Micro-computed tomography (micro-CT) is a consolidated imaging technology allowing non-destructive three-dimensional (3D) qualitative and quantitative analysis by the observation of microstructures with high resolution. This paper aims at delivering a structured overview of literature about studies performed using micro-CT in dentistry and maxillofacial surgery (MFS) by analyzing the entire set of articles to portray the state of the art of the last ten years of scientific publications on the topic. It draws the scenario focusing on biomaterials, in vitro and in/ex vivo applications, bone structure analysis, and tissue engineering. It confirms the relevance of the micro-CT analysis for traditional research applications and mainly in dentistry with respect to MFS. Possible developments are discussed in relation to the use of the micro-CT combined with other, traditional, and not, techniques and technologies, as the elaboration of 3D models based on micro-CT images and emerging numerical methods. Micro-CT results contribute effectively with whose ones obtained from other techniques in an integrated multimethod approach and for multidisciplinary studies, opening new possibilities and potential opportunities for the next decades of developments.
The main purpose of the study is to assess a selection of commercially available bone biomaterials substitutes used as scaffolds for tissue engineering applications in dentistry, performing a clinical study on human subjects and using the microcomputed tomography (micro-CT) analysis to investigate the main morphological and critical parameters of bone and biomaterials structures. Micro-CT was performed in both the phases, preclinical and clinical. In addition, it was combined with histology to analyze the extracted bone four months after implantation. Quantitative analysis of the main morphological parameters as the porosity, the bone volume fraction (BV/TV) and the trabecular thickness (Tb.Th) evidenced the main difference among the biomaterials properties and their influence on the bone tissue regeneration. Qualitative observations by the three-dimensional (3D) reconstruction of the microstructure, contributed to the visualization of the mineralized areas. The analyses conducted on the bone substitutes before and after the implantation allowed quantifying the main biomaterials morphological parameters and the characterization of the human bone tissue regeneration. Thus, micro-CT and its combined application with histology demonstrated as a powerful approach for the microstructural investigation and for the final assessment of the efficacy and effectiveness of the various treatments and implants.
Hip prosthetic implants represent a consolidated and successful solution to restore functional gait in patients affected by a wide range of disease including osteoarthritis degeneration processes, cancer effects, osteoporosis, traumatic injuries. While at the beginning of the worldwide dissemination of this joint replacement methodology the target patients were mainly part of a quite old population, characterized by moderate physical activity and only asking for restoring of an acceptable quality of life and of functional gait and standing, the scenario significantly changed along the years. Nowadays, hip implants are also used to treat young and active patients; moreover, the amount of expected life years is more and more increasing; and, last but not least, the average body mass of western populations is increasing as well. As an overall consequence of the above changes, hip implants need to be highly performing: they have to cope with many years of repetitive high stresses not only due to regular locomotor daily activities but also to sports, excessive loading, wear and ageing effects. It is thus of extremely relevance for Researchers, Industry, Health Authorities and Users, to gain deeper and deeper knowledge of mechanical properties and performance of hip prosthesis components, and behavior of the musculo-skeletal system which hosts the implant. Potentially dangerous conditions should be clearly identified and investigated so as to prevent implant structural failure, being implant revision highly demanding for patients and health structures in terms of worsening of health status and increase of overall assistance costs. The present chapter investigates the potentialities of research studies in the field of hip implants biomechanics which rely on a synergy between FE modeling and experimental mechanical fatigue tests and whose main goal is to infer about related risks. An example of the implemented methodology is described, and few practical applications are reported, analyzed and commented from clinical, biomechanical and regulatory point of view.
Additive manufacturing (AM), widely known as three-dimensional printing-3D printing, represents a disruptive innovation in healthcare sector. It is an innovative technology with great potential and economic implications. During the past few years, the improvement in 3D printing technologies and the availability of various printable materials (Stansbury & Idacavage, 2016; Youssef et al., 2017) have resulted in an increase in the number of companies that are leasing 3D printers to the users or on-demand printing services. The economic implications of such possibilities are significant in healthcare (Frost & Sullivan, 2019) because the manufacturing can be outsourced to a third party that may be providing manufacturing services onsite or off-site from the patient-specific custom models. The possibility to apply AM in the biomedical sector is extremely interesting for medical device manufacturers because on-demand manufacturing allows eliminating inventory and printing only the components that are needed at a given time. Personalized medical devices, specifically based on CT-scan
Silk fibroin (SF), a protein-based fiber extracted from Bombyx mori cocoons, has recently emerged with great potential for the biomedical field to be used as a biomaterial processable in a variety of formats and applications, due to its natural characteristics. The aims of the present study were to characterize the structural properties of the SF scaffolds, in the format of porous sponges, and to investigate their feasibility to support the adhesion of mesenchymal stromal/stem cells isolated from human Wharton’s jelly of the umbilical cord (WJ-MSC). Adhesion is a prerequisite for using the SF scaffold as biomaterial for supporting three-dimensional (3D) WJ-MSC cultures for several applications. The integration among micro-computed tomography, confocal analysis, and field emission scanning electron microscopy allowed carrying out a deep investigation based on quantitative morphological parameters and qualitative observations at high resolution. High levels of porosity, interconnection, and contact surface–volume ratio confirmed the appropriateness of the designed SF porous scaffolds as supports for cell cultures. WJ-MSC was demonstrated to be capable of adhering to and colonizing the SF scaffold applicable as a 3D cell culture system, of conducting in vitro experiments in a more controlled environment, and possibly of being used in tissue engineering, regenerative medicine, and applications in oncology.
Fatigue behavior of hip prostheses is usually assessed experimentally, through the implementation of mechanical tests according to International Technical Standards. Based on FE elastic-linear simulations, this study aims at investigating the stress resulting from loading conditions which are slightly different from the reference condition indicated in the ISO7206-4:2010 but which are reasonable from both a clinical and biomechanical point of view. Main results are reported and suggestions delivered for the assessment of risky conditions.
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