• Biomedical Engineering Letters
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• 제8권4호
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• pp.337-344
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• 2018

Additive manufacturing (AM) is an alternative metal fabrication technology. The outstanding advantage of AM (3D-printing, direct manufacturing), is the ability to form shapes that cannot be formed with any other traditional technology. 3D-printing began as a new method of prototyping in plastics. Nowadays, AM in metals allows to realize not only net-shape geometry, but also high fatigue strength and corrosion resistant parts. This success of AM in metals enables new applications of the technology in important fields, such as production of medical implants. The 3D-printing of medical implants is an extremely rapidly developing application. The success of this development lies in the fact that patient-specific implants can promote patient recovery, as often it is the only alternative to amputation. The production of AM implants provides a relatively fast and effective solution for complex surgical cases. However, there are still numerous challenging open issues in medical 3D-printing. The goal of the current research review is to explain the whole technological and design chain of bio-medical bone implant production from the computed tomography that is performed by the surgeon, to conversion to a computer aided drawing file, to production of implants, including the necessary post-processing procedures and certification. The current work presents examples that were produced by joint work of Polygon Medical Engineering, Russia and by TechMed, the AM Center of Israel Institute of Metals. Polygon provided 3D-planning and 3D-modelling specifically for the implants production. TechMed were in charge of the optimization of models and they manufactured the implants by Electron-Beam Melting ($EBM^{(R)}$), using an Arcam $EBM^{(R)}$ A2X machine.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권1호
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• pp.49-53
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• 2011

Introduction: This study compared the strength of osseointegration as determined by the resistance to reverse torque rotation of three different hydroxyapatite coated implants in the rabbit femur model. Materials and Methods: Three hydroxyapatite coated implants (HAPTITE), Tapered Screw-Vent (TSV) and BioTite-H - were used. A total of 40 implants were placed in the femur of 20 adult male rabbits. The animals were divided into two groups. In group A (n=10); one HAPTITE was placed into each right femur and one TSV was placed into each left femur. In group B (n=10); one HAPTITE was placed into each right femur and one BioTite-H was placed into each left femur. Five rabbits of each group were sacrificed at 4 and 8 weeks. The implants were removed by reverse torque rotation using a digital torque-measuring device. A total of 40 implants in 20 rabbits were used for the removal torque measurements. Results: In the Group A, 4 weeks after implant placement, the mean removal torque for the HAPTITE and TSV was $70.7{\pm}31.6$ N cm and $28.9{\pm}15.1$ N cm, respectively. Eight weeks after implant placement, the mean removal torque for the HAPTITE and TSV was $87.9{\pm}26.2$ N cm and $54.9{\pm}22.4$ N cm, respectively. In the Group B, 4 weeks after implant placement, the mean removal torque for the HAPTITE and BioTite-H was $58.0{\pm}29.6$ N cm and $37.7{\pm}14.1$ N cm, respectively. Eight weeks after implant placement, the mean removal torque for the HAPTITE and BioTite-H was $91.4{\pm}47.1$ N cm and $30.8{\pm}9.8$ N cm. HAPTITE showed a higher removal torque than the other implants. Conclusion: These results suggest that HAPTITE increases the strength of osseointegration significantly as determined by the resistance to reverse torque rotation.

• Journal of International Society for Simulation Surgery
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• 제3권2호
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• pp.49-59
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• 2016

3D printing is also known as additive manufacturing technique in which has been used in various commercial fields such as engineering, art, education, and medicine. The applications such as fabrication of tissues and organs, implants, drug delivery, creation surgical models using 3D printer in medical field are expanding. Recently, 3D printing has been developing for produce biomimetic 3D structure using biomaterials containing living cells and that is commonly called "3D bio-printing". The 3D bio-printing technologies are usually classified four upon printing methods: Laser-assisted printing, Inkjet, extrusion, and stereolithograpy. In the bio-printing, bio-inks (combined hydrogels and living cells) are as important components as bio-printing technologies. The presence of various types of bioinks, however, in this review, we focused on the bio-inks which enables bioprinting efficacy using hydrogels with living cells.

• Journal of Periodontal and Implant Science
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• 제52권3호
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• pp.242-257
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• 2022

Purpose: This study investigated periodontal ligament (PDL) restoration in osseointegrated implants using stem cells. Methods: Commercial pure titanium and zirconium oxide (zirconia) were coated with beta-tricalcium phosphate (β-TCP) using a long-pulse Nd:YAG laser (1,064 nm). Isolated bone marrow mesenchymal cells (BMMSCs) from rabbit tibia and femur, isolated PDL stem cells (PDLSCs) from the lower right incisor, and co-cultured BMMSCs and PDLSCs were tested for periostin markers using an immunofluorescent assay. Implants with 3D-engineered tissue were implanted into the lower right central incisors after extraction from rabbits. Forty implants (Ti or zirconia) were subdivided according to the duration of implantation (healing period: 45 or 90 days). Each subgroup (20 implants) was subdivided into 4 groups (without cells, PDLSC sheets, BMMSC sheets, and co-culture cell sheets). All groups underwent histological testing involving haematoxylin and eosin staining and immunohistochemistry, stereoscopic analysis to measure the PDL width, and field emission scanning electron microscopy (FESEM). The natural lower central incisors were used as controls. Results: The BMMSCs co-cultured with PDLSCs generated a well-formed PDL tissue that exhibited positive periostin expression. Histological analysis showed that the implantation of coated (Ti and zirconia) dental implants without a cell sheet resulted in a well-osseointegrated implant at both healing intervals, which was confirmed with FESEM analysis and negative periostin expression. The mesenchymal tissue structured from PDLSCs only or co-cultured (BMMSCs and PDLSCs) could form a natural periodontal tissue with no significant difference between Ti and zirconia implants, consequently forming a biohybrid dental implant. Green fluorescence for periostin was clearly detected around the biohybrid implants after 45 and 90 days. FESEM showed the invasion of PDL-like fibres perpendicular to the cementum of the bio-hybrid implants. Conclusions: β-TCP-coated (Ti and zirconia) implants generated periodontal tissue and formed biohybrid implants when mesenchymal-tissue-layered cell sheets were isolated from PDLSCs alone or co-cultured BMMSCs and PDLSCs.

• The Journal of Advanced Prosthodontics
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• 제3권2호
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• pp.96-100
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• 2011

An 18-year-old male presented severe hypodontia due to hypohidrotic ectodermal dysplasia was treated with Le Fort I maxillary osteotomy with simultaneous sinus floor augmentation using the mixture of cortical autogenous bone graft harvested from iliac crest and organic Bio-Oss to position the maxilla in a right occlusal plane with respect to the mandible, and to construct adequate bone volume at posterior maxilla allowing proper implant placement. Due to the poor bone quality at other sites, ridge augmentation with onlay graft was done to construct adequate bone volume allowing proper implant placement, using tissue harvested from the iliac bone. Seven implants were placed in the maxilla and 7 implants were inserted in the mandible and screw-retained metal ceramic FPDs were fabricated. The two year follow up data showed that dental implants should be considered as a good treatment modality for patients with ectodermal dysplasia.

• 한국정밀공학회지
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• 제26권12호
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• pp.138-145
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• 2009

Custom medical treatment is being widely adapted to lots of medical applications. A technology for 3D modeling is strongly required to fabricate medical implants for individual patient. Needs on true 3D CAD data of a patient is strongly required for tissue engineering and human body simulations. Medical imaging devices show human inner section and 3D volume rendering images of human organs. CT or MRI is one of the popular imaging devices for that use. However, those image data is not sufficient to use for medical fabrication or simulation. This paper mainly deals how to generate 3D geometry data from those medical images. A new image processing technology is introduced to reconstruct 3D geometry of a human body vacancy from the medical images. Then a surface geometry data is reconstructed by using Marching cube algorithm. Resulting CAD data is a custom 3D geometry data of human vacancy. This paper introduces a novel 3D reconstruction process and shows some typical examples with implemented software.

• Journal of Periodontal and Implant Science
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• 제54권2호
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• pp.96-107
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• 2024

Purpose: Deproteinized bovine bone or synthetic hydroxyapatite are 2 prevalent bone grafting materials used in the clinical treatment of peri-implant bone defects. However, the differences in bone formation among these materials remain unclear. This study evaluated osteogenesis kinetics in peri-implant defects using 2 types of deproteinized bovine bone (Bio-Oss^® and Bio-Oss/Collagen^®) and 2 types of synthetic hydroxyapatite (Apaceram-AX^® and Refit^®). We considered factors including newly generated bone volume; bone, osteoid, and material occupancy; and bone-to-implant contact. Methods: A beagle model with a mandibular defect was created by extracting the bilateral mandibular third and fourth premolars. Simultaneously, an implant was inserted into the defect, and the space between the implant and the surrounding bone walls was filled with Bio-Oss, Bio-Oss/Collagen, Apaceram-AX, Refit, or autologous bone. Micro-computed tomography and histological analyses were conducted at 3 and 6 months postoperatively (Refit and autologous bone were not included at the 6-month time point due to their rapid absorption). Results: All materials demonstrated excellent biocompatibility and osteoconductivity. At 3 months, Bio-Oss and Apaceram-AX exhibited significantly greater volumes of formation than the other materials, with Bio-Oss having a marginally higher amount. However, this outcome was reversed at 6 months, with no significant difference between the 2 materials at either time point. Apaceram-AX displayed notably slower bioresorption and the largest quantity of residual material at both time points. In contrast, Refit had significantly greater bioresorption, with complete resorption and rapid maturation involving cortical bone formation at the crest at 3 months, Refit demonstrated the highest mineralized tissue and osteoid occupancy after 3 months, albeit without statistical significance. Conclusions: Overall, the materials demonstrated varying post-implantation behaviors in vivo. Thus, in a clinical setting, both the properties of these materials and the specific conditions of the defects needing reinforcement should be considered to identify the most suitable material.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제45권1호
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• pp.29-33
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• 2019

Objectives: Bone density seems to be an important factor affecting implant stability. The relationship between bone density and primary and secondary stability remains under debate. The aim of this study was to compare primary and secondary stability measured by resonance frequency analysis (RFA) between different bone types and to compare implant stability at different time points during 3 months of follow-up. Materials and Methods: Our study included 65 implants (BioHorizons Implant Systems) with 3.8 or 4.6 mm diameter and 9 or 10.5 mm length in 59 patients. Bone quality was assessed by Lekholm-Zarb classification. After implant insertion, stability was measured by an Osstell device using RFA at three follow-up visits (immediately, 1 month, and 3 months after implant insertion). ANOVA test was used to compare primary and secondary stability between different bone types and between the three time points for each density type. Results: There were 9 patients in type I, 18 patients in type II, 20 patients in type III, and 12 patients in type IV. Three implants failed, 1 in type I and 2 in type IV. Stability values decreased in the first month but increased during the following two months in all bone types. Statistical analysis showed no significant difference between RFA values of different bone types at each follow-up or between stability values of each bone type at different time points. Conclusion: According to our results, implant stability was not affected by bone density. It is difficult to reach a certain conclusion about the effect of bone density on implant stability as stability is affected by numerous factors.

• 한국임상수의학회지
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• 제24권2호
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• pp.182-191
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• 2007

Bioabsorbable devices have been utilized and experimented in many aspects of orthopaedic surgery. Depending upon their constituent polymers, these materials can be tailored to provide sufficient rigidity to allow bone healing, retain mechanical strength for certain period of time, and then eventually begin to undergo degradation. The objective of this study was to estimate extent in which Poly-L-latic acid (PLLA) implants had bioabsorbability and biocompatibility with bone and soft tissue in dogs and also to develop bioabsorbable, biocompatible materials with the appropriate strength and degradation characteristics to allow for regular clinical use for treating orthopedic problems in humans as well as animals. Eighteen dogs were used as experimental animals and were inserted two types of PLLA implants. PLLA rods were inserted into subcutaneous tissue of back or the abdomen wall. And the rods were tested for material properties including viscosity, molecular weight, melting point, melting temperature, crystallinity, flexural strength, and flexural modulus over time. PLLA screws were inserted through cortical bone into bone marrow in the femur of the dogs and stainless steel screw was inserted in the same femur. Radiographs were taken after surgery to observe locations of screw. Histological variations including cortical bone response, muscular response, bone marrow response were analyzed over the time for 62weeks. The physical properties of PLLA rods had delicate balances between mechanical, thermal and viscoelastic factors. PLLA screws did not induce any harmful effects and clinical complications on bone and soft tissue for degradation period. These results suggest that PLLA implants could be suitable for clinical use.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2015년도 추계학술대회
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• pp.988-991
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• 2015

3D 프린터란 3차원으로 특정 물건을 찍어내는 프린터로, 입체적으로 만들어진 설계도만 있으면 종이에 인쇄하듯 3차원 공간 안에 실제 사물을 만들어 낼 수 있는 기기다. 최근 3D 프린팅 기술은 의학 분야에서 다양하게 활용되고 있으며, 생체 의학적 응용은 지금까지 가장 중요한 연구 주제 중 하나로 주목 받아왔다. 3D 프린팅 기술은 의료 뿐 아니라 자동차, 항공, 선반 등 제조업 전반에 혁신적인 변화를 일으키고 있다. 현재 3D 프린터의 의료산업 적용 분야는 가상 시뮬레이션, 맞춤형의료보형물 제작, 의료 인력 교육 실습 등이다. 따라서 본 연구에서는 의료서비스를 위한 3D 프린팅 기술과 적용사례를 비교 분석하였다.