Accurate detection of bone resorption is extremely important in the orthodontic treatment process as it can provide a basis for clinical treatment strategies. Recently, pH-responsive fluorescence probes have received tremendous attention in bone resorption monitoring owing to their high sensitivity, good specificity, and in situ and real-time detection capabilities, but there are still some shortcomings like the increase in the risk of osteonecrosis of the jaw by use of bisphosphonate as the bone-targeting moiety and the insufficient monitoring accuracy due to susceptibility to interference. Herein, we designed and synthesized a near-infrared ratiometric hemicyanine-based pH fluorescence probe (Hcy-Asp6) with fluorescence-imaging and pH-determining capabilities, and bone targetability for more reliably and safely monitoring the bone resorption in orthodontic treatment. In vitro optical performance tests of Hcy-Asp6 revealed that the probe had high sensitivity, excellent photostability, reversibility, and strong resistance to interference, and the probe suggested excellent bone-binding ability and biocompatibility in the bone-targeting evaluation and the cytotoxicity test. Furthermore, in vitro and in vivo bone resorption monitoring assays demonstrated that this probe can detect bone resorption by fluorescence imaging and quantitative monitoring of pH associated with the bone resorption. Thus, the results indicated that this probe possessing bone targetability and accurate bone resorption-monitoring capability has an extraordinarily great clinical potential to be employed for real-time monitoring of bone resorption in orthodontic treatment and could also serve as a reference in bone resorption monitoring for other bone resorption-related diseases.

The incidence of human immunodeficiency virus (HIV)-infected cases that need total joint replacement (TJR) is generally rising. On the other hand, modern management of HIV-infected cases has enabled them to achieve longevity while increasing the need for arthroplasty procedures due to the augmented dege-nerative joint disease and fragility fractures, and the risk of osteonecrosis. Although initial investigations on joint replacement in HIV-infected cases showed a high risk of complications, the recent ones reported acceptable outcomes. It is a matter of debate whether HIV-infected cases are at advanced risk for adverse TJR consequences; however, the weak immune profile has been associated with an increased probability of complications. Likewise, surgeons and physicians should be aware of the complication rate after TJR in HIV-infected cases and include an honest discussion of the probable unwelcoming complication with their patients contemplating TJR. Therefore, a fundamental review and understanding of the interaction of HIV and arthroplasty are critical.

Epstein-Barr virus (EBV) -positive mucocutaneous ulcer (EBVMCU) was first described as a lymphoproliferative disorder in 2010. In recent years, EBVMCU has been reported in the field of oral surgery. On the other hand, medication-related osteonecrosis of the jaw (MRONJ) is an osteomyelitis that occurs in patients receiving antiresorptive agents including bisphosphonates (BP) and/or denosumab developing with bacterial infections such as dental diseases and mucositis. MRONJ caused by EBVMCU in the elderly has not been reported. Here, we report a rare case of MRONJ caused by EBVMCU in the elderly. The patient, an 82-year-old woman, had received BP for more than 2 years. An ulcerative lesion was found in the palatal mucosa; biopsy performed from the site confirmed the diagnosis of EBVMCU. At follow-up, the lesion disappeared spontaneously. At the 6-month follow-up, bone formation was observed at the site of the lesion, and the sequestrum was removed. At the 12-month follow-up healing of the EBVMCU region was seen indicating a good prognosis.

The potential mechanisms governing drug induced osteonecrosis of the jaw (ONJ) is not well understood, and is one of the objectives of this study. Thus, we tested the release of IFN-γ within different immune compartments including bone marrow and gingivae upon treatment with zoledronic acid (ZOL) and denosumab which are known to induce ONJ in susceptible individuals.

Benign osteonecrosis of the external ear canal is a rare pathology that commonly gets misdiagnosed as cholesteatoma of the external ear canal, keratosis obturans and malignant otitis externa. Each pathology has characteristics that allow for differentiation between them. Careful analysis is required to diagnose properly and determine the best modality of management. This case series presents two patients that were diagnosed with benign osteonecrosis of the external ear canal and is being managed conservatively with serial debridement. Response to conservative treatment has resulted in adequate control of symptoms in both patients.

Diffuse tenosynovial giant cell tumor (TGCT), also known as pigmented villonodular synovitis, is a benign, neoplastic disease of the synovium that can lead to joint destruction, osteoarthritis, and long-term morbidity1,2. Often, there is extra-articular involvement in the intercondylar notch and posterior soft tissues. A complete anterior and posterior synovectomy of the knee is indicated for treating diffuse TGCT when the anterior and posterior compartments of the knee joint are involved. Additionally, either an anterior or posterior synovectomy may be performed when the TGCT is limited to 1 compartment of the knee. Although an anterior synovectomy is relatively straightforward technically, a posterior synovectomy is challenging because of the presence of the neurovascular and muscular structures, which limit access, and because of the infrequency of the procedure.

Press-fit transfemoral osseointegration is the technique of inserting an intramedullary metal implant into the residual femur of an amputee; the implant is passed transcutaneously to attach to a standard prosthesis that includes a knee, tibia, ankle, and foot. This allows the prosthesis to be skeletally anchored, eliminating socket-related problems such as tissue compression that can provoke neurogenic pain, skin abrasion, and fitting problems resulting from residual limb size fluctuation1. Amputees with osseointegrated prostheses typically wear their prosthesis more and experience better mobility, quality of life, and extremity proprioception compared to those with socket prostheses2-4.

The aim of this study was to assess patient satisfaction relating to inpatient stays. In this prospective observational study, adult patients with oncological (oral cancer, medication-related osteonecrosis of the jaw) and non-oncological (mandibular fracture) diagnoses, and who had undergone surgery, were contacted 4 weeks after discharge. Two validated questionnaires were used: EORTC QLQ-C30 for quality of life and IN-PATSAT32 for patient satisfaction. For quality of life, the mandibular fracture group had a lower impairment of physical functioning (M = 83.59, SD = 24.44; p = 0.029) in comparison with both other groups (M = 68.84, SD = 26.24; M = 59.33, SD = 24.43, for oral cancer and osteonecrosis, respectively). Regarding patient satisfaction, patients with oral cancer were slightly more satisfied with doctors' availability (M = 48.91, SD = 24.11; p = 0.583) compared with the other groups (M = 36.54, SD = 19.11; M = 46.67, SD = 20.86, for mandibular fracture and ostenecrosis, respectively). Patients with an unplanned inpatient stay following an acute event tended to be less satisfied than patients with a planned inpatient stay. Within the limitations of the study it seems that knowledge of these influencing external factors and their effects can support physicians and nursing staff in providing improved patient care.

Bone metastasis from lung cancer predicts a decrease in the quality of life and a shortening of survival for patients. While controlling the primary disease, active prevention and treatment of skeletal-related events (SREs) are crucial. The use of bisphosphonates as a basic drug for bone metastases from lung cancer has been increasing; also, the corresponding adverse effects have emerged. The case is here reported of two cases of osteonecrosis of the jaw associated with zoledronic acid treatment were reported in patients with epidermal growth factor receptor -sensitive mutation non-small-cell lung cancer(NSCLC) and discussed the clinical features, early recognition and interventions.

We report a case of vertebral osteonecrosis after chemotherapy in a 24-year-old man with non-Hodgkin lymphoma, with transient avidity on 18F-FDG PET initially misinterpreted as recurrent extranodal disease. The patient demonstrated a partial metabolic response on midtreatment restaging PET; however, posttreatment PET showed an increase in uptake in T4 and T5 vertebrae, interpreted as recurrent vertebral disease. Repeat PET performed 9 days later showed resolution of thoracic vertebral uptake without interval treatment. On follow-up PET study, thoracic vertebrae demonstrated photopenia with sclerosis on CT, concerning for osteonecrosis. MRI features were concordant with this diagnosis.

Type 2 diabetic osteoporosis (T2DOP) is a chronic bone metabolic disease. Compared with traditional menopausal osteoporosis, the long-term high glucose (HG) microenvironment increases patients' risk of fracture and osteonecrosis. We were accumulating evidence that implicated ferroptosis as a pivotal mechanism of glucolipotoxicity-mediated death of osteocytes and osteoblast, a novel form of programmed cell death resulting from uncontrolled lipid peroxidation depending on iron. Vitamin K2 (VK2), a fat-soluble vitamin, is clinically applied to prevent osteoporosis and improve coagulation. This study aimed to clarify the role and mechanism of VK2 in HG-mediated ferroptosis. We established the mouse T2DOP model by intraperitoneal injection of streptozotocin solution and a high-fat and high-sugar diet. We also cultured bone marrow mesenchymal stem cells (BMSCs) in HG to simulate the diabetic environment in vitro. Based on our data, VK2 inhibited HG-mediated bone loss and ferroptosis, the latter manifested by decreased levels of mitochondrial reactive oxygen species, lipid peroxidation, and malondialdehyde and increased glutathione in vitro. In addition, VK2 treatment was capable of restoring bone mass and strengthening the expression of SIRT1, GPX4, and osteogenic markers in the distal femurs. As for further mechanism exploration, we found that VK2 could activate AMPK/SIRT1 signaling, and knockdown of SIRT1 by siRNA prevented the VK2-mediated positive effect in HG-cultured BMSCs. Summarily, VK2 could ameliorate T2DOP through the activation of the AMPK/SIRT1 signaling pathway to inhibit ferroptosis.