Solid-State Processing of CoCrMoNbTi High-Entropy Alloy for Biomedical Applications.

High-entropy alloys (HEAs) gained interest in the field of biomedical applications due to their unique effects and to the combination of the properties of the constituent elements. In addition to the required property of biocompatibility, other requirements include properties such as mechanical resistance, bioactivity, sterility, stability, cost effectiveness, etc. For this paper, a biocompatible high-entropy alloy, defined as bio-HEA by the literature, can be considered as an alternative to the market-available materials due to their superior properties. According to the calculation of the valence electron concentration, a majority of body-centered cubic (BCC) phases were expected, resulting in properties such as high strength and plasticity for the studied alloy, confirmed by the XRD analysis. The tetragonal (TVC) phase was also identified, indicating that the presence of face-centered cubic (FCC) phases in the alloyed materials resulted in high ductility. Microstructural and compositional analyses revealed refined and uniform metallic powder particles, with a homogeneous distribution of the elemental particles observed from the mapping analyses, indicating that alloying had occurred. The technological characterization of the high-entropy alloy-elaborated powder revealed the particle dimension reduction due to the welding and fracturing process that occurs during mechanical alloying, with a calculated average particle size of 45.12 µm.

Metal-Ceramic Compatibility in Dental Restorations According to the Metallic Component Manufacturing Procedure.

In terms of production technology, metal-ceramic systems for dental restorations comply with a concrete algorithm, the efficiency of which is always dependent on the applications for which they are intended. The first stage involves obtaining metal support, followed by firing the ceramic on the surface of the metal to meet the list of functional and aesthetic requirements of a future restoration. The compatibility of the two materials-the metal component and the ceramic component-must be ensured in several respects: chemical compatibility, thermo-chemical compatibility, and mechanical compatibility. Thus, there is a need to simulate the thermal behavior of the metal-ceramic couple in its processing to achieve appropriate dental prostheses. In this study, three types of Co-Cr metal frames were manufactured using three different production technologies: conventional casting, milling (CAM), and selective laser melting (SLM). Composition analyses, scanning electron microscopy (SEM), and microstructural analyses of the metal-ceramic interface for each type of production technology, as well as the determination of the hardness and the thermal expansion coefficients of experimental materials and three-point bending tests, were carried out in this study. Considering all these aspects, we demonstrated the influence of the technology of producing the metallic part of the metal-ceramic bonding process in dental prostheses.

Pulmonary Crohn's Disease or Crohn's Disease with Lung Sarcoidosis? A Case Report and Literature Review.

BACKGROUND: Crohn's disease and ulcerative hemorrhagic colitis are forms of granulomatous inflammatory intestinal disease, which usually affects the gastrointestinal tract. There are also reported rare localizations at the skin, kidney, joints, liver and eye level. Pulmonary involvement is relatively rare, and it is most commonly reported in suppuration with bronchiectasis. On the other hand, sarcoidosis is, in principle, a thoracic localization of a granulomatosis disease, although bowel, skin and intestinal disorders are described. There is not a clear line to separate Crohn's disease from sarcoidosis with, possibly because they are, in fact, considered to have the same inflammatory granulomatosis disease pathology. The diagnoses of the two entities, sarcoidosis and Crohn's disease, are based on non-pathognomonic, inclusive clinical and paraclinical criteria, without elements of the mutual exclusion of typical locations. CASE REPORT: We present a very rare case of a young male, already diagnosed with small-bowel Crohn's disease. Granulomatous lung disease with major hemoptysis requires emergency surgery. An intraoperative assessment revealed a necrotic hemorrhagic lesion located in the left lower lobe and a lobectomy was performed. The final pathological report showed the presence of non-caseous granulomatous inflammation, with the identification of specific multinucleated giant cells. CONCLUSIONS: The identical diagnostic principles of Crohn's disease and sarcoidosis, Crohn's disease as a predecessor to pulmonary lesions, the clinical picture and the necrotico-hemorrhagic appearance of the unilateral pulmonary lesion, which are similar to aggressive necrotico-hemorrhagic or perforating intestinal forms, are arguments in favor of the diagnosis of pulmonary Crohn's disease and not pulmonary sarcoidosis. At the same time, in general, the two diseases have overlapping elements, suggesting they are, in fact, not the same disease with different facets.

Adhesive-Ceramic Interface Behavior in Dental Restorations. FEM Study and SEM Investigation.

The purpose of this study is to identify the stress levels that act in inlay and onlay restorations, according to the direction and value of the external force applied. The study was conducted using the Finite Element Method (FEM) of three types of ceramics: pressed lithium disilicate and monolith, zirconia, and three different adhesive systems: self-adhesive, universal, and dual-cure cements. In addition to FEM, the inlay/onlay-dental structure interface analysis was performed by means of Scanning Electron Microscopy (SEM). The geometric models were reconstructed based on computer tomography images of an undamaged molar followed by geometrical procedures of inducing the inlay and onlay reconstructions. The two functional models were then simulated for different orientations of external force and different material properties, according to the considered adhesives and ceramics. The Scanning Electron Microscopy (SEM) was conducted on 30 extracted teeth, divided into three groups according to the adhesive cement type. Both FEM simulation and SEM investigations reveal very good mechanical behavior of the adhesive-dental structure and adhesive-ceramic interfaces for inlay and onlay reconstructions. All results lead to the conclusion that a physiological mastication force applied, regardless of direction, cannot produce a mechanical failure of either inlay or onlay reconstructions. The adhesive bond between the restorations and the dental structure can stabilize the ceramic restorations, resulting in a higher strength to the action of external forces.

Nanoparticles and Nanostructured Surface Fabrication for Innovative Cranial and Maxillofacial Surgery.

A novel strategy to improve the success of soft and hard tissue integration of titanium implants is the use of nanoparticles coatings made from basically any type of biocompatible substance, which can advantageously enhance the properties of the material, as compared to its similar bulk material. So, most of the physical methods approaches involve the compaction of nanoparticles versus micron-level particles to yield surfaces with nanoscale grain boundaries, simultaneously preserving the chemistry of the surface among different topographies. At the same time, nanoparticles have been known as one of the most effective antibacterial agents and can be used as effective growth inhibitors of various microorganisms as an alternative to antibiotics. In this paper, based on literature research, we present a comprehensive review of the mechanical, physical, and chemical methods for creating nano-structured titanium surfaces along with the main nanoparticles used for the surface modification of titanium implants, the fabrication methods, their main features, and the purpose of use. We also present two patented solutions which involve nanoparticles to be used in cranioplasty, i.e., a cranial endoprosthesis with a sliding system to repair the traumatic defects of the skull, and a cranial implant based on titanium mesh with osteointegrating structures and functional nanoparticles. The main outcomes of the patented solutions are: (a) a novel geometry of the implant that allow both flexible adaptation of the implant to the specific anatomy of the patient and the promotion of regeneration of the bone tissue; (b) porous structure and favorable geometry for the absorption of impregnated active substances and cells proliferation; (c) the new implant model fit 100% on the structure of the cranial defect without inducing mechanical stress; (d) allows all kinds of radiological examinations and rapid osteointegration, along with the patient recover in a shorter time.

Investigation of the Microstructure, Hardness and Corrosion Resistance of a New 58Ag24Pd11Cu2Au2Zn1.5In1.5Sn Dental Alloy.

Higher-noble dental alloys (Au, Ag, and Pd) are the most desirable for dentistry applications, but they are expensive. Low-noble (Ag, Pd, Cu) dental alloys are alternatives to higher-noble ones due to their lower price. In this regard, the paper supports the price lowering of dental alloy by increasing the Cu content, i.e., a new 58Ag24Pd11Cu2Au2Zn1.5In1.5Sn dental alloy. The increasing addition of the Cu leads to a complex structure consisting of a solid solution that engulfs compounds of micrometric and nanometric sizes. The 58Ag24Pd11Cu2Au2Zn1.5In1.5Sn has demonstrated a much better electrochemical corrosion behavior in artificial saliva compared to the Paliag and Unique White dental alloys. The improved corrosion behavior of the new alloy is supported by the diminishing of the Cu selective diffusion into the electrolyte due to its retaining into compounds and into Ag-Pd solid solution. Also, the synergic effects of Cu, Zn, In, Sn may improve the corrosion resistance, but they have strengthened the 58Ag24Pd11Cu2Au2Zn1.5In1.5Sn matrix. The main finding addressed in the paper consists in a new 58Ag24Pd11Cu2Au2Zn1.5In1.5Sn dental alloy with improved corrosion resistance in artificial saliva.

Failure Analysis of a Humeral Shaft Locking Compression Plate-Surface Investigation and Simulation by Finite Element Method.

A case study of a failed humeral shaft locking compression plate is presented, starting with a clinical case where failure occurred and an implant replacement was required. This study uses finite element method (FEM) in order to determine the failure modes for the clinical case. Four loading scenarios that simulate daily life activities were considered for determining the stress distribution in a humeral shaft locking compression plate (LCP). Referring to the simulation results, the failure analysis was performed on the explant. Using fracture surface investigation methods, stereomicroscopy and scanning electron microscopy (SEM), a mixed mode failure was determined. An initial fatigue failure occurred followed by a sudden failure of the plate implant as a consequence of patient's fall. The fracture morphology was mostly masked by galling; the fractured components were in a sliding contact. Using information from simulations, the loading was inferred and correlated with fracture site and surface features.

Naturally-Derived Biphasic Calcium Phosphates through Increased Phosphorus-Based Reagent Amounts for Biomedical Applications.

Calcium carbonate from marble and seashells is an eco-friendly, sustainable, and largely available bioresource for producing natural bone-like calcium phosphates (CaPs). Based on three main objectives, this research targeted the: (i) adaptation of an indirect synthesis route by modulating the amount of phosphorus used in the chemical reaction, (ii) comprehensive structural, morphological, and surface characterization, and (iii) biocompatibility assessment of the synthesized powdered samples. The morphological characterization was performed on digitally processed scanning electron microscopy (SEM) images. The complementary 3D image augmentation of SEM results also allowed the quantification of roughness parameters. The results revealed that both morphology and roughness were modulated through the induced variation of the synthesis parameters. Structural investigation of the samples was performed by Fourier transform infrared spectroscopy and X-ray diffraction. Depending on the phosphorus amount from the chemical reaction, the structural studies revealed the formation of biphasic CaPs based on hydroxyapatite/brushite or brushite/monetite. The in vitro assessment of the powdered samples demonstrated their capacity to support MC3T3-E1 pre-osteoblast viability and proliferation at comparable levels to the negative cytotoxicity control and the reference material (commercial hydroxyapatite). Therefore, these samples hold great promise for biomedical applications.

Biopolymers - Calcium phosphates composites with inclusions of magnetic nanoparticles for bone tissue engineering.

Composites based on combination of biopolymers (chitosan, hyaluronic acid and bovine serum albumin or gelatin), calcium phosphates (CP) and magnetic nanoparticles have been prepared by a biomimetic co-precipitation method. The biomimetic strategy is inspired by natural mineralization processes, where the synthesized minerals are usually combined with proteins, polysaccharides or other mineral forms to form composite, in physiological conditions of temperature and pH. The morphology of the magnetic composites, studied using scanning electron microscopy (SEM) indicated a macroporous structure, which influenced the retention of simulated biological fluids. Fourier transformed infrared spectroscopy and X-ray diffraction and Energy-dispersive X-ray spectroscopy (EDX) confirmed the composition of the scaffolds and the formation of various types of calcium phosphates with amorphous nature. The in vitro degradation studies showed a slow degradation process for magnetic composites that confirmed the tightly connection of the polymeric matrix with calcium phosphates, which limits the enzyme access to the degradable components and material disintegration. The magnetic scaffolds exhibited no negative effect on osteoblasts cell, emphasizing a good biocompatibility. Considering the scaffolds properties, some compositions based on calcium phosphates, chitosan, Hya/Bsa and more than 3% of MNPs are recommended for further optimization and in vivo tests.

Osteoblast Cell Response to Naturally Derived Calcium Phosphate-Based Materials.

The demand of calcium phosphate bioceramics for biomedical applications is constantly increasing. Efficient and cost-effective production can be achieved using naturally derived materials. In this work, calcium phosphate powders, obtained from dolomitic marble and Mytilus galloprovincialis seashells by a previously reported and improved Rathje method were used to fabricate microporous pellets through cold isostatic pressing followed by sintering at 1200 °C. The interaction of the developed materials with MC3T3-E1 pre-osteoblasts was explored in terms of cell adhesion, morphology, viability, proliferation, and differentiation to evaluate their potential for bone regeneration. Results showed appropriate cell adhesion and high viability without distinguishable differences in the morphological features. Likewise, the pre-osteoblast proliferation overtime on both naturally derived calcium phosphate materials showed a statistically significant increase comparable to that of commercial hydroxyapatite, used as reference material. Furthermore, evaluation of the intracellular alkaline phosphatase activity and collagen synthesis and deposition, used as markers of the osteogenic ability of these bioceramics, revealed that all samples promoted pre-osteoblast differentiation. However, a seashell-derived ceramic demonstrated a higher efficacy in inducing cell differentiation, almost equivalent to that of the commercial hydroxyapatite. Therefore, data obtained demonstrate that this naturally sourced calcium-phosphate material holds promise for applications in bone tissue regeneration.

Preparation and cytocompatibility evaluation for hydrosoluble phosphorous acid-derivatized cellulose as tissue engineering scaffold material.

Chemical modification of cellulose by phosphorylation enhances its bioactivity and provides new derivatives and materials with specific end uses. In the present study, cellulose derivatized with phosphorous acid was obtained using the reaction of microcrystalline cellulose with phosphorous acid-urea mixture, in molten state, in comparison with others methods that used different solvents and catalysts. Completely water soluble films with a substitution degree close to one were obtained and characterized by analytical and spectral analysis (FT-IR, (31)P NMR), contact angle, metallographic microscopy and atomic force microscopy (AFM). 31P NMR spectra of derivatized cellulose showed a signal at 2.58 ppm (assigned to P-O-C6) while the doublets at 4.99-5.29 and at 7.38 ppm were assigned to P-O-C2 and P-O-C3, respectively; thus, the formation of monosubstituted phosphorous acid esters of cellulose is advocated. Contact angle measurements showed that the work of adhesion is more important in water than in ethylene glycol, for the phosphorous acid derivatized cellulose. The cytocompatibility of this hydrosoluble derivatized cellulose was tested by direct contact and also by indirect assays on normal human dermal fibroblasts and on osteoblast-like cells (human osteosarcoma). Cell growth on phosphorylated cellulose pellicle and the results from viability assays had shown a good cytocompatibility and lack of toxicity. Phosphorous acid derivatized cellulose would offer a promising biomaterial, useful as scaffolds for new biopolymer composites, and subject for further development as an ionic crosslinker.