Three-dimensional printed pure-titanium implantation for chest wall reconstruction involving the sternum and ribs: a novel approach.

Chest wall reconstruction is challenging due to the complex shape and large defect size. The three-dimensional printing technology enables the fabrication of customized implants, and 3D-printed pure-titanium could provide superior mechanical properties to conventional materials. The aim of this study was to evaluate long-term outcomes of patients undergoing chest wall reconstruction with a 3D-printed pure-titanium implant. Between August 2018 and May 2021, 5 patients underwent surgery due to sternal metastasis (n = 3), postoperative sternal wound infection (n = 1) and deformity (n = 1). The customized implant was designed and constructed based on the size and shape of the chest wall defect measured on computed tomography. All patients demonstrated uneventful recovery without complications during the hospital course. During the median follow-up of 20 months, 1 patient underwent revision surgery due to implant breakage, and 1 removed the implant due to trauma-related chest wall infection. One patient died from cancer progression, while 3 patients are alive without any implant-related complications. Chest wall reconstruction using a 3D-printed pure-titanium implant could be a novel alternative for patients with various conditions affecting the sternum and ribs.

Investigating the accuracy of mandibulectomy and reconstructive surgery using 3D customized implants and surgical guides in a rabbit model.

BACKGROUND: This study aimed to analyze the accuracy of the output of three-dimensional (3D) customized surgical guides and titanium implants in a rabbit model, and of mandibulectomy, reconstructive surgery, and surgical outcome; additionally, the correlation between surgical accuracy and surgical outcomes, including the differences in surgical outcome according to surgical accuracy, was analyzed. RESULTS: The output of implants was accurately implemented within the error range (- 0.03-0.03 mm), and the surgical accuracy varied depending on the measured area (range - 0.4-1.1 mm). Regarding surgical outcomes, angle between the mandibular lower borders showed the most sensitive results and distance between the lingual cusps of the first molars represented the most accurate outcomes. A significant correlation was noted between surgical accuracy in the anteroposterior length of the upper borders pre- and postoperatively and the angle between the mandibular lower borders (regression coefficient = 0.491, p = 0.028). In the group wherein surgery was performed more accurately, the angle between the mandibular lower borders was reproduced more accurately (p = 0.021). A selective laser melting machine accurately printed the implants as designed. Considering the positive correlation among surgical accuracy in the mandibular upper borders, angle between the mandibular lower borders, and more accurately reproduced angle between the mandibular lower borders, the angle between the mandibular lower borders is considered a good indicator for evaluating the outcomes of reconstructive surgery. CONCLUSION: To reduce errors in surgical outcomes, it is necessary to devise a positioner for the surgical guide and design a 3D surgical guide to constantly maintain the direction of bone resection. A fixed area considering the concept of three-point fixation should be selected for stable positioning of the implant; in some cases, bilateral cortical bone fixation should be considered. The angle between the mandibular lower borders is a sensitive indicator for evaluating the outcomes of reconstructive surgery.

Customizing the mechanical properties of additively manufactured metallic meta grain structure with sheet-based gyroid architecture.

The use of cellular structures has led to unprecedented outcomes in various fields involving optical and mechanical cloaking, negative thermal expansion, and a negative Poisson's ratio. The unique characteristics of periodic cellular structures primarily originate from the interconnectivity, periodicity, and unique design of the unit cells. However, the periodicity often induces unfavorable mechanical behaviors such as a "post-yielding collapse", and the mechanical performance is often limited by the design of the unit cells. Therefore, we propose a novel structure called a meta grain structure (MGS), which is inspired by a polycrystalline structure, to enhance flexibility in design and mechanical reliability. A total of 138 different MGSs were built and tested numerically, and the correlations between the design parameters (e.g., the relative density) and mechanical properties of the MGSs were rigorously analyzed. A systematic design methodology was developed to obtain the optimal design of the MGS with the target Young's modulus. This methodology makes it possible to build a unique structure that offers various design options and overcomes the current limitations of cellular structures. Furthermore, a systematic inverse design methodology makes it possible to produce an MGS that satisfies the required mechanical performance.

Reliability Verification of Damping Capacity Assessment Through In Vitro Analysis of Implant Micromotion in Peri-implant Bone Loss Model.

PURPOSE: This in vitro study aimed to determine the efficacy of a damping capacity assessment in evaluating the implant stability in a simulated peri-implant bone loss model. MATERIALS AND METHODS: The same type of implant was placed sequentially in 0.5-mm-depth increments in polyurethane bone of a constant density, resulting in 11 specimens with varying surrounding bone levels. The implant stability was evaluated by a damping capacity assessment consisting of six consecutive impacts in one set. The damping results, including the contact time and stability index, were measured by three repeated sets of stability tests for each specimen. All implant micromotions were recorded in real time using a laser scanning vibrometer during these stability tests. The micromotions were analyzed in terms of three parameters: maximum displacement, expected mobility, and vibration frequency. Additionally, two other stability indices were acquired three times each for reference. Pearson correlation analysis was used to confirm the correlations among all the variables; P < .05 was considered statistically significant. RESULTS: As the peri-implant bone level increased, the contact time results decreased gradually from 502 to 290 µs, and the stability index increased from 55 to 78. The implant micromotions of all specimens showed a damped sine waveform graph, which can be divided into impact displacement and self-vibration patterns by the contact end points. As the implant stability increased, these contact end points converged toward the third peak, the maximum displacement and expected mobility decreased, and the vibration frequency increased (ρ = -0.85, -0.88, and 0.99, respectively). Two other stability indices reflected the implant stability due to peri-implant bone loss. The statistical analysis indicated significant correlations among all measured variables; in particular, the three stability indices exhibited high correlations with each other (ρ = 0.99, -0.99, and -1.00, respectively). CONCLUSION: Within the limitations of this in vitro study, the implant stability measured by a damping capacity assessment was suitable for investigating the extent of implant micromotions, which were determined by 0.5-mm horizontal changes in the peri-implant bone level.

Custom Implant for Reconstruction of Mandibular Continuity Defect.

PURPOSE: The purpose of this study was to compare the daily food intake rate and the rate of screw loosening between 2 groups of rabbits with mandibular continuity defects: custom implant (CI) group and 5-hole mini-plate group. MATERIALS AND METHODS: Two types of cylindrical implants were printed, and their physical strength was compared. In this study using rabbits, 1 group (n = 5) received a CI for the reconstruction of a mandibular continuity defect (CI group) and the other group (n = 5) received a 5-hole mini-plate without a bone graft (reconstruction plate [RP] group). After reconstruction, the daily food intake rate and the rate of screw loosening were examined postoperatively. Histologic examination in the CI group was performed 3 months after the operation. RESULTS: The design that mimicked the mandible showed greater physical strength. The amount of time required to achieve 50% recovery was shorter in the CI group than in the RP group (P = .011). The total number of loosened screws in the CI group was lower than that in the RP group at 3 months postoperatively (P = .008). New bone formation in the porous CI was evident in the CI group. CONCLUSIONS: Rabbits with mandibular continuity defects treated with CIs for reconstruction showed faster recovery of the daily food intake rate and fewer loosened screws than those treated with a 5-hole mini-plate without bone graft.

Increasing strength and conductivity of Cu alloy through abnormal plastic deformation of an intermetallic compound.

The precipitation strengthening of Cu alloys inevitably accompanies lowering of their electric conductivity and ductility. We produced bulk Cu alloys arrayed with nanofibers of stiff intermetallic compound through a precipitation mechanism using conventional casting and heat treatment processes. We then successfully elongated these arrays of nanofibers in the bulk Cu alloys to 400% of original length without breakage at room temperature using conventional rolling process. By inducing such an one-directional array of nanofibers of intermetallic compound from the uniform distribution of fine precipitates in the bulk Cu alloys, the trade-off between strength and conductivity and between strength and ductility could be significantly reduced. We observed a simultaneous increase in electrical conductivity by 1.3 times and also tensile strength by 1.3 times in this Cu alloy bulk compared to the conventional Cu alloys.

Reliable and cost effective design of intermetallic Ni2Si nanowires and direct characterization of its mechanical properties.

We report that a single crystal Ni2Si nanowire (NW) of intermetallic compound can be reliably designed using simple three-step processes: casting a ternary Cu-Ni-Si alloy, nucleate and growth of Ni2Si NWs as embedded in the alloy matrix via designing discontinuous precipitation (DP) of Ni2Si nanoparticles and thermal aging, and finally chemical etching to decouple the Ni2Si NWs from the alloy matrix. By direct application of uniaxial tensile tests to the Ni2Si NW we characterize its mechanical properties, which were rarely reported in previous literatures. Using integrated studies of first principles density functional theory (DFT) calculations, high-resolution transmission electron microscopy (HRTEM), and energy-dispersive X-ray spectroscopy (EDX) we accurately validate the experimental measurements. Our results indicate that our simple three-step method enables to design brittle Ni2Si NW with high tensile strength of 3.0 GPa and elastic modulus of 60.6 GPa. We propose that the systematic methodology pursued in this paper significantly contributes to opening innovative processes to design various kinds of low dimensional nanomaterials leading to advancement of frontiers in nanotechnology and related industry sectors.

Microstructural characterization of Ni-22Fe-22Cr-6Al metallic foam by transmission electron microscopy.

Ni-22Fe-22Cr-6Al metallic foam, prepared using a thermomechanical treatment and alloying elements, was studied via transmission electron microscopy (TEM) in order to clarify the relationship between the mechanical properties and the nanoscale microstructural characteristics. Due to the unique porous structure of the metallic foam, TEM specimens were prepared using an embedding-process-assisted-ion-milling technique and a focused-ion-beam method. The Cr-, Fe- and Al-clustered regions around the surface of the metallic foam were investigated using elemental maps. The Ni(3)Al (γ') precipitates, which can affect the mechanical properties of the Ni-Fe-Cr (γ) matrix, were characterized in the metallic foam.