Craniofacial Implants Success in Facial Rehabilitation

Effect of spatial arrangement and clinical service lifetime simulation on the retention of magnetic units used in implant-anchored orbital prostheses

STATEMENT OF PROBLEM

Evidence for the optimal spatial arrangement of magnetic attachments in implant-supported orbital prostheses is lacking.

PURPOSE

The purpose of this in vitro study was to assess the effect of 6 different spatial arrangements on the retentive force of magnetic attachments following the in vitro simulation of clinical service by insertion-removal test cycles and the contribution of artificial aging to the morphological alterations induced on the magnetic surfaces.

MATERIAL AND METHODS

Ni-Cu-Ni plated disk-shaped neodymium (Nd) magnetic units (d=5 mm, h=1.6 mm) were secured on leveled (50×50×5 mm, n=3) and angled (40×45×40 mm, interior angle=90 degrees, n=3) pairs of test panels in 6 different spatial arrangements: triangular_leveled (TL), triangular_angled (TA), square_leveled (SL), square_angled (SA), circular_leveled (CL), and circular_angled (CA) generating corresponding test assemblies (N=6). TL and TA arrangements included 3 magnetic units (3-magnet groups) and SL, SA, CL, and CA 4 (4-magnet groups). The retentive force (N) was measured at a mean crosshead speed of 10 mm/min (n=10). Each test assembly was subjected to insertion-removal test cycles with a 9-mm amplitude, ν=0.1 Hz, and n=10 consequent retentive force measurements at a crosshead speed of 10 mm/min at 540, 1080, 1620, and 2160 test cycles. Surface roughness alterations following the 2160 test cycles were measured by calculating the Sa, Sz, Sq, Sdr, Sc, and Sv parameters with an optical interferometric profiler with 5 new magnetic units used as a control group. Data were analyzed with 1-way ANOVA and Tukey HSD post hoc tests (α=.05).

RESULTS

The 4-magnet groups had statistically significantly higher retentive force than the 3-magnet ones at baseline and following the 2160 test cycles (P<.05). In the 4-magnet group, the ranking at baseline was SA<CA<CL<SL (P<.05) and following the test cycles SA=CA<CL<SL (P<.05). No statistically significant differences were found in the surface roughness parameters (Sa, Sz, Sq, Sdr, Sc, and Sv) following the 2160 test cycles among the experimental groups tested (P>.05).

CONCLUSIONS

Four magnetic attachments placed on an SL spatial arrangement resulted in the highest retention force but presented with the highest force reduction following the in vitro simulation of clinical service by insertion-removal test cycles.

Retention and Mechanical Behavior of Attachment Systems for Implant-Retained Auricular Prostheses

OBJECTIVE

Auricular prostheses are artificial substitutes for facial defects. The retention of these has often been a problem. This study aimed to evaluate the mechanical behavior of 3 retained auricular prosthetic connections when submitted to a mechanical cycling test.

MATERIALS AND METHODS

Twelve samples with installed implants were obtained and divided into 3 groups according to their retention system with 4 samples in each group. I: bar-clip system; II: magnet system; and III: ball/o-ring system. Each of samples was submitted to the pull-out test during 3240 cycles (f = 0.5 Hz) to determine its tensile strength. The mechanical cycling test was performed using the servo-hydraulic machine MTS 810-Flex Test 40 (Eden Prairie, MN) that had a 2.5 mm shift at a 10 mm/s velocity. The retaining strength for each of the samples was obtained at 7 intervals.

RESULTS

The tensile strength for the group retained by the bar-clip system (29.60 N) was higher with statistically significant difference (P < 0.05) when compared with the group retained by the ball/o-ring system (9.41 N) and magnets system (8.61 N) for all periods assessed. The ball/o-ring system showed loss of retention during the fatigue test (Kruskal-Wallis, chi-squared = 17.28; P < 0.01).

CONCLUSIONS

The evaluated systems showed a tensile strength compatible with the clinical use and no fractures of the components were observed.