The optimization of loading protocols following dental implant insertion requires setting up patient-specific protocols, customized according to the actual implant osseointegration, measured through quantitative, objective methods. Various devices for the assessment of implant stability as an indirect measure of implant osseointegration have been developed. They are analyzed here, introducing the respective physical models, outlining major advantages and critical aspects, and reporting their clinical performance. A careful discussion of underlying hypotheses is finally reported, as is a suggestion for further development of instrumentation and signal analysis.
Resonance frequencies and their trends towards osseointegration level may differ between implant designs, and in different boundary conditions that are related to implant position inside the mandible; tapered implants are the most sensitive to bone maturation levels, small implants have very little sensitivity. Resonance frequencies are less sensitive to bone maturation level beyond 50%.
The most recent developments of Fused Deposition Modelling (FDM) techniques are moving the application of Additive Manufacturing (AM) technologies toward new areas of investigation such as the biomedical, aerospace, and marine engineering in addition to the more consolidated industrial and civil fields. Some specific characteristics are required for the components designed for peculiar applications, such as complex geometries, lightweight, and high strength as well as breathability and aesthetic appearance specifically in the biomedical field. All these design specifications could be potentially satisfied by manufacturing with 3D printing techniques. Moreover, the development of purpose-dedicated filaments can be considered a key factor to successfully meet all the requirements. In this paper, fabrication and applications of five new thermoplastic materials with fillers are described and analyzed. They are organic bio-plastic compounds made of polylactic acid (PLA) and organic by-products. The growing interest in these new composite materials reinforced with organic by-products is due to the reduction of production management costs and their low environmental impact. In this study, the production workflow has been set up and described in detail. The main properties of these new thermoplastic materials have been analyzed with a major emphasis on strength, lightweight, and surface finish. The analysis showed that these materials can be particularly suitable for biomedical applications. Therefore, two different biomedical devices were selected and relative prototypes were manufactured with one of the analyzed thermoplastic materials. The feasibility, benefits, and performance of the thermoplastic material considered for these applications were successfully assessed.
Principal components analysis is a powerful technique which can be used to reduce data dimensionality. With reference to three-dimensional bone shape models, it can be used to generate an unlimited number of models, defined by thousands of nodes, from a limited (less than twenty) number of scalars. The full procedure has been here described in detail and tested. Two databases were used as input data: the first database comprised 40 mandibles, while the second one comprised 98 proximal femurs. The “average shape” and principal components that were required to cover at least 90% of the whole variance were identified for both bones, as well as the statistical distributions of the respective principal components weights. Fifteen principal components sufficed to describe the mandibular shape, while nine components sufficed to describe the proximal femur morphology. A routine has been set up to generate any number of mandible or proximal femur geometries, according to the actual statistical shape distributions. The set-up procedure can be generalized to any bone shape given a sufficiently large database of the respective 3D shapes.
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