Efeito do filme de carbono DLC aplicado por plasma como recobrimento em Polietileno de Ultra Densidade e Alto Peso Molecular (UHWPE) e planejamento virtual utilizando a técnica de elementos finitos em cirúrgias de próteses totais da ATM
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Data
2016-01-14
Autores
Silva, Alecsandro de Moura [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
Este trabalho teve por objetivo avaliar o efeito do filme de carbono (DLC) aplicado por plasma como recobrimento da liga de Ti -6Al-4V e do polietileno de alto peso molecular (UHMWPE) em prótese totais de ATM, com a finalidade de melhorar suas propriedades bio-tribológicas. Outro aspecto abordado neste trabalho a aplicação do planejamento virtual utilizando a técnica de elementos finitos (FEA), na apresentação de um caso clínico, colocando a importância do cirurgião de conhecer a fundo tanto o planejamento cirúrgico quanto o desenvolvimento da prótese customizadas (TMJ), e assim evitar possíveis falhas biomecânicas. Material: Para o desenvolvimento deste trabalho primeiramente foram utilizados 40 corpos de prova de Ti-6Al-V, dos quais 15 foram recobertas com um DLC e 15 por DLC-Ag pelo método de deposição químico (PECVD), e 10 foram mantidos sem recobrimento como controle. Além disso, foram confeccionados 30 corpos de prova de UHMWPE, dos quais, 15 foram recobertas por DLC pelo sistema de deposição físico (CVD) e 15 foram mantidas sem recobrimento como controle. Métodos: Foram avaliadas as características superfíciais das amostras, adesão em simulador de fadiga deslizante reproduzindo o trabalho condili fossapo 2000,000 de ciclos em banhocom ringuer lactato a 36 graus, a uma carga 200 N. As amostras com filmes foram submetidas a teste de citotoxicidade com células osteoblásticas. Resultados: As células se mostraram uma biocompatibilidade significativa com as amostras portando filme de DLC em substrato Ti6Al4v, se mostrando inerte ao polietileno. Neste estudo também foi apresentado um caso clinico, paciente com 12 anos de idade genero feminino, portadora de anquilose bilateral da ATM relatou já ter sido submetida a cirurgias repetidas sem sucesso, apresentando deformidade esqueletal classe II, em consequência da anquilose temporomandibular, abertura bucal limitada inicial (4,9 mm) e pos cirurgico reconstrução bilateral com prótese total de ATM customizada após o ato cirúrgico, mostrou se com uma abertura de (23 mm) após um ano, com melhora significativa para alimentação e apneia severa do sono. Conclusão: O Dlc em titânio dentro dos parâmetros que conseguimos de deposição, se apresenta como promissor para cobertura de peças protéticas a serem colocadas em seres humanos por sua baixa condutividade elétrica, ótima resposta biológica.
This study aimed to evaluate the effect of carbon film (DLC) applied by plasma as coating the Ti-6Al-4V alloy and ultra high molecular weight polyethylene (UHMWPE) in total TMJ prosthesis, in order to improve their bio-tribological properties. Another aspects addressed in this work are the application of virtual planning using the technique of finite element (FEA) and the presentation of a case, placing the importance of the surgeon to know the background both surgical planning and the development of customized prosthesis (TMJ) and thus avoid possible biomechanical faults. Material: For the development of this work were first used 40 specimens of Ti-6Al-V, of which 15 were coated with a DLC and 15 DLC-Ag by chemical deposition method (PECVD), and 10 were kept without coating as control. In addition, they made 30 UHMWPE specimens, of which 15 were coated with DLC by physical deposition system (CVD) and 15 were maintained without coating as a control. Methods: The surface characteristics of the samples were evaluated for adhesion sliding fatigue tester reproducing the work condili fossapo 2000.000 cycles in banhocom ringuer lactate at 36 degrees, to a load 200 N. The film samples were subjected to cytotoxicity testing in osteoblastic cells. Results: The cells showed a significant biocompatibility with samples carrying DLC film on Ti6Al4V substrate, showing inert to the polyethylene. This study also presented a clinical case patient with 12 years of female gender age, bearer of bilateral ankylosis of the TMJ reported having been subjected to repeated unsuccessful attempts, with deformity skeletal class II, as a result of temporomandibular ankylosis, limited mouth opening initial (4.9 mm) and post surgical bilateral reconstruction with customized ATM denture after surgery, showed up with an opening (23 mm) after one year, with a significant improvement for food and severe sleep apnea. Conclusion: Dlc titanium within the parameters we can deposition, is presented as promising to cover prosthetic pieces to be placed on humans for its low electrical conductivity, good biological response.
This study aimed to evaluate the effect of carbon film (DLC) applied by plasma as coating the Ti-6Al-4V alloy and ultra high molecular weight polyethylene (UHMWPE) in total TMJ prosthesis, in order to improve their bio-tribological properties. Another aspects addressed in this work are the application of virtual planning using the technique of finite element (FEA) and the presentation of a case, placing the importance of the surgeon to know the background both surgical planning and the development of customized prosthesis (TMJ) and thus avoid possible biomechanical faults. Material: For the development of this work were first used 40 specimens of Ti-6Al-V, of which 15 were coated with a DLC and 15 DLC-Ag by chemical deposition method (PECVD), and 10 were kept without coating as control. In addition, they made 30 UHMWPE specimens, of which 15 were coated with DLC by physical deposition system (CVD) and 15 were maintained without coating as a control. Methods: The surface characteristics of the samples were evaluated for adhesion sliding fatigue tester reproducing the work condili fossapo 2000.000 cycles in banhocom ringuer lactate at 36 degrees, to a load 200 N. The film samples were subjected to cytotoxicity testing in osteoblastic cells. Results: The cells showed a significant biocompatibility with samples carrying DLC film on Ti6Al4V substrate, showing inert to the polyethylene. This study also presented a clinical case patient with 12 years of female gender age, bearer of bilateral ankylosis of the TMJ reported having been subjected to repeated unsuccessful attempts, with deformity skeletal class II, as a result of temporomandibular ankylosis, limited mouth opening initial (4.9 mm) and post surgical bilateral reconstruction with customized ATM denture after surgery, showed up with an opening (23 mm) after one year, with a significant improvement for food and severe sleep apnea. Conclusion: Dlc titanium within the parameters we can deposition, is presented as promising to cover prosthetic pieces to be placed on humans for its low electrical conductivity, good biological response.
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Palavras-chave
Protese articular, Transtornos da articulação temporomandibular, Nanotecnologia, Joint prosthesis, Temporomandibular joint desorders, Nanothecnology