Background and objectives: Guided bone regeneration (GBR) is commonly used for osseous defect reconstruction. The objective of this study was to evaluate in real-time (in-vivo) the efficacy of equine bone graft for GBR in segmental critical-size defects (CSD) of the femur in a rat model. Materials and methods: Following ethical approval, 30 male Wistar-Albino rats (age 12-14 months/weight 450-500 grams) were included. Under general-anesthesia, a mid-diaphyseal segmental CSD (5 mm) was created in the femur and stabilized using titanium Miniplate(4 holes,1.0 mm thickness). Depending upon material used for GBR, animals were randomly divided into three groups(n = 10/per group). Negative control-Defect covered with resorbable collagen membrane(RCM); Positive control-Defect filled with autologous bone and covered by RCM; Equine bone-Defect filled with equine bone and covered by RCM. Real-time in-vivo Micro-CT was performed at baseline, 2, 4, 6 and 8 weeks to determine volume and mineral density of newly formed bone (NFB) and remaining bone graft particles (BGP). Results: In-vivo micro-CT revealed increase in volume and mineral density of NFB within defects from baseline to 8-weeks in all groups. At 8-weeks NFB-volume in the equine bone group(53.24 ± 13.83 mm3; p < 0.01) was significantly higher than the negative control(5.6 ± 1.06 mm3) and positive control(26.07 ± 5.44 mm3) groups. Similarly, NFB-mineral density in the equine bone group(3.33 ± 0.48 g/mm3; p < 0.01) was higher than the other (negative control-0.27 ± 0.02 g/mm3; positive control-2.55 ± 0.6 g/mm3). A gradual decrease in the BGP-volume and BGP-mineral density was observed. Conclusion: The use of equine bone for GBR in femoral segmental defects in rats, results in predictable new bone formation as early as 2-weeks after bone graft placement.
The use of additive manufacturing in medical applications has become more prevalent over the last decade. Studies have proved that reconstruction plates with a mesh structure enhance the biocompatibility and bone-ingrowth formation. However, limited studies have been reported in the customization and in vivo clinical assessment of mesh implants. The purpose of this study was to investigate the surgical treatment and implant fitting accuracy using three different reconstruction plates. Fifteen goats were divided into one control and three experimental groups (Groups 1, 2, and 3) with five in each group. An experimental segmental defect was created on these animals and was adopted with customized electron beam melting reconstruction titanium plates with mesh in Group 1 and without mesh in Group 2 and commercial reconstruction plate in Group 3. All the animals were subjected to radiographic analysis before and after surgery. The subjected animals were sacrificed after 3 months and the electron beam melting reconstruction plates were compared with the commercial plate based on clinical and histology analysis and implant fitting accuracy. Both the electron beam melting reconstruction plates (with mesh and without mesh) and commercial plates survived the three months post-operation, revealing good wound-healing with new bone formation and without any foreign-body reaction. The electron beam melting reconstructed plate with mesh (Group 1) was found to have a better implant fitting when compared to the other two groups. The average discrepancy between Groups 2 and 3 was not significant. Certainly, the commercial plate (Group 3) was found to have the least accuracy as compared to other electron beam melting reconstruction plates (Group 1 and Group 2). Custom design electron beam melting fabricated reconstruction plates possessed better functionality, aesthetic outcome, and long-term biocompatibility when compared to commercial plates. Animal results indicated that the electron beam melting plates with mesh (Group 1) were superior in comparison to the other two groups due to its ability to provide better bone-in-growth and osseointegration on its porous microstructure.
AT&T is embarking on an exciting journey to revolutionize its network by transforming itself into a software company running the largest and most intelligent programmable cloud on the planet. Indeed, the network of Domain 2.0 (D2) will be intelligent software systems and applications operating on general-purpose commodity hardware [1]. This transformation will not only drive down CAPEX, OPEX and help to configure our network with less human intervention, but it will also create significant opportunities to scale and monetize existing and new intelligent services. This transformation will enable AT&T's D2 to establish a new services ecosystem equivalent in concept to the application ecosystem adopted by the Apple iOS and Android. D2 will facilitate mass marketing existing and new services, and lower the barrier to entry for enterprise and small business customers to create new innovative services.This paper will provide a demonstration of how intelligent services can be realized within the D2 architecture.
Fractures of severely atrophic (height < 10 mm) edentulous mandibles are infrequent and challenging to manage. Factors such as sclerotic bone and decreased vascularity combined with systemic diseases complicate the management of such fractures. Osteogenesis imperfecta (OI) is a heterogeneous group of inherited disorders of type I collagen metabolism. Patients with OI characteristically present with histories of long bone fractures, deformities, blue sclerae, and opalescent dentin. However, fractures of the facial skeleton are rare. Bisphosphonate therapy has been proven to effectively reduce the fracture risk in patients with OI. The purpose of this clinical report is to present an unusual case of spontaneous fracture of the atrophic mandible in a patient with OI. Despite open reduction and internal fixation (ORIF) with miniplate osteosynthesis, the patient developed a second fracture at a screw placement site distal to the first fracture. The patient was successfully treated with ORIF using locking reconstruction plates fixed in the symphyseal and angle regions. Bone healing following ORIF was normal, and no clinical sign of osteonecrosis as a result of bisphosphonate therapy was observed. Patients with OI can present with spontaneous fractures of already weakened mandibles. Although such fractures can be managed with care using established protocols, further research is required to examine the effects of concomitant medication, such as bisphosphonates.
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