Biocompatibility Evaluation of an Artificial Metallic Bone with Lattice Structure for Reconstruction of Bone Defect.

Mandibular reconstruction for large bone defects is performed with consideration of patients' specific morphology and sufficient strength. Metal additive manufacturing techniques have been used to develop biomaterials for mandibular reconstruction. Titanium artificial mandibles with a lattice structure have been proposed, and the optimal conditions for their strength to withstand mechanical stress around the mandible have been reported. This study investigated the biocompatibility of a titanium artificial bone with a lattice structure fabricated under optimal conditions. The samples were fabricated using metal additive manufacturing. Body diagonals with nodes (BDN) were selected as suitable lattice structures. Dode medium (DM) was selected for comparison. The samples were implanted into rabbit tibial defects and resected with the surrounding bone at two and four weeks. Specimens were evaluated radiographically, histologically, and histomorphometrically. Radiopacity in each lattice structure was observed at two and four weeks. Histological evaluation showed trabecular bone-like tissue inside the BDN compared to the DM at four weeks. No significant differences were noted in the bone volume inside the structures. This study demonstrated the in vivo compatibility of artificial metallic bones with a BDN structure under mechanical stress conditions.

Investigation of the Mechanical Strength of Artificial Metallic Mandibles with Lattice Structure for Mandibular Reconstruction.

Mandibular reconstructive surgery is necessary for large bone defects. Although various reconstruction methods have been performed clinically, there is no mandibular reconstruction method that meets both sufficient strength criteria and the patient's specific morphology. In this study, the material strength of the cylindrical lattice structures formed by electron-beam melting additive manufacturing using titanium alloy powder was investigated for mandibular reconstruction. The virtual strengths of 28 lattice structures were compared using numerical material tests with finite element method software. Subsequently, to compare the material properties of the selected structures from the preliminary tests, compression test, static bending test and fatigue test were conducted. The results showed that there were correlations with relative density and significant differences among the various structures when comparing internal stress with deformation, although there was a possibility of localized stress concentration and non-uniform stress distribution based on the lattice structure characteristics. These results suggest that the lattice structure of body diagonals with nodes and a cell size of 3.0 mm is a potential candidate for metallic artificial mandibles in mandibular reconstruction surgery.

Custom-Made Titanium Mesh Tray for Mandibular Reconstruction Using an Electron Beam Melting System.

Mandibular reconstruction using a titanium mesh tray and autologous bone is a common procedure in oral and maxillofacial surgery. However, there can be material problems-such as broken titanium mesh trays-which may undermine long-term functionality. This study was designed to investigate the optimal conditions for a titanium mesh tray with an ideal mandibular shape and sufficient strength, using computer-aided design, computer-aided manufacturing technology, and electron beam additive manufacturing. Specimens were prepared using Ti-6Al-4V extra low interstitial titanium alloy powder and an electron beam melting (EBM) system. The mechanical strength of the plate-shaped specimens was examined for differences in the stretch direction with respect to the stacking direction and the presence or absence of surface treatment. While evaluating the mechanical strength of the tray-shaped specimens, the topology was optimized and specimens with a honeycomb structure were also verified. Excellent mechanical strength was observed under the condition that the specimen was stretched vertically in the stacking direction and the surface was treated. The results of the tray-shaped specimens indicated that the thickness was 1.2 mm, the weight reduction rate was 20%, and the addition of a honeycomb structure could withstand an assumed bite force of 2000 N. This study suggests that the EBM system could be a useful technique for preparing custom-made titanium mesh trays of sufficient strength for mandibular reconstruction by arranging various manufacturing conditions.

Microstructures and mechanical properties of Co-29Cr-6Mo alloy fabricated by selective laser melting process for dental applications.

The selective laser melting (SLM) process was applied to a Co-29Cr-6Mo alloy, and its microstructure, mechanical properties, and metal elution were investigated to determine whether the fabrication process is suitable for dental applications. The microstructure was evaluated using scanning electron microscopy with energy-dispersed X-ray spectroscopy (SEM-EDS), X-ray diffractometry (XRD), and electron back-scattered diffraction pattern analysis. The mechanical properties were evaluated using a tensile test. Dense builds were obtained when the input energy of the laser scan was higher than 400 J mm⁻³, whereas porous builds were formed when the input energy was lower than 150 J mm⁻³. The microstructure obtained was unique with fine cellular dendrites in the elongated grains parallel to the building direction. The γ phase was dominant in the build and its preferential <001> orientation was confirmed along the building direction, which was clearly observed for the builds fabricated at lower input energy. Although the mechanical anisotropy was confirmed in the SLM builds due to the unique microstructure, the yield strength, UTS, and elongation were higher than those of the as-cast alloy and satisfied the type 5 criteria in ISO22764. Metal elution from the SLM build was smaller than that of the as-cast alloy, and thus, the SLM process for the Co-29Cr-6Mo alloy is a promising candidate for fabricating dental devices.

Effects of chromium and nitrogen content on the microstructures and mechanical properties of as-cast Co-Cr-Mo alloys for dental applications.

The microstructure and mechanical properties of as-cast Co-(20-33)Cr-5Mo-N alloys were investigated to develop ductile Co-Cr-Mo alloys without Ni addition for dental applications that satisfy the requirements of the type 5 criteria in ISO 22674. The effects of the Cr and N contents on the microstructure and mechanical properties are discussed. The microstructures were evaluated using scanning electron microscopy with energy-dispersive X-ray spectroscopy (EDS), X-ray diffractometry (XRD), and electron back-scattered diffraction pattern analysis. The mechanical properties were evaluated using tensile testing. The proof strength and elongation of N-containing 33Cr satisfied the type 5 criteria in ISO 22674. ε-phase with striations was formed in the N-free (20-29)Cr alloys, while there was slight formation of ε-phase in the N-containing (20-29)Cr alloys, which disappeared in N-containing 33Cr. The lattice parameter of the γ-phase increased with increasing Cr content (i.e. N content) in the N-containing alloys, although the lattice parameter remained almost the same in the N-free alloys because of the small atomic radius difference between Co and Cr. Compositional analyses by EDS and XRD revealed that in the N-containing alloys Cr and Mo were concentrated in the cell boundary, which became enriched in N, stabilizing the γ-phase. The mechanical properties of the N-free alloys were independent of the Cr content and showed low strength and limited elongation. Strain-induced martensite was formed in all the N-free alloys after tensile testing. On the other hand, the proof strength, ultimate tensile strength, and elongation of the N-containing alloys increased with increasing Cr content (i.e. N content). Since formation of ε-phase after tensile testing was confirmed in the N-containing alloys the deformation mechanism may change from strain-induced martensite transformation to another form, such as twinning or dislocation slip, as the N content increases. Thus the N-containing 33Cr alloy with large elongation is promising for use in dentures with adjustable clasps through one piece casting.