Laser ablation machining or microtomy (LAM) is a relatively new approach to producing slide mounted sections of translucent materials. We evaluated the method with a variety of problems from the bone, joint and dental tissues fields where we require thin undecalcified and undistorted sections for correlative light microscopy (LM) and backscattered electron scanning electron microscopy (BSE SEM). All samples were embedded in poly-methylmethacrlate (PMMA) and flat block surfaces had been previously studied by BSE-SEM and confocal scanning light microscopy (CSLM). Most were also studied by X-yay microtomography (XMT). The block surface is stuck to a glass slide with cyanoacrylate adhesive. Setting the section thickness and levelling uses inbuilt optical coherence tomographic imaging. Tight focusing of near-infrared laser radiation in the sectioning plane gives extreme intensities causing photodisruption of material at the focal point. The laser beam is moved by a fast scanner to write a cutting line, which is simultaneously moved by an XY positioning unit to create a sectioning plane. The block is thereby released from the slide, leaving the section stuck to the slide. Light, wet polishing on the finest grade (4000 grit) silicon carbide polishing paper is used to remove a 1-2 μm thick damaged layer at the surface of the section. Sections produced by laser cutting are fine in quality and superior to those produced by mechanical cutting and can be thinner than the 'voxel' in most laboratory X-ray microtomography systems. The present extensive pilot studies have shown that it works to produce samples which we can study by both light and electron microscopy.

Bone diseases such as osteoporosis and rickets cause significant reduction in both bone quantity and quality, leading to mechanical abnormalities at the organ level. While the reduction of bone quantity can be assessed using existing clinical tools like DXA and pQCT, there is little quantitative knowledge of how altered bone quality in diseased bone increases fracture risk. For example, patients suffering from glucocorticoid induced osteoporosis (GIOP) have a higher fracture risk at similar bone mineral density (BMD) level compared with controls. This indicates that bone quantity, as currently assessed by BMD, is neither the overriding nor sole factor involved in bone fracture risk. There is a clear need for high-resolution diagnostic techniques to close the gap between onset of fracture relevant changes in bone quality and clinical diagnosis. Here, a functional imaging technique (in-situ synchrotron X-ray imaging with micromechanics) was developed to measure alterations in fibrillar deformation mechanisms in GIOP. During applied loading, percentage shifts in Bragg peak positions arising from the meridional collagen stagger, measured from the small angle X-ray scattering (SAXS) patterns, give fibrillar level strain as a function of applied stress in real time. A mouse model of Cushing syndrome, with a N-ethyl-N-nitrosourea (ENU)-induced corticotrophin releasing hormone promoter mutation, that developed secondary osteoporosis was used. The fibril modulus, maximum fibril strain and fibril-to-tissue strain ratio were determined. A significant reduction of fibril modulus and enhancement of maximum fibril strain was found in GIOP mice. A significantly larger fibril strain/tissue strain ratio was also found in GIOP mice compared to wildtype mice, as well as a significantly increased randomness of fibrillar orientation indicative of a lowered mechanical competence at the bone matrix level. These results demonstrate the ability of synchrotron-based in-situ X-ray nanomechanical imaging to identify functional alterations, at the nanoscale, in bone quality in clinically important metabolic bone diseases.

Ecto-nucleotide pyrophosphatase/phosphodiesterases (NPPs) hydrolyse nucleotide triphosphates to the corresponding nucleotide monophosphates and the mineralisation inhibitor, pyrophosphate (PPi). This study examined the role of NPP1 in osteocytes, osteoclasts and cortical bone, using a mouse model lacking NPP1 (Enpp1−/−). We used microcomputed tomography (μCT) to investigate how NPP1 deletion affects cortical bone structure; excised humerus bones from 8, 15 and 22-week old mice were scanned at 0.9μm. Although no changes were evident in the cortical bone of 8-week old Enpp1−/− mice, significant differences were observed in older animals. Cortical bone volume was decreased 28% in 22-week Enpp1−/− mice, whilst cortical porosity was reduced 30% and 60% at 15 and 22-weeks, respectively. This was accompanied by up to a 15% decrease in closed pore diameter and a 55% reduction in the number of pores. Cortical thickness was reduced up to 35% in 15 and 22-week Enpp1−/− animals and the endosteal diameter was increased up to 23%. Thus, the cortical bone from Enpp1−/− mice was thinner and less porous, with a larger marrow space. Scanning electron microscopy (SEM) revealed a decrease in the size and number of blood vessel channels in the cortical bone as well as a 40% reduction in the mean plan area of osteocyte lacunae. We noted that the number of viable osteocytes isolated from the long bones of Enpp1−/− mice was decreased ≤50%. In contrast, osteoclast formation and resorptive activity were unaffected by NPP1 deletion. μCT and histological analysis of Enpp1−/− mice also revealed calcification of the joints and vertebrae as well as soft tissues including the whisker follicles, ear pinna and trachea. This calcification worsened as the animals aged. Together, these data highlight the key role of NPP1 in regulating calcification of both soft and skeletal tissues.

It is widely held that bone architecture is finely regulated in accordance with homeostatic requirements. Aberrant remodelling (hyperdensification and/or cyst formation in the immediately subchondral region) has previously been described in bone underlying cartilage in arthropathies. The present study examined the trabecular architecture of samples of bone, initially in the severe osteoarthropathy of alkaptonuria, but subsequently in osteoarthritis using a combination of light microscopy, 3D scanning electron microscopy and quantitative backscattered electron scanning electron microscopy. We report an extraordinary and previously unrecognised bone phenotype in both disorders, including novel microanatomical structures. The underlying subchondral trabecular bone contained idiosyncratic architecture. Trabecular surfaces had numerous outgrowths that we have termed "trabecular excrescences", of which three distinct types were recognised. The first type arose from incomplete resorption of branching secondary trabeculae arising from the deposition of immature (woven) bone in prior marrow space. These were characterised by very deeply scalloped surfaces and rugged edges. The second type had arisen in a similar way but been smoothed over by new bone deposition. The third type, which resembled coarse stucco, probably arises from resting surfaces that had been focally reactivated. These were poorly integrated with the prior trabecular wall. We propose that these distinctive microanatomical structures are indicative of abnormal osteoclast/osteoblast modelling in osteoarthropathies, possibly secondary to altered mechanical loading or other aberrant signalling. Identification of the mechanisms underlying the formation of trabecular excrescences will contribute to a better understanding of the role of aberrant bone remodelling in arthropathies and development of new therapeutic strategies.

Advances in diagnosis and treatment of some bone disorders can be made by understanding the linkage between mineral content and mechanical function. Bone is approximately half by volume a hydrated protein network, and the remainder is a biomineral analogue of hydroxyapatite. In the current work, paired measurements of mechanical properties, using nanoindentation, and of bone mineral volume fraction, computed from quantitative back-scattered electron imaging, were made on six different types of normal and outlier bone samples. Local elastic modulus was plotted against mineral fraction and compared with predictions of engineering bounds for a two-phase composite material. Experimental data spanning the composite bounds showed no one-to-one relationship between mechanical stiffness and bone composition, excluding the possibility of any single, simple composites model for bone at nanometer length-scales.

In the current study, the effects of polar solvents on tissue volume and mechanical properties are considered. Area shrinkage measurements are conducted for mineralized, bone tissue samples soaked in polar solvents. Area shrinkage is used to calculate approximate linear and volume shrinkage. Results are compared with viscoelastic mechanical parameters for bone in the same solvents (as measured previously) and with both shrinkage measurements and mechanical data for nonmineralized tissues, as taken from the existing literature. As expected, the shrinkage of mineralized tissues is minimal when compared with shrinkage of nonmineralized tissues immersed in the same polar solvents. The mechanical changes in bone are also substantially less than in nonmineralized tissues. The largest stiffness values are found in shrunken bone samples (immersed in acetone and ethanol). The mineral phase in bone thus resists tissue shrinkage that would otherwise occur in the pure soft tissue phase.

The effective elastic modulus of composite materials results from a combination of elastic moduli of the component phases. Recent efforts to understand the mechanical behavior of calcified tissues in bones and teeth require estimates of the component phase properties, which are difficult to establish independently. A three-phase system, based on naturally occurring bone, is therefore examined by a combined nanoindentation and finite element modelling approach to better understand the proportions and properties of the component phases. Bone samples were prepared in four two- or three-phase composite configurations as follows: (1) as a dehydrated mineral-protein composite (with some void space); (2) similarly dehydrated mineral-protein composite but with polymethylmethacrylate (PMMA) resin filling the voids resulting in three solid phases; (3) as a PMMA-mineral composite following protein removal and replacement with PMMA, and (4) as a PMMA-protein composite following mineral removal and replacement with PMMA. Effective component volume fractions and elastic moduli for each phase in each system were computed based on the composite nanoindentation results. Finite element models of the two- and three-phase systems were constructed to explore the structural anisotropy of the composite systems, as demonstrated in the nanoindentation tests, and to examine the sensitivity of the composite results to changes in the assumed component properties.

Nanomechanical properties of mineralized tissues are determined by microstructural tissue organization and relative composition of organic, mineral, and water phases. We combine nanoindentation and quantitative backscattered electron (qBSE) imaging to understand how these factors influence material properties at the ultrastructural and tissue level. Developmental stages of equine tooth enamel provide a good situation for studying the effects of enamel prism orientation and mineralization. Equine cheek teeth continue to form new enamel whilst mature tissue is being worn away. Hence we can study graded mineral content that increases with enamel maturity. Hunter-Schreger bands (HSBs) containing enamel prisms of contrasting orientations allow investigation of the effect of orientation on modulus. An equine second mandibular molar (2-year-old) was embedded in poly-methylmethacrylate, sectioned longitudinally, polished, carbon coated, imaged in qBSE, and subjected to nanoindentation testing. Elastic modulus increases significantly during maturation as enamel protein matrix degradation makes space for increased mineral content with closer proximity of enamel crystals, finally reaching values exceeding 80 GPa for little further increase in mineral content. Indentations spanning HSBs in immature, poorly mineralized enamel yielded modulus values that varied with prism orientation in a sinusoidal pattern where modulus varies by as much as a factor of three. Nanoindentation helps to elucidate how the composition and ultrastructural organization of enamel contribute to mechanical properties.

We describe morphological aspects of the articular calcified cartilage mineralizing front 'tidemark' in the distal joint surface of the third metacarpal bone from 14 horses. Compositional backscattered electron scanning electron microscopy and confocal scanning light microscopy were conducted on polymethylmethacrylate (PMMA)-embedded medio-lateral slices. After maceration, scanning electron microscopy (SEM) was used to study the calcified cartilage surface in the 'wedges' intervening between the slices. An anatomically reproducible clustering of canals in the calcified cartilage was found at one site on the sagittal ridge in all the horses. The site is one that is relatively less loaded during joint function. These canals through calcified cartilage result from osteoclastic resorption (cutting cones) penetrating from bone through to the non-mineralized hyaline articular cartilage. Their presence may indicate a pathway for connection between bone and cartilage extracellular fluid. In one horse, repair of such canals by plugging with new calcified cartilage was demonstrated. Differences in the degree of mineralization of regions of cartilage were seen in the combined compositional-cum-topographical backscattered SEM images of the macerated 'tidemark' front. More-or-less circular patches of lower mineralization density were frequently centred on (and may possibly originate from) canals. These microanatomical features should be searched for in other joints, at other ages and in other species to discover their frequency and significance.

Deposition, mineralization, and resorption of FD bone compared with unaffected bone from FD patients was investigated in iliac crest biopsy specimens from 13 patients. Compared with unaffected bone, lesional FD bone seemed to be very sensitive to the effects of PTH and renal phosphate wasting, which respectively bring about hyperparathyroid or osteomalacic changes in the lesional bone.Introduction: Fibrous dysplasia is a genetic noninherited disease caused by activating mutations of the GNAS1 gene, resulting in the deposition of qualitatively abnormal bone and marrow. This study was designed to learn more about the local processes of bone deposition, mineralization, and resorption within lesional fibrous dysplasia (FD) bone compared with unaffected bone of FD patients.Methods: Histology, histomorphometry, and quantitative back-scattered electron imaging (qBSE) analysis was conducted on affected and unaffected biopsy specimens from 13 patients and correlated to markers of bone metabolism.Results and Conclusions: There was a marked excess of unmineralized osteoid with a nonlamellar structure and a reduced mineral content in mineralized bone within FD lesions (p < 0.001). A negative correlation (p = 0.05) between osteoid thickness (O.Th) and renal tubular phosphate reabsorption (measured as TmP/GFR) was observed for lesional bone, but not for unaffected bone, in which no histological or histomorphometric evidence of osteomalacia was observed in patients with renal phosphate wasting. Histological and histomorphometric evidence of increased bone resorption was variable in lesional bone and correlated with serum levels of parathyroid hormone (PTH). Hyperparathyroidism-related histological changes were observed in fibrous dysplastic bone, but not in the unaffected bone, of patients with elevated serum PTH secondary to vitamin D deficiency. Our data indicate that, compared with unaffected bone, lesional FD bone is very sensitive to the effects of PTH and renal phosphate wasting, which, respectively, bring about hyperparathyroid or osteomalacic changes in the lesional bone. Osteomalacic and hyperparathyroid changes, which emanate from distinct metabolic derangements (which superimpose on the local effects of GNAS1 mutations in bone), influence, in turn, the severity and type of skeletal morbidity in FD.

Large, cylindrical implants of a porous calcium phosphate ceramic ("hydroxyapatite" starting material, HAC) were used to replace far greater than critical-sized sections of the midshaft of sheep tibiae and retrieved at 2 and 9 months; external fixation was used in the first 5 months. Excellent clinical function of these implants was reported in a previous study. The material retrieved was embedded in PMMA, and blocks were sectioned and surfaces were polished and carbon coated prior to study using digital backscattered electron (BSE) imaging. Detailed scanning electron microscopy study of the pattern of osseointegration of the implanted material at early (2 months) and late (9 months) timepoints revealed a previously unrecognized pattern of integration/disintegration of this implant material in tandem with bone growth. We conclude that bone adaptation to the HAC leads to its fracture and that the newly generated surfaces are equally osteoconductive. This leads to a self-propagating, self-annealing system in which defects in the HAC are mended by intercalation of bone.

The effects of estrogen suppression on bone mineralization in young women were studied by quantitative backscattered electron (BSE) imaging of transiliac biopsies taken before and after treatment for endometriosis. Treatment (6 months) was with analogs of gonadotrophin releasing hormone (GnRH) given either alone (six paired biopsies), which resulted in a marked reduction in the levels of circulating estrogen, or in conjunction with tibolone, a synthetic steroid with estrogenic, progestrogenic, and androgenic properties (four paired biopsies). Estrogen withdrawal increased (p < 0.01) and concomitant tibolone treatment decreased (p < 0.05) the overall mean bone density. Estrogen withdrawal increased the fraction of bone with a high mineralization density [pretreatment: 0.236 ± 0.007; GnRH: 0.279 ± 0.009, mean ± standard error of the mean (SEM); p < 0.01]. The concomitant addition of tibolone reversed these effects and increased the proportion of bone with a low mineralization density (pretreatment: 0.198 ± 0.005; tibolone: 0.230 ± 0.008, p < 0.01). Using previously published data, the mean bone density was inversely correlated with mean wall thickness in cancellous bone (p = 0.030) and with the percentage of active osteons (p = 0.023) in cortical bone. Although treatment had similar effects on the mean bone mineralization density of cortical and cancellous bone, there were different distributions of mineralization between the two sites, with cancellous bone having more skewed and kurtotic distributions both before and after estrogen withdrawal. This study indicates that a short-term estrogen suppression results in the accumulation of bone with a higher mineralization density. As bone with a high mineral content has a decreased impact resistance, this might increase fracture risk. Understanding the cellular and biochemical mechanisms responsible for the local distribution of bone mineral when estrogen is withdrawn may allow the development of new strategies for maintaining bone quality after menopause.

In the normal adult human skeleton, new bone formation by osteoblasts restores the contours of bone surfaces following osteoclastic bone resorption, but the evidence for resorption-repair coupling remains circumstantial. To investigate whether sites of prior resorption, more than the surrounding unresorbed surface, attract osteoblasts or stimulate them to proliferate or make new matrix, we developed a simple in vitro system in which resorption-repair coupling occurs. Resorption pits were produced in mammalian dentine or bone slabs by culturing chick bone-derived cells on them for 2-3 days. The chick cells were swept off and the substrata reseeded with rat calvarial osteoblastic cells, which make bone nodules in vitro, for periods of up to 8 weeks. Cell positions and new bone formation were investigated by ordinary light microscopy, fluorescence and reflection confocal laser microscopy, and SEM, in stained and unstained samples. There was no evidence that the osteoblasts were especially attracted to, or influenced by, the sites of resorption in dentine or bone before cell confluence was reached. Bone formation was identified by light microscopy by the accumulation of matrix, staining with alizarin and calcein and by von Kossa's method, and confirmed by scanning electron microscopy (SEM) by using backscattered electron (BSE) and transmitted electron imaging of unembedded samples and BSE imaging of micro-milled embedded material. These new bone patches were located initially in the resorption pits. The model in vitro system may throw new light on the factors that control resorption-repair coupling in the mineralised tissues in vivo.