Effects of four Ni-Ti preparation techniques on root canal geometry assessed by micro computed tomography

AIM

The aim of this study was to compare the effects of four preparation techniques on canal volume and surface area using three-dimensionally reconstructed root canals in extracted human maxillary molars. In addition, micro CT data was used to describe morphometric parameters related to the four preparation techniques.

METHODOLOGY

A micro computed tomography scanner was used to analyse root canals in extracted maxillary molars. Specimens were scanned before and after canals were prepared using Ni-Ti - K-Files, Lightspeed instruments, ProFile.04 and GT rotary instruments. Differences in dentine volume removed, canal straightening, the proportion of unchanged area and canal transportation were calculated using specially developed software.

RESULTS

Instrumentation of canals increased volume and surface area. Prepared canals were significantly more rounded, had greater diameters and were straighter than unprepared canals. However, all instrumentation techniques left 35% or more of the canals' surface area unchanged. Whilst there were significant differences between the three canal types investigated, very few differences were found with respect to instrument types.

CONCLUSIONS

Within the limitations of the micro CT system, there were few differences between the four canal instrumentation techniques used. By contrast, a strong impact of variations of canal anatomy was demonstrated. Further studies with 3D-techniques are required to fully understand the biomechanical aspects of root canal preparation.

Changes in root canal geometry after preparation assessed by high-resolution computed tomography

Root canal morphology changes during canal preparation, and these changes may vary depending on the technique used. Such changes have been studied in vitro by measuring cross-sections of canals before and after preparation. This current study used nondestructive high-resolution scanning tomography to assess changes in the canals' paths after preparation. A microcomputed tomography scanner (cubic resolution 34 microm) was used to analyze 18 canals in 6 extracted maxillary molars. Canals were scanned before and after preparation using either K-Files, Lightspeed, or ProFile .04 rotary instruments. A special mounting device enabled precise repositioning and scanning of the specimens after preparation. Differences in surface area (deltaA in mm2) and volume (deltaV in mm3) of each canal before and after preparation were calculated using custom-made software. deltaV ranged from 0.64 to 2.86, with a mean of 1.61 +/- 0.7, whereas deltaA varied from 0.72 to 9.66, with a mean of 4.16 +/- 2.63. Mean deltaV and deltaA for the K-File, ProFile, and Lightspeed groups were 1.28 +/- 0.57 and 2.58 +/- 1.83; 1.79 +/- 0.66 and 4.86 +/- 2.53; and 1.81 +/- 0.57 and 5.31 +/- 2.98, respectively. Canal anatomy and the effects of preparation were further analyzed using the Structure Model Index and the Transportation of Centers of Mass. Under the conditions of this study variations in canal geometry before preparation had more influence on the changes during preparation than the techniques themselves. Consequently studies comparing the effects of root canal instruments on canal anatomy should also consider details of the preoperative canal geometry.

Calibration of trabecular bone structure measurements of in vivo three-dimensional peripheral quantitative computed tomography with 28-microm-resolution microcomputed tomography

It has recently been shown that high-resolution computed tomography and magnetic resonance imaging have the potential to assess information about the microarchitecture of bone in a noninvasive way. However, due to the limited spatial resolution of the in vivo measurements, the individual trabeculae are not depicted with their true thickness. Nevertheless, the spacing of the structural elements allows the assessment of trabecular number. In a previous publication, the ridge number density (RND) was introduced as a measure for this structural index. It can be extracted from high-resolution three-dimensional (3D) images of patients and shows a reproducibility of 1.6%. In this work the Ridge extraction procedure is compared to and calibrated with microcomputed tomography (microCT) measurements. Three-dimensional measurements of 15 bone biopsies are made with a 28-microm-resolution microCT scanner as well as with a 165-microm-resolution peripheral quantitative computed tomography (pQCT) scanner. For the latter, the same settings are used as for patient examinations. The 15 pairs of measurements are analyzed and the resulting structural indices are compared. The results show that structural indices such as trabecular number, mean thickness, and mean separation can be determined from the 3D pQCT data with an r2 of between 0.81 and 0.96 if the microCT data are taken as the gold standard. The calibration equation found for the bone volume fraction has an intercept of 0.04 and a slope of 0.86 (r2 = 0.98), and trabecular number as the main additional structural index shows a nonsignificant intercept and a calibration slope of 0.91 with the microCT. The calibration procedure can be used directly for patient examinations. Applied to time-series measurements it may be of value for monitoring and quantifying microarchitectural changes due to therapy or aging.

Micro-computed tomography-current status and developments

The recent rapid increase in interest in tomographic imaging of small animals and of human (and large animal) organ biopsies is driven largely by drug discovery, cancer detection/monitoring, phenotype identification and/or characterization, and development of disease detection methods and monitoring efficacies of drugs in disease treatment. In biomedical applications, micro-computed tomography (CT) scanners can function as scaled-down (i.e., mini) clinical CT scanners that provide a three-dimensional (3-D) image of most, if not the entire, torso of a mouse at image resolution (50-100 microm) scaled proportional to that of a human CT image. Micro-CT scanners, on the other hand, image specimens the size of intact rodent organs at spatial resolutions from cellular (20 microm) down to subcellular dimensions (e.g., 1 microm) and fill the resolution-hiatus between microscope imaging, which resolves individual cells in thin sections of tissue, and mini-CT imaging of intact volumes.

Digital and Advanced Imaging in Endodontics: A Review

This review provides an overview of digital radiography as it exists, including advanced imaging such as computed tomography (CT), cone beam volumetric imaging, and micro-CT as relevant to the practice of endodontics. An evidence-based approach to adoption of different imaging technologies is included to assist the practitioner with the selection process of imaging modalities. Commonly used imaging terminology is introduced, as well as the advantages and disadvantages of image processing. New image reconstruction techniques have been introduced that provide information three-dimensionally to the clinician for routine endodontic and surgical treatment planning. The age of three-dimensional imaging and image processing is here. Limitations and advantages of newly introduced imaging modalities are discussed briefly.

An improved segmentation method for in vivo microCT imaging

Image segmentation methods for microCT can influence the accuracy of bone morphometry calculations. A new automated segmentation method is introduced, and its performance is compared with standard segmentation methods. The new method can improve the results of in vivo microCT, where the need to keep radiation dose low limits scan quality.

INTRODUCTION

An important topic for microCT analysis of bone samples is the segmentation of the original reconstructed grayscale data sets to separate bone from non-bone. Problems like noise, resolution limitations, and beam-hardening make this a nontrivial issue. Inappropriate segmentation methods will reduce the potential power of microCT and may introduce bias in the architectural measurements, in particular, when new in vivo microCT with its inherent limitations in scan quality is used. Here we introduce a new segmentation method using local thresholds and compare its performance to standard global segmentation methods.

MATERIAL AND METHODS

The local threshold method was validated by comparing the result of the segmentation with histology. Furthermore, the effect of choosing this new method versus standard segmentation methods using global threshold values was investigated by studying the sensitivity of these methods to signal to noise ratio and resolution.

RESULTS

Using the new method on high-quality scans yielded accurate results and virtually no differences between histology and the segmented data sets could be observed. When prior knowledge about the volume fraction of the bone was available the global threshold also resulted in appropriate results. Degrading the scan quality had only minor effects on the performance of the new segmentation method. Although global segmentation methods were not sensitive to noise, it was not possible to segment both lower mineralized thin trabeculae and the higher mineralized cortex correctly with the same threshold value.

CONCLUSION

At high resolutions, both the new local and conventional global segmentation methods gave near exact representations of the bone structure. When scanned samples are not homogenous (e.g., thick cortices and thin trabeculae) and when resolution is relatively low, the local segmentation method outperforms global methods. It maximizes the potential of in vivo microCT by giving good structural representation without the need to use longer scanning times that would increase absorption of harmful X-ray radiation by the living tissue.

Quantification of the degree of mineralization of bone in three dimensions using synchrotron radiation microtomography

The availability of three-dimensional measuring techniques coupled to specific image processing methods opens new opportunities for the analysis of bone structure. In particular, synchrotron radiation microtomography may provide three-dimensional images with spatial resolution as high as one micrometer. Moreover, the use of a monoenergetic synchrotron beam, which avoids beam-hardening effects, allows quantitative measurements of the degree of mineralization in bone samples. Indeed, the reconstructed gray levels of tomographic images correspond directly to a map of the linear attenuation coefficient within the sample. Since the absorption depends on the amount of mineral content, we proposed a calibration method to evaluate the three-dimensional distribution of the degree of mineralization within the sample. First a theoretical linear relationship modeling the linear attenuation coefficient as a function of the hydroxyapatite concentrations was derived. Then, an experimental validation on phantoms confirmed both the accuracy of the image processing tools and the experimental setup used. Finally, the analysis of the degree of mineralization in four iliac crest bone biopsy samples was reported. Our method was compared to the reference microradiography technique, currently used for this quantification in two dimensions. The concentration values of the degree of mineralization were found with both techniques in the range 0.5-1.6 g of mineral per cubic centimeter of bone, both in cortical and in trabecular region. The mean difference between the two techniques was around 4.7%, and was slightly higher in trabecular region than in cortical bone.

Finite element analysis of trabecular bone structure: a comparison of image-based meshing techniques

In this study, we investigate if finite element (FE) analyses of human trabecular bone architecture based on 168 microm images can provide relevant information about the bone mechanical characteristics. Three human trabecular bone samples, one taken from the femoral head, one from the iliac crest, and one from the lumbar spine, were imaged with micro-computed tomography (micro-CT) using a 28 microm resolution. After reconstruction the resolution was coarsened to 168 microm. First, all reconstructions were thresholded and directly converted to FE-models built of hexahedral elements. For the coarser resolutions of two samples, this resulted in a loss of trabecular connections and a subsequent loss of stiffness. To reduce this effect, a tetrahedral element meshing based on the marching cubes algorithm, as well as a modified hexahedron meshing, which thresholds the image such that load carrying bone mass is preserved, were employed. For each sample elastic moduli and tissue Von Mises stresses of the three different 168 microm models were compared to those from the hexahedron 28 microm model. For one sample the hexahedron meshing at 168 microm produced excellent results. For the other two samples the results obtained from the hexahedral models at 168 microm resolution were poor. Considerably better results were attained for these samples when using the mass-compensated or tetrahedron meshing techniques. We conclude that the accuracy of the FE-models at 168 microm strongly depends on the bone morphology, in particular its trabecular thickness. A substantial loss of trabecular connections during the hexahedron meshing process indicates that poor FE results will be obtained. In this case the tetrahedron or mass-compensated hexahedron meshing techniques can reduce the loss of connections and produce better results than the plain hexahedron meshing techniques.

Analysis of 3D bone ingrowth into polymer scaffolds via micro-computed tomography imaging

This paper illustrates the utility of micro-computed tomography (micro-CT) to study the process of tissue engineered bone growth. A micro-CT facility for imaging and visualising biomaterials in three dimensions (3D) is described. The facility is capable of acquiring 3D images made up of 2000(3) voxels on specimens up to 60mm in extent with resolutions down to 2 microm. This allows the 3D structure of tissue engineered materials to be imaged across three orders of magnitude of detail. The capabilities of micro-CT are demonstrated by imaging the Haversian network within human femoral cortical bone (distal diaphysis) and bone ingrowth into a porous scaffold at varying resolutions. Phase identification combined with 3D visualisation enables one to observe the complex topology of the canalicular system of the cortical bone. Imaging of the tissue engineered bone at a scale of 1cm and resolutions of 10 microm allows visualisation of the complex ingrowth of bone into the polymer scaffold. Further imaging at 2 microm resolution allows observation of bone ultra-structure. These observations illustrate the benefits of tomography over traditional techniques for the characterisation of bone morphology and interconnectivity and performs a complimentary role to current histomorphometric techniques.

Surface layer erosion of natural caries lesions with phosphoric and hydrochloric acid gels in preparation for resin infiltration

The infiltration of proximal enamel lesions with low-viscosity light curing resins could be a viable approach to stop lesion progression. However, penetration of sealant might be hampered by the comparatively highly mineralized surface layers of natural lesions. Therefore, the aim of this study was to compare the efficacy of three different etching gels in removing the surface layer in various etching times. Extracted human molars and premolars showing proximal white spot lesions were cut across the demineralized areas. Ninety-six lesions expected from visual examination to be confined to the outer enamel (C1) were selected. The cut surface and half of each lesion were varnished, thus serving as control. Subsequently, the lesions were etched with either phosphoric (37%) or hydrochloric (5 or 15%) acid gel for 30-120 s (n = 8/group). Specimens were examined using confocal microscopy and transversal microradiography. Surface layer reduction was significantly increased in lesions etched with 15% HCl gel for 90 and 120 s compared to those etched with H(3)PO(4) gel for 30-120 s (p < 0.05). No significant differences regarding the depths of erosion in the lesions compared to sound enamel could be observed (p > 0.05). An effective reduction in the surface layer of natural enamel caries can be achieved by etching with 15% hydrochloric acid gel for 90-120 s.

X-ray microtomography (microCT) using phase contrast for the investigation of organic matter

PURPOSE

We show that microtomography (microCT) using synchrotron radiation (SR) can be extended to include X-ray phase contrast, which is two to three orders of magnitude more sensitive than conventional attenuation contrast and better suited for the investigation of specimens consisting chiefly of light elements for photon energies ranging at least from 1 to 100 keV.

METHOD

Phase contrast is generated by placing the specimen in one of the interfering beams of an X-ray interferometer. With use of 12-keV X-rays, phase projections of the specimen are recorded at 180 or 360 angular settings equally spaced between 0 and 180 degrees. One phase projection consists of four pairs of "associated" radiograms in the sense that one is taken with and the other without the specimen in the beam. Between pairs a parallel-sided phase-shifter plate is rotated for changing the relative phase of the two interfering beams by multiples of pi/2 rad. By calculating phase-weighted sums of all associated pairs of radiograms, true phase-shift projections are obtained for all angular settings of the specimen, which are then reconstructed.

RESULTS

Three-dimensional images have been obtained from rat cerebrum and rat trigeminal nerve, showing cell structures at 8- to 15-micron spatial resolution. Gray and white matter of cerebrum and neurons in the trigeminal nerve are clearly visible.

CONCLUSION

X-ray phase-contrast microCT is becoming a valuable tool for studies of organic samples in medicine and biology.

Subchondral bone micro-architectural alterations in osteoarthritis: a synchrotron micro-computed tomography study

OBJECTIVES

We evaluated the three-dimensional (3D) micro-architecture of subchondral trabecular (Tb) bone in osteoarthritis (OA). Due to high signal-to-noise ratio and high resolution, micro-computed tomography (micro-CT) by synchrotron radiation is considered as the gold standard for bone micro-architecture imaging.

DESIGN

Subchondral bone were extracted from femoral heads in OA cases in areas without cartilage (OAc-; n=6) and in adjacent areas with cartilage (OAc+; n=6) and compared to eight subchondral bone cores from osteoporosis cases (OP). The voxel size of images was 10.13 microm. We measured the bone volume fraction (BV/TV) and morphological parameters: Tb thickness (TbTh), Tb spacing (TbSp), Tb number (TbN), and bone surface/bone volume (BS/BV). The degree of anisotropy (DA), the connectivity by the Euler number and the degree of mineralization (DM) were equally assessed.

RESULTS

BV/TV and morphological parameters showed significant differences between OAc- and OP samples (P<0.01 except TbTh: P<0.05) and between OAc- and OAc+ (0.05<P<0.01) but no difference between OAc+ and OP except TbN (P<0.01). The connectivity was higher in OAc- comparatively to OAc+ and OP. The DA were significantly different between OA and OP cases (P<0.01) but not between OAc- and OAc+ specimens. The DMs (mean+/-SD) were 0.817+/-0.142 g/cm(3), 0.873+/-0.161 g/cm(3), 0.906+/-0.156 g/cm(3) for OAc-, OAc+, OP (P<0.01), respectively.

CONCLUSION

Subchondral bone changes were mainly observed in advanced OA, when cartilage has been deleted and preserved in adjacent area. These data suggest that subchondral bone changes would be rather secondary to the cartilage deterioration than a primitive mechanism of OA. Nevertheless, longitudinal data could bring more accurate conclusions.

Quantification of periapical bone destruction in mice by micro-computed tomography

Bacterial infections of the dental pulp result in tissue destruction and periapical bone resorption. The availability of genetically engineered mouse strains is a major advantage in the use of this model system for studies of periapical pathogenesis. The main limitation of the mouse model is its small size, and the necessity for laborious histologic analyses to quantify periapical bone destruction. In the present study, we evaluated the use of a new technology, high-resolution micro-computed tomography (micro-CT), for the rapid and non-invasive quantification of periapical bone destruction. Periapical lesions were induced in the lower first molars of mice by exposing the pulp to the oral environment. Mandibles were harvested on day 21 after pulp exposure, and were subjected to micro-CT analysis, with 17-microm-thick radiographic sections. Samples were then decalcified, embedded, and sectioned for histology. The cross-sectional area of periapical lesions was determined by image analysis of corresponding micro-CT and histologic sections. The results showed a highly significant correlation between micro-CT and histology (p < 0.0001), with mean differences of 4. 1% (range, 0.9 to 7.2%) between the two methods. The mean error associated with image analysis was 4.9% for images obtained by both micro-CT and histology. The variability of replicate (n = 5) independent micro-CT determinations was 3.4%, less than that associated with the image analysis error. These results demonstrate that micro-CT imaging is a rapid, reproducible, and non-invasive method, that gives results that are closely comparable with those obtained by histology. Micro-CT appears to have utility for the accurate quantification of changes in bone architecture in small biological specimens.

MicroCT evaluation of normal and osteoarthritic bone structure in human knee specimens

Although trabecular bone structure has been evaluated, variation with knee compartment and depth from joint surface is not completely understood. Cadaver knees were evaluated with microcomputed tomography analysis for these variations. Objective differences were compared between: medial vs. lateral compartments; femoral vs. tibial bone; and normal vs. arthritic knees. Depth dependent changes in the parameters were observed for the first 6 mm of the cores in normal knees: BV/TV, Tb.N and Conn.D gradually decrease, while Tb.Sp and SMI increase. In the first 6 mm of the normal tibia BV/TV, Tb.N, and Tb.Th are greater than in the femur on both the medial and lateral compartments while Tb.Sp, SMI, and Conn.D are lower. The medial compartment values for BV/TV, Tb.N, Tb.Th and Conn.D are generally greater than for the lateral in both the femur and tibia while Tb.Sp and SMI are lower. In comparison of normal vs. arthritic knees significant differences are observed in the first 6 mm of the medial tibia. With arthritis BV/TV and Tb.Th are lower, while SMI and Tb.Sp are higher. Tb.N and Conn.D show no statistically significant difference. The bone structure variations are, thus, most prominent in the first 6 mm of depth and medial compartment bone is generally more structurally sound than lateral. Severely arthritic bone changes are most prominent in the medial compartment of the tibia and bone structure is less sound in severe arthritis.

X-ray microtomography: nondestructive three-dimensional imaging for in vitro endodontic studies

Article shows the application of a laboratory x-ray microtomography system, a miniaturized form of conventional computerized axial tomography, to the study of root canal morphologic characteristics and changes in the course of root canal treatment in extracted teeth. After reconstruction of the three-dimensional images, the IDL software package (Research Systems, Inc., Colorado) was used to obtain cross-sectional slices of the tooth and three-dimensional views of rendered surfaces of constant mineral density. The root canal systems and changes in these were imaged at a resolution (cubic voxel side-length) of approximately 40 microns.

Imaging Artificial Caries on the Occlusal Surfaces with Polarization-Sensitive Optical Coherence Tomography

Polarization-sensitive optical coherence tomography (PS-OCT) is a nondestructive imaging system that can utilize near-infrared (IR) light to produce depth-resolved images of dental enamel and has the potential to monitor early enamel occlusal caries. The objective of this study was to investigate the relationship between the magnitude of backscattered light and depolarization recorded by PS-OCT with changes in the enamel mineral volume in an artificial caries model. Artificial lesions were created on a selected region on the occlusal surfaces of sound posterior teeth (n=10) using a well-characterized 14-day pH cycling model. An all-fiber-based PS-OCT system operating at 1,310 nm was used to collect serial images at day 0 and day 14 prior to tooth sectioning. The quantitative mineral content profile and relative mineral loss, DeltaZ (%volxmicrom), of the carious enamel samples were obtained from transverse sections using high-resolution digital microradiography (DM). Line profiles of PS-OCT and DM images were used to evaluate the artificial caries severity and depth. The integrated reflectivity of the perpendicular-axis PS-OCT image, quantifying lesion severity, was correlated to the DeltaZ of the caries lesions. There was also a strong correlation between the lesion depth calculated from both imaging modalities. PS-OCT can image and quantify artificial occlusal caries by measuring the increase in backscattering and depolarization of near-IR light. This optical method has promising applications for in vivo detection and monitoring of early enamel occlusal caries.

Comparison of microcomputed tomographic and microradiographic measurements of cortical bone porosity

Cortical bone is perforated by a network of canals that have a significant impact upon its material properties. Microcomputed tomography offers the possibility of noninvasively visualizing and quantifying cortical pores in both two and three dimensions. Establishing how two-dimensional (2D) microcomputed tomographic (microCT) analysis compares with conventional methods for analyzing cortical porosity is an important prerequisite for the wider adoption of this technique and the development of three-dimensional (3D) analysis. Therefore, we compared porosity-related parameters from 2D microcomputed tomographic images with those from matching microradiographic sections. Samples from five human femora were scanned at a 10-microm resolution and then sequentially sectioned and microradiographed. An average of eight image pairs were produced from each femur (total, n = 41). The repeatability and comparability of the two techniques was assessed for three parameters; cortical porosity (%), mean pore area (microm(2)), and pore density (pores/mm(2)). For repeatability, no significant difference ( P > 0.05) was found between the two methods for cortical porosity and mean pore area; however, pore density differed significantly ( P < 0.001). For comparability, the bias (+/- error) between the methods was found to be 0.51% (+/-0.31%) for cortical porosity and -155 microm(2) (+/-293 microm(2)) for mean pore area. The bias for pore density was dependent upon measurement size with microcomputed tomographic images having 14% (+/-9.3%) fewer pores per millimeter squared. The qualitative and quantitative similarities between the two techniques demonstrated the utility of 2D microcomputed tomographic for cortical porosity analysis. However, the relatively poor results for pore density revealed that a higher resolution (<10 microm) is needed to consistently visualize all cortical pores in human bone.

Comparison of laser fluorescence and longitudinal microradiography for quantitative assessment of in vitro enamel caries

A new quantitative, non-destructive method using laser-induced fluorescence (LAF) was compared with longitudinal microradiography (LMR) for assessment of mineral changes in enamel slices using an in vitro caries model. Ten enamel slices, cut longitudinally from sound natural smooth surfaces of human teeth, were exposed to de- and remineralization in a pH-cycling model. The enamel slices were subjected to LAF and LMR measurements before and at 2, 4, 7, and 9 days of demineralization. For LAF, the average fluorescence radiance decreased during the demineralization period with 11% by day 2 and 49% by day 9. For LMR, the corresponding average loss of mineral content changed with 0.01 and 0.10 kg.m-2 over the same time period. The mineral losses in each individual enamel slice measured with the two techniques were strongly correlated, r = 0.97. The Spearman rank correlation coefficient for all LAF and LMR demineralization results was 0.86. The precision (coefficient of variation) for LAF was 3.1%, corresponding to 0.005 kg.m-2, and the repeatability error for LMR was 0.02 kg.m-2, indicating a lower discrimination threshold for LAF compared to LMR. It was concluded that the new, sensitive, non-destructive LAF method provides possibilities for further improvement in the quantification of initial caries lesions in natural smooth enamel surfaces for use in in vitro studies. Furthermore, it offers potential in in situ caries studies as well as a tool in the diagnosis of early enamel caries in vivo.

In osteoporotic women treated with strontium ranelate, strontium is located in bone formed during treatment with a maintained degree of mineralization

In postmenopausal osteoporotic women and up to 3 years of treatment with strontium ranelate, strontium was present only in recently deposited bone tissue resulting from formation activity during the period of treatment. Strontium was shown to be dose-dependently deposited into this newly formed bone with preservation of the mineralization.

INTRODUCTION

Interactions between strontium (Sr) and bone mineral and its effects on mineralization were investigated in women treated with strontium ranelate.

METHODS

Bone biopsies from osteoporotic women were obtained over 5-year strontium ranelate treatment from phases II and III studies. Bone samples obtained over 3-year treatment were investigated by X-ray microanalysis for bone Sr uptake and focal distribution, and by quantitative microradiography for degree of mineralization. On some samples, Sr distribution (X-ray cartography) was analyzed on whole sample surfaces and the percentage of bone surface containing Sr was calculated. Bone Sr content was chemically measured on whole samples.

RESULTS

In treated women, Sr was exclusively present in bone formed during treatment; Sr deposition depended on the dose with higher focal content in new bone structural units than in old ones constantly devoid of Sr, even after 3-year treatment. A plateau in global bone Sr content was reached after 3 years of treatment. Cartography illustrated the extent of surfaces containing Sr, and formation activity during strontium ranelate treatment was higher in cancellous than in cortical bone. Mineralization was maintained during treatment.

CONCLUSION

The quality of bone mineral was preserved after treatment with strontium ranelate, supporting the safety of this agent at the bone tissue level.

The protective role of eicosapentaenoic acid [EPA] in the pathogenesis of nephrolithiasis

The low incidence of atherosclerosis and other degenerative diseases including stone disease in the Greenland Eskimo has been attributed to their high consumption of oily fish with its high concentration of eicosapentaenoic acid (EPA). Man cannot synthesis EPA from the precursor essential fatty acid, linolenic acid, and can only assimilate preformed EPA present in fish and fish oil, to bring about a change in the pathway of eicosanoid metabolism from the n-6 to the n-3 series. With a westernised diet the oxygenated products of renal prostaglandin synthesis are metabolites of the n-6 series and these are known to play an important role in several pathophysiological states including stone disease. Our previous studies have shown a relationship between prostaglandin activity and urinary calcium excretion and it would seem that the initiating factor/s for stone formation trigger the mechanisms for prostaglandin synthesis resulting in the biochemical abnormalities associated with stone disease. The Eskimo may be protected from these events by possession of an eicosanoid metabolism that follows an n-3 pathway. To test this hypothesis experiments were performed using an animal model of nephrocalcinosis. The animals were divided into three groups; one group was given an intra-peritoneal injection of 10% calcium gluconate daily for 10 days to induce nephrocalcinosis; a second group was fed MaxEPA fish oil before and during the calcium gluconate injections and a third group only received an intra-peritoneal injection of N saline. A group of 12 recurrent, hypercalciuric/hyperoxaluric stone-formers were treated with fish oil for eight weeks to study the effects on solute excretion. Nephrocalcinosis, which was readily produced in the control animals, was prevented in the experimental animals by pre-treatment with fish oil and urine calcium excretion was significantly reduced. The urinary calcium and oxalate excretion in the recurrent, hypercalciuric stone-formers was significantly reduced with fish oil treatment over an eight week period. There were no untoward side-effects. These studies indicate that the incorporation of EPA in the diet as a substitute metabolic pathway could be a unique way of correcting the biochemical abnormalities of idiopathic urolithiasis.

Quantification of formation and remineralization of artificial enamel lesions with a new portable fluorescence device

Quantitative laser fluorescence has been reported as a useful method for the non-destructive in vitro and in vivo diagnosis of early enamel caries. A portable system for intraoral use has been developed with a new light source and filter system replacing the laser light to facilitate clinical application. This new device was validated with microradiographic and chemical analyses for assessment of mineral changes in enamel during lesion formation and remineralization in vitro and compared with the laser light equipment. A significant correlation was found between fluorescence changes and mineral loss: r = 0.79 (laser system) and r = 0.84 (portable lamp system). The correlation between the two fluorescence methods was r = 0.93. The portable fluorescence device seemed to be a promising new tool for reproducible and sensitive assessment of the severity of incipient enamel lesions.

Characteristics of tissue growth into Proplast and porous polyethylene implants in bone

(1) Bone does not form within internal pores of undistorted Proplast implants because of the small interconnecting pore size of the material; (2) the nonosseous, fibrous tissue which exists in the pores of Proplast implants in bone is not attached to the surrounding bone (i.e., Sharpey's fibers are not present). The load-bearing support which can be afforded by Proplast implants is limited by the incomplete bone ingrowth along the margins of the material and the tensile strength of Proplast.

Micro- and nano-CT for the study of bone ultrastructure

Micro-computed tomography (micro-CT)-a version of X-ray CT operating at high spatial resolution-has had a considerable success for the investigation of trabecular bone micro-architecture. Currently, there is a lot of interest in exploiting CT techniques at even higher spatial resolutions to assess bone tissue at the cellular scale. After recalling the basic principles of micro-CT, we review the different existing system, based on either standard X-ray tubes or synchrotron sources. Then, we present recent applications of micro- and nano-CT for the analysis of osteocyte lacunae and the lacunar-canalicular network. We also address the question of the quantification of bone ultrastructure to go beyond the sole visualization.

Increased remineralization of tooth enamel by milk containing added casein phosphopeptide-amorphous calcium phosphate

Casein phosphopeptide amorphous calcium phosphate nanocomplexes (CPP-ACP) in chewing gum, lozenges and mouthrinses have been shown to remineralize enamel subsurface lesions in human in situ experiments. The aim of this double-blind, randomized clinical study was to investigate the capacity of CPP-ACP added to bovine milk to remineralize enamel subsurface lesions in situ. Ten subjects drank milk containing either 2·0 or 5·0 g CPP-ACP/l or a control milk whilst wearing removable appliances with enamel slabs containing subsurface demineralized lesions. Each 200 ml milk sample was consumed once a day for each weekday over three consecutive weeks. After each treatment and one weeks rest the subjects crossed over to the other treatments. At the completion of the treatments the enamel slabs were removed and remineralization determined using microradiography and microdensitometry. The results demonstrated that all three milk samples remineralized enamel subsurface lesions. However, the milk samples containing CPP-ACP produced significantly greater remineralization than the control milk. The remineralising effect of CPP-ACP in milk was dose-dependent with 2·0 and 5·0 g CPP-ACP/l producing an increase in mineral content of 70 and 148%, respectively, relative to the control milk. The differences in remineralization following exposure to the three milk samples were all statistically significant (P<0·001). In conclusion, this study shows that the addition of 2·0–5·0 g CPP-ACP/l to milk substantially increases its ability to remineralize enamel subsurface lesions.

Study of subchondral bone adaptations in a rodent surgical model of OA using in vivo micro-computed tomography

OBJECTIVE

To non-invasively investigate the changes to epiphyseal bone occurring in a longitudinal pre-clinical model of osteoarthritis (OA) using in vivo micro-computed tomography (micro-CT).

DESIGN

In vivo micro-CT images were acquired using a bench-top micro-CT scanner, which produces three-dimensional data with isotropic voxel spacing of 0.046 mm. Male rodents were scanned prior to surgical destabilization, consisting of anterior cruciate ligament transection and partial medial menisectomy (ACLX). Subsequent scans were performed every 4 weeks post-ACLX, for up to 5 months. Volumetric bone mineral density (vBMD) was measured in specific, anatomically segmented regions within each image. The ACLX rodent data were compared with the contralateral non-operated hind limb of the same animal, as well as a sham-operated group (SHAM) of animals, for each time point. End-point histology compared changes to cartilage and bone between the ACLX and control animals.

RESULTS

The micro-CT protocol produced sufficient spatial resolution and signal-to-noise ratio (SNR=19) to quantify subchondral bone pathology, with an acceptable entrance exposure to radiation (0.36 Gy). Significantly lower vBMD was measured in the ACLX group, vs SHAM rodents, at 1, 4, and 5 months post-surgery (P<0.05). Qualitative observations of ACLX joints revealed significant loss of cartilage, subchondral bone cysts, and calcification of tendon similar to changes found in humans.

CONCLUSIONS

This study demonstrates in vivo micro-CT as an effective method for investigating the development of rodent knee OA longitudinally. This method can be applied, in future pre-clinical trials, to non-destructively monitor the efficacy of pharmacological interventions.