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Local Response of Sialoliths to Lithotripsy: Cues on Fragmentation Outcome

Published online by Cambridge University Press:  24 April 2017

Pedro Nolasco ,
Ana J. dos Anjos ,
José Dias ,
Paulo V. Coelho ,
Carla Coelho ,
Manuel Evaristo ,
Albano Cavaleiro ,
António Maurício ,
Manuel F. C. Pereira  and
Virgínia Infante
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Pedro Nolasco*
Affiliation:
CeFEMA, Instituto Superior Técnico, University of Lisbon, Av. Rovisco Pais, 1049-001 Lisboa, Portugal
Ana J. dos Anjos
Affiliation:
Clindem-Clínica dentária e médica Lda., Rua José Morais, 23 r/c Dto, 2685-076 Sacavém, Loures, Portugal
José Dias
Affiliation:
Service of Stomotology, Centro Hospitalar de Lisboa Norte, Av. Prof. Egas Moniz, 1649-035 Lisboa, Portugal
Paulo V. Coelho
Affiliation:
Nova Medical School – Medical Sciences Faculty (NMS/FCM), Nova University of Lisbon, Campo Mártires da Pátria, 130, 1169-056 Lisboa, Portugal Service of Maxillofacial Surgery, Centro Hospitalar de Lisboa Central, R. José António Serrano, 1150-199 Lisboa, Portugal
Carla Coelho
Affiliation:
Nova Medical School – Medical Sciences Faculty (NMS/FCM), Nova University of Lisbon, Campo Mártires da Pátria, 130, 1169-056 Lisboa, Portugal Service of Maxillofacial Surgery, Centro Hospitalar de Lisboa Central, R. José António Serrano, 1150-199 Lisboa, Portugal
Manuel Evaristo
Affiliation:
EG-CEMUC, Department of Mechanical Engineering, University of Coimbra, R. Luís Reis Santos, P-3030 788 Coimbra, Portugal
Albano Cavaleiro
Affiliation:
EG-CEMUC, Department of Mechanical Engineering, University of Coimbra, R. Luís Reis Santos, P-3030 788 Coimbra, Portugal
António Maurício
Affiliation:
CERENA, Department of Civil Engineering, Architecture and Georesources, Instituto Superior Técnico, University of Lisbon, Av. Rovisco Pais, 1049-001 Lisboa, Portugal
Manuel F. C. Pereira
Affiliation:
CERENA, Department of Civil Engineering, Architecture and Georesources, Instituto Superior Técnico, University of Lisbon, Av. Rovisco Pais, 1049-001 Lisboa, Portugal
Virgínia Infante
Affiliation:
LAETA, IDMEC, Instituto Superior Técnico, University of Lisbon, Av. Rovisco Pais, 1049-001 Lisboa, Portugal
António P. Alves de Matos
Affiliation:
CESAM/CiiEM, Instituto Egas Moniz, Monte da Caparica, 2829-511 Caparica, Portugal
Raúl C. Martins
Affiliation:
IT, Department of Bioengineering, Instituto Superior Técnico, University of Lisbon, Av. Rovisco Pais, 1049-001 Lisboa, Portugal
Patricia A. Carvalho
Affiliation:
CeFEMA, Instituto Superior Técnico, University of Lisbon, Av. Rovisco Pais, 1049-001 Lisboa, Portugal SINTEF Materials and Chemistry, Forskningsveien, 1, 0373 Oslo, Norway
*
*Corresponding author. pedro.nolasco@ist.utl.pt
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Abstract

Lithotripsy methods show relatively low efficiency in the fragmentation of sialoliths compared with the success rates achieved in the destruction of renal calculi. However, the information available on the mechanical behavior of sialoliths is limited and their apparently tougher response is not fully understood. This work evaluates the hardness and Young’s modulus of sialoliths at different scales and analyzes specific damage patterns induced in these calcified structures by ultrasonic vibrations, pneumoballistic impacts, shock waves, and laser ablation. A clear correlation between local mechanical properties and ultrastructure/chemistry has been established: sialoliths are composite materials consisting of hard and soft components of mineralized and organic nature, respectively. Ultrasonic and pneumoballistic reverberations damage preferentially highly mineralized regions, leaving relatively unaffected the surrounding organic matter. In contrast, shock waves leach the organic component and lead to erosion of the overall structure. Laser ablation destroys homogeneously the irradiated zones regardless of the mineralized/organic nature of the underlying ultrastructure; however, damage is less extensive than with mechanical methods. Overall, the present results show that composition and internal structure are key features behind sialoliths’ comminution behavior and that the organic matter contributes to reduce the therapeutic efficiency of lithotripsy methods.

Keywords

sialolithslithotripsymultimodal managementcomposite materialmechanical properties
Type
Biological Science Applications
Information
Microscopy and Microanalysis , Volume 23 , Issue 3 , June 2017 , pp. 584 - 598
Copyright
© Microscopy Society of America 2017 

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