O uso do Sistema CAD/CAM já é bastante consagrado na Odontologia, não sendo diferente na reabilitação facial. Traz diversas facilidades, porém poucos trabalhos relatam as reabilitações da região óculo-palpebral. Nesse estudo, a aquisição de imagem tridimensional foi feita com o uso de um escâner de superfície a laser, FARO Edge ScanArm®, protegendo-se o olho contralateral com uso de lente gelatinosa preta; método que demonstrou eficiência na obtenção de imagem de pálpebras abertas para confecção de protótipo reverso. Foram selecionados 10 pacientes com exenteração de órbita, de ambos os gêneros, sendo 5 com mutilação à esquerda e 5 à direita. Todos os pacientes receberam duas próteses óculo-palpebrais, uma confeccionada pelo método convencional e outra pelo sistema CAD/CAM. As reabilitações foram registradas fotograficamente e avaliadas por 30 indivíduos leigos, 3 especialistas em prótese bucomaxilofacial e pelos próprios pacientes, usando-se a Escala VAS. Para avaliar a variação intraexaminador, 15 leigos repetiram a avaliação com intervalo de uma semana, assim como os 3 especialistas. Os resultados demonstraram consistência interna e uma boa reprodutibilidade dos dados em todos os grupos. A percepção estética foi melhor avaliada nas próteses obtidas pelo método convencional; entretanto, a relevância da diferença observada entre os dois métodos foi avaliada como razoável. / The use of CAD/CAM system is already an established method in Dentistry, no different in facial rehabilitation. It brings several facilities, but few studies have already reported the rehabilitations of the orbital area. In this research the acquisition of the three dimensional image was taken using a surface laser scanner, FARO Edge ScanArm®, protecting the contralateral eye with the use of a black gelatinous contact lens; this method has demonstrated effectiveness in getting image with open eyelids for making reverse prototype. 10 patients were select with orbit exenteration, of both genders, 5 with left mutilation and 5 with right. All patients received two oculopalpebral prostheses, one obtained by the conventional method and another by the CAD/CAM system. The rehabilitations were photo registrated and assessed by 30 lay assessors, 3 bucomaxillofacial prosthetic specialists and by the patients themselves using the VAS Scale. To evaluate the intraexaminer variation, 15 lay assessors repeated the evaluation with one week interval, as did the specialists. The results demonstrated good interexaminer variation and reproducibility of data in all groups. The aesthetic perception was better evaluated in prostheses obtained by the conventional method; however, the relevance of difference between the two methods was assessed as a reasonable one.

A proposta deste estudo foi analisar o desenvolvimento da força máxima de mordida em um grupo de pacientes que recebeu próteses parciais fixas sobre implantes (PPFSI) nas regiões de molares, pré-molares até caninos e incisivos antagonizando com dentes naturais e comparar os resultados obtidos com as áreas dentadas do mesmo grupo de pacientes, durante um período de 64 meses (5,3 anos). As forças de mordida foram medidas em cinco regiões da boca: molares em ambos os lados, pré-molares ou caninos em ambos os lados e incisivos; nas áreas de próteses sobre implantes e também nas áreas de dentes naturais. Para tanto, foi usado um transdutor medidor de força de mordida, que tem como princípio de funcionamento uma célula de força colada a um garfo de mordida, amplamente usado na literatura e sempre operado pelo pesquisador. As medições foram feitas imediatamente após a instalação das próteses, 3, 30 e 64 meses depois. Comparando o desenvolvimento das forças de mordida entre as áreas implantadas e de dentes naturais encontra-se já no primeiro controle, após 3 meses de instalação, um aumento das forças de mordida nas próteses sobre implantes instaladas na região de molares que supera as forças desenvolvidas por dentes naturais na mesma região. Para as próteses instaladas na área de incisivos, ao contrário, não foi registrado aumento estatístico destas forças, havendo uma tendência em permanecerem menores quando comparadas às forças desenvolvidas nas mesmas regiões por dentes naturais. Na região de pré-molares ou caninos não houve aumento estatístico de força nas PPFSI. Quando analisadas as áreas dentadas dos pacientes, não houve mudança estatística de força de mordida em nenhuma das regiões durante todo o experimento. / This study proposal was to analyse the changes on the maximal bite force on a patients sample who had implant-supported partial fixed prosthesis (FPP) installed and the results were compared to the ones obtained from the dentate areas on the same sample. Sixteen patients were followed for sixty-four months (5.3 years) and the bite forces were measured on the mouth regions which the prosthesis were installed (molars and premolars up to canines and incisors regions). This measured occurred on five regions of the mouth: both side molars, pre-molars or canines and incisives; either on the places it had a implant as well as on the natural teeth area. In order to do that, it was used as a measuring device, a largely used apparatus which consisted of a biting fork provided with a strain gauge. The bite forces recordings were made at the time of prosthesis installation, after 3, 30 and 64 months thereafter. It was found a bite force increase in the initial period of 3 months after the prosthesis installation in the area of FPP in the molar regions. In this period the bite forces became higher than in dentate situation in the same region and it manteined on this level until the final of the experiment. Comparing the bite straight development between the implanted areas and the natural teeth areas, we found a bite force increased on the prostheses installed over the molars region that overcome the straight development for natural teeth on the same area. On the other hand, for the prostheses installed on the incisive areas, we had not found a statistical straight increased. Actually, it was a tendency to keep smaller than the straight developed on the same regions by natural teeth. On premolars regions or canines, there was not a straight statistical increased on PPFSI. When we analyze the patients? teeth areas, there was not a statistical bite increase on any of the premolars or canines regions during the entire experiment.

Este estudo objetivou pesquisar a distribuição das tensões através de próteses fixas implanto-suportadas e dento-implanto-suportadas em hemi-mandíbulas de canis familiaris mediante o método de interferometria holográfica de dupla exposição. Três cães foram selecionados e colocados três implantes em cada um deles (hemi-mandíbula direita: um implante e na hemi-mandíbula esquerda: dois implantes). Após a espera de dois meses, os dois tipos de próteses foram fixados sobre os implantes e os animais sacrificados. A seguir, as hemi -mandíbulas foram extraídas e fixadas no dispositivo especialmente desenhado para tal fim (CAMPOS, 2001). Todo o sistema foi colocado sobre uma mesa holográf ica e carga estática foi aplicada sobre três posições previamente estabelecidas nas próteses (sobre o pilar anterior, ponto médio da barra e pilar posterior). 18 hologramas foram obtidos mediante a técnica holográfica. A análise dos hologramas revelou que de forma geral, as hemi-mandíbulas com próteses dento-implanto-suportadas sofreram maior tensão quando comparadas com as hemi-mandíbulas com próteses implanto-suportadas. Em relação às próteses, as implanto-suportadas foram aquelas que melhor distribuíram os esforços quando comparadas com as dento-implanto-suportadas. / The aim of this study was to investigate the stress distribution of tooth-implant and implant supported prosthesis in dog mandibles by means of holographic interferometry double exposition method. Three mongrel dogs were selectioned and three osseointegrated implants were placed (right hemi-mandible: one implant and in the left hemi-mandible: two implants). After two months, both prostheses were fixed on the implants and the animals were sacrificed. The hemi-mandibles were fixed in a special device (CAMPOS, 2001) and placed on the holographic table. A static load was applied on three different positions on the prosthesis (anterior abutment, midpoint of the bar and posterior abutment) and eighteen holograms were obtained. The hologram analysis revealed that the hemi-mandibles with tooth-implant prosthesis transmitted more tension that the hemi-mandibles with implant supported prosthesis. In addition to, an equal distribution of stress were observed in the implant supported prosthesis when compared with the tooth-implant prosthesis.

Background Recent conflicts have seen an increase in trauma related military amputees who incur complex injuries which result in varied residual limbs. In many cases these amputees have been provided with state of the art (SOTA) components with the expectation that they will transfer into NHS care after military discharge. However, there is a lack of knowledge around how prosthetic prescriptions are made in both the MOD and NHS, including patient involvement. It is important to explore prosthetic prescription decisions to enhance the quality, consistency and equity of care delivery for trauma amputees. This thesis explores decision making in prosthetic care for trauma amputees in the UK during this period of change. Aims To explore aspects of prosthetic care provision in the UK including clinical decision making, patient experience and the transition of prosthetic care from the MOD to the NHS. Design An exploratory qualitative project informed by decision making and patient involvement theory. Semi-structured interviews were carried out with nineteen clinical staff involved in prosthetic provision, six civilian and five veteran trauma amputees. Thematic analysis was used to analyse the data. Findings Prosthetists used a wide range of factors in making prescription decisions, including physical characteristics, patients’ goals, and predicted activity levels. Prescription decision making varied depending on the prosthetists’ level of experience and the different ‘cues’ identified. In some cases there was a lack of transparency about drivers for the prescription choice. Prescription decisions are influenced by long term relationships between prosthetist and patient, allowing a trial and error approach with increasing patient involvement over time. Patient experiences of their trauma amputation influenced their approach to rehabilitation. Patients reported wanting different levels of involvement in their prosthetic care, however, communication was essential for all. Veteran amputees benefited from peer support opportunities which NHS services were less conducive to. However, NHS amputees were more likely to have been ‘involved’ in care decisions. The expectations that MOD patients had of inferior care in the NHS were not realised in the majority of veteran cases. Recommendations Research is needed to support prosthetists’ decisions to become more consistent and transparent. The NHS should consider introducing a peer support model for trauma patients, and particularly in the early stages of rehabilitation.

This diploma thesis has an aim to fabricate a prototype of esthetical prosthesis using solely Rapid Prototyping aditive technology and to explore the possibility of using commercially available biocompatible materials. In the theoretical part, a description of types of ocular prosthesis types with the focus being on esthetic ocular prosthesis. is given. The practical part of the work offers a comprehensive view on the whole process of the prototype fabrication. It provides a description of creating the 3D model by scanning, geometrical adjustments of the model, textures mapping, print optimization and the printing itself. The closing part of the thesis consists of a discussing focused on an evaluation of the fabricated prototype followed by technical-economical assesment, a proposal of next steps, and a proposal of current usage of the created method.

This master thesis deals with lower-limb prosthesis. The aim of the first part of this work is stress-strain analysis of trans-tibial prosthesis, which is understand without prosthetic socket and the foam prosthetic feet. Analysis is made using finite element method in ANSYS Workbench 12.0 software. For the purpose of setting up the computational model it is necessary to make few partial models. Model of geometry of the prosthesis is made in SolidWorks 2009. Based on the outputs of stress-strain analysis and the results evaluation, the critical component is chosen and this one is evaluated according to limite state for fatigue. The algorithm of evaluation of named component in the state of high cycle fatigue is discussed in the second part of this thesis.

This report presents the design and manufacturing process of a bionic signal messagebroker (BSMB), intended to allow communication between implanted electrodes andprosthetic legs designed by Ossur. The BSMB processes and analyses the data intorelevant information to control the bionic device. The intention is to carry out eventdetection in the BSMB, where events in the muscle signal are matched to the events ofthe gait cycle (toe-o, stance, swing).The whole system is designed to detect muscle contraction via sensors implantedin residual muscles and transmit the signals wireless to a control unit that activatesassociated functions of a prosthetic leg. Two users, one transtibial and one transfemoral,underwent surgery in order to get electrodes implantable into their residual leg muscles.They are among the rst users in the world to get this kind of implanted sensors.A prototype of the BSMB was manufactured. The process took more time thanexpected, mainly due to the fact that it was decided to use a ball grid array (BGA)microprocessor in order to save space. That meant more complicated routing and higherstandards for the manufacturing of the board. The results of the event detection indicatethat the data from the implanted electrodes can be used in order to get sucient controlover prosthetic legs. These are positive ndings for users of prosthetic legs and shouldincrease their security and quality of life.It is important to keep in mind when the results of this report are evaluated that allthe testing carried out were only done on one user each.

No description available.

Student Number : 9710738R - MSc (Eng) dissertation - Faculty of Engineering and the Built Environment / This dissertation investigates the use of digital modeling methods for selected medical applications. The digital methods include the design of a cranial implant, auricular prosthesis and the duplication of an oral prosthesis. The digital process includes imaging, image processing, design and fabrication steps. Three types of imaging used are contact and non-contact measurement systems and CT scanning. The investigation uses a Phantom haptic device for digital design. The implants and prostheses are fabricated using a Thermojet printer and investment casting. Traditional and digital processes are compared using four case studies on selected criteria. The conclusions of the investigation are that a digital process can be used and is equal to or better than traditional methods in prosthesis and implant design.

Objetivo: Medir a pulsatilidade da parede do aneurisma de aorta humano antes e depois de sua correção endoluminal. Método: Cinco aneurismas foram submetidos à perfusão pulsátil antes e depois do implante de uma endoprótese. Resultado: o nível da coluna de água oscilou durante a pulsação com variações de 17, 16, 13, 7 e 25 cm antes da colocação da endoprótese. Depois da prótese, a oscilação diminuiu em todos os casos para 13, 12, 9, 3,5 e 23 cm, respectivamente. Conclusão: A pulsação da endoprótese é transmitida à parede do aneurisma / Objective: To measure the pulsatility of human aortic aneurysms before and after exclusion with endograft. Method: Five aneurysms were submitted to pulsatile perfusion before and after implantation of a bifurcated endograft. Result: The level of the water column oscillated during pulsation, in each case, with an amplitude of 17, 16, 13, 7 and 25 cm before the endograft insertion. After that, the amplitudes dropped to, respectively 13, 12, 9, 3.5 and 23 cm.Conclusion: Pulsation of an endograft is transmitted to the aneurysm wall even in the absence of endoleak