The influence of alveolar structures on the torsional strain field in a gorilla corporeal cross-section

Anthropologists have often used mandibular torsional properties to make inferences about primate dietary adaptations. Most of the methods employed are based on assumptions related to periodontal and alveolar properties. This study uses the finite element method to evaluate some of these assumptions with a cross-section through the third molar of a gorilla. Results indicate that the properties of alveolar bone play an important role in determining the strain field. In comparison, the exact stiffness values of the periodontal ligaments seem to have a much smaller impact. Replacing the dental roots and periodontal ligaments with alveolar bone, however, has a significant influence on the strain field. It underestimates the maximum shear strain by about 28% along its periosteal aspect when alveoli are modeled as cortical bone. It overestimates the strain by a smaller amount when alveoli are modeled as trabecular bone. This study supports the assumption that primate mandibles behave like a closed-section under torsion under the limiting condition that the alveolar bone stiffness is more than half of the value of cortical bone; alveolar bone can then be modeled as cortical bone with a minimal loss of accuracy. In addition, this study suggests that the minimum cortical thickness should be considered for torsional strength. Finally, modeling accuracy can be significantly increased if both dental and periodontal structures can be realistically incorporated into mandibular biomechanical models. However, this may not be always feasible in studies of fossil mandibles. This is due mainly to the difficulties involved in estimating alveolar bone densities and in distinguishing boundaries between cortical bone, alveolar bone, periodontal ligaments, and dental roots in fossil specimens.     

Mechanical responses of the periodontal ligament in the transverse section of the rat mandibular incisor at various velocities of loading in vitro

Stress-strain curves of the periodontal ligament (PDL) were obtained at various velocities of extrusive loading of 1, 10, 10(2), 10(3) and 10(4) mm/24 h in vitro. Significant increases of the maximum shear stress, tangent modulus and failure strain energy density were found with increases in the velocity of loading. The maximum shear strain increased from a velocity of 1 to 10 mm/24 h but decreased from 10 to 10(4) mm/24 h. It was shown histologically that the free surface of the PDL adhering to the cementum after mechanical testing was rough and irregular at higher velocities and rather smooth at lower velocities. These results showed that the mechanical properties and mode of failure of the rat incisor PDL were greatly dependent on the strain rate. It is possible that the PDL of the continuously erupting rat incisor has mechanical characteristics favourable for resisting weakly to slow and small eruptive forces but strongly to the fast and large occlusal forces as suggested previously [Chiba and Komatsu, The Biological Mechanisms of Tooth Eruption and Root Resorption (1988)].     

The structure of bovine periodontal ligament with special reference to the epithelial cell rests

The aim of this study was to determine the structure of the bovine periodontal ligament, with special reference to epithelial cell rests (ECR) and their cytokeratin content. Periodontal ligament was obtained from bovine molar teeth and studied at both the light microscopic and electron microscopic levels. Cytokeratin content was determined using immunohistochemistry against a number of cytokeratin antibodies and specificity tested against bovine and human oral mucosa. Collagen fibril diameters and the area of a fiber bundle occupied by collagen were determined using a digital planimeter with a digitizing tablet. The majority of periodontal fibroblasts possessed considerable quantities of roughened endoplasmic reticulum, indicating rapid synthesis and secretion of collagen, but no intracellular collagen profiles were present. Endothelial cells showed Weibel-Palade bodies. Collagen fibril diameters showed a unimodal distribution with a mean collagen fibril diameter of 55.3 nm. The mean percentage area of the extracellular matrix occupied by collagen was 42%. Structurally, ECR were unusual in exhibiting large numbers of microvilli and conspicuous amounts of cytokeratin filaments. Bovine ECR showed a positive reaction to the pancytokeratin MNF116 (which reacts with the cytokeratins 5, 6, 8, 17, and probably 19), to PCK-26 (which reacts with the type II cytokeratins 1, 5, 6, and 8) and to cytokeratin 13. There was no reaction for cytokeratins 1, 4, 10, 11 and 18. Structurally, bovine periodontal ligament showed features common to other species. However, ECR in terms of both structure and cytokeratin content showed features indicative of important species differences which may have relevance when considering the etiology of radicular cysts.     

The effect of temperature on the

The tensile stress-strain behavior and failure mechanisms of Ti-24Al-11Nb and a SiC/ Ti-24Al-11Nb composite with continuous SCS-6 fibers oriented parallel to the loading direction have been examined over a range of temperatures from 23 °C to 815°C in air. Failure in Ti- 24Al-11Nb occurred at strains of approximately 4 pct soon after crack initiation at low tem- peratures. Ductility increased with temperature up to a maximum of 20 pct elongation at 600 °C, as surface-initiated cracks did not propagate readily at intermediate temperatures. At higher temperatures, the onset of grain boundary and interfacial void nucleation limited ductility. Com- posite failure appeared to be controlled by fiber fracture at all temperatures; for practical en- gineering purposes, composite failure occurred at 0.8 pct strain at all temperatures. At temperatures of 425 °C and less, fiber fractures occurred at intervals along the lengths of the fibers and appeared to be cumulative, while at temperatures of 650 °C and greater, fiber fractures were only observed locally to the fracture surfaces. The decreased radial residual stresses, interfacial strengths, and matrix properties at 650 °C and 815 °C allowed the composite to unload at 0.8 pct strain, due to fiber fractures, followed by a reloading in which fibers pulled out and the matrix failed, resulting in composite failure. The decreasing residual stresses with increasing temper- ature determined from an elastic-plastic concentric cylinder model were shown to affect the stress-strain response of the composite and were consistent with the measured decreasing inter- facial shear stresses, the increased fiber pullout with temperature, and the circumferential de- bonding observed around the fibers at higher temperatures.     

Anatomy and histological characteristics of the spinoglenoid ligament

The spinoglenoid (inferior transverse scapular) ligament, when present, is located at the spinoglenoid notch. The ligament originates on the spine of the scapula and inserts on the superior margin of the glenoid neck. Because of discrepancies in the literature, we sought to determine its prevalence and to define its histological characteristics. We dissected 112 shoulders of seventy-six cadavera and classified the ligament as absent or an insubstantial structure, a thin fibrous band (type I), or a distinct ligament (type II). We found no distinct ligamentous structure in twenty-two shoulders (20 percent), a type-I ligament in sixty-eight shoulders (61 percent), and a type-II ligament in twenty-two shoulders (20 percent). Overall, ninety (80 percent) of the shoulders had a fibrous band of tissue that, together with the spine of the scapula, formed a narrow fibro-osseous tunnel through which the suprascapular nerve traveled. The bone-spinoglenoid ligament-bone complexes from three specimens were analyzed histologically. There were two type-I ligaments and one type-II ligament; all three ligaments were composed of collagen fibers. One type-I ligament and the type-II ligament demonstrated Sharpey fibers at their origin on the spine of the scapula. The other type-I ligament attached to the spine of the scapula through the periosteum. All three ligaments inserted into the periosteum of the glenoid neck.     

A quantitative enzyme histochemical analysis of the distribution of alkaline phosphatase activity in the periodontal ligament of the rat incisor

The spatial distribution of alkaline phosphatase (ALP) activity was examined in the periodontal ligament of the continuously growing rat incisor. With the indoxyl-tetrazolium salt method, enzyme activity was demonstrated in undecalcified cryosections, and the amount of reaction product was quantified. ALP activity appeared to be distributed heterogeneously. Its highest activity was found in the bone-related compartment of the ligament. In the tooth-related compartment and the supracrestal extension of the ligament, enzyme activity was significantly lower, but still higher than in the lamina propria of the gingiva. In the part of the ligament bordering the cementum, highest activity was found in the apical region just occlusal to Hertwig's epithelial root sheath, where formation of acellular cementum begins. From there toward the incisal edge, the activity of the enzyme gradually decreased. It is suggested that differences among the various parts of the periodontal ligament are related to local variations in phosphate metabolism and cementum deposition.     

On the orthogonal anisotropy of human skin as a function of anatomical region

Skin samples were obtained from 8 anatomical sites of 6 human deceased at ages ranging from 30 to 80 years 24 hours post mortem. As shown by biochemical analysis the collagen content varied between 71% and 78% depending on the anatomical location of the skin samples. The content of collagen type III was in the range of 19.2% to 22.2% of the total collagen concentration. As to the biomechanical analysis the axes of minimum and maximum shrinkage after excision were determined and correlated with Langer cleavage line drawn on the specimen with a marker after incision. Two-dimensional biomechanical tests were conducted with a multiaxial tensile testing device consisting of 12 loading axes. The in vivo configuration was a circle with 30 mm diameter. The in vivo stresses were determined by restoring the original shape of the specimen. According to the nonlinear stress-strain relationship incremental strains were applied to the sample with the in vivo configuration and states of uniform extension as reference. The corresponding stresses were recorded after stress relaxation was completed and the equilibrium stresses were regarded as the elastic contribution to the viscoelastic biomechanical behavior. The elastic parameters as a function of the initial strain level were calculated using a set of different incremental strains and stresses. The highest in vivo stresses were found in patella, and upper and lower back. The maximum deviation of the direction of maximum in vivo stress from the Langer cleavage line was found in upper back, the volar part of thigh, and sternum. In vivo orthogonal anisotropy was most pronounced in patella and hollow of the knee.     

A poroelastic model that predicts some phenomenological responses of ligaments and tendons

Experimental evidence suggests that the tensile behavior of tendons and ligaments is in part a function of tissue hydration. The models currently available do not offer a means by which the hydration effects might be explicitly explored. To study these effects, a finite element model of a collagen sub-fascicle, a substructure of tendon and ligament, was formulated. The model was microstructurally based, and simulated oriented collagen fibrils with elastic-orthotropic continuum elements. Poroelastic elements were used to model the interfibrillar matrix. The collagen fiber morphology reflected in the model interacted with the interfibrillar matrix to produce behaviors similar to those seen in tendon and ligament during tensile, cyclic, and relaxation experiments conducted by others. Various states of hydration and permeability were parametrically investigated, demonstrating their influence on the tensile response of the model.     

Regulation of skeletal muscle perfusion during exercise

OBJECTIVE: To compare the composition and mechanical properties of the newly developed bladder acellular matrix graft (BAMG) with the normal urinary bladder in rat, pig and human. MATERIALS AND METHODS: Rat, pig and human urinary bladders were harvested and divided into control and experimental groups. For the latter, BAMGs were prepared, and light and transmission electron microscopic studies performed. Strips from the normal bladders and the BAMGs (10 in each group) were tested under tension, and the ultimate tensile strength, maximum strain, and elastic modulus were determined from stress/strain curves. RESULTS: Both types I and III collagen, as well as elastic fibres, were observed as major components of the matrix scaffold. There were more collagen type I fibres in the rat than in the pig and human BAMGs, whereas the pig, and particularly the human, both showed higher levels of type III collagen and elastic fibres. These different matrix scaffold patterns were confirmed by electron microscopy. Results from biomechanical testing showed no significant differences for strength, strain or elastic modulus between BAMG and control bladder strips, except in the rat where the maximum strain values were significantly lower. CONCLUSION: There are variations in the acellular matrix structure with similar biomechanical properties between the BAMG and the normal urinary bladder in three different species. These results may underscore the potential of the BAMG. Furthermore, this in vitro model provides a suitable method to study the mechanical properties of the urinary bladder and may serve as a diagnostic tool for various investigations.     

Effect of Fiber Diameter on Quasi-static and Dynamic Compressive Properties of Zr-Based Amorphous Matrix Composites Reinforced with Stainless Steel Continuous Fibers

In this study, two Zr-based amorphous alloy matrix composites reinforced with STS304 stainless steel continuous fibers whose diameters were 110 and 250 μm were fabricated by the liquid pressing process. Using a Hopkinson pressure bar, the compressive deformation behavior was investigated at a strain rate of about 10³ s^?1, and the results were then compared with those obtained under quasi-static loading. 65 to 68 vol pct of STS fibers were homogeneously distributed in the amorphous matrix, in which considerable amounts of dendritic crystalline phases were present. According to the dynamic compressive test results, shear cracks were formed at the maximum shear stress direction in the 110-μm-diameter-fiber-reinforced composite to reach the final failure. In the 250-μm-diameter-fiber-reinforced composite, fibers were not cut by shear cracks because the fiber diameter was large enough to restrict the propagation of shear cracks, while taking over a considerable amount of compressive loads over 1500 MPa. This composite showed the higher yield and maximum compressive strengths and plastic strain than the 110-μm-diameter-fiber-reinforced composite because of the sufficient ductility of STS fibers, the effective interruption of propagation of shear cracks, and the strain hardening of fibers themselves.     

Experimental Study of the Biaxial Cyclic Behavior of Thin-Wall Tubes of NiTi Shape Memory Alloys

Combined torsion-tension cycling experiments were performed on thin-wall tubes (with thickness/radius ratio of 1:20, similar to that found for stents) of nearly equiatomic NiTi shape memory alloys (SMAs). Experiments were controlled by axial displacement and torsional angle with step loading involving torsional loading to a maximum strain, followed by tensile loading, and reverse-order unloading. The superelasticity of the material is confirmed by pure torsion and tension experiments at the test temperature. The evolution of equivalent stress-strain curves as well as the separated tensile and torsional stress-strain curves during cycling is analyzed. Results show that the equivalent stress increases greatly with a small amount of applied axial strain, and the equivalent stress-strain curves have negative slopes in the phase transformation region. The shear stress drops when the torsional strain is maintained at its maximum value and the tensile strain is increased. The shear stress increases with decreasing tensile strain, but it cannot recover to the original value after the complete unloading of the tensile strain. Attention is also paid to dissipated energy density and characteristic stress evolutions during cycling.     

Ultrastructure of the rat periodontal ligament as observed with quick-freeze, deep-etch and replica methods: arrangement of collagen and related structures

The ultrastructure of the periodontal ligament of rat molars was examined with the quick-freeze, deep-etch replica methods. It was mainly composed of elongated fibroblast-like cells and 40- to 50-nm-wide collagen fibrils that are arranged parallel to one another to form fibers approximately 1 micron in width. Collagen fibrils are composed of 10-nm-wide substructures that may run helically against the long axis of the fibril. Numerous rod-like structures ('rods') approximately 10 nm in width are present around the collagen fibrils. Individual or groups of rods span spaces between neighboring collagen fibrils to interconnect them. The surfaces of the fibroblast-like cells are also connected to the nearest collagen fibrils through the rods. In place, strands with a thickness similar to that of the rods were seen self-assembled into irregular meshwork structures. The treatment of the tissue with 10% sodium hydroxide for up to 5 days removed most of these rods and strands, thus exposing a three-dimensional arrangement of collagen fibrils that is often not fully visualized in untreated tissues. With histochemical staining of thinly sectioned tissues using Alcian blue, these rods and strands were positively stained, and thus they were demonstrated to be composed of proteoglycans. The ultrastructural arrangement of the periodontal ligament, observed in this study as a delicate interaction of collagen and proteoglycan components, is likely to play a significant role in the transmission of occlusal forces applied to the tissue and in the dissipation of mechanical shock.     

Role of ligaments and facets in lumbar spinal stability

STUDY DESIGN: The issue of segmental stability using finite element analysis was studied. Effect of ligament and facet (total and partial) removal and their geometry on segment response were studied from the viewpoint of stability. OBJECTIVES: To predict factors that may be linked to the cause of rotational instabilities, spondylolisthesis, retrospondylolisthesis, and stenosis. SUMMARY OF BACKGROUND DATA: The study provides a comprehensive study on the role of facets and ligaments and their geometry in preserving segmental stability. No previous biomechanical study has explored these issues in detail. METHODS: Three-dimensional nonlinear finite element analysis was performed on L3-L4 motion segments, with and without posterior elements (ligaments and facets), subjected to sagittal moments. Effects of ligament and facet (partial and total) removal and their orientations on segment response are examined from the viewpoint of stability. RESULTS: Ligaments play an important role in resisting flexion rotation and posterior shear whereas facets are mainly responsible for preventing large extension rotation and anterior displacement. Facet loads and stresses are high under large extension and anterior shear loading. Unlike total facetectomy, selective removal of facets does not compromise segmental stability. Facet loads are dependent on spatial orientation. CONCLUSIONS: Rotational instability in flexion or posterior displacement (retrospondylolisthesis) is unlikely without prior damage of ligaments, whereas instability in extension rotation or forward displacement (spondylolisthesis) is unlikely before facet degeneration or removal. The facet stress and displacement distribution predicts that facet osteoarthritis or hypertrophy leading to spinal stenosis is most likely under flexion-anterior shear loading. Selective facetectomy may restore spinal canal size without compromising the stability of the segment. A facet that is more sagittally oriented may be linked to the cause of spondylolisthesis, whereas a less transversely oriented facet joint may be linked to rotational instabilities in extension.     

The regenerative potential of oxytalan fibers. An experimental study in the monkey

Although a number of studies have described the oxytalan fibers as being a natural component of the periodontal ligament, little information exists about the regenerative potential of these connective tissue fibers. The aim of the present study was to examine whether oxytalan fibers have the capacity to reform after regenerative periodontal therapy. Intrabony defects were produced surgically at the mesial aspects of teeth 37, 35, 45, 47 and at the distal aspects of teeth 11, 21, 31, 41 in one monkey (Macaca fascicularis). After 3 months, the defects were exposed using a full-thickness flap procedure. The root surfaces were debrided and subsequently PDGF-growth factors were placed in the defects. 4 of the 8 sites were covered with a bioresorbable membrane before closure of the wound. Post-surgically, antibiotics were given systemically for 1 week, and tooth cleaning was carried out 1x a week during the entire experimental period. After 5 months, the animal was sacrificed and the oral tissues were fixed by perfusion with 10% buffered formalin. Specimens containing the defects and surrounding tissues were dissected free and histological sections were cut in the mesio-distal direction, parallel to the long axes of the teeth. The sections were stained with hematoxylin and eosin or with the oxone-aldehyde-fuchsin-Halmi staining method and subsequently examined in the light and in the electron microscope. The results revealed that new oxytalan fibers oriented mainly in an apico-occlusal direction had developed in the regenerated periodontal ligament. Many of the newly-formed fibers were inserted into the new cementum, thus suggesting a strong relationship between this tissue and the oxytalan fibers. It is concluded that the regenerated periodontal ligament connective tissue formed after surgery contains oxytalan fibers similar to those present in the original tissue. These results demonstrate that oxytalan fibers develop de novo in the newly-formed periodontal ligament.     

Micromechanics of shear ligament toughening

A new toughening mechanism is proposed based on the fracture of shear ligaments which are formed in the process zone as the result of mismatched crack planes of deflected cracks. The anticipated toughness enhancement due to these shear ligaments has been evaluated by a micromechanical approach that considers the plastic dissipation associated with fracturing of the shear ligaments. Additional toughness increases due to frictional dissipation at fracture surface asperities that experience rubbing have also been considered. The amount of toughening, as represented by a toughening ratio, has been shown to depend on the ligament length, a ligament toughness parameter representing the work to fracture, the area fraction of the ligament, and the area fraction of frictional contacts, if rubbing of the fracture surfaces is present. The proposed model is used to explain roughness-induced toughness in general, and that in α + β Ti-alloys and two-phase TiAl-alloys in particular.     

Homology modelling by distance geometry

The collateral ligaments can be clearly distinguished in the 25-day fetal rabbit knee joint. Type I and V collagens are present in the extracellular matrix between the cells of the lateral and medial collateral ligaments and this distribution persists until the rabbit is skeletally mature. From 8 months onwards type III collagen is also present, particularly around the cells. Type I collagen mRNA is expressed by the cells from the 25-day fetal to 8-month-old adult ligament. The ligament sheath is composed of types III and V collagens. The cruciate ligaments are present between the femur and tibia in the 20-day fetus. The matrix is composed of types I and V collagens from the 25-day fetus until at 12- to 14-weeks postnatal, type III collagen appears in the pericellular regions together with type V. At 8 months and 2 years the amount of type III collagen has increased. All the cells express the mRNA for type I collagen at 12- to 14-weeks, but only isolated cells express this mRNA at 8 months. Thus, both the collateral and cruciate ligaments undergo changes in their complement of collagens during postnatal development and ageing. The implications of these complex interactions of different types of collagen are discussed in relation to healing and the surgical replacement of torn ligaments by tendons.     

Stress governs tissue phenotype at the femoral insertion of the rabbit MCL

The cells in the midsubstance portion of skeletal ligaments typically have elongated shapes, but where ligaments insert into bone the cells appear very rounded and the tissue phenotype is that of fibrocartilage. Between the midsubstance and the insertions there is a gradient in cell shape and tissue phenotype that has been hypothesized to reflect a gradient of mechanical stresses. To test this hypothesis, cell shapes (an index of tissue phenotype) were quantified in the central part of the femoral insertion of the rabbit medial collateral ligament by computer-assisted histomorphometry. Morphometric measurements were correlated with the mechanical stresses and strains in the central part of the insertion as predicted by finite element analysis. Throughout the ligament the direction of the predicted principal tensile stresses coincides with the direction of the collagen fibers which curve from the midsubstance to meet the femur at nearly right angles. Principal compressive stresses also occur within the ligament: the highest are localized near the bone; the lowest in the midsubstance. The areas with the roundest cells correspond to the areas with the highest principal compressive stresses in the model; the areas with the flattest cells correspond to the areas with the lowest compressive stresses in the model. A correlation between cell shape and mechanical stresses suggests that physiological loading of the MCL is important for the maintenance of tissue phenotype throughout this insertion. We theorize that the cells in ligament insertions adapt to the prevailing local mechanical environment.     

The effect of prednisolone on canine neutrophil function: in vivo and in vitro studies

It is generally accepted that growth of muscle tissue depends in part on biomechanical factors. However, the precise relationships that govern mechanically induced growth are not known. This paper uses available data to propose a set of biomechanical growth laws for striated and smooth muscle. For striated muscle fibers, transverse and longitudinal growth are hypothesized to depend on the active and passive fiber stress, respectively. For smooth muscle fibers in arteries, transverse growth is assumed to depend on the fiber stress (active behavior is ignored), with longitudinal growth depending on both fiber stress and the shear stress on the endothelium due to blood flow. In both types of muscle, the rate of growth is assumed to depend linearly on the stresses. Relatively simple models for skeletal muscle, the heart, and arteries are used to show that the proposed growth laws can predict many of the known characteristics of muscle growth during development and following load perturbations in the mature animal.     

Salient shear bands and second-phase addition interactions of bulk metallic glass matrix composite

This article discusses Charpy impact testing and fracture morphology of the Zr_41.25Ti_13.75Cu_12.5Ni₁₀Be_22.5 bulk metallic glass matrix composite with long tungsten fibers. Energy to failure was measured via the impact test as well as by integrating the compressive stress-strain curves, and compared for various fiber fractions. Failure energy increased with fiber volume fraction by both measures. Observation of fracture surfaces was made by using scanning electron microscopy. The results show that the fracture surface of the unreinforced bulk metallic glass (BMG) exhibits three different regions, i.e., the impact zone, the transition zone, and the ridged zone, which have different morphology. The composites present uneven or jagged morphology on macroscopic scale, while the microstructure exhibits salient shear bands and second-phase addition interactions. Bridge formation between tungsten fibers is interpreted as evidence that the shear band propagation in the matrix is suppressed by the fibers. Furthermore, shear lips were observed for the composites containing over 50 pct, fiber volume fraction, showing a great improvement in toughness.     

Computerized morphometric quantitation of elastin and collagen in SMAS and facial skin and the possible role of fat cells in SMAS viscoelastic properties

Recently, the superficial musculoaponeurotic system (SMAS) was found to be a composite tissue comprising collagen, elastic fibers, and fat cells in an extracellular viscous matrix. Both SMAS and facial skin tissues exhibit viscoelastic properties, but SMAS tissue has delayed stress relaxation. As a consequence, SMAS is viewed as a firmer elastic foundation for the more viscous facial skin. In some patients, a slackening effect of SMAS tissue takes place over a period ranging from weeks to months after tightening. To determine the relative quantity of viscoelastic components and better understand their biomechanical behavior, a quantitative morphometric study of the elastic and collagen fibers in the SMAS and facial skin was conducted. Thirty-four SMAS preparations were taken from 17 patients during either primary face lift operations (12 women) or reoperative face lift procedures (4 women, 1 man), which were performed 4 to 9 months after the original surgery, to examine the elastin and collagen content. For comparison, preauricular skin was also gathered from these patients. The specimens were stained with Weigert's staining to identify elastin and collagen fibers. Using a computerized morphometric analysis, 100 fields of each SMAS and skin specimen were examined. According to our findings, the average percentage of elastin and collagen fibers in SMAS and facial skin was as follows: (1) the percentage of elastin fibers in the SMAS was 4.71 +/- 1.2 (standard error of mean +/- 0.0291); (2) the percentage of elastin fibers in the skin was 6.1 +/- 1.8 (standard error of mean +/- 0.0436); (3) The percentage of collagen fibers in the SMAS was 38.7 +/- 5.9 (standard error of mean +/- 0.1430); and (4) the percentage of collagen fibers in the skin was 48.47 +/- 6.96 (standard error of mean +/- 0.1688). A statistical significance of p < 0.0001 was demonstrated between the collagen and elastin groups. A different percentage of elastin and collagen fibers was found among the 17 patients and within each of them separately. Neither gender nor age differences were found regarding elastin and collagen fiber content. No statistical differences were demonstrated between specimen sources, i.e., whether the operations were primary or reoperative face lift procedures. Findings from previous studies indicate that the cheek has two viscoelastic layers, the skin and the SMAS. The proportional similarity in average percentages of elastin and collagen in SMAS and facial skin cannot explain the relatively delayed stress relaxation effect of the SMAS. Therefore, the fat cells that are found exclusively in the SMAS probably lend a certain degree of firmness to this layer and play a significant role in the long-term efficacy of SMAS surgery.