Search Results (29)

Laser powder bed fusion (LPBF) is an advanced additive manufacturing technology that is gaining increasing interest for biomedical implants because it can produce dense, patient-specific metallic components with controlled microstructures. This study investigated the LPBF fabrication of 316L stainless steel, which is widely used in orthopedic and dental implants, and examined the effects of laser power and scanning speed on the microstructure and mechanical properties relevant to biomedical applications. The study achieved 99.97% density and refined columnar and cellular austenitic grains, with optimized molten pool morphology. The optimal LPBF parameters, 190 W laser power and 700 mm/s, produced a tensile strength of 762.83 MPa and hardness of 253.07 HV_0.2, which exceeded the values of conventional cast 316L stainless steel. These results demonstrated the potential of optimized LPBF 316L stainless steel for functional biomedical applications that require high mechanical integrity and biocompatibility. Full article

Magnesium-based biomaterials have emerged as highly promising candidates in the realm of biomedical engineering due to certain unique properties. However, their widespread application has been limited by a number of challenges, such as insufficient mechanical strength and rapid degradation rates. This study sought to advance the development of high-performance magnesium alloys by examining the microstructural evolution and associated strengthening mechanisms of Mg-Zn alloys modified with varying Nd contents. Comprehensive characterization techniques—including optical microscopy, XRD, and SEM/EDS—were employed to explain the influence of Nd additions on the microstructures. Mechanical performance was assessed through hardness testing, the RFDA method for elastic modulus, and tensile testing. The microstructural analysis of the as-cast Mg-Zn-Nd alloys revealed a complex phase composition comprising dendritic α-Mg, Mg₄₁Nd₅, and a Mg₃Nd binary phase enriched with rare earth elements. Notably, increasing the Nd content from 0.5% to 5% by weight resulted in a significant enhancement of hardness, reaching 59 HV compared to 42 HV in the base alloy. The tensile strength increased significantly from 62.9 MPa in the Mg-2.5Zn-0.5Nd alloy to 186.8 MPa in the Mg-2.5Zn-5Nd alloy. The elastic modulus values across all investigated alloys remained consistently comparable, which is expected as the elastic modulus is primarily determined by atomic bonding and is not significantly affected by alloying additions. These findings underscore the potential of Nd-alloyed Mg-Zn systems as viable, mechanically robust alternatives for next-generation biodegradable orthopedic implants. Full article

Biodegradable magnesium-based composites show potential application in orthopedic implants, with excellent biocompatibility, low density, and biodegradable characteristics inside the human body. In this study, the stir casting procedure was employed to produce magnesium–zinc MMCs (metal matrix composites) reinforced with MgO nanoparticles, and they were characterized intensively. The analyzed compositions were Mg/4Zn, Mg/4Zn/0.4MgO, and Mg/4Zn/0.6MgO. Their mechanical properties, corrosion resistance, and microstructure were then investigated employing tensile, impact, hardness, wear, and corrosion tests, supplemented with SEM analysis. The results indicate that the Mg-4Zn-0.6MgO composite exhibited the highest performance among the tested formulations, with a tensile strength of 150 MPa, a hardness of 65 HRE (Rockwell Hardness, E-scale), and enhanced corrosion resistance. These improvements are attributed to the uniform dispersion of MgO nanoparticles and the formation of a protective Mg(OH)₂ layer, which together contribute to mechanical reinforcement and controlled degradation behavior. The combination of superior mechanical properties and customizable biodegradability verifies the engineered Mg/4Zn/0.6MgO composite as a promising candidate for a biodegradable orthopedic fixation plate without secondary surgery. Full article

Three-dimensional printing technology offers significant advantages in the production of orthopedic casts, providing a promising alternative to conventional plaster and fiberglass materials. Polylactic acid (PLA) is widely used for this purpose; however, its adoption is limited due to poor mechanical properties, including high brittleness, low thermal stability, and limited elongation. These challenges can be mitigated by blending PLA with other biodegradable polymers. This study investigated a blend of PLA with poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV), a type of polyhydroxyalkanoate (PHA), and polycaprolactone (PCL) for the development of 3D printed orthopedic casts. The key mechanical properties—tensile strength, percent elongation at break, Young’s modulus, flexural strength, flexural modulus, and impact strength—were evaluated as a function of the printing parameters, including nozzle temperature, layer height, and raster angle. The grey relational analysis (GRA) approach was applied to optimize these mechanical properties. The optimal printing parameters were found to be a nozzle temperature of 180 °C, a layer height of 0.18 mm, and a raster angle of 0°, resulting in a tensile strength of 44.4 ± 4.4 MPa, an elongation at break of 68.5 ± 11.6%, a Young’s modulus of 948.7 ± 25.1 MPa, a flexural strength of 54.6 ± 8.9 MPa, a flexural modulus of 1549.3 ± 141 MPa, and an impact strength of 80.77 ± 5.6 J/m. Statistical analysis using analysis of variance (ANOVA) revealed that for tensile strength, 50.18% was influenced by the raster angle, 26.38% by the layer height, and 18.92% by the nozzle temperature; for flexural strength, 69.81% was influenced by the raster angle, 20.67% by the layer height, and 3.53% by the nozzle temperature; and for impact strength, 75.11% was influenced by the raster angle, 13.16% by the layer height, and 4.45% by the nozzle temperature. Full article

Introduction: Patients with orthopedic injuries often require cast immobilization therapy using casts. Driving with a cast on the right lower limb restricts many things. This study aimed to investigate the factors associated with driving capacity after orthopedic fixation of the right lower limb in healthy adult volunteers. This study’s hypothesis was that the orthopedic splint immobilization would have delayed reaction when in a driving simulation. Materials and Methods: We carried out an experimental study between 17 April 2023 and 19 May 2023. We set up the study in two phases: a driving simulation experiment without immobilization with a cast on the right lower limb and a driving simulation experiment with immobilization with a cast on the right lower limb. The data collected through the questionnaire were then analyzed in R version 4.2.2. Results: A total of 47 individuals participated in the study with a mean height of 167.68, of which 68.09% were females. Overall, 78.7% of the study participants could not drive after immobilization with a cast on the right lower limb. There was a significant difference between participants who could drive and those who could not drive by height (p = 0.04), age (p = 0.038), and body type (p = 0.046). Conclusions: Our study demonstrates that an individual’s height, age, and body type are associated with an individual’s driving ability after orthopedic immobilization of the right lower limb. Our findings suggest that regulations regarding the ability to drive after orthopedic immobilization of the right lower limb must be reconsidered. Full article

Atypical swallowing has a high incidence in growing subjects. Orthopedic treatment with orthodontic appliances and speech therapy are the main approaches to this problem. The aim of this prospective study was to evaluate the changes in the dental arches induced by one year of treatment with the Froggy Mouth myofunctional appliance designed to correct atypical swallowing. In total, 16 patients with atypical swallowing were instructed to use the Froggy Mouth appliance. A digital intraoral impression was taken at baseline (T0). The Froggy Mouth appliance had to be used for 15 min/day throughout the treatment period. At the end of the first year of treatment (T1), another impression was taken with the same intraoral scanner. Digital casts of the T0 and T1 impressions were obtained using software and the two casts were superimposed to record the following measurements: upper intercanine distance, upper arch diameter, upper arch width, overbite and overjet. The data were statistically analyzed (significance threshold: p < 0.05). Student’s t-test was used to compare pre- and post-treatment measurements. Linear regressions were performed to assess the influence of arch width on anterior and posterior diameters. A significant increase was found for the upper arch diameters (p < 0.05), whereas no statistically significant difference was found for the incisor relationship (overjet/overbite) (p > 0.05). To date, the efficacy of this appliance has not been extensively studied. According to the present prospective study, the Froggy Mouth protocol could be a valuable method as a myofunctional therapy for atypical swallowing, but further studies are needed to confirm these preliminary results. Full article

To develop an orthopedic scaffold that could overcome the limitations of implants used in clinics, we designed poly(ester-urethane) foams and compared their properties with those of a commercial gold standard. A degradable poly(ester-urethane) was synthetized by polyaddition between a diisocyanate poly(ε-caprolactone) prepolymer (PCL di-NCO, M_n = 2400 g·mol⁻¹) and poly(lactic-co-glycolic acid) diol (PLGA, M_n = 2200 g·mol⁻¹) acting as a chain extender. The resulting high-molecular-weight poly(ester-urethane) (PEU, M_n = 87,000 g·mol⁻¹) was obtained and thoroughly characterized by NMR, FTIR and SEC-MALS. The porous scaffolds were then processed using the solvent casting (SC)/particle leaching (PL) method with different NaCl crystal concentrations. The morphology, pore size and porosity of the foams were evaluated using SEM, showing interconnected pores with a uniform size of around 150 µm. The mechanical properties of the scaffolds are close to those of the human meniscus (Ey = 0.5~1 MPa). Their degradation under accelerated conditions confirms that incorporating PLGA into the scaffolds greatly accelerates their degradation rate compared to the gold-standard implant. Finally, a cytotoxicity study confirmed the absence of the cytotoxicity of the PEU, with a 90% viability of the L929 cells. These results suggest that degradable porous PLGA/PCL poly(ester-urethane) has potential in the development of meniscal implants. Full article

The effects of occupational isocyanate exposure range from asthma and contact dermatitis to neurotoxicity and cancer. Respiratory sensitization due to orthopedic cast application has been well documented. This study aims to compare the safety of standard-of-care fiberglass casts and a novel waterproof cast alternative by measuring the amount of isocyanate released during off-gassing over time. A 3D-printed arm simulator with comparable casing material amounts was placed in a sealed chamber. An isocyanate-sensing color-changing (SafeAir) tag was used to measure the levels of toxic exposure. Triplicate trials were conducted across all time periods (15 min, 1 h, and 24 h) and conditions. The bare arm simulator and freshly opened tags served as negative controls. Normalized pixel intensity indexes and isocyanate release estimates in ppb were derived from ImageJ-analyzed SafeAir tag photos. Fiberglass casts exhibited greater isocyanate release than both the waterproof alternative (p = 0.0002) and no-cast controls (p = 0.0006), particularly at 24 h. The waterproof alternative and no-cast control did not statistically differ (p = 0.1603). Therefore, the waterproof alternative released less isocyanate than the fiberglass casts. Waterproof cast alternatives may be safer than fiberglass by limiting medical professionals’ exposure to toxic isocyanates and, thus, decreasing their risk of suffering occupational asthma. Full article

Fabrication, characterization and testing of protective biomimetic orthopedic footwear advanced insole materials are introduced. The main objective of this material is to preserve and isolate a set of sensors for the Weight-Bearing Monitoring System (WBMS) device. Twenty-one samples of renewably sourced Polyurethane Foam (PUF) composed of poly(trimethylene ether) glycol (PO₃G) and unmodified castor oil (CO) were synthesized and evaluated according to predetermined criteria. Response surface methodology of Box—Behnken design was applied to study the effect of the polyols ratio, isocyanate index (II), and blowing agent ratio on the properties (hardness, density) of PUFs. Results showed that CO/PO₃G/Tolyene Diisocyanate (TDI) PUFs with hardness Shore A 17–22 and density of 0.19–0.25 g/cm³ demonstrate the required characteristics and can potentially be used as a durable and functional insole material. Phase separation studies have found the presence of well-segregated structures in PUFs having polyols ratio of CO:PO₃G 1:3 and low II, which further explains their extraordinary elastic properties (400% elongation). Analysis of cushioning performance of PUF signified that five samples have Cushioning Energy (CE) higher than 70 N·mm and Cushioning Factor (CF) in the range of 4–8, hence are recommended for application in WBMS due to superior weight-bearing and pressure-distributing properties. Moreover, the developed formulation undergoes anaerobic soil bacterial degradation and can be categorized as a “green” bio-based material. Full article

In this paper, we present the mechanisms of premature fracture of modular neck stems in two case studies: (I) when the neck and stem are both made of the same Ti6Al4V alloy, and (II) when the neck and stem are made from two different alloys, CoCrMo and Ti6Al4V alloy. Our study integrates two orthopedic patients who have undergone primary uncemented THA for usual indications in two orthopedic centers (Community Health Centre and University Medical Centre). Both centers are part of the national public health care system. Both surgeries were performed by two skilled orthopedic surgeons with more than 10 years of experience in THA. The survivorship of the modular neck of cast CoCrMo alloy was 24 months. The survivorship of the modular neck from Ti6Al4V alloy was 84 months. Multivariate analyses were performed to assess the differences in the fretting, corrosion, and fatigue of the two prematurely failed modular neck stems: stereo light microscopy (SLM), scanning electron microscopy (SEM), X-ray energy-dispersive spectroscopy (EDS), and electron backscatter diffraction (EBSD). Patient demographic information, including sex, age, body mass index, survivorship of implants, and reason for the revision, was collected from medical records. We found that fretting and fatigue occurred on both neck-stem retrievals due to additional galvanic corrosion, but the CoCrMo/Ti6Al4V alloy system suffered more corrosion due to additional galvanic corrosion and fractured earlier than the Ti6Al4V/Ti6Al4V metal alloy system. Both metallic alloy systems used in this application are known to be highly corrosion-resistant, but the bio-tribo-corrosion processes need to be understood in detail and characterized so that appropriate improvements in design and materials can be made. Full article

Bone defects, a common orthopedic problem in clinical practice, are a serious threat to human health. As alternative materials to autologous bone grafts, synthetic cell-free functionalized scaffolds have been the focus of recent research in designing scaffolds for bone tissue engineering. Butyryl chitin (BC) is a derivative of chitin (CT) with improved solubility. It has good biocompatibility, but few studies have investigated its use in bone repair. In this study, BC was successfully synthesized with a degree of substitution of 2.1. BC films were prepared using the cast film method and showed strong tensile strength (47.8 ± 4.54 N) and hydrophobicity (86.4 ± 2.46°), which was favorable for mineral deposition. An in vitro cytological assay confirmed the excellent cell attachment and cytocompatibility of the BC film; meanwhile, in vivo degradation indicated the good biocompatibility of BC. Hydroxyapatite (HA), extracted from bovine cancellous bone, had good cytocompatibility and osteogenic induction activity for the mouse osteoblast cell line MC3T3-E1. With the aim of combining the advantages of BC and HA, a BC–HA composite scaffold, with a good pore structure and mechanical strength, was prepared by physical mixing. Administered into skull defects of rats, the scaffolds showed perfect bone-binding performance and effective structural support, and significantly promoted the regeneration of new bone. These results prove that the BC–HA porous scaffold is a successful bone tissue engineering scaffold and has strong potential to be further developed as a substitute for bone transplantation. Full article

Aim: The upper jaw transverse deficit is certainly one of the most common clinical issues in the orthodontic field. It can be due to skeletal or dental factors, and its etiology may be both genetic and environmental. Rapid maxillary expanders (RMEs) are certainly the most effective appliance for upper transverse deficiency correction. The aim of this study was to evaluate the changes that occurred in the mandibular arch during treatment with RMEs in growing subjects by analyzing tridimensional lower digital casts. Materials and Methods: The study group (SG) consisted of 20 subjects (10 M, 10 F; mean age 9.4 ± 2.8 years old) randomly selected at the Department of Orthodontics at the University of Rome, “Tor Vergata”. The inclusion criteria were negative posterior transverse interarch discrepancy ≥ 4 mm, mixed dentition phase with first permanent molars erupted, and prepubertal skeletal maturation stage (CS1-2), evaluated on a lateral radiograph through the Cervical Vertebral Maturation method. The SG was compared to an untreated control group (CG) of 20 subjects (10 M, 10 F, mean age 8.7 ± 2.3 years old) enrolled with the same inclusion criteria. The SG was treated by using RMEs. Dental casts of the lower arch were taken at two different times (T0–T1 = 6 months). All the dental casts were scanned with an OrthoXscan (Dentaurum 6mmbh E Co., Ispringen, Germany) and twenty points on the mandibular arch were digitized using Viewbox software. A Student t-test was used to compare the means of the quantitative variables associated with the effect of the device over time T0 and T1. Results: The results show a statistically significant increase (p < 0.05) in the intercanine and the intermolar diameters between the times T0 and T1 when compared to the CG. Conclusions: Rapid maxillary orthopedic expansion may achieve an increase in mandibular intercanine and intermolar diameter. Full article

The High Speed High Pressure Torsion (HSHPT) is the severe plastic deformation method (SPD) designed for the grain refinement of hard-to-deform alloys, and it is able to produce large, rotationally complex shells. In this paper, the new bulk nanostructured Ti-Nb-Zr-Ta-Fe-O Gum metal was investigated using HSHPT. The biomaterial in the as-cast state was simultaneously compressed up to 1 GPa and torsion was applied with friction at a temperature that rose as a pulse in less than 15 s. The interaction between the compression, the torsion, and the intense friction that generates heat requires accurate 3D finite element simulation. Simufact Forming was employed to simulate severe plastic deformation of a shell blank for orthopedic implants using the advancing Patran Tetra elements and adaptable global meshing. The simulation was conducted by applying to the lower anvil a displacement of 4.2 mm in the z-direction and applying a rotational speed of 900 rpm to the upper anvil. The calculations show that the HSHPT accumulated a large plastic deformation strain in a very short time, leading to the desired shape and grain refinement. Full article

This paper presents a comprehensive effort to develop and analyze first-of-its-kind design-specific and bioactive piezoelectric scaffolds for treating orthopedic defects. The study has three major highlights. First, this is one of the first studies that utilize extrusion-based 3D printing to develop design-specific macroporous piezoelectric scaffolds for treating bone defects. The scaffolds with controlled pore size and architecture were synthesized based on unique composite formulations containing polycaprolactone (PCL) and micron-sized barium titanate (BaTiO₃) particles. Second, the bioactive PCL-BaTiO₃ piezoelectric composite formulations were explicitly developed in the form of uniform diameter filaments, which served as feedstock material for the fused filament fabrication (FFF)-based 3D printing. A combined method comprising solvent casting and extrusion (melt-blending) was designed and deemed suitable to develop the high-quality PCL-BaTiO₃ bioactive composite filaments for 3D printing. Third, clinical ultrasonic stimulation (US) was used to stimulate the piezoelectric effect, i.e., create stress on the PCL-BaTiO₃ scaffolds to generate electrical fields. Subsequently, we analyzed the impact of scaffold-generated piezoelectric stimulation on MC3T3 pre-osteoblast behavior. Our results confirmed that FFF could form high-resolution, macroporous piezoelectric scaffolds, and the poled PCL-BaTiO₃ composites resulted in the d₃₃ coefficient in the range of 1.2–2.6 pC/N, which is proven suitable for osteogenesis. In vitro results revealed that the scaffolds with a mean pore size of 320 µm resulted in the highest pre-osteoblast growth kinetics. While 1 Hz US resulted in enhanced pre-osteoblast adhesion, proliferation, and spreading, 3 Hz US benefited osteoblast differentiation by upregulating important osteogenic markers. This study proves that 3D-printed bioactive piezoelectric scaffolds coupled with US are promising to expedite bone regeneration in orthopedic defects. Full article

The purpose of this study was to analyze the effects of locking plate fixation used for bridging of tibial segmental ostectomy and of cast immobilization on gait biomechanics in goats. We hypothesized that stable fixation of a segmental bone defect, using a locking plate construct, would result in minimal changes in biomechanical variables of gait in goats, but full-limb immobilization would result in lasting alterations in the immobilized limb’s gait kinetics. A pressure-sensing walkway was used to measure biomechanical characteristics for stride, gait, and walking vertical force. Thirteen, non-lame adult Boer-cross goats were trained to walk over a pressure-sensing walkway prior to instrumentation. Segmental ostectomy was performed on the right hind tibia of each goat and the defect was stabilized using bridging plate fixation with a locking compression plate. Per the protocol of an ongoing orthopedic study, the same goats underwent right hindlimb cast immobilization between one and four months postoperatively. Data was collected preoperatively and then over twelve months postoperatively in goats with unrestricted mobility. Statistical analysis revealed no significant alterations in hindlimb kinematics or maximum force when comparing the period after surgery with that after cast immobilization; significant decreases in forelimb stride length and velocity were noted postoperatively but normalized prior to cast placement, suggesting the overall functional stability of fixation. Cast immobilization had a profound and sustained effect on gait with significant alterations in both forelimb kinetics and hindlimb kinetics and kinematics for the remainder of the trial period; increased hindlimb asymmetry characterized by greater weight distribution and impulse to the left hindlimb was observed, suggesting the potential for long-term and/or permanent detrimental effects of prolonged limb immobilization. Full article