3-D Printed Protective Equipment during COVID-19 Pandemic

While the number of coronavirus cases from 2019 continues to grow, hospitals are reporting shortages of personal protective equipment (PPE) for frontline healthcare workers. Furthermore, PPE for the eyes and mouth, such as face shields, allow for additional protection when working with aerosols. 3-D printing enables the easy and rapid production of lightweight plastic frameworks based on open-source data. The practicality and clinical suitability of four face shields printed using a fused deposition modeling printer were examined. The weight, printing time, and required tools for assembly were evaluated. To assess the clinical suitability, each face shield was worn for one hour by 10 clinicians and rated using a visual analogue scale. The filament weight (21-42 g) and printing time (1:40-3:17 h) differed significantly between the four frames. Likewise, the fit, wearing comfort, space for additional PPE, and protection varied between the designs. For clinical suitability, a chosen design should allow sufficient space for goggles and N95 respirators as well as maximum coverage of the facial area. Consequently, two datasets are recommended. For the final selection of the ideal dataset to be used for printing, scalability and economic efficiency need to be carefully balanced with an acceptable degree of protection

Fully guided implant surgery using Magnetic Resonance Imaging – An in vitro study on accuracy in human mandibles

Objectives: The objective of this in vitro study was to assess the accuracy of fully guided implant placement following virtual implant planning based on MRI. Material and methods: Sixteen human cadaver hemimandibles with single missing teeth (n = 3), partially edentulous (n = 6) and edentulous situations (n = 7) were imaged using MRI. MRI and optical scans obtained with an intraoral scanner, were imported into an implant planning software. Virtual prosthetic and implant planning were performed regarding hard- and soft-tissue anatomy. Drill guides were manufactured, and fully guided implant placement was performed. Buccal and lingual bone and implant nerve distance were measured by three examiners in preoperative MRI and postoperative CBCT. The implant position was assessed using a software for deviation of implant positions displayed in CBCT and optical scans, respectively. Results: MRI displayed relevant structures for implant planning such as cortical and cancellous bone, inferior alveolar nerve and neighboring teeth. Implant planning, CAD/CAM of drill guides and guided implant placement were performed. Deviations between planned and actual implant positions in postoperative CBCT and optical scans were 1.34 mm (SD 0.84 mm) and 1.03 mm (SD 0.46 mm) at implant shoulder; 1.41 mm (SD 0.88 mm) and 1.28 mm (SD 0.52 mm) at implant apex, and 4.84° (SD 3.18°) and 4.21° (SD 2.01°). Measurements in preoperative MRI and postoperative CBCT confirmed the compliance with minimum distances of implants to anatomical structures. Conclusions: Relevant anatomical structures for imaging diagnostics in implant dentistry are displayed with MRI. The accuracy of MRI-based fully guided implant placement in vitro is comparable to the workflow using CBCT

Impurities in commercial titanium dental implants – A mass and optical emission spectrometry elemental analysis

Objective: Titanium (Ti) is considered bioinert and is still regarded as the “gold standard” material for dental implants. However, even ‘commercial pure’ Ti will contain minor fractions of elemental impurities. Evidence demonstrating the release of Ti ions and particles from ‘passive’ implant surfaces is increasing and has been attributed to biocorrosion processes which may provoke immunological reactions. However, Ti observed in peri-implant tissues has been shown to be co-located with elements considered impurities in biomedical alloys. Accordingly, this study aimed to quantify the composition of impurities in commercial Ti dental implants. Methods: Fifteen commercial titanium dental implant systems were analyzed using inductively coupled plasma-mass spectrometry (ICP-MS) and optical emission spectrometry (ICP-OES). Results: The elemental composition of implants manufactured from commercially pure grades of Ti, Ti-6Al-4V, and the TiZr alloy (Roxolid) conformed to the respective ISO/ASTM standards or manufacturers´ data (TiZr/Roxolid). However, all implants investigated included exogenous metal contaminants including Ni, Cr, Sb, and Nb to a variable extent. Other contaminants detected in a fraction of implants included As and the radionuclides U-238 and Th-232. Significance: Although all Ti implant studies conformed with their standard compositions, potentially allergenic, noxious metals and even radionuclides were detected. Since there are differences in the degree of contamination between the implant systems, a certain impurity fraction seems technically avoidable. The clinical relevance of these findings must be further investigated, and an adaptation of industry standards should be discussed

Three water restriction schedules used in rodent behavioral tasks transiently impair growth and differentially evoke a stress hormone response without causing dehydration

Water restriction is commonly used to motivate rodents to perform behavioral tasks; however, its effects on hydration and stress hormone levels are unknown. Here, we report daily body weight and bi-weekly packed red blood cell volume and corticosterone in adult male rats across 80 days for three commonly used water restriction schedules. We also assessed renal adaptation to water restriction using post-mortem histological evaluation of renal medulla. A control group received ad libitum water. After one week of water restriction, rats on all restriction schedules resumed similar levels of growth relative to the control group. Normal hydration was observed, and water restriction did not drive renal adaptation. An intermittent restriction schedule was associated with an increase in corticosterone relative to the control group. However, intermittent restriction evokes a stress response which could affect behavioral and neurobiological results. Our results also suggest that stable motivation in behavioral tasks may only be achieved after one week of restriction.Peer reviewe

Characterization of macrophages infiltrating periâ implantitis lesions

ObjectivesThe mechanisms involved in the initiation and progression of periâ implantitis lesions are poorly understood. It was the aim to determine the content and activation status of macrophages present in human periâ implantitis lesions and compare the current findings with the macrophage polarization associated with periodontitis lesions.Material and MethodsA total of 14 patients were studied in this investigation. Seven were soft tissue biopsies from dental implants affected by periâ implantitis that required explantation. Seven biopsies were from chronic periodontal disease. Immunofluorescence stains were performed using biomarkers to identify macrophages (CD68+) undergoing M1 polarization (iNOS+) and M2 polarization (CD206+), along with Hoechst 33,342 to identify DNA content. All samples were stained and photographed, and doubleâ positive cells for CD68 and iNOS or CD68 and CD206 were quantified.ResultsAll periâ implantitis biopsies examined revealed a mixed population of macrophages undergoing M1 polarization and M2 polarization. Further analysis demonstrated the coâ expression of iNOS and CD206, which indicates the presence of a heterogenic immune response on periâ implantitis lesions. Macrophage polarization in periâ implantitis lesions presents a distinct pattern than in periodontitis. We observed a significant increase in the population of M1 macrophages on periâ implantitis samples compared to periodontal disease samples.ConclusionOur results demonstrate that periâ implantitis has higher numbers of macrophages displaying a distinct macrophage M1 polarization signature compared to periodontitis lesions. This pattern may explain, in part, the distinct nature of periâ implantitis progression vs. periodontitis in humans.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154542/1/clr13568_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154542/2/clr13568.pd

Vitality of autologous retromolar bone grafts for alveolar ridge augmentation after a 3-months healing period: A prospective histomorphometrical analysis.

OBJECTIVES The incorporation of retromolar bone grafts used for alveolar ridge augmentation is not well understood. This prospective observational study aims to supply histomorphometrical data from bone graft biopsies taken at the time of retrieval and after a 3-month healing period using patient-matched biopsies. MATERIALS AND METHODS In 17 patients, trephine biopsies of the graft were acquired at the time of graft retrieval and after a 3-month healing period. The biopsies were compared histomorphometrically regarding the number of osteocytes, appearance of osteocyte lacunae, quantity, surface area, and activity of the Haversian canals. RESULTS All grafts appeared clinically stable after screw removal and 17 implants were placed. Histomorphometric analysis revealed no significant difference in the number of osteocytes (p = .413), osteocyte lacunae (p = .611), the ratio of filled/empty osteocyte lacunae (p = .467) and active Haversian canals (p = .495) between the biopsies retrieved after a 3-months healing period with those at the time of grafting. The only significant difference was noted in the mean surface area of the Haversian canals (p = .002). Specifically, the grafts post 3-month healing showed a significantly larger mean area (0.069 mm2) compared to the time of grafting (0.029 mm2). CONCLUSION This study demonstrates, compared to other data, a high rate of vital structures in retromolar bone block grafts after 3 months of healing, exhibiting the same histological features in comparison to the biopsies from the native alveolar ridge. Standard histomorphometrical parameters, e.g., the amount of filled or empty osteocyte lacunae for the description of the vitality of the graft need to be reappraised

A matter of origin - identification of SEMA3A, BGLAP, SPP1 and PHEX as distinctive molecular features between bone site-specific human osteoblasts on transcription level

In oral and maxillofacial bone reconstruction, autografts from the iliac crest represent the gold standard due to their superior clinical performance, compared to autografts derived from other extraoral regions. Thus, the aim of our study was to identify putative differences between osteoblasts derived from alveolar (hOB-A) and iliac crest (hOB-IC) bone of the same donor (nine donors) by means of their molecular properties in 2D and 3D culture. We thereby focused on the gene expression of biomarkers involved in osteogenic differentiation, matrix formation and osteoclast modulation. Furthermore, we examined the transcriptional response to Vit.D3 in hOB-A and hOB-IC. Our results revealed different modulation modes of the biomarker expression in osteoblasts, namely cell origin/bone entity-dependent, and culture configuration- and/or time-dependent modulations. SEMA3A, SPP1, BGLAP and PHEX demonstrated the strongest dependence on cell origin. With respect to Vit.D3-effects, BGLAP, SPP1 and ALPL displayed the highest Vit.D3-responsiveness. In this context we demonstrated that the transcriptional Vit.D3-response concerning SPP1 and ALPL in human osteoblasts depended on the cell origin. The results indicate a higher bone remodeling activity of iliac crest than alveolar osteoblasts and support the growing evidence that a high osteoclast activity at the host-/donor bone interface may support graft integration

Murine model for Fusarium oxysporum invasive fusariosis reveals organ-specific structures for dissemination and long-term persistence

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