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Recent advances in the reconstruction of cranio-maxillofacial defects using computer-aided design/computer-aided manufacturing

  • Oh, Ji-hyeon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.2.1-2.7
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    • 2018
  • With the development of computer-aided design/computer-aided manufacturing (CAD/CAM) technology, it has been possible to reconstruct the cranio-maxillofacial defect with more accurate preoperative planning, precise patient-specific implants (PSIs), and shorter operation times. The manufacturing processes include subtractive manufacturing and additive manufacturing and should be selected in consideration of the material type, available technology, post-processing, accuracy, lead time, properties, and surface quality. Materials such as titanium, polyethylene, polyetheretherketone (PEEK), hydroxyapatite (HA), poly-DL-lactic acid (PDLLA), polylactide-co-glycolide acid (PLGA), and calcium phosphate are used. Design methods for the reconstruction of cranio-maxillofacial defects include the use of a pre-operative model printed with pre-operative data, printing a cutting guide or template after virtual surgery, a model after virtual surgery printed with reconstructed data using a mirror image, and manufacturing PSIs by directly obtaining PSI data after reconstruction using a mirror image. By selecting the appropriate design method, manufacturing process, and implant material according to the case, it is possible to obtain a more accurate surgical procedure, reduced operation time, the prevention of various complications that can occur using the traditional method, and predictive results compared to the traditional method.

Bio-toxicity of Titanium Dioxide Nano Particles (P-25) in Zebrafish Development Stage (Zebrafish 발생기에서 $TiO_2(P-25)$ 나노 입자의 생물 독성)

  • Yeo, Min-Kyeong;Jo, Yoon-Hee
    • Environmental Analysis Health and Toxicology
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    • v.22 no.3
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    • pp.189-196
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    • 2007
  • [ $TiO_2$ ] is widely used because it is non-toxic. Recently, however, nanometer size $TiO_2$ particles (P-25) have been produced and used to increase the photo catalysis efficiency. Nanometer-sized $TiO_2$ is efficient, but due to its small size ($20{\sim}30\;nm$), it can flow into ecosystems and into cells. Thus, it may affect human health. Additionally, $TiO_2$ can produce a second contaminant, OH-radical, which is a health risk for all living organisms during photo degradation reaction. Hence, when nanometer-sized $TiO_2$ flows into natural streams and attaches to living organisms, it will create health risks. We investigated the biological toxicity of this condition in zebrafish embryos. We observed abnormal morphology, hatching rate, and measured the catalase activity to determine anti-oxidation at 100 post fertilization hours. Zebrafish were somewhat affected by $TiO_2$ nanometer sized particles under UV-A (a condition similar to sunlight). Powdered $TiO_2$ is toxic to the zebrafish fly. Even without light, $TiO_2$ particles attached to embryos and flies, having an effect on both.

Microstructure-Properties Relationships of Ti-6Al-4V Parts Fabricated by Selective Laser Melting

  • Mezzetta, Justin;Choi, Joon-Phil;Milligan, Jason;Danovitch, Jason;Chekir, Nejib;Bois-Brochu, Alexandre;Zhao, Yaoyao Fiona;Brochu, Mathieu
    • International Journal of Precision Engineering and Manufacturing-Green Technology
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    • v.5 no.5
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    • pp.605-612
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    • 2018
  • This work investigates the relationships between the static mechanical properties of Ti-6Al-4V manufactured through selective laser melting (SLM) and post-process heat treatments, namely stress relieve, annealing and hot isostatic pressing (HIP). In particular, Ti-6Al-4V parts were fabricated in three different build orientations of X, Z, and $45^{\circ}$ to investigate the multi-directional mechanical properties. The results showed that fully densified Ti-6Al-4V parts with densities of up to 99.5% were obtained with optimized SLM parameters. The microstructure of stress relieved and mill annealed samples was dominated by fine ${\alpha}^{\prime}$ martensitic needles. After HIP treatment, the martensite structure was fully transformed into ${\alpha}$ and ${\beta}$ phases (${\alpha}+{\beta}$ lamellar). Within the realm of tensile properties, the yield and ultimate strength values were found statistically similar with respect to the built orientation for a given heat treatment. However, the ductility was found orientation dependent for the HIP samples, where a lower value was observed for samples built in the X direction.

Advanced Optical and Electrical Properties of TIO Thin Films by Thermal Surface Treatment of Electron Beam Irradiation (전자빔 열 표면처리에 따른 TIO 박막의 투명전극 특성 개선 효과)

  • Yeon-Hak Lee;Min-Sung Park;Daeil Kim
    • Journal of the Korean Society for Heat Treatment
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    • v.36 no.4
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    • pp.193-197
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    • 2023
  • Transparent and conducting titanium (Ti) doped indium oxide (TIO) thin films were deposited on the poly-imide (PI) substrate with radio frequency magnetron sputtering and then electron irradiation was conducted on the TIO film's surface to investigate the effect electron irradiation on the crystallization and opto-electrical properties of the films. All x-ray diffraction (XRD) pattern showed two diffraction peaks of the In2O2 (431) and (444) planes with regardless of the electron beam irradiation energy. In the AFM analysis, the surface roughness of as deposited films was 3.29 nm, while the films electron irradiated at 700 eV, show a lower RMS roughness of 2.62 nm. In this study, the FOM of as deposited TIO films is 6.82 × 10-3 Ω-1, while the films electron irradiated at 500 eV show the higher FOM value of 1.0 × 10-2 Ω-1. Thus, it is concluded that the post-deposition electron beam irradiation at 500 eV is the one of effective methods of crystallization and enhancement of opto-electrical performance of TIO thin film deposited on the PI substrate.

Effect of RGD peptide coating of implant titanium surface on human mesenchymal stem cell response (양극산화 티타늄 표면에 서로 다른 RGD 펩타이드 코팅 방법이 인간간엽줄기세포 반응에 미치는 영향)

  • Kim, Min-Su;Jeong, Chang-Mo;Jeon, Young-Chan;Ryu, Jae-Jun;Huh, Jung-Bo;Yun, Mi-Jung
    • The Journal of Korean Academy of Prosthodontics
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    • v.49 no.3
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    • pp.245-253
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    • 2011
  • Purpose: The aim of this in vitro study was to estimate surface characteristic after peptide coating and investigate biological response of human mesenchymal stem cell to anodized titanium discs coated with RGD peptide by physical adhesion and chemical fixation. Materials and methods: Fluorescence isothiocyanate (FITC) modified RGD-peptide was coated on the anodized titanium discs (diameter 12 mm, height 3 mm) using two methods. One was physical adhesion method and the other was chemical fixation method. Physical adhesion was performed by dip and dry procedure, chemical fixation was performed by covalent bond via silanization. In this study, human mesenchymal stem cell was used for experiments. The experiments consisted of surface characteristic evaluation after peptide coating, analysis about cell adhesion, proliferation, differentiation, and mineralization. Obtained data are statistically treated using Kruskal-Wallis test and Bonferroni test was performed as post hoc test (P=.05). Results: The evaluation of FE-SEM images revealed no diffenrence at micro-surfaces between each groups. Total coating dose was higher at physical adhesion experimental group than at chemical fixation experimental group. In cell adhesion and proliferation, RGD peptide coating did not show a statistical significance compared with control group (P>.05). In cell differentiation and mineralization, physical adhesion method displayed significantly increased levels compared with control group and chemical fixation method (P<.05). Conclusion: RGD peptide coating seems to enhance osseointegration by effects on the response of human mesenchymal stem cell. Especially physical adhesion method showed more effective than chemical fixation method on response of human mesenchymal stem cell.

The instrument-centering ability of four Nickel-Titanium instruments in simulated curved root canals (만곡된 레진 모형 근관에서 4종의 엔진 구동형 니켈-티타늄 기구의 근관 중심율 유지 능력)

  • Ku, Jae-Hoon;Chang, Hoon-Sang;Chang, Seok-Woo;Cho, Hwan-Hee;Bae, Ji-Myung;Min, Kyung-San
    • Restorative Dentistry and Endodontics
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    • v.31 no.2
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    • pp.113-118
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    • 2006
  • The aim of this study was to evaluate the ability of newly marketed NRT instruments to maintain the original root canal configuration and curvature during preparation in comparison with the three existing instruments in simulated root canals. Simulated canals in resin blocks were prepared with ProFile. K3, ProTaper and NRT instrument (n = 10 canals in each case). Pre- and post-operative images were recorded, and assessment of canal shape was completed with a computer image analysis program. The data were analyzed statistically using the One-way ANOVA followed by Duncan s test. The ability or instruments to remain centered in prepared canals at 1-, 2-mm levels was significantly better in ProFile groups than in other groups (p < 0.05). The change of centering ratio in NRT groups at 5-mm level was significantly greater than ProFile group and at 6- and 7-mm level than all other groups (p < 0.05). Although the NRT system was comparable to other systems in regards to its ability to maintain the canal configuration of apical portion, this system was more influenced by the mid-root curvature due to its stainless-steel files for coronal preflaring.

Removal torque of sandblasted large grit, acid etched treated mini-implant (Sandblasted large grit, acid etched 표면처리에 따른 교정용 미니 임플랜트의 제거회전력에 관한 연구)

  • Oh, Nam-Hee;Kim, Seong-Hun;Kook, Yoon-Ah;Lee, Keun-Hye;Kang, Yoon-Goo;Mo, Sung-Seo
    • The korean journal of orthodontics
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    • v.36 no.5
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    • pp.324-330
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    • 2006
  • Objective: The purposes of this study were to evaluate the differences between sand blasted, large grit and acid-etched (SLA) treated mini-implants and smooth surface orthodontic mini-implants in relation to the removal torque as well as the histologic analysis. Methods: Custom-made, screw-shaped, titanium implants with a length of 9.5 mm and an outer diameter of 1.8 mm were divided into 2 groups; the SLA group (20 SLA treated orthodontic mini-implants) and the smooth surface group (20 smooth surface mini-implants), and placed In the tibia metaphysis of 10 rabbits. Each rabbit had 4 mini-implants placed, 2 in each tibia. The right tibia were implanted with the SLA group mini-implants and the left tibia had the smooth group mini-implants placed. Each mini-implant group were immediately applied with a continuous traction force of 150 g using a Ni-Ti coil spring. The rabbits were sacrificed 6 weeks post-surgically. Subsequently, the legs were stabilized, the Ni-Ti coil springs were removed and the mini-implants were removed under reverse torque rotation with a digital torque gauge. Results: 6 weeks after placement, the SIA group presented a higher mean removal torque value (8.29 Ncm) than the smooth group (3.34 Ncm) and histologic analysis revealed a higher new bone formation aspect along the screw in the SLA group. Conclusion: Results of this study indicates that SLA treated mini-implants may endure higher orthodontic forces without loosening.

Comparison of the mechanical efficacy of sonic activated irrigation and passive ultrasonic irrigation for intracanal medicaments removal

  • Jang, Ju-Kyong;Kwak, Sangwon;Choi, Ga Young;Ha, Jung-Hong;Choi, Sung-Baik;Kim, Hyeon-Cheol
    • The Journal of the Korean dental association
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    • v.53 no.10
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    • pp.743-750
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    • 2015
  • Objectives: This study compared the mechanical efficacy of sonic activated and passive ultrasonic irrigation for removing intracanal medicament from a simulated root canal under controlled conditions. Materials and Methods: Thirty simulated root canal in resin blocks were randomly divided into 3-groups. The canals were enlarged using ProTaper files and K3XF (#30/0.06). After cleaning and drying, canals were filled with Calcipex. Overfilled materials were wiped out and measured their weight to the unit of 1/10mg. After one week storage in 100% humidity $37^{\circ}C$ temperature, canals were irrigated using 20mL of saline with one of following methods according to the designated groups (n = 10). For group-NI, 30-gauge nickel-titanium irrigation needle was used. During irrigation with every 5mL, needle was moved in-and-out with 4-mm amplitudes. EndoActivator and ultrasonic tip were used for group-EA and group-UT respectively for 20 seconds after every 5mL irrigation using needle. Then the weight was measured again to calculate the weight of residual remnants. The data were analyzed by one-way ANOVA and Duncan's post-hoc test at a significance level of 95%. Results: The weight of the residual medicaments were $3.62{\pm}0.81mg$, $2.84{\pm}0.28mg$, and $2.73{\pm}0.90mg$ for group-NI, -EA, and -UT, respectively. Group-EA and group-UT had no significant differences to remove intracanal medicament and left significantly less amount of paste than group-NI (p < 0.05). Conclusions: Under the controlled conditions of this study, the sonic activation and PUI have similar mechanical efficacy for removing intracanal medicament.

Autogenous Bone Grafts versue Metal Cage with Allogenic Bone Grafts for Post-Corpectomy Anterior Column Reconstruction in Patients with Infectious Spondylitis

  • Cha, Jae-Ryong;Hwang, Il-Yeong;Kwon, Sun-Hwan;Chung, Hee-Yoon
    • Journal of Korean Neurosurgical Society
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    • v.63 no.2
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    • pp.218-227
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    • 2020
  • Objective : To evaluate and compare the clinical and radiographic features of 25 patients with infectious spondylitis treated with anterior debridement and reconstruction using autogenous bone grafts vs. a metal cage with allogenic bone grafts. Methods : The study analyzed 25 patients diagnosed with infectious thoracolumbar spondylitis who underwent anterior radical debridement and reconstruction. Autogenous bone grafts were used in 13 patients (group 1), and a metal cage with allogenic bone grafts was used in 12 patients (group 2). Clinical outcomes were assessed by the visual analogue scale (VAS) scores and neurological status. Additionally, the serological results and the radiographic results using the sagittal Cobb angle were compared. Fusion was evaluated by computed tomography (CT) imaging at 24 months postoperatively. Results : Both groups showed a significant decrease in the postoperative mean VAS scores; however, only, group 1 patients showed a significantly higher VAS score than group 2 patients, 1 month postoperatively (p=0.002). The postoperative neurological status significantly improved. Elevated C-reactive protein levels and erythrocyte sedimentation rate values returned to normal limits at the 2-year follow-up without recurrent infection. No significant intergroup difference was observed in Cobb angle. Bony fusion was confirmed in all patients at CT 24 months postoperatively. Conclusion : Although the use of a metal cage with allogenic bone grafts for anterior column reconstruction remains controversial, our results suggest that it can be considered as an effective treatment of option for anterior column reconstruction in patients with infectious spondylitis.

A Novel Implantable Cerebrospinal Fluid Reservoir : A Pilot Study

  • Byun, Yoon Hwan;Gwak, Ho Shin;Kwon, Ji-Woong;Kim, Kwang Gi;Shin, Sang Hoon;Lee, Seung Hoon;Yoo, Heon
    • Journal of Korean Neurosurgical Society
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    • v.61 no.5
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    • pp.640-644
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    • 2018
  • Objective : The purpose of this pilot study was to examine the safety and function of the newly developed cerebrospinal fluid (CSF) reservoir called the V-Port. Methods : The newly developed V-Port consists of a non-collapsible reservoir outlined with a titanium cage and a connector for the ventricular catheter to be assembled. It is designed to be better palpated and more durable to multiple punctures than the Ommaya reservoir. A total of nine patients diagnosed with leptomeningeal carcinomatosis were selected for V-Port insertion. Each patient was followed up for evaluation for a month after the operation. Results : The average operation time for V-Port insertion was 42 minutes and the average incision size was 6.6 cm. The surgical technique of V-Port insertion was found to be intuitive by all neurosurgeons who participated in the pilot study. There was no obstruction or leakage of the V-Port during intrathecal chemotherapy or CSF drainage. Also, there were no complications including post-operative intracerebral hemorrhage, infection and skin problems related to the V-Port. Conclusion : V-Port is a safe and an easy to use implantable CSF reservoir that addresses problems of other implantable CSF reservoirs. Further multicenter clinical trial is needed to prove the safety and the function of the V-Port.