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The influence of lithium fluoride on in vitro biocompatibility and bioactivity of calcium aluminate-pMMA composite cement.

The objective of this study is to assess the influence of lithium fluoride on in vitro biocompatibility and bioactivity of calcium aluminate (CA)-polymethylmethacrylate (PMMA) composite cement exhibiting quick setting time ( < 15 min), low exothermic temperature (< 47 degrees C), and high compressive strength (> 100 MPa). The biocompatibility was measured by examining cytotoxicity tests such as the agar diffusion test with L929 cell line and the hemolysis test with fresh rabbit blood. To estimate the bioactivity of CA-PMMA composite cement, we determined hydroxyapatite (HAp) formation on the surface of composite cement in the simulated body (SBF) solution by using thin-film XRD, XPS, SEM, EPMA and ICP-AES. The results of biocompatibility tests indicated that all experimental compositions of this study had no cytotoxicity and no hemolysis so that there was no cytotoxicity with regard to non-reacted monomers (MMA and TEGDMA) and lithium fluoride. The results of bioactivity tests revealed that CA-PMMA composite cement without lithium fluoride did not form HAp on its surface after 60 days of soaking in the SBF. On the other hand, LiAl2(OH)7 . 2H2O and HAp were formed on the surface of CA-PMMA composite cement including 1.0% by weight of lithium fluoride after 7 and 15 days of soaking in the SBF, respectively. The 5 microm of LiAl2(OH)7 . 2H2O and HAp mixed layers were formed on the surface of specimen after 60 days of soaking in the SBF.

Acrylic Resins↗

Fabrication of 1-dimensional porous hydroxyapatite and evaluation of its osteoconductivity.

Porous HA ceramics with 1-dimensional pore channels were fabricated to obtain controllable microstructure. 1-dimensional porous HA was objected to find out the optimum condition of bone ingrowth and also to facilitate the observation of osteocondutive behavior in porous HA. The porous structure was formed by burnt-out of polymeric fibers and the size of pores was determined by the diameter of polymeric fibers. The porosity could be varied by the thickness of HA slurry coated on polymeric fiber and by the thickness of HA tapes inserted between fiber layers. As result, 1-dimensional porous HA ceramics of this study have the uniform interconnection size (50-500 microm) and the linearly open pore structure. The compressive strength of 1-dimensional porous HA was 6-10 MPa similar to that of human cancellous bone. On the in vivo test, oteon-like osteoconduction in pore channel of 1-dimensional porous HA was observed, like what had been found in cortical bones. This osteon-like new bone grew from the surface to the center of pore channels. The 1-dimensional porous HA ceramics prepared in this study were very useful as a model system to observe bone ingrowth in the porous HA implants.

Animals↗

In vivo absorption of porous apatite- and wollastonite-containing glass-ceramic.

The behavior of porous apatite- and wollastonite-containing glass-ceramic (AW) in the bone marrow cavity was investigated. Cylinders of porous AW (4 mm in diameter and 20 mm long, mean porosity of 70% and mean pore diameter of 200 microm) were implanted into the bone marrow cavity of rabbit femurs, and analyzed by chronological radiograms and by scanning electron microscopy one, three, six, and 12 months later. The pores of porous AW are interconnected and homogeneously distributed, and its compressive strength is nearly equal to that of human cancellous bone. Bone formed in the pores at the center of the material by one month and bonded to the material directly. The volume of newly formed bone in the material pores reached a peak at three months, and decreased gradually after six months. The trabecular structures of AW were gradually remodeled by newly formed bone, while AW-bone bonding was maintained during bone remodeling and material absorption. AW was absorbed continuously, and at six and 12 months the residual material corresponded to about 64 and 30% of the starting material, respectively. Porous AW may therefore be useful as an absorbable bone substitute.

Absorbable Implants↗

The controlled resorption of porous alpha-tricalcium phosphate using a hydroxypropylcellulose coating.

Tricalcium phosphate (TCP) ceramic is known in orthopedics to be a bioresorbable bone substitute. A porous TCP ceramic body also has high potential as a drug delivery system in bony defects. Porous alpha-TCP ceramic can be easily fabricated using conventional sintering of beta-TCP, since alpha-TCP is the thermodynamically stable phase at temperatures above 1 100 degrees C. However, the solubility of alpha-TCP is much higher than that of beta-TCP. Therefore, the dissolution of porous alpha-TCP progresses at a higher rate than bone repair. In the present study, we attempted to reduce the dissolution rate of porous alpha-TCP by employing an organic polymer coating. We fabricated porous alpha-TCP ceramic with a continuous 10-50 microm diameter pore structure by sintering a body made from a beta-TCP and potato starch slurry. The porous body obtained was coated with hydroxypropylcellulose (HPC), and then subjected to heat treatment. The chemical durability and mechanical properties of the body were examined before and after coating with the HPC. The dissolution of porous alpha-TCP in buffered solutions was reduced by coating with HPC and drying at 60 degrees C. The compressive strength of the porous alpha-TCP was also improved by coating with HPC. The results of in vivo experiments showed that some parts of the porous alpha-TCP ceramic coated with HPC remained in the canal of the tibia of a rabbit four weeks after implantation, whereas no residual was observed in a non-coated alpha-TCP ceramic. Coating with HPC was found to be effective for controlling bioresorption and improving the workability of porous alpha-TCP ceramic. The prepared porous alpha-TCP ceramic is expected to be useful as a novel material for bone fillers by incorporating it with drugs or osteoinductive factors.

Animals↗

Nonlinear model of skin mechanical behaviour analysis with finite element method.

BACKGROUND/AIMS: A problem commonly encountered in plastic and reconstructive surgery is the prediction of the stress put on the skin when various types of skin flaps are used. METHODS/RESULTS: We developed a mathematical model based on the finite element method, in order to determine the stress field, by simulating the mechanical behaviour of human skin during wound closure. We chose to take into account the low compressive strength by modifying the mechanical parameters of the model at each step of the calculation. The model has been developed and tested on a diamond-shaped incision and applied on a Limberg incision. CONCLUSION: The results presented are the Von Mises stress in the area of skin around the scar and, when possible, the resultant closure force. They show the relevance of the method.

Biomechanical Phenomena↗

Mechanical properties of a composite inlay material following post-curing.

Compressive strength, fatigue limit, hardness and wear factors were determined for two shades of a composite inlay material both with and without post-cure annealing! The effect of the annealing procedure was to cause a small general improvement in properties. This was more noticeable in the Dentin shade of the material than in the Enamel shade. It is doubtful whether the small improvement in properties would have any significant effect on clinical durability.

Bisphenol A-Glycidyl Methacrylate↗

A preliminary report on the effect of storage in water on the properties of commercial light-cured glass-ionomer cements.

Two commercially available light-curable glass-ionomer cements, Vitrebond and XR-Ionomer, have been studied and their compressive strengths measured following storage under wet and dry conditions for varying lengths of time up to 3 months. The strongest cements were those stored in air and allowed to age. On the other hand, cements that were stored in water were found to become progressively weaker with time. Their failure mode was different from that of cements stored in air in that specimens became barrel-shaped as they were loaded and exhibited considerable plastic deformation prior to fracturing. By contrast, air-stored specimens behaved as predominantly brittle materials, the specimens essentially maintaining their integrity up to the point of catastrophic failure. Both of these findings indicate that the properties of these particular light-cured cements change markedly on exposure to moisture, a fact which is of clinical significance.

Air↗

Physical properties of ZnO base and resin cements.

Some physical properties of zinc phosphate, zinc polycarboxylate, and a resin cement of thick consistency suitable for cementation of orthodontic bands were evaluated. A new technique for evaluating the setting time is described. The setting times for resin and zinc polycarboxylate cements were about the same but less than that for zinc phosphate. The properties of percent solubility and compressive strength were significantly superior for resin cement.

Chemical Phenomena↗

Microstructure and properties of pitch-based carbon composites

Pitches prepared in the laboratory by thermal treatment and air-blowing of a commercial coal-tar pitch were used as matrix precursors of carbon composites using granular petroleum coke, foundry coke, amorphous graphite and anthracite. Pitches were characterized by standard procedures (elemental analysis, softening point, solubility tests and carbon yield) and light microscopy (mesophase content). Pitch pyrolysis behaviour was monitored by thermogravimetric analysis and from the optical texture of cokes. Pitch wettability to the different carbons, at different temperatures, was also studied. Experimental conditions selected for the preparation of composites were based on pitch composition and properties. The main microstructural features of composites were determined by light microscopy and scanning electron microscopy. Composite properties were described in terms of their density, porosity and compressive strength, and related to composite microstructure and the characteristics of the precursors. Thermal treatment and air-blowing of pitch improved carbon composite structure and properties. The lowest porosities and best mechanical properties were observed in those composites obtained with the thermally treated pitches combined with foundry coke and anthracite.

Journal Article↗

An investigation of segmentation methods and texture analysis applied to tomographic images of human vertebral cancellous bone.

The goal of this study is to determine architectural and textural parameters on computed tomographic (CT) images, allowing us to explain the mechanical compressive properties of bone. Although the resolution (150 microm) is of the same order of magnitude as the trabecular thickness, this method enables the possibility of perfecting an in vivo peripheral CT system with an acceptable radiation dose for the patient. This study was performed on L2 vertebrae cancellous bone specimens taken after necropsy in 22 subjects aged 47-95 years (mean: 79 years). The segmentation process is a crucial point in the determination of accurate architectural parameters. In this paper the use of two different segmentation methods is investigated, based on an edge enhancement and a region growing approach. The images are compared and the architectural parameters extracted from the images segmented by both methods lead to a quantitative evaluation. The parameters are found to be globally robust towards the segmentation process, although some of them are much more sensitive to the approach used. Highly significant correlations (P < 0.0005) have been obtained between the two segmentation methods for all the parameters, with rho ranging from 0.70 to 0.93. In order to improve the assessment of bone architecture, texture analysis (run length method) was investigated. New features are obtained from an image reduced to 16 grey-levels. Textural parameters in addition to architectural parameters in a multivariate regression model increase significantly (P = 0.01) the prediction of the maximum compressive strength (variation of r2 from 0.75 up to 0.89).

Aged↗

Voronoi cells, fractal dimensions and fibre composites.

The use of fibre-reinforced polymer matrix composite materials is growing at a faster rate than the gross domestic product (GDP) in many countries. An improved understanding of their processing and mechanical behaviour would extend the potential applications of these materials. For unidirectional composites, it is predicted that localized absence of fibres is related to longitudinal compression failure. The use of woven reinforcements permits more effective manufacture than for unidirectional fibres. It has been demonstrated experimentally that compression strengths of woven composites are reduced when fibres are clustered. Summerscales predicted that clustering of fibres would increase the permeability of the reinforcement and hence expedite the processing of these materials. Commercial fabrics are available which employ this concept using flow-enhancing bound tows. The net effect of clustering fibres is to enhance processability whilst reducing the mechanical properties. The effects reported above were qualitative correlations. To improve the design tools for reinforcement fabrics we have sought to quantify the changes in the micro/meso-structure of woven reinforcement fabrics. Gross differences in the appearance of laminate sections are apparent for different weave styles. The use of automated image analysis is essential for the quantification of subtle changes in fabric architecture. This paper considers Voronoi tessellation and fractal dimensions for the quantification of the microstructures of woven fibre-reinforced composites. It reviews our studies in the last decade of the process-property-structure relationships for commercial and experimental fabric reinforcements in an attempt to resolve the processing vs. properties dilemma. A new flow-enhancement concept has been developed which has a reduced impact on laminate mechanical properties.

Journal Article↗

Use of elastic compression stockings after deep venous thrombosis: a comparison of practices and perceptions of thrombosis physicians and patients.

Daily long-term use of elastic compression stockings (ECS) by patients with deep venous thrombosis (DVT) may help to prevent the post-thrombotic syndrome (PTS). However, the effectiveness of ECS in clinical practice is difficult to predict, since the practices and perceptions of patients and thrombosis physicians regarding ECS have not been documented. The objectives were to survey DVT patients and thrombosis physicians on their practices and perceptions regarding use of ECS after DVT, and to evaluate whether physician perceptions are supported by patient responses. Two surveys were conducted. The first was sent to 38 Canadian thrombosis physicians. The second was administered to 80 DVT patients attending Thrombosis Clinic at one of two Canadian university-affiliated hospitals. Most physicians believed that ECS were useful in preventing PTS and in managing venous symptoms. However, there was a lack of consensus regarding the optimal timing of initiation of ECS, duration of therapy, and compression strength, and only one-third routinely prescribed ECS to asymptomatic patients to prevent PTS. Most DVT patients who were prescribed ECS purchased them, 87% wore them daily, and most reported that ECS relieved swelling and symptoms. Physicians underestimated the degree of patient compliance with ECS, but correctly identified the main reasons for non-compliance. There is a lack of consensus among thrombosis physicians regarding ECS use after DVT. Patients with DVT are willing to comply with ECS therapy and most find them to be helpful. Our findings suggest that long-term study of the optimal use of ECS after DVT is both necessary and feasible.

Adult↗

[The texture-analysis of high-resolution computed tomograms as an additional procedure in osteoporosis diagnosis: in-vitro studies on vertebral segments].

PURPOSE: The purpose of this study was to perform texture analysis of high-resolution CT images obtained from human vertebral specimens and to correlate these parameters with the biomechanical stability of the specimens. In addition, structure data were compared with bone mineral density (BMD) assessed by quantitative CT (QCT). MATERIAL AND METHODS: High-resolution CT images and standard QCT sections were obtained in 36 vertebral motion segments, each consisting of two vertebrae with intact ligaments and intervertebral disc. The trabecular structure in the CT images was assessed using three texture analysis techniques: Trabecular threshold area ratio (TTAR), fractal dimension without thresholding (OTS) and fractal dimension with thresholding (ITS). Finally, the maximum compressive strength (MCS) was determined using a biomechanical testing device. RESULTS: A correlation of r = 0.76 (p < 0.01) was obtained for TTAR versus MCS, of r = 0.83 (p < 0.01) for ITS versus MCS, and of r = 0.35 (p > 0.01) for OTS versus MCS, while r = 0.76 (p < 0.01) was found for BMD versus MCS. Best results were obtained by combining structure measures and BMD (r = 0.85, p < 0.01). CONCLUSIONS: This in vitro study showed a significant correlation between structure measures and biomechanical strength, which was comparable to BMD and strength. However, best correlations were obtained by combining both measures. Using both BMD and structure measures therefore may improve the prediction of biomechanically determined bone strength.

Aged↗

[Primary stability of autologous and heterologous implants for intervertebral body spondylodesis].

In this study, we tested the stability of the xenograft SURGIBONE and of human iliac crest graft depending on the donor's bone density. The mean load bearing capacity of SURGIBONE was 4816 N, the compressive strength 32.8 N/mm2. This even exceeds the values given by the producer. Yet in clinical use the material caused problems by collapses or lysis of the graft. According to our results, those failures can not be explained by missing primary stability. Perhaps there is a immunogenic reaction of the host against the remaining protein as it once was proved for the "kielspan"-graft. The iliac crest grafts of donors with normal bone density had a load bearing capacity of 3397 N. Grafts of donors with reduced bone density of less than 60 mg/ml Ca-Equivalent showed reduced load bearing capacities of 2265 N. DEXA (Dual-Energy X-Ray Absorptiometry) seems to be suitable to scan preoperatively the iliac crest graft stability in order to recognize the danger of reduced stability by osteoporosis.

Absorptiometry, Photon↗

Cadmium content of human cancellous bone.

The cadmium content of human cancellous bone was related to age, sex, bone loss, physical properties, and elemental composition. Bone specimens from the anterior iliac crest were collected from 889 cadavers with a normal mineral status, and from 50 cadavers which had bone loss from chronic diseases and immobilization. The element concentrations were analyzed using atomic absorption spectrophotometry. Bone fluoride levels ere determined with the ion specific electrode, the mineral density with the gamma ray attenuation method, and the compressive strength with a strain transducer. The data were analyzed using multiple linear regression analysis. The mean cadmium content of 0.22 +/- 9.16 micrograms/g dry weight (+/- SD) in the samples did not change with age and its content was slightly greater in males than in females. Furthermore, no statistically significant relation was found in cadmium content to bone loss changes or to the calcium content of bone. The cadmium content had a high statistically significant positive correlation with the strontium and nickel content.

Adolescent↗

Cement stabilization of tannery sludge using quaternary ammonium salt exchanged bentonite as pre-solidification adsorbent.

In this paper a cement-based cementitious system is studied for the stabilization of tannery sludge. Two binders were used as stabilizing matrices: pozzolanic cement alone and a 3:7 cement/blast furnace slag mixture. Due to the high organic content of the sludge, organophilic bentonite was added to the stabilization system; the modified bentonite was obtained by ionic exchange with benzyldimethyloctadecylammonium chloride and proved to be an effective sorbent of the organic components of the sludge. The different process steps were arranged to minimize the water requirement. The process was evaluated from three different points of view: chemicaL environmental and technological. From the chemical point of view, it was found that the binder hydration products are unaffected by the presence of sludge, although the hydration process is retarded. From the environmental and technological points of view, it was found that the presence of organophilic bentonite strongly enhances process performance. In fact, th e release of both organic carbon and chromium is greatly reduced and the unconfined compressive strength of the stabilized products is increased. According to Italian standards, the stabilized products are suitable for the manufacture of pre-formed building blocks.

Adsorption↗

Thermal stabilization of metal finishing waste with clay.

Thermal treatment of metal finishing waste with locally available clay, in their varying ratios, was carried out at 850 degrees C and above temperatures. In the presence of 1:1 ratio of waste and clay a solidified product was obtained at 950 degrees C. Measurement of an appreciably high compressive strength, approximately 500 kg cm(-2) and a very small (0.4%) water absorption from the solidified product indicated its stable nature. Toxicity Characteristic Leaching Procedure (TCLP) test of the waste showed nearly 85 to 90% decrease of leaching of Fe, Cu, Ni, Zn, Mn and Cr after thermal treatment compared to their leaching without treatment. No hexavalent chromium (Cr(VI)) was observed from the leachate of the solidified product. This indicates the absence of re-oxidation phenomena of chromium during thermal treatment up to 950 degrees C. X - ray diffraction (XRD) of solidified product indicated the presence of hematite, and aluminum silicate as main phases of the solidified product. Involvement of the above waste metals with these phases during thermal treatment could be the reason for their immobilization.

Aluminum Silicates↗

Latent hydraulic reactivity of blended cement incorporating slag made from municipal solid waste incinerator fly ash.

The reactivity of cement pastes made by blending Portland cement with slag from municipal solid waste incinerator (MSWI) fly ash was investigated to assess the potential of recycling MSWI fly ash slag. The slag, prepared by melting MSWI fly ash at 1400 degrees C for 30 min, was pulverized and ground, then blended with ordinary Portland cement (OPC), using various substitution levels to make slag-blended cement (SBC). The pozzolanic reactivity of the ecocement was then characterized by determining variations in the compressive strength, degree of hydration, microstructure, speciation, and mineralogical crystalline phases. The results suggest that the strength of the pastes at an early age decreased with increasing substitution levels, whereas the strength at a later age of the tested pastes (with substitution levels less than 10%) outperformed OPC paste because of typical SBC properties. The development of strength at a later age was also confirmed by X-ray diffraction and scanning electron microscopy techniques. This implies that active silica (Si) and alumina (Al) react with the hydration product, calcium hydroxide (Ca(OH)2), to form calcium silicate hydrate (C-S-H), which contributed to strength development at a later age by the filling up of pores in the SBC pastes. The pozzolanic activity of the SBC pastes indicates that it is suitable for use as a substitute for OPC in blended cement.

Conservation of Natural Resources↗