recorded using OCT was analyzed and discussed. Moreover, the polarization properties of the bones, including retardation angles of the bones, were evaluated. Raman measurement confirmed the disappearance of the hydroxyapatite and the speed of this process. This work presents the results of the preliminary study on the possibility of measuring changes in bone mineralization by means of the proposed methods and confirms their potential for practical use in the future.

Fabrication of Hollow Maxillary Complete Denture Using Silicon Putty and Double Flask Technique

This article describes the fabrication of a hollow maxillary complete denture using silicone putty and a double flask technique. A successful complete denture directly depends on retention, stability and support accompanied by good aesthetics. However, in case of atrophic edentulous ridges the challenge lies in the fact that there is a significantly lesser denture bearing area that can lead to a number of problems. The most important of these is an increased interarch space resulting from excessive resorption of upper or lower arch. This can lead to a resulting heavy complete denture that further deteriorates the bone condition due to excessive and continuous load, accelerating bone resorption. Moreover, there is no effective support to deal with any kind of harmful lateral forces and this can lead to dislodgment of the denture. The operator’s efficiency lies in applying the basic principles of fabricating a denture and innovating various steps to counter critical situations. Various methods such as asbestos, silicone putty, modelling clay, thermocol, salt, wax have been used for creating a hollow space inside the denture. Out of the various methods that have been used for fabrication of a hollow space inside a complete denture, silicone putty method is one of the more convenient and accurate method for achieving the objective, thereby rendering a lighter prosthesis. A hollow maxillary denture is highly advantageous as it reduces the weight of acrylic resin, thereby preserving the residual alveolar ridge. It also helps in stability of the denture by indirectly reducing the lateral forces.

The Optical Coherence Tomography and Raman Spectroscopy for Sensing of the Bone Demineralization Process

Aim of the presented research was to develop an optical sensing system to investigate the demineralization process of the bones. Optical measurement techniques are widely used and increasingly adapted in biological and biomedical applications due to their non-destructive nature and safety. Optical examination of the bone condition could facilitate clinical trials and improve the safety of patients. The authors used a set of complementary methods: polarization-sensitive optical coherence tomography (PS-OCT) and Raman spectroscopy. To stimulate the process of demineralization and gradual removal of the hydroxyapatite, the test samples of chicken bones were placed into 10% acetic acid. Measurements were carried out in two series. The first one took two weeks with data acquired every day. In the second series, the measurements were made during one day at an hourly interval (after 1, 2, 3, 5, 7, 10, and 24 hours). Raman spectroscopy was used to evaluate the disappearance of the hydroxyapatite. The relation between the content of hydroxyapatite and images recorded using OCT was analyzed and discussed. Moreover, the polarization properties of the bones have been evaluated. Based on OCT images, the retardation angles of the bones have been calculated. This work presents a preliminary study on the mechanism of bone demineralization and confirms the potential of the applied optical methods.

993 Digital Monitoring of Paediatric Patients with Chronic Recurrent Multifocal Osteomyelitis at A National Orthopaedic Centre

Introduction Chronic recurrent multifocal osteomyelitis (CRMO) is a paediatric inflammatory bone condition requiring close monitoring by a multi-disciplinary team throughout childhood. Many UK patients are seen at the Royal National Orthopaedic Hospital, Stanmore for more than a decade of specialist management. Prior to the recent COVID crisis, we recognised need for more frequent monitoring without the inconvenience of cross-country travel and so piloted an online system of monitoring CRMO. Method An online assessment form was created using the GDPR-compliant Qualtrics system after consultation with CRMO paediatricians and a specialist nurse. 3 medical students telephoned parents of 31 patients to pilot the assessment form. Responses indicating issues were then referred to the CNS for follow-up. Results Response data confirmed need for close monitoring with 26% of respondents being seen quarterly, 29% reporting pain greater than 6/10, 29% having side-effects and 30% finding current treatment ineffective. 74% of respondents found online assessment extremely/very useful and 58% preferred it to face-to-face appointments. Conclusions A digital CRMO monitoring tool can successfully identify patients with both new and ongoing issues. In the COVID and post-COVID era, digital tools can closely monitor patients with chronic conditions like CRMO whilst improving quality of life by reducing need for face-to-face appointments.

Melorheostosis of the Fossa Intercondylaris Femoris – A Case Report and Review of the Literature

Introduction: Melorheostosis is a rare benign bone condition characterized by excessive segmental sclerosis of cortical bone being reminiscent of dripping candle wax. It typically affects the long bones and can cause impingement and nerve compression syndromes that may require surgical treatment. Case Report: We report the case of a 49-year-old male patient with a 12-month history of the left-sided knee pain and a concomitant limitation of his left knee flexion to 90 degree. Radiographic and magnetic resonance imaging revealed the typical radiographic appearance of melorheostosis with an extraosseous lesion in the fossa intercondylaris femoris being causative for the limited knee range of motion. Following the resection of the extraosseous part of the lesion through a direct open approach, the patient is pain free with a maximum of 110 degree knee flexion at 12-month follow-up. Conclusion: Melorheostosis can present with manifold clinical manifestations that potentially require surgical treatment. Even in patients with a challenging localization of extraosseous lesions, a good to excellent functional outcome is possible. Keywords: Melorheostosis, Léri disease, Candle wax disease, Surgery, Fossa intercondylaris femoris, Notch.

Laporan Kasus: Ekstraksi Gigi dengan Perubahan Matriks Tulang sebagai Persiapan Pembuatan Gigi Tiruan Lengkap

Patients in the elderly group have a higher risk for dental and oral health problems because in old age, caries and periodontal tissue are generally more severe and progressive. The aging process causes changes in the structure and appearance of the teeth, the oral mucosa, the decline in function salivary glands, and loss of bone minerals through bone matrix resorption. The occurrence of bone matrix resorption results in the elderly group more often experiencing tooth loss which can be exacerbated by the occurrence of periodontal disease. After tooth extraction, this condition needs to be considered by dentist so that the denture made later has good retention and stabilization and remains comfortable for the patient to use. The aim was providing an overview regarding the procedure of extraction teeth with the change of bone matrix as a preparation for the prosthodontic complete dentures treatment. A 56-year-old female patient came to RSGM Unsoed wanted to order complete dentures so that the remaining teeth shoul be extracted. Patient feels discomfort and difficulties when eating and drinking. Intraoral examination, only teeth 16 were left with gingival recession. The patient's alveolar bone condition showst ends to be flat in the edentulous posterior area. The extraction case in elderly patients must be carried out according to the right procedure with minimal trauma so as not to damage the supporting tissue around the tooth and facilitate the process of denture treatment.

Case Report of Osteopoikilosis: Sparse Cause of Bone Pain and Mimicker of Metastasis on Radiographs

Introduction: Osteopoikilosis (OPK) is an extremely rare benign condition with autosomal dominant inheritance characterized by sclerosing bony dysplasia with multiple benign enostoses. It is characterized by symmetrically distributed numerous, small, well-defined, homogenous circular or ovoid radiodensities clustered in epiphysis and metaphysis of long bones in periarticular region, and in some cases diffusely present throughout axial and appendicular skeleton. There is no age and sex predilection; age at the time of diagnosis ranges from 15 to 60 years. It is usually asymptomatic but rarely in 15–20% patients slight juxta-articular pain and joint effusions can be seen. These are incidental radiological findings in most of the cases, also sometimes confused as bony metastasis. There are no specific clinical features; histological features are similar to bony island and it may be associated with connective tissue disorders, synovial osteochondromatosis, and a rare bone condition melorheostosis. Case Report: We present a case of OPK in a 32-year-old male with bilateral hip and shoulder pain, based on the available literature and focus on clinical significance, due to its mimicking capability of other more severe conditions such as bone metastases and an extremely uncommon cause of bone pain. Conclusion: OPK is an uncommon hereditary condition involving juxta-articular region of long bones with intricate etiopathogenesis, often discovered incidentally on radiographs. It is characterized by multiple, symmetrical ovoid radiodensities, and in most instances confused with osteoblastic metastasis. This concludes that OPK is a condition that should be kept in mind to avoid misdiagnosis, in particular osteoblastic metastasis and undue distress to both the patients and doctors. Keywords: Osteopoikilosis, melorheostosis, bone metastases

Effect of glucocorticoids on bone metabolism in replacement therapy of adrenal insufficiency. Literature review

Adrenal insufficiency (AI) is a syndrome caused by disturbance in the synthesis and secretion of hormones of the adrenal cortex, which ensure the vital activity, energy and water-salt homeostasis. The widest hormonal deficiency is observed in primary hypocorticism, when the synthesis of not only glucocorticoids (GC) and adrenal androgens, but also mineralocorticoids is disrupted. Lifelong replacement therapy with GCs for this pathology may be associated with a risk of bone loss and osteoporosis. However, at present, there are no clear guidelines for diagnosis of bone condition, including and bone mineral density (BMD) monitoring during treatment with GCs in patients with AI. This review summarizes collected data on the key pathogenetic links of glucocorticoid-induced osteoporosis, incidence of decreased BMD and fractures in patients with AI. In this review factors that influence bone metabolism in this cohort of patients are considered: the type and the dose of prescribed GCs, the type (primary, secondary, HH in congenital adrenal cortex dysfunction) and the duration of AI, age, gender, and the presence of concomitant endocrine disorders (hypogonadism, growth hormone (GH) deficiency). In addition, the review presents data on the effect of adrenal androgen replacement therapy and recombinant GH therapy on bone metabolism in secondary AI.