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Tissue Engineering Strategies for Craniomaxillofacial Surgery: Current Trends in 3D-Printed Bioactive Ceramic Scaffolds
Chapter by: Witek, Lukasz; Nayak, Vasudev Vivekanand; Runyan, Christopher M; Tovar, Nick; Elhage, Sharbel; Melville, James C; Young, Simon; Kim, David H; Cronstein, Bruce N; Flores, Roberto L; Coelho, Paulo G
in: Innovative Bioceramics in Translational Medicine II by Choi, Andy H; Ben-Nissan, Besim [Eds]
Cham : Springer, 2022
pp. 55-74
ISBN: 978-981-16-7438-9
CID: 5457532
Trends in 3D Printing Parts for Medical and Dental Implant Technologies
Chapter by: Witek, Lukasz; Tovar, Nick
in: Encyclopedia of Materials: Plastics and Polymers by
[S.l.] : Elsevier, 2022
pp. 902-912
ISBN: 9780128232910
CID: 5457292
The Influence of Implant Design Features on Bone Healing Pathways: An Experimental Study in Sheep
Bergamo, Edmara Tp; de Oliveira, Paula Gpf; Jimbo, Ryo; Neiva, Rodrigo; Gil, Luiz F; Tovar, Nick; Witek, Lukasz; Bonfante, Estevam A; Coelho, Paulo G
The purpose of this study was to evaluate the influence of implant design features on osseointegration parameters. Two different implant macrogeometries and surface treatments were evaluated as follows: (1) progressive buttress threads possessing the SLActive surface (SLactive/BL), and (2) inner and outer trapezoidal threads possessing nano-hydroxyapatite coating over a dual acid-etched surface (Nano/U). Implants were placed in the right ilium of 12 sheep, and histologic/metric analyses were conducted after 12 weeks in vivo. The percentage of bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) within the threads were quantified. Histologic observations showed more intimate BIC in the SLactive/BL group compared to the Nano/U group. In contrast, the Nano/U group depicted woven bone formation generated between the wall of the osteotomy and implant threads within the healing chambers, while bone remodeling was evident at the tip of the outer thread. The SLActive/BL group presented higher BIC than the Nano/U group. On the other hand, significantly higher BAFO was observed at 12 weeks in the Nano/U group compared to the SLactive/BL group (P < .042). Differences in implant design features influenced the osseointegration pathway, which supports the need for further investigations to describe the clinical performance and differences in a timely fashion.
PMID: 36520119
ISSN: 1945-3388
CID: 5457162
Physio-mechanical and Biological Effects Due to Surface Area Modifications of 3D Printed β-tri- calcium phosphate: An In Vitro Study
Arbex, Leticia; Nayak, Vasudev Vivekanand; Ricci, John L.; Mijares, Dindo; Smay, James E.; Coelho, Paulo G.; Witek, Lukasz
Bone defects are associated with trauma, congenital disorders, non-unions, or infections following surgical procedures. Defects which are unable to heal spontaneously are categorized as "critical sized" and are commonly treated using bone grafts in an effort to facilitate bone regeneration and stabilization. Grafting materials can be either natural or synthetic, each having their respective advantages and disadvantages. Synthetic bone grafts are favored due to their ability to be tailored to exhibit desired properties and geometric configurations. β-tricalcium phosphate (β-TCP) is a synthetic grafting material that has been widely utilized for regenerative purposes due to its favorable osteoconductive properties. In combination with 3D printing, grafting materials can be further customized with respect to their macro and micro features. One way to customize devices is by using 3D printing and varying the surface area, by varying the internal component measurements. The objective of this study was to compare the effect of porosity and surface area of 3D printed β-TCP scaffolds with different strut diameters and the effect on cell proliferation in vitro. ß-TCP scaffolds were printed using a custom-built 3D direct-write micro printer with syringes equipped with different extrusion tip diameters (fdiameter: 200 µm, 250 µm and 330 µm). After sintering and post processing, scaffolds were subjected to micro-computed tomography (µCT) and a Scanning Electron Microscope (SEM) to evaluate surface area and porosity, respectively. Compressive strength was assessed using a universal testing machine. Cell proliferation was assessed through cellular viability, using human osteoprogenitor cells. The surface area of the scaffolds was found to increase with smaller strut diameters. Statistically significant differences (p<0.05) were detected for cellular proliferation, between the smallest extrusion diameter, 200 μm, and the largest diameter, 330 μm, after 48-, 72-, and 168-hours. No statistical significances were detected (p>0.05) with regards to the mechanical properties between groups. This study demonstrated that a smaller diameter rod yielded a higher surface area resulting in increased levels of cellular proliferation. Therefore, tailoring rod dimensions has the capacity to enhance cellular adhesion and ultimately, proliferation.
SCOPUS:85149611484
ISSN: 2666-9641
CID: 5446482
The Influence of Surface Treatment on Osseointegration of Endosteal Implants Presenting Decompressing Vertical Chambers: An In Vivo Study in Sheep
Parra, Marcelo; Benalcázar Jalkh, Ernesto B; Tovar, Nick; Torroni, Andrea; Badalov, Rafael M; Bonfante, Estevam A; Nayak, Vasudev; Castellano, Arthur; Coelho, Paulo G; Witek, Lukasz
PURPOSE/OBJECTIVE:blasting + maleic + HCl) in a large translational animal model at 3 and 6 weeks in vivo. MATERIALS AND METHODS/METHODS:Nine female sheep were used, and 72 implants with trapezoidal threads and decompressing vertical chambers of 0.6 mm in diameter and 0.2 mm in depth were placed in the ilium crest. After 3 and 6 weeks, the animals were euthanized, and biomechanical and histomophometric analyses were performed. RESULTS:Survey histologic evaluation indicated intimate contact between the bone and the implants independent of surface treatment at both times in vivo. Bone formation at both time points depicted an intramembranous-type healing pattern between the implant threads. The mean removal torque values for all groups showed a relative increase in removal torque from 3 to 6 weeks. In terms of bone area fraction occupancy analysis, significant differences were found at 6 weeks between surface treatments (P = .046), where the experimental surface yielded higher degrees of bone area fraction occupancy. CONCLUSION/CONCLUSIONS:Conical implants with decompressing vertical chambers between threads presented similar osseointegration parameters regarding bone-toimplant contact and torque-out test values irrespective of surface treatment. However, shifting from a minimally rough to a moderately rough surface (experimental surface with supplemental acid-etching) resulted in significantly improved bone area fraction occupancy at 6 weeks.
PMID: 36170307
ISSN: 1942-4434
CID: 5439392
A Histologic and Histomorphometric Evaluation of an Allograft, Xenograft, and Alloplast Graft for Alveolar Ridge Preservation in Humans: A Randomized Controlled Clinical Trial
Zampara, Eirini; Alshammari, Mukhlid; De Bortoli, Joao; Mullings, Otto; Gkisakis, Ioannis G; Benalcázar Jalkh, Ernesto B; Tovar, Nick; Coelho, Paulo G; Witek, Lukasz
The aim of this study was to clinically evaluate the guided bone regeneration (GBR) potential of allograft, xenograft, and alloplastic materials in combination with resorbable membranes in extraction sockets. The qualitative and quantitative assessments of this prospective study were accomplished through histologic and histomorphometric analysis. Three experimental groups and 1 control group for comparison (n = 8) received either an allograft (human cancellous bone, freeze dried, Deutsches Institut für Zell und Gewebeersatz, Berlin, Germany), xenograft (BioOss, Geistlich Pharma AG, Wolhusen, Switzerland), or alloplast (biphasic calcium sulphate, Bondbone, MIS Implants Technologies Ltd., Charlotte, NC). The negative control group received no regenerative material. Tissue samples were then qualitatively and quantitatively evaluated as a function of percentage of new vital bone, graft particles content, soft tissue, and bone marrow over time. All 3 study groups presented bone volume suitable for the successful placement of a dental implant. The xenograft group yielded significantly less amount of vital bone compared with the allograft and alloplast groups. When comparing the percentage of residual graft particles, there was significantly greater amounts associated with the xenograft group in contrast to the allograft and alloplast groups. Similarly, a significantly increased amount of soft tissue percentage was observed within the xenograft group relative to all other groups. No significant differences were observed in the percentage of residual graft particles between the allograft and alloplast groups. There were also no significant differences detected in vital bone percentage between the allograft, alloplast, and control groups. When evaluating the bone marrow percentage, the only significant difference detected was between the xenograft and alloplast materials. Overall, no complications (ie, fever, malaise, purulence or fistula) were observed during the entirety of clinical trial among all patients. The greatest GBR potential was associated with the allograft material because of the greater degree of vital bone and the lowest percentage of residual graft particles. All studied bone substitute materials resulted in bone apposition for efficient use in alveolar ridge preservation procedures.
PMID: 35446950
ISSN: 0160-6972
CID: 5433052
Stability of fatigued and aged ZTA compared to 3Y-TZP and Al2O3 ceramic systems
Benalcázar Jalkh, Ernesto B; Bergamo, Edmara T P; Campos, Tiago M B; de Araújo-Júnior, Everardo N S; Lopes, Adolfo C O; Tebcherani, Sérgio M; Yamaguchi, Satoshi; Genova, Luis A; Gierthmuehlen, Petra C; Witek, Lukasz; Coelho, Paulo G; Bonfante, Estevam A
To evaluate the effect of fatigue and aging on the crystalline content and reliability of a zirconia-toughened-alumina (ZTA) composite compared to its individual counterpart materials (3Y-TZP and Al2O3). Thirty-six disc-shaped specimens per group were obtained to comply with ISO 6872:2015. Crystalline content, microstructure and reliability of experimental groups were evaluated in four stages: 1) immediate; 2) aged; 3) fatigued; 4) aged + fatigue. Aging was performed in autoclave and Step-Stress-Accelerated-Life-Testing (SSALT) was performed using three stress profiles. Weibull statistics were used to determine Weibull parameters and life-expectancy. A significant increase in monoclinic phase in 3Y-TZP was observed after aging (19.31%), fatigue (17.88%) and aging + fatigue (55.81%), while ZTA evidenced minimal variation among all conditions (<5.69%). 3Y-TZP presented higher reliability than ZTA at 300 and 500 MPa, and ZTA outperformed Al2O3 at the same stress missions. None of the ceramics yielded acceptable reliability at 800 MPa. A higher characteristic strength was observed for 3Y-TZP, followed by ZTA and Al2O3. While after aging ZTA and Al2O3 remained stable, 3Y-TZP exhibited a significant increase in the characteristic stress. Aging did not affect the reliability of ZTA and Al2O3. 3Y-TZP demonstrated an increase in monoclinic content and characteristic strength after aging.
PMID: 36162164
ISSN: 1878-0180
CID: 5374842
Patient-specific 3D printed Poly-ether-ether-ketone (PEEK) dental implant system
Sonaye, Surendrasingh Y; Bokam, Vijay K; Saini, Akshay; Nayak, Vasudev V; Witek, Lukasz; Coelho, Paulo G; Bhaduri, Sarit B; Bottino, Marco C; Sikder, Prabaha
Fused Filament Fabrication (FFF)-based 3D printing is an efficient technique for developing medical implants, but it is not very useful in developing small yet mechanically robust design-specific fixtures such as dental implants (<15 mm). Specifically, it is challenging to 3D print robust Polyetheretherketone (PEEK) small implants due to PEEK's high melting temperature and melt viscosity. However, in this study, we efficiently utilize high-temperature FFF to develop the first-of-its-kind patient-specific robust PEEK dental implants with high print resolution. Specifically, we explore the effects of critical FFF processing conditions on the mechanical properties of the implants and subsequently determine an optimized set of processing conditions that are essential in developing durable dental implant systems. Our results indicate that the 3D printed dental implants exhibit good fatigue properties and suffice the clinical and industrial requirements for dental implants. Furthermore, we prove that the 3D printed implants exhibit adequate mechanical durability even after simulated (accelerated) aging of 30 years.
PMID: 36244326
ISSN: 1878-0180
CID: 5374892
Probability of survival and failure mode of endodontically treated incisors without ferrule restored with CAD/CAM fiber-reinforced composite (FRC) post-cores
Bergamo, Edmara T P; Lopes, Adolfo C O; Campos, Tiago M B; Amorim, Pedro Henrique; Costa, Fábio; Benalcázar Jalkh, Ernesto B; Carvalho, Laura F de; Zahoui, Abbas; Piza, Mariana M T; Gutierres, Eliezer; Witek, Lukasz; Bonfante, Estevam A
PURPOSE/OBJECTIVE:This study evaluated the probability of survival and failure mode of endodontically treated incisors without ferrule restored with CAD/CAM FRC post-cores. METHODS:Root canals of bovine incisors were treated, leaving post preparations of ∼10 mm. Teeth were allocated into three groups: (i) cast metal post-core, (ii) FRC prefabricated post with a direct resin core build-up, and (iii) CAD/CAM FRC post-core. Posts and zirconia crowns were cemented using resin cement. Specimens were subjected to step-stress accelerated-life fatigue testing in water. Use level probability Weibull curves, probability of survival for a mission of 100,000 cycles at 25, 50, and 100 N, Weibull modulus, and characteristic strength were calculated and plotted. Failure mode was examined under a stereomicroscope. RESULTS:Restored incisors demonstrated high probability of survival (93-100%) for missions estimated at 25 and 50 N, irrespective of post-core foundation. At 100 N, incisors restored with metal posts presented significantly higher probability of survival (99%) relative to CAD/CAM posts (79%), whereas FRC groups demonstrated no significant difference. Weibull analysis indicated no significant difference on the Weibull modulus (m = 3.38-5.92). Incisors reconstructed with metal post-cores (431 N) presented significantly higher characteristic strength relative to prefabricated (200 N) and CAD/CAM (202 N) FRC post-cores. While post fracture was the chief failure mode for prefabricated and CAD/CAM FRC post-cores, post and/or root fracture were the main event for metal post-cores. CONCLUSION/CONCLUSIONS:Endodontically treated incisors without ferrule restored with CAD/CAM FRC post-cores presented promising probability of survival for loads compatible with anterior masticatory forces and favorable failure modes.
PMID: 36279744
ISSN: 1878-0180
CID: 5365812
The effect of worked material hardness on stone tool wear
Rodriguez, Alice; Yanamandra, Kaushik; Witek, Lukasz; Wang, Zhong; Behera, Rakesh K; Iovita, Radu
The identification of ancient worked materials is one of the fundamental goals of lithic use wear analysis and one of the most important parts of understanding how stone tools were used in the past. Given the documented overlaps in wear patterns generated by different materials, it is imperative to understand how individual materials' mechanical properties might influence wear formation. Because isolating physical parameters and measuring their change is necessary for such an endeavor, controlled (rather than replicative) experiments combined with objective measurements of surface topography are necessary to better grasp how surface modifications formed on stone tools. Therefore, we used a tribometer to wear natural flint surfaces against five materials (bone, antler, beech wood, spruce wood, and ivory) under the same force, and speed, over one, three, and five hours. The study aimed to test if there is a correlation between surface modifications and the hardness of the worked material. We measured each raw material's hardness using a nano-indentation test, and we compared the surface texture of the flint bits using a 3D optical profilometer. The interfacial detritus powder was analyzed with a scanning electron microscope to look for abraded flint particles. We demonstrate that, contrary to expectation, softer materials, such as wood, create a smoother surface than hard ones, such as ivory.
PMCID:9584531
PMID: 36264949
ISSN: 1932-6203
CID: 5352502