Consequences of reaming with flat and convex reamers for bone volume and surface area of the glenoid; a basic science study.

BACKGROUND: The effect of reaming on bone volume and surface area of the glenoid is not precisely known. We hypothesize that (1) convex reamers create a larger surface area than flat reamers, (2) flat reamers cause less bone loss than convex reamers, and (3) the amount of bone loss increases with the amount of version correction. METHODS: Reaming procedures with different types of reamers are performed on similar-sized uniconcave and biconcave glenoids created from Sawbones foam blocks. The loss of bone volume, the size of the remaining surface area, and the reaming depth are measured and evaluated. RESULTS: Reaming with convex reamers results in a significantly larger surface area than with flat reamers for both uniconcave and biconcave glenoids (p = 0.013 and p = 0.001). Convex reamers cause more bone loss than flat reamers, but the difference is only significant for uniconcave glenoids (p = 0.007). CONCLUSIONS: In biconcave glenoids, convex reamers remove a similar amount of bone as flat reamers, but offer a larger surface area while maximizing the correction of the retroversion. In pathological uniconcave glenoids, convex reamers are preferred because of the conforming shape.

Influence of joint component mechanical properties and adhesive layer thickness on stress distribution in micro-tensile bond strength specimens.

OBJECTIVES: Differences in mechanical properties between adherents and adhesive result in stress singularity at the free edge for tensile test specimens. Beyond causing premature failures, these also trigger fracture initiation at the bond edge, where the use of the maximum stress at failure as a measure of strength is not a reliable parameter for obtaining bond strength. The aim of this study is to describe the pattern of stress concentration along the interface for micro-tensile bond strength (microTBS) specimens. Also, possible sources of variation in stress concentration (adhesive layer thickness and mechanical properties) were evaluated using the finite element method. METHODS: One-fourth models of typical microTBS specimens were created using axisymmetric elements. A 15MPa load was applied at the outer edge and finite element calculations were performed within the elastic deformation range. In the first set of runs, the adhesive thickness was varied and in the second set, different nu/E ratios between the adhesive and the adherent were assigned. RESULTS: When adhesive thickness increased, a significant increase in stress concentration at the free edge and in the length of the stress-affected area was observed. Increasing the nu/E ratio between adhesive and adherent lead to an increase in stress concentration at the free edge area without change in length of the stress-affected area. SIGNIFICANCE: If mechanical properties and adhesive thickness expected for a specific composite-dentin bond combination in microTBS specimens are known, stress concentration at the interface can be predicted. The adhesive thickness should remain constant when comparing different joints, as it facilitates the interpretation of nominal strength values.

Accuracy and repeatability of cone-beam computed tomography (CBCT) measurements used in the determination of facial indices in the laboratory setup.

AIM: To assess the three dimensional (3D) surface accuracy of a phantom's face acquired from a cone-beam computed tomography (CBCT) scan and to determine the reliability of selected cephalometric measurements performed with Maxilim software (Medicim N.V., Mechelen, Belgium). MATERIAL AND METHODS: A mannequin head was imaged with a CBCT (I-CAT, Imaging Sciences International, Inc., Hatfield, USA). The data were used to produce 3D surface meshes (Maxilim and Mimics, Materialise N.V., Leuven, Belgium) which were compared with an optical surface scan of the head using Focus Inspection software (Metris N.V., Leuven, Belgium). The intra- and inter-observer reliability for the measurement of distances between facial landmarks with Maxilim 3D cephalometry were determined by calculating Pearson correlation coefficients and intraclass correlation (ICC). The Dahlberg formula was used to assess the method error (ME). RESULTS: (1) The maximal range of the 3D mesh deviations was 1.9 mm for Maxilim, and 1.8mm for Mimics segmentation. (2) Test-retest and inter-observer reliability were high; Pearson's correlation coefficient was 1.000 and the ICC was 0.9998. The ME of the vertical measurements was a little larger than that calculated for the width measurements. Maximum ME was 1.33 mm. CONCLUSIONS: The 3D surface accuracy of CBCT scans segmented with Maxilim and Mimics software is high. Maxilim also shows satisfactory intra- and inter-assessor reliability for measurement of distances on a rigid facial surface.