Allestimento di modello sperimentale su animali di tessuto osseo ingegnerizzato

Questo studio ha valutato l'efficacia di un approccio rigenerativo utilizzando cellule staminali mesenchimali (MSC) e uno scaffold di idrossiapatite pura e porosa (HA) progettata con tecnologia CAD-CAM per sostituire il condilo dell'articolazione temporomandibolare (ATM). Metodi.Uno scaffolds di HA con porosità totale del 70% è stato prototipato per sostituire i due condili temporomandibolari (sinistro e destro) dello stesso animale. MSC sono state ottenute dalla cresta iliaca ed espanse in coltura. Guide chirurgiche su misura sono state create e utilizzate per esportare la pianificazione virtuale delle linee di taglio dell'osso nell'ambiente chirurgico. Sei pecore sono state sacrificate a 4 mesi dopo l'intervento.Gli scaffold sono stati espiantati, campioni istologici sono stati preparati, ed è stata eseguota l'analisi istomorfometrica. Risultati.L'analisi della riduzione di porosità per apposizione di osso neoformato mostrata una differenza statisticamente significativa tra la formazione ossea nei condili carichi di MSC rispetto ai condili senza (

New Application of Piezoelectric Ultrasounds in Maxillo-facial bone surgery

Background: Piezoelectric instrumentation seems to offer 3 important advantages for cutting bone structures. Be more precise because it is produced by micro-vibrations from the cutting insert. Be safer because the ultrasonic frequency used does not affect soft tissue. Thirdly, the less invasive cutting action produces minor tissue damage and consequently probably a better healing Aim of the Study: The aim of this study is to evaluate the effectiveness of piezoelectric device capability in maxillo-facial surgery, in order to take advantage of these favourable capacity. Material and Methods: Considering the several potential application of the piezoelectric technology in Orthognathic, Oncologic and Extractive surgery, we would like to design protocols in order to verify how this new device can modify the surgical technique, the surgical time, the patients healing and its quality of life. Results: Due to the precise Piezosurgery cut, we can manage the Cad-Cam-Custom Made plates protocol in Oncologic Surgery and in Orthognatic Surgery increasing our percentage of comparison between the 3D preoperative plan and the surgical execution. We also found a better quality of life impaction in Patient who underwent and extractive surgery Conclusion: Piezosurgery device seems to be a strong surgical aid were safe and precise cut are needed and its capability to reduce the discomfort Patients need to be study in deep also in major surgery like Orthognatic and Oncologic surgery.

Industrializzazione di una famiglia di componenti meccanici secondo i principi dell'industria 4.0

Il progetto di tesi tratta l'industrializzazione di una famiglia di componenti meccanici con gli obiettivi di riduzione del lead time e dei costi di produzione ed un miglioramento della qualità costruttiva. Per fare ciò è stato definito un nuovo ciclo di fabbricazione che riunisse tutte le operazioni di asportazione di truciolo in un unico centro di lavoro di fresatura. Sono state definite, progettate e messe in atto tutte le fasi del processo produttivo utilizzando i moderni software CAD-CAM-CNC. Al termine sono stati elaborati i risultati ottenuti svolgendo anche una analisi economica per valutare il risparmio percentuale annuo sul costo di produzione. Infine è stato fatto un confronto fra il vecchio ed il nuovo processo produttivo realizzato secondo i principi dell'Industria 4.0 ed i relativi vantaggi che esso permette di ottenere.

Computer-assisted design and manufacture of implants in the late reconstruction of extensive orbital fractures

To evaluate the use of computer-assisted designed and manufactured (CAD/CAM) orbital wall and floor implants for late reconstruction of extensive orbital fractures.

Maintenance of implant-supported maxillary prostheses: a 2-year controlled clinical trial

To analyze maintenance service of fixed maxillary prostheses and overdentures based on conventional gold bars or titanium bars and frameworks fabricated with computer-aided design/computer-assisted manufacture (CAD/CAM) technology.

Implants with Original and Non-Original Abutment Connections

AIM: To test in vitro the mechanical resistance, rotational misfit and failure mode of three original implant-abutment connections and to compare them to two connections between non-original abutments connected to one of the original implants. MATERIAL AND METHODS: Three different implants with small diameters (3.3 mm for Straumann Roxolid, 3.5 mm for Nobel Biocare Replace and Astra Tech Osseospeed TX) were connected with individualized titanium abutments. Twelve implants from each system were connected to their original abutments (Straumann CARES, Nobel Biocare Procera, Astra Tech Atlantis). Twenty-four Roxolid implants were connected with non-original abutments using CAD/CAM procedures from the other two manufacturers (12 Nobel Biocare Procera and 12 Astra Tech Atlantis). For the critical bending test, a Zwick/Roell 1475 machine and the Xpert Zwick/Roell software were used. RESULTS: The rotational misfit varied when comparing the different interfaces. The use of non-original grade V titanium abutments on Roxolid implants increased the force needed for deformation. The fracture mode was different with one of the original connections. CONCLUSIONS: Non-original abutments differ in design of the connecting surfaces and material and demonstrate higher rotational misfit. These differences may result in unexpected failure modes.

[Zirconia and removable partial dentures]

The present paper deals with the double crown technique in removable prosthodontics. New ceramic materials like zirconia are increasingly used in combination with CAD/CAM technologies for framework fabrication of fixed prosthesis, tooth- or implant-supported. However, zirconia is also a newly accepted material in removable prosthodontics. It replaces gold alloys for the fabrication of primary telescopic crowns. The Galvanoforming technology is preferably used to fabricate the secondary crowns. The combination of both techniques and materials results in a prosthetic reconstruction of high quality, optimum fit and good biocompatibility.

Prosthetic considerations

Implants have changed prosthodontics more than any other innovation in dentistry. Replacement of lost teeth by a fixed or removable prosthesis is considered to be a restitutio ad similem, while implants may provide a feeling of restitutio ad integrum. Implant prosthodontics means restoring function, aesthetics, and providing technology; biology and technology are combined. Placement of implants is a reconstructive, preprosthetic surgical intervention and is therefore different from most goals in oral surgery that consist of tooth extraction, treating infection and removing pathology from soft or hard tissues. Thus, implants are part of the final prosthetic treatment which encompasses functional, aesthetic and social rehabilitation. The patient's needs and functional status determine the goal of prosthetic treatment. Treatment outcomes in implant prosthodontics are survival of implants and prostheses, impact on physiological and psychological status, oral health-related impact on quality of life, and initial and maintenance costs. A variety of prosthetic solutions are available to restore the partially and completely edentulous jaw and more recently specific methods have been developed such as computer guided planning and CAD-CAM technologies. These should allow more uniform quality and passive fit of prostheses, and simultaneously enables processing of biologically well-accepted materials.

[Rehabilitation of a periodontally compromised dentition with implant-supported zirconia bridges. Case report]

Clinical aspects of reconstruction with fix prosthesis and dental implants in a patient with a history of periodontitis is shown. A successful stabilization and rehabilitation of the periodontally involved dentition can be achieved with tooth-worn crown and bridge reconstructions. From a functional and aesthetic point of view the result may not be satisfying due to mobility and overlength of the teeth and open approximal spaces. Today, dentist and patient have often to weigh if teeth shall be maintained or replaced by dental implants. Thereby, both must be aware of the fact that in complex cases long-term success and aesthetic outcome may be difficult to predict. An intense discussion with the patient on his expectations, invasive treatment, risks with regard to biologic and prosthetic aspects is mandatory and must be based on the best scientific evidence available. The present case report shows different considerations and describes a radical solution which meets the patient's needs and is based on modern CAD-CAM technology.

Die generative Herstellung von Dentalmodellen- eine Rapid Manufacturing Herausforderung

Heutzutage stehen zunehmend – z.B. durch den raschen Fortschritt bei den bildgebenden Verfahren – digitale Datensätze im Dentalbereich zur Verfügung. CAD/CAM-syteme gehören dabei in der Zahntechnik längst zum Stande der Technik. Für die Anwendung derartiger Systeme ist jedoch ein Gipsmodell nötig, welches zum Beginn der Prozesskette vom Zahntechniker mittels eines optischen Scanners digitalisiert wird. Die Weiterentwicklung intraoraler Scanner ermöglicht heutzutage außerdem die Digitalisierung ganzer Kiefer im Patientenmund durch den Zahnarzt. Insbesondere für z.B. die ästhetischen Restaurationen bildet hier das zahntechnische Modell nach wie vor die unersetzliche Arbeitsgrundlage für den Techniker. In der vorliegenden Arbeit wird dazu ein Rapid Manufacturing Verfahren zur Herstellung von Dentalmodellen auf Basis der Stereolithographie vorgestellt. Dabei wird auf die besonderen Anforderungen hinsichtlich Präzision, Robustheit und Wirtschaftlichkeit von generativen Fertigungsverfahren für dentale Applikationen eingegangen und eine neu entwickelte Baustrategie vorgestellt, mittels derer die o.g. Anforderungen erfüllt werden

Funktionales Konstruieren – Rapid Technologien für Architektur und Baukonstruktion

Nicht nur in der Medizintechnik, in der Luftfahrt und in der Automobilindustrie werden die generativen Verfahren zunehmend mehr als wichtige Produktionsverfahren angesehen. Auch die (Bau-) Industrie nimmt mehr und mehr die Möglichkeiten und Chancen wahr, welche diese Verfahren für andersartige Konstruktionen und Details eröffnen. Die Ergründung von Veränderungen und Auswirkungen dieser neuen Technologien auf den Entwurf und auf die Umsetzung von Architektur und Baukonstruktion ist Schwerpunkt der Forschungstätigkeiten von Dipl.-Ing. Holger Strauß an den Hochschulstandorten TU Delft, Niederlande und an der Hochschule Ostwestfalen-Lippe in Detmold. Das erste, umfangreiche Forschungsprojekt zu diesem Thema - „Influence of Additive Processes on the development of facade constructions“ - wurde 2008 in Kooperation mit der international agierenden Firma Kawneer-Alcoa im Forschungsschwerpunkt „ConstructionLab“ an der Detmolder Schule für Architektur und Innenarchitektur etabliert. Der Fokus der Bestrebungen liegt zunächst auf der Ergründung von Möglichkeiten für die generative Herstellung von Bauteilen als Ergänzung der Standardprodukte in Systemfassaden. Die Verwendung der Additiven Verfahren und Hightech CAD-CAM Anwendungen bedingt eine neue Art des Konstruierens. Nämlich nicht mehr das fertigungsgerechte, sondern das funktionsgerechte – das „Funktionale Konstruieren“. Neben der Bereicherung der Forschung und Lehre an den Hochschulen durch eine praxisnahe und zielorientierte Aufgabenstellung, fließen alle Ergebnisse in die Promotion von Holger Strauß an der Technischen Universität in Delft am Lehrstuhl Design of Construction bei Prof. Dr.-Ing. Ulrich Knaack ein.

Light curing through glass ceramics with a second- and a third-generation LED curing unit: effect of curing mode on the degree of conversion of dual-curing resin cements

Objectives The aim of this study was to measure the degree of conversion (DC) of five dual-curing resin cements after different curing modes with a second- and a third-generation light-emitting diode (LED) curing unit. Additionally, irradiance of both light curing units was measured at increasing distances and through discs of two glass ceramics for computer-aided design/manufacturing (CAD/CAM). Materials and methods Irradiance and spectra of the Elipar FreeLight 2 (Standard Mode (SM)) and of the VALO light curing unit (High Power Mode (HPM) and Xtra Power Mode (XPM)) were measured with a MARC radiometer. Irradiance was measured at increasing distances (control) and through discs (1.5 to 6 mm thickness) of IPS Empress CAD and IPS e.max CAD. DC of Panavia F2.0, RelyX Unicem 2 Automix, SpeedCEM, BisCem, and BeautiCem SA was measured with an attenuated total reflectance–Fourier transform infrared spectrometer when self-cured (negative control) or light cured in SM for 40 s, HPM for 32 s, or XPM for 18 s. Light curing was performed directly (positive control) or through discs of either 1.5- or 3-mm thickness of IPS Empress CAD or IPS e.max CAD. DC was analysed with Kruskal–Wallis tests followed by pairwise Wilcoxon rank sum tests (α = 0.05). Results Maximum irradiances were 1,545 mW/cm2 (SM), 2,179 mW/cm2 (HPM), and 4,156 mW/cm2 (XPM), and all irradiances decreased by >80 % through discs of 1.5 mm, ≥95 % through 3 mm, and up to >99 % through 6 mm. Generally, self-curing resulted in the lowest DC. For some cements, direct light curing did not result in higher DC compared to when light cured through ceramic discs. For other cements, light curing through ceramic discs of 3 mm generally reduced DC. Conclusions Light curing was favourable for dual-curing cements. Some cements were more susceptible to variations in curing mode than others. Clinical relevance When light curing a given cement, the higher irradiances of the third-generation LED curing unit resulted in similar DC compared to the second-generation one, though at shorter light curing times.

In vitro precision of fit of computer-aided design and computer-aided manufacturing titanium and zirconium dioxide bars

OBJECTIVES Optical scanners combined with computer-aided design and computer-aided manufacturing (CAD/CAM) technology provide high accuracy in the fabrication of titanium (TIT) and zirconium dioxide (ZrO) bars. The aim of this study was to compare the precision of fit of CAD/CAM TIT bars produced with a photogrammetric and a laser scanner. METHODS Twenty rigid CAD/CAM bars were fabricated on one single edentulous master cast with 6 implants in the positions of the second premolars, canines and central incisors. A photogrammetric scanner (P) provided digitized data for TIT-P (n=5) while a laser scanner (L) was used for TIT-L (n=5). The control groups consisted of soldered gold bars (gold, n=5) and ZrO-P with similar bar design. Median vertical distance between implant and bar platforms from non-tightened implants (one-screw test) was calculated from mesial, buccal and distal scanning electron microscope measurements. RESULTS Vertical microgaps were not significantly different between TIT-P (median 16μm; 95% CI 10-27μm) and TIT-L (25μm; 13-32μm). Gold (49μm; 12-69μm) had higher values than TIT-P (p=0.001) and TIT-L (p=0.008), while ZrO-P (35μm; 17-55μm) exhibited higher values than TIT-P (p=0.023). Misfit values increased in all groups from implant position 23 (3 units) to 15 (10 units), while in gold and TIT-P values decreased from implant 11 toward the most distal implant 15. SIGNIFICANCE CAD/CAM titanium bars showed high precision of fit using photogrammetric and laser scanners. In comparison, the misfit of ZrO bars (CAM/CAM, photogrammetric scanner) and soldered gold bars was statistically higher but values were clinically acceptable.

In vitro precision of fit of computer-aided designed and computer-aided manufactured titanium screw-retained fixed dental prostheses before and after ceramic veneering

OBJECTIVE To compare the precision of fit of full-arch implant-supported screw-retained computer-aided designed and computer-aided manufactured (CAD/CAM) titanium-fixed dental prostheses (FDP) before and after veneering. The null-hypothesis was that there is no difference in vertical microgap values between pure titanium frameworks and FDPs after porcelain firing. MATERIALS AND METHODS Five CAD/CAM titanium grade IV frameworks for a screw-retained 10-unit implant-supported reconstruction on six implants (FDI tooth positions 15, 13, 11, 21, 23, 25) were fabricated after digitizing the implant platforms and the cuspid-supporting framework resin pattern with a laser scanner (CARES(®) Scan CS2; Institut Straumann AG, Basel, Switzerland). A bonder, an opaquer, three layers of porcelain, and one layer of glaze were applied (Vita Titankeramik) and fired according to the manufacturer's preheating and fire cycle instructions at 400-800°C. The one-screw test (implant 25 screw-retained) was applied before and after veneering of the FDPs to assess the vertical microgap between implant and framework platform with a scanning electron microscope. The mean microgap was calculated from interproximal and buccal values. Statistical comparison was performed with non-parametric tests. RESULTS All vertical microgaps were clinically acceptable with values <90 μm. No statistically significant pairwise difference (P = 0.98) was observed between the relative effects of vertical microgap of unveneered (median 19 μm; 95% CI 13-35 μm) and veneered FDPs (20 μm; 13-31 μm), providing support for the null-hypothesis. Analysis within the groups showed significantly different values between the five implants of the FDPs before (P = 0.044) and after veneering (P = 0.020), while a monotonous trend of increasing values from implant 23 (closest position to screw-retained implant 25) to 15 (most distant implant) could not be observed (P = 0.169, P = 0.270). CONCLUSIONS Full-arch CAD/CAM titanium screw-retained frameworks have a high accuracy. Porcelain firing procedure had no impact on the precision of fit of the final FDPs. All implant microgap measurements of each FDP showed clinically acceptable vertical misfit values before and after veneering. Thus, the results do not only show accurate performance of the milling and firing but show also a reproducible scanning and designing process.