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| 2. |
- Thesleff, Alexander, 1986, et al.
(författare)
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The effect of cortical thickness and thread profile dimensions on stress and strain in bone-anchored implants for amputation prostheses
- 2022
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Ingår i: Journal of the Mechanical Behavior of Biomedical Materials. - : Elsevier BV. - 1751-6161 .- 1878-0180. ; 129
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Tidskriftsartikel (refereegranskat)abstract
- Skeletal attachment of limb prostheses ensures load transfer between the prosthetic leg and the skeleton. For individuals with lower limb amputation, these loads may be of substantial magnitude. To optimize the design of such systems, knowledge about the structural interplay between implant design features, dimensional changes, and material properties of the implant and the surrounding bone is needed. Here, we present the results from a parametric finite element investigation on a generic bone-anchored implant system of screw design, exposed to external loads corresponding to average and high ambulatory loading. Of the investigated parameters, cortical thickness had the largest effect on the stress and strain in the bone-anchored implant and in the cortical bone. 36%–44% reductions in maximum longitudinal stress in the bone-anchored implant was observed as a result of increased cortical thickness from 2 mm to 5 mm. A change in thread depth from 1.5 mm to 0.75 mm resulted in 20%–22% and 10%–18% reductions in maximum longitudinal stress in the bone-anchored implant at 2 mm and 5 mm cortical thickness respectively. The effect of changes in the thread root radius was less prominent, with 8% reduction in the maximum longitudinal stress in the bone-anchored implant being the largest observed effect, resulting from an increased thread root radius from 0.1 mm to 0.5 mm at a thread depth of 1.5 mm. Autologous transplantation of bone tissue distal to the fixture resulted in reductions in the longitudinal stress in the percutaneous abutment. The observed stress reduction of 10%–31% was dependent on the stiffness of the transplanted bone graft and the cortical thickness of surrounding bone. Results from this investigation may guide structural design optimization for bone-anchored implant systems for attachment of limb prostheses. © 2022 The Authors
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| 3. |
- Thesleff, Alexander, 1986, et al.
(författare)
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Low plasticity burnishing improves fretting fatigue resistance in bone-anchored implants for amputation prostheses
- 2022
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Ingår i: Medical Engineering & Physics. - : Elsevier BV. - 1350-4533 .- 1873-4030. ; 100
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Tidskriftsartikel (refereegranskat)abstract
- Fretting fatigue is a common problem for modular orthopedic implants which may lead to mechanical failure of the implant or inflammatory tissue responses due to excessive release of wear debris. Compressive residual stresses at the contacting surfaces may alleviate the problem. Here we investigate the potential of a surface enhancement method known as low plasticity burnishing (LPB) to increase the fretting fatigue resistance of bone-anchored implants for skeletal attachment of limb prostheses. Rotation bending fatigue tests performed on LPB treated and untreated test specimens demonstrate that the LPB treatment leads to statistically significantly increased resistance to fretting fatigue (LPB treated test specimens withstood on average 108,780 load cycles as compared with 37,845 load cycles for untreated test specimens, p = 0.004). LPB treated test specimens exhibited less wear at the modular interface as compared with untreated test specimens. This surface treatment may lead to reduced risk of fretting induced component failure and a reduced need for revision of implant system componentry.
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| 4. |
- Stenlund, Patrik, et al.
(författare)
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Effect of load on the bone around bone-anchored amputation prostheses
- 2017
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Ingår i: Journal of Orthopaedic Research. - : Wiley. - 0736-0266 .- 1554-527X. ; 35:5, s. 1113-1122
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Tidskriftsartikel (refereegranskat)abstract
- Osseointegrated transfemoral amputation prostheses have proven successful as an alternative method to the conventional socket-type prostheses. The method improves prosthetic use and thus increases the demands imposed on the bone-implant system. The hypothesis of the present study was that the loads applied to the bone-anchored implant system of amputees would result in locations of high stress and strain transfer to the bone tissue and thus contribute to complications such as unfavourable bone remodeling and/or elevated inflammatory response and/or compromised sealing function at the tissue-abutment interface. In the study, site-specific loading measurements were made on amputees and used as input data in finite element analyses to predict the stress and strain distribution in the bone tissue. Furthermore, a tissue sample retrieved from a patient undergoing implant revision was characterized in order to evaluate the long-term tissue response around the abutment. Within the limit of the evaluated bone properties in the present experiments, it is concluded that the loads applied to the implant system may compromise the sealing function between the bone and the abutment, contributing to resorption of the bone in direct contact with the abutment at the most distal end. This was supported by observations in the retrieved clinical sample of bone resorption and the formation of a soft tissue lining along the abutment interface. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1113–1122, 2017.
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| 5. |
- Li, Yan, et al.
(författare)
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Osseointegrated amputation prostheses and implanted electrodes
- 2021
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Ingår i: Bionic Limb Reconstruction. - Cham : Springer International Publishing. ; , s. 45-55
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- The load transfer from the external prosthesis to the residual limb via the socket can cause significant stress on the soft tissues, leading to irritation and skin ulcers. Osseointegrated bone-anchored prostheses systems create a direct structural and functional connection between the prosthesis and residual skeleton. Up to date, standardized implant systems, surgical techniques, and postoperative rehabilitation protocols have been developed for osseointegrated prostheses for the rehabilitation of amputees (OPRA), which has resulted in better functionality, fewer complications, and a better quality of life for implant recipients. The OPRA implant systems can now incorporate neuromuscular electrodes to facilitate myoelectric control and sensory feedback, which is especially important for upper extremity amputees. The latest development, called the osseointegrated human-machine gateway, allows for permanent implantation of neuromuscular electrodes, which provide long-term stable signals for myoelectric control, independent of limb position or environmental conditions, as well as artificial sensory feedback. In addition, the modular design of this system allows any part to be upgraded or replaced with minimal disturbance to the other components. The osseointegrated implants and the human-machine gateway represent frontiers in amputee rehabilitation.
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| 6. |
- Jarmar, T., et al.
(författare)
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Characterization of the surface properties of commercially available dental implants using scanning electron microscopy, focused ion beam, and high-resolution transmission electron microscopy
- 2008
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Ingår i: Clinical Implant Dentistry and Related Research. - : Wiley. - 1523-0899 .- 1708-8208. ; 10:1, s. 11-22
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Since osseointegration of the respective implant is claimed by all manufacturing companies, it is obvious that not just one specific surface profile including the chemistry controls bone apposition. PURPOSE: The purpose was to identify and separate out a particular set of surface features of the implant surfaces that can contribute as factors in the osseointegration process. MATERIAL AND METHODS: The surface properties of several commercially available dental implants were extensively studied using profilometry, scanning electron microscopy, and transmission electron microscopy. Ultrathin sections prepared with focused ion beam microscopy (FIB) provided microstructural and chemical data which have not previously been communicated. The implants were the Nobel Biocare TiUnite (Nobel Biocare AB, Goteborg, Sweden), Nobel Biocare Steri-Oss HA-coated (Nobel Biocare AB, Yorba Linda, CA, USA), Astra-Tech OsseoSpeed (Astra Tech AB, Molndal, Sweden), Straumann SLA (Straumann AG, Waldenburg, Switzerland), and the Branemark Integration Original Fixture implant (Branemark Integration, Goteborg, Sweden). RESULTS: It was found that their surface properties had differences. The surfaces were covered with crystalline TiO(2) (both anatase and rutile), amorphous titanium oxide, phosphorus doped amorphous titanium oxide, fluorine, titanium hydride, and hydroxyapatite, respectively. CONCLUSION: This indicates that the provision of osseointegration is not exclusively linked to a particular set of surface features if the implant surface character is a major factor in that process. The studied methodology provides an effective tool to also analyze the interface between implant and surrounding bone. This would be a natural next step in understanding the ultrastructure of the interface between bone and implants.
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| 7. |
- Jarmar, T., et al.
(författare)
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Technique for preparation and characterization in cross-section of oral titanium implant surfaces using focused ion beam and transmission electron microscopy
- 2008
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Ingår i: Journal of Biomedical Materials Research Part A. - : Wiley. - 1552-4965 .- 1549-3296. ; 87:4, s. 1003-9
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Tidskriftsartikel (refereegranskat)abstract
- The surface properties of materials are believed to control most of the biological reactions toward implanted materials. To study the surface structure, elemental distribution, and morphology, using transmission electron microscopy (TEM) techniques, thin foils of the surface (in cross-section) are needed. These have been cumbersome to produce, in particular, from the normally irregular screw-shaped metal implants. Focused ion beam (FIB) microscopy has been developed partly for TEM sample preparation, mainly within the microelectronics industry. Our study describes a method based on FIB for producing electron transparent foils/sections from a metal implant for TEM analysis. Using a screw-shaped titanium dental implant, it was demonstrated that thin foils can be prepared with submicron specificity and from almost any surface geometry. A comparison of different lift-out techniques showed that the in situ lift-out preparation technique allowed plasma cleaning and produced particularly good samples with excellent yield. The titanium oxide on the implant surface was analyzed using energy-filtered TEM (EFTEM) and high-resolution TEM (HRTEM) and the TiO(2) rutile phase being determined via the lattice parameters. This study provides the first set of data for the optimization of a new route for preparation and analysis of biomaterial surfaces and interfaces.
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| 8. |
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| 9. |
- Olsson, Rickard, 1959-, et al.
(författare)
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Production of osseointegrating (bone bonding) surfaces on titanium screws by laser melt disruption
- 2018
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Ingår i: Journal of Laser Applications. - Melville, NY : Laser Institute of America. - 1042-346X .- 1938-1387. ; 30:4
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Tidskriftsartikel (refereegranskat)abstract
- Several techniques can be used to modify implant surfaces in order to accelerate bone growth around titanium implants. One method is to generate a surface structure which stimulates bone growth and remodeling. This paper describes and explains a nonablative method for producing osseointegrating (structural and functional bone bonding) surfaces on titanium implants using laser processing. The focus is especially on surface texturing of dental implant screws, where the ability of a Nd:YAG laser to generate "splashy" surfaces covered in resolidified microscale droplets coated with nanoscale surface oxides is assessed. The surfaces produced were analyzed by a scanning electron microscope and energy dispersive x-ray spectroscopy. It is concluded that laser processing using Q-pulsed Nd:YAG lasers can generate surfaces which match the demands set by clinical experience. One important characteristic of the surfaces discussed here is that they involve overhanging features which are suitable for trapping red blood cells and which cannot be created by mechanical or chemical roughening techniques. © 2018 Laser Institute of America.
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| 10. |
- Benca, E., et al.
(författare)
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Thermal Effects during Bone Preparation and Insertion of Osseointegrated Transfemoral Implants
- 2021
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Ingår i: Sensors. - : MDPI AG. - 1424-8220. ; 21:18
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Tidskriftsartikel (refereegranskat)abstract
- Background: The preparation of bone for the insertion of an osseointegrated transfemoral implant and the insertion process are performed at very low speeds in order to avoid thermal damages to bone tissue which may potentially jeopardize implant stability. The aim of this study was to quantify the temperature increase in the femur at different sites and insertion depths, relative to the final implant position during the stepwise implantation procedure. Methods: The procedure for installation of the osseointegrated implant was performed on 24 femoral specimens. In one specimen of each pair, the surgery was performed at the clinically practiced speed, while the speed was doubled in the contralateral specimen. Six 0.075 mm K fine gauge thermocouples (RS Components, Sorby, UK) were inserted into the specimen at a distance of 0.5 mm from the final implant surface, and six were inserted at a distance of 1.0 mm. Results: Drilling caused a temperature increase of <2.5 degrees C and was not statistically significantly different for most drill sizes (0.002 < p < 0.845). The mean increase in temperature during thread tapping and implant insertion was <5.0 degrees C, whereas the speed had an effect on the temperature increase during thread tapping. Conclusions: Drilling is the most time-consuming part of the surgery. Doubling the clinically practiced speed did not generate more heat during this step, suggesting the speed and thus the time- and cost-effectiveness of the procedure could be increased. The frequent withdrawal of the instruments and removal of the bone chips is beneficial to prevent temperature peaks, especially during thread tapping.
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