1
|
Łoginoff J, Majos A, Elgalal M. The Evolution of Custom Subperiosteal Implants for Treatment of Partial or Complete Edentulism in Patients with Severe Alveolar Ridge Atrophy. J Clin Med 2024; 13:3582. [PMID: 38930111 PMCID: PMC11205043 DOI: 10.3390/jcm13123582] [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: 04/23/2024] [Revised: 06/09/2024] [Accepted: 06/15/2024] [Indexed: 06/28/2024] Open
Abstract
Dental implants have always played an important role in dentistry and have been used to replace missing teeth since around 600 AD. They can be classified into three groups: endosteal, subperiosteal, and transosteal. Over time, different materials have been used to manufacture dental implants and these, in turn, can be divided into three groups: metals, ceramics, and polymers. Today, the most commonly used treatment for edentulism is the use of endosteal implants. However, such an approach cannot be used in patients with severe alveolar ridge atrophy and, in such cases, custom subperiosteal implants are an alternative. This review article focuses on historical developments and improvements that have been made over recent years in treatment options for patients suffering from edentulism and significant resorption of the alveolar ridge. These treatment options involve the utilization of custom subperiosteal implants. This paper looks at the historical evolution of these implants, the significance of diagnostic imaging, and the application of the contemporary methods of production, such as CAD-CAM and additive manufacturing. The research emphasizes the importance of accuracy and personalization provided by these emerging technologies that have rendered subperiosteal implants a more feasible and less intrusive alternative for patients suffering from significant bone loss.
Collapse
Affiliation(s)
| | | | - Marcin Elgalal
- II Department of Radiology and Diagnostic Imaging, Central Teaching Hospital of the Medical University of Lodz, 92-213 Lodz, Poland; (J.Ł.); (A.M.)
| |
Collapse
|
2
|
Ayhan M, Ozturk Muhtar M, Kundakcioglu A, Kucukcakir O, Cansiz E. Evaluation of Clinical Success of the 3D-Printed Custom-Made Subperiosteal Implants. J Craniofac Surg 2024; 35:1146-1151. [PMID: 38709056 DOI: 10.1097/scs.0000000000010148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 02/27/2024] [Indexed: 05/07/2024] Open
Abstract
OBJECTIVE The authors aim to share their experiences in subperiosteal implant applications in atrophic jaws, which have been practiced in their clinic for about 2 years, and evaluate the complications and clinical success of the implants. MATERIAL AND METHOD Clinical and radiologic data of 32 patients who underwent subperiosteal implantation for advanced alveolar bone loss were evaluated, but 1 patient was excluded as they smoked. Of the 31 patients included in the study, 27 were operated with the diagnosis of total tooth loss, 3 for maxillectomy and 1 for partial tooth loss. A total of 60 subperiosteal implants were placed in them. The mean follow-up period was 15 months. RESULTS During the operation, implant-bone adaptation problems were encountered in 11 patients, implant skeletal fracture in 1 patient, and loss of primary stabilization during mini-screw fixation in 2. Although there were no complications in the early postoperative period, biological and prosthetic complications occurred in the late postoperative period. Soft tissue retraction at various levels in 12 patients (only keratinized tissue retraction in 6 and mucosal retraction exceeding keratinized tissue in 6), soft tissue infection in 5 and oroantral fistula development in 1, mini-screw loosening in 3 were the biological complications that occurred. CONCLUSIONS Various complications may occur during or after the application of custom-made subperiosteal implants. However, these are manageable and can be reapplied in case of a possible implant loss, making it an important alternative, especially in atrophic jaws where endosseous dental implants cannot be applied.
Collapse
Affiliation(s)
- Mustafa Ayhan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University
| | - Merve Ozturk Muhtar
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University
| | | | - Osman Kucukcakir
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University
| | - Erol Cansiz
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Istanbul University
- Ataşehir Memorial Hospital, Istanbul, Turkey
| |
Collapse
|
3
|
Vaira LA, Biglio A, Favro A, Salzano G, Abbate V, Lechien JR, De Riu G. Implant-prosthetic rehabilitation of the atrophic posterior mandible with additively manufactured custom-made subperiosteal implants: a cohort study. Int J Oral Maxillofac Surg 2024; 53:533-540. [PMID: 38272739 DOI: 10.1016/j.ijom.2024.01.003] [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: 04/24/2023] [Revised: 12/22/2023] [Accepted: 01/03/2024] [Indexed: 01/27/2024]
Abstract
The aim of this study was to retrospectively analyse a series of patients with posterior mandibular atrophy rehabilitated with custom-made subperiosteal implants. The study included patients with severe posterior mandibular atrophy who had undergone rehabilitation with subperiosteal implants between September 2018 and August 2022 in the Maxillofacial Surgery Operative Unit of the University Hospital of Sassari. Complications and the success rate were reviewed. Data from 30 implants placed in 17 patients were included and analysed. There were no major complications during the surgeries. The main postoperative sequela was oedema, which was reported as moderate by most patients and had completely regressed within 10 days of surgery. No partial or complete exposures, infections, or loss of the implants were detected during follow-up (average follow-up 22.5 months). Control computed tomography scans, performed at 6 months and then annually in all cases, did not show significant bone loss below the abutments, displacement of the implants, or loss or loosening of the osteosynthesis screws. Subperiosteal implants may represent a safe and reliable technique for the rehabilitation of severe atrophy of the posterior mandible. Prospective studies with a long follow-up will be needed to establish the long-term results of this type of implant-prosthetic rehabilitation.
Collapse
Affiliation(s)
- L A Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy; School of Biomedical Science, Biomedical Sciences Department, University of Sassari, Sassari, Italy.
| | - A Biglio
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - A Favro
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - G Salzano
- Maxillofacial Surgery Operative Unit, University Hospital of Naples "Federico II", Naples, Italy
| | - V Abbate
- Maxillofacial Surgery Operative Unit, University Hospital of Naples "Federico II", Naples, Italy
| | - J R Lechien
- Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS, Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium; Department of Otolaryngology-Head Neck Surgery, Elsan Polyclinic of Poitiers, Poitiers, France
| | - G De Riu
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| |
Collapse
|
4
|
Onică N, Budală DG, Baciu ER, Onică CA, Gelețu GL, Murariu A, Balan M, Pertea M, Stelea C. Long-Term Clinical Outcomes of 3D-Printed Subperiosteal Titanium Implants: A 6-Year Follow-Up. J Pers Med 2024; 14:541. [PMID: 38793123 PMCID: PMC11122366 DOI: 10.3390/jpm14050541] [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: 04/24/2024] [Revised: 05/09/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024] Open
Abstract
As an alternative to regenerative therapies, numerous authors have recently proposed bringing back subperiosteal implants. The aim of the study was to present our clinical experience with a subperiosteal jaw implant that needs minimal bone preparation and enables the rapid implantation of prosthetic teeth in edentulous, atrophic alveolar bone. The research included 36 complete or partial edentulous patients (61 subperiostal implants) over a period of 6 years. To create the patient-specific subperiostal implants design, DentalCAD 3.0 Galway software (exocad GmbH, Darmstadt, Germany) was used and fabricated with a Mysint 100 (Sisma S.p.A., Piovene Rocchette, Italy) by titanium alloy powder. The results showed that only 9 of the 36 cases were successful at 6-year follow-up, while 27 cases had complications, including exposure of the metal frame (early or delayed), mobility of the device prior to the first 4-6 months, and late mobility due to recurrent infections and progressive structure exposure; 1 case failed for reasons unrelated to the device. This study indicated that the prudent application of fully customized subperiosteal jaw implants is a dependable alternative for the dental rehabilitation of atrophic edentulous cases that necessitate bone grafts for traditional fixed dental implant solutions.
Collapse
Affiliation(s)
- Neculai Onică
- Department of Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (N.O.); (G.L.G.); (A.M.); (M.B.); (C.S.)
| | - Dana Gabriela Budală
- Department of Implantology, Removable Dentures, Dental Technology, Faculty of Dental Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania;
| | - Elena-Raluca Baciu
- Department of Implantology, Removable Dentures, Dental Technology, Faculty of Dental Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania;
| | - Cezara Andreea Onică
- Department of Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (N.O.); (G.L.G.); (A.M.); (M.B.); (C.S.)
| | - Gabriela Luminița Gelețu
- Department of Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (N.O.); (G.L.G.); (A.M.); (M.B.); (C.S.)
| | - Alice Murariu
- Department of Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (N.O.); (G.L.G.); (A.M.); (M.B.); (C.S.)
| | - Mihail Balan
- Department of Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (N.O.); (G.L.G.); (A.M.); (M.B.); (C.S.)
| | - Mihaela Pertea
- Department of Plastic Surgery, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania;
| | - Carmen Stelea
- Department of Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (N.O.); (G.L.G.); (A.M.); (M.B.); (C.S.)
| |
Collapse
|
5
|
Fathi A, Nadian F, Ghorbani M, Razavi P, Mosharraf R, Ebadian B. Enhancing oral function: A case report on mandibular overdenture utilization with custom-made subperiosteal implant. J Prosthodont 2024. [PMID: 38650475 DOI: 10.1111/jopr.13860] [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: 12/19/2023] [Accepted: 04/06/2024] [Indexed: 04/25/2024] Open
Abstract
Subperiosteal implants, previously set aside because of complications, are now emerging again as effective treatments for severe mandibular atrophy, aided by recent improvements in digital dentistry. Traditional dentures in such cases often face challenges with support and retention, necessitating complex regenerative procedures. This paper presents a case report of a 54-year-old male patient with significant mandibular atrophy who received a custom-made subperiosteal implant, showcasing promising results. The implant was precisely designed utilizing computed tomography (CT) scans, a 3D-printed model, the selective laser melting (SLM) technique, and constructed with biocompatible Ti6Al4V material. This innovative approach offered a practical solution, resulting in high patient satisfaction and no complications over a year of use.
Collapse
Affiliation(s)
- Amirhossein Fathi
- Department of Prosthodontics, Dental Materials Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farshad Nadian
- Department of Prosthodontics, Dental Materials Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahsa Ghorbani
- School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Pouyan Razavi
- Dental School, Islamic Azad University of Medical Sciences, Tehran, Iran
| | - Ramin Mosharraf
- Department of Prosthodontics, Dental Materials Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behnaz Ebadian
- Department of Prosthodontics, Dental Materials Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
6
|
El-Sawy MA, Hegazy SA. Subperiosteal implants constructed with digital technology: A systematic review. Oral Maxillofac Surg 2024:10.1007/s10006-024-01249-8. [PMID: 38642167 DOI: 10.1007/s10006-024-01249-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 03/29/2024] [Indexed: 04/22/2024]
Abstract
STATEMENT OF PROBLEM Atrophied jaw is a condition where there is insufficient bone quantity and quality. Several treatment plans are available for treating atrophied jaws, including subperiosteal implants. PURPOSE To evaluate the spectrum of subperiosteal implants for severely atrophied jaws using digital technology. MATERIALS AND METHODS An electronic and manual search was conducted in the PubMed, Scopus, and Google Scholar databases. Publications of cohort studies, case series, and case reports written in English without data restrictions that reported on subperiosteal implant management of patients with severely atrophied jaws in a completely and partially edentulous population. RESULTS A total of 26 articles, comprising 302 cases, were analyzed. In patients with severely atrophied jaws. The success rate was 87.7%, the surviving rate was 95.3%. The most common complications were biological, such as dehiscence and framework exposure. The rates of biologic complications were 11.5%, and the rates of prosthetic problems were 5.9%. CONCLUSIONS Subperiosteal implants designed and constructed using digital technology are a promising treatment in the short term. Attention should be directed to decrease the biological complication. Correct designing, implanting, fixing, and patient selection and maintenance are critical for the success of the treatment. Longer prospective studies with larger population are needed to view the effect on hard and soft tissue.
Collapse
|
7
|
Elgarba BM, Fontenele RC, Tarce M, Jacobs R. Artificial intelligence serving pre-surgical digital implant planning: A scoping review. J Dent 2024; 143:104862. [PMID: 38336018 DOI: 10.1016/j.jdent.2024.104862] [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: 12/14/2023] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
OBJECTIVES To conduct a scoping review focusing on artificial intelligence (AI) applications in presurgical dental implant planning. Additionally, to assess the automation degree of clinically available pre-surgical implant planning software. DATA AND SOURCES A systematic electronic literature search was performed in five databases (PubMed, Embase, Web of Science, Cochrane Library, and Scopus), along with exploring gray literature web-based resources until November 2023. English-language studies on AI-driven tools for digital implant planning were included based on an independent evaluation by two reviewers. An assessment of automation steps in dental implant planning software available on the market up to November 2023 was also performed. STUDY SELECTION AND RESULTS From an initial 1,732 studies, 47 met eligibility criteria. Within this subset, 39 studies focused on AI networks for anatomical landmark-based segmentation, creating virtual patients. Eight studies were dedicated to AI networks for virtual implant placement. Additionally, a total of 12 commonly available implant planning software applications were identified and assessed for their level of automation in pre-surgical digital implant workflows. Notably, only six of these featured at least one fully automated step in the planning software, with none possessing a fully automated implant planning protocol. CONCLUSIONS AI plays a crucial role in achieving accurate, time-efficient, and consistent segmentation of anatomical landmarks, serving the process of virtual patient creation. Additionally, currently available systems for virtual implant placement demonstrate different degrees of automation. It is important to highlight that, as of now, full automation of this process has not been documented nor scientifically validated. CLINICAL SIGNIFICANCE Scientific and clinical validation of AI applications for presurgical dental implant planning is currently scarce. The present review allows the clinician to identify AI-based automation in presurgical dental implant planning and assess the potential underlying scientific validation.
Collapse
Affiliation(s)
- Bahaaeldeen M Elgarba
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven & Department of Oral and Maxillofacial Surgery, University Hospitals, Campus Sint-Rafael, 3000 Leuven, Belgium & Department of Prosthodontics, Faculty of Dentistry, Tanta University, 31511 Tanta, Egypt.
| | - Rocharles Cavalcante Fontenele
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven & Department of Oral and Maxillofacial Surgery, University Hospitals, Campus Sint-Rafael, 3000 Leuven, Belgium
| | - Mihai Tarce
- Division of Periodontology & Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China & Periodontology and Oral Microbiology, Department of Oral Health Sciences, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven & Department of Oral and Maxillofacial Surgery, University Hospitals, Campus Sint-Rafael, 3000 Leuven, Belgium & Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| |
Collapse
|
8
|
Anitua E, Eguia A, Staudigl C, Alkhraisat MH. Clinical performance of additively manufactured subperiosteal implants: a systematic review. Int J Implant Dent 2024; 10:4. [PMID: 38315326 PMCID: PMC10844163 DOI: 10.1186/s40729-024-00521-6] [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: 06/12/2023] [Accepted: 01/11/2024] [Indexed: 02/07/2024] Open
Abstract
PURPOSE The aim of this study was to assess implant survival and complications rate of modern subperiosteal implants (CAD designed and additively manufactured). METHODS A systematic review was conducted using three electronic databases; Medline (Pubmed), Cochrane library, and SCOPUS, following the PRISMA statement recommendations to answer the PICO question: "In patients with bone atrophy (P), do additively manufactured subperiosteal implants (I), compared to subperiosteal implants manufactured following traditional approaches (c), present satisfactory implant survival and complication rates (O)? The study was pre-registered in PROSPERO (CRD42023424211). Included articles quality was assessed using the "NIH quality assessment tools". RESULTS Thirteen articles were finally selected (5 cohort studies and 8 case series), including 227 patients (121 female / 106 male; weighted mean age 62.4 years) and 227 implants. After a weighted mean follow-up time of 21.4 months, 97.8% of implants were in function (5 failures reported), 58 implants (25.6%) presented partial exposure, 12 patients (5.3%) suffered soft tissue or persistent infection. Fracture of the interim prosthesis was reported in 8 of the155 patients (5.2%) in which the use of a provisional prosthesis was reported. A great heterogeneity was found in terms of study design and methodological aspects. For this reason, a quantitative analysis followed by meta-analysis was not possible. CONCLUSIONS Within the limitations of this study, modern additively manufactured subperiosteal implants presented a good survival in the short-time, but a noticeable number of soft-tissue related complications were reported. Further studies are needed to assess the clinical behavior in the medium- and long-term.
Collapse
Affiliation(s)
- Eduardo Anitua
- University Institute for Regenerative Medicine and Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), Jose Maria Cagigal Kalea, 19, 01007, Vitoria-Gasteiz, Araba, Spain.
- BTI-Biotechnology Institute, Vitoria, Spain.
| | - Asier Eguia
- University of the Basque Country UPV/EHU and University Institute for Regenerative Medicine and Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain
| | - Christoph Staudigl
- Department of Cranio-Maxillofacial Surgery, Kepler Universitätsklinikum, Linz, Austria
| | - Mohammad Hamdan Alkhraisat
- University Institute for Regenerative Medicine and Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), Jose Maria Cagigal Kalea, 19, 01007, Vitoria-Gasteiz, Araba, Spain
- BTI-Biotechnology Institute, Vitoria, Spain
| |
Collapse
|
9
|
Herce-López J, Pingarrón MDC, Tofé-Povedano Á, García-Arana L, Espino-Segura-Illa M, Sieira-Gil R, Rodado-Alonso C, Sánchez-Torres A, Figueiredo R. Customized Subperiosteal Implants for the Rehabilitation of Atrophic Jaws: A Consensus Report and Literature Review. Biomimetics (Basel) 2024; 9:61. [PMID: 38275459 PMCID: PMC10812919 DOI: 10.3390/biomimetics9010061] [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: 12/31/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
(1) Background: The aim was to perform a literature review on customized subperiosteal implants (CSIs) and provide clinical guidelines based on the results of an expert consensus meeting held in 2023. (2) Methods: A literature search was performed in Pubmed (MEDLINE) in July 2023, including case series and cohort studies with a minimum follow-up of 6 months that analyzed totally or partially edentulous patients treated with CSIs. Previously, an expert consensus meeting had been held in May 2023 to establish the most relevant clinical guidelines. (3) Results: Six papers (four case series and two retrospective cohort studies) were finally included in the review. Biological and mechanical complication rates ranged from 5.7% to 43.8% and from 6.3% to 20%, respectively. Thorough digital planning to ensure the passive fit of the CSI is mandatory to avoid implant failure. (4) Conclusions: CSIs are a promising treatment option for rehabilitating edentulous patients with atrophic jaws; they seem to have an excellent short-term survival rate, a low incidence of major complications, and less morbidity in comparison with complex bone grafting procedures. As the available data on the use of CSIs are very scarce, it is not possible to establish clinical recommendations based on scientific evidence.
Collapse
Affiliation(s)
- Javier Herce-López
- Oral and Maxillofacial Surgeon, Virgen Macarena University Hospital, 41009 Seville, Spain;
| | | | - Álvaro Tofé-Povedano
- Oral and Maxillofacial Surgeon, Puerta del Mar University Hospital, 11009 Cádiz, Spain;
| | - Laura García-Arana
- Oral and Maxillofacial Surgeon, San Francisco de Asís University Hospital, 28002 Madrid, Spain;
| | | | - Ramón Sieira-Gil
- Oral and Maxillofacial Consultant, Hospital Clínic, Universitat de Barcelona, 08036 Barcelona, Spain;
| | | | - Alba Sánchez-Torres
- Professors of Oral Surgery, Faculty of Medicine and Health Sciences, Researchers at the IDIBELL Institute, University of Barcelona (Spain), 08907 Barcelona, Spain;
| | - Rui Figueiredo
- Professors of Oral Surgery, Faculty of Medicine and Health Sciences, Researchers at the IDIBELL Institute, University of Barcelona (Spain), 08907 Barcelona, Spain;
| |
Collapse
|
10
|
Slavin BV, Ehlen QT, Costello JP, Nayak VV, Bonfante EA, Benalcázar Jalkh EB, Runyan CM, Witek L, Coelho PG. 3D Printing Applications for Craniomaxillofacial Reconstruction: A Sweeping Review. ACS Biomater Sci Eng 2023; 9:6586-6609. [PMID: 37982644 DOI: 10.1021/acsbiomaterials.3c01171] [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] [Indexed: 11/21/2023]
Abstract
The field of craniomaxillofacial (CMF) surgery is rich in pathological diversity and broad in the ages that it treats. Moreover, the CMF skeleton is a complex confluence of sensory organs and hard and soft tissue with load-bearing demands that can change within millimeters. Computer-aided design (CAD) and additive manufacturing (AM) create extraordinary opportunities to repair the infinite array of craniomaxillofacial defects that exist because of the aforementioned circumstances. 3D printed scaffolds have the potential to serve as a comparable if not superior alternative to the "gold standard" autologous graft. In vitro and in vivo studies continue to investigate the optimal 3D printed scaffold design and composition to foster bone regeneration that is suited to the unique biological and mechanical environment of each CMF defect. Furthermore, 3D printed fixation devices serve as a patient-specific alternative to those that are available off-the-shelf with an opportunity to reduce operative time and optimize fit. Similar benefits have been found to apply to 3D printed anatomical models and surgical guides for preoperative or intraoperative use. Creation and implementation of these devices requires extensive preclinical and clinical research, novel manufacturing capabilities, and strict regulatory oversight. Researchers, manufacturers, CMF surgeons, and the United States Food and Drug Administration (FDA) are working in tandem to further the development of such technology within their respective domains, all with a mutual goal to deliver safe, effective, cost-efficient, and patient-specific CMF care. This manuscript reviews FDA regulatory status, 3D printing techniques, biomaterials, and sterilization procedures suitable for 3D printed devices of the craniomaxillofacial skeleton. It also seeks to discuss recent clinical applications, economic feasibility, and future directions of this novel technology. By reviewing the current state of 3D printing in CMF surgery, we hope to gain a better understanding of its impact and in turn identify opportunities to further the development of patient-specific surgical care.
Collapse
Affiliation(s)
- Blaire V Slavin
- University of Miami Miller School of Medicine, 1011 NW 15th St., Miami, Florida 33136, United States
| | - Quinn T Ehlen
- University of Miami Miller School of Medicine, 1011 NW 15th St., Miami, Florida 33136, United States
| | - Joseph P Costello
- University of Miami Miller School of Medicine, 1011 NW 15th St., Miami, Florida 33136, United States
| | - Vasudev Vivekanand Nayak
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, 1011 NW 15th St., Miami, Florida 33136, United States
| | - Estavam A Bonfante
- Department of Prosthodontics and Periodontology, University of Sao Paulo, Bauru School of Dentistry, Alameda Dr. Octávio Pinheiro Brisolla, Quadra 9 - Jardim Brasil, Bauru São Paulo 17012-901, Brazil
| | - Ernesto B Benalcázar Jalkh
- Department of Prosthodontics and Periodontology, University of Sao Paulo, Bauru School of Dentistry, Alameda Dr. Octávio Pinheiro Brisolla, Quadra 9 - Jardim Brasil, Bauru São Paulo 17012-901, Brazil
| | - Christopher M Runyan
- Department of Plastic and Reconstructive Surgery, Wake Forest School of Medicine, 475 Vine St, Winston-Salem, North Carolina 27101, United States
| | - Lukasz Witek
- Biomaterials Division, NYU Dentistry, 345 E. 24th St., New York, New York 10010, United States
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York University, 222 E 41st St., New York, New York 10017, United States
- Department of Biomedical Engineering, NYU Tandon School of Engineering, 6 MetroTech Center, Brooklyn, New York 11201, United States
| | - Paulo G Coelho
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, 1011 NW 15th St., Miami, Florida 33136, United States
- DeWitt Daughtry Family Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, 1120 NW 14th St., Miami, Florida 33136, United States
| |
Collapse
|
11
|
Nassar HI, Fateen A. Accuracy of fit for cobaltchromium bar over two implants fabricated with different manufacturing techniques: an in-vitro study. BMC Oral Health 2023; 23:946. [PMID: 38031111 PMCID: PMC10688085 DOI: 10.1186/s12903-023-03700-w] [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: 02/19/2023] [Accepted: 11/22/2023] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVE The purpose of the invitro research was to compare the fit of Cobalt Chromium customized bar fabricated with different manufacturing processes cast metal bar, milled bar and 3D printed bar using scanning electron microscope. MATERIALS AND METHODS Clear epoxy resin molds were prepared. In each mold two parallel implants with a 14 mm distance from each other were embedded. Thirty Co-Cr custom bars were constructed and were divided equally into three groups: Group (I) (Co-Cr conv), group (II) milled bar (Co-Cr milled), and group (III) printed bar (Co-Cr print). The marginal fit at implant-abutment interface was scanned using scanning electron microscope (SEM). RESULTS There was a significant difference between the three studied groups regarding marginal misfit the between implant and fabricated bars with p-value < 0.001. The highest value of micro-gap distance was found in Co-Cr conventional group (7.95 ± 2.21 μm) followed by Co-Cr 3D printed group (4.98 ± 1.73) and the lower value were found in Co-Cr milled (3.22 ± 0.75). CONCLUSION The marginal fit of milled, 3D printed and conventional cast for Co-Cr alloy were within the clinically acceptable range of misfit. CAD/CAM milled Co-Cr bar revealed a superior internal fit at the implant-abutment interface. This was followed by selective laser melting (SLM) 3D printed bar and the least fit was shown for customized bar with the conventional lost wax technique.
Collapse
Affiliation(s)
- Hossam I Nassar
- Faculty of Oral and Dental Medicine, Future University in Egypt, Cairo, Egypt.
| | - Ayman Fateen
- Faculty of Oral and Dental Medicine, Future University in Egypt, Cairo, Egypt
| |
Collapse
|
12
|
Arshad M, Khoramshahi N, Shirani G. Additively custom-made 3D-printed subperiosteal implants for the rehabilitation of the severely atrophic maxilla (a case report). Clin Case Rep 2023; 11:e8135. [PMID: 37942187 PMCID: PMC10628114 DOI: 10.1002/ccr3.8135] [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: 06/27/2022] [Revised: 08/22/2023] [Accepted: 10/21/2023] [Indexed: 11/10/2023] Open
Abstract
Key Clinical Message Subperiosteal implants might be the future first-line treatment in patients with compromised alveolar ridges, although the use of proper techniques and pre-surgical imaging is required to ensure treatment success. Abstract Severe bone loss puts the success of endosseous implants at risk. This technical report aims to introduce the subperiosteal implants (SPIs) created through additive manufacturing. A case study is presented, outlining the process and strategies employed to fully restore a maxillary structure using a customized subperiosteal implant. The patient, who had previously faced disappointment with traditional endosseous implants, received a customized SPI. A detailed 3-year follow-up is also provided. The design of the subperiosteal framework and abutments is based on digital records of the patient's jaw structure and a radiographic stent during occlusion. This ensures optimal placement within the dental arch. The implant and abutments are then three-dimensional (3D) printed using a titanium alloy, while a provisional denture is 3D-printed using polymer materials. SPIs offer a viable alternative for individuals with severe jaw bone degeneration, as demonstrated in this report detailing their application in complete maxillary restoration. This patient-specific, prosthesis-driven approach avoids the need for bone grafting and enables immediate functional recovery through a single surgical procedure.
Collapse
Affiliation(s)
- Mahnaz Arshad
- Department of Prosthodontics, School of Dentistry, International CampusTehran University of Medical SciencesTehranIran
| | - Nourin Khoramshahi
- School of Dentistry, International CampusTehran University of Medical SciencesTehranIran
| | - Gholamreza Shirani
- Department of Oral and Maxillofacial Surgery, School of DentistryTehran University of Medical SciencesTehranIran
| |
Collapse
|
13
|
Baecher H, Hoch CC, Knoedler S, Maheta BJ, Kauke-Navarro M, Safi AF, Alfertshofer M, Knoedler L. From bench to bedside - current clinical and translational challenges in fibula free flap reconstruction. Front Med (Lausanne) 2023; 10:1246690. [PMID: 37886365 PMCID: PMC10598714 DOI: 10.3389/fmed.2023.1246690] [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: 06/24/2023] [Accepted: 09/29/2023] [Indexed: 10/28/2023] Open
Abstract
Fibula free flaps (FFF) represent a working horse for different reconstructive scenarios in facial surgery. While FFF were initially established for mandible reconstruction, advancements in planning for microsurgical techniques have paved the way toward a broader spectrum of indications, including maxillary defects. Essential factors to improve patient outcomes following FFF include minimal donor site morbidity, adequate bone length, and dual blood supply. Yet, persisting clinical and translational challenges hamper the effectiveness of FFF. In the preoperative phase, virtual surgical planning and artificial intelligence tools carry untapped potential, while the intraoperative role of individualized surgical templates and bioprinted prostheses remains to be summarized. Further, the integration of novel flap monitoring technologies into postoperative patient management has been subject to translational and clinical research efforts. Overall, there is a paucity of studies condensing the body of knowledge on emerging technologies and techniques in FFF surgery. Herein, we aim to review current challenges and solution possibilities in FFF. This line of research may serve as a pocket guide on cutting-edge developments and facilitate future targeted research in FFF.
Collapse
Affiliation(s)
- Helena Baecher
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Cosima C. Hoch
- Medical Faculty, Friedrich Schiller University Jena, Jena, Germany
| | - Samuel Knoedler
- Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT, United States
- Division of Plastic Surgery, Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
- Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Bhagvat J. Maheta
- College of Medicine, California Northstate University, Elk Grove, CA, United States
| | - Martin Kauke-Navarro
- Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT, United States
| | - Ali-Farid Safi
- Craniologicum, Center for Cranio-Maxillo-Facial Surgery, Bern, Switzerland
- Faculty of Medicine, University of Bern, Bern, Switzerland
| | - Michael Alfertshofer
- Division of Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Leonard Knoedler
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
- Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT, United States
| |
Collapse
|
14
|
Dutta SD, Ganguly K, Patil TV, Randhawa A, Lim KT. Unraveling the potential of 3D bioprinted immunomodulatory materials for regulating macrophage polarization: State-of-the-art in bone and associated tissue regeneration. Bioact Mater 2023; 28:284-310. [PMID: 37303852 PMCID: PMC10248805 DOI: 10.1016/j.bioactmat.2023.05.014] [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: 11/17/2022] [Revised: 04/29/2023] [Accepted: 05/20/2023] [Indexed: 06/13/2023] Open
Abstract
Macrophage-assisted immunomodulation is an alternative strategy in tissue engineering, wherein the interplay between pro-inflammatory and anti-inflammatory macrophage cells and body cells determines the fate of healing or inflammation. Although several reports have demonstrated that tissue regeneration depends on spatial and temporal regulation of the biophysical or biochemical microenvironment of the biomaterial, the underlying molecular mechanism behind immunomodulation is still under consideration for developing immunomodulatory scaffolds. Currently, most fabricated immunomodulatory platforms reported in the literature show regenerative capabilities of a particular tissue, for example, endogenous tissue (e.g., bone, muscle, heart, kidney, and lungs) or exogenous tissue (e.g., skin and eye). In this review, we briefly introduced the necessity of the 3D immunomodulatory scaffolds and nanomaterials, focusing on material properties and their interaction with macrophages for general readers. This review also provides a comprehensive summary of macrophage origin and taxonomy, their diverse functions, and various signal transduction pathways during biomaterial-macrophage interaction, which is particularly helpful for material scientists and clinicians for developing next-generation immunomodulatory scaffolds. From a clinical standpoint, we briefly discussed the role of 3D biomaterial scaffolds and/or nanomaterial composites for macrophage-assisted tissue engineering with a special focus on bone and associated tissues. Finally, a summary with expert opinion is presented to address the challenges and future necessity of 3D bioprinted immunomodulatory materials for tissue engineering.
Collapse
Affiliation(s)
- Sayan Deb Dutta
- Department of Biosystems Engineering, Kangwon National University, Chuncheon, 24341, Republic of Korea
- Institute of Forest Science, Kangwon National University, Chuncheon, 24341, Republic of Korea
| | - Keya Ganguly
- Department of Biosystems Engineering, Kangwon National University, Chuncheon, 24341, Republic of Korea
| | - Tejal V. Patil
- Department of Biosystems Engineering, Kangwon National University, Chuncheon, 24341, Republic of Korea
- Interdisciplinary Program in Smart Agriculture, Kangwon National University, Chuncheon, 24341, Republic of Korea
| | - Aayushi Randhawa
- Department of Biosystems Engineering, Kangwon National University, Chuncheon, 24341, Republic of Korea
- Interdisciplinary Program in Smart Agriculture, Kangwon National University, Chuncheon, 24341, Republic of Korea
| | - Ki-Taek Lim
- Department of Biosystems Engineering, Kangwon National University, Chuncheon, 24341, Republic of Korea
- Institute of Forest Science, Kangwon National University, Chuncheon, 24341, Republic of Korea
- Interdisciplinary Program in Smart Agriculture, Kangwon National University, Chuncheon, 24341, Republic of Korea
| |
Collapse
|
15
|
Huang YC, Huang YC, Ding SJ. Primary stability of implant placement and loading related to dental implant materials and designs: A literature review. J Dent Sci 2023; 18:1467-1476. [PMID: 37799926 PMCID: PMC10548003 DOI: 10.1016/j.jds.2023.06.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/12/2023] [Indexed: 10/07/2023] Open
Abstract
A variety of implant placement and loading protocols are identified, ranging from immediate implant placement on the day of extraction to delayed placement for at least 6 months after complete healing. The method of assessment of implant placement and loading plays an important role in the implantation. The expected clinical outcomes depend largely on multiple factors, such as the macroscopic design of the implant, surgical technique, and the quality and quantity of local bone in contact with the implant, which would be described in detail. The purpose of this literature review was to explore the relationship between the factors influencing the implant placement stability and implant design. By understanding the original appearance of implant design and the stability requirements of implant placement, it is hoped that more research in the future can meet the needs of dentists and patients.
Collapse
Affiliation(s)
- Yu-Che Huang
- Institute of Oral Science, Chung Shan Medical University, Taichung, Taiwan
| | - Yen-Chang Huang
- Institute of Oral Science, Chung Shan Medical University, Taichung, Taiwan
| | - Shinn-Jyh Ding
- Institute of Oral Science, Chung Shan Medical University, Taichung, Taiwan
- Department of Stomatology, Chung Shan Medical University Hospital, Taichung, Taiwan
| |
Collapse
|
16
|
Cipollina A, Ceddia M, Di Pietro N, Inchingolo F, Tumedei M, Romasco T, Piattelli A, Specchiulli A, Trentadue B. Finite Element Analysis (FEA) of a Premaxillary Device: A New Type of Subperiosteal Implant to Treat Severe Atrophy of the Maxilla. Biomimetics (Basel) 2023; 8:336. [PMID: 37622941 PMCID: PMC10452205 DOI: 10.3390/biomimetics8040336] [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: 06/14/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 08/26/2023] Open
Abstract
Extreme atrophy of the maxilla still poses challenges for clinicians. Some of the techniques used to address this issue can be complex, risky, expensive, and time consuming, often requiring skilled surgeons. While many commonly used techniques have achieved very high success rates, complications may arise in certain cases. In this context, the premaxillary device (PD) technique offers a simpler approach to reconstruct severely atrophic maxillae, aiming to avoid more complicated and risky surgical procedures. Finite element analysis (FEA) enables the evaluation of different aspects of dental implant biomechanics. Our results demonstrated that using a PD allows for an optimal distribution of stresses on the basal bone, avoiding tension peaks that can lead to bone resorption or implant failure. ANSYS® was used to perform localized finite element analysis (FEA), enabling a more precise examination of the peri-crestal area and the PD through an accurate mesh element reconstruction, which facilitated the mathematical solution of FEA. The most favorable biomechanical behavior was observed for materials such as titanium alloys, which helped to reduce stress levels on bone, implants, screws, and abutments. Additionally, stress values remained within the limits of basal bone and titanium alloy strengths. In conclusion, from a biomechanical point of view, PDs appear to be viable alternatives for rehabilitating severe atrophic maxillae.
Collapse
Affiliation(s)
| | - Mario Ceddia
- Department of Mechanics, Mathematics and Management, Politecnico di Bari University, 70125 Bari, Italy; (M.C.); (B.T.)
| | - Natalia Di Pietro
- Department of Medical, Oral and Biotechnological Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (T.R.); (A.S.)
- Center for Advanced Studies and Technologies (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Margherita Tumedei
- Department of Medical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy;
| | - Tea Romasco
- Department of Medical, Oral and Biotechnological Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (T.R.); (A.S.)
- Center for Advanced Studies and Technologies (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Adriano Piattelli
- School of Dentistry, Saint Camillus International University of Health and Medical Sciences, 00131 Rome, Italy;
- Facultad de Medicina, UCAM Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain
| | - Alessandro Specchiulli
- Department of Medical, Oral and Biotechnological Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (T.R.); (A.S.)
| | - Bartolomeo Trentadue
- Department of Mechanics, Mathematics and Management, Politecnico di Bari University, 70125 Bari, Italy; (M.C.); (B.T.)
| |
Collapse
|
17
|
Wang X, Shujaat S, Shaheen E, Ferraris E, Jacobs R. Trueness of cone-beam computed tomography-derived skull models fabricated by different technology-based three-dimensional printers. BMC Oral Health 2023; 23:397. [PMID: 37328901 PMCID: PMC10273646 DOI: 10.1186/s12903-023-03104-w] [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: 02/08/2023] [Accepted: 06/04/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Three-dimensional (3D) printing is a novel innovation in the field of craniomaxillofacial surgery, however, a lack of evidence exists related to the comparison of the trueness of skull models fabricated using different technology-based printers belonging to different cost segments. METHODS A study was performed to investigate the trueness of cone-beam computed tomography-derived skull models fabricated using different technology based on low-, medium-, and high-cost 3D printers. Following the segmentation of a patient's skull, the model was printed by: (i) a low-cost fused filament fabrication printer; (ii) a medium-cost stereolithography printer; and (iii) a high-cost material jetting printer. The fabricated models were later scanned by industrial computed tomography and superimposed onto the original reference virtual model by applying surface-based registration. A part comparison color-coded analysis was conducted for assessing the difference between the reference and scanned models. A one-way analysis of variance (ANOVA) with Bonferroni correction was applied for statistical analysis. RESULTS The model printed with the low-cost fused filament fabrication printer showed the highest mean absolute error ([Formula: see text]), whereas both medium-cost stereolithography-based and the high-cost material jetting models had an overall similar dimensional error of [Formula: see text] and [Formula: see text], respectively. Overall, the models printed with medium- and high-cost printers showed a significantly ([Formula: see text]) lower error compared to the low-cost printer. CONCLUSIONS Both stereolithography and material jetting based printers, belonging to the medium- and high-cost market segment, were able to replicate the skeletal anatomy with optimal trueness, which might be suitable for patient-specific treatment planning tasks in craniomaxillofacial surgery. In contrast, the low-cost fused filament fabrication printer could serve as a cost-effective alternative for anatomical education, and/or patient communication.
Collapse
Affiliation(s)
- Xiaotong Wang
- OMFS-IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, Leuven, 3000 Belgium
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Harbin Medical University, Youzheng Street 23, Nangang, 150001 Harbin China
| | - Sohaib Shujaat
- OMFS-IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, Leuven, 3000 Belgium
- King Abdullah International Medical Research Center, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Kingdom of Saudi Arabia, Riyadh, 14611 Saudi Arabia
| | - Eman Shaheen
- OMFS-IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, Leuven, 3000 Belgium
| | - Eleonora Ferraris
- Department of Mechanical Engineering, KU Leuven Campus De Nayer, Jan Pieter de Nayerlaan 5, 2860 Sint-Katelijne-Waver, Belgium
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, Leuven, 3000 Belgium
- Department of Dental Medicine, Karolinska Institutet, Alfred Nobels allé 8, 141 52, Huddinge, Sweden
| |
Collapse
|
18
|
Celik HK, Koc S, Kustarci A, Caglayan N, Rennie AE. The state of additive manufacturing in dental research - A systematic scoping review of 2012-2022. Heliyon 2023; 9:e17462. [PMID: 37484349 PMCID: PMC10361388 DOI: 10.1016/j.heliyon.2023.e17462] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 06/08/2023] [Accepted: 06/19/2023] [Indexed: 07/25/2023] Open
Abstract
Background/purpose Additive manufacturing (AM), also known as 3D printing, has the potential to transform the industry. While there have been advancements in using AM for dental restorations, there is still a need for further research to develop functional biomedical and dental materials. It's crucial to understand the current status of AM technology and research trends to advance dental research in this field. The aim of this study is to reveal the current status of international scientific publications in the field of dental research related to AM technologies. Materials and methods In this study, a systematic scoping review was conducted using appropriate keywords within the scope of international scientific publishing databases (PubMed and Web of Science). The review included related clinical and laboratory research, including both human and animal studies, case reports, review articles, and questionnaire studies. A total of 187 research studies were evaluated for quantitative synthesis in this review. Results The findings highlighted a rising trend in research numbers over the years (From 2012 to 2022). The most publications were produced in 2020 and 2021, with annual percentage increases of 25.7% and 26.2%, respectively. The majority of AM-related publications in dentistry research originate from Korea. The pioneer dental sub-fields with the ost publications in its category are prosthodontics and implantology, respectively. Conclusion The final review result clearly stated an expectation for the future that the research in dentistry would concentrate on AM technologies in order to increase the new product and process development in dental materials, tools, implants and new generation modelling strategy related to AM. The results of this work can be used as indicators of trends related to AM research in dentistry and/or as prospects for future publication expectations in this field.
Collapse
Affiliation(s)
- H. Kursat Celik
- Dept. of Agr. Machinery and Technology Engineering, Akdeniz University, Antalya, 07070, Turkey
| | - Simay Koc
- Dept. of Endodontics, Fac. of Dentistry, Akdeniz University, Antalya, Turkey
| | - Alper Kustarci
- Dept. of Endodontics, Fac. of Dentistry, Akdeniz University, Antalya, Turkey
| | - Nuri Caglayan
- Dept. of Mechatronics, Fac. of Engineering, Akdeniz University, Antalya, Turkey
| | | |
Collapse
|
19
|
Kreve S, Oliveira VC, Santos ES, Oliveira TT, Valente MLC, Batalha RL, Nascimento CD, Reis AC. In situ evaluation of microbial profile formed on Ti-6Al-4V additive manufacturing disks: 16S rRNA sequencing. J Prosthet Dent 2023:S0022-3913(23)00192-0. [PMID: 37120373 DOI: 10.1016/j.prosdent.2023.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 03/27/2023] [Accepted: 03/28/2023] [Indexed: 05/01/2023]
Abstract
STATEMENT OF PROBLEM Dental implants obtained by additive manufacturing may present changes in the microbiome formed. However, studies profiling the microbial communities formed on Ti-6Al-4V are lacking. PURPOSE The purpose of this in situ study was to characterize the profile of the microbial communities formed on Ti-6Al-4V disks produced by additive manufacturing and machining. MATERIAL AND METHODS Titanium disks produced by additive manufacturing (AMD) and machining (UD) were housed in the buccal region of removable intraoral devices. These devices containing both disks were used by eight participants for 96 hours. After every 24 hours of intraoral exposure, the biofilm that had formed on the disks was collected. The 16S rRNA genes from each specimen were amplified and sequenced with the Miseq Illumina instrument and analyzed. Total microbial quantification was evaluated by analysis of variance-type statistics using the nparLD package. The Wilcoxon test was used to evaluate alpha diversity (α=.05). RESULTS A difference was found in the microbial communities formed on additively manufactured and machined disks, with a reduction in operational taxonomic units (OTUs) for the AMD group compared with the UD group. Firmicutes and Proteobacteria were the most abundant phyla. Of the 1256 genera sequenced, Streptococcus predominated on both disks. CONCLUSIONS The microbiome of the biofilm formed on the Ti-6Al-4V disks was significantly influenced by the fabrication method. The AMD disks showed lower total microbial counts than the UD disks.
Collapse
Affiliation(s)
- Simone Kreve
- Doctoral student, Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, USP, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Viviane C Oliveira
- Specialized Laboratory Technician, Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Ribeirao Preto, Brazil
| | - Emerson S Santos
- Specialized Laboratory Technician, Faculty of Pharmaceutical Sciences of Ribeirão Preto, Department of Clinical Toxicological and Bromatologic Analysis, USP, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Thaisa T Oliveira
- Master student, Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, USP, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Mariana L C Valente
- Post-doctoral student, Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, USP, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Rodolfo L Batalha
- Researcher, Materials and Technologies, Department of Research, Development and Innovation, Instituto de Soldadura e Qualidade, Porto Salvo, Oeiras, Portugal
| | - Cássio do Nascimento
- Associate Professor, Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, USP, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Andréa C Reis
- Associate Professor, Departament of Dental Materials and Prosthesis, Ribeirão Preto Dental School, USP, University of São Paulo, Ribeirão Preto, SP, Brazil.
| |
Collapse
|
20
|
Filipov I, Chirila L, Bolognesi F, Cristache CM. Buccally or Lingually Tilted Implants in the Lateral Atrophic Mandible: A Three-Year Follow-Up Study Focused on Neurosensory Impairment, Soft-Tissue-Related Impaction and Quality of Life Improvement. Medicina (B Aires) 2023; 59:medicina59040697. [PMID: 37109655 PMCID: PMC10143031 DOI: 10.3390/medicina59040697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/31/2023] [Accepted: 03/31/2023] [Indexed: 04/05/2023] Open
Abstract
Background and Objectives: In the severely resorbed posterior mandible, implant placement requires either bone regenerative procedures, subperiosteal implants or short implant placement with drawbacks including morbidity and increased treatment costs and duration. To overcome these inconveniences, some unconventional alternatives have been suggested, such as buccally or lingually tilted implants in the lateral mandible, bypassing the inferior alveolar nerve. The aim of the present retrospective study was to evaluate the three-year survival rate of implants inserted in the posterior atrophic mandible, bypassing the inferior alveolar nerve. The assessment was focused on the occurrence of postoperative complications related to neurosensory impairment and soft tissue impaction, as well as overall improvement in quality of life. Materials and Methods: Patients with severe bone atrophy in the lateral area of the mandible were included in the present study. Only the implants tilted either buccally or lingually to bypass the inferior alveolar nerve were analysed. The relation between peri-implant soft tissue and the healing abutment was assessed and a secondary revision surgery was performed when indicated. The Semmes–Weinstein pressure neurological test was used for qualitative assessment of inferior alveolar nerve function and the Geriatric Oral Health Assessment Index (GOHAI) was used for evaluating Oral-Health-Related Quality of Life (OHRQoL). Results: Fourteen implants were placed in nine patients during the evaluation period. Survival rate was 100%, temporary paraesthesia occurred in one patient and a limited definitive paraesthesia was seen in another patient. Mild or significant discomfort related to soft tissue impaction with healing abutment was observed in six out of nine patients. A statistically significant OHRQoL improvement was observed in all patients. Conclusions: Despite the limited number of patients and observation time, insertion of implants buccally or lingually bypassing the inferior alveolar nerve is a predictive treatment option for patients with severe bone atrophy in the posterior mandible.
Collapse
Affiliation(s)
- Iulian Filipov
- Doctoral School, “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania
- Department of Maxillofacial Surgery, “Queen Maria” Military Emergency Hospital, 9 Pietii Str., 500007 Brasov, Romania
| | - Lucian Chirila
- Department of Oral and Maxillofacial Surgery, “Carol Davila” University of Medicine and Pharmacy, 19 Plevnei Ave., 010221 Bucharest, Romania
| | - Federico Bolognesi
- Oral and Maxillo-Facial Surgery Unit, IRCCS Policlinico di Sant’Orsola, Via Giuseppe Massarenti, 9, 40138 Bologna, Italy
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 59 Via S. Vitale, 40100 Bologna, Italy
| | - Corina Marilena Cristache
- Department of Dental Techniques, “Carol Davila” University of Medicine and Pharmacy, 8, Eroilor Sanitari Blvd., 050474 Bucharest, Romania
| |
Collapse
|
21
|
The atrophic edentulous alveolus. A preliminary study on a new generation of subperiosteal implants. Oral Maxillofac Surg 2023; 27:69-78. [PMID: 35119553 DOI: 10.1007/s10006-022-01044-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 01/30/2022] [Indexed: 10/19/2022]
Abstract
The aim of this cohort case series is to present a new subperiosteal implant device that uses CAD-CAM technologies together with 3D metal printing capabilities to produce direct bone-anchored dental prosthetic solutions for the management of atrophic edentulous alveolus and jaws. The clinical experience of 21 subperiosteal devices implanted over a 4-year period is presented. The results of this study showed 14 of the 21 cases were successful (66.7%), while 7 cases had complications including exposure of the metal frame (5 cases), mobility of the device (1 case) and 1 case failed for reasons unrelated to the device. Four of the 7 cases were successfully salvaged resulting in an overall success rate of 85.7% (18 /21 cases). This study supports the use of fully customized subperiosteal jaw implants as a simple and reliable alternative for dental rehabilitation of atrophic edentulous cases which would otherwise require bone grafts for conventional fixed dental implant solutions. With more research, the clinical potential for this device is significant as it not only avoids the need for complex and lengthy reconstructive jaw surgery but also allows for the placement of immediate prosthetic teeth at the time of implantation.
Collapse
|
22
|
Castrillo G, Carnicero A, Perera R. Submodelling approach to screw-to-bone interaction in additively manufactured subperiosteal implant structures. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2023; 39:e3672. [PMID: 36541118 DOI: 10.1002/cnm.3672] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 11/01/2022] [Accepted: 12/17/2022] [Indexed: 06/17/2023]
Abstract
Thanks to new digital technologies, complex cases of severe maxillary atrophy may now be treated with additively manufactured subperiosteal implant structures (AMSISs). However, there are few studies addressing this topic and most of them focus on the mechanical behaviour of the AMSIS itself without considering its interaction with the maxilla bone. The aim of this study is to provide a methodology based on finite element analysis (FEA) to evaluate the effect of interaction between the maxilla bone and the screws fixing the AMSIS. The mechanical performance of an AMSIS was examined via a FEA based on submodelling. Significant differences were encountered in displacements and reaction forces when bone-screw interaction was considered. Stress in the cortical layer was found to be close to the maximum strength while the trabecular layer seems to have no effect on the results; stresses in the AMSIS are lower than the fatigue stress limit. Finally, the comparison of stresses between models with and without osseointegration shows how stresses drop once osseointegration is complete. The proposed submodelling approach considerably reduces the computational effort and enables both a detailed model of the interaction between the thread of the screws and the bone and an accurate evaluation of displacement and stress fields on the interface. The results have shown that stresses in the cortical bone are highly affected by the initial geometry of the thread inside the bone, which demonstrates the importance of modelling the effect of the thread.
Collapse
Affiliation(s)
- Gabriel Castrillo
- Department of Mechanical Engineering, Technical University of Madrid, Madrid, Spain
| | - Alberto Carnicero
- Institute for Research in Technology, ETSI-ICAI, Comillas Pontifical University of Madrid, Madrid, Spain
| | - Ricardo Perera
- Department of Mechanical Engineering, Technical University of Madrid, Madrid, Spain
| |
Collapse
|
23
|
The rehabilitation of the atrophic posterior maxilla with a custom-made subperiosteal implant in patient with a history of medications related to osteonecrosis of the jaws: One-year case report. ORAL AND MAXILLOFACIAL SURGERY CASES 2023. [DOI: 10.1016/j.omsc.2023.100292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
|
24
|
Strappa EM, Memè L, Cerea M, Roy M, Bambini F. Custom-made additively manufactured subperiosteal implant. Minerva Dent Oral Sci 2022; 71:353-360. [PMID: 36345834 DOI: 10.23736/s2724-6329.22.04640-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Subperiosteal implants were introduced in the last century. Poor clinical results led those implants to be progressively abandoned. Recently, several Authors suggested a revival of subperiosteal implants as an alternative to regenerative procedures. The purpose of this study was to describe the clinical application of custom-made additively manufactured subperiosteal implant for fixed prosthetic rehabilitation of edentulous maxilla. Plaster models of the upper and the lower arch were scanned, as well as the mock-up. Digital Imaging and Communications in Medicine data obtained from cone beam computed tomography were processed through the thresholding procedure. The design of the subperiosteal implant was drawn on the stereolithographic model and scanned. Once the digital project of the subperiosteal implant was completed, it was sent to additive manufacturing. After the surgery, the patient was strictly monitored for up to 2 years. The outcomes were assessed based on the incurrence of biological and mechanical complications, postoperative complications, and implant survival. The patient did not suffer from postoperative complications. Neither biological nor mechanical complications occurred during the follow-up period. At the end of the study, the implant was still in function. Custom-made subperiosteal implants could be considered as an alternative to regenerative procedures for the rehabilitation of severe bone atrophy. Further studies are needed in the future to confirm the positive outcome.
Collapse
Affiliation(s)
| | - Lucia Memè
- Department of Clinical Sciences and Stomatology, Marche Polytechnic University, Ancona, Italy
| | | | - Marco Roy
- Department of Prosthodontics, Poznań University of Medical Sciences, Poznań, Poland
| | - Fabrizio Bambini
- Department of Clinical Sciences and Stomatology, Marche Polytechnic University, Ancona, Italy
| |
Collapse
|
25
|
Rico ÁMS, Fernández ABM, Martínez EB, López AJE, Valadés RF, Plaza AM. Prosthetic restoration with virtual planned subperiosteal implant in adult patient with cleft lip and palate with severe sequelae. ANNALS OF 3D PRINTED MEDICINE 2022. [DOI: 10.1016/j.stlm.2022.100095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
|
26
|
Ayna M, Gülses A. Adapting a simple surgical manual tool to a 3D printed implantology protocol: the use of a universal screwdriver for fixation of custom-made laser sintered titanium subperiosteal implants. 3D Print Med 2022; 8:31. [PMID: 36302914 PMCID: PMC9615198 DOI: 10.1186/s41205-022-00159-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/18/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose Current paper aims to describe a simple technique used for the fixation of the screws of a customized implant via a universal screw driver (BoneTrust® Easy Screw according to Dr. Bayer, Medical Instinct®, GmbH, Germany) to simplify the surgical placement of the customized implants. Methods The insertion of the drilling screws for the retention of the implant with angulated handpiece into the palatinal region or zygomatic buttress were performed with universal screw driver. Results The retention screws could be inserted with a proper angulation without interfering with the surrounding tissues. The technique described herein has significantly simplified the surgical intervention. Conclusion The insertion of the drilling screws for the retention of the implant with angulated handpiece into the palatinal region or zygomatic buttress could be challenging, thus the anatomical structures and the insufficient length of the handpiece could interfere with the placement of the screw with a proper angulation. This problem could be easily managed with the use of universal screw driver.
Collapse
Affiliation(s)
| | - Aydin Gülses
- Department of Oral and Maxillofacial Surgery, Universitätsklinikum Schleswig Holstein, Christian Albrechts University, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany.
| |
Collapse
|
27
|
Tognini M, Hothi H, Tucker S, Broomfield E, Shafafy M, Gikas P, Di Laura A, Henckel J, Hart A. Blood titanium levels in patients with large and sliding titanium implants. BMC Musculoskelet Disord 2022; 23:783. [PMID: 35974363 PMCID: PMC9380337 DOI: 10.1186/s12891-022-05717-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/29/2022] [Indexed: 11/23/2022] Open
Abstract
Background Titanium, which is known to be a highly biologically inert element, is one of the most commonly used metals in orthopaedic implants. While cobalt and chromium blood metal ion testing is routinely used in the clinical monitoring of patients with metal-on-metal hip implants, much less is known about the levels of titanium in patients with other implant types. The aim of this study was to better understand the normal ranges of blood titanium levels in patients implanted with large and sliding titanium constructs by comparison with reference levels from conventional titanium hips. Methods This study examined data collected from 136 patients. Over a period of 24 months, whole blood samples were collected from 41 patients implanted with large titanium implants: long (range 15 to 30 cm) spine rods with a sliding mechanism (“spine rods”, n = 18), long bone tumour implants (“tumour implants”, n = 13) and 3D-printed customised massive acetabular defect implants (“massive acetabular implants”, n = 10). This data was compared with standard, uncemented primary titanium hip implants (“standard hips”, 15 cm long) (n = 95). Clinical, imaging and blood titanium levels data were collected for all patients and compared statistically between the different groups. Results The median (range) of blood titanium levels of the standard hip, spine rods, femoral tumour implants and massive acetabular implants were 1.2 ppb (0.6–4.9), 9.7 ppb (4.0–25.4), 2.6 ppb (0.4–104.4) and 5.7 ppb (1.6–31.5) respectively. Spine rods and massive acetabular implants had significantly greater blood titanium levels compared to the standard hips group (p < 0.001). Conclusion This study showed that titanium orthopaedic implants that are large and/or have a sliding mechanism have higher blood titanium levels compared to well-functioning, conventionally sized titanium hips. Reassuringly, the increased levels did not appear to induce adverse metal reactions. This study provides useful baseline data for future studies aimed at assessing blood titanium levels as a biomarker for implant function.
Collapse
Affiliation(s)
- Martina Tognini
- Institute of Orthopaedics and Musculoskeletal Science, University College London, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, UK.
| | - Harry Hothi
- Institute of Orthopaedics and Musculoskeletal Science, University College London, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, UK
| | - Stewart Tucker
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Edel Broomfield
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Masood Shafafy
- Department of Trauma and Orthopaedics, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Panos Gikas
- Institute of Orthopaedics and Musculoskeletal Science, University College London, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, UK
| | - Anna Di Laura
- Institute of Orthopaedics and Musculoskeletal Science, University College London, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, UK
| | - Johann Henckel
- Institute of Orthopaedics and Musculoskeletal Science, University College London, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, UK
| | - Alister Hart
- Institute of Orthopaedics and Musculoskeletal Science, University College London, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, UK
| |
Collapse
|
28
|
Singh S, Aburashed R, Natale G. CFD based analysis of 3D printed nasopharyngeal swabs for COVID-19 diagnostics. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 223:106977. [PMID: 35780521 PMCID: PMC9233993 DOI: 10.1016/j.cmpb.2022.106977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 06/12/2022] [Accepted: 06/25/2022] [Indexed: 05/29/2023]
Abstract
BACKGROUND AND OBJECTIVE Additive manufacturing of nasopharyngeal (NP) swabs using 3D printing technology presents a viable alternative to address the immediate shortage problem of standard flock-headed swabs for rapid COVID-19 testing. Recently, several geometrical designs have been proposed for 3D printed NP swabs and their clinical trials are already underway. During clinical testing of the NP swabs, one of the key criteria to compare the efficacy of 3D printed swabs with traditional swabs is the collection efficiency. In this study, we report a numerical framework to investigate the collection efficiency of swabs utilizing the computational fluid dynamics (CFD) approach. METHODS Three-dimensional computational domain comprising of NP swab dipped in the liquid has been considered in this study to mimic the dip test procedure. The volume of fluid (VOF) method has been employed to track the liquid-air interface as the NP swab is pulled out of the liquid. The governing equations of the multiphase model have been solved utilizing finite-volume-based ANSYS Fluent software by imposing appropriate boundary conditions. Taguchi's based design of experiment analysis has also been conducted to evaluate the influence of geometric design parameters on the collection efficiency of NP swabs. The developed model has been validated by comparing the numerically predicted collection efficiency of different 3D printed NP swabs with the experimental findings. RESULTS Numerical predictions of the CFD model are in good agreement with the experimental results. It has been found that there prevails huge variability in the collection efficiency of the 3D printed designs of NP swabs available in the literature, ranging from 2 µl to 120 µl. Furthermore, even the smallest alteration in the geometric design parameter of the 3D printed NP swab results in significant changes in the amount of fluid captured. CONCLUSIONS The proposed framework would assist in quantifying the collection efficiency of the 3D printed designs of NP swabs, rapidly and at a low cost. Moreover, we demonstrate that the developed framework can be extended to optimize the designs of 3D printed swabs to drastically improve the performances of the existing designs and achieve comparable efficacy to that of conventionally manufactured swabs.
Collapse
Affiliation(s)
- Sundeep Singh
- Complex Fluids Lab, Chemical and Petroleum Engineering, University of Calgary, Calgary, Alberta, T2N 1N4, Canada
| | - Raied Aburashed
- BioMEMS and Bioinspired Microfluidic Laboratory, Department of Mechanical and Manufacturing Engineering, University of Calgary, Calgary, Alberta T2N 1N4, Canada
| | - Giovanniantonio Natale
- Complex Fluids Lab, Chemical and Petroleum Engineering, University of Calgary, Calgary, Alberta, T2N 1N4, Canada.
| |
Collapse
|
29
|
Sheta SM, El-Sheikh SM. Nanomaterials and metal-organic frameworks for biosensing applications of mutations of the emerging viruses. Anal Biochem 2022; 648:114680. [PMID: 35429447 PMCID: PMC9007753 DOI: 10.1016/j.ab.2022.114680] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/26/2022] [Accepted: 04/01/2022] [Indexed: 12/15/2022]
Abstract
The world today lives in a state of terrible fear due to the mutation of the emerging COVID-19. With the continuation of this pandemic, there is an urgent need for fast, accurate testing devices to detect the emerging SARS-CoV-2 pandemic in terms of biosensors and point-of-care testing. Besides, the urgent development in personal defense tools, anti-viral surfaces and wearables, and smartphones open the door for simplifying the self-diagnosis process everywhere. This review introduces a quick COVID-19 overview: definition, transmission, pathophysiology, the identification and diagnosis, mutation and transformation, and the global situation. It also focuses on an overview of the rapidly advanced technologies based on nanomaterials and MOFs for biosensing, diagnosing, and viral control of the SARS-CoV-2 pandemic. Finally, highlight the latest technologies, applications, existing achievements, and preventive diagnostic strategies to control this epidemic and combat the emerging coronavirus. This humble effort aims to provide a helpful survey that can be used to develop a creative solution and to lay down the future vision of diagnosis against COVID-19.
Collapse
Affiliation(s)
- Sheta M. Sheta
- Department of Inorganic Chemistry, National Research Centre, 33 El-Behouth St., Dokki, Giza, 12622, Egypt,Corresponding author
| | - Said M. El-Sheikh
- Department of Nanomaterials and Nanotechnology, Central Metallurgical R & D Institute, Cairo, 11421, Egypt,Corresponding author
| |
Collapse
|
30
|
Xu Z, Yang Z, Yang J. Digital Workflow for the Design, Manufacture, and Application of Custom-Made Short Implants With Wing Retention Device. Front Bioeng Biotechnol 2022; 10:885746. [PMID: 35757795 PMCID: PMC9213801 DOI: 10.3389/fbioe.2022.885746] [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: 02/28/2022] [Accepted: 04/19/2022] [Indexed: 12/02/2022] Open
Abstract
The severe deficiency of vertical bone height in the posterior maxillary region poses a challenge to implant restoration. In response to this issue, this article introduces a custom-made short implant with a wing retention structure and describes a precise and minimally invasive dental implant restoration scheme with digital technology.
Collapse
Affiliation(s)
- Zexian Xu
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China.,School of Stomatology of Qingdao University, Qingdao, China.,Dental Digital Medicine and 3D Printing Engineering Laboratory of Qingdao, Qingdao, China
| | - Zhen Yang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China.,National Clinical Research Center for Oral Diseases, Beijing, China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China.,Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Jianjun Yang
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China.,School of Stomatology of Qingdao University, Qingdao, China.,Dental Digital Medicine and 3D Printing Engineering Laboratory of Qingdao, Qingdao, China
| |
Collapse
|
31
|
Mosaddad SA, Rasoolzade B, Namanloo RA, Azarpira N, Dortaj H. Stem cells and common biomaterials in dentistry: a review study. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2022; 33:55. [PMID: 35716227 PMCID: PMC9206624 DOI: 10.1007/s10856-022-06676-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 05/16/2022] [Indexed: 05/16/2023]
Abstract
Stem cells exist as normal cells in embryonic and adult tissues. In recent years, scientists have spared efforts to determine the role of stem cells in treating many diseases. Stem cells can self-regenerate and transform into some somatic cells. They would also have a special position in the future in various clinical fields, drug discovery, and other scientific research. Accordingly, the detection of safe and low-cost methods to obtain such cells is one of the main objectives of research. Jaw, face, and mouth tissues are the rich sources of stem cells, which more accessible than other stem cells, so stem cell and tissue engineering treatments in dentistry have received much clinical attention in recent years. This review study examines three essential elements of tissue engineering in dentistry and clinical practice, including stem cells derived from the intra- and extra-oral sources, growth factors, and scaffolds.
Collapse
Affiliation(s)
- Seyed Ali Mosaddad
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Boshra Rasoolzade
- Student Research Committee, Department of Pediatric Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Negar Azarpira
- Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hengameh Dortaj
- Department of Tissue Engineering, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
32
|
Sliding Flap for the Wide Upper Eyelid Margin Defect After Cancer Removal. J Craniofac Surg 2022; 33:2063-2066. [PMID: 35148531 DOI: 10.1097/scs.0000000000008551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 01/25/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Reconstruction of eyelid margin defects following resection of upper-eyelid skin malignancies is typically performed using a lower eyelid switch flap, including eyelash reconstruction. However, a subsequent procedure for flap separation, and prolonged swelling of the flap may occur as a complication. OBJECTIVE The authors performed anterior lamellar reconstruction using a sliding flap with excess upper eyelid skin, a procedure that is a less invasive and simpler. MATERIALS AND METHODS The authors performed anterior lamellar reconstruction using a sliding flap in 7 patients with full-thickness upper eyelid margin defect after skin cancer resection. The mean age of the patients was 76.0 years. The horizontal width of the defect in our cohort ranged from 11 to 25 mm and the vertical width ranged from 5 to 10 mm. RESULTS All the flaps and mucosal grafts were well taken, and none of the patients complained of lack of eyelash reconstruction. However, eyelid margin irregularity, possibly due to flap or mucosal graft contraction, was observed in 2 patients, and 1 patient developed keratoconjunctivitis. CONCLUSIONS The sliding flap technique is a minimally invasive and simple procedure for wide eyelid margin reconstruction. However, 2 patients developed eyelid margin irregularities and 1 patient developed keratoconjunctivitis. Those complications might have occurred owing to the condition of posterior lamellar reconstruction. Therefore, for the successful use of a sliding flap for anterior lamellar reconstruction, the form of the eyelid edge and the choice of posterior lamellar reconstruction are key considerations. In future, we plan to establish a better reconstructive technique by accumulating more evidence.
Collapse
|
33
|
Pitrmuc Z, Šimota J, Beránek L, Mikeš P, Andronov V, Sommer J, Holešovský F. Mechanical and Microstructural Anisotropy of Laser Powder Bed Fusion 316L Stainless Steel. MATERIALS (BASEL, SWITZERLAND) 2022; 15:551. [PMID: 35057266 PMCID: PMC8779437 DOI: 10.3390/ma15020551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/04/2022] [Accepted: 01/07/2022] [Indexed: 12/22/2022]
Abstract
This paper aims at an in-depth and comprehensive analysis of mechanical and microstructural properties of AISI 316L austenitic stainless steel (W. Nr. 1.4404, CL20ES) produced by laser powder bed fusion (LPBF) additive manufacturing (AM) technology. The experiment in its first part includes an extensive study of the anisotropy of mechanical and microstructural properties in relation to the built orientation and the direction of loading, which showed significant differences in tensile properties among samples. The second part of the experiment is devoted to the influence of the process parameter focus level (FL) on mechanical properties, where a 48% increase in notched toughness was recorded when the level of laser focus was identical to the level of melting. The FL parameter is not normally considered a process parameter; however, it can be intentionally changed in the service settings of the machine or by incorrect machine repair and maintenance. Evaluation of mechanical and microstructural properties was performed using the tensile test, Charpy impact test, Brinell hardness measurement, microhardness matrix measurement, porosity analysis, scanning electron microscopy (SEM), and optical microscopy. Across the whole spectrum of samples, performed analysis confirmed the high quality of LPBF additive manufactured material, which can be compared with conventionally produced material. A very low level of porosity in the range of 0.036 to 0.103% was found. Microstructural investigation of solution annealed (1070 °C) tensile test samples showed an outstanding tendency to recrystallization, grain polygonization, annealing twins formation, and even distribution of carbides in solid solution.
Collapse
Affiliation(s)
- Zdeněk Pitrmuc
- Department of Machining, Process Planning and Metrology, Center of Advanced Aerospace Technology, Faculty of Mechanical Engineering, The Czech Technical University in Prague, 160 00 Prague, Czech Republic; (J.Š.); (L.B.); (P.M.); (V.A.); (J.S.); (F.H.)
| | | | | | | | | | | | | |
Collapse
|
34
|
Korn P, Gellrich NC, Jehn P, Spalthoff S, Rahlf B. A New Strategy for Patient-Specific Implant-Borne Dental Rehabilitation in Patients With Extended Maxillary Defects. Front Oncol 2021; 11:718872. [PMID: 34956858 PMCID: PMC8708135 DOI: 10.3389/fonc.2021.718872] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 11/25/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose of the Study Patients undergoing ablative tumor surgery of the midface are faced with functional and esthetic issues. Various reconstructive strategies, such as implant-borne obturator prostheses or microvascular tissue transfer, are currently available for dental rehabilitation. The present study shows the first follow-up of patients treated with patient-specific implants (IPS Implants® Preprosthetic) for the rehabilitation of extended maxillary defects following ablative surgery. Patients and Methods All patients treated with patient specific implants due to postablative maxillary defects were included. 20 implants were placed in the 19 patients (bilateral implants were placed in one of the cases). In 65.75% of the cases, resection was performed due to squamous cell carcinoma. In addition to the primary stability, the clinical implant stability, soft tissue management, successful prosthodontic restoration, and complications were evaluated at a mean follow-up period of 26 months. Results All patient-specific implants showed primary stability and were clinically stable throughout the observation period. Definitive prosthodontic restorations were performed in all patients. No implant loosening was observed. Major complications occurred only in previously irradiated patients with insufficient soft tissue conditions (p = 0.058). Minor complications such as exposure of the underlying framework or mucositis were observed, but they never led to failure of restorations or implant loss. Conclusions Treatment of postablative maxillary defects with patient-specific implants offers a safe alternative with predictable results for full and rapid dental rehabilitation, avoiding time-consuming augmentation procedures and additional donor-site morbidity.
Collapse
Affiliation(s)
- Philippe Korn
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Nils-Claudius Gellrich
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Philipp Jehn
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Simon Spalthoff
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Björn Rahlf
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| |
Collapse
|
35
|
Shaikh MQ, Nath SD, Akilan AA, Khanjar S, Balla VK, Grant GT, Atre SV. Investigation of Patient-Specific Maxillofacial Implant Prototype Development by Metal Fused Filament Fabrication (MF 3) of Ti-6Al-4V. Dent J (Basel) 2021; 9:dj9100109. [PMID: 34677171 PMCID: PMC8534331 DOI: 10.3390/dj9100109] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 09/07/2021] [Accepted: 09/17/2021] [Indexed: 11/16/2022] Open
Abstract
Additive manufacturing (AM) and related digital technologies have enabled several advanced solutions in medicine and dentistry, in particular, the design and fabrication of patient-specific implants. In this study, the feasibility of metal fused filament fabrication (MF3) to manufacture patient-specific maxillofacial implants is investigated. Here, the design and fabrication of a maxillofacial implant prototype in Ti-6Al-4V using MF3 is reported for the first time. The cone-beam computed tomography (CBCT) image data of the patient’s oral anatomy was digitally processed to design a 3D CAD model of the hard tissue and fabricate a physical model by stereolithography (SLA). Using the digital and physical models, bone loss condition was analyzed, and a maxillofacial implant initial design was identified. Three-dimensional (3D) CAD models of the implant prototypes were designed that match the patient’s anatomy and dental implant requirement. In this preliminary stage, the CAD models of the prototypes were designed in a simplified form. MF3 printing of the prototypes was simulated to investigate potential deformation and residual stresses. The patient-specific implant prototypes were fabricated by MF3 printing followed by debinding and sintering using a support structure for the first time. MF3 printed green part dimensions fairly matched with simulation prediction. Sintered parts were characterized for surface integrity after cutting the support structures off. An overall 18 ± 2% shrinkage was observed in the sintered parts relative to the green parts. A relative density of 81 ± 4% indicated 19% total porosity including 11% open interconnected porosity in the sintered parts, which would favor bone healing and high osteointegration in the metallic implants. The surface roughness of Ra: 18 ± 5 µm and a Rockwell hardness of 6.5 ± 0.8 HRC were observed. The outcome of the work can be leveraged to further investigate the potential of MF3 to manufacture patient-specific custom implants out of Ti-6Al-4V.
Collapse
Affiliation(s)
- Mohammad Qasim Shaikh
- Materials Innovation Guild, University of Louisville, Louisville, KY 40208, USA; (M.Q.S.); (S.D.N.); (A.A.A.); (S.K.); (V.K.B.)
| | - Subrata Deb Nath
- Materials Innovation Guild, University of Louisville, Louisville, KY 40208, USA; (M.Q.S.); (S.D.N.); (A.A.A.); (S.K.); (V.K.B.)
| | - Arulselvan Arumugam Akilan
- Materials Innovation Guild, University of Louisville, Louisville, KY 40208, USA; (M.Q.S.); (S.D.N.); (A.A.A.); (S.K.); (V.K.B.)
| | - Saleh Khanjar
- Materials Innovation Guild, University of Louisville, Louisville, KY 40208, USA; (M.Q.S.); (S.D.N.); (A.A.A.); (S.K.); (V.K.B.)
| | - Vamsi Krishna Balla
- Materials Innovation Guild, University of Louisville, Louisville, KY 40208, USA; (M.Q.S.); (S.D.N.); (A.A.A.); (S.K.); (V.K.B.)
- Bioceramics and Coating Division, CSIR-Central Glass and Ceramic Research Institute, 196 Raja S.C. Mullick Road, Kolkata 700 032, India
| | | | - Sundar Vedanarayanan Atre
- Materials Innovation Guild, University of Louisville, Louisville, KY 40208, USA; (M.Q.S.); (S.D.N.); (A.A.A.); (S.K.); (V.K.B.)
- Correspondence:
| |
Collapse
|
36
|
Verhelst PJ, Smolders A, Beznik T, Meewis J, Vandemeulebroucke A, Shaheen E, Van Gerven A, Willems H, Politis C, Jacobs R. Layered deep learning for automatic mandibular segmentation in cone-beam computed tomography. J Dent 2021; 114:103786. [PMID: 34425172 DOI: 10.1016/j.jdent.2021.103786] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/05/2021] [Accepted: 08/16/2021] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To develop and validate a layered deep learning algorithm which automatically creates three-dimensional (3D) surface models of the human mandible out of cone-beam computed tomography (CBCT) imaging. MATERIALS & METHODS Two convolutional networks using a 3D U-Net architecture were combined and deployed in a cloud-based artificial intelligence (AI) model. The AI model was trained in two phases and iteratively improved to optimize the segmentation result using 160 anonymized full skull CBCT scans of orthognathic surgery patients (70 preoperative scans and 90 postoperative scans). Finally, the final AI model was tested by assessing timing, consistency, and accuracy on a separate testing dataset of 15 pre- and 15 postoperative full skull CBCT scans. The AI model was compared to user refined AI segmentations (RAI) and to semi-automatic segmentation (SA), which is the current clinical standard. The time needed for segmentation was measured in seconds. Intra- and inter-operator consistency were assessed to check if the segmentation protocols delivered reproducible results. The following consistency metrics were used: intersection over union (IoU), dice similarity coefficient (DSC), Hausdorff distance (HD), absolute volume difference and root mean square (RMS) distance. To evaluate the match of the AI and RAI results to those of the SA method, their accuracy was measured using IoU, DSC, HD, absolute volume difference and RMS distance. RESULTS On average, SA took 1218.4s. RAI showed a significant drop (p<0.0001) in timing to 456.5s (2.7-fold decrease). The AI method only took 17s (71.3-fold decrease). The average intra-operator IoU for RAI was 99.5% compared to 96.9% for SA. For inter-operator consistency, RAI scored an IoU of 99.6% compared to 94.6% for SA. The AI method was always consistent by default. In both the intra- and inter-operator consistency assessments, RAI outperformed SA on all metrics indicative of better consistency. With SA as the ground truth, AI and RAI scored an IoU of 94.6% and 94.4%, respectively. All accuracy metrics were similar for AI and RAI, meaning that both methods produce 3D models that closely match those produced by SA. CONCLUSION A layered 3D U-Net architecture deep learning algorithm, with and without additional user refinements, improves time-efficiency, reduces operator error, and provides excellent accuracy when benchmarked against the clinical standard. CLINICAL SIGNIFICANCE Semi-automatic segmentation in CBCT imaging is time-consuming and allows user-induced errors. Layered convolutional neural networks using a 3D U-Net architecture allow direct segmentation of high-resolution CBCT images. This approach creates 3D mandibular models in a more time-efficient and consistent way. It is accurate when benchmarked to semi-automatic segmentation.
Collapse
Affiliation(s)
- Pieter-Jan Verhelst
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, BE-3000 Leuven, Belgium; OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Kapucijnenvoer 33, BE-3000 Leuven, Belgium.
| | | | | | - Jeroen Meewis
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, BE-3000 Leuven, Belgium; OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Kapucijnenvoer 33, BE-3000 Leuven, Belgium
| | - Arne Vandemeulebroucke
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Kapucijnenvoer 33, BE-3000 Leuven, Belgium
| | - Eman Shaheen
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, BE-3000 Leuven, Belgium; OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Kapucijnenvoer 33, BE-3000 Leuven, Belgium
| | | | | | - Constantinus Politis
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, BE-3000 Leuven, Belgium; OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Kapucijnenvoer 33, BE-3000 Leuven, Belgium
| | - Reinhilde Jacobs
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, BE-3000 Leuven, Belgium; OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Kapucijnenvoer 33, BE-3000 Leuven, Belgium; Department of Dental Medicine, Karolinska Institutet, Box 4064, 141 04 Huddinge, Sweden
| |
Collapse
|
37
|
Abstract
Additive manufacturing's attributes include print customization, low per-unit cost for small- to mid-batch production, seamless interfacing with mainstream medical 3D imaging techniques, and feasibility to create free-form objects in materials that are biocompatible and biodegradable. Consequently, additive manufacturing is apposite for a wide range of biomedical applications including custom biocompatible implants that mimic the mechanical response of bone, biodegradable scaffolds with engineered degradation rate, medical surgical tools, and biomedical instrumentation. This review surveys the materials, 3D printing methods and technologies, and biomedical applications of metal 3D printing, providing a historical perspective while focusing on the state of the art. It then identifies a number of exciting directions of future growth: (a) the improvement of mainstream additive manufacturing methods and associated feedstock; (b) the exploration of mature, less utilized metal 3D printing techniques; (c) the optimization of additively manufactured load-bearing structures via artificial intelligence; and (d) the creation of monolithic, multimaterial, finely featured, multifunctional implants.
Collapse
Affiliation(s)
| | - Yosef Kornbluth
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| |
Collapse
|
38
|
Wang Y, Ahmed A, Azam A, Bing D, Shan Z, Zhang Z, Tariq MK, Sultana J, Mushtaq RT, Mehboob A, Xiaohu C, Rehman M. Applications of additive manufacturing (AM) in sustainable energy generation and battle against COVID-19 pandemic: The knowledge evolution of 3D printing. JOURNAL OF MANUFACTURING SYSTEMS 2021; 60:709-733. [PMID: 35068653 PMCID: PMC8759146 DOI: 10.1016/j.jmsy.2021.07.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/17/2021] [Accepted: 07/17/2021] [Indexed: 05/09/2023]
Abstract
Sustainable and cleaner manufacturing systems have found broad applications in industrial processes, especially aerospace, automotive and power generation. Conventional manufacturing methods are highly unsustainable regarding carbon emissions, energy consumption, material wastage, costly shipment and complex supply management. Besides, during global COVID-19 pandemic, advanced fabrication and management strategies were extremely required to fulfill the shortfall of basic and medical emergency supplies. Three-dimensional printing (3DP) reduces global energy consumption and CO2 emissions related to industrial manufacturing. Various renewable energy harvesting mechanisms utilizing solar, wind, tidal and human potential have been fabricated through additive manufacturing. 3D printing aided the manufacturing companies in combating the deficiencies of medical healthcare devices for patients and professionals globally. In this regard, 3D printed medical face shields, respiratory masks, personal protective equipment, PLA-based recyclable air filtration masks, additively manufactured ideal tissue models and new information technology (IT) based rapid manufacturing are some significant contributions of 3DP. Furthermore, a bibliometric study of 3D printing research was conducted in CiteSpace. The most influential keywords and latest research frontiers were found and the 3DP knowledge was categorized into 10 diverse research themes. The potential challenges incurred by AM industry during the pandemic were categorized in terms of design, safety, manufacturing, certification and legal issues. Significantly, this study highlights the versatile role of 3DP in battle against COVID-19 pandemic and provides up-to-date research frontiers, leading the readers to focus on the current hurdles encountered by AM industry, henceforth conduct further investigations to enhance 3DP technology.
Collapse
Affiliation(s)
- Yanen Wang
- Department of Industry Engineering, Northwestern Polytechnical University, Xi'an, 710072, PR China
| | - Ammar Ahmed
- Department of Industry Engineering, Northwestern Polytechnical University, Xi'an, 710072, PR China
| | - Ali Azam
- School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, 610031, PR China
| | - Du Bing
- Center of Stomatology, The Second People's Hospital of Foshan, Foshan, 528000, PR China
| | - Zhang Shan
- Department of Industry Engineering, Northwestern Polytechnical University, Xi'an, 710072, PR China
| | - Zutao Zhang
- School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, 610031, PR China
| | - Muhammad Kashif Tariq
- Department of Mechanical Engineering, University of Engineering & Technology, Lahore, 54890, Pakistan
| | - Jakiya Sultana
- Department of Industry Engineering, Northwestern Polytechnical University, Xi'an, 710072, PR China
| | - Ray Tahir Mushtaq
- Department of Industry Engineering, Northwestern Polytechnical University, Xi'an, 710072, PR China
| | - Asad Mehboob
- Department of Material Science and Engineering, Northwestern Polytechnical University, Xi'an, 710072, PR China
| | - Chen Xiaohu
- Department of Industry Engineering, Northwestern Polytechnical University, Xi'an, 710072, PR China
| | - Mudassar Rehman
- Department of Industry Engineering, Northwestern Polytechnical University, Xi'an, 710072, PR China
| |
Collapse
|
39
|
Selim OA, Lakhani S, Midha S, Mosahebi A, Kalaskar DM. Three-Dimensional Engineered Peripheral Nerve: Toward a New Era of Patient-Specific Nerve Repair Solutions. TISSUE ENGINEERING PART B-REVIEWS 2021; 28:295-335. [PMID: 33593147 DOI: 10.1089/ten.teb.2020.0355] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Reconstruction of peripheral nerve injuries (PNIs) with substance loss remains challenging because of limited treatment solutions and unsatisfactory patient outcomes. Currently, nerve autografting is the first-line management choice for bridging critical-sized nerve defects. The procedure, however, is often complicated by donor site morbidity and paucity of nerve tissue, raising a quest for better alternatives. The application of other treatment surrogates, such as nerve guides, remains questionable, and it is inefficient in irreducible nerve gaps. More importantly, these strategies lack customization for personalized patient therapy, which is a significant drawback of these nerve repair options. This negatively impacts the fascicle-to-fascicle regeneration process, critical to restoring the physiological axonal pathway of the disrupted nerve. Recently, the use of additive manufacturing (AM) technologies has offered major advancements to the bioengineering solutions for PNI therapy. These techniques aim at reinstating the native nerve fascicle pathway using biomimetic approaches, thereby augmenting end-organ innervation. AM-based approaches, such as three-dimensional (3D) bioprinting, are capable of biofabricating 3D-engineered nerve graft scaffolds in a patient-specific manner with high precision. Moreover, realistic in vitro models of peripheral nerve tissues that represent the physiologically and functionally relevant environment of human organs could also be developed. However, the technology is still nascent and faces major translational hurdles. In this review, we spotlighted the clinical burden of PNIs and most up-to-date treatment to address nerve gaps. Next, a summarized illustration of the nerve ultrastructure that guides research solutions is discussed. This is followed by a contrast of the existing bioengineering strategies used to repair peripheral nerve discontinuities. In addition, we elaborated on the most recent advances in 3D printing and biofabrication applications in peripheral nerve modeling and engineering. Finally, the major challenges that limit the evolution of the field along with their possible solutions are also critically analyzed.
Collapse
Affiliation(s)
- Omar A Selim
- Department of Surgical Biotechnology, Division of Surgery and Interventional Sciences, Royal Free Hospital, University College London (UCL), London, United Kingdom
| | - Saad Lakhani
- Department of Surgical Biotechnology, Division of Surgery and Interventional Sciences, Royal Free Hospital, University College London (UCL), London, United Kingdom
| | - Swati Midha
- Department of Surgical Biotechnology, Division of Surgery and Interventional Sciences, Royal Free Hospital, University College London (UCL), London, United Kingdom.,Department of Surgical Biotechnology, Special Centre for Nanoscience, Jawaharlal Nehru University, New Delhi, India
| | - Afshin Mosahebi
- Department of Plastic Surgery, Royal Free Hospital, University College London (UCL), London, United Kingdom
| | - Deepak M Kalaskar
- Department of Surgical Biotechnology, Division of Surgery and Interventional Sciences, Royal Free Hospital, University College London (UCL), London, United Kingdom.,Department of Surgical Biotechnology, Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedic Hospital, University College London (UCL), Stanmore, United Kingdom
| |
Collapse
|
40
|
Corona-Castuera J, Rodriguez-Delgado D, Henao J, Castro-Sandoval JC, Poblano-Salas CA. Design and Fabrication of a Customized Partial Hip Prosthesis Employing CT-Scan Data and Lattice Porous Structures. ACS OMEGA 2021; 6:6902-6913. [PMID: 33748604 PMCID: PMC7970571 DOI: 10.1021/acsomega.0c06144] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 02/23/2021] [Indexed: 05/22/2023]
Abstract
As a larger elderly human population is expected worldwide in the next 30 years, the occurrence of aging-associated illnesses will also be increased. The use of prosthetic devices by this population is currently important and will be even more dramatic in the near future. Hence, the design of prosthetic devices able to reduce some of the problems associated with the use of current components, such as stress shielding, reduced mobility, infection, discomfort, etc., becomes relevant. The use of additive manufacturing (AM) and the design fabrication of self-supported cellular structures in the biomedical area have opened up important opportunities for controlling the physical and mechanical properties of hip implants, resulting in specific benefits for the patients. Different studies have reported the development of hip prosthetic designs employing AM, although there are still opportunities for improvement when it comes to customized design and tuning of the physical and mechanical properties of such implants. This work shows the design and manufacture by AM of a personalized stainless-steel partial hip implant using tomography data and self-supported triply periodic minimal surface (TPMS) cell structures; the design considers dimensional criteria established by international standards. By employing tomography data, the external dimensions of the implant were established and the bone density of a specific patient was calculated; the density and mechanical properties in compression of the implant were modulated by employing an internal gyroid-type cell structure. Using such a cell structure, the patient's bone density was emulated; also, the mechanical properties of the implant were fine-tuned in order to make them comparable to those reported for the bone tissue replaced by the prosthesis. The implant design and manufacturing methodology developed in this work considered the clinical condition of a specific patient and can be reproduced and adjusted for different types of bone tissue qualities for specific clinical requirements.
Collapse
Affiliation(s)
- Jorge Corona-Castuera
- CIATEQ
A.C., Av. Manantiales
23-A, Parque Industrial Bernardo Quintana, El Marqués, Querétaro 76246, Mexico
| | - Daniela Rodriguez-Delgado
- CIATEQ
A.C., Av. Manantiales
23-A, Parque Industrial Bernardo Quintana, El Marqués, Querétaro 76246, Mexico
| | - John Henao
- CONACyT-CIATEQ
A.C., Av. Manantiales
23-A, Parque Industrial Bernardo Quintana, El Marqués, Querétaro 76246, Mexico
| | | | - Carlos A. Poblano-Salas
- CIATEQ
A.C., Av. Manantiales
23-A, Parque Industrial Bernardo Quintana, El Marqués, Querétaro 76246, Mexico
| |
Collapse
|
41
|
Pillai S, Upadhyay A, Khayambashi P, Farooq I, Sabri H, Tarar M, Lee KT, Harb I, Zhou S, Wang Y, Tran SD. Dental 3D-Printing: Transferring Art from the Laboratories to the Clinics. Polymers (Basel) 2021; 13:polym13010157. [PMID: 33406617 PMCID: PMC7795531 DOI: 10.3390/polym13010157] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/14/2020] [Accepted: 12/30/2020] [Indexed: 12/13/2022] Open
Abstract
The rise of three-dimensional (3D) printing technology has changed the face of dentistry over the past decade. 3D printing is a versatile technique that allows the fabrication of fully automated, tailor-made treatment plans, thereby delivering personalized dental devices and aids to the patients. It is highly efficient, reproducible, and provides fast and accurate results in an affordable manner. With persistent efforts among dentists for refining their practice, dental clinics are now acclimatizing from conventional treatment methods to a fully digital workflow to treat their patients. Apart from its clinical success, 3D printing techniques are now employed in developing haptic simulators, precise models for dental education, including patient awareness. In this narrative review, we discuss the evolution and current trends in 3D printing applications among various areas of dentistry. We aim to focus on the process of the digital workflow used in the clinical diagnosis of different dental conditions and how they are transferred from laboratories to clinics. A brief outlook on the most recent manufacturing methods of 3D printed objects and their current and future implications are also discussed.
Collapse
Affiliation(s)
- Sangeeth Pillai
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (S.P.); (A.U.); (P.K.); (H.S.); (M.T.); (K.T.L.); (I.H.); (S.Z.); (Y.W.)
| | - Akshaya Upadhyay
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (S.P.); (A.U.); (P.K.); (H.S.); (M.T.); (K.T.L.); (I.H.); (S.Z.); (Y.W.)
| | - Parisa Khayambashi
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (S.P.); (A.U.); (P.K.); (H.S.); (M.T.); (K.T.L.); (I.H.); (S.Z.); (Y.W.)
| | - Imran Farooq
- Faculty of Dentistry, University of Toronto, Toronto, ON M5S 1A1, Canada;
| | - Hisham Sabri
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (S.P.); (A.U.); (P.K.); (H.S.); (M.T.); (K.T.L.); (I.H.); (S.Z.); (Y.W.)
| | - Maryam Tarar
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (S.P.); (A.U.); (P.K.); (H.S.); (M.T.); (K.T.L.); (I.H.); (S.Z.); (Y.W.)
| | - Kyungjun T. Lee
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (S.P.); (A.U.); (P.K.); (H.S.); (M.T.); (K.T.L.); (I.H.); (S.Z.); (Y.W.)
| | - Ingrid Harb
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (S.P.); (A.U.); (P.K.); (H.S.); (M.T.); (K.T.L.); (I.H.); (S.Z.); (Y.W.)
| | - Stephanie Zhou
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (S.P.); (A.U.); (P.K.); (H.S.); (M.T.); (K.T.L.); (I.H.); (S.Z.); (Y.W.)
| | - Yifei Wang
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (S.P.); (A.U.); (P.K.); (H.S.); (M.T.); (K.T.L.); (I.H.); (S.Z.); (Y.W.)
| | - Simon D. Tran
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (S.P.); (A.U.); (P.K.); (H.S.); (M.T.); (K.T.L.); (I.H.); (S.Z.); (Y.W.)
- Correspondence: ; Tel.: +1-514-398-7203
| |
Collapse
|
42
|
Javaid M, Haleem A. Impact of industry 4.0 to create advancements in orthopaedics. J Clin Orthop Trauma 2020; 11:S491-S499. [PMID: 32774017 PMCID: PMC7394797 DOI: 10.1016/j.jcot.2020.03.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/15/2020] [Accepted: 03/16/2020] [Indexed: 12/19/2022] Open
Abstract
Scientists and health professional are focusing on improving the medical sciences for the betterment of patients. The fourth industrial revolution, which is commonly known as Industry 4.0, is a significant advancement in the field of engineering. Industry 4.0 is opening a new opportunity for digital manufacturing with greater flexibility and operational performance. This development is also going to have a positive impact in the field of orthopaedics. The purpose of this paper is to present various advancements in orthopaedics by the implementation of Industry 4.0. To undertake this study, we have studied the available literature extensively on Industry 4.0, technologies of Industry 4.0 and their role in orthopaedics. Paper briefly explains about Industry 4.0, identifies and discusses the major technologies of Industry 4.0, which will support development in orthopaedics. Finally, from the available literature, the paper identifies twelve significant advancements of Industry 4.0 in orthopaedics. Industry 4.0 uses various types of digital manufacturing and information technologies to create orthopaedics implants, patient-specific tools, devices and innovative way of treatment. This revolution is to be useful to perform better spinal surgery, knee and hip replacement, and invasive surgeries.
Collapse
Affiliation(s)
- Mohd Javaid
- Corresponding author., https://scholar.google.co.in/citations?user=rfyiwvsAAAAJ&hl=en
| | | |
Collapse
|
43
|
Revilla‐León M, Sadeghpour M, Özcan M. A Review of the Applications of Additive Manufacturing Technologies Used to Fabricate Metals in Implant Dentistry. J Prosthodont 2020; 29:579-593. [DOI: 10.1111/jopr.13212] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2020] [Indexed: 12/24/2022] Open
Affiliation(s)
- Marta Revilla‐León
- Comprehensive Dentistry Department, College of DentistryTexas A&M University Dallas TX
- Gradute Prosthodontics, Department of Restorative Dentistry, School of DentistryUniversity of Washington Seattle WA
| | - Mehrad Sadeghpour
- Revilla Research Center Madrid Spain
- Private practice in Dallas Dallas TX
| | - Mutlu Özcan
- Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, Center for Dental and Oral MedicineUniversity of Zurich Zürich Switzerland
| |
Collapse
|
44
|
Patient-Specific 3-Dimensional Printing Titanium Implant Biomechanical Evaluation for Complex Distal Femoral Open Fracture Reconstruction with Segmental Large Bone Defect: A Nonlinear Finite Element Analysis. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10124098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study proposes a novel titanium 3D printing patient-specific implant: a lightweight structure with enough biomechanical strength for a distal femur fracture with segmental large defect using nonlinear finite element (FE) analysis. CT scanning images were processed to identify the size and shape of a large bone defect in the right distal femur of a young patient. A novel titanium implant was designed with a proximal cylinder tube for increasing mechanical stability, proximal/distal shells for increasing bone ingrowth contact areas, and lattice mesh at the outer surface to provide space for morselized cancellous bone grafting. The implant was fixed by transverse screws at the proximal/distal host bone. A pre-contoured locking plate was applied at the lateral site to secure the whole construct. A FE model with nonlinear contact element implant-bone interfaces was constructed to perform simulations for three clinical stages under single leg standing load conditions. The three stages were the initial postoperative period, fracture healing, and post fracture healing and locking plate removal. The results showed that the maximum implant von Mises stress reached 1318 MPa at the sharp angles of the outer mesh structure, exceeding the titanium destruction value (1000 MPa) and requiring round mesh angles to decrease the stress in the initial postoperative period. Bone stress values were found decreasing all the way from the postoperative period to fracture healing and locking plate removal. The overall construct deformation value reached 4.8 mm in the postoperative period, 2.5 mm with fracture healing assisted by the locking plate, and 2.1 mm after locking plate removal. The strain value at the proximal/distal implant-bone interfaces were valuable in inducing bone grafting in the initial postoperative period. The proposed patient-specific 3D printed implant is biomechanically stable for treating distal femoral fractures with large defect. It provides excellent lightweight structure, proximal/distal bone ingrowth contact areas, and implant rounded outer lattice mesh for morselized cancellous bone grafting.
Collapse
|
45
|
Abstract
This paper is focused on the preparation of novel hybrid polymer composite materials for 3D filaments. As the reinforcing filler, expanded graphite, carbon fibers, and combinations thereof were used in various ratios up to 10%. The mechanical and thermal properties of virgin and recycled polyethylene phthalate glycol-modified (PETG) composite materials were determined. Almost all prepared composite materials were suitable for 3D printing and they have enhanced mechanical properties compared to the neat PETG matrices. Addition of the fillers to both polymer matrices has an only slight effect on the thermal stability, but the addition of carbon fibers significantly reduced the thermal expansion coefficient. The composites from cheaper recycled PETG have comparable properties to virgin PETG composites, which is of economic and ecological importance. New and cheaper materials can help expand 3D printing to manufacturing plants and the use of 3D printers for special applications.
Collapse
|