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Keywords = new cervical implant design

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13 pages, 4744 KiB  
Article
Preclinical Experimental Study on New Cervical Implant Design to Improve Peri-Implant Tissue Healing
by Sergio Alexandre Gehrke, Guillermo Castro Cortellari, Jaime Aramburú Júnior, Tiago Luis Eilers Treichel, Marco Aurelio Bianchini, Antonio Scarano and Piedad N. De Aza
Bioengineering 2024, 11(11), 1155; https://doi.org/10.3390/bioengineering11111155 - 16 Nov 2024
Viewed by 1517
Abstract
Objectives: In this preclinical study, we used an experimental rabbit model to investigate the effects of a new implant design that involves specific changes to the cervical portion, using a conventional implant design in the control group. Materials and Methods: We used 10 [...] Read more.
Objectives: In this preclinical study, we used an experimental rabbit model to investigate the effects of a new implant design that involves specific changes to the cervical portion, using a conventional implant design in the control group. Materials and Methods: We used 10 rabbits and 40 dental implants with two different macrogeometries. Two groups were formed (n = 20 per group): the Collo group, wherein implants with the new cervical design were used, which present a concavity (reduction in diameter) in the first 3.5 mm, the portion without surface treatment; the Control group, wherein conical implants with the conventional design were used, with surface treatment throughout the body. All implants were 4 mm in diameter and 10 mm in length. The initial implant stability quotient (ISQ) was measured immediately after the implant insertion (T1) and sample removal (T2 and T3). The animals (n = five animals/time) were euthanized at 3 weeks (T1) and 4 weeks (T2). Histological sections were prepared and the bone–implant contact (BIC%) and tissue area fraction occupancy (TAFO%) percentages were analyzed in the predetermined cervical area; namely, the first 4 mm from the implant platform. Results: The ISQ values showed no statistical differences at T1 and T2 (p = 0.9458 and p = 0.1103, respectively) between the groups. However, at T3, higher values were found for the Collo group (p = 0.0475) than those found for the Control group. The Collo samples presented higher BIC% values than those of the Control group, with statistical differences of p = 0.0009 at 3 weeks and p = 0.0007 at 4 weeks. There were statistical differences in the TAFO% (new bone, medullary spaces, and the collagen matrix) between the groups at each evaluation time (p < 0.001). Conclusions: Considering the limitations of the present preclinical study, the results demonstrate that the new implant design (the Collo group) had higher implant stability (ISQ) values in the samples after 4 weeks of implantation. Furthermore, the histomorphometric BIC% and TAFO% analyses showed that the Collo group had higher values at both measurement times than the Control group did. These findings indicate that changes made to the cervical design of the Collo group implants may benefit the maintenance of peri-implant tissue health. Full article
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14 pages, 7608 KiB  
Case Report
Peri-Implant Tissue Stability: A Series of Five Case Reports on an Innovative Implant Design
by Marco Aurélio Bianchini, Mario Escobar, Maria Elisa Galarraga-Vinueza, Thalles Yurgen Balduino and Sergio Alexandre Gehrke
Appl. Sci. 2024, 14(18), 8354; https://doi.org/10.3390/app14188354 - 17 Sep 2024
Viewed by 2539
Abstract
Background/Aim: The stability of peri-implant tissues is crucial for the long-term success of dental implant treatments. A new cervical implant design has been developed to address the challenges associated with peri-implant tissue stability, featuring a concave cervical portion to increase tissue volume in [...] Read more.
Background/Aim: The stability of peri-implant tissues is crucial for the long-term success of dental implant treatments. A new cervical implant design has been developed to address the challenges associated with peri-implant tissue stability, featuring a concave cervical portion to increase tissue volume in this area. The present study aimed to clinically evaluate the effectiveness of the new cervical implant design in maintaining peri-implant tissue stability. Materials and Methods: Five clinical cases involving completely edentulous patients were selected, in which 25 implants were installed. The marginal bone level around each implant was assessed at three different time points—T0: immediately after the prosthesis installation, T1: 6 months post installation, and T2: at the last control visit, up to 38 months later. Measurements were taken to analyze changes in marginal bone levels (MBLs) and the keratinized mucosa (KM) over time. Furthermore, the keratinized mucosa (KM) around the implants was evaluated. Results: The mean and standard deviation values of the marginal bone levels at each time point were as follows—T0: 0.59 ± 0.55 mm; T1: 1.41 ± 0.59 mm; T2: 1.76 ± 0.69 mm. Statistical analysis showed significant differences across the time points (ANOVA p < 0.0001). The overall mean KM values were 3.85 mm for T1 and T2, showing the stability of the peri-implant soft tissues at ≥1-year controls. Conclusion: Within the limitations of the present study, the results showed that the Collo implants presented measured MBL values increasing within the time range analyzed in each case but within the normal values cited in the literature for these types of rehabilitation treatments. However, the measured KM values presented, in all cases, an average above the values referenced in the literature as a minimum for maintaining the health of the peri-implant tissues. Full article
(This article belongs to the Special Issue Implant Dentistry: Advanced Materials, Methods and Technologies)
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13 pages, 5366 KiB  
Article
Controlled Lateral Pressure on Cortical Bone Using Blade-Equipped Implants: An Experimental Study in Rabbits
by Vitor Ferreira Balan, Mauro Ferri, Eduardo Pires Godoy, Leticia Gabriela Artioli, Daniele Botticelli, Erick Ricardo Silva and Samuel Porfirio Xavier
Bioengineering 2024, 11(8), 835; https://doi.org/10.3390/bioengineering11080835 - 16 Aug 2024
Cited by 3 | Viewed by 1296
Abstract
Background: This study aimed to evaluate the biological behavior of a novel implant design incorporating decompressive cervical blades. Hence, the aim of the present study was to evaluate the healing outcomes in cortical regions where decompressive protocols were implemented using implants equipped with [...] Read more.
Background: This study aimed to evaluate the biological behavior of a novel implant design incorporating decompressive cervical blades. Hence, the aim of the present study was to evaluate the healing outcomes in cortical regions where decompressive protocols were implemented using implants equipped with blades and installed applying a bicortical anchorage. Materials and Methods: Blades with varying diameters were integrated into the coronal portion of the implant to prepare the cortical region of rabbit tibiae. The blade diameters differed from the implant collar by the following amounts: control group (0 µm), +50 µm, and +200 µm. Results: No marginal bone loss was detected. Instead, all implants exhibited new bone formation in the coronal region. Complete closure was observed in the CG-0 group, as well as in the TG-50 and TG-200 groups, despite the presence of marginal gaps without primary bone contact at installation. In the apical region, most implants breached the cortical layer. Nevertheless, new bone formation in this region completely closed the osteotomy, effectively isolating the internal environment of the tibia from the external. Conclusions: The use of a blade incorporated into the implant body enabled precise preparation of the cortical layer, allowing for controlled decompression in the targeted area. This technique resulted in optimal osseointegration with no loss of marginal bone, and complete restoration of marginal gaps ranging from 0 µm to 200 µm. Full article
(This article belongs to the Section Biomedical Engineering and Biomaterials)
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31 pages, 4570 KiB  
Perspective
Advancements in Custom 3D-Printed Titanium Interbody Spinal Fusion Cages and Their Relevance in Personalized Spine Care
by Kai-Uwe Lewandrowski, Shaleen Vira, John C. Elfar and Morgan P. Lorio
J. Pers. Med. 2024, 14(8), 809; https://doi.org/10.3390/jpm14080809 - 30 Jul 2024
Cited by 7 | Viewed by 4675
Abstract
3D-printing technology has revolutionized spinal implant manufacturing, particularly in developing personalized and custom-fit titanium interbody fusion cages. These cages are pivotal in supporting inter-vertebral stability, promoting bone growth, and restoring spinal alignment. This article reviews the latest advancements in 3D-printed titanium interbody fusion [...] Read more.
3D-printing technology has revolutionized spinal implant manufacturing, particularly in developing personalized and custom-fit titanium interbody fusion cages. These cages are pivotal in supporting inter-vertebral stability, promoting bone growth, and restoring spinal alignment. This article reviews the latest advancements in 3D-printed titanium interbody fusion cages, emphasizing their relevance in modern personalized surgical spine care protocols applied to common clinical scenarios. Furthermore, the authors review the various printing and post-printing processing technologies and discuss how engineering and design are deployed to tailor each type of implant to its patient-specific clinical application, highlighting how anatomical and biomechanical considerations impact their development and manufacturing processes to achieve optimum osteoinductive and osteoconductive properties. The article further examines the benefits of 3D printing, such as customizable geometry and porosity, that enhance osteointegration and mechanical compatibility, offering a leap forward in patient-specific solutions. The comparative analysis provided by the authors underscores the unique challenges and solutions in designing cervical, and lumbar spine implants, including load-bearing requirements and bioactivity with surrounding bony tissue to promote cell attachment. Additionally, the authors discuss the clinical outcomes associated with these implants, including the implications of improvements in surgical precision on patient outcomes. Lastly, they address strategies to overcome implementation challenges in healthcare facilities, which often resist new technology acquisitions due to perceived cost overruns and preconceived notions that hinder potential savings by providing customized surgical implants with the potential for lower complication and revision rates. This comprehensive review aims to provide insights into how modern 3D-printed titanium interbody fusion cages are made, explain quality standards, and how they may impact personalized surgical spine care. Full article
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14 pages, 3722 KiB  
Article
A New Method to Evaluate Pressure Distribution Using a 3D-Printed C2-C3 Cervical Spine Model with an Embedded Sensor Array
by Maohua Lin, Rudy Paul, Xinqin Liao, James Doulgeris, Emma Lilly Menzer, Utpal Kanti Dhar, Chi-Tay Tsai and Frank D. Vrionis
Sensors 2023, 23(23), 9547; https://doi.org/10.3390/s23239547 - 1 Dec 2023
Cited by 4 | Viewed by 2440
Abstract
Cervical degenerative disc diseases such as myelopathy and radiculopathy often require conventional treatments like artificial cervical disc replacement or anterior cervical discectomy and fusion (ACDF). When designing a medical device, like the stand-alone cage, there are many design inputs to consider. However, the [...] Read more.
Cervical degenerative disc diseases such as myelopathy and radiculopathy often require conventional treatments like artificial cervical disc replacement or anterior cervical discectomy and fusion (ACDF). When designing a medical device, like the stand-alone cage, there are many design inputs to consider. However, the precise biomechanics of the force between the vertebrae and implanted devices under certain conditions require further investigation. In this study, a new method was developed to evaluate the pressure between the vertebrae and implanted devices by embedding a sensor array into a 3D-printed C2-C3 cervical spine. The 3D-printed cervical spine model was subjected to a range of axial loads while under flexion, extension, bending and compression conditions. Cables were used for the application of a preload and a robotic arm was used to recreate the natural spine motions (flexion, extension, and bending). To verify and predict the total pressure between the vertebrae and the implanted devices, a 3D finite element (FE) numerical mathematical model was developed. A preload was represented by applying 22 N of force on each of the anterior tubercles for the C2 vertebra. The results of this study suggest that the sensor is useful in identifying static pressure. The pressure with the robot arm was verified from the FE results under all conditions. This study indicates that the sensor array has promising potential to reduce the trial and error with implants for various surgical procedures, including multi-level artificial cervical disk replacement and ACDF, which may help clinicians to reduce pain, suffering, and costly follow-up procedures. Full article
(This article belongs to the Section Biomedical Sensors)
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12 pages, 1251 KiB  
Review
Cervical and Lumbar Disc Arthroplasty: A Review of Current Implant Design and Outcomes
by Ian J. Wellington, Cameron Kia, Ergin Coskun, Barrett B. Torre, Christopher L. Antonacci, Michael R. Mancini, John P. Connors, Sean M. Esmende and Heeren S. Makanji
Bioengineering 2022, 9(5), 227; https://doi.org/10.3390/bioengineering9050227 - 23 May 2022
Cited by 14 | Viewed by 5550
Abstract
While spinal disc pathology has traditionally been treated using fusion-based procedures, recent interest in motion-preserving disc arthroplasties has grown. Traditional spinal fusion is associated with loss of motion, alteration of native spine kinematics, and increased risks of adjacent segment disease. The motion conferred [...] Read more.
While spinal disc pathology has traditionally been treated using fusion-based procedures, recent interest in motion-preserving disc arthroplasties has grown. Traditional spinal fusion is associated with loss of motion, alteration of native spine kinematics, and increased risks of adjacent segment disease. The motion conferred by disc arthroplasty is believed to combat these complications. While the first implant designs resulted in poor patient outcomes, recent advances in implant design and technology have shown promising radiographic and clinical outcomes when compared with traditional fusion. These results have led to a rapid increase in the utilization of disc arthroplasty, with rates of cervical arthroplasty nearly tripling over the course of 7 years. The purpose of this review was to discuss the evolution of implant design, the current implant designs utilized, and their associated outcomes. Although disc arthroplasty shows significant promise in addressing some of the drawbacks associated with fusion, it is not without its own risks. Osteolysis, implant migration, and the development of heterotopic ossification have all been associated with disc arthroplasty. As interest in these procedures grows, so does the interest in developing improved implant designs aimed at decreasing these adverse outcomes. Though they are still relatively new, cervical and lumbar disc arthroplasty are likely to become foundational methodologies for the treatment of disc pathology. Full article
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11 pages, 2464 KiB  
Article
Radiation Grafting of a Polymeric Prodrug onto Silicone Rubber for Potential Medical/Surgical Procedures
by Hector Magaña, Claudia D. Becerra, Aracely Serrano-Medina, Kenia Palomino, Giovanni Palomino-Vizcaíno, Amelia Olivas-Sarabia, Emilio Bucio and José M. Cornejo-Bravo
Polymers 2020, 12(6), 1297; https://doi.org/10.3390/polym12061297 - 5 Jun 2020
Cited by 13 | Viewed by 3534
Abstract
Silicone rubber (SR) is a material used for medical procedures, with a common example of its application being in implants for cosmetic or plastic surgeries. It is also an essential component for the development of medical devices. SR was functionalized with the polymeric [...] Read more.
Silicone rubber (SR) is a material used for medical procedures, with a common example of its application being in implants for cosmetic or plastic surgeries. It is also an essential component for the development of medical devices. SR was functionalized with the polymeric prodrug of poly(2-methacryloyloxy-benzoic acid) (poly(2MBA)) to render the analgesic anti-inflammatory drug salicylic acid by hydrolysis. The system was designed by functionalizing SR films (0.5 cm × 1 cm) with a direct grafting method, using gamma irradiation (60Co source) to induce the polymerization process. The absorbed dose (from 20 to 100 kGy) and the monomer concentration (between 0.4 and 1.5 M) were critical in controlling the surface and the bulk modifications of SR. Grafting poly(2MBA) onto SR (SR-g-2MBA) were characterized by attenuated total reflectance Fourier transform infrared spectroscopy, thermogravimetric analysis, scanning electron microscopy/energy-dispersive X-ray spectrometry, fluorescence microscopy, the contact angle, and the swelling. SR-g-2MBA demonstrated the drug’s sustained and pH-dependent release in simulated physiological mediums (pH = 5.5 and 7.4). The drug’s release was quantified by high-performance liquid chromatography and confirmed by gas chromatography–mass spectrometry. Finally, cytocompatibility was demonstrated in murine fibroblast and human cervical cancer cell lines. The developed systems provide new polymeric drug release systems for medical silicone applications. Full article
(This article belongs to the Special Issue Biomedical Polymer Materials II)
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11 pages, 3780 KiB  
Article
Evaluation of a New Dental Implant Cervical Design in Comparison with a Conventional Design in an Experimental American Foxhound Model
by Maria Ángeles Pérez-Albacete Martínez, Carlos Pérez-Albacete Martínez, José Eduardo Maté Sánchez De Val, María Luisa Ramos Oltra, Manuel Fernández Domínguez and Jose Luis Calvo Guirado
Materials 2018, 11(4), 462; https://doi.org/10.3390/ma11040462 - 21 Mar 2018
Cited by 7 | Viewed by 4968
Abstract
The aim of this study was to evaluate osseointegration and crestal bone height in implants with a triangular cervical design in comparison with a standard rounded cervical design. The control group consisted of 24 implants with a standard cervical design, and the test [...] Read more.
The aim of this study was to evaluate osseointegration and crestal bone height in implants with a triangular cervical design in comparison with a standard rounded cervical design. The control group consisted of 24 implants with a standard cervical design, and the test group of 24 implants with a triangular cervical design. The implants were inserted in healed bone in six American Foxhounds. Crestal bone height and tissue thickness in the cervical portion were measured after 12 weeks healing. Data analysis found mean crestal bone loss of: 0.31 ± 0.24 mm on the buccal side, 0.35 ± 0.14 mm on the lingual in the test group, and 0.71 ± 0.28 mm buccal loss, and 0.42 ± 0.30 mm lingual in the control group; with statistically significant differences on the buccal aspect (p = 0.0019). Mean tissue thickness in the test group was 1.98 ± 0.17 mm on the buccal aspect, and 2.43 ± 0.93 mm in the lingual; in the control group it was 2.48 ± 0.61 mm buccal thickness, and 2.88 ± 0.14 mm lingual, with significant differences on both aspects (p = 0.0043; p = 0.0029). The results suggest that greater thickness of peri-implant tissue can be expected when the triangular cervical implant design is used rather than the standard cervical design. Full article
(This article belongs to the Special Issue Dental Implant Materials)
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