Search

Common genetic variants at the RIN3 locus on chromosome 14q32 predispose to Paget’s disease of bone (PDB) but the mechanisms by which they do so are unknown. Here, we analysed the skeletal phenotype of female mice with targeted inactivation of the mouse Rin3 gene (Rin3−/−) as compared with wild-type littermates. The Rin3−/− mice had higher trabecular bone volume (BV/TV%) compared with wild type. Mean ± standard deviation values at the distal femur at 8 weeks were 9.0 ± 2.5 vs. 7.0 ± 1.5 (p = 0.002) and at 52 weeks were 15.8 ± 9.5 vs. 8.5 ± 4.2 (p = 0.002). No differences were observed in femoral cortical bone parameters with the exception of marrow diameter which was significantly smaller in 52-week-old Rin3−/− mice compared to wild type: (0.43 mm ± 0.1 vs. 0.57 mm ± 0.2 (p = 0.001). Bone histomorphometry showed a lower osteoclast surface / bone surface (Oc.S/BS%) at 8 weeks in Rin3−/− mice compared to wild type (24.1 ± 4.7 vs. 29.7 ± 6.6; p = 0.025) but there were no significant differences in markers of bone formation at this time. At 52 weeks, Oc.S/BS did not differ between genotypes but single labelled perimeter (SL.Pm/B.Pm (%)) was significantly higher in Rin3−/− mice (24.4 ± 6.4 vs. 16.5 ± 3.8, p = 0.003). We conclude that Rin3 negatively regulates trabecular bone mass in mice by inhibiting osteoclastic bone resorption and favouring bone formation. Our observations also suggest that the variants that predispose to PDB in humans probably do so by causing a gain-in-function of RIN3.

This study aimed to compare and verify the osseointegration performance of a novel implant (NI) in vivo, which could provide a useful scientific basis for the further development of NIs. Thirty-two NIs treated with hydrofluoric acid and anodization and sixteen control implants (CIs) were placed in the mandibles of 8 beagles. Micro-CT showed that the trabecular number (Tb.N) significantly increased and trabecular separation (Tb.Sp) significantly decreased in the NIs at 2 weeks. Significant differences were found in the trabecular thickness, Tb.N, Tb.Sp, bone surface/bone volume ratio, and bone volume/total volume ratio between the two groups from the 2nd–4th weeks. However, there were no significant differences between the two groups in the bone volume density at 2, 4, 8, or 12 weeks or bone-implant contact at 2 or 4 weeks, but the BIC in the CIs was higher than that in the NIs at the 8th and 12th weeks. Meanwhile, the histological staining showed a similar osseointegration process between the two groups over time. Overall, the NIs could be used as new potential implants after further improvement.

Background/aim The success of treatment of bone fracture and defects are based on a proper contact and compression between the bone fracture fragments. Intraoperative manipulations such as bone compression or distractions are generally done in order to achieve this. However, none of the bone plates currently in routine use allow these manipulations after fixation to the bone, requiring refixation and repeated drilling, and screwing operations. Based on this shortcoming, we designed a novel adjustable bone plate (ABP) system which allows bone shortening and lengthening even after fixation to the bone surface. The aim of the paper is to clarify the unique properties of the novel bone plate. Materials and methods In this paper, the new generation adjustable bone plate applicability, design, indication, and new characteristics in addition to conventional bone plates with review of the literature were discussed and surgical technique was demonstrated in a saw bone model. Results This novel design allows for compression and distraction at the fracture ends post fixation as well as bone segment transfers. Conclusions The potential of the new generation ABP plate for use in bone compression, distraction, and the segmental bone transfer is a promising invention for clinical applications in the future.

Shao-Jie Zhang,1,2,&ast; Kun Li,2,3,&ast; Zhi-Jun Li,2,3 Xing Wang,2,3 Jia-Hui Dong,4 Jian Wang,2 Jie Chen,2 Xing-Yue Qu,2 Zi-Yu Li,2 Yu-Hang Liu2 1School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, People’s Republic of China; 2Department of Human Anatomy, Inner Mongolia Medical University, Hohhot, People’s Republic of China; 3Digital Medical Center, Inner Mongolia Medical University, Hohhot, People’s Republic of China; 4The First Clinical Medical College, Inner Mongolia Medical University, Hohhot, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zhi-Jun LiDepartment of Human Anatomy, Inner Mongolia Medical University, Hohhot, People’s Republic of ChinaTel +86 471-6636945Email zjl06_master@126.comObjective: This study aimed to investigate the safety of clival screw placement in children aged 1– 6 years.Methods: The cranial computed tomography data of 92 children aged 1– 6 years were divided into three groups, according to age, for three-dimensional reconstruction. Three clival screw placement points were defined: (1) median point A at the middle and upper third of the tripartite distance from the spheno-occipital synchondrosis to the base of the skull; (2, 3) critical points B and C on the horizontal line with point A, where the screw placement passage was parallel to the sagittal plane. Parameters such as the passage length and angle were measured for horizontal, vertical facial, and extreme screw placement.Results: The length parameters of the clival screw placement increased with age, and the screw passage length was the shortest for the vertical facial type in each age group. There were significant differences in all three groups between the length of screw placement in the vertical bone surface, the length of screw placement in the horizontal direction, and the length of screw placement on the limit at points A, B, and C (P < 0.05); the length of screw placement on the vertical bone surface was the shortest. There was no significant difference between the horizontal screw length at point A and the extreme screw length (P > 0.05). The difference between the horizontal screw length and the extreme screw length in the groups aged 1– 2 years and 5– 6 years was statistically significant (P < 0.05), and the horizontal screw length was longer.Conclusion: The cranial slope of children aged 1– 6 years has the morphological basis for the placement of 3.5 mm screws, and each placement point has a safe angle range for screw placement.Keywords: children, craniocervical junction region, clivus, internal screw fixation, spiral computed tomography scan

In this study, we investigated a method allowing the determination of the femur bone surface as well as its mechanical axis from some easy-to-identify bony landmarks. The reconstruction of the whole femur is therefore performed from these landmarks using a Statistical Shape Model (SSM). The aim of this research is therefore to assess the impact of the number, the position, and the accuracy of the landmarks for the reconstruction of the femur and the determination of its related mechanical axis, an important clinical parameter to consider for the lower limb analysis. Two statistical femur models were created from our in-house dataset and a publicly available dataset. Both were evaluated in terms of average point-to-point surface distance error and through the mechanical axis of the femur. Furthermore, the clinical impact of using landmarks on the skin in replacement of bony landmarks is investigated. The predicted proximal femurs from bony landmarks were more accurate compared to on-skin landmarks while both had less than 3 . 5 ∘ degrees mechanical axis angle deviation error. The results regarding the non-invasive determination of the mechanical axis are very encouraging and could open very interesting clinical perspectives for the analysis of the lower limb either for orthopedics or functional rehabilitation.

Bone surface modifications (BSMs) in faunal assemblages are frequently used to infer past agency and actions of hominins and carnivores, with implications for the emergence of key human behaviours. Patterning of BSMs has mostly been defined as a combination of the intensity of marks per bone portion and sometimes per element. Numerous variables involved in butchery can condition cut mark anatomical distribution, so much so that these variables are widely assumed to be stochastic. Here, we present a new methodological approach using a novel geospatial tool (Ikhnos) which combines the three-dimensional spatial documentation of cut mark patterns with spatial statistics based on wavelets, applied to three experimental and ethnoarchaeological faunal assemblages. We use wavelets to identify patterning of multiple longitudinal series of cut mark distributions on bones, and to establish similarities or differences in patterning within and across different assemblages. This method demonstrates the existence of general and behaviour-specific butchery patterns. It can also be used to effectively assess the proportion of mark clustering that is due to randomness, versus that which is conditioned by the butchery process.

Category: Midfoot/Forefoot; Trauma Introduction/Purpose: Midfoot fusions have long been used to treat a variety of procedures in the foot. Indications may include hallux valgus correction, first ray instability, midfoot arthritis, pes planovalgus, trauma, and Charcot reconstruction. One of the drawbacks of this procedure is nonunion, which has been consistently reported between 5-10%. Placing implants and obtaining fixation along the plantar surface of the bone may create a tension band implant construct during physiologic loading that helps to compress the arthrodesis site and thereby may further optimize the healing potential. This study reports on the radiographic and clinical outcomes of plantar plating and arthrodesis of midfoot joints for a variety of procedures. Methods: A retrospective review was undertaken of consecutive patients between 2012-2019 that underwent a midfoot fusion with plantar positioned implants by a fellowship-trained foot and ankle orthopedic surgeon at a single institution. 62 patients underwent arthrodesis of the midfoot as part of a correction for hallux valgus, flatfoot deformity, midfoot arthritis, Lisfranc injury, Charcot correction or a combination these diagnoses. Average follow-up was 36.2 months (range, 16-66 months). For those treated for a flatfoot deformity, the lateral talus-first metatarsal (Meary’s) angle and medial arch sag angle (MASA) were compared on preoperative and postoperative imaging to obtain the magnitude of radiographic correction achieved. For those treated for hallux valgus deformity, the inter-metatarsal angle (IMA) was utilized to establish the magnitude of deformity correction. Serial weight-bearing radiographs were independently evaluated for malunion, nonunion, or hardware migration to be logged as complications at the arthrodesis site. Results: The 1st TMT joint was fused in 43 patients, and the NC joint was fused in 23 patients. Five patients had simultaneous fusion of the 1st TMT and NC joints. Two patients underwent arthrodesis of the talonavicular (TN) joint with one patient having simultaneous arthrodesis of the TN and NC joints. We found statistically significant improvement in the lateral talus-first metatarsal-angle (Meary’s) and medial arch sag angle (MASA) for those treated for flatfoot corrections. For those treated for hallux valgus, there was significant reduction in the Intermetatarsal angle (IMA) from 15.4 to 6.8 degrees. The overall nonunion rate was 6.45% in all patients. The nonunion rate was reduced to 3.3%when excluding the Charcot neuroarthropathy patients. There was one symptomatic nonunion requiring revision surgery (1.7%). Conclusion: Deformity correction was successfully maintained in those treated for hallux valgus and flatfoot deformities. There were significant improvements in the IMA, the MASA, and Meary’s angle Plates implanted on the plantar bone surface for midfoot arthrodesis provided and maintained deformity correction without hardware irritation for a variety of orthopedic conditions. A clinical and radiographic union rate of94% (97% when excluding Charcot neuroarthropathy patients) was achieved. The risk of nonunion appeared to be higher in diabetic patients, in smokers, with the utilization of claw plates, and when fusion constructs included the NC joint. [Table: see text]

MicroCT-based morphological parameters are often used to quantify the structural properties of trabecular bone. Various software tools are available for calculating these parameters. Studies that examine the comparability of their results are rare. Four different software tools were used to analyse a set of 701 microCT images from human trabecular bone samples. Bone volume to total volume (BV/TV), bone surface (BS), trabecular thickness (Tb. Th.) and degree of anisotropy (DA) were evaluated. BV/TV shows very low difference (−0.18 ± 0.15%). The difference in BS could be reduced below 5% if artificial cut surfaces are not included. Tb. Th. and Tb. Sp. show differences of maximal −12% although the same theoretical background is used. DA is most critical with differences from 4.75 ± 3.70% (medtool vs. Scanco), over −38.61 ± 13.15% (BoneJ vs. Scanco), up to 80.52 ± 50.04% (medtool vs. BoneJ). Quantitative results should be considered with caution, especially when comparing different studies. Introducing standardization procedures and the disclosure of underlying algorithms and their respective implementations could improve this issue.

Motor skill learning of dental implantation surgery is difficult for novices because it involves fine manipulation of different dental tools to fulfill a strictly pre-defined procedure. Haptics-enabled virtual reality training systems provide a promising tool for surgical skill learning. In this paper, we introduce a haptic rendering algorithm for simulating diverse tool-tissue contact constraints during dental implantation. Motion forms of an implant tool can be summarized as the high degree of freedom (H-DoF) motion and the low degree of freedom (L-DoF) motion. During the H-DoF state, the tool can move freely on bone surface and in free space with 6 DoF. While during the L-DoF state, the motion degrees are restrained due to the constraints imposed by the implant bed. We propose a state switching framework to simplify the simulation workload by rendering the H-DoF motion state and the L-DoF motion state separately, and seamless switch between the two states by defining an implant criteria as the switching judgment. We also propose the virtual constraint method to render the L-DoF motion, which are different from ordinary drilling procedures as the tools should obey different axial constraint forms including sliding, drilling, screwing and perforating. The virtual constraint method shows efficiency and accuracy in adapting to different kinds of constraint forms, and consists of three core steps, including defining the movement axis, projecting the configuration difference, and deriving the movement control ratio. The H-DoF motion on bone surface and in free space is simulated through the previously proposed virtual coupling method. Experimental results illustrated that the proposed method could simulate the 16 different phases of the complete implant procedures of the Straumann® Bone Level(BL) Implants Φ4.8–L12 mm. According to the output force curve, different contact constraints could be rendered with steady and continuous output force during the operation procedures.

Amniotic membrane has been widely used in regenerative medicine especially ophthalmology. It has many advantages including anti-inflammatory, anti-fibrotic and antimicrobial properties. The purpose of the present work to study the effect of lyophilized human amniotic membrane on healing of bony defect in rabbits' femur. Eighteen male rabbits were used. Four mm wide and 5 mm deep defect was created in the femur diaphysis bilaterally in each rabbit. The defect of the right side was left empty (control), while the left side was filled with the amniotic membrane (study). Six rabbits were scarified at each of the experimental periods 2, 4 & 6 weeks postoperatively. The defect areas were dissected out and evaluated histologically & histomorphometrically. In the control group, at 2 weeks, woven bone spicules were seen extending from the periphery of the defect boundaries. At 4 weeks, the newly formed bone became more mature. At 6 weeks, the newly formed bone was more dense with newly formed osteons were seen. However, in the study group, the newly formed bone was much less in relation to the control group. Remnants of the amniotic membrane was seen folded at the center of the defect area surrounded by inflammatory cells. Histomorphometrically, the mean percentage of bone surface area in control group was higher than the study group in all experimental periods and the difference was statistically significant (p

This study investigatedthe different effects of long-term glucocorticoid (GC) interventions on the microarchitectures of cortical and cancellous bones of the femoral head. Eighteen female skeletal mature sheep were randomly allocated into 3 groups, 6 each. Group 1 received prednisolone interventions (0.60 mg/kg/day, 5 times weekly) for 7 months. Group 2 received the same interventions as Group 1 and then further observed 3 months without interventions. Control Group was left nonintervention. After killing the animals, all femoral heads were scanned by micro-CT to determine their microstructural properties. In cancellous bone of femoral head, GC interventions led to significant decrease of bone volume fraction, trabecular thickness, trabecular separation, but increase of structure model index and bone surface density (p 0.05) except greater trabecular thickness in the control group. In addition, three months after cessation of glucocorticoid interventions, most microstructural properties of cancellous bone were significant reversed, but not cortical thickness of femoral head. In contrast to cancellous bone, the microarchitectures of cortical bone were not changed obviously after long-term GC interventions.

© 2020 IPEM. Published by Elsevier Ltd. All rights reserved., Although the primary stability of joint implants is fundamental for successful osseointegration, little is know about this issue in the context of stemless shoulder implants. Considering 3D finite element models, the purpose of this study was to evaluate the primary stability of five stemless designs, based on the Sidus, SMR, Simpliciti, Eclipse, and Global Icon stemless systems. Three alternative bone quality conditions were considered for cancellous bone. For the Sidus, SMR, and Simpliciti designs, which do not possess a collar that sits on the cortical rim of the humeral resected surface, contact and no contact conditions were considered between the bone surface and the humeral head components. Micromotions at bone-implant interfaces promoting osseointegration were computed as a measure of primary stability for eight load cases consisting of peak in vivo joint loads measured during selected upper limb activities. Under good bone quality conditions, all stemless designs presented micromotions below 150 μm. The Eclipse-based and Global-Icon based designs were the least sensitive to bone quality. Stemless designs presenting a solid collar or contact between the humeral head component and bone provided more stability. Overall, the Eclipse-based and Global Icon-based designs presented the best performance from the primary stability point of view. However, if bone adaptation data available in the literature are considered along with the primary stability data computed here, the Global Icon-based design, as well as other designs, might be considered superior long-term options due to their better compromise between primary stability and impact on bone adaptation., This work was supported by the Portuguese Foundation for Science and Technology (FCT), through IDMEC, under LAETA, project UID/EMS/50022/2019 and project UIDB/50022/2020

Recent zooarchaeological and isotope analyses have largely settled the debate surrounding Neanderthal hunting capacities, repeatedly demonstrating their successful acquisition of large ungulates. Nevertheless, the functional identification of individual tools as hunting weapons remains a methodological challenge. In-depth studies have focussed mainly on small subsets of lithic artefacts from selected assemblages assessing features of breakage patterns, retouch, shape and use wear. Studies focussing on associated hunting lesions are rarer and often focus on reconstructing very specific bone surface marks encountered in the archaeological record. This study aims to add to our understanding of the formation and characteristics of projectile impact marks (PIMs) on bone through a series of highly monitored, replicative experiments, using thrusting and throwing spears with replica Levallois points into two wild pig carcasses. In total, 152 shots were made, and for each a series of attributes was recorded, including velocity and location of impact. Subsequent quantitative analyses focussed on understanding the various factors underlying the formation of different types of projectile impact marks. These experiments demonstrate that PIM formation results from the properties of both the impacting projectile and bone element. PIMs can signal impacts caused by different delivery methods but only on some parts of the skeleton. These results are contextualised in relation to the occurrence and recognition of Palaeolithic PIMs and patterns of Neanderthal behaviour. These experiments are only a first step in improving the recognition of these signatures in the archaeological record and providing better insights into understanding of the mechanisms of Neanderthal hunting.

We describe a procedure for ascertaining the extent of diagenesis in archaeological human skeletons through the distribution of Sr, Ba, Cu, Pb, Fe, and Mn in cross-sections of femoral cortical bone. Element mapping is performed through Laser Ablation Inductively Coupled Plasma Mass Spectrometry (LA-ICP-MS). Absolute calibrations of element concentrations were obtained using Inductively Coupled Plasma Mass Spectrometry (ICP-MS) on adjacent dissolved bulk bone samples. By comparing a modern individual to five medieval to early modern Danish skeletons, we demonstrate the degree to which concentrations of trace elements are attributable to diagenesis. Invasion from the exterior bone surface into a degraded part of the outer cortical bone is the most frequently occurring diagenetic change. In the archaeological skeletons investigated, diagenetic modification is restricted to, at most, the outer ca. 0.5 mm of bone. In one femur, Haversian channels were filled with diagenetic material, which appears to have entered the bone through a network of cavities largely made up by Haversian and Volkmann’s canals.

Fracture of a femoral component after modern unicompartmental knee arthroplasty is very rare. Although this is not the first case on this subject, no study has reported insufficient crimping as the cause of femoral component loosening that led to breakage of a metallic component. A 69-year-old man underwent medial unicompartmental knee arthroplasty for right medial knee osteoarthritis. His early postoperative course was good; however, the 1-year postoperative radiograph showed an apparent radiolucent line around the femoral component, and he occasionally had right knee pain. However, he had been followed up conservatively because he had been doing well even while doing heavy agricultural work. At 8 years after surgery, because breakage of the femoral component was found, revision surgery was performed using bicruciate-retaining total knee arthroplasty. The removed fractured femoral component revealed a thick cement mantle detached from the bone surface. The postoperative course of the patient after the revision surgery was excellent. We suggest that the causes of femoral component breakage include early implant loosening caused by uneven cement crimping of the femoral component to the bone and excessive loading stress as a result of heavy labour.

Background Bernese periacetabular osteotomy (PAO) has been shown to be applicable as a hip-preserving technique for the treatment of developmental dysplasia of the hip (DDH). The approach could be designed preoperatively using various types of reverse-engineering software and finite element analysis, but how to implement it in the actual PAO remains a challenge. This study examines and evaluates a solution to achieve higher accuracy when performing a PAO. Methods A patient-specific cutting and rotating template was predesigned through computer-aided design (CAD) with three-dimensional (3D) modeling programs. The templates were then reproduced with rapid prototyping (RP) technology and used in the actual PAO. Finally, the clinical and radiographic effects were assessed and compared between the newly developed PAO and conventional PAO groups. Results The customized cutting template fit well with the bone surface and served as a guide for surgeons as they slid the osteotome to the precise location that had been determined prior to surgery. A very similar acetabular fragment was reproduced, and no major complications occurred when performing the osteotomy along the edge of the cutting template. The acetabular fragment was then corrected to the predetermined position through one-off manipulation with the customized rotating template. The final position of the acetabular fragment in the new developed PAO group was highly consistent with the planned position, and the postoperative morphological parameters were consistent with the preoperative planned data compared to the conventional PAO group. The duration of the operation and the number of irradiation decreased significantly. The Harris hip score (HHS) and visual analogue scale (VAS) score improved significantly with the use of the new developed PAO. Conclusions We demonstrate that our system, which was based on CAD-RP technology, is feasible and could realize the predicted results accurately during the actual PAO.

In orthopaedic surgery, water jet drilling provides several advantages over classic drilling with rigid drilling bits, such as the always sharp cut, absence of thermal damage and increased manoeuvrability. Previous research showed that the heterogeneity of bone tissue can cause variation in drilling depth whilst water jet drilling. To improve control over the drilling depth, a new method is tested consisting of two water jets that collide directly below the bone surface. The expected working principle is that after collision the jets will disintegrate, with the result of eliminating the destructive power of the coherent jets and leaving the bone tissue underneath the focal point intact. To assess the working principle of colliding water jets (CWJ), the influence of inhomogeneity of the bone tissue on the variation of the drilling depth and the impact of jet time (twj) on the drilling depth were compared to a single water jet (SWJ) with a similar power. 98 holes were drilled in 14 submerged porcine tali with two conditions CWJ (impact angle of 30° and 90°) and SWJ. The water pressure was 70MPa for all conditions. The water jet diameter was 0.3 mm for CWJ and 0.4 mm for SWJ. twj was set at 1, 3, 5 and 8s. Drilling depth and hole diameter were measured using microCT scans. A non-parametric Levene's test was performed to assess a significant difference in variance between conditions SWJ and CWJ. A regression analysis was used to determine differences in influence of twj on the drilling depth. Hole diameter differences were assessed using a one way Anova. A significance level of p

In total knee arthroplasty, infection has always been cited as being the number one cause of failure. However, more recent studies have shown aseptic loosening as the top reason for failure now. Proper cement technique is an important factor in reducing the occurrence of aseptic loosening. Clean and dried bone are important in achieving rigid cement fixation. Subchondral cysts may be hidden below the cut bone surface and may interfere with cement interdigitation. During a recent total knee arthroplasty case, a simple technique was developed for identifying and clearing out these cysts. By only using the suction tip, the gentle sweeping of the cut-surface will excavate hidden subchondral cysts allowing for improved cement interdigitation.

Objective: The purpose of this study was to analyze stress distributions in the roots, periodontal ligaments (PDLs), and bones around cylindrical and tapered miniscrews inserted at different angles using a finite element analysis. Methods: We created a three-dimensional (3D) maxilla model of a dentition with extracted first premolars and used 2 types of miniscrews (tapered and cylindrical) with 1.45-mm diameters and 8-mm lengths. The miniscrews were inserted at 30°, 60°, and 90° angles with respect to the bone surface. A simulated horizontal orthodontic force of 2 N was applied to the miniscrew heads. Then, the stress distributions, magnitudes during miniscrew placement, and force applications were analyzed with a 3D finite element analysis. Results: Stresses were primarily absorbed by cortical bone. Moreover, very little stress was transmitted to the roots, PDLs, and cancellous bone. During cylindrical miniscrew insertion, the maximum von Mises stress increased as insertion angle decreased. Tapered miniscrews exhibited greater maximum von Mises stress than cylindrical miniscrews. During force application, maximum von Mises stresses increased in both groups as insertion angles decreased. Conclusions: For both cylindrical and tapered miniscrew designs, placement as perpendicular to the bone surface as possible is recommended to reduce stress in the surrounding bone.

Rheumatoid arthritis (RA) is an inflammatory disease which afflicts the joints with arthritis and periarticular bone destruction as a result. One of its central features is bone erosion, a consequence of excessive bone resorption and insufficient bone formation. High-resolution peripheral quantitative computed tomography (HR-pQCT) is a promising tool for monitoring RA. Quantification of bone erosions and detection of possible progression is essential in the management of treatment. Detection is performed manually and is a very demanding task as rheumatologists must annotate hundreds of 2D images and inspect any region of the bone structure that is suspected to be a sign of RA. We propose a 2D based method which combines an accurate segmentation of bone surface boundary and classification of patches along the surface as healthy or eroded. We use a series of classical image processing methods to segment CT volumes semi-automatically. They are used as training data for a U-Net. We train a Siamese net to learn the difference between healthy and eroded patches. The Siamese net alleviates the problem of highly imbalanced class labels by providing a base for one-shot learning of differences between patches. We trained and tested the method using 3 full HR-pQCT scans with bone erosion of various size. The proposed pipeline succeeded in classifying healthy and eroded patches with high precision and recall. The proposed algorithm is a preliminary work to demonstrate the potential of our pipeline in automating the process of detecting and locating the eroded regions of bone surfaces affected by RA.

Aim The aim of this study was to evaluate palatal vertical bone thickness and density in relation to soft tissue on the hard palate for better selection of adequate bone regions for the insertion of orthodontic mini-implants (MIs) in cleft palate patients. Materials and methods Cone beam computed tomography scans (CBCT) were obtained from 60 patients (mean age range 9–12). The study population included patients with isolate right side cleft palate formation (n = 20; 6 females; 14 males), left side cleft palate formation (n = 20; 9 females; 11 males) and without cleft formation as control group (n = 20; 15 females; 5 males). Bone and soft tissue measurements were performed vertical at a 90° angle to the bone surface, on previously defined measurement points (n = 88) on the hard palate. Bone density was measured on ten vertical layers in caudo-cranial direction. Results In non-cleft patient the highest bone thickness was in the anterior palate and decreased significantly in posterior direction. In patients with right and left cleft palate, the highest vertical bone level could be observed at the palatal premaxillary border opposite to the cleft side. Patients in the control group showed a significantly lower vertical soft tissue thickness than patients with palatal cleft formation. The evaluation of bone density showed no significant differences in all three groups. Conclusion The results suggest that the favorable region for orthodontic MI placement is in the similar anatomical region compared to non-cleft patients, but differs from one side in each group. In unilateral cleft palate patients, the highest bone level was found on the anterior palate side opposite to the cleft side, indicating the most effective region for MIs placement.

The presence of skull cups (bowls made from human calvaria) is considered evidence of the ritualistic treatment of human bodies. These artefacts are characterised by careful manufacturing which can be taphonomically observed in bone surface modifications (BSM) as cut marks and percussion marks. These BSM show morphological similarities across Upper Palaeolithic, Neolithic, and Bronze Age assemblages. This study is focused on the analysis of the frequency and spatial distribution of cut marks on skull cups from Gough's Cave (UK), Herxheim (Germany), and El Mirador Cave (Spain), as compared to the frequency and spatial distribution of modifications on human skulls (non-skull cups) from TD6.2 of Gran Dolina (Spain) and Fontbrégoua (France), with the aim of identifying a common pattern related to a symbolic background. Nearest neighbour analysis and Kernel analyses were used to identify the distribution pattern of anthropogenically induced modifications. The results indicate that the frequency and distribution of cut marks on human skulls modified into skull cups are unique and are most likely to be the result of meticulous cleaning of skulls. A similar frequency and distribution pattern of modifications was also observed on skulls from Fontbrégoua, possibly related to the collection of skulls as war trophies. No parallels with the treatment of skulls of Homo antecessor at TD6.2 of Gran Dolina were observed. We suggest that the treatment of human skulls for ritualistic purposes therefore results in a consistent pattern of modification., This work was supported by the Ministerio de Economía, Industria y Competitividad/Fondo Europeo de Desarrollo Regional [PGC2018-093925-B-C32]; the Agència de Gestió d'Ajuts Universitaris i de Recerca project number [SGR 2017-1040]; the Universitat Rovira i Virgili [2014, 2015 and 2016 PFR-URV-B2-17]; and the Departament de Cultura de Generalitat de Catalunya [100576, 2014], and is framed in Centres de Recerca de Catalunya Programme/Generalitat de Catalunya. A. Rodriguez-Hidalgo has the support of the Spanish Ministry of Science, Innovation and Universities [IJC2018-037447-I].

3D reconstruction of human anatomy from cross-sectional imaging has recently gained increasing importance in several medical fields thus designating the 3D bones reconstruction accuracy, critical for the success of the whole surgical intervention. The 3D anatomic model quality depends on the quality of the reconstructed image, on the quality of the images segmentation step and on the error introduced by the iso-surface triangulation algorithm. The influence of image processing procedures and relative parametrization has been largely studied in the scientific literature; however, the analysis of the direct impact of the quality of the reconstructed medical images is still lacking. In this paper, a comparative study on the influence of both image reconstruction algorithm (standard and iterative) and applied kernel is reported. Research was performed on the 3D reconstruction of a pig tibia, by using Philips Brilliance 64 CT scanner. At the stage of scanning and at the stage of 3D reconstruction, the same procedures were followed, while only image reconstruction algorithm and kernel were changed. The influence of such selection on the accuracy of bone geometry was assessed by comparing it against the 3D model obtained with a professional 3D scanner. Results show an average error in reconstructing the geometry of around 0.1 mm with a variance of 0.08 mm. The presented study highlights new opportunities to control the deviations on the geometry accuracy of the bones structures at the stage of cross sectional imaging generation.

In this study, we aim to create and validate a Finite Element (FE) model to estimate the bone temperature after cement injection and compare the simulation temperature results with experimental data in three key locations of the proximal femur. Simulation results suggest that the maximum temperature-rise measured at the bone surface is 10°C which occurs about 12 minutes after the injection. Temperature profiles measured during the experiment showed an agreement with those of the simulation with an average error of 1.73 °C Although additional experiments are required to further validate the model, results of this pilot study suggest that this model is a promising tool for bone augmentation planning to lower the risk of thermal necrosis.

Pullout tests to determine the effect of anchor threads on the pullout strength was conducted by using universal testing machine, synthetic cancellous bone and thread-less metallic anchor. Anchors were inserted at 45°, 90° or 135° from the surface and they were pulled at 45° from the surface. The maximum load to failure was compared among the 3 insertion angles. Pullout strength of the anchors inserted at 45° was significantly greater than those inserted at 90° or 135°. Pullout strength of the thread-less anchor was the greatest when it was inserted at 45° to the bone surface. Level of evidence level II.

Bone size and shape arise throughout ontogeny as a result of the coordinated activity of osteoblasts and osteoclasts, responsible for bone deposition and resorption, and growth displacements. The modelling processes leave specific microstructural features on the bone surface, which can be used to infer the mechanisms shaping craniofacial traits in extinct and extant species. However, the analysis of bone surfaces from fossils and archaeological samples faces some difficulties related to the bone loss caused by taphonomic factors, and the lack of formal methods for estimating missing information and comparing the patterns of bone modelling among several specimens and samples. The present study provides a new approach for the quantitative analysis of bone formation and resorption patterns obtained from craniofacial surfaces. First, interpolation techniques were used to estimate missing data on high-resolution replicas of the left maxilla in a sample of sub-adult and adult modern humans and sub-adult fossil hominins. The performance of this approach was assessed by simulating variable amounts of missing data. Then, we applied measures of dispersion and central tendency to represent the variation and average pattern of bone modelling within samples. The spatial interpolation resulted in reliable estimations of the type of cell activity (deposition or resorption) in the missing areas, even when large extensions of the bone surface were lost. The quantification of the histological data allowed us to integrate the information of different specimens and depict the areas with higher and lower variation in the bone modelling pattern of the maxilla among specimens. Overall, the main advantages of the quantitative approach used here for generating bone modelling patterns are the high replicability and the possibility of incorporating variation among specimens into the comparisons among samples., Facultad de Ciencias Naturales y Museo (FCNM)

Periosteal osteosarcoma is an extremely rare chondroblastic osteosarcoma in the flat bone. There were authors reporting of two cases of periosteal osteosarcoma in the highly unusual sites. One of them arose from the rib, in a 17-year-old male, which appeared as a hypodense juxtacortical mass with periosteal reaction on CT. The other one arose from the scapula, in a 17-year-old female, which showed the intermediate signal intensity (SI) on T1-weighted image (WI), heterogeneous high SI on T2WI, and rim-enhancement on contrast-enhanced T1WI with cortical destruction on MRI. Index terms: Bone surface tumor; Osteosarcoma; Rib; Scapula; Chest wall

Bone-degrading osteoclasts are formed through fusion of their monocytic precursors. In the population of human peripheral blood monocytes, three distinct subsets have been identified: classical, intermediate and non-classical monocytes. We have previously shown that when the monocyte subsets are cultured on bone, significantly more osteoclasts are formed from classical monocytes than from intermediate or non-classical monocytes. Considering that this difference does not exist when monocyte subsets are cultured on plastic, we hypothesized that classical monocytes adhere better to the bone surface compared to intermediate and non-classical monocytes. To investigate this, the different monocyte subsets were isolated from human peripheral blood and cultured on slices of human bone in the presence of the cytokine M-CSF. We found that classical monocytes adhere better to bone due to a higher expression of the integrin αMβ2 and that their ability to attach to bone is significantly decreased when the integrin is blocked. This suggests that integrin αMβ2 mediates attachment of osteoclast precursors to bone and thereby enables the formation of osteoclasts.

International audience; Medical orthoses aim at guiding anatomical joints along their natural trajectories while preventing pathological movements, especially in case of trauma or injuries. The motions that take place between bone surfaces have complex kinematics. These so-called arthrokinematic motions exhibit axes that move both in translation and rotation. Traditionally, orthoses are carefully adjusted and positioned such that their kinematics approximate the arthrokinematic movements as closely as possible in order to protect the joint. Adjustment procedures are typically long and tedious. We suggest in this paper another approach. We propose mechanisms having intrinsic self-aligning properties. They are designed such that their main axis self-adjusts with respect to the joint’s physiological axis during motion. When connected to a limb, their movement becomes homokinetic and they have the property of automatically minimizing internal stresses. The study is performed here in the planar case focusing on the most important component of the arthrokinematic motions of a knee joint.

Objectives: Non-homogeneous force distribution along the miniplates and the screws is an unsolved question for skeletal anchorage in orthodontics. To overcome this issue, a miniplate structure was designed featuring spikes placed on the surface facing the cortical bone. The aim of this study was to examine and compare the force distribution of the newly designed plate-screw systems with the conventional one.Methods: A model of bone surface with 1.5 mm cortical thickness, along with the two newly designed miniplates and a standard miniplate-screw were simulated on the three-dimensional model. 200 g experimental force was applied to the tip of the miniplates and the consequential effects on the screws and cortical bone was evaluated using three-dimensional finite element method.Results: As a result of this finite element study, remarkably lower stresses were observed on the screws and the cortical bone around the screws with the newly designed miniplate when compared with the conventional one.Conclusion: The newly designed miniplate that has spikes was found effective in reducing the stress on and around the screws and the force was distributed more equivalently. (Eur J Dent 2012;6:9-15)

The mandibular condyle is considered a good model for developing cancellous bone because of its rapid growth and high rate of remodeling. The aim of the present study was to analyze the simultaneous changes in microarchitecture and mineralization of cancellous bone during development in a three-dimensional fashion. Eight mandibular condyles of pigs aged 8 weeks prepartum to 108 weeks postpartum were scanned using microCT with an isotropic spatial resolution of 10 microm. The number of trabeculae decreased during development, whereas both the trabecular thickness and the distance between the trabeculae increased. The bone surface to volume ratio decreased during development, possibly limiting the amount of (re)modeling. Both the mean degree of mineralization and intratrabecular differences in mineralization between the surfaces and cores of trabecular elements increased during development. The trabecular surfaces were more highly mineralized in the older condyles compared to the younger ones. Together with the observed decrease in the relative size of trabecular surface, this finding suggests a decrease in (re)modeling activity during development. In accordance with the general growth and development of the pig, it was concluded that most developmental changes in cancellous bone occur until the age of 40 weeks postpartum.

Background Although the adult human skull is a complex and multifunctional structure, its 3D, complete, realistic, and stereotactic atlas has not yet been created. This work addresses the construction of a 3D interactive atlas of the adult human skull spatially correlated with the brain, cranial nerves, and intracranial vasculature. New method The process of atlas construction included computed tomography (CT) high-resolution scan acquisition, skull extraction, skull parcellation, 3D disarticulated bone surface modeling, 3D model simplification, brain–skull registration, 3D surface editing, 3D surface naming and color-coding, integration of the CT-derived 3D bony models with the existing brain atlas, and validation. Results The virtual skull model created is complete with all 29 bones, including the auditory ossicles (being among the smallest bones). It contains all typical bony features and landmarks. Comparison with existing method(s) The created skull model is superior to the existing skull models in terms of completeness, realism, and integration with the brain along with blood vessels and cranial nerves. Conclusions This skull atlas is valuable for medical students and residents to easily get familiarized with the skull and surrounding anatomy with a few clicks. The atlas is also useful for educators to prepare teaching materials. It may potentially serve as a reference aid in the reading and operating rooms.

This prospective randomized split-mouth study was performed to examine the effects of absorbable collagen membrane (ACM) application in augmented corticotomy using deproteinized bovine bone mineral (DBBM), during orthodontic buccal tipping movement in the dog. After buccal circumscribing corticotomy and DBBM grafting into the decorticated area, flaps were repositioned and sutured on control sides. ACM was overlaid and secured with membrane tacks, on test sides only, and the flaps were repositioned and sutured. Closed coil springs were used to apply 200 g orthodontic force in the buccolingual direction on the second and third premolars, immediately after primary flap closure. The buccal tipping angles were31.19±14.60° and28.12±11.48° on the control and test sides, respectively. A mean of79.5 ± 16.0% of the buccal bone wall was replaced by new bone on the control side, and on the test side78.9±19.5% was replaced. ACM application promoted an even bone surface. In conclusion, ACM application in augmented corticotomy using DBBM might stimulate periodontal tissue reestablishment, which is useful for rapid orthodontic treatment or guided bone regeneration. In particular, ACM could control the formation of mesenchymal matrix, facilitating an even bone surface.