Conventional Titanium Research Articles

The clinical use of computer aided designed/computer aided manufactured titanium nitride coated implant abutments: Surgical and prosthetic considerations-A case series.

To describe the clinical use of nitride-coated titanium CAD/CAM implant abutments in the maxillary esthetic zone in two patients with high esthetic and functional demands and, to highlight the advantages of nitride-coated milled titanium abutments when compared to stock/custom titanium, one-piece monolithic zirconia, and hybrid metal-zirconia implant abutments. Due to the inherent mechanical and esthetic clinical challenges, single implant-supported reconstructions in the maxillary esthetic zone are a complex restorative treatment. While CAD/CAM technology has been suggested to enhance and ease implant abutment design and manufacturing, implant abutment material selection remains as a critical decision affecting restoration's long-term clinical outcomes. To date, considering the esthetic disadvantages of conventional titanium implant abutments, the mechanical limitations of one-piece zirconia abutments and the manufacturing time and costs associated with hybrid metal-zirconia abutments, no abutment material can be considered "ideal" for all clinical scenarios. Due to their biocompatibility, biomechanical characteristics (hardness and wear resistance), optical properties (yellow color), and peri-implant soft tissue esthetic integration, the use of CAD/CAM titanium nitride-coated implant abutments has been suggested as a predictable implant abutment material in mechanically challenging but esthetically demanding clinical situations, as the maxillary esthetic zone. Two patients requiring a combined tooth-implant restorative treatment in the maxillary esthetic zone were treated using CAD/CAM nitride coated titanium implant abutments. The principal advantages of TiN coated abutments include comparable clinical outcomes to stock abutments, optimal biocompatibility, adequate fracture, wear, and corrosion resistance, reduced bacterial adhesion, and excellent esthetic integration with adjacent soft tissues. Clinical reports and short term mechanical, biological and esthetic clinical outcomes indicate that CAD/CAM nitride coated titanium implant abutments can represent a predictable restorative alternative to stock/custom and metal/zirconia implant abutments and be considered a clinical relevant option in mechanically challenging but esthetically demanding situations, as often found in the maxillary esthetic zone.

Antimicrobial Brushes on Titanium via “Grafting to” Using Phosphonic Acid/Pyridinium Containing Block Copolymers

AbstractCoating medical implants with antibacterial polymers may prevent postoperative infections which are a common issue for conventional titanium implants and can even lead to implant failure. Easily applicable diblock copolymers are presented that form polymer brushes via “grafting to” mechanism on titanium and equip the modified material with antibacterial properties. The polymers carry quaternized pyridinium units to combat bacteria and phosphonic acid groups which allow the linear chains to be anchored to metal surfaces in a convenient coating process. The polymers are synthesized via reversible‐addition‐fragmentation‐chain‐transfer (RAFT) polymerization and postmodifications and are characterized using NMR spectroscopy and SEC. Low grafting densities are a major drawback of the “grafting to” approach compared to “grafting from”. Thus, the number of phosphonic acid groups in the anchor block are varied to investigate and optimize the surface binding. Modified titanium surfaces are examined regarding their composition, wetting behavior, streaming potential, and coating stability. Evaluation of the antimicrobial properties revealed reduced bacterial adhesion and biofilm formation for certain polymers, albeit the cell biocompatibility against human gingival fibroblasts is also impaired. The presented findings show the potential of easy‐to‐apply polymer coatings and aid in designing next‐generation implant surface modifications.

Evaluation of photocatalytic activity, water contact angle, and annealing for TiO2 thin films deposited with mixed WOX–SiO2 thin films using radiofrequency sputtering

A mixture of hydrophilic silicon dioxide (SiO2) and visible-light-reactive tungsten oxide (WOX) has the potential to improve the photocatalytic activity of conventional titanium dioxide (TiO2). This study deposits mixed WOX–SiO2 thin films on TiO2 surfaces by controlling the composition of WOX:SiO2 using radiofrequency sputtering to improve photocatalytic activity and hydrophilicity. The photocatalytic activity is evaluated via the degradation of a methylene blue solution, and hydrophilicity is measured using the water contact angle. In addition, the effect of annealing is determined at 400 °C after deposition. The optical bandgap decreases as the composition of WOX increases and subsequently anneals. The XRD measurements show that polycrystalline monoclinic WO3 peaks appear after annealing when the composition of the mixed WOX–SiO2 thin films only consists of WOX. In contrast, monoclinic WO3 (200) appears after adding SiO2. Atomic force microscopy images show that the grain size decreases as the SiO2 content increases. Moreover, the photocatalytic activity of the mixed WOX–SiO2 thin films improves after annealing. In particular, the mixed WOX–SiO2 thin films that are deposited at a sputter power of WOX:SiO2 = 100:50 W demonstrate a remarkable improvement in photocatalytic activity. Furthermore, the water contact angle of the mixed WOX–SiO2 thin films decreases as the SiO2 content increases and after annealing. This proposed approach can be used for high-performance photocatalytic materials and be widely applied for the fabrication of various semiconducting devices.

BIOMECHANICAL EVALUATION FOR COMPARISON OF 3D TITANIUM MINIPLATES WITH CONVENTIONAL TITANIUM MINIPLATES IN THE MANAGEMENT OF MANDIBULAR FRACTURES

Aim of the Study:The aim of the study was to evaluate and compare the efficacy of the 3-dimensional titanium miniplates against conventional titanium miniplates in the management of mandibular fractures. Materials and Method:This study included 20 cases of either trauma, reconstructive or orthognathic surgery in which internal fixation is indicated. Patients were assigned to any one of the two equal groups randomly. Group A consisted of 10 patients treated by 3-dimensional titanium miniplates and group B consisted of 10 patients treated by conventional titanium miniplates. Intra-operative parameter included operating time of both the groups. Postoperative clinical examination was carried out on the 1st, 2nd, 3rd, 4th, 6th weeks and the 3rd postoperative month. Postoperative clinical evaluation included assessment of pain, stability, infection, bite force, wound dehiscence. The results of two groups were compared statistically. Results:A statistically significant difference was found in the operating time which was less in group A as compared to group B (p = 0.001). The bite forces recorded on 1st postoperative week were more in group A as compared to group B and were found to be statistically significant at incisor region (p=0.012), right canine region (p=0.014), left canine region (p=0.001), right premolar region (p=0.013) and left premolar region (p=0.046). No significant difference was found in other clinical parameters. Conclusion:Due to simultaneous stabilization at superior and inferior borders, operating time was relatively less. It provides three-dimensional stability at the fracture site. 3-dimensional miniplate seems to be an easy alternative to conventional miniplates.

Functional results and unfavorable events after treatment of proximal humerus fractures using a new locking plate system

BackgroundProximal humerus fractures are often treated with a fixed-angle titanium plate osteosynthesis. Recently, plates made of alternative materials such as carbon fibre-reinforced polyetheretherketone (CFR-PEEK) have been introduced. This study presents the postoperative results of patients treated with a CFR-PEEK plate.MethodsPatients with proximal humerus fractures treated with a CFR-PEEK plate (PEEKPower™ Humeral Fracture Plate (HFP)) were included. In follow-up examination, age and gender adjusted Constant-Murley Score (ACS), Subjective Shoulder Value (SSV), Quick Disabilities of the Arm, Shoulder and Hand Score (QDASH) and pain score (Visual Analog Scale (VAS)) were analyzed. General condition at follow-up was measured by European Quality of Life 5 Dimensions 3 Level Version (EQ-5D-3L). Range of motion was recorded. In addition, radiographs at follow-up, unfavorable events and revision rate were analyzed.ResultsIn total, 98 patients (66.0 ± 13.2 years, 74 females, 24 males) were reexamined. Mean follow-up was 27.6 ± 13.2 months. There were 15 2-part, 28 3-part and 55 4-part fractures. The functional scores showed good results: SSV 83.3 ± 15.6%, QDASH 13.1 ± 17.0 and ACS 80.4 ± 16.0. A 4-part-fracture, head split component, nonanatomic head shaft reposition and preoperative radiological signs of osteoarthritis were significant negative predictors for poorer clinical scores. Unfavourable events were observed in 27 patients (27.6%). Revision surgery was performed in 8 (8.2%) patients. Risk factors for an unfavourable event were female gender, age of 50 years and older, diabetes, affected dominant hand, 4-part fracture, head split and preoperative radiological signs of osteoarthritis.ConclusionThere are several advantages of the CFR-PEEK plate (PEEKPower™ Humeral Fracture Plate (HFP)) such as the polyaxial screw placement and higher stability of locking screws. In summary, the CFR-PEEK plate osteosynthesis is a good alternative with comparable clinical results and some biomechanical advantages. Proximal humerus fractures show good clinical results after treatment with a CFR-PEEK plate. The revision rate and the risk of unfavorable events are not increased compared to conventional titanium plate osteosynthesis.Level of evidenceIV

In Vivo Biofilm Formation on Novel PEEK, Titanium, and Zirconia Implant Abutment Materials.

The formation of biofilms on the surface of dental implants and abutment materials may lead to peri-implantitis and subsequent implant failure. Recently, innovative materials such as polyether-ether-ketone (PEEK) and its modifications have been used as abutment materials. However, there is limited knowledge on microbial adhesion to PEEK materials. The aim of this in vivo study was to investigate biofilm formation on the surface of conventional (titanium and zirconia) and PEEK implant abutment materials. Split specimens of titanium, zirconia, PEEK, and modified PEEK (PEEK-BioHPP) were manufactured, mounted in individual removable acrylic upper jaw splints, and worn by 20 healthy volunteers for 24 h. The surface roughness was determined using widefield confocal microscopy. Biofilm accumulation was investigated by fluorescence microscopy and quantified by imaging software. The surface roughness of the investigated materials was <0.2 µm and showed no significant differences between the materials. Zirconia showed the lowest biofilm formation, followed by titanium, PEEK, and PEEK-BioHPP. Differences were significant (p < 0.001) between the investigated materials, except for the polyether-ether-ketones. Generally, biofilm formation was significantly higher (p < 0.05) in the posterior region of the oral cavity than in the anterior region. The results of the present study show a material-dependent susceptibility to biofilm formation. The risk of developing peri-implantitis may be reduced by a specific choice of abutment material.

Comparison of radiological and clinical outcomes of 3D-printed artificial vertebral body with Titanium mesh cage in single-level anterior cervical corpectomy and fusion: A meta-analysis.

This meta-analysis aimed to determine whether 3D-printed artificial vertebral body have superior clinical and radiographic outcome than Titanium Mesh Cage(TMC) in single-level anterior cervical corpectomy and fusion. A comprehensive search of the PubMed, Embase, Cochrane Library, Web of Science, and CNKI (China National Knowledge Infrastructure) databases was conducted to find randomized control trials (RCTs) or cohort studies that compared 3D-printed artificial vertebral body with conventional Titanium Mesh Cage (TMC) in single-level anterior cervical corpectomy and fusion (SL-ACCF). Operation time; intraoperative blood loss; subsidence of vertebral body; preoperative, and final follow-up C2-C7 Cobb angle, Japanese Orthopedic Association (JOA) scores, and Visual Analog Scale(VAS) scores were collected from eligible studies for meta-analysis. We included 6 cohort studies with 341 patients. The results of the meta-analysis showed that the 3D group has a shorter operation time than the traditional TMC group(p = 0.04) and the TMC group had more severe subsidence(≥3 mm) of vertebral body than the 3D group(p < 0.0001). And the cervical C2-C7 Cobb angle in the 3D group was larger than that in the TMC group at the final follow-up. This meta-analysis demonstrates that 3D-printed artificial vertebral body is superior to traditional TMC in reducing the operation time and maintaining the postoperative vertebral height and restoring sagittal balance to the cervical spine in single-level anterior cervical corpectomy and fusion.

New design titanium miniplate versus conventional miniplate in treatment of mandibular angle fractures: A comparative study.

Mandibular angle fracture (MAF) is the second most common site of all fractures of the mandible with the highest complication rate. Management of MAF has evolved in the past four decades. The purpose of the prospective study was to compare the efficacy of new design titanium miniplate (NDM) with conventional titanium miniplate (CTM) in the treatment of MAF. Mouth opening, occlusion, bite force measurement, and radiographs compared preoperatively and first week, first month and third month postoperatively. Fourteen patients diagnosed with MAF were randomly divided into two groups: Group A (seven patients) was treated with NDM and Group B (seven patients) with CTM. Patients were assessed preoperatively and postoperatively at an interval of one week, one month and three months. Repeated measures ANOVA and Post hoc Tukey test showed a significant increase in bite force and mouth opening for both groups in first and third postoperative months. Unpaired t-test showed slightly better mouth opening in Group B and slightly higher bite force in Group A. Both miniplates fulfilled all the study objectives and equally satisfactory healing was seen at the end of third month. NDM offers better stability, rigidity, and anatomic reduction of the fracture with a drawback of difficulty in adaptation and increased operative timing compared to CTM. Hence, we would like to conclude that both miniplates are equally efficient in the treatment of non-comminuted angle fractures with the NDM having upper hand in stability.

Biomechanical comparison of different rod-to-rod connectors to a conventional titanium- and cobalt chromium posterior spinal fixation system

IntroductionSeveral types of rod-to-rod connectors are available for the extension of spinal fixation systems. However, scientific literature regarding the mechanical performance of different rod-to-rod connector systems is lacking. Research questionThe goal of this study was to evaluate the mechanical characteristics of axial and lateral rod connectors in comparison to a conventional pedicle screw rod (titanium and cobalt chromium) construct. Material and methodSix types of instrumentations were investigated in a standardized test model to quantify the mechanical differences: 1: titanium rod; 2: titanium rod with axial connector; 3: titanium rod with lateral connector; 4: cobalt chromium rod; 5: cobalt chromium rod with axial connector; 6: cobalt chromium rod with lateral connector. All groups were tested in static compression, static torsion and dynamic compression and statistically compared regarding failure load and stiffness. ResultsIn static compression loading, the use of connectors increased the construct stiffness, but unaffected the yield load. The use of a cobalt chromium rod significantly increased by approximately 40% the yield load and stiffness in comparison to the titanium rod configurations. Under dynamic compression, a similar or higher fatigue strength for all tested groups in comparison to the titanium rod configuration was evaluated, with the exception of titanium rod with axial connector. ConclusionBiomechanically, using rod connectors is a secure way for the extension of a construct and is mechanically equal to a conventional screw rod construct. However, in clinical use, attention should be paid regarding placement of the connectors at high loaded areas.

Reconstruction after resection of C2 vertebral tumors: A comparative study of 3D-printed vertebral body versus titanium mesh.

Surgical resection of C2 vertebral tumors is challenging owing to the complex anatomy of C2 vertebrae and the challenges to surgical exposure. Various surgical approaches are available, but some are associated with excessively high risks of complications. An additional challenge is reconstruction of the upper cervical spine following surgery. In the last decade, additive-manufacturing personalized artificial vertebral bodies (AVBs) have been introduced for the repair of large, irregular bony defects; however, their use and efficacy in upper cervical surgery have not been well addressed. Therefore, in this study, we compared instrumented fixation status between patients who underwent conventional titanium mesh reconstruction and those who underwent the same resection but with personalized AVBs. We performed a retrospective comparative study and recruited a single-institution cohort of patients with C2 vertebral tumors. Clinical data and imaging findings were reviewed. Through data processing and comparative analysis, we described and discussed the feasibility and safety of surgical resection and the outcomes of hardware implants. The primary outcome of this study was instrumented fixation status. The 31 recruited patients were divided into two groups. There were 13 patients in group A who underwent conventional titanium mesh reconstruction and 18 group B patients who underwent personalized AVBs. All patients underwent staged posterior and anterior surgical procedures. In the cohort, 9.7% achieved total en bloc resection of the tumor, while gross total resection was achieved in the remaining 90.3%. The perioperative complication and mortality rates were 45.2% and 6.5%, respectively. The occurrence of perioperative complications was related to the choice of anterior approach (p < 0.05). Group A had a higher complication rate than group B (p < 0.05). Four patients (4/13, 30.8%) developed hardware problems during the follow-up period; however, this rate was marginally higher than that of group B (1/18, 5.6%). Total resection of C2 vertebral tumors was associated with a high risk of perioperative complications. The staged posterior and retropharyngeal approaches are better surgical strategies for C2 tumors. Personalized AVBs can provide a reliable reconstruction outcome, yet minor pitfalls remain that call for further modification.

Novel Three-Holed Titanium Plate Fixation during Open Door Laminoplasty for Cervical Spondylotic Myelopathy: Comparison with Conventional Titanium Plate.

For reconstructing the posterior cervical muscular-ligament complex, attachment points and various modified techniques were designed and applied in clinical practice. This study investigated the clinical and radiographic outcomes of open door laminoplasty with modified centerpiece mini-plate fixation and extensor attachment point reconstruction in the treatment of cervical spondylotic myelopathy (CSM). Sixty-nine patients with CSM who underwent C3-C7 open door laminoplasty at our hospital from January 2016 to May 2018 were divided into two groups: 37 and 32 patients underwent laminoplasty with modified and conventional centerpiece titanium plate fixation (MPF and CPF groups), respectively. Changes in cervical spinal angle (CSA), cervical range of motion (ROM), posterior cervical muscle atrophy, neurological function (Japanese Orthopaedic Association [JOA] score), Neck Disability Index (NDI), and axial symptom severity were compared between the two groups. There were no significant differences in operative duration (136.7± 23.9 vs 128.3± 21.5 min, t=1.525, p > 0.05), volume of intraoperative blood loss (275.9± 33.1 vs 268.2± 31.6ml, t=0.984, p > 0.05), lamina open angle (41.2° ± 4.5° vs 39.4° ± 4.1°, t=1.726, p > 0.05), and spinal cord drift distance (2.4± 0.3 vs 2.3± 0.4 mm, t=1.184, p > 0.05) between the two groups. After surgery, JOA score significantly increased (p < 0.05), and neurological recovery rates were similar (62.7% vs 63.4%, t=0.208, p > 0.05). The NDI score was significantly decreased in both the groups (p< 0.05); however, the MPF group recovered to a greater degree than the CPF group (8.3± 1.2 vs 9.8± 1.4) (t=4.793, p< 0.05). There was no significant change in cervical ROM postoperatively compared with preoperatively in either group (p > 0.05). CSA decreased from 21.7° ± 2.8° to 18.3° ± 2.1°, and posterior cervical muscle cross-sectional area decreased from 35.2± 4.9 cm2 to 31.0 ± 4.1 cm2 in the CPF group (p < 0.05), but no significant change was observed in the MPF group (20.6° ± 2.5° to 20.4° ± 2.6°and 35.9± 5.1 to 34.1± 4.6 cm2 , respectively) (p> 0.05). Postoperative axial symptom severity was significantly worse in the CPF group than in the MPF group (Z=-2.357, p < 0.05). As an improvement to the conventional titanium plate, the modified centerpiece titanium plate effectively provides an attachment point for the posterior muscle-ligament complex, reducing posterior cervical muscle atrophy and improving neck function, without inflicting additional surgical trauma.

A short-term prospective study to evaluate the clinical performance of endosseous zirconia implants

Background: Endosseous zirconia implants have been established as an alternative to conventional titanium implants, especially in the aesthetic zone. This pilot study aimed to evaluate the outcome of rehabilitation with zirconia implants, in a subset of the Indian population, involving varying clinical scenarios. Methods: A total of 10 one-piece zirconia implants were placed in seven patients requiring rehabilitation of missing teeth. The survival rate and marginal bone levels were evaluated at six months and 12 months following implant placement. Results: Five implants were placed in the maxilla and five in the mandible, including well-healed sites, extraction sockets, a single cantilever in the lower anterior region, and a full-arch rehabilitation. During the observation period, two early implant failures were noted resulting in a survival rate of 80%. Mean marginal bone loss of 0.73mm was seen one year following implant placement, with maximum bone loss occurring in the first six months. Conclusion: The results of this study encourage the use of endosseous zirconia implants in diverse clinical scenarios with careful case selection. However, long-term studies are needed to further validate these findings.

Effect of TiO&lt;sub&gt;2&lt;/sub&gt; Nanoparticles with High Light Absorption on Improving Growth Parameters and Enzymatic Properties of Sorghum &lt;i&gt;(Sorghum bicolor L. Moench)&lt;/i&gt;

AbstractTitanium dioxide nanoparticles are great boosters for better sunlight absorption by plants. However, their band gap is so wide that they can only absorb UV light, which is a small portion of the sunlight. To improve the absorption of visible light, in this work, titanium nanoparticles were sensitized by saffron dye and the effect of foliar application of the dyed nanoparticles on growth parameters and enzymatic properties of sorghum was investigated and the results were compared with those of conventional titanium dioxide nanoparticles. The experiment was conducted in Zabol region, Iran. Saffron, a natural organic dye, was used as a sensitizer because of its availability and high extinction coefficient in the visible regions. To perform sensitization, titanium dioxide nanoparticles were immersed in saffron dye solution to absorb the dye on their surface. Then different concentrations of the sensitized nanoparticles were applied on plants by foliar spraying. The most improved growth parameters including root and shoot lengths, shoot fresh and dry weights, root fresh and dry weights were obtained after application of dye-sensitized TiO2 nanoparticles. Zinc and iron are the elements highly affected by the application of new nanoparticles. Enzyme activities of catalase, ascorbate peroxidase and guaiacol peroxidase were also increased significantly. Chlorophyll a and Chlorophyll a/b ratio showed the highest values in 500 ppm dye-sensitized TiO2 nanoparticles. The obtained results confirm the improvement in growth parameters and enzymatic properties of Sorghum after application of the new TiO2 nanoparticles.

Membrane-free electrodeionization using graphene composite electrode to purify copper-containing wastewater.

Membrane-free electrodeionization (MFEDI) technology involves in situ electric regeneration of ion exchange resin, and is used to efficiently purify copper-containing wastewater, so that both the wastewater and copper may be reused. The electrode is the core functional component of a MFEDI system. Electrode-selection greatly influences the electric regeneration efficiency, water recovery and energy consumption of MFEDI processes. In this study, a graphene composite electrode was developed to improve MFEDI-system performance. A graphene composite electrode and conventional platinum-plated titanium electrode were both characterized by scanning electron microscopy (SEM) and electrochemical testing. Furthermore, the treatment and electrical regeneration properties of MFEDI systems with these two electrodes were investigated. The specific surface area of the electrode increased after graphene loading, while the oxygen evolution potential decreased. Wastewater treatment experiments demonstrated that MFEDI systems with graphene composite electrodes effectively removed copper from wastewater. The study also highlighted that the electroregeneration efficiency of the MFEDI system was improved by loading with graphene; the average copper concentration in the regeneration solution increased by 1.4 times to 50.4 mg/L, while the energy consumption decreased from 1.55 to 1.48 kWh/m3, and the water recovery rate increased from 85 to 90%.

Biomechanical performance of Ti-PEEK dental implants in bone: An in-silico analysis

Stress-shielding is caused by a significant mismatch in stiffness between bone tissue and Ti alloy dental implants. Therefore, in this study, a Ti-PEEK composite implant was examined and compared with conventional titanium, to determine the behavior of the host bone. Twelve 3D finite element models were modeled with two conditions of marginal cortical bone (with and without marginal bone loss). Six implant designs were constructed. Implant (A) was made with a conventional design (dense titanium), implants (B), (C) and (D) are designed with Ti-PEEK composite (outer layer made of PEEK and inner structures made of Ti with hexagonal, cylindrical, and cross shapes for implants (B), (C) and (D), respectively), the implant (E) is designed with Ti at the upper half section and PEEK at the bottom half section, and the implant (F) is designed with PEEK at the upper half section and Ti at the bottom half section. An axial load of 200 N was applied to the buccal cusp and central fossa of the occlusal surface. The displacements, stress, and equivalent strain were analyzed at the level of bone tissue. The mechanostat of Frost was used to determine the behavior of the cancellous bone under these biomechanical conditions. Results showed that strains were greater in cancellous bone with marginal bone loss than in healthy bone (w/o MBL). When compared to implants (B)-(F), conventional implant (A) did not produce as much strain. Thus, results and analyses suggest that the Ti-PEEK implants outperform compared with the implant (A) in the case of no marginal bone loss. However, the implants (A) and (E) perform equally in terms of bone loss.

Unexpected reversible crystalline/amorphous (de)lithiation transformations enabling fast (dis)charge of high-capacity anatase mesocrystal anode

High-power, fast-charging capability is an urgent issue for the development of advanced Li-ion batteries (LIBs) for electrified mobility applications. An anatase titanium oxide mesocrystal (TOM) Li-ion battery (LIB) anode comprising extremely small (3–5 nm) and crystallographically coherent nanocrystallite subunits demonstrate a high specific capacity (up to 225 mAh g-1) and extraordinary rate capability and cycle stability under stressful currents (83 % capacity retention after 9000 cycles at 10 C rate, 1 C = 168 mA g-1), considerably outperforming the conventional nanocrystalline titanium oxide (TO) electrode. The investigation of the underlying (de)lithiation mechanism using synchrotron X-ray analyses and density functional theory calculations reveals a novel crystalline–amorphous–crystalline pathway for TOM involving an amorphous phase existing within a Li stoichiometry range approximately LixTiO2, x = 0.2–0.9. The combination of structure amorphization and existing of a fast inter-grain diffusion network inherent to the hierarchical interior of mesocrystal empowers the TOM electrode with orders-of-magnitude higher diffusion rates as compared with the TO electrode. The single-crystal-like crystallographic coherence of the (de)lithiation end-products enables favorable chemo-mechanical stability to avert particle cracking during high-rate cycling. The study indicates a potential new direction for engineering cycle-stable fast-charging electrode materials.

Blood titanium levels in patients with large and sliding titanium implants

BackgroundTitanium, which is known to be a highly biologically inert element, is one of the most commonly used metals in orthopaedic implants. While cobalt and chromium blood metal ion testing is routinely used in the clinical monitoring of patients with metal-on-metal hip implants, much less is known about the levels of titanium in patients with other implant types. The aim of this study was to better understand the normal ranges of blood titanium levels in patients implanted with large and sliding titanium constructs by comparison with reference levels from conventional titanium hips.MethodsThis study examined data collected from 136 patients. Over a period of 24 months, whole blood samples were collected from 41 patients implanted with large titanium implants: long (range 15 to 30 cm) spine rods with a sliding mechanism (“spine rods”, n = 18), long bone tumour implants (“tumour implants”, n = 13) and 3D-printed customised massive acetabular defect implants (“massive acetabular implants”, n = 10). This data was compared with standard, uncemented primary titanium hip implants (“standard hips”, 15 cm long) (n = 95). Clinical, imaging and blood titanium levels data were collected for all patients and compared statistically between the different groups.ResultsThe median (range) of blood titanium levels of the standard hip, spine rods, femoral tumour implants and massive acetabular implants were 1.2 ppb (0.6–4.9), 9.7 ppb (4.0–25.4), 2.6 ppb (0.4–104.4) and 5.7 ppb (1.6–31.5) respectively. Spine rods and massive acetabular implants had significantly greater blood titanium levels compared to the standard hips group (p < 0.001).ConclusionThis study showed that titanium orthopaedic implants that are large and/or have a sliding mechanism have higher blood titanium levels compared to well-functioning, conventionally sized titanium hips. Reassuringly, the increased levels did not appear to induce adverse metal reactions. This study provides useful baseline data for future studies aimed at assessing blood titanium levels as a biomarker for implant function.

The influence of composite bone plates in Vancouver femur B1 fracture fixation after post-operative, and healed bone stages: A finite element study

Conventional stainless steel or titanium plates are used for bone fracture fixation to provide support at fracture location. Plates with high elastic modulus reduce the transfer of compressive load at the fracture location (due to stress shielding), causing failure. The objective of the study is to find for composite bone plates with different types of fibers and varied fiber orientations for post-operative (PO) and healed bone (HB) conditions which can reduce the stress shielding. Femur fracture fixation was constructed with 12 holes narrow type with metal and composite bone plates. The fracture gap was constructed with soft bone region for post-operative (PO) condition and harder bone for healed bone (HB). Composite bone plates with different configurations (fiber directions) and types (thickness and width) were analyzed to study the stress distribution and movement in the fracture location. The models were analyzed and the stresses in plate and callus, movement and strain in axial and shear direction in both metal and composite bone plates were studied. The metal and composite plates (carbon fiber/epoxy, fiberglass/epoxy, and flax/epoxy) used for most common Vancouver type B1 fracture to observe the biomechanical behavior of different models in PO and HB condition. The FE simulation on different configurations and types of composite plates provide in-depth idea about choosing the suitable composite bone plate. There are variations in behavior for varying types and configurations, but the performance of most of the plates are either better or similar to that of metal plate, except the plates with higher width.

Efficiency and Reproducibility Enhancement in Perovskite Solar Cell With MoS₂ as Electron Transport Layer: A Computational Finding

The formamidinium lead triiodide (FAPbI <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">3</sub> )-based perovskite solar cell (FPSC) is perceived as a potential replacement of conventionally exploited methylammonium lead triiodide (MAPbI <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">3</sub> )-based PSC owing to its better stability. In this work, we explore the possibility of utilizing molybdenum disulfide (MoS <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> ) as a prospective replacement of conventional titanium dioxide (TiO <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> ) (requires high processing temperature) as an electron transport layer (ETL) in FPSC using SCAPS-1D. The results are quantitatively compared in terms of the performance metrics of simulated baseline models. Furthermore, the performance variations are also compared with respect to varying absorber layer defect density. Moreover, the reproducibility aspect of cells is compared with respect to varying carrier mobility of the absorber layer. We observe an outstanding improvement in efficiency and reproducibility of FPSCs with MoS <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> as ETL. The results highlight the vitality of ETL material properties toward efficiency and reproducibility enhancement of FPSCs. These findings serve as an important benchmark for improving the commercialization prospects of FPSCs.

Continuous Implant Load Monitoring to Assess Bone Healing Status—Evidence from Animal Testing

Background and Objectives: Fracture healing is currently assessed through qualitative evaluation of radiographic images, which is highly subjective in nature. Radiographs can only provide snapshots in time, which are limited due to logistics and radiation exposure. We recently proposed assessing the bone healing status through continuous monitoring of the implant load, utilizing an implanted sensor system, the Fracture Monitor. The device telemetrically transmits statistically derived implant parameters via the patient’s mobile phone to assist physicians in diagnostics and treatment decision-making. This preclinical study aims to systematically investigate the device safety and performance in an animal setting. Materials and Methods: Mid-shaft tibial osteotomies of different sizes (0.6–30 mm) were created in eleven Swiss mountain sheep. The bones were stabilized with either a conventional Titanium or stainless-steel locking plate equipped with a Fracture Monitor. Data were continuously collected over the device’s lifetime. Conventional radiographs and clinical CT scans were taken longitudinally over the study period. The radiographs were systematically scored and CTs were evaluated for normalized bone volume in the defect. The animals were euthanized after 9 months. The sensor output was correlated with the radiologic parameters. Tissue samples from the device location were histologically examined. Results: The sensors functioned autonomously for 6.5–8.4 months until energy depletion. No macroscopic or microscopic adverse effects from device implantation were observed. The relative implant loads at 4 and 8 weeks post-operation correlated significantly with the radiographic scores and with the normalized bone volume metric. Conclusions: Continuous implant load monitoring appears as a relevant approach to support and objectify fracture healing assessments and carries a strong potential to enable patient-tailored rehabilitation in the future.