Manipulation of osteoclastogenesis: Bioactive multiphasic silica/collagen composites and their effects of surface and degradation products

The intent of the present study was to demonstrate that multiphasic silica/collagen xerogels are able to manipulate cellular processes. These xerogels were prepared by a sol-gel approach allowing the incorporation of mineral phases. The resulting nanocomposites are designed as biomaterial for bone regeneration. Human osteoclasts derived from peripheral blood mononuclear cells were cultured both indirectly and directly, either in presence of different xerogel types or on their surface, to investigate the factor with the main influence on osteoclastogenesis. To this end, the incorporation of a third phase to silica/collagen xerogels was used to affect osteoclastogenesis. In cell culture, ambient ion conditions controlled by both the degradation products of the xerogel and the bioactivity-dependent ion release and reprecipitation were shown to have the main effect on osteoclast specific enzyme tartrate-resistant acid phosphatase (TRAP) 5b. Late stage of osteoclastogenesis characterized by resorption was strongly dependent on the xerogels composition. Surface chemistry of the xerogels was displayed to play an important role in osteoclast resorption. Biphasic silica/collagen xerogels and triphasic xerogels with calcium carbonate offered widespread resorbed areas, whereas hydroxyapatite containing xerogels showed distinctly reduced resorption. The incorporation of strontium carbonate and phosphate, respectively, as third phase changed TRAP 5b activity dose-dependently and inhibited resorption within 21 days. Quantitative evaluation on osteoclast differentiation was carried out using biochemical methods (TRAP 5b, cathepsin K) and was supported by confocal laser scanning microscopy and scanning electron microscopy (SEM). Qualitative estimation of resorption was carried out by SEM.

Development and evaluation of an internet-based blended-learning module in biomedicine for university applicants--Education as a challenge for the future

Background

Biomedical science, especially biomaterials, is an expanding field in medicine. Universities are being challenged to gain the best students for a later academic career. Pre-university assessment of pupils has become crucial to reach this aim. Blended learning is an emerging paradigm for science education even though it has not yet been rigorously assessed, especially in the pupil/undergraduate situation. The aim of the study was to develop and preliminarily test a blended-learning system in biomedicine for university applicants.

Methods

An internet-based blended-learning module in material science was developed in close collaboration between a university (Biomaterials Department, Dresden TU), a German Gymnasium and an internationally oriented medical college (IMC®, Münster). Forty pre-university students were taught by this learning module composed of school education and internet-based knowledge transfer and involved in the evaluation of the utility of this learning tool. Finally, the students took first-year university examinations in order to evaluate the success of this kind of education.

Results

The internet-based blended-learning module as a combination of e-learning tutorials and live online lectures which was applied in phase 3 of this study was developed on the basis of the findings of both pre-university studies. The results of the learning behavior regarding the number of invokes and the dwell time of the individual pages of the pre-university learning material, the results of the online evaluation and the results of the pre-phase examination were successively used to optimize the next phase. At the end of the pre-university learning, seven of eight participants were able to pass the first-year university examination followed by nationally accepted credit award.

Conclusion

Internet-based blended-learning module proved to be suitable to prepare students for biomedical university education while also giving them the possibility to assess their qualifications for studying biomedicine and subsequent scientific careers. Moreover, the module can help universities to find the best students.

Head & Face Medicine reviewer acknowledgement 2015

The editors of Head & Face Medicine would like to thank all reviewers who have contributed their time and expertise to the journal in Volume 11 (2015).

Reviewer acknowledgement 2014

The Editors of Head & Face Medicine would like to thank all our reviewers who have contributed to the journal in Volume 10 (2014).

Reviewer acknowledgement 2013

Contributing reviewers

The Editors of Head & Face Medicine would like to thank all our reviewers who have contributed to the journal in Volume 9 (2013).

Reviewer acknowledgement 2012

Contributing reviewers

The Editors of Head & Face Medicine would like to thank all our reviewers who have contributed to the journal in Volume 8 (2012).

Computer-aided approach for customized cell-based defect reconstruction

Computer-aided technologies like computer-aided design (CAD), computer-aided manufacturing (CAM), and a lot of other features like finite element method (FEM) have been recently employed for use in medical ways like in extracorporeal bone tissue engineering strategies. Aim of this pilot experimental study was to test whether autologous osteoblast-like cells cultured in vitro on individualized scaffolds can be used to support bone regeneration in a clinical environment. Mandibular bone defects were surgically introduced into the mandibles of Göttinger minipigs and the scaffold of the defect site was modelled by CAD/CAM techniques. From the minipigs harvested autologous bone cells from the porcine calvaria were cultivated in bioreactors. The cultured osteoblast-like cells were seeded on polylactic acid/polyglycolic acid (PLA/PGA) copolymer scaffolds being generated by rapid prototyping. The bone defects were then reconstructed by implanting these tissue-constructs into bone defects. The postoperative computerized topographic scans as well as the intraoperative sites demonstrated the accurate fit in the defect sites. The individual created, implanted scaffold constructs enriched with the porcine osteoblast-like cells were well tolerated and appeared to support bone formation, as revealed by immunohistochemical and histological analyses. The results of this investigations indicated that the in vitro expanded osteoblast-like cells spread on a resorbable individualized, computer-aided fabricated scaffold is capable of promoting the repair of bone tissue defects in vivo. The shown results warrant further attempts to combine computer modelling and tissue engineering for use in different ways in bone reconstructive surgery.

Effect of silica and hydroxyapatite mineralization on the mechanical properties and the biocompatibility of nanocomposite collagen scaffolds

A recently established materials concept of biomimetic composites based on silica, collagen, and calcium phosphates was adapted for the preparation of porous scaffolds suitable for tissue engineering applications. Mineralization was achieved by directed nucleation of silica on the templating organic phase during a sol-gel process with or without addition of hydroxyapatite. Both mineral phases (25 wt %, individually or combined in equal shares) influenced the scaffold's morphology at the nanoscale. Enhancement of apparent density and compressive strength was similar for silica or hydroxyapatite mineralization; however the stiffening effect of hydroxyapatite was much higher. All scaffold modifications provided proper conditions for adhesion, proliferation, and osteogenic differentiation of human bone marrow stromal cells. The open porosity allowed cells to migrate throughout the scaffolds while maintaining their viability, both confirmed by MTT staining and confocal laser scanning microscopy. Initial cell distributions were graduated due to collagen mineralization, but balanced out over the cultivation time of 28 days. RT-PCR analyses revealed higher gene expression of ALP but lower expression of BSP II and osteocalcin because of collagen mineralization. The results demonstrate that both silica and hydroxyapatite offer comparable possibilities to tailor mechanical properties of collagen-based scaffolds without being detrimental to in vitro biocompatibility.

Capillary-induced contact guidance

Topographical features are known to impose capillary forces on liquid droplets, and this phenomenon is exploited in applications such as printing, coatings, textiles and microfluidics. Surface topographies also influence the behavior of biological cells (i.e., contact guidance), with implications ranging from medicine to agriculture. An accurate physical description of how cells detect and respond to surface topographies is necessary in order to move beyond a purely heuristic approach to optimizing the topographies of biomaterial interfaces. Here, we have used a combination of Langmuir-Blodgett lithography and nanoimprinting to generate a range of synthetic microstructured surfaces with grooves of subcellular dimensions in order to investigate the influence of capillary forces on the biological process of contact guidance. The physical-chemical properties of these surfaces were assessed by measuring the anisotropic spreading of sessile water droplets. Having established the physical properties of each surface, we then investigated the influence of capillary forces on the processes of cellular contact guidance in biological organisms, using mammalian osteoblasts and germinating fungal spores as tester organisms. Our results demonstrate that capillary effects are present in topographical contact guidance and should therefore be considered in any physical model that seeks to predict how cells will respond to a particular surface topography.

Load-related bone modelling at the interface of orthodontic micro-implants

The purpose of this study was to determine the interface reaction of two different titanium micro-implant systems activated with different load regimens. A total of 200 micro-implants (100 Abso Anchor and 100 Dual Top) were placed in the mandible of eight Göttinger minipigs. Two implants each were immediately loaded in the opposite direction by various forces (100, 300 or 500 cN) through tension coils. Three different distances between the neck of the implant and the bone rim (1, 2, 3 mm) were used. The loads provided by superelastic tension coils (which are known to develop a virtually constant force) led to a range of tip moments 0-900 cN mm at the neck of implants. Non-loaded implants were used as a reference. Bone tissue responses were evaluated by histology, histomorphometry and scanning electron microscopy after 22 and 70 days of loading. Implant loosening was present in the groups where the load reached 900 cN mm. No movement of implants through the bone was found in the experimental groups, for any of the applied loads. A direct bone-to-implant contact to various extents was observed at differently loaded implants. Ultrastructural analysis confirmed the clinical and histological finding that implants (except when loaded at 900 cN mm) were well osseointegrated after 22 days. An increase in the bone-to-implant contact ratio was observed during the experimental period in the coronal part of the implants in most experimental groups. The difference reached a level of statistical significance at 500 cN mm (Abso Anchor) and 600 cN mm (Dual Top). We conclude that micro-implants can not only be loaded immediately without impairment of implant stability but many enhance bone formation at the interface when the load-related biomechanics do not exceed an upper limit of tip moment at the bone rim.

Mineralization at the interface of implants

Osseointegration of implants is crucial for the long-term success of oral implants. Mineralization of the bone's extracellular matrix as the ultimate step of a mature bone formation is closely related to implant osseointegration. Osteogenesis at oral implants is a complex process, driven by cellular and acellular phenomena. The biological process of the maintenance and emergence of minerals in the vicinity of oral implants is influenced to a great extent by biophysical parameters. Implant-related structural and functional factors, as well as patient-specific factors, govern the features of osteogenesis. To understand the influence of these factors in peri-implant bone mineralization, it is important to consider the basic biological processes. Biological and crystallographic investigations have to be applied to evaluate mineralization at implant surfaces at the different hierarchical levels of analysis. This review gives insight into the complex theme of mineral formation around implants. Special focus is given to new developments in implant design and loading protocols aimed at accelerating osseointegration of dental implants.

Principles of bone formation driven by biophysical forces in craniofacial surgery

Biophysical forces, particularly mechanical loading and electromagnetic signals, are important regulators of bone formation. Indeed, the regenerative capacity of bony tissue is largely the result of the bone's capacity to recognise the functional environment required for the emergence and maintenance of a structurally intact bone. Biophysical methods of stimulation have therefore been introduced and have proved successful in clinical practice with craniofacial bones. Distraction osteogenesis, application of ultrasound, calculated transfer of stresses, and exposure to an electromagnetic field are some examples of biophysically driven approaches to influencing bone formation. The purpose of this review is to provide an insight into cellular and tissue models that are used to study the effects of biophysical stimuli on bone.

Fast element mapping of titanium wear around implants of different surface structures

The effect of unintended titanium release around oral implants remains a biological concern. The current study was undertaken to evaluate a new detection system of element mapping in biological probes. A new scanning electron microscopy-energy dispersive spectroscopy detection method was used to map the features of titanium contamination in peri-implant bone around implants with different surface structures. The amount of titanium wear was highest adjacent to titanium-plasma-sprayed surfaces, followed by sandblastered large grid acid-etched and smooth surfaces. A high sensitivity of titanium detection over large areas of bone tissue was observed. A high spatial resolution of titanium wear particles (20 nm) could be reached and correlated to the ultrastructural morphological features of peri-implant tissue. Cells adjacent to titanium wear revealed no signs of morphological alterations on a nanoscale level at early periods of implant/bone interaction. The new technique may serve as a fast and effective tool to evaluate titanium release effects in biological probes.

[Osteoblast reaction on SLA and microgrooved implant surfaces]

The osseointegration process of dental implants depends on the tissue reaction at the tissue-implant interface. Osteoblasts are the main cells responsible for the regulation of osteoinduction. The manner and kinetics of the tissue reaction crucially depend on the interaction between osteoblasts and the morphology of the implant surface. The aim of this study was to investigate osteoblast behaviour on different implant surfaces (smooth, microgrooved, SLA) under standardized conditions. For this in vitro investigation we used primary bovine osteoblasts. Attachment kinetics, proliferation rate and synthesis of bone-associated proteins were used as parameters for cell reaction. The results demonstrate that both attachment and adhesion strength of the primary cell surface interaction was higher on the microgrooved surfaces than on SLA surfaces. The proliferation rate of cells and the synthesis of bone-specific proteins were higher on microgrooved surfaces in contrast to SLA surfaces. Ultrastructural analysis revealed phenotypic osteoblast-like cells on smooth and microgrooved surfaces, whereas cells on SLA surfaces showed a more fibroblastic appearance. This study demonstrates that the morphology of the implant surface determined the subsequent osteoblast reaction. An optimal cell reaction was found at surfaces which are smooth in the microenvironment of osteoblasts.

Load-related implant reaction of mini-implants used for orthodontic anchorage

The purpose of this study was to determine the clinical and biomechanical outcome of two different titanium mini-implant systems activated with different load regimens. A total of 200 mini-implants (102 Abso Anchor and 98 Dual Top) were placed in the mandible of eight Göttinger minipigs. Two implants each were immediately loaded in opposite direction by various forces (100, 300 or 500 cN) through tension coils. Additionally, three different distances between the neck of the implant and the bone rim (1, 2 and 3 mm) were used. The different load protocols were chosen to evaluate the load-related implant performance. The load was provided by superelastic tension coils, which are known to develop a virtually constant force. Non-loaded implants were used as a reference. Following an experimental loading period of 22 and 70 days half of the minipigs were sacrificed, and implant containing bone specimens evaluated for clinical performance and implant stability. Implant loosing was found to be statistically dependent on the tip moment (TM) at the bone rim. Clinical implant loosing were only present when load exceeded 900 cN mm. No movement of implants through the bone was found in the experimental groups, for any applied loads. Over the two experimental periods the non-loaded implants of one type of implant had a higher stability than those of the loaded implants. Dual Top implants revealed a slightly higher removal torque compared with Abso Anchor implants. Based on the results of this study, immediate loading of mini-implants can be performed without loss of stability when the load-related biomechanics do not exceed an upper limit of TM at the bone rim.

Interface reaction at dental implants inserted in condensed bone

PURPOSE

The influence of the osteotome technique on the interface reaction of cylinder implants (SLA, ITI) was compared with the interface reaction of conventional implant insertion in an animal model.

MATERIAL AND METHODS

A total of 64 implants were placed in the cranial and caudal tibia of 8 Göttinger minipigs. The implant site was prepared either by a conventional technique with drills (control group A) or by the osteotome technique (experimental group B). Bone tissue responses were evaluated by histomorphometry, fluorescence microscopy and scanning electron microscopy after 7 and 28 days of osseointegration.

RESULTS

The average initial (7 days) bone-to-implant contact ratio was not statistically significantly different for the osteotome technique (35.88+/-2.94%) than for the control group (43.78+/-3.39%, P<0.095). After 28 days, the bone-to-implant contact ratio became statistically significantly higher when implants were inserted by conventional preparation (44.81+/-3.07% (group B), 63.47+/-4.87% (group A), P=0.003). Whereas fluorescence and immunhistologic examination revealed new bone formation with osteocalcin deposition directly at the implant surface in both groups, the extent of direct bone/implant contact was enhanced in conventionally prepared implant sites. SEM analysis confirmed an intimate bone to implant bond without fibrous tissue formation in places of direct contact at an ultrastructured level.

CONCLUSION

Implant placement in conventionally prepared implantation sites is accompanied by an improved interface formation at an early stage of implantation.

Design and performance of a bioreactor system for mechanically promoted three-dimensional tissue engineering

There is currently considerable interest in increasing the response of mesenchymal cells to physical forces, and numerous loading devices have been used to increase the formation of skeletal tissue in vivo and in vitro. We have developed a bioreactor system to apply cyclic strains on three-dimensional specimens over a range of 0-20,000 mustrain. The piezoelectric-driven mechanism allows the precise adjustment and control over load-related deformations of tissue, as shown by finite-element calculations of deformation of a collagen gel under load. We present the design of the bioreactor and its performance in specimens of tissue containing activated osteoblasts and chondrocytes. Biaxial tissue straining at 2,000 mustrain led to a substantial increase in the number of both types of cell compared with unstimulated controls. The synthesis of cell-specific extracellular matrix proteins increased when physiological loads (2,000 mustrain) were applied in the bioreactor, whereas higher deformations (20,000 mustrain) resulted in a reduction in proliferation and differentiation of cells. The mechanisms whereby mechanical stimulation leads to a defined cell reaction are not known, but the application of physiological micromovements in extracorporeal tissue chambers is a promising approach to the formation of hard tissue.

Basic reactions of osteoblasts on structured material surfaces

In order to assess how bone substitute materials determine bone formation in vivo it is useful to understand the mechanisms of the material surface/tissue interaction on a cellular level. Artificial materials are used in two applications, as biomaterials alone or as a scaffold for osteoblasts in a tissue engineering approach. Recently, many efforts have been undertaken to improve bone regeneration by the use of structured material surfaces. In vitro studies of bone cell responses to artificial materials are the basic tool to determine these interactions. Surface properties of materials surfaces as well as biophysical constraints at the biomaterial surface are of major importance since these features will direct the cell responses. Studies on osteoblastlike cell reactivity towards materials will have to focus on the different steps of protein and cell reactions towards defined surface properties. The introduction of new techniques allows nowadays the fabrication of materials with ordered surface structures. This paper gives a review of present knowledge on the various stages of osteoblast reactions on material surfaces, focused on basic cell events under in vitro conditions. Special emphasis is given to cellular reactions towards ordered nano-sized topographies.

Osteoblast alignment, elongation and migration on grooved polystyrene surfaces patterned by Langmuir–Blodgett lithography

Topographically patterned surfaces are known to influence cellular behavior in a controllable manner. However, the relatively large surface areas (several cm2) required for many biomaterial applications are beyond the practical limits of traditional lithography. Langmuir-Blodgett lithography, a recently developed method, was used to fabricate regularly spaced grooves of different depths (50 and 150 nm) with a periodicity of 500 nm over several square centimeter on silicon surfaces. These topographies were transferred into polystyrene surfaces by means of nanoimprinting. Primary osteoblasts were cultured on the patterned polymer surfaces. They were observed to align, elongate and migrate parallel to the grooves. The combination of Langmuir-Blodgett lithography with nanoimprinting enables the fabrication of large, nanostructured surface areas on a wide spectrum of different biomaterials. Osteoblasts show a significant anisotropic behavior to these surfaces, which can enhance cell settlement on the surface or be used to direct tissue generation on the biomaterial interface.

Biological and biophysical principles in extracorporal bone tissue engineering. Part III

Over the last decade extracorporal bone tissue engineering has moved from laboratory to clinical application. The restoration of maxillofacial bones from cell harvesting through product manufacture and end-use has benefited from innovations in the fields of biomechanical engineering, product marketing and transplant research. Cell/scaffold bone substitutes face a variety of unique clinical challenges which must be addressed. This overview summarises the recent state of the art and future anticipations in the transplantation of extracorporally fabricated bone tissues.

Biological and biomechanical evaluation of bone remodelling and implant stability after using an osteotome technique

The influence of the osteotome technique on the osseointegration and biomechanical behaviour of cylinder implants (SLA, ITI was compared with conventional preparation of the implant site in an animal model. A total of 56 implants were placed in the cranial and caudal tibia condyle of six Gottinger minipigs. The implant site was prepared either by the conventional technique with drills (control group A) or by the osteotome technique (experimental group B). Resonance frequency measurements (RFMs) were made on each implant at the time of fixture placement and at the time of scarification. Half of the minipigs were sacrificed 7 days and 28 days after implant placement and the implants were removed with the surrounding bone. Bone tissue responses were evaluated by histological analysis and removal torque testing. For histological evaluation 30-50 microm-thick ground sections were examined. Biomechanical testing revealed a significantly higher stability of implants in the control group (A) than in the experimental group (B) (P = 0.004) at day 7. After 28 days implant stability in the control group remained significant higher (47%) than those of group B (P > 0.001). RFM demonstrated no significant difference between both groups and during the experimental course. Histological analysis demonstrated fractured trabeculae in peri-implant bone in the experimental group at day 7, while they were not posed at day 28. We conclude that the decreased implant stability by using the osteotome technique is based on microfractures in peri-implant bone.

Biological and biophysical principles in extracorporal bone tissue engineering

The aim of this review is to characterise the biological and biophysical background of in vitro bone tissue engineering. The paper focuses on basic principles in extracorporal engineering of bone-like tissues, considering parameters such as scaffold design, tissue construction, bioreactors, and cell stimulation in vivo and in vitro. Scaffolds have a key function concerning cellular invasion and bone formation. The intra-architectural scaffold geometry, as well as the scaffold material, play an important role in the process of bone regeneration. Various types of bioreactors have been tested for their utility in bone substitute fabrication that is clinically effective and reproducible. Sophisticated bioreactor systems are those that mimic the three-dimensional morphology and the mechanical situation of bones. Mechanical stimulation as well as other biophysical stimuli appear to be critical factors for proliferation and differentiation of bone cells and for bone mineral and structure formation. Furthermore an enhancement of bone regeneration by application of chemical stimulation factors is discussed.

Biological and biophysical principles in extracorporal bone tissue engineering

Advances in the field of bone tissue engineering have encouraged physicians to introduce these techniques into clinical practice. Bone tissue engineering is the construction, repair or replacement of damaged or missing bone in humans or animals. Engineering of bone can take place within the animal body or extracorporal in a bioreactor for later grafting into the body. Appropriate cell types and non-living substrata are minimal requirements for an extracorporal tissue engineering approach. This review discusses the biological and biophysical background of in vitro bone tissue engineering. Biochemical and biophysical stimuli of cell growth and differentiation are regarded as potent tools to improve bone formation in vitro. The paper focuses on basic principles in extracorporal engineering of bone-like tissues, intended to be implanted in animal experiments and clinical studies. Particular attention is given in this part to the contributions of cell and material science to the development of bone-like tissues. Several approaches are at the level of clinical applicability and it can be expected that widespread use of engineered bone constructs will change the surgeon's work in the near future.

Ultrastructural characterization of the implant/bone interface of immediately loaded dental implants

Primary stability and an optimized load transfer are assumed to account for an undisturbed osseointegration process of implants. Immediate loaded newly designed titanium dental implants inserted in the mandible of minipigs were used for the characterization of the interfacial area between the implant surface and the surrounding bone tissue during the early healing phase. Histological and electron microscopical studies were performed from implant containing bone specimens. Two different load regimens were applied to investigate the load related tissue reaction. Histological and electron microscopical analysis revealed a direct bone apposition on the implant surfaces, as well as the attachment of cells and matrix proteins in the early loading phase. A striking finding of the ultrastructural immunocytochemical investigations was the synthesis and deposition of bone related proteins (osteonectin, fibronectin, fibronectin receptor) by osteoblasts from day one of bone/biomaterial interaction. Calcium-phosphate needle-like crystallites were newly synthesized in a time-related manner directly at the titanium surface. No difference in the ultrastructural appearance of the interface was found between the two loading groups. Our experimental data suggest that loading of specially designed implants can be performed immediately after insertion without disturbing the biological osseointegration process.

Bone tissue engineering by primary osteoblast-like cells in a monolayer system and 3-dimensional collagen gel

PURPOSE

To engineer living bone tissue in vitro, bone cells must be multiplied and differentiated in cell culture. Osteoblasts are known to be the crucial cells responsible for the bone modeling process. Periosteal-derived osteoblasts were therefore cultured for up to 3 weeks in Petri dishes as well as in a 3-dimensional collagen gel.

METHODS

Proliferation, migration, and differentiation of cells as well as the synthesis of extracellular matrix proteins were monitored during the culture period by histology, electron microscopy, and immunohistochemistry. Mineral formation was investigated by electron diffraction studies and element analysis.

RESULTS

Osteoblasts proliferated and migrated in Petri dishes as well as in the collagen gel without loss of viability during the whole experimental period. They demonstrated a mature osteoblast phenotype as indicated by the synthesis of a bone-like extracellular matrix. They formed an extracellular matrix containing osteocalcin, osteonectin, and newly synthesized collagen type I in both environments. Mineral formation was seen in colocalization with the bone-like extracellular matrix proteins in Petri dishes. Microanalytical investigations revealed a matrix vesicle-mediated mineral formation at early stages of culture.

CONCLUSIONS

Our cell culture confirmed the ability to multiplicate differentiated and viable osteoblast-like cells in 2- and 3-dimensional space. Additionally, bone-like mineralization can be induced by primary osteoblasts in monolayer culture. The data suggest that this approach can be used as a tool in bone tissue engineering.

Aspects of collagen mineralization in hard tissue formation

Collagen is the dominant fibrous protein not only in connective tissues but also in hard tissues, bone, dentin, cementum, and even the mineralizing cartilage of the epiphyseal growth plate. It comprises about 80-90% (by weight) of the organic substance in demineralized dentin and bone. When collagen fibers are arranged in parallel to form thicker bundles, as in lamellar bone and cementum, interior regions may be less mineralized; in dentin, however, the collagen fibers form a network and collagen fibers are densely filled with a mineral substance. In the biomineralization of collagen fibers in hard tissues, matrix vesicles play a fundamental role in the induction of crystal formation. The mineralization of matrix vesicles precedes the biomineralization of the collagen fibrils and the intervening ground substance. In addition, immobilized noncollagenous fibrous macromolecules, bound in a characteristic way to the fibrous collagen surface, initiate, more intensely than collagen, mineral nucleation in the hard tissue matrix.

Evaluation of accuracy of insertion of dental implants and prosthetic treatment by computer-aided navigation in minipigs

The survival of loaded implants is critically dependent on their biomechanical stability. We have used a computer-guided navigation technique to evaluate the accuracy of computer-assisted insertion for immediately-loaded implants in minipigs. On the basis of computed tomographical data, the Robodent system was used for preoperative planning and guidance of inserting the implant. An optical tracking system allowed positioning of the implant and immediate prosthetic rehabilitation by inserting it in a plaster model and during the operation. Postoperative computed tomograms (CT) showed that the implants were placed precisely in the preoperatively planned position. The accuracy achieved corresponded well with the spatial resolution of the CT used. Immediate placement of the prefabricated crowns resulted in favourable occlusal positioning. Histological cross-sections showed that the implants were biomechanically stable. The accuracy of insertion of oral implants illustrated here suggests that insertion and prosthetic modelling of implants may benefit from computer-assisted navigation.

[Evaluating angiogenesis and osteogenesis modified by vascular endothelial growth factor (VEGF)]

PURPOSE

This intention of this study was to investigate the influence of controlled release of vascular endothelial growth factor (VEGF) on angiogenesis and osteogenesis in a mandibular defect model.

METHODS

A total of 56 rabbits were operated and bicortical holes were placed in the mandible. The defects were filled with collagen type I implants, collagen implants complexed with 0.8-microgram VEGF165, or left without any filling. After 3, 7, 14, and 28 days specimens were taken and histologic, histomorphometric, and immunohistologic analyses were carried out concerning density of vessels, total surface of vessels, bone surface, and bone density.

RESULTS

The number of vessels was increased in all groups up to 14 days, followed by physiologic regression in the control groups, whereas the study group showed persistently high numbers. The density of regenerated bone was significantly higher in the study group.

CONCLUSION

The activation of angiogenesis using VEGF165 leads to more intensive angiogenesis and bone regeneration.

TCP is hardly resorbed and not osteoconductive in a non-loading calvarial model

Tricalciumphosphate (TCP) has been used as a ceramic bone substitute material in the orthopedic field as well as in craniofacial surgery. Some controversies exist concerning the osteoconductive potential of this material in different implantation sites. This study was designed to evaluate the biological response of calvarial bone towards TCP granules under non-loading conditions to assess the potential of TCP as a biodegredable and osteoconductive bone substitue material for the cranial vault. Full-thickness non-critical size defects were made bilaterally in the calvaria of 21 adult Wistar rats. One side was filled by TCP granules, the contralateral side was left empty and used as a control. Animals were sacrified in defined time intervals up to 6 months. Bone regeneration was analyzed with special respect toward the micromorphological and microanalytical features of the material-bone interaction by electron microscopy and electron diffraction analysis. Histologic examination revealed no TCP degradation even after 6 months of implantation. In contrast, a nearly complete bone regeneration of control defects was found after 6 months. At all times TCP was surrounded by a thin fibrous layer without presence of osteoblasts and features of regular mineralization. As far as degradation and substitution are concerned, TCP is a less favourable material tinder conditions of non-loading.

Mechanical tension in distraction osteogenesis regulates chondrocytic differentiation

Differentiation of chondrocytes to cells of osteoblastic phenotype occurs during an interim period of bone development, fracture repair and distraction osteogenesis. To study the relationship between tension-stress and chondrogenesis, uniaxial strains (0 microstrains, 2000 microstrains, 20000 microstrains, 200000 microstrains, 300000 microstrains) were applied in a rabbit model of mandibular distraction osteogenesis. The results demonstrated that cell differentiation, apoptosis and tissue development in the newly formed gap tissue showed a correlation to the applied strain magnitudes. Only strains of 20000 microstrains resulted in a statistically significant (P<0.05) formation of cartilage struts with embedded chondrocyte-like cells. However, chondrocyte-like cells were rarely detected in samples distracted at lower or higher strain magnitudes. Osteoblasts appeared to replace cartilaginous matrix by mineralized bone matrix. The phenotypic change from chondrocytes to osteoblasts was accompanied by a decreased proteoglycan synthesis. a change in the expression from type II collagen towards type I and involved asymmetric cell divisions and apoptotic cell death. Therefore, we suggest that mechanical strain is an external stimulus responsible for phenotypic cell alterations.

Microstructural investigations of strain-related collagen mineralization

Distraction osteogenesis in rabbit mandibles after osteotomy can be used as an experimental model to study the microstructural features of mineralization of callus under defined mechanical loads. Our aim was to study the relation between the micromotions in the gap and the resulting features of mineralization of the matrix. We found that assembly of collagen and formation of crystals depended on the magnitude of the mechanical stress applied. At physiological bone strains (2000 microstrains), the callus had collagen type I in a mature bone-like extracellular arrangement, whereas at 20000 microstrains bundles were orientated predominantly towards the tension vector. Maximum loads (200000 microstrains) resulted in disorganized assembly of the collagen. Quantitative energy-dispersive analysis by X-rays confirmed that high strains were associated with substantially lower concentrations of calcium and phosphate. In contrast to bone-like apatitic formation of crystals at physiological strains, significantly fewer but larger crystals were detected by electron diffraction analysis in samples exposed to high strains. We suggest that mechanical stress regulates the assembly and mineralization of collagen during distraction osteogenesis.

Quantitative analyses of the biomineralization of different hard tissues

The primary crystallites of the different developing hard tissues have an apatite structure. However, they have crystal lattice distortions representing an intermediate state between amorphous and fully crystalline. We have applied energy-filtering transmission electron microscopy in the selected area electron diffraction mode to analyse different stages of crystal formation in dentine, bone, enamel and inorganic apatite mineral. We have obtained quantitative information on the degree of crystal lattice distortion using the paracrystal theory of Hosemann and Bagchi. We have found that the early formed crystallites of the hard tissues being analysed have a paracrystalline character comparable to biopolymers. However, with maturation, the lattice fluctuations of the crystallites of the hard tissues bone, enamel and dentine decrease to form a typical (para)crystalline character. Also the decrease of the organic proportion in the matrix corresponds to the decrease of the lattice fluctuation of the crystallites in the different hard tissues during maturation.

Three-dimensional magnetic resonance imaging of the orbit in craniofacial malformations and trauma

Craniofacial malformations and trauma often lead to changes in orbital soft tissues, requiring surgical correction of both hard and soft tissues. Computed tomographic scans and 3-dimensional reconstructions are the optimal tools for evaluation of the bony structures. However, there is no equivalent method for the orbital soft tissues. The aim of this study was to establish a 3-dimensional magnetic resonance imaging (3-D MRI) technique that allows a differentiated visualization of the different types of soft tissue in the orbit. A total of 8 patients with different pathologic conditions of the orbit was examined. Five of these patients underwent secondary correction after trauma, and 3 had craniofacial malformations. The 3-D reconstruction was performed in the volume-rendering technique after acquisition of 3-mm axial slices. It was shown that a differentiated visualization of the orbital soft tissues is possible. Although the thin bony structures have a weak signal and, therefore, the imaging is poor, reliable reconstruction of the globe was achieved by different radiologists because of its circular delimitation from the bone. This technique is an additional support in the planning of orbital surgery.

[Mechanical stimulation of osteoblasts in cell culture]

BACKGROUND

Mechanical loading of bone is known to play a crucial role in bone remodeling and regeneration. Whereas the clinical effects of mechanically modulated bone healing have been extensively studied, less is known about the underlying mechanisms on a cellular level. This study was aimed at investigating the effects of uniaxial strains on osteoblast-like cells in culture. Mechanical loading was applied in physiological and hyperphysiological magnitudes. Nonstimulated cultures served as controls.

RESULTS

Cultured primary bovine periosteal cells exhibited phenotypic features of osteoblast-like cells. Application of physiological strains (2,000 mu strain) led to a bone-specific expression of extracellular matrix proteins (osteonectin, osteocalcin, collagen type I). Hyperphysiological loads (10,000 mu strain) were associated with an increased synthesis of proteoglycans. Proliferation of cells was higher than the controls at 10,000 mu strain and showed no difference from physiologically loaded osteoblasts.

DISCUSSION

Our study demonstrates that physiological loading of osteoblast-like cells enhances the regenerative capacity of bone, whereas hyperphysiological loads may impair bone regeneration.

Capacitively coupled electric fields accelerate proliferation of osteoblast-like primary cells and increase bone extracellular matrix formation in vitro

Over the last few years, electric and electromagnetic fields have gained more and more significance in the therapy of bone fracture healing and bone disease. Yet, the underlying mechanisms on a cellular and molecular level are not completely understood. In the present study we have investigated the effects of capacitively coupled, pulsed electric fields on cellular proliferation, alkaline phosphatase activity, and matrix protein synthesis of osteoblast-like primary cells in vitro. Cells were derived from bovine periosteum and electrically stimulated by saw-tooth pulses of 100 V external voltage and 16 Hz frequency. This corresponds to an electric field of 6 kV/m across the cell membranes as could be shown by computer simulation. Field application caused acceleration of cell culture development. A significant increase of proliferation concurrent with an enhancement of alkaline phosphatase activity was observed in sub-confluent cultures. Exposure of confluent osteoblast-like primary cells to electric fields resulted in enhanced synthesis and secretion of extracellular matrix-related proteins. These findings suggest that capacitively coupled electric fields accelerate bone cell proliferation and differentiation in vitro and enhance the synthesis of cells leading to promoted matrix formation and maturation.

General principle of ordered apatitic crystal formation in enamel and collagen rich hard tissues

The biomineralization processes in different hard tissues like enamel, circumpulpal dentine, epiphyseal growth plates were analyzed morphologically and ultrastructurally by an energy filtering transmission electron microscope. In the primary stage of crystal formation Ca- and phosphate-ions accumulate at charged sites, "active sites", along the fiber matrix-molecules of the extracellular matrix. After exceeding the critical radius for nucleation, crystal nuclei appear that develop to "chains" of stable nanometer-sized paracrystalline particles. In the latest studies of small area electron diffraction it was found that in the earliest stage of crystal formation these mineral chains show a parallel orientation in the direction of the c-axis of apatite. This was supported by a texture of the 002 reflection in the corresponding diffraction patterns. Since apatite is bipolar in this direction crystal growth would be in like manner in both directions. Thus the center-to-center distances between nucleating sites along the matrix macromolecules show with the chains of nanometer islands the same process of biomineralization in the different mineralizing hard tissue systems. This way of crystal formation might be a general principle of apatitic biomineralization.

Periosteally derived osteoblast-like cells differentiate into chondrocytes in suspension culture in agarose

Pluripotent cells from the periosteal layer adjacent to cortical bone attain an osteoblast-like phenotype in culture when reaching confluence in monolayer. It is unknown whether such newly differentiated osteoblast-like cells preserve the chondrogenic potential characteristics for stem cells derived from the periosteum. Primary osteoprogenitor cells derived from bovine metacarpal periosteum were differentiated into alkaline phosphatase-positive osteoblast-like cells by an established monolayer culture protocol. After transfer into suspension culture in agarose gels, the cells differentiated into chondrocytes demonstrated by the production of collagen II, but not of collagen I, as well as alkaline phosphatase activity was abated. Contrarily, with continuation of monolayer culture, the cells maintained their osteoblast-like phenotype and secreted large amounts of collagen I and a minor quantity of collagen III and V. The alkaline phosphatase activity steadily increased during the entire culture period of 2 weeks. Thus, our culture techniques can serve as useful tools to study mechanisms of differentiation by modulating the phenotypic potential of osteogenic cells. The results presented here support the notion that the extracellular environment strongly influences the cell type and its metabolism.

Identification of apoptotic cell death in distraction osteogenesis

The purpose of this experimental work was to investigate whether apoptosis contributes to tissue remodelling during distraction bone healing. In a rabbit model of mandibular distraction osteogenesis, we quantitatively analysed the extent of apoptotic cell death in relation to differently applied mechanical loadings. Apoptotic cells were identified by means of an in situ detection assay for nuclear DNA fragmentation using a modified TUNEL procedure and by electron microscopical examination for typical morphological features of programmed cell death. TUNEL-positive cells were frequently detected in samples distracted at higher strain magnitudes. Ultrastructurally, these apoptotic cells displayed a condensed chromatin and fragmented nuclei, while the continuity of their plasma membranes remained intact. Our results clearly indicated that the discontinuous traction of osteotomized mandibles induced enhanced apoptosis. In contrast to non-distracted samples and mandibles distracted at low strain magnitudes, in which only minimal evidence of apoptotic cell death was detected, the application of hyperphysiological strain magnitudes resulted in an increased apoptosis rate. Thus, mechanical loading seems to be a triggering factor for apoptotic changes in osteoblastic cells. These findings suggest a pathophysiological role of apoptotic cell death in the control of tissue integrity during distraction osteogenesis.

The effect of magnitude and frequency of interfragmentary strain on the tissue response to distraction osteogenesis

PURPOSE

Bone regeneration is believed to be partially controlled by the applied local mechanical strain. To test whether the magnitude or frequency of discontinuous traction regulates the tissue response, defined daily strains were applied on mandibular osteotomies using an implanted mechanical distractor.

MATERIALS AND METHODS

Unilateral mandibular osteotomies were performed in skeletally immature rabbits (n = 36). and distraction was done by applying 2,000, 20,000, 200,000, or 300,000 microstrains once or 10 times (2,000, 20,000 microstrains) per day, respectively. Sham-operated animals (n = 6), serving as controls, underwent frame application and osteotomy without distraction. At the end of the distraction process, the newly formed tissue was evaluated histomorphometrically by the use of a well-defined scoring system of bone-forming indices.

RESULTS

The highest bone-forming indices were detected in the osteotomized, nondistracted group and in samples exposed to a physiologic strain (2,000 microstrains). Application of hyperphysiologic strains (200,000 and 300,000 microstrains) resulted in the formation of fibrous tissue and decreased bone-forming indices. Using Kruskal-Wallis tests, a statistically significant relationship was found between the bone-forming indices and the applied strain magnitudes. Scanning and transmission electron microscopic examinations showed osteoblastic differentiation and early mineral deposition in samples distracted up to 20,000 microstrains, whereas higher strain magnitudes led to the formation of fibroblast-like cells surrounded by collagen fibrils and only slight mineralization. Multiple strain applications (10 cycles/d vs 1 cycle/d) did not alter the histomorphometric indices or ultrastructural morphology significantly but increased the amount of newly formed tissue.

CONCLUSIONS

These results suggest that the magnitude and not the frequency of mechanical loading controls the differentiation of bone cells and the subsequent formation of bone tissue.

Quantitative electron spectroscopic diffraction analyses of the crystal formation in dentine

Newly formed apatitic crystallites of different hard tissues consist, according to our investigations, of chains composed of nanometre-sized particles (islands, dots) arising at nucleating sites of the collagenous and noncollagenous matrix macromolecules. In dentine these islands coalesce rapidly in longitudinal direction to form needle-like crystallites which further coalesce to ribbon-like crystallites. We have concluded that the centre-to-centre distances between these islands represent the distances between the nucleating sites of the matrix macromolecules. We have applied energy-filtering transmission electron microscopy in the selected area electron diffraction mode at different stages of crystal formation in dentine and have obtained quantitative information of the degree of crystal disorder on the basis of the paracrystal theory. The fluctuation of the lattice plane distances in c-axis direction decreases, proceeding from the region near the dentine/predentine border to the dentine/enamel border.

Strain-related bone remodeling in distraction osteogenesis of the mandible

Distraction osteogenesis has become a mainstay in craniofacial surgery. However, there are several unresolved problems concerning the biology of bone regeneration. We investigated the biomechanical effects of mandibular lengthening in 32 rabbits on a cellular and histologic level. The mandible was subjected to a corticotomy, held in a neutral position for 4 days, and then lengthened at various strain rates and frequencies for 10 days. Radiographic, histologic, and electron microscopic examinations showed a strain-related bone regeneration. Application of physiologic strain rates (2000 microstrains or 0.2 percent) led to a bridging of the artificial fracture exhibiting woven ossification, whereas at 20,000 microstrains trabecular bone formation was demonstrated. In contrast, hyperphysiologic strain magnitudes (200,000 microstrains and 300,000 microstrains) showed a fibrous tissue formation. Multiple strain applications (10 cycles/day versus 1 cycle/day) increased the width of the distraction gap without changing the stage of bone regeneration. The gradual distraction of bone in physiologic magnitudes at higher frequencies seems to be desirable for a bony differentiation and may help to improve clinical applications.

Sutural mineralization of rat calvaria characterized by atomic-force microscopy and transmission electron microscopy

The application of transmission electron microscopy (TEM) and atomic-force microscopy (AFM) aid the acquisition of detailed structural information on the process of hard tissue formation. The sutural mineralization of rat calvaria is taken as a model for a collagen-related mineralization system. After cryofixation or chemical fixation an anhydrous tissue preparation technique with no staining procedures is used. The atomic-force microscope and the transmission electron microscope are used for structural analysis of the mineralizing region of the sutural tissue. With the application of AFM the collagen macroperiod is shown to be well represented in the unmineralized sutural tissue. At the mineralization front the collagen fibrils are found to be thickened and to change to a characteristic stacked platelet structure. Using TEM the macroperiod is faintly visible before mineral crystallites have formed and is more prominent after the apatite crystallization has started in the fibrils. In this step a needle-like structure of the newly formed apatitic crystals is visible.

Potassium is involved in apatite biomineralization

The biogenetic formation of mineral crystals, one aspect of biomineralization, is a multistep process of apatite formation throughout the growth of dentin tissue. An important step is the transformation of the non-mineralized predentin matrix to mineralizing dentin matrix and its biological control. In this study, the high capacity of elemental mapping is combined with single x-ray point measurements to elucidate whether special elements are involved in initiation or regulation of mineral nucleation. Directly at the mineralization front, micro-areas with a strong co-enrichment of phosphorus (e.g., as phosphate) and potassium are found. During the beginning of the calcium enrichment and the subsequent apatite mineral formation in the characteristic micro-areas, the content of potassium decreases significantly. These findings indicate that potassium is involved in the process of dentin mineralization.

[MRI 3D imaging of the orbits in craniofacial abnormalities and injuries]

Craniofacial malformations and trauma often lead to changes in orbital soft tissues that require operative correction of both hard and soft tissues. CT scan and 3D reconstructions are optimal tools for the evaluation of the bony structures but there is no equivalent for the orbital soft tissues. The aim of this study was to establish a 3D-MRI technique that allows differentiated visualization of the different soft-tissue types of the orbit. A total of eight patients with different pathologic conditions of the orbit were examined. Five of these patients came for secondary correction after trauma and three showed a craniofacial malformation. 3D reconstruction was performed in volume-rendering technique after acquisition of 3 mm axial slices. It was shown that differentiated visualization of the orbital soft tissues is possible. Even though the thin bony structures have a weak signal and therefore the imaging is poor, the globe could be reconstructed reliably by different radiologists because of its circular delimitation from the bone. This technique provides additional support in the planning of orbital operations.

Analysis of a general principle of crystal nucleation, formation in the different hard tissues

We have found, at high EM magnification, on ultrathin sections of shock-frozen, freeze-dried, embedded pieces of the developing hard tissues, that the primary crystallites consist of strands composed of nanometer-sized apatitic islands, which rapidly coalesce to needles and afterward to platelets. By small-area electron diffraction, with energy-filtered electrons, it was clarified that these strands are already crystallographically oriented along the bipolar c-axis so that the center-to-center distances between the islands would reflect the distances between crystal-nucleating sites along the matrix. The EM analysis of the cross-cut stained unmineralized and of the unstained mineralized collagen fibers of turkey tibia tendon shows that the staining "nuclei" and the early crystallites, appearing as dark dots, surround "light" round structures, which we interpret as the collagen microfibrils, surrounded by the apatitic crystallites.

Quantitative electron-spectroscopic diffraction (ESD) and electron-spectroscopic imaging (ESI) analyses of dentine mineralisation in rat incisors

Primary crystal formations in all hard tissues are, according to our investigations, Ca-phosphate chains composed of nanometer sized particles (dots) which develop along the matrix macromolecules. In circumpulpal dentine the centre-to-centre distances between the dots inside the chains reflect the distances between the crystal nucleating sites ("active sites") along the collagen matrix macromolecule. The centre-to-centre distances at the surface of the mineralised collagen fibrils probably reflect the distances between nucleating sites of noncollagenous proteins attached to collagen. These needle-like chains of dots coalesce in lateral directions to form ribbon-like crystallites. The morphological results are supported by correlated small area diffraction studies in the same regions of dentine. We have found that the first appearing Bragg-reflection has a lattice spacing value of 0.388 nm, which corresponds to the (111) apatite value. For the earliest crystal formations the intensity of the (002) reflection is higher than that of the (300)-reflection. A maximum of the net-signal-intensity ratio of the (002) to (300) Bragg-reflection appears at the mineralisation front. This peak repeats with decreasing height 3 to 5 times with a distance range of about 8-16 microm through the whole dentine zone, which corresponds to the distances of the incremental lines, called "von Ebner lines".

The mineralization of mantle dentine and of circumpulpal dentine in the rat: an ultrastructural and element-analytical study

The purpose of this study was to compare the biomineralization of circumpulpal dentine with that of mantle dentine by ultrastructural and element-analytical techniques. Forty upper second molar germs of 10-day-old albino rats were cryofixed in liquid nitrogen-cooled propane and embedded in resin after freeze drying. Semithin dry sections were cut for analyzing the calcium and phosphorous concentration in initial mantle dentine, at the mineralization front of circumpulpal dentine, in the middle region of circumpulpal dentine and in mantle dentine peripheral to circumpulpal dentine. For the morphological evaluation of mineral deposits we compared ultrathin and unstained sections of cryofixed molars with chemically fixed molars. For both dentine types it was found that they develop via identical steps of mineral formation at collagen fibrils and non-collagenous matrix molecules. In circumpulpal dentine no globular mineral protrusions along the mineralization front (i.e. calcospherites) and no indications of interglobular dentine at the transition from circumpulpal dentine to mantle dentine were present. Two von Korff fibres were not only visible in mantle dentine but also in circumpulpal dentine. Matrix vesicles were present only during the formation of an initial coherent layer of mantle dentine and could not be observed during successive formation of mantle dentine and circumpulpal dentine. The element-analytical data did not demonstrate any difference in the mineral content between the two dentine types. Therefore, we conclude that mantle dentine and circumpulpal dentine in the rat molar possess a high degree of structural and chemical similarity and that only the extent of terminal branching of the odontoblast processes gives an approximate estimation of the thickness of mantle dentine.

Magnesium in newly formed dentin mineral of rat incisor

Small amounts of magnesium are always detectable in addition to calcium and phosphorus in mineralized tissues such as dentin or bone. Magnesium has been considered to influence the mineralization process, especially crystal growth. The present study reports on the location and enrichment of magnesium in the newly mineralized dentin by using the high lateral resolution of energy dispersive X-ray microanalysis combined with scanning transmission electron microscopy. To this end, we have used the continuously growing rat incisor as a model for a collagenous mineralizing system. Dental tissue was dissected free and cryofixed in liquid nitrogen-cooled propane. The distribution of elements was measured in freeze-dried ultrathin cryosections. The magnesium distribution of the newly formed dentin area near the predentin area was found to be inhomogeneous. In certain small dentin areas, characteristical magnesium enrichments were observed. Further, high magnesium-to-phosphate molar ratios were found in these areas, and these were correlated with low calcium-to-phosphate molar ratios. Our results support the theory that magnesium is involved in the process of biological apatite crystal formation.

Early mineralization of matrix vesicles in the epiphyseal growth plate

Matrix vesicles (MVs) induce the primary mineralization in collagen-rich hard tissues such as bone, mineralizing cartilage and dentine. Calcium and phosphate ions accumulate at the inner MV membrane. This accumulation takes place in association with phospholipids alone and/or in association with Annexin V, which displays Ca ion channel activity when inserted in membranes; consequently, Annexin V may be involved in Ca uptake by matrix vesicles. The first crystal nuclei are formed at these macromolecules of the MV inner membrane. They grow to stable nanometre-sized particles, dots, which coalesce to form chains of dots along the macromolecules of the MV inner membrane. At the same time, or shortly afterwards, chains of these Ca phosphate dots also develop inside the MVs. The measured centre-to-centre distances between these dots represent approximately the distances between the nucleating sites, called active sites, along the MV matrix molecules. The mineralization does not stop at the MV membrane but expands continuously into the extravesicular region in radial directions to form nodules. These radiating Ca phosphate chains, which coalesce to form needles, are composed of such primary dots, which have developed at the nucleating sites of the corresponding macromolecules.

Mineralization during matrix-vesicle-mediated mantle dentine formation in molars of albino rats: a microanalytical and ultrastructural study

The purpose of this study was to elucidate the mineralization process of mantle dentine by ultrastructural and element-analytical investigation of matrix vesicles and successive stages. Upper second molars of albino rats were cryofixed and embedded in resin after freeze drying. Semithin dry sections were prepared for analyzing the calcium and phosphorus concentrations in the mineralized matrix vesicles or noduli, larger mineralized islands, and the mantle dentine. For ultrastructural studies, it was necessary to reduce section contact with hydrous fluids to a minimum in order to avoid preparation artifacts. The first mineral deposits were recognized as dot-like formations both in the interior of matrix vesicles and in association with the inner vesicle membrane. This indicated the existence of mineral nucleating sites located both at the inner membrane and at calcium-phosphate-binding macromolecules in the interior of the matrix vesicles. A significantly higher mineral content was found in mineralized matrix vesicles than in the mineralized extravesicular regions of the mineralized islands, suggesting the existence of a rapidly and densely mineralized matrix in the matrix vesicles. A significant increase in mineral content per volume proceeding from the mineralized islands to mantle dentine suggested a further increase in the density of mineral.