Measurement of safe acetabular medial wall defect size in revision hip arthroplasty with a porous cup.

INTRODUCTION: The majority of acetabular revisions can be performed with an uncemented, porous acetabular component with or without bone grafting. These are contained acetabular defects, with an intact acetabular rim (Paprosky type I and II). As defects of the medial wall of the acetabulum are a challenge situation revision surgery, we performed this biomechanical study on a pig pelvis model with contained acetabular defects to determine the size of medial wall defect at which the acetabular cup will have sufficient primary stability. MATERIALS AND METHODS: In 24 pig pelvis models, different diameter of medial wall defects were created, followed by acetabular component placement. The acetabulum externally loaded, and the force at a level in which the acetabular component remains stable for each diameter of defect, or at which point the acetabular cup moves into the pelvis for >2 mm. RESULTS: In the models with acetabular medial wall defects of 10 and 20 mm, 2 mm acetabular displacement occurred under a force between 1000 and 1500 N. In those with a medial wall defect of 25 mm, the force that caused acetabular instability was between 700 and 1000 N. In the models with 30 mm of medial wall defect all acetabular components were unstable under a force of 700 N. CONCLUSIONS: According to our results, acetabular component should be stable if the defect of the medial wall of the acetabulum is less than 68% of the diameter of the acetabular component or if the uncovered surface area of the acetabular component is not greater than 27%, and the force <700 N. For a load of 1000 N, the medial wall defect should not exceed 45% of acetabular component diameter or 18% of uncovered acetabular component surface.

Shear Bond Strength of Orthodontic Brackets Bonded to Zirconium Crowns.

BACKGROUND: An increasing demand for esthetic restorations has resulted in an increased use of all-ceramic restorations, such as zirconium. However, one of the challenges the orthodontist must be willing to face is how to increase bond strength between the brackets and various ceramic restorations.Bond strength can beaffected bybracket type, by the material that bracketsaremade of, and their base surface design or retention mode. ​: Aim: of this study was to perform a comparative analysis of the shear bond strength (SBS) of metallic and ceramic orthodontic brackets bonded to all-zirconium ceramic surfaces used for prosthetic restorations, and also to evaluate the fracture mode of these two types of orthodontic brackets. MATERIAL AND METHODS: Twenty samples/semi-crowns of all-zirconium ceramic, on which orthodontic brackets were bonded, 10 metallic and 10 ceramic polycrystalline brackets, were prepared for this research. SBS has been testedby Universal Testing Machine, with a load applied using a knife edged rod moving at a fixed rate of 1 mm/min, until failure occurred. The force required to debond the brackets was recorded in Newton, then SBS was calculated to MPa. In addition, the samples were analyzed using a digital camera magnifier to determine Adhesive Remnant Index (ARI). Statistical data were processed using t-test, and the level of significance was set at α = 0.05. RESULTS: Higher shear bond strength values were observed in metallic brackets bonded to zirconium crowns compared tothoseof ceramic brackets, with a significant difference. During the test, two of the ceramic brackets were partially or totally damaged. CONCLUSION: Metallic brackets, compared to ceramic polycrystalline brackets, seemed tocreate stronger adhesion with all-zirconium surfaces due to their better retention mode. Also, ceramic brackets showed higher fragility during debonding.

Properties of axially loaded implant-abutment assemblies using digital holographic interferometry analysis.

OBJECTIVE: The aim of this study was to (i) obtain the force-related interferometric patterns of loaded dental implant-abutment assemblies differing in diameter and brand using digital holographic interferometry (DHI) and (ii) determine the influence of implant diameter on the extent of load-induced implant deformation by quantifying and comparing the obtained interferometric data. METHODS: Experiments included five implant brands (Ankylos, Astra Tech, blueSKY, MIS and Straumann), each represented by a narrow and a wide diameter implant connected to a corresponding abutment. A quasi-Fourier setup with a 25mW helium-neon laser was used for interferometric measurements in the cervical 5mm of the implants. Holograms were recorded in two conditions per measurement: a 10N preloaded and a measuring-force loaded assembly, resulting with an interferogram. This procedure was repeated throughout the whole process of incremental axial loading, from 20N to 120N. Each measurement series was repeated three times for each assembly, with complete dismantling of the implant-loading device in between. Additional software analyses calculated deformation data. Deformations were presented as mean values±standard deviations. Statistical analysis was performed using linear mixed effects modeling in R's lme4 package. RESULTS: Implants exhibited linear deformation patterns. The wide diameter group had lower mean deformation values than the narrow diameter group. The diameter significantly affected the deformation throughout loading sessions. SIGNIFICANCE: This study gained in vitro implant performance data, compared the deformations in implant bodies and numerically stated the biomechanical benefits of wider diameter implants.