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Lee UL, Yun S, Lee H, Cao HL, Woo SH, Jeong YH, Jung TG, Kim CM, Choung PH. Osseointegration of 3D-printed titanium implants with surface and structure modifications. Dent Mater 2022; 38:1648-1660. [PMID: 36075761 DOI: 10.1016/j.dental.2022.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 08/13/2022] [Accepted: 08/18/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND The purpose of this study was to establish a mechanical and histological basis for the development of biocompatible maxillofacial reconstruction implants by combining 3D-printed porous titanium structures and surface treatment. Improved osseointegration of 3D-printed titanium implants for reconstruction of maxillofacial segmental bone defect could be advantageous in not only quick osseointegration into the bone tissue but also in stabilizing the reconstruction. METHODS Various macro-mesh titanium scaffolds were fabricated by 3D-printing. Human mesenchymal stem cells were used for cell attachment and proliferation assays. Osteogenic differentiation was confirmed by quantitative polymerase chain reaction analysis. The osseointegration rate was measured using micro computed tomography imaging and histological analysis. RESULTS In three dimensional-printed scaffold, globular microparticle shape was observed regardless of structure or surface modification. Cell attachment and proliferation rates increased according to the internal mesh structure and surface modification. However, osteogenic differentiation in vitro and osseointegration in vivo revealed that non-mesh structure/non-surface modified scaffolds showed the most appropriate treatment effect. CONCLUSION 3D-printed solid structure is the most suitable option for maxillofacial reconstruction. Various mesh structures reduced osteogenesis of the mesenchymal stem cells and osseointegration compared with that by the solid structure. Surface modification by microarc oxidation induced cell proliferation and increased the expression of some osteogenic genes partially; however, most of the markers revealed that the non-anodized solid scaffold was the most suitable for maxillofacial reconstruction.
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Affiliation(s)
- Ui-Lyong Lee
- Department of Oral & Maxillofacial Surgery, Chung-Ang University Hospital, Seoul 06973, South Korea; Department of Oral & Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, South Korea.
| | - Seokhwan Yun
- Research Institute, Sphebio Co., Ltd., Pohang-si, Gyeongsanbuk 37666, South Korea
| | - Ho Lee
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Hua-Lian Cao
- Department of Oral & Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, South Korea
| | - Su-Heon Woo
- R&D Center, Medyssey Co, Ltd, Jechon, Chungcheongbuk-do 27159, South Korea
| | - Yong-Hoon Jeong
- Biomaterial Team, Dept. of Research & Development, Medical Device Development Center/Osong Medical Innovation Foundation, Cheongju, Chungcheongbuk-do 28160, South Korea
| | - Tae-Gon Jung
- Biomaterial Team, Dept. of Research & Development, Medical Device Development Center/Osong Medical Innovation Foundation, Cheongju, Chungcheongbuk-do 28160, South Korea
| | - Chul Min Kim
- Department of Mechatronics, Gyeongsang National University, Jinju-si, Gyeongsangnam-do 52828, South Korea
| | - Pill-Hoon Choung
- Department of Oral & Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, South Korea
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Koike M, Mitchell RJ, Horie T, Hummel SK, Okabe T. Biofilm accumulation on additive manufactured Ti-6Al-4V alloy surfaces. J Oral Sci 2022; 64:139-144. [DOI: 10.2334/josnusd.21-0521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Mari Koike
- The Nippon Dental University College at Tokyo, The Nippon Dental University
| | - Richard J. Mitchell
- Department of Biomaterials Science, University of Kentucky College of Dentistry
| | - Tetsuro Horie
- Department of Oral Health, The Nippon Dental University
| | | | - Toru Okabe
- Department of Biomaterials Science, Texas A & M University, Baylor College of Dentistry
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Bioprinting on 3D Printed Titanium Scaffolds for Periodontal Ligament Regeneration. Cells 2021; 10:cells10061337. [PMID: 34071316 PMCID: PMC8229613 DOI: 10.3390/cells10061337] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/21/2021] [Accepted: 05/21/2021] [Indexed: 01/09/2023] Open
Abstract
The three-dimensional (3D) cell-printing technique has been identified as a new biofabrication platform because of its ability to locate living cells in pre-defined spatial locations with scaffolds and various growth factors. Osseointegrated dental implants have been regarded as very reliable and have long-term reliability. However, host defense mechanisms against infections and micro-movements have been known to be impaired around a dental implant because of the lack of a periodontal ligament. In this study, we fabricated a hybrid artificial organ with a periodontal ligament on the surface of titanium using 3D printing technology. CEMP-1, a known cementogenic factor, was enhanced in vitro. In animal experiments, when the hybrid artificial organ was transplanted to the calvarial defect model, it was observed that the amount of connective tissue increased. 3D-printed hybrid artificial organs can be used with dental implants, establishing physiological tooth functions, including the ability to react to mechanical stimuli and the ability to resist infections.
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Lee UL, Lim JY, Park SN, Choi BH, Kang H, Choi WC. A Clinical Trial to Evaluate the Efficacy and Safety of 3D Printed Bioceramic Implants for the Reconstruction of Zygomatic Bone Defects. MATERIALS 2020; 13:ma13204515. [PMID: 33053855 PMCID: PMC7601564 DOI: 10.3390/ma13204515] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/06/2020] [Accepted: 10/09/2020] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to evaluate the clinical efficacy and safety of patient-specific additive-manufactured CaOSiO2-P2O5-B2O3 glass-ceramic (BGS-7) implants for reconstructing zygomatic bone defects at a 6-month follow-up. A prospective, single-arm, single-center, clinical trial was performed on patients with obvious zygoma defects who needed and wanted reconstruction. The primary outcome variable was a bone fusion between the implant and the bone evaluated by computed tomography (CT) at 6 months post surgery. Secondary outcomes, including implant immobilization, satisfaction assessment, osteolysis, subsidence of the BGS-7 implant, and safety, were assessed. A total of eight patients were enrolled in the study. Two patients underwent simultaneous reconstruction of the left and right malar defects using a BGS-7 3D printed implant. Cone beam CT analysis showed that bone fusion at 6 months after surgery was 100%. We observed that the average fusion rate was 76.97%. Osteolysis around 3D printed BGS-7 implants was not observed. The mean distance displacement of all 10 implants was 0.4149 mm. Our study showed no adverse event in any of the cases. The visual analog scale score for satisfaction was 9. All patients who enrolled in this trial were aesthetically and functionally satisfied with the surgical results. In conclusion, this study demonstrates the safety and promising value of patient-specific 3D printed BGS-7 implants as a novel facial bone reconstruction method.
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Affiliation(s)
- Ui-Lyong Lee
- Department of Oral and Maxillofacial Surgery, Chung-Ang University Hospital, Soeul 06973, Korea
- Chung-Ang 3D Craniofacial Research Society, Chun-Ang University, Seoul 06974, Korea
- Correspondence: (U.-L.L.); (W.-C.C.)
| | - Jun-Young Lim
- CGbio 3D Innovation Center, Seongnam-si 13211, Korea; (J.-Y.L.); (S.-N.P.); (B.-H.C.)
| | - Sung-Nam Park
- CGbio 3D Innovation Center, Seongnam-si 13211, Korea; (J.-Y.L.); (S.-N.P.); (B.-H.C.)
| | - Byoung-Hun Choi
- CGbio 3D Innovation Center, Seongnam-si 13211, Korea; (J.-Y.L.); (S.-N.P.); (B.-H.C.)
| | - Hyun Kang
- Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul 06974, Korea;
| | - Won-Cheul Choi
- Chung-Ang 3D Craniofacial Research Society, Chun-Ang University, Seoul 06974, Korea
- Department of Orthodontics, Chung-Ang University Hospital, Seoul 06974, Korea
- Correspondence: (U.-L.L.); (W.-C.C.)
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Mangano C, Bianchi A, Mangano FG, Dana J, Colombo M, Solop I, Admakin O. Custom-made 3D printed subperiosteal titanium implants for the prosthetic restoration of the atrophic posterior mandible of elderly patients: a case series. 3D Print Med 2020; 6:1. [PMID: 31915946 PMCID: PMC6950914 DOI: 10.1186/s41205-019-0055-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 12/20/2019] [Indexed: 11/24/2022] Open
Abstract
Purpose To present the application of custom-made 3D-printed subperiosteal implants for fixed prosthetic restoration of the atrophic posterior mandible of elderly patients. Methods Between January 2017 and June 2018, all partially edentulous patients aged over 65 years, with two or more missing teeth in the posterior atrophic mandible, and who did not want to undergo bone regenerative procedures, were included in this study. These patients were rehabilitated with custom-made subperiosteal implants, designed from cone beam computed tomography (CBCT) and fabricated in titanium by means of direct metal laser sintering (DMLS). The outcome measures were fit and stability of the implants at placement, duration of the intervention, implant survival, and early and late complications. All patients were followed for 1 year after surgery. Results Ten patients (four males, six females; mean age 69.6, SD ± 2.8, median 69, 95% CI 67.9–71.6) were included in the study. The fit of the implants was satisfactory, with a mean rating of 7 out of 10 (SD ± 1.6, median 7, 95% CI 6–8). Only two implants had insufficient fit, because of the presence of scattering in the CBCT; however, they were adapted to the sites during the interventions. The mean duration of the intervention was 44.3 min (SD ± 19.4, median 37, 95% CI 32.3–56.3). At the one-year follow-up, no implants were lost (survival rate 100%). One implant presented immediate postoperative complications with pain, discomfort and swelling, and two patients experienced late complications, having their provisional restorations fractured during the temporisation phase. All these complications were minor in nature, but the final complication rate amounted to 30% (three of ten patients). Conclusions Although this study has limits (small patient sample and short follow-up), DMLS has proven to be an effective method for fabricating accurate subperiosteal implants, with high survival rates. This may represent an alternative treatment procedure in elderly patients with a severely atrophic posterior mandible, since it allows avoidance of regenerative bone therapies. Further studies are needed to confirm these outcomes.
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Affiliation(s)
- Carlo Mangano
- Department of Dental Sciences, University Vita Salute S. Raffaele, 20132, Milan, Italy
| | - Andrea Bianchi
- Department of Periodontology and Implantology, Istituto Stomatologico Italiano, 20122, Milan, Italy
| | - Francesco Guido Mangano
- Department of Prevention and Communal Dentistry, Sechenov First Moscow State Medical University, 119991, Moscow, Russia.
| | | | | | - Ivan Solop
- Department of Prevention and Communal Dentistry, Sechenov First Moscow State Medical University, 119991, Moscow, Russia
| | - Oleg Admakin
- Department of Prevention and Communal Dentistry, Sechenov First Moscow State Medical University, 119991, Moscow, Russia
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Wally ZJ, Haque AM, Feteira A, Claeyssens F, Goodall R, Reilly GC. Selective laser melting processed Ti6Al4V lattices with graded porosities for dental applications. J Mech Behav Biomed Mater 2019; 90:20-29. [DOI: 10.1016/j.jmbbm.2018.08.047] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 08/09/2018] [Accepted: 08/28/2018] [Indexed: 10/28/2022]
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Mandibular Reconstruction Using a Customized Three-Dimensional Titanium Implant Applied on the Lingual Surface of the Mandible. J Craniofac Surg 2018; 29:415-419. [DOI: 10.1097/scs.0000000000004119] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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de Souza AB, Sukekava F, Tolentino L, César-Neto JB, Garcez-Filho J, Araújo MG. Narrow- and regular-diameter implants in the posterior region of the jaws to support single crowns: A 3-year split-mouth randomized clinical trial. Clin Oral Implants Res 2017; 29:100-107. [DOI: 10.1111/clr.13076] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2017] [Indexed: 12/20/2022]
Affiliation(s)
| | - Flávia Sukekava
- Division of Periodontics; School of Dentistry; University of São Paulo; São Paulo Brazil
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Lee UL, Kwon JS, Woo SH, Choi YJ. Simultaneous Bimaxillary Surgery and Mandibular Reconstruction With a 3-Dimensional Printed Titanium Implant Fabricated by Electron Beam Melting: A Preliminary Mechanical Testing of the Printed Mandible. J Oral Maxillofac Surg 2016; 74:1501.e1-1501.e15. [DOI: 10.1016/j.joms.2016.02.031] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 02/26/2016] [Accepted: 02/26/2016] [Indexed: 11/25/2022]
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Bone bonding strength of diamond-structured porous titanium-alloy implants manufactured using the electron beam-melting technique. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 59:1047-1052. [DOI: 10.1016/j.msec.2015.11.025] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 10/23/2015] [Accepted: 11/09/2015] [Indexed: 01/10/2023]
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Contributions of stress corrosion and cyclic fatigue to subcritical crack growth in a dental glass-ceramic. Dent Mater 2014; 30:884-90. [PMID: 24938923 DOI: 10.1016/j.dental.2014.05.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 02/28/2014] [Accepted: 05/21/2014] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The objective of this study was to test the following hypotheses: (1) both cyclic degradation and stress-corrosion mechanisms result in subcritical crack growth (SCG) in a fluorapatite glass-ceramic (IPS e.max ZirPress, Ivoclar-Vivadent) and (2) there is an interactive effect of stress corrosion and cyclic fatigue to accelerate subcritical crack growth. METHODS Rectangular beam specimens were fabricated using the lost-wax process. Two groups of specimens (N=30/group) with polished (15μm) or air-abraded surface were tested under rapid monotonic loading. Additional polished specimens were subjected to cyclic loading at two frequencies, 2Hz (N=44) and 10Hz (N=36), and at various stress amplitudes. All tests were performed using a fully articulated four-point flexure fixture in deionized water at 37°C. The SCG parameters were determined using the ratio of inert strength Weibull modulus to lifetime Weibull modulus. A general log-linear model was fit to the fatigue lifetime data including time to failure, frequency, peak stress, and the product of frequency and logarithm of stress in ALTA PRO software. RESULTS SCG parameters determined were n=21.7 and A=4.99×10(-5) for 2Hz, and n=19.1 and A=7.39×10(-6) for 10Hz. After fitting the general log-linear model to cyclic fatigue data, the coefficients of the frequency term (α1), the stress term (α2), and the interaction term (α3) had estimates and 95% confidence intervals of α1=-3.16 (-15.1, 6.30), α2=-21.2 (-34.9, -9.73), and α3=0.820 (-1.59, 4.02). Only α2 was significantly different from zero. SIGNIFICANCE (1) Cyclic fatigue does not have a significant effect on SCG in the fluorapatite glass-ceramic evaluated and (2) there was no interactive effect between cyclic degradation and stress corrosion for this material.
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