Search results for: Dental Prosthesis.

Authors: Bruno Henriques, Rafaela Santos, Mihaela Buciumeanu, Júlio Matias de Souza, Filipe Silva, Rubens Nascimento, Márcio Fredel

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Dental porcelain composites reinforced and toughened by 20 wt.% tetragonal zirconia (3Y-TZP) were processed by hot pressing at 1000°C. Two types of particles were tested: yttriastabilized zirconia (ZrO2–3%Y2O3) agglomerates and pre-sintered yttria-stabilized zirconia (ZrO2–3%Y2O3) particles. The composites as well as the reinforcing particles were analyzed by the means of optical and Scanning Electron Microscopy (SEM), Energy Dispersion Spectroscopy (EDS) and X-Ray Diffraction (XRD). The mechanical properties were obtained by the transverse rupture strength test. Wear tests were also performed on the composites and monolithic porcelain. The best mechanical results were displayed by the porcelain reinforced with the pre-sintered ZrO2–3%Y2O3 agglomerates.

Keywords: Composite, dental restoration, porcelain, strengthening, toughening, wear, zirconia.

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Authors: M. Amlie A. Kasim, Ahsana Aqilah, Ahmed Jaffar, Cheng Yee Low, Roseleena Jaafar, M. Saiful Bahari, Armansyah

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The study of human hand morphology reveals that developing an artificial hand with the capabilities of human hand is an extremely challenging task. This paper presents the development of a robotic prosthetic hand focusing on the improvement of a tendon driven mechanism towards a biomimetic prosthetic hand. The design of this prosthesis hand is geared towards achieving high level of dexterity and anthropomorphism by means of a new hybrid mechanism that integrates a miniature motor driven actuation mechanism, a Shape Memory Alloy actuated mechanism and a passive mechanical linkage. The synergy of these actuators enables the flexion-extension movement at each of the finger joints within a limited size, shape and weight constraints. Tactile sensors are integrated on the finger tips and the finger phalanges area. This prosthesis hand is developed with an exact size ratio that mimics a biological hand. Its behavior resembles the human counterpart in terms of working envelope, speed and torque, and thus resembles both the key physical features and the grasping functionality of an adult hand.

Keywords: Prosthetic hand, Biomimetic actuation, Shape Memory Alloy, Tactile sensing.

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Authors: S. Porojan, L. Sandu, F. Topalâ

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Microplasma welding is a less expensive alternative to laser welding in dental technology. The aim of the study was to highlight discontinuities present in the microplasma welded joints of dental base metal alloys by visual analysis. Five base metal alloys designated for fixed prostheses manufacture were selected for the experiments. Using these plates, preliminary tests were conducted by microplasma welding in butt joint configuration, without filler material, bilaterally and with filler material, proper for each base metal. Macroscopic visual inspection was performed to assess carefully the irregularities in the welds. Electron microscopy allowed detection of discontinuities that are not visible to the eye and revealing details regarding location, trajectory, morphology and size of discontinuities. Supplementing visual control with microscopic analysis allows to detect small discontinuities, which escapes the macroscopic control and to make a detailed study of the weld.

Keywords: base metal alloys, fixed prosthodontics, microplasmawelding, visual inspection

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Authors: Kaman M. O., Celik N.

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In this study, stress distributions on dental implants made of functionally graded biomaterials (FGBM) are investigated numerically. The implant body is considered to be subjected to axial compression loads. Numerical problem is assumed to be 2D, and ANSYS commercial software is used for the analysis. The cross section of the implant thread varies as varying the height (H) and the width (t) of the thread. According to thread dimensions of implant and material properties of FGBM, equivalent stress distribution on the implant is determined and presented with contour plots along with the maximum equivalent stress values. As a result, with increasing material gradient parameter (n), the equivalent stress decreases, but the minimum stress distribution increases. Maximum stress values decrease with decreasing implant radius (r). Maximum von Mises stresses increases with decreasing H when t is constant. On the other hand, the stress values are not affected by variation of t in the case of H = constant.

Keywords: Functionally graded biomaterials, dental implant finite element method.

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Authors: Anjana Goen, D. C. Tiwari

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Myoelectric control system is the fundamental component of modern prostheses, which uses the myoelectric signals from an individual’s muscles to control the prosthesis movements. The surface electromyogram signal (sEMG) being noninvasive has been used as an input to prostheses controllers for many years. Recent technological advances has led to the development of implantable myoelectric sensors which enable the internal myoelectric signal (MES) to be used as input to these prostheses controllers. The intramuscular measurement can provide focal recordings from deep muscles of the forearm and independent signals relatively free of crosstalk thus allowing for more independent control sites. However, little work has been done to compare the two inputs. In this paper we have compared the classification accuracy of six pattern recognition based myoelectric controllers which use surface myoelectric signals recorded using untargeted (symmetric) surface electrode arrays to the same controllers with multichannel intramuscular myolectric signals from targeted intramuscular electrodes as inputs. There was no significant enhancement in the classification accuracy as a result of using the intramuscular EMG measurement technique when compared to the results acquired using the surface EMG measurement technique. Impressive classification accuracy (99%) could be achieved by optimally selecting only five channels of surface EMG.

Keywords: Discriminant Locality Preserving Projections (DLPP), myoelectric signal (MES), Sparse Principal Component Analysis (SPCA), Time Frequency Representations (TFRs).

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Authors: A. Srion, W. Thepsuwan, N. Monmaturapoj

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Two Lithium Disilicate (LD) glass ceramics based on SiO2-Li2O-K2O-Al2O3 system were prepared through a glass melting method. The glass rods were then fabricated into dental crowns via a hot pressing at 900˚C and 850˚C in order to study the effect of the pressing temperatures on the phase formation and microstructure of the glasses. Different samples of as cast glass and heat treated samples (600˚C and 700˚C) were used to press for investigating the effect of an initial microstructure on the hot pressing technique. Xray diffraction (XRD) and scanning electron microscopy (SEM) were performed to determine the phase formation and microstructure of the samples, respectively. XRD results show that the main crystalline structure was Li2Si2O5 by having Li3PO4, Li0.6Al0.6Si2O6, Li2SiO3, Ca5 (PO4)3F and SiO2 as minor phases. Glass compositions with different heat treatment temperatures exhibited a difference phase formations but have less effect during pressing. SEM micrographs showed the microstructure of Li2Si2O5 as lath-like shape in all glasses. With increasing the initial heat treatment temperature, the longer the lath-like crystals of lithium disilicate were increased especially when using glass heat treatment at 700˚C followed by pressing at 900˚C. This could be suggested that LD1 heat treatment at 700˚C which pressing at 900˚C presented the best formation by the hot pressing and compiled microstructure.

Keywords: Lithium disilicate, Hot pressing, Dental crown, Microstructure.

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Authors: Sirbu R., Negreanu-Pirjol T., Leca M., Bechir A., Maris M., Maris D.

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In the paper we presented the possibility of application collagen gels with active principle-s from marine algae extract and chlorhexidine salt in dental medicine. The hydro-alcoholic extracts from marine algae have been used as they have been obtained. The extracts from marine algae and chlorhexidine salt (digluconate) are incorporated in type I non-denatured fibrillar collagen matrixes. In order to obtain therapeutic effects at nanostructure level, it is important to know the rheological characteristics of the relevant mixtures of collagen gels and extracts from marine algae selected for use. In this survey we have studied mixtures made of non-denatured fibrillar collagen hydro-gels where different concentrations of marine algae have been incorporated. Based on the data obtained for the shearing tensions, we have traced the rheograms – the diagrams for shearing tensions depending on the shearing speed values – from which we have calculated the apparent viscosities as ratios between shearing tension and speed values, which have been figured in relation to the shearing speed values, with a view to levelling dependency.

Keywords: rheological properties, fibrillar collagen hydro-gel, marine algae, chlorhexidine salt, dental medicine

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Authors: Areej R. Banjar, Abraham G. Campbell

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The use of Mixed Reality (MR) in teaching and training is growing popular and can improve students’ ability to perform technical procedures. This paper outlines the creation of an interactive educational MR 3D application that aims to improve the quality of instruction for dentistry students. This application is called ”MR-Implantology” and aims to teach and train dentistry students on single dental implant placement. MR-Implantology uses cone-beam computed tomography (CBCT) images as the source for 3D dental models that dentistry students will be able to freely manipulate within a 3D MR world to aid their learning process.

Keywords: Cone-Beam Computed Tomography, dentistry education, implantology, Mixed Reality, MR.

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Authors: Obinna K. Ihesiulor, Krishna Shankar, Paul Smith, Alan Fien

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Excessive fretting wear at the taper-trunnion junction (trunnionosis) apparently contributes to the high failure rates of hip implants. Implant wear and corrosion lead to the release of metal particulate debris and subsequent release of metal ions at the tapertrunnion surface. This results in a type of metal poisoning referred to as metallosis. The consequences of metal poisoning include; osteolysis (bone loss), osteoarthritis (pain), aseptic loosening of the prosthesis and revision surgery. Follow up after revision surgery, metal debris particles are commonly found in numerous locations. Background: A stable connection between the femoral ball head (taper) and stem (trunnion) is necessary to prevent relative motions and corrosion at the taper junction. Hence, the importance of component assembly cannot be over-emphasized. Therefore, the aim of this study is to determine the influence of head-stem junction assembly by press fitting and the subsequent disengagement/disassembly on the connection strength between the taper ball head and stem. Methods: CoCr femoral heads were assembled with High stainless hydrogen steel stem (trunnion) by Push-in i.e. press fit; and disengaged by pull-out test. The strength and stability of the two connections were evaluated by measuring the head pull-out forces according to ISO 7206-10 standards. Findings: The head-stem junction strength linearly increases with assembly forces.

Keywords: Wear, modular hip prosthesis, taper head-stem, force assembly, force disassembly.

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Authors: Dong Xie, Jun Zhao, Yiming Weng

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The objective of this study was to synthesize and characterize the poly(alkenoic acid)s with different molecular structures, use these polymers to formulate a dental cement restorative, and study the effect of molecular structures on reaction kinetics, viscosity, and mechanical strengths of the formed polymers and cement restoratives. In this study, poly(alkenoic acid)s with different molecular structures were synthesized. The purified polymers were formulated with commercial Fuji II LC glass fillers to form the experimental cement restoratives. The reaction kinetics was studied via 1HNMR spectroscopy. The formed restoratives were evaluated using compressive strength, diametral tensile strength, flexural strength, hardness and wear-resistance tests. Specimens were conditioned in distilled water at 37oC for 24 h prior to testing. Fuji II LC restorative was used as control. The results show that the higher the arm number and initiator concentration, the faster the reaction was. It was also found that the higher the arm number and branching that the polymer had, the lower the viscosity of the polymer in water and the lower the mechanical strengths of the formed restorative. The experimental restoratives were 31-53% in compressive strength, 37- 55% in compressive modulus, 80-126% in diametral tensile strength, 76-94% in flexural strength, 4-21% in fracture toughness and 53-96% in hardness higher than Fuji II LC. For wear test, the experimental restoratives were only 5.4-13% of abrasive and 6.4-12% of attritional wear depths of Fuji II LC in each wear cycle. The aging study also showed that all the experimental restoratives increased their strength continuously during 30 days, unlike Fuji II LC. It is concluded that polymer molecular structures have significant and positive impact on mechanical properties of dental cement restoratives.

Keywords: Poly(alkenoic acid)s, molecular structures, dental cement, mechanical strength.

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Authors: R. A. Shahmiri, O. C. Standard, J. N. Hart, C. C. Sorrell

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The ceramic yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) has been used as a dental biomaterial for several decades. The strength and toughness of this material can be accounted for by its toughening mechanisms, which include transformation toughening, crack deflection, zone shielding, contact shielding, and crack bridging. Prevention of crack propagation is of critical importance in high-fatigue situations, such as those encountered in mastication and para-function. However, the poor translucence of Y-TZP in polycrystalline form is such that it may not meet the aesthetic requirements due to its white/grey appearance. To improve the optical properties of Y-TZP, more detailed study of the optical properties is required; in particular, precise evaluation of the refractive index, absorption coefficient, and scattering coefficient are necessary. The measurement of the optical parameters has been based on the assumption that light scattered from biological media is isotropically distributed over all angles. In fact, the optical behavior of real biological materials depends on the angular scattering of light due to the anisotropic nature of the materials. The purpose of the present work is to evaluate the optical properties (including color, opacity/translucence, scattering, and fluorescence) of zirconia dental ceramics and their control through modification of the chemical composition, phase composition, and surface microstructure.

Keywords: Optical properties, opacity/translucence, scattering, fluorescence, chemical composition, phase composition, surface microstructure.

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Authors: Yanqi Yang, Chongshan Liao, Cheuk Hin Ho, Susan Bridges

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Aim: To investigate students’ perceptions of using e-models in an inquiry-based curriculum. Approach: 52 second-year dental students completed a pre- and post-test questionnaire relating to their perceptions of e-models and their use in inquiry-based learning. The pre-test occurred prior to any learning with e-models. The follow-up survey was conducted after one year's experience of using e-models. Results: There was no significant difference between the two sets of questionnaires regarding students’ perceptions of the usefulness of e-models and their willingness to use e-models in future inquiry-based learning. Most students preferred using both plaster models and e-models in tandem. Conclusion: Students did not change their attitude towards e-models and most of them agreed or were neutral that e-models are useful in inquiry-based learning. Whilst recognizing the utility of 3D models for learning, students' preference for combining these with solid models has implications for the development of haptic sensibility in an operative discipline.

Keywords: E-models, inquiry-based curriculum, education.

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Authors: Abdolvahab Ehsani Rad, Mohd Shafry Mohd Rahim, Alireza Norouzi

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Medical image analysis is one of the great effects of computer image processing. There are several processes to analysis the medical images which the segmentation process is one of the challenging and most important step. In this paper the segmentation method proposed in order to segment the dental radiograph images. Thresholding method has been applied to simplify the images and to morphologically open binary image technique performed to eliminate the unnecessary regions on images. Furthermore, horizontal and vertical integral projection techniques used to extract the each individual tooth from radiograph images. Segmentation process has been done by applying the level set method on each extracted images. Nevertheless, the experiments results by 90% accuracy demonstrate that proposed method achieves high accuracy and promising result.

Keywords: Integral production, level set method, morphological operation, segmentation.

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Authors: Shende Suraj Balu, A. B. Deoghare, K. M. Pandey

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The human middle ear (ME) is a delicate and vital organ. It has a complex structure that performs various functions such as receiving sound pressure and producing vibrations of eardrum and propagating it to inner ear. It consists of Tympanic Membrane (TM), three auditory ossicles, various ligament structures and muscles. Incidents such as traumata, infections, ossification of ossicular structures and other pathologies may damage the ME organs. The conditions can be surgically treated by employing prosthesis. However, the suitability of the prosthesis needs to be examined in advance prior to the surgery. Few decades ago, this issue was addressed and analyzed by developing an equivalent representation either in the form of spring mass system, electrical system using R-L-C circuit or developing an approximated CAD model. But, nowadays a three-dimensional ME model can be constructed using micro X-Ray Computed Tomography (μCT) scan data. Moreover, the concern about patient specific integrity pertaining to the disease can be examined well in advance. The current research work emphasizes to develop the ME model from the stacks of μCT images which are used as input file to MIMICS Research 19.0 (Materialise Interactive Medical Image Control System) software. A stack of CT images is converted into geometrical surface model to build accurate morphology of ME. The work is further extended to understand the dynamic behaviour of Harmonic response of the stapes footplate and umbo for different sound pressure levels applied at lateral side of eardrum using finite element approach. The pathological condition Cholesteatoma of ME is investigated to obtain peak to peak displacement of stapes footplate and umbo. Apart from this condition, other pathologies, mainly, changes in the stiffness of stapedial ligament, TM thickness and ossicular chain separation and fixation are also explored. The developed model of ME for pathologies is validated by comparing the results available in the literatures and also with the results of a normal ME to calculate the percentage loss in hearing capability.

Keywords: Computed tomography, human middle ear, harmonic response, pathologies, tympanic membrane.

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Authors: Luan Mavriqi, Ilma Robo, Emin Kuzimi, Egresa Baca

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The process of skeletal growth in an adolescent significantly affects the displacement of implants placed in the palatine suture. The problems caused by this process have an impact on the dental function and aesthetics of the affected data. If fixed prostheses are placed based on implants, the whole structure would impede maxillary growth. This is the significant difference between the maxilla and the mandible, as the lower jaw has no growth process that affects the movement of the implants or the latter to inhibit the growth of the jaw. In a teenager patient an accident occurred accompanied by loss of maxillary central incisors. The main complaint of patients is aesthetics and phonetics. Dental history of patients refers to the presence of a Maryland bridge that was accompanied by dissatisfaction on the part of the patient. Implant placement is not indicated as jaw augmentation may lead to displacement of the implant. The treatment plan includes the placement of implants in the palatum where this bone thickness allows as a procedure.in this article only the first stage of treatment is presented. Implant treatment is ongoing, will be followed by the second phase of treatment when the patient has reached the age of 18 years.

Keywords: Implants, palatum, adolescent, primary incisor teeth.

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Authors: Nélio Veiga, Paula Ferreira, Tiago Correia, Maria J. Correia, Carlos Pereira, Odete Amaral, Ilídio J. Correia

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Introduction: The application of fissure sealants is considered to be an important primary prevention method used in dental medicine. However, the formation of microleakage gaps between tooth enamel and the fissure sealant applied is one of the most common reasons of dental caries development in teeth with fissure sealants. The association between various dental biomaterials may limit the major disadvantages and limitations of biomaterials functioning in a complementary manner. The present study consists in the incorporation of a cariostatic agent – silver diamine fluoride (SDF) – in a resin-based fissure sealant followed by the study of release kinetics by spectrophotometry analysis of the association between both biomaterials and assessment of the inhibitory effect on the growth of the reference bacterial strain Streptococcus mutans (S. mutans) in an in vitro study. Materials and Methods: An experimental in vitro study was designed consisting in the entrapment of SDF (Cariestop^® 12% and 30%) into a commercially available fissure sealant (Fissurit^®), by photopolymerization and photocrosslinking. The same sealant, without SDF was used as a negative control. The effect of the sealants on the growth of S. mutans was determined by the presence of bacterial inhibitory halos in the cultures at the end of the incubation period. In order to confirm the absence of bacteria in the surface of the materials, Scanning Electron Microscopy (SEM) characterization was performed. Also, to analyze the release profile of SDF along time, spectrophotometry technique was applied. Results: The obtained results indicate that the association of SDF to a resin-based fissure sealant may be able to increase the inhibition of S. mutans growth. However, no SDF release was noticed during the in vitro release studies and no statistical significant difference was verified when comparing the inhibitory halo sizes obtained for test and control group.  Conclusions: In this study, the entrapment of SDF in the resin-based fissure sealant did not potentiate the antibacterial effect of the fissure sealant or avoid the immediate development of dental caries. The development of more laboratorial research and, afterwards, long-term clinical data are necessary in order to verify if this association between these biomaterials is effective and can be considered for being used in oral health management. Also, other methodologies for associating cariostatic agents and sealant should be addressed.

Keywords: Biomaterial, fissure sealant, primary prevention, silver diamine fluoride, S. mutans.

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Authors: Ilma Robo, Saimir Heta, Edona Hasanaj, Vera Ostreni

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The hybrid layer (HL), the way it is created and how it is protected against degradation over time, is the key to the clinical success of a composite restoration. The composite supports the dentinal structure exactly with the realized surface of micro-retention. Thus, this surface is in direct proportion to its size versus the duration of clinical use of composite dental restoration. Micro-retention occurs between dentin or acidified enamel and adhesive resin extensions versus pre-prepared spaces, such as hollow dentinal tubules. The way the adhesive resin binds to the acidified dentinal structure depends on the physical or chemical factors of this interrelationship between two structures with very different characteristics. During the acidification process, a precursor to the placement of the adhesive resin layer, activation of metalloproteinases of dental origin occurs, enzymes which are responsible for the degradation of the HL. These enzymes have expressed activity depending on the presence of Zn2+ or Ca2+ ions. There are several ways to inhibit these enzymes, and consequently, there are several ways to inhibit the degradation process of the HL. The study aim is to evaluate chlorhexidine (CHX) as a solution element, inhibitor of dentin activated metalloproteinases, as a result of the application of acidification. This study aims to look at this solution in advantage or contraindication theories, already published in the literature.

Keywords: Hybrid layer, chlorhexidine, degradation, smear layer.

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Authors: S. Hirokawa, M. Fukunaga, M. Mawatari

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Knee joint forces are available by in vivo measurement using an instrumented knee prosthesis for small to moderate knee flexion but not for high flexion yet. We created a 2D mathematical model of the lower limb incorporating several new features such as a patello-femoral mechanism, a thigh-calf contact at high knee flexion and co-contracting muscles' force ratio, then used it to determine knee joint forces arising from high knee flexions in four kneeling conditions: rising with legs in parallel, with one foot forward, with or without arm use. With arms used, the maximum values of knee joint force decreased to about 60% of those with arms not used. When rising with one foot forward, if arms are not used, the forward leg sustains a force as large as that sustained when rising with legs parallel.

Keywords: Knee joint force, kneeling, mathematical model, biomechanics.

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Authors: Isaac Cassar, Trevor Davis, Yi-Kai Lo, Wentai Liu

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Retinal prostheses have been successful in eliciting visual responses in implanted subjects. As these prostheses progress, one of their major limitations is the need for increased resolution. As an alternative to increasing the number of electrodes, virtual electrodes may be used to increase the effective resolution of current electrode arrays. This paper presents a virtual electrode technique based upon time-offsets between stimuli. Two adjacent electrodes are stimulated with identical pulses with too short of pulse widths to activate a neuron, but one has a time offset of one pulse width. A virtual electrode of twice the pulse width was then shown to appear in the center, with a total width capable of activating a neuron. This can be used in retinal implants by stimulating electrodes with pulse widths short enough to not elicit responses in neurons, but with their combined pulse width adequate to activate a neuron in between them.

Keywords: Electrical stimulation, Neuroprosthesis, Retinal implant, Retinal Prosthesis, Virtual electrode.

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Authors: T. Qasim, B. El Masoud, D. Ailabouni

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This in vitro study focused on investigating the fatigue resistance of veneered zirconia molar crowns with different veneering ceramic thicknesses, simulating the relative wear depths under simulated cyclic loading. A mandibular first molar was prepared and then scanned using computer-aided design/computer-aided manufacturing (CAD/CAM) technology to fabricate 32 zirconia copings of uniform 0.5 mm thickness. The manufactured copings then veneered with 1.5 mm, 1.0 mm, 0.5 mm, and 0.0 mm representing 0%, 33%, 66%, and 100% relative wear of a normal ceramic thickness of 1.5 mm. All samples were thermally aged to 6000 thermo-cycles for 2 minutes with distilled water between 5 ˚C and 55 ˚C. The samples subjected to cyclic fatigue and fracture testing using SD Mechatronik chewing simulator. These samples are loaded up to 1.25x10⁶ cycles or until they fail. During fatigue, testing, extensive cracks were observed in samples with 0.5 mm veneering layer thickness. Veneering layer thickness 1.5-mm group and 1.0-mm group were not different in terms of resisting loads necessary to cause an initial crack or final failure. All ceramic zirconia-based crown restorations with varying occlusal veneering layer thicknesses appeared to be fatigue resistant. Fracture load measurement for all tested groups before and after fatigue loading exceeded the clinical chewing forces in the posterior region. In general, the fracture loads increased after fatigue loading and with the increase in the thickness of the occlusal layering ceramic.

Keywords: All ceramic, dental crowns, relative wear, chewing simulator, cyclic loading, thermally ageing.

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Authors: Chau-Kuang Chen, Juanita Buford, Colette Davis, Raisha Allen, John Hughes, Jr., James Tyus, Dexter Samuels

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During the post-Civil War era, the city of Nashville, Tennessee, had the highest mortality rate in the United States. The elevated death and disease rates among former slaves were attributable to lack of quality healthcare. To address the paucity of healthcare services, Meharry Medical College, an institution with the mission of educating minority professionals and serving the underserved population, was established in 1876. Purpose: The social ecological framework and partial least squares (PLS) path modeling were used to quantify the impact of socioeconomic status and adverse health outcome on primary care professionals serving the disadvantaged community. Thus, the study results could demonstrate the accomplishment of the College’s mission of training primary care professionals to serve in underserved areas. Methods: Various statistical methods were used to analyze alumni data from 1975 – 2013. K-means cluster analysis was utilized to identify individual medical and dental graduates in the cluster groups of the practice communities (Disadvantaged or Non-disadvantaged Communities). Discriminant analysis was implemented to verify the classification accuracy of cluster analysis. The independent t-test was performed to detect the significant mean differences of respective clustering and criterion variables. Chi-square test was used to test if the proportions of primary care and non-primary care specialists are consistent with those of medical and dental graduates practicing in the designated community clusters. Finally, the PLS path model was constructed to explore the construct validity of analytic model by providing the magnitude effects of socioeconomic status and adverse health outcome on primary care professionals serving the disadvantaged community. Results: Approximately 83% (3,192/3,864) of Meharry Medical College’s medical and dental graduates from 1975 to 2013 were practicing in disadvantaged communities. Independent t-test confirmed the content validity of the cluster analysis model. Also, the PLS path modeling demonstrated that alumni served as primary care professionals in communities with significantly lower socioeconomic status and higher adverse health outcome (p < .001). The PLS path modeling exhibited the meaningful interrelation between primary care professionals practicing communities and surrounding environments (socioeconomic statues and adverse health outcome), which yielded model reliability, validity, and applicability. Conclusion: This study applied social ecological theory and analytic modeling approaches to assess the attainment of Meharry Medical College’s mission of training primary care professionals to serve in underserved areas, particularly in communities with low socioeconomic status and high rates of adverse health outcomes. In summary, the majority of medical and dental graduates from Meharry Medical College provided primary care services to disadvantaged communities with low socioeconomic status and high adverse health outcome, which demonstrated that Meharry Medical College has fulfilled its mission. The high reliability, validity, and applicability of this model imply that it could be replicated for comparable universities and colleges elsewhere.

Keywords: Disadvantaged Community, K-means Cluster Analysis, PLS Path Modeling, Primary care.

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Authors: John Tolentino, Yong Seok Park

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There are currently many people living with limb loss in the USA. The main causes for amputation can range from vascular disease, to trauma, or cancer. This number is expected increase over the next decade. Many patients have a single prosthetic for the first year but end up getting a second one to accommodate their changing physique. Afterwards, the prosthesis gets replaced every three to five years depending on how often it is used. This could cost the patient up to $500,000 throughout their lifetime. Complications do not end there, however. Due to the absence of nerves, it becomes more difficult to traverse terrain with a prosthetic. Moving on an incline or decline becomes difficult, thus curbs and stairs can be a challenge. Certain physical activities, such as cycling, could be even more strenuous. It will need to be relearned to accommodate for the change in weight, center of gravity, and transfer of energy from the leg to the pedal. The purpose of this research project is to develop a new, alternate below-knee cycling prosthetic using Dieter & Schmidt’s design process approach. It will be subjected to fatigue analysis under dynamic loading to observe the limitations as well as the strengths and weaknesses of the prosthetic. Benchmark comparisons will be made between existing prosthetics and the proposed one, examining the benefits and disadvantages. The resulting prosthetic will be 3D printed using acrylonitrile butadiene styrene (ABS) or polycarbonate (PC) plastic.

Keywords: 3D printing, cycling, prosthetic design, synthetic design.

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Authors: A. Vani, M. N. Mamatha

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Visual signal processing in human beings occurs in the occipital lobe of the brain. The signals that are generated in the brain are universal for all the human beings and they are called Visual Evoked Potential (VEP). Generally, the visually impaired people lose sight because of severe damage to only the eyes natural photo sensors, but the occipital lobe will still be functioning. In this paper, a technique of artificially generating VEP is proposed to enhance the visual ability of the subject. The system uses the electrical photoreceptors to capture image, process the image, to detect and recognize the subject or object. This voltage is further processed and can transmit wirelessly to a BIOMEMS implanted into occipital lobe of the patient’s brain. The proposed BIOMEMS consists of array of electrodes that generate the neuron potential which is similar to VEP of normal people. Thus, the neurons get the visual data from the BioMEMS which helps in generating partial vision or sight for the visually challenged patient. 

Keywords: Visual evoked potential, OpenViBe, BioMEMS, Neuro prosthesis.

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Authors: Binnur Sagbas

Abstract:

Artificial joint replacements such as total knee and total hip prosthesis have been applied to the patients who affected by osteoarthritis. Although different material combinations are used for these joints, biopolymers are most commonly preferred materials especially for acetabular cup and tibial component of hip and knee joints respectively. The main limitation that shortens the service life of these prostheses is wear. Wear is complicated phenomena and it must be considered with friction and lubrication. In this study, micro wave (MW) induced argon+oxygen plasma surface modification were applied on ultra-high molecular weight polyethylene (UHMWPE) and vitamin E blended UHMWPE (VE-UHMWPE) biopolymer surfaces to improve surface wettability and wear resistance of the surfaces. Contact angel measurement method was used for determination of wettability. Ball-on-disc wear test was applied under 25% bovine serum lubrication conditions. The results show that surface wettability and wear resistance of both material samples were increased by plasma surface modification.

Keywords: Artificial joints, plasma surface modification, UHMWPE, vitamin E, wear.

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Authors: Rami N. Khushaba, Ahmed Al-Ani, Adel Al-Jumaily

Abstract:

One of the approaches enabling people with amputated limbs to establish some sort of interface with the real world includes the utilization of the myoelectric signal (MES) from the remaining muscles of those limbs. The MES can be used as a control input to a multifunction prosthetic device. In this control scheme, known as the myoelectric control, a pattern recognition approach is usually utilized to discriminate between the MES signals that belong to different classes of the forearm movements. Since the MES is recorded using multiple channels, the feature vector size can become very large. In order to reduce the computational cost and enhance the generalization capability of the classifier, a dimensionality reduction method is needed to identify an informative yet moderate size feature set. This paper proposes a new fuzzy version of the well known Fisher-s Linear Discriminant Analysis (LDA) feature projection technique. Furthermore, based on the fact that certain muscles might contribute more to the discrimination process, a novel feature weighting scheme is also presented by employing Particle Swarm Optimization (PSO) for estimating the weight of each feature. The new method, called PSOFLDA, is tested on real MES datasets and compared with other techniques to prove its superiority.

Keywords: Discriminant Analysis, Pattern Recognition, SignalProcessing.

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Authors: Jung-hoon Ro, Soo-young Ye, Jae-hee Jung, Ah-young Jeon, Yun-jin KimIn-cheol Kim, Chul-han Kim, Gye-rok Jeon

Abstract:

As the increase of intraoral acidity due to ingestion of sweet foods and acidic beverages usually bring forth a dental caries and a erosion, the measurement of intraoral pH is essential in the study of oral environment. The indwelling intraoral pH telemetry for lasting longer than 24 hours in the mouth was developed to overcome the limits of conventional wire electrode method previously used for salivary and plaque pH measurement, and to assess its effectiveness.

Keywords: pH telemetry, intraoral acidity, wireless.

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Authors: Kevin T. O'Toole, Mark M. McGrath

Abstract:

The psychological and physical trauma associated with the loss of a human limb can severely impact on the quality of life of an amputee rendering even the most basic of tasks very difficult. A prosthetic device can be of great benefit to the amputee in the performance of everyday human tasks. This paper outlines a proposed mechanical design of a 12 degree-of-freedom SMA actuated artificial hand. It is proposed that the SMA wires be embedded intrinsically within the hand structure which will allow for significant flexibility for use either as a prosthetic hand solution, or as part of a complete lower arm prosthetic solution. A modular approach is taken in the design facilitating ease of manufacture and assembly, and more importantly, also allows the end user to easily replace SMA wires in the event of failure. A biomimetric approach has been taken during the design process meaning that the artificial hand should replicate that of a human hand as far as is possible with due regard to functional requirements. The proposed design has been exposed to appropriate loading through the use of finite element analysis (FEA) to ensure that it is structurally sound. Theoretical analysis of the mechanical framework was also carried out to establish the limits of the angular displacement and velocity of the finger tip as well finger tip force generation. A combination of various polymers and Titanium, which are suitably lightweight, are proposed for the manufacture of the design.

Keywords: Hand prosthesis, mechanical design, shape memory alloys, wire bundle actuation.

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Authors: R. Pääkkönen, L. Korpinen, T. Kava, I. Salmi

Abstract:

This study evaluates obstructive sleep apnea treatment through a case study involving a 67-year-old male driver who had a successful continuous positive airway pressure (CPAP) treatment at home but experienced difficulties with traveling and dental care. There are many cheap sleep apnea and snoring devices available, but there is little professional advice on what kind of devices can help. Professional drivers receive yearly specialized medical care follow-up.

Keywords: Sleep, apnea patient, CPAP, professional driver.

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Authors: Anamaria Bechir, Rodica Sirbu, Minodora Leca, Maria Maris, Dan Artenie Maris, Emilia Mihaela Cadar, Marius Maris

Abstract:

This paper aims at presenting the biotechnology used to obtain collagen-based gels from shark (Squalus acanthias) and brill skin, marine fish growing in the Black Sea. Due to the structure of its micro-fibres, collagen can be considered a nanomaterial; in order to use collagen-based matrixes as biomaterial, rheological studies must be performed first, to state whether they are stable or not. For the triple-helix structure to remain stable within these gels at room or human body temperature, they must be stabilized by reticulation.

Keywords: Collagen, biotechnology, reticulation.

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Authors: Gabi N. Nehme

Abstract:

Below-knee amputees commonly experience asymmetrical gait patterns. It is generally believed that ischemia is related to the formation of pressure sores due to uneven distribution of forces. Micro-vascular responses can reveal local malnutrition. Changes in local skin blood supply under various external loading conditions have been studied for a number of years. Radionuclide clearance, photo-plethysmography, trans-cutaneous oxygen tension along with other studies showed that the blood supply would be influenced by the epidermal forces, and the rate and the amount of blood supply would decrease with increased epidermal loads being shear forces or normal forces. Several cases of socket designs were investigated using Finite Element Model (FEM) and Design of Experiment (DOE) to increase flexibility and minimize the pressure at the limb/socket interface using ultra high molecular weight polyethylene (UHMWPE) and polyamide 6 (PA6) or Duraform. The pressure reliefs at designated areas where reducing thickness is involved are seen to be critical in determination of amputees’ comfort and are very important to clinical applications. Implementing a hole between the Patellar Tendon (PT) and Distal Tibia (DT) would decrease stiffness and increase prosthesis range of motion where flexibility is needed. In addition, displacement and prosthetic energy storage increased without compromising mechanical efficiency and prosthetic design integrity.

Keywords: Patellar tendon, distal tibia, prosthetic socket, relief areas, hole implementation.

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