Metabolic bone diseases

  • 文章类型: Journal Article
    牙齿萌出是口腔颌面系统发育的重要过程。一些遗传性和获得性疾病可能会影响这个严格调控的过程,导致过早,延迟,甚至是失败的牙齿萌出。本文的目的是回顾影响牙齿萌出的代谢性骨疾病的文献和临床参数。它检查了牙齿萌出的生理方面以及代谢性骨骼疾病引起的病理生理变化,包括骨代谢的变化,密度,和结构。这篇评论的搜索策略包括在PubMed中进行电子搜索,谷歌学者,Medline,Scopus,和Cochrane图书馆使用以下关键字:“代谢性骨骼疾病”,“牙齿萌出”,“延迟的牙齿萌出”,每种报告的疾病都与“牙齿萌出障碍”相结合,涵盖截至2024年3月的出版物,仅限于英语来源。了解代谢性骨骼疾病对牙齿萌出的影响对于管理与这些疾病相关的牙齿和骨骼表现至关重要。这篇综述表明,多学科治疗方法可以显着改善患有此类疾病的患者的口腔结局。临床医生应了解可能出现的特定牙齿异常,并考虑全面评估和个性化治疗计划。这些发现强调需要进一步研究解决这些异常的靶向疗法。
    Tooth eruption is an essential process for the development of the oral and maxillofacial system. Several inherited and acquired diseases might affect this tightly regulated process, resulting in premature, delayed, or even failed tooth eruption. The purpose of this article is to review the literature and the clinical parameters of metabolic bone diseases that affect tooth eruption. It examines the physiological aspects of tooth eruption and the pathophysiological changes induced by metabolic bone diseases, including changes in bone metabolism, density, and structure. The search strategy for this review included an electronic search in PubMed, Google Scholar, Medline, Scopus, and the Cochrane Library using the following keywords: \"metabolic bone diseases\", \"tooth eruption\", \"delayed tooth eruption\", and each reported disease in combination with \"tooth eruption disorders\", covering publications up to March 2024 and limited to English-language sources. Understanding the influence of metabolic bone diseases on tooth eruption is crucial for managing both dental and skeletal manifestations associated with these disorders. This review suggests that a multidisciplinary approach to treatment may significantly improve oral outcomes for patients suffering from such conditions. Clinicians should be aware of the specific dental abnormalities that may arise and consider comprehensive evaluations and individualized treatment plans. These findings underscore the need for further research into targeted therapies that address these abnormalities.
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  • 文章类型: Case Reports
    非创伤性骨折(ATF)是一种脆性骨折亚型,偶尔会出现法医学问题。ATF被定义为裂缝,因为低能量机制通常被认为不能产生裂缝。“他们是一种被低估的疾病,流行病学变化。以前报道的ATF现象不仅发生在老年人中,而且在儿童中,年轻人,老年人,和动物。这项研究是一个简短的回顾性病例系列,探讨了三级护理大学医院的无创伤骨折。在两年的时间里,共发现7例ATF病例。然而,只有5人符合纳入标准。病理性骨折的局部原因(例如,转移)和老年人虐待或忽视被排除。病例临床概况的比较,断裂剖面,管理完成了。所有5例病例均为体弱的女性,因药物和多种疾病而产生严重的骨毒性负担。ATF的介绍包括典型(如疼痛)和非典型(如无痛,响亮的裂缝,和突然的赠品)症状学。一名ATF同时出现了原因不明的无菌热。3例骨折不止1例(骨折级联),确认并进行X光检查。除1例进行髋关节置换术外,所有病例均采用保守治疗。护理计划包括管理骨毒性多发病负担,专注于整个身体,不仅仅是骨折或骨头。该研究提供了有关ATF表现挑战的见解(如骨折急性期反应:成骨无菌热)。风险因素通常被认为是骨质疏松症,但它通常是系统性和多因素的。骨折警告标志的高风险可以帮助减少ATF的发生或骨折级联。检测到四个ATF类别,以帮助医疗保健系统识别高风险患者并提高医务人员的意识,家庭,和照顾者。未来需要对高危人群进行研究,以了解ATF知识差距,挑战,最好的治疗方法。
    Atraumatic fractures (ATFs) are a fragility fracture subtype with occasional medicolegal issues. ATFs are defined as fractures because of a \"low-energy mechanism that is usually considered incapable of producing a fracture.\" They are an underreported disorder, with epidemiological variations. ATF phenomena were previously reported not only in older adults, but also in children, young adults, older adults, and animals. This study is a short retrospective case series exploring atraumatic fractures in a tertiary care university hospital. Over a period of two years, a total of seven ATF cases were identified. However, only five fulfilled the inclusion criteria. Local causes of pathologic fractures (e.g., metastasis) and elder abuse or neglect were excluded. Comparison of the cases\' clinical profile, fracture profile, and management was done. All five cases were frail females with significant osteotoxic burdens from medications and multi-morbidities. ATF presentations included typical (as pain) and atypical (as painless, loud crack, and sudden giveaway) symptomatology. One ATF had a coincident unexplained aseptic fever. Three cases had more than one fracture (fracture cascade), confirmed and followed up by x-rays. All the cases were managed conservatively except for one case that underwent hip hemiarthroplasty. Plans of care included managing the osteotoxic multi-morbidities burden, focusing on the whole body, not only on the fracture or bone. The study provided insights about challenges in presentations of ATF (as the bone fracture acute phase reaction: osteogenic aseptic fever). Risk factors are classically assumed to be osteoporosis, but it is usually systemic and multifactorial. A high risk of fracture warning sign could help decrease ATF occurrence or fracture cascades. Four ATF categories were detected to help healthcare systems identify high-risk patients and raise awareness among medical staff, families, and caregivers. Future studies of the at-risk groups are needed to understand ATF knowledge gaps, challenges, and the best treatments.
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  • 文章类型: Journal Article
    背景:在妊娠的最后三个月,大约80%的婴儿钙被掺入,出于这个原因,与足月出生的早产儿相比,早产儿的骨矿化更少。本系统审查的目的是确定,评估并总结了有关物理治疗方式在预防和治疗早产儿骨量减少中的作用的研究。
    方法:使用PubMed进行全面搜索(09/2019-02/2021),WebofScience,Scopus,ProQuest,SciELO,Latindex,ScienceDirect,进行了PEDro和ClinicalTrials.gov。提取了以下数据:参与者人数,参与者的特点,设计,干预的特点,结果衡量标准,评估时间和结果。对所提取的数据进行非定量合成。使用PEDro量表和ROB-2量表评估方法学质量和偏倚风险,分别。
    结果:共分析了16项研究,呈现3到8分的方法论质量,所有人都对他们的偏见风险表示担忧。几乎所有的研究(15/16)使用被动动员联合压力,以防止骨质减少,但是它们的应用强度和频率不同。
    结论:关节压力被动动员的日常锻炼计划,改善新生儿病房早产儿的骨矿化。
    BACKGROUND: During the last trimester of pregnancy, about 80% of the infant\'s calcium is incorporated, and for this reason, preterm infants have less bone mineralization compared to those born at term. The aim of the present systematic review was to identify, evaluate and summarize the studies that deal with the effect of physiotherapy modalities in the prevention and treatment of osteopenia in preterm infants.
    METHODS: A comprehensive search (09/2019-02/2021) using PubMed, Web of Science, SCOPUS, ProQuest, SciELO, Latindex, ScienceDirect, PEDro and ClinicalTrials.gov was carried out. The following data were extracted: The number of participants, characteristics of the participants, design, characteristics of the intervention, outcome measures, time of evaluation and results. A non-quantitative synthesis of the extracted data was performed. The methodological quality and risk of bias were assessed using a PEDro scale and ROB-2 scale, respectively.
    RESULTS: A total of 16 studies were analyzed, presenting a methodological quality that ranged from 3 to 8 points, and all showed some concerns regarding their risk of bias. Almost all studies (15/16) used passive mobilizations with joint pressure to prevent osteopenia, but they differed in the intensity and frequency of application.
    CONCLUSIONS: A daily exercise program of passive mobilizations with joint pressure, improves bone mineralization in preterm infants admitted to neonatal units.
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  • 文章类型: Journal Article
    Medication-related osteonecrosis of the jaw (MRONJ) is one of the most interesting diseases in the field of maxillofacial surgery. In addition to bisphosphonates, the use of antiresorptive and antiangiogenic agents is known to be the leading cause. However, the exact pathogenesis of MRONJ has not been established, and various hypotheses have been proposed, such as oxidative stress-related theory. As a result, a definitive treatment protocol for MRONJ has not been identified, while various therapeutic approaches are applied to manage patients with MRONJ. Although the surgical approach to treat osteomyelitis of the jaw has been proven to be most effective, there are limitations, such as recurrence and delayed healing. Many studies and clinical trials are being conducted to develop another effective therapeutic modality. The use of some materials, including platelet concentrates and bone morphogenetic proteins, showed a positive effect on MRONJ. Among them, teriparatide is currently the most promising material, and it has shown encouraging results when applied to patients with MRONJ. Furthermore, cell therapy using mesenchymal stem cells showed promising results, and it can be the new therapeutic approach for the treatment of MRONJ. This review presents various treatment methods for MRONJ and their limitations while investigating newly developed and researched molecular and cellular therapeutic approaches along with a literature review.
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  • 文章类型: Journal Article
    这项研究分析了与没有BFR的高强度(HI)运动相比,具有血流限制(BFR)的低强度(LI)运动对骨代谢的影响。使用以下关键词搜索以下数据库:治疗性闭塞训练或BFR训练或血管闭塞训练或KAATSU训练或缺血训练和成骨或骨生物标志物或骨质量或骨转换或骨质疏松症或骨量减少:PubMed,WebofScience,SPORTDiscus,CINAHL,科学直接,科克伦和谷歌学者。两名研究人员,独立和盲目,根据既定的纳入和排除标准选择研究.电子和手动搜索找到了170篇英文文章;经过筛选,只有4项研究表明,在多个人群中,有氧和无氧运动后,BFR训练可增加骨形成标志物(例如骨特异性碱性磷酸酶)的表达,并减少骨吸收标志物(例如I型胶原的氨基末端端肽).这项研究的结果表明,很少有研究证实BFR运动对骨代谢的积极作用,形成和再吸收。此外,没有样品的方法学标准化,锻炼类型,观察干预频率或持续时间。
    This study analysed the effect of low-intensity (LI) exercises with blood flow restriction (BFR) on bone metabolism compared with high-intensity (HI) exercises without BFR. The following databases were searched using the keywords therapeutic occlusion training OR BFR training OR vascular occlusion training OR KAATSU training OR ischaemia training AND osteogenesis OR bone biomarkers OR bone metabolic marker OR bone mass OR bone turnover OR osteoporosis OR osteopenia: PubMed, Web of Science, SPORTDiscus, CINAHL, Science Direct, Cochrane and Google Scholar. Two researchers, independently and blindly, selected the studies based on established inclusion and exclusion criteria. Electronic and manual searches located 170 articles published in English; after screening, only four studies showed that BFR training increases the expression of bone formation markers (e.g. bone-specific alkaline phosphatase) and decreases bone resorption markers (e.g. the amino-terminal telopeptides of type I collagen) after both aerobic and anaerobic exercise across several populations. The results of this study show that few studies have confirmed the positive effect of exercise with BFR on bone metabolism, formation and resorption. Furthermore, no methodological standardization of the samples, exercise type, intervention frequency or duration was observed.
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