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European Journal of Dentistry May 2024This study aimed to investigate the impact of bicarbonate air-abrasive powders and ultrasonic scaling with stainless steel tips on the micro- and nanotopography and...
OBJECTIVES
This study aimed to investigate the impact of bicarbonate air-abrasive powders and ultrasonic scaling with stainless steel tips on the micro- and nanotopography and roughness of three different implant-abutment junction titanium surfaces.
MATERIALS AND METHODS
Three types of sterile and decontaminated titanium surfaces (RS, UTM, XA) were used for analysis. Nine disks per surface type were subjected to micro- and nanotopography analysis, scanning electron microscopy (SEM), roughness analysis, and fibroblast cultivation. Ultrasonic debridement and air polishing were performed on the surfaces. Human dermal fibroblasts were cultured on the surfaces for 5 days.
STATISTICAL ANALYSIS
Data analysis adhered to ISO 25178 standards for surface texture assessment. SEM micrographs were used to reconstruct areas for extracting roughness parameters. Excel and Mex 6.0 software were utilized for quantitative and stereoscopic analysis.
RESULTS
The study found varying effects on surface roughness posttreatment. RS Disco samples exhibited higher surface roughness compared with UTM and XA samples, both in average and nanoscale roughness. Decontamination led to increased surface roughness for all samples, particularly RS Disco. Fibroblast growth tests revealed enhanced cell network formation on decontaminated discs, possibly due to increased nanoscale roughness or the presence of bicarbonate salts.
CONCLUSION
The study underscores the complex interplay between surface topography, microbial biofilm, and treatment efficacy in peri-implant disease management. While smoother surfaces may resist biofilm accumulation, increased nanoscale roughness postdecontamination can enhance fibroblast attachment and soft tissue integration. This dichotomy highlights the need for tailored treatment protocols that consider material-specific factors, emphasizing that successful implant therapy should balance microbial control with conducive surface characteristics for long-term osseointegration and soft tissue stability.
PubMed: 38698614
DOI: 10.1055/s-0044-1782190 -
Journal of Orthopaedic Surgery and... May 2024Talar malignant tumor is extremely rare. Currently, there are several alternative management options for talus malignant tumor including below-knee amputation,...
BACKGROUND
Talar malignant tumor is extremely rare. Currently, there are several alternative management options for talus malignant tumor including below-knee amputation, tibio-calcaneal arthrodesis, and homogenous bone transplant while their shortcomings limited the clinical application. Three-dimensional (3D) printed total talus prosthesis in talus lesion was reported as a useful method to reconstruct talus, however, most researches are case reports and its clinical effect remains unclear. Therefore, the current study was to explore the application of 3D printed custom-made modular prosthesis in talus malignant tumor.
METHODS
We retrospectively analyzed the patients who received the 3D printed custom-made modular prosthesis treatment due to talus malignant tumor in our hospital from February 2016 to December 2021. The patient's clinical data such as oncology outcome, operation time, and volume of blood loss were recorded. The limb function was evaluated with the Musculoskeletal Tumor Society 93 (MSTS-93) score, The American Orthopedic Foot and Ankle Society (AOFAS) score; the ankle joint ranges of motion as well as the leg length discrepancy were evaluated. Plain radiography and Tomosynthesis-Shimadzu Metal Artefact Reduction Technology (T-SMART) were used to evaluate the position of prosthesis and the osseointegration. Postoperative complications were recorded.
RESULTS
The average patients' age and the follow-up period were respectively 31.5 ± 13.1 years; and 54.8 months (range 26-72). The medium operation time was 2.4 ± 0.5 h; the intraoperative blood loss was 131.7 ± 121.4 ml. The mean MSTS-93 and AOFAS score was 26.8 and 88.5 respectively. The average plantar flexion, dorsiflexion, varus, and valgus were 32.5, 9.2, 10.8, and 5.8 degree respectively. One patient had delayed postoperative wound healing. There was no leg length discrepancy observed in any patient and good osseointegration was observed on the interface between the bone and talus prosthesis in all subjects.
CONCLUSION
The modular structure of the prosthesis developed in this study seems to be convenient for prosthesis implantation and screws distribution. And the combination of solid and porous structure improves the initial stability and promotes bone integration. Therefore, 3D printed custom-made modular talus prosthesis could be an alternative option for talus reconstruction in talus malignant tumor patients.
Topics: Humans; Talus; Printing, Three-Dimensional; Male; Adult; Female; Bone Neoplasms; Retrospective Studies; Middle Aged; Prosthesis Design; Young Adult; Prosthesis Implantation; Adolescent; Ankle Joint; Osseointegration; Treatment Outcome; Range of Motion, Articular; Prostheses and Implants
PubMed: 38698477
DOI: 10.1186/s13018-024-04728-6 -
Annals of Medicine and Surgery (2012) May 2024Bone ring (BR) grafts have been introduced to reconstruct alveolar ridge defects with simultaneous implant placement, but their clinical effectiveness remains... (Review)
Review
BACKGROUND
Bone ring (BR) grafts have been introduced to reconstruct alveolar ridge defects with simultaneous implant placement, but their clinical effectiveness remains undetermined. The aim of the current systematic review was to critically appraise evidence from animal studies regarding the effectiveness of BR grafts in alveolar ridge reconstruction and their variations under different surgical protocols.
METHODS
Electronic retrieval of six databases (MEDLINE, Embase, Cochrane Library, ScienceDirect, Web of Science, and Scopus) and citation search until 11 October 2023, for animal studies on bone augmentation employing BR grafts. The outcome variables were total bone area (BA), bone volume (BV), bone-implant contact (BIC), and histology. The protocol was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and prospectively registered with PROSPERO (CRD42023453949).
RESULTS
Ten studies were included in the qualitative analysis according to the screening criteria. Two studies demonstrated favorable bone remodeling and osseointegration of the BR with both the implant and pristine bone. A comparative study between autogenous BRs and allogenic BRs reported a higher percentage of BA and BIC at 4 months of healing, but conflicting data were observed at 8 months. Another study indicated a significant advantage of autogenous BRs over bovine and biphasic ceramic BRs in terms of BA and BIC after 5 weeks. Three studies found that using collagen membranes did not significantly affect BA, BV, or BIC when used simultaneously with autogenous BRs during implant placement. Two studies evaluated one-stage and two-stage implant placement in conjunction with BR grafts, revealing similar levels of BA, BV, and BIC except for differences in total treatment time. Furthermore, one study found that the use of mucogingival junction incision and split-thickness flap significantly reduced the incidence of wound dehiscence compared with conventional incision and flap.
CONCLUSIONS
Vertical bone augmentation surgery utilizing BR grafts with one-stage implant placement yielded histological and histomorphometric outcomes comparable to those achieved with two-stage implant placement or the additional application of collagen membrane.
PubMed: 38694314
DOI: 10.1097/MS9.0000000000001952 -
The Saudi Dental Journal Apr 2024This in vivo study evaluated the effect of graphene oxide and graphite coatings, coupled with the micro-arc oxidation (MAO) surface roughening technique, known for their...
BACKGROUND
This in vivo study evaluated the effect of graphene oxide and graphite coatings, coupled with the micro-arc oxidation (MAO) surface roughening technique, known for their mechanical strength, chemical stability, and antibacterial properties. The main objective was to assess the degree of improvement in osseointegration of titanium implants resulting from these interventions.
MATERIALS AND METHODS
In this study, 32 female rats were utilized and randomly allocated into four groups ( = 8 each): machined surface titanium implants (control), those roughened by the MAO method, those coated with graphene oxide-doped MAO, and those with a graphite-doped MAO coating. Titanium implants were surgically placed in the right tibia of the rats. Rats undergoing no additional procedures during the 4-week experimental period were sacrificed at the end. Then, the implants and surrounding bone tissues were separated and embedded in acrylic blocks for reverse torque analysis. Using a digital torque device, the rotational force was applied to all samples using a hex driver and racquet until implant separation from the bone occurred, with the corresponding values recorded on the digital display. Then, statistical analysis was performed to analyze the data.
RESULTS
No statistically significant difference between the groups was observed in the biomechanical bone-implant connection levels (N/cm) ( = 0.268). Post-hoc tests were not required because no discernible differences were identified between the groups.
CONCLUSION
Within the scope of this study, implants treated with the MAO method, along with those coated with graphene oxide- and graphite-doped MAO method, did not exhibit significant superiority in terms of osseointegration compared to machined surface titanium implants.
PubMed: 38690378
DOI: 10.1016/j.sdentj.2024.01.013 -
Cureus Mar 2024Lower limb amputation is a common orthopedic surgery in the United States and can be performed either above or below the knee. Prosthetics are typically externally... (Review)
Review
Lower limb amputation is a common orthopedic surgery in the United States and can be performed either above or below the knee. Prosthetics are typically externally fitted to the patient's residual stump; however, osseointegrated implants offer a potential alternative to this process. Transcutaneous limb osseointegration involves the intramedullary anchoring of an implant that can later attach to a prosthetic via a stoma in the residual limb. There are proposed benefits to this, including decreased skin and soft tissue complications as well as an increased sense of stability. As this is a relatively new procedure, the complications and efficacy are not well supported by the literature at this time. The primary aim of this analysis was to synthesize the currently available data on transfemoral and transtibial osseointegration in order to improve our understanding of the potential complications of the procedure. A literature search was performed in the following databases: Biomedical Reference Collection, CINAHL, Cochrane Library, and PubMed/MEDLINE. Articles were screened by three independent reviewers for studies written or available in English, study design, and study outcomes, including complications. No filter was applied for publication date, publication national origin, or sample size. A total of 20 articles were selected for the final qualitative analysis. This review demonstrates an overall low or non-inferior rate of both minor and severe complications in transtibial and transfemoral osseointegration. This procedure should be considered as an option during preoperative planning in the context of above-the-knee and below-the-knee amputations. However, continued studies with larger sample sizes and extended postoperative follow-up are necessary for a greater strength of recommendation.
PubMed: 38681289
DOI: 10.7759/cureus.57045 -
ACS Omega Apr 2024Implant-associated infections and the increasing number of bone implants loosening and falling off after implantation have become urgent global challenges, hence the... (Review)
Review
Implant-associated infections and the increasing number of bone implants loosening and falling off after implantation have become urgent global challenges, hence the need for intelligent alternative solutions to combat implant loosening and falling off. The application of polyetheretherketone (PEEK) in biomedical and medical therapy has aroused great interest, especially because its elastic modulus close to bone provides an effective alternative to titanium implants, thereby preventing the possibility of bone implants loosening and falling off due to the mismatch of elastic modulus. In this Review, we provide a comprehensive overview of recent advances in surface modifications to prevent bone binding deficiency and bacterial infection after implantation of bone implants, starting with inorganics for surface modification, followed by organics that can effectively promote bone integration and antimicrobial action. In addition, surface modifications derived from cells and related products of biological activity have been proposed, and there is increasing evidence of clinical potential. Finally, the advantages and future challenges of surface strategies against medical associated poor osseointegration and infection are discussed, with promising prospects for developing novel osseointegration and antimicrobial PEEK materials.
PubMed: 38680314
DOI: 10.1021/acsomega.4c00923 -
International Journal of Molecular... Apr 2024In this paper, the in vivo behavior of orthopedic implants covered with thin films obtained by matrix-assisted pulsed laser evaporation and containing bioactive glass, a...
In this paper, the in vivo behavior of orthopedic implants covered with thin films obtained by matrix-assisted pulsed laser evaporation and containing bioactive glass, a polymer, and natural plant extract was evaluated. In vivo testing was performed by carrying out a study on guinea pigs who had coated metallic screws inserted in them and also controls, following the regulations of European laws regarding the use of animals in scientific studies. After 26 weeks from implantation, the guinea pigs were subjected to X-ray analyses to observe the evolution of osteointegration over time; the guinea pigs' blood was collected for the detection of enzymatic activity and to measure values for urea, creatinine, blood glucose, alkaline phosphatase, pancreatic amylase, total protein, and glutamate pyruvate transaminase to see the extent to which the body was affected by the introduction of the implant. Moreover, a histopathological assessment of the following vital organs was carried out: heart, brain, liver, and spleen. We also assessed implanted bone with adjacent tissue. Our studies did not find significant variations in biochemical and histological results compared to the control group or significant adverse effects caused by the implant coating in terms of tissue compatibility, inflammatory reactions, and systemic effects.
Topics: Animals; Guinea Pigs; Plant Extracts; Nanostructures; Biocompatible Materials; Materials Testing; Glass; Prostheses and Implants; Male; Osseointegration
PubMed: 38673834
DOI: 10.3390/ijms25084249 -
Biomedicines Apr 2024With the aging population, there is a rising incidence of senile diseases, notably osteoporosis, marked by fractures, prolonged recovery, and elevated mortality rates,...
With the aging population, there is a rising incidence of senile diseases, notably osteoporosis, marked by fractures, prolonged recovery, and elevated mortality rates, underscoring the urgency for effective treatments. In this study, we applied the method of absorbing parathyroid hormone (PTH), a treatment for osteoporosis, into graft materials. Two types of graft materials with different properties, whitlockite (WH) and hydroxyapatite (HAP), were used. After forming calvarial defects in osteoporotic rats, WH and HAP grafts were implanted, with PTH applied directly to the graft sites. Micro-CT analysis was employed to assess bone regeneration, while tissue sections were stained to elucidate the regeneration process and bone cell dynamics. The results showed that bone regeneration was higher in the grafts that were actively degraded by osteoclasts in the early stage of regeneration. When PTH was applied, osteoclast activity increased, leading to enhanced bone regeneration. Furthermore, the activation of osteoclasts resulted in the penetration and formation of new bone within the degraded graft, which exhibited higher osseointegration. Therefore, for osteoporotic bone defects, bone grafts that can be easily degraded by osteoclasts are more suitable. Additionally, treatment with PTH can activate osteoclasts around the bone graft in the early stages of regeneration, inducing higher bone regeneration and improving osseointegration.
PubMed: 38672175
DOI: 10.3390/biomedicines12040820 -
Bioengineering (Basel, Switzerland) Mar 2024The occurrence of bone diseases has been increasing rapidly, in line with the aging population. A representative spinal fusion material, polyetheretherketone (PEEK), is...
The occurrence of bone diseases has been increasing rapidly, in line with the aging population. A representative spinal fusion material, polyetheretherketone (PEEK), is advantageous in this regard as it can work in close proximity to the elastic modulus of cancellous bone. However, if it is used without surface modification, the initial osseointegration will be low due to lack of bioactivity, resulting in limitations in surgical treatment. In this study, we aimed to modify the surface of PEEK cages to a hydrophilic surface by coating with polyethylene glycol (PEG), hyaluronic acid (HA), and polydopamine (PDA), and to analyze whether the coated surface exhibits improved bioactivity and changes in mechanical properties for orthopedic applications. Material properties of coated samples were characterized and compared with various PEEK groups, including PEEK, PEEK-PEG, PEEK-HA, and PEEK-PDA. In an in vitro study, cell proliferation was found to be enhanced on PDA-coated PEEK; it was approximately twice as high compared to the control group. In addition, mechanical properties, including static and torsion, were not affected by the presence of the coating. Thus, the results suggest that PEEK-PDA may have the potential for clinical application in fusion surgery for spinal diseases, as it may improve the rate of osseointegration.
PubMed: 38671765
DOI: 10.3390/bioengineering11040343 -
Bioengineering (Basel, Switzerland) Mar 2024The energy state of endosteal implants is dependent on the material, manufacturing technique, cleaning procedure, sterilization method, and surgical manipulation. An... (Review)
Review
The energy state of endosteal implants is dependent on the material, manufacturing technique, cleaning procedure, sterilization method, and surgical manipulation. An implant surface carrying a positive charge renders hydrophilic properties, thereby facilitating the absorption of vital plasma proteins crucial for osteogenic interactions. Techniques to control the surface charge involve processes like oxidation, chemical and topographical adjustments as well as the application of nonthermal plasma (NTP) treatment. NTP at atmospheric pressure and at room temperature can induce chemical and/or physical reactions that enhance wettability through surface energy changes. NTP has thus been used to modify the oxide layer of endosteal implants that interface with adjacent tissue cells and proteins. Results have indicated that if applied prior to implantation, NTP strengthens the interaction with surrounding hard tissue structures during the critical phases of early healing, thereby promoting rapid bone formation. Also, during this time period, NTP has been found to result in enhanced biomechanical fixation. As such, the application of NTP may serve as a practical and reliable method to improve healing outcomes. This review aims to provide an in-depth exploration of the parameters to be considered in the application of NTP on endosteal implants. In addition, the short- and long-term effects of NTP on osseointegration are addressed, as well as recent advances in the utilization of NTP in the treatment of periodontal disease.
PubMed: 38671741
DOI: 10.3390/bioengineering11040320