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BACKGROUND: Polyetheretherketone (PEEK) and Its composites have a unique set of properties, and 3D printing technology can customize personalized Implants according to the patient's condition, and the effective combination of the two plays a significant role In the field of bone repair. OBJECTIVE: To summarize the application status of PEEK and Its composite combined with 3D printing technology In the field of bone repair, and to further predict the application prospects of the effective combination of the two. METHODS: CNKI, PubMed, and Web of Science databases were retrieved with the search terms “PEEK, PEEK composites, bone defect repair, PEEK Implants, PEEK 3D printing, prosthodontlcs” in English and Chinese, respectively, for the articles published from April 1995 to April 2019. Totally 147 articles were searched, and finally 51 eligible articles were enrolled for review in accordance with the inclusion and exclusion criteria. RESULTS AND CONCLUSION: Biologically active materials and the particles or fibers with Improved mechanical properties were Introduced Into the PEEK matrix to prepare its composite. 3D printing technology was used to precisely customize Implants that are highly matched to the patient's defect. The Implants with good biocompatibility, bioactlvity, and mechanical properties exhibited good therapeutic effects In the repair of skull, jaw, spine, lumbar vertebra, artificial joint and oral defects. They Improved patient satisfaction after treatment. This article summarized the application of PEEK, its composite and 3D printing technology In the repair of various bone defects, and expressed its views on the application and prospect of personalized PEEK implants or prostheses prepared with 3D printing technology.
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In maxillofacial surgery, there is a significant need for the design and fabrication of porous scaffolds with customizable bionic structures and mechanical properties suitable for bone tissue engineering. In this paper, we characterize the porous Ti6Al4V implant, which is one of the most promising and attractive biomedical applications due to the similarity of its modulus to human bones. We describe the mechanical properties of this implant, which we suggest is capable of providing important biological functions for bone tissue regeneration. We characterize a novel bionic design and fabrication process for porous implants. A design concept of "reducing dimensions and designing layer by layer" was used to construct layered slice and rod-connected mesh structure (LSRCMS) implants. Porous LSRCMS implants with different parameters and porosities were fabricated by selective laser melting (SLM). Printed samples were evaluated by microstructure characterization, specific mechanical properties were analyzed by mechanical tests, and finite element analysis was used to digitally calculate the stress characteristics of the LSRCMS under loading forces. Our results show that the samples fabricated by SLM had good structure printing quality with reasonable pore sizes. The porosity, pore size, and strut thickness of manufactured samples ranged from (60.95± 0.27)% to (81.23±0.32)%, (480±28) to (685±31) μm, and (263±28) to (265±28) μm, respectively. The compression results show that the Young's modulus and the yield strength ranged from (2.23±0.03) to (6.36±0.06) GPa and (21.36±0.42) to (122.85±3.85) MPa, respectively. We also show that the Young's modulus and yield strength of the LSRCMS samples can be predicted by the Gibson-Ashby model. Further, we prove the structural stability of our novel design by finite element analysis. Our results illustrate that our novel SLM-fabricated porous Ti6Al4V scaffolds based on an LSRCMS are a promising material for bone implants, and are potentially applicable to the field of bone defect repair.
Subject(s)
Humans , Alloys , Bionics , Bone Substitutes/chemistry , Bone and Bones/pathology , Compressive Strength , Elastic Modulus , Finite Element Analysis , Lasers , Materials Testing , Maxillofacial Prosthesis Implantation , Porosity , Pressure , Printing, Three-Dimensional , Prostheses and Implants , Prosthesis Design , Stress, Mechanical , Surgery, Oral/instrumentation , Tissue Engineering/methods , Titanium/chemistryABSTRACT
Objective To research the clinical effect of platelet rich plasma combined with Bio-oss artificial bone meal in repairing bone defects around implants.Methods From January 2015 to January 2017,70 cases who completed the implant repair in Lishui People's Hospital,and later confirmed the defects around the implant were selected in the research.They were equally divided into observation group and control group according to admission,with 35 cases in each group.The control group was treated with Bio-oss artificial bone powder.The observation group was treated with platelet rich plasma combined with Bio-oss artificial bone powder.The clinical effects of the two groups were compared and analyzed.Results Before treatment,the probe depth (PD),clinical attachment loss (CAL),plaque index (PI),gingival sulcus hemorrhage index (SBI) of the observation group and the control group were (7.18 ± 1.31)mm,(5.68 ±0.87)mm,(1.23 ±0.31),(2.48 ±0.34) and (7.22 ± 1.28)mm,(5.74 ±0.83) mm,(1.27 ± 0.33),(2.53 ± 0.36),respectively,which were significantly higher than those after treatment (all P ＜ 0.05).Before treatment,the bone mineral density (BMD) levels of the two groups were (35.48 ± 4.58) g/cm3 and (35.74 ±4.61) g/cm3,respectively,which were significantly lower than those after treatment (all P ＜ 0.05).The levels of PD,CAL,PI and SBI in the observation group at 3 months and 6 months after treatment were (4.48 ± 1.01) mm,(4.27 ±0.53)mm,(0.68 ±0.21),(1.12 ±0.13) and (3.43 ±0.76) mm,(3.58 ±0.54)mm,(0.38 ±0.07),(0.41 ±0.08),respectively,which were significantly lower than those in the control group [(5.19 ± 0.83) mm,(4.83 ±0.71)mm,(0.89 ±0.27),(1.46 ±0.21) and (4.14 ±0.98)mm,(4.21 ±0.62)mm,(0.49 ±0.11),(0.63 ±0.13)],the differences were statistically significant (t =3.213,3.739,3.632,8.144 and 3.387,4.533,4.991,8.526,P =0.002,0.000,0.000,0.000,0.001,0.000,0.000,0.000,0.000,0.000).The levels of TA anterior temporalis muscle EMG and MA masseter muscle EMG in the two groups at 6 months after treatment were (76.81 ± 15.17) mV,(67.56 ±14.43)mV,(74.24 ± 13.28) mV,(68.27 ± 13.03) mV,(66.44 ± 13.28) mV,(58.76 ± 13.07) mV,(65.58 ±11.55) mV,(59.04 ± 10.76) mV,respectively,which were significantly higher than those before treatment [(46.48 ±11.15) mV,(38.19± 13.04) mV,(54.83 ±12.57) mV,(56.48 ±13.13) mV and (45.71 ±10.98) mV,(38.23 ±13.11)mV,(55.14±12.69) mV,(56.61 ± 13.08) mV] (all P ＜0.05).After treatment,the ICP-HB,ICMAP-MC,TA,EMG levels in the observation group were significantly higher than those in the control group,the differences were statistically significant (t =3.042,2.674,2.911,2.994,P =0.003,0.009,0.004 and 0.003).Conclusion The effect of rich plate plasma combined with Bio-oss artificial bone powder on the repair of bone defect around the implant is significant.The platelet rich plasma can speed up and improve the repair speed and repair quality of bone defect around the implant,so that the therapeutic effect of implant repair can be maintained for a long time.
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In maxillofacial surgery, there is a significant need for the design and fabrication of porous scaffolds with customizable bionic structures and mechanical properties suitable for bone tissue engineering. In this paper, we characterize the porous Ti6Al4V implant, which is one of the most promising and attractive biomedical applications due to the similarity of its modulus to human bones. We describe the mechanical properties of this implant, which we suggest is capable of providing important biological functions for bone tissue regeneration. We characterize a novel bionic design and fabrication process for porous implants. A design concept of “reducing dimensions and designing layer by layer” was used to construct layered slice and rod-connected mesh structure (LSRCMS) implants. Porous LSRCMS implants with different parameters and porosities were fabricated by selective laser melting (SLM). Printed samples were evaluated by microstructure characterization, specific mechanical properties were analyzed by mechanical tests, and finite element analysis was used to digitally calculate the stress characteristics of the LSRCMS under loading forces. Our results show that the samples fabricated by SLM had good structure printing quality with reasonable pore sizes. The porosity, pore size, and strut thickness of manufactured samples ranged from (60.95± 0.27)% to (81.23±0.32)%, (480±28) to (685±31) µm, and (263±28) to (265±28) µm, respectively. The compression results show that the Young’s modulus and the yield strength ranged from (2.23±0.03) to (6.36±0.06) GPa and (21.36±0.42) to (122.85±3.85) MPa, respectively. We also show that the Young’s modulus and yield strength of the LSRCMS samples can be predicted by the Gibson-Ashby model. Further, we prove the structural stability of our novel design by finite element analysis. Our results illustrate that our novel SLM-fabricated porous Ti6Al4V scaffolds based on an LSRCMS are a promising material for bone implants, and are potentially applicable to the field of bone defect repair.
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Objective@#To research the clinical effect of platelet rich plasma combined with Bio-oss artificial bone meal in repairing bone defects around implants.@*Methods@#From January 2015 to January 2017, 70 cases who completed the implant repair in Lishui People's Hospital, and later confirmed the defects around the implant were selected in the research.They were equally divided into observation group and control group according to admission, with 35 cases in each group.The control group was treated with Bio-oss artificial bone powder.The observation group was treated with platelet rich plasma combined with Bio-oss artificial bone powder.The clinical effects of the two groups were compared and analyzed.@*Results@#Before treatment, the probe depth (PD), clinical attachment loss (CAL), plaque index (PI), gingival sulcus hemorrhage index (SBI) of the observation group and the control group were (7.18±1.31)mm, (5.68±0.87)mm, (1.23±0.31), (2.48±0.34) and (7.22±1.28)mm, (5.74±0.83)mm, (1.27±0.33), (2.53±0.36), respectively, which were significantly higher than those after treatment (all P<0.05). Before treatment, the bone mineral density (BMD) levels of the two groups were (35.48±4.58)g/cm3 and (35.74±4.61)g/cm3, respectively, which were significantly lower than those after treatment (all P<0.05). The levels of PD, CAL, PI and SBI in the observation group at 3 months and 6 months after treatment were (4.48±1.01)mm, (4.27±0.53)mm, (0.68±0.21), (1.12±0.13) and (3.43±0.76)mm, (3.58±0.54)mm, (0.38±0.07), (0.41±0.08), respectively, which were significantly lower than those in the control group [(5.19±0.83)mm, (4.83±0.71)mm, (0.89±0.27), (1.46±0.21) and (4.14±0.98)mm, (4.21±0.62)mm, (0.49±0.11), (0.63±0.13)], the differences were statistically significant (t=3.213, 3.739, 3.632, 8.144 and 3.387, 4.533, 4.991, 8.526, P=0.002, 0.000, 0.000, 0.000, 0.001, 0.000, 0.000, 0.000, 0.000, 0.000). The levels of TA anterior temporalis muscle EMG and MA masseter muscle EMG in the two groups at 6 months after treatment were (76.81±15.17)mV, (67.56±14.43)mV, (74.24±13.28)mV, (68.27±13.03)mV, (66.44±13.28)mV, (58.76±13.07)mV, (65.58±11.55)mV, (59.04±10.76)mV, respectively, which were significantly higher than those before treatment [(46.48±11.15) mV, (38.19±13.04) mV, (54.83±12.57) mV, (56.48±13.13) mV and (45.71±10.98) mV, (38.23±13.11)mV, (55.14±12.69) mV, (56.61±13.08) mV] (all P<0.05). After treatment, the ICP-HB, ICMAP-MC, TA, EMG levels in the observation group were significantly higher than those in the control group, the differences were statistically significant (t=3.042, 2.674, 2.911, 2.994, P=0.003, 0.009, 0.004 and 0.003).@*Conclusion@#The effect of rich plate plasma combined with Bio-oss artificial bone powder on the repair of bone defect around the implant is significant.The platelet rich plasma can speed up and improve the repair speed and repair quality of bone defect around the implant, so that the therapeutic effect of implant repair can be maintained for a long time.
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Objective: To discuss the role of heparan sulfate (HS) in bone formation and bone remodeling and summarize the research progress in the osteogenic mechanism of HS.
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Objective To compare the application effects of pentobarbital sodium ,urethane and midazolam combined with ket-amine/Sumianxin Ⅱ in rabbit bone defect repair .Methods 120 healthy male adult rabbits were randomly divided into three groups according to different anesthetic agents ,40 cases in each group .The group A was intramuscularly injected by pentobarbital sodium , the group B was given urethane by the ear vein and the group C was given midazolam combined with ketamine/and Sumianxin Ⅱ by intramuscular injection .The onset time of anesthesia ,maintenance time ,breathing rate ,heart rate ,complications ,recovery time ,ad-ditional anesthetic agents and postoperative death rate in 3 groups were recorded respectively .Results The onset time of anesthesia in the group B and C was(4 .53 ± 0 .65) min and(3 .56 ± 1 .31) min respectively ,which were significantly shortened compared with the group A(P<0 .05);the maintenance time of anesthesia in the group B was (152 .12 ± 12 .53) min ,which was significantly short-ened compared with the group A and C (P<0 .05);the recovery time in the group C was (31 .05 ± 5 .73) min ,which was significant-ly shortened compared with the group A and B(P<0 .05) ,the propability of additional anesthetic agents and the postoperative mor-tality in the group C were significantly decreased compared with the group A and B (P<0 .05) .Conclusion The combined anesthe-sia of midazolam and ketamine/Sumianxin Ⅱ has definite effect without any observed intraoperative depressions of breathing rate and heart rate and with high safety ,high controllability and less influence on the long term survival of the experimental animals , which is a more ideal anesthesia method of the rabbit bone defect repair .
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@#ObjectiveTo investigate the effort of MHA-bBMP implantation combined with limited contacted titanium net duct fixation on femoral shaft bone defect of rabbit.Methods48 rabbits were divided into the experimental group (treated with bionic bone MHA-bBMP plus titanium net duck) and control group (treated with iliac autograft plus titanium net duct) with 24 animals in each group. The rabbit femoral shaft bone defect model was established by cutting 10 mm bone fragment off. After operation, bionic bone MHA-bBMP/iliac autograft was implanted into bone defect area and fixed with limited contacted titanium net duck. The general condition, serum alkaline phosphatase, X-ray, histopathologic examination and electron microscope were performed.ResultsThe fixation stability of titanium net duck in two groups was good. The bone defect of two groups was repaired. The results of phosphatase, X-ray, histopathologic examination and electron microscope of two groups were not significantly different.ConclusionBionic bone MHA-bBMP is a high bioactivity substitute, and can obtain therapeutic effect equal to iliac autograft when repairing rabbit's femoral shaft defect.
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[Objective]To investgate the expression of vascular endothelial growth factor in osteonecrosis of the femoral head during the repairing with biodegradable strontium-doped calcium polyphosphate in glucocorticoid-induced rabbits.[Method]Twenty mg/kg methylprednisolone was injected into right gluteus medius muscle at intervals of 24 hours for three times in 21 adult male Japanese white rabbits.Three rabbits were killed randomly at 2 weeks after methylpednisolone injection,both the femora and humeri were histologically examined for the presence of osteonecrosis. The remaining 18 animals with a total of 36 cylindrical 2.5?5 mm femoral head defects were created following the trapdoor procedure. Eighteen animals with femoral head bone defects were randomly divided into three groups. Group A:the defects filled with strontium-doped calcium polyphosphat,Group B:the defects filled with calcium polyphosphate and Group C:the defects filled with autologous cancellous bone alone. Roentgenographic and histological examinations were performed postoperatively. Finally,immunohistochemical analysis using monoclonal antibodies anti-VEGF was performed.[Result]No hip joint dislocation occurred. In Group A,the results of VEGF expression had a significantly difference from those in the other groups 12 weeks after operation. Most of the biodegradable strontium-doped calcium polyphosphate was resorbed and was largely replaced by newly formed trabecular bone at 12 weeks. While in Group B,a major part of defect were repaired. New formed trabecular bone in the defect was very thin. In Group C,morsellized cancellous bone was completely surrounded by fibrous and newly formed trabecular bone. [Conclusion]VEGF expression in the defect of osteonecrosis of the femoral head during the repairing with biodegradable strontium-doped calcium polyphosphate may play a role in stimulating vascular invasion and granulation tissue formation.This may be an important step toward facilitating the resorption in the osteonecrosis,thus impooring the repairing proceduce of femoral head defect.
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Objective To investigate the effect of simvastatin-polylactic acid compound on critical calvarial defects in rats.Methods Twenty male SD rats(150 g?10 g),were used to establish critical cranial defect(10 mm in diameter)model.The animals were randomly divided into control and experiment groups(10 in each).In the control group,40 mg of polylactic acid were implanted into the defect area;whereas in the experiment group,simvastatin-polylactic acid compound were used(20 mg simvastatin and 40 mg polylactic acid).Four and eight weeks after the implantation,the defect area of the rats was observed by X-ray and toluidine blue staining.Results Eight weeks after the operation,X-ray examination showed high-density regions in the defect area in the experiment group,while low-density regions in the control group.The radiopacity of cranial defects were 27.33%?2.54% in the control group,and 74.63%?2.42% in the experimental group(n=5,t=-30.148,P=0.000).Toluidine blue staining showed a few new bone tissues at 4 weeks and fully filled bone defect at 8 weeks in the experiment group.Meanwhile,in the control group,only a small quantity of new bone tissue could be seen on the edge of the cranial defects.Conclusion Locally implanted simvastain-polylactic acid compound is a promising method for the treatment of bone defect owing to its high osteogenic ability.