In vitro cytological comparison of osseointegration properties between biomimetic bone trabecular and regular porous structure / 西安交通大学学报(医学版)

【Objective】 To investigate the effects of biomimetic bone trabecular with the same porosity and pore size and regular porous structure on the adhesion, proliferation, and differentiation of osteoblasts, so as to provide theoretical basis for the improvement of osseointegration performance of titanium alloy implants. 【Methods】 The biomimetic bone trabecular and regular porous structures with the same porosity and pore size were generated by computer-aided software, and then processed into disc-shaped Ti6Al4V scaffolds with a diameter of 10 mm and a height of 3 mm by selective laser melting technology. MC3T3-E1 cells, the precursor cells of mouse osteoblasts in the logarithmic growth phase, were seeded on two kinds of scaffolds and divided into biomimetic bone trabecular group and regular porous structure group. After 3 hours of culture, acridine orange staining and phalloidin /DAPI staining were used to evaluate the number of cell adhesion. After 3 days of culture, the scaffolds were examined by scanning electron microscopy to evaluate the adhesion state of cells. After 1, 3, and 5 days of culture, the scaffolds were taken for CCK8 detection to observe the proliferation of cells. After 7 and 14 days of differentiation, alkaline phosphatase (ALP) activity was detected. After 14 days of differentiation, the expressions of osteogenesis-related genes (ALP, OCN, RUNX2) were detected by RT-PCR. After 30 days of differentiation, the scaffolds were stained with alizarin red and 100 g/L cetylpyridinium chloride was used to dissolve mineralized nodules. Calcium salt deposition was qualitatively and quantitatively detected to evaluate cell differentiation. 【Results】 The results of acridine orange and phalloidin /DAPI staining showed that the biomimetic trabecular Ti6Al4V scaffold adhered to more MC3T3-E1 cells than the regular porous structure, and the cytoskeleton of the former scaffold was more densely distributed. The results of scanning electron microscopy showed that the pseudopodia of MC3T3-E1 cells on the biomimetic bone trabecular Ti6Al4V scaffold were longer and the extension state was better than that of the regular porous structure. CCK8 test showed that the proliferation of MC3T3-E1 cells on the biomimetic trabecular bone titanium alloy scaffold was significantly higher than that on the regular porous structure on the 3rd and 5th day, and the difference gradually increased with the increase of time, with statistical significance (P<0.05). The results of cell differentiation test showed that ALP activity on the bionic trabecular scaffold was higher than that on the regular porous structure (P<0.05). The expressions of osteogenic genes (ALP, OCN, RUNX2) in MC3T3-E1 cells on the biomimetic bone trabecular titanium alloy scaffold were significantly higher than those on the regular porous structure (P<0.05). After 30 days of induction, the amount of calcium salt deposited in the bionic trabecular titanium alloy scaffold was significantly larger than that in the regular porous structure (P<0.05). 【Conclusion】 The biomimetic bone trabecular with a porosity of 65% and an equivalent pore size of 600 μm is more conducive to the adhesion, proliferation and differentiation of mouse osteoblast precursor cells MC3T3-E1 on the titanium alloy scaffold than the regular porous structure with the same porosity and pore size. It is theoretically more conducive to improving the osseointegration performance of titanium alloy implants.

Dosimetric Impact of Titanium Alloy Implant in Spinal IMRT Plan / 中国医疗器械杂志

The purpose of this study is to establish and apply a correction method for titanium alloy implant in spinal IMRT plan, a corrected CT-density table was revised from normal CT-density table to include the density of titanium alloy implant. Dose distribution after and before correction were calculated and compared to evaluate the dose deviation. Plans were also copied to a spinal cancer simulation phantom. A titanium alloy fixation system for spine was implanted in this phantom. Plans were recalculated and compared with the measurement result. The result of this study shows that the max dose of spinal cord showed significant difference after correction, and the deviation between calculation results and measurement results was reduced after correction. The method for expanding the range CT-density table, which means that the density of titanium alloy was included, can reduce the error in calculation.

Influence of traverse and waveone gold glider glide path files on the amount of apically extruded debris / Influência das limas glide path Traverse e Wave One Gold Glider na quantidade de detritos extruídos apicalmente

Objective: The aim of this study was to evaluate the effect of different glide path files on the amount of apically extruded debris. Material and Methods: Sixty single-canaled mandibular premolars were accessed and randomly divided into three groups (n= 20) according to the file used for glid path creation; group A using Traverse file, group B using WaveOne Gold Glider, group C using stainless steel K file. All teeth were then instrumented using the Reciproc system. The debris extruded apically during instrumentation were collected into pre-weighed Eppendorf tubes which were then stored in an incubator at 70 °C for 5 days. The weight of the dry extruded debris was established by subtracting the pre-instrumentation and post instrumentation weights of the Eppendorf tubes. The data were analyzed using one-way ANOVA test, and post hoc analysis. Results: WaveOne Gold Glider produced the least amount of apical extruded debris (0.41±0.25) followed by the Traverse group (0.59±0.20) then the K-file group (0.64±0.16) with a statistically significant difference (p=0.003). Conclusion: Apical extrusion of debris is inevitable during root canal cleaning and shaping. Creation of glide path using engine-driven files produces less amount of apically extruded debris compared to hand-driven K-files. (AU)

Objetivos: O objetivo deste estudo foi avaliar o efeito de diferentes limas glide path na quantidade de detritos extruídos apicalmente. Metodologia: Sessenta pré-molares inferiores com canal único foram acessados e divididos aleatoriamente em três grupos (n= 20) de acordo com a lima utilizada para criação do glid path; grupo A usando lima Traverse, grupo B usando WaveOne Gold Glider, grupo C usando lima K de aço inoxidável. Todos os dentes foram então instrumentados usando o sistema reciprocante. Os detritos extruídos apicalmente durante a instrumentação foram coletados em tubos Eppendorf pré-pesados que foram então armazenados em uma incubadora a 70°C por 5 dias. O peso dos detritos secos extruídos foi estabelecido subtraindo-se os pesos dos tubos Eppendorf antes e após instrumentação. Os dados foram analisados por meio do teste one-way ANOVA e análise post-hoc. Resultados: WaveOne Gold Glider produziu a menor quantidade de detritos apicais extruídos (0,41±0,25) seguido pelo grupo Traverse (0,59±0,20) e depois pelo grupo K-file (0,64±0,16) com uma diferença estatisticamente significativa (p=0,003). Conclusão: A extrusão apical de detritos é inevitável durante a limpeza e modelagem do canal radicular. A criação do glide path usando limas acionadas por motores produz menos quantidade de detritos extruídos apicalmente em comparação com as limas K manuais. (AU)

Effects of polydopamine-coated porous titanium alloy scaffolds loaded with zoledronic acid-gelatin nanoparticles for topical sustained drug release on osteoclasts: an in vitro study / 中华创伤骨科杂志

Objective:To analyze the effects of a novel type of polydopamine (PDA)-coated porous titanium alloy scaffolds loaded with zoledronic acid-gelatin nanoparticles (ZOL-GNPs) for topical sustained drug release on osteoclasts in vitro. Methods:After porous titanium alloy scaffolds were fabricated using electron beam melting technique and ZOL-GNPs with different ZOL concentrations (0, 1, 10, 50, 100, 500 μmol/L) were prepared by desolvation method, PDA-coated porous titanium alloy scaffolds loaded with ZOL-GNPs were constructed by combining the two. The characteristics of the scaffolds were analyzed. The biomechanics of 3 different scaffolds (bare porous titanium alloy scaffolds, PDA-coated porous titanium alloy scaffolds, and PDA-coated porous titanium alloy scaffolds loaded with ZOL-GNPs) were investigated. Drug release detection was carried out by high performance liquid chromatography on the 1st, 4th, 7th, 14th, 21st, and 28th days respectively. The osteoclasts were inoculated into the novel scaffolds with different ZOL concentrations. The expression of osteoclast-related genes was detected by real-time quantitative (RT)-polymerase chain reaction (PCR); the expression of osteoclast-related proteins was detected by Western-blot.Results:The PDA-coated porous titanium alloy scaffolds loaded with ZOL-GNPs were successfully constructed. Electron microscope scanning showed that the GNPs were well spheroidized, smooth in surface, and uniformly dispersed, with a particle size of (243.6±63.4) nm. The ZOL-GNPs were uniformly compounded on the surface and in the pores of the scaffolds, and the spheres were regular in shape with no adhesion. The biomechanical experiments showed that the elastic moduli of the porous titanium alloy scaffolds under 3 different conditions were (1.81±0.12) GPa, (1.80±0.23) GPa and (1.81±0.15) GPa, showing no significant difference ( P> 0.05). The drug release percentage in the porous titanium alloy scaffolds was obviously high on the first day, and increased gradually and slowly in the subsequent 27 days. In the scaffolds with a low concentration ZOL, more osteoclasts adhered and proliferated; in the 50 μmol/L scaffolds, spheroid cells appeared; the spheroid cells increased and even apoptosis occurred with an increase in the ZOL concentration. RT-PCR showed that the expression of Ctsk gene and TRAP gene increased with the increased ZOL concentration, peaked in the 50 μmol/L scaffolds, and then decreased with the increased concentration, showing statistically significant differences ( P < 0.05). Western-blot showed that the expression pattern of Ctsk and TRAP was similar to that of their related genes. Conclusions:The novel PDA-coated porous titanium alloy scaffolds loaded with ZOL-GNPs demonstrate good mechanical properties and an anti-osteoporosis effect via their topical sustained drug release. The scaffolds with a ZOL concentration of 50 μmol/L may exert the best effect on inhibition of osteoclasts.

Influence of titanium nanotubular surfaces, produced by anodization, on the behavior of osteogenic cells: in vitro evaluation / Influência da superfície nanotubular do titânio, produzido por anodização, no comportamento de células osteogênicas: avaliação in vitro

Objective: The objective of this study was to evaluate in vitro the influence of the anodized surface of Ti35Nb7Zr alloy on the behavior of osteogenic cells, for future application in biomedical implants. Material and Methods: For the development of this research, samples of commercially pure titanium (TiCp) and samples of Ti35Nb7Zr alloy were anodized, both were characterized by scanning electron microscopy (SEM) and were plated afterwards with human osteoblast-like cells (MG63 line) (2 x 104). Cell adhesion, cytotoxicity test, formation of mineralization nodules and a comet assay were also performed in different periods. The bottom of the plate was used as a control, without a sample. Results: SEM analysis showed that the topography of both samples presented surfaces covered by nanotubes. Cellular morphology exhibited spreading in both samples proposing an intimate cell- material liaison. After 3 days, the Ti35Nb7Zr group exhibited greater cell viability than the TiCp group (p<0.01). Regarding calcium content, there was no statistical difference between the anodized groups, but there was a difference between the experimental groups and the control group (p<0.01). In the comet assay, the percentage of DNA in the comet tail did not exhibit any significant difference (p>0.05) among the groups in the evaluated periods. Conclusion: It was concluded that this process of anodization was efficient to form nanotubes, as well as promote a positive influence on the behavior of osteogenic cells without promoting cell damage. (AU)

Objetivo: O objetivo deste estudo foi avaliar in vitro a influência da superfície anodizada da liga Ti35Nb7Zr no comportamento de células osteogênicas, para futura aplicação em implantes biomédicos. Material e Métodos: Para o desenvolvimento desta pesquisa, amostras de titânio comercialmente puro (TiCp) e amostras da liga Ti35Nb7Zr foram anodizadas, ambas foram caracterizadas por microscopia eletrônica de varredura (MEV) e posteriormente plaqueadas com células semelhantes a osteoblastos humanos (linha MG63) (2 x 104). Foram realizados em diferentes períodos a adesão celular, teste de citotoxicidade, formação de nódulos de mineralização e ensaio do cometa. O fundo da placa foi usado como controle, sem amostra. Resultados: A análise em MEV mostrou que a topografia de ambas as amostras apresentava superfícies cobertas por nanotubos. A morfologia celular exibiu espalhamento em ambas as amostras, propondo uma ligação íntima célula-material. Após 3 dias, o grupo Ti35Nb7Zr exibiu maior viabilidade celular do que o grupo TiCp (p<0.01). Em relação ao teor de cálcio, não houve diferença estatística entre os grupos anodizados, mas houve diferença entre os grupos experimentais e o grupo controle (p<0.01). No ensaio do cometa, a porcentagem de DNA na cauda do cometa não apresentou diferença significativa (p> 0.05) entre os grupos nos períodos avaliados. Conclusão:Concluiu-se que esse processo de anodização foi eficiente para formar nanotubos, além de promover uma influência positiva no comportamento das células osteogênicas sem promover dano celular. (AU)

Comparison of tantalum and titanium (Alloy) as orthopedic materials: Physical and chemical indexes, antibacterial and osteogenic ability / 中国组织工程研究

BACKGROUND: Tantalum and titanium (alloy) are the most widely employed metallic biomaterials in orthopedics. Tantalum is especially focused because of its excellent corrosion resistance and osteointegration. However, whether tantalum is better than titanium (alloy) as orthopedic materials is still in dispute. OBJECTIVE: To review the comparative studies on the biological performances of tantalum and titanium (alloy) and analyze the possible causes of the similarities and differences of biocompatibility of tantalum and titanium (alloy) materials in vivo and in vitro. METHODS: A computer-based search of CNKI, Wanfang and PubMed database was performed for articles relating to the comparative studies on the biological performances of tantalum and titanium (alloy) published until January 2020. The search words were “tantalum” in title and “titanium” in title or abstract, i.e., (tantalum[Title])) AND (titanium[Title/Abstract]). RESULTS AND CONCLUSION: Among the comparative studies on the biological performances of tantalum and titanium (alloy), two viewpoints were primarily involved according to the results from clinical follow-up, animal tests, and cellular experiments. One is that tantalum is superior to titanium (alloy) with better osteogenesis and bone formation and stronger antibacterial activity, while the other one is that tantalum has similar osteogenesis and bone formation and antibacterial activity to titanium (alloy). The primary reason responsible for this divergence is that the fabrication method and the surface chemistries, topographical structures or pore structures are different between the employed tantalum and titanium (alloy).

Research progress on the application of antibacterial titanium alloys in stomatology / 口腔疾病防治

@#Currently, titanium alloys are widely used in the field of stomatology; however, owing to long-term exposure to a complex microbial environment, dental plaques easily form on the surface of the materials, affecting the use efficiency and the service life of the materials. The antibacterial titanium alloy is a new kind of titanium alloy with antimicrobials added through surface modification or overall modification. Based on the location of antibacterial agents in titanium alloy materials, antibacterial titanium alloys can be divided into coating and alloy types. The antibacterial effect of coated antibacterial titanium alloy is good, but the disadvantage is that most of the coatings are not wear-resistant. The widely-used antibacterial agent of the alloy type is metal elements, which can be evenly distributed in the alloy, and the antibacterial properties are stable and long-lasting. Based on whether antibacterial agents can be released, antibacterial titanium alloys can be further divided into active antibacterial and passive antibacterial types. Active antibacterial type titanium alloys can release loaded antibacterial agents, and the antibacterial effect is more obvious, but the release duration of antibacterial agents is relatively short. Passive antibacterial titanium alloys exhibit an antibacterial effect by contact sterilization or inhibition of bacterial adhesion instead of releasing antibacterial agents. The antibacterial titanium alloy can inhibit the adhesion of bacteria on the surface of the material and prolong the service life of oral orthodontic appliances, implants and titanium plates. Moreover, the mechanical properties of the titanium alloy after antibacterial modification are not significantly affected, and the addition of antibacterial agents such as hydroxyapatite can increase the osteogenic function of the material. Therefore, the alloy has good application prospects in the fields of dental implant, orthodontic treatment and oral and maxillofacial surgery. However, most of the current studies on antibacterial titanium alloys are in vitro experiments, and their long-term clinical effects and antibacterial mechanisms are still unclear and need further study.

Enhanced osseointegration of porous titanium scaffold implanted with preload: an experiment study in rabbits / Osteointegración mejorada de malla de titanio poroso implantada con precarga: un estudio experimental en conejos

Porous titanium alloy scaffold was widely used in treating bone defect caused by traumatic injury and osteomyelitis, which was incapable of self-healing. The implantation of scaffold produced stress shielding thereby forming osteolysis. The objective of this study was to analysis trabecular morphological features of osseointegrated bone. 14 New Zealand rabbits were divided into two groups, surgery group and healthy control group. 7 rabbits in surgery group were selected to perform 3D printed porous titanium alloy scaffold implantation surgery with preload at the defect of femoral condyle for osseointegration. The other 7 rabbits in control group were feed free. After 90 days healing, femoral condyles were extracted to perform micro-CT scanning with hydroxyapatite calibration phantom. Mean bone mineral density (BMD), bone volume fraction (BV/TV), BS/TV (bone surface area ratio), Tb.Th (thickness of trabeculae), Tb.N (number of trabeculae), Tb.Sp (trabecular separation) and DA (degree of anisotropy) were calculated from micro-CT images. The results revealed that osseointegration inside and at the surface of scaffolds worked well from grey values of micro-CT images. After 12 weeks healing, mean bone mineral densities (BMD) in surgery group and healthy control group were calculated as 800±20mg/cm3 and 980±90mg/cm3, respectively. This revealed that the strength of trabeculae in surgery group might lower than that in the healthy group. Trabecular morphological parameters test showed that trabecular morphological parameters at the surface of scaffolds in the surgery group deteriorated significantly. It was found from micro-CT images that ingrowth bone was filled with pores of scaffold. Overall, the effect of osseointegration was promoted through the change of mechanical micro-environment in the scaffold region. Overall, preload could improve osseointegration effect in the long-term after surgery. However, the trabecular morphology in the surgery group was deteriorated, which might bring secondary fracture risk again.

La malla de aleación de titanio poroso se usó ampliamente en el tratamiento de defectos óseos causados por lesiones traumáticas y osteomielitis. El implante de la malla generó una protección contra el estrés, formando así osteolisis. El objetivo de este estudio fue analizar las características morfológicas trabeculares del hueso osteointegrado. Se dividieron 14 conejos (Neozelandeses) en dos grupos, grupo cirugía y grupo control saludable. Se seleccionaron 7 conejos en el grupo de cirugía para realizar una implantación de mallas de aleación de titanio poroso, impresas en 3D con precarga en el defecto del cóndilo femoral para la osteointegración. Los 7 conejos restantes del grupo control se mantuvieron sin alimentación. Después de 90 días de curación, se extrajeron los cóndilos femorales para realizar una exploración por micro-CT con un espectro de calibración de hidroxiapatita. Se calcularon a partir de imágenes de micro-CTDensidad mineral ósea media (DMO), fracción de volumen óseo (BV / TV), BS / TV (relación de área de superficie ósea), Tb.Th (espesor de trabéculas), Tb.N (número de trabéculas), Tb.Sp (trabecular separación) y DA (grado de anisotropía). Los resultados revelaron que la osteointegración dentro y en la superficie de los andamios funcionó bien a partir de los valores grises de las imágenes de micro-CT. Después de 12 semanas de curación, las densidades medias de minerales óseos (DMO) en el grupo cirugía y en el grupo control sano se calcularon como 800 ± 20 mg/cm3 y 980 ± 90 mg/cm3, respectivamente. Esto reveló que la fuerza de las trabéculas en el grupo de cirugía podría ser menor que la del grupo sano. La prueba de parámetros morfológicos trabeculares mostró que en el grupo de cirugía, la superficie de las mallas, se deterioraron significativamente. Se descubrió a partir de imágenes de microCT que el hueso en crecimiento estaba lleno de poros de andamio. En general, el efecto de la osteointegración se promovió mediante el cambio del microambiente mecánico en la región de la malla. En general, la precarga podría mejorar el efecto de osteointegración a largo plazo después de la cirugía. Sin embargo, la morfología trabecular en el grupo de cirugía se deterioró, lo que podría traer un nuevo riesgo de fractura secundaria.

Comparación del tamaño transversal de los arcos 0. 012, 0. 014 y 0. 016 de NiTi de tres marcas / Comparação do tamanho transversal dos arcos 0. 012, 0. 014 e 0.016 de NiTi de três marcas / Comparison of the cross-sectional size of the 0. 012, 0. 014 and 0. 016 NiTi archs of three brands

Objetivo: Determinar si existen diferencias en el tamaño de los arcos de NiTi en los calibres 0.012, 0.014 y 0.016 de tres marcas comerciales. Material y métodos: Se utilizaron 180 arcos de NiTi de las marcas American Orthodontics, TD Orthodontics y OrthoPremium. La estadística descriptiva, la ANOVA y el Post Hoc se realizaron en el programa SPSS 18. Resultados: los arcos de American Orthodontics presentaron diferencias estadísticas significativas en la parte anterior y posterior. En los arcos superiores de TD Orthodontics se encontró contracción en el calibre 0.016. En los arcos superiores OrthoPremium presento una contracción en la parte anterior y en el arco inferior de los 10 a los 40mm. Al comparar las tres marcas se encontraron diferencias estadísticas significativas (p<0.05) entre ellas con las pruebas de ANOVA. Conclusiones: existen diferencias en los tamaños de los arcos superiores e inferiores de cada marca y entre ellas.

Objective: To determine if there are differences between the 0.012, 0.014 and 0.016 NiTi archwires of three brands. Material and methods: 180 NiTi archwires of the following brands were used: American Orthodontics, TD Orthodontics and OrthoPremium. Descriptive statistics, ANOVA and Post Hoc were performed in the SPSS 18 program. Results: The American Orthodontics archwires presented significant statistical differences in the anterior and posterior parts. In the TD Orthodontics upper archwires, contraction was found in the 0.016 caliber. In the upper archwires, OrthoPremium presented a contraction in the anterior part and in the lower archwire of 10 to 40mm. When comparing the three brands, significant statistical differences (p <0.05) were found between them with the ANOVA tests. Conclusions: there are differences in the sizes of the upper and lower archwires of each brand and between them.

Objetivo: determinar se existem diferenças no tamanho dos arcos de NiTi em calibres 0, 12, 0, 14 e 0, 16 de três marcas comerciais. Material e métodos: foram utilizados 180 arcos NiTi das marcas American Orthodontics, TD Orthodontics e OrthoPremium. Estatística descritiva, ANOVA e Post Hoc foram realizadas no programa SPSS 18. Resultados: os arcos da American Orthodontics apresentaram diferenças estatísticas significativas na parte anterior e posterior. Nos arcos superiores da TD Ortodontia foi encontrada contração no calibre 0, 16. Nos arcos superiores, o OrthoPremium apresentou contração na parte anterior e no arco inferior de 10 a 40mm. Ao comparar as três marcas, foram encontradas diferenças estatísticas significativas (p <0,05) entre elas com os testes ANOVA. Conclusões: existem diferenças nos tamanhos dos arcos superior e inferior de cada marca e entre eles.

Research advance in surface modification of titanium alloys with chitosan / 中国骨伤

Titanium alloy has good biological properties and is commonly used in orthopedics, but its bone integrity and antibacterial properties are poor, so surface modification is needed to make up for its shortcomings. Chitosan has good biocompatibility and film forming ability, and can be used as a carrier to introduce the target drug to the surface of titanium alloy, which can effectively improve the biological properties of titanium alloy materials and increase its application range. In this paper, the related research of chitosan surface modified titanium alloy materials in recent years is summarized. The modification methods of chitosan coating, the improvement of osteogenesisand antibacterial properties of titanium alloy materials are discussed in order to provide guidance for the clinical application of coating modification of titanium alloy materials.

Tensile properties of three-dimensional printed porous titanium alloy trabecular bone / 中国组织工程研究

BACKGROUND: The three-dimensional printed titanium alloy porous structure has been developed rapidly in orthopedic implant design and clinical application due to its good mechanical properties and biocompatibility. Compared with coated prosthesis, the porous structure of titanium alloy trabecular bone has the advantages of fast and good bone growth. In order to ensure the safety of orthopedic implants, the tensile, shear and flexural fatigue strength of trabecular bone structures are determined by experimental methods. OBJECTIVE: To investigate the mechanical properties of trabecular bone porous structure by mechanical experiments and finite element numerical simulation. METHODS: (1) Tensile test of three-dimensional printed titanium alloy trabecular bone: three-dimensional printed titanium alloy trabecular bone was designed and fabricated. The wire diameter was 0.28-0.35 mm, the pore size was 0.71 mm, and the porosity was 73%. The tensile strength was detected, and the failure mechanism was analyzed. The effect of different printed parts on the tensile strength of trabecular bone was analyzed. (2) Numeric simulation test: a solid model of the tensile specimens including the theoretical structure of the trabecular bone was established to simulate the tensile failure process of trabecular bone specimens. RESULTS AND CONCLUSION: (1) The ultimate load of the three-dimensional printed titanium alloy trabecular bone was 39.55-47.11 kN, and an equivalent ultimate tensile stress was 62.79-74.53 MPa. The result of tensile failure was fracture of the network structure, suggesting that titanium alloy trabecular bone had higher tensile strength. (2) Results of tensile test and numeric simulation test showed that the failure location of trabecular bone was mainly on the wire diameter, but not on the interface between trabecular bone and titanium alloy solid. (3) The tensile failure load obtained by numerical simulation was lower than that of experimental results. The main reason is that the wire diameter of the three-dimensional printed trabecular bone (280-350 µm) was larger than that of the theoretical size (142 µm), and the pore size (75% porosity) was smaller than the theoretical value (96% porosity).

Absorbable rod or titanium alloy screws for Mason type II radial head fractures / 中国组织工程研究

BACKGROUND: At present, open reduction and internal fixation is an effective method for the treatment of Mason type II radial head fracture. The selection of internal fixation includes screws, micro plates, Kirschner wires, absorbable rods or nails. The clinical efficacy reported is inconsistent. OBJECTIVE: To compare the clinical efficacy of titanium alloy screws or absorbable rod for the internal fixation of Mason type II radial head fractures. METHODS: Totally 25 patients with radial head fractures were collected from January 2016 to February 2017 in Sichuan Provincial People’s Hospital, including 16 males and 9 females, at the age of 38-61 years. All patients received open reduction and internal fixation. Of them, 13 cases received titanium alloy screws, and 12 cases received absorbable rod. X-ray images were obtained during follow-up to identify fracture healing time. During the final follow-up, visual analogue score, elbow motion range, Mayo elbow joint function score and Broberg-Morrey scores were compared between the two groups. The study was approved by the Ethics Committee of Sichuan Provincial People’s Hospital Sichuan Academy of Medical Sciences. RESULTS AND CONCLUSION:(1) There was no significant difference in fracture healing time between the absorbable rod group(2.35±0.92 months) and titanium alloy screw group(2.10± 0.47 months)(P > 0.05).(2) In the final follow-up, there was no significant difference in Mayo elbow joint function score and Broberg-Morrey scores between the two groups(P > 0.05).(3) In the final follow-up, there was no significant difference in elbow flexion, extension, supination, and pronation angle between the two groups(P > 0.05).(4) In the final follow-up, there was no significant difference in visual analogue score between the two groups(P > 0.05).(5) These results indicate that the absorbable rod and titanium alloy screws can obtain satisfactory treatment outcomes for Mason type II radial head fractures. However, the absorbable rod can avoid the secondary operation for removing internal fixators, and the adverse impact of stress shielding.

Effect of different doses of aspirin on the early osseointegration of titanium alloy implants in rats / 口腔疾病防治

Objective@#To investigate the effects of different doses of aspirin on the early osteointegration of titanium alloy implants in the femurs of rats to provide a reference for dental implantation in patients who take aspirin.@*Methods @#Forty-eight 8-week-old SD male rats were randomly divided into four groups, namely, the control, A, B, and C groups. Forty-eight Ti-6Al-4 V implants with a diameter of 1.4 mm and a length of 6 mm were implanted at the distal end of the right femur. In the A, B, and C groups, dosages of aspirin of 8.93 mg/kg/d, 17.86 mg/kg/d, and 26.79 mg/kg/d were administered by gavage starting on the day of surgery, and the control group was given similar doses of 0.9% saline. HE, Masson, BMP-2 immunohistochemical and TRAP staining evaluations were performed in the 2nd and 4th weeks after surgery.@*Results @#Compared with the results in the control group, the HE staining results showed that the amount of new bone formation was reduced, the trabeculae were more sparse, and the bone marrow cavity was enlarged around the implants in the B and C groups, with the C group showing the most obvious effects. The Masson staining results showed that, compared with that in the control group, the red-stained area in the new bone tissue around the implant was reduced in groups B and C, and the reduction in group C was more significant. However, there was no significant difference between group A and the control group. The BMP-2 staining results indicated that the expression of BMP-2 was not significantly different between the control group and the A group (P > 0.05), and the expression in group C was lower than that in the other groups (P < 0.05). The TRAP staining results demonstrated that the number of positive cells per unit area was decreased sequentially in the control, A, B, and C groups, and the difference was statistically significant (P < 0.05).@*Conclusion@#Aspirin may reduce the formation of bone tissue by inhibiting the activity of osteoblasts and expression in osteoclasts. This effect on osteogenesis was aspirin dose-dependent, and large doses of aspirin can inhibit osteogenesis more significantly.

Clinical application of laser selective melting titanium alloy for removable partial denture frameworks / 口腔疾病防治

Objective@#To investigate the effect of denture stomatitis of selective laser melting (SLM) titanium alloy for removable partial denture frameworks.@*Methods @#Twenty patients with dentition defects in our hospital were divided into two groups according to the different methods of creating a removable partial denture framework: the SLM group and casting group. The success rate, placement rate, masticatory efficiency and incidence of denture stomatitis were compared. Experimental data were analyzed with SPSS20.0.@*Results @# The success rate of the SLM framework group was 100.00%, which was higher than that of the casting group (90.00%) (P ＜ 0.01). The rate of framework placement in the SLM group was slightly lower than that in the casting group (P ＜ 0.05). The masticatory efficiency of the SLM group was higher than that of the casting group (0.783 ± 0.030 vs. 0.699 ± 0.037, P ＜ 0.001). The incidence of denture stomatitis (10.00%) in the SLM group was significantly lower than that in the casting group (30.00%) (P ＜ 0.001). @*Conclusion @#SLM is superior to the traditional casting method in mastication efficiency and reducing the incidence of denture stomatitis. This method can meet the clinical requirements, but the accuracy of the long-term stent needs to be improved.

Inhibition of Osteoclast differentiation based on precipitation time of titanium surfaces immersed in modified simulated body fluid / 대한치과보철학회지

PURPOSE: The purpose of this study is to investigate the changes of osteoclast differentiation inhibition according to the period of precipitation when titanium disks were immersed in Modified simulated body fluid (mSBF). MATERIALS AND METHODS: Titanium alloy (Ti grade III) disks with machined surfaces and anodized surfaces were immersed in distilled water and mSBF, respectively. The immersion periods were 7 days, 14 days, 21 days and 28 days, and the control group was immersed in distilled water for each period. RAW 264.7 cells capable of differentiating into osteoclasts were used to measure the number of adherent cells, the measurement of TRAP activity, and the expression pattern of NFATc1 by western blotting. RESULTS: The degree of inhibition of osteoclast differentiation was found to be statistically significant when the disks were immersed in mSBF for more than 14 days on both machined surfaces and anodized surfaces. There was no correlation between immersion time and cell attachment. When the disks were immersed for more than 14 days, TRAP activity was decreased and NFATc1 expression was inhibited. Futhermore, the decrease in TRAP activity and the inhibition of NFATc1 expression remained unchanged. CONCLUSION: Immersion of titanium disks in mSBF for more than 14 days can prevent RAW 264.7 cells from differentiating into osteoclasts. Inhibition activity does not change even if the immersion period is for more than 14 days.

Platelet-Rich Plasma Pretreatment on Grit-Blasted Titanium Alloy for Enhanced Osteogenic Differentiation of Human Adipose-Derived Stem Cells

BACKGROUND: Adequate bone formation around titanium alloy implants is integral to successful implantation surgery. Stem cell-coated implants may accelerate peri-implant bone formation. This study investigates the effect of platelet-rich plasma (PRP) pretreatment on a titanium-alloy surface in terms of proliferation and osteogenic differentiation of human adipose-derived stem cells (hADSCs). METHODS: Allogenic leukocyte-depleted PRP was obtained from blood supernatants. The hADSCs were isolated from thigh subcutaneous fat tissue. Grit-blasted titanium plugs were used in two different groups. In one group, 200 µL of PRP was added to the grit-blasted titanium plugs. The hADSCs were seeded in two groups: grit-blasted titanium plugs with or without PRP. The number of hADSCs was measured after 4 hours, 3 days, and 7 days of culture using Cell Counting Kit-8. Osteogenesis of hADSCs was measured by using an alkaline phosphatase activity assay on days 7 and 14, and a calcium assay on days 14 and 21. Osteogenic gene expression was measured by using reverse transcription polymerase chain reaction analysis of alkaline phosphatase, osteocalcin, and type I collagen mRNA. The microscopic morphology of grit-blasted titanium plugs with or without PRP was examined with a field-emission scanning electron microscope using a JSM-7401F apparatus on days 1 and 7. RESULTS: Proliferation and osteogenic differentiation of hADSCs were found to be significantly higher on the grit-blasted titanium alloy preprocessed with PRP than the same alloy without pretreatment. Furthermore, a structural fibrillar mesh developed compactly on the grit-blasted titanium alloy with the PRP pretreatment. CONCLUSIONS: Our results demonstrate that a hADSC-based approach can be used for tissue-engineered peri-implant bone formation and that PRP pretreatment on the grit-blasted titanium alloy can improve proliferation and osteogenic differentiation of hADSCs.

Three-Dimensional Finite Element Analysis of PEEK Customized Reconstruction Plate for Mandibular Defect / 医用生物力学

Objective To study the stress distributions of mandible defect by reconstruction with polyetheretherketone (PEEK) and its composite reconstruction plate through three-dimensional finite element analysis. Methods The finite element models of reconstruction plate of titanium alloy, PEEK, carbon-fiber-reinforced polyetheretherketone (CFR)-PEEK with 30% endless carbon fibers and CFR-PEEK with 68% endless carbon fibers were established by CBCT scanning，Mimics software，SolidWorks, Geomagic Studio and ANSYS Workbench software, and titanium alloy served as control. Two occlusal situations were simulated in the mandible model. Loading I: anterior region loading with 300 N; loading II: left posterior region with 300 N. Results The ratio of the maximum Von Mises stress of the reconstructed plate to its yield strength under two load situations: PEEK system ＞ 30%CFR-PEEK system ＞ titanium alloy system ＞ 68% CFR-PEEK system; the maximum stress of the mandible: PEEK system ＞ 30% CFR-PEEK system ＞ titanium alloy system ＞ 68% CFR-PEEK system. In the PEEK system, the maximum Von Mises stress of reconstructed plate and mandibular exceeded its yield strength under loading I; in the other systems, the maximum Von Mises stresses of mandible and reconstruction plate were below the yield strength. Conclusions The reconstruction plate of CFR-PEEK with 68% endless carbon fibers distributed the stresses in a similar manner as the titanium reconstruction plate, which could meet the mechanical strength requirements of mandible defect reconstruction. The fracture risk of the reconstructed plate was lower than that of titanium alloy, but the incidence of stress shielding was slightly higher. The result can provide references for the selection of materials and clinical application of reconstruction plate for mandibular defects.

Effect of CT artifact on calculation of radiotherapy dose / 中华放射医学与防护杂志

Objective@#To investigate the effect of simple artifacts on the calculation of radiation dose in actual clinical operations by the aid of artificially caused CT artifacts.@*Methods@#The phantom was scanned using CT before and after replacing the titanium alloy component. Then, the CT values were measured at different distances before and after replacement. After correcting the CT value of the titanium alloy region to the CT value of the water phantom, the doses to the phantom were calculated by using Varian′s AAA algorithm, AXB algorithm and Pinnacle system′s CCC algorithm. The absolute dose values at different distances were furtherly analyzed.@*Results@#Varian system was consistent with Pinnacle system in evaluating the CT values. When the CT value deviated by less than 30 HU for a uniform phantom, the dose deviations of the three different algorithms were within 6.0 %-12.0 % at a distance of 0.5 cm from the body surface, and less than 1.0% at a distance of more than 1.5 cm from the body surface. When the CT value deviated by 15 HU for the lung phantom, both Varian′s AAA algorithm and Varian′s AXB algorithm showed about 1.0% dose deviation. However, the CCC algorithm of the Pinnacle system had a significant difference (5.0%) in dose values under the same conditions.@*Conclusions@#CT artifacts have noticeable effects on the calculation of radiation dose and change tissue dose distribution which may result in insufficient or excessive exposure doses.

Surface morphology characterization of laser-induced titanium implants: lesson to enhance osseointegration process

The surface properties of implant are responsible to provide mechanical stability by creating an intimate bond between the bone and implant; hence, play a major role on osseointegration process. The current study was aimed to measure surface characteristics of titanium modified by a pulsed Nd:YAG laser. The results of this study revealed an optimum density of laser energy (140 Jcm⁻²), at which improvement of osteointegration process was seen. Significant differences were found between arithmetical mean height (Ra), root mean square deviation (Rq) and texture orientation, all were lower for 140 Jcm⁻² samples compared to untreated one. Also it was identified that the surface segments were more uniformly distributed with a more Gaussian distribution for treated samples at 140 Jcm⁻². The distribution of texture orientation at high laser density (250 and 300 Jcm⁻²) were approximately similar to untreated sample. The skewness index that indicates how peaks and valleys are distributed throughout the surface showed a positive value for laser treated samples, compared to untreated one. The surface characterization revealed that Kurtosis index, which tells us how high or flat the surface profile is, for treated sample at 140 Jcm⁻² was marginally close to 3 indicating flat peaks and valleys in the surface profile.

Biomechanical study of nickel-titanium three-dimensional memory alloy mesh and autologous bone in treatment of canine tibial plateau collapse fracture / 中国修复重建外科杂志

Objective: To evaluate the biomechanical effect of a nickel-titanium (Ni-Ti) three-dimensional memory alloy mesh in treating a canine tibial plateau collapse fracture model and to lay a foundation for further experiments in vivo. Methods: Sixteen tibial plateau specimens of 8 adult Beagle dogs were harvested. Twelve specimens were taken to prepare canine tibial plateau collapse fracture models (Schatzker type Ⅲ) and randomly divided into groups A, B, and C, with 4 specimens in each group. Four normal tibia specimens were used as blank control group (group D). In groups A and B, the bone defects were repaired with Ni-Ti three-dimensional shape memory alloy mesh combined with autologous bone and simple autologous bone respectively, and fixed with the lateral plate and screw. In group C, the bone defect was directly fixed with the lateral plate and screw. By using a biomechanical tester, a progressive load (0-1 700 N) was loaded vertically above the femoral condyle. The maximum failure load was recorded and the stiffness was calculated according to the load-displacement curve. Results: The maximum failure loads in groups A, B, C, and D were (1 624.72±7.02), (1 506.57±3.37), (1 102.00±1.83), and (1 767.64±24.56) N, respectively; and the stiffnesses were (129.72±20.83), (96.54±27.05), (74.96±17.70), and (169.01±35.62) N/mm, respectively. The maximum failure load and stiffness in group A were significantly higher than those in groups B and C, but which were significantly lower than those in group D ( P<0.05). Conclusion: Ni-Ti three-dimensional memory alloy mesh combined with autologous bone can repair the Schatzker type Ⅲ tibial plateau collapse fracture, which has better biomechanical properties than simple autologous bone grafting.