Bone Plate Research Articles

Double Reinforcing Strategy with Perpendicular Plate of Ethmoid in Asian Secondary Unilateral Cleft Rhinoplasty: A Finite Element Analysis.

Deviation and asymmetry relapse after secondary unilateral cleft rhinoplasty with septal extension graft is a common yet serious problem especially among Asian patients. Therefore, finding an effective approach to reduce deformity relapse remains a great challenge to plastic surgeons. In this study, authors established finite element models to simulate different nasal cartilage-corrected options and different reinforcing strategies in secondary unilateral cleft rhinoplasty. A load of 0.01N was given to the nasal tip to simulate the soft tissue pressure, while two loads of 0.5N were separately given to the anterior and posterior part of the septal extension graft to simulate the rhinoplasty condition. Maximum deformations were evaluated to make stability judgments. The maximum deformation of different cartilage correction models in ascending order was: UCL deformity with septum correction, normal nasal cartilage, UCL nasal deformity, and UCL nasal deformity with lower lateral cartilage correction. When applied L-strut reinforcement graft was harvested from the perpendicular plate of the ethmoid bone, the maximum deformation of the models decreased significantly, and strong fixation of the septum could further enhance this decreasing effect. Correcting the septum and lower lateral cartilage together could improve the structural stability and symmetry in secondary unilateral cleft rhinoplasty. To keep the corrected septum stable and thus reduce deformity relapse, reinforcing the L-strut with perpendicular plate of ethmoid graft while strongly anchoring the septal cartilage to the anterior nasal spine was proved to be effective in both finite element analysis and clinical observation. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Biomechanical Analysis of a Femur Bone

In this paper, a CAD model of human femur bone was generated and was analysed which is useful for medical industry for implementing the correct size and correct plate that can withstand the stresses developed by the user. The purpose of the work is to find a suitable material which can withstand the maximum stress made by the user. In this paper internal fixation is analysed. The image of femur bone is generated by using the 3D slicer where CT scan data in form of DICOM files is sent to the software to generate 3D model and the Bone plate, screws are modelled by using SolidWorks, the dimensions of the plate and screws are taken according to the generated femur bone. The function of the bone was analyzed for four different materials i.e. Nylon, PMMA, SS316L, TI-6Al-4V by using Ansys software and when the body is physically active. Total deformation and von-misses stress analysis help to choose the material which can withstand the max stress under different activities. Index Terms: Femur, 3D Slicer, SolidWorks, Ansys, Von-mises stress.

Convolutional neural network for assisting accuracy of personalized clavicle bone implant designs

<span lang="EN-US">The clavicle is a long bone that tends to be frequently fractured in the midshaft region. The plate and screw fixing method is mainly applied to address this issue. This study aims to construct a clavicle bone implant design with a consideration to achieve a high accuracy and high-quality surface between the plate and the clavicle surface. The computational tomography scanning (CT-scan) image series data were processed using a convolutional neural network (CNN) to classify the clavicle image. The CNN outcomes were gathered as three-dimensional (3D) volume data of clavicle bone. This 3D model was then proposed for the plate design. The CNN testing results of 97.4% for the image clavicle bones classification, whereas the prints of the 3D model from clavicle bone and its plate and screw design reveal compatibility between the bone surface and the plate surface. Overall, the CNN application to the series of CT images could ease the classification of clavicle bone images that would precisely construct the 3D model of clavicle bone and its suitable clavicle bone plate design. This study could contribute as a guideline for other bone plate areas that need to fit the patient’s bone geometry.</span>

Half- and full-grafting alveolar ridge preservation with different sealing materials: A three-arm randomized clinical trial.

The objective of this study is to investigate the effect of different alveolar ridge preservation (ARP) approaches on bone resorption and their potential for facilitating implant placement. Patients who underwent one or two tooth extractions with a desire for restoration were included in the study. The participants were randomly assigned to one of three groups for ARP. The groups were as follows: (1) Half grafting of bovine bone mineral (DBBM-C) covered with non-resorbable dense polytetrafluoroethylene (dPTFE) membrane (Test 1 group); (2) Half grafting of bovine bone mineral (DBBM-C) covered with collagen membrane (Test 2 group); and (3) Full grafting with collagen membrane (DBBM-C + Collagen membrane) as the Control group. After 6-month healing period, the evaluation encompassed clinical, radiographic, implant-related outcomes, and the factors contributing to hard and soft tissue alterations. Enrollment in this study comprised 56 patients. At the 6-month follow-up, radiographic analysis in computed beam computed tomography images was conducted for 18, 19, and 19 patients with 18, 20, and 20 tooth sites in Test 1, Test 2, and Control groups, respectively. Additionally, a total of 15, 17, and 17 patients with 15, 18, and 17 implants were evaluated. Based on radiographic analysis, all groups showed limited ridge resorption at 1 mm from crest horizontally (Test 1: 1.29 ± 1.37; Test 2: 1.07 ± 1.07; Control: 1.54 ± 1.33 mm, p = 0.328), while the Control group showed greater radiographic bone height gain in mid-crestal part vertically (Test 1: 0.11 ± 1.02; Test 2: 0.29 ± 0.83; Control: -0.46 ± 0.95 mm, p = 0.032). There were no significant intergroup differences in terms of keratinized mucosal width, bone density, insertion torque, and the need of additional bone graft. However, the use of a dPTFE membrane resulted in a significantly higher vertical mucosal thickness (Test 1: 2.67 ± 0.90; Test 2: 3.89 ± 1.08; Control: 2.41 ± 0.51 mm, p < 0.001). The study showed comparable dimensional preservation with limited vertical shrinkage, while thin buccal bone plate, non-molar sites, and large discrepancy between buccal and palatal/lingual height may contribute to greater shrinkage. Thicker mucosa with dPTFE membrane required further investigation for interpretation. NCT06049823. This clinical trial was not registered prior to participant recruitment and randomization.

Concentrated growth factor and collagen as barrier materials in alveolar ridge preservation for posterior teeth: a prospective cohort study with one-year follow-up.

This study aims to evaluate the efficacy of concentrated growth factor (CGF) membrane and collagen as barrier materials in sealing the alveolar socket in alveolar ridge preservation (ARP) in the posterior region during a one-year follow-up. A total of 24 patients who underwent ARP in the posterior region were selected for inclusion and randomly assigned to the CGF group (12 cases) and Collagen group (12 cases). The patients in both groups underwent extraction of posterior teeth. The extraction sockets were filled with a bone substitute to the level of the pre-extraction buccal and lingual or palatal alveolar bone plates. The wounds in the CGF group were closed with a fabricated CGF overlaying the upper edge of the bone substitute material, whereas those in the Collagen group were closed with Bio-Oss Collagen. The implants were placed after 6 months. The evaluation was based on implant retention, re-grafting rate, and vertical and horizontal alveolar ridge bone volume changes measured by cone beam computed tomography (CBCT). Data were statistically analyzed using SPSS 28.0 software. No patient withdrew throughout the follow-up period. No implant failure and no severe peri-implant or mucosal soft tissue complications were observed. Six months after the operation, the degree of vertical alveolar ridge height resorption in the CGF group was lower than that in the Collagen group (P<0.05). There were no statistically difference between the groups at 1 year after the operation (P>0.05). The amount of bone reduction in horizontal alveolar ridge width showed no difference between the groups at 6 months and 1 year after surgery (P>0.05). CGF membrane and Bio-Oss Collagen as barrier materials for posterior ARP inhibited reduction in alveolar ridge bone mass.

A novel transcoronal surgical technique for the treatment of cystic lesions of the distal phalanx: A cadaveric study.

To assess the feasibility of a novel transcoronal approach for the treatment of axial type 3 cysts of the palmar/plantar aspect of the distal phalanx (P3). Ex vivo, experimental study. Ten cadaveric specimens, four forelimbs and six hindlimbs. All cadaveric specimens underwent radiographically guided drilling, followed by cortical screw placement. The cartilage was macroscopically assessed after disarticulation of the distal interphalangeal joint. The entry point and trajectory were evaluated with computed tomography. Results were categorized as: axial, near-axial and abaxial. The minimal distance from the outer margin of the drill hole and the proximal border of the subchondral bone plate was measured using frontal computed tomographic slices. Eight of the 10 screws were in an axial to near-axial position and nine followed the desired axial to near-axial trajectory. One screw was inserted axially but continued in an abaxial trajectory. Iatrogenic damage to the joint cartilage, flexor cortex and solar canal of P3 was not observed. All cortical screws were placed close to the proximal subchondral bone-plate of P3. The desired axial/near-axial drilling and screw placement, under radiographic guidance, was achieved in nine out of 10 specimens. This novel technique seems promising for the treatment of inaccessible P3 cysts. Additional studies are required to investigate its feasibility in clinical cases, and the long-term outcome following transcystic screw placement of type 3 P3 cysts.

Impact and torsional behavior of additive layer-manufactured biopolymer: An advancement for orthopedic applications.

Distal ulna locking bone plates (DLBPs) are commonly employed in the treatment of distal ulna fractures. However, commercially available metallic bone plates experience stress shielding and lack corrosion resistance. Poly lactic acid (PLA) is highly favored biopolymer due to its biocompatible and bioabsorbable nature with human tissues. The use of additive layer manufacturing (ALM) is gaining attention for creating customized implants with intricate structures tailored to patient autonomy. ALM-based PLA bone plates must provide high resistance against impact and torsional forces, necessitating the adjustment of printing process parameters. This study focuses on examining the influence of key printing parameters, on the impact strength and torque-withstanding capability of DLBPs. Experimental results, along with microscopic images, reveal that an increase in infill density (IF) and wall thickness imparts strong resistance to layers against crack propagation under impact and torsional loads. On the contrary, an increase in layer height and printing speed leads to delamination and early fracture of layers during impact and torsional testing. IF significantly contributes to improving the impact strength and torque-withstanding capability of DLBPs by 70.53% and 80.65%, respectively. The study highlights the potential of the ALM technique in developing DLBPs with sufficient mechanical strength for biomedical applications.

Cylindrical depth image based customized helical bone plate design

Commercial straight metal plates have been generally used to fix fractured bones, but recently, the need for customized and helical metal plates has emerged. Customized metal plates are designed to fit the shape of the fracture area that is a 3D curved surface, making it more difficult than designing on a 2D plane. Helical plates are researched due to their advantage in avoiding blood vessel damage compared to commercially available straight metal plates. In this paper, we propose a novel algorithm to design a customized helical metal plate for the femur using cylindrical depth images and Boolean operations. We also present the results of 3D printing a metal plate designed using the proposed algorithm, and the shape matching is verified by calculating the minimum distance between the surface of the printed plate and the surface of the femur.

Influence of CBCT filters and contrast adjustments on peri-implant buccal bone thickness measurement and blooming expression.

To assess whether filter and contrast adjustments can improve the accuracy of CBCT in measuring the buccal bone thickness (BBT) adjacent to dental implants by reducing blooming artifacts. Homogeneous bone blocks with peri-implant BBT of 0.3mm, 0.5mm, and 1mm were scanned using the Orthophos SL system. Three dentists measured the BBT in 234 CBCT scans under different settings of contrast adjustments and 'Sharpen' filter activation. Additionally, implant diameter measurements were taken to assess blooming artifact expression. The differences between tomographic and actual measurements of BBT and implant diameter [(CBCT - actual) * 100 / actual] were subjected to Mixed ANOVA (α = 0.05). The group with the thinnest BBT (0.3mm) had the greatest difference between tomographic and actual measurements (79.9% ± 29.0%). Conversely, the 0.5mm (36.1% ± 38.4%) and 1mm (29.4% ± 12.3%) groups exhibited lower differences (p < 0.05). 'Sharpen' filter activation reduced blooming expression since it resulted in a lower difference for implant diameter (p < 0.05), but it did not influence BBT measurements (p = 0.673). Contrast settings had no impact on BBT (p = 0.054) or implant diameter measurements (p = 0.079). Although filter activation reduced blooming artifacts, neither filter nor contrast adjustments improved the accuracy of CBCT in measuring peri-implant BBT; actual BBT influenced this task. When assessing the peri-implant buccal bone plate in the CBCT system studied, dental surgeons may find it beneficial to adjust contrast and apply filters according to their preferences, since such adjustments were found to have no adverse effects on the diagnostic accuracy of this task. The use of the 'Sharpen' filter may lead to improved representation of implant dimensions.

Advances in the application of the bony window technique in endodontic microsurgery

The bony window technique refers to cutting the intact bone plate to form a bone window and a free bone block to get access to lesions under the bone. At the end of the surgery, the dislocated bony lid needs to be repositioned to its original position. In endodontic microsurgery, compared with conventional osteotomy, the bony window technique has the advantages of improving the view of surgery and operability, reducing postoperative bone defects, promoting bone healing, and maintaining the integrity of the jaw outline. Accurate positioning and preparation of the bony window are important prerequisites for subsequent operations during the surgery, but it's difficult in some situations, such as when the operative area is located posteriorly or the bone cortex on the lesion surface is thick and intact. What's more, whether the free bone block can be stabilized in situ after repositioning is closely related to the prognosis of the surgery. The complementary application of digital navigation technology and bone cavity filling materials may help to improve the bony window technique and provide more possibilities for the retention of affected teeth in difficult cases.

Numerical evaluation of scaffolds as a method to restore continuity of a long bone

PurposeIn case of necessity of removing a bone fragment, the process of restoring bone continuity relies on the use of bone grafts or bone plates as osteosynthesis methods. These approaches are characterised by several disadvantages, such as significant changes in load transfer method through the bone. Recently, scaffolds emerged as potentially more efficient method in restoring bone continuity. In this paper, an attempt was made to validate the correctness of this statement. Materials and methodsThree lengths of bone defects were selected for the analysis: 35, 45 and 55 mm, located in the lower, middle and upper section of femur diaphysis. The following methods of restoring bone continuity were evaluated: 1 plate, 2 parallel plates, 1 plate and scaffold, 2 parallel plates and scaffold. Simulations of the forces generated during human gait cycle were performed. The evaluated parameters obtained were: maximal and average stresses, strain energy density as well as percentage changes in values of these parameters in relation to the values obtained for intact bone in its selected zones. ResultsStudies have shown that the best method of restoring bone continuity is to use a single plate with a scaffold. The stress distribution obtained by this method had the highest similarities to the one obtained for intact bone model in terms of load transfer as well as maximal stresses values obtained. ConclusionsThe study validated the statement that the use of a scaffold to restore bone continuity is potentially more efficient method than conventional approaches.

High-Resolution Ultrasound of Odontogenic Cutaneous Sinus Tract: An International Multicentric Experience and a Review of the Literature.

To investigate the role of high-resolution ultrasound (HR-US) in the initial and differential diagnosis of the Odontogenic Cutaneous Sinus Tract (OCST) in a multicentric setting. Skin HR-US examinations of OCSTs performed between January 2019 and June 2023 at different Institutions were retrospectively reviewed. Epidemiological and clinical data (age, gender, location of the skin lesion, causative tooth, and the clinical suspicion) as well as HR-US imaging findings (morphology and length of the sinus tract, Doppler signal, and cortical bone interruption of maxilla or mandible) were collected. US examinations were performed by expert radiologists using a high-performance US scanner, employing a high-frequency linear probe (15 MHz or higher frequencies). In only one patient the HR-US exam was integrated with strain elastography (SE). Sixteen patients were enrolled with a median age of 37.6 years (range 16-70 years). The most frequent clinical suspicion was epidermal cyst, while OCST was suspected in only two cases. In all cases, HR-US depicted the sinus tract as a nodular, triangular or "champignon-shaped" lesion in the subcutaneous layer, which continued with a slightly tortuous band structure, up to the focally interrupted cortical bone plate. Furthermore, color Doppler evaluation showed color signals around and/or within the lesion, expression of inflammation. On SE, the sinus tract showed a hard pattern, due to fibrous and granulomatous tissue. HR-US, thanks to its high spatial resolution, allows the evaluation of OCST, and play a crucial diagnostic role, mainly when the clinical suspicious is different.

Minimally Invasive Plate Osteosynthesis (MIPO) of Comminuted Radial Fractures Using a Locking Plate Contoured on a 3D-Printed Model of the Feline Antebrachium: A Cadaveric Study.

(1) Background: Due to the unique structural and functional characteristics of the forelimb in cats, fractures of the radius and ulna are best repaired using internal fixation and stabilization in accordance with AO principles. This study presents the results of reduction of 42 cadaveric comminuted feline radial fractures reduced by minimally invasive plate osteosynthesis (MIPO). (2) Methods: Radius fractures were created on 21 pairs of forelimbs with intact bones. MIPO was then performed using two locking bone plates pre-contoured on 3D-printed bone models of the antebrachium of a male and a female cat. Pre- and postoperative radiographs were taken, and radius length and anatomical lateral distal radial angle (aLDRA) were measured. (3) Results: All fractures were classified as complex diaphyseal fractures of the radius. The radial bone length did not change significantly after surgery (F1,18 = 0.01, p = 0.933). However, the aLDRA was modified after surgery (F1,18 = 7.51, p = 0.013), but this change was only observed in females, in whom the aLDRA was significantly reduced (p = 0.035) compared to the value determined by the shape of the plate. In males, the pre- and postoperative aLDRA values were similar (p = 0.824). In 40 cases, alignment, adjacency of bone fragments, and apparatus were judged to be satisfactory. In two cases, the plate was fixed to the proximal radius and distal ulna due to misidentification of the distal radius. In both cases, revision surgery and correct fixation of the radius gave proper alignment, adjacency, and apparatus. (4) Conclusion: A pre-contoured plate on a 3D-printed model of the male and female domestic cat antebrachium was suitable for the reduction and stabilization of comminuted radial fractures in a cohort of domestic cat cadavers without the need to print individual antebrachial bone models for each patient.

Design and Analysis of Composite Biomaterial Bone Graft Plate

The mixing technique was applied in this study to enhance the strength performance of the cement. The addition of 3% by weight of hydroxyapatite (HA) nanoparticles were mixed with 97% polymethyl methacrylate (PMMA) acrylic polymer, which has a nano size to serve as the matrix material. The surface roughness and continuous porosity of the bone cement were found to be slightly increased by the incorporation of nanoparticles, which enhanced bone-implant osseointegration and ingrowth. Atomic force microscopy (AFM) analysis revealed that the addition of hydroxyapatite (HAp) nanoparticles resulted in a surface roughness value (Sa) of 16.25 nm, which is similar to that of natural bone. The energy-dispersive X-ray spectroscopy (EDS) mapping results discover precentor material and uniform distribution. The Sample exhibited promising results in the antibacterial test, showing efficacy against bacteria both with and without sterilization, confirming its antibacterial properties. The mechanical tests conducted on the sample, including tensile, compression, bending and Vickers hardness tests, yielded favorable results and indicated that the sample is suitable for its intended application. In the theoretical works the design of the bone, screw, and bone plate was conducted using SolidWorks, followed by an analysis using ANSYS under both axial and bending load conditions. The theoretical analysis revealed that the safety factor was less than 1 when an axial load of 13 N was applied and a bending load of 2 N was applied, indicating that the structure may not be able to withstand these loads safely. Under both ambient and physiologically relevant conditions in the human body, HA and PMMA have demonstrated to be excellent choices for enhancing the clinical performance of bone cement. This, in turn, can lead to increased longevity of implants, decreased patient risk, and lower healthcare costs

The Socket Shield Technique: Stability of the Buccal Peri-implant Bone after Partial Root Removal - A Prospective Case Series of 20 patients, with 18 Months Follow-up.

This study aims to collect data on implant survival, bone volume maintenance, and complications associated with the socket shield technique. The socket shield technique was introduced in 2010. Since then, several systematic reviews have been published, showing good clinical outcomes. The behaviour of the buccal bone plate is so far not completely understood. The study involved the placement of 23 implants using the socket shield technique in 20 patients. AstraTech EV implants were used, and no bone substitutes or connective tissue grafts were applied. Patients were monitored for 18 months, recording implant survival, volumetric bone analysis on CBCT scans, interproximal bone levels, bone sounding, pink esthetic scores, and complications. Prosthetic procedures were also described, including temporary and final restorations. A 95.7% cumulative 18-month implant survival rate was obtained using the socket shield technique, with a significant but limited reduction in buccal bone thickness (BBT) after implant placement. One implant did not integrate and two shields were partially exposed. The mean pink esthetic score, 1 year after loading was 12.93 ± 1.22. The study suggests that the socket shield technique can result in limited reduction of the buccal bone volume, with a high implant survival rate. Re-entry studies are recommended to investigate the causes of bone resorption.

A metamaterial bone plate for biofixation based on 3D printing technology

Bone plate design and production methods are critical for producing metamaterial bone plates. This study investigated the design and development process of porous structures and metamaterial bone plates for biofixation applications. We designed the porous structures for bone plates using parametric modeling and fused them via the implicit surface fusion method. Likewise, we designed the metamaterial bone plate structure using reverse reconstruction and topological optimization. Thereafter, we utilized three-dimensional (3D) printing for producing and post-processing the metamaterial bone plate. We observed a reduced stress-shielding effect after topological optimization. Additionally, the resultant diamond porous structure maintained a high porosity under pressure. The 3D-printed bone plates and fillers had a bright porous surface, with clear pore structures and good connectivity. The assembly of the 3D-printed femur, bone plate, filler, and standardized screw indicated a good fitting, and the filler could be fixed by the inclined surface. Taken together, the findings of this study established the foundation for the prospective application of metamaterial bone plates in biofixation.

CBCT-3D radiographic analysis of an infected radicular cyst of the upper jaw: a case report

Objectives: The purpose of this case report is to find out the function of CBCT that can analyze in detail a radicular cyst case where CBCT has the ability to determine the density of a lesion. An overview of the density pattern of a radicular cyst can help determine the lesion and its margins. Case Report: : A 40-year-old patient complained of swelling in the palate that had been felt for about a year with a history of trauma due to an accident fifteen years ago. The patient underwent CBCT examination with the results of a hypodense area compared to the surrounding bone in the maxillary anterior area involving teeth 11,21,22 to 23 accompanied by a discontinuity of the cortical plate of the palatal bone and extending to involve the base of the nasal cavity. Part of the lesion is clearly demarcated, while the other side is diffuse. The suspected radiodiagnosis of the case was a moderately aggressive radicular cyst with a differential diagnosis of an odontogenic tumor. Conclusion: The final diagnosis of this case was a radicular cyst with chronic granulomatous inflammation, based on a combination of radiographic findings, clinical findings, and histopathological examination.

Patient-specific implants made of 3D printed bioresorbable polymers at the point-of-care: material, technology, and scope of surgical application

BackgroundBioresorbable patient-specific additive-manufactured bone grafts, meshes, and plates are emerging as a promising alternative that can overcome the challenges associated with conventional off-the-shelf implants. The fabrication of patient-specific implants (PSIs) directly at the point-of-care (POC), such as hospitals, clinics, and surgical centers, allows for more flexible, faster, and more efficient processes, reducing the need for outsourcing to external manufacturers. We want to emphasize the potential advantages of producing bioresorbable polymer implants for cranio-maxillofacial surgery at the POC by highlighting its surgical applications, benefits, and limitations.MethodsThis study describes the workflow of designing and fabricating degradable polymeric PSIs using three-dimensional (3D) printing technology. The cortical bone was segmented from the patient’s computed tomography data using Materialise Mimics software, and the PSIs were designed created using Geomagic Freeform and nTopology software. The implants were finally printed via Arburg Plastic Freeforming (APF) of medical-grade poly (L-lactide-co-D, L-lactide) with 30% β-tricalcium phosphate and evaluated for fit.Results3D printed implants using APF technology showed surfaces with highly uniform and well-connected droplets with minimal gap formation between the printed paths. For the plates and meshes, a wall thickness down to 0.8 mm could be achieved. In this study, we successfully printed plates for osteosynthesis, implants for orbital floor fractures, meshes for alveolar bone regeneration, and bone scaffolds with interconnected channels.ConclusionsThis study shows the feasibility of using 3D printing to create degradable polymeric PSIs seamlessly integrated into virtual surgical planning workflows. Implementing POC 3D printing of biodegradable PSI can potentially improve therapeutic outcomes, but regulatory compliance must be addressed.

Effect of matrix material property on the composite tibia fracture plate: a biomechanical study.

For the purpose of fixing tibia fractures, composite bone plates are suggested. Metal plates cause stress shielding, lessen the compression force at the fracture site, and have an impact on the healing process because they are significantly more rigid than bone. To prevent excessive shear strain and consequent instability at the fracture site, it is imperative to reduce stiffness in the axial direction without lowering stiffness in the transverse direction. Only a carefully crafted fiber reinforced composite with anisotropic properties will suffice to accomplish this. The purpose of the current study is to examine the impact of axial and shear movements at the fracture site on the fixing of metal and composite bone plates. After modeling the tibia with a 1 mm fracture gap, titanium plates, carbon/epoxy, carbon/PEEK, and carbon/UHMWPE composite bone plates were used to fix it. There are 6 holes on each of the 103 mm long plates. To determine the stresses and axial movement in the fracture site, anatomical 3D Finite Element (FE) models of the tibia with composite bone plates are built. The simulations that were run for various composite plate layouts and types give suggestions for selecting the best composite bone plate. Although the matrix material causes some variations in behaviors, most of the plates perform as well as or even better than metal plates. Thus, the appropriate composite combinations are recommended for a given fracture structure.

Surface modification of a commercial bone plate (Ti6Al4V) implant for improved antibacterial and cytocompatibility via thermal dewetting of a silver thin film

The high demand for bone grafts has motivated the development of implants with excellent osteogenic activity, whereas the risk of implant-associated infection, particularly given the rise of antimicrobial resistance, has compelled the development of implants with innovative antimicrobial strategies in which a small amount of bactericidal agent can effectively kill a wide range of bacteria. To induce antibacterial property, the surface of Grade-5 bone plate titanium implants used in clinical applications was modified using direct current (DC) sputter coating followed by thermal annealing. The 15 nm silver film-coated implants were thermally annealed in the furnace for 15 min at 750 °C. The modified implant surface’s antibacterial efficacy against Escherichia coli (E. coli), Staphylococcus aureus (S. aureus), Salmonella typhi, and Methicillin-resistant staphylococcus aureus bacteria has been assessed using a colony-forming assay. On the modified implant surface, the growth of E. coli and S. aureus bacteria is reduced by 99.72%, while highly drug-resistant bacteria are inhibited by 96.59%. The MTT assay was used to assess the cytotoxicity of the modified bone-implant surface against NIH3T3 mouse fibroblast cells. The modified bone-implant surface promoted fibroblast growth and demonstrated good cytocompatibility. Furthermore, the mechanical properties of the implant were not harmed by this novel surface modification method. This method is simple and provides new insight into surface modification of commercial metallic implants to have effective antibacterial properties against various classes of bacteria.