Stereology and histogram analysis of backscattered electron images: age changes in bone

Elemental composition of primary lamellar bone differs between parous and nulliparous rhesus macaque females

Extracting life history information from mineralized hard tissues of extant and extinct species is an ongoing challenge in evolutionary and conservation studies. Primary lamellar bone is a mineralized tissue with multidien periodicity that begins deposition prenatally and continues until adulthood albeit with concurrent resorption, thus maintaining a record spanning several years of an individual's life. Here, we use field-emission scanning electron microscopy and energy-dispersive X-ray analysis to measure the relative concentrations of calcium, phosphorous, oxygen, magnesium and sodium in the femora of seven rhesus macaque with known medical and life-history information. We find that the concentration of these elements distinguishes parous from nulliparous females; that in females calcium and phosphorus are lower in bone formed during reproductive events; and that significant differences in relative magnesium concentration correlate with breastfeeding in infants.

Early-Onset Osteoporosis: Rare Monogenic Forms Elucidate the Complexity of Disease Pathogenesis Beyond Type I Collagen

Early-onset osteoporosis (EOOP), characterized by low bone mineral density (BMD) and fractures, affects children, premenopausal women and men aged <50 years. EOOP may be secondary to a chronic illness, long-term medication, nutritional deficiencies, etc. If no such cause is identified, EOOP is regarded primary and may then be related to rare variants in genes playing a pivotal role in bone homeostasis. If the cause remains unknown, EOOP is considered idiopathic. The scope of this review is to guide through clinical and genetic diagnostics of EOOP, summarize the present knowledge on rare monogenic forms of EOOP, and describe how analysis of bone biopsy samples can lead to a better understanding of the disease pathogenesis. The diagnostic pathway of EOOP is often complicated and extensive assessments may be needed to reliably exclude secondary causes. Due to the genetic heterogeneity and overlapping features in the various genetic forms of EOOP and other bone fragility disorders, the genetic diagnosis usually requires the use of next-generation sequencing to investigate several genes simultaneously. Recent discoveries have elucidated the complexity of disease pathogenesis both regarding genetic architecture and bone tissue-level pathology. Two rare monogenic forms of EOOP are due to defects in genes partaking in the canonical WNT pathway: LRP5 and WNT1. Variants in the genes encoding plastin-3 (PLS3) and sphingomyelin synthase 2 (SGMS2) have also been found in children and young adults with skeletal fragility. The molecular mechanisms leading from gene defects to clinical manifestations are often not fully understood. Detailed analysis of patient-derived transiliac bone biopsies gives valuable information to understand disease pathogenesis, distinguishes EOOP from other bone fragility disorders, and guides in patient management, but is not widely available in clinical settings. Despite the great advances in this field, EOOP remains an insufficiently explored entity and further research is needed to optimize diagnostic and therapeutic approaches. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

Biochemical assessment of nanostructures in human trabecular bone: Proposal of a Raman microspectroscopy based measurements protocol

BACKGROUND

Improvements to the understating of the compositional contributions of bone mineral and organic components to the competence of trabecular bone are crucial. The purpose of this study was to propose a protocol to study biochemical composition of trabecular bone, based on two combined Raman analysis methodologies.

MATERIAL AND METHODS

Both cluster and single point Raman mappings were obtained, in order to assess bone degeneration associated with aging, disease, or injury, and to help in the evaluation and development of successful therapies. In this study, human trabecular bone has been analysed throughout a) Raman cluster analysis: bone mineral content, carbonate-to-phosphate ratio (both from the mineral components), the crosslinking and nature/secondary structure of collagen (both from the organic components); and b) Single point Raman spectra, where Raman points related to the minerals and organic components were also obtained, both techniques were employed in spectra attained at 400 to 1700 cm^-1.

RESULTS

Multivariate analysis confirmed: 1) the different spectral composition, 2) the existence of centroids grouped by chemical affinity of the various components of the trabecular bone, and 3) the several traces of centroids and distribution of chemical compositional clusters.

CONCLUSIONS

This study is important, because it delivers a study protocol that provides molecular variations information in both mineral and collagen structure of trabecular bone tissue. This will enable clinicians to benefit knowing the microstructural differences in the bone subjected to degeneration of their patients.

Nanostructure in the trabecular bone of postmenopausal women: Mechanical and chemical analysis

The possibility of diagnosis and prediction of multiple disorders in trabecular bone through nano-biomechanics and chemical analysis are summarized. Improvements to the understating of the compositional contributors of bone mineral and organic components to mechanical competence are crucial. Viscoelastic properties and Raman characterization have been used to evaluate possible alterations of the trabecular bone associated with aging, disease, or injury. In this study, the trabecular bone of postmenopausal women has been analyzed throughout. (a) Nanomechanical characterization, by using nano-DMA: complex modulus, tan δ, loss modulus (E'), and storage modulus (E'); and (b) Raman analysis: relative presence of minerals, carbonate-to-phosphate ratio (both from the mineral components), the crosslinking and nature/secondary structure of collagen (both from the organic components). Complementary nano-morphological studies were done assessing roughness (SRa) and collagen fibrils width, on this trabecular bone. A general idea of the behavior of the viscoelastic performance can be obtained by the Tan δ (E″/E'), that achieved 0.98GPa of damping. 249nm and 0.898μm of SRa roughness and fibrils width were obtained, respectively. The relative presence of minerals, the carbonate-to-phosphate ratio, the crosslinking and the nature/secondary structure of collagen, between 700 and 1700cm^-1, were also obtained, in order to propose a study protocol for trabecular bone characterization.

Inter-individual gene variants associated with trabecular bone plasticity: A step forward in the personal genomics of degenerative bone disease

Continuing tissue destruction in osteoarthrosis is maintained by molecular pathways related to an unbalanced chondrocyte metabolism, the loss of reactive oxygen species (ROS) homeostasis, increase catabolism in a degraded matrix and the limited response to growth factors due to cell aging. Rare deleterious gene variants driving relevant molecular pathways may play a key role in the pathogenesis and genetic control of common diseases and may also influence the common gene variants observed in GWAS. We use molecular profiling technologies based on massive sequencing of genes to interrogate clinical samples for a variety of molecules involved in the pathogenesis pathways of OA and also to derive new insights for drug targeting discovery at an early stage of the disease. By whole-exome sequencing performed in OA patients with extreme phenotypes and in non-related individuals without clinical evidence of OA, the most predominant of the rare gene variants found were non-synonymous single-nucleotide variants (SNV) from exonic DNA regions and with missense functional effects predicting a moderate impact on protein function. A total of 629, 577, and 639 gene variants for the TPF, COA, and ANHNF patients, respectively, were found not to be shared with the 20 non-disease-related individuals. After subtraction of the 306 variants shared among the OA patients, we obtained the individual profiles of 323, 271, and 333 gene variants, for the TPF, COA, and ANHNF patients, respectively. After filtering by the bioinformatics, genetic, and biological criteria established to assess the clinical consequences, comparative analysis of trio sequences using integrative genome visualization tool clearly demonstrate the differences between patients. Analysis of the collagen gene variants identified 78, 20, and 43 genetic collagen variants for the three extreme phenotypes. Rare gene variants encoding for proteins that are less abundant in the trabecular bone matrix, together with those responsible for the control and regulation of bone turnover and plasticity of subchondral trabecular bone, play important roles in OA and help to define the clinical phenotype.

Relationship between sample volumes and modulus of human vertebral trabecular bone in micro-finite element analysis

Micro-finite element (μFE) models have been widely used to assess the biomechanical properties of trabecular bone. How to choose a proper sample volume of trabecular bone, which could predict the real bone biomechanical properties and reduce the calculation time, was an interesting problem. Therefore, the purpose of this study was to investigate the relationship between different sample volumes and apparent elastic modulus (E) calculated from μFE model. 5 Human lumbar vertebral bodies (L1-L5) were scanned by micro-CT. Cubic concentric samples of different lengths were constructed as the experimental groups and the largest possible volumes of interest (VOI) were constructed as the control group. A direct voxel-to-element approach was used to generate μFE models and steel layers were added to the superior and inferior surface to mimic axial compression tests. A 1% axial strain was prescribed to the top surface of the model to obtain the E values. ANOVA tests were performed to compare the E values from the different VOIs against that of the control group. Nonlinear function curve fitting was performed to study the relationship between volumes and E values. The larger cubic VOI included more nodes and elements, and more CPU times were needed for calculations. E values showed a descending tendency as the length of cubic VOI decreased. When the volume of VOI was smaller than (7.34mm(3)), E values were significantly different from the control group. The fit function showed that E values approached an asymptotic values with increasing length of VOI. Our study demonstrated that apparent elastic modulus calculated from μFE models were affected by the sample volumes. There was a descending tendency of E values as the length of cubic VOI decreased. Sample volume which was not smaller than (7.34mm(3)) was efficient enough and timesaving for the calculation of E.

Trends in trabecular architecture and bone mineral density distribution in 152 individuals aged 30-90 years

The strength of trabecular bone depends on its microarchitecture and its tissue level properties. However, the interrelation between these two determinants of bone quality and their relation to age remain to be clarified. Iliac crest bone cores (n=152) from individuals aged 30-90 years were analyzed by quantitative backscattered electron imaging. Univariate and multivariate analyses were conducted to determine whether epidemiological parameters (age, sex or BMI), structural histomorphometrical variables (BV/TV, Tb.Th, Tb.N and Tb.Sp) and osteoid-related indices (OV/BV, OS/BS or O.Th) predict the degree of bone mineralization. While sex and BMI were not associated with bone mineralization, age was positively correlated with the most frequently occurring calcium concentrations (Ca peak), the percentage of highly mineralized bone areas (Ca high) and, in the case of adjusted covariates, also the mean calcium content (Ca mean). Bone volume fraction and trabecular thickness were both negatively correlated with Ca mean. However, trabecular thickness was additionally associated with Ca peak, Ca high as well as the amount of low mineralized bone (Ca low) and was the only structural parameter predicting bone mineralization independent of age. Furthermore, our analyses demonstrated that osteoid variables - within a normal range (<2% OV/BV) - were significantly associated with all mineralization parameters and represent the only predictor for the mineralization heterogeneity (Ca width). Taken together, we showed that elevated trabecular bone mineralization correlates with aging and bone loss. However, these associations are attributable to trabecular thinning that comes along with high bone mineralization due to the loss of low mineralized bone surfaces. Therefore, we demonstrated that the degree of areally resolved bone mineral is primarily associated with the amount of physiological osteoid present and the thickness of mineralized bone in trabeculae.

Lower cortical porosity and higher tissue mineral density in Chinese American versus white women

Asian women have lower rates of hip and forearm fractures compared to other racial groups despite lower areal bone mineral density (aBMD). We have demonstrated microarchitectural differences, including greater cortical thickness (Ct.Th) and cortical volumetric BMD (Ct.BMD), in Chinese American versus white women. Yet it is not known whether greater Ct.BMD in Chinese American women is a result of greater tissue mineral density (TMD) or reduced cortical porosity (Ct.Po). Using an advanced segmentation algorithm based on high-resolution peripheral quantitative computed tomography (HR-pQCT) images, we tested the hypothesis that Chinese American women have better cortical skeletal integrity owing to lower Ct.Po and higher Ct.TMD compared with white women. A total of 78 Chinese American women (49 premenopausal and 29 postmenopausal) and 114 white women (46 premenopausal and 68 postmenopausal) were studied. Premenopausal Chinese American versus white women had greater Ct.Th, Ct.BMD, and Ct.TMD at both the radius and tibia, and decreased Ct.Po (p < 0.05). A similar pattern was observed between postmenopausal Chinese American and white women. As expected, postmenopausal versus premenopausal women had lower Ct.BMD at the radius and tibia in both races (p < 0.001). Ct.Po largely increased between premenopausal and postmenopausal women, whereas Ct.TMD decreased by 3% to 8% (p < 0.001) in both races. Age-related differences in Ct.Po and Ct.TMD did not differ by race. In summary, both reduced Ct.Po and greater Ct.TMD explain higher Ct.BMD in Chinese American versus white women. Thicker and preserved cortical bone structure in Chinese American women may contribute to greater resistance to fracture compared to white women.

Nanomechanical mapping of the osteochondral interface with contact resonance force microscopy and nanoindentation

The bone-cartilage, or osteochondral, interface resists remarkably high shear stresses and rarely fails, yet its mechanical characteristics are largely unknown. A complete understanding of this hierarchical system requires mechanical-property information at the length scales of both the interface and the connecting tissues. Here, we combined nanoindentation and atomic force microscopy (AFM) methods to investigate the multiscale mechanical properties across the osteochondral region. The nanoindentation modulus M ranged from that of the subchondral bone (M=22.8±1.8GPa) to that of hyaline articular cartilage embedded in PMMA (M=5.7±1.0GPa) across a narrow transition region <5μm wide. Contact resonance force microscopy (CR-FM), which measures the frequency and quality factor of the AFM cantilever's vibrational resonance in contact mode, was used to determine the relative storage modulus and loss tangent of the osteochondral interface. With better spatial resolution than nanoindentation, CR-FM measurements indicated an even narrower interface width of 2.3±1.2μm. Furthermore, CR-FM revealed a 24% increase in the viscoelastic loss tangent from the articular calcified cartilage into the PMMA-embedded hyaline articular cartilage. Quantitative backscattered electron imaging provided complementary measurement of mineral content. Our results provide insight into the multiscale functionality of the osteochondral interface that will advance understanding of disease states such as osteoarthritis and aid in the development of biomimetic interfaces.

TRANSVERSE ISOTROPIC ELASTIC PROPERTIES OF VERTEBRAL TRABECULAR BONE MATRIX MEASURED USING MICROINDENTATION UNDER DRY CONDITIONS (EFFECTS OF AGE, GENDER, AND VERTEBRAL LEVEL)

The mechanical properties of bone extracellular matrix have become of increasing interest for the understanding of vertebral fracture risk. Depth-sensing indentation techniques allow the measurement of directional elastic properties of trabecular bone ex vivo with a high spatial resolution. Transverse isotropic elastic properties of vertebral trabecular bone obtained from two orthogonal directions were investigated using microindentation under dry conditions focusing on the influence of microanatomical location, age, gender, vertebral level, and anatomic direction on these properties. Biopsies were obtained from 104 human vertebrae (T1–L3) with a median age of 65 (21–94) years. Significantly, higher indentation moduli were found for indentations on axial than on transverse cross-sections of trabeculae (p < 0.01). Indentation moduli in the core were 1.05 to 1.12 times higher than in the periphery (p < 0.01). No difference in stiffness could be detected between males and females (p > 0.05) and different ages (p > 0.5). Vertebral level showed a weak correlation (p = 0.073, r2 ≈ 0.17). These results provide insights in the transverse isotropic properties of trabecular bone matrix related to age, gender, microanatomical location, and anatomic direction for a broad spectrum of human vertebrae.

Rehydration of vertebral trabecular bone: influences on its anisotropy, its stiffness and the indentation work with a view to age, gender and vertebral level

For understanding the fracture risk of vertebral bodies the macroscopic mechanical properties of the cancellous core are of major interest. Due to the hierarchical nature of bone, these depend in turn on the micromechanical properties of bone extracellular matrix which is at least linear elastic transverse isotropic. The experimental determination of local elastic properties of bone ex vivo necessitates a high spatial resolution which can be provided by depth-sensing indentation techniques. Using microindentation, this study investigated the effects of rehydration on the transverse isotropic elastic properties of vertebral trabecular bone matrix obtained from two orthogonal directions with a view to microanatomical location, age, gender, vertebral level and anatomic direction in a conjoint statistics. Biopsies were gained from 104 human vertebrae (T1-L3) with a median age of 65 years (21-94). Wet elastic moduli were 29% lower (p<0.05) than dry elastic moduli. For wet indentation the ratio of mean elastic moduli tested in axial to those tested in transverse indentation direction were 1.13 to 1.23 times higher than for dry indentation. The ratio of elastic moduli tested in the core to those tested in the periphery of trabeculae was 1.05 to 1.16 times higher when testing wet. Age and gender did not show any influence on the elastic moduli for wet and dry measurements. The correlation between vertebral level and elastic moduli became weaker after rehydration (p(wet)<0.09, r(wet)(2)=0.14) and (p(dry)<0.01, r(wet)(2)=0.38). Elastic and dissipated energies were similarly affected by rehydration compared to the elastic modulus. No significant difference in the energies could be found for gender (p>0.05). Significant differences in the energies were found for age (p<0.05) after rehydration. Qualitative and quantitative insights into the transverse isotropic elastic properties of trabecular bone matrix under two testing conditions over a broad spectrum of vertebrae could be given. This study could help to further improve understanding of the mechanical properties of vertebral trabecular bone.

Validation of a voxel-based FE method for prediction of the uniaxial apparent modulus of human trabecular bone using macroscopic mechanical tests and nanoindentation

Assessment of the mechanical properties of trabecular bone is of major biological and clinical importance for the investigation of bone diseases, fractures and their treatments. Finite element (FE) methods are getting increasingly popular for quantifying the elastic and failure properties of trabecular bone. In particular, voxel-based FE methods have been previously used to calculate the effective elastic properties of trabecular microstructures. However, in most studies, bone tissue moduli were assumed or back-calculated to match the apparent elastic moduli from experiments, which often lead to surprisingly low values when compared to nanoindentation results. In this study, voxel-based FE analysis of trabecular bone is combined with physical measures of volume fraction, micro-CT (microCT) reconstructions, uniaxial mechanical tests and specimen-specific nanoindentation tests for proper validation of the method. Cylindrical specimens of cancellous bone were extracted from human femurs and their volume fraction determined with Archimede's method. Uniaxial apparent modulus of the specimens was measured with an improved tension-compression testing protocol that minimizes boundary artefacts. Their microCT reconstructions were segmented to match the measured bone volume fraction and used to create full-size voxel models with 30-45 microm element size. For each specimen, linear isotropic elastic material properties were defined based on specific nanoindentation measurements of its embedded bone tissue. Linear FE analyses were finally performed to simulate the uniaxial mechanical tests. Additional parametric analyses were performed to evaluate the potential errors on the predicted apparent modulus arising from variations in segmentation threshold, tissue modulus, and the use of 125-mm(3) cubic sub-regions. The results demonstrate an excellent correspondence between experimental measures and FE predictions of uniaxial apparent modulus. In conclusion, the adopted voxel-based FE approach is found to be a robust method to predict the linear elastic properties of human cancellous bone, provided segmentation of the microCT reconstructions is carefully calibrated, tissue modulus is known a priori and the entire region of interest is included in the analysis.

The bone mineralization density distribution as a fingerprint of the mineralization process

The inhomogeneous mineral content and its topographical distribution on a microscopic scale are major determinants of the mechanical quality of trabecular bone. The kinetics of bone tissue deposition and resorption together with the kinetics of the mineralization process determine the distribution of mineral in the tissue. The heterogeneity of the mineral content is described by the well-established bone mineralization density distribution (BMDD), which is experimentally accessible, e.g., using quantitative electron backscattering imaging (qBEI). In the present work, we demonstrate that the shape of the BMDD histogram of trabecular bone reflects directly the mineralization kinetics. Based on the experimental BMDD data of trabecular bone from healthy human adults and using a mathematical model for the remodeling and the mineralization process, the following main results were obtained. The peaked BMDD reflects necessarily a two-phase mineralization process with a fast primary phase and a slow secondary phase where the corresponding time constants differ three orders of magnitude. The obtained mineralization law, which describes the increase in the mineral content in a bone packet as a function of time, provides information not only about the initial mineralization surge, but also about the slow increase afterwards on the time scale of years. In addition to the mineralization kinetics the turnover rate of the remodeling process has a strong influence on the peak position and the shape of the BMDD. The described theoretical framework opens new possibilities for an analysis of experimentally measured BMDDs with respect to changes caused by diseases or treatments. It allows addressing whether changes in the BMDD have to be attributed to a variation in the turnover rate which consequently affects the density distribution or to a primary disorder in the mineralization process most likely reflecting alterations of the organic matrix. This is of important clinical interest because it helps to find therapeutic approaches directly targeting the primary etiological defects to correct the patients' BMDD towards normal BMDD.

Strength of cancellous bone trabecular tissue from normal, ovariectomized and drug-treated rats over the course of ageing

Hormone therapy (HT) drugs and bisphosphonates prevent osteoporosis by inhibiting osteoclastic bone resorption. However, the effects of osteoporosis and anti-resorptive drugs on the mechanical behavior of the bone tissue constituting individual trabeculae have not yet been quantified. In this study, we test the hypothesis that the mechanical properties of bone trabecular tissue will differ for normal, ovariectomized and drug-treated rat bones over the course of ageing. Microtensile testing is carried on individual trabeculae from tibial bone of ovariectomized (OVX) rats, OVX rats treated with tibolone and placebo-treated controls. The method developed minimizes errors due to misalignment and stress concentrations at the grips. The local mineralization of single trabeculae is compared using micro-CT images calibrated for bone mineral content assessment. Our results indicate that ovariectomy in rats increases the stiffness, yield strength, yield strain and ultimate stress of the mineralized tissue constituting trabecular bone relative to normal; we found significant differences (P < 0.05) at 14, 34 and 54 weeks of treatment. These increases are complemented by a significant increase in the mineral content at the tissue level, although overall bone mineral density and mass are reduced. With drug treatment, the properties remain at, or slightly below, the placebo-treated controls levels for 54 weeks. The higher bone strength in the OVX group may cause the trabecular architecture to adapt as seen during osteopenia/osteoporosis, or alternately it may compensate for loss of trabecular architecture. These findings suggest that, in addition to the effects of osteoporosis and subsequent treatment on bone architecture, there are also more subtle processes ongoing to alter bone strength at the tissue level.

Stress-concentrating effect of resorption lacunae in trabecular bone

Analyses of the distributions of stress and strain within individual bone trabeculae have not yet been reported. In this study, four trabeculae were imaged and finite elements models were generated in an attempt to quantify the variability of stress/strain in real trabeculae. In three of these trabeculae, cavities were identified with depths comparable to values reported for resorption lacunae ( approximately 50 microm)-although we cannot be certain, it is most probable that they are indeed resorption lacunae. A tensile load was applied to each trabeculum to simulate physiological loading and to ensure that bending was minimized. The force carried by each trabecula was calculated from this value using the average cross sectional area of each trabecula. The analyses predict that very high stresses (>100 MPa) existed within bone trabecular tissue. Stress and strain distributions were highly heterogeneous in all cases, more so in trabeculae with the presumptive resorption lacunae where at least 30% of the tissue had a strain greater than 4000 micoepsilon in all cases. Stresses were elevated at the pit of the lacunae, and peak stress concentrations were located in the longitudinal direction ahead of the lacunae. Given these high strains, we suggest that microdamage is inevitable around resorption lacunae in trabecular bone, and may cause the bone multicellular unit to proceed to resorb a packet of bone in the trabeculum rather than just resorb whatever localized area was initially targeted.

Side-to-side differences in cortical bone mineral density of tibiae in young male athletes

The importance of physical activity in the development and maintenance of bone mineral density (BMD) is widely accepted. However, the effects on cortical BMD have not been clarified in detail. The present study examined bilateral asymmetries in cortical BMD of the tibia using peripheral quantitative computed tomography. Subjects comprised 37 young male athletes and 57 controls (age range, 18-28 years). BMD and geometrical indices were determined in bilateral tibiae. Cortical and trabecular BMD were calculated at the diaphysis and distal metaphysis, respectively. Cortical width, periosteal cross-sectional area, and cross-sectional moment of inertia were calculated using tomographic data of the tibial diaphysis. In athletes, the non-dominant leg showed greater cortical BMD than the dominant leg (mean difference, 5.42%; P < 0.0001). Cortical width and moment of inertia were also greater in the non-dominant leg. Periosteal area displayed no significant difference between legs. The control group exhibited similar results except for cortical BMD. No differences in trabecular BMD were noted between legs in either athletes or controls. These results implies the existence of mechanisms for the mechanical adaptation of cortical BMD. Dominant leg is used for mobility or manipulation whereas the non-dominant leg contributes to support the actions of the dominant leg. Loading differences in bilateral legs in young athletes might affect the remodeling rate leading to the side-to-side differences in cortical BMD.

Quantitative scanning acoustic microscopy compared to microradiography for assessment of new bone formation

Recently, it has been shown that quantitative scanning acoustic microscopy (SAM) is a powerful tool to image the acoustic impedance of even inhomogeneous materials like bone. Therefore, the aim of our study was to compare SAM to conventional microradiography with respect to histomorphometrical assessment of undecalcified sections of newly formed bone. Forty specimens were harvested 12 weeks after implantation of either autogenous cancellous bone graft or 5.0 mg of Osteogenic Protein-1 (BMP-7) in a critical-sized defect model in sheep. Undecalcified transverse bone sections of 500 microm thickness were investigated with conventional microradiography and SAM. Linear regression analysis was carried out to compare the measurements of the area of new bone formation within the defect sites. Both methods allowed for good discrimination between newly formed bone and cortical bone at the edges of the former defect. Images obtained with SAM revealed a better resolution and sharpness compared to that of microradiographs since SAM imaging unlike microradiography does not depend on the thickness of bone sections. The results of quantitative histomorphometric analysis obtained by both methods showed no significant differences, and it was possible to predict 90% of the variability of each method (coefficient of determination r2 = 0.90; P < 0.0001). In conclusion, SAM offers comparable quantitative histomorphometric information with a better spatial resolution than conventional microradiography. Thus, SAM is a promising new micro-visualizing technique for basic bone research.

Micro- and nano-structural analyses of damage in bone

Skeletal fractures represent a significant medical and economic burden for our society. In the US alone, age-related hip, spine, and wrist fractures accounted for more than $17 billion in direct health care costs in 2001. Moreover, skeletal fractures are not limited to the elderly; stress fractures and impact/trauma-related fractures are a significant problem in younger people also. Gaining insight into the mechanisms of fracture and how these mechanisms are modulated by intrinsic as well as extrinsic factors may improve the ability to define fracture risk and develop and assess preventative therapies for skeletal fractures. Insight into failure mechanisms of bone, particularly at the ultrastructural-level, is facilitated by the development of improved means of defining and measuring tissue quality. Included in these means are microscopic and spectroscopic techniques for the direct observation of crack initiation, crack propagation, and fracture behavior. In this review, we discuss microscopic and spectroscopic techniques, including laser scanning confocal microscopy (LSCM), scanning electron microscopy (SEM), transmission electron microscopy (TEM) and Raman spectroscopic imaging for visually observing microdamage in bone, and the current understanding of damage mechanisms derived from these techniques.

Vertebral cancellous bone turn-over: microcallus and bridges in backscatter electron microscopy

Backscatter electron microscopy (BSE) is a powerful technique for investigating cancellous bone structure. Its main function is to offer information regarding the degree of mineralization of the tissue within individual trabeculae. To illustrate the qualitative information that can be drawn from BSE imaging technique, we present a study on human vertebral cancellous bone. This tissue is continuously remodeled through osteoclastic resorption and osteoblastic new bone apposition. It is thought that osteoclastic resorption pits are especially deleterious for vertebral bone architecture since they often perforate the thin trabeculae; the osteoblasts being unable to repair the gap. In addition, excessive stress may also disrupt the architecture in case of trabecular fracture or damage accumulation. Waves of new bone formation were easy to identify in BSE. Often these waves were connecting both edges of a perforation and called bridges. Additionally, we present a few images of microcallus formations. A microcallus is described as a small mass of woven bone that generally repairs a trabecula. The microstructural aspects of different microcalluses are presented and discussed. Both bridges and microcallus should be considered as examples of the repair porcess since they obviously preserve the connectivity of the trabeculae. However, bridges were much more frequent than microcallus (396 vs 15). Both mechanisms probably illustrate the normal response to different local stimuli.

Registration of confocal scanning laser microscopy and quantitative backscattered electron images for the temporospatial quantification of mineralization density in 18-month old thoroughbred racehorse articular calcified cartilage

Combined backscattered electron scanning electron microscopy (BSE SEM) and confocal scanning laser microscopy (CSLM) have been used to put tissue mineralization data into the context of soft tissue histology and fluorescent label information. Mineralization density (Dm) and linear accretion rate (LAR) are quantifiable parameters associated with mineralizing fronts within calcified tissues. Quantitative BSE (qBSE) may be used to determine Dm, while CSLM may be used to detect label fluorescence from which LAR is calculated. Eighteen-month old Thoroughbred horses received single calcein injections 19 and 8 days prior to euthanasia, labeling sites of active mineralization with fluorescent bands. Confocal scanning laser microscopy images of articular calcified cartilage (ACC) from distal third metacarpal condyles were registered to qBSE images of the same sites using an in-house program. ImageJ and Sync Windows enabled the simultaneous collection of LAR and Dm data. The repeatability of the registration and measurement protocols was determined. Dm profiles between calcein labels were explored for an association with time. Dm was 119.7 +/- 24.5 (mean +/- standard deviation) gray levels (where 0 = backscattering from monobrominated and 255 from monoiodinated dimethacrylate standards, respectively), while modal and maximum LAR were 0.45 and 3.45 microm/day, respectively. Coefficients of variation (CV) for Dm were 0.70 and 0.77% with and without repeat registration, respectively; CVs for LAR were 1.90 and 2.26% with and without repeat registration, respectively. No relationship was identified between Dm and time in the 11-day interlabel interval. Registration of CSLM to qBSE images is sufficiently repeatable for quantitative studies of equine ACC.

First inventory of resorption lacunae on rods and plates of trabecular bone as observed by scanning electron microscopy

In the present study a novel systematic distribution scheme of resorption lacunae (RL) was applied using scanning electron microscopy. RL, classified as either reticulate patch resorption lacunae (RPR) or as longitudinally extended resorption lacunae (LER) [11, were analyzed and quantified according to their localizations on rods (middle, nodes or both) and plates (central or peripheral) in standardized segments from the femoral head of 24 Caucasian subjects without bone disease. Age and gender variations were explored. No clear gender-related distribution pattern could be detected on plates. On rods of males, however, the distribution of RL tended to be higher at the nodes, but seemed to be more prevalent in the middle or extended from the middle to the nodes of rods in females. Certain other non-conclusive tendencies in relation to age, gender, type of RL and localization were observed.

Bone mineralization density and femoral neck fragility

The traditional view of osteoporotic fractures is that they result from a reduction in bone mass combined with alterations in the micro-architecture. Apart from the effects of bone remodeling, the material properties of the remaining bone are thought to be unaffected. To test this, we compared the degree of matrix mineralization in femoral neck biopsies taken from cases of intracapsular hip fracture with age- and sex-matched postmortem controls. Whole femoral neck biopsies from seven female hip fracture cases (72-90 years) and nine controls (68-94 years) were embedded in methylmethacrylate, and sections stained with Solochrome Cyanin R for analysis of osteoid. The blocks were then diamond micro-milled, carbon coated, and analyzed for the degree of matrix mineralization using halogenated dimethacrylate standards for quantitative backscattered electron (qBSE) imaging (20 kV, entire block face, sampling interval 5 microm). The BSE gray scale was adjusted such that 0 corresponds to an electron backscattering coefficient of 0.1159 (approximately 1.70 g/ml) and 255-0.1519 (approximately 2.18 g/ml). Remodeling and mineralization data were analyzed for both the whole biopsy face and on a regional (anterior; inferior, posterior, or superior) basis. Over the whole biopsy, the level of mineralization was lower in the cases than the postmortem controls (-2.8%, P < 0.05). In both cases and controls, cortical mineralization was higher in the inferior (compressive) region compared with superior (tensile) region (P < 0.05). Mineralization was lower in all regions of the cases (inferior: -3.3%; posterior: -3.1%; anterior: -2.7%; superior: -1.6%) compared to the controls. Mineralization density in cancellous bone was not regionally dependent but was lower in the fracture cases (-3.5%; P = 0.001). Although there were weak relationships between osteoid formation (%O.Ar/B.Ar) and the mean level of mineralization in both cortical (P = 0.068) and cancellous (P < 0.01) bone, adjustment for this did not markedly affect the case-control differences. In conclusion, this study has shown that in cases of intracapsular hip fracture, matrix mineralization is reduced in the femoral neck. Unexpectedly, in view of the likely role of mild to moderate vitamin D deficiency osteopathy in hip fracture, this decreased mineralization was independent of osteoid indices and therefore potentially independent of bone age. This raises the possibility that alterations in the bone matrix such as excessive glycation or changes in the composition of the collagen fibrils affect its mineralization in hip fracture cases.

Quantitative analysis of the mineral content of sound and carious primary dentine using BSE imaging

Backscattered electron-scanning electron microscope (BSE-SEM) imaging has been recommended as a reliable tool to quantify the mineralisation state of calcified tissues and is commonly used in bone studies. The aim of this study is to investigate the use of BSE imaging to quantitatively analyse the mineral content of sound and carious dentine. Eight primary molars with untreated carious dentine were embedded in resin, axially sectioned and fine polished for this study. The BSE images were from a solid-state detector in an SEM operating at 1.5Torr gas pressure. BSE images of a number of different elements and compounds with atomic number ranged from 4 to 26 were analysed prior to the test to calibrate the experimental conditions and an enamel-carbon block. The mineral analysis was based on the change in BSE intensity (measured in graylevels). The results showed that variation in graylevels accurately represented difference in the atomic number and BSE coefficient of the test materials. The mineral content of sound primary dentine in the most regions was 59.3+/-5.5 wt.%, but it decreased gradually to be just 41.82+/-6.74 wt.% adjacent to the pulp. The carious dentine showed a marked reduction in mineral content which proceeded progressively toward the cavity floor, in which the minimum value of less than 10 wt.% was normally found in the outer layer of the lesion. The results show that BSE imaging is a simple and reliable technique that can be used to quantify the mineral content of sound and carious dentine. More importantly the variable pressure SEM offers an approach to minimize the impact of dehydration on carious dentine specimens.

Altered tissue properties induce changes in cancellous bone architecture in aging and diseases

The mechanical properties of cancellous bone depend on its architecture and the tissue properties of the mineralized matrix. The architecture is continuously adapted to external loads. In this paper, it was assumed that changes in tissue properties leading to changes in tissue deformation can induce adaptation of the architecture. We asked whether changes in cancellous bone architecture with aging and in e.g. early osteoarthrosis can be explained from changes in tissue properties. This was investigated using computer models in which the cancellous architecture was adapted to external loads. Bone tissue with deformations below a certain threshold was resorbed, deformations above another threshold induced formation. Deformations between these two boundaries, in the 'lazy zone', did not induce bone adaptation. The effects of changes in bone tissue stiffness on bone mass, global stiffness and architecture were investigated. The bone gain (40-60%) resulting from a 50% decrease in tissue stiffness (simulating diseased tissue) was much larger than the bone loss (2-30%) resulting from a 50% increase in tissue stiffness (simulating highly mineralized, old tissue). The adaptation induced by a decrease in tissue stiffness resulted in an almost constant stiffness in the main load bearing direction, but the transversal stiffness decreased. An increased tissue stiffness resulted in a higher stiffness in the main direction and overcompensation in the transversal directions: the global stiffness could become even smaller than the stiffness of the original model. Concluding, we showed that changes in trabecular bone in aging and diseases can be partly explained from changes in tissue properties.

Correlating the mechanical properties to the mineral content of carious dentine—a comparative study using an ultra-micro indentation system (UMIS) and SEM-BSE signals

The deterioration of the mechanical properties of carious dentine was assumed to be associated with the decrease in mineral content due to the carious process. This study aimed to compare the mechanical properties of carious dentine studied by an ultra-micro-indentation-system (UMIS) and the mineral content determined using backscattered scanning electron (BSE) imaging. Eight axial sectioned and fine polished primary molar teeth with untreated carious dentine were measured for hardness and elastic modulus using the UMIS. On each specimen two centrally located linear arrays of indentations were made from the pulp to lesion cavity floor, followed by the capture of a BSE image using a solid-state detector. The BSE intensity at the same spot as the indentation array on each specimen was analysed and compared to the UMIS results. The results show that the mechanical properties of dentine are dependent on its mineral content. The decrease in mechanical properties of carious dentine, namely hardness and elastic modulus are directly linked to the reduction in its mineral content (r2 = 0.93 and 0.92, respectively). The relationship between dentine hardness and elastic modulus values (y) can be expressed as an exponential function of the mineral content in wt.% (x) that is y = ae(bx).

Intrapopulation variability in mineralization density at the human femoral mid-shaft

One of several microstructural variables known to affect the mechanical properties of bone is the degree of mineralization of bone matrix. The aim of this study was to examine mineralization density, and its variability with age and sex, from a biomechanical perspective. Histological sections, prepared from mid-shaft femora obtained at autopsy from 40 individuals, were imaged using quantitative backscattered electron microscopy. Each cross-section montage was divided into 48 segments according to anatomical position. Mean grey-level values were quantified for each segment. One-way ANOVA with Tukey HSD post hoc tests were used to test for differences in mineralization between segments, age groups and sexes. Results showed a decrease in overall degree of mineralization density with adult age, but an increase in its coefficient of variation. Degree of mineralization was significantly lower in the periosteal third of the cortex, particularly in the antero-lateral aspect. This pattern was most prevalent amongst the youngest individuals in the sample. Whereas males between ages 45-64 years had a higher average degree of mineralization than females, the opposite was true of the older age group. Mineralization significantly decreased between middle and older age groups in males, but not in females. Despite limited consistencies in the location of high and low average mineralization bone through the cortex, the degree of interindividual variation, even within a single age and sex group, overwhelmed population level trends. The patterns of variability identified in this study are consistent with results of an analysis of collagen fibre orientation using the same sample material.

Irreversible perforations in vertebral trabeculae?

In human cancellous bone, osteoclastic perforations resulting from normal remodeling were generally considered irreversible. In human vertebral samples, examined by backscatter electron microscopy, there was clear evidence of bridging of perforation defects by new bone formation. Hence trabecular perforations may not be irreversible.

INTRODUCTION

Preservation of the trabecular bone microarchitecture is essential to maintain its load-bearing capacity and prevent fractures. However, during bone remodeling, the osteoclasts may perforate the platelike trabeculae and disconnect the structure. Large perforations (>100 microm) are generally considered irreversible because there is no surface on which new bone can be laid down. In this work, we investigated the outcome of these perforations on human vertebral cancellous bone.

MATERIALS AND METHODS

Using backscatter electron microscopy, we analyzed 264 vertebral bone samples from the thoracic and lumbar spine of nine subjects (44-88 years old). Nine fields (2 x 1.5 mm) were observed on each block. Several bone structural units (BSUs) were visible on a single trabecula, illustrating a dynamic, historical aspect of bone remodeling. A bridge was defined as a single and recent BSU connecting two segments of trabeculae previously separated by osteoclastic resorption. They were counted and measured (length and breadth, microm).

RESULTS AND CONCLUSION

We observed 396 bridges over 2376 images. By comparison, we found only 15 microcalluses on the same material. The median length of the bridge was 165 microm (range, 29-869 microm); 86% being longer than 100 microm and 35% longer than 200 microm. Their breadth was 56 microm (range, 6-255 microm), but the thinnest were still in construction. Bridges were found in all nine subjects included in the study, suggesting that it is a common feature of normal vertebral bone remodeling. These observations support the hypothesis that perforation could be repaired by new bone formation, and hence, might not be systematically irreversible.

Constant mineralization density distribution in cancellous human bone

The degree of mineralization of bone matrix is an important factor in determining the mechanical competence of bone. The remodeling and modeling activities of bone cells together with the time course of mineralization of newly formed bone matrix generate a characteristic bone mineralization density distribution (BMDD). In this study we investigated the biological variance of the BMDD at the micrometer level, applying a quantitative backscattered electron imaging (qBEI) method. We used the mean calcium concentration (Ca(Mean)), the most frequent calcium concentration (Ca(Peak)), and full width at half maximum (Ca(Width)) to characterize the BMDD. In none of the BMDD parameters were statistically significant differences found due to ethnicity (15 African-American vs. 27 Caucasian premenopausal women), skeletal site variance (20 ilium, 24 vertebral body, 13 patella, 13 femoral neck, and 13 femoral head), age (25 to 95 years), or gender. Additionally, the interindividual variance of Ca(Mean) and Ca(Peak), irrespective of biological factors, was found to be remarkably small (SD < 2.1% of means). However, there are significant changes in the BMDD in the case of bone diseases (e.g., osteomalacia) or following clinical treatment (e.g., alendronate). From the lack of intraindividual changes among different skeletal sites we conclude that diagnostic transiliac biopsies can be used to determine the BMDD variables of cancellous bone for the entire skeleton of the patient. In order to quantify deviations from normal mineralization, a reference BMDD for adult humans was calculated using bone samples from 52 individuals. Because we find the BMDD to be essentially constant in healthy adult humans, qBEI provides a sensitive means to detect even small changes in mineralization due to bone disease or therapeutic intervention.

Changes in bone structure and mass with advancing age in the male C57BL/6J mouse

To determine whether the mouse loses bone with aging and whether the changes mimic those observed in human aging, we examined the changes in the tibial metaphysis and diaphysis in the male C57BL/6J mouse over its life span using microcomputed tomography (microCT). Cancellous bone volume fraction (BV/TV) decreased 60% between 6 weeks and 24 months of age. Loss was characterized by decreased trabecular number (Tb.N), increased trabecular spacing (Tb.Sp), and decreased connectivity. Anisotropy decreased while the structure model index increased with age. Cortical bone thickness increased between 6 weeks and 6 months of age and then decreased continuously to 24 months (-12%). Cortical bone area (Ct.Ar) remained constant between 6 and 24 months. Fat-free weight reached a peak at 12 months and gradually declined to 24 months. Total mass lost between 12 and 24 months reached 10%. Overall, the age-related changes in skeletal mass and architecture in the mouse were remarkably similar to those seen in human aging. Furthermore, the rapid early loss of cancellous bone suggests that bone loss is not just associated with old age in the mouse but rather occurs as a continuum from early growth. We conclude that the C57BL/6J male mouse maybe a useful model to study at least some aspects of age-related bone loss in humans.

Trabecular bone's mechanical properties are affected by its non-uniform mineral distribution

The bone remodeling process takes place at the surface of trabeculae and results in a non-uniform mineral distribution. This will affect the mechanical properties of cancellous bone, because the properties of bone tissue depend on its mineral content. We investigated how large this effect is by simulating several non-uniform mineral distributions in 3D finite element models of human trabecular bone and calculating the apparent stiffness of these models. In the 'linear model' we assumed a linear relation between mineral content and Young's modulus of the tissue. In the 'exponential model' we included an empirical exponential relation in the model. When the linear model was used the mineral distribution slightly changed the apparent stiffness, the difference varied between an 8% decrease and a 4% increase compared to the uniform model with the same BMD. The exponential model resulted in up to 20% increased apparent stiffness in the main load-bearing direction. A thin less mineralized surface layer (28 microm) and highly mineralized interstitial bone (mimicking mineralization resulting from anti-resorptive treatment) resulted in the highest stiffness. This could explain large reductions in fracture risk resulting from small increases in BMD. The non-uniform mineral distribution could also explain why bone tissue stiffness determined using nano-indentation is usually higher than finite element (FE)-determined stiffness. We conclude that the non-uniform mineral distribution in trabeculae does affect the mechanical properties of cancellous bone and that the tissue stiffness determined using FE-modeling could be improved by including detailed information about mineral distribution in trabeculae in the models.

Ageing human bone: factors affecting its biomechanical properties and the role of collagen

The incidence of fractures increases with age. This is partly due to extraosseous factors and partly to the increased fragility of the bone material itself. Ageing adversely affects the "quality" of human bone material, its elastic and ultimate properties. The hypothesis here is that these effects are caused by factors such as architectural changes, compositional changes, physicochemical changes, changes at the micromechanical level, and the degree of prior in vivo microdamage. Examination of the extent of the secondary osteonal area, the porosity level, the calcium content, the mineral/wet weight fraction, the dry density, the condition of the collagen and its content in mature x-links, the elasticity of osteonal and interstitial lamellae at the microscopic level and the numerical- and surface-density of the in vivo fatigue microcracks has been undertaken. The findings show that some factors simply affect the stiffness and the strength of bone, while others soley affect its toughness. We discuss the implications of these findings in the context of the composite nature of the ageing bone material matrix.

Bone wound healing after maxillary molar extraction in ovariectomized aged rats: quantitative backscattered electron image analysis

The processes of bone wound healing after maxillary molar extraction in ovariectomized aged rats were examined by means of quantitative backscattered electron image analysis and energy-dispersive X-ray microanalysis. Six-month-old female rats were either sham-operated or underwent bilateral ovariectomy (OVX), and 60 days postoperatively, the maxillary first molars were extracted. On post-extraction days 7, 30, and 60, the dissected and resin-embedded maxillae were micromilled in the transverse direction through the extracted alveolar sockets, and new bone formation on the buccal maxillary bone surface and within the extracted alveolar sockets was examined. In both sham-operated control and OVX rats, new bone formation was recognized on the buccal bone surface, as well as within the extracted sockets, and increased daily through to day 60. In comparison to sham-operated controls, new bone formation in OVX rats was significantly decreased both on the buccal bone surface and within the extracted sockets. Our results suggest that bone wound healing by new bone formation after maxillary molar extraction is significantly decreased in OVX-induced osteoporosis.

Validation of quantitative backscattered electron imaging for the measurement of mineral density distribution in human bone biopsies

The measurement of bone mineral density (BMD) using X-rays is usually employed to monitor the mineral content in a given portion of bone. However, this method cannot differentiate between changes in bone volume or in degree of mineralization of the bone matrix. In contrast to BMD, bone mineral density distribution (BMDD), as measured on bone sections by quantitative backscattered electron imaging (qBEI), is able to distinguish differences in the degree of mineralization. For routine clinical research, we have validated the method of calibration and standardization of the backscattered electron (BE) signal. Carbon and aluminum were used as reference materials for BE gray levels and osteoid and apatite for calcium concentration. Experiments were performed to get knowledge about precision (intraassay variance-instrumental stability and interassay variance-reproducibility) and accuracy (standardization) of this method as well as the biological variance (intraindividual and interindividual) in human bone. On transiliac biopsies or necropsies from 20 individuals having had accidental death (13 females, 7 males, age 30-85 years) BMDD measurements were conducted. The patients' medical history as well as the histomorphology of these bones showed no evidence of metabolic bone disease. For instance, the standard deviations of the weighted mean calcium concentrations were <0.3%, <0.4%, <0.9%, and <2.6% of the mean for the intraassay, interassay, intraindividual, and interindividual variations, respectively. In addition, a mean BMDD histogram for transiliac bone specimens was calculated from the 20 aforementioned individuals. The method used allows detection of the degree of mineralization independently from the actual bone volume, a result that seems to be of special interest in the assessment of the effect of treatments for osteoporosis. The power of this technique is demonstrated by using bone from a patient with a metabolic bone disease. In this case of osteomalacia due to celiac disease, the mean calcium concentration in the bone matrix was reduced by 19.3% as compared with normal.

Errors in quantitative backscattered electron analysis of bone standardized by energy-dispersive x-ray spectrometry

Backscattered electron (BSE) imaging has proven to be a useful method for analyzing the mineral distribution in microscopic regions of bone. However, an accepted method of standardization has not been developed, limiting the utility of BSE imaging for truly quantitative analysis. Previous work has suggested that BSE images can be standardized by energy-dispersive x-ray spectrometry (EDX). Unfortunately, EDX-standardized BSE images tend to underestimate the mineral content of bone when compared with traditional ash measurements. The goal of this study is to investigate the nature of the deficit between EDX-standardized BSE images and ash measurements. A series of analytical standards, ashed bone specimens, and unembedded bone specimens were investigated to determine the source of the deficit previously reported. The primary source of error was found to be inaccurate ZAF corrections to account for the organic phase of the bone matrix. Conductive coatings, methylmethacrylate embedding media, and minor elemental constituents in bone mineral introduced negligible errors. It is suggested that the errors would remain constant and an empirical correction could be used to account for the deficit. However, extensive preliminary testing of the analysis equipment is essential.

Effect of estrogen suppression on the mineralization density of iliac crest biopsies in young women as assessed by backscattered electron imaging

The effects of estrogen suppression on bone mineralization in young women were studied by quantitative backscattered electron (BSE) imaging of transiliac biopsies taken before and after treatment for endometriosis. Treatment (6 months) was with analogs of gonadotrophin releasing hormone (GnRH) given either alone (six paired biopsies), which resulted in a marked reduction in the levels of circulating estrogen, or in conjunction with tibolone, a synthetic steroid with estrogenic, progestrogenic, and androgenic properties (four paired biopsies). Estrogen withdrawal increased (p < 0.01) and concomitant tibolone treatment decreased (p < 0.05) the overall mean bone density. Estrogen withdrawal increased the fraction of bone with a high mineralization density [pretreatment: 0.236+/-0.007; GnRH: 0.279+/-0.009, mean +/- standard error of the mean (SEM); p < 0.01]. The concomitant addition of tibolone reversed these effects and increased the proportion of bone with a low mineralization density (pretreatment: 0.198 +/- 0.005; tibolone: 0.230 +/-0.008, p < 0.01). Using previously published data, the mean bone density was inversely correlated with mean wall thickness in cancellous bone (p = 0.030) and with the percentage of active osteons (p = 0.023) in cortical bone. Although treatment had similar effects on the mean bone mineralization density of cortical and cancellous bone, there were different distributions of mineralization between the two sites, with cancellous bone having more skewed and kurtotic distributions both before and after estrogen withdrawal. This study indicates that a short-term estrogen suppression results in the accumulation of bone with a higher mineralization density. As bone with a high mineral content has a decreased impact resistance, this might increase fracture risk. Understanding the cellular and biochemical mechanisms responsible for the local distribution of bone mineral when estrogen is withdrawn may allow the development of new strategies for maintaining bone quality after menopause.

Mineralisation density of human mandibular bone: quantitative backscattered electron image analysis

This study examined the tissue level mineralisation density distribution in mandibles from 88 adult humans. Mandibles (19-96 y) were sectioned vertically in midline (MID), mental foramen (MF), and third molar (M3) regions. Surgical fragments from M3 were obtained from individuals aged 16-38 y. All specimens were cleaned, embedded in PMMA, micromilled and examined by digital 20 kV backscattered electron (BSE) stereology. Quantitation was based on rescaling image histograms to the signal range between a monobrominated (0) and a monoiodinated (255) dimethacrylate resin standard. Mineralisation density increased with age (r=0.70; P < 0.0001): the mean for 39 individuals aged between 16 and 50 y was significantly lower (P < 0.0001) than for 35 individuals over 51 y (mean (+/-S.E.M.): 158.20 (1.63) and 174.71 (1.27) normalised grey level units respectively). There was good correlation in mean mineralisation density between different sites in the same mandible, but MID was significantly less highly mineralised than the other sites: MID 173.90, MF 177.34, M3 177.11 (P < 0.002 and 0.01 for MF and M3 respectively; paired t test), as was the alveolar bone density when compared with the bone of the inferior cortex (e.g. MID: 171.13 (1.53) and 174.46 (1.14) P < 0.0001). No sex difference was found. Partially dentate mandibles generally had regions of higher mineralisation than fully dentate and edentulous mandibles. The lowest density bone occurred at the alveolar crest anteriorly and superolingually at M3, matching sites of net resorption following tooth loss. Highest densities were found inferolingually at MID, inferiorly at MF and buccally at M3, matching the sites thought to experience the highest functional strains. This stresses the importance that local factors may have in the remodelling of the edentulous mandible. Morphology showed that there is a preponderance of highly mineralised cement lines, and of packets containing dead, mineralised, osteocytes.

Determining mineral content variations in bone using backscattered electron imaging

The mechanical properties of bones are greatly influenced by the ratio of organic constituents to mineral. Determination of bone mineral content on a macroscopic scale is straightforward, but microscopic variations, which can yield new insights into remodelling activities, mechanical strength, and integrity, are profoundly more difficult to measure. Measurement of microscopic mineral content variations in bone material has traditionally been performed using microradiography. Backscattered electron (BSE) imaging is a technique with significantly better resolution than microradiography with demonstrated consistency, and it does not suffer from projection-effect errors. We report results demonstrating the applicability of quantitative BSE imaging as a tool for measuring microscopic mineral content variations in bones representing a broad range of mineralization. Bones from ten species were analyzed with Fourier-transformed infrared spectroscopy, X-ray diffraction, energy dispersive X-ray spectrometry, ash measurements, and BSE imaging. BSE image intensity (graylevel) had a very strong positive correlation to mineral (ash) content. Compositional and crystallographic variations among bones had negligible influence on backscattered electron graylevels. The present study confirms the use of BSE imaging as a tool to measure the microscopic mineral variability in a broad range of mineralized tissues.

Scanning electron microscopy of bone: instrument, specimen, and issues

There are many ways available now to maximise and analyse the information that can be obtained on the structure and constitution of bone using SEM. This paper considers a range of methods and the problems that arise relating to instrumentation and methodology as they apply to the use of SEM in the study of bone. In addition to the review content, some novel technical approaches to the SEM of bone are considered here for the first time; these include low kV imaging for the detection of new surface bone packets (and residual demineralized matrix after resorption), low kV BSE imaging of uncoated, embedded, and unembedded samples, environmental SEM for the study of wet tissue, low distortion, very low magnification imaging for the study of cancellous bone architecture, the use of multiple detectors for fast electrons in improving the imaging of porous samples, and high resolution, low voltage imaging for the study of collagen degradation during bone resorption.

Mineral density quantitation of the human cortical iliac crest by backscattered electron image analysis: variations with age, sex, and degree of osteoarthritis

Bone samples from the rim of the iliac crest were obtained at autopsy from 59 patients aged 23 to 75 years, of whom 10 men and 10 women aged 50-75 years had osteoarthritis diagnosed by hand X-rays. An equal number in the same age group and 10 men and 9 women aged less than 50 years were without osteoarthritis. After embedding the bone in PMMA, the blocks were cut, polished, and coated with carbon. The fractions of bone falling within four consecutive bands of signal level were derived from digital backscattered electron imaging. Normal males had more low and medium density bone and normal females more very high density phase tissue proportionately. In both male and female osteoarthritis cases, low and medium fractions were low. The very high density fraction was mainly calcified fibrocartilage; when it was excluded from the calculations, the low, medium, and high phases occurred equally in normal males but increased stepwise in normal females and in osteoarthritis cases of both sexes. The results suggest a lower rate of bone renewal in females than males, and in male osteoarthritis subjects than normal males. An increased proportion of bone of high density would reduce the quality of the bone by increasing its stiffness.