Hydroxyapatite nano-pillars on TI-6Al-4V: Enhancements in cell spreading and proliferation during cell/surface integration.

Despite the attractive combinations of cell/surface interactions, biocompatibility, and good mechanical properties of Ti-6Al-4V, there is still a need to enhance the early stages of cell/surface integration that are associated with the implantation of biomedical devices into the human body. This paper presents a novel, easy and reproducible method of nanoscale and nanostructured hydroxyapatite (HA) coatings on Ti-6Al-4V. The resulting nanoscale coatings/nanostructures are characterized using a combination of Raman spectroscopy, scanning electron microscopy equipped with energy dispersive x-ray spectroscopy. The nanostructured/nanoscale coatings are shown to enhance the early stages of cell spreading and integration of bone cells (hFOB cells) on Ti-6Al-4V surfaces. The improvements include the acceleration of extra-cellular matrix, cell spreading and proliferation by nanoscale HA structures on the coated surfaces. The implications of the results are discussed for the development of HA nanostructures for the improved osseointegration of Ti-6Al-4V in orthopedic and dental applications.

Optimization of culture medium to improve bio-cementation effect based on response surface method.

The main challenge in the large-scale application of MICP lies in its low efficiency and promoting biofilm growth can effectively address this problem. In the present study, a prediction model was proposed using the response surface method. With the prediction model, optimum concentrations of nutrients in the medium can be obtained. Moreover, the optimized medium was compared with other media via bio-cementation tests. The results show that this prediction model was accurate and effective, and the predicted results were close to the measured results. By using the prediction model, the optimized culture media was determined (20.0 g/l yeast extract, 10.0 g/l polypeptone, 5.0 g/l ammonium sulfate, and 10.0 g/l NaCl). Furthermore, the optimized medium significantly promoted the growth of biofilm compared to other media. In the medium, the effect of polypeptone on biofilm growth was smaller than the effect of yeast extract and increasing the concentration of polypeptone was not beneficial in promoting biofilm growth. In addition, the sand column solidified with the optimized medium had the highest strength and the largest calcium carbonate contents. The prediction model represents a platform technology that leverages culture medium to impart novel sensing, adjustive, and responsive multifunctionality to structural materials in the civil engineering and material engineering fields.

Clivus-Cervical Stabilization through Transoral Approach in Patients with Craniocervical Tumor: Three Cases and Surgical Technical Note.

Craniocervical tumors lead to cervical pain, instability, and neurological symptoms, reducing the quality of life. Effective surgical intervention at the craniocervical junction (CCJ) is critical and complex, involving comprehensive approaches and advanced reconstructive techniques. This study, conducted at Mexico City's National Institute of Cancerology, focused on three surgical cases that occurred in 2023 involving tumors at the CCJ: two chordomas and one prostate adenocarcinoma. We utilized a specialized technique: clivus-cervical stabilization reinforced with a polymethylmethacrylate (PMMA)-filled cervical mesh. Postoperatively, patients showed marked neurological recovery and reduced cervical pain, with enhanced Karnofsky and Eastern Cooperative Oncology Group (ECOG) scores indicating improved life quality. The surgical technique provided excellent exposure and effective tumor resection, utilizing PMMA-filled cervical mesh for stability. Tumoral lesions at the CCJ causing instability can be surgically treated through a transoral approach. This type of approach should be performed with precise indications to avoid complications associated with the procedure.

A State-Dependent Elasto-Plastic Model for Hydrate-Bearing Cemented Sand Considering Damage and Cementation Effects.

In order to optimize the efficiency and safety of gas hydrate extraction, it is essential to develop a credible constitutive model for sands containing hydrates. A model incorporating both cementation and damage was constructed to describe the behavior of hydrate-bearing cemented sand. This model is based on the critical state theory and builds upon previous studies. The damage factor Ds is incorporated to consider soil degradation and the reduction in hydrate cementation, as described by plastic shear strain. A computer program was developed to simulate the mechanisms of cementation and damage evolution, as well as the stress-strain curves of hydrate-bearing cemented sand. The results indicate that the model replicates the mechanical behavior of soil cementation and soil deterioration caused by impairment well. By comparing the theoretical curves with the experimental data, the compliance of the model was calculated to be more than 90 percent. The new state-dependent elasto-plastic constitutive model based on cementation and damage of hydrate-bearing cemented sand could provide vital guidance for the construction of deep-buried tunnels, extraction of hydrocarbon compounds, and development of resources.

Effect of laser remelting power on the microstructure and properties of vanadizing layer on AISI 52100 steel pin shaft.

The surface of AISI 52100 steel was pre-treated by laser remelting with different powers, and the vanadizing layer were prepared on remelted steel by pack cementation. The microstructure and properties of vanadizing layer were investigated by XRD, microhardness tester, metallographic microscope, scanning electron microscope, energy dispersive spectrometer, friction and wear tester. The critical load Lc was determined by observing the micro-scratch morphology of scratches through micro-scratch experiments, and its wear performance was studied. The results show that the hardness of remelting zone increase with the increase of laser power. When the laser power is 500 W, the microhardness is 424.6 HV0.2. The vanadizing layer formed on the remelting surfaces is uniform and dense. The layers are mainly composed of VCx phase and α-Fe/α'-Fe phase, the VC phase has the preferred orientation of (200) and (111) planes. There is a good metallurgical bonding between the vanadizing layer and the steel， and the thickness is 2.7 µm-12.15 µm, the microhardness is 2050.7 HV0.2-2350.9 HV0.2. When the laser remelting power is 300 W, the vanadizing layer is better in thickness, microhardness and average friction coefficient, the bonding force Lc between the vanadizing layer and the substrate is about 41.59 N, and the main failure mode is the spalling of the vanadizing layer. It can be concluded that laser remelting pre-treatment can greatly improve the hardness and wear resistance.

Physicochemical and mechanical properties of preheated composite resins for luting ceramic laminates.

This study analyzed and compared the physicochemical and mechanical properties of preheated resin composite with light-cured resin cement for luting indirect restorations. 210 specimens of resin cement/resin composite were prepared according to preheating treatment heated (Htd) or not (NHtd). Light-cured resin cement (Variolink Veneer, Ivoclar), and resin composite (Microhybrid-Z100, 3 M; Nanohybrid-Empress direct, Ivoclar; and Bulk fill-Filtek One, 3 M) were used (n = 10). Resin cement specimens were not preheated. The response variables were (n = 10): film thickness, microhardness, liquid sorption and solubility. Data were analyzed by 2-way ANOVA and Tukey HSD post-test (α = 0.05). Bulk fill NHtd resin had the highest film thickness values (p < 0.001). Microhybrid and nanohybrid Htd resins had the smallest thicknesses and did not differ from the cement (p > 0.05). The highest microhardness values were found for Bulk fill NHtd and Bulk fill Htd resins. The nanohybrid and microhybrid Htd resins showed the lowest microhardness values, with no difference in cement (p > 0.05). For liquid sorption, there was no significant difference between the groups (p = 0.1941). The microhybrid Htd resin showed higher solubility values than the other materials (p = 0.0023), but it did not differ statistically from resin cement (p > 0.05). Preheating composite resins reduced the film thickness. After heating, nanohybrid and Bulk fill resins retained stable microhardness, sorption, and solubility values.

Mapping the Landscape of the Digital Workflow of Esthetic Veneers from Design to Cementation: A Systematic Review.

The purpose of this systematic review was to map all the existing literature on digitally designed and fabricated esthetic veneers. We aimed to compare the accuracy of digitally designed preparation and cementation guides for esthetic indirect veneers with the conventional workflow. We evaluated studies comparing the accuracy and predictability of workflows between digitally fabricated indirect-esthetic veneers and conventional indirect veneers. Searches were performed in August 2023 across three databases, specifically Google Scholar, Cochrane, and PubMed, and were restricted to English-language publications. The search strategy was based on the PICO criteria. Reference lists of identified articles were manually checked to find further pertinent studies that were not discovered during the electronic search. The titles and abstracts were reviewed in the first stage, and then the full article texts were reviewed and cross-matched against the predetermined inclusion criteria. Following the search, 169 articles were identified: 41 from Google Scholar, 44 from Cochrane, and 71 from PubMed, with 13 added manually. Of these, 20 were chosen for a detailed quality assessment of the digital veneer workflow and the accuracy of digital preparations and cementation guides for laminate veneers. Based on our findings, the digitally fabricated laminate-veneer workflow demonstrated superior predictability and accuracy compared to the conventional workflow.

Effect of Porosity/Binder Index on Strength, Stiffness and Microstructure of Cemented Clay: The Impact of Sustainable Development Geomaterials.

Searching for alternative material options to reduce the extraction of natural resources is essential for promoting a more sustainable world. This is especially relevant in construction and infrastructure projects, where significant volumes of materials are used. This paper aims to introduce three alternative materials, crushed ground glass (GG), recycled gypsum (GY) and crushed lime waste (CLW), byproducts of construction industry geomaterials, to enhance the mechanical properties of clay soil in Cartagena de Indias, Colombia. These materials show promise as cementitious and frictional agents, combined with soil and cement. Rigorous testing, including tests on unconfined compressive strength (qu) and initial stiffness (Go) and with a scanning electron microscope (SEM), reveals a correlation between strength, stiffness and the novel porosity/binder index (η/Civ) and provides mixed design equations for the novel geomaterials. Micro-level analyses show the formation of hydrated calcium silicates and complex interactions among the waste materials, cement and clay. These new geomaterials offer an eco-friendly alternative to traditional cementation, contributing to geotechnical solutions in vulnerable tropical regions.

Evaluation of a water-based spacer fluid with additives for mud removal in well cementing operations.

This research evaluates the crucial role of effective well cementing in enhancing petroleum production, with a specific emphasis on the utilization of spacer fluids for pre-cementing well cleaning. Investigating the performance of a water-based spacer fluid enriched with barite, Xanthan Gum, potato starch, and Poly-Anionic Cellulose additives, this study systematically designs and evaluates three distinct spacer fluids featuring varied additive concentrations for optimal mud removal efficiency. Notably, Spacer B1, incorporating 0.51% PAC-LV and 0.51% starch, emerges as the most successful, exhibiting an impressive 67.84% mud removal rate. The flow behavior of the spacers is aptly described by the Herschel-Buckley model, providing valuable insights into their rheological characteristics. Rigorous compatibility tests affirm the absence of fluid incompatibility, instilling confidence in the chosen spacer compositions. Introducing a 5% surfactant results in a noteworthy 7-8% average increase in mud removal from the metal cylinder wall. In summary, this study contributes valuable perspectives on optimizing both well cementing practices and spacer fluid formulations, ultimately elevating efficiency in petroleum production processes.

Evaluation of the ceramic laminate veneer-tooth interface after different resin cement excess removal techniques.

OBJECTIVES: To compare, in vitro, resin cement excess removal techniques at the veneer-tooth interface. MATERIALS AND METHODS: Anterior human teeth were restored with ceramic veneers and randomly divided according to the following techniques (n = 10): removal of excess resin cement with brush and dental floss, followed by light-curing with Valo (Group 1) or Elipar (Group 2) for 1 min and 40 s; tack-curing with Valo (Group 3) or Elipar (Group 4) for 1 s; and tack-curing with Valo (Group 5) or Elipar (Group 6) for 5 s. The tack-curing was followed by removal of excess with probe and dental floss and light-curing for 1 min and 40 s. The area of excess resin cement (mm2) was measured in micro-CT images using AutoCAD program. The failures at the cervical margin in the X, Y, and Z axes (µm) of greater value were measured using the DataViewer program. The specimens were submitted to microleakage with 2% basic fuchsin. RESULTS: According to the Kruskal-Wallis and multiple comparison test, the highest area of excess resin cement was found in Group 1 (5.06 mm2), which did not differ statistically from Groups 2 (3.70 mm2) and 5 (2.19 mm2). Groups 2, 3 (1.73 mm2), 4 (1.14 mm2), and 5 (2.18 mm2) did not differ statistically. Group 6 (0.77 mm2) obtained the lowest value, which did not differ statistically from Groups 3 and 4. According to the Kruskal-Wallis and Dunn test, there was no significant difference in failures in X (p = 0.981), Y (p = 0.860), and Z (p = 0.638) axes and no significant difference in microleakage (p = 0.203) among the groups. CONCLUSIONS: Tack-curing for 1 s or 5 s, followed by removal of excess resin cement using a probe and a dental floss, tended to result in a lower amount of excess material around the margin. CLINICAL RELEVANCE: The technique used for resin cement excess removal influences the amount of excess leaved at the veneer-tooth interface. Tack-curing for 1 s or 5 s is recommended to mitigate the excess resin cement.

Technique for cementing screwmentable implant crowns to prevent misalignment.

The purpose of this article is to describe a technique to accurately cement implant crowns on an abutment extraorally and prevent misalignment that might change the desired position of the crown on the abutment when delivered. An implant-retained crown was tried-in and occlusal and interproximal contacts were adjusted for delivery. The cementation verification aid was fabricated using a polyvinylsiloxane bite registration material (Blu Mousse) to cement the crown onto the abutment extraorally to ensure proper alignment of the crown on the abutment. Cementation of the prosthesis occurred with no adjustments required to the interproximal or occlusal contacts during final delivery. This article provides a technique that aims to increase accuracy in the placement of the crown on the abutment when cementing screwmentable crowns.

The Effect of Restoration Thickness on the Fracture Resistance of 5 mol% Yttria-Containing Zirconia Crowns.

BACKGROUND: To determine what thickness of 5 mol% yttria zirconia (5Y-Z) translucent crowns cemented with different cements and surface treatments would have equivalent fracture resistance as 3 mol% yttria (3Y-Z) crowns. METHODS: The study included 0.8 mm, 1.0 mm, and 1.2 mm thickness 5Y-Z (Katana UTML) crowns and 0.5 and 1.0 mm thickness 3Y-Z (Katana HT) crowns as controls. The 5Y-Z crowns were divided among three treatment subgroups (n = 10/subgroup): (1) cemented using RMGIC (Rely X Luting Cement), (2) alumina particle-abraded then luted with the same cement, (3) alumina particle-abraded and cemented using a resin cement (Panavia SA Cement Universal). The 3Y-Z controls were alumina particle-abraded then cemented with RMGIC. The specimens were then loaded in compression at 30° until failure. RESULTS: All 5Y-Z crowns (regardless of thickness or surface treatment) had a similar to or higher fracture force than the 0.5 mm 3Y-Z crowns. Only the 1.2 mm 5Y-Z crowns with resin cement showed significantly similar fracture force to the 1 mm 3Y-Z crowns. CONCLUSION: In order to achieve a similar fracture resistance to 0.5 mm 3Y-Z crowns cemented with RMGIC, 5Y-Z crowns may be as thin as 0.8 mm. To achieve a similar fracture resistance to 1.0 mm 3Y-Z crowns cemented with RMGIC, 5Y-Z crowns must be 1.2 mm and bonded with resin cement.

Dental silicate ceramics surface modification by nonthermal plasma: A systematic review.

OBJECTIVES: Nonthermal atmospheric or low-pressure plasma (NTP) can improve the surface characteristics of dental materials without affecting their bulk properties. This study aimed to systematically review the available scientific evidence on the effectiveness of using NTP for the surface treatment of etchable, silica-based dental ceramics before cementation, and elucidate its potential to replace the hazardous and technically demanding protocol of hydrofluoric acid (HF) etching. METHODS: A valid search query was developed with the help of PubMed's Medical Subject Headings (MeSH) vocabulary thesaurus and translated to three electronic databases: PubMed, Web of Science, and Scopus. The methodological quality of the studies was assessed according to an adapted version of the Methodological Index for Non-Randomized Studies (MINORS). RESULTS: Thirteen in vitro study reports published between 2008 and 2023 were selected for the qualitative and quantitative data synthesis. The implemented methodologies were diverse, comprising 19 different plasma treatment protocols with various device settings. Argon, helium, oxygen, or atmospheric air plasma may significantly increase the wettability and roughness of silicate ceramics by plasma cleaning, etching, and activation, but the treatment generally results in inferior bond strength values after cementation compared to those achieved with HF etching. The technically demanding protocol of plasma-enhanced chemical vapor deposition was employed more commonly, in which the surface deposition of hexamethyl disiloxane with subsequent oxygen plasma activation proved the most promising, yielding bond strengths comparable to those of the positive control. Lack of power analysis, missing adequate control, absence of examiner blinding, and non-performance of specimen aging were common methodological frailties that contributed most to the increase in bias risk (mean MINORS score 15.3 ± 1.1). SIGNIFICANCE: NTP can potentially improve the adhesive surface characteristics of dental silicate ceramics in laboratory conditions, but the conventional protocol of HF etching still performs better in terms of the resin-ceramic bond strength and longevity. More preclinical research is needed to determine the optimal NTP treatment settings and assess the aging of plasma-treated ceramic surfaces in atmospheric conditions.

Influence of using different translucent composite resins for customizing fiber post on the bond strength of self-adhesive cement to root dentin.

This study evaluated the influence of different translucent resins (Z350 and Opallis) for customizing fiber posts and light-curing the cementation system using different LED equipment (V, Valo or R, Radii-Cal) on the bond strength and adhesive failure pattern at 24 h and 6 months. Eighty roots were prepared and divided into 4 groups (n=20): ZV (Z350 resin and LED Valo), ZR (Z350 resin and LED Radii-Cal), OV (Opallis resin and LED Valo), OR (Opallis resin and LED Radii-Cal). After post space preparation, the fiber post was customized and cemented with self-adhesive cement and light-curing using V or R LED equipment. Bond strength values were submitted to 2-way ANOVA test. ZV and ZR showed higher bond strength values than the other groups at 6 months of evaluation (p<0.05). The Z350 resin has a favorable influence on the bond strength of self-adhesive cement to root dentin, regardless of the LED polymerization equipment used.

A combined and sustainable approach and a novel mechanism for recovering Bi, Au and Ag from high-chloride leachate of waste printed circuit board smelting ash.

High-chloride leachate is a solution rich in precious metals that is produced in chloride hydrometallurgy. It has high levels of both rare and precious metals and hazardous chloride ions, and resource recovery from this solution and its safe disposal have become key objectives in the field of hydrometallurgy. In this study, a sustainable process involving "ultrasound-assisted precipitation-Pb powder cementation" was proposed for the stepwise separation and high-value utilization of Bi, Au and Ag obtained from high-chloride leachate. Targeted separation and conversion of Bi were achieved by precipitation-re-acid hydrolysis-ultrasonication-assisted coprecipitation-centrifugal purification. Under the optimal process conditions, the removal rate of Bi reached 99.52%, while the loss rates of Au and Ag were only 4.63% and 8.72%, respectively. Single-factor experiments of Au and Ag cementation by Pb powder showed that the recovery rates of precious metals could be improved by increasing the temperature, raising the solution pH, and applying mechanical force and ultrasonication. A possible reaction mechanism for Au and Ag cementation with Pb powder was proposed based on macroscopic kinetic analysis and microscopic mineral characterization. This work provides technical support and a theoretical basis for the separation and enrichment of rare and precious metals in chloride hydrometallurgy.

Influence of cement type, excess removal, and polishing on the cement joint.

OBJECTIVES: To compare marginal gap width and depth with different cementation systems, excess removal, and after polishing. METHOD AND MATERIALS: In total, 80 composite crowns were milled, divided into ten groups, and cemented on identical artificial teeth. Eight crowns per group were fixed with (i) zinc phosphate cement (ZnOPh), (ii) glass-ionomer cement (GIC), (iii) resin-reinforced glass-ionomer cement (GIC mod), (iv) dual-curing adhesive composite (Comp dual), or (v) dual-curing self-adhesive composite (Comp SE dual). Excess removal was performed with a scaler after brief light-cure (tack-cure), final light-cure, during rubber or gel phase or by wiping with foam pellet. Curing was completed in chemical, dark cure, or light-curing modus. The specimens were polished and stored in water (37°C). The margins were digitized using a 3D laser-scanning microscope (VK-X100 series, Keyence). The width and the depth of the marginal gap were measured at 10 points between the crown margin and the preparation margin. RESULTS: The width after excess removal varied between 65.1 ± 15.7 µm (Comp dual, wipe, with polishing) and 208.6 ± 266.7 µm (Comp SE dual, dark cure, without polishing). The depth varied between 29.8 ± 22.2 µm (Comp dual, wipe, with polishing) and 89.5 ± 45.2 µm (Comp SE dual, dark cure, without polishing). The impact on gap width and depth was detected for fixation material, excess removal, and polishing. CONCLUSION: The gap depth and width depend on the luting material and the mode of access removal. Polishing can improve the gap quality, especially for GIC and resin-based systems.

Endocrowns: Indications, Preparation Techniques, and Material Selection.

Endodontic treatment is often necessary in the field of dentistry. As the tooth structure is lost during such treatment, the tooth may become weaker and lose some of its mechanical qualities. Endodontically treated posterior teeth require cuspal coverage because of their anatomical features. Endocrowns are regarded as a suitable choice for restoring teeth that have undergone endodontic treatment. These restorations are recommended when there is a substantial loss of tooth structure, restricted interocclusal space, or a short clinical crown. They are also contraindicated in case of severe loss of tooth structure where adhesion is not applicable. Endocrowns require a specific preparation design that is distinct from the conventional crown. They can be manufactured by two methods: heat pressing or computer-aided design/computer-aided manufacturing (CAD/CAM). Moreover, several materials have been used in fabricating endocrown restoration. Lithium disilicate glass-ceramic is the most recommended material as it possesses excellent mechanical properties and esthetic results with the ability to bond to tooth structure. In conclusion, several kinds of literature recommend using them for molars. Further research is needed to evaluate this technique for premolar and anterior teeth.

Printed abutment model to limit residual cement: A dental technique.

Preventing retained cement around implant-retained crowns is crucial for the long-term health and success of the implant. Residual subgingival cement is strongly associated with peri-mucositis and can lead to peri-implantitis. This clinical technique utilizes a 3D printed model of a custom abutment to seat the implant crown on before cementing intra-orally to extrude excess cement. The technique aims to limit the amount of retained cement at the crown-abutment margin and also takes into consideration the cement space already designed into the crown-abutment complex.

Percutaneous cementoplasty of periprosthetic aseptic hip loosening.

Progressive population aging and improved healthcare have led to a significant increase in patients with hip arthroplasty (HA). In this patient group, the proportion of those who require a new arthroplasty (prosthetic replacement or secondary revision of the hip), has also increased. For this subgroup of patients in whom surgical prosthetic replacement should be considered but is contraindicated, a new technique has been developed since 2010: percutaneous injection of periprosthetic cement under fluoroscopic or CT control ("femoroplasty; FMP") as an alternative and less invasive treatment compared to surgery to stabilize the HA without replacing it, with excellent results on patients' quality of life. In this brief communication, we describe our positive experience regarding FMP, which we have performed for the first time in Spain on four patients (age range between 74-83 years, 2 female and 2 male patients, 3 right HA and 1 left HA), without post-complications. We highlight both the relative simplicity of this technique, which can be incorporated into radiological intervention even in regional hospitals, and the significant clinical improvement observed in all patients. In conclusion, we hope that our experience can contribute to the increased adoption of this innovative technique within the scientific community.

Cementation of a Metal Dual Mobility Liner in Patients Undergoing Revision Total Hip Arthroplasty.

Background: Dual mobility liners for primary and revision total hip arthroplasties can lead to decreased dislocation and revision rates. However, there are a lack of data analyzing their utilization when cementing into well-fixed acetabular components in a variety of scenarios. Therefore, the purpose of this study was to examine cementation of dual mobility liners into well-fixed existing acetabular components from previous hip procedures, into new acetabular components, or directly into the acetabulum without prior implants. We specifically aimed to assess the following: (1) aseptic revision-free implant survivorship, (2) patient-reported outcomes, (3) prosthetic joint infections, dislocations, and osteolysis, (4) medical complications and readmissions, and (5) radiographic outcomes. Methods: A total of 35 patients who underwent treatment with a cemented dual mobility liner from October 1, 2014, to July 1, 2018, were identified and followed up for a mean of 4 years (range, 4-8). The primary outcome of interest was revision-free survival. The secondary outcomes included patient-reported outcome measurements, dislocations, periprosthetic infections, periprosthetic fractures, pulmonary emboli, deep vein thromboses, radiographic osteolysis, and emergency visits as well as inpatient admissions. The patient-reported outcome measurements used were the Hip Disability and Osteoarthritis Outcome Score for Joint Replacement, Short-Form 12 Health Survey Mental Component, and Short-Form 12 Health Survey Physical Component. Results: Aseptic revision-free survivorship was 93.3%, 92.3%, and 100% for previous acetabular cup, new cup, and native acetabulum, respectively. The Hip Disability and Osteoarthritis Outcome Score for Joint Replacement improved and the Short-Form 12 Physical Component improved postoperatively for all groups. Surgical complications included 3 prosthetic joint infections (1 in a new cup and 2 in native acetabula). A total of 1 patient (previous cup) had an emergency visit and inpatient readmission. Only 1 cemented dual mobility recipient (new cup) demonstrated progressive acetabular radiolucencies and all cemented dual mobility patients had no evidence of acetabular subsidence. Conclusions: Cemented dual mobility bearing liners demonstrated exceptional survivorship, low complication rates, adequate radiographic results, and improved functional outcomes when cemented into previously inserted well-fixed acetabular components, new components, or native acetabula. To the best of the authors' knowledge, this is the first study to demonstrate success at a minimum of 4-year follow-up. These data are important to surgeons deciding on the appropriate implantation methods to use for their high-risk patients.