The influence of geometry on intervertebral disc stiffness.

Geometry plays an important role in intervertebral disc (IVD) mechanics. Previous computational studies have found a link between IVD geometry and stiffness. However, few experimental studies have investigated this link, possibly due to difficulties in non-destructively quantifying internal geometric features. Recent advances in ultra-high resolution MRI provides the opportunity to visualise IVD features in unprecedented detail. This study aimed to quantify 3D human IVD geometries using 9.4 T MRIs and to investigate correlations between geometric variations and IVD stiffness. Thirty human lumbar motion segments (fourteen non-degenerate and sixteen degenerate) were scanned using a 9.4 T MRI and geometric parameters were measured. A 1kN compressive load was applied to each motion segment and stiffness was calculated. Degeneration caused a reduction (p < 0.05) in IVD height, a decreased nucleus-annulus area ratio, and a 1.6 ± 3.0 mm inward collapse of the inner annulus. The IVD height, anteroposterior (AP) width, lateral width, cross-sectional area, nucleus-annulus boundary curvature, and nucleus-annulus area ratio had a significant (p < 0.05) influence on IVD stiffness. Linear relationships (p < 0.05, r > 0.47) were observed between these geometric features and IVD compressive stiffness and a multivariate regression model was generated to enable stiffness to be predicted from features observable on clinical imaging (stiffness, N/mm = 6062 - (61.2 × AP width, mm) - (169.2 × IVD height, mm)). This study advances our understanding of disc structure-function relationships and how these change with degeneration, which can be used to both generate and validate more realistic computational models.

A novel tool to quantify in vivo lumbar spine kinematics and 3D intervertebral disc strains using clinical MRI.

Medical imaging modalities that calculate tissue morphology alone cannot provide direct information regarding the mechanical behaviour of load-bearing musculoskeletal organs. Accurate in vivo measurement of spine kinematics and intervertebral disc (IVD) strains can provide important information regarding the mechanical behaviour of the spine, help to investigate the effects of injuries on the mechanics of the spine, and assess the effectiveness of treatments. Additionally, strains can serve as a functional biomechanical marker for detecting normal and pathologic tissues. We hypothesised that combining digital volume correlation (DVC) with 3T clinical MRI can provide direct information regarding the mechanics of the spine. Here, we have developed a novel non-invasive tool for in vivo displacement and strain measurement within the human lumbar spine and we used this tool to calculate lumbar kinematics and IVD strains in six healthy subjects during lumbar extension. The proposed tool enabled spine kinematics and IVD strains to be measured with errors that did not exceed 0.17 mm and 0.5%, respectively. The findings of the kinematics study identified that during extension the lumbar spine of healthy subjects experiences total 3D translations ranging from 1 mm to 4.5 mm for different vertebral levels. The findings of strain analysis identified that the average of the maximum tensile, compressive, and shear strains for different lumbar levels during extension ranged from 3.5% to 7.2%. This tool can provide base-line data that can be used to describe the mechanical environment of healthy lumbar spine, which can help clinicians manage preventative treatments, define patient-specific treatments, and to monitor the effectiveness of surgical and non-surgical interventions.

Quantifying deformations and strains in human intervertebral discs using Digital Volume Correlation combined with MRI (DVC-MRI).

Physical disruptions to intervertebral discs (IVDs) can cause mechanical changes that lead to degeneration and to low back pain which affects 75% of us in our lifetimes. Quantifying the effects of these changes on internal IVD strains may lead to better preventative strategies and treatments. Digital Volume Correlation (DVC) is a non-invasive technique that divides volumetric images into subsets, and measures strains by tracking the internal patterns within them under load. Applying DVC to MRIs may allow non-invasive strain measurements. However, DVC-MRI for strain measurements in IVDs has not been used previously. The purpose of this study was to quantify the strain and deformation errors associated with DVC-MRI for measurements in human IVDs. Eight human lumbar IVDs were MRI scanned (9.4 T) for a 'zero-strain study' (multiple unloaded scans to quantify noise within the system), and a loaded study (2 mm axial compression). Three DVC methodologies: Fast-Fourier transform (FFT), direct correlation (DC), and a combination of both FFT and DC approaches were compared with subset sizes ranging from 8 to 88 voxels to establish the optimal DVC methodology and settings which were then used in the loaded study. FFT + DC was the optimal method and a subset size of 56 voxels (2520 µm) was found to be a good compromise between errors and spatial resolution. Displacement and strain errors did not exceed 28 µm and 3000 microstrain, respectively. These findings demonstrate that DVC-MRI can quantify internal strains within IVDs non-invasively and accurately. The method has unique potential for assessing IVD strains within patients.

Fracture Toughness of Nanohybrid and Hybrid Composites Stored Wet and Dry up to 60 Days.

STATEMENT OF PROBLEM: Patients' demand for tooth-colored restoratives in the posterior region is increasing. Clinicians use universal nanohybrid resin composites for both anterior and posterior regions. There are few published reports comparing fracture toughness of nonohybrids and that of hybrid composite stored wet and dry. OBJECTIVES: To investigate the fracture toughness of three nanohybrids compared to that of a hybrid resin composite stored dry or wet up to 60 days, using four-point bending test. MATERIALS AND METHODS: Four resin composites were used: three nanohybrids; Filtek Supreme (3M), Ice (SDI), TPH3 (Dentsply) and one hybrid Filtek P60 (3M). For each material, 40 rectangular notched beam specimens were prepared with dimensions of 30 mm × 5mm × 2mm. The specimens were randomly divided into 4 groups (n = 10) and stored at 37ºC either in distilled water or dry for 1 and 60 days. The specimens were placed on the four-point test jig and subjected to force (N) using universal testing machine loaded at a crosshead speed of 0.5mm/min and maximum load at specimen failure was recorded and KIC was calculated. RESULTS: Three-way ANOVA showed a significant interaction between all the factors (all p < .0001). Except for TPH3, all tested materials showed significantly higher KIC when stored dry than stored wet (p < 0.05). After 1 day of dry storage, Ice showed the highest KIC (2.04± 0.32) followed by Filtek P60 and the lowest was for Filtek Supreme (1.39± 0.13) The effect of time on fracture toughness was material dependent. CONCLUSIONS: Wet storage adversely affected the fracture toughness of almost all materials. Keeping the restoration dry in the mouth may increase their fracture toughness. Therefore, using a coating agent on the surface of restoration may protect them from early water uptake and increase their strength during a time period.

A method for recording and analyzing intra-oral negative pressure in suckling rat pups.

A method for recording and analyzing intra-oral negative pressure in suckling rat pups is described. The technique is capable of detecting changes in sucking frequency, rate and amplitude. Three separate patterns of sucking are defined on the basis of these measures.