Comparison of Mechanical Resistance to Maximal Torsion Stress in Original and Nonoriginal or Compatible Prosthetic Implant Screws: An In Vitro Study

Micromovements of the implant-abutment connection influence peri-implant bone preservation. The maximal torque after a cycle of implant prosthetic screw tightening using original components of different manufacturers and replicas produced by other companies is evaluated and quantified in this study. A total of 30 Mis Seven® standard platform implants and 30 interfaces were used, and 30 standard platform screws were tested, 10 Mis®, 10 Iconekt®, and 10 Exaktus®. The screws were tightened with an MIS® torquemeter until their respective fracture, and the fracture point was measured through the equipment’s load cell, CS-Dental Testing Machine®. The screws were analyzed under an Olympus® SZ61 microscope. The fracture points were recorded and compared among all samples. To compare the mean values of the fracture torques, t-tests were performed using the reference values associated with each brand and the sample results. The variable “Place of Fracture” between the original Mis® brand and the Exaktus® replica compared to the Iconekt® replica presented a statistically significant difference (p < 0.001). When analyzing the variable “Fracture Torque,” although it was verified that the replica screws (Iconekt® and Exaktus®) had a lower maximum torque, 65.11 Nm and 62.89 Nm, respectively, compared to the original Mis® brand (70 Nm and 69 Nm), there were no statistically significant differences p > 0.05. Nonoriginal screws did not present different fracture resistances compared to the original Mis® brand screws. The fracture site of Iconekt® screws showed a different pattern compared to the other brands.

Who Killed the Small Mammals of Ittenheim? An Integrative Approach and New Taphonomic Data for Investigating Bone Assemblages Accumulated by Small Carnivores

Small carnivores are susceptible to regularly accumulating small- to medium-sized mammal remains in both natural and archaeological sites. However, compared to nocturnal birds of prey, these accumulations are still poorly documented and are generally based on a limited number of samples, including those of relatively small size. Here, we present an analysis of European hamster remains from Ittenheim, which were recovered from an infilled burrow, 3m below the current surface. The remains are well preserved and exhibit large proportions of tooth marks. Comparisons with a new and existing reference collection combined with an analysis of all recovered faunal remains suggest the accumulation reflects the action of young red foxes. This is supported by the fact that, although these young individuals leave teeth mark, they do not necessarily consume all parts of medium-sized prey species, including the European hamster. Conversely, the remains of smaller rodents, such as microtine, show distinct patterns of digestion and tooth marks. Carnivore bone accumulations from scats are generally poorly preserved; however, our results demonstrate prey size plays a major role, both qualitatively and quantitatively, in skeletal representation, bone preservation, and bone surface modifications. The present paper underlines the need for more diversified taphonomic reference collections based on an integrative approach designed to evaluate multi-taxa accumulations.

Chronic locked posterior gleno-humeral dislocation: technical note on fibular grafting for restoration of humeral head sphericity

Background Reconstruction of reverse Hill-Sachs defect using osteo-chondral allograft has the advantages of spherical re-contouring and provision of smooth biological articular surface of the reconstructed humeral head. However, worldwide availability and risk of disease transmission of osteo-chondral allograft remain points of increasing concerns. As an alternative to lacking osteo-chondral allograft, the current technical note describes a reconstructive technique of reverse Hill-Sachs defect using autologous fibular grafting. Methods Following open reduction of the dislocated humeral head, reverse Hill-Sachs defect was reconstructed using 3–4 autologous fibular pieces (each is of 10 mm in length) fixed in flush with the articular cartilage using 4-mm cancellous screws. Defect reconstruction was then followed by modified McLaughlin’s transfer and posterior capsulorrhaphy. Results Spherical contour of the humeral head and gleno-humeral range of motion were restored. Intra-operative dynamic testing of the reconstruct revealed no residual posterior gleno-humeral instability. Conclusion Currently reported technique might offer advantages of graft availability, technical simplicity, familiarity and reproducibility, safety (i.e. no disease transmission) and bone preservation facilitating future revision management (if needed). Nevertheless, long-term outcomes of this technique should be investigated via further cohort clinical studies.

Clinical and radiological results of high offset tri-lock bone preservation stem in unilateral primary total hip arthroplasty at a minimum follow-up of 3 years

Background Although the high offset Tri-Lock bone preservation stem (BPS) was used widely, few studies explored the clinical and radiological results. The purpose of this study was to determine the clinical and radiological results of high offset Tri-Lock BPS in unilateral primary total hip arthroplasty (THA) at a minimum follow-up of 3 years. Methods 55 patients who underwent cementless THA with high offset Tri-lock BPS from 2017 to 2018 were followed for a minimum follow-up of 3 years. Patients were assessed clinically for complications, Harris hip score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Oxford Hip Score (OHS). Femoral offset (FO), acetabular offset (AO), hip offset (HO), HO difference, and leg length discrepancy (LLD) were measured on the anteroposterior (AP) pelvic radiograph. Standard pelvic AP and lateral radiographs were used to evaluate for evidence of bone ingrowth, stem subsidence, stem alignment, radiolucent line around the stem, osteolysis, loosening, ectopic ossification, and femoral stress shielding. Results No patients reported complications during hospitalization nor the follow-up period. At a mean follow-up of 42.5 months, the mean HHS, WOMAC, and OHS scores showed a significant improvement from preoperative to the latest follow-up. No patients reported thigh pain. No revision nor sign of radiographic loosening had been detected. The high offset Tri-Lock BPS significantly improved the FO and HO postoperatively. HO difference and LLD were balanced postoperatively. No sign of stem subsidence, radiolucent line, osteolysis, loosening, ectopic ossification, nor severe stress shielding (more than grade 3–4) were observed at the latest follow-up. Conclusion The high offset Tri-Lock BPS demonstrated excellent clinical and radiographic outcomes at a minimum follow-up of 3 years. HO difference and LLD between legs decreased significantly and achieved balance postoperatively. Long-term follow-up is required for a definitive conclusion.

Human Skeletal Remains Recovered from a Napo Funerary Urn in the Ecuadorian Amazon

There is very little published literature regarding pre-Columbian burial practices that include human skeletal remains of the Napo culture (A.D. 1188–1480) in the western Amazon. Due to poor bone preservation and a history of looting practices, bioarchaeologists have rarely been able to collect, analyze, and interpret skeletal remains. Here, we provide the initial publication of a human skeleton from the Ecuadorian Amazon belonging to the Napo culture, preserved in a funerary urn acquired by the Museo de Arte Precolombino Casa del Alabado in Quito, Ecuador. This partial adult skeleton, radiocarbon dated to cal A.D. 1021–1155, consists primarily of broken long bones that indicate a robust individual with a height range of 160–170 cm. Although no trauma was observed, pathological conditions including cysts and likely Osgood-Schlatter’s disease were present and robust muscle insertions were noted. Taphonomic damage from termite osteophagy was inferred by the presence of round bore holes, cavities, tunneling, and cortical etching on the humerus, femur, and tibia. The urn itself is an anthropomorphic polychrome vessel that opens at the bottom, with six equally spaced holes to facilitate closure. The urn burial is similar to those of other Amazonian Polychrome Tradition cultures located to the east in Brazil. Las prácticas funerarias precolombinas que incluyen restos humanos esqueléticos de la cultura Napo (1188–1480 D.C.), en el oeste de la Amazonía, han sido escasamente dadas a conocer en la literatura arqueológica. Debido a la pobre preservación de los huesos en ese medio y a una dilatada trayectoria de huaquerismo, desde la bioarqueología no ha sido posible recoger, analizar e interpretar restos humanos. Este artículo trata de solventar este vacío al atender desde una perspectiva bioarqueológica los restos óseos humanos provenientes de la Amazonía ecuatoriana pertenecientes a la cultura Napo, preservados en una urna funeraria que se conserva en el Museo de Arte Precolombino Casa del Alabado en Quito, Ecuador. Por un lado, este esqueleto parcial del que se conservan huesos largos fragmentados de un adulto fue datado mediante técnicas radiométricas entre 1021 y 1155 cal D.C.Habría sido una persona robusta, con una altura que oscilaría entre los 160 y 170 cm. Aunque no se ha observado ningún traumatismo, las patologías registradas incluyen quistes, como los debidos a la enfermedad de Osgood-Schlatter, e inserciones musculares robustas. Entre las afecciones tafonómicas más relevantes, se han apreciado las causadas por osteofagia de termitas, las cuales se infieren por la presencia de perforaciones redondas, cavidades, túneles y decapado cortical en húmero, fémur y tibia. Por otro lado, la urna es un ejemplar antropomorfo policromado de apertura basal con seis orificios espaciados que ayudaban a cerrarla. El entierro en urna es similar a aquellos otros de las culturas de la Tradición Polícroma Amazónica localizadas al este en Brasil.

The Difference of Marginal Bone Preservation between Dental Implants with Non-Threaded or Micro-Threaded Collar Designs

This study analyzes the marginal bone loss (MBL) among dental implants characterized with non-threaded collar design (NT) when compared to the more classic micro-threaded collar design (MC) as such might reflect the future dentogengival esthetics, implant metal show, and mucositis. A total of 112 patients who received 311 implants have been included in the study and analyzed for their postoperative MBL using sequential periapical radiographs. The prevalence of postoperative peri-implant mucositis was recorded as well. The periapical radiographic comparison was performed between the immediate postoperative record and at the 24-month recall visit. Among the 311 implants, 124 (39.9%) had NT implants, and 187 (60.1%) had MC implants. Out of the 112 patients, 37 (44.6%) were females, and 10 (34.5%) were males included in the NT group. In contrast, 46 (55.4%) females and 19 (65.5%) males were in the MC group. The mean age among the two groups was 41.43 ± 15.900 and 46.68 ± 16.070, respectively. In contrast, the mean MBL among the groups were 0.544 ± 0.7129 and 0.061 ± 0.2648, respectively. The change in MBL was not positively correlated with gender (p-value = 0.154) or age (p-value = 0.115) in both groups. However, there was a significant difference (p-value = 0.001, X2 = 62.796, Df = 4) of MBL between the two implant systems themselves. The MBL was higher in people implanted with the NT system when compared to MC. Therefore, the MC implant system can be a better choice for marginal bone preservation, especially in restoring esthetically demanding areas in the mouth.

20 YEARS OF RSP – THE 5 MOST IMPORTANT LESSONS I’VE LEARNED

Introduction and aim This paper reports on 5 key aspects to consider when planning a successful RSA procedure, including patient selection, glenosphere positioning, glenoid fixation, humeral fixation, and soft tissue management/tensioning. Material, methods, results, and discussion Key in patient selection for RSA is understanding the relationship between indications, outcomes, patient mental state, and their expectations. When placing a glenosphere, prioritize sound principles of shoulder kinematics but always consider bone preservation and ease of placement. Glenoid fixation must take advantage of structural features of individual implant designs while factoring in specific-bone morphology/morphometry to optimize the resultant glenohumeral loading. For the stem, fixation prioritizes press-fit where bone quality and quantity permit. Always aim to achieve anatomical pivot point restoration with planning for stem position and avoid distalization that may lead to nerve injury and scapular spine fractures. Conclusions To increase the chances of a successful RSA procedure, a surgeon should emphasize picking the right patient, placing the implant in an optimum position, ensuring adequate glenoid and humeral fixation, and correctly balancing soft tissues. Keywords: reverse shoulder arthroplasty, surgeon education, patient optimization

Bone tissue preservation in seawater environment: a preliminary comparative analysis of bones with different post-mortem histories through anthropological and radiological perspectives

Bone taphonomy is a widely investigated topic; however, few data are available concerning marine bone taphonomy, especially on remains recovered from great depths and with short post-mortem intervals. To date, few studies have evaluated the bony changes which occur in seawater compared to samples with different post-mortem histories, and none through a comparative analysis of different approaches. To this purpose, this pilot study aims to examine the influence of seawater on bone preservation compared to other depositional contexts by multiple perspectives. Forty-nine human bone samples (femurs or tibiae) recovered from different environments (sea water, fresh water, outdoor, burial in coffin) were compared by macroscopic, microscopic and bone densitometric approaches. In order to investigate organic and inorganic components, undecalcified and decalcified histology of thin sections was performed. The analyses revealed a well-preserved bone tissue both macroscopically (92%) and microscopically (97% and 95% for undecalcified and decalcified sections). No significant differences were detected from radiological densitometric investigations (BMD = 1.6 g/cm2 ± 0.1), except between old and young individuals (p value < 0.001). Differences were observed for body decomposition and few scavenged samples (3/15). However, even if slight variations were observed, no relation was recorded with the depositional contexts. We found a similar bone preservation in the four environments at the time of recovery, both macroscopically and microscopically, but also with radiological densitometric investigations. Our observations enriched the literature on bone taphonomy, providing data on bone tissue preservation in the early post-mortem period from a multidisciplinary perspective, paving the way for further studies on the topic.

Management of large mandibular periapical cyst by cortical bone preservation: a case report

<p> </p><span lang="EN-IN">Management of large periapical cysts often require removal of overlying lateral cortical bone to gain access. We report a case in which huge periapical cyst was treated using a novel technique to preserve the overlying lateral cortical bone to facilitate faster healing of the defect. </span>