Prosthesis, Volume 2, Issue 1 (March 2020) – 4 articles

Obstruction of the left ventricular outflow tract (LVOT) is a common complication of transcatheter mitral valve replacement (TMVR). This procedure can determine an elongation of an LVOT (namely, the neo-LVOT), ultimately portending hemodynamic impairment and patient death. This study aimed to understand the biomechanical implications of LVOT obstruction in a patient who underwent TMVR using a transcatheter heart valve (THV) to repair a failed bioprosthetic heart valve. We first reconstructed the heart anatomy and the bioprosthetic heart valve to virtually implant a computer-aided-design (CAD) model of THV and evaluate the neo-LVOT area. A numerical simulation of THV deployment was then developed to assess the anchorage of the THV to the bioprosthetic heart valve as well as the resulting Von Mises stress at the mitral annulus and the contract pressure among implanted bioprostheses. Quantification of neo-LVOT and THV deployment may facilitate more accurate predictions of the LVOT obstruction in TMVR and help clinicians in the optimal choice of the THV size. Full article

The study presented in this paper details the development and experimental testing of a novel, magnetic, tactile feedback device that is able to deliver a stimulus to a patch of skin on the lower arm of a user. The device utilizes magnets to deliver a sensation that is not dependent on controlling specific frequency bands to stimulate the mechanoreceptors, as is the case with vibro-tactile methods. The device was tested on human volunteers to evaluate its ability to induce a response from the user through the magnetic interface. The study aims to quantify the ability of the user to sense the stimulus by analysis of the receiver operating characteristic (ROC) and delay in response under different experimental conditions. Three different speeds and two different distances were explored for the magnetic interface. A two-way, repeated-measures ANOVA with post-hoc analysis was performed for the percentage of correct responses, delay in response time, and area under the curve (AUC) of the obtained ROCs. The results showed that the different conditions had a significant effect on the number of correct responses and the AUC, but not on the delay. The magnetic interface thus needs to be optimized across different parameters to deliver the best detectable stimulus to the user. Future work includes further development of the device and working towards a comparative trial with other tactile feedback approaches. Full article

This case study concerns a patient who had lost all of his teeth, needing a rehabilitation with total prosthesis, who went to the dentist looking for help to overcome psycho-physical trauma and to overcome functional and social problems related to being a prosthesis wearer. Tooth loss occurs most in old age, even if it is not a direct consequence of aging. The rehabilitation of oral functions allows the patient to speak, chew, smile and feel confident in his own aesthetics and therefore improve, even a lot, his well-being in social relations. It is very important in oral rehabilitations to evaluate their type and therapeutic timing. This study stems from the idealization of a new protocol to simplify the supported oral rehabilitations. In this manuscript, a patient was considered and shown according to a complete photographical documentation all the phases. Rehabilitation included the use of Osstem (Osstem, Seoul, Korea) and equator type abutments (Rhein83, Bologna, Italy). This manuscript claims to represent the first of a whole series of cases demonstrating the utility of this protocol. Full article

The developments in the field of rehabilitation are proceeding hand in hand with those of cybernetics, with the result of obtaining increasingly performing prostheses and rehabilitations for patients. The purpose of this work is to make a brief exposition of new technologies regarding composites materials that are used in the prosthetic and rehabilitative fields. Data collection took place on scientific databases, limited to a collection of data for the last five years, in order to present news on the innovative and actual materials. The results show that some of the most commonly used last materials are glass fibers and carbon fibers. Even in the robotics field, materials of this type are beginning to be used, thanks above all to the mechanical performances they offer. Surely these new materials, which offer characteristics similar to those in humans, could favor both the rehabilitation times of our patients, and also a better quality of life. Full article