High failure rate after Beta-tricalcium phosphate grafting for the treatment of femoral head osteonecrosis: a retrospective analysis.

BACKGROUND: Non-vascularized bone grafting is a promising head-preserving technique for younger patients diagnosed as non-traumatic osteonecrosis of the femoral head (NONFH). Among the various types of bone grafting techniques, "light-bulb" procedure grafting with synthetic bone substitute is an attractive option. We aimed to assess the effectiveness of using beta-tricalcium phosphate (ß-TCP) for the treatment of pre-collapse and early post-collapse lesions NONFH. METHODS: From April 2010 to June 2014, 33 patients (47 hips) with NONFH were treated using the afore-mentioned technique. The clinical and radiological outcomes were recorded and compared statistically between pre- and post-operation. Harris hip score (HHS) was used to evaluate the clinical results, and Association Research Circulation Osseous (ARCO) stage was applied to assess the radiological outcomes. RESULTS: The 5-years survival rate of using ß-TCP grafting was accounting for 25.5%. HHS was decreased from 78.47 to 52.87 points, and a very significant worsening of radiological results were revealed (P <  0.05). Two hips collapsed more than 2 mm were awaiting for THA, and 33 of the 47 hips had converted to THAs in an average time to failure of 24.24 months postoperatively. Meanwhile, only 4 hips survived without collapse, and 8 hips collapsed less than 2 mm. After surgery, the time onset of head collapse was 3.65 months on average, and the first conversion to THA was performed at 5 months postoperative. CONCLUSIONS: Our results suggest that "light-bulb" procedure grafting with ß-TCP sticks presented with a high failure rate in the early postoperative period. It is not proposed for the treatment of pre-collapse and early post-collapse lesions NONFH.

A new fixation method for stick-shaped specimens in microtensile tests: laboratory tests and FEA.

PURPOSE: To introduce a new fixation method for stick-shaped specimens for use in microtensile tests and to evaluate the effect of this new method on microtensile bond strength, failure modes, and stress distribution. MATERIALS AND METHODS: Flat mid-coronal dentin surfaces were prepared on 12 caries-free human third molars and randomly divided into two groups for testing with two dental adhesives (Adper Single Bond 2 [SB2] and Clearfil SE Bond [SEB]). Following adhesive application and composite buildups, the bonded teeth were sectioned into beams. Sticks from each tooth were then equally divided into two subgroups for microtensile bond testing according to the utilized gripping devices (a flat Ciucchi's jig and the experimental setup). Failure modes were examined with a field-emission scanning electron microscope (FESEM). Three-dimensional models of each gripping device and specimen were developed, and stress distributions were analyzed by finite element analysis (FEA). Statistical significance was set at α = 0.05 RESULTS: Compared to those fixed using a flat Ciucchi's jig, sticks fixed with the experimental setup yielded lower bond strength values (p = 0.021 for SB2 and p = 0.007 for SEB) and more mixed failure patterns (p = 0.036 for both SB2 and SEB). In addition, the experimental setup guaranteed a uniaxial tensile force that was perpendicular to the bonding interface and produced a more uniform stress distribution at the bonding interface. CONCLUSION: An experimental setup for fixing microtensile sticks was proposed that was designed to provide a uniform stress distribution at the adhesive interface. FEA and failure mode analysis confirmed such uniform distribution, thus supporting the validity of the bond strength results obtained with this new fixture design.

Effect of iron salt type and dosing mode on Fenton-based pretreatment of rice straw for enzymatic hydrolysis.

Fenton-based processes with four different iron salts in two different dosing modes were used to pretreat rice straw (RS) samples to increase their enzymatic digestibility. The composition analysis shows that the RS sample pretreated by the dosing mode of iron salt adding into H2O2 has a much lower hemicellulose content than that pretreated by the dosing mode of H2O2 adding into iron salt, and the RS sample pretreated by the chloride salt-based Fenton process has a much lower lignin content and a slightly lower hemicellulose content than that pretreated by the sulphate salt-based Fenton process. The higher concentration of reducing sugar observed on the RS sample with lower lignin and hemicellulose contents justifies that the Fenton-based process could enhance the enzymic hydrolysis of RS by removing hemicellulose and lignin and increasing its accessibility to cellulase. FeCl3·6H2O adding into H2O2 is the most efficient Fenton-based process for RS pretreatment.

Ultrasound-assisted alkaline pretreatment for enhancing the enzymatic hydrolysis of rice straw by using the heat energy dissipated from ultrasonication.

Rice straw samples were exposed to ultrasound-assisted alkaline (NaOH) pretreatment by using the heat energy dissipated from ultrasonication to increase their enzymatic digestibility for saccharification. The characterization shows that the pretreatment could selectively remove lignin and hemicellulose without degrading cellulose, and increase porosity and surface area of rice straw. The porosity, surface area and cellulose content of rice straw increased with the increasing concentration of NaOH used. The rice straw sample pretreated by using the heat energy dissipated from ultrasonication has a higher surface area and a lower crystallinity index value than that pretreated by using the external source of heating, and the amount of reducing sugar released from the former sample at 48h of enzymatic saccharification, which is about 3.5 times as large as that from the untreated rice straw sample (2.91vs. 0.85gL-1), is slightly larger than that from the latter sample (2.91vs. 2.73gL-1). The ultrasound-assisted alkaline pretreatment by using the heat energy dissipated from ultrasonication was proved to be a reliable and effective method for rice straw pretreatment.

Depolymerization of microcrystalline cellulose by the combination of ultrasound and Fenton reagent.

In this study, the combined use of Fenton reagent and ultrasound to the pretreatment of microcrystalline cellulose (MCC) for subsequent enzyme hydrolysis was investigated. The morphological analysis showed that the aspect ratio of MCC was greatly reduced after pretreatment. The X-ray diffraction (XRD) and degree of polymerization (DP) analyses showed that Fenton reagent was more efficient in decreasing the crystallinity of MCC while ultrasound was more efficient in decreasing the DP of MCC. The combination of Fenton reaction and ultrasound, which produced the lowest crystallinity (84.8 ± 0.2%) and DP (124.7 ± 0.6) of MCC and the highest yield of reducing sugar (22.9 ± 0.3 g/100 g), provides a promising pretreatment process for MCC depolymerization.

[Selection of optimal occlusal thickness and shoulder thickness in mandibular first molar all-ceramic crown: a three-dimensional finite element analysis].

OBJECTIVE: To investigate the effect of different occlusal thickness and shoulder finish line depth on stress distribution of all-ceramic crowns and to select optimal occlusal thickness and shoulder finish line depth using continuous variation of parameters. METHODS: This analysis was performed using mandibular first molar finite element model. The range of occlusal thickness was set from 1 mm to 3 mm, and that of shoulder finish line depth was from 0.4 mm to 1.2 mm. Load of 225 N was applied perpendicularly to the occlusal surface of the tooth at all buccal cusps to simulate functional occlusal force. The maximum equivalent stresses in crown, cement layer, abutment, periodontal ligament, alveolar bone were calculated, and the sensitivities of stresses to the variables were also evaluated. RESULTS: The maximum equivalent stresses in crown, cement layer and abutment decreased as occlusal thickness and shoulder finish line depth were increased, while no obvious change were found in maximum equivalent stresses in periodontal ligament and alveolar bone. When occlusal thickness exceeded 1.87 mm and shoulder finish line depth exceeded 0.66 mm, the tangent slope rate of the maximum equivalent stress response curves ranged from -1 to 1. Data indicated that occlusal thickness played a more important role in reducing maximum equivalent stress in cement layer than finish line depth did, and shoulder finish line depth was a more effective parameter in reducing maximum equivalent stress in crown and abutment than occlusal thickness was. CONCLUSIONS: Occlusal thickness exceeding 1.87 mm and shoulder finish line depth exceeding 0.66 mm are optimal design for ceramic crown on mandibular first molar from biomechanical point of view.