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    Effect of lymphedema on the recovery of fractures
    (Elsevier, 2007) Arslan, Hueseyin; Uludag, Abuzer; Kapukaya, Ahmet; Gezici, Ayten; Bekler, H. Ibrahim; Ketani, Aydin
    Background. Lymphedema delays the healing of any wound by negatively affecting its inflammatory period. Whether it affects bone healing in a similar negative manner is unknown. Therefore, we experimentally investigated the effect of lymphedema on fracture recovery. Methods. We used thirty 200- to 250-g Sprague-Dawley rats for the experiment. The rats were randomly divided into two groups of 15 rats each for the experimental lymphedema and control groups. Lymphedema development was confirmed by measuring the circumference and diameter of the extremities together with lymphoscintigraphy. Twenty days after the development of lymphedema, a fracture model was created in both groups in the right tibia with mid-diaphyseal osteotomy and fixing with an intramedullary Kirschner wire. After 6 weeks, all rats were sacrificed and the callus tissue that formed along the osteotomy was compared between groups with respect to radiographic, histological, and biomechanical characteristics. Results. The three-point bending test yielded an average stiffness value of 1227 N/mm (n = 6) in the control group and 284 N/mm (n = 7) in the experimental lymphedema group (P < 0.05). At the end of week 6, radiographic evaluation showed that solid knitting was obtained in the control group, whereas in the lymphedema group delayed or no knitting was observed. In the control group, histological investigation revealed normal callus morphology. Trabecular bone was normal and osteoblast and osteoclast activity was clearly evident. The bone was stained homogeneously with hematoxylin and eosin, and ossification was within normal limits. In the lymphedema group, however, the histological appearance was mostly that of scar tissue. In addition, osteoblast and osteoclast activity was much less visible or absent. Conclusions. Lymphedema negatively affected bone healing in rats. However, the mechanism of this negative effect and its occurrence in humans are still unknown. Further experimental and clinical studies are needed to support and extend our findings.
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    Effects of estrogen deficiency on tooth movement after force application: an experimental study in ovariectomized rats
    (Taylor & Francis As, 2007) Arslan, Seher Guenduez; Arslan, Hueseyin; Ketani, Aydin; Hamamci, Orhan
    Objective. The aim of this study was to investigate the effects of estrogen deficiency on tooth movement in ovariectomized rats. Material and methods. Forty-two adult female Sprague-Dawley rats were assigned at random to one of the following groups: test group (n=20), ovariectomized rats (or estrogen-deficient rats); control group (n=22), non-ovariectomized rats. Two months after ovariectomy, expansion springs exerting 10 g of force were inserted between the upper central incisors in both groups. The amount of movement was measured daily until tooth movement began and then at intervals of 3 days. The rats were sacrificed 18 days after applying the expansion spring and histomorphometric analysis was performed along the left upper central incisor root towards the apex of the alveolar bone. Results. The amount and speed of movement was observed to be greater in ovariectomized rats. On histomorphometric analysis, osteoblast and osteocyte counts on the pressure side were higher in the non-ovariectomized group than in the ovariectomized group (p < 0.001). In contrast, the osteoclast count was significantly higher (p < 0.01) in the ovariectomized group than in the non-ovariectomized group. The osteoblast and osteocyte counts were significantly higher (p < 0.001) on tension side in the non-ovariectomized group than in the ovariectomized group. Conclusion. Estrogen deficiency increased orthodontic tooth movements but counts of osteoblasts, which are responsible for new bone formation, were lower in regions of tension and of pressure.