Cancellous Bone Tissue Research Articles

Computed tomography examination of the os cordis in a lamb (Ovis aries Linnaeus, 1758)

Objective. The present paper aims to investigate the role of computed tomography as an imaging technique of diagnosis in the identification of the os cordis in ovine, and also how this anatomical structure is morphotopographically characterized in macro and microscopic contexts, seeking to contribute for its functional understanding. Materials and method. The heart of a young male ovine had been donated to the Laboratory of Animal Anatomy of the Surgery Department of the FMVZ/USP, first being subject to a post-mortem examination by means of the cardiac “shedding” (transverse cross sectioning of the heart). A tomographic examination of the anatomic specimen was carried out, as well as the dissection and histological analysis of the collected sample. Results. The results indicate the presence of an osseous structure of 6.39 mm in length, located in the aortic valve of the heart, next to a ring comprised by three valve flaps, tendinous cords, and papillary muscles. The histological findings consist of fibrous connective tissue, cancellous bone tissue, and calcified hyaline cartilage wherein the cardiomyocytes are attached. Conclusions. It is concluded that computed tomography, even though seldom applied to animals of zootechnical interest, poses as an effective tool for the visualization of the os cordis in lambs.

Dose reduction potential in cone-beam CT imaging of upper extremity joints with a twin robotic x-ray system

Cone-beam computed tomography is a powerful tool for 3D imaging of the appendicular skeleton, facilitating detailed visualization of bone microarchitecture. This study evaluated various combinations of acquisition and reconstruction parameters for the cone-beam CT mode of a twin robotic x-ray system in cadaveric wrist and elbow scans, aiming to define the best possible trade-off between image quality and radiation dose. Images were acquired with different combinations of tube voltage and tube current–time product, resulting in five scan protocols with varying volume CT dose indices: full-dose (FD; 17.4 mGy), low-dose (LD; 4.5 mGy), ultra-low-dose (ULD; 1.15 mGy), modulated low-dose (mLD; 0.6 mGy) and modulated ultra-low-dose (mULD; 0.29 mGy). Each set of projection data was reconstructed with three convolution kernels (very sharp [Ur77], sharp [Br69], intermediate [Br62]). Five radiologists subjectively assessed the image quality of cortical bone, cancellous bone and soft tissue using seven-point scales. Irrespective of the reconstruction kernel, overall image quality of every FD, LD and ULD scan was deemed suitable for diagnostic use in contrast to mLD (very sharp/sharp/intermediate: 60/55/70%) and mULD (0/3/5%). Superior depiction of cortical and cancellous bone was achieved in FDUr77 and LDUr77 examinations (p < 0.001) with LDUr77 scans also providing favorable bone visualization compared to FDBr69 and FDBr62 (p < 0.001). Fleiss’ kappa was 0.618 (0.594–0.641; p < 0.001), indicating substantial interrater reliability. In this study, we demonstrate that considerable dose reduction can be realized while maintaining diagnostic image quality in upper extremity joint scans with the cone-beam CT mode of a twin robotic x-ray system. Application of sharper convolution kernels for image reconstruction facilitates superior display of bone microarchitecture.

Evaluation of Benzylpenicillin as an Internal Standard for Measurement of Piperacillin Bone Concentrations Via Microdialysis.

Microdialysis is a pharmacokinetic tool that can be advantageous when obtaining tissues' pharmacokinetic information. Since absolute extracellular tissue concentrations are needed in pharmacokinetic studies, calibrating the microdialysis system is necessary. The internal standard method is superior when compared to other calibration methods. However, thorough evaluation of the internal standard is required before it can be used. In vitro experiments and an in vivo study on pigs (n=8) were conducted to assess the relative recoveries by gain and by loss for piperacillin, both with and without a benzylpenicillin concentration of 5µg/mL. Furthermore, the in vivo setup allowed for an evaluation of piperacillin cancellous bone and subcutaneous tissue concentrations in a single 8h dosing interval. Ultra-high performance liquid chromatography (UHPLC) was used to determine piperacillin and benzylpenicillin concentrations. Relative recovery by loss for benzylpenicillin and relative recovery by gain for piperacillin were similar in in vitro and in vivo. Presence of benzylpenicillin did not affect the relative recovery for piperacillin. Relative recovery, pharmacokinetic parameters and fT>MIC were similar when comparing the retrodialysis by drug and the internal standard calibration methods (p > 0.31). Mean fT>MIC (16µg/mL) for plasma, cancellous bone and subcutaneous tissue were 232min, 255min and 295min, respectively. Our findings suggest that benzylpenicillin is suitable as an internal standard for piperacillin in microdialysis studies. Mean fT>MIC (16µg/mL) for plasma, cancellous bone, and subcutaneous tissue reached a target of 50% fT>MIC under the investigated conditions (mean range: 52%-66%); however, the target was not obtained in all pigs in all compartments. Moreover, 100% fT>MIC was not obtained in any case, suggesting that different strategies must be taken into consideration if higher targets are employed.

Augmentation of Pedicle Screws Using Bone Grafting in Patients with Spinal Osteoporosis.

The aim of the study was to develop a new method of vertebral augmentation based on autologous and allogeneic bone chips to be used in pedicle screw fixation and to compare this method with the technique based on polymethyl methacrylate (PMMA).Materials and MethodsThis prospective non-randomized study included 164 patients with degenerative pathologies or traumatic injuries of the lumbar spine and transitional thoracolumbar segments; 153 of the operated patients were followed up for 18 months. In these patients, radiodensity of the cancellous bone tissue was below 110 HU by the Hounsfield scale. Patients with degenerative spinal disorders underwent pedicle screw fixation using transforaminal interbody fusion; patients with traumatic spinal injuries underwent intermediate pedicle screw fixation, and those with a loss of vertebral body height by >50% underwent anterior fusion.The patients were divided into three groups: in group 1 (n=39), bone tissue augmentation was performed using PMMA; in group 2 (n=21), augmentation was done with bone chips; in group 3 (n=93), no augmentation was performed (control group). The follow-up period was 12 months; cases with fixator breakage or loosening were recorded.ResultsAfter augmentation with PMMA, 11 cases (28.2%) of fixator destabilization were detected. With bone chips, fixator instability developed in 2 patients (9.5%) only, whereas in patients operated without augmentation, the instability was observed in 43 cases (46.2%). With PMMA augmentation, the incidence rate of fixator destabilization did not significantly differ from that in the control group (p=0.0801), while the use of bone chips resulted in a statistically significant decrease of this index compared to the control group (p=0.0023). A logistic regression analysis confirmed the superiority of the developed method over the PMMA-based vertebral augmentation.ConclusionThe use of bone chips for vertebral augmentation provides a statistically significant decrease in the incidence of pedicle screw fixator destabilization in the post-operative period. By reducing the risk of proximal loosening and eliminating the risk of bone cement drainage into the spinal canal and vascular bed, the proposed method may become especially effective in patients with impaired bone density.

The role of cortical zone level and prosthetic platform angle in dental implant mechanical response: A 3D finite element analysis

ObjectiveThe aim of this study was to evaluate the influence of three different dental implant neck geometries, under a combined compressive/shear load using finite element analysis (FEA). The implant neck was positioned in D2 quality bone at the crestal level or 2 mm below. MethodsOne dental implant (4.2 × 9 mm) was digitized by reverse engineering techniques using micro CT and imported into Computer Aided Design (CAD) software. Non-uniform rational B-spline surfaces were reconstructed, generating a 3D volumetric model similar to the digitized implant. Three different models were generated with different implant neck configurations, namely 0°, 10° and 20°. D2 quality bone, composed of cortical and trabecular structure, was modeled using data from CT scans. The implants were included in the bone model using a Boolean operation. Two different fixture insertion depths were simulated for each implant: 2 mm below the crestal bone and exactly at the level of the crestal bone. The obtained models were imported to FEA software in STEP format. Von Mises equivalent strains were analyzed for the peri-implant D2 bone type, considering the magnitude and volume of the affected surrounding cortical and trabecular bone. The highest strain values in both cortical and trabecular tissue at the peri-implant bone interface were extracted and compared. ResultsAll implant models were able to distribute the load at the bone-implant contact (BIC) with a similar strain pattern between the models. At the cervical region, however, differences were observed: the models with 10° and 20° implant neck configurations (Model B and C), showed a lower strain magnitude when compared to the straight neck (Model A). These values were significantly lower when the implants were situated at crestal bone levels. In the apical area, no differences in strain values were observed. SignificanceThe implant neck configuration influenced the strain distribution and magnitude in the cortical bone and cancellous bone tissues. To reduce the strain values and improve the load dissipation in the bone tissue, implants with 10° and 20 neck configuration should be preferred instead of straight implant platforms.

Finite elements analysis of stresses formed in core and spongious bone tissue by restored implanted fixed prostheses with Polyetheretherketone (PEEK) and fiber-reinforced composite

Aim: This study uses the finite element analysis method to compare the effects of different abutments and prosthetic materials on stress distribution in the rehabilitation of maxillary anterior tooth deficiencies with fixed implanted prostheses. Methodology: In our study, two titanium implant models with a diameter of 4.1 mm and a length of 10 mm were designed for the maxillary central and canine teeth regions. 3D models of the prosthetic restorations were created with PEEK and fiber-reinforced composite and two different abutment materials (titanium and zirconia). After meshing the materials used with cortical and cancellous bone, Poisson ratio and young module values were loaded into the program. Maxillary central and canine to the palatal surface of the tooth, 2 mm below the incisal edge; a 178 N force was applied in both the vertical and 45° oblique directions, and analysis was performed. The distributions of the highest compression and tensile stress values in peri-implant cortical and cancellous bone were examined, and the results were compared. Results: Material with low elastic modulus caused higher stress accumulation in the cortical and cancellous bone tissue around the implant during oblique force application. In all study groups, the maximum stress values ​​observed in the cancellous and cortical bone during oblique force application were significantly higher than those observed during vertical force application. Thus, different prosthetic materials had different effects on stress distribution in peri-implant cortical and cancellous bone tissue, and the highest stress accumulations were in the peri-implant cortical bone. Conclusion: Different prosthetic materials had different effects on stress distribution in peri-implant cortical and cancellous bone tissue. How to cite this article: Zengingul AI, Goncu Basaran E, Celik H. Finite elements analysis of stresses formed in core and spongious bone tissue by restored implanted fixed prostheses with Polyetheretherketone (PEEK) and fiber-reinforced composite. Int Dent Res 2021;11(Suppl.1):250-8. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.37 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Biomechanical evaluation of 3-unit fixed partial dentures on monotype and two-piece zirconia dental implants

This study aimed to evaluate the biomechanical behavior, stress distributions and bone microstrain of fixed partial dentures (FPD) with ceramic abutments supported on monotype zirconia implants, titanium implants and two-piece zirconia implants, using finite element analysis. A three-dimensional model of the jaw was simulated containing 1.0 mm thick cortical bone and cancellous bone tissue. A FPD and implant models (4.1 x 10 mm) were modeled containing a cement-retained implant abutment. These models were replicated in three groups with similar geometries: Titanium Implant and Zirconia Abutment (Ti-Zr); Zirconia Implant and Zirconia Abutment (Zr-Zr) and Monotype Zirconia Implant (Zr-S). An axial load of 300 N was applied to the center of the first premolar. The microstrain (με) and the Von-Mises stress (MPa) were assumed as failures criteria. For the three groups, a higher stress concentration was observed in the region of FPD connectors. The Ti-Zr group showed a higher stress concentration in the prosthesis and implant when compared to the other groups. However, the smaller elastic modulus of the titanium implant, in relation to the zirconia, provided a lower stress in the abutment and in the prosthetic screw. The monotype implant system allowed a more homogeneous stress distribution and its strain were predominantly located in the cervical region of the peri-implant bone tissue. Monotype or two-piece zirconia implants can be used for rehabilitation with FPD. However, the absence of separation between implant and abutment in the monotype system avoids the stress concentration in the prosthetic screw and reduced the peri-implant bone strain.

P62 Overexpression Promotes Bone Metastasis of Lung Adenocarcinoma out of LC3-Dependent Autophagy.

p62 protein has been implicated in bone metastasis and is a multifunctional adaptor protein usually correlated with autophagy. Herein, we investigated p62 expression and its prognostic significance in bone metastasis of lung adenocarcinoma, and analyzed whether the mechanism involved depends on autophagy. mRNA and protein expression of p62, LC3B and Beclin 1 were detected by reverse transcription-quantitative PCR and western blotting, respectively, in fresh bone metastasis tissues (n=6 cases) and normal cancellous bone tissues (n=3 cases). The association between p62 and LC3B expression and patient prognosis was subsequently analyzed in 62 paraffin-embedded bone metastasis specimens by immunohistochemistry assay. Small interfering RNA (siRNA) was employed to downregulate p62 expression in SPC-A-1 and A549 cells. Cell proliferation and migration ability were tested by CCK8, CCF and Transwell assays respectively. Autophagy was induced by Rapamycin or inhibited by Atg 7 knockout/Chloroquine in A549 cells and p62 and LC3II/I expression were analyzed. After subcutaneous inoculation or intracardial injection of A549 cells into nude mice, the effect of p62 downregulation in vivo was analyzed by histopathological examination. The results showed that p62, LC3B and Beclin 1 mRNA and protein were all overexpressed in bone metastasis tissues (all P<0.01). Patient samples with high p62 expression levels were significantly associated with more bone lesions (>3), shorter overall survival rates and shorter progression free survival rates compared with patients having lower p62 expression (P=0.014, P=0.003, P=0.048, respectively). Cox regression analysis identified p62 expression as an independent prognostic indicator of overall survival of patients with bone metastasis (P=0.007). In vitro p62 downregulation inhibited SPC-A-1 and A549 cells migration but had no effect on cell proliferation. After autophagy induction or inhibition, p62 expression involved in autophagy flux and changed inconsistently according to the switch of LC3I to LC3II in different autophagy conditions. In vivo p62 downregulation had no effect on growth of subcutaneous tumor. Lung or bone metastasis lesion was not found in all mice model. These findings suggested that p62 overexpression promotes tumor cell invasion out of LC3-dependent autophagy, which could be used a potential prognostic biomarker and therapeutic target for bone metastasis of lung adenocarcinoma.

Imaging Assessment of the Postoperative Spine: An Updated Pictorial Review of Selected Complications

Imaging of the postoperative spine requires the identification of several critical points by the radiologist to be written in the medical report: condition of the underlying cortical and cancellous bone, intervertebral disc, and musculoskeletal tissues; location and integrity of surgical implants; evaluation of the success of decompression procedures; delineation of fusion status; and identification of complications. This article presents a pictorial narrative review of the most common findings observed in noninstrumented and instrumented postoperative spines. Complications in the noninstrumented spine were grouped in early (hematomas, pseudomeningocele, and postoperative spine infection) and late findings (arachnoiditis, radiculitis, recurrent disc herniation, spinal stenosis, and textiloma). Complications in the instrumented spine were also sorted in early (hardware fractures) and late findings (adjacent segment disease, hardware loosening, and implant migration). This review also includes a short description of the most used diagnostic techniques in postoperative spine imaging: plain radiography, ultrasound (US), computed tomography (CT), magnetic resonance (MR), and nuclear medicine. Imaging of the postoperative spine remained a challenging task in the early identification of complications and abnormal healing process. It is crucial to consider the advantages and disadvantages of the imaging modalities to choose those that provide more accurate spinal status information during the follow-up. Our review is directed to all health professionals dealing with the assessment and care of the postoperative spine.

Cancellous Bone May Have a Greater Adaptive Strain Threshold Than Cortical Bone.

ABSTRACTStrain magnitude has a controlling influence on bone adaptive response. However, questions remain as to how and if cancellous and cortical bone tissues respond differently to varied strain magnitudes, particularly at a molecular level. The goal of this study was to characterize the time‐dependent gene expression, bone formation, and structural response of the cancellous and cortical bone of female C57Bl/6 mice to mechanical loading by applying varying load levels (low: −3.5 N; medium: −5.2 N; high: −7 N) to the skeleton using a mouse tibia loading model. The loading experiment showed that cortical bone mass at the tibial midshaft was significantly enhanced following all load levels examined and bone formation activities were particularly elevated at the medium and high loads applied. In contrast, for the proximal metaphyseal cancellous bone, only the high load led to significant increases in bone mass and bone formation indices. Similarly, expression of genes associated with inhibition of bone formation (e.g., Sost) was altered in the diaphyseal cortical bone at all load levels, but in the metaphyseal cortico‐cancellous bone only by the high load. Finite element analysis determined that the peak tensile or compressive strains that were osteogenic for the proximal cancellous bone under the high load were significantly greater than those that were osteogenic for the midshaft cortical tissues under the low load. These results suggest that the magnitude of the strain stimulus regulating structural, cellular, and molecular responses of bone to loading may be greater for the cancellous tissues than for the cortical tissues. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

Inferior Turbinate Bone Graft for Dorsal Augmentation in Rhinoplasty.

The most serious form of nasal dorsum pathologies is saddle nose deformity. Vary of nasal dorsal augmentation grafts were reported in the literature but inferior bone graft (ITBG) alone has not attracted attention. The ITBG has advantages such as easy and fast harvesting, easy to shape due to cancellous bone tissue. The graft technique is similar to the inferior turbinoplasty with the medial mucosal flap technique and can be performed without bioabsorbable hemostatic material (e.g. Turkish Delight), suture fixation, or without tissue adhesives. Major complications of the ITBG technique are injury of the posterior lateral nasal branch of the sphenopalatine artery and subdermal mucous cyst that developing on nasal dorsum. Since easy application, fast harvesting, and similar permanence to cartilage grafts as augmentation material, ITBG can also been used successfully in minor dorsal deficits in addition to saddle nose deformities.

The effect of bioinert electroexplosive coatings on stress distribution near the dental implant-bone interface

In this study, the first time a 2d finite element models of the titanium dental implant with Ti–Zr or Ti–Nb coating sprayed by electro explosive method and bone tissue located near were constructed. The present models simulate small surface implant section and bone located near. Three models with or without bioinert coating were studied in two configurations with cortical or cancellous bone tissue. All materials used in this study were assumed to be linearly elastic, homogenous, and isotropic to simplify the calculation. The stress distribution in the implant and bone tissue located near is uniform. The largest von Mises stress was obtained near the bone-implant interface in the implant area. It has shown that the stress pattern changed in the models with bioinert coatings. The second stress maximum appeared on the boundary between titanium subtract and the coating layer. The most significant changes in stress distribution were reached in the model with Ti–Zr coating. The electro explosive bioinert coatings help to reduce the stress shielding effect and implant failure probability because of bone strength loss. It also was found shear stress changes in the bone tissue.

A 3D Printed Composite Scaffold Loaded with Clodronate to Regenerate Osteoporotic Bone: In Vitro Characterization.

Additive manufacturing (AM) is changing our current approach to the clinical treatment of bone diseases, providing new opportunities to fabricate customized, complex 3D structures with bioactive materials. Among several AM techniques, the BioCell Printing is an advanced, integrated system for material manufacture, sterilization, direct cell seeding and growth, which allows for the production of high-resolution micro-architectures. This work proposes the use of the BioCell Printing to fabricate polymer-based scaffolds reinforced with ceramics and loaded with bisphosphonates for the treatment of osteoporotic bone fractures. In particular, biodegradable poly(ε-caprolactone) was blended with hydroxyapatite particles and clodronate, a bisphosphonate with known efficacy against several bone diseases. The scaffolds’ morphology was investigated by means of Scanning Electron Microscopy (SEM) and micro-Computed Tomography (micro-CT) while Energy Dispersive X-ray Spectroscopy (EDX) and X-ray Photoelectron Spectroscopy (XPS) revealed the scaffolds’ elemental composition. A thermal characterization of the composites was accomplished by Thermogravimetric analyses (TGA). The mechanical performance of printed scaffolds was investigated under static compression and compared against that of native human bone. The designed 3D scaffolds promoted the attachment and proliferation of human MSCs. In addition, the presence of clodronate supported cell differentiation, as demonstrated by the normalized alkaline phosphatase activity. The obtained results show that the BioCell Printing can easily be employed to generate 3D constructs with pre-defined internal/external shapes capable of acting as a temporary physical template for regeneration of cancellous bone tissues.

Biomechanical effects of dental implant diameter, connection type, and bone density on microgap formation and fatigue failure: A finite element analysis

Understanding fatigue failure and microgap formation in dental implants, abutments, and screws under various clinical circumstances is clinically meaningful. In this study, these aspects were evaluated based on implant diameter, connection type, and bone density. Twelve three-dimensional finite element models were constructed by combining two bone densities (low and high), two connection types (bone and tissue levels), and three implant diameters (3.5, 4.0, and 4.5 mm). Each model was composed of cortical and cancellous bone tissues, the nerve canal, and the implant complex. After the screw was preloaded, vertical (100 N) and oblique (200 N) loadings were applied. The relative displacements at the interfaces between implant, abutment, and screw were analyzed. The fatigue lives of the titanium alloy (Ti-6Al-4V) components were calculated through repetitive mastication simulations. Mann-Whitney U and Kruskal-Wallis one-way tests were performed on the 50 highest displacement values of each model. At the implant/abutment interface, large microgaps were observed under oblique loading in the buccal direction. At the abutment/screw interface, microgap formation increased along the implant diameter under vertical loading but decreased under oblique loading (p < 0.001); the largest microgap formation occurred in the lingual direction. In all cases, the bone-level connection induced larger microgap formation than the tissue-level connections. Moreover, only the bone-level connection models showed fatigue failure, and the minimum fatigue life was observed for the implant diameter of 3.5 mm. Tissue-level implants possess biomechanical advantages compared to bone-level ones. Two-piece implants with diameters below 3.5 mm should be avoided in the posterior mandibular area.

Processing of Polyester-Urethane Filament and Characterization of FFF 3D Printed Elastic Porous Structures with Potential in Cancellous Bone Tissue Engineering.

This paper addresses the potential of self-made polyester-urethane filament as a candidate for Fused Filament Fabrication (FFF)-based 3D printing (3DP) in medical applications. Since the industry does not provide many ready-made solutions of medical-grade polyurethane filaments, we undertook research aimed at presenting the process of thermoplastic polyurethane (TPU) filament formation, detailed characteristics, and 3DP of specially designed elastic porous structures as candidates in cancellous tissue engineering. Additionally, we examined whether 3D printing affects the structure and thermal stability of the filament. According to the obtained results, the processing parameters leading to the formation of high-quality TPU filament (TPU_F) were captured. The results showed that TPU_F remains stable under the FFF 3DP conditions. The series of in vitro studies involving long- and short-term degradation (0.1 M phosphate-buffered saline (PBS); 5 M sodium hydroxide (NaOH)), cytotoxicity (ISO 10993:5) and bioactivity (simulated body fluid (SBF) incubation), showed that TPU printouts possessing degradability of long-term degradable tissue constructs, are biocompatible and susceptible to mineralization in terms of hydroxyapatite (HAp) formation during SBF exposure. The formation of HAp on the surface of the specially designed porous tissue structures (PTS) was confirmed by scanning electron microscope (SEM) and energy-dispersive X-ray spectroscopy (EDS) studies. The compression test of PTS showed that the samples were strengthened due to SBF exposure and deposited HAp on their surface. Moreover, the determined values of the tensile strength (~30 MPa), Young’s modulus (~0.2 GPa), and compression strength (~1.1 MPa) allowed pre-consideration of TPU_F for FFF 3DP of cancellous bone tissue structures.

Synthesis and Characterization of Hierarchical Mesoporous-Macroporous TiO2-ZrO2 Nanocomposite Scaffolds for Cancellous Bone Tissue Engineering Applications

Bone tissue engineering has been introduced several decades ago as a substitute for traditional grafting techniques to treat bone defects using engineered materials. The main goal in bone tissue engineering is to introduce materials and structures which can mimic the function of bone to restore the damaged tissue and promote cell restoration and proliferation. Titania and zirconia are well-known bioceramics which have been widely used in tissue engineering applications due to their unsurpassed characteristics. In this study, hierarchical meso/macroporous titania-zirconia (TiO2-ZrO2) nanocomposite scaffolds have been synthesized and evaluated for bone tissue engineering applications. The scaffolds were produced using the evaporation-induced self-assembly (EISA) technique along with the foamy method. To characterize the samples, X-ray diffraction (XRD), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), simultaneous thermal analysis (STA), and Brunauer-Emmett-Teller (BET) analysis were performed. The results showed that TiO2-ZrO2 scaffolds can be produced after sintering the samples at 550°C for 2 h. Among samples with different weight percentages of zirconia and titania, the sample containing 13 wt.% zirconia was considered as the optimum sample due to its structural integrity. This scaffold had pore size, pore wall size, and mesopores in the range of 185±66 μm, 15±4 μm, and 7-13 nm, respectively. The specific surface area obtained from the BET theory, total volume, and mean diameter of pores of this sample was 13.627 m2g1-, 0.03788 cm3g-1, and 11 nm, respectively. The results showed that the produced scaffolds can be considered as the promising candidates for cancellous bone regeneration.

MATHEMATICAL MODELING OF CANCELLOUS BONE TISSUE ADAPTATION APPLIED TO THE HUMAN MAXILLODENTAL SYSTEM

The bone tissue in different parts of the skeleton conforms to Wolff’s law: it aims to become optimal for the loading which acts on the corresponding bone; the bone is remodelling by means of osteosynthesis and resorption mechanisms. The modern problems of biomechanics demand research on the history of formation of bone structures in the course of time at both physiological and pathological loadings. Ever changing loadings of different nature have influence on development and functioning of the trabecular bone tissue. The mandible is one of the most liable to external and internal changes bones. Very often one has to deal with pathological changes caused by incorrect loading of different regions of bone tissue due to dysfunction of a dentition, a temporomandibular joint and so on. For example, the Popov-Godon’s syndrome which connects with tooth loss is accompanied by pathological remodelling of the surrounding bone tissue. Thus, the mathematical modeling of the cancellous bone tissue behavior in the human maxillodental system is one of the most topical problems of biomechanics and medicine. Trabecular bone tissue is a heterogeneous, porous, anisotropic material. Heterogeneity of spongy structure can be described by methods of quantitative stereology. At the same time, structural features of the trabecular bone can be described by means of the fabric tensor. This is possible to implement if there is both a constitutive relation which connects the stress tensor, the fabric tensor, and the strain tensor, and kinetic equations which describe the evolution of the fabric tensor and bone density. An initial boundary value problem on the trabecular bone tissue remodelling is stated. The effective numerical algorithm allowing to solve the problem is developed. This algorithm is implemented as a complex of problem-oriented programs. Verification of the model and identification of its parameters are carried out. All numerical calculations are performed using the ANSYS software. Trabecular bone tissue evolution is demonstrated on the set of model examples when the stress–strain state is changed. The results demonstrate different character of influence of changes of loading conditions on process of structure formation which follows from Wolff’s law.

P62 overexpression promotes neoplastic stromal cell proliferation and is associated with the recurrence of giant cell tumor of bone.

Giant cell tumor of bone (GCTB) is an intermediate (locally aggressive) bone tumor with a recurrence rate of >30% following surgery. GCTB recurrence is ultimately due to the proliferation of neoplastic stromal (NS) cells. However, the precise mechanism underlying the regulation of NS cell proliferation remains unknown. p62 protein is a multifunctional adaptor protein that exerts a positive role in bone tumors and metabolic bone diseases. In the present study, the mRNA and protein expression levels of p62 were detected by reverse transcription-quantitative PCR and western blotting, respectively, in 8 paired fresh GCTB tumor tissues and adjacent normal cancellous bone tissues. The association between p62 expression level and patient prognosis was subsequently analyzed in 54 paraffin-embedded tumor specimens by immunohistochemistry assay. NS cells were isolated from GCTB primary cell culture, and the role of p62 was evaluated using in vitro cell proliferation, migration and invasion assays. The results revealed that p62 mRNA and protein were overexpressed in tumor tissues. High p62 expression levels were significantly associated with the recurrence of GCTB (P=0.001). The patients in the high p62 expression group had shorter 5-year recurrence-free survival rates compared with the patients in the low p62 expression group (P<0.001). Cox regression analysis identified p62 expression as an independent prognostic indicator of the recurrence-free survival of patients with GCTB (P<0.001). The in vitro experiments revealed that p62 downregulation inhibited NS cell proliferation, invasion and migration, and promoted apoptosis. In conclusion, it was found that p62 overexpression is associated with the recurrence of GCTB via the promotion of NS cell proliferation. Therefore, p62 could be a novel prognostic indicator, and a potential therapeutic target for GCTB.

Timing of Antimicrobial Prophylaxis and Tourniquet Inflation: A Randomized Controlled Microdialysis Study.

Tourniquets are widely used during extremity surgery. In order to prevent surgical site infection, correct timing of antimicrobial prophylaxis and tourniquet inflation is important. We aimed to evaluate the time for which the free drug concentration of cefuroxime is maintained above the minimum inhibitory concentration (t > MIC) in porcine subcutaneous adipose tissue and calcaneal cancellous bone during 3 clinically relevant tourniquet application scenarios. Twenty-four female Danish Landrace pigs were included. Microdialysis catheters were placed bilaterally for sampling of cefuroxime concentrations in calcaneal cancellous bone and subcutaneous adipose tissue, and a tourniquet was applied to a randomly picked leg of each pig. Subsequently, the pigs were randomized into 3 groups to receive 1.5 g of cefuroxime by intravenous injection 15 minutes prior to tourniquet inflation (Group A), 45 minutes prior to tourniquet inflation (Group B), and at the time of tourniquet release (Group C). The tourniquet duration was 90 minutes in all groups. Dialysates and venous blood samples were collected for 8 hours after cefuroxime administration. Cefuroxime and various ischemic marker concentrations were quantified. Cefuroxime concentrations were maintained above the clinical breakpoint MIC for Staphylococcus aureus (4 µg/mL) in calcaneal cancellous bone and subcutaneous adipose tissue throughout the 90-minute tourniquet duration in Groups A and B. Cefuroxime administration at the time of tourniquet release (Group C) resulted in concentrations of >4 µg/mL for approximately of 3.5 hours in the tissues on the tourniquet side. Furthermore, tourniquet application induced ischemia (increased lactate:pyruvate ratio) and cell damage (increased glycerol) in subcutaneous adipose tissue and calcaneal cancellous bone. Tissue ischemia was sustained for 2.5 hours after tourniquet release in calcaneal cancellous bone. Administration of cefuroxime (1.5 g) in the 15 to 45-minute window prior to tourniquet inflation resulted in sufficient concentrations in calcaneal cancellous bone and subcutaneous adipose tissue throughout the 90-minute tourniquet application. Furthermore, tourniquet-induced tissue ischemia fully resolved 2.5 hours after tourniquet release. Cefuroxime administration 15 to 45 minutes prior to tourniquet inflation seems to be a safe window. If the goal is to maintain postoperative cefuroxime concentrations above relevant MIC values, our results suggest that a second dose of cefuroxime should be administered at the time of tourniquet release.

Prediction of failure in cancellous bone using extended finite element method.

The objective of our study is to develop extended finite element method models of cancellous bone specimens that are capable of accurately predicting the onset and propagation of cracks under mechanical loading. In order to do so, previously published three-point bending test results of a single trabecula were replicated using two different extended finite element method approaches, namely, elastic-plastic-fracture and elastic-fracture that considered different configurations of the elasto-plastic properties of bone from which the best approach to fit the experimental data was identified. The behavior of a single trabecula was then used in 2D extended finite element method models to quantify the strength of the trabecular tissue of the forearm along three perpendicular anatomical axes. The results revealed that the elastic-plastic-fracture model better represented the experimental data in the model of a single trabecula. Considering the 2D trabecular specimens, the elastic fracture model predicted higher strength than the elastic-plastic-fracture model and there was no difference in stiffness between the two models. In general, the specimens exhibited higher failure strain and more ductile behavior in compression than in tension. In addition, strength and stiffness were found to be higher in tension than compression on average. It can be concluded that with proper parameters, extended finite element method is capable of simulating the ductile behavior of cancellous bone. The models are able to quantify the tensile strength of trabecular tissue in the various anatomical directions reporting an increased strength in the longitudinal direction of forearm cancellous bone tissue. Extended finite element method of cancellous bone proves to be a valuable tool to predict the mechanical characteristics of cancellous bones as a function of the microstructure.