Mechanical Modeling of the Human Cricoid Cartilage Using Computer-Aided Design: Applications in Airway Balloon Dilation Research.

OBJECTIVES: Balloon dilation is generally considered first-line treatment for airway stenosis. Some dilation systems utilize a compliant balloon that can conform around rigid structures. Others use a noncompliant balloon that does not conform, allowing for dilation of more rigid stenoses. We hypothesized that subglottic dilation with a noncompliant balloon increases the likelihood of fracture of the cricoid when compared to a compliant balloon. METHODS: Three fresh human cricoid cartilages were placed in a universal testing system to determine the expansile force necessary for cricoid fracture. Using these data, a 3D printer was used to construct a synthetic cricoid model possessing near identical physical characteristics to the human cricoid. Simulated dilation was then performed on the model using a compliant and a noncompliant balloon. RESULTS: Human cricoid fracture occurred at 97.25 N (SD = 8.34), and the synthetic cricoid model fractured at 100.10 N (SD = 7.32). Both balloons fractured the model in every replicate experiment. Mean balloon internal pressure at fracture was 7.67 ATM (SD = 1.21) for the compliant balloon and 11.34 ATM (SD = 1.29) for the noncompliant balloon. CONCLUSIONS: These data show that fracture of the cricoid is a valid concern in balloon dilation procedures where the balloon spans the subglottis. Furthermore, the hypothesis was rejected in that the compliant balloon system was at least as likely to fracture the cricoid model as the noncompliant.

Polymeric-calcium phosphate cement composites-material properties: in vitro and in vivo investigations.

New polymeric calcium phosphate cement composites (CPCs) were developed. Cement powder consisting of 60 wt% tetracalcium phosphate, 30 wt% dicalcium phosphate dihydrate, and 10 wt% tricalcium phosphate was combined with either 35% w/w poly methyl vinyl ether maleic acid or polyacrylic acid to obtain CPC-1 and CPC-2. The setting time and compressive and diametral tensile strength of the CPCs were evaluated and compared with that of a commercial hydroxyapatite cement. In vitro cytotoxicity and in vivo biocompatibility of the two CPCs and hydroxyapatite cement were assessed. The setting time of the cements was 5-15 min. CPC-1 and CPC-2 showed significantly higher compressive and diametral strength values compared to hydroxyapatite cement. CPC-1 and CPC-2 were equivalent to Teflon controls after 1 week. CPC-1, CPC-2, and hydroxyapatite cement elicited a moderate to intense inflammatory reaction at 7 days which decreased over time. CPC-1 and CPC-2 show promise for orthopedic applications.

Brushing-induced surface roughness of nickel-, palladium-, and gold-based dental casting alloys.

STATEMENT OF PROBLEM: Alloys with high nickel content have been increasingly used for dental prostheses. These alloys have excellent hardness, elastic modulus, and strength, yet have high corrosion rates when exposed to chemical or physical forces that are common intraorally. PURPOSE: The purpose of the current study was to measure the susceptibility of several types of nickel-based alloys to brushing abrasion relative to gold- and palladium-based alloys. MATERIAL AND METHODS: Au-Pt, Au-Pd, Pd-Ag, Ni-Cr, and Ni-Cr-Be dental alloys were brushed with a toothbrush (Oral-B Soft) and toothpaste (Ultrabrite) in a linear brushing machine, then the surface roughness was measured by profilometry (R(a), R(v), R(p)). Specimens (n=4) were brushed for 48 hours in a saline solution (pH 7). The effect of brushing was determined using 2-sided t tests (alpha=.05), and roughness among alloys postbrushing was compared using 1-way ANOVA with Tukey post hoc analyses (alpha=.05). RESULTS: All polished alloy surfaces (before brushing) had roughnesses of 1 microm (R(a)). Ni-Cr alloys without Be had a postbrushing surface roughness of 0.25 microm (R(a)). Postbrushing roughness of all other alloys ranged from 0.1-0.25 microm (R(a)). R(v) and R(p) values behaved similarly to R(a) values for all alloys. CONCLUSIONS: Although they have many excellent mechanical properties, Ni-Cr-Be alloys may be prone to degradation from brushing.

Effect of toothbrushing on the toxicity of casting alloys.

STATEMENT OF PROBLEM: The biological properties of casting alloys have been assessed largely under passive conditions. The effect of common intraoral stresses such as brushing, toothpastes, and low pH on alloy toxicity are not known. PURPOSE: This study assessed the toxicity of 5 types of casting alloys commonly used in prosthodontics after toothbrushing, brushing in an acidic environment, or brushing with toothpaste. These toxicities were compared with those observed without any brushing. MATERIAL AND METHODS: Au-Pt, Au-Pd, Pd-Cu-Ga, Ni-Cr-Be, and Ni-Cr (no Be) alloys were brushed for 48 hours in a toothbrushing machine at 90 strokes/minute and 200g force. Alloys were brushed with either saline at pH 7, saline at pH 4 (acidified with sodium lactate), or saline with 1:7 (wt/wt) toothpaste. After the brushing regimen, the cytotoxicity of the alloys was assessed in a standard in vitro test. Cytotoxicities of the alloys after different brushing treatments were compared with unbrushed (control) specimens. Analysis of variance (ANOVA) and Tukey multiple comparison intervals (alpha=.05) were used to identify significant differences among brushing conditions. RESULTS: Brushing at pH 7 significantly increased the toxicity of the Pd-Cu-Ga alloy (15% to 20% over unbrushed specimens). Brushing at pH 4 increased the toxicity of the Au-Pt and Au-Pd alloys by 30% and the Pd-Cu-Ga alloy by >40%. The Ni-based alloys were not affected by acid. After being brushed with toothpaste, both Ni-based alloys were significantly more toxic, but Ni-Cr-Be was the worst, increasing more than 60% in toxicity over the controls. The toxicity of the Au-Pd alloy also increased significantly (15%). CONCLUSION: Brushing dental casting alloys may increase their cytotoxicity in vitro, but the increase depends heavily on the alloy type and brushing condition.