Search results for: bone turnover

Authors: K. Yadamma, K. Rudrama Devi

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The protective effect of Ginger Extract against cyclophosphamide induced cytotoxicity was evaluated in in vivo animal model using analysis of chromosomal aberrations in somatic cells of mice. Three doses of Ginger Extract (150mg/kg, 200mg/kg, and 250mg/kg body weight) were selected for modulation and given to animals after priming. The animals were sacrificed 24, 48, 72 hrs after the treatment and slides were prepared for the incidence of chromosomal aberrations in bone marrow cells of mice. When animals were treated with cyclophosphamide 50mg/kg, showed cytogenetic damage in somatic cells. However, a significant decrease was observed in the percentage of chromosomal aberrations when animals were primed with various doses of Ginger Extract. The present results clearly indicate the protective nature of Ginger Extract against cyclophosphamide induced genetic damage in mouse bone marrow cells.

Keywords: ginger extract, protection, bone marrow cells, swiss albino mice

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Authors: Aura Maria Lopera Echavarria, Angela Maria Lema Perez, Daniela Medrano David, Pedronel Araque Marin, Marta Elena Londoño Lopez

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Bone regeneration is the process by which the formation of new bone is stimulated. Bone fractures can originate at any time due to trauma, infections, tumors, congenital malformations or skeletal diseases. Currently there are different strategies to treat bone defects that in some cases, regeneration does not occur on its own. That is why they are treated with bone substitutes, which provide a necessary environment for the cells to synthesize new bone. The Demineralized Bone Matrix (DBM) is widely used as a bone implant due to its good properties, such as osteoinduction and bioactivity. However, the use of DBM is limited, because its presentation is powder, which is difficult to implant with precision and is susceptible to migrating to other sites through blood flow. That is why the DBM is commonly incorporated into a variety of vehicles or carriers. The objective of this project is to evaluate the bioactive and confinement properties of a bone substitute based on demineralized bone matrix (DBM). Also, structural and morphological properties were evaluated. Bone substitute was obtained from EIA Biomaterials Laboratory of EIA University and the DBM was facilitated by Tissue Bank Foundation. Morphological and structural properties were evaluated by scanning electron microscopy (SEM), X-ray diffraction (DRX) and Fourier transform infrared spectroscopy with total attenuated reflection (FTIR-ATR). Water absorption capacity and degradation were also evaluated during three months. The cytotoxicity was evaluated by the MTT test. The bioactivity of the bone substitute was evaluated through immersion of the samples in simulated body fluid during four weeks. Confinement tests were performed on tibial fragments of a human donor with bone defects of determined size, to ensure that the substitute remains in the defect despite the continuous flow of fluid. According of the knowledge of the authors, the methodology for evaluating samples in a confined environment has not been evaluated before in real human bones. The morphology of the samples showed irregular surface and presented some porosity. DRX confirmed a semi-crystalline structure. The FTIR-ATR determined the organic and inorganic phase of the sample. The degradation and absorption measurements stablished a loss of 3% and 150% in one month respectively. The MTT showed that the system is not cytotoxic. Apatite clusters formed from the first week were visualized by SEM and confirmed by EDS. These calcium phosphates are necessary to stimulate bone regeneration and thanks to the porosity of the developed material, osteinduction and osteoconduction are possible. The results of the in vitro evaluation of the confinement of the material showed that the migration of the bone filling to other sites is negligible, although the samples were subjected to the passage of simulated body fluid. The bone substitute, putty type, showed stability, is bioactive, non-cytotoxic and has handling properties for specialists at the time of implantation. The obtained system allows to maintain the osteoinductive properties of DBM and it can fill completely fractures in any way; however, it does not provide a structural support, that is, it should only be used to treat fractures without requiring a mechanical load.

Keywords: bone regeneration, cytotoxicity, demineralized bone matrix, hydrogel

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Authors: Kumaran Letchmanan, Shou-Cang Shen, Wai Kiong Ng

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Postoperative implant-associated infections in soft tissues and bones remain a serious complication in orthopaedic surgery, which leads to impaired healing, re-implantation, prolong hospital stay and increase cost. Drug-loaded implants with sustained release of antibiotics at the local site are current research interest to reduce the risk of post-operative infections and osteomyelitis, thus, minimize the need for follow-up care and increase patient comfort. However, the improved drug release of the drug-loaded bone cements is usually accompanied by a loss in mechanical strength, which is critical for weight-bearing bone cement. Recently, more attempts have been undertaken to develop techniques to enhance the antibiotic elution as well as preserve the mechanical properties of the bone cements. The present study investigates the potential influence of addition of mesoporous silica nanoparticles (MSN) on the in vitro drug release kinetics of gentamicin (GTMC), along with the mechanical properties of bone cements. Simplex P was formulated with MSN and loaded with GTMC by direct impregnation. Meanwhile, Simplex P with water soluble poragen (xylitol) and high loading of GTMC as well as commercial bone cement CMW Smartset GHV were used as controls. MSN-formulated bone cements are able to increase the drug release of GTMC by 3-fold with a cumulative release of more than 46% as compared with other control groups. Furthermore, a sustained release could be achieved for two months. The loaded nano-sized MSN with uniform pore channels significantly build up an effective nano-network path in the bone cement facilitates the diffusion and extended release of GTMC. Compared with formulations using xylitol and high GTMC loading, incorporation of MSN shows no detrimental effect on biomechanical properties of the bone cements as no significant changes in the mechanical properties as compared with original bone cement. After drug release for two months, the bending modulus of MSN-formulated bone cements is 4.49 ± 0.75 GPa and the compression strength is 92.7 ± 2.1 MPa (similar to the compression strength of Simplex-P: 93.0 ± 1.2 MPa). The unaffected mechanical properties of MSN-formulated bone cements was due to the unchanged microstructures of bone cement, whereby more than 98% of MSN remains in the matrix and supports the bone cement structures. In contrast, the large portions of extra voids can be observed for the formulations using xylitol and high drug loading after the drug release study, thus caused compressive strength below the ASTM F541 and ISO 5833 minimum of 70 MPa. These results demonstrate the potential applicability of MSN-functionalized poly(methyl methacrylate)-based bone cement as a highly efficient, sustained and local drug delivery system with good mechanical properties.

Keywords: antibiotics, biomechanical properties, bone cement, sustained release

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Authors: Caighley Logan

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The outcome of fire related fatalities, along with other research, has found fires can have a detrimental effect to the mineral and crystalline structures within bone. This study focused on the mineral and crystalline structures within porcine bone samples to analyse the changes caused, with the intent of effectively ‘reverse engineering’ the data collected from burned bone samples to discover what may have happened. Using Fourier Transform Infrared (FT-IR), and X-Ray Fluorescence (XRF), the data collected from a controlled source of intense heat (muffle furnace) and an open fire, based in a living room setting in a standard size shipping container (8.5ft x 8ft) of a similar temperature with a known ignition source, a gasoline lighter. This approach is to analyse the changes to the samples and how the changes differ depending on the heat source. Results have found significant differences in the levels of remaining minerals for each type of heat/burning (p=<0.001), particularly Phosphorus and Calcium, this also includes notable additions of absorbed elements and minerals from the surrounding materials, i.e., Cerium (Ce), Bromine (Br) and Neodymium (Ne). The analysis techniques included provide validated results in conjunction with previous studies.

Keywords: forensic anthropology, thermal alterations, porcine bone, FTIR, XRF

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Authors: Tom Spears, Zotique Laframboise

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Soil inorganic carbon is the most common form of carbon in arid and semiarid regions, and has a very long turnover time. However, little is known about dissolved inorganic carbon storage and its turnover time in these soils. With 81 arid soil samples taken from 6 profiles in the Nepean Desert, Canada, we investigated the soil inorganic carbon (SIC) and the soil dissolved inorganic carbon (SDIC) in whole profiles of saline and alkaline soils by analyzing their contents and ages with radiocarbon dating. The results showed that there is considerable SDIC content in SIC, and the variations of SDIC and SIC contents in the saline soil profile were much larger than that in the alkaline profile. We investigated the possible implications for tectonic platelet activity but identified none.

Keywords: soil, carbon storage, acidity, soil inorganic carbon (SIC)

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Authors: Mohammad Shakir, Reshma Jolly, Mohammad Shoeb Khan, Noor-E-Iram

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A nanocomposite system incorporating dextrin into nano-hydroxyapatite/chitin matrix (n-HA/DX/CT) has been successfully synthesized via co-precipitation route at room temperature for the application in bone tissue engineering by investigating biocompatibility, cytotoxicity and mechanical properties. The FTIR spectra of n-HA/DX/CT nanocomposite indicated a considerable intermolecular interaction between the various components of the system. The results of XRD, TEM and TGA/DTA revealed that the crystallinity, size and thermal stability of the n-HA/DX/CT scaffold has decreased and increased respectively. The result of SEM image of the n-HA/DX/CT scaffold indicated that the incorporation of dextrin affected the surface morphology while considerable in-vitro bioactivity has been observed in n-HA/DX/CT based on SBF study, referring a step towards possibility of making direct bond to living bone if implanted. Moreover, MTT assay suggested the non-toxic nature of n-HA/DX/CT to murine fibroblast L929 cells. The swelling study of n-HA/DX/CT scaffold indicated the low swelling rate for n-HADX/CT. All these results have paved the way for n-HA/DX/CT to be used as a competent material for bone tissue engineering.

Keywords: autograft, chitin, dextrin, nanocomposite

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Authors: Xianjia Meng, Chuanyong Qu

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Compact bone produces fatigue damage under the inevitable physiological load. The accumulation of fatigue damage can change the bone’s micro-structure at different scales and cause the catastrophic failure eventually. However, most tests were limited to the macroscopic modulus of bone and there is a need to assess the microscopic modulus during fatigue progress. In this paper, nano-identation was used to investigate the bone specimen subjected to four point bending. The microscopic modulus of the same area were measured at different degrees of damage including fracture. So microscopic damage can be divided into three stages: first, the modulus decreased rapidly and then They fell slowly, before fracture the decline became fast again. After fracture, the average modulus decreased by 20%. The results of inner and outer planes explained the influence of compressive and tensile loads on modulus. Both the compressive and tensile moduli decreased with the accumulation of damage. They reached the minimum at ending and increased after fracture. The modulus evolution under different strains were revealed by the side. They all fell slowly and then fast with the accumulation of damage. The fractured results indicated that the elastic modulus decreased obviously at the high strain while decreased less at the low strain. During the fatigue progress, there was a significant difference in modulus at low degree of damage. However, the dispersed modulus tended to be similar at high degree of damage, but they became different again after the failure.

Keywords: fatigue damage, fracture, microscopic modulus, bone, nano-identation

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Authors: Gyongyver Csapo, Andrea Czibor

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Machiavellianism is a personality trait based on the exploitation and deception of others. Machiavellian individuals are motivated to gain and to maintain power with the help of their strategic thinking, manipulation tactics, and interpersonal skills. Consequently, Machiavellianism is treated as a personality trait that can affect an individual’s career and work-related behavior. The aim of our research is to provide a narrative psychological approach to Machiavellianism in order to get a more comprehensive picture about the attitudes, values, and work-related behaviors of Machiavellian individuals. In this study, semi-structured interviews were made with employees (N=275) about their work-related experiences. Additionally, participants completed questionnaires about their turnover intention and perceived stress. The interviews were examined with narrative psychological content analysis and thematic analyzes. Based on the thematic analysis, mentioning of two topics (recognition at work and control) were associated with Machiavellianism. Scientific narrative psychological content analysis showed a negative association between Machiavellianism and positive emotions. Turnover intention and the magnitude of perceived work-related stress showed a significant positive correlation with Machiavellianism. In this study, qualitative and quantitative methodologies were combined in order to get a deeper insight of Machiavellianism from an organizational psychological perspective. Our research can contribute to a better understanding of this personality trait and provides an excellent basis for further investigations.

Keywords: machiavellianism, narrative psychology, turnover intention, work-related stress

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Authors: Kadir Gök

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In this study, a vacuum system was developed for orthopedic drilling processes, and the most efficient processing parameters were determined using statistical analysis of temperature rise. A reverse engineering technique was used to obtain a 3D model of the chip vacuum system, and the obtained point cloud data was transferred to Solidworks software in STL format. An experimental design method was performed by selecting different parameters and their levels, such as RPM, feed rate, and drill bit diameter, to determine the most efficient processing parameters in temperature rise using ANOVA. Additionally, the bone chip-vacuum device was developed and performed successfully to collect the whole chips and fragments in the bone drilling experimental tests, and the chip-collecting device was found to be useful in removing overheating from the drilling zone. The effects of processing parameters on the temperature levels during the chip-vacuuming were determined, and it was found that bone chips and fractures can be used as autograft and allograft for tissue engineering. Overall, this study provides significant insights into the development of a vacuum system for orthopedic drilling processes and the use of bone chips and fractures in tissue engineering applications.

Keywords: vacuum system, orthopedic drilling, temperature rise, bone chips

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Authors: Marzieh Jafarzadeh, Fatemeh Rezaee

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Introduction: The effect of ionizing radiation on human health can be effective for genomic integrity and cell viability. It also increases the risk of cancer and malignancy. Therefore, X-ray behavior and absorption dose calculation are considered. One of the applicable tools for calculating and evaluating the absorption dose in human tissues is Monte Carlo simulation. Monte Carlo offers a straightforward way to simulate and integrate, and because it is simple and straightforward, Monte Carlo is easy to use. The Monte Carlo BEAMnrc code is one of the most common diagnostic X-ray simulation codes used in this study. Method: In one of the understudy hospitals, a certain number of CT scan images of patients who had previously been imaged were extracted from the hospital database. BEAMnrc software was used for simulation. The simulation of the head of the device with the energy of 0.09 MeV with 500 million particles was performed, and the output data obtained from the simulation was applied for phantom construction using CT CREATE software. The percentage of depth dose (PDD) was calculated using STATE DOSE was then compared with international standard values. Results and Discussion: The ratio of surface dose to depth dose (D/Ds) in the measured energy was estimated to be about 4% to 8% for bone and 3% to 7% for bone marrow. Conclusion: MC simulation is an efficient and accurate method for simulating bone marrow and calculating the absorbed dose.

Keywords: Monte Carlo, absorption dose, BEAMnrc, bone marrow

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Authors: Anuj Kumar, Kummara M. Rao, Sung S. Han

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Bone tissue engineering has emerged as a potentially alternative method for localized bone defects or diseases, congenital deformation, and surgical reconstruction. The designing and the fabrication of the ideal scaffold is a great challenge, in restoring of the damaged bone tissues via cell attachment, proliferation, and differentiation under three-dimensional (3D) biological micro-/nano-environment. In this case, hydrogel system composed of high hydrophilic 3D polymeric-network that is able to mimic some of the functional physical and chemical properties of the extracellular matrix (ECM) and possibly may provide a suitable 3D micro-/nano-environment (i.e., resemblance of native bone tissues). Thus, this proposed hydrogel system is highly permeable and facilitates the transport of the nutrients and metabolites. However, the use of hydrogels in bone tissue engineering is limited because of their low mechanical properties (toughness and stiffness) that continue to posing challenges in designing and fabrication of tough and stiff hydrogels along with improved bioactive properties. For this purpose, in our lab, polyacrylamide-based hybrid hydrogels were synthesized by involving sodium alginate, cellulose nanocrystals and silica-based glass using one-step free-radical polymerization. The results showed good in vitro apatite-forming ability (biomineralization) and improved mechanical properties (under compression in the form of strength and stiffness in both wet and dry conditions), and in vitro osteoblastic (MC3T3-E1 cells) cytocompatibility. For in vitro cytocompatibility assessment, both qualitative (attachment and spreading of cells using FESEM) and quantitative (cell viability and proliferation using MTT assay) analyses were performed. The obtained hybrid hydrogels may potentially be used in bone tissue engineering applications after establishment of in vivo characterization.

Keywords: bone tissue engineering, cellulose nanocrystals, hydrogels, polyacrylamide, sodium alginate

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Authors: M. Benlebna, B. Serier, B. Bachir Bouiadjra, S. Khalkhal

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This study focuses on the mechanical behavior of a dental prosthesis subjected to dynamic loads chewing. It covers a three-dimensional analysis by the finite element method, the level of distribution of equivalent stresses induced in the bone between the implants (depending on the number of implants). The studied structure, consisting of a braced, implant and mandibular bone is subjected to dynamic loading of variable amplitude in three directions corrono-apical, mesial-distal and bucco-lingual. These efforts simulate those of mastication. We show that compared to the implantation of a single implant, implantology using two implants promotes the weakening of the bones. This weakness is all the more likely that the implants are located in close proximity to one another.

Keywords: stress, bone, dental implant, distribution, stress levels, dynamic, effort, interaction, prosthesis

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Authors: Irena Baranowska-Bosiacka, Mateusz Bosiacki, Patrycja Kupnicka, Anna Lubkowska, Dariusz Chlubek

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Physical activity and a balanced diet are among the key factors of "healthy ageing". Physical effort, including swimming in cold water (including bathing in natural water reservoirs), is widely recognized as a hardening factor, with a positive effect on the mental and physical health. At the same time, there is little scientific evidence to verify this hypothesis. In the literature to date, it is possible to obtain data on the impact of these factors on selected physiological and biochemical parameters of the blood, at the same time there are no results of research on the effect of immersing in cold water on mineral metabolism, especially bones, hence it seems important to perform such an analysis in relation to the key elements such as calcium (Ca), magnesium (Mg) and phosphorus (P). Taking the above into account, a hypothesis was put forward about the possibility of a positive effect of exercise in cold water on mineral metabolism and bone density in aging rats. The aim of the study was to evaluate the effect of an 8-week swimming training on mineral metabolism and bone density in aging rats in response to exercise in cold water (5oC) in comparison to swimming in thermal comfort (36oC) and sedentary (control) rats of both sexes. The examination of the concentration of the examined elements in the bones was carried out using inductively coupled plasma atomic emission spectrometry (ICP-OES). The mineral density of the femurs of the rats was measured using the Hologic Horizon DEXA System® densitometer. The results of our study showed that swimming in cold water affects bone mineral metabolism in aging rats by changing the Ca, Mg, P concentration and at the same time increasing their bone density. In males, a decrease in Mg concentration and no changes in bone density were observed. In the light of the research results, it seems that swimming in cold water may be a factor that positively modifies the bone aging process by improving the mechanisms affecting their density.

Keywords: swimming in cold water, adaptation to cold water, bone mineral metabolism, aging

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Authors: Benedetta Isella, Aleksander Drinic, Alissa Heim, Phillip Czichowski, Lisa Lauts, Hans Leemhuis

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Introduction: Membranes for guided bone regeneration are essential to perform a barrier function between the soft and the regenerating bone tissue. Bioabsorbable membranes are desirable in this field as they do not require a secondary surgery for removal, decreasing patient surgical risk. Collagen was the first bioabsorbable alternative introduced on the market, but its degradation time may be too fast to guarantee bone regeneration, and optimisation is needed. Silk fibroin, being biocompatible, slowly bioabsorbable, and processable into different scaffold types, could be a promising alternative. Objectives: The objective is to compare the general performance of a silk fibroin membrane for guided bone regeneration to current collagen alternatives developing suitable standardized tests for the mechanical and morphological characterization. Methods: Silk fibroin and collagen-based membranes were compared from the morphological and chemical perspective, with techniques such as SEM imaging and from the mechanical point of view with techniques such as tensile and suture retention strength (SRS) tests. Results: Silk fibroin revealed a high degree of reproducibility in surface density. The SRS of silk fibroin (0.76 ± 0.04 N), although lower than collagen, was still comparable to native tissues such as the internal mammary artery (0.56 N), and the same can be extended to general mechanical behaviour in tensile tests. The SRS could be increased by an increase in thickness. Conclusion: Silk fibroin is a promising material in the field of guided bone regeneration, covering the interesting position of not being considered a product containing cells or tissues of animal origin from the regulatory perspective and having longer degradation times with respect to collagen.

Keywords: guided bone regeneration, mechanical characterization, membrane, silk fibroin

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Authors: H. Yousefnia, A. Aghanejad, A. Mirzaei, R. Enayati, A. R. Jalilian, S. Zolghadri

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Bone metastases occur in many cases at an early stage of the tumour disease; however, their symptoms are recognized rather late. The aim of this study was the preparation and quality control of 111In-BPAMD for diagnostic purposes. 111In was produced at the Agricultural, Medical, and Industrial Research School (AMIRS) by means of 30 MeV cyclotron via natCd(p,x)111In reaction. Complexion of In‐111 with BPAMD was carried out by using acidic solution of 111InCl3 and BPAMD in absolute water. The effect of various parameters such as temperature, ligand concentration, pH, and time on the radiolabeled yield was studied. 111In-BPAMD was prepared successfully with the radiochemical purity of 95% at the optimized condition (100 µg of BPAMD, pH=5, and at 90°C for 1 h) which was measured by ITLC method. The final solution was injected to wild-type mice and biodistribution was determined up to 72 h. SPECT images were acquired after 2 and 24 h post injection. Both the biodistribution studies and SPECT imaging indicated high bone uptake while accumulation in other organs was approximately negligible. The results show that 111In-BPAMD can be used as an excellent tracer for diagnosis of bone metastases by SPECT imaging.

Keywords: biodistribution, BPAMD, 111In, SPECT

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Authors: Alaa T. Ali, Nevine H. Kheir El Din, Ehab S. Abdelhamid, Ahmed E. Amr

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Objective: Severe alveolar bone resorption is usually associated with a deficient amount of soft tissues. soft tissue expansion is introduced to provide an adequate amount of soft tissue over the grafted area. This study aimed to assess the efficacy of sub-periosteal self-inflating osmotic tissue expanders used as preparatory surgery before horizontal alveolar ridge augmentation using autogenous onlay block bone graft. Methods: A prospective randomized controlled clinical trial was performed. Sixteen partially edentulous patients demanding horizontal bone augmentation in the anterior maxilla were randomly assigned to horizontal ridge augmentation with autogenous bone block grafts harvested from the mandibular symphysis. For the test group, soft tissue expanders were placed sub-periosteally before horizontal ridge augmentation. Impressions were taken before and after STE, and the cast models were optically scanned and superimposed to be used for volumetric analysis. Horizontal ridge augmentation was carried out after STE completion. For the control group, a periosteal releasing incision was performed during bone augmentation procedures. Implants were placed in both groups at re-entry surgery after six months period. A core biopsy was taken. Histomorphometric assessment for newly formed bone surface area, mature collagen area fraction, the osteoblasts count, and blood vessel count were performed. The change in alveolar ridge width was evaluated through bone caliper and CBCT. Results: Soft tissue expander successfully provides a Surplus amount of soft tissues in 5 out of 8 patients in the test group. Complications during the expansion period were perforation through oral mucosa occurred in two patients. Infection occurred in one patient. The mean soft tissue volume gain was 393.9 ± 322mm. After 6 months. The mean horizontal bone gains for the test and control groups were 3.14 mm and 3.69 mm, respectively. Conclusion: STE with a sub-periosteal approach is an applicable method to achieve an additional soft tissue and to reduce bone block graft exposure and wound dehiscence.

Keywords: soft tissue expander, ridge augmentation, block graft, symphysis bone block

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Authors: N. Haj Salem, M. Belhadj, S. Ben Jomâa, R. Dhouieb, S. Saadi, M. A. Mesrati, A. Chadly

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Introduction: The hyoid bone is considered as one of many bones used to identify a missed person. There is a specificity of each population group in human identifications. Objective: To analyze the relationship between age, sex and metric parameters of hyoid bone in Tunisian population sample, using CT-scan. Materials and Methods: A prospective study was conducted in the Department of Forensic Medicine of FattoumaBourguiba Hospital of Monastir-Tunisia during 4 years. A total of 240 samples of hyoid bone were studied. The age of cases ranged from 18 days to 81 years. The specimens were collected only from the deceased of known age. Once dried, each hyoid bone was scanned using CT scan. For each specimen, 10 measurements were taken using a computer program. The measurements consisted of 6 lengths and 4 widths. A regression analysis was used to estimate the relationship between age, sex, and different measurements. For age estimation, a multiple logistic regression was carried out for samples ≤ 35 years. For sex determination, ROC curve was performed. Discriminant value finally retained was based on the best specificity with the best sensitivity. Results: The correlation between real age and estimated age was good (r²=0.72) for samples aged 35 years or less. The unstandardised canonical function equation was estimated using three variables: maximum length of the right greater cornua, length from the middle of the left joint space to the middle of the right joint space and perpendicular length from the centre point of a line between the distal ends of the right and left greater cornua to the centre point of the anterior view of the body of the hyoid bone. For sex determination, the ROC curve analysis reveals that the area under curve was at 81.8%. Discriminant value was 0.451 with a specificity of 73% and sensibility of 79%. The equation function was estimated based on two variables: maximum length of the greater cornua and maximum length of the hyoid bone. Conclusion: The findings of the current study suggest that metric analysis of the hyoid bone may predict the age ≤ 35 years. Sex estimation seems to be more reliable. Further studies dealing with the fusion of the hyoid bone and the current study could help to achieve more accurate age estimation rates.

Keywords: anthropology, age estimation, CT scan, sex determination, Tunisia

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Authors: Laura Canagueral-Pellice, Antonio Munar-Frau, Adaia Valls-Ontanon, Joao Carames, Federico Hernandez-Alfaro, Jordi Caballe-Serrano

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Objective: Guided bone regeneration (GBR) aims to replace the missing bone with a new structure to achieve long-term stability of rehabilitations. The aim of the present systematic review and meta-analysis is to determine the effect of barrier membranes on histological outcomes after GBR procedures. Moreover, the effect of the grafting material and tissue gain were analyzed. Materials & methods: Two independent reviewers performed an electronic search in Pubmed and Scopus, identifying all eligible publications up to March 2020. Only randomized controlled trials (RCTs) assessing a histological analysis of augmented areas were included. Results: A total of 6 publications were included for the present systematic review. A total of 110 biopsied sites were analysed; 10 corresponded to vertical bone augmentation procedures, whereas 100 analysed horizontal regeneration procedures. A mean tissue gain of 3 ± 1.48mm was obtained for horizontal defects. Histological assessment of new bone formation, residual particle and sub-epithelial connective tissue (SCT) was reported. The four main barrier membranes used were natural collagen membranes, e-PTFE, polylactic resorbable membranes and acellular dermal matrix membranes (AMDG). The analysis demonstrated that resorbable membranes result in higher values of new bone formation and lower values of residual particles and SCT. Xenograft resulted in lower new bone formation compared to allograft; however, no statistically significant differences were observed regarding residual particle and SCT. Overall, regeneration procedures adding autogenous bone, plasma derivate or growth factors achieved in general greater new bone formation and tissue gain. Conclusions: There is limited evidence favoring the effect of a certain type of barrier membrane in GBR. Data needs to be evaluated carefully; however, resorbable membranes are correlated with greater new bone formation values, especially when combined with allograft materials and/or the addition of autogenous bone, platelet reach plasma (PRP) or growth factors in the regeneration area. More studies assessing the histological outcomes of different GBR protocols and procedures testing different biomaterials are needed to maximize the clinical and histological outcomes in bone regeneration science.

Keywords: barrier membrane, graft material, guided bone regeneration, implant surgery, histology

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Authors: Alisha Gupta

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Osteoarthritis (OA) is the most common form of arthritis which is a degenerative joint disease causing joints to begin to break down and underlying bones to change. This “wear and tear” most frequently affects hands, hips, and knees. This is important because OA pain is considered to be a leading cause of mobility impairment in older adults, with hip and knee OA ranked 11th highest contributors to global disability. Bone tissue engineering utilizing polymer scaffolds and hydrogels is an emerging field for treating osteoarthritis. Polymer scaffolds provide a three-dimensional structure for tissue growth, and hydrogels can be used to deliver drugs and growth factors. The combination of the two materials creates a hybrid structure that can better withstand physiological and mechanical demands while also providing a more controlled environment for drug and nutrient delivery. I think using bone tissue engineering for making scaffold-hydrogel composites that are self-regenerating and vascularizing might be useful in solving this problem. Successful implementation can reconstruct healthy, simulated bone tissue on deficient applicants.

Keywords: tissue engineering, regenerative medicine, scaffold-hydrogel composites, osteoarthritis

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Authors: Moetazza M. Al-Shafei, Hala Abdel Karim, Eitedal M. Daoud, Hassan Zaki Hassuna

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Epilepsy is a common neurological disorder affecting all age groups. It is one of the world's most prevalent non-communicable diseases. Increased evidence suggesting that long term usage of anti-epileptic drugs can have adverse effects on bone mineralization and bone molding .Aiming to study these effects and to give guide lines to support bone health through early intervention. From Neurology Out-Patient Clinic kaser Elaini University Hospital, 60 Patients were enrolled, 40 patients on antiepileptic drugs for at least two years and 20 controls matched with age and sex, epileptic but before starting treatment both chosen under specific criteria. Patients were divided into four groups, three groups with monotherapy treated with either Phynetoin, Valporic acid or Carbamazipine and fourth group treated with both Valporic acid and Carbamazipine. Estimation of serum Carboxy-Terminal Telopeptide of Type I- Collagen(ICTP) bone resorption marker, serum 25(OH )vit D3, calcium ,magnesium and phosphorus were done .Results showed that all patients on AED had significant low levels of 25(OH) vit D3 (p<0.001) ,with significant elevation of ICTP (P<0.05) versus controls. In group treated with Phynotoin highly significant elevation of (ICTP) marker and decrease of both serum 25(OH) vit D3 (P<0, 0001) and serum calcium(P<0.05)versus control. Double drug group showed significant decrease of serum 25(OH) vit D3 (P<0.0001) and decrease in Phosphorus (P<0.05) versus controls. Serum magnesium showed no significant differences between studied groups. We concluded that Anti- epileptic drugs appears to be an aggravating factor on bone mineralization ,so therapeutically it can be worth wile to supplement calcium and vitamin D even before initiation of antiepileptic therapy. ICTP marker can be used to evaluate change in bone resorption before and during AED therapy.

Keywords: antiepileptic drugs, bone minerals, carboxy teminal telopeptidetype-1-collagen bone resorption marker, vitamin D

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Authors: Rajendra Kumar Kanojia

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Background; Massive bone gaps are common following road side accidents and injury to the tibia, specially open grade three fractures. It has been seen that the diaphyseal fractures in the tibia are prone to non-union, there are certain reasons known very well, like less soft tissues around the lower third tibia, less vascularity, less options of fixation of the fractures after trauma and prolonged surgical time, operation theatre time and special surgical means. Aim of study; To know the suitability of the ilizarov ring fixators in staged treatment of the fracture of the both bones leg, including tibia, we wish to see the role of ilizarov in management of open grade three fractures which have been operated and debrided, for getting the length use of ilizaorv ring in a tertiary canter is the aim of the study.

Keywords: open fracture, staged management, ilizarov, bone grafting, lengthening

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Authors: Xin Zhao

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3D printing is used in creating bone grafts of various architectures by printing materials in a layer-by-layer manner. Traditionally, to make materials printable, heating up or dissolving materials in organic solvents have been used, compromising their capability in loading biomolecules. Photocrosslinkable materials which are initially liquid and printable, and solidified upon light exposure are therefore developed. However, the existing photocrosslinkable materials are either too soft to bear load or non-degradable with potential long-term biocompatibility problems. Here, photocrosslinkable nanocomposite ink is developed composed of poly (lactide-co-propylene glycol-co-lactide) dimethacrylate (PmLnDMA) and hydroxyethyl methacrylate-functionalized hydroxyapatite nanoparticles (nHAMA) mimicking the hairy setae of gecko that can strongly interact with its surroundings to bear high load. Incorporation of nHAMA into PmLnDMA endows the nanocomposite ink with several advantages in (1) improved organic/inorganic interfacial compatibility to increase mechanical strength, (2) readily modulated rheological behaviors, wettability, and biodegradation, (3) enhanced osteoconductivity and osteoinductivity. Moreover, the ink can be rapidly crosslinked upon light exposure, load, and long-term release growth factors, and be printed into 3D bone scaffolds of various shapes and structures according to the patients’ needs. Altogether, this innovation will benefit patients all over the world who suffer from bone fractures, tumors, infections.

Keywords: photocrosslinkable nanocomposite, 3D printing, bone ink, personalized medicine

Procedia PDF Downloads 115

Authors: Faris Alkhalil, Rana Bitar, Amer Azaz, Hisham Natour, Noora Almeraikhi, Mohamad Miqdady

Abstract:

Background: Children with liver transplantation are achieving very good survival and so there is now a need to concentrate on achieving good health in these patients and preventing disease. Immunosuppressive medications have side effects that need to be monitored and if possible avoided. Glucocorticoids and calcineurin inhibitors are detrimental to bone and mineral homeostasis in addition steroids can also affect linear growth. Steroid sparing regimes in renal transplant children has shown to improve children’s height. Aim: We aim to review the growth and bone health of children post liver transplant by measuring bone mineral density (BMD) using dual energy X-ray absorptiometry (DEXA) scan and assessing if there is a clear link between poor growth and impaired bone health and use of long term steroids. Subjects and Methods: This is a single centre retrospective Cohort study, we reviewed the medical notes of children (0-16 years) who underwent a liver transplantation between November 2000 to November 2016 and currently being followed at our centre. Results: 39 patients were identified (25 males and 14 females), the median transplant age was 2 years (range 9 months - 16 years), and the median follow up was 6 years. Four patients received a combined transplant, 2 kidney and liver transplant and 2 received a liver and small bowel transplant. The indications for transplant included, Biliary Atresia (31%), Acute Liver failure (18%), Progressive Familial Intrahepatic Cholestasis (15%), transplantable metabolic disease (10%), TPN related liver disease (8%), Primary Hyperoxaluria (5%), Hepatocellular carcinoma (3%) and other causes (10%). 36 patients (95%) were on a calcineurin inhibitor (34 patients were on Tacrolimus and 2 on Cyclosporin). The other three patients were on Sirolimus. Low dose long-term steroids was used in 21% of the patients. A considerable proportion of the patients had poor growth. 15% were below the 3rd centile for weight for age and 21% were below the 3rd centile for height for age. Most of our patients with poor growth were not on long term steroids. 49% of patients had a DEXA scan post transplantation. 21% of these children had low bone mineral density, one patient had met osteoporosis criteria with a vertebral fracture. Most of our patients with impaired bone health were not on long term steroids. 20% of the patients who did not undergo a DEXA scan developed long bone fractures and 50% of them were on long term steroid use which may suggest impaired bone health in these patients. Summary and Conclusion: The incidence of impaired bone health, although studied in limited number of patients; was high. Early recognition and treatment should be instituted to avoid fractures and improve bone health. Many of the patients were below the 3rd centile for weight and height however there was no clear relationship between steroid use and impaired bone health, reduced weight and reduced linear height.

Keywords: bone, growth, pediatric, liver, transplantation

Procedia PDF Downloads 279

Authors: Vladyslav Povoroznyuk, Larysa Martynyuk, Iryna Syzonenko, Liliya Martynyuk

Abstract:

Osteoporosis is one of the important problems in postmenopausal women due to an increased risk of sudden and unexpected fractures. This study is aimed to determine the connection between bone mineral density (BMD) and trabecular bone score (TBS) in Ukrainian women suffering from metabolic syndrome. Participating in the study, 566 menopausal women aged 50-79 year-old were examined and divided into two groups: Group A included 336 women with no obesity (BMI ≤ 29.9 kg/m²), and Group B – 230 women with metabolic syndrome (diagnosis according to IDF criteria, 2005). Dual-energy X-ray absorptiometry was used for measuring of lumbar spine (L1-L4), femoral neck, total body and forearm BMD and bone quality indexes (last according to Med-Imaps installation). Data were analyzed using Statistical Package 6.0. A significant increase of lumbar spine (L1-L4), femoral neck, total body and ultradistal radius BMD was found in women with metabolic syndrome compared to those without obesity (p < 0.001) both in their totality and in groups of 50-59 years, 60-69 years, and 70-79 years. TBS was significantly higher in non-obese women compared to metabolic syndrome patients of 50-59 years and in the general sample (p < 0.05). Analysis showed significant positive correlation between body mass index (BMI) and BMD at all levels. Significant negative correlation between BMI and TBS (L1-L4) was established. Despite the fact that BMD indexes were significantly higher in women with metabolic syndrome, the frequency of vertebral and non-vertebral fractures did not differ significantly in the groups of patients.

Keywords: bone mineral density, trabecular bone score, metabolic syndrome, fracture

Procedia PDF Downloads 284

Authors: Ashlesha Khanapure, Harsh Kashyap, Abhinav Anand, Sanjana Habib, Anupama Bidargaddi

Abstract:

Technologies that are developing quickly are being developed daily in a variety of disciplines, particularly the medical field. For the purpose of detecting bone fractures in X-ray pictures of different body segments, our work compares the ResNet-50 and MobileNetV3 architectures. It evaluates accuracy and computing efficiency with X-rays of the elbow, hand, and shoulder from the MURA dataset. Through training and validation, the models are evaluated on normal and fractured images. While ResNet-50 showcases superior accuracy in fracture identification, MobileNetV3 showcases superior speed and resource optimization. Despite ResNet-50’s accuracy, MobileNetV3’s swifter inference makes it a viable choice for real-time clinical applications, emphasizing the importance of balancing computational efficiency and accuracy in medical imaging. We created a graphical user interface (GUI) for MobileNet V3 model bone fracture detection. This research underscores MobileNetV3’s potential to streamline bone fracture diagnoses, potentially revolutionizing orthopedic medical procedures and enhancing patient care.

Keywords: CNN, MobileNet V3, ResNet-50, healthcare, MURA, X-ray, fracture detection

Procedia PDF Downloads 63

Authors: B. V. Murlimanju

Abstract:

Background: Scaphoid bone is commonly fractured among all the bones of the wrist. The fracture can damage the arteries and would cause avascular necrosis of the scaphoid. In this present study, the goal was to study the topography and number of nutrient foramina in the scaphoid bones of South Indian population. Methods: We studied 46 human scaphoid bones, among them 20 were left sided and 26 belonged to the right side. The scaphoid bones were available at the department of anatomy of our institution. The scaphoid bones were macroscopically observed for the topography and number of nutrient foramina. The data was collected, tabulated and analyzed. Results: The nutrient foramina were observed in all the scaphoid bones (100%). The locations of the foramina were over the non-articular surfaces in all these scaphoids. They were distributed over the palmar and dorsal surfaces. The foramina were found proximal as well as distal to the mid waist of the scaphoid bone. Their number ranged between 9 and 54 in each scaphoid bone. The number ranged between 2-24 over the palmar surface and 7-36 over the dorsal surface. They ranged between 2-24 proximal to the waist and 3-39 distal to the waist. Conclusion: The knowledge of arterial supply, topography of nutrient foramen and their number is essential to understand the concepts of avascular necrosis of scaphoid bone. It will be enlightening to understand the non-union of the fracture of waist of the scaphoid. The morphological data is required to the operating hand surgeon. We do believe that the present study has provided additional information about the topography and number of nutrient foramina of the human scaphoid bones.

Keywords: avascular necrosis, nutrient foramen, scaphoid, vascular

Procedia PDF Downloads 269

Authors: B. V. Murlimanju, P. J. Jiji, Latha V. Prabhu, Mangala M. Pai

Abstract:

Background: The scaphoid is the most commonly fractured bone of the wrist. The fracture may disrupt the vessels and end up as the avascular necrosis of the bone. The objective of the present study was to investigate the morphology and number of the nutrient foramina in the cadaveric dried scaphoid bones of the Indian population. Methods: The present study included 46 scaphoid bones (26 right sided and 20 left sided) which were obtained from the gross anatomy laboratory of our institution. The bones were macroscopically observed for the nutrient foramina and the data was collected with respect to their number. The tabulation of the data and analysis were done. Results: All of our specimens (100%) exhibited the nutrient foramina over the non-articular surfaces. The foramina were observed only over the palmar and dorsal surfaces of the scaphoid bones. The foramina were observed both proximal and distal to the mid waist of the scaphoid bone. The foramen ranged between 9 and 54 in each scaphoid bone. The foramina over the palmar surface ranged between, 2-24 in number. The foramina over the dorsal surface ranged between, 7-36 in number. The foramina proximal to the waist ranged between 2 and 24 in number and distal to the waist ranged between 3 and 39. Conclusion: We believe that the present study has provided additional data about the nutrient foramina of the scaphoid bones. The data is enlightening to the orthopedic surgeon and would help in the hand surgeries. The morphological knowledge of the vasculature, their foramina of entry and their number is required to understand the concepts in the avascular necrosis of the proximal scaphoid and non-union of the fracture at the waist of the scaphoid.

Keywords: avascular necrosis, nutrient, scaphoid, vascular

Procedia PDF Downloads 343

Authors: Amin Jabbari

Abstract:

The state of the art in major 3D printing technologies, such as powder-based and slurry based, has led researchers to investigate the ability to fabricate bone scaffolds for bone tissue engineering using biomaterials. In addition, 3D printing technology can simulate mechanical and biological surface properties and print with high precision complex internal and external structures that match their functional properties. Polymer matrix composites reinforced with particulate bioceramics, hydrogels reinforced with particulate bioceramics, polymers coated with bioceramics, and non-porous bioceramics are among the materials that can be investigated for bone scaffold printing. Furthermore, it was shown that the introduction of high-density micropores into the sparingly dissolvable CSiMg10 and dissolvable CSiMg4 shell layer inevitably leads to a nearly 30% reduction in compressive strength, but such micropores can easily influence the ion release behavior of the scaffolds. Also, biocompatibility tests such as cytotoxicity, hemocompatibility and genotoxicity were tested on printed parts. The printed part was tested in vitro, and after 24-26 h for cytotoxicity, and 4h for hemocompatibility test, the CSiMg4@CSiMg10-p scaffolds were found to have significantly higher osteogenic capability than the other scaffolds of implantation. Overall, these experimental studies demonstrate that 3D printed, additively-manufactured bioceramic calcium (Ca)-silicate scaffolds with appropriate pore dimensions are promising to guide new bone ingrowth.

Keywords: AM, 3D printed implants, bioceramic, tissue engineering

Procedia PDF Downloads 66

Authors: Anthony Khawaja, Jacques Prioux, Ghassan Maalouf, Rawad El Hage

Abstract:

The regular practice of physical activities characterized by significant mechanical stresses stimulates bone formation and improves bone mineral density (BMD) in the most solicited sites. The purpose of this study was to explore the relationships between maximum power and bone variables in a group of young adult men. Identification of new determinants of BMD, bone mineral content (BMC) and hip geometric indices in young adult men, would allow screening and early management of future cases of osteopenia and osteoporosis. Fifty-three young adult men (18 – 35yr) voluntarily participated in this study. Weight and height were measured, and body mass index was calculated. Body composition, BMC and BMD were determined for each individual by Dual-energy X-ray absorptiometry (DXA; GE Healthcare, Madison, WI) at whole body (WB), lumbar spine (L1-L4), total hip (TH), and femoral neck (FN). FN cross-sectional area (CSA), strength index (SI), buckling ratio (BR), FN section modulus (Z), cross-sectional moment of inertia (CSMI) and L1-L4 TBS were also evaluated by DXA. The vertical jump was evaluated using a field test (sargent test). Two main parameters were retained: vertical jump performance (cm) and power (w). The subjects performed three jumps with 2 minutes of recovery between jumps. The highest vertical jump was selected. Maximum power (P max, in watts) was calculated. Maximum power was positively correlated to WB BMD (r = 0.41; p < 0.01), WB BMC (r = 0.65; p < 0.001), L1-L4 BMC (r = 0.54; p < 0.001), FN BMC (r = 0.35; p < 0.01), TH BMC (r = 0.50; p < 0.001), CSMI (r = 0.50; p < 0.001), CSA (r = 0.33; p < 0.05). Vertical jump was positively correlated to WB BMC (r = 0.31; p < 0.05), L1-L4 BMC (r = 0.40; p < 0.01), CSMI (r = 0.29; p < 0.05). The current study suggests that maximum power is a positive determinant of BMD, BMC and hip geometric indices in young adult men. In addition, it shows also that maximum power is a stronger positive determinant of bone variables than vertical jump in this population. Implementing strategies to increase maximum power in young adult men may be useful for preventing osteoporotic fractures later in life.

Keywords: bone variables, maximum power, osteopenia, osteoporosis, vertical jump, young adult men

Procedia PDF Downloads 178

Authors: Vladyslav Povoroznyuk, Larysa Martynyuk, Iryna Syzonenko, Liliya Martynyuk

Abstract:

Medical, social, and economic relevance of osteoporosis is caused by reducing quality of life, increasing disability and mortality of the patients as a result of fractures due to the low-energy trauma. This study is aimed to examine the associations of metabolic syndrome components, bone mineral density (BMD) and trabecular bone score (TBS) in menopausal women with non-vertebral fractures. 1161 menopausal women aged 50-79 year-old were examined and divided into three groups: A included 419 women with increased body weight (BMI - 25.0-29.9 kg/m²), B – 442 females with obesity (BMI >29.9 kg/m²)i and C – 300 women with metabolic syndrome (diagnosis according to IDF criteria, 2005). BMD of lumbar spine (L1-L4), femoral neck, total body and forearm was investigated with usage of dual-energy X-ray absorptiometry. The bone quality indexes were measured according to Med-Imaps installation. All analyses were performed using Statistical Package 6.0. BMD of lumbar spine (L1-L4), femoral neck, total body, and ultradistal radius was significant higher in women with obesity and metabolic syndrome compared to the pre-obese ones (p<0.001). TBS was significantly higher in women with increased body weight compared to obese and metabolic syndrome patients. Analysis showed significant positive correlation between waist circumference, triglycerides level and BMD of lumbar spine and femur. Significant negative association between serum HDL level and BMD of investigated sites was established. The TBS (L1-L4) indexes positively correlated with HDL (high-density lipoprotein) level. Despite the fact that BMD indexes were better in women with metabolic syndrome, the frequency of non-vertebral fractures was significantly higher in this group of patients.

Keywords: bone mineral density, trabecular bone score, metabolic syndrome, fracture

Procedia PDF Downloads 210