A review of the literature revealed that 1) all prosthetic heart valves to date are plagued by certain problems, 2) all prosthetic valves in current clinical use are central-occlusion valves which do not effectively simulate natural valve action, and 3) the development of a true central-flow valve with the potential benefits of reduced pressure drop, turbulence, hemolysis, and thromboembolism could be a significant contribution. A central-flow, double-leaflet valve was developed. The wear, pressure drop, turbulence, and regurgitation associated with the new valve were evaluated. The wear test results indicated the need for additional testing using more wear resistant pin-bearing combinations. The flow tests revealed that the new valve with a 65 degree opening angle produced less pressure drop than other prostheses, but the new valve did not reduce turbulence as compared to other prostheses. In addition, the backflow and mean leak associated with the new valve were too high. Details of the testing procedures are presented and recommendations for future valve modifications and testing are included. / M.S.

O presente estudo avaliou a intercambiabilidade dos componentes protéticos de implantes de hexágono externo medindo-se a precisão da interface implante/pilar (I/P) com microscopia eletrônica de varredura. Foram utilizados dez implantes para cada uma de três marcas (SIN, Conexão, Neodent) com seus respectivos pilares (base metálica de CoCr , rotacional e não rotacional) e um de marca alternativa (Microplant) em um arranjo com todas as combinações de I/P possíveis. O valor de referência para a intercambiabilidade das várias marcas de componentes foi definido pela diferença do pilar original para com seu respectivo implante. Dessa maneira, a intercambiabilidade foi considerada válida quando o resultado para um determinado pilar colocado sobre um implante fosse igual ou menor que a diferença medida, quando o pilar da mesma marca do implante foi posicionado. Um grau de desajuste foi observado em todos os espécimes. De uma maneira geral, o pilar antirrotacional foi mais preciso do que o rotacional. Estes variaram de 0,6 16,9m, com mediana 4,6m, enquanto o antirrotacional foi de 0,3 12,9m, com mediana de 3,4m. Os espécimes com o pilar e o implante Conexão tiveram uma diferença maior que o conjunto original para SIN e NEO (p<0,05). Apesar de estes últimos apresentarem resultados semelhantes com seus respectivos pilares, quando trocados, não mantiveram a mesma precisão original. Os resultados sugerem que a marca alternativa seria a única que apresentaria compatibilidade com todos os sistemas, enquanto as outras marcas não seriam completamente intercambiáveis. / The present study evaluated the interchangeability of prosthetic components for external hexagon implants by measuring the precision of the implant/abutment (I/A) interface using scanning electron microscopy. Ten implants for each of three brands (SIN, Conexão, Neodent) were tested with their respective abutments (milled CoCr collar rotational and non-rotational) and that of an alternative manufacturer (Microplant) in randomly arranged I/A combinations. The degree of interchangeability between the various brands of components was defined using the original abutment interface gap with its respective implant as the benchmark dimension. Accordingly, when the result for a given component placed on an implant was equal to or smaller then that gap measured when the component of the same brand as the implant was positioned, interchangeability was considered valid. Some degree of maladjustment was observed on all specimens. Generally, the non-rotational component was more accurate than its rotational counterpart. The latter samples ranged from 0.6 16.9m, with a median of 4.6m; the former from 0.3 12.9m, with a median of 3.4m. Specimens with the abutment and fixture from Conexão had larger microgap than the original set for Sin and Neodent (p<0.05). Even though the latter systems had similar results with their respective components, their interchanged abutments did not reproduce the original accuracy. The results suggest that the alternative brand abutment would have compatibility with all systems while the other brands were not completely interchangeable.

O presente estudo avaliou a intercambiabilidade dos componentes protéticos de implantes de hexágono externo medindo-se a precisão da interface implante/pilar (I/P) com microscopia eletrônica de varredura. Foram utilizados dez implantes para cada uma de três marcas (SIN, Conexão, Neodent) com seus respectivos pilares (base metálica de CoCr , rotacional e não rotacional) e um de marca alternativa (Microplant) em um arranjo com todas as combinações de I/P possíveis. O valor de referência para a intercambiabilidade das várias marcas de componentes foi definido pela diferença do pilar original para com seu respectivo implante. Dessa maneira, a intercambiabilidade foi considerada válida quando o resultado para um determinado pilar colocado sobre um implante fosse igual ou menor que a diferença medida, quando o pilar da mesma marca do implante foi posicionado. Um grau de desajuste foi observado em todos os espécimes. De uma maneira geral, o pilar antirrotacional foi mais preciso do que o rotacional. Estes variaram de 0,6 16,9m, com mediana 4,6m, enquanto o antirrotacional foi de 0,3 12,9m, com mediana de 3,4m. Os espécimes com o pilar e o implante Conexão tiveram uma diferença maior que o conjunto original para SIN e NEO (p<0,05). Apesar de estes últimos apresentarem resultados semelhantes com seus respectivos pilares, quando trocados, não mantiveram a mesma precisão original. Os resultados sugerem que a marca alternativa seria a única que apresentaria compatibilidade com todos os sistemas, enquanto as outras marcas não seriam completamente intercambiáveis. / The present study evaluated the interchangeability of prosthetic components for external hexagon implants by measuring the precision of the implant/abutment (I/A) interface using scanning electron microscopy. Ten implants for each of three brands (SIN, Conexão, Neodent) were tested with their respective abutments (milled CoCr collar rotational and non-rotational) and that of an alternative manufacturer (Microplant) in randomly arranged I/A combinations. The degree of interchangeability between the various brands of components was defined using the original abutment interface gap with its respective implant as the benchmark dimension. Accordingly, when the result for a given component placed on an implant was equal to or smaller then that gap measured when the component of the same brand as the implant was positioned, interchangeability was considered valid. Some degree of maladjustment was observed on all specimens. Generally, the non-rotational component was more accurate than its rotational counterpart. The latter samples ranged from 0.6 16.9m, with a median of 4.6m; the former from 0.3 12.9m, with a median of 3.4m. Specimens with the abutment and fixture from Conexão had larger microgap than the original set for Sin and Neodent (p<0.05). Even though the latter systems had similar results with their respective components, their interchanged abutments did not reproduce the original accuracy. The results suggest that the alternative brand abutment would have compatibility with all systems while the other brands were not completely interchangeable.

Indiana University-Purdue University Indianapolis (IUPUI) / Background: New glass ceramics and Computer-Aided Design/Computer Assisted Manufacture (CAD/CAM) have become common aspects of modern dentistry. The use of posterior ceramic crowns with a high level of esthetics, fabricated using the CAD/CAM technology is a current treatment modality. Several materials have been used to fabricate these crowns, including lithium disilicate glass-ceramics, which have not been fully investigated in the literature. Objective: to investigate the load to fracture of lithium disilicate glass ceramic posterior crowns fabricated by CAD/CAM technology with different material thicknesses adhesively cemented on epoxy resin. Methods: Four groups of different ceramic thicknesses (0.5 mm, 1 mm, 1.5 mm, and 2 mm) were fabricated by milling CAD/CAM lithium disilicate IPS emax CAD blocks. A total of 68 posterior crowns were surface treated and luted with a resin adhesive cement on an epoxy resin model. Samples were fatigued then loaded to fracture using a universal testing machine to test the fracture strength. Statistical comparisons between various crown thicknesses were performed using one-way ANOVA followed by Fisher's Protected Least Significant Differences. Results: There was a significant difference in the load-to-fracture (N) value for all comparisons of the four thickness groups (p < 0.0001), except 2 mm vs. 1.5 mm (p = 0.325). The mean load-to-fracture (N) was significantly higher for 2 mm than for 1 mm or 0.5 mm. Additionally, the mean load-to-fracture was significantly higher for 1.5 mm than for 1 mm or 0.5 mm. Furthermore, the mean load-to-fracture was significantly higher for 1 mm than for 0.5 mm. Conclusion: Within the limitation of this study, it is advisable for clinical applications to consider a crown thickness of 1.5 mm or greater of milled lithium disilicate for posterior single teeth.

Indiana University-Purdue University Indianapolis (IUPUI) / The objective of this study was to evaluate the in vivo performance of the novel press-fit dental implant fabricated via electron beam melting (EBM, Southern Methodist Univ.) and compare it to a commercially-available porous-coated press-fit dental implant (Endopore, Innova Corp.). Twelve cylindrical shaped implants 3 mm in diameter x 5 mm long were made by EBM (Southern Methodist Univ.) using Ti6Al4V ELI alloy. Twelve commercial implants (Endopore, Innova Corp.) of the same geometry were used as controls. Samples were implanted in rabbit tibia and retrieved six weeks postoperatively. Six specimens from each implant type were embedded undecalcified, sectioned, and stained with toluidine blue (Sigma) for histomorphometry analysis. Bone-to-implant contact (BIC) was measured. On the six remaining samples from each implant type, the mechanical properties were evaluated by pushout test on a material testing machine. The samples were loaded at a loading rate of 1 mm/min. The pushout strength was measured and the apparent shear stiffness was calculated. The results were analyzed with a paired-t test. The histology shows osteointegration of surrounding bone with both implant types. Bone was found to grow into the porous space between the beads. Both the Endopore (Innova Corp.) and the EBM (Southern Methodist Univ.) showed similar BIC. The mean BIC for the Endopore (Innova Corp.) and EBM (Southern Methodist Univ.) implant were 35 ± 6% and 32 ± 9%, respectively. It failed to reach statistical significance (p > 0.05). The peak pushout force for Endopore (Innova Corp.) and EBM (Southern Methodist Univ.) implants were 198.80 ± 61.29 N and 243.21 ± 69.75 N, respectively. The apparent shear stiffness between bone and implant for the Endopore (Innova Corp.) and EBM (Southern Methodist Univ.) implants were 577.36 ± 129.99 N/mm; and 584.48 ± 146.63 N/mm, respectively. Neither the peak pushout force nor the apparent shear stiffness of the implants was statistically different between the two groups (p > 0.05). The results suggest that the implants manufactured by EBM (Southern Methodist Univ.) perform equally well as the commercial implant Endopore (Innova Corp.) in this current animal model.

No / Epidemiologic research has shown that multifocal spectacle wearers (bifocal and progressive addition lenses [PALs]) are more than twice as likely to fall than are nonmultifocal spectacle wearers, with this risk further increasing when negotiating stairs. The present study investigated whether step and stair descent safety is improved by using single-vision distance lenses. METHODS: From a stationary standing position on top of a block, 20 long-term multifocal wearers stepped down (from different block heights) onto a lower level wearing bifocal, progressive addition, or single-vision distance lenses. RESULTS: Use of single-vision distance spectacles led to an increased single-limb support time, a reduced ankle and knee angle and vertical center-of-mass velocity at contact with the lower level, and a reduced ankle angular velocity and vertical center-of-mass velocity during initial landing (P < 0.03). These findings indicate that landing occurred in a more controlled manner when the subjects wore single-vision distance spectacles, rather than tending to "drop" onto the lower level as occurred when wearing bifocals or PALs. CONCLUSIONS: Use of single-vision distance spectacles led to improvements in landing control, consistent with individuals' being more certain regarding the precise height of the lower floor level. This enhanced control was attributed to having a view of the foot, step edge, and immediate floor area that was not blurred, magnified, or doubled and that did not suffer from image jump or peripheral distortions. These findings provide further evidence that use of single-vision distance lenses in everyday locomotion may be advantageous for elderly multifocal wearers who have a high risk of falling.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 5 uppsatser.