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1.
Mater Sci Eng C Mater Biol Appl ; 128: 112333, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34474884

RESUMO

Polyetheretherketone (PEEK) was widely applied into fabricating of orthopaedic implants, benefitting its excellent biocompatibility and similar mechanical properties to native bones. However, the inertness of PEEK hinders its integration with the surrounding bone tissue. Here PEEK scaffolds with a series of hydroxyapatite (HA) contents in gradient were manufactured via fused filament fabrication (FFF) 3D printing techniques. The influence of the pore size, HA content and printing direction on the mechanical properties of the PEEK/HA scaffolds was systematically evaluated. By adjusting the pore size and HA contents, the elastic modulus of the PEEK/HA scaffolds can be widely tuned in the range of 624.7-50.6 MPa, similar to the variation range of natural cancellous bone. Meanwhile, the scaffolds exhibited higher Young's modulus and lower compressive strength along Z printing direction. The mapping relationship among geometric parameters, HA content, printing direction and mechanical properties was established, which gave more accurate predictions and controllability of the modulus and strength of scaffolds. The PEEK/HA scaffolds with the micro-structured surface could promote cell attachment and mineralization in vitro. Therefore, the FFF-printed PEEK/HA composites scaffolds can be a good candidate for bone grafting and tissue engineering.


Assuntos
Durapatita , Cetonas , Benzofenonas , Polietilenoglicóis , Polímeros , Porosidade , Impressão Tridimensional , Tecidos Suporte
2.
Mater Sci Eng C Mater Biol Appl ; 127: 112250, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34225889

RESUMO

Customized spinal implants fabricated by additive manufacturing have been increasingly used clinically to restore the physiological functions. However, the mechanisms and methods about the design for the spinal implants are not clear, especially for the reconstruction of multi-segment vertebral. This study aims to develop a novel multi-objective optimization methodology based on various normal spinal activities, to design the artificial vertebral implant (AVI) with lightweight, high-strength and high-stability. The biomechanical performance for two types of AVI was analyzed and compared under different loading conditions by finite element method. These implants were manufactured via selective laser melting technology and evaluated via compressive testing. Results showed the maximum Mises stress of the optimized implant under various load cases were about 41.5% of that of the trussed implant, and below fatigue strength of 3D printed titanium materials. The optimized implant was about 2 times to trussed implant in term of the maximum compression load and compression stiffness to per unit mass, which indicated the optimized implant can meet the safety requirement. Finally, the optimized implant has been used in clinical practice and good short-term clinical outcomes were achieved. Therefore, the novel developed method provides a favorable guarantee for the design of 3D printed multi-segment artificial vertebral implants.


Assuntos
Próteses e Implantes , Titânio , Fenômenos Biomecânicos , Análise de Elementos Finitos , Lasers , Impressão Tridimensional , Estresse Mecânico
3.
J Mech Behav Biomed Mater ; 118: 104475, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33773239

RESUMO

Polyether-ether-ketone (PEEK) exhibits excellent mechanical properties and biocompatibility. Three-dimensional (3D) printing of PEEK bone substitutes has been widely used in clinical application. However, the inertness of pure PEEK hinders its integration with the surrounding bone tissue. In this study, for the first time, PEEK/hydroxyapatite (HA) composite specimens were fabricated using fused filament fabrication (FFF) technology. PEEK/HA filaments with HA contents of 0-30 wt% were fabricated via mechanical mixing and extrusion. The HA distributions inside the composite matrix and the surface morphology characteristics of the PEEK/HA composites were examined. The effects of the printing path and HA content on the mechanics of the PEEK/HA composites were systematically investigated. The results indicated that the HA particles were uniformly distributed on the composite matrix. With an increase in the HA content, the modulus of the PEEK/HA composite increased, while the strength and failure strain concomitantly decreased. When the HA content increased to 30 wt%, the tensile modulus of the composite increased by 68.6% compared with that of pure PEEK printed along the horizontal 90° path, while the tensile strength decreased by 48.2% compared with that of pure PEEK printed along the vertical 90° path. The fracture elongation of the printed specimens with different HA contents decreased in the following order: horizontal 0° > horizontal 90° > vertical 90°. The best comprehensive mechanical properties were achieved for pure PEEK fabricated along the horizontal 0° path. The results indicate that FFF technology is applicable for additive manufacturing of PEEK/HA composites with controllable compositions. Printed PEEK/HA composites have potential for applications in the design and manufacturing of personalized bone substitutes.


Assuntos
Materiais Biocompatíveis , Durapatita , Éteres , Cetonas , Polietilenoglicóis , Impressão Tridimensional
4.
J Mech Behav Biomed Mater ; 116: 104335, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33494021

RESUMO

Functional reconstruction of large-size mandibular continuity defect is still a major challenge in the oral and maxillofacial surgery due to the unsatisfactory repair effects and various complications. This study aimed to develop a new functional repair method for mandibular defects combined with 3D-printed polyetheretherketone (PEEK) implant and the free vascularized fibula graft, and evaluated the service performance of the implant under whole masticatory motion. The design criteria and workflows of the mandibular reconstruction were established based on the requirements of safety, functionality, and shape consistency. Both the biomechanical behavior and the mechanobiological property of mandibular reconstruction under various masticatory motion were investigated by the finite element analysis. The maximum von Mises stress of each component was lower than the yield strength of the corresponding material and the safety factor was more than 2.3 times, which indicated the security of the repair method can be guaranteed. Moreover, the actual deformation of the reconstruction model was lower than that of the normal mandible under most clenching tasks, which assured the primary stability. More than 80% of the volume elements in the bone graft can obtain effective mechanical stimulation, which benefited to reduce the risks of bone resorption. Finally, the novel repair method was applied in clinic and good clinical performances have been achieved. Compared with the conventional fibular bone graft for surgical mandibular reconstruction, this study provides excellent safety and stability to accomplish the functional reconstruction and aesthetic restoration of the mandible defect.


Assuntos
Reconstrução Mandibular , Transplante Ósseo , Fíbula , Cetonas , Mandíbula/cirurgia , Polietilenoglicóis , Impressão Tridimensional
5.
Comput Methods Programs Biomed ; 197: 105741, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32961386

RESUMO

BACKGROUND AND OBJECTIVE: Artificial vertebral implant with a lateral or posterior screw-rod fixation system are usually employed in lumbar reconstruction surgery to rebuild the lumbar spine after partial resection due to a tumor or trauma. However, few studies have investigated the effect of the various fixation systems on the biomechanics of the reconstructed lumbar system. This study aims to evaluate the influence of different surgical fixation strategies on the biomechanical performance of a reconstructed lumbar spine system in terms of the strength and long-term stability. METHODS: Two typical lumbar spine reconstruction case models that correspond to lateral or posterior fixation systems were built based on the clinical data. Finite element analyses were performed, and comparisons were made between the two models based on the predicted stress distribution of the reconstructed lumbar spine model, bone-growth area of the endplate, and the range of motion under various normal daily activities. RESULTS: The load from the upper vertebral body was found to be effectively transmitted onto the lower vertebral body by a vertebral implant with the lateral fixation system; this was favorable for bone growth after surgery. However, significantly high stresses were concentrated around the interaction region between the screws and bone, owing to the uneven lateral fixation structure; this may increase the risk of bone fractures and screw loosening in the long term. For the posterior fixation case, stably posterior fixation structure was favorable to maintain stability for the reconstructed lumbar spine. However, the load was mainly transmitted via the fixation rod rather than the vertebral implant, owing to the stress shielding effect. Therefore, the predicted strain on the endplate were insufficient for bone ingrowth under most of the spinal activates, which could cause bone loss and prosthesis loosening. CONCLUSIONS: In this study, the comparisons of the reconstructed lumbar spine system with lateral and posterior fixation strategies were conducted. The Pros and Cons of these two fixation strategies was deeply discussed and the associated clinical issues were provided. The results of this study will have a clear impact in understanding the biomechanics of the lumbar spine with different fixation strategies and providing necessary instructions to the design and application of the lumbar spinal fixation system.


Assuntos
Vértebras Lombares , Corpo Vertebral , Fenômenos Biomecânicos , Parafusos Ósseos , Análise de Elementos Finitos , Vértebras Lombares/cirurgia
6.
J Mech Behav Biomed Mater ; 103: 103561, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32090953

RESUMO

Chest wall reconstructions are mainly needed after surgical treatment of tumors or trauma. The costal cartilage is part of the chest wall, connecting sternum and ribs. The currently existing rib prostheses made of Titanium or PEEK were found lacking the costal cartilage portion, causing unsatisfactory functional rehabilitation of breath. This study proposed a newly bionic methodology for designing a costal cartilage prosthesis using a wavy elastic structure. By changing the design parameters, the mechanical properties can be accurately adjusted. Finite element analysis was carried out for the optimization of the prostheses. Then the prostheses were fabricated by fused deposition modelling manufacturing technology, using PEEK. Mechanical tests were carried out to determine the elastic modulus of the prostheses. The equivalent modulus ranged 0.5-17.3 MPa, and the tensile strength ranged 0.7-8.3 MPa. The results indicated that the mechanical behavior of the designed prostheses were close to those of the natural costal cartilage and that the wavy elastic structure was a reasonable choice for designing a costal cartilage prosthesis. Therefore, the designed PEEK costal cartilage prostheses have the potential as replacement of the natural costal cartilage with better breathing function for the patient undergoing chest wall reconstruction.


Assuntos
Cartilagem Costal , Biônica , Humanos , Cetonas , Polietilenoglicóis , Impressão Tridimensional , Próteses e Implantes , Desenho de Prótese
7.
Biomech Model Mechanobiol ; 18(3): 607-616, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30570674

RESUMO

Sheep model is the most favourable choice for animal study for functional evaluation of the cervical fusion prostheses before clinical application; however, significantly large differences between sheep and human existed in terms of morphological characteristics and daily-activity motions. Questions should be raised as whether the differences between the two species have influence on the reliability of sheep model. Finite element models (FEM) of the cervical spinal system were built to characterize the differences between the two species with respect to the range of motion (ROM) and biomechanical behaviour, and experimental cadaver tests on both species were employed for validation purposes. Results indicate that sheep model represents the worst-case scenario of the human model with exaggerated stresses (up to 3 times more) and ROM (up to 10 times more). Moreover, sheep model is very sensitive to the variation of prostheses design, whilst human model does not, which denotes that the sheep model provides a rather amplified effect of a certain design for its biomechanical performance. Therefore, caution needs to be taken when sheep models were used as the animal model for functional evaluation over various design, and the FEM built in this study can be employed as an effective methodology for performance evaluation of cage prostheses of cervical spine.


Assuntos
Vértebras Cervicais/cirurgia , Fusão Vertebral , Animais , Fenômenos Biomecânicos , Análise de Elementos Finitos , Humanos , Modelos Animais , Reprodutibilidade dos Testes , Ovinos
8.
Biomech Model Mechanobiol ; 17(4): 1083-1092, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29730771

RESUMO

A tumour resection normally involves a large tissue resection and bone replacement. Polyether ether ketone (PEEK) has become a suitable candidate for use in various prostheses owing to its lightness in weight, modulus close to that of natural bone, and good biocompatibility, among other factors. This study proposes a new design method for a rib prosthesis using the centroid trajectory of the natural replaced rib, where the strength can be adjusted by monitoring the cross-sectional area, shape, and properties. A custom-designed rib prosthesis was manufactured using fused deposition modelling (FDM) manufacturing technology, and the mechanical behaviour was found to be close to that of a natural rib. A finite element analysis of the designed rib was carried out under similar loading conditions to those used in mechanical testing. The results indicate that the centroid trajectory derived from a natural rib diaphysis can provide reliable guidance for the design of a rib prosthesis. Such methodology not only offers considerable design freedom in terms of shape and required strength, but also benefits the quality of the surface finishing for samples manufactured using the FDM technique. FDM-printed PEEK rib prostheses have been successfully implanted, and good clinical performances have been achieved.


Assuntos
Cetonas/química , Polietilenoglicóis/química , Impressão Tridimensional , Próteses e Implantes , Desenho de Prótese , Costelas/anatomia & histologia , Adulto , Fenômenos Biomecânicos , Análise de Elementos Finitos , Humanos , Masculino , Costelas/diagnóstico por imagem , Estresse Mecânico , Tomografia Computadorizada por Raios X
9.
Proc Inst Mech Eng H ; 232(4): 378-387, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29383959

RESUMO

Most vertebral body implants that are currently designed and produced in batches have difficulty meeting the patient-specific demands. Moreover, several complications, including a low fusion rate, subsidence occurrence, and rod displacement, are associated with these implants. This study aims to investigate the effects of patient-specific geometric and clinical parameters on the biomechanics of a vertebral body replacement. A three-dimensional patient-specific vertebral body replacement model was established as the basic model for parametric studies, including the anatomic design of the endplates, tilting angle, thickness, and dislocation of the vertebral body implant. A finite element analysis was applied to determine the stress distribution of the vertebral body implant when under various loading conditions. The model with an anatomical interfacing design generates 75% less stress concentration compared to a flat design; the peak stress of the model with a tilted angle closely matching the replaced vertebra segment is decreased by 30%; and the thickness close to the cortical bone can offer better bone growth capability and long-term stability. Patient-specific geometrical parameters were found to significantly affect the biomechanics of a vertebral body replacement, and therefore, a design customized especially for the endplates is necessary for better stability and long-term longevity of the prostheses. Regardless of such progress, how to balance the stability of a vertebral body implant and the safety of the peripheral nervous system remains a clinical challenge.


Assuntos
Vértebras Lombares/cirurgia , Fenômenos Mecânicos , Próteses e Implantes , Análise de Elementos Finitos , Humanos , Estresse Mecânico
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