Development of a multi-component fiber-reinforced composite implant for load-sharing conditions

Fiber-reinforced composites (FRC) have the potential for use as load-bearing orthopaedic implants if the high strength and elastic modulus of FRC implant can be matched with local requirements. This study tested the in vivo performance of novel FRC implants made of unidirectional glass fibers (E-glass fibers in Bis-GMA and TEGDMA polymeric matrix). The implant surface was covered with bioactive glass granules. Control implants were made of surface-roughened titanium. Stress-shielding effects of the implants were predicted by finite element modelling (FEM). Surgical stabilization of bone metastasis in the subtrochanteric region of the femur was simulated in 12 rabbits. An oblong subtrochanteric defect of a standardized size (reducing the torsional strength of the bones approximately by 66%) was created and an intramedullary implant made of titanium or the FRC composite was inserted. The contralateral femur served as the intact control. At 12 weeks of healing, the femurs were harvested and analyzed by radiography, torsional testing, micro-CT imaging and hard tissue histology. The functional recovery was unremarkable in both groups, although the final analysis revealed two healed undisplaced peri-implant fractures in the group of FRC implants. FEM studies demonstrated differences in stress-shielding effects of the titanium and FRC implants, but the expected biological consequences did not become evident during the follow-up time of the animal study. Biomechanical testing of the retrieved femurs showed no significant differences between the groups. The torsional strength of the fixed bones had returned the level of contralateral intact femurs. Both implants showed ongrowth of intramedullary new bone. No adverse tissue reactions were observed. Based on these favorable results, a large-scale EU-project (NewBone, www.hb.se/ih/polymer/newbone) has been launched for development of orthopaedic FRC implants.     

Hybrid type anterior fibre-reinforced composite resin prosthesis: a case report

A variety of therapeutic modalities, from implant to conventional Maryland prosthesis, can be used for the replacement of a missing anterior tooth. In patients refusing implant treatment, when minimal teeth reduction is preferred, a fibre reinforced composite (FRC) prosthesis can be a good alternative to conventional prosthetic techniques. The purpose of this case report is to describe the clinical procedure for fabricating hybrid type FRC prosthesis with pre-impregnated unidirectional E-glass fibres. Fibre-reinforced composite, in combination with adhesive technology, appears promising treatment option for replacing missing teeth. However, further clinical investigation will be required to provide additional information on this technique.     

Resin-bonded, glass fiber-reinforced composite fixed partial dentures: a clinical study

STATEMENT OF PROBLEM: Resin-bonded, glass fiber-reinforced composite fixed partial dentures (FPDs) have been under development for some time. There is a lack of data regarding the clinical usefulness of such prostheses. PURPOSE: The clinical performance of 31 resin-bonded, glass fiber-reinforced composite fixed partial dentures was evaluated in a preliminary study. MATERIAL AND METHODS: The prostheses were made to replace 1 to 3 missing maxillary or mandibular teeth in each of 31 patients. The prostheses had a framework made of continuous unidirectional E-glass fibers with multiphase polymer matrix and light-polymerized particulate composite resin veneering. The prostheses were examined after 6-month periods for up to 24 months (mean follow-up time was 14 months). Partial or total debonding of the prostheses or the framework fracture was considered a treatment failure. RESULTS: Two prostheses debonded during the follow-up period; 1 debonding was related to improper occlusal adjustment and the other to unknown reasons. Kaplan-Meier survival probability at 24 months was 93%. No framework fractures were observed. CONCLUSION: The results of this preliminary study suggest that the resin-bonded, glass fiber-reinforced FPDs may be an alternative for resin-bonded FPDs with a cast metal framework.     

Glass fiber reinforcement in repaired acrylic resin removable dentures: preliminary results of a clinical study.

The clinical usefulness of continuous E-glass partial fiber reinforcement of acrylic resin removable dentures was evaluated an average 13 months after the insertion of the fibers. Twelve removable complete dentures and ten removable partial dentures with a history of recurrent fracture were selected for this study. The partial fiber reinforcement was incorporated into the denture at the time of repair. One complete denture and one removable partial denture fractured in the region of reinforcement during the examination period. These fractures were most likely caused by faulty placement of the fiber reinforcement in the denture in the dental laboratory. In six dentures, new fractures occurred in regions without partial fiber reinforcement. The results revealed the importance of both the correct positioning of the partial fiber reinforcement in the denture and the use of accurate laboratory techniques.     

The effect of fiber orientation on the polymerization shrinkage strain of fiber-reinforced composites.

OBJECTIVE: The aim of this study was to characterize the linear polymerization shrinkage strain of glass fiber-reinforced composite (FRC) according to the fiber orientation. METHODS: Test specimens (n=5) (10.0 x 10.0 x 1.5mm) were prepared from different brands of photopolymerizable resin-preimpregnated FRC; unidirectional continuous FRC, experimental random-oriented FRC, and bidirectional continuous FRC. As control materials, particulate filler composite resin and unfilled dimethacrylate monomer resin were used. Two uniaxial strain gages (gage length 2mm) were used to measure shrinkage strains in two directions: longitudinally and transversally to the fiber direction. The uncured composite or resin was placed on top of the strain gages, covered with a separating sheet and a glass plate, and irradiated for 40s with a light-curing unit. The shrinkage strain was monitored for 300 s. ANOVA and Tukey's posthoc test were used at a significance level of 0.05. RESULTS: ANOVA revealed that orientation of fiber and brand of material had a significant effect (P<0.05) on shrinkage strain. The unidirectional FRC revealed no shrinkage longitudinally to the fiber direction, whereas the shrinkage occurred transversally to the fiber direction. Particulate filler composite resin and unfilled resin revealed equal shrinkage strain in both of the measured directions. SIGNIFICANCE: Anisotropic nature of FRC exists with regard to polymerization shrinkage strain. The variation of polymerization shrinkage strains of FRC compared to those of particulate filler composites and unfilled resin might be important for future clinical applications.     

Flexural properties of fiber reinforced root canal posts.

OBJECTIVES: Fiber-reinforced composite (FRC) root canal posts have been introduced to be used instead of metal alloys and ceramics. The aim of this study was to investigate the flexural properties of different types of FRC posts and compare those values with a novel FRC material for dental applications. METHODS: Seventeen different FRC posts of various brands (Snowpost, Carbopost, Parapost, C-post, Glassix, Carbonite) and diameters, (1.0-2.1 mm) and a continuous unidirectional E-glass FRC polymerized by light activation to a cylindrical form (everStick, diameter 1.5 mm) as a control material were tested. The posts (n=5) were stored at room's humidity or thermocycled (12.000 x, 5 degrees C/55 degrees C) and stored in water for 2 weeks before testing. A three-point bending test (span=10 mm) was used to measure the flexural strength and modulus of FRC post specimens. RESULTS: Analysis of ANOVA revealed that thermocycling, brand of material and diameter of specimen had a significant effect (p<0.001) on the fracture load and flexural strength. The highest flexural strength was obtained with the control material (everStick, 1144.9+/-99.9 MPa). There was a linear relationship between fracture load and diameter of posts for both glass fiber and carbon fiber posts. Thermocycling decreased the flexural modulus of the tested specimens by approximately 10%. Strength and fracture load decreased approximately 18% as a result of thermocycling. SIGNIFICANCE: Considerable variation can be found in the calculated strength values of the studied post brands. Commercial prefabricated FRC posts showed lower flexural properties than an individually polymerised FRC material.     

Effect of short-term water storage on the elastic properties of some dental restorative materials--A resonant ultrasound spectroscopy study.

OBJECTIVES: This study was aimed to determine if short-term water storage would change elastic properties of dental composite materials. METHODS: Particulate filler composite resin and continuous unidirectional E-glass FRC materials were photopolymerized and additionally post-polymerized by heat for testing elastic properties with the Resonance Ultrasound Spectroscopy method as a function of time in water storage. The test specimens were stored in 37 degrees C water for up to 30 days. RESULTS: About 1% weight increase due to water sorption was observed in both materials with both polymerization methods. Water sorption did not change the resonance frequencies towards lower values, indicating no significant decrease in elastic properties in these materials. Because of high damping of the polymer composite materials leading to wide resonance peaks and low number of the recorded peaks, accurate determination of the elastic properties was not possible. SIGNIFICANCE: Results suggest that the most likely explanation for the previously observed decrease in bending stiffness of FRC materials is the decreased yield limit of the hydrated polymer matrix. It is important to recognize that water sorption has the effect on mechanical properties of dental composite materials by changing the yield limit of the matrix rather than by changing the elastic properties of the material.     

Composite resin reinforced with pre-tensioned fibers: a three-dimensional finite element study on stress distribution

Pre-tensioned construction material is utilized in engineering applications of high strength demands. The purpose of this study was to evaluate the effect of the pre-tensioning fibers of fiber-reinforced composite (FRC) using three-dimensional finite element (FE) analysis. The 3D FE models of particulate composite resin (CR), FRC and composite resin reinforced with pre-tensioned fibers (PRE-T-FRC) were constructed. The uniaxial three-point bending test was simulated using FE analysis to calculate the principal stress distribution. In the FRC and PRE-T-FRC, stresses were higher than CR, and they were located in the fiber. However, the maximum principal stress value at the composite of PRE-T-FRC was lower than the FRC and CR. Composite resin reinforced with pre-tensioned fibers was advantageous for stress distribution and lowering the stress at the composite itself. Experimental studies on physical properties of pre-tensioned FRC are encouraged to be conducted.     

Bioactive composite for keratoprosthesis skirt

In this study, the fabrication and properties of a synthetic keratoprosthesis skirt for use in osteo-odonto-keratoprosthesis (OOKP) surgery are discussed. In the search for a new material concept, bioactive glass and polymethyl methacrylate (PMMA)-based composites were prepared. Three different bioactive glasses (i.e. 45S5, S53P4 and 1-98) and one slowly resorbing glass, FL107, with two different forms (i.e. particles and porous glass structures) were employed in the fabrication of specimens. In in vitro studies, the dissolution behaviour in simulated aqueous humour, compressive properties, and pore formation of the composites were investigated. According to the results, FL107 dissolved very slowly (2.4% of the initial glass content in three weeks); thus, the pore formation of the FL107 composite was also observed to be restricted. The dissolution rates of the bioactive glass-PMMA composites were greater (12%-17%). These faster dissolving bioactive glass particles caused some porosity on the outermost surfaces of the composite. The slight surface porosity was also confirmed by a decrease in compressive properties. During six weeks' in vitro dissolution, the compressive strength of the test specimens containing particles decreased by 22% compared to values in dry conditions (90-107?MPa). These results indicate that the bioactive composites could be stable synthetic candidates for a keratoprosthesis skirt in the treatment of severely damaged or diseased cornea.