Bone Support Research Articles

Evaluating Clear Aligners Versus Fixed Appliances for Periodontal Patients: A Comprehensive Narrative Review of Current Evidence

Periodontal patients may face orthodontic problems because of bone support loss, such as maxillary incisor proclination, spacing, rotation, extrusion, pathologic tooth migration (PTM) or traumatic occlusion. Orthodontic treatment is therefore an element within the comprehensive treatment of periodontitis after the periodontal condition has stabilized. The presence of fixed appliances (FAs) promotes the accumulation of bacterial biofilm and impedes hygiene procedures. The increasing popularity of clear aligner (CA) treatment is due to the convenience of use, less discomfort, better esthetics, easier hygiene, lower failure rate, and shorter, less frequent visits. Therefore, the question arises whether treatment with aligners is a good solution for periodontal patients. To answer this question, the PubMed/Medline, Cochrane Library and EMBASE databases were searched using the following keywords: periodontitis, orthodontic treatment, clear aligners, multibracket orthodontic appliances, fixed appliance, root resorption, gingival recession and pathologic tooth migration. The search strategy identified 18 relevant studies. A total of 1090 participants took part in the analyzed studies. The available literature was analyzed in terms of the occurrence of root apex resorption, the possibility of treating pathologic tooth migration, the occurrence of gingival recession, periodontal health status and occlusal stability in patients treated with CAs and FAs. Despite statistically significant differences in terms of Plaque Index (PI), probing depth (PD), apical root resorption and gingival recession favor the use of CAs. However, these values are mostly of no clinical significance. It is possible to treat PTM with CAs, but it is limited by the high degree of tooth mobility and incisor inclination. Obtaining perfect occlusion is comparably difficult in both CA and FA treatment. When planning orthodontic treatment in patients with reduced periodontium, the use of both CAs and FAs should be considered. The choice of method would ultimately depend on the patient’s dental condition.

The Influence of Smoking on Peri-Implantitis Treatment Outcomes: A Systematic Review and Evaluation of Adjunctive Therapies

Background: Peri-implantitis is a significant complication in implant dentistry, characterized by the progressive loss of bone support around implants, often exacerbated by heavy bacterial colonization in dental plaque. Smoking, a known risk factor for periodontal disease, may adversely affect peri-implant tissue health and treatment outcomes. Objective: This systematic review aims to analyze the impact of smoking on the clinical treatment outcomes of peri-implantitis in adult patients, focusing on key clinical parameters and the effectiveness of various treatment modalities. Methods: A systematic search was conducted across several databases including PubMed, Scopus, Web of Science, and Google Scholar using keywords related to smoking and peri-implantitis treatment to identify relevant articles published in English language without any restriction for the time of publication until 30th September 2024. Studies were included on the eligibility criteria, emphasizing adult smokers with diagnosed peri-implantitis undergoing various treatments. Data extraction focused on clinical parameters outcomes including plaque index (PI), bleeding on probing (BOP), probing depth (PD), and bone levels. Results: Seven studies met the inclusion criteria, highlighting that smokers exhibited higher PI, BOP, and PD at baseline compared to non-smokers. Adjunctive therapies, particularly antimicrobial photodynamic therapy (aPDT), significantly improved clinical parameters in smokers. However, smokers demonstrated less favorable outcomes in gingival recession and bone levels post-treatment. Conclusion: Smoking negatively impacts the treatment outcomes of peri-implantitis, with smokers showing heightened inflammatory responses and less improvement in clinical parameters. Clinicians should consider smoking status when planning treatment protocols for peri-implantitis to optimize patient outcomes. Further research is warranted to develop targeted interventions for this vulnerable population.

Investigation on structurally reinforced synthetic bone grafts via tricalcium silicate

AbstractTricalcium silicate (C3S) is one of the main components of mineral trioxide aggregates, which is used in dental endodontic treatment. C3S provides workable viscosity itself and fast hydration when water is added, and it is known to be nontoxic, noncarcinogenic, nongenotoxic, biocompatible, and insoluble in tissue fluids. In this study, C3S is added to synthetic bone‐graft materials from 30% to 60% to deliver viscosity to increase workability in the early stage of implant surgical procedure and to attain some degree of compressive strength after the hydration. Additionally, the porosity is not overly reduced to maintain the ability for bone regeneration. The porosity of the samples was confirmed to be 40%–50% with the formation of the C3S matrices. Simultaneously, the maximum compressive strength was ensured at 14.9 MPa within 24 h of curing time. The radiopacity required for post‐procedural diagnosis was evaluated. The radiopacity of the samples with 50% and 60% C3S was 1.0 mm Al and 1.1 mm Al, respectively. When ZrO2 was added, the radiopacity was enhanced to 1.6 mm Al. Overall, the experimental results showed that the bone‐graft added C3S would be suitable for alveolar bone support and rigid matrix formation in implant surgery.

Comparing Three-dimensional Radiologic Outcomes Between Early Versus Late Secondary Alveolar Bone Grafting.

Secondary alveolar bone grafting (SABG) during mixed dentition is the standard of care for patients with complete cleft of lip and palate. Early SABG (E-SABG; 4 to 7y) occurs before the eruption of lateral incisors, whereas late SABG (L-SABG; 8 to 12y) occurs before the eruption of maxillary permanent canines. This study compares outcomes of E-SABG versus L-SABG among patients with unilateral cleft of lip and palate (UCLP). A prospective cohort study was conducted evaluating nonsyndromic patients with UCLP who underwent SABG from April 2018 to January 2020, 48 consecutive patients with UCLP were included. Preoperative and 6 to 10-month postoperative cone beam computed tomography imaging were obtained to assess graft and periodontal outcomes. Among 48 patients with UCLP, of which 21 were in the E-SABG group (6.9 ± 1.1y), and 28 were in the L-SABG cohort (10.4 ± 1.6y). The initial alveolar cleft width is significantly smaller in the E-SABG cohort compared with the L-SABG cohort (5.1 ± 1.5 versus 6.5 ± 2.0mm, P = 0.008). Compared with the L-SABG cohort, the E-SABG cohort had higher rates of bony bridge formation (77.3% versus 65.4%, P= 0.367), thicker bony bridges (5.7 ± 2.1 versus 3.9 ± 1.5mm, P= 0.004), lower Bergland scores [1.5 (interquartile range: 1 to 2) versus 2.25 (interquartile range: 1.5 to 3.5), P= 0.026], and greater alveolar bone coverage (79.8 ± 16.7% versus 67.9 ± 18.1%, 0.024). The authors' findings suggest that patients who undergo E-SABG at ∼7 years may have better graft outcomes and benefits to the periodontal bone support on cleft-adjacent incisor compared with L-SABG at 11 years.

Use of De-Epithalialized Flap for Elevating the Alar Base in Patients With Cleft Lip.

Alar base asymmetry is a common problem in cleft lip patients. Caused by a lack of bone support and soft tissue deficiency, it is one of the problems that must be corrected during cleft lip repair. While it is encountered during primary lip repair, it can also be seen as a secondary cleft lip nasal deformity after repair. This study aimed to provide alar base symmetry with a de-epithelialized muscle-skin flap during the primary cleft lip repair of incomplete cleft lip patients and secondary cleft lip deformity repair. In incomplete cleft lip patients, the tissue under the incomplete part is de-epithelialized and elevated as a superiorly based flap. The flap is rotated and sutured under the alar base for the elevation. In secondary patients, scar tissue to be removed is de-epithelialized and elevated as a superiorly based flap. It is turned over and sutured under the alar base for augmentation. The effect of the surgery is monitored during the follow-up period. There were no complications related to the flap, and no volume loss was observed. Using a de-epithelialized musculocutaneous flap, the augmentation of the alar base and nasal sill can be achieved without additional incisions in patients undergoing primary incomplete cleft lip repair and in patients undergoing secondary cleft lip deformity repair. We think it is an effective and safe method, improving the esthetic outcomes of cleft lip patients.

Impact of vertical facial type on alveolar bone thickness and tooth morphology: A retrospective CBCT-based clinical study

IntroductionThe relationship between vertical facial patterns and the morphology of the alveolar bone and teeth is crucial for successful orthodontic treatment planning. This study aimed to evaluate the relationship between vertical facial patterns, bone thickness, and root-crown dimensions in the maxillary anterior teeth. MethodsThis retrospective study screened 300 cone-beam computed tomography (CBCT) scans of orthodontic patients between December 2022 and November 2023, with 115 meeting the inclusion criteria. Buccal and lingual alveolar bone thickness, along with crown and root lengths of maxillary anterior teeth, were measured and compared across short, normal, and long facial types, classified according to the Frankfort-Mandibular Plane Angle. One-way ANOVA, independent-samples Kruskal-Wallis, and post-hoc tests were used for statistical analysis. ResultsSignificant differences in alveolar bone thickness were observed across facial types, with short facial types showing consistently greater thickness in the apical and mid-palatal regions compared to normal and long facial types (p < 0.05). No significant differences in crown or root lengths were found among the facial types. ConclusionFacial type significantly influences alveolar bone thickness, particularly in short facial types, which demonstrate greater bone support. These findings underscore the importance of considering facial type in orthodontic treatment planning to minimize complications.

Influence of Augmented Fixation to Dynamic Hip Screw on Trochanteric Lateral Wall

This paper focused on lateral trochanteric wall stress which is a contributing factor for the success of complex trochanteric fracture management with loss of medical bone support. Its aim was to assess performance of augmented fixations to Dynamic Hip Screw (DHS). The analysis was performed using Finite Element (FE) method, where the femoral bone and fixations were developed from reverse engineering technique. The boundary conditions were physiological loads with constraints at distal condyle. It was revealed that lateral augmented fixation i.e. trochanteric stabilization plate raised the trochanteric lateral wall stress that could be at risk of bone breakage.

Influence of connection design and material properties on stress distribution and fatigue lifetime of zygomatic implants: A finite element analysis

Zygomatic implants (ZIs) were developed as a graftless alternative to rehabilitate severely reabsorbed maxillae. This study aims to employ three-dimensional finite element analysis (FEA) to simulate the impact of external hexagonal implant connection (EHC) and internal hexagonal implant connection (IHC) on the stress distribution and fatigue lifetime within the ZI systems using parameters defined in ISO 14801:2016. Two ZI assemblies (Nobel Biocare and Noris Medical) were scanned in a micro-CT scanner and reconstructed using Nrecon software. Three-dimensional models were generated by Simpleware ScanIP Medical software. All models were exported to FEA software (ABAQUS) and subsequently to a fatigue analysis software (Fe-safe). A compressive 150 N load was applied at a 40° angle on the cap surface. A 15 Hz frequency was applied in the in silico cyclic test. The implant components had material properties of commercially pure grade 4 titanium (CPTi) and Titanium-6Aluminum-4Vanadium alloy (Ti64). Von Mises stress data, contour plots, and fatigue limits were collected and analyzed. EHC models exhibited higher peak stresses in implant components for both materials compared to IHC models. However, simulated bone support results showed the opposite trend, with higher stresses on IHCthan EHC models. The fatigue analysis revealed that assemblies with both designs exceeded ISO 14801:2016 number of cycles limits using Ti64, while CPTi groups exhibited comparatively lower worst life-repeats. In conclusion, ZIs with IHC were found to have a more homogeneous and advantageous stress distribution within both materials tested. Ti64 demonstrates a prolonged service life for both design connections.

Fingertip Reconstruction in Hand Injuries

Fingertip amputations are a significant issue in the United States, with approximately 45,000 performed annually, with a 7.5 per 100,000 incidence rate. The primary cause of finger injuries is metal objects and bladed hand instruments, which can lead to cuts, loss of limbs, or damage to nerves and blood vessels. Therapy aims to restore sensation, long-lastingness, and bone support for nail development. Inadequate management can result in cosmetic issues, cold sensitivity, skin soreness, and persistent impairment in functionality. Nail bed injuries, such as lacerations, avulsions, and crush injuries, can result in post-traumatic fingertip amputation. Physical examinations are necessary to evaluate the functional and sensory capabilities of the damaged finger. Surgical intervention is necessary for severe cases, with primary closure or revision amputation being the preferred procedure. Full-thickness skin grafting is also used for fingertip amputations, preserving the structure of the recipient's fingers and addressing areas with insufficient skin. Flap repair is a method for managing fingertip amputations, using skin from another area or distant region. Local flaps are best for small covering areas, while regional flaps are used for extensive incisions. These flaps prevent prolonged immobilization and allow for a return of feeling in the fingertip. Post-amputation complications include delayed wound healing, nail abnormalities, heightened sensitivity, pain, intolerance to cold, scar retraction, limited finger movement, persistent ulcers, infection, and loss of tissue flaps. Inadequate management of fingertip amputations can lead to cosmetic flaws, reduced tolerance to cold, and increased skin sensitivity.

Incidental Findings Following Dental Implant Procedures in the Mandible: A New Post-Processing CBCT Software Analysis.

Background/Objectives: The aim of this study was to evaluate incidental findings in the mandible after the placement of dental implants using a new cone-beam computed tomography (CBCT) software. Methods: The initial sample consisted of 2872 CBCT scans of patients of both sexes. The parameters evaluated in this study were the location of the implants in the mandible, implant length, anatomical relationship of the implant with the mandibular canal, presence or absence of damage to the adjacent teeth, presence or absence of implant fractures, and presence or absence of bone support. Fisher's exact test was performed to compare the variables. The significance level was set at p = 0.05. Results: Out of 2872 CBCT scans, 214 images of patients with an average age of 44.5 years were included. The most frequent location of the implants was the posterior region (93.5%), with 54% of the implants having a length between 9 and 14 mm. It was found that 92% of the implants were positioned above the mandibular canal. Damage to adjacent teeth was observed, with no correlation with the implant positioning (p = 1.000). In 100% of cases of implants in the anterior region, there was bone support. Fracture was observed in 1.7% of implants with a length between 9 and 14 mm. Conclusions: The installation of implants in the mandible occurs more frequently in the posterior region, with a high presence of bone support and a low incidence of damage to adjacent teeth, anatomical structures, and fractures.

Evaluation of the accuracy of cone beam computed tomography (CBCT) in the detection of peri-implant fenestration

BackgroundAccurate assessment of the bone supporting the implant is crucial. Early detection of bone defects around the implant can prevent the loss of bone support that ultimately leads to the loss of the implant. Therefore, the purpose of this study is to check the accuracy of CBCT in detecting peri-implant fenestrations around the implant.Materials & methodsIn this laboratory study, healthy beef ribs were used. The ribs were divided into three groups of 12 (control group, 1–2 mm fenestration group, and 2–3 mm fenestration group). The blocks were cut to a length of 20 mm and 36 osteotomies with dimensions of 4 × 12 mm were made by the periodontist in order to place the implant in these bone blocks. Then the titanium implant was placed in the holes and the initial scan was performed with CBCT. In the second group, fenestration-like lesions were created on the same buccal side at a distance of 10 mm from the crest with a diameter of 1–2 mm and in the third group with a diameter of 2–3 mm, and the CBCT scan was performed again with the same parameters. Two radiologists evaluated the images twice for the presence and absence of fenestration.ResultsThere was no statistically significant difference between direct measurements and CBCT in the fenestration group of 1–2 mm (p < 0.05), but there was a significant difference between direct measurements and CBCT in the fenestration group of 2–3 mm and underestimation was observed in CBCT measurements.ConclusionThe findings of this study showed that CBCT radiography has a higher accuracy in measuring the fenestration around the implant with a smaller diameter and has an acceptable diagnostic value in detecting bone loss around the implant.

A Superparamagnetic Composite Hydrogel Scaffold as In Vivo Dynamic Monitorable Theranostic Platform for Osteoarthritis Regeneration.

Osteoarthritis (OA) is a prevalent disease, characterized by subchondral fractures in its initial stages, which has no precise and specific treatment now. Here, a novel multifunctional scaffold is synthesized by photopolymerizing glycidyl methacrylate-modified hyaluronic acid (GMHA) as the matrix in the presence of hollow porous magnetic microspheres based on hydroxyapatite. In vivo subchondral bone repairing results demonstrate that the scaffold's meticulous design has most suitable properties for subchondral bone repair. The porous structure of inorganic particles within the scaffold facilitates efficient transport of loaded exogenous vascular endothelial growth factor (VEGF). The Fe3O4 nanoparticles assembled in microspheres promote the osteogenic differentiation of bone marrow mesenchymal stem cells and accelerate the new bone generation. These features enable the scaffold to exhibit favorable subchondral bone repair properties and attain high cartilage repair scores. The therapy results prove that the subchondral bone support considerably influences the upper cartilage repair process. Furthermore, magnetic resonance imaging monitoring demonstrates that Fe3O4 nanoparticles, which are gradually replaced by new bone during osteochondral defect repair, allow a noninvasive and radiation-free assessment to track the newborn bone during the OA repair process. The composite hydrogel scaffold (CHS) provides a versatile platform for biomedical applications in OA treatment.

Radiological Landmarks for Joint Line Level in Challenging Total Ankle Arthroplasty.

Background: Although Total Ankle Arthroplasty (TAA) is primarily performed for post-traumatic ankle arthritis with joint disruption, anatomical landmarks for Joint Line (JL) level are typically preserved. However, severe Post-Traumatic Bone Loss (PTBL) or TAA revision may render some landmarks unidentifiable, challenging JL restoration. Methods: Patients undergoing customized TAA for severe PTBL or revision were enrolled. Custom-made implants, based on 3D CT scans, were designed to address bone defects and provide adequate bone support. Evaluated parameters, measured on bilateral ankle weight-bearing radiographs taken preoperatively and 6-8 months postoperatively, included JL Height Ratio (JLHR) and the distances from JL to the Lateral Malleolus apex (LM-JL), the posterior colliculus of the Medial Malleolus (MM-JL), and the Gissane Calcaneal Sulcus (CS-JL). Reproducibility and variability were assessed, and comparisons were made between radiological parameters measured at TAA and those at the contralateral ankle. Results: Thirteen patients were included. Intra- and interobserver reliability demonstrated excellent values. The least variability was observed in the LM-JL distance. Statistically significant correlations were found between CS-JL and MM-JL distances in the operated limb and between the CS-JL of the operated limb and the contralateral ankle. While TAA parameters did not show statistically significant differences compared with the contralateral ankle, a trend toward proximalization of the JL was noted. Conclusions: This study demonstrated good reproducibility of the analyzed parameters for evaluating JL in TAA among patients with severe PTBL or undergoing revision surgery. However, these parameters cannot be deemed fully reliable. Given their potential weaknesses, it is crucial to identify more reproducible values, preferably ratios.

Intentional Replantation in Combination with Fibroblast Growth Factor-2 Application and Orthodontic Tooth Extrusion for Periodontal Regeneration in the Treatment of Severe Endodontic-Periodontal Lesions.

Endodontic-periodontal lesions are characterized by the involvement of the pulp and periodontal disease in the same tooth. Despite successful root canal treatment, if the majority of bone support has been lost from periodontitis, the tooth may have a poor prognosis. In severe endodontic-periodontal lesions, the periodontal tissue regenerates poorly because of the significant loss of the periodontal ligament and cementum, poor tooth stability, and bone defect morphology unfavorable for bone regeneration. To overcome these difficult situations, in this case, osteotomy of the replantation bed and tooth replantation with horizontal rotation and deep placement were performed. To improve periodontal regeneration, fibroblast growth factor (FGF) 2 was applied to the artificially made periodontal defect. In addition, orthodontic extrusion of the deeply replaced tooth was performed for potential coronal migration of the periodontal tissue. This case presents a unique multidisciplinary method of treating severe endodontic-periodontal lesions using intentional replantation combined with FGF 2 application and orthodontic extrusion.

Periosteal skeletal stem cells can migrate into the bone marrow and support hematopoiesis after injury.

Skeletal stem cells have been isolated from various tissues, including periosteum and bone marrow, where they exhibit key functions in bone biology and hematopoiesis, respectively. The role of periosteal skeletal stem cells in bone regeneration and healing has been extensively studied, but their ability to contribute to the bone marrow stroma is still under debate. In the present study, we characterized a whole bone transplantation model that mimics the initial bone marrow necrosis and fatty infiltration seen after injury. Using this model and a lineage tracing approach, we observed the migration of periosteal skeletal stem cells into the bone marrow after transplantation. Once in the bone marrow, periosteal skeletal stem cells are phenotypically and functionally reprogrammed into bone marrow mesenchymal stem cells that express high levels of hematopoietic stem cell niche factors such as Cxcl12 and Kitl. In addition, using in-vitro and in-vivo approaches, we found that periosteal skeletal stem cells are more resistant to acute stress than bone marrow mesenchymal stem cells. These results highlight the plasticity of periosteal skeletal stem cells and their potential role in bone marrow regeneration after bone marrow injury.

Hydroxyapatite Reinforced Magnesium Alloy Composites Using the Ultrasonic-Assisted Rheo-Squeeze Casting Technique: Microstructural and Mechanical Performance Evaluation for Bone Fixture Applications

Magnesium-based biomaterials have recently been in the research spotlight in the field of biomedical engineering owing to their properties, such as density and biocompatibility that closely align with those of human bone. However, poor strength and rapid degradation impede their application as bone support fixtures. The present research aims to tailor the properties of Mg by using a novel ultrasonic-assisted rheo-squeeze casting approach. To satisfy the demand, pure Mg (Mg), MHA (Mg/5%HA), MZHA (Mg-1%Zn/5%HA/), and MSHA (Mg-1%Sn/5%HA) were fabricated, and various mechanical tests were conducted to assess the composite’s mechanical properties, including its microhardness, tensile strength, compressive strength, flexural strength, and impact strength. The microstructural and fractured morphology of the composites was examined by scanning electron microscopy (SEM), whereas their elemental composition was analyzed by field emission scanning electron microscopy (FESEM) equipped with elemental mapping. Comparing the MZHA, MHA, and pure Mg samples, the mechanical behavior of MSHA is significantly superior. This is due to composites containing Sn that possess finer-grained materials, which act as barriers to dislocation motion while increasing the strength of the materials. From the observed results, there is a significant improvement in the microhardness of MSHA of 64.5% when compared to that of pure Mg, and 42.7% compared to MHA. Furthermore, MSHA composites possess noticeable enhancements in tensile and compression performance of 80.8% and 58.3%, respectively, and 19% and 22.4% compared to MHA. Additionally, the impact and flexural performance of MSHA composites exhibit higher performance (41% and 42%) than pure Mg and 8% and 7% against the MHA composite.

Can the Upper Vermilion and the Nasolabial Fold Be Changed With Orthognathic Surgery?

BackgroundRetrusive profiles show an appearance of aging with an under-projected vermilion and pronounced nasolabial folds due to deficient bone support. PurposeA study was made of the association between orthognathic surgery and changes in the nasolabial and vermilion areas in patients with retrusive profiles. Study design, setting, sampleA retrospective cohort study evaluated patients subjected to bimaxillary surgery according to the Barcelona Line (BL) protocol during 2021 at Teknon Medical Center (Barcelona, Spain). Subjects with craniofacial syndromes, facial aesthetic procedures, and dental rehabilitations involving lip changes, were excluded. Predictor variableThe predictor variable was the timing of cephalometric measures, reported as T0 (preoperatively), T1 (one month after surgery), and T2 (after one year of follow-up). Main outcome variableThe outcome variable corresponded to the soft tissue changes of the nasolabial and vermilion area, reported as the nasolabial fold length and angle, nasolabial angle, upper lip concavity, vermilion length, and upper lip sagittal distance from BL. CovariatesThe covariates comprised patient demographic data, the surgical-orthodontic protocol, and the magnitude and direction of the skeletal movements. AnalysesDescriptive and inferential analyses were performed based on analysis of variance (ANOVA), the Bonferroni test, Pearson’s linear coefficient, the nonparametric Mann-Whitney U-test, Kruskal-Wallis test, and multiple linear regression models. Statistical significance was considered for p < 0.05. ResultsThe sample comprised 27 subjects with a mean age of 32.5 ± 11.2 years. A mean decrease in nasolabial angle of 5.5 ± 6º was recorded (p < 0.001), with a shortening of the nasolabial fold length of 4.4 ± 7.6 mm (p=0.019). An increase in upper lip concavity angle of 14.4 ± 12º was recorded (p < 0.001), along with a vermilion lengthening of 1.6 ± 1.3 mm (p < 0.001) and an increase in upper lip sagittal distance to BL of 5.7 ± 7.3 mm (p=0.001), indicating a more projected and everted upper vermilion. Conclusions and relevanceWhen adequate dentoskeletal support is provided by specific positional changes of the jaws planned through orthognathic surgery, the length of the nasolabial fold decreases, and the upper vermilion lengthens and becomes slightly everted.

Osteoperiosteal Cylindrical Iliac Bone Graft and Minced Cartilage as an Osteochondral Autograft for a Large Osteochondral Lesion

Mosaicplasty is a relatively challenging procedure used in the management of focal osteochondral lesions of the joints. Donor-site morbidity is still the main concern after mosaicplasty because it entails the harvesting of an osteochondral autograft from an otherwise healthy region to be impacted later on the weight-bearing damaged site. We describe a possible alternative to conventional mosaicplasty with subchondral bone support harvested from the iliac crest as an osteoperiosteal autograft and covered with a minced cartilage layer.

Study and optimization of process parameters for deformation machining stretching mode

Monolithic thin-structure parts with intricate geometric designs are employed in a variety of aeronautical, medical, marine, and automotive applications, which include the moldlines of the fuselage, turbine blades, impellers, avionic shelves, irregular fins, prostheses, bone and joint support, and skull plates. The deformation machining process is the solution to this challenging and difficult-to-manufacture high-quality components with intricate narrow geometries at competitive prices. The aim of the present study is to assess the effect of process parameters of the deformation machining process wherein a thin, floor-like structure is created by milling and is then formed using a single-point incremental forming tool. Investigation involves the design and development of tooling required for the process followed by feasibility checking of the process. To examine the impact of different process parameters on the process response, the experiments were carried out using the design of experiments. The findings of this study indicate that different process parameters, including spindle speed, tool diameter, incremental step depth, and feed rate, have a substantial impact on the process response, like thickness, surface finish, and hardness. Uneven and non-uniform surface patterns during SEM indicate that it is needed to examine the impact of process parameters. This research involves the feasibility study of a new hybrid technique of deformation machining. Conventionally, a metallic structure is produced by joining various components through welding or by fastening. These methods require additional expenditure on equipment, storage, floor space, human resources, etc., with higher lead time. Joining increases weight and reduces fatigue strength. The creation of monolithic structures can eliminate all these disadvantages.

Additive Manufacturing Titanium Dental Implants Placed in Sinuses Grafted with 70HA:30-TCP: A One-Year Retrospective Study for Evaluation of Survival Rate.

The present short-term retrospective study evaluated the implant survival rate and peri-implant bone loss around additive-manufactured titanium implants placed in sinuses grafted with Plenum Osshp (Plenum Bioengenharia, Jundia, SP, Brazil) (70HA:30β-TCP) material. A total of 39 implants were inserted after 23 sinus floor elevation procedures in 16 consecutive patients. Prosthetic rehabilitation included fixed partial prostheses (three units), single crowns (eleven units), and fixed full arches (three units). Clinical and radiographic parameters of implant-supported restorations were evaluated after at least one year of occlusal loading. The implant-crown success criteria included the absence of pain, suppuration, and clinical mobility, an average distance between the implant shoulder and the first visible bone contact (DIB) < 1.0 mm from the initial surgery, and the absence of prosthetic complications at the implant-abutment interface. The overall cumulative implant survival rate was 97.43%. No prosthetic complications at the implant-abutment interface were reported. After one year, the mean DIB was 0.23 mm ± 0.14. Within the limits of this retrospective study, it can be concluded that 70 HA:30 β-TCP allowed stable and reliable bone support to maintain healthy conditions around titanium dental implants produced by additive manufacturing.