Microstructures and mechanical properties of a new titanium alloy for surgical implant application

A new titanium alloy Ti12.5Zr2.5Nb2.5Ta（TZNT） for surgical implant application was synthesized and fully annealed at 700℃for 45 min.The microstructure and the mechanical properties such as tensile properties and fatigue properties were investigated.The results show that TZNT mainly consists of a lot of lamellaα-phase clusters with different orientations distributed in the originalβ-phase grain boundaries and a small amount ofβphases between the lamella a phases.The alloy exhibits better ductility,lower modulus of elasticity,and lower admission strain in comparison with Ti6A14V and Ti6A17Nb,indicating that it has better biomechanical compatibility with human bones.The fatigue limit of TZNT is 333 MPa,at which the specimen has not failed at 10^7 cycles.A large number of striations present in the stable fatigue crack propagation area,and many dimples in the fast fatigue crack propagation area are observed,indicating the ductile fracture of the new alloy.

Corrosion behaviors of a new titanium alloy TZNT for surgical implant application in Ringer’s solution

A new near α-titanium alloy Ti12.5Zr2.5Nb2.5Ta （TZNT） for surgical implants was designed. The potentiodynamic technique was performed to investigate the corrosion behaviors of TZNT in Ringer＇s solution, and Ti6A14V, Ti6Al7Nb, and TA2 were taken as comparison. The structure of the passive film was analyzed using an X-ray photoelectron spectrometer （XPS）. The results indicate that TZNT possesses better corrosion resistance, when compared with Ti6A14V, Ti6A17Nb, and TA2. The passive film formed on the TZNT surface is composed of oxides, such as TiO2, ZrO2, Nb2O5, and Ta2O5. The elements Zr and Ta are rich, whereas Ti and Nb are poor in the passive film. The addition of Zr, Nb, and Ta with relatively low electrochemical reaction potentials can reduce the anode activity and improve passive properties. Other than that, oxides such as ZrO2, Nb2O5, and Ta2O5 with the nobler equilibrium constants make the passive film more stable.

Designation and development of biomedical Ti alloys with finer biomechanical compatibility in long-term surgical implants

Developing the new titanium alloys with excellent biomechanical compatibility has been an important research direction of surgical implants materials. Present paper summarizes the international researches and developments of biomedical titanium alloys. Aiming at increasing the biomechanical compatibility, it also introduces the exploration and improvement of alloy designing, mechanical processing, microstructure and phase transformation, and finally outlines the directions for scientific research on the biomedical titanium alloys in the future.

Comparative Evaluation of Implant Placement with Conventional and Digital Surgical Guide Techniques: Two Case Reports

Background: Implant placement using a conventional surgical guide and digital surgical guide techniques is well documented in the literature. The most frequently reported disadvantages of conventional surgical guide placement are lack of accuracy in implant placement when compared to three-dimensional assessment in digital technique. Other factors listed are longer time duration and the need for impression techniques. In this case report, the authors present a comparison between the two techniques and the time taken between both cases one done conventionally and another case by digital technique. Case Presentation: For the digital surgical guide, a 44-year-old, male reported with the chief complaint of missing teeth needing replacement was considered. For the conventional technique, a female patient aged fifty-seven who had gone through various dentists with an existing bridge was considered. This patient wanted a good outcome at a reasonable cost. In both cases, molars were missing and needed replacement. The steps for digital flow for a surgical guide and step-by-step conventional methods are both highlighted in this article. Conclusion: Hence the digital technique saved time and was accurate when compared to the conventional in our experience.

Next-generation surgicalmeshes for drug delivery and tissue engineering applications:materials,design and emerging manufacturing technologies

Surgical meshes have been employed in the management of a variety of pathological conditions including hernia,pelvic floor dysfunctions,periodontal guided bone regeneration,wound healing and more recently for breast plastic surgery after mastectomy.These common pathologies affect a wide portion of the worldwide population;therefore,an effective and enhanced treatment is crucial to ameliorate patients’living conditions both from medical and aesthetic points of view.At present,non-absorbable synthetic polymers are the most widely used class of biomaterials for the manufacturing of mesh implants for hernia,pelvic floor dysfunctions and guided bone regeneration,with polypropylene and poly tetrafluoroethylene being the most common.Biological prostheses,such as surgical grafts,have been employed mainly for breast plastic surgery and wound healing applications.Despite the advantages of mesh implants to the treatment of these conditions,there are still many drawbacks,mainly related to the arising of a huge number of post-operative complications,among which infections are the most common.Developing a mesh that could appropriately integrate with the native tissue,promote its healing and constructive remodelling,is the key aim of ongoing research in the area of surgical mesh implants.To this end,the adoption of new biomaterials including absorbable and natural polymers,the use of drugs and advanced manufacturing technologies,such as 3D printing and electrospinning,are under investigation to address the previously mentioned challenges and improve the outcomes of future clinical practice.The aim of this work is to review the key advantages and disadvantages related to the use of surgical meshes,the main issues characterizing each clinical procedure and the future directions in terms of both novel manufacturing technologies and latest regulatory considerations.

Study of a Novel Small Caliber Vascular Graft in a Canine Model with Optical and Scanning Electron Microscopy

A novel biological small-diameter vascular graft was evaluated in a canine model. 3 cm long segments with 4 mm I.D. were implanted end-to-end in the carotid position of 12 dogs for 6 months. Color Doppler sonography was performed at the first week post-operation, and angiography was then administered to 9 grafts at 4th week, 12th week and 24th week respectively to monitor the graft pantency and blood flow characteristics. Vascular samples containing the grafts were collected at 1st week, 8th week, 12th week and 24th week after implantation. Morphological changes of the grafts were observed by optical and scanning electron microscopic (SEM) studies and compared with that of the original prosthesis and the normal host vessel. All grafts were patent throughout the experiment except one graft. Histopathology and SEM demonstrated both a nearly complete inner capsule of varied thickness lining the graft luminal surface and connective tissue adventitia formation at one-week post-operation. The neointima became confluent at 8 weeks and then compact but had no signs of hyperplasia up to 12 weeks; meanwhile on the neointimal surface newly grown endothelial-like cells were migrating from the stoma to the middle portion. The grafts also illustrated endothelialization in many “islands” in the mid-segment luminal surface of the grafts. In addition, the closer distance the cells towards the stoma were, the more morphological similarity the cells with the normal endothelial were. Taken together, the biological vascular graft remained patent for 24 weeks as a carotid prosthesis, characterized by the early and complete neointima formation plus endothelialization starting before 12 weeks post grafting. Therefore, the graft seems suitable for reconstruction of vascular lesions in dogs. Further studies may be carried out to extend the graft application for the clinical use.

Design and Experiments of Ultrasound Image-Guided Multi-DOF Robot System for Brachytherapy

To implant radioactive seeds through a needle precisely and safely, a novel multi-DOF surgical robotic system is presented in this paper for percutaneous prostate intervention through the patient’s perineum under real-time ultrasound image guidance. The proposed robot, which is designed with 9-DOF, consists of a 3-DOF automatic location platform for position adjustment, 2-DOF for automatic ultrasonic probe adjustment mounted with electromagnetic trackers, and 4-DOF for manually adjusting the guided template. Meanwhile, a new registration method based on the quaternion algorithm and least square method is developed, and the needle insertion is performed under the real-time guidance of a navigation system. Furthermore, the robot system has undergone some preliminary experiments with a laser tracker to evaluate the repeatability and accuracy of the robot system. The location error of the puncture needle tip can be controlled under 0.7 mm in air for the whole robotic system. The acquired results endorse the precision of the robot system for prostate seed implantation brachytherapy. © 2017, Tianjin University and Springer-Verlag GmbH Germany.

The use of virtual surgical planning and navigation in the treatment of orbital trauma

Virtual surgical planning （VSP） has recently been introduced in craniomaxillofacial surgery with the goal of improving efficiency and precision for complex surgical operations. Among many indications, VSP can also be applied for the treatment of congenital and acquired craniofacial defects, including orbital fractures. VSP permits the surgeon to visualize the complex anatomy of craniofacial region, showing the relationship between bone and neurovascular structures. It can be used to design and print using three- dimensional （3D） printing technology and customized surgical models. Additionally, intraoperative navigation may be useful as an aid in performing the surgery. Navigation is useful for both the surgical dissection as well as to confirm the placement of the implant. Navigation has been found to be especially useful for orbit and sinus surgery. The present paper reports a case describing the use of VSP and computerized navigation for the reconstruction of a large orbital floor defect with a custom implant.

Chemical composition analysis for laser solid forming of titanium alloys from blended elemental powders

Laser solid forming （LSF） from blended elemental powders is an advanced technique to investigate new alloy systems and to create innovative materials. Accurate composition control is critical for the applications of this technique. In this letter, the composition analysis is performed on LSF titanium alloys from blended Ti, Al, and V powders. It is found that the composition of as-deposited sample can be controlled by keeping the identity of the divergence angle of each elemental powder stream. Based on the consistency condition for divergence angles of different elemental powder streams, the matching relation among the Ti, Al, and V powder characteristics （particle size and density） can be obtained, which ensures the consistency in composition between the laser deposits and the blended elemental powders under different laser processing parameters.

An investigation on dysphotopsia of a sigma-edged intraocular lens

A sigma-edged design of intraocular lens （IOL） is proposed to minimize the reflected glare images associated with the edge. The optimal sigma inverse edge is investigated when pupil diameter is 5.0 mm by the established Escudero-Sanz＇s wide angle model. The non-sequential ray tracing program of Zemax-EE （Zemax Development Corp., San Diego, USA） is used to investigate the sigma edge of reducing the potential for edge glare phenomena. The results show that sigma-edged design can significantly reduce the reflected glare intensity on retina if the angle of its inverse edge is taken from 20 to 70 degrees.