Age changes in bone

Changes in bone structure as a function of age have been studied by simple inspection, x-ray imaging, stereo-photography, deep field optical microscopy, circularly polarised light microscopy, and scanning electron microscopy (SEM), including both topographic and compositional backscattered electron (BSE) imaging modes. The study of bone as a three-dimensional object, rather than in thin sections, enables us to envisage modelling and remodelling processes in context. The study of ultra-flat block surfaces permits the acquisition of data from an effectively very thin layer in the block face, and to examine bone as a spectrum of tissue types varying in the degree of mineralisation. Particular attention has been paid in our earlier studies to the iliac crest, lumbar vertebral bodies, femoral mid-shaft, neck and head and parietal and frontal skull bones. Recently, we have compared findings from these sites with observations on the mandible. We conclude, from our new imaging data, that common generalisations about the changes in bone in ageing and osteoporosis are too simplified, and that the mandible differs sufficiently from post-cranial skeletal sites that it would be unwise to extrapolate from findings in the jaw to the circumstances elsewhere.     

Age changes of skull dimensions

At cranial level, external apposition during ageing has been postulated by some authors. In longitudinal studies, a gradual increase of cranial diameters has been shown by cephalometry (Kendrick et al. 1967) or by lateral radiography (Israel 1968, 1970). However, these results are contested at methodological level by other longitudinal studies (Tallgren 1974). It is the aim of this study to analyse, in a cross-sectional sample, the effects of senescence on several cephalic dimensions. A series of skulls of known age and sex has been selected for this purpose.     

Subject-specific bone remodelling of the scapula

Finite element analyses, with increasing levels of detail and complexity, are becoming effective tools to evaluate the performance of joint replacement prostheses and to predict the behaviour of bone. As a first step towards the study of the complications of shoulder arthroplasty, the aim of this work was the development and validation of a 3D finite element model of an intact scapula for the prediction of the bone remodelling process based on a previously published model that attempts to follow Wolff's law. The boundary conditions applied include full muscle and joint loads taken from a multibody system of the upper limb based on the same subject whose scapula was here analysed. To validate the bone remodelling simulations, qualitative and quantitative comparisons between the predicted and the specimen's bone density distribution were performed. The results showed that the bone remodelling model was able to successfully reproduce the actual bone density distribution of the analysed scapula.     

Computational simulation of internal bone remodelling around dental implants: a sensitivity analysis

This study aimed to predict the distribution of bone trabeculae, as a density change per unit time, around a dental implant based on applying a selected mathematical remodelling model. The apparent bone density change as a function of the mechanical stimulus was the base of the applied remodelling model that describes disuse and overload bone resorption. The simulation was tested in a finite element model of a screw-shaped dental implant in an idealised bone segment. The sensitivity of the simulation to different mechanical parameters was investigated; these included element edge length, boundary conditions, as well as direction and magnitude of the implant loads. The alteration in the mechanical parameters had a significant influence on density distribution and model stability, in particular at the cortical bone region. The remodelling model could succeed to achieve trabeculae-like structure around osseointegrated dental implants. The validation of this model to a real clinical case is required.     

On the role of bone damage in calcium homeostasis

Bone serves as the reservoir of some minerals including calcium. If calcium is needed anywhere in the body, it can be removed from the bone matrix by resorption and put back into the blood flow. During bone remodelling the resorbed tissue is replaced by osteoid which gets mineralized very slowly. Then, calcium homeostasis is controlled by bone remodelling, among other processes: the more intense is the remodelling activity, the lower is the mineral content of bone matrix. Bone remodelling is initiated by the presence of microstructural damage. Some experimental evidences show that the fatigue properties of bone are degraded and more microdamage is accumulated due to the external load as the mineral content increases. That damage initiates bone remodelling and the mineral content is so reduced. Therefore, this process prevents the mineral content of bone matrix to reach very high (non-physiological) values. A bone remodelling model has been used to simulate this regulatory process. In this model, damage is an initiation factor for bone remodelling and is estimated through a fatigue algorithm, depending on the macroscopic strain level. Mineral content depends on bone remodelling and mineralization rate. Finally, the bone fatigue properties are defined as dependent on the mineral content, closing the interconnection between damage and mineral content. The remodelling model was applied to a simplified example consisting of a bar under tension with an initially heterogeneous mineral distribution. Considering the fatigue properties as dependent on the mineral content, the mineral distribution tends to be homogeneous with an ash fraction within the physiological range. If such dependance is not considered and fatigue properties are assumed constant, the homogenization is not always achieved and the mineral content may rise up to high non-physiological values. Thus, the interconnection between mineral content and fatigue properties is essential for the maintenance of bone's structural integrity as well as for the calcium homeostasis.     

A theoretical study of bone remodelling under PEMF at cellular level

Pulsed electromagnetic field (PEMF) devices have been used clinically to slow down osteoporosis and accelerate the healing of bone fractures for many years. However, the underlying mechanism by which bone remodelling under PEMF is regulated remains poorly understood. In this paper, a mathematical model of bone cell population of bone remodelling under PEMF at cellular level is developed to address this issue for the first time. On the basis of this model and control theory, parametric study of control mechanisms is carried out and a number of possible control mechanisms are identified. These findings will help further the understanding of bone remodelling under PEMF and advance therapies and pharmacological developments in clinical trials.     

Improving the damage accumulation in a biomechanical bone remodelling model

We extend, reformulate and analyse a phenomenological model for bone remodelling. The original macrobiomechanical model (MBM), proposed by Hazelwood et al. [J Biomech 2001; 34:299–308], couples a population equation for the cellular activities of the basic multicellular units (BMUs) in the bone and a rate equation to account for microdamage and repair. We propose to account for bone failure under severe overstressing by incorporating a Paris-like power-law damage accumulation term. The extended model agrees with the Hazelwood et al. predictions when the bone is under-stressed, and allows for suitably loaded bones to fail, in agreement with other MBM and experimental data regarding damage by fatigue. We numerically solve the extended model using a convergent algorithm and show that for unchanging loads, the stationary solution captures fully the model behaviour. We compute and analyse the stationary solutions. Our analysis helps guide additional extensions to this and other BMU activity based models.     

Modelling external bone adaptation using evolutionary structural optimisation

External remodelling is significant in the bone healing process, and it is essential to predict the bone external shape in the design of artificial bone grafts. This paper demonstrates the effectiveness of the evolutionary structural optimisation (ESO) method for the simulation of bone morphology. A two-dimensional ESO strategy is developed which is capable of finding the modified bone topology beginning with any geometry under any loading conditions. The morphology of bone structure is described by the quantitative bone adaptation theory, which is integrated with the finite element method. The evolutionary topology optimisation process is introduced to find the bone shape. A rectangle, which occupies a larger space than the external shape of the bone structure, is specified as a design domain; the evolutionary process iteratively eliminates and redistributes material throughout the domain to obtain an optimum arrangement of bone materials. The technique has been tested on a wide range of examples. In this paper, the formation of trabecular bone architecture around an implant is studied; as another example, the growth of the coronal section of a vertebral body is predicted. The examples support the assertion that the external shape of bone structure can be successfully predicted by the proposed ESO procedure.     

Revisiting the links between bone remodelling and osteocytes: insights from across phyla

We question two major tenets of bone biology: that the primary role of remodelling is to remove damage in the bone (so‐called damage‐driven remodelling) and that osteocytes are the only strain‐sensing orchestrators of this process. These concepts are distilled largely from research on model mammal species, but in fact, there are a number of features of various bones, from mammalian and non‐mammalian species, that do not accord with these ‘rules’. Here, we assemble a variety of examples, ranging from species that lack osteocytes but that still seem capable of remodelling their bones, to species with osteocytic bones that do not remodel, and to instances of inter‐species, inter‐bone and/or intra‐bone variation in bone remodelling that show that this purported repair process is not always where the ‘rules’ tell us it should be. This collection of points argues that our understanding of the advantages, roles and primary drivers of remodelling are inadequate and biased to quite a small phylogenetic cross section of the species that possess bone. We suggest a variety of new directions for bone research that would provide us with a better understanding of bone remodelling, tying together the interests of comparative biologists, palaeontologists and medical researchers.     

A meshless microscale bone tissue trabecular remodelling analysis considering a new anisotropic bone tissue material law

In this work, a novel anisotropic material law for the mechanical behaviour of the bone tissue is proposed. This new law, based on experimental data, permits to correlate the bone apparent density with the obtained level of stress. Combined with the proposed material law, a biomechanical model for predicting bone density distribution was developed, based on the assumption that the bone structure is a gradually self-optimising anisotropic biological material that maximises its own structural stiffness. The strain and the stress field required in the iterative remodelling process are obtained by means of an accurate meshless method, the Natural Neighbour Radial Point Interpolation Method (NNRPIM). Comparing with other numerical approaches, the inclusion of the NNRPIM presents numerous advantages such as the high accuracy and the smoother stress and strain field distribution. The natural neighbour concept permits to impose organically the nodal connectivity and facilitates the analysis of convex boundaries and extremely irregular meshes. The viability and efficiency of the model were tested on several trabecular benchmark patch examples. The results show that the pattern of the local bone apparent density distribution and the anisotropic bone behaviour predicted by the model for the microscale analysis are in good agreement with the expected structural architecture and bone apparent density distribution.     

The cellular transducer in damage-stimulated bone remodelling: a theoretical investigation using fracture mechanics

This paper reports on some theoretical work which used fracture mechanics concepts to draw conclusions about the nature of the so-called 'cellular transducer': the means by which bone cells detect the presence of damage and thus initiate remodelling and adaptation activities. Using analytical and numerical methods, we estimated the strains and displacements around cracks of the typical size, shape and orientation that normally occur in compact bone. We predicted that it is not possible for osteocytes or their processes to be fractured as a result of direct tensile strains, because the strains generated are much less than the expected failure strains of cellular material. We proposed a new failure mechanism by which osteocyte processes spanning the crack are cut by shearing motions between the crack faces. We predicted that failures of this type can occur. Failures begin to occur if crack lengths become greater than normal (100 microm), so this could act as a signal to initiate repair processes for individual cracks. Very large numbers of cell processes (greater than 1000) will fail if the crack length and/or applied stress reach dangerous levels (300 microm and 60 Mpa, respectively) at which point bone deposition may be required to prevent stress fractures. Similar results also occurred if we proposed a different mechanism of damage detection, involving cells' ability to detect the high levels of strain that occur near crack tips. This work, though based on theoretical mechanics considerations, suggests some biological experiments which might confirm our findings.     

Inhibition of bone resrption by selctive inactivators of cysteine proteinases

Incativators of cystein proteinases (CPs) were tested as inhibitors of bone resorption in vitro and in vivo. The following four CP inactivators were tested: Ep453, the membrane-permeant produrg of Ep475, a compound with low membrane pereability which inhibits cathepsins B, L, S, H, and calpain; Ep453, the membrane-permeant prodrug of Ep475; CA074, a compound with low membrane permeability which selectivly inactives cathepsin B; and CA07Me, the membrane-permanent prodrug of CA074. The test systems consisted of (1) monitoring the release of radioisotope from prelabelled mousecalvarial explants and (2) assessing the extene of bone resorption in and isolated osteoclast assay using confocal laser microscopy. Ep453, Ep475, and CA074Me inhebited both stimulated and basal bone resorption in vitro while CA074 WASA without effect; The inhibition was reversible and dose dependent. None of the inhibitors affected protein synthesis, DNA synthesis, the PTH-enhanced secretion of β-glucuronised, and N-acetyle-β-glucosaminidase, or the spontaneous release of lactate dehyrogenese. Ep453, Ep475, and CA074Me does-dependently inhibited the resorption activity of isolated areat osteoclassts cultured on bone slices with a maximal effect at 50 μM. The munber of resorption pits and their mean volume was reduced, whilest the mean administration subcutaneously at a dose of 60 μg/g body weight inhibited bone resorption in vivo as measured by an in vivo/in vitro assay, by about 20%. This study demonestration that cathepsins B,L, and/or S are involved in bone resorpotion in vitro and in vivo. Whilest cathepsin L and/or S act extracellularly, and possibly intractually, cathepsin B mediate its effects intracellularly perpheps through the activation of other proteinases involved in subsosteoclastic collagen degradition.     

Simulation of bone remodelling in orthodontic treatment

Orthodontic treatments not only displace irregular teeth but also induce responses in surrounding bone tissues. Bone remodelling is regarded as the regulatory mechanism triggered by mechanical loading. This study was aimed at investigating the effect of orthodontic loading on both tooth movement and neighbouring bone density distribution. A set of computational algorithms incorporating both external and internal remodelling mechanisms was implemented into a patient-specific 3D finite element (FE) model to investigate and analyse orthodontic treatment under four typical modes of orthodontic loading. The consequence of orthodontic treatment was reproduced numerically by using this FE-based technique. The results indicated that the diverse modes of orthodontic loading would result in different magnitudes of tooth movement and particular morphology of bone density distribution. It is illuminated that the newly developed algorithms may replicate the clinical situation more closely compared with the previous proposed method.     

The roles of bone‐derived exosomes and exosomal microRNAs in regulating bone remodelling

Pathological destructive bone diseases are primarily caused by the failure of a lifelong self‐renewal process of the skeletal system called bone remodelling. The mechanisms underlying this process include enhanced osteoclast activity and decreased generation of the osteoblast lineage. Intercellular interaction and crosstalk among these cell types are crucial for the maintenance of bone remodelling, either through the secretion of growth factors or direct cell–cell physical engagement. Recent studies have revealed that exosomes derived from bone cells, including osteoclasts, osteoblasts and their precursors, play pivotal roles on bone remodelling by transferring biologically active molecules to target cells, especially in the processes of osteoclast and osteoblast differentiation. Here, we review the contents of bone‐derived exosomes and their functions in the regulatory processes of differentiation and communication of osteoclasts and osteoblasts. In addition, we highlight the characteristics of microRNAs of bone‐derived exosomes involved in the regulation of bone remodelling, as well as the potential clinical applications of bone‐derived exosomes in bone remodelling disorders.     

Coupling factors and exosomal packaging microRNAs involved in the regulation of bone remodelling

Bone remodelling is a continuous process by which bone resorption by osteoclasts is followed by bone formation by osteoblasts to maintain skeletal homeostasis. These two forces must be tightly coordinated not only quantitatively, but also in time and space, and its malfunction leads to diseases such as osteoporosis. Recent research focusing on the cross‐talk and coupling mechanisms associated with the sequential recruitment of osteoblasts to areas where osteoclasts have removed bone matrix have identified a number of osteogenic factors produced by the osteoclasts themselves. Osteoclast‐derived factors and exosomal‐containing microRNA (miRNA) can either enhance or inhibit osteoblast differentiation through paracrine and juxtacrine mechanisms, and therefore may have a central coupling role in bone formation. Entwined with angiocrine factors released by vessel‐specific endothelial cells and perivascular cells or pericytes, these factors play a critical role in angiogenesis–osteogenesis coupling essential in bone remodelling.     

A novel adaptive algorithm for 3D finite element analysis to model extracortical bone growth

Extracortical bone growth with osseointegration of bone onto the shaft of massive bone tumour implants is an important clinical outcome for long-term implant survival. A new computational algorithm combining geometrical shape changes and bone adaptation in 3D Finite Element simulations has been developed, using a soft tissue envelope mesh, a novel concept of osteoconnectivity, and bone remodelling theory. The effects of varying the initial tissue density, spatial influence function and time step were investigated. The methodology demonstrated good correspondence to radiological results for a segmental prosthesis.     

The phylogenetic origin and evolution of acellular bone in teleost fishes: insights into osteocyte function in bone metabolism

Vertebrate bone is composed of three main cell types: osteoblasts, osteoclasts and osteocytes, the latter being by far the most numerous. Osteocytes are thought to play a fundamental role in bone physiology and homeostasis, however they are entirely absent in most extant species of teleosts, a group that comprises the vast majority of bony ‘fishes’, and approximately half of vertebrates. Understanding how this acellular (anosteocytic) bone appeared and was maintained in such an important vertebrate group has important implications for our understanding of the function and evolution of osteocytes. Nevertheless, although it is clear that cellular bone is ancestral for teleosts, it has not been clear in which specific subgroup the osteocytes were lost. This review aims to clarify the phylogenetic distribution of cellular and acellular bone in teleosts, to identify its precise origin, reversals to cellularity, and their implications. We surveyed the bone type for more than 600 fossil and extant ray‐finned fish species and optimised the results on recent large‐scale molecular phylogenetic trees, estimating ancestral states. We find that acellular bone is a probable synapomorphy of Euteleostei, a group uniting approximately two‐thirds of teleost species. We also confirm homoplasy in these traits: acellular bone occurs in some non‐euteleosts (although rarely), and cellular bone was reacquired several times independently within euteleosts, in salmons and relatives, tunas and the opah (Lampris sp.). The occurrence of peculiar ecological (e.g. anadromous migration) and physiological (e.g. red‐muscle endothermy) strategies in these lineages might explain the reacquisition of osteocytes. Our review supports that the main contribution of osteocytes in teleost bone is to mineral homeostasis (via osteocytic osteolysis) and not to strain detection or bone remodelling, helping to clarify their role in bone physiology.     

Influence of mastication and edentulism on mandibular bone density

The aim of this study was to demonstrate that external loading due to daily activities, including mastication, speech and involuntary open–close cycles of the jaw contributes to the internal architecture of the mandible. A bone remodelling algorithm that regulates the bone density as a function of stress and loading cycles is incorporated into finite element analysis. A three-dimensional computational model is constructed on the basis of computerised tomography (CT) images of a human mandible. Masticatory muscle activation involved during clenching is modelled by static analysis using linear optimisation. Other loading conditions are approximated by imposing mandibular flexure. The simulations predict that mandibular bone density distribution results in a tubular structure similar to what is observed in the CT images. Such bone architecture is known to provide the bone optimum strength to resist bending and torsion during mastication while reducing the bone mass. The remodelling algorithm is used to simulate the influence of edentulism on mandibular bone loss. It is shown that depending on the location and number of missing teeth, up to one-third of the mandibular bone mass can be lost due to lack of adequate mechanical stimulation.