Simulation of the mechanical behavior of a HIP implant. Implant fixed to bone by cementation under arbitrary load

NASA Astrophysics Data System (ADS)

Oldani, C. R.; Dominguez, A. A.

2007-11-01

In a previous work a finite elements model was constructed to simulate a fatigue assay according to the norm IRAM 9422-3. Three materials were studied, two of them are the most used in this type of implant (Stainless steel 3161 and alloy T16A14V) and the third was a new developed titanium alloy (Ti35Nb7Zr5Ta). Static loads were applied to the model according to the highest requirements of the norm and the stress - strain distribution were determined. In this study a simplified analysis of the material's fatigue was done according to the previous work. The best behavior of the titanium alloys vs. the stainless steel was evident. With the objective of studying the behavior of both: the implant and the femur bone, new finite elements models were realized, in which the presence of the bone was considered. Inside the bone, the femoral component of the implant was placed in a similar way of a cemented prosthesis in a total hip arthroplasty. The advantage of the titanium implant related to the stainless steel one, was very clear.

Screw vs cement-implant-retained restorations: an experimental study in the beagle. Part 2. Immunohistochemical evaluation of the peri-implant tissues.

PubMed

Assenza, Bartolomeo; Artese, Luciano; Scarano, Antonio; Rubini, Corrado; Perrotti, Vittoria; Piattelli, Maurizio; Thams, Ulf; San Roman, Fidel; Piccirilli, Marcello; Piattelli, Adriano

2006-01-01

Crestal bone loss has been reported to occur around dental implants. Even if the causes of this bone loss are not completely understood, the presence of a microgap between implant and abutment with a possible contamination of the internal portion of the implants has been suggested. The aim of this study was to see if there were differences in the vascular endothelial growth factor (VEGF) expression, microvessel density (MVD), proliferative activity (MIB-1), and inflammatory infiltrate in the soft tissues around implants with screwed and cemented abutments. Sandblasted and acid-etched implants were inserted in the mandibles of 6 Beagle dogs. Ten 3.5- x 10-mm root-form implants were inserted in each mandible. A total of 60 implants (30 with screwed abutments and 30 with cemented abutments) were used. After 12 months, all the bridges were removed and all abutments were checked for mobility. A total of 8 loosened screws (27%) were found in the screwed abutments, whereas no loosening was observed in cemented abutments. A gingival biopsy was performed in 8 implants with cemented abutments, in 8 implants with screwed abutments, and in 8 implants with unscrewed abutments. No statistically significant differences were found in the inflammatory infiltrate and in the MIB-1 among the different groups. No statistically significant difference was found in the MVD between screwed and cemented abutments (P = .2111), whereas there was a statistically significant difference in MVD between screwed and unscrewed abutments (P = .0277) and between cemented and unscrewed abutments (P = .0431). A low intensity of VEGF was prevalent in screwed and in cemented abutments, whereas a high intensity of VEGF was prevalent in unscrewed abutments. These facts could be explained by the effects induced, in the abutments that underwent a screw loosening, by the presence of bacteria inside the hollow portion of the implants or by enhanced reparative processes.

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.

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.

Fracture toughness of titanium-cement interfaces: effects of fibers and loading angles.

PubMed

Khandaker, Morshed; Utsaha, Khatri Chhetri; Morris, Tracy

2014-01-01

Ideal implant-cement or implant-bone interfaces are required for implant fixation and the filling of tissue defects created by disease. Micron- to nanosize osseointegrated features, such as surface roughness, fibers, porosity, and particles, have been fused with implants for improving the osseointegration of an implant with the host tissue in orthopedics and dentistry. The effects of fibers and loading angles on the interface fracture toughness of implant-cement specimens with and without fibers at the interface are not yet known. Such studies are important for the design of a long-lasting implant for orthopedic applications. The goal of this study was to improve the fracture toughness of an implant-cement interface by deposition of micron- to nanosize fibers on an implant surface. There were two objectives in the study: 1) to evaluate the influence of fibers on the fracture toughness of implant-cement interfaces with and without fibers at the interfaces, and 2) to evaluate the influence of loading angles on implant-cement interfaces with and without fibers at the interfaces. This study used titanium as the implant, poly(methyl methacrylate) (PMMA) as cement, and polycaprolactone (PCL) as fiber materials. An electrospinning unit was fabricated for the deposition of PCL unidirectional fibers on titanium (Ti) plates. The Evex tensile test stage was used to determine the interface fracture toughness (KC) of Ti-PMMA with and without PCL fibers at 0°, 45°, and 90° loading angles, referred to in this article as tension, mixed, and shear tests. The study did not find any significant interaction between fiber and loading angles (P>0.05), although there was a significant difference in the KC means of Ti-PMMA samples for the loading angles (P<0.05). The study also found a significant difference in the KC means of Ti-PMMA samples with and without fibers (P<0.05). The results showed that the addition of the micron- to nanosize PCL fibers on Ti improved the quality of the Ti-PMMA union. The results of the study are essential for fatigue testing and finite-element analysis of implant-cement interfaces to evaluate the performance of orthopedic and orthodontic implants.

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.

[Bone cement implant as an alternative for orbital floor reconstruction: A case report].

PubMed

Vargas-Solalinde, Enrique; Huichapa-Padilla, Marisol E; Garza-Cantú, Daniel; Reyna-Martínez, Víctor H; Alatorre-Ricardo, Julio; González-Treviño, Juan Luis

2017-12-01

The management of orbitary fractures is one of the most challenging in facial trauma; the variety of reconstruction materials for its treatment is broad and is constantly improving, but despite this there is no consensus for its use or literature that sustains it. To present the use and design of a preformed bone implant as an alternative for the reconstruction of orbital floor fractures in the pediatric age group. A 7-year old male who suffered a right hemifacial contusion trauma with clinical and tomographic diagnosis of right pure blowout type orbital floor fracture with inferior rectus muscle entrapment and right post-traumatic palpebral ptosis. Successful surgical reconstruction was performed 7 days later with a pre-constructed bone cement implant. Eight weeks after surgery the patient presented with mild residual palpebral ptosis, no ocular movement limitations and no diplopia. The use of a bone cement implant can be considered appropriate for the reconstruction of these fractures, as another alternative to be used by the ophthalmologist among the variety of all the other materials used for this purpose. We consider that our optimism based on the results obtained in this case obligates us to increase the number of patients treated in order to gather more evidence and do larger follow up. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

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.

Evaluation of injectable strontium-containing borate bioactive glass cement with enhanced osteogenic capacity in a critical-sized rabbit femoral condyle defect model.

PubMed

Zhang, Yadong; Cui, Xu; Zhao, Shichang; Wang, Hui; Rahaman, Mohamed N; Liu, Zhongtang; Huang, Wenhai; Zhang, Changqing

2015-02-04

The development of a new generation of injectable bone cements that are bioactive and have enhanced osteogenic capacity for rapid osseointegration is receiving considerable interest. In this study, a novel injectable cement (designated Sr-BBG) composed of strontium-doped borate bioactive glass particles and a chitosan-based bonding phase was prepared and evaluated in vitro and in vivo. The bioactive glass provided the benefits of bioactivity, conversion to hydroxyapatite, and the ability to stimulate osteogenesis, while the chitosan provided a cohesive biocompatible and biodegradable bonding phase. The Sr-BBG cement showed the ability to set in situ (initial setting time = 11.6 ± 1.2 min) and a compressive strength of 19 ± 1 MPa. The Sr-BBG cement enhanced the proliferation and osteogenic differentiation of human bone marrow-derived mesenchymal stem cells in vitro when compared to a similar cement (BBG) composed of chitosan-bonded borate bioactive glass particles without Sr. Microcomputed tomography and histology of critical-sized rabbit femoral condyle defects implanted with the cements showed the osteogenic capacity of the Sr-BBG cement. New bone was observed at different distances from the Sr-BBG implants within eight weeks. The bone-implant contact index was significantly higher for the Sr-BBG implant than it was for the BBG implant. Together, the results indicate that this Sr-BBG cement is a promising implant for healing irregularly shaped bone defects using minimally invasive surgery.

Loading capacity of zirconia implant supported hybrid ceramic crowns.

PubMed

Rohr, Nadja; Coldea, Andrea; Zitzmann, Nicola U; Fischer, Jens

2015-12-01

Recently a polymer infiltrated hybrid ceramic was developed, which is characterized by a low elastic modulus and therefore may be considered as potential material for implant supported single crowns. The purpose of the study was to evaluate the loading capacity of hybrid ceramic single crowns on one-piece zirconia implants with respect to the cement type. Fracture load tests were performed on standardized molar crowns milled from hybrid ceramic or feldspar ceramic, cemented to zirconia implants with either machined or etched intaglio surface using four different resin composite cements. Flexure strength, elastic modulus, indirect tensile strength and compressive strength of the cements were measured. Statistical analysis was performed using two-way ANOVA (p=0.05). The hybrid ceramic exhibited statistically significant higher fracture load values than the feldspar ceramic. Fracture load values and compressive strength values of the respective cements were correlated. Highest fracture load values were achieved with an adhesive cement (1253±148N). Etching of the intaglio surface did not improve the fracture load. Loading capacity of hybrid ceramic single crowns on one-piece zirconia implants is superior to that of feldspar ceramic. To achieve maximal loading capacity for permanent cementation of full-ceramic restorations on zirconia implants, self-adhesive or adhesive cements with a high compressive strength should be used. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

In vitro evaluation of reverse torque value of abutment screw and marginal opening in a screw- and cement-retained implant fixed partial denture design.

PubMed

Kim, Seok-Gyu; Park, Jae-Uk; Jeong, Jae-Heon; Bae, Chang; Bae, Tae-Soo; Chee, Winston

2009-01-01

The purpose of this study was to evaluate the clinical efficacy of implant prostheses retained by screws and cement (SCPs) by examining the reverse torque values (RTVs) of the abutment screws and the marginal openings of the implant prostheses. Two implants (3.8 x 13 mm; Camlog Biotechnologies) were embedded in an acrylic resin block 5 mm apart. Eighteen copies of this resin specimen were fabricated and randomly divided into two groups. Two-unit implant prostheses with two different designs-purely cement-retained implant prostheses (group 1) and SCPs (group 2)-were made out of type IV gold alloy and placed on the implants. After tightening to about 30 Ncm, the preloading RTVs of the abutment screws were measured. After retightening the abutment screws or cementing the prostheses, followed by cyclic loading, the postloading RTVs of the abutment screws were examined. Also, the marginal openings of the prostheses in the two groups were measured under a stereomicroscope. These measurements were compared statistically. The postloading RTVs and their differences from the preloading RTVs of the abutment screws demonstrated no significant differences between groups (P > .05). Group 2 prostheses showed significantly smaller marginal openings than group 1 prostheses (P < .05). The forces generated when torquing the abutment screw of the SCP did not cause more loosening of the abutment screws than the purely cement-retained implant prosthesis. The SCP showed better marginal adaptation of the cement-retained part than the purely cement-retained implant prosthesis, possibly as a result of the screw-retained abutment seating the restoration. Within the limitations of this in vitro test, the SCP showed no significant difference in RTV of the abutment screw and a smaller marginal gap compared to a purely cement-retained implant prosthesis.

Migration of polyethylene debris along well-fixed cemented implants.

PubMed

Massin, P; Viguier, E; Flautre, B; Hardouin, P; Astoin, E; Duponchel, B

2004-02-15

Implants, consisting of smooth Inox cylinders, were cemented into the lower femur and upper tibia of nine sheep to study the distal migration of polyethylene particles. Some implants had a titanium-bead porous coat at the proximal end. These were of three types: In the first type, the porous coat was covered with hydroxyapatite to obtain a bony seal; the second type was prepared for a polymethylmethacrylate seal; in the third type, the porous zone was surrounded by a 2-mm-thick space to allow the formation of a fibrous seal. Small polyethylene particles were injected into the knees once a week during the third and fourth months after implantation. The animals were euthanized 2 months later. Major longitudinal sections of the implants and the surrounding bone were examined under a polarized light microscope. Birefringent particles were counted at the cement-bone and cement-implant interfaces. Osteolysis was not observed. None of the seals significantly decreased the migration of particles around the cemented part of the implants. Particles were observed in cement fissures and vacuoles. They migrated at both interfaces and in the bone itself. They were visible in marrow spaces between bone trabeculae. Copyright 2003 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 68B: 140-148, 2004

The Interaction of Implant Luting Cements and Oral Bacteria Linked to Peri-Implant Disease: An In Vitro Analysis of Planktonic and Biofilm Growth--A Preliminary Study.

PubMed

Raval, Neal C; Wadhwani, Chandur P K; Jain, Sumita; Darveau, Richard P

2015-12-01

There is little consensus on the most appropriate cement to use when restoring a cement-retained, implant-supported restoration. One consideration should be the interaction of pathogenic oral bacteria with restorative cements. To determine how oral bacteria associated with peri-implant disease grow in the presence of implant cements. Five test cements with varying composition (zinc oxide-eugenol [TBO], eugenol-free zinc oxide [TBNE], zinc orthophosphate [FL], and two resin cements [PIC and ML]) were used to fabricate specimen disks. The disks were submerged in bacterial suspensions of either Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, or Porphyromonas gingivalis. Planktonic bacterial growth within the test media was measured by determining the optical density of the cultures (OD600 ). Positive controls (media and bacteria without cement disks) and negative controls (media alone) were similarly evaluated. The mean and standard deviations (SD) were calculated for planktonic growth from three separate experiments. ANOVA statistical analysis with post hoc Tukey tests was performed where differences existed (p < .05). Selected cement disks (TBO and ML) were further examined for bacterial biofilm growth. Surface bacteria were removed and grown on agar media, and colony-forming units (CFUs) were quantified. Planktonic growth for both A. actinomycetemcomitans and P. gingivalis was significantly inhibited (p < .05) when grown in the presence of cement disks consisting of TBNE, PIC, FL, and TBO. In contrast, neither of these bacteria displayed growth inhibition in the presence of ML cement disks. F. nucleatum growth was also significantly inhibited by PIC, FL. and TBO (p < .05), but not by ML and TBNE cement disks. CFU counts for the biofilm study for TBO gave minimal and, in some instances, no bacterial adherence and growth, in contrast to ML, which supported substantially greater bacterial biofilm growth. Cements display differing abilities to inhibit both planktonic and biofilm bacterial growth. Cements with the ability to reduce planktonic or biofilm growth of the test bacteria may be advantageous in reducing peri-implant disease. Understanding the microbial growth-inhibiting characteristics of different cement types should be considered important in the selection criteria. © 2014 Wiley Periodicals, Inc.

Comparison of The Effect of Implant Abutment Surface Modifications on Retention of Implant-Supported Restoration with A Polymer Based Cement

PubMed Central

Sahu, Nabaprakash; Lakshmi, Namratha; Azhagarasan, N.S.; Agnihotri, Yoshaskam; Rajan, Manoj; Hariharan, Ramasubramanian

2014-01-01

Background: In cement-retained implant-supported restoration it is important to gain adequate retention of definitive restoration as well as retrievability of prosthesis. The surface of the abutment, alloy of the restoration and the type of cement used influences the retention of the restoration. There is a need to analyze the influence of surface modifications of abutments on the retentive capabilities of provisional implant cements. Purpose of study: To compare the effect of implant abutment surface modifications on retention of implant-supported restoration cemented with polymer based cement. Materials and method: Thirty solid titanium implant abutments (ADIN), 8mm height, were divided into 3 groups. Ten abutments with retentive grooves (Group I) as supplied by the manufacturer, Ten abutments milled to 20 taper circumferentially (Group II), and Ten abutments milled and air-abraded with 110 μm aluminum oxide (Group III) were used in this study. Ni-Cr coping were casted for each abutment and polymer based cement was used to secure them to the respective abutments. Using a universal testing machine at a crosshead speed of 0.5 cm/minute, tensile bond strength was recorded (N). Results: Mean tensile bond strength of Group I, II and III were found to be 408.3, 159.9 and 743.8 Newton respectively. The values were statistically different from each other (p<0.001). Conclusion: Abutments with milled and sandblasted surface provide the highest retention followed by abutments with retentive grooves and then by abutments with milled surface when cast copings were cemented to implant abutments with polymer based cement. Clinical implications: Retention of restoration depends on the surface of the abutment as well as the luting agents used. Incorporation of retentive grooves or particle abrasion can enhance retention especially in situation of short clinical crown. PMID:24596785

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.

Incidence of undetected cement on CAD/CAM monolithic zirconia crowns and customized CAD/CAM implant abutments. A prospective case series.

PubMed

Wasiluk, Grzegorz; Chomik, Ewa; Gehrke, Peter; Pietruska, Małgorzata; Skurska, Anna; Pietruski, Jan

2017-07-01

The aim of this study was to assess the frequency of cement residues after cementation of CAD/CAM monolithic zirconia crowns on customized CAD/CAM titanium abutments. Sixty premolars and molars were restored on Astra Tech Osseospeed TX ™ implants using single monolithic zirconia crowns fixed on two types of custom-made abutments: Atlantis ™ titanium or Atlantis ™ Gold Hue. Occlusal openings providing access to the abutment screws were designed for retrievability of the crown/abutment connection. After fixation with glass ionomer cement, the crown/abutment units were unscrewed to evaluate the presence of residual cement. Dichotomous assessment of the presence or absence of cement at the crown/abutment unit and peri-implant tissues was performed. Clinically undetected cement excess was visible on 44 of 60 restorations (73.3%). There was no interdependency between residual cement presence and implant location or diameter. However, a dependency between the presence of residual cement and the aspect of the abutment/crown connection could be noted. The majority of the residues were observed on the distal (17.9%) and mesial (15%) aspects. While on the palatal/lingual aspect, the cement was visible in 8.8%; only 3.4% of all surfaces displayed cement residues. Within the limitations of the study, it can be concluded that the use of customized CAD/CAM abutments do not guarantee avoidance of subgingival cement residues after crown cementation. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A descriptive study of the radiographic density of implant restorative cements.

PubMed

Wadhwani, Chandur; Hess, Timothy; Faber, Thomas; Piñeyro, Alfonso; Chen, Curtis S K

2010-05-01

Cementation of implant prostheses is a common practice. Excess cement in the gingival sulcus may harm the periodontal tissues. Identification of the excess cement may be possible with the use of radiographs if the cement has sufficient radiopacity. The purpose of this study was to compare the radiographic density of different cements used for implant prostheses. Eight different cements were compared: TempBond Original (TBO), TempBond NE (TBN), Fleck's (FL), Dycal (DY), RelyX Unicem (RXU), RelyX Luting (RXL), Improv (IM), and Premier Implant Cement (PIC). Specimen disks, 2 mm in thickness, were radiographed. Images were made using photostimulable phosphor (PSP) plates with standardized exposure values. The average grey level of the central area of each specimen disk was selected and measured in pixels using a software analysis program, ImageTool, providing an average grey level value representative of radiodensity for each of the 8 cements. The radiodensity was determined using the grey level values of the test materials, which were recorded and compared to a standard aluminum step wedge. An equivalent thickness of aluminum in millimeters was calculated using best straight line fit estimates. To assess contrast effects by varying the exposure settings, a second experiment using 1-mm-thick cement specimens radiographed at both 60 kVp and 70 kVp was conducted. The PSP plates with specimens were measured for a grey level value comparison to the standard aluminum step wedge, using the same software program. The highest grey level values were recorded for the zinc cements (TBO, TBN, and FL), with the 1-mm specimen detectable at both 60- and 70-kVp settings. A lower grey level was recorded for DY, indicative of a lower radiodensity compared to the zinc cements, but higher than RXL and RXU. The implant-specific cements had the lowest grey level values. IM could only be detected in 2-mm-thick sections with a lower aluminum equivalence value than the previously mentioned cements. PIC could not be detected radiographically for either the 1-mm or 2-mm thicknesses at either of the kVp settings. Some types of cement commonly used for the cementation of implant-supported prostheses have poor radiodensity and may not be detectable following radiographic examination.

Long-term outcome of cemented versus screw-retained implant-supported partial restorations.

PubMed

Nissan, Joseph; Narobai, Demitri; Gross, Ora; Ghelfan, Oded; Chaushu, Gavriel

2011-01-01

The present study was designed to compare the long-term outcome and complications of cemented versus screw-retained implant restorations in partially edentulous patients. Consecutive patients with bilateral partial posterior edentulism comprised the study group. Implants were placed, and cemented or screw-retained restorations were randomly assigned to the patients in a split-mouth design. Follow-up (up to 15 years) examinations were performed every 6 months in the first year and every 12 months in subsequent years. The following parameters were evaluated and recorded at each recall appointment: ceramic fracture, abutment screw loosening, metal frame fracture, Gingival Index, and marginal bone loss. Thirty-eight patients were treated with 221 implants to support partial prostheses. No implants during the follow-up period (mean follow-up, 66 ± 47 months for screw-retained restorations [range, 18 to 180 months] and 61 ± 40 months for cemented restorations [range, 18 to 159 months]). Ceramic fracture occurred significantly more frequently (P < .001) in screw-retained (38% ± 0.3%) than in cemented (4% ± 0.1%) restorations. Abutment screw loosening occurred statistically significantly more often (P = .001) in screw-retained (32% ± 0.3%) than in cement-retained (9% ± 0.2%) restorations. There were no metal frame fractures in either type of restoration. The mean Gingival Index scores were statistically significantly higher (P < .001) for screw-retained (0.48 ± 0.5) than for cemented (0.09 ± 0.3) restorations. The mean marginal bone loss was statistically significantly higher (P < .001) for screw-retained (1.4 ± 0.6 mm) than for cemented (0.69 ± 0.5 mm) restorations. The long-term outcome of cemented implant-supported restorations was superior to that of screw-retained restorations, both clinically and biologically.

Is There a Correlation Between Tensile Strength and Retrievability of Cemented Implant-Retained Crowns Using Artificial Aging?

PubMed

Mehl, Christian; Ali, Shurouk; El Bahra, Shadi; Harder, Sönke; Vollrath, Oliver; Kern, Matthias

2016-01-01

The main goal of this in-vitro study was to evaluate whether tensile strength and retrievability of cemented implant-retained crowns correlate when using artificial aging. A total of 128 crowns were fabricated from a cobalt-chromium alloy for 128 tapered titanium abutments (6 degrees taper, 4.3 mm diameter, 4 mm length, Camlog). The crowns were cemented with glass-ionomer (Ketac Cem, 3M) or resin cements (Multilink Implant, Telio CS Cem [Ivoclar Vivadent], Retrieve [Parkell]). Multilink Implant was used without priming. The experimental groups were subjected to either 37,500 thermal cycles between 5°C and 55°C, 1,200,000 chewing cycles, or a combination of both. Control groups were stored for 10 days in deionized water. The crowns were removed with a universal testing machine or a clinically used removal device (Coronaflex, KaVo). Data were statistically analyzed using nonparametrical tests. Retention values were recorded between 31 N and 362 N. Telio CS Cem showed the lowest retention values, followed by Retrieve, Ketac Cem, and Multilink Implant (P≤.0001). The number of removal attempts with the Coronaflex were not significantly different between the cements (P>.05). Thermal cycling and chewing simulation significantly influenced the retrieval of Retrieve Telio CS Cem, and Ketac Cem specimens (P≤.05). Only for Multilink Implant and Telio CS Cem correlations between removal with the universal testing machine and the Coronaflex could be revealed (P≤.0001). Ketac Cem and Multilink Implant (without silane) can be used for a semipermanent cementation. Retrieve and Telio CS Cem are recommendable for a temporary cementation.

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.

Effects of Cement, Abutment Surface Pretreatment, and Artificial Aging on the Force Required to Detach Cantilever Fixed Dental Prostheses from Dental Implants.

PubMed

Kappel, Stefanie; Chepura, Taras; Schmitter, Marc; Rammelsberg, Peter; Rues, Stefan

To examine the in vitro effects of different cements, abutment surface preconditioning, and artificial aging on the maximum tensile force needed to detach cantilever fixed dental prostheses (FDPs) from dental implants with titanium abutments. A total of 32 tissue-level implants were combined with standardized titanium abutments. For each test group, eight cantilever FDPs were fabricated using selective laser melting (cobalt-chromium [CoCr] alloy). The inner surfaces of the cantilever FDPs and half of the abutments were sandblasted and then joined by use of four different cements (two permanent and two semi-permanent) in two different amounts per cement. Subgroups were tested after either artificial aging (thermocycling and chewing simulation) or 3 days of water storage. Finally, axial pull off-tests were performed for each abutment separately. Cement type and surface pretreatment significantly affected decementation behavior. The highest retention forces (approximately 1,200 N) were associated with sandblasted abutments and permanent cements. With unconditioned abutments, temporary cements (Fu < 100 N), as well as glass-ionomer cement (Fu ≈ 100 N), resulted in rather low retention forces. Zinc phosphate cement guaranteed high retention forces. After aging, retention was sufficient only for cementation with zinc phosphate cement and for the combination of sandblasted abutments and glass-ionomer cement. When glass-ionomer cement is used to fix cantilever FDPs on implants, sandblasting of standard titanium abutments may help prevent loss of retention. Retention forces were still high for FDPs fixed with zinc phosphate cement, even when the abutments were not pretreated. Use of permanent cements only, however, is recommended to prevent unwanted loosening of cantilever FDPs.

Platform-Switching for Cemented Versus Screwed Fixed Dental Prostheses: Reliability and Failure Modes: An In Vitro Study.

PubMed

Anchieta, Rodolfo Brunieira; Machado, Lucas Silveira; Hirata, Ronaldo; Bonfante, Estevam Augusto; Coelho, Paulo G

2016-08-01

The aim of this study was to evaluate the probability of survival of cemented and screwed three-unit implant-supported fixed dental prostheses (ISFDP) using different implant-abutment horizontal matching configurations (regular vs switching platforms). One hundred and sixty-eight implants with internal hexagon connection (4 mm diameter, 10 mm length, Emfils; Colosso Evolution System, Itú, SP, Brazil) were selected for this study according to the horizontal implant-abutment matching configuration (regular or switching) and retention method and divided in four groups (n = 21 per group) as follows: 1) regular platform cemented (IRC); 2) or screw-retained (IRS); 3) switched-platform cemented (ISC); or 4) screw-retained (ISS). Regular and platform-switched abutments (Colosso evolution, 4 mm and 3.3 mm, respectively) were torqued, and 84 three-unit metal bridges were fabricated (first molar pontic). Implants were embedded in polymethyl-methacrylate resin and subjected to step-stress accelerated life testing in water. Weibull distribution was used to determine the probability of survival for a mission of 100,000 cycles at 400 N (90% two-sided confidence intervals). Polarized light and scanning electron microscopes were used for fractographic analysis. The β values of 0.50, 1.19, 1.25, and 1.95 for groups IRC, IRS, ISC, and ISS respectively, indicated that fatigue accelerated the failure for all groups, except IRC. The cement-retained groups presented significantly higher probability of survival (IRC - 98%, ISC - 59%) than screw-retained groups (IRS - 23% and ISS - 0%). Screw-retained FDPs exclusively failed by abutment-screw fractures, whereas cement-retained presented implant/screw/abutment fractures. The probability of survival of cement-retained ISFDP was higher than screw-retained, irrespective of implant-abutment horizontal configuration. © 2015 Wiley Periodicals, Inc.

Acrylic resin guide for locating the abutment screw access channel of cement-retained implant prostheses.

PubMed

Ahmed, Ayman; Maroulakos, Georgios; Garaicoa, Jorge

2016-05-01

Abutment screw loosening represents a common and challenging technical complication of cement-retained implant prostheses. This article describes the fabrication of a simple and accurate poly(methyl methacrylate) guide for identifying the location and angulation of the abutment screw access channel of a cement-retained implant prosthesis with a loosened abutment screw. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Influence of cement film thickness on the retention of implant-retained crowns.

PubMed

Mehl, Christian; Harder, Sönke; Steiner, Martin; Vollrath, Oliver; Kern, Matthias

2013-12-01

The main goal of this study was to establish a new, high precision procedure to evaluate the influence of cement film thickness on the retention of cemented implant-retained crowns. Ninety-six tapered titanium abutments (6° taper, 4.3 mm diameter, Camlog) were shortened to 4 mm. Computer-aided design was used to design the crowns, and selective laser sintering, using a cobalt-chromium alloy, was used to produce the crowns. This method used a focused high-energy laser beam to fuse a localized region of metal powder to build up the crowns gradually. Before cementing, preset cement film thicknesses of 15, 50, 80, or 110 μm were established. Glass ionomer, polycarboxylate, or resin cements were used for cementation. After 3 days storage in demineralized water, the retention of the crowns was measured in tension using a universal testing machine. The cement film thicknesses could be achieved with a high level of precision. Interactions between the factors cement and cement film thickness could be found (p ≤ 0.001). For all cements, crown retention decreased significantly between a cement film thickness of 15 and 50 μm (p ≤ 0.001). At 15 μm cement film thickness, the resin cement was the most retentive cement, followed by the polycarboxylate and then the glass ionomer cement (p ≤ 0.05). The results suggest that cement film thickness has an influence on the retentive strength of cemented implant-retained crowns. © 2013 by the American College of Prosthodontists.

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.

Effect of Abutment Modification and Cement Type on Retention of Cement-Retained Implant Supported Crowns

PubMed Central

Farzin, Mitra; Torabi, Kianoosh; Ahangari, Ahmad Hasan; Derafshi, Reza

2014-01-01

Objective: Provisional cements are commonly used to facilitate retrievability of cement-retained fixed implant restorations; but compromised abutment preparation may affect the retention of implant-retained crowns.The purpose of this study was to investigate the effect of abutment design and type of luting agent on the retentive strength of cement-retained implant restorations. Materials and Method: Two prefabricated abutments were attached to their corresponding analogs and embedded in an acrylic resin block. The first abutment (control group) was left intact without any modifications. The screw access channel for the first abutment was completely filled with composite resin. In the second abutment, (test group) the axial wall was partially removed to form an abutment with 3 walls. Wax models were made by CAD/CAM. Ten cast copings were fabricated for each abutment. The prepared copings were cemented on the abutments by Temp Bond luting agent under standardized conditions (n=20). The assemblies were stored in 100% humidity for one day at 37°C prior to testing. The cast crown was removed from the abutment using an Instron machine, and the peak removal force was recorded. Coping/abutment specimens were cleaned after testing, and the testing procedure was repeated for Dycal luting agent (n=20). Data were analyzed with two- way ANOVA (α=0.05). Results: There was no significant difference in the mean transformed retention (Ln-R) between intact abutments (4.90±0.37) and the abutments with 3 walls (4.83±0.25) using Dycal luting agent. However, in TempBond group, the mean transformed retention (Ln-R) was significantly lower in the intact abutment (3.9±0.23) compared to the abutment with 3 walls (4.13±0.33, P=0.027). Conclusion: The retention of cement-retained implant restoration can be improved by the type of temporary cement used. The retention of cast crowns cemented to implant abutments with TempBond is influenced by the wall removal. PMID:25628660

Microstructure of titanium-cement-lithium disilicate interface in CAD-CAM dental implant crowns: a three-dimensional profilometric analysis.

PubMed

Cresti, Stefano; Itri, Angelo; Rebaudi, Alberto; Diaspro, Alberto; Salerno, Marco

2015-01-01

Peri-implantitis is an infection of the implant surface caused by adhesion of bacteria that generate bone resorption and sometimes even consequent implant loss. Both screw-retained and cemented fixed implants are affected. The purpose of this study is to investigate the morphological defects at the cemented interface between titanium abutment and ceramic crown, comparing different adhesive cements used to fill the marginal gap. Twelve computer-aided design-computer-aided manufacturing dental crowns were cemented to titanium abutments using three different resin composite cements. Sealed margins were polished using grommets with descending diamond particle size. Three groups of four crowns each were made according to the cement used, namely RelyX Unicem (3 M ESPE), Panavia F 2.0 (Kuraray), and NX3 (Nexus Kerr). Samples were analyzed using optical inspection, three-dimensional profilometry, and image analysis, including analysis of variance. Although RelyX showed significantly lower root mean square surface roughness (4.4 ± 1.5 μm) than that of NX3 (7.0 ± 2.9 μm), it showed no significant difference with Panavia (3.7 ± 1.5 μm). The marginal gap was significantly wider in Panavia (149 ± 108 μm) as compared with NX3 (71 ± 45 μm) and Relyx (64 ± 34 μm). For all groups, homogeneous heights of both metal-cement and ceramic-cement gaps were observed. Moreover, all samples showed homogeneity of the margins and absence of instrumental bias, thus validating both procedure and materials. When using the chosen polishing method, RelyX Unicem showed both low roughness and marginal width, and thus the smoothest and more continuous abutment-crown interlayer, promising a low probability of occurrence of peri-implantitis. © 2013 Wiley Periodicals, Inc.

Comparative study on stress distribution around internal tapered connection implants according to fit of cement- and screw-retained prostheses.

PubMed

Lee, Mi-Young; Heo, Seong-Joo; Park, Eun-Jin; Park, Ji-Man

2013-08-01

The aim of this study was to compare the passivity of implant superstructures by assessing the strain development around the internal tapered connection implants with strain gauges. A polyurethane resin block in which two implants were embedded served as a measurement model. Two groups of implant restorations utilized cement-retained design and internal surface of the first group was adjusted until premature contact between the restoration and the abutment completely disappeared. In the second group, only nodules detectable to the naked eye were removed. The third group employed screw-retained design and specimens were generated by computer-aided design/computer-aided manufacturing system (n=10). Four strain gauges were fixed on the measurement model mesially and distally to the implants. The strains developed in each strain gauge were recorded during fixation of specimens. To compare the difference among groups, repeated measures 2-factor analysis was performed at a level of significance of α=.05. The absolute strain values were measured to analyze the magnitude of strain. The mean absolute strain value ranged from 29.53 to 412.94 µm/m at the different strain gauge locations. According to the result of overall comparison, the cement-retained prosthesis groups exhibited significant difference. No significant difference was detected between milled screw-retained prostheses group and cement-retained prosthesis groups. Within the limitations of the study, it was concluded that the cement-retained designs do not always exhibit lower levels of stress than screw-retained designs. The internal adjustment of a cement-retained implant restoration is essential to achieve passive fit.

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.

[Augmentation with PMMA cement].

PubMed

Kühn, K-D; Höntzsch, D

2015-09-01

Cements based on polymethyl methacrylate (PMMA) can be used without any problem in a variety of clinical augmentations. Cement-related complications in surgical procedures involving PMMA cements, such as embolism, thermal necrosis, toxicity and hypersensitivity, are often due to other causes. Knowledge about the properties of the cement helps the user to safely employ PMMA cements in augmentations. High radio-opacity is required in vertebral body augmentations and this is provided in particular by zirconium dioxide. In vertebral body augmentations, a low benzoyl peroxide (BPO) content can considerably prolong the liquid dough phase. In augmentations with cement fillings in the region of a tumor, a high BPO content can specifically increase the peak temperature of the PMMA cement. In osteosynthetic augmentations with PMMA, necrosis is rare because heat development in the presence of metallic implants is low due to heat conduction via the implant. Larger cement fillings where there is no heat conduction via metal implants can exhibit substantially higher peak temperatures. The flow properties of PMMA cements are of particular importance for the user to allow optimum handling of PMMA cements. In patients with hypersensitivity to antibiotics, there is no need to avoid the use of PMMA as there are sufficient PMMA-based alternatives. The PMMA cements are local drug delivery systems and antibiotics, antiseptics, antimycotics and also cytostatics can be mixed with the cement. Attention must be paid to antagonistic and synergistic effects.

Prosthetic complications in fixed endosseous implant-borne reconstructions after an observations period of at least 40 months.

PubMed

De Boever, A L; Keersmaekers, K; Vanmaele, G; Kerschbaum, T; Theuniers, G; De Boever, J A

2006-11-01

One hundred and seventy-two fixed reconstructions (317 prosthetic units), made on 283 ITI implants in 105 patients (age range 25-86 years) with a minimum follow-up period of 40 months, were taken into the study to analyse technical complication rate, complication type and costs for repair. The mean evaluation time was 62.5 +/- 25.3 months. Eighty were single crowns and 92 different types of fixed partial dentures (FPDs). In 45 cases the construction was screw retained and in 127 cases cemented with zinc phosphate cement or an acrylic-based cement. Complications occurred after a minimum period of 2 months and a maximum period of 100 months (mean: 35.9 +/- 21.4 months). Fifty-five prosthetic interventions were needed on 44 constructions (25%) of which 88% in the molar/premolar region. The lowest percentage of complications occurred in single crowns (25%), the highest in 3-4 unit FPDs (35%) and in FPDs with an extension (44%). Of the necessary clinical repair, 36% was recementing and 38% tightening the screws. Of all interventions, 14% were classified as minor (no treatment or <10 min chair time), 70% as moderate (>10 min but <60 min chair time) and 14% as major interventions (>60 min and additional costs for replacement of parts and/or laboratory). For seven patients the additional costs ranged from euro 28 to euro 840. Bruxing seemed to play a significant role in the frequency of complications. Longer constructions seemed to be more prone to complications. The relatively high occurrence of technical complications should be discussed with the patient before the start of the treatment.

In vivo response of bioactive PMMA-based bone cement modified with alkoxysilane and calcium acetate.

PubMed

Sugino, Atsushi; Ohtsuki, Chikara; Miyazaki, Toshiki

2008-11-01

The use of polymethylmethacrylate (PMMA)-based bone cement is popular in orthopedics for the fixation of artificial joints with bone. However, it has a major problem with prostheses loosening because of coverage by fibrous tissue after long-term implantation. Recently, a bioactive bone cement has been developed that shows direct bonding to living bone through modification of PMMA resin with gamma-methacryloxypropyltrimethoxysilane (MPS) and calcium acetate. The cement is designed to exhibit bioactivity, through incorporation of silanol groups and calcium ions. Thus, it has the potential to form a layer of bone-like hydroxyapatite, which is essential for achieving direct bonding to living bone. This type of modification allows the cement to show spontaneous hydroxyapatite formation on its surface in a simulated body fluid after one day, and there is evidence of osteoconduction of the cement in rabbit tibia for periods of more than three weeks. However, the influence of the dissolved ions from the modified cement has not yet been clarified. Thus, the authors focused on the dissolution of the modified PMMA-based bone cement and its tissue response in muscle and bone by comparison with the behavior of non-modified PMMA-based bone cement. One week after implantation in the latissimus dorsi of a rabbit, the modified PMMA-based bone cement showed more inflammatory width than the commercial cement. However, four weeks after implantation, the inflammatory width of both cements was essentially the same. The osteoconductivity around the modified cement was higher than that for the conventional cement after four weeks implantation. These results indicate that the initial dissolution of calcium acetate from the modified cement to form the hydroxyapatite induced the acute inflammation around tissue, but also developed the osteoconductivity. It is suggested that the initial inflammation can be effective for inducing osteoconduction through a bone healing reaction when the material provides an environment that promotes bone formation.

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.

Improving the fit of implant prosthetics: an in vitro study.

PubMed

Yannikakis, Stavros; Prombonas, Anthony

2013-01-01

Accurate and passive fit between a prosthesis and its supporting implants has been considered a prerequisite for successful long-term osseointegration. The objective of this in vitro study was to evaluate the strain development during tightening of a five-unit screw-retained superstructure constructed using five different methods. Five-unit screw-retained fixed partial prostheses (n = 25) were fabricated on three implants embedded in an epoxy resin block using five different methods: (1) cobalt-chromium (Co-Cr), plastic cylinders, one-piece cast; (2) Co-Cr, plastic cylinders, framework sectioned, preceramic laser-welding soldering; (3) gold-platinum (Au-Pt), gold cylinders, one-piece cast; (4) Au-Pt, gold cylinders, framework sectioned, preceramic laser-welding soldering; (5) Co-Cr, one-piece cast, and cementation to "passive abutments" (Southern Implants) after final finishing and polishing. Strain gauges (SG) were attached to the fixed partial prosthesis (FPP) and to the resin block to measure the stress created during screw tightening. The combination of Co-Cr alloy and plastic cylinders in a one-piece cast showed such an inadequate fit among the fabricated methods that this group was excluded from the remainder of the experiment. Specimens of Au-Pt cast on gold cylinders in one piece showed higher strain development than the other groups used in this study, with strains ranging from 223.1 to 2,198.1 Μm/m. Sectioning and soldering significantly improved the overall fit. FPPs of Co-Cr in a one-piece cast cemented to "passive abutments" produced the best level of fit, with the least strain development in the prosthesis and the resin block (59 to 204.6 Μm/m). Absolute fit of superstructures on implants is not possible using conventional laboratory procedures. Cementing FPPs onto prefabricated cylinders directly onto the implants significantly reduces strain development compared to the other fabrication methods.

The effect of air abrasion of metal implant abutments on the tensile bond strength of three luting agents used to cement implant superstructures: an in vitro study.

PubMed

Jugdev, Jasvinder; Borzabadi-Farahani, Ali; Lynch, Edward

2014-01-01

To assess the effect of airborne particle abrasion of metal implant abutments on tensile bond strength (TBS) of TempBond, Retrieve, and Premier implant cements. Specimens were designed to replicate a single metal implant crown cemented to both smooth and airborne particle-abraded Osteo-Ti implant abutments with zero degrees of taper. Twenty castings were fabricated and cemented to either a smooth surface abutment (SSA) or to an airborne particle-abraded abutment (AAA). TBS was measured with a 50-kg load and a crosshead speed of 0.5 cm/min in a universal testing machine. Each cement was tested 10 times on both abutment types. The mean TBS values (standard deviations, 95% confidence intervals) of SSAs for TempBond, Retrieve, and Premier cements were 115.89 N (26.44, 96.98-134.81), 134.43 N (36.95, 108.25-160.60), and 132.51 N (55.10, 93.09-171.93), respectively. The corresponding values for AAAs were 129.69 N (30.39, 107.95-151.43), 298.67 N (80.36, 241.19-356.16), and 361.17 N (133.23, 265.86-456.48), respectively. There was no significant difference in TBS among the dental cements when used with an SSA. Air abrasion of abutments did not increase the TBS of TempBond but significantly increased crown retention with Retrieve and Premier. For SSAs, all failures were adhesive on the abutment surface; for AAAs, mostly cohesive cement failures occurred. The retention of copings cemented with Retrieve or Premier to zero-degree-taper abutments was significantly increased after airborne particle abrasion of the abutments. However, this was not significant when TempBond was used. Airborne particle abrasion of abutments and the use of Retrieve or Premier can be recommended for nonretrievable prostheses. Although TempBond functioned similarly to the two other cements in SSAs, it is advisable to limit its use to provisional prostheses; its long-term performance needs to be assessed clinically.

Adhesive strength of total knee endoprostheses to bone cement - analysis of metallic and ceramic femoral components under worst-case conditions.

PubMed

Bergschmidt, Philipp; Dammer, Rebecca; Zietz, Carmen; Finze, Susanne; Mittelmeier, Wolfram; Bader, Rainer

2016-06-01

Evaluation of the adhesive strength of femoral components to the bone cement is a relevant parameter for predicting implant safety. In the present experimental study, three types of cemented femoral components (metallic, ceramic and silica/silane-layered ceramic) of the bicondylar Multigen Plus knee system, implanted on composite femora were analysed. A pull-off test with the femoral components was performed after different load and several cementing conditions (four groups and n=3 components of each metallic, ceramic and silica/silane-layered ceramic in each group). Pull-off forces were comparable for the metallic and the silica/silane-layered ceramic femoral components (mean 4769 N and 4298 N) under standard test condition, whereas uncoated ceramic femoral components showed reduced pull-off forces (mean 2322 N). Loading under worst-case conditions led to decreased adhesive strength by loosening of the interface implant and bone cement using uncoated metallic and ceramic femoral components, respectively. Silica/silane-coated ceramic components were stably fixed even under worst-case conditions. Loading under high flexion angles can induce interfacial tensile stress, which could promote early implant loosening. In conclusion, a silica/silane-coating layer on the femoral component increased their adhesive strength to bone cement. Thicker cement mantles (>2 mm) reduce adhesive strength of the femoral component and can increase the risk of cement break-off.

[Mathematical simulation of stem/cement/bone mechanical interactions for Poldi-Cech, CF-30, MS-30 and PFC femoral components].

PubMed

Kovanda, M; Havlícek, V; Hudec, J

2009-04-01

PURPOSE OF THE STUDY The mid-term longevity of femoral components varies considerably, with some showing failure due to early aseptic loosening. Since the hip joint is subject to heavy mechanical loads, it can be assumed that the mechanical interaction of the implant, bone cement and femur will play a key role in the resultant reliability of an arthroplasty. This study was designed to examine this mechanical interaction in four femoral components different in construction (Poldi-Cech, CF-30, MS-30 and PFC) using mathematical simulation. MATERIAL AND METHODS Four stem/cement/femur 3-D mathematical models, comparable in quality, infolving the Poldi-Cech, CF-30, MS-30 and PFC stems, respectively, were constructed. A 3-D model for each stem was created according to its real, middle-size femoral component. Each 3-D model of the cement mantle corresponded in shape to the mantle of the appropriate real stem, with its thickness based on the recommended values of 4-7 mm in the proximal and 1-3 mm in the distal part, and with the cement mantle reaching as far as 10 mm distal to the femoral stem tip. For simplicitys sake the outer surface of the cement mantle was simulated as smooth. A 3-D model involving the proximal epiphysis and the metaphysis of a femur was reconstructed, based on a series of CT cross-sections obtained periodically at 10.5-mm and 2.5-mm distances. The sten/cement/femur model with the MS-30 stem also included a centraliser. The mechanical interaction of the stem, bone cement and bone tissue was examined by means of mathematical stimulation using ANSYS 5.7 software based on finite element analysis. RESULTS For the sake of simplicity, only two key parameters are presented, namely, contact stress at the stem-cement interface and equivalent deformation in the stem/cement/femur system. The least satisfactory stress loading was in the CF-30 stem whose sharp edges showed the values of contact stress about six-times higher than on the mid-medial portion of the stem, with the sharp edges behaving as stress concentrators. A satisfactory stress loading was found in Poldi-Cech, MS-30 and PFC stems, in which contact stress was evenly distributed along the whole lenght of the stem and the values at the edges and on the midmedial portion did not differ much. DISCUSSION The distribution of contact stress is one of the most important factors for the long-term longevity of implants. It was found least satisfactory in the CF-30 stem whose sharp edges act as stress condenser adversely affecting not only the stemcement interface, but also the resultant stress distribution within the femur. The most satisfactory results of stress distribution were recorded in the Poldi-Cech and MS-30 stems. The PFC stem also responded satisfactorily to the simulated stress loading. However, on loading whose substantial part would be torsion, the stems circular or oval cross-section could interfere with rotation stability of the implant; but this was impossible to detect by the mathematical simulation used in this study. CONCLUSIONS The results presented here show that, in the Poldi-Cech, CF-30, MS-30 and PFC femoral stems, a good agreement was achieved between the results of their clinical application and those of mathematical modelling of their mechanical properties. It can be concluded that mechanical interaction among the femoral stem, cement mantle and bone tissue plays the key role in the long-term longevity of such an implant. Key words: Poldi-Cech, CF-30, MS-30, PFC, mechanical interaction, contact stress.

Failure at the Tibial Cement-Implant Interface With the Use of High-Viscosity Cement in Total Knee Arthroplasty.

PubMed

Kopinski, Judith E; Aggarwal, Ajay; Nunley, Ryan M; Barrack, Robert L; Nam, Denis

2016-11-01

Recent literature has shown debonding of the tibial implant-cement interface as a potential cause for implant loosening. The purpose of this case series is to report this phenomenon in a historically well-performing implant when used with high-viscosity cement (HVC). Thirteen primary cemented Biomet Vanguard total knee arthroplasties were referred to 1 of 2 institutions with complaints of persistent pain after their index procedure. A radiographic and infectious work-up was completed for each patient. All 13 patients underwent a revision of the index surgery with intraoperative diagnosis of tibial component debonding at the implant-cement interface. HVC (Cobalt, DJO Surgical, Vista, CA and Depuy HVC; Depuy Inc, Warsaw, IN) was used in all index cases. The average time to revision surgery for the 13 patients was 2.7 ± 1.9 years from the index surgery. Laboratory infectious markers were within normal in most cases, and all intra-articular aspirations showed no bacterial, fungal, or anaerobic growth. Eleven of 13 patients showed no radiographic evidence of loosening; however, all cases demonstrated tibial component debonding intraoperatively. Given our institution's experience and previously reported data demonstrating excellent survivorship with this total knee arthroplasty prosthesis, we propose that the early failures seen in this case series may be associated with the use of HVC cement. In the setting of a negative infectious work-up and no radiographic evidence to suggest loosening, the surgeon should consider debonding of the tibial component as a potential cause for persistent pain if HVC cement was used with this prosthetic design. Copyright © 2016 Elsevier Inc. All rights reserved.

Retention System and Splinting on Morse Taper Implants in the Posterior Maxilla by 3D Finite Element Analysis.

PubMed

Lemos, Cleidiel Aparecido Araujo; Verri, Fellippo Ramos; Santiago, Joel Ferreira; Almeida, Daniel Augusto de Faria; Batista, Victor Eduardo de Souza; Noritomi, Pedro Yoshito; Pellizzer, Duardo Piza

2018-01-01

The purpose of this study was to evaluate different retention systems (cement- or screw-retained) and crown designs (non-splinted or splinted) of fixed implant-supported restorations, in terms of stress distributions in implants/components and bone tissue, by 3-dimensional (3D) finite element analysis. Four 3D models were simulated with the InVesalius, Rhinoceros 3D, and SolidWorks programs. Models were made of type III bone from the posterior maxillary area. Models included three 4.0-mm-diameter Morse taper (MT) implants with different lengths, which supported metal-ceramic crowns. Models were processed by the Femap and NeiNastran programs, using an axial force of 400 N and oblique force of 200 N. Results were visualized as the von Mises stress and maximum principal stress (σmax). Under axial loading, there was no difference in the distribution of stress in implants/components between retention systems and splinted crowns; however, in oblique loading, cemented prostheses showed better stress distribution than screwed prostheses, whereas splinted crowns tended to reduce stress in the implant of the first molar. In the bone tissue cemented prostheses showed better stress distribution in bone tissue than screwed prostheses under axial and oblique loading. The splinted design only had an effect in the screwed prosthesis, with no influence in the cemented prosthesis. Cemented prostheses on MT implants showed more favorable stress distributions in implants/components and bone tissue. Splinting was favorable for stress distribution only for screwed prostheses under oblique loading.

Fracture toughness of titanium–cement interfaces: effects of fibers and loading angles

PubMed Central

Khandaker, Morshed; Utsaha, Khatri Chhetri; Morris, Tracy

2014-01-01

Ideal implant–cement or implant–bone interfaces are required for implant fixation and the filling of tissue defects created by disease. Micron- to nanosize osseointegrated features, such as surface roughness, fibers, porosity, and particles, have been fused with implants for improving the osseointegration of an implant with the host tissue in orthopedics and dentistry. The effects of fibers and loading angles on the interface fracture toughness of implant–cement specimens with and without fibers at the interface are not yet known. Such studies are important for the design of a long-lasting implant for orthopedic applications. The goal of this study was to improve the fracture toughness of an implant–cement interface by deposition of micron- to nanosize fibers on an implant surface. There were two objectives in the study: 1) to evaluate the influence of fibers on the fracture toughness of implant–cement interfaces with and without fibers at the interfaces, and 2) to evaluate the influence of loading angles on implant–cement interfaces with and without fibers at the interfaces. This study used titanium as the implant, poly(methyl methacrylate) (PMMA) as cement, and polycaprolactone (PCL) as fiber materials. An electrospinning unit was fabricated for the deposition of PCL unidirectional fibers on titanium (Ti) plates. The Evex tensile test stage was used to determine the interface fracture toughness (KC) of Ti–PMMA with and without PCL fibers at 0°, 45°, and 90° loading angles, referred to in this article as tension, mixed, and shear tests. The study did not find any significant interaction between fiber and loading angles (P>0.05), although there was a significant difference in the KC means of Ti–PMMA samples for the loading angles (P<0.05). The study also found a significant difference in the KC means of Ti–PMMA samples with and without fibers (P<0.05). The results showed that the addition of the micron- to nanosize PCL fibers on Ti improved the quality of the Ti–PMMA union. The results of the study are essential for fatigue testing and finite-element analysis of implant–cement interfaces to evaluate the performance of orthopedic and orthodontic implants. PMID:24729704

Effects of abutment diameter, luting agent type, and re-cementation on the retention of implant-supported CAD/CAM metal copings over short abutments.

PubMed

Safari, Sina; Hosseini Ghavam, Fereshteh; Amini, Parviz; Yaghmaei, Kaveh

2018-02-01

The aim of this study was to evaluate the effects of abutment diameter, cement type, and re-cementation on the retention of implant-supported CAD/CAM metal copings over short abutments. Sixty abutments with two different diameters, the height of which was reduced to 3 mm, were vertically mounted in acrylic resin blocks with matching implant analogues. The specimens were divided into 2 diameter groups: 4.5 mm and 5.5 mm (n=30). For each abutment a CAD/CAM metal coping was manufactured, with an occlusal loop. Each group was sub-divided into 3 sub-groups (n=10). In each subgroup, a different cement type was used: resin-modified glass-ionomer, resin cement and zinc-oxide-eugenol. After incubation and thermocycling, the removal force was measured using a universal testing machine at a cross-head speed of 0.5 mm/min. In zinc-oxide-eugenol group, after removal of the coping, the cement remnants were completely cleaned and the copings were re-cemented with resin cement and re-tested. Two-way ANOVA, post hoc Tukey tests, and paired t-test were used to analyze data (α=.05). The highest pulling force was registered in the resin cement group (414.8 N), followed by the re-cementation group (380.5 N). Increasing the diameter improved the retention significantly ( P =.006). The difference in retention between the cemented and recemented copings was not statistically significant ( P =.40). Resin cement provided retention almost twice as strong as that of the RMGI. Increasing the abutment diameter improved retention significantly. Re-cementation with resin cement did not exhibit any difference from the initial cementation with resin cement.

Effects of abutment diameter, luting agent type, and re-cementation on the retention of implant-supported CAD/CAM metal copings over short abutments

PubMed Central

Safari, Sina; Amini, Parviz; Yaghmaei, Kaveh

2018-01-01

PURPOSE The aim of this study was to evaluate the effects of abutment diameter, cement type, and re-cementation on the retention of implant-supported CAD/CAM metal copings over short abutments. MATERIALS AND METHODS Sixty abutments with two different diameters, the height of which was reduced to 3 mm, were vertically mounted in acrylic resin blocks with matching implant analogues. The specimens were divided into 2 diameter groups: 4.5 mm and 5.5 mm (n=30). For each abutment a CAD/CAM metal coping was manufactured, with an occlusal loop. Each group was sub-divided into 3 sub-groups (n=10). In each subgroup, a different cement type was used: resin-modified glass-ionomer, resin cement and zinc-oxide-eugenol. After incubation and thermocycling, the removal force was measured using a universal testing machine at a cross-head speed of 0.5 mm/min. In zinc-oxide-eugenol group, after removal of the coping, the cement remnants were completely cleaned and the copings were re-cemented with resin cement and re-tested. Two-way ANOVA, post hoc Tukey tests, and paired t-test were used to analyze data (α=.05). RESULTS The highest pulling force was registered in the resin cement group (414.8 N), followed by the re-cementation group (380.5 N). Increasing the diameter improved the retention significantly (P=.006). The difference in retention between the cemented and recemented copings was not statistically significant (P=.40). CONCLUSION Resin cement provided retention almost twice as strong as that of the RMGI. Increasing the abutment diameter improved retention significantly. Re-cementation with resin cement did not exhibit any difference from the initial cementation with resin cement. PMID:29503708

Influence of the temperature on the cement disintegration in cement-retained implant restorations.

PubMed

Linkevicius, Tomas; Vindasiute, Egle; Puisys, Algirdas; Linkeviciene, Laura; Svediene, Olga

2012-01-01

The aim of this study was to estimate the average disintegration temperature of three dental cements used for the cementation of the implant-supported prostheses. One hundred and twenty metal frameworks were fabricated and cemented on the prosthetic abutments with different dental cements. After heat treatment in the dental furnace, the samples were set for the separation to test the integration of the cement. Results have shown that resin-modified glass-ionomer cement (RGIC) exhibited the lowest disintegration temperature (p<0.05), but there was no difference between zinc phosphate cement (ZPC) and dual cure resin cement (RC) (p>0.05). Average separation temperatures: RGIC - 306 ± 23 °C, RC - 363 ± 71 °C, it could not be calculated for the ZPC due to the eight unseparated specimens. Within the limitations of the study, it could be concluded that RGIC cement disintegrates at the lowest temperature and ZPC is not prone to break down after exposure to temperature.

Comparison of marginal bone loss between internal- and external-connection dental implants in posterior areas without periodontal or peri-implant disease.

PubMed

Kim, Dae-Hyun; Kim, Hyun Ju; Kim, Sungtae; Koo, Ki-Tae; Kim, Tae-Il; Seol, Yang-Jo; Lee, Yong-Moo; Ku, Young; Rhyu, In-Chul

2018-04-01

The purpose of this retrospective study with 4-12 years of follow-up was to compare the marginal bone loss (MBL) between external-connection (EC) and internal-connection (IC) dental implants in posterior areas without periodontal or peri-implant disease on the adjacent teeth or implants. Additional factors influencing MBL were also evaluated. This retrospective study was performed using dental records and radiographic data obtained from patients who had undergone dental implant treatment in the posterior area from March 2006 to March 2007. All the implants that were included had follow-up periods of more than 4 years after loading and satisfied the implant success criteria, without any peri-implant or periodontal disease on the adjacent implants or teeth. They were divided into 2 groups: EC and IC. Subgroup comparisons were conducted according to splinting and the use of cement in the restorations. A statistical analysis was performed using the Mann-Whitney U test for comparisons between 2 groups and the Kruskal-Wallis test for comparisons among more than 2 groups. A total of 355 implants in 170 patients (206 EC and 149 IC) fulfilled the inclusion criteria and were analyzed in this study. The mean MBL was 0.47 mm and 0.15 mm in the EC and IC implants, respectively, which was a statistically significant difference ( P <0.001). Comparisons according to splinting (MBL of single implants: 0.34 mm, MBL of splinted implants: 0.31 mm, P =0.676) and cement use (MBL of cemented implants: 0.27 mm, MBL of non-cemented implants: 0.35 mm, P =0.178) showed no statistically significant differences in MBL, regardless of the implant connection type. IC implants showed a more favorable bone response regarding MBL in posterior areas without peri-implantitis or periodontal disease.

Strontium enhances osseointegration of calcium phosphate cement: a histomorphometric pilot study in ovariectomized rats.

PubMed

Baier, Martin; Staudt, Patric; Klein, Roman; Sommer, Ulrike; Wenz, Robert; Grafe, Ingo; Meeder, Peter Jürgen; Nawroth, Peter P; Kasperk, Christian

2013-06-07

Calcium phosphate cements are used frequently in orthopedic and dental surgeries. Strontium-containing drugs serve as systemic osteoblast-activating medication in various clinical settings promoting mechanical stability of the osteoporotic bone. Strontium-containing calcium phosphate cement (SPC) and calcium phosphate cement (CPC) were compared regarding their local and systemic effects on bone tissue in a standard animal model for osteoporotic bone. A bone defect was created in the distal femoral metaphysis of 60 ovariectomized Sprague-Dawley rats. CPC and SPC were used to fill the defects in 30 rats in each group. Local effects were assessed by histomorphometry at the implant site. Systemic effects were assessed by bone mineral density (BMD) measurements at the contralateral femur and the spine. Faster osseointegration and more new bone formation were found for SPC as compared to CPC implant sites. SPC implants exhibited more cracks than CPC implants, allowing more bone formation within the implant. Contralateral femur BMD and spine BMD did not differ significantly between the groups. The addition of strontium to calcium phosphate stimulates bone formation in and around the implant. Systemic release of strontium from the SPC implants did not lead to sufficiently high serum strontium levels to induce significant systemic effects on bone mass in this rat model.

Fracture load of implant-supported zirconia all-ceramic crowns luted with various cements.

PubMed

Lim, Hyun-Pil; Yoo, Jeong-Min; Park, Sang-Won; Yang, Hong-So

2010-01-01

This study compared the fracture load and failure types of implant-supported zirconia all-ceramic crowns cemented with various luting agents. The ceramic frameworks were fabricated from a presintered yttria-stabilized zirconium dioxide block using computer-aided design/computer-assisted manufacturing technology, and were then veneered with feldspathic porcelain. Three luting agents were used. Composite resin cement (1,560.78 +/- 39.43 N) showed the highest mean fracture load, followed by acrylic/urethane cement (1,116.20 +/- 77.32 N) and zinc oxide eugenol cement (741.21 +/- 41.95 N) (P < .05). The types of failure varied between groups.

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.

Effect of Polyether Ether Ketone on Therapeutic Radiation to the Spine: A Pilot Study.

PubMed

Jackson, J Benjamin; Crimaldi, Anthony J; Peindl, Richard; Norton, H James; Anderson, William E; Patt, Joshua C

2017-01-01

Cadaveric model. To compare the effect of PEEK versus conventional implants on scatter radiation to a simulated tumor bed in the spine SUMMARY OF BACKGROUND DATA.: Given the highly vasculature nature of the spine, it is the most common place for bony metastases. After surgical treatment of a spinal metastasis, adjuvant radiation therapy is typically administered. Radiation dosing is primarily limited by toxicity to the spinal cord. The scatter effect caused by metallic implants decreases the accuracy of dosing and can unintentionally increase the effective dose seen by the spinal cord. This represents a dose-limiting factor for therapeutic radiation postoperatively. A cadaveric thorax specimen was utilized as a metastatic tumor model with two separate three-level spine constructs (one upper thoracic and one lower thoracic). Each construct was examined independently. All four groups compared included identical posterior instrumentation. The anterior constructs consisted of either: an anterior polyether ether ketone (PEEK) cage, an anterior titanium cage, an anterior bone cement cage (polymethyl methacrylate), or a control group with posterior instrumentation alone. Each construct had six thermoluminescent detectors to measure the radiation dose. The mean dose was similar across all constructs and locations. There was more variability in the upper thoracic spine irrespective of the construct type. The PEEK construct had a more uniform dose distribution with a standard deviation of 9.76. The standard deviation of the others constructs was 14.26 for the control group, 19.31 for the titanium cage, and 21.57 for the cement (polymethyl methacrylate) construct. The PEEK inter-body cage resulted in a significantly more uniform distribution of therapeutic radiation in the spine when compared with the other constructs. This may allow for the application of higher effective dosing to the tumor bed for spinal metastases without increasing spinal cord toxicity with either fractionated or hypofractionated radiotherapy. N/A.

Three-dimensional printing and nanotechnology for enhanced implantable materials

NASA Astrophysics Data System (ADS)

Tappa, Karthik Kumar

Orthopedic and oro-maxillofacial implants have revolutionized treatment of bone diseases and fractures. Currently available metallic implants have been in clinical use for more than 40 years and have proved medically efficacious. However, several drawbacks remain, such as excessive stiffness, accumulation of metal ions in surrounding tissue, growth restriction, required removal/revision surgery, inability to carry drugs, and susceptibility to infection. The need for additional revision surgery increases financial costs and prolongs recovery time for patients. These metallic implants are bulk manufactured and often do not meet patient's requirements. A surgeon must machine (cut, weld, trim or drill holes) them in order to best suit the patient specifications. Over the past few decades, attempts have been made to replace these metallic implants with suitable biodegradable materials to prevent secondary/revision surgery. Recent advances in biomaterials have shown multiple uses for lactic acid polymers in bone implant technology. However, a targeted/localized drug delivery system needs to be incorporated in these polymers, and they need to be customized to treat orthopedic implant-related infections and other bone diseases such as osteomyelitis, osteosarcoma and osteoporosis. Rapid Prototyping (RP) using additive manufacturing (AM) or 3D printing could allow customization of constructs for personalized medicine. The goal of this study was to engineer customizable and biodegradable implant materials that can elute bioactive compounds for personalized medicine and targeted drug delivery. Post-operative infections are the most common complications following dental, orthopedic and bone implant surgeries. Preventing post-surgical infections is therefore a critical need that current polymethylmethacrylate (PMMA) bone cements fail to address. Calcium Phosphate Cements (CPCs) are unique in their ability to crystallize calcium and phosphate salts into hydroxyapatite (HA) and hence is naturally osteoconductive. Due to its low mechanical strength, its use in implant fixation and bone repair is limited to nonload-bearing applications. Novel CPCs were formulated and were doped with drug loaded Halloysite Nanotubes (HNTs) to enhance their mechanical and anti-infective properties. In this study we also explored the use of customized biopolymer filaments and 3D printing technology to treat bone diseases such as osteomyelitis, osteosarcoma, and osteoporosis. Biopolymer filaments were successfully loaded with antibiotics, chemotherapeutics and hormones (female sex hormones). Using a Fused Deposition Modeling (FDM)-based 3D printer, these customized filaments were fabricating into 3D scaffolds. Constructs with variable mechanical strengths and porosities were successfully designed and 3D printed. Scanning electron microscopy was used to study the surface architecture of the scaffolds. Compression and flexural testing was conducted for testing the mechanical strength of the constructs. Bacterial and suitable cell culture studies were applied to test bioactivity of the constructs. From above experiments, this study showed that 3D printing technology can be used to fabricate bioactive biopolymers for personalized medicine and localized drug delivery.

Hardness depth profile of lattice strained cemented carbide modified by high-energy boron ion implantation

NASA Astrophysics Data System (ADS)

Yoshida, Y.; Matsumura, A.; Higeta, K.; Inoue, T.; Shimizu, S.; Motonami, Y.; Sato, M.; Sadahiro, T.; Fujii, K.

1991-07-01

The hardness depth profiles of cemented carbides which were implanted with high-energy B + ions have been estimated using a dynamic microhardness tester. The B + implantations into (16% Co)-cemented WC alloys were carried out under conditions where the implantation energies were 1-3 MeV and the fluences 1 × 10 17-1 × 10 18ions/cm 2. The profiles show that the implanted layer becomes harder as fluences are chosen at higher values and there is a peak at a certain depth which depends on the implantation energy. In X-ray diffraction (XRD) studies of the implanted surface the broadened refraction peaks of only WC and Co are detected and the increments of lattice strain and of residual stress in the near-surface region are observed. It is supposed that the hardening effect should be induced by an increase in residual stress produced by lattice strain. The hardness depth profile in successive implantation of ions with different energies agrees with the compounded profile of each one of the implantations. It is concluded that the hardness depth profile can be controlled under adequate conditions of implantation.

Cadaveric study validating in vitro monitoring techniques to measure the failure mechanism of glenoid implants against clinical CT.

PubMed

Junaid, Sarah; Gregory, Thomas; Fetherston, Shirley; Emery, Roger; Amis, Andrew A; Hansen, Ulrich

2018-03-23

Definite glenoid implant loosening is identifiable on radiographs, however, identifying early loosening still eludes clinicians. Methods to monitor glenoid loosening in vitro have not been validated to clinical imaging. This study investigates the correlation between in vitro measures and CT images. Ten cadaveric scapulae were implanted with a pegged glenoid implant and fatigue tested to failure. Each scapulae were cyclically loaded superiorly and CT scanned every 20,000 cycles until failure to monitor progressive radiolucent lines. Superior and inferior rim displacements were also measured. A finite element (FE) model of one scapula was used to analyze the interfacial stresses at the implant/cement and cement/bone interfaces. All ten implants failed inferiorly at the implant-cement interface, two also failed at the cement-bone interface inferiorly, and three showed superior failure. Failure occurred at of 80,966 ± 53,729 (mean ± SD) cycles. CT scans confirmed failure of the fixation, and in most cases, was observed either before or with visual failure. Significant correlations were found between inferior rim displacement, vertical head displacement and failure of the glenoid implant. The FE model showed peak tensile stresses inferiorly and high compressive stresses superiorly, corroborating experimental findings. In vitro monitoring methods correlated to failure progression in clinical CT images possibly indicating its capacity to detect loosening earlier for earlier clinical intervention if needed. Its use in detecting failure non-destructively for implant development and testing is also valuable. The study highlights failure at the implant-cement interface and early signs of failure are identifiable in CT images. © 2018 The Authors. Journal of Orthopaedic Research ® Published by Wiley Periodicals, Inc. on behalf of the Orthopaedic Research Society. J Orthop Res 9999:XX-XX, 2018. © 2018 The Authors. Journal of Orthopaedic Research® Published by Wiley Periodicals, Inc. on behalf of the Orthopaedic Research Society.

Effect of various fixation parameters on strain development of screw- and cement-retained implant-supported restorations.

PubMed

Schittenhelm, Birgit; Karl, Matthias; Graef, Friedrich; Heckmann, Siegfried; Taylor, Thomas

2013-01-01

The objective of this study was to quantify the potential effects of screw- and cement-retention on strain development of implant-supported fixed dental prostheses (FDPs). A total of 20 single crowns and 70 three-unit FDPs were fabricated to fit an in vitro model situation with two implants. Using strain gauges attached to the model material adjacent to the implants, strain development of the restorations during fixation was recorded while the parameters cement type (provisional and definitive cement), cementation force (10 N and 100 N), and tightening torque (5 Ncm, 10 Ncm, and 15 Ncm) were varied. MANOVA with Pillai's trace was used for pairwise comparisons between groups (α = .05). Mean absolute strain development ranged from 5.11 µm/m for to 27.26 µm/m for single crowns and from 16.46 µm/m to 689.04 µm/m for multi-unit restorations. Screw-retained single crowns exhibited significantly smaller strain development as compared to cement-retained single crowns (P = .009). The type of cement used seemed to have no effect on strain development of an FDP regardless of the cementation force applied (P = .064 and P = .605). An increase in tightening torque for screw-retained FDPs also had no effect on resulting strain development (P values ranging from .692 to .807). Nonuniform results were found when comparing screw- and cementretention as the retention mechanism for FDPs. Strain development seems to depend predominantly on the accuracy achieved during the fabrication process whereas the retention mechanisms themselves as well as their potential parameters only have a minor effect.

The fatigue behavior of an amorphous brittle composite material

NASA Astrophysics Data System (ADS)

Kumar, Brijesh

The use of poly methyl methacrylate (PMMA) based bone cement as a grouting agent for the in-vivo fixation of orthopaedic implants has been in practice for nearly fifty years. Fatigue failure of the bone cement has been identified as the primary cause of cement failure. Implant loosening due to the failure of the cement is one of the major reasons necessitating revision surgery. The need for a more fatigue resistant bone cement is well documented in the literature. One method of producing a more fatigue resistant bone cement is to reinforce it with short fibers. The fundamental purpose of this work was to investigate the possible improvement of the fatigue characteristics of bone cement provided by the following two types of fiber reinforcements: short flexible Polyethylene Terephalate (PET) fibers and stiff milled carbon fibers. It has been shown that the reinforcement of the bone cement with fibers provides substantial improvement of the fracture toughness of the bone cement. In this investigation the impact of fiber reinforcement on the fatigue properties of the bone cement was studied. The effects of the fiber reinforcement on the fatigue life of bone cement has been determined experimentally. Since fatigue characteristics are known to have considerable scatter, a methodology was developed to analyze the experimental data in a statistically rigorous manner. The effect of the fiber reinforcement on bone cement was also analyzed using a theoretical approach and by conducting extensive Scanning Electron Microscopy (SEM) of the fractured surfaces. The results of this study indicate that fiber reinforcement improves the fatigue life of bone cement at a very high level of reliability. This could potentially lead to a more fatigue tolerant bone cement, which would delay the need for revision surgery due to implant loosening.

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.

Retention of implant-supported zirconium oxide ceramic restorations using different luting agents.

PubMed

Nejatidanesh, Farahnaz; Savabi, Omid; Shahtoosi, Mojtaba

2013-08-01

The aim of this study was to evaluate the retention value of implant-supported zirconium oxide ceramic copings using different luting agents. Twenty ITI solid abutments of 5.5 mm height and ITI implant analogs were mounted vertically into autopolymerizing acrylic resin blocks. Ninety zirconium oxide copings (Cercon, Degudent) with a loop on the occlusal portion were made. All samples were airborne particle abraded with 110 μm Al₂O₃ and luted using different types of luting agents: resin cements (Clearfil SA, Panavia F2.0, Fuji Plus), conventional cements (Fleck's, Poly F, Fuji I), and temporary cements (Temp Bond, GC free eugenol, TempSpan) with a load of 5 Kg. (N = 10) All copings were incubated at 37°C for 24 h and conditioned in artificial saliva for 1 week, and thermal cycled for 5000 cycles 5-55°C with a 30-s dwell time. The dislodging force of the copings along the long axis of the implant-abutment complex was recorded using universal testing machine with 5 mm/min crosshead speed. Data were subjected to Kruskal-Wallis (α = 0.05) and Mann-Whitney tests with Bonferroni step down correction (α = 0.001). There was significant difference between the mean rank retention values of different luting agents (P < 0.001). The resin cements showed the highest retention (Clearfil SA, 203.49 ± 52.86; Fuji Plus, 190.61 ± 48.00; Panavia F 2.0, 172.16 ± 70.76 N). The conventional cements had more retention than the temporary cements and glass ionomer cement (P < 0.001). The retention of zircona ceramic restorations, over ITI solid abutments may be influenced by the type of cement. The application of an MDP-containing resin and resin-modified glass ionomer luting agents increase the retentive value of implant-supported zirconium oxide restorations. © 2011 John Wiley & Sons A/S.

Have cementless and resurfacing components improved the medium-term results of hip replacement for patients under 60 years of age?

PubMed Central

Mason, James; Baker, Paul; Gregg, Paul J; Porter, Martyn; Deehan, David J; Reed, Mike R

2015-01-01

Background and purpose The optimal hip replacement for young patients remains unknown. We compared patient-reported outcome measures (PROMs), revision risk, and implant costs over a range of hip replacements. Methods We included hip replacements for osteoarthritis in patients under 60 years of age performed between 2003 and 2010 using the commonest brand of cemented, cementless, hybrid, or resurfacing prosthesis (11,622 women and 13,087 men). The reference implant comprised a cemented stem with a conventional polyethylene cemented cup and a standard-sized head (28- or 32-mm). Differences in implant survival were assessed using competing-risks models, adjusted for known prognostic influences. Analysis of covariance was used to assess improvement in PROMs (Oxford hip score (OHS) and EQ5D index) in 2014 linked procedures. Results In males, PROMs and implant survival were similar across all types of implants. In females, revision was statistically significantly higher in hard-bearing and/or small-stem cementless implants (hazard ratio (HR) = 4) and resurfacings (small head sizes (< 48 mm): HR = 6; large head sizes (≥ 48 mm): HR = 5) when compared to the reference cemented implant. In component combinations with equivalent survival, women reported significantly greater improvements in OHS with hybrid implants (22, p = 0.006) and cementless implants (21, p = 0.03) (reference, 18), but similar EQ5D index. For men and women, National Health Service (NHS) costs were lowest with the reference implant and highest with a hard-bearing cementless replacement. Interpretation In young women, hybrids offer a balance of good early functional improvement and low revision risk. Fully cementless and resurfacing components are more costly and do not provide any additional benefit for younger patients. PMID:25285617

Cardiovascular ultrasonography detection of embolic sources in trauma.

PubMed

Saranteas, Theodosios; Mavrogenis, Andreas F; Poularas, John; Kostroglou, Andreas; Mandila, Christina; Panou, Fotios

2018-06-01

Venous thromboembolism (deep vein thrombosis and pulmonary embolism) and bone cement implantation syndrome are major sources of embolic events in trauma patients. In these patients, embolic events due to venous thromboembolism and bone cement implantation syndrome have been detected with cardiac and vascular ultrasonography in the emergency setting, during the perioperative period, and in the intensive care unit. This article discusses the ultrasonography modalities and imaging findings of embolic events related to venous thromboembolism and bone cement implantation syndrome. The aim is to present a short review with exceptional illustrations that can enable physicians to identify sources of emboli in trauma patients with cardiovascular ultrasonography. Copyright © 2018 Elsevier Inc. All rights reserved.

Audiometric evaluation of an attempt to optimize the fixation of the transducer of a middle-ear implant to the ossicular chain with bone cement.

PubMed

Snik, A; Cremers, C

2004-02-01

Typically, an implantable hearing device consists of a transducer that is coupled to the ossicular chain and electronics. The coupling is of major importance. The Vibrant Soundbridge (VSB) is such an implantable device; normally, the VSB transducer is fixed to the ossicular chain by means of a special clip that is crimped around the long process of the incus. In addition to crimping, bone cement was used to optimize the fixation in six patients. Long-term results were compared to those of five controls with crimp fixation alone. To assess the effect of bone cement (SerenoCem, Corinthian Medical Ltd, Nottingham, UK) on hearing thresholds, long-term post-surgery thresholds were compared to pre-surgery thresholds. Bone cement did not have any negative effect. Next, to test the hypothesis that aided thresholds might be better with the use of bone cement, aided thresholds were studied. After correction for the severity of hearing loss, only a small difference was found between the two groups at one frequency, viz. 2 kHz. It was concluded that there was no negative effect of using bone cement; however, there is also no reason to use bone cement in VSB users on a regular basis.

A novel injectable borate bioactive glass cement for local delivery of vancomycin to cure osteomyelitis and regenerate bone.

PubMed

Cui, Xu; Zhao, Cunju; Gu, Yifei; Li, Le; Wang, Hui; Huang, Wenhai; Zhou, Nai; Wang, Deping; Zhu, Yi; Xu, Jun; Luo, Shihua; Zhang, Changqing; Rahaman, Mohamed N

2014-03-01

Osteomyelitis (bone infection) is often difficult to cure. The commonly-used treatment of surgical debridement to remove the infected bone combined with prolonged systemic and local antibiotic treatment has limitations. In the present study, an injectable borate bioactive glass cement was developed as a carrier for the antibiotic vancomycin, characterized in vitro, and evaluated for its capacity to cure osteomyelitis in a rabbit tibial model. The cement (initial setting time = 5.8 ± 0.6 min; compressive strength = 25.6 ± 0.3 MPa) released vancomycin over ~25 days in phosphate-buffered saline, during which time the borate glass converted to hydroxyapatite (HA). When implanted in rabbit tibial defects infected with methicillin-resistant Staphylococcus aureus (MRSA)-induced osteomyelitis, the vancomycin-loaded cement converted to HA and supported new bone formation in the defects within 8 weeks. Osteomyelitis was cured in 87 % of the defects implanted with the vancomycin-loaded borate glass cement, compared to 71 % for the defects implanted with vancomycin-loaded calcium sulfate cement. The injectable borate bioactive glass cement developed in this study is a promising treatment for curing osteomyelitis and for regenerating bone in the defects following cure of the infection.

21 CFR 888.3027 - Polymethylmethacrylate (PMMA) bone cement.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Polymethylmethacrylate (PMMA) bone cement. 888... Polymethylmethacrylate (PMMA) bone cement. (a) Identification. Polymethylmethacrylate (PMMA) bone cement is a device... metallic prosthetic implants to living bone. (b) Classification. Class II (special controls). The special...

21 CFR 888.3027 - Polymethylmethacrylate (PMMA) bone cement.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Polymethylmethacrylate (PMMA) bone cement. 888... Polymethylmethacrylate (PMMA) bone cement. (a) Identification. Polymethylmethacrylate (PMMA) bone cement is a device... metallic prosthetic implants to living bone. (b) Classification. Class II (special controls). The special...

21 CFR 888.3027 - Polymethylmethacrylate (PMMA) bone cement.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Polymethylmethacrylate (PMMA) bone cement. 888... Polymethylmethacrylate (PMMA) bone cement. (a) Identification. Polymethylmethacrylate (PMMA) bone cement is a device... metallic prosthetic implants to living bone. (b) Classification. Class II (special controls). The special...

21 CFR 888.3027 - Polymethylmethacrylate (PMMA) bone cement.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Polymethylmethacrylate (PMMA) bone cement. 888... Polymethylmethacrylate (PMMA) bone cement. (a) Identification. Polymethylmethacrylate (PMMA) bone cement is a device... metallic prosthetic implants to living bone. (b) Classification. Class II (special controls). The special...

21 CFR 888.3027 - Polymethylmethacrylate (PMMA) bone cement.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Polymethylmethacrylate (PMMA) bone cement. 888... Polymethylmethacrylate (PMMA) bone cement. (a) Identification. Polymethylmethacrylate (PMMA) bone cement is a device... metallic prosthetic implants to living bone. (b) Classification. Class II (special controls). The special...

Phosphoserine-modified calcium phosphate cements: bioresorption and substitution.

PubMed

Offer, Liliana; Veigel, Bastian; Pavlidis, Theodoros; Heiss, Christian; Gelinsky, Michael; Reinstorf, Antje; Wenisch, Sabine; Lips, Katrin Susanne; Schnettler, Reinhard

2011-01-01

This work reports the effects of phosphoserine addition on the biodegradability of calcium phosphate cements. The characteristics of a phosphoserine-modified calcium phosphate cement without collagen in a large animal model are presented here for the first time. Critical size bone defects in the proximal tibia of 10 sheep were filled with the bone cement, and five sheep with empty defects were included as controls. The sheep were sacrificed after either 10 days or 12 weeks, and bones were processed for histological, histomorphometric and enzyme histochemical analyses as well as transmission electron microscopic examination. After 12 weeks, there was no significant reduction in either the implant or the bone defect cross-sectional area. Different amounts of fibrous tissue were observed around the implant and in the bone defect after 12 weeks. The direct bone-implant contact decreased after 12 weeks (p = 0.034). Although the implanted material properly filled the defect and promoted an initial activation of macrophages and osteoblasts, the resorption and simultaneous substitution did not reach expected levels during the experimental time course. Although other studies have shown that the addition of phosphoserine to calcium phosphate cements that have already been modified with collagen I resulted in an acceleration of cement resorption and bone regeneration, this study demonstrates that phosphoserine-modified calcium phosphate cements without collagen perform poorly in the treatment of bone defects. Efforts to use phosphoserine in the development of new composites should take into consideration the need to improve osteoconduction simultaneously via other means. Copyright © 2010 John Wiley & Sons, Ltd.

Anti-inflammation performance of curcumin-loaded mesoporous calcium silicate cement.

PubMed

Chen, Yuan-Chien; Shie, Ming-You; Wu, Yuan-Haw Andrew; Lee, Kai-Xing Alvin; Wei, Li-Ju; Shen, Yu-Fang

2017-09-01

Calcium silicate (CS) cements have excellent bioactivity and can induce the bone-like apatite formation. They are good biomaterials for bone tissue engineering and bone regenerative medicine. However, they have degradability and the dissolved CS can cause the inflammatory response at the early post-implantation stage. The purpose of this study was to design and prepare the curcumin-loaded mesoporous CS (MesoCS/curcumin) cements as a strategy to reduce the inflammatory reaction after implantation. The MesoCS/curcumin cements were designed and prepared. The characteristics of MesoCS/curcumin specimens were examined by transmission electron microscopy (TEM), X-ray diffraction (XRD) and scanning electron microscopy (SEM). Their physical properties, biocompatibility, and anti-inflammatory ability were also evaluated. The MesoCS/curcumin cements displayed excellent biocompatibility and physical properties. Their crystalline characterizations were very similar with MesoCS cements. After soaking in simulated body fluid, the bone-like apatite layer of the MesoCS/curcumin cements could be formed. In addition, it could inhibit the expression of tumor necrosis factor-α (TNF-α) and interleukin-1 (IL-1) after inflammation reaction induced by lipopolysaccharides and had good anti-inflammatory ability. Adding curcumin in MesoCS cements can reduce the inflammatory reaction, but does not affect the original biological activity and properties of MesoCS cements. It can provide a good strategy to inhibit the inflammatory reaction after implantation for bone tissue engineering and bone regenerative medicine. Copyright © 2017. Published by Elsevier B.V.

The role of fixation and bone quality on the mechanical stability of tibial knee components.

PubMed

Lee, R W; Volz, R G; Sheridan, D C

1991-12-01

Tibial component loosening remains one of the major causes of failure of cemented and noncemented total knee arthroplasties. In this study, the authors identified the role of implant design, method of fixation, and bone density as it related to implant stability. The physical properties of "good" and "bad" bone were simulated using a "good" and "bad" foam model of the proximal tibia, fabricated in the laboratory from DARO RF-100 foam. A generic tibial component permitting various fixation designs was implanted into "good" and "bad" variable density foam tibial models in both cemented and noncemented modes. The mechanical stability of the implants was determined using a Materials Testing Machine by the application of an eccentrically applied cyclic load. The micromotion (subsidence and lift-off) of the tibial implants was recorded using two Linear Variable Differential Transformers. Statistically significant differences in implant stability were recorded as a function of fixation method. The most rigid implant fixation was achieved using four peripherally placed, 6.5-mm cancellous screws. The addition of a central stem added stability only in the case of "poor" quality foam. The mechanical stability of noncemented implants related directly to the density of the foam. Implant stability was greatly enhanced in "poor" quality foam by the use of cement. The method of implant fixation and bone density are critical determinants to tibial implant stability.

In vivo implant fixation of carbon fiber-reinforced PEEK hip prostheses in an ovine model.

PubMed

Nakahara, Ichiro; Takao, Masaki; Bandoh, Shunichi; Bertollo, Nicky; Walsh, William R; Sugano, Nobuhiko

2013-03-01

Carbon fiber-reinforced polyetheretherketone (CFR/PEEK) is theoretically suitable as a material for use in hip prostheses, offering excellent biocompatibility, mechanical properties, and the absence of metal ions. To evaluate in vivo fixation methods of CFR/PEEK hip prostheses in bone, we examined radiographic and histological results for cementless or cemented CFR/PEEK hip prostheses in an ovine model with implantation up to 52 weeks. CFR/PEEK cups and stems with rough-textured surfaces plus hydroxyapatite (HA) coatings for cementless fixation and CFR/PEEK cups and stems without HA coating for cement fixation were manufactured based on ovine computed tomography (CT) data. Unilateral total hip arthroplasty was performed using cementless or cemented CFR/PEEK hip prostheses. Five cementless cups and stems and six cemented cups and stems were evaluated. On the femoral side, all cementless stems demonstrated bony ongrowth fixation and all cemented stems demonstrated stable fixation without any gaps at both the bone-cement and cement-stem interfaces. All cementless cases and four of the six cemented cases showed minimal stress shielding. On the acetabular side, two of the five cementless cups demonstrated bony ongrowth fixation. Our results suggest that both cementless and cemented CFR/PEEK stems work well for fixation. Cup fixation may be difficult for both cementless and cemented types in this ovine model, but bone ongrowth fixation on the cup was first seen in two cementless cases. Cementless fixation can be achieved using HA-coated CFR/PEEK implants, even under load-bearing conditions. Copyright © 2012 Orthopaedic Research Society.

21 CFR 888.3150 - Elbow joint metal/polymer constrained cemented prosthesis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... use with bone cement (§ 888.3027). (b) Classification. Class II. The special controls for this device...) “Guidance Document for Testing Orthopedic Implants with Modified Metallic Surfaces Apposing Bone or Bone... Biomaterials (Nonporous) for Surgical Implant with Respect to Effect of Material on Muscle and Bone,” (v) F...

21 CFR 888.3150 - Elbow joint metal/polymer constrained cemented prosthesis.

Code of Federal Regulations, 2012 CFR

2012-04-01

... use with bone cement (§ 888.3027). (b) Classification. Class II. The special controls for this device...) “Guidance Document for Testing Orthopedic Implants with Modified Metallic Surfaces Apposing Bone or Bone... Biomaterials (Nonporous) for Surgical Implant with Respect to Effect of Material on Muscle and Bone,” (v) F...

21 CFR 888.3150 - Elbow joint metal/polymer constrained cemented prosthesis.

Code of Federal Regulations, 2014 CFR

2014-04-01

... use with bone cement (§ 888.3027). (b) Classification. Class II. The special controls for this device...) “Guidance Document for Testing Orthopedic Implants with Modified Metallic Surfaces Apposing Bone or Bone... Biomaterials (Nonporous) for Surgical Implant with Respect to Effect of Material on Muscle and Bone,” (v) F...

21 CFR 888.3150 - Elbow joint metal/polymer constrained cemented prosthesis.

Code of Federal Regulations, 2013 CFR

2013-04-01

... use with bone cement (§ 888.3027). (b) Classification. Class II. The special controls for this device...) “Guidance Document for Testing Orthopedic Implants with Modified Metallic Surfaces Apposing Bone or Bone... Biomaterials (Nonporous) for Surgical Implant with Respect to Effect of Material on Muscle and Bone,” (v) F...

21 CFR 888.3150 - Elbow joint metal/polymer constrained cemented prosthesis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... use with bone cement (§ 888.3027). (b) Classification. Class II. The special controls for this device...) “Guidance Document for Testing Orthopedic Implants with Modified Metallic Surfaces Apposing Bone or Bone... Biomaterials (Nonporous) for Surgical Implant with Respect to Effect of Material on Muscle and Bone,” (v) F...

[Experiment of porous calcium phosphate/bone matrix gelatin composite cement for repairing lumbar vertebral bone defect in rabbit].

PubMed

Wang, Song; Yang, Han; Yang, Jian; Kang, Jianping; Wang, Qing; Song, Yueming

2017-12-01

To investigate the effect of a porous calcium phosphate/bone matrix gelatin (BMG) composite cement (hereinafter referred to as the "porous composite cement") for repairing lumbar vertebral bone defect in a rabbit model. BMG was extracted from adult New Zealand rabbits according to the Urist's method. Poly (lactic-co-glycolic) acid (PLGA) microsphere was prepared by W/O/W double emulsion method. The porous composite cement was developed by using calcium phosphate cement (CPC) composited with BMG and PLGA microsphere. The physicochemical characterizations of the porous composite cement were assessed by anti-washout property, porosity, and biomechanical experiment, also compared with the CPC. Thirty 2-month-old New Zealand rabbits were used to construct vertebral bone defect at L 3 in size of 4 mm×3 mm×3 mm. Then, the bone defect was repaired with porous composite cement (experimental group, n =15) or CPC (control group, n =15). At 4, 8, and 12 weeks after implantation, each bone specimen was assessed by X-ray films for bone fusion, micro-CT for bone mineral density (BMD), bone volume fraction (BVF), trabecular thickness (Tb. Th.), trabecular number (Tb.N.), and trabecular spacing (Tb. Sp.), and histological section with toluidine blue staining for new-born bone formation. The study demonstrated well anti-washout property in 2 groups. The porous composite cement has 55.06%±1.18% of porosity and (51.63±6.73) MPa of compressive strength. The CPC has 49.38%±1.75% of porosity and (63.34±3.27) MPa of compressive strength. There were significant differences in porosity and compressive strength between different cements ( t =4.254, P =0.006; t =2.476, P =0.034). X-ray films revealed that the zone between the cement and host bone gradually blurred with the time extending. At 12 weeks after implantation, the zone was disappeared in the experimental group, but clear in the control group. There were significant differences in BMD, BVF, Tb. Th., Tb. N., and Tb. Sp. between 2 groups at each time point ( P <0.05). Histological observation revealed that there was new-born bone in the cement with the time extending in 2 groups. Among them, bony connection was observed between the new-born bone and the host in the experimental group, which was prior to the control group. The porous composite cement has dual bioactivity of osteoinductivity and osteoconductivity, which are effective to promote bone defect healing and reconstruction.

Fracture and Fatigue Resistance of Cemented versus Fused CAD-on Veneers over Customized Zirconia Implant Abutments.

PubMed

Nossair, Shereen Ahmed; Aboushelib, Moustafa N; Morsi, Tarek Salah

2015-01-05

To evaluate the fracture mechanics of cemented versus fused CAD-on veneers on customized zirconia implant abutments. Forty-five identical customized CAD/CAM zirconia implant abutments (0.5 mm thick) were prepared and seated on short titanium implant abutments (Ti base). A second scan was made to fabricate 45 CAD-on veneers (IPS Empress CAD, A2). Fifteen CAD-on veneers were cemented on the zirconia abutments (Panavia F2.0). Another 15 were fused to the zirconia abutments using low-fusing glass, while manually layered veneers served as control (n = 15). The restorations were subjected to artificial aging (3.2 million cycles between 5 and 10 kg in a water bath at 37°C) before being axially loaded to failure. Fractured specimens were examined using scanning electron microscopy to detect fracture origin, location, and size of critical crack. Stress at failure was calculated using fractography principles (alpha = 0.05). Cemented CAD-on restorations demonstrated significantly higher (F = 72, p < 0.001) fracture load compared to fused CAD-on and manually layered restorations. Fractographic analysis of fractured specimens indicated that cemented CAD-on veneers failed due to radial cracks originating from the veneer/resin interface. Branching of the critical crack was observed in the bulk of the veneer. Fused CAD-on veneers demonstrated cohesive fracture originating at the thickest part of the veneer ceramic, while manually layered veneers failed due to interfacial fracture at the zirconia/veneer interface. Within the limitations of this study, cemented CAD-on veneers on customized zirconia implant abutments demonstrated higher fracture than fused and manually layered veneers. © 2014 by the American College of Prosthodontists.

Adding functionality with additive manufacturing: Fabrication of titanium-based antibiotic eluting implants.

PubMed

Cox, Sophie C; Jamshidi, Parastoo; Eisenstein, Neil M; Webber, Mark A; Hassanin, Hany; Attallah, Moataz M; Shepherd, Duncan E T; Addison, Owen; Grover, Liam M

2016-07-01

Additive manufacturing technologies have been utilised in healthcare to create patient-specific implants. This study demonstrates the potential to add new implant functionality by further exploiting the design flexibility of these technologies. Selective laser melting was used to manufacture titanium-based (Ti-6Al-4V) implants containing a reservoir. Pore channels, connecting the implant surface to the reservoir, were incorporated to facilitate antibiotic delivery. An injectable brushite, calcium phosphate cement, was formulated as a carrier vehicle for gentamicin. Incorporation of the antibiotic significantly (p=0.01) improved the compressive strength (5.8±0.7MPa) of the cement compared to non-antibiotic samples. The controlled release of gentamicin sulphate from the calcium phosphate cement injected into the implant reservoir was demonstrated in short term elution studies using ultraviolet-visible spectroscopy. Orientation of the implant pore channels were shown, using micro-computed tomography, to impact design reproducibility and the back-pressure generated during cement injection which ultimately altered porosity. The amount of antibiotic released from all implant designs over a 6hour period (<28% of the total amount) were found to exceed the minimum inhibitory concentrations of Staphylococcus aureus (16μg/mL) and Staphylococcus epidermidis (1μg/mL); two bacterial species commonly associated with periprosthetic infections. Antibacterial efficacy was confirmed against both bacterial cultures using an agar diffusion assay. Interestingly, pore channel orientation was shown to influence the directionality of inhibition zones. Promisingly, this work demonstrates the potential to additively manufacture a titanium-based antibiotic eluting implant, which is an attractive alternative to current treatment strategies of periprosthetic infections. Copyright © 2016 Elsevier B.V. All rights reserved.

The mechanical response of a polyetheretherketone femoral knee implant under a deep squatting loading condition.

PubMed

de Ruiter, Lennert; Janssen, Dennis; Briscoe, Adam; Verdonschot, Nico

2017-12-01

The current study was designed to investigate the mechanical response of a polyetheretherketone-on-polyethylene total knee replacement device during a deep squat. Application of this high-demand loading condition can identify weaknesses of the polyetheretherketone relative to cobalt-chromium. This study investigated whether the implant is strong enough for this type of loading, whether cement stresses are considerably changed and whether a polyetheretherketone femoral component is likely to lead to reduced periprosthetic bone loss as compared to a cobalt-chromium component. A finite element model of a total knee arthroplasty subjected to a deep squat loading condition, which was previously published, was adapted with an alternative total knee arthroplasty design made of either polyetheretherketone or cobalt-chromium. The maximum tensile and compressive stresses within the implant and cement mantle were analysed against their yield and fatigue stress levels. The amount of stress shielding within the bone was compared between the polyetheretherketone and cobalt-chromium cases. Relative to its material strength, tensile peak stresses were higher in the cobalt-chromium implant; compressive peak stresses were higher in the polyetheretherketone implant. The stress patterns differed substantially between polyetheretherketone and cobalt-chromium. The tensile stresses in the cement mantle supporting the polyetheretherketone implant were up to 33% lower than with the cobalt-chromium component, but twice as high for compression. Stress shielding was reduced to a median of 1% for the polyetheretherketone implant versus 56% for the cobalt-chromium implant. Both the polyetheretherketone implant and the underlying cement mantle should be able to cope with the stress levels present during a deep squat. Relative to the cobalt-chromium component, stress shielding of the periprosthetic femur was substantially less with a polyetheretherketone femoral component.

Evaluation of the effects of implant materials and designs on thermal necrosis of bone in cemented hip arthroplasty.

PubMed

Li, Chaodi; Kotha, Shiva; Mason, James

2003-01-01

The exothermic polymerization of bone cement may induce thermal necrosis of bone in cemented hip arthroplasty. A finite element formulation was developed to predict the evolution of the temperature with time in the cemented hip replacement system. The developed method is capable of taking into account both the chemical reaction that generates heat during bone cement polymerization (through a kinetic model) and the physical process of heat conduction (with an energy balance equation). The possibility of thermal necrosis of bone was then evaluated based on the temperature history in the bone and an appropriate damage criterion. Specifically, we evaluate the role of implant materials and designs on the thermal response of the system. Results indicated that the peak temperature at the bone/cement interface with a metal prosthesis was lower than that with a polymer or a composite prosthesis in hip replacement systems. Necrosis of bone was predicted to occur with a polymer or a composite prosthesis while no necrosis was predicted with a metal prosthesis in the simulated conditions. When reinforcing osteoporotic hips with injected bone cement in the cancellous core of the femur, the volume of bone cement implanted is increased which may increase the risk of thermal necrosis of bone. We evaluate whether this risk can be decreased through the use of an insulator to contain the bone cement. No thermal necrosis of bone was predicted with a 3 mm thick polyurethane insulator while more damage is predicted for the use of bone cement without the insulator. This method provides a numerical tool for the quantitative simulation of the thermal behavior of bone-cement-prosthesis designs and for examining and refining new designs computationally.

Do dynamic cement-on-cement knee spacers provide better function and activity during two-stage exchange?

PubMed

Jaekel, David J; Day, Judd S; Klein, Gregg R; Levine, Harlan; Parvizi, Javad; Kurtz, Steven M

2012-09-01

Implantation of an antibiotic bone cement spacer is used to treat infection of a TKA. Dynamic spacers fashioned with cement-on-cement articulating surfaces potentially facilitate patient mobility and reduce bone loss as compared with their static counterparts, while consisting of a biomaterial not traditionally used for load-bearing articulations. However, their direct impact on patient mobility and wear damage while implanted remains poorly understood. We characterized patient activity, surface damage, and porous structure of dynamic cement-on-cement spacers. We collected 22 dynamic and 14 static knee antibiotic cement spacers at revision surgeries at times ranging from 0.5 to 13 months from implantation. For these patients, we obtained demographic data and UCLA activity levels. We characterized surface damage using the Hood damage scoring method and used micro-CT analysis to observe the internal structure, cracking, and porosity of the cement. The average UCLA score was higher for patients with dynamic spacers than for patients with static spacers, with no differences in BMI or age. Burnishing was the only prevalent damage mode on all the bearing surfaces. Micro-CT analysis revealed the internal structure of the spacers was porous and highly inhomogeneous, including heterogeneous dispersion of radiopaque material and cavity defects. The average porosity was 8% (range, 1%-29%) and more than ½ of the spacers had pores greater than 1 mm in diameter. Our observations suggest dynamic, cement-on-cement spacers allow for increased patient activity without catastrophic failure. Despite the antibiotic loading and internal structural inhomogeneity, burnishing was the only prevalent damage mode that could be consistently classified with no evidence of fracture or delamination. The porous structure of the spacers varied highly across the surfaces without influencing the material failure.

Calcium phosphate compatible bone cement: Characterization, bonding properties and tissue response

NASA Astrophysics Data System (ADS)

Roemhildt, Maria Lynn

A novel, inorganic, bone cement, containing calcium phosphate, developed for implant fixation was evaluated. Setting properties were determined over a range of temperatures. The flow of the cement was greatly increased by application of vibration. Changes in the cement during hydration and aging were evaluated. Compressive strength of the cement over time was studied under simulated physiological conditions from 1 hour to 1 year after setting. After 1 day, this cement had equivalent compressive strength to commercially used PMMA cement. The strength was found to increase over 1 month and high strength was maintained up to 1 year. The shear strength of the cement-metal interface was studied in vitro using a pull-out test. Prepared specimens were stored under physiological conditions and tested at 4 hours, 24 hours, and 60 days. Comparable interfacial shear strength values were found at 4 hours, 24 hours and 60 days for the experimental cement and were not significantly different from values obtained for PMMA cement. In vivo tissue response was evaluated after cement implantation in the femoral medullary canal in canines. Tissue response and bonding at the cement-bone interface were evaluated at 2, 6, and 12 weeks. Cortical bone was found in direct contact with the OC-cement and was healthy. The strength of the cement-bone interface, measured using a push-out test, was significantly higher for the experimental cement than for commercial PMMA bone cement.

Short-term implantation effects of a DCPD-based calcium phosphate cement.

PubMed

Frayssinet, P; Gineste, L; Conte, P; Fages, J; Rouquet, N

1998-06-01

Calcium phosphate cements can be handled in paste form and set in a wet medium after precipitation of calcium phosphate crystals in the implantation site. Depending on the products entering into the chemical reaction leading to the precipitation of calcium phosphates, different phases can be obtained with different mechanical properties, setting times and injectability. We tested a cement composed of a powder, containing beta-tricalcium phosphate (beta-TCP) and sodium pyrophosphate mixed with a solution of phosphoric and sulphuric acids. The cement set under a dicalcium phosphate dihydrate (DCPD)-based matrix containing beta-TCP particles. This was injected with a syringe into a defect drilled in rabbit condyles, the control being an identical defect left empty in the opposite condyle. The condyles were analysed histologically 2, 6 and 18 weeks after implantation. After injection into the bone defect the cement set and formed a porous calcium phosphate structure. Two different calcium phosphate phases with different solubility rates could be identified by scanning electron microscopy (SEM) observation. The less-soluble fragments could be degraded by cell phagocytosis in cell compartments of low pH or integrated in the newly formed bone matrix. The degradation rate of the material was relatively high but compatible with the ingrowth of bone trabeculae within the resorbing material. The ossification process was different from the creeping substitution occurring at the ceramic contact. Bone did not form directly at the cement surface following the differentiation of osteoblasts at the material surface. The trabeculae came to the material surface from the edges of the implantation site. Bone formation in the implantation site was significantly higher than in the control region during the first week of implantation. In conclusion, this material set in situ was well tolerated, inducing a mild foreign-body reaction, which did not impair its replacement by newly formed bone within a few weeks.

Bone regeneration capacity of magnesium phosphate cements in a large animal model.

PubMed

Kanter, Britta; Vikman, Anna; Brückner, Theresa; Schamel, Martha; Gbureck, Uwe; Ignatius, Anita

2018-03-15

Magnesium phosphate minerals have captured increasing attention during the past years as suitable alternatives for calcium phosphate bone replacement materials. Here, we investigated the degradation and bone regeneration capacity of experimental struvite (MgNH 4 PO 4 ·6H 2 O) forming magnesium phosphate cements in two different orthotopic ovine implantation models. Cements formed at powder to liquid ratios (PLR) of 2.0 and 3.0 g ml -1 were implanted into trabecular bone using a non-load-bearing femoral drill-hole model and a load-bearing tibial defect model. After 4, 7 and 10 months the implants were retrieved and cement degradation and new bone formation was analyzed by micro-computed tomography (µCT) and histomorphometry. The results showed cement degradation in concert with new bone formation at both defect locations. Both cements were almost completely degraded after 10 months. The struvite cement formed with a PLR of 2.0 g ml -1 exhibited a slightly accelerated degradation kinetics compared to the cement with a PLR of 3.0 g ml -1 . Tartrat-resistant acid phosphatase (TRAP) staining indicated osteoclastic resorption at the cement surface. Energy dispersive X-ray analysis (EDX) revealed that small residual cement particles were mostly accumulated in the bone marrow in between newly formed bone trabeculae. Mechanical loading did not significantly increase bone formation associated with cement degradation. Concluding, struvite-forming cements might be promising bone replacement materials due to their good degradation which is coupled with new bone formation. Recently, the interest in magnesium phosphate cements (MPC) for bone substitution increased, as they exhibit high initial strength, comparably elevated degradation potential and the release of valuable magnesium ions. However, only few in vivo studies, mostly including non-load-bearing defects in small animals, have been performed to analyze the degradation and regeneration capability of MPC derived compounds. The present study examined the in vivo behavior of magnesiumammoniumphosphate hexahydrate (struvite) implants with different porosity in both mechanically loaded and non-loaded defects of merino sheep. For the first time, the effect of mechanical stimuli on the biological outcome of this clinically relevant replacement material is shown and directly compared to the conventional unloaded defect situation in a large animal model. Copyright © 2018 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Fixation strength of a polyetheretherketone femoral component in total knee arthroplasty.

PubMed

de Ruiter, Lennert; Janssen, Dennis; Briscoe, Adam; Verdonschot, Nico

2017-11-01

Introducing polyetheretherketone (PEEK) polymer as a material for femoral components in total knee arthroplasty (TKA) could potentially lead to a reduction of the cemented fixation strength. A PEEK implant is more likely to deform under high loads, rendering geometrical locking features less effective. Fixation strength may be enhanced by adding more undercuts or specific surface treatments. The aim of this study is to measure the initial fixation strength and investigate the associated failure patterns of three different iterations of PEEK-OPTIMA ® implants compared with a Cobalt-Chromium (CoCr) component. Femoral components were cemented onto trabecular bone analogue foam blocks and preconditioned with 86,400 cycles of compressive loading (2600 N-260 N at 1 Hz). They were then extracted while the force was measured and the initial failure mechanism was recorded. Four groups were compared: CoCr, regular PEEK, PEEK with an enhanced cement-bonding surface and the latter with additional surface primer. The mean pull-off forces for the four groups were 3814 N, 688 N, 2525 N and 2552 N, respectively. The initial failure patterns for groups 1, 3 and 4 were the same; posterior condylar foam fracture and cement-bone debonding. Implants from group 2 failed at the cement-implant interface. This study has shown that a PEEK-OPTIMA ® femoral TKA component with enhanced macro- and microtexture is able to replicate the main failure mechanism of a conventional CoCr femoral implant. The fixation strength is lower than for a CoCr implant, but substantially higher than loads occurring under in-vivo conditions. Copyright © 2017 IPEM. Published by Elsevier Ltd. All rights reserved.

Cement-retained versus screw-retained implant restorations: a critical review.

PubMed

Michalakis, Konstantinos X; Hirayama, Hiroshi; Garefis, Pavlos D

2003-01-01

This article presents a comparison of screw-retained and cement-retained implant prostheses based on the literature. The advantages, disadvantages, and limitations of the 2 different types of restorations are discussed, because it is important to understand the influence of the attachment mechanism on many clinical aspects of implant dentistry. Several factors essential to the long-term success of any implant prosthesis were reviewed with regard to both methods of fixation. These factors include: (1) ease of fabrication and cost, (2) passivity of the framework, (3) retention, (4) occlusion, (5) esthetics, (6) delivery, and (7) retrievability. (More than 50 references).

In vivo evaluation of teicoplanin- and calcium sulfate-loaded PMMA bone cement in preventing implant-related osteomyelitis in rats.

PubMed

Tuzuner, T; Sencan, I; Ozdemir, D; Alper, M; Duman, S; Yavuz, T; Yildirim, M

2006-12-01

The objective of this study was to evaluate the efficacy of teicoplanin- and calcium sulphate-loaded polymethylmethacrylate (PMMA) bone cements in preventing experimental implant-related osteomyelitis in rats. Four groups of antibiotic-loaded rods were prepared and were implanted into the lateral condylus of the rat femur after inoculation of Staphylococcus aureus. The effectiveness of these were assessed microbiologically, radiographically, and histopathologically. Radiographic evaluation revealed a significant reduction of periostal reaction and osteolysis in rats that received calcium sulphate- and teicoplanin-loaded rods. Histopathological evaluation confirmed these results. Acute infection and bone necrosis were found to be significantly lower in rats that had received calcium sulphate- and teicoplanin-loaded rods. The addition of calcium sulfate to teicoplanin-loaded PMMA bone cement appeared satisfactory as an antibiotic-carrying system for prophylaxis of experimental implant-related osteomyelitis, but further investigations are needed to reach definitive statements for clinical applications.

A simple procedure for retrieval of a cement-retained implant-supported crown: a case report.

PubMed

Buzayan, Muaiyed Mahmoud; Mahmood, Wan Adida; Yunus, Norsiah Binti

2014-02-01

Retrieval of cement-retained implant prostheses can be more demanding than retrieval of screw-retained prostheses. This case report describes a simple and predictable procedure to locate the abutment screw access openings of cementretained implant-supported crowns in cases of fractured ceramic veneer. A conventional periapical radiography image was captured using a digital camera, transferred to a computer, and manipulated using Microsoft Word document software to estimate the location of the abutment screw access.

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.

Influence of abutment material and luting cements color on the final color of all ceramics.

PubMed

Dede, Dogu Ömür; Armaganci, Arzu; Ceylan, Gözlem; Cankaya, Soner; Celik, Ersan

2013-11-01

The purpose of this study is to evaluate the effects of different abutment materials and luting cements color on the final color of implant-supported all-ceramic restorations. Ten A2 shade IPS e.max Press disc shape all-ceramic specimens were prepared (11 × 1.5 mm). Three different shades (translucent, universal and white opaque) of disc shape luting cement specimens were prepared (11 × 0.2 mm). Three different (zirconium, gold-palladium and titanium) implant abutments and one composite resin disc shape background specimen were prepared at 11 mm diameter and appropriate thicknesses. All ceramic specimens colors were measured with each background and luting cement samples on a teflon mold. A digital spectrophotometer used for measurements and data recorded as CIE L*a*b* color co-ordinates. An optical fluid applied on to the samples to provide a good optical connection and measurements on the composite resin background was saved as the control group. ΔE values were calculated from the ΔL, Δa and Δb values between control and test groups and data were analyzed with one-way variance analysis (ANOVA) and mean values were compared by the Tukey HSD test (α = 0.05). One-way ANOVA of ΔL, Δa, Δb and ΔE values of control and test groups revealed significant differences for backgrounds and seldom for cement color groups (p the 0.05). Only zirconium implant abutment groups and gold palladium abutment with universal shade cement group were found to be clinically acceptable (ΔE ≤ 3.0). Using titanium or gold-palladium abutments for implant supported all ceramics will be esthetically questionable and white opaque cement will be helpful to mask the dark color of titanium abutment.

Effect of modifying the screw access channels of zirconia implant abutment on the cement flow pattern and retention of zirconia restorations.

PubMed

Wadhwani, Chandur; Chung, Kwok-Hung

2014-07-01

The effect of managing the screw access channels of zirconia implant abutments in the esthetic zone has not been extensively evaluated. The purpose of this study was to determine the effect of an insert placed within the screw access channel of an anterior zirconia implant abutment on the amount of cement retained within the restoration-abutment system and on the dislodging force. Thirty-six paired zirconia abutments and restorations were fabricated by computer-aided design and computer-aided manufacturing and were divided into 3 groups: open abutment, with the screw access channel unfilled; closed abutment, with the screw access channel sealed; and insert abutment, with a thin, tubular metal insert projection continuous with the screw head and placed into the abutment screw access channel. The restorations were cemented to the abutments with preweighed eugenol-free zinc oxide cement (TempBond NE). Excess cement was removed, and the weight of the cement that remained in the restoration-abutment system was measured. Vertical tensile dislodging forces were recorded at a crosshead speed of 5 mm/min after incubation in a 37°C water bath for 24 hours. The specimens were examined for the cement flow pattern into the screw access channel after dislodgement. Data were analyzed with ANOVA, followed by multiple comparisons by using the Tukey honestly significant difference test (α = .05). The mean (standard deviation) of retentive force values ranged from 108.1 ± 29.9 N to 148.3 ± 21.0 N. The retentive force values differed significantly between the insert abutment and both the open abutment (P < .05) and closed abutment groups (P < .01). Distinct patterns of cement failure were noted. The weight of the cement that remained in the system differed significantly, with both open abutment and insert abutment being greater than closed abutment (P < .05). Modifying the internal configuration of the screw access channel of an esthetic zirconia implant abutment with a metal insert significantly affected both the cement retained within the abutment itself and the retention capabilities of the zirconia restoration cemented with TempBond NE cement. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Peri-implant soft tissue colour around titanium and zirconia abutments: a prospective randomized controlled clinical study.

PubMed

Cosgarea, Raluca; Gasparik, Cristina; Dudea, Diana; Culic, Bogdan; Dannewitz, Bettina; Sculean, Anton

2015-05-01

To objectively determine the difference in colour between the peri-implant soft tissue at titanium and zirconia abutments. Eleven patients, each with two contralaterally inserted osteointegrated dental implants, were included in this study. The implants were restored either with titanium abutments and porcelain-fused-to-metal crowns, or with zirconia abutments and ceramic crowns. Prior and after crown cementation, multi-spectral images of the peri-implant soft tissues and the gingiva of the neighbouring teeth were taken with a colorimeter. The colour parameters L*, a*, b*, c* and the colour differences ΔE were calculated. Descriptive statistics, including non-parametric tests and correlation coefficients, were used for statistical analyses of the data. Compared to the gingiva of the neighbouring teeth, the peri-implant soft tissue around titanium and zirconia (test group), showed distinguishable ΔE both before and after crown cementation. Colour differences around titanium were statistically significant different (P = 0.01) only at 1 mm prior to crown cementation compared to zirconia. Compared to the gingiva of the neighbouring teeth, statistically significant (P < 0.01) differences were found for all colour parameter, either before or after crown cementation for both abutments; more significant differences were registered for titanium abutments. Tissue thickness correlated positively with c*-values for titanium at 1 mm and 2 mm from the gingival margin. Within their limits, the present data indicate that: (i) The peri-implant soft tissue around titanium and zirconia showed colour differences when compared to the soft tissue around natural teeth, and (ii) the peri-implant soft tissue around zirconia demonstrated a better colour match to the soft tissue at natural teeth than titanium. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

21 CFR 888.3370 - Hip joint (hemi-hip) acetabular metal cemented prosthesis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Hip joint (hemi-hip) acetabular metal cemented... (hemi-hip) acetabular metal cemented prosthesis. (a) Identification. A hip joint (hemi-hip) acetabular metal cemented prosthesis is a device intended to be implanted to replace a portion of the hip joint...

21 CFR 888.3310 - Hip joint metal/polymer constrained cemented or uncemented prosthesis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Hip joint metal/polymer constrained cemented or... Hip joint metal/polymer constrained cemented or uncemented prosthesis. (a) Identification. A hip joint metal/polymer constrained cemented or uncemented prosthesis is a device intended to be implanted to...

21 CFR 888.3310 - Hip joint metal/polymer constrained cemented or uncemented prosthesis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint metal/polymer constrained cemented or... Hip joint metal/polymer constrained cemented or uncemented prosthesis. (a) Identification. A hip joint metal/polymer constrained cemented or uncemented prosthesis is a device intended to be implanted to...

21 CFR 888.3310 - Hip joint metal/polymer constrained cemented or uncemented prosthesis.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hip joint metal/polymer constrained cemented or... Hip joint metal/polymer constrained cemented or uncemented prosthesis. (a) Identification. A hip joint metal/polymer constrained cemented or uncemented prosthesis is a device intended to be implanted to...

21 CFR 888.3310 - Hip joint metal/polymer constrained cemented or uncemented prosthesis.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hip joint metal/polymer constrained cemented or... Hip joint metal/polymer constrained cemented or uncemented prosthesis. (a) Identification. A hip joint metal/polymer constrained cemented or uncemented prosthesis is a device intended to be implanted to...

21 CFR 888.3310 - Hip joint metal/polymer constrained cemented or uncemented prosthesis.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hip joint metal/polymer constrained cemented or... Hip joint metal/polymer constrained cemented or uncemented prosthesis. (a) Identification. A hip joint metal/polymer constrained cemented or uncemented prosthesis is a device intended to be implanted to...

Torque test measurement in segmental bone defects using porous calcium phosphate cement implants.

PubMed

Kroese-Deutman, Henriette C; Wolke, Joop G C; Spauwen, Paul H M; Jansen, John A

2010-10-01

This study was performed to assess the bone healing supporting characteristics of porous calcium phosphate (Ca-P) cement when implanted in a rabbit segmental defect model as well as to determine the reliability of torque testing as a method to verify bone healing. The middiaphyseal radius was chosen as the area to create bilaterally increasing defect sizes (5, 10, and 15 mm), which were either filled with porous Ca-P cement or left open as a control. After 12 weeks of implantation, torque test measurements as well as histological and radiographic evaluation were performed. In two of the open 15 mm control defects, bone bridging was visible at the radiographic and histological evaluation. Bone was observed to be present in all porous Ca-P cement implants (5, 10, and 15 mm defects) after 12 weeks. No significant differences in torque measurements were observed between the 5 and 10 mm filled and open control defects using a t-test. In addition, the mechanical strength of all operated specimens was similar compared with nonoperated bone samples. The torsion data for the 15 mm open defect appeared to be lower compared with the filled 15 mm defect, but no significant difference could be proven. Within the limitation of the study design, porous Ca-P cement implants demonstrated osteoconductive properties and confirmed to be a suitable scaffold material in a weight-bearing situation. Further, the used torque testing method was found to be unreliable for testing the mechanical properties of the healed bone defect.

Systematic review of some prosthetic risk factors for periimplantitis.

PubMed

Pesce, Paolo; Canullo, Luigi; Grusovin, Maria Gabriella; de Bruyn, Hugo; Cosyn, Jan; Pera, Paolo

2015-09-01

The recent literature underlines a correlation between plaque and the development of periimplantitis but neglects the importance of the prosthetic factors. The purpose of this systematic review was to appraise the available literature to evaluate the role played by cement excess and misfitting components on the development of periimplantitis. An electronic search restricted to the English language was performed in PubMed, Embase, and the Cochrane Register up to September 1, 2014, based on a selected search algorithm. Only cohort studies and case-control studies were included without additional restrictions. The presence of periimplantitis and implant failure were considered primary and secondary outcome variables. The search produced 275 potentially relevant titles, of which only 2 were found eligible. They showed a correlation in cemented implant prostheses between cement excess and the presence of periimplant disease, especially in patients with a history of periodontal disease. After cement excess removal by means of debridement, disease symptoms disappeared around most of the implants. Scientific articles on prosthetic risk factors for periimplantitis are scarce. Although the studies found on cement remnants have a high risk for bias, cement excess seems to be associated with mucositis and possibly with periimplantitis, especially in patients with a history of periodontal disease. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Reliability of retrievable cemented implant-supported prostheses.

PubMed

Nissan, Joseph; Snir, David; Rosner, Ofir; Kolerman, Roni; Chaushu, Liat; Chaushu, Gavriel

2016-05-01

One of the disadvantages of a cemented implant restoration is the potential difficulty of retrieving it. The restoration may be destroyed during removal. The purpose of this retrospective clinical study was to assess the long-term survival rates of cemented posterior metal ceramic implant-supported prostheses (ISPs) with a metal screw access hole. During a 12-year period, 274 cemented ISPs with an abutment screw access hole in the metal framework were assessed and served as the study group, and 119 conventional cemented ISPs (without access hole) served as the control group. Participants were followed every 6 months in the first year and once a year subsequently. Ceramic fracture, screw loosening, and refabrication were the prosthetic outcome parameters evaluated at the recall. The Pearson Chi square and Fisher exact test were used to compare the outcome parameters between the control and study groups. A total of 1005 implants and 393 ISPs were evaluated. Ceramic fracture occurred in 6.6% of the ISPs (6.2% test and 7.6% control). Screw loosening occurred in 3.28% of the test group and 3.36% of the control group. Refabrication of ISPs was done in 2.79% of all restorations, (1.45% test and 6.72% control [P=.012]). Within the limits of this study, preparing cemented ISPs with a screw access hole in the metal framework improves ISP survival rates over time and lowers the cost of maintenance without increasing the risk for porcelain fracture or screw loosening. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Primary cement spacers: a cost-effective, durable limb salvage option for knee tumors.

PubMed

Puri, Ajay; Gulia, Ashish; Pruthi, Manish; Koushik, S

2012-08-01

Of a total of 818 limb sparing resections in the lower limb requiring reconstruction between December 2002 and April 2010 at our centre, primary cement spacers were used in 15 cases. In three cases they were used as joint sparing intercalary reconstructions and in 12 cases knee arthrodesis was done. Implants used to provide stability to the construct included stacked intramedullary Kuntscher nails in four, an interlocking nail in one, plates in two and a combination of nail with plate in eight. Mean length of bone resected was 18 cm. Mean follow-up was 26 months (10-87 months). There were no local recurrences and none of the spacers needed revision for mechanical failure. The Musculoskeletal Tumor Society score for patients ranged from 20 to 29 with a mean of 24 (80%). Patients with intercalary resection had better functional scores than those with arthrodesis. The construct was successfully revised to a vascularised fibula arthrodesis or prosthesis with good eventual function in three cases. Cement spacers are a suitable cost-effective, durable reconstruction modality in selected patients with good functional outcomes. They are an option to amputation in patients with financial constraints and those that present with large volume or infected fungating tumors. Copyright © 2011 Elsevier B.V. All rights reserved.

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.

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.

Validation of multiple subject-specific finite element models of unicompartmental knee replacement.

PubMed

Tuncer, Mahmut; Cobb, Justin P; Hansen, Ulrich N; Amis, Andrew A

2013-10-01

Accurate computer modelling of the fixation of unicompartmental knee replacements (UKRs) is a valuable design tool. However, models must be validated with in vitro mechanical tests to have confidence in the results. Ten fresh-frozen cadaveric knees with differing bone densities were CT-scanned to obtain geometry and bone density data, then implanted with cementless medial Oxford UKRs by an orthopaedic surgeon. Five strain gauge rosettes were attached to the tibia and femur of each knee and the bone constructs were mechanically tested. They were re-tested following implanting the cemented versions of the implants. Finite element models of four UKR tibiae and femora were developed. Sensitivity assessments and convergence studies were conducted to optimise modelling parameters. The cemented UKR pooled R(2) values for predicted versus measured bone strains were 0.85 and 0.92 for the tibia and femur respectively. The cementless UKR pooled R(2) values were slightly lower at 0.62 and 0.73 which may have been due to the irregularity of bone resections. The correlation of the results was attributed partly to the improved material property prediction method used in this project. This study is the first to validate multiple UKR tibiae and femora for bone strain across a range of specimen bone densities. Copyright © 2013 IPEM. Published by Elsevier Ltd. All rights reserved.

Prospective assessment of CAD/CAM zirconia abutment and lithium disilicate crown restorations: 2.4 year results.

PubMed

Cooper, Lyndon F; Stanford, Clark; Feine, Jocelyne; McGuire, Michael

2016-07-01

Single-tooth implant restorations are commonly used to replace anterior maxillary teeth. The esthetic, functional, and biologic outcomes are, in part, a function of the abutment and crown. The purpose of this clinical study was to describe the implant, abutment, and crown survival and complication rates for CAD/CAM zirconia abutment and lithium disilicate crown restorations for single-tooth implants. As part of a broader prospective investigation that enrolled and treated 141 participants comparing tissue responses at the conical interface (CI; AstraTech OsseoSpeed), flat-to-flat interface (FI; NobelSpeedy), and platform-switch interface (PS; NanoTite Certain Prevail) of single-tooth implants, computer-aided design and computer-aided manufacturing (CAD/CAM) zirconia abutments (ATLANTIS Abutment) and cemented lithium disilicate (e.max) crowns were used in the restoration of all implants. After 2.4 years in function (3 years after implant placement), the implant, abutment, and crown of 110 participants were evaluated. Technical and biologic complications were recorded. Demographic results were tabulated as percentages with mean values and standard deviations. Abutment survival was calculated with the Kaplan-Meier method. After 2.4 years, no abutments or crowns had been lost. Abutment complications (screw loosening, screw fracture, fracture) were absent for all 3 implant groups. Crown complications were limited to 2 crowns debonding and 1 with excess cement (2.5%). Five biological complications (4.0%) were recorded. The overall complication rate was 6.5%. CAD/CAM zirconia abutments restored with cemented lithium disilicate crowns demonstrated high survival on 3 different implant-abutment interface designs. No abutment or abutment screw fracture occurred. The technical complications observed after 2.4 years were minor and reversible. The use of CAD/CAM zirconia abutments with cemented lithium disilicate crowns is associated with high technical and biologic success at 2.4 years. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

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.

Peri-Implant Distribution of Polyethylene Debris in Postmortem-Retrieved Knee Arthroplasties: Can Polyethylene Debris Explain Loss of Cement-Bone Interlock in Successful Total Knee Arthroplasties?

PubMed

Cyndari, Karen I; Goodheart, Jacklyn R; Miller, Mark A; Oest, Megan E; Damron, Timothy A; Mann, Kenneth A

2017-07-01

Loss of mechanical interlock between cement and bone with in vivo service has been recently quantified for functioning, nonrevised, cemented total knee arthroplasties (TKAs). The cause of interlocking trabecular resorption is not known. The goal of this study is to quantify the distribution of PE debris at the cement-bone interface and determine if polyethylene (PE) debris is locally associated with loss of interlock. Fresh, nonrevised, postmortem-retrieved TKAs (n = 8) were obtained en bloc. Laboratory-prepared constructs (n = 2) served as negative controls. The intact cement-bone interface of each proximal tibia was embedded in Spurr's resin, sectioned, and imaged under polarized light to identify birefringent PE particles. PE wear particle number density was quantified at the cement-bone interface and distal to the interface, and then compared with local loss of cement-bone interlock. The average PE particle number density for postmortem-retrieved TKAs ranged from 8.6 (1.3) to 24.9 (3.1) particles/mm 2 (standard error) but was weakly correlated with years in service. The average particle number density was twice as high as distal (>5mm) to the interface compared to at the interface. The local loss of interlock at the interface was not related to the presence, absence, or particle density of PE. PE debris can migrate extensively along the cement-bone interface of well-fixed tibial components. However, the amount of local bone loss at the cement-bone interface was not correlated with the amount of PE debris at the interface, suggesting that the observed loss of trabecular interlock in these well-fixed TKAs may be due to alternative factors. Copyright © 2017 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.

3D plotting of growth factor loaded calcium phosphate cement scaffolds.

PubMed

Akkineni, Ashwini Rahul; Luo, Yongxiang; Schumacher, Matthias; Nies, Berthold; Lode, Anja; Gelinsky, Michael

2015-11-01

Additive manufacturing allows to widely control the geometrical features of implants. Recently, we described the fabrication of calcium phosphate cement (CPC) scaffolds by 3D plotting of a storable CPC paste based on water-immiscible carrier liquid. Plotting and hardening is conducted under mild conditions allowing the (precise and local) integration of biological components. In this study, we have developed a procedure for efficient loading of growth factors in the CPC scaffolds during plotting and demonstrated the feasibility of this approach. Bovine serum albumin (BSA) or vascular endothelial growth factor (VEGF), used as model proteins, were encapsulated in chitosan/dextran sulphate microparticles which could be easily mixed into the CPC paste in freeze-dried state. In order to prevent leaching of the proteins during cement setting, usually carried out by immersion in aqueous solutions, the plotted scaffolds were aged in water-saturated atmosphere (humidity). Setting in humidity avoided early loss of loaded proteins but provided sufficient amount of water to allow cement setting, as indicated by XRD analysis and mechanical testing in comparison to scaffolds set in water. Moreover, humidity-set scaffolds were characterised by altered, even improved properties: no swelling or crack formation was observed and accordingly, surface topography, total porosity and compressive modulus of the humidity-set scaffolds differed from those of the water-set counterparts. Direct cultivation of mesenchymal stem cells on the humidity-set scaffolds over 21days revealed their cytocompatibility. Maintenance of the bioactivity of VEGF during the fabrication procedure was proven in indirect and direct culture experiments with endothelial cells. Additive manufacturing techniques allow the fabrication of implants with defined architecture (inner pore structure and outer shape). Especially printing technologies conducted under mild conditions allow additionally the (spatially controlled) integration of biological components such as drugs or growth factors. That enables the generation of individualized implants which can better meet the requirements of a patient and of tissue engineering constructs. To our knowledge, simultaneous printing of biological components was up to now only described for hydrogel/biopolymer-based materials which suffer from poor mechanical properties. In contrast, we have developed a procedure (based on 3D plotting of a calcium phosphate cement paste) for the fabrication of designed and growth factor loaded calcium-phosphate-based scaffolds applicable for bone regeneration. Copyright © 2015 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Initial mechanical stability of cementless highly-porous titanium tibial components

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

Stone, Timothy Brandon; Amer, Luke D; Warren, Christopher P

Cementless fixation in total knee replacement has seen limited use since reports of early failure surfaced in the late 80s and early 90s. However the emergence of improved biomaterials, particularly porous titanium and tantalum, has led to a renewed interest in developing a cementless tibial component to enhance long-term survivorship of the implants. Cement is commonly employed to minimize micromotion in new implants but represents a weak interface between the implant and bone. The elimination of cement and application of these new biomaterials, which theoretically provide improved stability and ultimate osseointegration, would likely result in greater knee replacement success. Additionally,more » the removal of cement from the procedure would help minimize surgical durations and get rid of the time needed for curing, thereby the chance of infection. The purpose of this biomechanical study was twofold. The first goal was to assess whether vibration analysis techniques can be used to evaluate and characterize initial mechanical stability of cementless implants more accurately than the traditional method of micromotion determination, which employs linear variable differential transducers (LVDTs). Second, an evaluative study was performed to determine the comparative mechanical stability of five designs of cementless tibial components under mechanical loading designed to simulate in vivo forces. The test groups will include a cemented Triathlon Keeled baseplate control group, three different 2-peg cementless baseplates with smooth, mid, and high roughnesses and a 4-peg cement/ess baseplate with mid-roughness.« less

An in vitro atomic force microscopic study of commercially available dental luting materials.

PubMed

Djordje, Antonijevic; Denis, Brajkovic; Nenadovic, Milos; Petar, Milovanovic; Marija, Djuric; Zlatko, Rakocevic

2013-09-01

The aim of this in vitro study was to compare the surface roughness parameters of four different types of dental luting agents used for cementation of implant restorations. Five specimens (8 mm high and 1 mm thick) of each cement were made using metal ring steelless molds. Atomic Force Microscope was employed to analyze different surface texture parameters of the materials. Bearing ratio analysis was used to calculate the potential microgap size between the cement and implant material and to calculate the depth of the valleys on the cement surface, while power spectral density (PSD) measurements were performed to measure the percentage of the surface prone to bacterial adhesion. Glass ionomer cement showed significantly lower value of average surface roughness then the other groups of the materials (P < 0.05) which was in line with the results of Bearing ratio analysis. On the other side, PSD analysis showed that zinc phosphate cement experience the lowest percentage of the surface which promote bacterial colonization. Glas ionomer cements present the surface roughness parameters that are less favorable for bacterial adhesion than that of zinc phosphate, resin-modified glass ionomer and resin cements. Copyright © 2013 Wiley Periodicals, Inc.

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.

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.

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

A New Biphasic Dicalcium Silicate Bone Cement Implant.

PubMed

Zuleta, Fausto; Murciano, Angel; Gehrke, Sergio A; Maté-Sánchez de Val, José E; Calvo-Guirado, José L; De Aza, Piedad N

2017-07-06

This study aimed to investigate the processing parameters and biocompatibility of a novel biphasic dicalcium silicate (C₂S) cement. Biphasic α´ L + β-C₂S ss was synthesized by solid-state processing, and was used as a raw material to prepare the cement. In vitro bioactivity and biocompatibility studies were assessed by soaking the cement samples in simulated body fluid (SBF) and human adipose stem cell cultures. Two critical-sized defects of 6 mm Ø were created in 15 NZ tibias. A porous cement made of the high temperature forms of C₂S, with a low phosphorous substitution level, was produced. An apatite-like layer covered the cement's surface after soaking in SBF. The cell attachment test showed that α´ L + β-C₂S ss supported cells sticking and spreading after 24 h of culture. The cement paste (55.86 ± 0.23) obtained higher bone-to-implant contact (BIC) percentage values (better quality, closer contact) in the histomorphometric analysis, and defect closure was significant compared to the control group (plastic). The residual material volume of the porous cement was 35.42 ± 2.08% of the initial value. The highest BIC and bone formation percentages were obtained on day 60. These results suggest that the cement paste is advantageous for initial bone regeneration.

21 CFR 888.3100 - Ankle joint metal/composite semi-constrained cemented prosthesis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Ankle joint metal/composite semi-constrained... Ankle joint metal/composite semi-constrained cemented prosthesis. (a) Identification. An ankle joint metal/composite semi-constrained cemented prosthesis is a device intended to be implanted to replace an...

21 CFR 888.3510 - Knee joint femorotibial metal/polymer constrained cemented prosthesis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint femorotibial metal/polymer constrained... Knee joint femorotibial metal/polymer constrained cemented prosthesis. (a) Identification. A knee joint femorotibial metal/polymer constrained cemented prosthesis is a device intended to be implanted to replace part...

21 CFR 888.3660 - Shoulder joint metal/polymer semi-constrained cemented prosthesis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Shoulder joint metal/polymer semi-constrained... Shoulder joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. A shoulder joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace a...

21 CFR 888.3650 - Shoulder joint metal/polymer non-constrained cemented prosthesis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Shoulder joint metal/polymer non-constrained... Shoulder joint metal/polymer non-constrained cemented prosthesis. (a) Identification. A shoulder joint metal/polymer non-constrained cemented prosthesis is a device intended to be implanted to replace a...

21 CFR 888.3100 - Ankle joint metal/composite semi-constrained cemented prosthesis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ankle joint metal/composite semi-constrained... Ankle joint metal/composite semi-constrained cemented prosthesis. (a) Identification. An ankle joint metal/composite semi-constrained cemented prosthesis is a device intended to be implanted to replace an...

A finite element analysis of novel vented dental abutment geometries for cement-retained crown restorations.

PubMed

Rodriguez, Lucas C; Saba, Juliana N; Meyer, Clark A; Chung, Kwok-Hung; Wadhwani, Chandur; Rodrigues, Danieli C

2016-11-01

Recent literature indicates that the long-term success of dental implants is, in part, attributed to how dental crowns are attached to their associated implants. The commonly utilized method for crown attachment - cementation, has been criticized because of recent links between residual cement and peri-implant disease. Residual cement extrusion from crown-abutment margins post-crown seating is a growing concern. This study aimed at (1) identifying key abutment features, which would improve dental cement flow characteristics, and (2) understanding how these features would impact the mechanical stability of the abutment under functional loads. Computational fluid dynamic modeling was used to evaluate cement flow in novel abutment geometries. These models were then evaluated using 3D-printed surrogate models. Finite element analysis also provided an understanding of how the mechanical stability of these abutments was altered after key features were incorporated into the geometry. The findings demonstrated that the key features involved in improved venting of the abutment during crown seating were (1) addition of vents, (2) diameter of the vents, (3) location of the vents, (4) addition of a plastic screw insert, and (5) thickness of the abutment wall. This study culminated in a novel design for a vented abutment consisting of 8 vents located radially around the abutment neck-margin plus a plastic insert to guide the cement during seating and provide retrievability to the abutment system.Venting of the dental abutment has been shown to decrease the risk of undetected residual dental cement post-cement-retained crown seating. This article will utilize a finite element analysis approach toward optimizing dental abutment designs for improved dental cement venting. Features investigated include (1) addition of vents, (2) diameter of vents, (3) location of vents, (4) addition of plastic screw insert, and (5) thickness of abutment wall.

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

In vitro effects of dental cements on hard and soft tissues associated with dental implants.

PubMed

Rodriguez, Lucas C; Saba, Juliana N; Chung, Kwok-Hung; Wadhwani, Chandur; Rodrigues, Danieli C

2017-07-01

Dental cements for cement-retained restorations are often chosen based on clinician preference for the product's material properties, mixing process, delivery mechanism, or viscosity. The composition of dental cement may play a significant role in the proliferation or inhibition of different bacterial strains associated with peri-implant disease, and the effect of dental cements on host cellular proliferation may provide further insight into appropriate cement material selection. The purpose of this in vitro study was to investigate the cellular host response of bone cells (osteoblasts) and soft tissue cells (gingival fibroblasts) to dental cements. Zinc oxide (eugenol and noneugenol), zinc phosphate, and acrylic resin cements were molded into pellets and directly applied to confluent preosteoblast (cell line MC3T3 E1) or gingival fibroblast cell cultures (cell line HGF) to determine cellular viability after exposure. Controls were defined as confluent cell cultures with no cement exposure. Direct contact cell culture testing was conducted following International Organization for Standardization 10993 methods, and all experiments were performed in triplicate. To compare either the MC3T3 E1 cell line, or the HGF cell line alone, a 1-way ANOVA test with multiple comparisons was used (α=.05). To compare the MC3T3 E1 cell line results and the HGF cell line results, a 2-way ANOVA test with multiple comparisons was used (α=.05). The results of this study illustrated that while both bone and soft tissue cell lines were vulnerable to the dental cement test materials, the soft tissue cell line (human gingival fibroblasts) was more susceptible to reduced cellular viability after exposure. The HGF cell line was much more sensitive to cement exposure. Here, the acrylic resin, zinc oxide (eugenol), and zinc phosphate cements significantly reduced cellular viability after exposure with respect to HGF cells only. Within the limitation of this in vitro cellular study, the results indicated that cell response to various implant cements varied significantly, with osteoblast proliferation much less affected than gingival fibroblast cells. Furthermore, the zinc oxide noneugenol dental cement appeared to affect the cell lines significantly less than the other test cements. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Retention Strength of Conical Welding Caps for Fixed Implant-Supported Prostheses.

PubMed

Nardi, Diego; Degidi, Marco; Sighinolfi, Gianluca; Tebbel, Florian; Marchetti, Claudio

This study evaluated the retention strength of welding caps for Ankylos standard abutments using a pull-out test. Each sample consisted of an implant abutment and its welding cap. The tests were performed with a Zwick Roell testing machine with a 1-kN load cell. The retention strength of the welding caps increased with higher abutment diameters and higher head heights and was comparable or superior to the values reported in the literature for the temporary cements used in implant dentistry. Welding caps provide a reliable connection between an abutment and a fixed prosthesis without the use of cement.

Mechanical aspects of degree of cement bonding and implant wedge effect.

PubMed

Yoon, Yong-San; Oxland, Thomas R; Hodgson, Antony J; Duncan, Clive P; Masri, Bassam A; Choi, Donok

2008-11-01

The degree of bonding between the femoral stem and cement in total hip replacement remains controversial. Our objective was to determine the wedge effect by debonding and stem taper angle on the structural behavior of axisymmetric stem-cement-bone cylinder models. Stainless steel tapered plugs with a rough (i.e. bonded) or smooth (i.e. debonded) surface finish were used to emulate the femoral stem. Three different stem taper angles (5 degrees , 7.5 degrees , 10 degrees ) were used for the debonded constructs. Non-tapered and tapered (7.5 degrees ) aluminum cylindrical shells were used to emulate the diaphyseal and metaphyseal segments of the femur. The cement-aluminum cylinder interface was designed to have a shear strength that simulated bone-cement interfaces ( approximately 8MPa). The test involved applying axial compression at a rate of 0.02mm/s until failure. Six specimens were tested for each combination of the variables. Finite element analysis was used to enhance the understanding of the wedge effect. The debonded stems sustained about twice as much load as the bonded stem, regardless of taper angle. The metaphyseal model carried 35-50% greater loads than the diaphyseal models and the stem taper produced significant differences. Based on the finite element analysis, failure was most probably by shear at the cement-bone interface. Our results in this simplified model suggest that smooth (i.e. debonded) stems have greater failure loads and will incur less slippage or shear failure at the cement-bone interface than rough (i.e. bonded) stems.

The effect of crown/implant ratio and crown height space on stress distribution in unsplinted implant supporting restorations.

PubMed

Nissan, Joseph; Ghelfan, Oded; Gross, Ora; Priel, Ilan; Gross, Martin; Chaushu, Gavriel

2011-07-01

To measure the transfer of axial and nonaxial load in unsplinted fixed implant supported restoration with varying crown to implant (C/I) ratios and crown height space (CHS). A photoelastic block model was constructed. Three holes were drilled vertically in a straight line in the mid axis of the photoelastic model at predetermined locations to lengths of 12 mm. Three implants were inserted into the model. Two strain gauges were cemented onto the neck of each implant on the buccal and lingual aspects, which provided a simultaneous direct reading of strain. Four groups of cement retained restorations with C/I ratios of 1:1; 1:1.5; 1:1.75, and 1:2 were used. CHS were 10, 15, 17.5, and 20 mm, respectively. Fifteen static loadings were carried out simultaneously with 20 kg weights via a custom-built loading apparatus at 0 and 30 degrees to the vertical axis. Descriptive analysis consisted of mean and standard deviation of microstrain values for each group. Groups were compared by the use of the 1-way parametric analysis of variance. A P value of less than .05 was considered statistically significant. Occlusal force application at 30 degrees showed a statistically significant increase in both buccal (1,588 ± 150 vs 2,610.59 ± 150) and palatal (64.92 ± 7 vs 146.59 ± 15) microstrain values as C/I ratio increased from 1:1 to 1:1.5 (P < .001). Force application at 30 degrees in cases with C/I ratio of 1:1.75 and 1:2 resulted in fracture of the abutment screw followed by dislodgment of the crowns. Failures were noted at CHS >15 mm. CHS is more significant than the C/I ratio in assessing biomechanical-related detrimental effects. Prosthetic failure occurred at CHS ≥ 15 mm. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Salivary bacterial leakage into implant-abutment connections: preliminary results of an in vitro study.

PubMed

Mencio, F; Papi, P; Di Carlo, S; Pompa, G

2016-06-01

The occurrence of bacterial leakage in the internal surface of implants, through implant-abutment interface (IAI), is one of the parameters for analyzing the fabrication quality of the connections. The aim of this in vitro study is to evaluate two different types of implant-abutment connections: the screwed connection (Group 1) and the cemented connection (Group 2), analyzing the permeability of the IAI to bacterial colonization, using human saliva as culture medium. A total of twelve implants were tested, six in each experimental group. Five healthy patients were enrolled in this study. Two milliliters of non-stimulated saliva were collected from each subject and mixed in a test tube. After 14 days of incubation of the bacteria sample in the implant fixtures, a PCR-Real Time analysis was performed. Fisher's exact test was used to compare the proportions of implant-abutment assembled structures detected with bacterial leakage. Differences in the bacterial counts of the two groups were compared using the Mann-Whitney U test. A p value < 0.05 was considered significant. The results showed a decreased stability with the screwed implant-abutment connections compared to the cemented implant-abutment connections. A mean total bacterial count of 1.2E+07 (± 0.25E+07) for Group 1 and of 7.2E+04 (± 14.4E+04) for Group 2 was found, with a high level of significance, p = .0001. Within the limitations of this study it can be concluded that bacterial species from human saliva may penetrate along the implant-abutment interface in both connections, however the cemented connection implants showed the lowest amount of bacterial colonization.

N-acetyl cysteine (NAC)-mediated detoxification and functionalization of poly(methyl methacrylate) bone cement.

PubMed

Tsukimura, Naoki; Yamada, Masahiro; Aita, Hideki; Hori, Norio; Yoshino, Fumihiko; Chang-Il Lee, Masaichi; Kimoto, Katsuhiko; Jewett, Anahid; Ogawa, Takahiro

2009-07-01

Currently used poly(methyl methacrylate) (PMMA)-based bone cement lacks osteoconductivity and induces osteolysis and implant loosening due to its cellular and tissue-toxicity. A high percentage of revision surgery following the use of bone cement has become a significant universal problem. This study determined whether incorporation of the amino acid derivative N-acetyl cysteine (NAC) in bone cement reduces its cytotoxicity and adds osteoconductivity to the material. Biocompatibility and bioactivity of PMMA-based bone cement with or without 25mm NAC incorporation was examined using rat bone marrow-derived osteoblastic cells. Osteoconductive potential of NAC-incorporated bone cement was determined by microCT bone morphometry and implant biomechanical test in the rat model. Generation of free radicals within the polymerizing bone cement was examined using electron spin resonance spectroscopy. Severely compromised viability and completely suppressed phenotypes of osteoblasts on untreated bone cement were restored to the normal level by NAC incorporation. Bone volume formed around 25mm NAC-incorporated bone cement was threefold greater than that around control bone cement. The strength of bone-bone cement integration was 2.2 times greater for NAC-incorporated bone cement. For NAC-incorporated bone cement, the spike of free radical generation ended within 12h, whereas for control bone cement, a peak level lasted for 6 days and a level greater than half the level of the peak was sustained for 20 days. NAC also increased the level of antioxidant glutathione in osteoblasts. These results suggest that incorporation of NAC in PMMA bone cement detoxifies the material by immediate and effective in situ scavenging of free radicals and increasing intracellular antioxidant reserves, and consequently adds osteoconductivity to the material.

21 CFR 888.3800 - Wrist joint metal/polymer semi-constrained cemented prosthesis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint metal/polymer semi-constrained... Wrist joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. A wrist joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace a wrist joint...

21 CFR 888.3110 - Ankle joint metal/polymer semi-constrained cemented prosthesis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ankle joint metal/polymer semi-constrained... Ankle joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. An ankle joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace an ankle...

21 CFR 888.3160 - Elbow joint metal/polymer semi-constrained cemented prosthesis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Elbow joint metal/polymer semi-constrained... Elbow joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. An elbow joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace an elbow...

21 CFR 888.3800 - Wrist joint metal/polymer semi-constrained cemented prosthesis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Wrist joint metal/polymer semi-constrained... Wrist joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. A wrist joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace a wrist joint...

21 CFR 888.3340 - Hip joint metal/composite semi-constrained cemented prosthesis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint metal/composite semi-constrained... Hip joint metal/composite semi-constrained cemented prosthesis. (a) Identification. A hip joint metal/composite semi-constrained cemented prosthesis is a two-part device intended to be implanted to replace a...

21 CFR 888.3110 - Ankle joint metal/polymer semi-constrained cemented prosthesis.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Ankle joint metal/polymer semi-constrained... Ankle joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. An ankle joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace an ankle...

21 CFR 888.3160 - Elbow joint metal/polymer semi-constrained cemented prosthesis.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Elbow joint metal/polymer semi-constrained... Elbow joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. An elbow joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace an elbow...

21 CFR 888.3110 - Ankle joint metal/polymer semi-constrained cemented prosthesis.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Ankle joint metal/polymer semi-constrained... Ankle joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. An ankle joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace an ankle...

21 CFR 888.3800 - Wrist joint metal/polymer semi-constrained cemented prosthesis.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Wrist joint metal/polymer semi-constrained... Wrist joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. A wrist joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace a wrist joint...

21 CFR 888.3800 - Wrist joint metal/polymer semi-constrained cemented prosthesis.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Wrist joint metal/polymer semi-constrained... Wrist joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. A wrist joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace a wrist joint...

21 CFR 888.3160 - Elbow joint metal/polymer semi-constrained cemented prosthesis.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Elbow joint metal/polymer semi-constrained... Elbow joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. An elbow joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace an elbow...

21 CFR 888.3160 - Elbow joint metal/polymer semi-constrained cemented prosthesis.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Elbow joint metal/polymer semi-constrained... Elbow joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. An elbow joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace an elbow...

21 CFR 888.3110 - Ankle joint metal/polymer semi-constrained cemented prosthesis.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Ankle joint metal/polymer semi-constrained... Ankle joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. An ankle joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace an ankle...

21 CFR 888.3800 - Wrist joint metal/polymer semi-constrained cemented prosthesis.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Wrist joint metal/polymer semi-constrained... Wrist joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. A wrist joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace a wrist joint...

Static coefficient of friction between stainless steel and PMMA used in cemented hip and knee implants.

PubMed

Nuño, N; Groppetti, R; Senin, N

2006-11-01

Design of cemented hip and knee implants, oriented to improve the longevity of artificial joints, is largely based on numerical models. The static coefficient of friction between the implant and the bone cement is necessary to characterize the interface conditions in these models and must be accurately provided. The measurement of this coefficient using a repeatable and reproducible methodology for materials used in total hip arthroplasty is missing from the literature. A micro-topographic surface analysis characterized the surfaces of the specimens used in the experiments. The coefficient of friction between stainless steel and bone cement in dry and wet conditions using bovine serum was determined using a prototype computerized sliding friction tester. The effects of surface roughness (polished versus matt) and of contact pressure on the coefficient of friction have also been investigated. The serum influences little the coefficient of friction for the matt steel surface, where the mechanical interactions due to higher roughness are still the most relevant factor. However, for polished steel surfaces, the restraining effect of proteins plays a very relevant role in increasing the coefficient of friction. When the coefficient of friction is used in finite element analysis, it is used for the debonded stem-cement situation. It can thus be assumed that serum will propagate between the stem and the cement mantle. The authors believe that the use of a static coefficient of friction of 0.3-0.4, measured in the present study, is appropriate in finite element models.

A New Biphasic Dicalcium Silicate Bone Cement Implant

PubMed Central

Murciano, Angel; Maté-Sánchez de Val, José E.

2017-01-01

This study aimed to investigate the processing parameters and biocompatibility of a novel biphasic dicalcium silicate (C2S) cement. Biphasic α´L + β-C2Sss was synthesized by solid-state processing, and was used as a raw material to prepare the cement. In vitro bioactivity and biocompatibility studies were assessed by soaking the cement samples in simulated body fluid (SBF) and human adipose stem cell cultures. Two critical-sized defects of 6 mm Ø were created in 15 NZ tibias. A porous cement made of the high temperature forms of C2S, with a low phosphorous substitution level, was produced. An apatite-like layer covered the cement’s surface after soaking in SBF. The cell attachment test showed that α´L + β-C2Sss supported cells sticking and spreading after 24 h of culture. The cement paste (55.86 ± 0.23) obtained higher bone-to-implant contact (BIC) percentage values (better quality, closer contact) in the histomorphometric analysis, and defect closure was significant compared to the control group (plastic). The residual material volume of the porous cement was 35.42 ± 2.08% of the initial value. The highest BIC and bone formation percentages were obtained on day 60. These results suggest that the cement paste is advantageous for initial bone regeneration. PMID:28773119

Evaluation of removal forces of implant-supported zirconia copings depending on abutment geometry, luting agent and cleaning method during re-cementation

PubMed Central

Rödiger, Matthias; Rinke, Sven; Ehret-Kleinau, Fenja; Pohlmeyer, Franziska; Lange, Katharina; Bürgers, Ralf

2014-01-01

PURPOSE To evaluate the effects of different abutment geometries in combination with varying luting agents and the effectiveness of different cleaning methods (prior to re-cementation) regarding the retentiveness of zirconia copings on implants. MATERIALS AND METHODS Implants were embedded in resin blocks. Three groups of titanium abutments (pre-fabricated, height: 7.5 mm, taper: 5.7°; customized-long, height: 6.79 mm, taper: 4.8°; customized-short, height: 4.31 mm, taper: 4.8°) were used for luting of CAD/CAM-fabricated zirconia copings with a semi-permanent (Telio CS) and a provisional cement (TempBond NE). Retention forces were evaluated using a universal testing machine. Furthermore, the influence of cleaning methods (manually, manually in combination with ultrasonic bath or sandblasting) prior to re-cementation with a provisional cement (TempBond NE) was investigated with the pre-fabricated titanium abutments (height: 7.5 mm, taper: 5.7°) and SEM-analysis of inner surfaces of the copings was performed. Significant differences were determined via two-way ANOVA. RESULTS Significant interactions between abutment geometry and luting agent were observed. TempBond NE showed the highest level of retentiveness on customized-long abutments, but was negatively affected by other abutment geometries. In contrast, luting with Telio CS demonstrated consistent results irrespective of the varying abutment geometries. Manual cleaning in combination with an ultrasonic bath was the only cleaning method tested prior to re-cementation that revealed retentiveness levels not inferior to primary cementation. CONCLUSION No superiority for one of the two cements could be demonstrated because their influences on retentive strength are also depending on abutment geometry. Only manual cleaning in combination with an ultrasonic bath offers retentiveness levels after re-cementation comparable to those of primary luting. PMID:25006388

Fatigue Failure of External Hexagon Connections on Cemented Implant-Supported Crowns.

PubMed

Malta Barbosa, João; Navarro da Rocha, Daniel; Hirata, Ronaldo; Freitas, Gileade; Bonfante, Estevam A; Coelho, Paulo G

2018-01-17

To evaluate the probability of survival and failure modes of different external hexagon connection systems restored with anterior cement-retained single-unit crowns. The postulated null hypothesis was that there would be no differences under accelerated life testing. Fifty-four external hexagon dental implants (∼4 mm diameter) were used for single cement-retained crown replacement and divided into 3 groups: (3i) Full OSSEOTITE, Biomet 3i (n = 18); (OL) OEX P4, Osseolife Implants (n = 18); and (IL) Unihex, Intra-Lock International (n = 18). Abutments were torqued to the implants, and maxillary central incisor crowns were cemented and subjected to step-stress-accelerated life testing in water. Use-level probability Weibull curves and probability of survival for a mission of 100,000 cycles at 200 N (95% 2-sided confidence intervals) were calculated. Stereo and scanning electron microscopes were used for failure inspection. The beta values for 3i, OL, and IL (1.60, 1.69, and 1.23, respectively) indicated that fatigue accelerated the failure of the 3 groups. Reliability for the 3i and OL (41% and 68%, respectively) was not different between each other, but both were significantly lower than IL group (98%). Abutment screw fracture was the failure mode consistently observed in all groups. Because the reliability was significantly different between the 3 groups, our postulated null hypothesis was rejected.

Hip Implant Modified To Increase Probability Of Retention

NASA Technical Reports Server (NTRS)

Canabal, Francisco, III

1995-01-01

Modification in design of hip implant proposed to increase likelihood of retention of implant in femur after hip-repair surgery. Decreases likelihood of patient distress and expense associated with repetition of surgery after failed implant procedure. Intended to provide more favorable flow of cement used to bind implant in proximal extreme end of femur, reducing structural flaws causing early failure of implant/femur joint.

Strain analysis of 9 different abutments for cement-retained crowns on an internal hexagonal implant.

PubMed

Salaita, Louai G; Yilmaz, Burak; Seidt, Jeremy D; Clelland, Nancy L; Chien, Hua-Hong; McGlumphy, Edwin A

2017-08-01

Many aftermarket abutments for cement-retained crowns are available for the tapered screw-vent implant. Aftermarket abutments vary widely, from stock to custom abutments and in materials such as zirconia, titanium, or a combination of the two. How these aftermarket abutments perform under occlusal loads with regard to strain distribution is not clear. The purpose of this in vitro study was to measure and compare the different strains placed upon the bone around implants by 9 different abutments for cement-retained crowns on an implant with an internal hexagonal platform. Nine 4.1×11.5-mm tapered screw-vent implants were placed into a 305×51×8-mm resin block for strain measurements. Five abutment specimens of each of the 9 different abutments (N=45) were evaluated with 1 of the 9 implants. Monolithic zirconia crowns were then fabricated for each of the 9 different abutments, the crowns were cyclically loaded (maximum force 225 N) at 30 degrees, twice at a frequency of 2 Hz, and the strain was measured and recorded. The strain to the resin block was determined using a 3-dimensional digital image correlation (3D DIC) technique. Commercial image correlation software was used to analyze the strain around the implants. Data for maximal and minimal principal strains were compared using analysis of variance with a Tukey-Kramer post hoc test (α=.05). Strain measurements showed no significant differences among any of the abutments for minimal (compression) principal strains (P>.05). For maximal (tensile) principal strains, the zirconia abutment showed the highest, and the patient-specific abutment showed the second-highest strain around the implant, with the zirconia being significantly greater than all abutments, with the exception of the patient-specific abutment, and the patient-specific abutment being significantly greater than the straight contoured abutment in titanium and also zirconia (P<.05). The name brand patient specific titanium and Atlantis zirconia abutments conferred the most tensile strain to the implants. When selecting an abutment for a cement-retained crown on a tapered screw-vent implant, practitioners should consider the abutment material and the manufacturer of the abutment because not all abutments that fit in an individual implant transmit the strains in the same way. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Implant-supported fixed dental prostheses with CAD/CAM-fabricated porcelain crown and zirconia-based framework.

PubMed

Takaba, Masayuki; Tanaka, Shinpei; Ishiura, Yuichi; Baba, Kazuyoshi

2013-07-01

Recently, fixed dental prostheses (FDPs) with a hybrid structure of CAD/CAM porcelain crowns adhered to a CAD/CAM zirconia framework (PAZ) have been developed. The aim of this report was to describe the clinical application of a newly developed implant-supported FDP fabrication system, which uses PAZ, and to evaluate the outcome after a maximum application period of 36 months. Implants were placed in three patients with edentulous areas in either the maxilla or mandible. After the implant fixtures had successfully integrated with bone, gold-platinum alloy or zirconia custom abutments were first fabricated. Zirconia framework wax-up was performed on the custom abutments, and the CAD/CAM zirconia framework was prepared using the CAD/CAM system. Next, wax-up was performed on working models for porcelain crown fabrication, and CAD/CAM porcelain crowns were fabricated. The CAD/CAM zirconia frameworks and CAD/CAM porcelain crowns were bonded using adhesive resin cement, and the PAZ was cemented. Cementation of the implant superstructure improved the esthetics and masticatory efficiency in all patients. No undesirable outcomes, such as superstructure chipping, stomatognathic dysfunction, or periimplant bone resorption, were observed in any of the patients. PAZ may be a potential solution for ceramic-related clinical problems such as chipping and fracture and associated complicated repair procedures in implant-supported FDPs. © 2012 by the American College of Prosthodontists.

Trivalent chromium incorporated in a crystalline calcium phosphate matrix accelerates materials degradation and bone formation in vivo.

PubMed

Rentsch, Barbe; Bernhardt, Anne; Henß, Anja; Ray, Seemun; Rentsch, Claudia; Schamel, Martha; Gbureck, Uwe; Gelinsky, Michael; Rammelt, Stefan; Lode, Anja

2018-03-15

Remodeling of calcium phosphate bone cements is a crucial prerequisite for their application in the treatment of large bone defects. In the present study trivalent chromium ions were incorporated into a brushite forming calcium phosphate cement in two concentrations (10 and 50 mmol/mol β-tricalcium phosphate) and implanted into a femoral defect in rats for 3 and 6 month, non-modified brushite was used as reference. Based on our previous in vitro findings indicating both an enhanced osteoclastic activity and cytocompatibility towards osteoprogenitor cells we hypothesized a higher in vivo remodeling rate of the Cr 3+ doped cements compared to the reference. A significantly enhanced degradation of the modified cements was evidenced by micro computed tomography, X-ray and histological examinations. Furthermore the formation of new bone tissue after 6 month of implantation was significantly increased from 29% to 46% during remodeling of cements, doped with the higher Cr 3+ amount. Time of flight secondary ion mass spectrometry (ToF-SIMS) of histological sections was applied to investigate the release of Cr 3+ ions from the cement after implantation and to image their distribution in the implant region and the surrounding bone tissue. The relatively weak incorporation of chromium into the newly formed bone tissue is in agreement to the low chromium concentrations which were released from the cements in vitro. The faster degradation of the Cr 3+ doped cements was also verified by ToF-SIMS. The positive effect of Cr 3+ doping on both degradation and new bone formation is discussed as a synergistic effect of Cr 3+ bioactivity on osteoclastic resorption on one hand and improvement of cytocompatibility and solubility by structural changes in the calcium phosphate matrix on the other hand. While biologically active metal ions like strontium, magnesium and zinc are increasingly applied for the modification of ceramic bone graft materials, the present study is the first report on the incorporation of low doses of trivalent chromium ions into a calcium phosphate based biomaterial and testing of its performance in bone defect regeneration in vivo. Chromium(III)-doped calcium phosphate bone cements show improved cytocompatibility and both degradation rate and new bone formation in vivo are significantly increased compared to the reference cement. This important discovery might be the starting point for the application of trivalent chromium salts for the modification of bone graft materials to increase their remodelling rate. Copyright © 2018 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Effects of Incorporating Carboxymethyl Chitosan into PMMA Bone Cement Containing Methotrexate

PubMed Central

Liu, Bo-Ming; Li, Ming; Yin, Bao-Sheng; Zou, Ji-Yang; Zhang, Wei-Guo; Wang, Shou-Yu

2015-01-01

Treatment of bone metastases usually includes surgical resection with local filling of methotrexate (MTX) in polymethyl methacrylate (PMMA) cement. We investigated whether incorporating carboxymethyl chitosan (CMCS) in MTX-PMMA cement might overcome disadvantages associated with MTX. To determine the optimal CMCS+MTX concentration to suppress the viability of cancer cells, an integrated microfluidic chip culturing highly metastatic lung cancer cells (H460) was employed. The mechanical properties, microstructure, and MTX release of (CMCS+MTX)-PMMA cement were evaluated respectively by universal mechanical testing machine, scanning electron microscopy (SEM), and incubation in simulated body fluid with subsequent HPLC-MS. Implants of MTX-PMMA and (CMCS+MTX)-PMMA cement were evaluated in vivo in guinea pig femurs over time using spiral computed tomography with three-dimensional image reconstruction, and SEM at 6 months. Viability of H460 cells was significantly lowest after treatment with 57 μg/mL CMCS + 21 μg/mL MTX, which was thus used in subsequent experiments. Incorporation of 1.6% (w/w) CMCS to MTX-PMMA significantly increased the bending modulus, bending strength, and compressive strength by 5, 2.8, and 5.2%, respectively, confirmed by improved microstructural homogeneity. Incorporation of CMCS delayed the time-to-plateau of MTX release by 2 days, but increased the fraction released at the plateau from 3.24% (MTX-PMMA) to 5.34%. Relative to the controls, the (CMCS+MTX)-PMMA implants integrated better with the host bone. SEM revealed pores in the cement of the (CMCS+MTX)-PMMA implants that were not obvious in the controls. In conclusion, incorporation of CMCS in MTX-PMMA appears a feasible and effective modification for improving the anti-tumor properties of MTX-PMMA cement. PMID:26657526

Effects of Incorporating Carboxymethyl Chitosan into PMMA Bone Cement Containing Methotrexate.

PubMed

Liu, Bo-Ming; Li, Ming; Yin, Bao-Sheng; Zou, Ji-Yang; Zhang, Wei-Guo; Wang, Shou-Yu

2015-01-01

Treatment of bone metastases usually includes surgical resection with local filling of methotrexate (MTX) in polymethyl methacrylate (PMMA) cement. We investigated whether incorporating carboxymethyl chitosan (CMCS) in MTX-PMMA cement might overcome disadvantages associated with MTX. To determine the optimal CMCS+MTX concentration to suppress the viability of cancer cells, an integrated microfluidic chip culturing highly metastatic lung cancer cells (H460) was employed. The mechanical properties, microstructure, and MTX release of (CMCS+MTX)-PMMA cement were evaluated respectively by universal mechanical testing machine, scanning electron microscopy (SEM), and incubation in simulated body fluid with subsequent HPLC-MS. Implants of MTX-PMMA and (CMCS+MTX)-PMMA cement were evaluated in vivo in guinea pig femurs over time using spiral computed tomography with three-dimensional image reconstruction, and SEM at 6 months. Viability of H460 cells was significantly lowest after treatment with 57 μg/mL CMCS + 21 μg/mL MTX, which was thus used in subsequent experiments. Incorporation of 1.6% (w/w) CMCS to MTX-PMMA significantly increased the bending modulus, bending strength, and compressive strength by 5, 2.8, and 5.2%, respectively, confirmed by improved microstructural homogeneity. Incorporation of CMCS delayed the time-to-plateau of MTX release by 2 days, but increased the fraction released at the plateau from 3.24% (MTX-PMMA) to 5.34%. Relative to the controls, the (CMCS+MTX)-PMMA implants integrated better with the host bone. SEM revealed pores in the cement of the (CMCS+MTX)-PMMA implants that were not obvious in the controls. In conclusion, incorporation of CMCS in MTX-PMMA appears a feasible and effective modification for improving the anti-tumor properties of MTX-PMMA cement.

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.

Effect of tightening torque on the marginal adaptation of cement-retained implant-supported fixed dental prostheses

PubMed Central

Ghanbarzadeh, Jalil; Dashti, Hossin; Karamad, Reza; Alikhasi, Marzieh; Nakhaei, Mohammadreza

2015-01-01

Background: The final position of the abutment changes with the amount of tightening torque. This could eventually lead to loss of passivity and marginal misfit of prostheses. The aim of this study was to evaluate the effect of three different tightening torques on the marginal adaptation of 3-unit cement-retained implant-supported fixed dental prostheses (FDPs). Materials and Methods: Two implants (Straumann) were inserted in an acrylic block so that one of the implants was placed vertically and the other at a 15° vertical angle. A straight abutment and a 15° angulated abutment were connected to the vertically and obliquely installed implants, respectively, so that the two abutments were parallel. Then, 10 cement-retained FDPs were waxed and cast. Abutments were tightened with 10, 20, and 35 Ncm torques, respectively. Following each tightening torque, FDPs were luted on respective abutments with temporary cement. The marginal adaptation of the retainers was evaluated using stereomicroscope. FDPs were then removed from the abutments and were sectioned at the connector sites. The retainers were luted again on their respective abutments. Luting procedures and marginal adaptation measurement were repeated. Data were analyzed by ANOVA and least significant difference tests (α = 0.05). After cutting the FDP connectors, the independent samples t-test was used to compare misfit values (α = 0.05). Results: Following 10, 20, and 35 Ncm tightening torques, the marginal discrepancy of the retainers of FDPs significantly increased (P < 0.05). There was no significant difference between the marginal discrepancies of these two retainers (P > 0.05). The marginal gap values of angulated abutment retainers (ANRs) were significantly higher than those of the straight abutment after cutting the connectors (P = 0.026). Conclusion: Within the limitations of this study, the marginal misfit of cement-retained FDPs increased continuously when the tightening torque increased. After cutting the connectors, the marginal misfit of the ANRs was higher than those of the straight abutment retainers. PMID:26288627

Effect of tightening torque on the marginal adaptation of cement-retained implant-supported fixed dental prostheses.

PubMed

Ghanbarzadeh, Jalil; Dashti, Hossin; Karamad, Reza; Alikhasi, Marzieh; Nakhaei, Mohammadreza

2015-01-01

The final position of the abutment changes with the amount of tightening torque. This could eventually lead to loss of passivity and marginal misfit of prostheses. The aim of this study was to evaluate the effect of three different tightening torques on the marginal adaptation of 3-unit cement-retained implant-supported fixed dental prostheses (FDPs). Two implants (Straumann) were inserted in an acrylic block so that one of the implants was placed vertically and the other at a 15° vertical angle. A straight abutment and a 15° angulated abutment were connected to the vertically and obliquely installed implants, respectively, so that the two abutments were parallel. Then, 10 cement-retained FDPs were waxed and cast. Abutments were tightened with 10, 20, and 35 Ncm torques, respectively. Following each tightening torque, FDPs were luted on respective abutments with temporary cement. The marginal adaptation of the retainers was evaluated using stereomicroscope. FDPs were then removed from the abutments and were sectioned at the connector sites. The retainers were luted again on their respective abutments. Luting procedures and marginal adaptation measurement were repeated. Data were analyzed by ANOVA and least significant difference tests (α = 0.05). After cutting the FDP connectors, the independent samples t-test was used to compare misfit values (α = 0.05). Following 10, 20, and 35 Ncm tightening torques, the marginal discrepancy of the retainers of FDPs significantly increased (P < 0.05). There was no significant difference between the marginal discrepancies of these two retainers (P > 0.05). The marginal gap values of angulated abutment retainers (ANRs) were significantly higher than those of the straight abutment after cutting the connectors (P = 0.026). Within the limitations of this study, the marginal misfit of cement-retained FDPs increased continuously when the tightening torque increased. After cutting the connectors, the marginal misfit of the ANRs was higher than those of the straight abutment retainers.

Use of prefabricated titanium abutments and customized anatomic lithium disilicate structures for cement-retained implant restorations in the esthetic zone.

PubMed

Lin, Wei-Shao; Harris, Bryan T; Zandinejad, Amirali; Martin, William C; Morton, Dean

2014-03-01

This report describes the fabrication of customized abutments consisting of prefabricated 2-piece titanium abutments and customized anatomic lithium disilicate structures for cement-retained implant restorations in the esthetic zone. The heat-pressed lithium disilicate provides esthetic customized anatomic structures and crowns independently of the computer-aided design and computer-aided manufacturing process. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

A 5-year comparison of marginal bone level following immediate loading of single-tooth implants placed in healed alveolar ridges and extraction sockets in the maxilla.

PubMed

Berberi, Antoine N; Sabbagh, Joseph M; Aboushelib, Moustafa N; Noujeim, Ziad F; Salameh, Ziad A

2014-01-01

The aim of present investigation was to evaluate marginal bone level after 5-year follow-up of implants placed in healed ridges and fresh extraction sockets in maxilla with immediate loading protocol. Thirty-six patients in need of a single-tooth replacement in the anterior maxilla received 42 Astra Tech implants (Astra Tech Implant system™, Dentsply Implants, Mölndal, Sweden). Implants were placed either in healed ridges (group I) or immediately into fresh extraction sockets (group II). Implants were restored and placed into functional loading immediately by using a prefabricated abutment. Marginal bone level relative to the implant reference point was recorded at implant placement, crown cementation, 12, 36, and 60 months following loading using intra-oral radiographs. Measurements were made on the mesial and distal sides of each implant. Overall, two implants were lost from the group II, before final crown cementation: they were excluded from the study. The mean change in marginal bone loss (MBL) after implant placement was 0.26 ± 0.161 mm for 1 year, and 0.26 ± 0.171 mm for 3 years, and 0.21 ± 0.185 mm for 5 years in extraction sockets and was 0.26 ± 0.176 mm for 1 year and 0.21 ± 0.175 mm for 3 years, and 0.19 ± 0.172 mm for 5 years in healed ridges group. Significant reduction of marginal bone was more pronounced in implants inserted in healed ridges (P < 0.041) compared to fresh surgical extraction sockets (P < 0.540). Significant MBL was observed on the mesial side of the implant after cementation of the provisional (P < 0.007) and after 12 months (P < 0.034) compared to the distal side which remained stable for 3 and 5 years observation period. Within the limitations of this study, responses of local bone to immediately loaded implants placed either in extraction sockets or healed ridges were similar. Functional loading technique by using prefabricated abutment placed during the surgery time seems to maintain marginal bone around implant in both healed and fresh extraction sites.

Four-year follow-up of a polymethyl methacrylate-based bone cement graft for optimizing esthetics in maxillary anterior implants: a case report.

PubMed

Torres, Érica Miranda De; Naldi, Luis Fernando; Bernades, Karina Oliveira; Carvalho, Alexandre Leite

2017-01-01

Tooth loss promotes bone and gingival tissue remodeling, thus breaking the harmony between the residual ridge and natural teeth. This is critical in the anterior region of the mouth, and the integration of several dental specialties is often essential to successful rehabilitation with implants. This article describes a multidisciplinary approach to implant-supported oral rehabilitation in the maxillary anterior region, presenting a new technique for optimizing esthetics in implants. A 19-year-old woman was missing her central and lateral incisors and had 2 dental implants in the lateral incisor sites. The patient exhibited deficient thickness of the alveolar edge, loss of lip support, and absence of gingival architecture, and the implants were improperly placed. A multidisciplinary team created a correct emergence profile through a polymethyl methacrylate-based bone cement graft along with connective tissue grafts. This technique may be a useful therapeutic adjunct in dental implantology, showing good predictability and regular healing procedures.

A finite element analysis of novel vented dental abutment geometries for cement‐retained crown restorations

PubMed Central

Rodriguez, Lucas C.; Saba, Juliana N.; Meyer, Clark A.; Chung, Kwok‐Hung; Wadhwani, Chandur

2016-01-01

Abstract Recent literature indicates that the long‐term success of dental implants is, in part, attributed to how dental crowns are attached to their associated implants. The commonly utilized method for crown attachment – cementation, has been criticized because of recent links between residual cement and peri‐implant disease. Residual cement extrusion from crown‐abutment margins post‐crown seating is a growing concern. This study aimed at (1) identifying key abutment features, which would improve dental cement flow characteristics, and (2) understanding how these features would impact the mechanical stability of the abutment under functional loads. Computational fluid dynamic modeling was used to evaluate cement flow in novel abutment geometries. These models were then evaluated using 3D‐printed surrogate models. Finite element analysis also provided an understanding of how the mechanical stability of these abutments was altered after key features were incorporated into the geometry. The findings demonstrated that the key features involved in improved venting of the abutment during crown seating were (1) addition of vents, (2) diameter of the vents, (3) location of the vents, (4) addition of a plastic screw insert, and (5) thickness of the abutment wall. This study culminated in a novel design for a vented abutment consisting of 8 vents located radially around the abutment neck‐margin plus a plastic insert to guide the cement during seating and provide retrievability to the abutment system.Venting of the dental abutment has been shown to decrease the risk of undetected residual dental cement post‐cement‐retained crown seating. This article will utilize a finite element analysis approach toward optimizing dental abutment designs for improved dental cement venting. Features investigated include (1) addition of vents, (2) diameter of vents, (3) location of vents, (4) addition of plastic screw insert, and (5) thickness of abutment wall. PMID:29744160

40 CFR 146.12 - Construction requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

...; and (B) A cement bond, temperature, or density log after the casing is set and cemented. (ii) For... cement bond, temperature, or density log after the casing is set and cemented. (e) At a minimum, the... water. The casing and cement used in the construction of each newly drilled well shall be designed for...

Evaluation of the Effect of Axial Wall Modification and Coping Design on the Retention of Cement-retained Implant-supported Crowns

PubMed Central

Derafshi, Reza; Ahangari, Ahmad Hasan; Torabi, Kianoosh; Farzin, Mitra

2015-01-01

Background and aims. Because of compromised angulations of implants, the abutments are sometimes prepared. The purpose of this study was to investigate the effect of removing one wall of the implant abutment on the retention of cement-retained crowns. Materials and methods. Four prefabricated abutments were attached to analogues and embedded in acrylic resin blocks. The first abutment was left intact. Axial walls were partially removed from the remaining abutments to produce abutments with three walls. The screw access channel for the first and second abutments were completely filled with composite resin. For the third and fourth abutments, only partial filling was done. Wax-up models were made by CAD/CAM. Ten cast copings were fabricated for each abutment. The copings of fourth abutment had an extension into the screw access channel. Copings were cemented with Temp Bond. The castings were removed from the abutment using an Instron machine, and the peak removal force was recorded. A one-way ANOVA was used to test for a significant difference followed by the pairwise comparisons. Results. The abutments with opened screw access channel had a significantly higher retention than the two other abutments. The abutment with removed wall and no engagement into the hole by the castings exhibited the highest retention. Conclusion. Preserving the opening of screw access channel significantly increases the retention where one of the axial walls of implant abutments for cement-retained restorations is removed during preparation. PMID:25973152

Nondestructive evaluation of orthopaedic implant stability in THA using highly nonlinear solitary waves

NASA Astrophysics Data System (ADS)

Yang, Jinkyu; Silvestro, Claudio; Sangiorgio, Sophia N.; Borkowski, Sean L.; Ebramzadeh, Edward; De Nardo, Luigi; Daraio, Chiara

2012-01-01

We propose a new biomedical sensing technique based on highly nonlinear solitary waves to assess orthopaedic implant stability in a nondestructive and efficient manner. We assemble a granular crystal actuator consisting of a one-dimensional tightly packed array of spherical particles, to generate acoustic solitary waves. Via direct contact with the specimen, we inject acoustic solitary waves into a biomedical prosthesis, and we nondestructively evaluate the mechanical integrity of the bone-prosthesis interface, studying the properties of the waves reflected from the contact zone between the granular crystal and the implant. The granular crystal contains a piezoelectric sensor to measure the travelling solitary waves, which allows it to function also as a sensor. We perform a feasibility study using total hip arthroplasty (THA) samples made of metallic stems implanted in artificial composite femurs using polymethylmethacrylate for fixation. We first evaluate the sensitivity of the proposed granular crystal sensor to various levels of prosthesis insertion into the composite femur. Then, we impose a sequence of harsh mechanical loading on the THA samples to degrade the mechanical integrity at the stem-cement interfaces, using a femoral load simulator that simulates aggressive, accelerated physiological loading. We investigate the implant stability via the granular crystal sensor-actuator during testing. Preliminary results suggest that the reflected waves respond sensitively to the degree of implant fixation. In particular, the granular crystal sensor-actuator successfully detects implant loosening at the stem-cement interface following violent cyclic loading. This study suggests that the granular crystal sensor and actuator has the potential to detect metal-cement defects in a nondestructive manner for orthopaedic applications.

Influence of Abutment Design on Stiffness, Strength, and Failure of Implant-Supported Monolithic Resin Nano Ceramic (RNC) Crowns.

PubMed

Joda, Tim; Huber, Samuel; Bürki, Alexander; Zysset, Philippe; Brägger, Urs

2015-12-01

Recent technical development allows the digital manufacturing of monolithic reconstructions with high-performance materials. For implant-supported crowns, the fixation requires an abutment design onto which the reconstruction can be bonded. The aim of this laboratory investigation was to analyze stiffness, strength, and failure modes of implant-supported, computer-assisted design and computer-aided manufacturing (CAD/CAM)-generated resin nano ceramic (RNC) crowns bonded to three different titanium abutments. Eighteen monolithic RNC crowns were produced and loaded in a universal testing machine under quasi-static condition according to DIN ISO 14801. With regard to the type of titanium abutment, three groups were defined: (1) prefabricated cementable standard; (2) CAD/CAM-constructed individualized; and (3) novel prefabricated bonding base. Stiffness and strength were measured and analyzed statistically with Wilcoxon rank sum test. Sections of the specimens were examined microscopically. Stiffness demonstrated high stability for all specimens loaded in the physiological loading range with means and standard deviations of 1,579 ± 120 N/mm (group A), 1,733 ± 89 N/mm (group B), and 1,704 ± 162 N/mm (group C). Mean strength of the novel prefabricated bonding base (group C) was 17% lower than of the two other groups. Plastic deformations were detectable for all implant-abutment crown connections. Monolithic implant crowns made of RNC seem to represent a feasible and stable prosthetic construction under laboratory testing conditions with strength higher than the average occlusal force, independent of the different abutment designs used in this investigation. © 2014 Wiley Periodicals, Inc.

Evaluation of Heat Transfer to the Implant-Bone Interface During Removal of Metal Copings Cemented onto Titanium Abutments.

PubMed

Cakan, Umut; Cakan, Murat; Delilbasi, Cagri

2016-01-01

The aim of this investigation was to measure the temperature increase due to heat transferred to the implant-bone interface when the abutment screw channel is accessed or a metal-ceramic crown is sectioned buccally with diamond or tungsten carbide bur using an air rotor, with or without irrigation. Cobalt-chromium copings were cemented onto straight titanium abutments. The temperature changes during removal of the copings were recorded over a period of 1 minute. The sectioning of coping with diamond bur and without water irrigation generated the highest temperature change at the cervical part of the implant. Both crown removal methods resulted in an increase in temperature at the implant-bone interface. However, this temperature change did not exceed 47°C, the potentially damaging threshold for bone reported in the literature.

Effects of Silicon on Osteoclast Cell Mediated Degradation, In Vivo Osteogenesis and Vasculogenesis of Brushite Cement.

PubMed

Vahabzadeh, Sahar; Roy, Mangal; Bose, Susmita

2015-12-14

Calcium phosphate cements (CPCs) are being widely used for treating small scale bone defects. Among the various CPCs, brushite (dicalcium phosphate dihydrate, DCPD) cement is widely used due to its superior solubility and ability to form new bone. In the present study, we have studied the physical, mechanical, osteoclast-like-cells differentiation and in vivo osteogenic and vasculogenic properties of silicon (Si) doped brushite cements. Addition of Si did not alter the phase composition of final product and regardless of Si level, all samples included β-tricalcium phosphate (β-TCP) and DCPD. 1.1 wt. % Si addition increased the compressive strength of undoped brushite cement from 4.78±0.21 MPa to 5.53±0.53 MPa, significantly. Cellular activity was studied using receptor activator of nuclear factor κβ ligand (RANKL) supplemented osteoclast-like-cells precursor RAW 264.7 cell. Phenotypic expressions of the cells confirmed successful differentiation of RAW264.7 monocytes to osteoclast-like-cells on undoped and doped brushite cements. An increased activity of osteoclast-like cells was noticed due to Si doping in the brushite cement. An excellent new bone formation was found in all cement compositions, with significant increase in Si doped brushite samples as early as 4 weeks post implantation in rat femoral model. After 4 weeks of implantation, no significant difference was found in blood vessel formation between the undoped and doped cements, however, a significant increase in vasculgenesis was found in 0.8 and 1.1 wt. % Si doped brushite cements after 8 weeks. These results show the influence of Si dopant on physical, mechanical, in vitro osteoclastogenesis and in vivo osteogenic and vasculogenic properties of brushite cements.

The Effect of Luting Cement and Titanium Base on the Final Color of Zirconium Oxide Core Material.

PubMed

Capa, Nuray; Tuncel, Ilkin; Tak, Onjen; Usumez, Aslihan

2017-02-01

To evaluate the effects of different types of luting cements and different colors of zirconium cores on the final color of the restoration that simulates implant-supported fixed partial dentures (FPDs) by using a titanium base on the bottom. One hundred and twenty zirconium oxide core plates (Zr-Zahn; 10 mm in width, 5 mm in length, 0.5 mm in height) were prepared in different shades (n = 20; noncolored, A2, A3, B1, C2, D2). The specimens were subdivided into two subgroups for the two types of luting cements (n = 10). The initial color measurements were made on zirconium oxide core plates using a spectrometer. To create the cement thicknesses, stretch strips with holes in the middle (5 mm in diameter, 70 μm in height) were used. The second measurement was done on the zirconium oxide core plates after the application of the resin cement (U-200, A2 Shade) or polycarboxylate cement (Lumicon). The final measurement was done after placing the titanium discs (5 mm in diameter, 3 mm in height) in the bottom. The data were analyzed with two-way ANOVA and Tukey's honestly significant differences (HSD) tests (α = 0.05). The ∆E* ab value was higher in the resin cement-applied group than in the polycarboxylate cement-applied group (p < 0.001). The highest ∆E* ab value was recorded for the zirconium oxide core-resin cement-titanium base, and the lowest was recorded for the polycarboxylate cement-zirconium oxide core (p < 0.001). The luting cement, the presence of titanium, and the color of zirconium are all important factors that determine the final shade of zirconia cores in implant-supported FPDs. © 2015 by the American College of Prosthodontists.

Crushed cement concrete substitution for construction aggregates; a materials flow analysis

USGS Publications Warehouse

Kelly, Thomas

1998-01-01

An analysis of the substitution of crushed cement concrete for natural construction aggregates is performed by using a materials flow diagram that tracks all material flows into and out of the cement concrete portion of the products made with cement concrete: highways, roads, and buildings. Crushed cement concrete is only one of the materials flowing into these products, and the amount of crushed cement concrete substituted influences the amount of other materials in the flow. Factors such as availability and transportation costs, as well as physical properties, that can affect stability and finishability, influence whether crushed cement concrete or construction aggregates should be used or predominate for a particular end use.

Design and properties of novel gallium-doped injectable apatitic cements.

PubMed

Mellier, Charlotte; Fayon, Franck; Boukhechba, Florian; Verron, Elise; LeFerrec, Myriam; Montavon, Gilles; Lesoeur, Julie; Schnitzler, Verena; Massiot, Dominique; Janvier, Pascal; Gauthier, Olivier; Bouler, Jean-Michel; Bujoli, Bruno

2015-09-01

Different possible options were investigated to combine an apatitic calcium phosphate cement with gallium ions, known as bone resorption inhibitors. Gallium can be either chemisorbed onto calcium-deficient apatite or inserted in the structure of β-tricalcium phosphate, and addition of these gallium-doped components into the cement formulation did not significantly affect the main properties of the biomaterial, in terms of injectability and setting time. Under in vitro conditions, the amount of gallium released from the resulting cement pellets was found to be low, but increased in the presence of osteoclastic cells. When implanted in rabbit bone critical defects, a remodeling process of the gallium-doped implant started and an excellent bone interface was observed. The integration of drugs and materials is a growing force in the medical industry. The incorporation of pharmaceutical products not only promises to expand the therapeutic scope of biomaterials technology but to design a new generation of true combination products whose therapeutic value stem equally from both the structural attributes of the material and the intrinsic therapy of the drug. In this context, for the first time an injectable calcium phosphate cement containing gallium was designed with properties suitable for practical application as a local delivery system, implantable by minimally invasive surgery. This important and original paper reports the design and in-depth chemical and physical characterization of this groundbreaking technology. Copyright © 2015 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Experimental and computational investigation of Morse taper conometric system reliability for the definition of fixed connections between dental implants and prostheses.

PubMed

Bressan, Eriberto; Lops, Diego; Tomasi, Cristiano; Ricci, Sara; Stocchero, Michele; Carniel, Emanuele Luigi

2014-07-01

Nowadays, dental implantology is a reliable technique for treatment of partially and completely edentulous patients. The achievement of stable dentition is ensured by implant-supported fixed dental prostheses. Morse taper conometric system may provide fixed retention between implants and dental prostheses. The aim of this study was to investigate retentive performance and mechanical strength of a Morse taper conometric system used as implant-supported fixed dental prostheses retention. Experimental and finite element investigations were performed. Experimental tests were achieved on a specific abutment-coping system, accounting for both cemented and non-cemented situations. The results from the experimental activities were processed to identify the mechanical behavior of the coping-abutment interface. Finally, the achieved information was applied to develop reliable finite element models of different abutment-coping systems. The analyses were developed accounting for different geometrical conformations of the abutment-coping system, such as different taper angle. The results showed that activation process, occurred through a suitable insertion force, could provide retentive performances equal to a cemented system without compromising the mechanical functionality of the system. These findings suggest that Morse taper conometrical system can provide a fixed connection between implants and dental prostheses if proper insertion force is applied. Activation process does not compromise the mechanical functionality of the system. © IMechE 2014.

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.

Cisplatin loaded PMMA: mechanical properties, surface analysis and effects on Saos-2 cell culture.

PubMed

Özben, Hakan; Eralp, Levent; Baysal, Gökhan; Cort, Ayşegül; Sarkalkan, Nazli; Özben, Tomris

2013-01-01

Despite wide resection and systemic chemotherapy, bone tumors may present with local recurrences, metastases and pathological fractures. Application of bone cement containing antineoplastic drug to fill the defect after resection of metastatic lesions and to support implants has been suggested to prevent local tumor growth and implant failures. In this study, we aimed to demonstrate the effects of the addition of cisplatin which is a widely used antineoplastic drug for osteosarcoma, on the mechanical properties of bone cement, and to evaluate the cytotoxic effects of eluted cisplatin on Saos-2 cell culture. Two cement samples were prepared by mixing 100 mg and 300 mg of cisplatin powder with 40 g cement powder. The bone cement of the control group did not contain cisplatin. Mechanical analyses included 4-point bending, compression and shear testing. For cytotoxicity analysis, samples were incubated in Dulbecco's Modified Eagle's medium for 15 days. Mediums were applied to Saos-2 cell culture and cell viability was measured. Surface analyses were performed by scanning electron microscope (SEM). The addition of cisplatin did not alter the mechanical properties of bone cement. It was observed that the eluted cisplatin had cytotoxic effects on Saos-2 cells. SEM analyses demonstrated cisplatin granules on the surface of cement samples. Cisplatin maintains its cytotoxic property when released from bone cement without compromising the mechanical stability. Application of cisplatin loaded bone cement may help local control of tumor growth. We believe that our study will shed light on to these new practices for the treatment of bone cancers and will encourage future studies.

CAD/CAM glass ceramics for single-tooth implant crowns: a finite element analysis.

PubMed

Akça, Kvanç; Cavusoglu, Yeliz; Sagirkaya, Elcin; Aybar, Buket; Cehreli, Murat Cavit

2013-12-01

To evaluate the load distribution of CAD/CAM mono-ceramic crowns supported with single-tooth implants in functional area. A 3-dimensional numerical model of a soft tissue-level implant was constructed with cement-retained abutment to support glass ceramic machinable crown. Implant-abutment complex and the retained crown were embedded in a Ø 1.5 × 1.5 cm geometric matrix for evaluation of mechanical behavior of mono-ceramic CAD/CAM aluminosilicate and leucite glass crown materials. Laterally positioned axial load of 300 N was applied on the crowns. Resulting principal stresses in the mono-ceramic crowns were evaluated in relation to different glass ceramic materials. The highest compressive stresses were observed at the cervical region of the buccal aspect of the crowns and were 89.98 and 89.99 MPa, for aluminosilicate and leucite glass ceramics, respectively. The highest tensile stresses were observed at the collar of the lingual part of the crowns and were 24.54 and 25.39 MPa, respectively. Stresses induced upon 300 N static loading of CAD/CAM aluminosalicate and leucite glass ceramics are below the compressive strength of the materials. Impact loads may actuate the progress to end failure of mono-ceramic crowns supported by metallic implant abutments.

Early failure mechanisms of constrained tripolar acetabular sockets used in revision total hip arthroplasty.

PubMed

Cooke, Christopher C; Hozack, William; Lavernia, Carlos; Sharkey, Peter; Shastri, Shani; Rothman, Richard H

2003-10-01

Fifty-eight patients received an Osteonics constrained acetabular implant for recurrent instability (46), girdlestone reimplant (8), correction of leg lengthening (3), and periprosthetic fracture (1). The constrained liner was inserted into a cementless shell (49), cemented into a pre-existing cementless shell (6), cemented into a cage (2), and cemented directly into the acetabular bone (1). Eight patients (13.8%) required reoperation for failure of the constrained implant. Type I failure (bone-prosthesis interface) occurred in 3 cases. Two cementless shells became loose, and in 1 patient, the constrained liner was cemented into an acetabular cage, which then failed by pivoting laterally about the superior fixation screws. Type II failure (liner locking mechanism) occurred in 2 cases. Type III failure (femoral head locking mechanism) occurred in 3 patients. Seven of the 8 failures occurred in patients with recurrent instability. Constrained liners are an effective method for treatment during revision total hip arthroplasty but should be used in select cases only.

Assessment and comparison of retention of zirconia copings luted with different cements onto zirconia and titanium abutments: An in vitro study

PubMed Central

Menon, Neelima Sreekumar; Kumar, G. P. Surendra; Jnanadev, K. R.; Satish Babu, C. L.; Shetty, Shilpa

2016-01-01

Aim: The purpose of this in vitro study was to assess and compare the retention of zirconia copings luted with different luting agents onto zirconia and titanium abutments. Materials and Methods: Titanium and zirconia abutments were torqued at 35 N/cm onto implant analogs. The samples were divided into two groups: Group A consisted of four titanium abutments and 32 zirconia copings and Group B consisted of four zirconia abutments and 32 zirconia copings and four luting agents were used. The cemented copings were subjected to tensile dislodgement forces and subjected to ANOVA test. Results: Zirconia abutments recorded a higher mean force compared to titanium. Among the luting agents, resin cement recorded the highest mean force followed by zinc phosphate, glass ionomer, and noneugenol zinc oxide cement, respectively. Conclusion: Highest mean retention was recorded for zirconia implant abutments compared to titanium abutments when luted with zirconia copings. PMID:27141162

Construction Material-Based Methodology for Military Contingency Base Construction: Case Study of Maiduguri, Nigeria

DTIC Science & Technology

2016-09-01

NSDA Nigerian Steel Development Authority OPC ordinary Portland cement PDF population density factor RCC Reynolds Construction Company RHA rice...construction. Byproducts include blast furnace slag cement and gas. The increased use of steel scrap in production creates less dependence on the raw...The construction resources are gravel, cement , ready-mix concrete, lumber, steel , and brick. In some cases, there are multiple central areas in a

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.

Dental cements for definitive luting: a review and practical clinical considerations.

PubMed

Hill, Edward E

2007-07-01

Dental cement used to attach an indirect restoration to a prepared tooth is called a luting agent. A clinically relevant discussion of conventional and contemporary definitive luting agents is presented in this article. Physical properties are listed in table form to assist in comparison and decision-making. Additional subtopics include luting agent requirements, classifications, retention and bonding, cement considerations for implant-supported teeth, and fatigue failure.

Use of an absorbable membrane to position biologically inductive materials in the periprosthetic space of cemented joints.

PubMed

DiResta, Gene R; Brown, Holly; Aiken, Sean; Doty, Steven; Schneider, Robert; Wright, Timothy; Healey, John H

2006-01-01

A device is presented that positions ultrahigh molecular weight polyethylene (UHMWPE) debris against periprosthetic bone surfaces. This can facilitate the study of aseptic loosening associated with cemented joint prostheses by speeding the appearance of this debris within the periprosthetic space. The device, composed of a 100 microm thick bioabsorbable membrane impregnated with 1.4 x 10(9) sub-micron particles of UHMWPE debris, is positioned on the endosteum of the bone prior to the insertion of the cemented orthopedic implant. An in vitro pullout study and an in vivo canine pilot study were performed to investigate its potential to accelerate "time to aseptic loosening" of cemented prosthetic joints. Pullout studies characterized the influence of the membrane on initial implant fixation. The tensile stresses (mean+/-std.dev.) required to withdraw a prosthesis cemented into canine femurs with and without the membrane were 1.15+/-0.3 and 1.54+/-0.01 MPa, respectively; these findings were not significantly different (p > 0.4). The in vivo pilot study, involving five dogs, was performed to evaluate the efficacy of the debris to accelerate loosening in a canine cemented hip arthroplasty. Aseptic loosening and lameness occurred within 12 months, quicker than the 30 months reported in a retrospective clinical review of canine hip arthroplasty.

Comparison of cemented and uncemented fixation in total knee arthroplasty.

PubMed

Brown, Thomas E; Harper, Benjamin L; Bjorgul, Kristian

2013-05-01

As a result of reading this article, physicians should be able to :1. Understand the rationale behind using uncemented fixation in total knee arthroplasty.2.Discuss the current literature comparing cemented and uncemented total knee arthroplasty3. Describe the value of radiostereographic analysis in assessing implant stability.4. Appreciate the limitations in the available literature advocating 1 mode of fixation in total knee arthroplasty. Total knee arthroplasty performed worldwide uses either cemented, cementless, or hybrid (cementless femur with a cemented tibia) fixation of the components. No recent literature review concerning the outcomes of cemented vs noncemented components has been performed. Noncemented components offer the potential advantage of a biologic interface between the bone and implants, which could demonstrate the greatest advantage in long-term durable fixation in the follow-up of young patients undergoing arthroplasty. Several advances have been made in the backing of the tibial components that have not been available long enough to yield long-term comparative follow-up studies. Short-term radiostereographic analysis studies have yielded differing results. Although long-term, high-quality studies are still needed, material advances in biologic fixation surfaces, such as trabecular metal and hydroxyapatite, may offer promising results for young and active patients undergoing total knee arthroplasty when compared with traditional cemented options. Copyright 2013, SLACK Incorporated.

A 5-year comparison of marginal bone level following immediate loading of single-tooth implants placed in healed alveolar ridges and extraction sockets in the maxilla

PubMed Central

Berberi, Antoine N.; Sabbagh, Joseph M.; Aboushelib, Moustafa N.; Noujeim, Ziad F.; Salameh, Ziad A.

2014-01-01

Purpose: The aim of present investigation was to evaluate marginal bone level after 5-year follow-up of implants placed in healed ridges and fresh extraction sockets in maxilla with immediate loading protocol. Materials and Methods: Thirty-six patients in need of a single-tooth replacement in the anterior maxilla received 42 Astra Tech implants (Astra Tech Implant system™, Dentsply Implants, Mölndal, Sweden). Implants were placed either in healed ridges (group I) or immediately into fresh extraction sockets (group II). Implants were restored and placed into functional loading immediately by using a prefabricated abutment. Marginal bone level relative to the implant reference point was recorded at implant placement, crown cementation, 12, 36, and 60 months following loading using intra-oral radiographs. Measurements were made on the mesial and distal sides of each implant. Results: Overall, two implants were lost from the group II, before final crown cementation: they were excluded from the study. The mean change in marginal bone loss (MBL) after implant placement was 0.26 ± 0.161 mm for 1 year, and 0.26 ± 0.171 mm for 3 years, and 0.21 ± 0.185 mm for 5 years in extraction sockets and was 0.26 ± 0.176 mm for 1 year and 0.21 ± 0.175 mm for 3 years, and 0.19 ± 0.172 mm for 5 years in healed ridges group. Significant reduction of marginal bone was more pronounced in implants inserted in healed ridges (P < 0.041) compared to fresh surgical extraction sockets (P < 0.540). Significant MBL was observed on the mesial side of the implant after cementation of the provisional (P < 0.007) and after 12 months (P < 0.034) compared to the distal side which remained stable for 3 and 5 years observation period. Conclusions: Within the limitations of this study, responses of local bone to immediately loaded implants placed either in extraction sockets or healed ridges were similar. Functional loading technique by using prefabricated abutment placed during the surgery time seems to maintain marginal bone around implant in both healed and fresh extraction sites. PMID:24550840

40 CFR 146.32 - Construction requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... would result. The casing and cement used in the construction of each newly drilled well shall be... and confining zones; and (7) Type and grade of cement. (b) Appropriate logs and other tests shall be... pilot holes and reaming are used, unless the hole will be cased and cemented by circulating cement to...

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.

40 CFR 146.22 - Construction requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... caliper logs before casing is installed; and (B) A cement bond, temperature, or density log after the...; and (C) A cement bond, temperature, or density log after the casing is set and cemented. (g) At a... drinking water. The casing and cement used in the construction of each newly drilled well shall be designed...

21 CFR 888.3660 - Shoulder joint metal/polymer semi-constrained cemented prosthesis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3660... device are: (1) FDA's: (i) “Use of International Standard ISO 10993 ‘Biological Evaluation of Medical... metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace a...

21 CFR 888.3650 - Shoulder joint metal/polymer non-constrained cemented prosthesis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3650... are: (1) FDA's: (i) “Use of International Standard ISO 10993 ‘Biological Evaluation of Medical Devices... metal/polymer non-constrained cemented prosthesis is a device intended to be implanted to replace a...

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.

Fabrication and characterization of a novel carbon fiber-reinforced calcium phosphate silicate bone cement with potential osteo-inductivity.

PubMed

Zheng, Jiangjiang; Xiao, Yu; Gong, Tianxing; Zhou, Shuxin; Troczynski, Tom; Yang, Quanzu; Bao, Chongyun; Xu, Xiaoming

2015-12-23

The repair of bone defects is still a pressing challenge in clinics. Injectable bone cement is regarded as a promising material to solve this problem because of its special self-setting property. Unfortunately, its poor mechanical conformability, unfavorable osteo-genesis ability and insufficient osteo-inductivity seriously limit its clinical application. In this study, novel experimental calcium phosphate silicate bone cement reinforced by carbon fibers (CCPSC) was fabricated and characterized. First, a compressive strength test and cell culture study were carried out. Then, the material was implanted into the femoral epiphysis of beagle dogs to further assess its osteo-conductivity using a micro-computed tomography scan and histological analysis. In addition, we implanted CCPSC into the beagles' intramuscular pouches to perform an elementary investigation of its osteo-inductivity. The results showed that incorporation of carbon fibers significantly improved its mechanical properties. Meanwhile, CCPSC had better biocompatibility to activate cell adhesion as well as proliferation than poly-methyl methacrylate bone cement based on the cell culture study. Moreover, pronounced biodegradability and improved osteo-conductivity of CCPSC could be observed through the in vivo animal study. Finally, a small amount of osteoid was found at the heterotopic site one month after implantation which indicated potential osteo-inductivity of CCPSC. In conclusion, the novel CCPSC shows promise as a bioactive bone substitute in certain load-bearing circumstances.

Study and evaluation of ferro-cement for use in wind tunnel construction

NASA Technical Reports Server (NTRS)

Larsen, H. J., Jr. (Compiler)

1972-01-01

The structural suitability and cost effectiveness of ferro-cement for large subsonic wind tunnel structures is investigated. This investigation was carried out in the following four main categories: (1) a state-of-the-art survey into the uses, properties, and costs of ferro-cement; (2) an evaluation of those ferro-cement properties critical to construction of large, subsonic wind tunnels, which have not been adequately established to date; (3) a laboratory testing program to determine preliminary values for those properties; and (4) a study to establish cost factors for ferro-cement as related to a preliminary construction scheme for a nacelle and shroud unit.

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.

Validation of the "Quality of Life related to function, aesthetics, socialization, and thoughts about health-behavioural habits (QoLFAST-10)" scale for wearers of implant-supported fixed partial dentures.

PubMed

Castillo-Oyagüe, Raquel; Perea, Carmen; Suárez-García, María-Jesús; Río, Jaime Del; Lynch, Christopher D; Preciado, Arelis

2016-12-01

To validate the 'Quality of Life related to function, aesthetics, socialization, and thoughts about health-behavioural habits (QoLFAST-10)' questionnaire for assessing the whole concept of oral health-related quality of life (OHRQoL) of implant-supported fixed partial denture (FPD) wearers. 107 patients were assigned to: Group 1 (HP; n=37): fixed-detachable hybrid prostheses (control); Group 2 (C-PD, n=35): cemented partial dentures; and Group 3 (S-PD, n=35): screwed partial dentures. Patients answered the QoLFAST-10 and the Oral Health Impact Profile (OHIP-14sp) scales. Information on global oral satisfaction, socio-demographic, prosthetic, and clinical data was gathered. The psychometric capacity of the QoLFAST-10 was investigated. The correlations between both indices were explored by the Spearman's rank test. The effect of the study variables on the OHRQoL was evaluated by descriptive and non-parametric probes (α=0.05). The QoLFAST-10 was reliable and valid for implant-supported FPD wearers, who attained comparable results regardless of the connection system being cement or screws. Both fixed partial groups demonstrated significantly better social, functional, and total satisfaction than did HP wearers with this index. All groups revealed similar aesthetic-related well-being and consciousness about the importance of health-behavioural habits. Several study variables modulated the QoLFAST-10 scores. Hybrid prostheses represent the least predictable treatment option, while cemented and screwed FPDs supplied equal OHRQoL as estimated by the QoLFAST-10 scale. The selection of cemented or screwed FPDs should mainly rely on clinical factors, since no differences in patient satisfaction may be expected between both types of implant rehabilitations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Peri-implant bone length changes and survival rates of implants penetrating the sinus membrane at the posterior maxilla in patients with limited vertical bone height.

PubMed

Kim, Hae-Young; Yang, Jin-Yong; Chung, Bo-Yoon; Kim, Jeong Chan; Yeo, In-Sung

2013-04-01

The aim of this study was to measure the peri-implant bone length surrounding implants that penetrate the sinus membrane at the posterior maxilla and to evaluate the survival rate of these implants. Treatment records and orthopantomographs of 39 patients were reviewed and analyzed. The patients had partial edentulism at the posterior maxilla and limited vertical bone height below the maxillary sinus. Implants were inserted into the posterior maxilla, penetrating the sinus membrane. Four months after implant insertion, provisional resin restorations were temporarily cemented to the abutments and used for one month. Then, a final impression was taken at the abutment level, and final cement-retained restorations were delivered with mutually protected occlusion. The complications from the implant surgery were examined, the number of failed implants was counted, and the survival rate was calculated. The peri-implant bone lengths were measured using radiographs. The changes in initial and final peri-implant bone lengths were statistically analyzed. Nasal bleeding occurred after implant surgery in three patients. No other complications were found. There were no failures of the investigated implants, resulting in a survival rate of 100%. Significantly more bone gain around the implants (estimated difference=-0.6 mm, P=0.025) occurred when the initial residual bone height was less than 5 mm compared to the >5 mm groups. No significant change in peri-implant bone length was detected when the initial residual bone height was 5 mm or larger. This study suggests that implants penetrating the sinus membrane at the posterior maxilla in patients with limited vertical bone height may be safe and functional.

In vivo performance of a reduced-modulus bone cement

NASA Astrophysics Data System (ADS)

Forehand, Brett Ramsey

Total joint replacement has become one of the most common procedures in the area of orthopedics and is often the solution in patients with diseased or injured hip joints. Component loosening is a significant problem and is primarily caused by bone resorption at the bone-cement interface in cemented implants. It is our hypothesis that localized shear stresses are responsible for the resorption. It was previously shown analytically that local stresses at the interface could be reduced by using a cement of lower modulus. A new reduced modulus cement, polybutyl methylmethacrylate (PBMMA), was developed to test the hypothesis. PBMMA was formulated to exist as polybutyl methacrylate filler in a polymethyl methacrylate matrix. The success of PBMMA cement is based largely on the fact that the polybutyl component of the cement will be in the rubbery state at body temperature. In vitro characterization of the cement was undertaken previously and demonstrated a modulus of approximately one-eighth that of conventional bone cement, polymethyl methacrylate (PMMA) and increased fracture toughness. The purpose of this experiment was to perform an in vivo comparison of the two cements. A sheep model was selected. Total hip arthroplasty was performed on 50 ewes using either PBMMA or PMMA. Radiographs were taken at 6 month intervals. At one year, the contralateral femur of each sheep was implanted so that each animal served as its own control, and the animals were sacrificed. The stiffness of the bone-cement interface of the femoral component within the femur was assessed by applying a torque to the femoral component and demonstrated a significant difference in loosening between the cements when the specimens were tested in external rotation (p < 0.007). Evaluation of the mechanical data also suggests that the PBMMA sheep had a greater amount of loosening for each subject, 59% versus 4% for standard PMMA. A radiographic analysis demonstrated more signs of loosening in the PMMA series of subjects. A brief histological examination showed similar bony reaction to both cements, however, study of the interface membrane was not able to be accomplished. Reasons for the rejection of the hypothesis are discussed.

In Vitro Evaluation of Cell Compatibility of Dental Cements Used with Titanium Implant Components.

PubMed

Marvin, Jason C; Gallegos, Silvia I; Parsaei, Shaida; Rodrigues, Danieli C

2018-03-09

To evaluate the biocompatibility of five dental cement compositions after directly exposing human gingival fibroblast (HGF) and MC3T3-E1 preosteoblast cells to cement alone and cement applied on commercially pure titanium (cpTi) specimens. Nanostructurally integrated bioceramic (NIB), resin (R), resin-modified glass ionomer (RMGIC), zinc oxide eugenol (ZOE), and zinc phosphate (ZP) compositions were prepared according to the respective manufacturer's instructions. Samples were prepared in cylindrical Teflon molds or applied over the entire surface of polished cpTi discs. All samples were cured for 0.5, 1, 12, or 24 hours post-mixing. Direct contact testing was conducted according to ISO 10993 by seeding 6-well plates at 350,000 cells/well. Plates were incubated at 37°C in a humidified atmosphere with 5% CO 2 for 24 hours before individually plating samples and cpTi control discs. Plates were then incubated for an additional 24 hours. Microtetrazolium (MTT) cell viability assays were used to measure sample cytotoxicity. For samples that cured for 24 hours prior to direct contact exposure, only NIB and ZP cements when cemented on cpTi demonstrated cell viability percentages above the minimum biocompatibility requirement (≥70%) for both the investigative cell lines. R, RMGIC, and ZOE cements exhibited moderate to severe cytotoxic effects on both cell lines in direct contact and when cemented on cpTi specimens. For HGF cells, ZOE cemented-cpTi specimens exhibited significantly decreased cytotoxicity, whereas RMGIC cemented-cpTi specimens exhibited significantly increased cytotoxicity. Despite previous studies that showed enhanced cpTi corrosion activity for fluoride-containing compositions (NIB and ZP), there was no significant difference in cytotoxicity between cement alone and cemented-cpTi. In general, the MC3T3-E1 preosteoblast cells were more sensitive than HGF cells to cement composition. Ultimately, cement composition played a significant role in maintaining host cell compatibility. Results of this work help illustrate the impact of different cement formulations on host cell health and emphasize the need for understanding material properties when selecting certain formulations of dental cements, which can ultimately influence the survival of dental implant systems. © 2018 by the American College of Prosthodontists.

Magnitude of cement-device interfacial stresses with and without tibial stemming: impact of BMI.

PubMed

Gopalakrishnan, Ananthkrishnan; Hedley, Anthony Keith; Kester, Mark A

2011-03-01

Patients expect their total knee arthroplasty to relieve pain and to be long lasting. With patients becoming more active, weighing more, and living longer, this expectation becomes increasingly more difficult to fulfill. Patients who are obese and active put greater loads on their implants and may have a greater risk of failure. Although much attention has been paid to decreasing polyethylene wear, a major cause of implant failure, very little research focus has been directed to elucidate other measures to reduce failure, such as the efficacy of prophylactic stemming of the tibial tray. This study explored whether additional mechanical support for tibial base plates would help reduce bone cement stresses in heavy patients, who, like patients with a high activity level, put added stress on their implants. A tibial base plate with a 12-mm-diameter x 50-mm-long stem was compared with the same tibial base plate with a 15-mm-diameter x 20-mm-long end cap using finite element analysis. The results indicate that the tibial base plate with a prophylactic stem significantly reduced compressive and shear stresses on the cement-device interface and therefore may help to reduce the possibility of tibial loosening in these at-risk patients. Further, such studies will aid the surgeon in educating patients and in selecting the appropriate implant strategy.

Cemented all-polyethylene and metal-backed polyethylene tibial components used for primary total knee arthroplasty: a systematic review of the literature and meta-analysis of randomized controlled trials involving 1798 primary total knee implants.

PubMed

Voigt, Jeffrey; Mosier, Michael

2011-10-05

The cost of the implant as part of a total knee arthroplasty accounts for a substantial portion of the costs for the overall procedure: all-polyethylene tibial components cost considerably less than cemented metal-backed tibial components. We performed a systematic review of the literature to determine whether the clinical results of lower-cost all-polyethylene tibial components were comparable with the results of a more expensive metal-backed tibial component. We searched The Cochrane Library, MEDLINE, EMBASE, EBSCO CINAHL, the bibliographies of identified articles, orthopaedic meeting abstracts, health technology assessment web sites, and important orthopaedic journals. This search was performed for the years 1990 to the present. No language restriction was applied. We restricted our search to Level-I studies involving participants who received either an all-polyethylene or a metal-backed tibial implant. The primary outcome measures were durability, function, and adverse events. Two reviewers independently screened the papers for inclusion, assessed trial quality, and extracted data. Effects estimates were pooled with use of fixed and random-effects models of risk ratios, calculated with 95% confidence intervals. Heterogeneity was assessed with the I2 statistic. Forest plots were also generated. Data on 1798 primary total knee implants from twelve studies were analyzed. In all studies, the median or mean age of the participants was greater than sixty-seven years, with a majority of the patients being female. There was no difference between patients managed with an all-polyethylene tibial component and those managed with a metal-backed tibial component in terms of adverse events. There was no significant difference between the two groups in terms of the durability of the implants at two, ten, and fifteen years postoperatively, regardless of the year or how durability was defined (revision or radiographic failure). Finally, with use of a variety of validated measures, there was no difference between the two groups in terms of functional status at two, eight, and ten years, regardless of the measure used. A less expensive all-polyethylene component as part of a total knee arthroplasty has results equivalent to those obtained with a cemented metal-backed tibial component. Using a total knee implant with a cemented all-polyethylene tibial component could save the healthcare system substantial money while obtaining equivalent results to more expensive cemented designs and materials.

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.

The Survival of Morse Cone-Connection Implants with Platform Switch.

PubMed

Cassetta, Michele; Di Mambro, Alfonso; Giansanti, Matteo; Brandetti, Giulia

2016-01-01

The aim of this prospective clinical study was to evaluate the survival up to 5 years of Morse cone-connection implants with platform switch considering the influence of biologically relevant, anatomical, and stress-related variables. STROBE guidelines were followed. Seven hundred forty-eight implants were inserted in 350 patients. Follow-up visits were scheduled at the time of stagetwo surgery (2 months later) and at 6, 12, 24, 36, and 60 months. All implants were initially loaded with a cemented provisional acrylic restoration. The definitive metal-ceramic restorations were cemented at the 6-month follow-up. Implant cumulative survival rates (CSRs) were calculated using life table actuarial method. Survival data were also analyzed by the log-rank test and Cox regression. The statistical analysis was conducted at the patient level. P ≤ .05 was considered as an indicator of statistical significance. During the follow-up (mean: 40 months; SD: 20.27), 28 patients were considered failed (8%). The CSR and its standard error (SE) was 92% ± 2.17%. Patients with implant-supported single crowns had a CSR of 90%, whereas those with implant-supported fixed dental prostheses had a CSR of 93%. The implant diameter (P = .0399) and implant length (P = .0441) were statistically significant. The probability of failure was almost 75% lower for patients with wide rather than standard implants, 91% lower for patients with long implants, and 69% lower for patients with standard implants compared with short implants. The use of Morse cone-connection implants with platform switch is a safe and reliable treatment method. Stress-related variables influence the risk of failure confirming the importance of biomechanical factors in the longevity of osseointegrated implants; thus, the clinician may obtain better results if attention is paid to these factors.

Bridging knee arthrodesis for limb salvage using an intramedullary cemented nail: a retrospective outcome analysis of a case series.

PubMed

Neuerburg, Carl; Bieger, Ralf; Jung, Sebastian; Kappe, Thomas; Reichel, Heiko; Decking, Ralf

2012-08-01

Failed total knee replacement with compromised bone and soft-tissues can be challenging. In these situations, arthrodesis remains a treatment option of a limb-saving procedure. We investigated the outcome of treatment with an intramedullary cemented knee arthrodesis nail implanted in 22 consecutive patients with forlorn situations after failed total knee replacement. There were three major complications due to re-infection and two minor complications due to wound-healing disturbances that healed with the implant retained after an average follow-up of 3.4 years. Clinical examination, Short Form-36 and Oxford knee scores revealed low pain levels, safe implant anchorage, and improved stability of the knee, whilst autonomous mobility utilizing walking aids was still possible. Bridging knee arthrodesis with an intramedullary nail is a valuable salvage procedure with acceptable clinical results. As recurring infection remains the most challenging complication, regular clinical and radiological follow-up examinations are necessary following implant-related knee arthrodesis to allow timely intervention in case of loosening.

Influence of the veneer-framework interface on the mechanical behavior of ceramic veneers: a nonlinear finite element analysis.

PubMed

Lazari, Priscilla Cardoso; Sotto-Maior, Bruno Salles; Rocha, Eduardo Passos; de Villa Camargos, Germana; Del Bel Cury, Altair Antoninha

2014-10-01

The chipping of ceramic veneers is a common problem for zirconia-based restorations and is due to the weak interface between both structures. The purpose of this study was to evaluate the mechanical behavior of ceramic veneers on zirconia and metal frameworks under 2 different bond-integrity conditions. The groups were created to simulate framework-veneer bond integrity with the crowns partially debonded (frictional coefficient, 0.3) or completely bonded as follows: crown with a silver-palladium framework cemented onto a natural tooth, ceramic crown with a zirconia framework cemented onto a natural tooth, crown with a silver-palladium framework cemented onto a Morse taper implant, and ceramic crown with a zirconia framework cemented onto a Morse taper implant. The test loads were 49 N applied to the palatal surface at 45 degrees to the long axis of the crown and 25.5 N applied perpendicular to the incisal edge of the crown. The maximum principal stress, shear stress, and deformation values were calculated for the ceramic veneer; and the von Mises stress was determined for the framework. Veneers with partial debonding to the framework (frictional coefficient, 0.3) had greater stress concentrations in all structures compared with the completely bonded veneers. The metal ceramic crowns experienced lower stress values than ceramic crowns in models that simulate a perfect bond between the ceramic and the framework. Frameworks cemented to a tooth exhibited greater stress values than frameworks cemented to implants, regardless of the material used. Incomplete bonding between the ceramic veneer and the prosthetic framework affects the mechanical performance of the ceramic veneer, which makes it susceptible to failure, independent of the framework material or complete crown support. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Effect of using nano and micro airborne abrasive particles on bond strength of implant abutment to prosthesis.

PubMed

Rismanchian, Mansour; Davoudi, Amin; Shadmehr, Elham

2015-01-01

Connecting prostheses to the implant abutments has become a concern and achieving a satisfactory retention has been focused in cement-retention prostheses recently. Sandblasting is a method to make a roughened surface for providing more retention. The aim of this study was to compare effects of nano and micro airborne abrasive particles (ABAP) in roughening surface of implant abutments and further retention of cemented copings. Thirty Xive abutments and analogues (4.5 D GH1) were mounted vertically in self-cured acrylic blocks. Full metal Ni-Cr copings with a loop on the top were fabricated with appropriate marginal adaptation for each abutment. All samples were divided into 3 groups: first group (MPS) was sandblasted with 50 µm Al2O3 micro ABAP, second group (NSP) was sandblasted with 80 nm Al2O3 nano ABAP, and the third group (C) was assumed as control. The samples were cemented with provisional cement (Temp Bond) and tensile bond strength of cemented copings was evaluated by a universal testing machine after thermic cycling. The t test for independent samples was used for statistical analysis by SPSS software (version 15) at the significant level of 0.05. Final result showed significant difference among all groups (p<0.001) and MPS manifested the highest mean retention (207.88 ± 45.61 N) with significant difference among other groups (p<0.001). The control group showed the lowest bond strength as predicted (48.95 ± 10.44 N). Using nano or micro ABAP is an efficient way for increasing bond strengths significantly, but it seems that micro ABAP was more effective.

Construction aggregates

USGS Publications Warehouse

Nelson, T.I.; Bolen, W.P.

2007-01-01

Construction aggregates, primarily stone, sand and gravel, are recovered from widespread naturally occurring mineral deposits and processed for use primarily in the construction industry. They are mined, crushed, sorted by size and sold loose or combined with portland cement or asphaltic cement to make concrete products to build roads, houses, buildings, and other structures. Much smaller quantities are used in agriculture, cement manufacture, chemical and metallurgical processes, glass production and many other products.

Giant cell tumor of the spine.

PubMed

Ozaki, Toshifumi; Liljenqvist, Ulf; Halm, Henry; Hillmann, Axel; Gosheger, Georg; Winkelmann, Winfried

2002-08-01

Six patients with giant cell tumor of the spine had surgery between 1981 and 1995. Three lesions were located in the scrum, two lesions were in the thoracic spine, and one lesion was in the lumbar spine. Preoperatively, all patients had local pain and neurologic symptoms. Two patients had cement implanted after curettage or intralesional excision of the sacral tumor; one patient had a local relapse. After the second curettage and cement implantation, the tumor was controlled. One patient with a sacral lesion had marginal excision and spondylodesis; no relapse developed. Two patients with thoracic lesions had planned marginal excision and spondylodesis; the margins finally became intralesional, but no relapse developed. One patient with a lumbar lesion had incomplete removal of the tumor and received postoperative irradiation. At the final followup (median, 69 months), five of six patients were disease-free and one patient died of disease progression. Two of the five surviving patients had pain after standing or neurologic problems. Although some contamination occurred, planning a marginal excision of the lesion seems beneficial for vertebral lesions above the sacrum. Total sacrectomy of a sacral lesion seems to be too invasive when cement implantation can control the lesion.

The damping effect of cement as a potential mitigation factor of squeaking in ceramic-on-ceramic total hip arthroplasty.

PubMed

Burgo, F J; Mengelle, D E; Ozols, A; Fernandez, C; Autorino, C M

2016-11-01

Studies reporting specifically on squeaking in total hip arthroplasty have focused on cementless, and not on hybrid, fixation. We hypothesised that the cement mantle of the femur might have a damping effect on the sound transmitted through the metal stem. The objective of this study was to test the effect of cement on sound propagation along different stem designs and under different fixation conditions. An in vitro model for sound detection, composed of a mechanical suspension structure and a sound-registering electronic assembly, was designed. A pulse of sound in the audible range was propagated along bare stems and stems implanted in cadaveric bone femurs with and without cement. Two stems of different alloy and geometry were compared. The magnitudes of the maximum amplitudes of the bare stem were in the range of 10.8 V to 11.8 V, whereas the amplitudes for the same stems with a cement mantle in a cadaveric bone decreased to 0.3 V to 0.7 V, implying a pulse-attenuation efficiency of greater than 97%. The same magnitude is close to 40% when the comparison is made against stems implanted in cadaveric bone femurs without cement. The in vitro model presented here has shown that the cement had a remarkable effect on sound attenuation and a strong energy absorption in cement mantle and bone. The visco-elastic properties of cement can contribute to the dissipation of vibro-acoustic energy, thus preventing hip prostheses from squeaking. This could explain, at least in part, the lack of reports of squeaking when hybrid fixation is used.Cite this article: F. J. Burgo, D. E. Mengelle, A. Ozols, C. Fernandez, C. M. Autorino. The damping effect of cement as a potential mitigation factor of squeaking in ceramic-on-ceramic total hip arthroplasty. Bone Joint Res 2016;5:531-537. DOI: 10.1302/2046-3758.511.BJR-2016-0058.R1. © 2016 Burgo et al.

Effects of different types of temporary cements on the tensile strength and marginal adaptation of crowns on implants.

PubMed

Akashia, Ana Eliza; Francischone, Carlos Eduardo; Tokutsune, Edson; da Silva, Walter

2002-01-01

The aim of this study was to evaluate the influence of four different types of temporary cements, Tempbond (Kerr), Tempbond NE (Kerr), Improv (Sterioss), and Dycal (Dentsply/Caulk), on the marginal adaptation and tensile strength of prosthetic specimens cemented on replicas of CeraOne abutments. Four test groups were formed: Group 1 (G-1), Tempbond (Kerr); Group 2 (G-2), Tempbond NE (Kerr); Group 3 (G-3), Improv (Sterioss); Group 4 (G-4), Dycal (Dentsply/Caulk). For the specimens, gold cylinders (DCB 160, Nobel Biocare) adapted to stainless steel replicas of CeraOne abutments (Nobel Biocare) were utilized. The replicas on a stainless steel base were made in a special machine for implant components. The cement thicknesses for each luting agent were measured using a Measurement Comparative Microscope (Mitutoyo). The readings obtained before cementation were used as the controls (G-0). Following each group's cementation, the specimens were submitted to tensile strength tests with a Universal Testing Machine (Kratus). The results of the marginal adaptation test as reflected by cement thicknesses were: G-0 = 11.7 microm, G-1 = 35.7 microm (+/- 8.8), G-2 = 41.7 microm (+/- 9.0), G-3 = 32.6 microm (+/- 9.7) and G-4 = 38.2 microm (+/- 6.7). The tensile strength tests yielded the following values: G-1 = 58.5 N (+/- 14.8), G-2 = 51 N (+/- 8.2), G-3 = 61.8 N (+/- 17.1) and G-4 = 71.8 N (+/- 9.3). The four temporary cements tested all provided similar marginal adaptation. G-4 (Dycal) showed a higher tensile strength than G-2 (Tempbond NE).

Effect of lavage and brush preparation on cement penetration and primary stability in tibial unicompartmental total knee arthroplasty: An experimental cadaver study.

PubMed

Scheele, Christian; Pietschmann, Matthias F; Schröder, Christian; Grupp, Thomas; Holderied, Melanie; Jansson, Volmar; Müller, Peter E

2017-03-01

Unicompartmental total knee arthroplasty (UKA) is a well-established treatment option for unicondylar osteoarthritis, and generally leads to better functional results than tricompartimental total knee arthroplasty (TKA). However, revision rates of UKAs are reported as being higher; a major reason for this is aseptic loosening of the tibial component due to implant-cement-bone interface fatigue. The objective of this study was to determine the effects of trabecular bone preparation, prior to implantation of tibial UKAs, on morphological and biomechanical outcomes in a cadaver study. Cemented UKAs were performed in 18 human cadaver knees after the bone bed was cleaned using pulsed lavage (Group A), conventional brush (Group B) or no cleaning at all (Group C, control). Morphologic cement penetration and primary stability were measured. The area proportion under the tibial component without visible cement penetration was significantly higher in Group C (21.9%, SD 11.9) than in both Group A (7.1%, SD 5.8), and Group B (6.5%, SD 4.2) (P=0.007). The overall cement penetration depth did not differ between groups. However, in the posterior part, cement penetration depth was significantly higher in Group B (1.9mm, SD 0.3) than in both Group A (1.3mm, SD 0.3) and Group C (1.4mm, SD 0.3) (P=0.015). The mode of preparation did not show a substantial effect on primary stability tested under dynamic compression-shear test conditions (P=0.910). Bone preparation significantly enhances cement interdigitation. The application of a brush shows similar results compared with the application of pulsed lavage. Copyright © 2016 Elsevier B.V. All rights reserved.

[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.

Success and complications of implant-retained prostheses provided by the Post-Doctoral Prosthodontics Program, University of Puerto Rico: a cross-sectional study.

PubMed

Loza-Herrero, María A; Rivas-Tumanyan, Sona; Morou-Bermudez, Evangelia

2015-11-01

The success rate of implant-retained prostheses in a postdoctoral prosthodontics program was unknown and could not be related to any set of potential clinical issues or patient characteristics. The purpose of this study was to determine the success rate of implant-retained prostheses placed by prosthodontic residents between 1997 and 2012 and to evaluate the associations between patient classifications and specific restoration characteristics as related to prosthesis success or failure. A total of 272 prostheses in 119 patients were clinically evaluated. Success was defined as the absence of prosthetic complications or any implant-related complication that affected prosthesis survival. Logistic regression was used to evaluate associations between prosthesis success/failure and a wide array of study variables, adjusting for patient age, sex, and prosthesis longevity. The overall success rate was 71%, with a mean prosthesis age of 4.5 years (range: 4 months to 16.8 years). Implant single crowns were the most successful prosthesis type (81% success). The most common complications observed were porcelain fractures in fixed dental prostheses (15%) and lack of stability (31%) and retention (29%) in removable dental prostheses. Having a removable prosthesis (versus natural dentition) in the opposing occlusion significantly decreased the odds of success (OR=0.26, 95% CI: 0.11-0.64). Definitively cemented fixed prostheses were more successful than those cemented with an interim cement (OR=4.56, 95% CI: 1.37-15.22). The overall success rate of the implant-retained prostheses placed in the program was low compared with previously published studies. This study revealed the need for an efficient, comprehensive recall system for patients receiving implant-retained prostheses, either fixed or removable. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Fracture analysis of randomized implant-supported fixed dental prostheses

PubMed Central

Esquivel-Upshaw, Josephine F.; Mehler, Alex; Clark, Arthur E.; Neal, Dan; Anusavice, Kenneth J.

2014-01-01

Objective Fractures of posterior fixed dental all-ceramic prostheses can be caused by one or more factors including prosthesis design, flaw distribution, direction and magnitude of occlusal loading, and nature of supporting infrastructure (tooth root/implant), and presence of adjacent teeth. This clinical study of implant-supported, all-ceramic fixed dental prostheses, determined the effects of (1) presence of a tooth distal to the most distal retainer; (2) prosthesis loading either along the non-load bearing or load bearing areas; (3) presence of excursive contacts or maximum intercuspation contacts in the prosthesis; and (4) magnitude of bite force on the occurrence of veneer ceramic fracture. Methods 89 implant-supported FDPs were randomized as either a three-unit posterior metal-ceramic (Au-Pd-Ag alloy and InLine POM, Ivoclar, Vivadent) FDP or a ceramic-ceramic (ZirCAD and ZirPress, Ivoclar, Vivadent) FDP. Two implants (Osseospeed, Dentsply) and custom abutments (Atlantis, Dentsply) supported these FDPs, which were cemented with resin cement (RelyX Universal Cement). Baseline photographs were made with markings of teeth from maximum intercuspation (MI) and excursive function. Patients were recalled at 6 months and 1 to 3 years. Fractures were observed, their locations recorded, and images compared with baseline photographs of occlusal contacts. Conclusion No significant relationship exists between the occurrence of fracture and: (1) the magnitude of bite force; (2) a tooth distal to the most distal retainer; and (3) contacts in load-bearing or non-load-bearing areas. However, there was a significantly higher likelihood of fracture in areas with MI contacts only. Clinical Significance This clinical study demonstrates that there is a need to evaluate occlusion differently with implant-supported prostheses than with natural tooth supported prostheses because of the absence of a periodontal ligament. Implant supported prostheses should have minimal occlusion and lighter contacts than ones supported by natural dentition. PMID:25016139

Rationale for one stage exchange of infected hip replacement using uncemented implants and antibiotic impregnated bone graft.

PubMed

Winkler, Heinz

2009-09-04

Infection of a total hip replacement (THR) is considered a devastating complication, necessitating its complete removal and thorough debridement of the site. It is undoubted that one stage exchange, if successful, would provide the best benefit both for the patient and the society. Still the fear of re-infection dominates the surgeons decisions and in the majority of cases directs them to multiple stage protocols. However, there is no scientifically based argument for that practice. Successful eradication of infection with two stage procedures is reported to average 80% to 98%. On the other hand a literature review of Jackson and Schmalzried (CORR 2000) summarizing the results of 1,299 infected hip replacements treated with direct exchange (almost exclusively using antibiotic loaded cement), reports of 1,077 (83%) having been successful. The comparable results suggest, that the major factor for a successful outcome with traditional approaches may be found in the quality of surgical debridement and dead space management. Failures in all protocols seem to be caused by small fragments of bacterial colonies remaining after debridement, whereas neither systemic antibiotics nor antibiotic loaded bone cement (PMMA) have been able to improve the situation significantly. Reasons for failure may be found in the limited sensitivity of traditional bacterial culturing and reduced antibiotic susceptibility of involved pathogens, especially considering biofilm formation. Whenever a new prosthesis is implanted into a previously infected site the surgeon must be aware of increased risk of failure, both in single or two stage revisions. Eventual removal therefore should be easy with low risk of additional damage to the bony substance. On the other hand it should also have potential of a good long term result in case of success. Cemented revisions generally show inferior long term results compared to uncemented techniques; the addition of antibiotics to cement reduces its biomechanical properties. Efficient cementing techniques will result in tight bonding with the underlying bone, making eventual removal time consuming and possibly associated with further damage to the osseous structures. All these issues are likely to make uncemented revisions more desirable. Allograft bone may be impregnated with high loads of antibiotics using special incubation techniques. The storage capacities and pharmacological kinetics of the resulting antibiotic bone compound (ABC) are more advantageous than the ones of antibiotic loaded cement. ABC provides local concentrations exceeding those of cement by more than a 100fold and efficient release is prolonged for several weeks. The same time they are likely to restore bone stock, which usually is compromised after removal of an infected endoprosthesis. ABC may be combined with uncemented implants for improved long term results and easy removal in case of a failure. Specifications of appropriate designs are outlined. Based on these considerations new protocols for one stage exchange of infected TJR have been established. Bone voids surrounding the implants may be filled with antibiotic impregnated bone graft; uncemented implants may be fixed in original bone. Recent studies indicate an overall success rate of more than 90% without any adverse side effects. Incorporation of allografts appears as after grafting with unimpregnated bone grafts. Antibiotic loaded bone graft seems to provide sufficient local antibiosis for protection against colonisation of uncemented implants, the eluted amounts of antibiotics are likely to eliminate biofilm remnants, dead space management is more complete and defects may be reconstructed efficiently. Uncemented implants provide improved long term results in case of success and facilitated re-revision in case of failure. One stage revision using ABC together with uncemented implants such should be at least comparably save as multiple stage procedures, taking advantage of the obvious benefits for patients and economy.

Effect of pulsed ultrasound in combination with gentamicin on bacterial killing of biofilms on bone cements in vivo

PubMed Central

Ensing, G.T.; Roeder, B.L.; Nelson, J.L.; van Horn, J.R.; van der Mei, H.C.; Busscher, H.J.; Pitt, W.G.

2008-01-01

Aim The aim of this study is to investigate whether pulsed ultrasound in combination with gentamicin yields increased killing of bacterial biofilms on bone cements in vivo. Methods and Results Bacterial survival on bone cement in the presence and absence of ultrasound was compared in a rabbit model. Two bone cement samples with E. coli ATCC 10798 biofilm were implanted in a total of nine rabbits. In two groups bone cement disks loaded with gentamicin were used, and in one group unloaded bone cement disks in combination with systemically administered gentamicin were used. Pulsed ultrasound with a mean acoustic intensity of 167 mW cm−2 and a maximum acoustic intensity of 500 mW cm−2 was applied from 24 h till 72 h post surgery on one of the two implanted disks. After euthanization, the bacteria removed from the disk were quantified. Application of ultrasound, combined with gentamicin, reduced the biofilm in all three groups varying between 58 to 69% compared to the negative control. Ultrasound proved to be safe with respect to creating skin lesions. Conclusions Ultrasound resulted in an tendency of improved efficacy of gentamicin, either applied locally or systemically. Significance and impact of Study This study implies that ultrasound could improve the prevention of infection, especially because the biomaterials, gentamicin and ultrasound used in this model are all in clinical usage, but not yet combined in clinical practice. PMID:16108785

Evaluation of four biodegradable, injectable bone cements in an experimental drill hole model in sheep.

PubMed

von Rechenberg, Brigitte; Génot, Oliver R; Nuss, Katja; Galuppo, Larry; Fulmer, Mark; Jacobson, Evan; Kronen, Peter; Zlinszky, Kati; Auer, Jörg A

2013-09-01

Four cement applications were tested in this investigation. Two dicalcium phosphate dihydrate (DCPD-brushite) hydraulic cements, an apatite hydraulic fiber loaded cement, and a calcium sulfate cement (Plaster of Paris) were implanted in epiphyseal and metaphyseal cylindrical bone defects in sheep. The in vivo study was performed to assess the biocompatibility and bone remodeling of four cement formulations. After time periods of 2, 4, and 6 months, the cement samples were clinically and histologically evaluated. Histomorphometrically, the amount of new bone formation, fibrous tissue, and bone marrow and the area of remaining cement were measured. In all specimens, no signs of inflammation were detectable either macroscopically or microscopically. Cements differed mainly in their resorption time. Calcium sulfate was already completely resorbed at 2 months and showed a variable amount of new bone formation and/or fibrous tissue in the original drill hole over all time periods. The two DCPD cements in contrast were degraded to a large amount at 6 months, whereas the apatite was almost unchanged over all time periods. Copyright © 2013. Published by Elsevier B.V.

Modified femoral pressuriser generates a longer lasting high pressure during cement pressurisation

PubMed Central

2011-01-01

Background The strength of the cement-bone interface in hip arthroplasty is strongly related to cement penetration into the bone. A modified femoral pressuriser has been investigated, designed for closer fitting into the femoral opening to generate higher and more constant cement pressure compared to a commercial (conventional) design. Methods Femoral cementation was performed in 10 Sawbones® models, five using the modified pressuriser and five using a current commercial pressuriser as a control. Pressure during the cementation was recorded at the proximal and distal regions of the femoral implant. The peak pressure and the pressure-time curves were analysed by student's t-test and Two way ANOVA. Results The modified pressuriser showed significantly and substantially longer durations at higher cementation pressures and slightly, although not statistically, higher peak pressures compared to the conventional pressuriser. The modified pressuriser also produced more controlled cement leakage. Conclusion The modified pressuriser generates longer higher pressure durations in the femoral model. This design modification may enhance cement penetration into cancellous bone and could improve femoral cementation. PMID:22004662

Hypobaric Conditions and Retention of Dental Crowns Luted with Manually or Automixed Dental Cements.

PubMed

Kielbassa, Andrej M; Müller, Johannes A G

2018-05-01

There is only scant information on the influence of the hypobaric environment on luting agents and their efficacy on dental crown cementation. The objective of this study was to provide data on the retentive characters of two cements commonly used on implant abutment surfaces both under normal and under hypobaric conditions. There were 56 implant abutments supplied with CAD/CAM milled zirconia oxide crowns. 1) A zinc phosphate cement (ZP), and 2) a resin-modified glass ionomer cement (RMGI), each mixed either A) manually or B) by means of automix capsules, were used for cementation. The cemented crowns of the 4 × 2 subgroups were either kept on the ground or were transported in an aircraft at altitudes up to 13,730 m (45,045.9 ft; N = 28 each), thus being subjected to the pressure changes (80×) every aircrew member or frequent flyer is exposed to. All cemented crowns were stored in climatized boxes during the experimental phase. Hand-mixing of ZP resulted in a significant reduction of mean (± SD) retention forces (581.6 ± 204.5 N) when compared to the control group on the ground (828.4 ± 147.9 N). Automixed ZP (931.9 ± 134.4 N in flight; 996.0 ± 107.4 N on the ground) and RMGI subgroups (ranging from 581.0 N ± 114.3 N to 662.4 N ± 92.5 N) were not affected by hypobaric conditions. When treating patients frequently exposed to hypobaric environments, automixing of ZP would seem favorable, while manual mixing should be avoided. RMGI is considered suitable and is not influenced by hand-mixing or barometric pressure changes.Kielbassa AM, Müller JAG. Hypobaric conditions and retention of dental crowns luted with manually or automixed dental cements. Aerosp Med Hum Perform. 2018; 89(5):446-452.

The comparison of properties and cost of material use of natural rubber and sand in manufacturing cement mortar for construction sub-base layer

NASA Astrophysics Data System (ADS)

Rahman, R.; Nemmang, M. S.; Hazurina, Nor; Shahidan, S.; Khairul Tajuddin Jemain, Raden; Abdullah, M. E.; Hassan, M. F.

2017-11-01

The main issue related to this research was to examine the feasibility of natural rubber SMR 20 in the manufacturing of cement mortar for sub-base layer construction. Subbase layers have certain functions that need to be fulfilled in order to assure strong and adequate permeability of pavement performance. In a pavement structure, sub-base is below the base and serves as the foundation for the overall pavement structure, transmitting traffic loads to the sub-grade and providing drainage. Based on this research, the natural rubber, SMR 20 was with the percentages of 0%, 5%, 10% and 15% to mix with sand in the manufacture of the cement mortar. This research describes some of the properties and cost of the materials for the natural rubber and sand in cement mortar manufacturing by laboratory testing. Effects of the natural rubber replacement on mechanical properties of mortar were investigated by laboratory testing such as compressive strength test and density. This study obtained the 5% of natural rubber replaced in sand can achieved the strength of normal mortar after 7 days and 28 days. The strength of cement mortar depends on the density of cement mortar. According to the cost of both materials, sand shows the lower cost in material for the cement mortar manufacturing than the uses of natural rubber. Thus, the convectional cement mortar which used sand need lower cost than the modified rubber cement mortar and the most economical to apply in industrial. As conclusion, the percentage of 5% natural rubber in the cement mortar would have the same with normal cement mortar in terms of the strength. However, in terms of the cost of the construction, it will increase higher than cost of normal cement mortar production. So that, this modified cement mortar is not economical for the road sub-base construction.

Potential for thermal damage to articular cartilage by PMMA reconstruction of a bone cavity following tumor excision: A finite element study.

PubMed

Radev, Boyko R; Kase, Jonathan A; Askew, Michael J; Weiner, Scott D

2009-05-29

Benign, giant cell tumors are often treated by intralesional excision and reconstruction with polymethylmethacrylate (PMMA) bone cement. The exothermic reaction of the in-situ polymerizing PMMA is believed to beneficially kill remaining tumor cells. However, at issue is the extent of this necrotic effect into the surrounding normal bone and the adjacent articular cartilage. Finite element analysis (ABAQUS 6.4-1) was used to determine the extent of possible thermal necrosis around prismatically shaped, PMMA implants (8-24cc in volume), placed into a peripheral, sagittally symmetric, metaphyseal defect in the proximal tibia. Temperature/exposure time conditions indicating necrotic potential during the exotherm of the polymerizing bone cement were found in regions of the cancellous bone within 3mm of the superior surface of the PMMA implant. If less than 3mm of cancellous bone existed between the PMMA implant and the subchondral bone layer, regions of the subchondral bone were also exposed to thermally necrotic conditions. However, as long as there were at least 2mm of uniform subchondral bone above the PMMA implant, the necrotic regions did not extend into the overlying articular cartilage. This was the case even when the PMMA was in direct contact with the subchondral bone. If the subchondral bone is not of sufficient thickness, or is not continuous, then care should be taken to protect the articular cartilage from thermal damage as a result of the reconstruction of the tumor cavity with PMMA bone cement.

Bone Repair and Military Readiness

DTIC Science & Technology

2012-10-25

formation. Orthopedic surgeons have had to adapt surgical techniques to account for issues with cementing total joint prostheses and subsequent total joint ...the silorane composite has the potential to support osseous integration around the cemented total joint implant and may generate less immunogenic wear...factors, and potential for osseointegration/osseoinduction, this material has potential to be used for screw augmentation, total hip/knee joint

Image-Based Macro-Micro Finite Element Models of a Canine Femur with Implant Design Implications

NASA Astrophysics Data System (ADS)

Ghosh, Somnath; Krishnan, Ganapathi; Dyce, Jonathan

2006-06-01

In this paper, a comprehensive model of a bone-cement-implant assembly is developed for a canine cemented femoral prosthesis system. Various steps in this development entail profiling the canine femur contours by computed tomography (CT) scanning, computer aided design (CAD) reconstruction of the canine femur from CT images, CAD modeling of the implant from implant blue prints and CAD modeling of the interface cement. Finite element analysis of the macroscopic assembly is conducted for stress analysis in individual components of the system, accounting for variation in density and material properties in the porous bone material. A sensitivity analysis is conducted with the macroscopic model to investigate the effect of implant design variables on the stress distribution in the assembly. Subsequently, rigorous microstructural analysis of the bone incorporating the morphological intricacies is conducted. Various steps in this development include acquisition of the bone microstructural data from histological serial sectioning, stacking of sections to obtain 3D renderings of void distributions, microstructural characterization and determination of properties and, finally, microstructural stress analysis using a 3D Voronoi cell finite element method. Generation of the simulated microstructure and analysis by the 3D Voronoi cell finite element model provides a new way of modeling complex microstructures and correlating to morphological characteristics. An inverse calculation of the material parameters of bone by combining macroscopic experiments with microstructural characterization and analysis provides a new approach to evaluating properties without having to do experiments at this scale. Finally, the microstructural stresses in the femur are computed using the 3D VCFEM to study the stress distribution at the scale of the bone porosity. Significant difference is observed between the macroscopic stresses and the peak microscopic stresses at different locations.

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.

Natural Cellulose Nanofibers As Sustainable Enhancers in Construction Cement

PubMed Central

Jiao, Li; Su, Ming; Chen, Liao; Wang, Yuangang; Zhu, Hongli; Dai, Hongqi

2016-01-01

Cement is one of the mostly used construction materials due to its high durability and low cost, but it suffers from brittle fracture and facile crack initiation. This article describes the use of naturally-derived renewable cellulose nanofibers (CNFs) to reinforce cement. The effects of CNFs on the mechanical properties, degree of hydration (DOH), and microstructure of cement pastes have been studied. It is found that an addition of 0.15% by weight of CNFs leads to a 15% and 20% increase in the flexural and compressive strengths of cement paste. The enhancement in mechanical strength is attributed to high DOH and dense microstructure of cement pastes after adding CNFs. PMID:28005917

Production and construction technology of C100 high strength concrete filled steel tube

NASA Astrophysics Data System (ADS)

Wu, Yanli; Sun, Jinlin; Yin, Suhua; Liu, Yu

2017-10-01

In this paper, the effect of the amount of cement, water cement ratio and sand ratio on compressive strength of C100 concrete was studied. The optimum mix ratio was applied to the concrete filled steel tube for the construction of Shenyang Huangchao Wanxin mansion. The results show that the increase of amount of cement, water cement ratio can improve the compressive strength of C100 concrete but increased first and then decreased with the increase of sand ratio. The compressive strength of C100 concrete can reach 110MPa with the amount of cement 600kg/m3, sand ratio 40% and water cement ratio 0.25.

Articulating spacers used in two-stage revision of infected hip and knee prostheses abrade with time.

PubMed

Fink, Bernd; Rechtenbach, Annett; Büchner, Hubert; Vogt, Sebastian; Hahn, Michael

2011-04-01

Articulating spacers used in two-stage revision surgery of infected prostheses have the potential to abrade and subsequently induce third-body wear of the new prosthesis. We asked whether particulate material abraded from spacers could be detected in the synovial membrane 6 weeks after implantation when the spacers were removed for the second stage of the revision. Sixteen hip spacers (cemented prosthesis stem articulating with a cement cup) and four knee spacers (customized mobile cement spacers) were explanted 6 weeks after implantation and the synovial membranes were removed at the same time. The membranes were examined by xray fluorescence spectroscopy, xray diffraction for the presence of abraded particles originating from the spacer material, and analyzed in a semiquantitative manner by inductively coupled plasma mass spectrometry. Histologic analyses also were performed. We found zirconium dioxide in substantial amounts in all samples, and in the specimens of the hip synovial lining, we detected particles that originated from the metal heads of the spacers. Histologically, zirconium oxide particles were seen in the synovial membrane of every spacer and bone cement particles in one knee and two hip spacers. The observations suggest cement spacers do abrade within 6 weeks. Given the presence of abrasion debris, we recommend total synovectomy and extensive lavage during the second-stage reimplantation surgery to minimize the number of abraded particles and any retained bacteria.

FNF Construction Inc. Window Rock Airport Project: Coverage Under General Air Quality Permit for New or Modified Minor Source Cement Batch Plants in Indian Country

EPA Pesticide Factsheets

Approved Request for Coverage under General Air Quality Permit for New or Modified Minor Source Cement Batch Plants in Indian Country for FNF Construction Inc. Window Rock Airport Soil Cement Mixing Plant Project, Beacon Road, Window Rock, Arizona 86515.

[One-stage reconstruction of zygomatico-orbital complex with the use of implants of different origin].

PubMed

Menabde, G T; Gvenetadze, Z V; Atskvereli, L Sh

2009-03-01

Reconstruction of zygomatico-orbital complex remains as one of the troublesome and topical problems at steady posttraumatic deformations and fresh traumas of the mentioned region. The present work provides analysis of our own experience of surgical treatment of patients suffering from posttraumatic deformations and defects of zygomatico-orbital complex. The work was based on the results of examination and treatment of 33 patients who underwent an operation during the period from 2003 to 2008 years. Of 33, 21 patients were operated due to fresh traumas of the zygomatico-orbital region, and 12 - due to steady posttraumatic deformations of the mentioned region. Of 33 clinical cases, 19 patients underwent reconstruction of zygomatico-orbital complex with the use of implant. In 11 cases implants were perforated titanic plates, in 6 cases - bone cement (Surgical Simplex P), and in 2 cases - combination of titanic plates with bone cement. The results of our investigations have shown that one-stage reconstruction of zygomatico-orbital complex with the use of titanic plates and bone cement liquidates functional and cosmetic disorders. It has been suggested that the use of elaborated complex approaches in treatment of posttraumatic deformations and fresh traumas of zygomatico-orbital region is reasonable and acceptable.

Research of cost aspects of cement pavements construction

NASA Astrophysics Data System (ADS)

Bezuglyi, Artem; Illiash, Sergii; Tymoshchuk, Oleksandr

2017-09-01

The tendency to increasing traffic volume on public roads and to increased axle loads of vehicles makes the road scientists to develop scientifically justified methods for preserving the existing and developing the new transport network of Ukraine. One of the options for solving such issues is the construction of roads with rigid (cement concrete) pavement. However, any solution must be justified considering technical and economic components. This paper presents the results of the research of cost aspects of cement pavements construction.

In vitro biomechanical comparison of pedicle screws, sublaminar hooks, and sublaminar cables.

PubMed

Hitchon, Patrick W; Brenton, Matthew D; Black, Andrew G; From, Aaron; Harrod, Jeremy S; Barry, Christopher; Serhan, Hassan; Torner, James C

2003-07-01

Three types of posterior thoracolumbar implants are in use today: pedicle screws, sublaminar titaniumcables, and sublaminar hooks. The authors conducted a biomechanical comparison of these three implants in human cadaveric spines. Spine specimens (T5-12) were harvested, radiographically assessed for fractures or metastases, and their bone mineral density (BMD) was measured. Individual vertebrae were disarticulated and fitted with either pedicle screws, sublaminar cables, or bilateral claw hooks. The longitudinal component of each construct consisted of bilateral 10-cm rods connected with two cross-connectors. The vertebral body was embedded in cement, and the rods were affixed to a ball-and-socket apparatus for the application of a distraction force. The authors analyzed 1) 20 vertebrae implanted with screws; 2) 20 with hooks, and 3) 20 with cables. The maximum pullout (MPO) forces prior to failure (mean +/- standard deviation) for the screw, hook, and cable implants were 972 +/- 330, 802 +/- 356, and 654 +/- 248 N, respectively (p = 0.0375). Cables allowed significantly greater displacement (6.80 +/- 3.95 mm) prior to reaching the MPO force than hooks (3.73 +/- 1.42 mm) and screws (4.42 +/- 2.15 mm [p = 0.0108]). Eleven screw-implanted vertebrae failed because of screw pullout. All hook-and-cable-implanted vertebrae failed because of pedicle, middle column, or laminar fracture. These findings suggest that screws possess the greatest pullout strength of the three fixation systems. Sublaminar cables are the least rigid of the three. When screw failure occurred, the mechanism was generally screw back-out, without vertebral fractures.

Solidification/stabilization of dredged marine sediments for road construction.

PubMed

Wang, Dong Xing; Abriak, Nor Edine; Zentar, Rachid; Xu, WeiYa

2012-01-01

Cement/lime-based solidification is an environmentally sound solution for the management of dredged marine sediments, instead of traditional solutions such as immersion. Based on the mineralogical composition and physical characteristics of Dunkirk sediments, the effects of cement and lime are assessed through Atterberg limits, modified Proctor compaction, unconfined compressive strength and indirect tensile strength tests. The variation of Atterberg limits and the improvement in strength are discussed at different binder contents. The potential of sediments solidified with cement or lime for road construction is evaluated through a proposed methodology from two aspects: I-CBR value and material classification. The test results show the feasibility of solidified dredged sediments for beneficial use as a material in road construction. Cement is superior to lime in terms of strength improvement, and adding 6% cement is an economic and reasonable method to stabilize fine sediments.

Effect of pulsed ultrasound in combination with gentamicin on bacterial viability in biofilms on bone cements in vivo.

PubMed

Ensing, G T; Roeder, B L; Nelson, J L; van Horn, J R; van der Mei, H C; Busscher, H J; Pitt, W G

2005-01-01

The aim of this study is to investigate whether pulsed ultrasound (US) in combination with gentamicin yields a decreased viability of bacteria in biofilms on bone cements in vivo. Bacterial survival on bone cement in the presence and absence of ultrasound was compared in a rabbit model. Two bone cement samples with an Escherichia coli ATCC 10798 biofilm were implanted in a total of nine rabbits. In two groups bone cement discs loaded with gentamicin, freshly prepared and aged were used, and in one group unloaded bone cement discs in combination with systemically administered gentamicin. Pulsed ultrasound with a frequency of 28.48 kHz and a maximum acoustic intensity of 500 mW cm(-2) was applied continuously from 24 h till 72 h postsurgery on one of the two implanted discs. After euthanization and removal of the bacteria from the discs, the number of viable bacteria were quantified and skin samples were analysed for histopathological examination. Application of ultrasound, combined with gentamicin, reduced the viability of the biofilms in all three groups varying between 58 and 69% compared with the negative control. Histopathological examinations showed no skin lesions. Ultrasound resulted in a tendency of improved efficacy of gentamicin, either applied locally or systemically. Usage of ultrasound in this model proved to be safe. This study implies that ultrasound could improve the prevention of infection immediately after surgery, especially because the biomaterials, gentamicin and ultrasound used in this model are all in clinical usage, but not yet combined in clinical practice.

40 CFR 146.86 - Injection well construction requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... stages. (4) Circulation of cement may be accomplished by staging. The Director may approve an alternative... injection tubing and long string casing. (b) Casing and cementing of Class VI wells. (1) Casing and cement... confining zone(s); (viii) Type or grade of cement and cement additives; and (ix) Quantity, chemical...

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.

In Vitro Toxicity and Activity of Dakin’s Solution, Mafenide Acetate, and Amphotericin B on Filamentous Fungi and Human Cells

DTIC Science & Technology

2013-08-01

there are some data alluding to their ability to be used in implantable bone cement placed into wounds.27,28 In this study, we have shown that...2012;46:369 372. 27. Grimsrud C, Raven R, Fothergill AW, et al. The in vitro elution charac- teristics of antifungal-loaded PMMA bone cement and calcium

A pilot trial comparing the tear-out behavior in screw-sockets and cemented polyethylene acetabular components - a cadaveric study.

PubMed

Möbius, R; Schleifenbaum, S; Grunert, R; Löffler, S; Werner, M; Prietzel, T; Hammer, N

2016-10-01

The removal of well-fixed acetabular components following THA (total hip arthroplasty) is a difficult operation and could be accompanied by the loss of acetabular bone stock. The optimal method for fixation is still under debate. The aim of this pilot study was to compare the tear-out resistance and failure behavior between osseo-integrated and non-integrated screw cups. Furthermore, we examined whether there are differences in the properties mentioned between screw sockets and cemented polyethylene cups. Tear-out resistance and related mechanical work required for the tear-out of osseo-integrated screw sockets are higher than in non-integrated screw sockets. Ten human coxal bones from six cadavers with osseo-integrated screw sockets (n=4), non-integrated (implanted post-mortem, n=3) screw sockets and cemented polyethylene cups (n=3) were used for tear-out testing. The parameters axial failure load and mechanical work for tear-out were introduced as measures for determining the stability of acetabular components following THA. The osseo-integrated screw sockets yielded slightly higher tear-out resistance (1.61±0.26kN) and related mechanical work compared to the non-integrated screw sockets (1.23±0.39kN, P=0.4). The cemented polyethylene cups yielded the lowest tear-out resistance with a failure load of 1.18±0.24kN. Compared to the screw cups implanted while alive, they also differ on a non-significant level (P=0.1). Osseous failure patterns differed especially for the screw sockets compared to the cemented polyethylene cups. Osseo-integration did not greatly influence the tear-out stability in cementless screw sockets following axial loading. Furthermore, the strength of the bone-implant-interface of cementless screw sockets appears to be similar to cemented polyethylene cups. However, given the high failure load, high mechanical load and because of the related bone failure patterns, removal should not be performed by means of tear-out but rather by osteotomes or other curved cutting devices to preserve the acetabular bone stock. Level III, case-control-study. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Cements of doped calcium phosphates for bone implantation =

NASA Astrophysics Data System (ADS)

Pina, Sandra Cristina de Almeida

The main objective of this study was the development of cements based on calcium phosphates doped with Mg, Sr and Zn, for clinical applications. Powder synthesis was obtained through precipitation reactions, followed by heat treatment in order to obtain appropriate phases, alpha and beta-TCP. The cements were prepared through mixing the powders with different liquids, using citric acid as setting accelerator, and polyethyleneglycol and hydroxyl propylmethylcellulose as gelling agents. Brushite was the end product of the hydration reaction. Injectability and setting behaviour were accessed through rheological measurements, extrusion, calorimetric analysis, Vicat and Gilmore needles. Phase quantification and the structural refinement of powders and cements were determined through X-ray diffraction with Rietveld refinement, as well as, BET specific surface area and particle size analysis. Mechanical strengths of wet hardened cements were evaluated. The results obtained showed that the incorporation of ions into cements led to a significant improvement of their overall properties. Initial setting time increased in the presence of rheological modifiers due to their specific roles at the solid/liquid interface and with increasing L/P ratio. Acceptable workability pastes were obtained for L/P ratios in the range of 0.30-0.34 mL g-1. The cement pastes presented good injectability even under a maximum applied force of 100 N. Filter pressing effects were absent, and all cement pastes could be fully injected for LPR > 0.36 mL g-1. Isothermal calorimetry revealed that hydration reactions produce exothermic effects due to: (i) dissolution of the starting powders and formation of intermediate phases; and (ii) nucleation and growth of brushite crystals. The intensity of the exothermic effects depended on doping element, being stronger in the case of Sr. Wet compressive strength of the cement specimens (after immersion in PBS solution for 48 h) was in the range of values reported for trabecular bone (10-30 MPa). Cell cultures used to evaluate citotoxicity, bioactivity and biocompatibility of cements revealed no toxic effects. The biocompatibility in vivo and cements resorption were evaluated using a pig model through histological and histomorphometric studies of decalcified sections. The results show that the implanted cements are biocompatible and osteoconductive, without foreign body reaction. These properties make them good candidates for applications as bone substitutes. None

Enhanced osteointegration of poly(methylmethacrylate) bone cements by incorporating strontium-containing borate bioactive glass

PubMed Central

Huang, Chengcheng; Zhang, Meng; Ruan, Changshun; Peng, Songlin; Li, Li; Liu, Wenlong; Wang, Ting; Li, Bing; Huang, Wenhai; Rahaman, Mohamed N.; Lu, William W.; Pan, Haobo

2017-01-01

Although poly(methylmethacrylate) (PMMA) cements are widely used in orthopaedics, they have numerous drawbacks. This study aimed to improve their bioactivity and osseointegration by incorporating strontium-containing borate bioactive glass (SrBG) as the reinforcement phase and bioactive filler of PMMA cement. The prepared SrBG/PMMA composite cements showed significantly decreased polymerization temperature when compared with PMMA and retained properties of appropriate setting time and high mechanical strength. The bioactivity of SrBG/PMMA composite cements was confirmed in vitro, evidenced by ion release (Ca, P, B and Sr) from SrBG particles. The cellular responses of MC3T3-E1 cells in vitro demonstrated that SrBG incorporation could promote adhesion, migration, proliferation and collagen secretion of cells. Furthermore, our in vivo investigation revealed that SrBG/PMMA composite cements presented better osseointegration than PMMA bone cement. SrBG in the composite cement could stimulate new-bone formation around the interface between the composite cement and host bone at eight and 12 weeks post-implantation, whereas PMMA bone cement only stimulated development of an intervening connective tissue layer. Consequently, the SrBG/PMMA composite cement may be a better alternative to PMMA cement in clinical applications and has promising orthopaedic applications by minimal invasive surgery. PMID:28615491

Enhanced osteointegration of poly(methylmethacrylate) bone cements by incorporating strontium-containing borate bioactive glass.

PubMed

Cui, Xu; Huang, Chengcheng; Zhang, Meng; Ruan, Changshun; Peng, Songlin; Li, Li; Liu, Wenlong; Wang, Ting; Li, Bing; Huang, Wenhai; Rahaman, Mohamed N; Lu, William W; Pan, Haobo

2017-06-01

Although poly(methylmethacrylate) (PMMA) cements are widely used in orthopaedics, they have numerous drawbacks. This study aimed to improve their bioactivity and osseointegration by incorporating strontium-containing borate bioactive glass (SrBG) as the reinforcement phase and bioactive filler of PMMA cement. The prepared SrBG/PMMA composite cements showed significantly decreased polymerization temperature when compared with PMMA and retained properties of appropriate setting time and high mechanical strength. The bioactivity of SrBG/PMMA composite cements was confirmed in vitro , evidenced by ion release (Ca, P, B and Sr) from SrBG particles. The cellular responses of MC3T3-E1 cells in vitro demonstrated that SrBG incorporation could promote adhesion, migration, proliferation and collagen secretion of cells. Furthermore, our in vivo investigation revealed that SrBG/PMMA composite cements presented better osseointegration than PMMA bone cement. SrBG in the composite cement could stimulate new-bone formation around the interface between the composite cement and host bone at eight and 12 weeks post-implantation, whereas PMMA bone cement only stimulated development of an intervening connective tissue layer. Consequently, the SrBG/PMMA composite cement may be a better alternative to PMMA cement in clinical applications and has promising orthopaedic applications by minimal invasive surgery. © 2017 The Author(s).

Admixtures in Cement-Matrix Composites for Mechanical Reinforcement, Sustainability, and Smart Features

PubMed Central

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

2016-01-01

For more than a century, several inclusions have been mixed with Portland cement—nowadays the most-consumed construction material worldwide—to improve both the strength and durability required for construction. The present paper describes the different families of inclusions that can be combined with cement matrix and reviews the achievements reported to date regarding mechanical performance, as well as two other innovative functionalities of growing importance: reducing the high carbon footprint of Portland cement, and obtaining new smart features. Nanomaterials stand out in the production of such advanced features, allowing the construction of smart or multi-functional structures by means of thermal- and strain-sensing, and photocatalytic properties. The first self-cleaning concretes (photocatalytic) have reached the markets. In this sense, it is expected that smart concretes will be commercialized to address specialized needs in construction and architecture. Conversely, other inclusions that enhance strength or reduce the environmental impact remain in the research stage, in spite of the promising results reported in these issues. Despite the fact that such functionalities are especially profitable in the case of massive cement consumption, the shift from the deeply established Portland cement to green cements still has to overcome economic, institutional, and technical barriers. PMID:28774091

Caustic ulcers caused by cement aqua: report of a case.

PubMed

Machovcova, Alena

2010-01-01

Chromium is widely used in various industries including construction sector. Skin contact with cement has been associated with allergic or irritant contact dermatitis. Contact dermatitis is one of the most frequently reported health problems among construction workers. Irritant contact dermatitis from cement ranges from cement burns to cumulative irritant contact dermatitis. Cement burns are rarely reported and are considered a severe form of acute irritant contact dermatitis. They are associated with amateur user working in a short ready-mix time-frame with poor protective measures. They usually result in significant morbidity and initially are associated with minimal discomfort. We report a typical case.

Accuracy of implant impressions without impression copings: a three-dimensional analysis.

PubMed

Kwon, Joo-Hyun; Son, Yong-Ha; Han, Chong-Hyun; Kim, Sunjai

2011-06-01

Implant impressions without impression copings can be used for cement-retained implant restorations. A comparison of the accuracy of implant impressions with and without impression copings is needed. The purpose of this study was to evaluate and compare the dimensional accuracy of implant definitive casts that are fabricated by implant impressions with and without impression copings. An acrylic resin maxillary model was fabricated, and 3 implant replicas were secured in the right second premolar, first, and second molars. Two impression techniques were used to fabricate definitive casts (n=10). For the coping group (Group C), open tray impression copings were used for the final impressions. For the no-coping group (Group NC), cementable abutments were connected to the implant replicas, and final impressions were made assuming the abutments were prepared teeth. Computerized calculation of the centroids and long axes of the implant or stone abutment replicas was performed. The Mann-Whitney U test analyzed the amount of linear and rotational distortion between groups (α =.05). At the first molar site, Group NC showed significantly greater linear distortion along the Y-axis, with a small difference between the groups (Group C, 7.8 ± 7.4 μm; Group NC, 19.5 ± 12.2). At the second molar site, increased distortion was noted in Group NC for every linear and rotational variable, except for linear distortion along the Z-axis. Implant impression with open tray impression copings produced more accurate definitive casts than those fabricated without impression copings, especially those with greater inter-abutment distance. Copyright © 2011 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

[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.

α-TCP cements prepared by syringe-foaming: Influence of Na2HPO4 and surfactant concentration.

PubMed

Vásquez, A F; Domínguez, S; Loureiro Dos Santos, L A

2017-12-01

The lack of intrinsic open porosity in calcium phosphate cements slows down the resorption rate and bone ingrowth when implanted In Vivo. In this study, macroporous structures were obtained by mixing α-TCP cement with a foamed liquid phase containing different concentrations of sodium hydrogen phosphate and a nonionic surfactant. The cement paste was prepared by hand mixing in a novel system of two syringes connected by a tube. Two different liquid to powder (L/P) ratios were used to prepare the cement paste. The cement samples showed open macropores with diameters>100μm. The specimens prepared with lower L/P ratio showed smaller porosity, macroporosity and pore size distribution. The cohesion of the cement paste in liquid solutions was assessed by adding 2wt% sodium alginate to the liquid phase. This study suggests that the final macrostructure of the foamed cements can be controlled by varying the phosphate and surfactant concentrations in the liquid phase and the L/P ratio. Copyright © 2017 Elsevier B.V. All rights reserved.

Mineral resource of the month: hydraulic cement

USGS Publications Warehouse

van Oss, Hendrik G.

2012-01-01

Hydraulic cements are the binders in concrete and most mortars and stuccos. Concrete, particularly the reinforced variety, is the most versatile of all construction materials, and most of the hydraulic cement produced worldwide is portland cement or similar cements that have portland cement as a basis, such as blended cements and masonry cements. Cement typically makes up less than 15 percent of the concrete mix; most of the rest is aggregates. Not counting the weight of reinforcing media, 1 ton of cement will typically yield about 8 tons of concrete.

Fracture Strength of Monolithic All-Ceramic Crowns on Titanium Implant Abutments.

PubMed

Weyhrauch, Michael; Igiel, Christopher; Scheller, Herbert; Weibrich, Gernot; Lehmann, Karl Martin

2016-01-01

The fracture strengths of all-ceramic crowns cemented on titanium implant abutments may vary depending on crown materials and luting agents. The purpose of this study was to examine differences in fracture strength among crowns cemented on implant abutments using crowns made of seven different monolithic ceramic materials and five different luting agents. In total, 525 crowns (75 each of Vita Mark II, feldspathic ceramic [FSC]; Ivoclar Empress CAD, leucite-reinforced glass ceramic [LrGC]; Ivoclar e.max CAD, lithium disilicate [LiDS]; Vita Suprinity, presintered zirconia-reinforced lithium silicate ceramic [PSZirLS]; Vita Enamic, polymer-reinforced fine-structure feldspathic ceramic [PolyFSP], Lava Ultimate; resin nanoceramic [ResNC], Celtra Duo; fully crystallized zirconia-reinforced lithium silicate [FcZirLS]) were milled using a CAD/CAM system. The inner surfaces of the crowns were etched and silanized. Titanium implant abutments were fixed on implant analogs, and airborne-particle abrasion was used on their exterior specific adhesion surfaces (Al2O3, 50 μm). Then, the abutments were degreased and silanized. The crowns were cemented on the implant abutments using five luting agents (Multilink Implant, Variolink II, RelyX Unicem, GC FujiCEM, Panavia 2.0). After thermocycling for 5,000 cycles (5 to 55°C, 30 seconds dwell time), the crowns were subjected to fracture strength testing under static load using a universal testing machine. Statistical analyses were performed using analysis of variance (α = .0002) and the Bonferroni correction. No significant difference among the luting agents was found using the different all-ceramic materials. Ceramic materials LiDS, PSZirLS, PolyFSP, and ResNC showed significantly higher fracture strength values compared with FSC, FcZirLS, and LrGC. The PSZirLS especially showed significantly better results. Within the limitations of this study, fracture strength was not differentially affected by the various luting agents. However, the fracture strength was significantly higher for PSZirLS, PolyFSP, ResNC, and LiDS ceramics than for the FSP, LrGC, and the FcZirLS ceramic with all luting agents tested.

Pre-operative digital templating in cemented hip hemiarthroplasty for neck of femur fractures.

PubMed

Kwok, Iris H Y; Pallett, Scott J C; Massa, Edward; Cundall-Curry, Duncan; Loeffler, Mark D

2016-03-01

Pre-operative digital templating allows the surgeon to foresee any anatomical anomalies which may lead to intra-operative problems, and anticipate appropriate instruments and implants required during surgery. Although its role is well-established in successful elective total hip arthroplasty, little work has been done on its use in hip hemiarthroplasty in neck of femur fractures. We describe our initial experience of digital templating in 40 consecutive patients who have undergone cemented hip hemiarthroplasty, assessing templating accuracy between templated implant sizes to actual implant sizes. 81% of implanted heads were templated to within two head sizes, and 89% of implanted stems were templated to within two sizes. Although there was a moderately strong correlation of 0.52 between templated and actual head sizes, this correlation was not demonstrated in femoral stem sizes. Mean leg length discrepancy was -2.5mm (S.D. 8.5), and the mean difference in femoral offset between the operated and non-operated hip was -1mm (S.D. 4.4). Digital templating is a useful adjunct to the surgeon in pre-operative planning of hip hemiarthroplasty in the restoration of leg length and femoral offset. However, its accuracy is inferior to that of elective total hip arthroplasty. Copyright © 2016 Elsevier Ltd. All rights reserved.

Portland cement concrete pavement restoration : final summary report.

DOT National Transportation Integrated Search

1988-07-01

This final summary report is comprised of an Initial Construction Report; a Final Report; and two Interim Reports. These reports document the construction of Louisiana's Portland Cement Concrete Pavement Restoration project and its performance during...

Survival rates and bone loss after immediate loading of implants in fresh extraction sockets (single gaps). A clinical prospective study with 4 year follow-up

PubMed Central

Wojtovicz, Eduardo; España-Lopez, Antonio; Jimenez-Guerra, Alvaro; Monsalve-Guil, Loreto; Ortiz-Garcia, Ivan; Serrera-Figallo, Maria-Angeles

2018-01-01

Background The aim of this prospective study was to report the outcome of treatment with implants inserted after tooth extraction and immediately loaded. Material and Methods Fifty-six patients with single tooth loss were treated with 116 IPX Galimplant® implants with internal connections and a sandblasted, acid-etched surface. All implants were placed after tooth extraction using a flapless approach without bone regeneration, and they were then immediately loaded with cemented acrylic prostheses. After a period of three months, definitive cemented ceramic prostheses were placed. Patients were examined throughout a total of 4 years of follow-up. Marginal bone loss and survival rates were evaluated using digital periapical radiographs, taking into account clinical variables such as age, gender, smoking, history of periodontitis, etiology of extraction, placement site, diameter, and implant length. The Mann-Whitney U and Kruskal-Wallis non-parametric tests were used to compare differences between subgroups created based on the different clinical variables identified. Results Clinical results indicate an implant survival and success rate of 97.4%. Three implants were lost. Of the 116 immediate acrylic single crowns initially placed, 113 were replaced with definitive ceramic crowns after 3 months. A total of 77.8% of implants were inserted in the maxilla, while 22.2% were inserted in the mandible. No further complications were reported after the follow-up period (4 years). The mean marginal bone loss was 0.67 mm ± 0.40 mm. No differences were found among the subgroups of study patients. Conclusions This study indicates that dental implants that are inserted after tooth extraction and immediately loaded may constitute a successful and predictable alternative implant treatment. Key words:Dental implants, post-extraction implants, fresh sockets, immediate loading, immediate prostheses, implant dentistry. PMID:29476669

Overdenture retained by teeth using a definitive denture base technique: a case report.

PubMed

Nascimento, D F F; dos Santos, J F F; Marchini, L

2010-09-01

This paper presents a technique involving the use of a definitive denture base to make overdentures. Cores with ball attachments were cemented over remaining lower teeth. Impressions of the edentulous maxilla and mandible were taken to obtain a definitive acrylic resin base. The definitive base of the mandible was perforated at the location of ball attachments and its female components were fixed to the base using acrylic resin directly in the patient's mouth. Wax rims were then made, jaw relationships recorded, teeth mounted and tried in, and the dentures were cured. This technique allowed for easy fixing of female components and better retention during the recording of jaw relationships, and can also be used in the construction of implant retained dentures.

Fracture Strength of Titanium based Lithium Disilicate and Zirconia Abutment Crowns

DTIC Science & Technology

2017-06-12

to assisting you in your future publication/presentation efforts. LINDA STEEL -GOODWIN, Col, USAF, BSC Director, Clinical Investigations & Research...The specimens were cemented to a titanium-base implant system, subjected to thermocycling and cyclic loading, and fractured in a material testing...being lost. No complications were noted with respect to the abutments and only three crowns had complications (i.e., 2 debonded, 1 excess cement

[Total hip arthroplasty in post-dysplastic hip arthritis. Can type and position of the acetabular component influence longevity of the prosthesis?].

PubMed

Fousek, J; Indráková, P

2007-02-01

The aim of the study was a retrospective evaluation of our patients with post-dysplastic hips treated by cemented or non-cemented total hip arthroplasty (THA) in order to ascertain which type and position of the acetabular component was most effective. In the years 1999-2002, 111 THA procedures were performed in 93 patients, 76 women and 17 men, with post-dysplastic hip arthritis. The average age of the patients at the time of implantation was 52.6 years. On the basis of pre-operative radiographic findings, the patients' conditions were evaluated using the Hartofilakidis classification into three disease categories: dysplasia, low dislocation and high dislocation, and the patients were placed in two groups. Group 1 included 78 patients, and group 2 comprised 26 patients. None of our patients was classified as having high dislocation. Thirty-nine of these patients had previously undergone surgery for dysplastic hips. A total of 104 THAs were evaluated, because radiographic data was incomplete in seven cases. In addition to X-ray findings, the prosthesis type (cemented, hybrid, non-cemented), post-operative complications and signs of loosening were included in the evaluation. Clinical outcomes were assessed by the Harris score. The follow-up terminating on 31st December 2005 was 67 months on the average. In group 1 patients, the average Harris score increased from 38.6 to 80.3 points and in group 2 patients from 35.5 to 84.9 points, mostly with excellent and good results. In 72.1 % of the hips, a press-fit acetabular component was implanted. In 55.8 % of the cases, the acetabular component was implanted off the anatomical center of rotation, into the high hip center, with the range from 9 to 20 mm and an average of 15 mm. The average limb lengthening was 2.5 cm, ranging from 1.0 to 3.5 cm. Our results show that it is more effective to use non-cemented THA for post-dysplastic hips. The implantation of a noncemented acetabular component into the high center provides better covering of the cup with solid bone, without the necessity of cotyloplasty or structural graft use. Also, it does not markedly affect hip function or patients' subjective feelings.

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.

Possibilities of using aluminate cements in high-rise construction

NASA Astrophysics Data System (ADS)

Kaddo, Maria

2018-03-01

The article describes preferable ways of usage of alternative binders for high-rise construction based on aluminate cements. Possible areas of rational use of aluminate cements with the purpose of increasing the service life of materials and the adequacy of the durability of materials with the required durability of the building are analyzed. The results of the structure, shrinkage and physical and mechanical properties of concrete obtained from dry mixes on the base of aluminate cements for self-leveling floors are presented. To study the shrinkage mechanism of curing binders and to evaluate the role of evaporation of water in the development of shrinkage was undertaken experiment with simple unfilled systems: gypsum binder, portland cement and «corrosion resistant high alumina cement + gypsum». Principle possibility of binder with compensated shrinkage based on aluminate cement, gypsum and modern superplasticizers was defined, as well as cracking resistance and corrosion resistance provide durability of the composition.

The contemporary cement cycle of the United States

USGS Publications Warehouse

Kapur, A.; Van Oss, H. G.; Keoleian, G.; Kesler, S.E.; Kendall, A.

2009-01-01

A country-level stock and flow model for cement, an important construction material, was developed based on a material flow analysis framework. Using this model, the contemporary cement cycle of the United States was constructed by analyzing production, import, and export data for different stages of the cement cycle. The United States currently supplies approximately 80% of its cement consumption through domestic production and the rest is imported. The average annual net addition of in-use new cement stock over the period 2000-2004 was approximately 83 million metric tons and amounts to 2.3 tons per capita of concrete. Nonfuel carbon dioxide emissions (42 million metric tons per year) from the calcination phase of cement manufacture account for 62% of the total 68 million tons per year of cement production residues. The end-of-life cement discards are estimated to be 33 million metric tons per year, of which between 30% and 80% is recycled. A significant portion of the infrastructure in the United States is reaching the end of its useful life and will need to be replaced or rehabilitated; this could require far more cement than might be expected from economic forecasts of demand for cement. ?? 2009 Springer Japan.

13. GROOVED FOOTING (CONSTRUCTION KEY) EXTENDING ABOVE CEMENT FLOOR IN ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

13. GROOVED FOOTING (CONSTRUCTION KEY) EXTENDING ABOVE CEMENT FLOOR IN FIRST UNLINED SECTION BEYOND SOUTH PORTAL. - Salinas River Project, Cuesta Tunnel, Southeast of U.S. 101, San Luis Obispo, San Luis Obispo County, CA

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 ...

[Polyethylene abrasion: cause or consequence of an endoprosthesis loosening? Investigations of firm and loosened hip implants].

PubMed

Busse, B; Niecke, M; Püschel, K; Delling, G; Katzer, A; Hahn, M

2007-01-01

Periprosthetic tissue was analysed by the combination of different investigation techniques without destruction. The localisation and geometry of polyethylene abrasion particles were determined quantitatively to differentiate between abrasion due to function and abrasion due to implant loosening. Non-polyethylene particles from implant components which contaminate the tissue were micro-analytically measured. The results will help us to understand loosening mechanisms and thus lead to implant optimisations. A non-destructive particle analysis using highly sensitive proton-induced X-ray emission (PIXE) was developed to achieve a better histological allocation. Five autopsy cases with firmly fitting hip endoprosthesis (2 x Endo-Modell Mark III, 1 x St. Georg Mark II, LINK, Germany; 2 x Spongiosa Metal II, ESKA, Germany) were prepared as ground tissue specimens. Wear investigations were accomplished with a combined application of different microscopic techniques and microanalysis. The abrasion due to implant loosening was histologically evaluated on 293 loosened cup implants (St. Georg Mark II, LINK, Germany). Wear particles are heterogeneously distributed in the soft tissue. In cases of cemented prostheses, cement particles are dominating whereas metal particles could rarely be detected. The concentration of the alloy constituent cobalt (Co) is increased in the mineralised bone tissue. The measured co-depositions depend on the localisation and/or lifetime of an implant. Functional polyethylene (PE) abrasion needs to be differentiated from PE abrasion of another genesis (loosening, impingement) morphologically and by different tissue reactions. In the past a reduction of abrasion was targeted primarily by the optimisation of the bearing surfaces and tribology. The interpretation of our findings indicates that different mechanisms of origin in terms of tissue contamination with wear debris and the alloy should be included in the improvement of implants or implantation techniques.

Cement Mason's Curriculum. Instructional Units.

ERIC Educational Resources Information Center

Hendirx, Laborn J.; Patton, Bob

To assist cement mason instructors in providing comprehensive instruction to their students, this curriculum guide treats both the skills and information necessary for cement masons in commercial and industrial construction. Ten sections are included, as follow: related information, covering orientation, safety, the history of cement, and applying…

Fracture resistance of implant- supported monolithic crowns cemented to zirconia hybrid-abutments: zirconia-based crowns vs. lithium disilicate crowns

PubMed Central

Nawafleh, Noor; Öchsner, Andreas; George, Roy

2018-01-01

PURPOSE The aim of this in vitro study was to investigate the fracture resistance under chewing simulation of implant-supported posterior restorations (crowns cemented to hybrid-abutments) made of different all-ceramic materials. MATERIALS AND METHODS Monolithic zirconia (MZr) and monolithic lithium disilicate (MLD) crowns for mandibular first molar were fabricated using computer-aided design/computer-aided manufacturing technology and then cemented to zirconia hybrid-abutments (Ti-based). Each group was divided into two subgroups (n=10): (A) control group, crowns were subjected to single load to fracture; (B) test group, crowns underwent chewing simulation using multiple loads for 1.2 million cycles at 1.2 Hz with simultaneous thermocycling between 5℃ and 55℃. Data was statistically analyzed with one-way ANOVA and a Post-Hoc test. RESULTS All tested crowns survived chewing simulation resulting in 100% survival rate. However, wear facets were observed on all the crowns at the occlusal contact point. Fracture load of monolithic lithium disilicate crowns was statistically significantly lower than that of monolithic zirconia crowns. Also, fracture load was significantly reduced in both of the all-ceramic materials after exposure to chewing simulation and thermocycling. Crowns of all test groups exhibited cohesive fracture within the monolithic crown structure only, and no abutment fractures or screw loosening were observed. CONCLUSION When supported by implants, monolithic zirconia restorations cemented to hybrid abutments withstand masticatory forces. Also, fatigue loading accompanied by simultaneous thermocycling significantly reduces the strength of both of the all-ceramic materials. Moreover, further research is needed to define potentials, limits, and long-term serviceability of the materials and hybrid abutments. PMID:29503716

Is reverse hybrid hip replacement the solution?

PubMed

Lindalen, Einar; Havelin, Leif I; Nordsletten, Lars; Dybvik, Eva; Fenstad, Anne M; Hallan, Geir; Furnes, Ove; Høvik, Oystein; Röhrl, Stephan M

2011-12-01

Reverse hybrid hip replacement uses a cemented all-polyethylene cup and an uncemented stem. Despite increasing use of this method in Scandinavia, there has been very little documentation of results. We have therefore analyzed the results from the Norwegian Arthroplasty Register (NAR), with up to 10 years of follow-up. The NAR has been collecting data on total hip replacement (THR) since 1987. Reverse hybrid hip replacements were used mainly from 2000. We extracted data on reverse hybrid THR from this year onward until December 31, 2009, and compared the results with those from cemented implants over the same period. Specific cup/stem combinations involving 100 cases or more were selected. In addition, only combinations that were taken into use in 2005 or earlier were included. 3,963 operations in 3,630 patients were included. We used the Kaplan-Meier method and Cox regression analysis for estimation of prosthesis survival and relative risk of revision. The main endpoint was revision for any cause, but we also performed specific analyses on different reasons for revision. We found equal survival to that from cemented THR at 5 years (cemented: 97.0% (95% CI: 96.8-97.2); reverse hybrid: 96.7% (96.0-97.4)) and at 7 years (cemented: 96.0% (95.7-96.2); reverse hybrid: 95.6% (94.4-96.7)). Adjusted relative risk of revision of the reverse hybrids was 1.1 (0.9-1.4). In patients under 60 years of age, we found similar survival of the 2 groups at 5 and 7 years, with an adjusted relative risk of revision of reverse hybrids of 0.9 (0.6-1.3) compared to cemented implants. With a follow-up of up to 10 years, reverse hybrid THRs performed well, and similarly to all-cemented THRs from the same time period. The reverse hybrid method might therefore be an alternative to all-cemented THR. Longer follow-up time is needed to evaluate whether reverse hybrid hip replacement has any advantages over all-cemented THR.

FEM evaluation of cemented-retained versus screw-retained dental implant single-tooth crown prosthesis

PubMed Central

Cicciu, Marco; Bramanti, Ennio; Matacena, Giada; Guglielmino, Eugenio; Risitano, Giacomo

2014-01-01

Prosthetic rehabilitation of partial or total edentulous patients is today a challenge for clinicians and dental practitioners. The application of dental implants in order to recover areas of missing teeth is going to be a predictable technique, however some important points about the implant angulation, the stress distribution over the bone tissue and prosthetic components should be well investigated for having final long term clinical results. Two different system of the prosthesis fixation are commonly used. The screw retained crown and the cemented retained one. All of the two restoration techniques give to the clinicians several advantages and some disadvantages. Aim of this work is to evaluate all the mechanical features of each system, through engineering systems of investigations like FEM and Von Mises analyses. The FEM is today a useful tool for the prediction of stress effect upon material and biomaterial under load or strengths. Specifically three different area has been evaluated through this study: the dental crown with the bone interface; the passant screw connection area; the occlusal surface of the two different type of crown. The elastic features of the materials used in the study have been taken from recent literature data. Results revealed an adequate response for both type of prostheses, although cemented retained one showed better results over the occlusal area. PMID:24955150

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

Potential biomedical applications of ion beam technology

NASA Technical Reports Server (NTRS)

Banks, B. A.; Weigand, A. J.; Babbush, C. A.; Vankampen, C. L.

1976-01-01

Electron bombardment ion thrusters used as ion sources have demonstrated a unique capability to vary the surface morphology of surgical implant materials. The microscopically rough surface texture produced by ion beam sputtering of these materials may result in improvements in the biological response and/or performance of implanted devices. Control of surface roughness may result in improved attachment of the implant to soft tissue, hard tissue, bone cement, or components deposited from blood. Potential biomedical applications of ion beam texturing discussed include: vascular prostheses, artificial heart pump diaphragms, pacemaker fixation, percutaneous connectors, orthopedic pros-thesis fixtion, and dental implants.

Potential biomedical applications of ion beam technology

NASA Technical Reports Server (NTRS)

Banks, B. A.; Weigand, A. J.; Van Kampen, C. L.; Babbush, C. A.

1976-01-01

Electron bombardment ion thrusters used as ion sources have demonstrated a unique capability to vary the surface morphology of surgical implant materials. The microscopically rough surface texture produced by ion beam sputtering of these materials may result in improvements in the biological response and/or performance of implanted devices. Control of surface roughness may result in improved attachment of the implant to soft tissue, hard tissue, bone cement, or components deposited from blood. Potential biomedical applications of ion beam texturing discussed include: vascular prostheses, artificial heart pump diaphragms, pacemaker fixation, percutaneous connectors, orthopedic prosthesis fixation, and dental implants.

Asphalt cement chip seals in Oregon : construction report

DOT National Transportation Integrated Search

2000-06-01

Most chip seals in Oregon have been constructed using an emulsified asphalt binder. However, chip seals using an asphalt cement (hot oil) binder have been tried in limited situations in Oregon. This report includes a literature review and summarizes ...

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.

40 CFR 147.2104 - Requirements for all wells.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (PVC, ABS, or others) casings shall: (1) Not construct a well deeper than 500 feet; (2) Use cement and additives compatible with such casing material; and (3) Cement the annular space above the injection... feet below the lowermost USDW; (ii) Cementing surface casing by recirculating the cement to the surface...

40 CFR 147.305 - Requirements for all wells.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., and others) casings shall: (1) Not construct a well deeper than 500 feet; (2) Use cement and additives compatible with such casing material; (3) Cement the annular space above the injection interval from the... base of the lowermost USDW; (ii) Cementing surface casing by recirculating the cement to the surface...

40 CFR 147.2104 - Requirements for all wells.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (PVC, ABS, or others) casings shall: (1) Not construct a well deeper than 500 feet; (2) Use cement and additives compatible with such casing material; and (3) Cement the annular space above the injection... feet below the lowermost USDW; (ii) Cementing surface casing by recirculating the cement to the surface...

40 CFR 147.305 - Requirements for all wells.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., and others) casings shall: (1) Not construct a well deeper than 500 feet; (2) Use cement and additives compatible with such casing material; (3) Cement the annular space above the injection interval from the... base of the lowermost USDW; (ii) Cementing surface casing by recirculating the cement to the surface...

Assessment of high early strength limestone blended cement for next generation transportation structures : final report.

DOT National Transportation Integrated Search

2016-12-01

This research on Type IL cements for high early strength concretes demonstrated that Type IL cements satisfying AASHTO M 240 specifications may be used in place of Type I/II cements which satisfy AASHTO M 85 specifications for construction of transpo...

Defining the impaction frequency and threshold force required for femoral impaction grafting in revision hip arthroplasty

PubMed Central

2011-01-01

Background and purpose The two most common complications of femoral impaction bone grafting are femoral fracture and massive implant subsidence. We investigated fracture forces and implant subsidence rates in embalmed human femurs undergoing impaction grafting. The study consisted of two arms, the first examining the force at which femoral fracture occurs in the embalmed human femur, and the second examining whether significant graft implant/subsidence occurs following impaction at a set force at two different impaction frequencies. Methods Using a standardized impaction grafting technique with modifications, an initial group of 17 femurs underwent complete destructive impaction testing, allowing sequentially increased, controlled impaction forces to be applied until femoral fracture occurred. A second group of 8 femurs underwent impaction bone grafting at constant force, at an impaction frequency of 1 Hz or 10 Hz. An Exeter stem was cemented into the neomedullary canals. These constructs underwent subsidence testing simulating the first 2 months of postoperative weight bearing. Results No femurs fractured below an impaction force of 0.5 kN. 15/17 of the femurs fractured at or above 1.6 kN of applied force. In the second group of 8 femurs, all of which underwent femoral impaction grafting at 1.6 kN, there was no correlation between implant subsidence and frequency of impaction. Average subsidence was 3.2 (1–9) mm. Interpretation It is possible to calculate a force below which no fracture occurs in the embalmed human femur undergoing impaction grafting. Higher impaction frequency at constant force did not reduce rates of implant subsidence in this experiment. PMID:21689068

Outcome of total knee replacement following explantation and cemented spacer therapy.

PubMed

Ghanem, Mohamed; Zajonz, Dirk; Bollmann, Juliane; Geissler, Vanessa; Prietzel, Torsten; Moche, Michael; Roth, Andreas; Heyde, Christoph-E; Josten, Christoph

2016-01-01

Infection after total knee replacement (TKR) is one of the serious complications which must be pursued with a very effective therapeutic concept. In most cases this means revision arthroplasty, in which one-setting and two-setting procedures are distinguished. Healing of infection is the conditio sine qua non for re-implantation. This retrospective work presents an assessment of the success rate after a two-setting revision arthroplasty of the knee following periprosthetic infection. It further considers drawing conclusions concerning the optimal timing of re-implantation. A total of 34 patients have been enclosed in this study from September 2005 to December 2013. 35 re-implantations were carried out following explantation of total knee and implantation of cemented spacer. The patient's group comprised of 53% (18) males and 47% (16) females. The average age at re-implantation time was 72.2 years (ranging from 54 to 85 years). We particularly evaluated the microbial spectrum, the interval between explantation and re-implantation, the number of surgeries that were necessary prior to re-implantation as well as the postoperative course. We reported 31.4% (11) reinfections following re-implantation surgeries. The number of the reinfections declined with increasing time interval between explantation and re-implantation. Patients who developed reinfections were operated on (re-implantation) after an average of 4.47 months. Those patients with uncomplicated course were operated on (re-implantation) after an average of 6.79 months. Nevertheless, we noticed no essential differences in outcome with regard to the number of surgeries carried out prior to re-implantation. Mobile spacers proved better outcome than temporary arthrodesis with intramedullary fixation. No uniform strategy of treatment exists after peri-prosthetic infections. In particular, no optimal timing can be stated concerning re-implantation. Our data point out to the fact that a longer time interval between explantation and re-implantation reduces the rate of reinfection. From our point of view, the optimal timing for re-implantation depends on various specific factors and therefore it should be defined individually.

Outcome of total knee replacement following explantation and cemented spacer therapy

PubMed Central

Ghanem, Mohamed; Zajonz, Dirk; Bollmann, Juliane; Geissler, Vanessa; Prietzel, Torsten; Moche, Michael; Roth, Andreas; Heyde, Christoph-E.; Josten, Christoph

2016-01-01

Background: Infection after total knee replacement (TKR) is one of the serious complications which must be pursued with a very effective therapeutic concept. In most cases this means revision arthroplasty, in which one-setting and two-setting procedures are distinguished. Healing of infection is the conditio sine qua non for re-implantation. This retrospective work presents an assessment of the success rate after a two-setting revision arthroplasty of the knee following periprosthetic infection. It further considers drawing conclusions concerning the optimal timing of re-implantation. Patients and methods: A total of 34 patients have been enclosed in this study from September 2005 to December 2013. 35 re-implantations were carried out following explantation of total knee and implantation of cemented spacer. The patient’s group comprised of 53% (18) males and 47% (16) females. The average age at re-implantation time was 72.2 years (ranging from 54 to 85 years). We particularly evaluated the microbial spectrum, the interval between explantation and re-implantation, the number of surgeries that were necessary prior to re-implantation as well as the postoperative course. Results: We reported 31.4% (11) reinfections following re-implantation surgeries. The number of the reinfections declined with increasing time interval between explantation and re-implantation. Patients who developed reinfections were operated on (re-implantation) after an average of 4.47 months. Those patients with uncomplicated course were operated on (re-implantation) after an average of 6.79 months. Nevertheless, we noticed no essential differences in outcome with regard to the number of surgeries carried out prior to re-implantation. Mobile spacers proved better outcome than temporary arthrodesis with intramedullary fixation. Conclusion: No uniform strategy of treatment exists after peri-prosthetic infections. In particular, no optimal timing can be stated concerning re-implantation. Our data point out to the fact that a longer time interval between explantation and re-implantation reduces the rate of reinfection. From our point of view, the optimal timing for re-implantation depends on various specific factors and therefore it should be defined individually. PMID:27066391

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.

Digital versus conventional techniques for pattern fabrication of implant-supported frameworks

PubMed Central

Alikhasi, Marzieh; Rohanian, Ahmad; Ghodsi, Safoura; Kolde, Amin Mohammadpour

2018-01-01

Objective: The aim of this experimental study was to compare retention of frameworks cast from wax patterns fabricated by three different methods. Materials and Methods: Thirty-six implant analogs connected to one-piece abutments were divided randomly into three groups according to the wax pattern fabrication method (n = 12). Computer-aided design/computer-aided manufacturing (CAD/CAM) milling machine, three-dimensional printer, and conventional technique were used for fabrication of waxing patterns. All laboratory procedures were performed by an expert-reliable technician to eliminate intra-operator bias. The wax patterns were cast, finished, and seated on related abutment analogs. The number of adjustment times was recorded and analyzed by Kruskal–Wallis test. Frameworks were cemented on the corresponding analogs with zinc phosphate cement and tensile resistance test was used to measure retention value. Statistical Analysis Used: One-way analysis of variance (ANOVA) and post hoc Tukey tests were used for statistical analysis. Level of significance was set at P < 0.05. Results: The mean retentive values of 680.36 ± 21.93 N, 440.48 ± 85.98 N, and 407.23 ± 67.48 N were recorded for CAD/CAM, rapid prototyping, and conventional group, respectively. One-way ANOVA test revealed significant differences among the three groups (P < 0.001). The post hoc Tukey test showed significantly higher retention for CAD/CAM group (P < 0.001), while there was no significant difference between the two other groups (P = 0.54). CAD/CAM group required significantly more adjustments (P < 0.001). Conclusions: CAD/CAM-fabricated wax patterns showed significantly higher retention for implant-supported cement-retained frameworks; this could be a valuable help when there are limitations in the retention of single-unit implant restorations. PMID:29657528

Digital versus conventional techniques for pattern fabrication of implant-supported frameworks.

PubMed

Alikhasi, Marzieh; Rohanian, Ahmad; Ghodsi, Safoura; Kolde, Amin Mohammadpour

2018-01-01

The aim of this experimental study was to compare retention of frameworks cast from wax patterns fabricated by three different methods. Thirty-six implant analogs connected to one-piece abutments were divided randomly into three groups according to the wax pattern fabrication method ( n = 12). Computer-aided design/computer-aided manufacturing (CAD/CAM) milling machine, three-dimensional printer, and conventional technique were used for fabrication of waxing patterns. All laboratory procedures were performed by an expert-reliable technician to eliminate intra-operator bias. The wax patterns were cast, finished, and seated on related abutment analogs. The number of adjustment times was recorded and analyzed by Kruskal-Wallis test. Frameworks were cemented on the corresponding analogs with zinc phosphate cement and tensile resistance test was used to measure retention value. One-way analysis of variance (ANOVA) and post hoc Tukey tests were used for statistical analysis. Level of significance was set at P < 0.05. The mean retentive values of 680.36 ± 21.93 N, 440.48 ± 85.98 N, and 407.23 ± 67.48 N were recorded for CAD/CAM, rapid prototyping, and conventional group, respectively. One-way ANOVA test revealed significant differences among the three groups ( P < 0.001). The post hoc Tukey test showed significantly higher retention for CAD/CAM group ( P < 0.001), while there was no significant difference between the two other groups ( P = 0.54). CAD/CAM group required significantly more adjustments ( P < 0.001). CAD/CAM-fabricated wax patterns showed significantly higher retention for implant-supported cement-retained frameworks; this could be a valuable help when there are limitations in the retention of single-unit implant restorations.

10. Downstream face of Mormon Flat Dam under construction. Cement ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

10. Downstream face of Mormon Flat Dam under construction. Cement storage shed is at center right. Photographer unknown, September 1924. Source: Salt River Project. - Mormon Flat Dam, On Salt River, Eastern Maricopa County, east of Phoenix, Phoenix, Maricopa County, AZ

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...

Evaluation of a platelet lysate bilayered system for periodontal regeneration in a rat intrabony three-wall periodontal defect.

PubMed

Babo, Pedro S; Cai, Xinjie; Plachokova, Adelina S; Reis, Rui L; Jansen, John; Gomes, Manuela E; Walboomers, X Frank

2018-02-01

With currently available therapies, full regeneration of lost periodontal tissues after periodontitis cannot be achieved. In this study, a combined compartmentalized system was tested, composed of (a) a platelet lysate (PL)-based construct, which was placed along the root aiming to regenerate the root cementum and periodontal ligament, and (b) a calcium phosphate cement composite incorporated with hyaluronic acid microspheres loaded with PL, aiming to promote the regeneration of alveolar bone. This bilayered system was assessed in a 3-wall periodontal defect in Wistar rats. The periodontal healing and the inflammatory response of the materials were scored for a period up to 6 weeks after implantation. Furthermore, histomorphometrical measurements were performed to assess the epithelial downgrowth, the formation of alveolar bone, and the formation of new connective tissue attachment. Our data showed that the stabilization of platelet-origin proteins on the root surface increased the overall periodontal healing score and restricted the formation of long epithelial junctions. Nevertheless, the faster degradation of the cement component with incorporated hyaluronic acid microspheres compromised the stability of the system, which hampered the periodontal regeneration. Overall, in this work, we proved the positive therapeutic effect of the immobilization of a PL-based construct over the root surface in a combined compartmentalized system to assist predictable healing of functional periodontium. Therefore, after optimization of the hard tissue analogue, the system should be further elaborated in (pre)clinical validation studies. Copyright © 2017 John Wiley & Sons, Ltd.

The Use of Ion Implantation for Materials Processing.

DTIC Science & Technology

1980-10-06

consists of a series of sections, each section being an annular insulator (glass) and a shaped metal electrode (polished aluminum ) cemented together. A...depending on the ion species, semiconductor material, attached materials (such as aluminum leads), implantation energy, and dose; but some devices are...concentration of subsurface carbon. Appearing directly beneath the oxide layer, the C concentration first reaches a maximum of about five times the bulk

Fracture strength and probability of survival of narrow and extra-narrow dental implants after fatigue testing: In vitro and in silico analysis.

PubMed

Bordin, Dimorvan; Bergamo, Edmara T P; Fardin, Vinicius P; Coelho, Paulo G; Bonfante, Estevam A

2017-07-01

To assess the probability of survival (reliability) and failure modes of narrow implants with different diameters. For fatigue testing, 42 implants with the same macrogeometry and internal conical connection were divided, according to diameter, as follows: narrow (Ø3.3×10mm) and extra-narrow (Ø2.9×10mm) (21 per group). Identical abutments were torqued to the implants and standardized maxillary incisor crowns were cemented and subjected to step-stress accelerated life testing (SSALT) in water. The use-level probability Weibull curves, and reliability for a mission of 50,000 and 100,000 cycles at 50N, 100, 150 and 180N were calculated. For the finite element analysis (FEA), two virtual models, simulating the samples tested in fatigue, were constructed. Loading at 50N and 100N were applied 30° off-axis at the crown. The von-Mises stress was calculated for implant and abutment. The beta (β) values were: 0.67 for narrow and 1.32 for extra-narrow implants, indicating that failure rates did not increase with fatigue in the former, but more likely were associated with damage accumulation and wear-out failures in the latter. Both groups showed high reliability (up to 97.5%) at 50 and 100N. A decreased reliability was observed for both groups at 150 and 180N (ranging from 0 to 82.3%), but no significant difference was observed between groups. Failure predominantly involved abutment fracture for both groups. FEA at 50N-load, Ø3.3mm showed higher von-Mises stress for abutment (7.75%) and implant (2%) when compared to the Ø2.9mm. There was no significant difference between narrow and extra-narrow implants regarding probability of survival. The failure mode was similar for both groups, restricted to abutment fracture. Copyright © 2017 Elsevier Ltd. All rights reserved.

Management of Broken Dental Implant Abutment in a Patient with Bruxism: A Rare Case Report and Review of Literature.

PubMed

Al-Almaie, Saad

2017-01-01

This rare case report describes prosthodontic complications resulting from a dental implant was placed surgically more distally in the area of the missing mandibular first molar with a cantilever effect and a crest width of >12 mm in a 59-year-old patient who had a history of bruxism. Fracture of abutment is a common complication in implant was placed in area with high occlusal forces. Inability to remove the broken abutment may most often end up in discarding the implant. Adding one more dental implant mesially to the previously placed implant, improvisation of technique to remove the broken abutment without sacrificing the osseointegrated dental implant, fabrication with cemented custom-made abutment to replace the broken abutment for the first implant, and the use of the two implants to replace a single molar restoration proved reliable and logical treatment solutions to avoid these prosthodontic complications.

The Influence of Cement Morphology Parameters on the Strength of the Cement-Bone Interface in Tibial Tray Fixation.

PubMed

Nagel, Katrin; Bishop, Nicholas E; Schlegel, Ulf J; Püschel, Klaus; Morlock, Michael M

2017-02-01

The strength of the cement-bone interface in tibial component fixation depends on the morphology of the cement mantle. The purpose of this study was to identify thresholds of cement morphology parameters to maximize fixation strength using a minimum amount of cement. Twenty-three cadaveric tibiae were analyzed that had been implanted with tibial trays in previous studies and for which the pull-out strength of the tray had been measured. Specimens were separated into a group failing at the cement-bone interface (INTERFACE) and one failing in the bulk bone (BULK). Maximum pull-out strength corresponds to the ultimate strength of the bulk bone if the cement-bone interface is sufficiently strong. 3D models of the cement mantle in situ were reconstructed from computed tomography scans. The influences of bone mineral density and 6 cement morphology parameters (reflecting cement penetration, bone-cement interface, cement volume) on pull-out strength of the BULK group were determined using multiple regression analysis. The threshold of each parameter for classification of the specimens into either group was determined using receiver operating characteristic analysis. Cement penetration exceeding a mean of 1.1 mm or with a maximum of 5.6 mm exclusively categorized all BULK bone failure specimens. Failure strength of BULK failure specimens increased with bone mineral density (R 2  = 0.67, P < .001) but was independent of the cement morphology parameters. To maximize fixation strength, a mean cement penetration depth of at least 1.1 mm should be achieved during tibial tray cementing. Copyright © 2016 Elsevier Inc. All rights reserved.

Development of calcium phosphate cement using chitosan and citric acid for bone substitute materials.

PubMed

Yokoyama, Atsuro; Yamamoto, Satoru; Kawasaki, Takao; Kohgo, Takao; Nakasu, Masanori

2002-02-01

We developed a calcium phosphate cement that could be molded into any desired shape due to its chewing-gum-like consistency after mixing. The powder component of the cement consists of alpha-tricalcium phosphate and tetracalcium phosphate, which were made by decomposition of hydroxyapatite ceramic blocks. The liquid component consists of citric acid, chitosan and glucose solution. In this study, we used 20% citric acid (group 20) and 45% citric acid (group 45). The mechanical properties and biocompatibility of this new cement were investigated. The setting times of cements were 5.5 min, in group 20 and 6.4 min, in group 45. When incubated in physiological saline, the cements were transformed to hydroxyapatite at 3, and 6 weeks, the compressive strengths were 15.6 and 20.7 MPa, in group 45 and group 20, respectively. The inflammatory response around the cement implanted on the bone and in the subcutaneous tissue in rats was more prominent in group 45 than in group 20 at 1 week after surgery. After 4 weeks, the inflammation disappeared and the cement had bound to bone in both groups. These results indicate that this new calcium phosphate cement is a suitable bone substitute material and that the concentration of citric acid in the liquid component affects its mechanical properties and biocompatibility.

A Navy User’s Guide for Quality Assurance of New Concrete Construction

DTIC Science & Technology

2012-06-01

types and blends of cements, fly ash, silica fume, and blast furnace slag . During construction, concrete samples are taken to test and document the...chemical compositions provided by specific types and blends of cements, fly ash, silica fume, and blast furnace slag when used with specific aggregates...of portland cement and blast furnace slag . Before the 11 owner accepts the completed structure, all cracks transverse to the steel rebar in excess

Octenidine in combination with polymethylmethacrylate: a new option for preventing infection?

PubMed

Weckbach, Sebastian; Möricke, Angelika; Braunwarth, Horst; Goroncy-Bermes, Peter; Bischoff, Mark; Gebhard, Florian

2012-01-01

Orthopedic implant infections represent a serious complication for both patient and surgeon. In order to minimize this risk, it has become standard practice in surgery and orthopedics to add antimicrobial substances to the polymethylmethacrylate (PMMA) bone cement. The aim of this study is to find new options for preventing infection by using alternative adjuvants in combination with PMMA. We hypothesized, that Octenidine, after being combined with PMMA, can be released in vitro and an antimicrobial efficacy of discharged Octenidine can be shown. The release of Octenidine from PMMA was assessed in high pressure liquid chromatography of the supernatant. In order to assess the efficacy of Octenidine on Staphylococcus aureus and Pseudomonas aeruginosa in vitro, a nutrient solution for these bacteria was incubated with a defined number of these bacteria (10(6) colony forming units) and cement pellets containing the antiseptic Octenidine for 24 h. After the incubation the number of bacteria in the solution was determined by counting the colony forming units on blood agar plates. Octenidine was shown to be released in a concentration-dependent manner from PMMA in the elution experiment. The experimental procedure using S. aureus demonstrated a bactericidal effect for bone cement containing Octenidine. For P. aeruginosa, bone cement containing 5-8% Octenidine was associated with tenfold reduction in bacterial count. These results suggest that Octenidine is released after combining it with PMMA and reaches working concentrations in vitro. These findings suggest a new and effective alternative for prevention of infection in cemented implants. Further investigations on the biocompatibility of this combination is needed.

Results of Laboratory Tests of the Filtration Characteristics of Clay-Cement Concrete

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

Sol’skii, S. V., E-mail: solskiysv@vniig.ru; Lopatina, M. G., E-mail: LoptainaMG@vniig.ru; Legina, E. E.

Laboratory studies of the filtration characteristics of clay-cement concrete materials for constructing filtering diaphragms of earth dams by the method of secant piles are reported. Areas for further study aimed at improving the quality of construction, increasing operational safety, and developing a standards base for the design, construction, and operation of these systems are discussed.

Construction, Instrumentation, and Testing of Fast-Setting Hydraulic Cement Concrete in Palmdale, California

DOT National Transportation Integrated Search

2000-08-01

To minimize the lane closure time for construction, Caltrans is exploring the use of fast-setting hydraulic cement concrete (FSHCC). The principal property of the FSHCC is its high early strength gain. This accelerated strength gain would increase th...

Low Carbon Footprint mortar from Pozzolanic Waste Material

NASA Astrophysics Data System (ADS)

Mehmannavaz, Taha; Mehman navaz, Hossein Ali; Moayed Zefreh, Fereshteh; Aboata, Zahra

2017-04-01

Nowadays, Portland cement clinker leads to emission of CO2 into the atmosphere and therefore causes greenhouse effect. Incorporating of Palm Oil Fuel Ash (POFA) and Pulverized Fuel Ash (PFA) as partial cement replacement materials into mix of low carbon mortar decreases the amount of cement use and reduces high dependence on cements compared to ordinary mortar. The result of this research supported use of the new concept in preparing low carbon mortar for industrial constructions. Strength of low carbon mortar with POFA and PFA replacement in cement was affected and changed by replacing percent finesse, physical and chemical properties and pozzolanic activity of these wastes. Waste material replacement instead of Ordinary Portland Cement (OPC) was used in this study. This in turn was useful for promoting better quality of construction and innovative systems in construction industry, especially in Malaysia. This study was surely a step forward to achieving quality products which were affordable, durable and environmentally friendly. Disposing ash contributes to shortage of landfill space in Malaysia. Besides, hazard of ash might be another serious issue for human health. The ash disposal area also might create a new problem, which is the area's sedimentation and erosion.

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.

Pozzolan cement study : final report.

DOT National Transportation Integrated Search

1979-12-01

An experimental section using Type 1P cement concrete was poured on an active construction project in south Louisiana, near Franklin. A comparison in quality was made between this section and the normal Type 1(B) cement concrete poured on the remaind...

Assessment of limestone blended cements for transportation applications : final report.

DOT National Transportation Integrated Search

2017-09-01

This research assessed the applicability of Type IL cements satisfying AASHTO M 240 specifications for use in transportation applications in place of Type I/II cements which satisfy AASHTO M 85 specifications for construction of transportation struct...

Vancomycin-Loaded Polymethylmethacrylate Spacers Fail to Eradicate Periprosthetic Joint Infection in a Clinically Representative Mouse Model.

PubMed

Carli, Alberto V; Bhimani, Samrath; Yang, Xu; de Mesy Bentley, Karen L; Ross, F Patrick; Bostrom, Mathias P G

2018-06-06

Periprosthetic joint infection (PJI) remains a devastating complication following total joint arthroplasty. Current animal models of PJI do not effectively recreate the clinical condition and thus provide limited help in understanding why treatments fail. We developed a mouse model of the first-stage surgery of a 2-stage revision for PJI involving a 3-dimensionally printed Ti-6Al-4V implant and a mouse-sized cement spacer that elutes vancomycin. Vancomycin was mixed with polymethylmethacrylate (PMMA) cement and inserted into custom-made mouse-sized spacer molds. Twenty C57BL/6 mice received a proximal tibial implant and an intra-articular injection of 3 × 10 colony-forming units of Staphylococcus aureus Xen36. At 2 weeks, 9 mice underwent irrigation and debridement of the leg with revision of the implant to an articulating vancomycin-loaded PMMA spacer. Postoperatively, mice underwent radiography and serum inflammatory-marker measurements. Following euthanasia of the mice at 6 weeks, bone and soft tissues were homogenized to quantify bacteria within periprosthetic tissues. Implants and articulating spacers were either sonicated to quantify adherent bacteria or examined under scanning electron microscopy (SEM) to characterize the biofilm. Vancomycin-loaded PMMA spacers eluted vancomycin for ≤144 hours and retained antimicrobial activity. Control mice had elevated levels of inflammatory markers, radiographic evidence of septic loosening of the implant, and osseous destruction. Mice treated with a vancomycin-loaded PMMA spacer had significantly lower levels of inflammatory markers (p < 0.01), preserved tibial bone, and no intra-articular purulence. Retrieved vancomycin-loaded spacers exhibited significantly lower bacterial counts compared with implants (p < 0.001). However, bacterial counts in periprosthetic tissue did not significantly differ between the groups. SEM identified S. aureus encased within biofilm on control implants, while vancomycin-loaded spacers contained no bacteria. This animal model is a clinically representative model of PJI treatment. The results suggest that the antimicrobial effects of PMMA spacers are tightly confined to the articular space and must be utilized in conjunction with thorough tissue debridement and systemic antibiotics. These data provide what we believe to be the first insight into the effect of antibiotic-loaded cement spacers in a clinically relevant animal model and justify the adjunctive use of intravenous antibiotics when performing a 2-stage revision for PJI.

Randomized clinical trial of implant-supported ceramic-ceramic and metal-ceramic fixed dental prostheses: preliminary results.

PubMed

Esquivel-Upshaw, Josephine F; Clark, Arthur E; Shuster, Jonathan J; Anusavice, Kenneth J

2014-02-01

The aim of this study was to determine the survival rates over time of implant-supported ceramic-ceramic and metal-ceramic prostheses as a function of core-veneer thickness ratio, gingival connector embrasure design, and connector height. An IRB-approved, randomized, controlled clinical trial was conducted as a single-blind pilot study involving 55 patients missing three teeth in either one or two posterior areas. These patients (34 women; 21 men; age range 52-75 years) were recruited for the study to receive a three-unit implant-supported fixed dental prosthesis (FDP). Two implants were placed for each of the 72 FDPs in the study. The implants (Osseospeed, Astra Tech), which were made of titanium, were grit blasted. A gold-shaded, custom-milled titanium abutment (Atlantis, Astra Tech), was secured to each implant body. Each of the 72 FDPs in 55 patients were randomly assigned based on one of the following options: (1) A. ceramic-ceramic (Yttria-stabilized zirconia core, pressable fluorapatite glass-ceramic, IPS e.max ZirCAD, and ZirPress, Ivoclar Vivadent) B. metal-ceramic (palladium-based noble alloy, Capricorn, Ivoclar Vivadent, with press-on leucite-reinforced glass-ceramic veneer, IPS InLine POM, Ivoclar Vivadent); (2) occlusal veneer thickness (0.5, 1.0, and 1.5 mm); (3) curvature of gingival embrasure (0.25, 0.5, and 0.75 mm diameter); and (4) connector height (3, 4, and 5 mm). FDPs were fabricated and cemented with dual-cure resin cement (RelyX, Universal Cement, 3M ESPE). Patients were recalled at 6 months, 1 year, and 2 years. FDPs were examined for cracks, fracture, and general surface quality. Recall exams of 72 prostheses revealed 10 chipping fractures. No fractures occurred within the connector or embrasure areas. Two-sided Fisher's exact tests showed no significant correlation between fractures and type of material system (p = 0.51), veneer thickness (p = 0.75), radius of curvature of gingival embrasure (p = 0.68), and connector height (p = 0.91). Although there were no significant associations between connector height, curvature of gingival embrasure, core/veneer thickness ratio, and material system and the survival probability of implant-supported FDPs with zirconia as a core material, the small number of fractures precludes a definitive conclusion on the dominant controlling factor. © 2013 by the American College of Prosthodontists.

Randomized Clinical Trial of Implant-Supported Ceramic-Ceramic and Metal-Ceramic Fixed Dental Prostheses: Preliminary Results

PubMed Central

Esquivel-Upshaw, Josephine F.; Clark, Arthur E.; Shuster, Jonathan J.; Anusavice, Kenneth J.

2013-01-01

Purpose The aim of this study was to determine the survival rates over time of implant-supported ceramic-ceramic and metal-ceramic prostheses as a function of core-veneer thickness ratio, gingival connector embrasure design, and connector height. Materials and Methods An IRB-approved, randomized, controlled clinical trial was conducted as a single-blind pilot study involving 55 patients missing three teeth in either one or two posterior areas. These patients (34 women; 21 men; age range 52–75 years) were recruited for the study to receive a 3-unit implant-supported fixed dental prosthesis (FDP). Two implants were placed for each of the 72 FDPs in the study. The implants (Osseospeed, Astra Tech), which were made of titanium, were grit blasted. A gold-shaded, custom-milled titanium abutment (Atlantis, Astra Tech), was secured to each implant body. Each of the 72 FDPs in 55 patients were randomly assigned based on one of the following options: (1) A. Material: ceramic-ceramic (Yttria-stabilized zirconia core, pressable fluorapatite glass-ceramic, IPS e.max ZirCAD and ZirPress, Ivoclar Vivadent) B. metal-ceramic (palladium-based noble alloy, Capricorn, Ivoclar Vivadent, with press-on leucite-reinforced glass-ceramic veneer, IPS InLine POM, Ivoclar Vivadent); (2) occlusal veneer thickness (0.5, 1.0, and 1.5 mm); (3) curvature of gingival embrasure (0.25, 0.5, and 0.75 mm diameter); and (4) connector height (3, 4, and 5 mm). FDPs were fabricated and cemented with dual-cure resin cement (RelyX, Universal Cement, 3M ESPE). Patients were recalled at 6 months, 1 year, and 2 years. FDPs were examined for cracks, fracture, and general surface quality. Results Recall exams of 72 prostheses revealed 10 chipping fractures. No fractures occurred within the connector or embrasure areas. Two-sided Fisher’s exact tests showed no significant correlation between fractures and type of material system (p = 0.51), veneer thickness (p = 0.75), radius of curvature of gingival embrasure (p = 0.68), and connector height (p = 0.91). Conclusions Although there were no significant associations between connector height, curvature of gingival embrasure, core/veneer thickness ratio, and material system and the survival probability of implant-supported FDPs with zirconia as a core material, the small number of fractures precludes a definitive conclusion on the dominant controlling factor. PMID:23758092

Evaluation of cement and fly ash treated RAP and aggregates for base construction : research project capsule

DOT National Transportation Integrated Search

2009-03-01

INTRODUCTION: Many entities currently use recycled asphalt pavement (RAP) and other aggregates as base material, temporary haul roads, and in hot mix asphalt construction. Several states allow the use of RAP combined with cement for stabilized base c...

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...

Evaluation of cement and fly ash treated recycled asphalt pavement and aggregates for base construction.

DOT National Transportation Integrated Search

2011-12-01

Many entities currently use recycled asphalt pavement (RAP) and other aggregates as base material, temporary haul roads, : and, in the case of RAP, hot mix asphalt construction. Several states currently allow the use of RAP combined with cement : for...

Perioperative mortality after hemiarthroplasty related to fixation method.

PubMed

Costain, Darren J; Whitehouse, Sarah L; Pratt, Nicole L; Graves, Stephen E; Ryan, Philip; Crawford, Ross W

2011-06-01

The appropriate fixation method for hemiarthroplasty of the hip as it relates to implant survivorship and patient mortality is a matter of ongoing debate. We examined the influence of fixation method on revision rate and mortality. We analyzed approximately 25,000 hemiarthroplasty cases from the AOA National Joint Replacement Registry. Deaths at 1 day, 1 week, 1 month, and 1 year were compared for all patients and among subgroups based on implant type. Patients treated with cemented monoblock hemiarthroplasty had a 1.7-times higher day-1 mortality compared to uncemented monoblock components (p < 0.001). This finding was reversed by 1 week, 1 month, and 1 year after surgery (p < 0.001). Modular hemiarthroplasties did not reveal a difference in mortality between fixation methods at any time point. This study shows lower (or similar) overall mortality with cemented hemiarthroplasty of the hip.

Overcoming boundaries of worldwide joint arthroplasty registers: the European Arthroplasty Register minimal dataset.

PubMed

Sadoghi, Patrick; Leithner, Andreas; Labek, Gerold

2013-09-01

Worldwide joint arthroplasty registers are instrumental to screen for complications or implant failures. In order to achieve comparable results a similar classification dataset is essential. The authors therefore present the European Federation of National Associations of Orthopaedics and Traumatology (EFORT) European Arthroplasty Register (EAR) minimal dataset for primary and revision joint arthroplasty. Main parameters include the following: date of operation, country, hospital ID-code, patient's name and prename, birthday, identification code of the implant, gender, diagnosis, preoperations, type of prosthesis (partial, total), side, cementation technique, use of antibiotics in the cement, surgical approach, and others specifically related to the affected joint. The authors believe that using this minimal dataset will improve the chance for a worldwide comparison of arthroplasty registers and ask future countries for implementation. Copyright © 2013 Elsevier Inc. All rights reserved.

Wastewater Sludge Used as Material for Bricks Fabrication

NASA Astrophysics Data System (ADS)

Jianu, N. R.; Moga, I. C.; Pricop, F.; Chivoiu, A.

2018-06-01

Current world trends related to wastewater sludges are: reuse in agriculture, utilization as retaining material for petroleum products or utilization in construction. Bricks from sand-cement or autoclaved cellular concrete are commonly used in construction. The authors propose innovative receipts for bricks and plasters based on textile wastewaters sludge. Centrifuged sludge is mixed with cement to obtain bricks and plaster. For bricks, the mixture is represented by 45% cement and 55% sludge. The paper presents the obtained results and the new materials used for bricks fabrication.

In vitro assessment of nanosilver-functionalized PMMA bone cement on primary human mesenchymal stem cells and osteoblasts.

PubMed

Pauksch, Linda; Hartmann, Sonja; Szalay, Gabor; Alt, Volker; Lips, Katrin S

2014-01-01

Peri-prosthetic infections caused by multidrug resistant bacteria have become a serious problem in surgery and orthopedics. The aim is to introduce biomaterials that avoid implant-related infections caused by multiresistant bacteria. The efficacy of silver nanoparticles (AgNP) against a broad spectrum of bacteria and against multiresistant pathogens has been repeatedly described. In the present study polymethylmethacrylate (PMMA) bone cement functionalized with AgNP and/or gentamicin were tested regarding their biocompatibility with bone forming cells. Therefore, influences on viability, cell number and differentiation of primary human mesenchymal stem cells (MSCs) and MSCs cultured in osteogenic differentiation media (MSC-OM) caused by the implant materials were studied. Furthermore, the growth behavior and the morphology of the cells on the testing material were observed. Finally, we examined the induction of cell stress, regarding antioxidative defense and endoplasmatic reticulum stress. We demonstrated similar cytocompatibility of PMMA loaded with AgNP compared to plain PMMA or PMMA loaded with gentamicin. There was no decrease in cell number, viability and osteogenic differentiation and no induction of cell stress for all three PMMA variants after 21 days. Addition of gentamicin to AgNP-loaded PMMA led to a slight decrease in osteogenic differentiation. Also an increase in cell stress was detectable for PMMA loaded with gentamicin and AgNP. In conclusion, supplementation of PMMA bone cement with gentamicin, AgNP, and both results in bone implants with an antibacterial potency and suitable cytocompatibility in MSCs and MSC-OM.

In vitro comparison of fracture load of implant-supported, zirconia-based, porcelain- and composite-layered restorations after artificial aging.

PubMed

Komine, Futoshi; Taguchi, Kohei; Fushiki, Ryosuke; Kamio, Shingo; Iwasaki, Taro; Matsumura, Hideo

2014-01-01

This study evaluated fracture load of single-tooth, implant-supported, zirconia-based, porcelain- and indirect composite-layered restorations after artificial aging. Forty-four zirconia-based molar restorations were fabricated on implant abutments and divided into four groups, namely, zirconia-based all-ceramic restorations (ZAC group) and three types of zirconia-based composite-layered restorations (ZIC-P, ZIC-E, and ZIC groups). Before layering an indirect composite material, the zirconia copings in the ZIC-P and ZIC-E groups were primed with Clearfil Photo Bond and Estenia Opaque Primer, respectively. All restorations were cemented on the abutments with glass-ionomer cement and then subjected to thermal cycling and cyclic loading. All specimens survived thermal cycling and cyclic loading. The fracture load of the ZIC-P group (2.72 kN) was not significantly different from that of the ZAC group (3.05 kN). The fracture load of the zirconia-based composite-layered restoration primed with Clearfil Photo Bond (ZIC-P) was comparable to that of the zirconia-based all-ceramic restoration (ZAC) after artificial aging.

The bacterial adhesion on and the cytotoxicity of various dental cements used for implant-supported fixed restorations.

PubMed

Winkler, Cornelia; Schäfer, Lina; Felthaus, Oliver; Allerdings, Juri; Hahnel, Sebastian; Behr, Michael; Bürgers, Ralf

2014-05-01

Bacterial adhesion on and cytotoxicity of eight luting agents used for implant-supported restorations were investigated. Surface roughness (Ra), surface free energy (SFE) values and three-dimensional images by atomic-force microscopy of circular specimens were determined. Bacterial suspensions of Streptococcus sanguinis and Streptococcus epidermidis were incubated at 37°C for 2 h. Adhering bacteria were examined with fluorescence dye CytoX-Violet, stained with 4',6-diamidino-2-phenylindole (DAPI) and visualized by fluorescence-microscopy. Cytotoxicity-testing was done with WST-1-tests (water soluble tetrazolium). No significant differences, neither with regard to Ra nor regarding SFE were determined. Adherence of S. sanguinis was less on titanium, TempBondNE and TempBond. TempBond, TempBondNE, RelyX Unicem and Implantlink Semi Classic presented low amounts of S. epidermidis. WST-testing showed high cytotoxic potential of Harvard, Aqualox, TempBondNE and TempBond. No combination of low adherent bacteria with low cytotoxicity was found. From a biological in-vitro perspective, none of the cements may be recommended for implant-supported restorations.

Evaluation of cement treated base courses : technical assistance report.

DOT National Transportation Integrated Search

2000-12-01

The objectives of this project are to determine the strength characteristics of soil cement bases that were constructed under stabilized procedures (DOTD TR 432M/432-99) and the cement treated design philosophy. This was accomplished by using the Fal...

Evaluation of hydraulic cement concretes containing slag added at the mixer.

DOT National Transportation Integrated Search

1985-01-01

The study evaluated the effect of ground, granulated, iron slags on the properties of hydraulic cement concretes such as normally used in highway construction. Two cements with different alkali contents and two slags with different activity indices, ...

[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.

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.

Negligence claims in UK total hip arthroplasty: a series of 167 consecutive cases.

PubMed

Whittingham-Jones, Paul; Williams, D; Raja, S; Bridle, S; Bircher, M

2012-01-01

A review of negligence reports, detailing 227 complaints from the practices of two orthopedic surgeons, was undertaken. There were demonstrable differences in the number of complaints over leg-length discrepancy; femoral fracture and cup malposition when cemented versus uncemented implants were compared. Surgeons must appreciate the less forgiving nature of uncemented hip implants and the importance of preoperative planning particularly in the presence of abnormal anatomy.

Innovative solutions to buried Portland concrete cement roadways : construction report.

DOT National Transportation Integrated Search

1999-01-01

Maine has hundreds of miles of highway that were constructed of Portland Concrete Cement : (PCC) roughly 6 to 6.1 meters (18 to 20 feet) wide forty or more years ago. Since that time these : same highways have been paved and widened to 6.7 or 7 meter...

Nano clay-enhanced calcium phosphate cements and hydrogels for biomedical applications

NASA Astrophysics Data System (ADS)

Jammalamadaka, Udayabhanu

Biomaterials are used as templates for drug delivery, scaffolds in tissue engineering, grafts in surgeries, and support for tissue regeneration. Novel biomaterial composites are needed to meet multifaceted requirements of compatibility, ease of fabrication and controlled drug delivery. Currently used biomaterials in orthopedics surgeries suffer limitations in toxicity and preventing infections. Polymethyl methacrylate (PMMA) used as bone cement suffers from limitations of thermal necrosis and monomer toxicity calls for development of better cementing biomaterials. A biodegradable/bioresorbable cement with good mechanical properties is needed to address this short coming. Metal implants used in fixing fractures or total joint replacement needs improvements in preventing biofilm formation and better tissue integration. This research addressed the above mentioned research gaps by formulating novel biomaterial composites. Calcium phosphate cements are the alternative bone cements that are bioresorbable and promote tissue integration. These cements lack sufficient mechanical strengths to be used in load bearing sites. The addition of nanoparticles is hypothesized to improve the mechanical properties without inducing toxicity to the tissue. This hypothesis was tested by evaluating compression and flexural strengths in addition to cytocompatibility tests. Results indicate that addition of nano-clay particles (halloysites nanotubes) improved the compressive strength and osteoinductive properties of calcium phosphate cements. To address the research need of preventing implant failure due to infection and aseptic loosening, novel coatings are needed. Hydrogels are well establish for their ability to mimic in vivo environment, promote cell viability and as drug delivery vehicles. Use of composites of hydrogels and drug-loaded nanoparticles to prevent infection was evaluated. Cytocompatibility results indicate good cell viability. Antibacterial results show sustained release of antibiotics from composite hydrogels and good zones of inhibition on agar plates inoculated with bacterial cultures. Fabricating a complex three-dimensional (3D) scaffold for tissue engineering was a huge challenge. With advancements in additive manufacturing, this research gap was addressed. Methods are needed to fabricate patient specific grafts made from biocompatible biomaterials. In this research, 3D printing was used as a platform to explore new biomaterials as grafts or scaffolds for tissue engineering. Computerized tomography scans were used to fabricate patient-specific grafts. The use of calcium cements to fabricate three-dimensionally complex scaffold or grafts reported in this research holds potential in personalized medicine.

Review of palm oil fuel ash and ceramic waste in the production of concrete

NASA Astrophysics Data System (ADS)

Natasya Mazenan, Puteri; Sheikh Khalid, Faisal; Shahidan, Shahiron; Shamsuddin, Shamrul-mar

2017-11-01

High demand for cement in the concrete production has been increased which become the problems in the industry. Thus, this problem will increase the production cost of construction material and the demand for affordable houses. Moreover, the production of Portland cement leads to the release of a significant amount of CO2 and other gases leading to the effect on global warming. The need for a sustainable and green construction building material is required in the construction industry. Hence, this paper presents utilization of palm oil fuel ash and ceramic waste as partial cement replacement in the production of concrete. Using both of this waste in the concrete production would benefit in many ways. It is able to save cost and energy other than protecting the environment. In short, 20% usage of palm oil fuel ash and 30% replacement of ceramic waste as cement replacement show the acceptable and satisfactory strength of concrete.

Displacement of Implant Abutments Following Initial and Repeated Torqueing.

PubMed

Yilmaz, Burak; Gilbert, Andy B; Seidt, Jeremy D; McGlumphy, Edwin A; Clelland, Nancy L

2015-01-01

To measure and compare the three-dimensional (3D) position of nine different abutments manufactured by different manufacturers after repeated torqueing on an internal-hexagon implant. Nine tapered implants were placed into an acrylic resin block. Five specimens each of nine different abutments (n = 45) were placed into one of nine implants. The abutments were handtightened and then torqued to the manufacturer-recommended torque of 30 Ncm. After 10 minutes, 30 Ncm of torque was reapplied. Another 10 minutes elapsed before testing was completed. Images were recorded in 12-second intervals. The spatial relationship of the abutments to the resin block was determined using 3D digital image correlation. Commercial image correlation software was used to analyze the displacements. Mean displacements for the abutments were calculated in three dimensions and overall for both torque applications. Statistical comparisons were done with a t test and a step-down Bonferroni correction. The overall 3D displacement of the Atlantis Titanium abutment after the second applied torque was significantly greater than that of two of the eight other abutments. Displacement in all three dimensions for the Atlantis Titanium abutment changed direction between the first and second torque applications. All abutments moved further in the same direction except for the Atlantis Titanium abutment, which moved back toward its original hand-tightened position horizontally after the second torque application. Re-torqueing of abutments after a 10-minute interval leads to minor displacement of varying degrees between the abutment and a tapered implant. A potential effect of embedment relaxation and/or manufacturing errors should be taken into consideration when selecting an abutment for a cement-retained crown on a tapered implant. Accordingly, clinicians may benefit from adjusting cement-retained implant crowns after re-torqueing the abutments to prevent potential occlusal and interproximal contact problems.

Ageing and moisture uptake in polymethyl methacrylate (PMMA) bone cements.

PubMed

Ayre, Wayne Nishio; Denyer, Stephen P; Evans, Samuel L

2014-04-01

Bone cements are extensively employed in orthopaedics for joint arthroplasty, however implant failure in the form of aseptic loosening is known to occur after long-term use. The exact mechanism causing this is not well understood, however it is thought to arise from a combination of fatigue and chemical degradation resulting from the hostile in vivo environment. In this study, two commercial bone cements were aged in an isotonic fluid at physiological temperatures and changes in moisture uptake, microstructure and mechanical and fatigue properties were studied. Initial penetration of water into the cement followed Fickian diffusion and was thought to be caused by vacancies created by leaching monomer. An increase in weight of approximately 2% was experienced after 30 days ageing and was accompanied by hydrolysis of poly(methyl methacrylate) (PMMA) in the outermost layers of the cement. This molecular change and the plasticising effect of water resulted in reduced mechanical and fatigue properties over time. Cement ageing is therefore thought to be a key contributor in the long-term failure of cemented joint replacements. The results from this study have highlighted the need to develop cements capable of withstanding long-term degradation and for more accurate test methods, which fully account for physiological ageing. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Influence of Nano-HA Coated Bone Collagen to Acrylic (Polymethylmethacrylate) Bone Cement on Mechanical Properties and Bioactivity

PubMed Central

Li, Tao; Weng, Xisheng; Bian, Yanyan; Zhou, Lei; Cui, Fuzhai; Qiu, Zhiye

2015-01-01

Objective This research investigated the mechanical properties and bioactivity of polymethylmethacrylate (PMMA) bone cement after addition of the nano-hydroxyapatite(HA) coated bone collagen (mineralized collagen, MC). Materials & Methods The MC in different proportions were added to the PMMA bone cement to detect the compressive strength, compression modulus, coagulation properties and biosafety. The MC-PMMA was embedded into rabbits and co-cultured with MG 63 cells to exam bone tissue compatibility and gene expression of osteogenesis. Results 15.0%(wt) impregnated MC-PMMA significantly lowered compressive modulus while little affected compressive strength and solidification. MC-PMMA bone cement was biologically safe and indicated excellent bone tissue compatibility. The bone-cement interface crosslinking was significantly higher in MC-PMMA than control after 6 months implantation in the femur of rabbits. The genes of osteogenesis exhibited significantly higher expression level in MC-PMMA. Conclusions MC-PMMA presented perfect mechanical properties, good biosafety and excellent biocompatibility with bone tissues, which has profoundly clinical values. PMID:26039750

Influence of Nano-HA Coated Bone Collagen to Acrylic (Polymethylmethacrylate) Bone Cement on Mechanical Properties and Bioactivity.

PubMed

Li, Tao; Weng, Xisheng; Bian, Yanyan; Zhou, Lei; Cui, Fuzhai; Qiu, Zhiye

2015-01-01

This research investigated the mechanical properties and bioactivity of polymethylmethacrylate (PMMA) bone cement after addition of the nano-hydroxyapatite(HA) coated bone collagen (mineralized collagen, MC). The MC in different proportions were added to the PMMA bone cement to detect the compressive strength, compression modulus, coagulation properties and biosafety. The MC-PMMA was embedded into rabbits and co-cultured with MG 63 cells to exam bone tissue compatibility and gene expression of osteogenesis. 15.0%(wt) impregnated MC-PMMA significantly lowered compressive modulus while little affected compressive strength and solidification. MC-PMMA bone cement was biologically safe and indicated excellent bone tissue compatibility. The bone-cement interface crosslinking was significantly higher in MC-PMMA than control after 6 months implantation in the femur of rabbits. The genes of osteogenesis exhibited significantly higher expression level in MC-PMMA. MC-PMMA presented perfect mechanical properties, good biosafety and excellent biocompatibility with bone tissues, which has profoundly clinical values.

[Orthopedic surgical implants and allergies. Joint statement by the Implant Allergy Working Group (AK 20) of the DGOOC (German Association of Orthopedics and Orthopedic Surgery), DKG (German Contact Dermatitis Research Group) and DGAKI (German Society for Allergology and Clinical Immunology)].

PubMed

Thomas, P; Schuh, A; Ring, J; Thomsen, M

2008-03-01

Materials used in osteosynthesis or artificial joint replacement are usually well tolerated. Complaints after such operations are mostly related to infection or mechanical problems but may also be caused by allergic reactions. The latter encompass skin changes, e.g., eczema, delayed wound/bone healing, recurrent effusion, pain, or implant loosening. In contrast to the high incidence of cutaneous metal contact allergy, allergies associated with implants are a rare condition. However, epidemiological data on the incidence of implant-related allergic reactions are still missing. Typical elicitors are nickel, chromium, cobalt, and constituents of bone cement (acrylates und additives such as gentamicin or benzoyl peroxide). After exclusion of the most common differential diagnoses, allergy diagnostic procedures are primarily based on patch tests including a metal and bone cement component series. Additional analysis of periimplant tissue is recommended. However, further studies are necessary to show the significance of the histologic findings and the role of the lymphocyte transformation test (LTT). Which combinations of factors will induce allergic sensitization to implants or trigger periimplant allergic reactions in the case of preexisting cutaneous metal allergy is still unknown. Titanium-based osteosynthesis materials are recommended for metal allergic patients. In elective hip replacements, a ceramic/polyethylene (PE) articulation should be used, and in knee replacements "alternative materials". If a regular, potentially applicable CoCr/PE articulation is preferred, the patient must be well informed and must give his/her written consent.

Systemic effect of mineral aggregate-based cements: histopathological analysis in rats.

PubMed

Garcia, Lucas da Fonseca Roberti; Huck, Claudia; Magalhães, Fernando Augusto Cintra; Souza, Pedro Paulo Chaves de; Souza Costa, Carlos Alberto de

2017-01-01

Several studies reported the local tissue reaction caused by mineral aggregate-based cements. However, few studies have investigated the systemic effects promoted by these cements on liver and kidney when directly applied to connective tissue. The purpose of this in vivo study was to investigate the systemic effect of mineral aggregate-based cements on the livers and kidneys of rats. Samples of Mineral Trioxide Aggregate (MTA) and a calcium aluminate-based cement (EndoBinder) containing different radiopacifiers were implanted into the dorsum of 40 rats. After 7 and 30 d, samples of subcutaneous, liver and kidney tissues were submitted to histopathological analysis. A score (0-3) was used to grade the inflammatory reaction. Blood samples were collected to evaluate changes in hepatic and renal functions of animals. The moderate inflammatory reaction (2) observed for 7 d in the subcutaneous tissue decreased with time for all cements. The thickness of inflammatory capsules also presented a significant decrease with time (P<.05). Systemically, all cements caused adverse inflammatory reactions in the liver and kidney, being more evident for MTA, persisting until the end of the analysis. Liver functions increased significantly for MTA during 30 d (P<.05). The different cements induced to a locally limited inflammatory reaction. However, from the systemic point of view, the cements promoted significant inflammatory reactions in the liver and kidney. For MTA, the reactions were more accentuated.

Repair and protection of hydraulic cement concrete bridge decks.

DOT National Transportation Integrated Search

1994-01-01

The report is an updated version of "A Manual for the Repair and Protection of Hydraulic Cement Concrete Bridge Decks" (VTRC 90-TAR2). The report was prepared for Chapter 2 of the Hydraulic Cement Concrete Construction School Study Guide which is dis...

Calcium hydroxide poisoning

MedlinePlus

These products contain calcium hydroxide: Cement Limewater Many industrial solvents and cleaners (hundreds to thousands of construction products, flooring strippers, brick cleaners, cement thickening products, and many ...

40 CFR 146.12 - Construction requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... water. The casing and cement used in the construction of each newly drilled well shall be designed for... intervals; and (7) Type or grade of cement. (c) All Class I injection wells, except those municipal wells... injection zone, or tubing with an approved fluid seal as an alternative. The tubing, packer, and fluid seal...

Short Implants Versus Standard Implants: Midterm Outcomes of a Clinical Study.

PubMed

Benlidayi, M Emre; Ucar, Yurdanur; Tatli, Ufuk; Ekren, Orhun; Evlice, Burcu; Kisa, Halil Ibrahim; Baksi, Uygar

2018-02-01

The aim of this study was to evaluate the midterm survival rate, marginal bone resorption (MBR), and stability of short implants and to compare the results with standard length implants. A total of 38 patients were included. In total, 147 implants (Nucleoss Implants, Izmir, Turkey) were placed (86 short implants and 61 standard implants). Cement-retained metal-ceramic prostheses were fabricated. MBR was evaluated on periapical radiographs taken at implant placement, at the time of crown insertion and annually thereafter. The stability of the implants was evaluated by resonance frequency analysis. The 3- and 5-year cumulative survival rates for standard implants was 98.4% and for short implants was 96.5% (P = 0.644). The MBR of the short implants was significantly lower than that of the standard implants after 1, 2, and 3 years of loading (P < 0.05). No significant differences were found between 2 groups after 6 and 12 months of loading in terms of implant stability (implant stability quotient values) (P > 0.05). Within the limits of this study, it is concluded that short implants achieved similar results as standard implants after 3 to 5 years of loading.

Transmission of acoustic emission in bones, implants and dental materials.

PubMed

Ossi, Zannar; Abdou, Wael; Reuben, Robert L; Ibbetson, Richard J

2013-11-01

There is considerable interest in using acoustic emission (AE) and ultrasound to assess the quality of implant-bone interfaces and to monitor for micro-damage leading to loosening. However, remarkably little work has been done on the transmission of ultrasonic waves though the physical and biological structures involved. The aim of this in vitro study is to assess any differences in transmission between various dental materials and bovine rib bones with various degrees of hydration. Two types of tests have been carried out using pencil lead breaks as a standard AE source. The first set of tests was configured to assess the surface propagation of AE on various synthetic materials compared with fresh bovine rib bone. The second is a set of transmission tests on fresh, dried and hydrated bones each fitted with dental implants with various degrees of fixity, which includes components due to bone and interface transmission. The results indicate that transmission through glass ionomer cement is closest to the bone. This would suggest that complete osseointegration could potentially be simulated using such cement. The transmission of AE energy through bone was found to be dependent on its degree of hydration. It was also found that perfusing samples of fresh bone with water led to an increase in transmitted energy, but this appeared to affect transmission across the interface more than transmission through the bone. These findings have implications not only for implant interface inspection but also for passive AE monitoring of implants.

Porous titanium particles for acetabular reconstruction in total hip replacement show extensive bony armoring after 15 weeks

PubMed Central

Walschot, Lucas H B; Aquarius, René; Verdonschot, Nico; Buma, Pieter

2014-01-01

Background and purpose — The bone impaction grafting technique restores bone defects in total hip replacement. Porous titanium particles (TiPs) are deformable, like bone particles, and offer better primary stability. We addressed the following questions in this animal study: are impacted TiPs osteoconductive under loaded conditions; do released micro-particles accelerate wear; and are systemic titanium blood levels elevated after implantation of TiPs? Animals and methods — An AAOS type-III defect was created in the right acetabulum of 10 goats weighing 63 (SD 6) kg, and reconstructed with calcium phosphate-coated TiPs and a cemented polyethylene cup. A stem with a cobalt chrome head was cemented in the femur. The goats were killed after 15 weeks. Blood samples were taken pre- and postoperatively. Results — The TiP-graft layer measured 5.6 (SD 0.8) mm with a mean bone ingrowth distance of 2.8 (SD 0.8) mm. Cement penetrated 0.9 (0.3–1.9) mm into the TiPs. 1 reconstruction showed minimal cement penetration (0.3 mm) and failed at the cement-TiP interface. There were no signs of accelerated wear, metallic particle debris, or osteolysis. Median systemic titanium concentrations increased on a log-linear scale from 0.5 (0.3–1.1) parts per billion (ppb) to 0.9 (0.5–2.8) ppb (p = 0.01). Interpretation — Adequate cement pressurization is advocated for impaction grafting with TiPs. After implantation, calcium phosphate-coated TiPs were osteoconductive under loaded conditions and caused an increase in systemic titanium concentrations. However, absolute levels remained low. There were no signs of accelerated wear. A clinical pilot study should be performed to prove that application in humans is safe in the long term. PMID:25238431

An esthetics rehabilitation with computer-aided design/ computer-aided manufacturing technology.

PubMed

Mazaro, Josá Vitor Quinelli; de Mello, Caroline Cantieri; Zavanelli, Adriana Cristina; Santiago, Joel Ferreira; Amoroso, Andressa Paschoal; Pellizzer, Eduardo Piza

2014-07-01

This paper describes a case of a rehabilitation involving Computer Aided Design/Computer Aided Manufacturing (CAD-CAM) system in implant supported and dental supported prostheses using zirconia as framework. The CAD-CAM technology has developed considerably over last few years, becoming a reality in dental practice. Among the widely used systems are the systems based on zirconia which demonstrate important physical and mechanical properties of high strength, adequate fracture toughness, biocompatibility and esthetics, and are indicated for unitary prosthetic restorations and posterior and anterior framework. All the modeling was performed by using CAD-CAM system and prostheses were cemented using resin cement best suited for each situation. The rehabilitation of the maxillary arch using zirconia framework demonstrated satisfactory esthetic and functional results after a 12-month control and revealed no biological and technical complications. This article shows the important of use technology CAD/CAM in the manufacture of dental prosthesis and implant-supported.

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.

Migration of cemented femoral components after THR. Roentgen stereophotogrammetric analysis.

PubMed

Kiss, J; Murray, D W; Turner-Smith, A R; Bithell, J; Bulstrode, C J

1996-09-01

We studied the migration of 58 cemented Hinek femoral components for total hip replacement, using roentgen stereophotogrammetric analysis over four years. The implants migrated faster during the first year than subsequently, and the pattern of migration in the second period was very different. During the first year they subsided, tilted into varus and internally rotated. After this there was slow distal migration with no change in orientation. None of the prostheses has yet failed. The early migration is probably caused by resorption of bone damaged by surgical trauma or the heat generated by the polymerisation of bone cement. Later migration may be due to creep in the bone cement or the surrounding fibrous membrane. The prosthesis which we studied allows the preservation of some of the femoral neck, and comparison with published migration studies of the Charnley stem suggests that this decreases rotation and may help to prevent loosening.

A New Experimental Design for Bacterial Microleakage Investigation at the Implant-Abutment Interface: An In Vitro Study.

PubMed

Zipprich, Holger; Miatke, Sven; Hmaidouch, Rim; Lauer, Hans-Christoph

2016-01-01

This study aimed to test bacterial microleakage at the implant-abutment interface (IAI) before and after dynamic loading using a new chewing simulation. Fourteen implant systems (n = 5 samples of each) were divided into two groups: (1) systems with conical implant-abutment connections (IACs), and (2) systems with flat IACs. For collecting samples without abutment disconnection, channels (Ø = 0.3 mm) were drilled into implants perpendicularly to their axes, and stainless-steel cannulas were adhesively glued inside these channels to allow a sterilized rinsing solution to enter the implant interior and to exit with potential contaminants for testing. Implants were embedded in epoxy resin matrices, which were supported by titanium cylinders with lateral openings for inward and outward cannulas. Abutments were tightened and then provided with vertically adjustable, threaded titanium balls, which were cemented using composite cement. Specimens were immersed in a bacterial liquid and after a contact time of 15 minutes, the implant interior was rinsed prior to chewing simulation (0 N ≘ static seal testing). Specimens were exposed to a Frankfurt chewing simulator. Two hundred twenty force cycles per power level (110 in ± X-axis) were applied to simulate a daily masticatory load of 660 chewing cycles (equivalent to 1,200,000 cycles/5 years). The applied load was gradually increased from 0 N to a maximum load of 200 N in 25-N increments. The implant interior was rinsed to obtain samples before each new power level. All samples were tested using fluorescence microscopy; invading microorganisms could be counted and evaluated. No bacterial contamination was detected under static loading conditions in both groups. After loading, bacterial contamination was detected in one sample from one specimen in group 1 and in two samples from two specimens in group 2. Controlled dynamic loading applied in this study simulated a clinical situation and enabled time-dependent analysis regarding the bacterial seal of different implant systems. Conical IACs offer a better bacterial seal compared with flat IACs, which showed increased microleakage after dynamic loading. IAC design plays a crucial role in terms of bacterial colonization. Taking samples of the implant interior without abutment disconnection eliminates an error source.

Compressive strength of concrete and mortar containing fly ash

DOEpatents

Liskowitz, J.W.; Wecharatana, M.; Jaturapitakkul, C.; Cerkanowicz, A.E.

1997-04-29

The present invention relates to concrete, mortar and other hardenable mixtures comprising cement and fly ash for use in construction. The invention includes a method for predicting the compressive strength of such a hardenable mixture, which is very important for planning a project. The invention also relates to hardenable mixtures comprising cement and fly ash which can achieve greater compressive strength than hardenable mixtures containing only concrete over the time period relevant for construction. In a specific embodiment, a formula is provided that accurately predicts compressive strength of concrete containing fly ash out to 180 days. In other specific examples, concrete and mortar containing about 15% to 25% fly ash as a replacement for cement, which are capable of meeting design specifications required for building and highway construction, are provided. Such materials can thus significantly reduce construction costs. 33 figs.

Compressive strength of concrete and mortar containing fly ash

DOEpatents

Liskowitz, J.W.; Wecharatana, M.; Jaturapitakkul, C.; Cerkanowicz, A.E.

1998-12-29

The present invention relates to concrete, mortar and other hardenable mixtures comprising cement and fly ash for use in construction. The invention includes a method for predicting the compressive strength of such a hardenable mixture, which is very important for planning a project. The invention also relates to hardenable mixtures comprising cement and fly ash which can achieve greater compressive strength than hardenable mixtures containing only concrete over the time period relevant for construction. In a specific embodiment, a formula is provided that accurately predicts compressive strength of concrete containing fly ash out to 180 days. In other specific examples, concrete and mortar containing about 15% to 25% fly ash as a replacement for cement, which are capable of meeting design specification required for building and highway construction, are provided. Such materials can thus significantly reduce construction costs. 33 figs.

Compressive strength of concrete and mortar containing fly ash

DOEpatents

Liskowitz, John W.; Wecharatana, Methi; Jaturapitakkul, Chai; Cerkanowicz, deceased, Anthony E.

1997-01-01

The present invention relates to concrete, mortar and other hardenable mixtures comprising cement and fly ash for use in construction. The invention includes a method for predicting the compressive strength of such a hardenable mixture, which is very important for planning a project. The invention also relates to hardenable mixtures comprising cement and fly ash which can achieve greater compressive strength than hardenable mixtures containing only concrete over the time period relevant for construction. In a specific embodiment, a formula is provided that accurately predicts compressive strength of concrete containing fly ash out to 180 days. In other specific examples, concrete and mortar containing about 15% to 25% fly ash as a replacement for cement, which are capable of meeting design specifications required for building and highway construction, are provided. Such materials can thus significantly reduce construction costs.

Compressive strength of concrete and mortar containing fly ash

DOEpatents

Liskowitz, John W.; Wecharatana, Methi; Jaturapitakkul, Chai; Cerkanowicz, deceased, Anthony E.

1998-01-01

The present invention relates to concrete, mortar and other hardenable mixtures comprising cement and fly ash for use in construction. The invention includes a method for predicting the compressive strength of such a hardenable mixture, which is very important for planning a project. The invention also relates to hardenable mixtures comprising cement and fly ash which can achieve greater compressive strength than hardenable mixtures containing only concrete over the time period relevant for construction. In a specific embodiment, a formula is provided that accurately predicts compressive strength of concrete containing fly ash out to 180 days. In other specific examples, concrete and mortar containing about 15% to 25% fly ash as a replacement for cement, which are capable of meeting design specification required for building and highway construction, are provided. Such materials can thus significantly reduce construction costs.

[Classification of prosthetic loosening and determination of wear particles].

PubMed

Otto, M

2008-11-01

Nowaday, loosening of orthopaedic implants implies important medical and socioeconomic problems. Implant loosening is caused by implant infections as well as aseptic loosening, due to particle disease and mechanical alterations. Clinically we divide the implant infection into early and late infections. Morphologically it is possible to reliably detect the infection by quantification of neutrophil granulocytes. Additionally molecular methods are suitable to detect micro-organisms which are responsible for the prosthetic joint infection including their resistance to antibiotics. Particle disease may be reproducibly classified by the detection of different types of wear particles, particularly polyethylene, metal, ceramic and cement. The aetiology of the indeterminate type of the periprosthetic membrane is obscure, but may be associated with osteopathies. This classification of the periprosthetic membrane morphology provides clinically significant information concerning clinical management of implant loosening.

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.

Early bone anchorage to micro- and nano-topographically complex implant surfaces in hyperglycemia.

PubMed

Ajami, Elnaz; Bell, Spencer; Liddell, Robert S; Davies, John E

2016-07-15

The aim of this work was to investigate the effect of implant surface design on early bone anchorage in the presence of hyperglycemia. 108 Wistar rats were separated into euglycemic (EG) controls and STZ-treated hyperglycemic (HG) groups, and received bilateral femoral custom rectangular implants of two surface topographies: grit blasted (GB) and grit-blast with a superimposed calcium phosphate nanotopography (GB-DCD). The peri-implant bone was subjected to a tensile disruption test 5, 7, and 9days post-operatively (n=28/time point); the force was measured; and the residual peri-implant bone was observed by scanning electron microscopy (SEM). Disruption forces at 5days were not significantly different from zero for the GB implants (p=0.24) in either metabolic group; but were for GB+DCD implants in both metabolic groups (p<0.001). Contact osteogenesis was greater on GB-DCD than the GB surface. The nano-and micro-surfaced implants showed significantly different disruption forces at all time points (e.g. >15N and <5N respectively at 9days). Such differences were not seen within the GB implants, as all values were very low (<5N). Even in hyperglycemia the GB-DCD surface outperformed the GB surfaces in both metabolic groups. Significantly, SEM of peri-implant bone showed compromised intra-fibrillar collagen mineralization in hyperglycemia, while inter-fibrillar and cement line mineralization remained unaffected. Enhanced bone anchorage to the implant surfaces was observed on the nanotopographically complex surface independent of metabolic group. The compromised intra-fibrillar mineralization observed provides a mechanism by which early bone mineralization is affected in hyperglycemia. It is generally accepted that the hyperglycemia associated with diabetes mellitus compromises bone quality, although the mechanism by which this occurs is unknown. Uncontrolled hyperglycemia is therefore a contra-indication for bone implant placement. It is also known that nano-topographically complex implant surfaces accelerate early peri-implant healing. In this report we show that, in our experimental model, nano-topographically complex surfaces can mitigate the compromised bone healing seen in hyperglycemia. Importantly, we also provide a mechanistic explanation for compromised bone quality in hyperglycemia. We show that intra-fibrillar collagen mineralization is compromised in hyperglycemia, but that interfibrillar and cement line mineralization, remain unaffected. Copyright © 2016 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

The influence of nano MgO and BaSO4 particle size additives on properties of PMMA bone cement.

PubMed

Ricker, Alyssa; Liu-Snyder, Peishan; Webster, Thomas J

2008-01-01

A common technique to aid in implant fixation into surrounding bone is to inject bone cement into the space between the implant and surrounding bone. The most common bone cement material used clinically today is poly(methyl methacrylate), or PMMA. Although promising, there are numerous disadvantages of using PMMA in bone fixation applications which has limited its wide spread use. Specifically, the PMMA polymerization reaction is highly exothermic in situ, thus, damaging surrounding bone tissue while curing. In addition, PMMA by itself is not visible using typical medical imaging techniques (such as X-rays required to assess new bone formation surrounding the implant). Lastly, although PMMA does support new bone growth, studies have highlighted decreased osteoblast (bone forming cell) functions on PMMA compared to other common orthopedic coating materials, such as calcium phosphates and hydroxyapatite. For these reasons, the goal of this study was to begin to investigate novel additives to PMMA which can enhance its cytocompatibility properties with osteoblasts, decrease its exothermic reaction when curing, and increase its radiopacity. Results of this study demonstrated that compared to conventional (or micron) equivalents, PMMA with nanoparticles of MgO and BaSO4 reduced harmful exothermic reactions of PMMA during solidification and increased radiopacity, respectively. Moreover, osteoblast adhesion increased on PMMA with nanoparticles of MgO and BaSO4 compared with PMMA alone. This study, thus, suggests that nanoparticles of MgO and BaSO4 should be further studied for improving properties of PMMA for orthopedic applications.

Functional aspects of treatment with implant-supported single crowns: a quality control study in subjects with tooth agenesis.

PubMed

Goshima, Kenichi; Lexner, Michala O; Thomsen, Carsten Eckhart; Miura, Hiroyuki; Gotfredsen, Klaus; Bakke, Merete

2010-01-01

No comprehensive patient-centered and clinical evaluations of the functional effect of treatment with implant-supported single crowns (ISSC) have been reported previously. To investigate whether and how treatment with ISSC affects masticatory function and Oral Health-Related Quality of Life (OHRQoL) in subjects with tooth agenesis. In nine females and nine males (32 + or - 10 years) with agenesis treated with one to four ISSC (68% in the premolar region), the treatment effect and masticatory function were assessed. The evaluation was performed first after implant placement shortly before crown cementation, and again 1 month after cementation. It consisted of questionnaires [including Oral Health Impact Profile (OHIP-49)] and functional examination with plastic strips, the Dental Prescale Film and the Occluzer system, Xylitol color-changeable gum and slices of Granny Smith apple. The patients' satisfaction with treatment was high and they experienced a significant overall improvement in their OHRQoL (on average 13% reduction in the total OHIP scores). The cementation of the crowns was associated with a significant increase in the number of near occlusal tooth contacts, contact area, bite force, and masticatory ability and performance. Correspondingly, there was a significant, positive correlation between the number of tooth contacts and (1) occlusal contact area, (2) bite force, and (3) masticatory performance. Treatment with ISSCs in subjects with tooth agenesis significantly increased masticatory function subjectively and clinically as well as OHRQoL. However, as the functional parameters before replacement of the teeth corresponded to values in subjects with complete dentitions, the functional importance of the increase may be questioned.

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.

Assessment of post-implantation integration of engineered tissues using fluorescence lifetime spectroscopy

NASA Astrophysics Data System (ADS)

Elahi, Sakib F.; Lee, Seung Y.; Lloyd, William R.; Chen, Leng-Chun; Kuo, Shiuhyang; Zhou, Ying; Kim, Hyungjin M.; Kennedy, Robert; Marcelo, Cynthia; Feinberg, Stephen E.; Mycek, Mary-Ann

2018-02-01

Clinical translation of engineered tissue constructs requires noninvasive methods to assess construct health and viability after implantation in patients. However, current practices to monitor post-implantation construct integration are either qualitative (visual assessment) or destructive (tissue histology). As label-free fluorescence lifetime sensing can noninvasively characterize pre-implantation construct viability, we employed a handheld fluorescence lifetime spectroscopy probe to quantitatively and noninvasively assess tissue constructs that were implanted in a murine model. We designed the system to be suitable for intravital measurements: portability, localization with precise maneuverability, and rapid data acquisition. Our model tissue constructs were manufactured from primary human cells to simulate patient variability and were stressed to create a range of health states. Secreted amounts of three cytokines that relate to cellular viability were measured in vitro to assess pre-implantation construct health. In vivo optical sensing assessed tissue integration of constructs at one-week and three-weeks post-implantation. At one-week post-implantation, optical parameters correlated with in vitro pre-implantation secretion levels of all three cytokines (p < 0.05). This relationship was no longer seen at three-weeks post-implantation, suggesting comparable tissue integration independent of preimplantation health. Histology confirmed re-epithelialization of these constructs independent of pre-implantation health state, supporting the lack of a correlation. These results suggest that clinical optical diagnostic tools based on label-free fluorescence lifetime sensing of endogenous tissue fluorophores could noninvasively monitor post-implantation integration of engineered tissues.

Evaluation of Autogenous Engineered Septal Cartilage Grafts in Rabbits- A Minimally Invasive Preclinical Model.

PubMed

Kushnaryov, Anton; Yamaguchi, Tomonoro; Briggs, Kristen K; Wong, Van W; Reuther, Marsha; Neuman, Monica; Lin, Victor; Sah, Robert L; Masuda, Koichi; Watson, Deborah

2014-07-23

Evaluate safety of autogenous engineered septal neocartilage grafts.Compare properties of implanted grafts versus in vitro controls. Prospective, basic science. Research laboratory. Constructs were fabricated from septal cartilage and serum harvested from adult rabbits and then cultured in vitro or implanted on the nasal dorsum as autogenous grafts for 30 or 60 days. Rabbits were monitored for local and systemic complications. Histological, biochemical and biomechanical properties of implanted and in vitro constructs were evaluated and compared. No systemic or serious local complications were observed. After 30 and 60 days, implanted constructs contained more DNA (p<0.01) and less sGAG per DNA (p<0.05) when compared with in vitro controls. Confined compressive aggregate moduli were also higher in implanted constructs when compared with in vitro controls (p<0.05) and increased with longer in vivo incubation time (p<0.01). Implanted constructs displayed resorption rates of 20-45 percent. Calcium deposition in implanted constructs was observed using alizarin red histochemistry and microtomographic analyses. Autogenous engineered septal cartilage grafts were well tolerated. As seen in experiments with athymic mice, implanted constructs accumulated more DNA and less sGAG when compared with in vitro controls. Confined compressive aggregate moduli were also higher in implanted constructs. Implanted constructs displayed resorption rates similar to previously published studies using autogenous implants of native cartilage. The basis for observed calcification in implanted constructs and its effect on long-term graft efficacy is unknown at this time and will be a focus of future studies.

Mineral of the month: cement

USGS Publications Warehouse

van Oss, Hendrik G.

2006-01-01

Hydraulic cement is a virtually ubiquitous construction material that, when mixed with water, serves as the binder in concrete and most mortars. Only about 13 percent of concrete by weight is cement (the rest being water and aggregates), but the cement contributes all of the concrete’s compressional strength. The term “hydraulic” refers to the cement’s ability to set and harden underwater through the hydration of the cement’s components.

Tentative to use wastes from thermal power plants for construction building materials

NASA Astrophysics Data System (ADS)

Bui, Quoc-Bao; Phan, To-Anh-Vu; Tran, Minh-Tung; Le, Duc-Hien

2018-04-01

Thermal power plants (TPP) generates wastes (bottom and fly ashes) which become a serious environmental problem in Vietnam. Indeed, although in several countries fly ash can be used for cement industry, fly ash from actual TPP in Vietnam does not have enough good quality for cement production, because the fly ash treatment phase has not yet included in the generations of existing Vietnamese TPP. That is why bottom ash and fly ash purely become wastes and their evacuation is an urgent demand of the society. This paper presents an investigation using fly and bottom ashes in the manufacturing of construction materials. The main aims of this study is to reduce environmental impacts of fly and bottom ashes, and to test another non-conventional binder to replace cement in the manufacture of unburnt bricks. Several proportions of fly ash, bottom ash, cement, gravel, sand and water were tested to manufacture concretes. Then, geopolymer was prepared from the fly ash and an activator. Specimens were tested in uniaxial compressions. Results showed that the cement concrete tested had the compressive strengths which could be used for low rise constructions and the material using geopolymer could be used for non-load-bearing materials (unburnt bricks).

Ageing and moisture uptake in polymethyl methacrylate (PMMA) bone cements☆

PubMed Central

Ayre, Wayne Nishio; Denyer, Stephen P.; Evans, Samuel L.

2014-01-01

Bone cements are extensively employed in orthopaedics for joint arthroplasty, however implant failure in the form of aseptic loosening is known to occur after long-term use. The exact mechanism causing this is not well understood, however it is thought to arise from a combination of fatigue and chemical degradation resulting from the hostile in vivo environment. In this study, two commercial bone cements were aged in an isotonic fluid at physiological temperatures and changes in moisture uptake, microstructure and mechanical and fatigue properties were studied. Initial penetration of water into the cement followed Fickian diffusion and was thought to be caused by vacancies created by leaching monomer. An increase in weight of approximately 2% was experienced after 30 days ageing and was accompanied by hydrolysis of poly(methyl methacrylate) (PMMA) in the outermost layers of the cement. This molecular change and the plasticising effect of water resulted in reduced mechanical and fatigue properties over time. Cement ageing is therefore thought to be a key contributor in the long-term failure of cemented joint replacements. The results from this study have highlighted the need to develop cements capable of withstanding long-term degradation and for more accurate test methods, which fully account for physiological ageing. PMID:24445003

In vitro Characteristics of a Glass Ionomer Cement.

PubMed

Driscoll, C L; Green, J D; Beatty, C W; McCaffrey, T V; Marrs, C D

1998-01-01

Glass ionomer cements were first described by Wilson and Kent and have been used in dentistry since 1969. It has been recommended for bridging ossicular chain defects, fixation of ossicular chain prosthesis, anchoring of cochlear implants, mastoid obliteration, and repair of tegmen and posterior canal wall defects. The biocompatability and stability of this material over time is vital to its usefulness in neurotologic surgery. The purpose of this study was to assess the stability of a glass ionomer cement in the presence of bacteria and in different pH environments. We demonstrated that bacteria readily adhere to the surface and their presence is associated with accelerated loss of matrix. We found the cement to be susceptible to low pH and to release a visible cloud of debris upon contact with fluid. Calcium concentration in the solution was elevated at all pH levels. Although we are able to demonstrate these findings in vitro the clinical relevance is unclear. There have been several cases of aseptic meningitis possibly due to intracranial release of components of the cement. Until further studies are done use of the cement in contact with cerebral spinal fluid should be avoided. This cement, or a similar material, would be useful in neurotologic surgery but prior to widespread use further testing should be done to assess safety.

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.

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.

Bond strength and interactions of machined titanium-based alloy with dental cements.

PubMed

Wadhwani, Chandur; Chung, Kwok-Hung

2015-11-01

The most appropriate luting agent for restoring cement-retained implant restorations has yet to be determined. Leachable chemicals from some types of cement designed for teeth may affect metal surfaces. The purpose of this in vitro study was to evaluate the shear bond strength and interactions of machined titanium-based alloy with dental luting agents. Eight dental luting agents representative of 4 different compositional classes (resin, polycarboxylate, glass ionomer, and zinc oxide-based cements) were used to evaluate their effect on machined titanium-6 aluminum-4 vanadium (Ti-6Al-4V) alloy surfaces. Ninety-six paired disks were cemented together (n=12). After incubation in a 37°C water bath for 7 days, the shear bond strength was measured with a universal testing machine (Instron) and a custom fixture with a crosshead speed of 5 mm/min. Differences were analyzed statistically with 1-way ANOVA and Tukey HSD tests (α=.05). The debonded surfaces of the Ti alloy disks were examined under a light microscope at ×10 magnification to record the failure pattern, and the representative specimens were observed under a scanning electron microscope. The mean ±SD of shear failure loads ranged from 3.4 ±0.5 to 15.2 ±2.6 MPa. The retention provided by both polycarboxylate cements was significantly greater than that of all other groups (P<.05). The scanning electron microscope examination revealed surface pits only on the bonded surface cemented with the polycarboxylate cements. Cementation with polycarboxylate cement obtained higher shear bond strength. Some chemical interactions occurred between the machined Ti-6Al-4V alloy surface and polycarboxylate cements during cementation. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Improving the accuracy of acetabular cup implantation using a bulls-eye spirit level.

PubMed

Macdonald, Duncan; Gupta, Sanjay; Ohly, Nicholas E; Patil, Sanjeev; Meek, R; Mohammed, Aslam

2011-01-01

Acetabular introducers have a built-in inclination of 45 degrees to the handle shaft. With patients in the lateral position, surgeons aim to align the introducer shaft vertical to the floor to implant the acetabulum at 45 degrees. We aimed to determine if a bulls-eye spirit level attached to an introducer improved the accuracy of implantation. A small circular bulls-eye spirit level was attached to the handle of an acetabular introducer. A saw bone hemipelvis was fixed to a horizontal, flat surface. A cement substitute was placed in the acetabulum and subjects were asked to implant a polyethylene cup, aiming to obtain an angle of inclination of 45 degrees. Two attempts were made with the spirit level masked and two with it unmasked. The distance of the air bubble from the spirit level's center was recorded by a single assessor. The angle of inclination of the acetabular component was then calculated. Subjects included both orthopedic consultants and trainees. Twenty-five subjects completed the study. Accuracy of acetabular implantation when using the unmasked spirit level improved significantly in all grades of surgeon. With the spirit level masked, 12 out of 50 attempts were accurate at 45 degrees inclination; 11 out of 50 attempts were "open," with greater than 45 degrees of inclination, and 27 were "closed," with less than 45 degrees. With the spirit level visible, all subjects achieved an inclination angle of exactly 45 degrees. A simple device attached to the handle of an acetabular introducer can significantly improve the accuracy of implantation of a cemented cup into a saw bone pelvis in the lateral position.

Management of Distal Tibial Metaphyseal Bone Defects With an Intramedullary Nitinol Scaffold: A Novel Technique.

PubMed

Ford, Samuel E; Ellington, J Kent

2017-08-01

Difficult problems that are faced when reconstructing severe pilon fractures include filling metaphyseal defects and supporting an impacted, multifragmented articular surface. Supplements to plate fixation currently available in a surgeon's armamentarium include cancellous bone autograft, structural bone allograft, demineralized bone matrix, and calcium-based cements. Cancellous autograft possesses limited inherent mechanical stability and is associated with graft site morbidity. Structural allografts incorporate inconsistently and are plagued by late resorption. Demineralized bone matrix also lacks inherent structural stability. Calcium phosphate cements are not rigidly fixed to bone unless fixation is applied from cortical bone or through a plate, which must be taken into consideration when planning fixation. The Conventus DRS (Conventus Orthopaedics, Maple Grove, MN) implant is an expandable nitinol scaffold that takes advantage of the elasticity and shape memory of nitinol alloy. Once deployed and locked, it serves as a stable intramedullary base for fragment-specific periarticular fracture fixation, even in the face of metaphyseal bone loss. Two cases of successful implant use are presented. In both cases, the implant is used to fill a metaphyseal void and provide stable articular support to the distal tibial plafond. Therapeutic Level V: Case Report, Expert Opinion.

Investigating the Influence of Waste Basalt Powder on Selected Properties of Cement Paste and Mortar

NASA Astrophysics Data System (ADS)

Dobiszewska, Magdalena; Beycioğlu, Ahmet

2017-10-01

Concrete is the most widely used man-made construction material in civil engineering applications. The consumption of cement and thus concrete, increases day by day along with the growth of urbanization and industrialization and due to new developments in construction technologies, population growing, increasing of living standard. Concrete production consumes much energy and large amounts of natural resources. It causes environmental, energy and economic losses. The most important material in concrete production is cement. Cement industry contributes to production of about 7% of all CO2 generated in the world. Every ton of cement production releases nearly one ton of CO2 to atmosphere. Thus the concrete and cement industry changes the environment appearance and influences it very much. Therefore, it has become very important for construction industry to focus on minimizing the environmental impact, reducing energy consumption and limiting CO2 emission. The need to meet these challenges has spurred an interest in the development of a blended Portland cement in which the amount of clinker is reduced and partially replaced with mineral additives - supplementary cementitious materials (SCMs). Many researchers have studied the possibility of using another mineral powder in mortar and concrete production. The addition of marble dust, basalt powder, granite or limestone powder positively affects some properties of cement mortar and concrete. This paper presents an experimental study on the properties of cement paste and mortar containing basalt powder. The basalt powder is a waste emerged from the preparation of aggregate used in asphalt mixture production. Previous studies have shown that analysed waste used as a fine aggregate replacement, has a beneficial effect on some properties of mortar and concrete, i.e. compressive strength, flexural strength and freeze resistance also. The present study shows the results of the research concerning the modification of cement paste and mortar with basalt powder. The modification consists in that the powder waste was added as partial replacement of cement. Four types of common cement were examined, i.e. CEM I, CEM II/A-S, CEM II/A-V and CEM II/B-V. The percentages of basalt powder in this research are 0%, 1%, 2%, 3%, 4%, 6%, 8% and 10% by mass. Results showed that the addition of basalt powder improved the strength of cement mortar. The use of mineral powder as the partial substitution of cement allows the effective management of industrial waste and improves some properties of cement mortar.

Liquid-solid phase transition alloy as reversible and rapid molding bone cement.

PubMed

Yi, Liting; Jin, Chao; Wang, Lei; Liu, Jing

2014-12-01

Acrylic bone cement has been an essential non-metallic implant used as fixing agent in the cemented total joint arthroplasty (THA). However, the currently available materials based mainly on polymethylmethacrylate (PMMA) still encounter certain limitations, such as time-consuming polymerization, thermal and chemical necrosis and troublesome revision procedure. Here from an alternative way, we proposed for the first time to adopt the injectable alloy cement to address such tough issues through introducing its unique liquid-solid phase transition mechanism. A typical cement along this way is thus made of an alloy Bi/In/Sn/Zn with a specifically designed low melting point 57.5 °C, which enables its rapid molding into various desired shapes with high plasticity and ultimate metallic behaviors. The fundamental characteristics including the mechanical strength, biocompatibility and phase transition-induced thermal effects have been clarified to demonstrate the importance of such alloy as unconventional cement with favorable merits. In addition, we also disclosed its advantage as an excellent contrast agent for radiation imaging on the bone interior structure which is highly beneficial for guiding the surgery and monitoring the therapeutic effects. Particularly, the proposed alloy cement with reversible phase transition feature significantly simplifies the revision of the cement and prosthesis. This study opens the way for employing the injectable alloy materials as reversible bone cement to fulfill diverse clinical needs in the coming time. Copyright © 2014 Elsevier Ltd. All rights reserved.

Systemic effect of mineral aggregate-based cements: histopathological analysis in rats

PubMed Central

Garcia, Lucas da Fonseca Roberti; Huck, Claudia; Magalhães, Fernando Augusto Cintra; de Souza, Pedro Paulo Chaves; de Souza Costa, Carlos Alberto

2017-01-01

Abstract Objective: Several studies reported the local tissue reaction caused by mineral aggregate-based cements. However, few studies have investigated the systemic effects promoted by these cements on liver and kidney when directly applied to connective tissue. The purpose of this in vivo study was to investigate the systemic effect of mineral aggregate-based cements on the livers and kidneys of rats. Material and Methods: Samples of Mineral Trioxide Aggregate (MTA) and a calcium aluminate-based cement (EndoBinder) containing different radiopacifiers were implanted into the dorsum of 40 rats. After 7 and 30 d, samples of subcutaneous, liver and kidney tissues were submitted to histopathological analysis. A score (0-3) was used to grade the inflammatory reaction. Blood samples were collected to evaluate changes in hepatic and renal functions of animals. Results: The moderate inflammatory reaction (2) observed for 7 d in the subcutaneous tissue decreased with time for all cements. The thickness of inflammatory capsules also presented a significant decrease with time (P<.05). Systemically, all cements caused adverse inflammatory reactions in the liver and kidney, being more evident for MTA, persisting until the end of the analysis. Liver functions increased significantly for MTA during 30 d (P<.05). Conclusion: The different cements induced to a locally limited inflammatory reaction. However, from the systemic point of view, the cements promoted significant inflammatory reactions in the liver and kidney. For MTA, the reactions were more accentuated. PMID:29211283

The role of hinges in primary total knee replacement.

PubMed

Gehrke, T; Kendoff, D; Haasper, C

2014-11-01

The use of hinged implants in primary total knee replacement (TKR) should be restricted to selected indications and mainly for elderly patients. Potential indications for a rotating hinge or pure hinge implant in primary TKR include: collateral ligament insufficiency, severe varus or valgus deformity (>20°) with necessary relevant soft-tissue release, relevant bone loss including insertions of collateral ligaments, gross flexion-extension gap imbalance, ankylosis, or hyperlaxity. Although data reported in the literature are inconsistent, clinical results depend on implant design, proper technical use, and adequate indications. We present our experience with a specific implant type that we have used for over 30 years and which has given our elderly patients good mid-term results. Because revision of implants with long cemented stems can be very challenging, an effort should be made in the future to use shorter stems in modular versions of hinged implants. ©2014 The British Editorial Society of Bone & Joint Surgery.

Early human bone response to laser metal sintering surface topography: a histologic report.

PubMed

Mangano, Carlo; Piattelli, Adriano; d'Avila, Susana; Iezzi, Giovanna; Mangano, Francesco; Onuma, Tatiana; Shibli, Jamil Awad

2010-01-01

This histologic report evaluated the early human bone response to a direct laser metal sintering implant surface retrieved after a short period of healing. A selective laser sintering procedure using a Ti-6Al-4V alloy powder with a particle size of 25-45 microm prepared this surface topography. One experimental microimplant was inserted into the anterior mandible of a patient during conventional implant surgery of the jaw. The microimplant and surrounding tissues were removed after 2 months of unloaded healing and were prepared for histomorphometric analysis. Histologically, the peri-implant bone appeared in close contact with the implant surface, whereas marrow spaces could be detected in other areas along with prominently stained cement lines. The mean of bone-to-implant contact was 69.51%. The results of this histologic report suggest that the laser metal sintering surface could be a promising alternative to conventional implant surface topographies.

Comparing the use of sewage sludge ash and glass powder in cement mortars.

PubMed

Chen, Zhen; Poon, Chi Sun

2017-06-01

This study explored the suitability of using sewage sludge ash (SSA) and mixed-colored glass powder (MGP) as construction materials in cement mortars. Positive findings from this study may help promote the recycling of waste SSA and MGP in construction works. The results indicated that the SSA decreased while MGP improved the mortar workability. The SSA exhibited very low pozzolanic activity, but the cement mortar prepared with 20% SSA yielded strength values slightly superior to those of the glass mortars due to its water absorption ability. MGP can serve as a pozzolan and when 20% of cement was replaced by MGP, apparent compressive strength gains were found at later curing ages. The SSA could be used to mitigate ASR expansion while the MGP was superior in resisting drying shrinkage.

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.

Effect of cyclic loading and retightening on reverse torque value in external and internal implants.

PubMed

Cho, Woong-Rae; Huh, Yoon-Hyuk; Park, Chan-Jin; Cho, Lee-Ra

2015-08-01

The aim of this study was to evaluate the effect of cyclic loading and screw retightening on reverse torque value (RTV) in external and internal type implants. Cement-retained abutments were connected with 30 Ncm torque to external and internal type implants. Experimental groups were classified according to implant connection type and retightening/loading protocol. In groups with no retightening, RTV was evaluated after cyclic loading for 100,000 cycles. In groups with retightening, RTV was measured after 3, 10, 100 cycles as well as every 20,000 cycles until 100,000 cycles of loading. Every group showed decreased RTV after cyclic loading. Before and after cyclic loading, external type implants had significantly higher RTVs than internal type implants. In external type implants, retightening did not affect the decrease in RTV. In contrast, retightening 5 times and retightening after 10 cycles of dynamic loading was effective for maintaining RTV in internal type implants. Retightening of screws is more effective in internal type implants than external type implants. Retightening of screws is recommended in the early stage of functional loading.

Research on and Application to BH-HTC High Density Cementing Slurry System on Tarim Region

NASA Astrophysics Data System (ADS)

Yuanhong, Song; Fei, Gao; Jianyong, He; Qixiang, Yang; Jiang, Yang; Xia, Liu

2017-08-01

A large section of salt bed is contented in Tarim region Piedmont which constructs complex geological conditions. For high-pressure gas well cementing difficulties from the region, high density cement slurry system has been researched through reasonable level of particle size distribution and second weighting up. The results of laboratory tests and field applications show that the high density cementing slurry system is available to Tarim region cementing because this system has a well performance in slurry stability, gas breakthrough control, fluidity, water loss, and strength.

In Vivo Osteogenic Potential of Biomimetic Hydroxyapatite/Collagen Microspheres: Comparison with Injectable Cement Pastes

PubMed Central

Manzanares, Maria-Cristina; Ginebra, Maria-Pau; Franch, Jordi

2015-01-01

The osteogenic capacity of biomimetic calcium deficient hydroxyapatite microspheres with and without collagen obtained by emulsification of a calcium phosphate cement paste has been evaluated in an in vivo model, and compared with an injectable calcium phosphate cement with the same composition. The materials were implanted into a 5 mm defect in the femur condyle of rabbits, and bone formation was assessed after 1 and 3 months. The histological analysis revealed that the cements presented cellular activity only in the margins of the material, whereas each one of the individual microspheres was covered with osteogenic cells. Consequently, bone ingrowth was enhanced by the microspheres, with a tenfold increase compared to the cement, which was associated to the higher accessibility for the cells provided by the macroporous network between the microspheres, and the larger surface area available for osteoconduction. No significant differences were found in terms of bone formation associated with the presence of collagen in the materials, although a more extensive erosion of the collagen-containing microspheres was observed. PMID:26132468

Clinical outcome after the use of a new craniocaudal expandable implant for vertebral compression fracture treatment: one year results from a prospective multicentric study.

PubMed

Noriega, David; Krüger, Antonio; Ardura, Francisco; Hansen-Algenstaedt, Nils; Hassel, Frank; Barreau, Xavier; Beyerlein, Jörg

2015-01-01

The purpose of this prospective multicentric observational study was to confirm the safety and clinical performance of a craniocaudal expandable implant used in combination with high viscosity PMMA bone cement for the treatment of vertebral compression fractures. Thirty-nine VCFs in 32 patients were treated using the SpineJack minimally invasive surgery protocol. Outcome was determined by using the Visual Analogue Scale for measuring pain, the Oswestry Disability Index for scoring functional capacity, and the self-reporting European Quality of Life scores for the quality of life. Safety was evaluated by reporting all adverse events. The occurrence of cement leakages was assessed by either radiographs or CT scan or both. Statistically significant improvements were found regarding pain, function, and quality of life. The global pain score reduction at 1 year was 80.9% compared to the preoperative situation and the result of the Oswestry Disability Index showed a decrease from 65.0% at baseline to 10.5% at 12 months postoperatively. The cement leakage rate was 30.8%. No device- or surgery-related complications were found. This observational study demonstrates promising and persistent results consisting of immediate and sustained pain relief and durable clinical improvement after the procedure and throughout the 1-year follow-up period.

Advanced concepts in knee arthrodesis.

PubMed

Wood, Jennifer H; Conway, Janet D

2015-03-18

The aim is to describe advanced strategies that can be used to diagnose and treat complications after knee arthrodesis and to describe temporary knee arthrodesis to treat infected knee arthroplasty. Potential difficult complications include nonunited knee arthrodesis, limb length discrepancy after knee arthrodesis, and united but infected knee arthrodesis. If a nonunited knee arthrodesis shows evidence of implant loosening or failure, then bone grafting the nonunion site as well as exchange intramedullary nailing and/or supplemental plate fixation are recommended. If symptomatic limb length discrepancy cannot be satisfactorily treated with a shoe lift, then the patient should undergo tibial lengthening over nail with a monolateral fixator or exchange nailing with a femoral internal lengthening device. If a united knee arthrodesis is infected, the nail must be removed. Then the surgeon has the option of replacing it with a long, antibiotic cement-coated nail. The authors also describe temporary knee arthrodesis for infected knee arthroplasty in patients who have the potential to undergo insertion of a new implant. The procedure has two goals: eradication of infection and stabilization of the knee. A temporary knee fusion can be accomplished by inserting both an antibiotic cement-coated knee fusion nail and a static antibiotic cement-coated spacer. These advanced techniques can be helpful when treating difficult complications after knee arthrodesis and treating cases of infected knee arthroplasty.

Advanced concepts in knee arthrodesis

PubMed Central

Wood, Jennifer H; Conway, Janet D

2015-01-01

The aim is to describe advanced strategies that can be used to diagnose and treat complications after knee arthrodesis and to describe temporary knee arthrodesis to treat infected knee arthroplasty. Potential difficult complications include nonunited knee arthrodesis, limb length discrepancy after knee arthrodesis, and united but infected knee arthrodesis. If a nonunited knee arthrodesis shows evidence of implant loosening or failure, then bone grafting the nonunion site as well as exchange intramedullary nailing and/or supplemental plate fixation are recommended. If symptomatic limb length discrepancy cannot be satisfactorily treated with a shoe lift, then the patient should undergo tibial lengthening over nail with a monolateral fixator or exchange nailing with a femoral internal lengthening device. If a united knee arthrodesis is infected, the nail must be removed. Then the surgeon has the option of replacing it with a long, antibiotic cement-coated nail. The authors also describe temporary knee arthrodesis for infected knee arthroplasty in patients who have the potential to undergo insertion of a new implant. The procedure has two goals: eradication of infection and stabilization of the knee. A temporary knee fusion can be accomplished by inserting both an antibiotic cement-coated knee fusion nail and a static antibiotic cement-coated spacer. These advanced techniques can be helpful when treating difficult complications after knee arthrodesis and treating cases of infected knee arthroplasty. PMID:25793160

[LOCAL ANTIBIOTIC THERAPY OF OSTEOMYELITIS USING NONABSORBABLE IMPLANT (REVIEW)].

PubMed

Tuleubaev, B; Saginova, D; Abiyev, T; Davletbaev, M; Koshanova, A

2016-06-01

Despite the variety of treatments available, including surgical procedures and antimicrobial therapy, bone infections is still a medical problem, because they are difficult to treat. Optimal treatment should stabilize the bone, promote the biological recovery of bone defects and destroy bacterial infection. Systemic antibiotics are part of the standard therapy after surgical treatment of infected bone, but their effectiveness is limited due to malnutrition and low absorption at the site of infection. Moreover, long-term treatment and higher doses are associated with serious side effects. In contrast, the antibiotic impregnated bone cements or fillers can act as a local anti-infective drug delivery system, which not only fills the dead space after debridement, but also provide high concentrations of antibiotics in a potential site of infection, no increase levels of antibiotics in serum. The review analyzed the use of antibiotic-impregnated cement as local delivery of antibiotics systems. Gentamycin impregnated polymethylmethacrylate (PMMA) beads, for the topical treatment of orthopedic infections clinically used for over 30 years. Application of antibiotic delivery systems using cement in the infected region is common method of treatment that continues to improve. On the downside of PMMA is that the material does not biodegradable requires subsequent invasive procedures necessary to remove the implant.

Comparative study of design and PCL-substituting systems of total knee prosthesis.

PubMed

Adam, R; Orban, C; Orban, H

2014-01-01

The aim of this study is to assess postoperative results obtained by different knee implants. The main implant types differences are given by generally implant design and by PCL substituting systems that are used. Between 04.2004 - 02.2012 we have performed 506 total knee arthroplasties (TKA), on a group of 460 patients. Our choice, was for cemented total knee prostheses, using PCL-substituting systems. Regarding general design and PCL-substituting systems of the implant we had divided the main group in three lots. In order to assess post operative result we had used the American Knee Society Score(AKSS). All prostheses types that we had implanted, had registered satisfactory values of AKSS. Our study showed that one group scored higher values of AKSS, compared the other two, but there are not statistical semnificative differences (p=0,09). Celsius.

Effect of Steam Autoclaving on the Tensile Strength of Resin Cements Used for Bonding Two-Piece Zirconia Abutments.

PubMed

Fadanelli, Marcos Alexandre; Amaral, Flávia Lucisano Botelho do; Basting, Roberta Tarkany; Turssi, Cecilia Pedroso; Sotto-Maior, Bruno Salles; França, Fabiana Mantovani Gomes

2017-04-01

The purpose of this study was to evaluate the effects of steam autoclave sterilization on the tensile strength of two types of resin cements used to bond customized CAD/CAM zirconia abutments onto titanium bases. Forty sets of zirconia abutments cemented to screwed titanium bases of implants analogs were divided into 4 groups (n = 10). Two groups were treated with a conventional chemically activated resin cement (ML, Multilink Ivoclar Vivadent) and the other two groups with a self-adhesive dual resin cement (RelyX U200, 3M ESPE). One group from each cement was submitted to steam autoclaving. The autoclave sterilization cycle was performed after 72 hours of cementation for 15 minutes at 121°C and 2.1 Kgf/cm 2 . The samples were subjected to tensile strength testing in a universal testing machine (200 Kgf, 0.5 mm/min), from which the means and standard deviations were obtained in Newtons. Results showed (via ANOVA and Tukey's test; α = 0.05) that in the absence of steam autoclaving, no difference was observed in tensile strength between the cements tested: ML: 344.87 (93.79) and U200: 280 (92.42) (P = .314). Steam autoclaving, however, significantly increased tensile strength for the ML: 465.42 (87.87) compared to U200: 289.10 (49.02) (P < .001). Despite the significant increase in the ML samples (P = .013), autoclaving did not affect the tensile strength of the U200 samples (P > 0.05). The authors concluded that steam autoclaving increases the mean tensile strength of the chemically activated cement compared to the dual-cure self-adhesive cement. The performance of both cements evaluated was similar if the sterilization step was disconsidered.

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

Evaluation of ternary cementitious combinations : tech summary.

DOT National Transportation Integrated Search

2012-02-01

Portland cement concrete (PCC) is the worlds most versatile and utilized construction material. Modern concrete consists of six : main ingredients: coarse aggregate, sand, portland cement, supplementary cementitious materials (SCMs), chemical admi...

Radon exhalation of hardening concrete: monitoring cement hydration and prediction of radon concentration in construction site.

PubMed

Kovler, Konstantin

2006-01-01

The unique properties of radon as a noble gas are used for monitoring cement hydration and microstructural transformations in cementitious system. It is found that the radon concentration curve for hydrating cement paste enclosed in the chamber increases from zero (more accurately - background) concentrations, similar to unhydrated cement. However, radon concentrations developed within 3 days in the test chamber containing cement paste were approximately 20 times higher than those of unhydrated cement. This fact proves the importance of microstructural transformations taking place in the process of cement hydration, in comparison with cement grain, which is a time-stable material. It is concluded that monitoring cement hydration by means of radon exhalation method makes it possible to distinguish between three main stages, which are readily seen in the time dependence of radon concentration: stage I (dormant period), stage II (setting and intensive microstructural transformations) and stage III (densification of the structure and drying). The information presented improves our understanding of the main physical mechanisms resulting in the characteristic behavior of radon exhalation in the course of cement hydration. The maximum value of radon exhalation rate observed, when cement sets, can reach 0.6 mBq kg(-1) s(-1) and sometimes exceeds 1.0 mBq kg(-1) s(-1). These values exceed significantly to those known before for cementitious materials. At the same time, the minimum ventilation rate accepted in the design practice (0.5 h(-1)), guarantees that the concentrations in most of the cases will not exceed the action level and that they are not of any radiological concern for construction workers employed in concreting in closed spaces.

Equally good fixation of cemented and uncemented cups in total trapeziometacarpal joint prostheses. A randomized clinical RSA study with 2-year follow-up.

PubMed

Hansen, Torben Baek; Stilling, Maiken

2013-02-01

Cup failure is a recognized problem in total trapeziometacarpal (TM) joint prostheses; it may be related to poor fixation, which can be revealed by radiostereometric analysis (RSA). We compared the early implant migration of cemented trapezium cups to that of uncemented screw cups. In a prospective, parallel-group, randomized patient-blinded clinical trial, we included 32 hands in 28 patients (5 males) with a mean age of 58 (40-77) years and with Eaton stage-2 or -3 osteoarthritis of the trapeziometacarpal joint. Patients were randomized to surgery with a cemented DLC all-polyethylene cup (C) (n = 16) or an uncemented hydroxyapatite-coated chrome-cobalt Elektra screw cup (UC) (n = 16). Uncemented cups were inserted without threading of the bone. Stereoradiographs for evaluation of cup migration (primary effect size) and DASH and pain scores were obtained during 2 years of follow-up. The 2-year total translation (TT) was similar (p = 0.2): 0.24 mm (SD 0.10) for the C (n = 11) and 0.19 mm (SD 0.16) for the UC (n = 11). Variances were similar (p = 0.4). Judged by RSA, 2 UC cups and 1 C cup became loose (TT > 1 mm). Both UC cups were found to be loose at revision. Grip strength, pain, and DASH scores were similar between groups at all measurement points. Early implant fixation and clinical outcome were equally good with both cup designs. This is the first clinical RSA study on trapezium cups, and the method appears to be clinically useful for detection of loose implants.

Interleukin-6 as an early marker for fat embolism

PubMed Central

Yoga, R; Theis, JC; Walton, M; Sutherland, W

2009-01-01

Background Fat Embolism is a complication of long bone fractures, intramedullary fixation and joint arthroplasty. It may progress to fat embolism syndrome, which is rare but involves significant morbidity and can occasionally be fatal. Fat Embolism can be detected at the time of embolization by transoesophageal echocardiography or atrial blood sampling. Later, a combination of clinical signs and symptoms will point towards fat embolism but there is no specific test to confirm the diagnosis. We investigated serum Interleukin-6 (IL-6) as a possible early marker for fat embolism. Methods An animal study was conducted to simulate a hip replacement in 31 adult male Sprague Dawley rats. The procedure was performed under general anesthesia and the animals divided into 3 groups: control, uncemented and cemented. Following surgery and recovery from anaesthesia, the rats allowed to freely mobilize in their cages. Blood was taken before surgery and at 6 hours, 12 hours and 24 hours to measure serum IL-6 levels. The rats were euthanized at 24 hours and lungs removed and stained for fat. The amount of fat seen was then correlated with serum IL-6 levels. Results No rats in the control group had fat emboli. Numerous fat emboli were seen in both the uncemented and cemented implant groups. The interleukin levels were raised in all groups reaching a peak at 12 hours after surgery reaching 100 pg/ml in the control group and around 250 pg/ml in the uncemented and cemented implant groups. The IL-6 levels in the control group were significantly lower than any of the implant groups at 12 and 24 hours. At these time points, the serum IL-6 correlated with the amount of fat seen on lung histology. Conclusion Serum IL-6 is a possible early marker of fat embolism. PMID:19523233

Rat subcutaneous tissue response to calcium silicate containing different arsenic concentrations

PubMed Central

MINOTTI, Paloma Gagliardi; ORDINOLA-ZAPATA, Ronald; MIDENA, Raquel Zanin; MARCIANO, Marina Angélica; CAVENAGO, Bruno Cavalini; BRAMANTE, Clovis Monteiro; GARCIA, Roberto Brandão; DUARTE, Marco Antonio Hungaro; de MORAES, Ivaldo Gomes

2015-01-01

Objective To evaluate the response of rat subcutaneous tissue in implanted polyethylene tubes that were filled with GMTA Angelus and Portland cements containing different arsenic concentrations. Material and Methods Atomic absorption spectrophotometry was utilized to obtain the values of the arsenic concentration in the materials. Thirty-six rats were divided into 3 groups of 12 animals for each experimental period. Each animal received two implants of polyethylene tubes filled with different test cements and the lateral of the tubes was used as a control group. After 15, 30 and 60 days of implantation, the animals were killed and the specimens were prepared for descriptive and morphometric analysis considering: inflammatory cells, collagen fibers, fibroblasts, blood vessels and other components. The results were analyzed utilizing the Kuskal-Wallis test and the Dunn´s Multiple test for comparison (p<0.05). Results The materials showed, according to atomic absorption spectrophotometry, the following doses of arsenic: GMTA Angelus: 5.01 mg/kg, WPC Irajazinho: 0.69 mg/kg, GPC Minetti: 18.46 mg/kg and GPC Votoran: 10.76 mg/kg. In a 60-day periods, all specimens displayed a neoformation of connective tissue with a structure of fibrocellular aspect (capsule). Control groups and MTA Angelus produced the lower amount of inflammatory reaction and GPC Minetti, the highest reaction. Conclusions There was no direct relationship between the concentration of arsenic present in the composition of the materials and the intensity of the inflammatory reactions. Higher values, as 18.46 mg/kg of arsenic in the cement, produce characteristics of severe inflammation reaction at the 60-day period. The best results were found in MTA angelus. PMID:25075671

A randomized study on migration of the Spectron EF and the Charnley flanged 40 cemented femoral components using radiostereometric analysis at 2 years.

PubMed

Kadar, Thomas; Hallan, Geir; Aamodt, Arild; Indrekvam, Kari; Badawy, Mona; Havelin, Leif Ivar; Stokke, Terje; Haugan, Kristin; Espehaug, Birgitte; Furnes, Ove

2011-10-01

We performed a randomized study to determine the migration patterns of the Spectron EF femoral stem and to compare them with those of the Charnley stem, which is regarded by many as the gold standard for comparison of implants due to its extensive documentation. 150 patients with a mean age of 70 years were randomized, single-blinded, to receive either a cemented Charnley flanged 40 monoblock, stainless steel, vaquasheen surface femoral stem with a 22.2-mm head (n = 30) or a cemented Spectron EF modular, matte, straight, collared, cobalt-chrome femoral stem with a 28-mm femoral head and a roughened proximal third of the stem (n = 120). The patients were followed with repeated radiostereometric analysis for 2 years to assess migration. At 2 years, stem retroversion was 2.3° and 0.7° (p < 0.001) and posterior translation was 0.44 mm and 0.17 mm (p = 0.002) for the Charnley group (n = 26) and the Spectron EF group (n = 74), respectively. Subsidence was 0.26 mm for the Charnley and 0.20 mm for the Spectron EF (p = 0.5). The Spectron EF femoral stem was more stable than the Charnley flanged 40 stem in our study when evaluated at 2 years. In a report from the Norwegian arthroplasty register, the Spectron EF stem had a higher revision rate due to aseptic loosening beyond 5 years than the Charnley. Initial stability is not invariably related to good long-term results. Our results emphasize the importance of prospective long-term follow-up of prosthetic implants in clinical trials and national registries and a stepwise introduction of implants.

Material Performance and Animal Clinical Studies on Performance-Optimized Hwangtoh Mixed Mortar and Concrete to Evaluate Their Mechanical Properties and Health Benefits

PubMed Central

Koo, Bon-Min; Kim, Jang-Ho Jay; Kim, Tae-Kyun; Kim, Byung-Yun

2015-01-01

In this study, the amount of cement used in a concrete mix is minimized to reduce the toxic effects on users by adjusting the concrete mixture contents. The reduction of cement is achieved by using various admixtures (ground granulated blast-furnace slag, flyash, ordinary Portland cement, and activated Hwangtoh powder). To apply the mix to construction, material property tests such as compressive strength, slump, and pH are performed. Preliminary experimental results showed that the Hwangtoh concrete could be used as a healthy construction material. Also, the health issues and effects of Hwangtoh mortar are quantitatively evaluated through an animal clinical test. Mice are placed in Hwangtoh mortar and cement mortar cages to record their activity. For the test, five cages are made with Hwangtoh and ordinary Portland cement mortar floors, using Hwangtoh powder replacement ratios of 20%, 40%, 60%, and 80% of the normal cement mortar mixing ratio, and two cages are made with Hwangtoh mortar living quarters. The activity parameter measurements included weight, food intake, water intake, residential space selection, breeding activity, and aggression. The study results can be used to evaluate the benefits of using Hwangtoh as a cement replacing admixture for lifestyle, health and sustainability. PMID:28793563

Material Performance and Animal Clinical Studies on Performance-Optimized Hwangtoh Mixed Mortar and Concrete to Evaluate Their Mechanical Properties and Health Benefits.

PubMed

Koo, Bon-Min; Kim, Jang-Ho Jay; Kim, Tae-Kyun; Kim, Byung-Yun

2015-09-17

In this study, the amount of cement used in a concrete mix is minimized to reduce the toxic effects on users by adjusting the concrete mixture contents. The reduction of cement is achieved by using various admixtures (ground granulated blast-furnace slag, flyash, ordinary Portland cement, and activated Hwangtoh powder). To apply the mix to construction, material property tests such as compressive strength, slump, and pH are performed. Preliminary experimental results showed that the Hwangtoh concrete could be used as a healthy construction material. Also, the health issues and effects of Hwangtoh mortar are quantitatively evaluated through an animal clinical test. Mice are placed in Hwangtoh mortar and cement mortar cages to record their activity. For the test, five cages are made with Hwangtoh and ordinary Portland cement mortar floors, using Hwangtoh powder replacement ratios of 20%, 40%, 60%, and 80% of the normal cement mortar mixing ratio, and two cages are made with Hwangtoh mortar living quarters. The activity parameter measurements included weight, food intake, water intake, residential space selection, breeding activity, and aggression. The study results can be used to evaluate the benefits of using Hwangtoh as a cement replacing admixture for lifestyle, health and sustainability.

Variability of cement-treated layers in MDOT road projects.

DOT National Transportation Integrated Search

2011-12-01

The Mississippi Department of Transportation revised the specifications for cement-treated : bases between the 1990 and 2004 editions of Mississippi Standard Specifications for Road and Bridge : Construction. The required compressive strength o...

New System of Shrinkage Measurement through Cement Mortars Drying

PubMed Central

Morón, Carlos; Saiz, Pablo; Ferrández, Daniel; García-Fuentevilla, Luisa

2017-01-01

Cement mortar is used as a conglomerate in the majority of construction work. There are multiple variants of cement according to the type of aggregate used in its fabrication. One of the major problems that occurs while working with this type of material is the excessive loss of moisture during cement hydration (setting and hardening), known as shrinkage, which provokes a great number of construction pathologies that are difficult to repair. In this way, the design of a new sensor able to measure the moisture loss of mortars at different age levels is useful to establish long-term predictions concerning mortar mass volume loss. The purpose of this research is the design and fabrication of a new capacitive sensor able to measure the moisture of mortars and to relate it with the shrinkage. PMID:28272297

Alumina as a filler for bone cement: a feasibility study.

PubMed

Ackley, M A; Monroe, E

1980-10-01

A composite bone cement of Alcoa A-10 Alumina and very finely ground poly(methyl methacrylate) beads (PMMA) was fabricated. It was tested in an attempt to improve on the conventionally used pure PMMA bone cement. By knowing the densities of the powders and their volumes, the mass of each was calculated for the most efficient packing of PMMA and Al2O3 powders and a 65% PMMA: 35% Al2O3 ratio by weight composition was determined. This was tested, as well as the pure cement so comparisons could be made. Cylinders for the strength tests were also made of silane treated Al2O3. The compositions were tested for compressive and tensile strengths. The pure PMMA, composite and silane treated composite had compressive strengths of 79.64 +/- 13.0, 83.17 +/- 4.8, and 71.52 +/- 8.6 MPa and the tensile strengths were 6.69 +/- 0.6, 5.12 +/- 0.3, and 7.12 +/- 0.5 MPa respectively. Also the 65%-35% PMMA-Al2O3 composite required 64% less monomer for mixing than did the pure cement which is thought to be better for tissue healing. The maximum temperature attained from room temperature was 110 degrees-115 degrees C for both cements. The composite took 6.5 min longer to reach its peak temperature than did the pure cement. The bone cements were implanted for one week in a rabbit and both compositions seemed acceptable by the tissue.

Development and characterization of an injectable cement of nano calcium-deficient hydroxyapatite/multi(amino acid) copolymer/calcium sulfate hemihydrate for bone repair

PubMed Central

Qi, Xiaotong; Li, Hong; Qiao, Bo; Li, Weichao; Hao, Xinyan; Wu, Jun; Su, Bao; Jiang, Dianming

2013-01-01

A novel injectable bone cement was developed by integration of nano calcium-deficient hydroxyapatite/multi(amino acid) copolymer (n-CDHA/MAC) and calcium sulfate hemihydrate (CSH; CaSO4 · 1/2H2O). The structure, setting time, and compressive strength of the cement were investigated. The results showed that the cement with a liquid to powder ratio of 0.8 mL/g exhibited good injectability and appropriate setting time and mechanical properties. In vitro cell studies indicated that MC3T3-E1 cells cultured on the n-CDHA/MAC/CSH composite spread well and showed a good proliferation state. The alkaline phosphatase activity of the MC3T3-E1 cells cultured on the n-CDHA/MAC/CSH composite was significantly higher than that of the cells on pure CSH at 4 and 7 days of culture. The n-CDHA/MAC/CSH cement was implanted into critical size defects of the femoral condyle in rabbits to evaluate its biocompatibility and osteogenesis in vivo. Radiological and histological results indicated that introduction of the n-CDHA/MAC into CSH enhanced new bone formation, and the n-CDHA/MAC/CSH cement exhibited good biocompatibility and degradability. In conclusion, the injectable n-CDHA/MAC/CSH composite cement has a significant clinical advantage over pure CSH cement, and may be a promising bone graft substitute for the treatment of bone defects. PMID:24293996

Clinical and histologic evaluation of calcium-phosphate bone cement in interproximal osseous defects in humans: a report in four patients.

PubMed

Mellonig, James T; Valderrama, Pilar; Cochran, David L

2010-04-01

This study evaluated the clinical and histologic results of a calcium phosphate bone cement in the treatment of human periodontal intraosseous defects. Four patients with chronic advanced periodontitis in whom treatment with complete dentures was planned were recruited. The cement was implanted in one defect per subject with a presurgical probing depth of at least 7 mm and a radiographic bone defect of 4 mm or more. Patients were seen every 2 weeks for periodontal maintenance. At 6 months, clinical measurements were repeated and the tooth was removed en bloc for histologic processing. Results demonstrated that all defects resulted in probing depth reduction and, at three of the four defects, in clinical attachment level gain. However, no site showed periodontal regeneration. There was no new bone formation. New cementum and connective tissue were limited to 0.2 mm or less. Large deposits of the bone cement were noted encapsulated in connective tissue.

Gentamicin release from commercially-available gentamicin-loaded PMMA bone cements in a prosthesis-related interfacial gap model and their antibacterial efficacy.

PubMed

Neut, Daniëlle; Kluin, Otto S; Thompson, Jonathan; van der Mei, Henny C; Busscher, Henk J

2010-11-10

Around about 1970, a gentamicin-loaded poly (methylmethacrylate) (PMMA) bone cement brand (Refobacin Palacos R) was introduced to control infection in joint arthroplasties. In 2005, this brand was replaced by two gentamicin-loaded follow-up brands, Refobacin Bone Cement R and Palacos R + G. In addition, another gentamicin-loaded cement brand, SmartSet GHV, was introduced in Europe in 2003. In the present study, we investigated differences in gentamicin release and the antibacterial efficacy of the eluent between these four cement brands. 200 μm-wide gaps were made in samples of each cement and filled with buffer in order to measure the gentamicin release. Release kinetics were related to bone cement powder particle characteristics and wettabilities of the cement surfaces. Gaps were also inoculated with bacteria isolated from infected prostheses for 24 h and their survival determined. Gentamicin release and bacterial survival were statistically analysed using the Student's t-test. All three Palacos variants showed equal burst releases but each of the successor Palacos cements showed significantly higher sustained releases. SmartSet GHV showed a significantly higher burst release, while its sustained release was comparable with original Palacos. A gentamicin-sensitive bacterium did not survive in the high gentamicin concentrations in the interfacial gaps, while a gentamicin-resistant strain did, regardless of the type of cement used. Survival was independent of the level of burst release by the bone cement. Although marketed as the original gentamicin-loaded Palacos cement, orthopaedic surgeons should be aware that the successor cements do not appear to have the same release characteristics as the original one. Overall, high gentamicin concentrations were reached inside our prosthesis-related interfacial gap model. These concentrations may be expected to effectively decontaminate the prosthesis-related interfacial gap directly after implantation, provided that these bacteria are sensitive for gentamicin.

In vitro Characteristics of a Glass Ionomer Cement

PubMed Central

Driscoll, Colin L. W.; Green, J. Douglas; Beatty, Charles W.; McCaffrey, Thomas V.; Marrs, Christopher D.

1998-01-01

Glass ionomer cements were first described by Wilson and Kent and have been used in dentistry since 1969. It has been recommended for bridging ossicular chain defects, fixation of ossicular chain prosthesis, anchoring of cochlear implants, mastoid obliteration, and repair of tegmen and posterior canal wall defects. The biocompatability and stability of this material over time is vital to its usefulness in neurotologic surgery. The purpose of this study was to assess the stability of a glass ionomer cement in the presence of bacteria and in different pH environments. We demonstrated that bacteria readily adhere to the surface and their presence is associated with accelerated loss of matrix. We found the cement to be susceptible to low pH and to release a visible cloud of debris upon contact with fluid. Calcium concentration in the solution was elevated at all pH levels. Although we are able to demonstrate these findings in vitro the clinical relevance is unclear. There have been several cases of aseptic meningitis possibly due to intracranial release of components of the cement. Until further studies are done use of the cement in contact with cerebral spinal fluid should be avoided. This cement, or a similar material, would be useful in neurotologic surgery but prior to widespread use further testing should be done to assess safety. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 9Figure 10Figure 11 PMID:17171062

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.

Tensile strength of cementing agents on the CeraOne system of dental prosthesis on implants.

PubMed

Montenegro, Alexandre Campos; Machado, Aldir Nascimento; Depes Gouvêa, Cresus Vinicius

2008-12-01

The aim of this in vitro study was to evaluate the tensile strength of titanium cylinders cemented on stainless steel abutment mock-ups by the Cerazone system. Four types of cements were used: glass ionomer, Fuji I (GC); zinc phosphate, Cimento LS (Vigodent); zinc oxide without eugenol, Rely x Temp NE (3M ESPE); and resin cement, Rely x ARC (3M ESPE). Four experimental groups were formed, each composed of 5 test specimens. Each test specimen consisted of a set of 1 cylinder and 1 stainless steel abutment mock-up. All cements tested were manipulated in accordance with manufacturers' instructions. A static load of 5 Newtons (N) for 2 minutes was used to standardize the procedure. The tensile tests were performed by a mechanical universal testing machine (EMIC DL500MF) at a crosshead speed of 0.5 mm/min. The highest bonding values resulting from the experiment were obtained by Cimento LS (21.86 MPa mean), followed by the resin cement Rely x ARC (12.95 MPa mean), Fuji I (6.89 MPa mean), and Rely x Temp NE (4.71 MPa mean). The results were subjected to analysis of variance (ANOVA) and the Student's t test. The cements differed amongst them as regards tensile strength, with the highest bonding levels recorded with zinc phosphate (Cimento LS) and the lowest with the zinc oxide without eugenol (Rely x Temp NE).

The Measurement Of Total Joint Loosening By X-Ray Photogrammetry

NASA Astrophysics Data System (ADS)

Lippert, Frederick G.; Veress, Sandor A.; Tiwari, Rama S.; Harrington, Richard M.

1980-07-01

Failure of total joint replacement due to loosening of the composents either between the implant and cement or between the cement and bone is emerging as a late complication with an incidence as high as 20 percent. Loosening may not only cause pain but progressive loss of support for the prosthesis with eventual structural failure. Early diagnosis is important so that revision may be carried when deterioration or pain occurs. No method is currently available which clearly establishes loosening at an early stage except surgical exploration. We have devised a method based on our in vivo photogrammetry studies of patellar tracking patterns using metallic markers placed in bone near both components of the total joint. Stereo x-rays taken with the joint loaded and unloaded are measured for relative motion between the implant and the metallic markers. Laboratory studies using prosthetic hip components mounted in plastic bone have revealed the ability of this method to detect pistoning movements as small as 80 microns. These findings were confirmed by physical measurements.

Soil-cement study : final report.

DOT National Transportation Integrated Search

1973-11-01

This study consisted of an examination of the compressive strengths of soil-cement mixtures on 15 construction projects from the standpoint of design and actual achievement. The laboratory design test was examined closely along with the present field...

Latex-modified concrete overlay containing Type K cement.

DOT National Transportation Integrated Search

2005-01-01

Hydraulic cement concrete overlays are usually placed on bridges to reduce the infiltration of water and chloride ions and to improve skid resistance, ride quality, and surface appearance. Constructed in accordance with prescription specifications, s...

Utilizing Coal Fly Ash and Recycled Glass in Developing Green Concrete Materials

DOT National Transportation Integrated Search

2012-06-01

The environmental impact of Portland cement concrete production has motivated researchers and the construction industry to evaluate alternative technologies for incorporating recycled cementing materials and recycled aggregates in concrete. One such ...

Osteoconductive Amine-Functionalized Graphene-Poly(methyl methacrylate) Bone Cement Composite with Controlled Exothermic Polymerization.

PubMed

Sharma, Rakesh; Kapusetti, Govinda; Bhong, Sayali Yashwant; Roy, Partha; Singh, Santosh Kumar; Singh, Shikha; Balavigneswaran, Chelladurai Karthikeyan; Mahato, Kaushal Kumar; Ray, Biswajit; Maiti, Pralay; Misra, Nira

2017-09-20

Bone cement has found extensive usage in joint arthroplasty over the last 50 years; still, the development of bone cement with essential properties such as high fatigue resistance, lower exothermic temperature, and bioactivity has been an unsolved problem. In our present work, we have addressed all of the mentioned shortcomings of bone cement by reinforcing it with graphene (GR), graphene oxide (GO), and surface-modified amino graphene (AG) fillers. These nanocomposites have shown hypsochromic shifts, suggesting strong interactions between the filler material and the polymer matrix. AG-based nanohybrids have shown greater osteointegration and lower cytotoxicity compared to other nanohybrids as well as pristine bone cement. They have also reduced oxidative stress on cells, resulting in calcification within 20 days of the implantation of nanohybrids into the rabbits. They have significantly reduced the exothermic curing temperature to body temperature and increased the setting time to facilitate practitioners, suggesting that reaction temperature and settling time can be dynamically controlled by varying the concentration of the filler. Thermal stability and enhanced mechanical properties have been achieved in nanohybrids vis-à-vis pure bone cement. Thus, this newly developed nanocomposite can create natural bonding with bone tissues for improved bioactivity, longer sustainability, and better strength in the prosthesis.

Postoperative stroke after hemiarthroplasty for femoral neck fracture: a report of 2 cases and review of literature.

PubMed

Ding, David Yi; Christoforou, Dimitrios; Turner, Garth; Tejwani, Nirmal C

2014-06-01

Femoral neck fractures in the elderly comprise a significant number of orthopedic surgical cases at a major trauma center. These patients are immediately incapacitated, and surgical fixation can help increase mobility, restore independence, and reduce morbidity and mortality. However, operative treatment carries its own inherent risks including infections, deep vein thromboses, and intraoperative cardiovascular collapse. Cerebrovascular stroke is a relatively uncommon occurrence after hip fractures. We present 2 cases with unusual postoperative medical complication after cemented hip hemiarthroplasty for femoral neck fracture that will serve to illustrate an infrequent but very serious complication. Case 1 was a 73-year-old man with a Garden IV femoral neck fracture who underwent a right hip unipolar cemented hemiarthroplasty under general anesthesia. After uneventful surgery, he developed neurological deficits, and a postoperative noncontrast head computed tomography showed a right medial thalamic infarct. Case 2 was an 82-year-old man with a Garden IV femoral neck fracture who underwent a right hip unipolar cemented hemiarthroplasty under general anesthesia. After uneventful surgery, the patient became hemodynamically unstable. A postoperative noncontrast head computed tomography showed a large evolving left middle cerebral artery stroke. General anesthesia in the setting of decreased cardiac function (decreased ejection fraction and output) carries the risk for ischemic injury to the brain from decreased cerebral perfusion. Risk factors including advanced age, history of coronary artery disease, atherosclerotic disease, and atrial fibrillation increase the risk for perioperative stroke. Furthermore, it is known that during the cementing of implants, microemboli can be released, which must be considered in patients with preoperative heart disease. As a result, consideration of using a noncemented implant or cementing without pressurizing in this clinical scenario should be an important aspect of the preoperative plan in an at-risk patient. Further studies are needed that can elucidate a causal relationship.

[Two-stage revision of infected total knee arthroplasty using antibiotic-impregnated articulating cement spacer].

PubMed

Cai, Pengde; Hu, Yihe; Xie, Lie; Wang, Long

2012-10-01

To investigate the effectiveness of two-stage revision of infected total knee arthroplasty (TKA) using an antibiotic-impregnated articulating cement spacer. The clinical data were analyzed from 23 patients (23 knees) undergoing two-stage revision for late infection after primary TKA between January 2007 and December 2009. There were 15 males and 8 females, aged from 43 to 75 years (mean, 65.2 years). Infection occurred at 13-52 months (mean, 17.3 months) after TKA. The time interval between infection and admission ranged from 15 days to 7 months (mean, 2.1 months). One-stage operation included surgical debridement and removal of all knee prosthesis and cement, then an antibiotic-impregnated articulating cement spacer was implanted. The re-implantation of prosthesis was performed after 8-10 weeks when infections were controlled. The American Hospital for Special Surgery (HSS) score and Knee Society Score (KSS) were used to compare the function of the knee between pre- and post-revision. The rate of infection control and complication were analyzed. All incisions healed primarily. Re-infection occurred in 2 cases after two-stage revision, and infection was controlled in the other 21 cases, with an infection control rate of 91.3%. The patients were followed up 2-5 years (mean, 3.6 years). The HSS score was increased from 60.6 +/- 9.8 at pre-revision to 82.3 +/- 7.4 at last follow-up, the KSS score was increased from 110.7 +/- 9.6 at pre-revision to 134.0 +/- 10.5 at last follow-up, all showing significant differences (P < 0.01). Radiographs showed that prosthesis had good position with no loosening, fracture, or periprosthetic radiolucent. Two-stage revision using an antibiotic-impregnated articulating cement spacer is an effective method to control infected TKA and to restore the function of affected knee.

[Has application of the decree banning the use of cement with a high chromium VI content led to a reduction in occupational cement dermatitis in salaried workers in the construction industries?].

PubMed

Halioua, Bruno; Bensefa-Colas, Lynda; Crepy, Marie-Noëlle; Bouquiaux, Barbara; Assier, Haudrey; Billon, Stéphane; Chosidow, Olivier

2013-03-01

Active employees in the construction industry are particularly exposed to occupational cement eczema (OCE) which affects the hands in 80 to 90% of cases. The importance of OCE in France and the impact of the application of decree n(o). 2005-577 on 26 May 2005 were estimated from data collected by the Occupational risks division of the French national health insurance fund for salaried workers (CNAMTS). This decree prohibits the placing on the market and use of cement (and preparations containing it) with a chromium VI content above 0.0002% in order to reduce its hazardousness. All cases of OCE reported to and recognized by the CNAMTS between 1 January 2004 and 31 December 2008 among construction workers were selected. The following parameters were noted in each case: age, gender, industrial sector concerned, local French National health insurance agency, causal agent and the number of working days lost. The incidence per 100,000 salaried workers could be determined from the total number of salaried workers followed up by occupational medicine as well as those working in the construction industry. For the five years studied, 3698 cases of occupational eczema (OE) were reported in construction workers and this was 17.1% of the total number of cases of OE for all salaried employees (n=12.689). Cement was the causal agent most frequently involved in the construction sector (57.8%, 2139/3698). The annual incidence of OCE decreased from 37.8 to 21.1 new cases per 100,000 employees in the construction industry per year between 2004 and 2008. The total number of days lost from work due to OCE decreased by 39% during the study period. This descriptive study highlights the importance and socio-economic impact of OCE in the construction industry. Application of decree n(o). 2005-577 on 26 May 2005 may explain a reduction in OCE. Copyright © 2012. Published by Elsevier Masson SAS.

Immediate, non-submerged, root-analogue zirconia implant in single tooth replacement.

PubMed

Pirker, W; Kocher, A

2008-03-01

This report demonstrates the successful clinical use of a modified root-analogue zirconia implant for immediate single tooth replacement. A right maxillary premolar was removed and a custom-made, root-analogue, roughened zirconia implant with macro-retentions in the interdental space was fabricated and placed into the extraction socket 4 days later. Four months after root implantation a composite crown was cemented. No complications occurred during the healing period. An excellent esthetic and functional result was achieved with the composite crown. No clinically noticeable bone resorption or soft-tissue recession was observed at 26 months follow up. Significant modifications such as macro-retentions seem to indicate that primary stability and excellent osseointegration of immediate root-analogue zirconia implants can be achieved, while preventing unesthetic bone resorption. The macro-retentions must be limited to the interdental space to avoid fracture of the thin buccal cortex. This successful case warrants further clinical research in well controlled trials.

[Treatment of periprosthetic and peri-implant fractures : modern plate osteosynthesis procedures].

PubMed

Raschke, M J; Stange, R; Kösters, C

2012-11-01

Periprosthetic fractures are increasing not only due to the demographic development with high life expectancy, the increase in osteoporosis and increased prosthesis implantation but also due to increased activity of the elderly population. The therapeutic algorithms are manifold but general valid rules for severe fractures are not available. The most commonly occurring periprosthetic fractures are proximal and distal femoral fractures but in the clinical routine fractures of the tibial head, ankle, shoulder, elbow and on the borders to other implants (peri-implant fractures) and complex interprosthetic fractures are being seen increasingly more. It is to be expected that in the mid-term further options, such as cement augmentation of cannulated polyaxial locking screws will extend the portfolio of implants for treatment of periprosthetic fractures. The aim of this review article is to present the new procedures for osteosynthesis of periprosthetic fractures.

[Treatment of periprosthetic and peri-implant fractures : modern plate osteosynthesis procedures].

PubMed

Raschke, M J; Stange, R; Kösters, C

2012-08-01

Periprosthetic fractures are increasing not only due to the demographic development with high life expectancy, the increase in osteoporosis and increased prosthesis implantation but also due to increased activity of the elderly population. The therapeutic algorithms are manifold but general valid rules for severe fractures are not available. The most commonly occurring periprosthetic fractures are proximal and distal femoral fractures but in the clinical routine fractures of the tibial head, ankle, shoulder, elbow and on the borders to other implants (peri-implant fractures) and complex interprosthetic fractures are being seen increasingly more. It is to be expected that in the mid-term further options, such as cement augmentation of cannulated polyaxial locking screws will extend the portfolio of implants for treatment of periprosthetic fractures. The aim of this review article is to present the new procedures for osteosynthesis of periprosthetic fractures.

Long-term results of uncemented alumina acetabular implants.

PubMed

Boehler, M; Knahr, K; Plenk, H; Walter, A; Salzer, M; Schreiber, V

1994-01-01

We report the clinical and tribological performance of 67 ceramic acetabular prostheses implanted between 1976 and 1979 without bone cement. They articulated with ceramic femoral heads mounted on mental femoral stems. After a mean elapsed period of 144 months, 59 sockets were radiographically stable but two showed early signs and six showed late signs of loosening. Four of the loose sockets have been revised. Histological analysis of the retrieved tissue showed a fibrous membrane around all the implants, with fibrocartilage in some. There was no bone ingrowth, and the fibrous membrane was up to 6 mm thick and infiltrated with lymphocytes, plasma cells, and macrophages. Intra- and extracellular birefringent wear particles were seen. Tribological analysis showed total wear rates in two retrieved alumina-on-alumina joints of 2.6 microns per year in a stable implant and 68 microns in a loose implant. Survival analysis showed a revision rate of 12.4% at 136 months.

Basic concepts in metal work failure after metastatic spine tumour surgery.

PubMed

Kumar, Naresh; Patel, Ravish; Wadhwa, Anshuja Charvi; Kumar, Aravind; Milavec, Helena Maria; Sonawane, Dhiraj; Singh, Gurpal; Benneker, Lorin Michael

2018-04-01

The development of spinal implants marks a watershed in the evolution of metastatic spine tumour surgery (MSTS), which has evolved from standalone decompressive laminectomy to instrumented stabilization and decompression with reconstruction when necessary. Fusion may not be feasible after MSTS due to poor quality of graft host bed along with adjunct chemotherapy and/or radiotherapy postoperatively. With an increase in the survival of patients with spinal tumours, there is a probability of an increase in the rate of implant failure. This review aims to help establish a clear understanding of implants/constructs used in MSTS and to highlight the fundamental biomechanics of implant/construct failures. Published literature on implant failure after spine surgery and MSTS has been reviewed. The evolution of spinal implants and their role in MSTS has been briefly described. The review defines implant/construct failures using radiological parameters that are practical, feasible, and derived from historical descriptions. We have discussed common modes of implant/construct failure after MSTS to allow further understanding, interception, and prevention of catastrophic failure. Implant failure rates in MSTS are in the range of 2-8%. Variability in patterns of failure has been observed based on anatomical region and the type of constructs used. Patients with construct/implant failures may or may not be symptomatic and present either as early (< 3months) or late failures (> 3months). It has been noted that not all the implant failures after MSTS result in revisions. Based on the observed radiological criteria and clinical presentations, we have proposed a clinico-radiological classification for implant/construct failure after MSTS.

A deep-sea agglutinated foraminifer tube constructed with planktonic foraminifer shells of a single species

NASA Astrophysics Data System (ADS)

Pearson, Paul N.; Expedition 363 Shipboard Scientific Party, IODP

2018-01-01

Agglutinated foraminifera are marine protists that show apparently complex behaviour in constructing their shells, involving selecting suitable sedimentary grains from their environment, manipulating them in three dimensions, and cementing them precisely into position. Here we illustrate a striking and previously undescribed example of complex organisation in fragments of a tube-like foraminifer (questionably assigned to Rhabdammina) from 1466 m water depth on the northwest Australian margin. The tube is constructed from well-cemented siliciclastic grains which form a matrix into which hundreds of planktonic foraminifer shells are regularly spaced in apparently helical bands. These shells are of a single species, Turborotalita clarkei, which has been selected to the exclusion of all other bioclasts. The majority of shells are set horizontally in the matrix with the umbilical side upward. This mode of construction, as is the case with other agglutinated tests, seems to require either an extraordinarily selective trial-and-error process at the site of cementation or an active sensory and decision-making system within the cell.

Self-cleaning geopolymer concrete - A review

NASA Astrophysics Data System (ADS)

Norsaffirah Zailan, Siti; Mahmed, Norsuria; Bakri Abdullah, Mohd Mustafa Al; Sandu, Andrei Victor

2016-06-01

Concrete is the most widely used construction materials for building technology. However, cement production releases high amounts of carbon dioxide (CO2) to the atmosphere that leads to increasing the global warming. Thus, an alternative, environmental friendly construction material such as geopolymer concrete has been developed. Geopolymer concrete applies greener alternative binder, which is an innovative construction material that replaces the Portland cement. This technology introduced nano-particles such as nanoclay into the cement paste in order to improve their mechanical properties. The concrete materials also have been developed to be functioned as self-cleaning construction materials. The self-cleaning properties of the concrete are induced by introducing the photocatalytic materials such as titania (TiO2) and zinc oxide (ZnO). Self-cleaning concrete that contains those photocatalysts will be energized by ultraviolet (UV) radiation and accelerates the decomposition of organic particulates. Thus, the cleanliness of the building surfaces can be maintained and the air surrounding air pollution can be reduced. This paper briefly reviews about self-cleaning concrete.

Effects of vanadium ion implantation on microstructure, mechanical and tribological properties of TiN coatings

NASA Astrophysics Data System (ADS)

Deng, Bin; Tao, Ye; Guo, Deliang

2012-09-01

TiN coatings were deposited on the substrates of cemented carbide (WC-TiC-Co) by Magnetic Filter Arc Ion Plating (MFAIP) and then implanted with vanadium through Metal Vacuum Vapor Arc (MEVVA) ion source with the doses of 1 × 1017 and 5 × 1017 ions/cm2 at 40 kV. The microstructures and chemical compositions of the V-implanted TiN coatings were investigated using Glancing Incidence X-ray Diffraction (GIXRD) and X-ray Photoelectron Spectroscopy (XPS), together with the mechanical and tribological properties of coatings were characterized using nano-indentation and ball-on-disk tribometer. It was found that the diffraction peaks of the V-implanted TiN coatings at the doses of 5 × 1017 ions/cm2 shifted to higher angles and became broader. The hardness and elastic modulus of TiN coatings increased after V ion implantation. The wear mechanism for both un-implanted and V-implanted TiN coatings against GCr15 steel ball was adhesive wear, and the V-implanted TiN coatings had a lower friction coefficient as well as a better wear resistance

The socially constructed breast: breast implants and the medical construction of need.

PubMed Central

Jacobson, N

1998-01-01

When silicone gel breast implants became the subject of a public health controversy in the early 1990s, the most pressing concern was safety. This paper looks at another, less publicized issue: the need for implants. Using a symbolic interactionist approach, the author explores the social construction of the need for implants by tracing the history of the 3 surgical procedures for which implants were used. Stakeholders in this history constructed need as legitimized individual desire, the form of which shifted with changes in the technological and social context. PMID:9702166

Effect of cyclic loading and retightening on reverse torque value in external and internal implants

PubMed Central

Cho, Woong-Rae; Huh, Yoon-Hyuk; Park, Chan-Jin

2015-01-01

PURPOSE The aim of this study was to evaluate the effect of cyclic loading and screw retightening on reverse torque value (RTV) in external and internal type implants. MATERIALS AND METHODS Cement-retained abutments were connected with 30 Ncm torque to external and internal type implants. Experimental groups were classified according to implant connection type and retightening/loading protocol. In groups with no retightening, RTV was evaluated after cyclic loading for 100,000 cycles. In groups with retightening, RTV was measured after 3, 10, 100 cycles as well as every 20,000 cycles until 100,000 cycles of loading. RESULTS Every group showed decreased RTV after cyclic loading. Before and after cyclic loading, external type implants had significantly higher RTVs than internal type implants. In external type implants, retightening did not affect the decrease in RTV. In contrast, retightening 5 times and retightening after 10 cycles of dynamic loading was effective for maintaining RTV in internal type implants. CONCLUSION Retightening of screws is more effective in internal type implants than external type implants. Retightening of screws is recommended in the early stage of functional loading. PMID:26330975

The Greenhouse Gas Emission from Portland Cement Concrete Pavement Construction in China.

PubMed

Ma, Feng; Sha, Aimin; Yang, Panpan; Huang, Yue

2016-06-24

This study proposes an inventory analysis method to evaluate the greenhouse gas (GHG) emissions from Portland cement concrete pavement construction, based on a case project in the west of China. The concrete pavement construction process was divided into three phases, namely raw material production, concrete manufacture and pavement onsite construction. The GHG emissions of the three phases are analyzed by a life cycle inventory method. The CO₂e is used to indicate the GHG emissions. The results show that for 1 km Portland cement concrete pavement construction, the total CO₂e is 8215.31 tons. Based on the evaluation results, the CO₂e of the raw material production phase is 7617.27 tons, accounting for 92.7% of the total GHG emissions; the CO₂e of the concrete manufacture phase is 598,033.10 kg, accounting for 7.2% of the total GHG emissions. Lastly, the CO₂e of the pavement onsite construction phase is 8396.59 kg, accounting for only 0.1% of the total GHG emissions. The main greenhouse gas is CO₂ in each phase, which accounts for more than 98% of total emissions. N₂O and CH₄ emissions are relatively insignificant.

Life Cycle Cost Analysis of Portland Cement Concrete Pavements

DOT National Transportation Integrated Search

1999-09-01

This report describes the development of a new life cycle cost analysis methodology for Portland cement concrete pavements - one that considers all aspects of pavement design, construction, maintenance, and user impacts throughout the analysis period...

Guide for curing of portland cement. Volume I

DOT National Transportation Integrated Search

2005-01-01

This document provides guidance on details of concrete curing practice as they pertain to construction of portland cement concrete pavements. The guide is organized around the major events in curing pavements: curing immediately after placement (init...

The effect of splinting implant-supported restorations on stress distribution of different crown-implant ratios and crown height spaces.

PubMed

Nissan, Joseph; Gross, Ora; Ghelfan, Oded; Priel, Ilan; Gross, Martin; Chaushu, Gavriel

2011-12-01

To assess whether splinting can counterbalance the detrimental effects of varying the crown-to-implant (C/I) ratio and crown height space (CHS) by decreasing nonaxial overload stresses. Three implants were inserted into a photoelastic block model. Two strain gauges were cemented onto the neck of each implant on the buccal and lingual aspects and provided a simultaneous direct reading of strain. Four groups of splinted cement-retained restorations with C/I ratios of 1:1, 1:1.5, 1:1.75, and 1:2 were used. CHSs were 10, 15, 17.5, and 20 mm, respectively. Fifteen static loadings were carried out simultaneously with 20-kg weights via a custom-built loading apparatus at 30° to the vertical axis. Occlusal force application at 30° showed a statistically significant increase in both buccal (1,911.65 ± 110 vs 3,252.06 ± 150) and palatal (35.58 ± 7 vs 286.85 ± 15) microstrain values as the C/I ratio increased from 1:1 to 1:1.5 (P < .001). Force application at 30° in cases with C/I ratios of 1:1.75 and 1:2 resulted in fracture of the abutment screw followed by dislodgement of the crowns. Failures were noted at a CHS of 15 mm or greater. In this biomechanical mode, splinting does not prevent prosthetic failure when the CHS is 15 mm or greater. Vertical bone augmentation is highly recommended in cases with a CHS of 15 mm or greater. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Evaluation of a setting reaction pathway in the novel composite TiHA-CSD bone cement by FT-Raman and FT-IR spectroscopy

NASA Astrophysics Data System (ADS)

Paluszkiewicz, Czesława; Czechowska, Joanna; Ślósarczyk, Anna; Paszkiewicz, Zofia

2013-02-01

The aim of this study was to determine a setting reaction pathway in a novel, surgically handy implant material, based on calcium sulfate hemihydrate (CSH) and titanium doped hydroxyapatite (TiHA). The previous studies confirmed superior biological properties of TiHA in comparison to the undoped hydroxyapatite (HA) what makes it highly attractive for future medical applications. In this study the three types of titanium modified HA powders: untreated, calcined at 800 °C, sintered at 1250 °C and CSH were used to produce bone cements. The Fourier Transform-InfraRed (FT-IR) spectroscopy and Raman spectroscopy were applied to evaluate processes taking place during the setting of the studied materials. Our results undoubtedly confirmed that the reaction pathways and the phase compositions differed significantly for set cements and were dependent on the initial heat treatment of TiHA powder. Final materials were multiphase composites consisting of calcium sulfate dihydrate, bassanite, tricalcium phosphate, hydroxyapatite and calcium titanate (perovskite). The FT-IR and Scanning Electron Microscopy (SEM) measurements performed after the incubation of the cement samples in the simulated body fluid (SBF), indicate on high bioactive potential of the obtained bone cements.

Stabilization of marly soils with portland cement

NASA Astrophysics Data System (ADS)

Piskunov, Maksim; Karzin, Evgeny; Lukina, Valentina; Lukinov, Vitaly; Kholkin, Anatolii

2017-10-01

Stabilization of marlous soils with Portland cement will increase the service life of motor roads in areas where marl is used as a local road construction material. The result of the conducted research is the conclusion about the principal possibility of stabilization of marlous soils with Portland cement, and about the optimal percentage of the mineral part and the binding agent. When planning the experiment, a simplex-lattice plan was implemented, which makes it possible to obtain a mathematical model for changing the properties of a material in the form of polynomials of incomplete third order. Brands were determined for compressive strength according to GOST 23558-94 and variants of stabilized soils were proposed for road construction.

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.

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.

Curved-stem Hip Resurfacing

PubMed Central

2008-01-01

Hip resurfacing is an attractive concept because it preserves rather than removes the femoral head and neck. Most early designs had high failure rates, but one unique design had a femoral stem. Because that particular device appeared to have better implant survival, this study assessed the clinical outcome and long-term survivorship of a hip resurfacing prosthesis. Four hundred forty-five patients (561 hips) were retrospectively reviewed after a minimum of 20 years’ followup or until death; 23 additional patients were lost to followup. Patients received a metal femoral prosthesis with a small curved stem. Three types of acetabular reconstructions were used: (1) cemented polyurethane; (2) metal-on-metal; and (3) polyethylene secured with cement or used as the liner of a two-piece porous-coated implant. Long-term results were favorable with the metal-on-metal combination only. The mean overall Harris hip score was 92 at 2 years of followup. None of the 121 patients (133 hips) who received metal-on-metal articulation experienced failure. The failure rate with polyurethane was 100%, and the failure rate with cemented polyethylene was 41%. Hip resurfacing with a curved-stem femoral component had a durable clinical outcome when a metal-on-metal articulation was used. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18338217

Eco-friendly GGBS Concrete: A State-of-The-Art Review

NASA Astrophysics Data System (ADS)

Saranya, P.; Nagarajan, Praveen; Shashikala, A. P.

2018-03-01

Concrete is the most commonly used material in the construction industry in which cement is its vital ingredient. Although the advantages of concrete are many, there are side effects leading to environmental issues. The manufacturing process of cement emits considerable amount of carbon dioxide (CO2). Therefore is an urgent need to reduce the usage of cement. Ground Granulated Blast furnace Slag (GGBS) is a by-product from steel industry. It has good structural and durable properties with less environmental effects. This paper critically reviews the literatures available on GGBS used in cement concrete. In this paper, the literature available on GGBS are grouped into engineering properties of GGBS concrete, hydraulic action of GGBS in concrete, durability properties of GGBS concrete, self- compacting GGBS concrete and ultrafine GGBS are highlighted. From the review of literature, it was found that the use of GGBS in concrete construction will be eco-friendly and economical. The optimum percentage of replacement of cement by GGBS lies between 40 - 45 % by weight. New materials that can be added in addition to GGBS for getting better strength and durability also highlighted.

Treatment of deep infection of total knee arthroplasty using a two-stage procedure.

PubMed

Pietsch, Martin; Hofmann, Siegfried; Wenisch, Christian

2006-03-01

Treatment of deep infection of total knee arthroplasty by two-stage reimplantation. Using an articulating spacer may reduce the disadvantages of a static spacer (ligament contracture, muscle atrophy, muscle contraction, arthrofibrosis, and bone loss). Restoration of pain-free loading and ability to walk. Late deep infection after total knee arthroplasty. infection occurring at least 6 weeks after the initial arthroplasty. Large metaphyseal bony defects of the distal femur and proximal tibia. Missing or insufficient extensor mechanism. The articulating spacer is made intraoperatively by cleaning and autoclaving the explanted femoral component and the tibial polyethylene insert. These components are reinserted by "press-fit cementing" without cement interdigitation into the trabecular bone. The cement is loaded with antibiotic during the same operation (2-4 g antibiotics per 40 g of cement powder). With the articulating spacer in place, partial weight bearing with crutches and continuous passive motion daily up to a flexion of 90 degrees are allowed. Usually, reimplantation with a standard revision system is scheduled for 6-12 weeks after spacer implantation. In a prospective study 33 consecutive patients were treated from February 2000 to July 2003. The average period of hospitalization after spacer implantation was 14 days (8-26 days). Three patients had recurrent infection (success rate 91%) after a mean follow-up period of 28 months (12-48 months). The average Hospital for Special Surgery Knee Score could be increased from 67 points (44-84 points) preoperatively to 87 points (53-97 points) after reimplantation. The complications were one temporary peroneal palsy, one dislocation of the spacer due to the absence of the extensor ligaments, and one fracture of the tibia due to substantial primary metaphyseal bone loss.

Can Arthroplasty Stem INfluence Outcome? (CASINO): a randomized controlled equivalence trial of 125 mm versus 150 mm Exeter V40 stems in total hip arthroplasty.

PubMed

Hamilton, David F; Ohly, Nicholas E; Gaston, Paul

2018-04-16

The use of shorter length femoral stems during total hip arthroplasty has been suggested to accommodate wider patient femoral geometry and offer maximal bone preservation. However, cemented short-stem designs may increase the risk of varus stem malalignment and influence patient outcomes. CASINO is a multi-centre randomised equivalence trial that will recruit 220 patients undergoing total hip arthroplasty for osteoarthritis at two NHS hospitals in Scotland. Patients will be aged 45-80, undergoing unilateral primary hip arthroplasty, with no plan for contralateral procedure within the study timeframe, and able to comply with the protocol. Participants will be randomised to receive either a short (125 mm) or a standard (150 mm) Exeter V40 stem. The Contemporary acetabular component will be used in all cases. All implants will be cemented. Patient pain, function and satisfaction will be assessed using change from baseline measurement in Oxford Hip Score, Forgotten Joint Score, EQ-5D, pain numerical rating scores, and patient satisfaction questionnaire at baseline and at 1 and 2 years following surgery. Radiographic assessment will evaluate stem position and will be appraised by independent reviewers. Patients will be blind to implant allocation. Stem length may be associated with outcome; however, we can find no randomised trial in which researchers investigated the effect of stem length on patient outcome following cemented total hip arthroplasty. The aim of this trial is to determine if the use of short cemented stems offers equivalent patient outcomes to those achieved following surgery with standard length stems. International Standard Randomised Controlled Trial Number, ISRCTN13154542 , Registered on 30 June 2017.

Cementless Oxford medial unicompartimental knee replacement: an independent series with a 5-year-follow-up.

PubMed

Panzram, Benjamin; Bertlich, Ines; Reiner, Tobias; Walker, Tilman; Hagmann, Sébastien; Gotterbarm, Tobias

2017-07-01

Cemented unicompartmental knee replacement (UKR) has proven excellent long-term survival rates and functional scores in Price et al. (Clin Orthop Relat Res 435:171-180, 2005), Price and Svard (Clin Orthop Relat Res 469(1):174-179, 2011) and Murray et al. (Bone Joint Surg Br 80(6):983-989, 1998). The main causes for revision, aseptic loosening and pain of unknown origin might be addressed by cementless UKR in Liddle et al. (Bone Joint J 95-B(2):181-187, 2013), Pandit et al. (J Bone Joint Surg Am 95(15):1365-1372, 2013), National Joint Registry for England, Wales and Northern Ireland: 10th Annual Report 2013 ( http://www.njrcentre.org.uk/njrcentre/Portals/0/Documents/England/Reports/10th_annual_report/NJR%2010th%20Annual%20Report%202013%20B.pdf , 2013), Swedish Knee Arthroplasty Register: Annual Report 2013 ( http://www.myknee.se/pdf/SKAR2013_Eng.pdf , 2013). This single-centre retrospective cohort study reports the 5-year follow-up results of our first 30 consecutively implanted cementless Oxford UKR (OUKR). Clinical outcome was measured using the OKS, AKSS, range of movement and level of pain (visual analogue scale). The results were compared to cemented OUKR in a matched-pair analysis. Implant survival was 89.7%. One revision each was performed due to tibial fracture, progression of osteoarthritis (OA) and inlay dislocation. The 5-year survival rate of the cementless group was 89.7% and of the cemented group 94.1%. Both groups showed excellent postoperative clinical scores. Cementless fixation shows good survival rates and clinical outcome compared to cemented fixation.

High early strength latex modified concrete overlay.

DOT National Transportation Integrated Search

1988-01-01

This report describes the condition of the first high early strength latex modified concrete (LMC-HE) overlay to be constructed for the Virginia Department of Transportation. The overlay was prepared with type III cement and with more cement and less...

Investigation of concrete containing slag : Hampton River Bridge.

DOT National Transportation Integrated Search

1986-01-01

The study evaluated the properties of concretes containing slag in a 50% replacement of the portland cement to assess their suitability as an alternative to the portland cement concretes normally used in the construction of bridge substructures. For ...

Biomechanical evaluation of fixation of intra-articular fractures of the distal part of the radius in cadavera: Kirschner wires compared with calcium-phosphate bone cement.

PubMed

Yetkinler, D N; Ladd, A L; Poser, R D; Constantz, B R; Carter, D

1999-03-01

The purpose of this study was to compare the biomechanical efficacy of an injectable calcium-phosphate bone cement (Skeletal Repair System [SRS]) with that of Kirschner wires for the fixation of intraarticular fractures of the distal part of the radius. Colles fractures (AO pattern, C2.1) were produced in ten pairs of fresh-frozen human cadaveric radii. One radius from each pair was randomly chosen for stabilization with SRS bone cement. These ten radii were treated with open incision, impaction of loose cancellous bone with use of a Freer elevator, and placement of the SRS bone cement by injection. In the ten control specimens, the fracture was stabilized with use of two horizontal and two oblique Kirschner wires. The specimens were cyclically loaded to a peak load of 200 newtons for 2000 cycles to evaluate the amount of settling, or radial shortening, under conditions simulating postoperative loading with the limb in a cast. Each specimen then was loaded to failure to determine its ultimate strength. The amount of radial shortening was highly variable among the specimens, but it was consistently higher in the Kirschner-wire constructs than in the bone fixed with SRS bone cement within each pair of radii. The range of shortening for all twenty specimens was 0.18 to 4.51 millimeters. The average amount of shortening in the SRS constructs was 50 percent of that in the Kirschner-wire constructs (0.51+/-0.34 compared with 1.01+/-1.23 millimeters; p = 0.015). With the numbers available, no significant difference in ultimate strength was detected between the two fixation groups. This study showed that fixation of an intra-articular fracture of the distal part of a cadaveric radius with biocompatible calcium-phosphate bone cement produced results that were biomechanically comparable with those produced by fixation with Kirschner wires. However, the constructs that were fixed with calcium-phosphate bone cement demonstrated less shortening under simulated cyclic load-bearing.

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.

Portland cement concrete pavement best practices summary report.

DOT National Transportation Integrated Search

2010-08-01

This report summarizes the work and findings from WA-RD 744. This work consisted of four separate efforts related to best practices for portland cement concrete (PCC) pavement design and construction: (1) a review of past and current PCC pavement, (2...

Recycling of red muds with the extraction of metals and special additions to cement

NASA Astrophysics Data System (ADS)

Zinoveev, D. V.; Diubanov, V. G.; Shutova, A. V.; Ziniaeva, M. V.

2015-01-01

The liquid-phase reduction of iron oxides from red mud is experimentally studied. It is shown that, in addition to a metal, a slag suitable for utilization in the construction industry can be produced as a result of pyrometallurgical processing of red mud. Portland cement is shown to be produced from this slag with mineral additions and a high-aluminate expansion addition to cement.

Perianal implantation of bioengineered human internal anal sphincter constructs intrinsically innervated with human neural progenitor cells.

PubMed

Raghavan, Shreya; Miyasaka, Eiichi A; Gilmont, Robert R; Somara, Sita; Teitelbaum, Daniel H; Bitar, Khalil N

2014-04-01

The internal anal sphincter (IAS) is a major contributing factor to pressure within the anal canal and is required for maintenance of rectoanal continence. IAS damage or weakening results in fecal incontinence. We have demonstrated that bioengineered, intrinsically innervated, human IAS tissue replacements possess key aspects of IAS physiology, such as the generation of spontaneous basal tone and contraction/relaxation in response to neurotransmitters. The objective of this study is to demonstrate the feasibility of implantation of bioengineered IAS constructs in the perianal region of athymic rats. Human IAS tissue constructs were bioengineered from isolated human IAS circular smooth muscle cells and human enteric neuronal progenitor cells. After maturation of the bioengineered constructs in culture, they were implanted operatively into the perianal region of athymic rats. Platelet-derived growth factor was delivered to the implanted constructs through a microosmotic pump. Implanted constructs were retrieved from the animals 4 weeks postimplantation. Animals tolerated the implantation well, and there were no early postoperative complications. Normal stooling was observed during the implantation period. At harvest, implanted constructs were adherent to the perirectal rat tissue and appeared healthy and pink. Immunohistochemical analysis revealed neovascularization. Implanted smooth muscle cells maintained contractile phenotype. Bioengineered constructs responded in vitro in a tissue chamber to neuronally evoked relaxation in response to electrical field stimulation and vasoactive intestinal peptide, indicating the preservation of neuronal networks. Our results indicate that bioengineered innervated IAS constructs can be used to augment IAS function in an animal model. This is a regenerative medicine based therapy for fecal incontinence that would directly address the dysfunction of the IAS muscle. Copyright © 2014 Mosby, Inc. All rights reserved.

The use of shale ash in dry mix construction materials

NASA Astrophysics Data System (ADS)

Gulbe, L.; Setina, J.; Juhnevica, I.

2017-10-01

The research was made to determine the use of shale ash usage in dry mix construction materials by replacing part of cement amount. Cement mortar ZM produced by SIA Sakret and two types of shale ashes from Narva Power plant (cyclone ash and electrostatic precipitator ash) were used. Fresh mortar properties, hardened mortar bulk density, thermal conductivity (λ10, dry) (table value) were tested in mortar ZM samples and mortar samples in which 20% of the amount of cement was replaced by ash. Compressive strenght, frost resistance and resistance to sulphate salt solutions were checked. It was stated that the use of electrostatic precipitator ash had a little change of the material properties, but the cyclone ash significantly reduced the mechanical strength of the material.

Comparison of Marginal and Internal Adaptation of CAD/CAM and Conventional Cement Retained Implant-Supported Single Crowns.

PubMed

Nejatidanesh, Farahnaz; Shakibamehr, Amir Hossein; Savabi, Omid

2016-02-01

To evaluate the accuracy of marginal and internal adaptation of 2 computer-aided design/computer-aided manufacturing (CAD/CAM) and 2 conventionally made cement retained implant-supported restorations. An abutment and its corresponding fixture analog (Astra Tech) were inserted in left central incisor area of a maxillary cast. Four types of implant-supported single restorations were fabricated on the abutment (n = 10): e.max CAD (Cerec AC system), zirconia-based (Cercon system), IPS e.max Press, and metal-ceramic restorations. The internal and marginal gaps of the studied groups were measured by replica method and stereomicroscope. Data were subjected to 1-way ANOVA and Scheffe post hoc tests (α = 0.05). Mean internal gaps of Cercon (59.48 ± 16.49 μm) and e.max Press (75.62 ± 26.92 μm) groups were significantly different from e.max CAD (120.29 ± 16.74 μm) group, but there was no significant difference between metal-ceramic restorations (89.65 ± 47.84 μm) and e.max CAD. The marginal gaps of e.max CAD (32.02 ± 10.38 μm) and Cercon restorations (34.26 ± 11.41 μm) were significantly superior from metal ceramics (59.19 ± 17.81 μm) and e.max press (74.99 ± 24.51 μm). Within the limitations of this study, it can be concluded that although the marginal and internal gaps of the studied implant-supported restorations were in the clinically acceptable range, single crowns made with CAD/CAM technology provide better marginal fit.

The Greenhouse Gas Emission from Portland Cement Concrete Pavement Construction in China

PubMed Central

Ma, Feng; Sha, Aimin; Yang, Panpan; Huang, Yue

2016-01-01

This study proposes an inventory analysis method to evaluate the greenhouse gas (GHG) emissions from Portland cement concrete pavement construction, based on a case project in the west of China. The concrete pavement construction process was divided into three phases, namely raw material production, concrete manufacture and pavement onsite construction. The GHG emissions of the three phases are analyzed by a life cycle inventory method. The CO2e is used to indicate the GHG emissions. The results show that for 1 km Portland cement concrete pavement construction, the total CO2e is 8215.31 tons. Based on the evaluation results, the CO2e of the raw material production phase is 7617.27 tons, accounting for 92.7% of the total GHG emissions; the CO2e of the concrete manufacture phase is 598,033.10 kg, accounting for 7.2% of the total GHG emissions. Lastly, the CO2e of the pavement onsite construction phase is 8396.59 kg, accounting for only 0.1% of the total GHG emissions. The main greenhouse gas is CO2 in each phase, which accounts for more than 98% of total emissions. N2O and CH4 emissions are relatively insignificant. PMID:27347987

Mix design and mechanical performance of geopolymer binder for sustainable construction and building material

NASA Astrophysics Data System (ADS)

Saeli, Manfredi; Novais, Rui M.; Seabra, Maria Paula; Labrincha, João A.

2017-11-01

Sustainability in construction is a major concern worldwide, due to the huge volume of materials and energy consumed by this sector. Associated supplementing industries (e.g. Portland cement production) constitute a significant source of CO2 emissions and global warming. Valorisation and reuse of industrial wastes and by-products make geopolymers a solid and sustainable via to be followed as a valid alternative to Portland cement. In this work the mix design of a green fly ash-based geopolymer is evaluated as an environmentally friendly construction material. In the pursuit of sustainability, wastes from a regional kraft pulp industry are exploited for the material processing. Furthermore, a simple, reproducible, and low-cost manufacture is used. The mix design is hence optimised in order to improve the desirable mechanical performance of the material intended for structural applications in construction. Tests indicate that geopolymers may efficiently substitute the ordinary Portland cement as a mortar/concrete binder. Furthermore, valorisation and reuse of wastes in geopolymers is a suboptimal way of gaining financial surplus for the involved industrial players, while contributes for the implementation of a desirable circular economy.

Incorporation of bitumen and calcium silicate in cement and lime stabilized soil blocks

NASA Astrophysics Data System (ADS)

Kwan, W. H.; Cheah, C. B.; Ramli, M.; Al-Sakkaf, Y. K.

2017-04-01

Providing affordable housing is the most critical problem in many of the developing countries. Using earth materials in building construction is one of the feasible methods to address this issue and it can be a way towards sustainable construction as well. However, the published information on the stabilized soil blocks is limited. Therefore, the present study is conducted to examine the characterization of the soils and engineering properties of the stabilized soil blocks. Four types of stabilizer were used in the study, namely; cement, slaked lime, bitumen emulsion and calcium silicate. Cement and slaked lime were added at different percentages in the range of 5% to 15%, with interval of 2.5%. The percentage was determined based on weight of soil. Meanwhile, bitumen emulsion and calcium silicate were incorporated at various percentages together with 10% of cement. Dosage of bitumen emulsion is in the range of 2% to 10% at interval of 2% while calcium silicate was incorporated at 0.50%, 0.75%, 1.00%, 1.25%, 1.50% and 2.00%. Results show that cement is the most viable stabilizer for the soil block among all stabilizers in this study. The bulk density, optimum moisture content and compressive strengths were increased with the increasing cement content. The most suitable cement content was 10% added at moisture content of 12%. Lime, bitumen and calcium contents were recommended at 5.0%, 6.0% and 1.25%, respectively.

Evaluation of Nontraditional Airfield Pavement Surfaces for Contingency Operations

DTIC Science & Technology

2014-01-01

such as asphalt or portland cement concrete are not readily available or are too cost-, labor-, or equipment-intensive to use. This report presents a...courses) are generally constructed using hot mix asphalt (HMA) or portland cement concrete (PCC), both of which are suitable for C-17 and C-130...associated with PCC or HMA surfacing. Stabilization can be accomplished by blending additives such as portland cement , lime, fly ash, asphalt binder

Design and Construction of Airport Pavements on Expansive Soils

DTIC Science & Technology

1976-06-01

Selection of the type anc amount of stabilizing agent (lime, cement , asphalt, only) (4) Test methods to determine the physical properties of sta...7 8.3 5.4 3.3 6.5 1 4.7 3-3, 1 (8) Investigate the effect of sulfate on cement -stabilized soils and establish...terested because the properties of soil/ cement mixtures and the relationships existing among these properties and various test values are discussed

Functionally graded bioactive coatings: From fabrication to testing

NASA Astrophysics Data System (ADS)

Foppiano, Silvia

Every year about half a million Americans undergo total joint replacement surgery of some kind. This number is expected to steadily increase in the future. About 20% of these patients will need a revision surgery because of implant failure, with a significant increase in health care cost. Current implant materials for load bearing applications must be strong enough to support the loads involved in daily activities, and bioinert, to limit reactivity in the body that may cause inflammatory and other adverse reactions. Metal alloys are typically used as materials for load bearing implants and rely on mechanical interlocking to achieve fixation which can be improved by using bone cements. To improve implant osteointegration, metal implants have been coated with a bone-like mineral: hydroxyapatite (HA). The plasma spray technique is commonly used to apply the HA coating. Such implants do not require the use of bone cement. Plasma sprayed HA coated implants are FDA approved and currently on the market, but their properties are not reproducible or reliable. Thus, coating delamination can occur. Our research group developed a novel family of bioactive glasses which were enameled onto titanium alloy using a functionally graded approach. We stratified the coating with different glass compositions to fulfill different functions. We coupled a first glass layer, with a good CTE match to the alloy, with a second layer of bioactive glass obtaining a functionally graded bioactive coating (FGC). In this thesis for the first time the cytocompatibility of novel bioactive glasses, and their functionally graded coatings on Ti6Al4V, was studied with an in vitro bone model (MC3T3-E1.4 mouse preosteblast cells). The novel bioactive glasses are cytocompatible and no compositional change is required. The fabrication process is reproducible, introduces a small (average 6 vol%) amount of crystallization, which does not significantly affect bioactivity in SBF as tested. The coatings are cytocompatible, but should be preconditioned in SBF prior to their use. Preconditioning stabilizes the coatings, eliminates possible contaminants introduced during processing and handling, and yields dissolution products capable of inducing specific gene expression (e.g. Runx-2). Future research will involve identification of such dissolution products as well as in vivo testing.

Center for Coal-Derived Low Energy Materials for Sustainable Construction

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

Jewell, Robert; Robl, Tom; Rathbone, Robert

2012-06-30

The overarching goal of this project was to create a sustained center to support the continued development of new products and industries that manufacture construction materials from coal combustion by-products or CCB’s (e.g., cements, grouts, wallboard, masonry block, fillers, roofing materials, etc). Specific objectives includes the development of a research kiln and associated system and the formulation and production of high performance low-energy, low-CO2 emitting calcium sulfoaluminate (CAS) cement that utilize coal combustion byproducts as raw materials.

Design and construction control guidance for chemically stabilized pavement base layers.

DOT National Transportation Integrated Search

2013-12-01

A laboratory and field study was conducted related to chemically stabilized pavement layers, which is also : referred to as soil-cement. Soil-cement practices within MDOT related to Class 9C soils used for base layers : were evaluated in this report....

Stable and rugged etalon for the Dynamics Explorer Fabry-Perot interferometer. I - Design and construction

NASA Astrophysics Data System (ADS)

Rees, D.; Fuller-Rowell, T. J.; Lyons, A.; Killeen, T. L.; Hays, P. B.

1982-11-01

The cemented etalons are shown to be rugged and highly stable for high-resolution spectroscopy and to be well suited to space applications. The etalons will be of considerable value as the tuning elements of dye laser systems and as the stable spectral disperser for pulse and CW laser spectroscopy. Even for etalons 15 cm in diameter, the strength of the cemented bond is greatly in excess of the maximum steady and impulsive forces experienced from the much larger etalon plate mass (2-4 kg rather than 200 g). It is thought that the small but systematic and significant positive increment in the thermal expansion coefficient which occurs when an etalon and its spacers are cemented may be linked to the cessation of the microscopic migration that occurs with an optically contacted bond under thermal or mechanical stress. The etalon comprises two flat plates of fused silica, with spacers constructed of Zerodur (a polycrystalline glass ceramic of extremely low expansion coefficient) which are cemented together using cyanoacrylic adhesives.

A comparison of resistance to fracture among four commercially available forms of hydroxyapatite cement.

PubMed

Miller, Lee; Guerra, Aldo Benjamin; Bidros, Rafi Sirop; Trahan, Christopher; Baratta, Richard; Metzinger, Stephen Eric

2005-07-01

Hydroxyapatite cement is a relatively new biomaterial that has found widespread use in craniomaxillofacial surgery. Despite its common usage, complication rates as high as 32% have been reported. When failed implants are removed, implant fracture has been cited as a potential cause of failure. The purpose of this study was to evaluate resistance to fracture among 4 commercially available hydroxyapatite cement formulations. The materials tested included Norian Craniofacial Repair System (carbonated apatite cement) (AO North America, Devon, PA), Norian CRS Fast Set Putty (carbonated apatite cement) (AO North America), BoneSource (hydroxyapatite cement) (Stryker Leibinger, Portage, MI), and Mimix (hydroxyapatite cement) (Walter Lorenz Surgical, Inc, Jacksonville, FL). To ensure consistency, all materials were embedded in acrylic wells. Each material was placed into a well 2.54 cm in diameter and 0.953 cm in thickness. The materials were prepared per manufacturer specifications. All materials were incubated at 37.0 degrees C, in 6% CO2, 100% humidity for 36 hours. Using the Bionix MTS Test System, a 12-mm-diameter probe applied incremental force to the center of the disk at a rate of 0.1 mm per second. The transmitted force was measured using a Bionix MTS Axial-Torsional Load Transducer for each disk. The force which resulted in fracture was recorded for each material. Ten disks of each material were processed by this method, for a total of 40 disks. The significance of resistance to fracture for the 4 compounds was analyzed using 1-way analysis of variance with post hoc Scheffe method. Mean fracture force with related P values was plotted for direct comparison of group outcomes. Material type contributed significantly to variance in fracture force for the biomaterials studied. Norian CRS required the greatest mean fracture force (1385 N, SD+/-292 N), followed by Norian CRS Fast Set Putty (1143 N, SD+/-193 N). Mimix required a mean fracture force of 740 N, SD+/-79 N. BoneSource required a mean fracture force of 558 N, SD+/-150 N. Mimix and BoneSource required significantly less force for fracture when compared with Norian CRS and Fast Set Putty (P<0.01). Comparisons of fracture load resistance between 4 commonly used bone substitute materials have not been previously reported. Increasing biomaterial strength may reduce complications resulting from reinjury to cranioplasty sites. In this model, Norian CRS and Norian CRS Fast Set Putty demonstrated a significantly greater resistance to fracture when compared with BoneSource and Mimix.

A new method to routinely achieve passive fit of ceramometal prostheses over Brånemark osseointegrated implants: a two-year report.

PubMed

Aparicio, C

1994-10-01

To maintain osseointegration, it is essential that the prosthesis fit with total passivity because the absence of a periodontal ligament makes the implant unable to adapt its position to a nonpassive framework. The traditional system of building a metal framework by melting over mechanized pieces--called gold cylinders in the Brånemark system--has been modified so these pieces are joined to the metal framework by means of physicochemical bonding. This bond is achieved by treating the metallic surfaces with a Silicoater system and a composite resin cement that sets in the mouth using an improved cementing protocol. In this paper, the clinical viability of this new philosophy, shown over 2 years, is presented. A total of 64 prostheses (39 maxillary and 25 mandibular) supported by 214 abutments, with an average observation period of 9 months, were evaluated. The results show that it is possible to routinely obtain a ceramometal prosthesis with a totally passive circular fitting while maintaining the possibility of retrieval, thus making postceramic soldering unnecessary.

Electrospun Nanofibrous P(DLLA-CL) Balloons as Calcium Phosphate Cement Filled Containers for Bone Repair: in Vitro and in Vivo Studies.

PubMed

Liu, Xunwei; Wei, Daixu; Zhong, Jian; Ma, Mengjia; Zhou, Juan; Peng, Xiangtao; Ye, Yong; Sun, Gang; He, Dannong

2015-08-26

The spinal surgeon community has expressed significant interest in applying calcium phosphate cement (CPC) for the treatment of vertebral compression fractures (VCFs) and minimizing its disadvantages, such as its water-induced collapsibility and poor mechanical properties, limiting its clinical use. In this work, novel biodegradable electrospun nanofibrous poly(d,l-lactic acid-ϵ-caprolactone) balloons (ENPBs) were prepared, and the separation, pressure, degradation, and new bone formation behaviors of the ENPBs when used as CPC-filled containers in vitro and in vivo were systematically analyzed and compared. CPC could be separated from surrounding bone tissues by ENPBs in vitro and in vivo. ENPB-CPCs (ENPBs serving as CPC-filled containers) exerted pressure on the surrounding bone microenvironment, which was enough to crush trabecular bone. Compared with the CPC implantation, ENPB-CPCs delayed the degradation of CPC (i.e., its water-induced collapsilibity). Finally, possible mechanisms behind the in vivo effects caused by ENPB-CPCs implanted into rabbit thighbones and pig vertebrae were proposed. This work suggests that ENPBs can be potentially applied as CPC-filled containers in vivo and provides an experimental basis for the clinical application of ENPBs for the treatment of VCFs. In addition, this work will be of benefit to the development of polymer-based medical implants in the future.

Clinical Evidence of OsseoSpeed EV Implants: A Retrospective Study and Characterization of the Newly Introduced System.

PubMed

Toia, Marco; Galli, Silvia; Cecchinato, Denis; Wennerberg, Ann; Jimbo, Ryo

2017-08-23

This retrospective study sought to compare a new implant (Astra Tech OsseoSpeed EV) with its predecessor (Astra Tech OsseoSpeed TX) by scanning electron microscopy and interferometry. Radiographic data from 19 patients who underwent implant restoration with EV (n = 49) with a median follow-up of 16 months were evaluated for mean bone level (MBL) changes from delivery of the definitive prosthesis. EV and TX did not differ in surface roughness, and both systems had a tight seal at the implant-abutment interface. The median MBL change of the EV was -0.02 mm mesiodistally after a median follow-up period of 16 months. Greater maintenance of MBL was found in the screw-retained restorations (n = 17) compared to cemented (0.35 ± 0.33 mm and -0.38 ± 0.76 mm, respectively; P = .03). The data suggest that EV shows minimal levels of bone loss and high implant survival.

Peri-Implant Strain in an In Vitro Model.

PubMed

Hussaini, Souheil; Vaidyanathan, Tritala K; Wadkar, Abhinav P; Quran, Firas A Al; Ehrenberg, David; Weiner, Saul

2015-10-01

An in vitro experimental model was designed and tested to determine the influence that peri-implant strain may have on the overall crestal bone. Strain gages were attached to polymethylmethacrylate (PMMA) models containing a screw-type root form implant at sites 1 mm from the resin-implant interface. Three different types of crown superstructures (cemented, 1-screw [UCLA] and 2-screw abutment types) were tested. Loading (1 Hz, 200 N load) was performed using a MTS Mechanical Test System. The strain gage data were stored and organized in a computer for statistical treatment. Strains for all abutment types did not exceed the physiological range for modeling and remodeling of cancellous bone, 200-2500 με (microstrain). For approximately one-quarter of the trials, the strain values were less than 200 με the zone for bone atrophy. The mean microstrain obtained was 517.7 με. In conclusion, the peri-implant strain in this in vitro model did not exceed the physiologic range of bone remodeling under axial occlusal loading.

In vivo evaluation of the effects of hydraulic calcium silicate dental cements on plasma and liver aluminium levels in rats.

PubMed

Demirkaya, Kadriye; Can Demirdöğen, Birsen; Öncel Torun, Zeynep; Erdem, Onur; Çetinkaya, Serdar; Akay, Cemal

2016-02-01

Our aim was to test whether the presence of three hydraulic calcium silicate dental cements--MTA Angelus, MTA Fillapex, and Theracal LC--in the dental extraction socket of an in vivo model, would affect the levels of aluminium (Al) in the plasma and liver. Following anesthesia, the right upper incisor of each male Wistar albino rat was extracted and polyethylene tubes filled with MTA Angelus, MTA Fillapex, or Theracal LC were inserted into the depth of the extraction socket and gingival tissue was sutured. The rats were killed 7, 30, or 60 d after the operation. Blood and liver samples were obtained from the rats before they were killed, and the levels of Al were measured by atomic absorption spectrometry. Plasma Al levels were higher in the rats in which the mineral trioxide aggregate (MTA) cements were implanted, especially MTA Angelus and MTA Fillapex, compared with control rats. In liver samples, however, the differences in Al level were not statistically significant. Our results show that Al might have been released into the circulation from the three dental cements tested, especially MTA Angelus and MTA Fillapex. Further research should be carried out on the possible biological effects of Al liberated from dental cements. © 2015 Eur J Oral Sci.

Pre-clinical evaluation of the mechanical properties of a low-stiffness cement-injectable hip stem.

PubMed

Eldesouky, Ibrahim; Harrysson, Ola; Marcellin-Little, Denis J; West, Harvey; El-Hofy, Hassan

2017-11-01

In total hip arthroplasty (THA), the femoral stem can be fixed with or without bone cement. Cementless stem fixation is recommended for young and active patients as it eliminates the risk of loss of fixation at the bone-cement and cement-implant interfaces. Cementless fixation, however, suffers from a relatively high early revision rate. In the current research, a novel low-stiffness hip stem was designed, fabricated and tested. The stem design provided the option to inject biodegradable bone cement that could enhance initial stem stability. The stem was made of Ti6Al4V alloy. The proximal portion of the stem was porous, with cubic cells. The stem was fabricated using electron beam melting (EBM) technology and tested in compression and bending. Finite-element analysis was used to evaluate stem performance under a dynamic load representing a stair descending cycle and compare it to the performance of a solid stem with similar geometry. The von Mises stresses and maximum principal strains generated within the bone increased after porous stem insertion compared to solid stem insertion. The low-modulus stem tested in this study has acceptable mechanical properties and generates strain patterns in bone that appear compatible with clinical use.

Dental Implant Complications.

PubMed

Liaw, Kevin; Delfini, Ronald H; Abrahams, James J

2015-10-01

Dental implants have increased in the last few decades thus increasing the number of complications. Since many of these complications are easily diagnosed on postsurgical images, it is important for radiologists to be familiar with them and to be able to recognize and diagnose them. Radiologists should also have a basic understanding of their treatment. In a pictorial fashion, this article will present the basic complications of dental implants which we have divided into three general categories: biomechanical overload, infection or inflammation, and other causes. Examples of implant fracture, loosening, infection, inflammation from subgingival cement, failure of bone and soft tissue preservation, injury to surround structures, and other complications will be discussed as well as their common imaging appearances and treatment. Lastly, we will review pertinent dental anatomy and important structures that are vital for radiologists to evaluate in postoperative oral cavity imaging. Copyright © 2015 Elsevier Inc. All rights reserved.

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.

Physical and Chemical Properties and Subcutaneous Implantation of Mineral Trioxide Aggregate Mixed with Propylene Glycol.

PubMed

Marciano, Marina Angélica; Guimarães, Bruno Martini; Amoroso-Silva, Pablo; Camilleri, Josette; Hungaro Duarte, Marco Antonio

2016-03-01

The aim of this study was to evaluate the physical, chemical, and biological properties of mineral trioxide aggregate (MTA) mixed with 80% distilled water and 20% propylene glycol (PG) compared with MTA mixed with distilled water only. Flowability, film thickness, and solubility were analyzed according to American National Standards Institute/American Dental Association specification 57/2000. Initial and final setting times were assessed according to American Society for Testing and Materials specification C266/08. Porosity was assessed by using mercury intrusion porosimetry after 1 and 28 days of hydration, and the pH and calcium ion release were assessed after 3, 24, 72, and 168 hours. For the tissue reaction, the cements were implanted in 24 albino rats (2 groups, n = 12). An analysis of the inflammatory infiltrate was performed after 15, 30, and 60 days. MTA + PG exhibited lower film thickness and higher final setting time. No differences were verified for flowability (P > .05). MTA + PG showed high porosity at 1 day of hydration (P < .05). All the test cements demonstrated an alkaline pH. Microscopic analysis of the specimens revealed neoformation of connective tissue in contact with the cements. The introduction of PG as a mixing vehicle alters the physical and chemical properties of MTA and is biologically acceptable. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Survival and failure modes: platform-switching for internal and external hexagon cemented fixed dental prostheses.

PubMed

Anchieta, Rodolfo B; Machado, Lucas S; Hirata, Ronaldo; Coelho, Paulo G; Bonfante, Estevam A

2016-10-01

This study evaluated the probability of survival (reliability) of platform-switched fixed dental prostheses (FDPs) cemented on different implant-abutment connection designs. Eighty-four-three-unit FDPs (molar pontic) were cemented on abutments connected to two implants of external or internal hexagon connection. Four groups (n = 21 each) were established: external hexagon connection and regular platform (ERC); external hexagon connection and switched platform (ESC); internal hexagon and regular platform (IRC); and internal hexagon and switched platform (ISC). Prostheses were subjected to step-stress accelerated life testing in water. Weibull curves and probability of survival for a mission of 100,000 cycles at 400 N (two-sided 90% CI) were calculated. The beta values of 0.22, 0.48, 0.50, and 1.25 for groups ERC, ESC, IRC, and ISC, respectively, indicated a limited role of fatigue in damage accumulation, except for group ISC. Survival decreased for both platform-switched groups (ESC: 74%, and ISC: 59%) compared with the regular matching platform counterparts (ERC: 95%, and IRC: 98%). Characteristic strength was higher only for ERC compared with ESC, but not different between internal connections. Failures chiefly involved the abutment screw. Platform switching decreased the probability of survival of FDPs on both external and internal connections. The absence in loss of characteristic strength observed in internal hexagon connections favor their use compared with platform-switched external hexagon connections. © 2016 Eur J Oral Sci.

One-stage revision of infected hip arthroplasty: outcome of 39 consecutive hips.

PubMed

Ilchmann, Thomas; Zimmerli, Werner; Ochsner, Peter Emil; Kessler, Bernhard; Zwicky, Lukas; Graber, Peter; Clauss, Martin

2016-05-01

There are various options for treating periprosthetic joint infection (PJI). Two-stage exchange has traditionally been the gold standard. However, if the appropriate surgical intervention is chosen according to a rational algorithm, the outcome is similar when using all types of interventions. In an observational cohort study, the outcome of patients with PJI after hip replacement treated with one-stage revision was analysed. All patients fulfilling all criteria for one-stage exchange according to the Infectious Diseases Society of America (IDSA) guidelines and six without preoperative identification of a microorganism were included. Implant removal, debridement and cemented or uncemented reimplantations were performed in a single intervention. If a cemented device was implanted, commercially available gentamicin cement was used in all cases. Antibiotic treatment was administered intravenously for at least 2 weeks, followed by oral therapy for a total duration of 3 months. Patients had standardised clinical and radiological follow-up visits. Between 1996 and 2011, 38 patients (39 hips) were treated with a one-stage procedure and followed for at least 2 years. Coagulase-negative staphylococci were the most frequent pathogens, and polymicrobial infection was observed in five cases. In 25 hips, an uncemented revision stem was implanted, and 37 hips received an acetabular reinforcement ring. The mean follow-up was 6.6 (2.0-15.1) years. No patient had persistent, recurrent or new infection. There were four stem revisions for aseptic loosening. The mean Harris Hip Score was 81 points (26-99) at the final follow-up. Excellent cure rate and function seen in our study suggest that one-stage exchange is a safe procedure, even without local antibiotic treatment, provided that the patient has no sinus tract or severe soft tissue damage, no major bone grafting is required and the microorganism is susceptible to orally administered agents with high bioavailability.

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.

Development of high-viscosity, two-paste bioactive bone cements.

PubMed

Deb, S; Aiyathurai, L; Roether, J A; Luklinska, Z B

2005-06-01

Self-curing two-paste bone cements have been developed using methacrylate monomers with a view to formulate cements with low polymerization exotherm, low shrinkage, better mechanical properties, and improved adhesion to bone and implant surfaces. The monomers include bis-phenol A glycidyl dimethacrylate (bis-GMA), urethane dimethacrylate (UDMA) and triethylene glycol dimethacrylate (TEGDMA) as a viscosity modifier. Two-paste systems were formulated containing 60% by weight of a bioactive ceramic, hydroxyapatite. A methacroyloxy silane (A174) was used as a coupling agent due to its higher water stability in comparison to other aminosilanes to silanate the hydroxyapatite particles prior to composite formulation. A comparison of the FT-infrared spectrum of hydroxyapatite and silanated hydroxyapatite showed the presence of the carbonyl groups ( approximately 1720 cm(-1)), -C=C-( approximately 1630 cm(-1)) and Si-O- (1300-1250 cm(-1)) which indicated the availability of silane groups on the filler surface. Two methods of mixing were effected to form the bone cement: firstly by mixing in an open bowl and secondly by extruding the two pastes by an auto-mixing tip using a gun to dispense the pastes. Both types of cements yielded low polymerization exotherms with good mechanical properties; however, the lower viscosity of UDMA allowed better extrusion and handling properties. A biologically active apatite layer formed on the bone cement surface within a short period after its immersion in simulated body fluid, demonstrating in vitro bioactivity of the composite. This preliminary data thus suggests that UDMA is a viable alternative to bis-GMA as a polymerizable matrix in the formation of bone cements.

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.

Life Cycle Assessment of Completely Recyclable Concrete.

PubMed

De Schepper, Mieke; Van den Heede, Philip; Van Driessche, Isabel; De Belie, Nele

2014-08-21

Since the construction sector uses 50% of the Earth's raw materials and produces 50% of its waste, the development of more durable and sustainable building materials is crucial. Today, Construction and Demolition Waste (CDW) is mainly used in low level applications, namely as unbound material for foundations, e.g., in road construction. Mineral demolition waste can be recycled as crushed aggregates for concrete, but these reduce the compressive strength and affect the workability due to higher values of water absorption. To advance the use of concrete rubble, Completely Recyclable Concrete (CRC) is designed for reincarnation within the cement production, following the Cradle-to-Cradle (C2C) principle. By the design, CRC becomes a resource for cement production because the chemical composition of CRC will be similar to that of cement raw materials. If CRC is used on a regular basis, a closed concrete-cement-concrete material cycle will arise, which is completely different from the current life cycle of traditional concrete. Within the research towards this CRC it is important to quantify the benefit for the environment and Life Cycle Assessment (LCA) needs to be performed, of which the results are presented in a this paper. It was observed that CRC could significantly reduce the global warming potential of concrete.

Life Cycle Assessment of Completely Recyclable Concrete

PubMed Central

De Schepper, Mieke; Van den Heede, Philip; Van Driessche, Isabel; De Belie, Nele

2014-01-01

Since the construction sector uses 50% of the Earth’s raw materials and produces 50% of its waste, the development of more durable and sustainable building materials is crucial. Today, Construction and Demolition Waste (CDW) is mainly used in low level applications, namely as unbound material for foundations, e.g., in road construction. Mineral demolition waste can be recycled as crushed aggregates for concrete, but these reduce the compressive strength and affect the workability due to higher values of water absorption. To advance the use of concrete rubble, Completely Recyclable Concrete (CRC) is designed for reincarnation within the cement production, following the Cradle-to-Cradle (C2C) principle. By the design, CRC becomes a resource for cement production because the chemical composition of CRC will be similar to that of cement raw materials. If CRC is used on a regular basis, a closed concrete-cement-concrete material cycle will arise, which is completely different from the current life cycle of traditional concrete. Within the research towards this CRC it is important to quantify the benefit for the environment and Life Cycle Assessment (LCA) needs to be performed, of which the results are presented in a this paper. It was observed that CRC could significantly reduce the global warming potential of concrete. PMID:28788174

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.

Titanium-titanium modular neck for primary THA. Result of a prospective series of 170 cemented THA with a minimum follow-up of 5 years.

PubMed

Ollivier, M; Parratte, S; Galland, A; Lunebourg, A; Flecher, X; Argenson, J-N

2015-04-01

Although they have been in use since the end of the 1980s, modular titanium neck components are associated with a risk of wear or fracture, and their safety has recently become a subject of debate and has never been evaluated in a consecutive series of patients. The goal of this study was to evaluate: revision-free survival of these implants after a minimum follow-up of 5 years; clinical and radiographic results; and the potential complications associated with the use of modular titanium neck components. The use of titanium modular neck on cemented titanium THA is safe at a minimum follow-up of 5 years. Between January 2006 and December 2008, we prospectively followed 170 patients (170 hips) who underwent primary anatomical THA with a modular cemented titanium stem design implant. The indications were unilateral THA for primary (n=160) or secondary (n=10) hip osteoarthritis (aseptic osteonecrosis of the femoral head or hip dysplasia). Mean age of patients was 75.4±5.8 years old (52-85), and mean BMI was 26.1±4.5 kg/m(2) (16.6-42.1). Patients were operated on by a modified Watson-Jones anterolateral approach based on preoperative 2D planning. All patients underwent annual clinical and radiological follow-up by an independent observer. At a mean follow-up of 71±8 months (60-84), 5 patients died and 7 were lost to follow-up. There was no revision of THA after a maximum follow-up of 84 months. The Harris score improved significantly from 50.4±11.3 (0-76) preoperatively to 84.5±15.2 (14-100) at the final follow-up. There was no difference in postoperative femoral offset or the position of the center of rotation compared to the opposite side. On the other hand, the neck-shaft angle (NSA) and limb length were corrected (2±5° [-11 to +14°] and 2.16±3.6 mm [-7.4 to +12.7 mm]) respectively. Fifteen patients (9%) had limb length discrepancies of more than 5 mm and 4 patients (2%) of more than 10 mm. There were no complications due to the modular implant design. Our study suggests that the use of cemented titanium implants with a modular titanium stem is safe at a follow-up of 5 years. The modular design does not prevent limb length discrepancies but restores femoral offset. IV: prospective, non-comparative study. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Ectopic bone formation in nude rats using human osteoblasts seeded poly(3)hydroxybutyrate embroidery and hydroxyapatite-collagen tapes constructs.

PubMed

Mai, Ronald; Hagedorn, Manolo Gunnar; Gelinsky, Michael; Werner, Carsten; Turhani, Dritan; Späth, Heike; Gedrange, Tomas; Lauer, Günter

2006-09-01

The aim of this study was to evaluate the ectopic bone formation using tissue engineered cell-seeded constructs with two different scaffolds and primary human maxillary osteoblasts in nude rats over an implantation period of up to 96 days. Collagen I-coated Poly(3)hydroxybutyrate (PHB) embroidery and hydroxyapatite (HAP) collagen tapes were seeded with primary human maxillary osteoblasts (hOB) and implanted into athymic rnu/run rats. A total of 72 implants were placed into the back muscles of 18 rats. 24, 48 and 96 days after implantation, histological and histomorphometric analyses were made. The osteoblastic character of the cells was confirmed by immunocytochemistry and RT-PCR for osteocalcin. Histological analysis demonstrated that all cell-seeded constructs induced ectopic bone formation after 24, 48 and 96 days of implantation. There was more mineralized tissue in PHB constructs than in HAP-collagen tapes (at day 24; p < 0.05). Bone formation decreased with the increasing length of the implantation period. Osteocalcin expression verified the osteoblastic character of the cell-seeded constructs after implantation time. No bone formation and no osteocalcin expression were found in the control groups. Cell-seeded constructs either with PHB embroidery or HAP-collagen tapes can induce ectopic bone formation. However, the amount of bone formed decreased with increasing length of implantation.

Detection of orthopaedic foot and ankle implants by security screening devices.

PubMed

Bluman, Eric M; Tankson, Cedric; Myerson, Mark S; Jeng, Clifford L

2006-12-01

A common question asked by patients contemplating foot and ankle surgery is whether the implants used will set off security screening devices in airports and elsewhere. Detectability of specific implants may require the orthopaedic surgeon to provide attestation regarding their presence in patients undergoing implantation of these devices. Only two studies have been published since security measures became more stringent in the post-9/11 era. None of these studies specifically focused on the large numbers of orthopaedic foot and ankle implants in use today. This study establishes empiric data on the detectability by security screening devices of some currently used foot and ankle implants. A list of foot and ankle procedures was compiled, including procedures frequently used by general orthopaedists as well as those usually performed only by foot and ankle specialists. Implants tested included those used for open reduction and internal fixation, joint fusion, joint arthroplasty, osteotomies, arthroreisis, and internal bone stimulation. A test subject walked through a gate-type security device and was subsequently screened using a wand-type detection device while wearing each construct grouping. The screening was repeated with the implants placed within uncooked steak to simulate subcutaneous and submuscular implantation. None of the implants were detected by the gate-type security device. Specific implants that triggered the wand-type detection device regardless of coverage with the meat were total ankle prostheses, implantable bone stimulators, large metatarsophalangeal hemiarthroplasty, large arthroreisis plugs, medial distal tibial locking construct, supramalleolar osteotomy fixation, stainless steel bimalleolar ankle fracture fixation, calcaneal fracture plate and screw constructs, large fragment blade plate constructs, intramedullary tibiotalocalcaneal fusion constructs, and screw fixation for calcaneal osteotomies, ankle arthrodeses, triple arthrodeses, and stainless steel first metatarsophalangeal joint arthrodeses. The placement of implants in meat prevented the detectability of only the stainless steel Jones fracture implant (stainless steel 6.5-mm cannulated screw) and the stainless steel midfoot fusion construct (four stainless steel 4.0-mm cannulated screws). These data may help the orthopaedic surgeon in counseling patients as to the detectability of some orthopaedic foot and ankle implants in use today. Specific constructs for which documentation may need to be provided to the patient are identified. As security standards evolve and the environments in which they are practiced change, empiric testing of many of these devices may need to be repeated.

Evaluation of the success rate of cone beam computed tomography in determining the location and direction of screw access holes in cement-retained implant-supported prostheses: An in vitro study.

PubMed

Neshandar Asli, Hamid; Dalili Kajan, Zahra; Gholizade, Fatemeh

2018-02-21

Cement-retained implant-supported restorations have advantages over screw-retained restorations but are difficult to retrieve. Identifying the approximate location of the screw access hole (SAH) may reduce damage to the prosthesis. The purpose of this in vitro study was to evaluate the ability of cone beam computed tomography (CBCT) imaging to determine the location and direction of SAHs in cement-retained implant prostheses. Five clear acrylic resin casts were made based on a mandibular model. Several implant osteotomies (n=30) were created on the models with surgical burs, and crowns were made using the standard laboratory method with a transfer coping and the closed tray impression technique. CBCT images from the acrylic resin casts were evaluated by a maxillofacial radiologist who was blind to the locations and angles of the osteotomies. The locations of the access holes were determined on multiplanar reconstruction images and transferred to the clinical crown surface as defined points. Based on cross-sectional images, the predicted angle of the access hole was provided to a prosthodontist who was requested to pierce the crown at the proposed location in the specified direction. If the location and/or direction of the access hole were found, the process was considered successful, as the crown could then be removed from the implant abutment through the SAH. The success rate in the detection of the location and direction of the SAH was calculated, and chi-square and Fisher exact tests were applied for data analysis (α=.05). According to the results of this study, the success rate of CBCT to define the location of SAHs was 83.3% and 80% to determine the direction. No significant differences were found among the different dental groups in determination of the location (P=.79) or the direction (P=.53) of the SAHs. Most of the failures in determining the location and direction of the access hole in the buccolingual and mesiodistal directions were in the buccal and mesial locations of the SAH. The success rate of using CBCT to determine the location of SAHs in straight abutments was 100%. A significant difference was found between angled and straight abutments (P=.042). Using CBCT could help determine the direction and location of SAHs in clinical situations. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

40 CFR 63.1341 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... cement. Clinker cooler means equipment into which clinker product leaving the kiln is placed to be cooled... system in a portland cement production process where a dry kiln system is integrated with the raw mill so... construction after May 6, 2009, for purposes of determining the applicability of the kiln, clinker cooler and...

40 CFR 63.1341 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... cement. Clinker cooler means equipment into which clinker product leaving the kiln is placed to be cooled... system in a portland cement production process where a dry kiln system is integrated with the raw mill so... construction after May 6, 2009, for purposes of determining the applicability of the kiln, clinker cooler and...

Innovative solutions to buried portland cement concrete roadways : first interim report.

DOT National Transportation Integrated Search

2000-05-01

Maine has hundreds of miles of highway that were constructed of Portland Cement : Concrete (PCC) roughly 6 to 6.1 meters (18 to 20 feet) wide forty or more years ago. Since that : time these same highways have been paved and widened to 6.7 or 7 meter...

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.

Contribution to the physical-mechanical study of cement CRS basis of dune-sand powder and other minerals

NASA Astrophysics Data System (ADS)

Dahmani, Saci; Kriker, Abdelouahed

2016-07-01

The Portland cements are increasingly used for the manufacture of cement materials (mortar or concrete). Sighting the increasing demand of the cement in the field of construction, and the wealth of our country of minerals. It is time to value these local materials in construction materials and in the manufacture of cement for the manufacture of a new type of cement or for the improvement of the cement of characteristics for several reasons either technical, or ecological or economic or to improve certain properties to the State fees or hardened. The uses of mineral additions remain associated to disadvantages on the time of solidification and the development of the mechanical resistance at the young age [8]. The objective of our work is to study the effects of the incorporation of additions minerals such the pozzolan (active addition) [3], slag of blast furnace (active addition) [4] and the sand dune powder (inert addition) on the physico-mechanical properties of compositions of mortar collaborated compositions according to different binary combinations basis of these additions. This will allow selecting of optimal dosages of these combinations the more efficient, from the point of view of mechanical resistanceas well. The results of this research work confirm that the rate of 10% of pozzolan, slag or powder of dune sand contributes positively on the development of resistance in the long term, at of this proportion time,there is a decrease in the latter except for the slag (20 - 40%) [4]Seems the more effective resistors and physical properties.

Scanning-electron-microscopy observations and mechanical characteristics of ion-beam-sputtered surgical implant alloys

NASA Technical Reports Server (NTRS)

Weigand, A. J.; Meyer, M. L.; Ling, J. S.

1977-01-01

An electron bombardment ion thruster was used as an ion source to sputter the surfaces of orthopedic prosthetic metals. Scanning electron microscopy photomicrographs were made of each ion beam textured surface. The effect of ion texturing an implant surface on its bond to bone cement was investigated. A Co-Cr-W alloy and surgical stainless steel were used as representative hard tissue implant materials to determine effects of ion texturing on bulk mechanical properties. Work was done to determine the effect of substrate temperature on the development of an ion textured surface microstructure. Results indicate that the ultimate strength of the bulk materials is unchanged by ion texturing and that the microstructure will develop more rapidly if the substrate is heated prior to ion texturing.

Cement burns: retrospective study of 18 cases and review of the literature.

PubMed

Poupon, M; Caye, N; Duteille, F; Pannier, M

2005-11-01

Cement is increasingly used in the construction industry, but the occurrence of cement burns is rarely reported. This retrospective study concerns patients treated for cement burns in our unit between 1997 and 2002. Eighteen patients 18-64 years of age, treated previously in our unit for cement burns, were interviewed by telephone for evaluation. The mean time since treatment was 39 months. Burns were predominantly seen on the lower limbs, and a third occurred during an accident on the job. All deep burns were excised, and 16 patients received grafts. Mean hospital stay was 10 days, and mean sick leave 2 months. Our study indicated that all patients were poorly informed about cement-related risks. Surgical treatment of full-thickness cement burns at diagnosis enables rapid healing with a minimum of sequelae and reduces the high socioeconomic costs resulting from these lesions. This study indicates once again the need to improve preventive measures; which are very often inadequate because of lack of awareness of risks.

Reduction of soil pollution by usingwaste of the limestone in the cement industry

NASA Astrophysics Data System (ADS)

Muñoz, M. Cecilia Soto; Robles Castillo, Marcelo; Blanco Fernandez, David; Diaz Gonzalez, Marcos; Naranjo Lamilla, Pedro; Moore Undurraga, Fernando; Pardo Fabregat, Francisco; Vidal, Manuel Miguel Jordan; Bech, Jaume; Roca, Nuria

2016-04-01

In the cement manufacturing process (wet) a residue is generated in the flotation process. This builds up causing contamination of soil, groundwater and agricultural land unusable type. In this study to reduce soil and water pollution 10% of the dose of cement was replaced by waste of origin limestone. Concretes were produced with 3 doses of cement and mechanical strengths of each type of concrete to 7, 28 and 90 days were determined. the results indicate that the characteristics of calcareous residue can replace up to 10% of the dose of cement without significant decreases in strength occurs. It is noted that use of the residue reduces the initial resistance, so that the dose of cement should not be less than 200 kg of cement per m3. The results allow recommends the use of limestone waste since it has been observed decrease in soil and water contamination without prejudice construction material Keywords: Soil contamination; Limestone residue; Adding concrete

Magnesium-phosphate-glass cements with ceramic-type properties

DOEpatents

Sugama, T.; Kukacka, L.E.

1982-09-23

Rapid setting magnesium phosphate (Mg glass) cementitious materials consisting of magnesium phosphate cement paste, polyborax and water-saturated aggregate, exhibits rapid setting and high early strength characteristics. The magnesium glass cement is prepared from a cation-leachable powder and a bivalent metallic ion-accepting liquid such as an aqueous solution of diammonium phosphate and ammonium polyphosphate. The cation-leachable powder includes a mixture of two different magnesium oxide powders processed and sized differently which when mixed with the bivalent metallic ion-accepting liquid provides the magnesium glass cement consisting primarily of magnesium ortho phosphate tetrahydrate, with magnesium hydroxide and magnesium ammonium phosphate hexahydrate also present. The polyborax serves as a set-retarder. The resulting magnesium mono- and polyphosphate cements are particularly suitable for use as a cementing matrix in rapid repair systems for deteriorated concrete structures as well as construction materials and surface coatings for fireproof structures.

Magnesium phosphate glass cements with ceramic-type properties

DOEpatents

Sugama, Toshifumi; Kukacka, Lawrence E.

1984-03-13

Rapid setting magnesium phosphate (Mg glass) cementitious materials consisting of magnesium phosphate cement paste, polyborax and water-saturated aggregate exhibiting rapid setting and high early strength characteristics. The magnesium glass cement is prepared from a cation-leachable powder and a bivalent metallic ion-accepting liquid such as an aqueous solution of diammonium phosphate and ammonium polyphosphate. The cation-leachable powder includes a mixture of two different magnesium oxide powders processed and sized differently which when mixed with the bivalent metallic ion-accepting liquid provides the magnesium glass cement consisting primarily of magnesium ortho phosphate tetrahydrate, with magnesium hydroxide and magnesium ammonium phosphate hexahydrate also present. The polyborax serves as a set-retarder. The resulting magnesium mono- and polyphosphate cements are particularly suitable for use as a cementing matrix in rapid repair systems for deteriorated concrete structures as well as construction materials and surface coatings for fireproof structures.

Nano-scale hydrogen-bond network improves the durability of greener cements

PubMed Central

Jacobsen, Johan; Rodrigues, Michelle Santos; Telling, Mark T. F.; Beraldo, Antonio Ludovico; Santos, Sérgio Francisco; Aldridge, Laurence P.; Bordallo, Heloisa N.

2013-01-01

More than ever before, the world's increasing need for new infrastructure demands the construction of efficient, sustainable and durable buildings, requiring minimal climate-changing gas-generation in their production. Maintenance-free “greener” building materials made from blended cements have advantages over ordinary Portland cements, as they are cheaper, generate less carbon dioxide and are more durable. The key for the improved performance of blends (which substitute fine amorphous silicates for cement) is related to their resistance to water penetration. The mechanism of this water resistance is of great environmental and economical impact but is not yet understood due to the complexity of the cement's hydration reactions. Using neutron spectroscopy, we studied a blend where cement was replaced by ash from sugar cane residuals originating from agricultural waste. Our findings demonstrate that the development of a distinctive hydrogen bond network at the nano-scale is the key to the performance of these greener materials. PMID:24036676

21 CFR 888.3540 - Knee joint patellofemoral polymer/metal semi-constrained cemented prosthesis.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices... Medical Devices—Part I: Evaluation and Testing,’ ” (ii) “510(k) Sterility Review Guidance of 2/12/90 (K90... device intended to be implanted to replace part of a knee joint in the treatment of primary...

Modular femoral component for conversion of previous hip surgery in total hip arthroplasty.

PubMed

Goldstein, Wayne M; Branson, Jill J

2005-09-01

The conversion of previous hip surgery to total hip arthroplasty creates a durable construct that is anatomically accurate. Most femoral components with either cemented or cementless design have a fixed tapered proximal shape. The proximal femoral anatomy is changed due to previous hip surgery for fixation of an intertrochanteric hip fracture, proximal femoral osteotomy, or a fibular allograft for avascular necrosis. The modular S-ROM (DePuy Orthopaedics Inc., Warsaw, Ind) hip stem accommodates these issues and independently prepares the proximal and distal portion of the femur. In preparation and implantation, the S-ROM hip stem creates less hoop stresses on potentially fragile stress risers from screws and thin bone. The S-ROM hip stem also prepares a previously distorted anatomy by milling through cortical bone that can occlude the femoral medullar canals and recreate proper femoral anteversion and reduces the risk of intraoperative or postoperative periprosthetic fracture due to the flexible titanium-slotted stem. The S-ROM femoral stem is recommended for challenging total hip reconstructions.

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.

Hypervelocity Impact Testing of Materials for Additive Construction: Applications on Earth, the Moon, and Mars

NASA Technical Reports Server (NTRS)

Ordonez, Erick; Edmunson, Jennifer; Fiske, Michael; Christiansen, Eric; Miller, Josh; Davis, Bruce Alan; Read, Jon; Johnston, Mallory; Fikes, John

2017-01-01

Additive Construction is the process of building infrastructure such as habitats, garages, roads, berms, etcetera layer by layer (3D printing). The National Aeronautics and Space Administration (NASA) and the United States Army Corps of Engineers (USACE) are pursuing additive construction to build structures using resources available in-situ. Using materials available in-situ reduces the cost of planetary missions and operations in theater. The NASA team is investigating multiple binders that can be produced on planetary surfaces, including the magnesium oxide-based Sorel cement; the components required to make Ordinary Portland Cement (OPC), the common cement used on Earth, have been found on Mars. The availability of OPC-based concrete on Earth drove the USACE to pursue additive construction for base housing and barriers for military operations. Planetary and military base structures must be capable of resisting micrometeoroid impacts with velocities ranging from 11 to 72km/s for particle sizes 200 micrometers or more (depending on protection requirements) as well as bullets and shrapnel with a velocity of 1.036km/s with projectiles 5.66mm diameter and 57.40mm in length, respectively.

Allergies in orthopaedic and trauma surgery.

PubMed

Lohmann, C H; Hameister, R; Singh, G

2017-02-01

Hypersensitivity reactions to implants in orthopaedic and trauma surgery are a rare but devastating complication. They are considered as a delayed-type of hypersensitivity reaction (type IV), characterized by an antigen activation of sensitized T-lymphocytes releasing various cytokines and may result in osteoclast activation and bone resorption. Potential haptens are originated from metal alloys or bone-cement. A meta-analysis has confirmed a higher probability of developing a metal hypersensitivity postoperatively and noted a greater risk of failed replacements compared to stable implants. Hypersensitivity to implants may present with a variety of symptoms such as pain, joint effusion, delayed wound/bone healing, persistent secretion, allergic dermatitis (localized or systemic), clicking noises, loss of joint function, instability and failure of the implant. Various diagnostic options have been offered, including patch testing, metal alloy patch testing, histology, lymphocyte transformation test (LTT), memory lymphocyte immunostimulation assay (MELISA), leukocyte migration inhibition test (LIF) and lymphocyte activation test (LAT). No significant differences between in vivo and in vitro methods have been found. Due to unconvincing evidence for screening methods, predictive tests are not recommended for routine performance. Infectious aetiology always needs to be excluded. As there is a lack of evidence on large-scale studies with regards to the optimal treatment option, management currently relies on individual case-by-case decisions. Several options for patients with (suspected) metal-related hypersensitivity exist and may include materials based on ceramic, titanium or oxinium or modified surfaces. Promising results have been reported, but long-term experience is lacking. More large-scaled studies are needed in this context. In patients with bone-cement hypersensitivity, the component suspected for hypersensitivity should be avoided. The development of (predictive) biomarkers is considered as a major contribution for the future. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Esthetic Evaluation of Anterior Single-Tooth Implants with Different Abutment Designs-Patients' Satisfaction Compared to Dentists' Observations.

PubMed

Patil, Ratnadeep; Gresnigt, Marco M M; Mahesh, Kavita; Dilbaghi, Anjali; Cune, Marco S

2017-07-01

To correlate patients' satisfaction and dentists' observations regarding two abutment designs used for single crowns in the esthetic zone: a divergent one (control) and a curved one (experimental), with special emphasis on muco-gingival esthetics. Twenty-six patients with nonadjacent missing teeth in the esthetic zone were enrolled in a randomized clinical trial (within-subject comparison). Two implants placed in each were restored using abutments of different geometry. Patients' appreciation was assessed on a visual analog scale (VAS) by recording answers to three questions, and dentists' appreciation was determined by means of the Pink Esthetic Score (PES) at T0 (crown cementation, baseline) and at T12 (1 year post-cementation). ANOVA with post hoc analysis was used to identify differences between groups and at different moments in time. Pearson correlations were calculated between all variables, both at T0 and at T12. No statistically significant differences were found at any time between the control and experimental abutment design, either for the PES or for the VAS score. PES slightly improved after 1 year, as did the VAS rating related to functioning with the implant-crown compared to the natural teeth. All PES and VAS scores demonstrated highly significant correlation. Both patient satisfaction and professional appreciation of muco-gingival conditions after single implant treatment in the esthetic zone were high; however, the curved, experimental abutment design performed no better than the conventional, divergent type. Curved abutment design does not significantly impact crown or gingival esthetics as assessed by PES and VAS scored by dentists and patients, respectively. © 2016 by the American College of Prosthodontists.

Biomechanical Consequences of the Elastic Properties of Dental Implant Alloys on the Supporting Bone: Finite Element Analysis

PubMed Central

Chávarri-Prado, David; Jiménez-Garrudo, Antonio; Solaberrieta-Méndez, Eneko; Diéguez-Pereira, Markel; Fernández-González, Felipe J.; Dehesa-Ibarra, Borja; Monticelli, Francesca

2016-01-01

The objective of the present study is to evaluate how the elastic properties of the fabrication material of dental implants influence peri-implant bone load transfer in terms of the magnitude and distribution of stress and deformation. A three-dimensional (3D) finite element analysis was performed; the model used was a section of mandibular bone with a single implant containing a cemented ceramic-metal crown on a titanium abutment. The following three alloys were compared: rigid (Y-TZP), conventional (Ti-6Al-4V), and hyperelastic (Ti-Nb-Zr). A 150-N static load was tested on the central fossa at 6° relative to the axial axis of the implant. The results showed no differences in the distribution of stress and deformation of the bone for any of the three types of alloys studied, mainly being concentrated at the peri-implant cortical layer. However, there were differences found in the magnitude of the stress transferred to the supporting bone, with the most rigid alloy (Y-TZP) transferring the least stress and deformation to cortical bone. We conclude that there is an effect of the fabrication material of dental implants on the magnitude of the stress and deformation transferred to peri-implant bone. PMID:27995137

Effects of Using Pozzolan and Portland Cement in the Treatment of Dispersive Clay

PubMed Central

Vakili, A. H.; Selamat, M. R.; Moayedi, H.

2013-01-01

Use of dispersive clay as construction material requires treatment such as by chemical addition. Treatments to dispersive clay using pozzolan and Portland cement, singly and simultaneously, were carried out in this study. When used alone, the optimum amount of pozzolan required to treat a fully dispersive clay sample was 5%, but the curing time to reduce dispersion potential, from 100% to 30% or less, was 3 month long. On the other hand, also when used alone, a 3% cement content was capable of reducing dispersion potential to almost zero percent in only 7 days; and a 2% cement content was capable of achieving similar result in 14 days. However, treatment by cement alone is costly and could jeopardize the long term performance. Thus, a combined 5% pozzolan and 1.5% cement content was found capable of reducing dispersion potential from 100% to zero percent in 14 days. The results indicate that although simultaneous treatment with pozzolan and cement would extend the required curing time in comparison to treatment by cement alone of a higher content, the task could still be carried out in a reasonable period of curing time while avoiding the drawbacks of using either pozzolan or cement alone. PMID:23864828

Magnesia-Based Cements: A Journey of 150 Years, and Cements for the Future?

PubMed

Walling, Sam A; Provis, John L

2016-04-13

This review examines the detailed chemical insights that have been generated through 150 years of work worldwide on magnesium-based inorganic cements, with a focus on both scientific and patent literature. Magnesium carbonate, phosphate, silicate-hydrate, and oxysalt (both chloride and sulfate) cements are all assessed. Many such cements are ideally suited to specialist applications in precast construction, road repair, and other fields including nuclear waste immobilization. The majority of MgO-based cements are more costly to produce than Portland cement because of the relatively high cost of reactive sources of MgO and do not have a sufficiently high internal pH to passivate mild steel reinforcing bars. This precludes MgO-based cements from providing a large-scale replacement for Portland cement in the production of steel-reinforced concretes for civil engineering applications, despite the potential for CO2 emissions reductions offered by some such systems. Nonetheless, in uses that do not require steel reinforcement, and in locations where the MgO can be sourced at a competitive price, a detailed understanding of these systems enables their specification, design, and selection as advanced engineering materials with a strongly defined chemical basis.

Effects of using pozzolan and Portland cement in the treatment of dispersive clay.

PubMed

Vakili, A H; Selamat, M R; Moayedi, H

2013-01-01

Use of dispersive clay as construction material requires treatment such as by chemical addition. Treatments to dispersive clay using pozzolan and Portland cement, singly and simultaneously, were carried out in this study. When used alone, the optimum amount of pozzolan required to treat a fully dispersive clay sample was 5%, but the curing time to reduce dispersion potential, from 100% to 30% or less, was 3 month long. On the other hand, also when used alone, a 3% cement content was capable of reducing dispersion potential to almost zero percent in only 7 days; and a 2% cement content was capable of achieving similar result in 14 days. However, treatment by cement alone is costly and could jeopardize the long term performance. Thus, a combined 5% pozzolan and 1.5% cement content was found capable of reducing dispersion potential from 100% to zero percent in 14 days. The results indicate that although simultaneous treatment with pozzolan and cement would extend the required curing time in comparison to treatment by cement alone of a higher content, the task could still be carried out in a reasonable period of curing time while avoiding the drawbacks of using either pozzolan or cement alone.

Study on Strength and Durability Characteristics of Concrete with Ternary Blend

NASA Astrophysics Data System (ADS)

Nissi Joy, C.; Ramakrishnan, K.; Snega, M.; Ramasundram, S.; Venkatasubramanian, C.; Muthu, D.

2017-07-01

In the present scenario to fulfill the demands of sustainable construction, concrete made with multi-blended cement system of Ordinary Portland Cement (OPC) and different mineral admixtures is the wise choice for the construction industry. In this research work, M20 grade mix of concrete (with water - binder ratio as 0.48) is adopted with glass powder (GP) and Sugar Cane Bagasse Ash (SCBA) as partial replacement of cement. GP is an inert material, they occupy the landfill space for considerable amount of time unless there is a potential for recycling. Such glass wastes in the crushed form have a good potential in the infrastructure industry. Replacement of cement by GP from 30% to 0% by weight of cement in step of 5% and by SCBA from 0% to 30% in step of 5% respectively was adopted. In total, seven different combinations of mixes were studied at two different ages of concrete namely 7 and 28 days. Compressive strength of cubes for various percentage of replacement were investigated and compared with conventional concrete to find out the maximum mix ratio. Flexural strength of concrete for the maximum mix ratio was found out and durability parameters viz., water absorption and sorptivity were studied. From the experimental study, 20% SCBA and 10% GP combination was found to be the maximum mix ratio.

Field and lab evaluation of the use of lime fly ash to replace soil cement as a base course : technical summary.

DOT National Transportation Integrated Search

1997-09-01

The purpose of this project was to design and construct lime/fly ash stabilized base course test sections which would be economical compared to a soil cement stabilized base, utilize a recyclable material, and possibly reduce shrinkage cracking on ba...

USE OF SUPPLEMENTARY CEMENTITIOUS MATERIALS IN HIGH PERFORMANCE, CO2 SEQUESTERING CONSTRUCTION MATERIAL - PHASE I

EPA Science Inventory

Innovative solutions to buried portland cement concrete roadways.

DOT National Transportation Integrated Search

2005-03-01

Forty or more years ago hundreds of miles of Maine highways were constructed of Portland Cement : Concrete (PCC) to a width of 5.5 to 6.0 m (18 to 20 ft). Since that time these same highways have been : paved and widened to 6.7 or 7.3 m (22 or 24 ft)...

Innovative solutions to buried portland cement concrete roadways : second interim.

DOT National Transportation Integrated Search

2001-04-01

Maine has hundreds of miles of highway that were constructed of : Portland Cement Concrete (PCC) roughly 6 to 6.1 m (18 to 20 ft) wide forty : or more years ago. Since that time these same highways have been paved : and widened to 6.7 or 7 m (22 or 2...

40 CFR 146.32 - Construction requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 24 2013-07-01 2013-07-01 false Construction requirements. 146.32... to Class III Wells § 146.32 Construction requirements. (a) All new Class III wells shall be cased and... would result. The casing and cement used in the construction of each newly drilled well shall be...

40 CFR 146.32 - Construction requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 24 2012-07-01 2012-07-01 false Construction requirements. 146.32... to Class III Wells § 146.32 Construction requirements. (a) All new Class III wells shall be cased and... would result. The casing and cement used in the construction of each newly drilled well shall be...

The effect of fly ash and coconut fibre ash as cement replacement materials on cement paste strength

NASA Astrophysics Data System (ADS)

Bayuaji, R.; Kurniawan, R. W.; Yasin, A. K.; Fatoni, H. AT; Lutfi, F. M. A.

2016-04-01

Concrete is the backbone material in the construction field. The main concept of the concrete material is composed of a binder and filler. Cement, concrete main binder highlighted by environmentalists as one of the industry are not environmentally friendly because of the burning of cement raw materials in the kiln requires energy up to a temperature of 1450° C and the output air waste CO2. On the other hand, the compound content of cement that can be utilized in innovation is Calcium Hydroxide (CaOH), this compound will react with pozzolan material and produces additional strength and durability of concrete, Calcium Silicate Hydrates (CSH). The objective of this research is to explore coconut fibers ash and fly ash. This material was used as cement replacement materials on cement paste. Experimental method was used in this study. SNI-03-1974-1990 is standard used to clarify the compressive strength of cement paste at the age of 7 days. The result of this study that the optimum composition of coconut fiber ash and fly ash to substitute 30% of cement with 25% and 5% for coconut fibers ash and fly ash with similar strength if to be compared normal cement paste.