EFFICACY OF INDIGENOUSLY MANUFACTURED TITANIUM BONE PLATES AND SCREWS IN MAXILLOFACIAL SURGERY.
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ABSTRACT:
SUBMITTER: Chatterjee A
PROVIDER: S-EPMC5531927 | biostudies-other | 1999 Oct
REPOSITORIES: biostudies-other
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Project description:Objective:Bioresorbable and titanium plates/screws are considered as a standard treatment for fixation of the bone segments of craniofacial area and paying attention to their biocompatibility is an important issue along with other aspects of application. The purpose of the study was to evaluate the cell viability of two types of plate and screw used in maxillofacial surgeries in contact with gingival fibroblasts and bone marrow stem cells. Materials and Methods:In this experimental study after extraction and cultivation of cells from healthy human gingival tissue and alveolar bone of jaw, cytotoxicity of device was evaluated. In direct contact method, samples had near vicinity contact with the both cell lines and in indirect contact method, by-products released, like ions, from samples after 8 weeks were used to assess cytotoxicity. Then cytotoxicity was evaluated on the 2nd, 4th and 6th day with MTS tests and microscopy. The data were analyzed by one-way ANOVA and independent t tests. Results:There was a statistically significant difference between the German plate and screw and all the samples studied on day 6 (P<0.05). Furthermore, a statistically significant difference was observed between both metal samples and both bio-absorbable samples on day 6 and both cell lines (P<0.05). Comparisons between the two groups with each other for both cell lines on the 6th day were statistically significant (P<0.05). Conclusion:Our results suggest that that cytotoxicity of biomaterial, from different brands, were not similar and some of the biomaterial showed lower degree of toxicity compared to others and specialist using these products showed be aware of this differences. Our investigation indicates more biocompatibility of bioresorbable plates and screws compared to titanium. In addition our results suggest that biomaterials were not completely neutral.
| S-EPMC6947002 | biostudies-literature
Project description:BackgroundRecognition of some of the limitations of titanium plates and screws used for the fixation of bones has led to the development of plates manufactured from bioresorbable materials. Whilst resorbable plates appear to offer clinical advantages over metal plates in orthognathic surgery, concerns remain about the stability of fixation and the length of time required for their degradation and the possibility of foreign body reactions. This review compares the use of titanium versus bioresorbable plates in orthognathic surgery and is an update of the Cochrane Review first published in 2007.ObjectivesTo compare the effects of bioresorbable fixation systems with titanium systems used during orthognathic surgery.Search methodsCochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 20 January 2017); the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 11) in the Cochrane Library (searched 20 January 2017); MEDLINE Ovid (1946 to 20 January 2017); and Embase Ovid (1980 to 20 January 2017). We searched the US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov (clinicaltrials.gov; searched 20 January 2017), and the World Health Organization International Clinical Trials Registry Platform (searched 20 January 2017) for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.Selection criteriaRandomised controlled trials comparing bioresorbable versus titanium fixation systems used for orthognathic surgery in adults.Data collection and analysisTwo review authors independently screened the results of the electronic searches, extracted data and assessed the risk of bias of the included studies. We resolved disagreement by discussion. Clinical heterogeneity between the included trials precluded pooling of data, and only a descriptive summary is presented.Main resultsThis review included two trials, involving 103 participants, one comparing titanium with resorbable plates and screws and the other titanium with resorbable screws. Both studies were at high risk of bias and provided very limited data for the primary outcomes of this review. All participants in one trial suffered mild to moderate postoperative discomfort with no statistically significant difference between the two plating groups at different follow-up times. Mean scores of patient satisfaction were 7.43 to 8.63 (range 0 to 10) with no statistically significant difference between the two groups throughout follow-up. Adverse effects reported in one study were two plate exposures in each group occurring between the third and ninth months. Plate exposures occurred mainly in the posterior maxillary region, except for one titanium plate exposure in the mandibular premolar region. Known causes of infection were associated with loosened screws and wound dehiscence with no statistically significant difference in the infection rate between titanium (3/196), and resorbable (3/165) plates.Authors' conclusionsWe do not have sufficient evidence to determine if titanium plates or resorbable plates are superior for fixation of bones after orthognathic surgery. This review provides insufficient evidence to show any difference in postoperative pain and discomfort, level of patient satisfaction, plate exposure or infection for plate and screw fixation using either titanium or resorbable materials.
| S-EPMC6485457 | biostudies-literature
Project description:Various types of metallic implants have been used in the form of screws, bone plates and compression plates to achieve rigid internal fixation. In the present study, bone response to imported titanium bone plates and indigenously manufactured stainless steel bone plates, has been evaluated in dogs.
| S-EPMC5529616 | biostudies-other
Project description:To guide the selection of osteosynthesis systems, this study compared the mechanical properties of biodegradable and titanium osteosynthesis systems. SonicPins Rx and xG were subjected to pull-out tests. Additionally, 15 biodegradable (Inion CPS 2.0 and 2.5 mm; LactoSorb 2.0 mm; Macropore 2.0 mm; Polymax 2.0 mm; BioSorb FX 2.0 mm; ResorbX 2.1 mm; Osteotrans-MX 2.0 mm with plate thicknesses 1.0 and 1.4 mm; SonicWeld Rxplate/Rxpins, xGplate/Rxpins and xGplate/xGpins 2.1 mm without and with tapping the burr hole) and six titanium (CrossDrive (2006), CrossDrive (2018), MaxDrive; all 1.5 and 2.0 mm) straight, four-hole osteosynthesis systems were evaluated. All systems were subjected to tensile, bending and torsion tests. Pull-out loads of the SonicPins were comparable (P = 0.423). Titanium systems' tensile loads were higher than biodegradable systems (P < 0.001). CrossDrive (2018) and MaxDrive systems' tensile and torsional stiffness were lower, accompanied with higher ductility, than corresponding CrossDrive (2006) systems (P < 0.001). Bending stiffness of 1.5 mm titanium systems was comparable to, and of the 2.0 mm systems higher than, all biodegradable systems (P < 0.001). Regarding biodegradable systems, Inion CPS 2.5 mm had highest tensile load and torsional stiffness, SonicWeld 2.1 mm highest tensile stiffness, and BioSorbFX 2.0 mm highest bending stiffness (P < 0.001). On the basis of the results of this study, the CrossDrive (2018) and MaxDrive 1.5 mm titanium systems are recommended for midface fractures (e.g., zygomatic or maxillary fractures) and osteotomies (e.g., Le Fort I osteotomy), and the CrossDrive (2018) and MaxDrive 2.0 mm titanium systems for mandibular fractures and osteotomies when a titanium osteosynthesis system is used. When there is an indication for a biodegradable osteosynthesis system, the SonicWeld 2.1 mm or BioSorbFX 2.0 mm are recommended for midface fractures and osteotomies, and the Inion CPS 2.5 mm biodegradable system for mandibular osteotomies and non-load bearing mandibular fractures, especially when high torsional forces are expected (e.g., mandibular symphysis fractures).
| S-EPMC7584639 | biostudies-literature
Project description:Immunomodulation is a technique for the modulation of immune responses against graft material to improve surgical success rates. The main target cell for the immunomodulation is a macrophage because it is the reaction site of the graft and controls the healing process. Macrophages can be classified into M1 and M2 types. Most immunomodulation techniques focus on the rapid differentiation of M2-type macrophage. An M2 inducer, 4-hexylresorcinol, has been recently identified and is used for bone grafts and dental implant coatings.
| S-EPMC7058765 | biostudies-literature
Project description:Microwave ablation has been widely accepted in treating bone tumor. However, its procedure is time-consuming and usually results in postoperative fractures. To solve this problem, we designed and fabricated titanium plates customized to the patients' bone structures. The personalized titanium plates were then used for fixation after the removal of tumorous tissue. Specifically, 3D models of tumor-bearing bone segments were constructed by using computed tomography (CT) and magnetic resonance imaging (MRI). The 3D models were used to design the personalized titanium plates. The plate model was transferred into a numerical control machine for manufacturing the personalized titanium plates by 3D printing. The plates were then surgically implanted for reconstruction assistance following microwave-induced hyperthermia to remove the bone tumor. Implementation parameters and knee functions were then evaluated. No postoperative fractures, implant failures or loosening problems occurred; mean Musculoskeletal Tumor Society score was 27.17 from the latest follow-up. Mean maximum flexion of affected knees was 114.08°. The results of knee gait analysis were comparable with normal population data. Our work suggests that personalized titanium plates can significantly improve the clinical outcomes in the surgical removal of bone tumor. This study represents the first-time effort in using personalized titanium plates for such surgery.
| S-EPMC5548746 | biostudies-literature
Project description:BackgroundBiodegradable fixation systems could reduce/delete the problems associated with titanium plate removal. This means less surgical discomfort, and a reduction in costs.AimThe aim of the present study was to compare the cost-effectiveness between a biodegradable and a titanium system in Maxillofacial surgery.Materials and methodsThis multicenter RCT was performed in the Netherlands from December 2006 to July 2009. Included were 230 patients who underwent a bilateral sagittal split osteotomy (BSSO), a Le Fort-I osteotomy, or a bi-maxillary osteotomy and those treated for fractures of the mandible, maxilla, or zygoma. The patients were randomly assigned to a titanium group (KLS Martin) or to a biodegradable group (Inion CPS). Costs were assessed from a societal perspective. Health outcomes in the incremental cost-effectiveness ratio (ICER) were bone healing (8 weeks) and plate removal (2 years).ResultsIn 25 out of the 117 patients who were randomized to the biodegradable group, the maxillofacial surgeon made the decision to switch to the titanium system intra-operatively. This resulted in an Intention-To-Treat (ITT-)analysis and a Treatment-Received (TR-) analysis. Both analyses indicated that operations performed with titanium plates and screws had better health outcomes. In the TR-analysis the costs were lower in the biodegradable group, in the ITT-analysis costs were lower in the titanium group.Conclusion and discussionThe difference in costs between the ITT and the TR analyses can be explained by the intra-operative switches: In the TR-analysis the switches were analysed in the titanium group. In the ITT-analysis they were analysed in the biodegradable group. Considering the cost-effectiveness the titanium system is preferable to the biodegradable system in the regular treatment spectrum of mandibular, Le Fort-I, and zygomatic fractures, and BSSO's, Le Fort-I osteotomies and bimaxillary osteotomies.Trial registrationControlled-Trials.com ISRCTN 44212338.
| S-EPMC4507946 | biostudies-literature
Project description:The effect of electron-beam melting (EBM) and selective laser melting (SLM) processes on the chemical composition, phase composition, density, microstructure, and microhardness of as-built Ti55511 blocks were evaluated and compared. The work also aimed to understand how each process setting affects the powder characteristics after processing. Experiments have shown that both methods can process Ti55511 successfully and can build parts with almost full density (>99%) without any internal cracks or delamination. It was observed that the SLM build sample can retain the phase composition of the initial powder, while EBM displayed significant phase changes. After the EBM process, a considerable amount of ? Ti-phase and lamella-like microstructures were found in the EBM build sample and corresponding powder left in the build chamber. Both processes showed a similar effect on the variation of powder morphology after the process. Despite the apparent difference in alloying composition, the EBM build Ti55511 sample showed similar microhardness as EBM build Ti-6Al-4V. Measured microhardness of the EBM build sample is approximately 10% higher than the SLM build, and it measured as 348 ± 30.20 HV.
| S-EPMC7178682 | biostudies-literature
Project description:Additively manufactured metallic materials typically exhibit preferential <001> or <110> crystallographic orientations along the build direction. Nowadays, the challenge is to program crystallographic orientation along arbitrary 3D direction in additive-manufactured materials. In this work, it is established a technique of multitrack coupled directional solidification (MTCDS) to program the <001> crystallographic orientation along an arbitrary 3D direction in biomedical beta-type Ti-Nb-Zr-Ta alloys via laser powder bed fusion (LPBF). MTCDS can be achieved via directional solidification of coupled multi-track melt pools with a specific temperature gradient direction. This results in continuous epitaxial growth of the β-Ti phase and consequently sets the <001> crystallographic orientation along an arbitrary 3D direction. This way, relatively low elastic modulus values of approximately 60 ± 1.2 GPa are customized along an arbitrary 3D direction. It is expected that MTCDS can be generalized to a wide range of applications for programming specific crystallographic orientations and, respectively, tailoring desired properties of different metallic materials.
| S-EPMC10558665 | biostudies-literature
Project description:BackgroundBone grafting has been considered the gold standard for hard tissue reconstructive surgery and is widely used for large mandibular defect reconstruction. However, the midface encompasses delicate structures that are surrounded by a complex bone architecture, which makes bone grafting using traditional methods very challenging. Three-dimensional (3D) bioprinting is a developing technology that is derived from the evolution of additive manufacturing. It enables precise development of a scaffold from different available biomaterials that mimic the shape, size, and dimension of a defect without relying only on the surgeon’s skills and capabilities, and subsequently, may enhance surgical outcomes and, in turn, patient satisfaction and quality of life.ReviewThis review summarizes different biomaterial classes that can be used in 3D bioprinters as bioinks to fabricate bone scaffolds, including polymers, bioceramics, and composites. It also describes the advantages and limitations of the three currently used 3D bioprinting technologies: inkjet bioprinting, micro-extrusion, and laser-assisted bioprinting.ConclusionsAlthough 3D bioprinting technology is still in its infancy and requires further development and optimization both in biomaterials and techniques, it offers great promise and potential for facial reconstruction with improved outcome.
| S-EPMC7270214 | biostudies-literature