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Dental Materials Journal Mar 2019To improve initial osteoblast adhesion and subsequent osseointegration, TiO nanotubes layer was constructed on the titanium (Ti) surface by anodic oxidation (AO), with...
To improve initial osteoblast adhesion and subsequent osseointegration, TiO nanotubes layer was constructed on the titanium (Ti) surface by anodic oxidation (AO), with an additional hydroxyapatite (HA) coating to form the AO/HA surface. Tests on in vitro cellular activity displayed that the AO surface, especially the AO/HA surface, promoted initial adhesion, proliferation and differentiation of osteoblast cells. The modified AO and AO/HA surfaces further presented an up-regulated gene expression of osteogenic and adhesion markers collagen type 1 (COL), osteopontin (OPN), osteocalcin (OCN) and vinculin. In addition, in vivo experiments with a rat model demonstrated that the AO surface, particularly the AO/HA surface, achieved earlier osseointegration and a superior bone bonding ability compared with Ti. Our study shed light on a synergistic role played by nanotopography and HA in promoting osteoblast adhesion, proliferation, differentiation and osseointegration, thus suggesting a promising method for better modifying the implant surface.
Topics: Animals; Cell Adhesion; Coated Materials, Biocompatible; Durapatite; Nanotubes; Osseointegration; Osteoblasts; Rats; Surface Properties; Titanium
PubMed: 30541994
DOI: 10.4012/dmj.2018-118 -
BMJ Open Oct 2020Lower extremity amputation uniformly impairs a person's vocational, social and recreational capacity. Rehabilitation in traditional socket prostheses (TSP) is associated...
Osseointegrated reconstruction and rehabilitation of transtibial amputees: the Osseointegration Group of Australia surgical technique and protocol for a prospective cohort study.
INTRODUCTION
Lower extremity amputation uniformly impairs a person's vocational, social and recreational capacity. Rehabilitation in traditional socket prostheses (TSP) is associated with a spectrum of complications involving the socket-residuum interface which lead to reduced prosthetic use and quality of life. Osseointegration has recently emerged as a novel concept to overcome these complications by eliminating this interface and anchoring the prosthesis directly to bone. Though the complications of TSPs affect both transfemoral and transtibial amputees, Osseointegration has been predominantly performed in transfemoral ones assuming a greater benefit/risk ratio. However, as the safety of the procedure has been established, we intend to extend the concept to transtibial amputees and document the outcomes.
METHODS AND ANALYSIS
This is protocol for a prospective cohort study, with patient enrolment started in 2014 and expected to be completed by 2022. The inclusion criteria are age over 18 years, unilateral, bilateral and mixed transtibial amputation and experiencing socket-related problems. All patients receive osseointegrated implants, the type of which depend on the length of the residuum and quality of bone, which are press-fitted into the residual bone. Objective functional outcomes comprising 6-Minute Walk Test, Timed Up-and-Go test and K-level, subjective patient-reported-quality-of-life outcomes (Short Form Health Survey 36, daily prosthetic wear hours, prosthetic wear satisfaction) and adverse events are recorded preoperatively and at postoperative follow-up intervals of 3, 6, 12 months and yearly, and compared with the preoperative values using appropriate statistical tests. Multivariable multilevel logistic regression will be performed with a focus to identify factors associated with outcomes and adverse events, specifically infection, periprosthetic fracture, implant fracture and aseptic loosening.
ETHICS AND DISSEMINATION
The Ethics approval for the study has been received from the University of Notre Dame, Sydney, Australia (014153S). The outcomes of this study will be disseminated by publications in peer-reviewed academic journals and scientific presentations at relevant orthopaedic conferences.
Topics: Adolescent; Amputees; Australia; Humans; Osseointegration; Prospective Studies; Prosthesis Design; Quality of Life; Treatment Outcome
PubMed: 33082192
DOI: 10.1136/bmjopen-2020-038346 -
Orthopaedic Surgery Jun 2022Digital trauma amputations and digital agenesis strongly affect the functionality and aesthetic appearance of the hand. Autologous reconstruction is the gold standard of... (Review)
Review
Digital trauma amputations and digital agenesis strongly affect the functionality and aesthetic appearance of the hand. Autologous reconstruction is the gold standard of treatment. Unfortunately, microsurgical options and transplantation procedures are not possible for patients who present contraindications or refuse to undergo transplantation from the toe (e.g. toe-to-thumb transplantation). To address these issues, osseointegrated finger prostheses are a promising alternative. The functional assessments registered during follow-up confirmed the promising outcomes of osseointegrated prostheses in the treatment of hand finger amputees. This review outlines (a) a detailed analysis of osseointegrated finger metallic components of the implants, (b) the surgical procedures suggested in the literature, and (c) the functional assessments and promising outcomes that demonstrate the potential of these medical osseointegrated devices in the treatment of finger amputees.
Topics: Amputation, Traumatic; Amputees; Artificial Limbs; Fingers; Humans; Osseointegration
PubMed: 35524645
DOI: 10.1111/os.13296 -
Medicina Oral, Patologia Oral Y Cirugia... Jul 2009Osteonecrosis of the jaw has been described in patients taking bisphosphonates after oral surgery procedures, including the placement of dental implants. This review is... (Review)
Review
Osteonecrosis of the jaw has been described in patients taking bisphosphonates after oral surgery procedures, including the placement of dental implants. This review is an update of the relationship between bisphosphonates and dental implants. Results obtained by different authors are compared, contrasting earlier studies where an improvement in implant osseointegration using bisphosphonates was observed, with ones where statistically significant differences were found, and more recent studies disagreeing with the use of bisphosphonates for causing necrosis of the jaw. The differing results obtained between animal studies and the situation observed in humans may be due to a short medication and follow-up period, as well as to the existence of few research studies where dental implants are placed in the oral cavity. Currently, dental implants are contraindicated in patients being treated with intravenous bisphosphonates. In 2007, the American Association of Oral and Maxillofacial Surgeons suggested guidelines for patients treated with oral bisphosphonates, based on the clinical situation of the patient and the length of treatment with the drug, and that greater caution prior and subsequent to surgery should be taken for three years after treatment. All patients treated with bisphosphonates must have the risk of possible loss of implants and the risk of suffering a bony necrosis of the operated jaw explained to them, and give their informed consent prior to dental implant surgery.
Topics: Animals; Bone Density Conservation Agents; Dental Implants; Diphosphonates; Humans; Jaw Diseases; Osseointegration; Osteonecrosis
PubMed: 19561566
DOI: No ID Found -
PloS One 2020Additive manufactured, porous bone implants have the potential to improve osseointegration and reduce failure rates of orthopaedic devices. Substantially porous implants...
The effect of strontium and silicon substituted hydroxyapatite electrochemical coatings on bone ingrowth and osseointegration of selective laser sintered porous metal implants.
Additive manufactured, porous bone implants have the potential to improve osseointegration and reduce failure rates of orthopaedic devices. Substantially porous implants are increasingly used in a number of orthopaedic applications. HA plasma spraying-a line of sight process-cannot coat the inner surfaces of substantially porous structures, whereas electrochemical deposition of calcium phosphate can fully coat the inner surfaces of porous implants for improved bioactivity, but the osseous response of different types of hydroxyapatite (HA) coatings with ionic substitutions has not been evaluated for implants in the same in vivo model. In this study, laser sintered Ti6Al4V implants with pore sizes of Ø 700 μm and Ø 1500 μm were electrochemically coated with HA, silicon-substituted HA (SiHA), and strontium-substituted HA (SrHA), and implanted in ovine femoral condylar defects. Implants were retrieved after 6 weeks and histological and histomorphometric evaluation were compared to electrochemically coated implants with uncoated and HA plasma sprayed controls. The HA, SiHA and SrHA coatings had Ca:P, Ca:(P+Si) and (Ca+Sr):P ratios of 1.53, 1.14 and 1.32 respectively. Electrochemically coated implants significantly promoted bone attachment to the implant surfaces of the inner pores and displayed improved osseointegration compared to uncoated scaffolds for both pore sizes (p<0.001), whereas bone ingrowth was restricted to the surface for HA plasma coated or uncoated implants. Electrochemically coated HA implants achieved the highest osseointegration, followed by SrHA coated implants, and both coatings exhibited significantly more bone growth than plasma sprayed groups (p≤0.01 for all 4 cases). SiHA had significantly more osseointegration when compared against the uncoated control, but no significant difference compared with other coatings. There was no significant difference in ingrowth or osseointegration between pore sizes, and the bone-implant-contact was significantly higher in the electrochemical HA than in SiHA or SrHA. These results suggest that osseointegration is insensitive to pore size, whereas surface modification through the presence of an osteoconductive coating plays an important role in improving osseointegration, which may be critically important for extensively porous implants.
Topics: Alloys; Animals; Coated Materials, Biocompatible; Durapatite; Femur; Implants, Experimental; Lasers; Materials Testing; Orthopedic Equipment; Osseointegration; Porosity; Sheep; Silicon; Strontium; Surface Properties; Titanium
PubMed: 31923253
DOI: 10.1371/journal.pone.0227232 -
International Journal of Molecular... Feb 2022A lack of primary stability and osteointegration in metallic implants may result in implant loosening and failure. Adding porosity to metallic implants reduces the...
On-Growth and In-Growth Osseointegration Enhancement in PM Porous Ti-Scaffolds by Two Different Bioactivation Strategies: Alkali Thermochemical Treatment and RGD Peptide Coating.
A lack of primary stability and osteointegration in metallic implants may result in implant loosening and failure. Adding porosity to metallic implants reduces the stress shielding effect and improves implant performance, allowing the surrounding bone tissue to grow into the scaffold. However, a bioactive surface is needed to stimulate implant osteointegration and improve mechanical stability. In this study, porous titanium implants were produced via powder sintering to create different porous diameters and open interconnectivity. Two strategies were used to generate a bioactive surface on the metallic foams: (1) an inorganic alkali thermochemical treatment, (2) grafting a cell adhesive tripeptide (RGD). RGD peptides exhibit an affinity for integrins expressed by osteoblasts, and have been reported to improve osteoblast adhesion, whereas the thermochemical treatment is known to improve titanium implant osseointegration upon implantation. Bioactivated scaffolds and control samples were implanted into the tibiae of rabbits to analyze the effect of these two strategies in vivo regarding bone tissue regeneration through interconnected porosity. Histomorphometric evaluation was performed at 4 and 12 weeks after implantation. Bone-to-implant contact (BIC) and bone in-growth and on-growth were evaluated in different regions of interest (ROIs) inside and outside the implant. The results of this study show that after a long-term postoperative period, the RGD-coated samples presented higher quantification values of quantified newly formed bone tissue in the implant's outer area. However, the total analyzed bone in-growth was observed to be slightly greater in the scaffolds treated with alkali thermochemical treatment. These results suggest that both strategies contribute to enhancing porous metallic implant stability and osteointegration, and a combination of both strategies might be worth pursuing.
Topics: Alkalies; Animals; Coated Materials, Biocompatible; Female; Implants, Experimental; Metallurgy; Oligopeptides; Osseointegration; Osteogenesis; Porosity; Powders; Rabbits; Temperature; Tissue Scaffolds; Titanium
PubMed: 35163682
DOI: 10.3390/ijms23031750 -
Injury Dec 2016Xenogeneic bone graft materials are an alternative to autologous bone grafting. Among such implants, coralline-derived bone grafts substitutes have a long track record... (Review)
Review
Xenogeneic bone graft materials are an alternative to autologous bone grafting. Among such implants, coralline-derived bone grafts substitutes have a long track record as safe, biocompatible and osteoconductive graft materials. In this review, we present the available literature surrounding their use with special focus on the commercially available graft materials. Corals thanks to their chemical and structural characteristics similar to those of the human cancellous bone have shown great potential but clinical data presented to date is ambiguous with both positive and negative outcomes reported. Correct formulation and design of the graft to ensure adequate osteo-activity and resorption appear intrinsic to a successful outcome.
Topics: Animals; Anthozoa; Biocompatible Materials; Bone Substitutes; Bone Transplantation; Cnidaria; Disease Models, Animal; Fracture Healing; Osseointegration; Sheep; Tibial Fractures; Transplantation, Heterologous
PubMed: 27836254
DOI: 10.1016/j.injury.2016.10.025 -
Indian Journal of Dental Research :... 2007The use of osseointegrated implants as a foundation for the prosthetic replacement of missing teeth has become widespread in the last decade. Owing to the remarkable... (Review)
Review
STATEMENT OF PROBLEM
The use of osseointegrated implants as a foundation for the prosthetic replacement of missing teeth has become widespread in the last decade. Owing to the remarkable success of dental implants, there has been growing interest in identifying the factors associated with implant failure. Given the well-documented deleterious effect of smoking on wound healing after tooth extraction and its association with poor quality bone and periodontal disease, a negative effect of tobacco use on implant success is to be expected.
PURPOSE
To establish the relationship between smoking and implant-related surgical procedures (i.e, sinus lift procedures, bone grafts and dental implants), including the incidence of complications related to these procedures and the long-term survival and success rates of dental implants among smokers and nonsmokers based on relevant literature.
MATERIALS AND METHODS
Relevant clinical studies published in English between 1990 and 2006 were reviewed. The articles were located through Medline and, manually, through the references of peer-reviewed literature. This was supplemented with a hand search of selected dental journals and text books.
RESULTS
The majority of the past and current literature implicates smoking as one of the prominent risk factors affecting the success rate of dental implants with only a handful of studies failing to establish a connection. Most of the studies report the failure rate of implants in smokers as being more than twice that in nonsmokers. These findings are difficult to ignore. There is a statistically significant difference between smokers and nonsmokers in the failure rates of dental implants. Smoking also has a strong influence on the complication rates of implants: it causes significantly more marginal bone loss after implant placement, it increases the incidence of peri-implantitis and affects the success rates of bone grafts. The failure rate of implants placed in grafted maxillary sinuses of smokers is again more than twice that seen in nonsmokers.
CONCLUSION
Smokers have higher failure rates and complications following dental implantation and implant-related surgical procedures. The failure rate of implants placed in grafted maxillary sinuses of smokers is more than twice that seen in nonsmokers.
Topics: Dental Implants; Dental Restoration Failure; Humans; Osseointegration; Postoperative Complications; Risk Factors; Smoking; Treatment Outcome
PubMed: 17938497
DOI: 10.4103/0970-9290.35831 -
Australian Dental Journal Jun 2008Dental implant surface technologies have been evolving rapidly to enhance a more rapid bone formation on their surface and hold a potential to increase the... (Review)
Review
Dental implant surface technologies have been evolving rapidly to enhance a more rapid bone formation on their surface and hold a potential to increase the predictability of expedited implant therapy. While implant outcomes have become highly predictable, there are sites and conditions that result in elevated implant loss. This paper reviews the impact of macro-retentive features which includes approaches to surface oxide modification, thread design, press-fit and sintered-bead technologies to increase predictability of outcomes. Implant designs that lead to controlled lateral compression of the bone can improve primary stability as long as the stress does not exceed the localized yield strength of the cortical bone. Some implant designs have reduced crestal bone loss by use of multiple cutting threads that are closely spaced, smoothed on the tip but designed to create a hoop-stress stability of the implant as it is completely seated in the osteotomy. Following the placement of the implant, there is a predictable sequence of bone turnover and replacement at the interface that allows the newly formed bone to adapt to microscopic roughness on the implant surface, and on some surfaces, a nanotopography (<10(-9) m scale) that has been shown to preferably influence the formation of bone. Newly emerging studies show that bone cells are exquisitely sensitive to these topographical features and will upregulate the expression of bone related genes for new bone formation when grown on these surfaces. We live in an exciting time of rapid changes in the modalities we can offer patients for tooth replacement therapy. Given this, it is our responsibility to be critical when claims are made, incorporate into our practice what is proven and worthwhile, and to continue to support and provide the best patient care possible.
Topics: Biocompatible Materials; Dental Implants; Dental Materials; Dental Prosthesis Design; Dental Prosthesis Retention; Humans; Osseointegration; Surface Properties
PubMed: 18498581
DOI: 10.1111/j.1834-7819.2008.00038.x -
Indian Journal of Dental Research :... 2012Surface plays a crucial role in biological interactions. Surface treatments have been applied to metallic biomaterials in order to improve their wear properties,... (Review)
Review
Surface plays a crucial role in biological interactions. Surface treatments have been applied to metallic biomaterials in order to improve their wear properties, corrosion resistance, and biocompatibility. A systematic review was performed on studies investigating the effects of implant surface treatments on biocompatibility. We searched the literature using PubMed, electronic databases from 1990 to 2009. Key words such as implant surface topography, surface roughness, surface treatment, surface characteristics, and surface coatings were used. The search was restricted to English language articles published from 1990 to December 2009. Additionally, a manual search in the major dental implant journals was performed. When considering studies, clinical studies were preferred followed by histological human studies, animal studies, and in vitro studies. A total of 115 articles were selected after elimination: clinical studies, 24; human histomorphometric studies, 11; animal histomorphometric studies, 46; in vitro studies, 34. The following observations were made in this review: · The focus has shifted from surface roughness to surface chemistry and a combination of chemical manipulations on the porous structure. More investigations are done regarding surface coatings. · Bone response to almost all the surface treatments was favorable. · Future trend is focused on the development of osteogenic implant surfaces. Limitation of this study is that we tried to give a broader overview related to implant surface treatments. It does not give any conclusion regarding the best biocompatible implant surface treatment investigated till date. Unfortunately, the eventually selected studies were too heterogeneous for inference of data.
Topics: Animals; Biocompatible Materials; Coated Materials, Biocompatible; Dental Etching; Dental Implants; Dental Prosthesis Design; Humans; Osseointegration; Osteogenesis; Surface Properties
PubMed: 23059581
DOI: 10.4103/0970-9290.102240