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Biomedical subjects

R Puers

Publications and source records attributed to R Puers.

10 recordsLinked to original sources

The influence of micro-motion on the tissue differentiation around immediately loaded cylindrical turned titanium implants.

OBJECTIVE: The aim of this study was to evaluate the effect of various degrees of implant displacement on the tissue differentiation around immediately loaded cylindrical turned titanium implants. DESIGN: The experiments were conducted in repeated sampling bone chambers placed in the tibia of 10 rabbits. Tissues could grow into the bone chambers via perforations. Due to its double structure, tissues inside the chamber could be harvested leaving the chamber intact. This allowed several experiments within the same animal. The chambers contained a cylindrical turned titanium implant that was loaded in a well-controlled manner. In each of the 10 chambers, four experiments were conducted with the following test conditions: immediate implant loading by inducing 0 (control), 30, 60 and 90 microm implant displacement, 800 cycles per day at a frequency of 1 Hz, twice a week during a period of 6 weeks. Histological and histomorphometrical analyses were performed on methylmethacrylate histological sections. An ANOVA was conducted on the dataset. RESULTS: The total tissue volume was significantly lowest in the unloaded control condition. The bone volume fraction on the other hand, was significantly larger in the unloaded and 90 microm implant displacement, compared to the 30 microm implant displacement. Bone density increased with increasing micro-motion with significantly higher values for the 60 microm- and 90 microm-test conditions compared to the unloaded situation. The chance to have bone-to-implant contact decreased in case of micro-motion at the tissues-implant interface. CONCLUSION: The magnitude of implant displacement had a statistically significant effect on the tissue differentiation around immediately loaded cylindrical turned titanium implants. Implant micro-motion had a detrimental effect on the bone-to-implant contact in an immediate loading regimen.

Animals↗

Intracorporeal Videoprobe (IVP).

The objective of the work in the EC project IVP is the development and evaluation of two prototypes of video systems:- a small wired videoprobe with a CMOS image sensorand- an autonomous video-capsule with a telemetric link for image data transfer to an external PC-based system.

Journal Article↗

Recent progress on transcutaneous energy transfer for total artificial heart systems.

For many years, transcutaneous energy transfer (TET) systems have been developed for energizing total artificial heart systems. Although such a basic system can be developed without too much design effort, optimization toward high power transfer efficiency forces the introduction of novel system topologies and design strategies. In addition, for medical applications, the thermal impact of a TET system on the biological tissue should be taken into account, resulting in limitations on usable coil geometries. This article presents a TET system that has been developed for a power transfer of 25 W over a distance of 1 cm with minimal dimensions of 1 x 6 x 4 cm for the external driver and 5 x 3 x 1 cm for the internal electronics. The coil geometries have a thickness of 2 mm and a diameter of 6 cm. An overall system efficiency of 80% was achieved for an internal load of 25 W.

Biomedical Engineering↗

Pre-load on oral implants after screw tightening fixed full prostheses: an in vivo study.

The fit of implant supported fixed prostheses is said to be of clinical concern because of the rigid fixation of an oral implant in its surrounding bone. The influence of the torque sequence of the set screws during fixation of implant supported fixed full prostheses on the final pre-load was investigated in vitro. No significant effect of the torque sequence of the set screws on the final pre-load was observed. The main objective of this study was to quantify and qualify the pre-load in vivo on implants supporting a fixed full prosthesis. This was performed when the prostheses were supported by all five or six implants and was repeated when the prostheses were supported by only four and three implants. A total of 13 patients with a fixed full implant supported prosthesis were selected. The existing abutments were changed for strain gauged abutments. After tightening the set screws with a torque of 10 N cm, the pre-load conditions were registered. The average (SEM) axial forces and bending moments in case of five or six, four and three supporting implants were 323 N (43 N), 346 N (59 N), 307 N (60 N) 21 N cm (3 N cm) and 21 N cm (2 N cm), 23 N cm (5 N cm), respectively. In addition, the pre-load was registered after fixation of a machined gold cylinder, as delivered by the manufacturer, on each of the supporting implants, representing the 'optimal fit' situation. The corresponding average (SEM) axial forces and bending moments in case of five or six, four and three supporting implants were 426 N (36 N), 405 N (40 N), 413 N (46 N) and 8 N cm (1 N cm), 8 N cm (1 N cm), 8 N cm (1 N cm), respectively. The induced axial forces after tightening the prostheses were significantly lower then after tightening the gold cylinder in case of five or six supporting implants (P < 0.02). The induced bending moments after tightening the prostheses were statistically significantly higher (P < 0.0001) then after tightening the gold cylinder in all test conditions (five or six, four or three supporting implants). This study underlines the static load present after screw tightening implant supported fixed full prostheses.

Adult↗

Concept, design and fabrication of smart orthopedic implants.

Extensive clinical experience has been built up using orthopaedic implants instrumented with strain gauges connected to a Wheatstone bridge by means of percutaneous leads. This research showed the medical relevance of the monitoring of the deformation of implants as a powerful tool to evaluate nursing and rehabilitation exercises, for tracing dangerous overloads and anticipating implant failure and also to observe the healing process. The IMPACT 3500 project focuses on the instrumentation of femoral implants with on board sensors: regular Benoist-Girard implants have been modified, to contain a 'sensing cell', and thoroughly tested in vitro and in vivo. The implant deformations are measured with resistive strain gauges, and the signal is transferred to a personal computer for processing and display, via a hard wired connection, or via a telemetry system. Two fully implantable wireless designs, called Linkstrain and Sealstrain, are powered from the outside by magnetic induction. As Sealstrain contains the whole telemetric system in its cavity, the highest miniaturization was required; this seriously deteriorates the efficiency of the inductive power link.

Biocompatible Materials↗

Magnitude and distribution of occlusal forces on oral implants supporting fixed prostheses: an in vivo study.

Since loading is increasingly believed to be a determining factor in the treatment outcome with oral implants, there is a need to expand the knowledge related to the biomechanics of oral implants. The aim of this study is to gain insight in the distribution and magnitude of occlusal forces on oral implants carrying fixed prostheses. This is done by in vivo quantification and qualification of these forces, which implies that not only the magnitude of the load but also its type (axial force or bending moment) will be registered. A total of 13 patients with an implant supported fixed full prosthesis were selected. Occlusal forces on the supporting implants were quantified and qualified during controlled load application of 50 N on several positions along the occlusal surface of the prostheses and during maximal biting in maximal occlusion by use of strain gauged abutments. The test was conducted when the prostheses were supported by all (5 or 6) implants and was repeated when the prostheses were supported by 4 and by 3 implants only. Despite considerable inter-individual variation, clear differences in implant loading between these test conditions were seen. Loading of the extension parts of the prostheses caused a hinging effect which induced considerable compressive forces on the implants closest to the place of load application and lower compressive or tensile forces on other implants. On average, higher forces were observed with a decreasing number of supporting implants. Bending moments were highest when 3 implants only were used.

Adult↗

Three-dimensional force measurements on oral implants: a methodological study.

This paper describes a methodology that allows in vitro and in vivo quantification and qualification of forces on oral implants. Strain gauges are adapted to the outer surface of 5.5 and 7 mm standard abutments (Brånemark System, Nobel Biocare, Sweden). The readings of the strain gauges are transformed into a numerical representation of the normal force and the bending moment around the X- and Y-axis. The hardware and the software of the 3D measuring device based on the strain gauge technology is explained and its accuracy and reliability tested. The accuracy level for axial forces and bending moments is 9.72 N and 2.5 N x cm, respectively, based on the current techniques for strain gauged abutments. As an example, an in vivo force analysis was performed in a patient with a full fixed prosthesis in the mandible. Since axial loads of 450 N and bending moments of 70 N x cm were recorded, it was concluded that the accuracy of the device falls well within the scope of our needs. Nevertheless, more in vivo research is needed before well defined conclusions can be drawn and strategies developed to improve the biomechanics of oral implants.

Aged↗

Influence of prosthesis material on the loading of implants that support a fixed partial prosthesis: in vivo study.

BACKGROUND: Since loading is increasingly believed to be a determining factor in the treatment outcome with oral implants, there is a need to expand the knowledge related to the biomechanics of oral implants and its influencing factors. PURPOSE: The aim of this study was to investigate the influence of prosthesis material on the distribution and magnitude of load on oral implants carrying a fixed partial prosthesis by in vivo quantification and qualification of this load. METHODS: Eight patients with in total nine three-unit fixed partial prostheses on three implants and three patients with in total four two-unit fixed partial prostheses on two implants were selected. Both metal and acrylic resin prostheses were made. Strain gauged abutments were used to measure the load on the supporting implants during controlled load application of 50 N on several positions along the occlusal surface of the prostheses and during maximal biting in maximal occlusion. Additional tests were conducted when the three-unit prostheses were supported only by two implants, thereby creating an extension pontic. RESULTS: A significantly better distribution of bending moments with the metal prostheses in comparison to the acrylic resin prostheses was observed in the case of the three-unit prostheses on two implants. No other difference in load or load distribution with the different prosthesis materials was noted. CONCLUSION: The clinical significance of the study reveals an increased risk for bending overload of the implants that are closest to the point of load application only in the case of acrylic resin long span prostheses or acrylic resin prostheses with extensions.

Acrylic Resins↗

In vivo forces on oral implants supporting a mandibular overdenture: the influence of attachment system.

This study was designed to gain insight into the influence of the attachment system on the loading conditions of oral implants supporting a mandibular overdenture on two implants. Five patients were selected and were provided with two implants in the canine area of the mandible (Brånemark System). All patients received a new mandibular overdenture that could be mounted on an ovoid-shaped bar (Dolder, C&M): (a) with and (b) without bilateral extensions and (c) on ball-attachments (Nobel Biocare). Using three strain gauges attached to the outer surface of the 5.5-mm standard abutments, the axial forces and bending moments on both supporting implants could be quantified. Load registrations were made during application of 50 N on seven predetermined positions along the occlusal surface of the prosthesis and during maximal biting in maximal occlusion (clenching). The results revealed no differences in induced axial force for the various anchorage devices, unlike the differences in bending moment. Although there is a tendency for better axial load sharing with bars and better sharing of bending moments with ball attachments, these differences were not significant.

Dental Implantation, Endosseous↗

The influence of bone mechanical properties and implant fixation upon bone loading around oral implants.

Finite element models were created to study the stress and strain distribution around a solitary Brånemark implant. The influence of a number of clinically relevant parameters was examined: bone-implant interface (fixed bond versus frictionless free contact), bone elastic properties, unicortical versus bicortical implant fixation and the presence of a lamina dura. Bone loading patterns in the vicinity of the implant seem to be very sensitive to these parameters. Hence they should be integrated correctly in numerical models of in vivo behaviour of oral implants. This necessitates the creation of patient-dependent finite element models.

Biomechanical Phenomena↗