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PubMed1994

Triage methodology for the evaluation of implant-bone interfaces.

Stainless steel plugs coated with and without Al2O3, TiO2 and Nb2O5 were inserted into canine femora in order to develop a methodology of rapid identification of appropriate specimens for deeper analysis of implant-bone interfaces. This approach is especially meaningful in areas where research funds are scarce. After a maximum follow-up period of 52 wk, bone segments containing plugs were radiographed using conventional techniques, high resolution techniques (which allowed a good preliminary evaluation) and microradiography. Analysis by X-ray fluorescence spectrometry indicated release of the materials by the implants. Microdensitometry of the microradiographs allowed a precise thickness determination of the tissue formed around the implants.

Aluminum Oxide↗

PubMed1987

Porous hydroxylapatite as a bone graft substitute in mandibular contour augmentation: a histometric study.

The buccal contour of the mandible was augmented in 17 dogs with 5 X 7.5 X 20 mm blocks of porous hydroxylapatite (HA) on one side and two-layered split rib autografts on the other. Both specimens were retrieved at three, six, 12, 24, and 48 months. Undecalcified sections were prepared for microradiography, light and UV microscopy, and histometry. A transmitted light video image digitizing system was used to trace implant and graft perimeters and calculate cross sectional areas. This system was also used to measure graft density and calculate bone and soft tissue compositions. The HA matrix, bone and soft tissue compositions of implant specimens were measured with a backscattered scanning electron microscope imaging digitizing system. All grafts became increasingly resorbed with time whereas all implants remained intact. Mature osteotonic bone ingrowth was present in all implants except one which failed to unite with the mandibular cortex. The mean graft areas decreased from 30.8 mm2 at three months to 0.7 mm2 at 48 months, while the implant areas averaged 35.5 mm2 and remained stable. The graft specimens were composed of 46.6% bone and 53.4% soft tissue or fluid space. The implant specimens were composed of 34.5% HA matrix, 28.6% bone, and 33.9% soft tissue. The HA matrix had a surface area of 9.8 mm2/mm3 that was 61.9% covered with bone ingrowth and 38.1% covered with soft tissue or fluid space. In contrast to the rapid resorption of graft onlays, the porous HA matrix demonstrated a long-term permanence with maintenance of contour and osseous incorporation over the four-year duration of this study.

Animals↗

PubMed1991

Bridging of mandibular defects with two different reconstruction systems: an experimental study.

To compare two different mandibular reconstruction systems, a 5-cm angular resection was performed in nine adult sheep. The defect was reconstructed using either a classic AO plate or the AO-THORP reconstruction system. The animals were killed 5, 9, and 14 weeks after operation. Serial sections with the plates and screws in place were prepared and studied histologically and with microradiography and fluorescence microscopy. Twenty-six percent of the 2.7-mm AO cortical screws were adequately fixed. The corresponding percentage for AO-THORP hollow screws was 73%. The main advantage of the latter system is the screw-plate locking principle, which allows plate stability to be maintained even if bone is resorbed under the plate. Whether the existence of a screw lumen is an advantage has not yet been established.

Animals↗

PubMed1990

Accuracy in radiographic diagnosis: Dutch practitioners and dental caries.

The effective diagnostic accuracy of dentists is the missing link in models for calculating the optimal frequency for radiographic recall. The purpose of this study was to describe the accuracy of Dutch general dental practitioners using bitewing radiographs for the diagnosis and treatment of approximal caries in dentine. Practitioners from a 10 per cent (n = 444) national random sample were sent a set of simulated bitewings, a patient description and a diagnostic response form. The radiographs showed tooth surfaces with (n = 45) and without (n = 60) dentine caries. Microradiography of the sectioned teeth was used as a diagnostic reference standard. The participants were asked to diagnose dentine caries using a five-point certainty scale and decide if restorative treatment was indicated. The response was 62 per cent (n = 276). The area under a mean receiver operating characteristic curve for the practitioners was 88 per cent of the area representing optimal accuracy. Diagnostic accuracy, however, varied considerably between dentists. For caries considered to be 'probably' in the dentine mean sensitivity was 54 per cent (s.d. 14 per cent) and specificity was 97 per cent (s.d. 5 per cent). The pooled restorative treatment decisions of the dentists had a mean sensitivity of 62 per cent and a specificity of 96 per cent. More surfaces were considered in need of treatment than were diagnosed as 'probably' having dentine caries. Treatment decisions were more accurate than diagnostic ability might indicate. Paradoxically this may be because errors in visual ability were partly compensated for by 'over treatment' decisions.

Decision Making↗

PubMed1991

Microscopical study on estimation of time since death in skeletal remains.

For the purpose of estimating time since death in skeletal remains, postmortem changes in human compact bones were examined by microradiography and electron microscopy. The UV-fluorescence of the peripheral zone of compact bone was also examined by microscopic spectrophotometry. Microradiographic examination revealed no morphological changes in bones left in the open air for long periods, except one of 15 years since death. In bones left in the soil, vacuoles of 5-10 microns diameter, which contained a honeycomb-like structure formed by small vacuoles of 0.5-1 microns diameter, were found in the peripheral zone of the substantia compacta approximately 5 years since death, and in bones of 6 years or more, this change extended to the mid-zone. In bones left in the sea for 4-5 years, vacuoles of 5-10 microns diameter were observed in the outer peripheral zone of the substantia compacta. The relative intensity of UV-fluorescence in bones dwindled with time since death and the correlation coefficient was considerably high.

Bone and Bones↗

PubMed1995

Scanning electron microscope observations of heat-treated human bone.

This report describes the heat-induced alterations in human bone tissue observed using scanning electron microscopy and microradiography. Femoral bone samples were taken from persons varying in age from 1 year to 97 years at the time of their death. The bone was heated at selected temperatures in the range 200-1600 degrees C for periods of 2, 12, 18 and 24 h. Macroscopically, changes in colour occurred, together with some shrinkage, fracturing and distortion. However, dramatic changes occurred at the ultrastructural level. These changes included the progressive combustion of the organic portion of the bone tissue up to 400 degrees C and recrystallisation of the bone mineral beginning at 600 degrees C. Recrystallisation produced a range of crystal morphologies: spherical, hexagonal, platelets, rosettes and irregular. Crystal growth occurred at temperatures > 600 degrees C. Sintering led to fusion of crystals at 1000 degrees C. This process continued up to temperatures > 1400 degrees C. At 1600 degrees C the bone mineral melted. On heating, the morphology of crystals formed, and the ultrastructural changes which occurred, were found to be related to the age of the deceased, the temperature to which the bone had been heated and the duration of heating. These results are of importance to forensic scientists, arson investigators and paleoarcheologists in their investigation of cremated human bones, particularly when only fragments of bone are available, in order to determine something of the life history of the deceased and the circumstances surrounding the death.

Adolescent↗

PubMedDate not supplied

Hypermineralized lamellae below the bone surface: a quantitative microradiographic study.

Hypermineralized lamellae similar to interstitial resting lines were identified by microradiography beneath haversian, endocortical, and trabecular resting surfaces in 42 subjects aged 18-96 years. In cross-sectioned osteons, this hypermineralized lamella appeared as a circle showing the same high microdensity as the inner margin of the haversian canal. Bone tissue separating this circle and the margin was more mineralized than the peripheral lamellae of the osteon. In the tibia, 13.7 +/- 0.9% (Mean +/- SE) of Haversian canals exhibited a hypermineralized circle, localized at a distance of 20 +/- 0.4 microns from the canal wall. The scalloped haversian canals, different from osteoclastic resorption cavities, represented 9.9 +/- 0.7% of the haversian canals. There was a significant correlation between both types of haversian canals. Therefore, hypermineralized lamellae can appear at the end of bone apposition, whatever the bone surface. Their high mineral content may secondarily lead to an increased brittleness of the most superficial lamellae and even to their disaggregation.

Adolescent↗

PubMed2004

Demineralization in enamel and hydroxyapatite aggregates at increasing ionic strengths.

Subsurface demineralization of dental enamel is a curious feature of both in vivo and in vitro lesion formation. Numerous explanations have been proposed to explain this. One general hypothesis is that subsurface demineralization in enamel and synthetic hydroxyapatite (HAP) aggregates may result from the phenomenon of coupled diffusion between the inward transport of acid and the outward transport of dissolution products. The aim of this study was to test the validity of this explanation. Inert electrolyte was added to demineralizing solutions in order to reduce electrostatic coupling between the diffusive flows that occur during lesion formation. Scanning microradiography (SMR) was used to examine surface layer formation, and to measure the rate of mineral loss at increasing ionic strengths. It was found that surface layer formation was significantly reduced as the concentration of inert electrolyte was increased. Further, the rate of mineral loss from the developing lesion increased as the concentration of inert electrolyte (and therefore the ionic strength) in the demineralizing solution increased. It is concluded that electrostatic coupling between counter diffusing acid and dissolution products during lesion formation can significantly influence the mineral concentration within the surface layer.

Dental Enamel↗

PubMed2004

The validation of quantitative light-induced fluorescence to quantify acid erosion of human enamel.

OBJECTIVE: The purpose of this study was to validate the Quantitative light-induced fluorescence (QLF) device against transverse microradiography (TMR) with regard to the quantification of enamel erosion in vitro. DESIGN: Longitudinal in vitro. METHODS: Thirty previously extracted, caries free, human premolars were selected and prepared by gentle pumicing and coating in an acid-resistant nail-varnish save for an exposed window on the buccal surface. QLF baseline images were taken and the teeth then exposed to an erosive solution, 0.1% citric acid (pH 2.74). Teeth were removed at 30min intervals, air-dried and QLF images taken. At this time one tooth was randomly selected, removed from solution and sectioned through the lesion at three sites. The polished sample (100microm) was subjected to TMR and analysed for erosive mineral loss using proprietary software, with the DeltaZ values noted. QLF images were analysed by a blinded examiner with DeltaF and DeltaQ values recorded. Data were entered into SPSS and the correlation between the DeltaZ and DeltaF, and DeltaZ and DeltaQ values calculated. RESULTS: A wide range of erosive lesions was produced, with a steady increase in both DeltaZ and DeltaF over time; DeltaZ (24.0 (S.D. 1.2)-6114.3 (S.D. 1177.57)); DeltaF (1.8-11.2), DeltaQ (2.5-202.6). The results were scatter plotted and a regression line calculated. A positive correlation between DeltaZ and DeltaF of 0.91 was found, and for DeltaZ and DeltaQ; 0.87. CONCLUSIONS: The ability for QLF to detect and longitudinally monitor in vitro erosion has been shown. The strong positive correlation of DeltaF with DeltaZ suggests that percentage fluorescence loss as measured by QLF could be of great value in the development of a non-destructive, longitudinal tool for use in vitro, in situ and possibly in vivo.

Acids↗

PubMed2006

Effect of turpentine-induced fever during the enamel formation of rat incisor.

OBJECTIVE: Some epidemiological studies have indicated that diseases resulting in prolonged and sustained fever, such as exanthemata, respiratory infections and otitis media in infantile period or childhood are likely to have a marked deleterious effect on enamel formation, but the relationship between fever and enamel defects is unknown. The purpose of the present study was to induce a persistent high fever and examine the effects on the developing tooth enamel. METHODS: Twenty male Wistar rats weighting 140+/-10 g were used in this study. For the experimental group, a dose of 2.3 ml/kg steam-distilled turpentine was subcutaneously injected into both hind limbs five times at 12h intervals. Control rats received 2.3 ml/kg of sterile saline into the same injection site. The rectal temperatures of animals were measured at the febrile period. After constant periods, the animals were sacrificed, and the mandibular incisors were examined by contact microradiography (CMR) and histological observation. RESULTS: The febrile state lasted for 57 h and the average temperature rose 1.51 degrees C higher than that of the control group. The ground sections, semi-thin and ultra-thin sections of mandibular incisors were prepared and the enamel was observed. The microradiographs showed a radiolucent line along with the incremental line in the enamel. Moreover, microscopic examination indicated disorientation of enamel prism and crystal-free area within this radiolucent lesion. CONCLUSIONS: Persistent high fever pattern was established firmly by the turpentine injections and the process of enamel formation was influenced by the febrile period.

Amelogenesis↗

PubMed2005

Influence of estrogen therapy at conventional and high doses on the degree of mineralization of iliac bone tissue: a quantitative microradiographic analysis in postmenopausal women.

The beneficial skeletal effects of menopausal estrogen replacement therapy (HRT) are well documented. The role of secondary mineralization of bone as a determinant of bone quality is now well established in postmenopausal women treated with bisphosphonates or SERMs. The aim of present study was to investigate the effect of conventional and high doses of estrogen on the main parameters reflecting the degree of mineralization of bone (DMB). Bone biopsies were obtained from 20 women with osteopenia or osteoporosis before and after 24 months (18 to 38 months) of conventional HRT, and from 19 women who had received high doses of estradiol (implant 100 mg every 3-6 months for 1.5-20 years). DMB parameters (mean DMB, DMB Freq. Max. and Heterogeneity Index of the individual distributions of DMB) were measured using quantitative microradiography in cortical, cancellous, and total bone and expressed as g mineral/cm(3) bone. Values obtained in women before HRT were lower than those reported in pre- and postmenopausal control women. After conventional HRT, there was an increase in mean DMB (total bone) of 4.4 +/- 1.9% (mean +/- SEM) versus pre-treatment values (4.1 +/- 2.1% in cortical bone, 4.5 +/- 2.3% in cancellous bone); these differences did not reach statistical significance (P = 0.055). Results were similar for DMB Freq. Max. but Heterogeneity Index was not significantly changed. After high dose estradiol therapy, mean DMB (total bone) was 6.9 +/- 1.9% higher than in untreated women (8.6 +/- 2.1% in cortical bone, 6.5 +/- 2.1% in cancellous bone); this difference was statistically significant (P </= 0.03). Results were similar for DMB Freq. Max. but once again Heterogeneity Index was not significantly modified. The increases in mean DMB were due to a shift of the curves towards high DMB with a decrease of the low DMB values, as confirmed by the absence of changes in the Heterogeneity Index. Estrogen therapy is associated with an increased degree of mineralization of bone induced by a prolongation of secondary mineralization, similar to that observed with other antiresorptive agents. However, this increase was about two-fold lower than that observed after alendronate therapy (10 mg/day/3 years) in postmenopausal osteoporotic women.

Aged↗

PubMed2006

Long-term tissue response to bioabsorbable poly-L-lactide and metallic screws: an experimental study.

Late, clinically manifest, adverse inflammatory reactions have sometimes occurred after the use of slowly degrading bioabsorbable poly-l-lactide (PLLA) devices in clinical series of bone fixation. In this study, long-term tissue response to bioabsorbable fracture fixation screws made of poly-l-lactide and to similar metallic screws in cancellous bone was examined and compared with intact bone. The postoperative evaluation of the rabbit femora was performed by using plain radiography, microradiography, histology, histomorphometry, and oxytetracycline labeling studies. The follow-up times were 36 and 51 months in groups of 15 and 14 rabbits, respectively. A walling-off response by formation of trabecular bone which outlined the screw profile was observed in the PLLA and metallic groups both. Connective tissue between this bone front and the implant was seen only in the PLLA group. There was no difference in the thickness of the layer between the two follow-up groups. Between the surgically handled femora and the intact control bone, there was no statistically significant difference in the amount of trabecular bone. The osteoid formation activity in the tissue-implant interface showed no differences between the groups. However, active osteoblasts were visible only in the PLLA group. The amount of birefringent PLLA material diminished between the 36-month and the 51-month follow-up groups. Within the follow-up times of this study, both the PLLA screws and the metallic screws were rather inert. Also, long-term walling-off was a typical response to both PLLA and metallic screws in cancellous bone. PLLA screws did not evoke any osteostimulatory reaction over the long-term follow-up. The findings clearly demonstrated that the overall degradation process of PLLA was very slow and accompanied by fibrous tissue formation. Macrophage activity seemed to be related to the slow degradation process of PLLA and might be associated with the formation of connective tissue replacing the original implant. The results of this study showed no significant differences between the bioabsorbable PLLA screws and the metallic screws in biocompatibility, and no signs of inflammatory foreign-body reactions occurred during the follow-up.

Absorbable Implants↗

PubMed2005

Inhibition of dentine demineralization by zinc oxide: in vitro and in situ studies.

OBJECTIVE: The objective of this study was to evaluate the inhibitory effect of zinc oxide on dentine demineralization in vitro and in situ. METHODS: In the in vitro study, dentine specimens treated with a zinc oxide suspension were demineralized in a pH 5 solution. In the in situ study, subjects wore dentine specimens on their teeth and instructed to rinse with zinc-containing toothpaste slurry three times a day for 14 days. The design of study was a crossover one. RESULTS: Microradiography employed in the in vitro study revealed the dentine surfaces treated with distilled water had a lower mineral content than those treated by zinc. Toothpaste with zinc had a statistically significant, 49% greater inhibitory efficacy on dentine demineralization over the control. In the in situ study, zinc-containing toothpaste was also confirmed to have an inhibitory effect on dentine demineralization when compared to the zinc-free toothpaste. These in vitro and in situ studies revealed that zinc oxide can have a significant effect on the inhibition of dentine demineralization, even when the zinc oxide is blended into toothpaste. SIGNIFICANCE: This suggests that zinc oxide may be effective in the prevention of root caries.

Adult↗

PubMed2005

Development of an in situ root caries model. A. In vitro investigations.

OBJECTIVES: The paper describes preliminary in vitro investigations, the objectives of which were to examine the influence of certain experimental parameters on artificial carious lesion formation in root hard tissues, and their remineralisation. These experiments formed part of a wider study that aimed to develop an in situ model of root caries, based on the existing coronal caries model used in Liverpool. The present studies examined the effects (a) of the anatomical origin of the dentine, the presence or absence of cementum, the exposure time and the type of demineralising system, on lesion development, and (b) of baseline lesion size on the extent and location of mineral re-precipitation. METHODS: Mineral content parameters in plano-parallel sections taken from dentine lesions were determined by computer-controlled transverse microradiography. RESULTS: The importance of the anatomical origin of the dentine on lesion formation was investigated by comparing in vitro lesion formation in premolar and molar dentine, and in dentine from apical, middle and coronal thirds of the root: no difference was observed between these sites. Lesions formed more rapidly in acid buffer solutions than in acid gel systems, and were more reliably produced when cementum was removed. The effect of baseline lesion size on subsequent in vitro remineralisation demonstrated that a small baseline mineral content was associated with a larger percentage mineral gain. The location of mineral deposition throughout the lesion was also influenced by baseline mineral content parameters. CONCLUSIONS: The results form a basis for the further development of an in situ dentinal caries model, providing data to suggest that manipulation of parameters involved in the preparation of artificial carious lesions has a significant effect on the behaviour of the lesion, particularly the phenomenon of remineralisation. Further work is needed to investigate the behaviour of the model in situ.

Bicuspid↗

PubMed2026

Pre-clinical evaluation of the anticaries effect of an experimental Malva sylvestris extract mouthwash using a cariogenic model in situ.

OBJECTIVE: The aim of this study was to evaluate the antimicrobial and anticariogenic potential of Malva sylvestris extract on enamel and dentin in situ. METHODS: A double-blind crossover in situ study was conducted with 12 participants wearing palatal appliances containing two bovine enamel and two dentin specimens per 3 phases, a total of 72 enamel and dentin specimens. Biofilm formation and daily sucrose exposure were allowed. Treatments were applied twice daily in three phases: Malva sylvestris (2.5%, MS); fluoride (225 ppm, F); and placebo (P). After seven days, biofilm was collected from the bovine specimens for analysis of Lactobacillus spp. and mutans streptococci by Colony Forming Unit counts (CFU log₁₀/mL). Dental demineralization of the bovine specimens was assessed by transverse microradiography (TMR). RESULTS: MS did not reduce Lactobacillus spp. counts (CFU log₁₀/mL: enamel 6.63±0.81; dentin 6.68±0.92) compared to P (6.63±0.70; 6.62±0.51). F also did not differ (6.29±0.75; 6.32±0.41; ANOVA/Tukey, p>0.38). Mutans streptococci data were inconclusive. In enamel, both MS (2320.8±768.2 %vol·µm; 101.6±27.0 µm) and F (1777.3±733.3 %vol·µm; 95.8±23.5 µm) significantly reduced integrated mineral loss and lesion depth compared to P (3517.2±1119.9 %vol·µm; 138.6±19.5 µm; ANOVA/Tukey, p≤0.0003). In dentin, MS significantly reduced integrated mineral loss (322.5 [250-580] %vol·µm) and lesion depth (30.1 [15-42.2] µm) compared to P (880 [580-1705]; 58.3 [32.2-88.6] µm; Kruskal-Wallis/Dunn, p≤0.001), while F (587.5 [305-720]; 25.2 [16.5-38.8] µm) did not differ significantly (p>0.05). CONCLUSIONS: Malva sylvestris extract had no antimicrobial effect on Lactobacillus spp. counts, but significantly reduced enamel and dentin demineralization, showing anticaries effect comparable to fluoride. CLINICAL RELEVANCE: Malva sylvestris has demonstrated promising biological activity. This study investigates the antimicrobial efficacy of Malva sylvestris against cariogenic microorganisms in situ. Our findings provide relevant evidence that M. sylvestris exert significant anticaries effects using an in situ model.

Biofilms↗

PubMed2005

Bone regeneration in osseous defects using a resorbable nanoparticular hydroxyapatite.

PURPOSE: This animal study examined the de novo bone formation in bony defects following the insertion of autogenous bone alone versus an injectable nanoparticle hydroxyapatite alone and in combination with 25% autogenous bone. The regenerative potentials of the tested materials were compared with each other. MATERIALS AND METHODS: A model with biological similarity to humans with regard to bone regeneration was a prerequisite for the transferability of the results to clinical practice. Therefore, the adult domestic pig was the animal of choice. A total observation period of 6 months was selected. Microradiographic and histologic evaluation of the bone specimens was completed at 8 defined times. RESULTS: Microradiography indicated mineralization rates in the 2 bone substitute groups that were not significantly lower than those found in the autogenous bone group. Histologically, there was suitable osseointegration and osteoconduction of the used material. Complete resorption of the nanoparticle hydroxyapatite had taken place after 12 weeks. CONCLUSIONS: It can be concluded that the evaluated nanoparticular hydroxyapatite met the clinical requirements for a bone substitute material within the limits of this experimental setting. Due to its microstructure, complete resorption took place during the course of this study.

Absorbable Implants↗

PubMed2005

Morphology of enamel in primary teeth from children in Thailand exposed to environmental lead.

Lead is one of the major environmental pollutants and a health risk. Dental hard tissues have a capacity to accumulate lead from the environment. Eighty exfoliated primary teeth were collected from children residing around a shipyard area in southern Thailand, known for its lead contamination. The morphology of the enamel was examined by polarized light microscopy (PLM), microradiography (MRG), and scanning electron microscopy (SEM). The specimens derived from two groups of children, one group with high blood levels of lead (57 teeth) and one group having low blood levels of lead (23 teeth). The enamel irrespective of group appeared normal. However, in a majority of the specimens the enamel surface appeared hypomineralized, which was confirmed in SEM. No morphological changes connected to lead in blood could be found. The hypomineralized surface zone could possibly be attributed to an acid oral environment.

Child↗

PubMed2005

Stability of autogenous bone grafts after sinus lift procedures: a comparative study between anterior and posterior aspects of the iliac crest and an intraoral donor site.

BACKGROUND: Autologous bone is the standard material used for augmentations in oral-maxillofacial surgery. Depending on the origin of the graft, subsequent bone resorption may vary. STUDY DESIGN: This prospective study evaluated 57 patients receiving 2-stage sinus floor augmentations. Monocortical samples were taken at the site of bone harvesting, including the posterior (n = 28) and anterior pelvic (n = 15) and retromolar (n = 14) regions. At second-stage surgery, 6 months after the implant insertion, bone cores were harvested at the site of implant placement. All samples were analyzed by microradiography. RESULTS: Mean retromolar mineralization was 68.7% +/- 8.75%; 35.1% +/- 7.6% in the anterior and 30.7% +/- 9.5% in the posterior iliac crest. Areas augmented with grafts originating from the retromolar region showed a significant decrease to 53.0% +/- 5.15% (P = .001). A stable mineralization of 36.1% +/- 7.59% was found in sites where bone grafts from the anterior pelvic crest were used. Grafts from the posterior pelvis showed a slight increase to 34.5% +/- 6.5%. CONCLUSION: This prospective clinical study demonstrates the differences in mineralization depending on the origin of autogenous bone. Even after 6 months, these values could still be correlated to the transplants origin.

Alveolar Ridge Augmentation↗