Dental Screws Research Articles

Laser Treatment of Dental Implants toward an Optimized Osseointegration: Evaluation via Tapping‐Mode Atomic Force Microscopy and Scanning Electron Microscopy

Surface modifications of dental implants play a crucial role for material stability, durability, and patient contentment; hence optimization of the commonly used techniques can have significant impact. Surface properties affect the osseointegration of implants; however, the surface for the optimal osseointegration is still being researched. Herein, the surface roughness and topography of dental implant screws after polishing, sandblasting, and laser treatment via tapping‐mode atomic force microscopy are investigated. The measurements are performed at the implants’ shank, crest, and root sites and evaluated for surface roughness, kurtosis, and skew values. Laser‐treated and sandblasted samples have a significantly higher roughness compared to the machined sample. The roughness at the root of the samples is higher in case of the laser‐treated and machined samples, while lower for the sandblasted implant. It is found that laser treatment leads to a roughness lower than that of sandblasted dental screws but significantly higher than that of mechanically polished implants. Differences in the roughness at different topological sites show the need for more precise treatment of implants in order to optimize the roughness.

ВЕРТИКАЛЬНЫЕ ТИТАНОВЫЕ ВИНТЫ С МОДИФИЦИРОВАННЫМ ПОКРЫТИЕМ ДЛЯ ПОВЫШЕНИЯ НАДЁЖНОСТИ ФИКСАЦИИ И СТАБИЛИЗАЦИИ АБАТМЕНТОВ К ПЛАТФОРМЕ ДЕНТАЛЬНЫХ ИМПЛАНТАТОВ

Vertical screws of abutments after dental implantation tend to loosen, unscrew and break, which is associated with low strength, tribological and corrosion properties of screw material under stress and aggressive environment in the oral cavity. The main causes of problems with dental screws are a decrease in their fatigue strength due to defects, residual tensile stresses and hydrogen pickup of surface layer, as well as the process of fretting corrosion that occurs under conditions of micro-displacement under cyclic loads of conditionally stationary tribocoupling. The design and operational characteristics of abutment screws, the main problematic properties of titanium materials are considered, the calculated dependences of torque, pre-tightening force, friction coefficients in thread and on support surface are given. The analysis of numerical values of these parameters is given. It is concluded that the use of vertical titanium screws with functional coatings is one of the ways of improving the reliability of the dental implantation system. The results of studies of the BioPateks diamond-like coating of the a-C:H/a-SiC-Ag system for vertical titanium abutment screws applied using cold atmospheric plasma are presented. The effectiveness of this coating has been demonstrated in metallographic analysis, static tensile tests, tribological studies, tests under microabrasive wear conditions, studies of barrier properties from the release of toxic vanadium and aluminum ions, studies of surface defects during fretting fatigue. The BioPateks coating and its application technology can be used both in industrial and in clinical and laboratory conditions. For these purposes, small-sized and low-energy equipment is used.

Effect of Er:YAG Laser Exposure on the Amorphous Smear Layer in the Marginal Zone of the Osteotomy Site for Placement of Dental Screw Implants: A Histomorphological Study.

The placement of dental screw implants typically involves the use of rotary techniques and drills to create a bone bed. This study explores the potential benefits of combining this method with an Er:YAG laser. Split osteotomies were performed on 10 jaws of euthanized domestic pigs (Sus scrofa domestica), with 12 mandibular implant osteotomies in each jaw, divided into 4 groups. In order to make a comprehensive assessment of the effect of Er:YAG lasers, histomorphological techniques were used to measure the reduction in amorphous layer thickness after Er:YAG laser treatment, both with and without the placement of dental screw implants from different manufacturers. Following bone decalcification and staining, the thickness of the amorphous layer was measured in four groups: Group A-osteotomy performed without Er:YAG laser treatment-had amorphous layer thicknesses ranging from 21.813 to 222.13 µm; Group B-osteotomy performed with Er:YAG laser treatment-had amorphous layer thicknesses ranging from 6.08 to 64.64 µm; Group C-an implant placed in the bone without laser treatment-had amorphous layer thicknesses of 5.90 to 54.52 µm; and Group D-an implant placed after bone treatment with Er:YAG laser-had amorphous layer thicknesses of 1.29 to 7.98 µm. The examination and photomicrodocumentation was performed using a LEICA DM1000 LED microscope (Germany) and LAS V 4.8 software (Leica Application Suite V4, Leica Microsystems, Germany). When comparing group A to group B and group C to D, statistically significant differences were indicated (p-value = 0.000, p < 0.05). The study demonstrates the synergistic effects and the possibility of integrating lasers into the conventional implantation protocol. By applying our own method of biomodification, the smear layer formed during rotary osteotomy can be reduced using Er:YAG lasers. This reduction leads to a narrower peri-implant space and improved bone-to-implant contact, facilitating accelerated osseointegration.

A novel functional gradient hydroxyapatite coating for zirconia-based implants

The bioactivity of zirconia in osseous-implant applications has been debated widely. Acid etching, grit blasting, etc., were employed to improve the microroughness and osseointegration. Coating of calcium phosphate minerals, which are established for metals like titanium is not compatible with zirconia and suffers delamination. Here ceramic dough processing-based composite slurry having HAp and zirconia was explored to form a thin (~10 μm) gradient coating on a zirconia dental screw implant. The coating has a homogeneous distribution of secondary phase without affecting the fine machined features like threads. Further, the matrix is porous with increased roughness, but a minimal compromise on strength. During the scratch test, the coating survived a normal load >70 N using a diamond indenter without any significant spalling or delamination. Given the simplicity and versatility, this approach is compatible and a promising solution for currently available bio-inert zirconia implants.

Comparative Study of Dental Custom CAD-CAM Implant Abutments and Dental Implant Stock Abutments.

The implementation of CAD-CAM systems in dentistry has significantly influenced the evolution of dental implantology and implant-supported prosthetics within the past three decades. Implant-supported prostheses are comfortable and aesthetic. The prosthetic abutment has also faced a rapid design evolution, from the individualization of standard stock abutments offered by various manufacturers to a modern customization process using CAD-CAM technology. This paper presents a comparative study between 20 dental custom CAD-CAM implant abutments and 20 dental implant stock abutments, based on a set of measurements performed on the digital casts obtained from 24 cases of prosthetic rehabilitation on implants. The statistical analysis (Mann-Whitney U test) revealed significant differences between these two types of abutments: the incisal margin line diameter dimensions for custom abutments were significantly improved compared to standard abutments at the cervical level (U = 343.00, z = 3.868, p < 0.0005) and the incisal/occlusal level (U = 352.00, z = 4.112, p < 0.0005), while the inclination angle of the custom abutments relative to the 0-axis was significantly smaller than that of standard abutments (U = 115.50, z = -2.286, p = 0.022). The use of custom abutments leads to an increase in the final size of the abutment, an improvement in the retention of the prosthetic work, and reduces the angulation of the abutment in relation to the implant axis, thus decreasing the risk of unscrewing or fracturing the dental screw.

Research Progress on Powder Injection Molding in Malaysia-A Review

In this era, parts complexity, dimensional accuracy, and cost-effectiveness are one of thebasic requirements of the modern industry. Most of the conventional manufacturingtechniques have failed to fulfill the industry’s needs. Powder injection molding (PIM) startedin the early 70s, which is a combination of powder metallurgy and plastic injection moldingthat fulfills the gaps in conventional manufacturing techniques. In Malaysia, PIM wasintroduced by SIRIM Sdn Bhd Malaysia in late 2000. The latter few universities startedworking on PIM. Among all universities, the Advanced Functional Materials Research(AFM) group at Universiti Teknologi PETRONAS (UTP) started to work in 2008 under thedirection of Prof. F. Ahmad and was decided to target various industries and their latestrequirements. The work completed during the past 11 years has been published in varioushigh-quality international journals, secure intellectual property (IP), i.e., trademarks, patents,a pre-commercialization grant from the government, one commercialization agreement, andsigned a technology licensing agreement. They also worked on carbon Nanotube reinforcedcopper nanocomposite for thermal management and secured two patents. This project wascommercialized for heat sink materials for LED Lights. The group is also working oncontrolling the orientation of fibers in the metal matrix to enhance thermal conductivity.Moreover, grafting graphene on metal oxide for its potential use as a radiation shieldingmaterial is one of the noble works. Currently, the group is working on the fabrication of softmagnetic material with enhanced permeability for potential use in hearing Aids, electricmotors, and several other applications. Besides, bio-medical parts like a dental screw, biomedical material of 316L SS reinforced by nano Titanium and additive manufacturing byusing ultra-fused BASF 316L SS parts made through FDM represent the scope of works inPIM.

Evaluation of Microbiologically Induced Corrosion in the Presence of Streptococcus Mutans

Titanium and titanium alloys are used in biomedical implants such as dental screws due to their excellent mechanical strength and high resistance to corrosion. The corrosion resistance of these alloys is largely due to the formation of a passive oxide layer on the titanium surface when in contact with oxygen. For the application of use in dental implants, titanium’s ability to withstand corrosion in the presence of oral bacteria is of utmost importance, specifically in the presence of Streptococcus mutans, the most common plaque causing oral bacteria. Previous literature has explored the effects of the formation of a S. mutans biofilm on the corrosion resistance of commercially pure titanium [1]. A decrease in corrosion resistance is observed following the formation of the biofilm, however this decrease in corrosion resistance does not invalidate the viability of titanium for use in orthodontic systems. Due to the electrochemical and material similarities between titanium and zirconium, including the formation of a passive oxide layer on the zirconium surface and high material strength, there is evidence to suggest zirconium and zirconium alloys may be a viable alternative to titanium for these applications [2]. Previous literature has explored the use of titanium-zirconium alloys in such applications and found no decrease in their ability to withstand colonization and microbiologically induced corrosion in the presence of Streptococci species relative to commercially available titanium [3]. The aim of this current research is to begin the exploration of the feasibility of zirconium based materials in orthodontic applications by investigating the microbiologically induced corrosion of commercially pure zirconium and a zirconium-niobium alloy in the presence of S. mutans and compare them against commercially pure titanium.

A review on application of biomaterials for medical and dental implants

Biological tissues in the body stop functioning normally at certain times due to genetic abnormalities, ageing, sickness, trauma, degeneration or accidents. Over the past few decades, biomaterials have been extensively used in the medical and dental fields. It is used as an alternate for natural bone with inflammation or mechanical integrity. The usages of biomaterials in various applications are implant materials, integral approach to promote healing of tissues, regeneration of tissues, probes and nanoparticles, biosensors and drug delivery system. Significant research and development are still being carried out for orthopaedic implants, dental screws, bone replacement, etc. Materials designed for biomedical applications have gone through three generations, with the first generation being bioinert materials, the second being bioactive and biodegradable materials and the third being molecular responses to materials (tissue level). Biocompatibility (biological and mechanical), corrosion resistance, wear resistance and osseointegration are factors to consider while using biomaterials for longer duration. Metals and their alloys, ceramics, polymers and composites are some bioimplant materials that are being used in the modern world. Some of the most important criteria for the selection or development of new biomaterials are kinds of oxide coatings generated on the surface and the mechanical properties of materials. The article reviews out categories of bioimplants and outlines the properties exhibited by various implant material, biological and mechanical factors favouring material selection, and few challenges shown by the materials.

Structure and Properties of Co-Cr-Mo Alloy Manufactured by Powder Injection Molding Method.

Cobalt–chromium–molybdenum alloys samples were obtained by the powder injection molding method (PIM). PIM is dedicated to the mass production of components and can manufacture several grades of dental screws, bolts, stabilizers, or implants. As a skeleton component, ethylene–vinyl acetate (EVA copolymer) with a low temperature of processing and softening point was used. The choice of a low-temperature binder made it necessary to use a coarse ceramic powder as a mechanical support of the green sample during sintering. The injection-molded materials were thermally degraded in N2 or Ar-5%H2 and further sintered in N2-5%H2 or Ar-5%H2 at 1300 or 1350 °C for 30 min. The structure of the obtained samples was characterized by X-ray diffraction and electron microscopy. Mechanical properties, including hardness and three-point bending tests, confirmed that a nitrogen-rich atmosphere significantly increases the bending strength compared to the material manufactured in Ar-5%H2. This is due to the precipitation of numerous fine nitrides and intermetallic phases that strengthen the ductile γ-phase matrix.

Nanotubular Oxide Layer Formed on Helix Surfaces of Dental Screw Implants

Surface modification is used to extend the life of implants. To increase the corrosion resistance and improve the biocompatibility of metal implant materials, oxidation of the Ti-13Nb-13Zr titanium alloy was used. The samples used for the research had the shape of a helix with a metric thread, with their geometry imitating a dental implant. The oxide layer was produced by a standard electrochemical method in an environment of 1M H3PO4 + 0.3% HF for 20 min, at a constant voltage of 30 V. The oxidized samples were analyzed with a scanning electron microscope. Nanotubular oxide layers with internal diameters of 30–80 nm were found. An analysis of the surface topography was performed using an optical microscope, and the Sa parameter was determined for the top of the helix and for the bottom, where a significant difference in value was observed. The presence of the modification layer, visible at the bottom of the helix, was confirmed by analyzing the sample cross-sections using computed tomography. Corrosion tests performed in the artificial saliva solution demonstrated higher corrosion current and less noble corrosion potential due to incomplete surface coverage and pitting. Necessary improved oxidation parameters will be applied in future work.

A simple and inexpensive method for evaluation of in vitro cell adhesion on screws.

Only a limited number of techniques are available for assessing the effect of different coating materials on cell adherence to screws. In this study, we describe a simple and inexpensive method for evaluation of cell adhesion on irregular surfaces such as the surgical or implant screws. For this purpose, we prepared semi-submerged screws in the petri dishes using agar. Using BSA- or HA-coated screws, we tested whether BSA or HA could improve cell adherence when used as coating materials. Agar-coated screws were used as internal control. Then the "ratio of cell adherence" was calculated by subtracting the reference RCA value obtained from the agar coated screws (internal control). When compared to that of the non-coated screws both the HA- and BSA-coating improved cell adherence on the screws by 2.34 and 2.72 fold respectively. Similarly, MTT assay data revealed that the metabolic capacities of cells on HA- or BSA-coated screws were improved by 2.36 and 2.86 fold respectively. These findings suggest that this protocol can be used for comparing the ability of cells to attach on irregular surfaces such as dental or orthopedic screws and assessing their viability.

Materials for Orthopedic Bioimplants: Modulating Degradation and Surface Modification Using Integrated Nanomaterials

Significant research and development in the field of biomedical implants has evoked the scope to treat a broad range of orthopedic ailments that include fracture fixation, total bone replacement, joint arthrodesis, dental screws, and others. Importantly, the success of a bioimplant depends not only upon its bulk properties, but also on its surface properties that influence its interaction with the host tissue. Various approaches of surface modification such as coating of nanomaterial have been employed to enhance antibacterial activities of a bioimplant. The modified surface facilitates directed modulation of the host cellular behavior and grafting of cell-binding peptides, extracellular matrix (ECM) proteins, and growth factors to further improve host acceptance of a bioimplant. These strategies showed promising results in orthopedics, e.g., improved bone repair and regeneration. However, the choice of materials, especially considering their degradation behavior and surface properties, plays a key role in long-term reliability and performance of bioimplants. Metallic biomaterials have evolved largely in terms of their bulk and surface properties including nano-structuring with nanomaterials to meet the requirements of new generation orthopedic bioimplants. In this review, we have discussed metals and metal alloys commonly used for manufacturing different orthopedic bioimplants and the biotic as well as abiotic factors affecting the failure and degradation of those bioimplants. The review also highlights the currently available nanomaterial-based surface modification technologies to augment the function and performance of these metallic bioimplants in a clinical setting.

Cytocompatible and Anti-bacterial Adhesion Nanotextured Titanium Oxide Layer on Titanium Surfaces for Dental and Orthopedic Implants.

It is widely recognized that surface nanotextures applied on a biomaterial can affect wettability, protein absorption and cellular and/or bacterial adhesion; accordingly, they are nowadays of great interest to promote fast osseointegration and to maintain physiological healing around biomedical implants. In order to be suitable for clinical applications, surface nanotextures must be not only safe and effective, but also, they should be produced through industrial processes scalable to real devices with sustainable processes and costs: this is often a barrier to the market entry. Based on these premises, a chemical surface treatment designed for titanium and its alloys able to produce an oxide layer with a peculiar sponge like nanotexture coupled with high density of hydroxyl group is here presented. The modified Ti-based surfaces previously showed inorganic bioactivity intended as the ability to induce apatite precipitation in simulated body fluid. Physicochemical properties and morphology of the obtained layers have been characterized by means of FESEM, XPS, and Zeta-potential. Biological response to osteoblasts progenitors and bacteria has been tested. The here proposed nanotextured surfaces successfully supported osteoblasts progenitors' adhesion, proliferation and extracellular matrix deposition thus demonstrating good biocompatibility. Moreover, the nanotexture was able to significantly reduce bacteria surface colonization when the orthopedic and the periodontal pathogens Staphylococcus aureus and Aggregatibacter actinomycetemcomitans strains were applied for a short time. Finally, the applicability of the proposed surface treatment to real biomedical devices (a 3D acetabular cup, a dental screw and a micro-sphered laryngeal implant) has been here demonstrated.

Biomedical Grade Stainless Steel Coating of Polycaffeic Acid via Combined Oxidative and Ultraviolet Light-Assisted Polymerization Process for Bioactive Implant Application.

Stainless steel as a biomedical implant material has been studied in various fields and in various forms, such as vascular stents, bone plates, dental screws, and artificial hip and bone material. In this study, we used polycaffeic acid (PCA), a natural phenolic compound, to coat the surface of medical grade stainless steel to provide added potential medicinal effects by virtue of its inherent anti-inflammatory, antiviral, antifibrosis, antithrombosis, and antihypertensive characteristics. We did this via UV irradiation under an alkaline state to solve the cost and time problems of other existing coating methods. The physicochemical properties of the samples were investigated through field emission scanning electron microscopy (FESEM), atomic force microscopy (AFM), contact angle, FTIR, and X-ray photoelectron spectroscopy (XPS). Surface bioactivity using NIH-3T3 cell lines were observed in vitro. We expect that the proposed methodology may contribute to the field of study of implantable metallic devices.

Heading process design of titanium alloy dental screws

This study is to investigate the effects of the process parameters on the heading load and metal flow pattern during heading processes of titanium alloy dental screws. The flow stresses of titanium alloy Ti-6Al-4V at different forming temperatures and strain rates are obtained by compression tests. A heading process composed of two stages of shaft extrusion and head forging is proposed. The material flow pattern of the billet inside the die is analyzed using the finite element analyses. The effects of the upper die stroke and forming speed on the heading loads and product shapes are discussed. On the other hand, die stress analysis inside the punch and lower die are also investigated.

TiO2 Nanotubes on Ti Dental Implant. Part 3: Electrochemical Behavior in Hank’s Solution of Titania Nanotubes Formed in Ethylene Glycol

Anodic oxidation is an easy and cheap surface treatment to form nanostructures on the surface of titanium items for improving the interaction between metallic implants and the biological environment. The long-term success of the devices is related to their stability. In this work, titanium nanotubes were formed on a dental screw, made of titanium CP2, through an anodization process using an “organic” solution based on ethylene glycol containing ammonium fluoride and water. Then, the electrochemical stability in the Hank’s solution of these “organic” nanotubes has been investigated for 15 days and compared to that of titanium nanotubes on a similar type of sample grown in an inorganic solution, containing phosphoric and hydrofluoridric acids. Morphological and crystallographic analysis were performed by using scanning electron microscopy (SEM) and X-Ray diffractometry (XRD) tests. Electrochemical measurements were carried out to study the stability of the nanotubes when are in contact with the biological environment. The morphological measurements revealed long nanotubes, small diameters, smooth side walls, and a high density of “organic” nanotubes if compared to the “inorganic” ones. XRD analysis demonstrated the presence of rutile form. An appreciable electrochemical stability has been revealed by Electrochemical Impedance Spectroscopy (EIS) analysis, suggesting that the “organic” nanotubes are more suitable for biomedical devices.

Gallium incorporation into phosphate based glasses: Bulk and thin film properties.

The osteogenic ions Ca2+, P5+, Mg2+, and antimicrobial ion Ga3+ were homogenously dispersed into a 1.45 µm thick phosphate glass coating by plasma assisted sputtering onto commercially pure grade titanium. The objective was to deliver therapeutic ions in orthopaedic/dental implants such as cementeless endoprostheses or dental screws. The hardness 4.7 GPa and elastic modulus 69.7 GPa, of the coating were comparable to plasma sprayed hydroxyapatite/dental enamel, whilst superseding femoral cortical bone. To investigate the manufacturing challenge of translation from a target to vapour condensed coating, structural/compositional properties of the target (P51MQ) were compared to the coating (P40PVD) and a melt-quenched equivalent (P40MQ). Following condensation from P51MQ to P40PVD, P2O5 content reduced from 48.9 to 40.5 mol%. This depolymerisation and reduction in the P-O-P bridging oxygen content as determined by 31P NMR, FTIR and Raman spectroscopy techniques was attributed to a decrease in the P2O5 network former and increases in alkali/alkali-earth cations. P40PVD appeared denser (3.47 vs. 2.70 g cm-3) and more polymerised than it's compositionally equivalent P40MQ, showing that structure/ mechanical properties were affected by manufacturing route.

Intraoral welding of titanium dental implants: Characterization of the joints

The aim of this work is to find the optimal conditions to obtain a continuous joint without alterations/oxidations in the intraoral welding of titanium by electric resistance technique. The proposed technique allows intraoral welding of titanium in order to obtain the solidarization of dental implants for improving their primary stability. Commercially pure titanium (c.p. Ti) wires and dental screws were welded by electric resistance technique. A metallographic and mechanical evaluation of the joining area was performed by electronic and optical microscopy, as well as by hardness measurements. The welding has been realized in different conditions by a circumferential pulse welding machine, in order to investigate the eventual drawbacks and to optimise the welding procedure. Moreover, the attention was focused on the use of a flux of argon during the procedure, in order to avoid oxidation and to improve the microstructural characteristics of the joint. The characterization of various welded Ti wires led to the individuation of the optimal conditions to obtain a continuous joint without alterations or oxidations. The best results were obtained by using two impulses and argon flux. A clinical case demonstrates the effectiveness of the technique in the improvement of dental implants primary stability.

Engineered protein coatings to improve the osseointegration of dental and orthopaedic implants

Here we present the design of an engineered, elastin-like protein (ELP) that is chemically modified to enable stable coatings on the surfaces of titanium-based dental and orthopaedic implants by novel photocrosslinking and solution processing steps. The ELP includes an extended RGD sequence to confer bio-signaling and an elastin-like sequence for mechanical stability. ELP thin films were fabricated on cp-Ti and Ti6Al4V surfaces using scalable spin and dip coating processes with photoactive covalent crosslinking through a carbene insertion mechanism. The coatings withstood procedures mimicking dental screw and hip replacement stem implantations, a key metric for clinical translation. They promoted rapid adhesion of MG63 osteoblast-like cells, with over 80% adhesion after 24 h, compared to 38% adhesion on uncoated Ti6Al4V. MG63 cells produced significantly more mineralization on ELP coatings compared to uncoated Ti6Al4V. Human bone marrow mesenchymal stem cells (hMSCs) had an earlier increase in alkaline phosphatase activity, indicating more rapid osteogenic differentiation and mineral deposition on adhesive ELP coatings. Rat tibia and femur in vivo studies demonstrated that cell-adhesive ELP-coated implants increased bone-implant contact area and interfacial strength after one week. These results suggest that ELP coatings withstand surgical implantation and promote rapid osseointegration, enabling earlier implant loading and potentially preventing micromotion that leads to aseptic loosening and premature implant failure.

Making the most of additive layer manufacture - development of tailored titanium implants with embedded therapeutics

Event Abstract Back to Event Making the most of additive layer manufacture - development of tailored titanium implants with embedded therapeutics Sophie Cox1, Hany Hassanin2*, Parastoo Jamshidi2*, Moataz Attallah2*, Duncan Shepherd3*, Owen Addison4* and Liam Grover1* 1 University of Birmingham, Chemical Engineering, United Kingdom 2 University of Birmingham, Materials and Metallurgy, United Kingdom 3 University of Birmingham, Mechanical Engineering, United Kingdom 4 University of Birmingham, Dentistry, United Kingdom Introduction: Musculoskeletal disorders cost society an estimated $254 billion annually[1]. Common metallic alloys used for bone prostheses, including titanium, exhibit modulus values significantly higher than native bone tissue. This mismatch results in a phenomena called stress shielding, which ultimately may impact implant functionality and patient quality of life. Furthermore, despite low incidence rates, infection of primary and revision prostheses represents one of the most serious and devastating complications[2]. Since invention in the 1980s, additive layer manufacture (ALM) techniques have been employed in a number of industries. The utilisation of such methods has provided researchers with improved geometrical design flexibility since the part is manufactured from a model constructed using computer aided design (CAD) software, which circumvents a number of limitations associated with traditional techniques, such as casting. Primarily, ALM techniques have been employed in medicine to manufacture tailored implants created from patient geometries obtained from CT or MRI data. We propose that these manufacturing modalities may be further exploited to address stress shielding and infection issues related to bone prostheses. In this case study we demonstrate the design and manufacture of novel implant models using selective laser melting (SLM), that incorporate a mechanically optimised reservoir containing a secondary biomaterial phase loaded with a therapeutic reagent. Materials and Methods: A dental screw model was altered using CAD (Solidworks) to incorporate a central reservoir connected to the extremities via four pore channels on the bottom face of the part (Figure 1). Implants were manufactured from a Ti-6Al-4V alloy using a Concept M2 Cusing System. Structures were then loaded with injectable calcium phosphate cements containing gentamicin sulphate as a model antibiotic. Results: Micro-CT revealed successful infiltration of the reservoir with optimised cement formulations. The majority, >80%, of cement porosity was found to be open and this is suggested to have contributed to release of gentamicin sulphate, which was monitored by UV absorbance. Within 72 hours the antibiotic payload had been released from the implant and was shown, using an agar diffusion assay, to inhibit the growth of staphylococcus aureus and epidermis bacteria. Conclusions: Restoring the structure and function of musculoskeletal disorders, particularly in areas of significant load bearing, continues to challenge researchers and clinicians. Promisingly, this case study demonstrates that by fully utilising the geometrical design flexibility of ALM further mechanical and therapeutic functionality may be incorporated into bone prostheses. The results of this study show that this innovative approach has the potential to address stress shielding and infection issues associated with implants, which currently devastatingly impact patient quality of life. EPSRC for financially supporting this research (EP/L020815/1)