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Schönegg D, Müller GT, Blumer M, Essig H, Wagner MEH. Two versus three magnesium screws for osteosynthesis of mandibular condylar head fractures: a finite element analysis. Clin Oral Investig 2024; 28:553. [PMID: 39327352 PMCID: PMC11427473 DOI: 10.1007/s00784-024-05927-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Accepted: 09/14/2024] [Indexed: 09/28/2024]
Abstract
OBJECTIVES Previous finite element analyses (FEA) have shown promising results for using two titanium screws in treating mandibular condylar head fractures but limited mechanical stability of a two-screw osteosynthesis with magnesium screws. Given the potential benefits of magnesium screws in terms of biocompatibility and resorption, this study aimed to compare two- and three-screw osteosynthesis solutions for a right condylar head fracture (AO CMF type p) with magnesium screws with a FEA. MATERIALS AND METHODS A previously validated finite element model simulating a 350 N bite on the contralateral molars was used to analyze von Mises stress within the screws, fragment deformation, and fracture displacement. All screws were modeled with uniform geometric specifications mirroring the design of Medartis MODUS® Mandible Hexadrive cortical screws. RESULTS The three-screw configuration demonstrated lower values for all three parameters compared to the two-screw scenario. There was a 30% reduction in maximum von Mises stress for the top screw and a 46% reduction for the bottom screw. CONCLUSIONS Fracture treatment with three magnesium screws could be a valuable and sufficiently stable alternative to the established treatment with titanium screws. Further studies on screw geometry could help improve material stability under mechanical loading, enhancing the performance of magnesium screws in clinical applications. CLINICAL RELEVANCE The use of magnesium screws for osteosynthesis of mandibular condylar head fractures offers the benefit of reducing the need for second surgery for hardware removal. Clinical data is needed to determine whether the advantages of resorbable screw materials outweigh potential drawbacks in condylar head fracture treatment.
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Affiliation(s)
- Daphne Schönegg
- Department of Cranio-Maxillofacial Surgery, University Hospital of Bern, Freiburgstrasse 20, Bern, CH-3010, Switzerland.
- Department of Oral and Maxillofacial Surgery, University Hospital Zurich, Frauenklinikstrasse 24, Zurich, CH-8091, Switzerland.
| | - Günter T Müller
- Department of Oral and Maxillofacial Surgery, University Hospital Zurich, Frauenklinikstrasse 24, Zurich, CH-8091, Switzerland
| | - Michael Blumer
- Department of Cranio-Maxillofacial Surgery, University Hospital of Bern, Freiburgstrasse 20, Bern, CH-3010, Switzerland
| | - Harald Essig
- Department of Oral and Maxillofacial Surgery, University Hospital Zurich, Frauenklinikstrasse 24, Zurich, CH-8091, Switzerland
| | - Maximilian E H Wagner
- Department of Oral and Maxillofacial Surgery, University Hospital Zurich, Frauenklinikstrasse 24, Zurich, CH-8091, Switzerland
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Dobrzyńska-Mizera M, Dodda JM, Liu X, Knitter M, Oosterbeek RN, Salinas P, Pozo E, Ferreira AM, Sadiku ER. Engineering of Bioresorbable Polymers for Tissue Engineering and Drug Delivery Applications. Adv Healthc Mater 2024:e2401674. [PMID: 39233521 DOI: 10.1002/adhm.202401674] [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: 05/06/2024] [Revised: 08/15/2024] [Indexed: 09/06/2024]
Abstract
Herein, the recent advances in the development of resorbable polymeric-based biomaterials, their geometrical forms, resorption mechanisms, and their capabilities in various biomedical applications are critically reviewed. A comprehensive discussion of the engineering approaches for the fabrication of polymeric resorbable scaffolds for tissue engineering, drug delivery, surgical, cardiological, aesthetical, dental and cardiovascular applications, are also explained. Furthermore, to understand the internal structures of resorbable scaffolds, representative studies of their evaluation by medical imaging techniques, e.g., cardiac computer tomography, are succinctly highlighted. This approach provides crucial clinical insights which help to improve the materials' suitable and viable characteristics for them to meet the highly restrictive medical requirements. Finally, the aspects of the legal regulations and the associated challenges in translating research into desirable clinical and marketable materials of polymeric-based formulations, are presented.
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Affiliation(s)
- Monika Dobrzyńska-Mizera
- Institute of Materials Technology, Polymer Division, Poznan University of Technology, Poznan, Poland
| | - Jagan Mohan Dodda
- New Technologies - Research Centre (NTC), University of West Bohemia, Univerzitní 8, Pilsen, 30100, Czech Republic
| | - Xiaohua Liu
- Chemical and Biomedical Engineering Department, University of Missouri, 1030 Hill Street, Columbia, Missouri, 65211, USA
| | - Monika Knitter
- Institute of Materials Technology, Polymer Division, Poznan University of Technology, Poznan, Poland
| | - Reece N Oosterbeek
- Department of Engineering Science, University of Oxford, Parks Road, Oxford, OX1 3PJ, UK
| | - Pablo Salinas
- Department of Cardiology, Hospital Clínico San Carlos, Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Eduardo Pozo
- Department of Cardiology, Hospital Clínico San Carlos, Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Ana Marina Ferreira
- School of Engineering, Newcastle University, Newcastle upon Tyne, Newcastle, NE1 7RU, UK
| | - Emmanuel Rotimi Sadiku
- Tshwane University of Technology, Department of Chemical, Metallurgical and Materials Engineering, Polymer Division & Institute for Nano Engineering Research (INER), Pretoria West Campus, Pretoria, South Africa
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Herzog P, Rendenbach C, Turostowski M, Ellinghaus A, Prates Soares A, Heiland M, Duda GN, Schmidt-Bleek K, Fischer H. Titanium versus plasma electrolytic oxidation surface-modified magnesium miniplates in a forehead secondary fracture healing model in sheep. Acta Biomater 2024; 185:98-110. [PMID: 39002920 DOI: 10.1016/j.actbio.2024.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 07/02/2024] [Accepted: 07/05/2024] [Indexed: 07/15/2024]
Abstract
Magnesium as a biodegradable material offers promising results in recent studies of different maxillo-facial fracture models. To overcome adverse effects caused by the fast corrosion of pure magnesium in fluid surroundings, various alloys, and surface modifications are tested in animal models. In specified cases, magnesium screws already appeared for clinical use in maxillofacial surgery. The present study aims to compare the bone healing outcome in a non-load-bearing fracture scenario of the forehead in sheep when fixed with standard-sized WE43 magnesium fixation plates and screws with plasma electrolytic oxidation (PEO) surface modification in contrast to titanium osteosynthesis. Surgery was performed on 24 merino mix sheep. The plates and screws were explanted en-bloc with the surrounding tissue after four and twelve weeks. The outcome of bone healing was investigated with micro-computed tomography, histological, immunohistological, and fluorescence analysis. There was no significant difference between groups concerning the bone volume, bone volume/ total volume, and newly formed bone in volumetric and histological analysis at both times of investigation. The fluorescence analysis revealed a significantly lower signal in the magnesium group after one week, although there was no difference in the number of osteoclasts per mm2. The magnesium group had significantly fewer vessels per mm2 in the healing tissue. In conclusion, the non-inferiority of WE43-based magnesium implants with PEO surface modification was verified concerning fracture healing under non-load-bearing conditions in a defect model. STATEMENT OF SIGNIFICANCE: Titanium implants, the current gold standard of fracture fixation, can lead to adverse effects linked to the implant material and often require surgical removal. Therefore, degradable metals like the magnesium alloy WE43 with plasma electrolytic oxidation (PEO) surface modification gained interest. Yet, miniplates of this alloy with PEO surface modification have not been examined in a fracture defect model of the facial skeleton in a large animal model. This study shows, for the first time, the non-inferiority of magnesium miniplates compared to titanium miniplates. In radiological and histological analysis, bone healing was undisturbed. Magnesium miniplates can reduce the number of interventions for implant removal, thus reducing the risk for the patient and minimizing the costs.
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Affiliation(s)
- Paulina Herzog
- Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Department of Oral and Maxillofacial Surgery, Augustenburger Platz 1, 13353 Berlin, Germany.
| | - Carsten Rendenbach
- Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Department of Oral and Maxillofacial Surgery, Augustenburger Platz 1, 13353 Berlin, Germany.
| | - Marta Turostowski
- Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Department of Oral and Maxillofacial Surgery, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Agnes Ellinghaus
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Julius Wolff Institute, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Ana Prates Soares
- Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Department of Oral and Maxillofacial Surgery, Augustenburger Platz 1, 13353 Berlin, Germany; Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Julius Wolff Institute, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Max Heiland
- Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Department of Oral and Maxillofacial Surgery, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Georg N Duda
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Julius Wolff Institute, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Katharina Schmidt-Bleek
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Julius Wolff Institute, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Heilwig Fischer
- Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Department of Oral and Maxillofacial Surgery, Augustenburger Platz 1, 13353 Berlin, Germany; Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Center for Musculoskeletal Surgery, Augustenburger Platz 1, 13353 Berlin, Germany; Berlin Institute of Health at Charité -Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Charitéplatz 1, 10117 Berlin, Germany
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Qiu T, Yang R, Chen L, Liu G, Han J, Guo C. Duplex Fluorinated and Atomic Layer Deposition-Derived ZrO 2 Coatings Improve the Corrosion Resistance and Mechanical Properties of Mg-2Zn-0.46Y-0.5Nd (wt.%) Alloy Plates and Screws. MATERIALS (BASEL, SWITZERLAND) 2024; 17:3485. [PMID: 39063780 PMCID: PMC11278270 DOI: 10.3390/ma17143485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Revised: 06/30/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024]
Abstract
This study investigated the corrosion resistance and mechanical properties of Mg-2Zn-0.46Y-0.5Nd (wt.%) alloy plates and screws with fluorinated coatings and atomic layer deposition (ALD)-derived zirconia (ZrO2) coatings in vitro under physiological stress conditions. Synthetic polyurethane hemimandible replicas were split and fixed as the following three groups of magnesium alloy plates and screws: no additional surface coating treatment (Group A), with fluorinated coatings (Group B), and with duplex fluorinated and ALD-derived 100 nm ZrO2 coatings (Group C). A circulating stress of 1-10 N was applied to the distal bone segment, and a 4-week simulated body fluid immersion test was employed to study the remaining material volume and the mechanical properties of the different groups. Compared with Group A and Group B, the degradation rate of magnesium alloy plates and screws' head regions was significantly slowed down under the protection of duplex MgF2/ZrO2 coatings (p < 0.01). There was no significant difference in the degradation rate of the screw shaft region between groups (p = 0.077). In contrast to fluoride coatings, duplex MgF2/ZrO2 coatings maintained the mechanical strength of magnesium alloy plates and screws after a 14 day in vitro SBF immersion test. We conclude that duplex MgF2/ZrO2 coatings exhibited a certain protective effect on the Mg alloy plates and screws under physiological stress conditions.
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Affiliation(s)
- Tiancheng Qiu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China; (T.Q.); (L.C.)
| | - Rong Yang
- Department of General Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China;
| | - Liangwei Chen
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China; (T.Q.); (L.C.)
| | - Guanqi Liu
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Department of Dental Materials, Peking University School and Hospital of Stomatology, Beijing 100081, China;
| | - Jianmin Han
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Department of Dental Materials, Peking University School and Hospital of Stomatology, Beijing 100081, China;
| | - Chuanbin Guo
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China; (T.Q.); (L.C.)
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5
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Thet PH, Kaboosaya B. Cephalometric evaluation of skeletal stability and pharyngeal airway changes after mandibular setback surgery: Bioabsorbable versus titanium plate and screw fixation. Imaging Sci Dent 2024; 54:181-190. [PMID: 38948194 PMCID: PMC11211026 DOI: 10.5624/isd.20230269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/15/2024] [Accepted: 03/23/2024] [Indexed: 07/02/2024] Open
Abstract
Purpose This study compared sequential changes in skeletal stability and the pharyngeal airway following mandibular setback surgery involving fixation with either a titanium or a bioabsorbable plate and screws. Materials and Methods Twenty-eight patients with mandibular prognathism undergoing bilateral sagittal split osteotomy by titanium or bioabsorbable fixation were randomly selected in this study. Lateral cephalometric analysis was conducted preoperatively and at 1 week, 3-6 months, and 1 year postoperatively. Mandibular stability was assessed by examining horizontal (BX), vertical (BY), and angular measurements including the sella-nasion to point B angle and the mandibular plane angle (MPA). Pharyngeal airway changes were evaluated by analyzing the nasopharynx, uvula-pharynx, tongue-pharynx, and epiglottis-pharynx (EOP) distances. Mandibular and pharyngeal airway changes were examined sequentially. To evaluate postoperative changes within groups, the Wilcoxon signed-rank test was employed, while the Mann-Whitney U test was used for between-group comparisons. Immediate postoperative changes in the airway were correlated to surgical movements using the Spearman rank test. Results Significant changes in the MPA were observed in both the titanium and bioabsorbable groups at 3-6 months post-surgery, with significance persisting in the bioabsorbable group at 1 year postoperatively (2.29°±2.28°; P<0.05). The bioabsorbable group also exhibited significant EOP changes (-1.21±1.54 mm; P<0.05) at 3-6 months, which gradually returned to non-significant levels by 1 year postoperatively. Conclusion Osteofixation using bioabsorbable plates and screws is comparable to that achieved with titanium in long-term skeletal stability and maintaining pharyngeal airway dimensions. However, a tendency for relapse exists, especially regarding the MPA.
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Affiliation(s)
- Phu Hnin Thet
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Boosana Kaboosaya
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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6
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Dallaev R. Advances in Materials with Self-Healing Properties: A Brief Review. MATERIALS (BASEL, SWITZERLAND) 2024; 17:2464. [PMID: 38793530 PMCID: PMC11123491 DOI: 10.3390/ma17102464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/17/2024] [Accepted: 05/18/2024] [Indexed: 05/26/2024]
Abstract
The development of materials with self-healing capabilities has garnered considerable attention due to their potential to enhance the durability and longevity of various engineering and structural applications. In this review, we provide an overview of recent advances in materials with self-healing properties, encompassing polymers, ceramics, metals, and composites. We outline future research directions and potential applications of self-healing materials (SHMs) in diverse fields. This review aims to provide insights into the current state-of-the-art in SHM research and guide future efforts towards the development of innovative and sustainable materials with enhanced self-repair capabilities. Each material type showcases unique self-repair mechanisms tailored to address specific challenges. Furthermore, this review investigates crack healing processes, shedding light on the latest developments in this critical aspect of self-healing materials. Through an extensive exploration of these topics, this review aims to provide a comprehensive understanding of the current landscape and future directions in self-healing materials research.
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Affiliation(s)
- Rashid Dallaev
- Department of Physics, Faculty of Electrical Engineering and Communication, Brno University of Technology, Technická 2848/8, 61600 Brno, Czech Republic
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Tatullo M, Piattelli A, Ruggiero R, Marano RM, Iaculli F, Rengo C, Papallo I, Palumbo G, Chiesa R, Paduano F, Spagnuolo G. Functionalized magnesium alloys obtained by superplastic forming process retain osteoinductive and antibacterial properties: An in-vitro study. Dent Mater 2024; 40:557-562. [PMID: 38326212 DOI: 10.1016/j.dental.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 01/28/2024] [Accepted: 01/31/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVES This study aimed to investigate the biocompatibility, osteogenic and antibacterial activity of biomedical devices based on Magnesium (Mg) Alloys manufactured by Superplastic Forming process (SPF) and subjected to Hydrothermal (HT) and Sol-Gel Treatment (Sol-Gel). METHODS Mg-SPF devices subjected to Hydrothermal (Mg-SPF+HT) and Sol-Gel Treatment (Mg-SPF+Sol-Gel) were investigated. The biocompatibility of Mg-SPF+Sol-Gel and Mg-SPF+HT devices was observed by indirect and direct cytotoxicity assays, whereas the colonization of sample surfaces was assessed by confocal microscopy. qRT-PCR analysis and microbial growth curve analyses were employed to evaluate the osteogenic and antibacterial activity of both SPF-Mg treated devices, respectively. RESULTS Mg-SPF+HT and Mg-SPF+Sol-Gel showed a high degree of biocompatibility. Analysis of mRNA expression of osteogenic genes in cells cultured on Mg-treated devices revealed a significant upregulation of the expression levels of BMP2 and Runx-2. Furthermore, the bacterial growth in strains developed in contact with both the Mg-SPF+HT and Mg-SPF+Sol-Gel devices was lower than that observed in the control. SIGNIFICANCE Hydrothermal and Sol-Gel Treatments of Mg alloys obtained through the SPF process demonstrated bioactive, osteogenic and antibacterial activity, offering a promising alternative to conventional Mg-based devices. The obtained Mg-based materials may have the potential to enhance the tunability of temporary devices in maxillary reconstruction, eliminating the need for second surgeries, and ensuring a good bone reconstruction and a reduced implant failure rate due to bacterial infections.
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Affiliation(s)
- Marco Tatullo
- Department of Translational Biomedicine and Neuroscience, School of Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy.
| | - Adriano Piattelli
- School of Dentistry, Saint Camillus International University of Health and Medical Sciences, 00131 Rome, Italy
| | - Roberta Ruggiero
- Stem Cells and Medical Genetics Units, Tecnologica Research Institute and Marrelli Health, 88900 Crotone, Italy
| | - Rosa Maria Marano
- Stem Cells and Medical Genetics Units, Tecnologica Research Institute and Marrelli Health, 88900 Crotone, Italy
| | - Flavia Iaculli
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, via S. Pansini 5, 80131 Naples, Italy
| | - Carlo Rengo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, via S. Pansini 5, 80131 Naples, Italy
| | - Ida Papallo
- CeSMA, University of Naples Federico II, Corso Nicolangelo Protopisani, 80146 Naples, Italy
| | - Gianfranco Palumbo
- Department of Mechanics, Polytechnic University of Bari, 70124 Bari, Italy
| | - Roberto Chiesa
- Department of Chemistry, Materials and Chemical Engineering 'G. Natta', Politecnico di Milano, 20135 Milan, Italy
| | - Francesco Paduano
- Stem Cells and Medical Genetics Units, Tecnologica Research Institute and Marrelli Health, 88900 Crotone, Italy
| | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, via S. Pansini 5, 80131 Naples, Italy.
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Roesner M, Zankovic S, Kovacs A, Benner M, Barkhoff R, Seidenstuecker M. Mechanical Properties and Corrosion Rate of ZnAg3 as a Novel Bioabsorbable Material for Osteosynthesis. J Funct Biomater 2024; 15:28. [PMID: 38391881 PMCID: PMC10890006 DOI: 10.3390/jfb15020028] [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: 12/22/2023] [Revised: 01/12/2024] [Accepted: 01/20/2024] [Indexed: 02/24/2024] Open
Abstract
Osteosynthesis in fracture treatment typically uses hardware that remains in the patient's body, which brings a permanent risk of negative side effects such as foreign body reactions or chronic inflammation. Bioabsorbable materials, however, can degrade and slowly be replaced by autologous bone tissue. A suitable material is requested to offer great biocompatibility alongside excellent mechanical properties and a reasonable corrosion rate. Zinc-silver alloys provide these characteristics, which makes them a promising candidate for research. This study investigated the aptitude as a bioabsorbable implant of a novel zinc-silver alloy containing 3.3 wt% silver (ZnAg3). Here, the tensile strength as well as the corrosion rate in PBS solution (phosphate buffered solution) of ZnAg3 were assessed. Furthermore, shear tests, including fatigue and quasi-static testing, were conducted with ZnAg3 and magnesium pins (MAGNEZIX®, Syntellix AG, Hannover, Germany), which are already in clinical use. The detected corrosion rate of 0.10 mm/year for ZnAg3 was within the proposed range for bioabsorbable implants. With a tensile strength of 237.5 ± 2.12 MPa and a shear strength of 144.8 ± 13.2 N, ZnAg3 satisfied the mechanical requirements for bioabsorbable implants. The fatigue testing did not show any significant difference between ZnAg3 and magnesium pins, whereas both materials withstood the cyclic loading. Thus, the results support the assumption that ZnAg3 is qualified for further investigation.
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Affiliation(s)
- Maria Roesner
- G.E.R.N. Tissue Replacement, Regeneration & Neogenesis, Department of Orthopedics and Trauma Surgery, Medical Center-Albert-Ludwigs-University of Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany
| | - Sergej Zankovic
- G.E.R.N. Tissue Replacement, Regeneration & Neogenesis, Department of Orthopedics and Trauma Surgery, Medical Center-Albert-Ludwigs-University of Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany
| | - Adalbert Kovacs
- Limedion GmbH, Coatings and Surface Analysis, Am Schäferstock 2-4, 68163 Mannheim, Germany
| | - Moritz Benner
- Limedion GmbH, Coatings and Surface Analysis, Am Schäferstock 2-4, 68163 Mannheim, Germany
- Quadralux e.K., Am Schäferstock 2-4, 68163 Mannheim, Germany
| | - Roland Barkhoff
- Quadralux e.K., Am Schäferstock 2-4, 68163 Mannheim, Germany
| | - Michael Seidenstuecker
- G.E.R.N. Tissue Replacement, Regeneration & Neogenesis, Department of Orthopedics and Trauma Surgery, Medical Center-Albert-Ludwigs-University of Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany
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Li H, Hao J, Liu X. Research progress and perspective of metallic implant biomaterials for craniomaxillofacial surgeries. Biomater Sci 2024; 12:252-269. [PMID: 38170634 DOI: 10.1039/d2bm01414a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Craniomaxillofacial bone serves a variety of functions. However, the increasing number of cases of craniomaxillofacial bone injury and the use of selective rare implants make the treatment difficult, and the cure rate is low. If such a bone injury is not properly treated, it can lead to a slew of complications that can seriously disrupt a patient's daily life. For example, premature closure of cranial sutures or skull fractures can lead to increased intracranial pressure, which can lead to headaches, vomiting, and even brain hernia. At present, implant placement is one of the most common approaches to repair craniomaxillofacial bone injury or abnormal closure, especially with biomedical metallic implants. This review analyzes the research progress in the design and development of degradable and non-degradable metallic implants in craniomaxillofacial surgery. The mechanical properties, corrosion behaviours, as well as in vitro and in vivo performances of these materials are summarized. The challenges and future research directions of metallic biomaterials used in craniomaxillofacial surgery are also identified.
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Affiliation(s)
- Huafang Li
- School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing, 100083, China.
| | - Jiaqi Hao
- School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing, 100083, China.
| | - Xiwei Liu
- Lepu Medical Technology Co., Ltd, Beijing 102200, China
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Tao YK, Zhao Y, Li Z. A Temporary Intraoperative Fixation Method for the Absorbable Plates Fixation of Condylar Fracture by Retromandibular Transparotid Approach. J Craniofac Surg 2024; 35:e94-e96. [PMID: 37972993 DOI: 10.1097/scs.0000000000009893] [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: 10/10/2023] [Accepted: 10/18/2023] [Indexed: 11/19/2023] Open
Abstract
The authors describe a temporary intraoperative fixation method for the absorbable plates' fixation of subcondylar fracture by retromandibular transparotid approach. First, the fracture was temporarily fixed with a 4-hole titanium microplate across the fracture line in the center of the lateral surface of the condyle to maintain the reduction of the fracture. Then, two 4-hole absorbable mini-plates were fixed on the posterior and anterior border of the condylar neck. Finally, the 4-hole titanium microplate and screws were removed before the wound closure. In the absorbable plates' fixation of subcondylar fracture by transparotid approach, the method of temporary intraoperative fixation using a 4-hole titanium microplate offsets the limited exposure of the operative field, smooths the operation, and offers the reliability and validity of the absorbable plates' fixation.
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Affiliation(s)
- Yan-Kai Tao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration
- Key Laboratory of Oral Biomedicine Ministry of Education
- Hubei Key Laboratory of Stomatology; School & Hospital of Stomatology, Wuhan University
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan
| | - Yang Zhao
- Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Zhi Li
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration
- Key Laboratory of Oral Biomedicine Ministry of Education
- Hubei Key Laboratory of Stomatology; School & Hospital of Stomatology, Wuhan University
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan
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11
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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 PMCID: PMC11229092 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.
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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
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12
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Nganzeu C, Esce A, Abu-Ghanem S, Meiklejohn DA, Sims HS. Laryngeal Trauma. Otolaryngol Clin North Am 2023; 56:1039-1053. [PMID: 37442662 DOI: 10.1016/j.otc.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Abstract
Laryngeal trauma is rare but potentially fatal. Initial evaluation includes efficient history and physical examination, imaging, bedside flexible laryngoscopy, and if necessary, operative endoscopic evaluation. Multiple classification systems exist for laryngeal trauma, and each has its merits. We recommend a patient-centered approach, rather than using the classification alone. Secure airways are the primary goal of acute management, with awake tracheostomy more often indicated over oral intubation compared with traumas not involving the larynx. More severe injuries typically require surgical intervention. Early intervention results in optimal voice and airway outcomes.
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Affiliation(s)
- Claude Nganzeu
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of New Mexico; Department of Surgery ENT 1, University of New Mexico, MSC10, 5610, Albuquerque, NM 87131, USA
| | - Antoinette Esce
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of New Mexico; Department of Surgery ENT 1, University of New Mexico, MSC10, 5610, Albuquerque, NM 87131, USA
| | - Sara Abu-Ghanem
- Laryngology and Bronchoesophagology, Department of Otolaryngology, SUNY Downstate & Maimonides Health, 185 Montague Street, 5th Floor, Brooklyn, NY 11220, USA
| | - Duncan A Meiklejohn
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of New Mexico; Department of Surgery ENT 1, University of New Mexico, MSC10, 5610, Albuquerque, NM 87131, USA
| | - H Steven Sims
- University of Illinois Hospital and Health Service Systems, 1855 West Taylor Street, Room 3.87, Chicago, IL 60612, USA.
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13
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Nifant'ev I, Tavtorkin A, Komarov P, Kretov E, Korchagina S, Chinova M, Gavrilov D, Ivchenko P. Dispersant and Protective Roles of Amphiphilic Poly(ethylene phosphate) Block Copolymers in Polyester/Bone Mineral Composites. Int J Mol Sci 2023; 24:11175. [PMID: 37446347 DOI: 10.3390/ijms241311175] [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: 06/15/2023] [Revised: 07/02/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023] Open
Abstract
Composites of synthetic bone mineral substitutes (BMS) and biodegradable polyesters are of particular interest for bone surgery and orthopedics. Manufacturing of composite scaffolds commonly uses mixing of the BMS with polymer melts. Melt processing requires a high homogeneity of the mixing, and is complicated by BMS-promoted thermal degradation of polymers. In our work, poly(L-lactide) (PLLA) and poly(ε-caprolactone) (PCL) composites reinforced by commercial β-tricalcium phosphate (βTCP) or synthesized carbonated hydroxyapatite with hexagonal and plate-like crystallite shapes (hCAp and pCAp, respectively) were fabricated using injection molding. pCAp-based composites showed advanced mechanical and thermal characteristics, and the best set of mechanical characteristics was observed for the PLLA-based composite containing 25 wt% of pCAp. To achieve compatibility of polyesters and pCAp, reactive block copolymers of PLLA or PCL with poly(tert-butyl ethylene phosphate) (C1 and C2, respectively) were introduced to the composite. The formation of a polyester-b-poly(ethylene phosphoric acid) (PEPA) compatibilizer during composite preparation, followed by chemical binding of PEPA with pCAp, have been proved experimentally. The presence of 5 wt% of the compatibilizer provided deeper homogenization of the composite, resulting in a marked increase in strength and moduli as well as a more pronounced nucleation effect during isothermal crystallization. The use of C1 increased the thermal stability of the PLLA-based composite, containing 25 wt% of pCAp. In view of positive impacts of polyester-b-PEPA on composite homogeneity, mechanical characteristics, and thermal stability, polyester-b-PEPA will find application in the further development of composite materials for bone surgery and orthopedics.
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Affiliation(s)
- Ilya Nifant'ev
- A.V. Topchiev Institute of Petrochemical Synthesis RAS, 29 Leninsky Pr., 119991 Moscow, Russia
- Chemistry Department, M.V. Lomonosov Moscow State University, 1-3 Leninskie Gory, 119991 Moscow, Russia
- Faculty of Chemistry, National Research University Higher School of Economics, Myasnitskaya St. 20, 101100 Moscow, Russia
| | - Alexander Tavtorkin
- A.V. Topchiev Institute of Petrochemical Synthesis RAS, 29 Leninsky Pr., 119991 Moscow, Russia
| | - Pavel Komarov
- A.V. Topchiev Institute of Petrochemical Synthesis RAS, 29 Leninsky Pr., 119991 Moscow, Russia
| | - Egor Kretov
- A.V. Topchiev Institute of Petrochemical Synthesis RAS, 29 Leninsky Pr., 119991 Moscow, Russia
- Faculty of Chemistry, National Research University Higher School of Economics, Myasnitskaya St. 20, 101100 Moscow, Russia
| | - Sofia Korchagina
- A.V. Topchiev Institute of Petrochemical Synthesis RAS, 29 Leninsky Pr., 119991 Moscow, Russia
| | - Maria Chinova
- A.V. Topchiev Institute of Petrochemical Synthesis RAS, 29 Leninsky Pr., 119991 Moscow, Russia
| | - Dmitry Gavrilov
- A.V. Topchiev Institute of Petrochemical Synthesis RAS, 29 Leninsky Pr., 119991 Moscow, Russia
- Chemistry Department, M.V. Lomonosov Moscow State University, 1-3 Leninskie Gory, 119991 Moscow, Russia
| | - Pavel Ivchenko
- A.V. Topchiev Institute of Petrochemical Synthesis RAS, 29 Leninsky Pr., 119991 Moscow, Russia
- Chemistry Department, M.V. Lomonosov Moscow State University, 1-3 Leninskie Gory, 119991 Moscow, Russia
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Al-Shalawi FD, Mohamed Ariff AH, Jung DW, Mohd Ariffin MKA, Seng Kim CL, Brabazon D, Al-Osaimi MO. Biomaterials as Implants in the Orthopedic Field for Regenerative Medicine: Metal versus Synthetic Polymers. Polymers (Basel) 2023; 15:2601. [PMID: 37376247 PMCID: PMC10303232 DOI: 10.3390/polym15122601] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
Patients suffering bone fractures in different parts of the body require implants that will enable similar function to that of the natural bone that they are replacing. Joint diseases (rheumatoid arthritis and osteoarthritis) also require surgical intervention with implants such as hip and knee joint replacement. Biomaterial implants are utilized to fix fractures or replace parts of the body. For the majority of these implant cases, either metal or polymer biomaterials are chosen in order to have a similar functional capacity to the original bone material. The biomaterials that are employed most often for implants of bone fracture are metals such as stainless steel and titanium, and polymers such as polyethene and polyetheretherketone (PEEK). This review compared metallic and synthetic polymer implant biomaterials that can be employed to secure load-bearing bone fractures due to their ability to withstand the mechanical stresses and strains of the body, with a focus on their classification, properties, and application.
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Affiliation(s)
- Faisal Dakhelallah Al-Shalawi
- Department of Mechanical and Manufacturing Engineering, Faculty of Engineering, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia; (F.D.A.-S.); (M.K.A.M.A.)
| | - Azmah Hanim Mohamed Ariff
- Department of Mechanical and Manufacturing Engineering, Faculty of Engineering, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia; (F.D.A.-S.); (M.K.A.M.A.)
- Research Center Advanced Engineering Materials and Composites (AEMC), Faculty of Engineering, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Dong-Won Jung
- Faculty of Applied Energy System, Major of Mechanical Engineering, Jeju National University, 102 Jejudaehak-ro, Jeju-si 63243, Republic of Korea
| | - Mohd Khairol Anuar Mohd Ariffin
- Department of Mechanical and Manufacturing Engineering, Faculty of Engineering, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia; (F.D.A.-S.); (M.K.A.M.A.)
| | - Collin Looi Seng Kim
- Department of Orthopaedic, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia;
| | - Dermot Brabazon
- Advanced Manufacturing Research Centre, and Advanced Processing Technology Research Centre, School of Mechanical and Manufacturing Engineering, Dublin City University, Glasnevin, D09 V209 Dublin 9, Ireland;
| | - Maha Obaid Al-Osaimi
- Department of Microbiology, Faculty of Agriculture, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia;
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15
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Rajewska J, Kowalski J, Matys J, Dobrzyński M, Wiglusz RJ. The Use of Lactide Polymers in Bone Tissue Regeneration in Dentistry-A Systematic Review. J Funct Biomater 2023; 14:83. [PMID: 36826882 PMCID: PMC9961440 DOI: 10.3390/jfb14020083] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/27/2023] [Accepted: 01/28/2023] [Indexed: 02/04/2023] Open
Abstract
(1) Background: Different compositions of biodegradable materials are being investigated to successfully replace non-resorbable ones in bone tissue regeneration in dental surgery. The systematic review tried to address the question, "Can biodegradable polymers act as a replacement for conventional materials in dental surgery procedures?" (2) Methods: An electronic search of the PubMed and Scopus databases was conducted in October 2022. The following keywords were used: (lactide polymers) and (hydroxyapatite or fluorapatite) and (dentistry) and (regeneration). Initially, 59 studies were found. Forty-one studies met the inclusion criteria and were included in the review. (3) Results: These usually improved the properties and induced osteogenesis, tissue mineralisation and bone regeneration by inducing osteoblast proliferation. Five studies showed higher induction of osteogenesis in the case of biomaterials, UV-HAp/PLLA, ALBO-OS, bioresorbable raw particulate hydroxyapatite/poly-L-lactide and PLGA/Hap, compared to conventional materials such as titanium. Four studies confirmed improvement in tissue mineralisation with the usage of biomaterials: hydroxyapatite/polylactic acid (HA/PLA) loaded with dog's dental pulp stem cells (DPSCs), Coll/HAp/PLCL, PDLLA/VACNT-O:nHAp, incorporation of hydroxyapatite and simvastatin. Three studies showed an acceleration in proliferation of osteoblasts for the use of biomaterials with additional factors such as collagen and UV light. (4) Conclusions: Lactide polymers present higher osteointegration and cell proliferation rate than the materials compared. They are superior to non-biodegradable materials in terms of the biocompability, bone remodelling and healing time tests. Moreover, because there is no need of reoperation, as the material automatically degrades, the chance of scars and skin sclerosis is lower. However, more studies involving greater numbers of biomaterial types and mixes need to be performed in order to find a perfect biodegradable material.
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Affiliation(s)
- Justyna Rajewska
- Department of Pediatric Dentistry and Preclinical Dentistry, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland
| | - Jakub Kowalski
- Department of Pediatric Dentistry and Preclinical Dentistry, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland
| | - Jacek Matys
- Laser Laboratory Dental Surgery Department, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland
- Department of Orthodontics, Technische Universitat Dresden, 01307 Dresden, Germany
| | - Maciej Dobrzyński
- Department of Pediatric Dentistry and Preclinical Dentistry, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland
- Institute of Low Temperature and Structure Research, Polish Academy of Sciences, Okolna 2, 50-422 Wroclaw, Poland
| | - Rafal J. Wiglusz
- Institute of Low Temperature and Structure Research, Polish Academy of Sciences, Okolna 2, 50-422 Wroclaw, Poland
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16
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Singh M, Singh B, Jha J, Passi D, Sharma A, Goyal J. Efficacy of bioresorbable plating system in the treatment of pediatric maxillary fractures: A short clinical study. Natl J Maxillofac Surg 2023; 14:86-92. [PMID: 37273446 PMCID: PMC10235745 DOI: 10.4103/njms.njms_342_21] [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: 03/23/2021] [Revised: 07/15/2021] [Accepted: 09/11/2021] [Indexed: 06/06/2023] Open
Abstract
Aim The aim of this study was to evaluate the efficacy, stability, and clinical outcomes of a bioresorbable plating system in the treatment of pediatric maxillary fractures. Materials and Methods Twenty pediatric patients with maxillary fractures (13 males and 7 females) were included in this study. The 1.5- and 2.0-mm resorbable plates were used and secured with monocortical resorbable screws 6 mm and 7 mm in length. All patients were followed up for 6 months. Clinical parameters, such as pain, swelling, soft-tissue infection, malocclusion, nerve injury, and bite force for stability, were prospectively assessed. Results Fall from height (50%) was the most common cause of etiology, followed by road traffic accidents (35%). Maxillary alveolar # (40) was the most common fracture site, followed by nasal complex # (25%) and zygomatic complex # (25%). Appropriate fixation and adequate primary bone healing was achieved in 100% of the cases. Few minor complications were observed: (1) soft-tissue infection (5%) and (2) paresthesia (10%). There was a significant increase in bite force in the incisor and molar regions. Observation in clinical parameters shows that there was a significant reduction in postoperative pain and swelling at different follow-up periods. Conclusion Bioresorbable plating system is used as a load-sharing plate in a semirigid fixation technique after anatomic fracture reduction. Although its high costs limit its feasibility for use low infection rates, minimized second surgery for implant removal attracts its use. 1.5- and 2-mm resorbable plating system along is a good treatment modality for moderately displaced maxillary fractures in pediatric patients. Larger sample size and longer follow-up studies are required for conclusive results.
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Affiliation(s)
- Mahinder Singh
- Department of Oral and Maxillofacial Surgery, Uttaranchal Dental and Medical Research Institute, Dehradun, Uttrakhand, India
| | - Barjinder Singh
- Department of Oral and Maxillofacial Surgery, Uttaranchal Dental and Medical Research Institute, Dehradun, Uttrakhand, India
| | - Jyotsna Jha
- Department of Oral and Maxillofacial Surgery, Uttaranchal Dental and Medical Research Institute, Dehradun, Uttrakhand, India
| | - Deepak Passi
- Department of Dentistry, CHC Mirzapur, Azamgarh, Uttar Pradesh, India
| | - Abhimanyu Sharma
- Department of Oral and Maxillofacial Surgery, ESIC Dental College and Hospital, New Delhi, India
| | - Jyoti Goyal
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
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17
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Titanium or Biodegradable Osteosynthesis in Maxillofacial Surgery? In Vitro and In Vivo Performances. Polymers (Basel) 2022; 14:polym14142782. [PMID: 35890557 PMCID: PMC9316877 DOI: 10.3390/polym14142782] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/30/2022] [Accepted: 07/02/2022] [Indexed: 02/06/2023] Open
Abstract
Osteosynthesis systems are used to fixate bone segments in maxillofacial surgery. Titanium osteosynthesis systems are currently the gold standard. However, the disadvantages result in symptomatic removal in up to 40% of cases. Biodegradable osteosynthesis systems, composed of degradable polymers, could reduce the need for removal of osteosynthesis systems while avoiding the aforementioned disadvantages of titanium osteosyntheses. However, disadvantages of biodegradable systems include decreased mechanical properties and possible foreign body reactions. In this review, the literature that focused on the in vitro and in vivo performances of biodegradable and titanium osteosyntheses is discussed. The focus was on factors underlying the favorable clinical outcome of osteosyntheses, including the degradation characteristics of biodegradable osteosyntheses and the host response they elicit. Furthermore, recommendations for clinical usage and future research are given. Based on the available (clinical) evidence, biodegradable copolymeric osteosyntheses are a viable alternative to titanium osteosyntheses when applied to treat maxillofacial trauma, with similar efficacy and significantly lower symptomatic osteosynthesis removal. For orthognathic surgery, biodegradable copolymeric osteosyntheses are a valid alternative to titanium osteosyntheses, but a longer operation time is needed. An osteosynthesis system composed of an amorphous copolymer, preferably using ultrasound welding with well-contoured shapes and sufficient mechanical properties, has the greatest potential as a biocompatible biodegradable copolymeric osteosynthesis system. Future research should focus on surface modifications (e.g., nanogel coatings) and novel biodegradable materials (e.g., magnesium alloys and silk) to address the disadvantages of current osteosynthesis systems.
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18
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Improvement of the mechanical properties and osteogenic activity of 3D-printed polylactic acid porous scaffolds by nano-hydroxyapatite and nano-magnesium oxide. Heliyon 2022; 8:e09748. [PMID: 35761932 PMCID: PMC9233213 DOI: 10.1016/j.heliyon.2022.e09748] [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: 03/08/2022] [Revised: 05/07/2022] [Accepted: 06/15/2022] [Indexed: 11/24/2022] Open
Abstract
Porous bone scaffolds based on high-precision 3D printing technology gave recently been developed for use in bone defect repair. However, conventional scaffold materials have poor mechanical properties and low osteogenic activity, limiting their clinical use. In this study, a porous composite tissue-engineered bone scaffold was prepared using polylactic acid, nano-hydroxyapatite, and nano-magnesium oxide as raw materials for high-precision 3D printing. The composite scaffold takes full advantage of the personalized manufacturing features of 3D printers and can be used to repair complex bone defects in clinical settings. The composite scaffold combines the advantages of nano-hydroxyapatite, which improves the formability of scaffold printing, and of nano-magnesium oxide, which regulates pH during degradation and provide a good environment for cell growth. Additionally, nano-magnesium oxide and nano-hydroxyapatite have a bidirectional effect on promoting the compressive strength and osteogenic activity of the scaffolds. The prepared composite porous scaffolds based on 3D printing technology show promise for bone defect repair.
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19
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Making Hardware Removal Unnecessary by Using Resorbable Implants for Osteosynthesis in Children. CHILDREN 2022; 9:children9040471. [PMID: 35455515 PMCID: PMC9031809 DOI: 10.3390/children9040471] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/08/2022] [Accepted: 03/21/2022] [Indexed: 11/30/2022]
Abstract
Introduction: Following osteosynthesis, children generally require a second surgery to remove the hardware. This becomes unnecessary, by using resorbable implants. Limiting the number of required surgeries and their associated risks, this technique provides critical aspects of minimally invasive surgery. This review focuses on resorbable implants for osteosynthesis for the treatment of fractures in children and discusses their clinical features. Method: We provide an overview of the two most common technologies used in resorbable osteosynthesis materials: polymer- and magnesium-based alloys. Clinical examples of osteosynthesis are presented using polymer-based ActivaTM products and magnesium-based Magnezix® products. Results: Polymer-based implants demonstrate surgical safety and efficacy. Due to their elasticity, initial placement of polymer-based products may demonstrate technical challenges. However, stability is maintained over the course of healing. While maintaining good biocompatibility, the rate of polymer-resorption may be controlled by varying the composition of polyesters and copolymers. Similarly, magnesium-based implants demonstrate good mechanical stability and resorption rates, while these characteristics may be controlled by varying alloy components. One of the significant shortcomings of magnesium is that metabolism results in the production of hydrogen gas. Both technologies provide equally good results clinically and radiographically, when compared to non-resorbable implants. Conclusion: Resorbable osteosynthesis materials demonstrate similar therapeutic results as conventional materials for osteosynthesis. Resorbable implants may have the potential to improve patient outcomes, by sparing children a second surgery for hardware removal.
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20
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Al Maruf DSA, Parthasarathi K, Cheng K, Mukherjee P, McKenzie DR, Crook JM, Wallace GG, Clark JR. Current and future perspectives on biomaterials for segmental mandibular defect repair. INT J POLYM MATER PO 2022. [DOI: 10.1080/00914037.2022.2052729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- D S Abdullah Al Maruf
- Craniomaxillofacial Prosthetic and Advanced Reconstructive Translational Surgery, Chris O’Brien Lifehouse, Camperdown, Australia
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Krishnan Parthasarathi
- Craniomaxillofacial Prosthetic and Advanced Reconstructive Translational Surgery, Chris O’Brien Lifehouse, Camperdown, Australia
| | - Kai Cheng
- Craniomaxillofacial Prosthetic and Advanced Reconstructive Translational Surgery, Chris O’Brien Lifehouse, Camperdown, Australia
- The Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, Australia
| | - Payal Mukherjee
- Craniomaxillofacial Prosthetic and Advanced Reconstructive Translational Surgery, Chris O’Brien Lifehouse, Camperdown, Australia
- The Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, Australia
| | - David R. McKenzie
- Biomedical Innovation, Chris O’Brien Lifehouse, Camperdown, Australia
- School of Physics, Faculty of Science, The University of Sydney, Camperdown, Australia
| | - Jeremy M. Crook
- Biomedical Innovation, Chris O’Brien Lifehouse, Camperdown, Australia
- Sarcoma and Surgical Research Centre, Chris O’Brien Lifehouse, Camperdown, Australia
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
- ARC Centre of Excellence for Electromaterials Science, Intelligent Polymer Research Institute, The University of Wollongong, Wollongong, Australia
- Illawarrah Health and Medical Research Institute, The University of Wollongong, Wollongong, Australia
| | - Gordon G. Wallace
- ARC Centre of Excellence for Electromaterials Science, Intelligent Polymer Research Institute, The University of Wollongong, Wollongong, Australia
| | - Jonathan R. Clark
- Craniomaxillofacial Prosthetic and Advanced Reconstructive Translational Surgery, Chris O’Brien Lifehouse, Camperdown, Australia
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
- The Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, Australia
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21
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Vasile VA, Istrate S, Iancu RC, Piticescu RM, Cursaru LM, Schmetterer L, Garhöfer G, Cherecheanu AP. Biocompatible Materials for Orbital Wall Reconstruction-An Overview. MATERIALS (BASEL, SWITZERLAND) 2022; 15:2183. [PMID: 35329635 PMCID: PMC8954765 DOI: 10.3390/ma15062183] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 02/27/2022] [Accepted: 03/14/2022] [Indexed: 12/04/2022]
Abstract
The reconstruction of an orbit after complex craniofacial fractures can be extremely demanding. For satisfactory functional and aesthetic results, it is necessary to restore the orbital walls and the craniofacial skeleton using various types of materials. The reconstruction materials can be divided into autografts (bone or cartilage tissue) or allografts (metals, ceramics, or plastic materials, and combinations of these materials). Over time, different types of materials have been used, considering characteristics such as their stability, biocompatibility, cost, safety, and intraoperative flexibility. Although the ideal material for orbital reconstruction could not be unanimously identified, much progress has been achieved in recent years. In this article, we summarise the advantages and disadvantages of each category of reconstruction materials. We also provide an update on improvements in material properties through various modern processing techniques. Good results in reconstructive surgery of the orbit require both material and technological innovations.
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Affiliation(s)
- Victor A Vasile
- Department of Ophthalmology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, District 5, 020021 Bucharest, Romania
| | - Sinziana Istrate
- Department of Ophthalmology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, District 5, 020021 Bucharest, Romania
- Department of Ophthalmology, University Emergency Hospital, 020021 Bucharest, Romania
| | - Raluca C Iancu
- Department of Ophthalmology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, District 5, 020021 Bucharest, Romania
- Department of Ophthalmology, University Emergency Hospital, 020021 Bucharest, Romania
| | - Roxana M Piticescu
- Nanostructured Materials Laboratory, National R&D Institute for Nonferrous and Rare Metals, 077145 Pantelimon, Romania
| | - Laura M Cursaru
- Nanostructured Materials Laboratory, National R&D Institute for Nonferrous and Rare Metals, 077145 Pantelimon, Romania
| | - Leopold Schmetterer
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore 168751, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore 169857, Singapore
- SERI-NTU Advanced Ocular Engineering (STANCE), Singapore 639798, Singapore
- School of Chemical and Biological Engineering, Nanyang Technological University, Singapore 637459, Singapore
- Department of Clinical Pharmacology, Medical University Vienna, 1090 Vienna, Austria
- Center for Medical Physics and Biomedical Engineering, Medical University Vienna, 1090 Vienna, Austria
- Institute of Molecular and Clinical Ophthalmology, 4056 Basel, Switzerland
| | - Gerhard Garhöfer
- Department of Clinical Pharmacology, Medical University Vienna, 1090 Vienna, Austria
| | - Alina Popa Cherecheanu
- Department of Ophthalmology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, District 5, 020021 Bucharest, Romania
- Department of Ophthalmology, University Emergency Hospital, 020021 Bucharest, Romania
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22
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Biocompatible Materials in Otorhinolaryngology and Their Antibacterial Properties. Int J Mol Sci 2022; 23:ijms23052575. [PMID: 35269718 PMCID: PMC8910137 DOI: 10.3390/ijms23052575] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/19/2022] [Accepted: 02/20/2022] [Indexed: 12/29/2022] Open
Abstract
For decades, biomaterials have been commonly used in medicine for the replacement of human body tissue, precise drug-delivery systems, or as parts of medical devices that are essential for some treatment methods. Due to rapid progress in the field of new materials, updates on the state of knowledge about biomaterials are frequently needed. This article describes the clinical application of different types of biomaterials in the field of otorhinolaryngology, i.e., head and neck surgery, focusing on their antimicrobial properties. The variety of their applications includes cochlear implants, middle ear prostheses, voice prostheses, materials for osteosynthesis, and nasal packing after nasal/paranasal sinuses surgery. Ceramics, such as as hydroxyapatite, zirconia, or metals and metal alloys, still have applications in the head and neck region. Tissue engineering scaffolds and drug-eluting materials, such as polymers and polymer-based composites, are becoming more common. The restoration of life tissue and the ability to prevent microbial colonization should be taken into consideration when designing the materials to be used for implant production. The authors of this paper have reviewed publications available in PubMed from the last five years about the recent progress in this topic but also establish the state of knowledge of the most common application of biomaterials over the last few decades.
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23
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Orassi V, Fischer H, Duda GN, Heiland M, Checa S, Rendenbach C. In Silico Biomechanical Evaluation of WE43 Magnesium Plates for Mandibular Fracture Fixation. Front Bioeng Biotechnol 2022; 9:803103. [PMID: 35223813 PMCID: PMC8866862 DOI: 10.3389/fbioe.2021.803103] [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: 10/27/2021] [Accepted: 12/29/2021] [Indexed: 11/18/2022] Open
Abstract
Titanium fixation devices are the gold standard for the treatment of mandibular fractures; however, they present serious limitations, such as non-degradability and generation of imaging artifacts. As an alternative, biodegradable magnesium alloys have lately drawn attention due to their biodegradability and biocompatibility. In addition, magnesium alloys offer a relatively high modulus of elasticity in comparison to biodegradable polymers, being a potential option to substitute titanium in highly loaded anatomical areas, such as the mandible. This study aimed to evaluate the biomechanical competence of magnesium alloy WE43 plates for mandibular fracture fixation in comparison to the clinical standard or even softer polymer solutions. A 3D finite element model of the human mandible was developed, and four different fracture scenarios were simulated, together with physiological post-operative loading and boundary conditions. In a systematic comparison, the material properties of titanium alloy Ti-6Al-4V, magnesium alloy WE43, and polylactic acid (PLA) were assigned to the fixation devices, and two different plate thicknesses were tested. No failure was predicted in the fixation devices for any of the tested materials. Moreover, the magnesium and titanium fixation devices induced a similar amount of strain within the healing regions. On the other hand, the PLA devices led to higher mechanical strains within the healing region. Plate thickness only slightly influenced the primary fixation stability. Therefore, magnesium alloy WE43 fixation devices seem to provide a suitable biomechanical environment to support mandibular fracture healing in the early stages of bone healing. Magnesium WE43 showed a biomechanical performance similar to clinically used titanium devices with the added advantages of biodegradability and radiopacity, and at the same time it showed a remarkably higher primary stability compared to PLA fixation devices, which appear to be too unstable, especially in the posterior and more loaded mandibular fracture cases.
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Affiliation(s)
- Vincenzo Orassi
- Berlin Institute of Health at Charité—Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
- Berlin-Brandenburg School for Regenerative Therapies, Berlin, Germany
| | - Heilwig Fischer
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Georg N. Duda
- Berlin Institute of Health at Charité—Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Sara Checa
- Berlin Institute of Health at Charité—Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
- *Correspondence: Sara Checa,
| | - Carsten Rendenbach
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
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24
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Barbeck M, Alkildani S, Jung O. Editorial of the Special Issue: “Soft and Hard Tissue Regeneration”. Biomedicines 2022; 10:biomedicines10020356. [PMID: 35203565 PMCID: PMC8962288 DOI: 10.3390/biomedicines10020356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/17/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Mike Barbeck
- Department of Ceramic Materials, Institute for Materials Science and Technologies, Technical University of Berlin, 10587 Berlin, Germany;
| | | | - Ole Jung
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany
- Correspondence: ; Tel.: +49-(0)-176-81022467
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25
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Kozakiewicz M, Gabryelczak I, Bielecki-Kowalski B. Clinical Evaluation of Magnesium Alloy Osteosynthesis in the Mandibular Head. MATERIALS 2022; 15:ma15030711. [PMID: 35160655 PMCID: PMC8836973 DOI: 10.3390/ma15030711] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 01/11/2022] [Accepted: 01/16/2022] [Indexed: 02/01/2023]
Abstract
Titanium alloys are used in skeletal surgery. However, once bone union is complete, such fixation material becomes unnecessary or even harmful. Resorbable magnesium materials have been available for several years (WE43 alloy). The aim of this study was to clinically compare magnesium versus titanium open reduction and rigid fixations in mandible condylar heads. Ten patients were treated for fractures of the mandibular head with magnesium headless compression screws (2.3 mm in diameter), and 11 patients were included as a reference group with titanium screws (1.8 mm in diameter) with similar construction. The fixation characteristics (delay, time, and number of screws), distant anatomical results (mandibular ramus height loss, monthly loss rate, and relative loss of reconstructed ramus height), basic functional data (mandibular movements, facial nerve function, and cutaneous perception) and the influence of the effects of the injury (fracture type, fragmentation, occlusion, additional fractures, and associated diseases) on the outcome were evaluated. The long-term results of treatment were evaluated after 18 months. Treatment results similar to those of traditional titanium fixation were found with magnesium screws. Conclusions: Resorbable metal screws can be a favored option for osteosynthesis because surgical reentry can be avoided. These materials provide proper and stable treatment results.
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26
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Modification of Biocorrosion and Cellular Response of Magnesium Alloy WE43 by Multiaxial Deformation. METALS 2022. [DOI: 10.3390/met12010105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The study shows that multiaxial deformation (MAD) treatment leads to grain refinement in magnesium alloy WE43. Compared to the initial state, the MAD-processed alloy exhibited smoother biocorrosion dynamics in a fetal bovine serum and in a complete cell growth medium. Examination by microCT demonstrated retardation of the decline in the alloy volume and the Hounsfield unit values. An attendant reduction in the rate of accumulation of the biodegradation products in the immersion medium, a less pronounced alkalization, and inhibited sedimentation of biodegradation products on the surface of the alloy were observed after MAD. These effects were accompanied with an increase in the osteogenic mesenchymal stromal cell viability on the alloy surface and in a medium containing their extracts. It is expected that the more orderly dynamics of biodegradation of the WE43 alloy after MAD and the stimulation of cell colonization will effectively promote stable osteosynthesis, making repeat implant extraction surgeries unnecessary.
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27
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Abd Al Razik Mohammed A. Biomechanical evaluation of magnesium plates for management of mandibular angle fracture. Br J Oral Maxillofac Surg 2021; 60:785-790. [PMID: 35623920 DOI: 10.1016/j.bjoms.2021.11.001] [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: 03/04/2021] [Accepted: 11/09/2021] [Indexed: 11/27/2022]
Abstract
The aim of this study was to evaluate the efficacy of magnesium plates for the management of fractures of the mandibular angle. Fresh sheep hemimandibles were divided into 7 groups and a biomechanical cantilever bending test was used for the groups: Group 1 included fractured hemimandibles fixed at the angle with a single 1mm magnesium miniplate; Group 2 had fixation with a 1mm double magnesium miniplate; Group 3 used a 2mm thick single magnesium miniplate; Group 4 used double 2mm magnesium plates; Group 5 each had a single 1mm thick titanium plate; Group 6 used 1mm thick double titanium plates; and Group 7 comprised intact hemimandibles. Each group was tested using universal testing machine yield loads; yield displacements and stiffness were compared using one way analysis of variance (ANOVA) Group 1 (1mm single magnesium plate) and Group 2 (1mm double magnesium plates) showed lower stability than other groups, while the 2mm magnesium plate showed stability similar to the corresponding 1mm titanium plate. Pure magnesium has good mechanical properties and when it is designed properly it can be used for the management of mandibular fracture.
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Affiliation(s)
- Altaib Abd Al Razik Mohammed
- Department of Oral and Maxillofacial Surgery, Faculty of Oral and Dental Medecine, South Valley University, Egypt.
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28
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Feeley A, Feeley I, Ni Fhoghlú C, Sheehan E, Kennedy M. Use of biomaterials in scaphoid fracture fixation, a systematic review. Clin Biomech (Bristol, Avon) 2021; 89:105480. [PMID: 34530377 DOI: 10.1016/j.clinbiomech.2021.105480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 09/02/2021] [Accepted: 09/04/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Scaphoid fractures account for 60-70% carpal injury. Due to limited vascular supply achieving adequate reduction and healing is important to avoid complications including avascular necrosis. Recent technological advances have led to renewed vigour in bioabsorbable material research to develop devices which could be used without the need for removal and complications including stress shielding and suboptimal imaging. METHODS A systematic search of databases including PubMed, Ovid Medline, and Google Scholar databases was made to identify studies related to the use of bioabsorbable materials in scaphoid fixation and postoperative patient outcomes. PRISMA guidelines were utilised for this review. FINDINGS Initial search results yielded 852 studies. 124 studies were screened, with 79 patients across 7 studies included in this review. Poly-L-Lactic acid derivatives were the most common biomaterial for scaphoid fixation, with magnesium and polyglycolide also used. Levels of evidence for studies ranged between III-IV. Analysis demonstrated mixed findings with generally comparable outcomes to conventional alloy-based screws. INTERPRETATION Development in bioabsorbable materials is ongoing, however there remains a dearth in data regarding their use in the scaphoid. Further research is needed to establish the efficacy and applicability of bioabsorbable devices in the scaphoid bone.
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Affiliation(s)
- Aoife Feeley
- Department of Orthopaedics, Midlands Regional Hospital Tullamore, Ireland; School of Medicine, University College Dublin, Ireland.
| | - Iain Feeley
- Department of Orthopaedics, National Orthopaedic Hospital Cappagh, Ireland
| | | | - Eoin Sheehan
- Department of Orthopaedics, Midlands Regional Hospital Tullamore, Ireland
| | - Muiris Kennedy
- Department of Orthopaedics, Midlands Regional Hospital Tullamore, Ireland
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Research status of biodegradable metals designed for oral and maxillofacial applications: A review. Bioact Mater 2021; 6:4186-4208. [PMID: 33997502 PMCID: PMC8099919 DOI: 10.1016/j.bioactmat.2021.01.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 01/10/2021] [Accepted: 01/10/2021] [Indexed: 01/08/2023] Open
Abstract
The oral and maxillofacial regions have complex anatomical structures and different tissue types, which have vital health and aesthetic functions. Biodegradable metals (BMs) is a promising bioactive materials to treat oral and maxillofacial diseases. This review summarizes the research status and future research directions of BMs for oral and maxillofacial applications. Mg-based BMs and Zn-based BMs for bone fracture fixation systems, and guided bone regeneration (GBR) membranes, are discussed in detail. Zn-based BMs with a moderate degradation rate and superior mechanical properties for GBR membranes show great potential for clinical translation. Fe-based BMs have a relatively low degradation rate and insoluble degradation products, which greatly limit their application and clinical translation. Furthermore, we proposed potential future research directions for BMs in the oral and maxillofacial regions, including 3D printed BM bone scaffolds, surface modification for BMs GBR membranes, and BMs containing hydrogels for cartilage regeneration, soft tissue regeneration, and nerve regeneration. Taken together, the progress made in the development of BMs in oral and maxillofacial regions has laid a foundation for further clinical translation.
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30
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Naseem R, Tzivelekis C, German MJ, Gentile P, Ferreira AM, Dalgarno K. Strategies for Enhancing Polyester-Based Materials for Bone Fixation Applications. Molecules 2021; 26:molecules26040992. [PMID: 33668466 PMCID: PMC7917714 DOI: 10.3390/molecules26040992] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/09/2021] [Accepted: 02/09/2021] [Indexed: 11/16/2022] Open
Abstract
Polyester-based materials are established options, regarding the manufacturing of bone fixation devices and devices in routine clinical use. This paper reviews the approaches researchers have taken to develop these materials to improve their mechanical and biological performances. Polymer blending, copolymerisation, and the use of particulates and fibre bioceramic materials to make composite materials and surface modifications have all been studied. Polymer blending, copolymerisation, and particulate composite approaches have been adopted commercially, with the primary focus on influencing the in vivo degradation rate. There are emerging opportunities in novel polymer blends and nanoscale particulate systems, to tune bulk properties, and, in terms of surface functionalisation, to optimise the initial interaction of devices with the implanted environment, offering the potential to improve the clinical performances of fracture fixation devices.
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Affiliation(s)
- Raasti Naseem
- School of Engineering, Newcastle University, Newcastle upon Tyne NE1 7RU, UK; (P.G.); (A.M.F.); (K.D.)
- Correspondence:
| | - Charalampos Tzivelekis
- School of Dental Sciences, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE1 7RU, UK; (C.T.); (M.J.G.)
| | - Matthew J. German
- School of Dental Sciences, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE1 7RU, UK; (C.T.); (M.J.G.)
| | - Piergiorgio Gentile
- School of Engineering, Newcastle University, Newcastle upon Tyne NE1 7RU, UK; (P.G.); (A.M.F.); (K.D.)
| | - Ana M. Ferreira
- School of Engineering, Newcastle University, Newcastle upon Tyne NE1 7RU, UK; (P.G.); (A.M.F.); (K.D.)
| | - Kenny Dalgarno
- School of Engineering, Newcastle University, Newcastle upon Tyne NE1 7RU, UK; (P.G.); (A.M.F.); (K.D.)
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31
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Change in Pull-Out Force during Resorption of Magnesium Compression Screws for Osteosynthesis of Mandibular Condylar Fractures. MATERIALS 2021; 14:ma14020237. [PMID: 33418924 PMCID: PMC7825024 DOI: 10.3390/ma14020237] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/31/2020] [Accepted: 01/04/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Magnesium has been used as degradable fixation material for osteosynthesis, but it seems that mechanical strength is still a current issue in these fixations. The aim of this study was to evaluate the axial pull-out force of compression headless screws made of magnesium alloy during their resorption. METHODS The tests included screws made for osteosynthesis of the mandible head: 2.2 mm diameter magnesium alloy MgYREZr (42 screws) and 2.5 mm diameter polylactic-co-glycolic acid (PLGA) (42 pieces, control). The screws were resorbed in Sørensen's buffer for 2, 4, 8, 12, and 16 weeks, and force was measured as the screw was pulled out from the polyurethane block. RESULTS The force needed to pull the screw out was significantly higher for MgYREZr screws than for PLGA ones (p < 0.01). Within eight weeks, the pull-out force for MgYREZr significantly decreased to one third of its initial value (p < 0.01). The dynamics of this decrease were greater than those of the pull-out force for PLGA screws (p < 0.05). After these eight weeks, the values for metal and polymer screws equalized. It seems that the described reduction of force requires taking into account when using magnesium screws. This will provide more stable resorbable metallic osteosynthesis.
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