Digital Workflow for the Design, Manufacture, and Application of Custom-Made Short Implants With Wing Retention Device.
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ABSTRACT:
SUBMITTER: Xu Z
PROVIDER: S-EPMC9213801 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Unlike conventional manufacturing techniques, additive manufacturing (AM) can form objects of complex shape and geometry in an almost unrestricted manner. AM’s advantages include higher control of local process parameters and a possibility to use two or more various materials during manufacture. In this work, we applied one of AM technologies, selective laser melting, using Ti6Al7Nb alloy to produce biomedical functional structures (BFS) in the form of bone implants. Five types of BFS structures (A1, A2, A3, B, C) were manufactured for the research. The aim of this study was to investigate such technological aspects as architecture, manufacturing methods, process parameters, surface modification, and to compare them with such functional properties such as accuracy, mechanical, and biological in manufactured implants. Initial in vitro studies were performed using osteoblast cell line hFOB 1.19 (ATCC CRL-11372) (American Type Culture Collection). The results of the presented study confirm high applicative potential of AM to produce bone implants of high accuracy and geometric complexity, displaying desired mechanical properties. The experimental tests, as well as geometrical accuracy analysis, showed that the square shaped (A3) BFS structures were characterized by the lowest deviation range and smallestanisotropy of mechanical properties. Moreover, cell culture experiments performed in this study proved that the designed and obtained implant’s internal porosity (A3) enhances the growth of bone cells (osteoblasts) and can obtain predesigned biomechanical characteristics comparable to those of the bone tissue.
| S-EPMC6024979 | biostudies-other
Project description:BackgroundCustom-made implants are a valid option in revision total hip arthroplasty to address massive acetabular bone loss. The aim of this study was to assess the accuracy of custom-made acetabular implants between preoperative planning and postoperative positioning using CT scans.MethodsIn a retrospective analysis, three patients who underwent an acetabular custom-made prosthesis were identified. The custom-made designs were planned through 3D CT analysis considering surgical points of attention. The accuracy of intended implants positioning was assessed by comparing pre- and postoperative CT analyzing the center of rotation (CoR), anteversion, inclination, screws, and implant surface in contact with the bone.ResultsThe three cases presented satisfactory accuracy in positioning. A malpositioning in the third case was observed due to the posterization of the CoR of the implant of more than 10 mm. The other CoR vectors considered in the third patient and all vectors in the other two cases fall within 10 mm. All the cases were positioned with a difference of less than 10° of anteversion and inclination with respect to the planning.ConclusionsThe current case series revealed promising accuracy in the positioning of custom-made acetabular prosthesis comparing the planned implant in preoperative CT with postoperative CT.
| S-EPMC10544156 | biostudies-literature
Project description:BACKGROUND:In cranial reconstruction, the features of artificial bone differ. Custom-made porous hydroxyapatite (HAp) implants for cranioplasty have been used all over the world because of their good cosmetic, biocompatibility, and osteoconductive properties. Surgical techniques were analyzed, and histological assessment of new bone formation in the hydroxyapatite was performed. METHODS:Over a 6-year time period, 41 patients underwent cranioplasty using a custom-made three-dimensional hybrid pore structured hydroxyapatite (3DHPoHAp) implant. The surgical techniques and histological evaluations of 3DHPoHAp in 2 cases, removed 6 months and 2.5 years after cranioplasty, are described. RESULTS:Using 3DHPoHAp, cranioplasty was successfully performed for all patients. The implant fit the bone defect exactly, and surgical manoeuvres were simple and easy. All implants were firmly fixed using a titanium plate, and postoperative infection occurred in 1 patient (2.4%). New bone formation was seen in 2 cases 6 months and 2.5 years after cranioplasty. Osteoblasts were progressing to the stoma at various depths, and bone tissue had ripened. Furthermore, lamellar structure was observed in the case at 2.5 years. CONCLUSIONS:In this study, there was a low infection rate, and new bone formation was seen in vivo after cranioplasty. This study also demonstrated that the 3DHPoHAp implant is a good candidate for cranial bone implants because its good osteoconductivity and biocompatibility.
| S-EPMC5288982 | biostudies-literature
Project description:The objective was to establish and evaluate a method for manufacture of custom trays for edentulous jaws using computer aided design and fused deposition modeling (FDM) technologies. A digital method for design the custom trays for edentulous jaws was established. The tissue surface data of ten standard mandibular edentulous plaster models, which was used to design the digital custom tray in a reverse engineering software, were obtained using a 3D scanner. The designed tray was printed by a 3D FDM printing device. Another ten hand-made custom trays were produced as control. The 3-dimentional surface data of models and custom trays was scanned to evaluate the accuracy of reserved impression space, while the difference between digitally made trays and hand-made trays were analyzed. The digitally made custom trays achieved a good matching with the mandibular model, showing higher accuracy than the hand-made ones. There was no significant difference of the reserved space between different models and its matched digitally made trays. With 3D scanning, CAD and FDM technology, an efficient method of custom tray production was established, which achieved a high reproducibility and accuracy.
| S-EPMC4725876 | biostudies-other
Project description:BackgroundManual moulding of cranioplasty implants after craniectomy is feasible, but does not always yield satisfying cosmetic results. In contrast, 3D printing can provide precise templates for intraoperative moulding of polymethylmethacrylate (PMMA) implants in cranioplasty. Here, we present a novel and easily implementable 3D printing workflow to produce patient-specific, sterilisable templates for PMMA implant moulding in cranioplastic neurosurgery.Methods3D printable templates of patients with large skull defects before and after craniectomy were designed virtually from cranial CT scans. Both templates - a mould to reconstruct the outer skull shape and a ring representing the craniectomy defect margins - were printed on a desktop 3D printer with biocompatible photopolymer resins and sterilised after curing. Implant moulding and implantation were then performed intraoperatively using the templates. Clinical and radiological data were retrospectively analysed.ResultsSixteen PMMA implants were performed on 14 consecutive patients within a time span of 10 months. The median defect size was 83.4 cm2 (range 57.8-120.1 cm2). Median age was 51 (range 21-80) years, and median operating time was 82.5 (range 52-152) min. No intraoperative complications occurred; PMMA moulding was uneventful and all implants fitted well into craniectomy defects. Excellent skull reconstruction could be confirmed in all postoperative computed tomography (CT) scans. In three (21.4%) patients with distinct risk factors for postoperative haematoma, revision surgery for epidural haematoma had to be performed. No surgery-related mortality or new and permanent neurologic deficits were recorded.ConclusionOur novel 3D printing-aided moulding workflow for elective cranioplasty with patient-specific PMMA implants proved to be an easily implementable alternative to solely manual implant moulding. The "springform" principle, focusing on reconstruction of the precraniectomy skull shape and perfect closure of the craniectomy defect, was feasible and showed excellent cosmetic results. The proposed method combines the precision and cosmetic advantages of computer-aided design (CAD) implants with the cost-effectiveness of manually moulded PMMA implants.
| S-EPMC8913485 | biostudies-literature
Project description:AimsIn brain research, the histopathological examination of coronar whole-brain slides provides important insights into spatial disease characteristics. Regarding brain tumor research, this enables visualization of tumor heterogeneity, infiltration patterns and the relationship with the surrounding brain parenchyma. The precise correlation between radiological imaging and post-mortem brains is of special interest.New methodWe developed a wide-field slide scanner, comprising a microscope, a high-precision remotely controllable x-y-stage, a camera and a computer workstation, for automatically scanning uncommonly large formats. We analyzed whole brain slides of three patients and constructed cellularity heatmaps and fiber tract maps using a custom-made image processing pipeline.ResultsThe obtained cellularity heatmaps allow for distinguishing compact tumor (5714 ± 1786 cells/mm², mean ± standard deviation) from white matter (3581 ± 828 cells/mm²) and grey matter (2473 ± 716 cells/mm²). Compared to magnetic resonance imaging, the proposed histopathological work-up (i) reveals a larger zone of tumor infiltration around the compact tumor areas and (ii) shows how pre-existing tracts are displaced by the tumor bulk. Moreover, we highlight differences in the histological tumor growth pattern of two different radiological progression subtypes.Comparison with existing method(s)Compared to existing (commercial) solutions, our slide scanning solution is adaptable and cost-efficient. Moreover, we showcase potential clinical applications by mapping whole brain histology to magnetic resonance imaging.ConclusionsWe herein provide instructions on how to (i) construct a custom-built slide scanner capable of scanning arbitrary slide formats, (ii) automatically evaluate the cell density and (iii) perform fiber tracking on whole brain slides.
| S-EPMC6269083 | biostudies-literature
Project description:BackgroundPhysicians' financial interests might conflict with the best service to patients. It is essential to gain a thorough understanding of the effect of remuneration systems on physician behaviour.MethodsWe conducted a controlled laboratory experiment using a within-subject design to investigate physician behaviour underpayment heterogeneity. Each physician provided medical care to patients whose treatments were paid for under fee-for-service (FFS) or capitation (CAP).ResultsWe observed that physicians customized their care in response to the payment system. FFS patients received considerably more medical care than did CAP patients with the same illness and treatment preference. Physicians over-served FFS patients and under-served CAP patients. After a CAP payment reduction, we observed neither a quantity reduction under CAP nor a spillover in FFS patients' treatment.ConclusionsThe results suggest that, in our experimental model, fee regulation can be used to some extent to control physician spending since we did not identify a behavioural response to the CAP payment cut. Physicians did not recoup lost income by altering treatment behaviour toward CAP and/or FFS patients. Experimental economics is an excellent tool for ensuring the welfare of all those involved in the health system. Further research should investigate payment incentives as a means of developing health care teams that are more efficient.
| S-EPMC7749502 | biostudies-literature
Project description:BACKGROUND AND OBJECTIVE: Mandibular reconstruction following tumor ablative surgery had been a challenge. It has gone through days of temporary stabilization with k-wire, stainless steel reconstruction plate to avascularized and vascularized bone grafts with varying degree of success and failure. Reconstruction with vascularized bone grafts, though most definitive, requires special expertise, expensive equipment, and long operative time. It also produces donor site morbidity and requires a significant learning curve. With the development of transport distraction techniques there has been a paradigm shift from "reconstructive" to "regenerative" surgery. The objective of this study was to identify the feasibility of an internal device for reconstruction of extensive mandibular defects. METHODS AND MATERIAL: This article is to highlight a process of attempted mandibular regeneration in two cases using an indigenously designed distractor device. In individuals with extensive post ablative mandibular defects who were unwilling to have a secondary surgical site or were medically unfit for a long reconstructive procedure, the distraction technique can be used to reconstruct the lost mandibular structures. CONCLUSION: A satisfactory amount of regenerate was achieved using a bifocal distraction osteogenesis technique for extensive defects of the mandible. The custom made device which was used for this purpose was moderately satisfactory and requires further evaluation and refinement.
| S-EPMC3052676 | biostudies-other
Project description:Proof of concept for the in vivo bacterial production of a polyester resin displaying various customizable affinity protein binding domains is provided. This was achieved by engineering various protein binding domains into a bacterial polyester-synthesizing enzyme. Affinity binding domains based on various structural folds and derived from molecular libraries were used to demonstrate the potential of this technique. Designed ankyrin repeat proteins (DARPins), engineered OB-fold domains (OBodies), and VHH domains from camelid antibodies (nanobodies) were employed. The respective resins were produced in a single bacterial fermentation step, and a simple purification protocol was developed. Purified resins were suitable for most lab-scale affinity chromatography purposes. All of the affinity domains tested produced polyester beads with specific affinity for the target protein. The binding capacity of these affinity resins ranged from 90 to 600 nmol of protein per wet gram of polyester affinity resin, enabling purification of a recombinant protein target from a complex bacterial cell lysate up to a purity level of 96% in one step. The polyester resin was efficiently produced by conventional lab-scale shake flask fermentation, resulting in bacteria accumulating up to 55% of their cellular dry weight as polyester. A further proof of concept demonstrating the practicality of this technique was obtained through the intracellular coproduction of a specific affinity resin and its target. This enables in vivo binding and purification of the coproduced "target protein." Overall, this study provides evidence for the use of molecular engineering of polyester synthases toward the microbial production of specific bioseparation resins implementing previously selected binding domains.
| S-EPMC4272739 | biostudies-literature
Project description:Recording and manipulating neural activity in awake behaving animal models requires long-term implantation of cranial implants that must address a variety of design considerations, which include preventing infection, minimizing tissue damage, mechanical strength of the implant, and MRI compatibility.Here we address these issues by designing legless, custom-fit cranial implants using structural MRI-based reconstruction of the skull and that are made from carbon-reinforced PEEK.We report several novel custom-fit radiolucent implant designs, which include a legless recording chamber, a legless stimulation chamber, a multi-channel microdrive and a head post. The fit to the skull was excellent in all cases, with no visible gaps between the base of the implants and the skull. The wound margin was minimal in size and showed no sign of infection or skin recession.Cranial implants used for neurophysiological investigation in awake behaving animals often employ methyl methacrylate (MMA) to serve as a bonding agent to secure the implant to the skull. Other designs rely on radially extending legs to secure the implant. Both of these methods have significant drawbacks. MMA is toxic to bone and frequently leads to infection while radially extending legs cause the skin to recede away from the implant, ultimately exposing bone and proliferating granulation tissue.These radiolucent implants constitute a set of technologies suitable for reliable long-term recording, which minimize infection and tissue damage.
| S-EPMC4323951 | biostudies-literature