Application of high voltage, high frequency pulsed electromagnetic field on cortical bone tissue

Over the last few decades, electric and electromagnetic fields have achieved important role as stimulator and therapeutic facility in biology and medicine. In particular, low magnitude, low frequency, pulsed electromagnetic field has shown significant positive effect on bone fracture healing and some bone diseases treatment. Nevertheless, to date, little attention has been paid to investigate the possible effect of high frequency, high magnitude pulsed electromagnetic field (pulse power) on functional behaviour and biomechanical properties of bone tissue. Bone is a dynamic, complex organ, which is made of bone materials (consisting of organic components, inorganic mineral and water) known as extracellular matrix, and bone cells (live part). The cells give the bone the capability of self-repairing by adapting itself to its mechanical environment. The specific bone material composite comprising of collagen matrix reinforced with mineral apatite provides the bone with particular biomechanical properties in an anisotropic, inhomogeneous structure. This project hypothesized to investigate the possible effect of pulse power signals on cortical bone characteristics through evaluating the fundamental mechanical properties of bone material. A positive buck-boost converter was applied to generate adjustable high voltage, high frequency pulses up to 500 V and 10 kHz. Bone shows distinctive characteristics in different loading mode. Thus, functional behaviour of bone in response to pulse power excitation were elucidated by using three different conventional mechanical tests applying three-point bending load in elastic region, tensile and compressive loading until failure. Flexural stiffness, tensile and compressive strength, hysteresis and total fracture energy were determined as measure of main bone characteristics. To assess bone structure variation due to pulse power excitation in deeper aspect, a supplementary fractographic study was also conducted using scanning electron micrograph from tensile fracture surfaces. Furthermore, a non-destructive ultrasonic technique was applied for determination and comparison of bone elasticity before and after pulse power stimulation. This method provided the ability to evaluate the stiffness of millimetre-sized bone samples in three orthogonal directions. According to the results of non-destructive bending test, the flexural elasticity of cortical bone samples appeared to remain unchanged due to pulse power excitation. Similar results were observed in the bone stiffness for all three orthogonal directions obtained from ultrasonic technique and in the bone stiffness from the compression test. From tensile tests, no significant changes were found in tensile strength and total strain energy absorption of the bone samples exposed to pulse power compared with those of the control samples. Also, the apparent microstructure of the fracture surfaces of PP-exposed samples (including porosity and microcracks diffusion) showed no significant variation due to pulse power stimulation. Nevertheless, the compressive strength and toughness of millimetre-sized samples appeared to increase when the samples were exposed to 66 hours high power pulsed electromagnetic field through screws with small contact cross-section (increasing the pulsed electric field intensity) compare to the control samples. This can show the different load-bearing characteristics of cortical bone tissue in response to pulse power excitation and effectiveness of this type of stimulation on smaller-sized samples. These overall results may address that although, the pulse power stimulation can influence the arrangement or the quality of the collagen network causing the bone strength and toughness augmentation, it apparently did not affect the mineral phase of the cortical bone material. The results also confirmed that the indirect application of high power pulsed electromagnetic field at 500 V and 10 kHz through capacitive coupling method, was athermal and did not damage the bone tissue construction.

Evaluation cortical bone elasticity in response to pulse power excitation using ultrasonic technique

This paper presents the ultrasonic velocity measurement method which investigates the possible effects of high voltage high frequency pulsed power on cortical bone material elasticity. Before applying a pulsed power signal on a live bone, it is essential to determine the safe parameters of pulsed power applied on bone non-destructively. Therefore, the possible changes in cortical bone material elasticity due to a specified pulsed power excitation have been investigated. A controllable positive buck-boost converter with adjustable output voltage and frequency has been used to generate high voltage pulses (500V magnitude at 10 KHz frequency). To determine bone elasticity, an ultrasonic velocity measurement has been conducted on two groups of control (unexposed to pulse power but in the same environmental condition) and cortical bone samples exposed to pulsed power. Young’s modulus of cortical bone samples have been determined and compared before and after applying the pulsed power signal. After applying the high voltage pulses, no significant variation in elastic property of cortical bone specimens was found compared to the control. The result shows that pulsed power with nominated parameters can be applied on cortical bone tissue without any considerable negative effect on elasticity of bone material.

The effect of high voltage, high frequency pulsed electric field on slain ovine cortical bone

High power, high frequency pulsed electric fields known as pulsed power (PP) has been applied recently in biology and medicine. However, little attention has been paid to investigate the application of pulse power in musculoskeletal system and its possible effect on functional behavior and biomechanical properties of bone tissue. This paper presents the first research investigating whether or not PP can be applied safely on bone tissue as a stimuli and what will be the possible effect of these signals on the characteristics of cortical bone by comparing the mechanical properties of this type of bone pre and post expose to PP and in comparison with the control samples. A positive buck‑boost converter was applied to generate adjustable high voltage, high frequency pulses (up to 500 V and 10 kHz). The functional behavior of bone in response to pulse power excitation was elucidated by applying compressive loading until failure. The stiffness, failure stress (strength) and the total fracture energy (bone toughness) were determined as a measure of the main bone characteristics. Furthermore, an ultrasonic technique was applied to determine and comprise bone elasticity before and after pulse power stimulation. The elastic property of cortical bone samples appeared to remain unchanged following exposure to pulse power excitation for all three orthogonal directions obtained from ultrasonic technique and similarly from the compression test. Nevertheless, the compressive strength and toughness of bone samples were increased when they were exposed to 66 h of high power pulsed electromagnetic field compared to the control samples. As the toughness and the strength of the cortical bone tissue are directly associated with the quality and integrity of the collagen matrix whereas its stiffness is primarily related to bone mineral content these overall results may address that although, the pulse power stimulation can influence the arrangement or the quality of the collagen network causing the bone strength and toughness augmentation, it apparently did not affect the mineral phase of the cortical bone material. The results also confirmed that the indirect application of high power pulsed electric field at 500 V and 10 kHz through capacitive coupling method was safe and did not destroy the bone tissue construction.

Bone tissue engineering

Bone is a complex, living, constantly changing tissue. Bone consists of cancellous and cortical bone. This architecture allows the skeleton to perform its essential mechanical functions.

WNT16 influences bone mineral density, cortical bone thickness, bone strength, and osteoporotic fracture risk

We aimed to identify genetic variants associated with cortical bone thickness (CBT) and bone mineral density (BMD) by performing two separate genome-wide association study (GWAS) meta-analyses for CBT in 3 cohorts comprising 5,878 European subjects and for BMD in 5 cohorts comprising 5,672 individuals. We then assessed selected single-nucleotide polymorphisms (SNPs) for osteoporotic fracture in 2,023 cases and 3,740 controls. Association with CBT and forearm BMD was tested for ~2.5 million SNPs in each cohort separately, and results were meta-analyzed using fixed effect meta-analysis. We identified a missense SNP (Thr>Ile; rs2707466) located in the WNT16 gene (7q31), associated with CBT (effect size of -0.11 standard deviations [SD] per C allele, P = 6.2×10-9). This SNP, as well as another nonsynonymous SNP rs2908004 (Gly>Arg), also had genome-wide significant association with forearm BMD (-0.14 SD per C allele, P = 2.3×10-12, and -0.16 SD per G allele, P = 1.2×10-15, respectively). Four genome-wide significant SNPs arising from BMD meta-analysis were tested for association with forearm fracture. SNP rs7776725 in FAM3C, a gene adjacent to WNT16, was associated with a genome-wide significant increased risk of forearm fracture (OR = 1.33, P = 7.3×10-9), with genome-wide suggestive signals from the two missense variants in WNT16 (rs2908004: OR = 1.22, P = 4.9×10-6 and rs2707466: OR = 1.22, P = 7.2×10-6). We next generated a homozygous mouse with targeted disruption of Wnt16. Female Wnt16-/- mice had 27% (P<0.001) thinner cortical bones at the femur midshaft, and bone strength measures were reduced between 43%-61% (6.5×10-13<P<5.9×10-4) at both femur and tibia, compared with their wild-type littermates. Natural variation in humans and targeted disruption in mice demonstrate that WNT16 is an important determinant of CBT, BMD, bone strength, and risk of fracture. © 2012 Zheng et al.

Hydroxyapatite-titanium bulk composites for bone tissue engineering applications

The research work on bulk hydroxyapatite (HA)-based composites are driven by the need to develop biomaterials with better mechanical properties without compromising its bioactivity and biocompatibility properties. Despite several years of research, the mechanical properties of the HA-based composites still need to be enhanced to match the properties of natural cortical bone. In this regard, the scope of this review on the HA-based bulk biomaterials is limited to the processing and the mechanical as well as biocompatibility properties for bone tissue engineering applications of a model system that is hydroxyapatite-titanium (HA-Ti) bulk composites. It will be discussed in this review how HA-Ti based bulk composites can be processed to have better fracture toughness and strength without compromising biocompatibility. The advantages of the functionally gradient materials to integrate the mechanical and biocompatibility properties is a promising approach in hard tissue engineering and has been emphasized here in reference to the limited literature reports. On the biomaterials fabrication aspect, the recent results are discussed to demonstrate that advanced manufacturing techniques, like spark plasma sintering can be adopted as a processing route to restrict the sintering reactions, while enhancing the mechanical properties. Various toughening mechanisms related to careful tailoring of microstructure are discussed. The in vitro cytocompatibilty, cell fate processes as well as in vivo biocompatibility results are also reviewed and the use of flow cytometry to quantify in vitro cell fate processes is being emphasized. (C) 2014 Wiley Periodicals, Inc.

Novel titanium foam for bone tissue engineering

Titanium foams fabricated by a new powder metallurgical process have bimodal pore distribution architecture (i.e., macropores and micropores), mimicking natural bone. The mechanical properties of the titanium foam with low relative densities of approximately 0.20-0.30 are close to those of human cancellous bone. Also, mechanical properties of the titanium foams with high relative densities of approximately 0.50-0.65 are close to those of human cortical bone. Furthermore, titanium foams exhibit good ability to form a bonelike apatite layer throughout the foams after pretreatment with a simple thermochemical process and then immersion in a simulated body fluid. The present study illustrates the feasibility of using the titanium foams as implant materials in bone tissue engineering applications, highlighting their excellent biomechanical properties and bioactivity.

Biomimetic modification of porous TiNbZr alloy scaffold for bone tissue engineering

Porous titanium (Ti) and Ti alloys are important scaffold materials for bone tissue engineering. In the present study, a new type of porous Ti alloy scaffold with biocompatible alloying elements, that is, niobium (Nb) and zirconium (Zr), was prepared by a space-holder sintering method. This porous TiNbZr scaffold with a porosity of 69% exhibits a mechanical strength of 67MPa and an elastic modulus of 3.9GPa, resembling the mechanical properties of cortical bone. To improve the osteoconductivity, a calcium phosphate (Ca/P) coating was applied to the surface of the scaffold using a biomimetic method. The biocompatibility of the porous TiNbZr alloy scaffold before and after the biomimetic modification was assessed using the SaOS2 osteoblast–like cells. Cell culture results indicated that the porous TiNbZr scaffold is more favorable for cell adhesion and proliferation than its solid counterpart. By applying a Ca/P coating, the cell proliferation rate on the Ca/P-coated scaffold was significantly improved. The results suggest that high-strength porous TiNbZr scaffolds with an appropriate osteoconductive coating could be potentially used for bone tissue engineering application.

Exercise loading and cortical bone distribution at the tibial shaft

Cortical bone is not a uniform tissue, and its apparent density [cortical volumetric density (vBMD)] varies around the bone cross-section as well as along the axial length of the bone. It is not yet known, whether the varying vBMD distribution is attributable to modulation in the predominant loads affecting bone. The aim of the present study was to compare the cortical bone mass distribution through the bone cortex (radial distribution) and around the center of mass (polar distribution) among 221 premenopausal women aged 17–40 years representing athletes involved in high impact, odd impact, high magnitude, repetitive low impact, repetitive non-impact sports and leisure time physical activity (referent controls). Bone cross-sections at the tibial mid-diaphysis were assessed with pQCT. Radial and polar vBMD distributions were analyzed in three concentric cortical divisions within the cortical envelope and in four cortical sectors originating from the center of the bone cross-section. MANCOVA, including age as a covariate, revealed no significant group by division/sector interaction in either radial or polar distribution, but the mean vBMD values differed between groups (P < 0.001). The high and odd-impact groups had 1.2 to 2.6% (P < 0.05) lower cortical vBMD than referents, in all analyzed sectors/divisions. The repetitive, low-impact group had 0.4 to 1.0% lower (P < 0.05) vBMD at the mid and outer cortical regions and at the anterior sector of the tibia. The high magnitude group had 1.2% lower BMD at the lateral sector (P < 0.05). The present results generate a hypothesis that the radial and polar cortical bone vBMD distributions within the tibial mid-shaft are not modulated by exercise loading but the mean vBMD level is slightly affected.

Effects of magnesium intake deficiency on bone metabolism and bone tissue around osseointegrated implants

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Advancements in the knowledge of induced tooth movement: idiopathic osteosclerosis, cortical bone and orthodontic movement

Movimentar ortodonticamente os dentes por áreas densas do trabeculado ósseo e pelas corticais pode requerer uma redução na intensidade e/ou na concentração das forças aplicadas. em parte, as forças ortodônticas aplicadas são dissipadas e reduzidas pela deflexão óssea que ocorre pelo discreto grau de elasticidade do tecido ósseo em condições de normalidade. Nas áreas de trabeculado denso e nas corticais, essa deflexão deve ser irrisória ou inexistente. Se não houver uma redução na intensidade das forças nessas regiões citadas, toda a força incidirá sobre a estrutura do ligamento periodontal, aumentando o risco de morte dos cementoblastos, hialinização e reabsorções radiculares. Novos trabalhos poderiam avaliar a prevalência dessas consequências em casuísticas selecionadas para essa finalidade, que, assim, deixariam de ser observações aleatórias.

Stress analysis in bone tissue around single implants with different diameters and veneering materials: A 3-D finite element study

The aimof this study was to evaluate the stress distribution on bone tissue with a single prosthesis supported by implants of large and conventional diameter and presenting different veneering materials using the 3-D finite elementmethod. Sixteenmodels were fabricated to reproduce a bone block with implants, using two diameters (3.75 × 10 mmand 5.00 × 10 mm), four different veneering materials (composite resin, acrylic resin, porcelain, and NiCr crown), and two loads (axial (200 N) and oblique (100 N)). For data analysis, the maximum principal stress and vonMises criterion were used. For the axial load, the cortical bone in allmodels did not exhibit significant differences, and the trabecular bone presented higher tensile stresswith reduced implant diameter. For the oblique load, the cortical bone presented a significant increase in tensile stress on the same side as the loading for smaller implant diameters. The trabecular bone showed a similar but more discreet trend. There was no difference in bone tissue with different veneering materials. The veneering material did not influence the stress distribution in the supporting tissues of single implant-supported prostheses. The large-diameter implants improved the transference of occlusal loads to bone tissue and decreased stress mainly under oblique loads.Oblique loading was more detrimental to distribution stresses than axial loading. © 2013 Elsevier B.V. All rights reserved.

Clinical and radiographic outcome of dental implants supporting fixed prostheses: the relevance of cortical bone formation

To evaluate the hard and the soft tissue parameters around implants supporting fixed prostheses over a period of 5 years and the possible association to the increase in periimplant bone density (IPBD).

Implant-supported mandibular overdentures and cortical bone formation: clinical and radiographic results

PURPOSE: The aim of this study was to evaluate the hard and soft tissue parameters around implants supporting overdentures and the possible influence of increased periimplant bone density (IPBD) on implant success. MATERIALS AND METHODS: A total of 44 dental implants placed in the mandible of 12 patients were included in the study. Implants were divided in 2 groups in relation to the optically detected IPBD. Periimplant clinical and radiographic variables were collected over the period of 5 years. RESULTS: Periimplant clinical and radiographic parameters for all implants did not change significantly throughout the observation period (P > 0.05). Significant differences were observed between implants with and without IPBD for periimplant soft tissue parameters and Periotest values (P < 0.05). Implants with and without IPBD at 5-year control showed mean bone loss of 0.04 ± 0.48 mm and 0.55 ± 0.96 mm, respectively (P = 0.026). All density values decreased throughout the observation period, except maximal values for implants with IPBD that overcome the initial values at the 5-year control. CONCLUSIONS: Implants supporting overdentures were clinically successful over the period of follow-up. IPBD may be related to the maintenance of the periimplant bone level.