When Cortical Bone Matrix Properties Are Indiscernible between Elderly Men with and without Type 2 Diabetes, Fracture Resistance Follows Suit.

Type 2 diabetes mellitus (T2DM) is a metabolic disease affecting bone tissue and leading to increased fracture risk in men and women, independent of bone mineral density (BMD). Thus, bone material quality (i.e., properties that contribute to bone toughness but are not attributed to bone mass or quantity) is suggested to contribute to higher fracture risk in diabetic patients and has been shown to be altered. Fracture toughness properties are assumed to decline with aging and age-related disease, while toughness of human T2DM bone is mostly determined from compression testing of trabecular bone. In this case-control study, we determined fracture resistance in T2DM cortical bone tissue from male individuals in combination with a multiscale approach to assess bone material quality indices. All cortical bone samples stem from male nonosteoporotic individuals and show no significant differences in microstructure in both groups, control and T2DM. Bone material quality analyses reveal that both control and T2DM groups exhibit no significant differences in bone matrix composition assessed with Raman spectroscopy, in BMD distribution determined with quantitative back-scattered electron imaging, and in nanoscale local biomechanical properties assessed via nanoindentation. Finally, notched three-point bending tests revealed that the fracture resistance (measured from the total, elastic, and plastic J-integral) does not significantly differ in T2DM and control group, when both groups exhibit no significant differences in bone microstructure and material quality. This supports recent studies suggesting that not all T2DM patients are affected by a higher fracture risk but that individual risk profiles contribute to fracture susceptibility, which should spur further research on improving bone material quality assessment in vivo and identifying risk factors that increase bone fragility in T2DM. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

Influence of water and protein content on the creep behavior in dental enamel.

The creep behavior of untreated and deproteinized dental enamel in dry and wet state was analyzed by nanoindentation with a spherical tip. Additionally, the influence of the loading rate was investigated. Dry untreated and deproteinized dental enamel only showed minor creep over 100 s and deproteinization did not affect the dry enamel's behavior significantly. With slower loading rates some creep already occurs during the loading period, such that the creep displacement during load hold is less than with faster loading rates. Wet untreated and deproteinized enamel showed significantly more creep compared to the dry samples. The differences between the untreated and deproteinized enamel were only minor but significant, revealing that water affects the creep behavior of biological materials such as enamel significantly. The proposed deformation mechanism of naturally porous enamel under compression is compaction of the HAP crystallites and fluid displacement within material underneath the indented area. STATEMENT OF SIGNIFICANCE: This study investigates the creep behavior of untreated and deproteinized dental enamel in dry and wet conditions. It is shown that while the protein content does not affect enamel's behavior significantly, the wet conditions lead to an increased creep in enamel. The proposed deformation mechanism of naturally porous enamel under compression is compaction of the HAP crystallites and fluid displacement within material underneath the indented area. Based on this observation a simple analytical model has been developed, aiming to deepen our understanding of the deformation behavior of biological materials.

The geometrical structure of interfaces in dental enamel: A FIB-STEM investigation.

In this study a high resolution structural analysis revealed that enamel prisms are surrounded by an interface that is discontinuous with frequent mineral to mineral contact separated by gaps. This contact manifests either by crystallites bridging the boundary between prismatic and interprismatic enamel or continuous crystallites curving and bridging the interprismatic enamel to the prisms. The geometrical resolution of this TEM investigation of the interfaces is ≤2 nm as a basis for micromechanical models. Within this resolution, contrary to existing structural descriptions of dental enamel structure in materials science literature, here the crystallites themselves are shown to be either in direct contact with each other, sometimes even fusing together, or are separated by gaps. Image analysis revealed that on average only 57 ± 15% of the interface consists of points of no contact between crystallites. This work reveals structural features of dental enamel that contribute important understanding to both the architecture and mechanical properties of this biological material. A new structural model is proposed and the implications for the mechanical properties of dental enamel are discussed. STATEMENT OF SIGNIFICANCE: In this study a high resolution structural analysis, employing focused ion beam and transmission electron microscopy revealed that enamel prisms are surrounded by interfaces that are discontinuous with frequent mineral to mineral contact separated by gaps. Although the interfaces in enamel have been investigated previously, existing studies are lacking in detail considering the geometry and morphology of the interfaces. We think that this result is of great importance when it comes to the understanding of the mechanical properties. In our opinion the concept of soft sheaths is no longer feasible. The resulting observations are included in a new structural model which provides new qualitative insights into the mechanical behavior. Existing analytical models were applied to simulate the new geometrical structure.

On the systematic documentation of the structural characteristics of bovine enamel: A critic to the protein sheath concept.

The common structural description of bovine enamel used in materials science studies - nano-sized hydroxyapatite crystallites form micron-sized prisms surrounded by protein sheaths, which in turn build a complex decussation pattern - overlook many important morphological information. This hampers the correct interpretation of the data determined by mechanical analysis. For a profound structural description of enamel morphology, the visualization of its building blocks by high-resolution electron microscopy and focused-ion beam tomography technique, which reveals their form, orientation and configuration at different regions of a tooth (cut in different directions), is undertaken in this work. We adapted here the paleontological classification system and terminology developed for the description of enamel microstructures seen in different species, and accordingly documented the morphological singularities of bovine incisor enamel. The appearance of the boundary regions between crystallites and prisms contradicts to the well-known protein sheath concept. Neighboring crystallites and prisms are not separated by prominent gap zones but they are largely in contact with each other. Proteins might exist within the pores of 20-30nm in size, which are distributed inhomogeneously through the boundary regions, rather than as protein sheaths covering each crystallite and prism.