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JRPMS 2019

Review Article JRPMS, Vol 4, No 1, March 2020, p.1-7
The role of vitamin D in dental implants osseointegration
Anna-Maria Vesala, Ismene Dontas
Keywords: Dental implants, Implant failure, Osseointegration, Vitamin D, Vitamin D deficiency
Dental implants currently constitute a well-established solution for both functional and aesthetic restoration of complete and partial edentulism. Osseontegration, however, is a complex and multifactorial phenomenon bearing concerns as to its strong association to implant, prosthetics and surgical protocols, as well to patients themselves. This literature review aims to research into potential correlations linking the osseointegration process in dental implants to low levels of vitamin D in dental patients. A number of scientific articles were retrieved from PubMed and MEDLINE databases, using the following key words: “vitamin D deficiency”; “osseointegration”; and “vitamin D AND dental implants”. Αll retrieved studies were limited to those involving human and animal experimental models, and only articles written in English. Nine animal studies investigated the osseointegration process in dental implants that may be attributed to the effects of vitamin D; and five studies used human subjects. However, none of the said studies demonstrated statistically significant differences. A number of patients, especially those with severe deficiency, reported beneficial outcomes following vitamin D systemic administration prior the surgery. In such patients, is important to maintain vitamin D levels, as it ensures bone reconstruction around the implant.
Οriginal Article JRPMS, Vol 4, No 1, March 2020, p.8-14
Coadministration of zoledronic acid and teriparatide in postmenopausal osteoporosis
Christiana Zidrou, Anastasios Beletsiotis
Keywords: Bisphosphonates, Bone mineral density, Osteoporosis, Teriparatide, Zoledronic acid
Objectives: The purpose of this study is to evaluate the effects of combination therapy with an intravenous infusion of zoledronic acid 5 mg and daily subcutaneous teriparatide 20 μg versus either agent alone on bone mineral density (BMD) and bone turnover markers. Methods: From January 2015 to December 2018, 206 postmenopausal women with osteoporosis (aged 55-89 years) were randomized to receive a single infusion of zoledronic acid 5 mg plus daily subcutaneous teriparatide 20 μg (n = 68), zoledronic acid alone (n=69), or teriparatide alone (n=69). The primary endpoint was percentage increase in lumbar spine and total hip BMD (assessed by DXA) at 52 weeks versus baseline. Results: At week 52, lumbar spine BMD had increased 7.5%, 7.0%, and 4.4% in the combination, teriparatide, and zoledronic acid groups, respectively while total hip -BMD increments were 2,3%, 1,1% and 2,2% in respective subgroups. Levels for bone turnover markers (PINP and b-CTX) were significantly lower with combination therapy versus teriparatide alone. Conclusions: The authors concluded that while teriparatide increases spine BMD more than zoledronic acid and zoledronic acid increases hip BMD more than teriparatide, combination therapy provides the largest, most rapid increments when both spine and hip sites are considered.
Review Article JRPMS, Vol 4, No 1, March 2020, p.15-19
Resistance mechanisms in the radiation therapy of osteosarcoma: a brief review
Georgia Koutsomplia, George I. Lambrou
Keywords: Osteosarcoma, Radiological features, Resistance mechanisms, Genomics
Osteosarcoma is the most common primary malignancy of bone, typically presenting in the first or second decade of life. Osteosarcoma is a very aggressive type of tumor, which has devastating effects on the patient. Especially, pediatric patients suffering from osteosarcoma, are very vulnerable to its side-effects. Most patients suffering from osteosarcoma have a very poor prognosis and thus the understanding of its mechanisms, both oncogenetic as well ontogenetic are of crucial importance. The stagnancy of clinical outcomes may is explained by heterogeneity and complexity as well as genetic background. Not many studies have dealt with the molecular mechanisms of resistance to radiation therapy in osteosarcoma, yet the main genes proposed for their participation include p53, p21, NF-κB, RAS, Rb and GRIM-19. In addition, recent studies have highlighted the role of epigenetic mechanisms in osteosarcoma resistance to therapy and in particular the role of miRNAs. Due to the devastating effect of the disease to the suffering patients, more studies are required in order to unravel the radiation-induced cell death resistance.
Mini Review JRPMS, Vol 4, No 1, March 2020, p.20-23
Stem cells in fracture healing
Efstathios G. Athanasakis
Keywords: Stem cells, Fracture healing, Nonunion
Bone fractures are the most common injuries seen in emergency departments worldwide. Fracture healing is a complex physiological process. Existing research has proved that Mesenchymal stem cells (MSCs) assist and augment fracture healing. This review is examining the importance of MSCs in bone healing. A literature search was performed using PubMed, and relevant articles were retrieved.
Review Article JRPMS, Vol 4, No 1, March 2020, p.24-29
Osteoporosis in frail patients
Georgia Manoli, Ioannis K. Triantafyllopoulos
Keywords: Frailty, Osteoporosis, Anorexia Nervosa, Cancer, Oldest Old
Frailty, a condition that many people share nowadays, is connected to both the modern way of life and also age, physical and mental condition of a person. Sometimes, it is characterized by rapid weight alterations, slow walking speed and extreme tiredness, symptoms which vary according to the patient. It is a condition that can be altered or in other cases treated and thus it is can be a challenge for both the doctor and patient. Osteoporosis in such patients can be a riddle - sometimes it is not discovered or it is not treated properly leading to more problems. Sarcopenic patients, namely those with severe anorexic disorders, people with transplants and malignant tumors can be harmed even more because their conditions allow osteoporosis not only to grow but also become harder to be traced by the doctors. Bone loss appreciation is an urgent process because it can prove to be supportive to the patients and doctors and by all means improves the problems that may occur to people suffering from frailty.