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Evolution of temporomandibular joint reconstruction: from autologous tissue transplantation to alloplastic joint replacement

The reconstruction of the temporomandibular joint presents a multifaceted clinical challenge in the realm of head and neck surgery, underscored by its relatively infrequent occurrence and the lack of comprehensive clinical guidelines. This review aims to elucidate the available approaches for TMJ reconstruction, with a particular emphasis on recent groundbreaking advancements. The current spectrum of TMJ reconstruction integrates diverse surgical techniques, such as costochondral grafting, coronoid process grafting, revascularized fibula transfer, transport distraction osteogenesis, and alloplastic TMJ replacement. Despite the available options, a singular, universally accepted ‘gold standard’ for reconstructive techniques or materials remains elusive in this field. Our review comprehensively summarizes the current available methods of TMJ reconstruction, focusing on both autologous and alloplastic prostheses. It delves into the differences of each surgical technique and outlines the implications of recent technological advances, such as 3D printing, which hold the promise of enhancing surgical precision and patient outcomes. This evolutionary progress aims not only to improve the immediate results of reconstruction but also to ensure the long-term health and functionality of the TMJ, thereby improving the quality of life for patients with end-stage TMJ disorders.

Dietary protein restriction elevates FGF21 levels and energy requirements to maintain body weight in lean men

Dietary protein restriction increases energy expenditure and enhances insulin sensitivity in mice. However, the effects of a eucaloric protein-restricted diet in healthy humans remain unexplored. Here, we show in lean, healthy men that a protein-restricted diet meeting the minimum protein requirements for 5 weeks necessitates an increase in energy intake to uphold body weight, regardless of whether proteins are replaced with fats or carbohydrates. Upon reverting to the customary higher protein intake in the following 5 weeks, energy requirements return to baseline levels, thus preventing weight gain. We also show that fasting plasma FGF21 levels increase during protein restriction. Proteomic analysis of human white adipose tissue and in FGF21-knockout mice reveal alterations in key components of the electron transport chain within white adipose tissue mitochondria. Notably, in male mice, these changes appear to be dependent on FGF21. In conclusion, we demonstrate that maintaining body weight during dietary protein restriction in healthy, lean men requires a higher energy intake, partially driven by FGF21-mediated mitochondrial adaptations in adipose tissue.

Global self-organization of solute induced by ion irradiation in polycrystalline alloys

Most materials are brought into nonequilibrium states during processing and during their service life. Materials for nuclear and space applications, for instance, are continuously exposed to energetic particle irradiation, which is often detrimental to materials’ performance. Here we demonstrate, however, that sustained irradiation can induce self-organization of the microstructure of polycrystalline alloys into steady-state patterns and, in turn, improve their radiation resistance. Using an Al −1.5 at.% Sb alloy as a model system, we show using transmission electron microscopy and atom probe tomography that, for nanocrystalline thin films irradiated at 75 °C with 2 MeV Ti ions to large doses, the microstructure consists of finite-size, self-organized AlSb nanoprecipitates inside the grains and along the grain boundaries. Furthermore, this steady state is independent of the initial microstructure, thus self-healing. Phase field modeling is employed to construct a steady-state phase diagram and extend the experimental results to other alloy systems and microstructures.

High strength and ductility in a rare-earth free magnesium alloy processed by rotary swaging and flash annealing

Magnesium (Mg) is the lightest structural metal. It is promising for aerospace applications if its mechanical properties can be improved at a reasonable cost, without using expensive alloying elements or time-consuming processing routes. Here, we develop a rare-earth free Mg-Al-Ca alloy, processed through rotary swaging followed by flash annealing. The resulting alloy exhibits superior strength and ductility, surpassing nearly all reported rare-earth free magnesium alloys. Nanosized Al-Ca precipitates and clusters, formed largely during rotary swaging and flash annealing, significantly strengthen the alloy. Deformation twinning is suppressed, necessitating the formation of more <c + a> dislocations to accommodate the severe plastic strain induced by rotary swaging. These <c + a> dislocations are retained during flash annealing due to the high climb energy barrier and pinning by those nanosized Al-Ca precipitates and clusters. This retention of <c + a> dislocations contributes to high ductility and provides forest hardening, further increasing strength. This study offers a simple strategy for designing and fabricating high-performance magnesium alloys.

Resolving the fundamentals of the J-integral concept by multi-method in situ nanoscale stress-strain mapping

The integrity of structural materials is oftentimes defined by their resistance against catastrophic failure through dissipative plastic processes at the crack tip, commonly quantified by the J-integral concept. However, to date the experimental stress and strain fields necessary to quantify the J-integral associated with local crack propagation in its original integral form were inaccessible. Here, we present a multi-method nanoscale strain- and stress-mapping surrounding a growing crack tip in two identical miniaturized fracture specimens made from a nanocrystalline FeCrMnNiCo high-entropy alloy. The respective samples were tested in situ in a scanning electron microscope and a synchrotron X-ray nanodiffraction setup, with detailed analyzes of loading states during elastic loading, crack tip blunting and general yielding, corroborated by a detailed elastic-plastic finite element model. This complementary in situ methodology uniquely enabled a detailed quantification of the J-integral along different integration paths from experimental nanoscale stress and strain fields. We find that conventional linear-elastic and elastic-plastic models, typically used to interpret fracture phenomena, have limited applicability at micron to nanoscale distances from propagating cracks. This for the first time unravels a limit to the path-independence of the J-integral, which has significant implications in the development and assessment of modern damage-tolerant materials and microstructures.

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