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Mineralization ability of cultured human osteoblast-like periosteal cells does not decline with aging.

Studies of the mechanisms of osteoporosis have not yet determined whether these conditions result from increased osteoclast activity or decreased osteoblast activity, or perhaps both. Osteoporosis is related to aging and to postmenopausal status. The function and the mitotic capacity of cultured human osteoblast-like cells were investigated in this study. The age at which these cells lose the ability to divide showed a strong negative correlation with donor age (r = .815, p less than .01). There was also significant correlation of maximum cell saturation density with donor age (r = .698, p less than .01). Alkaline phosphatase (ALP) activity and mineralization ability, typical functions of osteoblasts, continue undiminished up to the point at which mitotic capacity ceases. When cells were treated with 1 alpha, 25-dihydroxy vitamin D3 in the presence of 2 mM alpha-glycerophosphate, ALP activity and mineralization ability showed an increase, rather than a decrease, with advancing donor age. However, these functions showed no correlation with in vitro cell aging. We propose that human osteoblast-like cells from elderly subjects do not lose their functions of mineralization and ALP formation, and that loss of these functions with cell aging does not correlate with advancing age.

Adolescent↗

Physiologic periosteal changes in infancy.

Surface modulation is part of normal bone growth. However, the radiologic appearance of physiologically growing bone in infancy may resemble changes secondary to trauma. This case report reviews bone remodeling in the postnatal infant and describes its unique radiologic and pathologic characteristics, allowing normal to be differentiated from healing and repair.

Autopsy↗

Preservation of periosteal attachment in lateral osteotomy.

Cosmetic rhinoplasty with narrowing of the bony vault can potentially reduce the nasal airway. Current surgical methods may aggravate this problem. In an attempt to demonstrate the effect of lateral osteotomy on the resultant airway, 4 cadaver specimens were studied grossly and with CAT scans. It appeared that variations in osteotomy technique did have a demonstrable impact on the size of the nasal airway. An interrupted transperiosteal approach, preserving intervening strands of periosteum, resulted in a more stable nose with less compromise of the airway.

Cadaver↗

Complex midface reconstruction: maximizing contour and bone graft survival utilizing periosteal free flaps.

Midfacial bone and soft tissue defects present a unique challenge because they require a complex arrangement of tissues in a relatively limited space. This may be difficult to achieve with free osteocutaneous flaps. The use of bone grafts allows greater flexibility in reconstruction but is limited by graft resorption. This is the report of midface reconstruction using a large iliac crest graft covered with a radial forearm free fascioperiosteal flap to augment graft survival. Histopathology and patient follow-up evaluation are presented demonstrating viable bone throughout the graft at biopsy 4 months postoperatively.

Alveolar Process↗

Bone formation by revascularized periosteal and bone grafts, compared with traditional bone grafts.

Three groups of dogs were studied to compare the bone formation obtained with traditional bone grafting techniques, and that obtained with revascularized periosteum or revascularized bone grafts--all in unstressed bone. Revascularized periosteum did not produce a significant amount of bone in this unstressed model. At 4 months the revascularized rib grafts had a slightly greater tolerance to stress at the callus site than traditional bone grafts, but the incidence of non-union was the same. We conclude that the use of revascularized bone grafts should be reserved for situations in which traditional bone grafting techniques are unlikely to be successful.

Animals↗