Methods for Assessing Bone Quality: A Review

Donnelly, Eve

doi:10.1007/s11999-010-1702-0

Cited by 256 publications

(186 citation statements)

References 90 publications

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“…in a clinical setting. 22) This indicates the potential of evaluating bone quality in addition to BMD when determining bone strength in clinical practice. Moreover, clarification of BAp crystallite alignment in the jawbone would allow direction of occlusal load to be taken into account in orthodontic treatment involving tooth alignment.…”

Section: Discussionmentioning

confidence: 99%

Relationship between Biological Apatite Alignment and Hemi-occlusion in Rabbit Mandibular Cortical bone

Ogai

Morioka

Matsunaga

et al. 2012

J. Hard Tissue Biology.

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Biological apatite (BAp) crystallite c-axis alignment is known to one of the factor in mechanical function in bone. The purpose of this study was to investigate BAp crystallite alignment as a potential factor in the evaluation of bone strength in clinical practice by evaluating the relationship between BAp alignment and bone mineral density (BMD) using an experimental hemi-occlusion model in rabbit mandibular cortical bone.A higher degree of BAp crystallite c-axis alignment was observed in the mesiodistal direction on the nonocclusion than on the occlusion side in the alveolar area, a tendency that was not seen in the base of the mandible. No significant differences were observed in BMD between the alveolar area and the base of the mandible or between the occlusion and non-occlusion sides. No correlation was observed between BAp crystallite alignment and BMD.These results demonstrate that removal of occlusal force caused change in BAp crystallite alignment in the alveolar area in mandibular cortical bone. This indicates the importance of evaluating BAp crystallite alignment in addition to BMD in clinical practice. Moreover, clarification of BAp crystallite alignment in the jawbone would allow direction of occlusal load to be taken into account in orthodontic treatment involving tooth alignment.

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Section: Discussionmentioning

confidence: 99%

Relationship between Biological Apatite Alignment and Hemi-occlusion in Rabbit Mandibular Cortical bone

Ogai

Morioka

Matsunaga

et al. 2012

J. Hard Tissue Biology.

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“…It can be related to the inherent states of the two primary components of the bone matrix: hydroxyapatite and Type I collagen. Some measurable contributors to bone quality include chemical composition, mineral crystal size and crystallinity, mineral-matrix interactions, bone tissue density, degree of collagen cross-linking, accumulation of advanced glycation end-products (AGEs), microdamage, and collagen fiber orientation [91][92][93][94]. All of these factors can influence toughening mechanisms in bone [95], thus altering its ability to bear load and absorb energy.…”

Section: Bone Quality Versus Bone Quantitymentioning

confidence: 99%

Bone Quality and Quantity are Mediated by Mechanical Stimuli

Berman

Wallace

2016

Clinic Rev Bone Miner Metab

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Prevention of fracture through improved bone mechanical strength is of great importance given the large number of bone disease-related fractures each year, the decreased quality of life associated with fractures, and the large anticipated increase in fracture incidence over the upcoming years due to the aging population. Exercise and other forms of mechanical stimulation have been shown to increase bone mass, suggesting improved strength. However, while bone mass is a good indicator of strength, other components (such as bone quality) also contribute to bone mechanical integrity. While increased bone mass has been explored considerably using both exercise and targeted loading models, the role of mechanical stimulation in altering bone quality has been explored to a lesser degree. Understanding how to improve both the quantity and quality of bone is critical to increasing fracture resistance. Herein, we discuss quantity and quality-based improvements that have been observed using both exercise and targeted loading models of bone adaptation.

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“…In human vertebrae, for example, alignment of the trabeculae along the axis of the spine makes the bone nearly twice as strong when loaded along the superior-inferior axis as when loaded in either the AP or left-right direction [45,91]. Combined imaging and computational modeling advances allow cancellous bone architecture to be captured (see articles by Donnelly [35] and Burghardt et al [18] in this issue) and input into mechanics-based models that can be used to understand the effect of architecture on stiffness of whole bones such as the vertebral body, distal radius, or proximal femur [42,57,98,126]. These computational modeling approaches will be essential to identify trabecular failure mechanisms in whole bones [41], especially at clinically important sites.…”

Section: Intrinsic Influences On Whole Bone Mechanicsmentioning

confidence: 99%

Whole Bone Mechanics and Bone Quality

Cole

Meulen

2011

Clinical Orthopaedics &Amp; Related Research

136

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Background The skeleton plays a critical structural role in bearing functional loads, and failure to do so results in fracture. As we evaluate new therapeutics and consider treatments to prevent skeletal fractures, understanding the basic mechanics underlying whole bone testing and the key principles and characteristics contributing to the structural strength of a bone is critical. Questions/purposes We therefore asked: (1) How are whole bone mechanical tests performed and what are the key outcomes measured? (2) How do the intrinsic characteristics of bone tissue contribute to the mechanical properties of a whole bone? (3) What are the effects of extrinsic characteristics on whole bone mechanical behavior? (4) Do environmental factors affect whole bone mechanical properties? Methods We conducted a PubMed search using specific search terms and limiting our included articles to those related to in vitro testing of whole bones. Basic solid mechanics concepts are summarized in the context of whole bone testing and the determinants of whole bone behavior. Results Whole bone mechanical tests measure structural stiffness and strength from load-deformation data. Whole bone stiffness and strength are a function of total bone mass and the tissue geometric distribution and material properties. Age, sex, genetics, diet, and activity contribute to bone structural performance and affect the incidence of skeletal fractures. Conclusions Understanding and preventing skeletal fractures is clinically important. Laboratory tests of whole bone strength are currently the only measures for in vivo fracture prediction. In the future, combined imaging and engineering models may be able to predict whole bone strength noninvasively.

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Methods for Assessing Bone Quality: A Review

Abstract: Although no single method can completely characterize bone quality, current noninvasive imaging techniques can be combined with ex vivo mechanical and compositional techniques to provide a comprehensive understanding of bone quality.

Cited by 256 publications

References 90 publications

Relationship between Biological Apatite Alignment and Hemi-occlusion in Rabbit Mandibular Cortical bone

Relationship between Biological Apatite Alignment and Hemi-occlusion in Rabbit Mandibular Cortical bone

Bone Quality and Quantity are Mediated by Mechanical Stimuli

Whole Bone Mechanics and Bone Quality

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