Određivanje biomarkera gubitka alveolarne kosti kod pacijenata sa peri-implantitisom

Peri-implantitis is inflammatory process characterized by supporting bone loss of loaded oral implants. The pathognomonic characteristic of peri-implantitis is supporting bone loss of the loaded implant. This process is based on inflammatory osteoclastogenesis which simultaneously represent the central pathologic process of the disorder. Inflammatory osteoclastogenesis implies maturation of pre-osteoclasts and enhancement of the activity of maturated osteoclasts which are induced by achieving of the critical concentrations of proinflammatory mediators. Clinical characteristics of the peri-implantitis are still not strictly defined and they vary because in the physiological conditions the values of clinical parameters varies among individuals, for example peri-implant sulcus depth represents the individual determinant which could be from 0.5mm to 4mm as well. Simultaneously, the marginal bone loss is the physiological characteristic around implants in function, which is the most intensive in the first year of loading represented by the -0.78mm in the mesial sites and -0.85mm at the distal sites, and after that the process is constant and bone loss at the year level is approximately 0.2mm. The mentioned value is the average values that individually vary and it depends of the implant type, abutments and numerous other factors. From that reason the relative clinical attachment level (rCAL), nether radiological proof of bone loss could be accepted as the absolute indicators of the pathological bone loss. In the peri-implant diagnostics the most frequently are used the few different diagnostic procedures in the combination to give the complete diagnostic view. These diagnostic methods include: evaluation of clinical parameters, radiological analyses, microbiological analyses and quantitative and qualitative analyses of PICF. The PICF analysis is one of the most attractive methods in current implantology, where the one of the most precious values is providing of the direct information on peri-implant tissues d based on that providing information on early disease onset in the phase of reversible damage. This limitation of clinical methods results in time loss proportionally decreasing treatment success, and frequently resulting in inappropriate treatment planning. Based on that, evaluation of biomarkers in PICF sample compensates limitations of conventional diagnostic procedures without capability to provide accurate information on early disease. Numerous studies have been conducted to identify the biomolecules accurately reflecting peri-implant tissue condition, but since the pathology of local metabolism is complex, the method for evaluation is still under standardization...Peri-implantitis predstavlja inflamatorni proces koji se karakteriše gubitkom potporne kosti opterećenog oralnog implantata. Osnovna patološka karakteristika peri-implantitisa je gubitak potporne kosti implantata u funkciji. Ovaj proces je zasnovan na inflamatornoj osteoklastogenezi koja ujedno predstavlja centralni patološki proces peri-implantitisa. Inflamatorna osteoklastogeneza predstavlja proces sazrevanja pre-osteoklasta i pojačavanje aktivnosti zrelih osteoklasta pod uticajem kritičnih koncentracija pro-inflamatornih medijatora. Kliničke karakteristike peri-implantitisa nisu strogo definisane i variraju iz prostog razloga jer dubina peri-implantnog sulkusa značajno varira s'toga dubina džepa predstavlja individualnu determinantu. Istovremeno, proces gubitka marginalne kosti predstavlja fiziološku pojavu koja je najintezivnija u prvoj godini opterećenja, i istraživanja su pokazala da iznosi -0.78mm mezijalno i -0.85mm distalno, a zatim se kontinurano odvija i na godišnjem nivou iznosi oko 0.2mm. Pomenuta vrednost iznosi prosečnu vrednost ali ona takođe individualno varira i uslovljena je tipom implantata, dizajnom abatmenta i mnogim drugim faktorima. Iz tog razloga se relativni nivo pripojnog epitela (rCAL) kao ni radiološki evidentan gubitak kosti ne mogu usvojiti kao apsolutni indikatori patološkog gubitka kosti. U dijagnostici stanja peri-implantnih tkiva koristi se nekoliko tipova metoda i najčešće u kombinaciji radi što potpunijeg postavljanja dijagnoze. Dijagnostičke metode uključuju: određivanje kliničkih parametara, radiološke analize, mikrobiološke analize i kvalitativne i kvantitativne analize peri-implantnte krevikularne tečnosti (PICF). Analiza PICF predstavlja jednu od najatraktivnijih metoda u savremenoj implantologiji, pri čemu je njena najveća vrednost u tome što daje direktne informacije o stanju peri-implantinh tkiva i zasnovano na tome poseduje mogućnost da pokaže rane znake oboljenja peri-implantnih tkiva u fazi gde su tkivne promene reverzibilne. Ovo ograničenje kliničkih metoda rezultira u propuštanju vremena od momenta pojave bolesti koje proporcijonalno umanjuje uspeh terapije, a često i u izboru neadekvatnog terapijskog plana. Zasnovano na tome, metoda merenja specifičnih biomarkera u uzorku PICF nadomešćuje ograničenja konvencionalnih kliničkih dijagnostičkih metoda koje daju informacije u stadijumu razvijene bolesti. Brojne studije se sprovode u cilju identifikacije biomolekula koji pouzdano reflektuje stanje peri-implantnih tkiva, ali kako je patologija lokalnog meatbolizma kompleksna, a metoda evaluacije visoko-osetljiva, standardizacija ove metode je još uvek u toku..

One-shot Nano-device for Treatment of Peri-implantitis: Biological Proof of Concept

Objectives To compare biological effects of experimental nano device composed of nano-hydroxyapatite loaded with clindamycin, embedded in PLGA for continual release of daily MIC against Porphiromonas gingivalis for 21 days bone healing period (CLHap) with effects of nano-hydroxyapatite (Hap) and commercial bone substituent (BioOssÒ). Methods 6 female beagle dogs with similar characteristics underwent teeth extractions, implant placement and ligature induced PI, and were further surgically treated. Following open-flap debridement, the biomaterials were randomly allocated to ensure the serial distribution of antimicrobial material for pharmacokinetic testing of antibiotic systemic release. The biochemical and microbiological markers were compared before disease induction (baseline), before the treatment (pre-op) and 3 months (3m) following treatment. GM-CSF, TNFa, IL-6, IL-10 and OPG concentrations were estimated using Luminex method, while the RT-PCR kit was developed for quantification of the Porphyromonas gulae. Finally, following animal sacrifice, specimens were retrieved for histological analyses. Following fracture technique, decalcified samples were sectioned and stained for histomorphometric assessment of: apical extension of barrier epithelium (aBE), infiltrated connective tissue (ICT) area and respective apical extension (aICT). Results The pharmacokinetic test confirmed safety of the experimental material according to undetectable blood concentrations of the antibiotic. The concentrations of P. Gulae, GM-CSF, TNFa, OPG, IL-6 and IL-10 significantly decreased following treatment only in CLHap group while in other groups the changes remained insignificant. Both ICT and aICT were significantly lower CLHap when compared to both control groups. Conclusions Results of the present study demonstrated safe and promising treatment capacity of the experimental CLHap for managment of peri-implantitis

Determination of alveolar bone loss biomarkers related to peri-implantitis

Peri-implantitis predstavlja inflamatorni proces koji se karakteriše gubitkom potporne kosti opterećenog oralnog implantata. Osnovna patološka karakteristika peri-implantitisa je gubitak potporne kosti implantata u funkciji. Ovaj proces je zasnovan na inflamatornoj osteoklastogenezi koja ujedno predstavlja centralni patološki proces peri-implantitisa. Inflamatorna osteoklastogeneza predstavlja proces sazrevanja pre-osteoklasta i pojačavanje aktivnosti zrelih osteoklasta pod uticajem kritičnih koncentracija pro-inflamatornih medijatora. Kliničke karakteristike peri-implantitisa nisu strogo definisane i variraju iz prostog razloga jer dubina peri-implantnog sulkusa značajno varira s'toga dubina džepa predstavlja individualnu determinantu. Istovremeno, proces gubitka marginalne kosti predstavlja fiziološku pojavu koja je najintezivnija u prvoj godini opterećenja, i istraživanja su pokazala da iznosi -0.78mm mezijalno i -0.85mm distalno, a zatim se kontinurano odvija i na godišnjem nivou iznosi oko 0.2mm. Pomenuta vrednost iznosi prosečnu vrednost ali ona takođe individualno varira i uslovljena je tipom implantata, dizajnom abatmenta i mnogim drugim faktorima. Iz tog razloga se relativni nivo pripojnog epitela (rCAL) kao ni radiološki evidentan gubitak kosti ne mogu usvojiti kao apsolutni indikatori patološkog gubitka kosti. U dijagnostici stanja peri-implantnih tkiva koristi se nekoliko tipova metoda i najčešće u kombinaciji radi što potpunijeg postavljanja dijagnoze. Dijagnostičke metode uključuju: određivanje kliničkih parametara, radiološke analize, mikrobiološke analize i kvalitativne i kvantitativne analize peri-implantnte krevikularne tečnosti (PICF). Analiza PICF predstavlja jednu od najatraktivnijih metoda u savremenoj implantologiji, pri čemu je njena najveća vrednost u tome što daje direktne informacije o stanju peri-implantinh tkiva i zasnovano na tome poseduje mogućnost da pokaže rane znake oboljenja peri-implantnih tkiva u fazi gde su tkivne promene reverzibilne. Ovo ograničenje kliničkih metoda rezultira u propuštanju vremena od momenta pojave bolesti koje proporcijonalno umanjuje uspeh terapije, a često i u izboru neadekvatnog terapijskog plana. Zasnovano na tome, metoda merenja specifičnih biomarkera u uzorku PICF nadomešćuje ograničenja konvencionalnih kliničkih dijagnostičkih metoda koje daju informacije u stadijumu razvijene bolesti. Brojne studije se sprovode u cilju identifikacije biomolekula koji pouzdano reflektuje stanje peri-implantnih tkiva, ali kako je patologija lokalnog meatbolizma kompleksna, a metoda evaluacije visoko-osetljiva, standardizacija ove metode je još uvek u toku...Peri-implantitis is inflammatory process characterized by supporting bone loss of loaded oral implants. The pathognomonic characteristic of peri-implantitis is supporting bone loss of the loaded implant. This process is based on inflammatory osteoclastogenesis which simultaneously represent the central pathologic process of the disorder. Inflammatory osteoclastogenesis implies maturation of pre-osteoclasts and enhancement of the activity of maturated osteoclasts which are induced by achieving of the critical concentrations of proinflammatory mediators. Clinical characteristics of the peri-implantitis are still not strictly defined and they vary because in the physiological conditions the values of clinical parameters varies among individuals, for example peri-implant sulcus depth represents the individual determinant which could be from 0.5mm to 4mm as well. Simultaneously, the marginal bone loss is the physiological characteristic around implants in function, which is the most intensive in the first year of loading represented by the -0.78mm in the mesial sites and -0.85mm at the distal sites, and after that the process is constant and bone loss at the year level is approximately 0.2mm. The mentioned value is the average values that individually vary and it depends of the implant type, abutments and numerous other factors. From that reason the relative clinical attachment level (rCAL), nether radiological proof of bone loss could be accepted as the absolute indicators of the pathological bone loss. In the peri-implant diagnostics the most frequently are used the few different diagnostic procedures in the combination to give the complete diagnostic view. These diagnostic methods include: evaluation of clinical parameters, radiological analyses, microbiological analyses and quantitative and qualitative analyses of PICF. The PICF analysis is one of the most attractive methods in current implantology, where the one of the most precious values is providing of the direct information on peri-implant tissues d based on that providing information on early disease onset in the phase of reversible damage. This limitation of clinical methods results in time loss proportionally decreasing treatment success, and frequently resulting in inappropriate treatment planning. Based on that, evaluation of biomarkers in PICF sample compensates limitations of conventional diagnostic procedures without capability to provide accurate information on early disease. Numerous studies have been conducted to identify the biomolecules accurately reflecting peri-implant tissue condition, but since the pathology of local metabolism is complex, the method for evaluation is still under standardization..

Effects of the platelet rich plasma on apexogenesis in young monkeys: Radiological and hystologycal evaluation

Platelet-reach plasma (PRP) is an attractive tool in regenerative medicine due to its ability to stimulate proliferation and differentiation of stem cells. Since dental pulp derived stem cells are recognized as central in apexogenesis, the aim of the study was to evaluate radiologically and histologically effects of PRP on apexogenesis in teeth with immature roots. The study included eight monkeys (Cercopithecus Aethiops) divided in two equal groups for evaluation 3 and 12 months after treatment. All participants obtained the same treatment including pulpotomy and after-treatment with: hydroxiapatite (HA)-incisor and HA+canine PRP. Radiological evaluation was performed using the long cone paralleling technique for recording of defined parameters and histological evaluation was performed using tissue removed en block for the observation of parameters related to apexogenesis. The results obtained radiologically and histologically have shown increase in bridge formation in HA+PRP (75%) group after 3 months comparing to HA group (50%). Contrary to that, after 12 months there were no significant differences between groups. The root delay was not registered in the HA+PRP group contrary to HA group where it was registered in 25% after 12 months. Results of the study suggest that PRP is a powerful tool for intensive and rapid apexogenesis since it offers clear and comprehensive results (mostly in the first three months) which are early radiologically visible without any failure in the proposed requests

Impact of dental implant insertion method on the peri-implant bone tissue: Experimental study

Background/Aim. The function of dental implants depends on their stability in bone tissue over extended period of time, i.e. on osseointegration. The process through which osseointegration is achieved depends on several factors, surgical insertion method being one of them. The aim of this study was to histopathologically compare the impact of the surgical method of implant insertion on the peri-implant bone tissue. Methods. The experiment was performed on 9 dogs. Eight weeks following the extraction of lower premolars implants were inserted using the one-stage method on the right mandibular side and two-stage method on the left side. Three months after implantation the animals were sacrificed. Three distinct regions of bone tissue were histopathologically analyzed, the results were scored and compared. Results. In the specimens of one-stage implants increased amount of collagen fibers was found in 5 specimens where tissue necrosis was also observed. Only moderate osteoblastic activity was found in 3 sections. The analysis of bone-to-implant contact region revealed statistically significantly better results regarding the amount of collagen tissue fibers for the implants inserted in the two-stage method (Wa = 59 < 66,5, α = 0.05), but necrosis was found in all specimens, and no osteoblastic activity. Histopathological analysis of bone-implant interface of one-stage implants revealed increased amount of collagen fibers in all specimens, moderate osteoblastic activity and neovascularization in 2 specimens. No inflammation was observed. The analysis of two-stage implants revealed a marked increase of collagen fibers in 5 specimens, inflammation and bone necrosis were found in only one specimen. There were no statistically significant differences between the two methods regarding bone-implant interface region. Histopathological analysis of bone tissue adjacent to the one-stage implant revealed moderate increase of collagen tissue in only 1 specimen, moderate increase of osteoblasts and osteocytes in 3 specimens. No necrotic tissue was found. The analyzed specimens of bone adjacent to two-stage implants revealed a moderate increase in the number of osteocytes in 3 and a marked increase in 6 specimens respectively. This difference was statistically significant (Wb = 106.5 > 105, α = 0.05). No necrosis and osteoblastic activity were observed. Conclusion. Better results were achieved by the two-stage method in bone-to-implant contact region regarding the amount of collagen tissue, while the results were identical regarding the osteoblastic activity and bone tissue necrosis. There was no difference between the methods in the bone-implant interface region. In the bone tissue adjacent to the implant the results were identical regarding the amount of collagen tissue, osteoblastic reaction and bone tissue necrosis, while better results were achieved by the two-stage method regarding the number of osteocytes

Variation of the cytokine profiles in gingival crevicular fluid between different groups of periodontally healthy teeth

© 2020, University of Kragujevac, Faculty of Science. All rights reserved. Profiling of biomarkers of physiological process represents an integrative part in optimisation of diagnostic markers in order to adjust the diagnostic ranges to the potential effects of the local factors such occlusal forces in case of periodontal tissues. The objective of this study was estimation of IL-1β, IL-2, IL-4, IL-5, IL6, IL-9, IL-10, IL-12, IL-13, IL-17, IL-22, TNFα and IFNγ concentrations in gingival crevicular fluid samples (GCF) between different groups of teeth. Two hundred fifty-nine systemically healthy non-smokers having at least one vital tooth without restorations, with healthy periodontal tissues, were clinically examined and the GCF sample was retrieved. The cytokine levels were estimated using flow cytometry and compared between central incisors (CI), lateral incisors, canines, first premolars, second premolars, first molars and second molars. Cytokine profiles varied between different groups of teeth with tendency of increase in proinflammatory cytokines from anterior teeth toward molars. Molars might be considered teeth with natural predisposition for faster bone resorption while the adjustment of diagnostic range of periodontal biomarkers for anterior or posterior teeth should be considered within diagnostic context. Cytokine profiles varied between different groups of teeth with tendency of increase in proinflammatory cytokines from anterior teeth toward molars. Molars might be considered teeth with natural predisposition for faster bone resorption while the adjustment of diagnostic range of periodontal biomarkers for anterior or posterior teeth should be considered within diagnostic context

Varijacija profila citokina u gingivalnoj zglobnoj tečnosti između različitih grupa parodontalno zdravih zuba

Profiling of biomarkers of physiological process represents an integrative part in optimisation of diagnostic markers in order to adjust the diagnostic ranges to the potential effects of the local factors such occlusal forces in case of periodontal tissues. The objective of this study was estimation of IL-1β, IL-2, IL-4, IL-5, IL- 6, IL-9, IL-10, IL-12, IL-13, IL-17, IL-22, TNFα and IFNγ concentrations in gingival crevicular fluid samples (GCF) between different groups of teeth. Two hundred fifty-nine systemically healthy non-smokers having at least one vital tooth without restorations, with healthy periodontal tissues, were clinically examined and the GCF sample was retrieved. The cytokine levels were estimated using flow cytometry and compared between central incisors (CI), lateral incisors, canines, first premolars, second premolars, first molars and second molars. Cytokine profiles varied between different groups of teeth with tendency of increase in proinflammatory cytokines from anterior teeth toward molars. Molars might be considered teeth with natural predisposition for faster bone resorption while the adjustment of diagnostic range of periodontal biomarkers for anterior or posterior teeth should be considered within diagnostic context. Cytokine profiles varied between different groups of teeth with tendency of increase in proinflammatory cytokines from anterior teeth toward molars. Molars might be considered teeth with natural predisposition for faster bone resorption while the adjustment of diagnostic range of periodontal biomarkers for anterior or posterior teeth should be considered within diagnostic context.Profilisanje biomarkera fiziološkog procesa predstavlja integrativni deo optimalizacije dijagnostičkih markera, kako bi se dijagnostički rasponi prilagodili potencijalnim uticajima lokalnih faktora poput okluzijskih sila u slučaju parodontalnih tkiva. Cilj ove studije bila je procena koncentracija IL-1b, IL-2, IL-4, IL-5, IL-6, IL-9, IL-10, IL-12, IL-13, IL-17, IL- 22, TNFα i IFNγ u uzorcima gingivalne tečnosti (GT) kod različitih grupa zuba. Klinički je pregledano dvesta pedeset devet sistemski zdravih nepušača sa najmanje jednim vitalnim zubom bez restauracija, sa zdravim parodontalnim tkivima, i uzet je GT uzorak. Nivoi citokina procenjeni su protočnom citometrijom i upoređeni između centralnih sekutića (CS), bočnih sekutića, očnjaka, prvih i drugih premolara, kao i prvih i drugih kutnjaka. Profil citokina varirao je između različitih grupa zuba sa tendencijom povećanja pro-upalnih citokina od prednjih zuba do kutnjaka. Molari se mogu smatrati zubima sa prirodnom predispozicijom za bržu resorpciju kosti, dok bi podešavanje dijagnostičkog raspona parodontalnih biomarkera za prednje ili zadnje zube trebalo razmotriti unutar dijagnostičkog konteksta

Estimating the Effects of Dental Caries and Its Restorative Treatment on Periodontal Inflammatory and Oxidative Status: A Short Controlled Longitudinal Study

Dental caries and periodontitis are among the most common health conditions that are currently recognized as growing socio-economic problems relating to their increasing prevalence, negative socio-economic impact, and harmful effects on systemic health. So far, the exact effects of caries and standard restorative materials on periodontal inflammatory and oxidative status are not established. The present study aimed to investigate the effect of caries and its restoration using standard temporary and permanent filling materials on a panel of 16 inflammatory and oxidative markers in gingival crevicular fluid (GCF) of periodontally healthy individuals, 7 (D7) and 30 (D30) days post-restoration, while the intact teeth represented the control. One hundred ninety systemically and periodontally healthy patients with occlusal caries underwent standard cavity preparation and restorations with one of six standard temporary or permanent restorative material according to indication and randomization scheme. Interleukin (IL)-2, IFN- g, IL-12, IL-17A, IL-13, IL-9, IL-10, IL-6, IL-5, IL-4, IL-22, TNF-a, IL1- b, thiobarbituric acid reactive substances, superoxide dismutase, and reduced form of glutathione were measured in GCF samples by flowcytometry and spectrophotometry in aid of commercial diagnostic assays. Caries affected teeth exhibited significantly increased IL-1 b, IL-17, IL- 22, and TBARS and decreased IL-9 concentrations compared to healthy controls. Treatment generally resulted in an increased antioxidant capacity with exception of zinc-polycarboxylate cement showing distinctive inflammatory pattern. Comparison of inflammatory and oxidative profiles in temporary and permanent restorations showed material-specific patterning which was particularly expressed in temporary materials plausibly related to greater caries extension. Caries affected teeth exhibited a balanced inflammatory pattern in GCF, with a general tendency of homeostatic re-establishment following treatment. Restorative materials did not provide specific pathological effects, although some material groups did exhibit significantly elevated levels of inflammatory and oxidative markers compared to healthy controls, while the material-specific patterning was observed as well

Receptor activator of nuclear factor kappa B (RANK) as a determinant of peri-implantitis

Background/Aim. Peri-implantitis presents inflammatory process that affects soft and hard supporting tissues of osseointegrated implant based on inflammatory osteoclastogenesis. The aim of this study was to investigate whether receptor activator of nuclear factor kappa B (RANK) concentrations in peri-implant crevicular fluid could be associated with clinical parameters that reflect inflammatory nature of peri-implantitis. Methods. The study included 67 patients, 22 with diagnosed peri-implantitis, 22 persons with healthy peri-implant tissues and 23 patients with periodontitis. Clinical parameters from each patient were recorded and samples of peri-implant/gingival crevicular fluid were collected for the enzyme-linked immunosorbent assay (ELISA) analysis. Results. RANK concentration was significantly increased in samples from the patients with periimplantitis when compared to healthy implants (p < 0.0001), where the average levels were 9 times higher. At the same time RANK concentration was significantly higher in periimplantitis than in periodontitis sites (p < 0.0001). In implant patients pocket depths and bleeding on probing values were positively associated with high RANK concentrations (p < 0.0001). Conclusion. These results revealed association of increased RANK concentration in samples of periimplant/ gingival crevicular fluid with peri-implant inflammation and suggests that RANK could be a pathologic determinant of peri-implantitis, thereby a potential parameter in assessment of peri-implant tissue inflammation and a potential target in designing treatment strategies

Povezanost tipa preloma kosti i stepena formiranja kalusa sa koncentracijom leptina kod dece sa prelomima dugih kostiju

Background/Aim. Recent studies indicate that adipokines have an important role in bone physiology and pathology. Recent data indicate that adipokine leptin functions as a regulator of bone growth at multiple levels, systemically and locally. So far, it has been shown that leptin influences bone volume and bone mineral density in a population with metabolic and/or hormonal abnormality. Data concerning leptin values in non-obese children with fractures are scarce. Methods. This study included 93 non-obese children with long bone fractures (LBF), 14 children with short bone fractures (SBF), and 19 healthy children. Leptin concentration was determined in two blood samples (day 0 and day 21) and analyzed according to gender, fracture type, anatomical localization of the fracture, fracture topography, callus formation, and the healing outcome. Results. Children with LBF demonstrated significantly increased leptin levels compared to the control group (both day 0/day 21). In the control group, girls had significantly more leptin than boys. Leptin value was significantly influenced by anatomical localization since boys and girls with humerus fracture and girls with femur fracture had the highest average leptin concentration in the initial sample. Boys with incomplete callus formation had the highest leptin concentration (both day 0/day 21), significantly elevated compared to boys' samples in the control group, boys' samples with an intermediary and well-formed callus, and also increased compared to the initial samples of girls with incomplete callus. Better callus formation in girls was associated with an increment of leptin concentrations in the second over the initial sample. Girls with partially and satisfactorily formed callus had significantly increased leptin concentration in the second sample (day 21) compared to the boys' group. Conclusion. Leptin concentration was significantly increased (both samples) in children with LBF compared to children with SBF and corresponding controls. Leptin concentration was highly influenced by gender. High blood leptin concentrations in boys or low leptin concentrations in girls immediately upon fracture could be used to identify groups of children with incomplete callus formation.Uvod/Cilj.Novijestudije pokazuju da adipokini imaju važnu ulogu u fiziologiji i patologiji kostiju. Takođe, najnoviji podaci pokazuju da adipokin leptin funkcioniše kao regulator rasta kostiju sistemski i lokalno. Pokazano je da leptin utiče na volumen kostiju i mineralnu gustinu kostiju u populaciji sa metaboličkom i/ili hormonskom abnormalnošću. Podaci o vrednostima leptina kod negojazne dece sa frakturama su oskudni. Metode. U ovu studijubil a su uključena93 negojazna deteta sa prelomima dugih kostiju (LBF), 14 dece sa prelomima malih kostiju (SBF) i 19 zdrave dece. Koncentracija leptina određena je u 2 uzorka krvi (0. danai 21 . dana) i analizirana prema polu, tipu frakture, lokalizaciji anatomske frakture, topografiji frakture, formiranju kalusa i ishodu zarastanja.Rezultati.Deca sa LBF imala su značajnopovećane nivoeleptina u poređenju sa kontrolnom grupom u oba uzorka krvi ( 0. dana/21 . dana). U kontrolnoj grupi devojčice su imale značajno više nivoe leptina od dečaka. Na vrednost leptina značajno je uticala anatomska lokalizacija, jer su dečaci i devojčice sa prelomom humerusa i devojčice sa prelomom femura imali najveću prosečnu koncentraciju leptina u početnom uzorku. Dečaci sa nepotpuno for miranim kalusom imali su najveću koncentraciju leptina (u oba uzorka, 0. dana/21. dana),značajno višuu odnosu na kontrolne uzorke dečaka, uzorke dečaka s intermedijarnim i dobro formiranim kalusom, a takođe višu u odnosu na koncentracije leptina u početnim uzorcima djevojčica s nepotpunim kalusom. Bolje formiranje kalusa kod devojčica je bilo povezano sa poveć anjem koncentracije leptina u drugom (21. dan) u odnosu na početni uzorak(0. dan). Devojčice sa delimično i zadovoljavajuće formiranim kalusom imale su značajno višu koncentraciju leptina u drugom uzorku (21. dan ) u odnosu na grupu dečaka. Zaključak. Koncentracija leptina je značajno povećana (u oba uzorkakrvi ) kod dece sa LBF u poređenju sa decom sa SBF i odgovarajućim kontrolama. Koncentracija leptina je zavisna od pola. Visok nivo leptina u krvi kod dečaka ili niska koncentracija leptina kod devojčica odmah nakon preloma može se koristiti za identifikaciju grupa dece sa nepotpunim formiranjem kalusa