1
|
Li Y, Huang X, Fu W, Zhang Z, Xiao K, Lv H. Preparation of PDA-GO/CS composite scaffold and its effects on the biological properties of human dental pulp stem cells. BMC Oral Health 2024; 24:157. [PMID: 38297260 PMCID: PMC10832331 DOI: 10.1186/s12903-023-03849-4] [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: 09/14/2023] [Accepted: 12/31/2023] [Indexed: 02/02/2024] Open
Abstract
Reduced graphene oxide (rGO) is an graphene oxide (GO) derivative of graphene, which has a large specific surface area and exhibited satisfactory physicochemical characteristics. In this experiment, GO was reduced by PDA to generate PDA-GO complex, and then PDA-GO was combined with Chitosan (CS) to synthesize PDA-GO/CS composite scaffold. PDA-GO was added to CS to improve the degradation rate of CS, and it was hoped that PDA-GO/CS composite scaffolds could be used in bone tissue engineering. Physicochemical and antimicrobial properties of the different composite scaffolds were examined to find the optimal mass fraction. Besides, we examined the scaffold's biocompatibility by Phalloidin staining and Live and Dead fluorescent staining.Finally, we applied ALP staining, RT-qPCR, and Alizarin red S staining to detect the effect of PDA-GO/CS on the osteogenic differentiation of human dental pulp stem cells (hDPSCs). The results showed that PDA-GO composite was successfully prepared and PDA-GO/CS composite scaffold was synthesized by combining PDA-GO with CS. Among them, 0.3%PDA-GO/CS scaffolds improves the antibacterial activity and hydrophilicity of CS, while reducing the degradation rate. In vitro, PDA-GO/CS has superior biocompatibility and enhances the early proliferation, migration and osteogenic differentiation of hDPSCs. In conclusion, PDA-GO/CS is a new scaffold materialsuitable for cell culture and has promising application prospect as scaffold for bone tissue engineering.
Collapse
Affiliation(s)
- Yaoyao Li
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Xinhui Huang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Weihao Fu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Zonghao Zhang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Kuancheng Xiao
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Hongbing Lv
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, People's Republic of China.
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, People's Republic of China.
| |
Collapse
|
2
|
Frąckiewicz W, Szymlet P, Jedliński M, Światłowska-Bajzert M, Sobolewska E. Mechanical characteristics of zirconia produced additively by 3D printing in dentistry - A systematic review with meta-analysis of novel reports. Dent Mater 2024; 40:124-138. [PMID: 37940500 DOI: 10.1016/j.dental.2023.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 10/20/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVES This study was aimed at comparing the mechanical parameters of ceramics made using the addition and subtraction technique. METHODS A search was performed on four search engines on 5th April 2023. Quality assessment was performed using study type-specific scales. Where possible, a meta-analysis was performed. SOURCES Data were extracted from four search engines: PubMed, PubMed Central, Embase, Web of Science, Scopus. STUDY SELECTION The search strategy identified 686 potential articles. 19 papers were subject to qualitative analysis, and data from 11 papers were meta-analysed. The included studies were of high or medium quality. All included papers were in-vitro studies. No clinical trials were found in the literature. SIGNIFICANCE Ceramics made in the additive technology in terms of mechanical parameters can compete with ceramics made in the milling technology. There are no clinical studies yet that would indicate the use of this type of material for permanent restorations in patients. Studies presented in the literature vary greatly in terms of study design and reporting of results. The research did not receive external funding.
Collapse
Affiliation(s)
- Wojciech Frąckiewicz
- Department of Dental Prosthetics, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland.
| | - Paweł Szymlet
- Department of Dental Prosthetics, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
| | - Maciej Jedliński
- Department of Interdisciplinary Dentistry, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
| | - Małgorzata Światłowska-Bajzert
- Department of Dental Prosthetics, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
| | - Ewa Sobolewska
- Department of Dental Prosthetics, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
| |
Collapse
|
3
|
Frąckiewicz W, Królikowski M, Kwiatkowski K, Sobolewska E, Szymlet P, Tomasik M. Comparison of Dental Zirconium Oxide Ceramics Produced Using Additive and Removal Technology for Prosthodontics and Restorative Dentistry-Strength and Surface Tests: An In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2023; 17:168. [PMID: 38204022 PMCID: PMC10779906 DOI: 10.3390/ma17010168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/14/2023] [Accepted: 12/26/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND The aim of this in vitro study was to determine the mechanical and functional properties of zirconium oxide ceramics made using 3D printing technology and ceramics produced using conventional dental milling machines. METHODS Forty zirconia samples were prepared for this study: the control group consisted of 20 samples made using milling technology, and the test group consisted of 20 samples made using 3D printing technology. Their surface parameters were measured, and then their mechanical parameters were checked and compared. Density, hardness, flexural strength and compressive strength were tested by performing appropriate in vitro tests. After the strength tests, a comparative analysis of the geometric structure of the surfaces of both materials was performed again. Student's t-test was used to evaluate the results (p < 0.01). RESULTS Both ceramics show comparable values of mechanical parameters, and the differences are not statistically significant. The geometric structure of the sample surfaces looks very similar. Only minor changes in the structure near the crack were observed in the AM group. CONCLUSION Ceramics made using additive technology have similar mechanical and surface parameters to milled zirconium oxide, which is one of the arguments for the introduction of this material into clinical practice. This in vitro study has shown that this ceramic can compete with zirconium made using CAD/CAM (Computer-Aided Design and Computer-Aided Manufacturing) methods.
Collapse
Affiliation(s)
- Wojciech Frąckiewicz
- Department of Dental Prosthetics, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
| | - Marcin Królikowski
- Department of Manufacturing Engineering, Faculty of Mechanical Engineering and Mechatronics, West Pomeranian University of Technology in Szczecin, 70-310 Szczecin, Poland
| | - Konrad Kwiatkowski
- Department of Mechanics and Fundamentals of Machine Design, Faculty of Mechanical Engineering and Mechatronics, West Pomeranian University of Technology in Szczecin, 70-310 Szczecin, Poland
| | - Ewa Sobolewska
- Department of Dental Prosthetics, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
| | - Paweł Szymlet
- Department of Dental Prosthetics, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
| | - Małgorzata Tomasik
- Department of Interdisciplinary Dentistry, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
| |
Collapse
|
4
|
Su G, Zhang Y, Jin C, Zhang Q, Lu J, Liu Z, Wang Q, Zhang X, Ma J. 3D printed zirconia used as dental materials: a critical review. J Biol Eng 2023; 17:78. [PMID: 38129905 PMCID: PMC10740276 DOI: 10.1186/s13036-023-00396-y] [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: 07/14/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
In view of its high mechanical performance, outstanding aesthetic qualities, and biological stability, zirconia has been widely used in the fields of dentistry. Due to its potential to produce suitable advanced configurations and structures for a number of medical applications, especially personalized created devices, ceramic additive manufacturing (AM) has been attracting a great deal of attention in recent years. AM zirconia hews out infinite possibilities that are otherwise barely possible with traditional processes thanks to its freedom and efficiency. In the review, AM zirconia's physical and adhesive characteristics, accuracy, biocompatibility, as well as their clinical applications have been reviewed. Here, we highlight the accuracy and biocompatibility of 3D printed zirconia. Also, current obstacles and a forecast of AM zirconia for its development and improvement have been covered. In summary, this review offers a description of the basic characteristics of AM zirconia materials intended for oral medicine. Furthermore, it provides a generally novel and fundamental basis for the utilization of 3D printed zirconia in dentistry.
Collapse
Affiliation(s)
- Guanyu Su
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Yushi Zhang
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Chunyu Jin
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Qiyue Zhang
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Jiarui Lu
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Zengqian Liu
- Shi-Changxu Innovation Center for Advanced Materials, Institute of Metal Research, Chinese Academy of Sciences, Shenyang, 110016, China
- School of Materials Science and Engineering, University of Science and Technology of China, Hefei, 230026, China
| | - Qiang Wang
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Xue Zhang
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China.
| | - Jia Ma
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China.
| |
Collapse
|
5
|
Zhou Q, Su X, Wu J, Zhang X, Su R, Ma L, Sun Q, He R. Additive Manufacturing of Bioceramic Implants for Restoration Bone Engineering: Technologies, Advances, and Future Perspectives. ACS Biomater Sci Eng 2023; 9:1164-1189. [PMID: 36786214 DOI: 10.1021/acsbiomaterials.2c01164] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Treating bone defects is highly challenging because they do not heal on their own inside the patients, so implants are needed to assist in the reconstruction of the bone. Bioceramic implants based on additive manufacturing (AM) are currently emerging as promising treatment options for restoration bone engineering. On the one hand, additively manufactured bioceramic implants have excellent mechanical properties and biocompatibility, which are suitable for bone regeneration. On the other hand, the designable structure and adjustable pores of additively manufactured bioceramic implants allow them to promote suitable cell growth and tissue climbing. Herein, this review unfolds to introduce several frequently employed AM technologies for bioceramic implants. After that, advances in commonly used additively manufactured bioceramic implants, including bioinert ceramic implants, bioactive ceramic implants, and bioceramic/organic composite implants, are categorized and summarized. Finally, the future perspectives of additively manufactured bioceramic implants, in terms of mechanical performance improvement, innovative structural design, biological property enhancement, and other functionalization approaches, are proposed and forecasted. This review is believed to provide some fundamental understanding and cutting-edge knowledge for the additive manufacturing of bioceramic implants for restoration bone engineering.
Collapse
Affiliation(s)
- Qing Zhou
- Institute of Advanced Structure Technology, Beijing Institute of Technology, Beijing 100081, China
| | - Xiaonan Su
- Beijing Scrianen Pharmaceutical Co. Ltd., Beijing 102699, China
| | - Jianqin Wu
- Institute of Advanced Structure Technology, Beijing Institute of Technology, Beijing 100081, China
| | - Xueqin Zhang
- Institute of Advanced Structure Technology, Beijing Institute of Technology, Beijing 100081, China
| | - Ruyue Su
- Institute of Advanced Structure Technology, Beijing Institute of Technology, Beijing 100081, China
| | - Lili Ma
- Center of Dental Medicine, China-Japan Friendship Hospital, Beijing 100029, China
| | - Qiang Sun
- Center of Dental Medicine, China-Japan Friendship Hospital, Beijing 100029, China
| | - Rujie He
- Institute of Advanced Structure Technology, Beijing Institute of Technology, Beijing 100081, China
| |
Collapse
|
6
|
Effect of Temporary Cement, Surface Pretreatment and Tooth Area on the Bond Strength of Adhesively Cemented Ceramic Overlays-An In Vitro Study. Dent J (Basel) 2023; 11:dj11010019. [PMID: 36661557 PMCID: PMC9858129 DOI: 10.3390/dj11010019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/22/2022] [Accepted: 12/30/2022] [Indexed: 01/09/2023] Open
Abstract
Several viewpoints have been reported regarding the effect of temporary cements, different surface pretreatment protocols before adhesive cementation, and predictive factors. This in vitro study tested if temporary cement, pretreatment of the tooth surface, the size of enamel or dentine influence adhesive cementation to zirconia ceramics. Twenty premolars were prepared for determination of enamel and dentin area, bond strength test and failure analysis. The samples were divided into two groups: untreated prior adhesive cementation (n = 10) and with temporary cementation done, pretreated prior adhesive cementation (n = 10). Zirconia overlays (Katana Zirconia STML) were cemented on the grounded flat teeth surfaces using Panavia V5. An additional six premolars underwent dentine tubule analysis with SEM to detect temporary cement residues after temporary cementation on an untreated tooth surface (n = 3) and on a pretreated surface (n = 3). The independent sample t-test was used to compare the two groups and the means of the total tooth, dentin or enamel areas did not differ significantly between the untreated and pretreated specimens. The mean tensile bond strength was significantly (p = 0.005) higher in the pretreated specimens (337N) than in the untreated ones (204N). The overall multivariable linear regression model with three predictors (surface pre-treatment, enamel area and dentine area) was significant (p = 0.003), among which the size of enamel was the strongest predictor (β = 0.506; p = 0.049), followed by the pretreatment effect (β = 0.478; p = 0.001) and the size of dentin area (β = -0.105; p = 0.022).
Collapse
|
7
|
3D Printing of Bioinert Oxide Ceramics for Medical Applications. J Funct Biomater 2022; 13:jfb13030155. [PMID: 36135590 PMCID: PMC9505679 DOI: 10.3390/jfb13030155] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/06/2022] [Accepted: 09/12/2022] [Indexed: 11/23/2022] Open
Abstract
Three-dimensionally printed metals and polymers have been widely used and studied in medical applications, yet ceramics also require attention. Ceramics are versatile materials thanks to their excellent properties including high mechanical properties and hardness, good thermal and chemical behavior, and appropriate, electrical, and magnetic properties, as well as good biocompatibility. Manufacturing complex ceramic structures employing conventional methods, such as ceramic injection molding, die pressing or machining is extremely challenging. Thus, 3D printing breaks in as an appropriate solution for complex shapes. Amongst the different ceramics, bioinert ceramics appear to be promising because of their physical properties, which, for example, are similar to those of a replaced tissue, with minimal toxic response. In this way, this review focuses on the different medical applications that can be achieved by 3D printing of bioinert ceramics, as well as on the latest advances in the 3D printing of bioinert ceramics. Moreover, an in-depth comparison of the different AM technologies used in ceramics is presented to help choose the appropriate methods depending on the part geometry.
Collapse
|
8
|
Li Y, Kankala RK, Chen AZ, Wang SB. 3D Printing of Ultrathin MXene toward Tough and Thermally Resistant Nanocomposites. NANOMATERIALS (BASEL, SWITZERLAND) 2022; 12:2862. [PMID: 36014726 PMCID: PMC9414167 DOI: 10.3390/nano12162862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/08/2022] [Accepted: 08/17/2022] [Indexed: 06/15/2023]
Abstract
Liquid crystal display (LCD)-based 3D printing, a facile and cost-effective manufacturing technique, is often applied when fabricating objects with porcelain structures using photosensitive resins (PSRs). Currently, 3D printed constructions are typically used as models for demonstration purposes rather than industrial applications because of their poor performance. In this study, we prepared nanocomposites by incorporating Ti3C2 MXene nanosheets to enhance the overall characteristics of a PSR, including mechanical properties and thermal resistance. Notably, the designed nanocomposites showed optimum performance at an MXene loading of 0.5% w/w. The mechanical properties of the designed nanocomposites confirmed the enhanced ultimate tensile and flexural strengths (by 32.1% and 42.7%, respectively), at 0.5% w/w MXene loading. Moreover, the incorporated MXene presented no substantial influence on the toughness of the PSR. The glass transition and thermal degradation temperatures at 5% weight loss increased by 7.4 and 10.6 °C, respectively, resulting predominantly from the hydrogen bonding between the PSR and MXene. Together, the experimental results indicate that the designed PSR/MXene nanocomposites are expected to replace pristine resins for LCD printing in various practical applications.
Collapse
Affiliation(s)
- Yuewei Li
- Institute of Biomaterials and Tissue Engineering, Huaqiao University, Xiamen 361021, China
- Fujian Provincial Key Laboratory of Biochemical Technology, Huaqiao University, Xiamen 361021, China
| | - Ranjith Kumar Kankala
- Institute of Biomaterials and Tissue Engineering, Huaqiao University, Xiamen 361021, China
- Fujian Provincial Key Laboratory of Biochemical Technology, Huaqiao University, Xiamen 361021, China
| | - Ai-Zheng Chen
- Institute of Biomaterials and Tissue Engineering, Huaqiao University, Xiamen 361021, China
- Fujian Provincial Key Laboratory of Biochemical Technology, Huaqiao University, Xiamen 361021, China
| | - Shi-Bin Wang
- Institute of Biomaterials and Tissue Engineering, Huaqiao University, Xiamen 361021, China
- Fujian Provincial Key Laboratory of Biochemical Technology, Huaqiao University, Xiamen 361021, China
| |
Collapse
|
9
|
Moon JM, Jeong CS, Lee HJ, Bae JM, Choi EJ, Kim ST, Park YB, Oh SH. A Comparative Study of Additive and Subtractive Manufacturing Techniques for a Zirconia Dental Product: An Analysis of the Manufacturing Accuracy and the Bond Strength of Porcelain to Zirconia. MATERIALS (BASEL, SWITZERLAND) 2022; 15:ma15155398. [PMID: 35955331 PMCID: PMC9370019 DOI: 10.3390/ma15155398] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/18/2022] [Accepted: 08/02/2022] [Indexed: 06/01/2023]
Abstract
This study was aimed at preparing zirconia samples via additive manufacturing (AM) and subtractive manufacturing (SM) and testing the following aspects: (1) the manufacturing accuracy of the zirconia samples and (2) the bond strength of porcelain to zirconia to evaluate the applicability of the zirconia fabricated by AM in dental clinics. We used three milling machines for SM (AR, K5, and UP) and a 3D printer for AM (AO). The manufacturing accuracy of the zirconia specimen in the internal and marginal areas was evaluated by superimposing techniques to calculate the root mean square (RMS) values. The bond strengths of porcelain to zirconia prepared via SM and AM were measured using a universal testing machine. The internal and marginal RMS values of the zirconia prepared by AM (AO) were within the range of those of the zirconia prepared by SM (AR, K5, and UP). Moreover, the bond strength value of the zirconia prepared by AM (35.12 ± 4.09 MPa) was significantly higher than that of the zirconia prepared by SM (30.26 ± 5.20 MPa). Therefore, AM technology has significant potential for applications in dentistry.
Collapse
Affiliation(s)
- Joon-Mo Moon
- Department of Dental Biomaterials and the Institute for Biomaterials and Implant, College of Dentistry, Wonkwang University, Iksan 54538, Korea
| | - Chang-Sub Jeong
- Department of Dental Biomaterials and the Institute for Biomaterials and Implant, College of Dentistry, Wonkwang University, Iksan 54538, Korea
- Department of Dental Laboratory Technology, Faculty of Health and Medical Sciences, Wonkwang Health Science University, Iksan 54538, Korea
| | - Hee-Jeong Lee
- Department of Dental Biomaterials and the Institute for Biomaterials and Implant, College of Dentistry, Wonkwang University, Iksan 54538, Korea
| | - Ji-Myung Bae
- Department of Dental Biomaterials and the Institute for Biomaterials and Implant, College of Dentistry, Wonkwang University, Iksan 54538, Korea
| | - Eun-Joo Choi
- Department of Oral & Maxillofacial Surgery, College of Dentistry, Wonkwang University, Iksan 54538, Korea
| | - Sung-Tae Kim
- Department of Periodontology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Korea
| | - Young-Bum Park
- BK21 Plus Project, Oral Science Research Center, Department of Prosthodontics, Yonsei University College of Dentistry, Seoul 03722, Korea
| | - Seung-Han Oh
- Department of Dental Biomaterials and the Institute for Biomaterials and Implant, College of Dentistry, Wonkwang University, Iksan 54538, Korea
| |
Collapse
|
10
|
Guo DH, Li XM, Ma SQ, Zhao YC, Qi C, Xue Y. Total Hip Arthroplasty with Robotic Arm Assistance for Precise Cup Positioning: A Case-Control Study. Orthop Surg 2022; 14:1498-1505. [PMID: 35701994 PMCID: PMC9251322 DOI: 10.1111/os.13334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 05/12/2022] [Accepted: 05/16/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To determine whether more precise cup positioning can be achieved with robot-assisted total hip arthroplasty (THA) as compared to conventional THA. METHODS In this study, between July 2019 and May 2021, 93 patients aged 23-75 years with osteonecrosis of the femoral head (ONFH) and adult developmental dysplasia of hip who underwent first hip surgery were included in the study. They were randomly assigned to either the robotic-assisted THA group (n = 45) or the conventional THA group (n = 48). After the operation, all patients were given routine rapid rehabilitation guidance. The duration of operation was recorded to estimate the learning curve through cumulative summation analysis. We compared the demographics, duration of operation, cup positioning, leg length discrepancy, hip offset, and Harris Hip Score between robot-assisted THA and manual THA. Precision in the positioning of the acetabular prosthesis using the MAKO system was also compared between the two groups. RESULTS The mean duration of operation for the robot-assisted THA group was 91.37 ± 17.34 min (range: 63 to 135 min), which was significantly higher than that for the conventional THA group. When the number of procedures was increased to 13, the duration of operation in the robot-assisted group decreased significantly and gradually became stable. In terms of duration of operation, robot-assisted THA was associated with a learning curve of 13 cases. The mean amount of bleeding in the robot-assisted THA group was not significantly different from that in conventional THA group (328 ± 210 ml vs 315 ± 205 ml) (p = 0.741). There was no significant difference in the proportion of prostheses located within Lewinnek's safe zone between robot-assisted THA group and conventional THA group (69.81% vs 64.41%). The leg length discrepancy (LLD) was significantly smaller in the robot-assisted THA group than in the conventional THA group (p < 0.001), but both were within acceptable limits (10 mm). The inclination and anteversion angles of the acetabular prosthesis planned before operations were correlated with the actual measurement (r = 0.857 p < 0.001, r = 0.830, p < 0.001). After surgery, none of the patients experienced hip dislocation, aseptic loosening, or periprosthetic infection during the 3 months of follow-up. CONCLUSION The proportion of acetabular prostheses in the Lewinnek's safety zone was higher and the extent of LLD was significantly lower in the robot-assisted THA group, as compared to the same metrics in the conventional THA group. The MAKO robot improved the accuracy of implant placement in THA.
Collapse
Affiliation(s)
- Dong-Hui Guo
- Department of Orthopaedic Surgery, Tianjin Medical University General Hospital, Tianjin, China.,Department of Orthopaedic Surgery, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province, Cangzhou, China
| | - Xiao-Ming Li
- Department of Orthopaedic Surgery, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province, Cangzhou, China
| | - Shi-Qiang Ma
- Department of Orthopaedic Surgery, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province, Cangzhou, China
| | - Yun-Chao Zhao
- Department of Orthopaedic Surgery, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province, Cangzhou, China
| | - Chao Qi
- Department of Orthopaedic Surgery, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province, Cangzhou, China
| | - Yuan Xue
- Department of Orthopaedic Surgery, Tianjin Medical University General Hospital, Tianjin, China
| |
Collapse
|