Clinically, a reconstruction plate can be used for the facial repair of patients with mandibular segmental defects, but it cannot restore their chewing function. The main purpose of this research is to design a new three-dimensionally (3D) printed porous titanium mandibular implant with both facial restoration and oral chewing function reconstruction. Its biomechanical properties were examined using both finite element analysis (FEA) and in vitro experiments. Cone beam computed tomography images of the mandible of a patient with oral cancer were selected as a reference to create 3D computational models of the bone and of the 3D-printed porous implant. The pores of the porous implant were circles or hexagons of 1 or 2 mm in size. A nonporous implant was fabricated as a control model. For the FEA, two chewing modes, namely right unilateral molar clench and right group function, were set as loading conditions. Regarding the boundary condition, the displacement of both condyles was fixed in all directions. For the in vitro experiments, an occlusal force (100 N) was applied to the abutment of the 3D-printed mandibular implants with and without porous designs as the loading condition. The porous mandibular implants withstood higher stress and strain than the nonporous mandibular implant, but all stress values were lower than the yield strength of Ti-6Al-4V (800 MPa). The strain value of the bone surrounding the mandibular implant was affected not only by the shape and size of the pores but also by the chewing mode. According to Frost’s mechanostat theory of bone, higher bone strain under the porous implants might help maintain or improve bone quality and bone strength. The findings of this study serve as a biomechanical reference for the design of 3D-printed titanium mandibular implants and require confirmation through clinical investigations.
There is a distinct male predominance in head and neck cancers. The present study aimed to investigate the clinical and pathological features of male and female patients with oral squamous cell carcinoma (OSCC), and to simultaneously conduct a survival analysis. Patients (n = 2573) were identified between January 2008 and December 2018, and subsequently analyzed for characteristics such as age at squamous cell carcinoma diagnosis, lifestyle factors (smoking habit, betel nut chewing and alcohol consumption), pathological American Joint Committee on Cancer (AJCC) anatomic site, AJCC TNM stage, pathological recurrence factor and interval from first diagnosis to recurrence. A case-matched comparison between female (n = 122) and male (n = 2451) patients was conducted. Significant gender differences were noted in age at diagnosis, anatomic site of the tumor, smoking habit, betel nut chewing and alcohol consumption (p < 0.001). There were no significant gender differences in the other clinical and pathological characteristics and survival conditions. In conclusion, female patients with OSCC were older than male patients with OSCC, and mostly had tumors of the oral tongue. Once patients develop OSCC, there was no difference in survival between men and women in a Taiwanese population.
Satisfactory host bone quality and quantity promote greater primary stability and better osseointegration, leading to a high success rate in the use of dental implants. However, the increase in life expectancy as a result of medical advancements has led to an aging population, suggesting that osteoporosis may become a problem in clinical dental implant surgery. Notably, relative to the general population, bone insufficiency is more common in women with post-menopausal osteoporosis. The objective of this study was to compare the thickness of the crestal cortical bone at prospective dental implant sites between menopausal and non-menopausal women. Prospective dental implant sites in the jawbone were evaluated in two groups of women: a younger group (<50 years old), with 149 sites in 48 women, and an older group (>50 years old) with 191 sites, in 37 women. The thickness of the crestal cortical bone at the dental implant site was measured based on each patient’s dental cone-beam computed tomography images. For both groups, one-way analysis of variance and Tukey’s post-test were used to assess the correlation between cortical bone thickness and the presence of implants in the four jawbone regions. Student’s t-test was further used to compare differences between the older and younger groups. From the retrospective study results, for both groups, thickness of the crestal cortical bone was the highest in the posterior mandible, followed by anterior mandible, anterior maxilla, and posterior maxilla. Compared with the younger group, the older group had a lower mean thickness of the crestal cortical bone. Among the four regions, however, only in the posterior maxilla was the crestal cortical bone significantly thinner in the older group than in the younger group.
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