The mechanical strength of additive manufactured intraosseous transcutaneous amputation prosthesis, known as the ITAP

The focus of this research is the ability to manufacture, when using layer base production methods, the medical insert known as ITAP used for prosthetic attachment in a femur. It has been demonstrated using computational modelling that a 3-dimensional build of the ITAP has the lowest stress present when the honeycomb infill pattern’s percentage is set at 100%, with the ITAP being constructed on a horizontal printing bed with the shear forces acting adjacent to the honeycomb structure. The testing has followed the British standard ISO 527-2:2012, which shows a layer base printed tensile test sample, with a print setting of 100% infill and at a side print orientation; this was found to withstand a greater load before failure than any other printed test configuration. These findings have been validated through simulations that analyses the compression, shear and torque forces acting upon an augmented femur, with an imbedded ITAP model

Intraosseous transcutaneous amputation prostheses versus dental implants:a comparison between keratinocyte and gingival epithelial cell adhesion<i> in vitro</i>

Infection is the primary failure modality for transcutaneous implants because the skin breach provides a route for pathogens to enter the body. Intraosseous transcutaneous amputation prostheses (ITAP) are being developed to overcome this problem by creating a seal at the skin-implant interface. Oral gingival epithelial cell attachment creates an infection-free seal around dental implants. However, this has yet to be achieved consistently outside of the oral environment. Epithelial cells attach to metal substrates by means of hemidesmosomes and focal adhesions. Their density per unit cell is an indicator of attachment strength. We postulate that gingival epithelial cells express more hemidesmosomes and focal adhesions at earlier time points, compared with epidermal keratinocytes, and this increased speed and strength of attachment may be the reason why an infection-free seal is often achieved around dental implants but less frequently around ITAP. The aim of this study was to compare epidermal keratinocyte with oral gingival cell attachment on titanium alloy in vitro, to determine whether these two cell types differ in their speed and strength of attachment. We aimed to test the hypothesis that gingival cells up-regulate focal adhesion and hemidesmosome formation at earlier time points compared with extra-oral keratinocytes. To test this hypothesis we cultured epidermal keratinocytes and oral gingival cells on titanium alloy substrates and assessed cell attachment by focal adhesions and hemidesmosome expression at 4, 24, 48 and 72 hours. Formation and expression of hemidesmosomes temporally lagged behind that of focal adhesions in both cell types. Gingival derived cells up-regulated focal adhesion and hemidesmosome expression at earlier time points compared with epidermal keratinocytes. Hemidesmosome expression in oral gingival cells was 3 times greater compared with epidermal keratinocytes at 4 hours. Our findings indicate that earlier attachment may be key to the success of the dental implant transcutaneous interface