Biomedical subjects

J L Cunningham

Publications and source records attributed to J L Cunningham.

At least 19 recordsLinked to original sources

PubMed2006

An in vitro study of ultrasound signal loss across simple fractures in cortical bone mimics and bovine cortical bone samples.

Measurements have been performed on Sawbones and bovine cortical bone samples at 200 kHz using an axial transmission technique to investigate the factors that determine how ultrasonic waves propagate across a simulated fracture. The peak amplitude of the first arrival signal (FAS) was studied. Results taken from intact specimens were compared with those produced when a simple transverse fracture was introduced. These fracture simulation experiments were found to be consistent with Finite Difference modelling of the experimental conditions. The peak amplitude showed a characteristic variation across the fracture caused by interference between reradiated and scattered/diffracted waves at the fracture site and a net Fracture Transmission Loss (FTL). For small fracture gaps, the change in amplitude was sensitive to the presence of the fracture. This sensitivity suggests that this parameter could be a good quantitative indicator for the fracture healing process assuming the relative change in this parameter brought about by healing is measurable.

Animals↗

PubMed2006

Ultrasonic propagation in cortical bone mimics.

Understanding the velocity and attenuation characteristics of ultrasonic waves in cortical bone and bone mimics is important for studies of osteoporosis and fractures. Three complementary approaches have been used to help understand the ultrasound propagation in cortical bone and bone mimics immersed in water, which is used to simulate the surrounding tissue in vivo. The approaches used were Lamb wave propagation analysis, experimental measurement and two-dimensional (2D) finite difference modelling. First, the water loading effects on the free plate Lamb modes in acrylic and human cortical bone plates were examined. This theoretical study revealed that both the S0 and S1 mode velocity curves are significantly changed in acrylic: mode jumping occurs between the S0 and S1 dispersion curves. However, in human cortical bone plates, only the S1 mode curve is significantly altered by water loading, with the S0 mode exhibiting a small deviation from the unloaded curve. The Lamb wave theory predictions for velocity and attenuation were then tested experimentally on acrylic plates using an axial transmission technique. Finally, 2D finite difference numerical simulations of the experimental measurements were performed. The predictions from Lamb wave theory do not correspond to the measured and simulated first arrival signal (FAS) velocity and attenuation results for acrylic and human cortical bone plates obtained using the axial transmission technique, except in very thin plates.

Acrylates↗

PubMed2006

A novel approach to bite force measurements in a porcine model in vivo.

A novel device for a bite force measurement system in a porcine model is described. A single polyethylene layer was vacuum-formed into a splint, and a force sensor was fitted on to the splint occlusal surface and seated with a silicone layer. This design enabled the measurement of bite forces on selected teeth in a large animal model with either natural dentition or single implant crowns and could be used in assessing information on biomechanical adaptation of the bone-implant interface to masticatory loads. Preliminary recordings of force values obtained during mastication in the premolar region (200-560 N) and various limiting factors of the technical design are discussed.

Animals↗

PubMed2006

Shear bond strength and residual adhesive after orthodontic bracket debonding.

OBJECTIVE: To compare the shear bond strength and determine the area of residual adhesive on teeth after the debonding of brackets bonded with two types of orthodontic adhesives. These were a resin-modified glass ionomer cement (RMGIC; Fuji ORTHO LC, GC Corporation, Tokyo, Japan) and a resin applied as a precoated bracket (APC bracket, 3M Unitek GmbH, Seefeld, Germany). MATERIALS AND METHODS: A total of 60 premolar teeth were randomly divided into two groups, and brackets were bonded according to the manufacturers' instructions. In group 1, the teeth were conditioned using 10% polyacrylic acid, and the brackets were bonded using Fuji Ortho LC in wet condition. In group 2, the teeth were etched using 37% phosphoric acid, and the APC brackets were bonded. Bond strength was measured using a testing instrument (2000S, Lloyds Instruments, Fareham, England) at a crosshead speed of 1 mm/min, and the residual adhesive was quantified using a three-dimensional laser scanning instrument. RESULTS: The Mann-Whitney test showed that the median bond strength of group 1 was significantly lower than that of group 2 (P < .001). A Pearson chi-square test of the Adhesive Remnant Index (ARI) revealed a significant difference among the groups tested. All the adhesives in group 1 failed at the enamel/adhesive interface (100%), whereas group 2 exhibited cohesive failure of the adhesive (90%). CONCLUSIONS: The bond strength values obtained with the RMGIC were above the minimum values suggested in the literature to achieve a clinically effective adhesion in orthodontics.

Acid Etching, Dental↗

PubMed2005

The compatibility of ceramic bone graft substitutes as allograft extenders for use in impaction grafting of the femur.

This study investigates the use of porous biphasic ceramics as graft extenders in impaction grafting of the femur during revision hip surgery. Impaction grafting of the femur was performed in four groups of sheep. Group one received pure allograft, group two 50% allograft and 50% BoneSave, group three 50% allograft and 50% BoneSave type 2 and group four 10% allograft and 90% BoneSave as the graft material. Function was assessed using an index of pre- and post-operative peak vertical ground reaction force ratios. Changes in bone mineral density were measured by dual energy X ray absorptiometry (DEXA) scanning. Loosening and subsidence were assessed radiographically and by histological examination of the explanted specimens. There was no statistically significant difference between the four groups after 18 months of unrestricted functional loading for all outcome measures.

Absorptiometry, Photon↗

PubMed2003

Glass ionomer as an expander of allograft in revision arthroplasty of the hip.

The use of glass ionomer as a bone graft expander was investigated in an in vivo model of revision hip arthroplasty. Bone grafts of pure allograft and allograft + glass ionomer particles in a 50:50 by weight mixture were implanted in an ovine hemi-arthroplasty model. Post-operative assessments of locomotor function, radiographic appearance and quantitative changes in mineralisation around the graft were made at 2, 4 and 6 months. Post-mortem assessments of radiographic and histologic appearance of the grafts were made at 6 months. No significant differences were noted in any of the measured or assessed parameters between the two graft types. The glass ionomer particles seemed to be well tolerated within the matrix of new bone, smaller sized particles appearing to be better incorporated than larger ones. The use of particles of glass ionomer as a bone graft expander, in this in vivo model of revision hip arthroplasty, would therefore appear to offer no detriment in performance over pure allograft in the short to medium term.

Acrylic Resins↗

PubMed2002

Subsidence in impaction grafting: the effect of adding a ceramic bone graft extender to bone.

The incidence of revision total hip arthroplasty is increasing dramatically and the associated demand for allograft bone is likely to exceed the available supply. In addition, allograft presents potential problems with regard to infection, antigenicity, availability, reproducibility and cost. It is therefore desirable to develop an alternative to allograft. This study investigated BoneSave, a porous tricalcium phosphate-hydroxyapatite ceramic for use in impaction grafting of the femur at revision total hip arthroplasty. The findings of an in vitro mechanical study comparing the initial stability of pure allograft, a volume mixture of 50 per cent allograft and 50 per cent BoneSave, and a volume mixture of 10 per cent allograft and 90 per cent BoneSave are reported. The BoneSave-allograft mixtures exhibit both much greater mechanical stability and reproducibility than the pure allograft (p < 0.05) at all tested loads (200-800 N). At high peak loads the high volume (90%, v/v) BoneSave mix also provided higher mechanical stability than the medium volume (50 per cent BoneSave-50 per cent allograft) mix (p < 0.05). These results demonstrate thatfrom a mechanical standpoint the tested ceramic provides adequate initial stability to be used as a bone graft extender with allograft in impaction grafting of the femur.

Animals↗

PubMed2001

Accurate diagnosis of hip prosthesis loosening using a vibrational technique.

OBJECTIVE: To examine the potential role of vibration testing as a non-invasive method of diagnosing loosening of total hip replacements in the clinical setting. DESIGN: Single blind cohort study in two hospitals. BACKGROUND: Diagnosing loosening of total hip replacements is heavily dependent on investigative techniques that are unreliable. Previous studies into the use of vibration testing have produced conflicting results. METHODS: Comparison of vibration testing and radiographs in patients with a total hip replacement experiencing hip pain symptomatic of loosening, with patients showing evidence of a secure prosthesis. RESULTS: Vibration testing has a sensitivity of 80% and a specificity of 89%. The positive predictive value was 92% and the negative predictive value was 73%; it was unable to produce a definitive diagnosis in 8% of patients. When compared with radiographs from the same patients, vibration testing was shown to be 20% more sensitive and able to diagnose 13% more patients. CONCLUSIONS: Vibration testing can deliver more accurate information on the stability of total hip replacements than radiographs in the clinical setting, despite being in the early stages of development. Relevance. This study shows that 70 more patients may be provided with the correct diagnosis and 46 fewer patients may be undiagnosed each year, when using vibrometry as opposed to radiographs. In view of the relative disparity between the level of development between the two techniques and the encouraging results hitherto presented, it is felt that by improving vibration testing it may supersede radiographs in the detection of prosthesis loosening.

Adult↗

PubMed2001

A comparison of vertical force and temporal parameters produced by an in-shoe pressure measuring system and a force platform.

OBJECTIVE: To investigate the ability of Pedar in-shoe system to measure vertical force accurately, by comparing it with the Kistler force platform. DESIGN: In vivo experiment in normal subjects. BACKGROUND: It has been suggested Pedar is highly reliable, but absolute accuracy of the system with regard to force measurement has not been comprehensively tested. METHODS: Sampling at 99 Hz, using five healthy subjects, simultaneous data were collected barefoot, and in three types of shoes (Trainers, Oxfords, Slip-on Deck Type). Six variables obtained from the force/time curve from each footstep were compared. RESULTS: The temporal data recorded by Pedar correlated well with that obtained using Kistler, with significant differences only in overall duration of the step in Deck shoes (P < 0.001) and Oxford shoes (P < 0.01), and peak to peak barefoot (P < 0.01). Pedar recorded a lower first peak force and mid-peak force in all cases (P < 0.001). However, the magnitude of the 2nd peak force recorded by both systems was significantly different only in Trainers (P < 0.05) and Oxford shoes (P < 0.001). The impulse data obtained with Oxford shoes was not significantly different, although barefoot, Trainers and Deck shoes were significantly lower (P < 0.001) for Pedar. CONCLUSIONS: In most cases, comparison of data recorded by the two systems provided good evidence for the accuracy and reliability of temporal measurements and second peak force measurements taken with the Pedar in-shoe system. Relevance. In-shoe pressure data provides evidence for clinical decisions if the systems utilised are proven to be valid, repeatable and accurate. Comparison with an established force platform enables some assessment of these factors.

Adult↗

PubMed2001

Surface roughness and wettability of enamel and dentine surfaces prepared with different dental burs.

The aim of dental adhesive restorations is to produce a long lasting union between the restoration and the tooth structure. This bond depends on many variables including the geometry of the preparation and the type of bonding agent or luting cement. It is therefore suggested that the topography of the tooth surface may influence the wettability and the bonding quality of adhesive systems. This study measured the surface roughness and wettability of enamel and dentine after preparation with different dental burs. The mesial and distal surfaces of 15 extracted sound human premolar teeth were prepared with a tungsten carbide crown bur, a diamond bur and a tungsten carbide finishing bur and finished in enamel or dentin, respectively. The prepared surfaces were analysed with a surface profilometer and scanning electron microscopy (SEM). The contact angle of distilled water on each of the prepared surfaces was used as the measure of wettability. The differences in average surface roughness (Ra) were significant between the rotary instrument groups, as revealed by a two-way ANOVA test. No differences were detected between enamel and dentine surfaces prepared with the same type of dental bur. The smoothest surfaces were those completed with tungsten carbide finishing burs. The diamond bur preparations were intermediate in the roughness assessment and the tungsten carbide crown burs gave the roughest surfaces. There were no significant differences in the contact angle measurements for the various groups. It was concluded that the surface roughness of enamel and dentine prepared by different rotary instruments had no significant influence on the wettability of distilled water on these surfaces.

Analysis of Variance↗

PubMed2000

A comparison of vertical force and temporal parameters produced by an in-shoe pressure measuring system and a force platform.

OBJECTIVE: To investigate the ability of Pedar in-shoe system to measure vertical force accurately, by comparing it with the Kistler force platform. DESIGN: In vivo experiment in normal subjects. BACKGROUND: It has been suggested Pedar is highly reliable, but absolute accuracy of the system with regard to force measurement has not been comprehensively tested. METHODS: Sampling at 99 Hz, using five healthy subjects, simultaneous data were collected barefoot, and in three types of shoes (Trainers, Oxfords, Slip-on Deck Type). Six variables obtained from the force/time curve from each footstep were compared. RESULTS: The temporal data recorded by Pedar correlated well with that obtained using Kistler, with significant differences only in overall duration of the step in Deck shoes (P<0. 001) and Oxford shoes (P<0.01), and peak to peak barefoot (P<0.01). Pedar recorded a lower first peak force and mid-peak force in all cases (P<0.001). However, the magnitude of the 2nd peak force recorded by both systems was significantly different only in Trainers (P<0.05) and Oxford shoes (P<0.001). The impulse data obtained with Oxford shoes was not significantly different, although barefoot, Trainers and Deck shoes were significantly lower (P<0.001) for Pedar. CONCLUSIONS: In most cases, comparison of data recorded by the two systems provided good evidence for the accuracy and reliability of temporal measurements and second peak force measurements taken with the Pedar in-shoe system. Relevance In-shoe pressure data provides evidence for clinical decisions if the systems utilised are proven to be valid, repeatable and accurate. Comparison with an established force platform enables some assessment of these factors.

Adult↗

PubMed2000

Fracture stiffness measurement using the orthometer: reproducibility and sources of error.

OBJECTIVES: To elicit the reproducibility and the common sources of error in the use of the Orthometer, a commercially available goniometer based system, designed to measure the stiffness of healing fractures. DESIGN: A laboratory based study. BACKGROUND: The Orthometer is widely used to measure the progress of fracture healing in a quantitative manner. It has been shown previously that the bending stiffness of a fracture increases with healing and that a stiffness of 15 Nm/degree equates with the functional union of a tibial fracture. METHODS: The Orthometer was attached in a standard manner to nylon bars of known stiffness to determine the accuracy of the device. The Orthometer was then set up with changes in a single positional variable to assess the effect of this variable on the measurement accuracy. A number of different clinicians were asked to use the Orthometer before and after a simple training session and any improvements in the measurement accuracy were observed. RESULTS: Stiffness could be measured to within 10% or less of the true stiffness. Markedly different degrees of error were introduced with the various set-up variables. A simple training session improved clinician accuracy. CONCLUSIONS: Although the Orthometer does allow some degree of safety margin, it is essential that set-up is performed carefully, and that the clinician has been trained in the use of the device. RELEVANCE: Quantitative measurements of fracture healing have enormous potential benefits over manual and radiological methods of assessments. Provided these are carefully performed, the accuracy of these measurements is good.

Elasticity↗

PubMed2000

Shear bond strength of resin teeth to heat-cured and light-cured denture base resin.

The failure of the bond between acrylic resin teeth and denture base material remains a considerable problem. Previous research has indicated that the introduction of a bonding agent to the tooth-resin interface significantly increased the tensile bond strength. To further investigate this finding, and to complement the earlier study, a shear strength assessment was carried out. Both a commercial and an experimental bonding agent were evaluated for tooth retention when applied to heat-cured and visible light-cured (VLC) resin. A significant increase in shear bond strength was obtained when bonding agents were applied. The experimental cement gave the greatest increase in strength, although the VLC resin failed to achieve the same degree of tooth attachment as the heat-cured resin.

Acrylic Resins↗

PubMed2000

Transmembrane protein tyrosine phosphatase IA-2 (ICA512) is expressed in human midgut carcinoids but is not detectable in normal enterochromaffin cells.

A potential upregulation of receptor type protein tyrosine phosphatase IA-2 (ICA512) expression was detected by differential display and investigated in midgut carcinoid tumours. Normal intestine tissue and tumour tissue from 13 midgut carcinoid patients were studied by in situ hybridisation using an IA-2 ribonucleotide probe and confocal microscopy using specific IA-2 antibodies. Previously, it had been shown that IA-2 is located in the secretory granules of virtually all neuroendocrine cells. However, we found that IA-2 was not detectable in resting normal enterochromaffin (EC) cells of the small intestine, while high expression of IA-2 mRNA and protein was confirmed in both primary and metastatic carcinoid tissue. This difference in expression was not observed with chromogranin A or serotonin, two secretory granule hormones known to be expressed in EC cells, indicating that IA-2 was seemingly not necessary for the basal production and packaging of these hormones. When comparing patients receiving biotherapy before operation with untreated patients, we found expression of IA-2 to be lower in tumours from patients that had been treated with a combination of alpha-interferon and the somatostatin analogue, octreotide. There was no correlation between IA-2 expression and proliferation rates as measured by immunohistochemistry with antibodies against the Ki 67 antigen. Furthermore, we show that IA-2 is co-localised with serotonin in carcinoid tumours as well as in the pancreatic tumour cell line, BON1, which is interesting as serotonin secretion rate is presumably higher in tumour cells than in resting EC cells. Taken together, these findings may indicate a role for IA-2 in the later stages of the regulated secretory process.

Adult↗

PubMed1999

Axial preload in external fixator half-pins: a preliminary mechanical study of an experimental bone anchorage system.

OBJECTIVE: To demonstrate the effect of axial preload achieved with an experimental external fixator pin prototype on the initial stability of the pin-bone interface. DESIGN: An in vitro mechanical study comparing pin stability of an axially-preloaded experimental pin and a radially-preloaded conventional external fixation pin. BACKGROUND: The most common problem in clinical practice of external fixation is pin site failure. An experimental external fixator half-pin has been designed introducing axial preload as an alternative method of achieving a stable pin-bone interface. METHODS: Standardized measurements of pin insertion and removal torque comparing the experimental pin prototype and a conventional external fixator pin in a synthetic composite material and ovine tibial cortical bone. RESULTS: There is a positive correlation between axial preload and torque resistance of the coaxial experimental half-pin as well as significantly increased torque resistance of the axially-preloaded experimental pin over the conventional pin tested. In addition, significantly lower insertion torque of the experimental pin was observed with the applied insertion technique. CONCLUSIONS: 'Axial preload' achieved with appropriately-designed half pins might represent an effective biology-sparing method of increasing the mechanical stability of the pin-bone interface in unilateral external fixator frames. RELEVANCE: Several aspects of the current external fixator pin design and insertion technique have been implicated for the significant incidence of failure at the pin-bone interface manifested as pin loosening, pin track infection or even osteomyelitis. An axially-preloaded bone fastener system may be mechanically and biologically superior and therefore clinically advantageous.

Animals↗

PubMed1999

Digital image analysis: improving accuracy and reproducibility of radiographic measurement.

OBJECTIVE: To assess the accuracy and reproducibility of a digital image analyser and the human eye, in measuring radiographic dimensions. DESIGN: We experimentally compared radiographic measurement using either an image analyser system or the human eye with digital caliper. BACKGROUND: The assessment of total hip arthroplasty wear from radiographs relies on both the accuracy of radiographic images and the accuracy of radiographic measurement. METHODS: Radiographs were taken of a slip gauge (30+/-0.00036 mm) and slip gauge with a femoral stem. The projected dimensions of the radiographic images were calculated by trigonometry. The radiographic dimensions were then measured by blinded observers using both techniques. RESULTS: For a single radiograph, the human eye was accurate to 0.26 mm and reproducible to +/-0.1 mm. In comparison the digital image analyser system was accurate to 0.01 mm with a reproducibility of +/-0.08 mm. In an arthroplasty model, where the dimensions of an object were corrected for magnification by the known dimensions of a femoral head, the human eye was accurate to 0.19 mm, whereas the image analyser system was accurate to 0.04 mm. CONCLUSIONS: The digital image analysis system is up to 20 times more accurate than the human eye, and in an arthroplasty model the accuracy of measurement increases four-fold. We believe such image analysis may allow more accurate and reproducible measurement of wear from standard follow-up radiographs.

Hip Prosthesis↗

PubMed1999

An investigation of the variables which may affect the bond between plastic teeth and denture base resin.

OBJECTIVES: The failure of the bond between acrylic resin denture base material and resin teeth remains a significant problem. This study evaluated the tensile bond strength of specimens produced by commonly employed tooth preparation and processing methods as used in dental laboratories. METHODS: Twenty-two experimental groups, each consisting of 36 specimens, were investigated by subjecting the tooth-resin bond to tensile loading. The groups were allocated to one of five experimental sets to investigate: (a) effect of resin dough time, (b) effect of tooth surface condition, (c) effect of processing variables, (d) effect of monomer cementing, and (e) effect of acrylic resin cement. The results were analysed statistically using a one factor ANOVA and a Student t test. RESULTS: A significantly stronger bond was obtained when the resin was packed late in the dough stage, and a superior bond, in all cases, when high-impact resin was used. Tooth surface modification by grinding or grooving made no significant difference when compared with unmodified surfaces. Wax-contaminated surfaces produced highly significant weaker bonds. Time of introduction and duration of water-bath processing had no significant effect on bond strength. Monomer cementing of the tooth surface, especially with high-impact monomer. significantly improved the bond strength. The application of resin cements was found to produce the most significant increase in denture tooth bond strength. CONCLUSIONS: The important steps in obtaining a consistently high value denture tooth bond are thorough dewaxing of the tooth surface followed by the application of a suitable resin cement.

Acrylic Resins↗

PubMed1998

"Biological" internal fixation of long bone fractures: a biomechanical study of a "noncontact" plate system.

Based on existing knowledge of noncontact plates, an experimental prototype of a nonperiosteal contact internal fixation implant ("noncontact internal fixator") has been designed. The construct rigidity of osteotomised synthetic composite femora, fixed with the noncontact fixator and a reamed, statically-locked intramedullary nail were compared in axial compression, two plane bending and torsion in four types of diaphyseal fractures. With the exception of axial loading in the presence of extensive comminution, the fixation stability provided by the noncontact fixator is significantly higher than that of the tested intramedullary nail. Any degree of cortical contact between the two main fragments is important for the stability of this nonperiosteal contact fixation system under axial load. Appropriately-designed "internal fixators" could provide not only a number of biological and technical advantages, but also fixation stability comparable and in certain aspects superior to that of other fixation methods.

Biomechanical Phenomena↗