• Title/Summary/Keyword: Implant Design

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Design and 3D-printing of titanium bone implants: brief review of approach and clinical cases

  • Popov Jr, Vladimir V.;Muller-Kamskii, Gary;Kovalevsky, Aleksey;Dzhenzhera, Georgy;Strokin, Evgeny;Kolomiets, Anastasia;Ramon, Jean
    • Biomedical Engineering Letters
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    • v.8 no.4
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    • pp.337-344
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    • 2018
  • Additive manufacturing (AM) is an alternative metal fabrication technology. The outstanding advantage of AM (3D-printing, direct manufacturing), is the ability to form shapes that cannot be formed with any other traditional technology. 3D-printing began as a new method of prototyping in plastics. Nowadays, AM in metals allows to realize not only net-shape geometry, but also high fatigue strength and corrosion resistant parts. This success of AM in metals enables new applications of the technology in important fields, such as production of medical implants. The 3D-printing of medical implants is an extremely rapidly developing application. The success of this development lies in the fact that patient-specific implants can promote patient recovery, as often it is the only alternative to amputation. The production of AM implants provides a relatively fast and effective solution for complex surgical cases. However, there are still numerous challenging open issues in medical 3D-printing. The goal of the current research review is to explain the whole technological and design chain of bio-medical bone implant production from the computed tomography that is performed by the surgeon, to conversion to a computer aided drawing file, to production of implants, including the necessary post-processing procedures and certification. The current work presents examples that were produced by joint work of Polygon Medical Engineering, Russia and by TechMed, the AM Center of Israel Institute of Metals. Polygon provided 3D-planning and 3D-modelling specifically for the implants production. TechMed were in charge of the optimization of models and they manufactured the implants by Electron-Beam Melting ($EBM^{(R)}$), using an Arcam $EBM^{(R)}$ A2X machine.

Design of lattice structure for controlling elastic modulus in metal additive manufacturing (금속 적층제조에서의 격자구조 설계변수에 따른 탄성계수 분석)

  • In Yong Moon;Yeonghwan Song
    • Journal of the Korean Crystal Growth and Crystal Technology
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    • v.33 no.6
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    • pp.276-281
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    • 2023
  • With the high design freedom of the additive manufacturing process, there is a growing interest in multi-dimensional lattice structures among researchers, who are studying intricate structural modeling that is challenging to produce using conventional manufacturing processes. In the case of titanium alloy implants for human insertion, a multi-dimensional lattice structure is employed to ensure compatibility with bones, adjusting strength and elastic modulus to levels similar to those of bones. Therefore, securing a database on the mechanical properties based on lattice structure design variables and the development of related simulation techniques are believed to efficiently facilitate the customization of implants. In this study, lattice structures were additively manufactured using Ti-6Al-4V alloy, and the elastic modulus was measured based on design parameters. The results were compared with simulations, and an approach to finite element analysis for accurate prediction of the elastic modulus was proposed.

Implant restoration considering maintenance for a patient with excessive crown height space (과도한 치관높이 공간을 가진 환자에서 유지관리를 고려한 임플란트 수복증례)

  • Ma, Juri;Yang, Hong-So;Park, Sang-Won;Lim, Hyun-Pil;Yun, Kwi-Dug;Vang, Mong-Sook
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.2
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    • pp.107-112
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    • 2013
  • Complications increases when crown height space is excessive and one should be careful of choosing type of fixed prosthesis in case crown height space is over 12 mm. In this condition, tooth seems to be longer, therefore, it is needed to use gingival shade in aesthetically important area for fixed prosthesis. In this case, fixed prosthesis which has inappropriate maintenance and hygiene could hold food, plaque, calculus, thus increase incidence of inflammation and infection. Moreover, it could lead to chronic inflammation and infection and in that case surgical improvement could be necessary. In present case report, gingival inflammation and swelling developed around prosthesis after having made it considering articulation and aesthetic view in patient who had excessive crown height space. Finding out that design of prosthesis is a factor to make it hard to maintain oral hygiene, a temporary prosthesis which has enough interproximal space and proper emergence profile was fabricated. After two months of observation, significant abnormal symptoms are not found and oral reconstruction is performed using fixed prosthesis with zircornia infrastructure and porcelain build-up based on convenient self hygiene design. Through serial treatment, inappropriate soft tissue response is not observed and satisfactory result in functional aspect comes out.

Effect of immobilization of the recombinant human bone morphogenetic protein 2 (rhBMP-2) on anodized implants coated with heparin for improving alveolar ridge augmentation in beagle dogs: Radiographic observations (양극산화 임플란트 표면에 적용된 헤파린과 골형성단백질(rhBMP-2)이 치조골 증대에 미치는 효과: 방사선학적 평가)

  • Lee, So-Hyoun;Jo, Jae-Young;Yun, Mi-Jung;Jeon, Young-Chan;Huh, Jung-Bo;Jeong, Chang-Mo
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.4
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    • pp.307-314
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    • 2013
  • Purpose: The aim of this study was to evaluate the effect of immobilization of the recombinant human bone morphogenetic protein 2 (rhBMP-2) on anodized titaum implants coated with heparin to enhance the vertical alveolar ridge augmentation in the supraalveolar peri-implant defect region. Materials and methods: 18 pure titanium implants (7.0 mm in length, 3.5 mm in diameter) were manufactured for this study. All implants were anodized and designed insertion reference line marked with laser at the apical 2.5 mm from the fixture platform. Implantation of 6 noncoated anodized implants (Control group), 6 anodized implants physically adsorbed with rhBMP-2 by dip and dry method (BMP group) and 6 anodized implants chemically immobilized 3,4-dihydroxyphenylalanine (DOPA)-heparin/ rhBMP-2 (Hep-BMP group) was performed in the both mandibular of three male adult beagle dogs using split-mouth design. Radiologic examinations were performed immediately after implant placement and 4 and 8 weeks after implant placement. The amount of mesio-distal bone augmentation was evaluated by measuring the vertical distance from the platform to the marginal bone. Statistical analysis was performed using one-way analysis of variance (SPSS version 18.0) and multiple comparison analysis of The Kruskal-Wallis test and the Mann-Whitney U test. Statistical significance was established at the 5% significant level. Results: At the 4 weeks vertical alveolar ridge augmentation of Control group, BMP group and Hep-BMP group is $0.09{\pm}0.22mm$, $1.02{\pm}0.72mm$, and $1.29{\pm}0.51mm$, At the 8 weeks $0.11{\pm}1.26mm$, $1.11{\pm}0.58mm$, $1.59{\pm}0.79mm$ according to radiographic observations. The two experimental groups showed a significantly increasing in vertical bone height compared with the control group (P<.05). However, there is no significant difference between the BMP group and Hep-BMP group (P>.05). Conclusion: The rhBMP-2 coated implants were enhanced the vertical bone growth in the supraalveolar peri-implant defect area. However, there is no significant difference between chemically and physically coating method.

Analysis of periodontal attachment loss in relation to root form abnormalities

  • Chung, Young-Mi;Jeong, Seong-Nyum
    • Journal of Periodontal and Implant Science
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    • v.43 no.6
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    • pp.276-282
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    • 2013
  • Purpose: The aim of this study was to explore root shape abnormalities, to investigate the influence of root form abnormalities on periodontal attachment loss, and to gather basic data to assist in the diagnosis and treatment of aggressive periodontitis. Methods: From January 2010 to June 2012, a survey was conducted of all 3,284 periodontitis patients who visited the Department of Periodontology, Daejeon Dental Hospital, Wonkwang University School of Dentistry. Clinical parameters (probing depth, periodontal attachment loss, missing teeth) were measured and a radiographic examination was performed at the baseline. We classified the root shape abnormality of bicuspids and molars based on Meng classification. Results: The periodontal attachment loss was the highest at the maxillary first molar (6.03 mm). The loss of the second molar was prominent. Type V deformity was shown to be the most common in the second maxillary and mandibular molars (P<0.05). Type V root shape was associated with the highest attachment loss (P=0.01). Conclusions: Considering the small population and limited design of this study, definitive conclusions cannot be drawn. We suggest larger scale, methodologically more sophisticated studies that include normal controls and chronic periodontitis patients to clarify whether root form abnormalities are a potential risk factor for aggressive periodontitis.

Clinical Evaluation After Periodontal Flap Surgery with/without Non-Surgical Periodontal Therapy (비외과적 치주처치의 선행 유무에 따른 치주 판막술 후 임상적 평가)

  • Sinn, Ho-Beom;Yun, Chang-Yup;Kim, Sang-Mok;Kim, Byung-Ock;Han, Kyung-Yoon
    • Journal of Periodontal and Implant Science
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    • v.31 no.1
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    • pp.233-242
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    • 2001
  • In the treatment of chronic adult periodontitis, scaling and root planing have been generally performed prior to periodontal flap surgery. The purpose of this study was to evaluate the clinical significance of nonsurgical periodontal therapy prior to periodontal flap surgery in patients with chronic adult periodontitis. Fifty six molars showing bilateral bony defects and 4-6mm periodontal pocket in twelve patients with chronic adult periodontitis were selected. By randomized split-mouth design, in one side, flap operation was performed 4 weeks after scaling and root planing, in the other group, flap operation was only performed without scaling and root planing. Probing pocket depth, gingival recession, clinical attachment level, gingival index, plaque index, and tooth mobility were measured at baseline, before flap operation and post-operation

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Severe Ankle Osteoarthritis: Treatment with Total Ankle Arthroplasty (중증 족관절 관절염: 족관절 전치환술)

  • Jeong, Bi O;Jung, Hyuk
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.1
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    • pp.8-15
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    • 2018
  • Ankle osteoarthritis is a debilitating condition that causes severe pain associated with functional impairment and decreased activity. Ankle osteoarthritis, unlike that of the knee or hip joint, is rare in primary arthritis. Most cases are traumatic arthritis that occur after ankle sprain or fractures or chronic ankle instability. Although ankle fusion has been regarded as the standard treatment of ankle osteoarthritis in the past, total ankle arthroplasty (TAA) is increasing due to the development of the implant design and surgical techniques. TAA is biomechanically superior to ankle fusion by preserving the movement of the ankle joint. In particular, it is functionally superior to ankle fusion because it enables normal joint motion during gait. In addition, there is an advantage of preserving the movement of the hindfoot and reducing the abnormal stress applied to the adjacent joints after ankle fusion to prevent the occurrence of long-term adjacent joint arthritis. Although the short-term and mid-term results of TAA have been reported to be excellent, long-term follow-up has a relatively low survival rate and high complication rate compared to total knee or hip arthroplasty. Therefore, continuous and further research is needed.

Socket Preservation Utilizing Modified Free Connective Tissue Graft for Primary Closure : Wing Graft (발치와 보전술식시 변형 유리 결체조직 이식술을 이용한 일차 페쇄술식 : 익이식술)

  • Min, Kyoung-Man;Han, Soo-Boo;Lee, Chul-Woo;Kim, Dong-Kyun;Leem, Sang-Hoon
    • Journal of Periodontal and Implant Science
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    • v.28 no.3
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    • pp.409-418
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    • 1998
  • The socket preservation technique is very effective in preventing alveolar ridge collapse after tooth extraction. Many technigues have been proposed for the primary closure of the flap and we tested a new graft design, "wing graft", which is a modification of free connective tissue graft in this case report. With this technique, primary closure was achieved without shallowing the vestibule. Additionally some vertical ridge augmentation effect could be observed and therefore good esthetic and functional results were obtained from this technique even in the case where severe bone loss and gingival recession was present. Finally we observed good healing appearance in the donor site after 2weeks. The results from this report suggest that this "wing graft" can be used successfully as an adjunctive procedure with socket preservation technique.

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Zr-7Cu Alloy Design According to Sn Content for Bio-Metallic Materials (금속 생체재료를 위한 Sn 함량에 따른 Zr-7Cu 합금설계)

  • Kim, Min-Suk;Kim, Chung-Seok
    • Korean Journal of Materials Research
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    • v.31 no.12
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    • pp.690-696
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    • 2021
  • The purpose of this study is to develop a zirconium-based alloy with low modulus and magnetic susceptibility to prevent the stress-shielding effect and the generation of artifacts. Zr-7Cu-xSn (x = 1, 5, 10, 15 mass%) alloys are prepared by an arc melting process. Microstructure characterization is performed by microscopy and X-ray diffraction. Mechanical properties are evaluated using micro Vickers hardness and compression test. The magnetic susceptibility is evaluated using a SQUID-VSM. The average magnetic susceptibility value of the Zr-7Cu-xSn alloy is 1.176 × 10-8 cm3g-1. Corrosion tests of zirconium-based alloys are conducted through polarization test. The average Icorr value of the Zr-7Cu-xSn alloy is 0.1912 ㎂/cm2. The elastic modulus value of 14 ~ 18 GPa of the zirconium-based alloy is very similar to the elastic modulus value of 15 ~ 30 GPa of the human bone. Consequently, the Sn added zirconium alloy, Zr-7Cu-xSn, is very interesting and attractive as a biomaterial that reduces the stress-shielding effect caused by differences of elastic modulus between human bone and metallic implants. In addition, this material has the potential to be used in metallic dental implants to effectively eliminate artifacts in MRI images due to low magnetic susceptibility.

Total Ankle Arthroplasty Management and Rehabilitation (족관절 인공관절 치환술 후 관리 및 재활)

  • Lee, Kwang-Bok
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.3
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    • pp.118-122
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    • 2022
  • Although total ankle arthroplasty (TAA) has increased considerably in the past ten years, reflecting improvements in implant design and survivorship, the clinical outcomes have been less satisfactory than total hip or total knee arthroplasties. Several issues under debate include postoperative management and rehabilitation in TAA. Especially, there is no consensus or evidence for the most appropriate postoperative management and rehabilitation for patients undergoing TAA. This study was therefore undertaken to suggest appropriate postoperative management and rehabilitation in TAA, after reviewing published articles and focusing on the following topics: prehabilitation, hospital stay, immobilization type and duration, weight-bearing management, pharmacological treatment, and adopted rehabilitation protocols. In previous studies, the postoperative management and rehabilitation proposed depended on the surgeon's preference, the patient's characteristics, and the associated surgical procedures performed after TAA. Nonetheless, our research indicates the best approach is to include a prehabilitation program, immobilization in the early postoperative stage (2~4 weeks), range of motion exercise with partial weight-bearing ambulation, followed by full weight-bearing ambulation after six weeks. Further studies are required to develop a standardized rehabilitation protocol and improve the overall quality of care after TAA.