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World Journal of Cardiology May 2024In severe cases of coronary artery disease, percutaneous coronary intervention provide promising results. The stent used could be a drug-eluting stent (DES) or a...
BACKGROUND
In severe cases of coronary artery disease, percutaneous coronary intervention provide promising results. The stent used could be a drug-eluting stent (DES) or a titanium-nitride-oxide coated stent (TiNOS).
AIM
To compare the 5-year effectiveness and safety of the two stent types.
METHODS
The following systematic review and meta-analysis was conducted in accordance with the preferred reporting items for systematic reviews and meta-analysis guidelines, and PubMed/MEDLINE, Scopus, and Cochrane Central were searched from inception till August 2023. Primary outcomes were major adverse cardiac events (MACE), cardiac death, myocardial infarction (MI), cardiac death or MI, and ischemia-driven total lesion revascularization (ID-TLR).
RESULTS
Four randomized controlled trials (RCT), which analyzed a sum total of 3045 patients with acute coronary syndrome (ACS) after a median follow-up time of 5 years were included. Though statistically insignificant, an increase in the ID-TLR was observed in patients receiving TiNOSs DESs. In addition, MI, cardiac death and MI, and definite stent thrombosis (DST) were significantly decreased in the TiNOS arm. Baseline analysis revealed no significant results with meta-regression presenting non-ST elevated MI (NSTEMI) as a statistically significant covariate in the outcome of MACE.
CONCLUSION
TiNOS was found to be superior to DES in terms of MI, cardiac death or MI, and DST outcomes, however, the effect of the two stent types on ID-TLR and MACE was not significant. A greater number of studies are required to establish an accurate comparison of patient outcomes in TiNOS and DES.
PubMed: 38817643
DOI: 10.4330/wjc.v16.i5.293 -
Biomedicines Apr 2024The global population, especially in the Western world, is constantly aging and the need for total hip arthroplasties has rocketed, hence there has been a notable... (Review)
Review
BACKGROUND
The global population, especially in the Western world, is constantly aging and the need for total hip arthroplasties has rocketed, hence there has been a notable increase in revision total hip arthroplasty cases. As time has passed, a considerable developments in science and medicine have been attained which have also resulted in the evolution of both surgical techniques and implants. Continuous improvements have allowed large bore bearings to be utilized which provide an increased range of motion, with ameliorated stability and a very low rate of wear. The trend for almost the last two decades has been the employment of porous tantalum acetabular cups. Several studies exist comparing them with other conventional methods for total hip arthroplasties, exhibiting promising short and midterm results.
METHODS
The Preferred Reporting Items for Systematic Reviews and a Meta-Analysis (PRISMA) were used to identify published studies in a comprehensive search up to February 2023, and these studies were reviewed by the authors of the article. Specific rigorous pre-determined inclusion and exclusion criteria were implemented.
RESULTS
Fifty-one studies met our inclusion criteria and were involved in the systematic review. Sixteen studies examined postoperative clinical and radiological outcomes of using a tantalum cup in primary and revision total hip arthroplasty, whilst four biomechanical studies proved the superiority of tantalum acetabular components. Five articles provided a thorough comparison between tantalum and titanium acetabular cups, while the other studies analyzed long-terms results and complication rates.
CONCLUSIONS
Porous tantalum acetabular cups appear to be a valuable option in revision total hip arthroplasty, providing clinical improvement, radiological stability, and promising long-term outcomes. However, ongoing research, longer follow-up periods, and careful consideration of patient factors are essential to further validate and refine the use of tantalum in various clinical scenarios.
PubMed: 38790921
DOI: 10.3390/biomedicines12050959 -
Heliyon May 2024The objective of the systematic review is to find an answer to a question: "What is the influence of the building direction of titanium implants produced by additive... (Review)
Review
The objective of the systematic review is to find an answer to a question: "What is the influence of the building direction of titanium implants produced by additive manufacturing on their physical and mechanical properties?" This review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA 2020) and was registered in the Open Science Framework (OSF) (osf.io/rdc84). Searches were performed in PubMed, Scopus, Science Direct, Embase, and Google Scholar databases on February 17th, 2024. Articles were chosen in 2 steps by 2 blinded reviewers based on previously selected inclusion criteria: In vitro studies that evaluated the influence of the impression direction of titanium implants produced by additive manufacturing on their physical and mechanical properties were selected. Articles were excluded that (1) did not use additive technology to obtain the implants, 2) used surfaces other than titanium, 3) did not evaluate the direction of impression, 4) Studies with only in vivo analyses, clinical studies, systematic reviews, book chapters, short communications, conference abstracts, case reports, and personal opinions.). In the initial search, 581 results were found. Of this total, 108 were excluded for duplication and, after applying the eligibility criteria, 16 articles were included in the present review. The risk of bias was analyzed using the RoBDEMAT. The risk of bias was analyzed using the RoBDEMAT. In addition, the coefficient of interagreement of the reviewers (Cohen's Kappa) and the certainty of evidence by GRADE were analyzed. In general, different impression angles showed variations in the physical and mechanical characteristics of the groups evaluated, including roughness, tensile strength, hardness, and modulus of elasticity. While some impression orientations resulted in greater strength or hardness, others showed greater elasticity or lower surface roughness. These findings suggest that print orientation plays a significant role in determining material properties. It can be concluded that printing directions influence the physical and mechanical properties of titanium implants and the studies included showed that the 0°, 45°, and 90° directions are the most evaluated as they present lower probabilities of structural anisotropies and provide better results in their roughness, hardness, tensile and compressive strength.
PubMed: 38774089
DOI: 10.1016/j.heliyon.2024.e30108 -
The British Journal of Oral &... Apr 2024This systematic review aimed to evaluate results reported in the literature regarding the success rate of the titanium mesh technique for the placement of dental... (Review)
Review
This systematic review aimed to evaluate results reported in the literature regarding the success rate of the titanium mesh technique for the placement of dental implants. The topic focused on titanium mesh used as a physical barrier for ridge reconstruction in cases of partial or total edentulism. The authors conducted an electronic search of four databases up to October 2023. Six articles fulfilled the inclusion criteria and were analysed. A total of 100 titanium meshes with a minimum of 4.6 months follow up after surgery were studied, and 241 implants were placed. The review shows that the use of titanium mesh is a predictable method for the rehabilitation of complex atrophic sites. Further investigation generating long-term data is needed to confirm these findings.
PubMed: 38760261
DOI: 10.1016/j.bjoms.2024.04.005 -
Dental Materials : Official Publication... May 2024Nanotechnology is constantly advancing in dental science, progressing several features aimed at improving dental implants. An alternative for surface treatment of dental... (Review)
Review
OBJECTIVES
Nanotechnology is constantly advancing in dental science, progressing several features aimed at improving dental implants. An alternative for surface treatment of dental implants is electrochemical anodization, which may generate a nanotubular surface (TiO nanotubes) with antibacterial potential and osteoinductive features. This systematic review and meta-analysis aims to elucidate the possible antibacterial properties of the surface in question compared to the untreated titanium surface.
SOURCES
For that purpose, was performed a systematic search on the bases PubMed, Lilacs, Embase, Web Of Science, Cinahl, and Cochrane Central, as well as, manual searches and gray literature.
STUDY SELECTION
The searches resulted in 742 articles, of which 156 followed for full-text reading. Then, 37 were included in the systematic review and 8 were included in meta-analysis.
RESULTS
Fifteen studies revealed significant antibacterial protection using TiO nanotube surfaces, while 15 studies found no statistical difference between control and nanotextured surfaces. Meta-analysis of in vitro studies demonstrated relevant bacterial reduction only for studies investigating Staphylococcus aureus in a period of 6 h. Meta-analysis of in vivo studies revealed three times lower bacterial adhesion and proliferation on TiO nanotube surfaces.
CONCLUSIONS
TiO nanotube topography as a surface for dental implants in preclinical research has demonstrated a positive relationship with antibacterial properties, nevertheless, factors such as anodization protocols, bacteria strains, and mono-culture methods should be taken into consideration, consequently, further studies are necessary to promote clinical translatability.
PubMed: 38714394
DOI: 10.1016/j.dental.2024.04.009 -
International Journal of Clinical... Jan 2024The present review was conducted to test whether the addition of titanium dioxide (TiO) nanoparticles (NPs) within orthodontic bracket adhesives would alter their... (Review)
Review
OBJECTIVE
The present review was conducted to test whether the addition of titanium dioxide (TiO) nanoparticles (NPs) within orthodontic bracket adhesives would alter their properties and assess their antimicrobial activity against cariogenic microorganisms in addition to noteworthy mechanical properties.
MATERIALS AND METHODS
Using predetermined inclusion criteria, an electronic search was conducted using Dissertations and Thesis Global, the Web of Science, Cochrane, Scopus, and Medline/PubMed. Specific terms were utilized while searching the database.
RESULTS
Only seven of the 10 included studies assessed shear bond strength (SBS). The mean SBS among the control group varied from 9.43 ± 3.03 MPa to 34.4 ± 6.7 MPa in the included studies, while in the experimental group, it varied from 6.33 ± 1.51 MPa to 25.05 ± 0.5 MPa. Antibacterial activity was assessed in five of the 10 included studies using TiO NPs, which could easily diffuse through bacterial media to form the growth inhibition zone.
CONCLUSION
Antibacterial NPs added to orthodontic adhesives at a concentration of 1-5 wt% inhibit bacterial growth and have no effect on bond strength.
HOW TO CITE THIS ARTICLE
D Tivanani MVD, Mulakala V, Keerthi VS. Antibacterial Properties and Shear Bond Strength of Titanium Dioxide Nanoparticles Incorporated into an Orthodontic Adhesive: A Systematic Review. Int J Clin Pediatr Dent 2024;17(1):102-108.
PubMed: 38559855
DOI: 10.5005/jp-journals-10005-2729 -
International Journal of Dentistry 2024Establishing a proper soft tissue adhesion around the implant abutment is essential to prevent microbial invasion, inhibit epithelial downgrowth, and obtain an optimal... (Review)
Review
Establishing a proper soft tissue adhesion around the implant abutment is essential to prevent microbial invasion, inhibit epithelial downgrowth, and obtain an optimal healing process. This systematic review aims to evaluate the real potential of TiO coating on the behavior of peri-implant soft tissue health and maintenance. A specific aim was to evaluate clinically and histologically the effect of TiO abutment coating on epithelial and connective tissue attachment. Electronic database searches were conducted from 1990 to 2023 in MEDLINE/PubMed and the Web of Science databases. In total, 15 out of 485 publications were included. Eight studies involved humans, and seven were animal studies. Exposure time ranges from 2 days to 5 years. The peri-implant soft tissue evaluations included clinical assessment (plaque index (PI), peri-implant probing pocket depth (PPD), and bleeding on probing (BoP)), histological as well as histomorphometric analysis. The Office of Health Assessment and Translation (OHAT) Risk of Bias Rating Tool for Human and Animal Studies was used to evaluate the overall quality of the studies included in the review. The results showed some variation but remained within acceptable limits. Within the limitations of this systematic review, the present findings suggest that TiO coatings seem to influence soft tissue healing. TiO-coated abutments with a roughness value between 0.2 and 0.5 m enhance soft tissue health. Sol-gel-derived TiO coatings induced better soft tissue attachment than noncoated machined abutment surfaces. The anodized titanium abutments demonstrate comparable clinical and histological outcomes to conventional machined abutments. However, there was variation among the included studies concerning TiO coating characteristics and the measured outcomes used to evaluate the soft tissue response, and therefore, quantitative analysis was not feasible. Long-term in vivo studies with standardized soft tissue analysis and coating surface parameters are necessary before a definitive conclusion can be drawn. OSF Registration No.: 10.17605/OSF.IO/E5RQV.
PubMed: 38533472
DOI: 10.1155/2024/9079673 -
Annals of Joint 2023Periprosthetic femoral fractures (PFFs) are a frequent complication after total hip arthroplasty (THA). Both modular and non-modular tapered fluted titanium (TFT) stems... (Review)
Review
BACKGROUND
Periprosthetic femoral fractures (PFFs) are a frequent complication after total hip arthroplasty (THA). Both modular and non-modular tapered fluted titanium (TFT) stems could be used in total hip revisions (THRs). Nevertheless, the most appropriate femoral stem type is still under debate. The current systematic review aims to analyze the survival rate and all causes of stem revision, the overall complication rate and reason for reoperation, and patient reported outcome measures (PROMs) in THR for PFF using the modular tapered titanium stems (MTTS).
METHODS
A comprehensive search in four databases, PubMed, Scopus, Embase, and the Cochrane Database of Systematic Reviews databases, was performed, and following the PRISMA guidelines, a systematic review was conducted. Strict inclusion and exclusion criteria were applied, starting from 1,259 studies. The risk of bias was analyzed according to the MINORS tool system. Descriptive statistical analysis was performed for all data extracted.
RESULTS
Eighteen clinical studies were included in the qualitative analysis for a total of 775 patients enrolled. A mean MINORS criteria score of 9.8 [8-12] was reported. The overall survival of MTTS for PFF treatment was 95.4%, with an overall reintervention rate of 10.3% at an average follow-up of 4.5 years. Despite the use of modular components, postoperative hip instability remains the most frequent complication and cause of reintervention in these patients. In addition, a mean postoperative Harris Hip Score (HHS) of 78.1 was reported, which was considered acceptable given the high mean age of 74.1 years at the time of the revision.
CONCLUSIONS
Several therapeutic approaches and a wide variety of implants have been described in the literature for PFF management; however, no one solution has proven superior to others in the PFF treatment. MTTS has become a commonly used treatment option for Vancouver B2 and B3 fractures because they provide good clinical and radiological results with a reasonable survival rate. However, the complication rate of MTTS is still high.
PubMed: 38529241
DOI: 10.21037/aoj-23-27 -
Annals of Joint 2023Hip revision surgery in extensive acetabular bone defects represents a complex challenge for hip surgeons. The primary goal is to obtain a stable acetabular component... (Review)
Review
BACKGROUND
Hip revision surgery in extensive acetabular bone defects represents a complex challenge for hip surgeons. The primary goal is to obtain a stable acetabular component and restore the hip biomechanics. Through the years, different prosthetic implants have been developed to perform acetabular revision depending on bone loss location and extension. This systematic review aims to summarize the clinical outcomes and complications reported with trabecular titanium (TT) cups in hip revision surgery.
METHODS
A literature search of four databases (PubMed, Embase, Scopus and the Cochrane Database of systematic reviews) was performed according to the PRISMA guideline from January 2008 to December 2022. All studies written in English and reporting the clinical outcome of patients undergoing revision total hip arthroplasty using Delta TT cups were included. The initial screening identified 378 studies. Each eligible clinical article was analyzed according to the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence (LoE), and the papers' methodological quality was evaluated using The Methodological Index for Non-Randomized Studies Criteria (MINORS) score.
RESULTS
Eight clinical studies were included in the analysis. A total of 523 hip revisions were analyzed. Delta TT cups were used in 3.9%, Delta TT one cups in 46.8%, and Delta TT revisions in 49.3%. Paprosky IIIa was the most frequent acetabular bone defect reported in 26.4% of cases. The overall survival rate of TT cups was 93.4%. The dislocation was the most frequent complication in 4.1% of patients, while the prevalence of aseptic loosening was 1.5.
CONCLUSIONS
Managing severe acetabular bone defects remains a complex challenge for hip surgeons. Since their introduction, TT cups have exhibited good clinical results, with complication rates in line with or lower than those reported by similar implants.
PubMed: 38529221
DOI: 10.21037/aoj-23-28 -
Frontiers in Bioengineering and... 2024Due to the high incidence of implant failures, dual functionalization of titanium surfaces with antibacterial and osteogenic agents, like silver (Ag) and strontium...
Due to the high incidence of implant failures, dual functionalization of titanium surfaces with antibacterial and osteogenic agents, like silver (Ag) and strontium (Sr), has gained significant attention in recent years. However, so far, the combined antibacterial and osteoinductive effectiveness of Ag/Sr-based titanium surface coatings has only been analyzed in individual studies. This systematic review aims to evaluate the existing scientific literature regarding the PICOS question "Does dual incorporation of strontium/silver enhances the osteogenic and anti-bacterial characteristics of Ti surfaces ?". As a result of a web-based search adhering to the PRISMA Guidelines using three electronic databases (PubMed, Scopus, and Web of Science) until March 31, 2023, a total of 69 publications were identified as potentially relevant and 17 of which were considered appropriate for inclusion into this review. In all included publications, the use of Sr/Ag combination showed enhanced osteogenic and antibacterial effects, either alone or in combination with other agents. Moreover, the combination of Sr and Ag shows potential to synergistically enhance these effects. Nevertheless, further studies need to validate these findings under clinically more relevant conditions and evaluate the mechanism of antimicrobial and osteogenic activity of Sr/Ag combination.
PubMed: 38486866
DOI: 10.3389/fbioe.2024.1346426