Part II: A new perspective for modeling the bone remodeling process: Biology, mechanics, and pathologies.

In this paper, we explore the effects of biological (pathological) and mechanical damage on bone tissue within a benchmark model. Using the Finite Element Methodology, we analyze and numerically test the model's components, capabilities, and performance under physiologically and pathologically relevant conditions. Our findings demonstrate the model's effectiveness in simulating bone remodeling processes and self-repair mechanisms for micro-damage induced by biological internal conditions and mechanical external ones within bone tissue. This article is the second part of a series, where the first part presented the mathematical model and the biological and physical significance of the terms used in a simplified benchmark model. It explored the bone remodeling model's application, implementation, and results under physiological conditions.

Performance parametric formulation of carbon fiber-reinforced composite locking bone implant plates based on finite-element analysis.

The treatment of Giant Cell Tumor (GCT) in the distal radius poses challenges due to the intricate anatomical features of the bone. It often necessitates the use of long implant plates or the interconnection of multiple short plates after tumor excision. However, the deployment of metal plates may increase the risk of screw loosening and various complications. To address these challenges, this study proposes the adoption of carbon fiber-reinforced PEEK (CFRP) as the base material. As a unique strategy, performance parameters (PP) were developed to compare CFRP implant plates with a Ti-6Al-4V plate using the Finite-element Method. The focus was on four elements: the screw axial force, bone growth, callus formation, and bone resorption. The investigation into the screw axial force involved analyzing the internal force of the screw. The remaining parameters were evaluated using the stress, strain, or elastic energy induced in the bones. The findings showed that the second screw endured the largest screw axial force, measuring 10.16 N under a 90-degree 10-N loading at the translocated bone. The model without a callus exerted a significantly greater force on the screw than the model with a callus, leading to screw loosening in the early stage of treatment. The maximum PP, reached 1.62, was achieved with an angle-ply [456/-456] laminate, featuring a weighting fraction of 0.7 for bone growth and 0.1 for the other parameters. This study provides a generalized methodology for assessing the performances of CFRP implants and offers guidelines for future development in composite implant plate technology.

Investigating the Potential of Ghee Precursor-Derived Carbon Nano Onions for Enhancing Interfacial Bonding in Thermoplastic Composites.

In this study, we employed a straightforward flame synthesis process to produce carbon soot containing carbon nano onions (CNOs) using easily accessible ghee oil as a precursor. The ghee oil, with a molecular composition rich in more than 50 carbon atoms, served as an effective source for generating CNOs. The synthesized CNO particles underwent comprehensive characterization through high-resolution transmission electron microscopy (HRTEM), energy dispersive X-ray spectroscopy (EDX), Fourier transform infrared spectroscopy (FTIR), and X-ray diffraction (XRD) analyses, providing a detailed account of their physicochemical properties. In addition, we explored the direct deposition of CNOs on carbon fiber (CF) surfaces for 5 and 10 min via a soot deposition process. The resulting freeze-fracture images obtained from scanning electron microscope (SEM) offered insights into the morphology of the CNO-deposited CF. Our study aims to shed light on the potential applications of CNOs, focusing on their characterization and the possible benefits they may offer in diverse fields, including but not limited to enhancing interfacial bonding in thermoplastic composites.

Orbital Exenteration: Tumour Diversity and Survival-Report from a Cancer Centre of Northeast India.

Orbital exenteration is a mutilating surgery which involves the removal of the entire contents of the bony orbit, including the globe, extraocular muscles and periorbital fat, and many times includes the eyelids. Since it leads to severe disfigurement, it is an infrequent procedure largely indicated in malignant conditions. The current study aims to report the clinicodemographic profile and treatment outcome of orbital exenteration patients done in a cancer care center in Northeast India. This is a hospital-based retrospective study between January 2017 and December 2021, including patients undergoing orbital exenteration. All patient and treatment-related data were retrieved from the record of hospital files. A total of 18 patients were included in the study. The mean age of the patients was 51 ± 18 years and male: female ratio was 1:1. Most patients had primary in orbit (55.6%). The most common histology was squamous cell carcinoma, (8/18, 44.4%), followed by basal cell carcinoma (two patients, 11.1%). After a median follow-up was 25 months (range 3-92), the median DFS of the study population was 31.4 months. The five-year overall survival of the patients was 54%. Orbital exenteration is an infrequent surgery due to the associated disfigurement and hence reserved for conditions where eye preservation is impossible. We tried to report the experience of orbital exenteration from a single cancer center for five years.

Improved photocatalytic degradation of rhodamine B by g-C3N4 loaded BiVO4 nanocomposites.

Photocatalytic degradation has emerged as one of the most efficient methods to eliminate toxic dyes from wastewater. In this context, graphitic nitride (g-C3N4) loaded BiVO4 nanocomposites (5 wt% g-CN@BiVO4 and 10 wt% g-CN@BiVO4) have been fabricated by the wet impregnation method, and their efficiency towards photocatalytic removal of rhodamine B have been investigated under visible light irradiation. These hybrid composites have been characterized by XRD, FESEM, HRTEM, EDS-mapping, UV-Vis DRS, DLS, XPS and BET, etc. The HRTEM images revealed that BiVO4 has a decagonal shape covered by a layered nanosheet-like structure of g-C3N4. BET measurements suggest increasing the proportion of g-C3N4 results enhancement of the specific surface area. Among different photocatalysts, the 10 wt% g-C3N4@BiVO4 hybrid possesses the best catalytic activity with 86% degradation efficiency after 60 min of reaction time. The LC-MS studies suggest that the degradation reactions follow the de-ethylation pathway. Even after five cycles, the heterostructure shows only a 14% decrease in photocatalytic activity, confirming its stability. As a result, the binary composite can be regarded as a promising catalyst for the degradation of pollutants due to its ease of preparation, high stability and superior catalytic activity.

Thermal degradation and flame spread characteristics of epoxy polymer composites incorporating mycelium.

Although bioderived flame retardants are environmentally sustainable and less toxic, their impact on the thermal stability and flammability of polymers remains poorly understood. In this study, we assessed the influence of mycelium on the thermal stability and flame spread characteristics of epoxy through thermogravimetric analysis, Fourier transform infrared spectroscopy, the UL94 flammability test, and scanning electron microscopy. We observed a decrease in the maximum mass loss rate temperature when mycelium was incorporated into epoxy, indicating an earlier onset of thermal degradation. The inclusion of mycelium increased char yields above 418 °C due to mycelium's inherent char-forming ability. However, mycelium did not alter the thermal degradation pathway of epoxy. Furthermore, according to the UL94 test results, the incorporation of mycelium reduced the flame spread rate compared to that of neat epoxy. These findings contribute to our understanding of the interaction between bioderived flame retardants and polymers paving the way for the development of more sustainable fireproofing materials.

Uterine artery embolisation: fertility, adenomyosis and size - what is the evidence?

BACKGROUND: Uterine artery embolisation is well established as a treatment for symptomatic fibroids, however, there remain some uncertainties. We have carried out a focused literature review on three particularly challenging aspects - post-procedure fertility, symptomatic adenomyosis and large volume fibroids and uteri, to enable operators to utilise evidence-based guidance in patient selection, consent, and management. REVIEW: Literature searches were performed of the PubMed/Medline, Google scholar, EMBASE and Cochrane databases. The outcomes of our analysis of studies which recorded fertility rates in women desiring pregnancy following UAE for symptomatic fibroids found an overall mean pregnancy rate of 39.4%, live birth rate of 69.2% and miscarriage rate of 22%. The major confounding factor was patient age with many studies including women over 40 years who already have lower fertility compared to younger cohorts. Miscarriage rates and pregnancy rates in the studies analysed were comparable to the age matched population. Treatment of pure adenomyosis and adenomyosis with co-existing uterine fibroids with UAE has been shown to produce symptomatic improvement with better outcomes in those with combined disease. Although the effectiveness is not as high as it is in pure fibroid disease, UAE provides a viable and safe alternative for patients seeking symptom relief and uterine preservation. Our analysis of studies assessing the outcomes of UAE in patients with large volume uteri and giant fibroids (> 10 cm) demonstrate no significant difference in major complication rates demonstrating that fibroid size should not be a contraindication to UAE. CONCLUSION: Our findings suggest uterine artery embolisation can be offered to women desiring pregnancy with fertility and miscarriage rates comparable to that of the age-matched general population. It is also an effective therapeutic option for symptomatic adenomyosis as well as for the treatment of large fibroids > 10 cm in diameter. Caution is advised in those with uterine volumes greater than 1000cm3. It is however clear that the quality of evidence needs to be improved on with an emphasis on well-designed randomised controlled trials addressing all three areas and the consistent use of validated quality of life questionnaires for outcome assessment to enable effective comparison of outcomes in different studies.

Interfacial Engineering Methods in Thermoplastic Composites: An Overview.

The paper critically analyzed different interfacial enhancing methods used in thermoplastic composites. Although the absence of cross-linked polymer chains and chemical bonds on solidification enables the thermoplastics to be remelted, it creates weak interfacial adhesion between fibre reinforcements and the thermoplastic matrix. The weak fibre-matrix interface bonding reduces the efficiency with which the applied load can be transferred between these composite constituents, causing the composite to fail prematurely. Their need for high-temperature processing, poor compatibility with other polymer matrices, and relatively high viscosity render thermoplastics challenging when used to manufacture composite laminates. Therefore, various methods, including nanoparticles, changing the polarity of the fibre surface by plasma etching, chemical treatment with ozone, or an oxidative attack at the fibre surface, have been applied to improve the fibre/matrix bonding in thermoplastic composites. The fabrication steps followed in these techniques, their progress in research, and the associated toughening mechanisms are comprehensively discussed in this paper. The effect of different fibre-matrix interfacial enhancement methods on the mechanical properties of thermoplastic composites is also deliberated.

The rapid assessment for prostate imaging and diagnosis (RAPID) prostate cancer diagnostic pathway.

OBJECTIVE: To report outcomes within the Rapid Assessment for Prostate Imaging and Diagnosis (RAPID) diagnostic pathway, introduced to reduce patient and healthcare burdens and standardize delivery of pre-biopsy multiparametric magnetic resonance imaging (MRI) and transperineal biopsy. PATIENTS AND METHODS: A total of 2130 patients from three centres who completed the RAPID pathway (3 April 2017 to 31 March 2020) were consecutively entered as a prospective registry. These patients were also compared to a pre-RAPID cohort of 2435 patients. Patients on the RAPID pathway with an MRI score 4 or 5 and those with PSA density ≥0.12 and an MRI score 3 were advised to undergo a biopsy. Primary outcomes were rates of biopsy and cancer detection. Secondary outcomes included comparison of transperineal biopsy techniques, patient acceptability and changes in time to diagnosis before and after the introduction of RAPID. RESULTS: The median patient age and PSA level were 66 years and 6.6 ng/mL, respectively. Biopsy could be omitted in 43% of patients (920/2130). A further 7.9% of patients (168/2130) declined a recommendation for biopsy. The percentage of biopsies avoided among sites varied (45% vs 36% vs 51%; P < 0.001). In all, 30% (221/742) had a local anaesthetic (grid and stepper) transperineal biopsy. Clinically significant cancer detection (any Gleason score ≥3 + 4) was 26% (560/2130) and detection of Gleason score 3 + 3 alone constituted 5.8% (124/2130); detection of Gleason score 3 + 3 did not significantly vary among sites (P = 0.7). Among participants who received a transperineal targeted biopsy, there was no difference in cancer detection rates among local anaesthetic, sedation and general anaesthetic groups. In the 2435 patients from the pre-RAPID cohor, time to diagnosis was 32.1 days (95% confidence interval [CI] 29.3-34.9) compared to 15.9 days (95% CI 12.9-34.9) in the RAPID group. A total of 141 consecutive patient satisfaction surveys indicated a high satisfaction rate with the pathway; 50% indicated a preference for having all tests on a single day. CONCLUSIONS: The RAPID prostate cancer diagnostic pathway allows 43% of men to avoid a biopsy while preserving good detection of clinically significant cancers and low detection of insignificant cancers, although there were some centre-level variations.

Outcome of endovascular treatment of internal iliac artery aneurysms: a single center retrospective review.

PURPOSE: To evaluate the technical feasibility and clinical outcomes of endovascular treatment for internal iliac artery (IIA) aneurysms. MATERIAL AND METHODS: This was a retrospective analysis of 25 patients with 32 IIA aneurysms (mean diameter: 39.1 ± 12.6 mm) who underwent endovascular treatment over a 10-year period, and were available for follow-up. Univariate analysis was used to determine the association between variables (including aortoiliac involvement and technique) and outcome. RESULTS: The IIA inflow was covered with an iliac stent graft (N = 29) or embolized with a plug (N = 3). The IIA outflow was embolized in all but one case in which there was thrombotic occlusion of outflow branches. Outflow embolization using plugs or coils was performed in the distal IIA or anterior/posterior trunks in 9 cases and distal IIA branches in 22 cases. During a mean follow-up period of 39.9 months, 31.2% of aneurysms demonstrated endoleak and 12.5% demonstrated enlargement. Univariate analysis revealed that endoleak was associated with technical failure (p = 0.01) and that endoleak rate was higher in patients who underwent distal IIA branch embolization (p = 0.03). No variable was associated with sac expansion. Major complication occurred in one patient who died from aneurysm rupture. Minor complications were reported in six patients who developed femoral pseudoaneurysm (N = 2, 8%), buttock claudication (N = 3, 12%), and limb graft occlusion (N = 1, 4%). CONCLUSION: Endovascular treatment of IIA aneurysms effectively prevents sac expansion. Endoleak was more frequently observed in cases of technical failure and those in which distal IIA branches were embolized. LEVEL OF EVIDENCE: Level 3b, retrospective cohort study.

Development and characterisation of hybrid composite skin simulants based on short polyethylene fibre and bioactive glass particle-reinforced silicone.

Silicone elastomers are widely recognised as artificial skins for medical prosthesis and cranial injury assessment. Since silicone is not an ideal skin simulant due to the lack of mechanical stiffness and a fibrous structure, the present study aimed to tailor the mechanical and structural characteristics of silicone by integrating biocompatible reinforcements (namely, short polyethylene fibres and bioglass particles) to develop suitable bio-integrative skin simulant candidates. The influences of short polyethylene fibres and bioglass particles in the selected platinum silicone on the mechanical properties of silicone-based composite skin simulants were investigated with various factors, including filler concentration, KMnO4 surface treatment of the polyethylene fibre, and particle size. A comprehensive assessment of the tensile, compressive, and hardness properties of the examined composites was conducted, and they were compared with the properties of human biological skin. The results exhibited that the elastic moduli and the hardness of all composites increased with the concentration of both reinforcements. While integrating only the bioglass particles had the advantage of an insignificant effect on the hardness change of the silicone matrix, the composite with polyethylene fibres possessed superior tensile elastic modulus and tensile strength compared to those of the bioglass reinforced composite. The composites with 5% untreated polyethylene fibres, KMnO4 surface-treated fibres, and bioglass reinforcements enhanced the tensile elastic moduli from the pure silicone up to 32%, 44%, and 22%, respectively. It reflected that the surface treatment of the fibres promotes better interfacial adhesion between the silicone matrix and the fibres. Moreover, the smaller bioglass particle had a greater mechanical contribution than the larger glass particle. Systematically characterised for the first time, the developed composite skin simulants demonstrated essential mechanical properties within the range of the human skin and constituted better skin alternatives than pure silicone for various biomedical applications.

A SLC35C2 Transporter-Targeting Fluorescent Probe for the Selective Detection of B Lymphocytes Identified by SLC-CRISPRi and Unbiased Fluorescence Library Screening.

T and B lymphocytes are two major adaptive immune cells in the human defense system. To real-time monitor their diverse functions, a live-cell-selective probe for only one cell type is need to investigate the complex interaction of the immune cells. Herein, a small-molecule probe CDyB for live B cells is developed by an unbiased fluorescence library screening. The cell selectivity was confirmed by multiparametric single-cell analysis using CyTOF. Through a systematic SLC-CRISPRi library screening, the molecular target of CDyB was identified as SLC35C2 transporter based on a gating-oriented live-cell distinction (GOLD) mechanism. The gene expression analysis and knock-out experiments validated that the SLC35C2 transporter was the target for CDyB distinction. Interestingly, when CDyB was applied to study B cell development, the CDyB fluorescence and SLC35C2 expression were positively correlated with the B cell maturation process, and not involved in the T cell development.

Randomised Controlled Trial of Particles Used in Uterine fibRoid Embolisation (PURE): Non-Spherical Polyvinyl Alcohol Versus Calibrated Microspheres.

PURPOSE: The PURE study is a randomised controlled trial (RCT) comparing the clinical and MRI outcomes of patients treated with non-spherical polyvinyl alcohol, ns-PVA (Contour PVA-Boston Scientific-355-500 & 500-700 microns) versus calibrated hydrogel microspheres (Embozene-Varian Inc-700 & 900 microns) for symptomatic uterine fibroids. MATERIALS AND METHODS: Prospective, ethically approved non-sponsored RCT in 84 patients in a single UK tertiary IR unit, ISRCTN registry trial number ISRCTN18191539 in 2013 and 2014. All patients with symptomatic fibroid disease were eligible. UAE followed a standardised protocol with UFS-QOL and contrast-enhanced MRI before and 6 months post UAE. Outcome measures included: (1) Uterine Fibroid Symptom and Quality of Life questionnaire (UFS-QOL). (2) Percentage total and dominant fibroid infarction. (3) Uterine and dominant fibroid volume reduction. (4) Volume of embolics. RESULTS: Sixty-three patients completed the QOL follow-up (33 ns-PVA vs 30 Embozenes), the groups were equivalent at baseline. Patients were followed up for 6 months following UAE. There was no significant difference in symptom scores or HR-QOL between ns-PVA and Embozenes, p = 0.67 and 0.21, respectively. 92.7% of patients treated with ns-PVA achieved > 90% dominant fibroid infarction versus 61.8% treated with Embozenes (p = 0.0016). 66% of patients treated with ns = PVA achieved > 90% total fibroid percentage infarction compared with 35% in the Embozene group (p = 0.011). The mean vials/syringes used were 5.2 with Embozenes versus 4.1 using PVA (p = 0.08). CONCLUSION: The PURE study informs IRs regarding the efficacy of embolic agents in UAE, with superior fibroid infarction on MRI using ns-PVA versus Embozenes however no significant difference in clinical outcomes at 6 months after UAE.

Evaluating Orientation Effects on the Fire Reaction Properties of Flax-Polypropylene Composites.

In this work, the fire reaction properties of flax-polypropylene (PP) composites were investigated at multiple sample angles both experimentally and numerically under two different heat flux conditions (35 and 50 kW/m2) in the cone calorimeter environment. An innovative testing setup which can accommodate a wide range of angles between 0° and 90° for the sample angle frame was developed to perform cone calorimeter tests at different sample angles. An advanced numerical predictive model based on the finite volume method was developed using the fire dynamics simulator (FDS) to quantify the dependency of ignition and combustion properties with sample angles. The numerical model was validated against experimental data from the cone calorimeter tests. The experimental and numerical analyses were conducted to quantify the effects of sample orientation on the different fire reaction properties i.e., ignition time, ignition temperature, burn time, heat release rate (HRR), critical heat flux, etc. The numerical method was utilised to analyse the mechanisms controlling the effect of heat convection and radiation blockage on the heating process. The study establishes that the sample orientation (with respect to the heat flux normal) has a significant influence on the fire reaction properties of natural fibre composites.

Comprehensive and High-throughput Electrolysis of Water and Urea by 3-5†nm Nickel and Copper Coordination Polymers.

Metal-organic coordination polymers (CP) have attracted the scientific attention for electrochemical water oxidation as it has the similar coordination structure like natural photosynthetic coordinated complex. However, the harsh synthesis conditions and bulky nature pose a major challenge in the field of catalysis. Herein, 3-5 nm CP particles synthesized at room temperature using aqueous solutions of Ni2+ /Cu2+ and 2,5-dihydroxyterepthalic acid as precursor were applied for alkaline water and urea electrolysis. The overpotential required is only 300 mV at 10 mA cm-2 by Nano-Ni CP for water oxidation, with turnover frequency (TOF) of 21.4 s-1 which is around 8 times higher than its bulk-counterpart. Overall water and urea splitting were achieved with Nano-Cu (-) ∥ Nano-Ni (+) couple on Ni foam at 1.69 and 1.52 V to achieve 10 mA cm-2 , respectively. High electrochemical surface area (ECSA), high TOF, and enhanced mass diffusion are found to be the key parameters responsible for the state-of-the-art water and urea splitting performances of nano-CPs as compared to their bulk counterparts.

Lipid-Oriented Live-Cell Distinction of B and T Lymphocytes.

The identification of each cell type is essential for understanding multicellular communities. Antibodies set as biomarkers have been the main toolbox for cell-type recognition, and chemical probes are emerging surrogates. Herein we report the first small-molecule probe, CDgB, to discriminate B lymphocytes from T lymphocytes, which was previously impossible without the help of antibodies. Through the study of the origin of cell specificity, we discovered an unexpected novel mechanism of membrane-oriented live-cell distinction. B cells maintain higher flexibility in their cell membrane than T cells and accumulate the lipid-like probe CDgB more preferably. Because B and T cells share common ancestors, we tracked the cell membrane changes of the progenitor cells and disclosed the dynamic reorganization of the membrane properties over the lymphocyte differentiation progress. This study casts an orthogonal strategy for the small-molecule cell identifier and enriches the toolbox for live-cell distinction from complex cell communities.

Clinical experience with a shape memory polymer peripheral vascular embolisation plug: a case series.

BACKGROUND: Shape memory polymers are materials that are manufactured in a certain shape, can be stored in a temporary deformed shape, and then return to - or remember - their original shape upon exposure to external stimuli such as temperature and moisture. This property lends itself to application in endovascular medical devices. Peripheral vasculature embolisation devices incorporating this novel technology have become commercially available and this case series, where the data were collected as part of a post market registry, outlines initial clinical experience with these novel devices. RESULTS: Eight cases are described in this series. The disease state/conditions for which embolisation was indicated were right common iliac artery aneurysms (n = 3), a type II endoleak into the thoracic aorta following thoracic endovascular aneurysm repair (n = 1), a left inferior gluteal artery aneurysm (n = 1), left internal iliac artery aneurysms (n = 2), and a case of splenomegaly, where splenectomy was planned after the embolisation procedure (n = 1). Target arteries were 5-10 mm in diameter. In each case, at least one IMPEDE Embolization Plug (IMP-Device) of an appropriate diameter was used. All procedures were technically successful and target vessel thrombosis was achieved in all cases. Follow-up imaging available during the 45-90-day data collection timeframe showed sustained vessel occlusion. This case series includes examples of situations commonly encountered when embolising the peripheral vasculature, namely, the use of one or multiple devices in a single vessel and in combination with the use of other embolic devices (e.g., microcoils, gelatin sponge, and PVA particles) in the same case. There were no adverse events related to the specific use of the device. CONCLUSIONS: This small series illustrates the safety and efficacy of this novel sponge-based embolic device for the embolisation of small and medium sized arteries and further experience will demonstrate the utility of the shape memory polymer devices.

Smoking status and mortality outcomes following percutaneous coronary intervention.

OBJECTIVE: The aim of this study was to assess the impact of smoking on short (30-day) and intermediate (30-day to 6-month) mortality following percutaneous coronary intervention (PCI). BACKGROUND: The effect of smoking on mortality post-PCI is lacking in the modern PCI era. METHODS: This was a retrospective analysis of prospectively collected data comparing short- and intermediate-term mortality amongst smokers, ex-smokers and non-smokers. RESULTS: The study cohort consisted of 12,656 patients: never-smokers (n = 4288), ex-smokers (n = 4806) and current smokers (n = 3562). The mean age (±standard deviation) was 57 (±11) years in current smokers compared with 67 (±11) in ex-smokers and 67 (±12) in never-smokers; p < 0.0001. PCI was performed for acute coronary syndrome (ACS) in 84.1% of current smokers, 57% of ex-smokers and 62.9% in never-smokers; p < 0.0001. In a logistic regression model, the adjusted odds ratios (95% confidence intervals (CIs)) for 30-day mortality were 1.60 (1.10-2.32) in current smokers and 0.98 (0.70-1.38) in ex-smokers compared with never-smokers. In the Cox proportional hazard model, the adjusted hazard ratios (95% CI) for mortality between 30 days and 6 months were 1.03 (0.65-1.65) in current smokers and 1.19 (0.84-1.67) in ex-smokers compared with never-smokers. CONCLUSION: This large observational study of non-selected patients demonstrates that ex-smokers and never-smokers are of similar age at first presentation to PCI, and there is no short- or intermediate-term mortality difference between them following PCI. Current smokers undergo PCI at a younger age, more often for ACS, and have higher short-term mortality. These findings underscore the public message on the benefits of smoking cessation and the harmful effects of smoking.

Stress distribution within the ceramic veneer-tooth system with butt joint and feathered edge incisal preparation designs.

OBJECTIVE: This in-vitro study aims to study the stress distribution within the ceramic veneer-tooth system with two incisal preparation designs-butt joint (BJ) and feathered edge (FE), and to correlate these findings to the results of our previous published load-to-failure study. METHODS: Six photoelastic models were fabricated with an epoxy resin material (West System 105 Epoxy Resin/205 Fast Hardener, West System) to represent BJ and FE preparation configurations at 0° and 20° loading angulations. Lithium disilicate ceramic veneers (IPS e.max CAD, Ivoclar Vivadent) were bonded to the BJ and FE photoelastic models using resin cement (IPS Variolink Esthetic, Ivoclar Vivadent). Each model was loaded using an Instron Universal Testing Machine at the incisal edge at a cross-head speed of 0.25 mm/min till 100 N. RESULTS: BJ photoelastic model had more uniform distribution compared with FE photoelastic models under 0° and 20° loading angulations. CONCLUSION: Parallel to the results of our earlier load-to-failure published study, both incisal preparation designs affect stress distribution within the ceramic veneer-tooth system. BJ photoelastic model demonstrated a more uniform distribution compared with FE photoelastic model. CLINICAL SIGNIFICANCE: BJ incisal preparation design has more uniform stress distribution than FE preparation design within the ceramic veneer-tooth system.