Search results for: implant

Authors: Aura Maria Lopera Echavarria, Angela Maria Lema Perez, Daniela Medrano David, Pedronel Araque Marin, Marta Elena Londoño Lopez

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Bone regeneration is the process by which the formation of new bone is stimulated. Bone fractures can originate at any time due to trauma, infections, tumors, congenital malformations or skeletal diseases. Currently there are different strategies to treat bone defects that in some cases, regeneration does not occur on its own. That is why they are treated with bone substitutes, which provide a necessary environment for the cells to synthesize new bone. The Demineralized Bone Matrix (DBM) is widely used as a bone implant due to its good properties, such as osteoinduction and bioactivity. However, the use of DBM is limited, because its presentation is powder, which is difficult to implant with precision and is susceptible to migrating to other sites through blood flow. That is why the DBM is commonly incorporated into a variety of vehicles or carriers. The objective of this project is to evaluate the bioactive and confinement properties of a bone substitute based on demineralized bone matrix (DBM). Also, structural and morphological properties were evaluated. Bone substitute was obtained from EIA Biomaterials Laboratory of EIA University and the DBM was facilitated by Tissue Bank Foundation. Morphological and structural properties were evaluated by scanning electron microscopy (SEM), X-ray diffraction (DRX) and Fourier transform infrared spectroscopy with total attenuated reflection (FTIR-ATR). Water absorption capacity and degradation were also evaluated during three months. The cytotoxicity was evaluated by the MTT test. The bioactivity of the bone substitute was evaluated through immersion of the samples in simulated body fluid during four weeks. Confinement tests were performed on tibial fragments of a human donor with bone defects of determined size, to ensure that the substitute remains in the defect despite the continuous flow of fluid. According of the knowledge of the authors, the methodology for evaluating samples in a confined environment has not been evaluated before in real human bones. The morphology of the samples showed irregular surface and presented some porosity. DRX confirmed a semi-crystalline structure. The FTIR-ATR determined the organic and inorganic phase of the sample. The degradation and absorption measurements stablished a loss of 3% and 150% in one month respectively. The MTT showed that the system is not cytotoxic. Apatite clusters formed from the first week were visualized by SEM and confirmed by EDS. These calcium phosphates are necessary to stimulate bone regeneration and thanks to the porosity of the developed material, osteinduction and osteoconduction are possible. The results of the in vitro evaluation of the confinement of the material showed that the migration of the bone filling to other sites is negligible, although the samples were subjected to the passage of simulated body fluid. The bone substitute, putty type, showed stability, is bioactive, non-cytotoxic and has handling properties for specialists at the time of implantation. The obtained system allows to maintain the osteoinductive properties of DBM and it can fill completely fractures in any way; however, it does not provide a structural support, that is, it should only be used to treat fractures without requiring a mechanical load.

Keywords: bone regeneration, cytotoxicity, demineralized bone matrix, hydrogel

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Authors: Seyedmahdi Mousavihashemi

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Natural Akermanite (NAM) has been successfully prepared by a modified sol-gel method. Optimization in calcination temperature and mechanical ball milling resulted in a pure and nano-sized powder which characterized by means of scanning electron microscopy (SEM), X-ray diffraction (XRD), transmission electron microscopy (TEM) and Fourier transform infrared Spectroscopy (FT–IR). We hypothesized that nano-sized Akermanite (AM) would mimic more efficiently the nanocrystal structure and function of natural bone apatite, owing to the higher surface area, compare to conventional micron-size Akermanite (AM). Accordingly, we used the unique advantage of nanotechnology to improve novel nano akermanite particles as a potential candidate for bone tissue regeneration whether as a per implant filling powder or in combination with other biomaterials as a composite scaffold. Pure Akermanite (PAM) powders were successfully obtained via a simple sol-gel method followed by calcination at 1250 °C. Mechanical grinding in a ceramic ball mill for 7 hours resulted in akermanite (AM) nanoparticles in the range of about 30- 45 nm.

Keywords: biomedical engineering, nano composite, SEM, TEM

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Authors: Maksim Barsakov

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Introduction. In modern plastic surgery, there are a large number of breast lift techniques.Due to the spreading information about the "side effects" of silicone implants, interest in implant-free mastopexy is increasing year after year. However, despite the variety of techniques, patients sometimes do not get full satisfaction from the results of mastopexy because of the unexpressed filling of the upper pole, extended anchoring postoperative scars and sometimes because of obtaining an aesthetically unattractive breast shape. The stability of the result after mastopexy depends on many factors, including postoperative rehabilitation. Stability of weight and hormonal background, stretchability of tissues. The high recurrence rate of ptosis and short-term aesthetic effect of mastopexy indicate the urgency of improving surgical techniques and increasing the stabilization of breast tissue. Purpose of the study. To develop and introduce into practice a technique of mastopexy based on the use of a modified Ribeiro flap, as well as elements of tissue movement and fixation designed to increase the stability of postoperative mastopexy. In addition, to give indications for the application of this surgical technique. Materials and Methods. it operated on 103 patients aged 18 to 53 years from 2019 to 2023 according to the reported method. These were patients with primary mastopexy, secondary mastopexy, and also patient with implant removal and one-stage mastopexy. The patients were followed up for 12 months to assess the stability of the result. Results and their discussion. Observing the patients, we noted greater stability of the breast shape and upper pole filling compared to the conventional classical methods. We did not have to resort to anchoring scars. In 90 percent of cases, a inverted T-shape scar was used. In 10 percent, the J-scar was used. The quantitative distribution of complications identified among the operated patients is as follows: worsened healing of the junction of vertical and horizontal sutures at the period of 1-1.5 months after surgery - 15 patients; at treatment with ointment method healing was observed in 7-30 days; permanent loss of NAC sensitivity - 0 patients; vascular disorders in the area of NAC/areola necrosis - 0 patients; marginal necrosis of the areola-2 patients. independent healing within 3-4 weeks without aesthetic defects. Aesthetically unacceptable mature scars-3 patients; partial liponecrosis of the autoflap unilaterally - 1 patient. recurrence of ptosis - 1 patient (after weight loss of 12 kg). In the late postoperative period, 2 patients became pregnant, gave birth, and no lactation problems were observed. Conclusion. Thus, in the world of plastic surgery methods of breast lift continue to improve, which is especially relevant in modern times, due to the increased attention to this operation. The author's proposed method of mastopexy with glandular autoflap allows obtaining in most cases a stable result, a fuller breast shape, avoiding the presence of extended anchoring scars, and also preserves the possibility of lactation. The author of this article has obtained a patent for invention for this method of mastopexy.

Keywords: mastopexy, mammoplasty, autoflap, personal technique

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Authors: Hesham Kozou

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Sensorineural hearing loss (SNHL) poses a significant challenge due to limited access to the inner ear for therapies. Emerging treatments such as regenerative, genetic, and pharmacotherapies offer hope for addressing this condition. This study aims to highlight the potential of cochlear implants and emerging therapies in managing sensorineural hearing loss by improving access to the inner ear. The study is conducted through a review of relevant literature and research articles in the field of cochlear implants and emerging therapies for hearing loss. It outlines how advancements in cochlear implant technologies, electrodes, and surgical techniques can facilitate the delivery of therapies to the inner ear, potentially revolutionizing the treatment of sensorineural hearing loss. The study underscores the potential of cochlear implants and emerging therapies in revolutionizing the treatment landscape for sensorineural hearing loss, emphasizing the feasibility of curing this condition by leveraging technological advancements.

Keywords: therapies for hearing loss management, future of CI as a cochlear delivery channel, regenerative, genetic and pharmacotherapeutic management of hearing loss

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Authors: Dae Kyung Choi, Won Man Park, Kyungsoo Kim, Yoon Hyuk Kim

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The interspinous process devices have been recently used due to its advantages such as minimal invasiveness and less subsidence of the implant to the osteoporotic bone. In this paper, we have analyzed the influences of ligature tightening of several interspinous process devices using finite element analysis. Four types of interspinous process implants were inserted to the L3-4 spinal motion segment based on their surgical protocols. Inferior plane of L4 vertebra was fixed and 7.5 Nm of extension moment were applied on superior plane of L3 vertebra with 400N of compressive load along follower load direction and pretension of the ligature. The stability of the spinal unit was high enough than that of intact model. The higher value of pretension in the ligature led the decrease of dynamic stabilization effect in cases of the WallisTM, DiamTM, Viking, and Spear®. The results of present study could be used to evaluate surgical option and validate the biomechanical characteristics of the spinal implants.

Keywords: interspinous process device, bone fracture risk, lumbar spine, finite element analysis

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Authors: D. Zujur, J. Moret, D. Rodriguez, L. Cruz, J. Lira, L. Gil, E. Dominguez, J. F. Alvarez-Barreto

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In this work, chitosan (CH) has been used to produce a novel coating for Ti6Al4V, the most widely used alloy in orthopedic implants, so as to improve the biological tissue response at the metallic surface. The Ti6Al4V surface was sandblasted with alumina particles and observed by SEM. Chitosan was chemically modified, via crodiimide chemistry, with lactobionic and 4-azidebenzoic acid to make it soluble at physiological pH and photo-crosslinkable, respectively. The reaction was verified by FTIR, NMR, and UV/vis spectroscopy. Ti6Al4V surfaces were coated with solutions of the modified CH and exposed to UV light, causing the polymer crosslinking, and formation of a hydrogel on the surface. The crosslinking reaction was monitored by FTIR at different exposure times. Coating morphology was observed by SEM. The coating´s cytocompatibility was determined in vitro through the culture of rat bone marrow´s mesenchymal stem cells, using an MTT assay. The results show that the developed coating is cytocompatible, easy to apply and could be used for further studies in the encapsulation of bioactive molecules to improve osteogenic potential at the tissue-implant interface.

Keywords: chitosan, photo-crosslinking, Ti6Al4V, bioactive coating, hydrogel

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Authors: Vitaliy Petrov, Natalia Shusharina, Vitaliy Kasymov, Maksim Patrushev, Evgeny Bogdanov

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The leading worldwide death reasons are ischemic heart disease and other cardiovascular illnesses. Generally, the common symptom is high blood pressure. Long-time blood pressure control is very important for the prophylaxis, correct diagnosis and timely therapy. Non-invasive methods which are based on Korotkoff sounds are impossible to apply often and for a long time. Implantable devices can combine longtime monitoring with high accuracy of measurements. The main purpose of this work is to create a real-time monitoring system for decreasing the death rate from cardiovascular diseases. These days implantable electronic devices began to play an important role in medicine. Usually implantable devices consist of a transmitter, powering which could be wireless with a special made battery and measurement circuit. Common problems in making implantable devices are short lifetime of the battery, big size and biocompatibility. In these work, blood pressure measure will be the focus because it’s one of the main symptoms of cardiovascular diseases. Our device will consist of three parts: the implantable pressure sensor, external transmitter and automated workstation in a hospital. The Implantable part of pressure sensors could be based on piezoresistive or capacitive technologies. Both sensors have some advantages and some limitations. The Developed circuit is based on a small capacitive sensor which is made of the technology of microelectromechanical systems (MEMS). The Capacitive sensor can provide high sensitivity, low power consumption and minimum hysteresis compared to the piezoresistive sensor. For this device, it was selected the oscillator-based circuit where frequency depends from the capacitance of sensor hence from capacitance one can calculate pressure. The external device (transmitter) used for wireless charging and signal transmission. Some implant devices for these applications are passive, the external device sends radio wave signal on internal LC circuit device. The external device gets reflected the signal from the implant and from a change of frequency is possible to calculate changing of capacitance and then blood pressure. However, this method has some disadvantages, such as the patient position dependence and static using. Developed implantable device doesn’t have these disadvantages and sends blood pressure data to the external part in real-time. The external device continuously sends information about blood pressure to hospital cloud service for analysis by a physician. Doctor’s automated workstation at the hospital also acts as a dashboard, which displays actual medical data of patients (which require attention) and stores it in cloud service. Usually, critical heart conditions occur few hours before heart attack but the device is able to send an alarm signal to the hospital for an early action of medical service. The system was tested with wireless charging and data transmission. These results can be used for ASIC design for MEMS pressure sensor.

Keywords: MEMS sensor, RF power, wireless data, oscillator-based circuit

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Authors: Yasser M. Abd-elrhman, Mohamed A. Gepreel, Kiochi Nakamura, Ahmed Abd El-Moneim, Sengo Kobayashi, Mervat M. Ibrahim

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Titanium alloys are known as highly bio compatible metallic materials due to their high strength, low elastic modulus, and high corrosion resistance in biological media. Besides other important material features, the corrosion parameters and corrosion products are responsible for limiting the biological and chemical bio compatibility of metallic materials that produce undesirable reactions in implant-adjacent and/or more distant tissues. Electrochemical corrosion behaviors of novel beta titanium alloys, Ti-4.7Mo-4.5Fe, Ti-3Mo-0.5Fe, and Ti-2Mo-0.5Fe were characterized in naturally aerated Ringer’s solution at room temperature compared with common used biomedical titanium alloy, Ti-6Al-4V. The corrosion resistance of titanium alloys were investigated through open circuit potential (OCP), potentiodynamic polarization measurements and optical microscope (OM). A high corrosion resistance was obtained for all alloys due to the stable passive film formed on their surfaces. The new present alloys are promising metallic biomaterials for the future, owing to their very low elastic modulus and good corrosion resistance capabilities.

Keywords: titanium alloys, corrosion resistance, Ringer’s solution, electrochemical corrosion

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Authors: Kaushikk Iyer, Richard M Hall, David Keeling

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Hardware-in-the-loop (HIL) simulation is an advanced technique for developing and testing complex real-time control systems. This paper presents the benefits of HIL simulation and how it can be implemented and used effectively to develop, test, and validate advanced control algorithms used in a spinal joint Wear simulator for the Tribological testing of spinal disc prostheses. spinal wear simulator is technologically the most advanced machine currently employed For the in-vitro testing of newly developed spinal Discimplants. However, the existing control techniques, such as a simple position control Does not allow the simulator to test non-sinusoidal waveforms. Thus, there is a need for better and advanced control methods that can be developed and tested Rigorouslybut safely before deploying it into the real simulator. A benchtop HILsetupis was created for experimentation, controller verification, and validation purposes, allowing different control strategies to be tested rapidly in a safe environment. The HIL simulation aspect in this setup attempts to replicate similar spinal motion and loading conditions. The spinal joint wear simulator containsa four-Barlinkpowered by electromechanical actuators. LabVIEW software is used to design a kinematic model of the spinal wear Simulator to Validatehow each link contributes towards the final motion of the implant under test. As a result, the implant articulates with an angular motion specified in the international standards, ISO-18192-1, that define fixed, simplified, and sinusoid motion and load profiles for wear testing of cervical disc implants. Using a PID controller, a velocity-based position control algorithm was developed to interface with the benchtop setup that performs HIL simulation. In addition to PID, a fuzzy logic controller (FLC) was also developed that acts as a supervisory controller. FLC provides intelligence to the PID controller by By automatically tuning the controller for profiles that vary in amplitude, shape, and frequency. This combination of the fuzzy-PID controller is novel to the wear testing application for spinal simulators and demonstrated superior performance against PIDwhen tested for a spectrum of frequency. Kaushikk Iyer is a Ph.D. Student at the University of Leeds and an employee at Key Engineering Solutions, Leeds, United Kingdom, (e-mail: [email protected], phone: +44 740 541 5502). Richard M Hall is with the University of Leeds, the United Kingdom as a professor in the Mechanical Engineering Department (e-mail: [email protected]). David Keeling is the managing director of Key Engineering Solutions, Leeds, United Kingdom (e-mail: [email protected]). Results obtained are successfully validated against the load and motion tolerances specified by the ISO18192-1 standard and fall within limits, that is, ±0.5° at the maxima and minima of the motion and ±2 % of the complete cycle for phasing. The simulation results prove the efficacy of the test setup using HIL simulation to verify and validate the accuracy and robustness of the prospective controller before its deployment into the spinal wear simulator. This method of testing controllers enables a wide range of possibilities to test advanced control algorithms that can potentially test even profiles of patients performing various dailyliving activities.

Keywords: Fuzzy-PID controller, hardware-in-the-loop (HIL), real-time simulation, spinal wear simulator

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Authors: Tim Bolle, Franziska Kreimendahl, Thomas Gries, Stefan Jockenhoevel

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The therapeutic treatment of extensive, deep wounds is limited. Autologous split-skin grafts are used as a so-called ‘gold standard’. Most common deficits are the defects at the donor site, the risk of scarring as well as the limited availability and quality of the autologous grafts. The aim of this project is a tissue engineered dermal-epidermal skin replacement to overcome the limitations of the gold standard. A key requirement for the development of such a three-dimensional implant is the formation of a functional capillary-like network inside the implant to ensure a sufficient nutrient and gas supply. Tailored three-dimensional warp knitted spacer fabrics are used to reinforce the mechanically week fibrin gel-based scaffold and further to create a directed in vitro pre-vascularization along the parallel-oriented pile yarns within a co-culture. In this study various three-dimensional warp knitted spacer fabrics were developed in a factorial design to analyze the influence of the machine parameters such as the stitch density and the pattern of the fabric on the scaffold performance and further to determine suitable parameters for a successful fibrin gel-incorporation and a physiological performance of the scaffold. The fabrics were manufactured on a Karl Mayer double-bar raschel machine DR 16 EEC/EAC. A fine machine gauge of E30 was used to ensure a high pile yarn density for sufficient nutrient, gas and waste exchange. In order to ensure a high mechanical stability of the graft, the fabrics were made of biocompatible PVDF yarns. Key parameters such as the pore size, porosity and stress/strain behavior were investigated under standardized, controlled climate conditions. The influence of the input parameters on the mechanical and morphological properties as well as the ability of fibrin gel incorporation into the spacer fabric was analyzed. Subsequently, the pile yarns of the spacer fabrics were colonized with Human Umbilical Vein Endothelial Cells (HUVEC) to analyze the ability of the fabric to further function as a guiding structure for a directed vascularization. The cells were stained with DAPI and investigated using fluorescence microscopy. The analysis revealed that the stitch density and the binding pattern have a strong influence on both the mechanical and morphological properties of the fabric. As expected, the incorporation of the fibrin gel was significantly improved with higher pore sizes and porosities, whereas the mechanical strength decreases. Furthermore, the colonization trials revealed a high cell distribution and density on the pile yarns of the spacer fabrics. For a tailored reinforcing structure, the minimum porosity and pore size needs to be evaluated which still ensures a complete incorporation of the reinforcing structure into the fibrin gel matrix. That will enable a mechanically stable dermal graft with a dense vascular network for a sufficient nutrient and oxygen supply of the cells. The results are promising for subsequent research in the field of reinforcing mechanically weak biological scaffolds and develop functional three-dimensional scaffolds with an oriented pre-vascularization.

Keywords: fibrin-gel, skin replacement, spacer fabric, pre-vascularization

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Authors: Neelesh Papineni

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Aim: Piezosurgery is a relatively new technique for osteotomy and osteoplasty that uses ultrasonic vibration. The conventional method of treating periodontal cases are by conventional surgeries. However, in this advancing field the use of motor-driven instruments is being considered less invasive. Out of these motor-driven instruments, piezo-electric device has been introduced to the field of periodontics and oral implantology. This article discusses about the wide range of application of piezo-electric device in periodontology, its advantages over conventional surgical therapies and other motor-driven instruments. Results: Piezo- electric has shown better results in aspect of osteotomy, osteoplasty, implants, and any procedure which includes conserving the bone. Also piezo-electric does not cause any kind of damage to the surrounding soft tissue and eliminates the risk of bone necrosis which is a risk factor in other motor driven instruments. Conclusion: In this era of modern dentistry , a successful periodontal and implant surgery requires a sound osseous support. This review gives a pictorial representation about the wide range of application of piezo-electric device in periodontology.

Keywords: piezo-electric, osteotomy, osteoplasty, implantology

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Authors: Bokku Kang, Changsoo Chon, Han Sung Kim

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We developed new design of rod of pedicle screw system that is beneficial in maintaining the spacing between the vertebrae and assessed the performance of the posterior fixation screw systems by numerical analysis according to the range of motion (flexion, extension, lateral bending, and axial rotation) of the vertebral column after inserting the pedicle screws. The simulation results showed that the conventional rod was the most low equivalent stress value among implant units in the case of flexion, extension and lateral bending of the vertebrae. In all cases except the torsional rotation, the results showed that the stress level of the single and double rounded rod exceeded about 30% to 70% compare to the conventional rod. Therefore, this product is not suitable for actual application in the field yet and it seems that product design optimization is necessary. Acknowledgement: This research was supported by the Ministry of Trade, Industry & Energy (MOTIE), Korea Institute for Advancement of Technology (KIAT) through the Encouragement Program for The Industries of Economic Cooperation Region.

Keywords: lumber spine, internal fixation device, finite element method, biomechanics

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Authors: Banu Pradheepa Kamarajan, Muthusamy Ananthasubramanian

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Biofilm forming Pseudomonads occupy the top third position in causing hospital acquired infections. P. aeruginosa is notoriously known for its tendency to develop drug resistance. Major classes of drug such as β-lactams, aminoglycosides, quinolones, and polymyxins are found ineffective against multi-drug resistance Pseudomonas. To combat the infections, rather than administration of a single antibiotic, use of combinations (tobramycin and essential oils from plants and/or silver nanoparticles, chitosan, nitric oxide, cis-2-decenoic acid) in single formulation are suggested to control P. aeruginosa biofilms. Conventional techniques to prevent hospital-acquired implant infections such as coatings with antibiotics, controlled release of antibiotics from the implant material, contact-killing surfaces, coating the implants with functional DNase I and, coating with glycoside hydrolase are being followed. Coatings with bioactive components besides having limited shelf-life, require cold-chain and, are likely to fail when bacteria develop resistance. Recently identified nano-scale physical architectures on the insect wings are expected to have potential bactericidal property. Nanopillars are bactericidal to Staphylococcus aureus, Bacillus subtilis, K. pnuemoniae and few species of Pseudomonas. Our study aims to investigate the survival rate of biofilm forming Pseudomonas aeruginosa strain over non-biofilm forming strain on the nanopillar architecture of dragonfly (Pantala flavescens) wing. Dragonflies were collected near house-hold areas and, insect identification was carried out by the Department of Entomology, Tamilnadu Agricultural University, Coimbatore, India. Two strains of P. aeruginosa such as PAO1 (potent biofilm former) and MTCC 1688 (non-weak biofilm former) were tested against the glass coverslip (control) and wings of dragonfly (test) for 48 h. The wings/glass coverslips were incubated with bacterial suspension in 48-well plate. The plates were incubated at 37 °C under static condition. Bacterial attachment on the nanopillar architecture of the wing surface was visualized using FESEM. The survival rate of P. aeruginosa was tested using colony counting technique and flow cytometry at 0.5 h, 1 h, 2 h, 7 h, 24 h, and 48 h post-incubation. Cell death was analyzed using propidium iodide staining and DNA quantification. The results indicated that the survival rate of non-biofilm forming P. aeruginosa is 0.2 %, whilst that of biofilm former is 45 % on the dragonfly wings at the end of 48 h. The reduction in the survival rate of biofilm and non-biofilm forming P. aeruginosa was 20% and 40% respectively on the wings compared to the glass coverslip. In addition, Fourier Transformed Infrared Radiation was used to study the modification in the surface chemical composition of the wing during bacterial attachment and, post-sonication. This result indicated that the chemical moieties are not involved in the bactericidal property of nanopillars by the conserved characteristic peaks of chitin pre and post-sonication. The nanopillar architecture of the dragonfly wing efficiently deters the survival of non-biofilm forming P. aeruginosa, but not the biofilm forming strain. The study highlights the ability of biofilm formers to survive on wing architecture. Understanding this survival strategy will help in designing the architecture that combats the colonization of biofilm forming pathogens.

Keywords: biofilm, nanopillars, Pseudomonas aeruginosa, survival rate

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Authors: Mona Elhelbawy, Mac Gray

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Traditional wired endoscopy is an intrusive process that requires a long flexible tube to be inserted through the patient’s mouth while intravenously sedated. Only images of the upper 4 feet of stomach, colon, and rectum can be captured, leaving the remaining 20 feet of small intestines. Wireless capsule endoscopy offers a painless, non-intrusive, efficient and effective alternative to traditional endoscopy. In wireless capsule endoscopy (WCE), ingestible vitamin-pill-shaped capsules with imaging capabilities, sensors, batteries, and antennas are designed to send images of the gastrointestinal (GI) tract in real time. In this paper, we investigate the radiation performance and specific absorption rate (SAR) of a miniature conformal capsule antenna operating at the Medical Implant Communication Service (MICS) frequency band in the human body. We perform numerical simulations using the finite element method based commercial software, high-frequency structure simulator (HFSS) and the ANSYS human body model (HBM). We also investigate the in-body channel characteristics between the implantable capsule and an external antenna placed on the surface of the human body.

Keywords: IEEE 802.15.6, MICS, SAR, WCE

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Authors: Elnaz Dabiri, Somayeh Hamidnezhad

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Background and Objective: This study aims at investigating the effect of whole word method on Mean Length of Utterance (MLU) of 3 to 6 years old children with cochlear implants having normal IQ. Materials and Methods: In this quasi-experimental and interventional study, 20 children with cochlear implants, aged between 3and 6 years, and normal IQ were selected from Tabriz cochlear implants center using convenience sampling. Afterward, they were randomly bifurcated. The first group was educated by whole-word reading method along with traditional methods and the second group by traditional methods. Both groups had three sessions of 45-minutes each, every week continuously for a period of 3 months. Pre-test and post-test language abilities of both groups were assessed using the TOLD test. Results: Both groups before training have the same age, IQ, and MLU, but after training the first group shows a considerable improvement in MLU in comparison with the second group. Conclusions: Reading training by the whole word method have more effect on MLU of children with cochlear implants in comparison of the traditional method.

Keywords: cochlear implants, reading training, traditional methods, language therapy, whole word method, Mean Length of Utterance (MLU)

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Authors: M. J. Shivaram, Shashi Bhushan Arya, Jagannath Nayak, Bharat Bhooshan Panigrahi

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Titanium and its alloys have become more significant implant materials due to their mechanical properties, excellent biocompatibility and high corrosion resistance. Biomaterials can be produce by using the powder metallurgy (PM) methods and required properties can tailored by varying the processing parameters, such as ball milling time, space holder particles, and sintering temperature. The desired properties such as, structural and mechanical properties can be obtained by powder metallurgy method.  In the present study, deals with fabrication of solid and porous Ti-20Nb-5Ag alloy using high energy ball milling for different times (5 and 20 h). The resultant powder particles were used to fabricate solid and porous Ti-20Nb-5Ag alloy by adding space holder particles (NH₄HCO₃). The resultant powder particles, fabricated solid and porous samples were characterized by scanning electron microscopy (SEM). The compressive strength, elastic modulus and microhardness properties were investigated. Solid and porous Ti-20Nb-5Ag alloy samples showed good mechanical properties for 20 h ball milling time as compare to 5 h ball milling.

Keywords: ball milling, compressive strengths, microstructure, porous titanium alloy

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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: Bassem M. Darwish, Robert H. Ablove

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Introduction: Total knee arthroscopy (TKA) is a commonly performed procedure in patients with end-stage osteoarthritis and inaccuracy of component alignment in TKA has been shown to have many adverse post-operative outcomes such as accelerated implant wear, reduced functional outcomes, and shorter overall implant survival. Robotic surgical systems have been introduced to try and improve joint alignment and functional outcomes in knee arthroscopy, one recent iteration is the ROSA knee system, released to the market in 2019. The objective of this scoping review is to map the available evidence, identify the current types of evidence, and identify knowledge gaps to guide future studies on patient outcomes following ROSA-assisted total knee arthroplasties. Methods: An electronic search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews. Search terms included ROSA, knee arthroscopy, osteoarthritis, robotic, and malalignment. Types of study participants included patients with osteoarthritis, ages 18 and older, male or female, who received manual TKA (mTKA) or ROSA-assisted TKA (rTKA), and human patients or cadavers. Published, peer-reviewed controlled trials, observational studies, and case series were included. Case reports were not included in article review. Resulting articles were first screened based on title and abstract. Articles meeting inclusion criteria based on title and abstract review then underwent full-text review by the same reviewer. Results: This scoping review identified 11 total studies, 3 prospective observational studies, and 8 retrospective observational studies - a total of 970 rTKA patients and 1745 mTKA patients. There were no case series or randomized controlled trials comparing rTKA and mTKA. Patient-centered outcomes showed promise for rTKA, where it frequently showed significantly favorable functional outcomes, measured via KOOS-JR, VAS, KSS, OKS, FJS, and PROMIS scores, at various times postoperatively. However, there was much discrepancy about which score yielded significance at which postoperative follow-up. Complication rates, reoperation rates, and LOS were very similar between mTKA and rTKA groups. Studies also showed rTKA had more accurate joint alignment within the 0 ± 3o corridor and had significantly higher rates of achieving postoperative joint angles similar to the preoperative plan. Finally, there was major agreement that rTKA cases take significantly longer time at the start, however, there is a rapid learning curve. Once past the learning curve, rTKA cases are performed in a similar time to mTKA and reduced physician stress and strain. Conclusion: The ROSA knee system represents a promising option for the management of osteoarthritis via total knee arthroscopy. The studies reviewed in this paper favor the patient-centered function outcomes, joint alignments, and physician health implications of the ROSA knee system to conventional total knee arthroscopy. Further study is warranted, however, to better understand recovery periods, longer-term functional outcomes, operative fatigue, and reduction in radiation exposure.

Keywords: arthroplasty, knee, robotics, malalignment

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Authors: Phanawan Whangdee, Tomoaki Watanabe, Viritpon Srimaneepong, Dujreutai Pongkao Kashima

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The anodized films formed at high current density or high voltage have been widely prepared for dental implant because it can improve the hydrophilicity to the film. Our attempt is exploring whether low current density and low voltage could enhance the good hydrophilicity to the anodized films or not. Furthermore, UV irradiation would be one of the key factor to enhance their hydrophilicity. The anodized films were performed at low current density of 2 mA/cm2 in 1M H3PO4, 1 mA/cm2 in 1M MCPM and low voltage of 6 V in either 1M H3PO4 or 1M MCPM. All samples were treated with UV for various times up to 24 h. After UV irradiation, the contact angle decreased, the chemical species changed. The Ti 2p and O 1s peaks increased, while the C 1s peak decreased which might be due to removal of hydrocarbon. The functional groups of the films shown as the change of OH groups appeared at wave number 3700 cm-1 and 2900-3000 cm-1, however, the peak of H2O at 1630 cm-1disappeared. It is indicated that UV irradiation might change the stretching modes of OH groups coordinated to surface Ti4+ cation but UV did not affect to the changes in surface morphologies. The surface energies increased after UV irradiation resulting in improving of the hydrophilicity. The anodized films formed at low current density or low voltage after UV irradiation showed a low contact angle as well as the film formed at high current density or high voltage.

Keywords: hydrophilicity, low current density, low voltage, UV irradiation

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Authors: Yili Chen, Jixiang Fu, Zhihua Liu, Zhicheng Zhang, Rongmao Li, Nan Fu, Yaoqin Xie

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Retinal prothesis is designed to help the blind to get some sight.It is made up of internal part and external part.In external part ,there is made up of camera, image processing, and RF transmitter.In internal part, there is RF receiver, implant chip,micro-electrode.The image got from the camera should be processed by suitable stragies to corresponds to stimulus the electrode.Nowadays, the number of the micro-electrode is hundreds and we don’t know the mechanism how the elctrode stimulus the optic nerve, an easy way to the hypothesis is that the pixel in the image is correspondence to the electrode.So it is a question how to get the important information of the image captured from the picture.There are many strategies to experimented to get the most important information as soon as possible, due to the real time system.ROI is a useful algorithem to extract the region of the interest.Our paper will explain the details of the orinciples and functions of the ROI.And based on this, we simplified the ROI algrithem,and used it in outside image prcessing DSP system of the retinal prothesis.Results show that our image processing stratiges is suitable for real-time retinal prothesis and can cut redundant information and help useful information to express in the low-size image.

Keywords: image processing, region of interest, saliency map, low-size image, useful information express, cut redundant information in image

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Authors: A. L. R. Rangel, J. A. M. Chaves, A. P. R. Alves Claro

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Surface modification of titanium and its alloys using TiO2 nanotube growth has been widely studied for biomedical field due to excellent interaction between implant and biological environment. The success of this treatment is directly related to anatase phase formation (TiO2 phase) which affects the cells growth. The aim of this study was to evaluate the phases formed in the nanotubes growth on the Ti-15Mo surface. Nanotubes were grown by electrochemical anodization of the alloy in ammonium fluoride based glycerol electrolyte for 24 hours at 20V. Then, the samples were annealed at 200°,400°, 450°, 500°, 600°, and 800° C for 1 hour. Contact angles measurements, scanning electron microscopy images and X rays diffraction analysis (XRD) were carried out for all samples. Raman Spectroscopy was used to evaluate TiO2 phases transformation in nanotubes samples as well. The results of XRD showed anatase formation for lower temperatures, while at 800 ° C the rutile phase was observed all over the surface. Raman spectra indicate that this phase transition occurs between 500 and 600 °C. The different phases formed have influenced the nanotubes morphologies, since higher annealing temperatures induced agglutination of the TiO2 layer, disrupting the tubular structure. On the other hand, the nanotubes drastically reduced the contact angle, regardless the annealing temperature.

Keywords: nanotubes, TiO2, titanium alloys, Ti-15Mo

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Authors: David Downey

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With the introduction of additive manufacturing (3D printing) to produce titanium (Ti6Al4V) components in the medical/aerospace and automotive industries, intricate geometries can be produced with virtually complete design freedom. However, the consideration of microstructural anisotropy resulting from the additive manufacturing process becomes necessary due to this design flexibility and the need to print a geometric shape that can consist of numerous angles, radii, and swept surfaces. A femoral knee implant serves as an example of a 3D-printed near-net-shaped product. The mechanical properties of the printed components, and consequently, their machinability, are affected by microstructural anisotropy. Currently, finish-machining operations performed on titanium printed parts using selective laser melting (SLM) utilize the same cutting tools employed for processing wrought titanium components. Cutting forces for components manufactured through SLM can be up to 70% higher than those for their wrought counterparts made of Ti6Al4V. Moreover, temperatures at the cutting interface of 3D printed material can surpass those of wrought titanium, leading to significant tool wear. Although the criteria for tool wear may be similar for both 3D printed and wrought materials, the rate of wear during the machining process may differ. The impact of these issues on the choice of cutting tool material and tool lifetimes will be discussed.

Keywords: additive manufacturing, build orientation, microstructural anisotropy, printed titanium Ti6Al4V, tool wear

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Authors: Roxana Maria Angelescu, Doina Răducanu, Mariana Lucia Angelescu, Ion Cincă, Vasile Dănuţ Cojocaru, Cosmin Cotruț, Şerban Nicolae

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Titanium alloys are often used for biomedical applications as hard tissue replacements, such as: orthopedic implants, spinal fixation devices and dental implants. Their advantages are well known and demonstrated: excellent mechanical properties, biocompatibility and good corrosion resistance, but it is also known that the main disadvantage of the metallic materials is their tendency of corrosion in in-vivo environments. In 1987, titanium was found to be the only metallic biomaterial that osseointegrates. The aim of this study was to investigate the microstructure and the corrosion behavior of the Ti-20Nb-5Ta wt% alloy. In this case Nb stabilizes the β-Ti structure and Ta is a highly passivating metal. The as studied alloy was melt under argon protective atmosphere in a levitation induction melting furnace, type FIVE CELES - MP25, with a nominal power of 25 kW and a melting capacity of 30 cm3. The microstructure of the as studied alloy was analyzed by using the electronic microscope Tescan Vega II-XMU. The phase structure of the as studied alloy was determined, as well as the crystalline grain size (100-200µ). To determine the corrosion behavior of the as studied alloy, the technique used was the linear polarization, with the PARSTAT 4000 potentiostat, produced by Princeton Applied Research; potentiodynamic curves were obtained with the VeraStudio v.2.4.2 software.

Keywords: corrosion resistance, microstructure, titanium alloys

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Authors: Wera Supa, Panita Wannapiroon

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This paper is a report on the designing of the social collaborative learning model based on proactive involvement to Promote the global merit principle in cultivating youths’ morality. The research procedures into two phases, the first phase is to design the social collaborative learning model based on proactive involvement to promote the global merit principle in cultivating youths’ morality, and the second is to evaluate the social collaborative learning model based on proactive involvement. The sample group in this study consists of 15 experts who are dominant in proactive participation, moral merit principle and youths’ morality cultivation from executive level, lecturers and the professionals in information and communication technology expertise selected using the purposive sampling method. Data analyzed by arithmetic mean and standard deviation. This study has explored that there are four significant factors in promoting the hands-on collaboration of global merit scheme in order to implant virtues to adolescences which are: 1) information and communication Technology Usage; 2) proactive involvement; 3) morality cultivation policy, and 4) global merit principle. The experts agree that the social collaborative learning model based on proactive involvement is highly appropriate.

Keywords: social collaborative learning, proactive involvement, global merit principle, morality

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Authors: Jer Ping Ooi, Shah Rizal Bin Kasim, Nor Aini Saidin

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The objective of this study was to synthesize nano-sized β-tricalcium phosphate (β-TCP) powder and assess its cytotoxic effects on human osteoblast (hFOB1.19) by using four cytotoxicity assays, namely, lactose dehydrogenase (LDHe), tetrazolium hydroxide (XTT), neutral red (NR), and sulforhodamine B (SRB) assays. β-tricalcium phosphate (β-TCP) is a calcium phosphate compound commonly used as an implant material. To date, bulk-sized β-TCP is reported to be readily tolerated by the osteogenic cells and body based on in vitro, in vivo experiments and clinical studies. However, to what extent of nano-sized β-TCP will react in models as compared to bulk β-TCP is yet to be investigated. Thus, in this project, the cells were treated with nano β-TCP powder within a range of concentrations from 0 to 1000 μg/mL for 24, 48, and 72 h. The cytotoxicity tests showed that loss of cell viability ( > 50%) was high for hFOB1.19 cells in all assays. Cell cycle and apoptosis analysis of hFOB1.19 cells revealed that 50 μg/mL of the compound led to 30.5% of cells being apoptotic after 72 h of incubation, and the percentage was increased to 58.6% when the concentration was increased to 200 μg/mL. When the incubation time was increased from 24 to 72 h, the percentage of apoptotic cells increased from 17.3% to 58.6% when the hFOB1.19 were exposed with 200 μg/mL of nano β-TCP powder. Thus, both concentration and exposure duration affected the cytotoxicity effects of the nano β-TCP powder on hFOB1.19. We hypothesize that these cytotoxic effects on hFOB1.19 are related to the nano-scale size of the β-TCP.

Keywords: β-tricalcium phosphate, hFOB1.19, adipose-derived mesenchymal stem cells, cytotoxicity

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Authors: A. Mohamed, A. El-Aziz

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The pH of the body plays a great role in the degradation kinetics of biodegradable Mg-Ca orthopedic implants. At the location of fracture, the pH of the body becomes no longer neutral which draws the attention towards studying a range of different pH values of the body fluid. In this study, the pH of Hank’s balanced salt solution (HBSS) was modified by phosphate buffers into an aggressive acidic pH 1.8, a slightly acidic pH 5.3 and an alkaline pH 8.1. The biodegradation of Mg-0.8Ca implant was tested in those three different media using immersion test and electrochemical polarization means. It was proposed that the degradation rate has increased with decreasing the pH of HBSS. The immersion test revealed weight gain for all the samples followed by weight loss as the immersion time increased. The highest weight gain was pronounced for the acidic pH 1.8 and the least weight gain was observed for the alkaline pH 8.1. This was in agreement with the electrochemical polarization test results where the degradation rate was found to be high (7.29 ± 2.2 mm/year) in the aggressive acidic solution of pH 1.8 and relatively minimum (0.31 ± 0.06 mm/year) in the alkaline medium of pH 8.1. Furthermore, it was confirmed that the pH of HBSS has reached a steady state of an alkaline pH (~pH 11) at the end of the two-month immersion period regardless of the initial pH of the solution. Finally, the corrosion products formed on the samples’ surface were investigated by SEM, EDX and XRD analyses that revealed the formation of magnesium and calcium phosphates with different morphologies according to the pH.

Keywords: biodegradable, electrochemical polarization means, orthopedics, immersion test, simulated body fluid

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Authors: Divya SY. Ang, Mark B. Tan, Nicholas EM. Yeo, Siti RB. Sudirman, Khong Yik Chew

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Introduction: The importance of the amalgamation of technological and engineering advances with surgical principles of reconstruction cannot be overemphasized. With earlier detection of cancer, consequences of high-speed living and neglect, like traumatic injuries and infection, resulting in increasingly younger patients with bone defects. This may result in malformations and suboptimal function that is more noticeable and palpable in the younger, active demographic. Our team proposes a technique that encapsulates a mesh of multidisciplinary effort, tissue engineering and reconstructive principles. Methods/Materials: Our patient was a young competitive footballer in his early 30s who was diagnosed with submandibular adenoid cystic carcinoma with bony involvement. He was thus counselled for a right hemi mandibulectomy, the floor of mouth resection, right selective neck dissection, tracheostomy, and free fibular flap reconstruction of his mandible and required post-operative radiotherapy. Being young and in his prime sportsman years, he was unable to accept the morbidities associated with using his fibula to reconstruct his mandible despite it being the gold standard reconstructive option. The fibula is an ideal vascularized bone flap because it’s reliable and easily shaped with relatively minimal impact on functional outcomes. The fibula contributes to 30% of weightbearing and is the attachment for the lateral compartment muscles; it is stronger in footballers concerning lateral bending. When harvesting the fibula, the distal 6-8cm and up to 10% of the total length is preserved to maintain the ankle’s stability, thus, minimizing the impact on daily activities. There are studies that have noted gait variability post-operatively. Therefore, returning to a premorbid competitive level may be doubtful. To improve his functional outcomes, the decision was made to try and restore the fibula's form and function. Using the concept of Fused Deposition Modelling (FDM), our team comprising of Plastics, Otolaryngology, Orthopedics and Radiology, worked with Osteopore to design a 3D bioresorbable implant to regenerate the fibula defect (14.5cm). Bone marrow was harvested via reaming the contralateral hip prior to the wide resection. 30mls of his blood was obtained for extracting platelet rich plasma. These were packed into the Osteopore 3D-printed bone scaffold. This was then secured into the fibula defect with titanium plates and screws. The flexor hallucis longus and soleus were anchored along the construct and intraosseous membrane, done in a single setting. Results: He was reviewed closely as an outpatient over 10 months post operatively. He reported no discernable loss or difference in ankle function. He is satisfied and back in training and our team has video and photographs that substantiate his progress. Conclusion: FDM allows regeneration of long bone defects. However, we aimed to also restore his eversion and inversion that is imperative for footballers and hence reattached his previously dissected muscles along the length of the Osteopore implant. We believe that the reattachment of the muscle stabilizes not only the construct but allows optimum muscle tensioning when moving his ankle. This is a simple but effective technique in restoring complete function and form in a young patient whose minute muscle control is imperative to life.

Keywords: fused deposition modelling, functional reconstruction, lower limb bony defects, regenerative surgery, 3D printing, tissue engineering

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Authors: Tran Thi Anh Dao, M. Arnold, L. Schacher, D. C. Adolphe, G. Reys

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During tooth extraction or implant surgery, dentists are in contact with numerous infectious germs from patients' saliva and blood. For that reason, dentist's clothes have to play their role of protection from contamination. In addition, dentist's apparels should be not only protective but also comfortable and breathable because dentists have to perform many operations and treatments on patients throughout the day with high concentration and intensity. However, this type of protective garments has not been studied scientifically, whereas dentists are facing new risks and eager for looking for a comfortable personal protective equipment. For that reason, we have proposed some new designs of dentist's gown. They were expected to diminish heat accumulation that are considered as an important factor in reducing the level of comfort experienced by users. Experiments using infra-red technology were carried out in order to compare the breathable properties between a traditional gown and a new design with open zones. Another experiment using pressure sensors was also carried out to study ergonomic aspects trough the flexibility of movements of sleeves. The sleeves-design which is considered comfortable and flexible will be chosen for the further step. The results from the two experiments provide valuable information for the development of a new design of dentists' gowns in order to achieve maximum levels of cooling and comfort for the human body.

Keywords: garment, dentists, comfort, design, protection, thermal

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Authors: L. Siva Rama Krishna, Sriram Venkatesh, M. Sastish Kumar, M. Uma Maheswara Chary

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Rapid Prototyping (RP) is a technology that produces models and prototype parts from 3D CAD model data, CT/MRI scan data, and model data created from 3D object digitizing systems. There are several RP process like Stereolithography (SLA), Solid Ground Curing (SGC), Selective Laser Sintering (SLS), Fused Deposition Modelling (FDM), 3D Printing (3DP) among them SLS and FDM RP processes are used to fabricate pattern of custom cranial implant. RP technology is useful in engineering and biomedical application. This is helpful in engineering for product design, tooling and manufacture etc. RP biomedical applications are design and development of medical devices, instruments, prosthetics and implantation; it is also helpful in planning complex surgical operation. The traditional approach limits the full appreciation of various bony structure movements and therefore the custom implants produced are difficult to measure the anatomy of parts and analyse the changes in facial appearances accurately. Cranioplasty surgery is a surgical correction of a defect in cranial bone by implanting a metal or plastic replacement to restore the missing part. This paper aims to do a comparative study on the dimensional error of CAD and SLS RP Models for reconstruction of cranial defect by comparing the virtual CAD with the physical RP model of a cranial defect.

Keywords: rapid prototyping, selective laser sintering, cranial defect, dimensional error

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Authors: Khurram Munir, Cuie Wen, Yuncang Li

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Magnesium (Mg) metal matrix composites (MMCs) reinforced with graphene nanoplatelets (GNPs) have been developed by powder metallurgy (PM). In this study, GNPs with different concentrations (0.1-0.3 wt.%) were dispersed into Mg powders by high-energy ball-milling processes. The microstructure and resultant mechanical properties of the fabricated nanocomposites were characterized using transmission electron microscopy (TEM), scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDX), X-ray diffraction (XRD), Raman spectroscopy (RS), compression and nano-wear tests. The corrosion resistance of the fabricated composites was evaluated by electrochemical tests and hydrogen evolution measurements. Finally, the biological response of Mg-GNPs composites was assessed using osteoblast-like SaOS2 cells. The results indicate that GNPs are excellent candidates as reinforcements in Mg matrices for the manufacture of biodegradable Mg-based composite implants. GNP addition improved the mechanical properties of Mg via synergetic strengthening modes. Moreover, retaining the structural integrity of GNPs during PM processing improved the ductility, compressive strength, and corrosion resistance of the Mg-GNP composites as compared to monolithic Mg. Cytotoxicity assessments did not reveal any significant toxicity with the addition of GNPs to Mg matrices. This study demonstrates that Mg-xGNPs with x < 0.3 wt.%, may constitute novel biodegradable implant materials for load-bearing applications.

Keywords: magnesium-graphene composites, strengthening mechanisms, In vitro cytotoxicity, biocorrosion

Procedia PDF Downloads 158