Facial skeletal augmentation using hydroxyapatite cement.

PubMed

Shindo, M L; Costantino, P D; Friedman, C D; Chow, L C

1993-02-01

This study investigates the use of a new calcium phosphate cement, which sets to solid, microporous hydroxyapatite, for facial bone augmentation. In six dogs, the supraorbital ridges were augmented bilaterally with this hydroxyapatite cement. On one side, the hydroxyapatite cement was placed directly onto the bone within a subperiosteal pocket. On the opposite side, the cement was contained within a collagen membrane tubule and then inserted into a subperiosteal pocket. The use of collagen tubules facilitated easy, precise placement of the cement. All implants maintained their original augmented height throughout the duration of the study. They were well tolerated without extrusion or migration, and there was no significant sustained inflammatory response. Histologic studies, performed at 3, 6, and 9 months revealed that when the cement was placed directly onto bone, progressive replacement of the implant by bone (osseointegration of the hydroxyapatite with the underlying bone) without a loss of volume was observed. In contrast, when the cement-collagen tubule combination was inserted, primarily a fibrous union was noted. Despite such fibrous union, the hydroxyapatite-collagen implant solidly bonded to the underlying bone, and no implant resorption was observed. Hydroxyapatite cement can be used successfully for the experimental augmentation of the craniofacial skeleton and may be applicable for such uses in humans.

The Biomechanical Properties of Pedicle Screw Fixation Combined With Trajectory Bone Cement Augmentation in Osteoporotic Vertebrae.

PubMed

Fan, Haitao T; Zhang, Renjie J; Shen, Cailiang L; Dong, Fulong L; Li, Yong; Song, Peiwen W; Gong, Chen; Wang, Yijin J

2016-03-01

The biomechanics of pedicle screw fixation combined with trajectory cement augmentation with various filling volumes were measured by pull-out, periodic antibending, and compression fatigue tests. To investigate the biomechanical properties of the pedicle screw fixation combined with trajectory bone cement (polymethylmethacrylate) augmentation in osteoporotic vertebrae and to explore the optimum filling volume of the bone cement. Pedicle screw fixation is considered to be the most effective posterior fixation method. The decrease of the bone mineral density apparently increases the fixation failure risk caused by screw loosening and displacement. Trajectory bone cement augmentation has been confirmed to be an effective method to increase the bone intensity and could markedly increase the stability of the fixation interface. Sixteen elderly cadaveric 1-5 lumbar vertebral specimens were diagnosed with osteoporosis. The left and right vertebral pedicles were alternatively randomized for treatment in all groups, with the contralateral pedicles as control. The study groups included: group A (pedicle screw fixation with full trajectory bone cement augmentation), group B (75% filling), group C (50% filling), and group D (25% filling). Finally, the bone cement leakage and dispersion were assessed and the mechanical testing was conducted. The bone cement was well dispersed around the pedicle screw. The augmented bone intensity, pull-out strength, periodic loading times, and compression fatigue performance were markedly higher than those of the control groups. With the increase in trajectory bone cement, the leakage was also increased (P<0.05). The pull-out strength of the pedicle screw was increased with an increase in bone mineral density and trajectory bone cement. It peaked at 75% filling, with the largest power consumption. The optimal filling volume of the bone cement was 75% of the trajectory volume (about 1.03 mL). The use of excessive bone cement did not increase the fixation intensity but increased the risk of leakage.

Results of cement augmentation and curettage in aneurysmal bone cyst of spine

PubMed Central

Basu, Saumyajit; Patel, Dharmesh R; Dhakal, Gaurav; Sarangi, T

2016-01-01

Aneurysmal bone cyst (ABC) is a vascular tumor of the spine. Management of spinal ABC still remains controversial because of its location, vascular nature and incidence of recurrence. In this manuscript, we hereby describe two cases of ABC spine treated by curettage, vertebral cement augmentation for control of bleeding and internal stabilization with two years followup. To the best of our knowledge, this is the first case report in the literature describing the role of cement augmentation in spinal ABC in controlling vascular bleeding in curettage of ABC of spine. Case 1: A 22 year old male patient presented with chronic back pain. On radiological investigation, there were multiple, osteolytic septite lesions at L3 vertebral body without neural compression or instability. Percutaneous transpedicular biopsy of L3 from involved pedicle was done. This was followed by cement augmentation through the uninvolved pedicle. Next, transpedicular complete curettage was done through involved pedicle. Case 2: A 15-year-old female presented with nonradiating back pain and progressive myelopathy. On radiological investigation, there was an osteolytic lesion at D9. At surgery, decompression, pedicle screw-rod fixation and posterolateral fusion from D7 to D11 was done. At D9 level, through normal pedicle cement augmentation was added to provide anterior column support and to control the expected bleeding following curettage. Transpedicular complete curettage was done through the involved pedicle with controlled bleeding at the surgical field. Cement augmentation was providing controlled bleeding at surgical field during curettage, internal stabilization and control of pain. On 2 years followup, pain was relieved and there was a stable spinal segment with well filled cement without any sign of recurrence in computed tomography scan. In selected cases of spinal ABC with single vertebral, single pedicle involvement; cement augmentation of vertebra through normal pedicle has an important role in surgery aimed for curettage of vertebra. PMID:26955184

Correlation of pull-out strength of cement-augmented pedicle screws with CT-volumetric measurement of cement.

PubMed

Fölsch, Christian; Goost, Hans; Figiel, Jens; Paletta, Jürgen R J; Schultz, Wolfgang; Lakemeier, Stefan

2012-12-01

Cement augmentation of pedicle screws increases fixation strength in an osteoporotic spine. This study was designed to determine the cement distribution and the correlation between the pull-out strength of the augmented screw and the cement volume within polyurethane (PU) foam. Twenty-eight cannulated pedicle screws (6×45 mm) (Peter Brehm, Erlangen, Germany) with four holes at the distal end of the screw were augmented with the acrylic Stabilit ER Bone Cement Vertebral Augmentation System (DFine Inc., San Jose, CA, USA) and implanted into open-cell rigid PU foam (Pacific Research Laboratories, Vashon Island, WA, USA) with a density of 0.12 g/cm3, resembling severe osteoporosis. Volumetric measurement of the cement with consideration of the distribution around the screws was done with multislice computed tomography scan (Somatom Definition, Siemens, Erlangen, Germany). Pull-out strength was tested with a servohydraulic system (MTS System Corporation, Eden Prairie, MN, USA), and nonaugmented screws served as control. Pearson's correlation coefficient with significance level α=0.05 and one-way analysis of variance test were used. We found a high (r=0.88) and significant (p<0.01) correlation between the cement volume and the pull-out strength, which increased by more than 5-fold with a volume of 3 ml. The correlation appeared linear at least up to 4 ml cement volume and failure always occurred at the cement-bone interface. The cement distribution was symmetric and circular around the most proximal hole, with a distance of 14 mm from the tip, and nearly 90% of the cement was found 6 mm distal and cranial to it. The 95% confidence interval for the relative amount of cement was 37%-41% within 2 mm of the most proximal hole. Compared with the control, a cement volume between 2.0 and 3.0 ml increased the pull-out strength significantly and is relevant for clinical purposes, whereas a volume of 0.5 ml did not. A cement volume beyond 3.0 ml should further increase the pull-out strength because the correlation was linear at least up to 4.0 ml, but the possibility of in vivo cement leakage with increasing volume has to be considered. Pressure-controlled cement application might be a tool to avoid this complication. The cement almost completely penetrated the most proximal perforation.

Variability of the pullout strength of cancellous bone screws with cement augmentation.

PubMed

Procter, P; Bennani, P; Brown, C J; Arnoldi, J; Pioletti, D P; Larsson, S

2015-06-01

Orthopaedic surgeons often face clinical situations where improved screw holding power in cancellous bone is needed. Injectable calcium phosphate cements are one option to enhance fixation. Paired screw pullout tests were undertaken in which human cadaver bone was augmented with calcium phosphate cement. A finite element model was used to investigate sensitivity to screw positional placement. Statistical analysis of the data concluded that the pullout strength was generally increased by cement augmentation in the in vitro human cadaver tests. However, when comparing the individual paired samples there were surprising results with lower strength than anticipated after augmentation, in apparent contradiction to the generally expected conclusion. Investigation using the finite element model showed that these strength reductions could be accounted for by small screw positional changes. A change of 0.5mm might result in predicted pullout force changes of up to 28%. Small changes in screw position might lead to significant changes in pullout strength sufficient to explain the lower than expected individual pullout values in augmented cancellous bone. Consequently whilst the addition of cement at a position of low strength would increase the pullout strength at that point, it might not reach the pullout strength of the un-augmented paired test site. However, the overall effect of cement augmentation produces a significant improvement at whatever point in the bone the screw is placed. The use of polymeric bone-substitute materials for tests may not reveal the natural variation encountered in tests using real bone structures. Copyright © 2015 Elsevier Ltd. All rights reserved.

Discrete particle model for cement infiltration within open-cell structures: Prevention of osteoporotic fracture.

PubMed

Ramos-Infante, Samuel Jesús; Ten-Esteve, Amadeo; Alberich-Bayarri, Angel; Pérez, María Angeles

2018-01-01

This paper proposes a discrete particle model based on the random-walk theory for simulating cement infiltration within open-cell structures to prevent osteoporotic proximal femur fractures. Model parameters consider the cement viscosity (high and low) and the desired direction of injection (vertical and diagonal). In vitro and in silico characterizations of augmented open-cell structures validated the computational model and quantified the improved mechanical properties (Young's modulus) of the augmented specimens. The cement injection pattern was successfully predicted in all the simulated cases. All the augmented specimens exhibited enhanced mechanical properties computationally and experimentally (maximum improvements of 237.95 ± 12.91% and 246.85 ± 35.57%, respectively). The open-cell structures with high porosity fraction showed a considerable increase in mechanical properties. Cement augmentation in low porosity fraction specimens resulted in a lesser increase in mechanical properties. The results suggest that the proposed discrete particle model is adequate for use as a femoroplasty planning framework.

Timing of PMMA cement application for pedicle screw augmentation affects screw anchorage.

PubMed

Schmoelz, Werner; Heinrichs, Christian Heinz; Schmidt, Sven; Piñera, Angel R; Tome-Bermejo, Felix; Duart, Javier M; Bauer, Marlies; Galovich, Luis Álvarez

2017-11-01

Cement augmentation is an established method to increase the pedicle screw (PS) anchorage in osteoporotic vertebral bodies. The ideal timing for augmentation when a reposition maneuver is necessary is controversial. While augmentation of the PS before reposition maneuver may increase the force applied it on the vertebrae, it bears the risk to impair PS anchorage, whereas augmenting the PS after the maneuver may restore this anchorage and prevent early screw loosening. The purpose of the present study was to evaluate the effect of cement application timing on PS anchorage in the osteoporotic vertebral body. Ten lumbar vertebrae (L1-L5) were used for testing. The left and right pedicles of each vertebra were instrumented with the same PS size and used for pairwise comparison of the two timing points for augmentation. For the reposition maneuver, the left PS was loaded axially under displacement control (2 × ±2 mm, 3 × ±6 mm, 3 × ±10 mm) to simulate a reposition maneuver. Subsequently, both PS were augmented with 2 ml PMMA cement. The same force as measured during the left PS maneuver was applied to the previously augmented right hand side PS [2 × F (±2 mm), 3 × F (±6 mm), 3 × F (±10 mm)]. Both PS were cyclically loaded with initial forces of +50 and -50 N, while the lower force was increased by 5 N every 100 cycles until total failure of the PS. The PS motion was measured with a 3D motion analysis system. After cyclic loading stress, X-rays were taken to identify the PS loosening mechanism. In comparison with PS augmented prior to the reposition maneuver, PS augmented after the reposition maneuver showed a significant higher number of load cycles until failure (5930 ± 1899 vs 3830 ± 1706, p = 0.015). The predominant loosening mechanism for PS augmented after the reposition maneuver was PS toggling with the attached cement cloud within the trabecular bone. While PS augmented prior to the reposition, maneuver showed a motion of the screw within the cement cloud. The time of cement application has an effect on PS anchorage in the osteoporotic vertebral body if a reposition maneuver of the instrumented vertebrae is carried out. PS augmented after the reposition maneuver showed a significant higher number of load cycles until screw loosening.

Percutaneous Dorsal Instrumentation of Vertebral Burst Fractures: Value of Additional Percutaneous Intravertebral Reposition—Cadaver Study

PubMed Central

Krüger, Antonio; Schmuck, Maya; Noriega, David C.; Ruchholtz, Steffen; Baroud, Gamal; Oberkircher, Ludwig

2015-01-01

Purpose. The treatment of vertebral burst fractures is still controversial. The aim of the study is to evaluate the purpose of additional percutaneous intravertebral reduction when combined with dorsal instrumentation. Methods. In this biomechanical cadaver study twenty-eight spine segments (T11-L3) were used (male donors, mean age 64.9 ± 6.5 years). Burst fractures of L1 were generated using a standardised protocol. After fracture all spines were allocated to four similar groups and randomised according to surgical techniques (posterior instrumentation; posterior instrumentation + intravertebral reduction device + cement augmentation; posterior instrumentation + intravertebral reduction device without cement; and intravertebral reduction device + cement augmentation). After treatment, 100000 cycles (100–600 N, 3 Hz) were applied using a servohydraulic loading frame. Results. Overall anatomical restoration was better in all groups where the intravertebral reduction device was used (p < 0.05). In particular, it was possible to restore central endplates (p > 0.05). All techniques decreased narrowing of the spinal canal. After loading, clearance could be maintained in all groups fitted with the intravertebral reduction device. Narrowing increased in the group treated with dorsal instrumentation. Conclusions. For height and anatomical restoration, the combination of an intravertebral reduction device with dorsal instrumentation showed significantly better results than sole dorsal instrumentation. PMID:26137481

The three-pin modified 'Harrington' procedure for advanced metastatic destruction of the acetabulum.

PubMed

Tillman, R M; Myers, G J C; Abudu, A T; Carter, S R; Grimer, R J

2008-01-01

Pathological fractures due to metastasis with destruction of the acetabulum and central dislocation of the hip present a difficult surgical challenge. We describe a series using a single technique in which a stable and long-lasting reconstruction was obtained using standard primary hip replacement implants augmented by strong, fully-threaded steel rods with cement and steel mesh, where required. Between 1997 and 2006, 19 patients with a mean age of 66 years (48 to 83) were treated using a modified Harrington technique. Acetabular destruction was graded as Harrington class II in six cases and class III in 13. Reconstruction was achieved using three 6.5 mm rods inserted through a separate incision in the iliac crest followed by augmentation with cement and a conventional cemented Charnley or Exeter primary hip replacement. There were no peri-operative deaths. At the final follow-up (mean 25 months (5 to 110)) one rod had fractured and one construct required revision. Of the 18 patients who did not require revision, 13 had died. The mean time to death was 16 months (5 to 55). The mean follow-up of the five survivors was 31 months (18 to 47). There were no cases of dislocation, deep infection or injury to a nerve, the blood vessels or the bladder.

Implant Augmentation: Adding Bone Cement to Improve the Treatment of Osteoporotic Distal Femur Fractures

PubMed Central

Wähnert, Dirk; Hofmann-Fliri, Ladina; Richards, R. Geoff; Gueorguiev, Boyko; Raschke, Michael J.; Windolf, Markus

2014-01-01

Abstract The increasing problems in the field of osteoporotic fracture fixation results in specialized implants as well as new operation methods, for example, implant augmentation with bone cement. The aim of this study was to determine the biomechanical impact of augmentation in the treatment of osteoporotic distal femur fractures. Seven pairs of osteoporotic fresh frozen distal femora were randomly assigned to either an augmented or nonaugmented group. In both groups, an Orthopaedic Trauma Association 33 A3 fractures was fixed using the locking compression plate distal femur and cannulated and perforated screws. In the augmented group, additionally, 1 mL of polymethylmethacrylate cement was injected through the screw. Prior to mechanical testing, bone mineral density (BMD) and local bone strength were determined. Mechanical testing was performed by cyclic axial loading (100 N to 750 N + 0.05N/cycle) using a servo-hydraulic testing machine. As a result, the BMD as well as the axial stiffness did not significantly differ between the groups. The number of cycles to failure was significantly higher in the augmented group with the BMD as a significant covariate. In conclusion, cement augmentation can significantly improve implant anchorage in plating of osteoporotic distal femur fractures. PMID:25415673

Cement augmentation of implants--no general cure in osteoporotic fracture treatment. A biomechanical study on non-displaced femoral neck fractures.

PubMed

Hofmann-Fliri, Ladina; Nicolino, Tomas I; Barla, Jorge; Gueorguiev, Boyko; Richards, R Geoff; Blauth, Michael; Windolf, Markus

2016-02-01

Femoral neck fractures in the elderly are a common problem in orthopedics. Augmentation of screw fixation with bone cement can provide better stability of implants and lower the risk of secondary displacement. This study aimed to investigate whether cement augmentation of three cannulated screws in non-displaced femoral neck fractures could increase implant fixation. A femoral neck fracture was simulated in six paired human cadaveric femora and stabilized with three 7.3 mm cannulated screws. Pairs were divided into two groups: conventional instrumentation versus additional cement augmentation of screw tips with 2 ml TraumacemV+ each. Biomechanical testing was performed by applying cyclic axial load until failure. Failure cycles, axial head displacement, screw angle changes, telescoping and screw cut-out were evaluated. Failure (15 mm actuator displacement) occurred in the augmented group at 12,500 cycles (± 2,480) compared to 15,625 cycles (± 4,215) in the non-augmented group (p = 0.041). When comparing 3 mm vertical displacement of the head no significant difference (p = 0.72) was detected between the survival curves of the two groups. At 8,500 load-cycles (early onset failure) the augmented group demonstrated a change in screw angle of 2.85° (± 0.84) compared to 1.15° (± 0.93) in the non-augmented group (p = 0.013). The results showed no biomechanical advantage with respect to secondary displacement following augmentation of three cannulated screws in a non-displaced femoral neck fracture. Consequently, the indication for cement augmentation to enhance implant anchorage in osteoporotic bone has to be considered carefully taking into account fracture type, implant selection and biomechanical surrounding. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Perfusion pressure of a new cannulating fenestrated pedicle screw during cement augmentation.

PubMed

Wang, Zhirong; Zhang, Wen; Xu, Hao; Lu, Aiqing; Yang, Huilin; Luo, Zong-Ping

2018-06-18

Cannulating fenestrated pedicle screws are effective for fixating osteoporotic vertebrae. However, a major limitation is the excessive pressure required to inject a sufficient amount of cement into the vertebral body through the narrow hole of a pedicle screw. We have recently proposed a new cannulating fenestrated pedicle screw with a large hole diameter and a matched inner pin for screw-strength maintenance. Our purpose was to determine whether the new screw can significantly reduce bone-cement perfusion pressure during cement augmentation, METHODS: Two different methods were used to examine perfusion pressure. Hagen-Poisseuille's flow model in a tube was used to calculate pressure drop in the bone-cement channel. Experimentally, both Newtonian silicone oil and bone-cement (polymethyl methacrylate) were tested using a cement pusher through the cannulating screw at a constant rate of 2 ml/min. The internal hollow portion of the screw was the bottleneck of the perfusion, and the new design significantly reduced the perfusion pressure. Specifically, perfusion pressure dropped by 59% (P < 0.05) when diameter size was doubled. The new design effectively improved the application of bone-cement augmentation with the ease of bone-cement perfusion, thereby enhancing operational safety. Copyright © 2018. Published by Elsevier Ltd.

Biomechanical evaluation of bone screw fixation with a novel bone cement.

PubMed

Juvonen, Tiina; Nuutinen, Juha-Pekka; Koistinen, Arto P; Kröger, Heikki; Lappalainen, Reijo

2015-07-30

Bone cement augmentation is commonly used to improve the fixation stability of orthopaedic implants in osteoporotic bone. The aim of this study was to evaluate the effect of novel bone cements on the stability of bone screw fixation by biomechanical testing and to compare them with a conventional Simplex(®)P bone cement and requirements of the standards. Basic biomechanical properties were compared with standard tests. Adhesion of bone cements were tested with polished, glass blasted and corundum blasted stainless steel surfaces. Screw pullout testing with/without cement was carried out using a synthetic bone model and cancellous and cortical bone screws. All the tested bone cements fulfilled the requirements of the standard for biomechanical properties and improved the screw fixation stability. Even a threefold increase in shear and tensile strength was achieved with increasing surface roughness. The augmentation improved the screw pullout force compared to fixation without augmentation, 1.2-5.7 times depending on the cement and the screw type. The good biomechanical properties of novel bone cement for osteoporotic bone were confirmed by experimental testing. Medium viscosity of the bone cements allowed easy handling and well-controlled penetration of bone cement into osteoporotic bone. By proper parameters and procedures it is possible to achieve biomechanically stable fixation in osteoporotic bone. Based on this study, novel biostable bone cements are very potential biomaterials to enhance bone screw fixation in osteoporotic bone. Novel bone cement is easy to use without hand mixing using a dual syringe and thus makes it possibility to use it as required during the operation.

Is Polymethyl Methacrylate a Viable Option for Salvaging Lateral Mass Screw Failure in the Subaxial Cervical Spine?

PubMed Central

Gallizzi, Michael A.; Kuhns, Craig A.; Jenkins, Tyler J.; Pfeiffer, Ferris M.

2014-01-01

Study Design Biomechanical analysis of lateral mass screw pullout strength. Objective We compare the pullout strength of our bone cement–revised lateral mass screw with the standard lateral mass screw. Methods In cadaveric cervical spines, we simulated lateral mass screw “cutouts” unilaterally from C3 to C7. We salvaged fixation in the cutout side with polymethyl methacrylate (PMMA) or Cortoss cement (Orthovita, Malvern, Pennsylvania, United States), allowed the cement to harden, and then drilled and placed lateral mass screws back into the cement-augmented lateral masses. On the contralateral side, we placed standard lateral mass screws into the native, or normal lateral, masses and then compared pullout strength of the cement-augmented side to the standard lateral mass screw. For pullout testing, each augmentation group was fixed to a servohydraulic load frame and a specially designed pullout fixture was attached to each lateral mass screw head. Results Quick-mix PMMA-salvaged lateral mass screws required greater force to fail when compared with native lateral mass screws. Cortoss cement and PMMA standard-mix cement-augmented screws demonstrated less strength of fixation when compared with control-side lateral mass screws. Attempts at a second round of cement salvage of the same lateral masses led to more variations in load to failure, but quick-mix PMMA again demonstrated greater load to failure when compared with the nonaugmented control lateral mass screws. Conclusion Quick-mix PMMA cement revision equips the spinal surgeon with a much needed salvage option for a failed lateral mass screw in the subaxial cervical spine. PMID:25649421

Cement Augmentation in Sacroiliac Screw Fixation Offers Modest Biomechanical Advantages in a Cadaver Model.

PubMed

Osterhoff, Georg; Dodd, Andrew E; Unno, Florence; Wong, Angus; Amiri, Shahram; Lefaivre, Kelly A; Guy, Pierre

2016-11-01

Sacroiliac screw fixation in elderly patients with pelvic fractures is prone to failure owing to impaired bone quality. Cement augmentation has been proposed as a possible solution, because in other anatomic areas this has been shown to reduce screw loosening. However, to our knowledge, this has not been evaluated for sacroiliac screws. We investigated the potential biomechanical benefit of cement augmentation of sacroiliac screw fixation in a cadaver model of osteoporotic bone, specifically with respect to screw loosening, construct survival, and fracture-site motion. Standardized complete sacral ala fractures with intact posterior ligaments in combination with ipsilateral upper and lower pubic rami fractures were created in osteoporotic cadaver pelves and stabilized by three fixation techniques: sacroiliac (n = 5) with sacroiliac screws in S1 and S2, cemented (n = 5) with addition of cement augmentation, and transsacral (n = 5) with a single transsacral screw in S1. A cyclic loading protocol was applied with torque (1.5 Nm) and increasing axial force (250-750 N). Screw loosening, construct survival, and sacral fracture-site motion were measured by optoelectric motion tracking. A sample-size calculation revealed five samples per group to be required to achieve a power of 0.80 to detect 50% reduction in screw loosening. Screw motion in relation to the sacrum during loading with 250 N/1.5 Nm was not different among the three groups (sacroiliac: 1.2 mm, range, 0.6-1.9; cemented: 0.7 mm, range, 0.5-1.3; transsacral: 1.1 mm, range, 0.6-2.3) (p = 0.940). Screw subsidence was less in the cemented group (3.0 mm, range, 1.2-3.7) compared with the sacroiliac (5.7 mm, range, 4.7-10.4) or transsacral group (5.6 mm, range, 3.8-10.5) (p = 0.031). There was no difference with the numbers available in the median number of cycles needed until failure; this was 2921 cycles (range, 2586-5450) in the cemented group, 2570 cycles (range, 2500-5107) for the sacroiliac specimens, and 2578 cycles (range, 2540-2623) in the transsacral group (p = 0.153). The cemented group absorbed more energy before failure (8.2 × 10 5 N*cycles; range, 6.6 × 10 5 -22.6 × 10 5 ) compared with the transsacral group (6.5 × 10 5 N*cycles; range, 6.4 × 10 5 -6.7 × 10 5 ) (p = 0.016). There was no difference with the numbers available in terms of fracture site motion (sacroiliac: 2.9 mm, range, 0.7-5.4; cemented: 1.2 mm, range, 0.6-1.9; transsacral: 2.1 mm, range, 1.2-4.8). Probability values for all between-group comparisons were greater than 0.05. The addition of cement to standard sacroiliac screw fixation seemed to change the mode and dynamics of failure in this cadaveric mechanical model. Although no advantages to cement were observed in terms of screw motion or cycles to failure among the different constructs, a cemented, two-screw sacroiliac screw construct resulted in less screw subsidence and greater energy absorbed to failure than an uncemented single transsacral screw. In osteoporotic bone, the addition of cement to sacroiliac screw fixation might improve screw anchorage. However, larger mechanical studies using these findings as pilot data should be performed before applying these preliminary findings clinically.

Anterior cement augmentation of adjacent levels after vertebral body replacement leads to superior stability of the corpectomy cage under cyclic loading-a biomechanical investigation.

PubMed

Oberkircher, Ludwig; Krüger, Antonio; Hörth, Dominik; Hack, Juliana; Ruchholtz, Steffen; Fleege, Christoph; Rauschmann, Michael; Arabmotlagh, Mohammad

2018-03-01

In the operative treatment of osteoporotic vertebral body fractures, a dorsal stabilization in combination with a corpectomy of the fractured vertebral body might be necessary with respect to the fracture morphology, whereby the osteoporotic bone quality may possibly increase the risk of implant failure. To achieve better stability, it is recommended to use cement-augmented screws for dorsal instrumentation. Besides careful end plate preparation, cement augmentation of the adjacent end plates has also been reported to lead to less reduction loss. The aim of the study was to evaluate biomechanically under cyclic loading whether an additional cement augmentation of the adjacent end plates leads to improved stability of the inserted cage. Methodical cadaver study. Fourteen fresh frozen human thoracic spines with proven osteoporosis were used (T2-T7). After removal of the soft tissues, the spine was embedded in Technovit (Kulzer, Germany). Subsequently, a corpectomy of T5 was performed, leaving the dorsal ligamentary structures intact. After randomization with respect to bone quality, two groups were generated: Dorsal instrumentation (cemented pedicle screws, Medtronic, Minneapolis, MN, USA)+cage implantation (CAPRI Corpectomy Cage, K2M, Leesburg, VA, USA) without additional cementation of the adjacent endplates (Group A) and dorsal instrumentation+cage implantation with additional cement augmentation of the adjacent end plates (Group B). The subsequent axial and cyclic loading was performed at a frequency of 1 Hz, starting at 400 N and increasing the load within 200 N after every 500 cycles up to a maximum of 2,200 N. Load failure was determined when the cages sintered macroscopically into the end plates (implant failure) or when the maximum load was reached. One specimen in Group B could not be clamped appropriately into the test bench for axial loading because of a pronounced scoliotic misalignment and had to be excluded. The mean strength for implant failure was 1,000 N±258.2 N in Group A (no cement augmentation of the adjacent end plates, n=7); on average, 1,622.1±637.6 cycles were achieved. In Group B (cement augmentation of the adjacent end plates, n=6), the mean force at the end of loading was 1,766.7 N±320.4 N; an average of 3,572±920.6 cycles was achieved. Three specimens reached a load of 2,000 N. The differences between the two groups were significant (p=.006 and p=.0047) regarding load failure and number of cycles. Additional cement augmentation of the adjacent end plates during implantation of a vertebral body replacement in osteoporotic bone resulted in a significant increased stability of the cage in the axial cyclic loading test. Copyright © 2017 Elsevier Inc. All rights reserved.

Radiofrequency-activated PMMA-augmentation through cannulated pedicle screws: A cadaver study to determine the biomechanical benefits in the osteoporotic spine.

PubMed

Karius, T; Deborre, C; Wirtz, D C; Burger, C; Prescher, A; Fölsch, A; Kabir, K; Pflugmacher, R; Goost, H

2017-01-01

PMMA-augmentation of pedicle screws strengthens the bone-screw-interface reducing cut-out risk. Injection of fluid cement bears a higher risk of extravasation, with difficulty of application because of inconsistent viscosity and limited injection time. To test a new method of cement augmentation of pedicle screws using radiofrequency-activated PMMA, which is suspected to be easier to apply and have less extravasations. Twenty-seven fresh-frozen human cadaver lumbar spines were divided into 18 osteoporotic (BMD ≤ 0.8 g/cm2) and 9 non-osteoporotic (BMD > 0.8 g/cm2) vertebral bodies. Bipedicular cannulated pedicle screws were implanted into the vertebral bodies; right screws were augmented with ultra-high viscosity PMMA, whereas un-cemented left pedicle screws served as negative controls. Cement distribution was controlled with fluoroscopy and CT scans. Axial pullout forces of the screws were measured with a material testing machine, and results were analyzed statistically. Fluoroscopy and CT scans showed that in all cases an adequately big cement depot with homogenous form and no signs of extravasation was injected. Pullout forces showed significant differences (p < 0.001) between the augmented and non-augmented pedicle screws for bone densities below 0.8 g/cm2 (661.9 N ± 439) and over 0.8 g/cm2 (744.9 N ± 415). Pullout-forces were significantly increased in osteoporotic as well as in non-osteoporotic vertebral bodies without a significant difference between these groups using this standardized, simple procedure with increased control and less complications like extravasation.

Influence of cement compressive strength and porosity on augmentation performance in a model of orthopedic screw pull-out.

PubMed

Pujari-Palmer, Michael; Robo, Celine; Persson, Cecilia; Procter, Philip; Engqvist, Håkan

2018-01-01

Disease and injuries that affect the skeletal system may require surgical intervention and internal fixation, i.e. orthopedic plate and screw insertion, to stabilize the injury and facilitate tissue repair. If the surrounding bone quality is poor the screws may migrate, or the bone may fail, resulting in fixation failure. While numerous studies have shown that cement augmentation of the interface between bone and implant can increase screw pull-out force, the physical properties of cement that influence pull-out force have not been investigated. The present study sought to determine how the physical properties of high strength calcium phosphate cements (hsCPCs, specifically dicalcium phosphate) affected the corresponding orthopedic screw pull-out force in urethane foam models of "healthy" and "osteoporotic" synthetic bone (Sawbones). In the simplest model, where only the bond strength between screw thread and cement (without Sawbone) was tested, the correlation between pull-out force and cement compressive strength (R 2 = 0.79) was weaker than correlation with total cement porosity (R 2 = 0.89). In open pore Sawbone that mimics "healthy" cancellous bone density the stronger cements produced higher pull-out force (50-60% increase). High strength, low porosity cements also produced higher pull-out forces (50-190% increase) in "healthy" Sawbones with cortical fixation if the failure strength of the cortical material was similar to, or greater than (a metal shell), actual cortical bone. This result is of particular clinical relevance where fixation with a metal plate implant is indicated, as the nearby metal can simulate a thicker cortical shell, thereby increasing the pull-out force of screws augmented with stronger cements. The improvement in pull-out force was apparent even at low augmentation volumes of 0.5mL (50% increase), which suggest that in clinical situations where augmentation volume is limited the stronger, lower porosity calcium phosphate cement (CPC) may still produce a significant improvement in screw pull-out force. When the correlation strength of all the tested models were compared both cement porosity and compressive strength accurately predicted pull-out force (R 2 =1.00, R 2 =0.808), though prediction accuracy depended upon the strength of the material surrounding the Sawbone. The correlations strength was low for bone with no, or weak, cortical fixation (R 2 =0.56, 0.36). Higher strength and lower porosity CPCs also produced greater pull-out force (1-1.5kN) than commercial CPC (0.2-0.5kN), but lower pull-out force than PMMA (2-3kN). The results of this study suggest that the likelihood of screw fixation failure may be reduced by selecting calcium phosphate cements with lower porosity and higher compressive strength, in patients with healthy bone mineral density and/or sufficient cortical thickness. This is of particular clinical relevance when fixation with metal plates is indicated, or where the augmentation volume is limited. Copyright © 2017 Elsevier Ltd. All rights reserved.

A modified cementing technique using BoneSource to augment fixation of the acetabulum in a sheep model.

PubMed

Timperley, A John; Nusem, Iulian; Wilson, Kathy; Whitehouse, Sarah L; Buma, Pieter; Crawford, Ross W

2010-08-01

Our aim was to assess in an animal model whether the use of HA paste at the cement-bone interface in the acetabulum improves fixation. We examined, in sheep, the effect of interposing a layer of hydroxyapatite cement around the periphery of a polyethylene socket prior to fixing it using polymethylmethacrylate (PMMA). We performed a randomized study involving 22 sheep that had BoneSource hydroxyapatite material applied to the surface of the acetabulum before cementing a polyethylene cup at arthroplasty. We studied the gross radiographic appearance of the implant-bone interface and the histological appearance at the interface. There were more radiolucencies evident in the control group. Histologically, only sheep randomized into the BoneSource group exhibited a fully osseointegrated interface. Use of the hydroxyapatite material did not give any detrimental effects. In some cases, the material appeared to have been fully resorbed. When the material was evident in histological sections, it was incorporated into an osseointegrated interface. There was no giant cell reaction present. There was no evidence of migration of BoneSource to the articulation. The application of HA material prior to cementation of a socket produced an improved interface. The technique may be useful in humans, to extend the longevity of the cemented implant by protecting the socket interface from the effect of hydrodynamic fluid flow and particulate debris.

Potential risks of using cement-augmented screws for spinal fusion in patients with low bone quality.

PubMed

Martín-Fernández, M; López-Herradón, A; Piñera, A R; Tomé-Bermejo, F; Duart, J M; Vlad, M D; Rodríguez-Arguisjuela, M G; Alvarez-Galovich, L

2017-08-01

Dramatic increases in the average life expectancy have led to increases in the variety of degenerative changes and deformities observed in the aging spine. The elderly population can present challenges for spine surgeons, not only because of increased comorbidities, but also because of the quality of their bones. Pedicle screws are the implants used most commonly in spinal surgery for fixation, but their efficacy depends directly on bone quality. Although polymethyl methacrylate (PMMA)-augmented screws represent an alternative for patients with osteoporotic vertebrae, their use has raised some concerns because of the possible association between cement leakages (CLs) and other morbidities. To analyze potential complications related to the use of cement-augmented screws for spinal fusion and to investigate the effectiveness of using these screws in the treatment of patients with low bone quality. A retrospective single-center study. This study included 313 consecutive patients who underwent spinal fusion using a total of 1,780 cement-augmented screws. We analyzed potential complications related to the use of cement-augmented screws, including CL, vascular injury, infection, screw extraction problems, revision surgery, and instrument failure. There are no financial conflicts of interest to report. A total of 1,043 vertebrae were instrumented. Cement leakage was observed in 650 vertebrae (62.3%). There were no major clinical complications related to CL, but two patients (0.6%) had radicular pain related to CL at the S1 foramina. Of the 13 patients (4.1%) who developed deep infections requiring surgical debridement, two with chronic infections had possible spondylitis that required instrument removal. All patients responded well to antibiotic therapy. Revision surgery was performed in 56 patients (17.9%), most of whom had long construction. A total of 180 screws were removed as a result of revision. There were no problems with screw extraction. These results demonstrate the efficacy and safety of cement-augmented screws for the treatment of patients with low bone mineral density. Copyright © 2017 Elsevier Inc. All rights reserved.

Does bone cement in percutaneous vertebroplasty act as a stress riser?

PubMed

Aquarius, René; van der Zijden, Astrid Maria; Homminga, Jasper; Verdonschot, Nico; Tanck, Esther

2013-11-15

An in vitro cadaveric study. To determine whether percutaneous vertebroplasty (PVP) with a clinically relevant amount of bone cement is capable of causing stress peaks in adjacent-level vertebrae. It is often suggested that PVP of a primary spinal fracture causes stress peaks in adjacent vertebrae, thereby leading to additional fractures. The in vitro studies that demonstrated this relationship, however, use bigger volumes of bone cement used clinically. Ten fresh-frozen vertebrae were loaded until failure, while registering force and displacement as well as the pressure under the lower endplate. After failure, the vertebrae were augmented with clinically relevant amounts of bone cement and then again loaded until failure. The force, displacement, and pressure under the lower endplate were again registered. Stress peaks were not related to the location of the injected bone cement. Both failure load and stiffness were significantly lower after augmentation. On the basis of our findings, we conclude that vertebral augmentation with clinically relevant amounts of bone cement does not lead to stress peaks under the endplate. It is therefore unlikely that PVP, in itself, causes detrimental stresses in the adjacent vertebrae, leading to new vertebral fractures. N/A.

A Particle Model for Prediction of Cement Infiltration of Cancellous Bone in Osteoporotic Bone Augmentation.

PubMed

Basafa, Ehsan; Murphy, Ryan J; Kutzer, Michael D; Otake, Yoshito; Armand, Mehran

2013-01-01

Femoroplasty is a potential preventive treatment for osteoporotic hip fractures. It involves augmenting mechanical properties of the femur by injecting Polymethylmethacrylate (PMMA) bone cement. To reduce the risks involved and maximize the outcome, however, the procedure needs to be carefully planned and executed. An important part of the planning system is predicting infiltration of cement into the porous medium of cancellous bone. We used the method of Smoothed Particle Hydrodynamics (SPH) to model the flow of PMMA inside porous media. We modified the standard formulation of SPH to incorporate the extreme viscosities associated with bone cement. Darcy creeping flow of fluids through isotropic porous media was simulated and the results were compared with those reported in the literature. Further validation involved injecting PMMA cement inside porous foam blocks - osteoporotic cancellous bone surrogates - and simulating the injections using our proposed SPH model. Millimeter accuracy was obtained in comparing the simulated and actual cement shapes. Also, strong correlations were found between the simulated and the experimental data of spreading distance (R(2) = 0.86) and normalized pressure (R(2) = 0.90). Results suggest that the proposed model is suitable for use in an osteoporotic femoral augmentation planning framework.

PMMA-augmented SI screw: a biomechanical analysis of stiffness and pull-out force in a matched paired human cadaveric model.

PubMed

Grechenig, Stephan; Gänsslen, Axel; Gueorguiev, Boyko; Berner, Arne; Müller, Michael; Nerlich, Michael; Schmitz, Paul

2015-10-01

Current literature data and clinical experience show that the number of pelvic fractures continuously rises due to the increasing elderly population. In the elderly with suspected osteoporosis additional implant augmentation with bone cement seems to be an option to avoid secondary displacement. There are no reported biomechanical data in the literature comparing the fixation strength (and anchorage) of standard and augmented SI screws so far. The purpose of this study was to assess the biomechanical performance of cement-augmented versus non-augmented SI screws in a human cadaveric pelvis model. Six human cadaveric pelvises preserved with the method of Thiel were used in this study. Each pelvis was split to a pair of 2 hemi-pelvises, assigned to 2 different groups for instrumentation with one non-augmented or one contralateral cement-augmented SI screw, placed in the body of S1 in a randomized fashion. The osteosynthesis followed a standard procedure with 3D controlled percutaneous iliosacral screw positioning. A biomechanical setup for a quasistatic pullout test of each SI screw was used. Construct stiffness and maximum pullout force were calculated from the load-displacement curve of the machine data. Statistical evaluation was performed at a level of significance p = .05 for all statistical tests. Stiffness and pullout force in the augmented group (501.6 N/mm ± 123.7, 1336.8 N ± 221.1) were significantly higher than in the non-augmented one (289.7 N/mm ± 97.1, 597.7 N ± 115.5), p = .04 and p = .014, respectively. BMD influenced significantly the pullout force in all study groups. Cement augmentation significantly increased the fixation strength in iliosacral screw osteosynthesis of the sacrum in a biomechanical human cadaveric model. Copyright © 2015 Elsevier Ltd. All rights reserved.

Pullout strength of cement-augmented and wide-suture transosseous fixation in the greater tuberosity.

PubMed

Shi, Brendan Y; Diaz, Miguel; Belkoff, Stephen M; Srikumaran, Uma

2017-12-01

Obtaining strong fixation in low-density bone is increasingly critical in surgical repair of rotator cuff tears because of the aging population. To evaluate two new methods of improving pullout strength of transosseous rotator cuff repair in low-density bone, we analyzed the effects of 1) using 2-mm suture tape instead of no. 2 suture and 2) augmenting the lateral tunnel with cement. Eleven pairs of osteopenic or osteoporotic cadaveric humeri were identified by dual-energy x-ray absorptiometry. One bone tunnel and one suture were placed in the heads of 22 specimens. Five randomly selected pairs were repaired with no. 2 suture; the other six pairs were repaired with 2-mm suture tape. One side of each pair received lateral tunnel cement augmentation. Specimens were tested to suture pullout. Data were fitted to multivariate models that accounted for bone mineral density and other specimen characteristics. Two specimens were excluded because of knot-slipping during testing. Use of suture tape versus no. 2 suture conferred a 75-N increase (95% CI: 37, 113) in pullout strength (P<0.001). Cement augmentation conferred a 42-N improvement (95% CI: 10, 75; P=0.011). Other significant predictors of pullout strength were age, sex, and bone mineral density. We show two methods of improving the fixation strength of transosseous rotator cuff repairs in low-density bone: using 2-mm suture tape instead of no. 2 suture and augmenting the lateral tunnel with cement. These methods may improve the feasibility of transosseous repairs in an aging patient population. Copyright © 2017 Elsevier Ltd. All rights reserved.

Revision Stapedectomy with Necrosis of the Long Process of the Incus: Does the Degree of Necrosis Matter? A Retrospective Clinical Study.

PubMed

Ghonim, Mohamed; Shabana, Yousef; Ashraf, Bassem; Salem, Mohamed

2017-04-01

To discuss the different modalities for managing necrosis of the long process of the incus in revision stapedectomy on the basis of the degree of necrosis and compare the results with those reported in the literature. Thirty-six patients underwent revision stapedectomy with the necrosis of the long process of the incus from 2009 to 2016. The patients were divided into three groups on the basis of the degree of necrosis. For group A (minimal necrosis), augmentation technique with bone cement was performed. For group B (partial necrosis), the cement plug technique was performed. For group C (sever necrosis), malleus relocation with malleovestibulopexy was performed using reshaped necrosed incus. Air and bone conduction thresholds at frequencies of 500-3000 Hz were reviewed pre- and postoperatively using conventional audiometry. The air-bone gap (ABG) and bone conduction thresholds were measured. Postoperative ABG was reduced to <10 dB in 28 cases (77.8%) and <20 dB in all cases (100%). There was no significant change in postoperative bone conduction thresholds. The mean patient follow-up duration was 23 (range, 18-36) months. The cement plug technique was used in 75% of cases. Managing necrosis of the long process of the incus in revision stapedectomy should be considered according to the degree of necrosis. The cement plug technique is considered to be a reasonable option in most cases. Malleus relocation with malleovestibulopexy is an effective alternative to prosthesis.

Augmentation of failed human vertebrae with critical un-contained lytic defect restores their structural competence under functional loading: An experimental study.

PubMed

Alkalay, Ron N; von Stechow, Dietrich; Hackney, David B

2015-07-01

Lytic spinal lesions reduce vertebral strength and may result in their fracture. Vertebral augmentation is employed clinically to provide mechanical stability and pain relief for vertebrae with lytic lesions. However, little is known about its efficacy in strengthening fractured vertebrae containing lytic metastasis. Eighteen unembalmed human lumbar vertebrae, having simulated uncontained lytic defects and tested to failure in a prior study, were augmented using a transpedicular approach and re-tested to failure using a wedge fracture model. Axial and moment based strength and stiffness parameters were used to quantify the effect of augmentation on the structural response of the failed vertebrae. Effects of cement volume, bone mineral density and vertebral geometry on the change in structural response were investigated. Augmentation increased the failed lytic vertebral strength [compression: 85% (P<0.001), flexion: 80% (P<0.001), anterior-posterior shear: 95%, P<0.001)] and stiffness [(40% (P<0.05), 53% (P<0.05), 45% (P<0.05)]. Cement volume correlated with the compressive strength (r(2)=0.47, P<0.05) and anterior-posterior shear strength (r(2)=0.52, P<0.05) and stiffness (r(2)=0.45, P<0.05). Neither the geometry of the failed vertebrae nor its pre-fracture bone mineral density correlated with the volume of cement. Vertebral augmentation is effective in bolstering the failed lytic vertebrae compressive and axial structural competence, showing strength estimates up to 50-90% of historical values of osteoporotic vertebrae without lytic defects. This modest increase suggests that lytic vertebrae undergo a high degree of structural damage at failure, with strength only partially restored by vertebral augmentation. The positive effect of cement volume is self-limiting due to extravasation. Copyright © 2015. Published by Elsevier Ltd.

Augmented PMMA distribution: improvement of mechanical property and reduction of leakage rate of a fenestrated pedicle screw with diameter-tapered perforations.

PubMed

Tan, Quan-Chang; Wu, Jian-Wei; Peng, Fei; Zang, Yuan; Li, Yang; Zhao, Xiong; Lei, Wei; Wu, Zi-Xiang

2016-06-01

OBJECTIVE This study investigated the optimum injection volume of polymethylmethacrylate (PMMA) to augment a novel fenestrated pedicle screw (FPS) with diameter-tapered perforations in the osteoporotic vertebral body, and how the distribution characteristics of PMMA affect the biomechanical performance of this screw. METHODS Two types of FPSs were designed (FPS-A, composed of 6 perforations with an equal diameter of 1.2 mm; and FPS-B, composed of 6 perforations each with a tapered diameter of 1.5 mm, 1.2 mm, and 0.9 mm from tip to head. Each of 28 human cadaveric osteoporotic vertebrae were randomly assigned to 1 of 7 groups: FPS-A1.0: FPS-A+1.0 ml PMMA; FPS-A1.5: FPS-A+1.5 ml PMMA; FPS-A2.0: FPS-A+2.0 ml PMMA; FPS-B1.0: FPS-B+1.0 ml PMMA; FPS-B1.5: FPS-B+1.5 ml PMMA; FPS-B2.0: FPS-B+2.0 ml PMMA; and conventional pedicle screws (CPSs) without PMMA. After the augmentation, 3D CT was performed to assess the cement distribution characteristics and the cement leakage rate. Axial pullout tests were performed to compare the maximum pullout force thereafter. RESULTS The CT construction images showed that PMMA bone cement formed a conical mass around FPS-A and a cylindrical mass around FPS-B. When the injection volume was increased from 1.0 ml to 2.0 ml, the distribution region of the PMMA cement was enlarged, the PMMA was distributed more posteriorly, and the risk of leakage was increased. When the injection volume reached 2.0 ml, the risk of cement leakage was lower for screws having diameter-tapered perforations. The pullout strengths of the augmented FPS-A groups and FPS-B groups were higher than that of the CPS group (p < 0.0001). All FPS-B groups had a higher pullout strength than the FPS-A groups. CONCLUSIONS The diameter of the perforations affects the distribution of PMMA cement. The diameter-tapered design enabled PMMA to form larger bone-PMMA interfaces and achieve a relatively higher pullout strength, although statistical significance was not reached. Study results indicated 1.5-ml of PMMA was a conservative volume for PMMA augmentation; more cement injection would significantly increase the risk of cement leakage.

The effect of in situ augmentation on implant anchorage in proximal humeral head fractures.

PubMed

Unger, Stefan; Erhart, Stefanie; Kralinger, Franz; Blauth, Michael; Schmoelz, Werner

2012-10-01

Fracture fixation in patients suffering from osteoporosis is difficult as sufficient implant anchorage is not always possible. One method to enhance implant anchorage is implant/screw augmentation with PMMA-cement. The present study investigated the feasibility of implant augmentation with PMMA-cement to enhance implant anchorage in the proximal humerus. A simulated three part humeral head fracture was stabilised with an angular stable plating system in 12 pairs of humeri using six head screws. In the augmentation group the proximal four screws were treated with four cannulated screws, each augmented with 0.5ml of PMMA-cement, whereas the contra lateral side served as a non-augmented control. Specimens were loaded in varus-bending or axial-rotation using a cyclic loading protocol with increasing load magnitude until failure of the osteosynthesis occurred. Augmented specimens showed a significant higher number of load cycles until failure than non-augment specimens (varus-bending: 8516 (SD 951.6) vs. 5583 (SD 2273.6), P=0.014; axial-rotation: 3316 (SD 348.8) vs. 2050 (SD 656.5), P=0.003). Non-augmented specimens showed a positive correlation of load cycles until failure and measured bone mineral density (varus-bending: r=0.893, P=0.016; axial-rotation: r=0.753, P=0.084), whereas no correlation was present in augmented specimens (varus-bending: r=0,258, P=0.621; axial-rotation r=0.127, P=0.810). These findings suggest that augmentation of cannulated screws is a feasible method to enhance implant/screw anchorage in the humeral head. The improvement of screw purchase is increasing with decreasing bone mineral density. Copyright © 2012 Elsevier Ltd. All rights reserved.

[Revenue and losses with vertebral augmentation under the G-DRG system 2012 - a comparison of supply costs in the context of vertebroplasty and kyphoplasty].

PubMed

Krüger, A; Wollny, M; Oberkircher, L; Bornemann, R; Pflugmacher, R

2012-10-01

If clearly indicated and implemented, augmentations of vertebral bodies with cement are standardized, safe and low-risk procedures. However, the multiplicity of providers and systems are today more varied than ever. At present, the systems differ starkly from one another not only in specifications, possible applications and extensions of indications, but they are also extremely variable in price. Publications have shown that in times of medical-economic change, vertebral augmentations make sense not only medically, but also in terms of economics and the national economy. Our analysis targets the question of how insurance costs with vertebroplasty and kyphoplasty affect profit margins per G-DRG (German Diagnosis Related Groups) in consideration of the different system approaches of the providers. After reviewing the literature, extremely varied, minimally invasive augmentation methods and techniques for treating vertebral body fractures were identified and classified. These were grouped based also [sic: on] OPS and possibly further subdivisions. Material costs were gathered based on average price quotations of different providers and techniques and aligned with those from the literature. The inpatient costs per day were estimated as a lump sum according to published information, since our analysis was interested in less detailed process costs as these are difficult to transfer to other clinics due to parameters being unique to each facility. The G-DRGs concerned were likewise determined according to the case-based lump sum catalogue from 2012. Based on this, the material costs as well as the daily costs per day of inpatient stay according to the average length of stay per G-DRG were subtracted. Vertebral augmentation methods are classified into vertebroplasty and kyphoplasty according to OPS. In addition, according to current literature, a further subdivision of kyphoplasty into substance-conserving or direct cement injection techniques and substance-destroying or indirect cement injection techniques took place. The procedures involve material costs between 10-40 % of G-DRG revenue. The profit margin of vertebral augmentation ranges from approx. 4100 € to approx. 11 400 €. The calculative costs of the inpatient care per day amount to 488.86 €. Based on the average lengths of stay per G-DRG (7.8-12.6 days) for 2012 determined by the InEK (Institut für das Entgeltsystem im Krankenhaus [Institute for the Hospital Remuneration System]), the financial costs of inpatient care were calculated between 3813.11 € and 6159.65 €. A shortfall of -197.53 € for the treatment of a vertebral body resulted for the vertebroplasty. This shortfall increases with the treatment of three vertebral bodies and a PCCL = 4 to -466.30 €. The indirect cement injection techniques accounted for a positive profit margin of 196.03 € for the treatment of a vertebra. Due to high material costs, however, this dips into the negative in the amount of -1227.70 € for two vertebrae and increases to -2522.50 € for the treatment of three vertebral bodies. In contrast, the multilevel care in substance-preserving kyphoplasty techniques show a positive profit margin of 72.30 € for the treatment of two vertebrae and 577.50 € for the treatment of three vertebrae. Against the background of the increasing economization of the health care system, it should be emphasized once more that the decision for a therapy or a system based on medical reasons should only be made by the treating physician. The vertebroplasty could not be performed at a profit in our analysis, despite comparatively low material costs. A shortfall between -197.53 € and -466.30 € was determined. The comparatively higher material costs of the kyphoplasty make comparisons important. The results of our investigation also show that supposedly inexpensive purchases of materials are not automatically a favorable alternative. In addition, the kyphoplasty techniques currently available on the market are not necessarily comparable. According to our investigation, profits of between 196.03 € and 577.50 € are to be realized in the selection of vertebral augmentation systems based on purely economic considerations. The results of our analysis show that the pure comparison of figures of the average material costs of a G-DRG and the material price distort the picture. A calculation of the profit margin on the basis of costs of care per vertebral body is more definitive. Georg Thieme Verlag KG Stuttgart · New York.

Short segment pedicle screw instrumentation and augmentation vertebroplasty in lumbar burst fractures: an experience

PubMed Central

Akbar, Saleem; Dhar, Shabir A.

2008-01-01

To assess the efficacy and feasibility of vertebroplasty and posterior short-segment pedicle screw fixation for the treatment of traumatic lumbar burst fractures. Short-segment pedicle screw instrumentation is a well described technique to reduce and stabilize thoracic and lumbar spine fractures. It is relatively a easy procedure but can only indirectly reduce a fractured vertebral body, and the means of augmenting the anterior column are limited. Hardware failure and a loss of reduction are recognized complications caused by insufficient anterior column support. Patients with traumatic lumbar burst fractures without neurologic deficits were included. After a short segment posterior reduction and fixation, bilateral transpedicular reduction of the endplate was performed using a balloon, and polymethyl methacrylate cement was injected. Pre-operative and post-operative central and anterior heights were assessed with radiographs and MRI. Sixteen patients underwent this procedure, and a substantial reduction of the endplates could be achieved with the technique. All patients recovered uneventfully, and the neurologic examination revealed no deficits. The post-operative radiographs and magnetic resonance images demonstrated a good fracture reduction and filling of the bone defect without unwarranted bone displacement. The central and anterior height of the vertebral body could be restored to 72 and 82% of the estimated intact height, respectively. Complications were cement leakage in three cases without clinical implications and one superficial wound infection. Posterior short-segment pedicle fixation in conjunction with balloon vertebroplasty seems to be a feasible option in the management of lumbar burst fractures, thereby addressing all the three columns through a single approach. Although cement leakage occurred but had no clinical consequences or neurological deficit. PMID:18193300

Effect of Augmentation Material Stiffness on Adjacent Vertebrae after Osteoporotic Vertebroplasty Using Finite Element Analysis with Different Loading Methods.

PubMed

Cho, Ah-Reum; Cho, Sang-Bong; Lee, Jae-Ho; Kim, Kyung-Hoon

2015-11-01

Vertebroplasty is an effective treatment for osteoporotic vertebral fractures, which are one of the most common fractures associated with osteoporosis. However, clinical observation has shown that the risk of adjacent vertebral body fractures may increase after vertebroplasty. The mechanism underlying adjacent vertebral body fracture after vertebroplasty is not clear; excessive stiffness resulting from polymethyl methacrylate has been suspected as an important mechanism. The aim of our study was to compare the effects of bone cement stiffness on adjacent vertebrae after osteoporotic vertebroplasty under load-controlled versus displacement-controlled conditions. An experimental computer study using a finite element analysis. Medical research institute, university hospital, Korean. A three-dimensional digital anatomic model of L1/2 bone structure was reconstructed from human computed tomographic images. The reconstructed three-dimensional geometry was processed for finite element analysis such as meshing elements and applying material properties. Two boundary conditions, load-controlled and displacement-controlled methods, were applied to each of 5 deformation modes: compression, flexion, extension, lateral bending, and torsion. The adjacent L1 vertebra, irrespective of augmentation, revealed nearly similar maximum von Mises stresses under the load-controlled condition. However, for the displacement-controlled condition, the maximum von Mises stresses in the cortical bone and inferior endplate of the adjacent L1 vertebra increased significantly after cement augmentation. This increase was more significant than that with stiffer bone cement under all modes, except the torsion mode. The finite element model was simplified, excluding muscular forces and incorporating a large volume of bone cement, to more clearly demonstrate effects of bone cement stiffness on adjacent vertebrae after vertebroplasty. Excessive stiffness of augmented bone cement increases the risk of adjacent vertebral fractures after vertebroplasty in an osteoporotic finite element model. This result was most prominently observed using the displacement-controlled method.

Cement Leakage in Percutaneous Vertebral Augmentation for Osteoporotic Vertebral Compression Fractures: Analysis of Risk Factors.

PubMed

Xie, Weixing; Jin, Daxiang; Ma, Hui; Ding, Jinyong; Xu, Jixi; Zhang, Shuncong; Liang, De

2016-05-01

The risk factors for cement leakage were retrospectively reviewed in 192 patients who underwent percutaneous vertebral augmentation (PVA). To discuss the factors related to the cement leakage in PVA procedure for the treatment of osteoporotic vertebral compression fractures. PVA is widely applied for the treatment of osteoporotic vertebral fractures. Cement leakage is a major complication of this procedure. The risk factors for cement leakage were controversial. A retrospective review of 192 patients who underwent PVA was conducted. The following data were recorded: age, sex, bone density, number of fractured vertebrae before surgery, number of treated vertebrae, severity of the treated vertebrae, operative approach, volume of injected bone cement, preoperative vertebral compression ratio, preoperative local kyphosis angle, intraosseous clefts, preoperative vertebral cortical bone defect, and ratio and type of cement leakage. To study the correlation between each factor and cement leakage ratio, bivariate regression analysis was employed to perform univariate analysis, whereas multivariate linear regression analysis was employed to perform multivariate analysis. The study included 192 patients (282 treated vertebrae), and cement leakage occurred in 100 vertebrae (35.46%). The vertebrae with preoperative cortical bone defects generally exhibited higher cement leakage ratio, and the leakage is typically type C. Vertebrae with intact cortical bones before the procedure tend to experience type S leakage. Univariate analysis showed that patient age, bone density, number of fractured vertebrae before surgery, and vertebral cortical bone were associated with cement leakage ratio (P<0.05). Multivariate analysis showed that the main factors influencing bone cement leakage are bone density and vertebral cortical bone defect, with standardized partial regression coefficients of -0.085 and 0.144, respectively. High bone density and vertebral cortical bone defect are independent risk factors associated with bone cement leakage.

Suture anchor fixation strength with or without augmentation in osteopenic and severely osteoporotic bones in rotator cuff repair: a biomechanical study on polyurethane foam model.

PubMed

Er, Mehmet Serhan; Altinel, Levent; Eroglu, Mehmet; Verim, Ozgur; Demir, Teyfik; Atmaca, Halil

2014-08-22

The purpose of the present study was to compare the results of various types of anchor applications with or without augmentation in both osteopenic and severely osteoporotic bone models. Two different types of suture anchors were tested in severely osteoporotic (SOP) and osteopenic polyurethane (PU) foam blocks using an established protocol. An Instron machine applied static loading parallel to the axis of insertion until failure, and the mean anchor failure strengths were calculated. The mode of failure (anchor pullout, suture tear) was recorded. The anchors tested included the Corkscrew (CS) (Arthrex Inc., Naples, FL, USA) (without augmentation, polymethylmethacrylate (PMMA)-augmented, and bioabsorbable tricalcium phosphate (TCP) cement-augmented) and Corkscrew FT II (CS FT II) 5.5 mm (without augmentation as used routinely). The mean failure loads for both SOP and osteopenic PU foam blocks, respectively, were as follows: CS, 16.2 and 212.4 N; CS with TCP, 75.2 and 396 N; CS with PMMA, 101.2 and 528.8 N; CS FT II, 13.8 and 339.8 N. Augmentation of CS with TCP or PMMA would be essential to SOP bones. In the osteopenic bone model, although anchor fixation augmented with PMMA is the best fixation method, CS augmented with TCP cement or CS FT II without any need for augmentation may also be used as an alternative.

Biomechanical in vitro assessment of screw augmentation in locked plating of proximal humerus fractures.

PubMed

Röderer, Götz; Scola, Alexander; Schmölz, Werner; Gebhard, Florian; Windolf, Markus; Hofmann-Fliri, Ladina

2013-10-01

Proximal humerus fracture fixation can be difficult because of osteoporosis making it difficult to achieve stable implant anchorage in the weak bone stock even when using locking plates. This may cause implant failure requiring revision surgery. Cement augmentation has, in principle, been shown to improve stability. The aim of this study was to investigate whether augmentation of particular screws of a locking plate aimed at a region of low bone quality is effective in improving stability in a proximal humerus fracture model. Twelve paired human humerus specimens were included. Quantitative computed tomography was performed to determine bone mineral density (BMD). Local bone quality in the direction of the six proximal screws of a standard locking plate (PHILOS, Synthes) was assessed using mechanical means (DensiProbe™). A three-part fracture model with a metaphyseal defect was simulated and fixed with the plate. Within each pair of humeri the two screws aimed at the region of the lowest bone quality according to the DensiProbe™ were augmented in a randomised manner. For augmentation, 0.5 ml of bone cement was injected in a screw with multiple outlets at its tip under fluoroscopic control. A cyclic varus-bending test with increasing upper load magnitude was performed until failure of the screw-bone fixation. The augmented group withstood significantly more load cycles. The correlation of BMD with load cycles until failure and BMD with paired difference in load cycles to failure showed that augmentation could compensate for a low BMD. The results demonstrate that augmentation of screws in locked plating in a proximal humerus fracture model is effective in improving primary stability in a cyclic varus-bending test. The augmentation of two particular screws aimed at a region of low bone quality within the humeral head was almost as effective as four screws with twice the amount of bone cement. Screw augmentation combined with a knowledge of the local bone quality could be more effective in enhancing the primary stability of a proximal humerus locking plate because the effect of augmentation can be exploited more effectively limiting it to the degree required. Copyright © 2013 Elsevier Ltd. All rights reserved.

Cement augmentation of the Proximal Femoral Nail Antirotation (PFNA) - A multicentre randomized controlled trial.

PubMed

Kammerlander, Christian; Hem, Einar S; Klopfer, Tim; Gebhard, Florian; Sermon, An; Dietrich, Michael; Bach, Olaf; Weil, Yoram; Babst, Reto; Blauth, Michael

2018-04-22

New implant designs like the Proximal Femoral Nail Antirotation (PFNA) were developed to reduce failure rates in unstable pertrochanteric fractures in the elderly. Standardized implant augmentation with up to 6 mL of polymethylmethacrylate (PMMA) cement has been introduced to enhance implant anchorage by increasing the implant-bone interface in osteoporotic bone conditions. Biomechanically, loads to failure were significantly higher with augmentation. The primary objective of this study was to compare the mobility of patients with closed unstable trochanteric fractures treated by PFNA either with or without cement augmentation. A prospective multicentre, randomized, patient-blinded trial was conducted with ambulatory patients aged 75 or older who sustained a closed, unstable trochanteric fracture. Surgical fixation had to be performed within 72 h after admission. Outcomes were evaluated at baseline, during surgery, 3 to 14 days after surgery, 3 months, 6 months, and 12 months after surgery. To evaluate the primary objective, patients' walking speed was assessed by the Timed Up and Go (TUG) test. Secondary objectives included the analysis of implant migration assessed on radiographs, quality of life measured by the Barthel Index, mobility measured by the Parker Mobility Score, and complications. Of 253 randomized patients, 223 patients were eligible: 105 patients were allocated to the PFNA Augmentation group and 118 to PFNA group. At 3 to 14 days after surgery, there was no statistical significant difference in mean walking speed between the treatment groups. For the secondary objectives, also no statistical significant differences were found. However, no patient in the PFNA Augmentation group had a reoperation due to mechanical failure or symptomatic implant migration compared to 6 patients in the PFNA group. Augmentation of the PFNA blade did not improve patients' walking ability compared to the use of a non-augmented PFNA but might have the potential to prevent reoperations by strengthening the osteosynthesis construct. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Results of press-fit stems in revision knee arthroplasties.

PubMed

Wood, Gavin C; Naudie, Douglas D R; MacDonald, Steven J; McCalden, Richard W; Bourne, Robert B

2009-03-01

The ideal method of stem fixation in revision knee arthroplasty is controversial with advantages and disadvantages for cemented and press-fit designs. Studies have suggested cemented revision knee stems may provide better long-term survival. The aim of this study was to report our experience with press-fit uncemented stems and metaphyseal cement fixation in a selected series of patients undergoing revision total knee arthroplasty. One hundred twenty-seven patients (135 knees) who underwent revision total knee arthroplasty using a press-fit technique (press-fit diaphyseal fixation and cemented metaphyseal fixation) were reviewed. Minimum followup was 2 years (mean, 5 years; range, 2-12 years). A Kaplan-Meier survivorship analysis using an end point of revision surgery or radiographic loosening was used to determine probability of survival at 5 and 10 years. Of the 127 patients (135 knees), 31 patients (36 knees) died and two patients (two knees) were lost to followup. Six patients (six knees) had revisions at a mean of 3.5 years (range, 1-8 years). Kaplan-Meier survivorship analysis revealed a probability of survival free of revision for aseptic loosening of 98% at 12 years. Survivorship of press-fit stems for revision knee arthroplasty is comparable to reported survivorship of cemented stem revision knee arthroplasty. Radiographic analysis has shown continued satisfactory appearances regardless of constraint, stem size, and augmentations.

Suture anchor fixation strength with or without augmentation in osteopenic and severely osteoporotic bones in rotator cuff repair: a biomechanical study on polyurethane foam model

PubMed Central

2014-01-01

Background The purpose of the present study was to compare the results of various types of anchor applications with or without augmentation in both osteopenic and severely osteoporotic bone models. Methods Two different types of suture anchors were tested in severely osteoporotic (SOP) and osteopenic polyurethane (PU) foam blocks using an established protocol. An Instron machine applied static loading parallel to the axis of insertion until failure, and the mean anchor failure strengths were calculated. The mode of failure (anchor pullout, suture tear) was recorded. The anchors tested included the Corkscrew® (CS) (Arthrex Inc., Naples, FL, USA) (without augmentation, polymethylmethacrylate (PMMA)-augmented, and bioabsorbable tricalcium phosphate (TCP) cement-augmented) and Corkscrew® FT II (CS FT II) 5.5 mm (without augmentation as used routinely). Results The mean failure loads for both SOP and osteopenic PU foam blocks, respectively, were as follows: CS, 16.2 and 212.4 N; CS with TCP, 75.2 and 396 N; CS with PMMA, 101.2 and 528.8 N; CS FT II, 13.8 and 339.8 N. Conclusions Augmentation of CS with TCP or PMMA would be essential to SOP bones. In the osteopenic bone model, although anchor fixation augmented with PMMA is the best fixation method, CS augmented with TCP cement or CS FT II without any need for augmentation may also be used as an alternative. PMID:25148925

[Traumatology in the elderly : Multimodal prevention of delirium and use of augmentation techniques].

PubMed

Wähnert, D; Roos, A; Glasbrenner, J; Ilting-Reuke, K; Ohrmann, P; Hempel, G; Duning, T; Roeder, N; Raschke, M J

2017-02-01

Recent data show that 20-80% of surgery patients are affected by delirium during inpatient clinical treatment. The medical consequences are often dramatic and include a 20 times higher mortality and treatment expenses of the medical unit increase considerably. At the University Hospital of Münster a multimodal and interdisciplinary concept for prevention and management of delirium was developed: all patients older than 65 years admitted for surgery are screened by a specialized team for the risk of developing delirium and treated by members of the team if there is a risk of delirium. Studies proved that by this multimodal approach the incidence of delirium was lowered and therefore the quality of medical care improved.When surgical treatment of fractures in the elderly is required, limited bone quality as well as pre-existing implants can complicate the procedure. Secondary loss of reduction after osteosynthesis and avulsion of the implant in particular must be prevented. Augmentation of the osteosynthetic implant with bone cement can increase the bone-implant interface and therefore stability can be improved. Additional intraoperative 3D imaging can be necessary depending on the localization of the fracture. In biomechanical studies we could prove greater stability in the osteosynthesis of osteoporotic fractures of the distal femur when using additional bone cement; therefore, the use of bone cement is an important tool, which helps to prevent complications in the surgical treatment of fractures in the elderly. Nevertheless, special implants and technical skills are required and some safety aspects should be considered.

Composite time-lapse computed tomography and micro finite element simulations: A new imaging approach for characterizing cement flows and mechanical benefits of vertebroplasty.

PubMed

Stadelmann, Vincent A; Zderic, Ivan; Baur, Annick; Unholz, Cynthia; Eberli, Ursula; Gueorguiev, Boyko

2016-02-01

Vertebroplasty has been shown to reinforce weak vertebral bodies and reduce fracture risks, yet cement leakage is a major problem that can cause severe complications. Since cement flow is nearly impossible to control during surgery, small volumes of cement are injected, but then mechanical benefits might be limited. A better understanding of cement flows within bone structure is required to further optimize vertebroplasty and bone augmentation in general. We developed a novel imaging method, composite time-lapse CT, to characterize cement flow during injection. In brief, composite-resolution time-lapse CT exploits the qualities of microCT and clinical CT. The method consists in overlaying low-resolution time-lapse CT scans acquired during injection onto pre-operative high-resolution microCT scans, generating composite-resolution time-lapse CT series of cement flow within bone. In this in vitro study, composite-resolution time-lapse CT was applied to eight intact and five artificially fractured cadaveric vertebrae during vertebroplasty. The time-lapse scans were acquired at one-milliliter cement injection steps until a total of 10 ml cement was injected. The composite-resolution series were then converted into micro finite element models to compute strains distribution under virtual axial loading. Relocation of strain energy density within bone structure was observed throughout the progression of the procedure. Interestingly, the normalized effect of cement injection on the overall stiffness of the vertebrae was similar between intact and fractured specimens, although at different orders of magnitude. In conclusion, composite time-lapse CT can picture cement flows during bone augmentation. The composite images can also be easily converted into finite element models to compute virtual strain distributions under loading at every step of an injection, providing deeper understanding on the biomechanics of vertebroplasty. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

Height restoration and maintenance after treating unstable osteoporotic vertebral compression fractures by cement augmentation is dependent on the cement volume used.

PubMed

Krüger, Antonio; Baroud, Gamal; Noriega, David; Figiel, Jens; Dorschel, Christine; Ruchholtz, Steffen; Oberkircher, Ludwig

2013-08-01

Two different procedures, used for percutaneous augmentation of vertebral compression fractures were compared, with respect to height restoration and maintenance after cyclic loading. Additionally the impact of the cement volume used was investigated. Wedge compression fractures were created in 36 human cadavaric vertebrae (T10-L3). Twenty-seven vertebrae were treated with the SpineJack® with different cement volumes (maximum, intermediate, and no cement), and 9 vertebrae were treated with Balloon Kyphoplasty. Vertebral heights were measured pre- and postfracture as well as after treatment and loading. Cyclic loading was performed with 10,000cycles (1Hz, 100-600N). The average anterior height after restoration was 85.56% for Kyphoplasty; 96.20% for SpineJack® no cement; 93.44% for SpineJack® maximum and 96% for the SpineJack® intermediate group. The average central height after restoration was 93.89% for Kyphoplasty; 100.20% for SpineJack® no cement; 99.56% for SpineJack® maximum and 101.13% for the SpineJack® intermediate group. The average anterior height after cyclic loading was 85.33 % for Kyphoplasty; 87.30% in the SpineJack® no cement, 92% in the SpineJack® maximum and 87% in the SpineJack® intermediate group. The average central height after cyclic loading was 92% for Kyphoplasty; 93.80% in the SpineJack® no cement; 98.56% in the SpineJack® maximum and 94.25% in the SpineJack® intermediate group. Height restoration was significantly better for the SpineJack® group compared to Kyphoplasty. Height maintenance was dependent on the cement volume used. The group with the SpineJack® without cement nevertheless showed better results in height maintenance, yet the statistical significance could not be demonstrated. Copyright © 2013 Elsevier Ltd. All rights reserved.

Percutaneous osteoplasty with a bone marrow nail for fractures of long bones: experimental study.

PubMed

Nakata, Kouhei; Kawai, Nobuyuki; Sato, Morio; Cao, Guang; Sahara, Shinya; Tanihata, Hirohiko; Takasaka, Isao; Minamiguchi, Hiroyuki; Nakai, Tomoki

2010-09-01

To develop percutaneous osteoplasty with the use of a bone marrow nail for fixation of long-bone fractures, and to evaluate its feasibility and safety in vivo and in vitro. Six long bones in three healthy swine were used in the in vivo study. Acrylic cement was injected through an 11-gauge bone biopsy needle and a catheter into a covered metallic stent placed within the long bone, creating a bone marrow nail. In the in vitro study, we determined the bending, tug, and compression strengths of the acrylic cement nails 9 cm long and 8 mm in diameter (N = 10). The bending strength of the artificially fractured bones (N = 6) restored with the bone marrow nail and cement augmentation was then compared with that of normal long bones (N = 6). Percutaneous osteoplasty with a bone marrow nail was successfully achieved within 1 hour for all swine. After osteoplasty, all swine regained the ability to run until they were euthanized. Blood tests and pathologic findings showed no adverse effects. The mean bending, tug, and compression strengths of the nail were 91.4 N/mm(2) (range, 75.0-114.1 N/mm(2)), 20.9 N/mm(2) (range, 6.6-30.4 N/mm(2)), and 103.0 N/mm(2) (range, 96.3-110.0 N/mm(2)), respectively. The bending strength ratio of artificially fractured bones restored with bone marrow nail and cement augmentation to normal long bone was 0.32. Percutaneous osteoplasty with use of a bone marrow nail and cement augmentation appears to have potential in treating fractures of non-weight-bearing long bones. Copyright 2010 SIR. Published by Elsevier Inc. All rights reserved.

Less invasive reduction and fusion of fresh A2 and A 3 traumatic L 1-L 4 fractures with a novel vertebral body augmentation implant and short pedicle screw fixation and fusion.

PubMed

Korovessis, Panagiotis; Vardakastanis, Konstantinos; Repantis, Thomas; Vitsas, Vasilios

2014-04-01

The aim of this clinical study was to report on the efficacy in reduction and safety in PMMA leakage of a novel vertebral augmentation technique with PEEK and PMMA, together with pedicle screws in the treatment of fresh vertebral fractures in young adults. Twenty consecutive young adults aged 45 ± 11 years with fresh burst A3/AO or severely compressed A2/AO fractures underwent via a less invasive posterior approach one-staged reduction with a novel augmentation implant and PMMA plus 3-vertebrae pedicle screw fixation and fusion. Radiologic parameters as segmental kyphosis (SKA), anterior (AVBHr) and posterior vertebral body height ratio (PVBHr), spinal canal encroachment (SCE), cement leakage and functional parameters as VAS, SF-36 were measured pre- and post-operatively. Hybrid construct restored AVBHr (P < 0.000), PVBHr (P = 0.02), SKA (P = 0.015), SCE (P = 0.002) without loss of correction at an average follow-up of 17 months. PMMA leakage occurred in 3 patients (3 vertebrae) either anteriorly to the fractured vertebral body or to the adjacent disc, but in no case to the spinal canal. Two pedicle screws were malpositioned (one medially, one laterally to the pedicle at the fracture level) without neurologic sequelae. Solid posterolateral spinal fusion occurred 8-10 months post-operatively. Pre-operative VAS and SF-36 scores improved post-operatively significantly. This study showed that this novel vertebral augmentation technique using PEEK implant and PMMA reduces and stabilizes via less invasive technique A2 and A3 vertebral fractures without loss of correction and leakage to the spinal canal.

Effects of a cementing technique in addition to luting agent on the uniaxial retention force of a single-tooth implant-supported restoration: an in vitro study.

PubMed

Santosa, Robert E; Martin, William; Morton, Dean

2010-01-01

Excess residual cement around the implant margin has been shown to be detrimental to the peri-implant tissue. This in vitro study examines the retentive strengths of two different cementing techniques and two different luting agents on a machined titanium abutment and solid screw implants. The amount of reduction of excess cement weight between the two cementation techniques was assessed. Forty gold castings were fabricated for 4.1 mm in diameter and 10 mm in length solid-screw dental implants paired with 5.5-mm machined titanium abutments. Twenty implants received a provisional cement, and 20 implants received a definitive cement. Each group was further divided into two groups. In the control group, cement was applied and the castings seated over the implant-abutment assembly. The excess cement was then removed. In the study group, a "practice abutment" was used to express excess cement prior to cementation. The weight of the implant-casting assembly was measured and the residual weight of cement was calculated. The samples were then stored for 24 hours at 100% humidity prior to tensile strength testing. Statistical analysis revealed significant differences in tensile strength across the groups. Further Tukey tests showed no significant difference in tensile strength between the practice abutment technique and the conventional technique for both definitive and provisional cements. There was a significant reduction in residual cement weight, irrespective of the type of cement, when the practice abutment was used prior to cementation. Cementation of implant restorations on a machined abutment using the practice abutment technique and definitive cement may provide similar uniaxial retention force and significantly reduced residual cement weight compared to the conventional technique of cement removal.

PMMA embolization to the left dorsal foot artery during percutaneous vertebroplasty for spinal metastases.

PubMed

Iliopoulos, Panagiotis; Panagiotis, Iliopoulos; Korovessis, Panagiotis; Panagiotis, Korovessis; Vitsas, Vasilios; Vasilios, Vitsas

2014-05-01

Distal arterial embolization to the foot with PMMA during vertebral augmentation has not been previously reported. We report a rare case of distal PMMA embolization to the dorsal foot artery during ipsilateral percutaneous lumbar vertebral augmentation in a patient with spinal osteolytic metastases. A 68-year-old woman was admitted because of severe disabling low back pain. Plain roentgenograms, MRI and CT-scan revealed osteolysis in the L4 and L5 vertebral bodies with prevertebral soft tissue involvement. Percutaneous vertebroplasty with PMMA was performed in L2 to L5 vertebrae under general anesthesia. Intraoperatively, leakage into the segmental vessels L3 and L5 was observed. Four hours after the procedure the clinical diagnosis of acute ischemia and drop foot on the left was made. CT-angiography justified linear cement leakage in the course of the left third lumbar vein and fifth lumbar artery, and to the ipsilateral common iliac artery. The patient was treated with low molecular heparin and the ischemia resolved without further sequelae 1 week postoperatively. PMMA leakage is a complication associated with vertebroplasty and kyphoplasty. Although the outcome of the PMMA embolization to the vessels resolved without sequelae, in our case spine surgeons and interventional radiologists should be aware on this rare complication in patients with osteolytic vertebral metastases even when contemporary cement containment techniques are used.

[Is height restoration possible with a comparatively smaller amount of cement in radiofrequency kyphoplasty using a monopedicle approach?].

PubMed

Röllinghoff, M; Hagel, A; Siewe, J; Gutteck, N; Delank, K-S; Steinmetz, A; Zarghooni, K

2013-04-01

Percutaneous cement augmentation systems have been proven to be an effective treatment for vertebral compression fractures in the last 10 years. A special form available since 2009 is the radiofrequency kyphoplasty (RF) in which the applied energy raises the viscosity of the cement. The aim of this study is to find out if a smaller cement amount in radiofrequency kyphoplasty can also restore vertebral body height in osteoporotic vertebral compression fractures. The treatment was minimally invasive using the StabiliT® vertebral augmentation system by DFine. In a retrospective study from 2011 to January 2012, 35 patients underwent RF kyphoplasty for 49 fresh osteoporotic vertebral compression fractures. From the clinical side the parameters, demographics and pain relief using a visual analogue scale (VAS: 0 to 100 mm) were collected. For the radiological outcome the vertebral body height (anterior, mean and posterior vertebral body height with kyphosis angle) after surgery and after three months was measured and compared to the cement volume. All patients still had permanent pain on the fractured level after conservative treatment. The time from initial painful fracture to treatment was 3.0 weeks ± 1.3. Average visual analogue scale results decreased significantly from 71 ± 9.2 preoperatively to 35 ± 6.2 postoperatively (p < 0.001) and to 30 ± 5.7 (p < 0.001) after three months. With a mean cement volume in the thoracic spine of 2.9 ± 0.7 ml (1.8-4.1) and lumbar spine of 3.0 ± 0.7 ml (2.0-5.0) we had a significant vertebral body height restoration. Anterior and mean vertebral body heights significantly increased by an average of 2.3 and 3.1 mm, kyphosis angle significantly decreased with an average of 2.1° at three-month follow-up (p < 0.05). In two vertebrae (4.1 %) a minimal asymptomatic cement leakage occurred into the upper disc. In two patients (5.7 %) we had new fractures in the directly adjacent segment that were also successfully treated with radiofrequency kyphoplasty. With a mean cement volume of 3.0 ml radiofrequency kyphoplasty achieves rapid and short-term improvements of clinical symptoms with a significant restoration of vertebral body height. There was no correlation between restoration of vertebral body height and pain relief. With a cement leakage of 4.1 % RF kyphoplasty is a safe and effective minimally invasive percutaneous cement augmentation procedure. Our data confirm the higher safety described in literature for kyphoplasty in contrast to vertebroplasty. Georg Thieme Verlag KG Stuttgart · New York.

Temperature evaluation during PMMA screw augmentation in osteoporotic bone--an in vitro study about the risk of thermal necrosis in human femoral heads.

PubMed

Boner, Vanessa; Kuhn, Philipp; Mendel, Thomas; Gisep, Armando

2009-08-01

The use of polymethylmethacrylate (PMMA) bone cement to augment hip screws reduces cut-out risk but is associated with an exothermic reaction. This in vitro investigation evaluated the risk of thermal necrosis when augmenting the implant purchase with PMMA. A pilot study analyzed the effects of different PMMA layer thicknesses on temperatures around an implant. The main study used either 3.0 or 6.0 cc PMMA for hip screw augmentation in human femoral heads. The risk of thermal necrosis was estimated according to critical values reported in literature. Highest temperatures were measured inside the PMMA with a significant drop of average maximum temperatures from the center of the PMMA to the PMMA/bone interface. Risk of thermal necrosis exists with PMMA layer thicknesses greater than 5.0 mm. In the main study, we found no risk of thermal necrosis at the PMMA/bone interface or in the surrounding bone, neither with 3.0 nor 6.0 cc PMMA. The results of the two studies were consistent regarding average peak temperatures related to associated cement layer thicknesses. The results of this in vitro study reduce objections concerning the risk of thermal necrosis when augmenting cancellous bone around hip screws with up to 6.0 cc PMMA.

Bone preserving techniques for explanting the well-fixed cemented acetabular component.

PubMed

Stevens, Jarrad; Macpherson, Gavin; Howie, Colin

2018-06-01

Removal of a well-fixed, cemented acetabular component at the time of revision hip surgery can be complex. It is essential to remove the implant and cement mantle in a timely fashion while preserving bone stock and osseous integrity. The biomechanical properties of polymethylmethacrylate cement and polyethylene can be utilised to aid with the removal of well cemented implants which are often harder than the surrounding bone. While removal of loose components may be relatively straightforward, the challenge for the revision arthroplasty surgeon often involves the removal of well-fixed implants. Here, we present three established techniques for the removal of a well-fixed cemented acetabular component and one novel modification we have described before. We collate and review four techniques for removing well-fixed cemented acetabular implants that utilise the different biomechanical properties of bone cement and polyethylene. These techniques are illustrated with a photographic series utilising saw bones. A step-by-step approach to our new technique is shown in photographs, both in the clinical setting and with a "Sawbone". This is accompanied by a clinical video that details the surgical technique in its entirety. These techniques utilise different biomechanical principles to extract the acetabular component. Each technique has advantages and disadvantages. Our new technique is a simplification of a previously published extraction manoeuvre that utilises tensile force between cement and the implant to remove the polyethylene cup. This is a safe and reproducible technique in patients with a well-fixed cemented acetabular implant. Understanding the biomechanical properties of polymethylmethacrylate bone cement and polyethylene can aid in the safe removal of a well-fixed cemented acetabular component in revision hip surgery. The optimal technique for removal of a cemented acetabular component varies depending on a number of patient and implant factors. This summary of the available techniques will be of interest to revision arthroplasty surgeons.

Operative treatment of 2-part surgical neck fractures of the proximal humerus (AO 11-A3) in the elderly: Cement augmented locking plate Philos™ vs. proximal humerus nail MultiLoc®.

PubMed

Helfen, Tobias; Siebenbürger, Georg; Mayer, Marcel; Böcker, Wolfgang; Ockert, Ben; Haasters, Florian

2016-10-28

Proximal humeral fractures are with an incidence of 4-5 % the third most common fractures in the elderly. In 20 % of humeral fractures there is an indication for surgical treatment according to the modified Neer-Criteria. A secondary varus dislocation of the head fragment and cutting-out are the most common complications of angle stable locking plates in AO11-A3 fractures of the elderly. One possibility to increase the stability of the screw-bone-interface is the cement augmentation of the screw tips. A second is the use of a multiplanar angle stablentramedullary nail that might provide better biomechanical properties after fixation of 2-part-fractures. A comparison of these two treatment options augmented locking plate versus multiplanar angle stable locking nail in 2-part surgical neck fractures of the proximal humerus has not been carried out up to now. Forty patients (female/male, ≥60 years or female postmenopausal) with a 2-part-fracture of the proximal humerus (AO type 11-A3) will be randomized to either to augmented plate fixation group (PhilosAugment) or to multiplanar intramedullary nail group (MultiLoc). Outcome parameters are Disabilities of the Shoulder, Arm and Hand-Score (DASH) Constant Score (CS), American Shoulder and Elbow Score (ASES), Oxford Shoulder Score (OSS), Range of motion (ROM) and Short Form 36 (SF-36) after 3 weeks, 6 weeks, 3 months, 6 months, 12 and 24 months. Because of the lack of clinical studies that compare cement augmented locking plates with multiplanar humeral nail systems after 2-part surgical neck fractures of the proximal humerus, the decision of surgical method currently depends only on surgeons preference. Because only a randomized clinical trial (RCT) can sufficiently answer the question if one treatment option provides advantages compared to the other method we are planning to perform a RCT. Clinical Trial ( NCT02609906 ), November 18, 2015, registered retrospectively.

Subsequent Vertebral Fractures Post Cement Augmentation of the Thoracolumbar Spine: Does it Correlate With Level-specific Bone Mineral Density Scores?

PubMed

Hey, Hwee Weng Dennis; Hwee Weng, Dennis Hey; Tan, Jun Hao; Jun, Hao Tan; Tan, Chuen Seng; Chuen, Seng Tan; Tan, Hsi Ming Bryan; Ming, Bryan Tan Hsi; Lau, Puang Huh Bernard; Huh, Bernard Lau Puang; Hee, Hwan Tak; Hwan, Tak Hee

2015-12-01

A case-control study. In this study, we investigated the correlation between level-specific preoperative bone mineral density and subsequent vertebral fractures. We also identified factors associated with subsequent vertebral fractures. Complications of cement augmentation of the spine include subsequent vertebral fractures, leading to unnecessary morbidity and more treatment. Ability to predict at-risk vertebra will help guide management. We studied all patients with osteoporotic compression fractures who underwent cement augmentation in a single institution from November 2001 to December 2010 by a single surgeon. Association between level-specific bone mineral density T-scores and subsequent fractures was assessed. Multivariable analysis was performed to identify significant factors associated with subsequent vertebral fractures. 93 patients followed up for a mean duration of 25.1 months (12-96) had a mean age of 76.8 years (47-99). Vertebroplasty was performed in 58 patients (62.4%) on 68 levels and kyphoplasty in 35 patients (37.6%) on 44 levels. Refracture was seen in 16 patients (17.2%). The time to subsequent fracture post cement augmentation was 20.5 months (2-90). For refracture cases, 43.8% (7/16) fractured in the adjacent vertebrae. Subsequently fractured vertebra had a mean T-score of -2.860 (95% confidence interval -3.268 to -2.452) and nonfractured vertebra had a mean T-score of -2.180 (95% confidence interval -2.373 to -1.986). A T-score of -2.2 or lower is predictive of refracture at that vertebra (P = 0.047). Odds ratio increases with decreasing T-scores from -2.2 or lower to -2.6 or lower. A T-score of -2.6 or lower gives no additional predictive advantage. After multivariable analysis, age (P = 0.049) and loss of preoperative anterior vertebral height (P = 0.017) are associated with refracture. Level-specific T-scores are predictive of subsequent fractures and the odds ratio increases with lower T-scores from -2.2 or less to -2.6 or less. They have a low positive predictive value, but a high negative predictive value for subsequent fractures. Other significant associations with subsequent refractures include age and anterior vertebral height. 4.

[Significance of bone mineral density and modern cementing technique for in vitro cement penetration in total shoulder arthroplasty].

PubMed

Pape, G; Raiss, P; Kleinschmidt, K; Schuld, C; Mohr, G; Loew, M; Rickert, M

2010-12-01

Loosening of the glenoid component is one of the major causes of failure in total shoulder arthroplasty. Possible risk factors for loosening of cemented components include an eccentric loading, poor bone quality, inadequate cementing technique and insufficient cement penetration. The application of a modern cementing technique has become an established procedure in total hip arthroplasty. The goal of modern cementing techniques in general is to improve the cement-penetration into the cancellous bone. Modern cementing techniques include the cement vacuum-mixing technique, retrograde filling of the cement under pressurisation and the use of a pulsatile lavage system. The main purpose of this study was to analyse cement penetration into the glenoid bone by using modern cement techniques and to investigate the relationship between the bone mineral density (BMD) and the cement penetration. Furthermore we measured the temperature at the glenoid surface before and after jet-lavage of different patients during total shoulder arthroplasty. It is known that the surrounding temperature of the bone has an effect on the polymerisation of the cement. Data from this experiment provide the temperature setting for the in-vitro study. The glenoid surface temperature was measured in 10 patients with a hand-held non-contact temperature measurement device. The bone mineral density was measured by DEXA. Eight paired cadaver scapulae were allocated (n = 16). Each pair comprised two scapulae from one donor (matched-pair design). Two different glenoid components were used, one with pegs and the other with a keel. The glenoids for the in-vitro study were prepared with the bone compaction technique by the same surgeon in all cases. Pulsatile lavage was used to clean the glenoid of blood and bone fragments. Low viscosity bone cement was applied retrogradely into the glenoid by using a syringe. A constant pressure was applied with a modified force sensor impactor. Micro-computed tomography scans were applied to analyse the cement penetration into the cancellous bone. The mean temperature during the in-vivo arthroplasty of the glenoid was 29.4 °C (27.2-31 °C) before and 26.2 °C (25-27.5 °C) after jet-lavage. The overall peak BMD was 0.59 (range 0.33-0.99) g/cm (2). Mean cement penetration was 107.9 (range 67.6-142.3) mm (2) in the peg group and 128.3 (range 102.6-170.8) mm (2) in the keel group. The thickness of the cement layer varied from 0 to 2.1 mm in the pegged group and from 0 to 2.4 mm in the keeled group. A strong negative correlation between BMD and mean cement penetration was found for the peg group (r (2) = -0.834; p < 0.01) and for the keel group (r (2) = -0.727; p < 0.041). Micro-CT shows an inhomogenous dispersion of the cement into the cancellous bone. Data from the in-vivo temperature measurement indicate that the temperature at the glenohumeral surface under operation differs from the body core temperature and should be considered in further in-vitro studies with human specimens. Bone mineral density is negatively correlated to cement penetration in the glenoid. The application of a modern cementing technique in the glenoid provides sufficient cementing penetration although there is an inhomogenous dispersion of the cement. The findings of this study should be considered in further discussions about cementing technique and cement penetration into the cancellous bone of the glenoid. © Georg Thieme Verlag KG Stuttgart · New York.

Effect of different mixing methods on the physical properties of Portland cement.

PubMed

Shahi, Shahriar; Ghasemi, Negin; Rahimi, Saeed; Yavari, Hamidreza; Samiei, Mohammad; Jafari, Farnaz

2016-12-01

The Portland cement is hydrophilic cement; as a result, the powder-to-liquid ratio affects the properties of the final mix. In addition, the mixing technique affects hydration. The aim of this study was to evaluate the effect of different mixing techniques (conventional, amalgamator and ultrasonic) on some selective physical properties of Portland cement. The physical properties to be evaluated were determined using the ISO 6786:2001 specification. One hundred sixty two samples of Portland cement were prepared for three mixing techniques for each physical property (each 6 samples). Data were analyzed using descriptive statistics, one-way ANOVA and post hoc Tukey tests. Statistical significance was set at P <0.05. The mixing technique had no significant effect on the compressive strength, film thickness and flow of Portland cement ( P >0.05). Dimensional changes (shrinkage), solubility and pH increased significantly by amalgamator and ultrasonic mixing techniques ( P <0.05). The ultrasonic technique significantly decreased working time, and the amalgamator and ultrasonic techniques significantly decreased the setting time ( P <0.05). The mixing technique exerted no significant effect on the flow, film thickness and compressive strength of Portland cement samples. Key words: Physical properties, Portland cement, mixing methods.

Salvage Percutaneous Vertebral Augmentation Using Polymethyl Methacrylate in Patients with Failed Interbody Fusion.

PubMed

Yun, Dong-Ju; Hwang, Byeong-Wook; Oh, Hyeong-Seok; Kim, Jin-Sung; Jeon, Sang-Hyeop; Lee, Sang-Ho

2016-11-01

Percutaneous vertebral augmentation with cement is used as a salvage procedure for failed instrumentation. Few studies have reported the use of this procedure for failed anterior lumbar fusion in elderly patients with osteoporosis and other complicated diseases who have undergone a previous major operation. Between January 2007 and December 2015, the clinical and radiographic results of 8 patients with osteoporosis who showed subsidence and migration of the implant after an initial operation were examined. After the development of implant failure, the patients underwent vertebral augmentation with polymethyl methacrylate. Mean patient age was 73.4 years (range, 67-78 years), and mean bone mineral density was -2.96 (range, -2.1 to -3.8). The mean radiologic follow-up period between augmentation and the last follow-up examination was 16 months (range, 3-38 months). Although the subjective clinical outcome was not satisfying to the patients, no loss of correction, fractures, or screw loosening occurred during the follow-up period. The injection of cement around the instrument might help to stabilize it by providing strength to the axis and preventing further loosening. This salvage procedure could be an alternative in the management of cases with failed interbody fusion. Copyright © 2016 Elsevier Inc. All rights reserved.

The Use of Structural Allograft in Primary and Revision Knee Arthroplasty with Bone Loss

PubMed Central

Kuchinad, Raul A.; Garbedian, Shawn; Rogers, Benedict A.; Backstein, David; Safir, Oleg; Gross, Allan E.

2011-01-01

Bone loss around the knee in the setting of total knee arthroplasty remains a difficult and challenging problem for orthopaedic surgeons. There are a number of options for dealing with smaller and contained bone loss; however, massive segmental bone loss has fewer options. Small, contained defects can be treated with cement, morselized autograft/allograft or metal augments. Segmental bone loss cannot be dealt with through simple addition of cement, morselized autograft/allograft, or metal augments. For younger or higher demand patients, the use of allograft is a good option as it provides a durable construct with high rates of union while restoring bone stock for future revisions. Older patients, or those who are low demand, may be better candidates for a tumour prosthesis, which provides immediate ability to weight bear and mobilize. PMID:21991418

Bone Graft Substitute Provides Metaphyseal Fixation for a Stemless Humeral Implant.

PubMed

Kim, Myung-Sun; Kovacevic, David; Milks, Ryan A; Jun, Bong-Jae; Rodriguez, Eric; DeLozier, Katherine R; Derwin, Kathleen A; Iannotti, Joseph P

2015-07-01

Stemless humeral fixation has become an alternative to traditional total shoulder arthroplasty, but metaphyseal fixation may be compromised by the quality of the trabecular bone that diminishes with age and disease, and augmentation of the fixation may be desirable. The authors hypothesized that a bone graft substitute (BGS) could achieve initial fixation comparable to polymethylmethacrylate (PMMA) bone cement. Fifteen fresh-frozen human male humerii were randomly implanted using a stemless humeral prosthesis, and metaphyseal fixation was augmented with either high-viscosity PMMA bone cement (PMMA group) or a magnesium-based injectable BGS (OsteoCrete; Bone Solutions Inc, Dallas, Texas) (OC group). Both groups were compared with a control group with no augmentation. Initial stiffness, failure load, failure displacement, failure cycle, and total work were compared among groups. The PMMA and OC groups showed markedly higher failure loads, failure displacements, and failure cycles than the control group (P<.01). There were no statistically significant differences in initial stiffness, failure load, failure displacement, failure cycle, or total work between the PMMA and OC groups. The biomechanical properties of magnesium-based BGS fixation compared favorably with PMMA bone cement in the fixation of stemless humeral prostheses and may provide sufficient initial fixation for this clinical application. Future work will investigate the long-term remodeling characteristics and bone quality at the prosthetic-bone interface in an in vivo model to evaluate the clinical efficacy of this approach. Copyright 2015, SLACK Incorporated.

Can we improve fixation and outcomes? Use of bone substitutes.

PubMed

Moroni, Antonio; Larsson, Sune; Hoang Kim, Amy; Gelsomini, Letizia; Giannoudis, Peter V

2009-07-01

Hip fractures secondary to osteoporosis are common in the elderly. Stabilizing these fractures until union is achieved is a challenge due to poor bone stock and insufficient purchase of the implant to the bone. The reported high rate of complications has prompted extensive research in the development of fixation techniques. Furthermore, manipulation of both the local fracture environment in terms of application of growth factors, scaffolds, and mesenchymal cells and the systemic administration of agents promoting bone formation and bone strength has been considered as a treatment option with promising results. There are only a few evidence-based studies reporting on fixation augmentation techniques. This article reports on the efficacy of bone graft substitutes for the fixation of hip fractures, in particular calcium phosphates, which have been used as granules, cements, and implant coatings.

Evaluation of effectiveness of cement removal from implant-retained crowns using a proposed circular crisscross flossing technique.

PubMed

Ferreira, Cimara Fortes; Shafter, Mohamed Amer; Jain, Vinay; Wicks, Russel Anthony; Linder, Erno; Ledo, Carlos Alberto da Silva

2018-02-13

Extruded cement during dental implant crown cementation may cause peri-implant diseases if not removed adequately. Evaluate the efficiency of removal of cement after cementation of implant crowns using an experimental "circular crisscross flossing technique (CCCFT) flossing technique, compared to the conventional "C" shape flossing technique (CSFT). Twenty-four patients rendered 29 experimental and 29 control crowns. Prefabricated abutments were secured to the implant with the margins at least 1 mm subgingivally. The abutments were scanned using CADCAM technology and Emax crowns were fabricated in duplicates. Each crown was cemented separately and excess cement was removed using the CSFT and the CCFT techniques. After completion of cementation was completed, the screw access holes were accessed and the crown was unscrewed along with the abutment. The samples were disinfected using 70% ethanol for 10 minutes. Crowns were divided into 4 parts using a marker in order to facilitate measurement data collection. Vertical and horizontal measurements were made for extruded cement for each control and experimental groups by means of a digital microscope. One-hundred and seventeen measurements were made for each group. Mann-Whitney test was applied to verify statistical significance between the groups. The CCFT showed a highly statistically significant result (104.8 ± 13.66, p<0.0001) for cement removal compared with the CSFT (291.8 ± 21.96, p<0.0001). The vertical lengths of the extruded cement showed a median of 231.1 µm (IQR = 112.79 -398.39) and 43.62 µm (IQR = 0 - 180.21) for the control and the experimental flossing techniques, respectively. The horizontal length of the extruded cement showed a median of 987.1 µm (IQR = 476.7 - 1,933.58) and 139.2 µm (IQR = 0 - 858.28) for the control and the experimental flossing techniques, respectively. The CCFT showed highly statistically significant less cement after implant crowns cementation when compared with the CSFT.

Sacroplasty procedural extravasation with high viscosity bone cement: comparing the intraoperative long-axis versus short-axis techniques in osteoporotic cadavers.

PubMed

Miller, Jeffrey W; Diani, Art; Docsa, Steve; Ashton, Kristi; Sciamanna, Michele

2017-09-01

Percutaneous sacroplasty involves image-guided injection of bone cement for sacral insufficiency fractures to alleviate pain and facilitate mobility. Correct sacral placement of the cement and the risk of cement extravasation present procedural challenges. This study compares the occurrence, number, location, and surface area of high viscosity radiopaque bone cement extravasation via biplane fluoroscopy with Dyna CT between the fluoroscopically-guided intraoperative long-axis and short-axis sacroplasty techniques in osteoporotic cadavers. Ten osteoporotic cadavers underwent bilateral percutaneous instillation of VertaPlex HV High Viscosity Radiopaque Bone Cement. Long- and short-axis sacroplasty techniques were randomly assigned to zone 1 of the left or right sacral ala of each cadaver. Cement extravasation data were summarized by technique (long-axis vs short-axis) and time period (15-min and 3-hour post-procedure syngo DynaCT scan) in the form of point and CI estimates for the true proportions of cement extravasation. No procedural sacral extravasation differences were observed between the long-axis and short-axis sacroplasty techniques. There were no occurrences of intra-procedural or post-procedural cement extravasation at 15 min or 3 hours in association with either the long-axis sacroplasty technique or the short-axis sacroplasty technique. The long- and short-axis sacroplasty techniques, using high viscosity cement with careful post-procedural positioning, result in no occurrence of cement extravasation in porous osteoporotic cadaver bone. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Influence of technique and manipulation on self-adhesive resin cements used to cement intraradicular posts.

PubMed

Shiratori, Fábio Kenji; Valle, Accácio Lins do; Pegoraro, Thiago Amadei; Carvalho, Ricardo Marins; Pereira, Jefferson Ricardo

2013-07-01

Resin cements are widely used to cement intraradicular posts, but bond strength is significantly influenced by the technique and material used for cementation. The purpose of this study was to evaluate the bond strength of 3 self-adhesive cements used to cement intraradicular glass fiber posts. The cements all required different application and handling techniques. Forty-five human maxillary canines were selected and randomly divided into 3 groups n= 15 by drawing lots: Group BIS - Biscem, Group BRE - Breeze, and Group MAX - Maxcem. Each group was divided into 3 subgroups according to application and handling techniques: Sub-group A - Automix/Point tip applicator, Sub-group L - Handmix/Lentulo, and Sub-group C - Handmix/Centrix. Cementation of the posts was performed according to the manufacturers' instructions. The push-out test was performed with a crosshead speed of 0.5 mm/min, and bond strength was expressed in megapascals. The results were evaluated by 2-way ANOVA and the all pairwise multiple comparison procedures (Tukey test) (α=.05). Breeze cement showed the highest average for the subgroups A, L, and C when compared to the Biscem cement and Maxcem Elite (P<.05). Statistically significant differences among the subgroups were only observed for Biscem. This study shows that application and handling techniques may influence the bond strength of different self-adhesive cements when used for intraradicular post cementation. Copyright © 2013 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

Mineralogenic characteristics of osteogenic lineage-committed human dental pulp stem cells following their exposure to a discoloration-free calcium aluminosilicate cement.

PubMed

Niu, Li-Na; Pei, Dan-Dan; Morris, Matthew; Jiao, Kai; Huang, Xue-Qing; Primus, Carolyn M; Susin, Lisiane F; Bergeron, Brian E; Pashley, David H; Tay, Franklin R

2016-10-01

An experimental discoloration-free calcium aluminosilicate cement has been developed with the intention of maximizing the beneficial attributes of tricalcium silicate cements and calcium aluminate cements. The present study examined the effects of this experimental cement (Quick-Set2) on the mineralogenic characteristics of osteogenic lineage-committed human dental pulp stem cells (hDPSCs), by comparing the cellular responses with a commercially available tricalcium silicate cement (white mineral trioxide aggregate (ProRoot(®) MTA); WMTA). The osteogenic potential of hDPSCs exposed to the cements was examined using qRT-PCR for osteogenic gene expressions, Western blot for osteogenic-related protein expressions, alkaline phosphatase enzyme activity, Alizarin red S staining, Fourier transform infrared spectroscopy and transmission electron microscopy of extracellular calcium deposits. Results of the six assays indicated that osteogenic differentiation of hDPSCs was significantly enhanced after exposure to the tricalcium silicate cement or the experimental calcium aluminosilicate cement, with the former demonstrating better mineralogenic stimulation capacity. The better osteogenic stimulating effect of the tricalcium silicate cement on hDPSCs may be due to its relatively higher silicate content, or higher OH(-) and Ca(2+) release. Further investigations with the use of in vivo animal models are required to validate the potential augmenting osteogenic effects of the experimental discoloration-free calcium aluminosilicate cement. Published by Elsevier Ltd.

Study of the viability and adhesion of osteoblast cells to bone cements mixed with hydroxyapatite at different concentrations to use in vertebral augmentation techniques.

PubMed

Pino-Mínguez, J; Jorge-Mora, A; Couceiro-Otero, R; García-Santiago, C

2015-01-01

The purpose of this study is to compare the biocompatibility and the effect in osteoblasts of polymethyl methacrylate alone, and mixed with hydroxyapatite in different concentrations of 5, 10, 15 and 20%, without exceeding 20%, as it can alter mechanical properties of the composite. Experimental study comparing osteoblast response to Polymethyl methacrylate alone and with hydroxyapatite in different concentrations. Composites at 15 and 20% obtained better osteoblast response, with higher osteoblastic activity markers, and lower apoptosis markers. Electron microscopy images show improved adhesion of osteoblasts. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

Adjacent vertebral body fracture following vertebroplasty with polymethylmethacrylate or calcium phosphate cement: biomechanical evaluation of the cadaveric spine.

PubMed

Nouda, Shinya; Tomita, Seiji; Kin, Akihiro; Kawahara, Kunihiko; Kinoshita, Mitsuo

2009-11-15

A biomechanical study using human cadaveric thoracolumbar spinal columns. To compare the effect of treatment by vertebroplasty (VP) with polymethylmethacrylate cement and VP with calcium phosphate cement on the creation of adjacent vertebral body fracture following VP. Adjacent vertebral body fractures have been reported as a complication following VP. Twenty-four spinal columns (T10-L2) from human cadavers were subjected to dual energy radiograph absorptiometry to assess bone mineral density. They were divided into the P group and C group, and experimental vertebral compression fractures were created at T12 vertebrae. T12 vertebrae were augmented with polymethylmethacrylate and calcium phosphate cement in the P group and C group, respectively. Each spinal column was compressed until a new fracture occurred at any vertebra, and the location of newly fractured vertebra and failure load was investigated. There was no significant difference in bone mineral density at each level within each group. In the P group, a new fracture occurred at T10 in 2 specimens, T11 in 8, and L1 in 2. In the C group, it occurred at T10 in 1 specimen, T11 in 2, L1 in 1, and T12 (treated vertebra) in 8. The failure loads of the spinal column were 1774.8+/-672.3 N and 1501.2+/-556.5 N in the P group and C group, respectively. There was no significant difference in the failure load of the spinal column between each group. New vertebral fractures occurred at the vertebra adjacent to augmented vertebrae in the P group and in the augmented vertebrae in the C group. The difference in the fractured site may be because of the difference in strength between the 2 bone filler materials. Therefore, the strength of bone filler materials is considered a risk factor in developing adjacent vertebral body fractures after VP.

Comparison of Radiofrequency-targeted Vertebral Augmentation With Balloon Kyphoplasty for the Treatment of Vertebral Compression Fractures: 2-Year Results.

PubMed

Bornemann, Rahel; Jansen, Tom R; Kabir, Koroush; Pennekamp, Peter H; Stüwe, Brit; Wirtz, Dieter C; Pflugmacher, Robert

2017-04-01

A retrospective study. The aim of this study was the evaluation of the safety and effectiveness of radiofrequency-targeted vertebral augmentation (RF-TVA) in comparison with balloon kyphoplasty (BK) for the treatment of acute painful vertebral compression fractures (VCFs) on the basis of matched pairs. Vertebroplasty and BK are the common surgical interventions for the treatment of VCF. Both are effective and safe but pose some risks such as adjacent fractures and cement leakage. In 2009, RF-TVA was introduced as an innovative augmentation procedure for the treatment of VCF. A total of 192 patients (116 female; 51-90 y) with VCF (n=303) at 1 to 3 levels were treated with RF-TVA or BK. Functionality (Oswestry Disability Index), pain (visual analogue scale), vertebral height (anterior, middle), and kyphotic angle were evaluated over a 2-year period (postoperatively, 3-4 d, 3, 6, 12, and 24 mo). In addition, operating time and occurrence of cement leakage were recorded. Pain and functionality were significantly improved after both treatments. In both groups, there was an increase in the vertebral height and a decrease in the kyphotic angle, which remained relatively consistent during 24 months. The incidence of cement leakage was 9.4% (n=9) in the RF-TVA group and 24.0% (n=25) in the BK group. The mean operating time with radiofrequency kyphoplasty was 25.9±9.9 minutes, and with balloon kyphoplasty 48.0±18.4 minutes. RF-TVA is a safe and effective procedure for the treatment of vertebral compression fractures when compared with BK. Improvement in pain and functional scores after RF-TVA are durable through 24 months postprocedure and remained better than those after BK at long-term follow-up. Operating time for RF-TVA is shorter and the risk of cement leakage is lower. Both procedures provided similar results in vertebral height restoration and reduction in the kyphotic angle.

Novel cemented cup-holding technique while performing total hip arthroplasty with navigation system.

PubMed

Takai, Hirokazu; Takahashi, Tomoki

2017-09-01

Recently, navigation systems have been more widely utilized in total hip arthroplasty. However, almost all of these systems have been developed for cementless cups. In the case of cemented total hip arthroplasty using a navigation system, a special-ordered cemented holder is needed. We propose a novel cemented cup-holding technique for navigation systems using readily available articles. We combine a cementless cup holder with an inverted cementless trial cup. The resulting apparatus is used as a cemented cup holder. The upside-down cup-holding technique is useful and permits cemented cup users to utilize a navigation system for placement of the acetabular component.

The dynamic volume changes of polymerising polymethyl methacrylate bone cement.

PubMed

Muller, Scott D; Green, Sarah M; McCaskie, Andrew W

2002-12-01

The Swedish hip register found an increased risk of early revision of vacuum-mixed cemented total hip replacements. The influence of cement mixing technique on the dynamic volume change in polymerising PMMA is not well understood and may be relevant to this observation. Applying Archimedes' principle, we have investigated the dynamic volume changes in polymerising cement and determined the influence of mixing technique. All specimens showed an overall volume reduction: hand-mixed 3.4% and vacuum-mixed 6.0%. Regression analysis of sectional porosity and volume reduction showed a highly significant relationship. Hand-mixed porous cement showed a transient volume increase before solidification. However, vacuum-mixed cement showed a progressive volume reduction throughout polymerisation. Transient expansion of porous cement occurs at the critical time of micro-interlock formation, possibly improving fixation. Conversely, progressive volume reduction of vacuum-mixed cement throughout the formation of interlock may damage fixation. Stable fixation of vacuum-mixed cement may depend on additional techniques to offset the altered volumetric behaviour of vacuum-mixed cement.

Does a cemented cage improve revision THA for severe acetabular defects?

PubMed

Hansen, Erik; Shearer, David; Ries, Michael D

2011-02-01

Evidence suggests a growing incidence of revision total hip arthroplasty (THA) including a subset with large acetabular defects. Revision THA for severe acetabular bone loss is associated with a relatively high rate of mechanical failure. We questioned whether cementing a cage to the reconstructed acetabular defect and pelvis would improve the rate of mechanical failure for patients with Type 3 defects (Paprosky et al.) with and without pelvic discontinuity in comparison to historical controls. We retrospectively collected data on 33 patients who underwent 35 revision THAs using an acetabular reconstruction cage cemented to morselized allograft and either structural allograft or trabecular metal augmentation for Type 3 defects in the presence (n = 13) and absence (n = 22) of pelvic discontinuity at a mean followup of 59 months (range, 24-92 months). The primary outcome was mechanical failure, defined as revision of the acetabular reconstruction for aseptic loosening. Revision surgery for mechanical failure occurred in four of the 13 patients with pelvic discontinuity and two of the 22 patients without discontinuity. Radiographic loosening occurred in one patient with and one patient without pelvic discontinuity. Seven of the 35 revisions were subsequently revised for deep infection all in patients who were immunocompromised. Cementing the cage to the pelvis can offer an advantage for treating severe acetabular defects. Trabecular metal augmentation appears to provide better initial mechanical stability than a structural allograft, but successful allograft reconstruction may restore bone stock. Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Percutaneous Management of Accidentally Retained Foreign Bodies During Image-Guided Non-vascular Procedures: Novel Technique Using a Large-Bore Biopsy System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it; Garnon, Julien, E-mail: juleiengarnon@gmail.com; Ramamurthy, Nitin, E-mail: nitin-ramamurthy@hotmail.com

ObjectiveTo describe a novel percutaneous image-guided technique using a large-bore biopsy system to retrieve foreign bodies (FBs) accidentally retained during non-vascular interventional procedures.Materials and MethodsBetween May 2013 and October 2015, five patients underwent percutaneous retrieval of five iatrogenic FBs, including a biopsy needle tip in the femoral head following osteoblastoma biopsy and radiofrequency ablation (RFA); a co-axial needle shaft within a giant desmoid tumour following cryoablation; and three post-vertebroplasty cement tails within paraspinal muscles. All FBs were retrieved immediately following original procedures under local or general anaesthesia, using combined computed tomography (CT) and fluoroscopic guidance. The basic technique involved positioningmore » a 6G trocar sleeve around the FB long axis and co-axially advancing an 8G biopsy needle to retrieve the FB within the biopsy core. Retrospective chart review facilitated analysis of procedures, FBs, technical success, and complications.ResultsMean FB size was 23 mm (range 8–74 mm). Four FBs were located within 10 mm of non-vascular significant anatomic structures. The basic technique was successful in 3 cases; 2 cases required technical modifications including using a stiff guide-wire to facilitate retrieval in the case of the post-cryoablation FB; and using the central mandrin of the 6G trocar to push a cement tract back into an augmented vertebra when initial retrieval failed. Overall technical success (FB retrieval or removal to non-hazardous location) was 100 %, with no complications.ConclusionPercutaneous image-guided retrieval of iatrogenic FBs using a large-bore biopsy system is a feasible, safe, effective, and versatile technique, with potential advantages over existing methods.« less

Presentation and management of symptomatic central bone cement embolization.

PubMed

Barakat, Ahmed Samir; Owais, Tamer; Alhashash, Mohamed; Shousha, Mootaz; El Saghir, Hesham; Lauer, Bernward; Boehm, Heinrich

2017-08-18

With more cement augmentation procedures done, the occurrence of serious complications is also expected to rise. Symptomatic central cement embolization is a rare but very serious complication. Moreover, the pathophysiology and treatment of intrathoracic cement embolism remain controversial. In this case series, we are trying to identify various presentations and suggest our emergent management scheme for symptomatic central cement embolization. Retrospective case series of nine patients with symptomatic central cement embolism identified after vertebroplasty with 24 months of follow-up. Level IV. The degree of dyspnea measured by the New York Heart Association (NYHA) score and/or death related to cement embolism induced cardio/respiratory failure at the final follow-up at 24 months. The nine patients, eight females, and one male had a mean age of 70.25 years (range 65-78 years) and were operated between January 2004 and December 2014. They had percutaneous vertebroplasty for osteoporotic non-traumatic and malignant vertebral collapse of dorsal and lumbar vertebrae. Post-vertebroplasty dyspnea and stitching chest pain were striking in the nine patients. After exclusion of cardiac ischemia and medical pulmonary causes for dyspnea, we identified radiopaque lesions on the chest X-ray. Further echocardiography and high-resolution chest CT were performed for optimal localization. Emergent heart surgery was performed in two patients: interventional therapy was conducted in one patient, while the remaining six patients were conservatively treated by anticoagulation. The management decision was taken in the setting of an interdisciplinary meeting depending on localization, fragmentation, and clinical status. All patients of this series showed gradual improvement and an uneventful hospital stay. During our 24-month follow-up phase, eight patients showed no subsequent cardiological and/or respiratory symptoms (NYHA I). However, one mortality due to advanced malignancy occurred. Preoperative anemia was the only common intersecting preoperative parameter among these nine patients. After cement augmentation, close clinical monitoring is mandatory. A chest CT is pivotal in determining the interdisciplinary management approach in view of the availability of necessary expertise, facilities and the location of the cement emboli whether accessible by cardiac or vascular surgical means. The clinical presentation and its timing may vary and the patient may be seen subsequently by other health care providers obligating a wide-spread awareness for this serious entity among health care providers for this age group as spine surgeons, family and emergency room doctors, and institutional or home-care nurses. Most symptomatic central cement emboli may be treated conservatively.

Multicenter Prospective Clinical Series Evaluating Radiofrequency Ablation in the Treatment of Painful Spine Metastases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bagla, Sandeep, E-mail: sandeep.bagla@gmail.com; Sayed, Dawood; Smirniotopoulos, John

BackgroundRadiofrequency ablation (RFA) of vertebral body metastases (VBM) has been reported as safe and effective in retrospective studies. This single-arm prospective multicenter clinical study evaluates RFA in the treatment of painful VBM.MethodsFifty patients with VBM were prospectively enrolled during a 13-month period at eight US centers under an IRB-approved study. Percutaneous RFA was performed under imaging guidance with cement augmentation at the discretion of the operator. Pain, disability and quality of life were evaluated at baseline, prior to discharge, days 3, 7, 30 and 90 using the Numerical Pain Rating Scale, Oswestry Disability Index (ODI), the Functional Assessment of Cancermore » Therapy-General 7 (FACT-G7) and Functional Assessment of Cancer Therapy Quality-of-Life Measurement in Patients with Bone Pain (FACT-BP). Adverse events were monitored throughout this time interval.ResultsTwenty-six male and 24 female patients (mean age 61.0) underwent 69 treatments (30 thoracic and 39 lumbar). Cement augmentation was performed in 96 % of reported levels. Significant improvement in mean scores for pain, disability and cancer-specific health-related quality of life from baseline to all time intervals was seen. NRPS improved from 5.9 to 2.1 (p < 0.0001). ODI improved from 52.9 to 37.0 (p < 0.08). FACT-G7 improved form 10.9 to 16.2 (p = 0.0001). FACT-BP improved from 22.6 to 38.9 (p < 0.001). No complications related to the procedure were reported.ConclusionRFA with cement augmentation safely and effectively reduces pain and disability rapidly, while increasing quality of life in patients suffering from vertebral body metastases.« less

Multicenter Prospective Clinical Series Evaluating Radiofrequency Ablation in the Treatment of Painful Spine Metastases.

PubMed

Bagla, Sandeep; Sayed, Dawood; Smirniotopoulos, John; Brower, Jayson; Neal Rutledge, J; Dick, Bradley; Carlisle, James; Lekht, Ilya; Georgy, Bassem

2016-09-01

Radiofrequency ablation (RFA) of vertebral body metastases (VBM) has been reported as safe and effective in retrospective studies. This single-arm prospective multicenter clinical study evaluates RFA in the treatment of painful VBM. Fifty patients with VBM were prospectively enrolled during a 13-month period at eight US centers under an IRB-approved study. Percutaneous RFA was performed under imaging guidance with cement augmentation at the discretion of the operator. Pain, disability and quality of life were evaluated at baseline, prior to discharge, days 3, 7, 30 and 90 using the Numerical Pain Rating Scale, Oswestry Disability Index (ODI), the Functional Assessment of Cancer Therapy-General 7 (FACT-G7) and Functional Assessment of Cancer Therapy Quality-of-Life Measurement in Patients with Bone Pain (FACT-BP). Adverse events were monitored throughout this time interval. Twenty-six male and 24 female patients (mean age 61.0) underwent 69 treatments (30 thoracic and 39 lumbar). Cement augmentation was performed in 96 % of reported levels. Significant improvement in mean scores for pain, disability and cancer-specific health-related quality of life from baseline to all time intervals was seen. NRPS improved from 5.9 to 2.1 (p < 0.0001). ODI improved from 52.9 to 37.0 (p < 0.08). FACT-G7 improved form 10.9 to 16.2 (p = 0.0001). FACT-BP improved from 22.6 to 38.9 (p < 0.001). No complications related to the procedure were reported. RFA with cement augmentation safely and effectively reduces pain and disability rapidly, while increasing quality of life in patients suffering from vertebral body metastases.

Physical and mechanical properties of PMMA bone cement reinforced with nano-sized titania fibers.

PubMed

Khaled, S M Z; Charpentier, Paul A; Rizkalla, Amin S

2011-02-01

X-ray contrast medium (BaSO(4) or ZrO(2)) used in commercially available PMMA bone cements imparts a detrimental effect on mechanical properties, particularly on flexural strength and fracture toughness. These lower properties facilitate the chance of implant loosening resulting from cement mantle failure. The present study was performed to examine the mechanical properties of a commercially available cement (CMW1) by introducing novel nanostructured titania fibers (n-TiO(2) fibers) into the cement matrix, with the fibers acting as a reinforcing phase. The hydrophilic nature of the n-TiO(2) fibers was modified by using a bifunctional monomer, methacrylic acid. The n-TiO(2) fiber content of the cement was varied from 0 to 2 wt%. Along with the mechanical properties (fracture toughness (K (IC)), flexural strength (FS), and flexural modulus (FM)) of the reinforced cements the following properties were investigated: complex viscosity-versus-time, maximum polymerization temperature (T (max)), dough time (t (dough)), setting time (t (set)), radiopacity, and in vitro biocompatibility. On the basis of the determined mechanical properties, the optimized composition was found at 1 wt% n-TiO(2) fibers, which provided a significant increase in K (IC) (63%), FS (20%), and FM (22%), while retaining the handling properties and in vitro biocompatibility compared to that exhibited by the control cement (CMW1). Moreover, compared to the control cement, there was no significant change in the radiopacity of any of the reinforced cements at p = 0.05. This study demonstrated a novel pathway to augment the mechanical properties of PMMA-based cement by providing an enhanced interfacial interaction and strong adhesion between the functionalized n-TiO( 2) fibers and PMMA matrix, which enhanced the effective load transfer within the cement.

Hall versus conventional stainless steel crown techniques: in vitro investigation of marginal fit and microleakage using three different luting agents.

PubMed

Erdemci, Zeynep Yalçınkaya; Cehreli, S Burçak; Tirali, R Ebru

2014-01-01

This study's purpose was to investigate microleakage and marginal discrepancies in stainless steel crowns (SSCs) placed using conventional and Hall techniques and cemented with three different luting agents. Seventy-eight human primary maxillary second molars were randomly assigned to two groups (N=39), and SSCs were applied either with the Hall or conventional technique. These two groups were further subgrouped according to the material used for crown cementation (N=13 per group). Two specimens in each group were processed for scanning electron microscopy investigation. The extent of microleakage and marginal fit was quantified in millimeters on digitally photographed sections using image analysis software. The data were compared with a two-way independent and a two-way mixed analysis of variance (P=.05). The scores in the Hall group were significantly worse than those in the conventional technique group (P<.05). In both groups, resin cement displayed the lowest extent of microleakage, followed by glass ionomer and polycarboxylate cements (P<.05). Stainless steel crowns applied using the Hall technique displayed higher microleakage scores than those applied using the conventional technique, regardless of the cementation material. When the interaction of the material and technique was assessed, resin cement presented as the best choice for minimizing microleakage in both techniques.

Pre-cementation of deep shaft

NASA Astrophysics Data System (ADS)

Heinz, W. F.

1988-12-01

Pre-cementation or pre-grouting of deep shafts in South Africa is an established technique to improve safety and reduce water ingress during shaft sinking. The recent completion of several pre-cementation projects for shafts deeper than 1000m has once again highlighted the effectiveness of pre-grouting of shafts utilizing deep slimline boreholes and incorporating wireline technique for drilling and conventional deep borehole grouting techniques for pre-cementation. Pre-cementation of deep shaft will: (i) Increase the safety of shaft sinking operation (ii) Minimize water and gas inflow during shaft sinking (iii) Minimize the time lost due to additional grouting operations during sinking of the shaft and hence minimize costly delays and standing time of shaft sinking crews and equipment. (iv) Provide detailed information of the geology of the proposed shaft site. Informations on anomalies, dykes, faults as well as reef (gold bearing conglomerates) intersections can be obtained from the evaluation of cores of the pre-cementation boreholes. (v) Provide improved rock strength for excavations in the immediate vicinity of the shaft area. The paper describes pre-cementation techniques recently applied successfully from surface and some conclusions drawn for further considerations.

Cement-in-cement acetabular revision with a constrained tripolar component.

PubMed

Leonidou, Andreas; Pagkalos, Joseph; Luscombe, Jonathan

2012-02-17

Dislocation of a total hip replacement (THR) is common following total hip arthroplasty (THA). When nonoperative management fails to maintain reduction, revision surgery is considered. The use of constrained acetabular liners has been extensively described. Complete removal of the old cement mantle during revision THA can be challenging and is associated with significant complications. Cement-in-cement revision is an established technique. However, the available clinical and experimental studies focus on femoral stem revision. The purpose of this study was to present a case of cement-in-cement acetabular revision with a constrained component for recurrent dislocations and to investigate the current best evidence for this technique. This article describes the case of a 74-year-old woman who underwent revision of a Charnley THR for recurrent low-energy dislocations. A tripolar constrained acetabular component was cemented over the primary cement mantle following removal of the original liner by reaming, roughening the surface, and thoroughly irrigating and drying the primary cement. Clinical and radiological results were good, with the Oxford Hip Score improving from 11 preoperatively to 24 at 6 months postoperatively. The good short-term results of this case and the current clinical and biomechanical data encourage the use of the cement-in-cement technique for acetabular revision. Careful irrigation, drying, and roughening of the primary surface are necessary. Copyright 2012, SLACK Incorporated.

Revealing the influence of water-cement ratio on the pore size distribution in hydrated cement paste by using cyclohexane

NASA Astrophysics Data System (ADS)

Bede, Andrea; Ardelean, Ioan

2017-12-01

Varying the amount of water in a concrete mix will influence its final properties considerably due to the changes in the capillary porosity. That is why a non-destructive technique is necessary for revealing the capillary pore distribution inside hydrated cement based materials and linking the capillary porosity with the macroscopic properties of these materials. In the present work, we demonstrate a simple approach for revealing the differences in capillary pore size distributions introduced by the preparation of cement paste with different water-to-cement ratios. The approach relies on monitoring the nuclear magnetic resonance transverse relaxation distribution of cyclohexane molecules confined inside the cement paste pores. The technique reveals the whole spectrum of pores inside the hydrated cement pastes, allowing a qualitative and quantitative analysis of different pore sizes. The cement pastes with higher water-to-cement ratios show an increase in capillary porosity, while for all the samples the intra-C-S-H and inter-C-S-H pores (also known as gel pores) remain unchanged. The technique can be applied to various porous materials with internal mineral surfaces.

Revision of Infected Total Knee Arthroplasty: Two-Stage Reimplantation Using an Antibiotic-Impregnated Static Spacer

PubMed Central

Almeida, Fernando; Renovell, Pablo; Morante, Elena; López, Raúl

2013-01-01

Background A two-stage revision remains as the "gold standard" treatment for chronically infected total knee arthroplasties. Methods Forty-five septic knee prostheses were revised with a minimum follow-up of 5 years. Static antibiotic-impregnated cement spacers were used in all cases. Intravenous antibiotics according to sensitivity test of the culture were applied during patients' hospital stay. Oral antibiotics were given for another 5 weeks. Second-stage surgery was undertaken after control of infection with normal erythrocyte sedimentation rate and C-reactive protein values. Extensile techniques were used if needed and metallic augments were employed for bone loss in 32 femoral and 29 tibial revisions. Results The average interval between the first-stage resection and reimplantation was 4.4 months. Significant improvement was obtained with respect to visual analog scale pain and clinical and functional scores, and infection was eradicated in 95.6% of cases following a two-stage revision total knee arthroplasty. Radiographic evaluation showed suitable alignment without signs of mechanical loosening. Conclusions This technique is a reasonable procedure to eradicate chronic infection in knee arthroplasty and provides proper functional and clinical results. However, it sometimes requires extensile surgical approaches that could imply arduous surgeries. Metallic augments with cementless stems available in most of the knee revision systems are a suitable alternative to handle bone deficiencies, avoiding the use of bone allografts with its complications. PMID:24009903

Revision of infected total knee arthroplasty: two-stage reimplantation using an antibiotic-impregnated static spacer.

PubMed

Silvestre, Antonio; Almeida, Fernando; Renovell, Pablo; Morante, Elena; López, Raúl

2013-09-01

A two-stage revision remains as the "gold standard" treatment for chronically infected total knee arthroplasties. Forty-five septic knee prostheses were revised with a minimum follow-up of 5 years. Static antibiotic-impregnated cement spacers were used in all cases. Intravenous antibiotics according to sensitivity test of the culture were applied during patients' hospital stay. Oral antibiotics were given for another 5 weeks. Second-stage surgery was undertaken after control of infection with normal erythrocyte sedimentation rate and C-reactive protein values. Extensile techniques were used if needed and metallic augments were employed for bone loss in 32 femoral and 29 tibial revisions. The average interval between the first-stage resection and reimplantation was 4.4 months. Significant improvement was obtained with respect to visual analog scale pain and clinical and functional scores, and infection was eradicated in 95.6% of cases following a two-stage revision total knee arthroplasty. Radiographic evaluation showed suitable alignment without signs of mechanical loosening. This technique is a reasonable procedure to eradicate chronic infection in knee arthroplasty and provides proper functional and clinical results. However, it sometimes requires extensile surgical approaches that could imply arduous surgeries. Metallic augments with cementless stems available in most of the knee revision systems are a suitable alternative to handle bone deficiencies, avoiding the use of bone allografts with its complications.

Preparation and Characterization of Injectable Brushite Filled-Poly (Methyl Methacrylate) Bone Cement

PubMed Central

Rodriguez, Lucas C.; Chari, Jonathan; Aghyarian, Shant; Gindri, Izabelle M.; Kosmopoulos, Victor; Rodrigues, Danieli C.

2014-01-01

Powder-liquid poly (methyl methacrylate) (PMMA) bone cements are widely utilized for augmentation of bone fractures and fixation of orthopedic implants. These cements typically have an abundance of beneficial qualities, however their lack of bioactivity allows for continued development. To enhance osseointegration and bioactivity, calcium phosphate cements prepared with hydroxyapatite, brushite or tricalcium phosphates have been introduced with rather unsuccessful results due to increased cement viscosity, poor handling and reduced mechanical performance. This has limited the use of such cements in applications requiring delivery through small cannulas and in load bearing. The goal of this study is to design an alternative cement system that can better accommodate calcium-phosphate additives while preserving cement rheological properties and performance. In the present work, a number of brushite-filled two-solution bone cements were prepared and characterized by studying their complex viscosity-versus-test frequency, extrusion stress, clumping tendency during injection through a syringe, extent of fill of a machined void in cortical bone analog specimens, and compressive strength. The addition of brushite into the two-solution cement formulations investigated did not affect the pseudoplastic behavior and handling properties of the materials as demonstrated by rheological experiments. Extrusion stress was observed to vary with brushite concentration with values lower or in the range of control PMMA-based cements. The materials were observed to completely fill pre-formed voids in bone analog specimens. Cement compressive strength was observed to decrease with increasing concentration of fillers; however, the materials exhibited high enough strength for consideration in load bearing applications. The results indicated that partially substituting the PMMA phase of the two-solution cement with brushite at a 40% by mass concentration provided the best combination of the properties investigated. This alternative material may find applications in systems requiring highly injectable and viscous cements such as in the treatment of spinal fractures and bone defects. PMID:28788212

[Chromatic study of all-ceramic crown--IPS Empress: difference of color by manufacturing technique and cements].

PubMed

Hata, Utako; Sadamitsu, Kenichiro; Yamamura, Osamu; Kawauchi, Daisuke; Fujii, Teruhisa

2004-12-01

In recent years,aesthetic appearance and function are called for and all-ceramic crowns are spreading. By choosing an all-ceramic crown the problem of metal ceramics is avoided. There are difficulties of color tone reproducibility of cervical margin and darkness of gingival margin. We examined IPS Empress also in various all-ceramic crowns. IPS Empress has high permeability a ceramic ingot of various color tones and excellent color tone reproducibility of natural teeth. Generally a layering technique is used for an anterior tooth and the staining technique is used for a molar. However the details are unknown We examined how differences of manufacturing method and cement affect the color tone of all ceramics clinically. Two kinds of Empress crown were fabricated for a 27 year-old woman's upper left-side central incisors:the staining technique of IPS Empress and the layering technique of IPS Empress II. Various try-in pastes(transparent opaque white white and yellow) of VariolinkII of the IPS Empress System were used for cementing. Color was measured using a spectrophotometer CMS 35FS. The L*a*b* color system was used for showing a color. The right-side central incisors on the opposite side of the same name teeth were used for comparison. We analyzed the color difference (DeltaE* ab)with a natural tooth. Consequently when it had no cement of staining technique and was tranceparent small values were obtained. It is considered that the color tone can be adjusted by color cement. It is effective to use the staining technique for an anterior tooth crown depending on the case. The crown manufactured using the layering technique is not easily influenced by cement. The crown manufactured by the staining technique tends to be influenced by cement.

Marginal Adaptation and Quality of Interfaces in Lithium Disilicate Crowns - Influence of Manufacturing and Cementation Techniques.

PubMed

Melo Freire, C A; Borges, G A; Caldas, Dbm; Santos, R S; Ignácio, S A; Mazur, R F

To evaluate the cement line thickness and the interface quality in milled or injected lithium disilicate ceramic restorations and their influence on marginal adaptation using different cement types and different adhesive cementation techniques. Sixty-four bovine teeth were prepared for full crown restoration (7.0±0.5 mm in height, 8.0 mm in cervical diameter, and 4.2 mm in incisal diameter) and were divided into two groups: CAD/CAM automation technology, IPS e.max CAD (CAD), and isostatic injection by heat technology, IPS e.max Press (PRESS). RelyX ARC (ARC) and RelyX U200 resin cements were used as luting agents in two activation methods: initial self-activation and light pre-activation for one second (tack-cure). Next, the specimens were stored in distilled water at 23°C ± 2°C for 72 hours. The cement line thickness was measured in micrometers, and the interface quality received scores according to the characteristics and sealing aspects. The evaluations were performed with an optical microscope, and scanning electron microscope images were presented to demonstrate the various features found in the cement line. For the cement line thickness, data were analyzed with three-way analysis of variance (ANOVA) and the Games-Howell test (α=0.05). For the variable interface quality, the data were analyzed with the Mann-Whitney U-test, the Kruskal-Wallis test, and multiple comparisons nonparametric Dunn test (α=0.05). The ANOVA presented statistical differences among the ceramic restoration manufacturing methods as well as a significant interaction between the manufacturing methods and types of cement (p<0.05). The U200 presented lower cement line thickness values when compared to the ARC with both cementation techniques (p<0.05). With regard to the interface quality, the Mann-Whitney U-test and the Kruskal-Wallis test demonstrated statistical differences between the ceramic restoration manufacturing methods and cementation techniques. The PRESS ceramics obtained lower scores than did the CAD ceramics when using ARC cement (p<0.05). Milled restorations cemented with self-adhesive resin cement resulted in a thinner cement line that is statistically different from that of CAD or pressed ceramics cemented with resin cement with adhesive application. No difference between one-second tack-cure and self-activation was noted.

Impact of Casing Expansion on the Mechanical and Petro-Physical Properties of Wellbore Cements

NASA Astrophysics Data System (ADS)

Oyibo, A. E.

2014-12-01

The main objective of this research is to investigate the applicability of expandable casing technology as a remediation technique for leaky wells resulting in gas migration problems. Micro annulus is usually created at the cement-formation/cement-casing interface or within the cement matrix either due to poor primary cementing or as a result of activities such as temperature and pressure variation or fracturing operations. Recent reports on gas migration in hydraulically fractured wellbores, has raised concerns on the contamination of fresh water aquifers resulting from fluid migration though this flow path. A unique bench-scale physical model which utilizes expandable tubulars in the remediation of micro annular gas flow has been used to simulate expansion of a previously-cemented casing under field-like conditions. Three different designs of cement slurry: regular 16.4 lb. /gal, 16.4 lb. /gal base slurry foamed to 13 lb. /gal and 16.4 lb. /gal cement slurry with 10% salt concentration. Gas flow path (microannulus) was artificially created at the pipe-cement interface by rotating the inner pipe in a pipe inside pipe assembly with cement in the annulus within the first few hours of hydration to create debonding at the cement-casing interface. Nitrogen gas flow-through experiments were performed before and after the expansion to confirm the sealing of the microannulus. The results obtained confirmed the effectiveness of this technique in the complete closure of gas leakage path, providing seal-tight cement-formation interface free of microannulus. The manipulation of the cement sheath during the casing expansion resulted in improved porosity, permeability and the strength of the cement sheath. SEM micrographs revealed decrease in pore size and fracturing of unhydrated cement grains within the cement matrix. This technology has great potential to become one of the leading cement remediation techniques for leaks behind the casing if implemented. Keywords: Wellbore Integrity, Casing Expansion, Well Gas Leaks, CSH, Pore Collapse, Cement Pore Water.

Cement-in-cement stem revision for Vancouver type B periprosthetic femoral fractures after total hip arthroplasty. A 3-year follow-up of 23 cases.

PubMed

Briant-Evans, Toby W; Veeramootoo, Darmaraja; Tsiridis, Eleftherios; Hubble, Matthew J

2009-10-01

Revision surgery for periprosthetic femoral fractures around an unstable cemented femoral stem traditionally requires removal of existing cement. We propose a new technique whereby a well-fixed cement mantle can be retained in cases with simple fractures that can be reduced anatomically when a cemented revision is planned. This technique is well established in femoral stem revision, but not in association with a fracture. We treated 23 Vancouver type B periprosthetic femoral fractures by reducing the fracture and cementing a revision stem into the pre-existing cement mantle, with or without supplementary fixation. 3 patients died in the first 6 months for reasons unrelated to surgery. In addition, 1 was too frail to attend follow-up and was therefore excluded from the study, and 1 patient underwent revision surgery for a nonunion. The remaining 18 cases all healed with radiographic union after an average time of 4.4 (2-11) months. There was no sign of loosening or subsidence of the revision stems within the old cement mantle in any of these cases at the most recent follow-up after an average of 3 (0.3-9) years. Our results support the use of the cement-in-cement revision in anatomically reducible periprosthetic fractures with a well-preserved pre-existing cement mantle. This technique is particularly useful for the elderly patient and for those who are not fit for prolonged surgical procedures.

In vitro evaluation of marginal adaptation in five ceramic restoration fabricating techniques.

PubMed

Ural, Cağri; Burgaz, Yavuz; Saraç, Duygu

2010-01-01

To compare in vitro the marginal adaptation of crowns manufactured using ceramic restoration fabricating techniques. Fifty standardized master steel dies simulating molars were produced and divided into five groups, each containing 10 specimens. Test specimens were fabricated with CAD/CAM, heat-press, glass-infiltration, and conventional lost-wax techniques according to manufacturer instructions. Marginal adaptation of the test specimens was measured vertically before and after cementation using SEM. Data were statistically analyzed by one-way ANOVA with Tukey HSD tests (a = .05). Marginal adaptation of ceramic crowns was affected by fabrication technique and cementation process (P < .001). The lowest marginal opening values were obtained with Cerec-3 crowns before and after cementation (P < .001). The highest marginal discrepancy values were obtained with PFM crowns before and after cementation. Marginal adaptation values obtained in the compared systems were within clinically acceptable limits. Cementation causes a significant increase in the vertical marginal discrepancies of the test specimens.

Patient-specific finite element modeling for femoral bone augmentation

PubMed Central

Basafa, Ehsan; Armiger, Robert S.; Kutzer, Michael D.; Belkoff, Stephen M.; Mears, Simon C.; Armand, Mehran

2015-01-01

The aim of this study was to provide a fast and accurate finite element (FE) modeling scheme for predicting bone stiffness and strength suitable for use within the framework of a computer-assisted osteoporotic femoral bone augmentation surgery system. The key parts of the system, i.e. preoperative planning and intraoperative assessment of the augmentation, demand the finite element model to be solved and analyzed rapidly. Available CT scans and mechanical testing results from nine pairs of osteoporotic femur bones, with one specimen from each pair augmented by polymethylmethacrylate (PMMA) bone cement, were used to create FE models and compare the results with experiments. Correlation values of R2 = 0.72–0.95 were observed between the experiments and FEA results which, combined with the fast model convergence (~3 min for ~250,000 degrees of freedom), makes the presented modeling approach a promising candidate for the intended application of preoperative planning and intraoperative assessment of bone augmentation surgery. PMID:23375663

Computer-assisted revision total knee replacement.

PubMed

Sikorski, J M

2004-05-01

A technique for performing allograft-augmented revision total knee replacement (TKR) using computer assistance is described, on the basis of the results in 14 patients. Bone deficits were made up with impaction grafting. Femoral grafting was made possible by the construction of a retaining wall or dam which allowed pressurisation and retention of the graft. Tibial grafting used a mixture of corticocancellous and morsellised allograft. The position of the implants was monitored by the computer system and adjusted while the cement was setting. The outcome was determined using a six-parameter, quantitative technique (the Perth CT protocol) which measured the alignment of the prosthesis and provided an objective score. The final outcomes were not perfect with errors being made in femoral rotation and in producing a mismatch between the femoral and tibial components. In spite of the shortcomings the alignments were comparable in accuracy with those after primary TKR. Computer assistance shows considerable promise in producing accurate alignment in revision TKR with bone deficits.

LEACHING BOUNDARY IN CEMENT-BASED WASTE FORMS

EPA Science Inventory

Cement-based fixation systems are among the most commonly employed stabilization/solidification techniques. These cement haste mixtures, however, are vulnerable to ardic leaching solutions. Leaching of cement-based waste forms in acetic acid solutions with different acidic streng...

The mechanical effect of the existing cement mantle on the in-cement femoral revision.

PubMed

Keeling, Parnell; Lennon, Alexander B; Kenny, Patrick J; O'Reilly, Peter; Prendergast, Patrick J

2012-08-01

Cement-in-cement revision hip arthroplasty is an increasingly popular technique to replace a loose femoral stem which retains much of the original cement mantle. However, some concern exists regarding the retention of the existing fatigued and aged cement in such cement-in-cement revisions. This study investigates whether leaving an existing fatigued and aged cement mantle degrades the mechanical performance of a cement-in-cement revision construct. Primary cement mantles were formed by cementing a polished stem into sections of tubular steel. If in the test group, the mantle underwent conditioning in saline to simulate ageing and was subject to a fatigue of 1 million cycles. If in the control group no such conditioning or fatigue was carried out. The cement-in-cement procedure was then undertaken. Both groups underwent a fatigue of 1 million cycles subsequent to the revision procedure. Application of a Mann-Whitney test on the recorded subsidence (means: 0.51, 0.46, n=10+10, P=0.496) and inducible displacement (means: 0.38, 0.36, P=0.96) revealed that there was no statistical difference between the groups. This study represents further biomechanical investigation of the mechanical behaviour of cement-in-cement revision constructs. Results suggest that pre-revision fatigue and ageing of the cement may not be deleterious to the mechanical performance of the revision construct. Thus, this study provides biomechanical evidence to back-up recent successes with this useful revision technique. Copyright © 2012 Elsevier Ltd. All rights reserved.

Early-age monitoring of cement structures using FBG sensors

NASA Astrophysics Data System (ADS)

Wang, Chuan; Zhou, Zhi; Zhang, Zhichun; Ou, Jinping

2006-03-01

With more and more broad applications of the cement-based structures such as neat cement paste, cement mortar and concrete in civil engineering, people hope to find out what their performances should like. The in-service performances of cement-based structures are highly affected by their hardening process during the early-age. But it is still a big problem for traditional sensors to be used to monitor the early curing of cement-based structures due to such disadvantages as difficulties to install sensors inside the concrete, limited measuring points, poor durability and interference of electromagnetic wave and so on. In this paper, according to the sensing properties of the Fiber Bragg Grating sensors and self-characters of the cement-based structures, we have successfully finished measuring and monitoring the early-age inner-strain and temperature changes of the neat cement paste, concrete with and without restrictions, mass concrete structures and negative concrete, respectively. Three types of FBG-based sensors have been developed to monitor the cement-based structures. Besides, the installation techniques and the embedding requirements of FBG sensors in cement-based structures are also discussed. Moreover, such kind of technique has been used in practical structure, 3rd Nanjing Yangtze Bridge, and the results show that FBG sensors are well proper for measuring and monitoring the temperature and strain changes including self-shrinkage, dry shrinkage, plastic shrinkage, temperature expansion, frost heaving and so on inside different cement-based structures. This technique provides us a new useful measuring method on early curing monitoring of cement-based structures and greater understanding of details of their hardening process.

Cavitational kyphoplasty: a new technique for reducing the rates of cement extravasation through targeted low-pressure cement injection.

PubMed

Mattei, Tobias A

2017-06-01

Previous studies have demonstrated lower rates of cement extravasation when comparing balloon kyphoplasty with vertebroplasty, an effect attributed to the low-pressure injection. However, in patients with isolated endplate fractures, balloon kyphoplasty may lead to further endplate damage and increased risks of intradiscal extravasation. The author provides a stepwise description of a new technique called cavitational kyphoplasty that allows targeted low-pressure cement injection without the necessity of balloon inflation. The new technique of cavitational kyphoplasty has been shown to be specially useful in patients with isolated endplate fractures without significant loss of the vertebral body height.

Ridge augmentation with soft tissue procedures in aesthetic dentistry: first clinical results measured with a new kind of moire technique

NASA Astrophysics Data System (ADS)

Studer, Stephan P.; Bucher, Andreas; Mueller, Felix

1993-09-01

The oral health of the Swiss population was significantly improved by the successful prevention of dental caries and periodontitis. Along with the healthy dentition the demand for aesthetic dentistry is increasing. Removable partial dentures are becoming less accepted. Therefore, to substitute lost teeth by permanent fixed partial prosthesis (bridges), the often deformed alveolar ridge has to be operated, either to improve the aesthetic appearance or to make it possible to restore the missing teeth by a fixed cemented bridge. The aim of this paper is (1) to evaluate whether the moire technique is an appropriate and handy method, and (2) to validate the precision of the new method. The measuring system consisted of a moire projector with an integrated phase shift device and a moire viewer with a CCD video camera, connected to a frame grabber in a personal computer. a highly versatile software was allowed to control the system as well as to grab the moire images using the four-phase shift technique in order to compute the phase image of the actual object. The new technique was validated with one solid test object measured by a 3D coordination, high precision measuring machine.

Optimising implant anchorage (augmentation) during fixation of osteoporotic fractures: is there a role for bone-graft substitutes?

PubMed

Larsson, Sune; Procter, Philip

2011-09-01

When stabilising a fracture the contact between the screw and the surrounding bone is crucial for mechanical strength. Through development of screws with new thread designs, as well as optimisation of other properties, improved screw purchase has been gained. Other alternatives to improve screw fixation in osteoporotic bone, as well as normal bone if needed, includes the use of various coatings on the screw that will induce a bonding between the implant surface and the bone implant, as well as application of drugs such as bisphosphonates locally in the screw hole to induce improved screw anchorage through their anticatabolic effect on the bone tissue. As failure of internal fixation of fractures in osteoporotic bone typically occurs through breakage of the bone that surrounds the implant, rather than the implant itself, an alternative strategy in osteoporotic bone can include augmentation of the bone around the screw. This is useful when screws alone are being used for fixation, as it will increase pull-out resistance, but also when conventional plates and screws are used. In angularly stable plate-screw systems, screw back-out is not a problem if the locking mechanism between the screws and the plate works. However, augmentation that will strengthen the bone around the screws can also be useful in conjunction with angle-stable plate-screw systems, as the augmentation will provide valuable support when subjected to loading that might cause cut-out. For many years conventional bone cement, polymethylmethacrylate (PMMA), has been used for augmentation, but due to side effects--including great difficulties if removal becomes necessary--the use of PMMA has never gained wide acceptance. With the introduction of bone substitutes, such as calcium phosphate cement, it has been shown that augmentation around screws can be achieved without the drawbacks seen with PMMA. When dealing with fixation of fractures in osteoporotic bone where screw stability might be inadequate, it therefore seems an attractive option to include bone substitutes for augmentation around screws as part of the armamentarium. Clinical studies now are needed to determine the indications in which bone augmentation with bone-graft substitutes (BGSs) would merit clinical usage. Copyright © 2011. Published by Elsevier Ltd.

Assessment of bone healing ability of calcium phosphate cements loaded with platelet lysate in rat calvarial defects.

PubMed

Babo, Pedro S; Carvalho, Pedro P; Santo, Vítor E; Faria, Susana; Gomes, Manuela E; Reis, Rui L

2016-11-01

Injectable calcium phosphate cements have been used as a valid alternative to autologous bone grafts for bone augmentation with the additional advantage of enabling minimally invasive implantation procedures and for perfectly fitting the tissue defect. Nevertheless, they have low biodegradability and lack adequate biochemical signaling to promote bone healing and remodeling. In previous in vitro studies, we observed that the incorporation of platelet lysate directly into the cement paste or loaded in hyaluronic acid microspheres allowed to modulate the cement degradation and the in vitro expression of osteogenic markers in seeded human adipose derived stem cells. The present study aimed at investigating the possible effect of this system in new bone formation when implanted in calvarial bilateral defects in rats. Different formulations were assessed, namely plain calcium phosphate cements, calcium phosphate cements loaded with human platelet lysate, hybrid injectable formulations composed of the calcium phosphate cement incorporating hyaluronin acid non-loaded microparticles (20% hyaluronin acid) or with particles loaded with platelet lysate. The degradability and new bone regrowth were evaluated in terms of mineral volume in the defect, measured by micro-computed tomography and histomorphometric analysis upon 4, 8 and 12 weeks of implantation. We observed that the incorporation of hyaluronin acid microspheres induced an overly rapid cement degradation, impairing the osteoconductive properties of the cement composites. Moreover, the incorporation of platelet lysate induced higher bone healing than the materials without platelet lysate, up to four weeks after surgery. Nevertheless, this effect was not found to be significant when compared to the one observed in the sham-treated group. © The Author(s) 2016.

Blooming gelatin: an individual additive for enhancing nanoapatite precipitation, physical properties, and osteoblastic responses of nanostructured macroporous calcium phosphate bone cements

PubMed Central

Orshesh, Ziba; Hesaraki, Saeed; Khanlarkhani, Ali

2017-01-01

In recent years, there has been a great interest in using natural polymers in the composition of calcium phosphate bone cements to enhance their physical, mechanical, and biological performance. Gelatin is a partially hydrolyzed form of collagen, a natural component of bone matrix. In this study, the effect of blooming gelatin on the nanohydroxyapatite precipitation, physical and mechanical properties, and cellular responses of a calcium phosphate bone cement (CPC) was investigated. Various concentrations of blooming gelatin (2, 5, and 8 wt.%) were used as the cement liquid and an equimolar mixture of tetracalcium phosphate and dicalcium phosphate was used as solid phase. The CPC without any gelatin additive was also evaluated as a control group. The results showed that gelatin accelerated hydraulic reactions of the cement paste, in which the reactants were immediately converted into nanostructured apatite precipitates after hardening. Gelatin molecules induced 4%–10% macropores (10–300 μm) into the cement structure, decreased initial setting time by ~190%, and improved mechanical strength of the as-set cement. Variation in the above-mentioned properties was influenced by the gelatin concentration and progressed with increasing the gelatin content. The numbers of the G-292 osteoblastic cells on gelatin-containing CPCs were higher than the control group at entire culture times (1–14 days), meanwhile better alkaline phosphatase (ALP) activity was determined using blooming gelatin additive. The observation of cell morphologies on the cement surfaces revealed an appropriate cell attachment with extended cell membranes on the cements. Overall, adding gelatin to the composition of CPC improved the handling characteristics such as setting time and mechanical properties, enhanced nanoapatite precipitation, and augmented the early cell proliferation rate and ALP activity. PMID:28176961

Blooming gelatin: an individual additive for enhancing nanoapatite precipitation, physical properties, and osteoblastic responses of nanostructured macroporous calcium phosphate bone cements.

PubMed

Orshesh, Ziba; Hesaraki, Saeed; Khanlarkhani, Ali

2017-01-01

In recent years, there has been a great interest in using natural polymers in the composition of calcium phosphate bone cements to enhance their physical, mechanical, and biological performance. Gelatin is a partially hydrolyzed form of collagen, a natural component of bone matrix. In this study, the effect of blooming gelatin on the nanohydroxyapatite precipitation, physical and mechanical properties, and cellular responses of a calcium phosphate bone cement (CPC) was investigated. Various concentrations of blooming gelatin (2, 5, and 8 wt.%) were used as the cement liquid and an equimolar mixture of tetracalcium phosphate and dicalcium phosphate was used as solid phase. The CPC without any gelatin additive was also evaluated as a control group. The results showed that gelatin accelerated hydraulic reactions of the cement paste, in which the reactants were immediately converted into nanostructured apatite precipitates after hardening. Gelatin molecules induced 4%-10% macropores (10-300 μm) into the cement structure, decreased initial setting time by ~190%, and improved mechanical strength of the as-set cement. Variation in the above-mentioned properties was influenced by the gelatin concentration and progressed with increasing the gelatin content. The numbers of the G-292 osteoblastic cells on gelatin-containing CPCs were higher than the control group at entire culture times (1-14 days), meanwhile better alkaline phosphatase (ALP) activity was determined using blooming gelatin additive. The observation of cell morphologies on the cement surfaces revealed an appropriate cell attachment with extended cell membranes on the cements. Overall, adding gelatin to the composition of CPC improved the handling characteristics such as setting time and mechanical properties, enhanced nanoapatite precipitation, and augmented the early cell proliferation rate and ALP activity.

Porous polymethylmethacrylate as bone substitute in the craniofacial area.

PubMed

Bruens, Marco L; Pieterman, Herman; de Wijn, Joost R; Vaandrager, J Michael

2003-01-01

In craniofacial surgery, alloplastic materials are used for correcting bony defects. Porous polymethylmethacrylate (PMMA) is a biocompatible and nondegradable bone cement. Porous PMMA is formed by the classic bone cement formulation of methylmethacrylate liquid and PMMA powder in which an aqueous biodegradable carboxymethylcellulose gel is dispersed to create pores in the cement when cured. Pores give bone the opportunity to grow in, resulting in a better fixation of the prostheses. We evaluated the long-term results (n = 14), up to 20 years, of augmentations and defect fillings in the craniofacial area, with special interest in possible side effects and bone ingrowth. The evaluation consisted of a questionnaire, a physical examination, and a computed tomography (CT) scan. There were no side effects that could be ascribed to the porous PMMA. Twelve CT scans showed bone ingrowth into the prostheses, proving the validity behind the concept of porous PMMA.

Revision total hip arthroplasty: the femoral side using cemented implants.

PubMed

Holt, Graeme; Hook, Samantha; Hubble, Matthew

2011-02-01

Advances in surgical technique and implant technology have improved the ten-year survival after primary total hip arthroplasty (THA). Despite this, the number of revision procedures has been increasing in recent years, a trend which is predicted to continue into the future. Revision THA is a technically demanding procedure often complicated by a loss of host bone stock which may be compounded by the need to remove primary implants. Both cemented and uncemented implant designs are commonly used in the United Kingdom for primary and revision THA and much controversy still exists as to the ideal method of stem fixation. In this article we discuss revision of the femur using cemented components during revision THA. We focus on three clinical scenarios including femoral cement-in-cement revision where the primary femoral cement-bone interface remains well fixed, femoral cement-in-cement revision for peri-prosthetic femoral fractures, and femoral impaction grafting. We discuss the clinical indications, surgical techniques and clinical outcomes for each of these procedures.

Infection following percutaneous vertebral augmentation with polymethylmethacrylate.

PubMed

Park, Jae-Woo; Park, Sang-Min; Lee, Hui Jong; Lee, Choon-Ki; Chang, Bong-Soon; Kim, Hyoungmin

2018-04-27

Although the incidence of infection following vertebroplasty or kyphoplasty is rare, postoperative infection and cement augmentation in preexistent spondylitis can cause life-threatening complications in frail patients with notable comorbidities. In such cases, urgent culture and biopsy and the long-term use of proper antibiotics are necessary. Infection following vertebral augmentation with polymethylmethacrylate (PMMA) is rare. We aimed to analyze 11 cases of pyogenic spondylitis and spondylodiscitis that occurred after vertebroplasty or kyphoplasty and to review similar cases in the literature. All cases of postoperative spinal infections in our institution between January 2005 and November 2016 that primarily underwent percutaneous vertebroplasty or kyphoplasty were retrospectively reviewed. Eleven patients (mean age 76.3 years) were included. The incidence of infection following vertebroplasty/kyphoplasty was 0.36%. Postoperative infection occurred in 3 of 826 cases. All patients underwent combined surgical and antibiotic treatment because of neurologic deficit on the initial diagnosis of the infection or failure of prior medical treatment of the infection. The surgical procedure was thorough debridement of infected tissue and material including PMMA following anterior column reconstruction via anterior/posterior/combined approach in 10 patients and percutaneous pedicle screw fixation alone in 1 patient aged 96 years. The mean follow-up period was 21.1 months after the revision operation, excluding one patient who died 17 days after revision surgery. Ten patients recovered from infection. Although the incidence of infection following vertebroplasty or kyphoplasty is rare, postoperative infection and cement augmentation in preexisting spondylitis can develop into a life-threatening complication in frail patients with notable comorbidities. In treating infected vertebroplasty and kyphoplasty, immediate culture and biopsy and the long-term use of proper antibiotics are critical. Prompt surgical treatment should be considered in case of significant neurologic deficit, severe instability due to infected fracture, and resistance to antibiotics.

Monitoring the integrity of the cement-metal interface of total joint components in vitro using acoustic emission and ultrasound.

PubMed

Davies, J P; Tse, M K; Harris, W H

1996-08-01

Debonding of the cement-metal interface of cemented femoral components of total hip arthroplasty has been shown from clinical and autopsy material to be a common occurrence. Experimentally, debonding has been shown to increase markedly the strains in the adjacent cement mantle. Studies of autopsy-retrieved specimens demonstrate that debonding of the cement-metal interface is a key initiating event in loosening of cemented femoral components of total hip arthroplasty. However, both the radiographic and autopsy evidence of cement-metal interfacial debonding exist after the fact, that is, after debonding has occurred. The lack of prospective data showing that debonding does indeed occur under physiologic loading and occurs prior to other forms of failure of fixation leaves uncertain the issue of debonding and its role in initiating loosening of cemented femoral components. Knowing when, where, and to what extent the cement-metal interface debonds is critical information in understanding the process of loosening of cemented femoral components. Such information would contribute to improving the durability of stems and improving cementing techniques. In this study, the two nondestructive techniques of acoustic emission and ultrasonic evaluation of the cement-metal interface of cemented femoral stems of total hip arthroplasty were combined to investigate when, where, and to what extent cement-metal debonding occurred in vitro in simulated femurs loaded physiologically in fatigue in simulated single-leg stance. Debonding of the cement-metal interface of a cemented femoral component in this model was both an initiating event and a major mechanism of compromise of the cement-metal interface. Additional acoustic emission signals arose from cracks that developed in the cement.

Guides emerge for cementing horizontal strings

DOE Office of Scientific and Technical Information (OSTI.GOV)

Parcevaux, P.

1987-10-19

This article recommends the following guidelines for cementing of horizontal strings: turbulent flow displacement technique for ensuring vest casing centralization and a cement slurry with a density as close as possible to that of the drilling mud.

A novel injectable calcium phosphate-based nanocomposite for the augmentation of cannulated pedicle-screw fixation

PubMed Central

Sun, Haolin; Liu, Chun; Liu, Huiling; Bai, Yanjie; Zhang, Zheng; Li, Xuwen; Li, Chunde; Yang, Huilin; Yang, Lei

2017-01-01

Polymethyl methacrylate (PMMA)-augmented cannulated pedicle-screw fixation has been routinely performed for the surgical treatment of lumbar degenerative diseases. Despite its satisfactory clinical outcomes and prevalence, problems and complications associated with high-strength, stiff, and nondegradable PMMA have largely hindered the long-term efficacy and safety of pedicle-screw fixation in osteoporotic patients. To meet the unmet need for better bone cement for cannulated pedicle-screw fixation, a new injectable and biodegradable nanocomposite that was the first of its kind was designed and developed in the present study. The calcium phosphate-based nanocomposite (CPN) exhibited better anti-pullout ability and similar fluidity and dispersing ability compared to clinically used PMMA, and outperformed conventional calcium phosphate cement (CPC) in all types of mechanical properties, injectability, and biodegradability. In term of axial pullout strength, the CPN-augmented cannulated screw reached the highest force of ~120 N, which was higher than that of PMMA (~100 N) and CPC (~95 N). The compressive strength of the CPN (50 MPa) was three times that of CPC, and the injectability of the CPN reached 95%. In vivo tests on rat femur revealed explicit biodegradation of the CPN and subsequent bone ingrowth after 8 weeks. The promising results for the CPN clearly suggest its potential for replacing PMMA in the application of cannulated pedicle-screw fixation and its worth of further study and development for clinical uses. PMID:28490878

Optimisation of a two-liquid component pre-filled acrylic bone cement system: a design of experiments approach to optimise cement final properties.

PubMed

Clements, James; Walker, Gavin; Pentlavalli, Sreekanth; Dunne, Nicholas

2014-10-01

The initial composition of acrylic bone cement along with the mixing and delivery technique used can influence its final properties and therefore its clinical success in vivo. The polymerisation of acrylic bone cement is complex with a number of processes happening simultaneously. Acrylic bone cement mixing and delivery systems have undergone several design changes in their advancement, although the cement constituents themselves have remained unchanged since they were first used. This study was conducted to determine the factors that had the greatest effect on the final properties of acrylic bone cement using a pre-filled bone cement mixing and delivery system. A design of experiments (DoE) approach was used to determine the impact of the factors associated with this mixing and delivery method on the final properties of the cement produced. The DoE illustrated that all factors present within this study had a significant impact on the final properties of the cement. An optimum cement composition was hypothesised and tested. This optimum recipe produced cement with final mechanical and thermal properties within the clinical guidelines and stated by ISO 5833 (International Standard Organisation (ISO), International standard 5833: implants for surgery-acrylic resin cements, 2002), however the low setting times observed would not be clinically viable and could result in complications during the surgical technique. As a result further development would be required to improve the setting time of the cement in order for it to be deemed suitable for use in total joint replacement surgery.

Bond enhancement techniques for PCC white topping

DOT National Transportation Integrated Search

1996-01-01

This research was initiated in 1991 as a part of a whitetopping project to study the effectiveness of various techniques to enhance bond strength between a new portland cement concrete (PCC) overlay and an existing asphalt cement concrete (ACC) pavem...

Microwave assisted preparation of magnesium phosphate cement (MPC) for orthopedic applications: a novel solution to the exothermicity problem.

PubMed

Zhou, Huan; Agarwal, Anand K; Goel, Vijay K; Bhaduri, Sarit B

2013-10-01

There are two interesting features of this paper. First, we report herein a novel microwave assisted technique to prepare phosphate based orthopedic cements, which do not generate any exothermicity during setting. The exothermic reactions during the setting of phosphate cements can cause tissue damage during the administration of injectable compositions and hence a solution to the problem is sought via microwave processing. This solution through microwave exposure is based on a phenomenon that microwave irradiation can remove all water molecules from the alkaline earth phosphate cement paste to temporarily stop the setting reaction while preserving the active precursor phase in the formulation. The setting reaction can be initiated a second time by adding aqueous medium, but without any exothermicity. Second, a special emphasis is placed on using this technique to synthesize magnesium phosphate cements for orthopedic applications with their enhanced mechanical properties and possible uses as drug and protein delivery vehicles. The as-synthesized cements were evaluated for the occurrences of exothermic reactions, setting times, presence of Mg-phosphate phases, compressive strength levels, microstructural features before and after soaking in (simulated body fluid) SBF, and in vitro cytocompatibility responses. The major results show that exposure to microwaves solves the exothermicity problem, while simultaneously improving the mechanical performance of hardened cements and reducing the setting times. As expected, the cements are also found to be cytocompatible. Finally, it is observed that this process can be applied to calcium phosphate cements system (CPCs) as well. Based on the results, this microwave exposure provides a novel technique for the processing of injectable phosphate bone cement compositions. © 2013.

Pedicle screw anchorage of carbon fiber-reinforced PEEK screws under cyclic loading.

PubMed

Lindtner, Richard A; Schmid, Rene; Nydegger, Thomas; Konschake, Marko; Schmoelz, Werner

2018-03-01

Pedicle screw loosening is a common and significant complication after posterior spinal instrumentation, particularly in osteoporosis. Radiolucent carbon fiber-reinforced polyetheretherketone (CF/PEEK) pedicle screws have been developed recently to overcome drawbacks of conventional metallic screws, such as metal-induced imaging artifacts and interference with postoperative radiotherapy. Beyond radiolucency, CF/PEEK may also be advantageous over standard titanium in terms of pedicle screw loosening due to its unique material properties. However, screw anchorage and loosening of CF/PEEK pedicle screws have not been evaluated yet. The aim of this biomechanical study therefore was to evaluate whether the use of this alternative nonmetallic pedicle screw material affects screw loosening. The hypotheses tested were that (1) nonmetallic CF/PEEK pedicle screws resist an equal or higher number of load cycles until loosening than standard titanium screws and that (2) PMMA cement augmentation further increases the number of load cycles until loosening of CF/PEEK screws. In the first part of the study, left and right pedicles of ten cadaveric lumbar vertebrae (BMD 70.8 mg/cm 3  ± 14.5) were randomly instrumented with either CF/PEEK or standard titanium pedicle screws. In the second part, left and right pedicles of ten vertebrae (BMD 56.3 mg/cm 3  ± 15.8) were randomly instrumented with either PMMA-augmented or nonaugmented CF/PEEK pedicle screws. Each pedicle screw was subjected to cyclic cranio-caudal loading (initial load ranging from - 50 N to + 50 N) with stepwise increasing compressive loads (5 N every 100 cycles) until loosening or a maximum of 10,000 cycles. Angular screw motion ("screw toggling") within the vertebra was measured with a 3D motion analysis system every 100 cycles and by stress fluoroscopy every 500 cycles. The nonmetallic CF/PEEK pedicle screws resisted a similar number of load cycles until loosening as the contralateral standard titanium screws (3701 ± 1228 vs. 3751 ± 1614 load cycles, p = 0.89). PMMA cement augmentation of CF/PEEK pedicle screws furthermore significantly increased the mean number of load cycles until loosening by 1.63-fold (5100 ± 1933 in augmented vs. 3130 ± 2132 in nonaugmented CF/PEEK screws, p = 0.015). In addition, angular screw motion assessed by stress fluoroscopy was significantly smaller in augmented than in nonaugmented CF/PEEK screws before as well as after failure. Using nonmetallic CF/PEEK instead of standard titanium as pedicle screw material did not affect screw loosening in the chosen test setup, whereas cement augmentation enhanced screw anchorage of CF/PEEK screws. While comparable to titanium screws in terms of screw loosening, radiolucent CF/PEEK pedicle screws offer the significant advantage of not interfering with postoperative imaging and radiotherapy. These slides can be retrieved under Electronic Supplementary Material.

[Minimally invasive cement augmentation of osteoporotic vertebral compression fractures with the new radiofrequency kyphoplasty].

PubMed

Mattyasovszky, S G; Kurth, A A; Drees, P; Gemidji, J; Thomczyk, S; Kafchitsas, K

2014-10-01

Minimally invasive cement augmentation of painful osteoporotic vertebral compression fractures in elderly patients. Painful osteoporotic vertebral compression fractures in elderly patients (> 65 years of age) after conservative therapy failure. Painful aggressive primary tumors of the spine or osteolytic metastases to the spine with high risk of vertebral fracture in the palliative care setting. General contraindications for surgical interventions. Local soft-tissue infection. Osteomyelitis, discitis or systemic infection. Coagulopathy refractory to treatment or bleeding diathesis. Asymptomatic vertebral compression fractures. Burst of the posterior vertebral column with high degree of spinal canal stenosis. Primary or metastatic spinal tumors with epidural growth. Prone position on a radiolucent operating table. Fluoroscopic localization of the fractured vertebra using two conventional C-arm devices (anteroposterior and lateral views). Fluoroscopic localization of the fractured vertebra using two conventional C-arm devices (anteroposterior and lateral views). An introducer is inserted through a small skin incision into the pedicle under fluoroscopic guidance. To create a site- and size-specific three-dimensional cavity in the center of the fractured vertebra, the navigational VertecoR™ MidLine Osteotome was inserted through the correctly sited introducer and guided fluoroscopically. As the MidLine Osteotome allows angulation of the tip up to 90° by rotating the handle, a cavity over the midline of the vertebral body can mainly be created through one pedicle. The radiofrequency activated cohesive ultrahigh viscosity PMMA cement (ER(2) bone cement) is injected stepwise on demand by remote control under continuous pressure from the hydraulic assembly into the vertebral body. Bed rest for 6 h postoperatively in supine position. Early mobilization without a corset on the day of surgery. Specific back and abdominal exercises that strengthen the back and abdominal muscles. Pain dependent increase of weight bearing. Continue osteoporosis therapy and start specific drug therapy according to the local guidlines if necessary. In all, 44 patients (29 women, 15 men) with a mean age of 73.5 years with a total of 62 painful osteoporotic vertebral fractures were treated with RF kyphoplasty from May 2009 until July 2010, and followed over a period of 12 months. The mean operating time per patient was 36.2 min, the operating time per vertebra was 25.7 min. All the patients studied experienced an early and persistent significant pain relief even 12 months after therapy (8 ± 1.4 vs. 2.7 ± 1.9) according to the visual analogue pain scale. According to the Oswestry Disability Index (ODI) as a disease-specific disability measure all the patients improved significantly (p < 0.001) in the level of disability after operative treatment (56.2 ± 18.8 vs. 34.5 ± 16.6). Cement leakage was detected in 17 out of 62 (27.4 %) augmented vertebrae, whereas all the patients with cement leakage remained asymptomatic. One patient had subsequent vertebral fractures after a period of 6 months.

Effect of Instrumentation Techniques, Irrigant Solutions and Artificial accelerated Aging on Fiberglass Post Bond Strength to Intraradicular Dentin.

PubMed

Santana, Fernanda Ribeiro; Soares, Carlos José; Silva, Júlio Almeida; Alencar, Ana Helena Gonçalves; Renovato, Sara Rodrigues; Lopes, Lawrence Gonzaga; Estrela, Carlos

2015-07-01

To evaluate the effect of instrumentation techniques, irrigant solutions and specimen aging on fiberglass posts bond strength to intraradicular dentine. A total of 120 bovine teeth were prepared and randomized into control and experimental groups resulting from three study factors (instrumentation techniques, irrigant solutions, specimen aging). Posts were cemented with RelyX U100. Samples were submitted to push-out test and failure mode was evaluated under a confocal microscope. In specimens submitted to water artificial aging, nickel-titanium rotary instruments group presented higher bond strength values in apical third irrigated with NaOCl or chlorhexi-dine. Irrigation with NaOCl resulted in higher bond strength than ozonated water. Artificial aging resulted in significant bond strength increase. Adhesive cement-dentin failure was prevalent in all the groups. Root canal preparation with NiTi instruments associated with NaOCl irrigation and ethylenediaminetetra acetic acid (EDTA) increased bond strength of fiberglass posts cemented with self-adhesive resin cement to intraradicular dentine. Water artificial aging significantly increased post-Clinical significance: The understanding of factors that may influence the optimal bond between post-cement and cement-dentin are essential to the success of endodontically treated tooth restoration.

Practical Problems in the Cement Industry Solved by Modern Research Techniques

ERIC Educational Resources Information Center

Daugherty, Kenneth E.; Robertson, Les D.

1972-01-01

Practical chemical problems in the cement industry are being solved by such techniques as infrared spectroscopy, gas chromatography-mass spectrometry, X-ray diffraction, atomic absorption and arc spectroscopy, thermally evolved gas analysis, Mossbauer spectroscopy, transmission and scanning electron microscopy. (CP)

A novel technique of intra-spinous process injection of PMMA to augment the strength of an inter-spinous process device such as the X STOP.

PubMed

Idler, Cary; Zucherman, James F; Yerby, Scott; Hsu, Ken Y; Hannibal, Matthew; Kondrashov, Dimitriy

2008-02-15

Biomechanical. To determine if cement injection into the spinous process will improve compression strength. The X STOP (St. Francis Medical Technologies) has been shown to be a safe and effective means for decompressing 1- or 2-level lumbar spinal stenosis (LSS). The X STOP is indicated for LSS patients with osteoporosis, but contraindicated for patients with severe osteoporosis. In an attempt to address these LSS patients with demonstrably weaker bone, a technique to strengthen the spinous process with polymethylmethacrylate (PMMA) injection is presented. Nine pairs of adjacent fresh frozen cadaveric lumbar vertebrae were DEXA scanned before testing. They were randomly assigned to the PMMA group and a control group. Nine of the specimens were injected with PMMA. Each spinous process was then compressed between 2 X STOPs. The testing model was designed to simulate the loading of a 2-level X STOP placement. The mean load to failure and stiffness values of the treated and untreated groups were calculated. The specimens were inspected carefully for PMMA infiltration and extrusion. The mean bone mineral density (BMD) values of the control and PMMA treatment groups were 0.99 +/- 0.13 g/cm and 0.98 +/- 0.10 g/cm, respectively; P > 0.616. The mean volume of cement injected was 2.2 +/- 0.3 cc. The mean failure load values of the control and PMMA treatment groups were 1250 +/- 627 N and 2386 +/- 1034 N, respectively; P < 0.001. The mean stiffness values of the control and PMMA treatment groups were 296 +/- 139 N/mm and 381 +/- 131 N/mm, respectively; P > 0.059. Most specimens had flow of the cement into the laminae and some into the facet and pedicle. No PMMA was found within the spinal canal. This first reported technique of posterior element vertebroplasty may increase the indications and success for patients with decreased BMD who seek an interspinous implant such as the X STOP. A possible role may exist in increasing the effectiveness of such devices. However, clinical trials have yet been performed. These results demonstrate that PMMA injection in the spinous processes is effective in increasing resistance to compressive forces in an X STOP model.

The influence of a suction device on fixation of a cemented cup using RSA.

PubMed

Timperley, A John; Whitehouse, Sarah L; Hourigan, Patrick G

2009-03-01

The quality of technique used at the time of socket cementation is crucial in ensuring a durable long-term result of the implant. We asked whether a new instrument, an aspirator retractor introduced into the wing of the ilium before socket preparation and cementation, would enhance cement fixation as defined by RSA and radiographic examination. We randomized 38 patients into two groups. The surgical technique was identical between the groups with the exception of the use of the aspirator retractor. Patients were followed clinically and with radiostereometry at a minimum of 2 years. We compared gross radiographic appearances, including the depth of penetration of cement and the incidence of postoperative and 2-year radiolucent lines. There was no difference in proximal migration between the two groups. No improvement of fixation was proven from the measured translations and rotations of the socket in the suction group. We found no difference in the number or extent of radiolucent lines or the depth of cement penetration when the iliac suction device was used in conjunction with contemporary cementing techniques. Although the data suggest no short-term advantage in this small study, we will continue to follow these patients presuming there will be improved outcomes in the longer term and since the device provides an easier method of obtaining adequate fixation, especially if technical difficulties are encountered during the pressurization procedure.

Cementless total knee arthroplasty

PubMed Central

Risitano, Salvatore; Sabatini, Luigi; Giachino, Matteo; Agati, Gabriele; Massè, Alessandro

2016-01-01

Interest for uncemented total knee arthroplasty (TKA) has greatly increased in recent years. This technique, less used than cemented knee replacement in the last decades, sees a revival thanks an advance in prosthetic design, instrumentation and operative technique. The related literature in some cases shows conflicting data on survival and on the revision’s rate, but in most cases a success rate comparable to cemented TKA is reported. The optimal fixation in TKA is a subject of debate with the majority of surgeons favouring cemented fixation. PMID:27162779

Comparison of the marginal adaptation of direct and indirect composite inlay restorations with optical coherence tomography.

PubMed

Türk, Ayşe Gözde; Sabuncu, Metin; Ünal, Sena; Önal, Banu; Ulusoy, Mübin

2016-01-01

The purpose of the study was to use the photonic imaging modality of optical coherence tomography (OCT) to compare the marginal adaptation of composite inlays fabricated by direct and indirect techniques. Class II cavities were prepared on 34 extracted human molar teeth. The cavities were randomly divided into two groups according to the inlay fabrication technique. The first group was directly restored on cavities with a composite (Esthet X HD, Dentsply, Germany) after isolating. The second group was indirectly restored with the same composite material. Marginal adaptations were scanned before cementation with an invisible infrared light beam of OCT (Thorlabs), allowing measurement in 200 µm intervals. Restorations were cemented with a self-adhesive cement resin (SmartCem2, Dentsply), and then marginal adaptations were again measured with OCT. Mean values were statistically compared by using independent-samples t-test and paired samples t-test (p<0.05), before and after cementation. Direct inlays presented statistically smaller marginal discrepancy values than indirect inlays, before (p=0.00001442) and after (p=0.00001466) cementation. Marginal discrepancy values were increased for all restorations after cementation (p=0.00008839, p=0.000000952 for direct and indirect inlays, respectively). The mean marginal discrepancy value of the direct group increased from 56.88±20.04 µm to 91.88±31.7 µm, whereas the indirect group increased from 107.54±35.63 µm to 170.29±54.83 µm. Different techniques are available to detect marginal adaptation of restorations, but the OCT system can give quantitative information about resin cement thickness and its interaction between tooth and restoration in a nondestructive manner. Direct inlays presented smaller marginal discrepancy than indirect inlays. The marginal discrepancy values were increased for all restorations that refer to cement thickness after cementation.

Impact of implant size on cement filling in hip resurfacing arthroplasty.

PubMed

de Haan, Roel; Buls, Nico; Scheerlinck, Thierry

2014-01-01

Larger proportions of cement within femoral resurfacing implants might result in thermal bone necrosis. We postulate that smaller components are filled with proportionally more cement, causing an elevated failure rate. A total of 19 femoral heads were fitted with polymeric replicas of ReCap (Biomet) resurfacing components fixed with low-viscosity cement. Two specimens were used for each even size between 40 and 56 mm and one for size 58 mm. All specimens were imaged with computed tomography, and the cement thickness and bone density were analyzed. The average cement mantle thickness was 2.63 mm and was not correlated with the implant size. However, specimen with low bone density had thicker cement mantles regardless of size. The average filling index was 36.65% and was correlated to both implant size and bone density. Smaller implants and specimens with lower bone density contained proportionally more cement than larger implants. According to a linear regression model, bone density but not implant size influenced cement thickness. However, both implant size and bone density had a significant impact on the filling index. Large proportions of cement within the resurfacing head have the potential to generate thermal bone necrosis and implant failure. When considering hip resurfacing in patients with a small femoral head and/or osteoporotic bone, extra care should be taken to avoid thermal bone necrosis, and alternative cementing techniques or even cementless implants should be considered. This study should help delimiting the indications for hip resurfacing and to choose an optimal cementing technique taking implant size into account.

Stabilization techniques for reactive aggregate in soil-cement base course : technical summary.

DOT National Transportation Integrated Search

2003-01-01

The objectives of this research are 1) to identify the mineralogical properties of soil-cement bases which have heaved or can potentially heave, 2) to simulate expansion of cement-stabilized soil in the laboratory, 3) to correlate expansion with the ...

Validation of a measuring technique with computed tomography for cement penetration into trabecular bone underneath the tibial tray in total knee arthroplasty on a cadaver model

PubMed Central

2014-01-01

Background In total knee arthroplasty (TKA), cement penetration between 3 and 5 mm beneath the tibial tray is required to prevent loosening of the tibia component. The objective of this study was to develop and validate a reliable in vivo measuring technique using CT imaging to assess cement distribution and penetration depth in the total area underneath a tibia prosthesis. Methods We defined the radiodensity ranges for trabecular tibia bone, polymethylmethacrylate (PMMA) cement and cement-penetrated trabecular bone and measured the percentages of cement penetration at various depths after cementing two tibia prostheses onto redundant femoral heads. One prosthesis was subsequently removed to examine the influence of the metal tibia prostheses on the quality of the CT images. The percentages of cement penetration in the CT slices were compared with percentages measured with photographs of the corresponding transversal slices. Results Trabecular bone and cement-penetrated trabecular bone had no overlap in quantitative scale of radio-density. There was no significant difference in mean HU values when measuring with or without the tibia prosthesis. The percentages of measured cement-penetrated trabecular bone in the CT slices of the specimen were within the range of percentages that could be expected based on the measurements with the photographs (p = 0.04). Conclusions CT scan images provide valid results in measuring the penetration and distribution of cement into trabecular bone underneath the tibia component of a TKA. Since the proposed method does not turn metal elements into artefacts, it enables clinicians to assess the width and density of the cement mantle in vivo and to compare the results of different cementing methods in TKA. PMID:25158996

In-place cement stabilized base reconstruction techniques interim report : "construction and two year evaluation".

DOT National Transportation Integrated Search

2002-08-01

The purpose of this research was to evaluate the effectiveness of soil cement shrinkage crack mitigation techniques. The contents of this report reflect an evaluation of the construction of the test sections and a two-year evaluation of the test sect...

In-place cement stabilized base reconstruction techniques interim report, "construction and two year evaluation" : technical summary.

DOT National Transportation Integrated Search

2002-08-01

The purpose of this research is to evaluate the effectiveness of soil cement shrinkage crack mitigation techniques. Ten test sections, 1000 feet long, were constructed on LA 89 in Vermilion Parish. The shrinkage crack mitigation methods being evaluat...

Cement paste surface roughness analysis using coherence scanning interferometry and confocal microscopy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Apedo, K.L., E-mail: apedo@unistra.fr; Munzer, C.; He, H.

2015-02-15

Scanning electron microscopy and scanning probe microscopy have been used for several decades to better understand the microstructure of cementitious materials. Very limited work has been performed to date to study the roughness of cementitious materials by optical microscopy such as coherence scanning interferometry (CSI) and chromatic confocal sensing (CCS). The objective of this paper is to better understand how CSI can be used as a tool to analyze surface roughness and topography of cement pastes. Observations from a series of images acquired using this technique on both polished and unpolished samples are described. The results from CSI are comparedmore » with those from a STIL confocal microscopy technique (SCM). Comparison between both optical techniques demonstrates the ability of CSI to measure both polished and unpolished cement pastes. - Highlights: • Coherence scanning interferometry (CSI) was used to analyze cement paste surfaces. • The results from the CSI were compared with those from a confocal microscopy. • 3D roughness parameters were obtained using the window resizing method. • Polished and unpolished cement pastes were studied.« less

Fit Analysis of Different Framework Fabrication Techniques for Implant-Supported Partial Prostheses.

PubMed

Spazzin, Aloísio Oro; Bacchi, Atais; Trevisani, Alexandre; Farina, Ana Paula; Dos Santos, Mateus Bertolini

2016-01-01

This study evaluated the vertical misfit of implant-supported frameworks made using different techniques to obtain passive fit. Thirty three-unit fixed partial dentures were fabricated in cobalt-chromium alloy (n = 10) using three fabrication methods: one-piece casting, framework cemented on prepared abutments, and laser welding. The vertical misfit between the frameworks and the abutments was evaluated with an optical microscope using the single-screw test. Data were analyzed using one-way analysis of variance and Tukey test (α = .05). The one-piece casted frameworks presented significantly higher vertical misfit values than those found for framework cemented on prepared abutments and laser welding techniques (P < .001 and P < .003, respectively). Laser welding and framework cemented on prepared abutments are effective techniques to improve the adaptation of three-unit implant-supported prostheses. These techniques presented similar fit.

Comparison of high-viscosity cement vertebroplasty and balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures.

PubMed

Wang, Cheng-hu; Ma, Jin-zhu; Zhang, Chuan-chen; Nie, Lin

2015-01-01

Percutaneous vertebroplasty is a widely used vertebral augmentation procedure for treating osteoporotic vertebral compression fractures (OVCFs). But high cement leakage rate caused by a low-viscosity cement and high injection pressure has limited its general use. Balloon kyphoplasty (BKP) and high-viscosity cement vertebroplasty (HVCV) are 2 modifications of vertebroplasty designed to decrease cement leakage. To assess the safety and efficacy of HVCV compared with BKP. A prospective cohort study. Department of Spine Surgery, an affiliated hospital of a medical university. One hundred seven patients suffering from painful OVCFs were randomly assigned into HVCV or BKP groups. Visual Analog Scale (VAS), Oswestry Disability Index (ODI), cement leakage, and vertebral height restoration were evaluated. All occurring complications and injected cement volumes were recorded. The follow-up time was one year. VAS and ODI scores improved in both groups, and did not differ significantly between the 2 groups. More cement was used in the BKP group than in HVCV group (4.22 vs. 3.31 mL, P < 0.0001). The incidence of cement leakage in the HVCV group was lower than that of the BKP group (13.24% vs 30.56%, P < 0.05). No symptomatic cement leakages occurred in the HVCV group. In the BKP group, one patient experienced discogenic back pain related to a disc leak, and another patient had asymptomatic cement emboli in the lung related to venous leakage. The mean compression rate before the procedure was 29.98% in the HVCV group and 28.67% in the BKP group (P = 0.94). The vertebral height was improved significantly and maintained at one-year follow-up in both groups. BKP was more effective in vertebral height restoration than HVCV (44.87% vs. 23.93%, P < 0.0001). There was one case of a new adjacent vertebral fracture in the HVCV group (2%), and 4 cases of new nonadjacent vertebral fractures in the BKP group (7.84%) (P = 0.18). A single-center and relatively small-sample size study. HVCV and BKP are safe and effective in improving quality of life and relieving pain. HVCV has a lower cement leakage rate, whereas BKP is more effective in vertebral height restoration. Subsequent fractures are not different between the 2 groups.

Fracture toughness of Kevlar 29/poly(methyl methacrylate) composite materials for surgical implantations.

PubMed

Pourdeyhimi, B; Robinson, H H; Schwartz, P; Wagner, H D

1986-01-01

A study of the fracture behaviour of Kevlar 29 reinforced dental cement is undertaken using both linear elastic and nonlinear elastic fracture mechanics techniques. Results from both approaches--of which the nonlinear elastic is believed to be more appropriate--indicate that a reinforcing effect is obtained for the fracture toughness even at very low fibre content. The flexural strength and modulus are apparently not improved, however, by the incorporation of Kevlar 29 fibres in the PMMA cement, probably because of the presence of voids, the poor fibre/matrix interfacial bonding and unsatisfying cement mixing practice. When compared to other PMMA composite cements, the present system appears to be probably more effective than carbon/PMMA, for example, in terms of fracture toughness. More experimental and analytical work is needed so as to optimize the mechanical properties with respect to structural parameters and cement preparation technique.

Micro-scale experimental study of Microbial-Induced Carbonate Precipitation (MICP) by using microfluidic devices

NASA Astrophysics Data System (ADS)

Wang, Y.; Soga, K.; DeJong, J. T.; Kabla, A.

2017-12-01

Microbial-induced carbonate precipitation (MICP), one of the bio-mineralization processes, is an innovative subsurface improvement technique for enhancing the strength and stiffness of soils, and controlling their hydraulic conductivity. These macro-scale engineering properties of MICP treated soils controlled by micro-scale factors of the precipitated carbonate, such as its content, amount and distribution in the soil matrix. The precipitation process itself is affected by bacteria amount, reaction kinetics, porous medium geometry and flow distribution in the soils. Accordingly, to better understand the MICP process at the pore scale a new experimental technique that can observe the entire process of MICP at the pore-scale was developed. In this study, a 2-D transparent microfluidic chip made of Polydimethylsiloxane (PDMS) representing the soil matrix was designed and fabricated. A staged-injection MICP treatment procedure was simulated inside the microfluidic chip while continuously monitored using microscopic techniques. The staged-injection MICP treatment procedure started with the injection of bacteria suspension, followed with the bacteria setting for attachment, and then ended with the multiple injections of cementation liquid. The main MICP processes visualized during this procedure included the bacteria transport and attachment during the bacteria injection, the bacteria attachment and growth during the bacteria settling, the bacteria detachment during the cementation liquid injection, the cementation development during the cementation liquid injection, and the cementation development after the completion of cementation liquid injection. It is suggested that the visualization of the main MICP processes using the microfluidic technique can improve understating of the fundamental mechanisms of MICP and consequently help improve the treatment technique for in situ implementation of MICP.

High-volume use of self-cementing spray dry absorber material for structural applications

NASA Astrophysics Data System (ADS)

Riley, Charles E.

Spray dry absorber (SDA) material, or spray dryer ash, is a byproduct of energy generation by coal combustion and sulfur emissions controls. Like any resource, it ought to be used to its fullest potential offsetting as many of the negative environmental impacts of coal combustion as possible throughout its lifecycle. Its cementitious and pozzolanic properties suggest it be used to augment or replace another energy and emissions intensive product: Portland cement. There is excellent potential for spray dryer ash to be used beneficially in structural applications, which will offset CO2 emissions due to Portland cement production, divert landfill waste by further utilizing a plentiful coal combustion by-product, and create more durable and sustainable structures. The research into beneficial use applications for SDA material is relatively undeveloped and the material is highly underutilized. This dissertation explored a specific self-cementing spray dryer ash for use as a binder in structural materials. Strength and stiffness properties of hydrated spray dryer ash mortars were improved by chemical activation with Portland cement and reinforcement with polymer fibers from automobile tire recycling. Portland cement at additions of five percent of the cementitious material was found to function effectively as an activating agent for spray dryer ash and had a significant impact on the hardened properties. The recycled polymer fibers improved the ductility and toughness of the material in all cases and increased the compressive strength of weak matrix materials like the pure hydrated ash. The resulting hardened materials exhibited useful properties that were sufficient to suggest that they be used in structural applications such as concrete, masonry block, or as a hydraulic cement binder. While the long-term performance characteristics remain to be investigated, from an embodied-energy and carbon emissions standpoint the material investigated here is far superior to Portland cement.

An Ice Block: A Novel Technique of Successful Prevention of Cement Leakage Using an Ice Ball

DOE Office of Scientific and Technical Information (OSTI.GOV)

Uri, Ishaq Fahmi, E-mail: uri.isaac@gmail.com; Garnon, Julien, E-mail: juliengarnon@gmail.com; Tsoumakidou, Georgia, E-mail: georgia.tsoumakidou@chru-strasbourg.fr

2015-04-15

We report three cases of painful bone metastases with extraosseous invasion treated with cementoplasty and cryoablation. Due to significant cortical loss in all cases, the ice ball was used simultaneously during cementoplasty to deter potential cement leakage. This was achieved by direct application of the ice ball against the cortical surface, resulting in adequate consolidation and successful containment of the cement within the treated bones. To the authors’ knowledge, this is the first report to describe such a combined technique.

Augmented wedge-shaped glenoid component for the correction of glenoid retroversion: a finite element analysis.

PubMed

Hermida, Juan C; Flores-Hernandez, Cesar; Hoenecke, Heinz R; D'Lima, Darryl D

2014-03-01

This study undertook a computational analysis of a wedged glenoid component for correction of retroverted glenoid arthritic deformity to determine whether a wedge-shaped glenoid component design with a built-in correction for version reduces excessive stresses in the implant, cement, and glenoid bone. Recommendations for correcting retroversion deformity are asymmetric reaming of the anterior glenoid, bone grafting of the posterior glenoid, or a glenoid component with posterior augmentation. Eccentric reaming has the disadvantages of removing normal bone, reducing structural support for the glenoid component, and increasing the risk of bone perforation by the fixation pegs. Bone grafting to correct retroverted deformity does not consistently generate successful results. Finite element models of 2 scapulae models representing a normal and an arthritic retroverted glenoid were implanted with a standard glenoid component (in retroversion or neutral alignment) or a wedged component. Glenohumeral forces representing in vivo loading were applied and stresses and strains computed in the bone, cement, and glenoid component. The retroverted glenoid components generated the highest compressive stresses and decreased cyclic fatigue life predictions for trabecular bone. Correction of retroversion by the wedged glenoid component significantly decreased stresses and predicted greater bone fatigue life. The cement volume estimated to survive 10 million cycles was the lowest for the retroverted components and the highest for neutrally implanted glenoid components and for wedged components. A wedged glenoid implant is a viable option to correct severe arthritic retroversion, reducing the need for eccentric reaming and the risk for implant failure. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

Vertebral Augmentation with Nitinol Endoprosthesis: Clinical Experience in 40 Patients with 1-Year Follow-up

DOE Office of Scientific and Technical Information (OSTI.GOV)

Anselmetti, Giovanni Carlo, E-mail: gc.anselmetti@fastwebnet.it; Manca, Antonio, E-mail: anto.manca@gmail.com; Marcia, Stefano, E-mail: stemarcia@gmail.com

PurposeThis study was designed to assess the clinical outcomes of patients treated by vertebral augmentation with nitinol endoprosthesis (VNE) to treat painful vertebral compression fractures.MethodsForty patients with one or more painful osteoporotic VCF, confirmed by MRI and accompanied by back-pain unresponsive to a minimum 2 months of conservative medical treatment, underwent VNE at 42 levels. Preoperative and postoperative pain measured with Visual Analog Scale (VAS), disability measured by Oswestry Disability Index (ODI), and vertebral height restoration (measured with 2-dimensional reconstruction CT) were compared at last follow-up (average follow-up 15 months). Cement extravasation, subsequent fractures, and implant migration were recorded.ResultsLong-term follow-up was obtainedmore » in 38 of 40 patients. Both VAS and ODI significantly improved from a median of 8.0 (range 5–10) and 66 % (range 44–88 %) to 0.5 (range 0–8) and 6 % (range 6–66 %), respectively, at 1 year (p < 0.0001). Vertebral height measurements comparing time points increased in a statistically significant manner (ANOVA, p < 0.001). Overall cement extravasation rate was 9.5 %. Discal and venous leakage rates were 7.1 and 0 % respectively. No symptomatic extravasations occurred. Five of 38 (13.1 %) patients experienced new spontaneous, osteoporotic fractures. No device change or migration was observed.ConclusionsVNE is a safe and effective procedure that is able to provide long-lasting pain relief and durable vertebral height gain with a low rate of new fractures and cement leakages.« less

Effect of Cementation Technique of Individually Formed Fiber-Reinforced Composite Post on Bond Strength and Microleakage

PubMed Central

Makarewicz, Dominika; Le Bell-Rönnlöf, Anna-Maria B; Lassila, Lippo V.J.; Vallittu, Pekka K.

2013-01-01

Objectives: The aim of this study was to evaluate the effect of two different cementation techniques of individually formed E-glass fiber-reinforced composite (FRC) post on bond strength and microleakage. Methods: The crowns of extracted third molars were removed and post preparation was carried out with parapost drills (diameter 1.5 mm). After application of bonding agents individually formed FRC posts (everStick POST, diameter 1.5 mm) were cemented into the post spaces with either ParaCem®Universal or self-adhesive RelyX™Unicem, using two different cementation techniques: 1) an “indirect (traditional) technique” where the post was prepolymerized prior application of luting cement and insertion into the post space or 2) a “direct technique” where the uncured post was inserted to the post space with luting cement and light-polymerized in situ at the same time. After water storage of 48 hours, the roots (n = 10/group) were cut into discs of thickness of 2 mm. A push-out force was applied until specimen fracture or loosening of the post. A microleakage test was carried out on roots which were not subjected to the loading test (n= 32) to evaluate the sealing capacity of the post-canal interface. The microleakage was measured using dye penetration depth under a stereomicroscope. Results: Higher bond strength values (p<0.05) and less microleakage (p<0.05) were obtained with the “direct technique” compared to the “indirect technique”. None of the FRC posts revealed any dye penetration between the post and the cement. Conclusions: The “direct technique” seems to be beneficial when cementing individually formed FRC posts. PMID:23986792

Longevity of metal-ceramic crowns cemented with self-adhesive resin cement: a prospective clinical study

PubMed

Brondani, Lucas Pradebon; Pereira-Cenci, Tatiana; Wandsher, Vinicius Felipe; Pereira, Gabriel Kalil; Valandro, Luis Felipe; Bergoli, César Dalmolin

2017-04-10

Resin cements are often used for single crown cementation due to their physical properties. Self-adhesive resin cements gained widespread due to their simplified technique compared to regular resin cement. However, there is lacking clinical evidence about the long-term behavior of this material. The aim of this prospective clinical trial was to assess the survival rates of metal-ceramic crowns cemented with self-adhesive resin cement up to six years. One hundred and twenty-nine subjects received 152 metal-ceramic crowns. The cementation procedures were standardized and performed by previously trained operators. The crowns were assessed as to primary outcome (debonding) and FDI criteria. Statistical analysis was performed using Kaplan-Meier statistics and descriptive analysis. Three failures occurred (debonding), resulting in a 97.6% survival rate. FDI criteria assessment resulted in scores 1 and 2 (acceptable clinical evaluation) for all surviving crowns. The use of self-adhesive resin cement is a feasible alternative for metal-ceramic crowns cementation, achieving high and adequate survival rates.

Properties of injectable ready-to-use calcium phosphate cement based on water-immiscible liquid.

PubMed

Heinemann, S; Rössler, S; Lemm, M; Ruhnow, M; Nies, B

2013-04-01

Calcium phosphate cements (CPCs) are highly valuable materials for filling bone defects and bone augmentation by minimal invasive application via percutaneous injection. In the present study some key features were significantly improved by developing a novel injectable ready-to-use calcium phosphate cement based on water-immiscible carrier liquids. A combination of two surfactants was identified to facilitate the targeted discontinuous exchange of the liquid for water after contact with aqueous solutions, enabling the setting reaction to take place at distinct ratios of cement components to water. This prolonged the shelf life of the pre-mixed paste and enhanced reproducibility during application and setting reactions. The developed paste technology is applicable for different CPC formulations. Evaluations were performed for the formulation of an α-TCP-based CPC as a representative example for the preparation of injectable pastes with a powder-to-carrier liquid ratio of up to 85:15. We demonstrate that the resulting material retains the desirable properties of conventional CPC counterparts for fast setting, mechanical strength and biocompatibility, shows improved cohesion and will most probably show a similar degree of resorbability due to identical mineral structure of the set products. Copyright © 2012 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

The use of waste materials for concrete production in construction applications

NASA Astrophysics Data System (ADS)

Teara, Ashraf; Shu Ing, Doh; Tam, Vivian WY

2018-04-01

To sustain the environment, it is crucial to find solutions to deal with waste, pollution, depletion and degradation resources. In construction, large amounts of concrete from buildings’ demolitions made up 30-40 % of total wastes. Expensive dumping cost, landfill taxes and limited disposal sites give chance to develop recycled concrete. Recycled aggregates were used for reconstructing damaged infrastructures and roads after World War II. However, recycled concrete consists fly ash, slag and recycled aggregate, is not widely used because of its poor quality compared with ordinary concrete. This research investigates the possibility of using recycled concrete in construction applications as normal concrete. Methods include varying proportion of replacing natural aggregate by recycled aggregate, and the substitute of cement by associated slag cement with fly ash. The study reveals that slag and fly ash are effective supplementary elements in improving the properties of the concrete with cement. But, without cement, these two elements do not play an important role in improving the properties. Also, slag is more useful than fly ash if its amount does not go higher than 50%. Moreover, recycled aggregate contributes positively to the concrete mixture, in terms of compression strength. Finally, concrete strength increases when the amount of the RA augments, related to either the high quality of RA or the method of mixing, or both.

Electrocoagulation improving bone cement use in middle-ear surgery: short-term and middle-term results.

PubMed

Galy-Bernadoy, C; Akkari, M; Mondain, M; Uziel, A; Venail, F

2016-12-01

Bone cement is used for ossicular chain repair and revision stapes surgery. Its efficient use requires cautious removal of mucosa from the ossicles. This paper reports a technique for easy, fast and safe removal of this mucosa prior to cement application. It consists of the application of monopolar electrocoagulation on the ossicles prior to bone cement application. The outcomes of six cases of revision stapes surgery and seven cases of partial ossiculoplasty, conducted between 2007 and 2012 using this new technique, were evaluated. Intra-operative reports and audiometric data were collected. During the last assessment, reconstruction using bone cement resulted in mean post-operative air-bone gaps of 4.1 ± 6.5 dB in revision stapes surgery cases and 5.7 ± 5.5 dB in partial ossiculoplasty cases, reflecting a significant hearing improvement (p = 0.03). No complications were observed. Electrocoagulation allows the removal of mucosa from the ossicles in an easy, fast and safe manner, enabling the use of bone cement for ossicular chain reconstruction.

A critical assessment of proximal macrotexturing on cemented femoral components.

PubMed

Duffy, G P; Muratoglu, O K; Biggs, S A; Larson, S L; Lozynsky, A J; Harris, W H

2001-12-01

We analyzed the cement-metal interface of 3 different types of femoral components that had proximal macrotexturing after in vitro insertion and after fatigue testing designed to produce debonding and micromotion. These components were compared with clinical retrieval specimens. The cement did not flow into the macrotexturing; rather, hollow, brittle volcanoes or calderas were formed. These fragile protrusions of cement become worn down or abraded by debonded components. This abrasion of cement may contribute to the early and aggressive osteolysis seen in some of these early failures with proximal macrotextured components. The formation of these volcanos and calderas can be aborted by placing bone-cement onto the macrotexturing before stem insertion. This simple technique allows the macrotexturing to be filled with cement.

Cemented tibial component fixation performs better than cementless fixation: a randomized radiostereometric study comparing porous-coated, hydroxyapatite-coated and cemented tibial components over 5 years.

PubMed

Carlsson, Ake; Björkman, Anders; Besjakov, Jack; Onsten, Ingemar

2005-06-01

The question whether the tibial component of a total knee arthroplasty should be fixed to bone with or without bone cement has not yet been definitely answered. We studied movements between the tibial component and bone by radiostereometry (RSA) in total knee replacement (TKR) for 3 different types of fixation: cemented fixation (C-F), uncemented porous fixation (UC-F) and uncemented porous hydroxyapatite fixation (UCHA-F). 116 patients with osteoarthrosis, who had 146 TKRs, were included in 2 randomized series. The first series included 86 unilateral TKRs stratified into 1 of the 3 types of fixation. The second series included 30 patients who had simultaneous bilateral TKR surgery, and who were stratified into 3 subgroups of pairwise comparisons of the 3 types of fixation. After 5 years 2 knees had been revised, neither of which were due to loosening. 1 UCHA-F knee in the unilateral series showed a large and continuous migration and a poor clinical result, and is a pending failure. The C-F knees rotated and migrated less than UC-F and UCHA-F knees over 5 years. UCHA-F migrated less than UC-F after 1 year. Cementing of the tibial component offers more stable bone-implant contact for 5 years compared to uncemented fixation. When using uncemented components, however, there is evidence that augmenting a porous surface with hydroxyapatite may mean less motion between implant and bone after the initial postoperative year.

Pull-out stability of anchors for rotator cuff repair is also increased by bio-absorbable augmentation: a cadaver study.

PubMed

Postl, L K; Ahrens, P; Beirer, M; Crönlein, M; Imhoff, A B; Foehr, P; Burgkart, R; Braun, C; Kirchhoff, Chlodwig

2016-08-01

Osteoporosis is a highly focused issue in current scientific research and clinical treatment. Especially in rotator cuff repair, the low bone quality of patients suffering from osteoporosis is an important issue. In this context, non-biological solutions using PMMA for anchor augmentation have been developed in the recent past. The aim of this study was to evaluate whether augmentation of suture anchors using bio-absorbable osteoconductive fiber-reinforced calcium phosphate results in improved failure load of suture anchors as well. Altogether 24 suture anchors (Corkscrew FT 1 Suture Anchors, Arthrex, Naples, FL, USA) were evaluated by applying traction until pullout in 12 paired fresh frozen human cadaver humeri using a servo-hydraulic testing machine. Inclusion criteria were an age of more than 64 years, a macroscopically intact RC and an intact bone. The anchors were evaluated at the anterolateral and posteromedial aspect of the greater tuberosity. 12 suture anchors were augmented and 12 suture anchors were conventionally inserted. The failure load was significantly enhanced by 66.8 % by the augmentation method. The fiber-reinforced calcium phosphate could be easily injected and applied. The bio-absorbable cement in this study could be a promising augmentation material for RC reconstructions, but further research is necessary-the material has to be evaluated in vivo.

Evaluation of the phase properties of hydrating cement composite using simulated nanoindentation technique

NASA Astrophysics Data System (ADS)

Gautham, S.; Sindu, B. S.; Sasmal, Saptarshi

2017-10-01

Properties and distribution of the products formed during the hydration of cementitious composite at the microlevel are investigated using a nanoindentation technique. First, numerical nanoindentation using nonlinear contact mechanics is carried out on three different phase compositions of cement paste, viz. mono-phase Tri-calcium Silicate (C3S), Di-calcium Silicate (C2S) and Calcium-Silicate-Hydrate (CSH) individually), bi-phase (C3S-CSH, C2S-CSH) and multi-phase (more than 10 individual phases including water pores). To reflect the multi-phase characteristics of hydrating cement composite, a discretized multi-phase microstructural model of cement composite during the progression of hydration is developed. Further, a grid indentation technique for simulated nanoindentation is established, and employed to evaluate the mechanical characteristics of the hydrated multi-phase cement paste. The properties obtained from the numerical studies are compared with those obtained from experimental grid nanoindentation. The influence of composition and distribution of individual phase properties on the properties obtained from indentation are closely investigated. The study paves the way to establishing the procedure for simulated grid nanoindentation to evaluate the mechanical properties of heterogeneous composites, and facilitates the design of experimental nanoindentation.

Comparison of the marginal adaptation of direct and indirect composite inlay restorations with optical coherence tomography

PubMed Central

TÜRK, Ayşe Gözde; SABUNCU, Metin; ÜNAL, Sena; ÖNAL, Banu; ULUSOY, Mübin

2016-01-01

ABSTRACT Objective The purpose of the study was to use the photonic imaging modality of optical coherence tomography (OCT) to compare the marginal adaptation of composite inlays fabricated by direct and indirect techniques. Material and Methods Class II cavities were prepared on 34 extracted human molar teeth. The cavities were randomly divided into two groups according to the inlay fabrication technique. The first group was directly restored on cavities with a composite (Esthet X HD, Dentsply, Germany) after isolating. The second group was indirectly restored with the same composite material. Marginal adaptations were scanned before cementation with an invisible infrared light beam of OCT (Thorlabs), allowing measurement in 200 µm intervals. Restorations were cemented with a self-adhesive cement resin (SmartCem2, Dentsply), and then marginal adaptations were again measured with OCT. Mean values were statistically compared by using independent-samples t-test and paired samples t-test (p<0.05), before and after cementation. Results Direct inlays presented statistically smaller marginal discrepancy values than indirect inlays, before (p=0.00001442) and after (p=0.00001466) cementation. Marginal discrepancy values were increased for all restorations after cementation (p=0.00008839, p=0.000000952 for direct and indirect inlays, respectively). The mean marginal discrepancy value of the direct group increased from 56.88±20.04 µm to 91.88±31.7 µm, whereas the indirect group increased from 107.54±35.63 µm to 170.29±54.83 µm. Different techniques are available to detect marginal adaptation of restorations, but the OCT system can give quantitative information about resin cement thickness and its interaction between tooth and restoration in a nondestructive manner. Conclusions Direct inlays presented smaller marginal discrepancy than indirect inlays. The marginal discrepancy values were increased for all restorations that refer to cement thickness after cementation. PMID:27556210

The extent of slits at the interfaces between luting cements and enamel, dentin and alloy.

PubMed

Oilo, G

1978-01-01

Four different cements were used to assess the presence of slits at the cement/tooth or the cement/alloy interfaces using a tooth-crown model. The model consisted of ground sections of teeth and plane plates of silver/palladium alloy. The plates were fixed with bolts between two brass plates and with three different dimensions of the cement film between tooth and alloy, i.e. 50 micrometer, 100 micrometer and 200 micrometer. The tooth-alloy specimens were sectioned and the adaption of cements was studied with an indirect technique (replica) in a scanning electron microscope. The extent of slits was expressed as the length of all slits relative to the total length of the interface in each specimen. The results showed that the zinc phosphate cement and polycarboxylate cement exhibited a slight to moderate tendency to formation of slits at the interfaces. The EBA cement had a small extent of slits adjacent to thin cement films, but more slits were observed with increasing film thickness. The composite resin cement had a marked tendency to slit formation independent of the cement film thickness.

[Bonding of visible light cured composite resins to glass ionomer and Cermet cements].

PubMed

Kakaboura, A; Vougiouklakis, G

1990-04-01

The "sandwich" technique involves combination of composite resins to etched glassionomer cements, is used today in restorative dentistry. The purpose of this study is to evaluate the bond strength between several composite resins and glass ionomer or cerment cements. Cylindrical specimens of the cements Ketac-Silver, Ionobond and GC-Lining Ce-ment were inserted in a mold and their flat free surfaces were etched for 30". Cylindrical plastic tubes were set upon each one of these surfaces and filled with the Composite resins Durafill, Brilliant Lux, Estilux posterior, Estilux posterior CVS and Herculite XR. Half of the specimens transferred in tap water for 24 hours and the others after thermocycling in the first month, kept for 4 months. Shear bond strengths were determined in Monsanto Testing Machine and some fractured surfaces were examined under SEM. The results of this investigation indicate that this technique produces bond strengths between composite resins and glassioners and the combination type of resin and type of cement, affects the values of the strength. Glass cermeet--small particle resin provides the most effective strength and glass ionomer--microfill resins the least. Storage time and thermocycling don't significantly effect the bond strength. SEM examination showed that all fracture failures were obtained in the cement while the opposite resin surfaces were covered with particles of the cements.

Energy release rate analysis on the interface cracks of enamel-cement-bracket fracture using virtual crack closure technique

NASA Astrophysics Data System (ADS)

Samshuri, S. F.; Daud, R.; Rojan, M. A.; Mat, F.; Basaruddin, K. S.; Hassan, R.

2017-10-01

This paper presents the energy method to evaluate fracture behavior of enamel-cement-bracket system based on cement thickness. Finite element (FE) model of enamel-cement-bracket was constructed by using ANSYS Parametric Design Language (APDL). Three different thickness were used in this study, 0.05, 0.2, and 0.271 mm which assigned as thin, medium and thick for both enamel-cement and cement bracket interface cracks. Virtual crack closure technique (VCCT) was implemented as a simulation method to calculated energy release rate (ERR). Simulation results were obtained for each thickness are discussed by using Griffith’s energy balance approach. ERR for thin thickness are found to be the lowest compared to medium and thick. Peak value of ERR also showed a significant different between medium and thick thickness. Therefore, weakest bonding occurred at low cement thickness because less load required to produce enough energy to detach the bracket. For medium and thick thickness, both increased rapidly in energy value at about the mid-point of the enamel-cement interface. This behavior occurred because of the increasing in mechanical and surface energy when the cracks are increasing. However, result for thick thickness are higher at mid-point compared to thin thickness. In conclusion, fracture behavior of enamel cracking process for medium most likely the safest to avoid enamel fracture and withstand bracket debonding.

Does metaphyseal cement augmentation in fracture management influence the adjacent subchondral bone and joint cartilage?: an in vivo study in sheep stifle joints.

PubMed

Goetzen, Michael; Hofmann-Fliri, Ladina; Arens, Daniel; Zeiter, Stephan; Stadelmann, Vincent; Nehrbass, Dirk; Richards, R Geoff; Blauth, Michael

2015-01-01

Augmentation of implants with polymethylmethacrylate (PMMA) bone cement in osteoporotic fractures is a promising approach to increase implant purchase. Side effects of PMMA for the metaphyseal bone, particularly for the adjacent subchondral bone plate and joint cartilage, have not yet been studied. The following experimental study investigates whether subchondral PMMA injection compromises the homeostasis of the subchondral bone and/or the joint cartilage.Ten mature sheep were used to simulate subchondral PMMA injection. Follow-ups of 2 (4 animals) and 4 (6 animals) months were chosen to investigate possible cartilage damage and subchondral plate alterations in the knee. Evaluation was completed by means of high-resolution peripheral quantitative computed tomography (HRpQCT) imaging, histopathological osteoarthritis scoring, and determination of glycosaminoglycan content in the joint cartilage. Results were compared with the untreated contralateral knee and statistically analyzed using nonparametric tests.Evaluation of the histological osteoarthritis score revealed no obvious cartilage damage for the treated knee; median histological score after 2 months 0 (range 4), after 4 months 1 (range 5). There was no significant difference when compared with the untreated control site after 2 and 4 months (P = 0.23 and 0.76, respectively). HRpQCT imaging showed no damage to the metaphyseal trabeculae. Glycosaminoglycan measurements of the treated joint cartilage after 4 months revealed no significant difference compared with the untreated cartilage (P = 0.24).The findings of this study support initial clinical observation that PMMA implant augmentation of metaphyseal fractures appears to be a safe procedure for fixation without harming the subchondral bone plate and adjacent joint cartilage.

Acetabular Cup Revision.

PubMed

Kim, Young-Ho

2017-09-01

The use of acetabular cup revision arthroplasty is on the rise as demands for total hip arthroplasty, improved life expectancies, and the need for individual activity increase. For an acetabular cup revision to be successful, the cup should gain stable fixation within the remaining supportive bone of the acetabulum. Since the patient's remaining supportive acetabular bone stock plays an important role in the success of revision, accurate classification of the degree of acetabular bone defect is necessary. The Paprosky classification system is most commonly used when determining the location and degree of acetabular bone loss. Common treatment options include: acetabular liner exchange, high hip center, oblong cup, trabecular metal cup with augment, bipolar cup, bulk structural graft, cemented cup, uncemented cup including jumbo cup, acetabular reinforcement device (cage), trabecular metal cup cage. The optimal treatment option is dependent upon the degree of the discontinuity, the amount of available bone stock and the likelihood of achieving stable fixation upon supportive host bone. To achieve successful acetabular cup revision, accurate evaluation of bone defect preoperatively and intraoperatively, proper choice of method of acetabular revision according to the evaluation of acetabular bone deficiency, proper technique to get primary stability of implant such as precise grafting technique, and stable fixation of implant are mandatory.

Multiphasic modelling of bone-cement injection into vertebral cancellous bone.

PubMed

Bleiler, Christian; Wagner, Arndt; Stadelmann, Vincent A; Windolf, Markus; Köstler, Harald; Boger, Andreas; Gueorguiev-Rüegg, Boyko; Ehlers, Wolfgang; Röhrle, Oliver

2015-01-01

Percutaneous vertebroplasty represents a current procedure to effectively reinforce osteoporotic bone via the injection of bone cement. This contribution considers a continuum-mechanically based modelling approach and simulation techniques to predict the cement distributions within a vertebra during injection. To do so, experimental investigations, imaging data and image processing techniques are combined and exploited to extract necessary data from high-resolution μCT image data. The multiphasic model is based on the Theory of Porous Media, providing the theoretical basis to describe within one set of coupled equations the interaction of an elastically deformable solid skeleton, of liquid bone cement and the displacement of liquid bone marrow. The simulation results are validated against an experiment, in which bone cement was injected into a human vertebra under realistic conditions. The major advantage of this comprehensive modelling approach is the fact that one can not only predict the complex cement flow within an entire vertebra but is also capable of taking into account solid deformations in a fully coupled manner. The presented work is the first step towards the ultimate and future goal of extending this framework to a clinical tool allowing for pre-operative cement distribution predictions by means of numerical simulations. Copyright © 2015 John Wiley & Sons, Ltd.

Long-Term Behaviour of Fly Ash and Slag Cement Grouts for Micropiles Exposed to a Sulphate Aggressive Medium.

PubMed

Ortega, José Marcos; Esteban, María Dolores; Rodríguez, Raúl Rubén; Pastor, José Luis; Ibanco, Francisco José; Sánchez, Isidro; Climent, Miguel Ángel

2017-05-30

Nowadays, one of the most popular ways to get a more sustainable cement industry is using additions as cement replacement. However, there are many civil engineering applications in which the use of sustainable cements is not extended yet, such as special foundations, and particularly micropiles, even though the standards do not restrict the cement type to use. These elements are frequently exposed to the sulphates present in soils. The purpose of this research is to study the effects in the very long-term (until 600 days) of sulphate attack in the microstructure of micropiles grouts, prepared with ordinary Portland cement, fly ash and slag commercial cements, continuing a previous work, in which these effects were studied in the short-term. The microstructure changes have been analysed with the non-destructive impedance spectroscopy technique, mercury intrusion porosimetry and the "Wenner" resistivity test. The mass variation and the compressive strength have also been studied. The impedance spectroscopy has been the most sensitive technique for following the sulphate attack process. Considering the results obtained, micropiles grouts with slag and fly ash, exposed to an aggressive medium with high content of sulphates, have shown good behaviour in the very long-term (600 days) compared to grouts made with OPC.

Long-Term Behaviour of Fly Ash and Slag Cement Grouts for Micropiles Exposed to a Sulphate Aggressive Medium

PubMed Central

Ortega, José Marcos; Esteban, María Dolores; Rodríguez, Raúl Rubén; Pastor, José Luis; Ibanco, Francisco José; Sánchez, Isidro; Climent, Miguel Ángel

2017-01-01

Nowadays, one of the most popular ways to get a more sustainable cement industry is using additions as cement replacement. However, there are many civil engineering applications in which the use of sustainable cements is not extended yet, such as special foundations, and particularly micropiles, even though the standards do not restrict the cement type to use. These elements are frequently exposed to the sulphates present in soils. The purpose of this research is to study the effects in the very long-term (until 600 days) of sulphate attack in the microstructure of micropiles grouts, prepared with ordinary Portland cement, fly ash and slag commercial cements, continuing a previous work, in which these effects were studied in the short-term. The microstructure changes have been analysed with the non-destructive impedance spectroscopy technique, mercury intrusion porosimetry and the “Wenner” resistivity test. The mass variation and the compressive strength have also been studied. The impedance spectroscopy has been the most sensitive technique for following the sulphate attack process. Considering the results obtained, micropiles grouts with slag and fly ash, exposed to an aggressive medium with high content of sulphates, have shown good behaviour in the very long-term (600 days) compared to grouts made with OPC. PMID:28772958

Minimum Abutment Height to Eliminate Bone Loss: Influence of Implant Neck Design and Platform Switching.

PubMed

Spinato, Sergio; Galindo-Moreno, Pablo; Bernardello, Fabio; Zaffe, Davide

This retrospective study quantitatively analyzed the minimum prosthetic abutment height to eliminate bone loss after 4.7-mm-diameter implant placement in maxillary bone and how grafting techniques can affect the marginal bone loss in implants placed in maxillary areas. Two different implant types with a similar neck design were singularly placed in two groups of patients: the test group, with platform-switched implants, and the control group, with conventional (non-platform-switched) implants. Patients requiring bone augmentation underwent unilateral sinus augmentation using a transcrestal technique with mineralized xenograft. Radiographs were taken immediately after implant placement, after delivery of the prosthetic restoration, and after 12 months of loading. The average mesial and distal marginal bone loss of the control group (25 patients) was significantly more than twice that of the test group (26 patients), while their average abutment height was similar. Linear regression analysis highlighted a statistically significant inverse relationship between marginal bone loss and abutment height in both groups; however, the intercept of the regression line, both mesially and distally, was 50% lower for the test group than for the control group. The marginal bone loss was annulled with an abutment height of 2.5 mm for the test group and 3.0 mm for the control group. No statistically significant differences were found regarding marginal bone loss of implants placed in native maxillary bone compared with those placed in the grafted areas. The results suggest that the shorter the abutment height, the greater the marginal bone loss in cement-retained prostheses. Abutment height showed a greater influence in platform-switched than in non-platform-switched implants on the limitation of marginal bone loss.

Two imaging techniques for 3D quantification of pre-cementation space for CAD/CAM crowns.

PubMed

Rungruanganunt, Patchanee; Kelly, J Robert; Adams, Douglas J

2010-12-01

Internal three-dimensional (3D) "fit" of prostheses to prepared teeth is likely more important clinically than "fit" judged only at the level of the margin (i.e. marginal "opening"). This work evaluates two techniques for quantitatively defining 3D "fit", both using pre-cementation space impressions: X-ray microcomputed tomography (micro-CT) and quantitative optical analysis. Both techniques are of interest for comparison of CAD/CAM system capabilities and for documenting "fit" as part of clinical studies. Pre-cementation space impressions were taken of a single zirconia coping on its die using a low viscosity poly(vinyl siloxane) impression material. Calibration specimens of this material were fabricated between the measuring platens of a micrometre. Both calibration curves and pre-cementation space impression data sets were obtained by examination using micro-CT and quantitative optical analysis. Regression analysis was used to compare calibration curves with calibration sets. Micro-CT calibration data showed tighter 95% confidence intervals and was able to measure over a wider thickness range than for the optical technique. Regions of interest (e.g., lingual, cervical) were more easily analysed with optical image analysis and this technique was more suitable for extremely thin impression walls (<10-15μm). Specimen preparation is easier for micro-CT and segmentation parameters appeared to capture dimensions accurately. Both micro-CT and the optical method can be used to quantify the thickness of pre-cementation space impressions. Each has advantages and limitations but either technique has the potential for use as part of clinical studies or CAD/CAM protocol optimization. Copyright © 2010 Elsevier Ltd. All rights reserved.

Patch-augmented rotator cuff repair: influence of the patch fixation technique on primary biomechanical stability.

PubMed

Jung, Christian; Spreiter, Gregor; Audigé, Laurent; Ferguson, Stephen J; Flury, Matthias

2016-05-01

There is an ongoing debate about the potential of patch augmentation to improve biomechanical stability and healing associated with rotator cuff repair. The biomechanical properties of three different patch-augmented rotator cuff repair techniques were assessed in vitro and compared with a standard repair. Dermal collagen patch augmentation may increase the primary stability and strength of the repaired tendon in vitro, depending on the technique used for patch application. Forty cadaveric sheep shoulders with dissected infraspinatus tendons were randomized into four groups (n = 10/group) for tendon repair using a knotless double-row suture anchor technique. A xenologous dermal extracellular matrix patch was used for augmentation in the three test groups using an "integrated", "cover", or "hybrid" technique. Tendons were preconditioned, cyclically loaded from 10 to 30 N at 1 Hz, and then loaded monotonically to failure. Biomechanical properties and the mode of failure were evaluated. Patch augmentation significantly increased the maximum load at failure by 61 % in the "cover" technique test group (225.8 N) and 51 % in the "hybrid" technique test group (211.4 N) compared with the non-augmented control group (140.2 N) (P ≤ 0.015). For the test group with "integrated" patch augmentation, the load at failure was 28 % lower (101.6 N) compared with the control group (P = 0.043). There was no significant difference in initial and linear stiffness among the four experimental groups. The most common mode of failure was tendon pullout. No anchor dislocation, patch disruption or knot breakage was observed. Additional patch augmentation with a collagen patch influences the biomechanical properties of a rotator cuff repair in a cadaveric sheep model. Primary repair stability can be significantly improved depending on the augmentation technique.

Calculus removal on a root cement surface by ultrashort laser pulses

NASA Astrophysics Data System (ADS)

Kraft, Johan F.; Vestentoft, Kasper; Christensen, Bjarke H.; Løvschall, Henrik; Balling, Peter

2008-01-01

Ultrashort-pulse-laser ablation of dental calculus (tartar) and cement is performed on root surfaces. The investigation shows that the threshold fluence for ablation of calculus is a factor of two to three times smaller than that of a healthy root cement surface. This indicates that ultrashort laser pulses may provide an appropriate tool for selective removal of calculus with minimal damage to the underlying root cement. Future application of an in situ profiling technique allows convenient on-line monitoring of the ablation process.

Application of resistivity monitoring to evaluate cement grouting effect in earth filled dam

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, Jin-Mo; Yoon, Wang-Jung

In this paper, we applied electrical resistivity monitoring method to evaluate the cement grouting effect. There are a lot of ways to evaluate cement grouting effect. In order to do this evaluation in a great safety, high efficiency, and lower cost, resistivity monitoring is found to be the most appropriate technique. In this paper we have selected a dam site from Korea to acquire resistivity monitoring data and compare the results of inversion to estimate the cement grouting effect.

Development of monetite-nanosilica bone cement: a preliminary study.

PubMed

Zhou, Huan; Luchini, Timothy J F; Agarwal, Anand K; Goel, Vijay K; Bhaduri, Sarit B

2014-11-01

In this paper, we reported the results of our efforts in developing DCPA/nanosilica composite orthopedic cement. It is motivated by the significances of DCPA and silicon in bone physiological activities. More specifically, this paper examined the effects of various experimental parameters on the properties of such composite cements. In this work, DCPA cement powders were synthesized using a microwave synthesis technique. Mixing colloidal nanosilica directly with synthesized DCPA cement powders can significantly reduce the washout resistance of DCPA cement. In contrast, a DCPA-nanosilica cement powder prepared by reacting Ca(OH)2 , H3 PO4 and nanosilica together showed good washout resistance. The incorporation of nanosilica in DCPA can improve compressive strength, accelerate cement solidification, and intensify surface bioactivity. In addition, it was observed that by controlling the content of NaHCO3 during cement preparation, the resulting composite cement properties could be modified. Allowing for the development of different setting times, mechanical performance and crystal features. It is suggested that DCPA-nanosilica composite cement can be a potential candidate for bone healing applications. © 2014 Wiley Periodicals, Inc.

Fracture resistance of metal-free composite crowns-effects of fiber reinforcement, thermal cycling, and cementation technique.

PubMed

Lehmann, Franziska; Eickemeyer, Grit; Rammelsberg, Peter

2004-09-01

The improved mechanical properties of contemporary composites have resulted in their extensive use for the restoration of posterior teeth. However, the influence of fiber reinforcement, cementation technique, and physical stress on the fracture resistance of metal-free crowns is unknown. This in vitro study evaluated the effect of fiber reinforcement, physical stress, and cementation methods on the fracture resistance of posterior metal-free Sinfony crowns. Ninety-six extracted human third molars received a standardized tooth preparation: 0.5-mm chamfer preparation and occlusal reduction of 1.3 to 1.5 mm. Sinfony (nonreinforced crowns, n=48) and Sinfony-Vectris (reinforced crowns, n=48) crowns restoring original tooth contour were prepared. Twenty-four specimens of each crown type were cemented, using either glass ionomer cement (GIC) or resin cement. Thirty-two crowns (one third) were stored in humidity for 48 hours. Another third was exposed to 10,000 thermal cycles (TC) between 5 degrees C and 55 degrees C. The remaining third was treated with thermal cycling and mechanical loading (TCML), consisting of 1.2 million axial loads of 50 N. The artificial crowns were then vertically loaded with a steel sphere until failure occurred. Significant differences in fracture resistance (N) between experimental groups were assessed by nonparametric Mann-Whitney U-test (alpha=.05). Fifty percent of the Sinfony and Sinfony-Vectris crowns cemented with glass ionomer cement loosened after thermal cycling. Thermal cycling resulted in a significant reduction in the mean fracture resistance for Sinfony crowns cemented with GIC, from 2037 N to 1282 N (P=.004). Additional fatigue produced no further effects. Fiber reinforcement significantly increased fracture resistance, from 1555 N to 2326 N (P=.001). The minimal fracture resistance was above 600 N for all combinations of material, cement and loading. Fracture resistance of metal-free Sinfony crowns was significantly increased by fiber reinforcement. Adhesive cementation may be recommended to avoid cementation failure.

Microstructural characterization of catalysis product of nanocement based materials: A review

NASA Astrophysics Data System (ADS)

Sutan, Norsuzailina Mohamed; Izaitul Akma Ideris, Nur; Taib, Siti Noor Linda; Lee, Delsye Teo Ching; Hassan, Alsidqi; Kudnie Sahari, Siti; Mohamad Said, Khairul Anwar; Rahman Sobuz, Habibur

2018-03-01

Cement as an essential element for cement-based products contributed to negative environmental issues due to its high energy consumption and carbon dioxide emission during its production. These issues create the need to find alternative materials as partial cement replacement where studies on the potential of utilizing silica based materials as partial cement replacement come into picture. This review highlights the effectiveness of microstructural characterization techniques that have been used in the studies that focus on characterization of calcium hydroxide (CH) and calcium silicate hydrate (C-S-H) formation during hydration process of cement-based product incorporating nano reactive silica based materials as partial cement replacement. Understanding the effect of these materials as cement replacement in cement based product focusing on the microstructural development will lead to a higher confidence in the use of industrial waste as a new non-conventional material in construction industry that can catalyse rapid and innovative advances in green technology.

investigating the use of geophysical techniques to detect hydrocarbon seeps

NASA Astrophysics Data System (ADS)

Somwe, Vincent Tambwe

In the Cement oil field, seeps occur in the Hydrocarbon Induced Diagenetic Aureole (HIDA).This 14 square km diagenetic alteration region is mainly characterized by the: (1) secondary carbonate minerals deposition that tends to form ridges throughout the oil field; (2) disseminated pyrite in the vicinity of the fault zones; (3) uranium occurrence and the change in color pattern from red to bleached red sandstone. Generally the HIDA of the Cement oil field is subdivided into four zones: (1) carbonate cemented sandstone zone (zone 1), (2) altered sandstone zone (zone 2), (3) sulfide zone (zone 3) and (4) unaltered sandstone zone (zone 4). This study investigated the use of geophysical techniques to detect alteration zones over the Cement oil field. Magnetic and electromagnetic data were acquired at 5 m interval using the geometric G858 magnetometer and the Geonics EM-31 respectively. Both total magnetic intensity and bulk conductivity were found to decrease across boundaries between unaltered and altered sandstones. Boundaries between sulfide and carbonate zones, which in most cases were located in fault zones, were found to be characterized by higher magnetic and bulk conductivity readings. The contrast between the background and the highest positive peak was found to be in the range of 0.5-10% for total magnetic intensity and 258-450% for bulk conductivity respectively; suggesting that the detection of hydrocarbon seeps would be more effective with EM techniques. The study suggests that geophysical techniques can be used to delineate contact between the different alteration zones especially where metallic minerals such as pyrite are precipitated. The occurrence of carbonate cemented sandstone in the Cement oil field can be used as a pathfinder for hydrocarbon reservoir. The change in color in the altered sandstone zone can still be useful in the hydrocarbon exploration.

Is there still a place for the cemented titanium femoral stem?

PubMed Central

2012-01-01

Background and purpose Despite the fact that there have been some reports on poor performance, titanium femoral stems intended for cemented fixation are still used at some centers in Europe. In this population-based registry study, we examined the results of the most frequently used cemented titanium stem in Norway. Patients and methods 11,876 cases implanted with the cemented Titan stem were identified for the period 1987–2008. Hybrid arthroplasties were excluded, leaving 10,108 cases for this study. Stem survival and the influence of age, sex, stem offset and size, and femoral head size were evaluated using Cox regression analyses. Questionnaires were sent to the hospitals to determine the surgical technique used. Results Male sex, high stem offset, and small stem size were found to be risk factors for stem revision, (adjusted RR = 2.5 (1.9–3.4), 3.3 (2.3–4.8), and 2.2 (1.4–3.5), respectively). Patients operated in the period 2001–2008 had an adjusted relative risk (RR) of 4.7 (95% CI: 3.0–7.4) for stem revision due to aseptic stem loosening compared to the period 1996–2000. Changes in broaching technique and cementing technique coincided with deterioration of the results in some hospitals. Interpretation The increased use of small stem sizes and high-offset stems could only explain the deterioration of results to a certain degree since the year 2000. The influence of discrete changes in surgical technique over time could not be fully evaluated in this registry study. We suggest that this cemented titanium stem should be abandoned. The results of similar implants should be carefully evaluated. PMID:22206445

Application of Neutron imaging in pore structure of hydrated wellbore cement: comparison of hydration of H20 with D2O based Portland cements

NASA Astrophysics Data System (ADS)

Dussenova, D.; Bilheux, H.; Radonjic, M.

2012-12-01

Wellbore Cement studies have been ongoing for decades. The studies vary from efforts to reduce permeability and resistance to corrosive environment to issues with gas migration also known as Sustained Casing Pressure (SCP). These practical issues often lead to health and safety problems as well as huge economic loss in oil and gas industry. Several techniques have been employed to reduce the impact of gas leakage. In this study we purely focus on expandable liners, which are introduced as part of oil well reconstruction and work-overs and as well abandonment procedures that help in prevention of SCP. Expandable liner is a tube that after application of a certain tool can increase its diameter. The increase in diameter creates extra force on hydrated cement that results in reducing width of interface fractures and cement-tube de-bonding. Moreover, this also causes cement to change its microstructure and other porous medium properties, primarily hydraulic conductivity. In order to examine changes before and after operations, cement pore structure must be well characterized and correlated to cement slurry design as well as chemical and physical environmental conditions. As modern oil well pipes and tubes contain iron, it is difficult to perform X-ray tomography of a bulk measurement of the cement in its wellbore conditions, which are tube wall-cement-tube wall. Neutron imaging is a complementary technique to x-ray imaging and is well suited for detection of light elements imbedded in metallic containers. Thus, Neutron Imaging (NI) is investigated as a tool for the detection of pore structure of hydrated wellbore cement. Recent measurements were conducted at the Oak Ridge National Laboratory (ORNL) High Flux Isotope Reactor (HFIR) neutron imaging facility. NI is is highly sensitive to light elements such as Hydrogen (H). Oil well cements that have undergone a full hydration contain on average 30%-40% of free water in its pore structure. The unreacted water is the main storage of the hydrogen atom. In such case, neutron tomography does not give information of the pore structure as neutrons will strongly scatter of H and the data have low count and low statistics or low neutron transmission. Hence, as the comparison and the possible tuning technique, neutron tomography measurements are performed on a Deuterium Oxide (D2O) or heavy water samples the same dimensions, cement composition, cement/liquid content and hydration time as the H2O samples. The advantage of using heavy water is that the total neutron cross-section for Deuterium is approximately four times smaller than Hydrogen's and, thus, permits better neutron transmission, i.e. better statistics. D2O does not alter cement properties or its chemical composition; therefore, the samples are almost identical. Comparison of the measurements using water and heavy water samples and the preparation of the measurement cement samples are discussed in this

Novel Augmentation Technique for Patellar Tendon Repair Improves Strength and Decreases Gap Formation: A Cadaveric Study.

PubMed

Black, James C; Ricci, William M; Gardner, Michael J; McAndrew, Christopher M; Agarwalla, Avinesh; Wojahn, Robert D; Abar, Orchid; Tang, Simon Y

2016-12-01

Patellar tendon ruptures commonly are repaired using transosseous patellar drill tunnels with modified-Krackow sutures in the patellar tendon. This simple suture technique has been associated with failure rates and poor clinical outcomes in a modest proportion of patients. Failure of this repair technique can result from gap formation during loading or a single catastrophic event. Several augmentation techniques have been described to improve the integrity of the repair, but standardized biomechanical evaluation of repair strength among different techniques is lacking. The purpose of this study was to describe a novel figure-of-eight suture technique to augment traditional fixation and evaluate its biomechanical performance. We hypothesized that the augmentation technique would (1) reduce gap formation during cyclic loading and (2) increase the maximum load to failure. Ten pairs (two male, eight female) of fresh-frozen cadaveric knees free of overt disorders or patellar tendon damage were used (average donor age, 76 years; range, 65-87 years). For each pair, one specimen underwent the standard transosseous tunnel suture repair with a modified-Krackow suture technique and the second underwent the standard repair with our experimental augmentation method. Nine pairs were suitable for testing. Each specimen underwent cyclic loading while continuously measuring gap formation across the repair. At the completion of cyclic loading, load to failure testing was performed. A difference in gap formation and mean load to failure was seen in favor of the augmentation technique. At 250 cycles, a 68% increase in gap formation was seen for the control group (control: 5.96 ± 0.86 mm [95% CI, 5.30-6.62 mm]; augmentation: 3.55 ± 0.56 mm [95% CI, 3.12-3.98 mm]; p = 0.02). The mean load to failure was 13% greater in the augmentation group (control: 899.57 ± 96.94 N [95% CI, 825.06-974.09 N]; augmentation: 1030.70 ± 122.41 N [95% CI, 936.61-1124.79 N]; p = 0.01). This biomechanical study showed improved performance of a novel augmentation technique compared with the standard repair, in terms of reduced gap formation during cyclic loading and increased maximum load to failure. Decreased gap formation and higher load to failure may improve healing potential and minimize failure risk. This study shows a potential biomechanical advantage of the augmentation technique, providing support for future clinical investigations comparing this technique with other repair methods that are in common use such as transosseous suture repair.

Imaging Wellbore Cement Degradation by Carbon Dioxide under Geologic Sequestration Conditions Using X-ray Computed Microtomography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jung, Hun Bok; Jansik, Danielle; Um, Wooyong

2013-01-02

ABSTRACT: X-ray microtomography (XMT), a nondestructive three-dimensional imaging technique, was applied to demonstrate its capability to visualize the mineralogical alteration and microstructure changes in hydrated Portland cement exposed to carbon dioxide under geologic sequestration conditions. Steel coupons and basalt fragments were added to the cement paste in order to simulate cement-steel and cement-rock interfaces. XMT image analysis showed the changes of material density and porosity in the degradation front (density: 1.98 g/cm3, porosity: 40%) and the carbonated zone (density: 2.27 g/cm3, porosity: 23%) after reaction with CO2- saturated water for 5 months compared to unaltered cement (density: 2.15 g/cm3, porosity:more » 30%). Three-dimensional XMT imaging was capable of displaying spatially heterogeneous alteration in cement pores, calcium carbonate precipitation in cement cracks, and preferential cement alteration along the cement-steel and cement-rock interfaces. This result also indicates that the interface between cement and host rock or steel casing is likely more vulnerable to a CO2 attack than the cement matrix in a wellbore environment. It is shown here that XMT imaging can potentially provide a new insight into the physical and chemical degradation of wellbore cement by CO2 leakage.« less

Fixation method does not affect restoration of rotation center in hip replacements: A single-site retrospective study

PubMed Central

2012-01-01

Background Aseptic loosening is one of the greatest problems in hip replacement surgery. The rotation center of the hip is believed to influence the longevity of fixation. The aim of this study was to compare the influence of cemented and cementless cup fixation techniques on the position of the center of rotation because cemented cup fixation requires the removal of more bone for solid fixation than the cementless technique. Methods We retrospectively compared pre- and post-operative positions of the hip rotation center in 25 and 68 patients who underwent artificial hip replacements in our department in 2007 using cemented or cementless cup fixation, respectively, with digital radiographic image analysis. Results The mean horizontal and vertical distances between the rotation center and the acetabular teardrop were compared in radiographic images taken pre- and post-operatively. The mean horizontal difference was −2.63 mm (range: -11.00 mm to 10.46 mm, standard deviation 4.23 mm) for patients who underwent cementless fixation, and −2.84 mm (range: -10.87 to 5.30 mm, standard deviation 4.59 mm) for patients who underwent cemented fixation. The mean vertical difference was 0.60 mm (range: -20.15 mm to 10.00 mm, standard deviation 3.93 mm) and 0.41 mm (range: -9.26 mm to 6.54 mm, standard deviation 3.58 mm) for the cementless and cemented fixation groups, respectively. The two fixation techniques had no significant difference on the position of the hip rotation center in the 93 patients in this study. Conclusions The hip rotation center was similarly restored using either the cemented or cementless fixation techniques in this patient cohort, indicating that the fixation technique itself does not interfere with the position of the center of rotation. To completely answer this question further studies with more patients are needed. PMID:22686355

Fire and ice: percutaneous ablative therapies and cement injection in management of metastatic disease of the spine.

PubMed

Munk, Peter L; Murphy, Kieran J; Gangi, Afshin; Liu, David M

2011-04-01

Oncology intervention is actively moving beyond simple bone cement injection. Archimedes taught us that a volume displaces its volume. Where does the tumor we displace with our cement injection go? It is no longer acceptable that we displace tumor into the venous system with our cement injections. We must kill the tumor first. Different image-guided percutaneous techniques can be used for treatment in patients with primary or secondary bone tumors. Curative ablation can be applied for the treatment of specific benign or in selected cases of malignant localized spinal tumors. Pain palliation therapy of primary and secondary bone tumors can be achieved with safe, fast, effective, and tolerable percutaneous methods. Ablation (chemical, thermal, mechanical), cavitation (radiofrequency ionization), and consolidation (cementoplasty) techniques can be used separately or in combination. Each technique has its indications, with both advantages and drawbacks. To prevent pathological fractures, a consolidation is necessary. In spinal or acetabular tumors, a percutaneous cementoplasty should be associated with cryoablation to avoid a compression fracture. The cement is injected after complete thawing of the ice ball or the day after the cryotherapy. A syndrome of multiorgan failure, severe coagulopathy, and disseminated intravascular coagulation following hepatic cryoablation has been described and is referred to as the cryoshock phenomenon. © Thieme Medical Publishers.

Bibliography on augmentation of convective heat and mass transfer-II

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bergles, A.E.; Nirmalan, V.; Junkhan, G.H.

1983-12-01

Heat transfer augmentation has developed into a major specialty area in heat transfer research and development. This report presents and updated bibliography of world literature on augmentation. The literature is classified into passive augmentation techniques, which require no external power, and active techniques, which do require external power. The fifteen techniques are grouped in terms of their applications to the various modes of heat transfer. Mass transfer is included for completeness. Key words are included with each citation for technique/mode identification. The total number of publications cited is 3045, including 135 surveys of various techniques and 86 papers on performancemore » evaluation of passive techniques. Patents are not included, as they are the subject of a separate bibliographic report.« less

Bibliography on augmentation of convective heat and mass transfer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bergles, A.E.; Webb, R.L.; Junkhan, G.H.

1979-05-01

Heat transfer augmentation has developed into a major specialty area in heat transfer research and development. A bibliography of world literature on augmentation is presented. The literature is classified into passive augmentation techniques, which require no external power, and active techniques, which do require external power. The fourteen techniques are grouped in terms of their application to the various modes of heat transfer. Mass transfer is included for completeness. Key words are included with each citation for technique/mode identification. The total number of publications cited is 1,967, including 75 surveys of various techniques and 42 papers on performance evaluation ofmore » passive techniques. Patents are not included as they will be the subject of a future topical report.« less

Effects of Cementing on Ligament Balance During Total Knee Arthroplasty.

PubMed

Chow, Jimmy; Wang, Kevin; Elson, Leah; Anderson, Christopher; Roche, Martin

2017-05-01

Complications related to joint imbalance may contribute to some of the most predominant modes of failure in total knee arthroplasty (TKA). These complications include instability, aseptic loosening, asymmetric component wear, and idiopathic pain. Fixation may represent a step that introduces unchecked variability into the procedure and may contribute to the incidence of joint imbalance-related complications. The ability to quantify in vivo loading in the medial and lateral compartments would allow for the ability to confirm balance after fixation and prior to wound closure. This retrospective study sought to capture any variability and imbalance associated with cementing technique. A total of 93 patients underwent sensor-assisted TKA. All patients were confirmed to have quantifiably balanced joints prior to cementation. After cementing and final component placement, the sensor was reinserted into the joint to capture any cementation-induced changes in loading. Imbalance was observed in 44% of patients after cementation. There was no difference in the proportion of imbalance due to surgeon experience (P=.456), cement type (P=.429), or knee system (P=.792). A majority of knees exhibited loading increase in the medial compartment. It was concluded that cementation technique contributes to a significant amount of balance-related variability at the fixation stage of the procedure. The use of the sensor in this study allowed for the correction of all instances of imbalance prior to closure. More objective methods of balance verification may be important for ensuring optimal surgical outcomes. [Orthopedics. 2017; 40(3):e455-e459.]. Copyright 2017, SLACK Incorporated.

[Anterior bridges with the IPS-Empress-2 System after alveolar ridge augmentation. A case report].

PubMed

Zawta, C; Bernhard, M

2000-01-01

The success of a prosthesis is judged according to optimal function, good chewing comfort, adequate phonetics and white and pink esthetics. The aim of a treatment is to approach the perfection of nature. For anterior bridgework, the all-ceramic System IPS Empress 2 offers light transmission and reflection comparable to that of natural teeth, provided that the pink esthetics are optimised in the preprosthetic phase. The provision of an anterior bridge in the IPS Empress 2-system is presented here in the form of a case report. After extraction of the anterior teeth, a ridge augmentation including preparation of the pontic bed was carried out. The type of post and core, preparation and cementation are important parameters for the success of all-ceramic restorations.

Utility of cement injection to stabilize split-depression tibial plateau fracture by minimally invasive methods: A finite element analysis.

PubMed

Belaid, D; Vendeuvre, T; Bouchoucha, A; Brémand, F; Brèque, C; Rigoard, P; Germaneau, A

2018-05-08

Treatment for fractures of the tibial plateau is in most cases carried out by stable fixation in order to allow early mobilization. Minimally invasive technologies such as tibioplasty or stabilization by locking plate, bone augmentation and cement filling (CF) have recently been used to treat this type of fracture. The aim of this paper was to determine the mechanical behavior of the tibial plateau by numerically modeling and by quantifying the mechanical effects on the tibia mechanical properties from injury healing. A personalized Finite Element (FE) model of the tibial plateau from a clinical case has been developed to analyze stress distribution in the tibial plateau stabilized by balloon osteoplasty and to determine the influence of the cement injected. Stress analysis was performed for different stages after surgery. Just after surgery, the maximum von Mises stresses obtained for the fractured tibia treated with and without CF were 134.9 MPa and 289.9 MPa respectively on the plate. Stress distribution showed an increase of values in the trabecular bone in the treated model with locking plate and CF and stress reduction in the cortical bone in the model treated with locking plate only. The computed results of stresses or displacements of the fractured models show that the cement filling of the tibial depression fracture may increase implant stability, and decrease the loss of depression reduction, while the presence of the cement in the healed model renders the load distribution uniform. Copyright © 2018 Elsevier Ltd. All rights reserved.

Four-point injection technique for lip augmentation.

PubMed

Sahan, Ali; Funda, Tamer

2018-06-01

Lip augmentation procedures with hyaluronic acid dermal fillers have become increasingly popular worldwide because full lips are often considered beautiful and youthful. The goal of a lip augmentation procedure is to create smooth lips with adequate volume and a natural appearance. Various techniques for lip augmentation have been utilized and described. In the four-point injection technique, the lips were divided equally into right side and left side. Four entry points were made above the vermilion border for the upper lip and below the vermilion border for the lower lip. The filler was administered with a fanning technique through each entry point. Between January 2017 and November 2017, 50 female patients underwent a nonsurgical lip augmentation procedure with injectable fillers using this technique. Forty-five patients (90%) reported that they were satisfied or extremely satisfied with their lip enhancement procedure. No serious complications were observed. The advantages of this technique are reducing the risk of complications like erythema, edema, and vascular injuries, and providing easy access to injection sites.

ESEM analysis of polymeric film in EVA-modified cement paste

DOE Office of Scientific and Technical Information (OSTI.GOV)

Silva, D.A.; Monteiro, P.J.M.

2005-10-01

Portland cement pastes modified by 20% weight (polymer/cement ratio) of poly(ethylene-co-vinyl acetate) (EVA) were prepared, cured, and immersed in water for 11 days. The effects of water saturation and drying on the EVA polymeric film formed in cement pastes were observed using environmental scanning electron microscopy (ESEM). This technique allowed the imaging of the EVA film even in saturated samples. The decrease of the relative humidity inside the ESEM chamber did not cause any visual modification of the polymeric film during its drying.

A digital approach to fabricating an abutment replica to control cement volume in a cement-retained implant prosthesis.

PubMed

Lee, Ju-Hyoung; Park, In-Sook; Sohn, Dong-Seok

2016-07-01

If a cement-retained implant prosthesis is placed on an abutment, excess cement should be minimized or removed to prevent periimplant inflammation. Various methods for fabricating an abutment replica have been introduced to maintain tissue health and reduce clean-up time. The purpose of this article is to present an alternative technique for fabricating an abutment replica with computer-aided design/computer-aided manufacturing (CAD/CAM) technology. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Vibrational investigation of calcium-silicate cements for endodontics in simulated body fluids

NASA Astrophysics Data System (ADS)

Taddei, Paola; Modena, Enrico; Tinti, Anna; Siboni, Francesco; Prati, Carlo; Gandolfi, Maria Giovanna

2011-05-01

Calcium-silicate MTA (Mineral Trioxide Aggregate) cements have been recently developed for oral and endodontic surgery. This study was aimed at investigating commercial (White ProRoot MTA, White and Grey MTA-Angelus) and experimental (wTC-Bi) accelerated calcium-silicate cements with regards to composition, hydration products and bioactivity upon incubation for 1-28 days at 37 °C, in Dulbecco's Phosphate Buffered Saline (DPBS). Deposits on the surface of the cements and the composition changes during incubation were investigated by micro-Raman and ATR/FT-IR spectroscopy, and pH measurements. Vibrational techniques disclosed significant differences in composition among the unhydrated cements, which significantly affected the bioactivity as well as pH, and hydration products of the cements. After one day in DPBS, all the cements were covered by a more or less homogeneous layer of B-type carbonated apatite. The experimental cement maintained a high bioactivity, only slightly lower than the other cements and appears a valid alternative to commercial cements, in view of its adequate setting time properties. The bioactivity represents an essential property to favour bone healing and makes the calcium-silicate cements the gold standard materials for root-apical endodontic surgery.

Shoulder rehabilitation using portland cement and recycled asphalt pavement.

DOT National Transportation Integrated Search

2007-04-01

Maine has hundreds of miles of roadway originally constructed with Portland Cement Concrete that now : are covered with Hot Mix Asphalt overlays. In 2001 the Maine Department of Transportation utilized an : experimental construction technique on one ...

Damage of Wood-Concrete Composite subjected to variable hygrometric conditions

NASA Astrophysics Data System (ADS)

Loulou, L.; Caré, S.; Le Roy, R.; Bornert, M.

2010-06-01

This paper discusses the factors influencing the durability of glued assemblies of wood and cementitious material under variable hygrometric conditions. The composite specimens are composed of cement paste connected to plywood using epoxy glue. The cement paste is subjected to autogeneous shrinkage and the wood is subjected to imbibition test. Plywood is used so that the swelling deformations due to the imbibition process are parallel to the connection plane. Swelling strains in wood are related to the water content measured by gammadensimetry technique. Global strains above and below the glue interface have been measured and have been compared to the free strains. We showed that there are restrained deformations at the glue interface and that the cement paste is damaged. Local strains have been characterized by means of the digital image correlation technique. We showed in particular that the deformations in wood are related to the microstructure of the layers of plywood and that the restrained deformations at the glue interface lead to a bending of the cement paste. In the case of strong adhesion properties, this bending induces cracking in cement paste.

Periodontal considerations for esthetics: edentulous ridge augmentation.

PubMed

Rosenberg, E S; Cutler, S A

1993-01-01

Edentulous ridge augmentation is a plastic surgical technique that is performed to improve patient esthetics when unsightly, deformed ridges exist. This article describes the etiology of ridge deformities and the many procedures that can be executed to achieve an esthetic, functional result. Historically, soft-tissue mucogingival techniques were described to augment collapsed ridges. Pedicle grafts, free soft-tissue grafts, and subepithelial connective tissue grafts are predictable forms of therapy. More recently, ridge augmentation techniques were developed that regenerate the lost periodontium. These include allografts, bioglasses, guided tissue regenerative procedures, and tissue expansion.

Comparative study of methods to measure the density of Cementious powders.

PubMed

Helsel, Michelle A; Ferraris, Chiara F; Bentz, Dale

2016-11-01

The accurate measurement of the density of hydraulic cement has an essential role in the determination of concrete mixture proportions. As more supplementary cementitious materials (SCM), such as fly ash, and slag, or cement replacements materials such as limestone and calcium carbonate are used in blended cements, knowledge of the density of each powder or of the blended cement would allow a more accurate calculation of the proportions of a concrete mixture by volume instead of by mass. The current ASTM standard for measuring cement density is the "Test Method for Density of Hydraulic Cements" (ASTM C188-14), which utilizes a liquid displacement method to measure the volume of the cement. This paper will examine advantageous modifications of the current ASTM test, by alcohol substitutions for kerosene. In addition, a gas (helium) pycnometry method is evaluated as a possible alternative to the current standard. The described techniques will be compared to determine the most precise and reproducible method for measuring the density of hydraulic cements and other powders.

The incidence of secondary vertebral fracture of vertebral augmentation techniques versus conservative treatment for painful osteoporotic vertebral fractures: a systematic review and meta-analysis.

PubMed

Song, Dawei; Meng, Bin; Gan, Minfeng; Niu, Junjie; Li, Shiyan; Chen, Hao; Yuan, Chenxi; Yang, Huilin

2015-08-01

Percutaneous vertebroplasty (PVP) and balloon kyphoplasty (BKP) are minimally invasive and effective vertebral augmentation techniques for managing osteoporotic vertebral compression fractures (OVCFs). Recent meta-analyses have compared the incidence of secondary vertebral fractures between patients treated with vertebral augmentation techniques or conservative treatment; however, the inclusions were not thorough and rigorous enough, and the effects of each technique on the incidence of secondary vertebral fractures remain unclear. To perform an updated systematic review and meta-analysis of the studies with more rigorous inclusion criteria on the effects of vertebral augmentation techniques and conservative treatment for OVCF on the incidence of secondary vertebral fractures. PubMed, MEDLINE, EMBASE, SpringerLink, Web of Science, and the Cochrane Library database were searched for relevant original articles comparing the incidence of secondary vertebral fractures between vertebral augmentation techniques and conservative treatment for patients with OVCFs. Randomized controlled trials (RCTs) and prospective non-randomized controlled trials (NRCTs) were identified. The methodological qualities of the studies were evaluated, relevant data were extracted and recorded, and an appropriate meta-analysis was conducted. A total of 13 articles were included. The pooled results from included studies showed no statistically significant differences in the incidence of secondary vertebral fractures between patients treated with vertebral augmentation techniques and conservative treatment. Subgroup analysis comparing different study designs, durations of symptoms, follow-up times, races of patients, and techniques were conducted, and no significant differences in the incidence of secondary fractures were identified (P > 0.05). No obvious publication bias was detected by either Begg's test (P = 0.360 > 0.05) or Egger's test (P = 0.373 > 0.05). Despite current thinking in the field that vertebral augmentation procedures may increase the incidence of secondary fractures, we found no differences in the incidence of secondary fractures between vertebral augmentation techniques and conservative treatment for patients with OVCFs. © The Foundation Acta Radiologica 2014.

New method for antibiotic release from bone cement (polymethylmethacrylate): Redefining boundaries.

PubMed

Carbó-Laso, E; Sanz-Ruiz, P; Del Real-Romero, J C; Ballesteros-Iglesias, Y; Paz-Jiménez, E; Arán-Ais, F; Sánchez-Navarro, M; Pérez-Limiñana, M A; López-Torres, I; Vaquero-Martín, J

The increasing antimicrobial resistance is promoting the addition of antibiotics with high antistaphylococcal activity to polymethylmethacrylate (PMMA), for use in cement spacers in periprosthetic joint infection. Linezolid and levofloxacin have already been used in in-vitro studies, however, rifampicin has been shown to have a deleterious effect on the mechanical properties of PMMA, because it inhibits PMMA polymerization. The objective of our study was to isolate the rifampicin during the polymerization process using microencapsulation techniques, in order to obtain a PMMA suitable for manufacturing bone cement spacers. Microcapsules of rifampicin were synthesized with alginate and PHBV, using Rifaldin ® . The concentration levels of rifampicin were studied by UV-visible spectrophotometry. Compression, hardness and setting time tests were performed with CMW ® 1 cement samples alone, with non-encapsulated rifampicin and with alginate or PHBV microcapsules. The production yield, efficiency and microencapsulation yield were greater with alginate (P = .0001). The cement with microcapsules demonstrated greater resistance to compression than the cement with rifampicin (91.26±5.13, 91.35±6.29 and 74.04±3.57 MPa in alginate, PHBV and rifampicin, respectively) (P = .0001). The setting time reduced, and the hardness curve of the cement with alginate microcapsules was similar to that of the control. Microencapsulation with alginate is an appropriate technique for introducing rifampicin into PMMA, preserving compression properties and setting time. This could allow intraoperative manufacturing of bone cement spacers that release rifampicin for the treatment of periprosthetic joint infection. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

Improved specifications for hydraulic cement concrete : final report.

DOT National Transportation Integrated Search

1983-01-01

This is the final report of a study of the application of statistical concepts to specifications for hydraulic cement concrete as used in highway facilities. It reviews the general problems associated with the application of statistical techniques to...

Influence of Silica Fume Addition in the Long-Term Performance of Sustainable Cement Grouts for Micropiles Exposed to a Sulphate Aggressive Medium

PubMed Central

Esteban, María Dolores; Rodríguez, Raúl Rubén; Ibanco, Francisco José; Sánchez, Isidro

2017-01-01

At present, sustainability is of major importance in the cement industry, and the use of additions such as silica fume as clinker replacement contributes towards that goal. Special foundations, and particularly micropiles, are one of the most suitable areas for the use of sustainable cements. The aim of this research is to analyse the effects in the very long-term (for 600 days) produced by sulphate attack in the microstructure of grouts for micropiles in which OPC (ordinary Portland cement) has been replaced by 5% and 10% silica fume. This line of study is building on a previous work, where these effects were studied in slag and fly ash grouts. Grouts made using a commercial sulphate-resisting Portland cement were also studied. The non-destructive impedance spectroscopy technique, mercury intrusion porosimetry, and Wenner resistivity testing were used. Mass variation and the compressive strength have also been analysed. Apparently, impedance spectroscopy is the most suitable technique for studying sulphate attack development. According to the results obtained, grouts for micropiles with a content of silica fume up to 10% and exposed to an aggressive sulphate medium, have a similar or even better behaviour in the very long-term, compared to grouts prepared using sulphate-resisting Portland cement. PMID:28767078

Influence of Silica Fume Addition in the Long-Term Performance of Sustainable Cement Grouts for Micropiles Exposed to a Sulphate Aggressive Medium.

PubMed

Ortega, José Marcos; Esteban, María Dolores; Rodríguez, Raúl Rubén; Pastor, José Luis; Ibanco, Francisco José; Sánchez, Isidro; Climent, Miguel Ángel

2017-08-02

At present, sustainability is of major importance in the cement industry, and the use of additions such as silica fume as clinker replacement contributes towards that goal. Special foundations, and particularly micropiles, are one of the most suitable areas for the use of sustainable cements. The aim of this research is to analyse the effects in the very long-term (for 600 days) produced by sulphate attack in the microstructure of grouts for micropiles in which OPC (ordinary Portland cement) has been replaced by 5% and 10% silica fume. This line of study is building on a previous work, where these effects were studied in slag and fly ash grouts. Grouts made using a commercial sulphate-resisting Portland cement were also studied. The non-destructive impedance spectroscopy technique, mercury intrusion porosimetry, and Wenner resistivity testing were used. Mass variation and the compressive strength have also been analysed. Apparently, impedance spectroscopy is the most suitable technique for studying sulphate attack development. According to the results obtained, grouts for micropiles with a content of silica fume up to 10% and exposed to an aggressive sulphate medium, have a similar or even better behaviour in the very long-term, compared to grouts prepared using sulphate-resisting Portland cement.

Nano-Inclusions Applied in Cement-Matrix Composites: A Review

PubMed Central

Bastos, Guillermo; Patiño-Barbeito, Faustino; Patiño-Cambeiro, Faustino; Armesto, Julia

2016-01-01

Research on cement-based materials is trying to exploit the synergies that nanomaterials can provide. This paper describes the findings reported in the last decade on the improvement of these materials regarding, on the one hand, their mechanical performance and, on the other hand, the new properties they provide. These features are mainly based on the electrical and chemical characteristics of nanomaterials, thus allowing cement-based elements to acquire “smart” functions. In this paper, we provide a quantitative approach to the reinforcements achieved to date. The fundamental concepts of nanoscience are introduced and the need of both sophisticated devices to identify nanostructures and techniques to disperse nanomaterials in the cement paste are also highlighted. Promising results have been obtained, but, in order to turn these advances into commercial products, technical, social and standardisation barriers should be overcome. From the results collected, it can be deduced that nanomaterials are able to reduce the consumption of cement because of their reinforcing effect, as well as to convert cement-based products into electric/thermal sensors or crack repairing materials. The main obstacle to foster the implementation of such applications worldwide is the high cost of their synthesis and dispersion techniques, especially for carbon nanotubes and graphene oxide. PMID:28774135

Nanotechnology for treating osteoporotic vertebral fractures

PubMed Central

Gao, Chunxia; Wei, Donglei; Yang, Huilin; Chen, Tao; Yang, Lei

2015-01-01

Osteoporosis is a serious public health problem affecting hundreds of millions of aged people worldwide, with severe consequences including vertebral fractures that are associated with significant morbidity and mortality. To augment or treat osteoporotic vertebral fractures, a number of surgical approaches including minimally invasive vertebroplasty and kyphoplasty have been developed. However, these approaches face problems and difficulties with efficacy and long-term stability. Recent advances and progress in nanotechnology are opening up new opportunities to improve the surgical procedures for treating osteoporotic vertebral fractures. This article reviews the improvements enabled by new nanomaterials and focuses on new injectable biomaterials like bone cements and surgical instruments for treating vertebral fractures. This article also provides an introduction to osteoporotic vertebral fractures and current clinical treatments, along with the rationale and efficacy of utilizing nanomaterials to modify and improve biomaterials or instruments. In addition, perspectives on future trends with injectable bone cements and surgical instruments enhanced by nanotechnology are provided. PMID:26316746

Attachment techniques for high temperature strain

NASA Astrophysics Data System (ADS)

Wnuk, Steve P., Jr.

1993-01-01

Attachment methods for making resistive strain measurements to 2500 F were studied. A survey of available strain gages and attachment techniques was made, and the results are compiled for metal and carbon composite test materials. A theoretical analysis of strain transfer into a bonded strain gage was made, and the important physical parameters of the strain transfer medium, the ceramic matrix, were identified. A pull tester to measure pull-out tests on commonly used strain gage cements indicated that all cements tested displayed adequate strength for good strain transfer. Rokide flame sprayed coatings produced significantly stronger bonds than ceramic cements. An in-depth study of the flame spray process produced simplified installation procedures which also resulted in greater reliability and durability. Application procedures incorporating improvements made during this program are appended to the report. Strain gages installed on carbon composites, Rene' 41, 316 stainless steel, and TZM using attachment techniques developed during this program were successfully tested to 2500 F. Photographs of installation techniques, test procedures, and graphs of the test data are included in this report.

Advanced intellect-augmentation techniques

NASA Technical Reports Server (NTRS)

Engelbart, D. C.

1972-01-01

User experience in applying our augmentation tools and techniques to various normal working tasks within our center is described so as to convey a subjective impression of what it is like to work in an augmented environment. It is concluded that working-support, computer-aid systems for augmenting individuals and teams, are undoubtedly going to be widely developed and used. A very special role in this development is seen for multi-access computer networks.

Vertical misfit of laser-sintered and vacuum-cast implant-supported crown copings luted with definitive and temporary luting agents.

PubMed

Castillo-de-Oyagüe, Raquel; Sánchez-Turrión, Andrés; López-Lozano, José-Francisco; Albaladejo, Alberto; Torres-Lagares, Daniel; Montero, Javier; Suárez-García, Maria-Jesús

2012-07-01

This study aimed to evaluate the vertical discrepancy of implant-supported crown structures constructed with vacuum-casting and Direct Metal Laser Sintering (DMLS) technologies, and luted with different cement types. Crown copings were fabricated using: (1) direct metal laser sintered Co-Cr (LS); (2) vacuum-cast Co-Cr (CC); and (3) vacuum-cast Ti (CT). Frameworks were luted onto machined implant abutments under constant seating pressure. Each alloy group was randomly divided into 5 subgroups (n = 10 each) according to the cement system utilized: Subgroup 1 (KC) used resin-modified glass-ionomer Ketac Cem Plus; Subgroup 2 (PF) used Panavia F 2.0 dual-cure resin cement; Subgroup 3 (RXU) used RelyX Unicem 2 Automix self-adhesive dual-cure resin cement; Subgroup 4 (PIC) used acrylic/urethane-based temporary Premier Implant Cement; and Subgroup 5 (DT) used acrylic/urethane-based temporary DentoTemp cement. Vertical misfit was measured by scanning electron microscopy (SEM). Two-way ANOVA and Student-Newman-Keuls tests were run to investigate the effect of alloy/fabrication technique, and cement type on vertical misfit. The statistical significance was set at α = 0.05. The alloy/manufacturing technique and the luting cement affected the vertical discrepancy (p < 0.001). For each cement type, LS samples exhibited the best fit (p < 0.01) whereas CC and CT frames were statistically similar. Within each alloy group, PF and RXU provided comparably greater discrepancies than KC, PIC, and DT, which showed no differences. Laser sintering may be an alternative to vacuum-casting of base metals to obtain passive-fitting implant-supported crown copings. The best marginal adaptation corresponded to laser sintered structures luted with glass-ionomer KC, or temporary PIC or DT cements. The highest discrepancies were recorded for Co-Cr and Ti cast frameworks bonded with PF or RXU resinous agents. All groups were within the clinically acceptable misfit range.

Vertebral Augmentation Involving Vertebroplasty or Kyphoplasty for Cancer-Related Vertebral Compression Fractures: A Systematic Review

PubMed Central

Pron, Gaylene; Holubowich, Corinne; Kaulback, Kellee

2016-01-01

Background Cancers that metastasize to the spine and primary cancers such as multiple myeloma can result in vertebral compression fractures or instability. Conservative strategies, including bed rest, bracing, and analgesic use, can be ineffective, resulting in continued pain and progressive functional disability limiting mobility and self-care. Surgery is not usually an option for cancer patients in advanced disease states because of their poor medical health or functional status and limited life expectancy. The objectives of this review were to evaluate the effectiveness and safety of percutaneous image-guided vertebral augmentation techniques, vertebroplasty and kyphoplasty, for palliation of cancer-related vertebral compression fractures. Methods We performed a systematic literature search for studies on vertebral augmentation of cancer-related vertebral compression fractures published from January 1, 2000, to October 2014; abstracts were screened by a single reviewer. For those studies meeting the eligibility criteria, full-text articles were obtained. Owing to the heterogeneity of the clinical reports, we performed a narrative synthesis based on an analytical framework constructed for the type of cancer-related vertebral fractures and the diversity of the vertebral augmentation interventions. Results The evidence review identified 3,391 citations, of which 111 clinical reports (4,235 patients) evaluated the effectiveness of vertebroplasty (78 reports, 2,545 patients) or kyphoplasty (33 reports, 1,690 patients) for patients with mixed primary spinal metastatic cancers, multiple myeloma, or hemangiomas. Overall the mean pain intensity scores often reported within 48 hours of vertebral augmentation (kyphoplasty or vertebroplasty), were significantly reduced. Analgesic use, although variably reported, usually involved parallel decreases, particularly in opioids, and mean pain-related disability scores were also significantly improved. In a randomized controlled trial comparing kyphoplasty with usual care, improvements in pain scores, pain-related disability, and health-related quality of life were significantly better in the kyphoplasty group than in the usual care group. Bone cement leakage, mostly asymptomatic, was commonly reported after vertebroplasty and kyphoplasty. Major adverse events, however, were uncommon. Conclusions Both vertebroplasty and kyphoplasty significantly and rapidly reduced pain intensity in cancer patients with vertebral compression fractures. The procedures also significantly decreased the need for opioid pain medication, and functional disabilities related to back and neck pain. Pain palliative improvements and low complication rates were consistent across the various cancer populations and vertebral fractures that were investigated. PMID:27298655

Vertebral Augmentation Involving Vertebroplasty or Kyphoplasty for Cancer-Related Vertebral Compression Fractures: A Systematic Review.

PubMed

2016-01-01

Cancers that metastasize to the spine and primary cancers such as multiple myeloma can result in vertebral compression fractures or instability. Conservative strategies, including bed rest, bracing, and analgesic use, can be ineffective, resulting in continued pain and progressive functional disability limiting mobility and self-care. Surgery is not usually an option for cancer patients in advanced disease states because of their poor medical health or functional status and limited life expectancy. The objectives of this review were to evaluate the effectiveness and safety of percutaneous image-guided vertebral augmentation techniques, vertebroplasty and kyphoplasty, for palliation of cancer-related vertebral compression fractures. We performed a systematic literature search for studies on vertebral augmentation of cancer-related vertebral compression fractures published from January 1, 2000, to October 2014; abstracts were screened by a single reviewer. For those studies meeting the eligibility criteria, full-text articles were obtained. Owing to the heterogeneity of the clinical reports, we performed a narrative synthesis based on an analytical framework constructed for the type of cancer-related vertebral fractures and the diversity of the vertebral augmentation interventions. The evidence review identified 3,391 citations, of which 111 clinical reports (4,235 patients) evaluated the effectiveness of vertebroplasty (78 reports, 2,545 patients) or kyphoplasty (33 reports, 1,690 patients) for patients with mixed primary spinal metastatic cancers, multiple myeloma, or hemangiomas. Overall the mean pain intensity scores often reported within 48 hours of vertebral augmentation (kyphoplasty or vertebroplasty), were significantly reduced. Analgesic use, although variably reported, usually involved parallel decreases, particularly in opioids, and mean pain-related disability scores were also significantly improved. In a randomized controlled trial comparing kyphoplasty with usual care, improvements in pain scores, pain-related disability, and health-related quality of life were significantly better in the kyphoplasty group than in the usual care group. Bone cement leakage, mostly asymptomatic, was commonly reported after vertebroplasty and kyphoplasty. Major adverse events, however, were uncommon. Both vertebroplasty and kyphoplasty significantly and rapidly reduced pain intensity in cancer patients with vertebral compression fractures. The procedures also significantly decreased the need for opioid pain medication, and functional disabilities related to back and neck pain. Pain palliative improvements and low complication rates were consistent across the various cancer populations and vertebral fractures that were investigated.

Advanced Intellect-Augmentation Techniques.

ERIC Educational Resources Information Center

Engelbart, D. C.

This progress report covers a two-year project which is part of a program that is exploring the value of computer aids in augmenting human intellectual capability. The background and nature of the program, its resources, and the activities it has undertaken are outlined. User experience in applying augmentation tools and techniques to various…

Optimization of multi-image pose recovery of fluoroscope tracking (FTRAC) fiducial in an image-guided femoroplasty system

NASA Astrophysics Data System (ADS)

Liu, Wen P.; Armand, Mehran; Otake, Yoshito; Taylor, Russell H.

2011-03-01

Percutaneous femoroplasty [1], or femoral bone augmentation, is a prospective alternative treatment for reducing the risk of fracture in patients with severe osteoporosis. We are developing a surgical robotics system that will assist orthopaedic surgeons in planning and performing a patient-specific, augmentation of the femur with bone cement. This collaborative project, sponsored by the National Institutes of Health (NIH), has been the topic of previous publications [2],[3] from our group. This paper presents modifications to the pose recovery of a fluoroscope tracking (FTRAC) fiducial during our process of 2D/3D registration of X-ray intraoperative images to preoperative CT data. We show improved automata of the initial pose estimation as well as lower projection errors with the advent of a multiimage pose optimization step.

A new anchor augmentation technique with a cancellous screw in osteoporotic rotator cuff repair: an in vitro biomechanical study on sheep humerus specimens.

PubMed

Uruc, Vedat; Ozden, Raif; Dogramacı, Yunus; Kalacı, Aydıner; Hallaceli, Hasan; Küçükdurmaz, Fatih

2014-01-01

The aim of this study was to test a simple technique to augment the pullout resistance of an anchor in an over-drilled sheep humerus model. Sixty-four paired sheep humeri were harvested from 32 male sheep aged 18 months. Specimens were divided into an augmented group and non-augmented group. FASTIN RC 5-mm titanium screw anchors (DePuy Mitek, Raynham, MA) double loaded with suture material (braided polyester, nonabsorbable USP No. 2) were used in both groups. Osteoporosis was simulated by over-drilling with a 4.5-mm drill. Augmentation was performed by fixing 1 of the sutures 1.5 cm inferior to the anchor insertion site with a washer screw. This was followed by a pull-to-failure test at 50 mm/min. The ultimate load (the highest value of strength before anchor pullout) was recorded. A paired t test was used to compare the biomechanical properties of the augmented and non-augmented groups. In all specimens the failure mode was pullout of the anchor. The ultimate failure loads were statistically significantly higher in the augmented group (P < .0001). The mean pullout strength was 121.1 ± 10.17 N in the non-augmented group and 176.1 ± 10.34 N in the augmented group. The described augmentation technique, which is achieved by inferior-lateral fixation of 1 of the sutures of the double-loaded anchor to a fully threaded 6.5-mm cancellous screw with a washer, significantly increases the ultimate failure loads in the over-drilled sheep humerus model. Our technique is simple, safe, and inexpensive. It can be easily used in all osteoporotic patients and will contribute to the reduction of anchor failure. This technique might be difficult to apply arthroscopically. Cannulated smaller screws would probably be more practical for arthroscopic use. Further clinical studies are needed. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Use of Polymethyl Methacrylate-Based Cement for Cosmetic Correction of Donor-Site Defect following Transposition of Temporalis Myofascial Flap and Evaluation of Results after Adjuvant Radiotherapy.

PubMed

Mandlik, Dushyant; Gupta, Karan; Patel, Daxesh; Patel, Purvi; Toprani, Rajendra; Patel, Kaustubh

2015-11-01

Temporalis myofascial flap is a versatile flap for reconstruction of the oral cavity defects, but results in an esthetically compromised deformity at the donor site. We used polymethyl methacrylate (PMMA) cement to correct the volume loss defect caused by temporalis myofascial flap and evaluated its results before and after adjuvant radiotherapy. We discuss our experience of using PMMA cement to augment donor-site deformity in 25 patients (17 males, 8 females) between years 2005 and 2009. The primary defect was a result of the ablative surgery for squamous cell carcinoma of the upper alveolar and the buccoalveolar sulcus. A modified curved hemicoronal incision was used as an access for better cosmetic outcome. The volume of cement required was decided during the surgery. All patients are in regular follow-up, alive and free of complications at implant site, except one patient who developed wound dehiscence. The condition of the implant was evaluated by postoperative computed tomographic scan, repeated after adjuvant radiotherapy in cases required. There were no radiation-induced changes in the contour and volume of the implants. Cosmetic result of the implant was reported satisfactory by the patients postoperatively.  Restoration of the temporal area defect after the temporalis myofascial flap harvest with the use of PMMA cement is an easy and safe method, with excellent esthetic results. The implant is stable and resistant to any changes in contour and loss of volume even after adjuvant radiotherapy, with no added morbidity to the patients. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The long-term in vivo behavior of polymethyl methacrylate bone cement in total hip arthroplasty.

PubMed

Oonishi, Hiroyuki; Akiyama, Haruhiko; Takemoto, Mitsuru; Kawai, Toshiyuki; Yamamoto, Koji; Yamamuro, Takao; Oonishi, Hironobu; Nakamura, Takashi

2011-10-01

The long-term success of cemented total hip arthroplasty (THA) has been well established. Improved outcomes, both radiographically and clinically, have resulted mainly from advances in stem design and improvements in operating techniques. However, there is concern about the durability of bone cement in vivo. We evaluated the physical and chemical properties of CMW1 bone cements retrieved from patients undergoing revision THA. CMW1 cements were retrieved from 14 patients who underwent acetabular revision because of aseptic loosening. The time in vivo before revision was 7-30 years. The bending properties of the retrieved bone cement were assessed using the three-point bending method. The molecular weight and chemical structure were analyzed by gel permeation chromatography and Fourier-transform infrared spectroscopy. The porosity of the bone cements was evaluated by 3-D microcomputer tomography. The bending strength decreased with increasing time in vivo and depended on the density of the bone cement, which we assume to be determined by the porosity. There was no correlation between molecular weight and time in vivo. The infrared spectra were similar in the retrieved cements and in the control CMW1 cements. Our results indicate that polymer chain scission and significant hydrolysis do not occur in CMW1 cement after implantation in vivo, even in the long term. CMW1 cement was stable through long-term implantation and functional loading.

The Effect of Different Mixing Methods on Working Time, Setting Time, Dimensional Changes and Film Thickness of Mineral Trioxide Aggregate and Calcium-Enriched Mixture.

PubMed

Shahi, Shahriar; Ghasemi, Negin; Rahimi, Saeed; Yavari, Hamidreza; Janani, Maryam; Mokhtari, Hadi; Bahari, Mahmood; Rabbani, Parastu

2015-01-01

The aim of the present study was to evaluate the effect of different mixing techniques (conventional, amalgamator and ultrasonic mixing) on the physical properties the working time (WT), setting time (ST), dimensional changes (DC) and film thickness (FT)] of calcium-enriched mixture (CEM) cement and mineral trioxide aggregate (MTA). The mentioned physical properties were determined using the ISO 6786:2001 specification. Six samples of each material were prepared for three mixing techniques (totally 36 samples). Data were analyzed using descriptive statistics, two-way ANOVA and Post Hoc Tukey's tests. The level of significance was defined at 0.05. Irrespective of mixing technique, there was no significant difference between the WT and FT of the tested materials. Except for the DC of MTA and the FT of the all materials, other properties were significantly affected with mixing techniques (P<0.05). The ultrasonic technique decreased the ST of MTA and CEM cement and increased the WT of CEM cement (P<0.05). The mixing technique of the materials had no significant effect on the dimensional changes of MTA and the film thickness of both materials.

Construction of a thin-bonded Portland cement concrete overlay using accelerated paving techniques.

DOT National Transportation Integrated Search

1992-01-01

The report describes the Virginia Department of Transportations' first modern experience with the construction of thin-bonded Portland cement concrete overlays of existing concrete pavements and with the fast track mode of rigid paving. The study was...

Internal fit of three-unit fixed dental prostheses produced by computer-aided design/computer-aided manufacturing and the lost-wax metal casting technique assessed using the triple-scan protocol.

PubMed

Dahl, Bjørn E; Dahl, Jon E; Rønold, Hans J

2018-02-01

Suboptimal adaptation of fixed dental prostheses (FDPs) can lead to technical and biological complications. It is unclear if the computer-aided design/computer-aided manufacturing (CAD/CAM) technique improves adaptation of FDPs compared with FDPs made using the lost-wax and metal casting technique. Three-unit FDPs were manufactured by CAD/CAM based on digital impression of a typodont model. The FDPs were made from one of five materials: pre-sintered zirconium dioxide; hot isostatic pressed zirconium dioxide; lithium disilicate glass-ceramic; milled cobalt-chromium; and laser-sintered cobalt-chromium. The FDPs made using the lost-wax and metal casting technique were used as reference. The fit of the FDPs was analysed using the triple-scan method. The fit was evaluated for both single abutments and three-unit FDPs. The average cement space varied between 50 μm and 300 μm. Insignificant differences in internal fit were observed between the CAD/CAM-manufactured FDPs, and none of the FPDs had cement spaces that were statistically significantly different from those of the reference FDP. For all FDPs, the cement space at a marginal band 0.5-1.0 mm from the preparation margin was less than 100 μm. The milled cobalt-chromium FDP had the closest fit. The cement space of FDPs produced using the CAD/CAM technique was similar to that of FDPs produced using the conventional lost-wax and metal casting technique. © 2017 Eur J Oral Sci.

A new method to analyze copolymer based superplasticizer traces in cement leachates.

PubMed

Guérandel, Cyril; Vernex-Loset, Lionel; Krier, Gabriel; De Lanève, Michel; Guillot, Xavier; Pierre, Christian; Muller, Jean François

2011-03-15

Enhancing the flowing properties of fresh concrete is a crucial step for cement based materials users. This is done by adding polymeric admixtures. Such additives have enabled to improve final mechanicals properties and the development of new materials like high performance or self compacting concrete. Like this, the superplasticizers are used in almost cement based materials, in particular for concrete structures that can have a potential interaction with drinking water. It is then essential to have suitable detection techniques to assess whether these organic compounds are dissolved in water after a leaching process or not. The main constituent of the last generation superplasticizer is a PolyCarboxylate-Ester copolymer (PCE), in addition this organic admixture contains polyethylene oxide (free PEO) which constitutes a synthesis residue. Numerous analytical methods are available to characterize superplasticizer content. Although these techniques work well, they do not bring suitable detection threshold to analyze superplasticizer traces in solution with high mineral content such as leachates of hardened cement based materials formulated with superplasticizers. Moreover those techniques do not enable to distinguish free PEO from PCE in the superplasticizer. Here we discuss two highly sensitive analytical methods based on mass spectrometry suitable to perform a rapid detection of superplasticizer compounds traces in CEM I cement paste leachates: MALDI-TOF mass spectrometry, is used to determine the free PEO content in the leachate. However, industrial copolymers (such as PCE) are characterized by high molecular weight and polymolecular index. These two parameters lead to limitation concerning analysis of copolymers by MALDI-TOFMS. In this study, we demonstrate how pyrolysis and a Thermally assisted Hydrolysis/Methylation coupled with a triple-quadrupole mass spectrometer, provides good results for the detection of PCE copolymer traces in CEM I cement paste leachates. Copyright © 2011 Elsevier B.V. All rights reserved.

Impact of drying on pore structures in ettringite-rich cements

DOE Office of Scientific and Technical Information (OSTI.GOV)

Galan, I., E-mail: isabelgalan@abdn.ac.uk; Beltagui, H.; García-Maté, M.

Drying techniques affect the properties of cement pastes to varying extents. The effect of different drying techniques on calcium sulfoaluminate-based (C$A) cements and their constituent phases is reported for a range of simulated and commercial C$A pastes which are benchmarked against an OPC paste. The recommended methodologies used to dry samples were identified from the literature and include D-drying and solvent exchange. These methods were used in conjunction with mercury intrusion porosimetry (MIP) and X-ray powder diffraction (XRPD) measurements to assess the changes in pore structure and the damage to crystalline phases, respectively. D-drying and isopropanol exchange are the mostmore » satisfactory and least damaging methods for drying C$A based pastes.« less

Comparative study of methods to measure the density of Cementious powders

PubMed Central

Helsel, Michelle A.; Bentz, Dale

2016-01-01

The accurate measurement of the density of hydraulic cement has an essential role in the determination of concrete mixture proportions. As more supplementary cementitious materials (SCM), such as fly ash, and slag, or cement replacements materials such as limestone and calcium carbonate are used in blended cements, knowledge of the density of each powder or of the blended cement would allow a more accurate calculation of the proportions of a concrete mixture by volume instead of by mass. The current ASTM standard for measuring cement density is the “Test Method for Density of Hydraulic Cements” (ASTM C188-14), which utilizes a liquid displacement method to measure the volume of the cement. This paper will examine advantageous modifications of the current ASTM test, by alcohol substitutions for kerosene. In addition, a gas (helium) pycnometry method is evaluated as a possible alternative to the current standard. The described techniques will be compared to determine the most precise and reproducible method for measuring the density of hydraulic cements and other powders. PMID:27099404

Reinforcement Strategies for Load-Bearing Calcium Phosphate Biocements

PubMed Central

Geffers, Martha; Groll, Jürgen; Gbureck, Uwe

2015-01-01

Calcium phosphate biocements based on calcium phosphate chemistry are well-established biomaterials for the repair of non-load bearing bone defects due to the brittle nature and low flexural strength of such cements. This article features reinforcement strategies of biocements based on various intrinsic or extrinsic material modifications to improve their strength and toughness. Altering particle size distribution in conjunction with using liquefiers reduces the amount of cement liquid necessary for cement paste preparation. This in turn decreases cement porosity and increases the mechanical performance, but does not change the brittle nature of the cements. The use of fibers may lead to a reinforcement of the matrix with a toughness increase of up to two orders of magnitude, but restricts at the same time cement injection for minimal invasive application techniques. A novel promising approach is the concept of dual-setting cements, in which a second hydrogel phase is simultaneously formed during setting, leading to more ductile cement–hydrogel composites with largely unaffected application properties.

Accelerated ageing of blended OPC cements

DOE Office of Scientific and Technical Information (OSTI.GOV)

Quillin, K.C.; Duerden, S.L.; Majumdar, A.J.

1994-12-31

An accelerated experimental technique using high water:cement ratios has been developed to study the long term hydration of blended cements that may be used in a repository for the disposal of radioactive waste. This technique has been used to investigate the hydration reactions of Ordinary Portland Cement (OPC) blended with ground granulated blastfurnace slag (ggbs) or pulverised fuel ash (pfa). The effects of high sulphate-bearing and high carbonate-bearing ground waters on the compounds formed on hydration were investigated. Solid/solution compositional data were collected during the course of the hydration process for periods up to 2 years. Thomsonite, thaumasite, afwillite andmore » a tobermorite-like phase were found in addition to the expected cement hydration products. The pH of the aqueous solution in contact with 60 pfa:40 OPC blends hydrated at 90{degrees}C fell to below 8. This is lower than the value required to inhibit the corrosion of steel canisters in a repository. The pH of the aqueous solution in contact with OPC and 75 ggbs:25 OPC blends remained above 11, although if the ground waters in contact with the OPC/ggbs blends were periodically replaced the pH eventually fell below 10.« less

Thermal Properties of Cement-Based Composites for Geothermal Energy Applications.

PubMed

Bao, Xiaohua; Memon, Shazim Ali; Yang, Haibin; Dong, Zhijun; Cui, Hongzhi

2017-04-27

Geothermal energy piles are a quite recent renewable energy technique where geothermal energy in the foundation of a building is used to transport and store geothermal energy. In this paper, a structural-functional integrated cement-based composite, which can be used for energy piles, was developed using expanded graphite and graphite nanoplatelet-based composite phase change materials (CPCMs). Its mechanical properties, thermal-regulatory performance, and heat of hydration were evaluated. Test results showed that the compressive strength of GNP-Paraffin cement-based composites at 28 days was more than 25 MPa. The flexural strength and density of thermal energy storage cement paste composite decreased with increases in the percentage of CPCM in the cement paste. The infrared thermal image analysis results showed superior thermal control capability of cement based materials with CPCMs. Hence, the carbon-based CPCMs are promising thermal energy storage materials and can be used to improve the durability of energy piles.

Synthesization and characterization of poly(lactic-co-glycolic acid) / calcium phosphate bone cement from crab shells

NASA Astrophysics Data System (ADS)

Hanan, M. R. Abdul; Daud, N. M.; Ismail, L. H.; Saidin, S.

2017-05-01

An injectable calcium phosphate (CaP) bone cement has been widely used for musculoskeletal and bone disorder due to its biocompatible and osteoconductive properties. In this study, CaP was successfully synthesized from crab shells by a wet chemical route. Poly(lactic-co-glycolic acid) (PLGA) microspheres which have been produced through a double emulsion technique were incorporated into the CaP mixture for the purpose of bone cement solidification. The ratio of both compounds, CaP and PLGA, were set at 8:2. The CaP and PLGA/CaP bone cement were analyzed by ATR-FTIR, FESEM-EDX and contact angle analyses. The bone cement was composed of CaP and PLGA where the micro-powders of CaP were agglomerated on the PLGA microspheres. Addition of the PLGA has increased the hydrophilicity of the bone cement which will be beneficial for materials degradation and bone integration.

Thermal Properties of Cement-Based Composites for Geothermal Energy Applications

PubMed Central

Bao, Xiaohua; Memon, Shazim Ali; Yang, Haibin; Dong, Zhijun; Cui, Hongzhi

2017-01-01

Geothermal energy piles are a quite recent renewable energy technique where geothermal energy in the foundation of a building is used to transport and store geothermal energy. In this paper, a structural–functional integrated cement-based composite, which can be used for energy piles, was developed using expanded graphite and graphite nanoplatelet-based composite phase change materials (CPCMs). Its mechanical properties, thermal-regulatory performance, and heat of hydration were evaluated. Test results showed that the compressive strength of GNP-Paraffin cement-based composites at 28 days was more than 25 MPa. The flexural strength and density of thermal energy storage cement paste composite decreased with increases in the percentage of CPCM in the cement paste. The infrared thermal image analysis results showed superior thermal control capability of cement based materials with CPCMs. Hence, the carbon-based CPCMs are promising thermal energy storage materials and can be used to improve the durability of energy piles. PMID:28772823

Dynamic augmentation restores anterior tibial translation in ACL suture repair: a biomechanical comparison of non-, static and dynamic augmentation techniques.

PubMed

Hoogeslag, Roy A G; Brouwer, Reinoud W; Huis In 't Veld, Rianne; Stephen, Joanna M; Amis, Andrew A

2018-02-03

There is a lack of objective evidence investigating how previous non-augmented ACL suture repair techniques and contemporary augmentation techniques in ACL suture repair restrain anterior tibial translation (ATT) across the arc of flexion, and after cyclic loading of the knee. The purpose of this work was to test the null hypotheses that there would be no statistically significant difference in ATT after non-, static- and dynamic-augmented ACL suture repair, and they will not restore ATT to normal values across the arc of flexion of the knee after cyclic loading. Eleven human cadaveric knees were mounted in a test rig, and knee kinematics from 0° to 90° of flexion were recorded by use of an optical tracking system. Measurements were recorded without load and with 89-N tibial anterior force. The knees were tested in the following states: ACL-intact, ACL-deficient, non-augmented suture repair, static tape augmentation and dynamic augmentation after 10 and 300 loading cycles. Only static tape augmentation and dynamic augmentation restored ATT to values similar to the ACL-intact state directly postoperation, and maintained this after cyclic loading. However, contrary to dynamic augmentation, the ATT after static tape augmentation failed to remain statistically less than for the ACL-deficient state after cyclic loading. Moreover, after cyclic loading, ATT was significantly less with dynamic augmentation when compared to static tape augmentation. In contrast to non-augmented ACL suture repair and static tape augmentation, only dynamic augmentation resulted in restoration of ATT values similar to the ACL-intact knee and decreased ATT values when compared to the ACL-deficient knee immediately post-operation and also after cyclic loading, across the arc of flexion, thus allowing the null hypotheses to be rejected. This may assist healing of the ruptured ACL. Therefore, this study would support further clinical evaluation of dynamic augmentation of ACL repair.

Mechanical, material, and antimicrobial properties of acrylic bone cement impregnated with silver nanoparticles.

PubMed

Slane, Josh; Vivanco, Juan; Rose, Warren; Ploeg, Heidi-Lynn; Squire, Matthew

2015-03-01

Prosthetic joint infection is one of the most serious complications that can lead to failure of a total joint replacement. Recently, the rise of multidrug resistant bacteria has substantially reduced the efficacy of antibiotics that are typically incorporated into acrylic bone cement. Silver nanoparticles (AgNPs) are an attractive alternative to traditional antibiotics resulting from their broad-spectrum antimicrobial activity and low bacterial resistance. The purpose of this study, therefore, was to incorporate metallic silver nanoparticles into acrylic bone cement and quantify the effects on the cement's mechanical, material and antimicrobial properties. AgNPs at three loading ratios (0.25, 0.5, and 1.0% wt/wt) were incorporated into a commercial bone cement using a probe sonication technique. The resulting cements demonstrated mechanical and material properties that were not substantially different from the standard cement. Testing against Staphylococcus aureus and Staphylococcus epidermidis using Kirby-Bauer and time-kill assays demonstrated no antimicrobial activity against planktonic bacteria. In contrast, cements modified with AgNPs significantly reduced biofilm formation on the surface of the cement. These results indicate that AgNP-loaded cement is of high potential for use in primary arthroplasty where prevention of bacterial surface colonization is vital. Copyright © 2014 Elsevier B.V. All rights reserved.

Natural cement in the nineteenth century city of Madrid. Identification of their application, conservation status and their compatibility with moderns cements.

NASA Astrophysics Data System (ADS)

Corrochano, Cristina Mayo; Lasheras Merino, Felix; Sanz-Arauz, David

2016-04-01

Roman cement was patented in 1796 and it arrived to Spain in 1835. Although the natural cement used in Madrid came mainly from Guipúzcoa's factories, there were a few small factories producing natural cement in the area. In the south east of Madrid, in "Morata de Tajuña", are the marl quarries of the Madrid Community. Natural cement was extensively used to decorate buildings in Madrid during the 19th century and the beginning of the 20th. It was highly demanded in various sectors of civil engineering: sewerage, water supply, canals, ports and tunnels. In the building sector, at first the use of cements was limited to building foundations and masonry mortars, but never as render mortar because it was considered an unsightly and vulgar material. For renders still traditional lime mortar was used. And is not till the end of the 19th century when it was used in facade decorations for the first time. We have analysed 25 buildings in Madrid built in that period of time. It was used microscopy techniques for the identification of these cements, checking how many of them used natural cement, how they used it, what is its conservation status and their compatibility with modern cements.

Clinically used adhesive ceramic bonding methods: a survey in 2007, 2011, and in 2015.

PubMed

Klosa, K; Meyer, G; Kern, M

2016-09-01

The objective of the study is to evaluate practices of dentists regarding adhesive cementation of all-ceramic restorations over a period of 8 years. The authors developed a questionnaire regarding adhesive cementation procedures for all-ceramic restorations. Restorations were distinguished between made out of silicate ceramic or oxide ceramic. The questionnaire was handed out to all dentists participating in a local annual dental meeting in Northern Germany. The returned questionnaires were analyzed to identify incorrect cementation procedures based upon current evidence-based technique from the scientific dental literature. The survey was conducted three times in 2007, 2011, and 2015 and their results were compared. For silicate ceramic restorations, 38-69 % of the participants used evidence-based bonding procedures; most of the incorrect bonding methods did not use a silane containing primer. In case of oxide ceramic restorations, most participants did not use air-abrasion prior to bonding. Only a relatively low rate (7-14 %) of dentists used evidence-based dental techniques for bonding oxide ceramics. In adhesive cementation of all-ceramic restorations, the practices of surveyed dentists in Northern Germany revealed high rates of incorrect bonding. During the observation period, the values of evidence-based bonding procedures for oxide ceramics improved while the values for silicate ceramics declined. Based on these results, some survey participants need additional education for adhesive techniques. Neglecting scientifically accepted methods for adhesive cementation of all-ceramic restorations may result in reduced longevity of all-ceramic restorations.

A comparison of retentive strength of implant cement depending on various methods of removing provisional cement from implant abutment

PubMed Central

Keum, Eun-Cheol

2013-01-01

PURPOSE This study evaluated the effectiveness of various methods for removing provisional cement from implant abutments, and what effect these methods have on the retention of prosthesis during the definitive cementation. MATERIALS AND METHODS Forty implant fixture analogues and abutments were embedded in resin blocks. Forty cast crowns were fabricated and divided into 4 groups each containing 10 implants. Group A was cemented directly with the definitive cement (Cem-Implant). The remainder were cemented with provisional cement (Temp-Bond NE), and classified according to the method for cleaning the abutments. Group B used a plastic curette and wet gauze, Group C used a rubber cup and pumice, and Group D used an airborne particle abrasion technique. The abutments were observed using a stereomicroscope after removing the provisional cement. The tensile bond strength was measured after the definitive cementation. Statistical analysis was performed using one-way analysis of variance test (α=.05). RESULTS Group B clearly showed provisional cement remaining, whereas the other groups showed almost no cement. Groups A and B showed a relatively smooth surface. More roughness was observed in Group C, and apparent roughness was noted in Group D. The tensile bond strength tests revealed Group D to have significantly the highest tensile bond strength followed in order by Groups C, A and B. CONCLUSION A plastic curette and wet gauze alone cannot effectively remove the residual provisional cement on the abutment. The definitive retention increased when the abutments were treated with rubber cup/pumice or airborne particle abraded to remove the provisional cement. PMID:24049563

Microwave processing of cement and concrete materials – towards an industrial reality?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Buttress, Adam, E-mail: adam.buttress@nottingham.ac.uk; Jones, Aled; Kingman, Sam

2015-02-15

Each year a substantial body of literature is published on the use of microwave to process cement and concrete materials. Yet to date, very few if any have lead the realisation of a commercial scale industrial system and is the context under which this review has been undertaken. The state-of the–art is evaluated for opportunities, and the key barriers to the development of new microwave-based processing techniques to enhance production, processing and recycling of cement and concrete materials. Applications reviewed include pyro-processing of cement clinker; accelerated curing, non-destructive testing and evaluation (NDT&E), and end-of-life processing including radionuclide decontamination.

Techniques used by United Kingdom consultant plastic surgeons to select implant size for primary breast augmentation.

PubMed

Holmes, W J M; Timmons, M J; Kauser, S

2015-10-01

Techniques used to estimate implant size for primary breast augmentation have evolved since the 1970s. Currently no consensus exists on the optimal method to select implant size for primary breast augmentation. In 2013 we asked United Kingdom consultant plastic surgeons who were full members of BAPRAS or BAAPS what was their technique for implant size selection for primary aesthetic breast augmentation. We also asked what was the range of implant sizes they commonly used. The answers to question one were grouped into four categories: experience, measurements, pre-operative external sizers and intra-operative sizers. The response rate was 46% (164/358). Overall, 95% (153/159) of all respondents performed some form of pre-operative assessment, the others relied on "experience" only. The most common technique for pre-operative assessment was by external sizers (74%). Measurements were used by 57% of respondents and 3% used intra-operative sizers only. A combination of measurements and sizers was used by 34% of respondents. The most common measurements were breast base (68%), breast tissue compliance (19%), breast height (15%), and chest diameter (9%). The median implant size commonly used in primary breast augmentation was 300cc. Pre-operative external sizers are the most common technique used by UK consultant plastic surgeons to select implant size for primary breast augmentation. We discuss the above findings in relation to the evolution of pre-operative planning techniques for breast augmentation. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Probabilistic analysis of the influence of the bonding degree of the stem-cement interface in the performance of cemented hip prostheses.

PubMed

Pérez, M A; Grasa, J; García-Aznar, J M; Bea, J A; Doblaré, M

2006-01-01

The long-term behavior of the stem-cement interface is one of the most frequent topics of discussion in the design of cemented total hip replacements, especially with regards to the process of damage accumulation in the cement layer. This effect is analyzed here comparing two different situations of the interface: completely bonded and debonded with friction. This comparative analysis is performed using a probabilistic computational approach that considers the variability and uncertainty of determinant factors that directly compromise the damage accumulation in the cement mantle. This stochastic technique is based on the combination of probabilistic finite elements (PFEM) and a cumulative damage approach known as B-model. Three random variables were considered: muscle and joint contact forces at the hip (both for walking and stair climbing), cement damage and fatigue properties of the cement. The results predicted that the regions with higher failure probability in the bulk cement are completely different depending on the stem-cement interface characteristics. In a bonded interface, critical sites appeared at the distal and medial parts of the cement, while for debonded interfaces, the critical regions were found distally and proximally. In bonded interfaces, the failure probability was higher than in debonded ones. The same conclusion may be established for stair climbing in comparison with walking activity.

Biomechanical Evaluation of All-Polyethylene Pegged Bony Ingrowth Glenoid Fixation Techniques on Implant Micromotion.

PubMed

Wiater, Brett P; Moravek, James E; Kurdziel, Michael D; Baker, Kevin C; Wiater, J Michael

2016-01-01

Newer glenoid components that allow for hybrid cement fixation via traditional cementation of peripheral pegs and bony ingrowth into an interference-fit central peg introduce the possibility of long-term biological fixation. However, little biomechanical work has been done on the initial stability of these components and the various fixation options. We conducted a study in which all-polyethylene glenoid components with a centrally fluted peg were implanted in polyurethane blocks with interference-fit, hybrid cement, and fully cemented fixation (5 per fixation group). Biomechanical evaluation of glenoid loosening, according to ASTM Standard F-2028-12, subjected the glenoids to 50,000 cycles of rim loading, and glenoid component motion was recorded with 2 differential variable reluctance transducers fixed to each glenoid prosthesis. Fully cemented fixation exhibited significantly less mean distraction in comparison with interference-fit fixation (P < .001) and hybrid cement fixation (P < .001). Hybrid cement fixation exhibited significantly less distraction (P < .001), more compression (P < .001), and no significant difference in glenoid translation (P = .793) in comparison with interference-fit fixation. Fully cemented fixation exhibited the most resistance to glenoid motion in comparison with hybrid cement fixation and interference-fit fixation. However, hybrid cement fixation and interference-fit fixation exhibited equivocal motion. Given these results, cementation of peripheral pegs may confer no additional initial stability over that provided by uncemented interference-fit fixation.

IPS Empress crown system: three-year clinical trial results.

PubMed

Sorensen, J A; Choi, C; Fanuscu, M I; Mito, W T

1998-02-01

The IPS Empress system is a highly esthetic hot pressed glass ceramic material for fabrication of single crowns. Adhesive cementation of the system not only contributes to the esthetics but is necessary for increased strength of the crown. The purpose of this prospective clinical trials was to evaluate the longevity of 75 adhesively cemented Empress full crowns. An additional aim was to assess the adhesive cementation methodology and potential side effects. At the three-year point, one molar crown fractured for a 1.3 percent failure rate. The resin cementation technique that was employed exhibited a low incidence of microleakage with few clinical side effects. There was a 5.6 percent incidence of post-cementation sensitivity, with all symptoms subsiding by eight weeks. None of the crowns in the study required endodontic therapy.

Augmentation of oxygen transport by various hemoglobins as determined by pulsed field gradient NMR.

PubMed

Budhiraja, Vikas; Hellums, J David; Post, Jan F M

2002-11-01

Diffusion of oxyhemoglobin has been shown to augment the oxygen transport inside the red blood cells. Measurement of hemoglobin diffusion coefficients by pulsed-field gradient (PFG) nuclear magnetic resonance (NMR) technique can be used for estimating this augmentation effect. Self-diffusion coefficients of polymerized and unpolymerized bovine hemoglobin (Hb) and several other proteins were measured using this technique. The Hb diffusion coefficient was used to determine the effective permeability of oxygen and augmentation of oxygen transport through samples of Hb solutions due to diffusion of oxyhemoglobin. The values compared well with our previous diffusion cell measurements of effective diffusivity and augmentation. Our NMR studies show that even at low concentrations the augmentation of oxygen transport due to diffusion can be significant. The PFG NMR technique can thus provide an accurate and easy method for measuring augmentation of oxygen transport, especially in dilute samples of Hb. The results on polyhemoglobin and high-molecular-weight hemoglobin are of both basic interest and practical value in assessing the promise and performance of hemoglobin-based blood substitutes.

Efficacy and safety of newly developed cross-linked dextran gel injection for glans penis augmentation with a novel technique

PubMed Central

Yang, Dae Yul; Ko, Kyungtae; Lee, Seong Ho; Moon, Du Geon; Kim, Jong Wook; Lee, Won Ki

2018-01-01

There is no safe and effective standard method for glans penis augmentation. Furthermore, there has been scant research on glans penis augmentation due to a poor understanding of glans anatomy, technical difficulty, and a lack of suitable substances for augmentation. Cross-linked dextran gel is a newly developed filler for soft-tissue augmentation. We evaluated the efficacy and safety of using a novel technique to inject cross-linked dextran gel for glans penis augmentation during a 24-week follow-up study. This prospective, single-arm, multicenter study enrolled twenty healthy adult men who underwent glans penis augmentation between June and August 2013. Cross-linked dextran gel was injected into the glans penis using a simple and easy technique. The sizes of the glans penis and individual satisfaction were assessed. Any adverse event was also reported. A total of 18 individuals were analyzed; two of them were lost to follow-up. The mean procedure time and injected volume were about 30 min and 6.6 ± 0.9 ml, respectively. The mean surface areas of the glans at baseline and 24 weeks were 20.0 ± 3.5 cm2 and 33.6 ± 5.4 cm2, respectively, representing a mean increase of 68.7% ± 14.0% (P < 0.001). Sixteen individuals (88.9%) were satisfied with the outcomes, and none were dissatisfied. There were no serious adverse events during the study. Cross-linked dextran gel injection for glans penis augmentation was easy and showed a significant augmentative effect on the glans penis, good durability, and was well tolerated without serious adverse events. Therefore, cross-linked dextran gel injection may be an effective, new technique for glans penis augmentation. PMID:28303807

The long-term in vivo behavior of polymethyl methacrylate bone cement in total hip arthroplasty

PubMed Central

2011-01-01

Background and purpose The long-term success of cemented total hip arthroplasty (THA) has been well established. Improved outcomes, both radiographically and clinically, have resulted mainly from advances in stem design and improvements in operating techniques. However, there is concern about the durability of bone cement in vivo. We evaluated the physical and chemical properties of CMW1 bone cements retrieved from patients undergoing revision THA. Methods CMW1 cements were retrieved from 14 patients who underwent acetabular revision because of aseptic loosening. The time in vivo before revision was 7–30 years. The bending properties of the retrieved bone cement were assessed using the three-point bending method. The molecular weight and chemical structure were analyzed by gel permeation chromatography and Fourier-transform infrared spectroscopy. The porosity of the bone cements was evaluated by 3-D microcomputer tomography. Results The bending strength decreased with increasing time in vivo and depended on the density of the bone cement, which we assume to be determined by the porosity. There was no correlation between molecular weight and time in vivo. The infrared spectra were similar in the retrieved cements and in the control CMW1 cements. Interpretation Our results indicate that polymer chain scission and significant hydrolysis do not occur in CMW1 cement after implantation in vivo, even in the long term. CMW1 cement was stable through long-term implantation and functional loading. PMID:22103279

Confocal Raman Microscopy: new perspective on the weathering of anhydrous cement

NASA Astrophysics Data System (ADS)

Torres-Carrasco, M.; del Campo, A.; de la Rubia, MA; Reyes, E.; Moragues, A.; Fernández, JF

2017-10-01

Raman spectroscopy when is combined with Confocal microscopy is a non-destructive technique that allow us to obtain information in cementitious materials. In this study, we present non-destructive image and structural analysis of anhydrous cement with carbonation evidences by Confocal Raman Microscopy (CRM). The results obtained by CRM show a direct relationship between the presence of the weathering processes of an anhydrous cement with the presence of sulphates and surprisingly, with the existence of amorphous carbon in the medium.

Treatment of root fracture with accompanying resorption using cermet cement.

PubMed

Lui, J L

1992-02-01

A method of treating an apical root fracture with accompanying resorption at the junction of the fracture fragments using glass-cermet cement is described. Endodontically, the material had previously been used for repair of lateral resorptive root defects and retrograde root fillings. Complete bone regeneration was observed three years post-operatively following treatment of the root fracture in the conventional manner. The various advantages of glass-cermet cement as a root filling material used in the technique described are discussed.

Using virtual ridge augmentation and 3D printing to fabricate a titanium mesh positioning device: A novel technique letter.

PubMed

Al-Ardah, Aladdin; Alqahtani, Nasser; AlHelal, Abdulaziz; Goodacre, Brian; Swamidass, Rajesh; Garbacea, Antoanela; Lozada, Jaime

2018-05-02

This technique describes a novel approach for planning and augmenting a large bony defect using a titanium mesh (TiMe). A 3-dimensional (3D) surgical model was virtually created from a cone beam computed tomography (CBCT) and wax-pattern of the final prosthetic outcome. The required bone volume (horizontally and vertically) was digitally augmented and then 3D printed to create a bone model. The 3D model was then used to contour the TiMe in accordance with the digital augmentation. With the contoured / preformed TiMe on the 3D printed model a positioning jig was made to aid the placement of the TiMe as planned during surgery. Although this technique does not impact the final outcome of the augmentation procedure, it allows the clinician to virtually design the augmentation, preform and contour the TiMe, and create a positioning jig reducing surgical time and error.

How Effective Is the Tent Screw Pole Technique Compared to Other Forms of Horizontal Ridge Augmentation?

PubMed

Deeb, George R; Tran, Dan; Carrico, Caroline K; Block, Erin; Laskin, Daniel M; Deeb, Janina Golob

2017-10-01

The tent screw pole technique is one of the methods available for practitioners to perform horizontal ridge augmentation to facilitate dental implant placement. The purpose of this study was to evaluate the efficacy of the tent screw pole technique for horizontal ridge augmentation and to compare the results with those of the tunnel technique and open ridge augmentation. In this retrospective cohort study, 35 patients underwent horizontal ridge augmentation with the tent screw pole technique, a 1:1 ratio of mineralized freeze-dried bone allograft and particulate bovine hydroxyapatite, and a resorbable collagen membrane. The incidence of early wound dehiscence and membrane exposure, the number of courses of antibiotics and postoperative visits required for their management, and the number of sites that subsequently had successful implant placement were recorded. These parameters were compared with those in 21 patients who had undergone horizontal ridge augmentation by the tunnel technique and 31 patients who had been treated using an open procedure and a resorbable polytetrafluoroethylene (PTFE) membrane in the authors' previous study (J Oral Maxillofac Surg 74:1752, 2016). Implant placement rate was similar for all 3 methods (71 to 97%). However, there were significant differences among the 3 surgical techniques for membrane exposure and wound dehiscence (P = .0033), graft loss (P = .0256), courses of antibiotics (P = .0017), and postoperative visits (P = .0043). The PTFE method consistently had the highest rate of complications, whereas the tent screw and tunnel techniques were comparable. All 3 techniques allowed a high rate of implant placement; however, the PTFE technique was consistently associated with increased postoperative complications compared with the other 2 methods. The tent screw technique might be more favorable than the tunnel technique in cases in which the bony deficiency is flat. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Vertical misfit of laser-sintered and vacuum-cast implant-supported crown copings luted with definitive and temporary luting agents

PubMed Central

Sánchez-Turrión, Andrés; López-Lozano, José F.; Albaladejo, Alberto; Torres-Lagares, Daniel; Montero, Javier; Suárez-García, Maria J.

2012-01-01

Objectives. This study aimed to evaluate the vertical discrepancy of implant-supported crown structures constructed with vacuum-casting and Direct Metal Laser Sintering (DMLS) technologies, and luted with different cement types. Study Design. Crown copings were fabricated using: (1) direct metal laser sintered Co-Cr (LS); (2) vacuum-cast Co-Cr (CC); and (3) vacuum-cast Ti (CT). Frameworks were luted onto machined implant abutments under constant seating pressure. Each alloy group was randomly divided into 5 subgroups (n = 10 each) according to the cement system utilized: Subgroup 1 (KC) used resin-modified glass-ionomer Ketac Cem Plus; Subgroup 2 (PF) used Panavia F 2.0 dual-cure resin cement; Subgroup 3 (RXU) used RelyX Unicem 2 Automix self-adhesive dual-cure resin cement; Subgroup 4 (PIC) used acrylic/urethane-based temporary Premier Implant Cement; and Subgroup 5 (DT) used acrylic/urethane-based temporary DentoTemp cement. Vertical misfit was measured by scanning electron microscopy (SEM). Two-way ANOVA and Student-Newman-Keuls tests were run to investigate the effect of alloy/fabrication technique, and cement type on vertical misfit. The statistical significance was set at α = 0.05. Results. The alloy/manufacturing technique and the luting cement affected the vertical discrepancy (p < 0.001). For each cement type, LS samples exhibited the best fit (p < 0.01) whereas CC and CT frames were statistically similar. Within each alloy group, PF and RXU provided comparably greater discrepancies than KC, PIC, and DT, which showed no differences. Conclusions. Laser sintering may be an alternative to vacuum-casting of base metals to obtain passive-fitting implant-supported crown copings. The best marginal adaptation corresponded to laser sintered structures luted with glass-ionomer KC, or temporary PIC or DT cements. The highest discrepancies were recorded for Co-Cr and Ti cast frameworks bonded with PF or RXU resinous agents. All groups were within the clinically acceptable misfit range. Key words:Dental alloy, laser sintering, implant-supported prostheses, vertical discrepancy, vertical misfit. PMID:22322524

Secondary Breast Augmentation.

PubMed

Brown, Mitchell H; Somogyi, Ron B; Aggarwal, Shagun

2016-07-01

After studying this article, the participant should be able to: 1. Assess common clinical problems in the secondary breast augmentation patient. 2. Describe a treatment plan to correct the most common complications of breast augmentation. 3. Provide surgical and nonsurgical options for managing complications of breast augmentation. 4. Decrease the incidence of future complications through accurate assessment, preoperative planning, and precise surgical technique. Breast augmentation has been increasing steadily in popularity over the past three decades. Many of these patients present with secondary problems or complications following their primary breast augmentation. Two of the most common complications are capsular contracture and implant malposition. Familiarity and comfort with the assessment and management of these complications is necessary for all plastic surgeons. An up-to-date understanding of current devices and techniques may decrease the need to manage future complications from the current cohort of breast augmentation patients.

Strategies and Challenges in Simultaneous Augmentation Mastopexy.

PubMed

Spring, Michelle A; Hartmann, Emily C; Stevens, W Grant

2015-10-01

Simultaneous breast augmentation and mastopexy is a common procedure often considered to be one of the most difficult cosmetic breast surgeries. One-stage augmentation mastopexy was initially described more than 50 years ago. The challenge lies in the fact that the surgery has multiple opposing goals: to increasing the volume of a breast, enhance the shape, and simultaneously decrease the skin envelope. Successful outcomes in augmentation can be expected with proper planning, technique, and patient education. This article focuses on common indications for simultaneous augmentation mastopexy, techniques for safe and effective combined procedures, challenges of the procedure, and potential complications. Copyright © 2015 Elsevier Inc. All rights reserved.

Stabilized phosphogypsum: class C fly ash: Portland type II cement composites for potential marine application.

PubMed

Guo, T; Malone, R F; Rusch, K A

2001-10-01

Phosphogypsum (PG, CaSO4 x H20), a byproduct of phosphoric acid manufacturing, contains low levels of Ra226. PG can be stabilized with portland type II cement and class C fly ash for use in marine environments, thus eliminating the airborne vector of transmission for radon gas. An augmented simplex centroid design with pseudocomponents was used to select 10 PG:class C fly ash:portland type II cement compositions. The 43 cm3 blocks were fabricated and subjected to a 1.5-yr field submergence test and a 28-d saltwater dynamic leaching study. All field composites survived with no signs of degradation. Dynamic leaching resulted in effective calcium diffusion coefficients ranging from 0.21 to 7.5 x 10(-14)m2 s(-1). Effective diffusion depths, calculated for t=1 and 30 yr, ranged from 0.4 to 2.2 mm and from 2.0 to 11.9 mm, respectively. Scanning electron microscopy and wavelength dispersive microprobe and X-ray diffraction analyses of the leached composites identified a 40-60-microm calcite layer that was absent in the control composites. This suggests that a reaction between the composites and the saltwater results in the precipitation of calcite onto the block surface, encapsulating the composites and protecting them from saltwater attack and dissolution.

Utilization of lime-dried sludge for eco-cement clinker production: effects of different feeding points.

PubMed

Cao, Haihua; Liu, Wei; Xu, Jingcheng; Liu, Jia; Huang, Juwen; Huang, Xiangfeng; Li, Guangming

2018-02-01

Co-processing lime-dried sludge (LDS) in cement kilns is an appropriate technique to solve the problem of LDS disposal and promote the sustainable development for cement industry. However, there were limited studies that investigated the effects of feeding points on product quality and cement kiln emissions. In this study, simulated experiments were conducted by dividing the feeding points into high-temperature zones (HTZs) and raw mill (RM). Cement quality and major cement kiln emission characteristics were comprehensively investigated. The results showed that in terms of burnability, compressive strength and microstructure, the optimum co-processing amount of LDS were 9 wt% when feeding at RM, while 6% when feeding at HTZs. Meanwhile, the organic emissions of RM samples were mainly low environmental risk compounds of amides and nitrogenous heterocyclic compounds. Inorganic gaseous pollutions of NO X and SO 2 , respectively, were 8.11 mg/g DS and 12.89 mg/g DS, compared with 7.61 mg/g DS and 4.44 mg/g DS for HTZs. However, all the cement kiln emissions concentration were still much lower than standard requirements. Overall, RM had a bigger LDS co-processing capacity and higher, but acceptable, cement kiln emissions. Feeding LDS via RM could dispose larger amounts of sludge and provide more alternative materials for cement manufacturing.

Investigation of fatigue crack growth in acrylic bone cement using the acoustic emission technique.

PubMed

Roques, A; Browne, M; Thompson, J; Rowland, C; Taylor, A

2004-02-01

Failure of the bone cement mantle has been implicated in the loosening process of cemented hip stems. Current methods of investigating degradation of the cement mantle in vitro often require sectioning of the sample to confirm failure paths. The present research investigates acoustic emission as a passive experimental method for the assessment of bone cement failure. Damage in bone cement was monitored during four point bending fatigue tests through an analysis of the peak amplitude, duration, rise time (RT) and energy of the events emitted from the damage sections. A difference in AE trends was observed during failure for specimens aged and tested in (i) air and (ii) Ringer's solution at 37 degrees C. It was noted that the acoustic behaviour varied according to applied load level; events of higher duration and RT were emitted during fatigue at lower stresses. A good correlation was observed between crack location and source of acoustic emission, and the nature of the acoustic parameters that were most suited to bone cement failure characterisation was identified. The methodology employed in this study could potentially be used as a pre-clinical assessment tool for the integrity of cemented load bearing implants.

Influence of Cellulosic Fibres on the Physical Properties of Fibre Cement Composites

NASA Astrophysics Data System (ADS)

Hospodarova, V.; Stevulova, N.; Vaclavik, V.; Dvorsky, T.

2017-10-01

Nowadays, there are new approaches directing to processing of non-conventional fibre-cement composites for application in the housing construction. Vegetable cellulosic fibres coming from natural resources used as reinforcement in cost-effective and environmental friendly building products are in the spotlight. The applying of natural fibres in cement based composites is narrowly linked to the ecological building sector, where a choice of materials is based on components including recyclable, renewable raw materials and low-resource manufacture techniques. In this paper, two types of cellulosic fibres coming from wood pulp and recycled waste paper with 0.2%; 0.3% and 0.5% of fibre addition into cement mixtures were used. Differences in the physical characteristics (flowability, density, coefficient of thermal conductivity and water absorbability) of 28 days hardened fibre-cement composites are investigated. Addition of cellulosic fibres to cement mixture caused worsening the workability of fresh mixture as well as absorbability of hardened composites due to hydrophilic nature of biomaterial, whereas density and thermal conductivity of manufactured cement based fibre plaster are enhanced. The physical properties of cement plasters based on cellulosic fibres depend on structural, physical characteristics of cellulosic fibres, their nature and processing.

Research on A3 steel corrosion behavior of basic magnesium sulfate cement

NASA Astrophysics Data System (ADS)

Xing, Sainan; Wu, Chengyou; Yu, Hongfa; Jiang, Ningshan; Zhang, Wuyu

2017-11-01

In this paper, Tafel polarization technique is used to study the corrosion behavior of A3 steel basic magnesium sulfate, and then analyzing the ratio of raw materials cement, nitrites rust inhibitor and wet-dry cycle of basic magnesium sulfate corrosion of reinforced influence, and the steel corrosion behavior of basic magnesium sulfate compared with magnesium oxychloride cement and Portland cement. The results show that: the higher MgO/MgSO4 mole ratio will reduce the corrosion rate of steel; Too high and too low H2O/MgSO4 mole ratio may speed up the reinforcement corrosion effect; Adding a small amount of nitrite rust and corrosion inhibitor, not only can obviously reduce the alkali type magnesium sulfate in the early hydration of cement steel bar corrosion rate, but also can significantly reduce dry-wet circulation under the action of alkali type magnesium sulfate cement corrosion of reinforcement effect. Basic magnesium sulfate cement has excellent ability to protect reinforced, its long-term corrosion of reinforcement effect and was equal to that of Portland cement. Basic magnesium sulfate corrosion of reinforced is far below the level in the MOC in the case.

Cement pulmonary embolism after vertebroplasty.

PubMed

Sifuentes Giraldo, Walter Alberto; Lamúa Riazuelo, José Ramón; Gallego Rivera, José Ignacio; Vázquez Díaz, Mónica

2013-01-01

In recent years, the use of vertebral cementing techniques for vertebroplasty and kyphoplasty has spread for the treatment of pain associated with osteoporotic vertebral compression fractures. This is also associated with the increased incidence of complications related with these procedures, the most frequent being originated by leakage of cementation material. Cement can escape into the vertebral venous system and reach the pulmonary circulation through the azygous system and cava vein, producing a cement embolism. This is a frequent complication, occurring in up to 26% of patients undergoing vertebroplasty but, since most patients have no clinical or hemodynamical repercussion, this event usually goes unnoticed. However, some serious, and even fatal cases, have been reported. We report the case of a 74-year-old male patient who underwent vertebroplasty for persistent pain associated with osteoporotic L3 vertebral fracture and who developed a cement leak into the cava vein and right pulmonary artery during the procedure. Although he developed a pulmonary cement embolism, the patient remained asymptomatic and did not present complications during follow-up. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Influence of Carbon Nanotube Clustering on Mechanical and Electrical Properties of Cement Pastes

PubMed Central

Jang, Sung-Hwan; Kawashima, Shiho; Yin, Huiming

2016-01-01

Given the continued challenge of dispersion, for practical purposes, it is of interest to evaluate the impact of multi-walled carbon nanotubes (MWCNTs) at different states of clustering on the eventual performance properties of cement paste. This study evaluated the clustering of MWCNTs and the resultant effect on the mechanical and electrical properties when incorporated into cement paste. Cement pastes containing different concentrations of MWCNTs (up to 0.5% by mass of cement) with/without surfactant were characterized. MWCNT clustering was assessed qualitatively in an aqueous solution through visual observation, and quantitatively in cement matrices using a scanning electron microscopy technique. Additionally, the corresponding 28-day compressive strength, tensile strength, and electrical conductivity were measured. Results showed that the use of surfactant led to a downward shift in the MWCNT clustering size distribution in the matrices of MWCNT/cement paste, indicating improved dispersion of MWCNTs. The compressive strength, tensile strength, and electrical conductivity of the composites with surfactant increased with MWCNT concentration and were higher than those without surfactant at all concentrations. PMID:28773348

Nano-chemo-mechanical signature of conventional oil-well cement systems: Effects of elevated temperature and curing time

DOE Office of Scientific and Technical Information (OSTI.GOV)

Krakowiak, Konrad J., E-mail: kjkrak@mit.edu; Thomas, Jeffrey J., E-mail: JThomas39@slb.com; Musso, Simone, E-mail: SMusso@slb.com

2015-01-15

With ever more challenging (T,p) environments for cementing applications in oil and gas wells, there is a need to identify the fundamental mechanisms of fracture resistant oil well cements. We report results from a multi-technique investigation of behavior and properties of API class G cement and silica-enriched cement systems subjected to hydrothermal curing from 30 °C to 200 °C; including electron probe microanalysis, X-ray diffraction, thermogravimetry analysis, electron microscopy, neutron scattering (SANS), and fracture scratch testing. The results provide a new insight into the link between system chemistry, micro-texture and micro-fracture toughness. We suggest that the strong correlation found betweenmore » chemically modulated specific surface and fracture resistance can explain the drop in fracture properties of neat oil-well cements at elevated temperatures; the fracture property enhancement in silica-rich cement systems, between 110° and 175 °C; and the drop in fracture properties of such systems through prolonged curing over 1 year at 200 °C.« less

High stenghth concrete with high cement substitution by adding fly ash, CaCO3, silica sand, and superplasticizer

NASA Astrophysics Data System (ADS)

Wicaksono, Muchammad Ridho Sigit; Qoly, Amelia; Hidayah, Annisaul; Pangestuti, Endah Kanti

2017-03-01

Concrete is a mixture of cement, fine aggregate, coarse aggregate and water with or without additives. Concrete can be made with substitution of cement with materials like Fly Ash, CaCO3 and silica sand that can increase the binding on pasta and also increase the compressive strength of concrete. The Superplasticizer on a mixture is used to reduce the high water content, improve concrete durability, low permeability concrete by making it more resilient, and improve the quality of concrete. The combination between Fly Ash (30% of cement required), CaCO3 (10% of cement required) and silica sand (5% of cement required) with added MasterGlenium ACE 8595 as much as 1,2% from total cement will produces compressive strength of up to 1080 kN/cm2 or 73,34 Mpa when the concrete is aged at 28 day. By using this technique and innovation, it proves that the cost reduction is calculated at 27%, which is much more efficient. While the strength of the concrete is increased at 5% compared with normal mixture.

Patellar Tendon Repair Augmentation With a Knotless Suture Anchor Internal Brace: A Biomechanical Cadaveric Study.

PubMed

Rothfeld, Alex; Pawlak, Amanda; Liebler, Stephenie A H; Morris, Michael; Paci, James M

2018-04-01

Patellar tendon repair with braided polyethylene suture alone is subject to knot slippage and failure. Several techniques to augment the primary repair have been described. Purpose/Hypothesis: The purpose was to evaluate a novel patellar tendon repair technique augmented with a knotless suture anchor internal brace with suture tape (SAIB). The hypothesis was that this technique would be biomechanically superior to a nonaugmented repair and equivalent to a standard augmentation with an 18-gauge steel wire. Controlled laboratory study. Midsubstance patellar tendon tears were created in 32 human cadaveric knees. Two comparison groups were created. Group 1 compared #2 supersuture repair without augmentation to #2 supersuture repair with SAIB augmentation. Group 2 compared #2 supersuture repair with an 18-gauge stainless steel cerclage wire augmentation to #2 supersuture repair with SAIB augmentation. The specimens were potted and biomechanically loaded on a materials testing machine. Yield load, maximum load, mode of failure, plastic displacement, elastic displacement, and total displacement were calculated for each sample. Standard statistical analysis was performed. There was a statistically significant increase in the mean ± SD yield load and maximum load in the SAIB augmentation group compared with supersuture alone (mean yield load: 646 ± 202 N vs 229 ± 60 N; mean maximum load: 868 ± 162 N vs 365 ± 54 N; P < .001). Group 2 showed no statistically significant differences between the augmented repairs (mean yield load: 495 ± 213 N vs 566 ± 172 N; P = .476; mean maximum load: 737 ± 210 N vs 697 ± 130 N; P = .721). Patellar tendon repair augmented with SAIB is biomechanically superior to repair without augmentation and is equivalent to repair with augmentation with an 18-gauge stainless steel cerclage wire. This novel patellar tendon repair augmentation is equivalent to standard 18-gauge wire augmentation at time zero. It does not require a second surgery for removal, and it is biomechanically superior to primary repair alone.

An on-belt elemental analyser for the cement industry.

PubMed

Lim, C S; Tickner, J R; Sowerby, B D; Abernethy, D A; McEwan, A J; Rainey, S; Stevens, R; Manias, C; Retallack, D

2001-01-01

On-line control of raw mill feed composition is a key factor in the improved control of cement plants. A new and improved on-conveyor belt elemental analyser for cement raw mill feed based on neutron inelastic scatter and capture techniques has been developed and tested successfully in Adelaide Brighton's Birkenhead cement plant on highly segregated material with a depth range of 100 to 180 mm. Dynamic tests in the plant have shown analyser RMS total errors of 0.49, 0.52, 0.38 and 0.23 wt% (on a loss free basis) for CaO, SiO2, Al2O3 and Fe2O3 respectively, when 10-minute counting periods are used.

Hearing Outcome With the Use of Glass Ionomer Cement as an Alternative to Crimping in Stapedotomy.

PubMed

Elzayat, Saad; Younes, Ahmed; Fouad, Ayman; Erfan, Fatthe; Mahrous, Ali

2017-10-01

To evaluate early hearing outcomes using glass ionomer cement to fix the Teflon piston prosthesis onto the long process of incus to minimize residual conductive hearing loss after stapedotomy. Original report of prospective randomized control study. Tertiary referral center. A total of 80 consecutive patients with otosclerosis were randomized into two groups. Group A is a control group in which 40 patients underwent small fenestra stapedotomy using the classic technique. Group B included 40 patients who were subjected to small fenestra stapedotomy with fixation of the incus-prosthesis junction with glass ionomer bone cement. Stapedotomy with the classical technique in group A and the alternative technique in group B. The audiometric results before and after surgery. Analysis of the results was performed using the paired t test to compare between pre and postoperative results. χ test was used to compare the results of the two groups. A p value less than 0.05 was considered significant from the statistical standpoint. Significant postoperative improvement of both pure-tone air conduction thresholds and air-bone gaps were reported in the two studied groups. The postoperative average residual air-bone gap and hearing gain were statistically significant in group B (p < 0.05) compared with group A. The use of glass ionomer bone cement in primary otosclerosis surgery using the aforementioned prosthesis and the surgical technique is of significant value in producing maximal closure of the air-bone gap and better audiological outcomes.

In vitro evaluation of microleakage of various types of dental cements.

PubMed

Medić, Vesna; Obradović-Djuricić, Kosovka; Dodić, Slobodan; Petrović, Renata

2010-01-01

Microleakage is defined as the clinically undetectable seepage of oral fluids containing bacteria and debris between cement layer and tooth restoration. This in vitro study investigated the effect of different dental cements (zinc-phosphate, polycarboxylate, glass-ionomer and resin cement) on microleakage in different ceramic crown systems (metal ceramic crown, metal ceramic crown with a porcelain margin, Empress 2 and in Ceram all-ceramic crowns) fixed on extracted human teeth. One hundred and sixty intact human premolars were randomized to four groups of forty teeth each, according to the different ceramic crown systems. They were prepared in a standardized manner for metal-ceramic and all-ceramic crowns. Crowns were made following a standard laboratory technique, and each group of crowns were divided into four groups according to the different cement agents and cemented on their respective abutments. The specimens were subjected to thermocycling, placed in methylene blue solutions, embedded in resin blocks and vertically cut in the bucco-oral and meso-distal direction. The microleakage in the area of tooth-cement interface was defined as linear penetration of methylene blue and was determined with a microscope to assign microleakage scores using a five-point scale. A significant association was found between a cement type and degree of microleakage (p = 0.001). No statistically significant differences were found among the different ceramic crown systems luted with the same dental cement. The smallest degree of microleakage was observed in specimens luted with resin cement (X = 1.73), followed by glass-ionomer cement (X=2.45) and polycarboxylate cement (X = 3.20). The greatest degree of microleakage was detected in the crowns fixed with zincphosphate cement (X = 3.33). The investigated dental cements revealed different sealing abilities. The use of resin cement resulted in the percentage of 0 microleakage scores. Due to this feature, the resin cement is to be recommended in everyday clinical practice.

Reductive Augmentation of the Breast.

PubMed

Chasan, Paul E

2018-06-01

Although breast reduction surgery plays an invaluable role in the correction of macromastia, it almost always results in a breast lacking in upper pole fullness and/or roundness. We present a technique of breast reduction combined with augmentation termed "reductive augmentation" to solve this problem. The technique is also extremely useful for correcting breast asymmetry, as well as revising significant pseudoptosis in the patient who has previously undergone breast augmentation with or without mastopexy. An evolution of techniques has been used to create a breast with more upper pole fullness and anterior projection in those patients desiring a more round, higher-profile appearance. Reductive augmentation is a one-stage procedure in which a breast augmentation is immediately followed by a modified superomedial pedicle breast reduction. Often, the excision of breast tissue is greater than would normally be performed with breast reduction alone. Thirty-five patients underwent reductive augmentation, of which 12 were primary surgeries and 23 were revisions. There was an average tissue removal of 255 and 227 g, respectively, per breast for the primary and revision groups. Six of the reductive augmentations were performed for gross asymmetry. Fourteen patients had a previous mastopexy, and 3 patients had a previous breast reduction. The average follow-up was 26 months. Reductive augmentation is an effective one-stage method for achieving a more round-appearing breast with upper pole fullness both in primary breast reduction candidates and in revisionary breast surgery. This technique can also be applied to those patients with significant asymmetry. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Reinforcement of cement-based matrices with graphite nanomaterials

NASA Astrophysics Data System (ADS)

Sadiq, Muhammad Maqbool

Cement-based materials offer a desirable balance of compressive strength, moisture resistance, durability, economy and energy-efficiency; their tensile strength, fracture energy and durability in aggressive environments, however, could benefit from further improvements. An option for realizing some of these improvements involves introduction of discrete fibers into concrete. When compared with today's micro-scale (steel, polypropylene, glass, etc.) fibers, graphite nanomaterials (carbon nanotube, nanofiber and graphite nanoplatelet) offer superior geometric, mechanical and physical characteristics. Graphite nanomaterials would realize their reinforcement potential as far as they are thoroughly dispersed within cement-based matrices, and effectively bond to cement hydrates. The research reported herein developed non-covalent and covalent surface modification techniques to improve the dispersion and interfacial interactions of graphite nanomaterials in cement-based matrices with a dense and well graded micro-structure. The most successful approach involved polymer wrapping of nanomaterials for increasing the density of hydrophilic groups on the nanomaterial surface without causing any damage to the their structure. The nanomaterials were characterized using various spectrometry techniques, and SEM (Scanning Electron Microscopy). The graphite nanomaterials were dispersed via selected sonication procedures in the mixing water of the cement-based matrix; conventional mixing and sample preparation techniques were then employed to prepare the cement-based nanocomposite samples, which were subjected to steam curing. Comprehensive engineering and durability characteristics of cement-based nanocomposites were determined and their chemical composition, microstructure and failure mechanisms were also assessed through various spectrometry, thermogravimetry, electron microscopy and elemental analyses. Both functionalized and non-functionalized nanomaterials as well as different micro-scale fibers were used for comparison purposes at different volume fractions. Replicated mixes and tests were considered to provide the basis for statistically reliable inferences. Theoretical studies were conducted in order to develop insight into the reinforcement mechanisms of properly functionalized graphite nanomaterials. The results suggested that modified graphite nanomaterials improve the mechanical performance of cement-based matrices primarily through control of microcrack size and propagation, relying on their close spacing within matrix and dissipation of substantial energy by debonding and frictional pullout over their enormous surface areas. The gains in barrier qualities of cement-based materials with introduction of modified graphite nanomaterials could be attributed to the increased tortuosity of diffusion paths in the presence of closely spaced nanomaterials. Experimental investigations were designed and implemented towards identification of the optimum (nano- and micro-scale) reinforcement systems for high-performance concrete through RSA (Response Surface Analysis). A comprehensive experimental data base was developed on the mechanical, physical and durability characteristics as well as the structure and composition of high-performance cementitious nanocomposites reinforced with modified graphite nanomaterials and/ or different micro-fibers.

Architecture and Key Techniques of Augmented Reality Maintenance Guiding System for Civil Aircrafts

NASA Astrophysics Data System (ADS)

hong, Zhou; Wenhua, Lu

2017-01-01

Augmented reality technology is introduced into the maintenance related field for strengthened information in real-world scenarios through integration of virtual assistant maintenance information with real-world scenarios. This can lower the difficulty of maintenance, reduce maintenance errors, and improve the maintenance efficiency and quality of civil aviation crews. Architecture of augmented reality virtual maintenance guiding system is proposed on the basis of introducing the definition of augmented reality and analyzing the characteristics of augmented reality virtual maintenance. Key techniques involved, such as standardization and organization of maintenance data, 3D registration, modeling of maintenance guidance information and virtual maintenance man-machine interaction, are elaborated emphatically, and solutions are given.

Cermet reinforcement of a weakened endodontically treated root: a case report.

PubMed

Lui, J L

1992-08-01

Many clinical applications have been recommended for glass-cermet cement because of its improved properties compared to the original glass-ionomer cements. It has also been accepted as a dentinal substitute that can strengthen teeth. In this paper, an additional clinical application for glass-cermet cement, the reinforcement of weakened endodontically treated roots, is suggested. This technique is in keeping with the trends of tooth conservation and the use of an adhesive restorative material in the restoration of severely damaged teeth by a conservative approach.

Effect of electric arc, gas oxygen torch and induction melting techniques on the marginal accuracy of cast base-metal and noble metal-ceramic crowns.

PubMed

Gómez-Cogolludo, Pablo; Castillo-Oyagüe, Raquel; Lynch, Christopher D; Suárez-García, María-Jesús

2013-09-01

The aim of this study was to identify the most appropriate alloy composition and melting technique by evaluating the marginal accuracy of cast metal-ceramic crowns. Seventy standardised stainless-steel abutments were prepared to receive metal-ceramic crowns and were randomly divided into four alloy groups: Group 1: palladium-gold (Pd-Au), Group 2: nickel-chromium-titanium (Ni-Cr-Ti), Group 3: nickel-chromium (Ni-Cr) and Group 4: titanium (Ti). Groups 1, 2 and 3 were in turn subdivided to be melted and cast using: (a) gas oxygen torch and centrifugal casting machine (TC) or (b) induction and centrifugal casting machine (IC). Group 4 was melted and cast using electric arc and vacuum/pressure machine (EV). All of the metal-ceramic crowns were luted with glass-ionomer cement. The marginal fit was measured under an optical microscope before and after cementation using image analysis software. All data was subjected to two-way analysis of variance (ANOVA). Duncan's multiple range test was run for post-hoc comparisons. The Student's t-test was used to investigate the influence of cementation (α=0.05). Uncemented Pd-Au/TC samples achieved the best marginal adaptation, while the worst fit corresponded to the luted Ti/EV crowns. Pd-Au/TC, Ni-Cr and Ti restorations demonstrated significantly increased misfit after cementation. The Ni-Cr-Ti alloy was the most predictable in terms of differences in misfit when either torch or induction was applied before or after cementation. Cemented titanium crowns exceeded the clinically acceptable limit of 120μm. The combination of alloy composition, melting technique, casting method and luting process influences the vertical seal of cast metal-ceramic crowns. An accurate use of the gas oxygen torch may overcome the results attained with the induction system concerning the marginal adaptation of fixed dental prostheses. Copyright © 2013 Elsevier Ltd. All rights reserved.

Bone augmentation as an adjunct to dental implant rehabilitation in patients with diabetes mellitus: A review of literature

PubMed Central

Ladha, Komal; Sharma, Ankit; Tiwari, Bhawana; Bukya, Dwaraka N

2017-01-01

The aim of the present article is to review the success of bone augmentation performed as an adjunct to dental implant rehabilitation in patients with diabetes mellitus. A literature review was conducted in PubMed on this topic, which yielded a total of 102 publications. For inclusion, publications had to be human studies, written in English language and should report on the success of bone augmentation as an adjunct to dental implant rehabilitation in diabetic patients. After screening the titles and abstracts, 11 full texts publications were obtained, of which seven were included in the review. These studies provided data on various bone augmentation techniques such as sinus floor elevation (SFE), guided bone regeneration (GBR), and onlay bone grafting. Even though the current review revealed that there are not many studies reporting data relevant to the analyzed topic, the data obtained suggests that; (1) staged GBR technique should be considered more feasible and predictable for bone augmentation, (2) clinicians must take meticulous care when planning and conducting SFE, and (3) block bone augmentation technique should be avoided. PMID:29386810

Multiple Perforations of the Sinus Floor During Maxillary Sinus Floor Augmentation to Provide Access to the Bone Marrow Space: A Technical Report.

PubMed

Ulm, Christian; Bertl, Kristina; Strbac, Georg D; Esfandeyari, Azadeh; Stavropoulos, Andreas; Zechner, Werner

2017-12-01

Sinus floor augmentation is a routinely used surgical technique for increasing the bone height/volume of the atrophic posterior maxilla. Optimal integration of the implanted augmentation material within the newly formed bone will-at least partly-depend on adequate vascularization to ensure sufficient recruitment of osteoblast and osteoclast precursor cells. The present technical note describes a modification intended to facilitate increased blood inflow into the augmented space. After preparation of the lateral window and elevation of the Schneiderian membrane, the cortical bone of the sinus floor is perforated several times either by using a piezoelectric device or a microsurgical handpiece with the corresponding tip or bur; these perforations should extend into the trabecular bone. The experiences with this modified technique after 12 patients are presented and discussed. It is expected that by means of this relatively simple technique, increased blood and cell inflow into the augmented space is achieved. This may, in turn, enhance new bone formation and improve the integration of the augmentation material.

Vascularized interpositional periosteal connective tissue flap: A modern approach to augment soft tissue

PubMed Central

Agarwal, Chitra; Deora, Savita; Abraham, Dennis; Gaba, Rohini; Kumar, Baron Tarun; Kudva, Praveen

2015-01-01

Context: Nowadays esthetics plays an important role in dentistry along with function of the prosthesis. Various soft tissue augmentation procedures are available to correct the ridge defects in the anterior region. The newer technique, vascularized interpositional periosteal connective tissue (VIP-CT) flap has been introduced, which has the potential to augment predictable amount of tissue and has many benefits when compared to other techniques. Aim: The study was designed to determine the efficacy of the VIP-CT flap in augmenting the ridge defect. Materials and Methods: Ten patients with Class III (Seibert's) ridge defects were treated with VIP-CT flap technique before fabricating fixed partial denture. Height and width of the ridge defects were measured before and after the procedure. Subsequent follow-up was done every 3 months for 1-year. Statistical Analysis Used: Paired t-test was performed to detect the significance of the procedure. Results: The surgical site healed uneventfully. The predictable amount of soft tissue augmentation had been achieved with the procedure. The increase in height and width of the ridge was statistically highly significant. Conclusion: The VIP-CT flap technique was effective in augmenting the soft tissue in esthetic area that remained stable over a long period. PMID:25810597

"Non-filling" procedures for lip augmentation: a systematic review of contemporary techniques and their outcomes.

PubMed

Moragas, Joan San Miguel; Vercruysse, Herman Junior; Mommaerts, Maurice Y

2014-09-01

Ideal lip augmentation techniques have good longevity, low complication rates, and optimal functional and aesthetic results. No systematic review is currently available regarding the efficacy of lip augmentation techniques. This review will focus only on non-filling procedures for lip augmentation (NFPLAs). Current databases Elsevier Science Direct, PubMed, HighWire Press, Springer Standard Collection, SAGE, DOAJ, Sweetswise, Free E-Journals, Ovid Lippincott Williams & Wilkins, Willey Online Library Journals and Cochrane Plus were scrutinized and relevant article reference sections were studied for additional publications. The search heading sequence used was ("Lip" or "Mouth" or "Perioral" or "Nasolabial") and ("Augmentation" or "Enhancement" or "Surgery" or "Lift" or "V-Y" or "Corner"). Exclusion criteria applied to 6436 initial keyword-search retrievals yielded 12 articles. Eight more articles were retrieved from reference sections, for a total of 18 papers assessed. Only one article made a direct comparison of efficacy between two surgical techniques for lip augmentation, and none directly compared complications associated with different NFPLAs. Although this systematic review revealed a lack of quality data in comparing the efficacy and complications among different NFPLAs, it is important to review and pool the existing studies to better suggest proper treatment to patients. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Apatite formation on bioactive calcium-silicate cements for dentistry affects surface topography and human marrow stromal cells proliferation.

PubMed

Gandolfi, Maria Giovanna; Ciapetti, Gabriela; Taddei, Paola; Perut, Francesca; Tinti, Anna; Cardoso, Marcio Vivan; Van Meerbeek, Bart; Prati, Carlo

2010-10-01

The effect of ageing in phosphate-containing solution of bioactive calcium-silicate cements on the chemistry, morphology and topography of the surface, as well as on in vitro human marrow stromal cells viability and proliferation was investigated. A calcium-silicate cement (wTC) mainly based on dicalcium-silicate and tricalcium-silicate was prepared. Alpha-TCP was added to wTC to obtain wTC-TCP. Bismuth oxide was inserted in wTC to prepare a radiopaque cement (wTC-Bi). A commercial calcium-silicate cement (ProRoot MTA) was tested as control. Cement disks were aged in DPBS for 5 h ('fresh samples'), 14 and 28 days, and analyzed by ESEM/EDX, SEM/EDX, ATR-FTIR, micro-Raman techniques and scanning white-light interferometry. Proliferation, LDH release, ALP activity and collagen production of human marrow stromal cells (MSC) seeded for 1-28 days on the cements were evaluated. Fresh samples exposed a surface mainly composed of calcium-silicate hydrates CSH (from the hydration of belite and alite), calcium hydroxide, calcium carbonate, and ettringite. Apatite nano-spherulites rapidly precipitated on cement surfaces within 5 h. On wTC-TCP the Ca-P deposits appeared thicker than on the other cements. Aged cements showed an irregular porous calcium-phosphate (Ca-P) coating, formed by aggregated apatite spherulites with interspersed calcite crystals. All the experimental cements exerted no acute toxicity in the cell assay system and allowed cell growth. Using biochemical results, the scores were: fresh cements>aged cements for cell proliferation and ALP activity (except for wTC-Bi), whereas fresh cements

Computer Augmented Lectures (CAL): A New Teaching Technique for Chemistry.

ERIC Educational Resources Information Center

Masten, F. A.; And Others

A new technique described as computer augmented lectures (CAL) is being used at the University of Texas at Austin. It involves the integration of on-line, interactive, time sharing computer terminals and theater size video projectors for large screen display. This paper covers the basic concept, pedagogical techniques, experiments conducted,…

[Fiber reinforced composite posts: literature review].

PubMed

Frydman, G; Levatovsky, S; Pilo, R

2013-07-01

FRC (Fiber-reinforced composite) posts have been used since the beginning of the 90s with the introduction of carbon fiber posts. Fiber posts are widely used to restore endodontically treated teeth that have insufficient coronal tooth structure. Many in vitro and in vivo studies have shown the advantage of using FRC over prefabricated and cast metal post especially indicated in narrow root canals which are prone to vertically root fracture. The most frequent failure of FRC is debonding of a post at the resin cement/dentin interface. Bonding to dentin may be achieved by using etch-and-rinse and self-etch adhesives. The bond strength formed by self-adhesive cements is noticeably lower in comparison to the bond strength formed with resin cements applied in combination with etch-and-rinse adhesives. In an attempt to maximize resin bonding to fiber posts, several surface treatments have been suggested. Sandblasting with alumina particles results in an increased surface roughness and surface area without affecting the integrity of the post as long as it is applied by 50 microm alumina particles at 2.5 bars for maximally 5 seconds at a distance of 30 mm. The efficiency of post salinization is controversial and its contribution to the retention is of minor importance. Hydrofluoric acid has recently been proposed for etching glass fiber posts but this technique produced substantial damage to the glass fibers and affected the integrity of the post. Delayed cementation of fiber post (at least 24h post endodontic treatment) resulted in higher retentive strengths in comparison to immediate cementation and the best results were obtained when the luting agent was brought into the post space with lentulo spirals or specific syringes. The resin cement film thickness also influences the pullout strengths of fiber-reinforced posts .The highest bond strength values were obtained when the cement layer oversized the post spaces but not larger than 0.3 mm. The use of core build-up materials as post luting cements is not recommended. The use of FRC post, combined with proper adhesive cementation technique can give an excellent solution when restoring endodontically treated teeth that are prone to fracture.

[A study of different polishing techniques for amalgams and glass-cermet cement by scanning electron microscope (SEM)].

PubMed

Kakaboura, A; Vougiouklakis, G; Argiri, G

1989-01-01

Finishing and polishing an amalgam restoration, is considered as an important and necessary step of the restorative procedure. Various polishing techniques have been recommended to success a smooth amalgam surface. The aim of this study was to investigate the influence of three different polishing treatments on the marginal integrity and surface smoothness of restorations made of three commercially available amalgams and a glass-cermet cement. The materials used were the amalgams, Amalcap (Vivadent), Dispersalloy (Johnson and Johnson), Duralloy (Degussa) and the glass-cermet Katac-Silver (ESPE). The occlusal surfaces of the restorations were polished by the methods: I) round bur, No4-rubber cup-zinc oxide paste in a small brush, II) round bur No 4-bur-brown, green and super green (Shofu) polishing cups and points successively and III) amalgam polishing bur of 12-blades-smooth amalgam polishing bur. Photographs from unpolished and polished surfaces of the restorations, were taken with scanning electron microscope, to evaluate the polishing techniques. An improvement of marginal integrity and surface smoothness of all amalgam restorations was observed after the specimens had been polished with the three techniques. Method II, included Shofu polishers, proved the best results in comparison to the methods I and III. Polishing of glass-cermet cement was impossible with the examined techniques.

An alternative method for the treatment of waste produced at a dye and a metal-plating industry using natural and/or waste materials.

PubMed

Fatta, Despo; Papadopoulos, Achilleas; Stefanakis, Nikos; Loizidou, Maria; Savvides, Chrysanthos

2004-08-01

The aim of this study was to develop cost-effective, appropriate solidification technologies for treating hazardous industrial wastes that are currently disposed of in ways that may threaten the quality of local groundwater. One major objective was to use materials other than cement, and preferably materials that are themselves wastes, as the solidification additives, namely using wastes to treat wastes or locally available natural material. This research examines the cement-based and lime-based stabilization/solidification (S/S) techniques applied for waste generated at a metal-plating industry and a dye industry. For the lime-based S/S process the following binder mixtures were used: cement kiln dust/ lime, bentonite/lime and gypsum/lime. For the cement-based S/S process three binder mixtures were used: cement kiln dust/cement, bentonite/cement and gypsum/cement. The leachability of the wastes was evaluated using the toxicity characteristic leaching procedure. The applicability and optimum weight ratio of the binder mixtures were estimated using the unconfined compressive strength test. The optimum ratio mixtures were mixed with waste samples in different ratios and cured for 28 days in order to find the S/S products with the highest strength and lowest leachability at the same time. The results of this work showed that the cement-and lime-based S/S process, using cement kiln dust and bentonite as additives can be effectively used in order to treat industrial waste.

Assessment of Pb-slag, MSWI bottom ash and boiler and fly ash for using as a fine aggregate in cement mortar.

PubMed

Saikia, Nabajyoti; Cornelis, Geert; Mertens, Gilles; Elsen, Jan; Van Balen, Koenraad; Van Gerven, Tom; Vandecasteele, Carlo

2008-06-15

Three types of wastes, metallurgical slag from Pb production (SLG), the sand-sized (0.1-2 mm) fraction of MSWI bottom ash from a grate furnace (SF), and boiler and fly ash from a fluidised bed incinerator (BFA), were characterized and used to replace the fine aggregate during preparation of cement mortar. The chemical and mineralogical behaviour of these wastes along with the reactivities of the wastes with lime and the hydration behaviour of ordinary Portland cement paste with and without these wastes added were evaluated by various chemical and instrumental techniques. The compressive strengths of the cement mortars containing waste as a partial substitution of fine aggregates were also assessed. Finally, leaching studies of the wastes and waste containing cement mortars were conducted. SLG addition does not show any adverse affect during the hydration of cement, or on the compressive strengths behaviours of mortars. Formation of expansive products like ettringite, aluminium hydroxide and H2 gas due to the reaction of some constituents of BFA and SF with alkali creates some cracks in the paste as well as in the cement mortars, which lower the compressive strength of the cement mortars. However, utilization of all materials in cement-based application significantly improves the leaching behaviour of the majority of the toxic elements compared to the waste as such.

Influence of Thermal Treatment Conditions on the Properties of Dental Silicate Cements.

PubMed

Voicu, Georgeta; Popa, Alexandru Mihai; Badanoiu, Alina Ioana; Iordache, Florin

2016-02-18

In this study the sol-gel process was used to synthesize a precursor mixture for the preparation of silicate cement, also called mineral trioxide aggregate (MTA) cement. This mixture was thermally treated under two different conditions (1400 °C/2 h and 1450 °C/3 h) followed by rapid cooling in air. The resulted material (clinker) was ground for one hour in a laboratory planetary mill (v = 150 rot/min), in order to obtain the MTA cements. The setting time and mechanical properties, in vitro induction of apatite formation by soaking in simulated body fluid (SBF) and cytocompatibility of the MTA cements were assessed in this study. The hardening processes, nature of the reaction products and the microstructural characteristics were also investigated. The anhydrous and hydrated cements were characterized by different techniques e.g., X-ray diffraction (XRD), scanning electron microscopy (SEM), infrared spectroscopy (FT-IR) and thermal analysis (DTA-DTG-TG). The setting time of the MTA cement obtained by thermal treatment at 1400 °C/2 h (MTA1) was 55 min and 15 min for the MTA cement obtained at 1450 °C/3 h (MTA2). The compressive strength values were 18.5 MPa (MTA1) and 22.9 MPa (MTA2). Both MTA cements showed good bioactivity (assessed by an in vitro test), good cytocompatibility and stimulatory effect on the proliferation of cells.

Alkali activated slag mortars provide high resistance to chloride-induced corrosion of steel

NASA Astrophysics Data System (ADS)

Criado, Maria; Provis, John L.

2018-06-01

The pore solutions of alkali-activated slag cements and Portland-based cements are very different in terms of their chemical and redox characteristics, particularly due to the high alkalinity and high sulfide content of alkali-activated slag cement. Therefore, differences in corrosion mechanisms of steel elements embedded in these cements could be expected, with important implications for the durability of reinforced concrete elements. This study assesses the corrosion behaviour of steel embedded in alkali-activated blast furnace slag (BFS) mortars exposed to alkaline solution, alkaline chloride-rich solution, water, and standard laboratory conditions, using electrochemical techniques. White Portland cement (WPC) mortars and blended cement mortars (white Portland cement and blast furnace slag) were also tested for comparative purposes. The steel elements embedded in immersed alkali-activated slag mortars presented very negative redox potentials and high apparent corrosion current values; the presence of sulfide reduced the redox potential, and the oxidation of the reduced sulfur-containing species within the cement itself gave an electrochemical signal that classical electrochemical tests for reinforced concrete durability would interpret as being due to steel corrosion processes. However, the actual observed resistance to chloride-induced corrosion was very high, as measured by extraction and characterisation of the steel at the end of a 9-month exposure period, whereas the steel embedded in white Portland cement mortars was significantly damaged under the same conditions.

Effects of cement on redistribution of trace metals and dissolution of organics in sewage sludge and its inorganic waste-amended products.

PubMed

Lim, T T; Chu, J; Goi, M H

2006-01-01

The suitability of using cement-stabilized sludge products as artificial soils in earth works was evaluated. The sludge products investigated were cemented sludge, cement-treated clay-amended sludge (SS+MC), and cement-treated copper slag-amended sludge (SS+CS). The leachability of lead (Pb), zinc (Zn), copper (Cu), and chromium (Cr) were assessed using the sequential extraction technique, toxicity characteristic leaching procedure (TCLP), NEN 7341 availability test, and column leaching test. The results indicated that Zn leachability was reduced in all the cement-stabilized sludge products. In contrast, Cu was transferred from the organic fraction to the readily leachable phases in the cement-stabilized sludge products and therefore exhibited increased leachability. The increased Cu leachability could be attributed to dissolution of humic substances in the sludge as a result of elevated pH. Good correlation between dissolved organic carbon (DOC) and heavy metal leaching from the cement-stabilized sludge products was observed in the column leaching experiment. Even with a cement percentage as small as 12.5%, calcium silicate hydrate (C-S-H) was formed in the SS+MC and SS+CS products. Inclusion of the marine clay in the SS+MC products could reduce the leaching potentials of Zn, and this was the great advantage of the marine clay over the copper slag for sludge amendment.

Spectroscopic investigation of Ni speciation in hardened cement paste.

PubMed

Vespa, M; Dähn, R; Grolimund, D; Wieland, E; Scheidegger, A M

2006-04-01

Cement-based materials play an important role in multi-barrier concepts developed worldwide for the safe disposal of hazardous and radioactive wastes. Cement is used to condition and stabilize the waste materials and to construct the engineered barrier systems (container, backfill, and liner materials) of repositories for radioactive waste. In this study, Ni uptake by hardened cement paste has been investigated with the aim of improving our understanding of the immobilization process of heavy metals in cement on the molecular level. X-ray absorption spectroscopy (XAS) coupled with diffuse reflectance spectroscopy (DRS) techniques were used to determine the local environment of Ni in cement systems. The Ni-doped samples were prepared at two different water/cement ratios (0.4, 1.3) and different hydration times (1 hour to 1 year) using a sulfate-resisting Portland cement. The metal loadings and the metal salts added to the system were varied (50 up to 5000 mg/kg; NO3(-), SO4(2-), Cl-). The XAS study showed that for all investigated systems Ni(ll) is predominantly immobilized in a layered double hydroxide (LDH) phase, which was corroborated by DRS measurements. Only a minor extent of Ni(ll) precipitates as Ni-hydroxides (alpha-Ni(OH)2 and beta-Ni(OH)2). This finding suggests that Ni-Al LDH, rather than Ni-hydroxides, is the solubility-limiting phase in the Ni-doped cement system.

Influence of CAD/CAM systems and cement selection on marginal discrepancy of zirconia-based ceramic crowns.

PubMed

Martínez-Rus, Francisco; Suárez, María J; Rivera, Begoña; Pradíes, Guillermo

2012-04-01

To analyze the effect of ceramic manufacturing technique and luting cement selection on the marginal adaptation of zirconium oxide-based all-ceramic crowns. An extracted mandibular first premolar was prepared for a complete coverage restoration and subsequently duplicated 40 times in a liquid crystal polymer (LCP). All-ceramic crowns (n = 10) were fabricated on LCP models using the following systems: glass-infiltrated zirconia-toughened alumina (In-Ceram Zirconia) and yttrium cation-doped tetragonal zirconia polycrystals (In-Ceram YZ, Cercon, and Procera Zirconia). The restorations (n = 5) were cemented on their respective dies with glass-ionomer cement (Ketac Cem Aplicap) and resin cement (Panavia 21). The absolute marginal discrepancy of the crowns was measured before and after cementation by scanning electronic microscopy at 160 points along the circumferential margin. The data were analyzed using one-way ANOVA for repeated measures and for independent samples, Scheffé's multiple range post hoc test, and Student's t-test (alpha = 0.05). There were statistical differences in the mean marginal openings among the four all-ceramic systems before and after luting (P < 0.0001). The Procera restorations had the lowest pre- and post-cementation values (P < 0.0001). A significant increase in the marginal gap size caused by luting media occurred in all tested groups (P < 0.0001). Resin cement resulted in larger marginal discrepancies than glass-ionomer cement (P < 0.0001).

Push-out bond strength of fiber posts to root dentin using glass ionomer and resin modified glass ionomer cements.

PubMed

Pereira, Jefferson Ricardo; Rosa, Ricardo Abreu da; Só, Marcus Vinícius Reis; Afonso, Daniele; Kuga, Milton Carlos; Honório, Heitor Marques; Valle, Accácio Lins do; Vidotti, Hugo Alberto

2014-01-01

The purpose of this study was to assess the push-out bond strength of glass fiber posts to root dentin after cementation with glass ionomer (GICs) and resinmodified glass ionomer cements (RMGICs). Fifty human maxillary canines were transversally sectioned at 15 mm from the apex. Canals were prepared with a step back technique until the application of a #55 K-file and filled. Post spaces were prepared and specimens were divided into five groups according to the cement used for post cementation: Luting & Lining Cement; Fuji II LC Improved; RelyX Luting; Ketac Cem; and Ionoseal. After cementation of the glass fiber posts, all roots were stored at 100% humidity until testing. For push-out test, 1-mm thick slices were produced. The push-out test was performed in a universal testing machine at a crosshead speed of 0.5 mm/minute and the values (MPa) were analyzed by Kolmogorov-Smirnov and Levene's tests and by two-way ANOVA and Tukey's post hoc test at a significance level of 5%. Fiber posts cemented using Luting & Lining Cement, Fuji II LC Improved, and Ketac Cem presented the highest bond strength to root dentin, followed by RelyX Luting. Ionoseal presented the lowest bond strength values (P>0.05). The post level did not influence the bond strength of fiber posts to root dentin (P=0.148). The major cause of failure was cohesive at the cement for all GICs and RMGICs. Except for Ionoseal, all cements provided satisfactory bond strength values.

Push-out bond strength of fiber posts to root dentin using glass ionomer and resin modified glass ionomer cements

PubMed Central

PEREIRA, Jefferson Ricardo; da ROSA, Ricardo Abreu; SÓ, Marcus Vinícius Reis; AFONSO, Daniele; KUGA, Milton Carlos; HONÓRIO, Heitor Marques; do VALLE, Accácio Lins; VIDOTTI, Hugo Alberto

2014-01-01

Objective The purpose of this study was to assess the push-out bond strength of glass fiber posts to root dentin after cementation with glass ionomer (GICs) and resin-modified glass ionomer cements (RMGICs). Material and Methods Fifty human maxillary canines were transversally sectioned at 15 mm from the apex. Canals were prepared with a step back technique until the application of a #55 K-file and filled. Post spaces were prepared and specimens were divided into five groups according to the cement used for post cementation: Luting & Lining Cement; Fuji II LC Improved; RelyX Luting; Ketac Cem; and Ionoseal. After cementation of the glass fiber posts, all roots were stored at 100% humidity until testing. For push-out test, 1-mm thick slices were produced. The push-out test was performed in a universal testing machine at a crosshead speed of 0.5 mm/minute and the values (MPa) were analyzed by Kolmogorov-Smirnov and Levene's tests and by two-way ANOVA and Tukey's post hoc test at a significance level of 5%. Results Fiber posts cemented using Luting & Lining Cement, Fuji II LC Improved, and Ketac Cem presented the highest bond strength to root dentin, followed by RelyX Luting. Ionoseal presented the lowest bond strength values (P>0.05). The post level did not influence the bond strength of fiber posts to root dentin (P=0.148). The major cause of failure was cohesive at the cement for all GICs and RMGICs. Conclusions Except for Ionoseal, all cements provided satisfactory bond strength values. PMID:25004052

Rehabilitation of postrior atrophic edentulous jaws: prostheses supported by 5 mm short implants or by longer implants in augmented bone? One-year results from a pilot randomised clinical trial.

PubMed

Esposito, Marco; Pellegrino, Gerardo; Pistilli, Roberto; Felice, Pietro

2011-01-01

To evaluate whether 5 mm short dental implants could be an alternative to augmentation with anorganic bovine bone and placement of at least 10 mm long implants in posterior atrophic jaws. Fifteen patients with bilateral atrophic mandibles (5-7 mm bone height above the mandibular canal), and 15 patients with bilateral atrophic maxillae (4-6 mm bone height below the maxillary sinus) and bone thickness of at least 8 mm, were randomised according to a splitmouth design to receive one to three 5 mm short implants or at least 10 mm long implants in augmented bone. Mandibles were vertically augmented with interpositional bone blocks and maxillary sinuses with particulated bone via a lateral window. Implants were placed after 4 months, submerged and loaded, after 4 months, with provisional prostheses. Four months later, definitive provisionally cemented prostheses were delivered. Outcome measures were: prosthesis and implant failures, any complication and peri-implant marginal bone level changes. In 5 augmented mandibles, the planned 10 mm long implants could not be placed and shorter implants (7 and 8.5 mm) had to be used instead. One year after loading no patient dropped out. Two long (8.5 mm in the mandible and 13 mm in the maxilla) implants and one 5 mm short maxillary implant failed. There were no statistically significant differences in failures or complications. Patients with short implants lost on average 1 mm of peri-implant bone and patients with longer implants lost 1.2 mm. This difference was statistically significant. This pilot study suggests that 1 year after loading, 5 mm short implants achieve similar if not better results than longer implants placed in augmented bone. Short implants might be a preferable choice to bone augmentation since the treatment is faster, cheaper and associated with less morbidity, however their long-term prognosis is unknown.

Cemented total knee replacement in 24 dogs: surgical technique, clinical results, and complications.

PubMed

Allen, Matthew J; Leone, Kendall A; Lamonte, Kimberly; Townsend, Katy L; Mann, Kenneth A

2009-07-01

To characterize the performance of cemented total knee replacement (TKR) in dogs. Preclinical research study. Skeletally mature, male Hounds (25-30 kg; n=24) with no preexisting joint pathology. Dogs had unilateral cemented TKR and were evaluated at 6, 12, 26, or 52 weeks (6 dogs/time point) by radiography, bone density analysis, visual gait assessment, and direct measurement of thigh circumference and stifle joint range of motion as indicators of functional recovery. At study end, the stability of the cemented tibial component was determined by destructive mechanical testing. Joint stability was excellent in 16 dogs (67%) and good in 8 dogs. None of the tibial components had evidence of migration or periprosthetic osteolysis whereas 1 femoral component was loose at 52 weeks. There was an early and significant decrease in tibial bone density, likely because of disuse of the operated limb. Dogs returned to full activity by 12 weeks. The tibial cement-bone interface maintained its strength over 52 weeks. Cement provides stable fixation of the tibial component in canine TKR. Cemented TKR yields adequate clinical function and stifle joint excursion in the dog. Clinical studies are needed to determine the long-term fate of cemented TKR implants, to assess the influence of implant design on implant fixation and wear, and to obtain objective functional data.

Sample environment for in situ synchrotron XRD measurements for CO2 interaction with subsurface materials

NASA Astrophysics Data System (ADS)

Elbakhshwan, M.; Gill, S.; Weidner, R.; Ecker, L.

2017-12-01

Sequestration of CO2 in geological formations requires a deep understanding of its interaction with the cement-casing components in the depleted oil and gas wells. Portland cement is used to seal the wellbores; however it tends to interact with the CO2. Therefore it is critical to investigate the wellbore integrity over long term exposure to CO2. Studies showed that, CO2 leakage is due to the flow through the casing-cement microannulus, cement-cement fractures, or the cement-caprock interface. The objective of this work is to gain a better understanding of the dissolution process of the cement-casing in the CO2 flow channels alongside with the carbonation reactions at the interfaces using XRF, XANES and X-ray tomography techniques. In this study, a synthetic wellbore system, consisting of cement with an embedded rectangular length of steel casing that had grooves to accommodate fluid flow, was used to investigate the casing-cement microannulus through core-flood experiments. The objective of this work is to gain a better understanding of the dissolution process of the cement-casing in the CO2 flow channels alongside with the carbonation reactions at the interfaces using a sample environment designed and built for in situ X-ray diffraction in the National Synchrotron Light Source II (NSLS II). The formation of carbonate phases at cement -fluid and cement-steel/fluid interfaces will be monitored in real time. Samples may be exposed to super critical CO2 at pressures above 1100 psi and temperatures around 50°C. The reaction cell is built from hastealloy to provide corrosion resistance, while the experimental temperature and pressure are controlled with thermocouples and pressure vessel.

Utilizing TEMPO surface estimates to determine changes in emissions, community exposure and environmental impacts from cement kilns across North America using alternative fuels

NASA Astrophysics Data System (ADS)

Pegg, M. J.; Gibson, M. D.; Asamany, E.

2015-12-01

A major problem faced by all North American (NA) Governments is managing solid waste from residential and non-residential sources. One way to mitigate the need to expand landfill sites across NA is waste diversion for use as alternative fuel in industries such as cement manufacture. Currently, waste plastic, tires, waste shingles and other high carbon content waste destined for landfill are being explored, or currently used, as an alternative supplemental fuels for use in cement kilns across NA. While this is an attractive, environmentally sustainable solution, significant knowledge gaps remain in our fundamental understanding of whether these alternative fuels may lead to increased air pollution emissions from cement kilns across NA. The long-term objective of using TEMPO is to advance fundamental understanding of uncharacterized air pollution emissions and to assess the actual or potential environmental and health impacts of these emissions from cement kilns across NA. TEMPO measurements will be made in concert with in-situ observations augmented by air dispersion, land-use regression and receptor modelling. This application of TEMPO follows on from current research on a series of bench scale and pilot studies for Lafarge Canada Inc., that investigated the change in combustion emissions from various mixtures of coal (C), petroleum coke (PC) and non-recyclable alternative fuels. From our work we demonstrated that using an alternative fuel mixture in a cement kiln has potential to reduce emissions of CO2 by 34%; reduce NOx by 80%, and reduce fuel SO2 emissions by 98%. We also provided evidence that there would be a significant reduction in the formation of secondary ground-level ozone (O3) and secondary PM2.5 in downwind stack plumes if alternative waste derived fuels are used. The application of air dispersion, source apportionment, land use regression; together with remote sensing offers a powerful set of tools with the potential to improve air pollution community exposure research in NA. The application of the new NASA TEMPO satellite to track the dispersion of SO2, PM2.5 and NO2 in plumes and secondary O3 and aerosol formation downwind of cement kilns opens up an exciting new avenue of air pollution research in NA.

Confocal microscopic observation of structural changes in glass-ionomer cements and tooth interfaces.

PubMed

Watson, T F; Pagliari, D; Sidhu, S K; Naasan, M A

1998-03-01

This study aimed to develop techniques to allow dynamic imaging of a cavity before, during and after placement of glass-ionomer restorative materials. Cavities were cut in recently extracted third molars and the teeth longitudinally sectioned. Each hemisected tooth surface was placed in green modelling compound at 90 to the optical axis of the microscope. The cavity surface was imaged using a video rate confocal microscope in conjunction with an internally focusable microscope objective. The sample on the stage was pushed up to the objective lens which 'clamped' the cover glass onto it. Water, glycerine or oil was placed below the coverglass, with oil above. Internal tooth structures were imaged by changing the internal focus of the objective. The restorative material was then placed into the cavity. Video images were stored either onto video tape or digitally, using a frame grabber, computer and mass memory storage. Software controls produced time-lapse recordings of the interface over time. Preliminary experiments have examined the placement and early maturation of conventional glass-ionomer cements and a syringeable resin-modified glass-ionomer cement. Initial contact of the cement matrix and glass particles was visible as the plastic material rolled past the enamel and dentine, before making a bond. Evidence for water movement from the dentine into the cement has also been seen. After curing, the early dimensional changes in the cements due to water flux were apparent using the time-lapse facility. This new technique enables examination of developing tooth/restoration interfaces and the tracking of movement in materials.

Evaluation of the amount of excess cement around the margins of cement-retained dental implant restorations: the effect of the cement application method.

PubMed

Chee, Winston W L; Duncan, Jesse; Afshar, Manijeh; Moshaverinia, Alireza

2013-04-01

Complete removal of excess cement from subgingival margins after cementation of implant-supported restorations has been shown to be unpredictable. Remaining cement has been shown to be associated with periimplant inflammation and bleeding. The purpose of this study was to investigate and compare the amount of excess cement after cementation with 4 different methods of cement application for cement-retained implant-supported restorations. Ten implant replicas/abutments (3i) were embedded in acrylic resin blocks. Forty complete veneer crowns (CVCs) were fabricated by waxing onto the corresponding plastic waxing sleeves. The wax patterns were cast and the crowns were cemented to the implant replicas with either an interim (Temp Bond) or a definitive luting agent (FujiCEM). Four methods of cement application were used for cementation: Group IM-Cement applied on the internal marginal area of the crown only; Group AH-Cement applied on the apical half of the axial walls of the crown; Group AA-Cement applied to all axial walls of the interior surface of the crown, excluding the occlusal surface; and Group PI-Crown filled with cement then seated on a putty index formed to the internal configuration of the restoration (cementation device) (n=10). Cement on the external surfaces was removed before seating the restoration. Cement layers were applied on each crown, after which the crown was seated under constant load (80 N) for 10 minutes. The excess cement from each specimen was collected and measured. One operator performed all the procedures. Results for the groups were compared, with 1 and 2-way ANOVA and the Tukey multiple range test (α=.05). No significant difference in the amount of excess/used cement was observed between the 2 different types of cements (P=.1). Group PI showed the least amount of excess cement in comparison to other test groups (P=.031). No significant difference was found in the amount of excess cement among groups MI, AH, and AA. Group AA showed the highest amount of excess cement. The volume of cement used for group PI specimens was significantly higher than for those in the other groups (P=.001). With respect to the volume of cement loaded into the test crowns no statistically significant difference was observed among other test groups (groups IM, AH, and AA). Group MI used the least amount of cement, followed by group AH and AA. No correlation between the amount of used cement and the amount of excess cement was found in any of the tested groups. Within the limitations of this in vitro study, the least amount of excess cement was present when a cementation device was used to displace the excess cement before seating the crown on the abutment (Group PI). With this technique a uniform layer of the luting agent is distributed over the internal surface of the crown leaving minimal excess cement when the restoration is seated. Copyright © 2013 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

Evaluation of damage progression and mechanical behavior under compression of bone cements containing core-shell nanoparticles by using acoustic emission technique.

PubMed

Pacheco-Salazar, O F; Wakayama, Shuichi; Sakai, Takenobu; Cauich-Rodríguez, J V; Ríos-Soberanis, C R; Cervantes-Uc, J M

2015-06-01

In this work, the effect of the incorporation of core-shell particles on the fracture mechanisms of the acrylic bone cements by using acoustic emission (AE) technique during the quasi-static compression mechanical test was investigated. Core-shell particles were composed of a poly(butyl acrylate) (PBA) rubbery core and a methyl methacrylate/styrene copolymer (P(MMA-co-St)) outer glassy shell. Nanoparticles were prepared with different core-shell ratio (20/80, 30/70, 40/60 and 50/50) and were incorporated into the solid phase of bone cement at several percentages (5, 10 and 15 wt%). It was observed that the particles exhibited a spherical morphology averaging ca. 125 nm in diameter, and the dynamic mechanical analysis (DMA) thermograms revealed the desired structuring pattern of phases associated with core-shell structures. A fracture mechanism was proposed taking into account the detected AE signals and the scanning electron microscopy (SEM) micrographs. In this regard, core-shell nanoparticles can act as both additional nucleation sites for microcracks (and crazes) and to hinder the microcrack propagation acting as a barrier to its growth; this behavior was presented by all formulations. Cement samples containing 15 wt% of core-shell nanoparticles, either 40/60 or 50/50, were fractured at 40% deformation. This fact seems related to the coalescence of microcracks after they surround the agglomerates of core-shell nanoparticles to continue growing up. This work also demonstrated the potential of the AE technique to be used as an accurate and reliable detection tool for quasi-static compression test in acrylic bone cements. Copyright © 2015 Elsevier Ltd. All rights reserved.

Augmentation of the Nasal Dorsum Using the Multistrip Autologous Cartilage Technique.

PubMed

Liu, Liqiang; Bu, Zhaoyun; Fan, Jincai; Tian, Jia; Gan, Cheng; Yang, Zengjie; Jiao, Hu

2017-12-01

Nasal augmentation is a popular modern technique requested by many Asian people. There are two kinds of autologous cartilage used to augment the nose at present: carved as a monobloc or diced into pieces. Each approach has its pros and cons. The authors performed their surgical technique on a group of 28 patients. Twenty of these patients had undergone rhinoplasties performed before referral to our hospital; eight of these patients had undergone a primary rhinoplasty. Bilateral conchal, nasal septum, or rib cartilage was harvested; deep temporal fascia or abdominal muscle fascia to be prepared for packing stripped cartilage was also removed at this time. The cartilage was placed on a plastic cutting board and cut into strips with a transverse section of 1 × 1 mm. Then, these strips were packed and covered by fascia to form the grafts. The median follow-up was 23 months (range, 12 to 48 months). Twenty-two patients were satisfied with their augmented noses. Through examinations, biopsies, and magnetic resonance imaging scans, less resorption was observed with the multistrip autologous cartilage technique. Junctional stepoffs, excessive prominence, and slanting grafts occurred in three patients, two of whom had revisions. Using multistrip autologous cartilage grafts is an easier method to perform and could be another alternative technique for augmentative and reconstructive rhinoplasties.

Microstructural Effects of Sulphate Attack in Sustainable Grouts for Micropiles.

PubMed

Ortega Álvarez, José Marcos; Esteban Pérez, María Dolores; Rodríguez Escribano, Raúl Rubén; Pastor Navarro, José Luís; Sánchez Martín, Isidro

2016-11-08

Nowadays, the use of micropiles has undergone a great development. In general, they are made with cement grout, reinforced with steel tubing. In Spain, these grouts are prepared using OPC, although the standards do not forbid the use of other cements, like sustainable ones. Micropiles are in contact with soils and groundwater, in which the presence of sulphates is common. Their deleterious effects firstly affect to the microstructure. Then, the aim of this research is to study the effects of sulphate attack in the microstructure of micropiles grouts, prepared with OPC, fly ash and slag commercial cements, compared to their behaviour when they are exposed to an optimum hardening condition. The microstructure evolution has been studied with the non-destructive impedance spectroscopy technique, which has never been used for detecting the effects of sulphate attack when slag and fly ash cements are used. Its results have been contrasted with mercury intrusion porosimetry and "Wenner" resistivity ones. The 28-day compressive strength of grouts has been also determined. The results of microstructure characterization techniques are in agreement, although impedance spectroscopy is the most sensitive for following the changes in the porous network of grouts. The results showed that micropiles made using fly ash and slag cements could have a good performance in contact with aggressive sodium sulphate media, even better than OPC ones.

Microstructural Effects of Sulphate Attack in Sustainable Grouts for Micropiles

PubMed Central

Ortega Álvarez, José Marcos; Esteban Pérez, María Dolores; Rodríguez Escribano, Raúl Rubén; Pastor Navarro, José Luís; Sánchez Martín, Isidro

2016-01-01

Nowadays, the use of micropiles has undergone a great development. In general, they are made with cement grout, reinforced with steel tubing. In Spain, these grouts are prepared using OPC, although the standards do not forbid the use of other cements, like sustainable ones. Micropiles are in contact with soils and groundwater, in which the presence of sulphates is common. Their deleterious effects firstly affect to the microstructure. Then, the aim of this research is to study the effects of sulphate attack in the microstructure of micropiles grouts, prepared with OPC, fly ash and slag commercial cements, compared to their behaviour when they are exposed to an optimum hardening condition. The microstructure evolution has been studied with the non-destructive impedance spectroscopy technique, which has never been used for detecting the effects of sulphate attack when slag and fly ash cements are used. Its results have been contrasted with mercury intrusion porosimetry and “Wenner” resistivity ones. The 28-day compressive strength of grouts has been also determined. The results of microstructure characterization techniques are in agreement, although impedance spectroscopy is the most sensitive for following the changes in the porous network of grouts. The results showed that micropiles made using fly ash and slag cements could have a good performance in contact with aggressive sodium sulphate media, even better than OPC ones. PMID:28774026

Cement line staining in undecalcified thin sections of cortical bone

NASA Technical Reports Server (NTRS)

Bain, S. D.; Impeduglia, T. M.; Rubin, C. T.

1990-01-01

A technique for demonstrating cement lines in thin, undecalcified, transverse sections of cortical bone has been developed. Cortical bone samples are processed and embedded undecalcified in methyl methacrylate plastic. After sectioning at 3-5 microns, cross-sections are transferred to a glass slide and flattened for 10 min. Sections of cortical bone are stained for 20 sec free-floating in a fresh solution of 1% toluidine blue dissolved in 0.1% formic acid. The section is dehydrated in t-butyl alcohol, cleared in xylene, and mounted with Eukitt's medium. Reversal lines appear as thin, scalloped, dark blue lines against a light blue matrix, whereas bone formation arrest lines are thicker with a smooth contour. With this technique cellular detail, osteoid differentiation, and fluorochrome labels are retained. Results demonstrate the applicability of a one-step staining method for cement lines which will facilitate the assessment of bone remodeling activity in thin sections of undecalcified cortical bone.

Efficacy and Safety of Augmenting the Preclose Technique with a Collagen-Based Closure Device for Percutaneous Endovascular Aneurysm Repair

DOE Office of Scientific and Technical Information (OSTI.GOV)

Patel, Rafiuddin, E-mail: rafiuddin.patel@ouh.nhs.uk; Juszczak, Maciej T.; Bratby, Mark J.

PurposeTo report our experience of selectively augmenting the preclose technique for percutaneous endovascular aneurysm repair (p-EVAR) with an Angio-Seal device as a haemostatic adjunct in cases of significant bleeding after tensioning the sutures of the suture-mediated closure devices.Materials and MethodsProspectively collected data for p-EVAR patients at our institute were analysed. Outcomes included technical success and access site complications. A logistic regression model was used to analyse the effects of sheath size, CFA features and stent graft type on primary failure of the preclose technique necessitating augmentation and also on the development of complications.Resultsp-EVAR was attempted via 122 CFA access sitesmore » with a median sheath size of 18-French (range 12- to 28-French). Primary success of the preclose technique was 75.4 % (92/122). Angio-Seal augmentation was utilised as an adjunct to the preclose technique in 20.5 % (25/122). The overall p-EVAR success rate was 95.1 % (116/122). There was a statistically significant relationship (p = 0.0093) between depth of CFA and primary failure of preclose technique. CFA diameter, calcification, type of stent graft and sheath size did not have significant effects on primary preclose technique failure. Overall 4.9 % (6/122) required surgical conversion but otherwise there were no major complications.ConclusionAugmentation with an Angio-Seal device is a safe and effective adjunct to increase the success rate of the preclose technique in p-EVAR.« less

Optical coherence tomography investigations of ceramic lumineers

NASA Astrophysics Data System (ADS)

Fernandes, Luana O.; Graça, Natalia D. R. L.; Melo, Luciana S. A.; Silva, Claudio H. V.; Gomes, Anderson S. L.

2016-02-01

Lumineers are veneer laminates used as an alternative for aesthetic dental solutions of the highest quality, but the only current means of its performance assessment is visual inspection. The objective of this study was to use the Optical Coherence Tomography (OCT) technique working in spectral domain to analyze in vivo in a single patient, 14 lumineers 180 days after cementation. It was possible to observe images in various kinds of changes in the cementing line and the laminate. It was concluded that the OCT is an effective and promising method to clinical evaluation of the cementing line in lumineers.

Augmentation cystoplasty in neurogenic bladder

PubMed Central

Kocjancic, Ervin; Demirdağ, Çetin

2016-01-01

The aim of this review is to update the indications, contraindications, technique, complications, and the tissue engineering approaches of augmentation cystoplasty (AC) in patients with neurogenic bladder. PubMed/MEDLINE was searched for the keywords "augmentation cystoplasty," "neurogenic bladder," and "bladder augmentation." Additional relevant literature was determined by examining the reference lists of articles identified through the search. The update review of of the indications, contraindications, technique, outcome, complications, and tissue engineering approaches of AC in patients with neurogenic bladder is presented. Although some important progress has been made in tissue engineering AC, conventional AC still has an important role in the surgical treatment of refractory neurogenic lower urinary tract dysfunction. PMID:27617312

The Subfascial Approach to Primary and Secondary Breast Augmentation with Autologous Fat Grafting and Form-Stable Implants.

PubMed

Sampaio Goes, João Carlos; Munhoz, Alexandre Mendonça; Gemperli, Rolf

2015-10-01

This article presents an overview of the subfascial approach to primary and secondary breast augmentation with form-stable implants associated with autologous fat grafting. Although breast augmentation is a well-studied procedure, there are few previous reports concerning the subfascial technique and, especially, this technique associated with lipofilling. Consequently, the authors present their experience with a form-stable, anatomically shaped silicone gel breast implant, which has recently been approved in the United States following FDA clinical trials. Primary and secondary breast augmentations using form-stable implants resulted in satisfactory outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

Evaluation of fit of cement-retained implant-supported 3-unit structures fabricated with direct metal laser sintering and vacuum casting techniques.

PubMed

Oyagüe, Raquel Castillo; Sánchez-Turrión, Andrés; López-Lozano, José Francisco; Montero, Javier; Albaladejo, Alberto; Suárez-García, María Jesús

2012-07-01

This study evaluated the vertical discrepancy of implant-fixed 3-unit structures. Frameworks were constructed with laser-sintered Co-Cr, and vacuum-cast Co-Cr, Ni-Cr-Ti, and Pd-Au. Samples of each alloy group were randomly luted in standard fashion using resin-modified glass-ionomer, self-adhesive, and acrylic/urethane-based cements (n = 12 each). Discrepancies were SEM analyzed. Three-way ANOVA and Student-Newman-Keuls tests were run (P < 0.05). Laser-sintered structures achieved the best fit per cement tested. Within each alloy group, resin-modified glass-ionomer and acrylic/urethane-based cements produced comparably lower discrepancies than the self-adhesive agent. The abutment position did not yield significant differences. All misfit values could be considered clinically acceptable.

The effects of modern cementing techniques on the longevity of total hip arthroplasty.

PubMed

Poss, R; Brick, G W; Wright, R J; Roberts, D W; Sledge, C B

1988-07-01

Modern prosthetic design and cementing techniques have dramatically improved femoral component fixation. Compared to studies reported in the 1970s, the incidence of radiographic loosening for periods up to 5 years postoperatively has been reduced by at least a factor of 10. These results are the benchmark by which alternative forms of femoral component fixation must be measured. With the likelihood of increased longevity of total hip arthroplasty resulting from improved fixation, the problems of wear debris from the bearing surfaces and loss of bone stock with time will become preeminent.

The Use of Micro and Nano Particulate Fillers to Modify the Mechanical and Material Properties of Acrylic Bone Cement

NASA Astrophysics Data System (ADS)

Slane, Joshua A.

Acrylic bone cement (polymethyl methacrylate) is widely used in total joint replacements to provide long-term fixation of implants. In essence, bone cement acts as a grout by filling in the voids left between the implant and the patient's bone, forming a mechanical interlock. While bone cement is considered the `gold standard' for implant fixation, issues such as mechanical failure of the cement mantle (aseptic loosening) and the development of prosthetic joint infection (PJI) still plague joint replacement procedures and often necessitate revision arthroplasty. In an effort to address these failures, various modifications are commonly made to bone cement such as mechanical reinforcement with particles/fibers and the addition of antibiotics to mitigate PJI. Despite these attempts, issues such as poor particle interfacial adhesion, inadequate drug release, and the development of multidrug resistant bacteria limit the effectiveness of bone cement modifications. Therefore, the overall goal of this work was to use micro and nanoparticles to enhance the properties of acrylic bone cement, with particular emphasis placed on improving the mechanical properties, cumulative antibiotic release, and antimicrobial properties. An acrylic bone cement (Palacos R) was modified with three types of particles in various loading ratios: mesoporous silica nanoparticles (for mechanical reinforcement), xylitol microparticles (for increased antibiotic release), and silver nanoparticles (as an antimicrobial agent). These particles were used as sole modifications, not in tandem with one another. The resulting cement composites were characterized using a variety of mechanical (macro to nano, fatigue, fracture, and dynamic), imaging, chemical, thermal, biological, and antimicrobial testing techniques. The primary outcomes of this dissertation demonstrate that: (1) mesoporous silica, as used in this work, is a poor reinforcement phase for acrylic bone cement, (2) xylitol can significantly increase the cumulative antibiotic release from acrylic cement, and (3) silver nanoparticles are a potential alternative to traditional antibiotics in cement, such as gentamicin.

The effect of root canal sealers and timing of cementation on the microlekage of the parapost luted with resin cement

PubMed Central

Al Kahtani, Ahmed M.

2010-01-01

Objectives The objectives of the study were to study the effect of root canal sealers either eugenol or non-eugenol and timing of cementation on microleakage of the parapost luted with resin cement. Materials and methods Seventy extracted human, single-rooted teeth were instrumented using a crown-down technique. All teeth were instrumented up to a size 50 .04 taper ProFile followed by the use of Gates Glidden drills from size 2 up to 5. Following instrumentation, the teeth were randomly divided into four experimental groups of fifteen teeth each, based on type of root canal sealer (eugenol or non-eugenol sealer) and timing of post cementation (immediate or delayed). The remaining ten teeth were divided into two control groups with five teeth per group. All teeth were tested for microleakage using a fluid filtration method. Results The microleakage of the paraposts luted with resin cement increased over time, irrespective of sealer type or timing of post cementation. Immediate post cementation following obturation with AH26 (non-eugenol sealer) produced the least microleakage at all three time periods at 24 h, 2 months and 3 months. Conclusions The microleakage paraposts luted with resin cement was not influenced by either sealer type or timing of post placement. All experimental groups demonstrated a significant increase in microleakage over time as well as the presence of voids at the resin–dentin interface. PMID:24109165

Percutaneous vertebroplasty and bone cement leakage: clinical experience with a new high-viscosity bone cement and delivery system for vertebral augmentation in benign and malignant compression fractures.

PubMed

Anselmetti, Giovanni Carlo; Zoarski, Gregg; Manca, Antonio; Masala, Salvatore; Eminefendic, Haris; Russo, Filippo; Regge, Daniele

2008-01-01

The aim of this study was to assess the feasibility of and venous leakage reduction in percutaneous vertebroplasty (PV) using a new high-viscosity bone cement (PMMA). PV has been used effectively for pain relief in osteoporotic and malignant vertebral fractures. Cement extrusion is a common problem and can lead to complications. Sixty patients (52 female; mean age, 72.2 +/- 7.2) suffering from osteoporosis (46), malignancy (12), and angiomas (2), divided into two groups (A and B), underwent PV on 190 vertebrae (86 dorsal, 104 lumbar). In Group A, PV with high-viscosity PMMA (Confidence, Disc-O-Tech, Israel) was used. This PMMA was injected by a proprietary delivery system, a hydraulic saline-filled screw injector. In Group B, a standard low-viscosity PMMA was used. Postprocedural CT was carried out to detect PMMA leakages and complications. Fisher's exact test and Wilcoxon rank test were used to assess significant differences (p < 0.05) in leakages and to evaluate the clinical outcome. PV was feasible, achieving good clinical outcome (p < 0.0001) without major complications. In Group A, postprocedural CT showed an asymptomatic leak in the venous structures of 8 of 98 (8.2%) treated vertebrae; a discoidal leak occurred in 6 of 98 (6.1%). In Group B, a venous leak was seen in 38 of 92 (41.3%) and a discoidal leak in 12 of 92 (13.0%). Reduction of venous leak obtained by high-viscosity PMMA was highly significant (p < 0.0001), whereas this result was not significant (p = 0.14) related to the disc. The high-viscosity PMMA system is safe and effective for clinical use, allowing a significant reduction of extravasation rate and, thus, leakage-related complications.

Three-dimensional shape optimization of a cemented hip stem and experimental validations.

PubMed

Higa, Masaru; Tanino, Hiromasa; Nishimura, Ikuya; Mitamura, Yoshinori; Matsuno, Takeo; Ito, Hiroshi

2015-03-01

This study proposes novel optimized stem geometry with low stress values in the cement using a finite element (FE) analysis combined with an optimization procedure and experimental measurements of cement stress in vitro. We first optimized an existing stem geometry using a three-dimensional FE analysis combined with a shape optimization technique. One of the most important factors in the cemented stem design is to reduce stress in the cement. Hence, in the optimization study, we minimized the largest tensile principal stress in the cement mantle under a physiological loading condition by changing the stem geometry. As the next step, the optimized stem and the existing stem were manufactured to validate the usefulness of the numerical models and the results of the optimization in vitro. In the experimental study, strain gauges were embedded in the cement mantle to measure the strain in the cement mantle adjacent to the stems. The overall trend of the experimental study was in good agreement with the results of the numerical study, and we were able to reduce the largest stress by more than 50% in both shape optimization and strain gauge measurements. Thus, we could validate the usefulness of the numerical models and the results of the optimization using the experimental models. The optimization employed in this study is a useful approach for developing new stem designs.

Temporary arthrodesis using fixator rods in two-stage revision of septic knee prothesis with severe bone and tissue defects.

PubMed

Röhner, Eric; Pfitzner, Tilman; Preininger, Bernd; Zippelius, Timo; Perka, Carsten

2016-01-01

The present study describes a new temporary arthrodesis procedure, which aims for septic knee prosthesis replacement, in particular for larger bone and soft tissue defects. Our technique offers high stability and full weight-bearing capacity of the knee joint. The study included 16 patients with major bone defects (AORI type IIb or greater) after receiving a radical debridement and a septic two-stage revision total knee arthroplasty. After removing the infected prosthesis and debridement, two AO fixator rods were positioned into the intramedullary space of the femur and tibia. Subsequently, both rods were joined tube-to-tube and adjusted in the center of the knee joint. Finally, the whole cavity of the knee joint was filled with PMMA. The number of previous surgeries, bacterial spectrum, risk factors for further infection and reinfection rates was recorded. Immediately after the temporary arthrodesis, radiographs of the knee with the enclosed spacers were taken in order to compare to previous radiographs and avoiding to miss possible spacer loosening. Nine of sixteen patients underwent more than two revision surgeries before receiving our new arthrodesis technique. No cases of spacer loosening were observed in all 16 patients; further, there were no peri-implant fractures, and four persistent infections were noted. Temporary arthrodesis using AO fixator rods offers a high stability without loosening. Its potential to replace conventional augmentation techniques should be taken into account, particularly in the case of larger bone and tissue defects. In clinical practice, the cemented spacer using AO fixator rods could be an alternative technique for temporary knee arthrodesis after septic debridement. Retrospective case series, Level IV.

Axial load-bearing capacity of an osteochondral autograft stabilized with a resorbable osteoconductive bone cement compared with a press-fit graft in a bovine model.

PubMed

Kiss, Marc-Olivier; Levasseur, Annie; Petit, Yvan; Lavigne, Patrick

2012-05-01

Osteochondral autografts in mosaicplasty are inserted in a press-fit fashion, and hence, patients are kept nonweightbearing for up to 2 months after surgery to allow bone healing and prevent complications. Very little has been published regarding alternative fixation techniques of those grafts. Osteochondral autografts stabilized with a resorbable osteoconductive bone cement would have a greater load-bearing capacity than standard press-fit grafts. Controlled laboratory study. Biomechanical testing was conducted on 8 pairs of cadaveric bovine distal femurs. For the first 4 pairs, 6 single osteochondral autografts were inserted in a press-fit fashion on one femur. On the contralateral femur, 6 grafts were stabilized with a calcium triglyceride osteoconductive bone cement. For the 4 remaining pairs of femurs, 4 groups of 3 adjacent press-fit grafts were inserted on one femur, whereas on the contralateral femur, grafts were cemented. After a maturation period of 48 hours, axial loading was applied on all single grafts and on the middle graft of each 3-in-a-row series. For the single-graft configuration, median loads required to sink the press-fit and cemented grafts by 2 and 3 mm were 281.87 N versus 345.56 N (P = .015) and 336.29 N versus 454.08 N (P = .018), respectively. For the 3-in-a-row configuration, median loads required to sink the press-fit and cemented grafts by 2 and 3 mm were 260.31 N versus 353.47 N (P = .035) and 384.83 N versus 455.68 N (P = .029), respectively. Fixation of osteochondral grafts using bone cement appears to improve immediate stability over the original mosaicplasty technique for both single- and multiple-graft configurations. Achieving greater primary stability of osteochondral grafts could potentially accelerate postoperative recovery, allowing early weightbearing and physical therapy.

Adaption of synchronously scanned luminescence spectroscopy to organic-rich fluid inclusion microanalysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Musgrave, J.A.; Carey, R.G.; Janecky, D.R.

1994-06-01

The instrumentation, the luminescence microprobe, and synchronously scanned luminescence spectroscopy technique described here can be used to classify microliter quantities of oil such as those in fluid inclusions in cements from petroleum reservoirs. It is primarily constructed to obtain synchronously scanned luminescence spectra from microscopic sized samples to characterize the organic classes of compounds that predominate. At present no other technique can so readily analyze a single oil-bearing fluid inclusion. The data collected from the technique are pertinent to evaluating systems and providing quantitative data for solving problems in oil migration and maturation determinations, oil-to-oil and oil-to-source correlations, oil degradation,more » and episodes and chemistry of cementation.« less

Effect of acid and laser etching on shear bond strength of conventional and resin-modified glass-ionomer cements to composite resin.

PubMed

Navimipour, Elmira Jafari; Oskoee, Siavash Savadi; Oskoee, Parnian Alizadeh; Bahari, Mahmoud; Rikhtegaran, Sahand; Ghojazadeh, Morteza

2012-03-01

Success in sandwich technique procedures can be achieved through an acceptable bond between the materials. The aim of this study was to compare the effect of 35% phosphoric acid and Er,Cr:YSGG laser on shear bond strength of conventional glass-ionomer cement (GIC) and resin-modified glass-ionomer cement (RMGIC) to composite resin in sandwich technique. Sixty-six specimens were prepared from each type of glass-ionomer cements and divided into three treatment groups as follows: without pretreatment, acid etching by 35% phosphoric acid for 15 s, and 1-W Er,Cr:YSGG laser treatment for 15 s with a 600-μm-diameter tip aligned perpendicular to the target area at a distance of 1 mm from the surface. Energy density of laser irradiation was 17.7 J/cm(2). Two specimens in each group were prepared for evaluation under a scanning electron microscope (SEM) after surface treatment and the remainder underwent bonding procedure with a bonding agent and composite resin. Then the shear bond strength was measured at a crosshead speed of 0.5 mm/min. Two-factor analysis of variance and post-hoc Tukey test showed that the cement type, surface treatment method, and the interaction of these two factors significantly affect the shear bond strength between glass-ionomer cements and composite resin (p < 0.05). Surface treatment with phosphoric acid or Er,Cr:YSGG laser increased the shear bond strength of GIC to composite resin; however, in RMGIC only laser etching resulted in significantly higher bond strength. These findings were supported by SEM results. The fracture mode was evaluated under a stereomicroscope at ×20.

Misfit and microleakage of implant-supported crown copings obtained by laser sintering and casting techniques, luted with glass-ionomer, resin cements and acrylic/urethane-based agents.

PubMed

Castillo-Oyagüe, Raquel; Lynch, Christopher D; Turrión, Andrés S; López-Lozano, José F; Torres-Lagares, Daniel; Suárez-García, María-Jesús

2013-01-01

This study evaluated the marginal misfit and microleakage of cement-retained implant-supported crown copings. Single crown structures were constructed with: (1) laser-sintered Co-Cr (LS); (2) vacuum-cast Co-Cr (CC) and (3) vacuum-cast Ni-Cr-Ti (CN). Samples of each alloy group were randomly luted in standard fashion onto machined titanium abutments using: (1) GC Fuji PLUS (FP); (2) Clearfil Esthetic Cement (CEC); (3) RelyX Unicem 2 Automix (RXU) and (4) DentoTemp (DT) (n=15 each). After 60 days of water ageing, vertical discrepancy was SEM-measured and cement microleakage was scored using a digital microscope. Misfit data were subjected to two-way ANOVA and Student-Newman-Keuls multiple comparisons tests. Kruskal-Wallis and Dunn's tests were run for microleakage analysis (α=0.05). Regardless of the cement type, LS samples exhibited the best fit, whilst CC and CN performed equally well. Despite the framework alloy and manufacturing technique, FP and DT provide comparably better fit and greater microleakage scores than did CEC and RXU, which showed no differences. DMLS of Co-Cr may be a reliable alternative to the casting of base metal alloys to obtain well-fitted implant-supported crowns, although all the groups tested were within the clinically acceptable range of vertical discrepancy. No strong correlations were found between misfit and microleakage. Notwithstanding the framework alloy, definitive resin-modified glass-ionomer (FP) and temporary acrylic/urethane-based (DT) cements demonstrated comparably better marginal fit and greater microleakage scores than did 10-methacryloxydecyl-dihydrogen phosphate-based (CEC) and self-adhesive (RXU) dual-cure resin agents. Copyright © 2012 Elsevier Ltd. All rights reserved.

Connective tissue grafts for thickening peri-implant tissues at implant placement. One-year results from an explanatory split-mouth randomised controlled clinical trial.

PubMed

Wiesner, Günter; Esposito, Marco; Worthington, Helen; Schlee, Markus

2010-01-01

Nothing to declare. To evaluate whether connective tissue grafts performed at implant placement could be effective in augmenting peri-implant soft tissues. Ten partially edentulous patients requiring at least one single implant in the premolar or molar areas of both sides of the mandible were randomised to have one side augmented at implant placement with a connective soft tissue graft harvested from the palate or no augmentation. After 3 months of submerged healing, abutments were placed and within 1 month definitive crowns were permanently cemented. Outcome measures were implant success, any complications, peri-implant marginal bone level changes, patient satisfaction and preference, thickness of the soft tissues and aesthetics (pink aesthetic score) evaluated by an independent and blinded assessor 1 year after loading. One year after loading, no patients dropped out, no implants failed and no complications occurred. Both groups lost statistically significant amounts of peri-implant bone 1 year after loading (0.8 mm in the grafted group and 0.6 mm in the non-grafted group), but there was no statistically significant difference between groups. Soft tissues at augmented sites were 1.3 mm thicker (P < 0.001) and had a significantly better pink aesthetic score (P < 0.001). Patients were highly satisfied (no statistically significant differences between treatments) though they preferred the aesthetics of the augmented sites (P = 0.031). However, five patients would not undergo the grafting procedure again and two were uncertain. Connective tissue grafts are effective in increasing soft tissue thickness, thus improving aesthetics. Longer follow-ups are needed to evaluate the stability of peri-implant tissues over time.

[Percutaneous treatment of unstable spine fractures - OP video and results from over 300 cases].

PubMed

Prokop, A; Chmielnicki, M

2014-02-01

Minimally invasive surgery for vertebral fractures results in less approach-related morbidity, decreased postoperative pain, and rapid mobilisation of patients. Such procedures can be performed even in elderly patients. However, along with the many advantages, minimally invasive procedures are technically demanding, require sophisticated tools, and there is a learning curve for surgeons. Intraoperative visualisation is often possible only radiologically, and implants are generally much more expensive. Using the data from over 300 unstable vertebral fracture cases treated over the past 3.5 years, we have developed a differentiated treatment concept, depending on the age of the patient and the fracture characteristics. Unstable fractures with involvement of the posterior edge are stabilised from posterior, percutaneously with a fixator. In patients under 60 years, monoaxial screws with inserted rods (top loading) are used, with which distraction and restoration of lordosis are also possible. Patients over 60 years are treated percutaneously with a polyaxial sextant system with rods inserted to avoid avulsion of the pedicle screws from the vertebral body. To avoid cutting through the vertebra, the fenestrated screws can be augmented with cement. The operation technique is demonstrated by a video. Georg Thieme Verlag KG Stuttgart · New York.

Release of U(VI) from spent biosorbent immobilized in cement concrete blocks

DOE Office of Scientific and Technical Information (OSTI.GOV)

Venkobachar, C.; Iyengar, L.; Mishra, U.K.

1995-12-01

This paper deals with cementation as the method for the disposal of spent biosorbent, Ganoderma lucidum (a wood rotting macrofungi) after it is used for the removal of Uranium. Results on the uranium release during the curing of cement-concrete (CC) blocks indicated that placing the spent sorbent at the center of the blocks during their casting yields better immobilization of uranium as compared to the homogeneous mixing of the spent sorbent with the cement. Short term leach tests indicated that the uranium release was negligible in simulated seawater, 1.8% in 0.2 N sodium carbonate and 6.0% in 0.2 N HCl.more » The latter two leachates were used to represent the extreme environmental conditions. It was observed that the presence of the spent biosorbent up to 5% by weight did not affect the compressive strength of CC blocks. Thus cementation technique is suitable for the immobilization of uranium loaded biosorbent for its ultimate disposal.« less

Effect of pulse pressure on borehole stability during shear swirling flow vibration cementing.

PubMed

Cui, Zhihua; Ai, Chi; Lv, Lei; Yin, Fangxian

2017-01-01

The shear swirling flow vibration cementing (SSFVC) technique rotates the downhole eccentric cascade by circulating cementing fluid. It makes the casing eccentrically revolve at high speed around the borehole axis. It produces strong agitation action to the annulus fluid, makes it in the state of shear turbulent flow, and results in the formation of pulse pressure which affects the surrounding rock stress. This study was focused on 1) the calculation of the pulse pressure in an annular turbulent flow field based on the finite volume method, and 2) the analysis of the effect of pulse pressure on borehole stability. On the upside, the pulse pressure is conducive to enhancing the liquidity of the annulus fluid, reducing the fluid gel strength, and preventing the formation of fluid from channeling. But greater pulse pressure may cause lost circulation and even formation fracturing. Therefore, in order to ensure smooth cementing during SSFVC, the effect of pulse pressure should be considered when cementing design.

Cusp Fracture Resistance of Maxillary Premolars Restored with the Bonded Amalgam Technique Using Various Luting Agents

PubMed Central

Marchan, Shivaughn M.; Coldero, Larry; White, Daniel; Smith, William A. J.; Rafeek, Reisha N.

2009-01-01

Objective. This in vitro study uses measurements of fracture resistance to compare maxillary premolars restored with the bonded amalgam technique using a new resin luting cement, glass ionomer, and resin-modified glass ionomer as the bonding agents. Materials. Eighty-five sound maxillary premolars were selected and randomly assigned to one of five test groups of 17 teeth each. One group of intact teeth served as the control. The remaining groups were prepared to a standard cavity form relative to the dimensions of the overall tooth and restored with amalgam alone or a bonded amalgam using one of three luting agents: RelyX Arc (a new resin luting cement), RelyX luting (a resin-modified glass ionomer), or Ketac-Cem μ (a glass ionomer) as the bonding agents. Each tooth was then subjected to compressive testing until catastrophic failure occurred. The mean loads at failure of each group were statistically compared using ANOVA with a post hoc Bonferroni test. Results. It was found that regardless of the luting cement used for the amalgam bonding technique, there was little effect on the fracture resistance of teeth. Conclusion. Cusp fracture resistance of premolars prepared with conservative MOD cavity preparations is not improved by using an amalgam-bonding technique compared to similar cavities restored with amalgam alone. PMID:20339450

Acrylic kyphoplasty in recent nonosteoporotic fractures of the thoracolumbar junction: a prospective clinical and 3D radiologic study of 54 patients.

PubMed

Saget, Mathieu; Teyssedou, Simon; Prebet, Remi; Vendeuvre, Tanguy; Gayet, Louis-Etienne; Pries, Pierre

2014-08-01

Prospective clinical and radiological study. To evaluate the impact of stand-alone acrylic kyphoplasty in the treatment of recent traumatic fractures of the thoracolumbar spine in young patients. The management of fractures of the thoracolumbar spine without neurological deficit remains controversial. For a long time clinicians could only chose between functional treatment, orthopedic treatment, and traditional surgery. The recent advent of minimally invasive surgical techniques is an interesting alternative. Fifty-four patients with a mean age of 45.8±18.2 years and who had recently sustained a fracture of the thoracolumbar junction were enrolled into the study. Balloon kyphoplasty was performed using acrylic cement. Radiologic assessments (computed tomography scans) and clinical assessments (including Visual Analog Scale and Oswestry Disability Index scores) were used to determine kyphoplasty success and measure patient recovery over 2 years. Kyphoplasty reduced mean vertebral kyphosis from 12.8±5.0 degrees at trauma to 8.2±5.1 degrees at 2-year follow-up. Mean vertebral kyphosis was corrected by -5.7±4.7 degrees (P=0.0001) at the point of first verticalization, with no significant change at the 2-year follow-up visit (+1.1±4.3 degrees, P=0.1058). Kyphoplasty significantly augmented the height of the 6 anterior and intermediate segments. Maximum mean augmentation of intermediate vertebral height after 6 months was (11.6%±15.5%, P<0.0001). Patients tolerated the procedure well and 56% of them returned to work 3 months after kyphoplasty. Kyphoplasty is safe and effective in the correction of nonosteoporotic fractures of the thoracolumbar junction in young patients, and remains stable for at least 2 years postsurgery.

Calcium Orthophosphate Cements and Concretes

PubMed Central

Dorozhkin, Sergey V.

2009-01-01

In early 1980s, researchers discovered self-setting calcium orthophosphate cements, which are a bioactive and biodegradable grafting material in the form of a powder and a liquid. Both phases form after mixing a viscous paste that after being implanted, sets and hardens within the body as either a non-stoichiometric calcium deficient hydroxyapatite (CDHA) or brushite, sometimes blended with unreacted particles and other phases. As both CDHA and brushite are remarkably biocompartible and bioresorbable (therefore, in vivo they can be replaced with newly forming bone), calcium orthophosphate cements represent a good correction technique for non-weight-bearing bone fractures or defects and appear to be very promising materials for bone grafting applications. Besides, these cements possess an excellent osteoconductivity, molding capabilities and easy manipulation. Furthermore, reinforced cement formulations are available, which in a certain sense might be described as calcium orthophosphate concretes. The concepts established by calcium orthophosphate cement pioneers in the early 1980s were used as a platform to initiate a new generation of bone substitute materials for commercialization. Since then, advances have been made in the composition, performance and manufacturing; several beneficial formulations have already been introduced as a result. Many other compositions are in experimental stages. In this review, an insight into calcium orthophosphate cements and concretes, as excellent biomaterials suitable for both dental and bone grafting application, has been provided.

Immobilization of Fast Reactor First Cycle Raffinate

DOE Office of Scientific and Technical Information (OSTI.GOV)

Langley, K. F.; Partridge, B. A.; Wise, M.

This paper describes the results of work to bring forward the timing for the immobilization of first cycle raffinate from reprocessing fuel from the Dounreay Prototype Fast Reactor (PFR). First cycle raffinate is the liquor which contains > 99% of the fission products separated from spent fuel during reprocessing. Approximately 203 m3 of raffinate from the reprocessing of PFR fuel is held in four tanks at the UKAEA's site at Dounreay, Scotland. Two methods of immobilization of this high level waste (HLW) have been considered: vitrification and cementation. Vitrification is the standard industry practice for the immobilization of first cyclemore » raffinate, and many papers have been presented on this technique elsewhere. However, cementation is potentially feasible for immobilizing first cycle raffinate because the heat output is an order of magnitude lower than typical HLW from commercial reprocessing operations such as that at the Sellafield site in Cumbria, England. In fact, it falls within the upper end of the UK definition of intermediate level waste (ILW). Although the decision on which immobilization technique will be employed has yet to be made, initial development work has been undertaken to identify a suitable cementation formulation using inactive simulant of the raffinate. An approach has been made to the waste disposal company Nirex to consider the disposability of the cemented product material. The paper concentrates on the process development work that is being undertaken on cementation to inform the decision making process for selection of the immobilization method.« less

Laboratory-Scale Solidification of Basin F Concentrate, Rocky Mountain Arsenal

DTIC Science & Technology

1983-07-01

follows: ," a. Cement-based processes b. Pozzolanic processes (silicate processes that do not use cement) c. Thermoplastic techniques d. Organic polymer ...ARSENAL 6. AUTHOR(S) MYERST.; THOMPSON.D. 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBER ARMY ENG!NEER...SWLP Leachates Organics in EP and SWLP Leachates Leachable Contaminant Densities Qualitative Assessments of Ammonia Gas Release by Solidification

MicroCT analysis of a retrieved root restored with a bonded fiber-reinforced composite dowel: a pilot study.

PubMed

Lorenzoni, Fabio Cesar; Bonfante, Estevam A; Bonfante, Gerson; Martins, Leandro M; Witek, Lukasz; Silva, Nelson R F A

2013-08-01

This evaluation aimed to (1) validate micro-computed tomography (microCT) findings using scanning electron microscopy (SEM) imaging, and (2) quantify the volume of voids and the bonded surface area resulting from fiber-reinforced composite (FRC) dowel cementation technique using microCT scanning technology/3D reconstructing software. A fiberglass dowel was cemented in a condemned maxillary lateral incisor prior to its extraction. A microCT scan was performed of the extracted tooth creating a large volume of data in DICOM format. This set of images was imported to image-processing software to inspect the internal architecture of structures. The outer surface and the spatial relationship of dentin, FRC dowel, cement layer, and voids were reconstructed. Three-dimensional spatial architecture of structures and volumetric analysis revealed that 9.89% of the resin cement was composed of voids and that the bonded area between root dentin and cement was 60.63% larger than that between cement and FRC dowel. SEM imaging demonstrated the presence of voids similarly observed using microCT technology (aim 1). MicroCT technology was able to nondestructively measure the volume of voids within the cement layer and the bonded surface area at the root/cement/FRC interfaces (aim 2). The interfaces at the root dentin/cement/dowel represent a timely and relevant topic where several efforts have been conducted in the past few years to understand their inherent features. MicroCT technology combined with 3D reconstruction allows for not only inspecting the internal arrangement rendered by fiberglass adhesively bonded to root dentin, but also estimating the volume of voids and contacted bond area between the dentin and cement layer. © 2013 by the American College of Prosthodontists.

Influence of bone density on the cement fixation of femoral hip resurfacing components.

PubMed

Bitsch, Rudi G; Jäger, Sebastian; Lürssen, Marcus; Loidolt, Travis; Schmalzried, Thomas P; Clarius, Michael

2010-08-01

In clinical outcome studies, small component sizes, female gender, femoral shape, focal bone defects, bad bone quality, and biomechanics have been associated with failures of resurfacing arthroplasties. We used a well-established experimental setup and human bone specimens to analyze the effects of bone density on cement fixation of femoral hip resurfacing components. Thirty-one fresh frozen femora were prepared for resurfacing using the original instruments. ASR resurfacing prostheses were implanted after dual-energy X-ray densitometer scans. Real-time measurements of pressure and temperature during implantation, analyses of cement penetration, and measurements of micro motions under torque application were performed. The associations of bone density and measurement data were examined calculating regression lines and multiple correlation coefficients; acceptability was tested with ANOVA. We found significant relations between bone density and micro motion, cement penetration, cement mantle thickness, cement pressure, and interface temperature. Mean bone density of the femora was 0.82 +/- 0.13 g/cm(2), t-score was -0.7 +/- 1.0, and mean micro motion between bone and femoral resurfacing component was 17.5 +/- 9.1 microm/Nm. The regression line between bone density and micro motion was equal to -56.7 x bone density + 63.8, R = 0.815 (p < 0.001). Bone density scans are most helpful for patient selection in hip resurfacing, and a better bone quality leads to higher initial component stability. A sophisticated cementing technique is recommended to avoid vigorous impaction and incomplete seating, since increasing bone density also results in higher cement pressures, lower cement penetration, lower interface temperatures, and thicker cement mantles. Copyright 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Tooth surface treatment strategies for adhesive cementation

PubMed Central

2017-01-01

PURPOSE The aim of this study was to evaluate the effect of tooth surface pre-treatment steps on shear bond strength, which is essential for understanding the adhesive cementation process. MATERIALS AND METHODS Shear bond strengths of different cements with various tooth surface treatments (none, etching, priming, or etching and priming) on enamel and dentin of human teeth were measured using the Swiss shear test design. Three adhesives (Permaflo DC, Panavia F 2.0, and Panavia V5) and one self-adhesive cement (Panavia SA plus) were included in this study. The interface of the cement and the tooth surface with the different pre-treatments was analyzed using SEM. pH values of the cements and primers were measured. RESULTS The highest bond strength values for all cements were achieved with etching and primer on enamel (25.6 ± 5.3 - 32.3 ± 10.4 MPa). On dentin, etching and priming produced the highest bond strength values for all cements (8.6 ± 2.9 - 11.7 ± 3.5 MPa) except for Panavia V5, which achieved significantly higher bond strengths when pre-treated with primer only (15.3 ± 4.1 MPa). Shear bond strength values were correlated with the micro-retentive surface topography of enamel and the tag length on dentin except for Panavia V5, which revealed the highest bond strength with primer application only without etching, resulting in short but sturdy tags. CONCLUSION The highest bond strength can be achieved for Panavia F 2.0, Permaflo DC, and Panavia SA plus when the tooth substrate is previously etched and the respective primer is applied. The new cement Panavia V5 displayed low technique-sensitivity and attained significantly higher adhesion of all tested cements to dentin when only primer was applied. PMID:28435616

Silver-Doped Calcium Phosphate Bone Cements with Antibacterial Properties

PubMed Central

Rau, J. V.; Fosca, M.; Graziani, V.; Egorov, A. A.; Zobkov, Yu. V.; Fedotov, A. Yu.; Ortenzi, M.; Caminiti, R.; Baranchikov, A. E.; Komlev, V. S.

2016-01-01

Calcium phosphate bone cements (CPCs) with antibacterial properties are demanded for clinical applications. In this study, we demonstrated the use of a relatively simple processing route based on preparation of silver-doped CPCs (CPCs-Ag) through the preparation of solid dispersed active powder phase. Real-time monitoring of structural transformations and kinetics of several CPCs-Ag formulations (Ag = 0 wt %, 0.6 wt % and 1.0 wt %) was performed by the Energy Dispersive X-ray Diffraction technique. The partial conversion of β-tricalcium phosphate (TCP) phase into the dicalcium phosphate dihydrate (DCPD) took place in all the investigated cement systems. In the pristine cement powders, Ag in its metallic form was found, whereas for CPC-Ag 0.6 wt % and CPC-Ag 1.0 wt % cements, CaAg(PO3)3 was detected and Ag (met.) was no longer present. The CPC-Ag 0 wt % cement exhibited a compressive strength of 6.5 ± 1.0 MPa, whereas for the doped cements (CPC-Ag 0.6 wt % and CPC-Ag 1.0 wt %) the reduced values of the compressive strength 4.0 ± 1.0 and 1.5 ± 1.0 MPa, respectively, were detected. Silver-ion release from CPC-Ag 0.6 wt % and CPC-Ag 1.0 wt % cements, measured by the Atomic Emission Spectroscopy, corresponds to the average values of 25 µg/L and 43 µg/L, respectively, rising a plateau after 15 days. The results of the antibacterial test proved the inhibitory effect towards pathogenic Escherichia coli for both CPC-Ag 0.6 wt % and CPC-Ag 1.0 wt % cements, better performances being observed for the cement with a higher Ag-content. PMID:27096874

Calcium phosphate cement augmentation in the treatment of depressed tibial plateau fractures with open reduction and internal fixation.

PubMed

Oztürkmen, Yusuf; Caniklioğlu, Mustafa; Karamehmetoğlu, Mahmut; Sükür, Erhan

2010-01-01

We aimed to evaluate the clinical and radiological outcomes of open reduction and internal fixation augmented with calcium phosphate cement (CPC) in the treatment of depressed tibial plateau fractures. Twenty-eight knees of 28 patients [19 males and 9 females; mean age, 41.2 years (range 22-72 years)] who had open reduction and internal fixation combined with CPC augmentation were included in this study. Seventeen fractures were Schatzker type II, 5 were type III, 3 were type IV, 2 were type V, and 1 was type VI. CPC was used to fill the subchondral bone defects in all knees. Fixation of the fragments was done with screws in 3 knees (10%). Standard proximal tibial plates or buttress plates were used in 25 knees (90%) with an additional split fragment extending distally to achieve internal fixation. Full weight-bearing was allowed in 6.4 weeks (range 6-12 weeks) after surgery. Resorption of CPC granules was defined as the decrease in the size and density of grafting material on radiographs. Rasmussen's radiological and clinical scores were determined postoperatively. Functionality was assessed with Lysholm knee scoring system. Activity was graded with Tegner's activity scale. Union was achieved in all patients with a mean follow-up of 22.2 months (range 6-36 months). There were no intraoperative complications. At the latest follow-up radiographs, resorption of the graft was observed in 25 knees (89%). Rasmussen's radiologic score was excellent in 17 patients (61%), good in 9 patients (32%), and fair in 2 patients (7%). Rasmussen's clinical score was excellent in 9 patients (32%), good in 18 patients (64%), and fair in 1 patient (4%). According to the Lysholm knee score, functional results were excellent in 16 patients (57%), good in 8 patients (29%), and fair in 4 patients (14%). Twenty-two patients (78%) achieved the preoperative activity level after surgery, and there was no significant difference between the mean preoperative and postoperative Tegner scores (4.11±0.68 and 4.04±0.64, respectively, p=0.161). CPC is a safe biomaterial with many advantages in augmenting the open reduction and internal fixation of depressed tibial plateau fractures, including elimination of morbidity associated with bone graft harvesting, the unlimited supply of bone substitute, the optimum filling of irregular bone defects, and shortening of the postoperative full weight-bearing time.

Single implants in the aesthetic region preceded by local ridge augmentation; a 10-year randomized controlled trial.

PubMed

Meijndert, Caroliene M; Raghoebar, Gerry M; Meijndert, Leo; Stellingsma, Kees; Vissink, Arjan; Meijer, Henny J A

2017-04-01

The aim of this randomized controlled trial was to assess the 10-year effects of three different augmentation techniques (augmentation with chin bone, augmentation with chin bone plus a membrane and augmentation with a bone substitute plus a membrane) for implant-supported restorations in the maxillary aesthetic region regarding clinical and radiographic parameters, and patient-centred outcomes. Ninety-three patients requesting single tooth replacement and presenting with a horizontal bone deficiency were included. After augmentation, 93 implants were placed. Clinical variables, standardized radiographs and photographs and patient questionnaires were analysed to assess the impact of the various augmentation techniques 1 month (T 1 ), 12 months (T 12 ) and 120 months (T 120 ) after final crown placement. 10-years implant survival was 95.7% and did not differ between the groups neither were significant differences observed in the other treatment outcomes assessed. Peri-implant bone loss was low, viz. 0.48 ± 1.19 mm (mesial) and 0.30 ± 1.24 mm (distal) at T 120 . Loss of midbuccal marginal gingival level at T 120 was 0.32 ± 0.83 mm. Mean overall satisfaction at T 120 was 8.6 with 98.6% of the patients satisfied. Clinical, radiographic, aesthetic and patient centred outcomes were very favourable after 10 years and did not differ between the groups with different bone augmentation techniques. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Improvement of Implant Placement after Bone Augmentation of Severely Resorbed Maxillary Sinuses with 'Tent-Pole' Grafting Technique in Combination with rhBMP-2.

PubMed

Zhang, Qiao; Zhang, Li Li; Yang, Yang; Lin, Yi Zhen; Miron, Richard J; Zhang, Yu Feng

To study the clinical effect of short implant placement using osteotome sinus floor elevation technique and tent-pole grafting technique with recombinant human bone morphogenetic protein 2 (rhBMP-2) in severely resorbed maxillary area. Eleven patients with insufficient bone height in the posterior maxillary area were included. According to the native bone height and crown height space (CHS), the patients were divided into two groups: immediate placement of short implants with simultaneous bone augmentation (group A, 5 patients) and delayed dental implant placement (4 to 6 months) after bone augmentation. The rhBMP-2 was added into a deproteinised bovine bone mineral (DBBM) bone grafting material to shorten the treatment procedure and enhance the final effect of bone augmentation in both groups. Tent-pole grafting technique was applied for vertical bone augmentation in group B (6 patients). The success rate of the implants placed was 100% in both groups. In group A, the short implants treatment was successful, with a vertical gain of 1.5 to 6.4 mm in bone height after 4 to 6 months. In group B, the tent-pole grafting procedure in combination with DBBM and rhBMP-2 increased vertical bone height between 3.1 and 8.1 mm, an optimistic and adequate increase for implant placement. This bone increase was maintained following implant placement and final crown placement in the maxillary region (3.5 to 7.3 mm). The tent-pole grafting technique was a viable alternative choice to lateral sinus floor elevation in cases with excessive CHS. The application of rhBMP-2 with a shortened treatment time demonstrated positive outcomes in sinus floor augmentation procedures.

New Medium for Isolation of Bacteria From Cement Kiln Dust with a Potential to Apply in Bio-Concrete

NASA Astrophysics Data System (ADS)

Alshalif, A. F.; Irwan, J. M.; Othman, N.; Al-Gheethi, A.

2018-04-01

The present study aimed to introduce a new isolation medium named kiln dust medium (KDM) for recovering of bacteria from cement kiln dust with high pH (>pH 11) without the need for nutrients additives. The cement kiln dust samples were collected from five different areas of Cement Industries of Malaysia Berhad (CIMA). The bacterial isolates were recovered on KDM by direct plating technique. The chemical components for all collected samples were identified using X-ray fluorescence (XRF). The primary identification for the bacterial isolates indicated that these bacteria belongs to Bacillus spp. Based on the morphological characteristics. The growth curve of the bacterial strains was monitored using the optical density (OD) with 650 nm wavelength, which in role confirmed that all isolated bacteria had the ability to grow successfully in the proposed medium. The ability of the bacterial strains to grow at high pH reflects their potential in the bio-concrete applications (aerated and non-aerated concrete). These findings indicated that the cement kiln dust samples from Cement Industries represent the most appropriate source for bacteria used in the bioconcrete.

Design and biomechanical evaluation of a cementable endosteal blade implant.

PubMed

Pugh, J; Weiss, C; Weiss, F; Malkin, D

1976-07-01

A cementable endosteal blade implant has been developed and evaluated. Inherent in the design are the following factors: minimization of stress concentrators, ease of implantation, and high resistance to loosening. Other potential advantages of this design as compared with conventional endosteal blade implants include reduced hazards of postoperative infection and reduced likelihood of metallic corrosion. Six conventional endosteal implants and six cementable implants were installed in steer mandibles using standard dental surgical techniques and Simplex-brand methyl methacrylate bone cement. They were loaded in uniaxial compresstion at a loading rate of 0.0122 in./min. the stiffness (S), deformation at 900-lb load (D900), proportional limil (PL), and load at 0.04 in. deformation (L0.04) were calculated for each test. The cementable design showed a twofold increase in stiffness, only 17% of the deformation at 900lb, more than twice the proportional limit, and at least twice the load at 0.04 in. deformation when compared with similar values for the conventional endosteal implants. This study reveals that, in addition to being unstable in bone, conventional endosteal implants are also unstable when used with acrylic bone cement. The new design should eliminate most of the problems associated with endosteal blade implantation.

An Experimental Investigation on the Effect of Addition of Ternary Blend on the Mix Design Characteristics of High Strength Concrete using Steel Fibre

NASA Astrophysics Data System (ADS)

Sinha, Deepa A., Dr; Verma, A. K., Dr

2017-08-01

This paper presents the results of M60 grade of concrete. M60 grade of concrete is achieved by maximum density technique. Concrete is brittle and weak in tension and develops cracks during curing and due to thermal expansion / contraction over a period ot time. Thus the effect of addition of 1% steel fibre is studied. For ages, concrete has been one of the widely used materials for construction. When cement is manufactured, every one ton of cement produces around one ton of carbon dioxide leading to global warming and also as natural resources are finishing, so use of supplementary cementitious material like alccofine and flyash is used as partial replacement of cement is considered. The effect of binary and ternary blend on the strength characteristics is studied. The results indicate that the concrete made with alccofine and flyash generally show excellent fresh and hardened properties. The ternary system that is Portland cement-fly ash-Alccofine concrete was found to increase the strength of concrete when compared to concrete made with Portland cement or even from Portland cement and fly ash.

Research on an augmented Lagrangian penalty function algorithm for nonlinear programming

NASA Technical Reports Server (NTRS)

Frair, L.

1978-01-01

The augmented Lagrangian (ALAG) Penalty Function Algorithm for optimizing nonlinear mathematical models is discussed. The mathematical models of interest are deterministic in nature and finite dimensional optimization is assumed. A detailed review of penalty function techniques in general and the ALAG technique in particular is presented. Numerical experiments are conducted utilizing a number of nonlinear optimization problems to identify an efficient ALAG Penalty Function Technique for computer implementation.

Nano-modified cement composites and its applicability as concrete repair material

NASA Astrophysics Data System (ADS)

Manzur, Tanvir

Nanotechnology or Nano-science, considered the forth industrial revolution, has received considerable attention in the past decade. The physical properties of a nano-scaled material are entirely different than that of bulk materials. With the emerging nanotechnology, one can build material block atom by atom. Therefore, through nanotechnology it is possible to enhance and control the physical properties of materials to a great extent. Composites such as concrete materials have very high strength and Young's modulus but relatively low toughness and ductility due to their covalent bonding between atoms and lacking of slip systems in the crystal structures. However, the strength and life of concrete structures are determined by the microstructure and mass transfer at nano scale. Cementitious composites are amenable to manipulation through nanotechnology due to the physical behavior and size of hydration products. Carbon nanotubes (CNT) are nearly ideal reinforcing agent due to extremely high aspect ratios and ultra high strengths. So there is a great potential to utilize CNT in producing new cement based composite materials. It is evident from the review of past literature that mechanical properties of nanotubes reinforced cementitious composites have been highly variable. Some researches yielded improvement in performance of CNT-cement composites as compared to plain cement samples, while other resulted in inconsequential changes in mechanical properties. Even in some cases considerable less strengths and modulus were obtained. Another major difficulty of producing CNT reinforced cementitious composites is the attainment of homogeneous dispersion of nanotubes into cement but no standard procedures to mix CNT within the cement is available. CNT attract more water to adhere to their surface due to their high aspect ratio which eventually results in less workability of the cement mix. Therefore, it is extremely important to develop a suitable mixing technique and an optimum mix proportion to produce CNT reinforced cement composites. In this study, an extensive parametric study has been conducted using different types of treated and untreated multi walled nanotubes (MWNT) as reinforcement of cementitious composites having different mix proportions. It is found that mixing of nanotubes within cement matrix is the key to develop composites having desirable properties. A mixing technique has been proposed to address the issues related to dispersion of nanotubes within cement matrix. Polycarboxylate based super plasticizer has been proposed to use as surfactant. It is evident that there exists an optimum concentration of MWNT and mix proportion to achieve proper reinforcement behavior and strength properties. The affect of size of MWNT on strengths (both compressive and flexure) of composites has also been investigated. Based on the parametric study and statistical analysis, a tentative optimum mix proportion has been proposed. Composites made by the proposed mixing technique and design mix obtained 26, 27 and 16% higher compressive strength as compared to control samples at the age of 3, 7 and 28 day, respectively. Flexural strengths of those composites at 3, 7 and 28 day were about 24, 24.5 and 20% higher than that of control samples, respectively. It has also been suggested that application of MWNT reinforced cement mortar as concrete repair material has excellent potential since composites exhibited desirable behavior in setting time, bleeding and slant shear.

An insight into current concepts and techniques in resin bonding to high strength ceramics.

PubMed

Luthra, R; Kaur, P

2016-06-01

Reliable bonding between high strength ceramics and resin composite cement is difficult to achieve because of their chemical inertness and lack of silica content. The aim of this review was to assess the current literature describing methods for resin bonding to ceramics with high flexural strength such as glass-infiltrated alumina and zirconia, densely sintered alumina and yttria-partially stabilized tetragonal zirconia polycrystalline ceramic (Y-TZP) with respect to bond strength and bond durability. Suitable peer reviewed publications in the English language were identified through searches performed in PubMed, Google Search and handsearches. The keywords or phrases used were 'resin-ceramic bond', 'silane coupling agents', 'air particle abrasion', 'zirconia ceramic' and 'resin composite cements'. Studies from January 1989 to June 2015 were included. The literature demonstrated that there are multiple techniques available for surface treatments but bond strength testing under different investigations have produced conflicting results. Within the scope of this review, there is no evidence to support a universal technique of ceramic surface treatment for adhesive cementation. A combination of chemical and mechanical treatments might be the recommended solution. The hydrolytic stability of the resin ceramic bond should be enhanced. © 2016 Australian Dental Association.

Augmentation of autologous hamstring graft during anterior cruciate ligament reconstruction using the bone chip technique.

PubMed

Nha, Kyung Wook; Shetty, Gautam M; Ahn, Jin Hwan; Lee, Yong Seuk; Chae, Dong Ju; Nam, Hyok Woo; Lee, Dae Hee

2010-01-01

The use of autologous quadrupled hamstring tendon graft is a well-known technique for anterior cruciate ligament reconstruction. In cases where the diameter of the graft is inadequate, the stability of graft fixation and subsequent bone to tendon healing may be compromised. We describe a new technique to augment the autologous double looped hamstring tendon graft during anterior cruciate ligament reconstruction using cancellous bone chips. This simple technique effectively enhances graft fixation and stability.

Effect of an internal coating technique on tensile bond strengths of resin cements to zirconia ceramics.

PubMed

Kitayama, Shuzo; Nikaido, Toru; Maruoka, Rena; Zhu, Lei; Ikeda, Masaomi; Watanabe, Akihiko; Foxton, Richard M; Miura, Hiroyuki; Tagami, Junji

2009-07-01

This study was conducted to enhance the tensile bond strengths of resin cements to zirconia ceramics. Fifty-six zirconia ceramic specimens (Cercon Base) and twenty-eight silica-based ceramic specimens (GN-1, GN-1 Ceramic Block) were air-abraded using alumina. Thereafter, the zirconia ceramic specimens were divided into two subgroups of 28 each according to the surface pretreatment; no pretreatment (Zr); and the internal coating technique (INT). For INT, the surface of zirconia was coated by fusing silica-based ceramics (Cercon Ceram Kiss). Ceramic surfaces were conditioned with/without a silane coupling agent followed by bonding with one of two resin cements; Panavia F 2.0 (PF) and Superbond C&B (SB). After 24 hours storage in water, the tensile bond strengths were tested (n=7). For both PF and SB, silanization significantly improved the bond strength to GN-1 and INT (p<0.05). The INT coating followed by silanizaton demonstrated enhancement of bonding to zirconia ceramics.

The Palatal Window for Treating an Incompletely Augmented Maxillary Sinus.

PubMed

Florio, Salvatore; Suzuki, Takanori; Cho, Sang-Choon

2017-04-01

Maxillary sinus augmentation through a lateral window is reported as one of the most predictable bone augmentation procedures before implant placement. The elevation of the membrane represents a delicate and crucial step that allows the creation of the space for the bone graft material. If the elevation is not completed, the regenerated bone might be inadequate for the implant placement. In this case, a new intervention will be necessary to complete the bone augmentation. Reaccessing from a lateral window, however, would be challenging due to thickness of the buccal boney wall because of the first grafting procedure; therefore, a different approach has to be used. The aim of this case report is to present the palatal window technique for treating incompletely augmented maxillary sinus. The detailed step-by-step diagnostic and surgical procedures are described, and the advantages and limitations of the technique are discussed through a review of the literature.

Comparison of shear bond strength of self-etch and self-adhesive cements bonded to lithium disilicate, enamel and dentin.

PubMed

Naranjo, Jennifer; Ali, Mohsin; Belles, Donald

2015-11-01

Comparison of shear bond strength of self-etch and self-adhesive cements bonded to lithium disilicate, enamel and dentin. With several self-adhesive resin cements currently available, there is confusion about which product and technique is optimal for bonding ceramic restorations to teeth. The objective of this study was to compare the shear bond strength of lithium disilicate cemented to enamel and dentin using 5 adhesive cements. 100 lithium disilicate rods were pretreated with 5% hydrofluoric acid, silane, and cemented to 50 enamel and 50 dentin surfaces using five test cements: Variolink II (etch-and-rinse) control group, Clearfil Esthetic (two step self-etch), RelyX Unicem, SpeedCEM, and BifixSE (self-adhesive). All specimens were stored (37 degrees C, 100% humidity) for 24 hours before testing their shear bond strength using a universal testing machine (Instron). Debonded surfaces were observed under a low-power microscope to assess the location and type of failure. The highest bond strength for both enamel and dentin were recorded for Variolink II, 15.1MPa and 20.4MPa respectively, and the lowest were recorded for BifixSE, 0.6MPa and 0.9MPa respectively. Generally, higher bond strengths were found for dentin (7.4MPa) than enamel (5.3MPa). Tukey's post hoc test showed no significant difference between Clearfil Esthetic and SpeedCem (p = 0.059), Unicem and SpeedCem (p = 0.88), and Unicem and BifixSE (p = 0.092). All cements bonded better to lithium disilicate than to enamel or dentin, as all bond failures occurred at the tooth/adhesive interface except for Variolink II. Bond strengths recorded for self-adhesive cements were very low compared to the control "etch and rinse" and self-etch systems. Further improvements are apparently needed in self-adhesive cements for them to replace multistep adhesive systems. The use of conventional etch and rinse cements such as Veriolink II should be preferred for cementing all ceramic restorations over self-adhesive cements until the bond strengths are improved.

Cement-based materials' characterization using ultrasonic attenuation

NASA Astrophysics Data System (ADS)

Punurai, Wonsiri

The quantitative nondestructive evaluation (NDE) of cement-based materials is a critical area of research that is leading to advances in the health monitoring and condition assessment of the civil infrastructure. Ultrasonic NDE has been implemented with varying levels of success to characterize cement-based materials with complex microstructure and damage. A major issue with the application of ultrasonic techniques to characterize cement-based materials is their inherent inhomogeneity at multiple length scales. Ultrasonic waves propagating in these materials exhibit a high degree of attenuation losses, making quantitative interpretations difficult. Physically, these attenuation losses are a combination of internal friction in a viscoelastic material (ultrasonic absorption), and the scattering losses due to the material heterogeneity. The objective of this research is to use ultrasonic attenuation to characterize the microstructure of heterogeneous cement-based materials. The study considers a real, but simplified cement-based material, cement paste---a common bonding matrix of all cement-based composites. Cement paste consists of Portland cement and water but does not include aggregates. First, this research presents the findings of a theoretical study that uses a set of existing acoustics models to quantify the scattered ultrasonic wavefield from a known distribution of entrained air voids. These attenuation results are then coupled with experimental measurements to develop an inversion procedure that directly predicts the size and volume fraction of entrained air voids in a cement paste specimen. Optical studies verify the accuracy of the proposed inversion scheme. These results demonstrate the effectiveness of using attenuation to measure the average size, volume fraction of entrained air voids and the existence of additional larger entrapped air voids in hardened cement paste. Finally, coherent and diffuse ultrasonic waves are used to develop a direct relationship between attenuation and water to cement (w/c) ratio. A phenomenological model based on the existence of fluid-filled capillary voids is used to help explain the experimentally observed behavior. Overall this research shows the potential of using ultrasonic attenuation to quantitatively characterize cement paste. The absorption and scattering losses can be related to the individual microstructural elements of hardened cement paste. By taking a fundamental, mechanics-based approach, it should be possible to add additional components such as scattering by aggregates or even microcracks in a systematic fashion and eventually build a realistic model for ultrasonic wave propagation study for concrete.

[Modified Exeter technique in revision hip surgery].

PubMed

de Thomasson, E; Guingand, O; Terracher, R; Mazel, C

2008-06-01

The Exeter technique opened new perspectives for the treatment of femoral bone stock loss in revision hip arthroplasty. Implant migration in the cement sheath is, however, a frequent finding. According to the promoters of the technique, this would favor transformation of the allograft into living bone. For others it is a worrisome problem since it alters the heterogeneous cement sheath, leading to loosening and final surgical revision, with an incidence up to 20%. We propose an analysis of the mid-term results of the modified Exeter technique with the objective of cementing the distal part of the implant directly into the recipient bone in order to achieve satisfactory primary stability. The purpose of this work was to analyze the consequences of this method on the long-term evolution of the allograft. After preparing the femur, a specific gun is filled with allograph dough obtained from frozen femoral heads fragmented with an acetabular reamer. The Mersilene mesh enables the deposit of a tube of graft material at the desired level. The implant is sealed after impaction of the graft to enable direct distal cementing in contact with the recipient bone. Partial weight bearing is allowed as early as the fifth day and increased progressively to complete weight bearing at three months. Forty-five patients (46 hips) were treated between June 1996 and January 2002. Six patients were not retained for analysis due to insufficient follow-up. For three patients, graft outcome could not be properly assessed due to a major complication. In addition, two patients died and one was lost to follow-up. In all 39 patients (40 hips) were analyzed at mean follow-up of 84 months (range 48-110). There were no cases of revision for femoral loosening. Femoral bone loss was mainly moderate to severe type II and III hips (Sofcot classification) but limited in height (no grade IV in the Endo-Klinik classification). Clinical outcome was excellent in 13 hips, good in 16, fair in nine and poor in two (Postel-Merle-d'Aubigné score). Defective distal cementing with implant migration (less than 5 mm) was noted in four cases followed by secondary stabilization. Transformation of the allograft occurred in 36 cases, associated with corticalization of the recipient bone in 14. This technique is reproducible since primary stability was obtained in 90% of hips, without hindering transformation of the allograft. The results, which are sustained over time, are the same as with the princeps technique and no radiographic evidence of stress shielding could be found.

Augmented Reality: A Brand New Challenge for the Assessment and Treatment of Psychological Disorders

PubMed Central

Chicchi Giglioli, Irene Alice; Pedroli, Elisa

2015-01-01

Augmented Reality is a new technological system that allows introducing virtual contents in the real world in order to run in the same representation and, in real time, enhancing the user's sensory perception of reality. From another point of view, Augmented Reality can be defined as a set of techniques and tools that add information to the physical reality. To date, Augmented Reality has been used in many fields, such as medicine, entertainment, maintenance, architecture, education, and cognitive and motor rehabilitation but very few studies and applications of AR exist in clinical psychology. In the treatment of psychological disorders, Augmented Reality has given preliminary evidence to be a useful tool due to its adaptability to the patient needs and therapeutic purposes and interactivity. Another relevant factor is the quality of the user's experience in the Augmented Reality system determined from emotional engagement and sense of presence. This experience could increase the AR ecological validity in the treatment of psychological disorders. This paper reviews the recent studies on the use of Augmented Reality in the evaluation and treatment of psychological disorders, focusing on current uses of this technology and on the specific features that delineate Augmented Reality a new technique useful for psychology. PMID:26339283

Augmented Reality: A Brand New Challenge for the Assessment and Treatment of Psychological Disorders.

PubMed

Chicchi Giglioli, Irene Alice; Pallavicini, Federica; Pedroli, Elisa; Serino, Silvia; Riva, Giuseppe

2015-01-01

Augmented Reality is a new technological system that allows introducing virtual contents in the real world in order to run in the same representation and, in real time, enhancing the user's sensory perception of reality. From another point of view, Augmented Reality can be defined as a set of techniques and tools that add information to the physical reality. To date, Augmented Reality has been used in many fields, such as medicine, entertainment, maintenance, architecture, education, and cognitive and motor rehabilitation but very few studies and applications of AR exist in clinical psychology. In the treatment of psychological disorders, Augmented Reality has given preliminary evidence to be a useful tool due to its adaptability to the patient needs and therapeutic purposes and interactivity. Another relevant factor is the quality of the user's experience in the Augmented Reality system determined from emotional engagement and sense of presence. This experience could increase the AR ecological validity in the treatment of psychological disorders. This paper reviews the recent studies on the use of Augmented Reality in the evaluation and treatment of psychological disorders, focusing on current uses of this technology and on the specific features that delineate Augmented Reality a new technique useful for psychology.

The C-stem in clinical practice: fifteen-year follow-up of a triple tapered polished cemented stem.

PubMed

Purbach, Bodo; Kay, Peter R; Siney, Paul D; Fleming, Patricia A; Wroblewski, B Michael

2013-09-01

The triple tapered polished cemented stem, C-Stem, introduced in 1993 was based on the original Charnley concept of the "flat back" polished stem. We present our continuing experience with the C-Stem in 621 consecutive primary arthroplasties implanted into 575 patients between 1993 and 1997. Four hundred and eighteen arthroplasties had a clinical and radiological follow-up past 10 years with a mean follow-up of 13 years (10-15). There were no revisions for stem loosening but 2 stems were revised for fracture - both with a defective cement mantle proximally. The stem design and the surgical technique support the original Charnley concept of limited stem subsidence within the cement mantle and the encouraging results continue to stand as a credit to Sir John Charnley's original philosophy. Copyright © 2013 Elsevier Inc. All rights reserved.

Las Vegas Basin Seismic Response Project: Measured Shallow Soil Velocities

NASA Astrophysics Data System (ADS)

Luke, B. A.; Louie, J.; Beeston, H. E.; Skidmore, V.; Concha, A.

2002-12-01

The Las Vegas valley in Nevada is a deep (up to 5 km) alluvial basin filled with interlayered gravels, sands, and clays. The climate is arid. The water table ranges from a few meters to many tens of meters deep. Laterally extensive thin carbonate-cemented lenses are commonly found across parts of the valley. Lenses range beyond 2 m in thickness, and occur at depths exceeding 200 m. Shallow seismic datasets have been collected at approximately ten sites around the Las Vegas valley, to characterize shear and compression wave velocities in the near surface. Purposes for the surveys include modeling of ground response to dynamic loads, both natural and manmade, quantification of soil stiffness to aid structural foundation design, and non-intrusive materials identification. Borehole-based measurement techniques used include downhole and crosshole, to depths exceeding 100 m. Surface-based techniques used include refraction and three different methods involving inversion of surface-wave dispersion datasets. This latter group includes two active-source techniques, the Spectral Analysis of Surface Waves (SASW) method and the Multi-Channel Analysis of Surface Waves (MASW) method; and a new passive-source technique, the Refraction Mictrotremor (ReMi) method. Depths to halfspace for the active-source measurements ranged beyond 50 m. The passive-source method constrains shear wave velocities to 100 m depths. As expected, the stiff cemented layers profoundly affect local velocity gradients. Scale effects are evident in comparisons of (1) very local measurements typified by borehole methods, to (2) the broader coverage of the SASW and MASW measurements, to (3) the still broader and deeper resolution made possible by the ReMi measurements. The cemented layers appear as sharp spikes in the downhole datasets and are problematic in crosshole measurements due to refraction. The refraction method is useful only to locate the depth to the uppermost cemented layer. The surface-wave methods, on the other hand, can process velocity inversions. With the broader coverage of the active-source surface wave measurements, through careful inversion that takes advantage of prior information to the greatest extent possible, multiple, shallow, stiff layers can be resolved. Data from such broader-coverage methods also provide confidence regarding continuity of the cemented layers. For the ReMi measurements, which provide the broadest coverage of all methods used, the more generalized shallow profile is sometimes characterized by a strong stiffness inversion at a depth of approximately 10 m. We anticipate that this impedance contrast represents the vertical extent of the multiple layered deposits of cemented media.

Forehead augmentation with a methyl methacrylate onlay implant using an injection-molding technique.

PubMed

Park, Dong Kwon; Song, Ingook; Lee, Jin Hyo; You, Young June

2013-09-01

The forehead, which occupies about one third of the face, is one of the major determinants of a feminine or masculine look. Various methods have been used for the augmentation of the forehead using autologous fat grafts or alloplastic materials. Methylmethacrylate (MMA) is the most appropriate material for augmentation of the forehead, and we have used an injection-molding technique with MMA to achieve satisfactory results. Under local anesthesia with intravenous (IV) sedation, an incision was made on the scalp and a meticulous and delicate subperiosteal dissection was then performed. MMA monomers and polymers were mixed, the dough was injected into the space created, and manual molding was performed along with direct inspection. This surgery was indicated for patients who wanted to correct an unattractive appearance by forehead augmentation. Every patient in this study visited our clinics 3 months after surgery to evaluate the results. We judged the postoperative results in terms of re-operation rates caused by the dissatisfaction of the patients and complications. During a 13-year period, 516 patients underwent forehead augmentation with MMA. With the injection-molding technique, the inner surface of the MMA implant is positioned close to the underlying frontal bone, which minimizes the gap between the implant and bone. The borders of the implant should be tapered sufficiently until no longer palpable or visible. Only 28 patients (5.4%) underwent a re-operation due to an undesirable postoperative appearance. The injection-molding technique using MMA is a simple, safe, and ideal method for the augmentation of the forehead.

Forehead Augmentation with a Methyl Methacrylate Onlay Implant Using an Injection-Molding Technique

PubMed Central

Park, Dong Kwon; Song, Ingook; Lee, Jin Hyo

2013-01-01

Background The forehead, which occupies about one third of the face, is one of the major determinants of a feminine or masculine look. Various methods have been used for the augmentation of the forehead using autologous fat grafts or alloplastic materials. Methylmethacrylate (MMA) is the most appropriate material for augmentation of the forehead, and we have used an injection-molding technique with MMA to achieve satisfactory results. Methods Under local anesthesia with intravenous (IV) sedation, an incision was made on the scalp and a meticulous and delicate subperiosteal dissection was then performed. MMA monomers and polymers were mixed, the dough was injected into the space created, and manual molding was performed along with direct inspection. This surgery was indicated for patients who wanted to correct an unattractive appearance by forehead augmentation. Every patient in this study visited our clinics 3 months after surgery to evaluate the results. We judged the postoperative results in terms of re-operation rates caused by the dissatisfaction of the patients and complications. Results During a 13-year period, 516 patients underwent forehead augmentation with MMA. With the injection-molding technique, the inner surface of the MMA implant is positioned close to the underlying frontal bone, which minimizes the gap between the implant and bone. The borders of the implant should be tapered sufficiently until no longer palpable or visible. Only 28 patients (5.4%) underwent a re-operation due to an undesirable postoperative appearance. Conclusions The injection-molding technique using MMA is a simple, safe, and ideal method for the augmentation of the forehead. PMID:24086816

Combined usage of intercostal nerve block and tumescent anaesthesia: an effective anaesthesia technique for breast augmentation.

PubMed

Shimizu, Yusuke; Nagasao, Tomohisa; Taneda, Hiroko; Sakamoto, Yoshiaki; Asou, Toru; Imanishi, Nobuyuki; Kishi, Kazuo

2014-02-01

Patients are occasionally unhappy with the size, shape, and positioning of breast implants. An option to improve their satisfaction with breast augmentation includes directly involving them in the process with awake surgery done under nerve block and tumescence. This study describes the resultsof using such an awake anaesthesia technique in 35 patients. After the intercostal nerves dominating the Th3 to Th6 regions were anaesthetized using 0.5% bupivacaine, a tumescent solution consisting of lidocaine, epinephrine, and saline was injected around the mammary gland, and breast augmentation was conducted using silicon implants. The majority of patients (31/35) reported no pain during the procedure and all patients were able to choose and confirm their final implant size and positioning. In all cases, blood loss was less than 10 ml. No patient experienced pneumothorax or toxicity of local anaesthetics. Combined usage of the intercostal nerve block and tumescent anaesthesia effectively reduces pain during breast augmentation. Keeping patient conscious enables meeting their requests during operation, contributing to increased satisfaction. For these advantages, combined usage of the intercostal nerve block and tumescent anaesthesia is recommended as a useful anaesthetic technique for breast augmentation.

Carbon Nanofiber Cement Sensors to Detect Strain and Damage of Concrete Specimens Under Compression

PubMed Central

Baeza, F. Javier; Garcés, Pedro

2017-01-01

Cement composites with nano-additions have been vastly studied for their functional applications, such as strain and damage sensing. The capacity of a carbon nanofiber (CNF) cement paste has already been tested. However, this study is focused on the use of CNF cement composites as sensors in regular concrete samples. Different measuring techniques and humidity conditions of CNF samples were tested to optimize the strain and damage sensing of this material. In the strain sensing tests (for compressive stresses up to 10 MPa), the response depends on the maximum stress applied. The material was more sensitive at higher loads. Furthermore, the actual load time history did not influence the electrical response, and similar curves were obtained for different test configurations. On the other hand, damage sensing tests proved the capability of CNF cement composites to measure the strain level of concrete samples, even for loads close to the material’s strength. Some problems were detected in the strain transmission between sensor and concrete specimens, which will require specific calibration of each sensor one attached to the structure. PMID:29186797

Carbon Nanofiber Cement Sensors to Detect Strain and Damage of Concrete Specimens Under Compression.

PubMed

Galao, Oscar; Baeza, F Javier; Zornoza, Emilio; Garcés, Pedro

2017-11-24

Cement composites with nano-additions have been vastly studied for their functional applications, such as strain and damage sensing. The capacity of a carbon nanofiber (CNF) cement paste has already been tested. However, this study is focused on the use of CNF cement composites as sensors in regular concrete samples. Different measuring techniques and humidity conditions of CNF samples were tested to optimize the strain and damage sensing of this material. In the strain sensing tests (for compressive stresses up to 10 MPa), the response depends on the maximum stress applied. The material was more sensitive at higher loads. Furthermore, the actual load time history did not influence the electrical response, and similar curves were obtained for different test configurations. On the other hand, damage sensing tests proved the capability of CNF cement composites to measure the strain level of concrete samples, even for loads close to the material's strength. Some problems were detected in the strain transmission between sensor and concrete specimens, which will require specific calibration of each sensor one attached to the structure.

Modeling Framework for Fracture in Multiscale Cement-Based Material Structures

PubMed Central

Qian, Zhiwei; Schlangen, Erik; Ye, Guang; van Breugel, Klaas

2017-01-01

Multiscale modeling for cement-based materials, such as concrete, is a relatively young subject, but there are already a number of different approaches to study different aspects of these classical materials. In this paper, the parameter-passing multiscale modeling scheme is established and applied to address the multiscale modeling problem for the integrated system of cement paste, mortar, and concrete. The block-by-block technique is employed to solve the length scale overlap challenge between the mortar level (0.1–10 mm) and the concrete level (1–40 mm). The microstructures of cement paste are simulated by the HYMOSTRUC3D model, and the material structures of mortar and concrete are simulated by the Anm material model. Afterwards the 3D lattice fracture model is used to evaluate their mechanical performance by simulating a uniaxial tensile test. The simulated output properties at a lower scale are passed to the next higher scale to serve as input local properties. A three-level multiscale lattice fracture analysis is demonstrated, including cement paste at the micrometer scale, mortar at the millimeter scale, and concrete at centimeter scale. PMID:28772948

Performance and safety of collagenated xenogeneic bone block for lateral alveolar ridge augmentation and staged implant placement. A monocenter, prospective single-arm clinical study.

PubMed

Schwarz, Frank; Mihatovic, Ilja; Ghanaati, Shahram; Becker, Jürgen

2017-08-01

To assess the clinical safety and performance of collagenated xenogeneic bone block (CXBB) for lateral alveolar ridge augmentation and two-stage implant placement. In ten patients exhibiting a single-tooth gap, the surgical procedure included the preparation of mucoperiosteal flaps, a rigid fixation of CXBB (Geistlich Bio-Graft ® ) using an osteosynthesis screw, and contour augmentation. After 24 weeks of submerged healing, the primary endpoint was defined as the final ridge width sufficient to place an adequately dimensioned titanium implant at the respective sites. Secondary outcomes included, for example, the gain in ridge width (mm). Clinical parameters (e.g., bleeding on probing - BOP, probing depth - PD, mucosal recession - MR) were assessed immediately after the cementation of the crown and at the final visit. At 24 weeks, implant placement could be achieved in 8 of 10 patients exhibiting a mean gain in ridge width (mean ± SD) of 3.88 ± 1.75 mm. Histological analysis has pointed to a homogeneous osseous organization of CXBB. The changes of mean BOP, PD, and MR values at the final visit amounted to 16.62 ± 32.02%, 0.04 ± 0.21 mm, and -0.04 ± 0.12 mm, respectively. CXBB may be successfully used to support lateral alveolar ridge augmentation and two-stage implant placement. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Nonsurgical Medical Penile Girth Augmentation: Experience-Based Recommendations.

PubMed

Oates, Jayson; Sharp, Gemma

2017-10-01

Penile augmentation is increasingly sought by men who are dissatisfied with the size and/or appearance of their penis. However, augmentation procedures are still considered to be highly controversial with no standardized recommendations reported in the medical literature and limited outcome data. Nevertheless, these procedures continue to be performed in increasing numbers in private settings. Therefore, there is a need for safe, effective, and minimally invasive procedures to be developed, evaluated, and reported in the research literature. In this article, we focus particularly on girth enhancement procedures rather than lengthening procedures as penile girth appears to be particularly important for sexual satisfaction. We discuss the advantages and disadvantages of the common techniques to date, with a focus on the minimally invasive injectable girth augmentation techniques. Based on considerable operative experience, we offer our own suggestions for patient screening, technique selection, and perioperative care. © 2017 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

A new adhesive technique for internal fixation in midfacial surgery

PubMed Central

Endres, Kira; Marx, Rudolf; Tinschert, Joachim; Wirtz, Dieter Christian; Stoll, Christian; Riediger, Dieter; Smeets, Ralf

2008-01-01

Background The current surgical therapy of midfacial fractures involves internal fixation in which bone fragments are fixed in their anatomical positions with osteosynthesis plates and corresponding screws until bone healing is complete. This often causes new fractures to fragile bones while drilling pilot holes or trying to insert screws. The adhesive fixation of osteosynthesis plates using PMMA bone cement could offer a viable alternative for fixing the plates without screws. In order to achieve the adhesive bonding of bone cement to cortical bone in the viscerocranium, an amphiphilic bone bonding agent was created, analogous to the dentin bonding agents currently on the market. Methods The adhesive bonding strengths were measured using tension tests. For this, metal plates with 2.0 mm diameter screw holes were cemented with PMMA bone cement to cortical bovine bone samples from the femur diaphysis. The bone was conditioned with an amphiphilic bone bonding agent prior to cementing. The samples were stored for 1 to 42 days at 37 degrees C, either moist or completely submerged in an isotonic NaCl-solution, and then subjected to the tension tests. Results Without the bone bonding agent, the bonding strength was close to zero (0.2 MPa). Primary stability with bone bonding agent is considered to be at ca. 8 MPa. Moist storage over 42 days resulted in decreased adhesion forces of ca. 6 MPa. Wet storage resulted in relatively constant bonding strengths of ca. 8 MPa. Conclusion A new amphiphilic bone bonding agent was developed, which builds an optimizied interlayer between the hydrophilic bone surface and the hydrophobic PMMA bone cement and thus leads to adhesive bonding between them. Our in vitro investigations demonstrated the adhesive bonding of PMMA bone cement to cortical bone, which was also stable against hydrolysis. The newly developed adhesive fixing technique could be applied clinically when the fixation of osteosynthesis plates with screws is impossible. With the detected adhesion forces of ca. 6 to 8 MPa, it is assumed that the adhesive fixation system is able to secure bone fragments from the non-load bearing midfacial regions in their orthotopic positions until fracture consolidation is complete. PMID:18489785

Effect of Resin-modified Glass Ionomer Cement Dispensing/Mixing Methods on Mechanical Properties.

PubMed

Sulaiman, T A; Abdulmajeed, A A; Altitinchi, A; Ahmed, S N; Donovan, T E

2018-03-23

Resin-modified glass ionomer cements (RMGIs) are often used for luting indirect restorations. Hand-mixing traditional cements demands significant time and may be technique sensitive. Efforts have been made by manufacturers to introduce the same cement using different dispensing/mixing methods. It is not known what effects these changes may have on the mechanical properties of the dental cement. The purpose of this study was to evaluate the mechanical properties (diametral tensile strength [DTS], compressive strength [CS], and fracture toughness [FT]) of RMGIs with different dispensing/mixing systems. The RMGI specimens (n=14)-RelyX Luting (hand mix), RelyX Luting Plus (clicker-hand mix), RelyX Luting Plus (automix) (3M ESPE), GC Fuji PLUS (capsule-automix), and GC FujiCEM 2 (automix) (GC)-were prepared for each mechanical test and examined after thermocycling (n=7/subgroup) for 20,000 cycles to the following: DTS, CS (ISO 9917-1) and FT (ISO standard 6872; Single-edge V-notched beam method). Specimens were mounted and loaded with a universal testing machine until failure occurred. Two-/one-way analysis of variance followed by Tukey honestly significantly different post hoc test was used to analyze data for statistical significance ( p<0.05). The interaction effect of both dispensing/mixing method and thermocycling was significant only for the CS test of the GC group ( p<0.05). The different dispensing/mixing methods had no effect on the DTS of the tested cements. The CS of GC Fuji PLUS was significantly higher than that of the automix version ( p<0.05). The FT decreased significantly when switching from RelyX (hand mix) to RelyX Luting Plus (clicker-hand mix) and to RelyX Luting Plus (automix) ( p<0.05). Except in the case of the DTS of the GC group and the CS of GC Fuji PLUS, thermocycling had a significant effect reducing the mechanical properties of the RMGI cements ( p<0.05). Introducing alternative dispensing/mixing methods for mixing RMGIs to reduce time and technique sensitivity may affect mechanical properties and is brand dependent.

Adhesive permeability affects coupling of resin cements that utilise self-etching primers to dentine.

PubMed

Carvalho, R M; Pegoraro, T A; Tay, F R; Pegoraro, L F; Silva, N R F A; Pashley, D H

2004-01-01

To examine the effects of an experimental bonding technique that reduces the permeability of the adhesive layer on the coupling of resin cements to dentine. Extracted human third molars had their mid to deep dentin surface exposed flat by transversally sectioning the crowns. Resin composite overlays were constructed and cemented to the surfaces using either Panavia F (Kuraray) or Bistite II DC (Tokuyama) resin cements mediated by their respective one-step or two-step self-etch adhesives. Experimental groups were prepared in the same way, except that the additional layer of a low-viscosity bonding resin (LVBR, Scotchbond Multi-Purpose Plus, 3M ESPE) was placed on the bonded dentine surface before luting the overlays with the respective resin cements. The bonded assemblies were stored for 24 h in water at 37 degrees C and subsequently prepared for microtensile bond strength testing. Beams of approximately 0.8 mm(2) were tested in tension at 0.5 mm/min in a universal tester. Fractured surfaces were examined under scanning electron microscopy (SEM). Additional specimens were prepared and examined with TEM using a silver nitrate-staining technique. Two-way ANOVA showed significant interactions between materials and bonding protocols (p<0.05). When bonded according to manufacturer's directions, Panavia F produced bond strengths that were significantly lower than Bistite II DC (p<0.05). The placement of an additional layer of a LVBR improved significantly the bond strengths of Panavia F (p<0.05), but not of Bistite II DC (p>0.05). SEM observation of the fractured surfaces in Panavia F showed rosette-like features that were exclusive for specimens bonded according to manufacturer's directions. Such features corresponded well with the ultrastructure of the interfaces that showed more nanoleakage associated with the more permeable adhesive interface. The application of the additional layer of the LVBR reduced the amount of silver impregnation for both adhesives suggesting that reduced permeability of the adhesives resulted in improved coupling of the resin cements to dentin. Placement of an intermediate layer of a LVBR between the bonded dentine surface and the resin cements resulted in improved coupling of Panavia F to dentine.

Experimental studies on a new bioactive material: HAIonomer cements.

PubMed

Yap, A U J; Pek, Y S; Kumar, R A; Cheang, P; Khor, K A

2002-02-01

The lack of exotherm during setting, absence of monomer and improved release of incorporated therapeutic agents has resulted in the development of glass ionomer cements (GICs) for biomedical applications. In order to improve biocompatibility and biomechanically match GICs to bone, hydroxyapatite-ionomer (HAIonomer) hybrid cements were developed. Ultra-fine hydroxyapatite (HA) powders were produced using a new induction spraying technique that utilizes a radio-frequency source to spheriodize an atomized suspension containing HA crystallites. The spheriodized particulates were then held at 800 degrees C for 4 h in a carbolite furnace using a heating and cooling rate of 25 degrees C/min to obtain almost fully crystalline HA powders. The heat-treated particles were characterized and introduced into a commercial glass ionomer cement. 4 (H4), 12 (H12) and 28 (H28) vol% of fluoroalumino silicate were substituted by crystalline HA particles that were dispersed using a high-speed dispersion technique. The HAIonomer cements were subjected to hardness, compressive and diametral tensile strength testing based upon BS6039:1981. The storage time were extended to one week to investigate the effects of cement maturation on mechanical properties. Commercially available capsulated GIC (GC) and GIC at maximum powder:liquid ratio (GM) served as comparisons. Results were analyzed using factorial ANOVA/Scheffe's post-hoc tests and independent samples t-test at significance level 0.05. The effect of time on hardness was material dependent. With the exception of H12, a significant increase in hardness was observed for all materials at one week. A significant increase in compressive strength was, however, observed for H12 over time. At 1 day and 1 week, the hardness of H28 was significantly lower than for GM, H4, and H12. No significant difference in compression and diametral tensile strengths were observed between materials at both time intervals. Results show that HAIonomers is a promising material, which possess good mechanical properties. Potential uses of this new material include bone cements and performed implants for hard tissue replacement in the field of otological, oral-maxillofacial and orthopedic surgery.

Vertical discrepancy and microleakage of laser-sintered and vacuum-cast implant-supported structures luted with different cement types.

PubMed

Oyagüe, Raquel Castillo; Sánchez-Turrión, Andrés; López-Lozano, José Francisco; Suárez-García, M Jesús

2012-02-01

This study aimed to evaluate the vertical misfit and microleakage of laser-sintered and vacuum-cast cement-retained implant-supported frameworks. Three-unit implant-fixed structures were constructed with: (1) laser-sintered Co-Cr (LS); (2) vacuum-cast Co-Cr (CC); and (3) vacuum-cast Pd-Au (CP). Every framework was luted onto 2 prefabricated abutments under constant seating pressure. Each alloy group was randomly divided into three subgroups (n=10) according to the cement used: (1) Ketac Cem Plus (KC); (2) Panavia F 2.0 (PF); and (3) RelyX Unicem 2 Automix (RXU). After 30 days of water ageing, vertical discrepancy was measured by SEM, and marginal microleakage was scored using a digital microscope. Three-way ANOVA and Student-Newman-Keuls tests were run to investigate the effect of alloy/fabrication technique, FDP retainer, and cement type on vertical misfit. Data for marginal microleakage were analysed with Kruskal-Wallis and Dunn's tests (α=0.05). Vertical discrepancy was affected by alloy/manufacturing technique and cement type (p<0.001). Despite the luting agent, LS structures showed the best marginal adaptation, followed by CP, and CC. Within each alloy group, KC provided the best fit, whilst the use of PF or RXU resulted in no significant differences. Regardless of the framework alloy, KC exhibited the highest microleakage scores, whilst PF and RXU showed values that were comparable to each other. Laser-sintered Co-Cr structures achieved the best fit in the study. Notwithstanding the framework alloy, resin-modified glass-ionomer demonstrated better marginal fit but greater microleakage than did MDP-based and self-adhesive dual-cure resin cements. All groups were within the clinically acceptable misfit range. Laser-sintered Co-Cr may be an alternative to cast base metal and noble alloys to obtain passive-fitting structures. Despite showing higher discrepancies, resin cements displayed lower microleakage than resin-modified glass-ionomer. Further research is necessary to determine whether low microleakage scores may guarantee a suitable seal that could compensate for misfit. Copyright © 2011 Elsevier Ltd. All rights reserved.

In vitro Evaluation of the Marginal Fit and Internal Adaptation of Zirconia and Lithium Disilicate Single Crowns: Micro-CT Comparison Between Different Manufacturing Procedures.

PubMed

Riccitiello, Francesco; Amato, Massimo; Leone, Renato; Spagnuolo, Gianrico; Sorrentino, Roberto

2018-01-01

Prosthetic precision can be affected by several variables, such as restorative materials, manufacturing procedures, framework design, cementation techniques and aging. Marginal adaptation is critical for long-term longevity and clinical success of dental restorations. Marginal misfit may lead to cement exposure to oral fluids, resulting in microleakage and cement dissolution. As a consequence, marginal discrepancies enhance percolation of bacteria, food and oral debris, potentially causing secondary caries, endodontic inflammation and periodontal disease. The aim of the present in vitro study was to evaluate the marginal and internal adaptation of zirconia and lithium disilicate single crowns, produced with different manufacturing procedures. Forty-five intact human maxillary premolars were prepared for single crowns by means of standardized preparations. All-ceramic crowns were fabricated with either CAD-CAM or heat-pressing procedures (CAD-CAM zirconia, CAD-CAM lithium disilicate, heat-pressed lithium disilicate) and cemented onto the teeth with a universal resin cement. Non-destructive micro-CT scanning was used to achieve the marginal and internal gaps in the coronal and sagittal planes; then, precision of fit measurements were calculated in a dedicated software and the results were statistically analyzed. The heat-pressed lithium disilicate crowns were significantly less accurate at the prosthetic margins (p<0.05) while they performed better at the occlusal surface ( p <0.05). No significant differences were noticed between CAD-CAM zirconia and lithium disilicate crowns ( p >0.05); nevertheless CAD-CAM zirconia copings presented the best marginal fit among the experimental groups. As to the thickness of the cement layer, reduced amounts of luting agent were noticed at the finishing line, whereas a thicker layer was reported at the occlusal level. Within the limitations of the present in vitro investigation, the following conclusions can be drawn: the recorded marginal gaps were within the clinical acceptability irrespective of both the restorative material and the manufacturing procedures; the CAD-CAM processing techniques for both zirconia and lithium disilicate produced more consistent marginal gaps than the heat-pressing procedures; the tested universal resin cement can be safely used with both restorative materials.

Evaluation of concrete slab fracturing techniques in mitigating reflective cracking through asphalt overlays.

DOT National Transportation Integrated Search

2002-09-01

This report presents the results of an evaluation of concrete slab fracturing techniques as a means of arresting or retarding reflective cracking through asphalt overlays placed on severely distressed portland cement concrete pavement. The study invo...

Cement technique for reducing post-operative bursitis after trochanteric fixation.

PubMed

Derman, Peter B; Horneff, John G; Kamath, Atul F; Garino, Jonathan

2013-02-01

Post-operative trochanteric bursitis is a known complication secondary to the surgical approach in total hip arthroplasty. This phenomenon may be partially attributable to repetitive microtrauma generated when soft tissues rub against implanted hardware. Significant rates of post-operative trochanteric bursitis have been observed following procedures in which a trochanteric fixation device, such as a bolt-washer mechanism or a cable-grip/claw system, is used to secure the trochanteric fragment after trochanteric osteotomy. We present a simple technique for use with a bolt-washer system or grip plate in which trochanteric components are covered in bone wax followed by a layer of cement to decrease friction and to diminish the risk of post-operative bursitis.

Effective Permeability Change in Wellbore Cement with Carbon Dioxide Reaction

DOE Office of Scientific and Technical Information (OSTI.GOV)

Um, Wooyong; Jung, Hun Bok; Martin, Paul F.

2011-11-01

Portland cement, a common sealing material for wellbores for geological carbon sequestration was reacted with CO{sub 2} in supercritical, gaseous, and aqueous phases at various pressure and temperature conditions to simulate cement-CO{sub 2} reaction along the wellbore from carbon injection depth to the near-surface. Hydrated Portland cement columns (14 mm diameter x 90 mm length; water-to-cement ratio = 0.33) including additives such as steel coupons and Wallula basalt fragments were reacted with CO{sub 2} in the wet supercritical (the top half) and dissolved (the bottom half) phases under carbon sequestration condition with high pressure (10 MPa) and temperature (50 C)more » for 5 months, while small-sized hydrated Portland cement columns (7 mm diameter x 20 mm length; water-to-cement ratio = 0.38) were reacted with CO{sub 2} in dissolved phase at high pressure (10 MPa) and temperature (50 C) for 1 month or with wet CO{sub 2} in gaseous phase at low pressure (0.2 MPa) and temperature (20 C) for 3 months. XMT images reveal that the cement reacted with CO{sub 2} saturated groundwater had degradation depth of {approx}1 mm for 1 month and {approx}3.5 mm for 5 month, whereas the degradation was minor with cement exposure to supercritical CO{sub 2}. SEM-EDS analysis showed that the carbonated cement was comprised of three distinct zones; the innermost less degraded zone with Ca atom % > C atom %, the inner degraded zone with Ca atom % {approx} C atom % due to precipitation of calcite, the outer degraded zone with C atom % > Ca atom % due to dissolution of calcite and C-S-H, as well as adsorption of carbon to cement matrix. The outer degraded zone of carbonated cement was porous and fractured because of dissolution-dominated reaction by carbonic acid exposure, which resulted in the increase in BJH pore volume and BET surface area. In contrast, cement-wet CO{sub 2}(g) reaction at low P (0.2 MPa)-T (20 C) conditions for 1 to 3 months was dominated by precipitation of micron-sized calcite on the outside surface of cement, which resulted in the decrease in BJH pore volume and BET surface area. Cement carbonation and pore structure change are significantly dependent on pressure and temperature conditions as well as the phase of CO{sub 2}, which controls the balance between precipitation and dissolution in cement matrix. Geochemical modeling result suggests that ratio of solid (cement)-to-solution (carbonated water) has a significant effect on cement carbonation, thus the cement-CO{sub 2} reaction experiment needs to be conducted under realistic conditions representing the in-situ wellbore environment of carbon sequestration field site. Total porosity and air permeability for a duplicate cement column with water-to-cement ratio of 0.38 measured after oven-drying by Core Laboratories using Boyle's Law technique and steady-state method were 31% and 0.576 mD. A novel method to measure the effective liquid permeability of a cement column using X-ray micro-tomography images after injection of pressurized KI (potassium iodide) is under development by PNNL. Preliminary results indicate the permeability of a cement column with water-to-cement ratio of 0.38 is 4-8 mD. PNNL will apply the method to understand the effective permeability change of Portland cement by CO{sub 2}(g) reaction under a variety of pressure and temperature conditions to develop a more reliable well-bore leakage risk model.« less

Predicting the Impact of Multiwalled Carbon Nanotubes on the Cement Hydration Products and Durability of Cementitious Matrix Using Artificial Neural Network Modeling Technique

PubMed Central

Fakhim, Babak; Hassani, Abolfazl; Rashidi, Alimorad; Ghodousi, Parviz

2013-01-01

In this study the feasibility of using the artificial neural networks modeling in predicting the effect of MWCNT on amount of cement hydration products and improving the quality of cement hydration products microstructures of cement paste was investigated. To determine the amount of cement hydration products thermogravimetric analysis was used. Two critical parameters of TGA test are PHPloss and CHloss. In order to model the TGA test results, the ANN modeling was performed on these parameters separately. In this study, 60% of data are used for model calibration and the remaining 40% are used for model verification. Based on the highest efficiency coefficient and the lowest root mean square error, the best ANN model was chosen. The results of TGA test implied that the cement hydration is enhanced in the presence of the optimum percentage (0.3 wt%) of MWCNT. Moreover, since the efficiency coefficient of the modeling results of CH and PHP loss in both the calibration and verification stages was more than 0.96, it was concluded that the ANN could be used as an accurate tool for modeling the TGA results. Another finding of this study was that the ANN prediction in higher ages was more precise. PMID:24489487

A simple infrared-augmented digital photography technique for detection of pupillary abnormalities.

PubMed

Shazly, Tarek A; Bonhomme, G R

2015-03-01

The purpose of the study was to describe a simple infrared photography technique to aid in the diagnosis and documentation of pupillary abnormalities. An unmodified 12-megapixel "point and shoot" digital camera was used to obtain binocular still photos and videos under different light conditions with near-infrared illuminating frames. The near-infrared light of 850 nm allows the capture of clear pupil images in both dim and bright light conditions. It also allows easy visualization of the pupil despite pigmented irides by augmenting the contrast between the iris and the pupil. The photos and videos obtained illustrated a variety of pupillary abnormalities using the aforementioned technique. This infrared-augmented photography technique supplements medical education, and aids in the more rapid detection, diagnosis, and documentation of a wide spectrum of pupillary abnormalities. Its portability and ease of use with minimal training complements the education of trainees and facilitates the establishment of difficult diagnoses.

The application of rapid prototyping technique in chin augmentation.

PubMed

Li, Min; Lin, Xin; Xu, Yongchen

2010-04-01

This article discusses the application of computer-aided design and rapid prototyping techniques in prosthetic chin augmentation for mild microgenia. Nine cases of mild microgenia underwent an electrobeam computer tomography scan. Then we performed three-dimensional reconstruction and operative design using computer software. According to the design, we determined the shape and size of the prostheses and made an individualized prosthesis for each chin augmentation with the rapid prototyping technique. With the application of computer-aided design and a rapid prototyping technique, we could determine the shape, size, and embedding location accurately. Prefabricating the individual prosthesis model is useful in improving the accuracy of treatment. In the nine cases of mild microgenia, three received a silicone implant, four received an ePTFE implant, and two received a Medpor implant. All patients were satisfied with the results. During follow-up at 6-12 months, all patients remained satisfied. The application of computer-aided design and rapid prototyping techniques can offer surgeons the ability to design an individualized ideal prosthesis for each patient.

Bone Replacement Materials and Techniques Used for Achieving Vertical Alveolar Bone Augmentation

PubMed Central

Sheikh, Zeeshan; Sima, Corneliu; Glogauer, Michael

2015-01-01

Alveolar bone augmentation in vertical dimension remains the holy grail of periodontal tissue engineering. Successful dental implant placement for restoration of edentulous sites depends on the quality and quantity of alveolar bone available in all spatial dimensions. There are several surgical techniques used alone or in combination with natural or synthetic graft materials to achieve vertical alveolar bone augmentation. While continuously improving surgical techniques combined with the use of auto- or allografts provide the most predictable clinical outcomes, their success often depends on the status of recipient tissues. The morbidity associated with donor sites for auto-grafts makes these techniques less appealing to both patients and clinicians. New developments in material sciences offer a range of synthetic replacements for natural grafts to address the shortcoming of a second surgical site and relatively high resorption rates. This narrative review focuses on existing techniques, natural tissues and synthetic biomaterials commonly used to achieve vertical bone height gain in order to successfully restore edentulous ridges with implant-supported prostheses.

Effective Techniques for Augmenting Heat Transfer: An Application of Entropy Generation Minimization Principles.

DTIC Science & Technology

1980-12-01

augmentation techniques, entropy generation, irreversibility, exergy . 20. ABSTRACT (Continue on rovers. side If necessary and Identify by block number...35 3.5 Internally finned tubes ...... ................. .. 37 3.6 Internally roughened tubes ..... ............... . 41 3.7 Other heat transfer...irreversibility and entropy generation as fundamental criterion for evaluating and, eventually, minimizing the waste of usable energy ( exergy ) in energy

The "All-Inside" Arthroscopic Broström Procedure Augmented With a Proximal Suture Anchor: An Innovative Technique.

PubMed

Cottom, James M; Richardson, Phillip E

Arthroscopic treatments of chronic lateral ankle stability have been reported in the literature. The authors report on an innovative technique augmenting the "All- Inside" Arthroscopic Broström procedure with an additional suture anchor. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

[Use of pedicle percutaneous cemented screws in the management of patients with poor bone stock].

PubMed

Pesenti, S; Graillon, T; Mansouri, N; Adetchessi, T; Tropiano, P; Blondel, B; Fuentes, S

2016-12-01

Management of patients with poor bone stock remains difficult due to the risks of mechanical complications such as screws pullouts. At the same time, development of minimal invasive spinal techniques using a percutaneous approach is greatly adapted to these fragile patients with a reduction in operative time and complications. The aim of this study was to report our experience with cemented percutaneous screws in the management of patients with a poor bone stock. Thirty-five patients were included in this retrospective study. In each case, a percutaneous osteosynthesis using cemented screws was performed. Indications were osteoporotic fractures, metastasis or fractures on ankylosing spine. Depending on radiologic findings, short or long constructs (2 levels above and below) were performed and an anterior column support (kyphoplasty or anterior approach) was added. Evaluation of patients was based on pre and postoperative CT-scans associated with clinical follow-up with a minimum of 6 months. Eleven men and 24 women with a mean age of 73 years [60-87] were included in the study. Surgical indication was related to an osteoporotic fracture in 20 cases, a metastasis in 13 cases and a fracture on ankylosing spine in the last 2 cases. Most of the fractures were located between T10 and L2 and a long construct was performed in 22 cases. Percutaneous kyphoplasty was added in 24 cases and a complementary anterior approach in 3 cases. Average operative time was 86minutes [61-110] and blood loss was estimated as minor in all the cases. In the entire series, average volume of cement injected was 1.8 cc/screw. One patient underwent a major complication with a vascular leakage responsible for a cement pulmonary embolism. With a 9 months average follow-up [6-20], no cases of infection or mechanical complication was reported. Minimal invasive spinal techniques are greatly adapted to the management of fragile patients. The use of percutaneous cemented screws is, in our experience, a valuable alternative for spinal fixation in patients with poor bone stock. This technique allows a good bony fixation with a low rate of complications. However, rigorous preoperative planning is necessary in order to avoid complications. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Clinical outcome of alveolar ridge augmentation with individualized CAD-CAM-produced titanium mesh.

PubMed

Sagheb, K; Schiegnitz, E; Moergel, M; Walter, C; Al-Nawas, B; Wagner, W

2017-12-01

The augmentation of the jaw has been and continues to be a sophisticated therapy in implantology. Modern CAD-CAM technologies lead to revival of old and established augmentation techniques such as the use of titanium mesh (TM) for bone augmentation. The aim of this retrospective study was to evaluate the clinical outcome of an individualized CAD-CAM-produced TM based on the CT/DVT-DICOM data of the patients for the first time. In 17 patients, 21 different regions were augmented with an individualized CAD-CAM-produced TM (Yxoss CBR®, Filderstadt, Germany). For the augmentation, a mixture of autologous bone and deproteinized bovine bone mineral (DBBM) or autologous bone alone was used. Reentry with explantation of the TM and simultaneous implantation of 44 implants were performed after 6 months. Preoperative and 6-month postoperative cone beam computed tomographies (CBCT) were performed to measure the gained bone height. The success rate for the bone grafting procedure was 100%. Thirty-three percent of cases presented an exposure of the TM during the healing period. However, premature removal of these exposed meshes was not necessary. Exposure rate in augmentations performed with mid-crestal incisions was higher than in augmentations performed with a modified poncho incision (45.5 vs. 20%, p = 0.221). In addition, exposure rates in the maxilla were significantly higher than in the mandible (66.7 vs. 8.3%, p = 0.009). Gender, smoking, periodontal disease, gingiva type, used augmentation material, and used membrane had no significant influence on the exposure rate (p > 0.05). The mean vertical augmentation was 6.5 ± 1.7 mm, and the mean horizontal augmentation was 5.5 ± 1.9 mm. Implant survival rate after a mean follow-up of 12 ± 6 months after reentry was 100%. Within the limits of the retrospective character of this study, this study shows for the first time that individualized CAD-CAM TM provide a sufficient and safe augmentation technique, especially for vertical and combined defects. However, the soft tissue handling for sufficient mesh covering remains one of the most critical steps using this technique.

Balloon-augmented Onyx embolization of cerebral arteriovenous malformations using a dual-lumen balloon: a multicenter experience.

PubMed

Spiotta, Alejandro M; James, Robert F; Lowe, Stephen R; Vargas, Jan; Turk, Aquilla S; Chaudry, M Imran; Bhalla, Tarun; Janjua, Rashid M; Delaney, John J; Quintero-Wolfe, Stacey; Turner, Raymond D

2015-10-01

Conventional Onyx embolization of cerebral arteriovenous malformations (AVMs) requires lengthy procedure and fluoroscopy times to form an adequate 'proximal plug' which allows forward nidal penetration while preventing reflux and non-targeted embolization. We review our experience with balloon-augmented Onyx embolization of cerebral AVMs using a dual-lumen balloon catheter technique designed to minimize these challenges. Retrospectively acquired data for all balloon-augmented cerebral AVM embolizations performed between 2011 and 2014 were obtained from four tertiary care centers. For each procedure, at least one Scepter C balloon catheter was advanced into the AVM arterial pedicle of interest and Onyx embolization was performed through the inner lumen after balloon inflation via the outer lumen. Twenty patients underwent embolization with the balloon-augmented technique over 24 discreet treatment episodes. There were 37 total arterial pedicles embolized with the balloon-augmented technique, a mean of 1.9 per patient (range 1-5). The treated AVMs were heterogeneous in their location and size (mean 3.3±1.6 cm). Mean fluoroscopy time for each procedure was 48±26 min (28 min per embolized pedicle). Two Scepter C balloon catheter-related complications (8.3% of embolization sessions, 5.4% of pedicles embolized) were observed: an intraprocedural rupture of a feeding pedicle and fracture and retention of a catheter fragment. This multicenter experience represents the largest reported series of balloon-augmented Onyx embolization of cerebral AVMs. The technique appears safe and effective in the treatment of AVMs, allowing more efficient and controlled injection of Onyx with a decreased risk of reflux and decreased fluoroscopy times. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Indoor vs. Outdoor Depth Perception for Mobile Augmented Reality

DTIC Science & Technology

2009-03-01

International Symposium on Mixed and Augmented Reality, pages 77–86, Sept. 2008. [12] M. A. Livingston, J. E. Swan II, J. L. Gabbard , T. H. Höllerer, D. Hix...D. Brown, Y. Baillot, J. L. Gabbard , and D. Hix. A perceptual matching technique for depth judgments in optical, see-through augmented reality. In

Polymer-cement interactions towards improved wellbore cement fracture sealants

NASA Astrophysics Data System (ADS)

Beckingham, B. S.; Iloejesi, C.; Minkler, M. J.; Schindler, A. K.; Beckingham, L. E.

2017-12-01

Carbon capture, utilization, and storage (CCUS) in deep geologic formations is a promising means of reducing point source emissions of CO2. In these systems, CO2 is captured at the source and then injected to be utilized (eg. in enhanced oil recovery or as a working fluid in enhanced geothermal energy plants) or stored in geologic formations such as depleted oil and gas reservoirs or saline aquifers. While CCUS in subsurface systems could aid in reducing atmospheric CO2 emissions, the potential for CO2 leakage from these systems to overlying formations remains a major limitation and poses a significant risk to the security of injected CO2. Thus, improved materials for both initial wellbore isolation and repairing leakage pathways that develop over time are sought. One approach for the repair of cement fractures in wellbore (and other) systems is the injection of polymer materials into the fracture with a subsequent environmentally dependent (temperature, pressure, pH, etc.) densification or solidification. Here, we aim to investigate novel polymer materials for use to repair leaking wellbores in the context of CCUS. We synthesize and fully characterize a series of novel polymer materials and utilize a suite of analysis techniques to examine polymer-cement interactions at a range of conditions (namely temperature, pressure and pH). Initial findings will be leveraged to design novel polymer materials for further evaluation in polymer-cement composite cores, cement fracture healing, and the aging behavior of healed cements.

Coblation vertebroplasty for complex vertebral insufficiency fractures.

PubMed

Wilson, David J; Owen, Sara; Corkill, Rufus A

2013-07-01

Coblation to create a cavity in the affected vertebral body was performed for complex fractures and/or when there was a posterior wall defect. This permitted a low-pressure injection and potentially reduces the risk of extravasation of cement into the spinal canal. Prospective audit for outcome measures and complications allowed retrospective review of cases treated by coblation. A commercial wand inserted via a wide-bore vertebroplasty needle created a cavity before inserting cement. A visual analogue scale assessed pain and Roland Morris scoring assessed mobility. Thirty-two coblation procedures were performed. Primary diagnoses were myeloma, metastases, osteoporosis and trauma. Outcome measures were recorded with a 56 % success rate, 6 % no change and 32 % with mixed but mainly positive results; 6 % died before follow-up. No complications were observed; in particular no patient suffered neurological damage and none have developed subsequent fractures at the treated levels. This technique makes possible cementation of patients who would otherwise be unsuitable for vertebroplasty. The modest pain and disability improvement is partly due to our stringent criteria as well as fracture complexity. Further work will assess the efficacy of the method compared with conservative measures. • Treatment of vertebral compression fractures with possible posterior wall defects is controversial. • Coblation before vertebroplasty allows a low-pressure injection into fractured vertebrae. • This technique reduces risk of extravasation of cement. • No serious complication of our coblation procedures was observed.

A small punch test technique for characterizing the elastic modulus and fracture behavior of PMMA bone cement used in total joint replacement.

PubMed

Giddings, V L; Kurtz, S M; Jewett, C W; Foulds, J R; Edidin, A A

2001-07-01

Polymethylmethacrylate (PMMA) bone cement is used in total joint replacements to anchor implants to the underlying bone. Establishing and maintaining the integrity of bone cement is thus of critical importance to the long-term outcome of joint replacement surgery. The goal of the present study was to evaluate the suitability of a novel testing technique, the small punch or miniaturized disk bend test, to characterize the elastic modulus and fracture behavior of PMMA. We investigated the hypothesis that the crack initiation behavior of PMMA during the small punch test was sensitive to the test temperature. Miniature disk-shaped specimens, 0.5 mm thick and 6.4 mm in diameter, were prepared from PMMA and Simplex-P bone cement according to manufacturers' instructions. Testing was conducted at ambient and body temperatures, and the effect of test temperature on the elastic modulus and fracture behavior was statistically evaluated using analysis of variance. For both PMMA materials, the test temperature had a significant effect on elastic modulus and crack initiation behavior. At body temperature, the specimens exhibited "ductile" crack initiation, whereas at room temperature "brittle" crack initiation was observed. The small punch test was found to be a sensitive and repeatable test method for evaluating the mechanical behavior of PMMA. In light of the results of this study, future small punch testing should be conducted at body temperature.

Long palatal connective tissue rolled pedicle graft with demineralized freeze-dried bone allograft plus platelet-rich fibrin combination: A novel technique for ridge augmentation - Three case reports

PubMed Central

Reddy, Pathakota Krishnajaneya; Bolla, Vijayalakshmi; Koppolu, Pradeep; Srujan, Peruka

2015-01-01

Replacement of missing maxillary anterior tooth with localized residual alveolar ridge defect is challenging, considering the high esthetic demand. Various soft and hard tissue procedures were proposed to correct alveolar ridge deformities. Novel techniques have evolved in treating these ridge defects to improve function and esthetics. In the present case reports, a novel technique using long palatal connective tissue rolled pedicle graft with demineralized freeze-dried bone allografts (DFDBAs) plus Platelet-rich fibrin (PRF) combination was proposed to correct the Class III localized anterior maxillary anterior alveolar ridge defect. The present technique resulted in predictable ridge augmentation, which can be attributed to the soft and hard tissue augmentation with a connective tissue pedicle and DFDBA plus PRF combination. This technique suggests a variation in roll technique with DFDBA plus PRF and appears to promise in gaining predictable volume in the residual ridge defect and can be considered for the treatment of moderate to severe maxillary anterior ridge defects. PMID:26015679

Achieving a predictable 24-hour return to normal activities after breast augmentation: part II. Patient preparation, refined surgical techniques, and instrumentation.

PubMed

Tebbetts, John B

2006-12-01

The goal of this study was to develop practices that would allow patients undergoing subpectoral augmentation to predictably return to full normal activities within 24 hours after the operation, free of postoperative adjuncts. Part I of this study used motion and time study principles to reduce operative times, medication dosages, perioperative morbidity, and recovery times in augmentation mammaplasty. Part II of the study focuses on details of patient education, preoperative planning, instrumentation, and surgical technique modifications that were identified, modified, and implemented to achieve the results reported in part I. Two groups of 16 patients each (groups 1 and 2) were studied retrospectively for comparison to a third group of 627 patients (group 3) studied prospectively. Patients in group 1 had axillary partial retropectoral breast augmentations in 1982-1983, using dissociative anesthesia, blunt instrument implant pocket dissection, and Dow Corning, double-lumen implants containing 20 mg of methylprednisolone and 20 cc of saline in the outer lumen of the implants. Patients in group 2 (1990) had inframammary, retromammary augmentations by using a combination of blunt and electrocautery dissection, Surgitek Replicon polyurethane-covered, silicone gel-filled implants, and general endotracheal anesthesia. Patients in group 3 (1998 to 2001, n = 627) had inframammary partial retropectoral, inframammary retromammary, and axillary partial retropectoral augmentations under general endotracheal anesthesia. Refined practices and surgical techniques from studies of groups 1 and 2 were applied in group 3. Videotapes from operative procedures of groups 1 and 2 were analyzed with macromotion and micromotion study principles, and tables of events were formulated for each move during the operation for all personnel in the operating room. Extensive details of surgical technique were examined and reexamined in 13 different stages by using principles of motion and time studies described in part I of this study to maximize efficiency without any change in quality. Unnecessary or unproductive motions and techniques were progressively eliminated, and essential, productive techniques were streamlined to eliminate wasted time and motion. Instrumentation and surgical techniques were evaluated in detail and modified to minimize bleeding and tissue trauma. Detailed data were presented in part I of this study that document shorter operative times, recovery times, time to discharge home, and time to return to normal activities. This part focuses on the patient education, preoperative planning, instrumentation, and surgical technique changes that were implemented on the basis of the findings in part I of the study. More extensive patient information integrated with staged informed consent resulted in a more in formed and confident patient. Applying motion and time study principles to analysis and refinement of instrumentation and surgical techniques resulted in a substantial reduction in perioperative morbidity and a simpler, shorter 24-hour return to full normal activity for 96 percent of the patients undergoing breast augmentation in group 3 compared with groups 1 and 2. More than 96 percent of patients in group 3 were able to return to normal activities, lift their arms above their heads, lift normal-weight objects, and drive their car within 24 hours after their partial retropectoral breast augmentation. Patient education, preoperative planning, instrumentation, and surgical technique modifications based on motion and time study video analyses reduced surgical trauma and bleeding, reduced perioperative morbidity, and allowed 96 percent of 627 breast augmentation patients in group 3 a predictable return to full, normal activity in 24 hours or less. Specific surgical factors that contributed to these results included (1) prospective hemostasis techniques with a zero tolerance for even the smallest amount of bleeding, (2) strict "no-touch" techniques for periosteum and perichondrium, (3) eliminating all blunt dissection, (4) performing all dissection under direct vision, (5) modified and simplified instrumentation, and (6) optimal use of muscle relaxants during subpectoral dissection.

Achieving a predictable 24-hour return to normal activities after breast augmentation: Part II. Patient preparation, refined surgical techniques, and instrumentation.

PubMed

Tebbetts, John B

2002-01-01

The goal of this study was to develop practices that would allow patients undergoing subpectoral augmentation to predictably return to full normal activities within 24 hours after the operation, free of postoperative adjuncts. Part I of this study used motion and time study principles to reduce operative times, medication dosages, perioperative morbidity, and recovery times in augmentation mammaplasty. Part II of the study focuses on details of patient education, preoperative planning, instrumentation, and surgical technique modifications that were identified, modified, and implemented to achieve the results reported in part I. Two groups of 16 patients each (groups 1 and 2) were studied retrospectively for comparison to a third group of 627 patients (group 3) studied prospectively. Patients in group 1 had axillary partial retropectoral breast augmentations in 1982-1983, using dissociative anesthesia, blunt instrument implant pocket dissection, and Dow Corning, double-lumen implants containing 20 mg of methylprednisolone and 20 cc of saline in the outer lumen of the implants. Patients in group 2 (1990) had inframammary, retromammary augmentations by using a combination of blunt and electrocautery dissection, Surgitek Replicon polyurethane-covered, silicone gel-filled implants, and general endotracheal anesthesia. Patients in group 3 (1998 to 2001, n = 627) had inframammary partial retropectoral, inframammary retromammary, and axillary partial retropectoral augmentations under general endotracheal anesthesia. Refined practices and surgical techniques from studies of groups 1 and 2 were applied in group 3. Videotapes from operative procedures of groups 1 and 2 were analyzed with macromotion and micromotion study principles, and tables of events were formulated for each move during the operation for all personnel in the operating room. Extensive details of surgical technique were examined and reexamined in 13 different stages by using principles of motion and time studies described in part I of this study to maximize efficiency without any change in quality. Unnecessary or unproductive motions and techniques were progressively eliminated, and essential, productive techniques were streamlined to eliminate wasted time and motion. Instrumentation and surgical techniques were evaluated in detail and modified to minimize bleeding and tissue trauma. Detailed data were presented in part I of this study that document shorter operative times, recovery times, time to discharge home, and time to return to normal activities. This part focuses on the patient education, preoperative planning, instrumentation, and surgical technique changes that were implemented on the basis of the findings in part I of the study. More extensive patient information integrated with staged informed consent resulted in a more informed and confident patient. Applying motion and time study principles to analysis and refinement of instrumentation and surgical techniques resulted in a substantial reduction in perioperative morbidity and a simpler, shorter 24-hour return to full normal activity for 96 percent of the patients undergoing breast augmentation in group 3 compared with groups 1 and 2. More than 96 percent of patients in group 3 were able to return to normal activities, lift their arms above their heads, lift normal-weight objects, and drive their car within 24 hours after their partial retropectoral breast augmentation. Patient education, preoperative planning, instrumentation, and surgical technique modifications based on motion and time study video analyses reduced surgical trauma and bleeding, reduced perioperative morbidity, and allowed 96 percent of 627 breast augmentation patients in group 3 a predictable return to full, normal activity in 24 hours or less. Specific surgical factors that contributed to these results included (1) prospective hemostasis techniques with a zero tolerance for even the smallest amount of bleeding, (2) strict "no-touch" techniques for periosteum and perichondrium, (3) eliminating all blunt dissection, (4) performing all dissection under direct vision, (5) modified and simplified instrumentation, and (6) optimal use of muscle relaxants during subpectoral dissection.

Marginal and internal fit of cobalt-chromium copings fabricated using the conventional and the direct metal laser sintering techniques: A comparative in vitro study.

PubMed

Ullattuthodi, Sujana; Cherian, Kandathil Phillip; Anandkumar, R; Nambiar, M Sreedevi

2017-01-01

This in vitro study seeks to evaluate and compare the marginal and internal fit of cobalt-chromium copings fabricated using the conventional and direct metal laser sintering (DMLS) techniques. A master model of a prepared molar tooth was made using cobalt-chromium alloy. Silicone impression of the master model was made and thirty standardized working models were then produced; twenty working models for conventional lost-wax technique and ten working models for DMLS technique. A total of twenty metal copings were fabricated using two different production techniques: conventional lost-wax method and DMLS; ten samples in each group. The conventional and DMLS copings were cemented to the working models using glass ionomer cement. Marginal gap of the copings were measured at predetermined four points. The die with the cemented copings are standardized-sectioned with a heavy duty lathe. Then, each sectioned samples were analyzed for the internal gap between the die and the metal coping using a metallurgical microscope. Digital photographs were taken at ×50 magnification and analyzed using measurement software. Statistical analysis was done by unpaired t -test and analysis of variance (ANOVA). The results of this study reveal that no significant difference was present in the marginal gap of conventional and DMLS copings ( P > 0.05) by means of ANOVA. The mean values of internal gap of DMLS copings were significantly greater than that of conventional copings ( P < 0.05). Within the limitations of this in vitro study, it was concluded that the internal fit of conventional copings was superior to that of the DMLS copings. Marginal fit of the copings fabricated by two different techniques had no significant difference.

Internal coating of zirconia restoration with silica-based ceramic improves bonding of resin cement to dental zirconia ceramic.

PubMed

Kitayama, Shuzo; Nikaido, Toru; Ikeda, Masaomi; Alireza, Sadr; Miura, Hiroyuki; Tagami, Junji

2010-01-01

Resin bonding to zirconia ceramic cannot be established by standard methods that are utilized for conventional silica-based dental ceramics. This study was aimed to examine the tensile bond strength of resin cement to zirconia ceramic using a new laboratory technique. Sixty-four zirconia ceramic specimens were air-abraded using Al2O3 particles and divided into two groups; the control group with no pretreatment (Control), and the group pretreated using the internal coating technique (INT), in which the surface of the zirconia specimens were thinly coated by fusing silica-based ceramic and air-abraded in the same manner. The specimens in each group were further divided into two subgroups according to the silane coupling agents applied; a mixture of dentin primer/silane coupling agent (Clearfil SE Bond Primer/Porcelain Bond Activator) or a newly developed single-component silane coupling agent (Clearfil Ceramic Primer). After bonding with dual-cured resin cement (Panavia F 2.0), they were stored in water for 24 h and half of them were additionally subjected to thermal cycling. The tensile bond strengths were tested using a universal testing machine. ANOVAs revealed significant influence of ceramic surface pretreatment (p<0.001), silane coupling agent (p<0.001) and thermal cycling (p<0.001); the INT coating technique significantly increased the bond strengths of resin cement to zirconia ceramic, whereas thermal cycling significantly decreased the bond strengths. The use of a single-component silane coupling agent demonstrated significantly higher bond strengths than that of a mixture of dentin primer/silane coupling agent. The internal coating of zirconia dental restorations with silica-based ceramic followed by silanization may be indicated in order to achieve better bonding for the clinical success.

Dental cementum in age estimation: a polarized light and stereomicroscopic study.

PubMed

Kasetty, Sowmya; Rammanohar, M; Raju Ragavendra, T

2010-05-01

Dental hard tissues are good candidates for age estimation as they are less destructive and procedures to determine age can be easily performed. Although cementum annulations and cementum thickness are important parameters in this regard, they are seldom used. This study was undertaken to review the methods, difficulties in execution of techniques, and accuracy of cementum thickness and annulations in estimating the age. Unstained and stained ground sections of tooth were used to measure cemental thickness and count cemental annulations based on which age was estimated and was compared with known age. Although there was positive relation between cemental thickness and annulations with age, only in 1-1.5% of cases, age could be predicted with accuracy.

Vertical marginal discrepancy of ceramic copings with different ceramic materials, finish lines, and luting agents: an in vitro evaluation.

PubMed

Quintas, Adriana Ferreira; Oliveira, Fabiano; Bottino, Marco Antonio

2004-09-01

Prosthetic restorations that fit poorly may affect periodontal health and occlusion. Studies that have evaluated the accuracy of fit of ceramic restorations before and after cementation assessed primarily intracoronal restorations. This in vitro study evaluated the effect of different finish lines, ceramic manufacturing techniques, and luting agents on the vertical discrepancy of ceramic copings. Two stainless steel molars were prepared for complete crowns with 2 different finish lines (heavy chamfer and rounded shoulder); each molar was duplicated to fabricate 90 copings. A total of 180 copings generated 18 groups (n=10 for each finish line-coping material-luting agent combination). Luting agents tested included zinc phosphate, resin-modified glass ionomer (Fuji Plus), and resin composite cements (Panavia F). A metal frame was developed on which to screw the stainless steel model and a ceramic coping; the distance (microm) between 2 predetermined points was measured before and after cementation by a profile projector under a torquing force. A 4-way ANOVA with repeated measurements was performed to assess the influence of each factor in the vertical marginal discrepancy: 3 between-coping factors (finish line-coping material-luting agent) and 1 within-coping factor (before and after cementation) (alpha=.05). Procera copings presented the lowest mean values ( P <.05) of vertical marginal discrepancy before and after cementation (25/44 microm) when compared to Empress 2 (68/110 microm) and InCeram Alumina copings (57/117 microm), regardless of any combinations among all finish lines and luting agents tested. Considering each factor separately, the ceramic manufacturing technique appeared to be the most important factor tested for the definitive vertical discrepancy of all-ceramic copings, with lower mean values for Procera copings.

Pilot-optimal augmentation synthesis

NASA Technical Reports Server (NTRS)

Schmidt, D. K.

1978-01-01

An augmentation synthesis method usable in the absence of quantitative handling qualities specifications, and yet explicitly including design objectives based on pilot-rating concepts, is presented. The algorithm involves the unique approach of simultaneously solving for the stability augmentation system (SAS) gains, pilot equalization and pilot rating prediction via optimal control techniques. Simultaneous solution is required in this case since the pilot model (gains, etc.) depends upon the augmented plant dynamics, and the augmentation is obviously not a priori known. Another special feature is the use of the pilot's objective function (from which the pilot model evolves) to design the SAS.

Percutaneous Vertebroplasty and Bone Cement Leakage: Clinical Experience with a New High-Viscosity Bone Cement and Delivery System for Vertebral Augmentation in Benign and Malignant Compression Fractures

DOE Office of Scientific and Technical Information (OSTI.GOV)

Anselmetti, Giovanni Carlo, E-mail: giovanni.anselmetti@ircc.i; Zoarski, Gregg; Manca, Antonio

The aim of this study was to assess the feasibility of and venous leakage reduction in percutaneous vertebroplasty (PV) using a new high-viscosity bone cement (PMMA). PV has been used effectively for pain relief in osteoporotic and malignant vertebral fractures. Cement extrusion is a common problem and can lead to complications. Sixty patients (52 female; mean age, 72.2 {+-} 7.2) suffering from osteoporosis (46), malignancy (12), and angiomas (2), divided into two groups (A and B), underwent PV on 190 vertebrae (86 dorsal, 104 lumbar). In Group A, PV with high-viscosity PMMA (Confidence, Disc-O-Tech, Israel) was used. This PMMA wasmore » injected by a proprietary delivery system, a hydraulic saline-filled screw injector. In Group B, a standard low-viscosity PMMA was used. Postprocedural CT was carried out to detect PMMA leakages and complications. Fisher's exact test and Wilcoxon rank test were used to assess significant differences (p < 0.05) in leakages and to evaluate the clinical outcome. PV was feasible, achieving good clinical outcome (p < 0.0001) without major complications. In Group A, postprocedural CT showed an asymptomatic leak in the venous structures of 8 of 98 (8.2%) treated vertebrae; a discoidal leak occurred in 6 of 98 (6.1%). In Group B, a venous leak was seen in 38 of 92 (41.3%) and a discoidal leak in 12 of 92 (13.0%). Reduction of venous leak obtained by high-viscosity PMMA was highly significant (p < 0.0001), whereas this result was not significant (p = 0.14) related to the disc. The high-viscosity PMMA system is safe and effective for clinical use, allowing a significant reduction of extravasation rate and, thus, leakage-related complications.« less

Modification of conventional glass-ionomer cements with N-vinylpyrrolidone containing polyacids, nano-hydroxy and fluoroapatite to improve mechanical properties.

PubMed

Moshaverinia, Alireza; Ansari, Sahar; Movasaghi, Zanyar; Billington, Richard W; Darr, Jawwad A; Rehman, Ihtesham U

2008-10-01

The objective of this study was to enhance the mechanical strength of glass-ionomer cements, while preserving their unique clinical properties. Copolymers incorporating several different segments including N-vinylpyrrolidone (NVP) in different molar ratios were synthesized. The synthesized polymers were copolymers of acrylic acid and NVP with side chains containing itaconic acid. In addition, nano-hydroxyapatite and fluoroapatite were synthesized using an ethanol-based sol-gel technique. The synthesized polymers were used in glass-ionomer cement formulations (Fuji II commercial GIC) and the synthesized nanoceramic particles (nano-hydroxy or fluoroapatite) were also incorporated into commercial glass-ionomer powder, respectively. The synthesized materials were characterized using FTIR and Raman spectroscopy and scanning electron microscopy. Compressive, diametral tensile and biaxial flexural strengths of the modified glass-ionomer cements were evaluated. After 24h setting, the NVP modified glass-ionomer cements exhibited higher compressive strength (163-167 MPa), higher diametral tensile strength (DTS) (13-17 MPa) and much higher biaxial flexural strength (23-26 MPa) in comparison to Fuji II GIC (160 MPa in CS, 12MPa in DTS and 15 MPa in biaxial flexural strength). The nano-hydroxyapatite/fluoroapatite added cements also exhibited higher CS (177-179 MPa), higher DTS (19-20 MPa) and much higher biaxial flexural strength (28-30 MPa) as compared to the control group. The highest values for CS, DTS and BFS were found for NVP-nanoceramic powder modified cements (184 MPa for CS, 22 MPa for DTS and 33 MPa for BFS) which were statistically higher than control group. It was concluded that, both NVP modified and nano-HA/FA added glass-ionomer cements are promising restorative dental materials with improved mechanical properties.

Cement Thickness of Inlay Restorations Made of Lithium Disilicate, Polymer-Infiltrated Ceramic and Nano-Ceramic CAD/CAM Materials Evaluated Using 3D X-Ray Micro-Computed Tomography.

PubMed

Uzgur, Recep; Ercan, Ertuğrul; Uzgur, Zeynep; Çolak, Hakan; Yalçın, Muhammet; Özcan, Mutlu

2016-08-12

To evaluate the marginal and internal cement thicknesses of inlay restorations made of various CAD/CAM materials using 3D X-ray micro-computed tomography (micro-CT) technique. Caries-free extracted mandibular molars (N = 30) with similar size were randomly assigned to three groups (N = 10 per group). Mesio-occlusal-distal (MOD) cavities were prepared, and inlay restorations were obtained by milling out CAD/CAM materials namely, (a) IPS: monolithic lithium disilicate (control), (b) VE: polymer-infiltrated ceramic, and (c) CS: nano-ceramic using a CAM unit. Marginal and internal cement thicknesses were measured using 3D micro-CT. Data were analyzed using 1-way ANOVA and Tukey's tests (alpha = 0.05). The mean marginal and internal cement thickness were not significant in all inlay materials (p > 0.05). Mean marginal cement thickness (μm) was the lowest for the IPS group (67.54 ± 10.16) followed by VE (84.09 ± 3.94) and CS (95.18 ± 10.58) (p > 0.05). The internal cement thickness (μm) was the lowest in the CS group (54.85 ± 6.94) followed by IPS (60.58 ± 9.22) and VE (77.53 ± 12.13) (p > 0.05). Marginal and internal cement thicknesses of MOD inlays made of monolithic lithium disilicate, polymer-infiltrated ceramic, and nano-ceramic CAD/CAM materials were similar and all less than 100 μm, which could be considered clinically acceptable. MOD inlays made of different CAD/CAM materials presented similar cement thickness, less than 100 μm. © 2016 by the American College of Prosthodontists.

Predictive validity of preoperative CT scans and the risk of pedicle screw loosening in spinal surgery.

PubMed

Bredow, Jan; Boese, C K; Werner, C M L; Siewe, J; Löhrer, L; Zarghooni, K; Eysel, P; Scheyerer, M J

2016-08-01

Pedicle screw fixation is the standard technique for the stabilization of the spine, a clinically relevant complication of which is screw loosening. This retrospective study investigates whether preoperative CT scanning can offer a predictor of screw loosening. CT-scan attenuation in 365 patients was evaluated to determine the mean bone density of each vertebral body. Screw loosening or dislocation was determined in CT scans postoperatively using the standard radiological criteria. Forty-five of 365 patients (12.3 %; 24 male, 21 female) suffered postoperative screw loosening (62 of 2038 screws) over a mean follow-up time of 50.8 months. Revision surgeries were necessary in 23 patients (6.3 %). The correlation between decreasing mean CT attenuation in Hounsfield Units (HU) and increasing patient age was significant (p < 0.001). Mean bone density was 116.3 (SD 53.5) HU in cases with screw loosening and 132.7 (SD 41.3) HU in cases in which screws remained fixed. The difference was statistically significant (p = 0.003). The determination of bone density with preoperative CT scanning can predict the risk of screw loosening and inform the decision to use cement augmentation to reduce the incidence of screw loosening.

Augmented reality and image overlay navigation with OsiriX in laparoscopic and robotic surgery: not only a matter of fashion.

PubMed

Volonté, Francesco; Pugin, François; Bucher, Pascal; Sugimoto, Maki; Ratib, Osman; Morel, Philippe

2011-07-01

New technologies can considerably improve preoperative planning, enhance the surgeon's skill and simplify the approach to complex procedures. Augmented reality techniques, robot assisted operations and computer assisted navigation tools will become increasingly important in surgery and in residents' education. We obtained 3D reconstructions from simple spiral computed tomography (CT) slides using OsiriX, an open source processing software package dedicated to DICOM images. These images were then projected on the patient's body with a beamer fixed to the operating table to enhance spatial perception during surgical intervention (augmented reality). Changing a window's deepness level allowed the surgeon to navigate through the patient's anatomy, highlighting regions of interest and marked pathologies. We used image overlay navigation for laparoscopic operations such cholecystectomy, abdominal exploration, distal pancreas resection and robotic liver resection. Augmented reality techniques will transform the behaviour of surgeons, making surgical interventions easier, faster and probably safer. These new techniques will also renew methods of surgical teaching, facilitating transmission of knowledge and skill to young surgeons.

"Spiral-Cap" ileocystoplasty for bladder augmentation and ureteric reimplant.

PubMed

Sawant, S Ajit; Tamhankar, Ashwin Sunil; Kumar, Vikash; Prakash, W Pawar; Gaurav, V Kasat; Bansal, Sumit

2016-01-01

To demonstrate the new technique of Spiral-cap ileocystoplasty for bladder augmentation and simultaneous ureteric reimplant. Seven patients with small capacity bladder and simultaneous lower ureteric involvement operated in single tertiary care institute over the last 5 years were included in this study. Spiral-cap ileocystoplasty was used in all the patients for bladder augmentation. Proximal part of the same ileal loop was used in isoperistaltic manner for ureteric reimplantation. Distal end of this ileal loop was intussuscepted into the pouch to decrease the incidence of reflux. Detubularized distal portion of the loop was reconfigured in spiral manner to augment the native bladder. Patients were analyzed for upper tract changes, serum creatinine, bladder capacity, and requirement of clean intermittent self-catheterization in follow-up over 5 years. There was no evidence of any urinary or bowel leak in the postoperative period. Recovery was equivalent with those treated with other methods of bladder augmentation. Follow-up ultrasonography showed good capacity bladder. Upper tracts were well preserved in follow-up. Urinary bladder and lower ureter pathologies were addressed simultaneously. Spiral-cap ileocystoplasty is a useful technique in patients who require simultaneous bladder augmentation and ureteric reimplant.

Towards Pervasive Augmented Reality: Context-Awareness in Augmented Reality.

PubMed

Grubert, Jens; Langlotz, Tobias; Zollmann, Stefanie; Regenbrecht, Holger

2017-06-01

Augmented Reality is a technique that enables users to interact with their physical environment through the overlay of digital information. While being researched for decades, more recently, Augmented Reality moved out of the research labs and into the field. While most of the applications are used sporadically and for one particular task only, current and future scenarios will provide a continuous and multi-purpose user experience. Therefore, in this paper, we present the concept of Pervasive Augmented Reality, aiming to provide such an experience by sensing the user's current context and adapting the AR system based on the changing requirements and constraints. We present a taxonomy for Pervasive Augmented Reality and context-aware Augmented Reality, which classifies context sources and context targets relevant for implementing such a context-aware, continuous Augmented Reality experience. We further summarize existing approaches that contribute towards Pervasive Augmented Reality. Based our taxonomy and survey, we identify challenges for future research directions in Pervasive Augmented Reality.

Calcium-enriched mixture cement as artificial apical barrier: A case series

PubMed Central

Nosrat, Ali; Asgary, Saeed; Eghbal, Mohammad Jafar; Ghoddusi, Jamileh; Bayat-Movahed, Saeed

2011-01-01

In comparison to the conventional apexification using calcium hydroxide, artificial apical barrier technique is more valuable and less time consuming. This article describes successful use of calcium-enriched mixture (CEM) cement as an artificial apical barrier in open apices. In this study, 13 single-rooted teeth with necrotic pulps and open apices were treated non-surgically. After copious irrigation of the root canals with NaOCl 5.25% and gentle filing, based on need for interappointment dressing, treatments were followed by CEM cement (BioniqueDent, Tehran, Iran) apical plug insertion in the first or second appointment. All cases were then permanently restored. All subjects were followed until radiographic evidence of periradicular healing was seen (mean 14.5 months). Clinically, all cases were functional and asymptomatic and complete osseous healing was observed in all the teeth. Considering the biological properties of CEM cement, this new endodontic biomaterial might be appropriate to be used as artificial apical barrier in the open apex teeth. PMID:22144818

New Amphiphilic Composite for Preparing Efficient Coated Potassium-Fertilizers for Top-Dressing Fertilization of Annual Crops.

PubMed

Urrutia, Oscar; Erro, Javier; Zabini, Andre; Hoshiba, Kent; Blandin, Anne F; Baigorri, Roberto; Martín-Pastor, Manuel; Alis, Yves; Yvin, Jean C; García-Mina, José M

2018-05-16

This study describes the efficiency of a new coating material for preparing granulated potassium-fertilizers with a potassium release to the soil solution sensitive to rainfall intensity. The composite is prepared by reaction of an alkyd-resin with cement in the absence of water. The complementary use of diverse analytical techniques showed that the presence of the cement fraction induced alkyd resin reticulation and gradual cement-resin hardening. Scanning electron microscopy revealed the formation of micro and nanopores within cement-clusters, whose water permeability is affected by the resin reticulation and amphiphilic character. Potassium release was evaluated in water, soil-columns, and in soil-plant trials in pots and open-field. Agronomic results were consistent with potassium release rates obtained in water solution and soil columns. The composite-coated potassium fertilizer was more efficient than the noncoated one in providing plant available potassium, with this effect being dependent on water presence in soil.

Energy efficiency technologies in cement and steel industry

NASA Astrophysics Data System (ADS)

Zanoli, Silvia Maria; Cocchioni, Francesco; Pepe, Crescenzo

2018-02-01

In this paper, Advanced Process Control strategies aimed at energy efficiency achievement and improvement in cement and steel industry are proposed. A flexible and smart control structure constituted by several functional modules and blocks has been developed. The designed control strategy is based on Model Predictive Control techniques, formulated on linear models. Two industrial control solutions have been developed, oriented to energy efficiency and process control improvement in cement industry clinker rotary kilns (clinker production phase) and in steel industry billets reheating furnaces. Tailored customization procedures for the design of ad hoc control systems have been executed, based on the specific needs and specifications of the analysed processes. The installation of the developed controllers on cement and steel plants produced significant benefits in terms of process control which resulted in working closer to the imposed operating limits. With respect to the previous control systems, based on local controllers and/or operators manual conduction, more profitable configurations of the crucial process variables have been provided.

Frictional Performance Assessment of Cemented Carbide Surfaces Textured by Laser

NASA Astrophysics Data System (ADS)

Fang, S.; Llanes, L.; Klein, S.; Gachot, C.; Rosenkranz, A.; Bähre, D.; Mücklich, F.

2017-10-01

Cemented carbides are advanced engineering materials often used in industry for manufacturing cutting tools or supporting parts in tribological system. In order to improve service life, special attention has been paid to change surface conditions by means of different methods, since surface modification can be beneficial to reduce the friction between the contact surfaces as well as to avoid unintended damage. Laser surface texturing is one of the newly developed surface modification methods. It has been successfully introduced to fabricate some basic patterns on cemented carbide surfaces. In this work, Direct Laser Interference Patterning Technique (DLIP) is implemented to produce special line-like patterns on a cobalt (Co) and nickel (Ni) based cemented tungsten carbide grade. It is proven that the laser-produced patterns have high geometrical precision and quality stability. Furthermore, tribology testing using a nano-tribometer unit shows that friction is reduced by the line-like patterns, as compared to the polished one, under both lubricated and dry testing regimes, and the reduction is more pronounced in the latter case.

Comparison of the Effect of Dentin Bonding, Dentin Sealing Agents on the Microleakage of Provisional Crowns Fabricated with Direct and Indirect Technique-An Invitro Study

PubMed Central

Muthukumar, B; Kumar, M Vasantha

2015-01-01

Background Postoperative sensitivity after temporization is a common complaint in Fixed Partial Denture patients. It is caused by weak and ill fitting temporary restorations which results in microleakage. This can be controlled by providing good temporary restorations and by coating the exposed dentinal tubules of the prepared tooth with dentin bonding agent or dental varnish. Aim The purpose of the study was to determine the effect of dentin-bonding, dentin sealing agents on the microleakage of temporary crowns made by tooth colored auto polymerizing resin fabricated with direct and indirect technique. Materials and Methods Thirty premolar and molar human teeth were collected which were extracted recently was used for the study. The teeth were marked and divided into 3 groups each containing 10 nos. They were individually mounted with self-cure acrylic resin. It was then mounted on a milling machine and crown preparations done. Temporary crowns were fabricated by direct and indirect method with two types of materials. In group A (Control group), the temporary crowns fabricated with both direct and indirect method were cemented directly with temporary luting cement. In group B dentine-bonding agent (solobond M) was applied once to the prepared surface of each tooth specimen before the cementation of temporary crowns where as in case of group C a single layer of dental varnish is applied prior to crown cementation. The entire specimens were immersed in 1% methylene blue and allowed to undergo thermal treatment. It was then sectioned in a hard tissue microtome. Each section was evaluated for dye penetration into the dentin tubules by comparing it with a visual scale. Statistical Analysis SPSS Version 13 software was used for non-parametric data analysis by a qualified statistician. P-values less than 0.05 (p-value<0.05) were considered to be statistically significant. Results Group B (Dentin Bonding Agent) specimens cemented with crowns fabricated in direct technique showed the least amount of microleakage when compared with group A and group C. Group C (Dental Varnish) specimen showed comparatively more amount of microleakage than that of group B. Group A (control group) specimens showed the maximum amount of microleakage. Conclusion The application of a single layer of Dental varnish appears to be of no significant benefit when compared to crowns cemented with the application of Dentin bonding agent on the tooth surface. The application of a single layer of Dentin bonding agent (Solobond M) and temporary crowns fabricated with direct technique may be of some benefit for crown preparations as an interim measure prior to the luting of final crown. PMID:26266219

Annular Pulse Shaping Technique for Large-Diameter Kolsky Bar Experiments on Concrete

DTIC Science & Technology

2014-10-01

practiced by a number of Kolsky bar researchers on a variety of brittle materials such as glass , ceramics , and ceramic composites using relatively... glass under compression/shear loading: Experiments. J Am Ceram Soc 90:2556–2562 37. Nie X, Sanborn B, Weerasooriya T, Chen W (2012) Inertia effects in...is comprised of ASTM type I/II cement [2], Grade 120 Slag cement [5] and Class F fly ash [4]. The 1344 Exp Mech (2014) 54:1343–1354 Author’s personal

Knee arthrodesis in failed total knee arthroplasty with severe osteolysis and ipsilateral long-stem total hip arthroplasty.

PubMed

Sim, Jae Ang; Lee, Beom Koo; Kwak, Ji Hoon; Moon, Sung Hoon

2009-02-01

We report a case of knee fusion after a failed total knee arthroplasty (TKA) with severe osteolysis including the epicondyle and ipsilateral total hip arthroplasty (THA) with long Wagner revision stem (Sulzer Orthopedics, Baar, Switzerland). The conventional devices for arthrodesis were unavailable in this case because of the long Wagner revision stem and poor bone stock. A connector was made between the long Wagner revision stem and an intramedullary nail (IM nail; Solco, Seoul, Korea). The custom-made connector was coupled with a femoral stem by cylindrical taper fit with additional cement augmentation and an intramedullary nail by screws. Osseous fusion was achieved without pain or instability.

A long term study of fluoride release from metal-containing conventional and resin-modified glass-ionomer cements.

PubMed

Williams, J A; Billington, R W; Pearson, G J

2001-01-01

The objective of this study was to determine long term release of fluoride from a resin-modified glass-ionomer cement (RMGIC) (Fuji II LC (FLC)) compared with that from two conventional acid-base setting cements (HiDense (HD) and KetacSilver (KS)) marketed for similar restorative purposes. Fluoride release from discs of cement immersed in water or artificial saliva was measured for 2.7 years using an ion selective electrode technique. The RMGIC was affected by water if immersed immediately after setting. This is similar to conventional acid-base cements and the experimental method was designed to allow for this. Over the 2.7-year period, the RMGIC and HD released similar amounts of fluoride into both water and artificial saliva. In water, the RMGIC released the most fluoride, while in artificial saliva the highest release was from HD. KS released the least amount of fluoride in both immersing liquids. In artificial saliva, release was reduced to 17-25% of that found in water, with the RMGIC showing the greatest reduction. Both acid-base cured cements showed changes in colour over the 2.7-year span, while the colour of the RMGIC was stable. It was concluded that the RMGIC released equivalent or greater amounts of fluoride than the two acid-base cure glass-ionomers over a period of 2.7 years.

The Effect of Polymethyl Methacrylate Augmentation on the Primary Stability of Cannulated Bone Screws in an Anterolateral Plate in Osteoporotic Vertebrae: A Human Cadaver Study

PubMed Central

Rüger, Matthias; Sellei, Richard M.; Stoffel, Marcus; von Rüden, Christian

2015-01-01

Study Design Cohort study. Objective Expandable anterolateral plates facilitate the reduction of posttraumatic deformities of thoracolumbar spine injuries and are commonly used in cases of unstable injuries or compromised bone quality. In this in vitro study, the craniocaudal yield load of the osseous fixation of an anterior angular stable plate fixation system and the effect of polymethyl methacrylate (PMMA) screw augmentation on the primary stability of the screw–bone interface during kyphosis reduction was evaluated in 12 osteoporotic human thoracolumbar vertebrae. Methods The anterolateral stabilization device used for this study is comprised of two swiveling flanges and an expandable midsection. It facilitates the controlled reduction of kyphotic deformities in situ with a geared distractor. Single flanges were attached to 12 thoracolumbar vertebrae. Six specimens were augmented with PMMA by means of cannulated bone screws. The constructs were subjected to static, displacement-controlled craniocaudal loading to failure in a servohydraulic testing machine. Results The uncemented screws cut out at a mean 393 ± 66 N, whereas the cemented screws showed significantly higher yield load of 966 ± 166 N (p < 0.02). We detected no significant correlation between bone mineral density and yield load in this setting. Conclusion Our results indicate that PMMA augmentation is an effective method to increase two- to threefold the primary stability of the screw–bone interface of an anterolateral spine stabilization system in osteoporotic bone. We recommend it in cases of severely compromised bone quality to reduce the risk of screw loosening during initial kyphosis correction and to increase long-term construct stability. PMID:26835201

The Effect of Polymethyl Methacrylate Augmentation on the Primary Stability of Cannulated Bone Screws in an Anterolateral Plate in Osteoporotic Vertebrae: A Human Cadaver Study.

PubMed

Rüger, Matthias; Sellei, Richard M; Stoffel, Marcus; von Rüden, Christian

2016-02-01

Study Design Cohort study. Objective Expandable anterolateral plates facilitate the reduction of posttraumatic deformities of thoracolumbar spine injuries and are commonly used in cases of unstable injuries or compromised bone quality. In this in vitro study, the craniocaudal yield load of the osseous fixation of an anterior angular stable plate fixation system and the effect of polymethyl methacrylate (PMMA) screw augmentation on the primary stability of the screw-bone interface during kyphosis reduction was evaluated in 12 osteoporotic human thoracolumbar vertebrae. Methods The anterolateral stabilization device used for this study is comprised of two swiveling flanges and an expandable midsection. It facilitates the controlled reduction of kyphotic deformities in situ with a geared distractor. Single flanges were attached to 12 thoracolumbar vertebrae. Six specimens were augmented with PMMA by means of cannulated bone screws. The constructs were subjected to static, displacement-controlled craniocaudal loading to failure in a servohydraulic testing machine. Results The uncemented screws cut out at a mean 393 ± 66 N, whereas the cemented screws showed significantly higher yield load of 966 ± 166 N (p < 0.02). We detected no significant correlation between bone mineral density and yield load in this setting. Conclusion Our results indicate that PMMA augmentation is an effective method to increase two- to threefold the primary stability of the screw-bone interface of an anterolateral spine stabilization system in osteoporotic bone. We recommend it in cases of severely compromised bone quality to reduce the risk of screw loosening during initial kyphosis correction and to increase long-term construct stability.

A framework for breast cancer visualization using augmented reality x-ray vision technique in mobile technology

NASA Astrophysics Data System (ADS)

Rahman, Hameedur; Arshad, Haslina; Mahmud, Rozi; Mahayuddin, Zainal Rasyid

2017-10-01

Breast Cancer patients who require breast biopsy has increased over the past years. Augmented Reality guided core biopsy of breast has become the method of choice for researchers. However, this cancer visualization has limitations to the extent of superimposing the 3D imaging data only. In this paper, we are introducing an Augmented Reality visualization framework that enables breast cancer biopsy image guidance by using X-Ray vision technique on a mobile display. This framework consists of 4 phases where it initially acquires the image from CT/MRI and process the medical images into 3D slices, secondly it will purify these 3D grayscale slices into 3D breast tumor model using 3D modeling reconstruction technique. Further, in visualization processing this virtual 3D breast tumor model has been enhanced using X-ray vision technique to see through the skin of the phantom and the final composition of it is displayed on handheld device to optimize the accuracy of the visualization in six degree of freedom. The framework is perceived as an improved visualization experience because the Augmented Reality x-ray vision allowed direct understanding of the breast tumor beyond the visible surface and direct guidance towards accurate biopsy targets.

Improved image guidance technique for minimally invasive mitral valve repair using real-time tracked 3D ultrasound

NASA Astrophysics Data System (ADS)

Rankin, Adam; Moore, John; Bainbridge, Daniel; Peters, Terry

2016-03-01

In the past ten years, numerous new surgical and interventional techniques have been developed for treating heart valve disease without the need for cardiopulmonary bypass. Heart valve repair is now being performed in a blood-filled environment, reinforcing the need for accurate and intuitive imaging techniques. Previous work has demonstrated how augmenting ultrasound with virtual representations of specific anatomical landmarks can greatly simplify interventional navigation challenges and increase patient safety. These techniques often complicate interventions by requiring additional steps taken to manually define and initialize virtual models. Furthermore, overlaying virtual elements into real-time image data can also obstruct the view of salient image information. To address these limitations, a system was developed that uses real-time volumetric ultrasound alongside magnetically tracked tools presented in an augmented virtuality environment to provide a streamlined navigation guidance platform. In phantom studies simulating a beating-heart navigation task, procedure duration and tool path metrics have achieved comparable performance to previous work in augmented virtuality techniques, and considerable improvement over standard of care ultrasound guidance.

High proximal migration in cemented acetabular revisions operated with bone impaction grafting; 47 revision cups followed with RSA for 17 years.

PubMed

Mohaddes, Maziar; Herberts, Peter; Malchau, Henrik; Johanson, Per-Erik; Kärrholm, Johan

2017-05-12

Bone impaction grafting is a biologically and mechanically appealing option in acetabular revision surgery, allowing restitution of the bone stock and restoration of the biomechanics. We analysed differences in proximal migration of the revision acetabular components when bone impaction grafting is used together with a cemented or an uncemented cup. 43 patients (47 hips), revised due to acetabular loosening and judged to have less than 50% host bone-implant contact were included. The hips were randomised to either an uncemented (n = 20) or a cemented (n = 27) revision cup. Radiostereometry and radiography was performed postoperatively, at 3 and 6 months, 1, 2, 3, 5, 7, 10 and 13 and 17 years postoperatively. Clinical follow-up was performed at 1, 2 and 5 years postoperatively and thereafter at the same interval as in the radiographic follow-up. There were no differences in the base line demographic data between the 2 groups. At the last follow-up (17 years) 14 hips (10 cemented, 4 uncemented) had been re-revised due to loosening. 3 additional cups (1 uncemented and 2 cemented) were radiographically loose. There was a higher early proximal migration in the cemented cups. Cups operated on with cement showed a higher early migration measured with RSA and also a higher number of late revisions. The reason for this is not known, but factors such as inclusion of cases with severe bone defects, use of smaller bone chips and issues related to the impaction technique might have had various degrees of influence.

Cement-based piezoelectric ceramic composites for sensor applications in civil engineering

NASA Astrophysics Data System (ADS)

Dong, Biqin

The objectives of this thesis are to develop and apply a new smart composite for the sensing and actuation application of civil engineering. Piezoelectric ceramic powder is incorporated into cement-based composite to achieve the sensing and actuation capability. The research investigates microstructure, polarization and aging, material properties and performance of cement-based piezoelectric ceramic composites both theoretically and experimentally. A hydrogen bonding is found at the interface of piezoelectric ceramic powder and cement phase by IR (Infrared Ray), XPS (X-ray Photoelectron Spectroscopy) and SIMS (Secondary Ion Mass Spectroscopy). It largely affects the material properties of composites. A simple first order model is introduced to explain the poling mechanism of composites and the dependency of polarization is discussed using electromechanical coupling coefficient kt. The mechanisms acting on the aging effect is explored in detail. Dielectrical, piezoelectric and mechanical properties of the cement-based piezoelectric ceramic composites are studied by experiment and theoretical calculation based on modified cube model (n=1) with chemical bonding . A complex circuit model is proposed to explain the unique feature of impedance spectra and the instinct of high-loss of cement-based piezoelectric ceramic composite. The sensing ability of cement-based piezoelectric ceramic composite has been evaluated by using step wave, sine wave, and random wave. It shows that the output of the composite can reflects the nature and characteristics of mechanical input. The work in this thesis opens a new direction for the current actuation/sensing technology in civil engineering. The materials and techniques, developed in this work, have a great potential in application of health monitoring of buildings and infrastructures.

Tensile Bond Strength of Self Adhesive Resin Cement After Various Surface Treatment of Enamel.

PubMed

Sekhri, Sahil; Mittal, Sanjeev; Garg, Sandeep

2016-01-01

In self adhesive resin cements adhesion is achieved to dental surface without surface pre-treatment, and requires only single step application. This makes the luting procedure less technique-sensitive and decreases postoperative sensitivity. The purpose of this study was to evaluate bond strength of self adhesive resin after surface treatment of enamel for bonding base metal alloy. On the labial surface of 64 central incisor rectangular base metal block of dimension 6 mm length, 5mm width and 1 mm height was cemented with RelyX U200 and Maxcem Elite self adhesive cements with and without surface treatment of enamel. Surface treatment of enamel was application of etchant, one step bonding agent and both. Tensile bond strength of specimen was measured with universal testing machine at a cross head speed of 1mm/min. Least tensile bond strength (MPa) was in control group i.e. 1.33 (0.32) & 1.59 (0.299), Highest bond strength observed when enamel treated with both etchant and bonding agent i.e. 2.72 (0.43) & 2.97 (0.19) for Relyx U200 and Elite cement. When alone etchant and bonding agent were applied alone bond strength is 2.19 (0.18) & 2.24 (0.47) for Relyx U200, and 2.38 (0.27) 2.49 (0.16) for Max-cem elite. Mean bond strength was higher in case of Max-cem Elite as compared to RelyX U200 resin cement, although differences were non-significant (p > 0.05). Surface treatment of enamel increases the bond strength of self adhesive resin cement.

Bond strength of selected composite resin-cements to zirconium-oxide ceramic

PubMed Central

Fons-Font, Antonio; Amigó-Borrás, Vicente; Granell-Ruiz, María; Busquets-Mataix, David; Panadero, Rubén A.; Solá-Ruiz, Maria F.

2013-01-01

Objectives: The aim of this study was to evaluate bond strengths of zirconium-oxide (zirconia) ceramic and a selection of different composite resin cements. Study Design: 130 Lava TM cylinders were fabricated. The cylinders were sandblasted with 80 µm aluminium oxide or silica coated with CoJet Sand. Silane, and bonding agent and/or Clearfil Ceramic Primer were applied. One hundred thirty composite cement cylinders, comprising two dual-polymerizing (Variolink II and Panavia F) and two autopolymerizing (Rely X and Multilink) resins were bonded to the ceramic samples. A shear test was conducted, followed by an optical microscopy study to identify the location and type of failure, an electron microscopy study (SEM and TEM) and statistical analysis using the Kruskal-Wallis test for more than two independent samples and Mann-Whitney for two independent samples. Given the large number of combinations, Bonferroni correction was applied (α=0.001). Results: Dual-polymerizing cements provided better adhesion values (11.7 MPa) than the autopolymerizing (7.47 MPa) (p-value M-W<0.001). The worst techniques were Lava TM + sandblasting + Silane + Rely X; Lava TM + sandblasting + Silane + Multilink and Lava TM + CoJet + silane + Multilink. Adhesive failure (separation of cement and ceramic) was produced at a lesser force than cohesive failure (fracture of cement) (p-value M-W<0.001). Electron microscopy confirmed that the surface treatments modified the zirconium-oxide ceramic, creating a more rough and retentive surface, thus providing an improved micromechanical interlocking between the cement and the ceramic. Key words:Shear bond strength, silica coating, surface treatment, zirconia ceramics, phosphate monomer. PMID:22926485

Effect of fabrication pressure on the fatigue performance of Cemex XL acrylic bone cement.

PubMed

Lewis, Gladius; Janna, S I

2004-01-01

During a cemented arthroplasty, the prepared polymerizing dough of acrylic bone cement is subjected to pressurization in a number of ways; first, during delivery into the freshly prepared bone bed, second, during packing in that bed (either digitally or with the aid of a mechanical device), and, third, during the insertion of the prosthesis. Only a few studies have reported on the influence of the level of pressurization experienced during these events (which, depending on the cementing technique used, has been put at between 8 and 273 kPa) on various properties of the cement. That was the focus of the present study, in which the fully reversed tension-compression (+/-15 MPa; 5 Hz) fatigue lives (expressed as number of cycles to fracture, N(f)) of rectangular cross-sectioned "dog-bone" specimens (Type V, per ASTM D 638) fabricated from Cemex XL cement, at pressure applied continuously to the cement dough during curing in the specimen mold, p=75,150, and 300 kPa, were determined. The N(f) results were analyzed using the linearized transformation of the three-parameter Weibull relationship to obtain estimates of the Weibull mean, N(WM), which was taken to be the index of fatigue performance of the specimen set. Over the range of p studied, N(WM) increased as p increased (for example, from 329,118 cycles when p was 75 kPa to 388,496 cycles when p was 300 kPa); however, the increase was not significant over any pair of p increment steps (Mann-Whitney U-test; alpha<0.05).

Usability engineering: domain analysis activities for augmented-reality systems

NASA Astrophysics Data System (ADS)

Gabbard, Joseph; Swan, J. E., II; Hix, Deborah; Lanzagorta, Marco O.; Livingston, Mark; Brown, Dennis B.; Julier, Simon J.

2002-05-01

This paper discusses our usability engineering process for the Battlefield Augmented Reality System (BARS). Usability engineering is a structured, iterative, stepwise development process. Like the related disciplines of software and systems engineering, usability engineering is a combination of management principals and techniques, formal and semi- formal evaluation techniques, and computerized tools. BARS is an outdoor augmented reality system that displays heads- up battlefield intelligence information to a dismounted warrior. The paper discusses our general usability engineering process. We originally developed the process in the context of virtual reality applications, but in this work we are adapting the procedures to an augmented reality system. The focus of this paper is our work on domain analysis, the first activity of the usability engineering process. We describe our plans for and our progress to date on our domain analysis for BARS. We give results in terms of a specific urban battlefield use case we have designed.

Influence of space size of abutment screw access channel on the amount of extruded excess cement and marginal accuracy of cement-retained single implant restorations.

PubMed

Al Amri, Mohammad D; Al-Johany, Sulieman S; Al-Qarni, Mohammed N; Al-Bakri, Ahmed S; Al-Maflehi, Nassr S; Abualsaud, Haythem S

2018-02-01

The detrimental effect of extruded excess cement on peri-implant tissue has been well documented. Although several techniques have been proposed to reduce this effect by decreasing the amount of extruded cement, how the space size of the abutment screw access channel (SAC) affects the amount of extruded cement and marginal accuracy is unclear. The purpose of this in vitro study was to evaluate the effect of the size of the unfilled space of the abutment SAC on the amount of extruded excess cement and the marginal accuracy of zirconia copings. Twelve implant replicas and corresponding standard abutments were attached and embedded in acrylic resin blocks. Computer-aided design and computer-aided manufacturing (CAD-CAM) zirconia copings with a uniform 30-μm cement space were fabricated by 1 dental technician using the standard method. The copings were temporarily cemented 3 times at different sizes of the left space of the SAC as follows: the nonspaced group (NS), in which the entire SAC was completely filled, the 1-mm-spaced group (1MMS), and the 2-mm-spaced group (2MMS). Abutments and crowns were ultrasonically cleaned, steam cleaned, and air-dried. The excess cement was collected and weighed. To measure the marginal accuracy, 20 measurements were made every 18 degrees along the coping margin at ×300 magnification and compared with the pre-cementation readings. One-way ANOVA was calculated to determine whether the amount of extruded excess cement differed among the 3 groups, and the Tukey test was applied for multiple comparisons (α=.05). The mean weights (mg) of extruded excess cement were NS (33.53 ±1.5), 1MMS (22.97 ±5.4), and 2MMS (15.17 ±5.9). Multiple comparisons showed significant differences in the amount of extruded excess cement among the 3 test groups (P<.001). The mean marginal discrepancy (μm) of the pre-cemented group (29.5 ±8.2) was significantly different (P<.01) from that of the NS (72.3 ±13.7), the 1MMS (70.1 ±19), and the 2MMS group (70.1 ±18.8). No significant differences were found in marginal accuracy among the 3 test groups (P=.942). Within the limitations of this in vitro study, leaving a 2-mm space in the SAC reduced the amount of extruded excess cement by 55% in comparison with the nonspaced abutments. However, no effect was found on the marginal accuracy of zirconia copings. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Research on Reasons for Repeated Falling of Tiles in Internal Walls of Construction

NASA Astrophysics Data System (ADS)

Xu, LiBin; Chen, Shangwei; He, Xinzhou; Zhu, Guoliang

2018-03-01

In view of the quality problem of repeated falling of facing tiles in some construction, the essay had a comparative trial in laboratory on cement mortar which is often used to paste tiles, special tile mortar and dry-hang glue, and measured durability of tile adhesive mortar through freezing and thawing tests. The test results indicated that ordinary cement mortar cannot meet standards due to reasons like big shrinkage and low adhesive. In addition, the ten times of freezing and thawing tests indicated that ordinary cement mortar would directly shell and do not have an adhesive force, and moreover, adhesive force of special tile mortar would reduce. Thus, for tiles of large size which are used for walls, dry-hang techniques are recommended to be used.

[Endodontics in motion: new concepts, materials and techniques 1. Hydraulic Calcium Silicate Cements].

PubMed

Moinzadeh, A T; Jongsma, L; de Groot-Kuin, D; Cristescu, R; Neirynck, N; Camilleri, J

2015-01-01

Hydraulic Calcium Silicate Cements (HCSCs) constitute a group of materials that have become increasingly popular in endodontics since the introduction of Mineral Trioxide Aggregate (MTA) in the 1990s. MTA is Portland cement to which bismuth oxide has been added to increase its radiopacity. The most important property of MTA is its capacity to set in water or a humid environment. However, MTA also has important limitations, for example, it's difficult to work with and can discolour teeth. Recently, numerous products based on HCSC chemistry, which can be considered as modifications of MTA intended to reduce its limitations, have become available on the market. Despite their potential advantages, all of these materials have their own specific limitations that are currently insufficiently known and investigated.

Evaluation of the efficacy of keratinized mucosa augmentation techniques around dental implants: a systematic review.

PubMed

Wu, Qingqing; Qu, Yili; Gong, Ping; Wang, Tianlu; Gong, Ting; Man, Yi

2015-05-01

The absence of periimplant keratinized mucosa is considered risky in patients with a predisposition to periodontitis or recession. Although various soft tissue augmentation techniques exist, dentists are seeking for more efficient approaches to augment periimplant keratinized mucosa. The purpose of this systematic review was to evaluate the efficacy of the various techniques and biomaterials adopted in periimplant keratinized mucosa augmentation and whether one technique or biomaterial is superior. A search in Medline-PubMed and the Cochrane Central Register of controlled trials was conducted. Randomized clinical trials, prospective cohort studies, clinical control studies, and case series from January 1, 1980, to December 31, 2013, with a follow-up of at least 6 months reporting changes on keratinized mucosa width were included. Several journals were hand-searched for related articles. The bibliographies of all publications selected for inclusion were also scanned. The screening of titles and abstracts resulted in 60 relevant publications. Six of them were finally included. Free gingival graft, connective tissue graft, acellular dermal matrix, and collagen matrix were used for keratinized mucosa augmentation. Because of heterogeneity of the studies, only descriptive analysis was performed. Improvements in keratinized mucosa width were reported in all studies. A definitive conclusion could not be achieved owing to the lack of well-designed studies and appropriate methods of studying soft tissue. The establishment of universal surgical guidelines and measurement systems is imperative in the future. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Deformation-based augmented reality for hepatic surgery.

PubMed

Haouchine, Nazim; Dequidt, Jérémie; Berger, Marie-Odile; Cotin, Stéphane

2013-01-01

In this paper we introduce a method for augmenting the laparoscopic view during hepatic tumor resection. Using augmented reality techniques, vessels, tumors and cutting planes computed from pre-operative data can be overlaid onto the laparoscopic video. Compared to current techniques, which are limited to a rigid registration of the pre-operative liver anatomy with the intra-operative image, we propose a real-time, physics-based, non-rigid registration. The main strength of our approach is that the deformable model can also be used to regularize the data extracted from the computer vision algorithms. We show preliminary results on a video sequence which clearly highlights the interest of using physics-based model for elastic registration.

A novel autologous scaffold for diced-cartilage grafts in dorsal augmentation rhinoplasty.

PubMed

Bullocks, Jamal M; Echo, Anthony; Guerra, Gerardo; Stal, Samuel; Yuksel, Eser

2011-08-01

Diced-cartilage grafts have been used for dorsal nasal augmentation for several years with good results. However, compounds such as Surgicel and temporalis fascia used as a wrap have inherent problems associated with them, predominantly inflammation and graft resorption. An autologous carrier could provide stabilization of cartilage grafts while avoiding the complications seen with earlier techniques. In our patients, a malleable construct was used for dorsal nasal augmentation in which autologous diced-cartilage grafts were stabilized with autologous tissue glue (ATG) created from platelet-rich plasma (platelet gel) and platelet-poor plasma (fibrin glue). A prospective analysis of 68 patients, who underwent dorsal nasal augmentation utilizing ATG and diced-cartilage grafts between 2005 and 2008, were included in the study. Although there was notable maintenance of the dorsal height, no complications occurred that required explantation over a mean follow-up of 15 months. The use of ATG to stabilize diced-cartilage grafts is a safe, reliable technique for dorsal nasal augmentation. The platelet gel provides growth factors while the fibrin glue creates a scaffold that allows stabilization and diffusion of nutrients to the cartilage graft.

The Elite-Plus stem migrates more than the flanged Charnley stem

PubMed Central

Sanzén, Lennart; Besjakov, Jack; Carlsson, Åke

2010-01-01

Background and purpose The Charnley Elite-Plus stem was introduced in 1993 as a presumed improvement of the flanged Charnley stem. We started this study in 1996 to investigate the migratory pattern of the Elite-Plus stem. Patients and methods We followed 114 patients with osteoarthritis and a primary total hip replacement with the Elite-Plus stem. Mean age at the time of operation was 64 (50–76) years. The mean follow-up time was 6.5 (2–7) years. Radiographs were evaluated with respect to cementing technique, migration, and wear measured by radiostereometry (RSA). Results The stem survival was 98% (CI: 96–100) at 7 years and 92% (CI: 86–97) at 10 years. Mean migration of the femoral head was 0.35 mm (SD 0.3) medially, 0.51 mm (SD 0.6) distally, and 1.1 mm (SD 1.8) in the dorsal direction. Mean total point motion was 1.7 mm (SD 1.7). The migration of the stems stabilized after 5 years in the medial and dorsal directions, but continued to subside slightly. Migration along any of the axes was higher if the cementing technique was inferior. Interpretation Patients with a Charnley Elite-Plus stem and defects in the cement mantle or other signs of inferior implantation technique should be carefully monitored. PMID:20367422

Primary hybrid THA using a polymethyl methacrylate-precoated stem: A single-center experience with a 10-year minimum follow-up.

PubMed

Kim, Wanlim; Yoon, Pil Whan; Kwak, Hong Suk; Yoo, Jeong Joon; Kim, Hee Joong; Yoon, Kang Sup

2017-07-01

The high failure rate of cemented femoral components in the 1970s facilitated the improvement of the cementing technique and surface finishes such as polymethylmethacrylate (PMMA)-precoated stems, reporting a survival rate of >95% at 10 years from some studies. However, controversy persists regarding whether precoated femoral stems are associated with a longer revision-free prosthesis survival. The purpose of this study was to evaluate the clinical and radiological outcomes of PMMA-precoated femoral stems, and analyze factors associated with implant survival. We retrospectively reviewed 73 primary hybrid total hip arthroplasties performed using PMMA-precoated femoral stems. The mean age of the patients was 61 years. During the mean follow-up period of 13 years, 18 hips (24.7%) underwent aseptic loosening, and all of the loosened stems were subjected to revision surgery 8.8 years (range 4.6-15.5 years) from the index surgery. Younger age and poor cementing were significantly associated with aseptic loosening (P = 0.013 and P < 0.001, respectively). However, the aseptic loosening rate was also high at 13.1% even with a good cementing technique. In conclusion, the PMMA-precoated stem failed to show expected advantages and needs to be replaced with other surface finish stem designs. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1300-1306, 2017. © 2016 Wiley Periodicals, Inc.

[Patellar bone deficiency in revision total knee arthroplasty].

PubMed

Kloiber, J; Goldenitsch, E; Ritschl, P

2016-05-01

Patellar bone deficiency in revision total knee arthroplasty (TKA) determines the surgical procedure. Different reconstructive and ablative techniques, dependent on the remaining bone stock, are described. The primary patella implant can be retained in up to 50 % of revision situations. Reasons for replacement are aseptic and septic loosening, implant failure, expanding osteolysis, maltracking of the patella and "metal-backed" prosthesis. The aim of the reconstruction is the stable fixation and proper tracking of the implant by restoring the extensor mechanism. Dependent on the extent of bone loss and the availability of a patellar rim, the following surgical procedures are recommended. When the remaining bone thickness is 10 mm or more: implantation of a polyethylene "onlay-type" patella; when it is between 6-9 mm and there is an intact patellar rim: reconstruction with a biconvex "inlay-type" patella implant, where the biconvex shape replaces the bone defect partially. When there is deficient bone stock (less than 6 mm) or no cortical patellar rim then augmenting procedures with autologous spongiosa and procedures such as "impaction bone grafting", "trabecular metal" prosthesis, where the trabecular part of the implant serves as the base for the cemented polyethylene button, "gull-wing" osteotomy, which is an adapting and configuring technique of osteotomy; and in exceptional cases patelloplasty or patellectomy are used. Regarding the importance of the patellar component in biomechanics of the joint and function of the extensor mechanism, the reconstruction of the patella should be the primary aim. Patelloplasty or patellectomy should be avoided.

Free Diced Cartilage: A New Application of Diced Cartilage Grafts in Primary and Secondary Rhinoplasty.

PubMed

Kreutzer, Christian; Hoehne, Julius; Gubisch, Wolfgang; Rezaeian, Farid; Haack, Sebastian

2017-09-01

Irregularities or deformities of the nasal dorsum after hump reduction account for a significant number of revision rhinoplasties. The authors therefore developed a technique of meticulously dicing and exactly placing free diced cartilage grafts, harvested from septum, rib, or ear cartilage. The cartilage paste is used for smoothening, augmentation, or camouflaging of the nasal dorsum in primary or revision rhinoplasties. A retrospective analysis of multisurgeon consecutive open approach rhinoplasties from January to December of 2014 was conducted at a single center. The authors compared the outcome of three different techniques to augment or cover the nasal dorsum after an observation period of 7 months. In group I, 325 patients with free diced cartilage grafts as the only onlay were included. In group II, consisting of 73 patients, the dorsal onlay was either fascia alone or in combination with free diced cartilage grafts. Forty-eight patients in group III received a dorsal augmentation with the classic diced cartilage in fascia technique. Four hundred forty-six patients undergoing primary and secondary rhinoplasties in which one of the above-mentioned diced cartilage techniques was used were included in the study. The authors found revision rates for dorsal irregularities within the 7-month postoperative observation period of 5.2, 8.2, and 25 percent for groups I, II, and III, respectively. The authors' findings strongly support their clinical experience that the free diced cartilage graft technique presents an effective and easily reproducible method for camouflage and augmentation in aesthetic and reconstructive rhinoplasty.

A minimally invasive technique for percutaneous lumbar facet augmentation: Technical description of a novel device

PubMed Central

Smith, Zachary A.; Armin, Sean; Raphael, Dan; Khoo, Larry T.

2011-01-01

Background: We describe a new posterior dynamic stabilizing system that can be used to augment the mechanics of the degenerating lumbar segment. The mechanism of this system differs from other previously described surgical techniques that have been designed to augment lumbar biomechanics. The implant and technique we describe is an extension-limiting one, and it is designed to support and cushion the facet complex. Furthermore, it is inserted through an entirely percutaneous technique. The purpose of this technical note is to demonstrate a novel posterior surgical approach for the treatment of lumbar degenerative. Methods: This report describes a novel, percutaneously placed, posterior dynamic stabilization system as an alternative option to treat lumbar degenerative disk disease with and without lumbar spinal stenosis. The system does not require a midline soft-tissue dissection, nor subperiosteal dissection, and is a truly minimally invasive means for posterior augmentation of the functional facet complex. This system can be implanted as a stand-alone procedure or in conjunction with decompression procedures. Results: One-year clinical results in nine individual patients, all treated for degenerative disease of the lower lumbar spine, are presented. Conclusions: This novel technique allows for percutaneous posterior dynamic stabilization of the lumbar facet complex. The use of this procedure may allow a less invasive alternative to traditional approaches to the lumbar spine as well as an alternative to other newly developed posterior dynamic stabilization systems. PMID:22145084

Grit blasting and the marginal accuracy of two ceramic veneer systems--a pilot study.

PubMed

Lim, C; Ironside, J G

1997-04-01

Margins of ceramic restorations can be damaged during removal of investment materials with grit blasting and result in relatively large marginal discrepancies and excessive marginal discrepancies with greater exposure of cement to the oral environment. Subsequent dissolution of cement can encourage plaque retention, dental caries, and periodontal problems. This study compared marginal adaptation of ceramic veneers created by the refractory die technique (R), Dicor glass ceramic technique (D), and effects of grit blasting on their margins. Two groups of ceramic veneers were constructed for each system, one without grit blasting (R g and D g) and one with grit blasting (R+g and D+g). Statistical analyses revealed that grit blasting had a greater effect in reducing marginal accuracy for Dicor ceramic veneers compared with refractory die ceramic veneers.

Characterization and modeling of the rheology of cement paste: With applications toward self-flowing materials

NASA Astrophysics Data System (ADS)

Saak, Aaron Wilbur

The objective of this research is to better understand the important mechanisms that control the rheology of cement paste. In order to understand these mechanisms, new experimental techniques are developed. The insights gained through these studies are then applied toward designing self-flowing materials, particularly self-compacting concrete (SCC). A new testing program is developed where both the peak and equilibrium stress flow curves of cement paste are obtained by testing only one sample. Additionally, the influence of wall slip on yield stress and viscoelastic measurements is determined using a vane. The results indicate that a slip layer develops when the shear stress approaches the yield point. A three-dimensional model relating slump to yield stress is derived as a function of cone geometry. The results indicate that the model fits experimental data for cylindrical slumps over a wide range of yield stress values for a variety of materials. When compared to other published models, the results suggest that a fundamental relationship exists between yield stress and slump that is material independent and largely independent of cone geometry. The affect of various mixing techniques on the rheology of cement paste is investigated using a rheometer as a highly controlled mixer. The results suggest that there is a characteristic shear rate where the viscosity of cement paste is minimized. The influence of particle packing density, morphology and surface area on the viscosity of cement paste is quantified. The data suggest that even though packing density increases with the addition of fine particles, the benefits are largely overshadowed by a dramatic increase in surface area. Finally, a new methodology is introduced for designing self-compacting concrete. This approach incorporates a "self-flow zone" where the rheology of the paste matrix provides high workability, yet segregation resistance. The flow properties of fresh concrete are measured using a U-tube apparatus to test the general applicability of the proposed methodology. Using the new design approach, concrete with a slump of 29 cm (11 inches) and slump flow diameter of 60.9 cm (24 inches) is produced.

Electrosteric stabilization of heteroflocculating suspensions and its application to the processing of self-compacting engineered cementitious composites

NASA Astrophysics Data System (ADS)

Kong, Hyun-Joon

This dissertation investigates a dispersion/stabilization technique to improve the fluidity of heteroflocculating concentrated suspensions, and applies the technique to develop self-compacting Engineered Cementitious Composites (ECC), defined as a cementitious material which compacts without any external consolidation in the fresh state, while exhibiting strain-hardening performance in the hardened state. To meet the criteria of micromechanical design to achieve the ductile performance and processing design to attain high fluidity, this work has focused on preparing cement suspensions with low viscosity and high cohesiveness at a particle loading determined by the micromechanical design. Therefore, the goal of this work is to quantify how to adjust the strong flocculation between cement particles due to electrostatic and van der Waals attractive forces. For this purpose, a strong polyelectrolyte, melamine formaldehyde sulfonate (MFS), to disperse the oppositely-charged particles present in the cement dispersion, is combined with a non-ionic polymer, hydroxypropylmethylcellulose (HPMC). The combination of these two polymers to prevent re-flocculation leads to "complementary electrosteric dispersion/ stabilization". With these polymers, suspensions with the desired fluidity for processing are obtained. To quantify the roles of the two polymers in imparting stability, a heteroflocculating model suspension was developed, which facilitates the control of the interactions typical of cement suspensions, but without irreversible hydration. This model suspension is composed of alumina and silica particles, which bear surface potentials of opposite sign at intermediate pHs, as well as has a comparable magnitude of the Hamaker constant as compared to cement particles. As a result, the model system displays not only van der Waals attraction but also electrostatic attraction between dissimilar particles. Rheological studies of the model system stabilized by MFS and HPMC show behavior identical to that of the cement suspensions, allowing the model system to be used to interpret the role of the stabilizers in altering the system microstructure and fluidity. Finally, the self-compacting performance of fresh ECC mixes made with the electrosterically stabilized fresh matrix mix and the ductile strain-hardening performance of the hardened ECC were demonstrated.

Immediate impact on the rim zone of cement based materials due to chemical attack

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schwotzer, M., E-mail: matthias.schwotzer@kit.edu; Scherer, T.; Gerdes, A.

2015-01-15

Cement based materials are in their widespread application fields exposed to various aqueous environments. This can lead to serious chemical changes affecting the durability of the materials. In particular in the context of service life prediction a detailed knowledge of the reaction mechanisms is a necessary base for the evaluation of the aggressivity of an aqueous medium and this is deduced commonly from long term investigations. However, these processes start immediately at the material/water-interface, when a cementitious system comes into contact with an aqueous solution, altering here the chemical composition and microstructure. This rim zone represents the first hurdle thatmore » has to be overcome by an attacking aqueous solution. Therefore, the properties of the surface near area should be closely associated with the further course of deterioration processes by reactive transport. In this context short term exposure experiments with hardened cement paste over 4 and 48 h have been carried out with demineralized water, hard tap water and different sulfate solutions. In order to investigate immediate changes in the near-surface region, depth profile cuts have been performed on the cement paste samples by means of focused ion beam preparation techniques. A scanning beam of Gallium ions is applied to cut a sharp edge in the cement paste surface, providing insights into the composition and microstructure of the upper ten to hundred microns. Electron microscopic investigations on such a section of the rim zone, together with surface sensitive X-ray diffraction accompanied by a detailed characterization of the bulk composition confirm that the properties of the material/water interface are of relevance for the durability of cement based systems in contact with aqueous solutions. In this manner, focused ion beam investigations constitute auspicious tools to contribute to a more sophisticated understanding of the reaction mechanisms. - Highlights: • The chemical stability is related to the properties of material/water interface. • Properties of the rim zone readjust quickly, triggered by hydrochemical conditions. • Durability research can be improved by combining FIB techniques and common analytics.« less

Outcomes of Modified Harrington Reconstructions for Nonprimary Periacetabular Tumors: An Effective and Inexpensive Technique.

PubMed

Bernthal, Nicholas M; Price, Shawn L; Monument, Michael J; Wilkinson, Brandon; Jones, Kevin B; Randall, R Lor

2015-11-01

Metastatic disease to the acetabulum presents a difficult technical and philosophical challenge: complicated surgeries in patients with often short life expectancies force us to examine both the outcome and cost of these operations. Therefore, we studied the durability of a cement-screw rebar reconstruction technique and risk factors for failure, and we compare the results to other reconstruction options. This is a retrospective review of 52 acetabular reconstructions in 50 patients for nonprimary disease using a retrograde screw-rebar-cement all-polyethylene technique. Mean age was 57 years (range 25-81 years). Twenty-four lesions were classified as Harrington class II; 28 were Harrington class III. Mean follow-up was 17.7 months (range 1-92 months). Outcomes included patient survival, prosthesis survival, and complications. Forty-eight of 50 (96 %) patients ambulated after surgery. Five of 52 (9.6 %) of prostheses failed, three from loosening due to tumor progression, one from aseptic loosening, and one from soft tissue instability (dislocation). The three cases of tumor progression failure occurred in patients with massive preoperative ischial tumor burden. Mean surgical time was 198 min, and hospital stay was 5.2 days. The screw-cement-rebar all-polyethylene cup reconstruction technique is a comparatively successful and inexpensive reconstruction option for treating nonprimary oncologic disease in the acetabulum. All cases of loosening occurred beyond the median patient survival. Surgeons should be wary of massive ischial tumor burden in patients with projected longevity, as it may be associated with implant failure. Surgical time and hospital stay are consistent with historical data for alternative implants, and implant cost is lower.

Reverse-Muscle Sling Reduces Complications in Revisional Mastopexy-Augmentation.

PubMed

Valente, Denis Souto

2018-06-20

Simultaneous augmentation-mastopexy is a particularly tricky operation with a considerable reoperation rate. The pectoralis muscle sling has proven to be a suitable alternative technique for long-term results in breast parenchyma suspension without silicone implants. This study aims to propose a promising approach to simultaneous augmentation-mastopexy revisional surgery using an inverted dual-plane technique acting as a muscular sling. A 10-year historic cohort was conducted to obtain the following variables from our preexisting database: age, preoperative measurements, operative technicalities, implant details, time from procedure to revision, complications, and outcomes. Twenty-six patients assessed after the initial postoperative year were analyzed. Review of this series of patients revealed a revision rate of 3.8% and overall rate of morbidity of 11.5%. Simultaneous augmentation-mastopexy using an inverted dual-plane technique acting as a muscular sling is a reliable and safe procedure. Review of this series of patients revealed low rates of morbidity and reoperation need. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Experimental rotator cuff repair. A preliminary study.

PubMed

Gerber, C; Schneeberger, A G; Perren, S M; Nyffeler, R W

1999-09-01

The repair of chronic, massive rotator cuff tears is associated with a high rate of failure. Prospective studies comparing different repair techniques are difficult to design and carry out because of the many factors that influence structural and clinical outcomes. The objective of this study was to develop a suitable animal model for evaluation of the efficacy of different repair techniques for massive rotator cuff tears and to use this model to compare a new repair technique, tested in vitro, with the conventional technique. We compared two techniques of rotator cuff repair in vivo using the left shoulders of forty-seven sheep. With the conventional technique, simple stitches were used and both suture ends were passed transosseously and tied over the greater tuberosity of the humerus. With the other technique, the modified Mason-Allen stitch was used and both suture ends were passed transosseously and tied over a cortical-bone-augmentation device. This device consisted of a poly(L/D-lactide) plate that was fifteen millimeters long, ten millimeters wide, and two millimeters thick. Number-3 braided polyester suture material was used in all of the experiments. In pilot studies (without prevention of full weight-bearing), most repairs failed regardless of the technique that was used. The simple stitch always failed by the suture pulling through the tendon or the bone; the suture material did not break or tear. The modified Mason-Allen stitch failed in only two of seventeen shoulders. In ten shoulders, the suture material failed even though the stitches were intact. Thus, we concluded that the modified Mason-Allen stitch is a more secure method of achieving suture purchase in the tendon. In eight of sixteen shoulders, the nonaugmented double transosseous bone-fixation technique failed by the suture pulling through the bone. The cortical-bone-augmentation technique never failed. In definite studies, prevention of full weight-bearing was achieved by fixation of a ten-centimeter-diameter ball under the hoof of the sheep. This led to healing in eight of ten shoulders repaired with the modified Mason-Allen stitch and cortical-bone augmentation. On histological analysis, both the simple-stitch and the modified Mason-Allen technique caused similar degrees of transient localized tissue damage. Mechanical pullout tests of repairs with the new technique showed a failure strength that was approximately 30 percent of that of an intact infraspinatus tendon at six weeks, 52 percent of that of an intact tendon at three months, and 81 percent of that of an intact tendon at six months. The repair technique with a modified Mason-Allen stitch with number-3 braided polyester suture material and cortical-bone augmentation was superior to the conventional repair technique. Use of the modified Mason-Allen stitch and the cortical-bone-augmentation device transferred the weakest point of the repair to the suture material rather than to the bone or the tendon. Failure to protect the rotator cuff post-operatively was associated with an exceedingly high rate of failure, even if optimum repair technique was used. Different techniques for rotator cuff repair substantially influence the rate of failure. A modified Mason-Allen stitch does not cause tendon necrosis, and use of this stitch with cortical-bone augmentation yields a repair that is biologically well tolerated and stronger in vivo than a repair with the conventional technique. Unprotected repairs, however, have an exceedingly high rate of failure even if optimum repair technique is used. Postoperative protection from tension overload, such as with an abduction splint, may be necessary for successful healing of massive rotator cuff tears.

Traditional Portland cement and MgO-based cement: a promising combination?

NASA Astrophysics Data System (ADS)

Tonelli, Monica; Martini, Francesca; Calucci, Lucia; Geppi, Marco; Borsacchi, Silvia; Ridi, Francesca

2017-06-01

MgO/SiO2 cements are materials potentially very useful for radioactive waste disposal, but knowledge about their physico-chemical properties is still lacking. In this paper we investigated the hydration kinetics of cementitious formulations prepared by mixing MgO/SiO2 and Portland cement in different proportions and the structural properties of the hydrated phases formed in the first month of hydration. In particular, the hydration kinetics was investigated by measuring the free water index on pastes by means of differential scanning calorimetry, while the structural characterization was carried out by combining thermal (DTA), diffractometric (XRD), and spectroscopic (FTIR, 29Si solid state NMR) techniques. It was found that calcium silicate hydrate (C-S-H) and magnesium silicate hydrate (M-S-H) gels mainly form as separate phases, their relative amount and structural characteristics depending on the composition of the hydrated mixture. Moreover, the composition of the mixtures strongly affects the kinetics of hydration and the pH of the aqueous phase in contact with the cementitious materials. The results here reported show that suitable mixtures of Portland cement and MgO/SiO2 could be used to modify the properties of hydrated phases with potential application in the storage of nuclear waste in clayey disposal.

Impedance Spectroscopy Study of the Effect of Environmental Conditions on the Microstructure Development of Sustainable Fly Ash Cement Mortars.

PubMed

Ortega, José Marcos; Sánchez, Isidro; Climent, Miguel Ángel

2017-09-25

Today, the characterisation of the microstructure of cement-based materials using non-destructive techniques has become an important topic of study, and among them, the impedance spectroscopy has recently experienced great progress. In this research, mortars with two different contents of fly ash were exposed to four different constant temperature and relative humidity environments during a 180-day period. The evolution of their microstructure was studied using impedance spectroscopy, whose results were contrasted with mercury intrusion porosimetry. The hardening environment has an influence on the microstructure of fly ash cement mortars. On one hand, the impedance resistances R₁ and R₂ are more influenced by the drying of the materials than by microstructure development, so they are not suitable for following the evolution of the porous network under non-optimum conditions. On the other hand, the impedance spectroscopy capacitances C₁ and C₂ allow studying the microstructure development of fly ash cement mortars exposed to those conditions, and their results are in accordance with mercury intrusion porosimetry ones. Finally, it has been observed that the combined analysis of the abovementioned capacitances could be very useful for studying shrinkage processes in cement-based materials kept in low relative humidity environments.

Influence of semipermanent cement application used in immediately loaded, implant-supported restorations on crestal bone resorption.

PubMed

Błaszczyszyn, Artur; Kubasiewicz-Ross, Paweł; Gedrange, Tomasz; Dominiak, Marzena

2013-01-01

The paper presents clinical-radiological research on the impact of the new semi-cement luting agent in the immediately loaded implant-supported restoration on alveolar ridge resorption. 25 patients with a partially edentulous alveolar ridge in the anterior section of the maxilla or mandible were included in the study. The implants were inserted with the application of traditional burs or with a Piezosurgery device supplied by Mectron. Taking into account the method of implant bed preparation, the scientific material was divided into two groups. The implants were loaded immediately with single crown restorations cemented with the Implantlink semi cement application. The following indices were taken into consideration: pocket depth around implant calculated at four measuring points, marginal alveolar bone loss measured using radio-visiography, the 3-degree Wachtel scale of healing of the soft tissue. In addition, the presence and possible width or height of any recession around the implants was measured. The success of the implant treatment was assessed according to the Albrektsson success criteria. The research results were subjected to statistical analysis. The results of our study revealed no influence of the Implant-link semi cement on the crestal bone level, regardless of the bone bed preparation technique.

Clinical investigations of polymethylmethacrylate cement viscosity during vertebroplasty and related in vitro measurements

PubMed Central

Boger, A.; Schenk, B.; Heini, P. F.

2009-01-01

Percutaneous vertebroplasty, comprising an injection of polymethylmethacrylate (PMMA) into vertebral bodies, is a practical procedure for the stabilization of osteoporotic compression fractures as well as other weakening lesions. Cement leakage is considered to be one of the major and most severe complications during percutaneous vertebroplasty. The viscosity of the material plays a key role in this context. In order to enhance the safety for the patient, a rheometer system was developed to measure the cement viscosity intraoperatively. For this development, it is of great importance to know the proper viscosity to start the procedure determined by experienced surgeons and the relation between the time period when different injection devices are used and the cement viscosity. The purpose of the study was to investigate the viscosity ranges for different injection systems during conventional vertebroplasty. Clinically observed viscosity values and related time periods showed high scattering. In order to get a better understanding of the clinical observations, cement viscosity during hardening at different ambient temperatures and by simulation of the body temperature was investigated in vitro. It could be concluded, that the direct viscosity assessment with a rheometer during vertebroplasty can help clinicians to define a lower threshold viscosity and thereby decrease the risk of leakage and make adjustments to their injection technique in real time. Secondly, the acceleration in hardening of PMMA-based cements at body temperature can be useful in minimizing leakages by addressing them with a short injection break. PMID:19479285

Influence of chloride in mortar made of Portland cement types II, III, and V on the near-field microwave reflection properties

NASA Astrophysics Data System (ADS)

Hu, Cairong; Benally, Aaron D.; Case, Tobias; Zoughi, Reza; Kurtis, Kimberly

2000-07-01

Corrosion of steel rebar in reinforced concrete structures, can be induced by the presence of chloride in the structure. Corrosion of steel rebar is a problematic issue in the construction industry as it compromises the strength and integrity of the structure. Although techniques exist for chloride detection and its migration into a structure, they are destructive, time consuming and cannot be used for the interrogation of large surfaces. In this investigation three different portland cement types; namely, ASTM types II, III and V were used, and six cubic (8' X 8' X 8') mortar specimens were produced all with water-to-cement (w/c) ratio of 0.6 and sand-to-cement (s/c) ratio of 1.5. Tap water was used when producing three of these specimens (one of each cement type). For the other three specimens calcium chloride was added to the mixing tap water resulting in a salinity of 2.5%. These specimens were placed in a hydration room for one day and thereafter left it the room temperature with low humidity. The reflection properties of these specimens, using an open-ended rectangular waveguide probe, were monitored daily at 3 GHz (S-band) and 10 GHz (X-band). The results show the influence of cement type on the reflection coefficient as well as the influence of chloride on the curing process and setting time.

FEM analysis of different dental root canal-post systems in young permanent teeth.

PubMed

Vitale, M C; Chiesa, M; Coltellaro, F; Bignardi, C; Celozzi, M; Poggio, C

2008-09-01

Aim of this work was to carry out a comparative evaluation of the structural behaviour of different root canal posts (cylindrical, conical and triple conical) fitted in a second lower bicuspid and subjected to compression and bending test. This study has been carried out by numerical method of structural analysis of finite elements (FEM, Finite Element Method). Different tridimensional models were obtained by CAT images of an extracted tooth, endodontically treated, filled with guttapercha and triple conical glass post. Images have been elaborated by a software for images (Mimics and Ansys) and CAD (Rhinoceros 3 D). In the models a II Class restoration has been virtually created. In the numerical simulation dental tissues (enamel, dentine and root cement), guttapercha, root canal cement, different posts, different techniques of cementation and crown restoration (composites and adhesive systems) have been considered. Strain distributions in dental tissues, in root canal cement and in posts have been compared. The equivalent tensions and the single components (traction, compression and cut) have been analysed. In all examined posts, the most strained part is resulted the coronal one, even if the total tension, in the different tooth-post analyzed systems, resulted uniformly distributed. A similar behaviour was shown by the root canal cement. According to the analyzed conditions of bond and load, varying according to the geometry of the considered posts, our results confirm that there is no substantial difference of deformation in posts, root canal cement and treated tooth.

Empress 2. First year clinical results.

PubMed

Culp, L

1999-03-01

As the search for perfect dental restorative materials continues, it seems we routinely return to ceramics as our standard. Current all-ceramic systems are state-of-the-art with regard to esthetics and function, but are limited in use to single unit restorations. Recently, an all-ceramic lithium disilicate-fluorapatite ceramic system was introduced (IPS Empress 2, Ivoclar North America, Amherst, NY), that allows multiple unit restorations to be fabricated and cemented using adhesive or traditional cementation techniques. This article will overview the technical procedures and advantages of this new ceramic system.

Elastoplasty: A Silicon Polymer as a New Filling Material for Kyphoplasty in Comparison to PMMA.

PubMed

Bornemann, Rahel; Rommelspacher, Yorck; Jansen, Tom R; Sander, Kirsten; Wirtz, Dieter C; Pflugmacher, Robert

2016-07-01

Painful vertebral compression fractures (VCF) caused by osteoporosis are a common health problem in the elderly population. If conservative treatments are unsuccessful, surgical treatments like vertebroplasty or kyphoplasty are recommended. But the use of Polymethylmethacrylat (PMMA) bone cement for augmentation surgery is associated with risks. Evaluation of the effectiveness and safety of a newly developed silicon polymer (VK100) that can be used instead of PMMA bone cement for kyphoplasty treatments. A retrospective study of 30 patients comparing the outcomes of kyphoplasty treatments conducted with PMMA and VK100. Clinic for Orthopedics and Trauma Surgery Bonn, Germany. Thirty patients with one to 3 VCF were treated either with balloon kyphoplasty using VK100 or balloon kyphoplasty using PMMA bone cement. Data from both groups was compared by a matched pair analysis. The medial vertebral height was measured at each examination radiologically. The patients stated their pain intensity using the Visual Analogue Scale (VAS) and the patient's functional impairment was evaluated with the Oswestry-Disability-Index (ODI).All data were assessed before surgery, and 3 days, 3 months, 6 months, and 12 months after surgery. Intraoperative and postoperative adverse events were documented. The patients' functional impairment and pain improved significantly after surgery. The course of ODI and VAS was comparable in both treatment groups, but the improvement in the VK group was significantly ongoing until the 12 month follow-up. Vertebral height improvement was significant in both groups, but the PMMA group achieved a better absolute restoration. The vertebral height stayed constant during the follow-up in the VK group and worsened significantly in the PMMA group. There was no significant difference between groups concerning the occurrence of additional fractures; and no other types of complications or surgery-related adverse events were observed in either the PMMA group or in the VK group. The study is only a matched pair analysis of 15 patients for each procedure and the amount of injected filling material was not recorded. The study results demonstrate that the clinical outcome of VAS and ODI of using the silicon polymer VK100 is comparable or slightly better than using PMMA. VK 100 shows a trend to minor additional fractures during the follow-up. However, height restoration is not satisfactory in comparison to PMMA, although vertebral height stayed more or less constant in the VK group. To address the augmentation success further, it would be necessary to study a larger patient group over a longer study period and to assess additional parameters such as bone density and injected amount of filling material.

Preparation and evaluation of a novel star-shaped polyacid-constructed dental glass-ionomer system.

PubMed

Howard, Leah; Weng, Yiming; Xie, Dong

2014-06-01

The objective of this study was to synthesize and characterize novel star-shaped poly(acrylic acid-co-itaconic acid)s via chain-transfer radical polymerization technique, use these polyacids to formulate the resin-modified glass-ionomer cements, and evaluate the mechanical strengths of the formed cements The star-shaped poly(acrylic acid-co-itaconic acid)s were synthesized via a chain-transfer radical polymerization reaction using a newly synthesized star-shaped chain-transfer agent. The effects of MW, GM-tethering ratio, P/L ratio and aging on the compressive properties of the formed experimental cements were studied. Compressive, diametral tensile as well as flexural strengths were evaluated and compared to those of Fuji II and Fuji II LC cements. The star-shaped polyacids showed significantly lower viscosities in water as compared to their linear counterparts. The cements formulated with these novel polyacids showed significantly improved mechanical strengths i.e., 49% in yield strength, 41% in modulus, 25% in CS, 20% in DTS and 36% in FS, higher than commercial Fuji II LC. After aging in water for 30 days, the compressive strengths of the experimental cements were significantly changed with an increase of 29% in YS, 19% in modulus as well as 23% in CS and a decrease of 5% in toughness, indicating that aging in water enhances the salt-bridge formation and increases brittleness. A novel light-cured glass-ionomer cement system composed of the star-shaped poly(carboxylic acid)s has been developed via a cost-effective and time-efficient chain-transfer radical polymerization. Copyright © 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Tensile Bond Strength of Self Adhesive Resin Cement After Various Surface Treatment of Enamel

PubMed Central

Sekhri, Sahil; Garg, Sandeep

2016-01-01

Introduction In self adhesive resin cements adhesion is achieved to dental surface without surface pre-treatment, and requires only single step application. This makes the luting procedure less technique-sensitive and decreases postoperative sensitivity. Aim The purpose of this study was to evaluate bond strength of self adhesive resin after surface treatment of enamel for bonding base metal alloy. Materials and Methods On the labial surface of 64 central incisor rectangular base metal block of dimension 6 mm length, 5mm width and 1 mm height was cemented with RelyX U200 and Maxcem Elite self adhesive cements with and without surface treatment of enamel. Surface treatment of enamel was application of etchant, one step bonding agent and both. Tensile bond strength of specimen was measured with universal testing machine at a cross head speed of 1mm/min. Results Least tensile bond strength (MPa) was in control group i.e. 1.33 (0.32) & 1.59 (0.299), Highest bond strength observed when enamel treated with both etchant and bonding agent i.e. 2.72 (0.43) & 2.97 (0.19) for Relyx U200 and Elite cement. When alone etchant and bonding agent were applied alone bond strength is 2.19 (0.18) & 2.24 (0.47) for Relyx U200, and 2.38 (0.27) 2.49 (0.16) for Max-cem elite. Mean bond strength was higher in case of Max-cem Elite as compared to RelyX U200 resin cement, although differences were non–significant (p > 0.05). Conclusion Surface treatment of enamel increases the bond strength of self adhesive resin cement. PMID:26894165

Marginal adaptation of lithium disilicate ceramic crowns cemented with three different resin cements.

PubMed

Peroz, Ingrid; Mitsas, Triantafyllos; Erdelt, Kurt; Kopsahilis, Niko

2018-04-17

The cementation process and cementation materials have an influence on the marginal adaptation of restorations. The gap could be affected by thermal and mechanical loading (TCML). The computerized x-ray microtomography (μCT) method offers the possibility of measuring the marginal gap without destruction of the restoration. The aim of this study was to evaluate the marginal gap (MG) and the absolute marginal discrepancy (AMD) before and after TCML. Thirty-nine human premolars were prepared for full ceramic crowns made of lithium disilicate. The crowns were cemented by three different resins-Panavia F 2.0, Variolink II, and Relyx Unicem. The MG and AMD were evaluated by μCT before and after TCML. Panavia F 2.0 had the lowest MG (before 118 μm-after TMCL 124 μm) and AMD (before 145 μm-after TMCL 154 μm), followed by Relyx Unicem (MG: before 164 μm-after TCML 155 μm; AMD: before 213 μm-after TMCL 209 μm) and Variolink II (MG: before 317 μm-after TMCL 320 μm; AMD: before 412 μm-after TMCL 406 μm). The differences were statistically significant before and after TCML. Rather than TCML, it appeared the resin cement was responsible for differences between the MG and AMD before and after TCML. μCT is an accurate technique for assessing cemented restorations. Panavia F 2.0 has the lowest MG and AMD before and after TCML. The resin material that features a three-step protocol (Variolink II) produced higher MG and AMG values than the Panavia or Relyx Unicem varieties with less or no intermediate steps at all.

Creating a Vision Channel for Observing Deep-Seated Anatomy in Medical Augmented Reality

NASA Astrophysics Data System (ADS)

Wimmer, Felix; Bichlmeier, Christoph; Heining, Sandro M.; Navab, Nassir

The intent of medical Augmented Reality (AR) is to augment the surgeon's real view on the patient with the patient's interior anatomy resulting from a suitable visualization of medical imaging data. This paper presents a fast and user-defined clipping technique for medical AR allowing for cutting away any parts of the virtual anatomy and images of the real part of the AR scene hindering the surgeon's view onto the deepseated region of interest. Modeled on cut-away techniques from scientific illustrations and computer graphics, the method creates a fixed vision channel to the inside of the patient. It enables a clear view on the focussed virtual anatomy and moreover improves the perception of spatial depth.

An approximate model for cancellous bone screw fixation.

PubMed

Brown, C J; Sinclair, R A; Day, A; Hess, B; Procter, P

2013-04-01

This paper presents a finite element (FE) model to identify parameters that affect the performance of an improved cancellous bone screw fixation technique, and hence potentially improve fracture treatment. In cancellous bone of low apparent density, it can be difficult to achieve adequate screw fixation and hence provide stable fracture fixation that enables bone healing. Data from predictive FE models indicate that cements can have a significant potential to improve screw holding power in cancellous bone. These FE models are used to demonstrate the key parameters that determine pull-out strength in a variety of screw, bone and cement set-ups, and to compare the effectiveness of different configurations. The paper concludes that significant advantages, up to an order of magnitude, in screw pull-out strength in cancellous bone might be gained by the appropriate use of a currently approved calcium phosphate cement.

Self-curing concrete with different self-curing agents

NASA Astrophysics Data System (ADS)

Gopala krishna sastry, K. V. S.; manoj kumar, Putturu

2018-03-01

Concrete is recognised as a versatile construction material globally. Properties of concrete depend upon, to a greater extent, the hydration of cement and microstructure of hydrated cement. Congenial atmosphere would aid the hydration of cement and hence curing of concrete becomes essential, till a major portion of the hydration process is completed. But in areas of water inadequacy and concreting works at considerable heights, curing is problematic. Self-Curing or Internal Curing technique overcomes these problems. It supplies redundant moisture, for more than sufficient hydration of cement and diminish self-desiccation. Self-Curing agents substantially help in the conservation of water in concrete, by bringing down the evaporation during the hydration of Concrete. The present study focuses on the impact of self-curing agents such as Poly Ethylene Glycol (PEG), Poly Vinyl Alcohol (PVA) and Super Absorbent Polymer (SAP) on the concrete mix of M25 grade (reference mix). The effect of these agents on strength properties of Concrete such as compressive strength, split tensile strength and flexural strength was observed on a comparative basis which revealed that PEG 4000 was the most effective among all the agents.

Late diagenetic indicators of buried oil and gas: II, Direct detection experiment at Cement and Garza oil fields, Oklahoma and Texas, using enhanced LANDSAT I and II images

USGS Publications Warehouse

Donovan, Terrence J.; Termain, Patricia A.; Henry, Mitchell E.

1979-01-01

The Cement oil field, Oklahoma, was a test site for an experiment designed to evaluate LANDSAT's capability to detect an alteration zone in surface rocks caused by hydrocarbon microseepage. Loss of iron and impregnation of sandstone by carbonate cements and replacement of gypsum by calcite are the major alteration phenomena at Cement. The bedrock alterations are partially masked by unaltered overlying beds, thick soils, and dense natural and cultivated vegetation. Interpreters biased by detailed ground truth were able to map the alteration zone subjectively using a magnified, filtered, and sinusoidally stretched LANDSAT composite image; other interpreters, unbiased by ground truth data, could not duplicate that interpretation. Similar techniques were applied at a secondary test site (Garza oil field, Texas), where similar alterations in surface rocks occur. Enhanced LANDSAT images resolved the alteration zone to a biased interpreter and some individual altered outcrops could be mapped using higher resolution SKYLAB color and conventional black and white aerial photographs suggesting repeat experiments with LANDSAT C and D.

Augmentation of the Pullout Repair of a Medial Meniscus Posterior Root Tear by Arthroscopic Centralization.

PubMed

Koga, Hideyuki; Watanabe, Toshifumi; Horie, Masafumi; Katagiri, Hiroki; Otabe, Koji; Ohara, Toshiyuki; Katakura, Mai; Sekiya, Ichiro; Muneta, Takeshi

2017-08-01

The meniscus roots are critical for meniscus function in preserving correct knee kinematics and avoiding meniscus extrusion and, consequently, in the progression of osteoarthritis. Several techniques exist for medial meniscus posterior root tear repair; however, current surgical techniques have been proved to fail to reduce meniscus extrusion, which has been shown to be associated with development of osteoarthritis, although significant improvements in the postoperative clinical findings have been achieved. This Technical Note describes an arthroscopic technique for the medial meniscus posterior root tear in which a pullout repair is augmented by a centralization technique to restore and maintain the medial meniscus function by efficiently reducing meniscus extrusion.

Augmentation of machine structure to improve its diagnosability

NASA Technical Reports Server (NTRS)

Hsieh, L.

1973-01-01

Two methods of augmenting the structure of a sequential machine so that it is diagnosable are presented. The checkable (checking sequences) and repeated symbol distinguishing sequences (RDS) are discussed. It was found that as few as twice the number of outputs of the given machine is sufficient for constructing a state-output augmentation with RDS. Techniques for minimizing the number of states in resolving convergences and in resolving equivalent and nonreduced cycles are developed.

Complications related to bone augmentation procedures of localized defects in the alveolar ridge. A retrospective clinical study.

PubMed

Jensen, Anders Torp; Jensen, Simon Storgård; Worsaae, Nils

2016-06-01

This retrospective clinical study aims to evaluate complications after augmentation of localized bone defects of the alveolar ridge. From standardized registrations, the following complications related to bone augmentation procedures were recorded: soft tissue dehiscence, infection, sensory disturbance, additional augmentation procedures needed, and early implant failure. A total of 223 patients (132 women, 91 men; mean age 23.5 years; range 17-65 years) with 331 bone defects had bone augmentation performed into which 350 implants were placed. Soft tissue dehiscence occurred in 1.7 % after GBR procedures, 25.9 % after staged horizontal ridge augmentation, and 18.2 % after staged vertical ridge augmentation. Infections were diagnosed in 2 % after GBR procedures, 12.5 % after sinus floor elevation (SFE) (transcrestal technique), 5 % after staged SFE, 11 % after staged horizontal ridge augmentation, and 9 % after staged vertical ridge augmentation. Additional augmentation procedures were needed in 2 % after GBR procedures, 37 % after staged horizontal ridge augmentation, and 9 % after staged vertical ridge augmentation. A total of six early implant failures occurred (1.7 %), four after GBR procedures (1.6 %), and two (12 %) after staged vertical ridge augmentation. Predictable methods exist to augment localized defects in the alveolar ridge, as documented by low complication rates and high early implant survival rates.

Feasibility study of fluxless brazing cemented carbides to steel

NASA Astrophysics Data System (ADS)

Tillmann, W.; Sievers, N.

2017-03-01

One of the most important brazing processes is the joints between cemented carbides and steel for the tool industry such as in rotary drill hammers or saw blades. Even though this technique has already been used for several decades, defects in the joint can still occur and lead to quality loss. Mostly, the joining process is facilitated by induction heating and the use of a flux to enhance the wetting of the filler alloy on the surface of the steel and cemented carbide in an ambient atmosphere. However, although the use of flux enables successful joining, it also generates voids within the joint, which reduces the strength of the connection while the chemicals within the flux are toxic and polluting. In this feasibility study, a fluxless brazing process is used to examine the joint between cemented carbides and steel for the first time. For this, ultrasound is applied during induction heating to enable the wetting between the liquid filler metal and the surfaces of the cemented carbide and steel. The ultrasound generates cavitations within the liquid filler metal, which remove the oxides from the surface. Several filler metals such as a silver based alloy Ag449, pure Zn, and an AlSi-alloy were used to reduce the brazing temperature and to lower the thermal residual stresses within the joint. As a result, every filler metal successfully wetted both materials and led to a dense connection. The ultrasound has to be applied carefully to prevent a damage of the cemented carbide. In this regard, it was observed that single grains of the cemented carbide broke out and remained in the joint. This positive result of brazing cemented carbides to steel without a flux but using ultrasound, allows future studies to focus on the shear strength of these joints as well as the behavior of the thermally induced residual stresses.

Pyriform Aperture Augmentation as An Adjunct to Rhinoplasty.

PubMed

Yaremchuk, Michael J; Vibhakar, Dev

2016-01-01

Skeletal deficiency in the central midface impacts nasal aesthetics. This lack of lower face projection can be corrected by alloplastic augmentation of the pyriform aperture. Creating convexity in the deficient midface will make the nose seem less prominent. Augmentation of the pyriform aperture is, therefore, often a useful adjunct during the rhinoplasty procedure. Augmenting the skeleton in this area can alter the projection of the nasal base, the nasolabial angle, and the vertical plane of the lip. The implant design and surgical techniques described here are extensions of others' previous efforts to improve paranasal aesthetics. Copyright © 2016 Elsevier Inc. All rights reserved.

Patient radiation exposure during different kyphoplasty techniques.

PubMed

Panizza, Denis; Barbieri, Massimo; Parisoli, Francesco; Moro, Luca

2014-01-01

The scope of this study was to quantify patient radiation exposure during two different techniques of kyphoplasty (KP), which differ by a cement delivery method, in order to assess whether or not one of the two used methods can reduce the patient dose. Twenty patients were examined for this investigation. One X-ray fluoroscopy unit was used for localization, navigation and monitoring of cement delivery. The patient biometric data, the setting of the fluoroscope, the exposure time and the kerma-area product (KAP) were monitored in all the procedures for anteroposterior (AP) and lateral (LL) fluoroscopic projections in order to assess the range of radiation doses imparted to the patient. Theoretical entrance skin dose (ESD) and effective dose (E) were calculated from intraoperatively measured KAP. An average ET per procedure was 1.5±0.5 min for the manual injection technique (study A) and 1.4±0.4 min for the distance delivery technique (study B) in the AP plane, while 3.2±0.7 and 5.1±0.6 min in the lateral plane, respectively. ESD was estimated as an average of 0.10±0.06 Gy for study A and 0.13±0.13 Gy for study B in the AP or/and 0.59±0.46 and 1.05±0.36 Gy in the lateral view, respectively. The cumulative mean E was 1.9±1.0 mSv procedure(-1) for study A and 3.6±0.9 mSv procedure(-1) for study B. Patient radiation exposure and associated effective dose from KP may be considerable. The technique of distance cement delivery appears to be slower than the manual injection technique and it requires a more protracted fluoroscopic control in the lateral projection, so that this system entails a higher amount of dose to the patient.

Adjustment of localized alveolar ridge defects by soft tissue transplantation to improve mucogingival esthetics: a proposal for clinical classification and an evaluation of procedures.

PubMed

Studer, S; Naef, R; Schärer, P

1997-12-01

Esthetically correct treatment of a localized alveolar ridge defect is a frequent prosthetic challenge. Such defects can be overcome not only by a variety of prosthetic means, but also by several periodontal surgical techniques, notably soft tissue augmentations. Preoperative classification of the localized alveolar ridge defect can be greatly useful in evaluating the prognosis and technical difficulties involved. A semiquantitative classification, dependent on the severity of vertical and horizontal dimensional loss, is proposed to supplement the recognized qualitative classification of a ridge defect. Various methods of soft tissue augmentation are evaluated, based on initial volumetric measurements. The roll flap technique is proposed when the problem is related to ridge quality (single-tooth defect with little horizontal and vertical loss). Larger defects in which a volumetric problem must be solved are corrected through the subepithelial connective tissue technique. Additional mucogingival problems (eg, insufficient gingival width, high frenum, gingival scarring, or tattoo) should not be corrected simultaneously with augmentation procedures. In these cases, the onlay transplant technique is favored.

Elastic properties and strain-to-crack-initiation of calcium phosphate bone cements: Revelations of a high-resolution measurement technique.

PubMed

Ajaxon, Ingrid; Acciaioli, Alice; Lionello, Giacomo; Ginebra, Maria-Pau; Öhman-Mägi, Caroline; Baleani, Massimiliano; Persson, Cecilia

2017-10-01

Calcium phosphate cements (CPCs) should ideally have mechanical properties similar to those of the bone tissue the material is used to replace or repair. Usually, the compressive strength of the CPCs is reported and, more rarely, the elastic modulus. Conversely, scarce or no data are available on Poisson's ratio and strain-to-crack-initiation. This is unfortunate, as data on the elastic response is key to, e.g., numerical model accuracy. In this study, the compressive behaviour of brushite, monetite and apatite cements was fully characterised. Measurement of the surface strains was done using a digital image correlation (DIC) technique, and compared to results obtained with the commonly used built-in displacement measurement of the materials testers. The collected data showed that the use of fixed compression platens, as opposed to spherically seated ones, may in some cases underestimate the compressive strength by up to 40%. Also, the built-in measurements may underestimate the elastic modulus by up to 62% as compared to DIC measurements. Using DIC, the brushite cement was found to be much stiffer (24.3 ± 2.3GPa) than the apatite (13.5 ± 1.6GPa) and monetite (7.1 ± 1.0GPa) cements, and elastic moduli were inversely related to the porosity of the materials. Poisson's ratio was determined to be 0.26 ± 0.02 for brushite, 0.21 ± 0.02 for apatite and 0.20 ± 0.03 for monetite. All investigated CPCs showed low strain-to-crack-initiation (0.17-0.19%). In summary, the elastic modulus of CPCs is substantially higher than previously reported and it is concluded that an accurate procedure is a prerequisite in order to properly compare the mechanical properties of different CPC formulations. It is recommended to use spherically seated platens and measuring the strain at a relevant resolution and on the specimen surface. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Augmented reality-guided neurosurgery: accuracy and intraoperative application of an image projection technique.

PubMed

Besharati Tabrizi, Leila; Mahvash, Mehran

2015-07-01

An augmented reality system has been developed for image-guided neurosurgery to project images with regions of interest onto the patient's head, skull, or brain surface in real time. The aim of this study was to evaluate system accuracy and to perform the first intraoperative application. Images of segmented brain tumors in different localizations and sizes were created in 10 cases and were projected to a head phantom using a video projector. Registration was performed using 5 fiducial markers. After each registration, the distance of the 5 fiducial markers from the visualized tumor borders was measured on the virtual image and on the phantom. The difference was considered a projection error. Moreover, the image projection technique was intraoperatively applied in 5 patients and was compared with a standard navigation system. Augmented reality visualization of the tumors succeeded in all cases. The mean time for registration was 3.8 minutes (range 2-7 minutes). The mean projection error was 0.8 ± 0.25 mm. There were no significant differences in accuracy according to the localization and size of the tumor. Clinical feasibility and reliability of the augmented reality system could be proved intraoperatively in 5 patients (projection error 1.2 ± 0.54 mm). The augmented reality system is accurate and reliable for the intraoperative projection of images to the head, skull, and brain surface. The ergonomic advantage of this technique improves the planning of neurosurgical procedures and enables the surgeon to use direct visualization for image-guided neurosurgery.

The effect of endodontic access preparation on the failure load of lithium disilicate glass-ceramic restorations.

PubMed

Qeblawi, Dana; Hill, Thomas; Chlosta, Kelly

2011-11-01

Endodontic access preparation through lithium disilicate ceramic restorations may damage the restoration and compromise its load-bearing capability. The purpose of this in vitro research was to investigate the effect of simulated endodontic access preparation through lithium disilicate glass-ceramic restorations on their load to failure. Sixty lithium disilicate glass-ceramic (IPS e.max CAD) complete-coverage restorations were milled and crystallized. Five coats of die relief were applied internally in the crown to provide a cement space approximately 60 μm in thickness. Composite resin dies were fabricated by backfilling each crown. The specimens were then stored at 37°C and 100% humidity for 30 days. The crowns with their respective dies were divided into 6 groups: Groups M-C, M-ZR, M-SC, and M-CRF were adhesively bonded with a resin cement (Multilink Implant), and Groups F-C and F-ZR were conventionally cemented with zinc phosphate cement (Fleck's). After storing all groups for 1 week, Groups M-C and F-C served as the intact controls for the 2 cementation techniques, while Groups M-ZR and F-ZR had an access prepared with a 126 μm grit-size diamond rotary instrument. For Groups M-SC and M-CRF, the endodontic access was prepared with 150 μm and 180 μm grit-size diamond rotary instruments, respectively. Access preparations were restored with composite resin. All specimens were stored at 37°C and 100% humidity for 1 week before they were loaded to failure with a universal loading apparatus (crosshead speed=1mm/min). The results were analyzed with a 1-way ANOVA followed by Tukey's HSD test (α=.05). The highest failure loads were achieved with Groups M-C (3316 N ±483) and M-ZR (3464 N ±645) Larger grit rotary instruments resulted in lower failure-loads in Groups M-SC (2915 N ±569) and M-CRF (2354 N ±476). Groups F-C (2242 N ±369) and F-ZR(1998 N ±448) had significantly lower failure loads than their adhesively bonded counterparts (P<.05). The use of 126 μm grit size did not significantly alter the failure loads of the restorations in either cementation technique. Adhesively bonded restorations sustained significantly higher loads to failure than those conventionally cemented. The use of a high efficiency, smaller-grit diamond rotary instrument for endodontic access preparation did not alter the load to failure of lithium disilicate restorations, regardless of the cement used. The use of a larger-grit rotary instrument did not improve the cutting efficiency and reduced the failure load of bonded restorations. Copyright © 2011 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

Tribochemical Glass Ceramic Coating as a New Approach for Resin Adhesion to Zirconia.

PubMed

Wandscher, Vinícius Felipe; Fraga, Sara; Pozzobon, João Luiz; Soares, Fabio Zovico Maxnuck; Foletto, Edson Luiz; May, Liliana Gressler; Valandro, Luiz Felipe

To investigate the effects of a novel tribochemical silica coating technique with powders made from feldspathic ceramic and leucite-based ceramic on the bond strength of zirconia to resin cement before and after aging. Zirconia blocks were divided into 3 groups according to the material used for airborne-particle abrasion: 1) SP (control): silica-coated alumina particles; 2) FP: feldspathic ceramic powder; 3) LP: leucite glass-ceramic powder. After silanization, composite resin cylinders were cemented on the zirconia surface using a dual-curing resin cement. Prior to the shear bond strength (SBS) test, half of the samples (n = 15) were stored in distilled water for 24 h; the other half (n = 15) were submitted to aging (10,000 thermocycles of 5°C to 55°C; 150 days of water storage). The bond strength data were analyzed using two-way ANOVA and Tukey's test (α = 0.05). Scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), and x-ray diffraction analysis were performed. The initial bond strengths did not differ significantly between the groups (p = 0.053). However, after aging procedures, airborne-particle abrasion with feldspathic ceramic powder (FP) resulted in higher values of bond strength (p = 0.0001). SEM and EDS indicated that all the treatments promoted silica deposition on the Y-TZP surface ceramic. Airborne-particle abrasion with FP and LP induced a lower percentage of the monoclinic phase. Airborne abrasion with fine feldspathic ceramic particles is a novel tribochemical technique and appears to be suitable for improving the bond strength between zirconia and resin cements.

The augmented Lagrangian method for parameter estimation in elliptic systems

NASA Technical Reports Server (NTRS)

Ito, Kazufumi; Kunisch, Karl

1990-01-01

In this paper a new technique for the estimation of parameters in elliptic partial differential equations is developed. It is a hybrid method combining the output-least-squares and the equation error method. The new method is realized by an augmented Lagrangian formulation, and convergence as well as rate of convergence proofs are provided. Technically the critical step is the verification of a coercivity estimate of an appropriately defined Lagrangian functional. To obtain this coercivity estimate a seminorm regularization technique is used.

Use of overlapping buccal mucosa graft urethroplasty for complex anterior urethral strictures

PubMed Central

2015-01-01

Complex anterior urethral stricture disease typically manifests as a symptomatic, severely narrowed, long stricture (or multiple strictures) in which conventional excision and/or augmentation is not feasible. Overlapping buccal mucosal graft urethroplasty (OBMGU) is an innovative hybrid technique, combining the well-established principles of dorsal and ventral graft augmentation to allow single stage reconstruction of complex anterior urethral strictures. In this review, we discuss the rationale, techniques, and outcomes of OBMGU for complex anterior urethral strictures. PMID:26813234

Evaluation of composite pavement unbonded overlays : phase III.

DOT National Transportation Integrated Search

2007-08-01

In recent years, thin whitetopping has evolved as a viable rehabilitation technique for deteriorated asphalt cement concrete (ACC) pavements. Numerous projects have been constructed and tested, allowing researchers to identify the important elements ...

Applied Augmented Reality for High Precision Maintenance

NASA Astrophysics Data System (ADS)

Dever, Clark

Augmented Reality had a major consumer breakthrough this year with Pokemon Go. The underlying technologies that made that app a success with gamers can be applied to improve the efficiency and efficacy of workers. This session will explore some of the use cases for augmented reality in an industrial environment. In doing so, the environmental impacts and human factors that must be considered will be explored. Additionally, the sensors, algorithms, and visualization techniques used to realize augmented reality will be discussed. The benefits of augmented reality solutions in industrial environments include automated data recording, improved quality assurance, reduction in training costs and improved mean-time-to-resolution. As technology continues to follow Moore's law, more applications will become feasible as performance-per-dollar increases across all system components.

[Progress of Masquelet technique to repair bone defect].

PubMed

Yin, Qudong; Sun, Zhenzhong; Gu, Sanjun

2013-10-01

To summarize the progress of Masquelet technique to repair bone defect. The recent literature concerning the application of Masquelet technique to repair bone defect was extensively reviewed and summarized. Masquelet technique involves a two-step procedure. First, bone cement is used to fill the bone defect after a thorough debridement, and an induced membrane structure surrounding the spacer formed; then the bone cement is removed after 6-8 weeks, and rich cancellous bone is implanted into the induced membrane. Massive cortical bone defect is repaired by new bone forming and consolidation. Experiments show that the induced membrane has vascular system and is also rich in vascular endothelial growth factor, transforming growth factor beta1, bone morphogenetic protein 2, and bone progenitor cells, so it has osteoinductive property; satisfactory results have been achieved in clinical application of almost all parts of defects, various types of bone defect and massive defect up to 25 cm long. Compared with other repair methods, Masquelet technique has the advantages of reliable effect, easy to operate, few complications, low requirements for recipient site, and wide application. Masquelet technique is an effective method to repair bone defect and is suitable for various types of bone defect, especially for bone defects caused by infection and tumor resection.

Transforming Polar Research with Google Glass Augmented Reality (Invited)

NASA Astrophysics Data System (ADS)

Ruthkoski, T.

2013-12-01

Augmented reality is a new technology with the potential to accelerate the advancement of science, particularly in geophysical research. Augmented reality is defined as a live, direct or indirect, view of a physical, real-world environment whose elements are augmented (or supplemented) by computer-generated sensory input such as sound, video, graphics or GPS data. When paired with advanced computing techniques on cloud resources, augmented reality has the potential to improve data collection techniques, visualizations, as well as in-situ analysis for many areas of research. Google is currently a pioneer of augmented reality technology and has released beta versions of their wearable computing device, Google Glass, to a select number of developers and beta testers. This community of 'Glass Explorers' is the vehicle from which Google shapes the future of their augmented reality device. Example applications of Google Glass in geophysical research range from use as a data gathering interface in harsh climates to an on-site visualization and analysis tool. Early participation in the shaping of the Google Glass device is an opportunity for researchers to tailor this new technology to their specific needs. The purpose of this presentation is to provide geophysical researchers with a hands-on first look at Google Glass and its potential as a scientific tool. Attendees will be given an overview of the technical specifications as well as a live demonstration of the device. Potential applications to geophysical research in polar regions will be the primary focus. The presentation will conclude with an open call to participate, during which attendees may indicate interest in developing projects that integrate Google Glass into their research. Application Mockup: Penguin Counter Google Glass Augmented Reality Device

Transforming Polar Research with Google Glass Augmented Reality (Invited)

NASA Astrophysics Data System (ADS)

Ramachandran, R.; McEniry, M.; Maskey, M.

2011-12-01

Augmented reality is a new technology with the potential to accelerate the advancement of science, particularly in geophysical research. Augmented reality is defined as a live, direct or indirect, view of a physical, real-world environment whose elements are augmented (or supplemented) by computer-generated sensory input such as sound, video, graphics or GPS data. When paired with advanced computing techniques on cloud resources, augmented reality has the potential to improve data collection techniques, visualizations, as well as in-situ analysis for many areas of research. Google is currently a pioneer of augmented reality technology and has released beta versions of their wearable computing device, Google Glass, to a select number of developers and beta testers. This community of 'Glass Explorers' is the vehicle from which Google shapes the future of their augmented reality device. Example applications of Google Glass in geophysical research range from use as a data gathering interface in harsh climates to an on-site visualization and analysis tool. Early participation in the shaping of the Google Glass device is an opportunity for researchers to tailor this new technology to their specific needs. The purpose of this presentation is to provide geophysical researchers with a hands-on first look at Google Glass and its potential as a scientific tool. Attendees will be given an overview of the technical specifications as well as a live demonstration of the device. Potential applications to geophysical research in polar regions will be the primary focus. The presentation will conclude with an open call to participate, during which attendees may indicate interest in developing projects that integrate Google Glass into their research. Application Mockup: Penguin Counter Google Glass Augmented Reality Device

Powdered ZELIAC augmented sequencing batch reactors (SBR) process for co-treatment of landfill leachate and domestic wastewater.

PubMed

Mojiri, Amin; Aziz, Hamidi Abdul; Zaman, Nastaein Q; Aziz, Shuokr Qarani; Zahed, Mohammad Ali

2014-06-15

Sequencing batch reactor (SBR) is one of the various methods of biological treatments used for treating wastewater and landfill leachate. This study investigated the treatment of landfill leachate and domestic wastewater by adding a new adsorbent (powdered ZELIAC; PZ) to the SBR technique. ZELIAC consists of zeolite, activated carbon, lime stone, rice husk ash, and Portland cement. The response surface methodology and central composite design were used to elucidate the nature of the response surface in the experimental design and describe the optimum conditions of the independent variables, including aeration rate (L/min), contact time (h), and ratio of leachate to wastewater mixture (%; v/v), as well as their responses (dependent variables). Appropriate conditions of operating variables were also optimized to predict the best value of responses. To perform an adequate analysis of the aerobic process, four dependent parameters, namely, chemical oxygen demand (COD), color, ammonia-nitrogen (NH3-N), and phenols, were measured as responses. The results indicated that the PZ-SBR showed higher performance in removing certain pollutants compared with SBR. Given the optimal conditions of aeration rate (1.74 L/min), leachate to wastewater ratio (20%), and contact time (10.31 h) for the PZ-SBR, the removal efficiencies for color, NH3-N, COD, and phenols were 84.11%, 99.01%, 72.84%, and 61.32%, respectively. Copyright © 2014 Elsevier Ltd. All rights reserved.

Design and Validation of an Augmented Reality System for Laparoscopic Surgery in a Real Environment

PubMed Central

López-Mir, F.; Naranjo, V.; Fuertes, J. J.; Alcañiz, M.; Bueno, J.; Pareja, E.

2013-01-01

Purpose. This work presents the protocol carried out in the development and validation of an augmented reality system which was installed in an operating theatre to help surgeons with trocar placement during laparoscopic surgery. The purpose of this validation is to demonstrate the improvements that this system can provide to the field of medicine, particularly surgery. Method. Two experiments that were noninvasive for both the patient and the surgeon were designed. In one of these experiments the augmented reality system was used, the other one was the control experiment, and the system was not used. The type of operation selected for all cases was a cholecystectomy due to the low degree of complexity and complications before, during, and after the surgery. The technique used in the placement of trocars was the French technique, but the results can be extrapolated to any other technique and operation. Results and Conclusion. Four clinicians and ninety-six measurements obtained of twenty-four patients (randomly assigned in each experiment) were involved in these experiments. The final results show an improvement in accuracy and variability of 33% and 63%, respectively, in comparison to traditional methods, demonstrating that the use of an augmented reality system offers advantages for trocar placement in laparoscopic surgery. PMID:24236293

Mathematical Model Relating Uniaxial Compressive Behavior of Manufactured Sand Mortar to MIP-Derived Pore Structure Parameters

PubMed Central

Tian, Zhenghong; Bu, Jingwu

2014-01-01

The uniaxial compression response of manufactured sand mortars proportioned using different water-cement ratio and sand-cement ratio is examined. Pore structure parameters such as porosity, threshold diameter, mean diameter, and total amounts of macropores, as well as shape and size of micropores are quantified by using mercury intrusion porosimetry (MIP) technique. Test results indicate that strains at peak stress and compressive strength decreased with the increasing sand-cement ratio due to insufficient binders to wrap up entire sand. A compression stress-strain model of normal concrete extending to predict the stress-strain relationships of manufactured sand mortar is verified and agreed well with experimental data. Furthermore, the stress-strain model constant is found to be influenced by threshold diameter, mean diameter, shape, and size of micropores. A mathematical model relating stress-strain model constants to the relevant pore structure parameters of manufactured sand mortar is developed. PMID:25133257

Research on curing behavior of concrete with anti-frost admixtures at subzero temperature

NASA Astrophysics Data System (ADS)

Ionov, Yulian; Kramar, Ludmila; Kirsanova, Alena; Kolegova, Irina

2017-01-01

The purpose of this paper is research on curing behavior of cold-weather concrete with anti-frost admixtures. During the study derivative thermal and X-ray phase analyses were performed and tests were carried out according to the standard GOST technique. The research results obtained reveal the peculiarities of cement hydration and concrete curing at subzero temperatures. The influence of subzero temperatures and anti-frost admixtures on hydrated phases of hardened cement paste and concrete strength formation was studied. It is found that cold-weather concrete does not cure at subzero temperatures, but when defrosting it attains 80 to 85% of its grade strength by the 28th day. Concrete achieves its grade strength when curing in normal conditions in 60 days only. Freezing concrete with anti-frost admixtures results in increase of calcium hydroxide content in hardened cement paste immediately when produced and has increased tendency of concrete to carbonation.

Comparative Effect of Bio-waste Ashes on Strength Properties of Cement Mortar

NASA Astrophysics Data System (ADS)

Ajay, Goyal; Hattori, Kunio; Ogata, Hidehiko; Ashraf, Muhammad; Ahmed, Mohamed Anwar

Biomass fuels produce about 400 million tonnes of ashes as waste material. This paper discusses the pozzolanic character of bio-waste ashes obtained from dry tree leaves (AML), Korai grass (KRI) and Tifton grass (TFT). Ashes were obtained by control incineration of the wastes at 600°C for 5 hours and mortar specimens were prepared by substituting cement with 10, 20 and 30% ash. Strength development of ash-blended mortar specimens was evaluated by conducting destructive tests as well as non-destructive tests till 91 days. X-ray diffraction, scanning electron microscopic and thermo-gravimetric techniques were used to analyze the influence of ash substitution on strength properties of blended-mortar. Pozzolanic reactivity of AML- and KRI-ash was confirmed, but TFT-ash did not show enough reactivity. Overall results confirmed that up to 20% substitution of cement can be made with AML- or KRI-ash with strength approaching 90% of that of control.

Performance Characteristics of Waste Glass Powder Substituting Portland Cement in Mortar Mixtures

NASA Astrophysics Data System (ADS)

Kara, P.; Csetényi, L. J.; Borosnyói, A.

2016-04-01

In the present work, soda-lime glass cullet (flint, amber, green) and special glass cullet (soda-alkaline earth-silicate glass coming from low pressure mercury-discharge lamp cullet and incandescent light bulb borosilicate glass waste cullet) were ground into fine powders in a laboratory planetary ball mill for 30 minutes. CEM I 42.5N Portland cement was applied in mortar mixtures, substituted with waste glass powder at levels of 20% and 30%. Characterisation and testing of waste glass powders included fineness by laser diffraction particle size analysis, specific surface area by nitrogen adsorption technique, particle density by pycnometry and chemical analysis by X-ray fluorescence spectrophotometry. Compressive strength, early age shrinkage cracking and drying shrinkage tests, heat of hydration of mortars, temperature of hydration, X-ray diffraction analysis and volume stability tests were performed to observe the influence of waste glass powder substitution for Portland cement on physical and engineering properties of mortar mixtures.

Spheroidization of glass powders for glass ionomer cements.

PubMed

Gu, Y W; Yap, A U J; Cheang, P; Kumar, R

2004-08-01

Commercial angular glass powders were spheroidized using both the flame spraying and inductively coupled radio frequency plasma spraying techniques. Spherical powders with different particle size distributions were obtained after spheroidization. The effects of spherical glass powders on the mechanical properties of glass ionomer cements (GICs) were investigated. Results showed that the particle size distribution of the glass powders had a significant influence on the mechanical properties of GICs. Powders with a bimodal particle size distribution ensured a high packing density of glass ionomer cements, giving relatively high mechanical properties of GICs. GICs prepared by flame-spheroidized powders showed low strength values due to the loss of fine particles during flame spraying, leading to a low packing density and few metal ions reacting with polyacrylic acid to form cross-linking. GICs prepared by the nano-sized powders showed low strength because of the low bulk density of the nano-sized powders and hence low powder/liquid ratio of GICs.

Mathematical model relating uniaxial compressive behavior of manufactured sand mortar to MIP-derived pore structure parameters.

PubMed

Tian, Zhenghong; Bu, Jingwu

2014-01-01

The uniaxial compression response of manufactured sand mortars proportioned using different water-cement ratio and sand-cement ratio is examined. Pore structure parameters such as porosity, threshold diameter, mean diameter, and total amounts of macropores, as well as shape and size of micropores are quantified by using mercury intrusion porosimetry (MIP) technique. Test results indicate that strains at peak stress and compressive strength decreased with the increasing sand-cement ratio due to insufficient binders to wrap up entire sand. A compression stress-strain model of normal concrete extending to predict the stress-strain relationships of manufactured sand mortar is verified and agreed well with experimental data. Furthermore, the stress-strain model constant is found to be influenced by threshold diameter, mean diameter, shape, and size of micropores. A mathematical model relating stress-strain model constants to the relevant pore structure parameters of manufactured sand mortar is developed.

Fluid-chemical evidence for one billion years of fluid flow through Mesoproterozoic deep-water carbonate mounds (Nanisivik zinc district, Nunavut)

NASA Astrophysics Data System (ADS)

Hahn, K. E.; Turner, E. C.; Kontak, D. J.; Fayek, M.

2018-02-01

Ancient carbonate rocks commonly contain numerous post-depositional phases (carbonate minerals; quartz) recording successive diagenetic events that can be deciphered and tied to known or inferred geological events using a multi-pronged in situ analytical protocol. The framework voids of large, deep-water microbial carbonate seep-mounds in Arctic Canada (Mesoproterozoic Ikpiarjuk Formation) contain multiple generations of synsedimentary and late cement. An in situ analytical study of the post-seafloor cements used optical and cathodoluminescence petrography, SEM-EDS analysis, fluid inclusion (FI) microthermometry and evaporate mound analysis, LA-ICP-MS analysis, and SIMS δ18O to decipher the mounds' long-term diagenetic history. The six void-filling late cements include, in paragenetic order: inclusion-rich euhedral dolomite (ED), finely crystalline clear dolomite (FCD), hematite-bearing dolomite (HD), coarsely crystalline clear dolomite (CCD), quartz (Q), replacive calcite (RC) and late calcite (LC). Based on the combined analytical results, the following fluid-flow history is defined: (1) ED precipitation by autocementation during shallow burial (fluid 1; Mesoproterozoic); (2) progressive mixing of Ca-rich hydrothermal fluid with the connate fluid, resulting in precipitation of FCD followed by HD (fluid 2; also Mesoproterozoic); (3) precipitation of hydrothermal dolomite (CCD) from high-Ca and K-rich fluids (fluid 3; possibly Mesoproterozoic, but timing unclear); (4) hydrothermal Q precipitation (fluid 4; timing unclear), and (5) RC and LC precipitation from a meteoric-derived water (fluid 5) in or since the Mesozoic. Fluids associated with FCD, HD, and CCD may have been mobilised during deposition of the upper Bylot Supergroup; this time interval was the most tectonically active episode in the region's Mesoproterozoic to Recent history. The entire history of intermittent fluid migration and cement precipitation recorded in seemingly unimportant void-filling mineral phases spans over 1 billion years, and was decipherable only because of the in situ protocol used. The multiple-method in situ analytical protocol employed in this study substantially augments the knowledge of an area's geological history, parts of which cannot be discerned by means other than meticulous study of diagenetic phases, and should become routine in similar studies.

Longevity of bond strength of resin cements to root dentine after radiation therapy.

PubMed

Yamin, P A; Pereira, R D; Lopes, F C; Queiroz, A M; Oliveira, H F; Saquy, P C; Sousa-Neto, M D

2018-05-04

To evaluate the bond strength and adhesive interface between several resin cements and root dentine immediately and 6 months after radiotherapy. Sixty maxillary canines were selected and randomly assigned to two groups (n = 30): one group was not irradiated and the other one was subjected to a cumulative radiation dose of 60 Gy. The teeth were sectioned to obtain roots 16 mm long and the canals were prepared with the Reciproc system (R50) and filled using a lateral condensation technique with an epoxy resin sealer. Each group was divided into three subgroups (n = 10) according to the resin cement used for fibreglass fibre post cementation: RelyX-U200, Panavia-F2.0 and RelyX ARC. The posts were cemented in accordance with the manufacturer's recommendations. Three 1-mm-thick dentine slices were then obtained from each root third. The first two slices in the crown-apex direction of each third were selected for the push-out test. The failure mode after debonding was determined with a stereo microscope. The third slice from each root third was selected for scanning electron microscopy (SEM) analyses to examine the resin cement-dentine interface with 100, 1000, 2000 and 4000× magnification. Bond strength data were analysed by anova and Tukey's test (α = 0.05). Significantly lower bond strength (P < 0.0001) was obtained after irradiation compared to nonirradiated teeth. RelyX-U200 cemented fibre posts had the higher bond strength (15.17 ± 5.89) compared with RelyX ARC (P < 0.001) and Panavia-F2.0 (P < 0.001). The evaluation after 6 months revealed lower bond strength values compared to the immediate values (P < 0.001) for irradiated and nonirradiated teeth. Cohesive failures occurred in the irradiated dentine. SEM revealed fractures, microfractures and fewer collagen fibres in irradiated root dentine. RelyX-U200 and Panavia-F2.0 were associated with a juxtaposed interface of the cement with the radicular dentine in irradiated and nonirradiated teeth, and for RelyX ARC, hybrid layer formation and tags were observed in both irradiated and nonirradiated teeth. Radiation was associated with a decrease in the push-out bond strength and with lower resin cement/root dentine interface adaptation. Self-adhesive resin cement was a better alternative for fibre post cementation in teeth subjected to radiation therapy. The bond strength decreased after 6 months. © 2018 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Properties of Chemically Combusted Calcium Carbide Residue and Its Influence on Cement Properties.

PubMed

Sun, Hongfang; Li, Zishanshan; Bai, Jing; Memon, Shazim Ali; Dong, Biqin; Fang, Yuan; Xu, Weiting; Xing, Feng

2015-02-13

Calcium carbide residue (CCR) is a waste by-product from acetylene gas production. The main component of CCR is Ca(OH)₂, which can react with siliceous materials through pozzolanic reactions, resulting in a product similar to those obtained from the cement hydration process. Thus, it is possible to use CCR as a substitute for Portland cement in concrete. In this research, we synthesized CCR and silica fume through a chemical combustion technique to produce a new reactive cementitious powder (RCP). The properties of paste and mortar in fresh and hardened states (setting time, shrinkage, and compressive strength) with 5% cement replacement by RCP were evaluated. The hydration of RCP and OPC (Ordinary Portland Cement) pastes was also examined through SEM (scanning electron microscope). Test results showed that in comparison to control OPC mix, the hydration products for the RCP mix took longer to formulate. The initial and final setting times were prolonged, while the drying shrinkage was significantly reduced. The compressive strength at the age of 45 days for RCP mortar mix was found to be higher than that of OPC mortar and OPC mortar with silica fume mix by 10% and 8%, respectively. Therefore, the synthesized RCP was proved to be a sustainable active cementitious powder for the strength enhanced of building materials, which will result in the diversion of significant quantities of this by-product from landfills.

Does a simple syringe applicator enhance bone cement set up time in knee arthroplasty?

PubMed Central

Sodhi, Nipun; Dalton, Sarah E.; Khlopas, Anton; Sultan, Assem A.; Curtis, Gannon L.; Harb, Matthew A.; Naziri, Qais; Barrington, John W.; Mont, Michael A.

2017-01-01

Background The time required for polymethylmethacrylate (PMMA) cement curing or hardening can be modified by a number of variables including the mixing technique, and the temperature and pressure at which the process is taking place. Therefore, the purpose of this study was to evaluate two different methods of PMMA application in terms of set up time. Specifically, we (I) compared the PMMA set up time of cement that remained in the mixing bowl to cement that was placed in a syringe and (II) extrapolated the associated annual cost difference on the national and individual surgeon levels. Methods The cement set up time was measured for a total of 146 consecutive patients who underwent either unicompartmental knee arthroplasty (n=136) or patellofemoral arthroplasty (n=10) between January 2016 and April 2017. One pack of PMMA powder and monomer were mixed, placed in a 300 mL small plastic bowl, and mixed with a tongue depressor. Then, 50 mL of the mixed PMMA was placed in a sterile 60 mL syringe with the tip cut to a 6-mm opening, and the syringe was used to apply the cement to the bone and the prosthesis surface. The remaining unused cement in the syringe (syringe group) and the remaining unused cement in the plastic bowl (bowl group) were removed and formed into a two separate 2 cm diameter cubes that were allowed to cure at room temperature on a sterile set of osteotomes. The two cubes of cement were timed for complete PMMA curing. A two-tailed student’s t-test was used to compare the curing time for the two groups. Annual cost differences were calculated on the national and individual surgeon level. The total number of daily cases performed and the operative time savings using the syringe applicator was used to find daily and annual cost savings. Results The mean time for the cement to set up in the bowl group was 16.8±2.1 minutes, and the mean time for cement set up in the syringe group was 15.1±1.7 minutes. Compared to the bowl group cement set up time, the syringe group set up time was significantly lower (P<0.0001). An estimated 350,000 cemented knee arthroplasties are performed each year in the United States. With 1.7 minutes saved per case, 595,000 operating room minutes per year could be saved, resulting in a nearly $71,000,000 national and $110,000 individual surgeon annual cost savings. Conclusions The results of the present study demonstrated that the utilization of a simple, inexpensive syringe applicator enhanced the cement set up time by over one and a half minutes. This may be a result of the pressure differences in the syringe applicator. In addition to the control of and precision of where the cement is placed, the syringe applicator could provide an important potential time advantage to the arthroplasty surgeon. PMID:29299472

Application of augmented reality for inferior alveolar nerve block anesthesia: A technical note

PubMed Central

2017-01-01

Efforts to apply augmented reality (AR) technology in the medical field include the introduction of AR techniques into dental practice. The present report introduces a simple method of applying AR during an inferior alveolar nerve block, a procedure commonly performed in dental clinics. PMID:28879340

Application of augmented reality for inferior alveolar nerve block anesthesia: A technical note.

PubMed

Won, Yu-Jin; Kang, Sang-Hoon

2017-06-01

Efforts to apply augmented reality (AR) technology in the medical field include the introduction of AR techniques into dental practice. The present report introduces a simple method of applying AR during an inferior alveolar nerve block, a procedure commonly performed in dental clinics.

Evaluation of Fiber Reinforced Cement Using Digital Image Correlation

PubMed Central

Melenka, Garrett W.; Carey, Jason P.

2015-01-01

The effect of short fiber reinforcements on the mechanical properties of cement has been examined using a splitting tensile – digital image correlation (DIC) measurement method. Three short fiber reinforcement materials have been used in this study: fiberglass, nylon, and polypropylene. The method outlined provides a simple experimental setup that can be used to evaluate the ultimate tensile strength of brittle materials as well as measure the full field strain across the surface of the splitting tensile test cylindrical specimen. Since the DIC measurement technique is a contact free measurement this method can be used to assess sample failure. PMID:26039590

Custom-Made Antibiotic Cement Nails in Orthopaedic Trauma: Review of Outcomes, New Approaches, and Perspectives

PubMed Central

Wasko, Marcin K.; Kaminski, Rafal

2015-01-01

Since the first description in 2002 by Paley and Herzenberg, antibiotic bone cement nails (ACNs) have become an effective tool in the orthopaedic trauma surgeons' hands. They simultaneously elute high amounts of antibiotics into medullary canal dead space and provide limited stability to the debrided long bone. In this paper, we perform a systematic review of current evidence on ACNs in orthopaedic trauma and provide an up-to-date review of the indications, operative technique, failure mechanisms, complications, outcomes, and outlooks for the ACNs use in long bone infection. PMID:26509153

Recent Development of Augmented Reality in Surgery: A Review.

PubMed

Vávra, P; Roman, J; Zonča, P; Ihnát, P; Němec, M; Kumar, J; Habib, N; El-Gendi, A

2017-01-01

The development augmented reality devices allow physicians to incorporate data visualization into diagnostic and treatment procedures to improve work efficiency, safety, and cost and to enhance surgical training. However, the awareness of possibilities of augmented reality is generally low. This review evaluates whether augmented reality can presently improve the results of surgical procedures. We performed a review of available literature dating from 2010 to November 2016 by searching PubMed and Scopus using the terms "augmented reality" and "surgery." Results . The initial search yielded 808 studies. After removing duplicates and including only journal articles, a total of 417 studies were identified. By reading of abstracts, 91 relevant studies were chosen to be included. 11 references were gathered by cross-referencing. A total of 102 studies were included in this review. The present literature suggest an increasing interest of surgeons regarding employing augmented reality into surgery leading to improved safety and efficacy of surgical procedures. Many studies showed that the performance of newly devised augmented reality systems is comparable to traditional techniques. However, several problems need to be addressed before augmented reality is implemented into the routine practice.

[Early aseptic loosening of the CF 30 femoral stem].

PubMed

Kovanda, M; Havlícek, V; Hudec, J

2007-02-01

The CF 30 stem in combination with a cementless acetabulum was used at the First Department of Orthopedic Surgery in Brno in the years 1994 to 1995. From the second year following implantation, aseptic stem loosening was recorded. In order to find explanation of this early loosening, the authors, in cooperation with the Institute of Solid Mechanics, Mechatronics and Biomechanics, carried out the stress-strain analysis in a model system. Eighty patients (31 men and 49 women) received a cemented CF30 femoral component in 1994. Of them, 16 patients underwent revision arthroplasty, three died of causes unrelated to the surgery, and four were lost to follow-up. The final clinical and radiographic check-up was carried out in 2001. The results of a comprehensive examination were available in 57 patients with a CF30 stem. The patients were evaluated on the basis of the Harris hip score and anteroposterior radiographs of the hip. X-ray films obtained immediately after surgery and those taken at regular intervals during follow-up were compared. The following characteristics were noted: translucent lines in individual zones along the stem at the cement-bone interface; osteolysis, i. e., non-linear translucent areas, at least 5 mm long, at the cement-bone interface; and subsidence of the femoral component, i. e., migration of the stem distal to the tip of the greater trochanter. The CF 30 stem survival curve showed that aseptic stem loosening occurred from post-implantation year 2, and increased during the following years. At 6 years and 6 months, a total of 16 patients underwent revision surgery, involving reimplantation in 14 and implant removal in 2 patients. Potential causes of aseptic loosening: Polyethylene wear.However, no acetabular loosening was found in this group, although acetabular components are reported to become loose more often than femoral components. By comparison of the stem survival curves for Poldi and CF 30 stems it appeared that, at 6 years and 6 months, the Poldi stem survival curve showed better results. Matt surface finish of the stem. However, the link between the CF 30 stem and cement was so strong that, in all 16 revised hips, the stem was removed together with nearly a complete cement mantle. The authors therefore dismiss this as a cause. Also, in the remaining cases of CF 30 aseptic loosening, which had not been revised, radiographic evidence suggested loosening between bone and cement. The authors did not find any movement of the CF stem in its cement mantle. The stem always fitted in with the cement mantle. Erroneous surgical technique or cementing was unlikely. The procedures were performed by experienced orthopedic surgeons who used the second-generation cementing technique. In patients with a Poldi stem, the first-generation cementing method was used and the proportion of aseptic loosening at 6 years of follow-up was only 4 %. In contrast, loosening in patients with the CF 30 stem was 20 % at 6 years and 6 months postoperatively. Shape of the CF 30 stem with the intention to find a relationship between stem shape and its early aseptic loosening, the authors started cooperation with the Institute of Solid Mechanics, Mechatronics and Biomechanics at the Faculty of Mechanical Engineering, Brno University of Technology. Using the method of finite elements, they carried out the stressstrain analysis in a model system. Stress at the cement-bone interface in the CF 30 stem was higher than in the Poldi stem, and this difference was statistically significant. The authors believe that the more frequent loosening found in patients with the CF 30 stem can be accounted for by its shape. The survival curve for the CF 30 femoral stem did not show good results, and therefore this stem is not recommended for implantation. The authors suggest that a more frequent early aseptic loosening of CF 30 stems may have been caused by its unsuitable shape.

Optical characterization of a light guide for the polymerization of root canal fillers: preliminary results

NASA Astrophysics Data System (ADS)

Munin, Egberto; Lupato Conrado, Luis A.; Alves, Leandro P.; Zangaro, Renato A.

2004-05-01

The sealing cements used in endodontics are commonly of the type activated by chemical reactions. During polymerization, mechanical contractions are not uncommon, leading to non-perfect sealing or treatment failure. Photopolymerizable cements usually presents superior performance as compared to those chemically activated. However, difficulties in carrying-up the light to difficult-to-reach regions like the dental apex preclude those material of being accepted in the dental office routine. Recently, a novel technique for the light curing of photopolymerizable cements in endodontic applications has been proposed. Such a technique makes use of a polymeric light guide to deliver the curing light to the apex region, for a single step polymerization of the canal filler. For this work, a 28 mm long polymer light-guide, has been produced. The polymer surface was roughened to produce light scattering and allow the light to escape from the guide. The light scattering profile along the body of the guide is an important property for the proposed application. We used an integrating sphere to measure the irradiation profile for the proposed endodontic device. It was found that the experimental data for the amount of light coupled into the integrating sphere as a function of the length of the cone inside the sphere fits to a double exponential model.

Long-term Outcomes of Temporal Hollowing Augmentation by Targeted Volume Restoration of Fat Compartments in Chinese Adults.

PubMed

Huang, Ru-Lin; Xie, Yun; Wang, Wenjin; Tan, Pohching; Li, Qingfeng

2018-04-19

Previous anatomical and clinical studies have suggested that targeted restoration of the volume and distribution of fat compartments using appropriate cannula entry sites and injection planes is an excellent fat-grafting technique for facial contouring and hand rejuvenation. To perform subjective and objective evaluations of the safe and effective profile of the targeted fat-grafting technique for temporal hollowing augmentation. In a retrospective cohort study, a total of 96 consecutive patients with temporal hollowing were treated at the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai, China, with the targeted fat-grafting technique from January 1, 2009, to January 1, 2017. The safety and efficacy profile of this technique was evaluated by the following methods: (1) a quantitative measurement of fat-graft survival and temporal augmentation rates by using 3-dimensional laser scanning, (2) a subjective assessment using a satisfaction survey and the Hollowness Severity Rating Scale (grades range from 0-3, with higher grades representing more hollowness), and (3) the complication rate. Of the 96 study patients, 94 (97.9%) were women and the mean (SD) age was 34.4 (7.4) years. Of the 142 autologous fat-grafting procedures performed, the mean (SD) total follow-up time was 16.3 (3.2) months, with a mean (SD) of 1.5 (0.7) procedures performed. The mean (SD) baseline volume requirement per temple for each patient was 12.8 (4.8) mL, and the total volume of the fat graft per temple was 17.8 (7.5) mL. Quantitative analysis revealed that the mean (SD) total augmentation volume per temple was 11.7 (3.0) mL, the total survival rate of the fat grafts was 65.7% (12.6%), and total augmentation rate of hollowness was 91.4% (23.4%). Subjective analysis revealed that all patients showed an improved appearance after fat grafting, and 142 temples (74.0%) exhibited clinical improvement by more than 2 grades. In all, 88 patients (91.7%) were satisfied with the outcomes, with a low complication rate reported. The targeted fat-grafting technique allows the transplant of fat tissue into 4 separate fat compartments in a double-plane manner through a unique cannula entry site that avoids severe neurovascular injury. The long-term results demonstrate that this technique is an effective, reproducible, and safe approach for temporal hollowing augmentation. 4.

Lateral Augmentation Procedures in Anterior Cruciate Ligament Reconstruction: Anatomic, Biomechanical, Imaging, and Clinical Evidence.

PubMed

Weber, Alexander E; Zuke, William; Mayer, Erik N; Forsythe, Brian; Getgood, Alan; Verma, Nikhil N; Bach, Bernard R; Bedi, Asheesh; Cole, Brian J

2018-02-01

There has been an increasing interest in lateral-based soft tissue reconstructive techniques as augments to anterior cruciate ligament reconstruction (ACLR). The objective of these procedures is to minimize anterolateral rotational instability of the knee after surgery. Despite the relatively rapid increase in surgical application of these techniques, many clinical questions remain. To provide a comprehensive update on the current state of these lateral-based augmentation procedures by reviewing the origins of the surgical techniques, the biomechanical data to support their use, and the clinical results to date. Systematic review. A systematic search of the literature was conducted via the Medline, EMBASE, Scopus, SportDiscus, and CINAHL databases. The search was designed to encompass the literature on lateral extra-articular tenodesis (LET) procedures and the anterolateral ligament (ALL) reconstruction. Titles and abstracts were reviewed for relevance and sorted into the following categories: anatomy, biomechanics, imaging/diagnostics, surgical techniques, and clinical outcomes. The search identified 4016 articles. After review for relevance, 31, 53, 27, 35, 45, and 78 articles described the anatomy, biomechanics, imaging/diagnostics, surgical techniques, and clinical outcomes of either LET procedures or the ALL reconstruction, respectively. A multitude of investigations were available, revealing controversy in addition to consensus in several categories. The level of evidence obtained from this search was not adequate for systematic review or meta-analysis; thus, a current concepts review of the anatomy, biomechanics, imaging, surgical techniques, and clinical outcomes was performed. Histologically, the ALL appears to be a distinct structure that can be identified with advanced imaging techniques. Biomechanical evidence suggests that the anterolateral structures of the knee, including the ALL, contribute to minimizing anterolateral rotational instability. Cadaveric studies of combined ACLR-LET procedures demonstrated overconstraint of the knee; however, these findings have yet to be reproduced in the clinical literature. The current indications for LET augmentation in the setting of ACLR and the effect on knee kinematic and joint preservation should be the subject of future research.

Original technique for penile girth augmentation through porcine dermal acellular grafts: results in a 69-patient series.

PubMed

Alei, Giovanni; Letizia, Piero; Ricottilli, Francesco; Simone, Pierfranco; Alei, Lavinia; Massoni, Francesco; Ricci, Serafino

2012-07-01

Although different techniques for augmentation phalloplasty have been reported in the medical literature, this issue is still highly controversial, and none of the proposed procedures has been unanimously approved. The aim of this study is to describe an innovative surgical technique for penile girth augmentation with porcine dermal acellular grafts, through a small transverse incision at the penile base, along the penopubic junction. Between 2000 and 2009, 104 patients were referred to our institution for penile enhancement. After a preoperative psychosexual consultation and a general medical assessment, 69 patients were deemed suitable good candidates for surgery. The average penis circumference was measured at the mid-length of the penis and was 8.1 cm (5.4-10.7 cm) and 10.8 cm (6.5-15.8 cm) during flaccidity and erection, respectively. All patients received penile augmentation with porcine dermal acellular grafts. Results evaluation of an innovative technique for penile girth augmentation through exogenous porcine grafts and small penobubic incision. Postoperative measurements were performed at 6 and 12 months. At the 1-year follow-up, the average penis circumference was 11.3 cm (8.2-13.2 cm, 3.1 cm mean increase) during flaccidity and 13.2 cm (8.8-14.5 cm, 2.4 cm mean increase) during erection. No major complications occurred in the series. Minor complications were resolved with conservative treatment within 3 weeks. Sexual activity was resumed from 1 to 2 months after surgery. The psychosexual impact of the operation was beneficial in the majority of cases. Penile girth enlargement with acellular dermal matrix grafts has several advantages over augmentation with autogenous dermis-fat grafts: the elimination of donor site morbidity and a significantly shorter operation time. With this approach, through a short dorsal incision at the base of the penis, the scar is concealed in a crease covered by pubic hair and thus hardly visible. © 2012 International Society for Sexual Medicine.

Second generation locked plating for complex proximal humerus fractures in very elderly patients.

PubMed

Gavaskar, Ashok S; Karthik B, Bhupesh; Tummala, Naveen C; Srinivasan, Parthasarathy; Gopalan, Hitesh

2016-11-01

Humeral head sacrificing procedures are more favored in elderly patients with complex proximal humerus fractures because of high incidence of failures and complications with osteosynthesis. The purpose of this study is to assess the outcome of second generation locked plating techniques in 3 and 4 part fractures in active elderly patients >70years with an emphasis on function and complications. 29 patients with displaced 3 and 4 part proximal humerus fractures were treated using the principles of second-generation proximal humerus locked plating. Fixed angle locked plating (PHILOS) using the anterolateral deltoid spilt approach augmented with traction cuff sutures was performed. Minimum of 7 locking head screws including 2 calcar screws were used. In cases with a comminuted medial calcar, an endosteal fibular strut was used. Subchondral metaphyseal bone voids were filled with injectable calcium phosphate cement. Radiological outcome (union, head - shaft angle, tuberosity reduction), functional outcome assessment (Constant and ASES scores) and complications (loss of reduction, nonunion and osteonecrosis) were assessed. The fracture united in 24 of the 26 patients available for follow up at a mean of 27 months (12-40 months). 3 patients developed complications that required arthroplasty (fixation failure in 2 patients and osteonecrosis in 1 patient). Follow up age adjusted Constant (63.1±11.9) and ASES scores (62.58±7.5) showed the extent of functional improvement post surgery. Patients with fractures having a non-comminuted medial calcar and valgus displacement of the humeral head had better functional scores and fewer complications. Osteosynthesis with second generation locked plating techniques provide satisfactory outcome in very elderly patients with complex proximal humerus fractures with minimal complications. Copyright © 2016 Elsevier Ltd. All rights reserved.

A hybrid technique for sinus floor elevation in the severely resorbed posterior maxilla

PubMed Central

Jung, Ui-Won; Hong, Ji-Youn; Lee, Jung-Seok; Kim, Chang-Sung; Cho, Kyoo-Sung

2010-01-01

Purpose This study aimed to evaluate the effectiveness of the modified sinus floor elevation technique described hereafter as a "hybrid technique," in 11 patients with severely resorbed posterior maxillae. Methods Eleven patients who received 22 implants in the maxillary premolar and molar areas by the hybrid technique were enrolled in this study. A slot-shaped osteotomy for access was prepared on the lateral wall along the lower border of the sinus floor. The Schneiderian membrane was fully reflected through the lateral slot. Following drilling with the membrane protected by a periosteal elevator, the bone was grafted. All implants were placed simultaneously with sinus augmentation. The cumulative success rate was calculated and clinical parameters were recorded. Radiographic measurements were performed. Results All implants were well maintained at last follow up (cumulative success rate=100%). The mean residual bone height, augmented bone height, crown-to-implant ratio, and marginal bone loss were 4.1±1.64 mm, 8.76±1.77 mm, 1.21±0.33 mm, and 0.34±0.72 mm, respectively. Conclusions Simultaneous implant placement with sinus augmentation by hybrid technique showed successful clinical results over a 2-year observation period and may be a reliable modality for reconstruction of a severely resorbed posterior maxilla. PMID:20498764

Inference of the phase-to-mechanical property link via coupled X-ray spectrometry and indentation analysis: Application to cement-based materials

DOE Office of Scientific and Technical Information (OSTI.GOV)

Krakowiak, Konrad J.; Wilson, William; James, Simon

2015-01-15

A novel approach for the chemo-mechanical characterization of cement-based materials is presented, which combines the classical grid indentation technique with elemental mapping by scanning electron microscopy-energy dispersive X-ray spectrometry (SEM-EDS). It is illustrated through application to an oil-well cement system with siliceous filler. The characteristic X-rays of major elements (silicon, calcium and aluminum) are measured over the indentation region and mapped back on the indentation points. Measured intensities together with indentation hardness and modulus are considered in a clustering analysis within the framework of Finite Mixture Models with Gaussian component density function. The method is able to successfully isolate themore » calcium-silica-hydrate gel at the indentation scale from its mixtures with other products of cement hydration and anhydrous phases; thus providing a convenient means to link mechanical response to the calcium-to-silicon ratio quantified independently via X-ray wavelength dispersive spectroscopy. A discussion of uncertainty quantification of the estimated chemo-mechanical properties and phase volume fractions, as well as the effect of chemical observables on phase assessment is also included.« less

Slump Flows inside Pipes: Numerical Results and Comparison with Experiments

NASA Astrophysics Data System (ADS)

Malekmohammadi, S.; Naccache, M. F.; Frigaard, I. A.; Martinez, D. M.

2008-07-01

In this work an analysis of the buoyancy-driven slumping flow inside a pipe is presented. This flow usually occurs when an oil well is sealed by a plug cementing process, where a cement plug is placed inside the pipe filled with a lower density fluid, displacing it towards the upper cylinder wall. Both the cement and the surrounding fluids have a non Newtonian behavior. The cement is viscoplastic and the surrounding fluid presents a shear thinning behavior. A numerical analysis was performed to evaluate the effects of some governing parameters on the slump length development. The conservation equations of mass and momentum were solved via a finite volume technique, using Fluent software (Ansys Inc.). The Volume of Fluid surface-tracking method was used to obtain the interface between the fluids and the slump length as a function of time. The results were obtained for different values of fluids densities differences, fluids rheology and pipe inclinations. The effects of these parameters on the interface shape and on the slump length versus time curve were analyzed. Moreover, the numerical results were compared to experimental ones, but some differences are observed, possibly due to chemical effects at the interface.

Corrosion susceptibility of steel drums containing cemented intermediate level nuclear wastes

NASA Astrophysics Data System (ADS)

Duffó, Gustavo S.; Farina, Silvia B.; Schulz, Fátima M.; Marotta, Francesca

2010-10-01

Cementation processes are used as immobilization techniques for low or intermediate level radioactive waste for economical and safety reasons and for being a simple operation. In particular, ion-exchange resins commonly used for purification of radioactive liquid waste from nuclear reactors are immobilized before being stored to improve the leach resistance of the waste matrix and to maintain mechanical stability. Combustible solid radioactive waste can be incinerated and the resulting ashes can also be immobilized before storage. The immobilized resins and ashes are then contained in steel drums that may undergo corrosion depending on the presence of certain contaminants. The work described in this paper was aimed at evaluating the corrosion susceptibility of steel drums in contact with cemented ion-exchange resins and incineration ashes containing different concentrations of aggressive species (mostly chloride and sulphate ions). A special type of specimen was designed to simulate the cemented waste in the drum. The evolution of the corrosion potential and the corrosion current density of the steel, as well as the electrical resistivity of the matrix were monitored over a time period of 1 year. The results show the deleterious effect of chloride on the expected lifespan of the waste containers.

Sensitivity of acoustic nonlinearity parameter to the microstructural changes in cement-based materials

NASA Astrophysics Data System (ADS)

Kim, Gun; Kim, Jin-Yeon; Kurtis, Kimberly E.; Jacobs, Laurence J.

2015-03-01

This research experimentally investigates the sensitivity of the acoustic nonlinearity parameter to microcracks in cement-based materials. Based on the second harmonic generation (SHG) technique, an experimental setup using non-contact, air-coupled detection is used to receive the consistent Rayleigh surface waves. To induce variations in the extent of microscale cracking in two types of specimens (concrete and mortar), shrinkage reducing admixture (SRA), is used in one set, while a companion specimen is prepared without SRA. A 50 kHz wedge transducer and a 100 kHz air-coupled transducer are implemented for the generation and detection of nonlinear Rayleigh waves. It is shown that the air-coupled detection method provides more repeatable fundamental and second harmonic amplitudes of the propagating Rayleigh waves. The obtained amplitudes are then used to calculate the relative nonlinearity parameter βre, the ratio of the second harmonic amplitude to the square of the fundamental amplitude. The experimental results clearly demonstrate that the nonlinearity parameter (βre) is highly sensitive to the microstructural changes in cement-based materials than the Rayleigh phase velocity and attenuation and that SRA has great potential to avoid shrinkage cracking in cement-based materials.

Combined Use of Shrinkage Reducing Admixture and CaO in Cement Based Materials

NASA Astrophysics Data System (ADS)

Tittarelli, Francesca; Giosuè, Chiara; Monosi, Saveria

2017-10-01

The combined addition of a Shrinkage-Reducing Admixture (SRA) with a CaO-based expansive agent (CaO) has been found to have a synergistic effect to improve the dimensional stability of cement based materials. In this work, aimed to further investigate the effect, mortar and self-compacting concrete specimens were prepared either without admixtures, as reference, or with SRA alone and/or CaO. Their performance was compared in terms of compressive strength and free shrinkage measurements. Results showed that the synergistic effect in reducing shrinkage is confirmed in the specimens manufactured with SRA and CaO. In order to clarify this phenomenon, the effect of SRA on the hydration of CaO as well as cement was evaluated through different techniques. The obtained results show that SRA induces a finer microstructure of the CaO hydration products and a retarding effect on the microstructure development of cement based materials. A more deformable mortar or concrete, due to the delay in microstructure development by SRA, coupled with a finer microstructure of CaO hydration products could allow higher early expansion, which might contribute in contrasting better the successive drying shrinkage.

An Assessment of Fatigue Damage and Crack Growth Prediction Techniques (L’Evaluation de l’Endommagement en Fatigue et les Techniques de Prediction de la Propagation des Fissures)

DTIC Science & Technology

1994-03-01

reality the structure of even one individual aircraft consists of many bat- ches and the tens of thousand of cars of one type manufactured in even...generated neural network power spectral densities of surface pressures are used to augment existing data and then load an elastic finite clement...investigated for possible use in augmenting this information which is required for fatigue life calculations. Since empennage environments on fighter

Reconstruction of Vertebral Body After Radiofrequency Ablation and Augmentation in Dorsolumbar Metastatic Vertebral Fracture: Analysis of Clinical and Radiological Outcome in a Clinical Series of 18 Patients.

PubMed

Maugeri, Rosario; Graziano, Francesca; Basile, Luigi; Gulì, Carlo; Giugno, Antonella; Giammalva, Giuseppe Roberto; Visocchi, Massimiliano; Iacopino, Domenico Gerardo

2017-01-01

Painful spinal metastases usually occur in malignant neoplastic disease. Treatment for bone metastases has been largely conservative, and it includes the use of high doses of analgesics, radiotherapy, chemotherapy, hormone therapy, and bisphosphonates; however, results are sometimes transient and ineffective. In the presence of neurological involvement a surgical strategy should be considered. Recently, percutaneous procedures such as radiofrequency ablation, vertebroplasty, and kyphoplasty have been introduced as palliative techniques to treat painful vertebral metastases [3, 11, 25]. In our study we combined the use of radiofrequency ablation with vertebroplasty in the treatment of dorsolumbar metastatic vertebral fractures in order to examine the relationship between restoration of the vertebral structure and decrease in pain. From January 2014 to March 2015 we retrospectively analyzed 18 patients with malignant vertebral lesions who underwent radiofrequency ablation with vertebroplasty followed by cementoplasty, with posterior transpedicle fixation on levels near the lesions. The parameters examined were: demographics, pain relief, and the distribution of polymethylmethacrylate (PMMA) determined by the mean Saliou filling score; all complications were recorded. The mean age of the patients was 55.72 years (range 34-69); average operative time was 60.4 min (range, 51-72). The average pain index score (visual analog score; VAS) decreased significantly from 8.05 at baseline to 3.0 (p < 0.05) after 6 months. The Saliou filling score revealed a distribution of PMMA in the vertebral body that was satisfactory (12-18) in eight patients, mediocre (6-12) in seven patients, and inadequate (0-6) in the remaining three patients. In two vertebrae, minimal asymptomatic cement leakage occurred in the lateral recess without neurological damage. No pulmonary embolism and no visceral or neural damage was recorded. Radiofrequency ablation combined with vertebroplasty seems to achieve rapid and lasting improvement in clinical symptoms in patients with malignant vertebral lesions. There was wide diffusion of PMMA in the vertebral body, with a mean cement volume of 4.5 ml.

Post-processing techniques to enhance reliability of assignment algorithm based performance measures.

DOT National Transportation Integrated Search

2011-01-01

This study develops an enhanced transportation planning framework by augmenting the sequential four-step : planning process with post-processing techniques. The post-processing techniques are incorporated through a feedback : mechanism and aim to imp...

Penetration of 38% hydrogen peroxide into the pulp chamber in bovine and human teeth submitted to office bleach technique.

PubMed

Camargo, Samira Esteves Afonso; Valera, Marcia Carneiro; Camargo, Carlos Henrique Ribeiro; Gasparoto Mancini, Maria Nadir; Menezes, Marcia Maciel

2007-09-01

This study evaluated the pulp chamber penetration of peroxide bleaching agent in human and bovine teeth after office bleach technique. All the teeth were sectioned 3 mm apical of the cement-enamel junction and were divided into 2 groups, A (70 third human molars) and B (70 bovine lateral incisors), that were subdivided into A1 and B1 restored by using composite resin, A2 and B2 by using glass ionomer cement, and A3 and B3 by using resin-modified glass ionomer cement; A4, A5, B4, and B5 were not restored. Acetate buffer was placed in the pulp chamber, and the bleaching agent was applied for 40 minutes as follows: A1-A4 and B1-B4, 38% hydrogen peroxide exposure and A5 and B5, immersion into distilled water. The buffer solution was transferred to a glass tube in which leuco crystal violet and horseradish peroxidase were added, producing a blue solution. The optical density of the blue solution was determined by spectrophotometer and converted into microgram equivalents of hydrogen peroxide. Data were submitted to analysis of variance and Dunnett, Kruskal-Wallis, and Tukey tests (5%). A higher level of hydrogen peroxide penetrated into the pulp chamber in resin-modified glass ionomer cements in bovine (0.79 +/- 0.61 microg) and human (2.27 +/- 0.41 microg) groups. The bleaching agent penetration into the pulp chamber was higher in human teeth for any experimental situation. The penetration of the hydrogen peroxide depends on restorative materials, and under the conditions of this study human teeth are more susceptible to penetration of bleaching agent into the pulp chamber than bovine teeth.

Internal adaptation, marginal accuracy and microleakage of a pressable versus a machinable ceramic laminate veneers.

PubMed

Aboushelib, Moustafa Nabil; Elmahy, Waleed AbdelMeguid; Ghazy, Mohammed Hamed

2012-08-01

The aim of this study was to evaluate the internal adaptation and marginal properties of ceramic laminate veneers fabricated using pressable and machinable CAD/CAM techniques. 40 ceramic laminate veneers were fabricated by either milling ceramic blocks using a CAD/CAM system (group 1 n=20) or press-on veneering using lost wax technique (group 2 n=20). The veneers were acid etched using hydrofluoric acid, silanated, and cemented on their corresponding prepared teeth. All specimens were stored under water (37 °C) for 60 days, then received thermocycling (15,000 cycles between 5 and 55 °C and dwell time of 90 s) followed by cyclic loading (100,000 cycles between 50 and 100 N) before immersion in basic fuchsine dye for 24 h. Half of the specimens in each group were sectioned in labio-lingual direction and the rest were horizontally sectioned using precision cutting machine (n=10). Dye penetration, internal cement film thickness, and vertical and horizontal marginal gaps at the incisal and cervical regions were measured (α=0.05). Pressable ceramic veneers demonstrated significantly lower (F=8.916, P<0.005) vertical and horizontal marginal gaps at the cervical and incisal margins and lower cement film thickness (F=50.921, P<0.001) compared to machinable ceramic veneers. The inferior marginal properties of machinable ceramic veneers were associated with significantly higher microleakage values. Pressable ceramic laminate veneers produced higher marginal adaptation, homogenous and thinner cement film thickness, and improved resistance to microleakage compared to machinable ceramic veneers. The manufacturing process influences internal and marginal fit of ceramic veneers. Therefore, dentist and laboratory technicians should choose a manufacturing process with careful consideration. Copyright © 2012 Elsevier Ltd. All rights reserved.

[Reimplantation of devitalized tumor-bearing bone in pelvic reconstruction after en-bloc tumor resection].

PubMed

Yang, Yi; Guo, Wei; Yang, Rongli; Tang, Xiaodong; Yan, Taiqiang; Ji, Tao; Wei, Ran

2014-10-01

To analyze the clinical outcome of an operative technique using recycling bones to reconstruct pelvis after primary malignant pelvic tumor resection. Fifteen patients who presented with malignant pelvic tumors were treated by wide or marginal resection and reconstruction using recycling bone in our institute from January 2003 to December 2011. The median age was 31 (15-62) years, and the most common diagnosis was chondrosarcoma, followed by Ewing sarcoma. The operative technique consisted of en-bloc excision of the pelvic tumor, removal of soft tissue, curettage of the tumor, incubated in 65 °C 20% hypertonic saline for 30 minutes, reimplantation of recycling bone, and internal fixation with plates, screws and/or total hip replacement. Bone cement was used to augment bone strength when necessary. Bone healing features and function of lower limbs were evaluated with the International Society of Limb Salvage (ISOLS) graft evaluation method and Musculoskeletal Tumor Society (MSTS) score, respectively. Adjuvant therapies were used according to the type and extension of the primary tumor. One patient died of severe peri-operative bleeding 2 days after operation, and the other patients were followed-up for 6 to 96 months (mean 40.4 months), and 5 patients died of local recurrence or metastasis. Eleven operations were followed by complications of any kind. Most mechanical complications were related to the use of hip arthroplasties, where implant breakdown and dislocation were the commonest.Infection was seen in 7 cases (superficial 4 cases and deep 3 cases). Healing and functional scores were fair. The median ISOLS score and MSTS score were 81.0% (range 30.0% to 95.0%) and 60.0% (range 23.0% to 93.0%), respectively. Recycling reconstruction technique is valid for young patients with low-grade chondrosarcoma or other chemo-sensitive tumor in pelvis. Although many complications are seen, this method remains our treatment of choice.

Using Augmented Reality to Support a Software Editing Course for College Students

ERIC Educational Resources Information Center

Wang, Y.-H.

2017-01-01

This study aimed to explore whether integrating augmented reality (AR) techniques could support a software editing course and to examine the different learning effects for students using online-based and AR-based blended learning strategies. The researcher adopted a comparative research approach with a total of 103 college students participating…

Soft tissue augmentation in skin of color: market growth, available fillers, and successful techniques.

PubMed

Burgess, Cheryl M

2007-01-01

In recent years, people of color have become an increasingly important market force for the cosmetics industry. Product lines have been expanded to accommodate a broader spectrum of skin colors and marketing strategies have been specialized in order to target specific ethnic populations. In addition, it is predicted that people with pigmented skin will eventually comprise a majority of the domestic and international population during the 21st century. Not surprisingly, people of color are increasingly seeking out products and procedures to fight the effects of aging, including an increase in surgical and nonsurgical cosmetic procedures. Among nonsurgical procedures, soft tissue augmentation has experienced dramatic growth. Today, clinicians are performing more and more of these procedures in people of color. As a result of these shifts in the cosmetics industry, clinicians performing soft tissue augmentation require increased expertise in the treatment of ethnic skin. This article reviews the important differences that exist between the appearance of the aging faces of Caucasians and people of color. In addition, soft tissue augmentation strategies and injection techniques that are specific to skin of color are discussed.

The robotic appendicovesicostomy and bladder augmentation: the next frontier in robotics, are we there?

PubMed

Cohen, Andrew J; Pariser, Joseph J; Anderson, Blake B; Pearce, Shane M; Gundeti, Mohan S

2015-02-01

There is growing interest in applying robotic-assisted laparoscopic techniques to complex reconstructive pelvic surgery owing to inherent benefits of precision, tissue handling, and articulating instruments for suturing. This review examines preliminary experiences with robotic-assisted laparoscopic augmentation ileocystoplasty and Mitrofanoff appendicovesicostomy (RALIMA) as either an isolated or combined procedure. These series suggest RALIMA is feasible, with the benefit of early recovery and improved cosmetic results in selected patients. The robotic approach incurs functional outcomes and complication rates similar to those of open techniques. Given the steep learning curve, only surgeons with extensive robotic experience are currently adopting this technique. Copyright © 2015 Elsevier Inc. All rights reserved.

Evaluation of the bond strength of resin cements used to lute ceramics on laser-etched dentin.

PubMed

Giray, Figen Eren; Duzdar, Lale; Oksuz, Mustafa; Tanboga, Ilknur

2014-07-01

The purpose of this study was to investigate the shear bond strength (SBS) of two different adhesive resin cements used to lute ceramics on laser-etched dentin. Erbium, chromium: yttrium, scandium, gallium, garnet (Er,Cr:YSGG) laser irradiation has been claimed to improve the adhesive properties of dentin, but results to date have been controversial, and its compatibility with existing adhesive resin cements has not been conclusively determined. Two adhesive cements, one "etch-and-rinse" [Variolink II (V)] and one "self-etch" [Clearfil Esthetic Cement (C)] luting cement, were used to lute ceramic blocks (Vita Celay Blanks, Vita) onto dentin surfaces. In total, 80 dentin specimens were distributed randomly into eight experimental groups according to the dentin surface-etching technique used Er,Cr:YSGG laser and Er:YAG laser: (1) 37% orthophosphoric acid+V (control group), (2) Er,Cr:YSGG laser+V, (3) Er,Cr:YSGG laser+acid+V, (4) Er:YAG laser+V, (5) Er:YAG laser+acid+V, (6) C, (7) Er,Cr:YSGG laser+C, and (8) Er:YAG laser+C. Following these applications, the ceramic discs were bonded to prepared surfaces and were shear loaded in a universal testing machine until fracture. SBS was recorded for each group in MPa. Shear test values were evaluated statistically using the Mann-Whitney U test. No statistically significant differences were evident between the control group and the other groups (p>0.05). The Er,Cr:YSGG laser+A+V group demonstrated significantly higher SBS than did the Er,Cr:YSGG laser+V group (p=0.034). The Er,Cr:YSGG laser+C and Er:YAG laser+C groups demonstrated significantly lower SBS than did the C group (p<0.05). Dentin surfaces prepared with lasers may provide comparable ceramic bond strengths, depending upon the adhesive cement used.

The Effects of Alkaline pH on Microleakage of Mineral Trioxide Aggregate and Calcium Enriched Mixture Apical Plugs.

PubMed

Mirhadi, Hossein; Moazzami, Fariborz; Rangani Jahromi, Saeed; Safarzade, Sareh

2016-03-01

Alkaline pH can affect the physical and chemical properties and sealing ability of apical plug material. Calcium hydroxide is used as an intracanal medication to complete disinfection of root canals. It raises the pH of environment to alkaline value. The aim of this in vitro study was to evaluate and compare the effect of alkaline pH on the sealing ability of calcium-enriched mixture (CEM) cement and mineral trioxide aggregate (MTA) apical plugs. Seventy single-rooted human maxillary anterior teeth were randomly divided to two experimental groups for Angelus MTA and CEM cement (n=30) and two control groups (n=5). Each group was divided into two subgroups of 15 for neutral and alkaline pH, and 1 negative and 1 positive control groups of 5. The root canals were cleaned and shaped by using ProTaper rotary system (Dentsply Maillefer; Ballaigues, Switzerland) and the terminal 3mm of the roots were resected. Then, MTA and CEM cement were condensed in apical region with 3mm thickness. The samples were exposed to two environments with different pH values of 13 and 7.4. The leakage was assessed by using the fluid filtration technique at 1, 7, 14, 30 days intervals. Data were analyzed by the repeated measures MANOVA. There was no statistically significant difference in the rate of microleakage between neutral and alkaline pH of CEM cement and MTA (p> 0.05). The sealing ability of MTA in an alkaline pH of 13 was significantly less than CEM cement in this pH (p< 0.05). An environment with alkaline pH had no adverse effect on the sealing ability of MTA and CEM cement used as apical plugs. CEM cement had better sealing ability in alkaline pH.

Microencapsulation of rifampicin: A technique to preserve the mechanical properties of bone cement.

PubMed

Sanz-Ruiz, Pablo; Carbó-Laso, Esther; Del Real-Romero, Juan Carlos; Arán-Ais, Francisca; Ballesteros-Iglesias, Yolanda; Paz-Jiménez, Eva; Sánchez-Navarro, Magdalena; Pérez-Limiñana, María Ángeles; Vaquero-Martín, Javier

2018-01-01

Two-stage exchange with antibiotic-loaded bone cement spacers remains the gold standard for chronic periprosthetic joint infection (PJI). Rifampicin is highly efficient on stationary-phase staphylococci in biofilm; however, its addition to PMMA to manufacture spacers prevents polymerization and reduces mechanical properties. Isolation of rifampicin during polymerization by microencapsulation could allow manufacturing rifampicin-loaded bone cement maintaining elution and mechanical properties. Microcapsules of rifampicin with alginate, polyhydroxybutyratehydroxyvalerate (PHBV), ethylcellulose and stearic acid (SA) were synthesized. Alginate and PHBV microcapsules were added to bone cement and elution, compression, bending, hardness, setting time and microbiological tests were performed. Repeated measures ANOVA and Bonferroni post-hoc test were performed, considering a p < 0.05 as statistical significance. Bone cement specimens containing alginate microcapsules eluted more rifampicin than PHBV microcapsules or non-encapsulated rifampicin over time (p < 0.012). Microencapsulation of rifampicin allowed PMMA to preserve mechanical properties in compression and bending tests. Cement with alginate microcapsules showed similar behavior in hardness tests to control cement over the study period (73 ± 1.68H D ). PMMA with alginate microcapsules exhibited the largest zones of inhibition in microbiological tests. Statistically significant differences in mean diameters of zones of inhibition between PMMA loaded with alginate-rifampicin (p = 0.0001) and alginate-PHBV microcapsules (p = 0.0001) were detected. Rifampicin microencapsulation with alginate is the best choice to introduce rifampicin in PMMA preserving mechanical properties, setting time, elution, and antimicrobial properties. The main applicability of this study is the opportunity for obtaining rifampicin-loaded PMMA by microencapsulation of rifampicin in alginate microparticles, achieving high doses of rifampicin in infected tissues, increasing the successful of PJI treatment. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:459-466, 2018. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Influence of laser structuring of PEEK, PEEK-GF30 and PEEK-CF30 surfaces on the shear bond strength to a resin cement.

PubMed

Henriques, Bruno; Fabris, Douglas; Mesquita-Guimarães, Joana; Sousa, Anne C; Hammes, Nathalia; Souza, Júlio C M; Silva, Filipe S; Fredel, Márcio C

2018-08-01

The aim of this study was to evaluate the influence of a surface conditioning technique using laser ablation and acid etching on PEEK substrate on its bonding strength to a resin cement. Cylindrical specimens of unfilled PEEK, 30% glass fiber reinforced PEEK and 30% carbon fiber reinforced PEEK were separated in four groups according to the following surface treatments: acid etching with H 2 SO 4 , laser ablation with 200 µm holes spaced 400 µm apart (D2E4), laser ablation with 200 µm holes spaced 600 µm apart (D2E6), and laser ablation (D2E4) followed by acid etching. A dual-curing resin cement (Allcem CORE) was then applied to the PEEK surface. Specimens were aged in distilled water at 37 °C for 24 h. Shear bond strength tests were performed to the fracture of the samples. Two-way ANOVA statistical analysis was performed with a significance level of 0.05. Scanning electron microscopy analysis was performed to analyse the conditioned and fracture surfaces. SEM images of the test interfaces showed that the resin cement could not flow in the holes designed by the laser ablation on the PEEK surface. The shear bond strength of PEEK to resin cement was not improved by the surface modification of the PEEK. Also, there was a statistically significant decrease in shear bond strength for unfilled PEEK specimens. On carbon or glass reinforced PEEK, the change was not significant. SEM images of the fracture surfaces revealed that the failure mode was mainly adhesive. Although laser ablation promoted the PEEK surface modification by the formation of retentive holes, the test resin cement could not thoroughly flow on the rough modified surfaces to establish an effective mechanical interlocking. That negatively affected the shear bonding strength of PEEK to the resin cement. Further studies should be carried out to increase the bonding between PEEK and resin cements. Copyright © 2018 Elsevier Ltd. All rights reserved.

Two-Stage Revision for Infected Total Knee Arthroplasty: Based on Autoclaving the Recycled Femoral Component and Intraoperative Molding Using Antibiotic-Impregnated Cement on the Tibial Side.

PubMed

Lee, Byoung-Joo; Kyung, Hee-Soo; Yoon, Seong-Dae

2015-09-01

The purpose of this study was to determine the degree of infection control and postoperative function for new articulating metal-on-cement spacer. A retrospective study of 19 patients (20 cases), who underwent a two-stage revision arthroplasty using mobile cement prosthesis, were followed for a minimum of 2 years. This series consisted of 16 women and 3 men, having an overall mean age of 71 years. During the first stage of revision, the femoral implant and all the adherent cement was removed, after which it was autoclaved before replacement. The tibial component was removed and a doughy state, antibiotic-impregnated cement was inserted on the tibial side. To achieve joint congruency, intraoperative molding was performed by flexing and extending the knee joint. Each patient was evaluated clinically and radiologically. The clinical assessments included range of motion, and the patients were scored as per the Hospital for Special Surgery (HSS) and Knee Society (KS) criteria. The mean range of knee joint motion was 70° prior to the first stage operation and 72° prior to the second stage revision arthroplasty; following revision arthroplasty, it was 113° at the final follow-up. The mean HSS score and KS knee and function scores were 86, 82, and 54, respectively, at the final follow-up. The success rate in terms of infection eradication was 95% (19/20 knees). No patient experienced soft tissue contracture requiring a quadriceps snip. This novel technique provides excellent radiological and clinical outcomes. It offers a high surface area of antibiotic-impregnated cement, a good range of motion between first and second stage revision surgery for the treatment of chronic infection after total knee arthroplasty, and is of a reasonable cost.

3D-Printed Bioactive Ca3SiO5 Bone Cement Scaffolds with Nano Surface Structure for Bone Regeneration.

PubMed

Yang, Chen; Wang, Xiaoya; Ma, Bing; Zhu, Haibo; Huan, Zhiguang; Ma, Nan; Wu, Chengtie; Chang, Jiang

2017-02-22

Silicate bioactive materials have been widely studied for bone regeneration because of their eminent physicochemical properties and outstanding osteogenic bioactivity, and different methods have been developed to prepare porous silicate bioactive ceramics scaffolds for bone-tissue engineering applications. Among all of these methods, the 3D-printing technique is obviously the most efficient way to control the porous structure. However, 3D-printed bioceramic porous scaffolds need high-temperature sintering, which will cause volume shrinkage and reduce the controllability of the pore structure accuracy. Unlike silicate bioceramic, bioactive silicate cements such as tricalcium silicate (Ca 3 SiO 5 and C 3 S) can be self-set in water to obtain high mechanical strength under mild conditions. Another advantage of using C 3 S to prepare 3D scaffolds is the possibility of simultaneous drug loading. Herein, we, for the first time, demonstrated successful preparation of uniform 3D-printed C 3 S bone cement scaffolds with controllable 3D structure at room temperature. The scaffolds were loaded with two model drugs and showed a loading location controllable drug-release profile. In addition, we developed a surface modification process to create controllable nanotopography on the surface of pore wall of the scaffolds, which showed activity to enhance rat bone-marrow stem cells (rBMSCs) attachment, spreading, and ALP activities. The in vivo experiments revealed that the 3D-printed C 3 S bone cement scaffolds with nanoneedle-structured surfaces significantly improved bone regeneration, as compared to pure C 3 S bone cement scaffolds, suggesting that 3D-printed C 3 S bone cement scaffolds with controllable nanotopography surface are bioactive implantable biomaterials for bone repair.

Scanning Electron Microscopy and Energy-Dispersive X-Ray Microanalysis of Set CEM Cement after Application of Different Bleaching Agents.

PubMed

Samiei, Mohammad; Janani, Maryam; Vahdati, Amin; Alemzadeh, Yalda; Bahari, Mahmoud

2017-01-01

The present study evaluated the element distribution in completely set calcium-enriched mixture (CEM) cement after application of 35% carbamide peroxide, 40% hydrogen peroxide and sodium perborate as commercial bleaching agents using an energy-dispersive x-ray microanalysis (EDX) system. The surface structure was also observed using the scanning electron microscope (SEM). Twenty completely set CEM cement samples, measuring 4×4 mm 2 , were prepared in the present in vitro study and randomly divided into 4 groups based on the preparation technique as follows: the control group; 35% carbamide peroxide group in contact for 30-60 min for 4 times; 40% hydrogen peroxide group with contact time of 15-20 min for 3 times; and sodium perborate group, where the powder and liquid were mixed and placed on CEM cement surface 4 times. Data were analyzed at a significance level of 0.05 through the one Way ANOVA and Tukey's post hoc tests. EDX showed similar element distribution of oxygen, sodium, calcium and carbon in CEM cement with the use of carbamide peroxide and hydroxide peroxide; however, the distribution of silicon was different ( P <0.05). In addition, these bleaching agents resulted in significantly higher levels of oxygen and carbon ( P <0.05) and a lower level of calcium ( P <0.05) compared to the control group. SEM of the control group showed plate-like and globular structure. Sodium perborate was similar to control group due to its weak oxidizing properties. Globular structures and numerous woodpecker holes were observed on the even surface on the carbamide peroxide group. The mean elemental distribution of completely set CEM cement was different when exposed to sodium perborate, carbamide peroxide and hydrogen peroxide.

Present and future of glass-ionomers and calcium-silicate cements as bioactive materials in dentistry: biophotonics-based interfacial analyses in health and disease.

PubMed

Watson, Timothy F; Atmeh, Amre R; Sajini, Shara; Cook, Richard J; Festy, Frederic

2014-01-01

Since their introduction, calcium silicate cements have primarily found use as endodontic sealers, due to long setting times. While similar in chemistry, recent variations such as constituent proportions, purities and manufacturing processes mandate a critical understanding of service behavior differences of the new coronal restorative material variants. Of particular relevance to minimally invasive philosophies is the potential for ion supply, from initial hydration to mature set in dental cements. They may be capable of supporting repair and remineralization of dentin left after decay and cavity preparation, following the concepts of ion exchange from glass ionomers. This paper reviews the underlying chemistry and interactions of glass ionomer and calcium silicate cements, with dental tissues, concentrating on dentin-restoration interface reactions. We additionally demonstrate a new optical technique, based around high resolution deep tissue, two-photon fluorescence and lifetime imaging, which allows monitoring of undisturbed cement-dentin interface samples behavior over time. The local bioactivity of the calcium-silicate based materials has been shown to produce mineralization within the subjacent dentin substrate, extending deep within the tissues. This suggests that the local ion-rich alkaline environment may be more favorable to mineral repair and re-construction, compared with the acidic environs of comparable glass ionomer based materials. The advantages of this potential re-mineralization phenomenon for minimally invasive management of carious dentin are self-evident. There is a clear need to improve the bioactivity of restorative dental materials and these calcium silicate cement systems offer exciting possibilities in realizing this goal. Copyright © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Augmented assessment as a means to augmented reality.

PubMed

Bergeron, Bryan

2006-01-01

Rigorous scientific assessment of educational technologies typically lags behind the availability of the technologies by years because of the lack of validated instruments and benchmarks. Even when the appropriate assessment instruments are available, they may not be applied because of time and monetary constraints. Work in augmented reality, instrumented mannequins, serious gaming, and similar promising educational technologies that haven't undergone timely, rigorous evaluation, highlights the need for assessment methodologies that address the limitations of traditional approaches. The most promising augmented assessment solutions incorporate elements of rapid prototyping used in the software industry, simulation-based assessment techniques modeled after methods used in bioinformatics, and object-oriented analysis methods borrowed from object oriented programming.

Bone Marrow Stimulation Technique Augmented by an Ultrapurified Alginate Gel Enhances Cartilage Repair in a Canine Model.

PubMed

Baba, Rikiya; Onodera, Tomohiro; Matsuoka, Masatake; Hontani, Kazutoshi; Joutoku, Zenta; Matsubara, Shinji; Homan, Kentaro; Iwasaki, Norimasa

2018-05-01

The optimal treatment for a medium- or large-sized cartilage lesion is still controversial. Since an ultrapurified alginate (UPAL) gel enhances cartilage repair in animal models, this material is expected to improve the efficacy of the current treatment strategies for cartilage lesions. The bone marrow stimulation technique (BMST) augmented by UPAL gel can induce hyaline-like cartilage repair. Controlled laboratory study. Two cylindrical osteochondral defects were created in the patellar groove of 27 beagle dogs. A total of 108 defects were divided into 3 groups: defects without intervention (control group), defects with the BMST (microfracture group), and defects with the BMST augmented by implantation of UPAL gel (combined group). At 27 weeks postoperatively, macroscopic and histological evaluations, micro-computed tomography assessment, and mechanical testing were performed for each reparative tissue. The defects in the combined group were almost fully covered with translucent reparative tissues, which consisted of hyaline-like cartilage with well-organized collagen structures. The macroscopic score was significantly better in the combined group than in the control group ( P < .05). The histological scores in the combined group were significantly better than those in the control group ( P < .01) and microfracture group ( P < .05). Although the repaired subchondral bone volumes were not influenced by UPAL gel augmentation, the mechanical properties of the combined group were significantly better than those of the microfracture group ( P < .05). The BMST augmented by UPAL gel elicited hyaline-like cartilage repair that had characteristics of rich glycosaminoglycan and matrix immunostained by type II collagen antibody in a canine osteochondral defect model. The present results suggest that the current technique has the potential to be one of the autologous matrix-induced chondrogenesis techniques of the future and to expand the operative indications for the BMST without loss of its technical simplicity. The data support the clinical reality of 1-step minimally invasive cartilage-reparative medicine with UPAL gel without harvesting donor cells.

Hydroxyapatite cement cranioplasty in translabyrinthine acoustic neuroma surgery.

PubMed

Arriaga, Moisês A; Chen, Douglas A

2002-05-01

Hydroxyapatite cement cranioplasty (HAC) after translabyrinthine resection of acoustic neuroma is a promising new technique for wound reconstruction. This study reviews the efficacy of HAC for the prevention of cerebrospinal fluid (CSF) leakage and the long-term wound outcomes of HAC versus abdominal fat graft (AFG) reconstruction. This retrospective study of l08 consecutive acoustic neuromas operated on by Pittsburgh Ear Associates uses chart review, telephone interview, and mail questionnaire data. Fifty-four patients received AFG dural repair, and 54 patients received HAC. Seven AFG patients (12.5%) had CSF leaks versus 2 (3.7%) of the overall group of 54 HAC patients. However, none (0%) of the 47 HAC patients had CSF leakage with current HAC techniques. HAC also produced significantly less postauricular wound depression and superior cosmetic results in comparison with AFG. Although HAC patients experienced less postoperative discomfort, wound complications requiring medical or surgical intervention were extremely uncommon in both groups. HAC offers significant CSF leakage control and long-term cosmetic and comfort advantages over AFG alone. We recommend HAC as the standard closure technique for translabyrinthine acoustic neuroma surgery.

Interventions for Dental Implant Placement in Atrophic Edentulous Mandibles: Vertical Bone Augmentation and Alternative Treatments. A Meta-Analysis of Randomized Clinical Trials.

PubMed

Camps-Font, Octavi; Burgueño-Barris, Genís; Figueiredo, Rui; Jung, Ronald E; Gay-Escoda, Cosme; Valmaseda-Castellón, Eduard

2016-12-01

The purpose of the current study is to assess which vertical bone augmentation techniques are most effective for restoring atrophic posterior areas of the mandible with dental implants and compare these procedures with alternative treatments. Electronic literature searches in PubMed (MEDLINE), Ovid, and the Cochrane Library were conducted to identify all relevant articles published up to July 1, 2015. Eligibility was based on inclusion criteria, and quality assessments were conducted. The primary outcome variables were implant and prosthetic failure. After data extraction, meta-analyses were performed. Out of 527 potentially eligible papers, 14 randomized clinical trials were included. Out of these 14 studies, four trials assessed short implants (5 to 8 mm) as an alternative to vertical bone augmentation in sites with a residual ridge height of 5 to 8 mm. No statistically significant differences were found in implant (odds ratio [OR]: 1.02; 95% confidence interval [CI]: 0.31 to 3.31; P = 0.98; I 2 : 0%) or prosthetic failure (OR: 0.64; 95% CI: 0.21 to 1.96; P = 0.43; I 2 : 0%) after 12 months of loading. However, complications at treated sites increased with the augmentation procedures (OR: 8.33; 95% CI: 3.85 to 20.0; P <0.001; I 2 : 0%). There was no evidence of any vertical augmentation procedure being of greater benefit than any other for the primary outcomes (implant and prosthetic failure). Short implants in the posterior area of the mandible seem to be preferable to vertical augmentation procedures, which present similar implant and prosthetic failure rates but greater morbidity. All the vertical augmentation technique comparisons showed similar intergroup results.

An Evaluation of Installation Methods for STS-1 Seismometers

USGS Publications Warehouse

Holcomb, L. Gary; Hutt, Charles R.

1992-01-01

INTRODUCTION This report documents the results of a series of experiments conducted by the authors at the Albuquerque Seismological Laboratory (ASl) during the spring and summer of 1991; the object of these experiments was to obtain and document quantitative performance comparisons of three methods of installing STS-1 seismometers. Historically, ASL has installed STS-1 sensors by cementing their thick glass base plates to the concrete floor of the vault (see Peterson and Tilgner, 1985, p 44 and Figure 31, p 51 for the details of this installation technique). This installation technique proved to be fairly satisfactory for the China Digital Seismic Network and for several sets of STS-1 sensors installed in other locations since that time. However, the cementing operation is rather labor intensive and the concrete requires a lengthy (about 1 week) curing time during which the sensor installed on it is noisy. In addition it is difficult to assure that all air bubbles have been removed from the interface between the cement and the glass base plate. If air bubbles are present beneath the plate, horizontal sensors can be unacceptably noisy. Moving a sensor installed in this manner requires the purchase of a new glass base plate because the old plate normally can not be removed without breakage. Therefore, this study was undertaken with the aim of developing an improved method of installing STS-1's. The goals were to develop a method which requires less field site labor during the installation and assures a higher quality installation when finished. In addition, the improved installation technique should promote portability. Two alternate installation techniques were evaluated in this study. One method replaces the cement between the base plate and the vault floor with sand. This method has been used in the French Geoscope program and in several IRIS/IDA installations made by the University of California at San Diego (UCSD) and possibly others. It is easily implemented in the field and is quite cheap. The other method utilizes a so called warpless housing designed by E. Wielandt and implemented at ASL. This housing is quite similar to the case design of the STS-2 sensor system. It is designed to minimize the effects of atmospheric pressure variations on the sealed housing.

Osteotomy in direct sinus lift. A comparative study of the rotary technique and ultrasound

PubMed Central

Peñarrocha-Diago, Miguel; Sanchez-Recio, Cristina; Peñarrocha-Oltra, David; Romero-Millán, Javier

2012-01-01

Purpose: The present study investigates sinus membrane rupture in direct maxillary sinus lift with the rotary technique and with ultrasound, examining the survival of implants placed after sinus augmentation, and analyzing the bone gain obtained after the operation and 12 months after placement of the prosthetic restoration. Material and Methods: A retrospective study was made of 45 patients requiring maxillary sinus lift or augmentation for implant-prosthetic rehabilitation. Use was made of the hand piece and ostectomy drills for the rotary technique, and of specific tips for ultrasound. The implant success criteria were based on those developed by Buser. The bone gain obtained as a result of sinus lift was calculated from the postoperative panoramic X-rays. Results: A total of 57 direct elevations of the maxillary sinus were carried out: 32 with the rotary technique and 25 with ultrasound. Perforations of Schneider’s membrane with the rotary technique and ultrasound occurred in 7% and 1.7% of the cases, respectively, with membrane integrity being preserved in 91.2%. Of the 100 implants placed, 5 failed after one year of follow-up in the rotary technique group, while one implant failed in the ultrasound group. The rotary technique in turn afforded a bone gain of 5.9 mm, versus 6.7 mm with ultrasound. Conclusions: Perforations of the membrane sinusal in direct lift were more frequent with the rotary technique (7%) than with ultrasound (1.7%). Implant survival and bone gain were both greater when ultrasound was used. Key words:Bone sectioning, maxillary sinus augmentation, piezosurgery. PMID:22143735

Comparison study on disturbance estimation techniques in precise slow motion control

NASA Astrophysics Data System (ADS)

Fan, S.; Nagamune, R.; Altintas, Y.; Fan, D.; Zhang, Z.

2010-08-01

Precise low speed motion control is important for the industrial applications of both micro-milling machine tool feed drives and electro-optical tracking servo systems. It calls for precise position and instantaneous velocity measurement and disturbance, which involves direct drive motor force ripple, guide way friction and cutting force etc., estimation. This paper presents a comparison study on dynamic response and noise rejection performance of three existing disturbance estimation techniques, including the time-delayed estimators, the state augmented Kalman Filters and the conventional disturbance observers. The design technique essentials of these three disturbance estimators are introduced. For designing time-delayed estimators, it is proposed to substitute Kalman Filter for Luenberger state observer to improve noise suppression performance. The results show that the noise rejection performances of the state augmented Kalman Filters and the time-delayed estimators are much better than the conventional disturbance observers. These two estimators can give not only the estimation of the disturbance but also the low noise level estimations of position and instantaneous velocity. The bandwidth of the state augmented Kalman Filters is wider than the time-delayed estimators. In addition, the state augmented Kalman Filters can give unbiased estimations of the slow varying disturbance and the instantaneous velocity, while the time-delayed estimators can not. The simulation and experiment conducted on X axis of a 2.5-axis prototype micro milling machine are provided.

Breast Massage, Implant Displacement, and Prevention of Capsular Contracture After Breast Augmentation With Implants: A Review of the Literature.

PubMed

Sood, Aditya; Xue, Erica Y; Sangiovanni, Christopher; Therattil, Paul J; Lee, Edward S

2017-01-01

Objective: Capsular contracture, the most common complication following breast augmentation with implants, is a complex inflammatory reaction that ultimately leads to fibrosis at the contact site between the implant and tissue. A number of peri-, pre-, and postoperative techniques have been postulated and implemented by many surgeons to reduce the incidence of capsular contracture. Breast massage and implant displacement technique is a commonly recommended practice that has not been well studied in regard to capsular contracture prevention. The authors present a review of the literature addressing methods and efficacy of massage and implant displacement techniques after breast augmentation. Methods: A literature review was performed using PubMed and the Cochrane Collaboration Library for primary research articles on breast massage or implant displacement after breast augmentation with implants for breast contracture prevention between January 1975 and March 2017. Exclusion criteria were studies that were focused on the treatment rather than prevention of breast contracture, addressed other strategies of preventing contracture as the main focus, or did not report the number of patients studied. Information related to massage technique and capsular contracture outcomes was extracted. Results: The literature search yielded 4 relevant studies, with a total of 587 patients. Outcomes evaluated included massage technique, onset of massage, frequency of massage, and incidence of capsular contracture. Breast massage was introduced between 2 days and 2 weeks postoperatively, performed twice daily, and lasted from 2 to 5 minutes for each breast. Final postoperative follow-up concluded between 6 and 36 months. The average capsular contracture rate was similar, 31% (range, 0-35) in the massage group versus 40% (range, 30-90) in the nonmassage group. Conclusions: While multiple techniques have been proposed and practiced in the prevention of capsular contracture, breast massage and implant displacement techniques remain controversial. While there is a method to measure adequacy of breast massage pressure, it is not widely utilized. The available data do not support breast massage to prevent capsular contracture; more studies with standardized techniques are needed to better assess the efficacy of breast massage in preventing capsular contracture.

Recent Development of Augmented Reality in Surgery: A Review

PubMed Central

Vávra, P.; Zonča, P.; Ihnát, P.; El-Gendi, A.

2017-01-01

Introduction The development augmented reality devices allow physicians to incorporate data visualization into diagnostic and treatment procedures to improve work efficiency, safety, and cost and to enhance surgical training. However, the awareness of possibilities of augmented reality is generally low. This review evaluates whether augmented reality can presently improve the results of surgical procedures. Methods We performed a review of available literature dating from 2010 to November 2016 by searching PubMed and Scopus using the terms “augmented reality” and “surgery.” Results. The initial search yielded 808 studies. After removing duplicates and including only journal articles, a total of 417 studies were identified. By reading of abstracts, 91 relevant studies were chosen to be included. 11 references were gathered by cross-referencing. A total of 102 studies were included in this review. Conclusions The present literature suggest an increasing interest of surgeons regarding employing augmented reality into surgery leading to improved safety and efficacy of surgical procedures. Many studies showed that the performance of newly devised augmented reality systems is comparable to traditional techniques. However, several problems need to be addressed before augmented reality is implemented into the routine practice. PMID:29065604