UNASSIGNED: Proper nutrition is a crucial factor in preventing osteoporosis, a significant pathological cause linked to skeletal weakness; this study investigated the relationship between dietary diversity score and food group diversity score with osteoporosis in postmenopausal women.
UNASSIGNED: This case-control study was conducted on 378 menopausal women aged 45-85 in Tehran, Iran. The age-matching method to control the confounding effect of age was used. The method of dual-energy X-ray absorptiometry (DXA) was used for assessing the bone mineral density of lumbar vertebrae and femoral neck. The bone mass status was evaluated with WHO criteria. All subjects were divided into the osteoporosis group and the non-osteoporosis group according to their T-score. A convenience sampling method was utilized to select the participants, which included two groups: case (n = 189) and control (n = 189). Data was collected using demographic and anthropometric information questionnaires, a valid 147 item food frequency questionnaire, and a physical activity questionnaire. Statistical analyses were conducted using SPSS-26, and p-values less than 0.05 were deemed to be statistically significant.
UNASSIGNED: The results indicated significant differences in weight, body mass index, physical activity, smoking, and alcohol use between the two groups. The mean ± standard deviation of dietary diversity score (DDS) was lower in participants with osteoporosis (case) (3.31 ± 1.26) than in control (4.64 ± 1.33) (p < 0.001). The mean ± standard deviation of diversity score of cereals, fruits, and vegetables in the osteoporosis group (respectively: 0.71 ± 0.21, 0.94 ± 0.76, and 0.45 ± 0.44) was less than the control group (respectively: 0.80 ± 0.21, 1.64 ± 0.55 and 0.87 ± 0.42) (p < 0.001). After adjusting the confounding variables, the risk of osteoporosis had an inverse relationship with the diversity score of vegetable (OR = 0.16; 95%CI: 0.07-0.35), bread and cereal (OR = 0.21; 95% CI: 0.05-0.87) and fruit (OR = 0.35; 95%CI: 0.22-0.56) (p < 0.05). Nevertheless, no discernible correlation was seen between the tertiles of DDS, dairy and meat diversity score, and osteoporosis.
UNASSIGNED: We found a correlation between the diversity score of fruits, vegetables, and grains and osteoporosis. However, there is no significant correlation between the DDS triads and the diversity score of dairy products and meats with osteoporosis.

BACKGROUND: The relationship between the dietary insulin index (DII) and the disease\'s risk is unknown, despite the fact that hyperinsulinemia is presumed to contribute to osteoporosis. The insulin response of various diets determines the DII. This study aimed to investigate the connection between postmenopausal Iranian women\'s adherence to a diet with a higher insulinemic potential and osteoporosis.
METHODS: A total of 380 postmenopausal women were included in the current case-control study. A 168-item food frequency questionnaire (FFQ) with established validity and reliability was used to evaluate individuals\' daily calorie intake. The standard formula was employed to determine the dietary insulin load of each product. Subsequently, the calculation of DII was performed by dividing the dietary insulin load by the total energy consumed for each individual. In order to investigate the relationship between osteoporosis and DII, logistic regression was implemented.
RESULTS: The results of the current study demonstrated a substantial inverse relationship between osteoporosis and the DII, even after accounting for confounding variables (OR = 0.927; 95% CI = 0.888-0.967). The mean scores of DII (P < 0.001) was significantly higher in control group (36.82 ± 8.98) compared to the case group (33.53 ± 6.28).
CONCLUSIONS: Our findings suggest that keeping a diet high in insulin index and low in foods that are insulinogenic may improve bone mass density. Consequently, it may be essential for postmenopausal women to consume nutrients that stimulate insulin production in order to prevent osteoporosis.

OBJECTIVE: Knowledge about oral hygiene, gingival bleeding, mineral density, and resorption of jaw bones in patients with hemophilia is limited. We evaluated the periodontal and bone status in such patients.  Material and methods: Forty-eight patients with severe type A/B hemophilia and 49 age- and sex-matched controls were included. Assessments included simplified oral hygiene index (OHI-S), calculus index, debris index, gingival index (GI), gingival bleeding time index (GBTI), and decayed, missing, and filled teeth index (DMFTI). Bone resorption was evaluated using panoramic mandibular index (PMI), mental index (MI), and alveolar crest ratio (ACR). Mineral density in the condyle, angulus, and premolar areas was assessed using fractal analysis, with fractal dimensions denoted as condyle fractal dimension (CFD) for the condyle, angulus fractal dimension (AFD) for angulus, and premolar fractal dimension (PFD) for premolar region.
RESULTS: The mean scores were DMFTI = 11.77, OHI-S = 2.44, PMI = 0.268, MI = 5.822, GI = 3.02, GBTI = 2.64, ACR = 2.06, CFD = 1.31, AFD = 1.31, and PFD = 1.17 in the hemophilia group and DMFTI = 11.449, PMI = 0.494, MI = 7.43, GI = 0.67, GBTI = 0.98, OHI-S = 1.45, ACR = 2.87, CFD = 1.35, AFD = 1.35, and PDF = 1.23 in the control group. Differences were significant for all parameters (p < 0.005) except for the DMFTI index.  Conclusions: Because of poor oral hygiene, high bone resorption, and low bone mineral density in these patients, clinicians should consider potential bone changes when planning to treat these patients.

BACKGROUND: Coronavirus disease 19 (COVID-19) is a viral infection mediated by coronavirus-2 that causes severe acute respiratory syndrome (SARS-CoV-2). The disease may affect biochemical parameters and electrolytes. C-terminal cross-linking telopeptide (CTX-I) is released during mature bone resorption and is a biomarker for predicting bone resorption.
OBJECTIVE: As the pandemic progressed, understanding the effects of COVID-19 disease remained critical. Inflammatory responses triggered by the virus can result in a bone metabolism regulation imbalance. As such, this study aimed to analyze serum levels of CTX-I, calcium (CA), phosphorus (P), magnesium (Mg), C-reactive protein (CRP), and alkaline phosphatase (ALP) in COVID-19 patients to investigate the relationship between bone resorption and the disease.
METHODS: The study included 56 individuals with COVID-19 (divided into mild, moderate and severe subgroups depending on disease severity) and 25 healthy adults as a control group. Serum CTX-I concentrations were measured with enzyme-linked immunosorbent assay (ELISA). In addition, CRP, Ca, Mg, P, and ALP levels were measured using an automated clinical chemistry analyzer.
RESULTS: Serum CTX-I levels were significantly higher in COVID-19 patients than in the control group (p < 0.05). Furthermore, a positive weak relationship was detected between CRP and CTX-I (r = 0.303, p < 0.05).
CONCLUSIONS: Increased serum CTX-I levels in the patient group caused COVID-19-driven bone degradation, though serum CTX-I levels did not differ according to disease severity.

BACKGROUND: Bisphosphonates have an inhibitory impact on osteoclastic activity, reducing bone resorption. However, the influence of risedronate on tooth movement is not well-defined.
OBJECTIVE: This systematic review assessed the effect of risedronate intake on orthodontic tooth movement. A case report was also provided.
METHODS: Two independent reviewers searched six databases (PubMed, Web of Science, Ovid, Lilacs, Scopus, and Open Grey). The searches were carried out in April/2020, and an update was set in place in June/2023. Therefore, the searches considered a timeline from the databases\' inception date until June/2023, with no publication date and/or language restrictions. The clinical question focused on evaluating the orthodontic tooth movement and relapse movement (Outcome) in animals (Population) exposed to risedronate (Exposure), compared to control groups (Comparison). The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were applied, and the protocol was registered in PROSPERO (CRD42020168581). The risk of bias was determined using the Systematic Review Centre for Laboratory Animal Experimentation protocol (SYRCLE).
RESULTS: Two studies in rats and one in guinea pigs were included in the systematic review. The studies reported a decrease in orthodontic tooth movement, a reduction in the relapse movement, and a reduced number of positive tartrate-resistant acid phosphatase (TRAP) cells, with a significantly reduced number of bone gaps after the administration of risedronate in rats. A case report illustrated the effects of risedronate administration in one patient.
CONCLUSIONS: Based on the systematic review, risedronate seems to impair orthodontic tooth movement and relapse due to a decrease in bone resorption cells.

UNASSIGNED: Osteoporosis, a prevalent bone malady, is prevalent in Iran. Several studies have represented the role of dietary antioxidants on osteoporosis. The dietary antioxidant index (DAI) is a valid and reliable index, which indicates a comprehensive view of dietary antioxidant capacity. This study aimed to survey the relationship of the DAI with the risk of osteoporosis in postmenopausal women in Iran. This research aimed to examine the association between the DAI and the risk of osteoporosis among postmenopausal women in Iran.
UNASSIGNED: In this case-control study, 440 postmenopausal women (220 cases and 220 controls) were enrolled. The dietary intake of contributors was evaluated using a 147-item food frequency questionnaire. To estimate the DAI, the amount of six antioxidant micronutrients such as Vitamins A, C, and E, selenium, manganese, and zinc was standardized. Then, the DAI was estimated by collecting the standardized consumption of these antioxidant micronutrients.
UNASSIGNED: Our findings represented the participants in the first (crude odds ratio [OR] = 1.79, 95% confidence interval [CI]: 1.13-2.85, P = 0.013) and second (crude OR = 1.60, 95% CI: 1.01-2.55, P = 0.043) tertiles of the DAI scores had significantly higher odds of osteoporosis compared to those in the third one; while after modifying for confounding factors, this significant reverse relationship was observed just between women in the first and third tertiles of the DAI scores (adjusted OR = 1.90, 95% CI: 1.34-3.18, P = 0.015).
UNASSIGNED: The consequence of this study suggested that adherence to a diet rich in antioxidant compounds may have protective effects against osteoporosis.

UNASSIGNED: Subperiosteal implants might be the future first-line treatment in patients with compromised alveolar ridges, although the use of proper techniques and pre-surgical imaging is required to ensure treatment success.
UNASSIGNED: Severe bone loss puts the success of endosseous implants at risk. This technical report aims to introduce the subperiosteal implants (SPIs) created through additive manufacturing. A case study is presented, outlining the process and strategies employed to fully restore a maxillary structure using a customized subperiosteal implant. The patient, who had previously faced disappointment with traditional endosseous implants, received a customized SPI. A detailed 3-year follow-up is also provided. The design of the subperiosteal framework and abutments is based on digital records of the patient\'s jaw structure and a radiographic stent during occlusion. This ensures optimal placement within the dental arch. The implant and abutments are then three-dimensional (3D) printed using a titanium alloy, while a provisional denture is 3D-printed using polymer materials. SPIs offer a viable alternative for individuals with severe jaw bone degeneration, as demonstrated in this report detailing their application in complete maxillary restoration. This patient-specific, prosthesis-driven approach avoids the need for bone grafting and enables immediate functional recovery through a single surgical procedure.

BACKGROUND: We report an interesting case of bone resorption of vertebral bodies at the operative segment after Peek Prevail cervical interbody fusion. Instability of cervical vertebrae is likely to occur due to increased stress in Peek Prevail implant body for bone resorption. The finite element analysis was used to clarify the biomechanical effects of bone resorption and stress distribution in Peek Prevail implant body.
METHODS: We reported the case of a 48-year-old male patient who underwent Peek Prevail cervical interbody fusion and exhibited bone resorption 1 month after the surgery in X-ray of cervical vertebra. The degree of bone resorption was aggravated 2 months after surgery. Bone resorption in 3 months was similar to that in 2 months. We established a 3D reconstruction of the surgical segment in this case using Mimics software (vision 20.0) to generate basic boss resorption model. We simulated models of bone resorption using Ansys 17.0. The stress distribution of the contact surface between the screw and bone was analyzed under 6 conditions: flexion, extension, left and right flexion, and left and right rotation.
RESULTS: The loading conditions affected the stress distribution in the implant body. When bone resorption occurred, the stress distribution of the contact surface between screw and bone focus in the tip of the screw increased sharply.
CONCLUSIONS: Bone resorption of vertebral bodies in the operative segment may be a potential complication after Peek Prevail cervical interbody fusion. Great attention must be paid when bone resorption was occurred in order to avoid screw loosening before vertebral fusion.

BACKGROUND: Gorham-Stout disease is a rare condition with fewer than 400 reported cases in the literature. The presentation of Gorham-Stout disease varies on the basis of location, extent, fracture, and accompanying symptoms. It lacks a specific histopathological appearance but is characterized by vascular changes and the absence of cellular atypia.
METHODS: This article presents a case study of a 16-year-old Persian boy with an entire femur with Gorham-Stout disease, highlighting the difficulties in managing this condition. The lack of a clear diagnosis resulted in prolonged procedures, delayed medical treatments, and ultimately required total femoral replacement with an endoprosthesis.
CONCLUSIONS: It is important to note that raising awareness of this disease and its potential complications can facilitate timely and appropriate treatment for patients presenting in the early stages of the disease.

UNASSIGNED: Denosumab, is a potent anti-resorptive that, increases bone mineral density, and reduces fracture risk in osteoporotic patients. However, several case studies have reported multiple vertebral fractures in patients discontinuing denosumab.
UNASSIGNED: This case report describes a 64-year-old female with postmenopausal osteoporosis treated with denosumab, who had her 11th injection delayed by 4 months. The patient suffered eight spontaneous vertebral fractures. After consent, an iliac crest bone biopsy was obtained following re-initiation of the denosumab treatment and analyzed by micro-computed tomography and histomorphometry.
UNASSIGNED: micro-computed tomography analysis revealed a low trabecular bone volume of 10 %, a low trabecular thickness of 97 μm, a low trabecular spacing of 546 μm, a high trabecular number of 1.8/mm, and a high structure model index of 2.2, suggesting trabecular thinning and loss of trabecular plates. Histomorphometric trabecular bone analysis revealed an eroded perimeter per bone perimeter of 33 % and an osteoid perimeter per bone perimeter of 62 %. Importantly, 88 % of the osteoid perimeter was immediately above an eroded-scalloped cement line with no sign of mineralization, and often with no clear bone-forming osteoblasts on the surface. Moreover, only 5 % of the bone perimeter was mineralizing, reflecting that only 8 % of the osteoid perimeter underwent mineralization, resulting in a mineralization lag time of 545 days. Taken together, this indicates limited bone formation and delayed mineralization.
UNASSIGNED: We present a case report of multiple vertebral fractures after denosumab discontinuation with histomorphometric evidence that denosumab discontinuation leads to extensive trabecular bone resorption followed by a limited bone formation and delayed mineralization if the denosumab treatment is reinitiated. This highlights the importance of developing optimal discontinuation strategies for patients that are to discontinue treatment.