Workflow for Maxilla/Mandible Individual [Mai®] Implant by Integra Implants-How Individual Implants Are Manufactured.

The newest technology allows the medical industry to manufacture innovative products such as milled titanium prosthodontic parts in an implant for a screw-retained suprastructure. In the literature, there are some articles on the clinical usage of subperiosteal implants, but none of these publications, either in PubMed or Google Scholar, thoroughly describe the workflow for the design and manufacture of individual implants for maxillofacial surgery with milled threads for a screw-retained prosthodontic bridge. The aim of the article is to present a step-by-step method of producing personalized implants, from the first steps of production to the implantation of the final product. The article includes information on patient qualification for surgery, computational preparation and skull printing, planning of Mai Implants®, meshing, 3D printing and milling, cleaning, rinsing, anodizing, and laser marking, as well as the cleaning and sterilization process in a hospital or dental clinic. A detailed description of implant production allows for the analysis of each step and the development of technology. The production of implants is an expensive procedure, but considering all the advantages of the Mai Implants® treatment and the disadvantages of alternatives, the product is worth the price.

Electrochemical Polishing of Ti and Ti6Al4V Alloy in Non-Aqueous Solution of Sulfuric Acid.

This paper reports the results of our study on electrochemical polishing of titanium and a Ti-based alloy using non-aqueous electrolyte. It was shown that electropolishing ensured the removal of surface defects, thereby providing surface smoothing and decreasing surface roughness. The research was conducted using samples made of titanium and Ti6Al4V alloy, as well as implant system elements: implant analog, multiunit, and healing screw. Electropolishing was carried out under a constant voltage (10-15 V) with a specified current density. The electrolyte used contained methanol and sulfuric acid. The modified surface was subjected to a thorough analysis regarding its surface morphology, chemical composition, and physicochemical properties. Scanning electron microscope images and profilometer tests of roughness confirmed significantly smoother surfaces after electropolishing. The surface profile analysis of processed samples also yielded satisfactory results, showing less imperfections than before modification. The EDX spectra showed that electropolishing does not have significant influence on the chemical composition of the samples.

Finite Element Analysis and Fatigue Test of INTEGRA Dental Implant System.

The study involved numerical FEA (finite element analysis) of dental implants. Based on this, fatigue tests were conducted according to the PN-EN 14801 standard required for the certification of dental products. Thanks to the research methodology developed by the authors, it was possible to conduct a thorough analysis of the impact of external and internal factors such as material, geometry, loading, and assembly of the dental system on the achieved value of fatigue strength limit in the examined object. For this purpose, FEM studies were based on identifying potential sites of fatigue crack initiation in reference to the results of the test conducted on a real model. The actions described in the study helped in the final evaluation of the dental system design process named by the manufacturer as INTEGRA OPTIMA 3.35. The objective of the research was to identify potential sites for fatigue crack initiation in a selected dental system built on the INTEGRA OPTIMA 3.35 set. The material used in the research was titanium grade 4. A map of reduced von Mises stresses was used to search for potential fatigue crack areas. The research [loading] was conducted on two mutually perpendicular planes positioned in such a way that the edge intersecting the planes coincided with the axis of the system. The research indicated that the connecting screw showed the least sensitivity (stress change) to the change in the loading plane, while the value of preload has a significant impact on the achieved fatigue strength of the system. In contrast, the endosteal implant (root) and the prosthetic connector showed the greatest sensitivity to the change in the loading plane. The method of mounting [securing] the endosteal implant using a holder, despite meeting the standards, may contribute to generating excessive stress concentration in the threaded part. Observation of the prosthetic connector in the Optima 3.35 system, cyclically loaded with a force of F ≈ 300 N in the area of the upper hexagonal peg, revealed a fatigue fracture. The observed change in stress peak in the dental connector for two different force application surfaces shows that the positioning of the dental system (setting of the socket in relation to the force action plane) is significantly decisive in estimating the limited fatigue strength.

Zirconium Surface Treatment via Chemical Etching.

The increased demand for implants that do not pose a threat to patients diagnosed using high-resolution magnetic resonance imaging and concerns arising from titanium allergies require the development of alternative implant materials. One promising concept is a use of zirconium as corrosion-resistant, nontoxic material that is lower in magnetic susceptibility. To achieve this, safe and efficient surface treatment methods of zirconium metal have to be developed. In this study, zirconium samples were treated with fluoride-free and fluoride-containing etching mixtures to determine their effect on the surface of Zr. SEM images were taken to investigate the preliminary effects of the etchants. Then, a second set of experiments was carried out using mixtures of HF-H2SO4 and ammonium persulfate-fluoride salts, as they gave the most promising results in the first trial. SEM images were taken and measurements on roughness, wettability, and atomic composition were made. The results showed an even zirconium surface in APS-fluoride salts, along with the formation of pits (1-3 µm) similar to those found in commercially available implants. There was no significant increase in the roughness of the treated samples. The addition of NO3- ions in the form of KNO3 speeded up etching and promoted pit formation. The HF-H2SO4 mixture was found to give unsatisfying results, as the surface was too rough and the formed pits were too large. It was concluded that etching zirconium in ammonium persulfate and fluoride salts is a promising area of research for the preparation of zirconium implants; however, further research has to be carried out on sandblasted samples.

Nanodiamond Decorated PEO Oxide Coatings on NiTi Alloy.

Cardiovascular diseases (CVDs) remain a leading cause of death in the European population, primarily attributed to atherosclerosis and subsequent complications. Although statin drugs effectively prevent atherosclerosis, they fail to reduce plaque size and vascular stenosis. Bare metal stents (BMS) have shown promise in acute coronary disease treatment but are associated with restenosis in the stent. Drug-eluting stents (DES) have improved restenosis rates but present long-term complications. To overcome these limitations, nanomaterial-based modifications of the stent surfaces have been explored. This study focuses on the incorporation of detonation nanodiamonds (NDs) into a plasma electrolytic oxidation (PEO) coating on nitinol stents to enhance their performance. The functionalized ND showed a high surface-to-volume ratio and was incorporated into the oxide layer to mimic high-density lipoproteins (HDL) for reverse cholesterol transport (RCT). We provide substantial characterization of DND, including stability in two media (acetone and water), Fourier transmission infrared spectroscopy, and nanoparticle tracking analysis. The characterization of the modified ND revealed successful functionalization and adequate suspension stability. Scanning electron microscopy with EDX demonstrated successful incorporation of DND into the ceramic layer, but the formation of a porous surface is possible only in the high-voltage PEO. The biological assessment demonstrated the biocompatibility of the decorated nitinol surface with enhanced cell adhesion and proliferation. This study presents a novel approach to improving the performance of nitinol stents using ND-based surface modifications, providing a promising avenue for cardiovascular disease.