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Fulltext Microwave-assisted fibrous decoration of mPE surface utilizing Aloe vera extract for tissue engineering applications

Balaji A, Jaganathan SK, Supriyanto E, Muhamad II, Khudzari AZ

Int J Nanomedicine, 2015;10:5909-23.
PMID: 26425089 DOI: 10.2147/IJN.S84307

Developing multifaceted, biocompatible, artificial implants for tissue engineering is a growing field of research. In recent times, several works have been reported about the utilization of biomolecules in combination with synthetic materials to achieve this process. Accordingly, in this study, the ability of an extract obtained from Aloe vera, a commonly used medicinal plant in influencing the biocompatibility of artificial material, is scrutinized using metallocene polyethylene (mPE). The process of coating dense fibrous Aloe vera extract on the surface of mPE was carried out using microwaves. Then, several physicochemical and blood compatibility characterization experiments were performed to disclose the effects of corresponding surface modification. The Fourier transform infrared spectrum showed characteristic vibrations of several active constituents available in Aloe vera and exhibited peak shifts at far infrared regions due to aloe-based mineral deposition. Meanwhile, the contact angle analysis demonstrated a drastic increase in wettability of coated samples, which confirmed the presence of active components on glazed mPE surface. Moreover, the bio-mimic structure of Aloe vera fibers and the influence of microwaves in enhancing the coating characteristics were also meticulously displayed through scanning electron microscopy micrographs and Hirox 3D images. The existence of nanoscale roughness was interpreted through high-resolution profiles obtained from atomic force microscopy. And the extent of variations in irregularities was delineated by measuring average roughness. Aloe vera-induced enrichment in the hemocompatible properties of mPE was established by carrying out in vitro tests such as activated partial thromboplastin time, prothrombin time, platelet adhesion, and hemolysis assay. In conclusion, the Aloe vera-glazed mPE substrate was inferred to attain desirable properties required for multifaceted biomedical implants.

Matched MeSH terms: Prostheses and Implants
Microwave-assisted fabrication of titanium implants with controlled surface topography for rapid bone healing

Kutty MG, De A, Bhaduri SB, Yaghoubi A

ACS Appl Mater Interfaces, 2014 Aug 27;6(16):13587-93.
PMID: 25095907 DOI: 10.1021/am502967n

Morphological surface modifications have been reported to enhance the performance of biomedical implants. However, current methods of introducing graded porosity involves postprocessing techniques that lead to formation of microcracks, delamination, loss of fatigue strength, and, overall, poor mechanical properties. To address these issues, we developed a microwave sintering procedure whereby pure titanium powder can be readily densified into implants with graded porosity in a single step. Using this approach, surface topography of implants can be closely controlled to have a distinctive combination of surface area, pore size, and surface roughness. In this study, the effect of various surface topographies on in vitro response of neonatal rat calvarial osteoblast in terms of attachment and proliferation is studied. Certain graded surfaces nearly double the chance of cell viability in early stages (∼one month) and are therefore expected to improve the rate of healing. On the other hand, while the osteoblast morphology significantly differs in each sample at different periods, there is no straightforward correlation between early proliferation and quantitative surface parameters such as average roughness or surface area. This indicates that the nature of cell-surface interactions likely depends on other factors, including spatial parameters.

Matched MeSH terms: Prostheses and Implants*
Microbial colonization of medical devices and novel preventive strategies

Shunmugaperumal T

Recent Pat Drug Deliv Formul, 2010 Jun;4(2):153-73.
PMID: 20236065

Upon implantation or insertion into patient's body for exerting the intended purpose like salvage of normal functions of vital organs, the medical devices are unfortunately becoming the sites of competition between host cell integration and microbial adhesion. Moreover, since there is an increased use of implanted medical devices, the incidence of biofilm-and medical devices-related nosocomial infections is also increasing progressively. To control microbial colonization and subsequent biofilm formation of the medical devices, different approaches either to enhance the efficiency of certain antimicrobial agents or to disrupt the basic physiology of the pathogenic microorganisms including novel small molecules and antipathogenic drugs are being explored. In addition, the various lipid-and polymer-based drug delivery carriers are also investigated for applying antibiofilm coating of the medical devices especially over catheters. The main intention of this review is therefore to summarize the major and/breakthrough inventions disclosed in patent literature as well as in research papers related to microbial colonization of medical devices and novel preventive strategies. This review starts with an overview of the preventive strategies followed by a short description about the potential of different lipidic-and polymeric-drug delivery carriers in eradicating the biofilm-associated infections from the medical devices.

Matched MeSH terms: Prostheses and Implants/microbiology*
Fulltext Methyl methacrylate cranioplasty

Azmi A, Latiff AZ, Johari A

Med J Malaysia, 2004 Aug;59(3):418-21.
PMID: 15727391

We conducted a prospective study in order to audit our experience of repairing cranial defects using Methyl methacrylate. This included a total of 49 patients undergoing cranioplasty using methyl methacrylate, of which 45 were males and 4 females. The age of patients at the time of surgery ranged from 16 to 40 years old, with an average of 24 years. Malays were the majority (67%), followed by Chinese (23%) and Indian (10%). Cranial defects were mainly caused by motor vehicle accident (94%), while gunshot wounds, industrial accidents and tumours, each contribute 2%. Bone flaps were commonly removed during previous surgery related to traumatic subdural haemorrhage (33%), contusion (21%) and intracerebral haemorrhage (14%). The size of cranial defects ranged from 28 cm2 to 440 cm2, with an average of 201 cm2. Most had right sided (55%) and lateral defects [temporoparietal (52%) followed by temporal (16%), frontal (16%), frontotemporal (14%) and occipital (2%)]. Duration of surgery ranged from 70 to 275 minutes, with an average of 135 minutes. Nine of 12 patients (75%) with neurological disability had some improvement while 85% of symptomatic patients had symptoms improvement after cranioplasty. The infection rate in this series was 4%.

Matched MeSH terms: Prostheses and Implants*
Metallic materials stimulating bone formation

Kokubo T

Med J Malaysia, 2004 May;59 Suppl B:91-2.
PMID: 15468833

Metallic materials implanted into bone defects are generally encapsulated by a fibrous tissue. Some metallic materials such as titanium and tantalum, however, have been revealed to bond to the living bone without forming the fibrous tissue, when they were subjected to NaOH solution and heat treatments. Thus treated metals form bone tissue around them even in muscle, when they take a porous form. This kind of osteoconductive and osteoinductive properties are attributed to sodium titanate or tantalate layer on their surfaces formed by the NaOH and heat treatments. These layers induce the deposition of bonelike apatite on the surface of the metals in the living body. This kind of bioactive metals are useful as bone substitutes even highly loaded portions, such as hip joint, spine and tooth root.

Matched MeSH terms: Prostheses and Implants*
Fulltext Mechanism of Fatigue Crack Growth in Biomedical Alloy Ti-27Nb

Amjad M, Badshah S, Rafique AF, Adil Khattak M, Khan RU, Abdullah Harasani WI

Materials (Basel), 2020 May 16;13(10).
PMID: 32429420 DOI: 10.3390/ma13102299

Implants are widely used in the human body for the replacement of affected bones. Fatigue failure is one of the serious concerns for implants. Therefore, understanding of the underlying mechanism leading to fatigue failure is important for the longevity of biomaterial implants. In this paper, the fracture toughness and fatigue crack growth of titanium alloy biomaterial Ti-27Nb has been experimentally investigated. The Ti-27Nb material is tested for fatigue crack growth in different environmental conditions representing the ambient and in vitro environments for 504 hours and 816 hours, respectively. Fractography of the tested specimen is conducted using Scanning Electron Microscope (SEM). The results of the fatigue crack growth propagation of the ambient and in vitro samples are similar in the Paris crack growth region. However, in the threshold region, the crack growth rate is higher for the Simulated Body Fluid (SBF) treated specimen. The fracture surface morphology of in vitro samples shows brittle fracture as compared to ambient specimens with significant plasticity and striations marks. It is proposed that a similar investigation may be conducted with specimens treated in SBF for prolonged periods to further ascertain the findings of this study.

Matched MeSH terms: Prostheses and Implants
Fulltext Maxillary implant-supported fixed detachable prosthesis : a case report

Abdul Aziz, A, Ahmad, S.F., Muslim, Y.R

Ann Dent, 2006;13(1):34-38.
MyJurnal

This clinical case report details the clinical sequence of a 78-year-old male receiving prosthetic rehabilitation using an implant-supported screwretained fixed partial denture. Despite the limitations imposed, the aesthetic and functional demands of the patient were fulfilled by this prosthetic rehabilitation. The importance of detailed prosthetic planning and evaluation prior to implant surgery is essential, therefore ideally, it should be done by the same operator or a team of operators working together. Problems can arise when the construction of the prosthesis is performed by other people who are not involved in the planning stage.

Matched MeSH terms: Prostheses and Implants
Fulltext Management of extensive surgical wounds of the extremity after tumour resections using two simultaneous composite flaps: two case reports

Faisal, A., Ahmad, S.H., Zulmi, W.

Journal of Surgical Academia, 2011;1(1):42-45.
MyJurnal

Tumour surgery for locally extensive malignant neoplasms of the extremity will sometimes result in extensive composite soft tissue defect. Local flaps are usually inadequate to cover these large defects. More than one tissue flap might be required to cover any exposed neurovascular structures, bone or prosthesis. We present two cases where two composite flaps were simultaneously used to cover extensive surgical defects after ablative tumour resections in the extremity. These resulted in uncomplicated wound healing and limb salvage.

Matched MeSH terms: Prostheses and Implants
Fulltext Lost wax-bolus technique to process closed hollow obturator with uniform wall thickness using single flasking procedure

Patil PG, Nimbalkar-Patil S

J Indian Prosthodont Soc, 2017 2 22;17(1):84-88.
PMID: 28216851 DOI: 10.4103/0972-4052.176538

INTRODUCTION: Maxillary obturator prosthesis is more frequent treatment modality than surgical reconstruction for maxillectomy in patients suffering from oral cancer. The obturators often become heavy and hence are hollowed out in the defect portion to reduce its weight as a standard practice.
MATERIALS AND METHODS: The processing technique described the incorporation of the preshaped "wax-bolus" during packing procedure of the Obturtor prosthesis and eliminated later by melting it once the curing procedure is completed.
RESULTS: This article is a single step procedure resulting into the closed-hollow obturator as single unit with uniform wall thickness around the hollow space ensuring the least possible weight of the hollow obturator.
CONCLUSION: This processing technique achieves predictable internal dimension of the hollow space providing uniform wall thickness of the obturator.

Matched MeSH terms: Prostheses and Implants
Fulltext Ipsilateral proximal and distal radius fractures with unstable elbow joint: Which should we address first?

Akma Kamaludin NA, Ferdaus Kamudin NA, Abdullah S, Sapuan J

Chin J Traumatol, 2019 Feb;22(1):59-62.
PMID: 30745113 DOI: 10.1016/j.cjtee.2018.04.007

Simultaneous ipsilateral fractures involving radial head and distal end of radius are uncommon. We present our thoughts on which fracture should be addressed first. A 68-year-old lady sustained an ipsilateral fracture of the right radial head and distal end of radius following a fall. Clinically her right elbow was posteriorly dislocated and right wrist was deformed. Plain radiographs showed an intraarticular fracture of the distal end of radius and a comminution radial head fracture with a proximally migrated radius. Magnetic resonance imaging (MRI) showed no significant ligament injuries. We addressed her distal radius first with an anatomical locking plate followed by her radial head with a radial head replacement. Our rationale to treat the distal end radius: first was to obtain a correct alignment of Lister's tubercle and correct the distal radius height. Lister's tubercle was used to guide for the correct rotation of the radial head prosthesis. Correcting the distal end fracture radial height helped us with length selection of the radial head prosthesis and address the proximally migrated radial shaft and neck. Postoperative radiographs showed an acceptable reduction. The Cooney score was 75 at 3 months postoperatively, which was equivalent to a fair functional outcome.

Matched MeSH terms: Prostheses and Implants
Ion-Doped Silicate Bioceramic Coating of Ti-Based Implant

Mohammadi H, Sepantafar M

Iran Biomed J, 2016 Sep;20(4):189-200.
PMID: 26979401

Titanium and its alloy are known as important load-bearing biomaterials. The major drawbacks of these metals are fibrous formation and low corrosion rate after implantation. The surface modification of biomedical implants through various methods such as plasma spray improves their osseointegration and clinical lifetime. Different materials have been already used as coatings on biomedical implant, including calcium phosphates and bioglass. However, these materials have been reported to have limited clinical success. The excellent bioactivity of calcium silicate (Ca-Si) has been also regarded as coating material. However, their high degradation rate and low mechanical strength limit their further coating application. Trace element modification of (Ca-Si) bioceramics is a promising method, which improves their mechanical strength and chemical stability. In this review, the potential of trace element-modified silicate coatings on better bone formation of titanium implant is investigated.

Matched MeSH terms: Prostheses and Implants*
Fulltext In Situ Controlled Surface Microstructure of 3D Printed Ti Alloy to Promote Its Osteointegration

Shan L, Kadhum AAH, Al-Furjan MSH, Weng W, Gong Y, Cheng K, et al.

Materials (Basel), 2019 Mar 10;12(5).
PMID: 30857349 DOI: 10.3390/ma12050815

It is well known that three-dimensional (3D) printing is an emerging technology used to produce customized implants and surface characteristics of implants, strongly deciding their osseointegration ability. In this study, Ti alloy microspheres were printed under selected rational printing parameters in order to tailor the surface micro-characteristics of the printed implants during additive manufacturing by an in situ, controlled way. The laser path and hatching space were responsible for the appearance of the stripy structure (S), while the bulbous structure (B) and bulbous⁻stripy composite surface (BS) were determined by contour scanning. A nano-sized structure could be superposed by hydrothermal treatment. The cytocompatibility was evaluated by culturing Mouse calvaria-derived preosteoblastic cells (MC3T3-E1). The results showed that three typical microstructured surfaces, S, B, and BS, could be achieved by varying the 3D printing parameters. Moreover, the osteogenic differentiation potential of the S, B, and BS surfaces could be significantly enhanced, and the addition of nano-sized structures could be further improved. The BS surface with nano-sized structure demonstrated the optimum osteogenic differentiation potential. The present research demonstrated an in situ, controlled way to tailor and optimize the surface structures in micro-size during the 3D printing process for an implant with higher osseointegration ability.

Matched MeSH terms: Prostheses and Implants
Fulltext Improving bond strength and thermal behaviour of new sodalite infiltrate ceramic core materials

Naji, Ghassan Abdul-Hamid, Ros Anita Omar, Rosiyah Yahya

International Medical Journal Malaysia, 2017;16(21):2-2.
MyJurnal

The mismatch in coefficient of thermal expansion (CTE) between the veneered
porcelain and the ceramic core has been primarily identified as the cause of core/veneer chipping
in all-ceramic restorations. This study aimed to evaluate the effect of sodalite infiltration on the
CTE behaviour and bond strength of different all-ceramic prostheses. Materials and Methods: The
experimental groups were synthesised sodalite-infiltrated alumina (IA-SOD) and synthesised
sodalite-infiltrated zirconia-toughened alumina (ZTA) (IZ-SOD), while the control groups were glassinfiltrated alumina (IA-glass) and glass-infiltrated ZTA (IZ-glass). (Copied from article).

Matched MeSH terms: Prostheses and Implants
Hydroxapatite and tricalcium phosphate prepared by precipitation method

Cik Rohaida CH, Idris B, Mohd Reusmaazran Y, Rusnah M, Fadzley Izwan AM

Med J Malaysia, 2004 May;59 Suppl B:156-7.
PMID: 15468865

A mixture with different compositions of HA and TCP were synthesize in this work by precipitation method using Ca(NO3)2 4H2 and (NH4)2HPO4 as the starting materials. A mixture with HA and TCP phases in different ratios were produced. The powders were sintered from 1000 degrees C to 1250 degrees C. The phase compositions of the mixtures were then studied via XRD. This work shows that the pH value determines the different phase compositions of the HA-TCP mixture. Chemical analyses were carried out by FTIR. The microstructure was observed under SEM.

Matched MeSH terms: Prostheses and Implants*
Fulltext Huge Chest Wall Tumour Resection and Reconstruction using Titanium Mesh

Adli Azam MR, Raja Amin RM

Malays J Med Sci, 2015 Jan-Feb;22(1):70-3.
PMID: 25892952 MyJurnal

Malignant chest wall tumour is rare. The presentation is usually aggressive that requires extensive resection to prevent recurrence. However, the extensive resection is to the expense of causing defect on the chest wall and hence, respiratory mechanics. Two cases of chest wall tumour are discussed including the surgical approach of radical tumour resection which was combined with placement of titanium mesh and Tranverse Rectus Abdominis Myocutaneus (TRAM) flap to cover the defect and preserve respiratory mechanical functions. The morbidity of using titanium mesh demonstrated in the case series were infection and injury to surrounding tissue due to its rigidity and large size which required its removal. However the formation of 'pseudopleura' made the thoracic cage return back as closed cavity even after the removal of the titanium mesh and allow normal respiratory functions.

Matched MeSH terms: Prostheses and Implants
Hospital Universiti Sains Malaysia experience in orbital floor reconstruction: autogenous graft versus Medpor

Wajih WA, Shaharuddin B, Razak NH

J Oral Maxillofac Surg, 2011 Jun;69(6):1740-4.
PMID: 21272979 DOI: 10.1016/j.joms.2010.07.053

A normally restored orbital structure after reconstructive surgery would accelerate the return of orbital function. The aim of the present study was to compare the outcomes of 2 orbital implants: autogenous grafts and porous polyethylene (Medpor).

Matched MeSH terms: Prostheses and Implants*
Fulltext Growing endoprosthesis in management of bone tumours in Malaysia

Saravanan S, Vivek AS

Med J Malaysia, 2007 Dec;62(5):418-9.
PMID: 18705481 MyJurnal

This is to report on the use of growing endoprosthesis, also known as lengthening prosthesis in the management of four patients in the paedriatic age group in the Orthopaedic Oncolgy Unit at University Malaya Medical Centre. These are custom made prosthesis, designed and made in India based on measured roentrograms. The ages of these patients vary from 6 to 13 years old. These are cases of Osteosarcoma and Ewing's sarcoma around the knee. This is the first time these custom made prosthesis have ever been used in Malaysia. We feel that this is a feasible option for limb salvage in the treatment of primary bone tumours in growing children.

Matched MeSH terms: Prostheses and Implants*
Fulltext Gait Analysis in Patients with Wide Resection and Endoprosthesis Replacement Around the Knee

Singh VA, Heng CW, Yasin NF

Indian J Orthop, 2018 2 9;52(1):65-72.
PMID: 29416172 DOI: 10.4103/ortho.IJOrtho_188_17

Background: Limb salvage surgery with endoprosthesis for bone tumor around the knee is reported to have good functional and oncological outcomes. However, the functional assessment using musculoskeletal tumor society (MSTS) and Toronto extremity scoring system remains subjective. We performed gait analysis as an objective assessment of their functional outcome.
Materials and Methods: Gait analysis was performed in 20 patients with endoprosthesis replacement around the knee. The temporal parameters assessed during gait analysis were walking velocity, stride length, duration of stance, and goniometry of the knee. These parameters were compared with the functional outcome score of the MSTS.
Results: The mean free-paced walking velocity was 0.91 m/s (normal is 1.33 m/s), which was 68% lower than normal gait. The stride length and stance phase were shorter for the affected limb compared to normal (P < 0.05). However, the gait was symmetrical with no difference in stride length (P = 0.148), velocity (P = 0.918), knee flexion (P = 0.465), and knee extension (P = 0.321) between the affected and unaffected limbs. Sixteen patients demonstrated stiff knee gait, two had a flexed knee gait, and only two patients had normal gait during the stance phase. The mean MSTS score was 21. There was significant correlation between overall MSTS scores (P = 0.023), function (P = 0.039), and walking scores (P = 0.007).
Conclusion: Limb salvage surgery with endoprosthesis reconstruction around the knee gives good functional outcome, both objectively and subjectively, as evidenced by the symmetrical gait pattern and significant correlation with MSTS score. Despite decreased walking velocity, stride length, and stance phase of the operated limb, the patient still has a symmetrical gait.

Matched MeSH terms: Prostheses and Implants
Fulltext Finite element modelling and simulation for lower limb of human bone: a review

Muhammad Hanif Ramlee

Malaysian Journal of Medicine and Health Sciences, 2020;16(3):262-271.
MyJurnal

Most orthopaedic cases that involved with bone fracture are normally treated with medical implants. To be noticed that some precautions in terms of biomechanical and biomaterial properties are necessary for a successful post-sur- gery process. The biomechanical evaluation of implants could be carried out using computing and engineering technologies. However, in the computer simulation, some assumptions are needed as the limitations on computer resources and data input. This review focuses on the current method of developing the finite element model for patients with specific values of material properties for lower limb part such as hip, knee and ankle joint. Previous literature was reviewed from which keywords and search engines were identified. In this review, inclusion and exclusion criteria were used to limit the literature search. We reviewed the state-of-the-art in this area and provide recommendations for future research. In conclusion, the previous published reports illustrated different methods to develop numerical models.

Matched MeSH terms: Prostheses and Implants
Evaluation of Osteogenic Potentials of Avian Demineralized Bone Matrix in the Healing of Osseous Defects in Pigeons

Sanaei R, Abu J, Nazari M, Zuki MA, Allaudin ZN

Vet Surg, 2015 Jul;44(5):603-12.
PMID: 25656987 DOI: 10.1111/vsu.12292

To evaluate avian allogeneic demineralized bone matrix (DBM) in the healing of long bone defects as a function of geometry and time in a pigeon model.

Matched MeSH terms: Prostheses and Implants

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