Background: Mandibular condyle fractures in pediatric patients can lead to crippling sequelae such as ankylosis, pain and facial deformity if not managed properly. However, there is no consensus on the best approach for treating these fractures in children. Objective: This study aimed to describe the management of mandibular condyle fractures in growing patients across 14 maxillofacial departments worldwide. Methods: A retrospective multicenter study was conducted on children and adolescents aged 0 to 16 who had at least one mandibular condyle fracture. This study included patients who underwent expectant, closed, or open management and were treated over an 11-year period. Results: 180 patients had at least one mandibular condyle fracture, and 37 had a second condylar fracture. One hundred sixteen patients (65%) were males, and 64 (35%) were females (ratio 1.8:1). An expectant strategy was chosen in 51 (28%) patients, a closed treatment—stand-alone maxillomandibular fixation (MMF)—in 47 (26%), and open reduction and internal fixation (ORIF) was performed in 82 (46%) patients. The management varied significantly between the different departments (p < 0.0001). Significant differences were also identified between the fracture type (non-displaced, displaced or comminuted) and the management of the 180 patients with a single condylar fracture. Out of 50 non-displaced fractures, only 3 (6%) had ORIF, 25 (50%) had expectant management, and 22 (44%) had MMF. Out of 129 displaced fractures, 79 (62%) had ORIF, 25 (19%) had a soft diet, and 25 (19%) had MMF. Conclusions: Expectative management, MMF, and ORIF were all effective in treating pediatric mandibular condyle fractures, with a low incidence of complications and asymmetry.
Cu-Al-Nishape memory alloys (SMAs) are widely known for their better properties in comparison to other SMAs (lower production costs, increased ductility, enhanced machinability, reduced liquidus temperature, and decreased hysteresis), but there is still controversy in terms of the biological properties of these materials. The aim of this study was to evaluate biofunctional performances of Cu-Al-Ni alloy produced by continuous casting. The micro-chemical analysis was investigated by SEM/EDX. Immersion tests performed for seven days were used to estimate the quantity of Cu, Al, and Ni ions released in neutral pH and slightly acidic artificial saliva. To assess the biocompatibility of the Cu-Al-Ni alloy samples, MTT assay on fibroblasts and dental pulp cells was performed in indirect and direct contact with samples after 1,3, and 7 days.The study revealed that continuous casting enables the primary fabrication of Cu-Al-Ni rods with a shape memory effect. Samples immersed in artificial saliva with 6.5 pH value showed no significant amounts of released ions, despite the high concentration of copper in the alloy. However, in the acidic environment, the suppression of Cu was 0.14 µg/cm2, Al 1.9 µg/cm2, and Ni 0.73 µg/cm2, and as expected, it was confirmed that Cu-Al-Ni alloy is not corrosion resistant in an acidic environment. In conclusion, this study showed that biocompatibility concerns are related only to materials with a high Cu content in acidic environments. Oppositely, small doses of Cu ions promote cell proliferation, which might be useful in further attempts to enrich different biomedical materials with copper.
Due to the unique functional properties of shape memory alloys (SMAs) and current scientific interest in Cu-containing biomaterials, a continuously cast Cu-Al-Ni alloy in the form of rods has been investigated as a potential candidate for biomedical application. Additionally, the fact that Cu- complexes have an antitumour effect served as a cornerstone to develop more efficient drugs based on trace element complexes. In line with that, our study aimed to analyse the basic properties of the Cu-Al-Ni alloy, along with its anticancer properties. The detailed chemical analysis of the Cu-Al-Ni alloy was performed using XRF and SEM/EDX analyses. Furthermore, a microstructural and structure investigation was carried out, combined with hardness measurements using the static Vickers method. Observations have shown that the Cu-Al-Ni microstructure is homogeneous, with the presence of typical martensitic laths. XRD analysis confirmed the presence of two phases, β′ (monoclinic) and γ′ (orthorhombic). The viability of osteosarcoma cells in contact with the Cu-Al-Ni alloy was evaluated using epifluorescence microscopy, while their morphology and attachment pattern were observed and analysed using a high-resolution SEM microscope. Biocompatibility testing showed that the Cu-Al-Ni alloy exerted a considerable antineoplastic effect.
In this study, a TiNi alloy with a composition of 50 at.% of titanium and 50 at.% of nickel is investigated in terms of its corrosion and biocompatibility behavior for biomedical applications. The corrosion measurements, which include the determination of open-circuit potential and linear polarization resistance measurements, cyclic polarization measurements, and electrochemical impedance spectroscopy in 9 g L−1 NaCl, show that TiNi has satisfactory corrosion stability. According to the SEM and EDS analysis, after cyclic polarization, pitting corrosion occurred, accompanied by the dissolution of the unstable Ti2Ni inclusions. The analysis also showed that TiNi has good biocompatibility for human osteoblast-like cells, as determined by the mitochondrial activity, which was assessed using a direct contact test following ISO standard 10993-5, via scanning electron microscopy (SEM) and fluorescent microscopy.
A high-noble Au–Pt–Ge porcelain-fused-to-metal (PFM) dental alloy without the known adverse metallic elements and with the addition of germanium (Ge) was produced as a more cost-effective alternative to other precious alloying metals, with investigations for determining the functionality and clinical use of this alloy. The thermomechanical, biocompatibility, durability, workability and economic characteristics of the produced dental alloy were investigated. These properties were investigated with in vitro biocompatibility testing on human gingival fibroblasts (HGFs); static immersion testing for metal ion release; DSC analysis; hardness, tensile testing, density and coefficient of thermal expansion (CTE) measurements; metallographic and SEM/EDX microstructure investigations; and finally with the production of a test PFM dental bridge. The results of the thermomechanical testing showed alloy properties suitable for dental restorations and clinical use, with somewhat lower mechanical properties, making the alloy not suitable for extensive multiunit fixed restorations. The microstructure investigations showed segregations of Ge in the homogeneous alloy matrix, which reduce the alloy’s mechanical properties. The produced PFM dental bridge showed excellent workability of the alloy in a dental laboratory setting, as well as a high standard of the final dental restoration. The ion release was negligible, well below any harmful quantities, while the cell viability examination showed significantly higher viability ratings on polished alloy samples as compared to as-cast samples. The results showed that a dental substructure in direct contact with oral tissue and fluids should be highly polished. The performed investigations showed that the produced PFM dental alloy is suitable for clinical use in producing high-quality dental restorations with high biocompatibility for patients prone to metal allergies.
Thermomechanical, biocompatibility, durability, workability and economic characteristics are the main criteria for development of dental alloys. In an attempt to provide a noble metal dental alloy without the known adverse metallic elements, a novel alloy was produced with the addition of Germanium (Ge), as a more cost-effective alternative to other precious alloying metals. The objective of this investigation was to analyse the thermomechanical and biocompatibility properties of a high noble Au-Pt-Ge porcelain-fused-to-metal (PFM) alloy. These properties were investigated with DSC analysis, hardness, density and coefficient of thermal expansion (CTE) measurements, as well as with metallographic and SEM/EDX microstructure investigations, with the production of a test PFM dental bridge, static immersion testing for metal ion release, and an in vitro primary biocompatibility testing on human gingival cells. The results of the thermomechanical testing showed alloy properties suitable for dental restorations and clinical use, with somewhat lower hardness, making the alloy not suitable for extensive multiunit fixed restorations. The microstructure investigations showed segregations of Ge in a homogeneous alloy matrix, which reduce the alloy’s mechanical properties. The produced PFM dental bridge shows excellent workability of the alloy in a dental laboratory setting, as well as a high standard of the final dental restoration. The ion release was negligible, well below any harmful quantities, while the cell viability examination showed significantly higher viability ratings on polished alloy samples as compared to as-cast samples. The results showed that a dental substructure in direct contact with oral tissue and fluids should be highly polished.