The deer femur--a morphological and biomechanical animal model of the human femur.

BACKGROUND: The need for continued refinement of animal models in orthopaedic studies persists despite decades of research. OBJECTIVE: This study investigates the merits of deer bone in comparison to the more commonly used pig and sheep bone as an animal model for the human femur. METHOD: A morphological and biomechanical comparison of deer, pig and sheep rear femurs to those of the human femur is presented. Morphological parameters measured include bone length, cortical and medullary diaphyseal diameters, cortical thickness, cortical cross-sectional area and bone density along the diaphysis. Biomechanical tests included whole-bone four-point flexure tests to determine the bending stiffness (N/mm), Young's modulus of bending (GPa), and ultimate strength in bending (MPa). In addition torsional stiffness (Nm/degree) as well as mid-diaphyseal cortical compressive elastic modulus (GPa) and strength (MPa) is investigated. RESULTS: On average, deer bone was found to be the least dissimilar from human femur. However, no single bone type consistently resembled the human femur. CONCLUSION: Deer femora should be considered a suitable animal model for the human femur.

Influence of implant framework and mandibular flexure on the strain distribution on a Kennedy class II mandible restored with a long-span implant fixed restoration: a pilot study.

STATEMENT OF PROBLEM: The human mandible flexes during different jaw movements. Mandibular flexure is known to be restricted when natural dentition is restored with long-span fixed prostheses, but its effect on implant-supported fixed prostheses is unknown. Restriction of mandibular movement by implant-supported fixed prostheses may lead to excess strain accumulation, which could affect the outcome of implant treatment. PURPOSE: The purpose of this study was to investigate the influence of mandibular flexure on the implant bone interface by measuring the strain distribution in the body of the mandible at the periimplant level and at the implant framework level during the unilateral loading of a long-span implant-supported fixed prosthesis. MATERIAL AND METHODS: A partially edentulous mandible model with the mandibular left premolars and molars missing was fabricated in epoxy resin. Two implants were placed in the edentulous area, one in the position of the first premolar and one in the position of the second molar. Strain gauges were cemented at the implant bone interface parallel to each implant on the body of the mandible and on the framework. Three screw-retained, 3 × 3-mm bar-shaped frameworks were cast from cobalt-chromium alloy. The fit of these frameworks was deemed clinically acceptable with a routine clinical assessment technique. The mandible model was suspended by elastic cords to a universal testing machine. A 50-N load cell was placed on the occlusal surface of the right first molar. The mandible model was then loaded to 50 N on the working side first without any framework and then a second time with the framework in place. Information from the strain gauges were collected with a computer for analysis. RESULTS: When the mandible model was loaded without the implant framework, the buccal aspect of the body of the mandible experienced mainly compression, whereas the lingual aspect was mainly in tension on the working side under unilateral loading. At the implant-bone interface, compression strain was detected on the mesial aspect of the mesial implant. When frameworks were placed and a unilateral load applied, compression was detected on the mesial and buccal aspect of the mesial implant with all 3 frameworks. The amount of strain recorded was higher than that recorded without any framework in place. CONCLUSIONS: Mandibular flexure occurred during unilateral loading. The amount of strain transmitted to the implants increased with the screw-retained fixed-implant frameworks in place. The amount of strain introduced by mandibular flexure under unilateral loading may not be enough to stimulate bone remodeling; however, the accumulative strain generated by mandibular flexure under cyclic loading and its relationship with bone remodeling is unclear.

Remote ballistic fractures in a gelatine model--aetiology and surgical implications.

BACKGROUND: Remote ballistic femoral fractures are rare fractures reported in the literature but still debated as to their existence and, indeed, their treatment. This study aimed to prove their existence, understand how they occur and determine which ammunition provides the greatest threat. In addition, fracture patterns, soft tissue disruption and contamination were assessed to aid in treatment planning. METHOD: We filmed 42 deer femora embedded in ballistic gelatine and shot with four different military (5.56 × 45 mm, 7.62 × 39 mm) and civilian (9 × 19 mm, .44 in.) bullets, at varying distances off the bone (0-10 cm). RESULTS: Two remote ballistic fractures occurred, both with .44 in. hollow-point bullets shot 3 cm off the bone. These fractures occurred when the leading edge of the expanding temporary cavity impacted the femur's supracondylar region, producing a wedge-shaped fracture with an undisplaced limb, deceivingly giving the appearance of a spiral fracture. No communication was seen between the fracture and permanent cavity, despite the temporary cavity encasing the fracture and stripping periosteum from its base. CONCLUSION: These fractures occur with civilian ammunition, but cannot prove their existence with military rounds. They result from the expanding temporary cavity affecting the weakest part of the bone, creating a potentially contaminated wedge-shaped fracture, important for surgeons considering operative intervention.

Direct comparison of the bond strength results of the different test methods: a critical literature review.

OBJECTIVE: The goal of this paper is to undertake a literature search collecting all dentin bond strength data obtained for six adhesives with four tests (shear, microshear, tensile and microtensile) and to critically analyze the results with respect to average bond strength, coefficient of variation, mode of failure and product ranking. METHOD: A PubMed search was carried out for the years between 1998 and 2009 identifying publications on bond strength measurements of resin composite to dentin using four tests: shear, tensile, microshear and microtensile. The six adhesive resins were selected covering three step systems (OptiBond FL, Scotch Bond Multi-Purpose Plus), two-step (Prime & Bond NT, Single Bond, Clearfil SE Bond) and one step (Adper Prompt L Pop). RESULTS: Pooling results from 147 references showed an ongoing high scatter in the bond strength data regardless which adhesive and which bond test was used. Coefficients of variation remained high (20-50%) even with the microbond test. The reported modes of failure for all tests still included high number of cohesive failures. The ranking seemed to be dependant on the test used. SIGNIFICANCE: The scatter in dentin bond strength data remains regardless which test is used confirming Finite Element Analysis predicting non-uniform stress distributions due to a number of geometrical, loading, material properties and specimens preparation variables. This reopens the question whether, an interfacial fracture mechanics approach to analyze the dentin-adhesive bond is not more appropriate for obtaining better agreement among dentin bond related papers.

Novel thienopyrimidine and thiazolopyrimidine kinase inhibitors with activity against Tie-2 in vitro and in vivo.

The SAR and improvement in potency against Tie2 of novel thienopyrimidine and thiazolopyrimidine kinase inhibitors are reported. The crystal structure of one of these compounds bound to the Tie-2 kinase domain is consistent with the SAR. These compounds have moderate potency in cellular assays of Tie-2 inhibition, good physical properties, DMPK, and show evidence of in vivo inhibition of Tie-2.

Australian chiropractic sports medicine: half way there or living on a prayer?

Sports chiropractic within Australia has a chequered historical background of unorthodox individualistic displays of egocentric treatment approaches that emphasise specific technique preference and individual prowess rather than standardised evidence based management. This situation has changed in recent years with the acceptance of many within sports chiropractic to operate under an evidence informed banner and to embrace a research culture. Despite recent developments within the sports chiropractic movement, the profession is still plagued by a minority of practitioners continuing to espouse certain marginal and outlandish technique systems that beleaguer the mainstream core of sports chiropractic as a cohesive and homogeneous group. Modern chiropractic management is frequently multimodal in nature and incorporates components of passive and active care. Such management typically incorporates spinal and peripheral manipulation, mobilisation, soft tissue techniques, rehabilitation and therapeutic exercises. Externally, sports chiropractic has faced hurdles too, with a lack of recognition and acceptance by organized and orthodox sports medical groups. Whilst some arguments against the inclusion of chiropractic may be legitimate due to its historical baggage, much of the argument appears to be anti-competitive, insecure and driven by a closed-shop mentality.sequently, chiropractic as a profession still remains a pariah to the organised sports medicine world. Add to this an uncertain continuing education system, a lack of protection for the title 'sports chiropractor', a lack of a recognized specialist status and a lack of support from traditional chiropractic, the challenges for the growth and acceptance of the sports chiropractor are considerable. This article outlines the historical and current challenges, both internal and external, faced by sports chiropractic within Australia and proposes positive changes that will assist in recognition and inclusion of sports chiropractic in both chiropractic and multi-disciplinary sports medicine alike.

Analysis of tensile bond strengths using Weibull statistics.

Tensile strength tests of restorative resins bonded to dentin, and the resultant strengths of interfaces between the two, exhibit wide variability. Many variables can affect test results, including specimen preparation and storage, test rig design and experimental technique. However, the more fundamental source of variability, that associated with the brittle nature of the materials, has received little attention. This paper analyzes results from micro-tensile tests on unfilled resins and adhesive bonds between restorative resin composite and dentin in terms of reliability using the Weibull probability of failure method. Results for the tensile strengths of Scotchbond Multipurpose Adhesive (3M) and Clearfil LB Bond (Kuraray) bonding resins showed Weibull moduli (m) of 6.17 (95% confidence interval, 5.25-7.19) and 5.01 (95% confidence interval, 4.23-5.8). Analysis of results for micro-tensile tests on bond strengths to dentin gave moduli between 1.81 (Clearfil Liner Bond 2V) and 4.99 (Gluma One Bond, Kulzer). Material systems with m in this range do not have a well-defined strength. The Weibull approach also enables the size dependence of the strength to be estimated. An example where the bonding area was changed from 3.1 to 1.1 mm diameter is shown. Weibull analysis provides a method for determining the reliability of strength measurements in the analysis of data from bond strength and tensile tests on dental restorative materials.