Indiana University-Purdue University Indianapolis (IUPUI) / Background: VST-50 (a room temperature-vulcanizing silicone (RTV) by Factor II Inc.) has long been proposed as a potential alternative material for MDX4-4210, another RTV by Dow Corning Corp. and the current material of choice for maxillofacial prosthesis. Though VST-50 has similar chemistry and flexibility as MDX4-4210, its mechanical properties is still too low for it to be used in the clinic. An improvement in the mechanical property of VST-50 is a critical step to bring the material to clinical application. Objective: To investigate the effect of AEROSIL® R 812S (colloid silica) addition on the mechanical properties of VST-50 and compared to that of MDX4-4210. Methods: The VST-50 was mixed with AEROSIL® R 812S at 2 or 4 parts per hundred parts of rubber. That material was mixed with the catalyst under vacuum. The mixture was poured onto a machined plastic mold to produce a silicone sheet 3.0 ± 0.2 mm thick. All samples were prepared by manufacturer recommended method. Testing samples were prepared and tested following ISO 37 for tensile strength, ASTM D624 for tear strength and ASTM D2240 for shore A hardness test. One way ANOVA was used to compare the groups (Alpha=0.05). Result: Significant differences (P<0.001) were found between MDX4-4210 and modified VST-50 groups. The mean value of tensile strength, tear strength and hardness of VST-50 (4phr colloid silica) were 7.43(MPa), 34.82(N/mm) and 40.4 respectively, compared to MDX4-4210 were 3.67(MPa), 5.48(N/mm) and 31.5, respectively. Conclusion: Modified VST-50 with 4phr silica revealed improved mechanical properties to use as a maxillofacial prosthetic silicone elastomer.

Hip-knee-ankle-foot (HKAF) prostheses are full lower limb devices for people with hip amputations. They are designed to enable individuals to regain their mobility and move freely with little restriction. HKAFs typically have high rejection rates among users, as well as gait asymmetry and increased trunk anterior-posterior lean and pelvic tilt. In this thesis, a novel integrated hip-knee (IHK) unit was designed and evaluated to address the limitations of existing solutions. This IHK combines powered hip and microprocessor controlled knee joints into one structure, with shared electronics, sensors, and batteries. The unit is also adjustable to the user leg length by a prosthetist. ISO-10328 standard mechanical testing demonstrated acceptable structural safety and rigidity. Successful functional testing involved three able-bodied participants walking with the IHK in a hip prosthesis simulator. Hip and knee joint angles and pelvic tilt angles were recorded, gait characteristics were analyzed using video recordings. Testing showed that the participants were able to walk using the IHK, and data showed that participants used different walking strategies. Points of improvement were identified for future development of the thigh unit, including completion of a synergistic gait control system, improved battery holding mechanism, and amputee user testing.

No description available.

Esta tese de Doutorado busca contribuir na formação de subsídios científicos tanto para o projeto de uma prótese antropomórfica para membros superiores, quanto para a criação de um ambiente de treinamento, ou seja, um ambiente virtual de ação e realimentação das sensações, que poderá incorporar os mecanismos, atuadores, sensores ou estimuladores desenvolvidos. Ao final desta pesquisa, foram projetados e testados os mecanismos, sensores e alguns dispositivos de realimentação que farão parte do desenvolvimento de uma prótese de mão, a Mão de São Carlos, que possuirá características antropomórficas, para reproduzir os movimentos naturais da mão humana com um controle simplificado para o paciente. A motivação principal deste trabalho é diminuir o índice de rejeição das próteses para membros superiores, facilitando seu processo de treinamento e controle / This Doctoral thesis should contribute to the gathering of scientific subsidies for the project of a multifunction anthropomorphic upper limb prosthesis, in special the artificial hand, and for the creation of a training software, i.e., a software for the sensory's action and feedback. At the end of this research, the mechanisms, sensors, actuators and some feedback devices were designed and tested, that will be part of the development of a hand prosthesis, the São Carlos Hand, which will possess anthropomorphic characteristics, a simplified control for the patient and will reproduce the natural movements of the human hand. The main motivation of this work is to reduce the rejection index of the upper limb prosthesis, facilitating training process and control

Esta tese de Doutorado busca contribuir na formação de subsídios científicos tanto para o projeto de uma prótese antropomórfica para membros superiores, quanto para a criação de um ambiente de treinamento, ou seja, um ambiente virtual de ação e realimentação das sensações, que poderá incorporar os mecanismos, atuadores, sensores ou estimuladores desenvolvidos. Ao final desta pesquisa, foram projetados e testados os mecanismos, sensores e alguns dispositivos de realimentação que farão parte do desenvolvimento de uma prótese de mão, a Mão de São Carlos, que possuirá características antropomórficas, para reproduzir os movimentos naturais da mão humana com um controle simplificado para o paciente. A motivação principal deste trabalho é diminuir o índice de rejeição das próteses para membros superiores, facilitando seu processo de treinamento e controle / This Doctoral thesis should contribute to the gathering of scientific subsidies for the project of a multifunction anthropomorphic upper limb prosthesis, in special the artificial hand, and for the creation of a training software, i.e., a software for the sensory's action and feedback. At the end of this research, the mechanisms, sensors, actuators and some feedback devices were designed and tested, that will be part of the development of a hand prosthesis, the São Carlos Hand, which will possess anthropomorphic characteristics, a simplified control for the patient and will reproduce the natural movements of the human hand. The main motivation of this work is to reduce the rejection index of the upper limb prosthesis, facilitating training process and control

This thesis deals with the current state of development of active lower limb prostheses and focuses mainly on own design of active prostheses. The introduction deals with the anatomy of lower limb and briefly describes the walk cycle. In other chapters are summarized amputation techniques in the lower limb, followed by a description of the allocation of prostheses according to the level of amputation, which were described in earlier chapters. The thesis also deals with the division of prostheses according to the patient's activity level and briefly describes the structural differences in these individual cases. Chapter describing the actual development in the field of active prostheses initiates part dealing with the detailed description of the part of the prosthesis. The following chapters deal with the design and implementation of a prototype of active transfemoral prosthesis. The penultimate chapter deals with the software description of all parts of the prosthesis. This chapter is followed by an evaluation of the achieved results.

Prosthesis treatment requires the close interaction of different actors. In fitting prostheses to patients, special attention is given to the manufacturing of the socket. The continuous development of the technologies involved in the fitting and optimization of prostheses is shown in the literature. The assessment of orthopedic technicians and their influence in the process is thus far largely unexplored. Ten orthopedic technicians were interviewed about the socket fitting process after transfemoral amputation. The research goal was to clarify the socket treatment process with regards to the German context. The results showed that the orthopedic technicians focussing on the patient during the fitting process. This study underlines the importance of interaction and empathy. Volume fluctuations are decisive within the treatment process and are interactively influenced by various factors. Furthermore, the research emphasizes the need for appropriate assistive technologies and the potential for the further development of existing systems.

ITC/USA 2009 Conference Proceedings / The Forty-Fifth Annual International Telemetering Conference and Technical Exhibition / October 26-29, 2009 / Riviera Hotel & Convention Center, Las Vegas, Nevada / Even after rehabilitation, patients with lower-limb amputation may continue to exhibit suboptimal gait. A wireless telemetry system, featuring force sensors, accelerometers, control electronics and a Bluetooth transmission module was developed to measure plantar pressure information and remotely monitor patient mobility. Plantar pressure characterization studies were performed to determine the optimal sensor placement. Finally, the wireless telemetry system was integrated with a previously developed haptic feedback system in order to allow remote monitoring of patient mobility during haptic system validation trials.

A utilização dos implantes cone morse muito favorece a estética peri-implantar e seu uso em conjunto com próteses cimentadas favorece ainda mais a estabilidade do sistema, simplificando também os procedimentos protéticos. O presente estudo histológico e histomorfométrico utilizou os implantes cone morse com o intuito de avaliar o comportamento tecidual com relação à posição da margem da cimentação protética em relação ao tecido ósseo quando se faz o uso próteses cimentadas. Foram utilizados quatro cães, os quais tiveram todos os pré-molares inferiores extraídos numa primeira fase cirúrgica. Após três meses, realizou-se a segunda fase cirúrgica, na qual foi realizada a técnica da carga imediata, com a instalação dos implantes juntamente com os pilares protéticos. Foram instalados vinte e quatro implantes numa profundidade de 3 mm infra óssea e eles foram igualmente divididos entre os grupos Controle e Experimental. Os pilares protéticos utilizados foram do tipo munhão universal e apresentavam diferentes alturas transmucosas iguais a 1.5 mm, 3.5 mm, e 5.5 mm. Isto fez com que a margem da cimentação se posicionasse a 1.5 mm infra óssea, a 0.5 mm supra óssea e a 2.5 mm supra óssea. No grupo Controle, foi realizada a instalação dos implantes e dos pilares protéticos somente. No grupo Experimental, foi realizada a instalação dos implantes, dos pilares protéticos e, sobre estes, foram cimentados cilindros de alumina. Os animais permaneceram sobre controle de placa durante 10 semanas subsequentes a instalação dos implantes, sendo este o tempo final do experimento através da realização da eutanásia. As amostras foram preparadas para análise histológica e avaliação dos tecidos peri-implantares. A região de interesse foi medida através da distância entre a margem do pilar protético e a porção mais coronal da crista óssea peri-implantar. Foram utilizados os testes estatísticos ANOVA a três critérios com medidas repetidas e teste de Tukey com o nível de significância de p < 0.05. Os resultados mostraram que não houve diferenças estatisticamente significantes entre os grupos Controle e Experimental (p = 0.2764) e que os pilares de 1.5 mm mostram menos perda óssea comparada aos outros pilares, considerando que a distância média da remodelação óssea foi menor neste grupo (0.6859 mm) comparada com os pilares de 3.5 mm (1.2917 mm) e 5.5 mm (1.0823 mm). Conclui-se que não há influência da profundidade da margem da cimentação protética no comportamento da crista óssea e que a utilização de diferentes alturas dos pilares protéticos não parece alterar o tecido ósseo marginal ao redor dos implantes Cone Morse. / The use of Morse taper implants has increased because of some positive features. Cemented crowns can be extensively used, taking advantage of the system connection stability, also simplifying the prosthetic procedures. The present histological and histomorphometric study used Morse taper implants with the purpose of evaluating bone behavior with respect to the cementation margin position of the prosthetic crown. Four dogs had all premolars extracted at a first surgical procedure. After three months, there was a second surgical procedure with simultaneous installation of implants and abutments, submitted to immediate load. Twenty four implants were installed 3 mm below the bone level and they were equally divided between Control and Experimental groups. The universal post abutments used had three different transmucosal heights, 1.5 mm, 3.5 mm and 5.5 mm. Thus there were implants with the level of the cementation margin positioned 1.5 mm below the bone level, as well as 0.5 mm and 2.5 mm above the bone level. In the Control group, installation of implants and abutments only was performed. In the Experimental group immediately after the placement of implants and abutments alumina cylinders were cemented. The animals were kept on plaque control for 10 weeks after implant placement and then euthanized. Samples were prepared for histological analysis and evaluation of peri-implant tissues. The region of interest was measured by the distance between the prosthetic margin of the abutment to the most coronal peri-implant bone crest. ANOVA test at three criteria with repeated measures and Tukey test with a significance level of p < 0.05 were applied. The results showed no statistically significant differences between Control and Experimental groups (p = 0.2764). The 1.5 mm abutments presented less bone loss compared to all other abutments tested, because the distance average of bone remodelation was shorter in this group (0.6859 mm) compared to the 3.5 mm abutment (1.2917 mm) and the 5.5 mm one (1.0823 mm). Conclusion: There is no influence of the depth of prosthetic marginal cementation on the behavior of bone crest and the use of different transmucosal heights of abutments does not seem to change the marginal bone surrounding morse taper implants.

Objetivo: Próteses subgengivais aumentam a incidência de inflamação gengival, principalmente em periodontos delgados, culminando com o desenvolvimento de retrações gengivais em dentes e implantes. A proposta deste trabalho foi avaliar se o aumento da espessura gengival pode prevenir a formação de retrações gengivais. Materiais e Métodos: Modelo de boca dividida foi utilizado em 8 cães, retalho dividido foi realizado para inserir a matriz colágena suína (MCS) para aumento da espessura gengival e após três meses, próteses subgengivais foram instaladas para gerar inflamação gengival e depois de três meses os animais foram sacrificados. Os grupos: Grupo 1 (G1): MCS adaptada na região de Pré-molar 2 (P2), Pré-molar 3 (P3) e Pré-molar 4 (P4), com próteses subgengivais; Grupo 2 (G2): sem MCS na região de P2, P3 e P4, com próteses subgengivais; Grupo 3 (G3): controle do grupo 1, MCS adaptada na região de Pré-molar 1 (P1), sem próteses e Grupo 4 (G4): controle do grupo 2, sem MCS na região de P1 e sem próteses. Foram realizadas medidas clínicas de espessura e altura do tecido gengival queratinizado, profundidade de sondagem e nível clínico de inserção em três tempos (antes do aumento gengival, antes da instalação das próteses e após o sacrifício). Análise imunohistoquímica foi realizada para detectar a presença de células de defesa e padrão de queratinização gengival. Análise histomorfométrica foi realizada para quantificar as diferenças dos tecidos duros e moles entre os diferentes grupos de tratamento. Resultados: Durante os períodos de avaliação não houve variação na altura do tecido queratinizado entre os grupos, no entanto, G1 e G2 apresentaram maior espessura gengival quando comparados a G3 e G4. A profundidade de sondagem foi superior em G3 e G4 quando comparada a G1 e G2. Houve perda de inserção clínica somente em G1 e G2. As análises histomorfométricas para tecido mole e duro confirmaram os resultados clínicos. A análise imunohistoquímica não encontrou diferenças na contagem das células de defesa. Conclusão: A MCS foi capaz de aumentar a espessura gengival e prevenir a ocorrência de retrações gengivais em dentes que receberam próteses subgengivais em modelo experimental canino. / Aim: Subgingival prosthesis increases the gingival inflammation incidence, especially in thin gingival biotype, leading to the development of gingival recessions. The purpose of this study was to evaluate whether the increase in gingival thickness can prevent the formation of gingival recession. Materials and Methods: Eight dogs received porcine collagen matrix to increase gingival thickness, which was then followed by subgingival prosthesis placement in order to generate gingival inflammation. Group 1: gingival thickness increase from second to fourth premolars, using subgingival prostheses; Group 2: subgingival prosthesis placement from second to fourth molars; Group 3: gingival thickness increase in the first premolar, no prostheses; Group 4: control. Clinical measurements of gingival thickness and height, clinical probing depth and clinical attachment levels were performed. Immunohistochemical analyses were performed to detect defense cells, keratinization patterns and differences between soft and mineralized tissues. Results: There was no variation in keratinized tissue height. Thicker gingiva was encountered in Groups 1 and 2, which developed gingival recession, which did not occur in Groups 3 and 4. Probing depth was more pronounced in Groups 3 and 4. Histomorphometric analysis for soft and mineralized tissues confirmed clinical findings. Immunohistochemical analysis did not show differences in defense cell counting. Conclusion: The increase in gingival thickness may minimize gingival recessions when associated with subgingival prosthesis.