BACKGROUND Dentition defect,a common clinical oral disease developed in humans,not only causes masticatory dysfunction and articulation difficulties but also affects facial appearance and increases the burden on the i...BACKGROUND Dentition defect,a common clinical oral disease developed in humans,not only causes masticatory dysfunction and articulation difficulties but also affects facial appearance and increases the burden on the intestinal tract.Restorative treatment is the primary option for this disease.However,traditional restorations have many drawbacks,such as mismatch with the body,low reliability,and incomplete occlusal function recovery.AIM to analyze the efficacy of orthodontics combined with 3D printing guide plate implant restoration in treating patients with dentition defects and its influence on masticatory and phonic functions.METHODS A prospective study was carried out in 86 patients with dentition defects who received implant prosthesis after orthodontic treatment in our hospital between January 2018 and January 2019.Those patients were divided into a control group and an intervention group with 43 patients in each group using a random number table.The control group received traditional implant restoration,whereas the intervention group received 3D printing guide plate implant restoration.Treatment outcomes,cosmetic appearance,dental function,implant deviation,and quality of life were compared between the two groups.RESULTS The overall response rate in the intervention group was significantly higher than that in the control group(95.35%vs 81.40%,χ^(2)=4.071,P=0.044).The number of cases with neatly trimmed cosmetic appearance(χ^(2)=4.497,P=0.034),complete coverage(χ^(2)=4.170,P=0.041),and normal occlusion(χ^(2)=5.512,P=0.019)in the intervention group was higher than that in the control group.After treatment,mastication,swallowing,and articulation were significantly improved in both groups.Masticatory(t=2.980,P=0.004),swallowing(t=2.199,P=0.031),and phonic functions(t=3.950,P=0.004)were better in the intervention group than those in the control group.The deviation value and the deviation angle(t=5.440,P=0.000)at the top(t=6.320,P=0.000)and middle parts of the implants(t=22.295,P=0.000)in the intervention group were lower than those in the control group after treatment.Functional limitations,psychosocial and physical pain and discomfort,and total scores decreased in both groups.The functional limitation(t=2.379,P=0.020),psychosocial(t=2.420,P=0.000),physical pain and discomfort(t=6.581,P=0.000),and total scores(t=2.140,P=0.035)were lower in the intervention group than those in the control group.CONCLUSION Orthodontic treatment combined with 3D printing guide plate implant restoration can significantly improve the masticatory and phonic functions,quality of life,and psychological health of patients with dentition defects.Therefore,it is highly recommended in clinic application.展开更多
Oral antibiotics are often prescribed to prevent infection after implant surgery;however, only a small fraction of the antibiotics can reach the implants. Thus, there are concerns about overusing antibiotics. We desig...Oral antibiotics are often prescribed to prevent infection after implant surgery;however, only a small fraction of the antibiotics can reach the implants. Thus, there are concerns about overusing antibiotics. We designed and fabricated porous implants with interconnecting 3D structures (I3D) and hypothesized that such I3D structures could serve as a depository for antimicrobial agents to prevent infection locally. The implants were either treated with antibiotics or coated with silver nanoparticles (AgNPs) by electrodeposition to test this hypothesis. The antimicrobial assay was conducted, and bacterial growth zones of inhibition (ZOIs) were monitored. Overall, I3D implants resulted in larger ZOIs than did the solid implants, and the center I3D (cI3D)-implant produced the largest ZOI. In the antibiotic treatment testing, the diameters of ZOIs of the solid implant vs. I3D implant were about 14 mm vs. 15 to 18 mm on day 2;however, the diameter quickly reduced to 9 mm on day 3 and 5 mm on days 6 and 8 for the solid implant, while no obvious change of the zone was seen for I3D implants. For the AgNPs coated implants, the ZOIs for the I3D implants were generally greater than the solid implant over four weeks of incubation. A significantly larger ZOI (~1 - 2 mm larger on average) was seen for AgNPs coated I3D implants at 0.1 V - 0.01 M, 0.3 V - 0.01 M, and 1.5 V - 0.01 M treatments compared to AgNPs coated solid implants. Given that we have previously shown that I3D implants can reserve chemoattractants to recruit stem cells to enhance osseointegration, we conclude that implants with the I3D structures could be beneficial not only for osseointegration but also in preventing infection.展开更多
Osteochondral lesion of the talus(OLT)is a common cause of ankle pain that often occurs in the talar dome and leads to talar cartilage and subchondral bone damage.Osteochondral autograft transplantation is a logical t...Osteochondral lesion of the talus(OLT)is a common cause of ankle pain that often occurs in the talar dome and leads to talar cartilage and subchondral bone damage.Osteochondral autograft transplantation is a logical treatment option.It is known that if the cartilage does not heal properly after injury,it degenerates,and osteoarthritis worsens.A three dimensional(3D)-printed guide plate can be used to find the curved articular surface from the donor site which optimally fits the defect in the talus.Herein,we present the case of a 28-year-old man who had an open injury from the crash of a tricycle in the right ankle at the age of 5.Radiographs revealed a large defect in the medial talar dome that affected nearly half of the talar dome.We performed the debridement of the ankle lesion.An osteochondral autograft was harvested from the medial femoral condyle(MFC)with the help of a personalised 3D-printed guide plate.This 3D-printed guide plate simulated the contour of a specific area in the talar dome,which involved the site of the defect.The autograft was then transplanted into the talus defect.The efficacy of this technique was evaluated at 2,4,and 7 months after surgery and proven to be reliable.展开更多
Surgical resection and perioperative adjuvant chemotherapy-based therapies have improved the prognosis of patients with osteosarcoma;however,intraoperative bone defects,local tumour recurrence,and chemotherapy-induced...Surgical resection and perioperative adjuvant chemotherapy-based therapies have improved the prognosis of patients with osteosarcoma;however,intraoperative bone defects,local tumour recurrence,and chemotherapy-induced adverse effects still affect the quality of life of patients.Emerging 3D-printed titanium alloy(Ti6Al4V)implants have advantages over traditional implants in bone repair,including lower elastic modulus,lower stiffness,better bone conduction,more bone in-growth,stronger mechanical interlocking,and lager drug-loading capacity by their inherent porous structure.Here,cisplatin,a clinical first-line anti-osteosarcoma drug,was loaded into Ti6Al4V implants,within a PLGA-PEG-PLGA thermo-sensitive hydrogel,to construct bone substitutes with both anti-osteosarcoma and bone-repair functions.The optimal concentrations of cisplatin(0.8 and 1.6 mg/mL)were first determined in vitro.Thereafter,the anti-tumour effect and biosafety of the cisplatin/hydrogel-loaded implants,as well as their bone-repair potential were evaluated in vivo in tumour-bearing mouse,and bone defect rabbit models,respectively.The loading of cisplatin reduced tumour volume by more than two-thirds(from 641.1 to 201.4 mm3)with negligible organ damage,achieving better anti-tumour effects while avoiding the adverse effects of systemic cisplatin delivery.Although bone repair was hindered by cisplatin loading at 4 weeks,no difference was observed at 8 weeks in the context of implants with versus without cisplatin,indicating acceptable long-term stability of all implants(with 8.48%-10.04%bone in-growth and 16.94%-20.53%osseointegration).Overall,cisplatin/hydrogel-loaded 3D-printed Ti6Al4V implants are safe and effective for treating osteosarcoma-caused bone defects,and should be considered for clinical use.展开更多
To investigate the feasibility and early efficacy of 3D-printed vertebral body implantation combined with robotic radiosurgery in the treatment of spinal tumors.This study included 14 patients with spinal tumors from ...To investigate the feasibility and early efficacy of 3D-printed vertebral body implantation combined with robotic radiosurgery in the treatment of spinal tumors.This study included 14 patients with spinal tumors from December 2017 to June 2018.Before surgery,all patients were subjected to CT scan and 3D data of the corresponding vertebral segments were collected.Titanium alloy formed 3D-printed vertebral body implantation and robotic stereotactic radiotherapy were performed because of the risk of postoperative residual,high risk of recovery,or recurrence after surgery.The main outcomes included the remission of symptoms,vertebral body stability,robotic stereotactic surgical precision,and local tumor control.All patients received complete and successful combination therapy,and all healed primarily without complications.The error of the coverage accuracy for robotic radiosurgery was less than 0.5 mm,and the error of the rotation angle was less than 0.5.The therapeutic toxicity was limited(mainly in grades 1–2),and adverse events were uncommon.The evaluation of vertebral body stability and histocompatibility for all patients met the postoperative clinical requirements.For patients with post spinal injury,the pain symptoms were reduced or disappeared(93%),and nerve function was improved or even recovered after treatment(100%).During our follow-up period,most tumors were locally well controlled(93%).3D-printed vertebral body implantation combined with robotic radiosurgery may offer a new treatment of spinal tumors.Chinese clinical trial registry:ChiCTR-ONN-17013946.展开更多
The selection of ideal posttraumatic augmentation rhinoplasty materials and technical strategies has always been a pressing challenge.Owing to the complexity of the traumatic nasal anatomical structure,such procedures...The selection of ideal posttraumatic augmentation rhinoplasty materials and technical strategies has always been a pressing challenge.Owing to the complexity of the traumatic nasal anatomical structure,such procedures are more complicated than ordinary cosmetic rhinoplasty.The choice of reconstruction material should emphasize its inherent characteristics,such as biocompatibility,anti-infective ability,strength,and plasticity.With the development of rhinoplasty,the choice of material is less limited and composite materials have become mainstream.This review outlines current composite materials and techniques in posttraumatic augmentation rhinoplasty.展开更多
Postoperative anatomical reconstruction and prevention of local recurrence after tumor resection are two vital clinical challenges in osteosarcoma treatment.A three-dimensional(3D)-printed porous Ti6Al4V scaffold(3DTi...Postoperative anatomical reconstruction and prevention of local recurrence after tumor resection are two vital clinical challenges in osteosarcoma treatment.A three-dimensional(3D)-printed porous Ti6Al4V scaffold(3DTi)is an ideal material for reconstructing critical bone defects with numerous advantages over traditional implants,including a lower elasticity modulus,stronger bone-implant interlock,and larger drug-loading space.Simvastatin is a multitarget drug with anti-tumor and osteogenic potential;however,its efficiency is unsatisfactory when delivered systematically.Here,simvastatin was loaded into a 3DTi using a thermosensitive poly(lactic-co-gly-colic)acid(PLGA)-polyethylene glycol(PEG)-PLGA hydrogel as a carrier to exert anti-osteosarcoma and oste-ogenic effects.Newly constructed simvastatin/hydrogel-loaded 3DTi(Sim-3DTi)was comprehensively appraised,and its newfound anti-osteosarcoma mechanism was explained.Specifically,in a bone defect model of rabbit condyles,Sim-3DTi exhibited enhanced osteogenesis,bone in-growth,and osseointegration compared with 3DTi alone,with greater bone morphogenetic protein 2 expression.In our nude mice model,simvastatin loading reduced tumor volume by 59%-77%without organic damage,implying good anti-osteosarcoma activity and biosafety.Furthermore,Sim-3DTi induced ferroptosis by upregulating transferrin and nicotinamide adenine dinucleotide phosphate oxidase 2 levels in osteosarcoma both in vivo and in vitro.Sim-3DTi is a promising osteogenic bone substitute for osteosarcoma-related bone defects,with a ferroptosis-mediated anti-osteosarcoma effect.展开更多
3D-printing is an emerging technology that challenged wrought counterparts by one-step manufacturing for complicated biological devices.However,the material properties and surface features due to manufacturing paramet...3D-printing is an emerging technology that challenged wrought counterparts by one-step manufacturing for complicated biological devices.However,the material properties and surface features due to manufacturing parameters play an important role on the corrosion behaviour and influence the toxicity of the material as an implant.In this paper,the improvement of pitting potential was observed by electrochemical experiments as the result of grain refinement of DMLS 316 L at 200 W laser power.The ICP results verified the supressed release of toxic cations after the formation of the passive film with enhanced characteristics.However,the pores from DMLS 316 L have the potential to develop into pits when polarised above pitting potential,promoting the risk of using 3D-printed 316 L as implant materials.展开更多
文摘BACKGROUND Dentition defect,a common clinical oral disease developed in humans,not only causes masticatory dysfunction and articulation difficulties but also affects facial appearance and increases the burden on the intestinal tract.Restorative treatment is the primary option for this disease.However,traditional restorations have many drawbacks,such as mismatch with the body,low reliability,and incomplete occlusal function recovery.AIM to analyze the efficacy of orthodontics combined with 3D printing guide plate implant restoration in treating patients with dentition defects and its influence on masticatory and phonic functions.METHODS A prospective study was carried out in 86 patients with dentition defects who received implant prosthesis after orthodontic treatment in our hospital between January 2018 and January 2019.Those patients were divided into a control group and an intervention group with 43 patients in each group using a random number table.The control group received traditional implant restoration,whereas the intervention group received 3D printing guide plate implant restoration.Treatment outcomes,cosmetic appearance,dental function,implant deviation,and quality of life were compared between the two groups.RESULTS The overall response rate in the intervention group was significantly higher than that in the control group(95.35%vs 81.40%,χ^(2)=4.071,P=0.044).The number of cases with neatly trimmed cosmetic appearance(χ^(2)=4.497,P=0.034),complete coverage(χ^(2)=4.170,P=0.041),and normal occlusion(χ^(2)=5.512,P=0.019)in the intervention group was higher than that in the control group.After treatment,mastication,swallowing,and articulation were significantly improved in both groups.Masticatory(t=2.980,P=0.004),swallowing(t=2.199,P=0.031),and phonic functions(t=3.950,P=0.004)were better in the intervention group than those in the control group.The deviation value and the deviation angle(t=5.440,P=0.000)at the top(t=6.320,P=0.000)and middle parts of the implants(t=22.295,P=0.000)in the intervention group were lower than those in the control group after treatment.Functional limitations,psychosocial and physical pain and discomfort,and total scores decreased in both groups.The functional limitation(t=2.379,P=0.020),psychosocial(t=2.420,P=0.000),physical pain and discomfort(t=6.581,P=0.000),and total scores(t=2.140,P=0.035)were lower in the intervention group than those in the control group.CONCLUSION Orthodontic treatment combined with 3D printing guide plate implant restoration can significantly improve the masticatory and phonic functions,quality of life,and psychological health of patients with dentition defects.Therefore,it is highly recommended in clinic application.
文摘Oral antibiotics are often prescribed to prevent infection after implant surgery;however, only a small fraction of the antibiotics can reach the implants. Thus, there are concerns about overusing antibiotics. We designed and fabricated porous implants with interconnecting 3D structures (I3D) and hypothesized that such I3D structures could serve as a depository for antimicrobial agents to prevent infection locally. The implants were either treated with antibiotics or coated with silver nanoparticles (AgNPs) by electrodeposition to test this hypothesis. The antimicrobial assay was conducted, and bacterial growth zones of inhibition (ZOIs) were monitored. Overall, I3D implants resulted in larger ZOIs than did the solid implants, and the center I3D (cI3D)-implant produced the largest ZOI. In the antibiotic treatment testing, the diameters of ZOIs of the solid implant vs. I3D implant were about 14 mm vs. 15 to 18 mm on day 2;however, the diameter quickly reduced to 9 mm on day 3 and 5 mm on days 6 and 8 for the solid implant, while no obvious change of the zone was seen for I3D implants. For the AgNPs coated implants, the ZOIs for the I3D implants were generally greater than the solid implant over four weeks of incubation. A significantly larger ZOI (~1 - 2 mm larger on average) was seen for AgNPs coated I3D implants at 0.1 V - 0.01 M, 0.3 V - 0.01 M, and 1.5 V - 0.01 M treatments compared to AgNPs coated solid implants. Given that we have previously shown that I3D implants can reserve chemoattractants to recruit stem cells to enhance osseointegration, we conclude that implants with the I3D structures could be beneficial not only for osseointegration but also in preventing infection.
基金the Clinical Research Program of 9th People’s Hospital,Shanghai Jiao Tong University School of Medicine(No.JYLJ015)the Clinical Research Plan of SHDC(No.16CR3099B)+1 种基金the National Key Research and Development Program of China(No.2017YFC1103900)the Class IV Peak Subject Program of Shanghai Jiao Tong University School of Medicine(No.GXQ03)。
文摘Osteochondral lesion of the talus(OLT)is a common cause of ankle pain that often occurs in the talar dome and leads to talar cartilage and subchondral bone damage.Osteochondral autograft transplantation is a logical treatment option.It is known that if the cartilage does not heal properly after injury,it degenerates,and osteoarthritis worsens.A three dimensional(3D)-printed guide plate can be used to find the curved articular surface from the donor site which optimally fits the defect in the talus.Herein,we present the case of a 28-year-old man who had an open injury from the crash of a tricycle in the right ankle at the age of 5.Radiographs revealed a large defect in the medial talar dome that affected nearly half of the talar dome.We performed the debridement of the ankle lesion.An osteochondral autograft was harvested from the medial femoral condyle(MFC)with the help of a personalised 3D-printed guide plate.This 3D-printed guide plate simulated the contour of a specific area in the talar dome,which involved the site of the defect.The autograft was then transplanted into the talus defect.The efficacy of this technique was evaluated at 2,4,and 7 months after surgery and proven to be reliable.
基金This work was supported by the Ministry of Science and Technology of the People’s Republic of China[grant number 2016YFB1101501]the National Natural Science Foundation of China[grant number 81772320].
文摘Surgical resection and perioperative adjuvant chemotherapy-based therapies have improved the prognosis of patients with osteosarcoma;however,intraoperative bone defects,local tumour recurrence,and chemotherapy-induced adverse effects still affect the quality of life of patients.Emerging 3D-printed titanium alloy(Ti6Al4V)implants have advantages over traditional implants in bone repair,including lower elastic modulus,lower stiffness,better bone conduction,more bone in-growth,stronger mechanical interlocking,and lager drug-loading capacity by their inherent porous structure.Here,cisplatin,a clinical first-line anti-osteosarcoma drug,was loaded into Ti6Al4V implants,within a PLGA-PEG-PLGA thermo-sensitive hydrogel,to construct bone substitutes with both anti-osteosarcoma and bone-repair functions.The optimal concentrations of cisplatin(0.8 and 1.6 mg/mL)were first determined in vitro.Thereafter,the anti-tumour effect and biosafety of the cisplatin/hydrogel-loaded implants,as well as their bone-repair potential were evaluated in vivo in tumour-bearing mouse,and bone defect rabbit models,respectively.The loading of cisplatin reduced tumour volume by more than two-thirds(from 641.1 to 201.4 mm3)with negligible organ damage,achieving better anti-tumour effects while avoiding the adverse effects of systemic cisplatin delivery.Although bone repair was hindered by cisplatin loading at 4 weeks,no difference was observed at 8 weeks in the context of implants with versus without cisplatin,indicating acceptable long-term stability of all implants(with 8.48%-10.04%bone in-growth and 16.94%-20.53%osseointegration).Overall,cisplatin/hydrogel-loaded 3D-printed Ti6Al4V implants are safe and effective for treating osteosarcoma-caused bone defects,and should be considered for clinical use.
基金This research was funded by key clinical projects of Peking University Third Hospital(Peking University talent introduction fund,BYSY2017030).
文摘To investigate the feasibility and early efficacy of 3D-printed vertebral body implantation combined with robotic radiosurgery in the treatment of spinal tumors.This study included 14 patients with spinal tumors from December 2017 to June 2018.Before surgery,all patients were subjected to CT scan and 3D data of the corresponding vertebral segments were collected.Titanium alloy formed 3D-printed vertebral body implantation and robotic stereotactic radiotherapy were performed because of the risk of postoperative residual,high risk of recovery,or recurrence after surgery.The main outcomes included the remission of symptoms,vertebral body stability,robotic stereotactic surgical precision,and local tumor control.All patients received complete and successful combination therapy,and all healed primarily without complications.The error of the coverage accuracy for robotic radiosurgery was less than 0.5 mm,and the error of the rotation angle was less than 0.5.The therapeutic toxicity was limited(mainly in grades 1–2),and adverse events were uncommon.The evaluation of vertebral body stability and histocompatibility for all patients met the postoperative clinical requirements.For patients with post spinal injury,the pain symptoms were reduced or disappeared(93%),and nerve function was improved or even recovered after treatment(100%).During our follow-up period,most tumors were locally well controlled(93%).3D-printed vertebral body implantation combined with robotic radiosurgery may offer a new treatment of spinal tumors.Chinese clinical trial registry:ChiCTR-ONN-17013946.
文摘The selection of ideal posttraumatic augmentation rhinoplasty materials and technical strategies has always been a pressing challenge.Owing to the complexity of the traumatic nasal anatomical structure,such procedures are more complicated than ordinary cosmetic rhinoplasty.The choice of reconstruction material should emphasize its inherent characteristics,such as biocompatibility,anti-infective ability,strength,and plasticity.With the development of rhinoplasty,the choice of material is less limited and composite materials have become mainstream.This review outlines current composite materials and techniques in posttraumatic augmentation rhinoplasty.
基金supported by National Natural Science Foundation of China(grant number 82272456 and 82202748)China Postdoctoral Science Foundation(grant number 2022M720297).
文摘Postoperative anatomical reconstruction and prevention of local recurrence after tumor resection are two vital clinical challenges in osteosarcoma treatment.A three-dimensional(3D)-printed porous Ti6Al4V scaffold(3DTi)is an ideal material for reconstructing critical bone defects with numerous advantages over traditional implants,including a lower elasticity modulus,stronger bone-implant interlock,and larger drug-loading space.Simvastatin is a multitarget drug with anti-tumor and osteogenic potential;however,its efficiency is unsatisfactory when delivered systematically.Here,simvastatin was loaded into a 3DTi using a thermosensitive poly(lactic-co-gly-colic)acid(PLGA)-polyethylene glycol(PEG)-PLGA hydrogel as a carrier to exert anti-osteosarcoma and oste-ogenic effects.Newly constructed simvastatin/hydrogel-loaded 3DTi(Sim-3DTi)was comprehensively appraised,and its newfound anti-osteosarcoma mechanism was explained.Specifically,in a bone defect model of rabbit condyles,Sim-3DTi exhibited enhanced osteogenesis,bone in-growth,and osseointegration compared with 3DTi alone,with greater bone morphogenetic protein 2 expression.In our nude mice model,simvastatin loading reduced tumor volume by 59%-77%without organic damage,implying good anti-osteosarcoma activity and biosafety.Furthermore,Sim-3DTi induced ferroptosis by upregulating transferrin and nicotinamide adenine dinucleotide phosphate oxidase 2 levels in osteosarcoma both in vivo and in vitro.Sim-3DTi is a promising osteogenic bone substitute for osteosarcoma-related bone defects,with a ferroptosis-mediated anti-osteosarcoma effect.
基金supported by the Postdoctor Research Foundation of Shunde Graduate School of University of Science and Technology Beijing(No.2020BH013)National Natural Science Foundation of China(Grant No.51871027)High-tech Ship Research Projects Sponsored by MIIT(No.2019GXB01-01-004)。
文摘3D-printing is an emerging technology that challenged wrought counterparts by one-step manufacturing for complicated biological devices.However,the material properties and surface features due to manufacturing parameters play an important role on the corrosion behaviour and influence the toxicity of the material as an implant.In this paper,the improvement of pitting potential was observed by electrochemical experiments as the result of grain refinement of DMLS 316 L at 200 W laser power.The ICP results verified the supressed release of toxic cations after the formation of the passive film with enhanced characteristics.However,the pores from DMLS 316 L have the potential to develop into pits when polarised above pitting potential,promoting the risk of using 3D-printed 316 L as implant materials.
