Evaluation of the Effect of Cranioplasty Using Different Prosthetic Materials on Functional Improvement in Patients with Post-traumatic Brain Injury: A Protocol

Background: Cranioplasty is considered an essential step for restoring defects in the skull, generally due to the esthetic appearance, safety of the brain, or handling the adverse effect of the Trephined Syndrome (TS) or sinking skin flap syndrome. Moreover, many studies saw the unexpected enhancement of cognitive and motor function after cranioplasty. These favorable progressive effects can be helpful in further therapy preparations in association with cranioplasty effects. Nevertheless, the proof is mainly restricted to case studies that do not target comparison between different materials in post-traumatic brain injury (P-TBI) people even though it is helpful but not enough. Objectives: To comparatively evaluate the effect of cranioplasty using autologous bone graft, polymethylmethacrylate (PMMA), titanium, and bone cement on cognitive and functional improvement in patients with P-TBI. Methodology: 40 subjects will be allocated into four groups. Group A (10 using Autologous bone graft) Group B (10 using PMMA), Group C (10 using Titanium), and Group D (10 using Bone cement). Glasgow Coma Scale (GCS) and Mini-Mental State Examination (MMSE) will be used for cognitive improvement. For functional improvement, Muscle power and Barthel index will be used. The data will be compared before and after cranioplasty. Expected Results: Cognitive and functional improvement will be present after cranioplasty. But the effect of cranioplasty using autologous bone graft, polymethylmethacrylate (PMMA), titanium, and bone cement has to be evaluated & compared to assess the patient’s cognitive and functional improvement and provide desired intervention as required. Conclusion: This study will comparatively evaluate the effect of cranioplasty using different prosthetic materials and determine which material is better for patients' cognitive and functional improvement.

Design and Manufacturing of a New Prosthetic Foot

All prosthetic foot designs, adapted in common use, don't imitate the specific qualities of a typical human foot. The premise of this task is to explore current prosthetics so as to plan and assemble a more human like prosthesis. In attempted such a structure, the new prosthesis will show a more extensive scope of qualities than those showed in current prosthetic feet. In doing as such, the new prosthesis will give a closer portrayal of the capacities inalienable to an ordinary human foot. The qualities associated with ordinary strolling incorporate dorsiflexion foot test. The qualities showed in the produced new foot tried are contrasted with those of" SACH foot". The qualities showed by prostheses which compared well with those of a human foot were researched further. Another prosthetic foot is structured and made from composite random E-glass-polyester. The premise of the new prosthetic plan consolidates current prosthetic structure components, such as, prosthetic materials and segments. The scientific part presents the aftereffects of the static investigation by techniques, such as, mathematical strategies (Finite Element method FEM) and experimental methods. Thus the new foot was designed and dorsiflexion were measured. The new prosthetic foot has a good characteristics when compared with the SACH foot, such as good dorsiflexion (7°-6.4°) respectively.Prosthetic foot

Genomic analysis of a rare recurrent Listeria monocytogenes prosthetic joint infection indicates a protected niche within biofilm on prosthetic materials

Listeria monocytogenes is a rare cause of prosthetic joint infections (PJI). In this study, we describe a case of recurrent L. monocytogenes infections, 39 months apart, following debridement and retention of a prosthetic hip. Despite numerous studies reporting persistent L. monocytogenes in human infections, the genomic and phenotypic changes that clinically relevant strains undergo in the host are poorly understood. Improved knowledge of how PJI occurs is needed to improve the management of prosthetic infections. We used a combination of long- and short-read sequencing to identify any potential genomic differences between two L. monocytogenes isolates that occurred over 39-month incubation in the host. The isolates, QI0054 and QI0055, showed three single nucleotide polymorphisms and three insertions or deletions, suggesting that the recurrent infection was caused by the same strain. To identify potential differences in the capacity for persistence of these isolates, their biofilm-forming ability and potential to colonize prosthesis-relevant materials was investigated both in microtitre plates and on prosthetic material titanium, stainless steel 316 and ultra-high molecular weight polyethylene. Whilst the L. monocytogenes isolate from the most recent infection (QI0055) was able to form higher biofilm in microtitre plates, this did not lead to an increase in biomass on prosthetic joint materials compared to the initial isolate (QI0054). Both clinical isolates were able to form significantly more biofilm on the two metal prosthetic materials than on the ultra-high molecular weight polyethylene, in contrast to reference strain Scott A. Transcriptomics revealed 41 genes overexpressed in biofilm state and 643 in planktonic state. Moreover, genes with mutations were actively expressed in both isolates. We conclude the isolates are derived from the same strain and hypothesize that L. monocytogenes formed biofilm on the prosthetic joint materials, with minimal exposure to stresses, which permitted their survival and growth.

MICROBIOLOGICAL STUDY OF THE ORAL CAVITY FOR PROSTHETICS OF DEFECTS OF DENTITION

Prosthetic materials interact with the tissuesof the prosthetic role and often harmthe oral cavity condition. This depends on the material from which the prosthesis is made, the specificsof its structure, the state of oral hygiene, and the body's characteristics. The use of dental prosthetics is anintervention that changes the biological balance and microflora in thetissues of the oral cavity. It plays an important role in formingsoft and hard caries on the surface of the denture and the structure of damage in it.Keywords: defects of the tooth row, oral cavity, microbiology

Optimal chest wall prosthesis: comparative study of mechanical and functional behaviour

OBJECTIVES Chest wall resections are most commonly performed for tumours, infection, radiation necrosis and trauma. Defects in the anterior chest greater than 5 cm, posterior defects more than 10 cm or resection including more than 3 ribs, independently of the location, require skeletal prosthetic reconstruction. The aim of this paper was to evaluate the strength of prostheses that reproduced the normal human anatomy using different materials subjected to the most dangerous loading conditions. METHODS The biomechanical behaviours of different prosthetic materials under critical rib fracture conditions were analysed using the finite element method and then validated through mechanical testing of 3-dimensional polymethylmethacrylate ribs as a prosthesis reproducing the native anatomy of the human ribcage. RESULTS The prosthetic materials and the polymethylmethacrylate prosthesis were tested under 3 load conditions: sternal load (an anterior–posterior load applied at the third rib); lateral load (strength applied at the lateral arch of the fifth rib) and vertical load (vertical load applied at the first sternocostal junction) and showed the same results in terms of failures compared to the results from the finite element method model simulation (same location and number of fractures were detected). Although the displacement error between the finite element method and experimental test was up to 5% overall, no other microcracking was observed. CONCLUSIONS This experimental study demonstrated that all prosthetic materials currently available for human use show optimal mechanical behaviour in term of resistance and organ protection. Specifically, polymethylmethacrylate was a good candidate as a prosthetic material in term of lightness, resistance and prosthetic weight.

The Effect of Different Cleaning Protocols of Polymer-Based Prosthetic Materials on the Behavior of Human Gingival Fibroblasts

Dental implant abutment and prosthetic materials, their surface treatment, and cleaning modalities are important factors for the formation of a peri-implant soft tissue seal and long-term stability of bone around the implant. This study aimed to investigate the influence of a polymeric material surface cleaning method on the surface roughness, water contact angle, and human gingival fibroblasts (HGF) proliferation. Polymeric materials tested: two types of milled polymethylmethacrylate (PMMA-Ker and PMMA-Bre), three-dimensionally (3D) printed polymethylmethacrylate (PMMA-3D), polyetheretherketone (PEEK), and polyetherketoneketone (PEKK). Titanium (Ti) and zirconia oxide ceramics (ZrO-HT) were used as positive controls. A conventional surface cleaning protocol (CCP) was compared to a multi-step research cleaning method (RCP). Application of the RCP method allowed to reduce Sa values in all groups from 0.14–0.28 µm to 0.08–0.17 µm (p < 0.05 in PMMA-Ker and PEEK groups). Moreover, the water contact angle increased in all groups from 74–91° to 83–101° (p < 0.05 in the PEKK group), except ZrO-HT—it was reduced from 98.7 ± 4.5° to 69.9 ± 6.4° (p < 0.05). CCP resulted in higher variability of HGF viability after 48 and 72 h. RCP application led to higher HGF viability in PMMA-3D and PEKK groups after 48 h, but lower for the PMMA-Ker group (p < 0.05). After 72 h, no significant differences in HGF viability between both cleaning methods were observed. It can be concluded that the cleaning method of the polymeric materials affected surface roughness, contact angle, and HGF viability at 48 h.