Radio-opaque polyethylene for personalized craniomaxillofacial implants

Kozakiewicz, Marcin; Olbrzymek, Leszek; Stefańczyk, Ludomir; Olszycki, Marek; Komorowski, Piotr; Walkowiak, Bogdan; Konieczny, Bartłomiej; Krasowski, Michał; Sokołowski, Jerzy

doi:10.1007/s00784-016-1978-x

Cited by 4 publications

(14 citation statements)

References 19 publications

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“…37,73 Mild radiopacity is a requirement in various maxillofacial implants such as orbital reconstructions, where monitoring of the implant for malpositioning is crucial. 18,19 Polyethylene is preferred over titanium in craniofacial implants due to its ease of shaping, biocompatibility, smoother edges, low cost, and lack of thermal sensitivity. 18,19,37,74,75 Kozakiewicz et al incorporated 2, 4, and 6% TiO 2 in PE for lower orbital reconstruction to impart mild radiopacity relative to the surrounding fat and muscle tissues for X-ray CT. 18 HU values of −83.2 ± 7.7 HU, − 25.2 ± 8.2 HU, and 67.9 ± 5.2 HU, respectively, were obtained, which fell within the range of fat and muscle (−70.1 ± 19.2 HU and 82.65 ± 7.1 HU, respectively).…”

Section: ■ Resultsmentioning

confidence: 99%

“…18,19 Polyethylene is preferred over titanium in craniofacial implants due to its ease of shaping, biocompatibility, smoother edges, low cost, and lack of thermal sensitivity. 18,19,37,74,75 Kozakiewicz et al incorporated 2, 4, and 6% TiO 2 in PE for lower orbital reconstruction to impart mild radiopacity relative to the surrounding fat and muscle tissues for X-ray CT. 18 HU values of −83.2 ± 7.7 HU, − 25.2 ± 8.2 HU, and 67.9 ± 5.2 HU, respectively, were obtained, which fell within the range of fat and muscle (−70.1 ± 19.2 HU and 82.65 ± 7.1 HU, respectively). While a deterioration of the mechanical properties of PE was observed as a result of the addition of TiO 2 , i.e., reduced tensile and compressive strength, no cytotoxicity to human osteoblast cells was found, and the material was deemed suitable for application in craniomaxillofacial implants.…”

Section: ■ Resultsmentioning

confidence: 99%

“…Numerous studies have investigated the incorporation of contrast agents to enhance the visibility of polymers in radiographs. ,, Imparting radiopacity to polymers has proven to aid in monitoring the implant to allow precise surgical placement, evaluate biodegradation, or to detect malpositioning, migration, and wear. − We aimed to conduct a thorough search of the literature to identify and summarize these contrast agents.…”

Section: Introductionmentioning

confidence: 99%

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Radiopacity Enhancements in Polymeric Implant Biomaterials: A Comprehensive Literature Review

Emonde,

Eggers,

Wichmann

et al. 2024

ACS Biomater. Sci. Eng.

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Polymers as biomaterials possess favorable properties, which include corrosion resistance, light weight, biocompatibility, ease of processing, low cost, and an ability to be easily tailored to meet specific applications. However, their inherent low X-ray attenuation, resulting from the low atomic numbers of their constituent elements, i.e., hydrogen (1), carbon (6), nitrogen (7), and oxygen (8), makes them difficult to visualize radiographically. Imparting radiopacity to radiolucent polymeric implants is necessary to enable noninvasive evaluation of implantable medical devices using conventional imaging methods. Numerous studies have undertaken this by blending various polymers with contrast agents consisting of heavy elements. The selection of an appropriate contrast agent is important, primarily to ensure that it does not cause detrimental effects to the relevant mechanical and physical properties of the polymer depending upon the intended application. Furthermore, its biocompatibility with adjacent tissues and its excretion from the body require thorough evaluation. We aimed to summarize the current knowledge on contrast agents incorporated into synthetic polymers in the context of implantable medical devices. While a single review was found that discussed radiopacity in polymeric biomaterials, the publication is outdated and does not address contemporary polymers employed in implant applications. Our review provides an up-to-date overview of contrast agents incorporated into synthetic medical polymers, encompassing both temporary and permanent implants. We expect that our results will significantly inform and guide the strategic selection of contrast agents, considering the specific requirements of implantable polymeric medical devices.

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Section: ■ Resultsmentioning

confidence: 99%

Section: ■ Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Radiopacity Enhancements in Polymeric Implant Biomaterials: A Comprehensive Literature Review

Emonde,

Eggers,

Wichmann

et al. 2024

ACS Biomater. Sci. Eng.

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“…• Bone window: ww: 1500 HU; wl: 300 HU 6 • Brain window: ww: 100 HU; wl: 50 HU 7 Bone window was the default window setting for all measurements except when obtaining the retro-globe plane (brain window was used). Procedure 1.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Mapping the Posterior Ledge and Optic Foramen in Orbital Floor Blowout Fractures

et al. 2023

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Background: The posterior ledge (PL) is a vital structure that supports the implant posteriorly during orbital floor reconstruction. This study describes a technique for mapping the posterior ledge in relation to the infraorbital margin in patients with orbital floor blowout fractures. The relationship between the optic foramen and posterior ledge was established. Methods: Facial computed tomography (FCT) scans of 67 consecutive patients with isolated orbital floor blow-out fractures were analyzed using Osirix. Planes of Reference for Orbital Fractures (PROF), a standardized technique for performing measurements on FCT, was used. Viewed coronally, the orbit was divided into 7 equal sagittal slices (L1 laterally to L7 medially) with reference to the mid-orbital plane. The distances of PL from infra-orbital margin (IM), and location of optic foramen were determined. Results: The greatest distance to PL is found at slice L5 (Median:30.1mm, Range:13.5–37.1mm). The median and ranges for each slice are as follows: L1 (Median:0.0mm, Range:0.0–19.9mm), L2 (Median:0.0mm, Range:0.0–21.5mm), L3 (Median:15.8mm, Range:0.0–31.7mm), L4 (Median:26.1mm, Range:0.0–34.0mm), L5 (Median:30.1mm, Range:13.5–37.1mm), L6 (Median:29.0mm, Range:0.0–36.3mm), L7 (Median:20.8mm, Range:0.0–39.2mm). The median distance of the optic foramen from IM is 43.7mm (Range:37.0– 49.1mm) at slice L7. Conclusion: Distance to PL from IM increases medially until the slice L5 before decreasing. A reference map of the posterior ledge in relation to the infraorbital margin and optic foramen is generated. The optic foramen is located in close proximity to the posterior ledge at the medial orbital floor. This aids in pre-operative planning and intra-operative dissection.

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“…In a different study, Kozakiewicz et al. attempted to make a radiopaque UHMWPE using TiO [119]. Their experimental data suggested that some of the mechanical properties of the polymer including hardness, tensile modulus and strength of modulus of the polymer decreased.…”

Section: Radiopaque Uhmwpementioning

confidence: 99%

Medical-grade ultra-high molecular weight polyethylene: Past, current and future

Zaribaf

2018

Materials Science and Technology

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Ultra-high molecular weight polyethylene is a semi-crystalline polymer (45%-60%) with six decades of orthopaedic applications. This polymer has a high fracture toughness (30 kJ/m 2 ) which comes from the molecular weight and the chain entanglements. Adverse alteration of the properties may lead to the part's pre-mature failure. This paper reviews the current manufacturing methods, and their effect on the properties of the polymer. The review also focused on the attempts of enhancing the polymer properties. The main cause of failure is implant loosing due to the polymeric wear particles. Many manufacturers have attempted to enhance the wear and oxidation properties of the polymer, the outcome of the new technologies is critically reviewed. Finally, the review explores the potential for future developments.

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Radio-opaque polyethylene for personalized craniomaxillofacial implants

Abstract: Maxilloafacial surgery is still looking for new implantologic materials. The proposed one is a new way to manufacture an implant visible in computed tomography which does not interfere with its shape in radiological examination and makes it possible to observe the surrounding soft tissues.

Cited by 4 publications

References 19 publications

Radiopacity Enhancements in Polymeric Implant Biomaterials: A Comprehensive Literature Review

Radiopacity Enhancements in Polymeric Implant Biomaterials: A Comprehensive Literature Review

Mapping the Posterior Ledge and Optic Foramen in Orbital Floor Blowout Fractures

Medical-grade ultra-high molecular weight polyethylene: Past, current and future

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