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Bioengineering Tools Applied to Medical and Surgical Sciences

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A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Applied Dentistry and Oral Sciences".

Deadline for manuscript submissions: closed (20 May 2022) | Viewed by 28684

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Prof. Dr. Gabriele Cervino

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Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina-Policlinico "Gaetano Martino”, Via Consolare Valeria, 98100 Messina, Italy
Interests: biomaterials; oral surgery; implantology; oral pathology; prosthodontics; bioengineering
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Prof. Dr. Alberto Bianchi

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Department of General Surgery and Medical-Surgery Specialities, University of Catania, 95100 Catania, CT, Italy
Interests: oral surgery; maxillofacial surgery; rehabilitation; biomaterials
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Dr. Salvatore Crimi

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Maxillo Facial Unit, University Hospital “Policlinico San Marco” of Catania, 95124 Catania, Italy
Interests: oral surgery; oral cancers; head and neck cancers; cutaneous lesions; head and neck trauma
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

It is well known that bioengineering today represents a new step for researchers and clinicians who aim to have less invasive surgery as well as safe biomaterial applied to surgery or regenerative medicine. Recently, new tools, digital devices, 3D models and bioengineering interfaces signaled a step forward in the development of new strategies in patients’ treatment and health. Although much research has offered promising clinical results, the international literature is still focused on creating materials and new medical devices able to offer predictable and long-term clinical success to patients involved in surgical procedures. In this Special Issue, we aim to provide a global overview of the advances in bioengineering tools and devices applied to medical and clinical practice, underlining aspects of all innovative solutions. This Issue will also cover new advances in 3D planning treatment and medical 3D surgical software for tissue regeneration.

On behalf of Applied Sciences, you are cordially invited to contribute an article to the Special Issue “Bioengineering Tools Applied to Medical and Surgical Sciences”.

Prof. Dr. Gabriele Cervino
Prof. Dr. Alberto Bianchi
Dr. Salvatore Crimi
Guest Editors

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Keywords

bioengineering
biomaterial
tissue graft
3D model
3D printing

Published Papers (12 papers)

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Editorial

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3 pages, 184 KiB

Open AccessEditorial

Current Orientations of Surgical–Prosthetic Rehabilitation: Analogue, Digital and Biomechanical Considerations

by Gabriele Cervino

Appl. Sci. 2023, 13(5), 2792; https://0-doi-org.brum.beds.ac.uk/10.3390/app13052792 - 22 Feb 2023

Viewed by 835

Abstract

In the last decade, the available digital technologies have made it possible to expand the range of therapeutic options, simplify operational protocols and improve therapeutic plans due to a greater focus on diagnosis and operational protocols [...] Full article

(This article belongs to the Special Issue Bioengineering Tools Applied to Medical and Surgical Sciences)

Research

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8 pages, 382 KiB

Open AccessArticle

Virtual Surgical Planning in Orthognathic Surgery: Two Software Platforms Compared

by Pasquale Piombino, Vincenzo Abbate, Lorenzo Sani, Stefania Troise, Umberto Committeri, Emanuele Carraturo, Fabio Maglitto, Giacomo De Riu, Luigi Angelo Vaira and Luigi Califano

Appl. Sci. 2022, 12(18), 9364; https://0-doi-org.brum.beds.ac.uk/10.3390/app12189364 - 19 Sep 2022

Cited by 2 | Viewed by 2522

Abstract

Over 70% of patients suffering from dentofacial deformities mention esthetics as the biggest issue pushing them to look for orthodontic and orthognathic treatment. At present, several pieces of software for computer-aided surgery have been released on the market. This surgical planning software allows surgeons to manipulate digital representations of hard and soft tissue profile tracings and subsequently morph the pretreatment image to produce a treatment simulation. The aims of this study were to investigate and find the difference between two of the most used pieces of digital software in pre-surgical planning for patients affected by dentofacial deformities by using the following parameters: usability, validity, timing, accessibility, efficacy, and predictability of the pre-surgical planning. Analyzing the results obtained from our study, it is correct to define both software tools useful and valid in digital surgical planning for the treatment of patients with dentofacial deformities. Each software has negligible differences in performance that do not in any way affect the success of surgical planning. The IPS software represents a valid alternative to the most popular and tested Dolphin Imaging software, and we are even inclined to evaluate it as better in terms of accuracy, effectiveness, and reliability. Full article

(This article belongs to the Special Issue Bioengineering Tools Applied to Medical and Surgical Sciences)

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9 pages, 14496 KiB

Open AccessArticle

Sutureless Amniotic Membrane Transplantation in Inflammatory Corneal Perforations

by Alessandro Meduri, Antonio Valastro, Leandro Inferrera, Giovanni William Oliverio, Ivan Ninotta, Umberto Camellin, Maura Mancini, Anna Maria Roszkowska and Pasquale Aragona

Appl. Sci. 2022, 12(8), 3924; https://0-doi-org.brum.beds.ac.uk/10.3390/app12083924 - 13 Apr 2022

Cited by 2 | Viewed by 3321

Abstract

Introduction: The aim of this study was to evaluate the efficacy of sutureless amniotic membrane transplantation (SAMT) in patients with corneal perforation secondary to ocular surface inflammatory diseases. Methods: Twelve eyes of eleven patients with corneal perforation associated with Sjögren’s syndrome and ocular cicatricial pemphigoid were included. Surgical procedure consisted in the application of two layers of amniotic membrane covering the corneal perforation and a therapeutic contact lens placed above the two layers, followed by sutureless tarsorrhaphy with Steri-strip applied for 15 days to immobilize the eyelids. All patients underwent slit-lamp examination, fluorescein corneal staining, and anterior segment optical coherence tomography (AS-OCT), preoperatively and post-surgery, weekly for one month, and then every two weeks for three months. Results: All 12 eyes had complete resolution of corneal perforation. Pachymetry measurements improved in all eyes, and complete healing of the corneal ulcer was obtained following treatment and maintained up to 3 months follow-up in all patients. Conclusions: SAMT was proven to be a safe and effective option for the management of inflammatory corneal perforation. The procedure is non-traumatic and easy to perform since the surgical technique is sutureless and does not require topical therapy because it takes advantage of the intrinsic properties of the membrane itself. Full article

(This article belongs to the Special Issue Bioengineering Tools Applied to Medical and Surgical Sciences)

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8 pages, 43018 KiB

Open AccessArticle

Mandibular Reconstruction with Bridging Customized Plate after Ablative Surgery for ONJ: A Multi-Centric Case Series

by Salvatore Battaglia, Francesco Ricotta, Salvatore Crimi, Rosalia Mineo, Fabio Michelon, Achille Tarsitano, Claudio Marchetti and Alberto Bianchi

Appl. Sci. 2021, 11(22), 11069; https://0-doi-org.brum.beds.ac.uk/10.3390/app112211069 - 22 Nov 2021

Cited by 1 | Viewed by 1756

Abstract

Purpose: Computer-aided methods for mandibular reconstruction have improved both functional and morphological results in patients who underwent segmental mandibular resection. The purpose of this study is to evaluate the overlaying of virtual planning in terms of measures of the Computer Assisted Design/Computer Assisted Manufacturing CAD/CAM plate for mandibular reconstruction in patients who are ineligible for the insertion of reconstructing the titanium plate supported by fibular free flap, due to their poor health status, or in the presence of specific contraindications to autologous bone flap harvest. Materials and methods: The retrospective study performed analyzed the results of nine patients. The patients were treated at the Maxillofacial Surgery Unit of Policlinico S. Orsola of Bologna, Italy, and Policlinico San Marco, Catania, Italy, from April 2016 to June 2021. Superimposition between planning and post operative Computed Tomography CT scan was performed to assess the accuracy. Results: All reconstructive procedures were carried out successfully. No microsurgery-related complications occurred. In two cases, we had plate misplacement, and in one case, plate exposure that led to plate removal. The average accuracy of the series assessed after CT superimposition, as previously described, was 0.95 mm. Conclusions: Considering that microvascular bone transfer is a high-risk procedure in BRONJ patients, we can conclude that the positioning of a customized bridging mandibular prosthesis (CBMP), whether or not it is associated with a microvascular soft tissue transfer, is a safe technique in terms of surgical outcome and feasibility. Full article

(This article belongs to the Special Issue Bioengineering Tools Applied to Medical and Surgical Sciences)

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8 pages, 4337 KiB

Open AccessArticle

Spontaneous Bone Regeneration after Enucleation of Mandibular Cysts: Retrospective Analysis of the Volumetric Increase with a Full-3D Measurement Protocol

by Andrea Vitale, Salvatore Battaglia, Salvatore Crimi, Chiara Ricceri, Gabriele Cervino, Marco Cicciù, Francesco Saverio De Ponte, Rosalia Maria Leonardi and Alberto Bianchi

Appl. Sci. 2021, 11(11), 4731; https://0-doi-org.brum.beds.ac.uk/10.3390/app11114731 - 21 May 2021

Cited by 4 | Viewed by 2373

Abstract

The goal of surgical treatment of mandibular cysts is their eradication. This result can be achieved by ensuring minimum risk of morbidity, while preserving the integrity of the bone structure and the functionality of the inferior alveolar nerve. The generation of bone defects after enucleation has always posed the dilemma of using filler materials or not. The aim of this study is to evaluate the degree of spontaneous bone regeneration, in terms of volume, in patients undergoing enucleation of mandibular cysts, measuring the real 3D volume of the cystic residual cavities. We included in our study 15 patients with mandibular cysts, treated from January 2018 to June 2020 at the Policlinico-Vittorio Emanuele and Policlinico-San Marco hospital of Catania and evaluated preoperatively (T0), 6 months after surgery (T1), and 12 months after surgery (T2). The results showed that after 6 months, independent of the initial volume of the cyst, around 90% of the cavity was filled with new generated bone. In conclusion, we believe that the full-3D measurement protocol can help us to understand the timing and modality of bone restoration after mandibular cyst enucleation. Full article

(This article belongs to the Special Issue Bioengineering Tools Applied to Medical and Surgical Sciences)

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10 pages, 7331 KiB

Open AccessArticle

Correlation between Mesio-Distal Angulation and Bucco.-Lingual Inclination of First and Second Maxillary Premolars Evaluated with Panoramic Radiography and Cone-Beam Computed Tomography

by Marta Fontana, Rosamaria Fastuca, Piero A. Zecca, Riccardo Nucera, Angela Militi, Alessandra Lucchese, Marco Portelli and Alberto Caprioglio

Appl. Sci. 2021, 11(5), 2374; https://0-doi-org.brum.beds.ac.uk/10.3390/app11052374 - 08 Mar 2021

Cited by 3 | Viewed by 2602

Abstract

Background: Panoramic radiography creates distortion in teeth position and inclination especially in lateral areas of the arches due to acquisition and curved shape of dental arch. The aim of this study was to evaluate panoramic distortion compared to cone-beam computed tomography. Methods: Mesiodistal angulations were measured on panoramic radiography. Mesiodistal angulations and buccolingual inclinations of the teeth were determined on cone-beam computed tomography scans. The previous measurements were then compared through Pearson correlation coefficient. Results: The results showed higher correlation between mesiodistal 2D angulation and buccolingual 3D inclination, especially for first premolars, rather than between mesiodistal angulations measured in 2D and 3D. Conclusion: Especially for the lateral areas of the dental arches, root mesiodistal angulation measured on panoramic radiography is not reliable; in fact, it is greatly influenced by buccolingual inclination. Therefore, clinical evaluation is highly recommended with panoramic radiography to provide correct diagnosis and the most satisfactory results. Full article

(This article belongs to the Special Issue Bioengineering Tools Applied to Medical and Surgical Sciences)

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15 pages, 9699 KiB

Open AccessArticle

Angled Screwdriver Solutions and Low-Profile Attachments in Full Arch Rehabilitation with Divergent Implants

by Roberto Scrascia, Marco Cicciù, Carlo Manco, Adele Miccoli and Gabriele Cervino

Appl. Sci. 2021, 11(3), 1122; https://0-doi-org.brum.beds.ac.uk/10.3390/app11031122 - 26 Jan 2021

Cited by 3 | Viewed by 1807

Abstract

Edentulism is one of the most significant problems given the increase in the elderly population. The aim of the present investigation is to evaluate a case report with angled screwdriver solutions and new kinds of low-profile attachments in full arch rehabilitation with divergent implants. In this clinical case we will analyze how low-profile abutments with angled screwdriver channel in the OT Bridge system (Rhein83, Bologna, Italy) can be a predictable solution over time to create a fixed prosthesis on disparallel implants with a digital structure (New Ancorvis, Bologna, Italy) for the satisfaction of the patient and of the work team. Full article

(This article belongs to the Special Issue Bioengineering Tools Applied to Medical and Surgical Sciences)

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13 pages, 3546 KiB

Open AccessArticle

Virtual Surgical Planning and the “In-House” Rapid Prototyping Technique in Maxillofacial Surgery: The Current Situation and Future Perspectives

by Fabio Maglitto, Giovanni Dell’Aversana Orabona, Umberto Committeri, Giovanni Salzano, Gianluca Renato De Fazio, Luigi Angelo Vaira, Vincenzo Abbate, Paola Bonavolontà, Pasquale Piombino and Luigi Califano

Appl. Sci. 2021, 11(3), 1009; https://0-doi-org.brum.beds.ac.uk/10.3390/app11031009 - 23 Jan 2021

Cited by 8 | Viewed by 2729

Abstract

Background: The first applications of computer-aided design/computer-aided manufacturing (CAD/CAM) in maxillofacial surgery date back to the 1980s. Since then, virtual surgical planning (VSP) has undergone significant development and is now routinely used in daily practice. Indeed, in an extraordinary period, such as that of the current COVID-19 pandemic, it offers a valuable tool in relation to the protection of healthcare workers. In this paper we provide a comprehensive summary of the clinical applications reported in the literature and review our experience using an in-house rapid prototyping technique in the field of maxillofacial surgery. methods: Our research was focused on reconstructive surgery, traumatology (especially in relation to orbital floor and zygomatic arch fractures), and COVID-19 masks. The first step was a radiographic study. Next, computed tomography (CT) scans were segmented in order to obtain a three-dimensional (3D) model. Finally, in the editing phase, through the use of specific software, a customized device for each patient was designed and printed. results: Four reconstructive procedures were performed with a perfect fitting of the surgical device produced by means of VSP. In nine orbital floor fracture cases a good overlapping of the mesh on the orbital floor was obtained. In sixteen zygomatic arch cases the post-operative CT scan showed an excellent fitting of the device and a correct fracture reduction. Regarding the COVID-19 period, six masks and shields produced proved to provide effective protection. conclusions: The timescale and costs required for the production of our “home-made” virtual design are low, which makes this method applicable to a large number of cases, for both ordinary and extraordinary activities. Full article

(This article belongs to the Special Issue Bioengineering Tools Applied to Medical and Surgical Sciences)

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9 pages, 2654 KiB

Open AccessArticle

An Easy and Effective Technique for Silicone Facial Implant Insertion and Fixation to Periosteum

by Raffaele Rauso, Giorgio Lo Giudice, Carmelo Lo Faro, Giovanni Francesco Nicoletti, Romolo Fragola, Enrico Sesenna and Gianpaolo Tartaro

Appl. Sci. 2020, 10(18), 6508; https://0-doi-org.brum.beds.ac.uk/10.3390/app10186508 - 18 Sep 2020

Cited by 1 | Viewed by 4064

Abstract

In this paper, we present a simple way to place the implant into a harvested pocket and to subsequently fix it percutaneously. Eighteen patients (1 male, 13 females, 4 transgender), underwent facial implant placement; a total of 31 implants were placed (1 pair of angles of the mandible implants, 12 pairs of malar/sub-malar implants, and 5 chin implants). The intraoral approach was performed on 15 patients, and on the remaining three patients, the sub-ciliary lower lid approach was preferred. Patients were followed up for at least one year with a maximum follow-up of seven years (mean 1.8 years). In all the cases, except one, patients healed without complications. One case of implant displacement and infection was recorded. No other complication was documented. The technique described is similar to the one suggested by Peled, although some useful tips were added, namely the use of sutures, not only to fix the implant but also to drive it into the harvested pocket. In addition, larger absorbable “left in place” sutures were used, avoiding accidental implant dislocation during their removal. Further studies are required to gain a more complete understanding of the effectiveness and reproducibility of this surgical technique. Full article

(This article belongs to the Special Issue Bioengineering Tools Applied to Medical and Surgical Sciences)

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Review

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7 pages, 3638 KiB

Open AccessReview

OT-Equator^® Attachments Comparison for Retaining an Early Loaded Implant Overdenture on Two or Three Implants: 1 Year RCT Preliminary Data

by Marco Tallarico, Gabriele Cervino, Marco Montanari, Roberto Scrascia, Emiliano Ferrari, Alessio Casucci, Erta Xhanari, Saturnino Marco Lupi, Silvio Meloni, Francesco Mattia Ceruso, Ruggero Rodriguez y Baena and Marco Cicciù

Appl. Sci. 2021, 11(18), 8601; https://0-doi-org.brum.beds.ac.uk/10.3390/app11188601 - 16 Sep 2021

Cited by 3 | Viewed by 1598

Abstract

The purpose of this multicenter randomized controlled trial was to compare the clinical, radiographic, and patient-centered outcomes of early loaded mandibular overdentures deliberately placed on two or three implants. The outcomes were: implant and prosthesis success and survival rates; biological and technical complications; marginal bone loss; patient satisfaction; and periodontal parameters. The results showed no differences between the groups in any of the outcomes analyzed. With the limitations of the present study, and looking at long-term follow-up, the gold standard of prosthetic rehabilitations with attachments, in agreement with the scientific community, should prefer two non-splinted implants. Full article

(This article belongs to the Special Issue Bioengineering Tools Applied to Medical and Surgical Sciences)

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10 pages, 1966 KiB

Open AccessReview

Facial Artery Myomucosal Flap vs. Islanded Facial Artery Myomucosal Flap Viability: A Systematic Review

by Giorgio Lo Giudice, Romolo Fragola, Giovanni Francesco Nicoletti, Gabriele Cervino, Eugenio Pedullà, Nicola Zerbinati and Raffaele Rauso

Appl. Sci. 2021, 11(9), 4202; https://0-doi-org.brum.beds.ac.uk/10.3390/app11094202 - 05 May 2021

Cited by 5 | Viewed by 1806

Abstract

The aim of this study was to estimate the overall viability of the islanded facial artery myomucosal flap (iFAMM) compared to the facial artery myomucosal flap (FAMM). A systematic review of English articles was performed on PubMed and Cochrane Library electronic databases. Search terms included every nomenclature variant for FAMM flap and iFAMM flap. A total of 373 articles were identified, and 20 articles were considered eligible for inclusion in the review. A total of 486 flaps were evaluated (350 FAMM and 136 i-FAMM flaps). In all studies, the primary outcome assessed was flap viability, collecting the rate of total and partial flap necrosis and then comparing FAMM to i-FAMM. Overall reported partial/total necrosis rate for FAMM flap was 9.7%, 1.4% as total and 8.3% as partial necrosis. Overall partial/total reported necrosis rate for iFAMM flaps was 2.2%, 1.5% as total and 0.7% as partial necrosis. FAMM flaps, both as classical or islanded variants, are an effective option for intraoral small/medium sized defect reconstruction. Outcomes from the present review show a higher partial/total survival rate when this flap is harvested as islanded flap. Full article

(This article belongs to the Special Issue Bioengineering Tools Applied to Medical and Surgical Sciences)

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Other

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5 pages, 1107 KiB

Open AccessTechnical Note

Can a 3D Virtual Imaging Model Predict Eagle Syndrome?

by Enrico Nastro Siniscalchi, Enricomaria Mormina, Samuele Cicchiello, Francesca Granata, Sergio Lucio Vinci, Karol Galletta, Luciano Catalfamo and Francesco Saverio De Ponte

Appl. Sci. 2022, 12(9), 4564; https://0-doi-org.brum.beds.ac.uk/10.3390/app12094564 - 30 Apr 2022

Cited by 1 | Viewed by 1639

Abstract

Eagle Syndrome is an underestimated syndrome with broad and often unspecific signs and symptoms. Both the neuropathic and vascular patterns need a thorough investigation in terms of all their clinical and radiological aspects. A positional/dynamic study is mandatory in the case of suspicion of Eagle Syndrome due to the strong influence of head and neck positions. This work aims to propose a new virtual technique able to predict conflicts between the styloid process and neck vascular structures. Full article

(This article belongs to the Special Issue Bioengineering Tools Applied to Medical and Surgical Sciences)

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