Reconstruction of Complex Zygomatic Bone Defects Using Mirroring Coupled with EBM Fabrication of Titanium Implant

Reconstruction of the orbitozygomatic framework: State of the art and perspectives

The reconstruction of the whole orbitozygomatic framework (OZF) is complex and can be encountered in cases of congenital midface deformity, after tumor ablative surgery and in severe facial trauma. Nowadays, surgeon has a wide range of available techniques that have continually grown over the past years, optimizing the surgical management and the aesthetical outcomes. Among them, the autologous bone graft (ABG) remains one of the most suitable options : ABG is easy to harvest and has optimal biological properties for bone healing. It can be tailored to the patient anatomy thanks to the recent advances in computer-assisted surgery. However, substantial drawbacks remain such as the early resorption of the non-vascularized graft, the need of a donor site and its potential morbidity. Alloplastic reconstruction is another option that can resolve both the resorption issue and the donor site morbidity. Moreover, the 3D-printing technologies also allows the manufacturing of patient specific implants. However, alloplastic materials have a variable success, especially due to the high risk of infection or exposure. Consequently, regenerative medicine is a promising field that aims to find a procedure without the disadvantages of ABG or alloplastic based reconstructions, but displaying similar or even higher success rate. Indeed, recent tissue engineering strategies have demonstrated encouraging results for bone regeneration using natural or synthetic biomaterials, patient cells and synthetic bioactive substances. The objective of this review is to present the etiologies of OZF defect, the available reconstruction procedures as well as the current state of the research.

Achieving the Minimum Roughness of Laser Milled Micro-Impressions on Ti 6Al 4V, Inconel 718, and Duralumin

Titanium-aluminium-vanadium (Ti 6Al 4V) alloys, nickel alloys (Inconel 718), and duraluminum alloys (AA 2000 series) are widely used materials in numerous engineering applications wherein machined features are required to having good surface finish. In this research, micro-impressions of 12 µm depth are milled on these materials though laser milling. Response surface methodology based design of experiment is followed resulting in 54 experiments per work material. Five laser parameters are considered naming lamp current intensity (I), pulse frequency (f), scanning speed (V), layer thickness (LT), and track displacement (TD). Process performance is evaluated and compared in terms of surface roughness through several statistical and microscopic analysis. The significance, strength, and direction of each of the five laser parametric effects are deeply investigated for the said alloys. Optimized laser parameters are proposed to achieve minimum surface roughness. For the optimized combination of laser parameters to achieve minimum surface roughness (Ra) in the titanium alloy, the said alloy consists of I = 85%, f = 20 kHz, V = 250 mm/s, TD = 11 µm, and LT = 3 µm. Similarly, optimized parameters for nickel alloy are as follows: I = 85%, f = 20 kHz, V = 256 mm/s, TD = 8 µm, and LT = 1 µm. Minimum roughness (Ra) on the surface of aluminum alloys can be achieved under the following optimized parameters: I = 75%, f = 20 kHz, V = 200 mm/s, TD = 12 µm, and LT = 3 µm. Micro-impressions produced under optimized parameters have surface roughness of 0.56 µm, 2.46 µm, and 0.54 µm on titanium alloy, nickel alloy, and duralumin, respectively. Some engineering applications need to have high surface roughness (e.g., in case of biomedical implants) or some desired level of roughness. Therefore, validated statistical models are presented to estimate the desired level of roughness against any laser parametric settings.

Development of AM Technologies for Metals in the Sector of Medical Implants

Additive manufacturing (AM) processes have undergone significant progress in recent years, having been implemented in sectors as diverse as automotive, aerospace, electrical component manufacturing, etc. In the medical sector, different devices are printed, such as implants, surgical guides, scaffolds, tissue engineering, etc. Although nowadays some implants are made of plastics or ceramics, metals have been traditionally employed in their manufacture. However, metallic implants obtained by traditional methods such as machining have the drawbacks that they are manufactured in standard sizes, and that it is difficult to obtain porous structures that favor fixation of the prostheses by means of osseointegration. The present paper presents an overview of the use of AM technologies to manufacture metallic implants. First, the different technologies used for metals are presented, focusing on the main advantages and drawbacks of each one of them. Considered technologies are binder jetting (BJ), selective laser melting (SLM), electron beam melting (EBM), direct energy deposition (DED), and material extrusion by fused filament fabrication (FFF) with metal filled polymers. Then, different metals used in the medical sector are listed, and their properties are summarized, with the focus on Ti and CoCr alloys. They are divided into two groups, namely ferrous and non-ferrous alloys. Finally, the state-of-art about the manufacture of metallic implants with AM technologies is summarized. The present paper will help to explain the latest progress in the application of AM processes to the manufacture of implants.