ABSTRACT
This study details the design, fabrication, clinical trials' evaluation, and analysis after the clinical application of 3D-printed bone reconstruction implants made of nHAp@PLDLLA [nanohydroxyapatite@poly(L-lactide-co-D,L-lactide)] biomaterial. The 3D-printed formulations have been tested as bone reconstruction Cranioimplants in 3 different medical cases, including frontal lobe, mandibular bone, and cleft palate reconstructions. Replacing one of the implants after 6 months provided a unique opportunity to evaluate the post-surgical implant obtained from a human patient. This allowed us to quantify physicochemical changes and develop a spatial map of osseointegration and material degradation kinetics as a function of specific locations. To the best of our knowledge, hydrolytic degradation and variability in the physicochemical and mechanical properties of the biomimetic, 3D-printed implants have not been quantified in the literature after permanent placement in the human body. Such analysis has revealed the constantly changing properties of the implant, which should be considered to optimize the design of patient-specific bone substitutes. Moreover, it has been proven that the obtained composition can produce biomimetic, bioresorbable and bone-forming alloplastic substitutes tailored to each patient, allowing for shorter surgery times and faster patient recovery than currently available methods.
Subject(s)
Durapatite , Printing, Three-Dimensional , Humans , Durapatite/chemistry , Absorbable Implants , Bone Substitutes/chemistry , Skull/surgery , Polyesters/chemistry , Male , Prosthesis Design , Biocompatible Materials/chemistry , FemaleABSTRACT
UNLABELLED: Osteoporosis is a serious health problem among postmenopausal women. Many clinical studies have shown a correlation between low bone mineral density (BMD) parameters of spinal column, hip and bone status of mandible. AIM: The aim of the study was to compare the status of mandibular bone and the lumbar part of the spine in postmenopausal women with osteoporosis, osteopenia and normal BMD. MATERIALS AND METHODS: 47 postmenopausal women (mean age 54.80 +/- 3.65 years) were included into the study. Densitometry (DXA) of the lumbar part of the spinal column was performed in all patients. The results of densitometry helped to differentiate the patients into 3 groups: those with osteoporosis (n=10) or osteopenia (n=20) and those with normal BMD (n=17). Panoramic radiographs of the mandible were taken of all the patients. Obtained results were analyzed stastically. RESULTS: No correlations were found between the panoramic mandibular index (PMI) and mandibular ratio (MR) and vertebral (lumbar) bone loss in postmenopausal women. There was a positive correlation between the distance from the inferior margin of the mental foramen to the inferior mandibular cortex and the degree of lumbar BMD deficiency. CONCLUSIONS: Our study shows that PMI and MR are not adequate radiological marker of vertebral bone loss in postmenopausal women. However, measurements of the distance between the inferior margin of the mental foramen and the inferior mandibular cortex did correlate with the degree of lumbar BMD deficiency. This parameter can be useful in the estimation of osteoporosis risk.
Subject(s)
Bone Density , Bone Diseases, Metabolic/pathology , Lumbar Vertebrae/physiopathology , Mandible/pathology , Osteoporosis, Postmenopausal/pathology , Postmenopause , Bone Diseases, Metabolic/diagnosis , Female , Humans , Mandible/diagnostic imaging , Middle Aged , Osteoporosis, Postmenopausal/diagnosis , Radiography, PanoramicABSTRACT
UNLABELLED: Profound hypoestrogenism causes increased risk of osteoporosis and bone fracture in menopause. This period of women life is also characterized by decrease number of teeth and deterioration of oral cavity health. AIM: The aim of the study was to assess the number of teeth, hormonal profile (Follicle-stimualting hormone (FSH), estradiol (E2), testosterone (T) and dehydroepiandrosterone sulphate (DHEA-S) and the bone mineral density (BMD) of the lumbar part of the spine in postmenopausal women with osteoporosis, osteopenia and normal BMD. The next step of the study was to determine whether there was a correlation between vertebral mineral bone density, the hormonal profile and the number of teeth. MATERIALS AND METHODS: A total number of 47 women was involved in the study. Based on the results of densitometry tests (DEXA) of vertebral column the subjects were divided into 3 groups: 10 with osteoporosis, 20 with osteopenia and 17 with normal BMD. All the subjects had undergone a hormonal assessment which included blood serum estimation for FSH, E2, DHEA-S and T levels. Also the total number of teeth present was recorded. RESULTS: Serum estradiol and testosterone levels in postmenopausal women were found to be positively correlated with the number of teeth present. A negative correlation was found between age and the number of maxillary teeth in postmenopausal women with osteopenia. There was no influence of serum FSH, estradiol, testosterone and DHEA-S levels on vertebral BMD loss in postmenopausal women. There was no correlation between teeth number and BMD of vertebral column. CONCLUSIONS: Serum levels of estradiol and testosterone in postmenopausal women positively correlate with teeth numbers. Age is the main risk factor for teeth loss in postmenopausal women.
