Mechanical properties-translucency-microstructure relationships in commercial monolayer and multilayer monolithic zirconia ceramics.

OBJECTIVES: To evaluate the phase composition, microstructure, optical properties and mechanical properties of eight commercially available multilayer and monolayer monolithic dental zirconias. METHODS: Five commercial 3Y-TZP (GC ST, GC HT [GC, Tokyo Japan]; Katana ML, Katana HT [Kuraray Noritake] and Lava Plus [3M Oral Care]) and three Y-PSZ (Katana STML, Katana UTML [Kuraray Noritake]; GC UHT [GC, Tokyo Japan]) zirconia ceramic grades were cut in plate-shaped specimens, sintered according to the manufacturer's instructions and mirror polished. The zirconia chemical composition was determined using X-ray fluorescence (XRF), phase composition was characterized using X-ray diffraction (XRD), while the grain size was measured using scanning electron microscopy (SEM). The translucency Parameter (TP) and Contrast Ratio (CR) were measured with a spectrophotometer (n = 10/group). The indentation fracture toughness (n = 10), Vickers hardness (n = 10) and biaxial strength (n = 20) of the sintered ceramics were assessed. The stress distribution during biaxial testing was assessed by Finite element analysis (FEA). Statistical analysis involved one-way ANOVA and post-hoc Tukey's HSD test and Pearson correlation test (α = 0.05). RESULTS: FEA showed that the stress distribution in plate shape specimens was the same as for disks, rationalizing the use of plates for biaxial strength testing. As expected, higher quantities of Y2O3 were related to a higher cubic ZrO2 phase content and lower tetragonality t-ZrO2, which improved translucency but diminished flexural strength and toughness. While there was no significant correlation between grain size and other material properties, addition of pigments to the zirconia grade statistically negatively affected hardness. CONCLUSION: Even though an improvement in strength and translucency could be recorded for the last Y-TZP generation, future research still needs to strive for combined improvement of optical properties and mechanical reliability of zirconia ceramics.

Modelling the effect of repositioning on the evolution of skeletal muscle damage in deep tissue injury.

Deep tissue injury (DTI) is a localized area of tissue necrosis that originates in the subcutaneous layers under an intact skin and tends to develop when soft tissue is compressed for a prolonged period of time. In clinical practice, DTI is particularly common in bedridden patients and remains a serious issue in todays health care. Repositioning is generally considered to be an effective preventive measure of pressure ulcers. However, limited experimental research and no computational studies have been undertaken on this method. In this study, a methodology was developed to evaluate the influence of different repositioning intervals on the location, size and severity of DTI in bedridden patients. The spatiotemporal evolution of compressive stresses and skeletal muscle viability during the first 48 h of DTI onset was simulated for repositioning schemes in which a patient is turned every 2, 3, 4 or 6 h. The model was able to reproduce important experimental findings, including the morphology and location of DTI in human patients as well as the discrepancy between the internal tissue loads and the contact pressure at the interface with the environment. In addition, the model indicated that the severity and size of DTI were reduced by shortening the repositioning intervals. In conclusion, the computational framework presented in this study provides a promising modelling approach that can help to objectively select the appropriate repositioning scheme that is effective and efficient in the prevention of DTI.

Angiogenesis in bone fracture healing: a bioregulatory model.

The process of fracture healing involves the action and interaction of many cells, regulated by biochemical and mechanical signals. Vital to a successful healing process is the restoration of a good vascular network. In this paper, a continuous mathematical model is presented that describes the different fracture healing stages and their response to biochemical stimuli only (a bioregulatory model); mechanoregulatory effects are excluded here. The model consists of a system of nonlinear partial differential equations describing the spatiotemporal evolution of concentrations and densities of the cell types, extracellular matrix types and growth factors indispensable to the healing process. The model starts after the inflammation phase, when the fracture callus has already been formed. Cell migration is described using not only haptokinetic, but also chemotactic and haptotactic influences. Cell differentiation is controlled by the presence of growth factors and sufficient vascularisation. Matrix synthesis and growth factor production are controlled by the local cell and matrix densities and by the local growth factor concentrations. Numerical simulations of the system, using parameter values based on experimental data obtained from literature, are presented. The simulation results are corroborated by comparison with experimental data from a standardised rodent fracture model. The results of sensitivity analyses on the parameter values as well as on the boundary and initial conditions are discussed. Numerical simulations of compromised healing situations showed that the establishment of a vascular network in response to angiogenic growth factors is a key factor in the healing process. Furthermore, a correct description of cell migration is also shown to be essential to the prediction of realistic spatiotemporal tissue distribution patterns in the fracture callus. The mathematical framework presented in this paper can be an important tool in furthering the understanding of the mechanisms causing compromised healing and can be applied in the design of future fracture healing experiments.