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Longhitano GA, Chiarelli M, Prada D, Zavaglia CADC, Maciel Filho R. Personalized lattice-structured prosthesis as a graftless solution for mandible reconstruction and prosthetic restoration: A finite element analysis. J Mech Behav Biomed Mater 2024; 152:106460. [PMID: 38340477 DOI: 10.1016/j.jmbbm.2024.106460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/12/2024]
Abstract
Oral cavity tumors are a prevalent cause of mandible reconstruction surgeries. The mandible is vital for functions like oralization, respiration, mastication, and deglutition. Current mandible reconstruction methods have low success rates due to complications like plate fracture or exposure, infections, and screw loosening. Autogenous bone grafts are commonly used but carry the risk of donor region morbidity. Despite technological advances, an ideal solution for mandible reconstruction remains elusive. Additive manufacturing in medicine offers personalized prosthetics from patient-specific medical images, allowing for the creation of porous structures with tailored mechanical properties that mimic bone properties. This study compared a commercial reconstruction plate with a lattice-structured personalized prosthesis under different biting and osseointegration conditions using Finite Element Analysis. Patient-specific images were obtained from an individual who underwent mandible reconstruction with a commercial plate and suffered from plate fracture by fatigue after 26 months. Compared to the commercial plate, the maximum von Mises equivalent stress was significantly lowered for the personalized prosthesis, hindering a possible fatigue fracture. The equivalent von Mises strains found in bone were within bone maintenance and remodeling intervals. This work introduces a design that doesn't require grafts for large bone defects and allows for dental prosthesis addition without the need for implants.
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Affiliation(s)
- Guilherme Arthur Longhitano
- National Institute of Biofabrication (INCT-BIOFABRIS), Campinas, 13083-852, Brazil; Faculdade de Engenharia Química, Universidade Estadual de Campinas (UNICAMP), Campinas, 13083-852, Brazil; 3D Printing Open Lab, Center for Information Technology Renato Archer, Campinas, 13069-901, Brazil; Faculdade de Engenharia Mecânica, Universidade Estadual de Campinas (UNICAMP), Campinas, 13083-860, Brazil.
| | - Murillo Chiarelli
- Oral and Maxillofacial Surgeon, Secretaria de Estado da Saúde, Hospital Governador Celso Ramos/SMS, Florianópolis, 88015-270, Brazil
| | - Daniel Prada
- Faculdade de Engenharia Mecânica, Universidade Estadual de Campinas (UNICAMP), Campinas, 13083-860, Brazil
| | - Cecília Amélia de Carvalho Zavaglia
- National Institute of Biofabrication (INCT-BIOFABRIS), Campinas, 13083-852, Brazil; Faculdade de Engenharia Mecânica, Universidade Estadual de Campinas (UNICAMP), Campinas, 13083-860, Brazil
| | - Rubens Maciel Filho
- National Institute of Biofabrication (INCT-BIOFABRIS), Campinas, 13083-852, Brazil; Faculdade de Engenharia Química, Universidade Estadual de Campinas (UNICAMP), Campinas, 13083-852, Brazil
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Longhitano GA, Conde A, Arenas MA, Jardini AL, Zavaglia CADC, Maciel Filho R, de Damborenea JJ. Corrosion resistance improvement of additive manufactured scaffolds by anodizing. Electrochim Acta 2021. [DOI: 10.1016/j.electacta.2020.137423] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Longhitano GA, Conde A, Arenas MA, Larosa MA, Jardini AL, Maciel Filho R, Zavaglia CADC, Damborenea JJD. Influence of unit cell and geometry size on scaffolds electrochemical response. J Electroanal Chem (Lausanne) 2019. [DOI: 10.1016/j.jelechem.2019.113528] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Calderoni DR, Gilioli R, Munhoz ALJ, Maciel Filho R, Zavaglia CADC, Lambert CS, Lopes ÉSN, Toro IFC, Kharmandayan P. Paired evaluation of calvarial reconstruction with prototyped titanium implants with and without ceramic coating. Acta Cir Bras 2014; 29:579-87. [DOI: 10.1590/s0102-8650201400150005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 07/23/2014] [Indexed: 11/21/2022] Open
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Jardini AL, Larosa MA, Maciel Filho R, Zavaglia CADC, Bernardes LF, Lambert CS, Calderoni DR, Kharmandayan P. Cranial reconstruction: 3D biomodel and custom-built implant created using additive manufacturing. J Craniomaxillofac Surg 2014; 42:1877-84. [PMID: 25175080 DOI: 10.1016/j.jcms.2014.07.006] [Citation(s) in RCA: 129] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 06/27/2014] [Accepted: 07/29/2014] [Indexed: 11/27/2022] Open
Abstract
Additive manufacturing (AM) technology from engineering has helped to achieve several advances in the medical field, particularly as far as fabrication of implants is concerned. The use of AM has made it possible to carry out surgical planning and simulation using a three-dimensional physical model which accurately represents the patient's anatomy. AM technology enables the production of models and implants directly from a 3D virtual model, facilitating surgical procedures and reducing risks. Furthermore, AM has been used to produce implants designed for individual patients in areas of medicine such as craniomaxillofacial surgery, with optimal size, shape and mechanical properties. This work presents AM technologies which were applied to design and fabricate a biomodel and customized implant for the surgical reconstruction of a large cranial defect. A series of computed tomography data was obtained and software was used to extract the cranial geometry. The protocol presented was used to create an anatomic biomodel of the bone defect for surgical planning and, finally, the design and manufacture of the patient-specific implant.
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Affiliation(s)
- André Luiz Jardini
- National Institute of Biofabrication (INCT-BIOFABRIS), Campinas, Brazil; School of Chemical Engineering, State University of Campinas, Campinas, Brazil
| | - Maria Aparecida Larosa
- National Institute of Biofabrication (INCT-BIOFABRIS), Campinas, Brazil; School of Chemical Engineering, State University of Campinas, Campinas, Brazil.
| | - Rubens Maciel Filho
- National Institute of Biofabrication (INCT-BIOFABRIS), Campinas, Brazil; School of Chemical Engineering, State University of Campinas, Campinas, Brazil
| | - Cecília Amélia de Carvalho Zavaglia
- National Institute of Biofabrication (INCT-BIOFABRIS), Campinas, Brazil; School of Mechanical Engineering, State University of Campinas, Campinas, Brazil
| | - Luis Fernando Bernardes
- National Institute of Biofabrication (INCT-BIOFABRIS), Campinas, Brazil; School of Chemical Engineering, State University of Campinas, Campinas, Brazil
| | - Carlos Salles Lambert
- National Institute of Biofabrication (INCT-BIOFABRIS), Campinas, Brazil; Institute of Physics, State University of Campinas, Campinas, Brazil
| | - Davi Reis Calderoni
- National Institute of Biofabrication (INCT-BIOFABRIS), Campinas, Brazil; School of Medical Sciences, State University of Campinas, Campinas, Brazil
| | - Paulo Kharmandayan
- National Institute of Biofabrication (INCT-BIOFABRIS), Campinas, Brazil; School of Medical Sciences, State University of Campinas, Campinas, Brazil
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Abstract
The optimization of the monomer composition, using a polymerization kinetic study and the mechanical behavior study of the composites, was the principal objective of this work. The monomeric mixture analyzed is a part of the composite that has been in development at the University of Campinas, Brazil. Parameters such as initiator, accelerator, and macro-components composition were optimized. The infrared spectroscopy was the analytical technique used in the kinetic study. On the mechanical characterization, the stress strain, flexure stress and its modulus, were the properties analyzed. The dependency between the polymeric reaction and the physical behavior of the composites and the monomer composition was observed and studied. Finally, the monomer optimum composition was determined.
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Affiliation(s)
- Raúl Ernesto López Palacio
- Department of Engineering of Materials, College of Engineering Mechanics, State University of Campinas, São Carlos, SP, Brazil.
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Testa Pezzin AP, Cardoso TP, do Carmo Alberto Rincón M, de Carvalho Zavaglia CA, de Rezende Duek EA. Bioreabsorbable polymer scaffold as temporary meniscal prosthesis. Artif Organs 2003; 27:428-31. [PMID: 12752202 DOI: 10.1046/j.1525-1594.2003.07251.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Menisci have an important role in load bearing, shock absorption, knee joint stability, and joint lubrication. Meniscal lesions and meniscectomy are followed by osteoarthritis in a high percentage of patients. At present, there is no ideal prosthesis for meniscal substitution. In this work, a bioreabsorbable polymer scaffold made of poly(L-lactic acid) (PLLA) and poly(p-dioxanone) (PPD) blend was developed to be used as a temporary meniscal prosthesis to stimulate the formation of an in situ meniscal replication while the scaffold is reabsorbed by the organism. Total meniscectomy of medial meniscus and arthrotomy was made in both back knees of 34 adult New Zealand white rabbits by medial parapatellar incision. The scaffolds were sutured in one of the knees, and other was used as a control. A meniscal replica was developed, suggesting that this material has great potential to be used as a meniscal prosthesis, especially because the new meniscus promoted a significant protection of cartilage, and cartilage degeneration in the control condyles was observed.
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Affiliation(s)
- Ana Paula Testa Pezzin
- State University of Campinas, UNICAMP, Faculty of Mechanical Engineering, Campinas, SP, Brazil.
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