Keynote Speakers

Lucian Toma Ciocan

Dr. Ciocan is an educationist, researcher and specialist in dental materials and dental technology. He received his Dental Diploma from “Carol Davila” University of Medicine and Pharmacy, Bucharest, 2002. Between 2002 and 2005 he graduated the Oral Surgery specialization. After receiving his DMD completed the Master Program in the Biomaterials field in the Bucharest Polytechnic University (2004) and PhD thesis “Interface Studies regarding Endoseous Implants Biointegration” in University of Medicine and Pharmacy of Bucharest (2011). In 2012 Graduated the 2yrs Linhart Continuing Educational Program: Current Concepts in American Dentistry-Aesthetics and Oral Rehabilitation, NYU Faculty of Dentistry, having the dissertation entitled “Biomechanical aspects of implant dentistry”. From 2002 until present he activates in the Department of Prosthetic Technology and Dental Materials of Bucharest “Carol Davila” University of Medicine and Pharmacy, nowadays (2019) being the head of this department. Also, from 2010 until present he holds the course and seminar activities as Associate Professor the Dental Medicine Basis Department, Faculty of Medical Engineering, University Politehnica of Bucharest.

Dr. Ciocan has numerous publications, an inventing patent and many awards received at national and international conferences. He is member in international and national professional societies: Affiliate of the European Academy of Esthetic Dentistry, Italian Academy of Prosthetic Dentistry, National Association of Dentists, Romanian Society of Biomaterials, Dental Technical Committee of the ASRO (Standards Association Romania), The Romanian Society of Bioinformatics, Romanian Center of Dental Education.

Modern polymers technologies and applications in prosthodontics

Lucian Toma Ciocan¹

¹“Carol Davila” University of Medicine and Pharmacy, Bucharest, România

For a long time, polymeric materials had a limited indication of use, especially for obtaining short-term temporary prosthetic restorations, due to the many disadvantages (low mechanical resistance behaviour, open porosity, aging coefficient, biocompatibility) compared to inorganic materials. The development of new polymeric materials, biocompatible and with increased mechanical resistance, as well as the modernization of the corresponding processing technologies, made the indications of these materials wide in prosthodontics, and the prognosis over time of restorations obtained from high-density polymeric materials increased significantly.

This presentation aims to present the evolution and current state of development of polymeric materials. Their applicability will be highlighted by exemplifying on clinical cases.

Răzvan Ene

Răzvan Ene MD, PhD, is an Associate Professor at the “Carol Davila” University of Medicine and Pharmacy in Bucharest, Faculty of General Medicine. He is currently the Vice President of the Romanian Society of Orthopedics and Traumatology and also the head of the Orthopedics and Traumatology II department within the Bucharest Emergency Clinical Hospital. He graduated from the Faculty of General Medicine at the University of Medicine and Pharmacy in Craiova in 2002 and since 2011 he has a PhD in medical sciences. He is a prominent member of professional societies both in the country and abroad (Romanian Society of Orthopedics and Traumatology, Romanian Society of Arthroscopy and Sports Traumatology, International Society of Orthopedic and Traumatological Surgery, European Federation of National Orthopedic and Traumatology Associations), with a significant experience in orthopedics and traumatology for about 20 years, being specialized in traumatological surgery, sports surgery, musculoskeletal oncological surgery, reconstructive arthroplasty surgery. Besides the surgical activity, he is also involved in the research activity, being the main investigator or co-investigator in numerous clinical studies, but also in the didactic activity, with students, resident doctors, specialists and senior doctors. He is also a trainer of AO trauma and AO Recon. Coordinates the osteo-tendon transplant program within the Bucharest Emergency Clinical Hospital. He also has a Master in Public Health Services from the Academy of Economic Studies in Bucharest.

Is the two stage prosthetic revision using an antibiotic impregnated hip spacer worth it?

Razvan Ene^1,2, Elisa Popescu¹, Catalin Eduard Georgescu¹, Alexandru Lisias Dimitriu^1,2

(Times New Roman font, size 12, bold). The name of the presenting author should be underlined.

¹ Clinical Emergency Hospital Bucharest, Calea Floreasca no. 8, Bucharest, Romania, razvan77ene@yahoo.com

² Carol Davila University of Medicine and Pharmacy, Blvd. Eroii Sanitari no. 8, Bucharest, Romania

Introduction: Periprosthetic Joint infection (PJI) is one of the most severe complication of total hip arthroplasty[1]. One stage and two stage revision strategies are the two main options for treating chronic PJI, however there is an outgoing dilemma regarding which treatment option is the best[2]. We aimed to compare the clinical and cost effectiveness of these methods in regards to our hospital’s experience and also compared it to other’s research findings.

Experimental: The study included 37 patients assessed over a 6 year period (between 2016 and 2022), out of which 20 males (54,05%) and 17 females (45,94%), ages 64 to 82 years old that had a PJI after primary THA. We created 2 groups (group A – 1 stage revision, group B – 2 stage revision). We compared the pathogen incidence by sonication of removed implants, time from symptomatology onset to surgery, type of infection, presence of sinus tract (fistula), antibiotics administration interval, reinfection rates, local and general complications rates (dislocation, periprosthetic fractures, PE, death), WOMAC scores and inflammatory markers dosed at different intervals and assessed the costs and social burden between the groups.

Results and Discussion: Infection eradication rates at 2 years were 91,66% for group A and 96% for group B. Clinical outcomes regarding the reinfection rate, antibiotics interval, local and general complications, overall WOMAC proved to be similar between the groups at 24 months after the surgery. Our cost assessment showed a 1.8 times higher mean value for the two-stage surgery, but we don’t consider this to be an indication for the one-stage surgery.

Fig. 1: WOMAC scores (group A – blue, group B – red

Conclusions. Two-stage surgery is worth it for carefully selected patients: polymicrobial, Enterococcus and MRSA infection, no major comorbidities and given the limitations of the study (small no. of patients treated in the same Medical Center) further investigations are necessary

References. (Times New Roman font, size 11)

[1] Kurtz SM, Lau E, Watson H, Schmier JK, Parvizi J. Economic burden of periprosthetic joint infection in the United States. J Arthroplasty. 2012 Sep;27(8 Suppl):61-5.e1. doi: 10.1016/j.arth.2012.02.022. Epub 2012 May 2. PMID: 22554729.

[2] Kildow BJ, Della-Valle CJ, Springer BD. Single vs 2-Stage Revision for the Treatment of Periprosthetic Joint Infection. J Arthroplasty. 2020 Mar;35(3S):S24-S30. doi: 10.1016/j.arth.2019.10.051. PMID: 32046827.

Sebastian E. Gradinaru

Mr Sebastian Gradinaru is a consultant general surgeon at Ilfov County Emergency Hospital holding a teaching position as Associated Profesor in General Surgery at Titu Maiorescu University, Faculty of Medicine. His expertise in emergency surgery, breast, oncological, upper GI and colorectal surgery has offered him exposure to novel technologies and various biomaterials with surgical applications such as herniorrhaphy materials, different stents for viscera, suture materials, haemostatic sponges, dies for mapping and sentinel lymph node biopsies, inks for tattooing and healing promoting agents.

Apart from publishing numerous papers approaching both fundamental and clinical research, Mr Sebastian Gradinaru authored books and chapters in surgical textbooks. He coordinates graduation and doctoral theses and is involved with the surgical training programme in his department.

He trained in breast oncoplastic surgery in Ireland where he experienced working with multiple types of implants, metallic and resorbable clips, cosmetic stitches and novel fluorescent dies.

Biomaterials design strategies appliable for hernia repair

Sebastian Gradinaru, Radu Costin, Catalin Alius, Tatiana Baciu, Aurora Antoniac.

Abstract

Hernia repair is among the most common surgical procedures performed worldwide. It became increasingly apparent to early surgeons, that the need for an artificial prosthetic capable of replicating the density and toughness of fascia and tendon in order to effectively cure hernia symptoms. Prior to the introduction of novel biomaterials, suture repair comprising multiple techniques for abdominal hernia repair. Implant design remains a critical challenge for the successful repair and prevention of recurrent hernias, and despite significant progress, there is no ideal mesh for every surgery. This review summarizes the evolution of prostheses design toward successful hernia repair and the major milestones in implant design are discussed. The goal of surgical mesh prostheses for hernia repair is to fortify and replace localized tissue defects in an effort to stabilize the abdominal wall for long term relief of symptoms and surgeons must take into account several additional physiological considerations to better understand the suitability of the implant. The design and construction parameters of surgical meshes can greatly alter the behavior of the prosthetic itself and should be fully understood before making appropriate selections for repair. This review not only summarizes the

state of the art in hernia repair, but also suggests future research directions toward improved hernia repair utilizing novel materials and fabrication methods. Biomaterials research has undergone a paradigm shift from creating largely passive scaffolds, designed to provide mechanical and structural stability while having minimal positive effect on tissue growth, to “active” materials, capable of influencing and directing tissue regeneration via the incorporation of drugs, cells, or materials with favorable intrinsic properties within the scaffold. Hernia repair remains largely dependent on non-degradable materials designed as one size fits all patches with minimal to no ability to actively encourage tissue regeneration. Future research will focus on the incorporation of new technologies and of new materials toward solving these remaining challenges and improving patient outcomes. Novel materials will lead to improved host response and material integration, while improved manufacturing will result in custom implants capable of better mimicking the native tissue in terms of mechanics and will incorporate not only scaffolding but active elements such as drugs, growth factors, and cells capable of improving and accelerating the healing process.

Lidia Benea

Lidia Benea is Professor and Ph.D. Supervisor in Materials Science and Engineering at Dunărea de Jos University of Galati, Romania (www.cc-ites.ugal.ro), member of the National Council for Attesting Titles, Diplomas and University Certificates (CNATDCU), Ministry of Education and Research, România. Author and co-author of over 300 scientific articles, 115 being in ISI journals and ISI proceedings volume, cumulating an Impact Factor of 240.808, 23 books and book-chapters and more than 360 presentations at scientific conferences. Her research interests are in the field of composite coatings, biomaterials, multifunctional materials and nanomaterials. In particular, she develops research activities related with nanostructured hybrid layers metallic and polymeric matrix composites and biomaterials. Invited professor at Ecole Centrale Paris-France and Katholieke Universiteit Leuven-Belgium in different periods. Many achievements in electrochemical methods applied to surface modification and materials characterization. In 2020 and 2021 she is cited in Top 2 World Ranking of the World’s Top Scientists by Stanford University in conjunction with Elsevier Publishing and SciTech Strategies.

Applied electrochemistry for nanostructuring and surface functionalization of biomaterials

Lidia Benea

Competences Center: Interfaces-Tribocorrosion-Electrochemical Systems, Faculty of Engineering, Dunarea de Jos University of Galati, 47 Domnească Street, RO-800008, Galati, Romania, e-mail: Lidia.Benea@ugal.ro

Introduction. Electrochemical method for the preparation of high-quality nanostructured surfaces and functionalization are highlighted in this work. There are two applied electrochemical methods in our laboratories in order to obtain hybrid and nanocomposite structured films or advanced functionalization of material surfaces: (i) bottom-up nanotechnology direct by electro-codeposition process and (ii) top-down nanotechnology by electrochemically oxidation of materials to form controlled growth of nanoporous oxide films. The main goal of the research paper is to make a summary of results obtained from applying electrochemical surface modification techniques in obtaining advanced functional surfaces and their properties characterization in terms of surface morphology and structure (SEM-EDX, XRD), the roughness, thickness, corrosion, tribocorrosion as well as the mechanical properties as nanohardness or wear resistance. The controlled oxide growth by anodization and electro-codeposition can lead to a large class of hybrid films and composite layers or nanostructured coatings on different materials and structures necessary for a future based on nanotechnology and nanomaterials to improve the surface properties face to aggressive environments and degradation processes.

Experimental. Electrochemical oxidation is carried out in potentiostatic mode at room temperature using a direct current (DC) voltage source in acidic electrolyte. The electrochemical oxidations is conducted in a two-electrode cell with titanium or titanium alloy as samples being the anodic electrode. The growth of porous TiO₂ film is done by applying a high voltage of 100-275 V for different times. During anodic oxidation process the electrolyte is stirred in order to accelerate the escape of the gas from the surface of anodic electrode and keep the homogeneity of the electrolyte. The schematic oxidation process is shown in Fig. 1.

Fig. 1. Presentation of electrochemical oxidation process to obtain nanoporous TiO₂ film on titanium and titanium alloys: (a) electrochemical cell showing the electrodes and reactions at electrodes in anodization electrolyte; (b) schematic nanoporous TiO₂ on titanium alloy surface; (c) Ti6Al4V bulk alloy; (d) measured roughness of TiO₂ nanoporous film aproximated as nanopores depth; (e) SEM surface morphology of TiO₂ nanoporous film obtained showing the nanopores measurements of diameter size; (f) SEM surface morphology of TiO₂ nanoporous film obtained on Ti6Al4V alloy.

Results and Discussion. The results show a nanostructuration of biomaterial surface by formation of a nanoporous oxide film on titanium or titanium alloys. The occurrence of nanopores is proved by the aspect of the anodic formed films observed by SEM, Fig. 1 (f). Improving surface properties will increase the life cycle of biomaterials.

Conclusions. Overall, the electrochemical formation of oxide film on titanium or titanium alloys confirms the possibility of the properties improvement especially the resistance to degradation by corrosion or tribocorrosion processes of implants.

Madalina Simona Baltatu

Lecturer Ph.D Eng. Madalina Simona BALTATU is a young researcher since 2014 in the field of biomaterials, a hardworker on titanium alloys. She obtained her Ph.D in 2017 with the subject “Contributions regarding the improvement of the properties of Ti-Mo alloys for medical applications”. Currently is a postdoctoral researcher in the Advanced Research Postdoctoral Training Program on the “Gheorghe Asachi” Technical University of Iasi, Faculty of Science and Engineering. In 2022 she received the Excellence Award, offered by the “Gheorghe Asachi” Technical University of Iasi, for the “Young researcher with the best performance in scientific research” category. Her activity is embodied and highlighted in the list of works, which are mostly in the field of biomaterials (obtaining, characterization, testing and expertise of new biomaterials; medical devices; surface properties; tissue-implant interaction phenomena; functionalization). The publication record is over 50 articles of which 30 are indexed in journals with IF (9 papers in Q1, 14 papers in Q2). Other achievements include: 6 international books, 2 national books, 4 international book chapters, 5 patent applications and 61 awards at invention salons. As experience in research projects, she was director/responsible for 3 grants, member of 3 international projects, and a member of 8 national projects. Also, she is Co-founder on SIMTIT ENGINEERING Spin-off (www.simtit.ro), a company dealing with obtaining and characterizing of new materials for medical applications. She is Guest Editor for 9 Special Issues on MDPI and has made over 300 reviews on articles in the field. H-index = 14. Personal webpage: http://www.afir.org.ro/msb/.

Innovative Titanium Alloys Suitable for Medical Applications

Madalina Simona Baltatu¹, Petrica Vizureanu¹

¹ “Gheorghe Asachi” Technical University of Iasi, Faculty of Materials Science and Engineering, 41 “D. Mangeron” Street, 700050, Iasi, Romania, e-mail: madalina-simona.baltatu@academic.tuiasi.ro

Biomaterials are continually advancing to enhance the quality of life, aiming to introduce a new generation of multifunctional implants with long-term performance. Titanium and its alloys have gained significant prominence in medical applications due to their unique properties and biocompatibility; these include: excellent mechanical properties (lower modulus of elasticity compared to stainless steel or CoCr alloys, fatigue strength, corrosion resistance) and high biocompatibility.

The mechanical properties of titanium alloys depend on their chemical composition, structure, and intended function within the human body. To simulate the properties of the targeted tissues, it is crucial to develop titanium-based alloys by incorporating non-toxic elements that are biocompatible with human tissue, such as molybdenum, zirconium, tantalum, niobium, manganese, and silicon. This study focuses on the latest trends in titanium-based systems, their properties, and their applications in the medical field. Specifically, it investigates the influence of alloying elements on titanium alloys for orthopaedic applications. The research examines the impact of alloying elements on the mechanical properties and microstructure of titanium alloys, differentiating between α and β alloys. The production of new titanium alloys from non-toxic elements (Mo, Zr, Ta, and Nb) using the argon arc-melting method is explored through optical and electron microscopy, X-ray diffraction (XRD), indentation tests, and biocompatibility tests.

Research on new titanium alloys developed for biomedical applications demonstrates superior properties compared to conventional alloys. These advancements aim to address the limitations of cobalt-based materials and stainless steels, such as their high modulus of elasticity, low corrosion resistance, and limited biocompatibility depending on individual patient immunological factors. The newly created alloys aim to improve the modulus of elasticity (close to the human bone) and mechanical strength without compromising the biological capabilities of the alloy. Additionally, they seek to reduce production costs.

The obtained results highlight the promising potential of these new alloys as biomaterials, positioning them as potential candidates for various medical applications. The research approach encompasses a multidisciplinary perspective, combining fundamental aspects of materials engineering with essential notions in the medical field, particularly in the realm of implantology.

Acknowledgements: This paper was financially supported by the Project “Network of excellence in applied research and innovation for doctoral and postdoctoral programs / InoHubDoc”, project co-funded by the European Social Fund financing agreement no. POCU/993/6/13/153437. This paper was also supported by “Gheorghe Asachi” Technical University from Iaşi (TUIASI), through the Project “Performance and excellence in postdoctoral research 2022”.

Bogdan Istrate

Assoc. Prof. PhD. Istrate Bogdan, ”Gh. Asachi” Technical Univeristy of Iasi, 34 years, has expertise in characterizing biodegradable Mg-based alloys, Ti-based biocompatible alloys, thermal coatings, modern methods of micro and nano structural characterization. He has published as an author / co-author a number of of 125 scientific papers, at 27 being the main author; of the 125 scientific articles: 50 articles are with ISI impact factor (rated ISI Web of Science), 12 of them being the first author/corresponding author; 32 articles are ISI Proceedings (conference volumes indexed Web of Science); 43 articles are in journals or conference volumes indexed BDI more than 340 times (278 citations are in ISI indexed articles – h-index ISI: 9; h-index Scopus: 10). He is the co-author of an OSIM patent and 6 OSIM patent applications, of which 4 patent applications are in the field of Mg-based alloys. He has published the following books as first author “Magnesium-based biodegradable metallic materials”, ”Metallographic expertise” and a laboratory guide – “Materials Science and Engineering – Laboratory guide” (co-author). Within the research – development projects he led as research partner/manager 5 research contracts: project director – UEFISCDI national competition (PN III TE 27/2022 – PN-III-P1-1_1-TE-2021-0702), entitled „Materiale metalice biodegradabile inovative din sistemul Mg-Ca-Zn utilizate în aplicații ortopedice”, 2022-2024; TUIASI partner manager – Pr. Comp. 3 – Pr. Complex „OBTAINING AND EXPERTISE OF NEW BIOCOMPATIBLE MATERIALS FOR MEDICAL APPLICATIONS” (2018-2021); director Grant Intern TUIASI Nr. 0430/2018 (2018-2019), “Novel biodegradable materials from the Mg-Ca-Mn-Zr system used as implants in the reconstruction of biological bone”, director of the Mobility Project PNCDI III RU-MC 313MC / 2019 – X-ray diffraction, in Almelo, Netherlands and director Contract with economic agent no. 14921 / 03.08.2020-Microstructural, compositional analyzes (SEM-EDX) and X-ray diffraction for various materials”. He has also been a member of 20 other research project teams. The doctoral thesis entitled ” Cercetări asupra influenței unor depuneri superficiale pe aliaje metalice biodegradabile utilizate în domeniul medical ” fits best in the field of the project proposal, being awarded with the “SUM CUM LAUDE” grade. Also, in 2019 he won the “Gheorghe Vasilcă” award in the field of advanced materials tribology, offered by the National Institute of Aerospace Research – INCAS Bucharest, in 2020 he won the EXCELLENCE AWARD, in the category “Young researcher with the best performance in scientific research ”, offered by the“ Gheorghe Asachi ”Technical University of Iași and in 2022 the Diploma of Excellence of Modtech Awards for Most Performing Young Researcher.

Mg-Ca-Zn biodegradable alloys and their importance in the medical applications and material science

Istrate Bogdan¹, Munteanu Corneliu^{1,2 *}

¹ ”Gheorghe Asachi” Technical University of Iasi, Faculty of Mechanical Engineering, 63 D Mangeron Blvd, Iasi 700050, Romania.

² Technical Science Academy Romania, 26 Dacia Blvd, Bucharest 030167, Romania

Abstract.

Previous studies on Mg-based biodegradable alloys of various ternary Mg-Ca-X systems, correlating biodegradation rate with osseointegration, found an increase in biodegradation time with the introduction of Mg-substituted elements. In this way, it was possible to correlate the biodegradation rate at different substitution values in order to reach an optimum for medical uses. Biodegradable magnesium alloys are suitable for ankle, foot, hand, and wrist implants, according to orthopedic implant research. Magnesium absorbs zinc (Zn), a crucial alloying component and its solid solution reinforcing and age-strengthening capabilities improves alloy`s mechanical properties. As noted, Mg–Zn alloys with up to 5 wt.% Zn has significantly higher UTS and elongation. Also, Zn controls gene expression, anti-atherosclerosis, nucleic acid and protein creation, and nervous system function. Zirconium (Zr) is a magnesium grain refiner. In alloys with Zn, RE, Y, and Th, elements cannot be mixed with Al or Mn since these elements produce stable compounds with Zr. Magnesium is often combined with RE elements (Y) in order to improve its creep resistance and high-temperature strength. The excellent solubility enables Yttrium (Y) to dissolve, form solid solutions, and precipitate at grain boundaries. Mn refines microstructures and promotes germination during initial solidification and improves mechanical properties. Gadolinium (Gd) helps improve alloy strength but reduces ductility. This paper compares the effects of the Zn element from Mg-Ca-Zn alloys performed in the research program with other studied alloying elements like Zr, Y, Mn, and Gd in the Mg-Ca system. Microstructure, mechanical properties, electrochemical analysis, in vitro, and in vivo tests were used to study the Mg-0.5Ca-xZn alloy with Mg-0.5Ca-y(Zr/Y/Mn/Gd) systems, with x and y being from 0.5 wt.% to 3%.

References.

[1] Antoniac, I.; Miculescu, M.; Manescu, V.; Stere, A.; Quan, P.H.; Paltanea, G.; Robu, A.; Earar, K. Magnesium-Based Alloys Used in Orthopedic Surgery. Materials 2022, 15 (3), 1148.

[2] Istrate B., Munteanu C., Antoniac I.-V., Lupescu Ș.-C., Current Research Studies of Mg–Ca–Zn Biodegradable Alloys Used as Orthopedic Implants—Review, Crystals, 2022, 12 (10), 1468.

[3] Istrate B., Munteanu C., Baltatu M.S., Cimpoesu R., Ioanid N., Microstructural and Electrochemical Influence of Zn in MgCaZn Biodegradable Alloys. Materials, 2023, 16 (6), 2487.

Acknowledgement.

This work was supported by a grant of the Ministry of Research, Innovation and Digitization, CNCS – UEFISCDI, project number PN-III-P1-1.1-TE-2021-0702, within PNCDI III.

Agop Forna Doriana

Dr. Agop Forna Doriana is Associate Professor at the UMF „Grigore T. Popa”, Iasi, Romania, and Resident coordinator on dento-alveolar surgery, Primary Physician – Dento-alveolar Surgery. His work is defined by research and development in the field of Oral Surgery. He is the author/coauthor of over 45 papers in peer-reviewed journals, 5 book chapters, and has presented over 90 papers at international conferences, and has an H-index of 17 in Google Scholar.

Bone Loss Management Using Biodegradable Grafting Materials

Agop-Forna Doriana¹, Norina Forna¹, Ovidiu Stamatin¹, Iulian Antoniac²

¹ Grigore T. Popa University of Medicine and Pharmacy, 16 Univesității, Iași, Romania, profforna@gmail.com

² Materials Science and Engineering Faculty University Politehnica of Bucharest, Romania

Introduction. Intraoral bone loss resulting from trauma, infection, or pathological conditions presents a significant challenge in dental and maxillofacial surgery. The use of biodegradable grafting materials has shown promise in facilitating bone regeneration and restoring oral function. The future study aims to evaluate the efficacy of biodegradable grafting materials in the management of intraoral bone loss.

Experimental. The design of a experimental study includes a significant number of adult male Wistar rats. Standardized bone defects have to be created in the mandible of each rat to simulate intraoral bone loss. The rats are randomly divided into two groups: the experimental group, where the bone defects are filled with biodegradable grafting material, and the control group, where no grafting material is used. Radiographic imaging, histological analysis, and micro-CT scans are performed at 4, 8, and 12 weeks postoperatively to assess bone regeneration, graft integration, and volume maintenance.

Results and Discussion. Radiographic analysis has to perform a comparison between bone regeneration in the experimental group compared to the control group at all time points. Histological examination has to evaluate the tissue integration, increased new bone formation, and enhanced vascularization in the experimental group. Micro-CT analysis is used to asses the bone volume and level of graft resorption in the experimental group.

Conclusions. This study aimes to inquire for evidence supporting the effectiveness of biodegradable grafting materials in managing intraoral bone loss. The biodegradable grafts are supposed promoting enhanced bone regeneration, improved tissue integration, and favorable graft resorption characteristics. The use of biodegradable grafting materials hold promise as a reliable and biocompatible option for intraoral bone loss management. Further investigations are warranted to explore optimal graft compositions, mechanical properties, and long-term outcomes.

Keywords: Intraoral bone loss, biodegradable grafting materials, bone regeneration, tissue integration, graft resorption

References.

[1] Hänzi AC, Sologubenko AS, Uggowitzer PJ (2009) Design strategy for microalloyed ultra-ductile magnesium alloys for medical applications. Mater Sci Forum 618–619:75–82;

[2] Hermawan H, Mantovani D (2009) Degradable metallic biomaterials: the concept, current developments and future directions. Minerva Biotecnol 21:207–216;

[3] Jacobs JJ, Gilbert JL, Urban RM., 1998 – Corrosion of metal orthopaedic implants. J Bone Joint Surg, 80:268– 82;

[4] Kraus T, Fischerauer SF, Hänzi AC, Uggowitzer PJ, Löffler JF, Weinberg AM (2012) Magnesium alloys for temporary implants in osteosynthesis: in vivo studies of their degradation and interaction with bone. ActaBiomater 8:1230–1238;

Horea Benea

Horea Benea, MD, PhD, is Associated Professor at “Iuliu Hatieganu” University of Medicine and Pharmacy from Cluj-Napoca, Romania. With more than 10 years of experience as specialist orthopedic surgeon, he is the Head of Orthopedics and Traumatology University Clinic Cluj-Napoca, a renowned public service of 110 beds, 10 specialist surgeons and 30 residents. He is the fellow of the dear departed Professor Philippe Hardy, who taught him shoulder arthroscopy in 2010-2011, in Paris, France, and of Professor Giuseppe Milano, former ESA President, who helped him perfect his practice during a fellowship in 2015 in Rome, Italy. He is an Arthroscopy DIU graduate in France, promotion 2010-2011. He is an active member of ESA Communication Workgroup for almost 4 years and founding member of Romanian Arthroscopy Society SRATS. His clinical activity is focused on shoulder surgery, arthroscopy, prosthetic replacement and trauma, but he is also fond of knee, hip and ankle surgery and general orthopedic trauma. His scientific activity resulted in more than 30 ISI papers published, 9 research projects, 20 invited lectures and 50 podium or poster presentations at international events, with a special interest on cartilage and bone regeneration and implant osseointegration. The most important awards received are the ESSKA-ON Foundation Partnership Award: Best Abstract In Orthoregeneration for ESSKA 2020 Congress and the Young Researcher Prize for Surgical Sciences from UMF Cluj-Napoca in 2013. He is the organizer of an annual Hands-on Course of Knee Arthroscopy Initiation in Cluj-Napoca, Romania. Contact: drbenea.ortho@yahoo.fr.

Pyrocarbon Hemiprosthesis of the Shoulder: Exploring Successes and Challenges

Horia Mihnea Fotescu¹, Vladimir Ciornei^1,2, Claudiu Cîmpean^1,2, Rareș Edveș^1,2, Horea Benea^1-2

¹”Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania, horiafotescu@gmail.com

² Department of Orthopedics and Traumatology, ”Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania

The management of glenohumeral osteoarthritis and avascular necrosis is challenging in young patients. The quest for an optimal biomaterial to regenerate the articular surface of the glenohumeral joint in young individuals suffering from arthritis, as well as the rising requirement for durable implants among highly active individuals, has become a pressing scientific pursuit. Total shoulder arthroplasty is commonly avoided in young arthritic patients due to its high revision rates, while hemiarthroplasty is not preferred because of the risk of glenoid erosion caused by the metallic head of the prosthesis. These complications significantly and adversely impact the lives of young patients.

Pyrocarbon (PC) has been considered to reduce glenoid erosion in shoulder arthroplasty and even promote glenoid bone remodelling in order to re-establish the normal shape and version of glenoid articular surface. PC has a very low coefficient of friction, preserving subchondral bone and reducing glycosaminoglycan loss. In vitro studies, PC proves to have elastic modulus similar to cortical bone and promotes the formation of cartilage-like tissue. Klawitter JJ et al. demonstrated PyroCarbon hemiarthroplasty implants significantly produce less damage to the bone in simulated shoulder function compared to conventional cobalt-chromium implants.

Kleim BD et al. considered that hemi-prostheses with a pyrocarbon head could be a better choice for Walch B glenoid and arthritis caused by instability. In a study conducted by Tsitlakidis et al., a cohort of 16 patients with a mean age of 52.8 years underwent hemiarthroplasty of the shoulder utilizing PC heads. The findings revealed highly favorable short-term outcomes, nearly reaching an excellent level, at an average follow-up period of 2 years. Recently, Stryker is the first company to offer the first FDA-cleared pyrocarbon-bearing material option for shoulder hemiarthroplasty in the United States. In Europe, Tornier

However, there is a need for more long-term follow-up results to successfully compare the superiority of PC prosthesis compared to conventional hemiarthroplasty and total shoulder arthroplasty.

References:

[1] Kleim BD, Garving C, Brunner UH. RSA, TSA and PyC hemi-prostheses: comparing indications and clinical outcomes using a second-generation modular short-stem shoulder prosthesis. Arch Orthop Trauma Surg. 2021 Oct;141(10):1639-1648. doi: 10.1007/s00402-020-03529-w. Epub 2020 Oct 6. PMID: 33025070; PMCID: PMC8437863.

[2] Klawitter JJ, Patton J, More R, Peter N, Podnos E, Ross M. In vitro comparison of wear characteristics of PyroCarbon and metal on bone: Shoulder hemiarthroplasty. Shoulder Elbow. 2020 Dec;12(1 Suppl):11-22. doi: 10.1177/1758573218796837. Epub 2018 Sep 11. PMID: 33343712; PMCID: PMC7726179.

[3] Tsitlakidis, S., Doll, J., Westhauser, F., Wolf, M., Hetto, P., Maier, M., & Sowa, B. (2021). Promising results after hemi-shoulder arthroplasty using pyrolytic carbon heads in young and middle-aged patients. Orthopaedics and Traumatology: Surgery and Research, 107(4), 102896. https://doi.org/10.1016/j.otsr.2021.102896

[4] Mehta, N., Hall, D. J., Pourzal, R., & Garrigues, G. E. (2020). The Biomaterials of Total Shoulder Arthroplasty: Their Features, Function, and Effect on Outcomes. JBJS Reviews, 8(9), 1–11. https://doi.org/10.2106/JBJS.RVW.19.00212

Ondine Patricia Lucaciu

Dr. Lucaciu, Ondine Patricia (Author ID: 25027765600), DMD PhD, defanded her PhD thesis “Tissue engineering of bone tissue usable in cranio-maxillofacial bone defect plasty. A study performed on an animal model” in 2009. OL published in medical field 27 articles in ISI rated journals (6 articles as principal author and 1 as co-author in Q1, 3 articles as principal author and 2 as co-author in Q2, 12 articles as principal author and 3 as co-author in Q3), 21 articles in IDB rated journals, 2 books and 12 book chapters. She defanded her habilitation thesis in 2019 “Innovative strategies in oral tissue regeneration therapies for enhancing life quality of patients.”. Competence in Tissue Engineering, obtained following a training program as part of the Scientific Cooperation Program in Hightech Research Zenter (HFZ), Department of Cranio-Maxillofacial Surgery, under the supervision of Prof. Dr. Dr. Hans-Florian Zeilhofer. OL was project director of two national projects, scientific manager of one national project and team member in one international and 7 national grants. Her work was awarded with 14 international and national awards. She is a senior oral surgent, with expertise in implantology. In the field of research, she has expertise in stem cells, tissue engineering, regenerative medicine, osseointegration.

Validation of a new drug delivery system for periodontal regeneration on an animal model

Ondine Lucaciu¹, Nausica Petrescu¹, Bogdan Crisan², Ovidiu Aghiorghiesei², Ioana Codruta Mirica², Evelyn Vanea¹, Dragos Apostu³

¹ Department of Oral Health, Iuliu Hatieganu University of Medicine and Pharmacy Str. Victor Babes 15, Cluj-Napoca, Romania.

² Department of Maxillofacial Surgery and Oral Implantology, Iuliu Hatieganu University of Medicine and Pharmacy, Cardinal Iuliu Hossu nr 37, Cluj-Napoca, Romania.

³ Department of Orthopaedics and Traumatology, Iuliu Hatieganu University of Medicine and Pharmacy, Traian Mosoiu nr 47-49, Cluj-Napoca, Romania.

Introduction: Guided tissue regeneration (GTR), which uses a barrier membrane has been demonstrated to regenerate tooth-supporting tissues, including periodontal ligament, cementum and new alveolar bone [1,2].

The aim of this study was to explore the dual release system on periodontal regeneration in an animal model using a new biodegradable NM from poly(e-caprolactone) (PCL), with gentamicin (GEN) and nano-hydroxyapatite (nHap) embedded in the fiber, for a controlled release, obtained through the electrospinning process as an innovative highly efficient, low-cost treatment for P-D.

Experimental: We conducted an animal study on 50 Wistar rats designed in 3 steps: step 1-initial evaluation of specimens and application of the silk ligature; step 2- evaluation of the induced periodontal inflammation, ligature removal and treatment application and step 3 – clinical evaluation of therapeutic outcomes and animals’ euthanasia to collect tissue specimens for histological examination.

Results and Discussion: After removing the ligature, curettage + membrane procedure is more efficient than simple curettage, in recovering the subjects mass, significantly reduces probing depths and in a shorter time, accelerates the healing of bleeding, dental mobility and bacterial plaque.

Conclusion: Taken together, our in vivo study indicates that gentamicin and nano-hydroxyapatite incorporated biodegradable membranes might be a promising therapeutic option for periodontal disease treatment.

References:

Buser, D., Brägger, U., Lang, N., & Nyman, S. (1990). Regeneration and enlargement of jaw bone using guided tissue regeneration. Clinical Oral Implants Research, 1(1), 22-32.
Garrett, S. (1996). Periodontal regeneration around natural teeth. Annals of periodontology, 1(1), 621-666.

Acknowledgements:This work was supported by a grant of the Ministry of Research, Innovation and Digitization, CNCS – UEFISCDI, project number PN-III-P1-1.1-TE-2021-0531, within PNCDI III.

Marius Manole

Marius Manole, DDS, PhD, Associate Professor of Propedeutic and Esthetic Dentistry, Department of Prosthetics and Dental Materials, Faculty of Dentistry, University of Medicine and Pharmacy „Iuliu Hatieganu” Cluj-Napoca, Vice Dean – Academic, Management and Development, I graduated the Faculty of Dentistry UMF Cluj-Napoca in 2001, holds a PhD in Medicine and a Master degree in implant supported prosthesis and radio-diagnosis course. More then 20 years experience in dental prosthetics, dental esthetics and implant supported prothesis. Professional and Scientific activities : 1 books published as co –autor, more then 40 papers published in extenso, many scientific presentations and paper published as abstract in the proceeding of international conferences, invited speaker at several national scientific meetings, reviewer for several specialty scientific journals. Also, he was involved in various research projects focused on dental biomaterials. Research interest: prosthetic dentistry, prosthetic on implants, esthetic dentistry, dental biomaterials, digital dentistry.

Biomaterials used in prosthetic structures on dental implants

Marius Manole

DDS, PhD

Associate Professor of Propedeutic and Esthetic Dentistry,

Department of Prosthetics and Dental Materials, Faculty of Dentistry,

University of Medicine and Pharmacy „Iuliu Hatieganu” Cluj-Napoca

In the field of dental implantology, the design of interface esthetics not only affects the esthetic coutcome, but also affects the health and long-term stability of the tissue around dental implant.

Establishing and maintaining a soft-tissue seal around transmucosal abutments on bone-level implants or on the collar of one-stage tissue-level implants is paramount to maintaining crestal bone height, and failing to do so will result in apical migration of the soft tissue onto the implant

The emergence profile located at the junction of these four components is an important form of oral esthetics.

Using different types of dental materials in guiding soft tissue healing, correct transmission of information at the dental officel level, using different types of prosthetic abutments, in order to finally achieve a properly done work from a clinical and technical point of view, this is only a part of the conditions imposed for the proper completion of this type of prosthetic works.

Alina Vladescu Dragomir

Dr. Eng. Alina Vladescu (Dragomir), has a B.S. in Materials Science and Engineering from the University Politehnica of Bucharest (2002) and an MS in Biomaterials from the Department of Bioengineering and Biotechnology, University Politehnica of Bucharest (2004). Her PhD however is in Materials Science from University Politehnica of Bucharest (2011). She works at National Institute of RD for Optoelectronics INOE2000, Department for Advanced Surface Processing and Analysis by Vacuum Technologies (since 2002). She is also affiliated as research scientist at National Research Tomsk Polytechnic University.

Expertise: • Functional coatings (metals, nitrides, carbides, oxides and oxynitrides) deposited by magnetron sputtering and cathodic arc techniques), especially for optics, optoelectronics, mechanical and tribological applications, but also with special properties, such as corrosion resistant and biomaterials. • Oxide thin films by electron gun evaporation technique, especially for optoelectronics applications and (again) for biomaterials. • Analysis and characterization of thin films using various spectroscopies (UV-Vis-NIR, EDS), X-ray diffraction, morphological, mechanical, anticorrosion and tribological characterization.

Reviewer for ISI journals: ♦Surface and Coating Technology; ♦Thin Solid Films; ♦RSC Advances; ♦Applied Surface Science; ♦Vacuum; Materials Science and Engineering B.

Guest Editor: Frontiers in Materials (2016-2017), Composite Interfaces (2016), Coatings (2019-present).

Consequently, she has over 142 ISI papers, and over 300 presentations, 17 patents, 7 books, 18 awards at Invention Exhibitions. Hirsh score is 25 (according to Web of Science); no. of citations is 1650.

ZrCu-based thin films metallic glasses for orthopaedic aims

Alina Vladescu (Dragomir)^1*, Anca C.Parau¹, Mihaela Dinu¹, Cosmin M.Cotrut²

¹Department for Advanced Surface Processing and Analysis by Vacuum Technologies (ReCAST), National Institute of Research and Development for Optoelectronics – INOE 2000, 409 Atomistilor St., R077125, Magurele, Romania

² University Politehnica of Bucharest, Faculty of Materials Science and Engineering, 313 Spl. Independentei, RO60042, Bucharest, Romania

*Corresponding author: alinava@inoe.ro

Abstract: The paper presents the development of ZrCu based thin films metallic glasses using the cathodic arc evaporation technique. The coatings are prepared to improve the surface properties of 316L stainless steel orthopaedic implant materials. The ZrCu-based coatings combine their exceptional mechanical capabilities with the corrosion resistance of amorphous metallic glasses. Small amount of Ca, Mo, Mg, Si, and Sr were added into ZrCu structure, forming ternary systems. The electrochemical tests were performed in SBF at human body at 37°C. In vitro immersion tests were also carried out in SBF for 1, 7, and 14 days at 37 ± 0.5 °C. The surfaces were characterised by smooth morphologies in most cases, results being ascribed to their amorphous nature. The hardness and adhesion were improved, the best one was achieved in the case of ZrCuSi. Both in vitro electrochemical and bioactivity experiments showed that all coatings improve substrate behaviour in simulated conditions, emphasizing their potential as medical biomaterials.

Keywords: cathodic arc, corrosion resistance, metallic glasses, coatings

Acknowledgements: We acknowledge the support of the Romanian Ministry of Education and Research, CNCS – UEFISCDI, project PN-III-P4-ID-PCE-2020-1264 (PCE95/2021), within PNCDI III, and to Romanian Core Program project no. PN 23 05 (id: PN11N-03-01-2023) and through contract no. 18PFE/30.12.2021.

Dorobantu Lucian

Lucian Florin Dorobantu is Professor of Cardiovascular Surgery since 2022 and has the Habilitation Certificate since 2021.

He is the Head of Cardiovascular Surgery Chair, Monza Hospital since 2020 and Scientific Director of Monza Hospital, Bucharest, Romania since 2020

He is Author of 5 books, 25 articles in the ISI/PubMed database (11 as first author with IH = 9), 8 articles in the CNCSIS database, author/coauthor of 34 book chapters, 90 studies published in ISSN/ISBN.

He is also Reviewer of 2 ISI journals – Journal of Cardiothoracic Surgery and Archives of Medical Sciences

He obtained numerous international and national prizes like:

Gold medal of „Salon International de Inventions”, Geneva 2019 and other 9 international prizes as part of the reserch team of the Digital Capillaroscope – in 2019, 2020, and 2021

„Young vascular surgeon of the year 2007” nominee – European Society of Cardivascular Surgery, Venezia, 2007 for the poster comunication „The brachio-brachial arteriovenous fistula: a new alternative to prosthetic grafts”

Review of the article „The brachio-brachial arteriovenous fistula: a new method in patients without a superficial venous system in the upper limb”, J Vasc Access. 2006 Apr-Jun;7(2):87-9, in the Research Highlights section of „Nature Clinical Practice Nephrology” in 2007

„Iuliu Hatieganu” Award in Medicine of the Romanian Academy for the book „Actualities in acute myocardial infarction”, Ed. Academiei, 2003.

Excellence Award „Medic.Ro” for „Compendiu de Boli Cardiovasculare” ed. 2004

Universitary Book Diploma for „Surgery of the patient with hemodialysis”, 2006

Transaortic mitral valve reconstruction in hypertrophic obstructive cardiomyopathy – does it simplify or complicate the surgical strategy?

Lucian F. Dorobantu¹, Toma A. Iosifescu¹, Razvan Ticulescu¹, Maria Greavu¹, Maria Alexandrescu¹, Monica Trofin¹, Andrei D. Dermengiu¹

¹Cardiomyopathy Center, Monza Hospital, Bucharest, Romania

Objective: Septal myectomy for hypertrophic obstructive cardiomyopathy (HOCM) is often recommended to be performed only by highly experienced surgeons. Anomalies of the mitral valve (MV) apparatus have been increasingly shown to contribute to left ventricular outflow tract obstruction (LVOTO) in patients with HOCM. We report our 7-year experience with the systematic association of a transaortic MV reconstruction to a shallow myectomy procedure in a center started from scratch / initially inexperienced center.

Methods: We retrospectively studied 120 consecutive patients who underwent surgery for symptomatic LVOTO, between June 2015 and November 2022. In all cases, a transaortic shallow septal myectomy was performed, consisting of just a third of the preoperative septal thickness, as measured with cardiac magnetic resonance (CMR). In addition, extensive mobilization of the papillary muscles was performed, and fibrotic or retracted secondary chordae of the anterior MV were cut selectively.

Results: We report one death (0.8%) during hospital stay, no iatrogenic ventricular septal defects (VSD), and two (1.6%) MV replacements. Mean maximal outflow gradient decreased from 92.2 ± 29.6 to 14.9 ± 11.9 mmHg (p<0.001). Mean maximal septal thickness decreased from 23.4 ± 5.1 to 16.9 ± 3.2 mm (p<0.001), consistent with a mean thickness of the myectomy specimen of 6.9 ± 1.5 mm. The mean mass of excised muscle was 3.9 g (range 0.8 – 12). Significant (grade 3 or 4) mitral regurgitation was noticed in one patient postoperatively (0.8%), from 50 (41.6%) before surgery. The mean number of secondary MV chordae cut was 6.3 (range 2 – 13).

Conclusions: Routine association of secondary MV chordal cutting and papillary muscle mobilization to septal myectomy apparently complicates the surgical procedure, but allows for a thinner ventricular septum resection, greatly reducing the risk of iatrogenic VSD. Also, it permits the correction of the concomitant congenital MV anomalies involved in the mechanism of LVOTO. The addition of a tailored preoperative CMR planning to the presented operative technique could standardize the method, an essential step in the development of new HOCM surgical centers.

Lucian Gheorghe Gruionu

Lucian Gheorghe Gruionu, Hab., PhD., Eng., is Professor at the Faculty of Mechanics from the University of Craiova (UCV), one of the major universities from Romania. Prof. Gruionu’s research in the last 22 years was focused on biomedical engineering, innovation in medicine, biomechanics and medical instruments and equipment development. He worked in medical robotics research and interventional radiology instrumentation at the Johns Hopkins University, Baltimore and Georgetown University, Washington USA and he had research collaborations and common projects with the prestigious international institutions like Department of Surgery at the Massachusetts General Hospital and Harvard Medical School or Catholic University from Washington. He isin present director of a second international grant, leading a consortium of 6 important institutions like SINTEF Research Institute and Norwegian University of Science and Technology from Norway. Prof. Gruionu was director of 16 national research grants, he founded two mechanical and biomedical engineering laboratories with state-of-the art equipment, he is the author and co-author of over 100 peer reviewed scientific publications and conference proceedings and he was granted 4 international patents (USA, WPO) and one national in medical devices and robotics. Prof. Gruionu is co-founder and CEO of three medical and biomedical engineering R&D start-ups.

LUNG AIRWAYS NAVIGATION SYSTEM USING SHAPE SENSING AND ARTIFICIAL INTELLIGENCE

Lucian Gheorghe Gruionu¹

¹Faculty of Mechanics from the University of Craiova, România

Currently early diagnosis of malignant lesions at the periphery of lung parenchyma requires guidance of the biopsy needle catheter from the bronchoscope into the smaller peripheral airways via harmful X-ray radiation. Previously, we developed an image guiding system (iMTECH) using electromagnetic tracking to navigate the tip of a biopsy catheter and replace most of the necessary X scans during the medical procedure.

A different navigation method to trace the entire catheter with the potential to decrease the positioning error in the peripheral airways was developed. We developed the prototype of a shape sensing guidance system containing a fiber-Bragg grating catheter and an artificial intelligence (AI) software named AIrShape to guide biopsy instruments after extension outside the bronchoscope, inside the lung airways, without radiation or electromagnetic navigation. The fiber with four cores and a shape-sensing length of 25 cm was placed in the working channel of a custom made three-lumen carrier catheter with a tip bending mechanism. The software identifies the position of the fiber-catheter system by comparing its shape with the lung airways center line using an AI algorithm. The fiber-Bragg – AI system feasibility was tested in the airways of an anatomically accurate lung model and validated both visually and using iMTECH platform.

The results prove a viable hardware and software solution for optical fibers to be used with medical instruments to identify the correct airway for peripheral malignant lung lesion biopsy. In future studies, the feasibility of fiber-Bragg approach for shape-sensing catheter navigation will be tested in a large animal model

Horia Octavian Manolea

Horia Octavian Manolea is Professor at the Prostheses Technology and Dental Materials Department and currently Chief of the 1-st Department of the Faculty of Dentistry from the University of Medicine and Pharmacy, Craiova, Romania. He graduated as valedictorian the Faculty of Dentistry in 2001, holds a PhD in Medicine and a Master degree in implant supported prosthesis. Research interests include the bioactive materials study, mainly of bone augmentation materials, restorative materials research, implant supported prosthesis technologies, development of ceramic and metal-ceramic technology, dental and periodontal structures morphology study. His professional and scientific activity comprises 10 textbooks, more than 70 papers published in scientific journals of which 42 were published in ISI journals with impact factor, more than 150 papers published in abstract in the proceedings of international or national conferences, invited speaker at several national and international scientific meetings, reviewer for several specialty scientific journals.

Teaching dental biomaterials in the 21-st century. The need for a paradigm shift

Manolea Horia¹, Sinescu Cosmin², Marius Manole³, Lucian Toma Ciocan⁴, Antoniac Iulian⁵

¹ Department of Dental Materials, Faculty of Dentistry, University of Medicine and Pharmacy Craiova, Romania, horia.manolea@umfcv.ro

²Department of Dental Prosthesis Technology and Dental Materials , Faculty of Dentistry, University of Medicine and Pharmacy “ Victor Babeș” Timișoara, Romania, sinescu.cosmin@umft.ro

³Department of Prosthetic Dentistry and Dental Materials, Faculty of Dental Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania, marius.manole@umfcluj.ro

⁴Prosthetics Technology and Dental Materials Department, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; lucian.ciocan@umfcd.ro

⁵Department of Materials Science and Physical Metallurgy , Faculty Materials Science and Engineering, University POLITEHNICA of Bucharest, Romania, antoniac.iulian@gmail.com

Abstract:

The extremely rapid development of the dental materials market and the abundance of new concepts and technologies make choosing the best dental material for a given clinical situation not easy especially for young clinicians. Even the new generations have an increased familiarity with communications, media, and digital technologies, the too many choices make this task a difficult one. Throughout the presentation we will discuss the factors that determine the choice of a dental material: the properties of the material, the experience in its use, the ability of the clinician to work with it, economic aspects, patient expectations, cost-effectiveness ratio.

In order to have future dentist capable of making the right decisions in the medicine of the 21st century, it is necessary to change the way of thinking and teaching medical information in general and especially in an effervescent field like that of dental biomaterials. The exhaustive presentation of some more or less classic materials should be replaced by a preparation of the student for a critical thinking that will provide him with the necessary skills to cope in a world characterized by an abundance of information that often lacks a solid scientific foundation.

Particular attention will be paid to the role that can be played by student research in acquiring the necessary skills for the right clinical choices. Thus, it is a truism of medical education that students should do research, because early exposure to scientific inquiry develop the students critical thinking and spark curiosity for specific subjects. These abilities not only help students better understand the medical pathology, but help them to read and interpret scientific literature in order to distinguish the valuable information.

Key words: dental material, critical thinking, student research

Simona Cavalu

Professor Simona Cavalu serves as Full Professor in the Department of Preclinical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, ROMANIA and Head of Cells Culture Laboratory. She obtained an International Ph.D. in Sciences at Babes-Bolyai University, Cluj -Napoca, Romania and she has worked as invited professor in several international institutions including Istanbul Technical University, Debrecen University (Hungary) and ISM-CNR Rome, Italy. She is also member of several Academic Societies: International Society for Ceramic in Medicine, Romanian (European) Society of Biomaterials, Romanian Society of Pure and Applied Biophysics, Romanian Society of Medical Physics. Professor’s Simona Cavalu research focuses on bio nano-materials for orthopaedic, dental and tissue regeneration applications, natural polymeric composites for controlled and targeted drug release, titanium cranioplasty, nanoparticles production and characterization, nanomedicine, animal model (in vivo biocompatibility tests), in vitro biocompatibility tests, natural compounds for different therapeutic strategies. She also served as invited lecturer at prestigious international conferences and co-organizer of international meetings, international reviewer and Editorial Board Member for prestigious, top-ranked international journals in MDPI, Frontiers, Springer, Elsevier. Her publishing activity comprises more than 100 papers in international ranked journals. She has been awarded with various research prizes from international and national organizations: “Daniel Bunea“ Award of Romanian Society of Biomaterials 2014, Excellence Award SRB 2015, Best Conference Chairperson EMN Biomaterials Phuket 2016, Gold Medal – National Research Council of Thailand (NRCT) 2018, Special Honour of Invention – Toronto International Society of Innovation & Advanced Skills 2018 (TISIAS), Special Award & Gold Medal – Malaysian Research & Innovation Society, and Special Award & Medal – Association of Polish Inventors and Rationalizers, 2018, as a group member of the invention “Cranial implant with osteointegrating structures and functional coatings”.

Natural and manufactured collagenic membranes for tissue regeneration: new approaches and improvements

Simona Cavalu¹, Anca Porumb¹

¹ Faculty of Medicine and Pharmacy, University of Oradea, Romania, P-ta 1 Decembrie 10, 410087 Oradea, Romania

simona.cavalu@gmail.com

Not all collagenic membranes (CM) biologically behave the same way, as they differ from their origin and structure, with repercussion on their mechanical properties, biointegration and clinical performance. One of the most interesting aspects of CM is that the speed of resorption may vary. For example, the structural and ultrastructural characteristics of the amniotic membrane (AM) along with its biological properties recommend this natural biomaterial as a support matrix for tissue regeneration, including corneal and conjunctiva surface reconstruction. It is not a substitute, but rather a substrate upon which the epithelial cells can easily grow, differentiate and migrate, helping tissue to regenerate. On the other hand, many manufacturers and companies are developing a variety of collagen-based films or membranes derived from human or animal sources with different structures and crosslinking technology. A special attention was paid to collagenic materials for wound healing, in the context of the complex healing process which depends on multiple factors such as the presence of multiple types cells, regulation processes involved in hemostasis, inflammation, proliferation and tissue remodeling.

The aim of this work is to present the ultrastructural modifications and biomedical performances of the natural collagenic membranes after different modifications such as: UV exposure and/or antibiotic treatment, incorporation of natural bio-compounds (propolis, azelaic acid) by combining the histological/immunohistochemical examination with high-sensitivity atomic force microscopy (AFM) measurements and Fourier transform infrared (FTIR) spectroscopy. We also aimed to present the bio-integration capacity and the immune response generated by the tissue in the framework of animal model, along with a clinical case presentation (pterygium) requiring corneal surgery and resurfacing with (AM) showing the most important outcome and advantages of this technique.

The results might have importance in the context of the current debate over whether the AM should be used intact (fresh, preserved at -20˚C) or photo-crosslinked as a grafting material, taking into account the denaturation influenced by post-surgical antibiotic treatment. Also, being well known the antibacterial and anti-inflammatory effect of propolis and azelaic acid, our results might have a significant importance, as a promising option for healing the deep and large cutaneous tissue defects.

References:

Cavalu, S.; Roiu, G.; Pop,O.; Heredea, D.A.P.; Costea, T.O.;Costea, C.F. Nano-Scale Modifications of Amniotic Membrane Induced by UV and Antibiotic Treatment:Histological, AFM and FTIR Spectroscopy Evidence. Materials 2021, 14, 863. https://doi.org/10.3390/ma14040863.
Roiu, G., Cavalu, S., Teusdea, A., Petricas-Heredea, D.A., Fratila, O. Assessment of Antibiotic Influence on Structural Modifications of Amniotic Membrane by FTIR Spectroscopy, Mater. Plast., 57(2), 2020, 191-198. https://doi.org/10.37358/MP.20.2.5365.
P. M. Pasca, S. Cavalu, The influence of propolis nanoparticles on dermal fibroblasts migration:premises for development of propolis-based collagen dermal patches. Digest Journal of Nanomaterials and Biostructures Vol. 16, No. 3, July – September 2021, p. 929 – 938.

Aurel G. Mohan

Univ. Prof. Dr. Mohan Aurel-George, was born in the city of Oradea on 27.04.1983, Bihor county, graduated from the Oltea Doamna General School, after which he graduated from the Mihai Eminescu National College in 2001. He attended the Faculty of Medicine and Pharmacy Oradea, specializing in General Medicine in the period 2002-2008, after which he was a resident doctor in the clinical department of Neurosurgery at the Oradea County Emergency Clinical Hospital between 2009-2015. In 2014, he obtained the title of doctor in medical sciences at the doctoral school of the Carol Davilla University of Medicine and Pharmacy in Bucharest.

He began his university career in 2009, obtaining through a competition the position of university trainer in the Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea. In 2016, he took the exam for the position of Head of Works at the University of Oradea – Faculty of Medicine and Pharmacy, and at the same time, from the position of specialist neurosurgeon, he became the head doctor/coordinator of the operating room at the Oradea County Emergency Clinical Hospital.

In 2019, he becomes a University Lecturer at the University of Oradea, and in 2021 he takes the primary exam, thus becoming a primary neurosurgeon also at the Oradea Neurosurgery Clinic.

In 2022, he takes the exam for the position of University Professor at Oradea University and is appointed Secretary of State at the Bucharest Ministry of Health, where he begins his work.

Currently, Dr. Mohan Aurel-George leads the residency program at the Oradea Neurosurgery clinic, as a University Professor and primary neurosurgeon and is the coordinator of the Oradea County Emergency Clinical Hospital.

Cranioplasty after Traumatic brain Injury (TBI) – Customized polyetheretherketone (Peek) cranial repair system implants review.

Ghiurau N Adrian^1a, Mohan G. Aurel², Mărcuţ F Lavinia³, Ciurea V. Alexandru⁴, Antoniac V. Iulian⁵.

^1,2,)Faculty of Medicine and Pharmacy, University of Oradea, Department of Neurosurgery, Romania,

³⁾Faculty of Medicine and Pharmacy, University of Oradea, Department of Anesthesia and Intensive Care, Romania,

⁴⁾Carol Davila University of Medicine and Pharmacy, Sanador Medical Center Hospital, Department of Neurosurgery, Bucharest, Romania,

⁵⁾University Politehnica of Bucharest, Faculty of Material Science and Engineering, Department of Materials Science and Physical Metallurgy, Bucharest, Romania.

E-mail: ^a)ghiurau.adrian@yahoo.com / Tel.: 0040743952768

Keywords: Cranioplasty, TBI, Peek, Biomaterials.

Background: Cranioplasty represents the surgical procedure to repair a defect of the skull bone. The loss of cranial bone integrity due to a trauma or injury of the head is a contemporary example of tissue failure, which usually requires the permanent or temporary implantation of a bone substituent and may become challenging in case of large defects. Our paper presents a study regarding post-traumatic cranioplasty using polyetheretherketone (PEEK) implants.

Aim of Study: The aim of this study is to report the using of polyetheretherketone (Peek) implants in cranioplasty with biomaterials after severe traumatic brain injury.

Material and Method: The implant allows the replacement of the bone gaps of the patient’s craniofacial skeleton. The implant is modeled and sized to fit the individual anatomy of each patient. The implant is designed with a software, after receiving the patient’s CT scan and made of polyetheretherketone (Peek), being supplied as a single component or as multiple components. The implant is attached to the native bone with self-locking plates or fixed using standard cranial fixation systems or using standard titanium screws. We reviewed a number of 16 cases which were subjected to cranial reconstruction following traumatic brain injury. A total of 16 patients, 10 males and 6 females, aged between 23 and 54 years, underwent elective delayed cranioplasty surgery to achieve morphological and functional rehabilitation of the cranial vault performed during the period from 1^st January 2019 to 31^st December 2022. All surgeries were performed in accordance with the widely-accepted indications for cranioplasty.

Results: The polyetheretherketone(Peek) implants were used. Biomaterials implants are a safe and time effective way to reconstruct cranial defects following severe traumatic brain injury. Among the advantages of polyetheretherketone implants is their‘s nonferromagnetic capacity which permits the safe examination in magnetic resonance imaging high field, useful for long-term follow-up. Prefabricated Peek implants were effective for cranioplasty, reducing surgical time, surgical blood loss and technical simplicity. There were no infected implants and none of the patients required a second surgery.

Conclusion: Biomaterials represent a tremendous leap forward in the surgical management of skull deformities. Biomaterials implants are extremly effective for cranioplasty. These implants also contribute in a special way to the social reintegration of these patients, the psychological component having an essential role in their recovery. The materials and techniques used in cranioplasty are in a continuous development and evolution.

Anca Porumb

Prof. Univ. Habil. Dr. Porumb Anca – University from Oradea

Graduated from the “Iuliu Hatieganu” Faculty of Medicine and Pharmacy from Cluj-Napoca in 1998.

Primary doctor in General Dentistry

Primary doctor in Orthodontics

Competence in Maxillo-Dental Radiodiagnosis

Private practice in Oradea

Doctor in Medical Sciences, Dentistry, at UMF Iuliu Hatieganu Cluj Napoca in 2008

Habilitation thesis in January 2020

University Professor from 2021

Author of several specialized books

Invited as a speaker at a large number of congresses.

The assessment of ceramic dental materials during the treatment of severe adult cleft palate

Anca Porumb, Simona Cavalu, Florian Bodog

University of Oradea, Faculty of Medicine and Pharmacy, P-ta 1 Decembrie no. 10, Oradea, Romania

anca.porumb@yahoo.com

Abstract.

The materials used in the treatment of an adult patient with severe cleavage need to be choose very carefull, according with the biological aspects. First of all, is mandatory to choose a proper material for endodontic treatment and use a correct technique. Second, the cement used in order to fix a RPD (rapid palatinal disjunctor) has to be glass-ionomer cement, because the oral and nasal cavity are still communicating. On the other hand, the dental ceramic material used in the prosthetic treatment has to be a special one, pink-colored in those regions where cleavage is present. For this reason, the cases with cleavage need a complex treatment, usually during a few years and several steps. They need a good collaboration between doctors of different specialities: maxillofacial surgery, orthodontics, prosthetics and plastic surgery. The aim of the present study is to underline the importance of ceramic dental materials during the laborious treatment in the case of an adult with cleavage, in order to obtain the best results.

Keywords: ceramic dental materials, cleft palate, rapid palatinal disjunctor.

BIOREMED 2023