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Bone formation and bone healing were studied in the mandible, tibia and skull bones in adult, healthy and estrogen deficient rabbits implanted with different bone substitutes. In the first study an evaluation of the differences in bone regeneration in and around solid (Alveograf *) and porous hydroxyapatite (Interpore 200*) was undertaken. The implant material was placed into experimentally made bone defects and in half of the defects hydroxyapatite was mixed with a fibrin sealant (Tisseel *). The material alone or mixed with Tisseel was also placed subperiostally in the mandible. The observation time was six month. No difference in bone regeneration was found between solid or porous hydroxyapatite granulas and the addition of Tisseel* did not seem to disturb the bone healing process. The implant material placed subperiostally did not induce bone formation nor did it provoke any bone resorption. The addition of Tisseel made the implant material much easier to handle and retain in the tissue during surgery. Bone healing around hydroxyapatite implants was also evaluated in the second study. Experimental cavities in the mandible and tibia were filled with hydroxyapatite in granules or blocks (Interpore 200*) but now with or without autolyzed, antigen-extracted, allogeneic bone (AAA). Also in this study Tisseel* was used to facilitate the handling of the material. All cavities implanted with AAA-bone, regardless of the combination with hydroxyapatite or Tisseel, demonstrated excessive bone formation resembling exostosis formation. Thus, hydroxyapatite, both as granules and blocks, can be successfully combined with AAA bone utilizing the bone inductive capacity of AAA bone. The same model was used to study the healing in ovariectomized animals in the third study. Bone cavities were implanted with or without AAA bone and left to heal. The results indicate that the osteoinductive capacity of AAA bone is in operation also in animals deprived of a normal estrogen production. The effect of using AAA bone prior to implant insertion was studied in paper four. The bone-implant contact was significant higher when AAA bone had been used. The implant stability did not seem to be affected. In paper five defects were made in skull and tibial bone in estrogen deficient animals. The deficiency of estrogen was confirmed through blood analysis, the decrease in the weight of uterus and bone mineral density. The whole body scanning with DEXA showed that the ovariectomized animals developed osteopenia. Various degree of bone formation was seen in the defects due to the influence of the bone inductive substance AAA bone. The studies indicate that a conductive material like hydroxyapatite in granules or blocks could be useful in oral reconstructive surgery. The combination with AAA bone enhanced the bone formation in calvarial and tibial bone in healthy and estrogen deficient animals. Tisseel* could be used to facilitate handling and retention of the material in the intended position during the healing process without negative effects.

<p>Bone formation and bone healing were studied in the mandible, tibia and skull bones in adult, healthy and estrogen deficient rabbits implanted with different bone substitutes. </p><p>In the first study an evaluation of the differences in bone regeneration in and around solid (Alveograf *) and porous hydroxyapatite (Interpore 200*) was undertaken. The implant material was placed into experimentally made bone defects and in half of the defects hydroxyapatite was mixed with a fibrin sealant (Tisseel *). The material alone or mixed with Tisseel was also placed subperiostally in the mandible. The observation time was six month. No difference in bone regeneration was found between solid or porous hydroxyapatite granulas and the addition of Tisseel* did not seem to disturb the bone healing process. The implant material placed subperiostally did not induce bone formation nor did it provoke any bone resorption. The addition of Tisseel made the implant material much easier to handle and retain in the tissue during surgery.</p><p>Bone healing around hydroxyapatite implants was also evaluated in the second study. Experimental cavities in the mandible and tibia were filled with hydroxyapatite in granules or blocks (Interpore 200*) but now with or without autolyzed, antigen-extracted, allogeneic bone (AAA). Also in this study Tisseel* was used to facilitate the handling of the material. All cavities implanted with AAA-bone, regardless of the combination with hydroxyapatite or Tisseel, demonstrated excessive bone formation resembling exostosis formation. Thus, hydroxyapatite, both as granules and blocks, can be successfully combined with AAA bone utilizing the bone inductive capacity of AAA bone.</p><p>The same model was used to study the healing in ovariectomized animals in the third study. Bone cavities were implanted with or without AAA bone and left to heal. The results indicate that the osteoinductive capacity of AAA bone is in operation also in animals deprived of a normal estrogen production.</p><p>The effect of using AAA bone prior to implant insertion was studied in paper four. The bone-implant contact was significant higher when AAA bone had been used. The implant stability did not seem to be affected.</p><p>In paper five defects were made in skull and tibial bone in estrogen deficient animals. The deficiency of estrogen was confirmed through blood analysis, the decrease in the weight of uterus and bone mineral density. The whole body scanning with DEXA showed that the ovariectomized animals developed osteopenia. Various degree of bone formation was seen in the defects due to the influence of the bone inductive substance AAA bone. </p><p>The studies indicate that a conductive material like hydroxyapatite in granules or blocks could be useful in oral reconstructive surgery. The combination with AAA bone enhanced the bone formation in calvarial and tibial bone in healthy and estrogen deficient animals. Tisseel* could be used to facilitate handling and retention of the material in the intended position during the healing process without negative effects. </p>

Virtual three-dimensional (3D) auditory displays utilize signal-processing techniques to alter sounds presented through headphones so that they seem to originate from specific spatial locations around the listener. In some circumstances bone-conduction headsets (bonephones) can provide an alternative sound presentation mechanism. However, existing 3D audio rendering algorithms need to be adjusted to use bonephones rather than headphones. This study provided anchor points for a function of shift values that could be used to adapt virtual 3D auditory displays for use with bonephones. The shift values were established by having participants adjust phase and amplitude of two waves in order to cancel out the signal and thus produce silence. These adjustments occurred in a listening environment consisting of air-conducted and bone-conducted tones, as well as air- conducted masking. Performance in the calibration condition suggested that participants understood the task, and could do this task with reasonable accuracy. In the bone-to-air listening conditions, the data produced a clear set of anchor points for an amplitude shift function. The data did not reveal, however, anchor points for a phase shift function the data for phase were highly variable and inconsistent. Application of shifts, as well as future research to establish full functions and better understand phase are discussed, in addition to validation and follow-up studies.

Top screw pullout is a significant problem in anterior scoliosis correction, with rates of 5-15% reported in the literature. The Mater Misericordiae Hospital in Brisbane currently has a series of 125 patients with scoliosis treated by thoracoscopic anterior fusion, instrumentation and correction between April 2000 and August 2007. In this series 11 top screws are known to have pulled out (a rate of 8.8%), with six occurring in the first week, and all within 6 weeks, suggesting that the problem is one of excessive static force rather than fatigue. This thesis describes a biomechanical investigation into the mechanics of vertebral body screw pullout in anterior scoliosis surgical constructs. Previous biomechanical studies of vertebral body screws have evaluated their resistance to either straight pullout or cephalo-caudad compression forces, however the aim of this study was to assess screw resistance to more realistic loading conditions, namely pullout of initially angled screws, and pullout where the motion path is an arc rather than a straight axial pullout, as would be expected in a single rod anterior construct. The first series of experiments involved straight and angled pullout tests using synthetic bone. In the angled tests, both locked and free-to-pivot configurations were tested. The second series of experiments tested the effect of cephalo-caudad pre-compression (the actual deformity correction step performed during surgery) on subsequent axial pullout strength. A third series of experiments performed arc pullouts using synthetic bone, and the final series of experiments tested the pullout resistance of a newly proposed screw position configuration against the standard screw positioning using ovine lumbar vertebrae. Synthetic bone testing revealed that for initially angled pullout, resistance is greatest as the screw angle approaches 0 (ie a direct axial pullout). Cephalo-caudad pre-compression reduced subsequent pullout strength for cases where a staple was not used under the screw head, but if a staple was used the pre-compression did not decrease pullout force significantly. Arc pullout resistance was greatest when the screw was angled at 10 cephalad, and the mean pullout strength for the proposed screw configuration using ovine lumbar vertebrae (1864N) was almost double that of the standard screw positioning (993N). The clinical implication of this study is that top screw pullout resistance can be maximised by placing the top screw as close as possible to the top endplate and the bottom screw as close as possible to the bottom endplate, although this will have detrimental effects on the pullout of the second screw should the top screw pull out. Screw angulation is a less important factor but any angulation should be in a cephalad direction and around 10º in magnitude. The experimental results also suggest that the use of a staple may play a role in preventing cephalo-caudad pre-compression forces from reducing screw resistance to subsequent pullout forces.

Un os long est composé de tissus osseux cortical et spongieux. Ces tissus ont des structures et des caractéristiques physiques différentes mais ont tous deux la capacité de se régénérer de façon naturelle suite à une lésion. Cette régénération ou réparation implique une séquence bien caractérisée d’événements contrôlés par l’interaction étroite entre des facteurs de croissance, des cellules, l’environnement chimique et dynamique, ainsi que par la matrice extracellulaire. L’ostéopontine (OPN) et la sialoprotéine osseuse (BSP) sont des protéines de la matrice extracellulaire exerçant des fonctions importantes dans le tissu osseux. Le but de ce travail a été d’étudier le rôle de l’OPN et de la BSP dans la réparation osseuse par génétique expérimentale. Les modèles utilisés dans cette études consistent en des lésions, l’un diaphysaire et purement cortical, l’autre région épi-métaphysaire mêlant destruction de l’os cortical, trabéculaire et de la plaque de croissance. La réparation de ces lésions a été analysée par microtomographie haute résolution aux rayons X et par histomorphométrie. Dans un premier temps, la réparation d’une perforation épi-métaphysaire dans le fémur chez la souris, a été caractérisée et comparée à celle de même diamètre réalisée dans la diaphyse. Dans cette étude comparative, des profils distincts de réparation ont été mis en évidence bien que tous deux mettent en place un mécanisme d’ossification intramembranaire. Ainsi, le défect cortical diaphysaire est comblé par une formation osseuse centripète restreinte à la zone corticale. Dans le modèle épi-métaphysaire, la formation osseuse est initiée au fond du défect et se propager vers le cortex. Ce processus aboutit à une restauration des travées mais à une réparation incompléte du cortex. Ainsi, le premier modèle apparaît comme pertinent pour l’étude de la réparation corticale alors que le modèle épi-métaphysaire se présente plus adapté à l’étude de la réparation de l’os trabéculaire. L’OPN et la BSP n’ont pas de fonctions redondantes dans la réparation de ces lésions. En effet, l’OPN intervient principalement dans la réparation de l’os trabéculaire, son absence entraîne un retard lié à un défaut de progression de l’os au sein de la cavité. L’absence de BSP quant à elle, semble intervenir uniquement dans le processus de réparation de l’os cortical diaphysaire, provoquant un retard de réparation dû à un défaut de minéralisation de l’ostéoïde. Les travaux réalisés au cours de cette thèse ont permis de caractériser des modèles de lésions osseuses pertinents pour l’étude de la réparation de l’os cortical et spongieux. L’utilisation de ces modèles a permis d’améliorer la compréhension du rôle de deux protéines de la matrice extracellulaire osseuse dans la réparation de cortical et trabéculaire grâce aux modèles de génétique expérimentale. / Long bones consist of cortical and spongious bone tissue, which have different structures and physiological characteristics. Both can heal spontaneously. Bone healing is a complex multi-step process which depends on cells, soluble factors, mechanical environment and bone matrix. Osteopontin (OPN) and Bone Sialoportein (BSP) are extracellular matrix proteins, which have been shown to exert important functions in bone. The aim of this study is to address the role of OPN and BSP in bone repair using experimental genetic strategies. Injured bone models are drilled-hole defects performed in diaphyseal cortical bone or in the epi-metaphyseal region. Bone healing was analyzed by micro-tomography and histomorphometry. Epi-metaphyseal defect healing was characterized and compared to cortical bone repair. In this comparative study, distinct patterns of bone repair have been shown while in both models repair occurs through intramembranous ossification. Diaphyseal defect was rapidly filled with newly bone formed in a centripetal manner within the cortical gap. In contrast, bone formation within the epi-metaphyseal defect was initiated from the depth of the cavity and spread towards the cortical edges, regenerating cancellous bone and albeit not completely cortical wall. Therefore, diaphyseal drill defects appear pertinent for the study of spontaneous cortical healing whereas epi-metaphyseal drill defects appear as appropriate models to investigate spongy bone regeneration. OPN and BSP do not show redundancy in the bone repair process of these two models. Indeed, OPN is mainly involved in trabecular bone repair; its deficiency induced a delay due to impaired bone progression within the epi-metaphyseal cavity. The lack of BSP only delayed cortical bone repair due to an impaired mineralization of the bone matrix. This study permits to characterize pertinent models of cortical and trabecular bone repair. Application of these models added new insights on the involvement of matrix proteins in cortical defect healing and trabecular bone repair using experimental genetic models.