Morsellised sawbones is an acceptable experimental substitute for the in vitro elastic and viscoelastic mechanical characterisation of morsellised cancellous bone undergoing impaction grafting

Rau T. Pull-Out Strength of Orthodontic Miniscrews in the Temporal Bone

BACKGROUND

Minimally invasive cochlear implant surgery by using a microstereotactic frame demands solid connection to the bone. We aimed to determine the stability of commercially available orthodontic miniscrews to evaluate their feasibility for frame's fixation. In addition, which substitute material most closely resembles the mechanical properties of the human temporal bone was evaluated.

METHODS

Pull-out tests were carried out with five different types of orthodontic miniscrews in human temporal bone specimens. Furthermore, short fiber filled epoxy (SFFE), solid rigid polyurethane (SRPU50), bovine femur, and porcine iliac bone were evaluated as substitute materials. In total, 57 tests in human specimens and 180 tests in the substitute materials were performed.

RESULTS

In human temporal bone, average pull-out forces ranged from 220 N to 285 N between screws. Joint stiffness in human temporal bone ranged between 14 N/mm and 358 N/mm. Statistically significant differences between the tested screws were measured in terms of stiffness and elastic energy. One screw type failed insertion due to tip breakage. No significant differences occurred between screws in maximum pull-out force. The average pull-out values of SFFE were 14.1 N higher compared to human specimen.

CONCLUSION

Orthodontic miniscrews provided rigid fixation when partially inserted in human temporal bone, as evidenced by pull-out forces and joint stiffness. Average values exceeded requirements despite variations between screws. Differences in stiffness and elastic energy indicate screw-specific interface mechanics. With proper insertion, orthodontic miniscrews appear suitable for microstereotactic frame anchoring during minimally invasive cochlear implant surgery. However, testing under more complex loading is needed to better predict clinical performance. For further pull-out tests, the most suitable substitute material is SFFE.

Mechanical Behavior of Human Cancellous Bone in Alveolar Bone under Uniaxial Compression and Creep Tests

In the process of orthodontic treatment, the remodeling of cancellous bone in alveolar bone (in this paper, cancellous bone in alveolar bone is abbreviated as CBAB) is key to promoting tooth movement. Studying the mechanical behavior of CBAB is helpful to predict the displacement of teeth and achieve the best effect of orthodontic treatment. Three CBAB samples were cut from alveolar bone around the root apex of human teeth. A uniaxial compression test was used to study the transient elastic properties of CBAB. A creep test was used to study the time-dependent viscoelastic properties of CBAB. Both tests were carried out at the loading rates of 0.02 mm/min, 0.1 mm/min and 0.5 mm/min. The results revealed that CBAB is a nonlinear viscoelastic and hyperelastic material. The stress−strain curve obtained from the uniaxial compression test could be divided into three stages: the collapse stage of the front section, the exponential stage of the middle section and the almost linear stage of the rear end. According to the strain−time curve obtained from the compression creep test, a trend of increasing strain over time was relatively obvious within the first 30 s. After 200 s, the curve gradually tended to plateau. Four hyperelastic models and three viscoelastic models were used to fit the test data. Finally, the fifth-order polynomial hyperelastic model (coefficient of determination “R2 > 0.999”) was used to describe the hyperelastic properties of CBAB, and the seven-parameter model of the generalized Kelvin modified model (“R2 > 0.98”) was used to describe the viscoelastic properties of CBAB.

Impaction technique influences implant stability in low-density bone model

Aims

Cementless acetabular components rely on press-fit fixation for initial stability. In certain cases, initial stability is more difficult to obtain (such as during revision). No current study evaluates how a surgeon’s impaction technique (mallet mass, mallet velocity, and number of strikes) may affect component fixation. This study seeks to answer the following research questions: 1) how does impaction technique affect a) bone strain generation and deterioration (and hence implant stability) and b) seating in different density bones?; and 2) can an impaction technique be recommended to minimize risk of implant loosening while ensuring seating of the acetabular component?

Methods

A custom drop tower was used to simulate surgical strikes seating acetabular components into synthetic bone. Strike velocity and drop mass were varied. Synthetic bone strain was measured using strain gauges and stability was assessed via push-out tests. Polar gap was measured using optical trackers.

Results

A phenomenon of strain deterioration was identified if an excessive number of strikes was used to seat a component. This effect was most pronounced in low-density bone at high strike velocities. Polar gap was reduced with increasing strike mass and velocity.

Conclusion

A high mallet mass with low strike velocity resulted in satisfactory implant stability and polar gap, while minimizing the risk of losing stability due to over-striking. Extreme caution not to over-strike must be exercised when using high velocity strikes in low-density bone for any mallet mass.

Cite this article: Bone Joint Res 2020;9(7):386–393.

Large-scale additive manufacturing with bioinspired cellulosic materials

Cellulose is the most abundant and broadly distributed organic compound and industrial by-product on Earth. However, despite decades of extensive research, the bottom-up use of cellulose to fabricate 3D objects is still plagued with problems that restrict its practical applications: derivatives with vast polluting effects, use in combination with plastics, lack of scalability and high production cost. Here we demonstrate the general use of cellulose to manufacture large 3D objects. Our approach diverges from the common association of cellulose with green plants and it is inspired by the wall of the fungus-like oomycetes, which is reproduced introducing small amounts of chitin between cellulose fibers. The resulting fungal-like adhesive material(s) (FLAM) are strong, lightweight and inexpensive, and can be molded or processed using woodworking techniques. We believe this first large-scale additive manufacture with ubiquitous biological polymers will be the catalyst for the transition to environmentally benign and circular manufacturing models.

Optimizing the grain size distribution of allografts in bone impaction grafting

In bone impaction grafting, allografts in the form of bone chips are used for reconstruction of defects and to induce bone remodeling. Optimizing grain size distribution of this allograft material should help prevent implant subsidence by achieving higher primary stability of the graft. We evaluated the influence of grain size distribution on the mechanical stability of allograft material. Bone tissue was rinsed, and the grain size distribution of the allograft material was determined by performing a sieve analysis. Uniaxial compression tests were carried out before and after a standardized compaction procedure for samples with controlled grain size distribution and a control group. Allografts with controlled grain size distribution showed a yield limit almost twice as high as in the control group after a standardized compaction procedure. A better interlocking between bone particles was observed compared to the control group. Thus, grain size distribution has a major impact on the mechanical stability of bone grafts. By controlling the grain size distribution of allograft material, a tighter packing can be achieved and subsequently implant subsidence of implants could be avoided.