Dual X-ray absorptiometry (DEXA) is the current gold standard for the diagnosis of osteoporosis. However, patients can suffer osteoporotic fractures despite normal bone mineral density, partly because of unmeasured influences of both the protein and mineral phases of bone that are affected in osteoporosis. There is currently no clinically applicable method of evaluating the health of the protein phase. The proteins in human nail (keratin) and bone (collagen) require sulphation and disulphide bond (S-S) formation for structural integrity and disorders of either sulphur metabolism or cystathione beta-synthase can lead to structural abnormalities in these tissues. Raman protein spectra provide a method of non-invasive measurement of the degree of sulphation of structurally related proteins that may be indicative of bone health. Raman spectroscopy was used to evaluate the disulphide (S-S) content of fingernails. The nail samples came from from 169 women (84 pre- and 85 post-menopausal), of which 39 had a history of osteoporotic fracture. BMD was measured by DXA at the spine. Analyses included parametric and non-parametric tests, dependent on the distribution of the test variable. Mean disulphide content of the nail reduced with age and was slightly higher in pre-, compared to post-menopausal women (P = 0.187). Significantly lower disulphide content was observed in nails obtained from subjects with a history of fracture (P = 0.025). When either disulphide content or BMD was used as a predictor, the odds ratio of these two measures were found to be comparable predictors for fracture status. This suggests that measurements of change in the protein phase of structural proteins such as keratin in the human nail may be correlated with clinically relevant changes in bone proteins that are important in fracture risk.
There is an accepted clinical requirement for a luting cement that can be command set upon satisfactory placement of an orthodontic appliance onto dentition. This work evaluates the suitability of ultrasound, imparted from a dental scaler, as a potential mechanism for achieving this. The net setting times and subsequent compressive strengths of a range of commercial and experimental glass polyalkenoate cements (GPCs) were evaluated, using modified ISO 9917 methods, when set both chemically and by ultrasound. The ultrasound was applied to the GPC through an orthodontic brace. It was possible to command set GPCs by the application of five to ten seconds of ultrasound; the exact time required being dependent upon the composition of the GPC in question. The compressive strengths of these cements can be improved by around 90% with the command set when the optimum PAA molecular weight and tartaric acid content is employed.
Acid washing is known to influence the handling properties of ionomer glasses used in glass ionomer cements due to the production of an ion depleted-zone on the surface of the glass particles. The influence of acid washing on the particle size distribution and surface area of four glasses was examined by scanning electron microscopy (SEM), particle size analysis (PSA) and accelerated surface area porosimetry (ASAP) and the working and setting times of cements, produced from the glasses, correlated to changes in surface morphology. A linear relationship was found between the specific surface area of acid-washed SiO(2)-Al(2)O(3)-XF(2)-P(2)O(5) glasses (X being either calcium or strontium) and their cement working and setting times. These changes directly correlated with increases in the mesopore volume. However, the influence of acid washing on the surface morphology was also found to be glass composition-dependent with the addition of sodium into the glass network resulting in no significant change in the surface area or mesopore volume despite changes in the working and setting time. Through examination of the influence of acid washing and glass composition on the specific surface area improvements in the control of the working and setting times of glass ionomer cements may be achieved.
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