WorldWideScience

Sample records for bone-anchored titanium implants

  1. Intralesional triamcinolone acetonide injection in hypertrophic skin surrounding the percutaneous titanium implant of a bone-anchored hearing aid.

    NARCIS (Netherlands)

    Rijswijk, JB Van; Mylanus, E.A.M.

    2008-01-01

    OBJECTIVE: We present a patient with persistent hypertrophic skin surrounding the percutaneous implant of a bone-anchored hearing aid system, successfully treated with intralesional applied corticosteroids. METHOD: Case report and review of the world literature concerning bone-anchored hearing aid

  2. Laser-Modified Surface Enhances Osseointegration and Biomechanical Anchorage of Commercially Pure Titanium Implants for Bone-Anchored Hearing Systems

    Science.gov (United States)

    Omar, Omar; Simonsson, Hanna; Palmquist, Anders; Thomsen, Peter

    2016-01-01

    Osseointegrated implants inserted in the temporal bone are a vital component of bone-anchored hearing systems (BAHS). Despite low implant failure levels, early loading protocols and simplified procedures necessitate the application of implants which promote bone formation, bone bonding and biomechanical stability. Here, screw-shaped, commercially pure titanium implants were selectively laser ablated within the thread valley using an Nd:YAG laser to produce a microtopography with a superimposed nanotexture and a thickened surface oxide layer. State-of-the-art machined implants served as controls. After eight weeks’ implantation in rabbit tibiae, resonance frequency analysis (RFA) values increased from insertion to retrieval for both implant types, while removal torque (RTQ) measurements showed 153% higher biomechanical anchorage of the laser-modified implants. Comparably high bone area (BA) and bone-implant contact (BIC) were recorded for both implant types but with distinctly different failure patterns following biomechanical testing. Fracture lines appeared within the bone ~30–50 μm from the laser-modified surface, while separation occurred at the bone-implant interface for the machined surface. Strong correlations were found between RTQ and BIC and between RFA at retrieval and BA. In the endosteal threads, where all the bone had formed de novo, the extracellular matrix composition, the mineralised bone area and osteocyte densities were comparable for the two types of implant. Using resin cast etching, osteocyte canaliculi were observed directly approaching the laser-modified implant surface. Transmission electron microscopy showed canaliculi in close proximity to the laser-modified surface, in addition to a highly ordered arrangement of collagen fibrils aligned parallel to the implant surface contour. It is concluded that the physico-chemical surface properties of laser-modified surfaces (thicker oxide, micro- and nanoscale texture) promote bone bonding

  3. Bone-anchored titanium implants for auricular rehabilitation: case report and review of literature.

    Science.gov (United States)

    Gumieiro, Emne Hammoud; Dib, Luciano Lauria; Jahn, Ricardo Schmitutz; Santos Junior, João Ferreira dos; Nannmark, Ulf; Granström, Gösta; Abrahão, Márcio

    2009-01-01

    Osseointegrated implants have acquired an important role in the prosthetic rehabilitation of patients with craniofacial defects. The main indications are lack of local tissue for autogenous reconstruction, previous reconstruction failure and selection of this technique by the patient. This paper presents a clinical case and discusses indications and advantages of the osseointegrated implant technique for retention of auricular prostheses. Case report, Universidade Federal de São Paulo (UNIFESP). A female patient received three auricular implants after surgical resection of a hemangioma in her left ear. The time taken for osseointegration of the temporal bone was three months. After fabrication of the implant-retained auricular prosthesis, the patient was monitored for 12 months. The clinical parameters evaluated showed good postoperative healing, healthy peri-implant tissue, good hygiene and no loss of implants. Good hygiene combined with thin and immobile peri-implant soft tissues resulted in minimal complications. Craniofacial implant integration appears to be site-dependent; increasing age affects osseointegration in the temporal bone. The frequency of adverse skin reactions in peri-implant tissues is generally low. The surgical technique for rehabilitation using implant-retained auricular prostheses seems to be simple. It is associated with low rates of adverse skin reactions and long-term complications. Prostheses anchored by osseointegrated implants seem to provide better retention than do prostheses supported on spectacle frames, less risk of discoloration through the use of adhesives and better esthetic results than do prostheses anchored in the surgical cavity.

  4. Bone-anchored titanium implants for auricular rehabilitation: case report and review of literature

    Directory of Open Access Journals (Sweden)

    Emne Hammoud Gumieiro

    Full Text Available CONTEXT AND OBJECTIVE: Osseointegrated implants have acquired an important role in the prosthetic rehabilitation of patients with craniofacial defects. The main indications are lack of local tissue for autogenous reconstruction, previous reconstruction failure and selection of this technique by the patient. This paper presents a clinical case and discusses indications and advantages of the osseointegrated implant technique for retention of auricular prostheses. TYPE OF STUDY: Case report, Universidade Federal de São Paulo (UNIFESP. METHODS: A female patient received three auricular implants after surgical resection of a hemangioma in her left ear. The time taken for osseointegration of the temporal bone was three months. After fabrication of the implant-retained auricular prosthesis, the patient was monitored for 12 months. RESULTS: The clinical parameters evaluated showed good postoperative healing, healthy peri-implant tissue, good hygiene and no loss of implants. Good hygiene combined with thin and immobile peri-implant soft tissues resulted in minimal complications. Craniofacial implant integration appears to be site-dependent; increasing age affects osseointegration in the temporal bone. The frequency of adverse skin reactions in peri-implant tissues is generally low. CONCLUSION: The surgical technique for rehabilitation using implant-retained auricular prostheses seems to be simple. It is associated with low rates of adverse skin reactions and long-term complications. Prostheses anchored by osseointegrated implants seem to provide better retention than do prostheses supported on spectacle frames, less risk of discoloration through the use of adhesives and better esthetic results than do prostheses anchored in the surgical cavity

  5. Complications of bone-anchored hearing aid implantation.

    Science.gov (United States)

    Hobson, J C; Roper, A J; Andrew, R; Rothera, M P; Hill, P; Green, K M

    2010-02-01

    Bone-anchored hearing aid implantations have been performed in Manchester for over 20 years. This study examined a range of variables that can occur during the implantation process, and the effect they may have on successful outcome. Retrospective study and literature review. Tertiary referral centre in central Manchester. Details of 602 bone-anchored hearing aid implantation procedures were retrieved from the departmental database. The overall complication rate was 23.9 per cent. The rate of revision surgery was 12.1 per cent. This study involved a significantly larger number of patients than any previously reported, similar study. Possible reasons for differences in outcomes, and recommendations for best practice, are discussed.

  6. Peri-operative cerebrospinal fluid leak during single-stage bone-anchored hearing aid implantation: case report.

    Science.gov (United States)

    Dimbleby, G; Mitchell-Innes, A; Murphy, J

    2014-12-01

    A bone-anchored hearing aid uses the principle of bone conduction and osseointegration to transfer sound vibrations to a functioning inner ear. It consists of a permanent titanium implant, and removable abutment and sound processor. Informed consent requires discussion of the procedural benefits, alternatives and complications. The risks of bone-anchored hearing aid surgery include infection, soft tissue hypertrophy, skin graft or flap failure, osseointegration failure, and the need for further surgery. A case of cerebrospinal fluid leak in a patient undergoing bone-anchored hearing aid surgery is reported and discussed. Bone-anchored hearing aid surgery poses a risk of breaching the inner table of the temporal bone and dura, resulting in a cerebrospinal fluid leak; the risk of meningitis is rare but serious. The surgeon should discuss the possibility of cerebrospinal fluid leak when consenting patients. Pre-operative computerised tomography scanning should be considered in certain individuals to aid implant placement.

  7. Commercially pure titanium (cp-Ti) versus titanium alloy (Ti6Al4V) materials as bone anchored implants - Is one truly better than the other?

    Science.gov (United States)

    Shah, Furqan A; Trobos, Margarita; Thomsen, Peter; Palmquist, Anders

    2016-05-01

    Commercially pure titanium (cp-Ti) and titanium alloys (typically Ti6Al4V) display excellent corrosion resistance and biocompatibility. Although the chemical composition and topography are considered important, the mechanical properties of the material and the loading conditions in the host have, conventionally, influenced material selection for different clinical applications: predominantly Ti6Al4V in orthopaedics while cp-Ti in dentistry. This paper attempts to address three important questions: (i) To what extent do the surface properties differ when cp-Ti and Ti6Al4V materials are manufactured with the same processing technique?, (ii) Does bone tissue respond differently to the two materials, and (iii) Do bacteria responsible for causing biomaterial-associated infections respond differently to the two materials? It is concluded that: (i) Machined cp-Ti and Ti6Al4V exhibit similar surface morphology, topography, phase composition and chemistry, (ii) Under experimental conditions, cp-Ti and Ti6Al4V demonstrate similar osseointegration and biomechanical anchorage, and (iii) Experiments in vitro fail to disclose differences between cp-Ti and Ti6Al4V to harbour Staphylococcus epidermidis growth. No clinical comparative studies exist which could determine if long-term, clinical differences exist between the two types of bulk materials. It is debatable whether cp-Ti or Ti6Al4V exhibit superiority over the other, and further comparative studies, particularly in a clinical setting, are required. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. [Clinical application of bone-anchored hearing aid implantation].

    Science.gov (United States)

    Xia, Yin; Zhang, Hua; Gong, Shu-sheng; Wang, Dan-ni; Zheng, Ya-li; Li, Yu-ling; Dong, Bo-ya; Han, De-min

    2013-08-01

    To discuss the indications, surgery methods and effects of the BAHA implantation by analyzing the patients' medical records of bone-anchored hearing aids(BAHA). Retrospective analyzed the records of 16 patients of BAHA implantation, including nine males and seven females. Their average age was 31 years old (8-53ys). Nine of them were congenital ear malformation, two were chronic suppurative otitis media, two were otosclerosis and three were unilateral severe sensorineural deafness. We evaluated their pure tone audiometry (PTA), speech audiometry and temporal CT before the surgery, and evaluated the aided PTA in soundfield and speech audiometry in sound field. These patients received BAHA implantation and installed the speech processor their months later. The average preoperative PTA measurements (PTA at 0.5, 1, 2, 4 kHz) was (63.2 ± 19.0) dB HL and postoperative aided PTA in sound field was (35.5 ± 10.9)dB HL. The average improvement in Hearing In Noise Test (HINT) was 37.0% ± 31.7%. The average improvement in Mandarin Speech Test was 76.0% ± 19.7%. After 4-16 months' follow-up, no significant complications were recorded. BAHA is a safe and effective bone implantable hearing device.

  9. Implant survival rate in bone-anchored hearing aid users: long-term results.

    Science.gov (United States)

    Wallberg, E; Granström, G; Tjellström, A; Stalfors, J

    2011-11-01

    To investigate the long-term survival rate of bone-anchored hearing aid implants, and to assess the number of patients who stop using their bone-anchored hearing aid. Patients who underwent bone-anchored hearing aid surgery between September 1977 and December 1986 were identified from a prospective database. Data were collected from patient records. During the study period, 143 patients were fitted with a bone-anchored hearing aid. Records from 132 patients were found, with a mean follow up of nine years. A total of 150 implants were installed in these patients. A total of 41 implants (27 per cent) were lost during follow up: 17 lost osseointegration, 16 were removed and eight were lost due to direct trauma. At the end of follow up, 119/132 (90 per cent) patients were still using their bone-anchored hearing aid. Despite a high incidence of implant loss over time, a large number of patients still continued to use their bone-anchored hearing aid.

  10. Successful bone-anchored hearing aid implantation in a patient with osteogenesis imperfecta.

    Science.gov (United States)

    Coutinho, M B; Marques, C; Mendes, G J; Gonçalves, C

    2015-11-01

    To report a case of successful bone-anchored hearing aid implantation in an adult patient with type III osteogenesis imperfecta, which is commonly regarded as a contraindication to this procedure. A 45-year-old man with type III osteogenesis imperfecta presented with mixed hearing loss. There was a mild sensorineural component in both ears, with an air-bone gap between 45 and 50 dB HL. He was implanted with a bone-anchored hearing aid. The audiological outcome was good, with no complications and good implant stability (as measured by resonance frequency analysis). To our knowledge, this is the first recorded case of bone-anchored hearing aid implantation in a patient with osteogenesis imperfecta.

  11. Z-plasty for skin complications of bone-anchored hearing aid implantation.

    Science.gov (United States)

    Miura, M S; Rios, M N

    2015-06-01

    The bone-anchored hearing aid implantation technique is associated with post-operative skin reactions, which require conservative therapy and, in some cases, replacement of the abutment. Z-plasty is a technique that allows resection of the granulation tissue, thus ensuring that disease-free skin will be in contact with the abutment. Use of the Z-plasty technique for resection of the peri-abutment granulation tissue is described. In the case presented herein, the episodes of skin reaction became very frequent and the patient was unable to use his bone-anchored hearing aid for 2 to 3 days a week. We opted for surgical treatment with Z-plasty for management of the skin complications. Use of the Z-plasty technique is recommended for the management of skin reactions associated with bone-anchored hearing aid implantation.

  12. Clinical Outcome of a Wide-diameter Bone-anchored Hearing Implant and a Surgical Technique With Tissue Preservation

    DEFF Research Database (Denmark)

    Mowinckel, Marius S; Møller, Martin N; Wielandt, Kirsten N

    2016-01-01

    OBJECTIVE: To investigate the clinical outcome of a surgical technique with tissue preservation for a wide bone-anchored hearing implant concerning postoperative complications, skin reactions, implant loss, and implant stability. STUDY DESIGN: Consecutive, prospective case series. SETTING: Tertia...

  13. Bone-anchored hearing aid implant location in relation to skin reactions.

    Science.gov (United States)

    Faber, Hubert T; de Wolf, Maarten J F; de Rooy, Jacky W J; Hol, Myrthe K S; Cremers, Cor W R J; Mylanus, Emmanuel A M

    2009-08-01

    To evaluate the effect of implant location and skin thickness on the frequency and degree of adverse skin reactions around the abutment. Retrospective multivariate analysis of implant position related to skin thickness and clinical variables. Tertiary referral center. Random sample of 248 patients with bone-anchored hearing aids. Bone-anchored hearing aid implant placement by means of the linear incision technique. Type and number of skin reactions and implant loss. The mean (SD) distance from the external auditory ear canal to implant was 48.8 (8.0) mm (range, 29-84 mm). The mean skin thickness was 5.5 (1.9) mm. Severe skin reactions (Holgers classification, 2-4) were seen in 46 of the 248 patients (18.5%). Implant loss occurred in 4 patients (1.6%). Three implants were lost owing to failed osseointegration (1.3%), and another implant was removed because of deterioration of cochlear function (0.9%). No implant was lost as a result of infection. Implant location and skin thickness were not correlated with implant loss or the frequency or degree of adverse skin reactions around the abutment.

  14. Ethnic disparity in skin complications following bone-anchored hearing aid implantation.

    Science.gov (United States)

    Zeitler, Daniel M; Herman, Bjorn S; Snapp, Hillary A; Telischi, Fred F; Angeli, Simon I

    2012-08-01

    Sound processor loading after implantation of a bone-anchored hearing aid is often delayed by skin-site complications. This study examined the frequency of skin-site complications in various ethnic groups and determined factors that may lead to higher rates of skin-site complications resulting in delayed processor loading. Adult, English-speaking patients who underwent implantation of a bone-anchored hearing aid between 2007 and 2010 were reviewed. Demographic data including ethnicity, tobacco use, diabetes mellitus, immunosuppression, and long-term steroid use were determined. Major and minor skin-site complications and the time to processor loading were recorded. The mean time to processor loading was 9.5 weeks, and the mean follow-up time was 23 months. There were no cases of osseointegration failure. African American patients had a significantly higher rate of major skin-site complications (p bone-anchored hearing aid. There is a higher rate of major skin-site complications in African American patients, and these often delay processor loading. The risk of skin-site complications is not correlated with smoking, diabetes mellitus, or immunosuppression. An increased risk of skin-site complications is an important consideration for preoperative counseling.

  15. A new wide-diameter bone-anchored hearing implant-prospective 1-year data on complications, implant stability, and survival

    DEFF Research Database (Denmark)

    Foghsgaard, Søren; Caye-Thomasen, Per

    2014-01-01

    OBJECTIVE: To investigate a new wide bone-anchored hearing implant considering initial stability, stability over time, implant loss, and skin reaction. STUDY DESIGN: Consecutive, prospective case series. SETTING: Tertiary referral center. PATIENTS: Twenty adult patients were enrolled. All operati...

  16. A minimally invasive technique for the implantation of bone-anchored hearing devices.

    Science.gov (United States)

    Wilson, David F; Kim, Harold H

    2013-09-01

    To describe and evaluate a novel technique for the implantation of bone conduction hearing devices as compared with a common, conventional technique. Case series with chart review. Tertiary referral otology and neurotology practice. Individuals who underwent the implantation of bone-anchored hearing devices between January 1, 2004, and December 31, 2011, were identified. Demographic data, surgical indications, surgical technique used, surgical time, and complications were recorded. Soft tissue complications were graded on the Holgers classification scheme. Group 1 was defined as those undergoing a traditional technique using a dermatome with subcutaneous tissue reduction. Group 2 was defined as those undergoing the described technique for implantation of the coupling hardware with minimal subcutaneous soft tissue reduction. Forty patients underwent the procedure, with 11 patients comprising group 1 and 29 patients comprising group 2. Group 2 required a shorter operative time (32.3 vs 56.1 minutes, P bone-anchored hearing devices using the described technique that necessitated minimal soft tissue reduction.

  17. Bone-anchored hearing aid and skin graft removal with subsequent cochlear implantation.

    Science.gov (United States)

    Britt, Christopher J; Coughlin, Adam R; Gubbels, Samuel P

    2016-11-01

    We describe a novel technique of scalp flap rearrangement for cochlear implant (CI) candidates who have previously undergone ipsilateral bone-anchored hearing aid (BAHA) placement. One patient with single-sided deafness (SSD) underwent removal of a BAHA with subsequent scalp rearrangement for coverage of the implant site. After adequate healing of the scalp rotational flap, he underwent uncomplicated cochlear implantation without soft tissue complications. With increasing utilization of CIs in SSD, there will be more patients undergoing cochlear implantation who have previously had a BAHA. We present a novel method for accomplishing this goal while minimizing the risk of soft tissue complications. Laryngoscope, 126:2601-2604, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  18. [Bone-anchored auricular prosthesis].

    Science.gov (United States)

    Bille, M; Homøe, P; Vesterhauge, S; Rixen, M; Bretlau, P

    1994-10-03

    During the period February 1989-September 1991, 15 patients with absent or defective pinna were treated with a bone-anchored auricular prosthesis at the ENT-department, Rigshospitalet, Copenhagen. These patients were followed up from the hospital records and by means of a questionnaire. Altogether 40 titanium implants have been inserted, of which one implant was found not to be integrated at the time of the second-stage surgery. Five patients underwent additional surgery, one patient because of non-integration of a screw, and four patients on account of soft-tissue reactions. From the questionnaire replies it appears that all patients found the cosmetic result and the technique concerning mounting of the prosthesis very satisfactory. Nearly half the patients found that the care of the skin around the abutments caused considerable problems. Three patients had experienced unintended losses of the prosthesis. In conclusion, treatment with a bone anchored auricular prosthesis has considerable advantages compared to treatment with a prosthesis attached by adhesive. Furthermore the use of a bone-anchored prosthesis should be considered a viable alternative to surgical reconstruction because of the outstanding aesthetic result and because the surgical procedure puts less strain on the patient. The disadvantage of the method is the lifelong daily care of the skin and the dependence on the health services.

  19. Comparison of implant stability measurement devices for bone-anchored hearing aid systems.

    Science.gov (United States)

    Westover, Lindsey; Faulkner, Gary; Hodgetts, William; Raboud, Don

    2018-01-01

    The success of implants for bone-anchored hearing aids (BAHA) relies on proper osseointegration at the bone-implant interface. Clinical evaluation of implant stability is important in prescribing loading, identifying the risk of failure, and monitoring the long-term health of the implant. The purpose of this in vitro study was to evaluate 2 measurement systems for BAHA implant stability: the most commonly used, Osstell implant stability quotient (ISQ), and a newly developed advance system for implant stability testing (ASIST). BAHA implants (Oticon Medical Ponto and Cochlear BAHA Connect systems) were installed in plastic materials with adhesive to simulate implants integrated in bone with varying levels of interface stiffness. Different lengths of BAHA abutments were used with each implant specimen, and stability measurements were obtained with both the Osstell ISQ and the ASIST systems. The measurement systems were evaluated in terms of sensitivity to differences in interface stiffness and the effect of abutment length on the stability measurement. Repeated measures ANOVA followed by post hoc t tests were used for the comparisons with a Bonferroni adjusted alpha value of .05/15 = .003 to control for potential type 1 errors. Changing the abutment length of a single implant installation had minimal effect on the ASIST stability coefficient, whereas large variations were observed in the Osstell implant stability quotient (ISQ). The Osstell showed a clear relationship of decreasing ISQ with increasing abutment length for both the Oticon Medical and the Cochlear implant systems. Both the ASIST and the Osstell were found to be sensitive to changes in interface properties, with the ASIST being more sensitive to these changes. The ASIST system is more sensitive to changes in interface properties and shows smaller variation because of changes in abutment length than the Osstell ISQ system. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry

  20. Surgical outcome of bone anchored hearing aid (baha) implant surgery: a 10 years experience.

    Science.gov (United States)

    Asma, A; Ubaidah, M A; Hasan, Siti Salbiah; Wan Fazlina, W H; Lim, B Y; Saim, L; Goh, B S

    2013-07-01

    Bone anchored hearing aid (Baha) implant is an option for patient with canal atresia, single sided deafness(SSD) and chronically discharging ears despite treatments. This retrospective study was conducted from 2001 to 2011 to evaluate the surgical outcome of Baha implant surgery. Thirty-three patients were identified during this study period. Their age at implantation ranged from 5 to 40 years. Of 33 patients, 29 (87.9 %) patients had bilateral microtia and canal atresia, 3 (9.1 %) patients had unilateral microtia and canal atresia and 1 (3.0 %) patients have SSD following labyrinthitis. One patient (3.2 %) had major complication which is lost of implant due to failure of osseointegration. Soft tissue reactions were seen 7 patients (21.1 %). Of these 7 patients, 4 patients required 3-4 procedures as day care operation for excision of the skin overgrowth surrounding the abutment. Recurrent antibiotic treatment was required in 3 patients (9.7 %). None of our patient had history of intraoperative or peri-operative complication following Baha surgery. The commonest complications are local infection and inflammation at the implant site. None of our patient had history of intraoperative or peri-operative complication following Baha implant surgery.

  1. Stability and survival of bone-anchored hearing aid implant systems in post-irradiated patients.

    Science.gov (United States)

    Wilkie, Mark D; Lightbody, Kathryn A; Salamat, Ali A; Chakravarthy, Kalyan M; Luff, David A; Temple, Robert H

    2015-06-01

    Bone-anchored hearing aids (BAHAs) are based on the principle of osseointegration, which is fundamental to implant stability and survival. Previous exposure to ionising radiation may compromise this, as evidenced in relation to dental and craniofacial implants. There is a dearth of data, however, regarding BAHA implant systems in patients with previously irradiated implant sites. We sought, therefore, to investigate implant stability and survival in such patients. Patients were identified retrospectively from our electronic BAHA database. Hospital records were reviewed for demographics; operative technique; complications; and details regarding previous irradiation. Implant stability was assessed by resonance frequency analysis (RFA), generating a numerical value-implant stability quotient (ISQ). Extrapolating from dental studies, successfully loaded implants typically have ISQs of ≥60. Readings were, therefore, interpreted with respect to this. Seven patients were identified for inclusion. Mean time between irradiation and implant insertion was 33 months (range 16-72 months), and mean time from implant insertion to RFA measurement was 41 months (range 3-96 months). Operatively, all patients underwent single-stage procedures under local anaesthesia. One patient suffered a Holger's grade 2 skin reaction, while two suffered significant skin flap failure, requiring revision procedures. The implant survival rate was 100 %. All ISQ values were >60, with a mean of 66.9 (95 % confidence interval 63.1-70.6). Our data support sufficient osseointegration of BAHA implant systems in post-irradiated patients, but highlight issues with wound healing. Contemporary soft tissue preservation operative techniques will likely overcome this, facilitating safe and efficacious BAHA insertion in this ever-increasing group of patients.

  2. Alternative techniques in reconstructive surgery: bone-anchored extraoral implants for burn cases.

    Science.gov (United States)

    Bottini, D J; Gentile, P; Colicchia, G; Grimaldi, M; Trimarco, A; Cervelli, V

    2008-01-01

    The authors present their experience with the use of extraoral implants for reconstruction of the ear area after burns. The first step of the protocol includes positioning of implants in the mastoid process. The second step, after 3 to 4 months, is to realize the auricle prosthesis and apply it. Extraoral, bone-integrated implants offer low surgical risks and few postsurgical complications, leading to optimal aesthetic results, mainly in the ear area. Compared with traditional surgery techniques, the aesthetic results are better, with less surgery, possibly only two surgery sessions. Adhesive prostheses can be placed without the usual local irritation, and a more correct positioning can be obtained. For this study, two female patients, treated from December 2001 to January 2005, were selected to receive auricle epitheses. In the authors' experience, 79% of case reporting describes the creation of this epithesis type. The patient age has a range of 26 years. The two study patients initially had the same diagnosis: burns of the auricle-temporal region. In all cases, a good aesthetic result was obtained. The authors believe that bone-anchored implants for the treatment of auricle burns is a valid and brilliant technique that complements traditional reconstructive procedures. The advantages are the low incidence of long-term complications and the possibility of obtaining excellent aesthetic lasting results even for very complicated cases that would not have been solved in the past.

  3. Experience of bone-anchored hearing aid implantation in children younger than 5 years of age.

    Science.gov (United States)

    Amonoo-Kuofi, Kwamena; Kelly, Andrea; Neeff, Michel; Brown, Colin R S

    2015-04-01

    To assess the practicality and benefit of Bone-anchored hearing aid (BAHA(®)) implantation in children younger than 5 years of age. FDA approval for use of BAHA(®) only exists for children 5 years of age and older. Their use in Australia is also rare, however their use for younger children is approved by the European Union. We wish to share our experience of implantation in an antipodean setting in this age group. Institutional board approval was obtained for this study. All children undergoing BAHA(®) implantation under 5 years old were included from our prospective database. We examined the variety of surgical techniques, (including skin grafting, limited soft tissue reduction and no soft tissue reduction), BAHA(®) implants and abutments used, and use of the new series 400 hydroxyapatite coatings. Demographic data obtained included age at surgery, follow up duration, gender, ethnicity and indication for surgery. Anonymous benefit questionnaires (Glasgow children's benefit inventory (GCBI) and parents' evaluation of aural performance of children (PEACH)) were completed online as well as a questionnaire on device use. Complications recorded included soft tissue reactions, implant loss/removal, abutment replacement/removal. We also assessed whether patient weight, ethnicity or socioeconomic status were risk factors for these complications. 24 Children (26 ears/26 implants) under five years were identified from the database and included in the study. There was a 14:10 male to female ratio. Patient caregivers reported subjective benefit and improved quality of life (QOL) despite setbacks and complications related to BAHA(®) usage. 10/24 (42%) of children required treatment for significant peri-implant skin reactions whilst 25% required replacement of their abutments and/or implants. An increased risk of major complication was associated with socioeconomic deprived backgrounds and in patients of New Zealand Maori and Pacific Island ethnicity but not in patients

  4. Has the use of the linear incision reduced skin complications in bone-anchored hearing aid implantation?

    Science.gov (United States)

    Roplekar, R; Lim, A; Hussain, S S M

    2016-06-01

    To compare the skin-related complications of the traditional skin flap method with a linear incision method of implantation. All cases of bone-anchored hearing aid surgery performed by a single surgeon (n = 117) were compared over two periods: 1999-2011, when the traditional method of skin flap and soft tissue removal was used (group 1; n = 86), and 2012-2013, when linear incision without soft tissue removal was used (group 2; n = 31). All patients were followed up for one year and complications were recorded for that period. There were 21 (24.4 per cent) skin-related complications in group 1 (skin overgrowth = 12, wound infection = 8 and numbness = 1) and 3 (9.7 per cent) complications in group 2 (wound infection = 3). Analysis using independent t-tests showed the results to be significant (p bone-anchored hearing aid implantation reduces skin complication rates.

  5. Results of the implantation of bone-anchored hearing aids in patients with treacher-collins syndrome

    OpenAIRE

    Oliveira,Alexandra Kolontai de Sousa; Ferro,Lília Pereira Abreu; Silva,Jaiede Nicacio da; Okada,Daniel Mochida

    2013-01-01

    Summary Introduction:?Treacher-Collins syndrome is characterized by craniofacial malformations, narrowing of the external auditory canal (EAC), and, in 30% of cases, agenesis of the canal and ossicular chain defects. The use of hearing aids (HA) is not possible in cases in which agenesis or stenosis of the EAC accompanies conductive deafness. In contrast, bone conduction implants such as the Bone Anchored Hearing Aid (BAHA?) allow direct stimulation of the cochlea and are thus superior to con...

  6. Bone-anchored hearing aid implantation in a patient with Goldenhar syndrome.

    Science.gov (United States)

    Santarelli, Griffin; Redfern, Roberta E; Benson, Aaron G

    2015-12-01

    Patients with Goldenhar syndrome exhibit a number of characteristic symptoms, including middle and internal ear malformations that may cause profound hearing loss. Bone-anchored hearing aids have been used to treat these patients in the past, although complications may arise due to the nature of the disease. Herein we present the case of a pediatric patient with Goldenhar syndrome whose hearing aid abutment extruded spontaneously because of poor bone quality, despite adequate thickness. We provide a brief review of the literature and suggest a flexible surgical plan for any syndromic pediatric patient.

  7. Comparison of the bone anchored hearing aid implantable hearing device with contralateral routing of offside signal amplification in the rehabilitation of unilateral deafness.

    Science.gov (United States)

    Niparko, John K; Cox, Kenneth M; Lustig, Lawrence R

    2003-01-01

    Monaural hearing imposes constraints under many listening conditions. The authors compared the effects of a semi-implantable bone conductor, the Entific bone anchored hearing aid, with conventional contralateral routing of offside signal amplification to assess rehabilitative benefit in adults with unilateral deafness. Prospective trials of subjects with unilateral deafness using benefit surveys, source identification testing, and hearing in noise testing. Tertiary referral center, outpatient surgical and audiologic services. Adults with unilateral deafness (pure tone average >90 dB, SD hearing loss (n = 1), and sudden sensorineural hearing loss with chronic suppurative otitis media (n = 1). Entry criteria included normal hearing in the contralateral ear (pure tone average 80%). Subjects were fitted with contralateral routing of offside signal amplification devices for 1 month and tested with contralateral routing of offside signal before mastoid implantation of the deaf ear, fitting, and testing for bone anchored hearing aid. Subjects' assessment of experience with their devices and patterns of use, 2) source azimuth identification in noise test, and 3) speech discrimination in quiet and in noise under conditions of noise-front, noise-to-normal-ear, and noise-to-deaf-ear. There was consistent satisfaction with bone anchored hearing aid implantation and amplification, and poor acceptance of contralateral routing of offside signal amplification. Sound localization was poor at baseline and with both bone anchored hearing aid and contralateral routing of offside signal. Relative to baseline, contralateral routing of offside signal and bone anchored hearing aid produced significantly better speech recognition in noise under most conditions. The bone anchored hearing aid enabled significantly better speech recognition than contralateral routing of offside signal in quiet and in a composite of noise conditions. The advantages may relate to averting the interference of

  8. Prospective analysis of stability testing for bone-anchored hearing implants in children after osseointegrating surgery without skin thinning.

    Science.gov (United States)

    Hultcrantz, Malou; Lanis, Aviya

    2015-04-01

    To report normative values for osseointegration in 10 children with bone-anchored hearing implants who were consecutively operated on using a tissue preserving technique with individualized abutments and prospectively followed with stability testing 1 year after surgery. Children were implanted with bone-anchored hearing devices using a non-skin thinning implantation technique and followed during the course of a year. Mean age was 5.1 years. Stability testing with Osstell's resonance frequency analysis (RFA) measurement was used at each visit, providing values between 0 and 100 (representing a range of low to high stability, respectively). Clinical signs and symptoms were also noted at each visit. Three of the children were operated on using a two-step procedure, while the remaining seven children were operated on using a one-step procedure. Eight of the children showed skin-related problems during the 1-year control period that were easily treated. Two children experienced an abutment loss early following surgery (1 two-step and 1 one-step) and showed low resonance measurements of 30 or less within the first 3-4 weeks. Two children experienced a traumatic abutment loss and two required a change in abutment length. During the 1-year follow-up, nine children demonstrated signs of peri-implant infections, only two of which were recurrent. Stability was measured to be higher in eight children with longer abutments. Two children experienced low stability (hearing aid and mean ISQ values were 56.2 and 47.5 for 6mm and 9mm abutments, respectively. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. Bone Anchored Hearing Aid

    Science.gov (United States)

    2002-01-01

    Executive Summary Objective The objective of this health technology policy assessment was to determine the effectiveness and cost-effectiveness of bone-anchored hearing aid (BAHA) in improving the hearing of people with conduction or mixed hearing loss. The Technology The (BAHA) is a bone conduction hearing device that includes a titanium fixture permanently implanted into the mastoid bone of the skull and an external percutaneous sound processor. The sound processor is attached to the fixture by means of a skin penetrating abutment. Because the device bypasses the middle ear and directly stimulates the cochlea, it has been recommended for individuals with conduction hearing loss or discharging middle ear infection. The titanium implant is expected to last a lifetime while the external sound processor is expected to last 5 years. The total initial device cost is approximately $5,300 and the external sound processor costs approximately $3,500. Review of BAHA by the Medical Advisory Secretariat The Medical Advisory Secretariat’s review is a descriptive synthesis of findings from 36 research articles published between January 1990 and May 2002. Summary of Findings No randomized controlled studies were found. The evidence was derived from level 4 case series with relative small sample sizes (ranging from 30-188). The majority of the studies have follow-up periods of eight years or longer. All except one study were based on monaural BAHA implant on the side with the best bone conduction threshold. Safety Level 4 evidence showed that BAHA has been be implanted safely in adults and children with success rates of 90% or higher in most studies. No mortality or life threatening morbidity has been reported. Revision rates for tissue reduction or resiting were generally under 10% for adults but have been reported to be as high as 25% in pediatric studies. Adverse skin reaction around the skin penetration site was the most common complication reported. Most of these

  10. Results of the implantation of bone-anchored hearing aids in patients with treacher-collins syndrome.

    Science.gov (United States)

    Oliveira, Alexandra Kolontai de Sousa; Ferro, Lília Pereira Abreu; da Silva, Jaiede Nicacio; Okada, Daniel Mochida

    2013-04-01

     Treacher-Collins syndrome is characterized by craniofacial malformations, narrowing of the external auditory canal (EAC), and, in 30% of cases, agenesis of the canal and ossicular chain defects. The use of hearing aids (HA) is not possible in cases in which agenesis or stenosis of the EAC accompanies conductive deafness. In contrast, bone conduction implants such as the Bone Anchored Hearing Aid (BAHA(®)) allow direct stimulation of the cochlea and are thus superior to conventional hearing aids in cases of severe conductive hearing loss.  To present 2 cases of patients with Treacher-Collins syndrome who underwent implantation of BAHA(®).  The first patient was a 52-year-old woman diagnosed with Treacher-Collins syndrome who presented with severe bilateral mixed hearing loss and a history of unsuccessful previous use of a bone contact conduction device. The BAHA(®) implantation was uneventful, and the post-operative results were good. The second patient was a 14-year-old girl who was also diagnosed with Treacher-Collins Syndrome with bilateral moderate conductive hearing loss by audiometry. The use of a bone vibrator contact device did not improve her hearing; however, implantation of a BAHA(®) resulted in a decreased gap postoperatively. Final comments: BAHA(®) hearing devices provide adequate rehabilitation and consequent improvement of the quality of life in patients with Treacher-Collins syndrome.

  11. Results of the implantation of bone-anchored hearing aids in patients with treacher-collins syndrome

    Directory of Open Access Journals (Sweden)

    Alexandra Kolontai de Sousa Oliveira1

    2013-04-01

    Full Text Available Introduction: Treacher-Collins syndrome is characterized by craniofacial malformations, narrowing of the external auditory canal (EAC, and, in 30% of cases, agenesis of the canal and ossicular chain defects. The use of hearing aids (HA is not possible in cases in which agenesis or stenosis of the EAC accompanies conductive deafness. In contrast, bone conduction implants such as the Bone Anchored Hearing Aid (BAHA® allow direct stimulation of the cochlea and are thus superior to conventional hearing aids in cases of severe conductive hearing loss. Objective: To present 2 cases of patients with Treacher-Collins syndrome who underwent implantation of BAHA®. Cases Reports: The first patient was a 52-year-old woman diagnosed with Treacher-Collins syndrome who presented with severe bilateral mixed hearing loss and a history of unsuccessful previous use of a bone contact conduction device. The BAHA® implantation was uneventful, and the post-operative results were good. The second patient was a 14-year-old girl who was also diagnosed with Treacher-Collins Syndrome with bilateral moderate conductive hearing loss by audiometry. The use of a bone vibrator contact device did not improve her hearing; however, implantation of a BAHA® resulted in a decreased gap postoperatively. Final comments: BAHA® hearing devices provide adequate rehabilitation and consequent improvement of the quality of life in patients with Treacher-Collins syndrome.

  12. Results of the implantation of bone-anchored hearing aids in patients with treacher-collins syndrome

    Science.gov (United States)

    Oliveira, Alexandra Kolontai de Sousa; Ferro, Lília Pereira Abreu; da Silva, Jaiede Nicacio; Okada, Daniel Mochida

    2013-01-01

    Summary Introduction: Treacher-Collins syndrome is characterized by craniofacial malformations, narrowing of the external auditory canal (EAC), and, in 30% of cases, agenesis of the canal and ossicular chain defects. The use of hearing aids (HA) is not possible in cases in which agenesis or stenosis of the EAC accompanies conductive deafness. In contrast, bone conduction implants such as the Bone Anchored Hearing Aid (BAHA®) allow direct stimulation of the cochlea and are thus superior to conventional hearing aids in cases of severe conductive hearing loss. Objective: To present 2 cases of patients with Treacher-Collins syndrome who underwent implantation of BAHA®. Cases Reports: The first patient was a 52-year-old woman diagnosed with Treacher-Collins syndrome who presented with severe bilateral mixed hearing loss and a history of unsuccessful previous use of a bone contact conduction device. The BAHA® implantation was uneventful, and the post-operative results were good. The second patient was a 14-year-old girl who was also diagnosed with Treacher-Collins Syndrome with bilateral moderate conductive hearing loss by audiometry. The use of a bone vibrator contact device did not improve her hearing; however, implantation of a BAHA® resulted in a decreased gap postoperatively. Final comments: BAHA® hearing devices provide adequate rehabilitation and consequent improvement of the quality of life in patients with Treacher-Collins syndrome. PMID:25992018

  13. [Function of prosthesis components in lower limb amputees with bone-anchored percutaneous implants : Biomechanical aspects].

    Science.gov (United States)

    Blumentritt, S

    2017-05-01

    Bone anchorage of an artificial limb has been proven to be an alternative intervention for amputees when prosthesis use is seriously reduced because of stump problems. Little is known about how prosthesis components interact with bone and joints and which potential the optimum use provides with respect to quality of treatment of leg amputees. Does osseointegration influence the motor activity of residual limbs differently compared with socket prostheses? How should prosthesis components be aligned? What type of prosthetic knee joints should be preferred in transfemoral amputees? Transfer of biomechanical knowledge of socket prosthetics to bone-anchored prostheses. Pilot studies with a limited number of amputees. Force transmission at the interface between the prosthesis and residual limb stump is completely different for osseointegrated fixation and socket design; however, the number of muscles available for control remains unchanged. Because the iliotibial tract is missing, bending moments of the femur are expected to be greater. Prosthetic alignment is very critical for gait pattern and the basic rules seem to be the same as for socket design. The foot position determines the knee function for below-knee amputees. The position of the femur influences the gait pattern of above-knee amputees. The lowest risk of falls and best functional properties are shown by microprocessor controlled knee joints. Osseointegrated leg prostheses have some biomechanical advantages over the socket design. Since rehabilitation quality is clearly affected the prosthetic alignment has to be done carefully and precisely. As a rule microprocessor controlled knee joints are indicated.

  14. Predisposing factors for adverse skin reactions with percutaneous bone anchored hearing devices implanted with skin reduction techniques.

    Science.gov (United States)

    Candreia, Claudia; Birrer, Ruth; Fistarol, Susanna; Kompis, Martin; Caversaccio, Marco; Arnold, Andreas; Stieger, Christof

    2016-12-01

    We present an analysis of adverse events after implantation of bone anchored hearing device in our patient population with focus on individual risk factors for peri-implant skin reactions. The investigation involved a chart review of adult Baha patients (n = 179) with 203 Bahas implanted with skin reduction techniques between 1993 and 2009, a questionnaire (n = 97) and a free clinical examination (n = 47). Skin reactions were graded by severity from 0 (no skin reaction) to 4 (implant loss resulting from infection) according to Holgers. We analyzed the skin reaction rate (SRR) defined as the number of skin reactions per year and the worst Holgers grade (WHG), which indicates the grade of the worst skin reaction per implant. We defined 20 parameters including the demographic characteristics, surgery details, subjective benefits, handling and individual factors. The most frequent adverse events (85 %) were skin reactions. The average SRR was 0.426 per Baha year. Six parameters showed an association with the SRR or the WHG. The clinically most relevant factors are an elevated Body Mass Index (BMI, p = 0.02) and darker skin type (p = 0.03). The SRR increased with the distance between the tragus and the implant (p = 0.02). Regarding the identified risk factors, the SRR might be reduced by selecting a location for the implant near the pinna and by specific counseling regarding post-operative care for patients with darker skin type or an elevated Body Mass Index (BMI). Few of the factors analyzed were found to influence the SRR and WHG. Since most adverse skin reactions could be treated easily with local therapy, our results suggest that in adult patients, individual risk factors for skin reactions are not a contraindication for Baha implantation. Thus, patients can be selected purely on audiological criteria.

  15. A Bone-Thickness Map as a Guide for Bone-Anchored Port Implantation Surgery in the Temporal Bone

    Science.gov (United States)

    Guignard, Jérémie; Arnold, Andreas; Weisstanner, Christian; Caversaccio, Marco; Stieger, Christof

    2013-01-01

    The bone-anchored port (BAP) is an investigational implant, which is intended to be fixed on the temporal bone and provide vascular access. There are a number of implants taking advantage of the stability and available room in the temporal bone. These devices range from implantable hearing aids to percutaneous ports. During temporal bone surgery, injuring critical anatomical structures must be avoided. Several methods for computer-assisted temporal bone surgery are reported, which typically add an additional procedure for the patient. We propose a surgical guide in the form of a bone-thickness map displaying anatomical landmarks that can be used for planning of the surgery, and for the intra-operative decision of the implant’s location. The retro-auricular region of the temporal and parietal bone was marked on cone-beam computed tomography scans and tridimensional surfaces displaying the bone thickness were created from this space. We compared this method using a thickness map (n = 10) with conventional surgery without assistance (n = 5) in isolated human anatomical whole head specimens. The use of the thickness map reduced the rate of Dura Mater exposition from 100% to 20% and suppressed sigmoid sinus exposures. The study shows that a bone-thickness map can be used as a low-complexity method to improve patient’s safety during BAP surgery in the temporal bone. PMID:28788390

  16. Bone-anchored hearing aid implant location in relation to skin reactions.

    NARCIS (Netherlands)

    Faber, H.T.; Wolf, M.J.F. de; Rooy, J.W.J. de; Hol, M.K.S.; Cremers, C.W.R.J.; Mylanus, E.A.M.

    2009-01-01

    OBJECTIVE: To evaluate the effect of implant location and skin thickness on the frequency and degree of adverse skin reactions around the abutment. DESIGN: Retrospective multivariate analysis of implant position related to skin thickness and clinical variables. SETTING: Tertiary referral center.

  17. Bone-anchored hearing implants in single-sided deafness patients: Long-term use and satisfaction by gender.

    Science.gov (United States)

    Faber, Hubert T; Nelissen, Rik C; Kramer, Sophia E; Cremers, Cor W R J; Snik, Ad F M; Hol, Myrthe K S

    2015-12-01

    To examine the long-term satisfaction and possible effects of gender in patients with single-sided deafness (SSD) who underwent bone-anchored hearing implant (BAHI) surgery. Retrospective case-control study. All (n = 145) consecutive SSD patients fitted with a BAHI between January 2001 and October 2011 were asked to complete a questionnaire consisting of the Abbreviated Profile of Hearing Aid Benefit (APHAB), the Communication Profile for the Hearing Impaired (CPHI), and the SSD questionnaire. Twenty-three of the 135 responding patients (17%) reported discontinuation of the device over an average follow-up time of 61.7 months. No significant differences were found in the degree of disability or coping between men and women, according to the APHAB and CPHI scores. Improvement in quality of life and appreciation of the BAHI were not affected by gender, age, directional hearing ability, and handling of the device. The appearance of the device positively affected their appreciation. At the mean follow-up time of 117 months, 69.2% was using their BAHI. In the domains background noise, reverberant surroundings, and aversion to sounds, the mean APHAB scores were significantly changed at 3 months, 1 year, and 10 years after implantation. Our study examined the results of BAHI use in SSD patients over a relatively long follow-up period, with an average of 5 years. The majority of users (83%) were satisfied with the device. No significant gender differences were in terms of reported appreciation, hearing disability, or coping with a BAHI. 3b. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  18. Outcomes of Bone Anchored Hearing Aid Implant at Universiti Kebangsaan Malaysia Medical Centre (UKMMC).

    Science.gov (United States)

    Rahim, Suhana Abdul; Goh, Bee-See; Zainor, Safinaz; Rahman, Roslenda Abdul; Abdullah, Asma

    2018-03-01

    The cross sectional study was conducted in Universiti Kebangsaan Malaysia Medical Center (UKMMC), Malaysia from August 2012 to December 2013. All patients implanted with in UKMMC from December 2001 until December 2012 was included. Glasgow Benefit Inventory (GBI) questionnaires and UKMMC questionnaires were used as part of the assessment tool. The GBI is a scoring which measures the change in health status produced by surgical interventions. UKMMC questionnaires was invented by our department to assess questions related to social and life style of patients and also the cosmetic perspective Baha implant and other daily related activities. The audiological assessment was assessed using hearing aid gain threshold. Complication with regards to skin reaction was graded using Holger Skin Classification. A total of 40 patients underwent Baha implant were recruited but only 35 patients fulfilled the criteria and included in this study for analysis. Age of patients ranged from 5 year old to 38 year old, with median of 13 years old. There were 22 patients (62.8%) were male and 13 patients (37.1%) were females. Almost all cases were canal atresia except one adult patient was a case of bilateral chronic discharging ear with chronic irritation with ear mould. Majority of patients 21 (60%) have hearing level of moderate to severe hearing loss (40-89 dB) and 14 patients (40%) have mild to moderate hearing loss (20-39 dB). The level of hearing was retested post operatively. All of the patients have improvement in their aided hearing with the range of 10-25 dBL which is statistically significant at p value of aided hearing which is statistically significant at p value of <0.05. BAHA has been proven to show significant benefit in audiological improvement and quality of life.

  19. Retrospective analysis of skin complications related to bone-anchored hearing aid implant: association with surgical technique, quality of life, and audiological benefit.

    Science.gov (United States)

    Peñaranda, Daniel; Garcia, Juan Manuel; Aparicio, Maria Leonor; Montes, Felipe; Barón, Clemencia; Jiménez, Roberto C; Peñaranda, Augusto

    2017-04-25

    The bone-anchored hearing aid is an effective form of auditory rehabilitation. Due to the nature of the implant, the most common complications are skin related. A number of alternative surgical implantation techniques have been used to reduce the frequency and severity of skin complications, including the U-shaped graft and the linear incision. To assess skin complications and their association with surgical technique, quality of life, and audiological benefit in patients with bone-anchored hearing aids. This was a retrospective study conducted in a tertiary referral center in Bogotá, Colombia. Patients who had been fitted with a bone-anchored hearing aid implant (unilaterally or bilaterally) for at least 6 months were included in the study. The Holgers classification was used to classify skin complications (Grade 0=none; Grade 1=erythema; Grade 2=erythema and discharge; Grade 3=granulation tissue; and Grade 4=inflammation/infection resulting in the removal of the abutment). The Glasgow Benefit Inventory questionnaire was used to determine quality of life, and the Abbreviated Profile of Hearing Aid Benefit questionnaire was used to determine the subjective audiological benefit. A total of 37 patients were included in the study (30 with unilateral implants and 7 with bilateral implant). Of the 44 implants evaluated, 31 (70.3%) were associated with skin complications (7 [15.9%] Grade 1; 4 [9.1%] Grade 2; 15 [34.1%] Grade 3, 5 [11.4%] Grade 4). The U-shaped graft was statistically associated with major complications (Grades 3 and 4) compared with the linear incision technique (p=0.045). No statistically significant differences were found between Abbreviated Profile of Hearing Aid Benefit scores and severity of complications. Similarly, no differences were found between Glasgow Benefit Inventory physical health questions and skin complications. Despite the high frequency, skin complications did not seem to affect quality of life or subjective audiological benefits of

  20. An approach to bilateral bone-anchored hearing aid surgery in children: contralateral placement of sleeper fixture.

    Science.gov (United States)

    Bernstein, J M; Sheehan, P Z

    2009-05-01

    Bone-anchored hearing aid surgery in younger children is a two-stage procedure, with a titanium fixture being allowed to osseointegrate for several months before an abutment is fitted through a skin graft. In the first procedure, it has been usual to place a reserve or sleeper fixture approximately 5 mm from the primary fixture as a backup in case the primary fixture fails to osseointegrate. This ipsilateral sleeper fixture is expensive, is often not used, and is placed in thinner calvarial bone where it is less likely to osseointegrate successfully. The authors have implanted the sleeper fixture on the contralateral side, with the additional objective of reducing the number of procedures for bilateral bone-anchored hearing aid implantation, providing a cost-effective use for the sleeper. The authors implanted the bone-anchored hearing aid sleeper fixture in the contralateral temporal bone instead of on the ipsilateral side in seven successive paediatric cases with bilateral conductive hearing loss requiring two-stage bone-anchored hearing aids, treated at the Royal Manchester Children's Hospital, UK. The seven patients ranged in age from five to 15 years, with a mean age of 10 years; in addition, a 20-year-old with learning disability was also treated. In each case, the contralateral sleeper fixture was not needed as a backup fixture, but was used in four patients (57 per cent) as the basis for a second-side bone-anchored hearing aid. In children with bilateral conductive hearing loss, in whom a bilateral bone-anchored hearing aid is being considered and the second side is to be operated upon at a later date, we recommend placing the sleeper fixture on the contralateral side at the time of primary first-side surgery. Our technique provides a sleeper fixture located in an optimal position, where it also offers the option of use for a second-side bone-anchored hearing aid and reduces the number of procedures needed.

  1. Long-term benefit perception, complications, and device malfunction rate of bone-anchored hearing aid implantation for profound unilateral sensorineural hearing loss.

    Science.gov (United States)

    Gluth, Michael B; Eager, Katrise M; Eikelboom, Robert H; Atlas, Marcus D

    2010-12-01

    To longitudinally evaluate short- and long-term subject satisfaction/benefit perception, device usage rates, complication rates, and external device repair rates of bone-anchored hearing aid (BAHA) implantation on a cohort of adult subjects with profound unilateral sensorineural hearing loss (PUSHL). Prospective clinical trial. Tertiary referral center. Fifty-six adults with PUSHL, 21 of which underwent BAHA implantation (followed for an average of 3.2 years after implantation; range, 0.8-4.6 yr). Short- and long-term satisfaction/benefit perception outcomes consisting of the Glasgow Hearing Aid Benefit Profile, Abbreviated Profile of Hearing Aid Benefit, and Single-Sided Deafness Questionnaire, including a comparison of results between implanted and nonimplanted subjects. Short- and long-term device usage rates, complications, and device failure issues also were carefully documented. There were statistically significant improvements in nearly all measures of benefit perception documented as well as a high rate of long-term device usage (81%). Although satisfaction and benefit perception outcomes generally tended to regress over time when compared with initial short-term outcomes, long-term scores still tended to be significantly improved nevertheless as compared with preoperative levels. Approximately 38% of implants experienced severe local skin reactions (Grade 2 and above) around the implant site at some point throughout the follow-up period, whereas only one (4.8%) required implant removal. 66.7% of subjects required repair of their external sound processor. BAHA implantation seems to provide a high level of short- and long-term perceived benefit and satisfaction in subjects with PUSHL and high rate of long-term device usage. Implant site adverse local skin reactions and repairs of the external sound processor were quite common.

  2. In vitro assessment of MRI safety at 1.5 T and 3.0 T for bone-anchored hearing aid implant

    Energy Technology Data Exchange (ETDEWEB)

    Yeon, Kyoo Jin; KIm, Hyun Soo; Lee, Seung Keun [Dept. of Radiology, Samsung Medical Center, Seoul (Korea, Republic of); Lee, Tae Soo [Dept. of Biomedical Engineering, Chungbuk National University, Cheongju (Korea, Republic of)

    2017-03-15

    The aim of this study was to evaluate Magnetic Resonance Imaging safety by measuring the translational attraction, torque and susceptibility artifact for Bone-Anchored Hearing Aid (BAHA) implant at 1.5 T and 3.0 T MRI by standard criteria. In vitro assessment tools were made of acrylic-resin by American Society for Testing and Materials (ASTM) F2052-06 and F2119-07 standard. Translational attraction of BAHA implant was measured by the maximum deflection angle at 96 cm position, where the magnetically induced deflection was the greatest. The torque was assessed by the qualitative criteria of evaluating the alignment and rotation pattern, when the BAHA implant was positioned on a line with 45° intervals inside the circular container in the center of the bore. The susceptibility artifact images were obtained using the hanged test tool, which was filled with CuSO4 solution. And then the artifact size was measured using Susceptibility Artifact Measurement (SAM) software. In results, the translational attraction was 0 mm at both 1.5 T and 3.0 T and the torque was 0(no torque) at 1.5 T, and +1(mild torque) at 3.0 T. The size of susceptibility artifacts was between 13.20 mm and 38.91 mm. Therefore, The BAHA implant was safe for the patient in clinical MR environment.

  3. [Development and application of bone-anchored hearing aid].

    Science.gov (United States)

    Liu, Yupeng; Yang, Jun

    2013-01-01

    Bone-anchored hearing aid is a hearing assisting technology that raise the hearing level via bone conduct and is also the only implantable hearing assisting device working by bone conduct. Because of the superior performance and simple process of implantation, it brings gospel to the patients who are not fitting the air conducting hearing devices. This article is a review of bone-anchored hearing aid from 6 aspects, including history, principle, indication, consulting, surgery and complication.

  4. Comparison of Speech-in-Noise and Localization Benefits in Unilateral Hearing Loss Subjects Using Contralateral Routing of Signal Hearing Aids or Bone-Anchored Implants.

    Science.gov (United States)

    Snapp, Hillary A; Holt, Fred D; Liu, Xuezhong; Rajguru, Suhrud M

    2017-01-01

    To compare the benefit of wireless contralateral routing of signal (CROS) technology to bone-anchored implant (BAI) technology in monaural listeners. Prospective, single-subject. Tertiary academic referral center. Adult English speaking subjects using either a CROS hearing aid or BAI as treatment for unilateral severe-profound hearing loss. Aided performance utilizing the subjects BAI or CROS hearing device. Outcome measures included speech-in-noise perception using the QuickSIN (Etymotic Research, Elkgrove Village, IL, 2001) speech-in-noise test and localization ability using narrow and broadband stimuli. Performance was measured in the unaided and aided condition and compared with normal hearing controls. Subjective outcomes measures included the Speech Spatial and Qualities hearing scale and the Glasgow Hearing Aid Benefit Profile. A significant improvement in speech-in-noise performance for monaural listeners (p hearing aid users. No significant difference was observed between treatment groups for subjective measures of post-treatment residual disability or satisfaction. Our data demonstrate that both CROS and BAI systems provide significant benefit for monaural listeners. There is no significant difference between CROS or BAI systems for objective measures of speech-in-noise performance. CROS and BAI hearing devices do not provide any localization benefit in the horizontal plane for monaural listeners and there is no significant difference between systems.

  5. Stability, survival, and tolerability of a 4.5-mm-wide bone-anchored hearing implant: 6-month data from a randomized controlled clinical trial.

    Science.gov (United States)

    Nelissen, Rik C; den Besten, Christine A; Mylanus, Emmanuel A M; Hol, Myrthe K S

    2016-01-01

    The objective of this study was to compare the stability, survival, and tolerability of 2 percutaneous osseointegrated titanium implants for bone conduction hearing: a 4.5-mm diameter implant (test) and a 3.75-mm diameter implant (control). Fifty-seven adult patients were included in this randomized controlled clinical trial. Sixty implants were allocated in a 2:1 (test-control) ratio. Follow-up visits were scheduled at 7, 14, 21, and 28 days; 6 and 12 weeks; and 6 months. At every visit, implant stability quotient (ISQ) values were recorded by means of resonance frequency analysis (RFA) and skin reactions were evaluated according to the Holgers classification. Implants were loaded with the bone conduction device at 3 weeks. Hearing-related quality of life was evaluated using the Abbreviated Profile of Hearing Aid Benefit (APHAB), the Glasgow Benefit Inventory (GBI), and the Glasgow Health Status Inventory (GHSI). ISQ values were statistically significantly higher for the test implant compared to the control implant. No implants were lost and soft tissue reactions were comparable for both implants. Positive results were reported in the hearing-related quality of life questionnaires. These 6-month results indicate that both implants and their corresponding hearing devices are safe options for hearing rehabilitation in patients with the appropriate indications. Loading at 3 weeks did not affect the stability of either implant.

  6. [The bone-anchored hearing aid].

    Science.gov (United States)

    Foghsgaard, Søren

    2014-08-11

    The bone-anchored hearing aid (Baha) was introduced in 1977 by Tjellström and colleagues and has now been used clinically for over 30 years. Generally, the outcomes are good, and several studies have shown improved audiological- and quality of life outcomes. The principle of the Baha is, that sound vibrations are led directly to the inner ear via the mastoid bone, bypassing the middle ear. This is achieved via an osseointegrated implant and a skin-penetrating abutment. Studies report high success rates and a majority of complications as typically minor in nature.

  7. Candidacy for the bone-anchored hearing aid.

    NARCIS (Netherlands)

    Snik, A.F.M.; Bosman, A.J.; Mylanus, E.A.M.; Cremers, C.W.R.J.

    2004-01-01

    The BAHA (bone-anchored hearing aid) is a bone conduction hearing aid with percutaneous transmission of sound vibrations to the skull. The device has been thoroughly evaluated by various implant groups. These studies showed that, in audiological terms, the BAHA is superior to conventional bone

  8. Benefit and quality of life in older bone-anchored hearing aid users.

    NARCIS (Netherlands)

    Wolf, M.J.F. de; Shival, M.L.; Hol, M.K.S.; Mylanus, E.A.M.; Cremers, C.W.R.J.; Snik, A.F.M.

    2010-01-01

    OBJECTIVE: Benefit and quality-of-life analysis in the older adult bone-anchored hearing aid (BAHA) users. STUDY DESIGN: Retrospective evaluation. METHODS: Four questionnaires (Glasgow Benefit Inventory, Abbreviated Profile of Hearing Aid Benefit [APHAB], Nijmegen Cochlear Implant Questionnaire

  9. Printing of Titanium implant prototype

    International Nuclear Information System (INIS)

    Wiria, Florencia Edith; Shyan, John Yong Ming; Lim, Poon Nian; Wen, Francis Goh Chung; Yeo, Jin Fei; Cao, Tong

    2010-01-01

    Dental implant plays an important role as a conduit of force and stress to flow from the tooth to the related bone. In the load sharing between an implant and its related bone, the amount of stress carried by each of them directly related to their stiffness or modulus. Hence, it is a crucial issue for the implant to have matching mechanical properties, in particular modulus, between the implant and its related bone. Titanium is a metallic material that has good biocompatibility and corrosion resistance. Whilst the modulus of the bulk material is still higher than that of bone, it is the lowest among all other commonly used metallic implant materials, such as stainless steel or cobalt alloy. Hence it is potential to further reduce the modulus of pure Titanium by engineering its processing method to obtain porous structure. In this project, porous Titanium implant prototype is fabricated using 3-dimensional printing. This technique allows the flexibility of design customization, which is beneficial for implant fabrication as tailoring of implant size and shape helps to ensure the implant would fit nicely to the patient. The fabricated Titanium prototype had a modulus of 4.8-13.2 GPa, which is in the range of natural bone modulus. The compressive strength achieved was between 167 to 455 MPa. Subsequent cell culture study indicated that the porous Titanium prototype had good biocompatibility and is suitable for bone cell attachment and proliferation.

  10. Comparison of Performance of Transcranial Contralateral Routing of Signal, Pre-Implanted Trimmer Digital and Digital Bone Anchored Hearing Aid in Adults with Unilateral Hearing Loss.

    Science.gov (United States)

    Devi, Neelamegarajan; Chatni, Suma; Ramadevi, Kasetty Jagannathaiah S; Fakruddin, Darga Baba

    2015-06-11

    Individuals with unilateral hearing loss of severe-profound degree face listening difficulties while localizing a sound source and while perceiving speech in the presence of noise. The objective was to compare the efficacy of the digitally programmable bone anchored hearing aid (BAHA), trimmer digital BAHA and the transcranial contralateral routing of signal (T-CROS) in improving the listening performance in adults with unilateral hearing loss. Twenty-four adults with unilateral hearing loss was assessed for sound field thresholds, speech perception performance in quiet and noise (direct and indirect conditions) and the subjective quality rating of speech in unaided and aided with either T-CROS or digitally programmable BAHA or trimmer digital BAHA attached to the headband. Results indicated that the participants performed better with both the digitally programmable and the trimmer digital BAHA than the T-CROS in both quiet and noise. However, the digitally programmable BAHA performed better when the speech arrived from the poorer ear side. The current study helps in prioritizing the hearing amplification devices for the trial and also helps in arriving at the appropriate hearing amplification device for the individuals with unilateral hearing loss.

  11. Comparison of performance of transcranial contralateral routing of signal, pre-implanted trimmer digital and digital bone anchored hearing aid in adults with unilateral hearing loss

    Directory of Open Access Journals (Sweden)

    Neelamegarajan Devi

    2015-06-01

    Full Text Available Individuals with unilateral hearing loss of severe-profound degree face listening difficulties while localizing a sound source and while perceiving speech in the presence of noise. The objective was to compare the efficacy of the digitally programmable bone anchored hearing aid (BAHA, trimmer digital BAHA and the transcranial contralateral routing of signal (T-CROS in improving the listening performance in adults with unilateral hearing loss. Twenty-four adults with unilateral hearing loss was assessed for sound field thresholds, speech perception performance in quiet and noise (direct and indirect conditions and the subjective quality rating of speech in unaided and aided with either T-CROS or digitally programmable BAHA or trimmer digital BAHA attached to the headband. Results indicated that the participants performed better with both the digitally programmable and the trimmer digital BAHA than the T-CROS in both quiet and noise. However, the digitally programmable BAHA performed better when the speech arrived from the poorer ear side. The current study helps in prioritizing the hearing amplification devices for the trial and also helps in arriving at the appropriate hearing amplification device for the individuals with unilateral hearing loss.

  12. A Retrospective Review of Temporal Bone Imaging With Respect to Bone-Anchored Hearing Aid Placement.

    Science.gov (United States)

    Baker, Aaron R; Fanelli, David G; Kanekar, Sangam; Isildak, Huseyin

    2017-01-01

    Current bone-anchored hearing aid (BAHA) guidelines recommend placement of the titanium implant 5 to 7 cm posterior to the ear canal. Previous studies show that bone conducted hearing is maximized the closer the transducer is to the cochlea. We aim to investigate the position of the sigmoid sinus with respect to BAHA implants to determine whether they may be safely placed closer to the ear canal in patients with chronic ear disease, enhancing the amplification available to the patient. We performed a retrospective review of high-resolution temporal bone computed tomographies (CTs), comparing multiple measurements between ears with chronic ear disease and normal controls. Images were obtained at a single academic medical center. Eighty patients (160 ears) with temporal bone CTs performed between 2006 and 2009 were measured. Patients with chronic ear disease were identified by international statistical classification of diseases and related health problems, revision 9 code and confirmation by review of the imaging. Measurements were made on axial CT slices from a point 1 cm posterior to the sigmoid sinus to the posterior margin of the external canal. The squamous temporal bone thickness was also measured at this point. Forty-seven patients (55 ears) had chronic ear disease. Distance from the posterior canal was significantly different between normal and diseased ears (36.3 mm versus 33.5 mm, p bone thickness varied widely, and was similar between groups (6.9 mm versus 6.8 mm, p = 0.76). According to our data, titanium implants for bone-anchored hearing aids may be safely placed closer to the external canal than the current recommendations. This could allow for better transduction as well as sound localization in BAHA patients.

  13. Conversion of traditional osseointegrated bone-anchored hearing aids to the Baha®attract in four pediatric patients.

    Science.gov (United States)

    Cedars, Elizabeth; Chan, Dylan; Lao, Anga; Hardies, Lauren; Meyer, Anna; Rosbe, Kristina

    2016-12-01

    Bone-anchored hearing aids are external devices attached to the skull via a titanium implant, and can be used for multiple types of hearing loss. Traditionally, osseointegrated implants have been coupled to the external processor with a percutaneous abutment, but more recently, a fully implanted, transcutaneous magnet-based system has become available. Skin reactions from the percutaneous portion are a common complication that can prevent use of the device during critical windows of language development and learning in children. We describe our experience replacing the Baha ® abutment system with the Baha ® Attract in four pediatric patients. Specific operative considerations for incision placement, and magnet and implant coverage are discussed. All patients maintained osseointegration, had excellent long-term wound healing without post-operative infection, and were able to wear their devices more consistently. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Individual titanium zygomatic implant

    Science.gov (United States)

    Nekhoroshev, M. V.; Ryabov, K. N.; Avdeev, E. V.

    2018-03-01

    Custom individual implants for the reconstruction of craniofacial defects have gained importance due to better qualitative characteristics over their generic counterparts – plates, which should be bent according to patient needs. The Additive Manufacturing of individual implants allows reducing cost and improving quality of implants. In this paper, the authors describe design of zygomatic implant models based on computed tomography (CT) data. The fabrication of the implants will be carried out with 3D printing by selective laser melting machine SLM 280HL.

  15. Cranioplasty with individual titanium implants

    Science.gov (United States)

    Mishinov, S.; Stupak, V.; Sadovoy, M.; Mamonova, E.; Koporushko, N.; Larkin, V.; Novokshonov, A.; Dolzhenko, D.; Panchenko, A.; Desyatykh, I.; Krasovsky, I.

    2017-09-01

    Cranioplasty is the second procedure in the history of neurosurgery after trepanation, and it is still relevant despite the development of civilization and progress in medicine. Each cranioplasty operation is unique because there are no two patients with identical defects of the skull bones. The development of Direct Metal Laser Sintering (DMLS) technique opened up the possibility of direct implant printing of titanium, a biocompatible metal used in medicine. This eliminates the need for producing any intermediate products to create the desired implant. We have produced 8 patient-specific titanium implants using this technique for patients who underwent different decompressive cranioectomies associated with bone tumors. Follow-up duration ranged from 6 to 12 months. We observed no implant-related reactions or complications. In all cases of reconstructive neurosurgery we achieved good clinical and aesthetic results. The analysis of the literature and our own experience in three-dimensional modeling, prototyping, and printing suggests that direct laser sintering of titanium is the optimal method to produce biocompatible surgical implants.

  16. Bone-anchored hearing aids in children and young adults: the Freeman Hospital experience.

    Science.gov (United States)

    Ramakrishnan, Y; Marley, S; Leese, D; Davison, T; Johnson, I J M

    2011-02-01

    To investigate the utilisation of bone-anchored hearing aids and Softband, as well as the effects on quality of life, amongst the paediatric and young adult population of Freeman Hospital, Newcastle Upon Tyne, UK. Retrospective, anonymised, cross-sectional survey using the Glasgow Benefit Inventory and Listening Situation Questionnaire (parent version), administered at least three months following the start of bone-anchored hearing aid or Softband use. One hundred and nine patients were included, of whom syndromic children made up a significant proportion (22 of 109). Patients using bone-anchored hearing aids obtained significant educational and social benefit from their aids. The mean Listening Situation Questionnaire difficulty score was 17 (15 patients), which is below the trigger score of 22+ at which further reassessment and rehabilitation is required. 87% (of 15 patients) did not require further intervention. The overall mean GBI score for the 22 patients (syndromic and non-syndromic) was +29. The use of bone-anchored hearing aids and Softband results in significant improvements in quality of life for children and young adults with hearing impairment. There is significant under-utilisation of bone-anchored hearing aids in children with skull and congenital abnormalities, and we would advocate bone-anchored hearing aid implantation for these patients.

  17. Management of repeated trauma to bone-anchored hearing aids in a paediatric patient.

    Science.gov (United States)

    Shamil, E; Topsakal, V; Grolman, W

    2013-02-01

    To outline the management options and neurological complications associated with repeated traumatic falls that cause intrusion of bone-anchored hearing aid abutments. A three-year-old boy with coloboma, heart defects, atresia of nasal choanae, retarded growth, genital abnormalities, ear defects and deafness was fitted with a bone-anchored hearing aid for severe conductive hearing loss and congenital ear malformations. Six months later, a traumatic fall caused an intrusion injury which rendered the bone-anchored hearing aid abutment unusable. Without removing the original abutment, a second abutment was inserted on the same side to aid his hearing. Two years later, the child fell again and damaged his second bone-anchored hearing aid abutment. Having been offered a surgical option to repair the area, the parents opted to keep the abutments in situ. Direct trauma to the fixture of a bone-anchored hearing aid is a relatively common long-term complication in children which can disrupt osseointegration and disable the implant. For young children who are either prone to falling or have behavioural problems, a bone-anchored hearing aid Softband may be more appropriate to non-invasively aid hearing.

  18. Bone-anchored hearing devices in children with unilateral conductive hearing loss: a patient-carer perspective.

    Science.gov (United States)

    Banga, Rupan; Doshi, Jayesh; Child, Anne; Pendleton, Elizabeth; Reid, Andrew; McDermott, Ann-Louise

    2013-09-01

    We sought to determine the outcome of implantation of a bone-anchored hearing device in children with unilateral conductive hearing loss. A retrospective case note analysis was used in a tertiary referral pediatric hospital to study 17 consecutive cases of pediatric patients with unilateral conductive hearing loss who were fitted with a bone-anchored hearing device between 2005 and 2010. The average age of the patients at the time of bone-anchored hearing device fitting was 10 years 6 months (range, 6 years 3 months to 16 years). Qualitative subjective outcome measures demonstrated benefit. The vast majority of patients reported improved social and physical functioning and improved quality of life. All 17 patients are currently using their bone-anchored hearing device on a daily basis after a follow-up of 6 months. This study has shown improved quality of life in children with unilateral hearing loss after implantation of their bone-anchored hearing device. There was a high degree of patient satisfaction and improvement in health status reported by children and/or carers. Bone-anchored hearing devices have an important role in the management of children with symptomatic unilateral hearing loss. Perhaps earlier consideration of a bone-anchored hearing device would be appropriate in selected cases.

  19. The bone-anchored hearing aid

    DEFF Research Database (Denmark)

    Foghsgaard, Søren

    2014-01-01

    The bone-anchored hearing aid (Baha) was introduced in 1977 by Tjellström and colleagues and has now been used clinically for over 30 years. Generally, the outcomes are good, and several studies have shown improved audiological- and quality of life outcomes. The principle of the Baha is, that sound...

  20. An overview of different systems: the bone-anchored hearing aid.

    Science.gov (United States)

    Dun, Catharina A J; Faber, Hubert T; de Wolf, Maarten J F; Cremers, Cor W R J; Hol, Myrthe K S

    2011-01-01

    In the past 30 years, a large amount of clinical and audiological research on bone conduction hearing devices has been performed. In this review, we give a brief history of the developments in indications, surgical techniques and sound processors with respect to implantable bone conduction devices like the bone-anchored hearing aid or Baha. Starting with the use of Baha in patients with bilateral conductive or mixed hearing loss (HL), the indications for such devices have been extended to patients with unilateral HL, children and moderate mentally retarded patients. Bilateral fitting has been shown to be beneficial in restoring binaural hearing in patients with bilateral acquired or congenital conductive HL. In addition, the surgical techniques used to implant the titanium fixture for Baha application have been modified and further developed to reach two main goals: (a) optimal osseointegration, and (b) preparation of the implant site to minimize the occurrence of soft tissue reactions. Currently, the most used techniques are the pedicled skin flap, dermatome and linear incision techniques. Several generations of the Baha(®) sound processor have been developed by Cochlear(TM) to provide sufficient amplification in different hearing situations. Improvements in sound quality, aesthetics and handling have been major points of interest. The Baha sound processors most often used today are the Baha(®) Divino, the Baha(®) Intenso and the Baha(®) Cordelle. Recently, the more flexible Baha(®) BP100 sound processor was launched. Copyright © 2011 S. Karger AG, Basel.

  1. Soft tissue overgrowth in bone-anchored hearing aid patients: use of 8.5 mm abutment.

    Science.gov (United States)

    Pelosi, S; Chandrasekhar, S S

    2011-06-01

    To review outcomes following implantation of an 8.5 mm bone-anchored hearing aid abutment, as regards post-operative management of scalp soft tissue overgrowth. Retrospective chart review of paediatric and adult patients implanted with bone-anchored hearing aids between 2003 and 2008 who subsequently underwent revision surgery for excessive soft tissue growth. A tertiary referral centre and a private otology and neurotology clinic. A total of 80 patients underwent bone-anchored hearing aid placement between 2003 and 2008. Of these patients, 14 had significant scalp soft tissue overgrowth unresponsive to first-line, nonsurgical local wound care. Fourteen patients underwent an average of 2.1 surgical procedures each for soft tissue overgrowth around their bone-anchored hearing aid abutment. The mean time between initial implantation and revision surgery was 13.6 months. Of these 14 patients, 11 were eventually fitted with an 8.5 mm abutment. Following placement of the longer abutment, only one patient required additional surgical reduction of soft tissue overgrowth (mean follow-up time 11.8 months). All patients were able to use their bone-anchored hearing aid. The 8.5 mm bone-anchored hearing aid abutment is successful in preventing the need for additional surgical intervention in the small but significant number of patients with post-implantation soft tissue overgrowth. Early consideration should be given to this option when first-line soft tissue care is inadequate.

  2. Surface modification of titanium and titanium alloys by ion implantation.

    Science.gov (United States)

    Rautray, Tapash R; Narayanan, R; Kwon, Tae-Yub; Kim, Kyo-Han

    2010-05-01

    Titanium and titanium alloys are widely used in biomedical devices and components, especially as hard tissue replacements as well as in cardiac and cardiovascular applications, because of their desirable properties, such as relatively low modulus, good fatigue strength, formability, machinability, corrosion resistance, and biocompatibility. However, titanium and its alloys cannot meet all of the clinical requirements. Therefore, to improve the biological, chemical, and mechanical properties, surface modification is often performed. In view of this, the current review casts new light on surface modification of titanium and titanium alloys by ion beam implantation. (c) 2010 Wiley Periodicals, Inc.

  3. Is there loss of vibration amplitude across the snap coupling of the bone-anchored hearing aid?

    Science.gov (United States)

    Majdalawieh, Osama; Van Wijhe, Rene G; Bance, Manohar

    2006-04-01

    There is loss of vibration transmission across the snap coupling connecting the Bone-Anchored Hearing Aid transducer to the implanted abutment on the head. The only nonrigid part of the Bone-Anchored Hearing Aid system is the connection between the output of the transducer and the abutment. Vibration losses across the coupling have not been previously measured. If a loss is found, a change in design could improve the efficiency of the Bone-Anchored Hearing Aid. This would be very helpful in borderline cases in which the Bone-Anchored Hearing Aid does not have enough power to achieve adequate hearing threshold levels. A laser Doppler vibrometer was used to measure vibrations on the output stem and four points on the abutment of the Bone-Anchored Hearing Aid. The Bone-Anchored Hearing Aid was coupled to a dry skull through a plexiglas bite bar screwed to the skull. The impedance load was varied by fixing the skull. A control loose coupling was measured. Five Bone-Anchored Hearing Aid Compacts were measured. There was little loss across the Bone-Anchored Hearing Aid snap coupling. At frequencies above 500 Hz, there was no more than 5-dB loss at any frequency. Changing the impedance load by fixing the skull did not change the loss across the coupling. The snap coupling is an efficient means of transmitting vibrations to the skull. There is little loss of vibration attenuation across it. Increases in functional Bone-Anchored Hearing Aid amplification gain cannot be achieved by further optimizing this interface.

  4. Bone-anchored hearing aids and unilateral sensorineural hearing loss: why do patients reject them?

    Science.gov (United States)

    Siau, D; Dhillon, B; Andrews, R; Green, K M J

    2015-04-01

    This study aimed to report the bone-anchored hearing aid uptake and the reasons for their rejection by unilateral sensorineural deafness patients. A retrospective review of 90 consecutive unilateral sensorineural deafness patients referred to the Greater Manchester Bone-Anchored Hearing Aid Programme between September 2008 and August 2011 was performed. In all, 79 (87.8 per cent) were deemed audiologically suitable: 24 (30.3 per cent) eventually had a bone-anchored hearing aid implanted and 55 (69.6 per cent) patients declined. Of those who declined, 26 (47.3 per cent) cited perceived limited benefits, 18 (32.7 per cent) cited reservations regarding surgery, 13 (23.6 per cent) preferred a wireless contralateral routing of sound device and 12 (21.8 per cent) cited cosmetic reasons. In all, 32 (40.5 per cent) suitable patients eventually chose the wireless contralateral routing of sound device. The uptake rate was 30 per cent for audiologically suitable patients. Almost half of suitable patients did not perceive a sufficient benefit to proceed to device implantation and a significant proportion rejected it. It is therefore important that clinicians do not to rush to implant all unilateral sensorineural hearing loss patients with a bone-anchored hearing aid.

  5. BAHA: Bone-Anchored Hearing Aid

    Science.gov (United States)

    Hagr, Abdulrahman

    2007-01-01

    Bone-Anchored Hearing Aid (BAHA) has proven performance and advantages for patients with aural atresia or chronic ear drainage who cannot wear air-conduction hearing aids. The BAHA has both cosmetic and acoustic advantages over most conventional hearing aids and hence is becoming increasingly popular. Moreover, BAHA improves the quality of life and has also significantly reduces ear discharge. This extensive review of the literature pertaining to BAHA discus the history, the indications, the advantages, the prediction of the outcome and the complications of this device as well as comparing it to the conventional hearing aids. PMID:21475438

  6. Clinical experience of bone anchored hearing aid: a case report.

    Science.gov (United States)

    Miyasaka, Muneo; Akamatsu, Tadashi; Yamazaki, Akihisa; Tanaka, Rica

    2008-04-20

    To improve conventional bone conduction hearing aids, Tjellstrom, Branemark, developed an implant system consisting of a maxillofacial implant that derived from dental implants and a bone conduction hearing aid that was attached directly to the implant. This system has been commercially available as a bone anchored hearing aid (BAHA). More than 10,000 patients have benefited from BAHA in Scandinavia, North America, and many other regions. BAHA first became available in 1977 in Sweden but has not been used in Japan as widely as expected. This paper reports a case of a 8-year use of BAHA for hearing loss caused by microtia and external auditory canal atresia, with a review of literature. The patient has been followed up for 9 years after implant placement. Play audiometry with a loudspeaker showed a hearing loss of 25 dB. The patient says that BAHA is superior to conventional transcutaneous bone conduction hearing aids in easiness of attachment, esthetics, and speech recognition and music recognition. The skin and the bone around the implants remain in favorable condition. She has been free from the use of a headband for a conventional hearing aid.

  7. Unusual complication following trauma to a bone-anchored hearing aid: case report and literature review.

    Science.gov (United States)

    McDermott, A-L; Barraclough, J; Reid, A P

    2009-03-01

    We report the second published case of a child with a serious traumatic injury involving the fixture and abutment of their bone-anchored hearing aid. Case reports and review of the world literature concerning unusual complications following trauma to bone-anchored hearing aids. A nine-year-old girl with Dubowitz syndrome sustained an intrusion injury of her bone-anchored hearing aid fixture and abutment following a fall. No other injury was sustained, and there was no neurological complication. The patient underwent immediate removal of the implant and subsequently made a full recovery. Such serious and unusual complications are fortunately very rare. On review of the literature, four cases of similar complications were identified. Only one involved a traumatic injury in a child. Provision of bone-anchored hearing aids involves many clinicians. All clinicians involved in this procedure must be aware of the need to monitor their patients carefully, and to remember that unusual and unexpected complications, although rare, do happen. The patient's need for care continues long after the surgery is complete.

  8. Outcome of the bone-anchored hearing aid procedure without skin thinning: a prospective clinical trial.

    Science.gov (United States)

    Hultcrantz, Malou

    2011-09-01

    To evaluate the outcome of Bone-Anchored Hearing Aid surgery without skin thinning, a test group with direct implantation without such thinning was compared with a control group that underwent the traditional procedure. This was a single-center, prospective clinical trial designed to evaluate a novel approach to Bone-Anchored Hearing Aid implantation. Eligible patients were enrolled consecutively in the test group or selected to be age-matched controls. University Hospital. Eighteen adult patients, suffering from hearing loss, suitable for implantable hearing aid. Single-step surgery was performed on 18 patients under local anesthesia. In 9 of these, a linear incision was made, a hole was punched through the skin above the bone-anchored implant, and a longer abutment (8.5-12 mm) was introduced, whereas the other 9 were subjected to the standard protocol, using a dermatome and skin thinning. All of the patients were followed for 12 months. The test group exhibited good preservation of the tissue, no increasing skin reactions and no adverse events. The time required for this surgery was reduced, as was their healing time. These patients also experienced less numbness and pain in the surrounding area and had an improved cosmetic outcome. MAIN OUTCOME AND CONCLUSION: This clinical trial indicates that introduction of the abutment to the osseointegrated screw directly through the skin, without skin thinning, could be beneficial. This approach had fewer negative effects than the conventional procedure during the 12- month follow-up period.

  9. Surgery for the bone-anchored hearing aid.

    Science.gov (United States)

    Arnold, Andreas; Caversaccio, Marco-Domenico; Mudry, Albert

    2011-01-01

    This review covers the surgery for the bone-anchored hearing aid (Baha(®)). PREOPERATIVE WORKUP: A review of the indications and preoperative diagnostics shows that best results are generally obtained in patients with conductive or mixed hearing loss rehabilitation when surgery is not applicable or has failed and in patients that suffer from single-sided deafness. An audiogram must confirm that the bone conduction hearing is within the inclusion criteria. A computed tomography scan is performed in cases of malformation to assure sufficient bone thickness at the site of screw implantation. The steps of the Baha implantation are described step by step including the setting and anesthesia, skin work with regard to different techniques, correct resection of subcutaneous tissue, preparation of the implant site, drilling and placement of the fixture and wound closure. After wound healing (6-8 weeks), the bone conduction aid is fitted on the abutment. Regular cleaning of the fixture is important to avoid irritations and infections. If performed carefully, the surgery for the Baha has a favorable outcome, regardless of the technique used. Copyright © 2011 S. Karger AG, Basel.

  10. Titanium surgical implants processed by powder metallurgy

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, M.V. de [INT-DMCM, Inst. Nacional de Tecnologia, Rio de Janeiro, RJ (Brazil); Pereira, L.C. [Programa de Eng. de Materiais e Metalurgica, UFRJ-COPPE (Brazil); Schwanke, C.M.; Schaeffer, L. [Centro de Tecnologia- LdTM-INT-DMCM, UFRGS, Venezuela, CEP, Rio de Janeiro, RJ (Brazil)

    2001-07-01

    Due to their low density coupled with excellent corrosion resistance and good mechanical properties, titanium and titanium alloys have been widely used for surgical implants. They have also a relatively low young's modulus, allowing a good load transfer to the bone. The elastic modulus difference between metallic implant material and bone is large, which can lead to a fracture of the implant. To solve this problem, many implants for artificial joint and dental applications have been produced by powder metallurgy routes, obtaining a porous material with an even lower young's modulus than that of the bulk titanium. This porous structure allows bone ingrowth, as the osseous tissue invade the holes of the porous material while growing and adheres to it. Besides, near net shape technologies like powder metallurgy and injection molding techniques, can reduce the components high costs due to machining final steps, also providing a fine, uniform grain structure and lack of texture and segregation. This work outlines the characteristics, properties and some of the powder routes for producing titanium surgical implants and implant porous coatings. (orig.)

  11. Enhancing osseointegration using surface-modified titanium implants

    Science.gov (United States)

    Yang, Y.; Oh, N.; Liu, Y.; Chen, W.; Oh, S.; Appleford, M.; Kim, S.; Kim, K.; Park, S.; Bumgardner, J.; Haggard, W.; Ong, J.

    2006-07-01

    Osseointegrated dental implants are used to replace missing teeth. The success of implants is due to osseointegration or the direct contact of the implant surface and bone without a fibrous connective tissue interface. This review discusses the enhancement of osseointegration by means of anodized microporous titanium surfaces, functionally macroporous graded titanium coatings, nanoscale titanium surfaces, and different bioactive factors.

  12. Bone-anchored hearing aids in conductive and mixed hearing losses: why do patients reject them?

    Science.gov (United States)

    Siau, Richard T K; Dhillon, Baljeet; Siau, Derrick; Green, Kevin M J

    2016-10-01

    This study aimed to report the bone-anchored hearing aid uptake rate and the reasons for their rejection by patients with conductive and mixed hearing losses. A retrospective review was performed of 113 consecutive patients with unilateral or bilateral conductive or mixed hearing loss referred to the Greater Manchester bone-anchored hearing aid (BAHA) programme between September 2008 and August 2011. 98 (86.7 %) patients were deemed audiologically suitable for BAHA implantation. Of these, 38 (38.8 %) had BAHA implanted; 60 (61.2 %) patients declined. Of those who declined, 27 (45 %) cited anxiety over surgery, 18 (30 %) cited cosmetic reasons, 16 (26.7 %) perceived limited benefit from the device and six (10 %) preferred conventional hearing aids. Our study highlights a 38.8 % BAHA uptake rate in audiologically suitable patients. The main reasons cited for rejection of BAHA were anxiety over surgery and cosmetic concerns. It is important that clinicians address these early during consultation with prospective BAHA recipients and avoid rushing to implant these patients with a bone-anchored hearing aid.

  13. An animal model to evaluate skin-implant-bone integration and gait with a prosthesis directly attached to the residual limb.

    Science.gov (United States)

    Farrell, Brad J; Prilutsky, Boris I; Kistenberg, Robert S; Dalton, John F; Pitkin, Mark

    2014-03-01

    Despite the number of advantages of bone-anchored prostheses, their use in patients is limited due to the lack of complete skin-implant integration. The objective of the present study was to develop an animal model that would permit both detailed investigations of gait with a bone-anchored limb prosthesis and histological analysis of the skin-implant-bone interface after physiological loading of the implant during standing and walking. Full-body mechanics of walking in two cats were recorded and analyzed before and after implantation of a percutaneous porous titanium pylon into the right tibia and attachment of a prosthesis. The rehabilitation procedures included initial limb casting, progressively increasing loading on the implant, and standing and locomotor training. Detailed histological analysis of bone and skin ingrowth into implant was performed at the end of the study. The two animals adopted the bone-anchored prosthesis for standing and locomotion, although loads on the prosthetic limb during walking decreased by 22% and 62%, respectively, 4months after implantation. The animals shifted body weight to the contralateral side and increased propulsion forces by the contralateral hindlimb. Histological analysis of the limb implants demonstrated bone and skin ingrowth. The developed animal model to study prosthetic gait and tissue integration with the implant demonstrated that porous titanium implants may permit bone and skin integration and prosthetic gait with a bone-anchored prosthesis. Future studies with this model will help optimize the implant and prosthesis properties. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. The bone-anchored hearing aid for children: recent developments.

    Science.gov (United States)

    Snik, Ad; Leijendeckers, Joop; Hol, Myrthe; Mylanus, Emmanuel; Cremers, Cor

    2008-09-01

    In 1984 the Bone-Anchored Hearing Aid, or BAHA, system was introduced. Its transducer is coupled directly to the skull percutaneously to form a highly effective bone-conduction hearing device. Clinical studies on adults with conductive hearing loss have shown that the BAHA system outperforms conventional bone-conduction hearing aids. Therefore, the next step was to apply the BAHA system in children with congenital or acquired conductive hearing loss. Reviewed data showed that, on average, such children benefited significantly more from the BAHA than from reconstructive surgery. Thus, BAHA application appears to be the best option to achieve normal communication and speech and language development in children with bilateral conductive hearing loss. However, in children under the age of three to four years, a conventional solution must be applied, e.g. a bone conductor with a transcutaneous coupling, because they are too young to undergo BAHA implant surgery. In the case of unilateral congenital conductive hearing loss, there is no convincing evidence in the clinical literature for early intervention. In summary, the BAHA system can be considered a new, indispensable tool for children with bilateral conductive hearing loss.

  15. Bone-anchored hearing device placement with translabyrinthine tumor removal.

    Science.gov (United States)

    McRackan, Theodore R; Goddard, John C; Wilkinson, Eric P; Slattery, William H; Brackmann, Derald E

    2015-02-01

    Translabyrinthine resection of intracranial tumors results in single-sided deafness, which can be treated by surgical and nonsurgical means. Here we describe the first series examining complication and device usage rates among patients receiving a surgically implanted bone-anchored hearing device (BAHD) at the time of translabyrinthine tumor removal. Case series with chart review. Private tertiary neurotologic referral center. Patients (N = 154) undergoing concurrent BAHD placement and translabyrinthine tumor resection. Concurrent BAHD placement and translabyrinthine tumor removal. Postoperative complication rates and BAHD usage. Of the 154 patients, 121 (78.6%) had no device-related complications. The most common device-related complications were skin overgrowth (8.4%), acute infection (5.2%), and chronic infection (3.2%). The overall and specific complication rates did not differ from published BAHD complication rates. One patient (0.6%) developed a cerebrospinal leak through the surgical site for the device. At the time of last follow-up (mean, 39.8 months), 151 patients (95.0%) were still using their devices. Patients undergoing concurrent translabyrinthine tumor removal and BAHD placement exhibit similar device-related complication profiles as patients undergoing standard device placement. Based on these outcomes and the high long-term usage rates, BAHD insertion at the time of translabyrinthine intracranial surgery can be considered a safe and useful procedure. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

  16. Antibacterial iodine-supported titanium implants.

    Science.gov (United States)

    Shirai, T; Shimizu, T; Ohtani, K; Zen, Y; Takaya, M; Tsuchiya, H

    2011-04-01

    Deep infection remains a serious complication in orthopedic implant surgery. In order to reduce the incidence of implant-associated infections, several biomaterial surface treatments have been proposed. This study focused on evaluating the antibacterial activity of iodine-supported titanium (Ti-I(2)) and its impact on post-implant infection, as well as determining the potential suitability of Ti-I(2) as a biomaterial. External fixation pins were used in this experiment as trial implants because of the ease of making the septic models. The antibacterial activity of the metal was measured using a modification of the Japanese Industrial Standards method. Activity was evaluated by exposing the implants to Staphylococcus aureus or Escherichia coli and comparing reaction of pathogens to Ti-I(2) vs. stainless steel and titanium controls. Ti-I(2) clearly inhibited bacterial colonization more than the control metals. In addition, cytocompatibility was assessed by counting the number of colonies that formed on the metals. The three metals showed the same amount of fibroblast colony formation. Japanese white rabbits were used as an in vivo model. Three pins were inserted into both femora of six rabbits for histological analysis. Pin sites were inspected and graded for infection and inflammation. Fewer signs of infection and inflammatory changes were observed in conjunction with the Ti-I(2) pins. Furthermore, osteoconductivity of the implant was evaluated with osteoid formation surface of the pin. Consecutive bone formation was observed around the Ti-I(2) and titanium pins, while little osteoid formation was found around the stainless steel pins. These findings suggest that Ti-I(2) has antimicrobial activity and exhibits cytocompatibility. Therefore, Ti-I(2) substantially reduces the incidence of implant infection and shows particular promise as a biomaterial. Copyright © 2010 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  17. Simplified bone-anchored hearing aid insertion using a linear incision without soft tissue reduction.

    Science.gov (United States)

    Husseman, J; Szudek, J; Monksfield, P; Power, D; O'Leary, S; Briggs, R

    2013-07-01

    Numerous techniques have been described to manage the skin and other soft tissues during bone-anchored hearing aid insertion. Previously, generally accepted techniques have sometimes led to distressing alopecia and soft tissue defects. Now, some surgeons are rejecting the originally described split skin flap in favour of a less invasive approach. To investigate bone-anchored hearing aid placement utilising a single, linear incision with either no or minimal underlying soft tissue reduction. Thirty-four adults were prospectively enrolled to undergo single-stage bone-anchored hearing aid placement with this modified technique. A small, linear incision was used at the standard position and carried down through the periosteum. Standard technique was then followed with placement of an extended length abutment. Patients were reviewed regularly to assess wound healing, including evaluation with Holgers' scale. Only 14.7 per cent of patients had a reaction score of 2 or higher. Most complications were limited to minor skin reactions that settled with silver nitrate cautery and/or antibiotics. None required revision surgery for tissue overgrowth, and there were no implant failures. Our results suggest this to be a simple and effective insertion technique with favourable cosmesis and patient satisfaction.

  18. Site for bone-anchored hearing system for children younger than 5 years.

    Science.gov (United States)

    Ukatu, Ceisha Chinwe; Desai, Nilesh Kundanlal; Todd, Norman Wendell

    2015-02-01

    To describe in children younger than the present US FDA-approved 5 years of age the thickest part of the temporal bone available for placement of a bone-anchored hearing system. Children with unilateral hearing loss, as with aural atresia, have deficits in at least language comprehension and oral expression. The early provision of hearing to the atretic ear may minimize the potential for auditory deprivation. Point prevalence descriptive study. Tertiary referral pediatric hospital. Thirty-eight patients less than 6 years old with congenital aural atresia had undergone temporal bone computed tomography (CT). Bone thickness lateral (ie, superficial) to the sinodural angle, in the topmost axial CT slice that included any adjacent petrous ridge, was measured. The mean bone thicknesses lateral to the sinodural angles of the atretic ears were 5.1, 5.0, 5.9, 5.2, 5.2, and 4.8 mm for the bone thickness lateral (ie, superficial) to the sinodural angle is sufficient for many children suffering from aural atresia to have bone-anchored hearing devices implanted younger than age 5 years. Use of the sinodural site would require a magnetic bone-anchored hearing system, which could be repositioned posteriorly at age 5 years when pinna construction and atresiaplasty endeavors typically begin. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

  19. Titanium implants in irradiated dog mandibles

    International Nuclear Information System (INIS)

    Schweiger, J.W.

    1989-01-01

    The use of osseointegrated titanium implants has been a great benefit to selected cancer patients who otherwise would not be able to wear conventional and/or maxillofacial prostheses. Cognizant of the risk of osteoradionecrosis, we used an animal model to seek experimental evidence for successful osseointegration in bone irradiated to tumoricidal levels. Five healthy male beagle dogs received 60 gray to a previously edentulated and healed area of the right hemimandible. The left hemimandible was kept as a nonirradiated control. After 9 months, titanium implants were placed and allowed an additional 5 1/2 months to osseointegrate. At that time, block specimens were obtained, radiographed, photographed, and analyzed histologically. Although statistical significance cannot be attached to the results, osseointegration was achieved in half of the irradiated specimens

  20. Porous Titanium for Dental Implant Applications

    Directory of Open Access Journals (Sweden)

    Zena J. Wally

    2015-10-01

    Full Text Available Recently, an increasing amount of research has focused on the biological and mechanical behavior of highly porous structures of metallic biomaterials, as implant materials for dental implants. Particularly, pure titanium and its alloys are typically used due to their outstanding mechanical and biological properties. However, these materials have high stiffness (Young’s modulus in comparison to that of the host bone, which necessitates careful implant design to ensure appropriate distribution of stresses to the adjoining bone, to avoid stress-shielding or overloading, both of which lead to bone resorption. Additionally, many coating and roughening techniques are used to improve cell and bone-bonding to the implant surface. To date, several studies have revealed that porous geometry may be a promising alternative to bulk structures for dental implant applications. This review aims to summarize the evidence in the literature for the importance of porosity in the integration of dental implants with bone tissue and the different fabrication methods currently being investigated. In particular, additive manufacturing shows promise as a technique to control pore size and shape for optimum biological properties.

  1. Bone-anchored hearing aids in unilateral inner ear deafness.

    NARCIS (Netherlands)

    Bosman, A.J.; Hol, M.K.S.; Snik, A.F.M.; Mylanus, E.A.M.; Cremers, C.W.R.J.

    2003-01-01

    In nine patients with unilateral deafness and normal hearing in the contralateral ear, measurements of sound localization and speech perception were obtained before intervention, with a conventional contralateral routing of sound (CROS) hearing aid and later with a bone-anchored hearing aid (BAHA)

  2. Stability Testing of a Wide Bone-Anchored Device after Surgery without Skin Thinning

    Directory of Open Access Journals (Sweden)

    Malou Hultcrantz

    2015-01-01

    Full Text Available Objective. To longitudinally follow the osseointegration using Resonance Frequency Analysis (RFA for different lengths of abutment on a new wide bone-anchored implant, introduced with the non-skin thinning surgical technique. Study Design. A single-center, prospective 1 year study following adults with bone-anchored hearing implants. Materials and Methods. Implantation was performed and followed for a minimum of 1 year. All patients were operated on according to the tissue preserving technique. A 4.5 mm wide fixture (Oticon Medical with varying abutments (9 to 12 mm was used and RFA was tested 1 week, 7 weeks, 6 months, and 12 months later. Implant Stability Quotient (ISQ, was measured from 1 to 100. Stability was compared to a group of patients (N=7 implanted with another brand (Cochlear BI400 of 4.5 mm fixtures. Results. All 10 adults concluded the study. None of the participants lost their implant during the test period indicating a good anchoring of abutments to the wide fixture tested. Stability testing was shown to vary depending on abutment length and time after surgery and with higher values for shorter abutments and increasing values over the first period of time. One patient changed the abutment from 12 to 9 mm and another from a 9 to a 12 during the year. No severe skin problems, numbness around the implant, or cosmetic problems arose. Conclusion. After 1 year of follow-up, combination of a wide fixture implant and the non-skin thinning surgical technique indicates a safe procedure with good stability and no abutment losses.

  3. Novel Bone-Anchored Vascular Access on the Mastoid for Hemodialysis: Concept and Preclinical Trials.

    Science.gov (United States)

    Stieger, Christof; Arnold, Andreas; Kruse, Anja; Wiedmer, Simona; Widmer, Matthias; Guignard, Jeremie; Schutz, Daniel; Guenat, Jean-Marc; Bachtler, Matthias; Caversaccio, Marco; Uehlinger, Dominik E; Frey, Felix J; Hausler, Rudolf

    2016-05-01

    We present the development of a bone-anchored port for the painless long-term hemodialytic treatment of patients with renal failure. This port is implanted behind the ear. The port was developed based on knowledge obtained from long-term experience with implantable hearing devices, which are firmly anchored to the bone behind the ear. This concept of bone anchoring was adapted to the requirements for a vascular access during hemodialysis. The investigational device is comprised of a base plate that is firmly fixed with bone screws to the bone behind the ear (temporal bone). A catheter leads from the base plate valve block through the internal jugular vein and into the right atrium. The valves are opened using a special disposable adapter, without any need to puncture the blood vessels. Between hemodialysis sessions, the port is protected with a disposable cover. Flow rate, leak tightness, and purification were tested on mockups. Preoperative planning and the surgical procedure were verified in 15 anatomical human whole head specimens. Preclinical evaluations demonstrated the technical feasibility and safety of the investigational device. Approximately 1.5 million people are treated with hemodialysis worldwide, and 25% of the overall cost of dialysis therapy results from vascular access problems. New approaches toward enhancing vascular access could potentially reduce the costs and complications of hemodialytic therapy.

  4. Abutment-free bone-anchored hearing devices in children: initial results and experience.

    Science.gov (United States)

    Centric, Aaron; Chennupati, Sri Kiran

    2014-05-01

    Bone-anchored implantable hearing devices are widely accepted as a surgical option for certain types of hearing loss in both adults and children. Most commercially available devices involve a percutaneous abutment to which a sound processor attaches. The rate of complications with such bone conduction systems is greater than 20%. Most complications arise from the abutment. Recently, the Sophono (Boulder, CO) Alpha 1, an abutment-free system, has been introduced. We conducted a retrospective chart review of the first five patients who underwent implantation with the Sophono abutment-free bone conduction hearing system with the Alpha 1 processor at our institution and report here on these patients' pre- and postoperative audiometric data and clinical courses. Average improvement in pure-tone average was 32dB hearing loss and average improvement in speech response threshold was 28dB hearing loss. All patients were responding in the normal to mild hearing loss range in the operated ear after device activation. Average improvement across individual frequencies was between 17 and 37dB (SD 5.5-11dB). Our audiometric results to date are promising and have been consistent with published data on other bone-anchored hearing devices. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. The role of bone anchored hearing aids in children with Down syndrome.

    Science.gov (United States)

    McDermott, Ann-Louise; Williams, Jo; Kuo, Michael J; Reid, Andrew P; Proops, David W

    2008-06-01

    To evaluate complication rates and outcomes of children with Down syndrome fitted with a Bone Anchored Hearing Aid (Baha). To evaluate whether the Bone Anchored Hearing Aid is a successful form of aural rehabilitation in children with Down syndrome from a patients' perspective. Retrospective case analysis and postal questionnaire study. The Birmingham Children's Hospital, UK. A total of 15 children were fitted with a Baha between February 1992 and February 2007. The age range was 2-15 years. A postal questionnaire was sent to each family. The Glasgow Children's Benefit Inventory (GCBI) was used in this study. Implantation results, skin reactions and other complications were recorded. Quality of life after receiving a Baha was assessed with the GCBI. All 15 patients are using their Baha 7 days a week for more than 8h a day after a follow-up of 14 months with continuing audiological benefit. No fixtures were lost, and skin problems were encountered in 3 (20%). Regarding quality of life, all 15 patients had improved social and physical functioning as a result of better hearing. Baha has an important role in the overall management of individuals with Down syndrome after conventional hearing aids and/or ventilation tubes have been considered or already failed. This study has shown a 20% rate of soft tissue reaction and there were no fixture losses in this group. No significant increase in complication rates was identified in children with Down syndrome. Finally, there was a significantly improved quality of life in children with Down syndrome after receiving their Baha. There was a high patient/carer satisfaction with Baha. Two of our series had bilateral two stage fixture procedures without any complications. More consideration should be given to bilateral bone anchored hearing aids in this group.

  6. Surface Modifications and Their Effects on Titanium Dental Implants

    Science.gov (United States)

    Jemat, A.; Ghazali, M. J.; Razali, M.; Otsuka, Y.

    2015-01-01

    This review covers several basic methodologies of surface treatment and their effects on titanium (Ti) implants. The importance of each treatment and its effects will be discussed in detail in order to compare their effectiveness in promoting osseointegration. Published literature for the last 18 years was selected with the use of keywords like titanium dental implant, surface roughness, coating, and osseointegration. Significant surface roughness played an important role in providing effective surface for bone implant contact, cell proliferation, and removal torque, despite having good mechanical properties. Overall, published studies indicated that an acid etched surface-modified and a coating application on commercial pure titanium implant was most preferable in producing the good surface roughness. Thus, a combination of a good surface roughness and mechanical properties of titanium could lead to successful dental implants. PMID:26436097

  7. Bone compaction enhances fixation of weightbearing titanium implants

    DEFF Research Database (Denmark)

    Kold, Søren Vedding; Rahbek, Ole; Vestermark, Marianne Toft

    2005-01-01

    are weightbearing, the effects of compaction on weightbearing implants were examined. The hypothesis was that compaction would increase implant fixation compared with conventional drilling. Porous-coated titanium implants were inserted bilaterally into the weightbearing portion of the femoral condyles of dogs...

  8. Artefacts in multimodal imaging of titanium, zirconium and binary titanium-zirconium alloy dental implants: an in vitro study.

    Science.gov (United States)

    Smeets, Ralf; Schöllchen, Maximilian; Gauer, Tobias; Aarabi, Ghazal; Assaf, Alexandre T; Rendenbach, Carsten; Beck-Broichsitter, Benedicta; Semmusch, Jan; Sedlacik, Jan; Heiland, Max; Fiehler, Jens; Siemonsen, Susanne

    2017-02-01

    To analyze and evaluate imaging artefacts induced by zirconium, titanium and titanium-zirconium alloy dental implants. Zirconium, titanium and titanium-zirconium alloy implants were embedded in gelatin and MRI, CT and CBCT were performed. Standard protocols were used for each modality. For MRI, line-distance profiles were plotted to quantify the accuracy of size determination. For CT and CBCT, six shells surrounding the implant were defined every 0.5 cm from the implant surface and histogram parameters were determined for each shell. While titanium and titanium-zirconium alloy induced extensive signal voids in MRI owing to strong susceptibility, zirconium implants were clearly definable with only minor distortion artefacts. For titanium and titanium-zirconium alloy, the MR signal was attenuated up to 14.1 mm from the implant. In CT, titanium and titanium-zirconium alloy resulted in less streak artefacts in comparison with zirconium. In CBCT, titanium-zirconium alloy induced more severe artefacts than zirconium and titanium. MRI allows for an excellent image contrast and limited artefacts in patients with zirconium implants. CT and CBCT examinations are less affected by artefacts from titanium and titanium-zirconium alloy implants compared with MRI. The knowledge about differences of artefacts through different implant materials and image modalities might help support clinical decisions for the choice of implant material or imaging device in the clinical setting.

  9. Ion Implantation Studies of Titanium Metal Surfaces.

    Science.gov (United States)

    1981-01-01

    this peak for both titanium and vanadium . It cannot be associated with an inter-band excitation of any of the oxygen states since it appears in the...Half inch diameter polycrystalline rods of titanium monoxide (TiO), titanium dioxide (TiO 2 and titanium sesquioxide (Ti2 03 ) were obtained from

  10. Branemark Titanium Implant Sebagai Salah Satu Pilihan Implan Tipe Screw

    OpenAIRE

    Riniwaty

    2008-01-01

    Tujuan dari penulisan ini adalah untuk mengenalkan Branemark Titanium Implant sehingga dapat menjadi salah satu pilihan yang cukup baik dalam menggantikan gigi yang hilang dalam rongga mulut. Implan gigi mempakan suatu alat yang ditanam secara bedah ke dalam jaringan lunak atau ke dalam tulang rahang. Pada prinsipnya, implan gigi memerlukan bahan yang dapat diterima jaringan tubuh, cukup kuat dan dapat berfungsi bersama-sama dengan restorasi prostetik. Branemark Titanium Implant merup...

  11. Mechanical, chemical and biological aspects of titanium and titanium alloys in implant dentistry.

    Science.gov (United States)

    Ottria, L; Lauritano, D; Andreasi Bassi, M; Palmieri, A; Candotto, V; Tagliabue, A; Tettamanti, L

    2018-01-01

    Implant dentistry has become a popular restorative option in clinical practice. Titanium and titanium alloys are the gold standard for endo-osseus dental implants production, thanks to their biocompatibility, resistance to corrosion and mechanical properties. The characteristics of the titanium implant surface seem to be particularly relevant in the early phase of osseointegration. Furthermore, the microstructure of implant surface can largely influence the bone remodelling at the level of the bone-implant surface. Recently, research has stated on the long-term of both survival and success rates of osseointegrated implants and mainly on biomechanical aspects, such as load distribution and biochemical and histological processes at the bone-implant interface. This short review reports recent knowledge on chemical and mechanical properties, biological aspects, innovations in preventing peri-implantitis, describing clinical applications and recent improvements of titanium dental implants. In addition, it highlights current knowledge about a new implant coating that has been demonstrated to reduce the number of initially adhering bacteria and peri-implantitis.

  12. The biocompatibility of SLA-treated titanium implants

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyeongil [Restorative Dentistry, School of Dental Medicine, University at Buffalo, New York 14214 (United States); Choi, Seong-Ho [Department of Periodontology, Research Institiute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul 120-752 (Korea, Republic of); Ryu, Jae-Jun [Department of Prosthodontics, College of Medicine, Korea University, Seoul 136-701 (Korea, Republic of); Koh, Seung-Yong; Park, Ju-Han [Dentium Co. Ltd, Suwon 443-270 (Korea, Republic of); Lee, In-Seop [Institute of Physics and Applied Physics, and Atomic-Scale Surface Science Research Center, Yonsei University, Seoul 120-749 (Korea, Republic of)], E-mail: inseop@yonsei.ac.kr

    2008-06-01

    The titanium implant surface was sandblasted with large grits and acid etched (SLA) to increase the implant surface for osseointegration. The topography of the titanium surface was investigated with scanning electron microscopy (SEM) and a profilometer. The SLA implant demonstrated uniform small micro pits (1-2 {mu}m in diameter). The values of average roughness (R{sub a}) and maximum height (R{sub t}) were 1.19 {mu}m and 10.53 {mu}m respectively after sandblasting and the acid-etching treatment. In the cell-surface interaction study, the human osteoblast cells grew well in vitro. The in vivo evaluation of the SLA implant placed in rabbit tibia showed good bone-to-implant contact (BIC) with a mean value of 29% in total length of the implant. In the short-term clinical study, SLA implants demonstrated good clinical performance, maintaining good crestal bone height.

  13. The biocompatibility of SLA-treated titanium implants

    International Nuclear Information System (INIS)

    Kim, Hyeongil; Choi, Seong-Ho; Ryu, Jae-Jun; Koh, Seung-Yong; Park, Ju-Han; Lee, In-Seop

    2008-01-01

    The titanium implant surface was sandblasted with large grits and acid etched (SLA) to increase the implant surface for osseointegration. The topography of the titanium surface was investigated with scanning electron microscopy (SEM) and a profilometer. The SLA implant demonstrated uniform small micro pits (1-2 μm in diameter). The values of average roughness (R a ) and maximum height (R t ) were 1.19 μm and 10.53 μm respectively after sandblasting and the acid-etching treatment. In the cell-surface interaction study, the human osteoblast cells grew well in vitro. The in vivo evaluation of the SLA implant placed in rabbit tibia showed good bone-to-implant contact (BIC) with a mean value of 29% in total length of the implant. In the short-term clinical study, SLA implants demonstrated good clinical performance, maintaining good crestal bone height

  14. Anodisation Increases Integration of Unloaded Titanium Implants in Sheep Mandible

    Science.gov (United States)

    Duncan, Warwick J.; Lee, Min-Ho; Bae, Tae-Sung; Lee, Sook-Jeong; Gay, Jennifer; Loch, Carolina

    2015-01-01

    Spark discharge anodic oxidation forms porous TiO2 films on titanium implant surfaces. This increases surface roughness and concentration of calcium and phosphate ions and may enhance early osseointegration. To test this, forty 3.75 mm × 13 mm titanium implants (Megagen, Korea) were placed into healed mandibular postextraction ridges of 10 sheep. There were 10 implants per group: RBM surface (control), RBM + anodised, RBM + anodised + fluoride, and titanium alloy + anodised surface. Resonant frequency analysis (RFA) was measured in implant stability quotient (ISQ) at surgery and at sacrifice after 1-month unloaded healing. Mean bone-implant contact (% BIC) was measured in undemineralised ground sections for the best three consecutive threads. One of 40 implants showed evidence of failure. RFA differed between groups at surgery but not after 1 month. RFA values increased nonsignificantly for all implants after 1 month, except for controls. There was a marked difference in BIC after 1-month healing, with higher values for alloy implants, followed by anodised + fluoride and anodised implants. Anodisation increased early osseointegration of rough-surfaced implants by 50–80%. RFA testing lacked sufficient resolution to detect this improvement. Whether this gain in early bone-implant contact is clinically significant is the subject of future experiments. PMID:26436099

  15. Bone compaction enhances fixation of weightbearing titanium implants

    DEFF Research Database (Denmark)

    Kold, Søren Vedding; Rahbek, Ole; Vestermark, Marianne Toft

    2005-01-01

    Implant stability is crucial for implant survival. A new surgical technique, compaction, has increased in vitro implant stability and in vivo fixation of nonweightbearing implants. However, the in vivo effects of compaction on weightbearing implants are unknown. As implants inserted clinically...... are weightbearing, the effects of compaction on weightbearing implants were examined. The hypothesis was that compaction would increase implant fixation compared with conventional drilling. Porous-coated titanium implants were inserted bilaterally into the weightbearing portion of the femoral condyles of dogs....... In each dog, one knee had the implant cavity prepared with drilling, and the other knee was prepared with compaction. Eight dogs were euthanized after 2 weeks, and eight dogs were euthanized after 4 weeks. Femoral condyles from an additional eight dogs represented Time 0. Compacted specimens had higher...

  16. Assessment of modified gold surfaced titanium implants on skeletal fixation

    DEFF Research Database (Denmark)

    Zainali, Kasra; Danscher, Gorm; Jakobsen, Thomas

    2013-01-01

    shown to liberate gold ions through the process termed dissolucytosis. Furthermore, gold ions are known to act in an anti-inflammatory manner by inhibiting cellular NF-κB-DNA binding. The present study investigated whether partial coating of titanium implants could augment early osseointegration...... osseointegration compared to control titanium implants in a similar model. Since sufficient early mechanical fixation is achieved with this new coating, it is reasonable to investigate the implant further in long-term studies. © 2012 Wiley Periodicals, Inc....

  17. A Simplified Technique for Orientation of a Bone Anchored Auricular Prostheses: a Clinical Report

    Directory of Open Access Journals (Sweden)

    Hussein G. El Charkawi

    2012-08-01

    Full Text Available Background: A simple technique was presented in this clinical report for orientation of a bone anchored auricular prosthesis.Methods: The proposed technique includes drawing the intact ear on a transparent celluloid paper or radiographic film and flipping it to the opposite side and relating it to the fixed anatomical features on the face of patient.Results: The drawing, by this way provides a simple and easy way to duplicate and transfer the exact size and position of the intact ear to the defect side.Conclusions: This technique provides a simple, safe, inexpensive and time saving yet, an accurate and effective surgical template that orients the craniofacial implants to the confines of the definitive auricular prosthesis. It is indicated for restoration of single missing external ear either in aplasia, injuries and total resection.

  18. Subdural Hematoma: A Rare Adverse Complication From Bone-Anchored Hearing Aid Placement.

    Science.gov (United States)

    Amin, Nikul; Aymat-Torrente, Antonio

    2017-03-01

    Bone-anchored hearing aids (BAHA) are bone conduction hearing aids commonly implantated by Ear, Nose, and Throat surgeons. We present the first documented case of a subdural hematoma secondary to primary fixation of a BAHA. We present a 65-year-old male patient undergoing a left sided BAHA for bilateral chronic ear infections and difficulty wearing conventional hearing aids. The procedure was uneventful, however, the patient developed a postoperative large acute left temporoparietal intracerebral hematoma associated with an ipsilateral acute subdural hematoma. This required emergency transfer to the local tertiary neurosurgical center for a left decompressive craniotomy and evacuation of the hematoma. The patient required a prolonged stay on an intensive care unit and was eventually discharged to the community for on-going neurological rehabilitation. This is a rare and devastating complication BAHA surgery. Otologist, general ENT surgeons, and neurosurgeons should be aware of this life-threatening complication of BAHA surgery.

  19. [Self-rated efficacy in bilateral aural atresia patients using bone-anchored hearing aid].

    Science.gov (United States)

    Yue, Fan; Yibei, Wang; Zhen, Wang; Pu, Wang; Xiaowei, Chen

    2015-03-01

    Using questionnaires to evaluate the audiological benefit and satisfaction of bilateral aural atresia patients with bone-anchored hearing aid (Baha). Implanted Baha user questionnaire was applied to 19 patients suffering bilateral aural atresia, and 15 of the patients were evaluated with abbreviated profile of hearing aid benefit (APHAB). Glasgow children's benefit inventory (GCBI) was used to measure subjective benefit of patients under the age of 18. The Baha user questionnaire demonstrated great satisfaction. The mean Baha scores for the subdomains of ease of communication (EC), backgroud noise (BN) and revereration (RV) were decreased by 54.6 ± 10.2 (t = 20.6, P hearing ability and quality of life of patients with bilateral aural atresia.

  20. Osseointegration of titanium, titanium alloy and zirconia dental implants: current knowledge and open questions.

    Science.gov (United States)

    Bosshardt, Dieter D; Chappuis, Vivianne; Buser, Daniel

    2017-02-01

    Bone healing around dental implants follows the pattern and sequence of intramembraneous osteogenesis with formation of woven bone first of all followed later by formation of parallel-fibered and lamellar bone. Bone apposition onto the implant surface starts earlier in trabecular bone than in compact bone. While the first new bone may be found on the implant surface around 1 week after installation, bone remodeling starts at between 6 and 12 weeks and continues throughout life. Bone remodeling also involves the bone-implant interface, thus transiently exposing portions of the implant surface. Surface modifications creating micro-rough implant surfaces accelerate the osseointegration process of titanium implants, as demonstrated in numerous animal experiments. Sandblasting followed by acid-etching may currently be regarded as the gold standard technique to create micro-rough surfaces. Chemical surface modifications, resulting in higher hydrophilicity, further increase the speed of osseointegration of titanium and titanium-zirconium implants in both animals and humans. Surface modifications of zirconia and alumina-toughened zirconia implants also have an influence on the speed of osseointegration, and some implant types reach high bone-to-implant contact values in animals. Although often discussed independently of each other, surface characteristics, such as topography and chemistry, are virtually inseparable. Contemporary, well-documented implant systems with micro-rough implant surfaces, placed by properly trained and experienced clinicians, demonstrate high long-term survival rates. Nevertheless, implant failures do occur. A low percentage of implants are diagnosed with peri-implantitis after 10 years in function. In addition, a low number of implants seem to be lost for primarily reasons other than biofilm-induced infection. Patient factors, such as medications interfering with the immune system and bone cells, may be an element contributing to continuous bone

  1. Benefit and quality of life in older bone-anchored hearing aid users.

    Science.gov (United States)

    de Wolf, Maarten J F; Shival, My-Linh C; Hol, Myrthe K S; Mylanus, Emmanuel A M; Cremers, Cor W R J; Snik, Ad F M

    2010-07-01

    Benefit and quality-of-life analysis in the older adult bone-anchored hearing aid (BAHA) users. Retrospective evaluation. Four questionnaires (Glasgow Benefit Inventory, Abbreviated Profile of Hearing Aid Benefit [APHAB], Nijmegen Cochlear Implant Questionnaire [NCIQ], and the Hearing Handicap Inventory for the Elderly screening version [HHIE-S]) were used. The response rate was 80%, mean age was 75 years (range, 62-93 yr), and mean pure-tone average at frequencies of 500, 1,000, 2,000, and 4,000 Hz for bone conduction was 42 +/- 13 dBHL. More than 80% of the patients were using their BAHA for more than 8 hours a day. To obtain a "snapshot" of current BAHA use, the NCIQ, HHIE-S, and the APHAB were used. The NCIQ showed good disability and handicap results (score range, 49-64). The HHIE-S showed that 60% of the patients had a mild to moderate handicap. The APHAB aided scores ranged from 39 to 58%. Mean benefit scores of the Glasgow Benefit Inventory were positive in 112 of the 134 patients (84%). The APHAB showed clinically significantly more benefit with the BAHA than with the previous aided or unaided situation. A trend could be seen-the higher the pure-tone average at frequencies of 500, 1,000, 2,000, and 4,000 Hz for bone conduction, the smaller the mean benefit scores on the questionnaires. Bone-anchored hearing aid users aged 60 years or older were able to place and handle the device very adequately and clean the skin around the implant. Most patients reported comparable or increased general benefit and good quality of life with the BAHA.

  2. Surface Functionalization of Orthopedic Titanium Implants with Bone Sialoprotein.

    Directory of Open Access Journals (Sweden)

    Andreas Baranowski

    Full Text Available Orthopedic implant failure due to aseptic loosening and mechanical instability remains a major problem in total joint replacement. Improving osseointegration at the bone-implant interface may reduce micromotion and loosening. Bone sialoprotein (BSP has been shown to enhance bone formation when coated onto titanium femoral implants and in rat calvarial defect models. However, the most appropriate method of BSP coating, the necessary level of BSP coating, and the effect of BSP coating on cell behavior remain largely unknown. In this study, BSP was covalently coupled to titanium surfaces via an aminosilane linker (APTES, and its properties were compared to BSP applied to titanium via physisorption and untreated titanium. Cell functions were examined using primary human osteoblasts (hOBs and L929 mouse fibroblasts. Gene expression of specific bone turnover markers at the RNA level was detected at different intervals. Cell adhesion to titanium surfaces treated with BSP via physisorption was not significantly different from that of untreated titanium at any time point, whereas BSP application via covalent coupling caused reduced cell adhesion during the first few hours in culture. Cell migration was increased on titanium disks that were treated with higher concentrations of BSP solution, independent of the coating method. During the early phases of hOB proliferation, a suppressive effect of BSP was observed independent of its concentration, particularly when BSP was applied to the titanium surface via physisorption. Although alkaline phosphatase activity was reduced in the BSP-coated titanium groups after 4 days in culture, increased calcium deposition was observed after 21 days. In particular, the gene expression level of RUNX2 was upregulated by BSP. The increase in calcium deposition and the stimulation of cell differentiation induced by BSP highlight its potential as a surface modifier that could enhance the osseointegration of orthopedic implants

  3. Auditory brainstem and cortical potentials following bone-anchored hearing aid stimulation.

    Science.gov (United States)

    Rahne, Torsten; Ehelebe, Thomas; Rasinski, Christine; Götze, Gerrit

    2010-11-30

    Patients suffering from conductive or mixed hearing loss and Single-Sided Deafness may benefit from implantable hearing devices relying on bone conducted auditory stimulation. However, with only passively cooperative patients, objective methods are needed to estimate the aided and unaided pure-tone audiogram. This study focuses on the feasibility aspect of an electrophysiological determination of the hearing thresholds with bone-anchored hearing aid stimulation. Therefore, 10 normal-hearing subjects were provided with a Baha Intenso (Cochlear Ltd.) which was temporarily connected to the Baha Softband (Cochlear Ltd.). Auditory evoked potentials were measured by auditory stimulation paradigm used in clinical routine. The amplitudes, latencies, and thresholds of the resulting auditory brainstem responses (ABR) and the cortically evoked responses (CAEP) were correlated with the respective responses without the use of the Baha Intenso. The recording of ABR and CAEP by delivering the stimuli to the Baha results in response waveforms which are comparable to those evoked by earphone stimulation and appears appropriate to be measured using the Baha Intenso as stimulator. At the ABR recordings a stimulus artifact at higher stimulation levels and a constant latency shift caused by the Baha Intenso has to be considered. The CAEP recording appeared promising as a frequency specific objective method to approve the fitting of bone-anchored hearing aids. At all measurements, the ABR and CAEP thresholds seem to be consistent with the normal hearing of the investigated participants. Thus, a recording of auditory evoked potentials using a Baha is in general possible if specific limitations are considered. Copyright © 2010 Elsevier B.V. All rights reserved.

  4. Rehabilitation in Franceschetti syndrome: an interdisciplinary approach using bone-anchored hearing aids.

    Science.gov (United States)

    Reuter, W F; Marks, C; Jovanovic, S; Gross, M

    1997-06-01

    The purpose of the study was to determine the effectiveness of a concept of combined interdisciplinary rehabilitation for children with mandibulofacial dysostosis, developed at the Center for Facial Malformations. It consists of binaural implantation of bone-anchored hearing aids and gradual distraction of the mandible. After audiological testing and mandibular distraction on a phantom head designed with data from a spiral CT, the surgery was done in three steps: implanting the fixtures for BAHA and the bone-lengthening device, removing the device after six weeks and completing the BAHA implantation two months later. The distraction procedure and orthodontic treatment were performed on an outpatient basis. The results (six patients, ages 6-19 years) were excellent: after implantation of the BAHA system speech perception increased from approximately 85% with the conventional BCHA to 95-100% with the BAHA. Quality of life was reported to be much better because of the general cosmetic improvement as well as the good acoustic orientation and sound quality with the new hearing devices. We conclude that the interdisciplinary approach provides favorable conditions for rehabilitation in cases of complex malformations of the head and neck.

  5. Clinical determination of target registration error of an image-guided otologic surgical system using patients with bone-anchored hearing aids

    Science.gov (United States)

    Balachandran, Ramya; Labadie, Robert F.; Fitzpatrick, J. Michael

    2007-03-01

    Image guidance in otologic surgery has been thwarted by the need for a non-invasive fiducial system with target registration error (TRE) at the inner ear below 1.5mm. We previously presented a fiducial frame for this purpose that attaches to the upper dentition via patient-specific bite blocks and demonstrated a TRE of 0.73mm (+/-0.23mm) on cadaveric skulls. In that study, TRE measurement depended upon placement of bone-implanted, intracranial target fiducials-clearly impossible to repeat clinically. Using cadaveric specimens, we recently presented a validation method based on an auditory implant system (BAHA System® Cochlear Corp., Denver, CO). That system requires a skull-implanted titanium screw behind the ear upon which a bone-anchored hearing aid (BAHA) is mounted. In our validation, we replace the BAHA with a fiducial marker to permit measurement of TRE. That TRE is then used to estimate TRE at an internal point. While the method can be used to determine accuracy at any point within the head, we focus in this study on the inner ear, in particular the cochlea, and we apply the method to patients (N=5). Physical localizations were performed after varying elapsed times since bite-block fabrication, and TRE at the cochlea was estimated. We found TRE to be 0.97mm at the cochlea within one month and 2.5mm after seven months. Thus, while accuracy deteriorates considerably with delays of seven months or more, if this frame is used within one month of the fabrication of the bite-block, it achieves the goal and in fact exhibits submillimetric accuracy.

  6. Thin hydroxyapatite surface layers on titanium produced by ion implantation

    CERN Document Server

    Baumann, H; Bilger, G; Jones, D; Symietz, I

    2002-01-01

    In medicine metallic implants are widely used as hip replacement protheses or artificial teeth. The biocompatibility is in all cases the most important requirement. Hydroxyapatite (HAp) is frequently used as coating on metallic implants because of its high acceptance by the human body. In this paper a process is described by which a HAp surface layer is produced by ion implantation with a continuous transition to the bulk material. Calcium and phosphorus ions are successively implanted into titanium under different vacuum conditions by backfilling oxygen into the implantation chamber. Afterwards the implanted samples are thermally treated. The elemental composition inside the implanted region was determined by nuclear analysis methods as (alpha,alpha) backscattering and the resonant nuclear reaction sup 1 H( sup 1 sup 5 N,alpha gamma) sup 1 sup 2 C. The results of X-ray photoelectron spectroscopy indicate the formation of HAp. In addition a first biocompatibility test was performed to compare the growing of m...

  7. Osteoconductivity of hydrophilic microstructured titanium implants with phosphate ion chemistry.

    Science.gov (United States)

    Park, Jin-Woo; Jang, Je-Hee; Lee, Chong Soo; Hanawa, Takao

    2009-07-01

    This study investigated the surface characteristics and bone response of titanium implants produced by hydrothermal treatment using H(3)PO(4), and compared them with those of implants produced by commercial surface treatment methods - machining, acid etching, grit blasting, grit blasting/acid etching or spark anodization. The surface characteristics were evaluated by scanning electron microscopy, thin-film X-ray diffractometry, X-ray photoelectron spectroscopy, contact angle measurement and stylus profilometry. The osteoconductivity of experimental implants was evaluated by removal torque testing and histomorphometric analysis after 6 weeks of implantation in rabbit tibiae. Hydrothermal treatment with H(3)PO(4) and subsequent heat treatment produced a crystalline phosphate ion-incorporated oxide (titanium oxide phosphate hydrate, Ti(2)O(PO(4))(2)(H(2)O)(2); TiP) surface approximately 5microm in thickness, which had needle-like surface microstructures and superior wettability compared with the control surfaces. Significant increases in removal torque forces and bone-to-implant contact values were observed for TiP implants compared with those of the control implants (p<0.001). After thorough cleaning of the implants removed during the removal torque testing, a considerable quantity of attached bone was observed on the surfaces of the TiP implants.

  8. Multicycle mechanical performance of titanium and stainless steel transpedicular spine implants.

    Science.gov (United States)

    Pienkowski, D; Stephens, G C; Doers, T M; Hamilton, D M

    1998-04-01

    This was a prospective in vitro study comparing titanium alloy and stainless steel alloy in transpedicular spine implants from two different manufactures. To compare the multicycle mechanical performance of these two alloys, used in each of two different implant designs. Transpedicular spine implants primarily have been manufactured from stainless steel, but titanium alloy offers imaging advantages. However, the notch sensitivity of titanium alloy has caused concern regarding how implants made from this material will compare in stiffness and fatigue life with implants made from stainless steel. Twenty-four implants (two alloys, two designs, six implants per group) were mounted in machined polyethylene wafers and repetitively loaded (up to 1 million cycles) from 80 N to 800 N using a 5-Hertz sinusoidal waveform. Load and displacement data were automatically and periodically sampled throughout the entire test. Implant stiffness increased with cycle load number, reached a steady state, then declined just before fatigue failure. Stiffness varied less in titanium transpedicular spine implants than in their stainless counterparts. All stainless steel implant types were stiffer (steady-state value, P titanium alloy counterparts. One titanium implant design failed with fewer (P stainless steel counterpart, whereas a stainless steel implant of another design failed with fewer (P titanium counterpart. Overall, fatigue life, i.e., the total number of load cycles until failure, was related to implant type (P implant material. A transpedicular spine implant's fatigue lifetime depends on both the design and the material and cannot be judged on material alone. Stainless steel implants are stiffer than titanium alloy implants of equal design and size; however, for those designs in which the fatigue life of the titanium alloy version is superior, enlargement of the implant's components can compensate for titanium's lower modulus of elasticity and result in an implant equally stiff

  9. Antibacterial and Bioactive Coatings on Titanium Implant Surfaces

    OpenAIRE

    Aranya, Anupama Kulkarni; Pushalkar, Smruti; Zhao, Minglei; LeGeros, Racquel Z.; Zhang, Yu; Saxena, Deepak

    2017-01-01

    Various surface modifications have been tried for enhancing osseointegration of the dental implants like mechanical and/or chemical treatments and deposition of calcium phosphate coatings. The objective of this research was to develop calcium-phosphate based thin coatings with antibacterial and bioactive properties for potential application in dental implants. Titanium (Ti) discs were immersed in different calcifying solutions: CaP (positive control), F-CaP, Zn-CaP and FZn-CaP and incubated f...

  10. Innovation in abutment-free bone-anchored hearing devices in children: Updated results and experience.

    Science.gov (United States)

    Baker, Shaun; Centric, Aaron; Chennupati, Sri Kiran

    2015-10-01

    Bone-anchored hearing devices are an accepted treatment option for hearing restoration in various types of hearing loss. Traditional devices have a percutaneous abutment for attachment of the sound processor that contributes to a high complication rate. Previously, our institution reported on the Sophono (Boulder, CO, USA) abutment-free system that produced similar audiologic results to devices with abutments. Recently, Cochlear Americas (Centennial, CO, USA) released an abutment-free bone-anchored hearing device, the BAHA Attract. In contrast to the Sophono implant, the BAHA Attract utilizes an osseointegrated implant. This study aims to demonstrate patient benefit abutment-free devices, compare the results of the two abutment-free devices, and examine complication rates. A retrospective chart review was conducted for the first eleven Sophono implanted patients and for the first six patients implanted with the BAHA Attract at our institution. Subsequently, we analyzed patient demographics, audiometric data, clinical course and outcomes. Average improvement for the BAHA Attract in pure-tone average (PTA) and speech reception threshold (SRT) was 41dB hearing level (dBHL) and 56dBHL, respectively. Considering all frequencies, the BAHA Attract mean improvement was 39dBHL (range 32-45dBHL). The Sophono average improvement in PTA and SRT was 38dBHL and 39dBHL, respectively. The mean improvement with Sophono for all frequencies was 34dBHL (range 24-43dBHL). Significant improvements in both pure-tone averages and speech reception threshold for both devices were achieved. In direct comparison of the two separate devices using the chi-square test, the PTA and SRT data between the two devices do not show a statistically significant difference (p-value 0.68 and 0.56, respectively). The complication rate for these abutment-free devices is lower than that of those featuring the transcutaneous abutment, although more studies are needed to further assess this potential advantage

  11. Inhomogeneity of deformed state during compression testing of titanium implant

    Directory of Open Access Journals (Sweden)

    Loginov Yury

    2017-01-01

    Full Text Available This study examines the inhomogeneity of deformed state during compression testing of porous titanium implant. The theoretical part of the article includes numerical simulation of deformation of a prismatic titanium sample compressed with absolutely rigid plates. The porosity was provided by the circular shape pores with titanium struts between them. To solve the problem by means of the finite element analysis, the boundary conditions were set using the ABAQUS software. The fields of strain, stresses and displacements were determined. Presumable place of fracture coincide with the highest values of strain which are localized in vertical struts. Physical modeling of the implant compression was performed at the second part of the study on the testing machine with video recording. It was shown that in the real process the localization of failure corresponds to the calculated data.

  12. Microhardness of boron, titanium, and nitrogen implanted steel

    International Nuclear Information System (INIS)

    Sowa, M.; Szyszko, W.; Sielanko, J.; Glusiec, L.

    1989-01-01

    Mechanically polished steel (1H18N9T) and (15GTM) samples are implanted with boron, titanium, and nitrogen ions, with dose ranging from 10 16 to 10 17 ions/cm 2 . The implantation energy varied from 100 to 250 keV. Implanted samples are heat-treated at 400 to 800 0 C in vacuum. The microhardness of implanted samples is measured by using a Hanneman tester with loads ranging from 2 to 40 g. The influence of annealing temperature on microhardness of the implanted layers is determined. The diffusion of boron from the implanted layers is also investigated by using the secondary ion mass spectrometer. The diffusion coefficients of boron in steel are determined. (author)

  13. Patient satisfaction and aesthetic outcomes after ear reconstruction with a Branemark-type, bone-anchored, ear prosthesis: a 16 year review.

    Science.gov (United States)

    Younis, Ibby; Gault, David; Sabbagh, Walid; Kang, Norbert V

    2010-10-01

    Reconstruction of the human ear with a bone-anchored prosthesis is a widely accepted alternative when autologous reconstruction is technically impossible or declined by the individual. However, there are relatively few data in the literature documenting patient satisfaction with this form of reconstruction. This study examines different aspects of patient satisfaction using an eighteen-point postal questionnaire to measure patient outcomes against a Likert rating scale. The questionnaire was sent to 33 patients who completed prosthetic ear reconstruction over a 16 year period at a specialist plastic surgery unit in the United Kingdom. Medical case notes for these cases were also reviewed. Twenty completed questionnaires were returned. The response rate was 61%. The majority of patients were satisfied with the aesthetics, ease of handling and comfort of the bone-anchored implant and prosthesis. However, the majority of patients was only moderately satisfied or was dissatisfied with this method of reconstruction. Specifically, 15 of the respondents reported skin problems around the abutments of the bone-anchored implant with 10 patients reporting ongoing skin complications. Granulation tissue was the most common skin problem (12 cases) followed by local infection (10 cases). Interestingly, despite the chronic skin problems, most patients indicated that they would undergo the same procedure again or would recommend it to others. Our survey shows that patients fitted with a Branemark-type bone-anchored implant for ear reconstruction are pleased with the aesthetic appearance but experience multiple, chronic, skin complications and other implant related problems. These affect their satisfaction with this method of reconstruction. Our findings may have significant implications for patients and surgeons considering this form of reconstruction and for the institutions making decisions about funding this treatment. Copyright 2009. Published by Elsevier Ltd.

  14. Synthesis of embedded titanium dioxide nanoparticles by oxygen ion implantation in titanium films

    Science.gov (United States)

    Rukade, Deepti. A.; Desai, C. A.; Kulkarni, Nilesh; Tribedi, L. C.; Bhattacharyya, Varsha

    2013-02-01

    Thin films of titanium of 100nm thickness are deposited on fused silica substrates. These films are implanted by oxygen ions with implantation energy of 60keV obtained from ECR based highly charged ion accelerator. The implanted films are later annealed in a tube furnace to establish nanophase formation. The post implanted annealed films are characterized by UV-Visible Spectroscopy and Glancing Angle X-ray Diffraction technique (GAXRD). The phase formed and particle size is determined by GAXRD. Nanoparticle formation is confirmed by the UV-VIS spectroscopic analysis that shows quantum size effects in the form of a blue shift in the band-gap energy of titanium-oxide.

  15. Surface characterization of titanium based dental implants; Caracterizacao de implantes odontologicos a base de titanio

    Energy Technology Data Exchange (ETDEWEB)

    Castilho, Guilherme Augusto Alcaraz

    2006-07-01

    Dental implantology uses metallic devices made of commercially pure titanium in order to replace lost teeth. Titanium presents favorable characteristics as bio material and modern implants are capable of integrate, witch is the union between bone and implant without fibrous tissue development. Three of the major Brazilian implant manufacturers were chosen to join the study. A foreign manufacturer participated as standard. The manufacturers had three specimens of each implant with two different surface finishing, as machined and porous, submitted to analysis. Surface chemical composition and implant morphology were analyzed by X-ray photoelectron spectroscopy (XP S), scanning electron microscopy (SEM) and microprobe. Implant surface is mainly composed of titanium, oxygen and carbon. Few contaminants commonly present on implant surface were found on samples. Superficial oxide layer is basically composed of titanium dioxide (TiO{sub 2}), another oxides as Ti O and Ti{sub 2}O{sub 3} were also found in small amount. Carbon on implant surface was attributed to manufacturing process. Nitrogen, Phosphorous and Silicon appeared in smaller concentration on surface. There was no surface discrepancy among foreign and Brazilian made implants. SEM images were made on different magnification, 35 X to 3500 X, and showed similarity among as machined implants. Porous surface finishing implants presented distinct morphology. This result was attributed to differences on manufacturing process. Implant bioactivity was accessed through immersion on simulated body solution (SBF) in order to verify formation of an hydroxyapatite (HA) layer on surface. Samples were divided on three groups according to immersion time: G1 (7 days), G2 (14 days), G3 (21 days), and deep in SBF solution at 37 deg C. After being removed from solution, XPS analyses were made and then implants have been submitted to microprobe analysis. XPS showed some components of SBF solution on sample surface but microprobe

  16. Titanium

    Science.gov (United States)

    Woodruff, Laurel G.; Bedinger, George M.; Piatak, Nadine M.; Schulz, Klaus J.; DeYoung,, John H.; Seal, Robert R.; Bradley, Dwight C.

    2017-12-19

    Titanium is a mineral commodity that is essential to the smooth functioning of modern industrial economies. Most of the titanium produced is refined into titanium dioxide, which has a high refractive index and is thus able to impart a durable white color to paint, paper, plastic, rubber, and wallboard. Because of their high strength-to-weight ratio and corrosion resistance, titanium metal and titanium metal alloys are used in the aerospace industry as well as for welding rod coatings, biological implants, and consumer goods.Ilmenite and rutile are currently the principal titanium-bearing ore minerals, although other minerals, including anatase, perovskite, and titanomagnetite, could have economic importance in the future. Ilmenite is currently being mined from two large magmatic deposits hosted in rocks of Proterozoic-age anorthosite plutonic suites. Most rutile and nearly one-half of the ilmenite produced are from heavy-mineral alluvial, fluvial, and eolian deposits. Titanium-bearing minerals occur in diverse geologic settings, but many of the known deposits are currently subeconomic for titanium because of complications related to the mineralogy or because of the presence of trace contaminants that can compromise the pigment production process.Global production of titanium minerals is currently dominated by Australia, Canada, Norway, and South Africa; additional amounts are produced in Brazil, India, Madagascar, Mozambique, Sierra Leone, and Sri Lanka. The United States accounts for about 4 percent of the total world production of titanium minerals and is heavily dependent on imports of titanium mineral concentrates to meet its domestic needs.Titanium occurs only in silicate or oxide minerals and never in sulfide minerals. Environmental considerations for titanium mining are related to waste rock disposal and the impact of trace constituents on water quality. Because titanium is generally inert in the environment, human health risks from titanium and titanium

  17. Fibronectin-Grafted Titanium Dental Implants: An In Vivo Study

    Directory of Open Access Journals (Sweden)

    Yu-Chi Chang

    2016-01-01

    Full Text Available Modification of the physiochemical properties of titanium surfaces using glow discharge plasma (GDP and fibronectin coating has been shown to enhance the surface hydrophilicity, surface roughness, cell adhesion, migration, and proliferation. This in vivo study aimed to evaluate the bone integration efficacy of a biologically modified implant surface. Two different surface-modified implants (Ar-GDP and GDP-fib were placed in the mandibular premolar area of six beagle dogs for 2–8 weeks. Three techniques [histologic evaluation, resonance frequency analysis (RFA, and microcomputed tomography (micro-CT evaluation] were used to detect the implant stability and bone-implant contact. The implant stability quotient values of GDP-fib implants were significantly greater than the Ar-GDP implants at 2 and 4 weeks (P<0.01. The bone volume/total volume ratio of GDP-fib implants was greater than the Ar-GDP implants in micro-CT evaluation. A high positive correlation was observed between RFA and micro-CT measurements. At 2 weeks, osteoblasts were seen to line the implant surface, and multinuclear osteoclasts could be seen on the surface of old parent bone. After 8 weeks, a majority of the space in the wound chamber appeared to be replaced by bone. Enhancement of the stability of biologically modified implants was proved by the results of RFA, micro-CT, and histological analysis. This enhanced stability may help fasten treatment and be clinically beneficial.

  18. Dynamic sterilization of titanium implants with ultraviolet light

    International Nuclear Information System (INIS)

    Singh, S.; Schaaf, N.G.

    1989-01-01

    All implantable devices must be sterile. However, autoclaves produce poor surface properties that jeopardize the integration process. The application of a modified ultraviolet light source has proven to enhance bioreactivity by controlling surface properties, but it lacks validation of its sterilization capabilities. Forty-eight titanium implants were contaminated with spores of the biological indicator Bacillus stearothermophilus and subjected to dynamic sterilization by ultraviolet light. Forty-seven of the implants were successfully sterilized, as indicated by not producing turbidity in a suitable growth medium. This sterilization technique only requires a 20-second exposure to achieve sterility

  19. Ion implantation induced nanotopography on titanium and bone cell adhesion

    Energy Technology Data Exchange (ETDEWEB)

    Braceras, Iñigo, E-mail: inigo.braceras@tecnalia.com [Tecnalia, Mikeletegi Pasealekua 2, 20009 Donostia-San Sebastian (Spain); CIBER de Bioingeniería, Biomateriales y Nanomedicina (Ciber-BBN) (Spain); Vera, Carolina; Ayerdi-Izquierdo, Ana [Tecnalia, Mikeletegi Pasealekua 2, 20009 Donostia-San Sebastian (Spain); CIBER de Bioingeniería, Biomateriales y Nanomedicina (Ciber-BBN) (Spain); Muñoz, Roberto [Tecnalia, Mikeletegi Pasealekua 2, 20009 Donostia-San Sebastian (Spain); Lorenzo, Jaione; Alvarez, Noelia [Tecnalia, Mikeletegi Pasealekua 2, 20009 Donostia-San Sebastian (Spain); CIBER de Bioingeniería, Biomateriales y Nanomedicina (Ciber-BBN) (Spain); Maeztu, Miguel Ángel de [Private Practice, P° San Francisco, 43 A-1°, 20400 Tolosa (Spain)

    2014-08-15

    Graphical abstract: Titanium surfaces modified by inert ion implantation affect cell adhesion through modification of the nanotopography in the same dimensional range of that of human bone inorganic phases. - Highlights: • Inert ion implantation on Ti modifies surface nanotopography and bone cell adhesion. • Ion implantation can produce nanostructured surfaces on titanium in the very same range as of those of the mineral phase of the human bone. • Appropriate tool for studying the relevance of nanostructured surfaces on bone mineralization and implant osseointegration. • Ion implantation induced nanotopography have a statistically significant influence on bone cell adhesion. - Abstract: Permanent endo-osseous implants require a fast, reliable and consistent osseointegration, i.e. intimate bonding between bone and implant, so biomechanical loads can be safely transferred. Among the parameters that affect this process, it is widely admitted that implant surface topography, surface energy and composition play an important role. Most surface treatments to improve osseointegration focus on micro-scale features, as few can effectively control the effects of the treatment at nanoscale. On the other hand, ion implantation allows controlling such nanofeatures. This study has investigated the nanotopography of titanium, as induced by different ion implantation surface treatments, its similarity with human bone tissue structure and its effect on human bone cell adhesion, as a first step in the process of osseointegration. The effect of ion implantation treatment parameters such as energy (40–80 keV), fluence (1–2 e17 ion/cm{sup 2}) and ion species (Kr, Ar, Ne and Xe) on the nanotopography of medical grade titanium has been measured and assessed by AFM and contact angle. Then, in vitro tests have been performed to assess the effect of these nanotopographies on osteoblast adhesion. The results have shown that the nanostructure of bone and the studied ion implanted

  20. Ion implantation induced nanotopography on titanium and bone cell adhesion

    International Nuclear Information System (INIS)

    Braceras, Iñigo; Vera, Carolina; Ayerdi-Izquierdo, Ana; Muñoz, Roberto; Lorenzo, Jaione; Alvarez, Noelia; Maeztu, Miguel Ángel de

    2014-01-01

    Graphical abstract: Titanium surfaces modified by inert ion implantation affect cell adhesion through modification of the nanotopography in the same dimensional range of that of human bone inorganic phases. - Highlights: • Inert ion implantation on Ti modifies surface nanotopography and bone cell adhesion. • Ion implantation can produce nanostructured surfaces on titanium in the very same range as of those of the mineral phase of the human bone. • Appropriate tool for studying the relevance of nanostructured surfaces on bone mineralization and implant osseointegration. • Ion implantation induced nanotopography have a statistically significant influence on bone cell adhesion. - Abstract: Permanent endo-osseous implants require a fast, reliable and consistent osseointegration, i.e. intimate bonding between bone and implant, so biomechanical loads can be safely transferred. Among the parameters that affect this process, it is widely admitted that implant surface topography, surface energy and composition play an important role. Most surface treatments to improve osseointegration focus on micro-scale features, as few can effectively control the effects of the treatment at nanoscale. On the other hand, ion implantation allows controlling such nanofeatures. This study has investigated the nanotopography of titanium, as induced by different ion implantation surface treatments, its similarity with human bone tissue structure and its effect on human bone cell adhesion, as a first step in the process of osseointegration. The effect of ion implantation treatment parameters such as energy (40–80 keV), fluence (1–2 e17 ion/cm 2 ) and ion species (Kr, Ar, Ne and Xe) on the nanotopography of medical grade titanium has been measured and assessed by AFM and contact angle. Then, in vitro tests have been performed to assess the effect of these nanotopographies on osteoblast adhesion. The results have shown that the nanostructure of bone and the studied ion implanted

  1. Nanotubular topography enhances the bioactivity of titanium implants.

    Science.gov (United States)

    Huang, Jingyan; Zhang, Xinchun; Yan, Wangxiang; Chen, Zhipei; Shuai, Xintao; Wang, Anxun; Wang, Yan

    2017-08-01

    Surface modification on titanium implants plays an important role in promoting mesenchymal stem cell (MSC) response to enhance osseointegration persistently. In this study, nano-scale TiO 2 nanotube topography (TNT), micro-scale sand blasted-acid etched topography (SLA), and hybrid sand blasted-acid etched/nanotube topography (SLA/TNT) were fabricated on the surfaces of titanium implants. Although the initial cell adherence at 60 min among TNT, SLA and TNT/SLA was not different, SLA and SLA/TNT presented to be rougher and suppressed the proliferation of MSC. TNT showed hydrophilic surface and balanced promotion of cellular functions. After being implanted in rabbit femur models, TNT displayed the best osteogenesis inducing ability as well as strong bonding strength to the substrate. These results indicate that nano-scale TNT provides favorable surface topography for improving the clinical performance of endosseous implants compared with micro and hybrid micro/nano surfaces, suggesting a promising and reliable surface modification strategy of titanium implants for clinical application. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Porous Structure Characterization in Titanium Coating for Surgical Implants

    Directory of Open Access Journals (Sweden)

    M.V. Oliveira

    2002-09-01

    Full Text Available Powder metallurgy techniques have been used to produce controlled porous structures, such as the porous coatings applied for dental and orthopedic surgical implants, which allow bony tissue ingrowth within the implant surface improving fixation. This work presents the processing and characterization of titanium porous coatings of different porosity levels, processed through powder metallurgy techniques. Pure titanium sponge powders were used for coating and Ti-6Al7Nb powder metallurgy rods were used as substrates. Characterization was made through quantitative metallographic image analysis using optical light microscope for coating porosity data and SEM analysis for evaluation of the coating/substrate interface integrity. The results allowed optimization of the processing parameters in order to obtain porous coatings that meet the requirements for use as implants.

  3. [Micro-porous titanium implants in orthognathic facial recontouring].

    Science.gov (United States)

    Charrier, Jean-Baptiste; Moreau, Nathan

    2016-09-01

    Facial symmetry has always been a longstanding objective of orthognathic surgery. Patients that present significant facial asymmetry desire functional dental occlusion but also seek to enhance their facial esthetics. In that regard, different surgical techniques have been proposed to enhance facial recontouring. Through a clinical case report and a literature review, this article explores the use of allopastic microporous titanium implants in volumetric corrections of the face. There is a current lack of evidence regarding the use of microporous titanium implants in volumetric corrections of the face, most papers reporting their use in post-traumatic or post-surgical cranio-facial defects repair. Pros and cons of such implants are discussed in association with the usefulness of this surgical technique in daily orthognathic surgical practice. © EDP Sciences, SFODF, 2016.

  4. Loaded titanium implant with hydroxyapatite coat: histological observations

    Science.gov (United States)

    Himmlova, Lucia; Dorazilova, V.; Dostalova, Tatjana; Jelinek, Miroslav

    2000-06-01

    The purpose of this study was to observe the response of surrounding tissues on long-term presence of coated titanium implants under loading. The protective layer based on hydroxy apatite was created by the method of pulsed laser deposition with KrF excimer laser on the kernel from pure titanium. The coating thickness was about 1 m. Implants were inserted into the mandible of minipigs up extracted premolars. After 14 weeks of healing without loading the metal-ceramic crowns were cemented and implants were moved in to the occlusion. Six months after the crown application the experimental animals were sacrificed and from the bone blocks with implants were manufactured microscopic ground sections. The implant position in the bone were determined by radiovisography. The bone structure around the implants were viewed in the microscope using transmitted light. Observation after six months long functional loading acknowledged the presence of newly formed bone around all implants. In no samples were found any inflammatory or regressive changes. Osseointegration of both surface types was similar.

  5. Extrusion of bone anchor suture following flexor digitorum profundus tendon avulsion injury repair.

    LENUS (Irish Health Repository)

    Tiong, William H C

    2011-09-01

    Flexor digitorum profundus (FDP) zone I tendon avulsion injury is traditionally repaired with a pullout suture technique. More recently, bone anchor sutures have been used as a viable alternative and have largely replaced areas in hand surgery where pullout suture technique was once required. To date, there have been very few complications reported related to bone anchor suture use in FDP tendon reattachment to the bone. We report a very unusual case of extrusion of bone anchor through the nailbed, 6 years after zone I FDP tendon avulsion injury repair and a brief review of literature.

  6. Patient satisfaction and functional results with the bone-anchored hearing aid (BAHA).

    Science.gov (United States)

    Saroul, N; Gilain, L; Montalban, A; Giraudet, F; Avan, P; Mom, T

    2011-06-01

    To assess patient satisfaction with bone-anchored hearing aids (BAHA) and the role of preoperative audiometric testing. A telephone satisfaction survey was conducted on all patients implanted between June 1, 2005 and February 1, 2008. Patients with unilateral total deafness underwent preoperative audiometric tests in quiet and in noise and stereoaudiometry with and without BAHA. Patients with a conductive hearing loss underwent preoperative audiometric tests in quiet and in noise and real-life testing at home using a headband. A standardized satisfaction questionnaire derived from the Entific BAHA questionnaire was used. Twenty-two out of 26 patients responded to the questionnaire. Ten patients were implanted for conductive hearing loss (CHL) and 12 for unilateral total deafness (UTD). Mean follow-up was 19 months in the UTD group and 21 months in the CHL group. Sixty-seven percent of UTD and 80% of CHL patients reported improved quality of life. The BAHA was worn for more than 4hours per day by 83% of UTD and 100% of CHL patients, and at least 5 days per week by 67% of UTD and 80% of CHL patients. BAHAs provided real benefit in all situations for CHL patients. In UTD, its benefit basically related to noisy environments. In UTD, satisfaction on preoperative stereoaudiometric testing in noise with and without BAHA was predictive of postimplantation satisfaction. In response to the question "Would you do it again?", 81% of patients answered "Yes". Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  7. Efficacy of Bone-Anchored Hearing Aids in Single-Sided Deafness: A Systematic Review.

    Science.gov (United States)

    Kim, Gaeun; Ju, Hyun Mi; Lee, Sun Hee; Kim, Hee-Soon; Kwon, Jeong A; Seo, Young Joon

    2017-04-01

    Bone-anchored hearing aids (BAHAs) have been known to partially restore some of the functions lost in subjects with single-sided deafness (SSD). Our aims in this systemic review were to analyze the present capabilities of BAHAs in the context of SSD, and to evaluate the efficacy of BAHAs in improving speech recognition in noisy conditions, sound localization, and subjective outcomes. A systematic search was undertaken until August 2015 by two independent reviewers, with disagreements resolved by consensus. Among 286 references, we analyzed 14 studies that used both subjective and objective indicators to assess the capabilities of a total of 296 patients in the unaided and aided situations. Although there was "no benefit" of BAHA implantation for sound localization, BAHAs certainly improved subjects' speech discrimination in noisy circumstances. In the six studies that dealt with sound localization, no significant difference was found after the implantation. Twelve studies showed the benefits of BAHAs for speech discrimination in noise. Regarding subjective outcomes of using the prosthesis in patients with SSD (abbreviated profile of hearing aid benefit [APHAB] and the Glasgow hearing aid benefit profile [GHABP], etc.), we noticed an improvement in the quality of life. This systematic review has indicated that BAHAs may successfully rehabilitate patients with SSD by alleviating the hearing handicap to a certain degree, which could improve patients' quality of life. This report has presented additional evidence of effective auditory rehabilitation for SSD and will be helpful to clinicians counseling patients regarding treatment options for SSD.

  8. Two Different Percutaneous Bone-Anchored Hearing Aid Abutment Systems: Comparative Clinical Study.

    Science.gov (United States)

    Polat, Beldan; İşeri, Mete; Orhan, Kadir Serkan; Yılmazer, Ayça Başkadem; Enver, Necati; Ceylan, Didem; Kara, Ahmet; Güldiken, Yahya; Çomoğlu, Şenol

    2016-04-01

    To compare two different percutaneous bone-anchored hearing aid (BAHA) abutment systems regarding operation time, scar healing, quality of life, implant stability, audiologic results, and complications. The study involves a prospective multi-center clinical evaluation. Thirty-two consecutive patients who had undergone BAHA surgery from January 2011 to January 2013 in two tertiary centers were included in the study. The Glasgow Inventory Benefit Score was used to assess the patients at least 6 months after surgery. The operation time and complications were recorded. Implant stability quotient (ISQ) values were recorded using resonance frequency analysis. Holger's classification was used to evaluate skin reactions. The mean length of the operation was 39.2±4 min for standard abutment and 18.3±5.7 min for hydroxyapatite-coated abutment. ISQ scores were significantly better for standard abutment in all tests. The mean total Glasgow Inventory Benefit Score was 39.3±19 for the standard abutment and 46.3±24.5 for the hydroxyapatite-coated abutment groups, but there was no statistical significance between the two groups. There was no difference in audiological improvement between the two groups after surgery. Hydroxyapatite-coated abutment provided a shorter operation time that was significantly different from standard abutment. There were no significant differences between standard abutment and hydroxyapatite-coated abutment regarding audiologic improvement, quality of life, loading time, and complications.

  9. Bone-anchored hearing aid: why do some patients refuse it?

    Science.gov (United States)

    Zawawi, Faisal; Kabbach, Ghassan; Lallemand, Marie; Daniel, Sam J

    2014-02-01

    Bone-anchored hearing aid (BAHA™) is a proven tool to improve hearing. Nevertheless, there are patients who are candidates for BAHA™ implants that end up refusing the surgery. The objective of this study is to review our BAHA™ experience with particular emphasis on reasons behind the refusal of some candidates. A prospective cohort of 100 consecutive new candidates referred to The BAHA™ program in a tertiary health care center. Candidates' demographics, hearing status, Co-morbidities and audiometeric tests were all recorded. Patients' acceptance or refusal was noted alongside the reasons to refuse BAHA™. 100 new candidates were seen for BAHA™ assessment, 10 patients were excluded due to incomplete data. There were 68 children and 22 adults. Unilateral Conductive Hearing Loss was the most common reason for consultation (40%), followed by unilateral SNHL (23.3%). Aural Atresia was the commonest clinical finding (36.6%). The commonest reason for refusal was social acceptance by the parents due to concern with cosmesis. The main reason of BAHA™ surgery refusal, in otherwise eligible candidates, is related to cosmesis. Patients with congenital anomalies were the most likely candidates to accept BAHA™ implants. Copyright © 2013. Published by Elsevier Ireland Ltd.

  10. Titanium and aluminium ions implanted by plasma on polyethylene

    International Nuclear Information System (INIS)

    Cruz, G.J.; Olayo, M.G.; Lopez, R.; Granda, E.; Munoz, A.; Valencia, R.; Morales, J.

    2007-01-01

    The ion implantation by plasma of titanium and aluminum on polyethylene thin films (PE) is presented. The results indicate that the polymers reacted firstly with the oxygen and/or nitrogen carrying gases, and later its received the metallic particles that formed thin films. The stainless steel and the titanium formed a single phase. The metallic layers grew in the interval of 1 to 2 nm/min, its are thin, but enough to change the hardness of the polymer that it is increased in more of 20 times. (Author)

  11. Corrosion resistance of titanium ion implanted AZ91 magnesium alloy

    International Nuclear Information System (INIS)

    Liu Chenglong; Xin Yunchang; Tian Xiubo; Zhao, J.; Chu, Paul K.

    2007-01-01

    Degradable metal alloys constitute a new class of materials for load-bearing biomedical implants. Owing to their good mechanical properties and biocompatibility, magnesium alloys are promising in degradable prosthetic implants. The objective of this study is to improve the corrosion behavior of surgical AZ91 magnesium alloy by titanium ion implantation. The surface characteristics of the ion implanted layer in the magnesium alloys are examined. The authors' results disclose that an intermixed layer is produced and the surface oxidized films are mainly composed of titanium oxide with a lesser amount of magnesium oxide. X-ray photoelectron spectroscopy reveals that the oxide has three layers. The outer layer which is 10 nm thick is mainly composed of MgO and TiO 2 with some Mg(OH) 2 . The middle layer that is 50 nm thick comprises predominantly TiO 2 and MgO with minor contributions from MgAl 2 O 4 and TiO. The third layer from the surface is rich in metallic Mg, Ti, Al, and Ti 3 Al. The effects of Ti ion implantation on the corrosion resistance and electrochemical behavior of the magnesium alloys are investigated in simulated body fluids at 37±1 deg. C using electrochemical impedance spectroscopy and open circuit potential techniques. Compared to the unimplanted AZ91 alloy, titanium ion implantation significantly shifts the open circuit potential (OCP) to a more positive potential and improves the corrosion resistance at OCP. This phenomenon can be ascribed to the more compact surface oxide film, enhanced reoxidation on the implanted surface, as well as the increased β-Mg 12 Al 17 phase

  12. Osseointegration of zirconia implants compared with titanium: an in vivo study

    Science.gov (United States)

    Depprich, Rita; Zipprich, Holger; Ommerborn, Michelle; Naujoks, Christian; Wiesmann, Hans-Peter; Kiattavorncharoen, Sirichai; Lauer, Hans-Christoph; Meyer, Ulrich; Kübler, Norbert R; Handschel, Jörg

    2008-01-01

    Background Titanium and titanium alloys are widely used for fabrication of dental implants. Since the material composition and the surface topography of a biomaterial play a fundamental role in osseointegration, various chemical and physical surface modifications have been developed to improve osseous healing. Zirconia-based implants were introduced into dental implantology as an altenative to titanium implants. Zirconia seems to be a suitable implant material because of its tooth-like colour, its mechanical properties and its biocompatibility. As the osseointegration of zirconia implants has not been extensively investigated, the aim of this study was to compare the osseous healing of zirconia implants with titanium implants which have a roughened surface but otherwise similar implant geometries. Methods Forty-eight zirconia and titanium implants were introduced into the tibia of 12 minipigs. After 1, 4 or 12 weeks, animals were sacrificed and specimens containing the implants were examined in terms of histological and ultrastructural techniques. Results Histological results showed direct bone contact on the zirconia and titanium surfaces. Bone implant contact as measured by histomorphometry was slightly better on titanium than on zirconia surfaces. However, a statistically significant difference between the two groups was not observed. Conclusion The results demonstrated that zirconia implants with modified surfaces result in an osseointegration which is comparable with that of titanium implants. PMID:19077228

  13. Silicon-Doped Titanium Dioxide Nanotubes Promoted Bone Formation on Titanium Implants.

    Science.gov (United States)

    Zhao, Xijiang; Wang, Tao; Qian, Shi; Liu, Xuanyong; Sun, Junying; Li, Bin

    2016-02-26

    While titanium (Ti) implants have been extensively used in orthopaedic and dental applications, the intrinsic bioinertness of untreated Ti surface usually results in insufficient osseointegration irrespective of the excellent biocompatibility and mechanical properties of it. In this study, we prepared surface modified Ti substrates in which silicon (Si) was doped into the titanium dioxide (TiO₂) nanotubes on Ti surface using plasma immersion ion implantation (PIII) technology. Compared to TiO₂ nanotubes and Ti alone, Si-doped TiO₂ nanotubes significantly enhanced the expression of genes related to osteogenic differentiation, including Col-I, ALP, Runx2, OCN, and OPN, in mouse pre-osteoblastic MC3T3-E1 cells and deposition of mineral matrix. In vivo, the pull-out mechanical tests after two weeks of implantation in rat femur showed that Si-doped TiO₂ nanotubes improved implant fixation strength by 18% and 54% compared to TiO₂-NT and Ti implants, respectively. Together, findings from this study indicate that Si-doped TiO₂ nanotubes promoted the osteogenic differentiation of osteoblastic cells and improved bone-Ti integration. Therefore, they may have considerable potential for the bioactive surface modification of Ti implants.

  14. [INFLUENCE OF TITANIUM COATING ON THE BIOCOMPATIBILITY OF POLYPROPYLENE IMPLANTS].

    Science.gov (United States)

    Babichenko, I I; Kazantsev, A A; Titarov, D L; Shemyatovsky, K A; Ghevondian, N M; Melchenko, D; Alekhin, A I

    2016-01-01

    Comparative analysis of the proliferative activity of inflammatory cells and distribution of collagen types I and III was carried out around the net materials of polypropylene and titanium coating polypropylene using im- munohistochemical method and polarization microscopy. Experimental modeling of implanted mesh material were made in the soft tissues of the lumbar region of rats. On the 7th postoperative day, quantitative analysis of proliferating cells delected using antibodies to the Ki-67 protein showed, a significant decrease (p polypropylene (29.1 ± 5.7 %), when com- pared to similar figures of infiltrates in titanium coating polypropylene (33.6 ± 3.1 %). Similar patterns were found on the 30th day of the experiment--15.9 ± 4.3 and 26.9 ± 3.6%--respectively (p polypropylene was 1.085 ± 0.022 and this rati around materials of titanium coated polypropylene was higher--1.107 ± 0.013 (p = 0.017). On the 30th posto- perative day in the interface area ratio I/III collagen significantly increased and amounted to 1.174 ± 0.036 and 1.246 ± 0.102, respectively (p = 0.045). Assessing the impact of the use of titanium as a coating on the po- lypropylene, it can be argued that it promotes the formation of collagen I type and a more mature connective tis- sue around the mesh of the implants.

  15. Highly antibacterial UHMWPE surfaces by implantation of titanium ions

    Energy Technology Data Exchange (ETDEWEB)

    Delle Side, D., E-mail: domenico.delleside@le.infn.it [LEAS, Dipartimento di Matematica e Fisica “Ennio de Giorgi”, Università del Salento, Lecce (Italy); Istituto Nazionale di Fisica Nucleare – Sezione di Lecce, Lecce (Italy); Nassisi, V.; Giuffreda, E.; Velardi, L. [LEAS, Dipartimento di Matematica e Fisica “Ennio de Giorgi”, Università del Salento, Lecce (Italy); Istituto Nazionale di Fisica Nucleare – Sezione di Lecce, Lecce (Italy); Alifano, P.; Talà, A.; Tredici, S.M. [Dipartimento di Scienze e Tecnologie Biologiche ed Ambientali, Università del Salento, Lecce (Italy)

    2014-07-15

    The spreading of pathogens represents a serious threat for human beings. Consequently, efficient antimicrobial surfaces are needed in order to reduce risks of contracting severe diseases. In this work we present the first evidences of a new technique to obtain a highly antibacterial Ultra High Molecular Weight Polyethylene (UHMWPE) based on a non-stoichiometric titanium oxide coating, visible-light responsive, obtained through ion implantation.

  16. Highly antibacterial UHMWPE surfaces by implantation of titanium ions

    Science.gov (United States)

    Delle Side, D.; Nassisi, V.; Giuffreda, E.; Velardi, L.; Alifano, P.; Talà, A.; Tredici, S. M.

    2014-07-01

    The spreading of pathogens represents a serious threat for human beings. Consequently, efficient antimicrobial surfaces are needed in order to reduce risks of contracting severe diseases. In this work we present the first evidences of a new technique to obtain a highly antibacterial Ultra High Molecular Weight Polyethylene (UHMWPE) based on a non-stoichiometric titanium oxide coating, visible-light responsive, obtained through ion implantation.

  17. Quality of life improvement for bone-anchored hearing aid users and their partners.

    Science.gov (United States)

    McNeil, M L; Gulliver, M; Morris, D P; Bance, M

    2011-06-01

    Bone-anchored hearing aid recipients experience well documented improvements in their audiometric performance and quality of life. While hearing aid recipients may understate their functional improvement, their partners may be more aware of such improvement. We sought to investigate patients' partners' perceptions of functional improvement following bone-anchored hearing aid fitting. Surveys were sent to 153 patients who had received a bone-anchored hearing aid through the Nova Scotia bone-anchored hearing aid programme. The validated survey asked patients' partners to give their subjective impression of the bone-anchored hearing aid recipient's functional status. Surveys were completed by 90 patients (58.8 per cent), of whom 72 reported having a partner. Partners reported a significant improvement in hearing (p ≤ 0.0001). Partners reported improvement in 87.0 per cent of functional scenarios, no change in 12.6 per cent, and a decline in 0.4 per cent. These findings demonstrate a significant improvement in the emotional and social effects of hearing impairment, as perceived by bone-anchored hearing aid recipients' partners.

  18. Patient quality of life with bone-anchored hearing aid: 10-year experience in Glasgow, Scotland.

    Science.gov (United States)

    Mace, A T M; Isa, A; Cooke, L D

    2009-09-01

    This study aimed to ascertain the usefulness of the bone-anchored hearing aid and its impact on the quality of life of patients fitted in Glasgow between 1996 and 2006. The Entific Medical Systems questionnaire and the Glasgow Benefit Inventory were posted to patients in order to assess their satisfaction and quality of life changes. Sixty adult patients were identified, with a questionnaire response rate of 63 per cent. Thirty-two respondents (85 per cent) reported using their bone-anchored hearing aid for more than eight hours per day. Twenty-nine respondents (75 per cent) found their bone-anchored hearing aid to be generally better than their previous, conventional aid. Twenty-seven respondents (71 per cent) reported that their bone-anchored hearing aid improved their quality of life. The median total Glasgow Benefit Inventory score was +33.3. Bone-anchored hearing aid usage rates and satisfaction levels were high amongst patients in Glasgow. Glasgow Benefit Inventory indices were comparable to published findings from other centres. Despite this, bone-anchored hearing aid funding is still not universally available within the National Health Service in Scotland.

  19. Does surface anodisation of titanium implants change osseointegration and make their extraction from bone any easier?

    OpenAIRE

    Langhoff, J; Mayer, J; Faber, L; Kästner, S B; Guibert, G; Zlinszky, K; Auer, J A; von Rechenberg, B

    2008-01-01

    Objectives: Titanium implants have a tendency for high bone-implant bonding, and, in comparison to stainless steel implants are more difficult to remove. The current study was carried out to evaluate, i) the release strength of three selected anodized titanium surfaces with increased nanohardness and low roughness, and ii) bone-implant bonding in vivo. These modified surfaces were intended to give improved anchorage while facilitating easier removal of temporary implants. Material and methods...

  20. UK and Ireland experience of bone anchored hearing aids (BAHA) in individuals with Down syndrome.

    Science.gov (United States)

    Sheehan, Patrick Z; Hans, Paul S

    2006-06-01

    To evaluate the indications, surgical techniques and post-operative problems seen in children with Down syndrome fitted with bone anchored hearing aids (BAHA). A postal survey of all registered United Kingdom and Ireland BAHA centres. There was a 98% response rate to the survey. Eighty-one centres in the United Kingdom and Ireland undertake BAHA surgery. Eighteen centres were identified to have undertaken BAHA surgery on individuals with Down syndrome. A total of 43 individuals were implanted. Twenty-four cases were under the age of 16. Soft tissue complications were encountered in 21 patients (49%). Osseointegration failures were encountered in four cases (9%). There was a high level of satisfaction with the BAHA system amongst patients, parents and carers. BAHA is a valuable method of hearing amplification in children with Down syndrome. It should be considered not as a primary method of amplification, but in the overall management of individuals with Down syndrome after conventional hearing aids and/or ventilation tubes have been considered or already failed. The survey shows a high patient and carer satisfaction with the system, despite short term early soft tissue complications.

  1. Bone-anchored hearing device surgery: Linear incision without soft tissue reduction. A prospective study.

    Science.gov (United States)

    Altuna, Xabier; Navarro, Juan José; Palicio, Idoia; Álvarez, Leire

    2015-01-01

    The classic surgical procedure for percutaneous bone-anchored hearing devices involves removal of a large area of subcutaneous tissue down to the periosteum. This leads to alopecia and raises the risk of devascularization of the overlying skin with the potential for infection and scarring. The objective of this study was to determine the results of implant placement using a single, linear incision with no underlying soft tissue reduction. A prospective study was conducted in our hospital over a period of 14 months in all consecutive surgeries performed using this technique in adults. Patients were reviewed regularly (week 1, week 3, weeks 4-6 and months 3, 6 and 12) to assess wound healing including evaluation with the Holgers scale. Corresponding to 34 patients, 34 cases were consecutively enrolled in this study. We found that 15% of the patients had minor skin reactions during the first visit (Holgers grade 1 or 2); this number raised to 20% in week 3, but at week 4 only 1 patient had a reaction score of 1 (which was solved by week 6). None of the cases required revision surgery and all skin reactions were treated topically. Our results suggest that the tissue preservation technique is a simple and effective insertion technique with a favourable healing process and cosmesis. Copyright © 2014 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

  2. Outcomes of Bone Anchored Hearing Aids (BAHA) for Single Sided Deafness in Nontraditional Candidates.

    Science.gov (United States)

    Schwartz, Seth R; Kobylk, Deborah

    2016-12-01

    To assess both quality of life (QOL) and hearing outcomes in bone anchored hearing aid (BAHA) users for single sided deafness with 1) less than total hearing loss in the deaf ear, or 2) some degree of hearing loss in the better ear and compare them to traditional candidates. Prospective comparative cohort study. Tertiary referral center. Patients with a BAHA for single sided deafness were assigned into groups based on hearing thresholds in the deaf ear (> or or hearing including Quick SIN and HINT in quiet and noise, and a localization task. Differences in QOL, hearing performance in noise, and localization ability. Nineteen patients were tested. Patients with residual hearing in the BAHA ear showed nonsignificant trends toward improved performance in noise localization compared with those without residual hearing. There were no statistically significant differences in QOL between groups. Patients with hearing loss in the control ear had equivalent QOL scores to those with normal hearing in the control ear despite performing worse on speech in noise tasks. BAHA patients with hearing loss in the better ear seem to perform worse in noise relative to those without but have equivalent perceived benefit. Residual hearing in the implanted ear may improve performance. A larger sample size is needed to confirm these trends.

  3. Loaded custom-made zirconia and titanium implants show similar osseointegration: an animal experiment.

    Science.gov (United States)

    Kohal, Ralf J; Weng, Dietmar; Bächle, Maria; Strub, Jörg R

    2004-09-01

    Zirconia might be an alternative material to titanium for dental implant fabrication. The aim of the present study was to investigate the histological behavior (osseointegration) of loaded zirconia implants in an animal model and to compare it with the behavior of titanium implants. Five months after extraction of the upper anterior teeth, 12 custom-made titanium implants (control group) and 12 custom-made zirconia implants (test group) were inserted in the extraction sites in six monkeys. Before insertion, the titanium implant surfaces were sandblasted with Al2O3 and subsequently acid-etched. The zirconia implants were only sandblasted. Six months following implant insertion, impressions were taken for the fabrication of single crowns. A further 3 months later, nonprecious metal crowns were inserted. Five months after insertion of the crowns, the implants with the surrounding hard and soft tissues were harvested, histologically prepared, and evaluated under the light microscope regarding the peri-implant soft tissue dimensions and mineralized bone-to-implant contact. No implant was lost during the investigational period. The mean height of the soft peri-implant tissue cuff was 5 mm around the titanium implants and 4.5 mm around the zirconia implants. No statistically significant differences were found in the extent of the different soft tissue compartments. The mean mineralized bone-to-implant contact after 9 months of healing and 5 months of loading amounted to 72.9% (SD: 14%) for the titanium implants and to 67.4% (SD: 17%) for the zirconia implants. There was no statistically significant difference between the different implant materials. Within the limits of this animal experiment, it can be concluded that the custom-made zirconia implants osseointegrated to the same extent as custom-made titanium control implants and show the same peri-implant soft tissue dimensions.

  4. Effects of cisplatin chemotherapy on the osseointegration of titanium implants.

    Science.gov (United States)

    Al-Mahalawy, Haytham; Marei, Hesham F; Abuohashish, Hatem; Alhawaj, Hussain; Alrefaee, Munir; Al-Jandan, Badr

    2016-04-01

    The effect of chemotherapy on the osseointegration of dental implants has received less interest compared with radiotherapy. Thus, the aim of the current study was to investigate the effect of cisplatin chemotherapy on the osseointegration of dental implants in a rabbit model. Sixteen New Zealand White rabbits were randomly assigned to two groups of treatment of either cisplatin at 2.5 mg/kg/week for 4 weeks (n = 8) or placebo (n = 8), in which the first dose was administered 2 days prior to the surgical procedure. Each rabbit received one titanium dental implant inserted in the right distal femoral condyle. Four rabbits from each group were sacrificed 4 and 8 weeks after implant insertion. Osseointegration of the dental implants was analysed using micro-computed tomography and histomorphometric evaluation. Analysis of micro-computed tomography data and histomorphometric data showed that the osseointegration parameters, including the ratio of bone volume to total volume (BV/TV) and bone-implant contact (BIC%) for the cisplatin group, were significantly lower compared to the control group at 4 and 8 weeks. (P ≤ 0.05). Cisplatin chemotherapy had a negative effect on the osseointegration of dental implants when inserted throughout the chemotherapeutic regimens in a rabbit model. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  5. Characteristics of the surface oxides on turned and electrochemically oxidized pure titanium implants up to dielectric breakdown: the oxide thickness, micropore configurations, surface roughness, crystal structure and chemical composition.

    Science.gov (United States)

    Sul, Young-Taeg; Johansson, Carina B; Petronis, Sarunas; Krozer, Anatol; Jeong, Yongsoo; Wennerberg, Ann; Albrektsson, Tomas

    2002-01-01

    Titanium implants have been used widely and successfully for various types of bone-anchored reconstructions. It is believed that properties of oxide films covering titanium implant surfaces are of crucial importance for a successful osseointegration, in particular at compromized bone sites. The aim of the present study is to investigate the surface properties of anodic oxides formed on commercially pure (c.p.) titanium screw implants as well as to study 'native' oxides on turned c.p. titanium implants. Anodic oxides were prepared by galvanostatic mode in CH3COOH up to the high forming voltage of dielectric breakdown and spark formation. The oxide thicknesses, measured with Auger electron spectroscopy (AES), were in the range of about 200-1000 nm. Barrier and porous structures dominated the surface morphology of the anodic film. Quantitative morphometric analyses of the micropore structures were performed using an image analysis system on scanning electron microscopy (SEM) negatives. The pore sizes were < or = 8 microm in diameter and had 1.27-2.1 microm2 opening area. The porosity was in the range of 12.7-24.4%. The surface roughness was in the range of 0.96-1.03 microm (Sa), measured with TopScan 3D. The crystal structures of the titanium oxide were amorphous, anatase, and a mixtures of anatase and rutile type, as analyzed with thin-film X-ray diffractometry (TF-XRD) and Raman spectroscopy. The chemical compositions consisted mainly of TiO2, characterized with X-ray photoelectron spectroscopy (XPS). The native (thermal) oxide on turned implants was 17.4 nm (+/- 6.2) thick and amorphous. Its chemical composition was TiO2. The surface roughness had an average height deviation of 0.83 microm (Sa). The present results are needed to elucidate the influence of the oxide properties on the biological reaction. The results of animal studies using the presently characterized surface oxides on titanium implants will be published separately.

  6. Biocompatibility of Advanced Manufactured Titanium Implants-A Review.

    Science.gov (United States)

    Sidambe, Alfred T

    2014-12-19

    Titanium (Ti) and its alloys may be processed via advanced powder manufacturing routes such as additive layer manufacturing (or 3D printing) or metal injection moulding. This field is receiving increased attention from various manufacturing sectors including the medical devices sector. It is possible that advanced manufacturing techniques could replace the machining or casting of metal alloys in the manufacture of devices because of associated advantages that include design flexibility, reduced processing costs, reduced waste, and the opportunity to more easily manufacture complex or custom-shaped implants. The emerging advanced manufacturing approaches of metal injection moulding and additive layer manufacturing are receiving particular attention from the implant fabrication industry because they could overcome some of the difficulties associated with traditional implant fabrication techniques such as titanium casting. Using advanced manufacturing, it is also possible to produce more complex porous structures with improved mechanical performance, potentially matching the modulus of elasticity of local bone. While the economic and engineering potential of advanced manufacturing for the manufacture of musculo-skeletal implants is therefore clear, the impact on the biocompatibility of the materials has been less investigated. In this review, the capabilities of advanced powder manufacturing routes in producing components that are suitable for biomedical implant applications are assessed with emphasis placed on surface finishes and porous structures. Given that biocompatibility and host bone response are critical determinants of clinical performance, published studies of in vitro and in vivo research have been considered carefully. The review concludes with a future outlook on advanced Ti production for biomedical implants using powder metallurgy.

  7. Laser bioengineering of glass-titanium implants surface

    Science.gov (United States)

    Lusquiños, F.; Arias-González, F.; Penide, J.; del Val, J.; Comesaña, R.; Quintero, F.; Riveiro, A.; Boutinguiza, M.; Pascual, M. J.; Durán, A.; Pou, J.

    2013-11-01

    Osseointegration is the mean challenge when surgical treatments fight against load-bearing bone diseases. Absolute bone replacement by a synthetic implant has to be completed not only from the mechanics point of view, but also from a biological approach. Suitable strength, resilience and stress distribution of titanium alloy implants are spoiled by the lack of optimal biological characteristics. The inert quality of extra low interstitial titanium alloy, which make it the most attractive metallic alloy for biomedical applications, oppose to an ideal surface with bone cell affinity, and capable to stimulate bone attachment bone growth. Diverse laser treatments have been proven as effective tools to modify surface properties, such as wettability in contact to physiological fluids, or osteoblast guided and slightly enhanced attachment. The laser surface cladding can go beyond by providing titanium alloy surfaces with osteoconduction and osteoinduction properties. In this research work, the laser radiation is used to produce bioactive glass coatings on Ti6Al4V alloy substrates. Specific silicate bioactive glass compositions has been investigated to achieve suitable surface tension and viscosity temperature behavior during processing, and to provide with the required release of bone growth gene up regulation agents in the course of resorption mediated by physiological fluids. The produced coatings and interfaces, the surface osteoconduction properties, and the chemical species release in simulated physiological fluid were characterized by scanning electron microscopy (SEM), hot stage microscopy (HSM), X-ray diffraction (XRD), X ray fluorescence (XRF), and Fourier transform infrared spectroscopy (FTIR).

  8. A study of the bone healing kinetics of plateau versus screw root design titanium dental implants.

    LENUS (Irish Health Repository)

    Leonard, Gary

    2009-03-01

    This study was designed to compare the bone healing process around plateau root from (PRF) and screw root from (SRF) titanium dental implants over the immediate 12 week healing period post implant placement.

  9. Does surface anodisation of titanium implants change osseointegration and make their extraction from bone any easier?

    Science.gov (United States)

    Langhoff, J D; Mayer, J; Faber, L; Kaestner, S B; Guibert, G; Zlinszky, K; Auer, J A; von Rechenberg, B

    2008-01-01

    Titanium implants have a tendency for high bone-implant bonding, and, in comparison to stainless steel implants are more difficult to remove. The current study was carried out to evaluate, i) the release strength of three selected anodized titanium surfaces with increased nanohardness and low roughness, and ii) bone-implant bonding in vivo. These modified surfaces were intended to give improved anchorage while facilitating easier removal of temporary implants. The new surfaces were referenced to a stainless steel implant and a standard titanium implant surface (TiMAX). In a sheep limb model, healing period was 3 months. Bone-implant bonding was evaluated either biomechanically or histologically. The new surface anodized screws demonstrated similar or slightly higher bone-implant-contact (BIC) and torque release forces than the titanium reference. The BIC of the stainless steel implants was significant lower than two of the anodized surfaces (p = 0.04), but differences between stainless steel and all titanium implants in torque release forces were not significant (p = 0.06). The new anodized titanium surfaces showed good bone-implant bonding despite a smooth surface and increased nanohardness. However, they failed to facilitate implant removal at 3 months.

  10. Functional treatment of skeletal Class II malocclusion using bone-anchored devices and intermaxillary elastics

    Directory of Open Access Journals (Sweden)

    Mahmood Reza Kalantar Motamedi

    2015-01-01

    Full Text Available Introduction: Dentofacial functional appliances used for the treatment of skeletal Class II malocclusion are divided into two groups: Removable appliances and fixed (bonded appliances, each with certain advantages and disadvantages. Considering the problems related to functional appliances such as high volume in the oral cavity, patient noncompliance, esthetics, tissue irritation or ulceration, speech or breathing difficulties, etc., there is considerable demand to develop a new appliance that can overcome these issues. Thus, the aim of the current study is to present a hypothesis regarding a new functional treatment technique. The hypothesis: We hypothesize that by fixing mini-plates or -implants in the posterior region of the mandible and the anterior part of the infrazygomatic crest region of the maxilla using intermaxillary elastics, we can expect a forward growth of the mandible in a growing child. Using this technique, the force vector will be in the oblique (forward-upward direction. By installing mini-plates with a long connecting bar in the infrazygomatic crest region (with the orthodontic attachment head approximating the level of the occlusal plane, and mini-plates or -implants in the most posterior and superior regions of the mandible, such as the retromolar region, the force vector can be placed in the most horizontal direction possible. Evaluation of the hypothesis: In the literature, significant growth modification results were reported in skeletal Class III patients using intermaxillary elastics and bone-anchored devices fixed in both jaws, when compared with those in the nontreatment group. Therefore, in practice, intermaxillary elastics can produce enough traction to stimulate the bone to change and grow. Thus, we presume that inverting the direction of the force vector (i.e., posterior-anterior force may have similar growth effects on the mandibles of growing children.

  11. Congenital aural atresia: bone-anchored hearing aid vs. external auditory canal reconstruction.

    Science.gov (United States)

    Bouhabel, Sarah; Arcand, Pierre; Saliba, Issam

    2012-02-01

    To compare the audiologic outcome and feasibility of bone-anchored hearing aid (BAHA) and external auditory canal reconstruction (EACR) surgeries in pediatric patients presenting a congenital aural atresia (CAA). A retrospective chart review of 40 patients operated in our tertiary pediatric care center between 2002 and 2010 was performed. 20 patients underwent EACR, whereas another 20 patients were implanted with a BAHA device. Air conduction (AC), bone conduction (BC), pure tone average (PTA) and speech discrimination score (SDS) were compared preoperatively, and hearing gain (HG) postoperatively at 6 and at 12 months at frequencies of 500, 1000, 2000 and 4000 Hz. Operative time, complications and associated microtia were documented as well. EACR patients were graded retrospectively upon Jahrsdoerfer's classification. Preoperative AC were significantly different between groups, at 500, 1000 and 2000 Hz but not at 4000 Hz. BAHA group compared postoperatively to EACR group showed significantly a superior HG of 46.9 ± 7.0 dB (paided air thresholds from the EACR group revealed an audiologic status similar to those of the BAHA group patients, at 6 months and one year postoperatively. Both groups had a similar evolution of their BC, as well as of the incidence of complications. We report one case of transient facial paralysis in the EACR group. Total operative time is significantly lower (p0.05) was found between patient's Jahrsdoerfer's score and their audiologic outcome. HG does not seem to be influenced by the presence of microtia. EACR, although constituting an attractive option, does not give acceptable results alone. It can however, when combined to conventional air conduction hearing aids, provide excellent audiologic outcomes comparable to BAHA. BAHA implantation is a reliable, safe and efficient therapeutic option that allows a significantly better audiologic outcome when compared to unaided EACR for patients with CAA. Copyright © 2011 Elsevier Ireland Ltd

  12. A multicenter study on objective and subjective benefits with a transcutaneous bone-anchored hearing aid device

    DEFF Research Database (Denmark)

    Hougaard, Dan Dupont; Boldsen, Soren Kjaergaard; Jensen, Anne Marie

    2017-01-01

    Examination of objective as well as subjective outcomes with a new transcutaneous bone-anchored hearing aid device. The study was designed as a prospective multicenter consecutive case-series study involving tertiary referral centers at two Danish University Hospitals. A total of 23 patients were...... implanted. Three were lost to follow-up. Patients had single-sided deafness, conductive or mixed hearing loss. Intervention: Rehabilitative. Aided and unaided sound field hearing was evaluated objectively using (1) pure warble tone thresholds, (2) pure-tone average (PTA4), (3) speech discrimination score...... (SDS) in quiet, and (4) speech reception threshold 50% at 70 dB SPL noise level (SRT50%). Subjective benefit was evaluated by three validated questionnaires: (1) the IOI-HA, (2) the SSQ-12, and (3) a questionnaire evaluating both the frequency and the duration of hearing aid usage. The mean aided PTA4...

  13. Titanium Nitride and Nitrogen Ion Implanted Coated Dental Materials

    Directory of Open Access Journals (Sweden)

    David W. Berzins

    2012-07-01

    Full Text Available Titanium nitride and/or nitrogen ion implanted coated dental materials have been investigated since the mid-1980s and considered in various applications in dentistry such as implants, abutments, orthodontic wires, endodontic files, periodontal/oral hygiene instruments, and casting alloys for fixed restorations. Multiple methodologies have been employed to create the coatings, but detailed structural analysis of the coatings is generally lacking in the dental literature. Depending on application, the purpose of the coating is to provide increased surface hardness, abrasion/wear resistance, esthetics, and corrosion resistance, lower friction, as well as greater beneficial interaction with adjacent biological and material substrates. While many studies have reported on the achievement of these properties, a consensus is not always clear. Additionally, few studies have been conducted to assess the efficacy of the coatings in a clinical setting. Overall, titanium nitride and/or nitrogen ion implanted coated dental materials potentially offer advantages over uncoated counterparts, but more investigation is needed to document the structure of the coatings and their clinical effectiveness.

  14. Effect of Surface Nanotopography on Bone Response to Titanium Implant.

    Science.gov (United States)

    Freitas, Gileade P; Lopes, Helena B; Martins-Neto, Evandro C; de Oliveira, Paulo T; Beloti, Marcio M; Rosa, Adalberto L

    2016-06-01

    Clinical success of implant therapy is directly related to titanium (Ti) surface properties and the quality of bone tissue. The treatment of Ti implants with H2SO4/H2O2 is a feasible, reproducible, and low-cost technique to create surface nanotopography (Ti-Nano). As this nanotopography induces osteoblast differentiation, we hypothesized that it may affect bone response to Ti. Thus, this study was designed to evaluate the bone response to a machined Ti implant treated with H2SO4/H2O2 to generate Ti-Nano and to compare it with a commercially available microtopographic Ti implant (Ti-Porous). Implants were placed in rabbit tibias and evaluated after 2 and 6 weeks, and the bone tissue formed around them was assessed by microtomography to record bone volume, bone surface, specific bone surface, trabecular number, trabecular thickness, and trabecular separation. Undecalcified histological sections were used to determine the percentages of bone-to-implant contact, bone area formed between threads, and bone area formed in the mirror area. At the end of 6 weeks, the removal torque was evaluated using a digital torque gauge. The results showed bone formation in close contact with both Ti-Nano and Ti-Porous implants without relevant morphological and morphometric differences, in addition to a similar removal torque irrespective of surface topography. In conclusion, our results have shown that a simple and low-cost method using H2SO4/H2O2 is highly efficient for creating nanotopography on Ti surfaces, which elicits a similar bone response compared with microtopography presented in a commercially available Ti implant.

  15. Antibacterial and bioactive coatings on titanium implant surfaces.

    Science.gov (United States)

    Kulkarni Aranya, Anupama; Pushalkar, Smruti; Zhao, Minglei; LeGeros, Racquel Z; Zhang, Yu; Saxena, Deepak

    2017-08-01

    Various surface modifications have been tried for enhancing osseointegration of the dental implants like mechanical and/or chemical treatments and deposition of calcium phosphate coatings. The objective of this research was to develop calcium-phosphate based thin coatings with antibacterial and bioactive properties for potential application in dental implants. Titanium (Ti) discs were immersed in different calcifying solutions: CaP (positive control), F-CaP, Zn-CaP, and FZn-CaP and incubated for 24 h. Negative control was uncoated Ti discs. Coated surfaces were characterized using X-ray diffraction, scanning electron microscopy and energy dispersive spectroscopy. Antibacterial properties were tested using Porphyromonas gingivalis because of its strong association with periodontal and peri-implant infections. Bacterial adhesion and colonization were studied at different timepoints. The coated surfaces had compositional characteristics similar to that of bone mineral and they inhibited the growth, colonization and adherence of P. gingivalis, resulted in reduced thickness of biofilms and bacterial inhibition in the culture medium as compared to the positive and negative controls (p  0.05). It has been previously demonstrated that these coatings have excellent in vitro bioactivity (formed carbonate hydroxyapatite when immersed in a simulated body fluid). Such coatings can enhance osseointegration and prevent infection in implants, thereby improving the success rates of implants. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 2218-2227, 2017. © 2017 Wiley Periodicals, Inc.

  16. Interactions between endothelial progenitor cells (EPC) and titanium implant surfaces.

    Science.gov (United States)

    Ziebart, Thomas; Schnell, Anne; Walter, Christian; Kämmerer, Peer W; Pabst, Andreas; Lehmann, Karl M; Ziebart, Johanna; Klein, Marc O; Al-Nawas, Bilal

    2013-01-01

    Endothelial cells play an important role in peri-implant angiogenesis during early bone formation. Therefore, interactions between endothelial progenitor cells (EPCs) and titanium dental implant surfaces are of crucial interest. The aim of our in vitro study was to investigate the reactions of EPCs in contact with different commercially available implant surfaces. EPCs from buffy coats were isolated by Ficoll density gradient separation. After cell differentiation, EPC were cultured for a period of 7 days on different titanium surfaces. The test surfaces varied in roughness and hydrophilicity: acid-etched (A), sand-blasted-blasted and acid-etched (SLA), hydrophilic A (modA), and hydrophilic SLA (modSLA). Plastic and fibronectin-coated plastic surfaces served as controls. Cell numbers and morphology were analyzed by confocal laser scanning microscopy. Secretion of vascular endothelial growth factor (VEGF)-A was measured by enzyme-linked immunosorbent assay and expressions of iNOS and eNOS were investigated by real-time polymerase chain reaction. Cell numbers were higher in the control groups compared to the cells of titanium surfaces. Initially, hydrophilic titanium surfaces (modA and modSLA) showed lower cell numbers than hydrophobic surfaces (A and SLA). After 7 days smoother surfaces (A and modA) showed increased cell numbers compared to rougher surfaces (SLA and modSLA). Cell morphology of A, modA, and control surfaces was characterized by a multitude of pseudopodia and planar cell soma architecture. SLA and modSLA promoted small and plump cell soma with little quantity of pseudopodia. The lowest VEGF level was measured on A, the highest on modSLA. The highest eNOS and iNOS expressions were found on modA surfaces. The results of this study demonstrate that biological behaviors of EPCs can be influenced by different surfaces. The modSLA surface promotes an undifferentiated phenotype of EPCs that has the ability to secrete growth factors in great quantities. In

  17. Is zirconia a viable alternative to titanium for oral implant? A critical review.

    Science.gov (United States)

    Sivaraman, Karthik; Chopra, Aditi; Narayan, Aparna I; Balakrishnan, Dhanasekar

    2017-08-17

    Titanium based implant systems, though considered as the gold standard for rehabilitation of edentulous spaces, have been criticized for many inherent flaws. The onset of hypersensitivity reactions, biocompatibility issues, and an unaesthetic gray hue have raised demands for more aesthetic and tissue compatible material for implant fabrication. Zirconia is emerging as a promising alternative to conventional Titanium based implant systems for oral rehabilitation with superior biological, aesthetics, mechanical and optical properties. This review aims to critically analyze and review the credibility of Zirconia implants as an alternative to Titanium for prosthetic rehabilitation. The literature search for articles written in the English language in PubMed and Cochrane Library database from 1990 till December 2016. The following search terms were utilized for data search: "zirconia implants" NOT "abutment", "zirconia implants" AND "titanium implants" AND "osseointegration", "zirconia implants" AND compatibility. The number of potential relevant articles selected were 47. All the human in vivo clinical, in vitro, animals' studies were included and discussed under the following subheadings: Chemical composition, structure and phases; Physical and mechanical properties; Aesthetic and optical properties; Osseointegration and biocompatibility; Surface modifications; Peri-implant tissue compatibility, inflammation and soft tissue healing, and long-term prognosis. Zirconia implants are a promising alternative to titanium with a superior soft-tissue response, biocompatibility, and aesthetics with comparable osseointegration. However, further long-term longitudinal and comparative clinical trials are required to validate zirconia as a viable alternative to the titanium implant. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  18. Effects of pore size, implantation time and nano-surface properties on rat skin ingrowth into percutaneous porous titanium implants

    OpenAIRE

    Farrell, Brad J.; Prilutsky, Boris I.; Ritter, Jana M.; Kelley, Sean; Popat, Ketul; Pitkin, Mark

    2013-01-01

    The main problem of percutaneous osseointegrated implants is poor skin-implant integration, which may cause infection. This study investigated the effects of pore size (Small, 40–100 microns and Large, 100–160 microns), nanotubular surface treatment (Nano), and duration of implantation (3 and 6 weeks) on skin ingrowth into porous titanium. Each implant type was percutaneously inserted in the back of 35 rats randomly assigned to 7 groups. Implant extrusion rate was measured w...

  19. [Interceptive treatment of maxillary hypoplasia with the use of bone anchors. A review of the literature].

    Science.gov (United States)

    Vermeulen, F M J; De Clerck, H J; van Beek, H; Becking, A G

    2014-02-01

    A Class III malocclusion is mainly caused by a hypoplastic maxilla and therefore the treatment is principally aimed at stimulating the growth of the maxilla. Disadvantages of conventional treatment methods are that treatment effects are mainly dentoalveolar rather than skeletal and that there is often an increase in the height of the lowerface. Moreover, patients are not always cooperative about wearing extra-oral appliances. Because of these disadvantages, a new treatment approach has been developed which makes use of skeletal anchoring. In this new technique, called 'bone anchored maxillary protraction, bone anchors are placed on both sides of the maxilla and the mandibula, onto which Class III elastics are attached. The literature shows that good results have been achieved with this method. Disadvantages of this method are that the placement of the bone anchors requires a surgical procedure and that complications, like the loosening or breaking of the anchors, can occur.

  20. Effects of Ultraviolet Photofunctionalization on Bone Augmentation and Integration Capabilities of Titanium Mesh and Implants.

    Science.gov (United States)

    Hirota, Makoto; Ikeda, Takayuki; Tabuchi, Masako; Ozawa, Tomomichi; Tohnai, Iwai; Ogawa, Takahiro

    Ultraviolet (UV)-mediated photofunctionalization has earned considerable attention for the enhancement of the biologic capabilities of titanium. The effects of photofunctionalization on bone augmentation and gap closure were examined using titanium implants and mesh in a rat femur model. An acid-etched titanium implant (4-mm length, 1-mm diameter) was placed in the gluteal tuberosity that resembles a knife-edge-like edentulous ridge. The lower half of the implant was located in a 2-mm-diameter defect created in the bone without cortical bone support; the upper half was exposed and covered with a titanium mesh to provide augmentation space. After 12 and 24 days of healing, specimens were subjected to microcomputed tomography (micro-CT)- and histology-based bone morphometry in three zones of analysis: augmentation, cortical bone-implant gap, and bone marrow. A biomechanical push-in test was performed to examine the strength of bone-implant integration. Photofunctionalization was performed by treating titanium implants and mesh with UV light for 12 minutes. Photofunctionalized titanium mesh and implants were hydrophilic, whereas untreated controls were hydrophobic. Bone volume was significantly greater in photofunctionalized implants and mesh than in untreated implants in all zones on days 12 and 24. Bone-to-implant contact of photofunctionalized implants was greater than that of untreated implants, not just in the bone marrow but also in the gap and augmented zones. The strength of osseointegration was three times greater for photofunctionalized implants than for untreated implants. Use of photofunctionalized titanium mesh and implants effectively enhanced vertical bone augmentation, cortical bone-implant gap closure, and osseointegration without innate bone support.

  1. Titanium Implant Osseointegration Problems with Alternate Solutions Using Epoxy/Carbon-Fiber-Reinforced Composite

    OpenAIRE

    Petersen, Richard C.

    2014-01-01

    The aim of the article is to present recent developments in material research with bisphenyl-polymer/carbon-fiber-reinforced composite that have produced highly influential results toward improving upon current titanium bone implant clinical osseointegration success. Titanium is now the standard intra-oral tooth root/bone implant material with biocompatible interface relationships that confer potential osseointegration. Titanium produces a TiO2 oxide surface layer reactively that can provide ...

  2. Method for histological preparation of bone sections containing titanium implants.

    Science.gov (United States)

    Hipp, J A; Brunski, J B; Cochran, G V

    1987-07-01

    A thin sectioning technique involving hand grinding has been developed to produce 20-40-microns-thick sections of bone-titanium implant sites. Components include: 1) surface staining of sections prior to mounting on slides so bone labels (oxytetracycline-HCl and 2,4-bis(N,N-dicarbomethyl)aminomethylfluorescein (DCAF] can be seen in sections viewed with transmitted light, 2) a pneumatic sample press for bonding sections to slides with a thin, uniform glue line and without trapped air bubbles, and 3) bonding methyl methacrylate embedded sections to clear acrylic slides with methyl methacrylate monomer to provide enhanced bond strength and grinding properties compared to those obtainable with glass slides. Sample cracking and distortion is minimized and the tissue-implant interface can be kept intact. The expense of start-up equipment for this technique is minimal.

  3. Histomorphometric and removal torque analysis for TiO2-blasted titanium implants. An experimental study on dogs

    DEFF Research Database (Denmark)

    Gotfredsen, K; Nimb, L; Hjörting-Hansen, E

    1992-01-01

    bilaterally and 24 commercial pure titanium implants were placed immediately in extraction sockets and covered with mucoperiosteum. Each dog had inserted 4 implants: 1 screw implant and 1 cylindrical implant blasted with titanium-dioxide-particles; 1 screw implant and 1 cylindrical implant with machine......-produced (m.p.) surface (controls). After a healing period of 12 weeks, 16 implants from 4 animals were used for removal torque test, which demonstrated that significantly higher removal torque force was needed to unscrew the implants blasted with titanium-dioxide-particles, than the normal m.p. implants......-blasted implants and the control implants. The implants blasted with titanium-dioxide-particles in this study showed a better anchorage than implants with a machine-produced surface. The screw implants showed a better anchorage than the cylindrical implants....

  4. Functional benefit of the bone-anchored hearing aid with different auditory profiles: objective and subjective measures.

    Science.gov (United States)

    van Wieringen, A; De Voecht, K; Bosman, A J; Wouters, J

    2011-04-01

    To examine sentence recognition and self-report outcomes in hearing-impaired persons with different auditory profiles and who were fitted unilaterally with a bone-anchored hearing aid. Prospective cohort study. Tertiary referral unit. Data were collected of six patients with single-sided deafness (SSD), seven with a mild to severe hearing loss at the bone-anchored hearing aid side and (near-)normal hearing at the other side and six with a severe bilateral hearing loss. Sound field thresholds, and sentence recognition in noise (presented from different angles) with bone-anchored hearing aid, without bone-anchored hearing aid and with bone-anchored hearing aid and other ear occluded. In addition, the Speech, Spatial and Qualities of hearing scale and the Abbreviated Profile of Hearing Aid Benefit questionnaire were administered as self-report measures. Patients with single-sided deafness listened mainly with their non-bone-anchored hearing aid ear, although the bone-anchored hearing aid lifted the head shadow effect. Patients with mild to severe hearing loss at the bone-anchored hearing aid side and (near-)normal hearing at the other side performed significantly differently in aided and unaided conditions and even regained limited binaural sensitivity with the device. The latter was also true for the patients with severe bilateral hearing loss. However, their hearing loss at the non-bone-anchored hearing aid side was too great to contribute to hearing and they listened predominantly with their bone-anchored hearing aid. Self-report outcomes provided useful information on hearing disability, although this information was not significantly differently for the 3 groups of patients. The bone-anchored hearing aid enhanced performance in different hearing configurations, albeit to different extents. © 2011 Blackwell Publishing Ltd.

  5. Production of titanium alloys for medical implants by powder metallurgy

    Energy Technology Data Exchange (ETDEWEB)

    Henriques, V.A.R. [Dept. de Engenharia de Materiais, Faculdade de Engenharia Quimica de Lorena, Lorena SP (Brazil); Silva, C.R.M. da [Div. de Materiais, CTA-IAE-AMR, Sao Jose dos Campos SP (Brazil)

    2001-07-01

    Titanium alloys are expected to be much more widely used for implant materials in the medical and dental fields because of their superior biocompatibility, corrosion resistance and specific strength compared with other metallic implant materials. Vanadium free alloys like Ti-6Al-7Nb and Ti-5Al-2,5Fe have been recently developed for biomedical use. More recently vanadium and aluminum free alloys composed of non-toxic elements like Nb, Ta, Zr and so on with lower modulus have been started to be developed. The {beta} type alloys like Ti-15Mo are now the main target for medical materials. A blended elemental titanium powder metallurgy process has been developed to offer low cost products. The process employs hydride-dehydride (HDH) powders and near-net shape techniques. In this work, the influence of the processing parameters and chemical composition of the elementary powders on the final microstructure was investigated. The alloys were characterized by means of scanning electron microscopy, X-ray diffraction, Vickers microhardness measurements, chemical analysis and density. The results indicate that the samples presented high densification, homogeneous chemical composition and coherent microstructures. The process parameters were defined aiming to reduce the interstitial pick-up (O, N) and to avoid the grain growth. (orig.)

  6. Titanium Implant Medialization Laryngoplasty Application in the Case of a Silicone and Gore-Tex Extrusion

    Directory of Open Access Journals (Sweden)

    Salih Bakir

    2014-08-01

    Full Text Available  Though the surgical technique of medialization laryngoplasty (ML has been standardized today, the ideal implant has not been well-defined yet. Various non-absorbable materials such as autogenous cartilage, silicone, hydroxylapatite, Gore-tex, and titanium have been used for ML. Titanium implant ML is a new technique and any complication has not been reported so far. Gore-tex and silicone implants have been used more longer and both of them are accepted safe and easy to handle materials. Extrusion of Gore-tex or silicone material after ML has been rarely reported. We present a case of a 38-year-old man with history of silicone and then Gore-tex implant extrusion after ML. Titanium implant was performed on the patient. Although rare, the possibility of silicone and Gore-tex extrusion after ML operation must not be ignored. Titanium implant may be a good alternative in such cases.

  7. Osseointegrated implants and auricular defects: a case series study.

    Science.gov (United States)

    Wright, Robert F; Zemnick, Candice; Wazen, Jack J; Asher, Eric

    2008-08-01

    The objective of this study was to report on the survival rate of 16 patients treated with extraoral implants in the auricular region, analyze treatment outcomes, and discuss important clinical variables encountered during treatment. Sixteen patients who received extraoral dental implants to retain auricular prostheses between 1987 and 2003 were followed retrospectively. The variables recorded were gender, initial diagnosis, number and size of implants, implant placement date, age at implant placement, history of radiation to the treated field, abutment size, design of initial prosthesis, age of initial prosthesis (when a remake was indicated), date of prosthesis delivery, soft tissue response, grafting procedure, date of last follow-up, and complications. All patients were thoroughly evaluated presurgically by the reconstruction team, which consisted of prosthodontists, a facial prosthetist, and an otolaryngologist. Surgical templates were used for all patients. The criteria for success of the prostheses included marginal accuracy, overall stability and function, symmetry/position, texture, color stability, and patient acceptance. Thirty-nine implants were placed in 16 patients. All 16 patients were completely satisfied with their reconstructions. No surgical complications, implant failures, or prosthetic failures were encountered. Therefore, the survival rate was 100%. Three patients (18.75%) had grade 0, seven (43.75%) had grade 1, five (31.25%) had grade 2, and one (6.25%) had grade 3 soft tissue inflammation. The inflammation completely resolved in 7 of the 13 patients (54%) with hygiene reinforcement or soft tissue reduction. The survival rate for bone-anchored titanium implants and prostheses was 100%. Bone-anchored titanium implants provided the 16 patients in this study with a safe, reliable, adhesive-free method to anchor auricular prostheses with recovery of normal appearance. Under the guidance of an appropriate implant team, proper positioning of

  8. Pectin nanocoating of titanium implant surfaces - an experimental study in rabbits

    DEFF Research Database (Denmark)

    Gurzawska, Katarzyna Aleksandra; Dirscherl, Kai; Jørgensen, Bodil

    2017-01-01

    ) into the left and right tibia of rabbits. Machined titanium implants without RG-I nanocoating were used as controls (n = 32). Total number of 128 implants was placed in tibias of 16 rabbits. Fluorochrome bone labels, calcein green and alizarin red S were given intravenously after 9 and 12 days, respectively...... showed that nanocoating of titanium implants with pectin RG-Is did not significantly enhance bone healing and osseointegration when placed in rabbit tibia bone....

  9. Esthetic Considerations for Reconstructing Implant Emergence Profile Using Titanium and Zirconia Custom Implant Abutments: Fifty Case Series Report.

    Science.gov (United States)

    Kutkut, Ahmad; Abu-Hammad, Osama; Mitchell, Richard

    2015-10-01

    Titanium and zirconia custom implant abutments are now commonly used for esthetic implant dentistry. Custom implant abutments allow the clinician to improve an implant's emergence profile, to customize cervical margins in accordance with the anatomy of the natural root, and to compensate for poor implant angulation. All of these are essential for optimum esthetic outcomes. Computer-aided design/computer-aided machining (CAD/CAM) technology allows the clinician to design custom implant abutment configurations and create natural-looking superstructures that are in harmony with the adjacent dentition and soft tissue. The CAD/CAM technique provides precise fit, reduces the cost of the procedure, and eliminates dimensional inaccuracies inherent in the conventional waxing and casting technique. The aim of this report is to describe a simplified technique for reconstructing emergence profiles during implant restoration using milled titanium and zirconia custom implant abutments. The results of 50 consecutive cases are reported.

  10. Gelatin functionalised porous titanium alloy implants for orthopaedic applications

    Energy Technology Data Exchange (ETDEWEB)

    Vanderleyden, E. [Polymer Chemistry and Biomaterials Research Group, Department of Organic Chemistry, University of Ghent, Krijgslaan 281 S4, 9000 Ghent (Belgium); Van Bael, S. [Prometheus, Division of Skeletal Tissue Engineering, Katholieke Universiteit Leuven, O and N 1, Herestraat 49, Box 813, 3000 Leuven (Belgium); Department of Mechanical Engineering, Division of Production Engineering, Machine Design and Automation, Katholieke Universiteit Leuven, Celestijnenlaan 300b, 3001 Leuven (Belgium); Department of Mechanical Engineering, Division of Biomechanics and Engineering Design, Katholieke Universiteit Leuven, Celestijnenlaan 300c, Box 2419, 3001 Heverlee (Belgium); Chai, Y.C. [Prometheus, Division of Skeletal Tissue Engineering, Katholieke Universiteit Leuven, O and N 1, Herestraat 49, Box 813, 3000 Leuven (Belgium); Tissue Engineering Laboratory, Skeletal Biology and Engineering Research Center, Katholieke Universiteit Leuven, O and N 1, Herestraat 49, Box 813, 3000 Leuven (Belgium); Kruth, J.-P. [Department of Mechanical Engineering, Division of Production Engineering, Machine Design and Automation, Katholieke Universiteit Leuven, Celestijnenlaan 300b, 3001 Leuven (Belgium); Schrooten, J. [Prometheus, Division of Skeletal Tissue Engineering, Katholieke Universiteit Leuven, O and N 1, Herestraat 49, Box 813, 3000 Leuven (Belgium); Department of Metallurgy and Materials Engineering, Katholieke Universiteit Leuven, Kasteelpark Arenberg 44, Bus 2450, 3001 Leuven (Belgium); Dubruel, P., E-mail: pbmugent@gmail.com [Polymer Chemistry and Biomaterials Research Group, Department of Organic Chemistry, University of Ghent, Krijgslaan 281 S4, 9000 Ghent (Belgium)

    2014-09-01

    In the present work, we studied the immobilisation of the biopolymer gelatin onto the surface of three dimensional (3D) regular Ti6Al4V porous implants to improve their surface bio-activity. The successful immobilisation of the gelatin coating was made possible by a polydopamine interlayer, a polymer coating inspired by the adhesive nature of mussels. The presence of both coatings was first optimised on two dimensional titanium (2D Ti) substrates and confirmed by different techniques including X-ray photelectron spectroscopy, contact angle measurements, atomic force microscopy and fluorescence microscopy. Results showed homogeneous coatings that are stable for at least 24 h in phosphate buffer at 37 °C. In a next step, the coating procedure was successfully transferred to 3D Ti6Al4V porous implants, which indicates the versatility of the applied coating procedure with regard to complex surface morphologies. Furthermore, the bio-activity of these stable gelatin coatings was enhanced by applying a third and final coating using the cell-attractive protein fibronectin. The reproducible immobilisation process allowed for a controlled biomolecule presentation to the surrounding tissue. This newly developed coating procedure outperformed the previously reported silanisation procedure for immobilising gelatin. In vitro cell adhesion and culture studies with human periosteum-derived cells showed that the investigated coatings did not compromise the biocompatible nature of Ti6Al4V porous implants, but no distinct biological differences between the coatings were found. - Highlights: • Ti6Al4V porous implants were produced by selective laser melting. • A procedure to obtain a stable gelatin coating was developed. • Successful transfer of the coating procedure from 2D to 3D Ti6Al4V porous implants. • In vitro cell studies showed that the developed coatings supported cell growth.

  11. Hearing rehabilitation in Treacher Collins Syndrome with bone anchored hearing aid

    Directory of Open Access Journals (Sweden)

    José Fernando Polanski

    2015-12-01

    Full Text Available Objective: To describe a case of hearing rehabilitation with bone anchored hearing aid in a patient with Treacher Collins syndrome. Case description: 3 years old patient, male, with Treacher Collins syndrome and severe complications due to the syndrome, mostly related to the upper airway and hearing. He had bilateral atresia of external auditory canals, and malformation of the pinna. The initial hearing rehabilitation was with bone vibration arch, but there was poor acceptance due the discomfort caused by skull compression. It was prescribed a model of bone-anchored hearing aid, in soft band format. The results were evaluated through behavioral hearing tests and questionnaires Meaningful Use of Speech Scale (MUSS and Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS. Comments: The patient had a higher acceptance of the bone-anchored hearing aid compared to the traditional bone vibration arch. Audiological tests and the speech and auditory skills assessments also showed better communication and hearing outcomes. The bone-anchored hearing aid is a good option in hearing rehabilitation in this syndrome.

  12. Hearing rehabilitation in Treacher Collins Syndrome with bone anchored hearing aid

    Science.gov (United States)

    Polanski, José Fernando; Plawiak, Anna Clara; Ribas, Angela

    2015-01-01

    Objective: To describe a case of hearing rehabilitation with bone anchored hearing aid in a patient with Treacher Collins syndrome. Case description: 3 years old patient, male, with Treacher Collins syndrome and severe complications due to the syndrome, mostly related to the upper airway and hearing. He had bilateral atresia of external auditory canals, and malformation of the pinna. The initial hearing rehabilitation was with bone vibration arch, but there was poor acceptance due the discomfort caused by skull compression. It was prescribed a model of bone-anchored hearing aid, in soft band format. The results were evaluated through behavioral hearing tests and questionnaires Meaningful Use of Speech Scale (MUSS) and Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS). Comments: The patient had a higher acceptance of the bone-anchored hearing aid compared to the traditional bone vibration arch. Audiological tests and the speech and auditory skills assessments also showed better communication and hearing outcomes. The bone-anchored hearing aid is a good option in hearing rehabilitation in this syndrome. PMID:26298651

  13. [Hearing rehabilitation in Treacher Collins Syndrome with bone anchored hearing aid].

    Science.gov (United States)

    Polanski, José Fernando; Plawiak, Anna Clara; Ribas, Angela

    2015-12-01

    To describe a case of hearing rehabilitation with bone anchored hearing aid in a patient with Treacher Collins syndrome. 3 years old patient, male, with Treacher Collins syndrome and severe complications due to the syndrome, mostly related to the upper airway and hearing. He had bilateral atresia of external auditory canals, and malformation of the pinna. The initial hearing rehabilitation was with bone vibration arch, but there was poor acceptance due the discomfort caused by skull compression. It was prescribed a model of bone-anchored hearing aid, in soft band format. The results were evaluated through behavioral hearing tests and questionnaires Meaningful Use of Speech Scale (Muss) and Infant-Toddler Meaningful Auditory Integration Scale (IT-Mais). The patient had a higher acceptance of the bone-anchored hearing aid compared to the traditional bone vibration arch. Audiological tests and the speech and auditory skills assessments also showed better communication and hearing outcomes. The bone-anchored hearing aid is a good option in hearing rehabilitation in this syndrome. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  14. The bone-anchored hearing aid in patients with a unilateral air-bone gap.

    NARCIS (Netherlands)

    Snik, A.F.M.; Mylanus, E.A.M.; Cremers, C.W.R.J.

    2002-01-01

    OBJECTIVES: To study the benefit of the application of a bone-anchored hearing aid in patients with a unilateral air-bone gap. STUDY DESIGN: Prospective evaluation in eight patients. METHODS: Binaural hearing was assessed in the sound field by comparing aided and unaided scores obtained with a sound

  15. Success and high predictability of intraorally welded titanium bar in the immediate loading implants

    OpenAIRE

    Fogli, V; Camerini, M; Lauritano, D; Carinci, F

    2014-01-01

    The implants failure may be caused by micromotion and stress exerted on implants during the phase of bone healing. This concept is especially true in case of implants placed in atrophic ridges. So the primary stabilization and fixation of implants are an important goal that can also allow immediate loading and oral rehabilitation on the same day of surgery. This goal may be achieved thanks to the technique of welding titanium bars on implant abutments. In fact, the procedure can be performed ...

  16. Primary Stability of Zirconium vs Titanium Implants: An In Vitro Comparison

    Science.gov (United States)

    2015-06-05

    length) Axis Biodental zirconia dental implants and 16 4.0x11.5 Biomet 3i Certain Parallel Walled titanium dental implants were placed into...primary stability adequate for successful osseointegration and immediate loading protocol. Biomet 3i implants achieve   x     significantly...the most important parameters in implant dentistry. It affects the healing and successful osseointegration of implants . Furthermore its importance

  17. Non-Destructive Analysis of Basic Surface Characteristics of Titanium Dental Implants Made by Miniature Machining

    Science.gov (United States)

    Babík, Ondrej; Czán, Andrej; Holubják, Jozef; Kameník, Roman; Pilc, Jozef

    2016-12-01

    One of the most best-known characteristic and important requirement of dental implant is made of biomaterials ability to create correct interaction between implant and human body. The most implemented material in manufacturing of dental implants is titanium of different grades of pureness. Since most of the implant surface is in direct contact with bone tissue, shape and integrity of said surface has great influence on the successful osseointegration. Among other characteristics of titanium that predetermine ideal biomaterial, it shows a high mechanical strength making precise machining miniature Increasingly difficult. The article is focused on evaluation of the resulting quality, integrity and characteristics of dental implants surface after machining.

  18. Hearing rehabilitation in congenital aural atresia using the bone-anchored hearing aid: audiological and satisfaction results.

    Science.gov (United States)

    Fuchsmann, Carine; Tringali, Stéphane; Disant, François; Buiret, Guillaume; Dubreuil, Christian; Froehlich, Patrick; Truy, Eric

    2010-12-01

    The BAHA (bone-anchored hearing aid) remains the most reliable method of auditory rehabilitation for patients with congenital aural atresia and improves hearing outcome and quality of life in these patients who are otherwise unable to benefit from traditional hearing aids. New techniques are being developed, such as fully implantable hearing devices, and will have to prove their efficacy and safety in this indication. To evaluate the audiological results and patient satisfaction after rehabilitation of congenital aural atresia using the BAHA. Sixteen patients suffering from bilateral congenital aural atresia were implanted with unilateral BAHA. Preoperative air- and bone-conduction thresholds and air-bone gap (ABG), preoperative sound reception threshold (SRT), postoperative aided thresholds, implantation complications, patient satisfaction, and the APHAB questionnaire were collected. After a mean follow-up period of 6.5 years, 15 patients were still using their device. Each patient had an average improvement of 33 ± 7 dB. Closure of the ABG within 15 dB of the preoperative bone-conduction thresholds occurred in 10 patients. Adverse skin reactions appeared in 50% of patients over 6.5 years of follow-up. Eleven of the 12 patients used their BAHA for more than 8 h per day.

  19. Development and Applications of Porous Tantalum Trabecular Metal Enhanced Titanium Dental Implants

    Science.gov (United States)

    Bencharit, Sompop; Byrd, Warren C.; Altarawneh, Sandra; Hosseini, Bashir; Leong, Austin; Reside, Glenn; Morelli, Thiago; Offenbacher, Steven

    2013-01-01

    Statement of Problem Porous tantalum trabecular metal has recently been incorporated in titanium dental implants as a new form of implant surface enhancement. However, there is little information on the applications of this material in implant dentistry. Methods We, therefore review the current literature on the basic science and clinical uses of this material. Results Porous tantalum metal is used to improve the contact between osseous structure and dental implants; and therefore presumably facilitate osseointegration. Success of porous tantalum metal in orthopedic implants led to the incorporation of porous tantalum metal in the design of root-from endosseous titanium implants. The porous tantalum three-dimensional enhancement of titanium dental implant surface allows for combining bone ongrowth together with bone ingrowth, or osseoincorporation. While little is known about the biological aspect of the porous tantalum in the oral cavity, there seems to be several possible advantages of this implant design. This article reviews the biological aspects of porous tantalum enhanced titanium dental implants, in particular the effects of anatomical consideration and oral environment to implant designs. Conclusions We propose here possible clinical situations and applications for this type of dental implant. Advantages and disadvantages of the implants as well as needed future clinical studies are discussed. PMID:23527899

  20. Can audiometric results predict qualitative hearing improvements in bone-anchored hearing aid recipients?

    Science.gov (United States)

    McNeil, M L; Gulliver, M; Morris, D P; Makki, F M; Bance, M

    2014-01-01

    Patients receiving a bone-anchored hearing aid have well-documented improvements in their quality of life and audiometric performance. However, the relationship between audiometric measurements and subjective improvement is not well understood. Adult patients enrolled in the Nova Scotia bone-anchored hearing aid programme were identified. The pure tone average for fitting the sound-field threshold, as well as the better and worse hearing ear bone conduction and air conduction levels, were collected pre-operatively. Recipients were asked to complete the Speech, Spatial and Qualities of Hearing questionnaire; their partners were asked to complete a pre- and post-bone anchored hearing aid fitting Hearing Handicap Inventory for Adults questionnaire. Forty-eight patients who completed and returned the Speech, Spatial and Qualities of Hearing questionnaire had partners who completed the Hearing Handicap Inventory for Adults questionnaire. The results from the Speech, Spatial and Qualities of Hearing questionnaire correlated with the sound-field hearing threshold post-bone-anchored hearing aid fitting and the pure tone average of the better hearing ear bone conduction (total Speech, Spatial and Qualities of Hearing Scale to the pre-operative better hearing ear air curve (r = 0.3); worse hearing ear air curve (r = 0.27); post-operative, bone-anchored hearing aid-aided sound-field thresholds (r = 0.35)). An improvement in sound-field threshold correlated only with spatial abilities. In the Hearing Handicap Inventory for Adults questionnaire, there was no correlation between the subjective evaluation of each patient and their partner. The subjective impressions of hearing aid recipients with regards to speech reception and the spatial qualities of hearing correlate well with pre-operative audiometric results. However, the overall magnitude of sound-field improvement predicts an improvement of spatial perception, but not other aspects of hearing, resulting in hearing aid

  1. Electrochemical corrosion characteristics and biocompatibility of nanostructured titanium for implants

    Science.gov (United States)

    Lu, Jinwen; Zhang, Yong; Huo, Wangtu; Zhang, Wei; Zhao, Yongqing; Zhang, Yusheng

    2018-03-01

    In the present study, a nano-grained (NG) surface layer on a commercial pure (Grade-2) titanium sheet was achieved by means of sliding friction treatment. The surface characteristics, in vitro corrosion behavior and biocompatibility of NG Ti were investigated, compared with those of the conventional coarse-grained (CG) substrate. The protective passive film on NG Ti surface is thicker than that on CG Ti, leading to its enhanced biological corrosion resistance in simulated body fluid (SBF) solution. In addition, NG Ti shows a much higher hydrophilicity and nano-roughness, which is related to its significantly improved cell attachment, spreading, proliferation and maturation relative to CG Ti. The enhanced biological anti-corrosion properties and biocompatibility render NG Ti a promising biomaterial for implants.

  2. Osseointegration improvement by shot peening in titanium dental implants

    International Nuclear Information System (INIS)

    Aparicio, C.; Gil, F.J.; Planell, J.A.; Padros, A.; Peraire, C.

    1998-01-01

    In order to optimize the implant-bone fixation, different shot peening treatments with different shot particles (TiO 2 , Al 2 O 3 ; SiC) have been made. The influence that each type of shot particle has in the bone colonization on the different treatment surfaces has been determined by means of osteoblast-like cells culture. Commercially pure titanium discs have been shot peened. Their qualitative and quantitative surface roughness have been characterized; as well as their surface contamination caused by the shot particles. Particle size has also been determined, before and after the treatment, in order to evaluate their breaking averages. Finally, a TiO 2 shot particles manufacture process by sintering has been developed. The manufacture has been necessary since this type of shot particles are not available in the market with the adequate size. (Author) 10 refs

  3. Alveolar Ridge Reconstruction with Titanium Meshes and Simultaneous Implant Placement: A Retrospective, Multicenter Clinical Study

    Science.gov (United States)

    Paraud Freixas, Andres; Han, Chang-Hun; Bechara, Sohueil; Tawil, Isaac

    2016-01-01

    Objective. To evaluate horizontal bone gain and implant survival and complication rates in patients treated with titanium meshes placed simultaneously with dental implants and fixed over them. Methods. Twenty-five patients treated with 40 implants and simultaneous guided bone regeneration with titanium meshes (i–Gen®, MegaGen, Gyeongbuk, Republic of Korea) were selected for inclusion in the present retrospective multicenter study. Primary outcomes were horizontal bone gain and implant survival; secondary outcomes were biological and prosthetic complications. Results. After the removal of titanium meshes, the CBCT evaluation revealed a mean horizontal bone gain of 3.67 mm (±0.89). The most frequent complications were mild postoperative edema (12/25 patients: 48%) and discomfort after surgery (10/25 patients: 40%); these complications were resolved within one week. Titanium mesh exposure occurred in 6 patients (6/25 : 24%): one of these suffered partial loss of the graft and another experienced complete graft loss and implant failure. An implant survival rate of 97.5% (implant-based) and a peri-implant marginal bone loss of 0.43 mm (±0.15) were recorded after 1 year. Conclusions. The horizontal ridge reconstruction with titanium meshes placed simultaneously with dental implants achieved predictable satisfactory results. Prospective randomized controlled trials on a larger sample of patients are required to validate these positive outcomes. PMID:27999799

  4. Alveolar Ridge Reconstruction with Titanium Meshes and Simultaneous Implant Placement: A Retrospective, Multicenter Clinical Study

    Directory of Open Access Journals (Sweden)

    Raquel Zita Gomes

    2016-01-01

    Full Text Available Objective. To evaluate horizontal bone gain and implant survival and complication rates in patients treated with titanium meshes placed simultaneously with dental implants and fixed over them. Methods. Twenty-five patients treated with 40 implants and simultaneous guided bone regeneration with titanium meshes (i–Gen®, MegaGen, Gyeongbuk, Republic of Korea were selected for inclusion in the present retrospective multicenter study. Primary outcomes were horizontal bone gain and implant survival; secondary outcomes were biological and prosthetic complications. Results. After the removal of titanium meshes, the CBCT evaluation revealed a mean horizontal bone gain of 3.67 mm (±0.89. The most frequent complications were mild postoperative edema (12/25 patients: 48% and discomfort after surgery (10/25 patients: 40%; these complications were resolved within one week. Titanium mesh exposure occurred in 6 patients (6/25 : 24%: one of these suffered partial loss of the graft and another experienced complete graft loss and implant failure. An implant survival rate of 97.5% (implant-based and a peri-implant marginal bone loss of 0.43 mm (±0.15 were recorded after 1 year. Conclusions. The horizontal ridge reconstruction with titanium meshes placed simultaneously with dental implants achieved predictable satisfactory results. Prospective randomized controlled trials on a larger sample of patients are required to validate these positive outcomes.

  5. Interruption of Electrical Conductivity of Titanium Dental Implants Suggests a Path Towards Elimination Of Corrosion.

    Directory of Open Access Journals (Sweden)

    Alex E Pozhitkov

    Full Text Available Peri-implantitis is an inflammatory disease that results in the destruction of soft tissue and bone around the implant. Titanium implant corrosion has been attributed to the implant failure and cytotoxic effects to the alveolar bone. We have documented the extent of titanium release into surrounding plaque in patients with and without peri-implantitis. An in vitro model was designed to represent the actual environment of an implant in a patient's mouth. The model uses actual oral microbiota from a volunteer, allows monitoring electrochemical processes generated by biofilms growing on implants and permits control of biocorrosion electrical current. As determined by next generation DNA sequencing, microbial compositions in experiments with the in vitro model were comparable with the compositions found in patients with implants. It was determined that the electrical conductivity of titanium implants was the key factor responsible for the biocorrosion process. The interruption of the biocorrosion current resulted in a 4-5 fold reduction of corrosion. We propose a new design of dental implant that combines titanium in zero oxidation state for osseointegration and strength, interlaid with a nonconductive ceramic. In addition, we propose electrotherapy for manipulation of microbial biofilms and to induce bone healing in peri-implantitis patients.

  6. The use of a bone-anchored hearing aid (Baha) in children with severe behavioural problems--the Birmingham Baha programme experience.

    Science.gov (United States)

    Doshi, Jayesh; McDermott, Ann-Louise; Reid, Andrew; Proops, David

    2010-06-01

    A trial of a bone conductor is traditionally used to determine whether a bone-anchored hearing aid (Baha) will be beneficial to a child. However there is a subgroup of children where a Baha assessment is not possible due to severe behavioural/mental/sensory disorders. We describe our experience in a small series of such children. Retrospective case series review of four children at the severe end of the spectrum of behavioural difficulties who underwent Baha implantation where no formal preoperative hearing aid assessment was possible. The Glasgow Children's Benefit Inventory and a visual analogue scale assessing health status were used to determine the benefit of Baha implantation in this group. There was no surgical morbidity in this group although a more intensive postoperative follow up was required. All four children wore their hearing aids at least 8h a day. Parents reported a positive impact of the Baha on the behaviour and mood of their children. The Baha showed a positive benefit when assessed using the Glasgow Children's Benefit Inventory and showed a positive change in health status. We feel that our early experience with Baha in children with severe behavioural difficulties has been positive to date. Multidisciplinary teams should not dismiss these children even if a trial of a bone conductor is not possible. We feel that the bone-anchored hearing aid has been successful in our cases because the children do not physically feel the presence of the hearing aid. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  7. Effects of pore size, implantation time, and nano-surface properties on rat skin ingrowth into percutaneous porous titanium implants.

    Science.gov (United States)

    Farrell, Brad J; Prilutsky, Boris I; Ritter, Jana M; Kelley, Sean; Popat, Ketul; Pitkin, Mark

    2014-05-01

    The main problem of percutaneous osseointegrated implants is poor skin-implant integration, which may cause infection. This study investigated the effects of pore size (Small, 40-100 μm and Large, 100-160 μm), nanotubular surface treatment (Nano), and duration of implantation (3 and 6 weeks) on skin ingrowth into porous titanium. Each implant type was percutaneously inserted in the back of 35 rats randomly assigned to seven groups. Implant extrusion rate was measured weekly and skin ingrowth into implants was determined histologically after harvesting implants. It was found that all three types of implants demonstrated skin tissue ingrowth of over 30% (at week 3) and 50% (at weeks 4-6) of total implant porous area under the skin; longer implantation resulted in greater skin ingrowth (p skin integration with the potential for a safe seal. Copyright © 2013 Wiley Periodicals, Inc.

  8. Periodontal ligament formation around different types of dental titanium implants. I. The self-tapping screw type implant system

    DEFF Research Database (Denmark)

    Warrer, K; Karring, T; Gotfredsen, K

    1993-01-01

    The aim of this study was to determine if a periodontal ligament can form around self-tapping, screw type titanium dental implants. Implants were inserted in contact with the periodontal ligament of root tips retained in the mandibular jaws of 7 monkeys. In each side of the mandible, 1 premolar...

  9. The bone-anchored hearing aid in the rehabilitation of single-sided deafness: experience with 58 patients.

    Science.gov (United States)

    Martin, T P C; Lowther, R; Cooper, H; Holder, R L; Irving, R M; Reid, A P; Proops, D W

    2010-08-01

    To assess the efficacy of the bone-anchored hearing aid (BAHA) in the rehabilitation of single-sided deafness (SSD). Retrospective case-control series review. Tertiary referral unit. Fifty-eight consecutive patients that had a bone-anchored hearing aid for single-sided deafness completed outcome questionnaires, building upon earlier audiological assessment of 19 patients. Single-sided deafness controls (n = 49) were mainly acoustic neuroma patients. speech discrimination testing in directional noise, speech and spatial qualities of hearing questionnaire and the Glasgow Benefit Inventory (GBI). The mean follow-up time was 28.4 months. Five (13%) of the bone-anchored hearing aid patients were non-users because of lack of benefit. The audiometric testing confirmed that when noise was on the bone-anchored hearing aid side speech perception was reduced but benefited when noise was on the side of the hearing ear. There was no difference between the Speech and Spatial Qualities of Hearing Scores in bone-anchored hearing aid users and controls. In particular there was no difference in the spatial subscores. In the bone-anchored hearing aid users the median Glasgow Benefit Inventory score was 11. If the non-users are included then 13 (22%) patients had no or detrimental (negative) Benefit scores. No or negative benefit scores were more frequent in those deaf for bone-anchored hearing aid was most useful in small groups or in 'one-to-one' conversation. Bone-anchored hearing aid rehabilitation for single-sided deafness is less successful than for other indications, reflected here by relatively low median Glasgow Benefit Inventory scores. There was also no significant difference between controls and bone-anchored hearing aid users in the Speech and Spatial Qualities of Hearing Questionnaire. Patients with a longer duration of deafness report greater subjective benefit than those more recently deafened, perhaps due to differing expectations.

  10. A comparison of fit of CNC-milled titanium and zirconia frameworks to implants.

    Science.gov (United States)

    Abduo, Jaafar; Lyons, Karl; Waddell, Neil; Bennani, Vincent; Swain, Michael

    2012-05-01

    Computer numeric controlled (CNC) milling was proven to be predictable method to fabricate accurately fitting implant titanium frameworks. However, no data are available regarding the fit of CNC-milled implant zirconia frameworks. To compare the precision of fit of implant frameworks milled from titanium and zirconia and relate it to peri-implant strain development after framework fixation. A partially edentulous epoxy resin models received two Branemark implants in the areas of the lower left second premolar and second molar. From this model, 10 identical frameworks were fabricated by mean of CNC milling. Half of them were made from titanium and the other half from zirconia. Strain gauges were mounted close to the implants to qualitatively and quantitatively assess strain development as a result of framework fitting. In addition, the fit of the framework implant interface was measured using an optical microscope, when only one screw was tightened (passive fit) and when all screws were tightened (vertical fit). The data was statistically analyzed using the Mann-Whitney test. All frameworks produced measurable amounts of peri-implant strain. The zirconia frameworks produced significantly less strain than titanium. Combining the qualitative and quantitative information indicates that the implants were under vertical displacement rather than horizontal. The vertical fit was similar for zirconia (3.7 µm) and titanium (3.6 µm) frameworks; however, the zirconia frameworks exhibited a significantly finer passive fit (5.5 µm) than titanium frameworks (13.6 µm). CNC milling produced zirconia and titanium frameworks with high accuracy. The difference between the two materials in terms of fit is expected to be of minimal clinical significance. The strain developed around the implants was more related to the framework fit rather than framework material. © 2011 Wiley Periodicals, Inc.

  11. Incorporation of different antibiotics into carbonated hydroxyapatite coatings on titanium implants, release and antibiotic efficacy

    NARCIS (Netherlands)

    Stigter, M.; Bezemer, J.M.; de Groot, K.; Layrolle, P.

    2004-01-01

    Carbonated hydroxyapatite (CHA) coatings were applied onto titanium implants by using a biomimetic precipitation method. Different antibiotics were incorporated into the CHA coatings and their release and efficacy against bacteria growth were studied in vitro. The following antibiotics were used

  12. Soft tissue response to zirconia and titanium implant abutments : an in vivo within-subject comparison

    NARCIS (Netherlands)

    van Brakel, Ralph; Meijer, Gert J.; Verhoeven, Jan Willem; Jansen, John; de Putter, Cornelis; Cune, Marco S.

    2012-01-01

    Aim To compare the health of the soft tissues towards zirconia and titanium abutments in man, as observed using histological data. Material and Methods Twenty patients received two mandibular implants with either a zirconia or titanium abutment (split mouth study design, left-right randomization).

  13. An overview of the corrosion aspect of dental implants (titanium and its alloys

    Directory of Open Access Journals (Sweden)

    Chaturvedi T

    2009-01-01

    Full Text Available Titanium and its alloys are used in dentistry for implants because of its unique combination of chemical, physical, and biological properties. They are used in dentistry in cast and wrought form. The long term presence of corrosion reaction products and ongoing corrosion lead to fractures of the alloy-abutment interface, abutment, or implant body. The combination of stress, corrosion, and bacteria contribute to implant failure. This article highlights a review of the various aspects of corrosion and biocompatibility of dental titanium implants as well as suprastructures. This knowledge will also be helpful in exploring possible research strategies for probing the biological properties of materials.

  14. Surface Modification of Dental Titanium Implant by Layer-by-Layer Electrostatic Self-Assembly

    Directory of Open Access Journals (Sweden)

    Quan Shi

    2017-08-01

    Full Text Available In vivo implants that are composed of titanium and titanium alloys as raw materials are widely used in the fields of biology and medicine. In the field of dental medicine, titanium is considered to be an ideal dental implant material. Good osseointegration and soft tissue closure are the foundation for the success of dental implants. Therefore, the enhancement of the osseointegration and antibacterial abilities of titanium and its alloys has been the focus of much research. With its many advantages, layer-by-layer (LbL assembly is a self-assembly technique that is used to develop multilayer films based on complementary interactions between differently charged polyelectrolytes. The LbL approach provides new methods and applications for the surface modification of dental titanium implant. In this review, the application of the LbL technique to surface modification of titanium including promoting osteogenesis and osseointegration, promoting the formation and healing of soft tissues, improving the antibacterial properties of titanium implant, achieving local drug delivery and sustained release is summarized.

  15. Titanium implant insertion into dog alveolar ridges augmented by allogenic material

    DEFF Research Database (Denmark)

    Pinholt, E M; Haanaes, H R; Donath, K

    1994-01-01

    The purpose of this investigation was to evaluate whether titanium endosseous implants would osseointegrate in dog alveolar ridges augmented by allogenic material. In 8 dogs en bloc resection, including 2 pre-molars, was performed bilaterally in the maxilla and the mandible. After a healing period...... and only minimal osteoconduction, few multinuclear giant cells and a sparse inflammatory reaction. The titanium implants healed mainly by fibrous encapsulation....

  16. Nanocoating of titanium implant surfaces with organic molecules. Polysaccharides including glycosaminoglycans

    DEFF Research Database (Denmark)

    Gurzawska, Katarzyna Aleksandra; Svava, Rikke; Jørgensen, Niklas Rye

    2012-01-01

    Long-term stability of titanium implants are dependent on a variety of factors. Nanocoating with organic molecules is one of the method used to improve osseointegration. Nanoscale modification of titanium implants affects surface properties, such as hydrophilicity, biochemical bonding capacity...... with focus on polysaccharides including glycosaminoglycans, and how these molecules change surface properties, cell reactions and affect on osseointegartion. The included in vitro studies demonstrated increased cell adhesion, proliferation and mineralization of a number of the tested polysaccharide...

  17. Periodontal ligament formation around different types of dental titanium implants. I. The self-tapping screw type implant system

    DEFF Research Database (Denmark)

    Warrer, K; Karring, T; Gotfredsen, K

    1993-01-01

    The aim of this study was to determine if a periodontal ligament can form around self-tapping, screw type titanium dental implants. Implants were inserted in contact with the periodontal ligament of root tips retained in the mandibular jaws of 7 monkeys. In each side of the mandible, 1 premolar......, a periodontal ligament can form on self-tapping, screw type titanium dental implants in areas where a void is present between the surrounding bone and the implant at the time of insertion....... and 2 molars were removed in such a manner that in approximately half the cases, the root tips were retained. Following healing, the experimental areas were examined on radiographs, and sites were selected for the insertion of the implants, so that every second implant would have a close contact...

  18. One-year results of maxillary overdentures supported by 2 titanium-zirconium implants - implant survival rates and radiographic outcomes.

    Science.gov (United States)

    Zembic, Anja; Tahmaseb, Ali; Jung, Ronald E; Wismeijer, Daniel

    2017-07-01

    To assess implant survival rates and peri-implant bone loss of 2 titanium-zirconium implants supporting maxillary overdentures at 1 year of loading. Twenty maxillary edentulous patients (5 women and 15 men) being dissatisfied with their complete dentures were included. In total, 40 diameter-reduced titanium-zirconium implants were placed in the anterior maxilla. Local guided bone regeneration (GBR) was allowed if the treatment did not compromise implant stability. Following 3 to 5 months of healing, implant-supported overdentures were inserted on two ball anchors. Implants and overdentures were assessed at 1, 2, 4, and 8 weeks after implant insertion and 2, 4, and 12 months after insertion of overdentures (baseline). Standardized radiographs were taken at implant loading and 1 year. Implant survival rates and bone loss were the primary outcomes. Nineteen patients (1 dropout) with 38 implants were evaluated at a mean follow-up of 1.1 years (range 1.0-1.7 years). One implant failed resulting in an implant survival rate of 97.3%. There was a significant peri-implant bone loss of the implants at 1 year of function (mean, 0.7 mm, SD = 1.1 mm; median: 0.48 mm, IQR = 0.56 mm). There was a high 1-year implant survival rate for edentulous patients receiving 2 maxillary implants and ball anchors as overdenture support. However, several implants exhibited an increased amount of bone loss of more than 2 mm. Overdentures supported by 2 maxillary implants should thus be used with caution as minimally invasive treatment for specific patients encountering problems with their upper dentures until more long-term data is available. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Bone-anchored hearing aid (Baha) in patients with Treacher Collins syndrome: tips and pitfalls.

    Science.gov (United States)

    Marsella, Pasquale; Scorpecci, Alessandro; Pacifico, Concettina; Tieri, Luigi

    2011-10-01

    Treacher Collins syndrome, also known as mandibulofacial dysostosis, is an autosomal dominant disorder of the cranio-facial morphogenesis affecting 1 of 50,000 live newborns. Most children with this disease present with bilateral, severe conductive hearing loss due to bilateral aural atresia. Auditory rehabilitation of these children can be effectively carried out with bone-anchored hearing aids (Baha). The aim of this retrospective study is to review the "Bambino Gesù" Children's Hospital's experience with Baha in Treacher Collins patients, highlighting the tips and pitfalls of Baha surgery in this particular population. The clinical charts were reviewed of all children with a Treacher Collins syndrome diagnosis receiving a Baha in the "Bambino Gesù" Children's Hospital from January 1995 to January 2010. Data were collected concerning patients' anagraphics and medical history, comorbidities, surgical technique, complications and functional outcome. 23 Treacher Collins children were included. A two-stage surgery was adopted in 51% (n=12) cases, while a one-stage approach was chosen in 49% (n=11). 2 children underwent 1st stage surgery as they were younger than 5. There were neither cases of osseointegration failure, nor cases of traumatic implant loss. Overall, the local complication rate was not different in the one-stage and in the two-stage group. The functional gain was significantly better with the Baha than with the conventional bone-conduction hearing aids (pBaha at an age younger than 5 years and the rest (p=0.23). Baha can provide effective auditory rehabilitation for children with Treacher Collins syndrome, as long as it is performed in a tertiary care center where a multidisciplinary approach to the frequent comorbidities is possible. The main challenge of Baha surgery in this population is the poor or irregular thickness of the patient's calvarial bone, which often makes it necessary to drill additional holes, to place the fixture in contact with the

  20. Evaluation of a new powerful bone-anchored hearing system: a comparison study.

    Science.gov (United States)

    Bosman, Arjan J; Snik, Ad F M; Hol, Myrthe K S; Mylanus, Emmanuel A M

    2013-06-01

    The recent introduction of digital hearing aid technology for bone-conduction devices employing percutaneous stimulation may be beneficial for patients with conductive and mixed hearing loss and single sided deafness. Performance of a recently released sound processor for bone-anchored implants, the Ponto Pro Power from Oticon Medical (bone-conduction device 2 [BCD2]), was compared with that of the Baha Intenso from Cochlear (bone-conduction device 1 [BCD1]). Direct comparison of the subject's own device (BCD1) with the new device (BCD2) was examined in a nonrandomized design. Subjects were initially tested with BCD1. BCD2 was tested after a 4 wk acclimatization period. Eighteen subjects with mixed hearing loss and with at least 4 mo experience with BCD1 completed the study. Mean air-conduction and bone-conduction thresholds averaged across the frequencies of 500, 1000, 2000, and 4000 Hz were 73.9 and 34.2 dB HL, respectively. Performance of the two devices was evaluated objectively by measuring aided free-field thresholds, speech perception in quiet, and speech perception in noise. A subjective evaluation was carried out with the Abbreviated Profile of Hearing Aid Benefit (APHAB) (Cox and Alexander, 1995) and the Speech, Spatial and Qualities of Hearing Scale (SSQ) questionnaire (Gatehouse and Noble, 2004). In addition, user experiences, user satisfaction, and device preference were obtained via proprietary questionnaires. Statistical significance was established with analysis-of-variance (ANOVA) and paired t-statistics with Bonferroni correction. Aided free-field thresholds and speech reception thresholds (SRTs) in quiet were not statistically significantly different for either device (p > 0.05). In contrast, SRTs in noise were 2.0 dB lower (p < 0.001) for BCD2 than for BCD1. APHAB questionnaire scores on all subscales provided statistically significantly greater benefit (p < 0.05) for BCD2 than for BCD1. Also, with the SSQ most items in the speech and sound

  1. A Review of Titanium Zirconium (TiZr Alloys for Use in Endosseous Dental Implants

    Directory of Open Access Journals (Sweden)

    Michel Dard

    2012-08-01

    Full Text Available Dental implants made from binary titanium-zirconium (TiZr alloys have shown promise as a high strength, yet biocompatible alternative to pure titanium, particularly for applications requiring small diameter implants. The aim of this review is to summarize existing literature reporting on the use of binary TiZr alloys for endosseous dental implant applications as tested in vitro, in animals and clinically. And furthermore to show that TiZr is “at least as good as” pure titanium in terms of biocompatibility and osseointergration. From the twelve papers that met the inclusion criteria, the current literature confirms that TiZr alloys produce small diameter implants with a strength up to 40% higher than conventional, cold-worked, grade IV titanium implants, and with a corrosion resistance and biocompatibility that is at least as good as pure titanium. The surface structure of TiZr is compatible with established surface treatments proven to aid in the osseointegration of titanium implants. Furthermore, binary TiZr alloys have been shown to achieve good osseointegration and high success rates both in animal and in clinical studies.

  2. SLM Produced Porous Titanium Implant Improvements for Enhanced Vascularization and Osteoblast Seeding

    Directory of Open Access Journals (Sweden)

    Julia Matena

    2015-04-01

    Full Text Available To improve well-known titanium implants, pores can be used for increasing bone formation and close bone-implant interface. Selective Laser Melting (SLM enables the production of any geometry and was used for implant production with 250-µm pore size. The used pore size supports vessel ingrowth, as bone formation is strongly dependent on fast vascularization. Additionally, proangiogenic factors promote implant vascularization. To functionalize the titanium with proangiogenic factors, polycaprolactone (PCL coating can be used. The following proangiogenic factors were examined: vascular endothelial growth factor (VEGF, high mobility group box 1 (HMGB1 and chemokine (C-X-C motif ligand 12 (CXCL12. As different surfaces lead to different cell reactions, titanium and PCL coating were compared. The growing into the porous titanium structure of primary osteoblasts was examined by cross sections. Primary osteoblasts seeded on the different surfaces were compared using Live Cell Imaging (LCI. Cross sections showed cells had proliferated, but not migrated after seven days. Although the cell count was lower on titanium PCL implants in LCI, the cell count and cell spreading area development showed promising results for titanium PCL implants. HMGB1 showed the highest migration capacity for stimulating the endothelial cell line. Future perspective would be the incorporation of HMGB1 into PCL polymer for the realization of a slow factor release.

  3. SLM Produced Porous Titanium Implant Improvements for Enhanced Vascularization and Osteoblast Seeding

    Science.gov (United States)

    Matena, Julia; Petersen, Svea; Gieseke, Matthias; Kampmann, Andreas; Teske, Michael; Beyerbach, Martin; Murua Escobar, Hugo; Haferkamp, Heinz; Gellrich, Nils-Claudius; Nolte, Ingo

    2015-01-01

    To improve well-known titanium implants, pores can be used for increasing bone formation and close bone-implant interface. Selective Laser Melting (SLM) enables the production of any geometry and was used for implant production with 250-µm pore size. The used pore size supports vessel ingrowth, as bone formation is strongly dependent on fast vascularization. Additionally, proangiogenic factors promote implant vascularization. To functionalize the titanium with proangiogenic factors, polycaprolactone (PCL) coating can be used. The following proangiogenic factors were examined: vascular endothelial growth factor (VEGF), high mobility group box 1 (HMGB1) and chemokine (C-X-C motif) ligand 12 (CXCL12). As different surfaces lead to different cell reactions, titanium and PCL coating were compared. The growing into the porous titanium structure of primary osteoblasts was examined by cross sections. Primary osteoblasts seeded on the different surfaces were compared using Live Cell Imaging (LCI). Cross sections showed cells had proliferated, but not migrated after seven days. Although the cell count was lower on titanium PCL implants in LCI, the cell count and cell spreading area development showed promising results for titanium PCL implants. HMGB1 showed the highest migration capacity for stimulating the endothelial cell line. Future perspective would be the incorporation of HMGB1 into PCL polymer for the realization of a slow factor release. PMID:25849656

  4. Determining the Young's modulus of a cellular titanium implant by FEM simulation

    Science.gov (United States)

    Loginov, Yu. N.; Golodnov, A. I.; Stepanov, S. I.; Kovalev, E. Yu.

    2017-12-01

    The role of additive manufacturing is noted for the construction of titanium medical implants. The purpose of the study is to determine the Young's modulus of cellular titanium implants, which is based on calculations performed by finite element analysis. A honeycomb structure from intersecting cylinder surfaces is offered for the implant made of the Ti-6Al-4V alloy. Boundary conditions are stated for the loading of the implant structure. It is demonstrated that the Young's modulus can be reduced more than three times comparing to a solid titanium alloy. Zones of strain and stress localization located near the abutment of the cylindrical surfaces. Recommendations for the further improvement of the implant architecture are generated.

  5. Demineralized bone matrix and human cancellous bone enhance fixation of titanium implants

    DEFF Research Database (Denmark)

    Babiker, Hassan; Ding, Ming; Overgaard, Søren

    from human tissue were included (IsoTis OrthoBiologics, Inc. USA). Both materials are commercially available. Titanium alloy implants (Biomet Inc.) of 10 mm in length and 10 mm in diameter were inserted bilaterally into the femoral condyles of 8 skeletally mature sheep. Thus four implants......Best Poster 5Demineralized bone matrix and human cancellous bone enhance fixation of titanium implants AuthorsBabiker , H.; Ding M.; Overgaard S.InstitutionOrthopaedic Research Laboratory, Department of Orthopaedic Surgery, Odense University Hospital, Clinical Institute, University of Southern......- and autograf as they have the capability of inducing new bone and improving implant fixation through enhancing bone ingrowth. The purpose of this study was to investigate the effect of DBM alone or with CB on the fixation of porous-coated titanium implants.Material and MethodsDBM100 (pure DBM) and CB produced...

  6. Development of binary and ternary titanium alloys for dental implants.

    Science.gov (United States)

    Cordeiro, Jairo M; Beline, Thamara; Ribeiro, Ana Lúcia R; Rangel, Elidiane C; da Cruz, Nilson C; Landers, Richard; Faverani, Leonardo P; Vaz, Luís Geraldo; Fais, Laiza M G; Vicente, Fabio B; Grandini, Carlos R; Mathew, Mathew T; Sukotjo, Cortino; Barão, Valentim A R

    2017-11-01

    The aim of this study was to develop binary and ternary titanium (Ti) alloys containing zirconium (Zr) and niobium (Nb) and to characterize them in terms of microstructural, mechanical, chemical, electrochemical, and biological properties. The experimental alloys - (in wt%) Ti-5Zr, Ti-10Zr, Ti-35Nb-5Zr, and Ti-35Nb-10Zr - were fabricated from pure metals. Commercially pure titanium (cpTi) and Ti-6Al-4V were used as controls. Microstructural analysis was performed by means of X-ray diffraction and scanning electron microscopy. Vickers microhardness, elastic modulus, dispersive energy spectroscopy, X-ray excited photoelectron spectroscopy, atomic force microscopy, surface roughness, and surface free energy were evaluated. The electrochemical behavior analysis was conducted in a body fluid solution (pH 7.4). The albumin adsorption was measured by the bicinchoninic acid method. Data were evaluated through one-way ANOVA and the Tukey test (α=0.05). The alloying elements proved to modify the alloy microstructure and to enhance the mechanical properties, improving the hardness and decreasing the elastic modulus of the binary and ternary alloys, respectively. Ti-Zr alloys displayed greater electrochemical stability relative to that of controls, presenting higher polarization resistance and lower capacitance. The experimental alloys were not detrimental to albumin adsorption. The experimental alloys are suitable options for dental implant manufacturing, particularly the binary system, which showed a better combination of mechanical and electrochemical properties without the presence of toxic elements. Copyright © 2017 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  7. The Birmingham bone anchored hearing aid programme: paediatric experience and results.

    Science.gov (United States)

    Powell, R H; Burrell, S P; Cooper, H R; Proops, D W

    1996-01-01

    Over a five-year period, 34 patients have been referred to the Birmingham bone anchored hearing aid programme, paediatric section, of who 21 are now wearing the bone anchored hearing aid (BAHA) and four are awaiting surgery for fitting of the BAHA. Of the patients assessed, found to be suitable and who proceeded to surgery for the BAHA, 44 per cent had Treacher Collins syndrome, 28 per cent had bilateral atresia or microtia, 16 per cent had Goldenhaar's syndrome, four per cent (one patient) had branchio-otorenal syndrome and eight per cent had chronic suppurative otitis media. This paper presents objective and subjective data collected from these patients. It is shown that the BAHA is a very effective hearing aid for children with congenital hearing loss.

  8. Comparison of stainless steel and titanium alloy orthodontic miniscrew implants: a mechanical and histologic analysis.

    Science.gov (United States)

    Brown, Ryan N; Sexton, Brent E; Gabriel Chu, Tien-Min; Katona, Thomas R; Stewart, Kelton T; Kyung, Hee-Moon; Liu, Sean Shih-Yao

    2014-04-01

    The detailed mechanical and histologic properties of stainless steel miniscrew implants used for temporary orthodontic anchorage have not been assessed. Thus, the purpose of this study was to compare them with identically sized titanium alloy miniscrew implants. Forty-eight stainless steel and 48 titanium alloy miniscrew implants were inserted into the tibias of 12 rabbits. Insertion torque and primary stability were recorded. One hundred grams of tensile force was applied between half of the implants in each group, resulting in 4 subgroups of 24 specimens each. Fluorochrome labeling was administered at weeks 4 and 5. When the rabbits were euthanized at 6 weeks, stability and removal torque were measured in half (ie, 12 specimens) of each of the 4 subgroups. Microdamage burden and bone-to-implant contact ratio were quantified in the other 12 specimens in each subgroup. Mixed model analysis of variance was used for statistical analysis. All implants were stable at insertion and after 6 weeks. The only significant difference was the higher (9%) insertion torque for stainless steel. No significant differences were found between stainless steel and titanium alloy miniscrew implants in microdamage burden and bone-to-implant contact regardless of loading status. Stainless steel and titanium alloy miniscrew implants provide the same mechanical stability and similar histologic responses, suggesting that both are suitable for immediate orthodontic clinical loads. Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  9. In vitro biological outcome of laser application for modification or processing of titanium dental implants.

    Science.gov (United States)

    Hindy, Ahmed; Farahmand, Farzam; Tabatabaei, Fahimeh Sadat

    2017-07-01

    There are numerous functions for laser in modern implant dentistry including surface treatment, surface coating, and implant manufacturing. As laser application may potentially improve osseointegration of dental implants, we systematically reviewed the literature for in vitro biological responses to laser-modified or processed titanium dental implants. The literature was searched in PubMed, ISI Web, and Scopus, using keywords "titanium dental implants," "laser," "biocompatibility," and their synonyms. After screening the 136 references obtained, 28 articles met the inclusion criteria. We found that Nd:YAG laser was the most commonly used lasers in the treatment or processing of titanium dental implants. Most of the experiments used cell attachment and cell proliferation to investigate bioresponses of the implants. The most commonly used cells in these assays were osteoblast-like cells. Only one study was conducted in stem cells. These in vitro studies reported higher biocompatibility in laser-modified titanium implants. It seems that laser radiation plays a vital role in cell response to dental implants; however, it is necessary to accomplish more studies using different laser types and parameters on various cells to offer a more conclusive result.

  10. Evaluation of Functionalized Porous Titanium Implants for Enhancing Angiogenesis in Vitro

    Science.gov (United States)

    Roland, Laura; Backhaus, Samantha; Grau, Michael; Matena, Julia; Teske, Michael; Beyerbach, Martin; Murua Escobar, Hugo; Haferkamp, Heinz; Gellrich, Nils-Claudius; Nolte, Ingo

    2016-01-01

    Implant constructs supporting angiogenesis are favorable for treating critically-sized bone defects, as ingrowth of capillaries towards the center of large defects is often insufficient. Consequently, the insufficient nutritional supply of these regions leads to impaired bone healing. Implants with specially designed angiogenic supporting geometry and functionalized with proangiogenic cytokines can enhance angiogenesis. In this study, Vascular Endothelial Growth Factor (VEGF) and High Mobility Group Box 1 (HMGB1) were used for incorporation into poly-ε-caprolactone (PCL)-coated porous titanium implants. Bioactivity of released factors and influence on angiogenesis of functionalized implants were evaluated using a migration assay and angiogenesis assays. Both implants released angiogenic factors, inducing migration of endothelial cells. Also, VEGF-functionalized PCL-coated titanium implants enhanced angiogenesis in vitro. Both factors were rapidly released in high doses from the implant coating during the first 72 h. PMID:28773427

  11. A Critical Review of Dental Implant Materials with an Emphasis on Titanium versus Zirconia

    Directory of Open Access Journals (Sweden)

    Reham B. Osman

    2015-03-01

    Full Text Available The goal of the current publication is to provide a comprehensive literature review on the topic of dental implant materials. The following paper focuses on conventional titanium implants and more recently introduced and increasingly popular zirconia implants. Major subtopics include the material science and the clinical considerations involving both implant materials and the influence of their physical properties on the treatment outcome. Titanium remains the gold standard for the fabrication of oral implants, even though sensitivity does occur, though its clinical relevance is not yet clear. Zirconia implants may prove to be promising in the future; however, further in vitro and well-designed in vivo clinical studies are needed before such a recommendation can be made. Special considerations and technical experience are needed when dealing with zirconia implants to minimize the incidence of mechanical failure.

  12. Load applied on bone-anchored transfemoral prosthesis: Characterization of a prosthesis—A pilot study

    OpenAIRE

    Laurent Frossard, PhD; Eva Häggström, CPO; Kerstin Hagberg, PhD; Rickard Brånemark, MD, PhD

    2013-01-01

    The objectives of this study were to (1) record the inner-prosthesis loading during activities of daily living (ADLs), (2) present a set of variables comparing loading data, and (3) provide an example of characterization of two prostheses. The load was measured at 200 Hz using a multi-axial transducer mounted between the residuum and the knee of an individual with unilateral transfemoral amputation fitted with a bone-anchored prosthesis. The load was measured while using two different prosthe...

  13. Bone integration capability of nanopolymorphic crystalline hydroxyapatite coated on titanium implants

    Directory of Open Access Journals (Sweden)

    Suzuki T

    2012-02-01

    Full Text Available Masahiro Yamada*, Takeshi Ueno*, Naoki Tsukimura, Takayuki Ikeda, Kaori Nakagawa, Norio Hori, Takeo Suzuki, Takahiro OgawaLaboratory of Bone and Implant Sciences, The Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, Biomaterials and Hospital Dentistry, UCLA School of Dentistry, Los Angeles, CA, USA *These authors contributed equally to this workAbstract: The mechanism by which hydroxyapatite (HA-coated titanium promotes bone–implant integration is largely unknown. Furthermore, refining the fabrication of nanostructured HA to the level applicable to the mass production process for titanium implants is challenging. This study reports successful creation of nanopolymorphic crystalline HA on microroughened titanium surfaces using a combination of flame spray and low-temperature calcination and tests its biological capability to enhance bone–implant integration. Sandblasted microroughened titanium implants and sandblasted + HA-coated titanium implants were subjected to biomechanical and histomorphometric analyses in a rat model. The HA was 55% crystallized and consisted of nanoscale needle-like architectures developed in various diameters, lengths, and orientations, which resulted in a 70% increase in surface area compared to noncoated microroughened surfaces. The HA was free from impurity contaminants, with a calcium/phosphorus ratio of 1.66 being equivalent to that of stoichiometric HA. As compared to microroughened implants, HA-coated implants increased the strength of bone–implant integration consistently at both early and late stages of healing. HA-coated implants showed an increased percentage of bone–implant contact and bone volume within 50 µm proximity of the implant surface, as well as a remarkably reduced percentage of soft tissue intervention between bone and the implant surface. In contrast, bone volume outside the 50 µm border was lower around HA-coated implants. Thus, this study

  14. Surgical repair of central slip avulsion injuries with Mitek bone anchor--retrospective analysis of a case series.

    LENUS (Irish Health Repository)

    Chan, Jeffrey C Y

    2007-01-01

    The purpose of this study is to describe our technique of central slip repair using the Mitek bone anchor and to evaluate the treatment outcome. Eight digits in eight patients were reconstructed using the bone anchor: three little fingers, two middle fingers, two index fingers and one ring finger. There were two immediate and six delayed repairs (range from one day to eight months). Four patients had pre-operative intensive splinting and physiotherapy to restore passive extension of the proximal interphalangeal joint prior to central slip reconstruction. All patients have made good progress since surgery. No patient requires a second procedure and none of the bone anchors have dislodged or loosened. We conclude that the Mitek bone anchor is a reliable technique to achieve soft tissue to bone fixation in central slip avulsion injuries. We recommend that this technique be considered as a treatment option for patients requiring surgical repair.

  15. A comparative radiographic evaluation of the titanium and zirconium implant-abutment gap of three different implant connections

    Directory of Open Access Journals (Sweden)

    Majid Sahebi

    2016-07-01

    Full Text Available Background and Aims: In response to esthetic demand and use of zirconia abutments; detection of implant-abutment connection misfit is so important. The purpose of this study was to evaluate the sensitivity and specificity of radiographic images in the detection of abutment-implant connection misfit in zirconia and titanium abutments of three different implant connections. Materials and Methods: One regular implant fixture of Branemark, Noble active and Replace systems were mount in acrylic models. Two pieces titanium and zirconium abutments were attached to the implants, once with correct adaptation and once with 0.5 mm spacer. Digital radiographic images were taken of 12 created states with zero degree vertical and horizontal inclination and evaluated by 10 specialists in implant treatment in two different time penods. Data were analyzed using Kappa analysis. Results: Interclass Correlation Coefficients (ICC of the agreement of answers in the first and second times were 97.4 and 97.5, respectively (P<0/001. Sensitivity of detecting gap in all groups was acceptable (95-100% except titanium abutment in Noble active which was the lowest value (35%. Specificity of all groups were acceptable (80-95% except zirconia abutments in Noble active and Replace with 45% and 30% values, respectively, and titanium abutments in Branemark had the highest value (95%. Conclusion: The sensitivity of radiographic images in detection of abutment-implant connection misfit only in Noble active with titanium abutment was not acceptable. Specificity of radiographic images in the absence of gap in titanium abutments was more favorable.

  16. Osseointegration of three-dimensional designed titanium implants manufactured by selective laser melting.

    Science.gov (United States)

    Shaoki, Algabri; Xu, Jia-Yun; Sun, Haipeng; Chen, Xian-Shuai; Ouyang, Jianglin; Zhuang, Xiu-Mei; Deng, Fei-Long

    2016-10-27

    The selective laser melting (SLM) technique is a recent additive manufacturing (AM) technique. Several studies have reported success in the SLM-based production of biocompatible orthopaedic implants and three-dimensional bone defect constructs. In this study, we evaluated the surface properties and biocompatibility of an SLM titanium implant in vitro and compared them with those of a machined (MA) titanium control surface. In addition, we evaluated the osseointegration capability of the SLM implants in vivo and compared it with those of MA and Nobel-speedy (Nobel-S) implants. SLM microtopographical surface analysis revealed porous and high roughness with varied geometry compared with a smooth surface in MA Ti samples but with similar favourable wettability. Osteoblast proliferation and alkaline phosphatase activity were significantly enhanced on the SLM surface. Histological analysis of the bone-implant contact ratio revealed no significant difference among SLM, MA, and Nobel-S implants. Micro-CT assessment indicated that there was no significant difference in bone volume fraction around the implant among SLM implants and other types of surface modification implants. The removal torque value measurement of SLM implants was significantly lower that of than Nobel-S implants P < 0.001 and higher than that of MA implants. The study demonstrates the capability of SLM implants to integrate with living bone. The SLM technique holds promise as a new dental implant manufacturing technique.

  17. Measurement of skull bone thickness for bone-anchored hearing aids: an experimental study comparing both a novel ultrasound system (SonoPointer) and computed tomographic scanning to mechanical measurements.

    Science.gov (United States)

    Federspil, Philipp A; Tretbar, Steffen H; Böhlen, Friederike H; Rohde, Stefan; Glaser, Simon; Plinkert, Peter K

    2010-04-01

    A-mode ultrasound scanning with coded signals allows bone thickness measurements at the site of bone-anchored hearing aid surgery as compared to computed tomographic scanning and mechanical measurements. Adequate bone thickness is a prerequisite for successful, long-lasting osseointegration of titanium fixtures for bone-anchored hearing aids. Computed tomography can be used to measure bone thickness but has several drawbacks. Bone thickness was measured at the site of bone-anchored hearing aids surgery in 28 formaldehyde-preserved human cadaver temporoparietal bones. Four blinded investigators used a hand-held, A-mode ultrasound system with direct coupling at 2.25 MHz transducer using coded signals (SonoPointer) and repeated the measurements twice. Comparisons were made with high-resolution computed tomographic scanning and mechanical micrometer caliper measurements. There was significant anatomical variation in the temporoparietal bones. Computed tomography was in good agreement with the mechanical reference. All specimens could be measured by the SonoPointer. The mean difference between the mechanical control and ultrasound scanning averaged for all measurements by all investigators was 0.3 mm (standard deviation, 1.2 mm). Trained ultrasound experts yielded better results (mean difference, 0.3 mm; standard deviation, 1.0 mm). Agreement was best for bone thickness up to 5 mm. Outliers occurred in bones thicker than 7.5 mm. The SonoPointer is a promising, noninvasive, hand-held tool for real-time measurement of bone thickness in bone-anchored hearing aid surgery, especially for children. Even disregarding the absolute thickness reading, the SonoPointer could be used to search intraoperatively for a local maximum of bone thickness.

  18. Morphology and Clinical Relevance of Vertebral Endplate Changes Following Limited Lumbar Discectomy With or Without Bone-anchored Annular Closure.

    Science.gov (United States)

    Kursumovic, Adisa; Kienzler, Jenny C; Bouma, Gerrit J; Bostelmann, Richard; Heggeness, Michael; Thome, Claudius; Miller, Larry E; Barth, Martin

    2018-03-13

    Post hoc analysis of a randomized controlled trial. To characterize the morphology and clinical relevance of vertebral endplate changes (VEPC) following limited lumbar discectomy with or without implantation of a bone-anchored annular closure device (ACD). Implantation of an ACD following limited lumbar discectomy has shown promise in reducing the risk of recurrent herniation in patients with large annular defects. However, the interaction between the ACD and the lumbar endplate over time is not well understood. Patients undergoing limited lumbar discectomy with large postsurgical annular defects were randomized intraoperatively to receive additional ACD implantation or limited lumbar discectomy only (Controls). VEPC morphology, area, and volume were assessed with low-dose computed tomography preoperatively and at 1 and 2 years follow-up. Of 554 randomized patients, the as-treated population consisted of 550 patients (267 ACD, 283 Controls). VEPC were preoperatively identified in 18% of patients in the ACD group and in 15% of Controls. At 2 years, VEPC frequency increased to 85% with ACD and 33% in Controls. Device- or procedure-related serious adverse event (8% vs. 17%, P = 0.001) and secondary surgical intervention (5% vs. 13%, P ACD group over Controls. In the ACD group, clinical outcomes were comparable in patients with and without VEPC at 2 years follow-up. In the Control group, patients with VEPC at 2 years had higher risk of symptomatic reherniation versus patients without VEPC (35% vs. 19%, P ACD reduces risk of postoperative complications despite a greater frequency of VEPC. VEPC were associated with higher risk of symptomatic reherniation in patients treated with limited lumbar discectomy, but not in those who received additional ACD implantation. 2.

  19. Acid etching and plasma sterilization fail to improve osseointegration of grit blasted titanium implants

    DEFF Research Database (Denmark)

    Mortensen, Mikkel Saksø; Jakobsen, Stig Storgaard; Saksø, Henrik

    2012-01-01

    Interaction between implant surface and surrounding bone influences implant fixation. We attempted to improve the bone-implant interaction by 1) adding surface micro scale topography by acid etching, and 2) removing surface-adherent pro-inflammatory agents by plasma cleaning. Implant fixation...... was evaluated by implant osseointegration and biomechanical fixation.The study consisted of two paired animal sub-studies where 10 skeletally mature Labrador dogs were used. Grit blasted titanium alloy implants were inserted press fit in each proximal tibia. In the first study grit blasted implants were......-implant tissue density) and mechanical push-out testing after four weeks observation time.Neither acid etching nor plasma sterilization of the grit blasted implants enhanced osseointegration or mechanical fixation in this press-fit canine implant model in a statistically significant manner....

  20. Application of nitrogen plasma immersion ion implantation to titanium nasal implants with nanonetwork surface structure

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Ying-Sui; Yang, Wei-En [Department of Dentistry, National Yang-Ming University, Taipei 112, Taiwan (China); Zhang, Lan [State Key Laboratory for Mechanical Behavior of Materials, Xi' an Jiaotong University, Xi' an 710049 (China); Zhu, Hongqin [State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai 200050 (China); Lan, Ming-Ying [Division of Rhinology, Department of Otolaryngology Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan and School of Medicine, National Yang-Ming University, Taipei 112, Taiwan (China); Lee, Sheng-Wei [Institute of Materials Science and Engineering, National Central University, Taoyuan 320, Taiwan (China); Huang, Her-Hsiung, E-mail: hhhuang@ym.edu.tw [Department of Dentistry, National Yang-Ming University, Taipei 112, Taiwan (China); Institute of Oral Biology, National Yang-Ming University, Taipei 112, Taiwan (China); Graduate Institute of Basic Medical Science, China Medical University, Taichung 404, Taiwan (China); Department of Medical Research, China Medical University Hospital, Taichung 407, Taiwan (China); Department of Bioinformatics and Medical Engineering, Asia University, Taichung 413, Taiwan (China); Department of Stomatology, Taipei Veterans General Hospital, Taipei 112, Taiwan (China)

    2016-07-15

    In nasal reconstruction, the response of cells to titanium (Ti) implants is mainly determined by surface features of the implant. In a pilot study, the authors applied electrochemical anodization to Ti surfaces in an alkaline solution to create a network of nanoscale surface structures. This nanonetwork was intended to enhance the responses of primary human nasal epithelial cell (HNEpC) to the Ti surface. In this study, the authors then treated the anodized, nanonetwork-structured Ti surface using nitrogen plasma immersion ion implantation (NPIII) in order to further improve the HNEpC response to the Ti surface. Subsequently, surface characterization was performed to elucidate morphology, roughness, wettability, and chemistry of specimens. Cytotoxicity, blood, and HNEpC responses were also evaluated. Our results demonstrate that NPIII treatment led to the formation of a noncytotoxic TiN-containing thin film (thickness <100 nm) on the electrochemically anodized Ti surface with a nanonetwork-structure. NPIII treatment was shown to improve blood clotting and the adhesion of platelets to the anodized Ti surface as well as the adhesion and proliferation of hNEpC. This research spreads our understanding of the fact that a TiN-containing thin film, produced using NPIII treatment, could be used to improve blood and HNEpC responses to anodized, nanonetwork-structured Ti surfaces in nasal implant applications.

  1. Biomimetic organic-inorganic nanocomposite coatings for titanium implants.

    Science.gov (United States)

    Sikirić, Maja Dutour; Gergely, Csilla; Elkaim, Rene; Wachtel, Ellen; Cuisinier, Frederic J G; Füredi-Milhofer, Helga

    2009-06-01

    A new class of organic-inorganic nanocomposites, to be used as coatings for surface enhancement of metal implants for bone replacement and repair, has been prepared by a biomimetic three-step procedure: (1) embedding amorphous calcium phosphate (ACP) particles between organic polyelectrolyte multilayers (PE MLs), (2) in situ transformation of ACP to octacalcium phospate (OCP) and/or poorly crystalline apatite nanocrystals by immersion of the material into a metastable calcifying solution (MCS) and (3) deposition of a final PE ML. The organic polyelectrolytes used were poly-L-glutamic acid and poly-L-lysine. The nanocomposites obtained by each successive step were characterized by scanning electron microscopy, energy dispersive X-ray analysis (EDS), and XRD, and their suitability as coatings for metal implants was examined by mechanical and in vitro biological tests. Coatings obtained by the first deposition step are mechanically unstable and therefore not suitable. During the second step, upon immersion into MCS, ACP particles were transformed into crystalline calcium phosphate, with large platelike OCP crystals as the top layer. After phase transformation, the nanocomposite was strongly attached to the titanium, but the top layer did not promote cell proliferation. However, when the coating was topped with an additional PE ML (step 3), smoother surfaces were obtained, which facilitated cell adhesion and proliferation as shown by in vitro biological tests using primary human osteoblasts (HO) directly seeded onto the nanocomposites. In fact, cell proliferation on nanocomposites with top PE MLs was far superior than on any of the individual components and was equivalent to proliferation on the golden standard (plastic). 2008 Wiley Periodicals, Inc.

  2. No positive effect of Acid etching or plasma cleaning on osseointegration of titanium implants in a canine femoral condyle press-fit model

    DEFF Research Database (Denmark)

    Saksø, Henrik; Jakobsen, Thomas Vestergaard; Mortensen, Mikkel Saksø

    2013-01-01

    Implant surface treatments that improve early osseointegration may prove useful in long-term survival of uncemented implants. We investigated Acid Etching and Plasma Cleaning on titanium implants.......Implant surface treatments that improve early osseointegration may prove useful in long-term survival of uncemented implants. We investigated Acid Etching and Plasma Cleaning on titanium implants....

  3. Nanostructured titanium-based materials for medical implants: Modeling and development

    DEFF Research Database (Denmark)

    Mishnaevsky, Leon; Levashov, Evgeny; Valiev, Ruslan Z.

    2014-01-01

    Nanostructuring of titanium-based implantable devices can provide them with superior mechanical properties and enhanced biocompatibity. An overview of advanced fabrication technologies of nanostructured, high strength, biocompatible Ti and shape memory Ni-Ti alloy for medical implants is given...

  4. Temporal sequence of hard and soft tissue healing around titanium dental implants.

    Science.gov (United States)

    Salvi, Giovanni E; Bosshardt, Dieter D; Lang, Niklaus P; Abrahamsson, Ingemar; Berglundh, Tord; Lindhe, Jan; Ivanovski, Saso; Donos, Nikos

    2015-06-01

    The objective of the present review was to summarize the evidence available on the temporal sequence of hard and soft tissue healing around titanium dental implants in animal models and in humans. A search was undertaken to find animal and human studies reporting on the temporal dynamics of hard and soft tissue integration of titanium dental implants. Moreover, the influence of implant surface roughness and chemistry on the molecular mechanisms associated with osseointegration was also investigated. The findings indicated that the integration of titanium dental implants into hard and soft tissue represents the result of a complex cascade of biological events initiated by the surgical intervention. Implant placement into alveolar bone induces a cascade of healing events starting with clot formation and continuing with the maturation of bone in contact with the implant surface. From a genetic point of view, osseointegration is associated with a decrease in inflammation and an increase in osteogenesis-, angiogenesis- and neurogenesis-associated gene expression during the early stages of wound healing. The attachment and maturation of the soft tissue complex (i.e. epithelium and connective tissue) to implants becomes established 6-8 weeks following surgery. Based on the findings of the present review it can be concluded that improved understanding of the mechanisms associated with osseointegration will provide leads and targets for strategies aimed at enhancing the clinical performance of titanium dental implants. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Titanium implants with modified surfaces: Meta-analysis of in vivo osteointegration

    Energy Technology Data Exchange (ETDEWEB)

    Gasik, Michael, E-mail: michael.gasik@aalto.fi [Aalto University Foundation, School of Chemical Technology, P.O. Box 16200, FIN-00076 AALTO (Finland); Braem, Annabel [Department of Metallurgy and Materials Engineering, KU Leuven, Kasteelpark Arenberg 44, B-3001 Heverlee (Belgium); Chaudhari, Amol; Duyck, Joke [Department of Prosthetic Dentistry, BIOMAT Research Cluster, KU Leuven, Kapucijnenvoer 7a, B-3000 Leuven (Belgium); Vleugels, Jozef [Department of Metallurgy and Materials Engineering, KU Leuven, Kasteelpark Arenberg 44, B-3001 Heverlee (Belgium)

    2015-04-01

    Titanium-based implants are widely used in modern clinical practice, but their “optimal” properties in terms of porosity and topology, roughness and hydrophilic parameters are being a subject of intensive discussions. Recent in vitro results have shown a possibility to optimize the surface of an implant with maximal repelling of bacteria (Staphylococcus aureus, Staphylococcus epidermidis) and improvement in human osteogenic and endothelial cell adhesion, proliferation and differentiation. In this work, these different grades titanium implants were tested in vivo using the same analytical methodology. In addition to material parameters, key histomorphometrical parameters such a regeneration area, bone adaptation area and bone-to-implant contact were determined after 2 and 4 weeks of implantation in rabbit animal model. Porous implants have more clear differences than non-porous ones, with the best optimum values obtained on hydrothermally treated electrophoretically deposited titanium. These in vivo data correlate well with the optimal prediction made by in vitro tests. - Highlights: • Various titanium specimens were studied in vivo on osteointegration vs their properties. • Non-porous implants had a better performance when coated with bioactive glass. • Porous implants have shown the best results for hydrothermally treated specimens. • Good correlation was found with the previous in vitro tests. • New analysis of the in vivo data has shown benefits to assess biomaterials performance.

  6. Titanium-Nitride Coating of Orthopaedic Implants: A Review of the Literature

    NARCIS (Netherlands)

    van Hove, R.P.; Sierevelt, I.N.; van Royen, B.J.; Nolte, P.A.

    2015-01-01

    Surfaces of medical implants can be enhanced with the favorable properties of titanium-nitride (TiN). In a review of English medical literature, the effects of TiN-coating on orthopaedic implant material in preclinical studies were identified and the influence of these effects on the clinical

  7. Revival of pure titanium for dynamically loaded porous implants using additive manufacturing.

    Science.gov (United States)

    Wauthle, Ruben; Ahmadi, Seyed Mohammad; Amin Yavari, Saber; Mulier, Michiel; Zadpoor, Amir Abbas; Weinans, Harrie; Van Humbeeck, Jan; Kruth, Jean-Pierre; Schrooten, Jan

    2015-09-01

    Additive manufacturing techniques are getting more and more established as reliable methods for producing porous metal implants thanks to the almost full geometrical and mechanical control of the designed porous biomaterial. Today, Ti6Al4V ELI is still the most widely used material for porous implants, and none or little interest goes to pure titanium for use in orthopedic or load-bearing implants. Given the special mechanical behavior of cellular structures and the material properties inherent to the additive manufacturing of metals, the aim of this study is to investigate the properties of selective laser melted pure unalloyed titanium porous structures. Therefore, the static and dynamic compressive properties of pure titanium structures are determined and compared to previously reported results for identical structures made from Ti6Al4V ELI and tantalum. The results show that porous Ti6Al4V ELI still remains the strongest material for statically loaded applications, whereas pure titanium has a mechanical behavior similar to tantalum and is the material of choice for cyclically loaded porous implants. These findings are considered to be important for future implant developments since it announces a potential revival of the use of pure titanium for additively manufactured porous implants. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. Structure and properties of Titanium for dental implants

    Directory of Open Access Journals (Sweden)

    M. Greger

    2009-10-01

    Full Text Available This paper describes manufacture of nano-structural titanium, its structure and properties. Nano-titanium has higher specific strength properties than ordinary (coarse-grained titanium. Nano-titanium was produced by the equal-channel angular pressing (ETAP process. The research it self was focused on physical base of strengthening and softening processes and developments occurring at the grain boundaries during the ECAP process at half-hot temperature. Strength of nano-titanium varies around 960 MPa, grain size around 300 nm.

  9. Titanium Implant Medialization Laryngoplasty Application in the Case of a Silicone and Gore-Tex Extrusion

    OpenAIRE

    Salih Bakir

    2014-01-01

     Though the surgical technique of medialization laryngoplasty (ML) has been standardized today, the ideal implant has not been well-defined yet. Various non-absorbable materials such as autogenous cartilage, silicone, hydroxylapatite, Gore-tex, and titanium have been used for ML. Titanium implant ML is a new technique and any complication has not been reported so far. Gore-tex and silicone implants have been used more longer and both of them are accepted safe and easy to handle materials...

  10. A morphometric and biomechanic comparison of titanium implants inserted in rabbit cortical and cancellous bone.

    Science.gov (United States)

    Sennerby, L; Thomsen, P; Ericson, L E

    1992-01-01

    The removal torques for screw-shaped pure titanium implants inserted in rabbit tibia and the femoral part of the knee joint and the tissue response to these implants, as quantitated with light microscopic morphometry on ground sections, were compared after 6 weeks, 3 months, and 6 months. The bone surrounding the femoral intra-articular implants was mostly cancellous, while cortical bone was formed around the tibial implants. The torque needed to remove the intra-articular implants increased with time, but there was no such increase for the tibial implants. At 6 weeks, significantly less torque was needed to remove the intra-articular implants in spite of the fact that significantly more bone was found in the threads of these implants as compared with the tibial implants. When calculating the amount of bone in threads situated in the cortical and subchondral passage, more was found in the threads of the tibial implants, which corresponded to the higher removal torque. Additional light microscopic observations on implants unscrewed after 12 months in rabbit tibia indicated that rupture occurred between the implant surface and calcified bone. Findings indicate that the resistance to unscrewing is dependent on the amount of compact bone surrounding a titanium implant.

  11. Bone-anchored hearing aid (BAHA: indications, functional results, and comparison with reconstructive surgery of the ear

    Directory of Open Access Journals (Sweden)

    Bento, Ricardo Ferreira

    2012-01-01

    Full Text Available Introduction: The bone-anchored hearing aid (BAHA is a bone conduction hearing device that transmits sound directly into the inner ear. It is mainly used in patients with conductive hearing loss associated with aural atresia, but it is also used in those with mixed and sensorineural hearing loss. Goals: To review the main indications for BAHA, to analyze the audiometric results and its benefits for patients and compare them with other treatment modalities, and to compare the literature data with our sample of 13 patients. Method: The research was performed using a database covering works in English, Spanish, and Portuguese, with no limitations in the years when the procedures were performed. We compared the literature data with our results for the 13 patients who underwent BAHA implantation between the years 2000 and 2009. Results: Most of the studies showed that BAHA has great advantages over reconstructive surgery in terms of hearing results, complications, and disease recurrence. The postoperative results for our 13 patients were satisfactory and comparable with the results from the literature, with closure of the air-bone gap in 7 patients and achieving an air-bone gap of 10 dB in 6 patients. No postoperative complications were observed. Conclusion: BAHA is a better treatment option than reconstructive surgery for patients with bilateral deafness. It is a relatively simple surgical procedure with few complications and good hearing results. Recent studies have examined its use in conductive and unilateral sensorineural hearing loss.

  12. Bone-anchored hearing aid (BAHA): indications, functional results, and comparison with reconstructive surgery of the ear.

    Science.gov (United States)

    Bento, Ricardo Ferreira; Kiesewetter, Alessandra; Ikari, Liliane Satomi; Brito, Rubens

    2012-07-01

     The bone-anchored hearing aid (BAHA) is a bone conduction hearing device that transmits sound directly into the inner ear. It is mainly used in patients with conductive hearing loss associated with aural atresia, but it is also used in those with mixed and sensorineural hearing loss.  To review the main indications for BAHA, to analyze the audiometric results and its benefits for patients and compare them with other treatment modalities, and to compare the literature data with our sample of 13 patients.  The research was performed using a database covering works in English, Spanish, and Portuguese, with no limitations in the years when the procedures were performed. We compared the literature data with our results for the 13 patients who underwent BAHA implantation between the years 2000 and 2009.  Most of the studies showed that BAHA has great advantages over reconstructive surgery in terms of hearing results, complications, and disease recurrence. The postoperative results for our 13 patients were satisfactory and comparable with the results from the literature, with closure of the air-bone gap in 7 patients and achieving an air-bone gap of 10 dB in 6 patients. No postoperative complications were observed.  BAHA is a better treatment option than reconstructive surgery for patients with bilateral deafness. It is a relatively simple surgical procedure with few complications and good hearing results. Recent studies have examined its use in conductive and unilateral sensorineural hearing loss.

  13. Bilateral Bone-anchored Hearing Aid: impact on quality of life measured with the Glasgow Benefit Inventory.

    Science.gov (United States)

    Ho, Eu Chin; Monksfield, Peter; Egan, Elizabeth; Reid, Andrew; Proops, David

    2009-10-01

    To investigate whether the fitting of bilateral Bone-anchored Hearing Aid (BAHA) would result in any additional improvement in patients' quality of life (QOL) over and above what we would experience from the fitting of a single-sided BAHA. Retrospective, anonymized, cross-sectional postal survey using the Glasgow Benefit Inventory (GBI). Tertiary referral center. All 93 adult patients who had been using bilateral BAHA for more than 6 months. Hearing rehabilitation using bilateral BAHA. These include the GBI benefit scores across the following domains: "overall benefit," "general health benefit," "physical health benefit," and "social benefit." Comparison of GBI scores against other otological interventions including single-sided BAHA. Response rate was 76%. Ninety-two percent of patients reported improvement in QOL. Positive QOL improvement scores were reported across all domains. Overall GBI benefit score was +ve 38. This is higher than the benefit scores reported by patients with single-sided BAHA, although this may not be statistically significant. After fitting the second BAHA, patients may report additional improvement in their QOL (of a smaller magnitude) over and above the initial improvement in their QOL after fitting of their first BAHA. In fact, the overall benefit score for bilateral BAHA seem to be close to that for cochlear implantation.

  14. Success and High Predictability of Intraorally Welded Titanium Bar in the Immediate Loading Implants

    Directory of Open Access Journals (Sweden)

    Vaniel Fogli

    2014-01-01

    Full Text Available The implants failure may be caused by micromotion and stress exerted on implants during the phase of bone healing. This concept is especially true in case of implants placed in atrophic ridges. So the primary stabilization and fixation of implants are an important goal that can also allow immediate loading and oral rehabilitation on the same day of surgery. This goal may be achieved thanks to the technique of welding titanium bars on implant abutments. In fact, the procedure can be performed directly in the mouth eliminating possibility of errors or distortions due to impression. This paper describes a case report and the most recent data about long-term success and high predictability of intraorally welded titanium bar in immediate loading implants.

  15. Titanium Implant Osseointegration Problems with Alternate Solutions Using Epoxy/Carbon-Fiber-Reinforced Composite

    Directory of Open Access Journals (Sweden)

    Richard C. Petersen

    2014-12-01

    Full Text Available The aim of the article is to present recent developments in material research with bisphenyl-polymer/carbon-fiber-reinforced composite that have produced highly influential results toward improving upon current titanium bone implant clinical osseointegration success. Titanium is now the standard intra-oral tooth root/bone implant material with biocompatible interface relationships that confer potential osseointegration. Titanium produces a TiO2 oxide surface layer reactively that can provide chemical bonding through various electron interactions as a possible explanation for biocompatibility. Nevertheless, titanium alloy implants produce corrosion particles and fail by mechanisms generally related to surface interaction on bone to promote an inflammation with fibrous aseptic loosening or infection that can require implant removal. Further, lowered oxygen concentrations from poor vasculature at a foreign metal surface interface promote a build-up of host-cell-related electrons as free radicals and proton acid that can encourage infection and inflammation to greatly influence implant failure. To provide improved osseointegration many different coating processes and alternate polymer matrix composite (PMC solutions have been considered that supply new designing potential to possibly overcome problems with titanium bone implants. Now for important consideration, PMCs have decisive biofunctional fabrication possibilities while maintaining mechanical properties from addition of high-strengthening varied fiber-reinforcement and complex fillers/additives to include hydroxyapatite or antimicrobial incorporation through thermoset polymers that cure at low temperatures. Topics/issues reviewed in this manuscript include titanium corrosion, implant infection, coatings and the new epoxy/carbon-fiber implant results discussing osseointegration with biocompatibility related to nonpolar molecular attractions with secondary bonding, carbon fiber in vivo

  16. Titanium Implant Osseointegration Problems with Alternate Solutions Using Epoxy/Carbon-Fiber-Reinforced Composite.

    Science.gov (United States)

    Petersen, Richard C

    2014-12-01

    The aim of the article is to present recent developments in material research with bisphenyl-polymer/carbon-fiber-reinforced composite that have produced highly influential results toward improving upon current titanium bone implant clinical osseointegration success. Titanium is now the standard intra-oral tooth root/bone implant material with biocompatible interface relationships that confer potential osseointegration. Titanium produces a TiO 2 oxide surface layer reactively that can provide chemical bonding through various electron interactions as a possible explanation for biocompatibility. Nevertheless, titanium alloy implants produce corrosion particles and fail by mechanisms generally related to surface interaction on bone to promote an inflammation with fibrous aseptic loosening or infection that can require implant removal. Further, lowered oxygen concentrations from poor vasculature at a foreign metal surface interface promote a build-up of host-cell-related electrons as free radicals and proton acid that can encourage infection and inflammation to greatly influence implant failure. To provide improved osseointegration many different coating processes and alternate polymer matrix composite (PMC) solutions have been considered that supply new designing potential to possibly overcome problems with titanium bone implants. Now for important consideration, PMCs have decisive biofunctional fabrication possibilities while maintaining mechanical properties from addition of high-strengthening varied fiber-reinforcement and complex fillers/additives to include hydroxyapatite or antimicrobial incorporation through thermoset polymers that cure at low temperatures. Topics/issues reviewed in this manuscript include titanium corrosion, implant infection, coatings and the new epoxy/carbon-fiber implant results discussing osseointegration with biocompatibility related to nonpolar molecular attractions with secondary bonding, carbon fiber in vivo properties, electrical

  17. Bone-anchored hearing aids (BAHAs) for people who are bilaterally deaf: a systematic review and economic evaluation.

    Science.gov (United States)

    Colquitt, J L; Jones, J; Harris, P; Loveman, E; Bird, A; Clegg, A J; Baguley, D M; Proops, D W; Mitchell, T E; Sheehan, P Z; Welch, K

    2011-07-01

    A bone-anchored hearing aid (BAHA) consists of a permanent titanium fixture, which is surgically implanted into the skull bone behind the ear, and a small detachable sound processor that clips onto the fixture. BAHAs are suitable for people with conductive or mixed hearing loss who cannot benefit fully from conventional hearing aids. To assess the clinical effectiveness and cost-effectiveness of BAHAs for people who are bilaterally deaf. Nineteen electronic resources, including MEDLINE, EMBASE and The Cochrane Library (inception to November 2009). Additional studies were sought from reference lists and clinical experts. Inclusion criteria were applied by two reviewers independently. Data extraction and quality assessment were undertaken by one reviewer and checked by a second. Prospective studies of adults or children with bilateral hearing loss were eligible. Comparisons were BAHAs versus conventional hearing aids [air conduction hearing aid (ACHA) or bone conduction hearing aid (BCHA)], unaided hearing and ear surgery; and unilateral versus bilateral BAHAs. Outcomes included hearing measures, validated measures of quality of life (QoL), adverse events and measures of cost-effectiveness. For the review of cost-effectiveness, full economic evaluations were eligible. Twelve studies were included (seven cohort pre-post studies and five cross-sectional 'audiological comparison' studies). No prospective studies comparing BAHAs with ear surgery were identified. Overall quality was rated as weak for all included studies and meta-analysis was not possible due to differences in outcome measures and patient populations. There appeared to be some audiological benefits of BAHAs compared with BCHAs and improvements in speech understanding in noise compared with ACHAs; however, ACHAs may produce better audiological results for other outcomes. The limited evidence reduces certainty. Hearing is improved with BAHAs compared with unaided hearing. Improvements in QoL with BAHAs were

  18. A Review of Temporal Bone CT Imaging With Respect to Pediatric Bone-anchored Hearing Aid Placement.

    Science.gov (United States)

    Baker, Aaron; Fanelli, David; Kanekar, Sangam; Isildak, Huseyin

    2016-10-01

    Bone-anchored hearing aid has been shown to be effective in hearing rehabilitation for conductive loss or single-sided deafness. Current FDA guidelines allow implantation in patients over 5 years old. This guideline is at least partially due to concern for thickness of bone stock at the implant site. We aim to investigate whether temporal bone thickness should be a deterrent to implantation in those younger than five. A retrospective review of high-resolution temporal bone computed tomographies (CTs) comparing measurements between ears with chronic disease and controls. Single institution tertiary care center. One hundred patients between 1 and 5.99 years had temporal bone CTs performed between 2000 and 2009. Patients with chronic ear disease were identified by ICD-9 code, as well as confirmation by review of the imaging. None. Temporal bone thickness was measured on axial CT slices at a point 1 cm posterior to the sigmoid sinus, at the superior margin of the bony canal. Average thickness was greater than 3 mm in all age groups. No significant difference was found between age groups, or between normal ears and ears with chronic disease (3.5 mm versus 3.3 mm, p = 0.21) when compared individually. This data shows pediatric temporal bone thickness is frequently greater than the recommended 3 mm, even in patients as young as one. Anatomically, concerns regarding temporal bone thickness in patients younger than five could be reliably addressed with imaging typically obtained in workup of hearing loss.

  19. [Susceptibility to infections and behavior of stainless steel : Comparison with titanium implants in traumatology].

    Science.gov (United States)

    Haubruck, Patrick; Schmidmaier, Gerhard

    2017-02-01

    Despite modern treatment options, implant-associated infections (IAI) remain a severe and challenging complication in the treatment of trauma patients. Almost 30 years after the introduction of implants made of titanium alloy into the treatment of trauma patients, there is still no uniform consensus regarding the clinical benefit of titanium alloy in the context of patients with IAI. We sought to determine if implants made of titanium alloy have been proven to be less susceptible regarding IAI in contrast to implants made of stainless steel. A review of the current literature on IAI in association with the utilized implant material was conducted. Relevant articles from the years 1995 to 2016 were searched in the PubMed database. A total of 183 articles were identified and all abstracts were reviewed for relevance. A total of 14 articles met the inclusion criteria and were stratified according to the level of evidence and furthermore evaluated regarding the influence of the implant material on IAI. Considerable debate remains concerning the influence of the implant material on the susceptibility to IAI; however, the available literature shows that despite slight tendencies, there is no proof of titanium alloy being favorable in the susceptibility to IAI. Furthermore, the literature shows that the design of plates for osteosynthesis might influence IAI. In particular, plates that cause less soft tissue damage and preserve perfusion of the periosteum proved to be beneficial regarding IAI.

  20. Direct Metal Laser Sintering Titanium Dental Implants: A Review of the Current Literature

    Directory of Open Access Journals (Sweden)

    F. Mangano

    2014-01-01

    Full Text Available Statement of Problem. Direct metal laser sintering (DMLS is a technology that allows fabrication of complex-shaped objects from powder-based materials, according to a three-dimensional (3D computer model. With DMLS, it is possible to fabricate titanium dental implants with an inherently porous surface, a key property required of implantation devices. Objective. The aim of this review was to evaluate the evidence for the reliability of DMLS titanium dental implants and their clinical and histologic/histomorphometric outcomes, as well as their mechanical properties. Materials and Methods. Electronic database searches were performed. Inclusion criteria were clinical and radiographic studies, histologic/histomorphometric studies in humans and animals, mechanical evaluations, and in vitro cell culture studies on DMLS titanium implants. Meta-analysis could be performed only for randomized controlled trials (RCTs; to evaluate the methodological quality of observational human studies, the Newcastle-Ottawa scale (NOS was used. Results. Twenty-seven studies were included in this review. No RCTs were found, and meta-analysis could not be performed. The outcomes of observational human studies were assessed using the NOS: these studies showed medium methodological quality. Conclusions. Several studies have demonstrated the potential for the use of DMLS titanium implants. However, further studies that demonstrate the benefits of DMLS implants over conventional implants are needed.

  1. Are clinical findings of systemic titanium dispersion following implantation explained by available in vitro evidence? An evidence-based analysis.

    Science.gov (United States)

    Curtin, Justin Paul; Wang, Minji

    2017-08-01

    Although the presence of titanium wear particles released into tissues is known to induce local inflammation following the therapeutic implantation of titanium devices into humans, the role that titanium ions play in adverse tissue responses has received little attention. Support that ongoing titanium ion release occurs is evidenced by the presence of ionic titanium bound to transferrin in blood, and ongoing excretion in the urine of patients with titanium devices. However, as reports documenting the presence of titanium within tissues do not distinguish between particulate and ionic forms due to technical challenges, the degree to which ionic titanium is released into tissues is unknown. To determine the potential for titanium ion release into tissues, this study evaluates available in vitro evidence relating to the release of ionic titanium under physiological conditions. This is a systematic literature review of studies reporting titanium ion release into solutions from titanium devices under conditions replicating the interstitial pH and constituents. Inclusion and exclusion criteria were defined. Of 452 articles identified, titanium ions were reported in nine media relevant to human biology in seventeen studies. Only one study, using human serum replicated both physiological pH and the concentration of constituents while reporting the presence of titanium ions. While there is insufficient information to explain the factors that contribute to the presence of titanium ions in serum of humans implanted with titanium devices, currently available information suggests that areas of future inquiry include the role of transferrin and organic acids.

  2. A Wrapping Method for Inserting Titanium Micro-Mesh Implants in the Reconstruction of Blowout Fractures

    Directory of Open Access Journals (Sweden)

    Tae Joon Choi

    2016-01-01

    Full Text Available Titanium micro-mesh implants are widely used in orbital wall reconstructions because they have several advantageous characteristics. However, the rough and irregular marginal spurs of the cut edges of the titanium mesh sheet impede the efficacious and minimally traumatic insertion of the implant, because these spurs may catch or hook the orbital soft tissue, skin, or conjunctiva during the insertion procedure. In order to prevent this problem, we developed an easy method of inserting a titanium micro-mesh, in which it is wrapped with the aseptic transparent plastic film that is used to pack surgical instruments or is attached to one side of the inner suture package. Fifty-four patients underwent orbital wall reconstruction using a transconjunctival or transcutaneous approach. The wrapped implant was easily inserted without catching or injuring the orbital soft tissue, skin, or conjunctiva. In most cases, the implant was inserted in one attempt. Postoperative computed tomographic scans showed excellent placement of the titanium micro-mesh and adequate anatomic reconstruction of the orbital walls. This wrapping insertion method may be useful for making the insertion of titanium micro-mesh implants in the reconstruction of orbital wall fractures easier and less traumatic.

  3. Effect of UV-photofunctionalization on oral bacterial attachment and biofilm formation to titanium implant material.

    Science.gov (United States)

    de Avila, Erica Dorigatti; Lima, Bruno P; Sekiya, Takeo; Torii, Yasuyoshi; Ogawa, Takahiro; Shi, Wenyuan; Lux, Renate

    2015-10-01

    Bacterial biofilm infections remain prevalent reasons for implant failure. Dental implant placement occurs in the oral environment, which harbors a plethora of biofilm-forming bacteria. Due to its trans-mucosal placement, part of the implant structure is exposed to oral cavity and there is no effective measure to prevent bacterial attachment to implant materials. Here, we demonstrated that UV treatment of titanium immediately prior to use (photofunctionalization) affects the ability of human polymicrobial oral biofilm communities to colonize in the presence of salivary and blood components. UV-treatment of machined titanium transformed the surface from hydrophobic to superhydrophilic. UV-treated surfaces exhibited a significant reduction in bacterial attachment as well as subsequent biofilm formation compared to untreated ones, even though overall bacterial viability was not affected. The function of reducing bacterial colonization was maintained on UV-treated titanium that had been stored in a liquid environment before use. Denaturing gradient gel-electrophoresis (DGGE) and DNA sequencing analyses revealed that while bacterial community profiles appeared different between UV-treated and untreated titanium in the initial attachment phase, this difference vanished as biofilm formation progressed. Our findings confirm that UV-photofunctionalization of titanium has a strong potential to improve outcome of implant placement by creating and maintaining antimicrobial surfaces. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Effect of UV-photofunctionalization on Oral Bacterial Attachment and Biofilm Formation to Titanium Implant Material

    Science.gov (United States)

    de Avila, Erica Dorigatti; Lima, Bruno P.; Sekiya, Takeo; Torii, Yasuyoshi; Ogawa, Takahiro; Shi, Wenyuan; Lux, Renate

    2015-01-01

    Bacterial biofilm infections remain prevalent reasons for implant failure. Dental implant placement occurs in the oral environment, which harbors a plethora of biofilm-forming bacteria. Due to its trans-mucosal placement, part of the implant structure is exposed to oral cavity and there is no effective measure to prevent bacterial attachment to implant materials. Here, we demonstrated that UV treatment of titanium immediately prior to use (photofunctionalization) affects the ability of human polymicrobial oral biofilm communities to colonize in the presence of salivary and blood components. UV-treatment of machined titanium transformed the surface from hydrophobic to superhydrophilic. UV-treated surfaces exhibited a significant reduction in bacterial attachment as well as subsequent biofilm formation compared to untreated ones, even though overall bacterial viability was not affected. The function of reducing bacterial colonization was maintained on UV-treated titanium that had been stored in a liquid environment before use. Denaturing gradient gel-electrophoresis (DGGE) and DNA sequencing analyses revealed that while bacterial community profiles appeared different between UV-treated and untreated titanium in the initial attachment phase, this difference vanished as biofilm formation progressed. Our findings confirm that UV-photofunctionalization of titanium has a strong potential to improve outcome of implant placement by creating and maintaining antimicrobial surfaces. PMID:26210175

  5. [Biomechanic and histomorphometric studies of HIP titanium glass ceramic, a new implant material, compared with glass ceramics, titanium and titanium alloy].

    Science.gov (United States)

    Schmitz, H J; Fritz, T R; Fuhrmann, G; Gross, U; Strunz, V

    1990-01-01

    Interfacial tensile strength and quantitative histomorphological properties of alloplastic implant materials for hard tissue application were studied in animal models. Physico-chemical bonding in the order of 1 N/mm2 of bone to glass-ceramic (Ceravital) was demonstrated independent of magnitude of surface roughness with mineralized bone in excess of 80% at the implant interface. No bone-bonding, but contact of mineralized bone at the metal surface was observed in pure titanium and titanium alloys (Ti6Al4V, Ti5Al2, 5Fe) with smooth surfaces. Rough or porous surfaced specimens, however, exhibited mechanical interlocking and interdigitation, thus yielding interfacial tensile strength of up to 4 N/mm2 in geometrically porous or madreporic surfaces. The new composite material HIP-Titanium-glass-ceramic (Ceravital) displayed physico-chemical bonding to bone as well as mechanical interdigitation within the secondary porous structure, thus giving support to expectations that HIP-Titanium-glass-ceramic coated implants should perform superior than bulk materials.

  6. Bone response to immediate loading through titanium implants with different surface roughness in rats.

    Science.gov (United States)

    Sato, Naoko; Kuwana, Toshie; Yamamoto, Miou; Suenaga, Hanako; Anada, Takahisa; Koyama, Shigeto; Suzuki, Osamu; Sasaki, Keiichi

    2014-07-01

    Because of its high predictability of success, implant therapy is a reliable treatment for replacement of missing teeth. The concept of immediate implant loading has been widely accepted in terms of early esthetic and functional recovery. However, there is little biological evidence to support this concept. The objective of this study was to examine the interactive effects of mechanical loading and surface roughness of immediately loaded titanium implants on bone formation in rats. Screw-shaped anodized titanium implants were either untreated (smooth) or acid-etched. Two implants were inserted parallel to each other in the tibiae of rats, and a closed coil spring (2.0 N) was immediately applied. Trabecular and cortical bone around both implants was analyzed using microtomographic images, and a removal torque test was performed at weeks 1, 2, and 4. Immediate loading of acid-etched implants resulted in significant decreases in bone mineral density, contact surface area, and cortical bone thickness. These effects were not observed after immediate loading of smooth implants. Conversely, loading did not influence acid-etched implant fixation; however, smooth implant fixation at week 1 was significantly reduced. These results imply that surface roughness regulates bone response to mechanical stress and that immediate loading might not inhibit osseointegration for smooth and rough implants in the late healing stages.

  7. Electrochemical Characteristics of Titanium for Dental Implants in Case of the Electroless Surface Modification

    Directory of Open Access Journals (Sweden)

    Klimecka-Tatar D.

    2016-06-01

    Full Text Available In the paper the results of research under effect of electroless phosphate coating of titanium dental implants on potentiokinetic polarization characteristic obtained in artificial saliva were presented. On the basis of electrochemical studies it was concluded that the electroless process of phosphating beneficialy effect on corrosion characteristic of titanium determined in solution simulating the oral cavity. Furthermore, the proposed technique of chemical treatment of titanium surface is conducive to the homogeneous development of the surface, which is extremely important from the point of view of titanium implants biointegration. Phosphating treatment affect on the development of surface geometry, resulting in a slight increase in roughness parameters (Ra, Rz and Rmax. The temperature increase of electroless phosphating treatment promotes the rate of conversion layer formation, whereas the effect of temperature of the chemical treatment efficiency is secondary important at longer exposure times (e.g. 45 minutes.

  8. Strategies For Immobilization Of Bioactive Organic Molecules On Titanium Implant Surfaces – A Review

    Directory of Open Access Journals (Sweden)

    Panayotov Ivan V.

    2015-03-01

    Full Text Available Numerous approaches have been used to improve the tissue-implant interface of titanium (Ti and titanium alloy (Ti6Al4V. They all aim at increasing cell migration and attachment to the metal, preventing unspecific protein adsorption and improving post-implantation healing process. Promising methods for titanium and titanium alloy surface modification are based on the immobilization of biologically active organic molecules. New and interesting biochemical approaches to such surface modification include layer-by-layer deposition of polyelectrolyte films, phage display-selected surface binding peptides and self-assembled DNA monolayer systems. The present review summarizes the scientific information about these methods, which are at in vitro or in vivo development stages, and hopes to promote their future application in dental implantology and in oral and maxillofacial surgery.

  9. The effective design of zirconia coping on titanium base in dental implant superstructure.

    Science.gov (United States)

    Mieda, Maiko; Atsuta, Ikiru; Matsushita, Yasuyuki; Morita, Takehiro; Ayukawa, Yasunori; Tsukiyama, Yoshihiro; Sawae, Yoshinori; Koyano, Kiyoshi

    2018-03-30

    Zirconia exhibits good tissue compatibility and nontoxicity, making it a widely used esthetic replacement material for implant abutments. To avoid abutment-fracture, the parts composed of zirconia with a bonded metal component connected to the implant can be used. The purpose of this study was to design titanium and zirconia components with high fracture resistance at the zirconia component's edge line. Three edge line designs of the titanium base and zirconia sleeve were made: chamfer, shoulder, and back-taper. To assess the strength of the abutment design, static loads were applied vertically and 30 degrees from the vertical axis. A test of tensile strength was also performed after chewing simulation. Conventional zirconia components mounted on a chamfer-type titanium base showed significantly lower fracture resistance than shoulder and back-taper types. This study suggests that to improve the durability of zirconia abutments with a titanium base, a back-tapered edge design is recommended.

  10. Immediate loading of titanium hexed screw-type implants in the edentulous patient: case report.

    Science.gov (United States)

    Calvo, M P; Muller, E; Garg, A K

    2000-01-01

    Histologic and histomorphometric studies in both animals and humans have shown that more rapid and greater bone-to-implant contact can be achieved with implants that incorporate certain surface characteristics compared with the original machined-surface implants. Such findings are significant because various implant designs may allow the fixtures to sufficiently resist functional loading sooner than originally thought. The case report presented here indicates that immediate loading of hexed titanium screw-type implants in the anterior mandible can lead to successful osseointegration and clinical outcome. The number of implants placed, their distribution, and the type of rigid connection are critical considerations for immediate loading. A bone height that can accommodate dental implants > or = 10 mm long is recommended. Biomechanically, the implants to be immediately loaded must be stable and resistant to macromovement to ensure good osseointegration.

  11. Effect of hafnium and titanium coated implants on several blood biochemical markers after osteosynthesis in rabbits.

    Science.gov (United States)

    Yousef, Ashraf; Akhtyamov, Ildar; Shakirova, Faina; Zubairova, Lyaili; Gatina, Elmira; Aliev, Capital Ie Cyrilliclchin

    2014-01-01

    An experimental study comparing the dynamics of several biochemical markers before and after osteosynthesis, utilizing implants coated with titanium and hafnium nitrides and non-coated implants on rabbits' bones. The Study has been conducted on 30 rabbits of both sexes, at the age of 6-7 months, weighing 2526.5±74.4 gm. Animals underwent open osteotomy of the tibia in the middle third of the diaphysis followed by the intramedullary nailing. The level of alkaline phosphatase, calcium, phosphorus, total protein, glucose, ALT and AST were monitored for 60 days. the use of implants coated with titanium and hafnium nitrides, which have high strength, thermal and chemical stability, was not accompanied by the development of additional negative reactive changes compared to non-coated implants. Nanotechnology used in manufacturing bioinert coatings for implants for osteosynthesis, has made the post-operative period less complicated as reflected by less expressed changing in the markers of bone metabolism and hepatotoxicity.

  12. Application of micro beam PIXE to detection of titanium ion release from dental and orthopaedic implants

    International Nuclear Information System (INIS)

    Ektessabi, A.M.; Otsuka, T.; Tsuboi, Y.; Yokoyama, K.; Albrektsson, T.; Sennerby, L.; Johansson, C.

    1994-01-01

    In the past two decades the utilization of dental and orthopaedic implants in reconstructive surgery has been spread widely. Most of these implants are inserted in the corrosive environment of the human body for long periods of time. The level of dissolution, release, and transport of metal ions as a result of corrosion of these materials are not fully known at present. We report the results of application of micro ion beam PIXE spectroscopy to detect release of titanium from titanium and titanium alloy implants inserted in the tibiae of rabbits for three months. It was found that titanium ions could be detected in the surrounding tissues, with high precision, as a gradient from the implant surface and in higher amounts in the bone tissue as compared with the soft tissues. It is concluded that application of micro ion beam PIXE spectroscopy for detection of metal ion release, and distribution of the released material around the implants with high special resolution and accuracy may be used to further investigate the mechanism of metal release, and the relation between surface micromorphology and corrosion resistance of the implant materials. (author)

  13. Material degradation in implant-retained cobalt-chrome and titanium frameworks.

    Science.gov (United States)

    Hjalmarsson, L; Smedberg, J-I; Wennerberg, A

    2011-01-01

    The purpose of the study was to estimate in vitro material degradation in implants and cobalt-chrome or titanium frameworks, before and after exposure to artificial saliva. Four full-arch implant frameworks were fabricated according to the Cresco™ method (Astra Tech AB, Mölndal, Sweden), two in a cobalt-chrome alloy and two in commercially pure (CP) titanium. They were cut vertically, and the three central sections of each framework were used. Element leakage into an artificial saliva solution was observed with mass spectrometry. Before artificial saliva exposure, three Brånemark System(®) implants (Nobel Biocare AB, Gothenburg, Sweden) were screw-retained to cobalt-chrome sections, and three to titanium sections. The contact surfaces with the implants of the framework sections and the corresponding surfaces of six implants were examined with optical interferometry before and after exposure to artificial saliva to evaluate material degradation. Conventional descriptive statistics were used to present the mass spectrometry and interferometry data. One-way anova and Dunnett's T3 post hoc test were used to identify and study differences between the groups. To highlight changes within the groups, the Student's t-test was used. The significance level was set at 5%. There was significantly more leakage of cobalt elements than of titanium and chrome (P chrome frameworks, both before and after saliva exposure (P < 0·05). The findings in this study suggest active material degradation processes for both implants and framework materials. © 2010 Blackwell Publishing Ltd.

  14. Gentamicin coating of nanotubular anodized titanium implant reduces implant-related osteomyelitis and enhances bone biocompatibility in rabbits

    Directory of Open Access Journals (Sweden)

    Liu D

    2017-07-01

    Full Text Available Denghui Liu,1,* Chongru He,2,* Zhongtang Liu,2 Weidong Xu2 1Department of Orthopedics, the 113 Military Hospital, Ningbo, 2Department of Orthopedics, Changhai Hospital Affiliated to the Second Military Medical University, Shanghai, People’s Republic of China *These authors contributed equally to this work Abstract: Titanium and titanium alloy are widely used as orthopedic implants for their favorable mechanical properties and satisfactory biocompatibility. The aim of the present study was to investigate the antibacterial effect and bone cell biocompatibility of a novel implant made with nanotubular anodized titanium coated with gentamicin (NTATi-G through in vivo study in ­rabbits. The animals were divided into four groups, each receiving different kinds of implants, that is, NTATi-G, titanium coated with gentamicin (Ti-G, nanotubular anodized titanium uncoated with gentamicin (NTATi and titanium uncoated with gentamicin (Ti. The results showed that NTATi-G implant prevented implant-related osteomyelitis and enhanced bone biocompatibility in vivo. Moreover, the body temperature of rabbits in NTATi-G and Ti-G groups was lower than those in Ti groups, while the weight of rabbits in NTATi-G and Ti-G groups was heavier than those in NTATi and Ti groups, respectively. White blood cell counts in NTATi-G group were lower than NTATi and Ti groups. Features of myelitis were observed by X-ray films in the NTATi and Ti groups, but not in the NTATi-G and Ti-G groups. The radiographic scores, which assessed pathology and histopathology in bone tissues, were significantly lower in the NTATi-G and Ti-G groups than those in the NTATi and Ti groups, respectively (P<0.05. Meanwhile, explants and bone tissue culture demonstrated significantly less bacterial growth in the NTATi-G and Ti-G groups than in the NTATi and Ti groups, respectively (P<0.01. The bone volume in NTATi-G group was greater than Ti-G group, and little bone formation was seen in NTATi and Ti

  15. Audiological and subjective benefit results in bone-anchored hearing device users.

    Science.gov (United States)

    Boleas-Aguirre, Maria Soledad; Bulnes Plano, Maria Dolores; de Erenchun Lasa, Iñigo Ruiz; Ibáñez Beroiz, Berta

    2012-06-01

    Audiological and subjective benefits in adult bone-anchored hearing device users. Retrospective evaluation. Tertiary referral center. Thirty-eight adult subjects fitted with unilateral bone-anchored hearing device. Audiometric measurements included sound-field pure-tone and speech audiometries (speech reception threshold, maximum speech discrimination). Subjective benefit was assessed by the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire. Ipsilateral and contralateral hearing loss was considered. Comparison was drawn between Compact, Divino, and Intenso processors. To compare sound-field pure-tone and speech audiometries and APHAB results with and without the device adjusted for the unaided results. With the device, sound-field pure-tone audiometry results revealed an increase gain in all frequencies. Sound-field speech audiometry showed that the mean threshold of speech recognition was 20 dB lower, maximum discrimination was attained at 5 dB less, and percentage of maximum discrimination increased by 5%. Scores in the APHAB questionnaire decreased except for the aversiveness subscale. Auditory-adjusted gain showed greater benefit in subjects with ipsilateral conductive hearing loss.Subjects with contralateral normal hearing or conductive hearing loss showed greater improvement that those with contralateral mixed or sensorineural hearing loss. There were no differences between Compact, Divino and Intenso processors. When comparisons are adjusted for unaided condition, the bone-anchored hearing device provided auditory and subjective benefit in subjects with ipsilateral conductive hearing loss and contralateral normal hearing or conductive hearing loss. It gave marginal benefit in ipsilateral mixed and contralateral mixed or sensorineural hearing loss. No differences were found between the Compact, Intenso, and Divino processors.

  16. Demineralized bone matrix and human cancellous bone enhance fixation of porous-coated titanium implants in sheep

    DEFF Research Database (Denmark)

    Babiker, Hassan; Ding, Ming; Overgaard, Søren

    2016-01-01

    of DBM alone, DBM with CB, or allograft on the fixation of porous-coated titanium implants. DBM100 and CB produced from human tissue were included. Both materials are commercially available. DBM granules are placed in pure DBM and do not contain any other carrier. Titanium alloy implants, 10 mm long × 10...

  17. Anti-infection activity of nanostructured titanium percutaneous implants with a postoperative infection model

    Science.gov (United States)

    Tan, Jing; Li, Yiting; Liu, Zhiyuan; Qu, Shuxin; Lu, Xiong; Wang, Jianxin; Duan, Ke; Weng, Jie; Feng, Bo

    2015-07-01

    The titanium percutaneous implants were widely used in clinic; however, they have an increased risk of infection since they breach the skin barrier. Lack of complete skin integration with the implants can cause infection and implant removal. In this work, three titania nanotubes (TNT) with different diameters, 50 nm (TNT-50), 100 nm (TNT-100) and 150 nm (TNT-150) arrays were prepared on titanium surfaces by anodization, pure titanium (pTi) was used as control. Samples were characterized by scanning electron microscopy (SEM), atomic force microscopy (AFM), and contact angle analysis. The antibacterial efficiency of TNT was evaluated in vitro against Staphylococcus aureus under the visible light. The results indicated that TNT-100 had the highest antibacterial efficiency under the visible light. Subsequently, TNT implants and pTi implants were placed subcutaneously to the dorsum of New Zealand White rabbits, 108 CFU S. aureus was inoculated into the implant sites 4 h after surgery. The TNF-alpha and IL-1alpha were determined using enzyme linked immunoassay (ELISA). TNT implants revealed less inflammatory factor release than pTi implants with or without injected S. aureus liquid. According to the histological results, the TNT implants displayed excellent tissue integration. Whereas, pTi implants were surrounded with fibrotic capsule, and the skin tissue was almost separated from the implant surface. Therefore, the TNT significantly inhibited the infection risk and enhanced tissue integration of the percutaneous implants compared to pTi. The immersion test in the culture medium suggested that one of causes be probably more proteins adsorbed on TNT than on pTi.

  18. CT provides precise size assessment of implanted titanium alloy pedicle screws.

    Science.gov (United States)

    Elliott, Michael J; Slakey, Joseph B

    2014-05-01

    After performing instrumented spinal fusion with pedicle screws, postoperative imaging using CT to assess screw position may be necessary. Stainless steel implants produce significant metal artifact on CT, and the degree of distortion is at least partially dependent on the cross-sectional area of the implanted device. If the same effect occurs with titanium alloy implants, ability to precisely measure proximity of screws to adjacent structures may be adversely affected as screw size increases. We therefore asked whether (1) CT provides precise measurements of true screw widths; and (2) precision degrades based on the size of the titanium implant imaged. CT scans performed on 20 patients after instrumented spinal fusion for scoliosis were reviewed. The sizes of 151 titanium alloy pedicle screws were measured and compared with known screw size. The amount of metal bloom artifact was determined for each of the four screw sizes. ANOVA with Tukey's post hoc test were performed to evaluate differences in scatter, and Spearman's rho coefficient was used to measure relationship between screw size and scatter. All screws measured larger than their known size, but even with larger 7-mm screws the size differential was less than 1 mm. The four different screw sizes produced scatter amounts that were different from each other (p titanium alloy pedicle screws produces minimal artifact, thus making this the preferred imaging modality to assess screw position after surgery. Although the amount of artifact increases with the volume of titanium present, the degree of distortion is minimal and is usually less than 1 mm.

  19. Cell responses to titanium treated by a sandblast-free method for implant applications.

    Science.gov (United States)

    Zhang, Jie; Xie, Youneng; Zuo, Jun; Li, Jiaxin; Wei, Qiuping; Yu, Zhiming; Tang, Zhangui

    2017-09-01

    Sandblast and acid-etching (SLA) is the most prevalent treatment to titanium implants, while residual sand particles are inevitably introduced on SLA titanium surfaces. NH 4 OH and H 2 O 2 mixture was used to etch titanium plates (E) and titanium bars (EB), aiming at substituting sandblast procedure. To study the effects of different scale rough structures on cell response of Human osteoblast-like cells (MG63), traditional H 2 SO 4 and HCl mixture was also used to further etch the titanium plates above (DE). Holes of 10-20μm were obtained on E and DE surfaces, which are very close to the size of osteoblasts. Surfaces with micro/nano and micro/submicro hierarchical structures were obtained on the treated titanium. As-prepared E, DE and EB surfaces are hydrophilic, while only EB stayed hydrophilic after 5days' exposure to air. MG63 cultured on E and EB surfaces showed higher proliferation rate and attachment area than on DE and P surfaces. E and DE showed higher alkaline phosphatases (ALP) activity after 7 and 14days of osteoinduction, while EB showed the highest osteopontin (OPN) and bone sialoprotein (BSP) production after 21days of osteoinduction. These results indicate that E and EB surfaces boost the proliferation and osteogenic differentiation of MG63 without introducing sand particles. This is a promising treatment to titanium implant. Copyright © 2017. Published by Elsevier B.V.

  20. Nano-crystalline diamond-coated titanium dental implants - a histomorphometric study in adult domestic pigs.

    Science.gov (United States)

    Metzler, Philipp; von Wilmowsky, Cornelius; Stadlinger, Bernd; Zemann, Wolfgang; Schlegel, Karl Andreas; Rosiwal, Stephan; Rupprecht, Stephan

    2013-09-01

    Promising biomaterial characteristics of diamond-coatings in biomedicine have been described in the literature. However, there is a lack of knowledge about implant osseointegration of this surface modification compared to the currently used sandblasted acid-etched Ti-Al6-V4 implants. The aim of this study was to investigate the osseointegration of microwave plasma-chemical-vapour deposition (MWP-CVD) diamond-coated Ti-Al6-V4 dental implants after healing periods of 2 and 5 months. Twenty-four MWP-CVD diamond-coated and 24 un-coated dental titanium-alloy implants (Ankylos(®)) were placed in the frontal skull of eight adult domestic pigs. To evaluate the effects of the nano-structured surfaces on bone formation, a histomorphometric analysis was performed after 2 and 5 months of implant healing. Histomorphometry analysed the bone-to-implant contact (BIC). No significant difference in BIC for the diamond-coated implants in comparison to reference implants could be observed for both healing periods. Scanning electron microscopy revealed an adequate interface between the bone and the diamond surface. No delamination or particle-dissociation due to shearing forces could be detected. In this study, diamond-coated dental titanium-alloy implants and sandblasted acid-etched implants showed a comparable degree of osseointegration. Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  1. Effect of ion-implantation on surface characteristics of nickel titanium and titanium molybdenum alloy arch wires

    Directory of Open Access Journals (Sweden)

    Manu Krishnan

    2013-01-01

    Full Text Available Aim: To evaluate the changes in surface roughness and frictional features of ′ion-implanted nickel titanium (NiTi and titanium molybdenum alloy (TMA arch wires′ from its conventional types in an in-vitro laboratory set up. Materials and Methods: ′Ion-implanted NiTi and low friction TMA arch wires′ were assessed for surface roughness with scanning electron microscopy (SEM and 3 dimensional (3D optical profilometry. Frictional forces were studied in a universal testing machine. Surface roughness of arch wires were determined as Root Mean Square (RMS values in nanometers and Frictional Forces (FF in grams. Statistical Analysis Used: Mean values of RMS and FF were compared by Student′s ′t′ test and one way analysis of variance (ANOVA. Results: SEM images showed a smooth topography for ion-implanted versions. 3D optical profilometry demonstrated reduction of RMS values by 58.43% for ion-implanted NiTi (795.95 to 330.87 nm and 48.90% for TMA groups (463.28 to 236.35 nm from controls. Nonetheless, the corresponding decrease in FF was only 29.18% for NiTi and 22.04% for TMA, suggesting partial correction of surface roughness and disproportionate reduction in frictional forces with ion-implantation. Though the reductions were highly significant at P < 0.001, relations between surface roughness and frictional forces remained non conclusive even after ion-implantation. Conclusion: The study proved that ion-implantation can significantly reduce the surface roughness of NiTi and TMA wires but could not make a similar reduction in frictional forces. This can be attributed to the inherent differences in stiffness and surface reactivity of NiTi and TMA wires when used in combination with stainless steel brackets, which needs further investigations.

  2. Clinical evidence on titanium-zirconium dental implants: a systematic review and meta-analysis.

    Science.gov (United States)

    Altuna, P; Lucas-Taulé, E; Gargallo-Albiol, J; Figueras-Álvarez, O; Hernández-Alfaro, F; Nart, J

    2016-07-01

    The use of titanium implants is well documented and they have high survival and success rates. However, when used as reduced-diameter implants, the risk of fracture is increased. Narrow diameter implants (NDIs) of titanium-zirconium (Ti-Zr) alloy have recently been developed (Roxolid; Institut Straumann AG). Ti-Zr alloys (two highly biocompatible materials) demonstrate higher tensile strength than commercially pure titanium. The aim of this systematic review was to summarize the existing clinical evidence on dental NDIs made from Ti-Zr. A systematic literature search was performed using the Medline database to find relevant articles on clinical studies published in the English language up to December 2014. Nine clinical studies using Ti-Zr implants were identified. Overall, 607 patients received 922 implants. The mean marginal bone loss was 0.36±0.06mm after 1 year and 0.41±0.09mm after 2 years. The follow-up period ranged from 3 to 36 months. Mean survival and success rates were 98.4% and 97.8% at 1 year after implant placement and 97.7% and 97.3% at 2 years. Narrow diameter Ti-Zr dental implants show survival and success rates comparable to regular diameter titanium implants (>95%) in the short term. Long-term follow-up clinical data are needed to confirm the excellent clinical performance of these implants. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  3. Efficacy of Octacalcium Phosphate Collagen Composite for Titanium Dental Implants in Dogs

    Directory of Open Access Journals (Sweden)

    Tadashi Kawai

    2018-02-01

    Full Text Available Background: Previous studies showed that octacalcium (OCP collagen composite (OCP/Col can be used to repair human jaw bone defects without any associated abnormalities. The present study investigated whether OCP/Col could be applied to dental implant treatment using a dog tooth extraction socket model. Methods: The premolars of dogs were extracted; each extraction socket was extended, and titanium dental implants were placed in each socket. OCP/Col was inserted in the space around a titanium dental implant. Autologous bone was used to fill the other sockets, while the untreated socket (i.e., no bone substitute material served as a control. Three months after the operation, these specimens were analyzed for the osseointegration of each bone substitute material with the surface of the titanium dental implant. Results: In histomorphometric analyses, the peri-implant bone areas (BA% and bone-implant contact (BIC% were measured. There was no difference in BA% or BIC% between OCP/Col and autologous bone. Conclusion: These results suggested that OCP/Col could be used for implant treatment as a bone substitute.

  4. Efficacy of Octacalcium Phosphate Collagen Composite for Titanium Dental Implants in Dogs

    Science.gov (United States)

    Kawai, Tadashi; Matsui, Keiko; Ezoe, Yushi; Kajii, Fumihiko; Suzuki, Osamu; Takahashi, Tetsu; Kamakura, Shinji

    2018-01-01

    Background: Previous studies showed that octacalcium (OCP) collagen composite (OCP/Col) can be used to repair human jaw bone defects without any associated abnormalities. The present study investigated whether OCP/Col could be applied to dental implant treatment using a dog tooth extraction socket model. Methods: The premolars of dogs were extracted; each extraction socket was extended, and titanium dental implants were placed in each socket. OCP/Col was inserted in the space around a titanium dental implant. Autologous bone was used to fill the other sockets, while the untreated socket (i.e., no bone substitute material) served as a control. Three months after the operation, these specimens were analyzed for the osseointegration of each bone substitute material with the surface of the titanium dental implant. Results: In histomorphometric analyses, the peri-implant bone areas (BA%) and bone-implant contact (BIC%) were measured. There was no difference in BA% or BIC% between OCP/Col and autologous bone. Conclusion: These results suggested that OCP/Col could be used for implant treatment as a bone substitute. PMID:29393874

  5. Effective removal of calcified deposits on microstructured titanium fixture surfaces of dental implants with erbium lasers.

    Science.gov (United States)

    Takagi, Toru; Aoki, Akira; Ichinose, Shizuko; Taniguchi, Yoichi; Tachikawa, Noriko; Shinoki, Takeshi; Meinzer, Walter; Sculean, Anton; Izumi, Yuichi

    2018-03-13

    Recently, the occurrence of peri-implantitis has been increasing. However, a suitable method to debride the contaminated surface of titanium implants has not been established. The aim of this study was to investigate the morphological changes of the microstructured fixture surface after erbium laser irradiation, and to clarify the effects of the erbium lasers when used to remove calcified deposits from implant fixture surfaces. In experiment 1, sandblasted, large grit, acid etched surface implants were treated with Er:YAG laser or Er,Cr:YSGG laser at 30-60 mJ/pulse and 20 Hz with water spray. In experiments 2 and 3, the effects of erbium lasers used to remove calcified deposits (artificially prepared deposits on virgin implants and natural calculus on failed implants) were investigated and compared with mechanical debridement using either a titanium curette or cotton pellets. After the various debridement methods, all specimens were analyzed by stereomicroscopy (SM), scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS). Stereomicroscopy and SEM showed that erbium lasers with optimal irradiation parameters did not have an effect on titanium microstructures. Compared to mechanical debridement, erbium lasers were more capable of removing calcified deposits on the microstructured surface without surface alteration using a non-contact sweeping irradiation at 40 mJ/pulse (ED 14.2 J/cm 2 /pulse) and 20 Hz with water spray. These results indicate that Er:YAG and Er,Cr:YSGG lasers are more advantageous in removing calcified deposits on the microstructured surface of titanium implants without inducing damage, compared to mechanical therapy by cotton pellet or titanium curette. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  6. Allergic reaction to vanadium causes a diffuse eczematous eruption and titanium alloy orthopedic implant failure.

    Science.gov (United States)

    Engelhart, Sally; Segal, Robert J

    2017-04-01

    Allergy as a cause of adverse outcomes in patients with implanted orthopedic hardware is controversial. Allergy to titanium-based implants has not been well researched, as titanium is traditionally thought to be inert. We highlight the case of a patient who developed systemic dermatitis and implant failure after surgical placement of a titanium alloy (Ti6Al4V) plate in the left foot. The hardware was removed and the eruption cleared in the following weeks. The plate and screws were submitted for metal analysis. The elemental composition of both the plate and screws included 3 major elements-titanium, aluminum, and vanadium-as well as trace elements. Metal analysis revealed that the plate and screws had different microstructures, and electrochemical studies demonstrated that galvanic corrosion could have occurred between the plate and screws due to their different microstructures, contributing to the release of vanadium in vivo. The patient was patch tested with several metals including components of the implant and had a positive patch test reaction only to vanadium trichloride. These findings support a diagnosis of vanadium allergy and suggests that clinicians should consider including vanadium when patch testing patients with a suspected allergic reaction to vanadium-containing implants.

  7. Histological and Histomorphometric Evaluation of Zirconia Dental Implants Modified by Femtosecond Laser versus Titanium Implants: An Experimental Study in Fox Hound Dogs.

    Science.gov (United States)

    Calvo-Guirado, Jose Luis; Aguilar-Salvatierra, Antonio; Delgado-Ruiz, Rafael Arcesio; Negri, Bruno; Fernández, María Piedad Ramírez; Maté Sánchez de Val, José Eduardo; Gómez-Moreno, Gerardo; Romanos, Georgios E

    2015-06-01

    This study applied femtosecond laser technology to zirconia dental implants (Bredent GmbH & Co.KG, Senden, Germany) to generate a surface texture of microgrooves over the entire intraosseous surface, analyzing its behavior in an in vivo model in comparison with titanium implants with sandblasted and acid-etched surfaces. The study used six American Fox Hound dogs. Each received four implants per hemi-mandible, making a total of eight implants per animal. The 48 immediate loaded implants were divided into two groups of 24 titanium implants (control group) and 24 zirconia implants (study/test group), distributed randomly. Bone-to-implant contact (BIC) values and crestal resorption were determined at 1 and 3 months, also measuring calcium, phosphorous, and carbon concentrations by means of energy dispersive x-ray. BIC percentages after 30 days were 51.36% for titanium implants and 44.68% for zirconia implants. After 90 days, values increased to 61.73% in titanium and 47.94% in zirconia implants. After 30 days, there was more crestal bone lost in the titanium group (0.77 mm) compared with the zirconia group (0.01 mm). After 90 days, zirconia implants showed greater marginal bone resorption (1.25 mm) compared with the titanium group (0.37 mm). The present study shows that zirconia implants with modified surfaces can produce good osseointegration values when compared with titanium implants in terms of BIC and crestal bone resorption at 1 and 3 months. © 2013 Wiley Periodicals, Inc.

  8. A study of strengthening mechanism for high energy titanium ion implantation into H13 steel

    International Nuclear Information System (INIS)

    Zhang Tonghe; Chen Jun

    1995-05-01

    The strengthening mechanism of high energy titanium ion implanted H13 steel was studied. The results shown that several kinds of strengthening factors played a part in strengthening together when the high energy titanium ions were implanted into H13 steel. The solution strengthening and dislocation strengthening were dominated if Ti ions were implanted with high dose at low temperature. The strengthening effects were increased. The Fe 2 Ti and TiC phases were formed in H13 steel when the Ti ions were implanted with high dose at 400 degree C. The dispersion strengthening phases of Fe 2 Ti and TiC were appeared. The strengthening effects are better than before. The hardness increased 3.2 times, the wear resistance increased 11 times. (2 tabs., 7 figs.)

  9. Shallow nitrogen ion implantation: Evolution of chemical state and defect structure in titanium

    Energy Technology Data Exchange (ETDEWEB)

    Manojkumar, P.A., E-mail: manoj@igcar.gov.in [Indira Gandhi Centre for Atomic Research, Kalpakkam 603102 (India); Chirayath, V.A.; Balamurugan, A.K.; Krishna, Nanda Gopala; Ilango, S.; Kamruddin, M.; Amarendra, G.; Tyagi, A.K. [Indira Gandhi Centre for Atomic Research, Kalpakkam 603102 (India); Raj, Baldev [National Institute of Advanced Studies, Bangalore 560 012 (India)

    2016-09-15

    Highlights: • Low energy nitrogen ion implantation in titanium was studied. • Chemical and defect states were analyzed using SIMS, XPS and PAS. • SIMS and depth resolved XPS data showed good agreement. • Depth resolved defect and chemical states information were revealed. • Formation of 3 layers of defect states proposed to fit PAS results. - Abstract: Evolution of chemical states and defect structure in titanium during low energy nitrogen ion implantation by Plasma Immersion Ion Implantation (PIII) process is studied. The underlying process of chemical state evolution is investigated using secondary ion mass spectrometry and X-ray photoelectron spectroscopy. The implantation induced defect structure evolution as a function of dose is elucidated using variable energy positron annihilation Doppler broadening spectroscopy (PAS) and the results were corroborated with chemical state. Formation of 3 layers of defect state was modeled to fit PAS results.

  10. The effect of low-intensity pulsed ultrasound on the osseointegration of titanium dental implants.

    Science.gov (United States)

    Liu, Qing; Liu, Xin; Liu, Baolin; Hu, Kaijin; Zhou, Xiaodong; Ding, Yuxiang

    2012-04-01

    Our aim was to record the effect of low-intensity pulsed ultrasound (LIPUS) on the osseointegration of endosseous dental implants in 10 New Zealand rabbits. One titanium implant with screw was inserted into the metaphyseal region of each femur and tibia in the knee joints of each rabbit, making a total of 40 implants. The area of one lateral knee joint, including implants, was irradiated with LIPUS for 10 min twice a day for 21 days. The other side acted as control, having been given "sham" irradiation. Two rabbits were killed at each of 0, 2, 4, 6, and 8 weeks after irradiation. A micro-computed tomogram (μCT), histological examination, and implant pull-out test were used to judge the reactions of the bone to the titanium implant. Histological and μCT examinations showed that osseointegration of the implants on the LIPUS-treated side happened earlier and more effectively than on the control side. The mechanical test showed that the maximal axial pull-out strength of the implants on the LIPUS-treated side was greater than that on the control side. We conclude that LIPUS has the potential to accelerate the osseointegration of dental implants. Copyright © 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  11. Multifunctions of dual Zn/Mg ion co-implanted titanium on osteogenesis, angiogenesis and bacteria inhibition for dental implants.

    Science.gov (United States)

    Yu, Yiqiang; Jin, Guodong; Xue, Yang; Wang, Donghui; Liu, Xuanyong; Sun, Jiao

    2017-02-01

    In order to improve the osseointegration and long-term survival of dental implants, it is urgent to develop a multifunctional titanium surface which would simultaneously have osteogeneic, angiogeneic and antibacterial properties. In this study, a potential dental implant material-dual Zn/Mg ion co-implanted titanium (Zn/Mg-PIII) was developed via plasma immersion ion implantation (PIII). The Zn/Mg-PIII surfaces were found to promote initial adhesion and spreading of rat bone marrow mesenchymal stem cells (rBMSCs) via the upregulation of the gene expression of integrin α1 and integrin β1. More importantly, it was revealed that Zn/Mg-PIII could increase Zn 2+ and Mg 2+ concentrations in rBMSCs by promoting the influx of Zn 2+ and Mg 2+ and inhibiting the outflow of Zn 2+ , and then could enhance the transcription of Runx2 and the expression of ALP and OCN. Meanwhile, Mg 2+ ions from Zn/Mg-PIII increased Mg 2+ influx by upregulating the expression of MagT1 transporter in human umbilical vein endothelial cells (HUVECs), and then stimulated the transcription of VEGF and KDR via activation of hypoxia inducing factor (HIF)-1α, thus inducing angiogenesis. In addition to this, it was discovered that zinc in Zn/Mg-PIII had certain inhibitory effects on oral anaerobic bacteria (Pg, Fn and Sm). Finally, the Zn/Mg-PIII implants were implanted in rabbit femurs for 4 and 12weeks with Zn-PIII, Mg-PIII and pure titanium as controls. Micro-CT evaluation, sequential fluorescent labeling, histological analysis and push-out test consistently demonstrated that Zn/Mg-PIII implants exhibit superior capacities for enhancing bone formation, angiogenesis and osseointegration, while consequently increasing the bonding strength at bone-implant interfaces. All these results suggest that due to the multiple functions co-produced by zinc and magnesium, rapid osseointegration and sustained biomechanical stability are enhanced by the novel Zn/Mg-PIII implants, which have the potential

  12. Clinical experiences with a new maintenance-free shock absorbing element in titanium implants.

    Science.gov (United States)

    Gaggl, A; Schultes, G

    2001-01-01

    Until now, the biokinetic elements of one implant system were to be substituted once a year in order to prevent complications of fractures of fixation screws. In this article a new implant with a maintenance-free shock absorbing element was examined. During the last 6 years, 384 dental implants with a biokinetic element (mobile-implant, SIS Inc., Klagenfurt, Austria) were placed in 138 patients. The implants were loaded with prosthetic superstructures 4 months after implantation. For comparison, 160 patients were treated with 494 conventional titanium implants of the same design without biokinetic elements. All patients were examined radiologically and clinically. Periimplant probing depth, periimplant bleeding, Periotest-values (Siemens, Bensheim, Germany) at the time of prosthetic treatment and 3, 6, 9, 12, and 24 months after implant loading were registered. Implantation was successful in 97.2% of mobile-implants and 98% of conventional implants. There was a low degree of sulcus bleeding and high degree of physiological periimplant probing depths in both patients groups. In mobile-implants, the Periotest-values were positive and similar to that of the control. There was no difference between the values in the maxilla and mandible. In the group with conventional implants, the Periotest-values were negative and showed a low degree of negativity during the first 12 months after implant loading. Periotest-values in the upper jaw were higher than in the lower jaw. There was a lower degree of periimplant bone loss after implant loading in patients with mobile-implants. In conclusion, mobile-implants demonstrate the positive effects of implants with shock absorbing elements. They are maintenance free.

  13. Anti-infection activity of nanostructured titanium percutaneous implants with a postoperative infection model

    International Nuclear Information System (INIS)

    Tan, Jing; Li, Yiting; Liu, Zhiyuan; Qu, Shuxin; Lu, Xiong; Wang, Jianxin; Duan, Ke; Weng, Jie; Feng, Bo

    2015-01-01

    Highlights: • We prepared three titania nanotubes (TNT-50, TNT-100, TNT-150) on titanium surfaces by anodization. • TNT-100 had the highest antibacterial efficiency under the visible light. • The immersion test in the culture medium suggested that TNT can adsorb more proteins than pTi. • TNT implants inhibited the infection risk and enhanced tissue integration of the percutaneous implants compared to pTi. - Abstract: The titanium percutaneous implants were widely used in clinic; however, they have an increased risk of infection since they breach the skin barrier. Lack of complete skin integration with the implants can cause infection and implant removal. In this work, three titania nanotubes (TNT) with different diameters, 50 nm (TNT-50), 100 nm (TNT-100) and 150 nm (TNT-150) arrays were prepared on titanium surfaces by anodization, pure titanium (pTi) was used as control. Samples were characterized by scanning electron microscopy (SEM), atomic force microscopy (AFM), and contact angle analysis. The antibacterial efficiency of TNT was evaluated in vitro against Staphylococcus aureus under the visible light. The results indicated that TNT-100 had the highest antibacterial efficiency under the visible light. Subsequently, TNT implants and pTi implants were placed subcutaneously to the dorsum of New Zealand White rabbits, 10 8 CFU S. aureus was inoculated into the implant sites 4 h after surgery. The TNF-alpha and IL-1alpha were determined using enzyme linked immunoassay (ELISA). TNT implants revealed less inflammatory factor release than pTi implants with or without injected S. aureus liquid. According to the histological results, the TNT implants displayed excellent tissue integration. Whereas, pTi implants were surrounded with fibrotic capsule, and the skin tissue was almost separated from the implant surface. Therefore, the TNT significantly inhibited the infection risk and enhanced tissue integration of the percutaneous implants compared to pTi. The

  14. Anti-infection activity of nanostructured titanium percutaneous implants with a postoperative infection model

    Energy Technology Data Exchange (ETDEWEB)

    Tan, Jing; Li, Yiting; Liu, Zhiyuan; Qu, Shuxin; Lu, Xiong; Wang, Jianxin; Duan, Ke; Weng, Jie; Feng, Bo, E-mail: fengbo@swjtu.edu.cn

    2015-07-30

    Highlights: • We prepared three titania nanotubes (TNT-50, TNT-100, TNT-150) on titanium surfaces by anodization. • TNT-100 had the highest antibacterial efficiency under the visible light. • The immersion test in the culture medium suggested that TNT can adsorb more proteins than pTi. • TNT implants inhibited the infection risk and enhanced tissue integration of the percutaneous implants compared to pTi. - Abstract: The titanium percutaneous implants were widely used in clinic; however, they have an increased risk of infection since they breach the skin barrier. Lack of complete skin integration with the implants can cause infection and implant removal. In this work, three titania nanotubes (TNT) with different diameters, 50 nm (TNT-50), 100 nm (TNT-100) and 150 nm (TNT-150) arrays were prepared on titanium surfaces by anodization, pure titanium (pTi) was used as control. Samples were characterized by scanning electron microscopy (SEM), atomic force microscopy (AFM), and contact angle analysis. The antibacterial efficiency of TNT was evaluated in vitro against Staphylococcus aureus under the visible light. The results indicated that TNT-100 had the highest antibacterial efficiency under the visible light. Subsequently, TNT implants and pTi implants were placed subcutaneously to the dorsum of New Zealand White rabbits, 10{sup 8} CFU S. aureus was inoculated into the implant sites 4 h after surgery. The TNF-alpha and IL-1alpha were determined using enzyme linked immunoassay (ELISA). TNT implants revealed less inflammatory factor release than pTi implants with or without injected S. aureus liquid. According to the histological results, the TNT implants displayed excellent tissue integration. Whereas, pTi implants were surrounded with fibrotic capsule, and the skin tissue was almost separated from the implant surface. Therefore, the TNT significantly inhibited the infection risk and enhanced tissue integration of the percutaneous implants compared to pTi. The

  15. Revival of pure titanium for dynamically loaded porous implants using additive manufacturing

    International Nuclear Information System (INIS)

    Wauthle, Ruben; Ahmadi, Seyed Mohammad; Amin Yavari, Saber; Mulier, Michiel; Zadpoor, Amir Abbas; Weinans, Harrie; Van Humbeeck, Jan; Kruth, Jean-Pierre; Schrooten, Jan

    2015-01-01

    Additive manufacturing techniques are getting more and more established as reliable methods for producing porous metal implants thanks to the almost full geometrical and mechanical control of the designed porous biomaterial. Today, Ti6Al4V ELI is still the most widely used material for porous implants, and none or little interest goes to pure titanium for use in orthopedic or load-bearing implants. Given the special mechanical behavior of cellular structures and the material properties inherent to the additive manufacturing of metals, the aim of this study is to investigate the properties of selective laser melted pure unalloyed titanium porous structures. Therefore, the static and dynamic compressive properties of pure titanium structures are determined and compared to previously reported results for identical structures made from Ti6Al4V ELI and tantalum. The results show that porous Ti6Al4V ELI still remains the strongest material for statically loaded applications, whereas pure titanium has a mechanical behavior similar to tantalum and is the material of choice for cyclically loaded porous implants. These findings are considered to be important for future implant developments since it announces a potential revival of the use of pure titanium for additively manufactured porous implants. - Highlights: • The mechanical properties of CP Ti grade 1 porous structures are studied. • The results are compared with identical structures in Ti6Al4V ELI and tantalum. • Ti6Al4V ELI structures are about two times stronger under a static compressive load. • CP Ti structures deform continuously without fracture while loaded statically. • CP Ti structures have a higher fatigue life compared to Ti6Al4V ELI structures

  16. Revival of pure titanium for dynamically loaded porous implants using additive manufacturing

    Energy Technology Data Exchange (ETDEWEB)

    Wauthle, Ruben, E-mail: ruben.wauthle@3dsystems.com [KU Leuven, Department of Mechanical Engineering, Section Production Engineering, Machine Design and Automation (PMA), Celestijnenlaan 300B, 3001 Leuven (Belgium); 3D Systems - LayerWise NV, Grauwmeer 14, 3001 Leuven (Belgium); Ahmadi, Seyed Mohammad; Amin Yavari, Saber [Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, 2628 CD, Delft (Netherlands); Mulier, Michiel [KU Leuven, Department of Orthopaedics, Weligerveld 1, 3212 Pellenberg (Belgium); Zadpoor, Amir Abbas [Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, 2628 CD, Delft (Netherlands); Weinans, Harrie [Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, 2628 CD, Delft (Netherlands); Department of Orthopedics & department of Rheumatology, UMC Utrecht, Heidelberglaan 100, 3584 CX, Utrecht (Netherlands); Van Humbeeck, Jan [KU Leuven, Department of Materials Engineering, Kasteelpark Arenberg 44, PB 2450, 3001 Leuven (Belgium); Kruth, Jean-Pierre [KU Leuven, Department of Mechanical Engineering, Section Production Engineering, Machine Design and Automation (PMA), Celestijnenlaan 300B, 3001 Leuven (Belgium); Schrooten, Jan [KU Leuven, Department of Materials Engineering, Kasteelpark Arenberg 44, PB 2450, 3001 Leuven (Belgium); KU Leuven, Prometheus, Division of Skeletal Tissue Engineering, PB 813, O& N1, Herestraat 49, 3000 Leuven (Belgium)

    2015-09-01

    Additive manufacturing techniques are getting more and more established as reliable methods for producing porous metal implants thanks to the almost full geometrical and mechanical control of the designed porous biomaterial. Today, Ti6Al4V ELI is still the most widely used material for porous implants, and none or little interest goes to pure titanium for use in orthopedic or load-bearing implants. Given the special mechanical behavior of cellular structures and the material properties inherent to the additive manufacturing of metals, the aim of this study is to investigate the properties of selective laser melted pure unalloyed titanium porous structures. Therefore, the static and dynamic compressive properties of pure titanium structures are determined and compared to previously reported results for identical structures made from Ti6Al4V ELI and tantalum. The results show that porous Ti6Al4V ELI still remains the strongest material for statically loaded applications, whereas pure titanium has a mechanical behavior similar to tantalum and is the material of choice for cyclically loaded porous implants. These findings are considered to be important for future implant developments since it announces a potential revival of the use of pure titanium for additively manufactured porous implants. - Highlights: • The mechanical properties of CP Ti grade 1 porous structures are studied. • The results are compared with identical structures in Ti6Al4V ELI and tantalum. • Ti6Al4V ELI structures are about two times stronger under a static compressive load. • CP Ti structures deform continuously without fracture while loaded statically. • CP Ti structures have a higher fatigue life compared to Ti6Al4V ELI structures.

  17. Surface treatment of a titanium implant using low temperature atmospheric pressure plasmas

    Science.gov (United States)

    Lee, Hyun-Young; Tang, Tianyu; Ok, Jung-Woo; Kim, Dong-Hyun; Lee, Ho-Jun; Lee, Hae June

    2015-09-01

    During the last two decades, atmospheric pressure plasmas(APP) are widely used in diverse fields of biomedical applications, reduction of pollutants, and surface treatment of materials. Applications of APP to titanium surface of dental implants is steadily increasing as it renders surfaces wettability and modifies the oxide layer of titanium that hinders the interaction with cells and proteins. In this study, we have treated the titanium surfaces of screw-shaped implant samples using a plasma jet which is composed of a ceramic coaxial tube of dielectrics, a stainless steel inner electrode, and a coper tube outer electrode. The plasma ignition occurred with Ar gas flow between two coaxial metal electrodes and a sinusoidal bias voltage of 3 kV with a frequency of 20 kHz. Titanium materials used in this study are screw-shaped implants of which diameter and length are 5 mm and 13 mm, respectively. Samples were mounted at a distance of 5 mm below the plasma source, and the plasma treatment time was set to 3 min. The wettability of titanium surface was measured by the moving speed of water on its surface, which is enhanced by plasma treatment. The surface roughness was also measured by atomic force microscopy. The optimal condition for wettability change is discussed.

  18. A multicenter study on objective and subjective benefits with a transcutaneous bone-anchored hearing aid device: first Nordic results.

    Science.gov (United States)

    Hougaard, Dan Dupont; Boldsen, Soren Kjaergaard; Jensen, Anne Marie; Hansen, Soren; Thomassen, Per Cayé

    2017-08-01

    Examination of objective as well as subjective outcomes with a new transcutaneous bone-anchored hearing aid device. The study was designed as a prospective multicenter consecutive case-series study involving tertiary referral centers at two Danish University Hospitals. A total of 23 patients were implanted. Three were lost to follow-up. Patients had single-sided deafness, conductive or mixed hearing loss. Rehabilitative. Aided and unaided sound field hearing was evaluated objectively using (1) pure warble tone thresholds, (2) pure-tone average (PTA4), (3) speech discrimination score (SDS) in quiet, and (4) speech reception threshold 50% at 70 dB SPL noise level (SRT50%). Subjective benefit was evaluated by three validated questionnaires: (1) the IOI-HA, (2) the SSQ-12, and (3) a questionnaire evaluating both the frequency and the duration of hearing aid usage. The mean aided PTA4 was lowered by 14.7 dB. SDS was increased by 37.5% at 50 dB SPL, SRT50% in noise improved 1.4 dB. Aided thresholds improved insignificantly at frequencies above 2 kHz. 52.9% of the patients used their device every day, and 76.5% used the device at least 5 days a week. Mean IOI-HA score was 3.4, corresponding to a good benefit. In SSQ-12, "quality of hearing" scored especially high. Patients with a conductive and/or mixed hearing loss benefitted the most. This device demonstrates a significant subjective hearing benefit 8 month post surgery. In patients with conductive and/or mixed hearing losses, patient satisfaction and frequency of use were high. Objective gain measures showed less promising results especially in patients with single-sided deafness (SSD) compared to other bone conduction devices.

  19. Clobetasol's Influence on the Management and Cost of Skin Overgrowth Associated with the Bone-Anchored Hearing Aid.

    Science.gov (United States)

    Hildrew, Douglas M; Guittard, Jesse A; Carter, John M; Molony, Timothy B

    2015-01-01

    Management of the skin/abutment interface in patients with bone-anchored hearing aids (BAHAs) can occasionally be a challenge. Even with the most compliant patients and the most intensive home/office treatment regimens, painful triamcinolone injections and revision surgery can become necessary. Such treatments can be associated with an inordinate cost burden. To our knowledge this research provides the first objective comparison of cost and patient outcomes after the introduction of topical 0.05% clobetasol cream for the care of the skin/abutment interface in patients with BAHAs. Thirty-three patients were managed with the traditional algorithm (local wound care, triamcinolone injection, and revision surgery). Nineteen patients were managed with the contemporary algorithm in which 0.05% topical clobetasol cream was added to the traditional treatment regimen. Common postoperative skin reactions were comparable in the traditional vs contemporary treatment groups: granulation tissue (53.8% vs 56.3%), soft-tissue overgrowth (30.8% vs 18.8%), and both granulation tissue and soft-tissue overgrowth (15.4% vs 25.0%). The addition of clobetasol cream was associated with a marked decrease in the invasive treatment endpoints in the contemporary vs traditional treatment groups: triamcinolone injections (0.0% vs 12.1%) and surgical revision (0.0% vs 9.1%). The difference in cost for managing soft-tissue overgrowth at the abutment site was substantial, with the traditional treatment group averaging $2,773.25 per patient and the contemporary treatment group averaging $47.94 per patient (P<0.021) according to 2013 estimates and values. Clobetasol use during early postoperative care of a BAHA implant dramatically decreases cost and improves treatment outcomes by reducing the need for invasive postoperative procedures to treat common postoperative skin reactions.

  20. The current practice trends in pediatric bone-anchored hearing aids in Canada: a national clinical and surgical practice survey

    Science.gov (United States)

    2013-01-01

    Background Since the introduction of bone-anchored hearing aids (BAHAs) in the 1980s, the practices of surgeons who implant these hearing aids have become varied; different indications and surgical techniques are utilized depending on the surgeon and institution. The objective of the current study is to describe the clinical and surgical practices of otolaryngologists in Canada who perform pediatric BAHA operations. Methods A detailed practice questionnaire was devised and sent to all members of the Canadian Society of Otolaryngology-Head and Neck Surgery. Those who performed pediatric BAHA surgeries were asked to participate. Results Twelve responses were received (response rate of 80%). All of the respondents identified congenital aural atresia to be an indication for pediatric BAHAs. Other indications were chronic otitis externa or media with hearing loss (92%), allergic reactions to conventional hearing aids (75%), congenital fixation or anomaly of ossicular chain (67%), and unilateral deafness (25%). Minor complications, such as skin reactions, were reported in 25% of cases, while major complications were very rare. There was great variability with regards to surgical techinque and post-operative management. The extent of financial support for the BAHA hardware and device also varied between provinces, and even within the same province. Conclusion There is a lack of general consensus regarding pediatric BAHA surgeries in Canada. With such a small community of otolaryngologists performing this procedure, we are hopeful that this survey can serve as an impetus for a national collaboration to establish a set of general management principles and inspire multi-site research ventures. PMID:23815797

  1. In vitro osteoinduction of human mesenchymal stem cells in biomimetic surface modified titanium alloy implants.

    Science.gov (United States)

    Santander, Sonia; Alcaine, Clara; Lyahyai, Jaber; Pérez, Maria Angeles; Rodellar, Clementina; Doblaré, Manuel; Ochoa, Ignacio

    2014-01-01

    Interaction between cells and implant surface is crucial for clinical success. This interaction and the associated surface treatment are essential for achieving a fast osseointegration process. Several studies of different topographical or chemical surface modifications have been proposed previously in literature. The Biomimetic Advanced Surface (BAS) topography is a combination of a shot blasting and anodizing procedure. Macroroughness, microporosity of titanium oxide and Calcium/Phosphate ion deposition is obtained. Human mesenchymal stem cells (hMCSs) response in vitro to this treatment has been evaluated. The results obtained show an improved adhesion capacity and a higher proliferation rate when hMSCs are cultured on treated surfaces. This biomimetic modification of the titanium surface induces the expression of osteblastic differentiation markers (RUNX2 and Osteopontin) in the absence of any externally provided differentiation factor. As a main conclusion, our biomimetic surface modification could lead to a substantial improvement in osteoinduction in titanium alloy implants.

  2. Bone reactions adjacent to titanium implants with different surface characteristics subjected to static load. A study in the dog (II)

    DEFF Research Database (Denmark)

    Gotfredsen, K; Berglundh, T; Lindhe, J

    2001-01-01

    extracted bilaterally. 12 weeks later, 2 implants with a TPS surface were placed in one side and 2 implants with a machined surface were placed in the contralateral side. Twelve weeks after implant installation, crowns, connected in pairs with orthodontic expansion screws, were fitted to the implants......The purpose of the present study was to compare bone reactions adjacent to titanium implants with either a titanium plasma-sprayed (TPS) or a machined surface subjected to lateral static loading induced by an expansion force. In 3 labrador dogs, the 2nd, 3rd and 4th mandibular premolars were...... and histometric examination. A higher marginal bone level was observed around implants with a TPS surface compared to machined implants. Furthermore, the values describing the amount of bone-to-implant contact at the bone/implant interface as well as the density of the peri-implant bone were lower at the machined...

  3. Plasma Electrolytic Oxidation of Titanium Implant Surfaces: Microgroove-Structures Improve Cellular Adhesion and Viability.

    Science.gov (United States)

    Hartjen, Philip; Hoffmann, Alexia; Henningsen, Anders; Barbeck, Mike; Kopp, Alexander; Kluwe, Lan; Precht, Clarissa; Quatela, Olivia; Gaudin, Robert; Heiland, Max; Friedrich, Reinhard E; Knipfer, Christian; Grubeanu, Daniel; Smeets, Ralf; Jung, Ole

    2018-01-01

    Plasma electrolytic oxidation (PEO) is an established electrochemical treatment technique that can be used for surface modifications of metal implants. In this study we to treated titanium implants with PEO, to examine the resulting microstructure and to characterize adhesion and viability of cells on the treated surfaces. Our aim was to identify an optimal surface-modification for titanium implants in order to improve soft-tissue integration. Three surface-variants were generated on titanium alloy Ti6Al4V by PEO-treatment. The elemental composition and the microstructures of the surfaces were characterized using energy dispersive X-ray spectroscopy, scanning electron microscopy and profilometry. In vitro cytocompatibility of the surfaces was assessed by seeding L929 fibroblasts onto them and measuring the adhesion, viability and cytotoxicity of cells by means of live/dead staining, XTT assay and LDH assay. Electron microscopy and profilometry revealed that the PEO-surface variants differed largely in microstructure/topography, porosity and roughness from the untreated control material as well as from one another. Roughness was generally increased after PEO-treatment. In vitro, PEO-treatment led to improved cellular adhesion and viability of cells accompanied by decreased cytotoxicity. PEO-treatment provides a promising strategy to improve the integration of titanium implants with surrounding tissues. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  4. The effect of zirconia and titanium implant abutments on light reflection of the supporting soft tissues

    NARCIS (Netherlands)

    van Brakel, Ralph; Noordmans, Herke Jan; Frenken, Joost; de Roode, Rowland; de Wit, Gerard C.; Cune, Marco S.

    2011-01-01

    Objectives: To determine the difference in light reflection of oral mucosa covering titanium (Ti) or zirconia (ZrO2) abutments as it relates to the thickness of the covering mucosa. Material and methods: Fifteen anterior implants (Astra Osseo speed (R)) in 11 patients were fitted with a Ti or a ZrO2

  5. Bone response to a titanium aluminium nitride coating on metallic implants.

    Science.gov (United States)

    Freeman, C O; Brook, I M

    2006-05-01

    The design, surface characteristics and strength of metallic implants are dependant on their intended use and clinical application. Surface modifications of materials may enable reduction of the time taken for osseointegration and improve the biological response of bio-mechanically favourable metals and alloys. The influence of a titanium aluminium nitride (TAN) coating on the response of bone to commercially pure titanium and austenitic 18/8 stainless steel wire is reported. TAN coated and plain rods of stainless steel and commercially pure titanium were implanted into the mid-shaft of the femur of Wistar rats. The femurs were harvested at four weeks and processed for scanning electron and light microscopy. All implants exhibited a favourable response in bone with no evidence of fibrous encapsulation. There was no significant difference in the amount of new bone formed around the different rods (osseoconduction), however, there was a greater degree of shrinkage separation of bone from the coated rods than from the plain rods (p = 0.017 stainless steel and p = 0.0085 titanium). TAN coating may result in reduced osseointegration between bone and implant.

  6. Comparison of biological characteristics of mesenchymal stem cells grown on two different titanium implant surfaces

    International Nuclear Information System (INIS)

    Wang Chengyue; Zhao Baohong; Ai Hongjun; Wang Yiwei

    2008-01-01

    This study examined the biological characteristics of mesenchymal stem cells (MSCs) grown on sand-blasted, large-grit, acid-etched (SLA) surface and hydroxyapatite (HA) coating on the SLA (HA/SLA) surface of titanium dental implants. The HA/SLA surfaces of titanium dental implants were formed by the ion beam assisted deposition (IBAD) method. Rabbit bone marrow derived mesenchymal stem cells cultured in vitro were seeded onto the surface of SLA and HA/SLA; the growth states of MSCs on the two samples were observed by a scanning electron microscope; the proliferation index, alkaline phosphatase (ALP) activity, osteocalcin (OCN) content of MSCs and mRNA relative expression level of osteopontin (opn) were compared between two groups. MSCs were found to be easier to adhere to the HA/SLA surface compared to the SLA surface. At the same time, the ALP activity and the OCN content of MSCs grown on the HA/SLA surface were obviously higher, and the relative expression level of opn mRNA was 4.78 times higher than that on the SLA surface. The HA coating formed by the IBAD method on the SLA surface of titanium dental implants significantly improves proliferation and well-differentiated osteoblastic phenotype of MSCs, which indicates a promising method for the surface modification of titanium dental implants

  7. Titanium implant insertion into dog alveolar ridges augmented by allogenic material

    DEFF Research Database (Denmark)

    Pinholt, E M; Haanaes, H R; Donath, K

    1994-01-01

    The purpose of this investigation was to evaluate whether titanium endosseous implants would osseointegrate in dog alveolar ridges augmented by allogenic material. In 8 dogs en bloc resection, including 2 pre-molars, was performed bilaterally in the maxilla and the mandible. After a healing period...

  8. Is galvanic corrosion between titanium alloy and stainless steel spinal implants a clinical concern?

    Science.gov (United States)

    Serhan, Hassan; Slivka, Michael; Albert, Todd; Kwak, S Daniel

    2004-01-01

    Surgeons are hesitant to mix components made of differing metal classes for fear of galvanic corrosion complications. However, in vitro studies have failed to show a significant potential for galvanic corrosion between titanium and stainless steel, the two primary metallic alloys used for spinal implants. Galvanic corrosion resulting from metal mixing has not been described in the literature for spinal implant systems. To determine whether galvanic potential significantly affects in vitro corrosion of titanium and stainless steel spinal implant components during cyclical compression bending. Bilateral spinal implant constructs consisting of pedicle screws, slotted connectors, 6.35-mm diameter rods and a transverse rod connector assembled in polyethylene test blocks were tested in vitro. Two constructs had stainless steel rods with mixed stainless steel (SS-SS) and titanium (SS-Ti) components, and two constructs had titanium rods with mixed stainless steel (Ti-SS) and titanium (Ti-Ti) components. Each construct was immersed in phosphate-buffered saline (pH 7.4) at 37 C and tested in cyclic compression bending using a sinusoidal load-controlling function with a peak load of 300 N and a frequency of 5 Hz until a level of 5 million cycles was reached. The samples were then removed and analyzed visually for evidence of corrosion. In addition, scanning electron microscopy (SEM) and energy dispersive spectrometry (EDS) were used to evaluate the extent of corrosion at the interconnections. None of the constructs failed during testing. Gross observation of the implant components after disassembly revealed that no corrosion had occurred on the surface of the implants that had not been in contact with another component. The Ti-Ti interfaces showed some minor signs of corrosion only detectable using SEM and EDS. The greatest amount of corrosion occurred at the SS-SS interfaces and was qualitatively less at the SS-Ti and Ti-SS interfaces. The results from this study indicate

  9. Tantalum implanted entangled porous titanium promotes surface osseointegration and bone ingrowth

    Science.gov (United States)

    Wang, Qi; Qiao, Yuqin; Cheng, Mengqi; Jiang, Guofeng; He, Guo; Chen, Yunsu; Zhang, Xianlong; Liu, Xuanyong

    2016-05-01

    Porous Ti is considered to be an ideal graft material in orthopaedic and dental surgeries due to its similar spatial structures and mechanical properties to cancellous bone. In this work, to overcome the bioinertia of Ti, Ta-implanted entangled porous titanium (EPT) was constructed by plasma immersion ion implantation & deposition (PIII&D) method. Ca-implanted and unimplanted EPTs were investigated as control groups. Although no difference was found in surface topography and mechanical performances, both Ca- and Ta-implanted groups had better effects in promoting MG-63 cell viability, proliferation, differentiation, and mineralization than those of unimplanted group. The expression of osteogenic-related markers examined by qRT-PCR and western blotting was upregulated in Ca- and Ta-implanted groups. Moreover, Ta-implanted EPT group could reach a higher level of these effects than that of Ca-implanted group. Enhanced osseointegration of both Ca- and Ta-implanted EPT implants was demonstrated through in vivo experiments, including micro-CT evaluation, push-out test, sequential fluorescent labeling and histological observation. However, the Ta-implanted group possessed more stable and continuous osteogenic activity. Our results suggest that Ta-implanted EPT can be developed as one of the highly efficient graft material for bone reconstruction situations.

  10. Osseointegration and cell response on titanium implant surface treatments

    OpenAIRE

    Mantalenakis, Spyridon

    2016-01-01

    Introdução: A osteointegração de um implante é essencial para garantir êxito clínico. Vários tratamentos de superfície foram introduzidos para melhorar a osseointegração e a biocompatibilidade de um implante. Objectivos: O objectivo de esta revisão bibliográfica é explorar as diferentes propriedades de Titanio e como á modifica-las, depois de introduzir um implante de Titanio num tecido de osso vivo, a osteointrgração, a resposta celular e a biocompatibilidade do implante...

  11. Comparison of titanium mesh implants with PLA-hydroxyapatite coatings for maxillofacial cancer reconstruction

    Science.gov (United States)

    Tverdokhlebov, S. I.; Choinzonov, E. L.; Kolokolova, O. V.; Cherdyntseva, N. V.

    2016-08-01

    Since 2013 physics of TPU and oncologists from the TCRI with participation of the "ConMet" company (Moscow) and the "Sintel" company (Tomsk Special Economic Zone resident) have been working on the theme entitled "Development of the composite implants for reconstructive surgery of a craniofacial areas of the traumatological and oncological patients" supported with the Federal Program "R&D, part 1.3". The goal was to develop the maxillo-facial implants on the basis of the transformable titanium mesh with PLA & hydroxyapatite coating. According to the Contract No. 14.578.21.0031, the team of developers had to start supplying these advanced implants to the industrial partners up to 2017. This research was supported with the preliminary market researches by the ISPMS SB RAS and the TP "MF". The stages of preliminary market researches were: 1) research of the Worldwide CMF market; 2) forecasting the BRIC CMF market up to 2020; 3) the total Russian market (epidemiology) estimation as a sum of official calculations and statistics; 4) looking for the best foreign analogue prices, comparing their and our implant properties; 5) search for the best Russian analogues; 6) the investigation of the world patent database Espacenet for the last years, and finding the owners and applicants of patents of CMF osteosynthesis plates on the basis of titanium coated with PLA & hydroxyapatite; 7) comparison of the domestic implants, and making conclusions. Several variants of the meshes have got the equal quality with the best foreign and Russian implants. The closest analogues were titanium, polyethylene, PEEK composite meshes suited to the patient shape by the Synthes company in 2014, and the only hybrid titanium "Grey" implant with layers of gelatin, dextran, collagen, HAP & BMP-2 was found. This implant was produced by Russian institution, and it was mentioned in the report on clinical trials by L.A. Pavlova et al., 2014 [1]. There are no manufacturers of the coated implants in Russia

  12. Strength and tribology of bulk and electroformed nickel amorphized by implantation of titanium and carbon

    International Nuclear Information System (INIS)

    Myers, S.M.; Knapp, J.A.; Follstaedt, D.M.; Dugger, M.T.; Christenson, T.R.

    1997-01-01

    Dual ion implantation of titanium and carbon was shown to produce an amorphous layer of exceptional strength within annealed bulk Ni and electroformed Ni and Ni 80 Fe 20 materials used in micro-electromechanical systems. The intrinsic elastic and plastic mechanical properties of the implanted region were quantified using nanoindentation testing in conjunction with finite-element modeling, and the results were interpreted in the light of microstructures observed by electron microscopy. The implantation treatment was found to produce substantial reductions in unlubricated friction and wear

  13. Antibacterial activity and biofilm inhibition by surface modified titanium alloy medical implants following application of silver, titanium dioxide and hydroxyapatite nanocoatings.

    Science.gov (United States)

    Besinis, A; Hadi, S D; Le, H R; Tredwin, C; Handy, R D

    2017-04-01

    One of the most common causes of implant failure is peri-implantitis, which is caused by bacterial biofilm formation on the surfaces of dental implants. Modification of the surface nanotopography has been suggested to affect bacterial adherence to implants. Silver nanoparticles are also known for their antibacterial properties. In this study, titanium alloy implants were surface modified following silver plating, anodisation and sintering techniques to create a combination of silver, titanium dioxide and hydroxyapatite (HA) nanocoatings. Their antibacterial performance was quantitatively assessed by measuring the growth of Streptococcus sanguinis, proportion of live/dead cells and lactate production by the microbes over 24 h. Application of a dual layered silver-HA nanocoating to the surface of implants successfully inhibited bacterial growth in the surrounding media (100% mortality), whereas the formation of bacterial biofilm on the implant surfaces was reduced by 97.5%. Uncoated controls and titanium dioxide nanocoatings showed no antibacterial effect. Both silver and HA nanocoatings were found to be very stable in biological fluids with material loss, as a result of dissolution, to be less than 0.07% for the silver nanocoatings after 24 h in a modified Krebs-Ringer bicarbonate buffer. No dissolution was detected for the HA nanocoatings. Thus, application of a dual layered silver-HA nanocoating to titanium alloy implants creates a surface with antibiofilm properties without compromising the HA biocompatibility required for successful osseointegration and accelerated bone healing.

  14. The electrochemical properties of four dental casting suprastructure alloys coupled with titanium implants

    Directory of Open Access Journals (Sweden)

    Suleyman Hakan Tuna

    2009-10-01

    Full Text Available OBJECTIVES: As the choice of suprastructure alloy to be combined with titanium for the oral cavity is still a much debated issue, the aim of this study was to investigate the electrochemical interaction of the suprastructure/implant couples under the determined experiment conditions. MATERIAL AND METHODS: The potentiodynamic polarization curves and open-circuit potentials (OCP of four UCLA type suprastructures coupled with straight Swiss Plus implant fixtures were taken in Afnor type artificial saliva solution at 37°C. The concentration of ions leached into artificial saliva solutions was estimated with ICP-MS. SEM images of the margins of suprastructure/implant couples were obtained before and after the electrochemical tests. RESULTS: The OCP value of titanium became passive at the most negative potential. The lowest difference between the initial and constant OCP value was exhibited by the Au based suprastructure. Suprastructures made greater contributions to the potentiodynamic polarization curves of the implant/suprastructure couples. According to the ICP-MS results, Pd based and Au based couples dissolved less than Co-Ni based and Co-Cr based couples. CONCLUSIONS: Within the conditions this study, it may be concluded that the titanium implant forms a stable passive oxide layer in artificial saliva exposed to open air and does not affect the corrosion properties of the suprastructures. Pd based and Au based couples have been found to be more corrosion-resistant than base alloy couples.

  15. Influence of the local application of sodium alendronate gel on osseointegration of titanium implants.

    Science.gov (United States)

    Guimarães, M B; Bueno, R S; Blaya, M B G; Shinkai, R S A; Marques, L M H

    2015-11-01

    The aim of this study was to perform a comparative analysis of aspects of the osseointegration of titanium implants placed with and without the local application of a bisphosphonate agent, after 28 days in vivo. The study involved the placement of 50 commercially pure titanium implants in the middle third of the tibia of 10 rabbits, with the right tibia used as the control and the left as the test site. Sodium alendronate gel was applied locally in the test group and sterile saline solution in the control group. After euthanasia, 10 implants from each group were analyzed for maximum removal torque. The remainder of the sample was processed to obtain non-decalcified slides, approximately 30μm thick, for histomorphological and histomorphometric analyses, including bone-implant contact (%BIC). Data were analyzed at the 5% level of significance. The removal torque values of the test group were, on average, half those obtained in the control group. The test group showed a lower %BIC and notable changes in bone quality. It is concluded that the initial events in the osseointegration of titanium implants are not favoured by the local application of sodium alendronate gel in rabbits. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  16. Bone reactions adjacent to titanium implants subjected to static load of different duration. A study in the dog (III)

    DEFF Research Database (Denmark)

    Gotfredsen, K; Berglundh, T; Lindhe, J

    2001-01-01

    The aim of the present experiment was to study the effect of a long-standing lateral static load on the peri-implant bone. Three beagle dogs were used. The mandibular premolars were extracted and 12 weeks later 3 titanium implants (ITI(R) Dental Implant System) were installed in each quadrant...

  17. Evaluating of bone healing around porous coated titanium implant and potential systematic bias on the traditional sampling method

    DEFF Research Database (Denmark)

    Babiker, Hassan; Ding, Ming; Overgaard, Søren

    2013-01-01

    could be affected by the various quality and quantity of bone in the local environment. Thus, implant fixation in one part might differ from the other part of the implant. This study aimed to investigate the influence of the sampling method on data evaluation. Material and methods: Titanium alloy implants...

  18. Fibrinogen and cellular adherability on differently treated titanium as implants

    Czech Academy of Sciences Publication Activity Database

    Fojt, Lukáš; Klapetek, P.; Strašák, Luděk; Vetterl, Vladimír

    2012-01-01

    Roč. 10, č. 1 (2012), s. 232-238 ISSN 1895-1082 R&D Projects: GA ČR(CZ) GAP205/10/2378 Institutional research plan: CEZ:AV0Z50040507; CEZ:AV0Z50040702 Keywords : AFM * titanium * osteoblasts Subject RIV: BO - Biophysics Impact factor: 0.905, year: 2012

  19. Nanoporous hydroxyapatite/sodium titanate bilayer on titanium implants for improved osteointegration.

    Science.gov (United States)

    Carradò, A; Perrin-Schmitt, F; Le, Q V; Giraudel, M; Fischer, C; Koenig, G; Jacomine, L; Behr, L; Chalom, A; Fiette, L; Morlet, A; Pourroy, G

    2017-03-01

    The aim of this study was to improve the strength and quality of the titanium-hydroxyapatite interface in order to prevent long-term failure of the implanted devices originating from coating delamination and to test it in an in-vivo model. Ti disks and dental commercial implants were etched in Kroll solution. Thermochemical treatments of the acid-etched titanium were combined with sol-gel hydroxyapatite (HA) coating processes to obtain a nanoporous hydroxyapatite/sodium titanate bilayer. The sodium titanate layer was created by incorporating sodium ions onto the Ti surface during a NaOH alkaline treatment and stabilized using a heat treatment. HA layer was added by dip-coating in a sol-gel solution. The bioactivity was assessed in vitro with murine MC3T3-E1 and human SaOs-2 cells. Functional and histopathological evaluations of the coated Ti implants were performed at 22, 34 and 60days of implantation in a dog lower mandible model. Nanoporous hydroxyapatite/sodium titanate bilayer on titanium implants was sensitive neither to crack propagation nor to layer delamination. The in vitro results on murine MC3T3-E1 and human SaOs-2 cells confirm the advantage of this coating regarding the capacity of cell growth and differentiation. Signs of progressive bone incorporation, such as cancellous bone formed in contact with the implant over the existing compact bone, were notable as early as day 22. Overall, osteoconduction and osteointegration mean scores were higher for test implants compared to the controls at 22 and 34 days. Nanoporous hydroxyapatite/sodium titanate bilayer improves the in-vivo osteoconduction and osteointegration. It prevents the delamination during the screwing and it could increase HA-coated dental implant stability without adhesive failures. The combination of thermochemical treatments with dip coating is a low-cost strategy. Copyright © 2017 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  20. Three year review following bone anchor repair of acute biceps tendon insertion rupture.

    Science.gov (United States)

    Hand, C J; Howell, G E

    2001-01-01

    Three patients with acute biceps brachii tendon insertion ruptures were treated (less than 7 days post injury) using bone anchor anatomical repair. Dynamometer assessment of strength in both limbs was performed after completion of rehabilitation and again at 3.3 years after surgery. All patients were male, age 34, 35 and 53 years. Early isokinetic assessment was performed at 6, 7 and 12 months post surgery and medium assessment at 3.3 years post surgery. A full range of movement was achieved at early assessment and maintained into medium term assessment. All patients returned to their full premorbid occupation and sporting activity. Dynamometer strength of a repaired dominant limb equated to two thirds of a normal non dominant limb at early assessment, equal power was found at medium term assessment and a measurable increase in strength in both affected and unaffected arms was seen.

  1. Bone-anchored hearing aids are effective and associated with a high degree of satisfaction

    DEFF Research Database (Denmark)

    Gardell, Ida Sofie Kristina; Andresen, Kathrine; Faber, Christian Emil

    2015-01-01

    -2013-period. The questionnaire was a combination of Satisfaction with Amplification in Daily Life questions from the Hearing Aid Research Lab at the University of Memphis and questions used in a previous Danish study. We also used data from each patient's medical records. All information was collected......INTRODUCTION: The objective of this study was to evaluate patients' satisfaction with bone-anchored hearing aids (BAHA). METHODS: This study was retrospective and based on a postal questionnaire. The study sample consisted of patients undergoing surgery at Odense University Hospital in the 1992...... in one-on-one conversations. CONCLUSION: BAHA is helpful in one-on-one conversations in quiet surroundings. Sound quality in group situations seems to be the main problem associated with BAHA. However, this study showed that BAHA is an effective hearing aid that is associated with a high degree...

  2. Macrophage proinflammatory response to the titanium alloy equipment in dental implantation.

    Science.gov (United States)

    Chen, X; Li, H S; Yin, Y; Feng, Y; Tan, X W

    2015-08-07

    Titanium alloy and stainless steel (SS) had been widely used as dental implant materials because of their affinity with epithelial tissue and connective tissue, and good physical, chemical, biological, mechanical properties and processability. We compared the effects of titanium alloy and SS on macrophage cytokine expression as well as their biocompatibility. Mouse macrophage RAW264.7 cells were cultured on titanium alloy and SS surfaces. Cells were counted by scanning electron microscopy. A nitride oxide kit was used to detect released nitric oxide by macrophages on the different materials. An enzyme linked immunosorbent assay was used to detect monocyte chemoattractant protein-1 levels. Scanning electron microscopy revealed fewer macrophages on the surface of titanium alloy (48.2 ± 6.4 x 10(3) cells/cm(2)) than on SS (135 ± 7.3 x 10(3) cells/cm(2)). The nitric oxide content stimulated by titanium alloy was 22.5 mM, which was lower than that stimulated by SS (26.8 mM), but the difference was not statistically significant (P = 0.07). The level of monocyte chemoattractant protein-1 released was significantly higher in the SS group (OD value = 0.128) than in the titanium alloy group (OD value = 0.081) (P = 0.024). The transforming growth factor-b1 mRNA expression levels in macrophages after stimulation by titanium alloy for 12 and 36 h were significantly higher than that after stimulation by SS (P = 0.31 and 0.25, respectively). Macrophages participate in the inflammatory response by regulating cytokines such as nitric oxide, monocyte chemoattractant protein-1, and transforming growth factor-b1. There were fewer macrophages and lower inflammation on the titanium alloy surface than on the SS surface. Titanium alloy materials exhibited better biological compatibility than did SS.

  3. Effectiveness of transfixation and length of instrumentation on titanium and stainless steel transpedicular spine implants.

    Science.gov (United States)

    Korovessis, P; Baikousis, A; Deligianni, D; Mysirlis, Y; Soucacos, P

    2001-04-01

    This study compares the effectiveness of transfixation on the stiffness of two pedicle screw-rod constructs of different manufacture, implant design, and alloy, applied in one-and two-level instability. Four screws composed of either stainless steel or Titanium were assembled in pairs to two polymethylmethacrylate blocks to resemble one-and two-level corpectomy models and the construct underwent nondestructive torsional, extension, and flexion loading. In every loading test, each construct was tested using stainless steel or titanium rods of 4.9-mm diameter in two different lengths (short, 10 cm; long, 15 cm), not augmented or augmented with different transfixation devices or a pair of devices. The authors compared the stiffness of stainless steel and titanium constructs without cross-link with the stiffness of that reinforced with single or double Texas Scottish Rite Hospital (TSRH) cross-link, closed new-type cross-link (closed NTC), or open new-type cross-link (open NTC). The results showed that augmentation or no augmentation of short rods conferred significantly more stiffness than that of long rods of the same material in all three loading modes. The closed NTC provided the greatest increase of torsional, extension, and flexion stiffness, and single TSRH provided the least amount of stiffness. Torsional stiffness of short stainless steel rods augmented or not augmented was significantly greater than that of their titanium counterparts. Torsional stiffness of long titanium rods was always greater than that of their stainless steel counterparts. Extension stiffness of short nonaugmented titanium rods was superior to that of long titanium rods, whereas extension stiffness of nonaugmented short and long stainless steel rods was similar. Nonaugmented short titanium rods showed greater flexion stiffness than that of long titanium rods. Long stainless steel rods displayed significantly greater flexion stiffness than did their titanium counterparts. This

  4. The combined action of UV irradiation and chemical treatment on the titanium surface of dental implants

    Energy Technology Data Exchange (ETDEWEB)

    Spriano, Silvia [Politecnico di Torino, Department of Applied Science and Technology, Corso Duca degli Abruzzi, 24-10129 Torino (Italy); Ferraris, Sara, E-mail: sara.ferraris@polito.it [Politecnico di Torino, Department of Applied Science and Technology, Corso Duca degli Abruzzi, 24-10129 Torino (Italy); Bollati, Daniele; Morra, Marco; Cassinelli, Clara [Nobil Bio Ricerche, Portacomaro (Italy); Lorenzon, Giorgio [Centro Chirurgico, Via Mallonetto, 47, 10032, Brandizzo Torino (Italy)

    2015-09-15

    Highlights: • A combined UV irradiation and H{sub 2}O{sub 2} treatment was applied to titanium surfaces. • A thin, homogeneous, not porous, crack-free and bioactive oxide layer was obtained. • The process significantly improves the biological response of titanium surfaces. • A clinical case demonstrates the effectiveness of the proposed treatment. - Abstract: The purpose of this paper is to describe an innovative treatment for titanium dental implants, aimed at faster and more effective osteointegration. The treatment has been performed with the use of hydrogen peroxide, whose action was enhanced by concomitant exposure to a source of ultraviolet light. The developed surface oxide layer was characterized from the physical and chemical points of view. Moreover osteoblast-like SaOS2 cells were cultured on treated and control titanium surfaces and cell behavior investigated by scanning electron microscope observation and gene expression measurements. The described process produces, in only 6 min, a thin, homogeneous, not porous, free of cracks and bioactive (in vitro apatite precipitation) oxide layer. High cell density, peculiar morphology and overexpression of several genes involved with osteogenesis have been observed on modified surfaces. The proposed process significantly improves the biological response of titanium surfaces, and is an interesting solution for the improvement of bone integration of dental implants. A clinical application of the described surfaces, with a 5 years follow-up, is reported in the paper, as an example of the effectiveness of the proposed treatment.

  5. On the evaluation of a superpower sound processor for bone-anchored hearing.

    Science.gov (United States)

    Bosman, A J; Kruyt, I J; Mylanus, E A M; Hol, M K S; Snik, A F M

    2018-04-01

    Performance of a superpower bone-anchored hearing aid (Baha), the Baha Cordelle from Cochlear Bone-Anchored Solutions (BCD1), was compared to its successor, the Baha 5 SuperPower (BCD2). A comparative study in which each patient served as its own control. Tertiary clinic. Ten experienced BCD1 users with profound mixed hearing loss. For comparison, data from another study with 10 experienced users with a severe mixed hearing loss using a Cochlear Baha 5 power sound processor (BCD-P) were included. Speech reception thresholds in noise and APHAB and SSQ questionnaires. Speech reception thresholds for the digits-in-noise (DIN) test were significantly lower (P  5%) from the BCD2 values. With the APHAB questionnaire scores were significantly lower, that is more favourable, for the ease of communication (P  5%). Scores for the speech and quality domains of the SSQ questionnaire were significantly higher, that is more favourable, for BCD2 than for BCD1. APHAB and SSQ scores for BCD-P were not significantly different from those for BCD2 (P > 5%). Data for BCD2 in profound mixed loss are similar to those for BCD-P and a severe mixed loss. Of 10 patients, 2 expressed a strong preference for BCD2 over BCD1, and 7 patients had a preference for BCD2 over BCD1. One patient preferred BCD1 because of its built-in telecoil facility. © 2017 The Authors. Clinical Otolaryngology Published by John Wiley & Sons Ltd.

  6. Osseointegration of a 3D Printed Stemmed Titanium Dental Implant: A Pilot Study

    Directory of Open Access Journals (Sweden)

    James Tedesco

    2017-01-01

    Full Text Available In this pilot study, a 3D printed Grade V titanium dental implant with a novel dual-stemmed design was investigated for its biocompatibility in vivo. Both dual-stemmed (n = 12 and conventional stainless steel conical (n = 4 implants were inserted into the tibial metaphysis of New Zealand white rabbits for 3 and 12 weeks and then retrieved with the surrounding bone, fixed, dehydrated, and embedded into epoxy resin. The implants were analyzed using correlative histology, microcomputed tomography, scanning electron microscopy (SEM, and transmission electron microscopy (TEM. The histological presence of multinucleated osteoclasts and cuboidal osteoblasts revealed active bone remodeling in the stemmed implant starting at 3 weeks and by 12 weeks in the conventional implant. Bone-implant contact values indicated that the stemmed implants supported bone growth along the implant from the coronal crest at both 3- and 12-week time periods and showed bone growth into microporosities of the 3D printed surface after 12 weeks. In some cases, new bone formation was noted in between the stems of the device. Conventional implants showed mechanical interlocking but did have indications of stress cracking and bone debris. This study demonstrates the comparable biocompatibility of these 3D printed stemmed implants in rabbits up to 12 weeks.

  7. Osseointegration of a 3D Printed Stemmed Titanium Dental Implant: A Pilot Study.

    Science.gov (United States)

    Tedesco, James; Lee, Bryan E J; Lin, Alex Y W; Binkley, Dakota M; Delaney, Kathleen H; Kwiecien, Jacek M; Grandfield, Kathryn

    2017-01-01

    In this pilot study, a 3D printed Grade V titanium dental implant with a novel dual-stemmed design was investigated for its biocompatibility in vivo. Both dual-stemmed ( n  = 12) and conventional stainless steel conical ( n  = 4) implants were inserted into the tibial metaphysis of New Zealand white rabbits for 3 and 12 weeks and then retrieved with the surrounding bone, fixed, dehydrated, and embedded into epoxy resin. The implants were analyzed using correlative histology, microcomputed tomography, scanning electron microscopy (SEM), and transmission electron microscopy (TEM). The histological presence of multinucleated osteoclasts and cuboidal osteoblasts revealed active bone remodeling in the stemmed implant starting at 3 weeks and by 12 weeks in the conventional implant. Bone-implant contact values indicated that the stemmed implants supported bone growth along the implant from the coronal crest at both 3- and 12-week time periods and showed bone growth into microporosities of the 3D printed surface after 12 weeks. In some cases, new bone formation was noted in between the stems of the device. Conventional implants showed mechanical interlocking but did have indications of stress cracking and bone debris. This study demonstrates the comparable biocompatibility of these 3D printed stemmed implants in rabbits up to 12 weeks.

  8. Effects of Calcium Phosphate Nanocrystals on Osseointegration of Titanium Implant in Irradiated Bone

    Directory of Open Access Journals (Sweden)

    Jun Yuan Li

    2015-01-01

    Full Text Available Radiotherapy may compromise the integration of implant and cause implant loss. Implant surface modifications have the possibility of promoting cell attachment, cell growth, and bone formation which ultimately enhance the osseointegration process. The present study aimed to investigate the effects of calcium phosphate nanocrystals on implant osseointegration in irradiated bone. Sixteen rabbits were randomly assigned into control and nano-CaP groups, receiving implants with dual acid-etched surface or dual acid-etched surface discretely deposited of nanoscale calcium-phosphate crystals, respectively. The left leg of all the rabbits received 15 Gy radiation, followed by implants placement one week after. Four animals in each group were sacrificed after 4 and 12 weeks, respectively. Implant stability quotient (ISQ, ratio of bone volume to total volume (BV/TV, bone growth rate, and bone-to-implant contact (BIC were evaluated. The nano-CaP group showed significantly higher ISQ (week 12, P=0.031 and bone growth rate (week 6, P=0.021; week 9, P=0.001 than that in control group. No significant differences in BV/TV and BIC were found between two groups. Titanium implant surface modified with CaP nanocrystals provides a potential alternative to improve bone healing around implant in irradiated bone.

  9. Benefit and quality of life after bone-anchored hearing aid fitting in children with unilateral or bilateral hearing impairment

    NARCIS (Netherlands)

    Wolf, M.J. de; Hol, M.K.S.; Mylanus, E.A.M.; Snik, A.F.M.; Cremers, C.W.R.J.

    2011-01-01

    OBJECTIVE: To evaluate the benefits of a bone-anchored hearing aid (BAHA) in the daily lives of hearing-impaired children. DESIGN: Retrospective questionnaire study. SETTING: Nijmegen Medical Centre, Nijmegen, the Netherlands. PATIENTS: Thirty-eight BAHA users with a minimum age of 4 years at BAHA

  10. Better performance with bone-anchored hearing aid than acoustic devices in patients with severe air-bone gap

    NARCIS (Netherlands)

    Wolf, M.J. de; Hendrix, S.; Cremers, C.W.R.J.; Snik, A.F.M.

    2011-01-01

    OBJECTIVES/HYPOTHESIS: A study performed in the 1990s with analogue linear hearing aids showed that in patients with mixed hearing loss and an air-bone gap that exceeded 25 to 30 dB, speech perception was better with a bone-anchored hearing aid (Baha) than with a conventional behind-the-ear (BTE)

  11. Rehabilitation of patients with conductive hearing loss and moderate mental retardation by means of a bone-anchored hearing aid.

    NARCIS (Netherlands)

    Kunst, S.J.W.; Hol, M.K.S.; Snik, A.F.M.; Mylanus, E.A.M.; Cremers, C.W.R.J.

    2006-01-01

    OBJECTIVE: To evaluate whether the bone-anchored hearing aid (BAHA) can be applied successfully to patients with conductive hearing loss and moderate mental retardation. STUDY DESIGN: Retrospective clinical evaluation. SETTING: Tertiary referral center. PATIENTS: Twenty-two patients with congenital

  12. The Effect of Hydroxyapatite Nanocrystals on Osseointegration of Titanium Implants: An In Vivo Rabbit Study

    Directory of Open Access Journals (Sweden)

    Karin Breding

    2014-01-01

    Full Text Available Osseointegration is dependent on implant surface characteristics, including surface chemistry and topography. The presence of nanosized calcium phosphates on the implant surface is interesting to investigate since they affect both the nanotopography and surface chemistry, forming a bone mineral resembling surface. In this work, the osseointegration of titanium implants with and without the presence of hydroxyapatite (HA nanocrystals has been evaluated in vivo. The integration was examined using removal torque measurements and real-time polymerase chain reaction (RT-PCR analysis. The study was performed using two healing time points, 3 and 12 weeks. The results showed that the torque needed to remove the implants was insignificant between the non- and HA-coated implants, both at weeks 3 and 12. The RT-PCR, however, showed significant differences for osteoblast, osteoclast, and proinflammation markers when HA nanocrystals were present.

  13. Surface modification of austenitic stainless steel by titanium ion implantation

    International Nuclear Information System (INIS)

    Evans, P.J.; Hyvarinen, J.; Samandi, M.

    1995-01-01

    The wear properties of AISI 316 austenitic stainless steel implanted with Ti were investigated for ion doses in the range (2.3-5.4)x10 16 ionscm -2 and average ion energies of 60 and 90keV. The implanted layer was examined by Rutherford backscattering, from which the retained doses were determined, and glow discharge optical emission spectroscopy. Following implantation, the surface microhardness was observed to increase with the greatest change occurring at higher ion energy. Pin-on-disc wear tests and associated friction measurements were also performed under both dry and lubricated conditions using applied loads of 2N and 10N. In the absence of lubrication, breakthrough of the implanted layer occurred after a short sliding time; only for a dose of 5.1x10 16 ionscm -2 implanted at an average energy of 90keV was the onset of breakthrough appreciably delayed. In contrast, the results of tests with lubrication showed a more gradual variation, with the extent of wear decreasing with implant dose at both 2N and 10N loads. Finally, the influence of Ti implantation on possible wear mechanisms is discussed in the light of information provided by several surface characterization techniques. ((orig.))

  14. Poly-ε-caprolactone Coated and Functionalized Porous Titanium and Magnesium Implants for Enhancing Angiogenesis in Critically Sized Bone Defects.

    Science.gov (United States)

    Roland, Laura; Grau, Michael; Matena, Julia; Teske, Michael; Gieseke, Matthias; Kampmann, Andreas; Beyerbach, Martin; Murua Escobar, Hugo; Haferkamp, Heinz; Gellrich, Nils-Claudius; Nolte, Ingo

    2015-12-22

    For healing of critically sized bone defects, biocompatible and angiogenesis supporting implants are favorable. Murine osteoblasts showed equal proliferation behavior on the polymers poly-ε-caprolactone (PCL) and poly-(3-hydroxybutyrate)/poly-(4-hydroxybutyrate) (P(3HB)/P(4HB)). As vitality was significantly better for PCL, it was chosen as a suitable coating material for further experiments. Titanium implants with 600 µm pore size were evaluated and found to be a good implant material for bone, as primary osteoblasts showed a vitality and proliferation onto the implants comparable to well bottom (WB). Pure porous titanium implants and PCL coated porous titanium implants were compared using Live Cell Imaging (LCI) with Green fluorescent protein (GFP)-osteoblasts. Cell count and cell covered area did not differ between the implants after seven days. To improve ingrowth of blood vessels into porous implants, proangiogenic factors like Vascular Endothelial Growth Factor (VEGF) and High Mobility Group Box 1 (HMGB1) were incorporated into PCL coated, porous titanium and magnesium implants. An angiogenesis assay was performed to establish an in vitro method for evaluating the impact of metallic implants on angiogenesis to reduce and refine animal experiments in future. Incorporated concentrations of proangiogenic factors were probably too low, as they did not lead to any effect. Magnesium implants did not yield evaluable results, as they led to pH increase and subsequent cell death.

  15. Poly-ε-caprolactone Coated and Functionalized Porous Titanium and Magnesium Implants for Enhancing Angiogenesis in Critically Sized Bone Defects

    Directory of Open Access Journals (Sweden)

    Laura Roland

    2015-12-01

    Full Text Available For healing of critically sized bone defects, biocompatible and angiogenesis supporting implants are favorable. Murine osteoblasts showed equal proliferation behavior on the polymers poly-ε-caprolactone (PCL and poly-(3-hydroxybutyrate/poly-(4-hydroxybutyrate (P(3HB/P(4HB. As vitality was significantly better for PCL, it was chosen as a suitable coating material for further experiments. Titanium implants with 600 µm pore size were evaluated and found to be a good implant material for bone, as primary osteoblasts showed a vitality and proliferation onto the implants comparable to well bottom (WB. Pure porous titanium implants and PCL coated porous titanium implants were compared using Live Cell Imaging (LCI with Green fluorescent protein (GFP-osteoblasts. Cell count and cell covered area did not differ between the implants after seven days. To improve ingrowth of blood vessels into porous implants, proangiogenic factors like Vascular Endothelial Growth Factor (VEGF and High Mobility Group Box 1 (HMGB1 were incorporated into PCL coated, porous titanium and magnesium implants. An angiogenesis assay was performed to establish an in vitro method for evaluating the impact of metallic implants on angiogenesis to reduce and refine animal experiments in future. Incorporated concentrations of proangiogenic factors were probably too low, as they did not lead to any effect. Magnesium implants did not yield evaluable results, as they led to pH increase and subsequent cell death.

  16. Partial titanium mesh explantation cured post-cranioplasty implant-associated scalp infection.

    Science.gov (United States)

    Chen, Bo; Li, Wenchen; Chen, Dawei; Fu, Shuanglin; Gao, Yanli; Li, Ri; Meng, Fanyang; Wang, Haifeng; Zhang, Shuyan

    2017-10-01

    Titanium mesh cranioplasty is routinely used worldwide for skull defect patients given its advantages, such as stability and biocompatibility. However, there are very few reports concerning the treatment of implant-associated scalp infection, which is one of the most common complications. The aim of the study is to retrospectively evaluate a novel operation technique for the treatment of titanium mesh-associated scalp infection post-cranioplasty, namely partial titanium mesh explantation (PTME). A retrospective study was conducted in all patients who underwent surgical treatment for implant-associated scalp infection from January 2012 to September 2016 in our hospital. In total, 17 patients were selected for study analysis among 231 patients who underwent cranioplasty. The treatment success rate of PTME was 85.7%. There was no statistically significant difference in demographics and characteristics except for follow-up length of time between the PTME group and TTME (total titanium mesh explantation) group (Non-paired Student's t-test, P=0.037). While, The PTME group exhibited a significantly reduced skull defect area post-operation compared with the TTME group (Non-paired Student's t-test, P=0.002). Moreover, post-PTME skull area also exhibited a significantly reduced skull defect area compared with the pre-cranioplasty area in the same patient (Non-paired Student's t-test, P=0.006). Compared with traditional surgical treatment of implant-associated scalp infection, PTME combined with strict debridement and antibiotic therapy can cure implant-associated scalp infection. Moreover, PTME could preserve sufficient titanium mesh for brain protection and cosmesis. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Air atmospheric-pressure plasma-jet treatment enhances the attachment of human gingival fibroblasts for early peri-implant soft tissue seals on titanium dental implant abutments.

    Science.gov (United States)

    Lee, Jung-Hwan; Kim, Yong-Hee; Choi, Eun-Ha; Kim, Kwang-Mahn; Kim, Kyoung-Nam

    2015-01-01

    Although dental implants are commonly used for tooth restoration, there is a lack of studies of treatment regimens for preventing extra-oral infection and decreasing osseointegration failures by establishing early peri-implant soft tissue seals on titanium dental implant abutments. In this study, air atmospheric-pressure plasma-jet (AAPPJ) treatment was applied to titanium disks to assay the potential for early peri-implant soft tissue seals on titanium dental implant abutment. After titanium disks were treated with AAPPJ for 10 s at 250, 500, 1000 and 1500 sccm, surface analysis was performed; the control group received air only or no treatment. Human gingival fibroblasts (HGF) were seeded onto the specimens for evaluating cell attachment and proliferation and adherent-cell morphology was visualized via confocal microscopy. In AAPPJ-treated specimens, the water contact angle decreased according to increased flow rate. Oxygen composition increased in XPS, but no topographical changes were detected. The effect of AAPPJ treatment at 1000 sccm was apparent 2 mm from the treated spot, with a 20% increase in early cell attachment and proliferation. Adherent HGF on AAPPJ-treated specimens displayed a stretched phenotype with more vinculin formation than the control group. Within the limitations of this study, the results indicate that AAPPJ treatment may enhance the early attachment and proliferation of HGF for establishing early peri-implant soft tissue seals on titanium dental implant abutments with possible favorable effects of osseointegration of dental implant.

  18. Micro-morphologic changes around biophysically-stimulated titanium implants in ovariectomized rats

    Directory of Open Access Journals (Sweden)

    Chang Ting-Ling

    2007-07-01

    Full Text Available Abstract Background Osteoporosis may present a risk factor in achievement of osseointegration because of its impact on bone remodeling properties of skeletal phsiology. The purpose of this study was to evaluate micro-morphological changes in bone around titanium implants exposed to mechanical and electrical-energy in osteoporotic rats. Methods Fifteen 12-week old sprague-dowley rats were ovariectomized to develop osteoporosis. After 8 weeks of healing period, two titanium implants were bilaterally placed in the proximal metaphyses of tibia. The animals were randomly divided into a control group and biophysically-stimulated two test groups with five animals in each group. In the first test group, a pulsed electromagnetic field (PEMF stimulation was administrated at a 0.2 mT 4 h/day, whereas the second group received low-magnitude high-frequency mechanical vibration (MECHVIB at 50 Hz 14 min/day. Following completion of two week treatment period, all animals were sacrificed. Bone sites including implants were sectioned, removed en bloc and analyzed using a microCT unit. Relative bone volume and bone micro-structural parameters were evaluated for 144 μm wide peri-implant volume of interest (VOI. Results Mean relative bone volume in the peri-implant VOI around implants PEMF and MECHVIB was significantly higher than of those in control (P P > .05 while the difference in trabecular-number among test and control groups was significant in all VOIs (P Conclusion Biophysical stimulation remarkably enhances bone volume around titanium implants placed in osteoporotic rats. Low-magnitude high-frequency MECHVIB is more effective than PEMF on bone healing in terms of relative bone volume.

  19. Ion enhanced deposition by dual titanium and acetylene plasma immersion ion implantation

    Science.gov (United States)

    Zeng, Z. M.; Tian, X. B.; Chu, P. K.

    2003-01-01

    Plasma immersion ion implantation and deposition (PIII-D) offers a non-line-of-sight fabrication method for various types of thin films on steels to improve the surface properties. In this work, titanium films were first deposited on 9Cr18 (AISI440) stainless bearing steel by metal plasma immersion ion implantation and deposition (MePIII-D) using a titanium vacuum arc plasma source. Afterwards, carbon implantation and carbon film deposition were performed by acetylene (C2H2) plasma immersion ion implantation. Multiple-layered structures with superior properties were produced by conducting Ti MePIII-D + C2H2 PIII successively. The composition and structure of the films were investigated employing Auger electron spectroscopy and Raman spectroscopy. It is shown that the mixing for Ti and C atoms is much better when the target bias is higher during Ti MePIII-D. A top diamond-like carbon layer and a titanium oxycarbide layer are formed on the 9Cr18 steel surface. The wear test results indicate that this dual PIII-D method can significantly enhance the wear properties and decrease the surface friction coefficient of 9Cr18 steel.

  20. Ion enhanced deposition by dual titanium and acetylene plasma immersion ion implantation

    International Nuclear Information System (INIS)

    Zeng, Z.M.; Tian, X.B.; Chu, P.K.

    2003-01-01

    Plasma immersion ion implantation and deposition (PIII-D) offers a non-line-of-sight fabrication method for various types of thin films on steels to improve the surface properties. In this work, titanium films were first deposited on 9Cr18 (AISI440) stainless bearing steel by metal plasma immersion ion implantation and deposition (MePIII-D) using a titanium vacuum arc plasma source. Afterwards, carbon implantation and carbon film deposition were performed by acetylene (C 2 H 2 ) plasma immersion ion implantation. Multiple-layered structures with superior properties were produced by conducting Ti MePIII-D + C 2 H 2 PIII successively. The composition and structure of the films were investigated employing Auger electron spectroscopy and Raman spectroscopy. It is shown that the mixing for Ti and C atoms is much better when the target bias is higher during Ti MePIII-D. A top diamond-like carbon layer and a titanium oxycarbide layer are formed on the 9Cr18 steel surface. The wear test results indicate that this dual PIII-D method can significantly enhance the wear properties and decrease the surface friction coefficient of 9Cr18 steel

  1. Electropolished Titanium Implants with a Mirror-Like Surface Support Osseointegration and Bone Remodelling

    Directory of Open Access Journals (Sweden)

    Cecilia Larsson Wexell

    2016-01-01

    Full Text Available This work characterises the ultrastructural composition of the interfacial tissue adjacent to electropolished, commercially pure titanium implants with and without subsequent anodisation, and it investigates whether a smooth electropolished surface can support bone formation in a manner similar to surfaces with a considerably thicker surface oxide layer. Screw-shaped implants were electropolished to remove all topographical remnants of the machining process, resulting in a thin spontaneously formed surface oxide layer and a smooth surface. Half of the implants were subsequently anodically oxidised to develop a thickened surface oxide layer and increased surface roughness. Despite substantial differences in the surface physicochemical properties, the microarchitecture and the composition of the newly formed bone were similar for both implant surfaces after 12 weeks of healing in rabbit tibia. A close spatial relationship was observed between osteocyte canaliculi and both implant surfaces. On the ultrastructural level, the merely electropolished surface showed the various stages of bone formation, for example, matrix deposition and mineralisation, entrapment of osteoblasts within the mineralised matrix, and their morphological transformation into osteocytes. The results demonstrate that titanium implants with a mirror-like surface and a thin, spontaneously formed oxide layer are able to support bone formation and remodelling.

  2. X-ray photoelectron spectroscopy characterization of high dose carbon-implanted steel and titanium alloys

    Science.gov (United States)

    Viviente, J. L.; García, A.; Alonso, F.; Braceras, I.; Oñate, J. I.

    1999-04-01

    A study has been made of the depth dependence of the atomic fraction and chemical bonding states of AISI 440C martensitic stainless steel and Ti-6Al-4V alloy implanted with 75 keV C + at very high doses (above 10 18 ions cm -2), by means of X-ray photoelectron spectroscopy combined with an Ar + sputtering. A Gaussian-like carbon distribution was observed on both materials at the lowest implanted dose. More trapezoidal carbon depth-profiles were found with increasing implanted doses, and a pure carbon layer was observed only on the titanium alloy implanted at the highest dose. The implanted carbon was combined with both base metal and carbon itself to form metallic carbides and graphitic carbon. Furthermore, carbon-enriched carbides were also found by curve fitting the C 1s spectra. The titanium alloy showed a higher carbidic contribution than the steel implanted at the same C + doses. A critical carbon concentrations of about 33 at.% and 23 at.% were measured for the formation of C-C bonds in Ti-6Al-4V and steel samples, respectively. The carbon atoms were bound with metal to form carbidic compounds until these critical concentrations were reached; when this C concentration was exceeded the proportion of C-C bonds increased and resulted in the growth of carbonaceous layers.

  3. Development of titanium alloys and surface treatments to increase the implants lifetime

    Directory of Open Access Journals (Sweden)

    Joan Lario-Femenía

    2016-12-01

    Full Text Available The population aging together with increase of life expectancy forces the development of new prosthesis which may present a higher useful life. The clinical success of implants is based on the osseointegration achievement. Therefore, metal implants must have a mechanical compatibility with the substituted bone, which is achieved through a combination of low elastic modulus, high flexural and fatigue strength. The improvement, in the short and long term, of the osseointegration depends on several factors, where the macroscopic design and dimensional, material and implant surface topography are of great importance. This article is focused on summarizing the advantages that present the titanium and its alloys to be used as biomaterials, and the development that they have suffered in recent decades to improve their biocompatibility. Consequently, the implants evolution has been recapitulated and summarized through three generations. In the recent years the interest on the surface treatments for metallic prostheses has been increased, the main objective is achieve a lasting integration between implant and bone tissue, in the shortest time possible. On this article various surface treatments currently used to modify the surface roughness or to obtain coatings are described it; it is worthy to mention the electrochemical oxidation with post-heat treated to modify the titanium oxide crystalline structure. After the literature review conducted for prepare this article, the ? titanium alloys, with a nanotubes surface of obtained by electrochemical oxidation and a subsequent step of heat treatment to obtain a crystalline structure are the future option to improve long term biocompatibility of titanium prostheses.

  4. Adding functionality with additive manufacturing: Fabrication of titanium-based antibiotic eluting implants

    Energy Technology Data Exchange (ETDEWEB)

    Cox, Sophie C. [School of Chemical Engineering, University of Birmingham, Edgbaston B15 2TT (United Kingdom); Jamshidi, Parastoo [School of Materials and Metallurgy, University of Birmingham, Edgbaston B15 2TT (United Kingdom); Eisenstein, Neil M. [School of Chemical Engineering, University of Birmingham, Edgbaston B15 2TT (United Kingdom); Royal Centre for Defence Medicine, Birmingham Research Park, Vincent Drive, Edgbaston B15 2SQ (United Kingdom); Webber, Mark A. [School of Biosciences, University of Birmingham, Edgbaston B15 2TT (United Kingdom); Hassanin, Hany [School of Materials and Metallurgy, University of Birmingham, Edgbaston B15 2TT (United Kingdom); School of Mechanical and Automotive Engineering, Kingston University, London SW15 3DW (United Kingdom); Attallah, Moataz M. [School of Materials and Metallurgy, University of Birmingham, Edgbaston B15 2TT (United Kingdom); Shepherd, Duncan E.T. [Department of Mechanical Engineering, School of Engineering, University of Birmingham, Edgbaston B15 2TT (United Kingdom); Addison, Owen [School of Dentistry, University of Birmingham, Edgbaston B15 2TT (United Kingdom); Grover, Liam M. [School of Chemical Engineering, University of Birmingham, Edgbaston B15 2TT (United Kingdom)

    2016-07-01

    Additive manufacturing technologies have been utilised in healthcare to create patient-specific implants. This study demonstrates the potential to add new implant functionality by further exploiting the design flexibility of these technologies. Selective laser melting was used to manufacture titanium-based (Ti-6Al-4V) implants containing a reservoir. Pore channels, connecting the implant surface to the reservoir, were incorporated to facilitate antibiotic delivery. An injectable brushite, calcium phosphate cement, was formulated as a carrier vehicle for gentamicin. Incorporation of the antibiotic significantly (p = 0.01) improved the compressive strength (5.8 ± 0.7 MPa) of the cement compared to non-antibiotic samples. The controlled release of gentamicin sulphate from the calcium phosphate cement injected into the implant reservoir was demonstrated in short term elution studies using ultraviolet-visible spectroscopy. Orientation of the implant pore channels were shown, using micro-computed tomography, to impact design reproducibility and the back-pressure generated during cement injection which ultimately altered porosity. The amount of antibiotic released from all implant designs over a 6 hour period (< 28% of the total amount) were found to exceed the minimum inhibitory concentrations of Staphylococcus aureus (16 μg/mL) and Staphylococcus epidermidis (1 μg/mL); two bacterial species commonly associated with periprosthetic infections. Antibacterial efficacy was confirmed against both bacterial cultures using an agar diffusion assay. Interestingly, pore channel orientation was shown to influence the directionality of inhibition zones. Promisingly, this work demonstrates the potential to additively manufacture a titanium-based antibiotic eluting implant, which is an attractive alternative to current treatment strategies of periprosthetic infections. - Highlights: • Titanium implants were additively manufactured with surface connected reservoirs. • Implants

  5. Adding functionality with additive manufacturing: Fabrication of titanium-based antibiotic eluting implants

    International Nuclear Information System (INIS)

    Cox, Sophie C.; Jamshidi, Parastoo; Eisenstein, Neil M.; Webber, Mark A.; Hassanin, Hany; Attallah, Moataz M.; Shepherd, Duncan E.T.; Addison, Owen; Grover, Liam M.

    2016-01-01

    Additive manufacturing technologies have been utilised in healthcare to create patient-specific implants. This study demonstrates the potential to add new implant functionality by further exploiting the design flexibility of these technologies. Selective laser melting was used to manufacture titanium-based (Ti-6Al-4V) implants containing a reservoir. Pore channels, connecting the implant surface to the reservoir, were incorporated to facilitate antibiotic delivery. An injectable brushite, calcium phosphate cement, was formulated as a carrier vehicle for gentamicin. Incorporation of the antibiotic significantly (p = 0.01) improved the compressive strength (5.8 ± 0.7 MPa) of the cement compared to non-antibiotic samples. The controlled release of gentamicin sulphate from the calcium phosphate cement injected into the implant reservoir was demonstrated in short term elution studies using ultraviolet-visible spectroscopy. Orientation of the implant pore channels were shown, using micro-computed tomography, to impact design reproducibility and the back-pressure generated during cement injection which ultimately altered porosity. The amount of antibiotic released from all implant designs over a 6 hour period (< 28% of the total amount) were found to exceed the minimum inhibitory concentrations of Staphylococcus aureus (16 μg/mL) and Staphylococcus epidermidis (1 μg/mL); two bacterial species commonly associated with periprosthetic infections. Antibacterial efficacy was confirmed against both bacterial cultures using an agar diffusion assay. Interestingly, pore channel orientation was shown to influence the directionality of inhibition zones. Promisingly, this work demonstrates the potential to additively manufacture a titanium-based antibiotic eluting implant, which is an attractive alternative to current treatment strategies of periprosthetic infections. - Highlights: • Titanium implants were additively manufactured with surface connected reservoirs. • Implants

  6. Effect of pore size on bone ingrowth into porous titanium implants fabricated by additive manufacturing: An in vivo experiment.

    Science.gov (United States)

    Taniguchi, Naoya; Fujibayashi, Shunsuke; Takemoto, Mitsuru; Sasaki, Kiyoyuki; Otsuki, Bungo; Nakamura, Takashi; Matsushita, Tomiharu; Kokubo, Tadashi; Matsuda, Shuichi

    2016-02-01

    Selective laser melting (SLM) is an additive manufacturing technique with the ability to produce metallic scaffolds with accurately controlled pore size, porosity, and interconnectivity for orthopedic applications. However, the optimal pore structure of porous titanium manufactured by SLM remains unclear. In this study, we evaluated the effect of pore size with constant porosity on in vivo bone ingrowth in rabbits into porous titanium implants manufactured by SLM. Three porous titanium implants (with an intended porosity of 65% and pore sizes of 300, 600, and 900μm, designated the P300, P600, and P900 implants, respectively) were manufactured by SLM. A diamond lattice was adapted as the basic structure. Their porous structures were evaluated and verified using microfocus X-ray computed tomography. Their bone-implant fixation ability was evaluated by their implantation as porous-surfaced titanium plates into the cortical bone of the rabbit tibia. Bone ingrowth was evaluated by their implantation as cylindrical porous titanium implants into the cancellous bone of the rabbit femur for 2, 4, and 8weeks. The average pore sizes of the P300, P600, and P900 implants were 309, 632, and 956μm, respectively. The P600 implant demonstrated a significantly higher fixation ability at 2weeks than the other implants. After 4weeks, all models had sufficiently high fixation ability in a detaching test. Bone ingrowth into the P300 implant was lower than into the other implants at 4weeks. Because of its appropriate mechanical strength, high fixation ability, and rapid bone ingrowth, our results indicate that the pore structure of the P600 implant is a suitable porous structure for orthopedic implants manufactured by SLM. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Evaluating the osseointegration of nanostructured titanium implants in animal models: Current experimental methods and perspectives (Review).

    Science.gov (United States)

    Babuska, Vaclav; Moztarzadeh, Omid; Kubikova, Tereza; Moztarzadeh, Amin; Hrusak, Daniel; Tonar, Zbynek

    2016-09-15

    The aim of this paper is to review the experimental methods currently being used to evaluate the osseointegration of nanostructured titanium implants using animal models. The material modifications are linked to the biocompatibility of various types of oral implants, such as laser-treated, acid-etched, plasma-coated, and sand-blasted surface modifications. The types of implants are reviewed according to their implantation site (endoosseous, subperiosteal, and transosseous implants). The animal species and target bones used in experimental implantology are carefully compared in terms of the ratio of compact to spongy bone. The surgical technique in animal experiments is briefly described, and all phases of the histological evaluation of osseointegration are described in detail, including harvesting tissue samples, processing undemineralized ground sections, and qualitative and quantitative histological assessment of the bone-implant interface. The results of histological staining methods used in implantology are illustrated and compared. A standardized and reproducible technique for stereological quantification of bone-implant contact is proposed and demonstrated. In conclusion, histological evaluation of the experimental osseointegration of dental implants requires careful selection of the experimental animals, bones, and implantation sites. It is also advisable to use larger animal models and older animals with a slower growth rate rather than small or growing experimental animals. Bones with a similar ratio of compact to spongy bone, such as the human maxilla and mandible, are preferred. A number of practical recommendations for the experimental procedures, harvesting of samples, tissue processing, and quantitative histological evaluations are provided.

  8. Examination of the inflammatory response following implantation of titanium plates coated with phospholipids in rats.

    Science.gov (United States)

    Kochanowski, Alexandra; Hoene, Andreas; Patrzyk, Maciej; Walschus, Uwe; Finke, Birgit; Luthringer, Bérengère; Feyerabend, Frank; Willumeit, Regine; Lucke, Silke; Schlosser, Michael

    2011-04-01

    Implantation of biomaterials like titanium (Ti) causes inflammatory reactions possibly affecting implant functionality. Surface modifications could improve biocompatibility and functionality of implants. Biomembrane-derived phospholipids might be useful as implant coating due to their biomimetic properties. In vitro studies demonstrated beneficial effects for 2-oleoyl-1-palmitoyl-sn-glycero-3-phosphoethanolamin (POPE) as coating regarding interactions with cells and bacteria. Therefore, this in vivo study aimed at examining local inflammatory reactions after implantation of POPE-coated Ti plates. Ti implants with POPE attached non-covalently or covalent via octadecylphosphonic acid (OPA), with OPA alone and uncoated controls were simultaneously implanted intramuscularly in rats for 7, 14 and 56 days. The peri-implant tissue was quantitatively analyzed by immunohistochemistry for total macrophages, tissue macrophages, T cells, antigen-presenting cells and proliferating cells. Overall, both POPE-coated series were comparable to the controls. Furthermore, no differences were found between POPE coating on a covalently linked OPA monolayer and POPE coating dried from solution. Together with earlier in vitro results, this demonstrates the potential of phospholipids for implant surface modification.

  9. Bone reactions adjacent to titanium implants with different surface characteristics subjected to static load. A study in the dog (II)

    DEFF Research Database (Denmark)

    Gotfredsen, K; Berglundh, T; Lindhe, J

    2001-01-01

    The purpose of the present study was to compare bone reactions adjacent to titanium implants with either a titanium plasma-sprayed (TPS) or a machined surface subjected to lateral static loading induced by an expansion force. In 3 labrador dogs, the 2nd, 3rd and 4th mandibular premolars were...

  10. Effect of surface treatment on cell responses to grades 4 and 5 titanium for orthodontic mini-implants.

    Science.gov (United States)

    Galli, Carlo; Piemontese, Marilina; Ravanetti, Francesca; Lumetti, Simone; Passeri, Giovanni; Gandolfini, Mauro; Macaluso, Guido M

    2012-06-01

    Mini-implants are used to improve orthodontic anchorage, but optimal composition and surface characteristics have yet to be determined. We investigated the behavior of osteoblast-like cells on grade 4 commercially pure titanium and grade 5 titanium alloy with different surface treatments for mini-implants. MC3T3 cells were plated on machined, acid-etched, or acid-etched grade 4 titanium enriched with calcium phosphate, or machined, anodized, or anodized and calcium phosphate-enriched grade 5 titanium disks. Surface and cell morphologies were assessed by scanning electron microscopy. Cell viability was measured by chemiluminescence, cytoskeletal organization was investigated by immunofluorescence, and real-time polymerase chain reaction for osteoblast-specific genes was performed to measure cell differentiation. Flattened shapes and strong stress fibers were observed on the machined surfaces; cells on the rough surfaces had a spindle shape, with lower cytoskeletal polarization. Cell proliferation was highest on smooth grade 4 titanium surfaces, whereas cells quickly reached a plateau on rough grade 4 titanium; no difference was observed after 72 hours in the grade 5 titanium groups. Calcium phosphate enrichment on grade 4 titanium significantly increased the messenger RNA levels for alkaline phosphatase and osteocalcin. Osteoblastic markers were higher on the grade 5 titanium machined surfaces than on the rough surfaces, and comparable with acid-etched grade 4 titanium. Although the grade 4 titanium enriched with calcium phosphate had the highest level of differentiation in vitro, the grade 5 titanium machined surfaces supported cell proliferation and matrix synthesis, and induced high expression of early differentiation markers. Increased mechanical resistance of grade 5 titanium makes it a potential candidate for orthodontic mini-implants. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  11. Surface modification of the titanium implant using TEA CO 2 laser pulses in controllable gas atmospheres - Comparative study

    Science.gov (United States)

    Ciganovic, J.; Stasic, J.; Gakovic, B.; Momcilovic, M.; Milovanovic, D.; Bokorov, M.; Trtica, M.

    2012-01-01

    Interaction of a TEA CO2 laser, operating at 10.6 μm wavelength and pulse duration of 100 ns (FWHM), with a titanium implant in various gas atmospheres was studied. The Ti implant surface modification was typically studied at the moderate laser beam energy density/fluence of 28 J/cm2 in the surrounding of air, N2, O2 or He. The energy absorbed from the TEA CO2 laser beam is partially converted to thermal energy, which generates a series of effects, such as melting, vaporization of the molten material, shock waves, etc. The following titanium implant surface changes and phenomena were observed, depending on the gas used: (i) creation of cone-like surface structures in the atmospheres of air, N2 and O2, and dominant micro-holes/pores in He ambient; (ii) hydrodynamic features, most prominent in air; (iii) formation of titanium nitride and titanium oxide layers, and (iv) occurrence of plasma in front of the implant. It can be concluded from this study that the reported laser fluence and gas ambiences can effectively be applied for enhancing the titanium implant roughness and creation of titanium oxides and nitrides on the strictly localized surface area. The appearance of plasma in front of the implants indicates relatively high temperatures created above the surface. This offers a sterilizing effect, facilitating contaminant-free conditions.

  12. The Otto Aufranc Award: Enhanced Biocompatibility of Stainless Steel Implants by Titanium Coating and Microarc Oxidation

    Science.gov (United States)

    Lim, Young Wook; Kwon, Soon Yong; Sun, Doo Hoon

    2010-01-01

    Background Stainless steel is one of the most widely used biomaterials for internal fixation devices, but is not used in cementless arthroplasty implants because a stable oxide layer essential for biocompatibility cannot be formed on the surface. We applied a Ti electron beam coating, to form oxide layer on the stainless steel surface. To form a thicker oxide layer, we used a microarc oxidation process on the surface of Ti coated stainless steel. Modification of the surface using Ti electron beam coating and microarc oxidation could improve the ability of stainless steel implants to osseointegrate. Questions/purposes The ability of cells to adhere to grit-blasted, titanium-coated, microarc-oxidated stainless steel in vitro was compared with that of two different types of surface modifications, machined and titanium-coated, and microarc-oxidated. Methods We performed energy-dispersive x-ray spectroscopy and scanning electron microscopy investigations to assess the chemical composition and structure of the stainless steel surfaces and cell morphology. The biologic responses of an osteoblastlike cell line (SaOS-2) were examined by measuring proliferation (cell proliferation assay), differentiation (alkaline phosphatase activity), and attraction ability (cell migration assay). Results Cell proliferation, alkaline phosphatase activity, migration, and adhesion were increased in the grit-blasted, titanium-coated, microarc-oxidated group compared to the two other groups. Osteoblastlike cells on the grit-blasted, titanium-coated, microarc-oxidated surface were strongly adhered, and proliferated well compared to those on the other surfaces. Conclusions The surface modifications we used (grit blasting, titanium coating, microarc oxidation) enhanced the biocompatibility (proliferation and migration of osteoblastlike cells) of stainless steel. Clinical Relevance This process is not unique to stainless steel; it can be applied to many metals to improve their biocompatibility

  13. In vitro studies of nanosilver-doped titanium implants for oral and maxillofacial surgery.

    Science.gov (United States)

    Pokrowiecki, Rafał; Zaręba, Tomasz; Szaraniec, Barbara; Pałka, Krzysztof; Mielczarek, Agnieszka; Menaszek, Elżbieta; Tyski, Stefan

    2017-01-01

    The addition of an antibacterial agent to dental implants may provide the opportunity to decrease the percentage of implant failures due to peri-implantitis. For this purpose, in this study, the potential efficacy of nanosilver-doped titanium biomaterials was determined. Titanium disks were incorporated with silver nanoparticles over different time periods by Tollens reaction, which is considered to be an eco-friendly, cheap, and easy-to-perform method. The surface roughness, wettability, and silver release profile of each disc were measured. In addition, the antibacterial activity was also evaluated by using disk diffusion tests for bacteria frequently isolated from the peri-implant biofilm: Streptococcus mutans, Streptococcus mitis, Streptococcus oralis, Streptococcus sanguis, Porphyromonas gingivalis, Staphylococcus aureus , and Escherichia coli . Cytotoxicity was evaluated in vitro in a natural human osteoblasts cell culture. The addition of nanosilver significantly increased the surface roughness and decreased the wettability in a dose-dependent manner. These surfaces were significantly toxic to all the tested bacteria following a 48-hour exposure, regardless of silver doping duration. A concentration of 0.05 ppm was sufficient to inhibit Gram-positive and Gram-negative species, with the latter being significantly more susceptible to silver ions. However, after the exposure of human osteoblasts to 0.1 ppm of silver ions, a significant decrease in cell viability was observed by using ToxiLight™ BioAssay Kit after 72 hours. Data from the present study indicated that the incorporation of nanosilver may influence the surface properties that are important in the implant healing process. The presence of nanosilver on the titanium provides an antibacterial activity related to the bacteria involved in peri-implantitis. Finally, the potential toxicological considerations of nanosilver should further be investigated, as both the antibacterial and cytotoxic properties

  14. How to Choose between the Implant Materials Steel and Titanium in Orthopedic Trauma Surgery: Part 2 - Biological Aspects.

    Science.gov (United States)

    Perren, S M; Regazzoni, P; Fernandez, A A

    2017-01-01

    BIOLOGICAL ASPECTS OF STEEL AND TITANIUM AS IMPLANT MATERIAL IN ORTHOPEDIC TRAUMA SURGERY The following case from the ICUC database, where a titanium plate was implanted into a flourishing infection, represents the clinical experience leading to preferring titanium over steel. (Fig. 1) (6). Current opinions regarding biological aspects of implant function. The "street" opinions regarding the biological aspects of the use of steel versus titanium as a surgical trauma implant material differ widely. Statements of opinion leaders range from "I do not see any difference in the biological behavior between steel and titanium in clinical application" to "I successfully use titanium implants in infected areas in a situation where steel would act as foreign body "sustaining" infection." Furthermore, some comments imply that clinical proof for the superiority of titanium in human application is lacking. The following tries to clarify the issues addressing the different aspects more through a practical clinical approach than a purely scientific one, this includes simplifications. Today's overall biocompatibility of implant materials is acceptable but: As the vast majority of secondary surgeries are elective procedures this allows the selection of implant materials with optimal infection resistance. The different biological reactions of stainless steel and titanium are important for this segment of clinical pathologies. Biological tole - rance (18) depends on the toxicity and on the amount of soluble implant material released. Release, diffusion and washout through blood circulation determine the local concentration of the corrosion products. Alloying components of steel, especially nickel and chromium, are less than optimal in respect to tissue tolerance and allergenicity. Titanium as a pure metal provides excellent biological tolerance (3, 4, 16). Better strength was obtained by titanium alloys like TiAl6V4. The latter found limited application as surgical implants. It

  15. On-Site Surface Functionalization for Titanium Dental Implant with Nanotopography: Review and Outlook

    Directory of Open Access Journals (Sweden)

    Byung Gyu Kim

    2016-01-01

    Full Text Available Titanium (Ti has been the first choice of material for dental implant due to bonding ability to natural bone and great biocompatibility. Various types of surface roughness modification in nanoscale have been made as promising strategy for accelerating osseointegration of Ti dental implant. To have synergetic effect with nanotopography oriented favors in cell attachment, on-site surface functionalization with reproducibility of nanotopography is introduced as next strategy to further enhance cellular bioactivity. Extensive research has been conducted to investigate the potential of nanotopography preserved on-site surface functionalization for Ti dental implant. This review will discuss nonthermal atmospheric pressure plasma, ultraviolet, and low level of laser therapy on Ti dental implant with nanotopography as next generation of surface functionalization due to its abilities to induce superhydrophilicity or biofunctionality without change of nanotopography.

  16. Micro-computerised tomography optimisation for the measurement of bone mineral density around titanium dental implants

    International Nuclear Information System (INIS)

    Park, C.; Swain, M.; Duncan, W.

    2010-01-01

    Titanium dental implants (screws) are commonly used to replace missing teeth by forming a biological union with bone ('osseointegration'). Micro-computerised tomography (μCT) may be useful for measuring bone mineral density around dental implants. Major issues arise because of various artefacts that occur with polychromatic X-rays associated bench type instruments that may compromise interpretation of the observations. In this study various approaches to minimise artefacts such as; beam hardening, filtering and edge effects are explored with a homogeneous polymeric material, Teflon, with and without an implant present. The implications of the limitations of using such polychromatic μCT systems to quantify bone mineral density adjacent to the implant are discussed. (author)

  17. Surface and corrosion characteristics of carbon plasma implanted and deposited nickel-titanium alloy

    International Nuclear Information System (INIS)

    Poon, R.W.Y.; Liu, X.Y.; Chung, C.Y.; Chu, P.K.; Yeung, K.W.K.; Lu, W.W.; Cheung, K.M.C.

    2005-01-01

    Nickel-titanium shape memory alloys (NiTi) are potentially useful in orthopedic implants on account of their super-elastic and shape memory properties. However, the materials are prone to surface corrosion and the most common problem is out-diffusion of harmful Ni ions from the substrate into body tissues and fluids. In order to improve the corrosion resistance and related surface properties, we used the technique of plasma immersion ion implantation and deposition to deposit an amorphous hydrogenated carbon coating onto NiTi and implant carbon into NiTi. Both the deposited amorphous carbon film and carbon plasma implanted samples exhibit much improved corrosion resistances and surface mechanical properties and possible mechanisms are suggested

  18. In vitro and in vivo follow-up of titanium transmucosal implants with a zirconia collar.

    Science.gov (United States)

    Bianchi, A E; Bosetti, M; Dolci, G; Sberna, M T; Sanfilippo, S; Cannas, M

    2004-01-01

    The advantages of transmucosal healing implants with a bioactive zirconia collar as a support for partially fixed prosthodontic restorations are optimal peri-implant marginal tissue sealing, reduction in plaque accumulation and satisfactory aesthetic results. The zirconia used in this study evidenced not only optimal clinical performances, but also good biocompatibility. The results from this study demonstrated that zirconia coating enhances fibroblasts and osteoblast-like cell adhesion, spreading and proliferation, favoring microscopic tissue/cell in-growth and clinical implant fixation improvement. From clinical analysis, it emerged that the treatment group obtained better scores in every peri-implant parameter. This evidence attests faster stabilization of soft and hard tissues around both the transmucosal zirconia collar and at the crestal level of the implant. A reduced plaque accumulation around the implant with zirconia collar could provide a better peri-implant microbiological en-vironment by allowing the soft tissues expression of optimal sealing and good bone adaptation to loading. From these clinical and radiographic comparative analyzes, it emerged that in the treatment group the mean values were always similarly low. A rapid stabilization of both hard and soft peri-implant tissues was documented in the 1st yr. In the treatment group, there was the formation of stable tissue sealing the zirconia collar, which could preserve mucosal and bone levels. In conclusion, 2-yr clin-ical results demonstrated that implants supporting fixed restorations using transmucosal healing implants with a zirconia collar appeared a valid method, reporting 100% implant survival rates. Moreover, in vivo results obtained using strict parame-ters to assess the peri-implant status affirmed that a zirconia collar offers excellent biological acceptance. Our preliminary in vitro results statistically evidenced increased fibroblast and osteoblast adhesion and proliferation to

  19. One-Piece Zirconia Ceramic versus Titanium Implants in the Jaw and Femur of a Sheep Model: A Pilot Study

    Directory of Open Access Journals (Sweden)

    A. Siddiqi

    2016-01-01

    Full Text Available Reports have documented titanium (Ti hypersensitivity after dental implant treatment. Alternative materials have been suggested including zirconia (Zr ceramics, which have shown predictable osseointegration in animal studies and appear free of immune responses. The aim of the research was to investigate the bone-to-implant contact (BIC of one-piece Zr, compared with one-piece Ti implants, placed in the jaws and femurs of domestic sheep. Ten New Zealand mixed breed sheep were used. A One-piece prototype Ti (control and one Zr (test implant were placed in the mandible, and one of each implant (Ti and Zr was placed into the femoral epicondyle of each animal. The femur implants were submerged and unloaded; the mandibular implants were placed using a one-stage transgingival protocol and were nonsubmerged. After a healing period of 12 weeks, %BIC was measured. The overall survival rate for mandibular and femur implants combined was 87.5%. %BIC was higher for Zr implants versus Ti implants in the femur (85.5%, versus 78.9% (p=0.002. Zirconia implants in the mandible showed comparable %BIC to titanium implants (72.2%, versus 60.3% (p=0.087. High failure rate of both Zr and Ti one-piece implants in the jaw could be attributed to the one-piece design and surface characteristics of the implant that could have influenced osseointegration. Further clinical trials are recommended to evaluate the performance of zirconia implants under loading conditions.

  20. One-Piece Zirconia Ceramic versus Titanium Implants in the Jaw and Femur of a Sheep Model: A Pilot Study.

    Science.gov (United States)

    Siddiqi, A; Duncan, W J; De Silva, R K; Zafar, S

    2016-01-01

    Reports have documented titanium (Ti) hypersensitivity after dental implant treatment. Alternative materials have been suggested including zirconia (Zr) ceramics, which have shown predictable osseointegration in animal studies and appear free of immune responses. The aim of the research was to investigate the bone-to-implant contact (BIC) of one-piece Zr, compared with one-piece Ti implants, placed in the jaws and femurs of domestic sheep. Ten New Zealand mixed breed sheep were used. A One-piece prototype Ti (control) and one Zr (test) implant were placed in the mandible, and one of each implant (Ti and Zr) was placed into the femoral epicondyle of each animal. The femur implants were submerged and unloaded; the mandibular implants were placed using a one-stage transgingival protocol and were nonsubmerged. After a healing period of 12 weeks, %BIC was measured. The overall survival rate for mandibular and femur implants combined was 87.5%. %BIC was higher for Zr implants versus Ti implants in the femur (85.5%, versus 78.9%) ( p = 0.002). Zirconia implants in the mandible showed comparable %BIC to titanium implants (72.2%, versus 60.3%) ( p = 0.087). High failure rate of both Zr and Ti one-piece implants in the jaw could be attributed to the one-piece design and surface characteristics of the implant that could have influenced osseointegration. Further clinical trials are recommended to evaluate the performance of zirconia implants under loading conditions.

  1. One-Piece Zirconia Ceramic versus Titanium Implants in the Jaw and Femur of a Sheep Model: A Pilot Study

    Science.gov (United States)

    De Silva, R. K.; Zafar, S.

    2016-01-01

    Reports have documented titanium (Ti) hypersensitivity after dental implant treatment. Alternative materials have been suggested including zirconia (Zr) ceramics, which have shown predictable osseointegration in animal studies and appear free of immune responses. The aim of the research was to investigate the bone-to-implant contact (BIC) of one-piece Zr, compared with one-piece Ti implants, placed in the jaws and femurs of domestic sheep. Ten New Zealand mixed breed sheep were used. A One-piece prototype Ti (control) and one Zr (test) implant were placed in the mandible, and one of each implant (Ti and Zr) was placed into the femoral epicondyle of each animal. The femur implants were submerged and unloaded; the mandibular implants were placed using a one-stage transgingival protocol and were nonsubmerged. After a healing period of 12 weeks, %BIC was measured. The overall survival rate for mandibular and femur implants combined was 87.5%. %BIC was higher for Zr implants versus Ti implants in the femur (85.5%, versus 78.9%) (p = 0.002). Zirconia implants in the mandible showed comparable %BIC to titanium implants (72.2%, versus 60.3%) (p = 0.087). High failure rate of both Zr and Ti one-piece implants in the jaw could be attributed to the one-piece design and surface characteristics of the implant that could have influenced osseointegration. Further clinical trials are recommended to evaluate the performance of zirconia implants under loading conditions. PMID:28058261

  2. Modified thyroplasty for unilateral vocal fold paralysis using an adjustable titanium implant.

    Science.gov (United States)

    Wen, Wu; Sun, Guangbin; Sun, Bifeng; Liu, Chang; Zhang, Mingxing

    2015-03-01

    This study aimed to describe a new titanium thyroplasty implant that can be adjusted with a screw. Six Beagle dogs were randomly divided into experimental and control groups (n = 3). The titanium screw was implanted in the experimental group after the left recurrent laryngeal nerve was cut off under general anaesthesia. This procedure caused arytenoid cartilage internal shift, allowing the vocal cord to locate at the median and the glottis to close during phonation. No other operation was conducted in the control group. Each group, respectively, underwent video laryngoscopy, CT scan and histopathology before and after operation. After 4 months of follow-up, the video laryngoscopy results showed that the left arytenoid cartilage in the experimental group underwent internal adduct and shift, whereas the left vocal cords in the control group located at the paramedian position and exhibited fissure during phonation. CT scan results showed that the adjustable titanium screw was in proper position. Postoperative pathological examination showed that, in addition to early local inflammation, the laryngeal muscle may atrophy. The adjustable titanium screw requires a simple operation and can be significantly adjusted. The effect of the operation can be immediately observed without rejection. Therefore, this method is an efficient treatment for unilateral vocal cord paralysis.

  3. [Modern methods for studying the surface of titanium implants (literature review)].

    Science.gov (United States)

    Suba, Csongor; Velich, Norbert; Vörös, János; Turi, Csaba; Szabó, György

    2004-02-01

    Studies of the coatings found on the surface of titanium implants employed in oral surgery are indispensable for understanding the interactions between the organism and the implant. This paper surveys the theory and practical applicability of the methods most frequently applied to study the surface structure and composition of the material. Detailed accounts are given of various structure investigation methods: scanning electron microscopy, stereo scanning electron microscopy, X-ray diffraction, atomic force microscopy and interference microscopy; and of various composition investigation methods: secondary ion mass spectroscopy, X-ray photoelectron spectroscopy, Auger electron spectroscopy; and also of the corrosion procedures for the study of electrochemical behaviour.

  4. Implantation of a titanium partial limb prosthesis in a white-naped crane (Grus vipio).

    Science.gov (United States)

    Rush, E Marie; Turner, Thomas M; Montgomery, Ronald; Ogburn, Anna L; Urban, Robert M; Sidebothum, Chris; LaVasser, Andrew

    2012-09-01

    A female white-naped crane (Grus vipio) was presented with an open, oblique fracture of the distal right tarsometatarsus and concomitant vascular and nerve damage. Conventional fracture fixation repairs failed, which led to implantation of a custom titanium limb prosthesis. After subsequent revisions with 2 different prosthetic devices, limb function was ultimately restored but a later yolk embolism caused a circulatory compromise in the opposite leg, which necessitated euthanasia. Histopathologic results revealed limited ingrowth of bone into the porous coated implant, which indicated that a limb prosthesis may provide salvage for long-legged, heavy-bodied birds with fractures of the tarsometatarsus.

  5. Plasma immersion ion implantation and deposition hybrid process on aluminum and titanium alloy

    International Nuclear Information System (INIS)

    Wang Langping; Wang Yuhang; Wang Xiaofeng; Tang Baoyin; Dong Shen

    2007-01-01

    Because of their variety excellent properties, aluminum and titanium alloy are widely used in aerospace, airplane, ship manufacture, energy source and chemical engineering. However, both of them show a low wear resistance. In our research, plasma immersion ion implantation and deposition was utilized to improve their wear resistance. The method of ion implantation + transition layer deposition + wear resistance layer deposition was applied on these alloys. And by employing the wear testing method, the influences of the structure and thickness of the transition layer on wear resistance were obtained. The experimental results reveal that the wear resistance of these alloys can be improved significantly by optimizing the processing window. (authors)

  6. Synergistic interactions between corrosion and wear at titanium-based dental implant connections: A scoping review.

    Science.gov (United States)

    Apaza-Bedoya, K; Tarce, M; Benfatti, C A M; Henriques, B; Mathew, M T; Teughels, W; Souza, J C M

    2017-12-01

    Two-piece implant systems are mainly used in oral implantology involving an osseointegrated implant connected to an abutment, which supports prosthetic structures. It is well documented that the presence of microgaps, biofilms and oral fluids at the implant-abutment connection can cause mechanical and biological complications. The aim of this review paper was to report the degradation at the implant-abutment connection by wear and corrosion processes taking place in the oral cavity. Most of the retrieved studies evaluated the wear and corrosion (tribocorrosion) of titanium-based materials used for implants and abutments in artificial saliva. Electrochemical and wear tests together with microscopic techniques were applied to validate the tribocorrosion behavior of the surfaces. A few studies inspected the wear on the inner surfaces of the implant connection as a result of fatigue or removal of abutments. The studies reported increased microgaps after fatigue tests. In addition, data suggest that micromovements occurring at the contacting surfaces can increase the wear of the inner surfaces of the connection. Biofilms and/or glycoproteins act as lubricants, although they can also amplify the corrosion of the surfaces. Consequently, loosening of the implant-abutment connection can take place during mastication. In addition, wear and corrosion debris such as ions and micro- and nanoparticles released into the surrounding tissues can stimulate peri-implant inflammation that can lead to pathologic bone resorption. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Doxycycline-loaded coaxial nanofiber coating of titanium implants enhances osseointegration and inhibits Staphylococcus aureus infection.

    Science.gov (United States)

    Song, Wei; Seta, Joseph; Chen, Liang; Bergum, Christopher; Zhou, Zhubin; Kanneganti, Praveen; Kast, Rachel E; Auner, Gregory W; Shen, Ming; Markel, David C; Ren, Weiping; Yu, Xiaowei

    2017-07-05

    Few studies have been reported that focus on developing implant surface nanofiber (NF) coating to prevent infection and enhance osseointegration by local drug release. In this study, coaxial doxycycline (Doxy)-doped polycaprolactone/polyvinyl alcohol (PCL/PVA) NFs were directly deposited on a titanium (Ti) implant surface during electrospinning. The interaction of loaded Doxy with both PVA and PCL NFs was characterized by Raman spectroscopy. The bonding strength of Doxy-doped NF coating on Ti implants was confirmed by a stand single-pass scratch test. The improved implant osseointegration by PCL/PVA NF coatings in vivo was confirmed by scanning electron microscopy, histomorphometry and micro computed tomography (μCT) at 2, 4 and 8 weeks after implantation. The bone contact surface (%) changes of the NF coating group (80%) is significantly higher than that of the no NF group (coating effectively inhibited bacterial infection and enhanced osseointegration in an infected (Staphylococcus aureus) tibia implantation rat model. Doxy released from NF coating inhibited bacterial growth up to 8 weeks in vivo. The maximal push-in force of the Doxy-NF coating (38 N) is much higher than that of the NF coating group (6.5 N) 8 weeks after implantation (p coating doped with Doxy and/or other drugs have great potential in enhancing implant osseointegration and preventing infection.

  8. Titanium alloy orthodontic mini-implants: scanning electron microscopic and metallographic analyses.

    Science.gov (United States)

    Burmann, Paola F P; Ruschel, Henrique C; Vargas, Ivana A; de Verney, José C K; Kramer, Paulo F

    2015-04-01

    Anchorage control is one of the determining factors of successful orthodontic mechanics. In mini-implants, fractures due to placement and removal have been related to implant design and titanium alloy quality. This study assessed the topography and microstructure of five brands of mini-implants (Neodent, SIN, Morelli, Conexao, Foresta Dent). Scanning electron microscopic analyses of the head, transmucosal neck, threaded body, and tip were performed to assess implant design and manufacturing defects (n=3/group). Metallographic analysis of longitudinal sections (n=15) and cross-sections (n=15) was performed under conventional light microscopy according to international standards of "American Society for Testing and Materials". The results showed significant differences in miniimplant design. Surface irregularities in the threaded body and tip were observed. Microstructural analyses revealed an alpha/beta-phase grain structure, in compliance with the ETTC-2 ("Technical Committee of European Titanium Producers" -2nd edition). No structural defects were detected. We conclude that differences in mini-implant design and the presence of surface irregularities may influence the effectiveness of orthodontic anchorage.

  9. Identification of early response genes to roughness and fluoride modification of titanium implants in human osteoblasts.

    Science.gov (United States)

    Ramis, Joana Maria; Taxt-Lamolle, Sébastien Francis; Lyngstadaas, Staale Petter; Reseland, Janne Elin; Ellingsen, Jan Eirik; Monjo, Marta

    2012-04-01

    Tissue response after implantation determines the success of the healing process. This response is not only dependent on the chemical properties of the implant surface but also by the surface topography or its roughness. Although in vitro and in vivo studies show improved results with rough- and fluoride-modified implants, the mechanisms behind these findings are still unknown. Here, we have used a two-step procedure to identify novel genes related to the early response of primary human osteoblasts to roughness and fluoride-modified titanium implants. Two hundred seventeen genes responding to roughness were identified by microarray analysis and 198 genes responding to fluoride, 33 genes were common. Those identified genes related to bone and mineralization were further investigated by real-time reverse-transcriptase polymerase chain reaction. After 1 day of culture, toll-like receptor 3, ankylosis-progressive homolog, decorin, osteocalcin, and runt-related transcription factor-2 were classified as responsive genes to roughness; Distal-less homeobox-2 and Tuftelin-1 as responsive genes to fluoride treatment. Responsive genes to both treatments were collagen type I, parathyroid hormone-like hormone, hairy and enhancer of split-1, follistatin, ectonucleotide pyrophosphatase/phosphodiesterase-1, and thyroid hormone receptor-alpha. Our strategy was useful for identifying novel genes that might be involved in the early response of osteoblasts to rough and fluoride-modified titanium implants.

  10. Guidelines for patient-specific jawline definition with titanium implants in esthetic, deformity, and malformation surgery

    OpenAIRE

    Mommaerts, Maurice Yves

    2016-01-01

    Context: Asymmetry and unfavorable esthetics of the jawline have become possible to correct in three dimensions using computer aided design and computer aided manufacturing. Aims: The aim of this study was to provide esthetic, technical, and operative guidelines for mandibular angle and border augmentation using patient-specific titanium implants made by selective laser melting. Settings and Design: University hospital - prospective registry. Subjects and Methods: Twelve patients and 17 impla...

  11. Coating of titanium implants with boron nitride by RF-magnetron ...

    Indian Academy of Sciences (India)

    Coating of titanium implants with boron nitride by RF-magnetron sputtering. CEREN GÖKMENO ˘GLU1,∗, NURDAN ÖZMERIÇ2, GAYE ÇAKAL3, NIHAN DÖKMETAS4,. CANSU ERGENE4 and BILGIN KAFTANO ˘GLU4. 1Department of Periodontology, Faculty of Dentistry, Ordu University, Güzelyalı Bulvarı 52100, Ordu, ...

  12. Enhancement of the implant integration: activation of model and real titanium surfaces

    Czech Academy of Sciences Publication Activity Database

    Pop-Georgievski, Ognen; Kubies, Dana; Zemek, Josef; Šlouf, Miroslav; Rypáček, František

    2013-01-01

    Roč. 8, 6s (2013), s. 219-220 ISSN 1746-0751. [World Conference on Regenerative Medicine 2013 /WCRM 2013/. 23.10.2013-25.10.2013, Leipzig] R&D Projects: GA MZd(CZ) NT13297; GA MŠk EE2.3.30.0029 Institutional support: RVO:61389013 ; RVO:68378271 Keywords : titanium * implant * surface modification Subject RIV: CE - Biochemistry

  13. Characterization of novel silane coatings on titanium implant surfaces

    NARCIS (Netherlands)

    Matinlinna, Jukka P; Tsoi, James Kit‐Hon; de Vries, Jacob; Busscher, Hendrik

    Objectives This in vitro study describes and characterizes a developed novel method to produce coatings on Ti. Hydrophobic coatings on substrates are needed in prosthetic dentistry to promote durable adhesion between luting resin cements and coated Ti surfaces. In implant dentistry the hydrophobic

  14. Positive Biomechanical Effects of Titanium Oxide for Sandblasting Implant Surface as an Alternative to Aluminium Oxide.

    Science.gov (United States)

    Gehrke, Sergio Alexandre; Taschieri, Silvio; Del Fabbro, Massimo; Coelho, Paulo Guilherme

    2015-10-01

    The aim of this study was to evaluate the physico-chemical properties and the in vivo host response of a surface sandblasted with particles of titanium oxide (TiO2) followed by acid etching as an alternative to aluminium oxide. Thirty titanium disks manufactured in the same conditions as the implants and 24 conventional cylindrical implants were used. Half of the implants had a machined surface (Gcon) while in the other half; the surface was treated with particles of TiO2 followed by acid etching (Gexp). Surface characterization was assessed by scanning electron microscope (SEM), energy dispersive X-ray spectrometry (EDS), profilometry, and wettability. For the in vivo test, 12 implants of each group were implanted in the tibia of 6 rabbits, and were reverse torque tested after periods of 30 or 60 days after implantation. Following torque, SEM was utilized to assess residual bone-implant contact. The surface characterization by SEM showed a very homogeneous surface with uniform irregularities for Gexp and a small amount of residues of the blasting procedure, while Gcon presented a surface with minimal irregularities from the machining tools. Wettability test showed decreased contact angle for the Gcon relative to the Gexp. The Gexp removal torque at 30 and 60 days was 28.7%, and 33.2% higher relative to the Gcon, respectively. Blasting the surface with particles of TiO2 represents an adequate option for the surface treatment of dental implants, with minimal risk of contamination by the residual debris from the blasting procedure.

  15. Peri-implant soft tissue colour around titanium and zirconia abutments: a prospective randomized controlled clinical study.

    Science.gov (United States)

    Cosgarea, Raluca; Gasparik, Cristina; Dudea, Diana; Culic, Bogdan; Dannewitz, Bettina; Sculean, Anton

    2015-05-01

    To objectively determine the difference in colour between the peri-implant soft tissue at titanium and zirconia abutments. Eleven patients, each with two contralaterally inserted osteointegrated dental implants, were included in this study. The implants were restored either with titanium abutments and porcelain-fused-to-metal crowns, or with zirconia abutments and ceramic crowns. Prior and after crown cementation, multi-spectral images of the peri-implant soft tissues and the gingiva of the neighbouring teeth were taken with a colorimeter. The colour parameters L*, a*, b*, c* and the colour differences ΔE were calculated. Descriptive statistics, including non-parametric tests and correlation coefficients, were used for statistical analyses of the data. Compared to the gingiva of the neighbouring teeth, the peri-implant soft tissue around titanium and zirconia (test group), showed distinguishable ΔE both before and after crown cementation. Colour differences around titanium were statistically significant different (P = 0.01) only at 1 mm prior to crown cementation compared to zirconia. Compared to the gingiva of the neighbouring teeth, statistically significant (P crown cementation for both abutments; more significant differences were registered for titanium abutments. Tissue thickness correlated positively with c*-values for titanium at 1 mm and 2 mm from the gingival margin. Within their limits, the present data indicate that: (i) The peri-implant soft tissue around titanium and zirconia showed colour differences when compared to the soft tissue around natural teeth, and (ii) the peri-implant soft tissue around zirconia demonstrated a better colour match to the soft tissue at natural teeth than titanium. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Pulsed Laser Deposition Processing of Improved Titanium Nitride Coatings for Implant Applications

    Science.gov (United States)

    Haywood, Talisha M.

    Recently surface coating technology has attracted considerable attention of researchers to develop novel coatings with enhanced functional properties such as hardness, biocompatibility, wear and corrosion resistance for medical devices and surgical tools. The materials currently being used for surgical implants include predominantly stainless steel (316L), cobalt chromium (Co-Cr), titanium and its alloys. Some of the limitations of these implants include improper mechanical properties, corrosion resistance, cytotoxicity and bonding with bone. One of the ways to improve the performance and biocompatibility of these implants is to coat their surfaces with biocompatible materials. Among the various coating materials, titanium nitride (TiN) shows excellent mechanical properties, corrosion resistance and low cytotoxicity. In the present work, a systematic study of pulsed laser ablation processing of TiN coatings was conducted. TiN thin film coatings were grown on commercially pure titanium (Ti) and stainless steel (316L) substrates at different substrate temperatures and different nitrogen partial pressures using the pulsed laser deposition (PLD) technique. Microstructural, surface, mechanical, chemical, corrosion and biological analysis techniques were applied to characterize the TiN thin film coatings. The PLD processed TiN thin film coatings showed improvements in mechanical strength, corrosion resistance and biocompatibility when compared to the bare substrates. The enhanced performance properties of the TiN thin film coatings were a result of the changing and varying of the deposition parameters.

  17. Controlled release of vanadium from titanium oxide coatings for improved integration of soft tissue implants.

    Science.gov (United States)

    Jarrell, John D; Dolly, Brandon; Morgan, Jeffrey R

    2009-07-01

    This study evaluates the potential of titanium oxide coatings for short-term delivery of vanadium for improved wound healing around implants. Titanium and vanadium oxides are bioactive agents that elicit different bioresponses in cells, ranging from implant integration and reduction of inflammation to modulation of cell proliferation and morphology. These oxides were combined in biomaterial coatings using metal-organic precursors and rapidly screened in cell-culture microplates to establish how vanadium-loading influences cell proliferation and morphology. Twenty-eight-day elution studies indicated that there was a controlled release of vanadium from stable titanium oxide matrices. Elution profiles were mathematically modeled for vanadium loading of 20-1.25% up to a period of 28 days. Scanning electron microscopy and energy dispersive spectroscopy of the coatings indicated that the vanadium was present as a nanoscale dispersion and not segregated micron-scale islands. The study confirmed that the observed bioresponse of cells was modulated by the soluble release of vanadium into the surrounding medium. Controlled release of vanadium from titania coatings may be used to influence soft-tissue integration of implants by modulating cell proliferation, attachment, inflammation, and wound healing dynamics.

  18. Enhanced osseointegration of titanium implants in a rat model of osteoporosis using multilayer bone mesenchymal stem cell sheets

    Science.gov (United States)

    Duan, Yan; Ma, Wei; Li, Dehua; Wang, Tongfei; Liu, Baolin

    2017-01-01

    The present study aimed to investigate whether bone marrow-derived mesenchymal stem cell (BMSC) sheets combined with titanium implants enhanced implant osseointegration in an ovariectomized (OVX) rat model of osteoporosis. Sprague-Dawley rats were randomly assigned into a test group and control group. Allogenic BMSCs were collected from the rats, cultured and stored via cryopreservation. At 6 months post-ovariectomy, establishment of the OVX model was confirmed by micro-computed tomography (CT) measurements. BMSC sheets were subsequently layered and wrapped over titanium implants for implantation. Unmodified implants served as the control. At 8 weeks post-implantation, samples were observed by micro-CT reconstruction and histomorphometric evaluation. Micro-CT reconstruction identified a marked improvement in the surrounding bone volume following treatment, with data analyses indicating a significant increase in bone volume in the BMSC-implant group compared with the control implant group (Pimplant contact surrounding the BMSC-implant constructs. These results indicate that the use of BMSC sheets as a novel tissue engineering approach improves the osseointegration of titanium implants in an osteoporosis model. This method may expand the operative indications in patients with osteoporosis and improve the success rate of clinical dental implant treatments. PMID:29250137

  19. Fracture strength of zirconia implant abutments on narrow diameter implants with internal and external implant abutment connections: A study on the titanium resin base concept.

    Science.gov (United States)

    Sailer, Irena; Asgeirsson, Asgeir G; Thoma, Daniel S; Fehmer, Vincent; Aspelund, Thor; Özcan, Mutlu; Pjetursson, Bjarni E

    2018-03-11

    There is limited knowledge regarding the strength of zirconia abutments with internal and external implant abutment connections and zirconia abutments supported by a titanium resin base (Variobase, Straumann) for narrow diameter implants. To compare the fracture strength of narrow diameter abutments with different types of implant abutment connections after chewing simulation. Hundred and twenty identical customized abutments with different materials and implant abutment connections were fabricated for five groups: 1-piece zirconia abutment with internal connection (T1, Cares-abutment-Straumann BL-NC implant, Straumann Switzerland), 1-piece zirconia abutment with external hex connection (T2, Procera abutment-Branemark NP implant, Nobel Biocare, Sweden), 2-piece zirconia abutments with metallic insert for internal connection (T3, Procera abutment-Replace NP implant, Nobel Biocare), 2-piece zirconia abutment on titanium resin base (T4, LavaPlus abutment-VarioBase-Straumann BL-NC implant, 3M ESPE, Germany) and 1-piece titanium abutment with internal connection (C, Cares-abutment-Straumann BL-NC implant, Straumann, Switzerland). All implants had a narrow diameter ranging from 3.3 to 3.5 mm. Sixty un-restored abutments and 60 abutments restored with glass-ceramic crowns were tested. Mean bending moments were compared using ANOVA with p-values adjusted for multiple comparisons using Tukey's procedure. The mean bending moments were 521 ± 33 Ncm (T4), 404 ± 36 Ncm (C), 311 ± 106 Ncm (T1) 265 ± 22 Ncm (T3) and 225 ± 29 (T2) for un-restored abutments and 278 ± 84 Ncm (T4), 302 ± 170 Ncm (C), 190 ± 55 Ncm (T1) 80 ± 102 Ncm (T3) and 125 ± 57 (T2) for restored abutments. For un-restored abutments, C and T4 had similar mean bending moments, significantly higher than those of the three other groups (p < .05). Titanium abutments (C) had significantly higher bending moments than identical zirconia abutments (T1) (p < .05). Zirconia

  20. Bending moments of zirconia and titanium implant abutments supporting all-ceramic crowns after aging.

    Science.gov (United States)

    Mühlemann, Sven; Truninger, Thomas C; Stawarczyk, Bogna; Hämmerle, Christoph H F; Sailer, Irena

    2014-01-01

    To test the fracture load and fracture patterns of zirconia abutments restored with all-ceramic crowns after fatigue loading, exhibiting internal and external implant-abutment connections as compared to restored and internally fixed titanium abutments. A master abutment was used for the customization of 5 groups of zirconia abutments to a similar shape (test). The groups differed according to their implant-abutment connections: one-piece internal connection (BL; Straumann Bonelevel), two-piece internal connection (RS; Nobel Biocare ReplaceSelect), external connection (B; Branemark MkIII), two-piece internal connection (SP, Straumann StandardPlus) and one-piece internal connection (A; Astra Tech AB OsseoSpeed). Titanium abutments with internal implant-abutment connection (T; Straumann Bonelevel) served as control group. In each group, 12 abutments were fabricated, mounted to the respective implants and restored with glass-ceramic crowns. All samples were embedded in acrylic holders (ISO-Norm 14801). After aging by means of thermocycling in a chewing simulator, static load was applied until failure (ISO-Norm 14801). Fracture load was analyzed by calculating the bending moments. Values of all groups were compared with one-way ANOVA followed by Scheffé post hoc test (P-valuecrown occurred in the test groups. In groups BL and A, fractures were located in the internal part of the connection, whereas in groups RS and SP, a partial deformation of the implant components occurred and cracks and fractures of the zirconia abutment were detected. The differently connected zirconia abutments exhibited similar bending moments with the exception of one group. Hence, the type of connection only had a minor effect on the stability of restored zirconia abutments. In general, restored titanium abutments exhibited the highest bending moments. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. The osteoinductive effect of chitosan-collagen composites around pure titanium implant surfaces in rats.

    Science.gov (United States)

    Kung, S; Devlin, H; Fu, E; Ho, K-Y; Liang, S-Y; Hsieh, Y-D

    2011-02-01

    The enhancing effects of chitosan on activation of platelets and differentiation of osteoprogenitor cells have been demonstrated in vitro. The purpose of this study was to evaluate the in vivo osteoinductive effect of chitosan-collagen composites around pure titanium implant surfaces. Chitosan-collagen composites containing chitosan of different molecular weights (450 and 750 kDa) were wrapped onto titanium implants and embedded into the subcutaneous area on the back of 15 Sprague-Dawley rats. The control consisted of implants wrapped with plain collagen type I membranes. Implants and surrounding tissues were retrieved 6 wks after surgery and identified by Alizarin red and Alcian blue whole mount staining. The newly formed structures in the test groups were further analyzed by Toluidine blue and Masson-Goldner trichrome staining, and immunohistochemical staining with osteopontin and alkaline phosphotase. The bone formation parameters of the new bone in the two test groups were measured and compared. New bone formed ectopically in both chitosan-collagen groups, whereas no bone induction occurred in the negative control group. These newly formed bone-like structures were further confirmed by immunohistochemical staining. Comparison of bone parameters of the newly induced bone revealed no statistically significant differences between the 450 and 750 kDa chitosan-collagen groups. Our results demonstrated that chitosan-collagen composites might induce in vivo new bone formation around pure titanium implant surfaces. Different molecular weights of chitosan did not show significantly different effects on the osteoinductive potential of the test materials. © 2010 John Wiley & Sons A/S.

  2. Osseointegration of dental implants in extraction sockets preserved with porous titanium granules - an experimental study.

    Science.gov (United States)

    Verket, Anders; Lyngstadaas, Ståle P; Rønold, Hans J; Wohlfahrt, Johan C

    2014-02-01

    This study investigated osseointegration of dental implants inserted in healed extraction sockets preserved with porous titanium granules (PTG). Three adult female minipigs (Gøttingen minipig; Ellegaard A/S, Dalmose, Denmark) had the mandibular teeth P2, P3 and P4 extracted. The extraction sockets were preserved with metallic PTG (Tigran PTG; Tigran Technologies AB, Malmö, Sweden) n = 12, heat oxidized white porous titanium granules (WPTG) (Tigran PTG White) n = 12 or left empty (sham) n = 6. All sites were covered with collagen membranes (Bio-Gide; Geistlich Pharma, Wolhausen, Switzerland) and allowed 11 weeks of healing before implants (Straumann Bone Level; Straumann, Basel, Switzerland) were inserted. The temperature was measured during preparation of the osteotomies. Resonance frequency analysis (RFA, Osstell; Osstell AB, Gothenburg, Sweden) was performed at implant insertion and at termination. After 6 weeks of submerged implant healing, the pigs were euthanized and jaw segments were excised for microCT and histological analyses. In the temperature and RFA analyses no significant differences were recorded between the test groups. The microCT analysis demonstrated an average bone volume of 61.7% for the PTG group compared to 50.3% for the WPTG group (P = 0.03) and 57.1% for the sham group. Histomorphometry demonstrated an average bone-to-implant contact of 68.2% for the PTG group compared to 36.6% for the WPTG group and 60.9% for the sham group (n.s). Eight out of ten implants demonstrated apical osseous defects in the WPTG group, but similar defects were observed in all groups. PTG preserved extraction sockets demonstrate a similar outcome as the sham control group for all analyses suggesting that this material potentially can be used for extraction socket preservation prior to implant installment. Apical osseous defects were however observed in all groups including the sham group, and a single cause could not be determined. © 2012 John Wiley & Sons A/S.

  3. Chemical and topographic analysis of treated surfaces of five different commercial dental titanium implants

    Directory of Open Access Journals (Sweden)

    Bruno Ramos Chrcanovic

    2012-06-01

    Full Text Available We present a detailed investigation of the surface characteristics of five commercial titanium implants with different surface finishing (double acid etching, anodization and incorporation of Ca/P, acid etching and deposition of Ca/P, hydroxyapatite-blasting, acid etching and Ca/P-blasting produced by five different manufacturers. A set of experimental techniques were employed to study the surface chemical composition and morphology: XPS, XRD, SEM, EDS, and AFM. According to the implat manufacturers, the addition of Ca and P at the implant surface is a main feature of these implants (except the double acid etched implant, which was included for comparative purpose. However, the results showed a great discrepancy on the final amount of these elements on the implant surface, which suggests a different effectiveness of the employed surface finishing methods to fix those elements on the implant surface. Our results show that only the method used by the manufacturer of hydroxyapatite-blasting surface finished implants was efficient to produce a hydroxyapatite coating. This group also showed the highest roughness parameters.

  4. Open magnetic resonance imaging using titanium-zirconium needles: improved accuracy for interstitial brachytherapy implants?

    International Nuclear Information System (INIS)

    Popowski, Youri; Hiltbrand, Emile; Joliat, Dominique; Rouzaud, Michel

    2000-01-01

    Purpose: To evaluate the benefit of using an open magnetic resonance (MR) machine and new MR-compatible needles to improve the accuracy of brachytherapy implants in pelvic tumors. Methods and Materials: The open MR machine, foreseen for interventional procedures, allows direct visualization of the pelvic structures that are to be implanted. For that purpose, we have developed MR- and CT-compatible titanium-zirconium (Ti-Zr) brachytherapy needles that allow implantations to be carried out under the magnetic field. In order to test the technical feasibility of this new approach, stainless steel (SS) and Ti-Zr needles were first compared in a tissue-equivalent phantom. In a second step, two patients implanted with Ti-Zr needles in the brachytherapy operating room were scanned in the open MR machine. In a third phase, four patients were implanted directly under open MR control. Results: The artifacts induced by both materials were significantly different, strongly favoring the Ti-Zr needles. The implantation in both first patients confirmed the excellent quality of the pictures obtained with the needles in vivo and showed suboptimal implant geometry in both patients. In the next 4 patients, the tumor could be punctured with excellent accuracy, and the adjacent structures could be easily avoided. Conclusion: We conclude that open MR using MR-compatible needles is a very promising tool in brachytherapy, especially for pelvic tumors

  5. Characterization and antibacterial performance of ZrCN/amorphous carbon coatings deposited on titanium implants

    Energy Technology Data Exchange (ETDEWEB)

    Lai, Chih-Ho [School of Medicine, China Medical University, Taichung, 404 Taiwan (China); Chang, Yin-Yu, E-mail: yinyu@mail2000.com.tw [Department of Mechanical and Computer-Aided Engineering, National Formosa University, Yunlin, Taiwan (China); Huang, Heng-Li [School of Dentistry, China Medical University, Taichung, Taiwan (China); Kao, Ho-Yi [Department of Materials Science and Engineering, Mingdao University, Changhua, Taiwan (China)

    2011-12-30

    Titanium (Ti)-based materials have been used for dental/orthopedic implants due to their excellent biological compatibility, superior mechanical strength and high corrosion resistance. The osseointegration of Ti implants is related to their composition and surface treatment. Better biocompatibility and anti-bacterial performances of Ti implant are beneficial for the osseointegration and for avoiding the infection after implantation surgery. In this study, nanocomposite ZrCN/amorphous carbon (a-C) coatings with different carbon contents were deposited on a bio-grade pure Ti implant material. A cathodic-arc evaporation system with plasma enhanced duct equipment was used for the deposition of ZrCN/a-C coatings. Reactive gas (N{sub 2}) and C{sub 2}H{sub 2} activated by the zirconium plasma in the evaporation process were used to deposit the ZrCN/a-C coatings. To verify the susceptibility of implant surface to bacterial adhesion, Actinobacillus actinomycetemcomitans (A. actinomycetemcomitans), one of the major pathogen frequently found in the dental implant-associated infections, was chosen for in vitro anti-bacterial analyses. In addition, the biocompatibility of human gingival fibroblast (HGF) cells on coatings was also evaluated by a cell proliferation assay. The results suggested that the ZrCN/a-C coatings with carbon content higher than 12.7 at.% can improve antibacterial performance with excellent HGF cell compatibility as well.

  6. Characterization and antibacterial performance of ZrCN/amorphous carbon coatings deposited on titanium implants

    International Nuclear Information System (INIS)

    Lai, Chih-Ho; Chang, Yin-Yu; Huang, Heng-Li; Kao, Ho-Yi

    2011-01-01

    Titanium (Ti)-based materials have been used for dental/orthopedic implants due to their excellent biological compatibility, superior mechanical strength and high corrosion resistance. The osseointegration of Ti implants is related to their composition and surface treatment. Better biocompatibility and anti-bacterial performances of Ti implant are beneficial for the osseointegration and for avoiding the infection after implantation surgery. In this study, nanocomposite ZrCN/amorphous carbon (a-C) coatings with different carbon contents were deposited on a bio-grade pure Ti implant material. A cathodic-arc evaporation system with plasma enhanced duct equipment was used for the deposition of ZrCN/a-C coatings. Reactive gas (N 2 ) and C 2 H 2 activated by the zirconium plasma in the evaporation process were used to deposit the ZrCN/a-C coatings. To verify the susceptibility of implant surface to bacterial adhesion, Actinobacillus actinomycetemcomitans (A. actinomycetemcomitans), one of the major pathogen frequently found in the dental implant-associated infections, was chosen for in vitro anti-bacterial analyses. In addition, the biocompatibility of human gingival fibroblast (HGF) cells on coatings was also evaluated by a cell proliferation assay. The results suggested that the ZrCN/a-C coatings with carbon content higher than 12.7 at.% can improve antibacterial performance with excellent HGF cell compatibility as well.

  7. Titanium nitride deposition in titanium implant alloys produced by powder metallurgy

    International Nuclear Information System (INIS)

    Henriques, V.A.R.; Cairo, C.A.A.; Faria, J.; Lemos, T.G.; Galvani, E.T.

    2009-01-01

    Titanium nitride (TiN) is an extremely hard material, often used as a coating on titanium alloy, steel, carbide, and aluminum components to improve wear resistance. Electron Beam Physical Vapor Deposition (EB-PVD) is a form of deposition in which a target anode is bombarded with an electron beam given off by a charged tungsten filament under high vacuum, producing a thin film in a substrate. In this work are presented results of TiN deposition in targets and substrates of Ti (C.P.) and Ti- 13 Nb- 13 Zr obtained by powder metallurgy. Samples were produced by mixing of hydride metallic powders followed by uniaxial and cold isostatic pressing with subsequent densification by sintering between 900°C up to 1400 °C, in vacuum. The deposition was carried out under nitrogen atmosphere. Sintered samples were characterized for phase composition, microstructure and microhardness by X-ray diffraction, scanning electron microscopy and Vickers indentation, respectively. It was shown that the samples were sintered to high densities and presented homogeneous microstructure, with ideal characteristics for an adequate deposition and adherence. The film layer presented a continuous structure with 15μm. (author)

  8. Mechanical failure of hydroxyapatite-coated titanium and cobalt-chromium-molybdenum alloy implants. An animal study

    DEFF Research Database (Denmark)

    Nimb, L; Gotfredsen, K; Steen Jensen, J

    1993-01-01

    a histological and biomechanical evaluation of HA-coated titanium and cobalt-chromium-molybdenum alloy implants in a non-weight-bearing model. Twelve cylindrical plugs were inserted into the medial femoral condyle on 6 mongrel dogs. HA-coatings of 80-120 microns thickness were applied to 6 Cr-Co-Mo implants...

  9. A 5-year prospective multicenter study of early loaded titanium implants with a sandblasted and acid-etched surface

    NARCIS (Netherlands)

    Cochran, D.L.; Jackson, J.M.; Bernard, J.P.; ten Bruggenkate, C.M.; Buser, D.; Taylor, T.D.; Weingart, D.; Schoolfield, J.D.; Jones, A.A.; Oates, T.W

    2011-01-01

    PURPOSE: For dental implants to be successful, osseointegration must occur, but it is unknown how much time must pass for osseointegration to be established. Preclinical studies suggested that titanium implants with a sandblasted and acid-etched (SLA) surface were more osteoconductive and allowed

  10. Decisional Conflict in Parents Considering Bone-Anchored Hearing Devices in Children With Unilateral Aural Atresia.

    Science.gov (United States)

    Graham, M Elise; Haworth, Rebecca; Chorney, Jill; Bance, Manohar; Hong, Paul

    2015-12-01

    The benefits of bone-anchored hearing devices (BAHD) in children with unilateral aural atresia are controversial. We sought to determine whether there is parental decisional conflict surrounding elective placement of BAHD for this indication. Caregivers of pediatric patients with unilateral aural atresia and normal contralateral ear undergoing percutaneous BAHD consultation were enrolled. All consultations were carried out by one pediatric otolaryngologist in a consistent manner. After consultation, the participants completed a demographics form and the Decisional Conflict Scale (DCS) questionnaire. Twenty-three caregivers of 15 male (65.2%) and 8 female (34.8%) children (mean age 5.65 years) participated. The overall median DCS score was 15.63 (standard error = 4.21). Significant decisional conflict (DCS score ≥ 25) was found in 10 participants (43.5%). The median DCS score in the group choosing surgery was 5.47, and it was 23.44 in those who did not choose surgery (Mann-Whitney U = 39, Z = -1.391, P = .164). The median DCS score for mothers and fathers was 25 and 3.91, respectively. Many parents experienced significant decisional conflict when considering percutaneous BAHD surgery in children with unilateral aural atresia in our study population. Future research should explore the impact of decisional conflict on health outcomes. © The Author(s) 2015.

  11. Comparison of two protocols for maxillary protraction: bone anchors versus face mask with rapid maxillary expansion

    Science.gov (United States)

    Cevidanes, Lucia; Baccetti, Tiziano; Franchi, Lorenzo; McNamara, James A.; De Clerck, Hugo

    2010-01-01

    Objective To test the hypothesis that there is no difference in the active treatment effects for maxillary advancement induced by bone-anchored maxillary protraction (BAMP) and the active treatment effects for face mask in association with rapid maxillary expansion (RME/FM). Materials and Methods This is a study on consecutively treated patients. The changes in dentoskeletal cephalometric variables from start of treatment (T1) to end of active treatment (T2) with an average T1–T2 interval of about 1 year were contrasted in a BAMP sample of 21 subjects with a RME/FM sample of 34 patients. All subjects were prepubertal at T1. Statistical comparison was performed with t-tests for independent samples. Results The BAMP protocol produced significantly larger maxillary advancement than the RME/FM therapy (with a difference of 2 mm to 3 mm). Mandibular sagittal changes were similar, while vertical changes were better controlled with BAMP. The sagittal intermaxillary relationships improved 2.5 mm more in the BAMP patients. Additional favorable outcomes of BAMP treatment were the lack of clockwise rotation of the mandible as well as a lack of retroclination of the lower incisors. Conclusions The hypothesis is rejected. The BAMP protocol produced significantly larger maxillary advancement than the RME/FM therapy. PMID:20578848

  12. The bone-anchored hearing aid (BAHA) in children with auricular malformations.

    Science.gov (United States)

    Granström, G; Tjellström, A

    1997-04-01

    A retrospective study was undertaken to evaluate the outcome of the use of the bone-anchored hearing aid (BAHA) in children. All patients included in the study had bilateral auricular malformations. Previous alternatives had been conventional hearing aids or surgical middle ear reconstruction. Thirty-seven patients under 16 years of age were studied. The most common syndrome in the group was Treacher Collins. Sixteen of the patients had earlier middle ear reconstruction, the results of which did not produce social hearing. Of 40 inserted fixtures to anchor the BAHA, three were lost during the follow-up period because of failed osseointegration. Skin reactions were graded according to a clinical scoring system and were determined to be comparable in number and severity to those of an adult population. All patients in the study considered the BAHA to be superior to earlier bone-conduction devices. It is concluded that the BAHA is an excellent alternative to bone-conduction devices in children with auricular malformations. Middle ear surgery can be postponed until adulthood or abandoned, especially in syndromic patients in whom it is known to be difficult and unpredictable.

  13. Bone-anchored hearing aids are effective and associated with a high degree of satisfaction.

    Science.gov (United States)

    Gardell, Ida Sofie Kristina; Andresen, Kathrine; Faber, Christian Emil; Wanscher, Jens Højberg

    2015-07-01

    The objective of this study was to evaluate patients' satisfaction with bone-anchored hearing aids (BAHA). This study was retrospective and based on a postal questionnaire. The study sample consisted of patients undergoing surgery at Odense University Hospital in the 1992-2013-period. The questionnaire was a combination of Satisfaction with Amplification in Daily Life questions from the Hearing Aid Research Lab at the University of Memphis and questions used in a previous Danish study. We also used data from each patient's medical records. All information was collected in a database. The response rate was 80% and the user percentage 88. The majority of the patients used their BAHA seven days a week and most of the day. 88% reported that it was in their best interest that they had received a BAHA. 80% of the respondents were able to communicate better using their BAHA in one-on-one conversations. BAHA is helpful in one-on-one conversations in quiet surroundings. Sound quality in group situations seems to be the main problem associated with BAHA. However, this study showed that BAHA is an effective hearing aid that is associated with a high degree of satisfaction. not relevant. not relevant.

  14. Transcutaneous Bone-anchored Hearing Aids Versus Percutaneous Ones: Multicenter Comparative Clinical Study.

    Science.gov (United States)

    Iseri, Mete; Orhan, Kadir Serkan; Tuncer, Ulku; Kara, Ahmet; Durgut, Merve; Guldiken, Yahya; Surmelioglu, Ozgur

    2015-06-01

    The aim of this study is to compare the clinical audiological outcomes as well as patient satisfaction of bone-anchored, hearing aid surgery between the percutaneous Dermalock and the transcutaneous Attract systems. This is a multicenter, retrospective clinical study. The patients who underwent Baha Dermalock and Baha Attract surgery were analyzed for hearing results, surgical complications, and postoperative follow-up specifications for both systems. Speech reception thresholds and bone conduction thresholds with and without aided conditions were evaluated. Patient satisfactions were also determined for both groups by Glasgow Benefit Inventory questionnaire. Both of the groups had some minor complications such as skin irritations around the abutment and skin erythema over the magnet. Both of the groups benefit from the devices audiologically; however, when the groups were compared, better results were observed in the percutaneous, bone-conduction group. We can confirm that both transcutaneous and percutaneous techniques are effective in the rehabilitation of conductive hearing loss when conventional hearing aids cannot be used. However, both of the systems have some advantages and limitations in terms of audiological and surgical perspectives.

  15. Adult bone anchored hearing aid services in the United Kingdom: building a consensus for development.

    Science.gov (United States)

    Hill, Penny; Norman, Gary; Davison, Tom; Andrew, Rachel; Shanks, Mary; Johnson, Ian; Burrell, Stuart; Reid, Andrew; Archbold, Sue

    2012-11-01

    In October 2009, a multi-disciplinary group of UK clinicians met to review issues relating to bone-anchored hearing-aid (BAHA) development. The aim was to help define a model for BAHA services and service development via a process of widespread consultation with UK BAHA professionals. A modified Delphi technique was used. Statements were proposed by the lead group and sent out for consultation. Those with ≥90% agreement were approved without further discussion. Statements with 50-89% agreement were discussed by the lead group to determine whether they should be included in the final document. Any statement with 75% agreement, with only six statements having <90% agreement. When these statements were presented to the UK BAHA Professionals group at their annual conference there was 89% agreement from the group for the consensus statements to be accepted. The levels of agreement for the final questionnaire show that the mandate for the consensus statements was exceptionally high. Implementation of the consensus is discussed, as are each of the key areas of the consensus, such as funding and minimum assessment standards.

  16. In vivo bioactivity of titanium and fluorinated apatite coatings for orthopaedic implants: a vibrational study

    Science.gov (United States)

    Taddei, Paola; Tinti, Anna; Reggiani, Matteo; Monti, Patrizia; Fagnano, Concezio

    2003-06-01

    The bone integration of implants is a complex process which depends on chemical composition and surface morphology. To accelerate osteointegration, metal implants are coated with porous metal or apatites which have been reported to increase mineralisation, improving prosthesis fixation. To study the influence of composition and morphology on the in vivo bioactivity, titanium screws coated by Plasma Flame Spraying (PFS) with titanium or fluorinated apatite (K690) were implanted in sheep tibia and femur for 10 weeks and studied by micro-Raman and IR spectroscopy. The same techniques, together with thermogravimetry, were used for characterising the pre-coating K690 powder. Contrary to the manufacturer report, the K690 pre-coating revealed to be composed of a partially fluorinated apatite containing impurities of Ca(OH) 2 and CaCO 3. By effect of PFS, the impurities were decomposed and the crystallinity degree of the coating was found to decrease. The vibrational spectra recorded on the implanted screws revealed the presence of newly formed bone; for the K690-coated screws at least, a high level of osteointegration was evidenced.

  17. Torque Analysis of a Triple Acid-Etched Titanium Implant Surface

    Science.gov (United States)

    Pontes, Ana Emília Farias; de Toledo, Cássio Torres; Garcia, Valdir Gouveia; Ribeiro, Fernando Salimon; Sakakura, Celso Eduardo

    2015-01-01

    The present study aimed to evaluate the removal torque of titanium implants treated with triple acid etching. Twenty-one rats were used in this study. For all animals, the tibia was prepared with a 2 mm drill, and a titanium implant (2 × 4 mm) was inserted after treatment using the subtraction method of triple acid etching. The flaps were sutured. Seven animals were killed 14, 28, and 63 days after implant installation, and the load necessary for removing the implant from the bone was evaluated by using a torque meter. The torque values were as follows: 3.3 ± 1.7 Ncm (14 days), 2.2 ± 1.3 Ncm (28 days), and 6.7 ± 1.4 Ncm (63 days). The torque value at the final healing period (63 days) was statistically significantly different from that at other time points tested (ANOVA, p = 0.0002). This preliminary study revealed that treatment with triple acid etching can create a promising and efficient surface for the process of osseointegration. PMID:26543898

  18. Bone Morphogenetic Protein Coating on Titanium Implant Surface: a Systematic Review

    Directory of Open Access Journals (Sweden)

    Haim Haimov

    2017-06-01

    Full Text Available Objectives: The purpose of the study is to systematically review the osseointegration process improvement by bone morphogenetic protein coating on titanium implant surface. Material and Methods: An electronic literature search was conducted through the MEDLINE (PubMed and EMBASE databases. The search was restricted for articles published during the last 10 years from October 2006 to September 2016 and articles were limited to English language. Results: A total of 41 articles were reviewed, and 8 of the most relevant articles that are suitable to the criteria were selected. Articles were analysed regarding concentration of bone morphogenetic protein (BMP, delivery systems, adverse reactions and the influence of the BMP on the bone and peri-implant surface in vivo. Finally, the present data included 340 implants and 236 models. Conclusions: It’s clearly shown from most of the examined studies that bone morphogenetic protein increases bone regeneration. Further studies should be done in order to induce and sustain bone formation activity. Osteogenic agent should be gradually liberated and not rapidly released with priority to three-dimension reservoir (incorporated titanium implant surface in order to avoid following severe side effects: inflammation, bleeding, haematoma, oedema, erythema, and graft failure.

  19. The effect of different cleaning methods on the surface and temperature of failed titanium implants: an in vitro study.

    Science.gov (United States)

    Hakki, Sema S; Tatar, Gulsah; Dundar, Niyazi; Demiralp, Burak

    2017-04-01

    The aims of this in vitro study are to compare the efficacy of different cleaning methods in removing debris of failed implants and to detect thermal changes of the implants treated by various scaling instruments. Twenty-seven failed implants and two unused implants as control were included to this study-group 1: plastic curette (P), group 2: titanium curette (T), group 3: carbon curette (C), group 4: titanium brush (TB), group 5: Er:YAG laser (laser 1 (L1) 100 mJ/pulse at 10 Hz), group 6: Er:YAG laser (laser 2 (L2) 150 mJ/pulse at 10 Hz), group 7: Er:YAG laser (laser 3 (L3) 200 mJ/pulse at 10 Hz), group 8: ultrasonic scaler appropriate for titanium (US), group 9: air abrasive method (AA) + citric acid, and group 10: implantoplasty (I). The changes on the treated/untreated titanium surfaces and remnant debris were observed by scanning electron microscopy (SEM). Temperature of the implants before and after treatment was detected using a thermocouple. The use of air abrasive and citric acid combination and Er:YAG laser groups was found as the best methods for the decontamination of titanium surfaces of failed implant. When the hand instruments were compared, titanium curette was found better than both the plastic and the carbon curettes which leave plastics and carbon remnants on the titanium surface. The temperature was higher after hand instrumentation when compared to other experimental groups (p < 0.05). Within the limitations of the present in vitro model, it can be concluded that the best method for decontamination of the implant surface is the use of air abrasives and Er:YAG laser.

  20. Characterization of Heat Treated Titanium-Based Implants by Nondestructive Eddy Current and Ultrasonic Tests

    Science.gov (United States)

    Mutlu, Ilven; Ekinci, Sinasi; Oktay, Enver

    2014-06-01

    This study presents nondestructive characterization of microstructure and mechanical properties of heat treated Ti, Ti-Cu, and Ti-6Al-4V titanium-based alloys and 17-4 PH stainless steel alloy for biomedical implant applications. Ti, Ti-Cu, and 17-4 PH stainless steel based implants were produced by powder metallurgy. Ti-6Al-4V alloy was investigated as bulk wrought specimens. Effects of sintering temperature, aging, and grain size on mechanical properties were investigated by nondestructive and destructive tests comparatively. Ultrasonic velocity in specimens was measured by using pulse-echo and transmission methods. Electrical conductivity of specimens was determined by eddy current tests. Determination of Young's modulus and strength is important in biomedical implants. Young's modulus of specimens was calculated by using ultrasonic velocities. Calculated Young's modulus values were compared and correlated with experimental values.

  1. Study of the plasma immersion implantation of titanium in stainless steel

    International Nuclear Information System (INIS)

    Nikitenkov, N N; Sutygina, A N; Shulepov, I A; Sivin, D O; Kashkarov, E B

    2015-01-01

    The results of the study of the pulsed plasma-immersion ion implantation of titanium in steel Cr18Ni10Ti depending on the time (dose) implantation are presented. It is shown that the change of the element and the phase composition of the surface layers and their microscopic characteristics and mechanical properties (hardness, wear resistance) depending on the implantation time is not monotonic, but follows to a certain rule. The possibility of interpretation of the obtained results in the thermal spike concept of the generation on the surface by the stable (magic) clusters is discussed. This concept follows logically from the recent studies on the plasma arc composition and from a polyatomic clusters-surface interaction. (paper)

  2. Study of the plasma immersion implantation of titanium in stainless steel

    Science.gov (United States)

    Nikitenkov, N. N.; Sutygina, A. N.; Shulepov, I. A.; Sivin, D. O.; Kashkarov, E. B.

    2015-04-01

    The results of the study of the pulsed plasma-immersion ion implantation of titanium in steel Cr18Ni10Ti depending on the time (dose) implantation are presented. It is shown that the change of the element and the phase composition of the surface layers and their microscopic characteristics and mechanical properties (hardness, wear resistance) depending on the implantation time is not monotonic, but follows to a certain rule. The possibility of interpretation of the obtained results in the thermal spike concept of the generation on the surface by the stable (magic) clusters is discussed. This concept follows logically from the recent studies on the plasma arc composition and from a polyatomic clusters-surface interaction.

  3. Anchorage of titanium implants with different surface characteristics: an experimental study in rabbits

    DEFF Research Database (Denmark)

    Gotfredsen, K; Berglundh, T; Lindhe, J

    2000-01-01

    ) TiO2-blasted with particles of grain size 10 to 53 microns; (3) TiO2-blasted, grain size 63 to 90 microns; (4) TiO2-blasted, grain size 90 to 125 microns; (5) titanium plasma-sprayed (TPS). The surface topography was determined by the use of an optical instrument. Twelve rabbits, divided into two...... groups, had a total of 120 implants inserted in the tibiae. One implant from each of the five surface categories was placed within the left tibia of each rabbit. By a second operation, implants were installed in the right tibia, after 2 weeks in group A and after 3 weeks in group B. Fluorochrome labeling...

  4. Pulsed laser-induced micro-and nanosized morphology and composition of titanium dental implants

    Science.gov (United States)

    Joób-Fancsaly, Á.; Divinyi, T.; Fazekas, Á.; Daroczi, Cs; Karacs, A.; Petõ, G.

    2002-10-01

    The surface morphology of machined screw-shaped titanium dental implants was modified by pulsed irradiation with an Nd glass laser. This method supplied very different surface elements in nanometer and micrometer ranges identified with scanning electron microscopy and atomic force microscopy as well. The surface composition was unchanged during these treatments. A rabbit experiment was carried out to investigate the direct bone contact (osseointegration) which was characterized by the removal torque of the implants. The 50 nm and 10-50 µm sized droplike elements were formed from the machined flat surface by the laser irradiation depending on the laser intensity. The osseointegration was enhanced by the increase of the density of nanosized elements and by the size of the microsized elements, showing the importance of this surface morphology in the direct bone-implant contact.

  5. Microstructural characterization of titanium dental implants by electron microscopy and mechanical tests

    International Nuclear Information System (INIS)

    Helfenstein, B.; Muniz, N.O.; Dedavid, B.A.; Gehrke, S.A.; Vargas, A.L.M.

    2010-01-01

    Mini screw types for titanium implants, with differentiated design, were tested for traction and torsion for behavior analysis of the shape relative to the requirements of ASTM F136. All implants showed mechanical tensile strength above by the standard requirement, being that 83.3% of them broke above the doughnut, in support of the prosthesis. Distinct morphologies in ruptured by mechanical tests, were obtained. However, both fracture surfaces showed fragile comportments. Metallographic tests, x-ray diffraction (XRD) and microhardness were used for microstructural characterization of material, before and after heat treatment. The presences of β phase in screw surface after quenching treatment proves that the thermal treatment can contribute for mechanical resistance in surface implants. (author)

  6. Marginal bone-level alterations of loaded zirconia and titanium dental implants: an experimental study in the dog mandible.

    Science.gov (United States)

    Thoma, Daniel S; Benic, Goran I; Muñoz, Fernando; Kohal, Ralf; Sanz Martin, Ignacio; Cantalapiedra, Antonio G; Hämmerle, Christoph H F; Jung, Ronald E

    2016-04-01

    The aim was to test whether or not the marginal bone-level alterations of loaded zirconia implants are similar to the bone-level alterations of a grade 4 titanium one-piece dental implant. In six dogs, all premolars and the first molars were extracted in the mandible. Four months later, three zirconia implants (BPI, VC, ZD) and a control titanium one-piece (STM) implant were randomly placed in each hemimandible and left for transmucosal healing (baseline). Six months later, CAD/CAM crowns were cemented. Sacrifice was scheduled at 6-month postloading. Digital X-rays were taken at implant placement, crowns insertion, and sacrifice. Marginal bone-level alterations were calculated, and intra- and intergroup comparisons performed adjusted by confounding factors. Implants were successfully placed. Until crown insertion, two implants were fractured (one VC, one ZD). At sacrifice, 5 more implants were (partly) fractured (one BPI, four ZD), and one lost osseointegration (VC). No decementation of crowns occurred. All implant systems demonstrated a statistically significant (except VC) loss of marginal bone between baseline and crown insertion ranging from 0.29 mm (VC; P = 0.116) to 0.80 mm (ZD; P = 0.013). The estimated marginal bone loss between baseline and 6 months of loading ranged between 0.19 mm (BPI) and 1.11 mm (VC), being statistically significant for STM and VC only (P implants and control implants (STM vs. BPI P = 0.007; vs. VC P = 0.001; vs. ZD P = 0.011). Zirconia implants were more prone to fracture prior to and after loading with implant-supported crowns compared to titanium implants. Individual differences and variability in the extent of the bone-level changes during the 12-month study period were found between the different implant types and materials. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Repositioning Titanium: An In Vitro Evaluation of Laser-Generated Microporous, Microrough Titanium Templates As a Potential Bridging Interface for Enhanced Osseointegration and Durability of Implants

    Directory of Open Access Journals (Sweden)

    Daniel Tang

    2017-12-01

    Full Text Available Although titanium alloys remain the preferred biomaterials for the manufacture of biomedical implants today, such devices can fail within 15 years of implantation due to inadequate osseointegration. Furthermore, wear debris toxicity due to alloy metal ion release has been found to cause side-effects including neurotoxicity and chronic inflammation. Titanium, with its known biocompatibility, corrosion resistance, and high elastic modulus, could if harnessed in the form of a superficial scaffold or bridging device, resolve such issues. A novel three-dimensional culture approach was used to investigate the potential osteoinductive and osseointegrative capabilities of a laser-generated microporous, microrough medical grade IV titanium template on human skeletal stem cells (SSCs. Human SSCs seeded on a rough 90-µm pore surface of ethylene oxide-sterilized templates were observed to be strongly adherent, and to display early osteogenic differentiation, despite their inverted culture in basal conditions over 21 days. Limited cellular migration across the template surface highlighted the importance of high surface wettability in maximizing cell adhesion, spreading and cell-biomaterial interaction, while restricted cell ingrowth within the conical-shaped pores underlined the crucial role of pore geometry and size in determining the extent of osseointegration of an implant device. The overall findings indicate that titanium only devices, with appropriate optimizations to porosity and surface wettability, could yet play a major role in improving the long-term efficacy, durability, and safety of future implant technology.

  8. Effect of pore size on bone ingrowth into porous titanium implants fabricated by additive manufacturing: An in vivo experiment

    Energy Technology Data Exchange (ETDEWEB)

    Taniguchi, Naoya, E-mail: tani110@kuhp.kyoto-u.ac.jp [Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo, Kyoto 606-8507 (Japan); Fujibayashi, Shunsuke, E-mail: shfuji@kuhp.kyoto-u.ac.jp [Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo, Kyoto 606-8507 (Japan); Takemoto, Mitsuru, E-mail: m.take@kuhp.kyoto-u.ac.jp [Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo, Kyoto 606-8507 (Japan); Sasaki, Kiyoyuki, E-mail: kiy-sasaki@spcom.co.jp [Sagawa Printing Co., Ltd., 5-3, Inui, Morimoto-Cho, Mukou-Shi, Kyoto 617-8588 (Japan); Otsuki, Bungo, E-mail: bungo@kuhp.kyoto-u.ac.jp [Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo, Kyoto 606-8507 (Japan); Nakamura, Takashi, E-mail: ntaka@kuhp.kyoto-u.ac.jp [National Hospital Organization Kyoto Medical Center, 1-1, Mukaihatacho, Hukakusa, Hushimi, Kyoto 612-8555 (Japan); Matsushita, Tomiharu, E-mail: matsushi@isc.chubu.ac.jp [Department of Biomedical Sciences, College of Life and Health Sciences, Chubu University, 1200 Matsumoto-cho, Kasugai, Aichi 487-8501 (Japan); Kokubo, Tadashi, E-mail: kokubo@isc.chubu.ac.jp [Department of Biomedical Sciences, College of Life and Health Sciences, Chubu University, 1200 Matsumoto-cho, Kasugai, Aichi 487-8501 (Japan); Matsuda, Shuichi, E-mail: smat522@kuhp.kyoto-u.ac.jp [Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo, Kyoto 606-8507 (Japan)

    2016-02-01

    Selective laser melting (SLM) is an additive manufacturing technique with the ability to produce metallic scaffolds with accurately controlled pore size, porosity, and interconnectivity for orthopedic applications. However, the optimal pore structure of porous titanium manufactured by SLM remains unclear. In this study, we evaluated the effect of pore size with constant porosity on in vivo bone ingrowth in rabbits into porous titanium implants manufactured by SLM. Three porous titanium implants (with an intended porosity of 65% and pore sizes of 300, 600, and 900 μm, designated the P300, P600, and P900 implants, respectively) were manufactured by SLM. A diamond lattice was adapted as the basic structure. Their porous structures were evaluated and verified using microfocus X-ray computed tomography. Their bone–implant fixation ability was evaluated by their implantation as porous-surfaced titanium plates into the cortical bone of the rabbit tibia. Bone ingrowth was evaluated by their implantation as cylindrical porous titanium implants into the cancellous bone of the rabbit femur for 2, 4, and 8 weeks. The average pore sizes of the P300, P600, and P900 implants were 309, 632, and 956 μm, respectively. The P600 implant demonstrated a significantly higher fixation ability at 2 weeks than the other implants. After 4 weeks, all models had sufficiently high fixation ability in a detaching test. Bone ingrowth into the P300 implant was lower than into the other implants at 4 weeks. Because of its appropriate mechanical strength, high fixation ability, and rapid bone ingrowth, our results indicate that the pore structure of the P600 implant is a suitable porous structure for orthopedic implants manufactured by SLM. - Highlights: • We studied the effect of pore size on bone tissue in-growth in a rabbit in vivo model. • Titanium samples with 300/600/900 μm pore size in three-dimensionally controlled shapes were fabricated by additive manufacturing. • Samples were

  9. Stress evaluation of titanium-gold and titanium-aluminum-vanadium alloy for orthodontic implants: A comparative finite element model study

    Directory of Open Access Journals (Sweden)

    Chinglembi Nongthombam

    2017-01-01

    Full Text Available Introduction: With the increased popularity of implants, orthodontists are in search of a better material. Titanium-gold (Ti-Au is a newer material and could be a choice to replace the currently popular titanium-aluminum-vanadium (Ti-6Al-4Va alloy. Materials and Methods: Using the finite element analysis method, three-dimensional computer-aided models of a mini-implant was designed. Two cylindrical bone pieces into which the implant was inserted were used. A force magnitude of 5 N was then horizontally and separately applied to the implant head. Results: Comparison of the maximum von Mises stress in the implants of Ti-6Al-4Va and Ti-Au was done. The maximum stress value of 252.356 and 242.415 Mpa, as well as maximum deformation of 0.025 mm and 0.019 mm, on Ti-6Al-4Va and Ti-Au can be observed, respectively. Conclusion: It was found that the maximum stress and maximum deformation values were lower in Ti-Au as compared to Ti-6Al-4Va implant. As the Ti-Au implant has greater resistance to deformation, it can be concluded that this newer alloy has better strength than Ti-6Al-4Va implant.

  10. A Novel Technique for the Connection of Ceramic and Titanium Implant Components Using Glass Solder Bonding

    Directory of Open Access Journals (Sweden)

    Enrico Mick

    2015-07-01

    Full Text Available Both titanium and ceramic materials provide specific advantages in dental implant technology. However, some problems, like hypersensitivity reactions, corrosion and mechanical failure, have been reported. Therefore, the combining of both materials to take advantage of their pros, while eliminating their respective cons, would be desirable. Hence, we introduced a new technique to bond titanium and ceramic materials by means of a silica-based glass ceramic solder. Cylindrical compound samples (Ø10 mm × 56 mm made of alumina toughened zirconia (ATZ, as well as titanium grade 5, were bonded by glass solder on their end faces. As a control, a two-component adhesive glue was utilized. The samples were investigated without further treatment, after 30 and 90 days of storage in distilled water at room temperature, and after aging. All samples were subjected to quasi-static four-point-bending tests. We found that the glass solder bonding provided significantly higher bending strength than adhesive glue bonding. In contrast to the glued samples, the bending strength of the soldered samples remained unaltered by the storage and aging treatments. Scanning electron microscopy (SEM and energy-dispersive X-ray (EDX analyses confirmed the presence of a stable solder-ceramic interface. Therefore, the glass solder technique represents a promising method for optimizing dental and orthopedic implant bondings.

  11. Titanium niobium nitride knee implants are not inferior to chrome cobalt components for primary total knee arthroplasty.

    Science.gov (United States)

    Thienpont, Emmanuel

    2015-12-01

    Metal allergy in total knee arthroplasty (TKA) is still a controversial topic. Oxinium, ceramic or titanium niobium nitride (TiNbN) coated implants are available for some knee systems. The hypothesis of this study was that the use of TiNbN-coated components would not lead to inferior results compared to conventional implants and that none of the allergic patients receiving TiNbN-coated implants would require revision for metal allergy. This study was a retrospective, 2 to 1 matched pairs study with 40 titanium niobium nitride-coated TKA compared with 80 conventional cobalt chrome implants. No demographic differences between these groups were observed. The mean follow-up for this study was 2 years. No differences in clinical, radiological, or patient-reported outcome measurements were observed between the two groups. No patients have been revised at this short- to medium-term outcome evaluation. Metal allergy leading to contact or systemic dermatitis is especially linked to chrome and cobalt allergy. Nickel allergy because of knee implants rarely gives cutaneous symptoms, but could potentially lead to peri-prosthetic osteolysis and loosening. The use of titanium niobium nitride implants in case of a positive history of metal allergy could avoid this devastating complication. The use of titanium niobium nitride-coated implants for primary knee osteoarthritis shows similar clinical and radiological outcomes as conventional TKA without revision for loosening at short- to medium-term follow-up. Level of evidence Level IV study.

  12. Stoichiometric titanium dioxide ion implantation in AISI 304 stainless steel for corrosion protection

    Science.gov (United States)

    Hartwig, A.; Decker, M.; Klein, O.; Karl, H.

    2015-12-01

    The aim of this study is to evaluate the applicability of highly chemically inert titanium dioxide synthesized by ion beam implantation for corrosion protection of AISI 304 stainless steel in sodium chloride solution. More specifically, the prevention of galvanic corrosion between carbon-fiber reinforced plastic (CFRP) and AISI 304 was investigated. Corrosion performance of TiO2 implanted AISI 304 - examined for different implantation and annealing parameters - is strongly influenced by implantation fluence. Experimental results show that a fluence of 5 × 1016 cm-2 (Ti+) and 1 × 1017 cm-2 (O+) is sufficient to prevent pitting corrosion significantly, while galvanic corrosion with CFRP can already be noticeably reduced by an implantation fluence of 5 × 1015 cm-2 (Ti+) and 1 × 1016 cm-2 (O+). Surface roughness, implantation energy and annealing at 200 °C and 400 °C show only little influence on the corrosion behavior. TEM analysis indicates the existence of stoichiometric TiO2 inside the steel matrix for medium fluences and the formation of a separated metal oxide layer for high fluences.

  13. Stoichiometric titanium dioxide ion implantation in AISI 304 stainless steel for corrosion protection

    International Nuclear Information System (INIS)

    Hartwig, A.; Decker, M.; Klein, O.; Karl, H.

    2015-01-01

    The aim of this study is to evaluate the applicability of highly chemically inert titanium dioxide synthesized by ion beam implantation for corrosion protection of AISI 304 stainless steel in sodium chloride solution. More specifically, the prevention of galvanic corrosion between carbon-fiber reinforced plastic (CFRP) and AISI 304 was investigated. Corrosion performance of TiO 2 implanted AISI 304 – examined for different implantation and annealing parameters – is strongly influenced by implantation fluence. Experimental results show that a fluence of 5 × 10 16 cm −2 (Ti + ) and 1 × 10 17 cm −2 (O + ) is sufficient to prevent pitting corrosion significantly, while galvanic corrosion with CFRP can already be noticeably reduced by an implantation fluence of 5 × 10 15 cm −2 (Ti + ) and 1 × 10 16 cm −2 (O + ). Surface roughness, implantation energy and annealing at 200 °C and 400 °C show only little influence on the corrosion behavior. TEM analysis indicates the existence of stoichiometric TiO 2 inside the steel matrix for medium fluences and the formation of a separated metal oxide layer for high fluences.

  14. Comparison of the use of silastic with titanium prefabricated implant in type I thyroplasty.

    Science.gov (United States)

    Malik, Akshat; Ramalingam, W V B S; Nilakantan, Ajith; Nair, Satish; Ramesh, A V; Raj, Poonam

    2014-04-01

    Type I thyroplasty is the treatment of choice for unilateral vocal cord palsy with no spontaneous recovery. To compare the use of silastic implant with titanium vocal fold medializing implant (TVFMI®) in type I thyroplasty for unilateral vocal cord palsy with respect to subjective and objective improvement in voice, endoscopic changes in vocal cords, surgical time, and cost effectiveness. This was a prospective study conducted on 40 patients with unilateral vocal cord paralysis who underwent type I thyroplasty with either silastic implant or TVFMI®. Pre-operative and four-week post-operative assessment and statistical comparison were performed by videolaryngoscopy, stroboscopy, perceptual assessment (GRBAS), subjective (voice handicap index) analysis of voice, and computer-assisted acoustic and electroglottographic assessment. The duration of surgery and cost of implant were also recorded. Although both implants showed improvement in quality of voice following thyroplasty, TVFMI® presents slightly better results in objective voice analysis. The surgery time for TVFMI®insertion was shorter, but the costs were higher. TVFMI® may be preferred for medialization thyroplasty as it presents better voice results and demands less surgical time; however, it is costlier than silastic implant.

  15. Stoichiometric titanium dioxide ion implantation in AISI 304 stainless steel for corrosion protection

    Energy Technology Data Exchange (ETDEWEB)

    Hartwig, A.; Decker, M.; Klein, O.; Karl, H., E-mail: helmut.karl@physik.uni-augsburg.de

    2015-12-15

    The aim of this study is to evaluate the applicability of highly chemically inert titanium dioxide synthesized by ion beam implantation for corrosion protection of AISI 304 stainless steel in sodium chloride solution. More specifically, the prevention of galvanic corrosion between carbon-fiber reinforced plastic (CFRP) and AISI 304 was investigated. Corrosion performance of TiO{sub 2} implanted AISI 304 – examined for different implantation and annealing parameters – is strongly influenced by implantation fluence. Experimental results show that a fluence of 5 × 10{sup 16} cm{sup −2} (Ti{sup +}) and 1 × 10{sup 17} cm{sup −2} (O{sup +}) is sufficient to prevent pitting corrosion significantly, while galvanic corrosion with CFRP can already be noticeably reduced by an implantation fluence of 5 × 10{sup 15} cm{sup −2} (Ti{sup +}) and 1 × 10{sup 16} cm{sup −2} (O{sup +}). Surface roughness, implantation energy and annealing at 200 °C and 400 °C show only little influence on the corrosion behavior. TEM analysis indicates the existence of stoichiometric TiO{sub 2} inside the steel matrix for medium fluences and the formation of a separated metal oxide layer for high fluences.

  16. Hierarchical tailoring of strut architecture to control permeability of additive manufactured titanium implants

    International Nuclear Information System (INIS)

    Zhang, Z.; Jones, D.; Yue, S.; Lee, P.D.; Jones, J.R.; Sutcliffe, C.J.; Jones, E.

    2013-01-01

    Porous titanium implants are a common choice for bone augmentation. Implants for spinal fusion and repair of non-union fractures must encourage blood flow after implantation so that there is sufficient cell migration, nutrient and growth factor transport to stimulate bone ingrowth. Additive manufacturing techniques allow a large number of pore network designs. This study investigates how the design factors offered by selective laser melting technique can be used to alter the implant architecture on multiple length scales to control and even tailor the flow. Permeability is a convenient parameter that characterises flow, correlating to structure openness (interconnectivity and pore window size), tortuosity and hence flow shear rates. Using experimentally validated computational simulations, we demonstrate how additive manufacturing can be used to tailor implant properties by controlling surface roughness at a microstructual level (microns), and by altering the strut ordering and density at a mesoscopic level (millimetre). Highlights: • Experimentally validated permeability prediction tools for hierarchical implants. • Randomised structures form preferential flow channels with stronger shear flows. • Hierarchical strut structures allow independent tailoring of flow and pore size

  17. Understanding long-term silver release from surface modified porous titanium implants.

    Science.gov (United States)

    Shivaram, Anish; Bose, Susmita; Bandyopadhyay, Amit

    2017-08-01

    Prevention of orthopedic device related infection (ODRI) using antibiotics has met with limited amount of success and is still a big concern during post-surgery. As an alternative, use of silver as an antibiotic treatment to prevent surgical infections is being used due to the well-established antimicrobial properties of silver. However, in most cases silver is used in particulate form with wound dressings or with short-term devices such as catheters but not with load-bearing implants. We hypothesize that strongly adherent silver to load-bearing implants can offer longer term solution to infection in vivo. Keeping that in mind, the focus of this study was to understand the long term release study of silver ions for a period of minimum 6months from silver coated surface modified porous titanium implants. Implants were fabricated using a LENS™ system, a powder based additive manufacturing technique, with at least 25% volume porosity, with and without TiO 2 nanotubes in phosphate buffer saline (pH 7.4) to see if the total release of silver ions is within the toxic limit for human cells. Considering the fact that infection sites may reduce the local pH, silver release was also studied in acetate buffer (pH 5.0) for a period of 4weeks. Along with that, the osseointegrative properties as well as cytotoxicity of porous titanium implants were assessed in vivo for a period of 12weeks using a rat distal femur model. In vivo results indicate that porous titanium implants with silver coating show comparable, if not better, biocompatibility and bonding at the bone-implant interface negating any concerns related to toxicity related to silver to normal cells. The current research is based on our recently patented technology, however focused on understanding longer-term silver release to mitigate infection related problems in load-bearing implants that can even arise several months after the surgery. Prevention of orthopedic device related infection using antibiotics has met

  18. FTIR absorption reflection study of biomimetic growth of phosphates on titanium implants

    Science.gov (United States)

    Stoch, A.; Jastrzębski, W.; Brożek, A.; Stoch, J.; Szaraniec, J.; Trybalska, B.; Kmita, G.

    2000-11-01

    Titanium has been used for many medical applications; however, its joining to a living bone still is not satisfactorily good, challenging appropriate investigations. The aim of this work was to generate chemical modifications at its surface such that in vivo conditions, heterogeneous nucleation, and then growth of apatite from the body fluid could be easily induced and successfully performed. For this purpose, on the titanium samples, the oxide sublayers containing titanium, calcium and silicon (TCS) were deposited from a suitable solution using the sol-gel deep-coating procedure. Dried samples were heated at 400°C then cooled and thermostatically held in synthetic body fluids (SBF, SBFIII) under physiological conditions to mimic the natural process of apatite formation. Changes in surface composition of TCS sublayers caused by the heating were studied with XPS. Infrared spectroscopy and scanning electron microscopy monitored successive steps of apatite growth. It was found that in SBF, at the precoated titanium surface, nucleation and growth of the apatite containing carbonate took place. In SBFIII, for a higher concentration of calcium ions in comparison with SBF, a much-enhanced growth of the apatite free of carbonate was observed. TCS precoatings applied on stainless steel and Cr-Co-Mo alloy (Micromed) act also as bioactive interfaces with high ability to nucleation of biologically equivalent apatite. Biomimetic formation of this apatite on biologically inactive materials can be an important step in implant surgery.

  19. Characterization and quantification of oxides generated by anodization on titanium for implantation purposes

    Science.gov (United States)

    Aloia Games, L.; Pastore, J.; Bouchet, A.; Ballarre, J.

    2011-12-01

    The use of titanium as implant material is widely known in the surgery field. The formation of natural or artificial compact and protective oxide is a convenient tool for metal protection and a good way to generate phosphate deposits to enhance biocompatibility and bone fixation with the existing tissue. The present work has the aim of superficially modify commercially pure titanium sheets used in orthopedics and odontology, with a potencistatic anodization process with an ammonium phosphate and ammonium fluoride solution as electrolyte. The objective is to generate titanium oxides doped with phosphorous on the surface, to promote bioactivity. The characterization and quantification of the generated deposits is presented as a starting point for the future application of these materials. The applied characterization methods are X ray diffraction, micro-Raman spectroscopy analysis for evaluating the chemical and phase composition on the modified surface and PDI image analysis techniques that allow the segmentation of SEM images and the measurement and quantification of the oxides generated by the anodization process. The samples with polished treated surface at 30V have the deposit of a phosphate rich thick layer covering almost all the surface and spherical-shaped titanium oxide crystals randomly placed (covering more than 20% of the surface area).

  20. Characterization and quantification of oxides generated by anodization on titanium for implantation purposes

    International Nuclear Information System (INIS)

    Games, L Aloia; Ballarre, J; Pastore, J; Bouchet, A

    2011-01-01

    The use of titanium as implant material is widely known in the surgery field. The formation of natural or artificial compact and protective oxide is a convenient tool for metal protection and a good way to generate phosphate deposits to enhance biocompatibility and bone fixation with the existing tissue. The present work has the aim of superficially modify commercially pure titanium sheets used in orthopedics and odontology, with a potencistatic anodization process with an ammonium phosphate and ammonium fluoride solution as electrolyte. The objective is to generate titanium oxides doped with phosphorous on the surface, to promote bioactivity. The characterization and quantification of the generated deposits is presented as a starting point for the future application of these materials. The applied characterization methods are X ray diffraction, micro-Raman spectroscopy analysis for evaluating the chemical and phase composition on the modified surface and PDI image analysis techniques that allow the segmentation of SEM images and the measurement and quantification of the oxides generated by the anodization process. The samples with polished treated surface at 30V have the deposit of a phosphate rich thick layer covering almost all the surface and spherical-shaped titanium oxide crystals randomly placed (covering more than 20% of the surface area).

  1. Digital processing technology for bone-anchored hearing aids: randomised comparison of two devices in hearing aid users with mixed or conductive hearing loss.

    Science.gov (United States)

    Hill-Feltham, P; Roberts, S A; Gladdis, R

    2014-02-01

    This study compared the performance of two new bone-anchored hearing aids with older bone-anchored hearing aids that were not fully digital. Fourteen experienced bone-anchored hearing aid users participated in this cross-over study. Performance of their existing bone-anchored hearing aid was assessed using speech-in-noise testing and questionnaires. Participants were then fitted with either a Ponto Pro or a BP100 device. After four weeks of use with each new device, the same assessments were repeated. Speech-in-noise testing for the 50 per cent signal-to-noise ratio (the ratio at which 50 per cent of responses were correct) showed no significant differences between the Ponto Pro and the BP100 devices (p = 0.1) However, both devices showed significant improvement compared with the participants' previous bone-anchored hearing aid devices (p bone-anchored hearing aids demonstrated superior speech processing compared with the previous generation of devices. There were no substantial differences between the two digital devices in either objective or subjective tests.

  2. Local and systemic changes associated with long-term, percutaneous, static implantation with titanium alloys in rhesus macaques (Macaca mulatta)

    Energy Technology Data Exchange (ETDEWEB)

    Frydman, Galit F.; Marini, Robert P.; Bakthavatchalu, Vasudevan; Biddle, Kathleen; Muthupalani, Sureshkumar; Vanderburg, Charles R.; Lai, Barry; Bendapudi, Pavan K.; Tompkins, Ronald G.; Fox, James G.

    2017-04-01

    Metal alloys are frequently used as implant materials in veterinary medicine. Recent studies suggest that many types of metal alloys may induce both local and systemic inflammatory responses. In this study, 37 rhesus macaques with long-term skull-anchored percutaneous titanium alloy implants (0-14 years duration) were evaluated for changes in their hematology, coagulation and serum chemistry profiles. Negative controls (n=28) did not have implants. All of the implanted animals were on IACUC-approved protocols and were not implanted for the purpose of this study. Animals with implants had significantly higher plasma D-dimer and lower antithrombin III concentrations compared with nonimplanted animals (p-values < 0.05). Additionally, animals with implants had significantly higher globulin, and lower albumin and calcium concentrations compared with nonimplanted animals (p-values < 0.05). Many of these changes were positively correlated with duration of implantation as well as the number of implants. Chronic bacterial infection was observed on the skin around many of the implant sites, and within deeper tissues. Representative histopathology around the implant site of two implanted animals revealed chronic suppurative to pyogranulomatous inflammation extending from the skin to the dura mater. X-ray fluorescence microscopy of tissue biopsies from the implant site of the same two animals revealed significant increases in free metal ions within the tissue, including titanium and iron. Free metal ions persisted in the tissues up to 6 months postexplant. These results suggest that long-term skull-anchored percutaneous titanium alloy implants results in localized inflammation, chronic infection, and leaching of metal ions into local tissues.

  3. Hybrid Titanium/Biodegradable Polymer Implants with an Hierarchical Pore Structure as a Means to Control Selective Cell Movement

    Science.gov (United States)

    Vrana, Nihal Engin; Dupret, Agnès; Coraux, Christelle; Vautier, Dominique; Debry, Christian; Lavalle, Philippe

    2011-01-01

    In order to improve implant success rate, it is important to enhance their responsiveness to the prevailing conditions following implantation. Uncontrolled movement of inflammatory cells and fibroblasts is one of these in vivo problems and the porosity properties of the implant have a strong effect on these. Here, we describe a hybrid system composed of a macroporous titanium structure filled with a microporous biodegradable polymer. This polymer matrix has a distinct porosity gradient to accommodate different cell types (fibroblasts and epithelial cells). The main clinical application of this system will be the prevention of restenosis due to excessive fibroblast migration and proliferation in the case of tracheal implants. Methodology/Principal Findings A microbead-based titanium template was filled with a porous Poly (L-lactic acid) (PLLA) body by freeze-extraction method. A distinct porosity difference was obtained between the inner and outer surfaces of the implant as characterized by image analysis and Mercury porosimetry (9.8±2.2 µm vs. 36.7±11.4 µm, p≤0.05). On top, a thin PLLA film was added to optimize the growth of epithelial cells, which was confirmed by using human respiratory epithelial cells. To check the control of fibroblast movement, PKH26 labeled fibroblasts were seeded onto Titanium and Titanium/PLLA implants. The cell movement was quantified by confocal microscopy: in one week cells moved deeper in Ti samples compared to Ti/PLLA. Conclusions In vitro experiments showed that this new implant is effective for guiding different kind of cells it will contact upon implantation. Overall, this system would enable spatial and temporal control over cell migration by a gradient ranging from macroporosity to nanoporosity within a tracheal implant. Moreover, mechanical properties will be dependent mainly on the titanium frame. This will make it possible to create a polymeric environment which is suitable for cells without the need to meet mechanical

  4. Evaluation in vitro and in vivo of biomimetic hydroxyapatite coated on titanium dental implants

    International Nuclear Information System (INIS)

    Rigo, E.C.S.; Boschi, A.O.; Yoshimoto, M.; Allegrini, S.; Konig, B.; Carbonari, M.J.

    2004-01-01

    Among several materials used as dental implants, metals present relatively high tensile strengths. Although metals are biotolerable, they do not adhere to bone tissues. On the other hand, bioactive ceramics are known to chemically bind to bone tissues, but they are not enough mechanically resistant to tension stresses. To overcome this drawback, biotolerable metals can be coated with bioactive ceramics. Various methods can be employed for coating ceramic layers on metal substrates, among them ion sputtering, plasma spray, sol-gel, electrodeposition and a biomimetic process [E.C.S. Rigo, L.C. Oliveira, L.A. Santos, A.O. Boschi, R.G. Carrodeguas. Implantes metalicos recobertos com hidroxiapatita. Revista de Engenharia Biomedica, vol. 15 (1999), numeros 1-2, 21-29. Rio de Janeiro]. The aim of this work was to study the effect of the substitution of G glass, employed in the conventional biomimetic method during the nucleation stage, by a solution of sodium silicate (SS) on the chemical and morphological characteristics, and the adhesion of biomimetic coatings deposited on Ti implants. The obtained coatings were analyzed by diffuse reflectance FTIR spectroscopy (DRIFT) and scanning electron microscopy (SEM). Titanium implants were immersed in synthetic body fluid (SBF) and SS. All implants were left inside an incubator at 37 deg. C for 7 days, followed by immersion in 1.5 SBF and taken back to the incubator for additional 6 days at 37 deg. C. The 1.5 SBF were refreshed every 2 days. At the end of the treatment, the implants were washed in distilled and deionized water and dried at room temperature. To check the osseointegration, titanium implants coated with biomimetic method were inserted in rabbit's tibia, remaining there for 8 weeks. During the healing period, polyfluorochrome sequential labeling was inoculated in the rabbits to determine the period of bone remodeling. Results from DRIFT and SEM showed that, for all processing variants employed, a HA coating was

  5. The osseointegration behavior of titanium-zirconium implants in ovariectomized rabbits.

    Science.gov (United States)

    Wen, Bo; Zhu, Feng; Li, Zhen; Zhang, Peng; Lin, Xingnan; Dard, Michel

    2014-07-01

    The aim of this study is to compare the osseointegration behavior of titanium (Ti) and titanium-zirconium (TiZr) implants in ovariectomized (OVX) rabbits. Twelve ovariectomized New Zealand rabbits submitted to a hypocalcic diet and 12 sham-aged rabbits were used. After the bone mass loss induction period, TiZr or Ti implants both benefiting from a SLActive surface treatment were randomly inserted in the tibia and femur of each animal. The total of 24 rabbits were divided in four groups (n = 6): SHAM + Ti, OVX + Ti, SHAM + TiZr,OVX + TiZr. The animals were respectively sacrificed 3 and 6 weeks after dental implant placement. Six implants in each group at each time point were subjected to removal torque testing, and the remaining implants were prepared for histomorphometric analysis. At the end of the healing period, all implants were osseointegrated. The removal torque value of the SHAM-TiZr group was significantly higher than those of the SHAM-Ti group (P implants were used. When TiZr implants were inserted, the values reached 60.7 and 76.2 Ncm with a similar group configuration. The BIC and the BA/TA analysis showed an increase between week 3 and 6 in the case of nonovariectomized animals. From week 3 to 6, the BIC went from 37.1 ± 14.3 to 47.7 ± 8.7 for the SHAM + Ti group and from 37.6 ± 10.9 to 50.4 ± 11 for the SHAM + TiZr group. The BIC values were not significantly different between groups. The parameters intended to be representative of the bone morphology (BIC & BATA) did not help to discriminate between Ti and TiZr which appeared to behave similarly in this experimental model. However, the removal torque values for the TiZr group were statistically higher than those of the Ti group in both the SHAM and the ovariectomized animals. That likely reflected an increased quality of bone around the TiZr implants. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

  6. Comparison of Selective Laser Melted Titanium and Magnesium Implants Coated with PCL

    Directory of Open Access Journals (Sweden)

    Julia Matena

    2015-06-01

    Full Text Available Degradable implant material for bone remodeling that corresponds to the physiological stability of bone has still not been developed. Promising degradable materials with good mechanical properties are magnesium and magnesium alloys. However, excessive gas production due to corrosion can lower the biocompatibility. In the present study we used the polymer coating polycaprolactone (PCL, intended to lower the corrosion rate of magnesium. Additionally, improvement of implant geometry can increase bone remodeling. Porous structures are known to support vessel ingrowth and thus increase osseointegration. With the selective laser melting (SLM process, defined open porous structures can be created. Recently, highly reactive magnesium has also been processed by SLM. We performed studies with a flat magnesium layer and with porous magnesium implants coated with polymers. The SLM produced magnesium was compared with the titanium alloy TiAl6V4, as titanium is already established for the SLM-process. For testing the biocompatibility, we used primary murine osteoblasts. Results showed a reduced corrosion rate and good biocompatibility of the SLM produced magnesium with PCL coating.

  7. Bisphenyl-Polymer/Carbon-Fiber-Reinforced Composite Compared to Titanium Alloy Bone Implant.

    Science.gov (United States)

    Petersen, Richard C

    2011-05-03

    Aerospace/aeronautical thermoset bisphenyl-polymer/carbon-fiber-reinforced composites are considered as new advanced materials to replace metal bone implants. In addition to well-recognized nonpolar chemistry with related bisphenol-polymer estrogenic factors, carbon-fiber-reinforced composites can offer densities and electrical conductivity/resistivity properties close to bone with strengths much higher than metals on a per-weight basis. In vivo bone-marrow tests with Sprague-Dawley rats revealed far-reaching significant osseoconductivity increases from bisphenyl-polymer/carbon-fiber composites when compared to state-of-the-art titanium-6-4 alloy controls. Midtibial percent bone area measured from the implant surface increased when comparing the titanium alloy to the polymer composite from 10.5% to 41.6% at 0.8 mm, P < 10 -4 , and 19.3% to 77.7% at 0.1 mm, P < 10 -8 . Carbon-fiber fragments planned to occur in the test designs, instead of producing an inflammation, stimulated bone formation and increased bone integration to the implant. In addition, low-thermal polymer processing allows incorporation of minerals and pharmaceuticals for future major tissue-engineering potential.

  8. Bisphenyl-Polymer/Carbon-Fiber-Reinforced Composite Compared to Titanium Alloy Bone Implant

    Directory of Open Access Journals (Sweden)

    Richard C. Petersen

    2011-01-01

    Full Text Available Aerospace/aeronautical thermoset bisphenyl-polymer/carbon-fiber-reinforced composites are considered as new advanced materials to replace metal bone implants. In addition to well-recognized nonpolar chemistry with related bisphenol-polymer estrogenic factors, carbon-fiber-reinforced composites can offer densities and electrical conductivity/resistivity properties close to bone with strengths much higher than metals on a per-weight basis. In vivo bone-marrow tests with Sprague-Dawley rats revealed far-reaching significant osseoconductivity increases from bisphenyl-polymer/carbon-fiber composites when compared to state-of-the-art titanium-6-4 alloy controls. Midtibial percent bone area measured from the implant surface increased when comparing the titanium alloy to the polymer composite from 10.5% to 41.6% at 0.8 mm, P<10−4, and 19.3% to 77.7% at 0.1 mm, P<10−8. Carbon-fiber fragments planned to occur in the test designs, instead of producing an inflammation, stimulated bone formation and increased bone integration to the implant. In addition, low-thermal polymer processing allows incorporation of minerals and pharmaceuticals for future major tissue-engineering potential.

  9. Comparison of Selective Laser Melted Titanium and Magnesium Implants Coated with PCL

    Science.gov (United States)

    Matena, Julia; Petersen, Svea; Gieseke, Matthias; Teske, Michael; Beyerbach, Martin; Kampmann, Andreas; Escobar, Hugo Murua; Gellrich, Nils-Claudius; Haferkamp, Heinz; Nolte, Ingo

    2015-01-01

    Degradable implant material for bone remodeling that corresponds to the physiological stability of bone has still not been developed. Promising degradable materials with good mechanical properties are magnesium and magnesium alloys. However, excessive gas production due to corrosion can lower the biocompatibility. In the present study we used the polymer coating polycaprolactone (PCL), intended to lower the corrosion rate of magnesium. Additionally, improvement of implant geometry can increase bone remodeling. Porous structures are known to support vessel ingrowth and thus increase osseointegration. With the selective laser melting (SLM) process, defined open porous structures can be created. Recently, highly reactive magnesium has also been processed by SLM. We performed studies with a flat magnesium layer and with porous magnesium implants coated with polymers. The SLM produced magnesium was compared with the titanium alloy TiAl6V4, as titanium is already established for the SLM-process. For testing the biocompatibility, we used primary murine osteoblasts. Results showed a reduced corrosion rate and good biocompatibility of the SLM produced magnesium with PCL coating. PMID:26068455

  10. Biomimetic organic-inorganic nanocomposite coatings for titanium implants. In vitro and in vivo biological testing.

    Science.gov (United States)

    Schade, R; Sikirić, M Dutour; Lamolle, S; Ronold, H J; Lyngstadass, S P; Liefeith, K; Cuisinier, F; Füredi-Milhofer, H

    2010-12-01

    Recently described organic-inorganic nanocomposite coatings of the chemical composition: (PLL/PGA)(10)CaP[(PLL/PGA)(5)CaP](4) (coating A) and (PLL/PGA)(10)CaP[(PLL/PGA)(5)CaP](4)(PLL/PGA)(5) (coating B), applied to chemically etched titanium plates, have been tested by extensive cell culture tests and in vivo biological experiments, with uncoated titanium plates serving as controls. Before testing, coated samples were stored for extended periods of time (from 2 weeks to 8 months) under dry, sterile conditions. Cells of the cell-lines MC3T3-E1 and/or SAOS-2 were used for the following cell culture tests: initial adhesion (4 h) and proliferation (up to 21 days), cell activity (XTT test), morphology, synthesis of collagen type I and alkaline phosphatase activity (all incubation up to 21 days). In addition, coating B was tested against uncoated control in a validated in vivo pull-out model in rabbit tibia. The results of both in vitro and in vivo experiments show excellent biological properties of chemically etched titanium which are even surpassed by surfaces covered with coating B. Thus, after 8 weeks of healing the implants coated with B were significantly better attached to the cortical bone of rabbit thibiae than uncoated titanium controls with more than twice the force needed to detach coated implants. However, coating A (top crystal layer) had an adverse effect on both cell proliferation and activity, which is explained by morphological observations, showing inhibited spreading of the cells on its rough surfaces. The results also show the remarkable stability of the coatings when shelved under dry and sterile conditions. © 2010 Wiley Periodicals, Inc. J Biomed Mater Res Part A, 2010.

  11. Analysis of titanium and other metals in human jawbones with dental implants - A case series study.

    Science.gov (United States)

    He, Xiuli; Reichl, Franz-Xaver; Wang, Yan; Michalke, Bernhard; Milz, Stefan; Yang, Yang; Stolper, Philipp; Lindemaier, Gabriele; Graw, Matthias; Hickel, Reinhard; Högg, Christof

    2016-08-01

    The aim of this study was to measure titanium (Ti) content in human jawbones and to show that Ti was released from dental implants inserted into these jawbones. Seven samples from four human subjects with dental implants were analysed as test group and six bone samples of similar topographical regions from six human subjects without implants served as control. The contents of various elements in human jawbones were detected by inductively coupled plasma optical emission spectrometry. The distributions of various isotopes in human mandibular bone were measured with laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS). Histological analyses of undecalcified, Giemsa-Eosin stained mandible sections were performed by light microscopy and particles were identified in human bone marrow by scanning electron microscope-energy dispersive X-ray analysis. In test group only Ti content was significantly higher compared to control group. The mean contents of Ti were 1940μg/kg in test group and 634μg/kg in control group. The highest Ti content detected in human mandibular bone was 37,700μg/kg-bone weight. In samples 4-7 (human subjects II-IV), increased Ti intensity was also detected by LA-ICP-MS in human mandibular tissues at a distance of 556-1587μm from implants, and the intensity increased with decreasing distance from implants. Particles with sizes of 0.5-40μm were found in human jawbone marrow tissues at distances of 60-700μm from implants in samples 4-7. Ti released from dental implants can be detected in human mandibular bone and bone marrow tissues, and the distribution of Ti in human bone was related to the distance to the implant. Copyright © 2016 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  12. Cyclosporine-a and bone density around titanium implants: a histometric study in rabbits

    Directory of Open Access Journals (Sweden)

    Celso Eduardo Sakakura

    2011-06-01

    Full Text Available Aim: Cyclosporine A (CsA is an immunosuppressive agent commonly used to prevent organ transplantation rejection. It has been demonstrated that CsA may negatively affect osseointegration around dental implants. Therefore, the aim of this study was to evaluate the effect of CsA administration on bone density around titanium dental implants. Materials and Methods: Fourteen New Zealand rabbits were randomly divided into 2 groups with seven animals each. The test group (CsA received daily subcutaneous injection of CsA (10mg/kg body weight and the control group (CTL received saline solution by the same route of administration. Three days after the beginning of immunosuppressive therapy, one machined dental implant (7.00 mm in lenght and 3.75 mm in diameter was inserted bilaterally at the region of the tibial methaphysis. After 4 and 8 weeks the animals were sacrificed and the histometrical procedures were performed to analyse the bone density around the first four threads of the coronal part of the implant. Results: A significant increase in the bone density was observed from the 4- to the 8 week-period in the control group (37.41% + 14.85 versus 58.23% + 16.38 – p < 0.01. In contrast, bone density consistently decreased in the test group overtime (46.31% + 17.38 versus 16.28 + 5.08 – p <0.05. In the 8-week period, there was a significant difference in bone density between the control and the test groups (58.23 + 16.38 eand16.28 + 5.08 – p= 0.001. Conclusion: Within the limits of this study, long-term CsA administration may reduce bone density around titanium dental implants during the osseointegration process.

  13. Residual stress in ion implanted titanium nitride studied by parallel beam glancing incidence x-ray diffraction

    International Nuclear Information System (INIS)

    Geist, D.E.; Perry, A.J.; Treglio, J.R.; Valvoda, V.; Rafaja, D.

    1995-01-01

    Ion implantation is known to increase the lifetime of cutting tools. Current theories are the increase in lifetime is caused by an increase in the residual stress, or by work hardening of the surface associated with the implantation. In this work the effect of ion implantation on the residual stress in titanium nitride coatings made by the standard industrial methods of chemical and physical vapor deposition (CVD and PVD) is studied. It is found in the as-received condition (unimplanted), the residual stress levels are near zero for CVD materials and highly compressive, of the order of 6 GPa, for PVD materials. Ion implantation has no effect on the residual stress in the coatings made by CVD. Nitrogen does increase the compressive residual stress by some 10% in the near surface regions of PVD coatings, while nickel-titanium dual metal ion implantation does not have any effect. It appears that the lifetime increase is not associated with residual stress effects

  14. Electrochemical Behaviour and Galvanic Effects of Titanium Implants Coupled to Metallic Suprastructures in Artificial Saliva

    Directory of Open Access Journals (Sweden)

    Ana Mellado-Valero

    2018-01-01

    Full Text Available The aim of the present study is to analyze the electrochemical behavior of five different dental alloys: two cobalt-chromium alloys (CoCr and CoCr-c, one nickel-chromium-titanium alloy (NiCrTi, one gold-palladium alloy (Au, and one titanium alloy (Ti6Al4V, and the galvanic effect when they are coupled to titanium implants (TiG2. It was carried out by electrochemical techniques (open circuit measurements, potentiodynamic curves and Zero-Resistance Ammetry in artificial saliva (AS, with and without fluorides in different acidic conditions. The studied alloys are spontaneously passivated, but NiCrTi alloy has a very narrow passive domain and losses its passivity in presence of fluorides, so is not considered as a good option for implant superstructures. Variations of pH from 6.5 to 3 in artificial saliva do not change the electrochemical behavior of Ti, Ti6Al4V, and CoCr alloys, and couples, but when the pH of the artificial saliva is below 3.5 and the fluoride content is 1000 ppm Ti and Ti6Al4V starts actively dissolving, and CoCr-c superstructures coupled to Ti show acceleration of corrosion due to galvanic effects. Thus, NiCrTi is not recommended for implant superstructures because of risk of Ni ion release to the body, and fluorides should be avoided in acidic media because Ti, Ti6Al4V, and CoCr-c superstructures show galvanic corrosion. The best combinations are Ti/Ti6Al4V and Ti/CoCr as alternative of noble gold alloys.

  15. Electrochemical Behaviour and Galvanic Effects of Titanium Implants Coupled to Metallic Suprastructures in Artificial Saliva

    Science.gov (United States)

    Mellado-Valero, Ana; Igual Muñoz, Anna; Guiñón Pina, Virginia

    2018-01-01

    The aim of the present study is to analyze the electrochemical behavior of five different dental alloys: two cobalt-chromium alloys (CoCr and CoCr-c), one nickel-chromium-titanium alloy (NiCrTi), one gold-palladium alloy (Au), and one titanium alloy (Ti6Al4V), and the galvanic effect when they are coupled to titanium implants (TiG2). It was carried out by electrochemical techniques (open circuit measurements, potentiodynamic curves and Zero-Resistance Ammetry) in artificial saliva (AS), with and without fluorides in different acidic conditions. The studied alloys are spontaneously passivated, but NiCrTi alloy has a very narrow passive domain and losses its passivity in presence of fluorides, so is not considered as a good option for implant superstructures. Variations of pH from 6.5 to 3 in artificial saliva do not change the electrochemical behavior of Ti, Ti6Al4V, and CoCr alloys, and couples, but when the pH of the artificial saliva is below 3.5 and the fluoride content is 1000 ppm Ti and Ti6Al4V starts actively dissolving, and CoCr-c superstructures coupled to Ti show acceleration of corrosion due to galvanic effects. Thus, NiCrTi is not recommended for implant superstructures because of risk of Ni ion release to the body, and fluorides should be avoided in acidic media because Ti, Ti6Al4V, and CoCr-c superstructures show galvanic corrosion. The best combinations are Ti/Ti6Al4V and Ti/CoCr as alternative of noble gold alloys. PMID:29361767

  16. Nanostructured model implants for in vivo studies: influence of well-defined nanotopography on de novo bone formation on titanium implants

    Science.gov (United States)

    Ballo, Ahmed; Agheli, Hossein; Lausmaa, Jukka; Thomsen, Peter; Petronis, Sarunas

    2011-01-01

    An implantable model system was developed to investigate the effects of nanoscale surface properties on the osseointegration of titanium implants in rat tibia. Topographical nanostructures with a well-defined shape (semispherical protrusions) and variable size (60 nm, 120 nm and 220 nm) were produced by colloidal lithography on the machined implants. Furthermore, the implants were sputter-coated with titanium to ensure a uniform surface chemical composition. The histological evaluation of bone around the implants at 7 days and 28 days after implantation was performed on the ground sections using optical and scanning electron microscopy. Differences between groups were found mainly in the new bone formation process in the endosteal and marrow bone compartments after 28 days of implantation. Implant surfaces with 60 nm features demonstrated significantly higher bone-implant contact (BIC, 76%) compared with the 120 nm (45%) and control (57%) surfaces. This effect was correlated to the higher density and curvature of the 60 nm protrusions. Within the developed model system, nanoscale protrusions could be applied and systematically varied in size in the presence of microscale background roughness on complex screw-shaped implants. Moreover, the model can be adapted for the systematic variation of surface nanofeature density and chemistry, which opens up new possibilities for in vivo studies of various nanoscale surface-bone interactions. PMID:22267926

  17. Guidelines for patient-specific jawline definition with titanium implants in esthetic, deformity, and malformation surgery.

    Science.gov (United States)

    Mommaerts, Maurice Yves

    2016-01-01

    Asymmetry and unfavorable esthetics of the jawline have become possible to correct in three dimensions using computer aided design and computer aided manufacturing. The aim of this study was to provide esthetic, technical, and operative guidelines for mandibular angle and border augmentation using patient-specific titanium implants made by selective laser melting. University hospital - prospective registry. Twelve patients and 17 implantation sites were documented and prospectively registered. Malformational, deformational, and purely esthetic indications were encountered. Descriptive. Patient satisfaction was high, probably because the patients had input into the planned dimensions and shape. A serious infection with implant removal occurred in one patient who had six previous surgeries at the same sites. Technical and surgical guidelines were developed including splitting implants into two segments when the mental nerve was at risk, using a three-dimensional (3D) puzzle connection, providing at least two screw holes per segment, using scaffolds at the bony contact side, using a "satin" finish at the periosteal side, referring to anatomical structures where possible, making provisions for transbuccal and transoral fixation, using a high vestibular incision, and using a double-layer closure. Esthetic guidelines are discussed but could not be upgraded. Mirroring techniques and 3D print accuracy up to 0.1 mm allow precise planning of jaw angle implants. Patients are pleased when given preoperative renderings for their consideration. Infections can be managed using technical and operative recommendations and careful patient selection.

  18. Discrete deposition of hydroxyapatite nanoparticles on a titanium implant with predisposing substrate microtopography accelerated osseointegration

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, Ichiro [UCLA School of Dentistry, Weintraub Center for Reconstructive Biotechnology and Division of Advanced Prosthodontics, Biomaterials and Hospital Dentistry, Los Angeles, CA (United States); Huang Yuhong [Chemat Technology, Incorporated, Northridge, CA (United States); Butz, Frank [UCLA School of Dentistry, Weintraub Center for Reconstructive Biotechnology and Division of Advanced Prosthodontics, Biomaterials and Hospital Dentistry, Los Angeles, CA (United States); Ogawa, Takahiro [UCLA School of Dentistry, Weintraub Center for Reconstructive Biotechnology and Division of Advanced Prosthodontics, Biomaterials and Hospital Dentistry, Los Angeles, CA (United States); Lin, Audrey [UCLA School of Dentistry, Weintraub Center for Reconstructive Biotechnology and Division of Advanced Prosthodontics, Biomaterials and Hospital Dentistry, Los Angeles, CA (United States); Wang, Chiachien Jake [UCLA School of Dentistry, Weintraub Center for Reconstructive Biotechnology and Division of Advanced Prosthodontics, Biomaterials and Hospital Dentistry, Los Angeles, CA (United States)

    2007-06-20

    We report here a new versatile method to deposit discrete hydroxyapatite (HA) nanoparticles on a titanium (Ti) implant with predisposing substrate microtopography, which exhibited an unexpectedly robust biological effect. Commercially pure Ti substrates were treated with 3-aminopropyltriethoxysilane, on which HA nanoparticles (20 nm) were deposited and chemically bonded to TiO{sub 2}. The HA deposition rate was linearly related to the treatment time and HA nanoparticles were deposited on up to 50% of the substrate surface. As a result, the discrete deposition of HA nanoparticles generated novel 20-40 nm nanotopography on the Ti substrate with microtopography that was smooth (turned) or roughened by double acid etching (DAE). The experimental implants with or without HA nanoparticles were surgically placed in rat femur and an implant push-in test was performed after two weeks of healing. The deposition of HA nanoparticles on the DAE surface increased the mechanical withstanding load by 129% and 782% as compared to the control DAE and turned implants, respectively. Micro-computed tomography-based 3D bone morphometry revealed equivalent bone volumes around the DAE implant with or without HA nanoparticles. These data suggest that the discrete deposition of HA nanoparticles accelerates the early osseointegration process, likely through increased shear bonding strengths.

  19. The Effectiveness of a Customized Titanium Mesh for Ridge Preservation with Immediate Implantation in Dogs.

    Science.gov (United States)

    Lim, Hyun-Chang; Kim, Min-Soo; Yang, Cheryl; Lee, Jung-Seok; Hong, Ji-Youn; Choi, Seong-Ho; Jung, Ui-Won

    2015-10-01

    The purpose of this study was to determine the effect of a newly designed titanium mesh (TM) for preserving the buccal bone around an immediately placed implant following tooth extraction in dogs. Immediate implant placements were performed bilaterally in the mesial socket of the fourth premolar in five dogs. In one site, the TM was affixed to the fixture using its own stabilization components (TM group), and the contralateral site was left untreated (control group). All surgical sites were intended to be submerged with primary flap closure. Histologic and histomorphometric analyses were performed 16 weeks postoperatively. All implants were histologically osseointegrated, and buccal bone resorption was evident in both groups with the high rate of TM exposure (4/5). The most coronal level of bone-implant contact and the bone crest were not statistically different between the TM and the control group. A dense connective tissue layer consistently predominated under the TM, where mineralized tissue was not observed, and the vascularity and cellularity were minimal. It can be conjectured that preservation of buccal plate by using the TM in immediate implantation was not predictable due to vulnerability to wound dehiscence and substantial pseudoperiosteum formation beneath the TM. © 2015 Wiley Periodicals, Inc.

  20. Adenoviral vector-mediated overexpression of osteoprotegerin accelerates osteointegration of titanium implants in ovariectomized rats.

    Science.gov (United States)

    Yin, G; Chen, J; Wei, S; Wang, H; Chen, Q; Lin, Y; Hu, J; Luo, E

    2015-08-01

    This study investigated the efficacy of human osteoprotegerin (hOPG) transgene to accelerate osteointegration of titanium implant in ovariectomized (OVX) rats. Bone marrow stromal cells transduced with Ad-hOPG-EGFP could sustainedly express hOPG. Osteoclast precursor RAW264.7 cells treated by the hOPG were examined by tartrate-resistant acid phosphatase (TRAP) staining and bone slice resorption assay. The results showed differentiation and function of osteoclasts were significantly suppressed by hOPG in vitro. Ad-hOPG-EGFP was locally administered to the bone defect prior to implant placement in OVX and sham rats. After 3, 7, 28 days of implantation, the femurs were harvested for molecular and histological analyses. Successful transgene expression was confirmed by western blot and cryosectioning. A significant reduction in TRAP+ numbers was detected in Ad-hOPG-EGFP group. Real-time reverse transcriptase-PCR examination revealed that hOPG transgene markedly diminished the expression of cathepsin K and receptor activator for nuclear factor-κ B ligand in vivo. The transgene hOPG modification revealed a marked increasing osteointegration and restored implant stability in OVX rats (POsteoprotegerin gene therapy may be an effective strategy to osteointegration of implants under osteoporotic conditions.

  1. Analysis of clinically relevant mechanical and thermal characteristics of titanium foam spinal implants during drilling.

    Science.gov (United States)

    Ito, Kiyoshi; Horiuchi, Tetsuyoshi; Murata, Takahiro; Hongo, Kazuhiro

    2015-09-01

    Although high biocompatibility promotes the use of titanium (Ti) alloy in spinal implants, this material shows high stiffness, which is an issue for removal by drilling. The recently developed, porous Ti foam implants, which have shown enhanced osteoformation, may overcome this flaw. Thus, this study aimed to compare the mechanical and thermal characteristics of Ti-foam (80 % porosity) and conventional Ti alloy (0 % porosity) implants drilled in clinically relevant conditions. Mechanical properties were analyzed by measuring axial and torque forces using a pressure sensor with a drill of 2.5-mm diameter at a rotation frequency of 20 Hz. Thermography was used to evaluate the heat generated by a diamond burr attached to a high-speed (80,000 rpm) drill. The torque and axial strengths of Ti foam (13.63 ± 1.43 and 82.60 ± 7.78 N, respectively) were significantly lower (P = 0.001) than those of Ti alloy (73.58 ± 13.60 and 850.72 ± 146.99 N, respectively). Furthermore, irrigation reduced the area of local heating for Ti foam to 56-82 % of that for Ti alloy, indicating lower thermal conductivity. These data suggest that the use of Ti foam implants may be advantageous in cases with a probability of implant drilling in the future.

  2. Grain size effect on yield strength of titanium alloy implanted with aluminum ions

    Energy Technology Data Exchange (ETDEWEB)

    Popova, Natalya, E-mail: natalya-popova-44@mail.ru [Tomsk State University of Architecture and Building, 2, Solyanaya Sq., 634003, Tomsk (Russian Federation); Institute of Strength Physics and Materials Science, SB RAS, 2/4, Akademicheskii Ave., 634021, Tomsk (Russian Federation); Nikonenko, Elena, E-mail: vilatomsk@mail.ru [Tomsk State University of Architecture and Building, 2, Solyanaya Sq., 634003, Tomsk (Russian Federation); National Research Tomsk Polytechnic University, 30, Lenin Str., 634050, Tomsk (Russian Federation); Yurev, Ivan, E-mail: yiywork@mail.ru [Tomsk State University of Architecture and Building, 2, Solyanaya Sq., 634003, Tomsk (Russian Federation); Kalashnikov, Mark, E-mail: kmp1980@mail.ru [Institute of Strength Physics and Materials Science, SB RAS, 2/4, Akademicheskii Ave., 634021, Tomsk (Russian Federation); Kurzina, Irina, E-mail: kurzina99@mail.ru [National Research Tomsk State University, 36, Lenin Str., 634050, Tomsk (Russian Federation)

    2016-01-15

    The paper presents a transmission electron microscopy (TEM) study of the microstructure and phase state of commercially pure titanium VT1-0 implanted by aluminum ions. This study has been carried out before and after the ion implantation for different grain size, i.e. 0.3 µm (ultra-fine grain condition), 1.5 µm (fine grain condition), and 17 µm (polycrystalline condition). This paper presents details of calculations and analysis of strength components of the yield stress. It is shown that the ion implantation results in a considerable hardening of the entire thickness of the implanted layer in the both grain types. The grain size has, however, a different effect on the yield stress. So, both before and after the ion implantation, the increase of the grain size leads to the decrease of the alloy hardening. Thus, hardening in ultra-fine and fine grain alloys increased by four times, while in polycrystalline alloy it increased by over six times.

  3. Discrete deposition of hydroxyapatite nanoparticles on a titanium implant with predisposing substrate microtopography accelerated osseointegration

    International Nuclear Information System (INIS)

    Nishimura, Ichiro; Huang Yuhong; Butz, Frank; Ogawa, Takahiro; Lin, Audrey; Wang, Chiachien Jake

    2007-01-01

    We report here a new versatile method to deposit discrete hydroxyapatite (HA) nanoparticles on a titanium (Ti) implant with predisposing substrate microtopography, which exhibited an unexpectedly robust biological effect. Commercially pure Ti substrates were treated with 3-aminopropyltriethoxysilane, on which HA nanoparticles (20 nm) were deposited and chemically bonded to TiO 2 . The HA deposition rate was linearly related to the treatment time and HA nanoparticles were deposited on up to 50% of the substrate surface. As a result, the discrete deposition of HA nanoparticles generated novel 20-40 nm nanotopography on the Ti substrate with microtopography that was smooth (turned) or roughened by double acid etching (DAE). The experimental implants with or without HA nanoparticles were surgically placed in rat femur and an implant push-in test was performed after two weeks of healing. The deposition of HA nanoparticles on the DAE surface increased the mechanical withstanding load by 129% and 782% as compared to the control DAE and turned implants, respectively. Micro-computed tomography-based 3D bone morphometry revealed equivalent bone volumes around the DAE implant with or without HA nanoparticles. These data suggest that the discrete deposition of HA nanoparticles accelerates the early osseointegration process, likely through increased shear bonding strengths

  4. Stress and strain analysis of the bone-implant interface: a comparison of fiber-reinforced composite and titanium implants utilizing 3-dimensional finite element study.

    Science.gov (United States)

    Shinya, Akikazu; Ballo, Ahmed M; Lassila, Lippo V J; Shinya, Akiyoshi; Närhi, Timo O; Vallittu, Pekka K

    2011-03-01

    This study analyzed stress and strain mediated by 2 different implant materials, titanium (Ti) and experimental fiber-reinforced composite (FRC), on the implant and on the bone tissue surrounding the implant. Three-dimensional finite element models constructed from a mandibular bone and an implant were subjected to a load of 50 N in vertical and horizontal directions. Postprocessing files allowed the calculation of stress and strain within the implant materials and stresses at the bone-to-implant interface (stress path). Maximum stress concentrations were located around the implant on the rim of the cortical bone in both implant materials; Ti and overall stresses decreased toward the Ti implant apex. In the FRC implant, a stress value of 0.6 to 2.0 MPa was detected not only on the screw threads but also on the implant surface between the threads. Clear differences were observed in the strain distribution between the materials. Based on the results, the vertical load stress range of the FRC implant was close to the stress level for optimal bone growth. Furthermore, the stress at the bone around the FRC implant was more evenly distributed than that with Ti implant.

  5. Mg ion implantation on SLA-treated titanium surface and its effects on the behavior of mesenchymal stem cell

    International Nuclear Information System (INIS)

    Kim, Beom-Su; Kim, Jin Seong; Park, Young Min; Choi, Bo-Young; Lee, Jun

    2013-01-01

    Magnesium (Mg) is one of the most important ions associated with bone osseointegration. The aim of this study was to evaluate the cellular effects of Mg implantation in titanium (Ti) surfaces treated with sand blast using large grit and acid etching (SLA). Mg ions were implanted into the surface via vacuum arc source ion implantation. The surface morphology, chemical properties, and the amount of Mg ion release were evaluated by scanning electron microscopy (SEM), Auger electron spectroscopy (AES), Rutherford backscattering spectroscopy (RBS), and inductively coupled plasma-optical emission spectrometer (ICP-OES). Human mesenchymal stem cells (hMSCs) were used to evaluate cellular parameters such as proliferation, cytotoxicity, and adhesion morphology by MTS assay, live/dead assay, and SEM. Furthermore, osteoblast differentiation was determined on the basis of alkaline phosphatase (ALP) activity and the degree of calcium accumulation. In the Mg ion-implanted disk, 2.3 × 10 16 ions/cm 2 was retained. However, after Mg ion implantation, the surface morphology did not change. Implanted Mg ions were rapidly released during the first 7 days in vitro. The MTS assay, live/dead assay, and SEM demonstrated increased cell attachment and growth on the Mg ion-implanted surface. In particular, Mg ion implantation increased the initial cell adhesion, and in an osteoblast differentiation assay, ALP activity and calcium accumulation. These findings suggest that Mg ion implantation using the plasma source ion implantation (PSII) technique may be useful for SLA-treated Ti dental implants to improve their osseointegration capacity. - Highlights: ► Mg ion was coated onto surface of SLA treated titanium via vacuum arc source ion implantation method. ► The morphological characteristics did not change after Mg ion implantation. ► Mg ion implanted SLA Ti is highly cytocompatible. ► Initial cell adhesion of MSCs is improved by Mg ion implantation. ► Mg ion implantation improved

  6. Mg ion implantation on SLA-treated titanium surface and its effects on the behavior of mesenchymal stem cell

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Beom-Su; Kim, Jin Seong [Wonkwang Bone Regeneration Research Institute, Wonkwang University, Iksan 570-749 (Korea, Republic of); Bonecell Biotech Inc., 77, Dunsan-ro, Seo-gu, Daejeon 302-830 (Korea, Republic of); Park, Young Min [DIO Corporation, 66, Centum seo-ro, Haeundae-gu, Busan (Korea, Republic of); Choi, Bo-Young [Department of Oral and maxillofacial Surgery, Wonkwang University Daejeon Dental Hospital, Daejeon 302-830 (Korea, Republic of); Lee, Jun, E-mail: omslee@wku.ac.kr [Wonkwang Bone Regeneration Research Institute, Wonkwang University, Iksan 570-749 (Korea, Republic of); Bonecell Biotech Inc., 77, Dunsan-ro, Seo-gu, Daejeon 302-830 (Korea, Republic of)

    2013-04-01

    Magnesium (Mg) is one of the most important ions associated with bone osseointegration. The aim of this study was to evaluate the cellular effects of Mg implantation in titanium (Ti) surfaces treated with sand blast using large grit and acid etching (SLA). Mg ions were implanted into the surface via vacuum arc source ion implantation. The surface morphology, chemical properties, and the amount of Mg ion release were evaluated by scanning electron microscopy (SEM), Auger electron spectroscopy (AES), Rutherford backscattering spectroscopy (RBS), and inductively coupled plasma-optical emission spectrometer (ICP-OES). Human mesenchymal stem cells (hMSCs) were used to evaluate cellular parameters such as proliferation, cytotoxicity, and adhesion morphology by MTS assay, live/dead assay, and SEM. Furthermore, osteoblast differentiation was determined on the basis of alkaline phosphatase (ALP) activity and the degree of calcium accumulation. In the Mg ion-implanted disk, 2.3 × 10{sup 16} ions/cm{sup 2} was retained. However, after Mg ion implantation, the surface morphology did not change. Implanted Mg ions were rapidly released during the first 7 days in vitro. The MTS assay, live/dead assay, and SEM demonstrated increased cell attachment and growth on the Mg ion-implanted surface. In particular, Mg ion implantation increased the initial cell adhesion, and in an osteoblast differentiation assay, ALP activity and calcium accumulation. These findings suggest that Mg ion implantation using the plasma source ion implantation (PSII) technique may be useful for SLA-treated Ti dental implants to improve their osseointegration capacity. - Highlights: ► Mg ion was coated onto surface of SLA treated titanium via vacuum arc source ion implantation method. ► The morphological characteristics did not change after Mg ion implantation. ► Mg ion implanted SLA Ti is highly cytocompatible. ► Initial cell adhesion of MSCs is improved by Mg ion implantation. ► Mg ion implantation

  7. Titanium as a Reconstruction and Implant Material in Dentistry: Advantages and Pitfalls

    Directory of Open Access Journals (Sweden)

    Mutlu Özcan

    2012-08-01

    Full Text Available Commercial pure titanium (cpTi has been the material of choice in several disciplines of dentistry due to its biocompatibility, resistance to corrosion and mechanical properties. Despite a number of favorable characteristics, cpTi as a reconstruction and oral implant material has several shortcomings. This paper highlights current knowledge on material properties, passive oxidation film formation, corrosion, surface activation, cell interactions, biofilm development, allergy, casting and machining properties of cpTi for better understanding and potential improvement of this material for its clinical applications.

  8. Titanium as a Reconstruction and Implant Material in Dentistry: Advantages and Pitfalls

    Science.gov (United States)

    Özcan, Mutlu; Hämmerle, Christoph

    2012-01-01

    Commercial pure titanium (cpTi) has been the material of choice in several disciplines of dentistry due to its biocompatibility, resistance to corrosion and mechanical properties. Despite a number of favorable characteristics, cpTi as a reconstruction and oral implant material has several shortcomings. This paper highlights current knowledge on material properties, passive oxidation film formation, corrosion, surface activation, cell interactions, biofilm development, allergy, casting and machining properties of cpTi for better understanding and potential improvement of this material for its clinical applications.

  9. Distortion of CAD-CAM-fabricated implant-fixed titanium and zirconia complete dental prosthesis frameworks.

    Science.gov (United States)

    Al-Meraikhi, Hadi; Yilmaz, Burak; McGlumphy, Edwin; Brantley, William A; Johnston, William M

    2018-01-01

    Computer-aided design and computer-aided manufacturing (CAD-CAM)-fabricated titanium and zirconia implant-supported fixed dental prostheses have become increasingly popular for restoring patients with complete edentulism. However, the distortion level of these frameworks is not well known. The purpose of this in vitro study was to compare the 3-dimensional (3D) distortion of CAD-CAM zirconia and titanium implant-fixed screw-retained complete dental prostheses. A master edentulous model with 4 implants at the positions of the maxillary first molars and canines was used. Multiunit abutments (Nobel Biocare) secured to the model were digitally scanned using scan bodies and a laboratory scanner (S600 ARTI; Zirkonzahn). Titanium (n=5) and zirconia (n=5) frameworks were milled using a CAD-CAM system (Zirkonzahn M1; Zirkonzahn). All frameworks were scanned using an industrial computed tomography (CT) scanner (Nikon/X-Tek XT H 225kV MCT Micro-Focus). The direct CT scans were reconstructed to generate standard tessellation language (STL) files. To calculate the 3D distortion of the frameworks, STL files of the CT scans were aligned to the CAD model using a sum of the least squares best-fit algorithm. Surface comparison points were placed on the CAD model on the midfacial aspect of all teeth. The 3D distortion of each direct scan to the CAD model was calculated. In addition, color maps of the scan-to-CAD comparison were constructed using a ±0.500 mm color scale range. Both materials exhibited distortion; however, no significant difference was found in the amount of distortion from the CAD model between the materials (P=.747). Absolute values of deviations from the CAD model were evident in the x and y plane and less so in the z direction. Zirconia and titanium frameworks showed similar 3D distortion compared with the CAD model for the tested CAD-CAM and implant systems. The distortion was more pronounced in the horizontal and sagittal plane than in the vertical plane

  10. A decomposable silica-based antibacterial coating for percutaneous titanium implant

    Directory of Open Access Journals (Sweden)

    Wang J

    2017-01-01

    Full Text Available Jia Wang,1,* Guofeng Wu,2,* Xiangwei Liu,3,* Guanyang Sun,1 Dehua Li,3 Hongbo Wei3 1State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an, 2Department of Prosthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, 3State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi’an, People’s Republic of China *These authors contributed equally to this work Abstract: Although percutaneous titanium implants have become one of the best choices as retainers in the facial defects, peri-implantitis still occurs at a significant rate. This unwanted complication occurs due to adhesion of bacteria and subsequent biofilm formation. To solve this problem, we have developed a novel antibiotic nanodelivery system based on self-decomposable silica nanoparticles. In this study, silica-gentamycin (SG nanoparticles were successfully fabricated using an innovative one-pot solution. The nanoparticles were incorporated within a gelatin matrix and cross-linked on microarc-oxidized titanium. To characterize the SG nanoparticles, their particle size, zeta potential, surface morphology, in vitro drug release, and decomposition process were sequentially evaluated. The antibacterial properties against the gram-positive Staphylococcus aureus, including bacterial viability, antibacterial rate, and bacteria morphology, were analyzed using SG-loaded titanium specimens. Any possible influence of released gentamycin on the viability of human fibroblasts, which are the main component of soft tissues, was investigated. SG nanoparticles from the

  11. Bio-activated titanium surface utilizable for mimetic bone implantation in dentistry—Part III: Surface characteristics and bone implant contact formation

    Science.gov (United States)

    Strnad, Jakub; Strnad, Zdeněk; Šesták, Jaroslav; Urban, Karel; Povýšil, Ctibor

    2007-05-01

    This study was carried out to quantify the effect of an alkali-modified surface on the bone implant interface formation during healing using an animal model. A total of 24 screw-shaped, self-tapping, (c.p.) titanium dental implants, divided into test group B—implants with alkali-modified surface (Bio surface) and control group M—implants with turned, machined surface, were inserted without pre-tapping in the tibiae of three beagle dogs. The animals were sacrificed after 2, 5 and 12 weeks and the bone implant contact (BIC%) was evaluated histometrically. The surface characteristics that differed between the implant surfaces, i.e. specific surface area, contact angle, may represent factors that influence the rate of osseointegration and the secondary implant stability. The alkali-treated surface enhances the BIC formation during the first 2 5 weeks of healing compared to the turned, machined surface.

  12. Mechanical, histological and histomorphometric evaluation of modified by femtosecond laser zirconia implants versus titanium implants. An experimental study in dogs at three months

    Directory of Open Access Journals (Sweden)

    J.L. Calvo-Guirado

    2013-06-01

    Full Text Available Aim The present study was aimed at quantifying implant´s stability and elemental composition by Periotest® and evaluating bone to implant contact (BIC and crestal bone loss of modified by femtosecond laser zirconia and titanium implants.Materials and methods Forty-eight implants were divided into 2 groups: titanium (control and modified by femtosecond laser zirconia (test and then inserted in 6 American Foxhound dogs. Primary stability and secondary stability were measured by Periotest, BIC was evaluated by histomorphometry at 1 and 3 months, elemental composition of the surrounding bone in both groups after 1 and 3 months was assessed.Results Differences between groups regarding primary stability and secondary stability were not significant (p>0.05. The Carbon ratio at zirconia (12.529% was significantly lower (p0.05 regarding BIC for titanium vs modified zirconia were observed. Crestal bone loss at 3 months was significantly (p<0.05 lower (0.07 ±0.34 mm in titanium group than in zirconia (1.25 ± 1.73 mm.Conclusion Surface treatment by using femtosecond laser equalizes osseointegration of zirconia implants.

  13. Surface treatment of screw shaped titanium dental implants by high intensity laser pulses

    Science.gov (United States)

    Pető, G.; Karacs, A.; Pászti, Z.; Guczi, L.; Divinyi, T.; Joób, A.

    2002-01-01

    Machined and Al 2O 3 blasted surfaces of screw shaped Ti dental implants were irradiated by 30 ns pulses of Nd:glass laser at 1064 nm wavelength with 0.5-3 J pulse energy. The laser treatment increased the temperature of the Ti surface well above the melting temperature. The resulting ablation of some surface layers was followed by a very rapid solidification. These thermal processes strongly modified the original morphology of the surface and removed the contaminations. The new morphology was characterized by features mostly in ten micron and partly in submicron ranges. The surface composition was the same as the bulk titanium without any segregation. Animal experiments demonstrated that this surface treatment seems to be promising for the improvement of the osseointegration of dental implants.

  14. Immediate loading of the edentulous maxilla with a definitive restoration supported by an intraorally welded titanium bar and tilted implants.

    Science.gov (United States)

    Degidi, Marco; Nardi, Diego; Piattelli, Adriano

    2010-01-01

    The aim of this prospective study was to evaluate the concept of intraoral welding as a suitable technique for the fabrication of a restoration for the edentulous atrophic maxilla on the day of placement of axial and tilted implants. Thirty patients received three axial and four tilted implants in the edentulous maxilla. Immediately after implant placement, definitive abutments were connected to the implants and then a titanium bar was welded to them using an intraoral welding unit. This framework was used as a support for the definitive restoration, which was attached on the day of implant placement. Mean marginal bone loss and radiographically detectable alteration of the welded framework were assessed using periapical radiographs immediately after surgery and at 6, 12, 24, and 36 months after placement. Sixteen men and 14 women with an average age of 58.1 years (SD 13.6) were consecutively treated with 210 immediately loaded implants. No fractures or radiographically detectable alterations of the welded frameworks were evident. A 100% prosthetic success rate was seen at 36 months. Three (1.4%) implants had serious biologic complications, resulting in success rates of 97.8% for axial implants and 99.2% for tilted implants. The accumulated mean marginal bone loss was 0.92 mm (SD 0.75; n = 90) for axial implants and 1.03 mm (SD 0.69; n = 120) for tilted implants. The average pocket probing depths were 1.87 mm (SD 0.98; n = 90) for the axial implants and 1.95 mm (SD 0.81; n = 120) for the tilted implants. It is possible on the day of implant placement surgery to successfully rehabilitate the edentulous atrophic maxilla with a fixed, definitive restoration supported by an intraorally welded titanium framework attached to axial and tilted implants.

  15. The Impact of Force Transmission on Narrow-Body Dental Implants Made of Commercially Pure Titanium and Titanium Zirconia Alloy with a Conical Implant-Abutment Connection: An Experimental Pilot Study.

    Science.gov (United States)

    Nelson, Katja; Schmelzeisen, Rainer; Taylor, Thomas D; Zabler, Simon; Wiest, Wolfram; Fretwurst, Tobias

    2016-01-01

    The purpose of this study was to visualize the mode and impact of force transmission in narrowdiameter implants with different implant-abutment designs and material properties and to quantify the displacement of the abutment. Narrow-diameter implants from two manufacturers were examined: Astra 3.0-mm-diameter implants (Astra OsseoSpeed TX; n = 2) and Straumann Bone Level implants with a 3.3-mm diameter made of commercially pure titanium (cpTi) Gr. 4 (n = 2) and 3.3-mm TiZr-alloy (n = 2; Bone Level, Straumann) under incremental force application using synchrotron radiography (absorption and inline x-ray phase-contrast) and tomography. During loading (250 N), Astra 3.0 and Bone Level 3.3- mm implants showed a deformation of the outer implant shoulder of 61.75 to 95 μm independent of the implant body material; the inner implant diameter showed a deformation of 71.25 to 109.25 μm. A deformation of the implant shoulder persisted after the removal of the load (range, 42.75 to 104.5 μm). An angulated intrusion of the abutment (maximum, 140 μm) into the implant body during load application was demonstrated; this spatial displacement persisted after removal of the load. This study demonstrated a deformation of the implant shoulder and displacement of the abutment during load application in narrow-diameter implants.

  16. Histomorphological and Histomorphometric Analyses of Grade IV Commercially Pure Titanium and Grade V Ti-6Al-4V Titanium Alloy Implant Substrates: An In Vivo Study in Dogs.

    Science.gov (United States)

    Ribeiro da Silva, Jonathan; Castellano, Arthur; Malta Barbosa, João Pedro; Gil, Luiz F; Marin, Charles; Granato, Rodrigo; Bonfante, Estevam A; Tovar, Nick; Janal, Malvin N; Coelho, Paulo G

    2016-10-01

    To evaluate the bone response to grade IV commercially pure titanium (G4) relative to Ti-6Al-4V (G5). Implant surface topography was characterized by optical interferometry and scanning electron microscopy (SEM). Thirty-six implants (Signo Vinces, n = 18 per group) were installed in the radius of 18 dogs. The animals were killed at 1, 3, and 6 weeks, resulting in 6 implants per group and time in vivo for bone morphology, bone-to-implant contact (BIC), and bone area fraction occupancy (BAFO) evaluation. SEM depicted a more uniform topography of G4 than G5. Surfaces were statistically homogeneous for Sa, Sq, and Sdr. At 1 week, new bone formation was observed within the healing connective tissue in contact with the implant surface. At 3 weeks, new bone in direct contact with the implant surface was observed at all bone regions. At 6 weeks, the healing chambers filled with woven bone depicted an onset of replacement by lamellar bone. No significant effect of substrate was detected. Time presented an effect on BIC and BAFO (P < 0.001). Both titanium substrates were biocompatible and osseoconductive at the bone tissue level.

  17. Hierarchical micro/nanostructured titanium with balanced actions to bacterial and mammalian cells for dental implants

    Directory of Open Access Journals (Sweden)

    Zhu Y

    2015-10-01

    Full Text Available Yu Zhu,1,* Huiliang Cao,2,* Shichong Qiao,1,* Manle Wang,2,3 Yingxin Gu,1 Huiwen Luo,1 Fanhao Meng,2 Xuanyong Liu,2 Hongchang Lai1 1Department of Oral and Maxillofacial Implantology, Shanghai Key Laboratory of Stomatology, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, 2State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, 3School of Materials Engineering, Shanghai University of Engineering Science, Shanghai, People’s Republic of China *These authors contributed equally to this work Abstract: A versatile strategy to endow dental implants with long-term antibacterial ability without compromising the cytocompatibility is highly desirable to combat implant-related infection. Silver nanoparticles (Ag NPs have been utilized as a highly effective and broad-spectrum antibacterial agent for surface modification of biomedical devices. However, the high mobility and subsequent hazardous effects of the particles on mammalian cells may limit its practical applications. Thus, Ag NPs were immobilized on the surface of sand-blasted, large grit, and acid-etched (SLA titanium by manipulating the atomic-scale heating effect of silver plasma immersion ion implantation. The silver plasma immersion ion implantation-treated SLA surface gave rise to both good antibacterial activity and excellent compatibility with mammalian cells. The antibacterial activity rendered by the immobilized Ag NPs was assessed using Fusobacterium nucleatum and Staphylococcus aureus, commonly suspected pathogens for peri-implant disease. The immobilized Ag NPs offered a good defense against multiple cycles of bacteria attack in both F. nucleatum and S. aureus, and the mechanism was independent of silver release. F. nucleatum showed a higher susceptibility to Ag NPs than S. aureus, which might be explained by the presence of different wall structures. Moreover, the

  18. Striated muscle microvascular response to silver implants: A comparative in vivo study with titanium and stainless steel.

    Science.gov (United States)

    Kraft, C N; Hansis, M; Arens, S; Menger, M D; Vollmar, B

    2000-02-01

    Local microvascular perfusion is the primary line of defense of tissue against microorganisms and plays a considerable role in reparative processes. The impairment of the microcirculation by a biomaterial may therefore have profound consequences. Silver is known to have excellent antimicrobial activity and, although regional and systemic toxic effects have been described, silver is regularly discussed as an implant material in bone surgery. Because little is known about the influence of silver implants on the adjacent host tissue microvasculature, we studied in vivo nutritive perfusion and leukocytic response, and compared these results with those of the conventionally used materials titanium and stainless steel. Using the hamster dorsal skinfold chamber preparation and intravital microscopy, the implantation of a commercially pure silver sample led to a distinct and persistent activation of leukocytes combined with a marked disruption of the microvascular endothelial integrity, massive leukocyte extravasation, and considerable venular dilation. Whereas animals with stainless-steel implants showed a moderate increase in these parameters with a tendency to recuperate, titanium implants caused only a transient increase of leukocyte-endothelial cell interaction within the first 120 min and no significant change in macromolecular leakage, leukocyte extravasation and venular diameter. After 3 days, five of six preparations with silver samples showed severe inflammation and massive edema. Thus, the use of silver as an implant material should be critically judged despite its bactericidal properties. The implant material titanium seems to be well tolerated by the local vascular system and currently represents the golden standard. Copyright 2000 John Wiley & Sons, Inc.

  19. Gallium-modified chitosan/poly(acrylic acid) bilayer coatings for improved titanium implant performances.

    Science.gov (United States)

    Bonifacio, Maria A; Cometa, Stefania; Dicarlo, Manuela; Baruzzi, Federico; de Candia, Silvia; Gloria, Antonio; Giangregorio, Maria M; Mattioli-Belmonte, Monica; De Giglio, Elvira

    2017-06-15

    A gallium-modified chitosan/poly(acrylic acid) bilayer was obtained by electrochemical techniques on titanium to reduce orthopaedic and/or dental implants failure. The bilayer in vitro antibacterial properties and biocompatibility were evaluated against Escherichia coli and Pseudomonas aeruginosa and on MG63 osteoblast-like cells, respectively. Gallium loading into the bilayer was carefully tuned by the electrochemical deposition time to ensure the best balance between antibacterial activity and cytocompatibility. The 30min deposition time was able to reduce in vitro the viable cell counts of E. coli and P. aeruginosa of 2 and 3 log cfu/sheet, respectively. Our results evidenced that the developed antibacterial coating did not considerably alter the mechanical flexural properties of titanium substrates and, in addition, influenced positively MG63 adhesion and proliferation. Therefore, the gallium-modified chitosan/poly(acrylic acid) bilayer can be exploited as a promising titanium coating to limit bacterial adhesion and proliferation, while maintaining osseointegrative potential. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Laser Surface Pattering of Titanium for Improving the Biological Performance of Dental Implants.

    Science.gov (United States)

    Zwahr, Christoph; Günther, Denise; Brinkmann, Tina; Gulow, Nikolai; Oswald, Steffen; Grosse Holthaus, Marzellus; Lasagni, Andrés Fabián

    2017-02-01

    Direct laser interference patterning (DLIP) is used to produce periodic line-like patterns on titanium surfaces. An Nd:YAG laser operating at 532 nm wavelength with a pulse duration of 8 ns is used for the laser patterning process. The generated periodic patterns with spatial periods of 5, 10, and 20 µm are produced with energy densities between 0.44 and 2.6 J cm - 2 with a single laser pulse. With variation of energy density, different shapes of the arising topography are observed due to the development of the solidification front of the molten material at the maxima positions. Characterization of the surface chemistry shows that the DLIP treatment enhances the content of nitrogen of the titanium reactive layer from 3.9% up to 23.4%. The structural analysis near the titanium surface shows no changes in microstructure after the laser treatment. Contact angles between 65° and 79° are measured on both structured and turned reference surfaces. Cell viability of human osteoblasts on line-like patterned surfaces after 7 d in cultivation medium is 16% higher compared to the grit-blasted and acid-etched references. Finally, the possibility of patterning complex 3D dental implants is shown. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  1. Stiffness, strength, and failure modes of implant-supported monolithic lithium disilicate crowns: influence of titanium and zirconia abutments.

    Science.gov (United States)

    Joda, Tim; Bürki, Alexander; Bethge, Stefan; Brägger, Urs; Zysset, Philippe

    2015-01-01

    The objective of this study was to evaluate stiffness, strength, and failure modes of monolithic crowns produced using computer-aided design/computer-assisted manufacture, which are connected to diverse titanium and zirconia abutments on an implant system with tapered, internal connections. Twenty monolithic lithium disilicate (LS2) crowns were constructed and loaded on bone level-type implants in a universal testing machine under quasistatic conditions according to DIN ISO 14801. Comparative analysis included a 2 × 2 format: prefabricated titanium abutments using proprietary bonding bases (group A) vs nonproprietary bonding bases (group B), and customized zirconia abutments using proprietary Straumann CARES (group C) vs nonproprietary Astra Atlantis (group D) material. Stiffness and strength were assessed and calculated statistically with the Wilcoxon rank sum test. Cross-sections of each tested group were inspected microscopically. Loaded LS2 crowns, implants, and abutment screws in all tested specimens (groups A, B, C, and D) did not show any visible fractures. For an analysis of titanium abutments (groups A and B), stiffness and strength showed equally high stability. In contrast, proprietary and nonproprietary customized zirconia abutments exhibited statistically significant differences with a mean strength of 366 N (Astra) and 541 N (CARES) (P zirconia abutments (groups C and D) below the implant shoulder. Depending on the abutment design, prefabricated titanium abutment and proprietary customized zirconia implant-abutment connections in conjunction with monolithic LS2 crowns had the best results in this laboratory investigation.

  2. Corrosion resistance of stainless steel, nickel-titanium, titanium molybdenum alloy, and ion-implanted titanium molybdenum alloy archwires in acidic fluoride-containing artificial saliva: Anin vitrostudy.

    Science.gov (United States)

    Pulikkottil, Venith Jojee; Chidambaram, S; Bejoy, P U; Femin, P K; Paul, Parson; Rishad, Mohamed

    2016-10-01

    (1) To evaluate the corrosion resistance of four different orthodontic archwires and to determine the effect of 0.5% NaF (simulating high fluoride-containing toothpaste of about 2250 ppm) on corrosion resistance of these archwires. (2) To assess whether surface roughness (Ra) is the primary factor influencing the corrosion resistance of these archwires. Four different archwires (stainless steel [SS], nickel-titanium [NiTi], titanium molybdenum alloy [TMA], and ion-implanted TMA) were considered for this study. Surface characteristics were analyzed using scanning electron microscopy, atomic force microscopy (AFM), and energy dispersive spectroscopy. Linear polarization test, a fast electrochemical technique, was used to evaluate the corrosion resistance, in terms of polarization resistance of four different archwires in artificial saliva with NaF concentrations of 0% and 0.5%. Statistical analysis was performed by one-way analysis of variance. The potentiostatic study reveals that the corrosion resistance of low-friction TMA (L-TMA) > TMA > NiTi > SS. AFM analysis showed the surface Ra of TMA > NiTi > L-TMA > SS. This indicates that the chemical composition of the wire is the primary influential factor to have high corrosion resistance and surface Ra is only secondary. The corrosion resistance of all wires had reduced significantly in 0.5% acidic fluoride-containing artificial saliva due to formation of fluoride complex compound. The presence of 0.5% NaF in artificial saliva was detrimental to the corrosion resistance of the orthodontic archwires. Therefore, complete removal of residual high-fluorinated toothpastes from the crevice between archwire and bracket during tooth brushing is mandatory.

  3. Evaluation on the movement of endosseous titanium implants under continuous orthodontic forces: an experimental study in the dog.

    Science.gov (United States)

    Hsieh, Yao-Dung; Su, Ching-Ming; Yang, Yi-Hsin; Fu, Earl; Chen, Hui-Lin; Kung, Suefang

    2008-06-01

    The purpose of this study was to evaluate the movement of pure titanium implants under different continuous forces in the edentulous alveolar ridge. Four pairs of titanium implants were inserted into the right maxillary and mandibular post-extraction edentulous ridge of the experimental dog. Three different levels of continuous force (100, 200, and 500 g) were loaded onto three pairs of adjacent implant abutments using a memory Ni-Ti coil spring for up to 6 months and the remaining two implant abutments as the control group received no force. The positions of implant abutments were observed and the distances between the implants abutment at the top, middle and base levels were measured at the 0th, 2nd, 3rd, 6th and 8th month of the follow-up period. There was no significant change in the distances between adjacent abutments loaded with 100 or 200 g continuous forces throughout the entire study period. However, significantly more movement of implant abutments was noted in the 500 g pair after the 3rd month of loading when compared with the 200 or the 100 g pair (both P < 0.001). This change further increased at the 6th month (P < 0.001, 0.01, respectively). Moreover, the difference in the measurements at the top, middle and base level indicated that the two adjacent implants moved in a tipping manner in the 500 g pair after 3 and 6 months of loading. The osseointegrated implants remained stable and rigid with a pulling force of 100 and 200 g after 6 months of loading. However, when the force reached 500 g, the implants moved in an inward-tipping pattern. The results suggested that endosseous titanium implants might not necessarily be rigid anchorages under all circumstances.

  4. Incorporation of different antibiotics into carbonated hydroxyapatite coatings on titanium implants, release and antibiotic efficacy.

    Science.gov (United States)

    Stigter, M; Bezemer, J; de Groot, K; Layrolle, P

    2004-09-14

    Carbonated hydroxyapatite (CHA) coatings were applied onto titanium implants by using a biomimetic precipitation method. Different antibiotics were incorporated into the CHA coatings and their release and efficacy against bacteria growth were studied in vitro. The following antibiotics were used within this study: cephalothin, carbenicillin, amoxicillin, cefamandol, tobramycin, gentamicin and vancomycin. Increased concentrations of antibiotics in the coating solution led to a higher quantity of antibiotic incorporated into the CHA coating. Some antibiotics were better incorporated than others depending on their chemical structure. Antibiotics, containing carboxylic groups such as cephalothin, carbenicillin and cefamandol, were better incorporated than antibiotics lacking these groups. A bacterial inhibition test on Staphylococcus aureus bacteria showed inhibition of growth for all antibiotics that were released from the CHA coating. A release test was conducted in phosphate buffer saline PBS at pH 7.4 and 37 degrees C and showed that antibiotics containing carboxylic groups like cephalothin were slower released from the CHA coating than others. These results suggest that certain antibiotics are able to bind/chelate with calcium, resulting in a better incorporation into the CHA coating and a slower release. Antibiotics incorporated in CHA coatings on titanium implants might be used to prevent post-surgical infections and to promote bone-bonding of orthopedic devices.

  5. Graphitic carbon in a nanostructured titanium oxycarbide thin film to improve implant osseointegration

    International Nuclear Information System (INIS)

    Zanoni, R.; Ioannidu, C.A.; Mazzola, L.; Politi, L.; Misiano, C.; Longo, G.; Falconieri, M.; Scandurra, R.

    2015-01-01

    A nanostructured coating layer on titanium implants, able to improve their integration into bones and to protect against the harsh conditions of body fluids, was obtained by Ion Plating Plasma Assisted, a method suitable for industrial applications. A titanium carbide target was attached under vacuum to a magnetron sputtering source powered with a direct current in the 500–1100 W range, and a 100 W radio frequency was applied to the sample holder. The samples produced at 900 W gave the best biological response in terms of overexpression of some genes of proteins involved in bone turnover. We report the characterization of a reference and of an implant sample, both obtained at 900 W. Different micro/nanoscopic techniques evidenced the morphology of the substrates, and X-ray Photoelectron Spectroscopy was used to disclose the surface composition. The layer is a 500 nm thick hard nanostructure, composed of 60% graphitic carbon clustered with 15% TiC and 25% Ti oxides. - Highlights: • Nanostructured TiC protective layers were produced on Ti samples for prostheses. • Ion Plating Plasma-Assisted Deposition from TiC targets was used on Ti samples. • A model of the surface layer has been drawn from XPS, Raman, AFM, FIB/SEM, TEM. • The layer is mainly composed of graphitic carbon in addition to TiC and Ti oxides

  6. Evaluation of an abutment-level superpower sound processor for bone-anchored hearing.

    Science.gov (United States)

    Bosman, A J; Kruyt, I J; Mylanus, E A M; Hol, M K S; Snik, A F M

    2018-02-16

    Performance of an abutment-level superpower sound processor for bone-anchored hearing, the Ponto 3 SuperPower from Oticon Medical (BCD2), was compared to an earlier model from Oticon Medical (BCD1). A comparative study in which each patient serves as its own control. Tertiary clinic. Eighteen experienced BCD1 users with profound mixed hearing loss. Speech reception thresholds in noise; APHAB and SSQ questionnaires. In a group of 18 patients with severe mixed hearing loss, the performance of a recently introduced bone conduction device (BCD2) is evaluated relative to that of an earlier model (BCD1). Speech reception thresholds for the sentence-in-noise test in the speech and noise frontal condition are not significantly different (P > .05) for BCD1 and BCD2. Speech reception thresholds for frontal speech and three identical noise sources are 1.7 dB lower for BCD2 than for BCD1 (P  .05). Scores for the speech, spatial and quality of hearing domains of the SSQ questionnaire are significantly higher (P < .01), that is more favourable, for BCD2 than for BCD1 with effect sizes of 1.22, 0.71 and 1.05, respectively. Scores for the SSQ-factors "speech understanding," "spatial," "clarity, separation and identification" and "listening effort and concentration" were all significantly higher (P < .05) for BCD2 than for BCD1, with effect sizes of 1.28, 0.64, 0.98 and 0.78, respectively. On a proprietary questionnaire, 16 patients indicate a preference for BCD2 over BCD1 for conversations in a small group and two patients have no preference for either device. In a large group, one patient prefers BCD1, six patients have no preference, and eleven patients prefer BCD2. When listening to music, all patients prefer BCD2 over BCD1, with a strong preference for BCD2 for seven patients. When asked for an overall preference, all patients prefer BCD2 over BCD1, with nine patients strongly preferring BCD2. The lower speech reception thresholds in noise with BCD2 relative to BCD1

  7. Controlled release and biocompatibility of polymer/titania nanotube array system on titanium implants

    Directory of Open Access Journals (Sweden)

    Tingting Wang

    2017-03-01

    Full Text Available Bacterial infection and tissue inflammation are the major causes of early failure of titanium-based orthopedic implants; thus, surgical implants with tunable drug releasing properties represent an appealing way to address some of these problems of bacterial infection and tissue inflammation in early age of orthopedic implants. In this work, a hybrid surface system composed of biodegradable poly(lactic-co-glycolic acid (PLGA and titania nanotubes (TNTs has been successfully constructed on Ti implants with the aim of preventing bacterial infection via long-term drug release. By varying the size of the TNTs and the thickness of the polymer film, the drug release profile can be tuned to achieve the optimal therapeutic action throughout the treatment time. The size of TNTs plays a dominant role in the drug loading dose of TNTs/PLGA hybrid coatings. In this work, TNTs with an average size of 80 nm can achieve the largest loading dose. Depending on the polymer thickness, significant improvement in the drug release characteristics is attained, for instance, reduced burst release (from 84% to 27% and overall release time extended from 5 to over 40 days. In addition, the PLGA layers may favor the proliferation and osteogenesis of MC3T3-E1 mouse cells at an earlier stage. Therefore, this TNT/PLGA hybrid surface system can be employed as an effective bioplatform for improving both self-antibacterial performance and biocompatibility of Ti-based biomaterials.

  8. Zinc-ion implanted and deposited titanium surfaces reduce adhesion of Streptococccus mutans

    International Nuclear Information System (INIS)

    Xu Juan; Ding Gang; Li Jinlu; Yang Shenhui; Fang Bisong; Sun Hongchen; Zhou Yanmin

    2010-01-01

    While titanium (Ti) is a commonly used dental implant material with advantageous biocompatible and mechanical properties, native Ti surfaces do not have the ability to prevent bacterial colonization. The objective of this study was to evaluate the chemical composition and bacterial adhesive properties of zinc (Zn) ion implanted and deposited Ti surfaces (Zn-PIIID-Ti) as potential dental implant materials. Surfaces of pure Ti (cp-Ti) were modified with increasing concentrations of Zn using plasma immersion ion implantation and deposition (PIIID), and elemental surface compositions were characterized by X-ray photoelectron spectrometry (XPS). To evaluate bacterial responses, Streptococcus mutans were seeded onto the modifiedTi surfaces for 48 h and subsequently observed by scanning electron microscopy. Relative numbers of bacteria on each surface were assessed by collecting the adhered bacteria, reculturing and counting colony forming units after 48 h on bacterial grade plates. Ti, oxygen and carbon elements were detected on all surfaces by XPS. Increased Zn signals were detected on Zn-PIIID-Ti surfaces, correlating with an increase of Zn-deposition time. Substantial numbers of S. mutans adhered to cp-Ti samples, whereas bacterial adhesion on Zn-PIIID-Ti surfaces signficantly decreased as the Zn concentration increased (p < 0.01). In conclusion, PIIID can successfully introduce Zn onto a Ti surface, forming a modified surface layer bearing Zn ions that consequently deter adhesion of S. mutans, a common bacterium in the oral environment.

  9. Zinc-ion implanted and deposited titanium surfaces reduce adhesion of Streptococccus mutans

    Energy Technology Data Exchange (ETDEWEB)

    Xu Juan, E-mail: doctorxue@126.com [Implant Center, School of Stomatology Jilin University, Changchun, Jilin (China) and Stomatological Hospital, Urumqi, Xinjiang (China); Ding Gang [Department of Stomatology, Yidu Central Hospital, Weifang, Shandong (China); Capital Medical University School of Stomatology, Beijing (China); Li Jinlu; Yang Shenhui; Fang Bisong [Capital Medical University School of Stomatology, Beijing (China); Sun Hongchen, E-mail: hcsun@jlu.edu.cn [Implant Center, School of Stomatology Jilin University, Changchun, Jilin (China); Zhou Yanmin, E-mail: zhouym62@126.com [Implant Center, School of Stomatology Jilin University, Changchun, Jilin (China)

    2010-10-01

    While titanium (Ti) is a commonly used dental implant material with advantageous biocompatible and mechanical properties, native Ti surfaces do not have the ability to prevent bacterial colonization. The objective of this study was to evaluate the chemical composition and bacterial adhesive properties of zinc (Zn) ion implanted and deposited Ti surfaces (Zn-PIIID-Ti) as potential dental implant materials. Surfaces of pure Ti (cp-Ti) were modified with increasing concentrations of Zn using plasma immersion ion implantation and deposition (PIIID), and elemental surface compositions were characterized by X-ray photoelectron spectrometry (XPS). To evaluate bacterial responses, Streptococcus mutans were seeded onto the modifiedTi surfaces for 48 h and subsequently observed by scanning electron microscopy. Relative numbers of bacteria on each surface were assessed by collecting the adhered bacteria, reculturing and counting colony forming units after 48 h on bacterial grade plates. Ti, oxygen and carbon elements were detected on all surfaces by XPS. Increased Zn signals were detected on Zn-PIIID-Ti surfaces, correlating with an increase of Zn-deposition time. Substantial numbers of S. mutans adhered to cp-Ti samples, whereas bacterial adhesion on Zn-PIIID-Ti surfaces signficantly decreased as the Zn concentration increased (p < 0.01). In conclusion, PIIID can successfully introduce Zn onto a Ti surface, forming a modified surface layer bearing Zn ions that consequently deter adhesion of S. mutans, a common bacterium in the oral environment.

  10. Laser and Electron Beam Additive Manufacturing Methods of Fabricating Titanium Bone Implants

    Directory of Open Access Journals (Sweden)

    Bartłomiej Wysocki

    2017-06-01

    Full Text Available Additive Manufacturing (AM methods are generally used to produce an early sample or near net-shape elements based on three-dimensional geometrical modules. To date, publications on AM of metal implants have mainly focused on knee and hip replacements or bone scaffolds for tissue engineering. The direct fabrication of metallic implants can be achieved by methods, such as Selective Laser Melting (SLM or Electron Beam M