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Biomedical subjects

S H Teoh

Publications and source records attributed to S H Teoh.

At least 19 recordsLinked to original sources

Heterogeneous meshing and biomechanical modeling of human spine.

We aim to develop a patient-specific biomechanical model of human spine for the purpose of surgical training and planning. In this paper, we describe the development of a finite-element model of the spine from the VHD Male Data. The finite-element spine model comprises volumetric elements suitable for deformation and other finite-element analysis using ABAQUS. The mesh generation solution accepts segmented radiological slices as input, and outputs three-dimensional (3D) volumetric finite element meshes that are ABAQUS compliant. The proposed mesh generation method first uses a grid plane to divide the contours of the anatomical boundaries and its inclusions into discrete meshes. A grid frame is then built to connect the grid planes between any two adjacent planes using a novel scheme. The meshes produced consist of brick elements in the interior of the contours and with tetrahedral and wedge elements at the boundaries. The nodal points are classified according to their materials and hence, elements can be assigned different properties. The resultant spine model comprises a detailed model of the 7 cervical vertebrae, 12 thoracic vertebrae, 5 lumbar vertebrae, and S1. Each of the vertebrae and intervertebral disc has between 1200 and 6000 elements, and approximately 1200 elements, respectively. The accuracy of the resultant VHD finite element spine model was good based on visual comparison of volume-rendered images of the original CT data, and has been used in a computational analysis involving needle insertion and static deformation. We also compared the mesh generated using our method against two automatically generated models; one consists of purely tetrahedral elements and the other hexahedral elements.

Adult↗

Radio-translucent 3-axis mechanical testing rig for the spine in micro-CT.

To date, no apparatus has yet been devised which would allow the study of bone microstructure of the whole vertebrae under mechanical loading. This paper outlines the design and development of a 3-axis radio-translucent mechanical testing rig for spinal research and testing. This rig is to be used in conjunction with a Shimadzu micro-CT scanner. Several tests were conducted to verify the feasibility of the rig design. First, the maximum range of deformation in compression, flexion\extension, and lateral bending that could be exerted on a goat lumbar functional spinal unit was evaluated using the noncontact digital markers method. Stepwise compression loading was also conducted on a single porcine vertebra and the loading data was compared to results obtained from an industrial grade compression testing machine. Finally, micro-CT scans of a porcine vertebra prior to and at a compression failure strain were obtained. The rig was confirmed to be able to exert pure moment loading in the above mentioned modes of deformation and the extent of deformation was comparable to previous documented results. The stepwise compression loading conducted in the rig was also found to effectively approximate a continuous loading of the same specimen in an industrial grade compression testing machine. Finally, resultant micro-CT images of isotropic resolution 32.80 mum of a porcine vertebra loaded in the rig were obtained. For the first time, trabecular microarchitecture detail of a whole vertebra buckling under 12.1% failure compression strain loading was studied using voxel-data visualization software. These initial series of tests verify the feasibility of the rig as an apparatus incorporating spinal testing and imaging.

Animals↗

An in vitro evaluation of PCL-TCP composites as delivery systems for platelet-rich plasma.

In this study, we first investigated the in vitro degradation properties of biodegradable, bioresorbable polycaprolactone-20% tricalcium phosphate (PCL-TCP) composites immersed in simulated body fluid (SBF) and phosphate buffered saline (PBS). Then, the release profiles of the growth factors present in platelet-rich plasma (PRP) loaded onto the composites incubated in SBF and PBS were compared. Composites immersed in both buffers showed water uptake of 13.7%+/-0.75 at day 1, followed by a constant uptake of 12.1%+/-0.3 until day 12. Henceforth the water uptake declined for SBF- and increased for PBS-soaked composites. The weight loss data did not reveal any trend. SBF- and PBS-soaked samples displayed 1-2% weight loss for 2 and 5 of the ten time points measured respectively. The original protein retention (PR) of the composites was 49.1%+/-1.50. After immersion in SBF and PBS for 4 weeks, the PR was augmented to 88.5%+/-1.40 and 69.1%+/-1.40 correspondingly. PRP after activation contained 164.7+/-24.8, 194+/-43 and 18.3+/-4.75 ng/ml of TGF-beta1, PDGF-BB and IGF-1. Microscopic analysis verified the attachment of PRP to the rods and pores of the composites. Interestingly, the buffers played an important role in determining the release profiles of TGF and PDGF. Firstly, PBS-soaked composites manifested a tri-phasic burst-like profile that was absent in SBF. Secondly, SBF-soaked composites experienced delayed release of the growth factors and total release was not achieved (64.4% for TGF and 60.5% for PDGF), whereas total release was realized for PBS-soaked composites. Lastly, release profiles from SBF-soaked composites were growth factor mediated in terms of their amounts and sizes. This was not observed for PBS-soaked composites. IGF-1, on the other hand, exhibited a progressive reduction in levels over the entire experimental period for both buffers. The mechanisms of release were theorized to be a combination of diffusion, degradation and bioactivity. Since SBF is analogous to our body fluids in terms of its ionic constituents, we expect the elution profiles derived from SBF-soaked samples to more accurately emulate the in vivo situation. In conclusion, this study has deemed PCL-TCP composites as suitable delivery systems for platelet-rich plasma.

Absorption↗

Flow modelling within a scaffold under the influence of uni-axial and bi-axial bioreactor rotation.

The problem of donor scarcity has led to the recent development of tissue engineering technologies, which aim to create implantable tissue equivalents for clinical transplantation. These replacement tissues are being realised through the use of biodegradable polymer scaffolds; temporary/permanent substrates, which facilitate cell attachment, proliferation, retention and differentiated tissue function. To optimise gas transfer and nutrient delivery, as well as to mimic the fluid dynamic environment present within the body, a dynamic system might be chosen. Experiments have shown that dynamic systems enhance tissue growth, with the aid of scaffolds, as compared to static culture systems. Very often, tissue growth within scaffolds is only seen to occur at the periphery. The present study utilises the Computational Fluid Dynamics package FLUENT, to provide a better understanding of the flow phenomena in scaffolds, within our novel bioreactor system. The uni-axial and bi-axial rotational schemes are studied and compared, based on a vessel rotating speed of 35 rpm. The wall shear stresses within and without the constructs are also studied. Findings show that bi-axial rotation of the vessel results in manifold increases of fluid velocity within the constructs, relative to uni-axial rotation about the X- and Z-axes, respectively.

Bioreactors↗

Laser surface modification of poly(epsilon-caprolactone) (PCL) membrane for tissue engineering applications.

Ultra-thin polycaprolactone (PCL) produced by bi-axial stretching was previously shown to have significant advantage for membrane tissue engineering. However, the permeability of the membrane needs to be enhanced. In this study, ablation experiments using femtosecond laser and excimer laser were carried out to modify the PCL surface. The use of the femtosecond laser produces neat drilled-through holes while the excimer laser is employed to produce blind-holes on the membrane. The modified surface of the membrane was studied and analyzed for different laser parameters (such as pulse energy and pulse repetition rate and characterized using several techniques that include optical microscopy, scanning electron microscopy and water contact angle measurements). Results showed that the morphological surface changes with different laser parameters, and the water contact angle decreases as the surface of the membrane is modified. The decrease in water contact angle suggests that surface of the membrane had become more hydrophilic than the non-laser treated membrane. The present study demonstrated that laser surface modification on the PCL can be achieved with high degree of success and precision. This paved the way for further enhancement in membrane tissue engineering.

Biocompatible Materials↗

Novel PCL-based honeycomb scaffolds as drug delivery systems for rhBMP-2.

This study investigated a novel drug delivery system (DDS), consisting of polycaprolactone (PCL) or polycaprolactone 20% tricalcium phosphate (PCL-TCP) biodegradable scaffolds, fibrin Tisseel sealant and recombinant bone morphogenetic protein-2 (rhBMP-2) for bone regeneration. PCL and PCL-TCP-fibrin composites displayed a loading efficiency of 70% and 43%, respectively. Fluorescence and scanning electron microscopy revealed sparse clumps of rhBMP-2 particles, non-uniformly distributed on the rods' surface of PCL-fibrin composites. In contrast, individual rhBMP-2 particles were evident and uniformly distributed on the rods' surface of the PCL-TCP-fibrin composites. PCL-fibrin composites loaded with 10 and 20 microg/ml rhBMP-2 demonstrated a triphasic release profile as quantified by an enzyme-linked immunosorbent assay (ELISA). This consisted of burst releases at 2 h, and days 7 and 16. A biphasic release profile was observed for PCL-TCP-fibrin composites loaded with 10 microg/ml rhBMP-2, consisting of burst releases at 2 h and day 14. PCL-TCP-fibrin composites loaded with 20 microg/ml rhBMP-2 showed a tri-phasic release profile, consisting of burst releases at 2 h, and days 10 and 21. We conclude that the addition of TCP caused a delay in rhBMP-2 release. Sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) and alkaline phosphatase assay verified the stability and bioactivity of eluted rhBMP-2 at all time points.

Body Fluids↗

Computational biomechanical modelling of the lumbar spine using marching-cubes surface smoothened finite element voxel meshing.

There is a need for the development of finite element (FE) models based on medical datasets, such as magnetic resonance imaging and computerized tomography in computation biomechanics. Direct conversion of graphic voxels to FE elements is a commonly used method for the generation of FE models. However, conventional voxel-based methods tend to produce models with jagged surfaces. This is a consequence of the inherent characteristics of voxel elements; such a model is unable to capture the geometries of anatomical structures satisfactorily. We have developed a robust technique for the automatic generation of voxel-based patient-specific FE models. Our approach features a novel tetrahedronization scheme that incorporates marching-cubes surface smoothing together with a smooth-distortion factor (SDF). The models conform to the actual geometries of anatomical structures of a lumbar spine segment (L3). The resultant finite element analysis (FEA) at the surfaces is more accurate compared to the use of conventional voxel-based generated FE models. In general, models produced by our method were superior compared to that obtained using the commercial software ScanFE.

Biomechanical Phenomena↗

The effect of rhBMP-2 on canine osteoblasts seeded onto 3D bioactive polycaprolactone scaffolds.

Our strategy entails investigating the influence of varied concentrations (0, 10, 100 and 1000ng/ml) of human recombinant bone morphogenetic protein-2 (rhBMP-2) on the osteogenic expression of canine osteoblasts, seeded onto poly-caprolactone 20% tricalcium phosphate (PCL-TCP) scaffolds in vitro. Biochemical assay revealed that groups with rhBMP-2 displayed an initial burst in cell growth that was not dose-dependent. However, after 13 days, cell growth declined to a value similar to control. Significantly less cell growth was observed for construct with 1000ng/ml of rhBMP-2 from 20 days onwards. Confocal microscopy confirmed viability of osteoblasts and at day 20, groups seeded with rhBMP-2 displayed heightened cell death as compared to control. Phase contrast and scanning electron microscopy revealed that osteoblasts heavily colonized surfaces, rods and pores of the PCL-TCP scaffolds. This was consistent for all groups. Finally, Von Kossa and osteocalcin assays demonstrated that cells from all groups maintained their osteogenic phenotype throughout the experiment. Calcification was observed as early as four days after stimulation for groups seeded with rhBMP-2. In conclusion, rhBMP-2 seems to enhance the differentiated function of canine osteoblasts in a non-dose dependent manner. This resulted in accelerated mineralization, followed by death of osteoblasts as they underwent terminal differentiation. Notably, PCL-TCP scaffolds seeded only with canine osteoblasts could sustain excellent osteogenic expression in vitro. Hence, the synergy of PCL with bioactive TCP and rhBMP-2 in a novel composite scaffold, could offer an exciting approach for bone regeneration.

Animals↗

Development of perforated microthin poly(epsilon-caprolactone) films as matrices for membrane tissue engineering.

The design and fabrication of thin films based on bioresorbable polymers such as poly(epsilon-caprolactone) (PCL) has been the focus of a part of current biomedical research, especially as matrices for membrane tissue engineering. We have successfully developed perforated microthin PCL membrane for this purpose. Two critical issues are the control of moisture permeability and understanding the degradation of PCL microthin film. In order to increase the moisture permeability. PCL films were biaxially stretched to a thickness of 10 +/- 3 microm and perforated with uniform array of holes (180-275 microm) using a Sony Robotic system. After perforation, the water vapour transmission rate was increased by 50% to a value of 47.6 +/- 2.7 g/h per m2. Accelerated hydrolytic degradations were performed in 5 M NaOH. The degraded samples were characterised for changes in weight, surface morphology, mechanical properties, crystallinity and molecular weight. Hydrolytic degradation commenced with random chain scission of backbone ester bonds on the film surface and followed by loss of material due to surface erosion. In general, the perforated films degraded faster than the unperforated microthin films. Scanning electron microscopic images showed that surface erosion led to extensive formation of micropores, microcracks and increased in surface roughness.

Calorimetry, Differential Scanning↗

Comparison of flexural properties of composite restoratives using the ISO and mini-flexural tests.

UNLABELLED: The purpose of this study was to investigate the flexural properties (flexural strength and flexural modulus) of four commercial composite restoratives (Silux Plus, Z100, Ariston and Surefil) using the ISO 4049 flexural test (IFT) and a mini-flexural test (MFT). Both tests involved the use of three-point loading and the same fixture. The difference between the tests was in the length of the composites specimens and the distance between the supports [20 mm (IFT) and 10 mm (MFT)]. Six specimens were made for each material and flexural test. Test specimens [25 x 2 x 2 mm (IFT) and 12 x 2 x 2 mm (MFT)] were fabricated according to manufacturers' recommendations. After light-polymerization, the specimens were stored in distilled water at 37 degrees C for 24 h. The specimens were subsequently blotted dry, measured and subjected to flexural testing using an Instron Universal Testing Machine with a crosshead speed of 0.75 mm min(-1). Data was analysed using anova/Scheffe's, paired samples test (P < 0.05) and Pearson's correlation (P < 0.01). For both IFT and MFT, results of statistical analysis of flexural strength were identical. Silux had significantly lower flexural strength compared with the other composites and the flexural strength of Ariston was significantly lower than Z100 and Surefil. For IFT, the flexural modulus of Z100 was significantly higher than Silux, Ariston and Surefil while for MFT, Silux had significantly lower modulus compared with Z100, Ariston and Surefil. A significant, strong and positive correlation (r = 0.95) was observed for flexural strength between IFT and MFT. Correlation for flexural modulus was also significant and positive but was weaker (r = 0.53). As MFT has the advantage of ease of specimen fabrication and is more clinically realistic, it is suggested for the testing of composite restoratives. CLINICAL RELEVANCE: The mini-flexural test may be better than the ISO flexural test for screening of composite restoratives for clinical applications.

Composite Resins↗

Compression-induced changes on physical structures and calcification of the aromatic polyether polyurethane composite.

It is generally accepted that stress causes calcification in both bio-prosthetic and polyurethane heart valves. However, simple uni-axially- and bi-axially-stretched samples did not yield a feasible model for the elaboration of the stress-induced calcification. In this study, heat compaction combined with the incorporation of polyethylene has been explored. Specimens of polyurethane were solution cast onto a porous bi-axially-drawn ultra-high-molecular-weight polyethylene film and then heat compacted under a pressure of 18 MPa at a chosen temperature for 1.5 h. The heat-compaction-induced calcification and physical changes of the polyurethane composite were evaluated using a 28-day in vitro calcification model and Attenuated Total Reflection-Fourier Transform-Infrared (ATR-FT-IR) spectroscopy. The calcification results indicated that heat-compaction-induced calcification was double that achieved without heat compaction. Heat-compacted polyurethane composite showed higher affinity to calcium ions than the non-heat compacted sample. The ATR-FT-IR results showed that the heat-compaction-induced physical changes include distortions of polymeric molecules and permanent changes of microstructures. The distortions of polymeric molecules could be deteriorated in contact with different media. The relaxation of the stressed structures of the polyether moiety might serve as a calcium trap and a heterogeneous nucleation site for calcification. The permanent changes of microstructures resulted from high distortions also served as affinity sites attracting calcification.

Biocompatible Materials↗

An elasto-plastic finite element model for polyethylene wear in total hip arthroplasty.

A new finite element model (FEM) based on an elasto-plastic behavior of ultra high molecular weight polyethylene (UHMWPE) was used to study the wear behavior of UHMWPE acetabular cup, which has a 32 mm diameter femoral head. The model imposed a plastic yield stress of 8 MPa on the UHMWPE so that any stresses beyond this would automatically be redistributed to its neighbor. The FEM model adopted a unique mesh design based on an open cube concept which eliminated the problems of singularities. Wear prediction combined the influences of contact stress, sliding distance and a surface wear coefficient. The new model predicted significantly higher volumetric wear rate (57 mm(3)/yr) well within the average reported clinical values. The model was also used to study the effect of friction and clearance between the acetabular cup and the femoral head. Increase in friction increased the volumetric wear rate but did not appear to affect the linear wear rate, which remained at 0.12 +/- 0.02 mm/yr. The predicted wear was sensitive to clearance. It was found that when the clearance was close to 0 and >0.5mm, severe wear occurred. The best clearance range was between 0.1 and 0.15 mm where the average linear wear rate was 0.1mm/yr and the volumetric wear was 55 mm(3)/yr. The present work indicates the importance of avoiding too tight or too loose a diametrical clearance.

Acetabulum↗

Effects of cyclic loading on occlusal contact area wear of composite restoratives.

OBJECTIVES: To investigate the effects of cyclic loading on occlusal contact area (OCA) wear and the possible presence of fatigue wear mechanisms in four composite resins (Silux, Z100, Ariston and Surefil) using a reciprocal compression-sliding test apparatus. METHODS: Six specimens were made for each composite material and the amalgam alloy (Dispersalloy) control. The wear specimens were subjected to wear testing at 20 MPa with artificial saliva as lubricant. Wear depth (microm) was measured using profilometry every 20,000 cycles up to 120,000 cycles. The worn specimens were subjected to SEM to determine the presence of fatigue wear mechanisms. Results were analyzed using ANOVA/Scheffe's test (P<0.05) and Pearson's Correlation (P<0.01). RESULTS: Dispersalloy had the lowest wear at all cyclic intervals. For all materials, OCA wear increased with increased number of cycles. Although Dispersalloy, Ariston and Surefil experienced no significant increase in wear between each 20,000 cycles increment, a significant increase was observed with Silux. For Z100, a significant difference was observed only from 40,000 cycles onwards. Both Z100 and Dispersalloy exhibited fatigue wear after wear testing for 120,000 cycles. Cyclic loading resulted in deep and wide microcracks in Silux. Fatigue wear was not observed with Silux, Ariston and Surefil. SIGNIFICANCE: The effects of cyclic loading on wear is material dependent. While some restorative materials exhibit fatigue wear, others exhibit deep microcrack formation with extended cyclic loading. The latter may precipitate catastrophic failure despite the low wear observed. Care should, therefore, be exercised when selecting materials for posterior stress-bearing areas.

Analysis of Variance↗

Environmental damage and occlusal contact area wear of composite restoratives.

The chemical environment is one aspect of the oral environment, which could have an appreciable influence on the in-vivo degradation of composite resins. The resin matrix can be softened and fillers constituents can be leached out when composites are exposed to certain chemicals/food-simulating liquids (FSLs). A reciprocal compression sliding wear device was used to study the effects of the chemical environment on occlusal contact area (OCA) wear of four composite restoratives (Silux Plus, Z100, Ariston pHc and Surefil). The effects of FSL on hardness was also investigated and correlated to wear. Thirty-six hardness/wear specimens of each material were made and stored in artificial saliva at 37 degrees C for 24 h. The specimens were then divided into six groups of six specimens and stored in the following FSL for 1 week at 37 degrees C: distilled water (W), 0.02 N citric acid (C), 0.02 N lactic acid (L), heptane (H) and 75-25% ethanol-water solution (E). Conditioning in artificial saliva (S) was used as control. After conditioning, the specimens were wear tested at 20 MPa contact stress against SS304 counter-bodies in the respective FSL/artificial saliva up to 20 000 cycles. Wear depth (lm, n=6) was measured using profilometry. Change in hardness (DeltaKHN, Knoop hardness number) was determined by microhardness testing pre- and post-conditioning. Results of statistical analyses (ANOVA/Scheffe's at significance level 0.05) of wear data were as follows: Silux - S, W > L, H, E and C, L > H; Z100 - S, W > all other mediums and E > H; Ariston - all other mediums > H; Surefil - W, C > S, L, H, E (> indicates significantly more wear). With the exception of Surefil, the greatest wear was observed with conditioning and wear testing in water. This ranged from 93.18 +/- 21.96 lm for Z100 to 31.43 +/- 2.80 lm for Surefil. For all materials, conditioning in heptane resulted in the least wear. This ranged from 8.9 +/- 2.2 microm for Ariston to 16.5 +/- 5.9 lm for Silux. The effects of the different FSL on OCA wear were material dependent. No correlation was observed between DeltaKHN and wear.

Analysis of Variance↗

Multi-axial spine biomechanical testing system with speckle displacement instrumentation.

This paper reports on the design and development of a multi-axis (up to 6 axes) mechanical tester for spinal research and testing. The developed spine tester allowed true motion to be simulated on a specimen in pure or combined modes. To demonstrate the capability of the new tester flexural stiffness properties of sheep lumbar motion segments were evaluated together wiith a non-contact speckle displacement measurement system. The flexural stiffness of the specimens was measured and compared under constrained and non-constrained testing conditions; with relieving of shear forces (non-constrained), it was found that the specimen behaved in a 'stiffer' manner.

Animals↗

Mechanical properties and cell cultural response of polycaprolactone scaffolds designed and fabricated via fused deposition modeling.

A number of different processing techniques have been developed to design and fabricate three-dimensional (3D) scaffolds for tissue-engineering applications. The imperfection of the current techniques has encouraged the use of a rapid prototyping technology known as fused deposition modeling (FDM). Our results show that FDM allows the design and fabrication of highly reproducible bioresorbable 3D scaffolds with a fully interconnected pore network. The mechanical properties and in vitro biocompatibility of polycaprolactone scaffolds with a porosity of 61 +/- 1% and two matrix architectures were studied. The honeycomb-like pores had a size falling within the range of 360 x 430 x 620 microm. The scaffolds with a 0/60/120 degrees lay-down pattern had a compressive stiffness and a 1% offset yield strength in air of 41.9 +/- 3.5 and 3.1 +/- 0.1 MPa, respectively, and a compressive stiffness and a 1% offset yield strength in simulated physiological conditions (a saline solution at 37 degrees C) of 29.4 +/- 4.0 and 2.3 +/- 0.2 MPa, respectively. In comparison, the scaffolds with a 0/72/144/36/108 degrees lay-down pattern had a compressive stiffness and a 1% offset yield strength in air of 20.2 +/- 1.7 and 2.4 +/- 0.1 MPa, respectively, and a compressive stiffness and a 1% offset yield strength in simulated physiological conditions (a saline solution at 37 degrees C) of 21.5 +/- 2.9 and 2.0 +/- 0.2 MPa, respectively. Statistical analysis confirmed that the five-angle scaffolds had significantly lower stiffness and 1% offset yield strengths under compression loading than those with a three-angle pattern under both testing conditions (p < or = 0.05). The obtained stress-strain curves for both scaffold architectures demonstrate the typical behavior of a honeycomb structure undergoing deformation. In vitro studies were conducted with primary human fibroblasts and periosteal cells. Light, environmental scanning electron, and confocal laser microscopy as well as immunohistochemistry showed cell proliferation and extracellular matrix production on the polycaprolactone surface in the 1st culturing week. Over a period of 3-4 weeks in a culture, the fully interconnected scaffold architecture was completely 3D-filled by cellular tissue. Our cell culture study shows that fibroblasts and osteoblast-like cells can proliferate, differentiate, and produce a cellular tissue in an entirely interconnected 3D polycaprolactone matrix.

Biocompatible Materials↗