Search results for: bone fracture

Authors: C. Busuioc, G. Voicu, S. I. Jinga

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The field of tissue engineering brings new challenges in terms of proposing original solutions for ongoing medical issues, improving the biological performances of existing clinical systems and speeding the healing process for a faster recovery and a more comfortable life as patient. In this context, we propose the obtaining of 3D porous scaffolds of mineral nature, dedicated to bone repairing and regeneration purposes or employed as bioactive filler for bone cements. Thus, bacterial cellulose - calcium phosphates composite materials have been synthesized by successive immersing of the polymeric membranes in the precursor solution containing Ca2+ and [PO4]3- ions. The mineral phase deposited on the surface of biocellulose fibers was varied as amount through the number of immersing cycles. The intermediary composites were subjected to thermal treatments at different temperatures in order to remove the organic part and provide the formation of a self-sustained 3D architecture. The resulting phase composition consists of common phosphates, while the morphology largely depends on the preparation parameters. Thus, the aspect of the 3D mineral scaffolds can be tuned from a loose microstructure composed of large grains connected via monocrystalline nanorods to a trabecular pattern crossed by parallel internal channels, just like the natural bone. The bioactivity and biocompatibility of the obtained materials have been also assessed, with encouraging results in the clinical use direction. In conclusion, the compositional, structural, morphological and biological characterizations sustain the suitability of the reported biostructures for integration in hard tissue engineering applications.

Keywords: bacterial cellulose, bone reconstruction, calcium phosphates, mineral scaffolds

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Authors: hassan gheisari

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Ferro silicate calcium nano particles are prepared through the sol-gel method using polyvinyl alcohol (PVA) as a chelating agent. The powder, as prepared, is annealed at three different temperatures (900 ºC, 1000 ºC, and 1100 ºC) for 3 h. The XRD patterns of the samples indicate broad peaks, and the full width at half maximum decreased with increasing annealing temperature. FTIR spectra of the samples confirm the presence of metal - oxygen complexes within the structure. The average particle size obtained from PSA curve demonstrates ultrafine particles. SEM micrographs indicate the particles synthesized have spherical morphology. The saturation magnetization (Ms) and remnant magnetization (Mr) of the samples show dependence on particle size and crystallinity of the samples. The highest saturation magnetization is achieved for the sample annealed at 1100 ºC having maximum average particle size. The high saturation magnetization of the samples suggests the present method is suitable for obtaining nano particles magnetic ferro bioceramic, which is desirable for practical applications such as hyperthermia bone cancer therapy.

Keywords: hyperthermia, bone cancer, bio ceramic; magnetic materials; sol– gel, silicate calcium

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Authors: Hassan Gheisari

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Ferro silicate calcium nano particles are prepared through the sol-gel method using polyvinyl alcohol (PVA) as a chelating agent. The powder as prepared is annealed at three different temperatures (900 ºC, 1000 ºC and 1100 ºC) for 3 h. The XRD patterns of the samples indicate broad peaks and the full width at half maximum decreased with increasing annealing temperature. FTIR spectra of the samples confirm the presence of metal - oxygen complexes within the structure. The average particle size obtained from PSA curve demonstrates ultrafine particles. SEM micrographs indicate the particles synthesized have spherical morphology. The saturation magnetization (Ms) and remnant magnetization (Mr) of the samples show dependence on particle size and crystallinity of the samples. The highest saturation magnetization is achieved for the sample annealed at 1100 ºC having maximum average particle size. The high saturation magnetization of the samples suggests the present method is suitable for obtaining nano particles magnetic ferro bioceramic which is desirable for practical applications such as hyperthermia bone cancer therapy.

Keywords: hyperthermia, bone cancer, bio ceramic, magnetic materials, sol– gel, silicate calcium

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Authors: Suleyman Karabal, Timothy L. Burnett, Egemen Avcu, Andrew H. Sherry, Philip J. Withers

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SA508 Grade 3 steel is widely used in the construction of nuclear pressure vessels, where its fracture toughness plays a critical role in ensuring operational safety and reliability. Understanding the ductile failure mechanisms in this steel grade is crucial for designing robust pressure vessels that can withstand severe nuclear environment conditions. In the present study, round bar specimens of SA508 Grade 3 steel with four distinct notch geometries were subjected to tensile loading while capturing continuous 2D images at 5-second intervals in order to monitor any alterations in their geometries to construct true stress-strain curves of the specimens. 3D reconstructions of X-ray computed tomography (CT) images at high-resolution (a spatial resolution of 0.82 μm) allowed for a comprehensive assessment of the influences of second-phase particles (i.e., manganese sulfide inclusions and cementite particles) on ductile failure initiation as a function of applied plastic strain. Additionally, based on 2D and 3D images, plasticity modeling was executed, and the results were compared to experimental data. A specific ‘two-parameter criterion’ was established and calibrated based on the correlation between stress triaxiality and equivalent plastic strain at failure initiation. The proposed criterion demonstrated substantial agreement with the experimental results, thus enhancing our knowledge of ductile fracture behavior in this steel grade. The implementation of X-ray CT and fractography analysis provided new insights into the diverse roles played by different populations of second-phase particles in fracture initiation under varying stress triaxiality conditions.

Keywords: ductile fracture, two-parameter criterion, x-ray computed tomography, stress triaxiality

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Authors: Hygreeva Kiran Namburi, Anna Hojna, Edita Lecianova, Fencl Zdenek

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Irradiation Assisted Stress Corrosion Cracking [IASCC] is one of the most significant environmental degradation in the internal components made from Austenitic stainless steel. This mechanism is still not fully understood and there are no suitable criteria for prediction of the damage during operation. In this work, core basket material 08Ch18N10T austenitic stainless steel acquired from decommissioned NPP Nord / Greifswald Unit 1, VVER 440-230 type, operated for 15 years and irradiated at 5.2 dpa is studied. This material was tensile tested at two different test temperatures and strain rates in air and at the elevated temperature under the water environment. SEM observations of the fracture surface documented ductile fracture of the samples tested in air, but areas of IASCC tested in water. This paper emphasizes on the microscopic examination results from the mechanically tested samples to determine the underlying IASCC physical damage process. TEM observations of thin foils made from the gauge sections that are closer to the fractured surface of the specimen aimed to find variances in interaction of dislocations and grain boundaries owing to different test conditions.

Keywords: irradiation assisted stress corrosion cracking, core basket material, SEM observations of the fracture surface, microscopic examination results

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Authors: Farid Saeidi, Serkan Dag

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In this study, fracture analysis of a fibrous composite laminate with variable fiber spacing is carried out using Jk-integral method. The laminate is assumed to be under thermal loading. Jk-integral is formulated by using the constitutive relations of plane orthotropic thermoelasticity. Developed domain independent form of the Jk-integral is then integrated into the general purpose finite element analysis software ANSYS. Numerical results are generated so as to assess the influence of variable fiber spacing on mode I and II stress intensity factors, energy release rate, and T-stress. For verification, some of the results are compared to those obtained using displacement correlation technique (DCT).

Keywords: Jk-integral, Variable Fiber Spacing, Thermoelasticity, T-stress, Finite Element Method, Fibrous Composite.

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Authors: Kathryn L. Duncan, Charles A. Kuntz, James O. Simcock

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A surgical approach to the cranium for treatment of frontal lobe and olfactory bulb neoplasia in dogs is described in this report, which provided excellent access for visualisation and removal of gross neoplastic tissue. An 8-year-old spayed female Shih Tzu crossbreed dog (dog 1) and a 13-year-old neutered male Miniature Fox Terrier (dog 2) were evaluated for removal of neoplasms involving both the frontal lobe and olfactory bulb. Both dogs presented with abnormal neurological clinical signs, decreased menace responses, and behavioural changes. Additionally, dog 2 presented with compulsive circling and generalized tonic-clonic seizure activity. Computed tomography was performed in both dogs, and MRI was also performed in dog 1. Imaging was consistent with frontal lobe and olfactory bulb neoplasia. A transorbital frontal bone craniectomy, with orbital ligament desmotomy and ventrolateral retraction of the globe, was performed in both cases without complication. Dog 1 had a focal area of lysis in the frontal bone adjacent to the neoplasm in the frontal lobe. The presence of the bone defect provided part of the impetus for this approach, as it would permit resection of the lytic bone. In addition, the neoplasms would be surgically accessible without encountering interposed brain parenchyma, reducing the risk of iatrogenic injury. Both dogs were discharged from the hospital within 72 hours post-operatively, both with normal mentation. Case 1 had a histopathologic diagnosis of malignant anaplastic neoplasm. The tumour recurred 101d postoperatively, and the patient was euthanized. Case 2 was diagnosed with a meningioma and was neurologically normal at 294d postoperatively. This transorbital surgical approach allowed successful removal of the intracranial frontal lobe and olfactory bulb neoplasms in 2 dogs. This approach should be considered for dogs with lateralized frontal lobe and olfactory bulb neoplasms that are closely associated with the suborbital region of the frontal bone.

Keywords: neurosurgery, small animal surgery, surgical oncology, veterinary neurology

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Authors: Iftikhar Ahmad, Abulhakim Almajid

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Alumina (Al2O3) is an attractive structural ceramic however; brittleness turns Al2O3 down for advanced applications. Development of multi-phase phase ceramics systems is promising to curtail the brittleness and the incorporation of strong/elastic graphene, as third phase, into dual phase (Al2O3-SiC) is striking for mechanical upgrading purpose. Thin graphene nanosheets (GNS) were prepared by thermal exfoliation process and reinforced into dual phase ceramic system. The hybrid nanocomposite was consolidated by novel HF-IH (high-frequency induction heating) sintering furnace at 1500 °C under 50 MPa in vacuum conditions. Structural features and grain size of the resulting nanocomposite were analyzed by SEM and TEM whilst the mechanical properties were assessed by microhardness and nanoindentation techniques. The fracture toughness of the hybrid nanocomposites was appraised by direct crack measurement method. Electron microscopic investigations confirmed the preparation of thin (< 10 nm) graphene nanosheets (GNS). HF-IH sintering route condensed the three-phase (GNS-Al2O3-SiC) hybrid nanocomposite system to > 99% relative densities. SEM of the hybrid nanocomposites fractured surfaces revealed even distribution of the nanocomposite constituents and changed in fracture-mode. Structurally, 88% grain reduction into hybrid nanocomposite was also obtained. Mechanically, enhanced fracture toughness (50%) and hardness (53%) were also achieved for hybrid nanocomposites were attained against bench marked monolithic Al2O3.

Keywords: alumina, graphene, hybrid nanocomposites, rapid sintering

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Authors: Ahmed A. M. Shoaib, Heba A. Esaily, Mahmoud M. Emara, Eman A. E. Badr, Amany S. Khalifa, Mayada M. M., Abdel-Raizk

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Background: DM is associated with metabolic bone diseases, osteoporosis, low-impact fractures and falls in geriatrics. Fetuin-A, which is a serum protein produced by the liver and promotes bone mineralization, is an independent risk factor for type 2 diabetes. Aim: Evaluation of fetuin-A level and bone mineral density in postmenopausal Egyptian female patients with type 2 diabetes mellitus and their correlation with each other & with other metabolic parameters. Patients and methods: Seventy postmenopausal female patients with type II diabetes and thirty postmenopausal female as control were included in this study. Measurement of Fetuin-A together with metabolic parameters and DXA in wrist, hip and spine, ALP, CBC, FBS, PP2H and HBA1c was done in all participants. Results: - Fetuin-A level was found to be highly significant (p< 0.001) between diabetic and nondiabetic groups and negatively correlated with BMD in spine. No difference in BMD was found between patients and control groups while significant negative correlation was found between FBS and hip BMD (<0.05) and between 2hpp and HBA1c with spine BMD in the diabetic group (<0.05). Osteoporosis represented 12.9% in spine area and 7.2% in hip and wrist areas in diabetic patients, while osteopenia were found in 58.5%, 57.1%, and 37.1% in diabetic patients in spine, wrist, and hip respectively. Conclusion: - type II diabetes cannot be considered as a risk factor for osteoporosis; while glycemic parameters (FBS, 2hpp & HBA1c) and serum Fetuin-A levels were correlated with BMD in diabetics. Good glycemic control can be protective against osteoporosis in diabetic elderly.

Keywords: fetuin-A, BMD, postmenopausal, DM type II

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Authors: Jie Chen, Chris Cheng, Kai Zhang

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Polycrystalline diamond compact (PDC) cutters with a polycrystalline diamond (PCD) table supported by a cemented tungsten carbide substrate have been widely used for earth-drilling tools in the oil and gas industry. Both wear and impact resistances are key figure of merits of PDC cutters, and they are closely related to the microstructure of the PCD table. As oil and gas exploration enters deeper, harder, and more complex formations, plus increasing requirement of accelerated downhole drilling speed and drilling cost reduction, current PDC cutters face unprecedented challenges for maintaining a longer drilling life than ever. Excessive wear on uneven hard formations, spalling, chipping, and premature fracture due to impact loads are common failure modes of PDC cutters in the field. Tailoring microstructure of the PCD table is one of the effective approaches to improve the wear and impact resistances of PDC cutters, along with other factors such as cutter geometry and bit design. In this research, cross-sectional microstructure, fracture surface, wear surface, and elemental composition of PDC cutters were analyzed using scanning electron microscopy (SEM) with both backscattered electron and secondary electron detectors, and energy dispersive X-ray spectroscopy (EDS). The microstructure and elemental composition were further correlated with the wear and impact resistances of corresponding PDC cutters. Wear modes and impact toughening mechanisms of state-of-the-art PDCs were identified. Directions to further improve the wear and impact resistances of PDC cutters were proposed.

Keywords: fracture surface, microstructure, polycrystalline diamond, PDC, wear surface

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Authors: Albert Suryaprawira

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The Nasion-Sella Line (NSL) has been used for several years as a reference line in longitudinal growth study. Therefore this line is considered to be stable not only to evaluate treatment outcome and to predict relapse possibility but also to manage prognosis. This is a radiographic superimposition of an adult male aged 19 years who complained of difficulty in aesthetic, talking and chewing. Patient has a midface hypoplasia profile (concave). He was diagnosed to have a severe Skeletal Class III with Class III malocclusion, increased lower vertical height, and an anterior open bite. A pre-treatment cephalometric radiograph was taken to analyse the skeletal problem and to measure the amount of bone movement and the prediction soft tissue response. A panoramic radiograph was also taken to analyse bone quality, bone abnormality, third molar impaction, etc. Before the surgery, a pre-surgical cephalometric radiograph was taken to re-evaluate the plan and to settle the final amount of bone cut. After the surgery, a post-surgical cephalometric radiograph was taken to confirm the result with the plan. The superimposition using NSL as a reference line between those radiographs was performed to analyse the outcome. It is important to describe the amount of hard and soft tissue movement and to predict the possibility of relapse after the surgery. The patient also needs to understand all the surgical plan, outcome and relapse prevention. The surgical management included maxillary impaction and advancement of Le Fort I osteotomy. The evaluation using NSL as a reference was a very useful method in determining the outcome and prognosis.

Keywords: Nasion-Sella Line, midface hypoplasia, Le Fort 1, maxillary advancement

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Authors: Yamina Boukari, Nashiru Billa, Andrew Morris, Stephen Doughty, Kevin Shakesheff

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Poly (lactic-co-glycolic) acid (PLGA) is a synthetic polymer that can be used in bone tissue engineering with the aim of creating a scaffold in order to support the growth of cells. The formation of microspheres from this polymer is an attractive strategy that would allow for the development of an injectable system, hence avoiding invasive surgical procedures. The aim of this study was to develop a microsphere delivery system for use as an injectable scaffold in bone tissue engineering and evaluate various formulation parameters on its properties. Porous and lysozyme-containing PLGA microspheres were prepared using the double emulsion solvent evaporation method from various molecular weights (MW). Scaffolds were formed by sintering to contain 1 -3mg of lysozyme per gram of scaffold. The mechanical and physical properties of the scaffolds were assessed along with the release of lysozyme, which was used as a model protein. The MW of PLGA was found to have an influence on microsphere size during fabrication, with increased MW leading to an increased microsphere diameter. An inversely proportional relationship was displayed between PLGA MW and mechanical strength of formed scaffolds across loadings for low, intermediate and high MW respectively. Lysozyme release from both microspheres and formed scaffolds showed an initial burst release phase, with both microspheres and scaffolds fabricated using high MW PLGA showing the lowest protein release. Following the initial burst phase, the profiles for each MW followed a similar slow release over 30 days. Overall, the results of this study demonstrate that lysozyme can be successfully incorporated into porous PLGA scaffolds and released over 30 days in vitro, and that varying the MW of the PLGA can be used as a method of altering the physical properties of the resulting scaffolds.

Keywords: bone, microspheres, PLGA, tissue engineering

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Authors: S. Ritddech, P. Aroonjarattham, K. Aroonjarattham

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The pullout strength had an effect on the stability of plate screw fixation when inserted in the cervical spine. Nine different titanium alloy bone screws were used to test the pullout strength through finite element analysis. The result showed that the Moss Miami I can bear the highest pullout force at 1,075 N, which causes the maximum von Mises stress at 858.87 MPa, a value over the yield strength of titanium. The bone screw should have large outer diameter, core diameter and proximal root radius to increase the pullout strength.

Keywords: pullout strength, screw parameter, cervical spine, finite element analysis

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Authors: F. Christie, M. Staber

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Malnutrition is a predictor of poor clinical outcome in the elderly. Up to 60% of hip fracture patients are clinically malnourished on admission. This study assessed the perioperative nutritional state of patients admitted with a proximal femoral fracture and examined if adequate nutritional support was achieved. Methods: Prospective, the observational audit of 30 patients, admitted with a proximal femoral fracture, over a one-month period. We recorded: patient demographics; surgical delay; nutritional state on admission; documentation of Malnutrition Universal Screening Tool (MUST) score; dietician input and daily calorie intake through food charts. The nutritional state was re-assessed weekly and at discharge. The outcome was measured by the length of hospital stay and thirty-day mortality. Results: Mean age 87, M:F 1:2 and all patients were ASA three or four. Five patients (17%) had a prolonged ( >24 hours) fasting period. All patients had a MUST score completed on admission, 27% were underweight and 30% were high risk for malnutrition. Twenty-six patients (87%) were appropriately assessed for dietician referral. Thirteen patients had food charts; on average, hospital meals provided 1500kcal daily. No patient achieved > 75% of the provided calories with 69% of patients achieving 50% or less. Only three patients were started on nutritional supplements. Twenty-three patients (77%) lost weight, averaging 6% weight loss during admission. Mean length of stay (LOS) was 23 days and 30-day mortality 9%. Four patients (13%) gained weight, their mean LOS was 17 days and 30-day mortality 0%. Discussion: Malnutrition in the elderly originates in the community. Following major trauma it’s difficult to reverse nutritional deficits in hospitals. It’s therefore concerning that no high-risk patient achieved their recommended calorie intake. Perioperative optimisation needs to include early nutritional intervention, early anaesthetic review and adjusted anaesthetic techniques to support feeding.

Keywords: trauma, nutrition, neck of femur fracture

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Authors: Yekta Ülgen, Fırat Matur

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Cole-Cole parameters of 40 post-menopausal women are compared with their DEXA bone mineral density measurements. Impedance characteristics of four extremities are compared; left and right extremities are statistically same, but lower extremities are statistically different than upper ones due to their different fat content. The correlation of Cole-Cole impedance parameters to bone mineral density (BMD) is observed to be higher for a dominant arm. With the post menopausal population, ANOVA tests of the dominant arm characteristic frequency, as a predictor for DEXA classified osteopenic and osteoporotic population around the lumbar spine, is statistically very significant. When used for total lumbar spine osteoporosis diagnosis, the area under the Receiver Operating Curve of the characteristic frequency is 0.875, suggesting that the Cole-Cole plot characteristic frequency could be a useful diagnostic parameter when integrated into standard screening methods for osteoporosis. Moreover, the characteristic frequency can be directly measured by monitoring frequency driven the angular behavior of the dominant arm without performing any complex calculation.

Keywords: bioimpedance spectroscopy, bone mineral density, osteoporosis, characteristic frequency, receiver operating curve

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Authors: Vladyslav Povoroznyuk, Anna Musiienko, Nataliia Zaverukha, Roksolana Povoroznyuk

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Along with the global aging of population, the number of people with somatic diseases is increasing, including such interrelated pathologies as obesity, osteoarthritis (OA) and osteoporosis (OP). The objective of the study is to examine the connection between body mass index (BMI), OA and bone mineral density (BMD) of lumbar spine, femoral neck and trabecular bone score (TBS) in postmenopausal women with OA. We have observed 359 postmenopausal women (50-89 years old) and divided them into four groups by age: 50-59 yrs, 60-69 yrs, 70-79 yrs and over 80 years old. In addition, according to the American College of Rheumatology (ACR) Clinical classification criteria for knee and hip OA, we divided them into 2 groups: group I – 117 females with symptomatic OA (including 89 patients with knee OA, 28 patients with hip OA) and group II –242 women with a normal functional activity of large joints. Analysis of data was performed taking into account their BMI, classified by World Health Organization (WHO). Diagnosis of obesity was established when BMI was above 30 kg/m². In woman with obesity, a symptomatic OA was detected in 44 postmenopausal women (41.1%), a normal functional activity of large joints - in 63 women (58.9%). However, in women with normal BMI – 73 women, who account for 29.0% of cases, a symptomatic OA was detected. According to a chi-squared (χ2) test, a significantly higher level of BMI was detected in postmenopausal women with OA (χ2 = 5.05, p = 0.02). Women with a symptomatic OA had a significantly higher BMD of lumbar spine compared with women who had a normal functional activity of large joints. No significant differences of BMD of femoral necks or TBS were detected in either the group with OA or with a normal functional activity of large joints.

Keywords: bone mineral density, body mass index, obesity, overweight, postmenopausal women, osteoarthritis

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Authors: Mona Hamdy, Iman Shaheen, Hadeel Seif Eldin, Basma Ali, Omnia Abdeldayem

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Summary: Bone involvement of sickle cell disease (SCD) patients varies from acute clinical manifestations of painful vaso-occlusive crises or osteomyelitis to more chronic affection of bone mineral density (BMD) and debilitating osteonecrosis and osteoporosis. Secreted klotho protein is involved in calcium (Ca) reabsorption in the kidney. This study aimed to measure serum klotho levels in children with SCD to determine the possibility of using it as a marker of low BMD in children with SCD in correlation with a dual-energy radiograph absorptiometry scan. This study included 60 sickle disease patients and 30 age-matched and sex-matched control participants without SCD. A highly statistically significant difference was found between patients with normal BMD and those with low BMD, with serum Ca and klotho levels being lower in the latter group. Klotho serum level correlated positively with both serum Ca and BMD. Serum klotho level showed 94.9% sensitivity and 95.2% specificity in the detection of low BMD. Both serum Ca and klotho serum levels may be useful markers for detection of low BMD related to SCD with high sensitivity and specificity; however, klotho may be a better indicator as it is less affected by the nutritional and endocrinal status of patients or by intake of Ca supplements.

Keywords: sickle cell disease, BMD, osteoporosis, DEXA, klotho

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Authors: Z. Karahaliloğlu, E. Yalçın, M. Demirbilek, E.B. Denkbaş

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Critical-sized bone defects caused by trauma, bone diseases, prosthetic implant revision or tumor excision cannot be repaired by physiological regenerative processes. Current orthopedic applications for critical-sized bone defects are to use autologous bone grafts, bone allografts, or synthetic graft materials. However, these strategies are unable to solve completely the problem, and motivate the development of novel effective biological scaffolds for tissue engineering applications and regenerative medicine applications. In particular, scaffolds combined with a variety of bio-agents as fundamental tools emerge to provide the regeneration of damaged bone tissues due to their ability to promote cell growth and function. In this study, a magnetic silk fibroin (SF) hydrogel scaffold was prepared by electrogelation process of the concentrated Bombxy mori silk fibroin (8 %wt) aqueous solution. For enhancement of osteoblast-like cells (SaOS-2) growth and adhesion, basal fibroblast growth factor (bFGF) were conjugated physically to the HSA-coated magnetic nanoparticles (Fe3O4) and magnetic SF e-gel scaffolds were prepared by incorporation of Fe3O4, HSA (human serum albumin)=Fe3O4 and HSA=Fe3O4-bFGF nanoparticles. HSA=Fe3O4, HSA=Fe3O4-bFGF loaded and bare SF e-gels scaffolds were characterized using scanning electron microscopy (SEM.) For cell studies, human osteoblast-like cell line (SaOS-2) was used and an MTT assay was used to assess the cytotoxicity of magnetic silk fibroin e-gel scaffolds and cell density on these surfaces. For the evaluation osteogenic activation, ALP (alkaline phosphatase), the amount of mineralized calcium, total protein and collagen were studied. Fe3O4 nanoparticles were successfully synthesized and bFGF was conjugated to HSA=Fe3O4 nanoparticles with %97.5 of binding yield which has a particle size of 71.52±2.3 nm. Electron microscopy images of the prepared HSA and bFGF incorporated SF e-gel scaffolds showed a 3D porous morphology. In terms of water uptake results, bFGF conjugated HSA=Fe3O4 nanoparticles has the best water absorbability behavior among all groups. In the in-vitro cell culture studies realized using SaOS-2 cell line, the coating of Fe3O4 nanoparticles surface with a protein enhance the cell viability and HSA coating and bFGF conjugation, the both have an inductive effect in the cell proliferation. One of the markers of bone formation and osteoblast differentiation, according to the ALP activity and total protein results, HSA=Fe3O4-bFGF loaded SF e-gels had significantly enhanced ALP activity. Osteoblast cultured HSA=Fe3O4-bFGF loaded SF e-gels deposited more calcium compared with SF e-gel. The proposed magnetic scaffolds seem to be promising for bone tissue regeneration and used in future work for various applications.

Keywords: basic fibroblast growth factor (bFGF), e-gel, iron oxide nanoparticles, silk fibroin

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Authors: Livia Eisler, Cristiane C. B. Alves, Cristina L. F. Ortolani, Kurt Faltin Jr.

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Purpose: This paper proposes a technically simple diagnosis method among orthodontists and maxillofacial surgeons in order to evaluate discrete bone alterations. The methodology consists of a protocol to optimize the diagnosis and minimize the possibility for orthodontic and ortho-surgical retreatment. Materials and Methods: A protocol of image processing and analysis, through ImageJ software and its plugins, was applied to 20 pairs of lateral cephalometric images obtained from cone beam computerized tomographies, before and 1 year after undergoing orthognathic surgery. The optical density of the images was analyzed in the condylar region to determine possible bone alteration after surgical correction. Results: Image density was shown to be altered in all image pairs, especially regarding the condyle contours. According to measures, condyle had a gender-related density reduction for p=0.05 and condylar contours had their alterations registered in mm. Conclusion: A simple, viable and cost-effective technique can be applied to achieve the more detailed image-based diagnosis, not depending on the human eye and therefore, offering more reliable, quantitative results.

Keywords: bone resorption, computer-assisted image processing, orthodontics, orthognathic surgery

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Authors: Jehnming Lin

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The effects of the contact ball-lens on the soda lime glass in laser thermal cleavage with a cw Nd-YAG laser were investigated in this study. A contact ball-lens was adopted to generate a bending force on the crack formation of the soda-lime glass in the laser cutting process. The Nd-YAG laser beam (wavelength of 1064 nm) was focused through the ball-lens and transmitted to the soda-lime glass, which was coated with a carbon film on the surface with a bending force from a ball-lens to generate a tensile stress state on the surface cracking. The fracture was controlled by the contact ball-lens and a straight cutting was tested to demonstrate the feasibility. Experimental observations on the crack propagation from the leading edge, main section and trailing edge of the glass sheet were compared with various mechanical and thermal loadings. Further analyses on the stress under various laser powers and contact ball loadings were made to characterize the innovative technology. The results show that the distributions of the side crack at the leading and trailing edges are mainly dependent on the boundary condition, contact force, cutting speed and laser power. With the increase of the mechanical and thermal loadings, the region of the side cracks might be dramatically reduced with proper selection of the geometrical constraints. Therefore, the application of the contact ball-lens is a possible way to control the fracture in laser cleavage with improved cutting qualities.

Keywords: laser cleavage, stress analysis, crack visualization, laser

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Authors: Amir Davood Elmi

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From the earliest light microscope to the most innovative X-ray imaging techniques, all of them have refined and improved our knowledge about the organization and composition of living tissues. The old techniques are time consuming and ultimately destructive to the tissues under the examination. In recent few decades, thanks to the boost of technology, non-destructive visualization techniques, such as X-ray computed tomography (CT), magnetic resonance imaging (MRI), selective plane illumination microscopy (SPIM), and optical projection tomography (OPT), have come to the forefront. Among these techniques, CT is excellent for mineralized tissues such as bone or dentine. In addition, CT it is faster than other aforementioned techniques and the sample remains intact. In this article, applications, advantages, and limitations of micro-CT is discussed, in addition to some information about micro-CT of soft tissue.

Keywords: Micro-CT, hard tissue, bone, attenuation coefficient, rapid prototyping

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Authors: Vinay Kant Shankhdhar

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Purpose: Maxillary defects are three dimensional and require complex bone and soft tissue reconstruction. Maxillary reconstruction using fibula osteocutaneous flaps in situation requiring orbital floor, orbital wall, palatal defects, and external skin, all at the same time require special planning and multiple osteotomies. We tried to improvise our reconstruction using multiple osteotomies and skin paddle designs for fibula and Flexor Hallucis Longus Muscle. This study aims at discussing the planning and outcome in complex maxillary reconstructions using fibula flaps and soft tissue flaps with or without bone grafts. Material and Methods: From 2011 to 2017 a total of 129 Free fibula flaps were done, 67 required two or more struts, 164 Anterolateral Thigh Flaps, 11 Deep Inferior Epigastric Artery perforator flaps and 3 vertical rectus abdominis muscle flaps with iliac crest bone graft. The age range was 2 to 70 years. The reconstruction was evaluated based on the post-operative rehabilitation including orbital support (prevention of diplopia), oral diet, speech and cosmetic appearance. Results: The follow- up is from 5 years to 1 year. In this series, we observed that the common complications were the de-vascularisation of most distal segment of osteotomised fibula and native skin necrosis. Commonest area of breakdown is the medial canthal region. Plate exposure occurs most commonly at the pyriform sinus. There was extrusion of one non-vascularized bone graft. All these complications were noticed post-radiotherapy. Conclusions: The use of free fibula osteocutaneous flap gives very good results when only alveolar reconstruction is required. The reconstruction of orbital floor with extensive skin loss with post operative radiotherapy has maximum complication rate in long term follow up. A soft tissue flap with non vascularized bone graft may be the best option in such cases.

Keywords: maxilla reconstruction, fibula maxilla, post cancer maxillary reconstruction

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Authors: A. Elrefaei

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The possibility of having sheets with different thicknesses and materials in one assembly facilitates the optimal material distribution within the final product and reduces the weight of the structure. Ability of joining process to assembly these different material combinations is always a challenge to the designer. In this study, 0.6 mm thick 6061-T6 and 2 mm thick 5182-O were robot CMT welded using ER5356 and ER4043 filler metals. The thermal effect of welding resulted in a loss of hardness in the 6061 HAZ. Joints welded by ER5356 filler metal were much higher in fracture load than joints welded by ER4043 and the elongation of joints welded by ER5356 was almost double its corresponding joints welded by ER4043 filler. Owing to the big difference in formability and thickness of base metals, the fracture in forming test occurred in the softened 6061 HAZ out from the weld centerline.

Keywords: aluminum, CMT, mechanical, welding

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Authors: Tarek Aly

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Introduction: Maintenance of the length, providing rotational stability, and preserving functional range of forearm motion is the mainstay of both bone forearm fractures treatment. Conservative treatment in older children may lead to malunion with poor remodeling capacity. Recent studies emphasized that the rate of complications with IM nailing was obviously increased in old children. Open reduction and internal fixation have been criticized for the amount of soft tissue dissection and periosteal stripping needed for fixation and excessive scar formation. The aim of this study was to evaluate the anatomical and functional outcomes of hybrid fixation in the treatment of closed proximal radius and ulna fractures in adolescents between 12 and 17 years of age. Patients and Methods: 30 cases of diaphyseal both bone forearm fractures treated with hybrid fixation (Nail radius – Plate ulna) and were available for a follow-up period of fewer than 24 months. Results: Clinically, 72% of cases had an excellent function, 22% had a good function, 4% had a fair function, and 2% had a poor function. Radiologically, signs of the union had appeared in the radius 2weeks earlier than in the ulna in 55% of cases. Conclusion: A hybrid fixation technique in adolescent proximal both-bones forearm fractures could be a viable option in managing these injuries.

Keywords: hyprid fixation, both bones, forearm, fractures

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Authors: Sri Suparwitri

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When an orthodontic force is applied to a tooth, an inflammatory response is initiated then lead to bone remodeling process, and the process accommodates tooth movement. One of cytokine that plays a prominent role in bone remodeling process was transforming growth factor-beta 1 (TGF-β1). The purpose of this study was to identify and compare changes of TGF-β1 in human gingival crevicular fluid during canine retraction using elastic chain and closed coil spring. Ten patients (mean age 20.7 ± 2.9 years) participated. The patients were entering the space closure phase of fixed orthodontic treatment. An upper canine of each patient was retracted using elastic chain, and the contralateral canine was retracted using closed coil spring. Gingival crevicular fluid samples were collected from the canine teeth before and 7 days after the force was applied. Transforming growth factor-beta 1 was determined by enzyme-linked immunosorbent assay (ELISA). The concentrations of TGF-β1 at 7 days were significantly higher compared to before canine retraction in both groups. In the evaluation of between-group difference, before retraction, the difference was insignificant, whereas at 7 days significantly higher values were determined in the closed coil spring group compared to elastic chain group. The result suggests that TGF-β1 is associated with the bone remodeling that occurs during canine distalization movement. Closed coil spring gave higher TGF-β1 concentrations thus more bone remodeling occurred and may be considered the treatment of choice.

Keywords: closed coil spring, elastic chain, gingival crevicular fluid, TGF-β1

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Authors: Ramin Khamedi, Isa Ahmadi

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In this study acoustic emission (AE) signals obtained during deformation and fracture of two types of ferrite-martensite dual phase steels (DPS) specimens have been analyzed in frequency domain. For this reason two low carbon steels with various amounts of carbon were chosen, and intercritically heat treated. In the introduced method, identifying the mechanisms of failure in the various phases of DPS is done. For this aim, AE monitoring has been used during tensile test of several DPS with various volume fraction of the martensite (VM) and attempted to relate the AE signals and failure mechanisms in these steels. Different signals, which referred to 2-3 micro-mechanisms of failure due to amount of carbon and also VM have been seen. By Fast Fourier Transformation (FFT) of signals in distinct locations, an excellent relationship between peak frequencies in these areas and micro-mechanisms of failure were seen. The results were verified by microscopic observations (SEM).

Keywords: acoustic emission, dual phase steels, deformation, failure, fracture

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Authors: Joaquim de Almeida Dultra, Daiana Cristina Pereira Santana, Fátima Karoline Alves Araújo Dultra, Liliane Akemi Kawano Shibasaki, Mariana Machado Mendes de Carvalho, Ieda Margarida Crusoé Rocha Rebello

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Defects originating from mandibular resections can cause significant functional impairment and facial disharmony, and they have complex rehabilitation. The aim of this report is to demonstrate the authors' experience facing challenging rehabilitation after mandibular resection in a patient with ameloblastoma. Clinical and surgical steps are described simultaneously, highlighting the adaptation of the final fixed prosthesis, reported in an unprecedented way in the literature. A 37-year-old male patient was seen after a sports accident, where a pathological fracture in the symphysis and left mandibular body was identified, where a large radiolucent lesion was found. The patient underwent resection, bone graft, distraction osteogenesis, rehabilitation with dental implants, prosthesis, and finally, orofacial harmonization, in an interval of six years. Rehabilitation should consider the patient's needs individually and should have as the main objective to provide similar aesthetics and function to that present before the disease. We also emphasize the importance of interdisciplinary work during the course of rehabilitation.

Keywords: ameloblastoma, mandibular reconstruction, distraction osteogenesis, dental implants. dental prosthesis, implant-supported, treatment outcome

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Authors: Irene Buj-Corral, Ali Bagheri, Alejandro Dominguez-Fernandez

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In recent years, use of ceramic prostheses as an implant in some parts of body has become common. In the present study, research has focused on replacement of the acetabulum bone, which is a part of the pelvis bone. Metallic prostheses have shown some problems such as release of metal ions into patient's blood. In addition, fracture of liners and squeezing between surface of femoral head and inner surface of acetabulum have been reported. Ceramic prostheses have the advantage of low debris and high strength, although they are more difficult to be manufactured than metallic ones. Specifically, new designs try to attempt an acetabulum in which the outer surface will be porous for proliferation of cells and fixation of the prostheses by means of osteointegration, while inner surface must be smooth enough to assure that the movement between femoral head and inner surface will be carried out with on feasibility. In the present study, 3D printing technologies are used for manufacturing ceramic prostheses. In Fused Deposition Modelling (FDM) process, 3D printed plastic prostheses are obtained by means of melting of a plastic filament and subsequent deposition on a glass surface. A similar process is applied to ceramics in which ceramic powders need to be mixed with a liquid polymer before depositing them. After 3D printing, parts are subjected to a sintering process in an oven so that they can achieve final strength. In the present paper, influence of printing parameters on surface roughness 3D printed ceramic parts are presented. Three parameter full factorial design of experiments was used. Selected variables were layer height, infill and nozzle diameter. Responses were average roughness Ra and mean roughness depth Rz. Regression analysis was applied to responses in order to obtain mathematical models for responses. Results showed that surface roughness depends mainly on layer height and nozzle diameter employed, while infill was found not to be significant. In order to get low surface roughness, low layer height and low infill should be selected. As a conclusion, layer height and infill are important parameters for obtaining good surface finish in ceramic 3D printed prostheses. However, use of too low infill could lead to prostheses with low mechanical strength. Such prostheses could not be able to bear the static and dynamic charges to which they are subjected once they are implanted in the body. This issue will be addressed in further research.

Keywords: ceramic, hip prostheses, surface roughness, 3D printing

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Authors: Ayhan Eymirli, Sila N. Usta

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The aim of this study is the comparison of the cyclic fatigue resistance of EndoArt Gold (EAG, Inci Dental, Istanbul, Turkey), EndoArt Blue (EAB, Inci Dental, Istanbul, Turkey), ProTaper Universal (PTU, Dentsply Tulsa Dental Specialties), and ProTaper Gold (PTG, Dentsply Tulsa Dental Specialties) files at body temperature. Twelve instruments of each EAG, EAB, PTU, PTG file system were included in this study. All selected files were rotated in the artificial canals, which have a 60° angle and a 5-mm radius of curvature until fracture occurred. The time to fracture (Ttf) was measured in seconds by a chronometer in the control panel that presents in the cyclic fatigue testing device when a fracture was detected visually and/or audibly. The lengths of the fractured fragments (FL) were also measured with a digital microcaliper. The data of Ttf and FL were analyzed using Kruskal-Wallis, one-way ANOVA and post hoc Bonferroni tests at the 5% significance level. There was a statistically significant difference among the file systems (p < 0.05). EAB had the statistically highest fatigue resistance, and PTU had the statistically lowest fatigue resistance (p < 0.05). PTG system had a statistically higher FL means than EAB and PTU file systems (p < 0.05). EAB had the greatest cyclic fatigue resistance amongst the other file systems. It can be stated that heat treatments may be a factor that increases fatigue resistance.

Keywords: cyclic fatigue resistance, Endo art blue, Endo art gold, pro taper gold, pro taper universal

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Authors: Shiamaa Eltantawy, Gihan Sobhy, Alif Alaam

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Wilson disease, or hepatolenticular degeneration, is an autosomal recessive disease that results in excess copper buildup in the body. It primarily affects the liver and basal ganglia of the brain, but it can affect other organ systems. Musculoskeletal abnormalities, including premature osteoarthritis, skeletal deformity, and pathological bone fractures, can occasionally be found in WD patients with a hepatic or neurologic type. The aim was to assess the prevalence of osteoporosis and osteopenia in Wilson’s disease patients. This case-control study was conducted on ninety children recruited from the inpatient ward and outpatient clinic of the Paediatric Hepatology, Gastroenterology, and Nutrition department of the National Liver Institute at Menofia University, aged from 1 to 18 years. Males were 49, and females were 41. Children were divided into three groups: (Group I) consisted of thirty patients with WD; (Group II) consisted of thirty patients with chronic liver disease other than WD; (Group III) consisted of thirty age- and sex-matched healthy The exclusion criteria were patients with hyperparathyroidism, hyperthyroidism, renal failure, Cushing's syndrome, and patients on certain drugs such as chemotherapy, anticonvulsants, or steroids. All patients were subjected to the following: 1- Full history-taking and clinical examination. 2-Laboratory investigations: (FBC,ALT,AST,serum albumin, total protein, total serum bilirubin,direct bilirubin,alkaline phosphatase, prothrombin time, serum critine,parathyroid hormone, serum calcium, serum phosphrus). 3-Bone mineral density (BMD, gm/cm2) values were measured by dual-energy X-ray absorptiometry (DEXA). The results revealed that there was a highly statistically significant difference between the three groups regarding the DEXA scan, and there was no statistically significant difference between groups I and II, but the WD group had the lowest bone mineral density. The WD group had a large number of cases of osteopenia and osteoporosis, but there was no statistically significant difference with the group II mean, while a high statistically significant difference was found when compared to group III. In the WD group, there were 20 patients with osteopenia, 4 patients with osteoporosis, and 6 patients who were normal. The percentages were 66.7%, 13.3%, and 20%, respectively. Therefore, the largest number of cases in the WD group had osteopenia. There was no statistically significant difference found between WD patients on different treatment regimens regarding DEXA scan results (Z-Score). There was no statistically significant difference found between patients in the WD group (normal, osteopenic, or osteoporotic) regarding phosphorus (mg/dL), but there was a highly statistically significant difference found between them regarding ionised Ca (mmol/L). Therefore, there was a decrease in bone mineral density when the Ca level was decreased. In summary, Wilson disease is associated with bone demineralization. The largest number of cases in the WD group in our study had osteopenia (66.7%). Different treatment regimens (zinc monotherapy, Artamin, and zinc) as well as different laboratory parameters have no effect on bone mineralization in WD cases. Decreased ionised Ca is associated with low BMD in WD patients. Children with WD should be investigated for BMD.

Keywords: wilson disease, Bone mineral density, liver disease, osteoporosis

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