Predictive Cell Culture Time Evolution Based on Electric Models

Obtaining cell concentration measurements from a culture assay by using bioimpedance is a very useful method that can be used to translate impedances to cell concentration values. The purpose of this study was to find a method to obtain the cell concentration values of a given cell culture assay in real time by using an oscillator as the measurement circuit. From a basic cell-electrode model, enhanced models of a cell culture immersed in a saline solution (culture medium) were derived. These models were used as part of a fitting routine to estimate the cell concentration in a cell culture in real time by using the oscillation frequency and amplitude delivered by the measurement circuits proposed by previous authors. Using real experimental data (the frequency and amplitude of oscillations) that were obtained by connecting the cell culture to an oscillator as the load, the fitting routine was simulated, and real-time data of the cell concentration were obtained. These results were compared to concentration data that were obtained by using traditional optical methods for counting. In addition, the error that we obtained was divided and analyzed in two parts: the first part of the experiment (when the few cells were adapting to the culture medium) and the second part of the experiment (when the cells exponentially grew until they completely covered the well). Low error values were obtained during the growth phase of the cell culture (the relevant phase); therefore, the results obtained were considered promising and show that the fitting routine is valid and that the cell concentration can be measured in real time by using an oscillator.

Sustainable Hybrid Manufacturing of AlSi5 Alloy Turbine Blade Prototype by Robotic Direct Energy Layered Deposition and Subsequent Milling: An Alternative to Selective Laser Melting?

Additive technologies enable the flexible production through scalable layer-by-layer fabrication of simple to intricate geometries. The existing 3D-printing technologies that use powders are often slow with controlling parameters that are difficult to optimize, restricted product sizes, and are relatively expensive (in terms of feedstock and processing). This paper presents the development of an alternative approach consisting of a CAD/CAM + combined wire arc additive-manufacturing (WAAM) hybrid process utilizing the robotic MIG-based weld surfacing and milling of the AlSi5 aluminum alloy, which achieves sustainably high productivity via structural alloys. The feasibility of this hybrid approach was analyzed on a representative turbine blade piece. SprutCAM suite was utilized to identify the hybrid-manufacturing parameters and virtually simulate the processes. This research provides comprehensive experimental data on the optimization of cold metal transfer (CMT)-WAAM parameters such as the welding speed, current/voltage, wire feed rate, wall thickness, torch inclination angle (shift/tilt comparison), and deposit height. The multi-axes tool orientation and robotic milling strategies, i.e., (a) the side surface from rotational one-way bottom-up and (b) the top surface in a rectangular orientation, were tested in virtual CAM environments and then adopted during the prototype fabrication to minimize the total fabrication time. The effect of several machining parameters and robotic stiffness (during WAAM + milling) were also investigated. The mean deviation for the test piece's tolerance between the virtual processing and experimental fabrication was -0.76 mm (approx.) at a standard deviation of 0.22 mm assessed by 3D scanning. The surface roughness definition Sa in the final WAAM pass corresponds to 36 µm, which was lowered to 14.3 µm after milling, thus demonstrating a 55% improvement through the robotic comminution. The tensile testing at 0° and 90° orientations reported fracture strengths of 159 and 161.3 MPa, respectively, while the yield stress and reduced longitudinal (0°) elongations implied marginally better toughness along the WAAM deposition axes. The process sustainability factors of hybrid production were compared with Selective Laser Melting (SLM) in terms of the part size freedom, processing costs, and fabrication time with respect to tight design tolerances. The results deduced that this alternative hybrid-processing approach enables an economically viable, resource/energy feasible, and time-efficient method for the production of complex parts in contrast to the conventional additive technologies, i.e., SLM.

Mechanical Fatigue Performance of Patient-Specific Polymer Plates in Oncologic Mandible Reconstruction

Mandible defects are conventionally reconstructed using titanium plates. However, titanium causes metallic artifacts which impair radiological imaging. This study aims at evaluating mechanical fatigue of radiolucent fiber-reinforced polyetheretherketone (f-PEEK), polyetheretherketone (PEEK), polyetherketoneketone (PEKK), and polyphenylsulfone (PPSU) polymer plates for mandible reconstruction. A total of 30 plates (titanium [n = 6], f-PEEK [n = 6], PEEK [n = 6], PEKK [n = 6], PPSU [n = 6]) were implanted in synthetic mandibulectomized polyurethane mandibles. Servo-pneumatic mechanical testing with cyclic application of 30−300 N at 3 Hz was conducted. Bite forces were 70% on the unresected and 30% on the resected side. Total number of cycles was set to 250,000. Testing was aborted in case of plate or screw failure. Axial load to failure was tested with a speed of 1 mm/s. Kruskal−Wallis and Dunn’s post hoc tests were used. Titanium, f-PEEK, and PEEK showed no failure in fatigue testing and PPSU (p < 0.001) failed against titanium, f-PEEK, PEEK, and PEKK. Titanium allowed the highest load to failure compared to f-PEEK (p = 0.049), PEEK (p = 0.008), PEKK (p < 0.001), and PPSU (p = 0.007). f-PEEK, PEEK, and PEKK withstood expected physiological bite force. Although titanium plates provided the highest fatigue strength, f-PEEK and PEEK plates showed no failure over 250,000 chewing cycles indicating sufficient mechanical strength for mandible reconstruction.

Evolutionary Stability Optimizer (ESO): A Novel Approach to Identify and Avoid Mutational Hotspots in DNA Sequences While Maintaining High Expression Levels

Modern synthetic biology procedures rely on the ability to generate stable genetic constructs that keep their functionality over long periods of time. However, maintenance of these constructs requires energy from the cell and thus reduces the host’s fitness. Natural selection results in loss-of-functionality mutations that negate the expression of the construct in the population. Current approaches for the prevention of this phenomenon focus on either small-scale, manual design of evolutionary stable constructs or the detection of mutational sites with unstable tendencies. We designed the Evolutionary Stability Optimizer (ESO), a software tool that enables the large-scale automatic design of evolutionarily stable constructs with respect to both mutational and epigenetic hotspots and allows users to define custom hotspots to avoid. Furthermore, our tool takes the expression of the input constructs into account by considering the guanine-cytosine (GC) content and codon usage of the host organism, balancing the trade-off between stability and gene expression, allowing to increase evolutionary stability while maintaining the high expression. In this study, we present the many features of the ESO and show that it accurately predicts the evolutionary stability of endogenous genes. The ESO was created as an easy-to-use, flexible platform based on the notion that directed genetic stability research will continue to evolve and revolutionize current applications of synthetic biology. The ESO is available at the following link: https://www.cs.tau.ac.il/~tamirtul/ESO/.

CAD-based hardware attenuation correction in PET/MRI: First methodical investigations and clinical application of a 16-channel RF breast coil

PURPOSE

Aim of this study was to evaluate the use of computer-aided design (CAD) models for attenuation correction (AC) of hardware components in positron emission tomography/magnetic resonance (PET/MR) imaging.

METHODS

The technical feasibility and quantitative impact of CAD-AC compared to computer tomography (CT)-based AC (reference) was investigated on a modular phantom consisting of 19 different material samples (plastics and metals arranged around a cylindrical emission phantom) typically used in phantoms, patient tables, and radiofrequency (RF) coils in PET/MR. The clinical applicability of the CAD-AC method was then evaluated on a 16-channel RF breast coil in a PET/MR patient study. The RF breast coil in this study was specifically designed PET compatible. Using this RF breast coil, the impact on clinical PET/MR breast imaging was systematically evaluated in breast phantom measurements and, furthermore, in n = 10 PET/MR patients with breast cancer. PET data were reconstructed three times: (1) no AC (NAC), (2) established CT-AC, and (3) CAD-AC. For both phantom measurements, a scan without attenuating hardware components (material probes or RF breast coil) was acquired serving as reference. Relative differences in PET data were calculated for all experiments.

RESULTS

In all phantom and patient measurements, significant gains in PET signal compared to NAC data were measurable with CT and CAD-AC. In initial phantom experiments, mean relative differences of -0.2% for CT-AC and 0.2% for CAD-AC were calculated compared to reference measurements without the material probes. The application to a RF breast coil depicts that CAD-AC results in significant gains compared to NAC data (10%) and a slight underestimation in PET signal of -1.3% in comparison to the no-coil reference measurement. In the patient study, a total of 15 congruent lesions in all 10 patients with a mean relative difference of 14% (CT and CAD-AC) in standardized uptake value compared to NAC data could be detected.

CONCLUSIONS

To ensure best possible PET image quality and accurate PET quantification in PET/MR imaging, the AC of hardware components such as phantoms and RF coils is important. In initial phantom experiments and in clinical application to an RF breast coil, it was found that CAD-based AC results in significant gains in PET signal compared to NAC data and provides comparably good results to the established method of CT-based AC.

3D Evaluation of Accuracy of Tooth Preparation for Laminate Veneers Assisted by Rigid Constraint Guides Printed by Selective Laser Melting

OBJECTIVE

To design and fabricate 3D-printed rigid constraint guides for the tooth preparation for laminate veneers and to evaluate the accuracy of guide-assisted preparation.

METHODS

Twenty maxillary right central incisor resin artificial teeth were randomly divided into two equal groups and prepared for laminate veneers. Tooth preparations were performed, assisted by guides in the test group and by depth gauge burs in the control group, and both were finished by freehand operation. The typodonts were 3D scanned before preparation, after initial preparation and after final preparation. The tooth preparation depths at each step, including initial preparation depth, final preparation depth and loss of tooth tissue during polishing, were measured by 3D deviation analysis. Statistical analyses were conducted to investigate differences.

RESULTS

The initial preparation depth was 0.488 mm (median, quartile 0.013 mm) in the test group and 0.521 mm (median, quartile 0.013 mm) in the control group. A statistically significant difference was found between them (P < 0.05). The final preparation depth in the test group (0.547 ± 0.029 mm) was significantly less than that in the control group (0.599 ± 0.051 mm) (P < 0.05), and closer to the predesigned value (0.5 mm). There was no statistically significant difference in the loss of tooth tissue during polishing between the test group (0.072 ± 0.023 mm) and the control group (0.089 ± 0.038 mm) (P > 0.05).

CONCLUSION

In maxillary central incisors, the tooth preparation for laminate veneers could be conducted using 3D-printed rigid constraint guides, the accuracy of which is better than that of depth gauge burs.

3D Printing of Pharmaceuticals and Drug Delivery Devices

The process of 3D printing (3DP) was patented in 1986; however, the research in the field of 3DP did not become popular until the last decade. There has been an increasing research into the areas of 3DP for medical applications for fabricating prosthetics, bioprinting and pharmaceutics. This novel method allows the manufacture of dosage forms on demand, with modifications in the geometry and size resulting in changes to the release and dosage behaviour of the product. 3DP will allow wider adoption of personalised medicine due to the diversity and simplicity to change the design and dosage of the products, allowing the devices to be designed specific to the individual with the ability to alternate the drugs added to the product. Personalisation also has the potential to decrease the common side effects associated with generic dosage forms. This Special Issue Editorial outlines the current innovative research surrounding the topic of 3DP, focusing on bioprinting and various types of 3DP on applications for drug delivery as well advantages and future directions in this field of research.

Rapid Prototyping of Personalized Articular Orthoses by Lamination of Composite Fibers upon 3D-Printed Molds

Advances in additive manufacturing technologies and composite materials are starting to be combined into synergic procedures that may impact the biomedical field by helping to achieve personalized and high-performance solutions for low-resource settings. In this article, we illustrate the benefits of 3D-printed rapid molds, upon which composite fibers can be laminated in a direct and resource-efficient way, for the personalized development of articular splints. The rapid mold concept presented in this work allows for a flexible lamination and curing process, even compatible with autoclaves. We demonstrate the procedure by completely developing an autoclave-cured carbon fiber-epoxy composite ankle immobilizing, supporting, or protecting splint. These medical devices may support patients in their recovery of articular injuries and for promoting a more personalized medical care employing high-performance materials, whose mechanical response is analyzed and compared to that of commercial devices. In fact, this personalization is fundamental for enhanced ergonomics, comfort during rehabilitation, and overall aesthetics. The proposed design and manufacturing strategies may support the low-cost and user-centered development of a wide set of biomedical devices and help to delocalize the supply chain for involving local populations in the development of medical technology.

The Use of 3D Printed Molds to Cast Tablets with a Designed Disintegration Profile

Development of new product design principles is crucial for obtaining pharmaceutical products with controlled functionality. Four different molds were designed using a computer-aided design (CAD) software and 3D printed with polylactic acid (PLA). A hydroxypropyl methylcellulose (HPMC) and polyethylene glycol (PEG)-based formulation containing indomethacin as the active pharmaceutical ingredient (API) was casted into the molds. Each mold produced a tablet that was designed to disintegrate into a defined number of sections (2, 4, and 6). This was achieved by incorporating break lines (regions that were significantly thinner than the remainder of the tablet) to control the disintegration process. Disintegration and drug release from these designed tablets was contrasted with a casted tablet without break lines. Disintegration studies confirmed that the casted tablets disintegrated according to their design. Drug-release studies meanwhile demonstrated that tablets with a greater number of sections released the API at a faster rate than those with fewer sections; for example, the 6-sectioned tablet released the API at twice the rate of the tablet without any break lines. It is expected that by using this concept, it would be possible to produce tablets with a designed disintegration profile, which could potentially allow the tailoring of the drug release.

Design, Manufacturing, and Inspection Data for a Three-Component Assembly

To better understand and address the challenges faced in linking all stages of a manufacturing and design process, an investigative fabrication process was designed and enacted as part of a collaboration between the National Institute of Standards and Technology (NIST) and the Manufacturing Technology Centre (MTC). This collaboration sought to test selected open standards’ ability to integrate the product-lifecycle stages of engineering design, manufacturing, and quality assurance through a thorough implementation of a small scale model-based enterprise (MBE). A dataset was generated as a result of the collaboration. This article provides details about the dataset and instructions for how to access and/or retrieve it.

Theoretical Design of Multilayer Dental Posts Using CAD-Based Approach and Sol-Gel Chemistry

A computer-aided design (CAD)-based approach and sol-gel chemistry were used to design a multilayer dental post with a compositional gradient and a Young’s modulus varying from 12.4 to 2.3 GPa in the coronal-apical direction. Specifically, we propose a theoretical multilayer post design, consisting of titanium dioxide (TiO₂) and TiO₂/poly(ε-caprolactone) (PCL) hybrid materials containing PCL up to 24% by weight obtained using the sol-gel method. The current study aimed to analyze the effect of the designed multilayer dental post in endodontically treated anterior teeth. Stress distribution was investigated along and between the post and the surrounding structures. In comparison to a metal post, the most uniform distributions with lower stress values and no significant stress concentration were found when using the multilayer post.

Further Theoretical Insight into the Mechanical Properties of Polycaprolactone Loaded with Organic-Inorganic Hybrid Fillers

Experimental/theoretical analyses have already been performed on poly(ε-caprolactone) (PCL) loaded with organic-inorganic fillers (PCL/TiO₂ and PCL/ZrO₂) to find a correlation between the results from the small punch test and Young's modulus of the materials. PCL loaded with Ti2 (PCL = 12, TiO₂ = 88 wt %) and Zr2 (PCL = 12, ZrO₂ = 88 wt %) hybrid fillers showed better performances than those obtained for the other particle composition. In this context, the aim of current research is to provide further insight into the mechanical properties of PCL loaded with sol-gel-synthesized organic-inorganic hybrid fillers for bone tissue engineering. For this reason, theoretical analyses were performed by the finite element method. The results from the small punch test and Young's modulus of the materials were newly correlated. The obtained values of Young's modulus (193 MPa for PCL, 378 MPa for PCL/Ti2 and 415 MPa for PCL/Zr2) were higher than those obtained from a previous theoretical modelling (144 MPa for PCL, 282 MPa for PCL/Ti2 and 310 MPa for PCL/Zr2). This correlation will be an important step for the evaluation of Young's modulus, starting from the small punch test data.

In vitro comparison of guided versus freehand implant placement: use of a new combined TRIOS surface scanning, Implant Studio, CBCT, and stereolithographic virtually planned and guided technique

Implant placement requires precise planning and execution to avoid collision with critical anatomical structures. Technology advances may improve placement outcomes. The purpose of this study was to trial and measure in an in vitro environment the accuracy of placing a single dental implant in the planned position using a specific guided surgery technique compared with a freehand surgery technique. The dental model of a patient missing tooth 16 was printed 30 times (EnvisionTEC 3Dent). Each print was scanned (TRIOS color scanner) to create a 3D surface model, and radiographed (Gendex CB-500) to create cone beam computed tomography (CBCT) data. The surface data and CBCT data were merged (Implant Studio software), and a Straumann RC bone level Ø 4.1 × 8 mm implant placement was planned. A surgical guide was printed (Stratasys OrthoDesk) for each case (n = 30). Simulated cases were assigned to Group A (guided) or Group B (freehand, where the fabricated guide was discarded). Implants were placed, and the models rescanned (TRIOS). The new data was superimposed on the original data, and the surgical implant location compared with the planned position for each model (Convince software) by a researcher blinded to group allocation. Differences in angulation (degrees); shoulder, apex, and depth displacements (mm); and direction of displacement were assessed with Mann-Whitney U and Fisher exact tests. Data was expressed as medians bounded by interquartile ranges (IQRs). Implant angulation and apical displacement were significantly closer to the planned position in the guided group compared with the freehand group (3.91 degrees: IQR 2.45 to 5.38 degrees vs 8.82 degrees: IQR 4.84 to 9.84 degrees, P = 0.005; and 0.87 mm: IQR 0.53 to 1.11 mm vs 1.48 mm: IQR 1.14 to 1.72 mm, P < 0.001, respectively). Implant shoulder displacement, depth displacements, and direction of displacement did not differ between the groups. Within the in vitro environment, merged 3D surface scan data and 3D CBCT scan data can be used to plan and guide implant placement with greater accuracy than with the freehand technique.

Monolithic implant-supported lithium disilicate (LS2) crowns in a complete digital workflow: A prospective clinical trial with a 2-year follow-up

BACKGROUND

The technical development of digital processing allows the production of anatomically full-contoured implant-supported restorations.

PURPOSE

The aim of this prospective clinical trial was to analyze the treatment concept of monolithic lithium disilicate (LS2) single-unit restorations in a complete digital workflow.

MATERIAL AND METHODS

Forty-four patients were restored with 50 screw-retained monolithic implant LS2 crowns bonded to pre-fabricated titanium abutments on soft tissue level implants (Institut Straumann AG, Basel, Switzerland) in premolar and molar sites. All implant restorations were digitally designed after intraoral optical scanning (IOS) and CAD/CAM-processing without physical model situations. Study participants were clinically and radiographically examined based on an annually performed follow-up. The "Functional Implant Prosthodontic Score" (FIPS) was applied for objective outcome assessment after 2 years of loading. Five variables were defined for FIPS evaluation, resulting in a maximum score of 10 per implant restoration. Descriptive statistics were calculated for mean scores standard deviations, medians, and Q₂₅ -Q₇₅ .

RESULTS

All patients could be successfully treated within two clinical appointments. No clinical modifications were necessary for the seating of the monolithic crowns, neither for interproximal nor occlusal sites. The implant LS2 restorations demonstrated survival rates of 100% without any technical or biological complications after 2 years. The mean total FIPS score was 7.7 ± 1.0, ranging from 6 to 10.

CONCLUSIONS

CAD/CAM-produced monolithic implant crowns out of LS2 in a complete digital workflow seem to be a feasible treatment concept for the rehabilitation of single-tooth gaps in posterior sites under mid-term observation.

Accuracy of three-dimensional facial soft tissue simulation in post-traumatic zygoma reconstruction

The aim of this study was to evaluate the accuracy of novel software-CMF-preCADS-for the prediction of soft tissue changes following repositioning surgery for zygomatic fractures. Twenty patients who had sustained an isolated zygomatic fracture accompanied by facial deformity and who were treated with repositioning surgery participated in this study. Cone beam computed tomography (CBCT) scans and three-dimensional (3D) stereophotographs were acquired preoperatively and postoperatively. The 3D skeletal model from the preoperative CBCT data was matched with the postoperative one, and the fractured zygomatic fragments were segmented and aligned to the postoperative position for prediction. Then, the predicted model was matched with the postoperative 3D stereophotograph for quantification of the simulation error. The mean absolute error in the zygomatic soft tissue region between the predicted model and the real one was 1.42±1.56mm for all cases. The accuracy of the prediction (mean absolute error ≤2mm) was 87%. In the subjective assessment it was found that the majority of evaluators considered the predicted model and the postoperative model to be 'very similar'. CMF-preCADS software can provide a realistic, accurate prediction of the facial soft tissue appearance after repositioning surgery for zygomatic fractures. The reliability of this software for other types of repositioning surgery for maxillofacial fractures should be validated in the future.

Predicting the Genetic Stability of Engineered DNA Sequences with the EFM Calculator

Unwanted evolution can rapidly degrade the performance of genetically engineered circuits and metabolic pathways installed in living organisms. We created the Evolutionary Failure Mode (EFM) Calculator to computationally detect common sources of genetic instability in an input DNA sequence. It predicts two types of mutational hotspots: deletions mediated by homologous recombination and indels caused by replication slippage on simple sequence repeats. We tested the performance of our algorithm on genetic circuits that were previously redesigned for greater evolutionary reliability and analyzed the stability of sequences in the iGEM Registry of Standard Biological Parts. More than half of the parts in the Registry are predicted to experience >100-fold elevated mutation rates due to the inclusion of unstable sequence configurations. We anticipate that the EFM Calculator will be a useful negative design tool for avoiding volatile DNA encodings, thereby increasing the evolutionary lifetimes of synthetic biology devices.

Rapid prototyping-assisted maxillofacial reconstruction

Rapid prototyping (RP) technologies have found many uses in dentistry, and especially oral and maxillofacial surgery, due to its ability to promote product development while at the same time reducing cost and depositing a part of any degree of complexity theoretically. This paper provides an overview of RP technologies for maxillofacial reconstruction covering both fundamentals and applications of the technologies. Key fundamentals of RP technologies involving the history, characteristics, and principles are reviewed. A number of RP applications to the main fields of oral and maxillofacial surgery, including restoration of maxillofacial deformities and defects, reduction of functional bone tissues, correction of dento-maxillofacial deformities, and fabrication of maxillofacial prostheses, are discussed. The most remarkable challenges for development of RP-assisted maxillofacial surgery and promising solutions are also elaborated.

Computer-aided design and rapid prototyping-assisted contouring of costal cartilage graft for facial reconstructive surgery

Complex 3-D defects of the facial skeleton are difficult to reconstruct with freehand carving of autogenous bone grafts. Onlay bone grafts are hard to carve and are associated with imprecise graft-bone interface contact and bony resorption. Autologous cartilage is well established in ear reconstruction as it is easy to carve and is associated with minimal resorption. In the present study, we aimed to reconstruct the hypoplastic orbitozygomatic region in a patient with left hemifacial microsomia using computer-aided design and rapid prototyping to facilitate costal cartilage carving and grafting. A three-step process of (1) 3-D reconstruction of the computed tomographic image, (2) mirroring the facial skeleton, and (3) modeling and rapid prototyping of the left orbitozygomaticomalar region and reconstruction template was performed. The template aided in donor site selection and extracorporeal contouring of the rib cartilage graft to allow for an accurate fit of the graft to the bony model prior to final fixation in the patient. We are able to refine the existing computer-aided design and rapid prototyping methods to allow for extracorporeal contouring of grafts and present rib cartilage as a good alternative to bone for autologous reconstruction.

Rapid tooling method for soft customized removable oral appliances

Traditionally oral appliances i.e. removable orthodontic appliances, bite splints and snoring / sleep apnea appliances are made with alginate impressions and wax registrations. Our aim was to describe the process of manufacturing customized oral appliances with a new technique i.e. rapid tooling method. The appliance should ideally be custom made to match the teeth. An orthodontic patient, scheduled for conventional orthodontic treatment, served as a study subject. After a precise clinical and radiographic examination, the approach was to digitize the patient’s dental arches and then to correct them virtually by computer. Additive manufacturing was then used to fabricate a mould for a soft customized appliance. The mould was manufactured using stereolithography from Somos ProtoGen O-XT 18420 material. Casting material for the mould to obtain the final appliance was silicone. As a result we managed to create a customized soft orthodontic appliance. Also, the accuracy of the method was found to be adequate. Two versions of the described device were manufactured: one with small and one with moderate orthodontic force. The study person also gave information on the subjective patient adaptation aspects of the oral appliance.