Degree Of Bone Mineralization Research Articles

The Coexistence of Carotico-Clinoid Foramen and Interclinoidal Osseous Bridge: An Anatomo-Radiological Study With Surgical Implications.

The coexistence of complete carotico-clinoid bridge (CCB), an ossification between the anterior (ACP) and the middle clinoid (MCP), and an interclinoidal osseous bridge (ICB), between the ACP and the posterior clinoid (PCP), represents an uncommonly reported anatomic variant. If not adequately recognized, osseous bridges may complicate open or endoscopic surgery, along with the pneumatization of the ACP, especially when performing anterior or middle clinoidectomies. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guidelines, a systematic scoping review was conducted up to June 5, 2023. PubMed, Scopus, Web of Science databases, and additional citations were searched. Two hundred high-resolution noncontrast computed tomography (CT) scans (400 sides) and 41 dry skulls (82 sides) were analyzed to identify the different morphology of sellar bridges, focusing on the coexistence of complete CCF and ICB. Two embalmed latex-injected heads with coexisting CCF and ICB were dissected step-by-step to show the anatomic relationship with the surrounding structures from an endoscopic and microscopic perspective. A total of 19 articles were included. The review identified a complete CCF and ICB rate ranging from 4.92% to 6.3%. The analysis of 200 CT scans revealed a rate of coexistence in 4% of the cases, all encountered in White women. Two different types of interclinoid bridges were identified based on the degree of bone mineralization. Both endoscopic and macroscopic step-by-step dissections highlighted variability in morphology and consistency of the sellar bridges and the close relationship with the cavernous sinus neurovascular structures. The coexistence of CCF and ICB is an anatomic variation found in 4% of cases. Preoperative knowledge of the degree of mineralization and its relationship with surrounding structures is essential to performing safe surgery and minimizing cranial nerve and vascular injuries. Preoperative high-resolution CT scans can adequately identify these anatomic variations.

Scanning electron microscopy and energy-dispersive X-ray spectroscopy on the degree of bone mineralization at the bone-implant interface

Background. The purpose of this research was to evaluate the degree of mineralization as well of the chemical composition at the interface of failed dental implants with surrounding bone. Material and methods. The analysis was performed on human histological samples by the aid of a scanning electron microscope and an energy-dispersive x-ray spectroscopy (ESEM-EDX). Results. The middle and the apical region of the implant surfaces had higher quantity of bone tissue deposition. A higher degree of mineralization was observed in these two regions as well. Conclusion. From the analysis performed by the aid of scanning electron microscopy, it appears that the bone tissue deposition is better represented in the middle and apical region of the implants.

Collagen10a1 GEN EXPRESSION AND BONE MINERALIZATION IN THE col10a1:nlGFP TRANSGENTIC MEDAKA FISH LARVAE

Objective: To assess the expression level of the osteoblast-specific collagen10a1 gene and the degree of bone mineralization during the early larval stages of col10a1:nlGFP transgenic medaka fish to identify a specific developmental time window suitable for conducting bone anabolic effect evaluations of bioactive substances. Methods: Homozygous and hemizygous col10a1:nlGFP fish larval groups at 7, 9, 10, 11, and 14 days post fertilization (dpf) were used in the study (n=…/group). The fish were subjected to live staining with alizarin red S (ARS) dye to visualize their mineralized bone structures. Fluorescent images were captured using a fluorescent stereoscope to document both the GFP and ARS signals in the fish. The density of the GFP signal was utilized to assess the expression level of the collagen10a1 gene in osteoblasts, while the density of the ARS signal was used to evaluate the extent of bone mineralization. ImageJ software was employed for this analysis. Results: The intensity of GFP signal exhibited an upward trend as the fish grew from 7 to 9 dpf, followed by a gradual decline from 9 to 14 dpf. Along with that, the intensity of ARS signal increased as the fish grew from 7 to 10 dpf, followed by a gradual decrease from 10 to 14 dpf. These findings indicate that the optimal developmental window for conducting tests on the fish with bioactive compounds, utilizing a stereo fluorescence microscope, is between 7 and 9 dpf.

Tensile Mechanical Properties of Dry Cortical Bone Extracellular Matrix: A Comparison Among Two Osteogenesis Imperfecta and One Healthy Control Iliac Crest Biopsies.

Osteogenesis imperfecta (OI) is a genetic, collagen-related bone disease that increases the incidence of bone fractures. Still, the origin of this brittle mechanical behavior remains unclear. The extracellular matrix (ECM) of OI bone exhibits a higher degree of bone mineralization (DBM), whereas compressive mechanical properties at the ECM level do not appear to be inferior to healthy bone. However, it is unknown if collagen defects alter ECM tensile properties. This study aims to quantify the tensile properties of healthy and OI bone ECM. In three transiliac biopsies (healthy n = 1, OI type I n = 1, OI type III n = 1), 23 microtensile specimens (gauge dimensions 10 × 5 × 2 μm3) were manufactured and loaded quasi-statically under tension in vacuum condition. The resulting loading modulus and ultimate strength were extracted. Interestingly, tensile properties in OI bone ECM were not inferior compared to controls. All specimens revealed a brittle failure behavior. Fracture surfaces were graded according to their mineralized collagen fibers (MCF) orientation into axial, mixed, and transversal fracture surface types (FST). Furthermore, tissue mineral density (TMD) of the biopsy cortices was extracted from micro-computed tomogra[hy (μCT) images. Both FST and TMD are significant factors to predict loading modulus and ultimate strength with an adjusted R 2 of 0.556 (p = 2.65e-05) and 0.46 (p = 2.2e-04), respectively. The influence of MCF orientation and DBM on the mechanical properties of the neighboring ECM was further verified with quantitative polarized Raman spectroscopy (qPRS) and site-matched nanoindentation. MCF orientation and DBM were extracted from the qPRS spectrum, and a second mechanical model was developed to predict the indentation modulus with MCF orientation and DBM (R 2 = 67.4%, p = 7.73e-07). The tensile mechanical properties of the cortical bone ECM of two OI iliac crest biopsies are not lower than the one from a healthy and are primarily dependent on MCF orientation and DBM. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

The Brown Algae Ishige sinicola Extract Ameliorates Ovariectomy-Induced Bone Loss in Rats and Suppresses Osteoclastogenesis through Downregulation of NFATc1/c-Fos.

Osteoporosis is characterized by reduction in bone mass and microarchitectural deterioration of the bone, which causes bone fragility and fracture susceptibility. Ishige sinicola, a brown alga, reportedly affects osteoblast differentiation. However, its protective effect on estrogen deficiency-induced bone loss has not been elucidated. This study aimed to investigate the effect of I. sinicola extract (ISE) on ovariectomy (OVX)-induced bone loss in vivo and osteoclastogenesis in vitro. Female Sprague-Dawley rats were randomly assigned to the sham-operated (SHAM) group and four OVX subgroups: SHAM, OVX, ISE20 (20 mg/kg), ISE200 (200 mg/kg), and estradiol (10 μg/kg). After 6 weeks of treatment, the bone mineral density (BMD), femur indices, and serum biomarker levels were measured. Furthermore, the effects of ISE on osteoclastogenesis and the expression of osteoclast-specific markers were measured. ISE administration improved the trabecular bone structure, bone biomechanical properties, BMD, and bone mineralization degree. In addition, the levels of serum bone turnover markers were decreased in the ISE group compared with those in the OVX group. Moreover, ISE inhibited osteoclast formation by downregulating NFATc1, TRAP, c-Src, c-Fos, and cathepsin K without any cytotoxic effects on RANKL-induced osteoclast formation. Therefore, we suggest that ISE has therapeutic potential in postmenopausal osteoporosis.

Duration-Dependent Increase of Human Bone Matrix Mineralization in Long-Term Bisphosphonate Users with Atypical Femur Fracture.

Bisphosphonates (BPs) are the most widely used drugs for the treatment of osteoporosis but prolonged use of BPs might increase the risk of atypical femur fracture (AFF). There are only a few studies that address the bone material quality in patients on long-term BP treatment with or without AFFs. We analyzed 52 trans-iliac bone biopsies from patients on long-term BP therapy with (n=26) and without (n=26) AFF. At the microscopic level, the degree of mineralization of bone (DMB) was assessed on whole bone by X-ray digitized microradiography while microhardness by Vickers microindentation, and bone matrix characteristics by Fourier transform infrared microspectroscopy (FTIRM) (mineral/organic ratio, mineral maturity and crystallinity, and collagen maturity) were measured at random focal areas. The AFF patients were treated longer than non-AFF patients (9.7 ± 3.3 years versus 7.9 ± 2.7 years). As expected, bone remodeling was low in both groups, without difference between them. The AFF group had significantly higher DMB in cortical bone (+2.9%, p=.001), which remained so after adjusting for treatment duration (p=.007), and showed a trend in cancellous bone (+1.6%, p=.05). Consistent with higher DMB, heterogeneity index (HI) was lower in the AFF than in the non-AFF group, illustrating lower heterogeneity of mineralization in the AFF group. A significant positive correlation between the duration of treatment and DMB in cortical bone was found in AFF, and not in the non-AFF group. Microhardness and bone matrix characteristics were similar between groups. We conclude that the AFF group had a duration-dependent increase in DMB leading to a significantly higher DMB than the non-AFF. Because BPs have high affinity to bone mineral and lining the walls of the osteocyte lacunae, the accumulation of matrix-bound BPs in AFF could lead to inhibition of the osteocyte cytoskeleton blunting their response to mechanical strains, a hypothesis to be further investigated. © 2021 American Society for Bone and Mineral Research (ASBMR).

Anisotropic elastic properties of human cortical bone tissue inferred from inverse homogenization and resonant ultrasound spectroscopy

Bone extravascular matrix (EVM) elasticity at several tens micrometer scale plays a key role in the mechanical behavior of bone at different length scales with implications on bone biology through mechanotransduction. The elastic properties of cortical bone EVM have been evaluated by several experimental methods, including nanoindentation, scanning acoustic microscopy (SAM) and mechanical testing on µm sized bone specimens. Nevertheless, these methods hardly give access to elastic anisotropy. In this work, we propose a novel inverse homogenization method to evaluate the anisotropic elastic properties of cortical bone EVM based on the transverse isotropic elastic tensor of millimeter-sized bone specimens measured by using resonant ultrasound spectroscopy and Fast Fourier Transform homogenization method. With the inverse homogenization method, the anisotropic EVM stiffness constants were evaluated on 50 human femoral cortical bone specimens from an elderly group. To our knowledge, this is the first time that the whole set of the EVM stiffness tensor is evaluated on the same specimen and on a large number of samples. Further comparison with the results from SAM and the degree of mineralization of bone (DMB) showed the potential of this method. Empirical laws between DMB and EVM anisotropic stiffness constants were also provided for the first time. With the anisotropic elasticity evaluated by the proposed method, more accurate models can be developed to better understand bone mechanics and biology, such as mechanotransduction.

The Effect of Parathyroid Hormone Analogues When Added to Mineralized Bone Xenografts.

Implants can be a treatment option when there is sufficient quantity and quality of bone to provide support for long-term success. In the reconstruction of defects, autogenous bone remains the gold standard for its osteogenic and compatibility properties. However, the disadvantage of secondary surgery and the associated donor site morbidity prompts researchers to develop the ideal bone substitute for optimum bone reconstruction. Parathyroid hormone (PTH1-34) has provided a new option for improvement in bone regeneration. This study used a pig model to evaluate the effectiveness of parathyroid hormone when added to a xenograft, Bio-Oss, in reconstructing mandible defects. Six domestic pigs were used to create 3 posterior mandibular defects measuring 2 × 1-cm bilaterally with a total of 36 defects to simulate tooth extraction sites in humans. The defects were grafted in random order and divided into 3 groups as follows: control (no graft), Bio-Oss without PTH, and Bio-Oss with PTH. Defects were assessed with cone beam computerized tomography (CBCT), micro computerized tomography (microCT), nanoindentation, and histology. Results showed that adding PTH1-34 significantly enhanced the graft construct. CBCT showed a significant increase in the degree of bone mineralization. Nanoindentation showed increased hardness of regenerated bone and accelerated bone mineralization with PTH. MicroCT analysis revealed a trend toward higher bone regeneration and mineralization. The histological analysis showed a positive trend of the increase in cortical bone thickness and mineral apposition rate. In conclusion, the local addition of PTH1-34 to a xenograft has shown promising results to enhance bone regeneration in the reconstruction of mandibular defects.

Condition of tiny dogs’ homeostasis diagnosed having “spuria polyodontia”

Nowadays special attention must be paid to pathology associated with the violation of the change of milk teeth to permanent of dogs of dwarf breeds. This fact is confirmed by the results of a statistical analysis of appeals from dog owners to specialized dental care at the “Veterinary Hospital”: 33 % of the animals were diagnosed with “false polyodontics” a general increase in the number of teeth due to non-temporal loss. In the literature, it is noted that the hormones of the thyroid and parathyroid glands, sex hormones regulate the exchange of calcium and phosphorus in the blood, thereby affecting the speed of tooth changes and the degree of bone mineralization. As a result of the research, the authors determined the features of hormonal and mineral homeostasis of the body during the period of teeth change in dogs of dwarf breeds at the age of 6 months in the blood serum, characterized by the thyroid gland profile, sex hormones – at the lower reference values, increased phosphorus and calcium levels.

Compositional and mechanical properties of growing cortical bone tissue: a study of the human fibula

Human cortical bone contains two types of tissue: osteonal and interstitial tissue. Growing bone is not well-known in terms of its intrinsic material properties. To date, distinctions between the mechanical properties of osteonal and interstitial regions have not been investigated in juvenile bone and compared to adult bone in a combined dataset. In this work, cortical bone samples obtained from fibulae of 13 juveniles patients (4 to 18 years old) during corrective surgery and from 17 adult donors (50 to 95 years old) were analyzed. Microindentation was used to assess the mechanical properties of the extracellular matrix, quantitative microradiography was used to measure the degree of bone mineralization (DMB), and Fourier transform infrared microspectroscopy was used to evaluate the physicochemical modifications of bone composition (organic versus mineral matrix). Juvenile and adult osteonal and interstitial regions were analyzed for DMB, crystallinity, mineral to organic matrix ratio, mineral maturity, collagen maturity, carbonation, indentation modulus, indicators of yield strain and tissue ductility using a mixed model. We found that the intrinsic properties of the juvenile bone were not all inferior to those of the adult bone. Mechanical properties were also differently explained in juvenile and adult groups. The study shows that different intrinsic properties should be used in case of juvenile bone investigation.

The study of the stress-strain state of the dental ceramic implants depending on their shape and bone mineralization degree

The article deals with the models of dental implants of cylindrical, conical, cylindrical reverse-conical and conical reverse-conical shape, installed in the central part of the maxilla. The maxilla model is made in accordance with the sizes of the three-dimensional tomographic image of the patient's maxilla. The stress-strain state of the cortical and cancellous bones, depending on the shape of the implant, as well as the degree of bone mineralization is investigated. The isotropic model of bone material at normal and critical degree of bone mineralization, which depends on the patient's age, is considered. According to the results of the study, the use of the reverse-conical shape of implants significantly reduces stress not only in the cancellous bone, but also in the cortical bone, as well as in the implant during critical bone mineralization.

Functional Calcium Binding Peptides from Pacific Cod (Gadus macrocephalus) Bone: Calcium Bioavailability Enhancing Activity and Anti-Osteoporosis Effects in the Ovariectomy-Induced Osteoporosis Rat Model.

Calcium binding peptides from Pacific cod (Gadus macrocephalus) bone have attracted attention due to their potential effects on bone health. In this study, calcium binding peptides (CBP) were prepared from Pacific cod bone by trypsin and neutral protease. Ultraviolet spectra, circular dichroism (CD), and Fourier transform infrared spectroscopy (FTIR) revealed that carboxyl and amino groups in CBP could bind to Ca2+, and form the peptide-calcium complex (CBP-Ca). Single-pass intestinal perfusion (SPIP) experiments indicated that the intestinal calcium absorption was significantly enhanced (p < 0.01) in CBP-Ca treated Wistar rats. The anti-osteoporosis activity of CBP-Ca was investigated in the ovariectomized (OVX) Wistar rat model. The administration of CBP-Ca significantly (p < 0.01) improved the calcium bioavailability, trabecular bone structure, bone biomechanical properties, bone mineral density, and bone mineralization degree. CBP-Ca notably (p < 0.01) increased serum calcium, however, it remarkably (p < 0.01) reduced the levels of osteocalcin (OCN), bone alkaline phosphatase (BALP), tartrate-resistant acid phosphatase isoform 5b (TRAP5b), and C-telopeptide of type I collagen (CTX-1) in serum. Results suggested that the cod bone derived CBP could bind with calcium, improve the intestinal calcium absorption, calcium bioavailability, and serum calcium, then reduce the bone turnover rate, and thus ameliorate osteoporosis.

Impaired rib bone mass and quality in end-stage cystic fibrosis patients

BackgroundAdvancements in research and clinical care have considerably extended the life expectancy of cystic fibrosis (CF) patients. However, with this extended survival come comorbidities. One of the leading co-morbidities is CF-related bone disease (CFBD), which progresses with disease severity and places patients at high risk for fractures, particularly of the ribs and vertebrae. Evidence that CF patients with vertebral fractures had higher bone mineral density (BMD) than the nonfracture group led us to postulate that bone quality is impaired in these patients. We therefore examined rib specimens resected at the time of lung transplant in CF patients to measure parameters of bone quantity and quality. MethodsIn this exploratory study, we analysed 19 end-stage CF and 13 control rib specimens resected from otherwise healthy lung donors. BMD, bone microarchitecture, static parameters of bone formation and resorption and microcrack density of rib specimens were quantified by imaging, histomorphometric and histological methods. Variables reflecting the mineralization of ribs were assessed by digitized microradiography. The degree of bone mineralization (g/cm3) and the heterogeneity index of the mineralization (g/cm3) were calculated for trabecular and cortical bone. ResultsCompared to controls, CF ribs exhibited lower areal and trabecular volumetric BMD, decreased trabecular thickness and osteoid parameters, and increased microcrack density, that was particularly pronounced in specimens from patients with CF-related diabetes. Static parameters of bone resorption were similar in both groups. Degree of mineralization of total bone, but not heterogeneity index, was increased in CF specimens.Conclusion: The combination of reduced bone mass, altered microarchitecture, imbalanced bone remodeling (maintained bone resorption but decreased formation), increased microdamage and a small increase of the degree of mineralization, may lead to decreased bone strength, which, when coupled with chronic coughing and chest physical therapy, may provide an explanation for the increased incidence of rib fractures previously reported in this population.

Mandibular bone mineral density variation in three West African Cercopithecoid monkey species: Associations with diet and feeding behavior

ObjectiveProcolobus badius, Colobus polykomos, and Cercocebus atys are three West African primate species known to have distinctive feeding behaviors. Our objectives were (1) to test whether intra-taxon variation in bone mineral content exists between anterior and posterior regions of the mandible and (2) to determine if interspecific differences are interpretable via feeding and dietary idiosyncracies among the three taxa. DesignTwenty-one mandibles from naturally deceased C. polykomos (n=7), P. badius (n=9), and C. atys (n=5) were scanned using cone beam computerized tomography. Alveolar bone (AB) and basal cortical bone (CB) of incisor (I1) and second molar (M2) regions were digitally isolated. Degree of bone mineralization (DBM) distribution was obtained using histograms of CT attenuation values. Mean, standard deviation (SD), the 5th (Low5) and the 95th (High5) percentiles of the DBM histogram were compared between the jaw regions in species. ResultsThe mean and Low5 of DBM were significantly lower for AB than CB of all species (p<0.001). The AB DBM parameters were not significantly different between I1 and M2 of all species (p>0.056) except the mean of C. polykomos (p<0.05). The mean, SD, High5 of CB DBM at M2 of C. atys was significantly higher than those of C. polykomos and P. badius (p<0.006). ConclusionsThe durophagous C. atys had higher CB DBM value at the M2 region than C. polykomos and P. badius, which supports the hypothesis that materially stiffer mandibular bone in C. atys can develop in response to the generation of high bite forces during hard object feeding.

Nonenzymatic Glycation and Degree of Mineralization Are Higher in Bone From Fractured Patients With Type 1 Diabetes Mellitus.

Low-energy fractures are frequent complications in type 1 diabetes mellitus patients (T1DM). Modifications of bone intrinsic composition might be a potential cause of fragility observed in diabetic subjects. Advanced glycation end products (AGEs) were found in numerous connective tissues from T1DM patients. However, whether AGEs are present at high levels in bone matrix from diabetic subjects is unknown. Moreover, whether elevated AGEs in the bone matrix impair mineralization has not been addressed in humans. The purposes of this study were 1) to determine whether bone matrix from fracturing and nonfracturing T1DM contained more AGEs than bone from healthy patients (CTL), and 2) to compare the degree of mineralization of bone and hardness between fracturing and nonfracturing T1DM versus CTL. We analyzed iliac crest bone biopsies from 5 fracturing T1DM patients, 5 nonfracturing T1DM patients, and 5 healthy subjects, all age- and sex-matched. AGEs (pentosidine) in bone matrix was measured by high-performance liquid chromatography separately in trabecular and cortical bone. The degree of mineralization of bone (DMB) was assessed by digitized microradiography, and mechanical properties by micro- and nanohardness tests. Trabecular bone from fracturing T1DM exhibited significantly higher levels of pentosidine than CTL (p = 0.04) and was more mineralized than nonfracturing T1DM (p = 0.04) and CTL (p = 0.04). Trabecular bone was not significantly different in pentosidine between nonfracturing T1DM and CTL. Cortical bone from nonfracturing T1DM was not significantly different from CTL. Positive correlations were found between HbA1c and pentosidine (r' = 0.79, p < 0.003) and between HbA1c and DMB (r' = 0.64, p < 0.02). Both modifications could lead to less flexible bone (reduced modulus of elasticity) and a tendency toward low-energy fractures in T1DM patients.

Cortical Bone Mineralization in the Human Femoral Neck in Cases and Controls from Synchrotron Radiation Study.

To compare the degree and distribution of mineralization in femoral neck cortex from 23 women with hip fractures (age 65-96years) and 17 female controls (age 72-103years), we obtained 3D data by synchrotron radiation microtomography (SRμCT). Variables were degree of mineralization of bone (DMB) in total cortex (cDMBSRMEAN), osteons (oDMBSRMEAN), and pure interstitial tissue (intDMBSRMEAN). The cortex on SRμCT images was divided into nine to twelve 50-μm zones from the periosteum to the endosteum; cDMBSRMEAN, oDMBSRMEAN, and intDMBSRMEAN were measured in each zone. We used descriptive statistics and t tests, general linear model analyses to compare DMBSR values across zones and individuals, one-way analysis of variance for within-group comparisons of zones. In patients, the variance of mineral content value was not different than in controls, but mean values of degree of mineralization varied across zones. These cross-sectional data suggest that bone fragility may be related to a greater heterogeneity of the distribution of mineralization in femoral neck cortex.

Cortical measurements of the tibia from high resolution peripheral quantitative computed tomography images: A comparison with synchrotron radiation micro-computed tomography

High resolution-peripheral quantitative computed tomography (HR-pQCT) measurements are carried out in clinical research protocols to analyze cortical bone. Micro-computed tomography (micro-CT) is a standard tool for ex vivo examination of bone in 3D. The aim of this work was to evaluate cortical measurements derived from HR-pQCT images compared to those from synchrotron radiation (SR) micro-CT in a distal position (4.2cm from the distal pilon).Twenty-nine tibia specimens were scanned with HR-pQCT using protocols provided by the manufacturer. The standard measured outcomes included volumetric bone density (gHA/cm3) of the cortical region (Dcomp), and the cortical thickness (Ct.Th, mm). New features, such as cortical porosity (Ct.Po) and mean pore diameter (Ct.Po.Dm), were measured by an auto-contouring process. All tibias were harvested from the posterior region and imaged with SR micro-CT (voxel size=7.5μm). The cortical thickness, (Ct.Thmicro-CT), porosity (PoV/TV), pore diameter, pore spacing, pore number, and degree of mineralization of bone (DMB) were obtained for SR micro-CT images. For standard measurements on HR-pQCT images, site matched analyses with micro-CT were completed to obtain Dcomplocal and Ct.Thlocal.Dcomp was highly correlated to PoV/TV (r=−0.84,p<10−4) but not to DMB. Dcomplocal was correlated to PoV/TV (r=−0.72, p<10−4) and to DMB (r=0.40, p>0.05). Ct.Thlocal and Ct.Thmicro-CT were moderately correlated (r=0.53,p<0.01). Ct.Th and Ct.Po results from the autocontouring process are influenced by the level of trabecularization of the cortical bone and need manual correction of the endosteal contour.Distal tibia is a reliable region to study cortical bone with Dcomp as the best parameter because it reflects both the micro-porosity (Havers canals) and macro-porosity (resorption lacunae) of the cortical bone.

A histomorphometric and micro–computed tomography study of bone regeneration in the maxillary sinus comparing biphasic calcium phosphate and deproteinized cancellous bovine bone in a human split-mouth model

The gain of mineralized bone was compared between deproteinized bovine bone allograft (DBA) and biphasic calcium phosphate (BCP) for dental implant placement. Five patients with atrophic maxillae underwent bilateral sinus elevation with DBA (Bio-Oss) and BCP (Straumann BoneCeramic). After 3 to 8 months, 32 Camlog implants were placed, and biopsies were retrieved. Bone and graft volume, degree of bone mineralization, and graft degradation gradient were determined using micro-computed tomography, and bone formation and resorption parameters were measured using histomorphometry. Implant functioning and peri-implant mucosa were evaluated up to 4 years. Patients were prosthetically successfully restored. All but one of the implants survived, and peri-implant mucosa showed healthy appearance and stability. Bone volume, graft volume, degree of bone mineralization, and osteoclast and osteocyte numbers were similar, but BCP-grafted biopsies had relatively more osteoid than DBA-grafted biopsies. The BCP and DBA materials showed similar osteoconductive patterns and mineralized bone, although signs of more active bone formation and remodeling were observed in BCP- than in DBA-grafted biopsies.

Bone Quality: The Determinants of Bone Strength and Fragility

Bone fragility is a major health concern, as the increased risk of bone fractures has devastating outcomes in terms of mortality, decreased autonomy, and healthcare costs. Efforts made to address this problem have considerably increased our knowledge about the mechanisms that regulate bone formation and resorption. In particular, we now have a much better understanding of the cellular events that are triggered when bones are mechanically stimulated and how these events can lead to improvements in bone mass. Despite these findings at the molecular level, most exercise intervention studies reveal either no effects or only minor benefits of exercise programs in improving bone mineral density (BMD) in osteoporotic patients. Nevertheless, and despite that BMD is the gold standard for diagnosing osteoporosis, this measure is only able to provide insights regarding the quantity of bone tissue. In this article, we review the complex structure of bone tissue and highlight the concept that its mechanical strength stems from the interaction of several different features. We revisited the available data showing that bone mineralization degree, hydroxyapatite crystal size and heterogeneity, collagen properties, osteocyte density, trabecular and cortical microarchitecture, as well as whole bone geometry, are determinants of bone strength and that each one of these properties may independently contribute to the increased or decreased risk of fracture, even without meaningful changes in aBMD. Based on these findings, we emphasize that while osteoporosis (almost) always causes bone fragility, bone fragility is not always caused just by osteoporosis, as other important variables also play a major role in this etiology. Furthermore, the results of several studies showing compelling data that physical exercise has the potential to improve bone quality and to decrease fracture risk by influencing each one of these determinants are also reviewed. These findings have meaningful clinical repercussions as they emphasize the fact that, even without leading to improvements in BMD, exercise interventions in patients with osteoporosis may be beneficial by improving other determinants of bone strength.

English

Abstract Introduction Piezoelectric device or piezosurgery device was originally developed for the atraumatic cutting of bone by way of ultrasonic vibrations and as an alternative to the mechanical and electrical instruments that are used in conventional oral surgery. Over the past two decades, an increasing amount of literature has shown that piezoelectric devices are innovative tools and that there is extensive indication of their use in dental implantology and oral and maxillofacial surgery. Recent publications have also shown the benefits of their use in craniofacial surgery, plastic and reconstructive surgery, head and neck surgery, neurosurgery, ophthalmology, traumatology, and orthopaedics. Key features of piezosurgery include the selective cutting of bone without damaging the adjacent soft tissue (e.g. vessels, nerves or mucosa), providing a clear visibility in the operating field, and cutting with micron sensitivity without the generation of heat. The cutting characteristics of piezosurgery are mainly depending upon the degree of bone mineralization, the design of the insert being used, the pressure being applied on the handpiece and the speed of movement during usage. Therefore, a novice user must know these factors and adapt their operating technique in order to utilize the advantages of piezosurgery. This critical review summarizes the basic operating principles of piezoelectric devices and outlines the application areas in oral and maxillofacial surgery that piezosurgery can be utilized supported by clinical examples. Conclusion Piezosurgery can create clear vision of the surgical area from pressurized irrigation and cavitation effect. Disadvantages can include large initial costs. The number of studies covering this topic is insufficient; thus, further research needs to be conducted to enable us to learn more and clarify any misconceptions.