1
|
Boccaccio A. A mechano-regulation model to design and optimize the surface microgeometry of titanium textured devices for biomedical applications. J Mech Behav Biomed Mater 2024; 157:106645. [PMID: 38963999 DOI: 10.1016/j.jmbbm.2024.106645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 06/20/2024] [Accepted: 06/29/2024] [Indexed: 07/06/2024]
Abstract
In a technological context where, thanks to the additive manufacturing techniques, even sophisticated geometries as well as surfaces with specific micrometric features can be realized, we propose a mechano-regulation algorithm to determine the optimal microgeometric parameters of the surface of textured titanium devices for biomedical applications. A poroelastic finite element model was developed including a portion of bone, a portion of a textured titanium device and a layer of granulation tissue separating the bone from the device and occupying the space between them. The algorithm, implemented in the Matlab environment, determines the optimal values of the root mean square and the correlation length that the device surface must possess to maximize bone formation in the gap between the bone and the device. For low levels of compression load acting on the bone, the algorithm predicts low values of root mean square and high values of correlation length. Conversely, high levels of load require high values of root mean square and low values of correlation length. The optimal microgeometrical parameters were determined for various thickness values of the granulation tissue layer. Interestingly, the predictions of the proposed computational model are consistent with the experimental results reported in the literature. The proposed algorithm shows promise as a valuable tool for addressing the demands of precision medicine. In this approach, the device or prosthesis is no longer designed solely based on statistical averages but is tailored to each patient's unique anthropometric characteristics, as well as considerations related to their metabolism, sex, age, and more.
Collapse
Affiliation(s)
- Antonio Boccaccio
- Dipartimento di Meccanica, Matematica e Management, Politecnico di Bari, Bari, Italy.
| |
Collapse
|
2
|
Bartoli M, Cardano F, Piatti E, Lettieri S, Fin A, Tagliaferro A. Interface properties of nanostructured carbon-coated biological implants: an overview. BEILSTEIN JOURNAL OF NANOTECHNOLOGY 2024; 15:1041-1053. [PMID: 39161465 PMCID: PMC11331541 DOI: 10.3762/bjnano.15.85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 08/05/2024] [Indexed: 08/21/2024]
Abstract
The interfaces between medical implants and living tissues are of great complexity because of the simultaneous occurrence of a wide variety of phenomena. The engineering of implant surfaces represents a crucial challenge in material science, but the further improvement of implant properties remains a critical task. It can be achieved through several processes. Among them, the production of specialized coatings based on carbon-based materials stands very promising. The use of carbon coatings allows one to simultaneously fine-tune tribological, mechanical, and chemical properties. Here, we review applications of nanostructured carbon coatings (nanodiamonds, carbon nanotubes, and graphene-related materials) for the improvement of the overall properties of medical implants. We are focusing on biological interactions, improved corrosion resistance, and overall mechanical properties, trying to provide a complete overview within the field.
Collapse
Affiliation(s)
- Mattia Bartoli
- Center for Sustainable Future Technologies (CSFT), Istituto Italiano di Tecnologia (IIT), Via Livorno, 60, 10144, Torino, Italy
- Consorzio Interuniversitario Nazionale per la Scienza e Tecnologia dei Materiali (INSTM), Via G. Giusti 9, 50121, Firenze, Italy
| | - Francesca Cardano
- Center for Sustainable Future Technologies (CSFT), Istituto Italiano di Tecnologia (IIT), Via Livorno, 60, 10144, Torino, Italy
- Department of Chemistry, University of Turin, Via P. Giuria 7, 10125 Torino, Italy
| | - Erik Piatti
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca Degli Abruzzi, 24, 10129, Torino, Italy
| | - Stefania Lettieri
- Center for Sustainable Future Technologies (CSFT), Istituto Italiano di Tecnologia (IIT), Via Livorno, 60, 10144, Torino, Italy
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca Degli Abruzzi, 24, 10129, Torino, Italy
| | - Andrea Fin
- Center for Sustainable Future Technologies (CSFT), Istituto Italiano di Tecnologia (IIT), Via Livorno, 60, 10144, Torino, Italy
- Department of Chemistry, University of Turin, Via P. Giuria 7, 10125 Torino, Italy
| | - Alberto Tagliaferro
- Consorzio Interuniversitario Nazionale per la Scienza e Tecnologia dei Materiali (INSTM), Via G. Giusti 9, 50121, Firenze, Italy
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca Degli Abruzzi, 24, 10129, Torino, Italy
| |
Collapse
|
3
|
Sass JO, Kebbach M, Lork C, Johannsen J, Weinmann M, Stenzel M, Bader R. Computational biomechanical study on hybrid implant materials for the femoral component of total knee replacements. J Mech Behav Biomed Mater 2024; 158:106681. [PMID: 39151255 DOI: 10.1016/j.jmbbm.2024.106681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/15/2024] [Accepted: 08/08/2024] [Indexed: 08/19/2024]
Abstract
Multifunctional materials have been described to meet the diverse requirements of implant materials for femoral components of uncemented total knee replacements. These materials aim to combine the high wear and corrosion resistance of oxide ceramics at the joint surfaces with the osteogenic potential of titanium alloys at the bone-implant interface. Our objective was to evaluate the biomechanical performance of hybrid material-based femoral components regarding mechanical stress within the implant during cementless implantation and stress shielding (evaluated by strain energy density) of the periprosthetic bone during two-legged squat motion using finite element modeling. The hybrid materials consisted of alumina-toughened zirconia (ATZ) ceramic joined with additively manufactured Ti-6Al-4V or Ti-35Nb-6Ta alloys. The titanium component was modeled with or without an open porous surface structure. Monolithic femoral components of ATZ ceramic or Co-28Cr-6Mo alloy were used as reference. The elasticity of the open porous surface structure was determined within experimental compression tests and was significantly higher for Ti-35Nb-6Ta compared to Ti-6Al-4V (5.2 ± 0.2 GPa vs. 8.8 ± 0.8 GPa, p < 0.001). During implantation, the maximum stress within the ATZ femoral component decreased from 1568.9 MPa (monolithic ATZ) to 367.6 MPa (Ti-6Al-4V/ATZ), 560.9 MPa (Ti-6Al-4V/ATZ with an open porous surface), 474.9 MPa (Ti-35Nb-6Ta/ATZ), and 648.4 MPa (Ti-35Nb-6Ta/ATZ with an open porous surface). The strain energy density increased at higher flexion angles for all models during the squat movement. At ∼90° knee flexion, the strain energy density in the anterior region of the distal femur increased by 25.7 % (Ti-6Al-4V/ATZ), 70.3 % (Ti-6Al-4V/ATZ with an open porous surface), 43.7 % (Ti-35Nb-6Ta/ATZ), and 82.5% (Ti-35Nb-6Ta/ATZ with an open porous surface) compared to monolithic ATZ. Thus, the hybrid material-based femoral component decreases the intraoperative fracture risk of the ATZ part and considerably reduces the risk of stress shielding of the periprosthetic bone.
Collapse
Affiliation(s)
- Jan-Oliver Sass
- Research Laboratory for Biomechanics and Implant Technology, Department of Orthopedics, Rostock University Medical Center, Doberaner Straße 142, D-18057 Rostock, Germany.
| | - Maeruan Kebbach
- Research Laboratory for Biomechanics and Implant Technology, Department of Orthopedics, Rostock University Medical Center, Doberaner Straße 142, D-18057 Rostock, Germany
| | - Cornelia Lork
- ZM Praezisionsdentaltechnik GmbH, Breite Straße 16, D-18055 Rostock, Germany
| | - Jan Johannsen
- Fraunhofer Research Institution for Additive Manufacturing Technologies IAPT, Am Schleusengraben 14, D-21029 Hamburg, Germany
| | | | | | - Rainer Bader
- Research Laboratory for Biomechanics and Implant Technology, Department of Orthopedics, Rostock University Medical Center, Doberaner Straße 142, D-18057 Rostock, Germany
| |
Collapse
|
4
|
Hosseini SA, Katoozian HR. Comparison of stress distribution in fully porous and dense-core porous scaffolds in dental implantation. J Mech Behav Biomed Mater 2024; 156:106602. [PMID: 38805873 DOI: 10.1016/j.jmbbm.2024.106602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/04/2024] [Accepted: 05/23/2024] [Indexed: 05/30/2024]
Abstract
The aim of this study is to compare the stress distribution in porous scaffolds with different structures with similar geometric parameters to study a new approach in dental implantation. Three-dimensional finite element models of the fully porous and dense-core porous scaffolds with defined porosity parameters including space diameter and thickness with two porosity patterns were embedded in the jaw bone model with cortical and cancellous bone. The cylindrical shape was considered as the main shape of the scaffolds. To evaluate the mechanical performance, the Von Mises stress was compared in the models under static and dynamic masticatory loading. Incidentally, to validate the modeling results, experimental strain gauge tests were performed on four specimens fabricated from Ti6Al4V. Finally, the stress distribution in the models was compared with the results of previous studies on commercial implants. The results of the finite element analysis show that there are considerable differences in the magnitude of the equivalent stress in the models in static and dynamic phases. Also, changes in the defined geometric parameters have significant effects on the stress distribution in terms of Von Mises stress in the overall models. The experimental results indicated good agreement with those of the modeling. It can be concluded that some porous structures with optimal geometries can be proposed as a new structure for dental implants. However, considering the physiology of bone when confronted with porous structures, further studies such as in vivo experiments are needed in this field.
Collapse
Affiliation(s)
- Seyed Aref Hosseini
- Department of Biomedical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
| | - Hamid Reza Katoozian
- Department of Biomedical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran.
| |
Collapse
|
5
|
Mohamed M, Beaudry E, Shehata AW, Raboud D, Hebert JS, Westover L. Evaluation of the Transfemoral Bone-Implant Interface Properties Using Vibration Analysis. Ann Biomed Eng 2024:10.1007/s10439-024-03561-6. [PMID: 38977531 DOI: 10.1007/s10439-024-03561-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 06/12/2024] [Indexed: 07/10/2024]
Abstract
Evaluating the bone-implant interface (BII) properties of osseointegrated transfemoral (TFA) implants is important for early failure detection and prescribing loads during rehabilitation. The objective of this work is to derive and validate a 1D finite element (FE) model of the Osseointegrated Prosthetic Limb (OPL) TFA system that can: (1) model its dynamic behaviour and (2) extract the BII properties. The model was validated by: (1) comparing the 1D FE formulation to the analytical and 3D FE solutions for a simplified cylinder, (2) comparing the vibration modes of the actual TFA geometry using 1D and 3D FE models, and (3) evaluating the BII properties for three extreme conditions (LOW, INTERMEDIATE, and HIGH) generated using 3D FE and experimental (where the implant was embedded, using different adhesives, in synthetic femurs) signals for additional validation. The modes predicted by the 1D FE model converged to the analytical and the 3D FE solutions for the cylinder. The 1D model also matched the 3D FE solution with a maximum frequency difference of 2.02% for the TFA geometry. Finally, the 1D model extracted the BII stiffness and the system's damping properties for the three conditions generated using the 3D FE simulations and the experimental INTERMEDIATE and HIGH signals. The agreement between the 1D FE and the 3D FE solutions for the TFA geometry indicates that the 1D model captures the system's dynamic behaviour. Distinguishing between the different BII conditions demonstrates the 1D model's potential use for the non-invasive clinical evaluation of the TFA BII properties.
Collapse
Affiliation(s)
- Mostafa Mohamed
- Department of Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, AB, Canada.
| | - Eric Beaudry
- Department of Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, AB, Canada
| | - Ahmed W Shehata
- Department of Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, AB, Canada
- Department of Biomedical Engineering, Faculty of Engineering & Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Donald Raboud
- Department of Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, AB, Canada
| | - Jacqueline S Hebert
- Department of Biomedical Engineering, Faculty of Engineering & Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Lindsey Westover
- Department of Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, AB, Canada
- Department of Biomedical Engineering, Faculty of Engineering & Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
6
|
Luptáková N, Dlouhý V, Sobola D, Fintová S, Weiser A, Beneš V, Dlouhý A. Interfaces between Cranial Bone and AISI 304 Steel after Long-Term Implantation: A Case Study of Cranial Screws. ACS Biomater Sci Eng 2024; 10:4297-4310. [PMID: 38900847 PMCID: PMC11234332 DOI: 10.1021/acsbiomaterials.4c00309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
Interfaces between AISI 304 stainless steel screws and cranial bone were investigated after long-term implantation lasting for 42 years. Samples containing the interface regions were analyzed using state-of-the-art analytical techniques including secondary ion mass, Fourier-transform infrared, Raman, and X-ray photoelectron spectroscopies. Local samples for scanning transmission electron microscopy were cut from the interface regions using the focused ion beam technique. A chemical composition across the interface was recorded in length scales covering micrometric and nanometric resolutions and relevant differences were found between peri-implant and the distant cranial bone, indicating generally younger bone tissue in the peri-implant area. Furthermore, the energy dispersive spectroscopy revealed an 80 nm thick steel surface layer enriched by oxygen suggesting that the AISI 304 material undergoes a corrosion attack. The attack is associated with transport of metallic ions, namely, ferrous and ferric iron, into the bone layer adjacent to the implant. The results comply with an anticipated interplay between released iron ions and osteoclast proliferation. The interplay gives rise to an autocatalytic process in which the iron ions stimulate the osteoclast activity while a formation of fresh bone resorption sites boosts the corrosion process through interactions between acidic osteoclast extracellular compartments and the implant surface. The autocatalytic process thus may account for an accelerated turnover of the peri-implant bone.
Collapse
Affiliation(s)
- Natália Luptáková
- Institute of Physics of Materials, AS CR, v. v. i., Žižkova 513/22, Brno 61662, Czech Republic
| | - Václav Dlouhý
- Department of Neurosurgery, Second Faculty of Medicine, Charles University and University Hospital Motol, V Úvalu 84, Prague 150 06, Czech Republic
| | - Dinara Sobola
- Institute of Physics of Materials, AS CR, v. v. i., Žižkova 513/22, Brno 61662, Czech Republic
| | - Stanislava Fintová
- Institute of Physics of Materials, AS CR, v. v. i., Žižkova 513/22, Brno 61662, Czech Republic
| | - Adam Weiser
- Institute of Physics of Materials, AS CR, v. v. i., Žižkova 513/22, Brno 61662, Czech Republic
| | - Vladimír Beneš
- Department of Neurosurgery, Second Faculty of Medicine, Charles University and University Hospital Motol, V Úvalu 84, Prague 150 06, Czech Republic
| | - Antonín Dlouhý
- Institute of Physics of Materials, AS CR, v. v. i., Žižkova 513/22, Brno 61662, Czech Republic
| |
Collapse
|
7
|
Cunningham DE, Habis AA, Uddin FZ, Johnson JA, Athwal GS. Stemless reverse shoulder arthroplasty neck shaft angle influences humeral component time-zero fixation and survivorship: a cadaveric biomechanical assessment. JSES Int 2024; 8:880-887. [PMID: 39035638 PMCID: PMC11258816 DOI: 10.1016/j.jseint.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2024] Open
Abstract
Background Stemless humeral components are being clinically investigated for reverse shoulder arthroplasty (RSA) procedures. There is, however, a paucity of basic science literature on the surgical parameters that influence the success of these procedures. Therefore, this cadaveric biomechanical study evaluated the neck shaft angle (NSA) of implantation on the survivability and performance of stemless RSA humeral components during cyclical loading. Methods Twelve paired cadaveric humeri were implanted with stemless RSA humeral components at NSAs of 135° and 145°. Implant-bone motion at the periphery of the implant was measured with 3 optical machine vision USB3 cameras outfitted with c-mount premium lenses and quantified with ProAnalyst software. A custom 3-dimensional loading apparatus was used to cyclically apply 3 loading directions representative of physiological states at 5 progressively increasing loading magnitudes. Stemless 135° and 145° implants were compared based on the maximum implant-bone relative distraction detected, as well as the survivorship of the implants throughout the loading protocol. Results Primary fixation and implant biomechanical survivorship were substantially better in the 145° NSA implants. The 135° NSA implants elicited significantly higher implant-bone distractions during cyclical loading (P = .001), and implant survivorship was considerably lower in the 135° NSA specimens when compared to the 145° NSA specimens (135° NSA: 0%, 145° NSA: 50%) (P < .001). Conclusion NSA is a modifiable parameter that influences time-zero implant stability, as well as the early survivorship of the stemless RSA humeral components tested in this study. NSA resections of 145° appear to promote better stability than those utilizing 135° NSAs during early postoperative eccentric loads. Further studies are required to assess if other stemless reversed humeral implant designs have improved time-zero fixation at higher NSAs.
Collapse
Affiliation(s)
- David E. Cunningham
- Department of Mechanical Engineering, The University of Western Ontario, London, ON, Canada
- The Roth|McFarlane Hand and Upper Limb Centre, St. Joseph’s Hospital, London, ON, Canada
| | - Ahmed A. Habis
- The Roth|McFarlane Hand and Upper Limb Centre, St. Joseph’s Hospital, London, ON, Canada
- Faculty of Medicine, Department of Orthopaedic Surgery, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Surgery, The University of Western Ontario, London, ON, Canada
| | - Fares Z.N. Uddin
- The Roth|McFarlane Hand and Upper Limb Centre, St. Joseph’s Hospital, London, ON, Canada
- Department of Surgery, The University of Western Ontario, London, ON, Canada
- Orthopedic Department, Bahrain Royal Guard/King Hamad University Hospital, Royal Medical Services-Bahrain, Defence Force, Al Sayh, Bahrain
| | - James A. Johnson
- Department of Mechanical Engineering, The University of Western Ontario, London, ON, Canada
- The Roth|McFarlane Hand and Upper Limb Centre, St. Joseph’s Hospital, London, ON, Canada
- Department of Surgery, The University of Western Ontario, London, ON, Canada
- Department of Biomedical Engineering, The University of Western Ontario, London, ON, Canada
| | - George S. Athwal
- The Roth|McFarlane Hand and Upper Limb Centre, St. Joseph’s Hospital, London, ON, Canada
- Department of Surgery, The University of Western Ontario, London, ON, Canada
| |
Collapse
|
8
|
Colabella L, Naili S, Le Cann S, Haiat G. Effect of collagen fibril orientation on the anisotropic properties of peri-implant bone. Biomech Model Mechanobiol 2024; 23:879-891. [PMID: 38300439 DOI: 10.1007/s10237-023-01811-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 12/22/2023] [Indexed: 02/02/2024]
Abstract
In orthopedic and dental surgery, the implantation of biomaterials within the bone to restore the integrity of the treated organ has become a standard procedure. Their long-term stability relies on the osseointegration phenomena, where bone grows onto and around metallic implants, creating a bone-implant interface. Bone is a highly hierarchical material that evolves spatially and temporally during this healing phase. A deeper understanding of its biomechanical characteristics is needed, as they are determinants for surgical success. In this context, we propose a multiscale homogenization model to evaluate the effective elastic properties of bone as a function of the distance from the implant, based on the tissue's structure and composition at lower scales. The model considers three scales: hydroxyapatite foam (nanoscale), ultrastructure (microscale), and tissue (mesoscale). The elastic properties and the volume fraction of the elementary constituents of bone matrix (mineral, collagen, and water), the orientation of the collagen fibril relative to the implant surface, and the mesoscale porosity constitute the input data of the model. The effect of a spatiotemporal variation in the collagen fibrils' orientation on the bone anisotropic properties in the proximity of the implant was investigated. The findings revealed a strong variation of the components of the effective elasticity tensor of the bone as a function of the distance from the implant. The effective elasticity appears to be primarily sensitive to the porosity (mesoscale) rather than to the collagen fibrils' orientation (sub-micro scale). However, the orientation of the fibrils has a significant influence on the isotropy of the bone. When analyzing the symmetry properties of the effective elasticity tensor, the ratio between the isotropic and hexagonal components is determined by a combination of the porosity and the fibrils' orientation. A decrease in porosity leads to a decrease in bone isotropy and, in turn, an increase in the impact of the fibrils' orientation. These results demonstrate that the collagen fibril orientation should be taken into account to properly describe the effective elastic anisotropy of bone at the organ scale.
Collapse
Affiliation(s)
- Lucas Colabella
- CNRS, Univ Paris Est Creteil, Univ Gustave Eiffel, UMR 8208, F-94010, Creteil, France
- INTEMA, CONICET, Av. Cristóbal Colón 10850, B7606BWV, Mar del Plata, Argentina
| | - Salah Naili
- Univ Paris Est Creteil, Univ Gustave Eiffel, CNRS, UMR 8208, MSME, F-94010, Creteil, France
| | - Sophie Le Cann
- CNRS, Univ Paris Est Creteil, Univ Gustave Eiffel, UMR 8208, F-94010, Creteil, France
| | - Guillaume Haiat
- CNRS, Univ Paris Est Creteil, Univ Gustave Eiffel, UMR 8208, F-94010, Creteil, France.
| |
Collapse
|
9
|
Hendi A, Mirzaee S, Falahchai M. The effect of different implant-abutment types and heights on screw loosening in cases with increased crown height space. Clin Exp Dent Res 2024; 10:e894. [PMID: 38881218 PMCID: PMC11180708 DOI: 10.1002/cre2.894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/13/2024] [Accepted: 04/23/2024] [Indexed: 06/18/2024] Open
Abstract
OBJECTIVES The stability of the abutment screw is pivotal for successful implant-supported restorations, yet screw loosening remains a common complication, leading to compromised function and potential implant failure. This study aims to evaluate the effect of different implant-abutment types and heights on screw loosening in cases with increased crown height space (CHS). MATERIALS AND METHODS In this in vitro study, a total of 64 abutments in eight distinct groups based on their type and height were evaluated. These groups included stock, cast, and milled abutments with heights of 4 mm (groups S4, C4, and M4), 7 mm (groups S7, C7, and M7), and 10 mm (groups C10 and M10). Removal torque loss (RTL) was assessed both before and after subjecting the abutments to dynamic cyclic loading. Additionally, the differences between initial RTL and RTL following cyclic loading were analyzed for each group (p < .05). RESULTS The C10 group demonstrated the highest RTL, whereas the S4 group exhibited the lowest initial RTL percentage (p < .05). Furthermore, the study established significant variations in RTL percentages and the discrepancies between initial and postcyclic loading RTL across different abutment groups (p < .05). Additionally, both abutment types and heights were found to significantly influence the RTL percentage (p < .05). CONCLUSION The type and height of the implant abutment affected screw loosening, and in an increased CHS of 12 mm, using a stock abutment with a postheight of 4 mm can be effective in minimizing screw loosening.
Collapse
Affiliation(s)
- Amirreza Hendi
- Department of Prosthodontics, School of Dentistry, Dental Sciences Research CenterGuilan University of Medical SciencesRashtIran
| | - Sobhan Mirzaee
- School of Dentistry, Dental Sciences Research CenterGuilan University of Medical SciencesRashtIran
| | - Mehran Falahchai
- Department of Prosthodontics, School of Dentistry, Dental Sciences Research CenterGuilan University of Medical SciencesRashtIran
| |
Collapse
|
10
|
García-Ávila J, González-Gallegos CP, Segura-Ibarra V, Vazquez E, Garcia-Lopez E, Rodríguez CA, Vargas-Martínez A, Cuan-Urquizo E, Ramírez-Cedillo E. Dynamic topology optimization of 3D-Printed transtibial orthopedic implant using tunable isotropic porous metamaterials. J Mech Behav Biomed Mater 2024; 153:106479. [PMID: 38492502 DOI: 10.1016/j.jmbbm.2024.106479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 02/07/2024] [Accepted: 02/24/2024] [Indexed: 03/18/2024]
Abstract
In this paper, we introduce the design and manufacturing process of a transtibial orthopedic implant. We used medical-grade polyurethane polymer resin to fabricate a 3D porous architected implant with tunable isotropy, employing a high-speed printing method known as Continuous Liquid Interface Production (CLIP). Our objective is to enhance the weight-bearing capabilities of the bone structures in the residual limb, thereby circumventing the traditional reliance on a natural bridge. To achieve a custom-made design, we acquire the topology and morphology of the residual limb as well as the bone structure of the tibia and fibula, utilizing computed tomography (CT) and high-resolution 3D scanning. We employed a dynamic topological optimization method, informed by gait cycle data, to effectively reduce the mass of the implant. This approach, which differs from conventional static methods, enables the quantification of variations in applied forces over time. Using the Euler-Lagrange energy approach, we propose the equations of motion for a homologous multibody model with three degrees of freedom. The versatility of the Solid Isotropic Material with Penalization (SIMP) method facilitates the integration of homogenization methods for microscale porous architectures into the optimized domain. The design of these porous architectures is based on a bias-driven tuning symmetry isotropy of a Triply Periodic Minimal Surface (Schwarz Primitive surface). The internal porosity of the structure significantly reduces weight without compromising the isotropic behavior of the implant.
Collapse
Affiliation(s)
- Josué García-Ávila
- Department of Mechanical Engineering, Stanford University, Stanford, CA, 94305-2004, USA
| | | | - Victor Segura-Ibarra
- Tecnologico de Monterrey, School of Engineering and Sciences, Av. Eugenio Garza Sada Sur 2501, Monterrey, Mexico
| | - Elisa Vazquez
- Tecnologico de Monterrey, School of Engineering and Sciences, Av. Eugenio Garza Sada Sur 2501, Monterrey, Mexico
| | - Erika Garcia-Lopez
- Tecnologico de Monterrey, School of Engineering and Sciences, Av. Eugenio Garza Sada Sur 2501, Monterrey, Mexico
| | - Ciro A Rodríguez
- Tecnologico de Monterrey, School of Engineering and Sciences, Av. Eugenio Garza Sada Sur 2501, Monterrey, Mexico; Laboratorio Nacional de Manufactura Aditiva y Digital (MADiT), Autopista Al Aeropuerto, Km., 9.5, Calle Alianza Norte #100, Parque PIIT, Apodaca, 66629, Mexico
| | - Adriana Vargas-Martínez
- Tecnologico de Monterrey, School of Engineering and Sciences, Av. Eugenio Garza Sada Sur 2501, Monterrey, Mexico
| | - Enrique Cuan-Urquizo
- Tecnológico de Monterrey, Institute of Advanced Materials for Sustainable Manufacturing, Monterrey, Mexico
| | - Erick Ramírez-Cedillo
- Tecnologico de Monterrey, School of Engineering and Sciences, Av. Eugenio Garza Sada Sur 2501, Monterrey, Mexico; Laboratorio Nacional de Manufactura Aditiva y Digital (MADiT), Autopista Al Aeropuerto, Km., 9.5, Calle Alianza Norte #100, Parque PIIT, Apodaca, 66629, Mexico; 3D Factory, Ramón Treviño 1109, Monterrey, Mexico.
| |
Collapse
|
11
|
Ahmed K, Blunn GW. A scoring system to evaluate stability of percutaneous osseointegrated implants for transfemoral amputation with validation in the ITAP clinical trial. Proc Inst Mech Eng H 2024; 238:412-422. [PMID: 38415608 DOI: 10.1177/09544119241231890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Percutaneous osseointegrated implants for individuals with lower limb amputation can increase mobility, reduce socket related pain, and improve quality of life. It would be useful to have an evaluation method to assess the interface between bone and implant. We assessed outpatient radiographs from the Intraosseous Transcutaneous Amputation Prosthesis clinical trial using an interface scoring system which summed and weighted equally measures of implant collar cortical ongrowth and radiolucency along the implant stem/bone interface. Radiographs from 12 participants with unilateral transfemoral amputations (10 males, 2 females, mean age = 43.2, SD = 7.4 years) in the clinical trial from cohort I (implanted in 2008/09) or cohort II (implanted in 2013/14) were collated (mean image span = 7.2, SD = 2.4 years), scale normalised, zoned, and measured in a repeatable way. Interface scores were calculated and then compared to clinical outcomes. Explanted participants received the lowest interface scores. A higher ratio of stem to residuum and shorter residuum's produced better interface scores and there was an association (weak correlation) between participants with thin cortices and the lowest interface scores. A tapered, cemented, non curved stem may provide advantageous fixation while stem alignment did not appear critical. In summary, the interface score successfully demonstrated a non-invasive evaluation of percutaneous osseointegrated implants interfaces when applied to the Intraosseous Transcutaneous Amputation Prosthesis clinical trial. The clinical significance of this work is to identify events leading to aseptic or septic implant removal and contribute to clinical guidelines for monitoring rehabilitation, design and surgical fixation choices.
Collapse
Affiliation(s)
- Kirstin Ahmed
- Center for Bionics and Pain Research, Mölndal, Sweden
- Division of Surgery and Interventional Science, University College London, Stanmore, UK
| | - Gordon William Blunn
- Division of Surgery and Interventional Science, University College London, Stanmore, UK
- School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, UK
| |
Collapse
|
12
|
Serino G, Distefano F, Zanetti EM, Pascoletti G, Epasto G. Multiscale Mechanical Characterization of Polyether-2-ketone (PEKK) for Biomedical Application. Bioengineering (Basel) 2024; 11:244. [PMID: 38534517 DOI: 10.3390/bioengineering11030244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/01/2024] [Accepted: 02/23/2024] [Indexed: 03/28/2024] Open
Abstract
Polyether-ether-2-ketone (PEKK) is a high-performance thermoplastic polymer used in various fields, from aerospace to medical applications, due to its exceptional mechanical and thermal properties. Nonetheless, the mechanical behavior of 3D-printed PEKK still deserves to be more thoroughly investigated, especially in view of its production by 3D printing, where mechanical properties measured at different scales are likely to be correlated to one another and to all play a major role in determining biomechanical properties, which include mechanical strength on one side and osteointegration ability on the other side. This work explores the mechanical behavior of 3D-printed PEKK through a multiscale approach, having performed both nanoindentation tests and standard tensile and compression tests, where a detailed view of strain distribution was achieved through Digital Image Correlation (DIC) techniques. Furthermore, for specimens tested up to failure, their fractured surfaces were analyzed through Scanning Electron Microscopy (SEM) to clearly outline fracture modes. Additionally, the internal structure of 3D-printed PEKK was explored through Computed Tomography (CT) imaging, providing a three-dimensional view of the internal structure and the presence of voids and other imperfections. Finally, surface morphology was analyzed through confocal microscopy. The multiscale approach adopted in the present work offers information about the global and local behavior of the PEKK, also assessing its material properties down to the nanoscale. Due to its novelty as a polymeric material, no previous studies have approached a multiscale analysis of 3D-printed PEKK. The findings of this study contribute to a comprehensive understanding of 3D-printed PEKK along with criteria for process optimization in order to customize its properties to meet specific application requirements. This research not only advances the knowledge of PEKK as a 3D-printing material but also provides insights into the multifaceted nature of multiscale material characterization.
Collapse
Affiliation(s)
- Gianpaolo Serino
- Department of Mechanical and Aerospace Engineering (DIMEAS), Politecnico di Torino, 10129 Turin, Italy
- PolitoBIOMed Laboratory, Politecnico di Torino, 10129 Torino, Italy
| | - Fabio Distefano
- Department of Engineering, University of Messina, Contrada Di Dio, 98166 Messina, Italy
| | | | - Giulia Pascoletti
- Department of Engineering, University of Perugia, 06125 Perugia, Italy
| | - Gabriella Epasto
- Department of Engineering, University of Messina, Contrada Di Dio, 98166 Messina, Italy
| |
Collapse
|
13
|
Melo-Fonseca F, Gasik M, Cruz A, Moreira D, S. Silva F, Miranda G, Mendes Pinto I. Engineering a Hybrid Ti6Al4V-Based System for Responsive and Consistent Osteogenesis. ACS OMEGA 2024; 9:8985-8994. [PMID: 38434873 PMCID: PMC10905591 DOI: 10.1021/acsomega.3c07232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/17/2023] [Accepted: 01/05/2024] [Indexed: 03/05/2024]
Abstract
As the aging population increases worldwide, the incidence of musculoskeletal diseases and the need for orthopedic implants also arise. One of the most desirable goals in orthopedic reconstructive therapies is de novo bone formation. Yet, reproducible, long-lasting, and cost-effective strategies for implants that strongly induce osteogenesis are still in need. Nanoengineered titanium substrates (and their alloys) are among the most used materials in orthopedic implants. Although having high biocompatibility, titanium alloys hold a low bioactivity profile. The osteogenic capacity and osseointegration of Ti-based implantable systems are limited, as they critically depend on the body-substrate interactions defined by blood proteins adsorbed into implant surfaces that ultimately lead to the recruitment, proliferation, and differentiation of mesenchymal stem cells (MSCs) to comply bone formation and regeneration. In this work, a hybrid Ti6Al4V system combining micro- and nanoscale modifications induced by hydrothermal treatment followed by functionalization with a bioactive compound (fibronectin derived from human plasma) is proposed, aiming for bioactivity improvement. An evaluation of the biological activity and cellular responses in vitro with respect to bone regeneration indicated that the integration of morphological and chemical modifications into Ti6Al4V surfaces induces the osteogenic differentiation of MSCs to improve bone regeneration by an enhancement of mineral matrix formation that accelerates the osseointegration process. Overall, this hybrid system has numerous competitive advantages over more complex treatments, including reproducibility, low production cost, and potential for improved long-term maintenance of the implant.
Collapse
Affiliation(s)
- Francisca Melo-Fonseca
- Center
for MicroElectroMechanical Systems (CMEMS-UMinho), University of Minho, Guimarães 4800-058, Portugal
- LABBELS—Associate
Laboratory, Braga, Guimarães 4710-057, Portugal
- International
Iberian Nanotechnology Laboratory (INL), Braga 4715-330, Portugal
| | - Michael Gasik
- School
of Chemical Engineering, Aalto University
Foundation, Espoo 00076, Finland
| | - Andrea Cruz
- International
Iberian Nanotechnology Laboratory (INL), Braga 4715-330, Portugal
| | - Daniel Moreira
- Institute
for Research and Innovation in Health (i3S), Porto 4200-135, Portugal
| | - Filipe S. Silva
- Center
for MicroElectroMechanical Systems (CMEMS-UMinho), University of Minho, Guimarães 4800-058, Portugal
- LABBELS—Associate
Laboratory, Braga, Guimarães 4710-057, Portugal
| | - Georgina Miranda
- CICECO, Aveiro
Institute of Materials, Department of Materials and Ceramic Engineering, University of Aveiro, Aveiro 3810-193, Portugal
| | - Inês Mendes Pinto
- International
Iberian Nanotechnology Laboratory (INL), Braga 4715-330, Portugal
- Institute
for Research and Innovation in Health (i3S), Porto 4200-135, Portugal
| |
Collapse
|
14
|
Sass JO, Sellin ML, Kauertz E, Johannsen J, Weinmann M, Stenzel M, Frank M, Vogel D, Bader R, Jonitz-Heincke A. Advanced Ti-Nb-Ta Alloys for Bone Implants with Improved Functionality. J Funct Biomater 2024; 15:46. [PMID: 38391899 PMCID: PMC10889793 DOI: 10.3390/jfb15020046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/08/2024] [Accepted: 02/15/2024] [Indexed: 02/24/2024] Open
Abstract
The additive manufacturing of titanium-niobium-tantalum alloys with nominal chemical compositions Ti-xNb-6Ta (x = 20, 27, 35) by means of laser beam powder bed fusion is reported, and their potential as implant materials is elaborated by mechanical and biological characterization. The properties of dense specimens manufactured in different build orientations and of open porous Ti-20Nb-6Ta specimens are evaluated. Compression tests indicate that strength and elasticity are influenced by the chemical composition and build orientation. The minimum elasticity is always observed in the 90° orientation. It is lowest for Ti-20Nb-6Ta (43.2 ± 2.7 GPa) and can be further reduced to 8.1 ± 1.0 GPa for open porous specimens (p < 0.001). Furthermore, human osteoblasts are cultivated for 7 and 14 days on as-printed specimens and their biological response is compared to that of Ti-6Al-4V. Build orientation and cultivation time significantly affect the gene expression profile of osteogenic differentiation markers. Incomplete cell spreading is observed in specimens manufactured in 0° build orientation, whereas widely stretched cells are observed in 90° build orientation, i.e., parallel to the build direction. Compared to Ti-6Al-4V, Ti-Nb-Ta specimens promote improved osteogenesis and reduce the induction of inflammation. Accordingly, Ti-xNb-6Ta alloys have favorable mechanical and biological properties with great potential for application in orthopedic implants.
Collapse
Affiliation(s)
- Jan-Oliver Sass
- Research Laboratory for Biomechanics and Implant Technology, Department of Orthopaedics, Rostock University Medical Center, Doberaner Straße 142, 18057 Rostock, Germany
| | - Marie-Luise Sellin
- Research Laboratory for Biomechanics and Implant Technology, Department of Orthopaedics, Rostock University Medical Center, Doberaner Straße 142, 18057 Rostock, Germany
| | - Elisa Kauertz
- Research Laboratory for Biomechanics and Implant Technology, Department of Orthopaedics, Rostock University Medical Center, Doberaner Straße 142, 18057 Rostock, Germany
| | - Jan Johannsen
- Fraunhofer Research Institution for Additive Manufacturing Technologies IAPT, Am Schleusengraben 14, 21029 Hamburg, Germany
| | | | | | - Marcus Frank
- Medical Biology and Electron Microscopy Center, Rostock University Medical Center, Strempelstraße 14, 18057 Rostock, Germany
- Department Life, Light and Matter, University of Rostock, 18051 Rostock, Germany
| | - Danny Vogel
- Research Laboratory for Biomechanics and Implant Technology, Department of Orthopaedics, Rostock University Medical Center, Doberaner Straße 142, 18057 Rostock, Germany
| | - Rainer Bader
- Research Laboratory for Biomechanics and Implant Technology, Department of Orthopaedics, Rostock University Medical Center, Doberaner Straße 142, 18057 Rostock, Germany
- Department Life, Light and Matter, University of Rostock, 18051 Rostock, Germany
| | - Anika Jonitz-Heincke
- Research Laboratory for Biomechanics and Implant Technology, Department of Orthopaedics, Rostock University Medical Center, Doberaner Straße 142, 18057 Rostock, Germany
| |
Collapse
|
15
|
Johnson JE, Clarke GA, de Cesar Netto C, Anderson DD. Influence of sidewall retention and interference fit in total ankle replacement on implant-bone micromotion: A finite element study. J Orthop Res 2024. [PMID: 38327023 DOI: 10.1002/jor.25796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 12/19/2023] [Accepted: 01/19/2024] [Indexed: 02/09/2024]
Abstract
The success of uncemented total ankle replacement (TAR) is linked to initial stability because bony ingrowth depends upon limited early micromotion. Tibial implant design fixation features resist micromotion aided by bony sidewall retention and interference fit. Our goal was to investigate factors influencing implant-bone micromotion in TAR. Two TAR tibial components were virtually inserted into CT-derived computer models of two distal tibias from patients with end-stage ankle arthritis. Density-based inhomogeneous material assignment was used to model bone compaction during press-fit. Finite element analysis (FEA) was used to simulate three fixation cases: (1) no sidewalls + line-to-line fit, (2) sidewalls + line-to-line fit, and (3) sidewalls + 50, 100, or 200 µm interference fit. Kinetic profiles from the stance phase of gait were simulated and micromotions computed from FEA output. Without sidewalls or interference fit, micromotions were largest in early and late stance, with largest micromotions (averaging ~150-250 µm) observed near heel strike. Micromotions decreased 39%-62% when sidewalls were retained. When interference fit was also modeled, micromotions decreased another 37%-61% to ~10 µm. Micromotion differences between patients persisted with sidewall retention but largely disappeared with interference fit. This study presents new insights into the effects of TAR fixation features on implant-bone micromotion. Stability appeared to be influenced by surrounding bone quality, but this influence was greatly diminished when interference fit was introduced. More complete understanding of TAR implant features and performance is needed, but our results show the importance of bone quality and interference fit in the stability of uncemented TAR.
Collapse
Affiliation(s)
- Joshua E Johnson
- Department of Orthopedics and Rehabilitation, The University of Iowa, Iowa City, Iowa, USA
| | - Gabriel A Clarke
- Department of Orthopedics and Rehabilitation, The University of Iowa, Iowa City, Iowa, USA
- Department of Biomedical Engineering, The University of Iowa, Iowa City, Iowa, USA
| | - Cesar de Cesar Netto
- Department of Orthopedics and Rehabilitation, The University of Iowa, Iowa City, Iowa, USA
| | - Donald D Anderson
- Department of Orthopedics and Rehabilitation, The University of Iowa, Iowa City, Iowa, USA
- Department of Biomedical Engineering, The University of Iowa, Iowa City, Iowa, USA
| |
Collapse
|
16
|
Furko M, Detsch R, Horváth ZE, Balázsi K, Boccaccini AR, Balázsi C. Amorphous, Carbonated Calcium Phosphate and Biopolymer-Composite-Coated Si 3N 4/MWCNTs as Potential Novel Implant Materials. NANOMATERIALS (BASEL, SWITZERLAND) 2024; 14:279. [PMID: 38334550 PMCID: PMC10856846 DOI: 10.3390/nano14030279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 01/24/2024] [Accepted: 01/27/2024] [Indexed: 02/10/2024]
Abstract
A biodegradable amorphous carbonated calcium phosphate (caCP)-incorporated polycaprolactone (PCL) composite layer was successfully deposited by a spin coater. In this specific coating, the PCL acts as a bioadhesive, since it provides a better adherence of the coatings to the substrate compared to powder coatings. The caCP-PCL coatings were deposited and formed thin layers on the surface of a Si3N4-3 wt% MWCNT (multiwalled carbon nanotube) substrate, which is an emerging type of implant material in the biomedical field. The composite coatings were examined regarding their morphology, structure and biological performance. The biocompatibility of the samples was tested in vitro with MC3T3-E1 preosteoblast cells. Owing to the caCP-PCL thin layer, the cell viability values were considerably increased compared to the substrate material. The ALP and LDH tests showed numerous living cells on the investrigated coatings. The morphology of the MC3T3-E1 cells was examined by fluorescent staining (calcein and DAPI) and scanning electron microscopy, both of which revealed a well-spread, adhered and confluent monolayer of cells. All performed biocompatibility tests were positive and indicated the applicability of the deposited thin composite layers as possible candidates for orthopaedic implants for an extended period.
Collapse
Affiliation(s)
- Monika Furko
- Centre for Energy Research, HUN-REN, 1121, Konkoly-Thege Road 29-33, 1121 Budapest, Hungary; (Z.E.H.); (K.B.)
| | - Rainer Detsch
- Institute of Biomaterials, Department of Materials Science and Engineering, University of Erlangen-Nuremberg, Cauer Str. 6, 91058 Erlangen, Germany; (R.D.); (A.R.B.)
| | - Zsolt E. Horváth
- Centre for Energy Research, HUN-REN, 1121, Konkoly-Thege Road 29-33, 1121 Budapest, Hungary; (Z.E.H.); (K.B.)
| | - Katalin Balázsi
- Centre for Energy Research, HUN-REN, 1121, Konkoly-Thege Road 29-33, 1121 Budapest, Hungary; (Z.E.H.); (K.B.)
| | - Aldo R. Boccaccini
- Institute of Biomaterials, Department of Materials Science and Engineering, University of Erlangen-Nuremberg, Cauer Str. 6, 91058 Erlangen, Germany; (R.D.); (A.R.B.)
| | - Csaba Balázsi
- Centre for Energy Research, HUN-REN, 1121, Konkoly-Thege Road 29-33, 1121 Budapest, Hungary; (Z.E.H.); (K.B.)
| |
Collapse
|
17
|
Yang X, Wu L, Li C, Li S, Hou W, Hao Y, Lu Y, Li L. Synergistic Amelioration of Osseointegration and Osteoimmunomodulation with a Microarc Oxidation-Treated Three-Dimensionally Printed Ti-24Nb-4Zr-8Sn Scaffold via Surface Activity and Low Elastic Modulus. ACS APPLIED MATERIALS & INTERFACES 2024; 16:3171-3186. [PMID: 38205810 DOI: 10.1021/acsami.3c16459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
Biomaterial scaffolds, including bone substitutes, have evolved from being primarily a biologically passive structural element to one in which material properties such as surface topography and chemistry actively direct bone regeneration by influencing stem cells and the immune microenvironment. Ti-6Al-4V(Ti6Al4V) implants, with a significantly higher elastic modulus than human bone, may lead to stress shielding, necessitating improved stability at the bone-titanium alloy implant interface. Ti-24Nb-4Zr-8Sn (Ti2448), a low elastic modulus β-type titanium alloy devoid of potentially toxic elements, was utilized in this study. We employed 3D printing technology to fabricate a porous scaffold structure to further decrease the structural stiffness of the implant to approximate that of cancellous bone. Microarc oxidation (MAO) surface modification technology is then employed to create a microporous structure and a hydrophilic oxide ceramic layer on the surface and interior of the scaffold. In vitro studies demonstrated that MAO treatment enhances the proliferation, adhesion, and osteogenesis capabilities on the scaffold surface. The chemical composition of the MAO-Ti2448 oxide layer is found to enhance the transcription and expression of osteogenic genes in bone mesenchymal stem cells (BMSCs), potentially related to the enrichment of Nb2O5 and SnO2 in the oxide layer. The MAO-Ti2448 scaffold, with its synergistic surface activity and low stiffness, significantly activates the anti-inflammatory macrophage phenotype, creating an immune microenvironment that promotes the osteogenic differentiation of BMSCs. In vivo experiments in a rabbit model demonstrated a significant improvement in the quantity and quality of the newly formed bone trabeculae within the scaffold under the contact osteogenesis pattern with a matched elastic modulus. These trabeculae exhibit robust connections to the external structure of the scaffold, accelerating the formation of an interlocking structure between the bone and implant and providing higher implantation stability. These findings suggest that the MAO-Ti2448 scaffold has significant potential as a bone defect repair material by regulating osteoimmunomodulation and osteogenesis to enhance osseointegration. This study demonstrates an optional strategy that combines the mechanism of reducing the elastic modulus with surface modification treatment, thereby extending the application scope of β-type titanium alloy.
Collapse
Affiliation(s)
- Xinyue Yang
- Department of Orthopaedic Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110055, P.R. China
| | - Lijun Wu
- Engineering Research Center of High Entropy Alloy Materials (Liaoning Province), School of Materials Science and Engineering, Dalian University of Technology, Dalian 116024, P.R. China
| | - Cheng Li
- Department of Orthopaedic Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110055, P.R. China
| | - Shujun Li
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, P.R. China
| | - Wentao Hou
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, P.R. China
| | - Yulin Hao
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, P.R. China
| | - Yiping Lu
- Engineering Research Center of High Entropy Alloy Materials (Liaoning Province), School of Materials Science and Engineering, Dalian University of Technology, Dalian 116024, P.R. China
| | - Lei Li
- Department of Orthopaedic Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110055, P.R. China
| |
Collapse
|
18
|
Młynarek-Żak K, Żmudzki J. The effect of porous compliance bushings in a dental implant on the distribution of occlusal loads. Sci Rep 2024; 14:1607. [PMID: 38238380 PMCID: PMC10796672 DOI: 10.1038/s41598-024-51429-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 04/02/2023] [Indexed: 01/22/2024] Open
Abstract
Porous dental implants are clinically used, but the mechanism of load distribution for stepped implant shaft surrounded by compliance bushings is still not known, especially for different bone conditions. The aim of the study was to assess the impact of the design of a dental implant with compliance bushings (CBs) on the occlusal load distribution during primary and secondary stability using finite element simulation (FEA), with a distinction between low and high quality cervical support under primary stability. The FEA of the oblique occlusal load transfer (250 N; 45°) was carried out for implants under variable bone conditions. The stepped shaft in the intermediate part of the dental implant was surrounded by CBs with an increasing modulus of elasticity of 2, 10 and 50 GPa. With a smaller Young's modulus of the bushings the increase of stress in the trabecular bone indicated that more bone tissue can be protected against disuse. The beneficial effect for the trabecular bone derived from the reduction of the stiffness of the bushings in relation to the loss of the implant's load bearing ability can be assessed using the FEM method.
Collapse
Affiliation(s)
- Katarzyna Młynarek-Żak
- Department of Engineering Processes Automation and Integrated Manufacturing Systems, Silesian University of Technology, Konarskiego 18a St., 44-100, Gliwice, Poland
| | - Jarosław Żmudzki
- Department of Engineering Materials and Biomaterials, Silesian University of Technology, Konarskiego 18a St., 44-100, Gliwice, Poland.
| |
Collapse
|
19
|
Makurat-Kasprolewicz B, Ossowska A. Electrophoretically deposited titanium and its alloys in biomedical engineering: Recent progress and remaining challenges. J Biomed Mater Res B Appl Biomater 2024; 112:e35342. [PMID: 37905698 DOI: 10.1002/jbm.b.35342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 08/23/2023] [Accepted: 10/14/2023] [Indexed: 11/02/2023]
Abstract
Over the past decade, titanium implants have gained popularity as the number of performed implantation operations has significantly increased. There are a number of methods for modifying the surface of biomaterials, which are aimed at extending the life of titanium implants. The developments in this field in recent years have required a comprehensive discussion of all the properties of electrophoretically deposited coatings on titanium and its alloys, taking into account their bioactivity. The development that took place in this field in recent years required a comprehensive discussion of all the properties of coatings electrophoretically deposited on titanium and its alloys, with particular emphasis on their bioactivity. Herein, we attempt to assess the influence of the electrophoretic deposition (EPD) process parameters on these coatings' biological and mechanical properties. Particular attention has been addressed to the in-vitro and in-vivo studies conducted hitherto. We have seen an increased interest in using titanium alloys without the addition of toxic compounds and gaps in the EPD field such as the uncommon endeavors to develop a "Design of experiments" approach as well as the lack of assessment of the surface free energy and detailed topography of electrophoretically deposited coatings. The exact correlation of coating properties with EPD process parameters still seems explicitly not understood, necessitating more future investigations. Ipso facto, the exact mechanism of particle agglomeration and Hamaker's law need to be fathomable.
Collapse
Affiliation(s)
| | - Agnieszka Ossowska
- Faculty of Mechanical Engineering and Ship Technology, Gdansk University of Technology, Gdańsk, Poland
| |
Collapse
|
20
|
Iezzi G, Zavan B, Petrini M, Ferroni L, Pierfelice TV, D'Amora U, Ronca A, D'Amico E, Mangano C. 3D printed dental implants with a porous structure: The in vitro response of osteoblasts, fibroblasts, mesenchymal stem cells, and monocytes. J Dent 2024; 140:104778. [PMID: 37951493 DOI: 10.1016/j.jdent.2023.104778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/14/2023] Open
Abstract
AIMS The first aim of this study was to characterize the surface topography of a novel 3D-printed dental implant at the micro- and macro-level. Its second aim was to evaluate the osteogenic, angiogenic, and immunogenic responses of human oral osteoblasts (hOBs), gingival fibroblasts (hGFs), mesenchymal stem cells (hAD-MSCs), and monocytes to this novel implant surface. METHODS A 3D-printed Ti-6Al-4 V implant was produced by selective laser melting and subjected to organic acid etching (TEST). It was then compared to a machined surface (CTRL). Its biological properties were evaluated via cell proliferation assays, morphological observations, gene expression analyses, mineralization assessments, and collagen quantifications. RESULTS Scanning electron microscopy analysis showed that the TEST group was characterized by a highly interconnected porous architecture and a roughed surface. The morphological observations showed good adhesion of cells cultured on the TEST surface, with a significant increase in hOB growth. Similarly, the gene expression analysis showed significantly higher levels of osseointegration biomarkers. Picrosirius staining showed a slight increase in collagen production in the TEST group compared to the CTRL group. hAD-MSCs showed an increase in endothelial and osteogenic commitment-related markers. Monocytes showed increased mRNA synthesis related to the M2 (anti-inflammatory) macrophagic phenotype. CONCLUSIONS Considering the higher interaction with hOBs, hGFs, hAD-MSCs, and monocytes, the prepared 3D-printed implant could be used for future clinical applications. CLINICAL RELEVANCE This study demonstrated the excellent biological response of various cells to the porous surface of the novel 3D-printed implant.
Collapse
Affiliation(s)
- Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" Chieti-Pescara, Via dei Vestini, 31, Chieti 66100, Italy
| | - Barbara Zavan
- Translational Medicine Department, University of Ferrara, Ferrara 44121, Italy
| | - Morena Petrini
- Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" Chieti-Pescara, Via dei Vestini, 31, Chieti 66100, Italy
| | - Letizia Ferroni
- Maria Cecilia Hospital, GVM Care & Research, Cotignola, Ravenna 48033, Italy
| | - Tania Vanessa Pierfelice
- Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" Chieti-Pescara, Via dei Vestini, 31, Chieti 66100, Italy
| | - Ugo D'Amora
- Institute of Polymers, Composites and Biomaterials National Research Council (IPCB-CNR), Naples 80125, Italy
| | - Alfredo Ronca
- Institute of Polymers, Composites and Biomaterials National Research Council (IPCB-CNR), Naples 80125, Italy
| | - Emira D'Amico
- Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" Chieti-Pescara, Via dei Vestini, 31, Chieti 66100, Italy.
| | | |
Collapse
|
21
|
Kolomenskaya E, Butova V, Poltavskiy A, Soldatov A, Butakova M. Application of Artificial Intelligence at All Stages of Bone Tissue Engineering. Biomedicines 2023; 12:76. [PMID: 38255183 PMCID: PMC10813365 DOI: 10.3390/biomedicines12010076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 12/23/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024] Open
Abstract
The development of artificial intelligence (AI) has revolutionized medical care in recent years and plays a vital role in a number of areas, such as diagnostics and forecasting. In this review, we discuss the most promising areas of AI application to the field of bone tissue engineering and prosthetics, which can drastically benefit from AI-assisted optimization and patient personalization of implants and scaffolds in ways ranging from visualization and real-time monitoring to the implantation cases prediction, thereby leveraging the compromise between specific architecture decisions, material choice, and synthesis procedure. With the emphasized crucial role of accuracy and robustness of developed AI algorithms, especially in bone tissue engineering, it was shown that rigorous validation and testing, demanding large datasets and extensive clinical trials, are essential, and we discuss how through developing multidisciplinary cooperation among biology, chemistry with materials science, and AI, these challenges can be addressed.
Collapse
Affiliation(s)
- Ekaterina Kolomenskaya
- The Smart Materials Research Institute, Southern Federal University, 178/24 Sladkova, 344090 Rostov-on-Don, Russia; (V.B.); (A.P.); (A.S.); (M.B.)
| | - Vera Butova
- The Smart Materials Research Institute, Southern Federal University, 178/24 Sladkova, 344090 Rostov-on-Don, Russia; (V.B.); (A.P.); (A.S.); (M.B.)
- Institute of General and Inorganic Chemistry, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria
| | - Artem Poltavskiy
- The Smart Materials Research Institute, Southern Federal University, 178/24 Sladkova, 344090 Rostov-on-Don, Russia; (V.B.); (A.P.); (A.S.); (M.B.)
| | - Alexander Soldatov
- The Smart Materials Research Institute, Southern Federal University, 178/24 Sladkova, 344090 Rostov-on-Don, Russia; (V.B.); (A.P.); (A.S.); (M.B.)
| | - Maria Butakova
- The Smart Materials Research Institute, Southern Federal University, 178/24 Sladkova, 344090 Rostov-on-Don, Russia; (V.B.); (A.P.); (A.S.); (M.B.)
| |
Collapse
|
22
|
Zhong S, Shi Q, Van Dessel J, Gu Y, Lübbers HT, Yang S, Sun Y, Politis C. Biomechanical feasibility of non-locking system in patient-specific mandibular reconstruction using fibular free flaps. J Mech Behav Biomed Mater 2023; 148:106197. [PMID: 37875041 DOI: 10.1016/j.jmbbm.2023.106197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/12/2023] [Accepted: 10/16/2023] [Indexed: 10/26/2023]
Abstract
Mandibular reconstruction with free fibular flaps is frequently used to restore segmental defects. The osteosythesis, including locking and non-locking plate/screw systems, is essential to the mandibular reconstruction. Compared with the non-locking system that requires good adaption between plate and bone, the locking system appears to present a better performance by locking the plate to fixation screws. However, it also brings about limitations on screw options, a higher risk of screw failure, and difficulties in screw placement. Furthermore, its superiority is undermined by the advancing of patient-specific implant design and additive manufacturing. A customized plate can be designed and fabricated to accurately match the mandibular contour for patient-specific mandibular reconstruction. Consequently, the non-locking system seems more practicable with such personalized plates, and its biomechanical feasibility ought to be estimated. Finite element analyses of mandibular reconstruction assemblies were conducted for four most common segmental mandibular reconstructions regarding locking and non-locking systems under incisal biting and right molars clenching, during which the influencing factor of muscles' capacity was introduced to simulate the practical loadings after mandibular resection and reconstruction surgeries. Much higher, somewhat lower, and similar maximum von Mises stresses are separately manifested by the patient-specific mandibular reconstruction plate (PSMRP), fixation screws, and reconstructed mandible with the non-locking system than those with the locking system. Equivalent maximum displacements are identified between PSMRPs, fixation screws, and reconstructed mandibles with the non-locking and locking system in all four reconstruction types during two masticatory tasks. Parallel maximum and minimum principal strain distributions are shared by the reconstructed mandibles with the non-locking and locking system in four mandibular reconstructions during both occlusions. Conclusively, it is feasible to use the non-locking system in case of patient-specific mandibular reconstruction with fibular free flaps based on the adequate safety, comparable stability, and analogous mechanobiology it presents compared with the locking system in a more manufacturable and economical way.
Collapse
Affiliation(s)
- Shengping Zhong
- Department of Imaging & Pathology, Biomedical Sciences Group, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Qimin Shi
- Department of Imaging & Pathology, Biomedical Sciences Group, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium; Yantai Research Institute, Harbin Engineering University, Qingdao Avenue 1, 264000, Yantai, PR China
| | - Jeroen Van Dessel
- Department of Imaging & Pathology, Biomedical Sciences Group, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Yifei Gu
- Department of Imaging & Pathology, Biomedical Sciences Group, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium; Department of Dentistry, Dushu Lake Hospital Affiliated to Soochow University, Chongwen Road 9, 215000, Suzhou, PR China
| | - Heinz-Theo Lübbers
- Clinic for Cranio-Maxillofacial Surgery, University Hospital of Zurich, Frauenklinikstrasse 24, Zurich, CH-8091, Switzerland
| | - Shoufeng Yang
- Yantai Research Institute, Harbin Engineering University, Qingdao Avenue 1, 264000, Yantai, PR China.
| | - Yi Sun
- Department of Imaging & Pathology, Biomedical Sciences Group, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.
| | - Constantinus Politis
- Department of Imaging & Pathology, Biomedical Sciences Group, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| |
Collapse
|
23
|
Larrañaga X, Sarasua JR, Zuza E. Role of Inorganic Fillers on the Physical Aging and Toughness Loss of PLLA/BaSO 4 Composites. ACS APPLIED POLYMER MATERIALS 2023; 5:9620-9631. [PMID: 38021210 PMCID: PMC10653123 DOI: 10.1021/acsapm.3c02112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023]
Abstract
The addition of inorganic fillers has been reported to increase the toughness of poly(l-lactide) (PLLA), but the effect of physical aging in such composites has been neglected. The present work discusses the effect of the still ongoing segmental relaxation in PLLA-based composites filled with BaSO4 inorganic particles in regard of the filler quantity. By means of differential scanning calorimetry, X-ray diffraction, and tensile testing of progressively aged PLLA filled with particles ranging from 0.5-10 wt %, we observed an increase in the mechanical energy required to activate the plastic flow of the primary structure in the PLLA matrix, which resulted in the embrittlement of the majority of composites upon enough aging. Results further clarify the role of debonding in the activation process of PLLA, and the behavior of the composite is described at the segmental level. Only an addition of 10% of particles has effectively preserved a ductile behavior of the samples beyond 150 aging days; therefore, we strongly remark the significance of studying the effect of physical aging in such composites.
Collapse
Affiliation(s)
- Xabier Larrañaga
- Department of Mining-Metallurgy
Engineering and Materials Science & POLYMAT, Faculty of Engineering, University
of the Basque Country (UPV/EHU), Alameda de Urquijo s/n, Bilbao 48013, Spain
| | - Jose R. Sarasua
- Department of Mining-Metallurgy
Engineering and Materials Science & POLYMAT, Faculty of Engineering, University
of the Basque Country (UPV/EHU), Alameda de Urquijo s/n, Bilbao 48013, Spain
| | - Ester Zuza
- Department of Mining-Metallurgy
Engineering and Materials Science & POLYMAT, Faculty of Engineering, University
of the Basque Country (UPV/EHU), Alameda de Urquijo s/n, Bilbao 48013, Spain
| |
Collapse
|
24
|
Rojas-Rojas L, Tozzi G, Guillén-Girón T. A Comprehensive Mechanical Characterization of Subject-Specific 3D Printed Scaffolds Mimicking Trabecular Bone Architecture Biomechanics. Life (Basel) 2023; 13:2141. [PMID: 38004281 PMCID: PMC10672154 DOI: 10.3390/life13112141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/25/2023] [Accepted: 10/28/2023] [Indexed: 11/26/2023] Open
Abstract
This study presents a polymeric scaffold designed and manufactured to mimic the structure and mechanical compressive characteristics of trabecular bone. The morphological parameters and mechanical behavior of the scaffold were studied and compared with trabecular bone from bovine iliac crest. Its mechanical properties, such as modulus of elasticity and yield strength, were studied under a three-step monotonic compressive test. Results showed that the elastic modulus of the scaffold was 329 MPa, and the one for trabecular bone reached 336 MPa. A stepwise dynamic compressive test was used to assess the behavior of samples under various loading regimes. With microcomputed tomography (µCT), a three-dimensional reconstruction of the samples was obtained, and their porosity was estimated as 80% for the polymeric scaffold and 88% for trabecular bone. The full-field strain distribution of the samples was measured using in situ µCT mechanics and digital volume correlation (DVC). This provided information on the local microdeformation mechanism of the scaffolds when compared to that of the tissue. The comprehensive results illustrate the potential of the fabricated scaffolds as biomechanical templates for in vitro studies. Furthermore, there is potential for extending this structure and fabrication methodology to incorporate suitable biocompatible materials for both in vitro and in vivo clinical applications.
Collapse
Affiliation(s)
- Laura Rojas-Rojas
- Materials Science and Engineering School, Tecnológico de Costa Rica, Cartago 30109, Costa Rica;
| | - Gianluca Tozzi
- School of Engineering, University of Greenwich, Chatham ME4 4TB, UK;
- School of Mechanical and Design Engineering, University of Portsmouth, Portsmouth PO1 3DJ, UK
| | - Teodolito Guillén-Girón
- Materials Science and Engineering School, Tecnológico de Costa Rica, Cartago 30109, Costa Rica;
| |
Collapse
|
25
|
Wu H, Chen X, Kong L, Liu P. Mechanical and Biological Properties of Titanium and Its Alloys for Oral Implant with Preparation Techniques: A Review. MATERIALS (BASEL, SWITZERLAND) 2023; 16:6860. [PMID: 37959457 PMCID: PMC10649385 DOI: 10.3390/ma16216860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/23/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023]
Abstract
Dental implants have revolutionised restorative dentistry, offering patients a natural-looking and durable solution to replace missing or severely damaged teeth. Titanium and its alloys have emerged as the gold standard among the various materials available due to their exceptional properties. One of the critical advantages of titanium and its alloys is their remarkable biocompatibility which ensures minimal adverse reactions within the human body. Furthermore, they exhibit outstanding corrosion resistance ensuring the longevity of the implant. Their mechanical properties, including hardness, tensile strength, yield strength, and fatigue strength, align perfectly with the demanding requirements of dental implants, guaranteeing the restoration's functionality and durability. This narrative review aims to provide a comprehensive understanding of the manufacturing techniques employed for titanium and its alloy dental implants while shedding light on their intrinsic properties. It also presents crucial proof-of-concept examples, offering tangible evidence of these materials' effectiveness in clinical applications. However, despite their numerous advantages, certain limitations still exist necessitating ongoing research and development efforts. This review will briefly touch upon these restrictions and explore the evolving trends likely to shape the future of titanium and its alloy dental implants.
Collapse
Affiliation(s)
| | | | | | - Ping Liu
- School of Materials and Chemistry, University of Shanghai for Science and Technology, Shanghai 200093, China; (H.W.); (X.C.); (L.K.)
| |
Collapse
|
26
|
Zhang Y, Cheng Z, Liu Z, Shen X, Cai C, Li M, Luo Z. Functionally Tailored Metal-Organic Framework Coatings for Mediating Ti Implant Osseointegration. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2303958. [PMID: 37705110 PMCID: PMC10582459 DOI: 10.1002/advs.202303958] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/24/2023] [Indexed: 09/15/2023]
Abstract
Owing to their mechanical resilience and non-toxicity, titanium implants are widely applied as the major treatment modality for the clinical intervention against bone fractures. However, the intrinsic bioinertness of Ti and its alloys often impedes the effective osseointegration of the implants, leading to severe adverse complications including implant loosening, detachment, and secondary bone damage. Consequently, new Ti implant engineering strategies are urgently needed to improve their osseointegration after implantation. Remarkably, metalorganic frameworks (MOFs) are a class of novel synthetic material consisting of coordinated metal species and organic ligands, which have demonstrated a plethora of favorable properties for modulating the interfacial properties of Ti implants. This review comprehensively summarizes the recent progress in the development of MOF-coated Ti implants and highlights their potential utility for modulating the bio-implant interface to improve implant osseointegration, of which the discussions are outlined according to their physical traits, chemical composition, and drug delivery capacity. A perspective is also provided in this review regarding the current limitations and future opportunities of MOF-coated Ti implants for orthopedic applications. The insights in this review may facilitate the rational design of more advanced Ti implants with enhanced therapeutic performance and safety.
Collapse
Affiliation(s)
- Yuan Zhang
- Joint Disease & Sport Medicine CentreDepartment of OrthopaedicsXinqiao HospitalArmy Medical UniversityChongqing400038China
| | - Zhuo Cheng
- School of Life ScienceChongqing UniversityChongqing400044China
| | - Zaiyang Liu
- Joint Disease & Sport Medicine CentreDepartment of OrthopaedicsXinqiao HospitalArmy Medical UniversityChongqing400038China
| | - Xinkun Shen
- Department of OrthopaedicsRuian People's HospitalThe Third Affiliated Hospital of Wenzhou Medical UniversityWenzhou325016China
| | - Chunyuan Cai
- Department of OrthopaedicsRuian People's HospitalThe Third Affiliated Hospital of Wenzhou Medical UniversityWenzhou325016China
| | - Menghuan Li
- School of Life ScienceChongqing UniversityChongqing400044China
| | - Zhong Luo
- School of Life ScienceChongqing UniversityChongqing400044China
| |
Collapse
|
27
|
Sass JO, Hembus J, Fuhrmann E, Vogel D, Bauer E, Link HD, Bader R. Pre-clinical characterization of a novel flexible surface stem design for total knee replacements. Proc Inst Mech Eng H 2023; 237:1154-1166. [PMID: 37747115 DOI: 10.1177/09544119231197596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Primary stability is crucial for implant osseointegration and the long-term stability of cementless total joint replacements. Biomechanical studies have shown the potential of femoral stems for total knee replacements to reduce micromotions at the bone-implant interface. However, approaches such as focusing on the structural elasticity of the femoral stems are rarely described. Three groups with different femoral stem designs were investigated: group 1: flexible surface stem, group 2: flexible surface stem with open-porous structured lamellas, and group 3: solid stem (reference). The stems were implanted into bone substitute material and dynamically loaded for 1000 cycles. Relative movement and subsidence were measured optically, and axial pull-out forces were determined after dynamic testing. Relative movements increased to 0.10 mm (groups 1 and 2) compared to 0.03 mm (group 3). Subsidence increased to 0.08 mm (group 1) and 0.11 mm (group 2) compared to 0.06 mm (group 3). For each group, subsidence mainly occurred during the first 500 cycles. A similar convergence was observed in the further course. Pull-out forces increased to 1815.0 N (group 1) and 1347.1 N (group 2) compared to 1306.4 N (group 3). The flexible surface stem design resulted in higher relative movements and subsidence, but also exhibited increased pull-out forces. The relative movements were below the critical limit of 0.15 mm and represent a superposition of the elastic deformations of the interacting implant components as well as the micromotion at the bone-implant interface. Therefore, the novel flexible surface stem design appears to offer promising primary implant fixation.
Collapse
Affiliation(s)
- Jan-Oliver Sass
- Department of Orthopedics, Rostock University Medical Center, Rostock, Mecklenburg-Vorpommern, Germany
| | - Jessica Hembus
- Department of Orthopedics, Rostock University Medical Center, Rostock, Mecklenburg-Vorpommern, Germany
| | - Erik Fuhrmann
- Department of Orthopedics, Rostock University Medical Center, Rostock, Mecklenburg-Vorpommern, Germany
| | - Danny Vogel
- Department of Orthopedics, Rostock University Medical Center, Rostock, Mecklenburg-Vorpommern, Germany
| | | | | | - Rainer Bader
- Department of Orthopedics, Rostock University Medical Center, Rostock, Mecklenburg-Vorpommern, Germany
| |
Collapse
|
28
|
Radwan-Pragłowska J, Janus Ł, Galek T, Szajna E, Sierakowska A, Łysiak K, Tupaj M, Bogdał D. Evaluation of Physiochemical and Biological Properties of Biofunctionalized Mg-Based Implants Obtained via Large-Scale PEO Process for Dentistry Applications. J Funct Biomater 2023; 14:338. [PMID: 37504833 PMCID: PMC10381468 DOI: 10.3390/jfb14070338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 05/23/2023] [Accepted: 06/07/2023] [Indexed: 07/29/2023] Open
Abstract
An increasing number of tooth replacement procedures ending with implant failure generates a great need for the delivery of novel biomedical solutions with appropriate mechanical characteristics that would mimic natural tissue and undergo biodegradation. This phenomenon constitutes a significant difficulty for scientists, since currently applied biomaterials dedicated for this purpose are based on stainless steel, Ti, and Ti and CoCr alloys. One of the most promising raw materials is magnesium, which has been proven to promote bone regeneration and accelerate the tissue healing process. Nevertheless, its high reactivity with body fluid components is associated with fast and difficult-to-control biocorrosion, which strongly limits the application of Mg implants as medical devices. The achievement of appropriate functionality, both physiochemical and biological, to enable the commercial use of Mg biomaterials is possible only after their superficial modification. Therefore, the obtainment of uniform, reproducible coatings increasing resistance to the aqueous environment of the human body combined with a nanostructured surface that enhances implant-cell behaviors is an extremely important issue. Herein, we present a successful strategy for the modification of Mg implants via the PEO process, resulting in the obtainment of biomaterials with lower corrosion rates and superior biological properties, such as the promotion of extracellular matrix formation and a positive impact on the proliferation of MG-63 cells. The implants were investigated regarding their chemical composition using the FT-IR and XRD methods, which revealed that MgO layer formation, as well as the incorporation of electrolyte components such as fluorine and silica, were responsible for the increased microhardness of the samples. An extensive study of the biomaterials' morphology confirmed that successful surface modification led to a microporous structure suitable for the attachment and proliferation of cells. The three-layer nature of the newly-formed coatings, typical for PEO modification, was confirmed via cross-section analysis. A biocorrosion and biodegradation study proved that applied modification increased their resistance to body fluids. The cell culture study performed herein confirmed that the correct adjustment of modification parameters results in a lack of cytotoxicity of the magnesium implants, cell proliferation enhancement, and improvement in extracellular matrix formation.
Collapse
Affiliation(s)
- Julia Radwan-Pragłowska
- Department of Biotechnology and Physical Chemistry, Faculty of Chemical Engineering and Technology, Cracow University of Technology, Warszawska 24 Street, 31-155 Cracow, Poland
| | - Łukasz Janus
- Department of Biotechnology and Physical Chemistry, Faculty of Chemical Engineering and Technology, Cracow University of Technology, Warszawska 24 Street, 31-155 Cracow, Poland
| | - Tomasz Galek
- Faculty of Mechanics and Technology, Rzeszow University of Technology, Kwiatkowskiego 4 Street, 37-450 Stalowa Wola, Poland
| | - Ernest Szajna
- WEA Techlab Sp. z o. o., Perla 10, 41-301 Dabrowa Gornicza, Poland
| | - Aleksandra Sierakowska
- Department of Biotechnology and Physical Chemistry, Faculty of Chemical Engineering and Technology, Cracow University of Technology, Warszawska 24 Street, 31-155 Cracow, Poland
| | - Karol Łysiak
- Faculty of Mechanics and Technology, Rzeszow University of Technology, Kwiatkowskiego 4 Street, 37-450 Stalowa Wola, Poland
| | - Mirosław Tupaj
- Faculty of Mechanics and Technology, Rzeszow University of Technology, Kwiatkowskiego 4 Street, 37-450 Stalowa Wola, Poland
| | - Dariusz Bogdał
- Department of Biotechnology and Physical Chemistry, Faculty of Chemical Engineering and Technology, Cracow University of Technology, Warszawska 24 Street, 31-155 Cracow, Poland
| |
Collapse
|
29
|
Aykanat F, Kose O, Guneri B, Celik HK, Cakar A, Tasatan E, Ulmeanu ME. Comparison of four different screw configurations for the fixation of Fulkerson osteotomy: a finite element analysis. J Orthop Traumatol 2023; 24:30. [PMID: 37358664 DOI: 10.1186/s10195-023-00714-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 06/04/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND Conventionally, two 4.5 mm cortical screws inserted toward the posterior tibial cortex are usually advocated for the fixation of Fulkerson osteotomy. This finite element analysis aimed to compare the biomechanical behavior of four different screw configurations to fix the Fulkerson osteotomy. MATERIALS AND METHODS Fulkerson osteotomy was modeled using computerized tomography (CT) data of a patient with patellofemoral instability and fixed with four different screw configurations using two 4.5 mm cortical screws in the axial plane. The configurations were as follows: (1) two screws perpendicular to the osteotomy plane, (2) two screws perpendicular to the posterior cortex of the tibia, (3) the upper screw perpendicular to the osteotomy plane, but the lower screw is perpendicular to the posterior cortex of the tibia, and (4) the reverse position of the screw configuration in the third scenario. Gap formation, sliding, displacement, frictional stress, and deformation of the components were calculated and reported. RESULTS The osteotomy fragment moved superiorly after loading the models with 1654 N patellar tendon traction force. Since the proximal cut is sloped (bevel-cut osteotomy), the osteotomy fragment slid and rested on the upper tibial surface. Afterward, the upper surface of the osteotomy fragment acted as a fulcrum, and the distal part of the fragment began to separate from the tibia while the screws resisted the displacement. The resultant total displacement was 0.319 mm, 0.307 mm, 0.333 mm, and 0.245 mm from the first scenario to the fourth scenario, respectively. The minimum displacement was detected in the fourth scenario (upper screw perpendicular to the osteotomy plane and lower screw perpendicular to the posterior tibial cortex). Maximum frictional stress and maximum pressure between components on both surfaces were highest in the first scenario (both screws perpendicular to the osteotomy plane). CONCLUSIONS A divergent screw configuration in which the upper screw is inserted perpendicular to the osteotomy plane and the lower screw is inserted perpendicular to the posterior tibial cortex might be a better option for the fixation of Fulkerson osteotomy. Level of evidence Level V, mechanism-based reasoning.
Collapse
Affiliation(s)
- Faruk Aykanat
- Vocational School of Health Services, SANKO University, Gaziantep, Turkey
| | - Ozkan Kose
- Department of Orthopedics and Traumatology, Antalya Training and Research Hospital, Varlık mah., Kazım Karabekir cd., Muratpasa, 07100, Antalya, Turkey.
| | - Bulent Guneri
- Department of Orthopedics and Traumatology, Adana City Education and Research Hospital, Adana, Turkey
| | - H Kursat Celik
- Agricultural Faculty, Department of Agricultural Machinery and Technology Engineering, Akdeniz University, Antalya, Turkey
| | - Albert Cakar
- Department of Orthopedics and Traumatology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Ersin Tasatan
- Department of Orthopedics and Traumatology, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Mihaela-Elena Ulmeanu
- Department of Manufacturing, Polytechnic University of Bucharest, Bucharest, Romania
| |
Collapse
|
30
|
Inchingolo AM, Malcangi G, Ferrante L, Del Vecchio G, Viapiano F, Inchingolo AD, Mancini A, Annicchiarico C, Inchingolo F, Dipalma G, Minetti E, Palermo A, Patano A. Surface Coatings of Dental Implants: A Review. J Funct Biomater 2023; 14:jfb14050287. [PMID: 37233397 DOI: 10.3390/jfb14050287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/17/2023] [Accepted: 05/19/2023] [Indexed: 05/27/2023] Open
Abstract
Replacement of missing teeth is possible using biocompatible devices such as endosseous implants. This study aims to analyze and recognize the best characteristics of different implant surfaces that ensure good peri-implant tissue healing and thus clinical success over time. The present review was performed on the recent literature concerning endosseous implants made of titanium, a material most frequently used because of its mechanical, physical, and chemical characteristics. Thanks to its low bioactivity, titanium exhibits slow osseointegration. Implant surfaces are treated so that cells do not reject the surface as a foreign material and accept it as fully biocompatible. Analysis of different types of implant surface coatings was performed in order to identify ideal surfaces that improve osseointegration, epithelial attachment to the implant site, and overall peri-implant health. This study shows that the implant surface, with different adhesion, proliferation, and spreading capabilities of osteoblastic and epithelial cells, influences the cells involved in anchorage. Implant surfaces must have antibacterial capabilities to prevent peri-implant disease. Research still needs to improve implant material to minimize clinical failure.
Collapse
Affiliation(s)
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Laura Ferrante
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Gaetano Del Vecchio
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Fabio Viapiano
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | | | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Ciro Annicchiarico
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Elio Minetti
- Department of Biomedical, Surgical, and Dental Science, University of Milan, 20122 Milan, Italy
| | - Andrea Palermo
- College of Medicine and Dentistry Birmingham, University of Birmingham, Birmingham B4 6BN, UK
| | - Assunta Patano
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| |
Collapse
|
31
|
Talebian S, Mendes B, Conniot J, Farajikhah S, Dehghani F, Li Z, Bitoque D, Silva G, Naficy S, Conde J, Wallace GG. Biopolymeric Coatings for Local Release of Therapeutics from Biomedical Implants. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2207603. [PMID: 36782094 PMCID: PMC10131825 DOI: 10.1002/advs.202207603] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Indexed: 06/18/2023]
Abstract
The deployment of structures that enable localized release of bioactive molecules can result in more efficacious treatment of disease and better integration of implantable bionic devices. The strategic design of a biopolymeric coating can be used to engineer the optimal release profile depending on the task at hand. As illustrative examples, here advances in delivery of drugs from bone, brain, ocular, and cardiovascular implants are reviewed. These areas are focused to highlight that both hard and soft tissue implants can benefit from controlled localized delivery. The composition of biopolymers used to achieve appropriate delivery to the selected tissue types, and their corresponding outcomes are brought to the fore. To conclude, key factors in designing drug-loaded biopolymeric coatings for biomedical implants are highlighted.
Collapse
Affiliation(s)
- Sepehr Talebian
- School of Chemical and Biomolecular EngineeringThe University of SydneySydneyNSW2006Australia
- Nano Institute (Sydney Nano)The University of SydneySydneyNSW2006Australia
| | - Bárbara Mendes
- ToxOmicsNOVA Medical School|Faculdade de Ciências MédicasNMS|FCMUniversidade Nova de LisboaLisboa1169‐056Portugal
| | - João Conniot
- ToxOmicsNOVA Medical School|Faculdade de Ciências MédicasNMS|FCMUniversidade Nova de LisboaLisboa1169‐056Portugal
| | - Syamak Farajikhah
- School of Chemical and Biomolecular EngineeringThe University of SydneySydneyNSW2006Australia
- Nano Institute (Sydney Nano)The University of SydneySydneyNSW2006Australia
| | - Fariba Dehghani
- School of Chemical and Biomolecular EngineeringThe University of SydneySydneyNSW2006Australia
- Nano Institute (Sydney Nano)The University of SydneySydneyNSW2006Australia
| | - Zhongyan Li
- School of Chemical and Biomolecular EngineeringThe University of SydneySydneyNSW2006Australia
| | - Diogo Bitoque
- ToxOmicsNOVA Medical School|Faculdade de Ciências MédicasNMS|FCMUniversidade Nova de LisboaLisboa1169‐056Portugal
| | - Gabriela Silva
- ToxOmicsNOVA Medical School|Faculdade de Ciências MédicasNMS|FCMUniversidade Nova de LisboaLisboa1169‐056Portugal
| | - Sina Naficy
- School of Chemical and Biomolecular EngineeringThe University of SydneySydneyNSW2006Australia
- Nano Institute (Sydney Nano)The University of SydneySydneyNSW2006Australia
| | - João Conde
- ToxOmicsNOVA Medical School|Faculdade de Ciências MédicasNMS|FCMUniversidade Nova de LisboaLisboa1169‐056Portugal
| | - Gordon G. Wallace
- Intelligent Polymer Research InstituteARC Centre of Excellence for Electromaterials ScienceAIIM FacilityUniversity of WollongongSydneyNSW2522Australia
| |
Collapse
|
32
|
Corbaz J, Barimani B, Vauclair F. Early aseptic loosening of a press-fit radial head prosthesis - A case series of 6 patients. J Int Med Res 2023; 51:3000605221135881. [PMID: 37082909 PMCID: PMC10126620 DOI: 10.1177/03000605221135881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
OBJECTIVE Radial head arthroplasty (RHA) is the principal treatment option for comminuted radial head (RH) fractures. Here, we present six cases of failed RHA using a modular monopolar press-fit RHA that was subsequently withdrawn from the market because it was associated with a high incidence of loosening. METHODS We retrospectively collected data from six patients who had received Radial Head Prothesis SystemTM at our centre between July 2015 and June 2016. The average follow-up was 40 months. RESULTS Aseptic loosening of the stem affected five (83%) of the six RHA. Four of these were symptomatic and RHA removal was performed. For these patients, the pain subsided and their elbow range of motion (ROM) improved. CONCLUSION While the ideal design for an RHA is still debatable, RHA is an efficient treatment option that restores elbow stability and function after a comminuted RH fracture. Importantly, removal of the prosthesis is an effective remedy following RHA associated elbow pain and decreased ROM.
Collapse
Affiliation(s)
- J Corbaz
- Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland
| | - B Barimani
- Department of Orthopaedic Surgery, McGill University, Montreal, Quebec, Canada
| | - F Vauclair
- Bone and Motion Center - Hirslanden, 1006 Lausanne, Switzerland
| |
Collapse
|
33
|
Dhatrak P, Bhadri K, Karnik N, Bora U. A mathematical approach to estimate micro-displacement of a dental implant using electromagnetic Frequency Response Analysis. J Mech Behav Biomed Mater 2023; 140:105735. [PMID: 36801784 DOI: 10.1016/j.jmbbm.2023.105735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023]
Abstract
The aim of this paper is to formulate a mathematical model of dental prosthetic using single degree of freedom (SDOF) to assess the micro-displacement under electromagnetic excitation. Using Finite Element Analysis (FEA) and values from literature, stiffness and damping values of the mathematical model were estimated. For ensuring the successful implantation of dental implant system, monitoring of primary stability in terms of micro-displacement is crucial. One of the most popular techniques for the measurement of stability is the Frequency Response Analysis (FRA). This technique assesses the resonant frequency of vibration corresponding to the maximum micro-displacement (micro-mobility) of the implant. Among the different FRA techniques, the most common method is the Electromagnetic FRA. The subsequent displacement of the implant in the bone is estimated by equations of vibration. A comparison has been made to observe the variation in resonance frequency and micro-displacement due to varying input frequency ranges of 1-40 Hz. The micro-displacement and corresponding resonance frequency were plotted using MATLAB and the variation in resonance frequency is found to be negligible. The present mathematical model is a preliminary approach to understand the variation of micro-displacement with reference to electromagnetic excitation force and to obtain the resonance frequency. The present study validated the use of input frequency ranges (1-30 Hz) with negligible variation in micro-displacement and corresponding resonance frequency. However, input frequency ranges beyond 31-40 Hz is not recommended due to large variation in micromotion and corresponding resonance frequency.
Collapse
Affiliation(s)
- Pankaj Dhatrak
- School of Mechanical Engineering, Dr. Vishwanath Karad, MIT- World Peace University, Pune, India.
| | - Karan Bhadri
- School of Mechanical Engineering, Dr. Vishwanath Karad, MIT- World Peace University, Pune, India
| | - Niharika Karnik
- School of Mechanical Engineering, Dr. Vishwanath Karad, MIT- World Peace University, Pune, India
| | - Urvi Bora
- School of Mechanical Engineering, Dr. Vishwanath Karad, MIT- World Peace University, Pune, India
| |
Collapse
|
34
|
Hériveaux Y, Le Cann S, Immel K, Vennat E, Nguyen VH, Brailovski V, Karasinski P, Sauer RA, Haïat G. Debonding of coin-shaped osseointegrated implants: Coupling of experimental and numerical approaches. J Mech Behav Biomed Mater 2023; 141:105787. [PMID: 36989873 DOI: 10.1016/j.jmbbm.2023.105787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/06/2023] [Accepted: 03/16/2023] [Indexed: 03/19/2023]
Abstract
While cementless implants are now widely used clinically, implant debonding still occur and is difficult to anticipate. Assessing the biomechanical strength of the bone-implant interface can help improving the understanding of osseointegration phenomena and thus preventing surgical failures. A dedicated and standardized implant model was considered. The samples were tested using a mode III cleavage device to assess the mechanical strength of the bone-implant interface by combining experimental and numerical approaches. Four rough (Sa = 24.5 μm) osseointegrated coin-shaped implants were left in sheep cortical bone during 15 weeks of healing time. Each sample was experimentally rotated at 0.03°/sec until complete rupture of the interface. The maximum values of the torque were comprised between 0.48 and 0.72 N m, while a significant increase of the normal force from 7-12 N to 31-43 N was observed during the bone-implant interface debonding, suggesting the generation of bone debris at the bone-implant interface. The experimental results were compared to an isogeometric finite element model describing the adhesion and debonding phenomena through a modified Coulomb's law, based on a varying friction coefficient to represent the transition from an unbroken to a broken bone-implant interface. A good agreement was found between numerical and experimental torques, with numerical friction coefficients decreasing from 8.93 to 1.23 during the bone-implant interface rupture, which constitutes a validation of this model to simulate the debonding of an osseointegrated bone-implant interface subjected to torsion.
Collapse
|
35
|
Application of Single-Cell and Spatial Omics in Musculoskeletal Disorder Research. Int J Mol Sci 2023; 24:ijms24032271. [PMID: 36768592 PMCID: PMC9917071 DOI: 10.3390/ijms24032271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/16/2023] [Accepted: 01/19/2023] [Indexed: 01/26/2023] Open
Abstract
Musculoskeletal disorders, including fractures, scoliosis, heterotopic ossification, osteoporosis, osteoarthritis, disc degeneration, and muscular injury, etc., can occur at any stage of human life. Understanding the occurrence and development mechanism of musculoskeletal disorders, as well as the changes in tissues and cells during therapy, might help us find targeted treatment methods. Single-cell techniques provide excellent tools for studying alterations at the cellular level of disorders. However, the application of these techniques in research on musculoskeletal disorders is still limited. This review summarizes the current single-cell and spatial omics used in musculoskeletal disorders. Cell isolation, experimental methods, and feasible experimental designs for single-cell studies of musculoskeletal system diseases have been reviewed based on tissue characteristics. Then, the paper summarizes the latest findings of single-cell studies in musculoskeletal disorders from three aspects: bone and ossification, joint, and muscle and tendon disorders. Recent discoveries about the cell populations involved in these diseases are highlighted. Furthermore, the therapeutic responses of musculoskeletal disorders, especially single-cell changes after the treatments of implants, stem cell therapies, and drugs are described. Finally, the application potential and future development directions of single-cell and spatial omics in research on musculoskeletal diseases are discussed.
Collapse
|
36
|
Kharin N, Bolshakov P, Kuchumov AG. Numerical and Experimental Study of a Lattice Structure for Orthopedic Applications. MATERIALS (BASEL, SWITZERLAND) 2023; 16:744. [PMID: 36676480 PMCID: PMC9864782 DOI: 10.3390/ma16020744] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/05/2023] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
Prosthetic reconstructions provide anatomical reconstruction to replace bones and joints. However, these operations have a high number of short- and long-term complications. One of the main problems in surgery is that the implant remains in the body after the operation. The solution to this problem is to use biomaterial for the implant, but biomaterial does not have the required strength characteristics. The implant must also have a mesh-like structure so that the bone can grow into the implant. The additive manufacturing process is ideal for the production of such a structure. The study deals with the correlation between different prosthetic structures, namely, the relationship between geometry, mechanical properties and biological additivity. The main challenge is to design an endoprosthesis that will mimic the geometric structure of bone and also meet the conditions of strength, hardness and stiffness. In order to match the above factors, it is necessary to develop appropriate algorithms. The main objective of this study is to augment the algorithm to ensure minimum structural weight without changing the strength characteristics of the lattice endoprosthesis of long bones. The iterative augmentation process of the algorithm was implemented by removing low-loaded ribs. A low-loaded rib is a rib with a maximum stress that is less than the threshold stress. Values within the range (10, 13, 15, 16, 17, 18, 19 and 20 MPa) were taken as the threshold stress. The supplement to the algorithm was applied to the initial structure and the designed structure at threshold stresses σf = 10, 13, 15, 16, 17, 18, 19 and 20 MPa. A Pareto diagram for maximum stress and the number of ribs is plotted for all cases of the design: original, engineered and lightened structures. The most optimal was the designed "lightweight" structure under the condition σf = 17 MPa. The maximum stress was 147.48 MPa, and the number of ribs was 741. Specimens were manufactured using additive manufacturing and then tested for four-point bending.
Collapse
Affiliation(s)
- Nikita Kharin
- Institute of Mathematics and Mechanics, Kazan Federal University, 420008 Kazan, Russia
- Institute of Engineering, Kazan Federal University, 420008 Kazan, Russia
| | - Pavel Bolshakov
- Department Machines Science and Engineering Graphics, Tupolev Kazan National Research Technical University, 420111 Kazan, Russia
| | - Alex G. Kuchumov
- Department of Computational Mathematics, Mechanics and Biomechanics, Perm National Research Polytechnic University, 614990 Perm, Russia
- Laboratory of Mechanics of Biocompatible Materials and Devices, Perm National Research Polytechnic University, 614990 Perm, Russia
| |
Collapse
|
37
|
Migliorini F, Schenker H, Betsch M, Maffulli N, Tingart M, Hildebrand F, Lecouturier S, Rath B, Eschweiler J. Silica coated high performance oxide ceramics promote greater ossification than titanium implants: an in vivo study. J Orthop Surg Res 2023; 18:31. [PMID: 36631843 PMCID: PMC9832611 DOI: 10.1186/s13018-022-03494-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 12/30/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND This in vitro study investigated the osseointegration and implant integration of high performance oxide ceramics (HPOC) compared to titanium implants in rabbits. METHODS Histomorphometry was conducted around the distal, proximal, medial, and lateral aspects of the HPOC to quantify the amount of mature and immature ossification within the bone interface. Histomorphometry was conducted by a trained musculoskeletal pathologist. The region of interest (ROI) represented the percentage of surrounding area of the implant. The percentage of ROI covered by osteoid implant contact (OIC) and mature bone implant contact (BIC) were assessed. The surrounding presence of bone resorption, necrosis, and/or inflammation were quantitatively investigated. RESULTS All 34 rabbits survived the 6- and 12-week experimental period. All HPOC implants remained in situ. The mean weight difference from baseline was + 647.7 mg (P < 0.0001). The overall OIC of the ceramic group was greater at 6 weeks compared to the titanium implants (P = 0.003). The other endpoints of interest were similar between the two implants at all follow-up points. No difference was found in BIC at 6- and 12-weeks follow-up. No bone necrosis, resorption, or inflammation were observed. CONCLUSION HPOC implants demonstrated a greater osteoid implant contact at 6 weeks compared to the titanium implants, with no difference found at 12 weeks. The percentage of bone implant contact of HPOC implants was similar to that promoted by titanium implants.
Collapse
Affiliation(s)
- Filippo Migliorini
- grid.412301.50000 0000 8653 1507Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074 Aachen, Germany ,Department of Orthopaedic and Trauma Surgery, Eifelklinik St. Brigida, 52152 Simmerath, Germany
| | - Hanno Schenker
- grid.412301.50000 0000 8653 1507Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Marcel Betsch
- grid.411668.c0000 0000 9935 6525Department of Orthopedics, University Hospital of Erlangen, 91054 Erlangen, Germany
| | - Nicola Maffulli
- grid.11780.3f0000 0004 1937 0335Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, SA Italy ,grid.9757.c0000 0004 0415 6205Faculty of Medicine, School of Pharmacy and Bioengineering, Keele University, Stoke-on-Trent, ST4 7QB UK ,grid.4868.20000 0001 2171 1133Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, 275 Bancroft Road, London, E1 4DG UK
| | | | - Frank Hildebrand
- grid.412301.50000 0000 8653 1507Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Sophie Lecouturier
- grid.412301.50000 0000 8653 1507Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Björn Rath
- grid.459707.80000 0004 0522 7001Department of Orthopaedic Surgery, Klinikum Wels-Grieskirchen, 4600 Wels, Austria
| | - Jörg Eschweiler
- grid.412301.50000 0000 8653 1507Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074 Aachen, Germany
| |
Collapse
|
38
|
Modeling the debonding process of osseointegrated implants due to coupled adhesion and friction. Biomech Model Mechanobiol 2023; 22:133-158. [PMID: 36284076 PMCID: PMC9957925 DOI: 10.1007/s10237-022-01637-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 09/06/2022] [Indexed: 11/02/2022]
Abstract
Cementless implants have become widely used for total hip replacement surgery. The long-term stability of these implants is achieved by bone growing around and into the rough surface of the implant, a process called osseointegration. However, debonding of the bone-implant interface can still occur due to aseptic implant loosening and insufficient osseointegration, which may have dramatic consequences. The aim of this work is to describe a new 3D finite element frictional contact formulation for the debonding of partially osseointegrated implants. The contact model is based on a modified Coulomb friction law by Immel et al. (2020), that takes into account the tangential debonding of the bone-implant interface. This model is extended in the direction normal to the bone-implant interface by considering a cohesive zone model, to account for adhesion phenomena in the normal direction and for adhesive friction of partially bonded interfaces. The model is applied to simulate the debonding of an acetabular cup implant. The influence of partial osseointegration and adhesive effects on the long-term stability of the implant is assessed. The influence of different patient- and implant-specific parameters such as the friction coefficient [Formula: see text], the trabecular Young's modulus [Formula: see text], and the interference fit [Formula: see text] is also analyzed, in order to determine the optimal stability for different configurations. Furthermore, this work provides guidelines for future experimental and computational studies that are necessary for further parameter calibration.
Collapse
|
39
|
Metzner F, Fischer B, Heyde CE, Schleifenbaum S. The effects of force application on the compressive properties of femoral spongious bone. Clin Biomech (Bristol, Avon) 2023; 101:105866. [PMID: 36577361 DOI: 10.1016/j.clinbiomech.2022.105866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 12/13/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND End artefacts play a major role in uniaxial compression tests with cancellous bone specimens. They lead to misinterpretation of mechanical parameters of bones due to uncontrolled introduction of bending moments into the free ends of trabeculae. This work aims to simplify current methods preventing end-artefacts and furthermore to investigate the influence of end artefacts on plateau stress. METHODS 176 cylindrical cancellous bone specimens were taken from human femoral condyles and tested in uniaxial compression. The specimens were divided into 2 groups (direct, end-cap) and compressive modulus, maximum stress, plateau stress, energy absorbtion as well as apparent density were evaluated. Density values are from separate specimens which are immediately adjacent to the mechanical specimen. FINDINGS All mechanical parameters were significantly higher in the end-cap specimens than in the direct ones by about 30 - 40 %, thus reaching similar differences as the previous studies. Greatest differences between groups were determined for compressive modulus (45 %) and plateau stress (35 %). Energy absorbtion can be explained with great accuracy by plateau stress (P < 0.001; R2 = 0.95). Among all parameters plateau stress can be best explained by apparent density using an exponential function (P < 0.001; R2 = 0.38). INTERPRETATION The end-cap method used here to prevent end artefacts showed variations consistent with the literature when compared to the direct method. Additionally it was shown that the way in which the force is applied to the specimen has a major influence on the failure progression behavior, which was characterized using the plateau stress.
Collapse
Affiliation(s)
- F Metzner
- ZESBO - Centre for Research on Musculoskeletal Systems, University of Leipzig, Leipzig, Germany; Department of Orthopedic, Trauma and Plastic Surgery, University of Leipzig, Leipzig, Germany.
| | - B Fischer
- ZESBO - Centre for Research on Musculoskeletal Systems, University of Leipzig, Leipzig, Germany; Department of Orthopedic, Trauma and Plastic Surgery, University of Leipzig, Leipzig, Germany
| | - C-E Heyde
- ZESBO - Centre for Research on Musculoskeletal Systems, University of Leipzig, Leipzig, Germany; Department of Orthopedic, Trauma and Plastic Surgery, University of Leipzig, Leipzig, Germany
| | - S Schleifenbaum
- ZESBO - Centre for Research on Musculoskeletal Systems, University of Leipzig, Leipzig, Germany; Department of Orthopedic, Trauma and Plastic Surgery, University of Leipzig, Leipzig, Germany; Fraunhofer Institute for Machine Tools and Forming Technology, Dresden, Germany
| |
Collapse
|
40
|
Maglio M, Sartori M, Gambardella A, Shelyakova T, Dediu VA, Santin M, Piñeiro Y, López MB, Rivas J, Tampieri A, Sprio S, Martini L, Gatti A, Russo A, Giavaresi G, Fini M. Bone Regeneration Guided by a Magnetized Scaffold in an Ovine Defect Model. Int J Mol Sci 2023; 24:ijms24010747. [PMID: 36614190 PMCID: PMC9821288 DOI: 10.3390/ijms24010747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 12/26/2022] [Accepted: 12/28/2022] [Indexed: 01/04/2023] Open
Abstract
The reconstruction of large segmental defects still represents a critical issue in the orthopedic field. The use of functionalized scaffolds able to create a magnetic environment is a fascinating option to guide the onset of regenerative processes. In the present study, a porous hydroxyapatite scaffold, incorporating superparamagnetic Fe3O4 nanoparticles (MNPs), was implanted in a critical bone defect realized in sheep metatarsus. Superparamagnetic nanoparticles functionalized with hyperbranched poly(epsilon-Lysine) peptides and physically complexed with vascular endothelial growth factor (VEGF) where injected in situ to penetrate the magnetic scaffold. The scaffold was fixed with cylindrical permanent NdFeB magnets implanted proximally, and the magnetic forces generated by the magnets enabled the capture of the injected nanoparticles forming a VEGF gradient in its porosity. After 16 weeks, histomorphometric measurements were performed to quantify bone growth and bone-to-implant contact, while the mechanical properties of regenerated bone via an atomic force microscopy (AFM) analysis were investigated. The results showed increased bone regeneration at the magnetized interface; this regeneration was higher in the VEGF-MNP-treated group, while the nanomechanical behavior of the tissue was similar to the pattern of the magnetic field distribution. This new approach provides insights into the ability of magnetic technologies to stimulate bone formation, improving bone/scaffold interaction.
Collapse
Affiliation(s)
- Melania Maglio
- Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Maria Sartori
- Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
- Correspondence: ; Tel.: +39-05-1636-6787
| | - Alessandro Gambardella
- Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Tatiana Shelyakova
- Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Valentin Alek Dediu
- Istituto per lo Studio dei Materiali Nanostrutturati, Consiglio Nazionale delle Ricerche, 40129 Bologna, Italy
| | - Matteo Santin
- Centre for Regenerative Medicine and Devices, School of Applied Sciences, University of Brighton Huxley Building Lewes Road, Brighton BN2 4GJ, UK
| | - Yolanda Piñeiro
- Department of Applied Physics, University of Santiago de Compostela, E15782 Santiago de Compostela, Spain
| | | | - Josè Rivas
- Department of Applied Physics, University of Santiago de Compostela, E15782 Santiago de Compostela, Spain
| | - Anna Tampieri
- Institute of Science, Technology and Sustainability for Ceramics-National Research Council (ISSMC-CNR, Former ISTEC), 48018 Faenza, Italy
| | - Simone Sprio
- Institute of Science, Technology and Sustainability for Ceramics-National Research Council (ISSMC-CNR, Former ISTEC), 48018 Faenza, Italy
| | - Lucia Martini
- Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Alessandro Gatti
- II Clinic of Orthopaedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Alessandro Russo
- II Clinic of Orthopaedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Gianluca Giavaresi
- Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Milena Fini
- Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| |
Collapse
|
41
|
Skriabin AS, Shakurov AV, Vesnin VR, Lukina YS, Tsygankov PA, Bionyshev-Abramov LL, Serejnikova NB, Vorob’ev EV. Titanium Membranes with Hydroxyapatite/Titania Bioactive Ceramic Coatings: Characterization and In Vivo Biocompatibility Testing. ACS OMEGA 2022; 7:47880-47891. [PMID: 36591210 PMCID: PMC9798509 DOI: 10.1021/acsomega.2c05718] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 12/01/2022] [Indexed: 06/12/2023]
Abstract
Titanium membranes and meshes are used for the repair of trauma, tumors, and hernia in dentistry and maxillofacial and abdominal surgery. But such membranes demonstrate the limited effectiveness of integration in recipients due to their bioinertness. In this study, we prepared titania oxide (by microarc oxidation) and/or HAp (by electrophoresis deposition) coatings with alginate soaking. We used annealing at 700 °C for 2.5 h for HAp crystallinity increasing with achievement of an acceptable Ca2+ release rate. The feedstock HAp and prepared coatings were characterized by X-ray diffraction, IR spectroscopy, electron and optical confocal microscopy, and thermal analysis, as well as the in vitro study of solubility in saline and in vivo tests with the animal model of subcutaneous implantation (with Wistar rats). Biocompatible compounds were found for all deposited coatings. We noted that the best biological response was detected for the annealed Ca-P/TiO2 bilayer with alginate binding. In this case, the coating crystallinity was ≈40.5-50.0%. The Ca2+ release rate was 2.042 ± 0.058%/mm2 at 168 h after immersion in saline. Thin and mature tissue capsules with minimal inflammation and vascularization were found in histological sections. We did not detect any unwanted responses around the implants, including inflammation infiltration, suppuration, bacterial infections, tissue lyses, and, finally, implant rejection. This information is expected to be useful for understanding the properties of bioactive ceramic coatings and improving the quality of medical care in dentistry and maxillofacial surgery and other applications of titanium membranes in medicine.
Collapse
Affiliation(s)
- Andrei S. Skriabin
- Bauman
Moscow State Technical University National Research University of
Technology, 2-Ya Baumanskaya 5, Moscow105005, Russia
| | - Alexey V. Shakurov
- Bauman
Moscow State Technical University National Research University of
Technology, 2-Ya Baumanskaya 5, Moscow105005, Russia
| | - Vladimir R. Vesnin
- Bauman
Moscow State Technical University National Research University of
Technology, 2-Ya Baumanskaya 5, Moscow105005, Russia
| | - Yulia S. Lukina
- Bauman
Moscow State Technical University National Research University of
Technology, 2-Ya Baumanskaya 5, Moscow105005, Russia
- FSBI
National Medical Research Center for Traumatology and Orthopedics
named after N N Priorov of the Ministry of Health of the Russian Federation, Priorova 10, Moscow127299, Russia
| | - Petr A. Tsygankov
- Universidad
Industrial de Santander, Carrera 27 # Calle 9, Bucaramanga68000, Colombia
| | - Leonid L. Bionyshev-Abramov
- FSBI
National Medical Research Center for Traumatology and Orthopedics
named after N N Priorov of the Ministry of Health of the Russian Federation, Priorova 10, Moscow127299, Russia
| | - Natalya B. Serejnikova
- I
M Sechenov First Moscow State Medical University Institute of Regenerative
Medicine, Trubetskaya,
8, Moscow119991, Russia
| | - Evgeny V. Vorob’ev
- Bauman
Moscow State Technical University National Research University of
Technology, 2-Ya Baumanskaya 5, Moscow105005, Russia
| |
Collapse
|
42
|
Gershov S, Xie J, Shah FA, Shemtov-Yona K, Rittel D. Modelling the resonant frequency associated with the spatio-temporal evolution of the bone-dental implant interface. Acta Biomater 2022; 154:302-311. [PMID: 36306984 DOI: 10.1016/j.actbio.2022.10.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/21/2022] [Accepted: 10/19/2022] [Indexed: 01/24/2023]
Abstract
Dental implant stability is greatly affected by the mechanical properties of the bone-implant interface (BII), and it is key to long-term successful osseointegration. Implant stability is often evaluated using the Resonant Frequency Analysis (RFA) method, and also by the quality of this interface, namely the bone-implant contact (BIC). True to this day, there is a scarcity of models tying BIC, RFA and a spatially and mechanically evolving BII. In this paper, based on the contact/distance osteogenesis concept, a novel numerical spatio-temporal model of the implant, surrounding bone and evolving interface, was developed to assess the evolution of the interfacial stresses on the one hand and the corresponding resonant frequencies on the other. We postulate that, since the BIC percentage reaches saturation over a very short time, long before densification of the interface, it becomes irrelevant as to load transmission between the implant and the bone due to the existence of an open gap. Gap closure is the factor that provides continuity between the implant and the surrounding bone. The results of the calculated RFA evolution match and provide an explanation for the multiple clinical observations of a sharp initial decline in RFA, followed by a gradual increase and plateau formation. STATEMENT OF SIGNIFICANCE: A novel three-dimensional numerical model of an evolving bone-dental implant interface (BII) is presented. The spatio-temporal evolution of the bone-implant contact (BIC) and the BII, based on contact/distance (CO/DO) osteogenesis, is modeled. A central outcome is that, until BII maturation into a solid continuous bone (no open gap between CO-DO fronts), the bone-implant load transfer is hampered, irrespective of the BIC. The resonant frequencies' evolution of the jawbone-BII-implant is calculated to reproduce the well-established implant stability analysis based on the Resonant Frequency Analysis. The results resemble those reported clinically, and here too, the determinant transition occurs only after interfacial gap closure. Those results should motivate clinicians to re-consider structural continuity of the BII rather than the BIC only.
Collapse
Affiliation(s)
- Sapir Gershov
- Technion Autonomous Systems Program, Technion - Israel Institute of Technology, Haifa 32000, Israel.
| | - Jing Xie
- State Key Laboratory of Explosion Science and Technology, Beijing Institute of Technology, Beijing 100081, China
| | - Furqan A Shah
- Department of Biomaterials, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Keren Shemtov-Yona
- Faculty of Mechanical Engineering, Technion - Israel Institute of Technology, Haifa 32000, Israel; The Maurice and Gabriela Goldschleger School of Dental Medicine, Department of Oral Biology, Tel Aviv University, Tel Aviv 39040, Israel
| | - Daniel Rittel
- Faculty of Mechanical Engineering, Technion - Israel Institute of Technology, Haifa 32000, Israel
| |
Collapse
|
43
|
Chandra G, Pandey A, Prabha S, Pandey KM. Microstructure, Mechanical, In Vitro Biodegradation, and Antimicrobial Behavior of a Mg-Zn-Ca-Sr/ZrO 2 Composite Prepared Using Powder Metallurgy. ACS APPLIED BIO MATERIALS 2022; 5:5148-5155. [PMID: 36245146 DOI: 10.1021/acsabm.2c00525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Biodegradable materials, especially Mg alloys, have an exceptional advantage over nonbiodegradable materials in orthopedic applications, such as avoiding second surgery for removal/replacement, stress shielding, but not enough mechanical strength, and so forth. By further improving the Mg alloy to get all the remaining required properties, it can be used for better biodegradable implants, which depend adequately on material optimization, processing, and so forth. A Mg-Zn-Ca-Sr/ZrO2 composite has been prepared using powder metallurgy by adding 0, 1, 2, and 3 wt % of ZrO2, which also contains Zn, Ca, and Sr as nutrient elements. Microstructure characterization, as well as mechanical and in vitro biodegradation, have been investigated by hardness, compression, and immersion tests. The highest compressive strength, contraction, and hardness of about 185.6 MPa, 9.5%, and 65.2 HRB are observed in the 2% ZrO2-containing composite, respectively, whereas a minimum biodegradation rate of 2.76 mm/year is observed on the same. The antibiotic sensitivity observations against Staphylococcus aureus suggest that the alloy C3 has superior biological activity against the pathogen which ranks this alloy on top in merit. Overall, Mg-Zn-Ca-Sr/ZrO2 exhibits impressive potential for use as a biodegradable and antibiotic material for orthopedic applications.
Collapse
Affiliation(s)
- Girish Chandra
- Department of Mechanical Engineering, Maulana Azad National Institute of Technology, Bhopal462003, India
| | - Ajay Pandey
- Department of Mechanical Engineering, Maulana Azad National Institute of Technology, Bhopal462003, India
| | - Sarit Prabha
- Department of Biological Science and Engineering, Maulana Azad National Institute of Technology, Bhopal462003, India
| | - Khushhali M Pandey
- Department of Biological Science and Engineering, Maulana Azad National Institute of Technology, Bhopal462003, India
| |
Collapse
|
44
|
Florea DA, Grumezescu V, Bîrcă AC, Vasile BȘ, Iosif A, Chircov C, Stan MS, Grumezescu AM, Andronescu E, Chifiriuc MC. Bioactive Hydroxyapatite-Magnesium Phosphate Coatings Deposited by MAPLE for Preventing Infection and Promoting Orthopedic Implants Osteointegration. MATERIALS (BASEL, SWITZERLAND) 2022; 15:7337. [PMID: 36295401 PMCID: PMC9609740 DOI: 10.3390/ma15207337] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 10/12/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
In this study, we used the matrix-assisted pulsed laser evaporation (MAPLE) technique to obtain hydroxyapatite (Ca10(PO4)6(OH)2) and magnesium phosphate (Mg3(PO4)2) thin coatings containing bone morphogenetic protein (BMP4) for promoting implants osteointegration and further nebulized with the antibiotic ceftriaxone (CXF) to prevent peri-implant infections. The samples were characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM), selected area electron diffraction (SAED), infrared microscopy (IRM) and Fourier-transform infrared spectroscopy (FT-IR). Furthermore, the antimicrobial properties were evaluated on Staphylococcus aureus biofilms and the cytocompatibility on the MC3T3-E1 cell line. The obtained results proved the potential of the obtained coatings for bone implant applications, providing a significant antimicrobial and antibiofilm effect, especially in the first 48 h, and cytocompatibility in relation to murine osteoblast cells.
Collapse
Affiliation(s)
- Denisa Alexandra Florea
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Politehnica University of Bucharest, 011061 Bucharest, Romania
| | - Valentina Grumezescu
- National Institute for Lasers, Plasma and Radiation Physics, 077125 Magurele, Romania
| | - Alexandra Cătălina Bîrcă
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Politehnica University of Bucharest, 011061 Bucharest, Romania
| | - Bogdan Ștefan Vasile
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Politehnica University of Bucharest, 011061 Bucharest, Romania
| | - Andrei Iosif
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Politehnica University of Bucharest, 011061 Bucharest, Romania
| | - Cristina Chircov
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Politehnica University of Bucharest, 011061 Bucharest, Romania
| | - Miruna S. Stan
- Research Institute of the University of Bucharest—ICUB, University of Bucharest, 050657 Bucharest, Romania
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania
| | - Alexandru Mihai Grumezescu
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Politehnica University of Bucharest, 011061 Bucharest, Romania
- Research Institute of the University of Bucharest—ICUB, University of Bucharest, 050657 Bucharest, Romania
- Academy of Romanian Scientists, Ilfov No. 3, 050044 Bucharest, Romania
| | - Ecaterina Andronescu
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Politehnica University of Bucharest, 011061 Bucharest, Romania
- Academy of Romanian Scientists, Ilfov No. 3, 050044 Bucharest, Romania
| | - Mariana Carmen Chifiriuc
- Academy of Romanian Scientists, Ilfov No. 3, 050044 Bucharest, Romania
- Department of Microbiology, Faculty of Biology, University of Bucharest, 060101 Bucharest, Romania
- The Romanian Academy, Calea Victoriei 25, District 1, 010071 Bucharest, Romania
| |
Collapse
|
45
|
Jolic M, Sharma S, Palmquist A, Shah FA. The impact of medication on osseointegration and implant anchorage in bone determined using removal torque-A review. Heliyon 2022; 8:e10844. [PMID: 36276721 PMCID: PMC9582727 DOI: 10.1016/j.heliyon.2022.e10844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/16/2022] [Accepted: 09/26/2022] [Indexed: 11/06/2022] Open
Abstract
Permanently anchored metal implants are frequently used in dental, craniomaxillofacial, and orthopaedic rehabilitation. The success of such therapies is owed to the phenomenon of osseointegration—the direct connection between the living bone and the implant. The extent of biomechanical anchorage (i.e., physical interlocking between the implant and bone) can be assessed with removal torque (RTQ) measurement. Implant anchorage is strongly influenced by underlying bone quality, involving physicochemical and biological properties such as composition and structural organisation of extracellular matrix, extent of micro-damage, and bone turnover. In this review, we evaluated the impact of various pharmacological agents on osseointegration, from animal experiments conducting RTQ measurements. In addition to substances whose antiresorptive and/or anti-catabolic effects on bone are well-documented (e.g., alendronate, zoledronate, ibandronate, raloxifene, human parathyroid hormone, odanacatib, and the sclerostin monoclonal antibody), positive effects on RTQ have been reported for substances that do not primarily target bone (e.g., aminoguanidine, insulin, losartan, simvastatin, bone morphogenetic protein, alpha-tocopherol, and the combination of silk fibroin powder and platelet-rich fibrin). On the contrary, several substances (e.g., prednisolone, cyclosporin A, cisplatin, and enamel matrix derivative) tend to adversely impact RTQ. While morphometric parameters such as bone-implant contact appear to influence the biomechanical anchorage, increased or decreased RTQ is not always accompanied by corresponding fluctuations in bone-implant contact. This further confirms that factors such as bone quality underpin biomechanical anchorage of metal implants. Several fundamental questions on drug metabolism and bioavailability, drug dosage, animal-to-human translation, and the consequences of treatment interruption remain yet unanswered. Effects of pharmacological agents on osseointegration of metal implants are reviewed. Removal torque is considered as an objective measure of osseointegration. Most investigated anabolic agents are alendronate, zoledronate, and ibandronate. hPTH has a positive effect while cyclosporin A and cisplatin have negative effects. Correction of underlying systemic disorders leads to improved osseointegration.
Collapse
|
46
|
Mohamed M, Westover L. Evaluating the dynamic behaviour of bone anchored hearing aids using a finite element model and its applications to implant stability assessment. Med Biol Eng Comput 2022; 60:2779-2795. [DOI: 10.1007/s11517-022-02607-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 06/07/2022] [Indexed: 10/17/2022]
|
47
|
Mechanical micromodeling of stress-shielding at the bone-implant interphase under shear loading. Med Biol Eng Comput 2022; 60:3281-3293. [DOI: 10.1007/s11517-022-02657-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 08/22/2022] [Indexed: 10/14/2022]
|
48
|
Abd El-Tawab AE, Farhana A. Three dimensional analysis of hip joint reaction force using Q Hip Force (AQHF) software: Implication as a diagnostic tool. PLoS One 2022; 17:e0273159. [PMID: 36155640 PMCID: PMC9512223 DOI: 10.1371/journal.pone.0273159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/03/2022] [Indexed: 11/18/2022] Open
Abstract
Assessment of hip joint reaction force (JRF) is one of the analytical methods that can enable an understanding of the healthy walking index and the propensity towards disease. In this study, we have designed software, Analysis Q Hip Force (AQHF), to analyze the data retrieved from the mathematical equations for calculating the JRF and ground reaction force (GRF) that act on the hip joint during the early part of the stance phase. The stance phase is considered the least stable sub-phase during walking on level ground, and the gait stability is sequentially minimized during walking on elevated ramps. We have calculated the JRF and GRF values of walking stances on varied inclinations. The data obtained from these calculations during walking on elevated ramps were exported from mathematical equations to Q Hip Force software as two separate values, namely the JRF data and GRF data of the hip joint. The Q Hip Force software stores the two reaction force data in a text file, which allows the import and easy readability of the analyzed data with the AQHF application. The input and output data from the AQHF software were used to investigate the effect of different walking ramps on the magnitude of the hip JRF and GRF. The result of this study demonstrates a significant correlation between the JRF/GRF values and healthy walking indices till a ramp elevation of 70°. The software is designed to calculate and extrapolate data to analyze the possibility of stress in the hip joint. The framework developed in this study shows promise for preclinical and clinical applications. Studies are underway to use the results of JRF and GRF values as a diagnostic and prognostic tools in different diseases.
Collapse
Affiliation(s)
- Amany Eid Abd El-Tawab
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Science, Jouf University, Aljouf, Saudi Arabia
- Faculty of Physical Therapy, Biomechanics Department, Cairo University, Cairo, Egypt
| | - Aisha Farhana
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Aljouf, Saudi Arabia
- * E-mail:
| |
Collapse
|
49
|
Uzan AY, Milo O, Politi Y, Bar-On B. Principles of elastic bridging in biological materials. Acta Biomater 2022; 153:320-330. [PMID: 36167236 DOI: 10.1016/j.actbio.2022.09.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/31/2022] [Accepted: 09/19/2022] [Indexed: 11/01/2022]
Abstract
Load-bearing biological materials employ specialized elastic bridging regions to connect material parts with substantially different properties. While such bridging regions emerge in diverse systems of biological systems, their functional-mechanical origins are yet disclosed. Here, we hypothesize that these elastic bridging regions evolved primarily to minimize the near-interface stress effects in the biological material and, supported by experiments and simulations, we develop a simple theoretical model for such stress-minimizing bridging modulus. Our theoretical model describes well extensive experimental data of diverse biomechanical systems, suggesting that despite their compositionally distinct bridging regions, they share a similar mechanical adaptation strategy for stress minimization. The theoretical model developed in this study may directly serve as a design guideline for bio-inspired materials, biomedical applications, and advanced interfacial architectures with high resilience to mechanical failure. STATEMENT OF SIGNIFICANCE: Biological materials exhibit unconventional structural-mechanical strategies allowing them to attain extreme load-bearing capabilities. Here, we identify the strategy of biological materials to connect parts of distinct elastic properties in an optimal manner of stress minimization. Our findings are compatible with broad types of biological materials, including biopolymers, biominerals, and their bio-composite combinations, and may promote novel engineering designs of advanced biomedical and synthetic materials.
Collapse
Affiliation(s)
- Avihai Yosef Uzan
- Department of Mechanical Engineering, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel
| | - Or Milo
- Department of Mechanical Engineering, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel
| | - Yael Politi
- B CUBE-Center for Molecular Bioengineering, Technische Universitat Dresden, Dresden 01307, Germany
| | - Benny Bar-On
- Department of Mechanical Engineering, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel..
| |
Collapse
|
50
|
Ripszky Totan A, Imre MM, Parvu S, Meghea D, Radulescu R, Enasescu DSA, Moisa MR, Pituru SM. Autophagy Plays Multiple Roles in the Soft-Tissue Healing and Osseointegration in Dental Implant Surgery-A Narrative Review. MATERIALS (BASEL, SWITZERLAND) 2022; 15:6041. [PMID: 36079421 PMCID: PMC9457242 DOI: 10.3390/ma15176041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/21/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
Dental endo-osseous implants have become a widely used treatment for replacing missing teeth. Dental implants are placed into a surgically created osteotomy in alveolar bone, the healing of the soft tissue lesion and the osseointegration of the implant being key elements to long-term success. Autophagy is considered the major intracellular degradation system, playing important roles in various cellular processes involved in dental implant integration. The aim of this review is an exploration of autophagy roles in the main cell types involved in the healing and remodeling of soft tissue lesions and implant osseointegration, post-implant surgery. We have focused on the autophagy pathway in macrophages, endothelial cells; osteoclasts, osteoblasts; fibroblasts, myofibroblasts and keratinocytes. In macrophages, autophagy modulates innate and adaptive immune responses playing a key role in osteo-immunity. Autophagy induction in endothelial cells promotes apoptosis resistance, cell survival, and protection against oxidative stress damage. The autophagic machinery is also involved in transporting stromal vesicles containing mineralization-related factors to the extracellular matrix and regulating osteoblasts' functions. Alveolar bone remodeling is achieved by immune cells differentiation into osteoclasts; autophagy plays an important and active role in this process. Autophagy downregulation in fibroblasts induces apoptosis, leading to better wound healing by improving excessive deposition of extracellular matrix and inhibiting fibrosis progression. Autophagy seems to be a dual actor on the scene of dental implant surgery, imposing further research in order to completely reveal its positive features which may be essential for clinical efficacy.
Collapse
Affiliation(s)
- Alexandra Ripszky Totan
- Department of Biochemistry, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Marina Melescanu Imre
- Department of Complete Denture, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Simona Parvu
- Department of Complementary Sciences, Hygiene and Medical Ecology Discipline, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Daniela Meghea
- Department of Complete Denture, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Radu Radulescu
- Department of Biochemistry, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Dan Sebastian Alexandru Enasescu
- Department of Biochemistry, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Mihai Radu Moisa
- Department of Biochemistry, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Silviu Mirel Pituru
- Department of Professional Organization and Medical Legislation-Malpractice, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| |
Collapse
|