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Finite element stress and strain analysis of the bone surrounding a dental implant: effect of variations in bone modulus.

The long-term clinical performance of a dental implant is dependent upon the preservation of good quality bone surrounding the implant and a sound interface between the bone and the biomaterial. Good quality bone is itself dependent upon the appropriate level of bone remodelling necessary to maintain the bone density and the avoidance of bone microfracture and failure. Both processes are governed by the stress and strain distribution in the bone. In this study, a dental implant which had the same geometry as the Branemark system, but with a bioactive surface coating added to produce a direct bond to the bone, was analysed. A finite element stress and strain analysis has been carried out for a range of bone density distributions under axial and lateral loading. The predictions indicated that there was no evidence of strain shielding around the neck of the implant. With lateral loading, high values of von Mises stresses (18 M Pa) were predicted around the neck of the implant. A reduction in the elastic modulus of the bone around the neck of the implant by a factor of 16 only produced a twofold reduction in the peak stress. This resulted in stress levels capable of inducing fatigue failure in this much weaker bone. This analysis has demonstrated that it is extremely important to have good quality dense bone around the neck of the implant to withstand the predicted peak stresses of between 9 and 18 M Pa. Failure to achieve this after implantation and subsequent healing may result in local fatigue failure and resorption at the neck upon resumption of physiological loading.

Bone Density↗

Osteoclast formation in bone marrow cultures from two inbred strains of mice with different bone densities.

For the purpose of identifying genes that affect bone volume, we previously identified two inbred mouse strains (C57BL/6J and C3H/HeJ) with large differences in femoral bone density and medullary cavity volume. The lower density and larger medullary cavity volume in C57BL/6J mice could result from either decreased formation or increased resorption or both. We recently reported evidence suggesting that bone formation was increased in vivo and that osteoblast progenitor cells are more numerous in the bone marrow of C3H/HeJ compared with C57BL/6J mice. In the present study, we determined whether osteoclast numbers in vivo and osteoclast formation from bone marrow cells in vitro might also differ between the two mouse strains. We have found that the number of osteoclasts on bone surfaces of distal humerus secondary spongiosa was 2-fold higher in 5.5-week-old C57BL/6J mice than in C3H/HeJ mice of the same age (p < 0.001). Bone marrow cells of C57BL/6J mice cocultured with Swiss/Webster mouse osteoblasts consistently produced more osteoclasts than did C3H/HeJ bone marrow cells at all ages tested from 3.5-14 weeks of age (p < 0.001). Osteoclast formation was also greater from spleen cells of 3.5-week-old C57BL/6J mice than C3H/HeJ mice. The distribution of nuclei per osteoclast and the 1, 25-dihydroxyvitamin D3 dose dependence of osteoclast production from bone marrow cells were similar. Osteoclasts that developed from both C57BL/6J and C3H/HeJ marrow cells formed pits in dentin slices. Cultures from C57BL/6J marrow cells formed 2.5-fold more pits than cultures from C3H/HeJ marrow cells (p < 0.02). We compared the abilities of C57BL/6J and C3H/HeJ osteoblasts to support osteoclast formation. When bone marrow cells from either C57BL/6J or C3H/HeJ mice were cocultured with osteoblasts from either C57BL/6J or C3H/HeJ newborn calvaria, the strain from which osteoblasts were derived did not affect the number of osteoclasts formed from marrow cells of either strain. Together, these observations suggest that genes affecting the bone marrow osteoclast precursor population may contribute to the relative differences in bone density that occur between C3H/HeJ and C57BL/6J mouse strains.

Animals↗

Food fractionation is a powerful tool to increase bone mass in growing rats and to decrease bone loss in aged rats: modulation of the effect by dietary phosphate.

The incidence of osteoporotic fractures has been associated with low bone mass. To reduce this incidence, it is therefore important to try to prevent the development of low bone mass by either increasing bone mass built up during adolescence and/or preventing bone loss in later life. It has been shown that food fractionation, a procedure that prevents the diurnal rhythm of bone resorption, increases bone mass in growing rats fed a high calcium (Ca), high phosphate (Pi) diet. In this paper, data are presented that show that providing growing rats with the same daily amount of a high Ca, low Pi diet (a Pi content similar to that of a human diet) in portions every 6 h instead of one meal increases total bone mineral content, trabecular bone mineral density, and cortical thickness, and markedly reduces the decrease in these parameters in aged rats. The effect is smaller when a high Ca, high Pi diet is fractionated. This could be the consequence of the transient postprandial increase in parathyroid hormone (PTH) following one large meal of a high Ca, high Pi diet, since the effect is similar to that reported after PTH injections which are anabolic for bone. Thus, a high dietary Pi must be considered as a confounding factor when treatments affecting bone mass are investigated in rats. The present data show that feeding habits have a profound effect on bone mass in the rat, independent of age. Whether bone mass in humans is also under the control of dietary habits is not yet clear. If so, frequent small meals of appropriate composition may help to prevent osteoporosis.

Aging↗

Greatly increased cancellous bone formation with rapid improvements in bone structure in the rat maternal skeleton after lactation.

There is a decrease in cancellous bone mass and strength during lactation but these are partially or completely reconstituted in the postlactational period. The purpose of this study was to determine changes in cancellous bone structure and formation after lactation in established breeder rats. For this, rats were taken at the end of the second pregnancy (Preg-2) and second lactation (Lac-2) and 2, 4, and 6 weeks after weaning. Nulliparous (NP) groups were included for comparisons. Bone structure was measured using morphometric methods and bone dynamics by histomorphometry. Tibial metaphyseal cancellous bone was lost during the first reproductive cycle, as expected, and again depleted during the Lac-2. Bone formation indices were elevated at the end of Lac-2, compared with those at the end of the second pregnancy or in the nulliparous animals. Within 2 weeks after the second weaning, the amount of double-labeled surface (dLS) increased approximately 800%, the mineralizing surface (MS) increased >400% with similar increases in bone formation rates (BFRs), compared with already elevated bone formation measured at the end of Lac-2. From 2 to 4 weeks after lactation, there were commensurate increases in cancellous bone mass and structural indices with essentially complete restoration of cancellous bone volume and structure compared with that measured at the end of Preg-2. The results show rapid and substantial increases in bone formation with reconstitution of cancellous bone mass and structure after lactation in rats. The skeletal changes that occur during the postlactational period may serve to prepare and protect the maternal skeleton for subsequent reproductive cycles.

Animals↗

Proteoglycan synthesis during intramembranous bone regeneration following avulsive wounding in guinea pig long bones.

Information on proteoglycan synthesis by bone cells and tissue is largely limited to studies of developing fetal bone. The present investigation focuses on proteoglycan synthesis during the intramembranous type of bone regeneration seen within avulsive (puncture-type) defects placed in guinea pig tibiae. [35S] Sulfate-labeled proteoglycans were extracted from tissue within regenerating tibial avulsive defects seven days following surgical wounding and also from xiphisternal cartilage utilized as an internal control. Labeled proteoglycans in 4M guanidine HCl extracts of regenerating bone and cartilage were purified by DEAE-Sephacel chromatography and further analyzed by chromatography and appropriate enzyme digestions. Regenerating bone tissue contained a proteoglycan relatively small in size (Kav = 0.56 following chromatography on Sepharose CL-2B) compared to proteoglycan from xiphisternal cartilage (Kav = 0.17). Alkaline borohydride treatment degraded this bone proteoglycan (Kav = 0.4 on Sepharose CL-6B), indicating an average molecular weight of glycosaminoglycan chains approximating 50,000. Enzymatic digestions followed by Sepharose CL-6B chromatography showed that glycosaminoglycan side chains of regenerating bone proteoglycan contained dermatan sulfate, with 60% chondroitinase AC II-resistant but chondroitinase ABC-sensitive material. This bone proteoglycan did not interact with hyaluronic acid to form aggregates under conditions where such aggregates were formed by xiphisternal cartilage proteoglycan. The regenerating bone proteoglycans are therefore similar to other bone proteoglycans in hydrodynamic size and glycosaminoglycan chain size, but differ in the per cent of iduronic acid within glycosaminoglycan side chains. This guinea pig bone proteoglycan may be associated with the large mesenchymal cell population noted histologically within the bone defects at seven days of regeneration.

Animals↗

Differential diagnosis of metastases in bone scans: chemotherapy induced bone necrosis.

AIM: Influenced by the incorrect diagnosis of a bone metastasis caused by bone necrosis we evaluated reasons and frequency of bone necrosis in patients referred for bone scanning in follow-up of tumors. METHODS: Bone scans performed within two years on patients with primary bone tumors or tumors metastatic to bone were reviewed in respect to the final diagnosis bone necrosis. RESULTS: We found the cases of three young patients who presented the appearance of hot spots on bone scintigrams which were finally diagnosed as bone necrosis. In two cases the diagnosis was based on histological findings, in one case the diagnosis was made evident by follow-up. All the three patients had been treated by chemotherapy and presented no other reason for the development of bone necrosis. Enhanced tracer uptake in all sites decreased within eight weeks up to two years without therapy. CONCLUSION: Single and multiple hot spots after chemotherapy may be originated by bone necrosis but mimicry metastases.

Adolescent↗

[Chronological study for solitary bone metastasis in the sternum from breast cancer with bone scintigraphy].

Since breast cancer is frequently associated with bone metastasis, bone scintigraphies have been performed to determine pre-operative staging and to survey postoperative bone metastasis. The sternum, in particular, is a site at which is difficult to differentiate between benign bone disease and bone metastasis, because of varied uptake and wide individual variations. In this study, chronological bone images were scintigraphied in six cases with solitary sternal metastasis and three cases with benign bone disease including two fracture cases and one arthritis case. On bone scintigrams in which solitary sternal metastasis appeared, increased uptake was found in five cases, and photon deficiency was observed in one case. During follow-up scintigraphies, abnormal accumulations, such as hot spots and cold lesions, increased in the bone metastasis while abnormal uptake disappeared or was unchanged in the benign bone disease cases. On CT, four cases showed osteolytic change, and one exhibited osteosclerotic change. These findings indicate that sternal metastasis usually shows osteolytic change, even if a hot lesion is recognized on bone scintigraphy. In solitary sternal metastasis, for which early diagnosis is difficult, both an integrated diagnosis using other imaging techniques and chronological bone scintigraphy are important.

Adult↗

Role of bone bark during growth in width of tubular bones. A study in human fetuses.

The morphologic features of bone bark, a structure surrounding the distal and proximal ends of long bones, were studied in the distal femur, proximal tibia, and proximal fibula of 77 spontaneously aborted human fetuses varying in gestational age from 10 to 20 weeks. Standard histologic techniques used in addition to in situ immunohistochemical staining allowed the examination of the structure of the bone bark and localization of Types 1, 2, and 3 collagens at different gestational ages. The bone bark was shaped like a cylindrical sheath of bone lamellae of varying thickness. The epiphyseal end of the bone bark, known as the groove of Ranvier, was covered outwardly by a fibrous layer and inwardly by the epiphyseal cartilage and contained mesenchymal cells, chondroblastic precursor cells, and densely packed cells differentiating into osteoblasts. Neither the cell density in the groove nor the thickness of the bone bark were identical circumferentially, indicating an unequal growth in width. In addition, the presence of periosteal apposition and endosteal resorption of the bone bark on one side and of endosteal bone deposition accompanied by periosteal resorption of the bone bark on the opposite side support the concept of a spatial drift of bones. These observations furnish histologic proof that groove and bone bark, although assuring an equal growth in length, contribute to an unequal and eccentric growth in width.

Bone Development↗

[Effect of ultrasonic shock waves on the bone-bone cement interface].

PURPOSE OF THE STUDY: Identification of the impact of ultrasound shock wave on the integration of bone cement in the bone and the examination of a potential application of this method in order to facilitate the extraction of cemented implants, mainly femoral component of total hip arthroplasty. MATERIAL: We used pig proximal femurs from which we made fragments involving approximately one third to one half of the profile of the bone and Palacos bone cement. METHOD: We made a groove in the cancellous bone, pressed bone cement with a wire loop in the cavity and let it harden. The samples were divided by random selection into two groups. Samples from A group were exposed to ultrasound shock waves and group B served as a control group. Then we measured the force needed for the extraction of the cement plug from the bone. RESULTS: Our measuring has shown an evident decrease of the force necessary for the extraction of the bone cement after the application of ultrasound shock wave. We did not find out any macroscopically evident damage of the bone cement or of the surrounding cortical bone. DISCUSSION: The results of our measuring are influenced by a different shape and size of the examined samples which also substantially differ from the situation when a stem of the endoprosthesis is implanted in the femoral canal and is surrounded by a cement mantle. As concerns risks associated with the application of the shock wave in this indication there is a risk of a fracture of the cortical bone around THR stem (the literature does not mention this complication) and a risk of the increase of pressure in the medullary cavity of the femur combined with a risk of fat embolism. In our view this increase of pressure is comparable with the effect of the implantation of femoral component. This method cannot be used for releasing cementless implants as the surrounding cortical bone gets damaged before the implant is released. CONCLUSION: Ultrasound shock wave is still used rarely in orthopaedics, however, the existing results are promising in many aspects. Of great importance is the fact that it is a non-invasive method. The field dealt with by this work covers only experiments in vitro but the results provide hope for a future clinical use.

Animals↗

[Comparative study on graft of autogeneic iliac bone and tissue engineered bone].

OBJECTIVE: To compare the clinical results of repairing bone defect of limbs with tissue engineering technique and with autogeneic iliac bone graft. METHODS: From July 1999 to September 2001, 52 cases of bone fracture were randomly divided into two groups (group A and B). Open reduction and internal fixation were performed in all cases as routine operation technique. Autogeneic iliac bone was implanted in group A, while tissue engineered bone was implanted in group B. Routine postoperative treatment in orthopedic surgery was taken. The operation time, bleeding volume, wound healing and drainage volume were compared. The bone union was observed by the X-ray 1, 2, 3, and 5 months after operation. RESULTS: The sex, age and disease type had no obvious difference between groups A and B. all the wounds healed with first intention. The swelling degree of wound and drainage volume had no obvious difference. The operation time in group A was longer than that in group B (25 minutes on average) and bleeding volume in group A was larger than that in group B (150 ml on average). Bone union completed within 3 to 7 months in both groups. But there were 2 cases of delayed union in group A and 1 case in group B. CONCLUSION: Repair of bone defect with tissue engineered bone has as good clinical results as that with autogeneic iliac bone graft. In aspect of operation time and bleeding volume, tissue engineered bone graft is superior to autogeneic iliac bone.

Adolescent↗

[Preparation and osteogenic activity of combining calcium phosphate cement with bone morphogenetic protein composite as a bone graft material].

OBJECTIVES: To construct new type of bone graft material by combining calcium phosphate cement (CPC) with bone morphogenetic protein (BMP), and then to detect its osteogenic activity. METHODS: The surface of CPC and CPC/BMP composite were observed by scanning electron microscope (SEM). CPC and CPC/BMP pellets were separately implanted into the thigh muscle pouches of mice. Samples obtained at different times were tested by histological analysis, SEM, organic substance detection, and alkaline phosphatase (ALP) measurement to observe the induced ectopic bone formation. RESULTS: Under SEM, the CPC and CPC/BMP composite was found to consist primarily of platy crystals, granular crystals and some small rod-like crystals with micropores about 10-50 microm in size. BMP about 1-5 microm in size was seen like micro globules distributing evenly in the micropores. Newly formed cartilage or bone was not found in the CPC group. In the CPC/BMP group, mesenchymal cells were proliferated and abundant cartilage was found in one week. Woven bone appeared at 2 weeks. New bone formation increased with bone marrow at 4 weeks. At 8 weeks, the implanted CPC/BMP became heterogeneous and a lot of collapsed granules were observed. At the end of 16 weeks, mature lamellar bone appeared and the volume of the implanted CPC/BMP became smaller. One week after implantation, the ALP increased evidently in the CPC/BMP groups and reached the highest level at the 4th week, which was about 168 U/L. The content of organic substance in specimens increased from 22% to 39% by the end of the 16th week, showing the continuous calcification and formation of new bone. SEM also showed that the CPC/BMP composite had good potentiality of ectopic bone induction, and the new bone formed accompanied by the slow degradation of the material. CONCLUSION: The results of this study suggested that the CPC/BMP composite could be used as material for bone graft substitute.

Animals↗

Low turnover bone disease is the more common form of bone disease in CAPD patients.

CAPD is considered a risk factor for low turnover bone disease. This was previously attributed to aluminum accumulation. We evaluated by biochemical and histomorphometric parameters (including double tetracycline labelling), 26 patients maintained on CAPD for 12-14 months. Three (11.5%) showed mild hyperparathyroidism, 5 (19.2%) osteitis fibrosa, 3 (11.5%) mixed forms, 4 (15%) osteomalacia and 11 (42.3%) adynamic bone disease. Only one patient with diabetes mellitus showed an aluminum stained bone surface > 10%. Intact PTH serum levels were lower in LTBD (133.2 +/- 128 vs 468.2 +/- 451 pg/ml; p < 0.05). We also evaluated prospectively 11 patients who underwent a bone biopsy at start of dialysis and after 12 months of CAPD treatment. Bone biopsies pre CAPD demonstrated normal-high bone turnover disease in 8/11 (72.7%) and low turnover bone disease in 3/11 (27%). In the follow-up biopsies, 2 patients showed osteitis fibrosa and other two mild forms. Low turnover bone disease was found in 7 patients (3 osteomalacia and 4 adynamic bone disease). We conclude that the predominant bone lesion in our CAPD patients is low turnover bone disease, predominantly adynamic forms, and aluminum does not seem to play a role on its genesis. Low intact PTH serum levels may be a predictor of low turnover bone disease.

Bone and Bones↗

[The study of tissue-engineering bone for repair of segmental bone defects].

OBJECTIVE: To investigate the effect of tissue-engineering bone on repair of segmental bone defects. METHODS: Segmental bone defect of 21mm was created at sheep left metatarsus, which was then implanted with tissue-engineering bone (the experimental group) and pure porous beta-TCP (the control group) respectively. The bone defect in the blank group was left without treatment. After the sheep were sacrificed at the 1st, 3rd, or 6th month postoperatively, the samples were taken and examined by radiological, histological and biomechanical methods as well as scanning electron microscopy. The sheep in the blank group were sacrificed at the 6th month postoperatively. RESULTS: The osteoid tissue, woven bone and lamellar bone in the defect of the experimental group occurred earlier than in the control group. The new bone formed directly without through a cartilaginous intermediate in the experimental group, while the defect was repaired in a "creep substitution" way in the control group. At the 6th month, radiological and biomechanical tests revealed nearly complete repair of the bone defect of the experimental group, partial repair in the control group and non-healing in the blank group. CONCLUSIONS: Tissue-engineering bone can repair bone defect, accelerating healing and without "creep substitution", which is a good option in repair of critical segmental bone defects. This study set up a basis for clinical applications in the future.

Animals↗

Immunohistochemical analysis of cortical and cancellous bone after radiation and the effect of platelet-rich plasma on autogenous bone grafting.

PURPOSE: The collection of autologous platelet-rich plasma (PRP) has demonstrated favorable affects on wound healing in compromised patients. The purpose of this study was to evaluate the expression of PDGF, bFGF, and TGF-beta in irradiated and nonirradiated bone in a rabbit tibia model and the ability of PRP to increase growth factor expression when added to autogenous bone graft in a rabbit cranial defect model. MATERIALS AND METHODS: Ten New Zealand White rabbit tibiae and calvariae were utilized for this study. Tibiae were irradiated at 60 to 70 cGy and evaluated for expression of PDGF, bFGF, and TGF-beta. Rabbit calvariae were also analyzed after grafting with autogenous bone and PRP for determination of growth factor expression. RESULTS: Decreased expression of PDGF, bFGF, and TGF-beta was seen in cortical and cancellous bone samples when irradiated bone was compared to nonirradiated rabbit tibiae. An increase in PDGF, bFGF, and TGF-beta expression was detected in cortical autogenous bone grafts with PRP at 1 and 2 months compared to autogenous bone alone. DISCUSSION: In this study, growth factors, which were decreased in irradiated cortical and cancellous bone, showed increased expression at 1 and 2 months when PRP was added to autogenous bone grafts. Thus, PRP may have potential therapeutic applications when bone grafting is required in patients with reduced bone vascularity, including patients with previous head and neck irradiation, diabetes, and smoking habits. CONCLUSIONS: Decreased expression of PDGF, bFGF, and TGF-beta was seen in radiated rabbit tibia as compared to nonirradiated controls, and increased expression of these growth factors was seen in PRP-containing autogenous bone grafts.

Animals↗

Resorbing bone stimulates tumor cell growth. A role for the host microenvironment in bone metastasis.

Demineralized extracts of bone matrix and conditioned media from cultured fetal rat calvaria have been reported to contain growth stimulatory activity for bone cells. To investigate the potential role of these local bone growth factors in the development of bone metastases, we chose the Walker 256 carcinosarcoma, a rat mammary tumor which causes osteolytic bone metastases and hypercalcemia. 45Ca-labeled, 19-day fetal Sprague-Dawley rat calvaria were cultured for 96 hours in BGJb medium. Walker cells from ascites tumors or cultures were grown in unconditioned media or in conditioned media harvested from the bone cultures, in the presence of 10% fetal calf serum. Media were changed every 2 days, cells were counted daily for 5 days, and 3H-thymidine uptake into acid insoluble residues was measured. The growth of tumor cells was 5-6-fold greater in conditioned media than in unconditioned media and the effect was dose dependent. Cells cultured in conditioned media demonstrated a approximately 3-fold enhancement of 3H-thymidine incorporation. Generation of growth stimulatory activity correlated with the extent of bone resorption, measured by release of 45Ca from the fetal parietal bones (r = 0.85; P less than 0.001). Conditioned media from bones cultured with 10(-7) M prostaglandin E2 (PGE2) contained greater amounts of growth stimulatory activity than untreated conditioned media, but PGE2 itself did not stimulate tumor cell growth. Addition of 3.5 mM PO4 to bone cultures blocked bone resorption and the generation of growth factors. Growth stimulatory activity was stable to heat (56 C for 30 minutes) and trypsin digestion, with an apparent molecular weight of less than 17,000 daltons by high-performance liquid chromatography. Conditioned medium also stimulated the growth of 13762 rat mammary adenocarcinoma cells, MB-MDA-231 human breast carcinoma cells, TE-85 osteosarcoma cells, a murine fibrosarcoma and rat embryonic fibroblasts, with the most potent effects noted for Walker tumor cells, the TE-85 osteosarcoma, and human breast carcinoma lines. These results suggest a mechanism by which bone resorption could promote the development of skeletal metastasis.

Animals↗

[Clinical study on bone mineral mass in metabolic bone disorders--I-125 photon absorptiometry].

Changes in bone mineral mass were investigated by 125I-photon absorptiometry in 5 groups of patients; postmenopausal osteoporosis (n = 50), after partial or total gastrectomy (n = 54), thyroid disorders (n = 28), parathyroid disorders (n = 6) and healthy subjects (n = 214) as control. Radial bone mineral content (BMC) was measured at the distal 1/3 and 1/6 sites of the radius and the densitometric patterns were analized . The results obtained were as follows: Age variation in bone mineral mass and bone mineral change in pathological status were more sensitively detectable at the distal 1/6 site of the radius (predominantly trabecular) than the distal 1/3 site of the radius (predominantly cortical). In osteoporosis there was a diminution in radial 1/6 BMC and a significant decrease of radial trabecular bone index ( RTBI ) estimated from densitometric patterns, as compared with age-matched control. Sequential changes of bone mineral mass were evaluated during the treatment. There was no significant change in bone mineral mass during the first 3 months of 1 alpha-OH-D3 administration. Bone mineral mass then decreased about 20% in radial 1/6 BMC in the course of the treatment. An increase in bone mineral mass at the distal 1/6 site of the radius was revealed at 1 year treatment with 1 alpha-OH-D3. But at the distal 1/3 site of the radius only a little change in bone mineral mass was recognized during the treatment. Total gastrectomy caused a significant deficit of radial BMC as compared to partial gastrectomy. 1 alpha-OH-D3 was also effective on bone mineral loss after gastrectomy. Loss of radial 1/6 BMC occurred in hyperthyroidism (high turn over osteoporosis) but not in hypothyroidism. Striking bone mineral loss was observed in hyperparathyroidism, which recovered after surgical treatment.

Adolescent↗

Two phases of the bone mineral as revealed by the high resolution scanning electron microscope on ion-etched bone surfaces and as seen on surfaces untreated and chemically etched.

Recently reported uses of the technique of high resolution scanning microscopy of polished and Argon ion-etched bone surfaces have revealed that, at the ultrastructural level, the bone mineral is spatially arranged in a network of twisted, closely packed segments containing globular and cylindrical components. The ion-etching technique, which preferentially removes organic and less dense material from the bone surface, has been subsequently used by the present authors for detailed screening of a quantity of human cortical and trabecular bone of different age and maturity during which it has been found that apart from this "structured bone' containing twisted segments, the mineral is also organised in another regular form, the "lining bone', which has the appearance of solid, smooth and dense slabs or sheets lining active bone surfaces and bone cell lacunae and canaliculi. In the present study, in order to exclude the possibility that these two newly described phases of the bone mineral microskeleton are results of an etching artifact, their SEM appearance in 14 Argon ion-etched human bone specimens from individuals aged 11 post-natal days to 79 years was compared in various compartments to that seen on surfaces which were untreated, just polished or etched by hot NaOCl. The results have shown that both the structured and lining bone are genuine features since although the best results for their clear and reliable distinction were achieved by the ion-etching technique, these images could also be recognised on bone surfaces which were untreated or treated in a different way.

Adolescent↗

Free vascularized bone grafts: factors affecting their survival and ability to heal to recipient bone defects.

Composite bone grafts revascularized by microvascular anastomoses with respect to bone cell survival, vessel architecture, and the grafts' ability to participate in healing toward a recipient bone were investigated in 21 adult mongrel dogs. Bone grafts with an intact medullary and periosteal supply were compared with bone grafts with only periosteal bone supply intact. It was demonstrated that bone grafts with both medullary and periosteal blood supplies survived completely but were partially resorbed with time. Periosteally supplied bone grafts demonstrated less resorption but showed, in some grafts, bone marrow necrosis and partial loss of osteocytes. The osteoblasts survived equally well in both groups. No difference in the ability to participate in healing to a recipient bone defect could be demonstrated, although microangiograms revealed significant differences in the medullary microvasculature and at the host-graft junctions in these two types of grafts. The question of whether to preserve the medullary blood supply when transferring whole bone segments by microvascular anastomoses is significant with respect to possible donor-site selection. This study has shown that bone grafts with an intact medullary and/or periosteal blood supply will survive transplantation and participate in healing to a recipient defect equally well.

Animals↗