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Sample records for breast implant surfaces

  1. Breast reconstruction - implants

    Science.gov (United States)

    Breast implants surgery; Mastectomy - breast reconstruction with implants; Breast cancer - breast reconstruction with implants ... to make reconstruction easier. If you will have breast reconstruction later, your surgeon will remove enough skin ...

  2. Risks of Breast Implants

    Science.gov (United States)

    ... Tissue Disease The FDA has not detected any association between silicone gel-filled breast implants and connective tissue disease, breast cancer, or reproductive problems. In order to rule out ...

  3. Delayed breast implant reconstruction

    DEFF Research Database (Denmark)

    Hvilsom, Gitte B.; Hölmich, Lisbet R.; Steding-Jessen, Marianne

    2012-01-01

    We evaluated the association between radiation therapy and severe capsular contracture or reoperation after 717 delayed breast implant reconstruction procedures (288 1- and 429 2-stage procedures) identified in the prospective database of the Danish Registry for Plastic Surgery of the Breast during...... reconstruction approaches other than implants should be seriously considered among women who have received radiation therapy....

  4. Enhancing surface properties of breast implants by using electrospun silk fibroin.

    Science.gov (United States)

    Valencia-Lazcano, A A; Román-Doval, R; De La Cruz-Burelo, E; Millán-Casarrubias, E J; Rodríguez-Ortega, A

    2017-08-24

    In the present study, a new electrospun silk fibroin coating of silicone breast implants with improved biocompatibility and mechanical properties was obtained. Fibrous scaffolds were produced by electrospinning a solution containing silk fibroin, derived from Bombyx mori cocoons, and polyethylene oxide (PEO) to be used as a coating of breast implants. A randomly oriented structure of fibroin/PEO was electrospun on implants as assessed by SEM analysis, roughness measurements and ATR-FTIR spectroscopy. The scaffold showed 0.25 µm diameter fibres, 0.76 µm size superficial pores, arithmetic roughness of 0.632 ± 0.12 µm and texture aspect ratio of 0.893 ± 0.04. ATR-FTIR spectroscopy demonstrates the presence of PEO and fibroin in the coating. The mechanical characterisation of the implants before and after being coated with fibroin/PEO demonstrated that the fibroin/PEO scaffold contributes to the increase in the elastic modulus from 0.392 ± 0.02 to 0.560 ± 0.03 MPa and to a more elastic behaviour of the breast implants. Using the fibroin/PEO coating, human fibroblasts seeded on this matrix increased viability up to 30% compared to conventional breast implants. Electrospun silk fibroin could represent a clinically compatible, viable form to coat breast implants. Low cytotoxicity by the fibroin coating and its physico-chemical and mechanical properties may find application in improving breast implants biocompatibility. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2017. © 2017 Wiley Periodicals, Inc.

  5. Delayed breast implant reconstruction

    DEFF Research Database (Denmark)

    Hvilsom, Gitte B.; Hölmich, Lisbet R.; Steding-Jessen, Marianne

    2011-01-01

    Studies of complications following reconstructive surgery with implants among women with breast cancer are needed. As the, to our knowledge, first prospective long-term study we evaluated the occurrence of complications following delayed breast reconstruction separately for one- and two-stage pro......Studies of complications following reconstructive surgery with implants among women with breast cancer are needed. As the, to our knowledge, first prospective long-term study we evaluated the occurrence of complications following delayed breast reconstruction separately for one- and two......-stage procedures. From the Danish Registry for Plastic Surgery of the Breast, which has prospectively registered data for women undergoing breast implantations since 1999, we identified 559 women without a history of radiation therapy undergoing 592 delayed breast reconstructions following breast cancer during...... the period 1999 to 2006; 239 one-stage procedures and 353 two-stage procedures. The postoperative course through November 2009 was evaluated by cumulative incidence adjusting for competing risks for the selected outcomes; hematoma, infection, seroma, implant rupture, severe capsular contracture (modified...

  6. Silicone Gel-Filled Breast Implants

    Science.gov (United States)

    ... Medical Procedures Implants and Prosthetics Breast Implants Silicone Gel-Filled Breast Implants Share Tweet Linkedin Pin it ... options Linkedin Pin it Email Print Description: Silicone gel-filled breast implants have a silicone outer shell ...

  7. Silicone breast implants: complications.

    Science.gov (United States)

    Iwuagwu, F C; Frame, J D

    1997-12-01

    Silicone breast implants have been used for augmentation mammoplasty for cosmetic purposes as well as for breast reconstruction following mastectomy for more than three decades. Though the use of the silicone gel filled variety has been banned in the USA except for special cases, they continue to be available elsewhere in the world including the UK. Despite the immense benefit they provide, their usage is associated with some complications. Most of these are related to the surgery and can be reduced by good surgical management. The major complications associated with their use is adverse capsular contracture, an outcome which can be very frustrating to manage. This article reviews the commonly reported complications and suggested management alternatives.

  8. Capsular Contracture In Silicone Breast Implants: Insights From Rat Models

    Directory of Open Access Journals (Sweden)

    VILBERTO J. VIEIRA

    Full Text Available ABSTRACT Breast augmentation with silicone implants is one of the most common procedures performed by plastic surgeons around the world. Capsular contracture is a frequent complication in breast augmentation and reconstructive surgery, that requires invasive intervention. The inflammatory response to implanted mammary prostheses appears to be directly associated to capsular contracture. This review discusses the evidences from rat models studies, on the role of inflammation and fibrosis in capsular contraction and its relation to silicone breast implants surface.

  9. Untreated silicone breast implant rupture.

    Science.gov (United States)

    Hölmich, Lisbet R; Vejborg, Ilse M; Conrad, Carsten; Sletting, Susanne; Høier-Madsen, Mimi; Fryzek, Jon P; McLaughlin, Joseph K; Kjøller, Kim; Wiik, Allan; Friis, Søren

    2004-07-01

    Implant rupture is a well-known complication of breast implant surgery that can pass unnoticed by both patient and physician. To date, no prospective study has addressed the possible health implications of silicone breast implant rupture. The aim of the present study was to evaluate whether untreated ruptures are associated with changes over time in magnetic resonance imaging findings, serologic markers, or self-reported breast symptoms. A baseline magnetic resonance imaging examination was performed in 1999 on 271 women who were randomly chosen from a larger cohort of women having cosmetic breast implants for a median period of 12 years (range, 3 to 25 years). A follow-up magnetic resonance imaging examination was carried out in 2001, excluding women who underwent explantation in the period between the two magnetic resonance imaging examinations (n = 44). On the basis of these examinations, the authors identified 64 women who had at least one ruptured implant at the first magnetic resonance imaging examination and, for comparison, all women who had intact implants at both examinations (n = 98). Magnetic resonance images from the two examinations were compared and changes in rupture configuration were evaluated. Comparisons were also made for self-reported breast symptoms occurring during the study period and for changes in serum values of antinuclear antibodies, rheumatoid factor, and cardiolipin antibodies immunoglobulin G and immunoglobulin M. The majority of the women with implant rupture had no visible magnetic resonance imaging changes of their ruptured implants. For 11 implants (11 percent) in 10 women, the authors observed progression of silicone seepage, either as a conversion from intracapsular into extracapsular rupture (n = 7), as progression of extra-capsular silicone (n = 3), or as increasing herniation of the silicone within the fibrous capsule (n = 1); however, in most cases, these changes were minor. Some changes could be ascribed to trauma, but

  10. Salvage of Infected Breast Implants

    Directory of Open Access Journals (Sweden)

    Joon Ho Song

    2017-11-01

    Full Text Available Background Implant-based breast reconstruction is being performed more frequently, and implants are associated with an increased risk of infection. We reviewed the clinical features of cases of implant infection and investigated the risk factors for breast device salvage failure. Methods We retrospectively analyzed 771 patients who underwent implant-based breast reconstruction between January 2010 and December 2016. Age, body mass index, chemotherapy history, radiation exposure, and smoking history were assessed as potential risk factors for postoperative infection. We also evaluated the presence and onset of infection symptoms, wound culture pathogens, and other complications, including seroma, hematoma, and mastectomy skin necrosis. Additionally, we examined the mastectomy type, the use of acellular dermal matrix, the presence of an underlying disease such as hypertension or diabetes, and axillary node dissection. Results The total infection rate was 4.99% (58 of 1,163 cases and the total salvage rate was 58.6% (34 of 58. The postoperative duration to closed suction drain removal was significantly different between the cellulitis and implant removal groups. Staphylococcus aureus infection was most frequently found, with methicillin resistance in 37.5% of the cases of explantation. Explantation after infection was performed more often in patients who had undergone 2-stage expander/implant reconstruction than in those who had undergone direct-to-implant reconstruction. Conclusions Preventing infection is essential in implant-based breast reconstruction. The high salvage rate argues against early implant removal. However, when infection is due to methicillin-resistant S. aureus and the patient’s clinical symptoms do not improve, surgeons should consider implant removal.

  11. Untreated silicone breast implant rupture

    DEFF Research Database (Denmark)

    Hölmich, Lisbet R; Vejborg, Ilse M; Conrad, Carsten

    2004-01-01

    were evaluated. Comparisons were also made for self-reported breast symptoms occurring during the study period and for changes in serum values of antinuclear antibodies, rheumatoid factor, and cardiolipin antibodies immunoglobulin G and immunoglobulin M. The majority of the women with implant rupture...... that implant rupture is a relatively harmless condition, which only rarely progresses and gives rise to notable symptoms. Even so, because of a small risk of silicone spread, the authors suggest that women with implant ruptures be followed clinically, if not operated on. Because implant ruptures often occur...

  12. A pictorial essay of breast implant imaging and implant complications.

    Science.gov (United States)

    Arslan, Gozde; Celik, Levent; Cubuk, Rahmi

    2016-01-01

    Nowadays as more breast conserving surgeries and mastectomies are being performed, more breast implants are being used. Follow-up of these patients is as important as treatment. We, radiologists should be aware of normal imaging appearance of implants during follow ups. We should also be aware of complications which we may encounter during controls. In our essay, we aim to show the normal and pathological appearence of implants by sharing ultrasound, mammography and MR images from our clinic. Breast, Implants, MRI, Rupture.

  13. Immediate Direct-To-Implant Breast Reconstruction Using Anatomical Implants

    Directory of Open Access Journals (Sweden)

    Sung-Eun Kim

    2014-09-01

    Full Text Available BackgroundIn 2012, a new anatomic breast implant of form-stable silicone gel was introduced onto the Korean market. The intended use of this implant is in the area of aesthetic breast surgery, and many reports are promising. Thus far, however, there have been no reports on the use of this implant for breast reconstruction in Korea. We used this breast implant in breast reconstruction surgery and report our early experience.MethodsFrom November 2012 to April 2013, the Natrelle Style 410 form-stable anatomically shaped cohesive silicone gel-filled breast implant was used in 31 breasts of 30 patients for implant breast reconstruction with an acellular dermal matrix. Patients were treated with skin-sparing mastectomies followed by immediate breast reconstruction.ResultsThe mean breast resection volume was 240 mL (range, 83-540 mL. The mean size of the breast implants was 217 mL (range, 125-395 mL. Breast shape outcomes were considered acceptable. Infection and skin thinning occurred in one patient each, and hematoma and seroma did not occur. Three cases of wound dehiscence occurred, one requiring surgical intervention, while the others healed with conservative treatment in one month. Rippling did not occur. So far, complications such as capsular contracture and malrotation of breast implant have not yet arisen.ConclusionsBy using anatomic breast implants in breast reconstruction, we achieved satisfactory results with aesthetics better than those obtained with round breast implants. Therefore, we concluded that the anatomical implant is suitable for breast reconstruction.

  14. Cutaneous Silicone Granuloma Mimicking Breast Cancer after Ruptured Breast Implant

    Directory of Open Access Journals (Sweden)

    Waseem Asim Ghulam El-Charnoubi

    2011-01-01

    Full Text Available Cutaneous manifestations due to migration of silicone from ruptured implants are rare. Migrated silicone with cutaneous involvement has been found in the chest wall, abdominal wall, and lower extremities. We describe a case of cutaneous silicone granuloma in the breast exhibiting unusual growth mimicking breast cancer after a ruptured implant.

  15. Permanent Breast Seed Implant Dosimetry Quality Assurance

    Energy Technology Data Exchange (ETDEWEB)

    Keller, Brian M., E-mail: Brian.Keller@sunnybrook.ca [Department of Medical Physics, Sunnybrook Health Sciences Center, Toronto, ON (Canada); Department of Radiation Oncology, University of Toronto, Sunnybrook Health Sciences Center, Toronto, ON (Canada); Ravi, Ananth [Department of Medical Physics, Sunnybrook Health Sciences Center, Toronto, ON (Canada); Sankreacha, Raxa [Carlo Fidani Regional Cancer Center, Mississauga, ON (Canada); Pignol, Jean-Philippe [Department of Radiation Oncology, University of Toronto, Sunnybrook Health Sciences Center, Toronto, ON (Canada)

    2012-05-01

    Purpose: A permanent breast seed implant is a novel method of accelerated partial breast irradiation for women with early-stage breast cancer. This article presents pre- and post-implant dosimetric data, relates these data to clinical outcomes, and makes recommendations for those interested in starting a program. Methods and Materials: A total of 95 consecutive patients were accrued into one of three clinical trials after breast-conserving surgery: a Phase I/II trial (67 patients with infiltrating ductal carcinoma); a Phase II registry trial (25 patients with infiltrating ductal carcinoma); or a multi-center Phase II trial for patients with ductal carcinoma in situ (3 patients). Contouring of the planning target volume (PTV) was done on a Pinnacle workstation and dosimetry calculations, including dose-volume histograms, were done using a Variseed planning computer. Results: The mean pre-implant PTV coverage for the V{sub 90}, V{sub 100}, V{sub 150}, and V{sub 200} were as follows: 98.8% {+-} 1.2% (range, 94.5-100%); 97.3% {+-} 2.1% (range, 90.3-99.9%), 68.8% {+-} 14.3% (range, 32.7-91.5%); and 27.8% {+-} 8.6% (range, 15.1-62.3%). The effect of seed motion was characterized by post-implant dosimetry performed immediately after the implantation (same day) and at 2 months after the implantation. The mean V{sub 100} changed from 85.6% to 88.4% (p = 0.004) and the mean V{sub 200} changed from 36.2% to 48.3% (p < 0.001). Skin toxicity was associated with maximum skin dose (p = 0.014). Conclusions: Preplanning dosimetry should aim for a V{sub 90} of approximately 100%, a V{sub 100} between 95% and 100%, and a V{sub 200} between 20% and 30%, as these numbers are associated with no local recurrences to date and good patient tolerance. In general, the target volume coverage improved over the duration of the seed therapy. The maximum skin dose, defined as the average dose over the hottest 1 Multiplication-Sign 1-cm{sup 2} surface area, should be limited to 90% of the

  16. Silicone breast implants and connective tissue disease

    DEFF Research Database (Denmark)

    Lipworth, Loren; Holmich, Lisbet R; McLaughlin, Joseph K

    2011-01-01

    -analyses and critical reviews, which have demonstrated that cosmetic breast implants are not associated with a subsequent increased occurrence of individual CTDs or all CTDs combined, including fibromyalgia. Moreover, there is no credible evidence for the conjectured excess of "atypical" CTD among women with cosmetic...... CTD, has been extensively studied. We have reviewed the epidemiologic literature regarding an association between cosmetic breast implants and CTDs, with particular emphasis on results drawn from the most recent investigations, many of which are large cohort studies with long-term follow-up, as well...... breast implants, or of a rheumatic symptom profile unique to these women. No increased risk of CTDs is evident in women with extracapsular ruptures in two studies, which evaluated risk by implant rupture status, and no consistent association has been observed between silicone breast implants...

  17. Longitudinal Ultrasound Study of Breast Implant Rupture Over a Six-Year Interval.

    Science.gov (United States)

    Rochira, Dario; Cavalcanti, Pietro; Ottaviani, Antonio; Tambasco, Damiano

    2016-02-01

    Silicone gel-filled implants as opposed to saline-filled breast implants are the most commonly used breast implants in Europe, and this has recently also become the case in the United States. Modern implants have a multiple layer silicone shell and high to very high levels of cohesive silicone gel inside. Although breast magnetic resonance imaging is at present considered the gold standard imaging method for breast implant rupture detection, breast ultrasound (US) imaging is still the first-step investigation in Europe. The aim of this study was to verify whether or not the stepladder sign at US is still associated to intracapsular rupture among the last generation silicone breast implant. In this study, 156 patients presenting for breast augmentation, mastopexy with implants and breast reconstruction for a total number of 303 breast implants inserted were enrolled. A preoperative breast ultrasonography was performed, and patients underwent a routine US scan every 6 months for 24 months to evaluate the implant status. A final US evaluation 6 years after implantation was also performed. Stepladder signs were seen at 6 years in 170 implants (56%) of the examined implants at US scan, and only 2 implants showed signs of possible rupture because of severe distortion of the implant profile with or without external silicone collection. A third ruptured implant was detected at magnetic resonance imaging by the presence of breach of the shell at the posterior surface of the implant with small external silicon collection and was eventually confirmed at surgery. Therefore, the overall rupture rate found at the United States at 6 years was about 1% (3 of 303 implants). According to our findings, the stepladder sign at the United States is no longer associated to intracapsular rupture. Plastic surgeons, patients, and financial departments of hospitals would also be delighted to know that surgeons should not take patients back to theater for implant explantation when aging signs

  18. Objective Comparison of Commercially Available Breast Implant Devices.

    Science.gov (United States)

    Henderson, Peter W; Nash, David; Laskowski, Marta; Grant, Robert T

    2015-10-01

    Breast implants are frequently used for both cosmetic breast augmentation and breast reconstruction after mastectomy. Three companies currently offer FDA-approved breast implants (Allergan, Mentor, and Sientra), but their product offerings-including permanent breast implants, breast tissue expanders, sizers, and post-operative warranty-can be difficult to compare because of brand names and company-specific jargon. The ability to have a brand-agnostic understanding of all available options is important for both the surgical trainee as well as the surgeon in clinical practice. After a brief review of the history of breast implant devices, this review utilizes a unique conceptual framework based on variables such as fill material, shape, relative dimensions, and surface coating to facilitate a better understanding of the similarities and differences between the different company's offerings. Specifically, we identify which types of devices are offered by all three companies, those that are offered by only one company, those that have very limited product offerings, and those combinations that are not available at all. Finally, clinical implications are drawn from this framework that can be used by both cosmetic and reconstructive surgeons to counsel patients about all available options. Importantly, this project is entirely independent of any company's funding, support, or input. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  19. The double capsules in macro-textured breast implants.

    Science.gov (United States)

    Giot, Jean-Philippe; Paek, Laurence S; Nizard, Nathanael; El-Diwany, Mostafa; Gaboury, Louis A; Nelea, Monica; Bou-Merhi, Joseph S; Harris, Patrick G; Danino, Michel A

    2015-10-01

    Breast implants are amongst the most widely used types of permanent implants in modern medicine and have both aesthetic and reconstructive applications with excellent biocompatibility. The double capsule is a complication associated with textured prostheses that leads to implant displacement; however, its etiology has yet to be elucidated. In this study, 10 double capsules were sampled from breast expander implants for in-depth analysis; histologically, the inner capsular layer demonstrated highly organized collagen in sheets with delamination of fibers. At the prosthesis interface (PI) where the implant shell contacts the inner capsular layer, scanning electron microscopy (SEM) revealed a thin layer which mirrored the three-dimensional characteristics of the implant texture; the external surface of the inner capsular layer facing the intercapsular space (ICS) was flat. SEM examination of the inner capsule layer revealed both a large bacterial presence as well as biofilm deposition at the PI; a significantly lower quantity of bacteria and biofilm were found at the ICS interface. These findings suggest that the double capsule phenomenon's etiopathogenesis is of mechanical origin. Delamination of the periprosthetic capsule leads to the creation of the ICS; the maintained separation of the 2 layers subsequently alters the biostability of the macro-textured breast implant. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Imaging of common breast implants and implant-related complications: A pictorial essay

    Directory of Open Access Journals (Sweden)

    Amisha T Shah

    2016-01-01

    Full Text Available The number of women undergoing breast implant procedures is increasing exponentially. It is, therefore, imperative for a radiologist to be familiar with the normal and abnormal imaging appearances of common breast implants. Diagnostic imaging studies such as mammography, ultrasonography, and magnetic resonance imaging are used to evaluate implant integrity, detect abnormalities of the implant and its surrounding capsule, and detect breast conditions unrelated to implants. Magnetic resonance imaging of silicone breast implants, with its high sensitivity and specificity for detecting implant rupture, is the most reliable modality to asses implant integrity. Whichever imaging modality is used, the overall aim of imaging breast implants is to provide the pertinent information about implant integrity, detect implant failures, and to detect breast conditions unrelated to the implants, such as cancer.

  1. Imaging of common breast implants and implant-related complications: A pictorial essay

    Science.gov (United States)

    Shah, Amisha T; Jankharia, Bijal B

    2016-01-01

    The number of women undergoing breast implant procedures is increasing exponentially. It is, therefore, imperative for a radiologist to be familiar with the normal and abnormal imaging appearances of common breast implants. Diagnostic imaging studies such as mammography, ultrasonography, and magnetic resonance imaging are used to evaluate implant integrity, detect abnormalities of the implant and its surrounding capsule, and detect breast conditions unrelated to implants. Magnetic resonance imaging of silicone breast implants, with its high sensitivity and specificity for detecting implant rupture, is the most reliable modality to asses implant integrity. Whichever imaging modality is used, the overall aim of imaging breast implants is to provide the pertinent information about implant integrity, detect implant failures, and to detect breast conditions unrelated to the implants, such as cancer. PMID:27413269

  2. Delayed breast reconstruction with implants after invasive breast cancer does not impair prognosis

    DEFF Research Database (Denmark)

    Holmich, L.R.; During, M.; Henriksen, T.F.

    2008-01-01

    We investigated if delayed breast implant reconstruction after breast cancer impairs prognosis. Using data from the Danish Breast Cancer Cooperative Group register, we identified all women......We investigated if delayed breast implant reconstruction after breast cancer impairs prognosis. Using data from the Danish Breast Cancer Cooperative Group register, we identified all women...

  3. The diagnosis of breast implant rupture

    DEFF Research Database (Denmark)

    Hölmich, Lisbet R; Vejborg, Ilse; Conrad, Carsten

    2005-01-01

    STUDY OBJECTIVE: The aim of this study was to evaluate the accuracy of Magnetic Resonance Imaging (MRI) as performed according to a strict study protocol in diagnosing rupture of silicone breast implants. MATERIAL AND METHODS: The study population consisted of 64 women with 118 implants, who had...... participated in either one or two study MRI examinations, aiming at determining the prevalence and incidence of silent implant rupture, respectively, and who subsequently underwent explantation. Implant rupture status was determined by four independent readers and a consensus diagnosis of either rupture...... (intracapsular or extracapsular), possible rupture or intact implant was then obtained. Strict predetermined rupture criteria were applied as described in this report and findings at surgery were abstracted in a standardised manner and results compared. RESULTS: At MRI, 66 implants were diagnosed as ruptured...

  4. Prepectoral Implant-Based Breast Reconstruction

    Directory of Open Access Journals (Sweden)

    Lyndsey Highton, BMBCh, MA, FRCS(Plast

    2017-09-01

    Conclusion:. Prepectoral implant placement with ADM cover is emerging as an alternative approach for IBR. This method facilitates breast reconstruction with a good cosmetic outcome for patients who want a quick recovery without potential compromise of pectoral muscle function and associated problems.

  5. Breast implants under siege: an historical commentary.

    Science.gov (United States)

    Fisher, J C; Brody, G S

    1992-01-01

    Despite 3 decades of rapidly expanding application of polydimethylsiloxane as a relatively safe implantable biomaterial, the American public is being told by a vocal minority that its use in the breast implant may be dangerous. Most of the furor has been generated by consumer advocates with support of a handful of scientists who have expressed opinions, not well supported by facts, about the risks of these devices. These anxieties have been fueled in the public's mind by a media more interested in sensationalism than disciplined reporting. The controversy has complicated the regulatory process and has become politicized in the halls of State Legislatures and Congress. Remarkably, this controversy has not involved the many other biomedical applications of silicone. How has this controversy gathered momentum? What role has the government played and how have the professional, scientific, corporate, and patient communities responded to public concern? This discussion places the breast implant battle into an historical perspective.

  6. Reconstructive breast implantation after mastectomy for breast cancer

    DEFF Research Database (Denmark)

    Henriksen, Trine F; Fryzek, Jon P; Hölmich, Lisbet R

    2005-01-01

    BACKGROUND: Clinical reports have raised concern about local complications following breast implantation used in reconstructive or cosmetic surgery, but there is a shortage of epidemiological studies in this area. OBJECTIVE: To assess in a prospective epidemiological manner the occurrence of shor...

  7. Relative implant volume and sensibility alterations after breast augmentation.

    Science.gov (United States)

    Pitanguy, Ivo; Vaena, Michel; Radwanski, Henrique N; Nunes, Daniel; Vargas, André F

    2007-01-01

    Recent studies have provided diverging results regarding the factors that may affect sensibility after primary breast augmentation. Implant volume is believed to be an important factor, but the relation of implant size to breast volume has not been adequately addressed. In addition, the literature shows that a conflict exists when the periareolar and inframammary approaches are compared. This study aimed to refine the volumetric analysis comparing the implant and final breast size as well as the intrinsic association of these two factors with postoperative sensory alteration of the breast. A prospective study investigated patients who underwent aesthetic breast augmentation between June 2004 and October 2005 (i.e., a 16-month period) at the Ivo Pitanguy Institute. The sensibility in nine regions of the breast was tested before and after surgery using Semmes-Weinstein monofilaments. Breast sizers were used to compare the pre- and postoperative breast volumes. Statistical analysis of the data took into consideration the relative volume of the implant, the surgical approach, the presence of minor complications, the breast-feeding history, and the subjective evaluation of sensory changes in the patients. A total of 37 patients who underwent breast augmentation were examined preoperatively. The relative volume of the implant was found to be associated with sensibility alterations. No difference was found between the periareolar and inframammary incision approaches. Other factors such as previous breast-feeding, minor complications, and subjective alterations were not associated with sensory alterations. The study findings suggest that larger implants and smaller breasts show an increased association with postoperative sensory alterations of the breast. Plastic surgeons and their patients should be aware of this possibility. Implant volume should be considered together with breast size to avoid sensory complications, and this is summarized in the concept of relative

  8. Local complications after cosmetic breast implant surgery in Finland

    DEFF Research Database (Denmark)

    Kulmala, Ilona; McLaughlin, Joseph K; Pakkanen, Matti

    2004-01-01

    cosmetic silicone breast implants between 1968 and 2002. Patient records were abstracted, and additional information was gathered using a structured questionnaire that was mailed to 470 of the women in the cohort. Overall, 36% of the women had 1 or more diagnoses of postoperative complications...... implantation. Most of the women were satisfied with the implantation, but only 40% considered the preoperative information on possible risks related to implantation as sufficient. With respect to the occurrence of local complications following cosmetic breast implantation, the findings of this study...

  9. Bacterial biofilms and capsular contracture in patients with breast implants.

    Science.gov (United States)

    Rieger, U M; Mesina, J; Kalbermatten, D F; Haug, M; Frey, H P; Pico, R; Frei, R; Pierer, G; Lüscher, N J; Trampuz, A

    2013-05-01

    It has been hypothesized that bacterial biofilms on breast implants may cause chronic inflammation leading to capsular contracture. The association between bacterial biofilms of removed implants and capsular contracture was investigated. Breast implants explanted between 2006 and 2010 at five participating centres for plastic and reconstructive surgery were investigated by sonication. Bacterial cultures derived from sonication were correlated with patient, surgical and implant characteristics, and the degree of capsular contracture. The study included 121 breast implants from 84 patients, of which 119 originated from women and two from men undergoing gender reassignment. Some 50 breast prostheses were implanted for reconstruction, 48 for aesthetic reasons and 23 implants were used as temporary expander devices. The median indwelling time was 4·0 (range 0·1-32) years for permanent implants and 3 (range 1-6) months for temporary devices. Excluding nine implants with clinical signs of infection, sonication cultures were positive in 40 (45 per cent) of 89 permanent implants and in 12 (52 per cent) of 23 temporary devices. Analysis of permanent implants showed that a positive bacterial culture after sonication correlated with the degree of capsular contracture: Baker I, two of 11 implants; Baker II, two of ten; Baker III, nine of 23; and Baker IV, 27 of 45 (P contracture, indicating the potential causative role of bacterial biofilms in the pathogenesis of capsular contracture. NCT01138891 (http://www.clinicaltrials.gov). © 2013 British Journal of Surgery Society Ltd. Published by John Wiley & Sons Ltd.

  10. [Comperative study of implant surface characteristics].

    Science.gov (United States)

    Katona, Bernadett; Daróczi, Lajos; Jenei, Attila; Bakó, József; Hegedus, Csaba

    2013-12-01

    The osseointegration between the implant and its' bone environment is very important. The implants shall meet the following requirements: biocompatibility, rigidity, resistance against corrosion and technical producibility. In our present study surface morphology and material characteristics of different implants (Denti Bone Level, Denti Zirconium C, Bionika CorticaL, Straumann SLA, Straumann SLA Active, Dentsply Ankylos and Biotech Kontact implant) were investigated with scanning electron microscopy and energy-dispersive X-ray spectroscopy. The possible surface alterations caused by the manufacturing technology were also investigated. During grit-blasting the implants' surface is blasted with hard ceramic particles (titanium oxide, alumina, calcium phosphate). Properties of blasting material are critical because the osseointegration of dental implants should not be hampered. The physical and chemical features of blasting particles could importantly affect the produced surfaces of implants. Titanium surfaces with micro pits are created after immersion in mixtures of strong acids. On surfaces after dual acid-etching procedures the crosslinking between fibrin and osteogenetic cells could be enhanced therefore bone formation could be directly facilitated on the surface of the implant. Nowadays there are a number of surface modification techniques available. These can be used as a single method or in combination with each other. The effect of the two most commonly used surface modifications (acid-etching and grit-blasting) on different implants are demonstrated in our investigation.

  11. A Ballistics Examination of Firearm Injuries Involving Breast Implants.

    Science.gov (United States)

    Pannucci, Christopher J; Cyr, Adam J; Moores, Neal G; Young, Jason B; Szegedi, Martin

    2017-07-06

    This ballistics study examines whether saline breast implants can decrease tissue penetration in firearm injuries. We hypothesize that the fluid column within a saline breast implant can alter bullet velocity and/or bullet pattern of mushrooming. The two experimental groups included saline implants with 7.4 cm projection and a no implant group. The experimental design allowed the bullet to pass-through an implant and into ballistics gel (n = 10) or into ballistics gel without passage through an implant (n = 11). Shots that passed through an implant had 20.6% decreased penetration distance when compared to shots that did not pass-through an implant; this difference was statistically significant (31.9 cm vs. 40.2 cm, p ballistics gel penetration. © 2017 American Academy of Forensic Sciences.

  12. Breast implants and the risk of breast cancer: a meta-analysis of cohort studies

    NARCIS (Netherlands)

    Noels, Eline C.; Lapid, Oren; Lindeman, Jan H. N.; Bastiaannet, Esther

    2015-01-01

    The popularity of cosmetic breast augmentation and the incidence of breast cancer have been increasing worldwide. It has been hypothesized that the risk of breast cancer may be greater among patients who have undergone cosmetic breast implantation. The authors performed a meta-analysis of the

  13. Psychological characteristics of Danish women with cosmetic breast implants

    DEFF Research Database (Denmark)

    Lipworth, Loren; Kjøller, Kim; Hölmich, Lisbet R

    2009-01-01

    An excess of suicide among women with cosmetic breast implants compared with controls has consistently been reported in epidemiologic studies. We have evaluated psychological characteristics among 423 Danish women with cosmetic breast implants, compared with 414 controls. Odds ratios (OR) with 95......% confidence intervals (CI) for self-reported psychological symptoms were calculated using multiple logistic regression. Substantial excesses of all studied symptoms before implant surgery were reported among women with breast implants compared with women with other cosmetic surgery, whereas ORs for virtually......, the corresponding ORs for these 3 psychological symptoms after surgery were 0.9 (95% CI = 0.6-1.4), 1.0 (95% CI = 0.7-1.5), and 1.0 (95% CI = 0.6-1.5), respectively. In conclusion, women with cosmetic breast implants reported preoperative psychological symptoms indicative of depressive disorders substantially more...

  14. Mortality and suicide among Danish women with cosmetic breast implants

    DEFF Research Database (Denmark)

    Jacobsen, Poul Harboe; Hölmich, Lisbet R; McLaughlin, Joseph K

    2004-01-01

    BACKGROUND: Epidemiologic studies indicate that women with cosmetic breast implants have a significantly increased risk of suicide. Our objectives were to examine mortality among Danish women who underwent cosmetic breast implant surgery and to evaluate the baseline prevalence of psychopathological...... disorders as measured by admission to a psychiatric hospital among women seeking cosmetic surgery. METHODS: Cohort study of 2761 women who underwent cosmetic breast implant surgery at private clinics of plastic surgery or public hospitals, 7071 women who underwent breast reduction surgery at public...... hospitals, and 1736 women who attended private clinics for cosmetic surgery other than breast implantation, between 1973 and 1995. Causes of death through 1999 were identified through the Danish Mortality Files. Information on admission to psychiatric hospitals prior to cosmetic surgery was obtained from...

  15. Management of tuberous breast deformity with anatomic cohesive silicone gel breast implants.

    Science.gov (United States)

    Panchapakesan, Vivek; Brown, Mitchell H

    2009-01-01

    Tuberous breast deformity is a rare congenital condition that often requires surgical correction. Numerous surgical techniques have been described, reflecting the reconstructive challenge of this deformity. The anatomic cohesive gel breast implant is a powerful tool in both aesthetic and reconstructive breast surgery. In the authors' experience, its use in treating tuberous breast deformity has provided the opportunity for a single-stage approach, with very good results. The senior author has managed more than 50 cases of single-stage reconstruction for tuberous breast deformity using anatomic cohesive gel breast implants. His surgical technique is described with suggestions for achieving optimal results. Representative case examples are provided. The anatomic cohesive silicone gel breast implant is an excellent device for treating tuberous breast deformity. It often can be used as a single-stage correction of the deformity with very good results. The authors strongly advocate consideration of its use in tuberous breast deformity reconstruction.

  16. Study of the radiation effect in breast implants

    Energy Technology Data Exchange (ETDEWEB)

    Moreno T, L. R.; Ramirez R, A., E-mail: lumor2000@yahoo.com.mx [Universidad Autonoma Metropolitana, Unidad Azcapotzalco, Departamento de Ciencias Basicas, Av. San Pablo No. 180, Col. Reynosa Tamaulipas, 02200 Mexico D. F. (Mexico)

    2013-10-01

    This breast cancer is one of the most important death causes in women. Among the more frequently medical treatment for advanced breast cancer is the mastectomy. This situation leads to silicone implants as an esthetic option. There have been cases in patients with implants where cancer was frequently detected, in which a conventional radiotherapy is required. In this work is presented a study of the probable adverse effects caused by the application of high power X-rays (6-10 MV) to the silicone implants and to the surrounding tissues. In the research carried out at the clinic, none Bolus effect was detected in patients with implants. Our results prescribe that in the case of patients with implants and frequent breast cancer, the removal of implants is not necessary due radiotherapy works directly in the damaged tissues. (Author)

  17. Is Salvage of Recently Infected Breast Implant After Breast Augmentation or Reconstruction Possible? An Experimental Study.

    Science.gov (United States)

    Castus, P; Heymans, O; Melin, P; Renwart, L; Henrist, C; Hayton, E; Mordon, S; Leclère, F M

    2018-01-23

    The reinsertion of an infected implant when peri-prosthetic infection occurs early after breast augmentation or breast reconstruction remains controversial. In this experimental study, the authors tried to remove bacteria, and their biofilm, from the colonized surface of breast prostheses, without damaging their integrity. A total of 112 shell samples of silicone breast prostheses, smooth (SPSS) and textured (TPSS), were colonized by S. epidermidis (SE) or S. aureus (SA) strains, all able to produce biofilms. After 15 days, all the samples were removed from the contaminated culture broth and constituted 4 groups of 20 contaminated samples: SPSS/SE (group I), SPSS/SA (group II), TPSS/SE (group III), TPSS/SE (group IV). In another group-group SEM-, 16 colonized samples were used for documentation with scanning electron microscopy (SEM). The remaining 16 samples were used to test the limits of detection of the sterility test. All samples of groups I-IV and 8 samples of group SEM were « washed » with a smooth brush in a povidone-iodine bath and rinsed with saline solution. A subset of the washed samples was sent for SEM and the others were immersed in sterile broth and were incubated at 35 °C for 3 weeks (groups I-IV). Fifteen days after contamination, all the samples in groups I-IV were colonized. In the SEM group, SEM images attested to the presence of bacteria in biofilm attached to the shells. After cleaning, SEM did not reveal any bacteria and there was no visible alteration in the outer structure of the shell. Sterility tests performed after decontamination in groups I-IV remained negative for all the samples. Breast prostheses recently contaminated with Staphylococci, frequently involved in peri-prosthetic breast implant infection and capable of producing biofilms, can be efficiently decontaminated by the procedure used in this study. Our decontamination procedure did not alter the surface structure of the prostheses. This decontamination procedure

  18. Tissue Reinforcement in Implant-based Breast Reconstruction

    Directory of Open Access Journals (Sweden)

    Michael Scheflan, MD

    2014-08-01

    Conclusions: ADM-assisted implant-based breast reconstruction may improve aesthetic outcomes. However, appropriate patient selection, surgical technique, and postoperative management are critical for its success, including minimizing the risk of complications.

  19. Surface modification of implants in long bone

    Science.gov (United States)

    Förster, Yvonne; Rentsch, Claudia; Schneiders, Wolfgang; Bernhardt, Ricardo; Simon, Jan C.; Worch, Hartmut; Rammelt, Stefan

    2012-01-01

    Coatings of orthopedic implants are investigated to improve the osteoinductive and osteoconductive properties of the implant surfaces and thus to enhance periimplant bone formation. By applying coatings that mimic the extracellular matrix a favorable environment for osteoblasts, osteoclasts and their progenitor cells is provided to promote early and strong fixation of implants. It is known that the early bone ongrowth increases primary implant fixation and reduces the risk of implant failure. This review presents an overview of coating titanium and hydroxyapatite implants with components of the extracellular matrix like collagen type I, chondroitin sulfate and RGD peptide in different small and large animal models. The influence of these components on cells, the inflammation process, new bone formation and bone/implant contact is summarized. PMID:23507866

  20. The Clinical Implications of Poly Implant Prothèse Breast Implants: An Overview

    Directory of Open Access Journals (Sweden)

    Umar Wazir

    2015-01-01

    Full Text Available Mammary implants marketed by Poly Implant Prothèse (PIP were found to contain industrial grade silicone and this caused heightened anxiety and extensive publicity regarding their safety in humans. These implants were used in a large number of patients worldwide for augmentation or breast reconstruction. We reviewed articles identified by searches of Medline, PubMed, Embase, and Google Scholar databases up to May 2014 using the terms: "PIP", "Poly Implant Prothèse", "breast implants" and "augmentation mammoplasty" "siloxanes" or "silicone". In addition the websites of regulating bodies in Europe, USA, and Australia were searched for reports related to PIP mammary implants. PIP mammary implants are more likely to rupture than other implants and can cause adverse effects in the short to the medium term related to the symptoms of rupture such as pain, lumps in the breast and axilla and anxiety. Based on peer-reviewed published studies we have calculated an overall rupture rate of 14.5% (383/2,635 for PIP implants. However, there is no evidence that PIP implant rupture causes long-term adverse health effects in humans so far. Silicone lymphadenopathy represents a foreign body reaction and should be treated conservatively. The long-term adverse effects usually arise from inappropriate extensive surgery, such as axillary lymph node dissection or extensive resection of breast tissue due to silicone leakage.

  1. Breast-implant texturing associated with delamination of capsular layers: A histological analysis of the double capsule phenomenon.

    Science.gov (United States)

    Efanov, J I; Giot, J P; Fernandez, J; Danino, M A

    2017-06-01

    Macro-texturing of breast implants was developed with the double goal of improving implant stabilization within the breast cavity and decreasing the rate of capsular contractures. However, recent evidence suggests that double capsular formation, a potentially worrisome phenomenon associated with late seromas and biofilms, occurs with preponderance in macro-textured implants. Our objective was to analyze histologically different regions of double capsules to determine if they are more prone to mechanical movements. A prospective analysis including patients undergoing second-stage expander to definitive breast-implant reconstruction post-mastectomy was conducted after intraoperative identification of the double capsule phenomenon. Two samples were collected from each capsules around the implant, located centrally and laterally. The specimens were sent for histological analysis by the institution's pathologist. In total, 10 patients were identified intraoperatively with partial double capsule phenomenon. Among samples retrieved from the lateral aspect of the breast implant, all were associated with delamination and fractures in the collagen matrix of the double capsules. This phenomenon was not observed in any sample from the dome of the breast. Breast-implant macro-texturing plays an important role on delamination of capsules on lateral portions of the breast, which may have an etiologic role in double capsule formation. Manufacturing implants with macro-texturing on one side and smooth surface on the other could diminish mechanical shear forces responsible for these findings. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  2. Anaplastic large cell lymphoma associated with breast implants

    Directory of Open Access Journals (Sweden)

    Vid Bajuk

    2017-02-01

    Full Text Available An increasing number of women worldwide decide for esthetic correction of breasts with silicone implants and post-cancer breast reconstruction with tissue expanders and silicone breast implants. It is estimated that more than 10 million women around the globe have them. Tere are approximately 200 known cases of patients with anaplastic large cell lymphoma (ALCL linked with silicone breast implants reported in medical literature. ALCL is a rare disease with an annual incidence of 0.1–0.3/100 000 women with breast silicone implants. In the presence of clinical signs, physician should also consider this rare form of ALCL in differential diagnosis. Patients are on average 50 years old. Long afer implantation surgery, the patient may experience breast swelling, pain and/or asymmetry. In diagnostics, ultrasound and cytological examination are required. During ultrasound examination fluid formation (seroma or solid tumor mass can be detected. Treatment is individualized. Due to tumor nature, implant resection and total capsulectomy are usually indicated; also, chemo- and radiotherapy might rarely be required. Five-year survival rate depends on tumor form and correlates well with clinical fndings of seroma or solid mass. In the more frequent form, seroma, fve-year survival rate is 100 %, while in the case of solid tumor mass fve-year survival rate is 75 %. The rarity of this disease makes it difficult to diagnose, but nevertheless, early detection and treatment are important for better recovery.

  3. CASE REPORT Breast cancer in a patient with silicone implants ...

    African Journals Online (AJOL)

    than in the breast mass. Breast cancer in a patient with silicone implants. R A Ahmed, MB ChB. Department of Radiology, Kalafong Hospital, University of Pretoria. CASE REPORT. Fig. 1. Inhomogeneous poorly outlined vascular mass in the left upper outer quadrant at two o'clock. Note the microcalcifications. This was the.

  4. Ion implantation into concave polymer surface

    Energy Technology Data Exchange (ETDEWEB)

    Sakudo, N. [Kanazawa Institute of Technology, Advanced Materials R and D Center, 3-1 Yatsukaho, Matto, Hakusan, Ishikawa 924-0838 (Japan)]. E-mail: sakudo@neptune.kanazawa-it.ac.jp; Shinohara, T. [Kanazawa Institute of Technology, Advanced Materials R and D Center, 3-1 Yatsukaho, Matto, Hakusan, Ishikawa 924-0838 (Japan); Amaya, S. [Kanazawa Institute of Technology, Advanced Materials R and D Center, 3-1 Yatsukaho, Matto, Hakusan, Ishikawa 924-0838 (Japan); Endo, H. [Kanazawa Institute of Technology, Advanced Materials R and D Center, 3-1 Yatsukaho, Matto, Hakusan, Ishikawa 924-0838 (Japan); Okuji, S. [Lintec Corp., 5-14-42 Nishiki-cho, Warabi, Saitama 335-0005 (Japan); Ikenaga, N. [Japan Science and Technology Corp., Nomigun, Ishikawa 923-1121 (Japan)

    2006-01-15

    A new technique for ion implantation into concave surface of insulating materials is proposed and experimentally studied. The principle is roughly described by referring to modifying inner surface of a PET (polyethylene terephthalate) bottle. An electrode that is supplied with positive high-voltage pulses is inserted into the bottle. Both plasma formation and ion implantation are simultaneously realized by the same high-voltage pulses. Ion sheath with a certain thickness that depends on plasma parameters is formed just on the inner surface of the bottle. Since the plasma potential is very close to that of the electrode, ions from the plasma are accelerated in the sheath and implanted perpendicularly into the bottle's inner surface. Laser Raman spectroscopy shows that the inner surface of an ion-implanted PET bottle is modified into DLC (diamond-like carbon). Gas permeation measurement shows that gas-barrier property enhances due to the modification.

  5. Infection Prophylaxis for Breast Implant Surgery: Could We Do Better?

    Science.gov (United States)

    Henderson, Julia R.; Kandola, Sandhir; Hignett, Susan P.; Teasdale, Rebecca L.; Topps, Ashley R.; Pennick, Mandana; Hwang, Meiju; Barnes, Nicola

    2017-01-01

    Objective: Infective complications following breast implant surgery may result in implant removal. This causes patient distress and is costly to treat. A range of precautions is undertaken at the time of surgery to reduce infection, with varying levels of supporting evidence. This study aimed to determine how frequently and consistently infection prevention precautions are used during breast implant surgery. Methods: Multicenter observational study of surgical practice with real-time data collection during breast implant surgery. Results: From 7 NHS breast units, 121 implant procedures were assessed in 94 patients under the care of 22 consultant surgeons. The commonest procedure was immediate reconstruction (58%; 70/121). All patients were methicillin-resistant Staphylococcus aureus (but not methicillin-sensitive Staphylococcus aureus) screened. Antibiotics were given at surgery in all cases; 92% (85/94) received postoperative antibiotics. Other precautions included closed glove technique (67%; 63/94), door signs to reduce theater traffic (72%; 68/94), glove changing prior to implant handling (98%; 119/121), laminar air flow theaters (55%; 52/94), disposable drapes (94%; 88/94) and gowns (74%; 70/94), and cavity washing (89%; 108/121). Among the 14 consultants evaluated on more than 1 procedure (range, 2-22; median = 5), only 1 consistently used exactly the same precautions when siting an implant. Conclusion: Despite national guidance, infection prevention measures are not applied consistently during breast implant surgery, with variability between surgeons and within individual surgeon's practice. The introduction of an infection prevention checklist for all breast implant procedures could improve the reliability with which these precautions are undertaken. PMID:28663774

  6. A simple method to inset and position polyurethane-covered breast implants.

    Science.gov (United States)

    Castello, Manuel Francisco; Han, Sheng; Silvestri, Alessandro; Grassetti, Luca; Torresetti, Matteo; Zhang, Yi Xin; Perdanasari, Aurelia Trisliana; Marcelli, Claudio; Gigliotti, Diego; Lazzeri, Davide

    2014-04-01

    Polyurethane-covered breast implants have been used increasingly for cosmetic and revision breast surgery. The incision for insertion should be of minimal length and the placement of these implants in the pocket can be more difficult than that of conventional implants because of the highly adherent textured surface of the polyurethane external layer that grasps the surrounding tissues. The use of a sterile plastic insertion sleeve that is open on both sides is suggested by the manufacturer to overcome the friction between the polyurethane implant and the skin and surrounding tissues. A new method to facilitate polyurethane implant insertion and adjustment in all cases of primary breast augmentation and revision surgery is presented. After the implant, which is in the sleeve, is located in the pocket, the plastic sleeve is filled with saline and antibiotics so the solution lubricates the surface around the implant. The sleeve is then twisted so that the solution is squeezed inside the pocket while the sleeve itself is pulled back and removed. Between 2010 and 2013, this method was used in 73 cases of primary augmentation and revision breast surgery without any complications. The method described here allows for easier removal of the plastic sleeve during polyurethane implant insertion without any complications or evidence of implant migration or rotation at follow-up. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .

  7. Psychological characteristics of Danish women with cosmetic breast implants.

    Science.gov (United States)

    Lipworth, Loren; Kjøller, Kim; Hölmich, Lisbet R; Friis, Søren; Olsen, Jørgen H; McLaughlin, Joseph K

    2009-07-01

    An excess of suicide among women with cosmetic breast implants compared with controls has consistently been reported in epidemiologic studies. We have evaluated psychological characteristics among 423 Danish women with cosmetic breast implants, compared with 414 controls. Odds ratios (OR) with 95% confidence intervals (CI) for self-reported psychological symptoms were calculated using multiple logistic regression. Substantial excesses of all studied symptoms before implant surgery were reported among women with breast implants compared with women with other cosmetic surgery, whereas ORs for virtually all symptoms occurring after surgery were close to or below 1.0. In particular, ORs for treatment for depression, cognitive/depressive symptoms, and depression/low spirit before surgery were 4.6 (95% CI = 2.1-10.0), 3.9 (95% CI = 1.9-7.8), and 2.5 (95% CI = 1.1-5.5), respectively. In contrast, the corresponding ORs for these 3 psychological symptoms after surgery were 0.9 (95% CI = 0.6-1.4), 1.0 (95% CI = 0.7-1.5), and 1.0 (95% CI = 0.6-1.5), respectively. In conclusion, women with cosmetic breast implants reported preoperative psychological symptoms indicative of depressive disorders substantially more frequently than women with other cosmetic surgery. Future studies using standardized, validated psychiatric assessment tools are needed to determine whether this can explain the higher risk for suicide among a subset of women seeking cosmetic breast implants.

  8. Silicone Breast Implants: A Rare Cause of Pleural Effusion

    Directory of Open Access Journals (Sweden)

    Imam H. Shaik

    2015-01-01

    Full Text Available Pleural effusions are one of the rarest complications reported in patients with silicone gel filled breast implants. The silicone implants have potential to provoke chronic inflammation of pleura and subsequent pulmonary complications such as pleural effusion. Herein, we report a 44-year-old female who presented with left sided pleural effusion, six weeks after a silicone breast implantation surgery. The most common infectious, inflammatory, and malignant causes of pleural effusion were excluded with pleural fluid cytology and cultures. With recurrent effusion in the setting of recent surgery, the chemical reaction to silicone breast implants was sought and exploration was performed which revealed foreign body reaction (FBR to silicone material. The symptoms dramatically improved after the explantation.

  9. Cancer risk among Danish women with cosmetic breast implants

    DEFF Research Database (Denmark)

    Friis, Søren; Hölmich, Lisbet R; McLaughlin, Joseph K

    2006-01-01

    -up of our earlier cohort study of Danish women with cosmetic breast implants by 7 years, yielding 30 years of follow-up for women with longest implant duration. The study population consisted of women who underwent cosmetic breast implant surgery at private clinics of plastic surgery (n = 1,653) or public...... (range = 0-30 years). Women with breast implants experienced a reduced risk of breast cancer (SIR = 0.7; 95% CI = 0.5-1.0), and an increased risk of non-melanoma skin cancer (SIR = 2.1; 95% CI = 1.5-2.7). Stratification by age at implantation, calendar year at implantation and time since implantation...... showed no clear trends, however, the statistical precision was limited in these analyses. When excluding non-melanoma skin cancer, the SIR for cancer overall was 1.0 (95% CI = 0.8-1.2). With respect to other site-specific cancers, no significantly increased or decreased SIR were observed. Similar results...

  10. Skin-reducing mastectomy and direct-to-implant reconstruction in giant phyllodes tumour of breast: case report

    Directory of Open Access Journals (Sweden)

    Francesco Ciancio

    2017-01-01

    Discussion and conclusion: In selected patients with large sized breasts (C-D cup and poor surface area of skin involved, a valid technique in the treatment of this pathology is the Skin-Reducing Mastectomy and immediate reconstruction with implants (DTI = direct to implant.

  11. Single lump breast surface stress assessment study

    Science.gov (United States)

    Vairavan, R.; Ong, N. R.; Sauli, Z.; Kirtsaeng, S.; Sakuntasathien, S.; Paitong, P.; Alcain, J. B.; Lai, S. L.; Retnasamy, V.

    2017-09-01

    Breast cancer is one of the commonest cancers diagnosed among women around the world. Simulation approach has been utilized to study, characterize and improvise detection methods for breast cancer. However, minimal simulation work has been done to evaluate the surface stress of the breast with lumps. Thus, in this work, simulation analysis was utilized to evaluate and assess the breast surface stress due to the presence of a lump within the internal structure of the breast. The simulation was conducted using the Elmer software. Simulation results have confirmed that the presence of a lump within the breast causes stress on the skin surface of the breast.

  12. Surface Modification Of Implants For Bone Surgery

    Directory of Open Access Journals (Sweden)

    Marciniak J.

    2015-09-01

    Full Text Available The study discusses the methods of surface modification methods for AISAI 316 L steel and Ti6Al4V ELI titanium alloy, dedicated to complex design implants used in bone surgery. Results of structural tests have been presented along with those evaluating the physicochemical properties of the formed surface layers. Clinical feasibility of the surface layers has also been evaluated.

  13. Mastication forces and implant-bearing surface.

    Science.gov (United States)

    Le Gall, M G; Lauret, J F; Saadoun, A P

    1994-01-01

    This article discusses the shift of emphasis in implantology from the phenomenon of osseointegration of implants to the accurate fabrication of the prosthesis, recognizing the implant/prosthesis unit as an actual replica rather than a replacement of the missing tooth. The study of kinetics with its succession of mandibular cycles is used to discuss the integration of mastication and occlusion. The importance of periimplant ligament in natural teeth is discussed, along with the impact of its absence on implant mobility. The impact of the bone types and the root surface architecture on the implant-bearing surface is presented along with the stress of the mastication forces. All these factors have to be considered in the treatment planning and effectively communicated to the laboratory. The learning objective of this article is to provide updated information in those areas for the reader.

  14. SU-F-T-314: Estimation of Dose Distributions with Different Types of Breast Implants in Various Radiation Treatment Techniques for Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, M; Lee, S; Suh, T [Department of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Jung, J [Department of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Department of Radiation Oncology, College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Kim, S; Cho, Y; Lee, I [Department of Radiation Oncology, Gangnam Severance Hospital, Seoul (Korea, Republic of)

    2016-06-15

    Purpose: This study investigates the effects of different kinds and designs of commercialized breast implants on the dose distributions in breast cancer radiotherapy under a variety of conditions. Methods: The dose for the clinical conventional tangential irradiation, Intensity Modulated Radiation Therapy (IMRT), volumetric modulated arc therapy (VMAT) breast plans was measured using radiochromic films and stimulated luminescence dosimeter (OSLD). The radiochromic film was used as an integrating dosimeter, while the OSLDs were used for real-time dosimetry to isolate the contribution of dose from individual segment. The films were placed at various slices in the Rando phantom and between the body and breast surface OSLDs were used to measure skin dose at 18 positions spaced on the two (right/left) breast. The implant breast was placed on the left side and the phantom breast was remained on the right side. Each treatment technique was performed on different size of the breasts and different shape of the breast implant. The PTV dose was prescribed 50.4 Gy and V47.88≥95%. Results: In different shapes of the breast implant, because of the shadow formed extensive around the breast implant, dose variation was relatively higher that of prescribed dose. As the PTV was delineated on the whole breast, maximum 5% dose error and average 3% difference was observed averagely. VMAT techniques largely decrease the contiguous hot spot in the skin by an average of 25% compared with IMRT. The both IMRT and VMAT techniques resulted in lower doses to normal critical structures than tangential plans for nearly all dose analyzation. Conclusion: Compared to the other technique, IMRT reduced radiation dose exposure to normal tissues and maintained reasonable target homogeneity and for the same target coverage, VMAT can reduce the skin dose in all the regions of the body.

  15. Silicone implant incompatibility syndrome (SIIS) in a 57-year-old woman with unilateral silicone breast implant

    DEFF Research Database (Denmark)

    Schierbeck, Juliane; Davidsen, Jesper Rømhild; Grindsted Nielsen, Sanne

    2017-01-01

    implants can lead to different interstitial lung manifestations predominantly with granuloma evolvement, leading to the so-called silicone implant incompatibility syndrome (SIIS). This case describes a 57-year-old woman with multiple lung infiltrations and a left-sided breast implant. The implant had been...

  16. Prevalence of Rupture in Poly Implant Prothese Silicone Breast Implants, Recalled from the European Market in 2010

    NARCIS (Netherlands)

    Maijers, M.C.; Niessen, F.B.

    2012-01-01

    Background: Known complications of silicone breast implants are rupture and silicone leakage, complications that are related not only to generation and implant age but also to the manufacturer. Implants from the French manufacturer Poly Implant Prothèse showed more rupture than expected and were

  17. Microbial Load Analysis in Silicone Gel Breast Implants

    Directory of Open Access Journals (Sweden)

    Glaucia Cristina Mello Santos

    2010-06-01

    Full Text Available Silicone breast implants consist of biomaterials widely used in breast reconstitution surgeries or in mammary augmentation for esthetic reasons. A preliminary stage of the implant production process is vulcanization, which consists of heating the implant to 165±5°C for approximately 9 hours. The aim of this work was to evaluate the bioburden of silicone breast implants prior to the vulcanization process and the decline in bioburden due to this process, and to confirm the sterility of the gel contained in the membrane. Breast implant production stages were evaluated by microbial counting in different steps, according to the USP 32 methodology. To evaluation of decrease in microbial load, spores strips were introduced inside the implant, and after vulcanization cycles the strips were removed from the implant. The strips were transferred to tubes containing TSB, followed by incubation for 7 days at 30-35°C. The results obtained showed that the level of microbial contamination of gel implants is relatively low, and that vulcanization allowed for the inactivation of up to 108 spores. This study led us to the conclusion that vulcanization leaded to sterility of the gel inside the product. Thus, the final sterilizing process contributed to an increase in the Sterility Assurance Level 1. Keywords: Silicone. Breast implant. Sterilization. Dry heat. Vulcanization. Bioburden. RESUMO Análise da Carga Microbiana de Implantes Mamários de Silicone Os implantes mamários de silicone constituem-se em biomateriais que têm sido amplamente utilizados em cirurgias para reconstituição da mama ou para o aumento do tamanho da mama por motivos estéticos. Uma etapa preliminar do processo produtivo do implante é a vulcanização, que consiste no aquecimento do implante a 165±5°C por aproximadamente 9 horas. O objetivo deste estudo foi avaliar a carga microbiana dos implantes mamários de silicone antes do processo de vulcanização, o decaimento da carga

  18. [The use of implants in ptosis, hypertrophic and breast deformities].

    Science.gov (United States)

    Ohana, J; Karcenty, B; Mekouar, R; Amar, A

    2005-10-01

    Breast precise analysis, due to a partial or global diformity, total or minor tuberous breast allows an interesting appreciation of the skin and gland importance in breast modifications. This same analysis enables us to consider the ptosis and hypertrophies under a different angle. Thus, the relative proportions in between the various segments, their evolution in the time and especially the glandular distribution mode, sometimes leads to a different technical approach. To ensure a better glandular distribution, an important factor of the breast stability, the use of a mastopexy, which everyone knows the limits, appears under a new light and, more often than one thought, the use of a breast implant ensures homogeneity of consistency and a more long term result. Concerning the various skin modifications, their specific analysis permit to establish the type of incision used for a better-adapted scar result. The approach we suggest, (detailed analytic study of the breast, glandular distribution, relative proportion of the different breast levels and a more frequent use of an implant) which in any case should not be systematic, can obviously in certain situation optimize the quality of the result (long term projection and a better stability of the mammary shape).

  19. Correction of tuberous breast deformity: A retrospective study comparing lipofilling versus breast implant augmentation.

    Science.gov (United States)

    Brault, Nicolas; Stivala, Alessio; Guillier, David; Moris, Vivien; Revol, Marc; François, Caroline; Cristofari, Sarra

    2017-05-01

    Breast implants and, more recently, autologous fat grafting are the two most common treatments used to correct tuberous breast deformity (TBD). The post-surgical quality of life between the two techniques is not well demonstrated. This study aimed to compare satisfaction and health-related quality of life in patients affected by TBD between these two techniques. All TBD patients operated between January 2008 and May 2015 were retrospectively identified, and only those treated with implants or lipofilling were included. Satisfaction was evaluated at least 6 months after surgery with the postoperative Breast-Q® augmentation module. From January 2008 to May 2015, 62 patients were recruited in our study, and 37 patients were evaluated using a Breast-Q questionnaire after at least 6 months of follow-up. Breast implant-augmented patients were significantly more satisfied concerning the "satisfaction with breasts" module (p = 0.002) and the "satisfaction with outcome" module (p = 0.00008). A question-by-question analysis revealed several interesting and significant differences, showing higher scores in most of the questions in the breast implant group. Patients in the lipofilling group, interestingly, had a mean of 1.6 interventions compared to the mean 1.36 interventions in the implant group (p = 0.23). This reflects the need to perform more surgical sessions in the lipofilling group to achieve a satisfactory result. Our study demonstrated that tuberous breast correction with implants can achieve better satisfaction along with good outcomes than lipofilling usually does. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  20. CO2 laser surface treatment of failed dental implants for re-implantation: an animal study.

    Science.gov (United States)

    Kasraei, Shahin; Torkzaban, Parviz; Shams, Bahar; Hosseinipanah, Seyed Mohammad; Farhadian, Maryam

    2016-07-01

    The aim of the present study was to evaluate the success rate of failed implants re-implanted after surface treatment with CO2 laser. Despite the widespread use of dental implants, there are many incidents of failures. It is believed that lasers can be applied to decontaminate the implant surface without damaging the implant. Ten dental implants that had failed for various reasons other than fracture or surface abrasion were subjected to CO2 laser surface treatment and randomly placed in the maxillae of dogs. Three failed implants were also placed as the negative controls after irrigation with saline solution without laser surface treatment. The stability of the implants was evaluated by the use of the Periotest values (PTVs) on the first day after surgery and at 1, 3, and 6 months post-operatively. The mean PTVs of treated implants increased at the first month interval, indicating a decrease in implant stability due to inflammation followed by healing of the tissue. At 3 and 6 months, the mean PTVs decreased compared to the 1-month interval (P implant stability. The mean PTVs increased in the negative control group compared to baseline (P implants were significantly lower than control group at 3 and 6 months after implant placement (P implantation of failed implants in Jack Russell Terrier dogs after CO2 laser surface debridement is associated with a high success rate in terms of implant stability.

  1. Breast magnetic resonance imaging: tips for the diagnosis of silicone-induced granuloma of a breast implant capsule (SIGBIC).

    Science.gov (United States)

    de Faria Castro Fleury, Eduardo; Gianini, Ana Claudia; Ayres, Veronica; Ramalho, Luciana C; Seleti, Rodrigo Oliveira; Roveda, Decio

    2017-08-01

    Complications resulting from the placement of silicone breast implants are becoming more frequent in our clinical practice. This is due to the increase in breast aesthetic surgeries at the beginning of the century, where breast augmentation using silicone implants was the main intervention performed. Generally, studies that discuss the complications of breast implants are restricted to reports of intra- or extra-capsular ruptures, contractures and haematomas. Currently, much importance has been given to anaplastic large cell lymphoma (ALCL) as a more severe complication related to silicone implants. Recently, granuloma formation induced by silicone particle bleeding from intact breast implants has been described when the free silicone comes into contact with the fibrous capsule of the implant. Few studies have demonstrated the characteristics and diagnostic keys for this entity. The objective of this study is to present cases of SIGBIC diagnosed in our service and to discuss the main findings that allow its diagnosis. Teaching Points • Breast implants induce fibrous capsule formation at the periphery of the implant. • Gel bleeding is inherent in all types of silicone breast implants. • Gel bleeding induces silicone-induced granuloma of breast implants. • Main diagnostic tips: heterogeneous mass, black-drop sign and late enhancement.

  2. Long-term health status of Danish women with silicone breast implants

    DEFF Research Database (Denmark)

    Breiting, Vibeke B; Hölmich, Lisbet R; Brandt, Bodil

    2004-01-01

    autoantibodies. Self-reported use of psychotropic drugs was higher among women with breast implants than among either control group. The authors conclude that long-term cosmetic breast implantation may cause capsular contracture and breast pain but does not appear to be associated with other symptoms, diseases...

  3. The capsular hammock flap for correction of breast implant ptosis.

    Science.gov (United States)

    Wessels, Louis; Murphy, Siun; Merten, Steven

    2014-04-01

    A well-defined inframammary fold (IMF) is essential in providing an aesthetically pleasing and stable result in breast procedures. The position of the IMF on the chest wall determines the "footprint" of the breast, and hence the breast and chest aesthetic as a whole. Implant malposition is reported in the literature to occur in 5-8 % of primary breast augmentation patients. This occurs most commonly in a caudal direction, which is the most difficult problem to correct, as reported by Tebbett (Clin Plast Surg 28:425-434, 2001). Numerous surgical techniques to correct the malpositioned IMF have been described, including periosteal anchorage techniques as reported by Persichetti et al. (Ann Plast Surg 70:636-638, 2013), periareolar approaches that secure the IMF to the rib cage, and superiorly based capsular flaps. Here we describe a novel simple capsular flap technique using the lower anterior capsule, which is divided and formed into an inferiorly based flap and used as a "hammock" to re-establish the IMF and support the implant. As the capsule is made of a compact fibrous shell with a dense collagen network and excellent blood supply, using it as a flap to reposition and maintain the implant is ideal. Previous studies and tests have shown the reliability of capsule-based flap reconstruction due to the capsule's intrinsic strength and good vascularity, as shown by Rubino et al. (Ann Plast Surg 46:95-102, 2001). We describe our series of 12 primary breast augmentation patients with caudal implant malposition who underwent IMF reconstruction and implant repositioning with this technique. We explain our simple and repeatable technique that shows a stable and very durable result in repositioning the IMF and implant, with no recurrence of implant ptosis. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors

  4. The stable status evaluation for female breast implant surgery by calculating related physics parameters.

    Science.gov (United States)

    Sun, Shuh-Ping; Hsu, Ko-Wen; Chen, Jing-Shyr

    2008-05-01

    Cosmetic doctor utilizes the position, size and shapes of female's breast to judge whether the breast is under steady-state condition after breast implant plastic surgery. Since, doctor evaluates the breast condition with the subjective discrimination (such as vision, sense of touch) without using the objective physical parameters auxiliary. This study uses the 3D optics scanner editing 3D image to obtain full-scale 3D female breasts image. The CAD system converts the breast position, size and shapes, as the length of the curve between UBL (upper breast line) and NBL (nipple base line), the length of the curve between NBL and LBL (lower breast line), breast volume and breasts congruence rate. The stability after the breast implant plastic surgery is one of the important successful indexes of plastic surgery, so with the continuity analysis the breast curve length, volume and congruence rate can let the doctor really grasp the stability of the breast after plastic surgery.

  5. And the Breast is History: Issues Surrounding FDA Regulation of Silicone Breast Implants

    OpenAIRE

    Simme, Jodi L.

    1995-01-01

    The breast implant crisis has raised serious issues for women. On one hand, it is difficult to argue against giving women the right to choose, especially when the choice involves their own bodies. Restricting freedom in that realm is politically unpopular these days. On the other hand, women have been harmed by the lack of conclusive health information and by deceptive and coercive messages sent by media, implant manufacturers and plastic surgeons. For women to benefit from their right to cho...

  6. Organic-inorganic surface modifications for titanium implant surfaces.

    NARCIS (Netherlands)

    Jonge, L.T. de; Leeuwenburgh, S.C.G.; Wolke, J.G.C.; Jansen, J.A.

    2008-01-01

    This paper reviews current physicochemical and biochemical coating techniques that are investigated to enhance bone regeneration at the interface of titanium implant materials. By applying coatings onto titanium surfaces that mimic the organic and inorganic components of living bone tissue, a

  7. [The influence of dental implant surface on osseointegration: review].

    Science.gov (United States)

    Livne, S; Marku-Cohen, S; Harel, N; Piek, D; Ormianer, Z

    2012-01-01

    Dental implant therapy is a prevalent and successful treatment, based on research and clinical experience. Ossointegration is the main factor that responsible for success or failure, initially of the implant, and in some cases followed with the whole treatment failure. The osseointegration process is influenced by several factors, among them the surface texture. Dental implants are available with different surface modifications that have been developed for enhancing clinical performances. This paper reviews the main treatments used for changing dental titanium implant surfaces, and compare the clinical performance of different types of implants. Based on existent literature, modified implant surface improves significantly the ability to achive optimise bone-implant contact and improve osseointegration. This review did not find any significant major differences between the surface modifications in use this days in terms of survival and success of specific implant. There are several methods that are no longer in use, due to poor clinical performance in the past.

  8. Implant Exposure after Immediate Reconstruction for Breast Cancer

    Directory of Open Access Journals (Sweden)

    Alfred Fitoussi

    2016-03-01

    Full Text Available Background: The technique most frequently employed for breast reconstruction, either immediate (IBR or delayed (DBR, is the insertion of a prosthesis. The placement of a foreign body always carries the risk, albeit small, of peri-prosthetic infection and exposure of the implant that necessitates its removal, signaling the temporary or permanent failure of the reconstruction.Methods: We retrospectively analyzed data of 738 consecutive patients immediate implant-only breast reconstructions between 1989 and 2005 in order to evaluate the contributing factors of failure.Results: Our statistical analysis identified 3 statistically significant risk factors of implant extrusion: irradiation (P = 0.01, post-operative chemotherapy (P = 0.03, and the use of non- Becker expanders (P = 0.02.Conclusions: It is important, especially for the multidisciplinary breast cancer team members, to be aware of these factors in order to make the optimal decision for immediate reconstruction after mastectomy and the suggested techniques. The patients should also be aware, as part of a shared medical decision, of the risks and their frequency before accepting IBR.

  9. What's really behind the attack on silicone breast implants.

    Science.gov (United States)

    Angell, M

    1996-09-09

    Millions of dollars are being awarded by injuries and a major company has been forced into bankruptcy because of litigation over silicone breast implants. Yet scientific research hasn't established a link between the implants and disease, notes Marcia Angell, executive editor of the New England Journal of Medicine. When she began studying the issue, this self-described feminist and liberal Democrat expected to uncover iniquities of big business and the implant manufacturers. Instead, she's written an indictment of the tort system, junk science, and the gullibility of the news media. Attorneys have twisted facts and played on the emotions of juries, with the consent of judges and often to the cheers of the press. Angell worries that it's now become politically correct to bash the scientific method in the name of diversity, multiculturalism, and feminism.

  10. The impact of cosmetic breast implants on breastfeeding: a systematic review and meta-analysis

    OpenAIRE

    Schiff, Michal; Algert, Charles S; Ampt, Amanda; Sywak, Mark S.; Roberts, Christine L

    2014-01-01

    Background Cosmetic breast augmentation (breast implants) is one of the most common plastic surgery procedures worldwide and uptake in high income countries has increased in the last two decades. Women need information about all associated outcomes in order to make an informed decision regarding whether to undergo cosmetic breast surgery. We conducted a systematic review to assess breastfeeding outcomes among women with breast implants compared to women without. Methods A systematic literatur...

  11. Polyurethane-Coated Breast Implants Revisited: A 30-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Nikki Castel

    2015-03-01

    Full Text Available BackgroundPolyurethane coating of breast implants has been shown to reduce capsular contracture in short-term follow-up studies. This 30-year study is the longest examination of the use of polyurethane-coated implants and their correlation with capsular contracture.MethodsThis study evaluates the senior surgeon's (F.D.P. experience with the use of polyurethane-coated implants in aesthetic breast augmentation in 382 patients over 30 years. Follow-up evaluations were conducted for six months after surgery. After the six-month follow-up period, 76 patients returned for reoperation. The gross findings, histology, and associated capsular contracture were noted at the time of explantation.ResultsNo patient during the six-month follow-up period demonstrated capsular contracture. For those who underwent reoperation for capsular contracture, Baker II/III contractures were noted nine to 10 years after surgery and Baker IV contractures were noted 12 to 21 years after surgery. None of the explanted implants had macroscopic evidence of polyurethane, which was only found during the first five years after surgery. The microscopic presence of polyurethane was noted in all capsules up to 30 years after the original operation.ConclusionsAn inverse correlation was found between the amount of polyurethane coating on the implant and the occurrence of capsular contracture. Increasingly severe capsular contracture was associated with a decreased amount of polyurethane coating on the surface of the implants. No contracture occurred in patients whose implants showed incomplete biodegradation of polyurethane, as indicated by the visible presence of polyurethane coating. We recommend research to find a non-toxic, non-biodegradable synthetic material as an alternative to polyurethane.

  12. Correction of tuberous breast with small volume asymmetry by using a new adjustable implant.

    Science.gov (United States)

    Dessy, L A; Mazzocchi, M; Corrias, F; Sorvillo, V; Scuderi, N

    2013-04-01

    The tuberous breast syndrome is a rare anomaly of breast shape, which can be associated to volume breast asymmetry. We report our caseload in the correction of tuberous breasts with small volume asymmetry by using the Muti's technique associated to the implantation of a new adjustable implant. Purpose of the study is to evaluate the efficacy of treating tuberous breast deformity with two different types of implants (a textured round high profile cohesive I implant in the larger breast and a Spectra™ implant in the smaller breast). Since May 2008, patients affected by tuberous breast combined to small breast volume asymmetry were enrolled in a prospective study. After gland deformity correction, the adjustable implant was positioned in the smaller breast. A textured round implant was positioned in the contralateral breast. Standard pictures were taken before surgery and during follow-up visits over one year. A visual analogue scale (VAS) scale was used to evaluate patients' and external physicians' judgment. Standardized objective measurements of breast and chest were also taken. Statistical significance of any value variation was assessed with the Wilconxon's rank sum test. Eleven patients were treated with the proposed surgical approach. VAS scores from patients and external physicians were high. Deformity correction was obtained in all patients as evidenced by the significant modifications of objective measurements. No major late complications occurred. The new adjustable implant provides a reliable corrective option for hypoplastic tuberous breasts with small volume asymmetry. This device allows intra-operative modification of implant volume according to breast volume discrepancy. Although our findings are satisfying, a longer follow-up is required to evaluate long term results.

  13. 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

  14. Bacterial adhesion on ion-implanted stainless steel surfaces

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Q. [Department of Mechanical Engineering, University of Dundee, Dundee DD1 4HN (United Kingdom)]. E-mail: q.zhao@dundee.ac.uk; Liu, Y. [Department of Mechanical Engineering, University of Dundee, Dundee DD1 4HN (United Kingdom); Wang, C. [Department of Mechanical Engineering, University of Dundee, Dundee DD1 4HN (United Kingdom); Wang, S. [Department of Mechanical Engineering, University of Dundee, Dundee DD1 4HN (United Kingdom); Peng, N. [Surrey Ion Beam Centre, University of Surrey, Surrey GU2 7XH (United Kingdom); Jeynes, C. [Surrey Ion Beam Centre, University of Surrey, Surrey GU2 7XH (United Kingdom)

    2007-08-31

    Stainless steel disks were implanted with N{sup +}, O{sup +} and SiF{sub 3} {sup +}, respectively at the Surrey Ion Beam Centre. The surface properties of the implanted surfaces were analyzed, including surface chemical composition, surface topography, surface roughness and surface free energy. Bacterial adhesion of Pseudomonas aeruginosa, Staphylococcus epidermidis and Staphylococcus aureus, which frequently cause medical device-associated infections was evaluated under static condition and laminar flow condition. The effect of contact time, growth media and surface properties of the ion-implanted steels on bacterial adhesion was investigated. The experimental results showed that SiF{sub 3} {sup +}-implanted stainless steel performed much better than N{sup +}-implanted steel, O{sup +}-implanted steel and untreated stainless steel control on reducing bacterial attachment under identical experimental conditions.

  15. Long-term safety and effectiveness of style 410 highly cohesive silicone breast implants

    DEFF Research Database (Denmark)

    Hedén, Per; Bronz, Giorgio; Elberg, Jens Jørgen

    2009-01-01

    Style 410 shaped gel breast implant before examination. The secondary end points included lactation, reproductive and breast disease history before and after implantation, and quality-of-life measurements and complications after implantation. RESULTS: The implant rupture rate was 1.7% a median of 8......BACKGROUND: In 2006, a single-center Swedish study demonstrated a low rupture rate and high patient satisfaction with the Style 410 shaped, form-stable gel implant. The current study aimed to validate the accuracy of the previously published results across multiple European sites. METHODS: A total...... than the preimplantation rates. Breast implantation surgery was considered advantageous by 91% of the subjects, demonstrating high patient satisfaction. CONCLUSIONS: The Style 410 anatomically shaped, form-stable gel breast implants demonstrated long-term safety and effectiveness....

  16. A feasibility study of magnetic resonance imaging of silicone breast implants in Finland

    DEFF Research Database (Denmark)

    Kulmala, Ilona; Boice, John D; McLaughlin, Joseph K

    2005-01-01

    Cosmetic breast implants have become increasingly popular throughout the world. However, there is insufficient knowledge about the frequency and severity of local complications such as rupture and capsular contracture. A pilot study of 25 Finnish women with 50 cosmetic breast implants was organized......-section of the different generations of implants in Finland, with implant ages varying from 4 months to 20 years. The average implant size was 215 mL, typical in Finnish cosmetic surgery. MR images were evaluated by two independent readers. The first reader diagnosed six implants with intracapsular rupture, while...

  17. Dental implant surfaces after insertion in bone: an in vitro study in four commercial implant systems.

    Science.gov (United States)

    Deppe, Herbert; Wolff, Carolina; Bauer, Florian; Ruthenberg, Ricarda; Sculean, Anton; Mücke, Thomas

    2017-10-24

    Primary healing of dental implants is influenced by their surface morphology. However, little is known about any alterations in morphology during their insertion. Therefore, the aim of this study was to evaluate the surface morphology of four different implant systems, following their insertion in porcine jaw bones. Four fresh porcine mandible specimens were used. Six new implants of four systems (Ankylos® 4.5 × 14 mm, Frialit Synchro® 4.5 × 15 mm, NobelReplace ® Tapered Groovy RP 4.3 × 13 mm, Straumann SLA® Bone Level 3.3 × 14 mm) were inserted, whereas one implant of each system served as a control. After their removal, implants were cleaned in an ultrasonic bath. All 28 implants were examined quantitatively by 3D confocal microscopy for surface characteristics. In the evaluated zones, implants of the Ankylos, Frialit, and Straumann systems showed mostly a reduction of the mean surface roughness Sa, the maximal surface roughness Sz, and the developed surface area ratio Sdr; Nobel implants showed an increase in these parameters. With respect to all three parameters Sa, Sz, and Sdr, statistical analysis revealed that differences between the four systems were highly significant in the apical region of implants. Controls showed no morphologic alterations. The insertion process had an impact on the surface of all four implant systems. Anodized implant surface modification seems to result in more alterations compared with subtractive surface modifications. Therefore, surgical planning should take into consideration the choice of surface treatment because the characteristics of the implants may be modified during the installation process. The given information is of value for daily implantation practice and the course of osseointegration.

  18. Surface treatments of titanium dental implants for rapid osseointegration.

    Science.gov (United States)

    Le Guéhennec, L; Soueidan, A; Layrolle, P; Amouriq, Y

    2007-07-01

    The osseointegration rate of titanium dental implants is related to their composition and surface roughness. Rough-surfaced implants favor both bone anchoring and biomechanical stability. Osteoconductive calcium phosphate coatings promote bone healing and apposition, leading to the rapid biological fixation of implants. The different methods used for increasing surface roughness or applying osteoconductive coatings to titanium dental implants are reviewed. Surface treatments, such as titanium plasma-spraying, grit-blasting, acid-etching, anodization or calcium phosphate coatings, and their corresponding surface morphologies and properties are described. Most of these surfaces are commercially available and have proven clinical efficacy (>95% over 5 years). The precise role of surface chemistry and topography on the early events in dental implant osseointegration remain poorly understood. In addition, comparative clinical studies with different implant surfaces are rarely performed. The future of dental implantology should aim to develop surfaces with controlled and standardized topography or chemistry. This approach will be the only way to understand the interactions between proteins, cells and tissues, and implant surfaces. The local release of bone stimulating or resorptive drugs in the peri-implant region may also respond to difficult clinical situations with poor bone quality and quantity. These therapeutic strategies should ultimately enhance the osseointegration process of dental implants for their immediate loading and long-term success.

  19. Long-term health status of Danish women with silicone breast implants.

    Science.gov (United States)

    Breiting, Vibeke B; Hölmich, Lisbet R; Brandt, Bodil; Fryzek, Jon P; Wolthers, Mette S; Kjøller, Kim; McLaughlin, Joseph K; Wiik, Allan; Friis, Søren

    2004-07-01

    Long-term safety data are important in the evaluation of possible adverse health outcomes related to silicone breast implants. The authors evaluated long-term symptoms and conditions and medication use among 190 Danish women with cosmetic silicone breast implants compared with 186 women who had undergone breast reduction surgery and with 149 women from the general population. Breast implant and reduction surgeries were performed from 1973 to 1988 at one public hospital and one private plastic surgery clinic. Among women with breast implants, the average implantation time was 19 years, 60 percent (n = 114) had only one implantation, and 10 percent (n = 19) had undergone explantation before the time of study (1997 to 1998). The authors found no material differences in self-reported diseases or symptoms among study groups, except for breast pain, which was reported nearly three times as often by women with implants than by women with breast reduction (odds ratio, 2.8; 95 percent confidence interval, 1.4 to 5.3). Approximately 80 percent of women in each study group reported at least one symptom. No consistent differences were observed in the seroprevalences of antinuclear antibodies or other autoantibodies. Self-reported use of psychotropic drugs was higher among women with breast implants than among either control group. The authors conclude that long-term cosmetic breast implantation may cause capsular contracture and breast pain but does not appear to be associated with other symptoms, diseases, or autoimmune reactivity. The authors' finding of excess use of drugs for treatment of depression and anxiety among women with breast implants may warrant further investigation.

  20. Osteomyelitis of sternum and rib after breast prosthesis implantation: A rare or underestimated infection?

    Directory of Open Access Journals (Sweden)

    Piseth Seng

    2015-01-01

    Full Text Available Sternum and rib osteomyelitis complicated from breast implant infection is rare. We report a case of early sternum and rib osteomyelitis occurred during breast implant infection managed in an inter-regional referral center for bone/joint infections in the south of France.

  1. Correlation between MRI results and intraoperative findings in patients with silicone breast implants

    NARCIS (Netherlands)

    N. Lindenblatt (Nicole); K. El-Rabadi (Karem); T. Helbich (Thomas); H. Czembirek (Heinrich); M. Deutinger (Maria); H. Benditte-Klepetko (Heike)

    2014-01-01

    textabstractBackground:Silicone gel breast implants may silently rupture without detection. This has been the main reason for magnetic resonance imaging (MRI) of the augmented or reconstructed breast. The aim of the present study was to investigate the accuracy of MRI for implant rupture.

  2. Self-reported musculoskeletal symptoms among Danish women with cosmetic breast implants

    DEFF Research Database (Denmark)

    Kjøller, Kim; Hölmich, Lisbet Rosenkrantz; Fryzek, Jon P

    2004-01-01

    No epidemiological evidence of an association between silicone breast implants and connective tissue disease has been found. Based on case reports, it has been hypothesized that silicone breast implants may be associated with a unique rheumatic symptom cluster termed "atypical connective tissue d...

  3. 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

  4. Risk of pacemaker or implantable cardioverter defibrillator after radiotherapy for early-stage breast cancer in Denmark, 1982-2005

    DEFF Research Database (Denmark)

    Rehammar, Jens Christian; Johansen, Jens Brock; Jensen, Maj-Britt

    2017-01-01

    BACKGROUND AND PURPOSE: To examine the risk of cardiac conduction abnormalities or severe ventricular arrhythmias requiring implantation of a cardiac implantable electronic device (CIED), either a pacemaker or an implantable cardioverter-defibrillator, subsequent to breast cancer (BC) radiotherapy...

  5. Surface characterization and clinical review of two commercially available implants.

    Science.gov (United States)

    Galli, Silvia; Jimbo, Ryo; Andersson, Martin; Bryington, Matthew; Albrektsson, Tomas

    2013-10-01

    To characterize topographically and chemically the surfaces of 2 commercially available implants. Furthermore, to gather an overview of the clinical results of these implant systems. Two commercially available oral implants were analyzed using optical interferometry, scanning electron microscopy, and energy dispersive spectroscopy. In addition, a literature search for all the clinical articles on the same implants was performed. No significant differences of topographical parameters were found between the 2 implants, except for the hybrid parameter Sdr presenting significant higher values for the Ankylos implants. Both surfaces had a homogenous microporosity. At higher magnifications of scanning electron microscope images, evenly distributed nanostructures (approximately 10 nm) were visible. Chemically, mainly titanium, oxygen and carbon were detected. Fifty-six clinical articles were included for the review. The implant survival rates (minimum follow-up: 5 years) ranged between 87.7% and 100%. The examined commercially available implants showed a moderately rough surface, with a homogenous microporosity. Nanofeatures were detected on the surface of both implants. The clinical performances of these implants were comparable to that of other commercialized implant systems.

  6. Bacterial Biofilm Infection Detected in Breast Implant-Associated Anaplastic Large-Cell Lymphoma.

    Science.gov (United States)

    Hu, Honghua; Johani, Khalid; Almatroudi, Ahmad; Vickery, Karen; Van Natta, Bruce; Kadin, Marshall E; Brody, Garry; Clemens, Mark; Cheah, Chan Yoon; Lade, Stephen; Joshi, Preeti Avinash; Prince, H Miles; Deva, Anand K

    2016-06-01

    A recent association between breast implants and the development of anaplastic large-cell lymphoma (ALCL) has been observed. The purpose of this study was to identify whether bacterial biofilm is present in breast implant-associated ALCL and, if so, to compare the bacterial microbiome to nontumor capsule samples from breast implants with contracture. Twenty-six breast implant-associated ALCL samples were analyzed for the presence of biofilm by real-time quantitative polymerase chain reaction, next-generation sequencing, fluorescent in situ hybridization, and scanning electron microscopy, and compared to 62 nontumor capsule specimens. Both the breast implant-associated ALCL and nontumor capsule samples yielded high mean numbers of bacteria (breast implant-associated ALCL, 4.7 × 10 cells/mg of tissue; capsule, 4.9 × 10 cells/mg of tissue). Analysis of the microbiome in breast implant-associated ALCL specimens showed significant differences with species identified in nontumor capsule specimens. There was a significantly greater proportion of Ralstonia spp. present in ALCL specimens compared with nontumor capsule specimens (p associated with nontumor capsule specimens compared with breast implant-associated ALCL specimens (p Bacterial biofilm was visualized both on scanning electron microscopy and fluorescent in situ hybridization. This novel finding of bacterial biofilm and a distinct microbiome in breast implant-associated ALCL samples points to a possible infectious contributing cause. Breast implants are widely used in both reconstructive and aesthetic surgery, and strategies to reduce their contamination should be more widely studied and practiced. Risk, V.

  7. Correlation between MRI results and intraoperative findings in patients with silicone breast implants.

    Science.gov (United States)

    Lindenblatt, Nicole; El-Rabadi, Karem; Helbich, Thomas H; Czembirek, Heinrich; Deutinger, Maria; Benditte-Klepetko, Heike

    2014-01-01

    Silicone gel breast implants may silently rupture without detection. This has been the main reason for magnetic resonance imaging (MRI) of the augmented or reconstructed breast. The aim of the present study was to investigate the accuracy of MRI for implant rupture. Fifty consecutive patients with 85 silicone gel implants were included in the study. The mean age of the patients was 51 (range 21-72) years, with a mean duration of implantation of 3.8 (range 1-28) years. All patients underwent clinical examination and breast MRI. Intraoperative implant rupture was diagnosed by the operating surgeon. Nineteen of the 50 patients suffered from clinical symptoms. An implant rupture was diagnosed by MRI in 22 of 85 implants (26%). In seven of 17 removed implants (41%), the intraoperative diagnosis corresponded with the positive MRI result. However, only 57% of these patients were symptomatic. Ultrasound imaging of the harvested implants showed signs of interrupted inner layers of the implant despite integrity of the outer shell. By microsurgical separation of the different layers of the implant shell, we were able to reproduce this phenomenon and to produce signs of implant rupture on MRI. Our results show that rupture of only the inner layers of the implant shell with integrity of the outer shell leads to a misdiagnosis on MRI. Correlation with clinical symptoms and the specific wishes of the patient should guide the indication for implant removal.

  8. Bone tissue response to plasma-nitrided titanium implant surfaces

    Science.gov (United States)

    FERRAZ, Emanuela Prado; SVERZUT, Alexander Tadeu; FREITAS, Gileade Pereira; SÁ, Juliana Carvalho; ALVES, Clodomiro; BELOTI, Marcio Mateus; ROSA, Adalberto Luiz

    2015-01-01

    A current goal of dental implant research is the development of titanium (Ti) surfaces to improve osseointegration. Plasma nitriding treatments generate surfaces that favor osteoblast differentiation, a key event to the process of osteogenesis. Based on this, it is possible to hypothesize that plasma-nitrided Ti implants may positively impact osseointegration. Objective The aim of this study was to evaluate the in vivo bone response to Ti surfaces modified by plasma-nitriding treatments. Material and Methods Surface treatments consisted of 20% N2 and 80% H2, 450°C and 1.5 mbar during 1 h for planar and 3 h for hollow cathode. Untreated surface was used as control. Ten implants of each surface were placed into rabbit tibiae and 6 weeks post-implantation they were harvested for histological and histomorphometric analyses. Results Bone formation was observed in contact with all implants without statistically significant differences among the evaluated surfaces in terms of bone-to-implant contact, bone area between threads, and bone area within the mirror area. Conclusion Our results indicate that plasma nitriding treatments generate Ti implants that induce similar bone response to the untreated ones. Thus, as these treatments improve the physico-chemical properties of Ti without affecting its biocompatibility, they could be combined with modifications that favor bone formation in order to develop new implant surfaces. PMID:25760262

  9. Saline-filled breast implant contamination with Curvularia species among women who underwent cosmetic breast augmentation.

    Science.gov (United States)

    Kainer, Marion A; Keshavarz, Homa; Jensen, Bette J; Arduino, Matthew J; Brandt, Mary E; Padhye, Arvind A; Jarvis, William R; Archibald, Lennox K

    2005-07-01

    During December 2000-July 2001, black sediment was noted in saline-filled silicone breast implants of women who had undergone revision surgery at facility A. Curvularia fungus was isolated from implant saline. To identify risk factors for contamination with Curvularia species, we performed case-control, retrospective cohort, and laboratory studies and conducted procedural reviews. A case patient was defined as any woman who underwent revision surgery at facility A between January 2000 and June 2001 and had black sediment in her implants. Five patients met the case definition. Contamination was associated with having had surgery performed in operating room (OR) 2 (4/88 vs. 1/140; P=.07) and a longer duration of surgery (PSurgery center infection control measures must include moisture control and balanced ventilation systems.

  10. Influence of breast composition and interseed attenuation in dose calculations for post-implant assessment of permanent breast {sup 103}Pd seed implant

    Energy Technology Data Exchange (ETDEWEB)

    Afsharpour, Hossein; Beaulieu, Luc [Departement de Radio-Oncologie et Centre de recherche en cancerologie de l' Universite Laval, Centre Hospitalier Universitaire de Quebec, 11 Cote du Palais, Quebec, QC G1R 2J6 (Canada); Pignol, Jean-Philippe; Keller, Brian [Department of Radiation Oncology, Sunnybrook and Women' s Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Carrier, Jean-Francois [Departement de Radiologie, Radio-Oncologie et Medecine Nucleaire, Hopital Notre-Dame de CHUM, 1560 Sherbrooke E, Montreal, QC H2L 4M1 (Canada); Reniers, Brigitte; Verhaegen, Frank, E-mail: beaulieu@phy.ulaval.c [Department of Radiation Oncology (MAASTRO), GROW, University Hospital Maastricht, Maastricht (Netherlands)

    2010-08-21

    The impact of tissue heterogeneity and interseed attenuation is studied in post-implant evaluation of five clinical permanent breast {sup 103}Pd seed implants using the Monte Carlo (MC) dose calculation method. Dose metrics for the target (PTV) as well as an organ at risk (skin) are used to visualize the differences between a TG43-like MC method and more accurate MC methods capable of considering the breast tissue heterogeneity as well as the interseed attenuation. PTV dose is reduced when using a breast tissue model instead of water in MC calculations while the dose to the skin is increased. Furthermore, we investigate the effect of varying the glandular/adipose proportion of the breast tissue on dose distributions. The dose to the PTV (skin) decreases (increases) with the increasing adipose proportion inside the breast. In a complete geometry and compared to a TG43-like situation, the average PTV D{sub 90} reduction varies from 3.9% in a glandular breast to 35.5% when the breast consists entirely of adipose. The skin D{sub 10} increases by 28.2% in an entirely adipose breast. The results of this work show the importance of an accurate and patient-dependent breast tissue model to be used in the dosimetry for this kind of low energy implant.

  11. Polyurethane foam-covered breast implants: a justified choice?

    Science.gov (United States)

    Scarpa, C; Borso, G F; Vindigni, V; Bassetto, F

    2015-01-01

    Even if the safety of the polyurethane prosthesis has been the subject of many studies and professional and public controversies. Nowadays, polyurethane covered implants are very popular in plastic surgery for the treatment of capsular contracture. We have identified 41 papers (1 is a communication of the FDA) by using search browsers such as Pubmed, Medline, and eMedicine. Eleven manuscripts have been used for an introduction, and the remaining thirty have been subdivided into three tables whose results have been summarized in three main chapters: (1) capsular formation and contracture, (2) complications, (3) biodegradation and cancer risk. (1) The polyurethanic capsule is a well defined foreign body reaction characterized by synovial metaplasia, a thin layer of disarranged collagen fibers and a high vascularization. These features make possible a "young" capsule and a low occurrence of capsular contracture even over a long period (10 years); (2) the polyurethane implants may be difficult to remove but there is no evidence that they cause an increase in the other complications; (3) there is no evidence of polyurethane related cancer in long-term studies (after 5 years). Polyurethane foam covered breast implants remain a valid choice for the treatment of capsular contracture even if it would be very useful to verify the ease of removal of the prosthesis and to continue investigations on biodegradation products.

  12. Titanium implant with nanostructured zirconia surface promotes maturation of peri-implant bone in osseointegration.

    Science.gov (United States)

    Dusad, Anand; Chakkalakal, Dennis A; Namavar, Fereydoon; Haider, Hani; Hanisch, Brock; Duryee, Michael J; Diaz, April; Rensch, Adam; Zhang, Yijia; Hess, Ryan; Thiele, Geoffrey M; Fehringer, Edward V

    2013-05-01

    The goal of the experiment outlined in this article is to improve upon noncemented methods of arthroplasty for clinical application in elderly patients. This was done by determining whether titanium implants with a novel nanostructured zirconia surface, which was created by ion beam-assisted deposition, would prevent impaired osseointegration of intramedullary implants in 1-year-old rats receiving a protein-deficient diet. Specifically, we asked whether the implant with the nanostructured zirconia surface would increase expression of markers of bone maturation within the remodeling of peri-implant woven bone. The control implants, which were made of commercially pure titanium, had a polished surface ex vivo but are known to acquire a microstructured titania surface in vivo. Ten 1-year-old rats received experimental implant (group A) and 10 had control (group B) implants. Ten 3-month-old rats received normal protein diet and the control implant (group C). Animals were euthanized 8 weeks after implantation, and transverse sections of femur-implant samples were used for histology, micro-computed tomography and immunohistochemical evaluations. In group B, the expression of α2β1 and α5β1 integrins, which are known to mediate osteoblast adhesion, glycosaminoglycans, heparan sulfate and chondroitin sulfate, was less than half of that in group C. Important to this study, the zirconia surface used in group A prevented these deficiencies. Therefore, these results indicate that nanostructured zirconia surface created on clinical implants by ion beam-assisted deposition may prevent impaired osseointegration in elderly patients by promoting quicker maturation of peri-implant woven bone.

  13. The evaluation of contralateral breast's dose and shielding efficiency by breast size about breast implant patient for radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Wook; Woo, Heon; Jeong, Hyeon Hak; Kim, Kyeong Ah; Kim, Chan Yong; Yoo, Suk Hyun [Dept. of Radiation Oncology, Seoul National University Hospital, Seoul (Korea, Republic of)

    2014-12-15

    To evaluate the dose on a contralateral breast and the usefulness of shielding according to the distance between the contralateral breast and the side of the beam by breast size when patients who got breast implant receive radiation therapy. We equipped 200 cc, 300 cc, 400 cc, and 500 cc breast model on the human phantom (Rando-phantom), acquired CT images (philips 16channel, Netherlands) and established the radiation treatment plan, 180 cGy per day on the left breast (EclipseTM ver10.0.42, Varian Medical Systems, USA) by size. We set up each points, A, B, C, and D on the right(contralateral) breast model for measurement by size and by the distance from the beam and attached MOSFET at each points. The 6 MV, 10 MV and 15 MV X-ray were irradiated to the left(target) breast model and we measured exposure dose of contralateral breast model using MOSFET. Also, at the same condition, we acquired the dose value after shielding using only Pb 2 mm and bolus 3 mm under the Pb 2 mm together. As the breast model is bigger from 200 cc to 500 cc, The surface of the contralateral breast is closer to the beam. As a result, from 200 cc to 500 cc, on 180 cGy basis, the measurement value of the scattered ray inclined by 3.22-4.17% at A point, 4.06-6.22% at B point, 0.4-0.5% at C point, and was under 0.4% at D point. As the X-ray energy is higher, from 6 MV to 15 MV, on 180 cGy basis, the measurement value of the scattered ray inclined by 4.06-5% at A point, 2.85-4.94% at B point, 0.74-1.65% at C point, and was under 0.4% at D point. As using Pb 2 mm for shield, scattered ray declined by average 9.74% at A and B point, 2.8% at C point, and is under 1% at D point. As using Pb 2 mm and bolus together for shield, scattered ray declined by average 9.76% at A and B point, 2.2% at C point, and is under 1% at D point. Commonly, in case of patients who got breast implant, there is a distance difference by breast size between the contralateral breast and the side of beam. As the distance is

  14. The Impact of Incorporating Antimicrobials into Implant Surfaces.

    Science.gov (United States)

    Hickok, N J; Shapiro, I M; Chen, A F

    2018-01-01

    With the increase in numbers of joint replacements, spinal surgeries, and dental implantations, there is an urgent need to combat implant-associated infection. In addition to stringent sterile techniques, an efficacious way to prevent this destructive complication is to create new implants with antimicrobial properties. Specifically, these implants must be active in the dental implant environment where the implant is bathed in the glycoprotein-rich salivary fluids that enhance bacterial adhesion, and propagation, and biofilm formation. However, in designing an antimicrobial surface, a balance must be struck between antimicrobial activity and the need for the implant to interact with the bone environment. Three types of surfaces have been designed to combat biofilm formation, while attempting to maintain osseous interactions: 1) structured surfaces where topography, usually at the nanoscale, decreases bacterial adhesion sufficiently to retard establishment of infection; 2) surfaces that actively elute antimicrobials to avert bacterial adhesion and promote killing; and 3) surfaces containing permanently bonded agents that generate antimicrobial surfaces that prevent long-term bacterial adhesion. Both topographical and elution surfaces exhibit varying, albeit limited, antimicrobial activity in vitro. With respect to covalent coupling, we present studies on the ability of the permanent antimicrobial surfaces to kill organisms while fostering osseointegration. All approaches have significant drawbacks with respect to stability and efficacy, but the permanent surfaces may have an edge in creating a long-term antibacterial environment.

  15. Laser surface modification of Ti implants to improve osseointegration

    Energy Technology Data Exchange (ETDEWEB)

    Marticorena, M [Laboratorio de Ablacion Laser, Facultad de Ingenieria, Universidad de Buenos Aires, Paseo Colon 850, 1063 Buenos Aires (Argentina); Corti, G [Laboratorio de Ablacion Laser, Facultad de Ingenieria, Universidad de Buenos Aires, Paseo Colon 850, 1063 Buenos Aires (Argentina); Olmedo, D [Catedra de Anatomia Patologica, Facultad de Odontologia, Universidad de Buenos Aires. Marcelo T. de Alvear 2142, 2 piso Sector ' A' , 1122 Buenos Aires (Argentina); Guglielmotti, M B [Catedra de Anatomia Patologica, Facultad de Odontologia, Universidad de Buenos Aires. Marcelo T. de Alvear 2142, 2 piso Sector ' A' , 1122 Buenos Aires (Argentina); Duhalde, S [Laboratorio de Ablacion Laser, Facultad de Ingenieria, Universidad de Buenos Aires, Paseo Colon 850, 1063 Buenos Aires (Argentina)

    2007-04-15

    Commercially Pure Titanium foils, were irradiated using a pulsed Nd:YAG laser under ambient air, in order to produce and characterize a well controlled surface texture (roughness and waviness) that enhances osseointegration. To study the 'peri-implant' reparative process response, the laser treated Ti foils were implanted in the tibia of 10 male Wistar rats. At 14 days post-implantation, the histological analysis showed a tendency to more bone formation compared to the untreated control implants. The formation of a layer of TiN on the surface and the obtained roughness, have been demonstrated to improve bone response.

  16. Laser microtexturing of implant surfaces for enhanced tissue integration

    Energy Technology Data Exchange (ETDEWEB)

    Ricci, J.L. [Univ. of Medicine and Dentistry of New Jersey, Newark, NJ (United States). Dept. of Orthodontics; Alexander, H. [Orthogen Corp., Springfield, NJ (United States)

    2001-07-01

    The success or failure of bone and soft tissue-fixed medical devices, such as dental and orthopaedic implants, depends on a complex combination of biological and mechanical factors. These factors are intimately associated with the interface between the implant surface and the surrounding tissue, and are largely determined by the composition, surface chemistry, and surface microgeometry of the implant. The relative contributions of these factors are difficult to assess. This study addresses the contribution of surface microtexture, on a controlled level, to tissue integration. (orig.)

  17. 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...

  18. Comparison of peri-implant bone formation around injection-molded and machined surface zirconia implants in rabbit tibiae

    Science.gov (United States)

    Kim, Hong-Kyun; Woo, Kyung mi; Shon, Won-Jun; Ahn, Jin-Soo; Cha, Seunghee; Park, Young-Seok

    2017-01-01

    The aim of this study was to compare osseointegration and surface characteristics of zirconia implants made by the powder injection molding (PIM) technique and made by the conventional milling procedure in rabbit tibiae. Surface characteristics of 2 types of implant were evaluated. Sixteeen rabbits received 2 types of external hex implants with similar geometry, machined zirconia implants and PIM zirconia implants, in the tibiae. Removal torque tests and histomorphometric analyses were performed. The roughness of PIM zirconia implants was higher than that of machined zirconia implants. The PIM zirconia implants exhibited significantly higher bone-implant contact and removal torque values than the machined zirconia implants (P zirconia implant is promising, and PIM, using the roughened mold etching technique, can produce substantially rough surfaces on zirconia implants. PMID:26235717

  19. Peri-implant bone formation and surface characteristics of rough surface zirconia implants manufactured by powder injection molding technique in rabbit tibiae.

    Science.gov (United States)

    Park, Young-Seok; Chung, Shin-Hye; Shon, Won-Jun

    2013-05-01

    To evaluate osseointegration in rabbit tibiae and to investigate surface characteristics of novel zirconia implants made by powder injection molding (PIM) technique, using molds with and without roughened inner surfaces. A total of 20 rabbits received three types of external hex implants with identical geometry on the tibiae: machined titanium implants, PIM zirconia implants without mold etching, and PIM zirconia implants with mold etching. Surface characteristics of the three types of implant were evaluated. Removal torque tests and histomorphometric analyses were performed. The roughness of PIM zirconia implants was higher than that of machined titanium implants. The PIM zirconia implants exhibited significantly higher bone-implant contact and removal torque values than the machined titanium implants (P mold showed significantly higher removal torque values than PIM zirconia implants without using roughened mold (P mold etching technique can produce substantially rough surfaces on zirconia implants. © 2012 John Wiley & Sons A/S.

  20. Breast reconstruction with anatomical implants: A review of indications and techniques based on current literature

    Directory of Open Access Journals (Sweden)

    Marco Gardani

    2017-09-01

    Full Text Available One important modality of breast cancer therapy is surgical treatment, which has become increasingly less mutilating over the last century. Breast reconstruction has become an integrated part of breast cancer treatment due to long-term psychosexual health factors and its importance for breast cancer survivors. Both autogenous tissue-based and implant-based reconstruction provides satisfactory reconstructive options due to better surgeon awareness of “the ideal breast size”, although each has its own advantages and disadvantages. An overview of the current options in breast reconstruction is presented in this article.

  1. The Relationship of Bacterial Biofilms and Capsular Contracture in Breast Implants

    Science.gov (United States)

    Ajdic, Dragana; Zoghbi, Yasmina; Gerth, David; Panthaki, Zubin J.; Thaller, Seth

    2016-01-01

    Capsular contracture is a common sequelae of implant-based breast augmentation. Despite its prevalence, the etiology of capsular contracture remains controversial. Numerous studies have identified microbial biofilms on various implantable materials, including breast implants. Furthermore, biofilms have been implicated in subclinical infections associated with other surgical implants. In this review, we discuss microbial biofilms as a potential etiology of capsular contracture. The review also outlines the key diagnostic modalities available to identify the possible infectious agents found in biofilm, as well as available preventative and treatment measures. PMID:26843099

  2. Bone Response to Surface-Modified Titanium Implants: Studies on the Early Tissue Response to Implants with Different Surface Characteristics

    Directory of Open Access Journals (Sweden)

    C. Larsson Wexell

    2013-01-01

    Full Text Available In a series of experimental studies, the bone formation around systematically modified titanium implants is analyzed. In the present study, three different surface modifications were prepared and evaluated. Glow-discharge cleaning and oxidizing resulted in a highly stoichiometric TiO2 surface, while a glow-discharge treatment in nitrogen gas resulted in implants with essentially a surface of titanium nitride, covered with a very thin titanium oxide. Finally, hydrogen peroxide treatment of implants resulted in an almost stoichiometric TiO2, rich in hydroxyl groups on the surface. Machined commercially pure titanium implants served as controls. Scanning Auger Electron Spectroscopy, Scanning Electron Microscopy, and Atomic Force Microscopy revealed no significant differences in oxide thickness or surface roughness parameters, but differences in the surface chemical composition and apparent topography were observed. After surface preparation, the implants were inserted in cortical bone of rabbits and evaluated after 1, 3, and 6 weeks. Light microscopic evaluation of the tissue response showed that all implants were in contact with bone and had a large proportion of newly formed bone within the threads after 6 weeks. There were no morphological differences between the four groups. Our study shows that a high degree of bone contact and bone formation can be achieved with titanium implants of different surface composition and topography.

  3. Inferior dermoglandular flap for autologous breast remodeling following explantation of breast implants in ptotic breasts: a case report and literature search

    Directory of Open Access Journals (Sweden)

    Umar Daraz Khan

    2015-04-01

    Full Text Available Explantation following aesthetic mammoplasty without implant replacement is quite uncommon and often leaves the patient worse off than prior to mammoplasty. A case is presented here in which patient's own tissue was used as an inferior dermoglandular flap for autologous breast remodeling. Inferior dermal flap has been described for breast reconstruction and simultaneous augmentation mammoplasty with mastopexy for prosthesis cover in the lower pole of the breast, but its use following explantation without implant replacement has not been described for breast remodeling and volume conservation.

  4. Surface Modification of Blood Contacting Biomedical Implants by Plasma Processes

    Science.gov (United States)

    Huang, N.; Yang, P.; Leng, Y. X.; Chen, J. Y.; Wang, J.; Sun, H.; Wan, G. J.; Chu, P. K.; Leng, Y.

    2003-06-01

    Surface modification is becoming an increasingly popular method to Improve the surface properties of biomedical materials and implants. Among the techniques plasma processes have been attracting attention because of their high effect and low cost. In this paper some application of plasma processes such as plasma modification, plasma polymerization, films synthesis, and plasma based ion implantation etc to modify blood contacting biomaterials and implants are presented. The authors work on the surface modification of artificial heart valves, stents and catheter etc. are provided. The further development of this discipline is discussed.

  5. Prevention and treatment of peri-implant diseases : Cleaning of titanium dental implant surfaces

    NARCIS (Netherlands)

    Louropoulou, A.

    2017-01-01

    The research presented in this thesis assessed the effect of variable instruments on differed titanium dental implant surfaces. Furthermore, a clinical guideline was developed and recommendations are made regarding the diagnosis, prevention and treatment of peri-implant diseases. Air abrasive

  6. Impact of Dental Implant Surface Modifications on Osseointegration

    Directory of Open Access Journals (Sweden)

    Ralf Smeets

    2016-01-01

    Full Text Available Objective. The aim of this paper is to review different surface modifications of dental implants and their effect on osseointegration. Common marketed as well as experimental surface modifications are discussed. Discussion. The major challenge for contemporary dental implantologists is to provide oral rehabilitation to patients with healthy bone conditions asking for rapid loading protocols or to patients with quantitatively or qualitatively compromised bone. These charging conditions require advances in implant surface design. The elucidation of bone healing physiology has driven investigators to engineer implant surfaces that closely mimic natural bone characteristics. This paper provides a comprehensive overview of surface modifications that beneficially alter the topography, hydrophilicity, and outer coating of dental implants in order to enhance osseointegration in healthy as well as in compromised bone. In the first part, this paper discusses dental implants that have been successfully used for a number of years focusing on sandblasting, acid-etching, and hydrophilic surface textures. Hereafter, new techniques like Discrete Crystalline Deposition, laser ablation, and surface coatings with proteins, drugs, or growth factors are presented. Conclusion. Major advancements have been made in developing novel surfaces of dental implants. These innovations set the stage for rehabilitating patients with high success and predictable survival rates even in challenging conditions.

  7. Multimodality Imaging-based Evaluation of Single-Lumen Silicone Breast Implants for Rupture.

    Science.gov (United States)

    Seiler, Stephen J; Sharma, Pooja B; Hayes, Jody C; Ganti, Ramapriya; Mootz, Ann R; Eads, Emily D; Teotia, Sumeet S; Evans, W Phil

    2017-01-01

    Breast implants are frequently encountered on breast imaging studies, and it is essential for any radiologist interpreting these studies to be able to correctly assess implant integrity. Ruptures of silicone gel-filled implants often occur without becoming clinically obvious and are incidentally detected at imaging. Early diagnosis of implant rupture is important because surgical removal of extracapsular silicone in the breast parenchyma and lymphatics is difficult. Conversely, misdiagnosis of rupture may prompt a patient to undergo unnecessary additional surgery to remove the implant. Mammography is the most common breast imaging examination performed and can readily depict extracapsular free silicone, although it is insensitive for detection of intracapsular implant rupture. Ultrasonography (US) can be used to assess the internal structure of the implant and may provide an economical method for initial implant assessment. Common US signs of intracapsular rupture include the "keyhole" or "noose" sign, subcapsular line sign, and "stepladder" sign; extracapsular silicone has a distinctive "snowstorm" or echogenic noise appearance. Magnetic resonance (MR) imaging is the most accurate and reliable means for assessment of implant rupture and is highly sensitive for detection of both intracapsular and extracapsular rupture. MR imaging findings of intracapsular rupture include the keyhole or noose sign, subcapsular line sign, and "linguine" sign, and silicone-selective MR imaging sequences are highly sensitive to small amounts of extracapsular silicone. ©RSNA, 2017.

  8. Adverse health outcomes in offspring of mothers with cosmetic breast implants : A review

    NARCIS (Netherlands)

    Kjoller, Kim; Friis, Soren; Lipworth, Loren; McLaughlin, Joseph K.; Olsen, Jorgen H.

    2007-01-01

    Background: To assess whether maternal cosmetic breast implants are associated with adverse health outcomes among offspring, the authors examined published findings of epidemiologic studies that addressed this hypothesis. Methods: Four epidemiologic studies, ail from Scandinavia, were identified.

  9. Microscopic Study of Surface Microtopographic Characteristics of Dental Implants

    Science.gov (United States)

    Sezin, M.; Croharé, L.; Ibañez, J.C.

    2016-01-01

    Objective: To determine and compare the micro topographic characteristics of dental implants submitted to different surface treatments, using scanning electron microscopy (SEM). Materials and Methods: Implants were divided into 7 groups of 3 specimens each, according to the surface treatment used: group 1: Osseotite, BIOMET 3i; group 2: SLA surface, Institut Straumann AG; group 3: Oxalife surface, Tree-Oss implant; group 4: B&W implant surface; group 5: Q-implant surface; group 6: ML implant surface; group 7: RBM surface, Rosterdent implant. The surfaces were examined under SEM (Carl Zeiss FE-SEM-SIGMA). Image Proplus software was used to determine the number and mean diameter of pores per area unit (mm). The data obtained were analyzed with the Mann-Whitney test. A confocal laser microscope (LEXT-OLS4100 Olympus) was used to conduct the comparative study of surface roughness (Ra). Data were analyzed using Tukey's HSD test. Results: The largest average pore diameter calculated in microns was found in group 5 (3.45 µm+/-1.91) while the smallest in group 7 (1.47µm+/-1.29). Significant differences were observed among each one of the groups studied (p<0.05). The largest number of pores/mm2 was found in group 2 (229343) and the smallest number in group 4 (10937). Group 2 showed significant differences regarding the other groups (p<0.05). The greatest roughness (Ra) was observed in group 2 (0.975µm+/-0.115) and the smallest in group 4 (0.304µm+/-0.063). Group 2 was significantly different from the other groups (p<0.05). Conclusion: The micro topography observed in the different groups presented dissimilar and specific features, depending on the chemical treatment used for the surfaces.. PMID:27335615

  10. Directing neuronal cell growth on implant material surfaces by microstructuring.

    OpenAIRE

    Reich, Uta; Fadeeva, Elena; Warnecke, Athanasia; Paasche, Gerrit; Müller, Peter; Chichkov, Boris; Stöver, Timo; Lenarz, Thomas; Reuter, Günter

    2012-01-01

    For best hearing sensation, electrodes of auditory prosthesis must have an optimal electrical contact to the respective neuronal cells. To improve the electrode-nerve interface, microstructuring of implant surfaces could guide neuronal cells toward the electrode contact. To this end, femtosecond laser ablation was used to generate linear microgrooves on the two currently relevant cochlear implant materials, silicone elastomer and platinum. Silicone surfaces were structured by two different me...

  11. The influence of surface treatment on the implant roughness pattern

    Science.gov (United States)

    ROSA, Marcio Borges; ALBREKTSSON, Tomas; FRANCISCHONE, Carlos Eduardo; SCHWARTZ FILHO, Humberto Osvaldo; WENNERBERG, Ann

    2012-01-01

    An important parameter for the clinical success of dental implants is the formation of direct contact between the implant and surrounding bone, whose quality is directly influenced by the implant surface roughness. A screw-shaped design and a surface with an average roughness of Sa of 1-2 µm showed a better result. The combination of blasting and etching has been a commonly used surface treatment technique. The versatility of this type of treatment allows for a wide variation in the procedures in order to obtain the desired roughness. Objectives To compare the roughness values and morphological characteristics of 04 brands of implants, using the same type of surface treatment. In addition, to compare the results among brands, in order to assess whether the type of treatment determines the values and the characteristics of implant surface roughness. Material and methods Three implants were purchased directly from each selected company in the market, i.e., 03 Brazilian companies (Biomet 3i of Brazil, Neodent and Titaniumfix) and 01 Korean company (Oneplant). The quantitative or numerical characterization of the roughness was performed using an interferometer. The qualitative analysis of the surface topography obtained with the treatment was analyzed using scanning electron microscopy images. Results The evaluated implants showed a significant variation in roughness values: Sa for Oneplant was 1.01 µm; Titaniumfix reached 0.90 µm; implants from Neodent 0.67 µm, and Biomet 3i of Brazil 0.53 µm. Moreover, the SEM images showed very different patterns for the surfaces examined. Conclusions The surface treatment alone is not able to determine the roughness values and characteristics. PMID:23138742

  12. Immediate breast reconstruction with a myocutaneous latissimus dorsi flap and implant following skin-sparing salvage mastectomy after irradiation as part of breast-conserving therapy

    NARCIS (Netherlands)

    van Huizum, Martine A.; Hage, J. Joris; Rutgers, Emiel J.; Hoornweg, Marije J.

    2016-01-01

    Local relapse after breast-conserving therapy including whole breast irradiation is typically treated by salvage mastectomy. Immediate reconstruction by pedicled transfer of a latissimus dorsi flap in combination with implantation of a definitive prosthesis or temporary tissue expander following

  13. Detoxification of Implant Surfaces Affected by Peri-Implant Disease: An Overview of Surgical Methods

    Directory of Open Access Journals (Sweden)

    Pilar Valderrama

    2013-01-01

    Full Text Available Purpose. Peri-implantitis is one of the major causes of implant failure. The detoxification of the implant surface is necessary to obtain reosseointegration. The aim of this review was to summarize in vitro and in vivo studies as well as clinical trials that have evaluated surgical approaches for detoxification of the implant body surfaces. Materials and Methods. A literature search was conducted using MEDLINE (PubMed from 1966 to 2013. The outcome variables were the ability of the therapeutic method to eliminate the biofilm and endotoxins from the implant surface, the changes in clinical parameters, radiographic bone fill, and histological reosseointegration. Results. From 574 articles found, 76 were analyzed. The findings, advantages, and disadvantages of using mechanical, chemical methods and lasers are discussed. Conclusions. Complete elimination of the biofilms is difficult to achieve. All therapies induce changes of the chemical and physical properties of the implant surface. Partial reosseointegration after detoxification has been reported in animals. Combination protocols for surgical treatment of peri-implantitis in humans have shown some positive clinical and radiographic results, but long-term evaluation to evaluate the validity and reliability of the techniques is needed.

  14. Detoxification of Implant Surfaces Affected by Peri-Implant Disease: An Overview of Surgical Methods

    Science.gov (United States)

    Wilson Jr, Thomas G.

    2013-01-01

    Purpose. Peri-implantitis is one of the major causes of implant failure. The detoxification of the implant surface is necessary to obtain reosseointegration. The aim of this review was to summarize in vitro and in vivo studies as well as clinical trials that have evaluated surgical approaches for detoxification of the implant body surfaces. Materials and Methods. A literature search was conducted using MEDLINE (PubMed) from 1966 to 2013. The outcome variables were the ability of the therapeutic method to eliminate the biofilm and endotoxins from the implant surface, the changes in clinical parameters, radiographic bone fill, and histological reosseointegration. Results. From 574 articles found, 76 were analyzed. The findings, advantages, and disadvantages of using mechanical, chemical methods and lasers are discussed. Conclusions. Complete elimination of the biofilms is difficult to achieve. All therapies induce changes of the chemical and physical properties of the implant surface. Partial reosseointegration after detoxification has been reported in animals. Combination protocols for surgical treatment of peri-implantitis in humans have shown some positive clinical and radiographic results, but long-term evaluation to evaluate the validity and reliability of the techniques is needed. PMID:23983691

  15. Ion beam analysis of metal ion implanted surfaces

    Energy Technology Data Exchange (ETDEWEB)

    Evans, P.J.; Chu, J.W.; Johnson, E.P.; Noorman, J.T. [Australian Nuclear Science and Technology Organisation, Lucas Heights, NSW (Australia); Sood, D.K. [Royal Melbourne Inst. of Tech., VIC (Australia)

    1993-12-31

    Ion implantation is an established method for altering the surface properties of many materials. While a variety of analytical techniques are available for the characterisation of implanted surfaces, those based on particle accelerators such as Rutherford backscattering (RBS) and nuclear reaction analysis (NRA) provide some of the most useful and powerful for this purpose. Application of the latter techniques to metal ion implantation research at ANSTO will be described with particular reference to specific examples from recent studies. Where possible, the information obtained from ion beam analysis will be compared with that derived from other techniques such as Energy Dispersive X-ray (EDX) and Auger spectroscopies. 4 refs., 5 figs.

  16. Modification of polyvinyl alcohol surface properties by ion implantation

    Energy Technology Data Exchange (ETDEWEB)

    Pukhova, I.V., E-mail: ivpuhova@mail.ru [National Research Tomsk State University, 36 Lenin Ave, Tomsk 634050 (Russian Federation); Institute of High Current Electronics, 2/3 Akademichesky Ave, Tomsk 634055 (Russian Federation); Kurzina, I.A. [National Research Tomsk State University, 36 Lenin Ave, Tomsk 634050 (Russian Federation); Savkin, K.P. [Institute of High Current Electronics, 2/3 Akademichesky Ave, Tomsk 634055 (Russian Federation); Laput, O.A. [National Research Tomsk Polytechnic University, 30 Lenin Ave, Tomsk 634050 (Russian Federation); Oks, E.M. [Institute of High Current Electronics, 2/3 Akademichesky Ave, Tomsk 634055 (Russian Federation)

    2017-05-15

    We describe our investigations of the surface physicochemical properties of polyvinyl alcohol modified by silver, argon and carbon ion implantation to doses of 1 × 10{sup 14}, 1 × 10{sup 15} and 1 × 10{sup 16} ion/cm{sup 2} and energies of 20 keV (for C and Ar) and 40 keV (for Ag). Infrared spectroscopy (IRS) indicates that destructive processes accompanied by chemical bond (−C=O) generation are induced by implantation, and X-ray photoelectron spectroscopy (XPS) analysis indicates that the implanted silver is in a metallic Ag3d state without stable chemical bond formation with polymer chains. Ion implantation is found to affect the surface energy: the polar component increases while the dispersion part decreases with increasing implantation dose. Surface roughness is greater after ion implantation and the hydrophobicity increases with increasing dose, for all ion species. We find that ion implantation of Ag, Ar and C leads to a reduction in the polymer microhardness by a factor of five, while the surface electrical resistivity declines modestly.

  17. Spontaneous progression of ligature induced peri-implantitis at implants with different surface roughness: an experimental study in dogs

    DEFF Research Database (Denmark)

    Berglundh, T; Gotfredsen, K; Zitzmann, N U

    2007-01-01

    : The aim of the current experiment was to study the progression of peri-implantitis around implants with different surface roughness. MATERIAL AND METHODS: In five beagle dogs, three implants with either a sandblasted acid-etched surface (SLA) or a polished surface (P) were installed bilaterally...

  18. Surface smoothing and template partitioning for cranial implant CAD

    Science.gov (United States)

    Min, Kyoung-june; Dean, David

    2005-04-01

    Employing patient-specific prefabricated implants can be an effective treatment for large cranial defects (i.e., > 25 cm2). We have previously demonstrated the use of Computer Aided Design (CAD) software that starts with the patient"s 3D head CT-scan. A template is accurately matched to the pre-detected skull defect margin. For unilateral cranial defects the template is derived from a left-to-right mirrored skull image. However, two problems arise: (1) slice edge artifacts generated during isosurface polygonalization are inherited by the final implant; and (2) partitioning (i.e., cookie-cutting) the implant surface from the mirrored skull image usually results in curvature discontinuities across the interface between the patient"s defect and the implant. To solve these problems, we introduce a novel space curve-to-surface partitioning algorithm following a ray-casting surface re-sampling and smoothing procedure. Specifically, the ray-cast re-sampling is followed by bilinear interpolation and low-pass filtering. The resulting surface has a highly regular grid-like topological structure of quadrilaterally arranged triangles. Then, we replace the regions to be partitioned with predefined sets of triangular elements thereby cutting the template surface to accurately fit the defect margin at high resolution and without surface curvature discontinuities. Comparisons of the CAD implants for five patients against the manually generated implant that the patient actually received show an average implant-patient gap of 0.45mm for the former and 2.96mm for the latter. Also, average maximum normalized curvature of interfacing surfaces was found to be smoother, 0.043, for the former than the latter, 0.097. This indicates that the CAD implants would provide a significantly better fit.

  19. Radiotherapy for breast cancer is not associated with increased risk of cied implantation

    DEFF Research Database (Denmark)

    Johansen, J. B.; Rehammar, J. C.; Jorgensen, O. D.

    2015-01-01

    tests were calculated. Results: Among 18,308 women treated with radiotherapy for early-stage breast cancer, 179 women had a CIED implanted (166 pacemakers, 13 ICD) subsequent to radiotherapy, 90 in 9,315 left sided and 89 in 8,993 right sided breast cancers. Follow-up time was minimum 8 years...

  20. Prepectoral Implant-Based Breast Reconstruction and Postmastectomy Radiotherapy: Short-Term Outcomes

    Directory of Open Access Journals (Sweden)

    Steven Sigalove, MD

    2017-12-01

    Conclusions:. Immediate implant-based prepectoral breast reconstruction followed by PMRT appears to be well tolerated, with no excess risk of adverse outcomes, at least in the short term. Longer follow-up is needed to better understand the risk of PMRT in prepectorally reconstructed breasts.

  1. The effect of post-mastectomy radiation therapy on breast implants: Unveiling biomaterial alterations with potential implications on capsular contracture

    Energy Technology Data Exchange (ETDEWEB)

    Ribuffo, Diego; Lo Torto, Federico [Department of Plastic Surgery, “Sapienza” University of Rome, Viale del Policlinico 155, 00166 Rome (Italy); Giannitelli, Sara M. [Tissue Engineering Unit, Department of Engineering, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo 21, 00128 Rome (Italy); Urbini, Marco; Tortora, Luca [Surface Analysis Laboratory, Department of Mathematics and Physics, University “Roma Tre”, Via della Vasca Navale 84, 00146 Rome (Italy); INFN — National Institute of Nuclear Physics, Section of Roma Tre, Via della Vasca Navale 84, 00146 Rome (Italy); Mozetic, Pamela; Trombetta, Marcella [Tissue Engineering Unit, Department of Engineering, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo 21, 00128 Rome (Italy); Basoli, Francesco; Licoccia, Silvia [Department of Chemical Science and Technologies, University of Rome “Tor Vergata”, Via della Ricerca Scientifica 1, 00173 Rome (Italy); Tombolini, Vincenzo [Department of Radiation Oncology, “Sapienza” University of Rome, Viale del Policlinico 155, 00166 Rome (Italy); Spencer-Lorillard Foundation, Viale Regina Elena 291, 00161 Rome (Italy); Cassese, Raffaele [Department of Radiation Oncology, “Sapienza” University of Rome, Viale del Policlinico 155, 00166 Rome (Italy); Scuderi, Nicolò [Department of Plastic Surgery, “Sapienza” University of Rome, Viale del Policlinico 155, 00166 Rome (Italy); and others

    2015-12-01

    Post-mastectomy breast reconstruction with expanders and implants is recognized as an integral part of breast cancer treatment. Its main complication is represented by capsular contracture, which leads to poor expansion, breast deformation, and pain, often requiring additional surgery. In such a scenario, the debate continues as to whether the second stage of breast reconstruction should be performed before or after post-mastectomy radiation therapy, in light of potential alterations induced by irradiation to silicone biomaterial. This work provides a novel, multi-technique approach to unveil the role of radiotherapy in biomaterial alterations, with potential involvement in capsular contracture. Following irradiation, implant shells underwent mechanical, chemical, and microstructural evaluation by means of tensile testing, Attenuated Total Reflectance Fourier Transform InfraRed spectroscopy (ATR/FTIR), Scanning Electron Microscopy (SEM), high resolution stylus profilometry, and Time of Flight Secondary Ion Mass Spectrometry (ToF-SIMS). Our findings are consistent with radiation-induced modifications of silicone that, although not detectable at the microscale, can be evidenced by more sophisticated nanoscale surface analyses. In light of these results, biomaterial irradiation cannot be ruled out as one of the possible co-factors underlying capsular contracture. - Highlights: • The debate continues whether to perform breast reconstruction before or after PMRT. • Radiation therapy may alter implant material, concurring to capsular contracture. • In this work, irradiated implants were investigated by a multi-technique approach. • Radiation-induced alterations could be evidenced by ATR/FTIR and ToF-SIMS. • Reported alteration might represent a co-factor underlying capsular contracture.

  2. Primary anaplastic large cell lymphoma of the breast arising in reconstruction mammoplasty capsule of saline filled breast implant after radical mastectomy for breast cancer: an unusual case presentation

    Directory of Open Access Journals (Sweden)

    Sur Monalisa

    2009-04-01

    Full Text Available Abstract Background Primary non-Hodgkin lymphoma (NHL of the breast represents 0.04–0.5% of malignant lesions of the breast and accounts for 1.7–2.2% of extra-nodal NHL. Most primary cases are of B-cell phenotype and only rare cases are of T-cell phenotype. Anaplastic large cell lymphoma (ALCL is a rare T-cell lymphoma typically seen in children and young adults with the breast being one of the least common locations. There are a total of eleven cases of primary ALCL of the breast described in the literature. Eight of these cases occurred in proximity to breast implants, four in relation to silicone breast implant and three in relation to saline filled breast implant with three out of the eight implant related cases having previous history of breast cancer treated surgically. Adjuvant postoperative chemotherapy is given in only one case. Secondary hematological malignancies after breast cancer chemotherapy have been reported in literature. However in contrast to acute myeloid leukemia (AML, the association between lymphoma and administration of chemotherapy has never been clearly demonstrated. Case Presentation In this report we present a case of primary ALCL of the breast arising in reconstruction mamoplasty capsule of saline filled breast implant after radical mastectomy for infiltrating ductal carcinoma followed by postoperative chemotherapy twelve years ago. Conclusion Primary ALK negative ALCL arising at the site of saline filled breast implant is rare. It is still unclear whether chemotherapy and breast implantation increases risk of secondary hematological malignancies significantly. However, it is important to be aware of these complications and need for careful pathologic examination of tissue removed for implant related complications to make the correct diagnosis for further patient management and treatment. It is important to be aware of this entity at this site as it can be easily misdiagnosed on histologic grounds and to exclude

  3. Breast implant rupture and connective tissue disease: a review of the literature

    DEFF Research Database (Denmark)

    Hölmich, Lisbet Rosenkrantz; Lipworth, Loren; McLaughlin, Joseph K

    2007-01-01

    Large-scale epidemiologic studies to date have not found any credible association between silicone breast implants and either well-defined connective tissue diseases or undefined or atypical connective tissue diseases. It has been hypothesized that implant rupture could prompt an immunologic...... reaction giving rise to autoimmune or related diseases. In this article, the authors review the available literature on implant ruptures and connective tissue disease....

  4. Self-reported musculoskeletal symptoms among Danish women with cosmetic breast implants.

    Science.gov (United States)

    Kjøller, Kim; Hölmich, Lisbet Rosenkrantz; Fryzek, Jon P; Jacobsen, Poul Harboe; Friis, Søren; McLaughlin, Joseph K; Lipworth, Loren; Henriksen, Trine Foged; Høier-Madsen, Mimi; Wiik, Allan; Olsen, Jørgen H

    2004-01-01

    No epidemiological evidence of an association between silicone breast implants and connective tissue disease has been found. Based on case reports, it has been hypothesized that silicone breast implants may be associated with a unique rheumatic symptom cluster termed "atypical connective tissue disease." We have evaluated self-reported rheumatic symptoms among women who received breast implants between 1977 and 1997 at 2 private plastic surgery clinics in Denmark. Women with other cosmetic surgery, including breast reduction, as well as women from the general population, were identified as controls. No statistically significant differences in mild (odds ratio [OR] = 0.9; 95% confidence interval [CI] = 0.6-1.3), moderate (OR = 0.7; 95% CI = 0.4-1.2), or severe (OR = 1.1; 95% CI = 0.6-2.1) musculoskeletal symptoms were observed when women with breast implants were compared with women with other cosmetic surgery. Compared with women from the general population, women with breast implants were statistically significantly less likely to have mild or moderate musculoskeletal symptoms (OR = 0.5; 95% CI = 0.3-0.7 and OR = 0.3; 95% CI = 0.2-0.5, respectively); for severe symptoms the deficit was not statistically significant (OR = 0.7; 95% CI = 0.3-1.3). For individual symptom groups, there was no consistent pattern of reporting among women with implants. We did not find an excess of rheumatic symptoms or symptom clusters among women with breast implants. In fact, the occurrence of mild, moderate, and severe musculoskeletal symptoms was generally lower among women with implants compared with women with other cosmetic surgery and women in the general population.

  5. Influence of ion implantation on titanium surfaces for medical applications

    Science.gov (United States)

    Krischok, Stefan; Blank, Claudia; Engel, Michael; Gutt, Richard; Ecke, Gernot; Schawohl, Jens; Spieß, Lothar; Schrempel, Frank; Hildebrand, Gerhard; Liefeith, Klaus

    2007-09-01

    The implantation of ions into the near surface layer is a new approach to improve the osseointegration of metallic biomaterials like titanium. Meanwhile it is well known that surface topography and surface physico-chemistry as well as visco-elastic properties influence the cell response after implantation of implants into the human body. To optimize the cell response of titanium, ion implantation techniques have been used to integrate calcium and phosphorus, both elements present in the inorganic bone phase. In this context, the concentration profile of the detected elements and their chemical state have been investigated using X-ray photoelectron spectroscopy and Auger electron spectroscopy depth profiling. Ion implantation leads to strong changes of the chemical composition of the near surface region, which are expected to modify the biofunctionality as observed in previous experiments on the cell response. The co-implantation of calcium and phosphorus samples, which showed best results in the performed tests (biological and physical), leads to a strong modification of the chemical surface composition.

  6. A Prospective Analysis of Dynamic Loss of Breast Projection in Tissue Expander-Implant Reconstruction

    Directory of Open Access Journals (Sweden)

    Lauren M Mioton

    2015-05-01

    Full Text Available BackgroundBreast projection is a critical element of breast reconstruction aesthetics, but little has been published regarding breast projection as the firm expander is changed to a softer implant. Quantitative data representing this loss in projection may enhance patient education and improve our management of patient expectations.MethodsFemale patients who were undergoing immediate tissue-expander breast reconstruction with the senior author were enrolled in this prospective study. Three-dimensional camera software was used for all patient photographs and data analysis. Projection was calculated as the distance between the chest wall and the point of maximal projection of the breast form. Values were calculated for final tissue expander expansion and at varying intervals 3, 6, and 12 months after implant placement.ResultsFourteen breasts from 12 patients were included in the final analysis. Twelve of the 14 breasts had a loss of projection at three months following the implant placement or beyond. The percentage of projection lost in these 12 breasts ranged from 6.30% to 43.4%, with an average loss of projection of 21.05%.ConclusionsThis study is the first prospective quantitative analysis of temporal changes in breast projection after expander-implant reconstruction. By prospectively capturing projection data with three-dimensional photographic software, we reveal a loss of projection in this population by three months post-implant exchange. These findings will not only aid in managing patient expectations, but our methodology provides a foundation for future objective studies of the breast form.

  7. Bilateral Breast Reconstruction with Extended Thoracodorsal Artery Perforator Propeller Flaps and Implants

    DEFF Research Database (Denmark)

    Gunnarsson, Gudjon L; Børsen-Koch, Mikkel; Nielsen, Henrik Toft

    2015-01-01

    (200-330), and the average implant size used was 350 cm(3) (195-650). We demonstrate how the extended thoracodorsal artery perforator propeller flap allows for a swift and reliable direct to implant bilateral total breast reconstruction in a simple setting and is a valuable adjunct to our armamentarium......We present our experience of bilateral total breast reconstruction using a double-sided extended thoracodorsal artery perforator propeller flap in a case series of 10 patients. Reconstruction was successfully achieved in all cases with few complications. The median time for surgery was 275 minutes...... of techniques for single-stage bilateral breast reconstruction....

  8. 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.

  9. Variable presentation of anaplastic large-cell lymphoma in patients with breast implants.

    Science.gov (United States)

    Locke, Michelle B; Lofts, Julian

    2017-10-01

    Anaplastic large-cell lymphoma (ALCL) has recently been reported in women with breast implants. The incidence of breast implant-related ALCL is extremely rare and most surgeons would not expect to see this disease in their career. However, the senior author has had three women present to his practice with ALCL over a 2-year period. The three patients and their presentation were reviewed to establish the presenting complaint in each case of subsequently diagnosed ALCL. Literature was reviewed to establish appropriate treatment protocols for any subsequent patients. The average time between first implant placement and presentation with breast implant-associated ALCL was 13.3 years (range: 10-16 years) and age at presentation was 49 years (range: 45-53 years). Each presentation was somewhat different, being a palpable mass, a painless seroma and a painful seroma. Both patients with seroma underwent ultrasound-guided aspiration of fluid which confirmed ALCL. All patients underwent implant removal and complete capsulectomy. The patient with a mass at presentation initially declined adjuvant treatment but subsequently developed an ALCL-associated seroma and was treated with surgery and post-operative chemotherapy. Patients with breast implant-associated ALCL can present with different clinical signs and symptoms. Late seroma is a relatively common presentation of breast implant-associated ALCL. While firm guidelines for the management of breast implant-related ALCL are lacking, we suggest that any late seroma in the absence of infection should be managed with aspiration and cytological analysis of the fluid. © 2015 Royal Australasian College of Surgeons.

  10. The Story of : Pathologic Risk Factors in Breast Implant Surgery

    Directory of Open Access Journals (Sweden)

    Caroline A Yao

    2014-07-01

    Full Text Available Serratia marcescens (S. marcescens emerged as an opportunist in the setting of immunodeficiency in the 1970s, when serious infections occurred in San Francisco hospitals after USA. Navy experiments had aerosolized the bacteria to study biologic warfare. We investigate the risks of S. marcescens in San Franciscans who undergo mastectomy with implant reconstruction. From 2007 to 2011, the senior author took breast capsule cultures for all patients at the time of tissue expander exchange/explant. Of the 142 women who had reconstruction, 23 had positive cultures. Only the two patients who were positive for S. marcescens developed clinical infections that required explantation. Both had postoperative chemotherapy with transient neutropenia, and both had close ties to San Francisco. Clinical signs of infection emerged for both patients months after initial surgery, despite having previously well healed incisions. Other patients were culture positive for Pseudomonas, Proteus, Enterococcus and MRSA and did not develop require explant. While the link between San Francisco and S. marcescens is controversial, a patient's geography is a simple screening tool when considering postoperative risks, especially in the immunocompromised. Closer monitoring for neutropenia during chemotherapy, and a lower threshold to administer S. marcescens targeted antibiotics may be warranted in these patients.

  11. Chronic biofilm infection in breast implants is associated with an increased T-cell lymphocytic infiltrate: implications for breast implant-associated lymphoma.

    Science.gov (United States)

    Hu, Honghua; Jacombs, Anita; Vickery, Karen; Merten, Steven L; Pennington, David G; Deva, Anand K

    2015-02-01

    Biofilm infection of breast implants significantly potentiates capsular contracture. This study investigated whether chronic biofilm infection could promote T-cell hyperplasia. In the pig study, 12 textured and 12 smooth implants were inserted into three adult pigs. Implants were left in situ for a mean period of 8.75 months. In the human study, 57 capsules from patients with Baker grade IV contracture were collected prospectively over a 4-year period. Biofilm and surrounding lymphocytes were analyzed using culture, nucleic acid, and visualization techniques. In the pig study, all samples were positive for bacterial biofilm. There was a significant correlation between the bacterial numbers and grade of capsular contracture (p = 0.04). Quantitative real-time polymerase chain reaction showed that all lymphocytes were significantly more numerous on textured compared with smooth implants (p biofilm. Analysis of lymphocyte numbers showed a T-cell predominance (p biofilm infection around breast prostheses produces an increased T-cell response both in the pig and in humans. A possible link between bacterial biofilm and T-cell hyperplasia is significant in light of breast implant-associated anaplastic large-cell lymphoma. Risk, V.

  12. Evaluation of the breast with implant using mammography, ultrasonography and magnetic resonance imaging; Avaliacao da mama com implante pelos diversos metodos de imagem: mamografia, ultra-sonografia e ressonancia magnetica

    Energy Technology Data Exchange (ETDEWEB)

    Louveira, Maria Helena; Castro, Iris Moura; Souza, Luis Ronan Marquez Ferreira de; Freitas, Andrea Goncalves de; Szejnfeld, Jacob; Kemp, Claudio [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Diagnostico por Imagem]. E-mail: agracino@uol.com.br

    2003-07-01

    Breast implants have been frequently used for cosmetic and reconstructive reasons. As a consequence, a growing number of patients are looking for imaging methods to evaluate breast lesions hidden by implants, as well as to evaluate their integrity. Mammography is the most efficient method to screen breast cancer, but it is of limited use in the study of breasts with implants. It is often necessary the association of ultrasound and magnetic resonance imaging to evaluate breast lesions and implants alterations. Each imaging method is useful to evaluate these patients and recognize the information given by each one is very important for an early diagnosis of breast lesions and implant complications. (author)

  13. Surface acoustic wave probe implant for predicting epileptic seizures

    Energy Technology Data Exchange (ETDEWEB)

    Gopalsami, Nachappa [Naperville, IL; Kulikov, Stanislav [Sarov, RU; Osorio, Ivan [Leawood, KS; Raptis, Apostolos C [Downers Grove, IL

    2012-04-24

    A system and method for predicting and avoiding a seizure in a patient. The system and method includes use of an implanted surface acoustic wave probe and coupled RF antenna to monitor temperature of the patient's brain, critical changes in the temperature characteristic of a precursor to the seizure. The system can activate an implanted cooling unit which can avoid or minimize a seizure in the patient.

  14. Antibacterial and Bioactive Coatings on Titanium Implant Surfaces

    OpenAIRE

    Aranya, Anupama Kulkarni; Pushalkar, Smruti; Zhao, Minglei; Racquel Z. LeGeros; 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...

  15. Directing neuronal cell growth on implant material surfaces by microstructuring.

    Science.gov (United States)

    Reich, Uta; Fadeeva, Elena; Warnecke, Athanasia; Paasche, Gerrit; Müller, Peter; Chichkov, Boris; Stöver, Timo; Lenarz, Thomas; Reuter, Günter

    2012-05-01

    For best hearing sensation, electrodes of auditory prosthesis must have an optimal electrical contact to the respective neuronal cells. To improve the electrode-nerve interface, microstructuring of implant surfaces could guide neuronal cells toward the electrode contact. To this end, femtosecond laser ablation was used to generate linear microgrooves on the two currently relevant cochlear implant materials, silicone elastomer and platinum. Silicone surfaces were structured by two different methods, either directly, by laser ablation or indirectly, by imprinting using laser-microstructured molds. The influence of surface structuring on neurite outgrowth was investigated utilizing a neuronal-like cell line and primary auditory neurons. The pheochromocytoma cell line PC-12 and primary spiral ganglion cells were cultured on microstructured auditory implant materials. The orientation of neurite outgrowth relative to the microgrooves was determined. Both cell types showed a preferred orientation in parallel to the microstructures on both, platinum and on molded silicone elastomer. Interestingly, microstructures generated by direct laser ablation of silicone did not influence the orientation of either cell type. This shows that differences in the manufacturing procedures can affect the ability of microstructured implant surfaces to guide the growth of neurites. This is of particular importance for clinical applications, since the molding technique represents a reproducible, economic, and commercially feasible manufacturing procedure for the microstructured silicone surfaces of medical implants. Copyright © 2012 Wiley Periodicals, Inc.

  16. Controlled implant/soft tissue interaction by nanoscale surface modifications of 3D porous titanium implants

    Science.gov (United States)

    Rieger, Elisabeth; Dupret-Bories, Agnès; Salou, Laetitia; Metz-Boutigue, Marie-Helene; Layrolle, Pierre; Debry, Christian; Lavalle, Philippe; Engin Vrana, Nihal

    2015-05-01

    Porous titanium implants are widely employed in the orthopaedics field to ensure good bone fixation. Recently, the use of porous titanium implants has also been investigated in artificial larynx development in a clinical setting. Such uses necessitate a better understanding of the interaction of soft tissues with porous titanium structures. Moreover, surface treatments of titanium have been generally evaluated in planar structures, while the porous titanium implants have complex 3 dimensional (3D) architectures. In this study, the determining factors for soft tissue integration of 3D porous titanium implants were investigated as a function of surface treatments via quantification of the interaction of serum proteins and cells with single titanium microbeads (300-500 μm in diameter). Samples were either acid etched or nanostructured by anodization. When the samples are used in 3D configuration (porous titanium discs of 2 mm thickness) in vivo (in subcutis of rats for 2 weeks), a better integration was observed for both anodized and acid etched samples compared to the non-treated implants. If the implants were also pre-treated with rat serum before implantation, the integration was further facilitated. In order to understand the underlying reasons for this effect, human fibroblast cell culture tests under several conditions (directly on beads, beads in suspension, beads encapsulated in gelatin hydrogels) were conducted to mimic the different interactions of cells with Ti implants in vivo. Physical characterization showed that surface treatments increased hydrophilicity, protein adsorption and roughness. Surface treatments also resulted in improved adsorption of serum albumin which in turn facilitated the adsorption of other proteins such as apolipoprotein as quantified by protein sequencing. The cellular response to the beads showed considerable difference with respect to the cell culture configuration. When the titanium microbeads were entrapped in cell

  17. The diagnosis of silicone breast-implant rupture: clinical findings compared with findings at magnetic resonance imaging

    DEFF Research Database (Denmark)

    Hölmich, Lisbet Rosenkrantz; Fryzek, Jon P; Kjøller, Kim

    2005-01-01

    The objective was to evaluate the usefulness of clinical examination in the evaluation of breast-implant integrity, using the diagnosis at magnetic resonance imaging (MRI) as the "gold standard." Fifty-five women with 109 implants underwent a breast examination either just before or shortly after...... an MRI examination. Twenty-four of 109 implants were clinically diagnosed with possible rupture or rupture. Eighteen of the 24 implants were ruptured according to the MRI examination (75%). Eighty-five implants were clinically classified as intact, and 43 of these were actually ruptured at MRI (51...... to identify implant rupture, neither the sensitivity nor the specificity is acceptable....

  18. Titanium implant surface modification by cathodic reduction in hydrofluoric acid: surface characterization and in vivo performance.

    Science.gov (United States)

    Lamolle, Sébastien F; Monjo, Marta; Lyngstadaas, Ståle P; Ellingsen, Jan E; Haugen, Håvard J

    2009-03-01

    Etching is used for the surface modification of titanium to improve the implant performance in bone. In this study, pure titanium implants were surface modified by a cathodic reduction process by using hydrofluoric acid (HF) at various concentrations (0.001, 0.01, and 0.1 vol %) and a constant current of 1 mA/cm(2). The resulting surface microtopographies were analyzed by atomic force microscopy, scanning electron microscopy, and profilometry, while the surface chemical contents were evaluated by time of flight secondary ion mass spectrometry. The competitive forces between ionic surface implementation induced by the current direction and the HF etching effect on titanium were highlighted. The implant performance was evaluated in an in vivo rabbit model by using a pull-out test method. The group of implants modified with 0.01% HF showed the highest retention in bone. Fluoride and hydride amounts measured in the surfaces, as well as surface skewness (S(sk)), kurtosis (S(ku)), and core fluid retention (S(ci)) were positively correlated to the implant's retention in bone in vivo. Frequently used parameters for characterizing the implant, such as oxide content and the average height deviation from the mean plane (S(a)), were not correlated to implant performance, suggesting that these parameters are not the most important in predicting the implant performance. (c) 2008 Wiley Periodicals, Inc.

  19. 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.

  20. Immediate breast reconstruction with anatomical implants following mastectomy: The radiation perspective

    Energy Technology Data Exchange (ETDEWEB)

    Ben-David, Merav, E-mail: Merav.ben-david@sheba.health.gov.il [Radiation Oncology Unit, Chaim Sheba Medical Center, Ramat Gan (Israel); Sackler School of Medicine, Tel Aviv University, Tel Aviv (Israel); Granot, Hila [Radiation Oncology Unit, Chaim Sheba Medical Center, Ramat Gan (Israel); Gelernter, Ilana [Statistical Laboratory, School of Mathematics, Tel Aviv University, Tel Aviv (Israel); Scheflan, Michael [Department of Surgery, Assuta and Herzliya Medical Centers, Ramat Gan (Israel)

    2016-07-01

    Immediate implant-based breast reconstruction followed by postmastectomy radiation therapy (PMRT) is controversial because of the risk of compromised treatment plans and concerns regarding cosmetic outcomes. We evaluated the effects of immediate direct-to-implant breast reconstruction with anatomical implants on the quality of PMRT delivered by 3-dimensional conformal radiotherapy (3D-CRT). In this retrospective, single-institution study, patients who had undergone reconstruction with direct anatomic implant, performed by a single surgeon, received 3D-CRT between 2008 and 2013. For each patient, 2 plans (including or excluding internal mammary nodes [IMN]) were created and calculated. The primary end point was the dose distribution among reconstructed breasts, heart, lungs, and IMNs, and between right and left breasts. Of 29 consecutive patients, 11 received right-sided and 18 received left-sided PMRT to a total dose of 50 Gy. For plans excluding IMN coverage, mean D{sub mean} for right and left reconstructed breasts was 49.09 Gy (98.2% of the prescribed dose) and 48.51 Gy (97.0%), respectively. For plans including IMNs, mean D{sub mean} was 49.15 Gy (98.3%) for right and 48.46 Gy (96.9%) for left reconstructed breasts; the mean IMN D{sub mean} was 47.27 Gy (right) and 47.89 Gy (left). Heart D{sub mean} was below 1.56 Gy for all plans. Mean total lung volume receiving a dose of ≥ 20 Gy was 13.80% to 19.47%. PMRT can be delivered effectively and safely by 3D-CRT after direct-to-implant breast reconstruction with anatomical implants, even if patients require IMN treatment.

  1. Pilot Study of Association of Bacteria on Breast Implants with Capsular Contracture▿

    Science.gov (United States)

    Del Pozo, Jose L.; Tran, Nho V.; Petty, Paul M.; Johnson, Craig H.; Walsh, Molly F.; Bite, Uldis; Clay, Ricky P.; Mandrekar, Jayawant N.; Piper, Kerryl E.; Steckelberg, James M.; Patel, Robin

    2009-01-01

    Capsular contracture is the most common and frustrating complication in women who have undergone breast implantation. Its cause and, accordingly, treatment and prevention remain to be elucidated fully. The aim of this prospective observational pilot study was to test the hypothesis that the presence of bacteria on breast implants is associated with capsular contracture. We prospectively studied consecutive patients who underwent breast implant removal for reasons other than overt infection at the Mayo Clinic from February through September 2008. Removed breast implants were processed using a vortexing/sonication procedure and then subjected to semiquantitative culture. Twenty-seven of the 45 implants collected were removed due to significant capsular contracture, among which 9 (33%) had ≥20 CFU bacteria/10 ml sonicate fluid; 18 were removed for reasons other than significant capsular contracture, among which 1 (5%) had ≥20 CFU/10 ml sonicate fluid (P = 0.034). Propionibacterium species, coagulase-negative staphylococci, and Corynebacterium species were the microorganisms isolated. The results of this study demonstrate that there is a significant association between capsular contracture and the presence of bacteria on the implant. The role of these bacteria in the pathogenesis of capsular contracture deserves further study. PMID:19261794

  2. Correlation between MRI results and intraoperative findings in patients with silicone breast implants

    Directory of Open Access Journals (Sweden)

    Lindenblatt N

    2014-07-01

    Full Text Available Nicole Lindenblatt,1 Karem El-Rabadi,2 Thomas H Helbich,2 Heinrich Czembirek,3 Maria Deutinger,4 Heike Benditte-Klepetko5 1Division of Plastic and Hand Surgery, Department of Surgery, University Hospital Zurich, Zurich, Switzerland; 2Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna - General Hospital Vienna, 3Department of Radiology, Hospital Wiener Privatklinik, 4Department of Plastic and Reconstructive Surgery, Hospital Rudolfstiftung, Vienna, Austria; 5Department of Plastic and Reconstructive Surgery, Erasmus Medical Center, Rotterdam, the Netherlands Background: Silicone gel breast implants may silently rupture without detection. This has been the main reason for magnetic resonance imaging (MRI of the augmented or reconstructed breast. The aim of the present study was to investigate the accuracy of MRI for implant rupture. Methods: Fifty consecutive patients with 85 silicone gel implants were included in the study. The mean age of the patients was 51 (range 21–72 years, with a mean duration of implantation of 3.8 (range 1–28 years. All patients underwent clinical examination and breast MRI. Intraoperative implant rupture was diagnosed by the operating surgeon. Results: Nineteen of the 50 patients suffered from clinical symptoms. An implant rupture was diagnosed by MRI in 22 of 85 implants (26%. In seven of 17 removed implants (41%, the intraoperative diagnosis corresponded with the positive MRI result. However, only 57% of these patients were symptomatic. Ultrasound imaging of the harvested implants showed signs of interrupted inner layers of the implant despite integrity of the outer shell. By microsurgical separation of the different layers of the implant shell, we were able to reproduce this phenomenon and to produce signs of implant rupture on MRI. Conclusion: Our results show that rupture of only the inner layers of the implant shell with integrity of

  3. Toward optimizing dental implant performance: Surface characterization of Ti and TiZr implant materials.

    OpenAIRE

    Murphy, Matthew; Walczak, Monika; Thomas, Andrew; Silikas, Nick; Berner, S.; Lindsay, Robert

    2017-01-01

    ObjectiveTargeting understanding enhanced osseointegration kinetics, the goal of this study was to characterize the surface morphology and composition of Ti and TiZr dental implant substrates subjected to one of two surface treatments developed by Straumann. These two treatments are typically known as SLA and SLActive, with the latter resulting in more rapid osseointegration.MethodsA range of techniques was applied to characterize four different substrate/surface treatment combinations (TiSLA...

  4. Cellular responses evoked by different surface characteristics of intraosseous titanium implants.

    Science.gov (United States)

    Feller, Liviu; Jadwat, Yusuf; Khammissa, Razia A G; Meyerov, Robin; Schechter, Israel; Lemmer, Johan

    2015-01-01

    The properties of biomaterials, including their surface microstructural topography and their surface chemistry or surface energy/wettability, affect cellular responses such as cell adhesion, proliferation, and migration. The nanotopography of moderately rough implant surfaces enhances the production of biological mediators in the peri-implant microenvironment with consequent recruitment of differentiating osteogenic cells to the implant surface and stimulates osteogenic maturation. Implant surfaces with moderately rough topography and with high surface energy promote osteogenesis, increase the ratio of bone-to-implant contact, and increase the bonding strength of the bone to the implant at the interface. Certain features of implant surface chemistry are also important in enhancing peri-implant bone wound healing. It is the purpose of this paper to review some of the more important features of titanium implant surfaces which have an impact on osseointegration.

  5. The diagnosis of silicone breast-implant rupture: clinical findings compared with findings at magnetic resonance imaging

    DEFF Research Database (Denmark)

    Hölmich, Lisbet Rosenkrantz; Fryzek, Jon P; Kjøller, Kim

    2005-01-01

    The objective was to evaluate the usefulness of clinical examination in the evaluation of breast-implant integrity, using the diagnosis at magnetic resonance imaging (MRI) as the "gold standard." Fifty-five women with 109 implants underwent a breast examination either just before or shortly after...

  6. 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.

  7. The Impact of Breast Implant Location on the Risk of Capsular Contraction

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Sørensen, Jens Ahm

    2016-01-01

    developing CC with subglandular compared to submuscular placement of the breast implant. METHODS: A total of 1,283 studies were identified from December 2003 to December 2013 by PUBMED and MEDLINE searches and a manual search strategy. Two levels of screening resulted in 10 studies suitable for meta......-analysis, providing data on a total of 17,520 breast implants. All statistical calculations were performed with Review Manager (RevMan) version 5.2.7. RESULTS: Random-effect (RE) pooled relative risk (RR) and confidence intervals (CI) were calculated for capsular contraction. The risk of developing capsular....... CONCLUSION: This analysis demonstrated a more than 2-fold increase in the risk of capsular contraction with subglandular compared to submuscular breast implant location.Clinical Question: Risk....

  8. Silicone granuloma from ruptured breast implants as a cause of cervical lymphadenopathy.

    Science.gov (United States)

    Borghol, K; Gallagher, G; Skelly, B L

    2016-09-01

    A 56-year-old woman with a 10-year history of bilateral silicone breast implants presented to the ear, nose and throat outpatient clinic with a 2-month history of a right-sided neck lump. She was found to have a 1.3cm supraclavicular lymph node that gave the clinical impression of being reactive. Ultrasonography guided fine needle aspiration was inconclusive and initial review of subsequent computed tomography failed to identify a cause. This was followed by excisional biopsy of the lymph node, which revealed a silicone granuloma that was linked to a ruptured right-sided breast implant placed ten years previously. This case highlights the importance for otolaryngologists to consider silicone granuloma among the differential diagnoses of cervical lymphadenopathy in patients with a history of silicone breast implants. Recognising this differential diagnosis could avoid undue anxiety for patient and clinician regarding more serious pathology.

  9. The In Vivo Pericapsular Tissue Response to Modern Polyurethane Breast Implants.

    Science.gov (United States)

    Frame, James; Kamel, Dia; Olivan, Marcelo; Cintra, Henrique

    2015-10-01

    Polyurethane breast implants were first introduced by Ashley (Plast Reconstr Surg 45:421-424, 1970), with the intention of trying to reduce the high incidence of capsular contracture associated with smooth shelled, high gel bleed, silicone breast implants. The sterilization of the polyurethane foam in the early days was questionable. More recently, ethylene oxide (ETO)-sterilized polyurethane has been used in the manufacturing process and this has been shown to reduce the incidence of biofilm. The improved method of attachment of polyurethane onto the underlying high cohesive gel, barrier shell layered, silicone breast implants also encourages bio-integration. Polyurethane covered, cohesive gel, silicone implants have also been shown to reduce the incidence of other problems commonly associated with smooth or textured silicone implants, especially with reference to displacement, capsular contracture, seroma, reoperation, biofilm and implant rupture. Since the introduction of the conical polyurethane implant (Silimed, Brazil) into the United Kingdom in 2009 (Eurosurgical, UK), we have had the opportunity to review histology taken from the capsules of polyurethane implants in three women ranging from a few months to over 3 years after implantation. All implants had been inserted into virgin subfascial, extra-pectoral planes. The results add to the important previously described histological findings of Bassetto et al. (Aesthet Plast Surg 34:481-485, 2010). Five distinct layers are identified and reasons for the development of each layer are discussed. Breast capsule around polyurethane implants, in situ for fifteen and 20 years, has recently been obtained and analysed in Brazil, and the histology has been incorporated into this study. After 20 years, the polyurethane is almost undetectable and capsular contracture may appear. These findings contribute to our understanding of polyurethane implant safety, and give reasoning for a significant reduction in clinical

  10. Evaluation of the effects of silicone implants on the breast parenchyma.

    Science.gov (United States)

    Roxo, Ana Claudia Weck; Nahas, Fabio Xerfan; Bazi, Fernanda; de Castro, Claudio Cardoso; Aboudib, Jose Horacio; Marques, Ruy Garcia

    2015-11-01

    Despite being the cosmetic procedure most performed worldwide, there are still few objective measurements of postoperative volumetric analysis of breast augmentation available in the literature. The aim of this study was to evaluate volumetric changes in the breast parenchyma after the placement of silicone implants in the subglandular plane. Thirty-four women were randomly allocated to the intervention group (n = 24), who underwent breast augmentation in the subglandular plane, or to the control group (n = 10), who received no intervention. Volumetric magnetic resonance imaging was performed at inclusion, and after 6 and 12 months in all participants. The non-parametric Friedman's test was used for statistical analysis. There was a significant reduction in glandular volume (mean, 22%) at 12 months postoperatively in patients who underwent breast augmentation. Breast augmentation caused reduction in the volume of the breast parenchyma. 3 Therapeutic. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  11. Surface treatments applied on titanium implants

    Directory of Open Access Journals (Sweden)

    Cosma Sorin Cosmin

    2015-06-01

    Full Text Available The aim of this systematic review was to identify new methods of surface treatments applied on titanium grafts and their clinical and histological outcomes, including different routes for surface treatments, respectively the results of in vitro or in vivo tests. These surface modifications analysed meet three main requirements: to prevent nonspecific absorption of denatured protein on the surface, to attract native tissue cells or progenitor cells capable of differentiation in an appropriate manner or to facilitate biochemical signals to induce biochemical healing mechanisms. Therefore, cells will recognize these surface modifications and will be influenced in their adhesion behavior, profiling and differentiation. This review summarizes some of the recent developments in coatings for medical field.

  12. Application of "CD−4" Theory for Determining the Width of Implant in Breast Augmentation

    Directory of Open Access Journals (Sweden)

    Jie Cai

    2015-01-01

    Full Text Available Background: The determination of the width of the implant is the first key step to select shape and volume of the implant in breast augmentation. The aim of this study was to introduce a new method to determine the width of the implant (W and explain the reasons to do so in details. Methods: From January 2006 to June 2014, the authors have found and applied "CD −4" theory to determine the width of breast implant (W in dual plane I or II breast augmentation cases through transaxillary or periareolar incision for 560 patients. "CD" is defined as the curved distance on skin from the midline of the sternal bone to the anterior axillary line (AAL on the lateral chest wall through the horizontal level on inferior mammary fold. W = CD − 4 (or 3.5 cm. Results: The 560 patients used both round and anatomic implants with W from 10.5 cm to 12.5 cm. Their CDs are from 14.5 cm to 17 cm. About 78% of the patients have got followed up from 1 month to 5 years postoperatively. Except for four patients who got unilateral capsular contractions, all the other patients are satisfied with their nature new breast shapes and volumes. Their new intermammary cleavages without bras are between 1 cm and 2.5 cm, and lateral borders of the breast are on the area of the AAL. Conclusions: W (width of the implant = CD − 4 (cm when doing dual plan I or II breast augmentation. For the very thin patient, 4 should be 3.5.

  13. Preoperative implant selection for unilateral breast reconstruction using 3D imaging with the Microsoft Kinect sensor.

    Science.gov (United States)

    Pöhlmann, Stefanie T L; Harkness, Elaine; Taylor, Christopher J; Gandhi, Ashu; Astley, Susan M

    2017-08-01

    This study aimed to investigate whether breast volume measured preoperatively using a Kinect 3D sensor could be used to determine the most appropriate implant size for reconstruction. Ten patients underwent 3D imaging before and after unilateral implant-based reconstruction. Imaging used seven configurations, varying patient pose and Kinect location, which were compared regarding suitability for volume measurement. Four methods of defining the breast boundary for automated volume calculation were compared, and repeatability assessed over five repetitions. The most repeatable breast boundary annotation used an ellipse to track the inframammary fold and a plane describing the chest wall (coefficient of repeatability: 70 ml). The most reproducible imaging position comparing pre- and postoperative volume measurement of the healthy breast was achieved for the sitting patient with elevated arms and Kinect centrally positioned (coefficient of repeatability: 141 ml). Optimal implant volume was calculated by correcting used implant volume by the observed postoperative asymmetry. It was possible to predict implant size using a linear model derived from preoperative volume measurement of the healthy breast (coefficient of determination R(2) = 0.78, standard error of prediction 120 ml). Mastectomy specimen weight and experienced surgeons' choice showed similar predictive ability (both: R(2) = 0.74, standard error: 141/142 ml). A leave one-out validation showed that in 61% of cases, 3D imaging could predict implant volume to within 10%; however for 17% of cases it was >30%. This technology has the potential to facilitate reconstruction surgery planning and implant procurement to maximise symmetry after unilateral reconstruction. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  14. Assessment of the implant geometry in fractionated interstitial HDR breast brachytherapy using an electromagnetic tracking system.

    Science.gov (United States)

    Kellermeier, Markus; Fietkau, Rainer; Strnad, Vratislav; Bert, Christoph

    During the partial-breast treatment course by interstitial brachytherapy, electromagnetic tracking (EMT) was applied to measure the implant geometry. Implant-geometry variation, choice of reference data, and three registration methods were assessed. The implant geometry was measured in 28 patients after catheter implantation (EMTbed), during CT imaging (EMTCT), and in each of up to n = 9 treatment fractions (EMTF(k), k = 1, 2,… n). EMTF(k) were registered to the planned implant reconstruction (CTplan) by using all dwell positions (DPs), the button centers, or three fiducial sensors on the patient's skin. Variation in implant geometry obtained from EMTF(k) was assessed for EMTbed, EMTCT, and CTplan. EMT was used to measure 3932 catheters. A duration of 6.5 ± 1.7 min was needed for each implant measurement (mean, 17 catheters) plus setup of the EMT system. Data registration based on the DP deviated significantly lower than registration on button centers or fiducial sensors. Within a registration group, there was a geometry in high-dose-rate interstitial brachytherapy breast treatments. EMTbed, EMTCT, and CTplan data can serve as reference for assessment of implant changes. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  15. Versatility of Capsular Flaps in the Salvage of Exposed Breast Implants

    Directory of Open Access Journals (Sweden)

    Beniamino Brunetti, MD

    2015-03-01

    Full Text Available Summary: Breast implant exposure due to poor tissue coverage or previous irradiation represents a surgical challenge both in the reconstructive and aesthetic plastic surgery practice. In case of implant extrusion or incipient exposure, the commonly suggested strategies, such as targeted antibiotic therapy, drainage and lavage of the cavity, fistulectomy, and primary closure, may be ineffective leading the surgeon to an unwanted implant removal or to adopt more invasive flap coverage procedures. Breast implant capsule, in its physiological clinical behavior, can be considered as a new reliable source of tissue, which can be used in a wide range of clinical situations. In our hands, capsular flaps proved to be a versatile solution not only to treat breast contour deformities or inframammary fold malpositions but also to salvage exposed breast implants. In this scenario, the use of more invasive surgical techniques can be avoided or simply saved and delayed for future recurrences.(Plast Reconstr Surg Glob Open 2015;3:e340; doi:10.1097/GOX.0000000000000307; Published online 30 March 2015.

  16. Multisite Infection with Mycobacterium abscessus after Replacement of Breast Implants and Gluteal Lipofilling

    OpenAIRE

    Eva Rüegg; Alexandre Cheretakis; Ali Modarressi; Stephan Harbarth; Brigitte Pittet-Cuénod

    2015-01-01

    Introduction. Medical tourism for aesthetic surgery is popular. Nontuberculous mycobacteria (NTM) occasionally cause surgical-site infections. As NTM grow in biofilms, implantations of foreign bodies are at risk. Due to late manifestation, infections occur when patients are back home, where they must be managed properly. Case Report. A 39-year-old healthy female was referred for acute infection of the right gluteal area. Five months before, she had breast implants replacement, abdominal l...

  17. [Radiological trap and oncological precautions in a patient who has undergone a permanent withdrawal of PIP breast implants].

    Science.gov (United States)

    Koutsomanis, A; Bruant-Rodier, C; Roedlich, M-N; Bretz-Grenier, M-F; Perrot, P; Bodin, F

    2015-12-01

    We report the case of a 57-year-old patient who presented radiological images similar to ruptured breast implants one year after the supposed withdrawal of the latter. This woman had benefited for the first time from cosmetic PIP breast implants in 2000. Early in 2014, she requested the removal of the implants without renewal because she was feeling pain and functional discomfort. A few months after the operation, she consulted for breast swelling in the upper pole of the breast. Radiological assessment showed liquid formations compatible with the presence of implants. At our request, the rereading of the MRI by the radiologist definitively concluded on a bilateral seroma within the persistent fibrous capsule. In the absence of symptoms, clinical monitoring had been decided. But at the recrudescence of anaplastic large cell lymphoma cases associated with breast implants, a cytological sampling was intended. In case of cytological abnormality or recurrence of the seroma, a surgical procedure should be performed. In conclusion, the removal of a breast implant without capsulectomy may result in the formation of a seroma whose images resemble those of an implant. It is always worthwhile to provide precise clinical data to the radiologist in order to help him to make informed interpretations. Every serous effusion in a breast lodge having contained a silicone implant must evoke the diagnosis of anaplastic large cell lymphoma. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  18. Re-osseointegration after treatment of peri-implantitis at different implant surfaces. An experimental study in the dog.

    Science.gov (United States)

    Persson, L G; Berglundh, T; Lindhe, J; Sennerby, L

    2001-12-01

    Peri-implantitis is a condition that includes soft tissue inflammation and rapid loss of bone. Treatment of peri-implantitis includes both antimicrobial and bone augmenting methods. The question of whether true re-osseointegration may occur following treatment of peri-implantitis is controversial. The aim of this study was to investigate whether the character of the implant surface was of importance for the occurrence of re-osseointegration following treatment of peri-implantitis. Four beagle dogs were used. The mandibular premolars were extracted. After 12 months, 3 ITI(R) solid screw dental implants were placed in each side of the mandible. In the left side, implants with a turned surface (Turned sites) were used, while in the right side implants with a SLA surface (SLA sites) were placed. After 3 months of healing, peri-implantitis was induced by ligature placement and plaque accumulation. When about 50% of the initial bone support was lost, the ligatures were removed. Five weeks later, treatment was initiated. Each animal received tablets of Amoxicillin and Metronidazole for a period of 17 days. Three days after the start of the antibiotic regimen, one implant site (experimental site) in each quadrant was exposed to local therapy. Following flap elevation, the exposed titanium surface was cleaned with the use of cotton pellets soaked in saline. The implants were submerged. Six months later, biopsies were obtained. Treatment resulted in a 72% bone fill of the bone defects at Turned sites and 76% at SLA sites. The amount of re-osseointegration was 22% at Turned sites and 84% at SLA sites. A treatment regimen that included (i) systemic administration of antibiotics combined with (ii) granulation tissue removal and implant surface cleaning resulted in resolution of peri-implantitis and bone fill in adjacent bone defects. Further, while substantial "re-osseointegration" occurred to an implant with a rough surface (SLA), bone growth on a previously exposed smooth

  19. Nanostructured implant surface effect on osteoblast gene expression and bone-to-implant contact in vivo

    Energy Technology Data Exchange (ETDEWEB)

    Mendonca, Gustavo, E-mail: gustavo_mendonca@dentistry.unc.edu [Universidade Catolica de Brasilia, Pos-Graduacao em Ciencias Genomicas e Biotecnologia, SGAN Quadra 916, Modulo B, Av. W5 Norte 70.790-160-Asa Norte Brasilia/DF (Brazil); Bone Biology and Implant Therapy Laboratory, Department of Prosthodontics, University of North Carolina at Chapel Hill, 404 Brauer Hall, CB 7450, Chapel Hill, NC 27511 (United States); Universidade Catolica de Brasilia, Curso de Odontologia, Taguatinga/DF (Brazil); Baccelli Silveira Mendonca, Daniela [Universidade Catolica de Brasilia, Pos-Graduacao em Ciencias Genomicas e Biotecnologia, SGAN Quadra 916, Modulo B, Av. W5 Norte 70.790-160-Asa Norte Brasilia/DF (Brazil) and Bone Biology and Implant Therapy Laboratory, Department of Prosthodontics, University of North Carolina at Chapel Hill, 404 Brauer Hall, CB 7450, Chapel Hill, NC 27511 (United States); Pagotto Simoes, Luis Gustavo; Araujo, Andre Luis; Leite, Edson Roberto [Departmento de Quimica, Universidade Federal de Sao Carlos-UFSCAR, Rod. Washington Luiz, 13565-905 Sao Carlos, SP (Brazil); Golin, Alexsander Luiz [Departmento de Engenharia Mecanica, Faculdade de Engenharia Mecanica, Pontificia Universidade Catolica de Curitiba, Curitiba, PR (Brazil); Aragao, Francisco J.L. [Universidade Catolica de Brasilia, Pos-Graduacao em Ciencias Genomicas e Biotecnologia, SGAN Quadra 916, Modulo B, Av. W5 Norte 70.790-160-Asa Norte Brasilia/DF (Brazil); Embrapa Recursos Geneticos e Biotecnologia, Laboratorio de Introducao e Expressao de Genes, PqEB W5 Norte, 70770-900, Brasilia, DF (Brazil); Cooper, Lyndon F., E-mail: lyndon_cooper@dentistry.unc.edu [Bone Biology and Implant Therapy Laboratory, Department of Prosthodontics, University of North Carolina at Chapel Hill, 404 Brauer Hall, CB 7450, Chapel Hill, NC 27511 (United States)

    2011-12-01

    The aim of this study was to investigate the response of nanostructured implant surfaces at the level of osteoblast differentiation and its effects in bone-to-implant contact (BIC) and removal-torque values (RTV). CpTi grade IV implants (1.6 x 4.0 mm) were machined or machined and subsequently coated with an oxide solution. The surfaces were divided into: machined (M), titania-anatase (An), titania-rutile (Ru), and zirconia (Zr). Surfaces were examined by scanning electron microscopy, atomic force microscopy, and by X-ray microanalysis. Implants were inserted in rat tibia and harvested from 0 to 21 days for measurement of Alkaline Phosphatase, Bone Sialoprotein, Osteocalcin, Osteopontin, and RUNX-2 mRNA levels by real time PCR; from 0 to 56 days for RTV; and from 0 to 56 days for BIC. The roughness parameter (Sa) was compared by one-way ANOVA followed by Tukey Test. Comparison of Torque removal values and histomorphometric measurements on implants in vivo was performed by Kruskal-Wallis test and the significance level for all statistical analyses was set at p {<=} 0.05. mRNA levels on all nanostructured surfaces were increased compared to M. At 56 days, the mean RTV in Ncm was 11.6 {+-} 2.5, 11.3 {+-} 2.4, 11.1 {+-} 3.5, 9.7 {+-} 1.4 for An, Ru, Zr, and M, respectively. Higher BIC (%) was measured for all the nanostructured surfaces versus M at 21 and 56 days (p < 0.05). Nanostructured topographic features composed of TiO{sub 2} or ZrO{sub 2} applied to machined cpTi implant promoted greater mesenchymal stem cell commitment to the osteoblast phenotype and associated increased BIC and physical association with bone. Highlights: {yields} Nanostructured surfaces using a sol-gel technique coated cpTi with TiO{sub 2} or ZrO{sub 2}. {yields} Evaluated molecular and mechanical effect of nanofeatures in vivo in rat tibiae. {yields} Nanofeatures improved the differentiation of rat MSCs into osteoblasts. {yields} Nanofeatures improved increased bone-to-implant contact and

  20. Surface characteristics of implants influence their bone integration after simultaneous placement of implant and GBR membrane.

    Science.gov (United States)

    Lima, Luiz A; Fuchs-Wehrle, Anita M; Lang, Niklaus P; Hämmerle, Christoph H F; Liberti, Edson; Pompeu, Eduardo; Todescan, José H

    2003-12-01

    The purpose of this study was to evaluate the influence of titanium surface characteristics on bone integration of implants, and to describe the pattern of peri-implant tissue healing after simultaneous implant placement and guided bone regeneration. In four healthy mongrel dogs mandibular premolars were extracted. Two weeks following full mouth prophylaxis and 4 months after extractions, simultaneous membrane and implant surgeries were performed. Efforts were made to produce bony defects with dimensions of 7 x 7 x 7 mm. Into these, 24 standard ITI implants (diameter = 4.1 mm; length = 8 mm) with either a titanium plasma-sprayed (TPS) or a machined surface (MS) were placed. Although implants were inserted 4 mm into cancellous bone, difficulties in achieving optimal primary stability were encountered. All dogs were maintained on a soft diet. Chlorhexidine rinses were performed three times a week. Full mouth prophylaxis was performed every 2 weeks. In the case of membrane exposure, the membranes were removed prematurely (4-6 or 14-15 weeks after surgery). Two dogs were sacrificed at 16 weeks and two at 24 weeks after surgery. Nondecalcified histologic sections were processed and histometric analyses were carried out. When membranes were removed after 4-6 weeks, a vertical bone growth (VB) of 45-61% of the original defect was noted. After membrane removal at 14-15 weeks, similar VB was observed. However, if membranes were left in situ for 24 weeks, VB was between 79% and 96%. In this group of sites, the VB was 66% at 16 weeks and 86% at 24 weeks. Osseointegration in the regenerated bone area ranged from 12% to 32% for the TPS and from 0.0% to 3.6% for the MS implants at 16 and 24 weeks combined. Osseointegration in the pristine host bone area ranged from 16% to 35% for the TPS and from 0.0% to 11% for the MS sites at 16 and 24 weeks. In conclusion, the fraction of implant-bone integration was much higher in the pristine bone compared to that in the regenerated bone

  1. Newton rings on the surface of implanted intraocular lenses.

    Science.gov (United States)

    Okada, K; Sagawa, H

    1989-01-01

    Using clinical specular microscopy, we studied a postoperative cellular reaction on the anterior surface of implanted artificial intraocular lenses in living human eyes. An amorphous coating filled the spaces between fibroblast-like cells, histiocytes, and foreign body giant cells in 29 of 118 eyes. In most cases the coating was observed as interference fringes (Newton rings). We observed the rings from seven to 63 days after surgery. Clinically, the patients did not show any visual disturbance at the time of these observations. With time, fibroblast-like cells decreased in number. By two months after surgery, most of the cells on the implants had already disappeared.

  2. Correlation of centroid-based breast size, surface-based breast volume, and asymmetry-score-based breast symmetry in three-dimensional breast shape analysis

    Directory of Open Access Journals (Sweden)

    Henseler, Helga

    2016-06-01

    Full Text Available Objective: The aim of this study was to investigate correlations among the size, volume, and symmetry of the female breast after reconstruction based on previously published data. Methods: The centroid, namely the geometric center of a three-dimensional (3D breast-landmark-based configuration, was used to calculate the size of the breast. The surface data of the 3D breast images were used to measure the volume. Breast symmetry was assessed by the Procrustes analysis method, which is based on the 3D coordinates of the breast landmarks to produce an asymmetry score. The relationship among the three measurements was investigated. For this purpose, the data of 44 patients who underwent unilateral breast reconstruction with an extended latissimus dorsi flap were analyzed. The breast was captured by a validated 3D imaging system using multiple cameras. Four landmarks on each breast and two landmarks marking the midline were used.Results: There was a significant positive correlation between the centroid-based breast size of the unreconstructed breast and the measured asymmetry (p=0.024; correlation coefficient, 0.34. There was also a significant relationship between the surface-based breast volume of the unaffected side and the overall asymmetry score (p<0.001; correlation coefficient, 0.556. An increase in size and especially in volume of the unreconstructed breast correlated positively with an increase in breast asymmetry in a linear relationship.Conclusions: In breast shape analysis, the use of more detailed surface-based data should be preferred to centroid-based size data. As the breast size increases, the latissimus dorsi flap for unilateral breast reconstruction increasingly falls short in terms of matching the healthy breast in a linear relationship. Other reconstructive options should be considered for larger breasts. Generally plastic surgeons should view the two breasts as a single unit when assessing breast aesthetics and not view each

  3. Two-Stage Latissimus Dorsi Flap with Implant for Unilateral Breast Reconstruction: Getting the Size Right

    Directory of Open Access Journals (Sweden)

    Jiajun Feng

    2016-03-01

    Full Text Available BackgroundThe aim of unilateral breast reconstruction after mastectomy is to craft a natural-looking breast with symmetry. The latissimus dorsi (LD flap with implant is an established technique for this purpose. However, it is challenging to obtain adequate volume and satisfactory aesthetic results using a one-stage operation when considering factors such as muscle atrophy, wound dehiscence and excessive scarring. The two-stage reconstruction addresses these difficulties by using a tissue expander to gradually enlarge the skin pocket which eventually holds an appropriately sized implant.MethodsWe analyzed nine patients who underwent unilateral two-stage LD reconstruction. In the first stage, an expander was placed along with the LD flap to reconstruct the mastectomy defect, followed by gradual tissue expansion to achieve overexpansion of the skin pocket. The final implant volume was determined by measuring the residual expander volume after aspirating the excess saline. Finally, the expander was replaced with the chosen implant.ResultsThe average volume of tissue expansion was 460 mL. The resultant expansion allowed an implant ranging in volume from 255 to 420 mL to be placed alongside the LD muscle. Seven patients scored less than six on the relative breast retraction assessment formula for breast symmetry, indicating excellent breast symmetry. The remaining two patients scored between six and eight, indicating good symmetry.ConclusionsThis approach allows the size of the eventual implant to be estimated after the skin pocket has healed completely and the LD muscle has undergone natural atrophy. Optimal reconstruction results were achieved using this approach.

  4. Enhancing osseointegration of orthopedic implants with titania nanotube surfaces

    Science.gov (United States)

    Baker, Erin A.

    Introduction: As joint arthroplasty surgical procedures increase annually, the development of new strategies, including novel materials and surface modifications, to attain solid bone-implant fixation are needed to increase implant terms of service. In this study, we evaluate two morphologies of titania nanotubes in both in vitro and in vivo experiments to quantify osseointegrative potential and material-level biocompatibility. Materials and Methods: Samples were prepared via an electrochemical etching process. Two different titania nanotube (TiNT) morphologies were produced, Aligned and Trabecular. For the in vitro experiment, Sprague Dawley (SD) rat marrow-derived bone marrow cells (BMC) were seeded on samples. Alkaline phosphatase (ALP) activity, osteocalcin (OC) expression, expression of relevant genes as well as cell attachment and morphology were assessed. In the first in vivo experiment, Kirschner wires were implanted unilaterally into SD rat femora with a TiNT-etched or unmodified (Control) implant. General health assessments and weekly body weights were recorded. At a 12-week endpoint, hematologic, systemic metal ion, and histologic analyses were performed. For the second in vivo experiment, Kirschner wires were implanted bilaterally into SD rat femora, with a TiNT-etched implant in one femora and unmodified (Control) implant as an internal control. At 4- and 12-week endpoints, femora were assessed via biomechanics, undecalcified histology, micro-computed tomography (muCT), and backscattered electron imaging (BEI) to characterize de novo bone formation. Results: In vitro experiments demonstrated BMC attachment and differentiation into osteoblasts as well as greater ALP activity, OC expression, total cell counts, and gene expression (of Col1a1, IGF-1, and osteonectin) on TiNT surfaces versus Controls. Cells on TiNT-etched substrates were smaller in diameter and more eccentric than Controls. In the first in vivo experiment, there were significant differences

  5. Innovative combination of therapeutic mammoplasty and expandable-implant breast augmentation for immediate partial breast reconstruction

    Directory of Open Access Journals (Sweden)

    A.M.H. Choo

    2016-01-01

    Conclusion: A “novel” oncoplastic technique herein termed “augmentation-therapeutic mastopexy” is described for partial breast reconstruction during the treatment of a patient with bilateral breast cancer. It enabled adequate treatment of her cancer while reshaping the breast and achieving the desired larger breast size. It should be considered in selected breast-conservation patients who wish to maintain or increase their breast size.

  6. Advanced wettability analysis of implant surfaces

    Directory of Open Access Journals (Sweden)

    Jennissen Herbert P.

    2016-09-01

    Full Text Available New methodologies are a major driving force of scientific progress. In this case the finding that contact angles can be expressed as complex numbers offers the possibility of a much refined analysis beyond zero degrees of rough ultra-/superhydrophilic, (now called hyperhydrophilic, metal surfaces, which play a distinct role in dental and orthopedic implantology. The approaches, a short theoretical introduction and examples from medical applications are given.

  7. A Simple and Practical Method for Setting Up a Criterion of Projection of Silicone Breast Implant After Simple Mastectomy.

    Science.gov (United States)

    Ishii, Naohiro; Ando, Jiro; Harao, Michiko; Takemae, Masaru; Kishi, Kazuo

    2017-01-01

    Objective: In breast reconstruction, decision of projection of silicone breast implant in tissue expander replacement is difficult because of the need to consider several parameters that cannot be expressed in accurate numerical form. The present study aimed at a quantitative analysis based on decreased projection of the reconstructed side compared with silicone breast implant projection and to develop a new method for simple and practical decision of silicone breast implant projection. Methods: Thirty-five patients who had mammary carcinoma and were treated with simple mastectomy, tissue expander insertion, and replacement with anatomical silicone breast implant from April 2013 to March 2016 were retrospectively identified. We recorded the projection of used silicone breast implant (Pi). The projections of reconstructed breast 6 months after silicone breast implant insertion (Pr) and that of the unaffected breast during silicone breast implant selection (Pu) were measured. The difference between Pi and Pr was defined as the revised numerical value (Rev). We investigated whether Rev significantly differed according to age, body mass index, or Pu and analyzed correlations between Rev and age, Pu, and body mass index. Results: Mean Rev in all patients was 1.2 ± 0.3 cm. Rev was significantly higher in patients with higher body mass index than in those with lower body mass index ( P < .01) and in patients with higher Pu than in those with lower Pu ( P < .01). Significant positive correlations of Rev with body mass index and Pu were found (β = .63, P < .01 and β = .67, P < .01, respectively). Conclusions: Rev was a simple, practical, and cost-effective concept. We believe that it is a useful indicator for deciding silicone breast implant projection.

  8. Surface modification of commercial tin coatings by carbon ion implantation

    Energy Technology Data Exchange (ETDEWEB)

    Liu, L.J.; Sood, D.K.; Manory, R.R. [Royal Melbourne Inst. of Tech., VIC (Australia)

    1993-12-31

    Commercial TiN coatings of about 2 {mu}m thickness on high speed steel substrates were implanted at room temperature with 95 keV carbon ions at nominal doses between 1 x 10{sup 17} - 8x10{sup 17} ions cm{sup -2}. Carbon ion implantation induced a significant improvement in ultramicrohardness, friction coefficient and wear properties. The surface microhardness increases monotonically by up to 115% until a critical dose is reached. Beyond this dose the hardness decreases, but remains higher than that of unimplanted sample. A lower friction coefficient and a longer transition period towards a steady state condition were obtained by carbon ion implantation. The changes in tribomechanical properties are discussed in terms of radiation damage and possible formation of a second phase rich in carbon. 6 refs., 3 figs.

  9. 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

  10. Early dental plaque formation on toothbrushed titanium implant surfaces.

    Science.gov (United States)

    Amarante, Evandro Scligliano; Chambrone, Leandro; Lotufo, Roberto Fraga Moreira; Lima, Luiz A

    2008-10-01

    To evaluate the qualitative and quantitative differences on dental plaque formation on two different roughness titanium implant surfaces, i.e. machined and titanium plasma sprayed, as well as the amount of plaque removal by regular toothbrushing after 72-hour plaque accumulation. Eight systemically healthy subjects were recruited from the patient pool of a private dental practice. All patients underwent oral hygiene instruction and full mouth prophylaxis. Subsequently, maxillary casts from all patients were obtained and removable 0.7 mm-thick acetate stents without occlusal contact points were fabricated to support four titanium specimens of 4 x 2 x 2 mm divided into two groups (machined and plasma sprayed). Subjects were instructed to wear the stents for 72 hours, full time, removing them only during regular oral hygiene. Subsequently, the appliances were immediately repositioned and then the test side was brushed for 20 seconds. At the end of the 72-hour period, the stents were removed and prepared for microbiological analysis. Both machined and plasma sprayed brushed surfaces presented statistically significant fewer bacteria than non-brushed surfaces. Similarly, regarding surface roughness, machined surfaces presented a total number of bacteria significantly smaller than those presented by plasma sprayed surfaces (P dental plaque than polished surfaces. Both brushed surfaces presented less plaque accumulation, however, implant brushing was more effective on machined surfaces.

  11. 3D silicon breast surface mapping via structured light profilometry

    Science.gov (United States)

    Vairavan, R.; Ong, N. R.; Sauli, Z.; Kirtsaeng, S.; Sakuntasathien, S.; Shahimin, M. M.; Alcain, J. B.; Lai, S. L.; Paitong, P.; Retnasamy, V.

    2017-09-01

    Digital fringe projection technique is one of the promising optical methods for 3D surface imaging as it demonstrates non contact and non invasive characteristics. The potential of this technique matches the requirement for human body evaluation, as it is vital for disease diagnosis and for treatment option selection. Thus, the digital fringe projection has addressed this requirement with its wide clinical related application and studies. However, the application of this technique for 3D surface mapping of the breast is very minimal. Hence, in this work, the application of digital fringe projection for 3D breast surface mapping is reported. Phase shift fringe projection technique was utilized to perform the 3D breast surface mapping. Maiden results have confirmed the feasibility of using the digital fringe projection method for 3D surface mapping of the breast and it can be extended for breast cancer detection.

  12. Shaped versus Round Implants for Breast Reconstruction: Indications and Outcomes

    Directory of Open Access Journals (Sweden)

    Maurice Y. Nahabedian, MD

    2014-03-01

    Conclusions: Both shaped and round silicone gel devices can result in natural aesthetic outcomes. Shaped devices are preferred for contouring the upper pole and for optimizing breast projection. Round devices are preferred when the upper pole is not deficient and the patient desires softer breasts. Longer follow-up studies will be necessary.

  13. Magnetic Resonance Imaging Screening Results Compared with Explantation Results in Poly Implant Prothese Silicone Breast Implants, Recalled from the European Market in 2010

    NARCIS (Netherlands)

    Maijers, M.C.; Niessen, F.B.; Veldhuizen, J.F.H.; Ritt, M.J.P.F.; Manoliu, R.A.

    2014-01-01

    BACKGROUND: In a prospective cohort study, the authors followed 112 women whose Poly Implant Prothèse silicone breast implants were recalled. Magnetic resonance imaging results and clinical consequences were previously published. The authors compared magnetic resonance imaging screening with

  14. Regulatory science of new technology: tendency of medical professionals' interests on silicone breast implants.

    Science.gov (United States)

    Nakazaki, Tomomichi; Ikeda, Koji; Iwasaki, Kiyotaka; Umezu, Mitsuo

    2016-09-01

    New technology related to artificial organs is most attractive for worldwide researchers. We believe they must contribute for the future patients against untreatable diseases. Regulatory science is a new science to establish 'social acceptance' of new technology into the clinical market as soon as possible. In the history of silicone breast implants, we could recognize risks many times; however, we missed such chances to prevent a subsequent crisis. We analyzed the trend of published literature related to silicone breast implants to review the medical professionals' interests on such risks. This trend showed, despite issues of a social acceptance of silicone breast implants in a few countries, other countries' medical professionals had no interest. Our hypothesis is 'medical professionals face the government and do not have contributed to re-establish the social acceptance of new technologies for patients'. Any technology does not have the complete evidence of safety, efficacy and quality, despite regulatory authorities' review and approval with clinical evidences. medical professionals need to conduct subsequently the epidemiological study, to take a meta-analysis periodically and to create/update the guidance for their patients under their professional ethics after the marketing of new technologies. We need to take seriously the 'lesson learned' from the history of silicone breast implants for all kind of new technologies existed in the present.

  15. Efficacy of Vancomycin-based Continuous Triple Antibiotic Irrigation in Immediate, Implant-based Breast Reconstruction

    Directory of Open Access Journals (Sweden)

    Lisa M. Hunsicker, MD, FACS

    2017-12-01

    Conclusions:. Continuous breast irrigation with a vancomycin-based triple antibiotic solution is a safe and effective accompaniment for immediate implant reconstruction. Use of intramuscular anesthetic injection for postoperative pain control allows the elastomeric infusion pump to be available for local tissue antibiotic irrigation.

  16. Evaluation of the severity of capsular contracture using elastography after breast implant reconstruction.

    Science.gov (United States)

    Sowa, Yoshihiro; Yokota, Isao; Itsukage, Sizu; Nakatsukasa, Katsuhiko; Sakaguchi, Koichi; Taguchi, Tetsuya; Numajiri, Toshiaki

    2017-01-01

    Capsular contracture around implants is a common complication after breast reconstruction. Strain elastography (STE) and shear-wave elastography (SWE) are noninvasive imaging techniques that can measure tissue stiffness and thickness of the capsule. The purposes of the study were to compare STE and SWE for measurement of capsular contracture after breast implant reconstruction using intra-class correlation coefficients (ICCs) and to investigate the correlation of these data with the Baker score, which is the most frequently used clinical staging scale for capsule contracture. The subjects were 20 patients (27 implants) who underwent breast reconstruction. The reproducibility of SWE (ICC: 0.878) was higher than that of STE (ICC: 0.724) for measurement of capsular contracture. The correlation coefficient between measurements with the two methods was low (r = 0.6788). The Baker score had a higher correlation with measurements with SWE (r = 0.8124) compared to those with STE (r = 0.6983). These results suggest that SWE is a better tool for assessment of the degree of capsule contracture surrounding implants after breast reconstruction.

  17. Risk of pacemaker or implantable cardioverter defibrillator after radiotherapy for early-stage breast cancer in Denmark, 1982-2005

    DEFF Research Database (Denmark)

    Rehammar, Jens Christian; Johansen, Jens Brock; Jensen, Maj-Britt

    2017-01-01

    BACKGROUND AND PURPOSE: To examine the risk of cardiac conduction abnormalities or severe ventricular arrhythmias requiring implantation of a cardiac implantable electronic device (CIED), either a pacemaker or an implantable cardioverter-defibrillator, subsequent to breast cancer (BC) radiotherapy....... CONCLUSIONS: BC RT as practiced in Denmark in 1982-2005 did not increase the risk of CIED implants. This indicates that RT for BC does not increase the risk of severe ventricular arrhythmias or cardiac conduction abnormalities....

  18. Titanium oral implants: surface characteristics, interface biology and clinical outcome

    Science.gov (United States)

    Palmquist, Anders; Omar, Omar M.; Esposito, Marco; Lausmaa, Jukka; Thomsen, Peter

    2010-01-01

    Bone-anchored titanium implants have revolutionized oral healthcare. Surface properties of oral titanium implants play decisive roles for molecular interactions, cellular response and bone regeneration. Nevertheless, the role of specific surface properties, such as chemical and phase composition and nanoscale features, for the biological in vivo performance remains to be established. Partly, this is due to limited transfer of state-of-the-art preparation techniques to complex three-dimensional geometries, analytical tools and access to minute, intact interfacial layers. As judged by the available results of a few randomized clinical trials, there is no evidence that any particular type of oral implant has superior long-term success. Important insights into the recruitment of mesenchymal stem cells, cell–cell communication at the interface and high-resolution imaging of the interface between the surface oxide and the biological host are prerequisites for the understanding of the mechanisms of osseointegration. Strategies for development of the next generation of material surface modifications for compromised tissue are likely to include time and functionally programmed properties, pharmacological modulation and incorporation of cellular components. PMID:20591849

  19. The clinical course of immediate breast implant reconstruction after breast cancer

    DEFF Research Database (Denmark)

    Hvilsom, Gitte B.; Friis, Søren; Frederiksen, Kirsten

    2011-01-01

    The number of women suitable for breast conserving treatment as well as immediate reconstruction after breast cancer has been increasing, and studies of complications hereafter are needed.......The number of women suitable for breast conserving treatment as well as immediate reconstruction after breast cancer has been increasing, and studies of complications hereafter are needed....

  20. Experimental total wrapping of breast implants with acellular dermal matrix: a preventive tool against capsular contracture in breast surgery?

    Science.gov (United States)

    Schmitz, Marweh; Bertram, Martin; Kneser, Ulrich; Keller, Andrea K; Horch, Raymund E

    2013-10-01

    Capsular contracture remains a hitherto unsolved complication after implantation of silicone gel-filled breast prostheses. Based on clinical and experimental data, the use of an acellular dermal matrix as a sheath around implants may lead to lesser capsular contracture acting as a proposed biological environment mimicking wound bed tissue. The aim of our study was to analyse the tissue reaction after implantation of silicone prosthesis with and without an envelope of acellular dermal matrix. Implantation of 60 silicone prostheses in the back of Lewis rats were carried out, randomly paired taking one rat from group A and one from group B. Group A included implants completely enveloped with xenogenic acellular dermis and group B undraped silicone implants. At 3, 6 and 12 weeks postoperatively, the samples were explanted and subjected to histological and immunohistochemical evaluation. A new myofibroblast tissue layer was identified in proximity to the implant in both groups. The thickness of the layer in group A was continuously thinner than in group B regarding the different explantation time points. Implants completely wrapped with acellular dermal matrix showed significantly lesser inflammatory signs at 3 and 12 weeks after implantation compared to controls. Cell proliferation after 12 weeks was significantly decreased in group A. The slight myofibroblast layer and reduced rate of inflammation and proliferation in the treatment group show a positive effect of total acellular dermal matrix envelope and hypothesise the decrease of capsular contracture in long-term periods. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  1. Cohort Study to Assess the Impact of Breast Implants on Breastfeeding.

    Science.gov (United States)

    Filiciani, Sandra; Siemienczuk, Guillermo F; Nardín, Juan M; Cappio, Bárbara; Albertengo, Andrés C; Nozzi, Guillermo; Caggioli, Matías

    2016-12-01

    The objective of this study was to evaluate the impact of breast implant surgery and its approaches on lactation by comparing women with and without breast implants at the time of childbirth. Between April of 2013 and July of 2014, in Rosario (Sanatorio de la Mujer and Centro Quirúrgico Rosario), Argentina, a prospective cohort study of women with and without breast implants was performed. Of a total of 3950 births that occurred during this period, 200 patients with similar anthropometric characteristics (maternal and newborn) were selected. Breastfeeding (exclusive or mixed) was compared with artificial feeding at 24 and 48 hours and 30 days in both groups, and the type of incision was also compared. Breastfeeding at 30 days showed a nonsignificant trend favoring the control group (OR, 7.39; 95 percent CI, 0.92 to 339.2). The percentage of women with implants who succeeded in establishing breastfeeding (exclusive or mixed) was very high (93 percent). In the control group, 99 percent of the women were breastfeeding at 30 days. In a comparison of the submammary and areola incision, breastfeeding showed odds ratios of 0.78 (95 percent CI, 0.33 to 1.87) at 24 hours, 1.10 (95 percent CI, 0.48 to 2.56) at 48 hours, and 0.18 (95 percent CI, 0.36 to 1.82) at 30 days. This study shows that most patients with breast implants were able to establish breastfeeding. However, there is a higher number of women without implants that established exclusive breastfeeding. No significant difference was found between the different surgical approaches. Therapeutic, II.

  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. 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.

  4. Breast Implant-Associated Anaplastic Large Cell Lymphoma: A Systematic Review.

    Science.gov (United States)

    Leberfinger, Ashley N; Behar, Brittany J; Williams, Nicole C; Rakszawski, Kevin L; Potochny, John D; Mackay, Donald R; Ravnic, Dino J

    2017-12-01

    Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), a rare peripheral T-cell lymphoma, is increasing in incidence. However, many practitioners who treat patients with breast cancer are not aware of this disease. To assess how BIA-ALCL develops, its risk factors, diagnosis, and subsequent treatment and to disseminate information about this entity to the medical field. A literature review was performed in an academic medical setting. All review articles, case reports, original research articles, and any other articles relevant to BIA-ALCL were included. Data on BIA-ALCL, such as pathophysiology, patient demographics, presentation, diagnosis, treatment, and outcomes, were extracted. Particular focus was paid to age, time to onset, implant type, initial symptoms, treatment, and survival. The search was conducted in January 2017 for studies published in any year. After duplicates were excluded, 304 relevant articles were assessed, and 115 were included from the first documented case in August 1997 through January 2017. Thirty review articles, 44 case reports or series, 15 original research articles, and 26 "other" articles (eg, techniques, special topics, letters) were reviewed. A total of 93 cases have been reported in the literature, and with the addition of 2 unreported cases from the Penn State Health Milton S. Hershey Medical Center, 95 patients were included in this systematic review. Almost all documented BIA-ALCL cases have been associated with a textured device. The underlying mechanism is thought to be due to chronic inflammation from indolent infections, leading to malignant transformation of T cells that are anaplastic lymphoma kinase (ALK) negative and CD30 positive. The mean time to presentation is approximately 10 years after implant placement, with 55 of 83 (66%) patients initially seen with an isolated late-onset seroma and 7 of 83 (8%) with an isolated new breast mass. Ultrasonography with fluid aspiration can be used for diagnosis

  5. Polyspecies biofilm formation on implant surfaces with different surface characteristics

    Directory of Open Access Journals (Sweden)

    Patrick R. SCHMIDLIN

    2013-01-01

    Full Text Available Objective To investigate the microbial adherence and colonization of a polyspecies biofilm on 7 differently processed titanium surfaces. Material and Methods Six-species biofilms were formed anaerobically on 5-mm-diameter sterilized, saliva-preconditioned titanium discs. Material surfaces used were either machined, stained, acid-etched or sandblasted/acid-etched (SLA. Samples of the latter two materials were also provided in a chemically modified form, with increased wettability characteristics. Surface roughness and contact angles of all materials were determined. The discs were then incubated anaerobically for up to 16.5 h. Initial microbial adherence was evaluated after 20 min incubation and further colonization after 2, 4, 8, and 16.5 h using non-selective and selective culture techniques. Results at different time points were compared using ANOVA and Scheffé post hoc analysis. Results The mean differences in microorganisms colonizing after the first 20 min were in a very narrow range (4.5 to 4.8 log CFU. At up to 16.5 h, the modified SLA surface exhibited the highest values for colonization (6.9±0.2 log CFU, p<0.05 but increasing growth was observed on all test surfaces over time. Discrepancies among bacterial strains on the differently crafted titanium surfaces were very similar to those described for total log CFU. F. nucleatum was below the detection limit on all surfaces after 4 h. Conclusion Within the limitations of this in vitro study, surface roughness had a moderate influence on biofilm formation, while wettability did not seem to influence biofilm formation under the experimental conditions described. The modified SLA surface showed the highest trend for bacterial colonization.

  6. 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).

  7. Surface and bulk vibrations in ion-implanted amorphous silica

    Energy Technology Data Exchange (ETDEWEB)

    Arnold, G. W.

    1980-01-01

    Infrared reflection spectroscopy (IRS) has been used to identify the Si-O vibrational mode and confirm previous assignments of Si-OH, and Si-OD vibrational modes in porous amorphous silica implanted with heavy ions and with H/sup +/ and D/sup +/ ions. The Si-O stretching mode (approx. 1015 cm/sup -1/) is produced by the damage cascade and is seen in all implanted bulk silicas as well as in porous silica. Implantation of porous silica with H/sup +/ and D/sup +/ ions produces bands at approx. 985 cm/sup -1/ and approx. 960 cm-/sup 1/, respectively. The position of all three bands is consistent with O, OH, and OD mass considerations. Implantation of D/sup +/ ions into porous silica containing molecular water and OH/sup -/ groups results in D-H exchange. The Si-OH and Si-OD vibrations are also seen in the bulk fused silica at low H/D fluences. These results suggest that intrinsic E'-type defects in bulk silica and dangling Si bonds at internal surface sites.

  8. Plasma Treatment Maintains Surface Energy of the Implant Surface and Enhances Osseointegration

    Directory of Open Access Journals (Sweden)

    Fernando P. S. Guastaldi

    2013-01-01

    Full Text Available The surface energy of the implant surface has an impact on osseointegration. In this study, 2 surfaces: nonwashed resorbable blasting media (NWRBM; control and Ar-based nonthermal plasma 30 days (Plasma 30 days; experimental, were investigated with a focus on the surface energy. The surface energy was characterized by the Owens-Wendt-Rabel-Kaelble method and the chemistry by X-ray photoelectron spectroscopy (XPS. Five adult beagle dogs received 8 implants (n=2 per surface, per tibia. After 2 weeks, the animals were euthanized, and half of the implants (n=20 were removal torqued and the other half were histologically processed (n=20. The bone-to-implant contact (BIC and bone area fraction occupancy (BAFO were evaluated on the histologic sections. The XPS analysis showed peaks of C, Ca, O, and P for the control and experimental surfaces. While no significant difference was observed for BIC parameter (P>0.75, a higher level for torque (P<0.02 and BAFO parameter (P<0.01 was observed for the experimental group. The surface elemental chemistry was modified by the plasma and lasted for 30 days after treatment resulting in improved biomechanical fixation and bone formation at 2 weeks compared to the control group.

  9. Numb chin syndrome as a manifestation of possible breast cancer metastasis around dental implants.

    Science.gov (United States)

    Orhan, Kaan; Bayndr, Hakan; Aksoy, Seçil; Seker, Basak Kusakci; Berberoğlu, Atilla; Ozan, Oğuz

    2011-05-01

    Numb chin syndrome, sometimes called numb lip syndrome, is an uncommon but well-recognized symptom in medical oncology. It may be a metastatic neurologic manifestation of malignancy, often with no clinically visible pathologic finding. The authors report a numb chin syndrome as a manifestation possible breast cancer metastasis around dental implants in a 69-year-old woman. The patient was presented with complaint of numbness in the lower jaw. Medical anamnesis revealed a metastatic breast carcinoma (CA). Radiographic imaging with conventional panoramic radiography and cone beam computed tomographic examination, revealed a moth-eaten shape, radiolucent, and radiopaque mixed appearance around the dental implants that was related with possible metastasis of the breast cancer. Numb chin syndrome is almost unknown within the dental and oral and maxillofacial community, despite being well reported in the medical literature. General dentists, oral medicine specialists, and oral and maxillofacial surgeons must be aware of this condition to consider metastatic cancer in patients with unexplained facial hypoesthesia. Moreover, although the development of metastatic lesions around implants is an uncommon pathologic finding, the examination of peri-implant lesion should be performed carefully considering the entire pathologic situations.

  10. Anaplastic Large-Cell Lymphoma Associated with Breast Implants: A Case Report of a Transgender Female.

    Science.gov (United States)

    Patzelt, Matej; Zarubova, Lucie; Klener, Pavel; Barta, Josef; Benkova, Kamila; Brandejsova, Adrianna; Trneny, Marek; Gürlich, Robert; Sukop, Andrej

    2017-11-03

    Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) is a rare peripheral T cell lymphoma. BIA-ALCL is a disease of the fibrous capsule surrounding the implant and occurs in patients after both breast reconstruction and augmentation. More than 300 cases have been reported so far, including two in a transgender patient. Here we describe BIA-ALCL presented with a mass in a transgender patient and the first case of BIA-ALCL in the Czech Republic. In 2007, a 33-year-old transgender male to female underwent bilateral breast augmentation as a part of his transformation to female. In June 2014, the patient developed a 5-cm tumorous mass in her left breast. Magnetic resonance imaging of the chest revealed a ruptured implant and a tumorous mass penetrating into the capsule and infiltrating the pectoral muscle. An R0 surgery was indicated-the implant, silicone gel and capsule were removed, and the tumorous mass was resected together with a part of the pectoral muscle. Histology revealed anaplastic large-cell lymphoma. The patient underwent standard staging procedures for lymphoma including a bone marrow trephine biopsy, which confirmed stage IE. The patient was treated with the standard chemotherapy for systemic ALCL-6 cycles of CHOP-21. The patient was tumor-free at the 2-year follow-up. BIA-ALCL has been reported mostly in women who received implants for either reconstructive or aesthetic augmentation. This is the third report of BIA-ALCL in a transgender person, the first in the Czech Republic. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  11. Novel rat model of methicillin-resistant Staphylococcus aureus-infected silicone breast implants: a study of biofilm pathogenesis.

    Science.gov (United States)

    Arad, Ehud; Navon-Venezia, Shiri; Gur, Eyal; Kuzmenko, Boris; Glick, Rivka; Frenkiel-Krispin, Daphna; Kramer, Eyal; Carmeli, Yehuda; Barnea, Yoav

    2013-02-01

    Clinical infection of breast implants occurs in 7 to 24 percent of breast reconstructions. It may persist over time in the form of biofilm without overt manifestation and is extremely difficult to eradicate. The authors' aim was to establish a novel model for biofilm infection of silicone breast implants in rats. Fifty-six rats underwent implantation of miniature silicone breast implants and/or methicillin-resistant Staphylococcus aureus (MRSA) bacteria. Group A received implants covered with MRSA biofilm. Group B received implants and free planktonic MRSA. Group C received free planktonic MRSA without implants. A control group received sterile implants without MRSA. Each group was divided to receive either saline or vancomycin injections between days 4 and 11. Clinical evaluation, bacterial counts, and scanning electron microscopy were performed. The mortality rate in group B (implants infected with free planktonic MRSA) was significantly higher than that in all other groups [37 percent versus groups A and D (0 percent) and group C (7 percent)]. Treatment with vancomycin lowered temperature in groups B and C (p < 0.05) and improved wound healing in group B (p < 0.01). Vancomycin treatment reduced wound bacterial counts in free planktonic MRSA groups B and C but had no significant effect on biofilm MRSA-infected group A. The model successfully induced persistent breast implant infection. Free planktonic MRSA produced in situ biofilm on silicone implants. Biofilm infection has milder manifestations than free planktonic MRSA infection, which has higher rates of systemic infections and death when compared with either isolated biofilm infection or free planktonic MRSA infection without implant. Vancomycin has limited effect against mature biofilm.

  12. Accelerated partial breast irradiation using the strut-adjusted volume implant single-entry hybrid catheter in brachytherapy for breast cancer in the setting of breast augmentation.

    Science.gov (United States)

    Bloom, Elizabeth S; Kirsner, Steve; Mason, Bryan E; Nelson, Chris L; Hunt, Kelly K; Baumann, Donald P; Gifford, Kent A

    2011-01-01

    Accelerated partial breast irradiation (APBI) has gained popularity as an alternative to adjuvant whole breast irradiation; however, owing to limitations of delivery devices for brachytherapy, APBI has not been a suitable option for all the patients. This report evaluates APBI using the strut-adjusted volume implant (SAVI) single-entry catheter to deliver brachytherapy for breast cancer in the setting of an augmented breast. The patient previously had placed bilateral subpectoral saline implants; stereotactic core biopsy revealed estrogen receptor- and progesterone receptor-positive ductal carcinoma in situ of intermediate nuclear grade. The patient underwent needle-localized segmental mastectomy of her left breast; pathologic specimen revealed no residual malignancy. An SAVI 8-1 device was placed within the segmental resection cavity. Treatment consisted of 3.4 Gy delivered twice a day for 5 days for a total dose of 34 Gy. Treatments were delivered with a high-dose-rate (192)Ir remote afterloader. Conformance of the device to the lumpectomy cavity was excellent at 99.2%. Dosimetric values of percentage of the planning target volume for evaluation receiving 90% of the prescribed dose, percentage of the planning target volume for evaluation receiving 95% of the prescribed dose, volume receiving 150% of the prescribed dose, and volume receiving 200% of the prescribed dose were 97.1%, 94.6%, 22.7 cc, and 11.6 cc, respectively. Maximum skin dose was 115% of the prescribed dose. The patient tolerated treatment well with excellent cosmetic results, and limited acute and late toxicity at 8 weeks and 6 months, respectively. Breast augmentation should not be an exclusion criterion for the option of APBI. The SAVI single-entry catheter is another option to successfully complete APBI using brachytherapy for breast cancer in the setting of an augmented breast. Copyright © 2011 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  13. Natrelle round silicone breast implants: Core Study results at 10 years.

    Science.gov (United States)

    Spear, Scott L; Murphy, Diane K

    2014-06-01

    Allergan's Natrelle round silicone-filled breast implants were approved by the U.S. Food and Drug Administration in 2006 based on interim results from the Core Study; final 10-year study results are now available. Seven hundred fifteen subjects were implanted with smooth and Biocell textured Natrelle round silicone implants and attended clinic visits at 0 to 4 weeks, 6 months, 1 year, and annually through 10 years. Approximately one-third of subjects underwent magnetic resonance imaging at years 1, 3, 5, 7, and 9 to assess rupture. Complication rates showed modest increases over the previously published 6-year rates. The Kaplan-Meier capsular contracture rate was 18.9 percent for augmentation, 28.7 percent for revision-augmentation, and 24.6 percent for reconstruction. Among augmentation subjects, capsular contracture was significantly lower (p = 0.023) for submuscular (15.7 percent) versus subglandular (26.3 percent) placement. The overall rupture rate in the magnetic resonance imaging cohort was 13.0 percent for subjects and 7.7 percent for implants. By the end of the study, 81.8 percent of augmentation subjects still had an original implant in place. Using a five-point scale, 94.2 percent of augmentation, 83.8 percent of revision-augmentation, and 90.7 percent of reconstruction subjects reported being satisfied or definitely satisfied with their implants. Significant improvement over baseline was also seen in overall breast satisfaction and satisfaction with breast size, shape, feel, and how well they matched. The 10-year data from the Natrelle Core Study, which can guide surgeons and patients in decision-making, demonstrate safety and high levels of patient satisfaction. Therapeutic, III.

  14. Destiny rides again: the reappearance of silicone gel-filled breast implant toxicity.

    Science.gov (United States)

    Brawer, A E

    2017-09-01

    Background Twenty-five years ago attorneys representing ailing women in class action litigation against silicone breast implant manufacturers made the procedural error of defining silicone-induced toxicity in the courtroom before it was properly studied in the exam room. This aberrant methodology perverted the proper research process, rendered verification of any real disease elusive, and cemented the groundwork for a repeat public health crisis potentially affecting two million women in the USA who possess new silicone gel devices inserted over the past 10 years. Patients and methods Six women, previously well, aged 27 to 53 (mean 42), were recipients of the new generations of cohesive silicone gel-filled breast implants approved for general use by the Food and Drug Administration (FDA) since December of 2006. They averaged seven years of total implantation time, and none experienced implant rupture. Results All six became ill on average 3.5 years from the time of implantation. By seven years the women manifested multiple types of skin rashes, polyarthritis, fatigue, protracted AM stiffness, myalgias, headaches, photosensitivity, hair loss, paresthesias, tinnitus, lymphadenopathy, chest pain, cognitive dysfunction, dry eyes, skin pigment changes, itching, muscle twitching, dizziness, nausea, easy bruising, and odor and smell sensitivity. Three of the four who were explanted noted improvement and/or resolution of at least 50% of their total disease manifestations. Conclusions These six women are representative of over 70,000 other breast implant recipients who, over the past three years, have had their new silicone devices permanently removed because of alleged gel-induced toxicity. The recurrence of this public health crisis has been fueled by manufacturers' research fraud, FDA ineptness, faulty informed consent, patient abandonment, proprietary manufacturing secrecy, misleading advertising, physician indifference, aberrant research methodology, and lax

  15. Antimicrobial effects of three different treatment modalities on dental implant surfaces.

    Science.gov (United States)

    Larsen, Olav Inge; Enersen, Morten; Kristoffersen, Anne Karin; Wennerberg, Ann; Bunæs, Dagmar F; Lie, Stein Atle; Leknes, Knut N

    2017-10-03

    Resolution of peri-implant inflammation and re-osseointegration of peri-implantitis affected dental implants seem to be dependent on bacterial decontamination. The aims of the this study were to evaluate the antimicrobial effects of three different instrumentations on a micro-textured dental implant surface contaminated with an avirulent or a virulent Porphyromonas gingivalis strain and to determine alterations to the implant surface following instrumentation. Forty-five dental implants (Straumann SLA) were allocated to three treatment groups: Er:YAG laser, chitosan brush, and titanium curette (10 implants each), a positive (10 implants) and a negative (five implants) control. Each treatment group and the positive control were split into subgroups of five implants subsequently contaminated with either the avirulent or virulent P. gingivalis strain. The antimicrobial effect of instrumentation was evaluated using checkerboard DNA-DNA hybridization. Implant surface alterations were determined using a light interferometer. Instrumentation significantly reduced the number of attached P. gingivalis (pimplant surface micro-texture. Neither the Er:YAG laser nor the chitosan brush significantly altered the implant surface. The three instrumentations appear to have a similar potential to remove P. gingivalis. The titanium curette significantly altered the microstructure of the implant surface.

  16. Toward optimizing dental implant performance: Surface characterization of Ti and TiZr implant materials.

    Science.gov (United States)

    Murphy, M; Walczak, M S; Thomas, A G; Silikas, N; Berner, S; Lindsay, R

    2017-01-01

    Targeting understanding enhanced osseointegration kinetics, the goal of this study was to characterize the surface morphology and composition of Ti and TiZr dental implant substrates subjected to one of two surface treatments developed by Straumann. These two treatments are typically known as SLA and SLActive, with the latter resulting in more rapid osseointegration. A range of techniques was applied to characterize four different substrate/surface treatment combinations (TiSLA, TiSLActive, TiZrSLA, and TiZrSLActive). Contact angle measurements established their hydrophilic/hydrophobic nature. Surface morphology was probed with scanning electron microscopy. X-ray diffraction, Raman μ-spectroscopy, and X-ray photoelectron spectroscopy were used to elucidate the composition of the near-surface region. Consistent with previous work, surface morphology was found to differ only at the nanoscale, with both SLActive substrates displaying nano-protrusions. Spectroscopic data indicate that all substrates exhibit surface films of titanium oxide displaying near TiO2 stoichiometry. Raman μ-spectroscopy reveals that amorphous TiO2 is most likely the only phase present on TiSLA, whilst rutile-TiO2 is also evidenced on TiSLActive, TiZrSLA, and TiZrSLActive. For TiZr alloy substrates, there is no evidence of discrete phases of oxidized Zr. X-ray photoelectron spectra demonstrate that all samples are terminated by adventitious carbon, with it being somewhat thicker (∼1nm) on TiSLA and TiZrSLA. Given previous in vivo studies, acquired data suggest that both nanoscale protrusions, and a thinner layer of adventitious carbon contribute to the more rapid osseointegration of SLActive dental implants. Composition of the surface oxide layer is apparently less important in determining osseointegration kinetics. Copyright © 2016 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  17. Does a large dehiscent implant surface at placement affect the 5-year treatment outcome? : An assessment of implants placed to support a maxillary overdenture

    NARCIS (Netherlands)

    Boven, G. C.; Meijer, H. J. A.; Slot, W.; Vissink, A.; Raghoebar, G. M.

    2015-01-01

    The aim of this study was to assess the 5-year clinical and radiographic outcome of implants with a dehiscent surface at implant placement. A total of 26 consecutive patients (mean age 61.6 years; SD 8.0 years) with at least one implant with a dehiscent implant surface of >= two thirds of the

  18. Staphylococcus aureus and Staphylococcus epidermidis Virulence Strains as Causative Agents of Persistent Infections in Breast Implants.

    Directory of Open Access Journals (Sweden)

    Daniela Chessa

    Full Text Available Staphylococcus epidermidis and Staphylococcus aureus are currently considered two of the most important pathogens in nosocomial infections associated with catheters and other medical implants and are also the main contaminants of medical instruments. However because these species of Staphylococcus are part of the normal bacterial flora of human skin and mucosal surfaces, it is difficult to discern when a microbial isolate is the cause of infection or is detected on samples as a consequence of contamination. Rapid identification of invasive strains of Staphylococcus infections is crucial for correctly diagnosing and treating infections. The aim of the present study was to identify specific genes to distinguish between invasive and contaminating S. epidermidis and S. aureus strains isolated on medical devices; the majority of our samples were collected from breast prostheses. As a first step, we compared the adhesion ability of these samples with their efficacy in forming biofilms; second, we explored whether it is possible to determine if isolated pathogens were more virulent compared with international controls. In addition, this work may provide additional information on these pathogens, which are traditionally considered harmful bacteria in humans, and may increase our knowledge of virulence factors for these types of infections.

  19. Idiopathic pseudoaneurysm in a patient with breast implants

    DEFF Research Database (Denmark)

    Khorasani, Hoda; Eiberg, Jonas; Bigaard, Janne

    2016-01-01

    implant surgery. After clinical assessment, the patient underwent surgery with resection of the aneurysm and ligation of the arterial branch. No early postoperative complications were reported. Pseudoaneurysms in small vessels such as the IMA or its branches are not well described in the literature...

  20. Evaluation of Implant Collar Surfaces for Marginal Bone Loss: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Koodaryan, Roodabeh; Hafezeqoran, Ali

    2016-01-01

    Background. It is important to understand the influence of different collar designs on peri-implant marginal bone loss, especially in the critical area. Objectives. The purpose of the present systematic review and meta-analysis was to compare dental implants with different collar surfaces, evaluating marginal bone loss and survival rates of implants. Methods. Eligibility criteria included clinical human studies, randomized controlled trials, and prospective and retrospective studies, which evaluated dental implants with different collar surface in the same study. Results. Twelve articles were included, with a total of 492 machined, 319 rough-surfaced, and 352 rough-surfaced microthreaded neck implants. There was less marginal bone loss at implants with rough-surfaced and rough-surfaced microthreaded neck than at machined-neck implants (difference in means: 0.321, 95% CI: 0.149 to 0.493; p bone loss.

  1. Surface Engineering for Bone Implants: A Trend from Passive to Active Surfaces

    Directory of Open Access Journals (Sweden)

    John Jansen

    2012-07-01

    Full Text Available The mechanical and biological properties of bone implants need to be optimal to form a quick and firm connection with the surrounding environment in load bearing applications. Bone is a connective tissue composed of an organic collagenous matrix, a fine dispersion of reinforcing inorganic (calcium phosphate nanocrystals, and bone-forming and -degrading cells. These different components have a synergistic and hierarchical structure that renders bone tissue properties unique in terms of hardness, flexibility and regenerative capacity. Metallic and polymeric materials offer mechanical strength and/or resilience that are required to simulate bone tissue in load-bearing applications in terms of maximum load, bending and fatigue strength. Nevertheless, the interaction between devices and the surrounding tissue at the implant interface is essential for success or failure of implants. In that respect, coatings can be applied to facilitate the process of bone healing and obtain a continuous transition from living tissue to the synthetic implant. Compounds that are inspired by inorganic (e.g., hydroxyapatite crystals or organic (e.g., collagen, extracellular matrix components, enzymes components of bone tissue, are the most obvious candidates for application as implant coating to improve the performance of bone implants. This review provides an overview of recent trends and strategies in surface engineering that are currently investigated to improve the biological performance of bone implants in terms of functionality and biological efficacy.

  2. Effect of surface contamination on osseointegration of dental implants surrounded by circumferential bone defects.

    LENUS (Irish Health Repository)

    Mohamed, Seif

    2010-05-01

    This study was designed to evaluate the effect of surface contamination on osseointegration of dental implants surrounded by a circumferential bone defect and to compare osseointegration around Osseotite with that around Nanotite implants.

  3. Long-term cosmetic outcome after breast implantation

    DEFF Research Database (Denmark)

    Hölmich, Lisbet R; Breiting, Vibeke B; Fryzek, Jon P

    2007-01-01

    All women who underwent breast augmentation at 1 public and 1 private clinic in Denmark from 1973 to 1988, and available for follow-up, were invited to participate in a clinical study including a self-administered questionnaire, medical record abstraction, and a clinical examination. One hundred ...

  4. Early osseointegration to hydrophilic and hydrophobic implant surfaces in humans.

    Science.gov (United States)

    Lang, Niklaus P; Salvi, Giovanni E; Huynh-Ba, Guy; Ivanovski, Saso; Donos, Nikolaos; Bosshardt, Dieter D

    2011-04-01

    To evaluate the rate and degree of osseointegration at chemically modified moderately rough, hydrophilic (SLActive) and moderately rough, hydrophobic (SLA) implant surfaces during early phases of healing in a human model. The devices used for this study of early healing were 4 mm long and 2.8 mm in diameter and had either an SLActive chemically modified or a moderately rough SLA surface configuration. These devices were surgically installed into the retro-molar area of 49 human volunteers and retrieved after 7, 14, 28 and 42 days of submerged healing. A 5.2-mm-long specially designed trephine with a 4.9 mm inside diameter, allowing the circumferential sampling of 1 mm tissue together with the device was applied. Histologic ground sections were prepared and histometric analyses of the tissue components (i.e. old bone, new bone, bone debris and soft tissue) in contact with the device surfaces were performed. All device sites healed uneventfully. All device surfaces were partially coated with bone debris. A significant fraction of this bone matrix coating became increasingly covered with newly formed bone. The process of new bone formation started already during the first week in the trabecular regions and increased gradually up to 42 days. The percentage of direct contact between newly formed bone and the device (bone-to-implant contact) after 2 and 4 weeks was more pronounced adjacent to the SLActive than to the SLA surface (14.8% vs. 12.2% and 48.3% vs. 32.4%, respectively), but after 42 days, these differences were no longer evident (61.6% vs. 61.5%). While healing showed similar characteristics with bone resorptive and appositional events for both SLActive and SLA surfaces between 7 and 42 days, the degree of osseointegration after 2 and 4 weeks was superior for the SLActive compared with the SLA surface. © 2011 John Wiley & Sons A/S.

  5. 3D mapping of breast surface using digital fringe projection

    Science.gov (United States)

    Vairavan, Rajendaran; Retnasamy, Vithyacharan; Mohamad Shahimin, Mukhzeer; Sauli, Zaliman; Leng, Lai Siang; Wan Norhaimi, Wan Mokhzani; Marimuthu, Rajeswaran; Abdullah, Othman; Kirtsaeng, Supap

    2017-02-01

    Optical sensing technique has inherited non-contact nature for generating 3D surface mapping where its application ranges from MEMS component characterization, corrosion analysis, and vibration analysis. In particular, the digital fringe projection is utilized for 3D mapping of objects through the illumination of structured light for medical application extending from oral dental measurements, lower back deformation analysis, monitoring of scoliosis and 3D face reconstruction for biometric identification. However, the usage of digital fringe projection for 3D mapping of human breast is very minimal. Thus, this paper addresses the application of digital fringe projection for 3D mapping of breast surface based on total non-contact nature. In this work, phase shift method is utilized to perform the 3D mapping. The phase shifted fringe pattern are displayed through a digital projector onto the breast surface, and the distorted fringe patterns are captured by a CCD camera. A phase map is produced, and phase unwrapping was executed to obtain the 3D surface mapping of the breast. The surface height profile from 3D fringe projection was compared with the surface height measured by a direct method using electronic digital vernier caliper. Preliminary results showed the feasibility of digital fringe projection in providing a 3D mapping of breast and its application could be further extended for breast carcinoma detection.

  6. Breast lift

    Science.gov (United States)

    Mastopexy; Breast lift with reduction; Breast lift with augmentation ... enlargement with implants) when they have a breast lift. ... it for medical reasons. Women usually have breast lifts to lift sagging, loose breasts. Pregnancy, breastfeeding, and ...

  7. Effect of implant surface properties on peri-implant bone healing: implant stability and microcomputed tomographic analysis.

    NARCIS (Netherlands)

    Al-Hamdan, S.H.; Al-Hamdan, K.; Junker, R.; Jansen, J.A.

    2012-01-01

    PURPOSE: The present study aimed to evaluate and compare two types of implants: grit-blasted and acidetched implants (SLActive) and nanometer-scale hydroxyapatite-modified implants (NanoTite). MATERIALS AND METHODS: Twenty-two SLActive and 22 NanoTite implants were inserted into the mandibles of 11

  8. Seed Placement in Permanent Breast Seed Implant Brachytherapy: Are Concerns Over Accuracy Valid?

    Energy Technology Data Exchange (ETDEWEB)

    Morton, Daniel, E-mail: dmorton@bccancer.bc.ca [Department of Medical Physics, BC Cancer Agency, Centre for the Southern Interior, Kelowna, British Columbia (Canada); Department of Physics and Astronomy, University of Victoria, Victoria, British Columbia (Canada); Hilts, Michelle [Department of Medical Physics, BC Cancer Agency, Centre for the Southern Interior, Kelowna, British Columbia (Canada); Department of Physics and Astronomy, University of Victoria, Victoria, British Columbia (Canada); Batchelar, Deidre [Department of Medical Physics, BC Cancer Agency, Centre for the Southern Interior, Kelowna, British Columbia (Canada); Crook, Juanita [Department of Radiation Oncology, BC Cancer Agency, Centre for the Southern Interior, Kelowna, British Columbia (Canada)

    2016-07-01

    Purpose: To evaluate seed placement accuracy in permanent breast seed implant brachytherapy (PBSI), to identify any systematic errors and evaluate their effect on dosimetry. Methods and Materials: Treatment plans and postimplant computed tomography scans for 20 PBSI patients were spatially registered and used to evaluate differences between planned and implanted seed positions, termed seed displacements. For each patient, the mean total and directional seed displacements were determined in both standard room coordinates and in needle coordinates relative to needle insertion angle. Seeds were labeled according to their proximity to the anatomy within the breast, to evaluate the influence of anatomic regions on seed placement. Dosimetry within an evaluative target volume (seroma + 5 mm), skin, breast, and ribs was evaluated to determine the impact of seed placement on the treatment. Results: The overall mean (±SD) difference between implanted and planned positions was 9 ± 5 mm for the aggregate seed population. No significant systematic directional displacements were observed for this whole population. However, for individual patients, systematic displacements were observed, implying that intrapatient offsets occur during the procedure. Mean displacements for seeds in the different anatomic areas were not found to be significantly different from the mean for the entire seed population. However, small directional trends were observed within the anatomy, potentially indicating some bias in the delivery. Despite observed differences between the planned and implanted seed positions, the median (range) V{sub 90} for the 20 patients was 97% (66%-100%), and acceptable dosimetry was achieved for critical structures. Conclusions: No significant trends or systematic errors were observed in the placement of seeds in PBSI, including seeds implanted directly into the seroma. Recorded seed displacements may be related to intrapatient setup adjustments. Despite observed seed

  9. Association between Enlarged Axillary Lymph Nodes and Silicone Breast Implant Ruptures seen on Magnetic Resonance Imaging.

    Science.gov (United States)

    Klang, Eyal; Amitai, Michal M; Raskin, Stephen; Rozendorn, Noa; Keddel, Nicholas; Pickovsky, Jana; Sklair-Levy, Miri

    2016-12-01

    Silicone breast augmentation is a common cosmetic surgery. Previous case reports demonstrated lymphadenopathy in the presence of implant ruptures. To investigate the association between enlarged axillary lymph nodes and silicone implant ruptures as seen on breast magnetic resonance imaging (MRI). Two groups were derived retrospectively from breast MRI reports in our institution for the period December 2011-May 2014. A search of our hospital records for "silicone" and "lymph node" was performed (group A), and the relationship between the presence of enlarged nodes and ruptures was evaluated. The prevalence of ruptures in the presence of nodes was calculated and the association between MRI imaging features and ruptures evaluated. A search for "silicone" and "implant rupture" was performed (group B) and, as for group A, the relationship between the presence of ruptures and nodes was evaluated and the prevalence of enlarged nodes in the presence of ruptures calculated. Group A comprised 45 women with enlarged nodes. Intracapsular ruptures were associated with nodes (P = 0.005), while extracapsular ruptures showed a trend of association with nodes (P = 0.08). The prevalence of ruptures in the presence of nodes was 31.4%. Nodes associated with ruptures showed a strong silicone signal (P = 0.008) and absent enhancement (P = 0.005). Group B comprised 73 women with ruptures. Enlarged nodes were associated with both intra- and extracapsular ruptures (P guide clinical decisions when either enlarged nodes or ruptures are encountered in patients with silicone implants. The association between silicone lymphadenopathy and implant rupture raises concerns regarding the role of rupture in silicone-induced systemic disease.

  10. Subcutaneous Implant-based Breast Reconstruction with Acellular Dermal Matrix/Mesh: A Systematic Review.

    Science.gov (United States)

    Salibian, Ara A; Frey, Jordan D; Choi, Mihye; Karp, Nolan S

    2016-11-01

    The availability of acellular dermal matrix (ADM) and synthetic mesh products has prompted plastic surgeons to revisit subcutaneous implant-based breast reconstruction. The literature is limited, however, with regards to evidence on patient selection, techniques, and outcomes. A systematic review of the Medline and Cochrane databases was performed for original studies reporting breast reconstruction with ADM or mesh, and subcutaneous implant placement. Studies were analyzed for level of evidence, inclusion/exclusion criteria for subcutaneous reconstruction, reconstruction characteristics, and outcomes. Six studies (186 reconstructions) were identified for review. The majority of studies (66.7%) were level IV evidence case series. Eighty percent of studies had contraindications for subcutaneous reconstruction, most commonly preoperative radiation, high body mass index, and active smoking. Forty percent of studies commenting on patient selection assessed mastectomy flap perfusion for subcutaneous reconstruction. Forty-five percent of reconstructions were direct-to-implant, 33.3% 2-stage, and 21.5% single-stage adjustable implant, with ADM utilized in 60.2% of reconstructions versus mesh. Pooled complication rates included: major infection 1.2%, seroma 2.9%, hematoma 2.3%, full nipple-areola complex necrosis 1.1%, partial nipple-areola complex necrosis 4.5%, major flap necrosis 1.8%, wound healing complication 2.3%, explantation 4.1%, and grade III/IV capsular contracture 1.2%. Pooled short-term complication rates in subcutaneous alloplastic breast reconstruction with ADM or mesh are low in preliminary studies with selective patient populations, though techniques and outcomes are variable across studies. Larger comparative studies and better-defined selection criteria and outcomes reporting are needed to develop appropriate indications for performing subcutaneous implant-based reconstruction.

  11. 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.

  12. Capsular contracture by silicone breast implants: possible causes, biocompatibility, and prophylactic strategies

    Directory of Open Access Journals (Sweden)

    Steiert AE

    2013-12-01

    Full Text Available Andreas E Steiert, Maria Boyce, Heiko Sorg Department of Plastic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany Abstract: The most common implanted material in the human body consists of silicone. Breast augmentation and breast reconstruction using silicone-based implants are procedures frequently performed by reconstructive and aesthetic surgeons. A main complication of this procedure continues to be the development of capsular contracture (CC, displaying the result of a fibrotic foreign body reaction after the implantation of silicone. For many years, experimental and clinical trials have attempted to analyze the problem of its etiology, treatment, and prophylaxis. Different theories of CC formation are known; however, the reason why different individuals develop CC in days or a month, or only after years, is unknown. Therefore, we hypothesize that CC formation, might primarily be induced by immunological mechanisms along with other reasons. This article attempts to review CC formation, with special attention paid to immunological and inflammatory reasons, as well as actual prophylactic strategies. In this context, the word “biocompatibility” has been frequently used to describe the overall biological innocuousness of silicone in the respective studies, although without clear-cut definitions of this important feature. We have therefore developed a new five-point scale with distinct key points of biocompatibility. Hence, this article might provide the basis for ongoing discussion in this field to reduce single-publication definitions as well as increase the understanding of biocompatibility. Keywords: biofilm, foreign body reaction, breast augmentation, biocompatibility, fibrosis

  13. Radiologic images of an aggressive implant-associated fibromatosis of the breast and chest wall: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Lourdes Alanis, MD, MPH

    2017-09-01

    Full Text Available Fibromatosis of the breast is a rare benign disease compromising <0.2% of all primary breast tumors. Although the chest wall is a common location, occurrences of implant-associated fibromatosis of the breast are extremely rare; only 33 cases have been reported. We present a case of a 42-year-old female who underwent breast augmentation with silicone breast implants, and 2 years later developed an aggressive implant-associated fibromatosis of the breast and chest wall. On imaging studies, the tumor mimicked breast carcinoma, and despite chemotherapy, the fibromatosis rapidly enlarged and was locally invasive requiring wide surgical excision. Unlike previously reported imaging findings, magnetic resonance imaging revealed an oval circumscribed mass with fringe-like internal architecture. We provide a review of the literature and discuss the imaging features of implant-associated fibromatosis of the breast.

  14. The Effect of Sterile Acellular Dermal Matrix Use on Complication Rates in Implant-Based Immediate Breast Reconstructions

    Directory of Open Access Journals (Sweden)

    Jun Ho Lee

    2016-11-01

    Full Text Available BackgroundThe use of acellular dermal matrix (ADM in implant-based immediate breast reconstruction has been increasing. The current ADMs available for breast reconstruction are offered as aseptic or sterile. No published studies have compared aseptic and sterile ADM in implant-based immediate breast reconstruction. The authors performed a retrospective study to evaluate the outcomes of aseptic versus sterile ADM in implant-based immediate breast reconstruction.MethodsImplant-based immediate breast reconstructions with ADM conducted between April 2013 and January 2016 were included. The patients were divided into 2 groups: the aseptic ADM (AlloDerm group and the sterile ADM (MegaDerm group. Archived records were reviewed for demographic data and postoperative complication types and frequencies. The complications included were infection, flap necrosis, capsular contracture, seroma, hematoma, and explantation for any cause.ResultsTwenty patients were reconstructed with aseptic ADM, and 68 patients with sterile ADM. Rates of infection (15.0% vs. 10.3%, flap necrosis (5.0% vs. 7.4%, capsular contracture (20.0% vs. 14.7%, seroma (10.0% vs. 14.7%, hematoma (0% vs. 1.5%, and explantation (10.0% vs. 8.8% were not significantly different in the 2 groups.ConclusionsSterile ADM did not provide better results regarding infectious complications than aseptic ADM in implant-based immediate breast reconstruction.

  15. Locally advanced breast implant associated anaplastic large cell lymphoma: A case report of successful treatment with radiation and chemotherapy

    Directory of Open Access Journals (Sweden)

    Christopher Fleighton Estes

    2015-02-01

    Full Text Available The development of breast implant associated anaplastic large cell lymphoma (ALCL is a rare phenomenon. A typical presentation is an effusion associated with a breast implant. Less commonly, disease can become more advanced locoregionally or distantly. The optimal treatment schema is a topic of debate: localized ALCL can potentially be cured with implant removal alone, while other cases in the literature, including those that are more advanced, have been treated with varying combinations of surgery, chemotherapy, and external beam radiotherapy. This is a case report of breast implant ALCL with pathologically proven lymph node involvement, the fifth such patient reported. Our patient experienced a favorable outcome with radiation therapy and chemotherapy.

  16. Acute Immunologic Reaction to Silicone Breast Implant after Mastectomy and Immediate Reconstruction: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Massoome Najafi

    2014-08-01

    Full Text Available Background: Since the introduction of silicone based medical devices in to clinical practice, several reports appeared in the medical literature regarding their adverse effects. However, there are few reports of immunologic reactions to these implants.Case presentation: A case of systemic reaction to a breast implant inserted for immediate breast reconstruction in a breast cancer patient is presented. The patient developed fever and skin rash two months after the surgery. Investigations disclosed no infectious origin for the fever and a dramatic response to steroid therapy was observed.Conclusion: Immunologic reaction should be considered in case of systemic signs and symptoms after silicone breast implant placement as a rare complication. 

  17. In Vitro Laser Treatment Platform Construction with Dental Implant Thread Surface on Bacterial Adhesion for Peri-Implantitis

    Science.gov (United States)

    Mei, Hsiang-I; Liu, Tse-Ying; Lo, Lun-Jou

    2017-01-01

    This study constructs a standard in vitro laser treatment platform with dental implant thread surface on bacterial adhesion for peri-implantitis at different tooth positions. The standard clinical adult tooth jaw model was scanned to construct the digital model with 6 mm bone loss depth on behalf of serious peri-implantitis at the incisor, first premolar, and first molar. A cylindrical suite connected to the implant and each tooth root in the jaw model was designed as one experimental unit set to allow the suite to be replaced for individual bacterial adhesion. The digital peri-implantitis and suite models were exported to fulfill the physical model using ABS material in a 3D printer. A 3 mm diameter specimen implant on bacterial adhesion against Escherichia coli was performed for gram-negative bacteria. An Er:YAG laser, working with a chisel type glass tip, was moved from the buccal across the implant thread to the lingual for about 30 seconds per sample to verify the in vitro laser treatment platform. The result showed that the sterilization rate can reach 99.3% and the jaw model was not damaged after laser irradiation testing. This study concluded that using integrated image processing, reverse engineering, CAD system, and a 3D printer to construct a peri-implantitis model replacing the implant on bacterial adhesion and acceptable sterilization rate proved the feasibility of the proposed laser treatment platform. PMID:28791302

  18. In Vitro Laser Treatment Platform Construction with Dental Implant Thread Surface on Bacterial Adhesion for Peri-Implantitis

    Directory of Open Access Journals (Sweden)

    Hsien-Nan Kuo

    2017-01-01

    Full Text Available This study constructs a standard in vitro laser treatment platform with dental implant thread surface on bacterial adhesion for peri-implantitis at different tooth positions. The standard clinical adult tooth jaw model was scanned to construct the digital model with 6 mm bone loss depth on behalf of serious peri-implantitis at the incisor, first premolar, and first molar. A cylindrical suite connected to the implant and each tooth root in the jaw model was designed as one experimental unit set to allow the suite to be replaced for individual bacterial adhesion. The digital peri-implantitis and suite models were exported to fulfill the physical model using ABS material in a 3D printer. A 3 mm diameter specimen implant on bacterial adhesion against Escherichia coli was performed for gram-negative bacteria. An Er:YAG laser, working with a chisel type glass tip, was moved from the buccal across the implant thread to the lingual for about 30 seconds per sample to verify the in vitro laser treatment platform. The result showed that the sterilization rate can reach 99.3% and the jaw model was not damaged after laser irradiation testing. This study concluded that using integrated image processing, reverse engineering, CAD system, and a 3D printer to construct a peri-implantitis model replacing the implant on bacterial adhesion and acceptable sterilization rate proved the feasibility of the proposed laser treatment platform.

  19. Air Abrasive Disinfection of Implant Surfaces in a Simulated Model of Peri-Implantitis

    Science.gov (United States)

    2016-06-01

    implantitis is an emerging complication leading to increased morbidity or mortality of osseointegrated implants. The prevalence of peri-implant...the implant specific impression coping and screw. The simulated defect model served as both the reservoir for the contaminant and site where...by first placing an impression coping into a resin model previously numbered with an indelible marker (1-26). The implant was removed from its

  20. Influencia de las cargas triboeléctricas y de la contaminación sintomática de los implantes Triboelectric charges and breast implant symptomatic contamination

    Directory of Open Access Journals (Sweden)

    G. Peña Cabús

    2007-12-01

    Full Text Available El hallazgo ocasional de energía estática importante en un implante mamario, generó una revisión sistemática de la información disponible al respecto que restableció una secuencia de eventos y conceptos de importancia, a nuestro juicio, en la práctica clínica Los implantes mamarios son elastómeros resultantes de la polimerización industrial que pueden generar cargas electrostáticas en su superficie. El efecto triboeléctrico puede mantener suficiente energía estática como para atraer partículas de material capaces de producir una contaminación periprotésica sintomática. El desconocer esta propiedad física puede llevar a una práctica clínica de riesgo al colocar implantes mamarios. Adicionalmente se revisa la microbiología involucrada en la formación capsular periprotésica sintomática y la infección por bacterias productoras de "biofilm".An incidental finding of static energy upon the surface of a breast implant, generated a systematic search that led to a link between triboelectric charges and symptomatic periprosthetic infection. Breast implants are industrial elastomers that may result with electrostatic charges on its surface. Its propper resistivity allows silicone to maintain enough static that atracts and adheres particulate matter to become surface contamination with periprosthetic tissue reaction. Recognition of this particular physical property and its clinical implications allows for safer conditions of practice. We review microbiology involved in periprosthetic capsular formation and infection by "biofilm" producer bacteria.

  1. Peri-implant conditions around sintered porous-surfaced (SPS) implants. A 36-month prospective cohort study.

    Science.gov (United States)

    Malchiodi, Luciano; Ghensi, Paolo; Cucchi, Alessandro; Pieroni, Stefano; Bertossi, Dario

    2015-02-01

    The specific aim of this study was to assess sintered porous-surfaced (SPS) implant system from a biological point of view, through a prospective study of the health status and the evolution of the peri-implant tissues over time and analysis of the changes observed in the various peri-implant parameters. Hundred and fifty-one patients were treated consecutively from 2005 to 2007 using 280 SPS implants, which were restored with a single crown or a partial fixed denture. To accurately monitor the health and biological evolution of peri-implant soft and hard tissues, a number of clinical parameters were adopted, such as the modified Plaque Index (mPI), the modified sulcus Bleeding Index (mBI), Peri-implant Probing Depth (PPD), and Crestal Bone Level (CBL). Clinical and radiographic examinations were scheduled over a 36-month follow-up of functional loading according to a well-established protocol generally applied to determine implant success rates and Peri-implant Bone Loss (PBL). Statistical analysis was used to determine any significant differences or correlations (P = 0.05). A total of 259 SPS implants in 136 patients were followed up for 36 months. According to Buser's success criteria, the overall implant-based success rate was 98.1% and the mean PBL was 0.48 ± 0.29 mm. MBI and mPI mean values showed statistically significant differences between baseline and follow-up analyses (P behavior of SPS implant system was characterized by high tissue stability during the observation period, both as regards soft and hard tissues. In particular, the crestal bone remodeling pattern was very similar to that reported in other studies, confirming that the bone loss around SPS implants, at least at 36 months, seems to be predictable. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Tailoring biomaterial surface properties to modulate host-implant interactions: implication in cardiovascular and bone therapy.

    Science.gov (United States)

    Pacelli, Settimio; Manoharan, Vijayan; Desalvo, Anna; Lomis, Nikita; Jodha, Kartikeya Singh; Prakash, Satya; Paul, Arghya

    Host body response to a foreign medical device plays a critical role in defining its fate post implantation. It is thus important to control host-material interactions by designing innovative implant surfaces. In the recent years, biochemical and topographical features have been explored as main target to produce this new type of bioinert or bioresponsive implants. The review discusses specific biofunctional materials and strategies to achieve a precise control over implant surface properties and presents possible solutions to develop next generation of implants, particularly in the fields of bone and cardiovascular therapy.

  3. Subcutaneously Placed Breast Implants after a Skin-Sparing Mastectomy: Do We Always Need ADM?

    Directory of Open Access Journals (Sweden)

    Apresh Singla, MBBS, MSc

    2017-07-01

    Full Text Available Background:. Immediate breast reconstruction is an acceptable treatment option after mastectomy for prophylaxis of early breast cancer. Different options exist for implant placement, incision technique, patient suitability, and institutional experience. This article is a case series exploring the feasibility and outcomes of patients undergoing immediate breast reconstruction using skin-sparing mastectomy without mesh or acellular dermal matrix (ADM and with a vertical inframammary incision. Methods:. A single-institution retrospective analysis was performed for all patients who underwent immediate single-stage reconstruction with subcutaneous silicon implants without ADM between 2009 and 2014 inclusive. Patient, operative and treatment variables were extracted. All patients with viable mastectomy skin flaps intraoperatively and at least 5 mm of subcutaneous tissue were eligible except for patients who were deemed too slim by the senior surgeon preoperatively and thus at risk of implant visibility or skin rippling. Results:. There were 26 patients (bilateral n = 12 and unilateral n = 14 eligible for analysis, with a median long-term follow-up of 51.5 months. The majority of complications were classified as minor affecting 46.2% of the cohort (n = 12. There were 20 episodes of complications overall. The most frequent episodes were contour defects (x = 5, minor seroma (x = 4, and malrotation and minor infection (x = 3. There was 1 episode of capsular contracture. Conclusion:. Skin-sparing mastectomy with immediate subcutaneous silicon implant reconstruction with a vertical incision and without the need for mesh or ADM is an acceptable and safe treatment option. Accurate patient selection and skin flap viability is the key to achieving optimal outcomes with this approach.

  4. Periodontopathogens around the surface of mini-implants removed from orthodontic patients

    OpenAIRE

    TORTAMANO, ANDRÉ; Morea, Gladys Cristina Dominguez; Haddad, Ana Cristina Soares Santos; Nunes, Fabio Daumas; Nacao, Mônica; Morea,Camillo

    2012-01-01

    Objective: To verify if mini-implant mobility is affected by the presence of periodontopathogens, frequently associated with peri-implantitis. Materials and Methods: The surfaces of 31 mini-implants used for skeletal anchorage in orthodontic patients were evaluated. Polymerase chain reaction was used for identification of the presence of DNA from three different periodontopathogens (P. intermedia [Pi], A. actinomycetemcomitans [Aa], and P. gingivalis [Pg]) in 16 mini-implants without mobility...

  5. [Advantages of the superior areolar approach for tuberous breast II and III correction with implants].

    Science.gov (United States)

    Servaes, M; Mahaudens, P; Sinna, R; Vanwijck, R; Denoel, C

    2011-08-01

    Tuberous breast is a mammary malformation that remains difficult to treat in most cases. It results from an abnormal development of the mammary base, mainly at the lower pole of the breast. The superficialis fascia is adherent to the dermis and deep plane. For type II and III of Grolleau's classification, we were confronted by some difficulties with inferior areolar approach as in Puckett's or Ribeiro's techniques. We had frequently an insufficient glandular volume at the inferior part of the breast and an early look of a "double bubble" deformity. We propose a technical modification to these procedures using a superior hemiareolar approach to place the implant. Associated with an incision of the deep part of the superficialis fascia, it provides a good-shaped lower pole of the breast by preserving glandular volume at this part and reduces the apparition of "double bubble". We operated on 14 types II-III tuberous breasts on nine female patients and had no significant complication. The mean follow-up is 36 months and the results were very satisfying for the patient and her surgeon. Copyright © 2010. Published by Elsevier SAS.

  6. Stealthy role of size-driven stresses in biomechanics of breast implants capsular contracture.

    Science.gov (United States)

    Fraldi, Massimiliano; Esposito, Luca; Cutolo, Arsenio; Carotenuto, Angelo Rosario; Adamo, Ciro; Molea, Guido

    2016-12-01

    Breast Capsular Contracture (BCC) is one of the adverse complications occurring with greater incidence in breast augmentation surgical procedures. Its formation can be interpreted as the conclusive result of the physiological process known as response to a foreign body. From a biochemical standpoint, the formation of the peri-prosthetic capsule is certainly a multifactorial process: many hypotheses concerning its etiology have been suggested in the literature and a number of related pharmacological protocols have been consequently proposed to clinically treat this pathology with the aim to prevent further complications and avoid future re-interventions. However, the vast majority of these theories seems to be only partially supported by clinical outcomes and thus a shared opinion on this matter is still absent among specialists. Within this framework, by starting from clinical observations which highlighted an unexpected correlation between histo-morphological features of fibrotic capsules and overall size of breast implants, the present study investigates the hypothesis that the biomechanical interaction between prosthesis and host tissue may play a crucial role in the biological processes governing the pathological phenomenon at hand. Therefore, to shed light on the underlying mechanisms which could trigger the breast capsular contracture, both simple analytical solutions, in which elasticity and growth are simultaneously taken into account, and more accurate geometrically faithful Finite Element-based numerical simulations have been exploited. The theoretical findings demonstrate that somehow counter-intuitive radial and hoop stress fields occur at the capsula-implant interface in a way such that their combined action, independently from other possible concurrent factors, results significantly amplified for small-size breast prostheses, localized stress peaks in these cases promoting detaching and rippling phenomena actually observed in BCC clinical

  7. Accelerated partial breast irradiation dosimetric criteria for the strut-adjusted volume implant.

    Science.gov (United States)

    Mooney, Karen E; Altman, Michael B; Edward, Sharbacha; Garcia-Ramirez, Jose; Thomas, Maria A; Zoberi, Imran; DeWees, Todd; Mullen, Daniel; Zoberi, Jacqueline E

    2016-01-01

    Current guidelines for high-dose-rate accelerated partial breast irradiation using single-entry implants are based on the National Surgical Adjuvant Breast and Bowel Project B-39/Radiation Therapy Oncology Group 0413 protocol, which assumed a balloon implant geometry. We have developed robust plan evaluation criteria specifically for the strut-adjusted volume implant (SAVI). Plan evaluation criteria were established using a "training data set" of 62 SAVI treatment plans and included the percentage volume of target receiving 90%, 95%, and 100% of the prescription dose (V90, V95, and V100), the absolute volume of target receiving 150% and 200% of prescription (V150 and V200), and the maximum doses to skin (Dskin max) and ribs (Drib max). "Ideal" and "expected" (routinely achievable) thresholds were determined for each criterion and compared to B-39 guidelines. A "test data set" collected from the next 25 patients was analyzed using the developed plan evaluation criteria. Ideal (expected) dosimetric thresholds established from the training data set were V90 ≥ 98% (95%), V95 ≥ 95% (92%), V100 ≥ 91% (88%), Dskin max skin sparing compared to B-39 guidelines. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  8. Modified Lower Pole Autologous Dermal Sling for Implant Reconstruction in Women Undergoing Immediate Breast Reconstruction after Mastectomy

    Directory of Open Access Journals (Sweden)

    Pankaj G. Roy

    2016-01-01

    Full Text Available Background. Autologous dermal sling with wise pattern skin reducing mastectomy allows one-stage implant reconstruction in women with large and ptotic breasts needing mastectomy for cancer or risk reduction. However, this technique is not suitable for women who lack ptosis and also carries risk of T-junction breakdown. Method. We have performed one-stage nipple sparing mastectomies with implant reconstruction in 5 women (8 breasts by modifying the autologous dermal sling approach. All these women had small to moderate breasts with no ptosis or pseudoptosis. Results. Three women had bilateral procedures, two underwent bilateral mastectomies simultaneously, and one had contralateral risk reduction surgery a year after the cancer side operation. All women underwent direct to implant reconstruction with implant volumes varying from 320 to 375 cc. There were no implant losses and only one required further surgery to excise the nipple for positive nipple shaves. A low complication rate was encountered in this series with good aesthetic outcome. Conclusion. The modified lower pole dermal sling allows direct to implant reconstruction in selected women with small to moderate sized breasts with minimal ptosis. The approach is safe and cost-effective and results in more natural reconstruction with preservation of nipple.

  9. Hydroxyapatite and bioactive glass surfaces for fiber reinforced composite implants via surface ablation by Excimer laser.

    Science.gov (United States)

    Kulkova, Julia; Moritz, Niko; Huhtinen, Hannu; Mattila, Riina; Donati, Ivan; Marsich, Eleonora; Paoletti, Sergio; Vallittu, Pekka K

    2017-11-01

    In skeletal reconstructions, composites, such as bisphenol-A-glycidyldimethacrylate resin reinforced with glass fibers, are potentially useful alternatives to metallic implants. Recently, we reported a novel method to prepare bioactive surfaces for these composites. Surface etching by Excimer laser was used to expose bioactive glass granules embedded in the resin. The purpose of this study was to analyze two types of bioactive surfaces created by this technique. The surfaces contained bioactive glass and hydroxyapatite granules. The selected processing parameters were adequate for the creation of the surfaces. However, the use of porous hydroxyapatite prevented the complete exposure the granules. In cell culture, for bioactive glass coatings, the pattern of proliferation of MG63 cells was comparable to that in the positive control group (Ti6Al4V) while inferior cell proliferation was observed on the surfaces containing hydroxyapatite granules. Scanning electron microscopy revealed osteointegration of implants with both types of surfaces. The technique is suitable for the exposure of solid bioactive glass granules. However, the long-term performance of the surfaces needs further assessment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Do textured breast implants decrease the rate of capsular contracture compared to smooth implants?

    Directory of Open Access Journals (Sweden)

    Ignacio Cifuentes

    2017-08-01

    Full Text Available Resumen El uso de implantes mamarios con propósitos estéticos y reconstructivos se ha convertido en uno de los procedimientos más comunes realizados por los cirujanos plásticos. Existen diversos modelos de implantes mamarios, los cuales difieren en su tamaño, relleno, forma y característica de la envoltura, pudiendo ser lisa o texturizada. La contractura capsular es una de las principales complicaciones del uso de implantes mamarios y se ha planteado que las prótesis texturizadas podrían disminuir la incidencia de contractura capsular. Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud a nivel mundial, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Identificamos cinco revisiones sistemáticas que en conjunto incluyen 15 estudios primarios, 13 de ellos correspondientes a ensayos aleatorizados pertinentes a la pregunta de interés. Extrajimos los datos desde las revisiones identificadas, reanalizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos tablas de resumen de los resultados utilizando el método GRADE. Concluimos que el uso de prótesis mamaria texturizada probablemente disminuye el riesgo de contractura capsular, sin embargo, podría asociarse a un aumento en el riesgo de linfoma anaplásico de células grandes.

  11. Improvement of in vitro corrosion and cytocompatibility of biodegradable Fe surface modified by Zn ion implantation

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Henan; Zheng, Yang; Li, Yan, E-mail: liyan@buaa.edu.cn; Jiang, Chengbao

    2017-05-01

    Highlights: • Fe{sub 2}O{sub 3}/ZnO oxides were formed on the surface of Zn implanted pure Fe samples. • The corrosion rate of the pure Fe in SBF was increased after Zn implantation. • Cytocompatibility of the pure Fe was improved by Zn ion implantation. - Abstract: Pure Fe was surface-modified by Zn ion implantation to improve the biodegradable behavior and cytocompatibility. Surface topography, chemical composition, corrosion resistance and cytocompatibility were investigated. Atomic force microscopy, auger electron spectroscopy and X-ray photoelectron spectroscopy results showed that Zn was implanted into the surface of pure Fe in the depth of 40–60 nm and Fe{sub 2}O{sub 3}/ZnO oxides were formed on the outmost surface. Electrochemical measurements and immersion tests revealed an improved degradable behavior for the Zn-implanted Fe samples. An approximately 12% reduction in the corrosion potential (E{sub corr}) and a 10-fold increase in the corrosion current density (i{sub corr}) were obtained after Zn ion implantation with a moderate incident ion dose, which was attributed to the enhanced pitting corrosion. The surface free energy of pure Fe was decreased by Zn ion implantation. The results of direct cell culture indicated that the short-term (4 h) cytocompatibility of MC3T3-E1 cells was promoted by the implanted Zn on the surface.

  12. Aesthetic outcomes of acellular dermal matrix in tissue expander/implant-based breast reconstruction.

    Science.gov (United States)

    Forsberg, Clay G; Kelly, David A; Wood, Benjamin C; Mastrangelo, Stephanie L; DeFranzo, Anthony J; Thompson, James T; David, Lisa R; Marks, Malcolm W

    2014-01-01

    Tissue expander and implant-based breast reconstruction after mastectomy is the most common method of breast reconstruction. Modifications of the traditional total submuscular reconstruction (TSR) have been made using acellular dermal matrix (ADM) to create an inferolateral sling and a more natural implant pocket for superior aesthetic results. The objective of this study was to assess aesthetic outcomes when using ADM in breast reconstruction. A retrospective chart review identified all patients who underwent implant-based breast reconstruction from 2005 to 2009 at our institution. Demographic information, complications, reoperations, and aesthetic outcome data were collected for all patients meeting inclusion criteria related to adequate follow-up and postoperative photographs. Five aesthetic outcomes were evaluated for all study patients by 18 blinded evaluators using postoperative photographs. Outcomes were scored on a scale of 1 to 5, with 5 representing the best possible aesthetic score. A total of 122 patients underwent 183 tissue expander-based reconstructions (ADM, n = 58; TSR, n = 125). The infection rate in patients with ADM was 16.2% compared to 5.9% in TSR patients, but this was not statistically significant (P = 0.09). Capsular contracture was more common in TSR patients (23.5%), compared to those with ADM (8.1%), P = 0.048. Aesthetic scores from the attending plastic surgeons were as follows: natural contour (ADM, 3.36; TSR, 3.02; P = 0.0001), symmetry of shape (ADM, 3.57; TSR, 3.27; P = 0.005), symmetry of size (ADM, 3.68; TSR, 3.42; P = 0.002), position on chest wall (ADM, 3.75; TSR, 3.45; P = 0.004), and overall aesthetic appearance (ADM, 3.56; TSR, 3.20; P = 0.0001). For all 5 aesthetic parameters evaluated, the ADM group scored significantly higher than the TSR group by 18 blinded evaluators. These consistent findings suggest that the use of ADM in breast reconstruction does confer a significant advantage in aesthetic outcomes for breast

  13. Colocación transpectoral superior de implantes mamarios: Relevancia técnica y anatómica Superior transpectoral insertion of breast implants: Anatomical and technical relevance

    Directory of Open Access Journals (Sweden)

    G. Peña Cabús

    2008-12-01

    dissection. A small but representative serie of cases, due to a unique single outcome, which was the main objective of the study, forced to an early stage investigational report. The clinical experience refers to a caudal subfascial plane and a subpectoral cephalic plane to create an implantation cavity in a 15 cases serie when every single case operated on did not showed any surface breast deformation upon pectoral muscle forced contraction. At this point earlier than anticipated, the study was thought to be sufficient and completed. Main interest is being attracted to the consequences of the particular tissue components involved in the formation of the wall capsule surrounding the breast implant. We do believe that the soft handling of breast implants and other implantable biomaterials, refers to maintenance of the implant material integrity and a non responsive tissue behavior, on the long term basis.

  14. 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.

  15. Primary role of electron work function for evaluation of nanostructured titania implant surface against bacterial infection

    Energy Technology Data Exchange (ETDEWEB)

    Golda-Cepa, M., E-mail: golda@chemia.uj.edu.pl [Faculty of Chemistry, Jagiellonian University, Ingardena 3, 30-060 Krakow (Poland); Syrek, K. [Faculty of Chemistry, Jagiellonian University, Ingardena 3, 30-060 Krakow (Poland); Brzychczy-Wloch, M. [Department of Bacteriology, Microbial Ecology and Parasitology, Jagiellonian University Medical College, Czysta 18, 31-121 Krakow (Poland); Sulka, G.D. [Faculty of Chemistry, Jagiellonian University, Ingardena 3, 30-060 Krakow (Poland); Kotarba, A., E-mail: kotarba@chemia.uj.edu.pl [Faculty of Chemistry, Jagiellonian University, Ingardena 3, 30-060 Krakow (Poland)

    2016-09-01

    The electron work function as an essential descriptor for the evaluation of metal implant surfaces against bacterial infection is identified for the first time. Its validity is demonstrated on Staphylococcus aureus adhesion to nanostructured titania surfaces. The established correlation: work function–bacteria adhesion is of general importance since it can be used for direct evaluation of any electrically conductive implant surfaces. - Highlights: • The correlation between work function and bacteria adhesion was discovered. • The discovered correlation is rationalized in terms of electrostatic bacteria–surface repulsion. • The results provide basis for the simple evaluation of implant surfaces against infection.

  16. Goldilocks Mastectomy: A Safe Bridge to Implant-Based Breast Reconstruction in the Morbidly Obese.

    Science.gov (United States)

    Schwartz, Jean-Claude

    2017-06-01

    Reconstructive surgeons are encountering an increasing number of obese women requiring postmastectomy reconstruction. These patients are poor candidates for autologous and prosthetic-based reconstructions as they have a high rate of reconstructive failure, surgical complications, and poor aesthetic outcomes. We demonstrate here the utility of the previously described Goldilocks mastectomy with free nipple grafts as a safe bridge to second stage implant-based breast reconstruction. Ten consecutive morbidly (BMI > 40) or super obese (BMI>50) women underwent bilateral Goldilocks mastectomy with free nipple grafts followed by second stage subpectoral implant placement at least three months postoperatively. Patients were assessed for implant-related complications including malposition, capsular contracture, dehiscence, and extrusion. Ten postmastectomy reconstructions in patients with BMIs ranging from 37 to 50 with a mean BMI of 45 underwent bilateral Goldilocks mastectomy with free nipple grafts. Two patients had wound healing complications after Goldilocks mastectomy but were completely healed within 8 weeks. There were no instances of delayed wound healing or reconstructive failure after prosthetic placement. With at least 9 months of follow-up on all patients, no patient has had a capsular contracture, significant malposition, or other complication requiring reoperation. The obese patient poses a significant reconstructive challenge for which no reproducible approach has been described. Here, we present a 2-stage strategy: the previously described Goldilocks mastectomy with free nipple grafts followed by second stage subpectoral definitive implant placement. This is the first proposed description of a reliable strategy for postmastectomy reconstruction in the morbidly and super obese.

  17. Systemic Sclerosis and Silicone Breast Implant: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Antonios Psarras

    2014-01-01

    Full Text Available Environmentally induced systemic sclerosis is a well-recognized condition, which is correlated with exposure to various chemical compounds or drugs. However, development of scleroderma-like disease after exposure to silicone has always been a controversial issue and, over time, it has triggered spirited debate whether there is a certain association or not. Herein, we report the case of a 35-year-old female who developed Raynaud’s phenomenon and, finally, systemic sclerosis shortly after silicone breast implantation surgery.

  18. Suction drains in esthetic breast implant exchange are associated with surgical site infections: A retrospective cohort study.

    Science.gov (United States)

    Hadad, Eran; Wiser, Itay; Rosenthal, Adaya; Landau, Geva; Ziv, Ella; Heller, Lior

    2017-11-01

    Surgical site infection (SSI) following esthetic breast implant exchange occurs in up to 2% of procedures. The effect of suction drains on SSI risk in these cases remains controversial. This study aimed to assess the SSI risk in the presence of suction drains after esthetic exchange of breast implants. This is a retrospective cohort study of patients undergoing esthetic breast implant exchange between 2012 and 2015. SSI was determined according to the definition of the Center for Disease Control and Prevention. Multivariate analysis using a logistic regression model to identify independent risk factors for SSI was performed. A total of 256 women (504 breasts) met the inclusion criteria and were included in the study. The mean age was 44 ± 11 years. The mean operative time was 93 ± 40 min. The mean implant age at the time of the exchange was 10.3 ± 6.5 years. Suction drains were used in 229 breasts (45.4%) and were removed after 6 ± 7 days. Twenty (4%) breasts were diagnosed with SSI, of which 17 had suction drains. Suction drain use and days until drain removal were associated with a higher risk of SSI (85.0% vs. 43.8%, p suction drains remained an independent risk factor for SSI after adjustment for age, smoking, and previous capsular contracture (OR = 10.66, CI 95% 2.42-46.82). Suction drain use in esthetic breast implant exchange is associated with an increased risk of SSI. Surgeons should carefully consider using suction drains in selected cases only. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  19. Evaluation of Implant Collar Surfaces for Marginal Bone Loss: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Roodabeh Koodaryan

    2016-01-01

    Full Text Available Background. It is important to understand the influence of different collar designs on peri-implant marginal bone loss, especially in the critical area. Objectives. The purpose of the present systematic review and meta-analysis was to compare dental implants with different collar surfaces, evaluating marginal bone loss and survival rates of implants. Methods. Eligibility criteria included clinical human studies, randomized controlled trials, and prospective and retrospective studies, which evaluated dental implants with different collar surface in the same study. Results. Twelve articles were included, with a total of 492 machined, 319 rough-surfaced, and 352 rough-surfaced microthreaded neck implants. There was less marginal bone loss at implants with rough-surfaced and rough-surfaced microthreaded neck than at machined-neck implants (difference in means: 0.321, 95% CI: 0.149 to 0.493; p<0.01. Conclusion. Rough and rough-surfaced microthreaded implants are considered a predictable treatment for preserving early marginal bone loss.

  20. Surface properties and implantation site affect the capsular fibrotic overgrowth.

    Science.gov (United States)

    Bakeine, G J; Bertolotti, A; Latina, M; Congiu, T; Prati, U; Roveda, L; Trotta, F; Tormen, M; Fabrizio, E Di; Carlini, G; Facoetti, A; Nano, R

    2007-12-15

    Transplantation of encapsulated pancreatic islets is a promising approach for the treatment of type 1 diabetes. Large-scale application of this technique, however, is hampered by insufficient biocompatibility of the capsules. In this study, we have evaluated the biocompatibility of a new synthetic material with six different chemical groups on their surface (amino, carboxy-sulfate, carboxylate, hydroxylate, sulfate, and PMMA) used for the fabrication of the microcapsules. Eight Lewis rats were inoculated with a suspension of empty capsules made for each candidate material in the retroperitoneal ileopsoas muscle and renal subcapsular space. Four weeks later kidney and muscle containing the capsules were explanted, paraffin embedded, sectioned and stained with Sirius Red and Masson's Trichrome for histological analysis. The amount of fibrosis was also ultrastructurally evaluated with scanning electron microscopy. The samples were then subjected to digitalized quantitative analysis using specific software to determine the degree of fibrotic overgrowth. The quantification of collagen deposition, calculated in proximity of the microcapsules, was expressed as a percentage of the total area and can be considered a good index for the biocompatibility, an essential prerequisite for functional pancreatic islet transplantation. The results show that subcapsular renal space is the best implantation site and the positive surface charge induces a more intense collagen synthesis. (c) 2007 Wiley Periodicals, Inc. J Biomed Mater Res, 2007.

  1. Radiological and echographic aspects of breasts with silicone implants; Aspectos radiologicos e ecograficos das mamas com protese de silicone

    Energy Technology Data Exchange (ETDEWEB)

    Pace Bauab, S. de [Instituto de Radiodiagnostico Rio Preto, Sao Jose do Rio Preto, SP (Brazil)

    1994-10-01

    The silicone prosthesis, its application in breast augmentation mammoplasty and the studies about its association with auto-immune diseases and cancer, are commented. The normal and the pathologic radiologic and echographic aspects of breasts with implants are discussed, concerning to the prosthesis itself and to the adjacent parenchyma. The validity of mammographic and ultrasound mammography in the detection of cancer and of alterations of the implants are emphasized and also the importance of exams of high technical quality.(author). 16 refs, 13 figs.

  2. Retrospective Evaluation of the Influence of the Collar Surface Topography on Peri-implant Bone Preservation.

    Science.gov (United States)

    Mendonça, Jose Alfredo; Senna, Plinio Mendes; Francischone, Carlos Eduardo; Francischone Junior, Carlos Eduardo; de Souza Picorelli Assis, Neuza Maria; Sotto-Maior, Bruno Salles

    To evaluate the influence of the collar surface topography on peri-implant marginal bone preservation. A total of 156 patients who received at least one cylindrical implant of regular diameter with an external-hexagon platform in the posterior region of the maxilla or mandible were recalled to the office for a retrospective evaluation. Implantation sites and implant length information were recorded, and implants were divided according to the collar surface topography: machined (M) or rough (R) surface. Each implant was assessed by digital periapical radiography, using a sensor holder for the paralleling technique. The marginal bone remodeling was determined as the distance from the implant platform to the first bone-to-implant contact, and the known implant length was used to calibrate the images in the computer software. The follow-up measurements were compared with those obtained from the radiograph taken at the time of prosthetic loading to determine the late bone remodeling. An independent t test was used to compare data. From 138 patients who attended the recall, 242 implants (M = 126; R = 116) were evaluated with a mean follow-up period of 4.6 ± 0.9 years. Similar success rates were found in both groups (M = 95.0%; R = 95.9%). Late bone remodeling in the maxilla was not influenced by the implant collar (P = .504); however, lower marginal bone loss was observed in the R group (1.20 ± 0.52 mm) compared with the M group (1.58 ± 0.73 mm) in the mandible (P = .007). Although the implant collar design did not influence the success rate of dental implants, the rough collar design reduced the late marginal bone remodeling around external-hexagon implants in the mandible. The maxilla was not benefited by the rough collar design.

  3. Flow cytometry of ALK-negative anaplastic large cell lymphoma of breast implant-associated effusion and capsular tissue.

    Science.gov (United States)

    Wu, David; Allen, Camilla T; Fromm, Jonathan R

    2015-01-01

    Anaplastic large cell lymphoma (ALCL) of the breast capsule is a rare lymphoma involving capsular tissues and/or effusions associated with breast implants. While several studies have detailed the histological and immunohistochemical (IHC) features of these tumors, no study has yet described flow cytometry features of the neoplastic cells of this entity. Here, we report two cases from our institution in which multi-parametric flow cytometry was performed. The immunophenotype of ALCL in association with breast implant was evaluated by flow cytometry. We show that much like CD30+ tumor cells of classical Hodgkin lymphoma (CHL) and ALCL of non-breast implant tumors, the neoplastic cells of this entity can be readily identified by flow cytometry. The neoplastic cells of both cases were largely devoid of T-cell antigens, but had expression of weak CD15, strong CD30, and expression of CD40. These results are correlated with routine morphologic and IHC analysis, supporting the flow cytometry immunophenotype. Flow cytometry can aid in the diagnostic evaluation of effusions or tissue samples in association with breast implant/prostheses. © 2014 Clinical Cytometry Society.

  4. Balancing microbial and mammalian cell functions on calcium ion-modified implant surfaces.

    Science.gov (United States)

    Anitua, Eduardo; Tejero, Ricardo; Pacha-Olivenza, Miguel Ángel; Fernández-Calderón, María Coronada; Delgado-Rastrollo, María; Zalduendo, Mari Mar; Troya, María; Pérez-Giraldo, Ciro; González-Martín, María Luisa

    2018-01-01

    Implant integration is a complex process mediated by the interaction of the implant surface with the surrounding ions, proteins, bacteria, and tissue cells. Although most implants achieve long-term bone-tissue integration, preventing pervasive implant-centered infections demands further advances, particularly in surfaces design. In this work, we analyzed classical microrough implant surfaces (only acid etched, AE; sandblasted then acid etching, SB + AE) and a new calcium-ion-modified implant surface (AE + Ca) in terms of soft- and hard-tissue integration, bacterial adhesion, and biofilm formation. We cultured on the surfaces primary oral cells from gingiva and alveolar bone, and three representative bacterial strains of the oral cavity, emulating oral conditions of natural saliva and blood plasma. With respect to gingiva and bone cells and in the presence of platelets and plasma proteins, AE + Ca surfaces yielded in average 86% higher adhesion, 44% more proliferation, and triggered 246% more synthesis of extracellular matrix biomolecules than AE-unmodified controls. Concomitantly, AE + Ca surfaces regardless of conditioning with saliva and/or blood plasma showed significantly less bacterial adhesion (67% reduction in average) and biofilm formation (40% reduction in average) than unmodified surfaces. These results highlight the importance of a calcium-rich hydrated interface to favor mammalian cell functions over microbial colonization at implant surfaces. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 421-432, 2018. © 2017 Wiley Periodicals, Inc.

  5. A review on the wettability of dental implant surfaces I: theoretical and experimental aspects.

    Science.gov (United States)

    Rupp, Frank; Gittens, Rolando A; Scheideler, Lutz; Marmur, Abraham; Boyan, Barbara D; Schwartz, Zvi; Geis-Gerstorfer, Jürgen

    2014-07-01

    The surface wettability of biomaterials determines the biological cascade of events at the biomaterial/host interface. Wettability is modulated by surface characteristics, such as surface chemistry and surface topography. However, the design of current implant surfaces focuses mainly on specific micro- and nanotopographical features, and is still far from predicting the concomitant wetting behavior. There is an increasing interest in understanding the wetting mechanisms of implant surfaces and the role of wettability in the biological response at the implant/bone or implant/soft tissue interface. Fundamental knowledge related to the influence of surface roughness (i.e. a quantification of surface topography) on titanium and titanium alloy surface wettability, and the different associated wetting regimes, can improve our understanding of the role of wettability of rough implant surfaces on the biological outcome. Such an approach has been applied to biomaterial surfaces only in a limited way. Focusing on titanium dental and orthopaedic implants, the present study reviews the current knowledge on the wettability of biomaterial surfaces, encompassing basic and applied aspects that include measurement techniques, thermodynamic aspects of wetting and models predicting topographical and roughness effects on the wetting behavior. Copyright © 2014 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  6. 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.

  7. Objective breast symmetry evaluation using 3-D surface imaging.

    Science.gov (United States)

    Eder, Maximilian; Waldenfels, Fee V; Swobodnik, Alexandra; Klöppel, Markus; Pape, Ann-Kathrin; Schuster, Tibor; Raith, Stefan; Kitzler, Elena; Papadopulos, Nikolaos A; Machens, Hans-Günther; Kovacs, Laszlo

    2012-04-01

    This study develops an objective breast symmetry evaluation using 3-D surface imaging (Konica-Minolta V910(®) scanner) by superimposing the mirrored left breast over the right and objectively determining the mean 3-D contour difference between the 2 breast surfaces. 3 observers analyzed the evaluation protocol precision using 2 dummy models (n = 60), 10 test subjects (n = 300), clinically tested it on 30 patients (n = 900) and compared it to established 2-D measurements on 23 breast reconstructive patients using the BCCT.core software (n = 690). Mean 3-D evaluation precision, expressed as the coefficient of variation (VC), was 3.54 ± 0.18 for all human subjects without significant intra- and inter-observer differences (p > 0.05). The 3-D breast symmetry evaluation is observer independent, significantly more precise (p < 0.001) than the BCCT.core software (VC = 6.92 ± 0.88) and may play a part in an objective surgical outcome analysis after incorporation into clinical practice. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. 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...... and roughness. This influences cell behaviour on the surface such as adhesion, proliferation and differentiation of cells as well as the mineralization of the extracellular matrix at the implant surfaces. The aim of the present systematic review was to describe organic molecules used for surface nanocoating...

  9. Novel surface coating materials for endodontic dental implant

    Energy Technology Data Exchange (ETDEWEB)

    Fathi, M.H. [Isfahan Univ. of Technology, Materials Engineering Dept., Isfahan (Iran, Islamic Republic of); Mortazavi, V.; Moosavi, S.B. [Isfahan Univ. of Medical Sciences, Faculty of Dentistry, Isfahan (Iran, Islamic Republic of)

    2003-07-01

    The aim of this study was to design and produce novel coating materials in order to obtain two goals including; improvement of the corrosion behavior of metallic dental endodontic implant and the bone osteointegration simultaneously. Stainless steel 316L (SS) was used as a metallic substrate and a novel Hydroxyapatite/Titanium (HA/Ti) composite coating was prepared on it. Structural characterization techniques including XRD, SEM and EDX were utilized to investigate the microstructure and morphology of the coating. Electrochemical tests were performed in physiological solutions in order to determine and compare the corrosion behavior of the coated and uncoated specimens as an indication of biocompatibility. Two types of endodontic implants including; SS with and without (HA/Ti) composite coating were prepared and subsequently implanted in the mandibular canine of 20 cats after completion of root canal treatment and osseous preparation. After a healing period of 4 months, osteointegration evaluation and histopathological interpretation was carried out using SEM and optical microscopy. Results indicate that the novel HA/Ti composite coating improves the corrosion behavior and biocompatibility of SS endodontic dental implant. The clinical evaluation (in vivo test) results showed that there was significant difference in osteointegration between coated and uncoated endodontic dental implants and average bone osteointegration of coated implants were more than uncoated implants. The histopathological results and bone tissue response to the coated implants was acceptable and it was concluded that HA/Ti composite coated SS could be used as well as an endodontic dental implant. (author)

  10. 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.

  11. Biofunctionalization of surfaces by energetic ion implantation: Review of progress on applications in implantable biomedical devices and antibody microarrays

    Science.gov (United States)

    Bilek, Marcela M. M.

    2014-08-01

    Despite major research efforts in the field of biomaterials, rejection, severe immune responses, scar tissue and poor integration continue to seriously limit the performance of today's implantable biomedical devices. Implantable biomaterials that interact with their host via an interfacial layer of active biomolecules to direct a desired cellular response to the implant would represent a major and much sought after improvement. Another, perhaps equally revolutionary, development that is on the biomedical horizon is the introduction of cost-effective microarrays for fast, highly multiplexed screening for biomarkers on cell membranes and in a variety of analyte solutions. Both of these advances will rely on effective methods of functionalizing surfaces with bioactive molecules. After a brief introduction to other methods currently available, this review will describe recently developed approaches that use energetic ions extracted from plasma to facilitate simple, one-step covalent surface immobilization of bioactive molecules. A kinetic theory model of the immobilization process by reactions with long-lived, mobile, surface-embedded radicals will be presented. The roles of surface chemistry and microstructure of the ion treated layer will be discussed. Early progress on applications of this technology to create diagnostic microarrays and to engineer bioactive surfaces for implantable biomedical devices will be reviewed.

  12. Cytological Diagnosis of Bilateral Breast Implant-Associated Lymphoma of the ALK-Negative Anaplastic Large-Cell Type. Clinical Implications of Peri-Implant Breast Seroma Cytological Reporting.

    Science.gov (United States)

    Granados, Rosario; Lumbreras, Eva M; Delgado, Manuel; Aramburu, José A; Tardío, Juan C

    2016-07-01

    The cytological examination of peri-prosthetic breast effusions allowed the diagnosis of bilateral breast-implant ALK-negative anaplastic large cell lymphoma (BI-ALCL) in the case reported. Ten years after reconstructive surgery with bilateral breast implants, a large unilateral seroma developed and was cytologically analyzed. The presence of CD30 and CD4-positive large-sized atypical lymphoid cells exhibiting horseshoe-shaped nuclei and a brisk mitotic activity rendered the diagnosis of BI-ALCL. Similar cells were seen in the peri-prosthetic fluid intraoperatively collected from the contralateral breast. Although initial histological analysis of the capsulectomy specimens showed unilateral tumor, the cytological findings prompted a more thorough tissue sampling, resulting in the diagnosis of bilateral disease. BI-ALCL usually follows an indolent clinical course; however, there are reported cases with an aggressive behavior. While the presence of bilateral disease is a putative risk factor for a bad prognosis, the small number of cases reported precludes a definitive assessment of this risk. Since most BI-ALCL present with late seromas, cytologic analysis of these effusions in women with breast implants should be mandatory. Cytology is a safe tool for diagnosis and follow-up of patients with breast implant-related late seromas, sometimes proven more sensitive than histological analysis. Complete bilateral capsulectomy and a detailed histological analysis should follow a cytological diagnosis of BI-ALCL in a breast effusion in order to avoid false negative diagnoses. Our case constitutes the first published report of a bilateral BI-ALCL diagnosed by cytology. Diagn. Cytopathol. 2016;44:623-627. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  13. Evaluation of Implant Collar Surfaces for Marginal Bone Loss: A Systematic Review and Meta-Analysis

    OpenAIRE

    Roodabeh Koodaryan; Ali Hafezeqoran

    2016-01-01

    Background. It is important to understand the influence of different collar designs on peri-implant marginal bone loss, especially in the critical area. Objectives. The purpose of the present systematic review and meta-analysis was to compare dental implants with different collar surfaces, evaluating marginal bone loss and survival rates of implants. Methods. Eligibility criteria included clinical human studies, randomized controlled trials, and prospective and retrospective studies, which ev...

  14. Detoxification of Implant Surfaces Affected by Peri-Implant Disease: An Overview of Non-surgical Methods

    Science.gov (United States)

    Valderrama, Pilar; Blansett, Jonathan A; Gonzalez, Mayra G; Cantu, Myrna G; Wilson, Thomas G

    2014-01-01

    Objective: The aim of this review is to summarize the findings of studies that have evaluated non-surgical approaches for detoxification of implant body surfaces in vitro and in vivo, and to evaluate clinical trials on the use of these methodologies for treating peri-implant disease. Materials and methods: A literature search was conducted using MEDLINE (Pubmed) from 1966 to 2013. In vitro and in vivo studies as well as clinical trials on non-surgical therapy were evaluated. The outcome variables were the ability of the therapeutic method to eliminate the biofilm and endotoxins from the implant surface, the changes in clinical parameters including probing depth, clinical attachment levels, bleeding on probing; radiographic bone fill and histological re-osseointegration. Results: From 134 articles found 35 were analyzed. The findings, advantages and disadvantages of using lasers as well as mechanical and chemical methods are discussed. Most of the in vivo and human studies used combination therapies which makes determining the efficacy of one specific method difficult. Most human studies are case series with short term longitudinal analysis without survival or failure reports. Conclusion: Complete elimination of the biofilms is difficult to achieve using these approaches. All therapies induce changes of the chemical and physical properties of the implant surface. Re-osseointegration may be difficult to achieve if not impossible without surgical access to ensure thorough debridement of the defect and detoxification of the implant surface. Combination protocols for non-surgical treatment of peri-implantitis in humans have shown some positive clinical results but long-term evaluation to evaluate the validity and reliability of the techniques is needed. PMID:24894571

  15. Surface topographical and structural analysis of Ag{sup +}-implanted polymethylmethacrylate

    Energy Technology Data Exchange (ETDEWEB)

    Arif, Shafaq, E-mail: sarif2005@gmail.com [Department of Physics, Lahore College for Women University, Lahore 54000 (Pakistan); Rafique, M. Shahid [Department of Physics, University of Engineering & Technology, Lahore 54000 (Pakistan); Saleemi, Farhat [Department of Physics, Lahore College for Women University, Lahore 54000 (Pakistan); Naab, Fabian; Toader, Ovidiu [Department of Nuclear Engineering and Radiological Sciences, Michigan Ion Beam Laboratory, University of Michigan, MI 48109-2104 (United States); Sagheer, Riffat [Department of Physics, Lahore College for Women University, Lahore 54000 (Pakistan); Bashir, Shazia [Center for Advanced Studies in Physics (CASP), Government College University, Lahore 54000 (Pakistan); Zia, Rehana [Department of Physics, Lahore College for Women University, Lahore 54000 (Pakistan); Siraj, Khurram; Iqbal, Saman [Department of Physics, University of Engineering & Technology, Lahore 54000 (Pakistan)

    2016-08-15

    Specimens of polymethylmethacrylate (PMMA) were implanted with 400-keV Ag{sup +} ions at different ion fluences ranging from 1 × 10{sup 14} to 5 × 10{sup 15} ions/cm{sup 2} using a 400-kV NEC ion implanter. The surface topographical features of the implanted PMMA were investigated by a confocal microscope. Modifications in the structural properties of the implanted specimens were analyzed in comparison with pristine PMMA by X-ray diffraction (XRD) and Raman spectroscopy. UV–Visible spectroscopy was applied to determine the effects of ion implantation on optical transmittance of the implanted PMMA. The confocal microscopic images revealed the formation of hillock-like microstructures along the ion track on the implanted PMMA surface. The increase in ion fluence led to more nucleation of hillocks. The XRD pattern confirmed the amorphous nature of pristine and implanted PMMA, while the Raman studies justified the transformation of Ag{sup +}-implanted PMMA into amorphous carbon at the ion fluence of ⩾5 × 10{sup 14} ions/cm{sup 2}. Moreover, the decrease in optical transmittance of PMMA is associated with the formation of hillocks and ion-induced structural modifications after implantation.

  16. Primary role of electron work function for evaluation of nanostructured titania implant surface against bacterial infection.

    Science.gov (United States)

    Golda-Cepa, M; Syrek, K; Brzychczy-Wloch, M; Sulka, G D; Kotarba, A

    2016-09-01

    The electron work function as an essential descriptor for the evaluation of metal implant surfaces against bacterial infection is identified for the first time. Its validity is demonstrated on Staphylococcus aureus adhesion to nanostructured titania surfaces. The established correlation: work function-bacteria adhesion is of general importance since it can be used for direct evaluation of any electrically conductive implant surfaces. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. Optimizing Safety, Predictability, and Aesthetics in Direct to Implant Immediate Breast Reconstruction: Evolution of Surgical Technique.

    Science.gov (United States)

    Kalus, Ram; Dixon Swartz, Jennifer; Metzger, Sarah Cristina

    2016-06-01

    Although immediate breast reconstruction with the insertion of a permanent prosthesis rather than a tissue expander (direct to implant [DTI]) has become gradually more preferred and requested by patients, the technique has yet to be fully embraced by most plastic surgeons, presumably due to concerns of patient safety and perceived higher complication and revision rates, despite not being supported by the literature. The authors review the senior author's protocol for patient selection and surgical technique in DTI reconstructions. A simple device is introduced which adds predictability and control in determining the inset suture line for the acellular dermal matrix and thus the position of the inframammary fold and lateral mammary fold, resulting in improved aesthetic outcomes, reduced complications, and reduced reoperation rates. A retrospective review of our one surgeon experience with 134 DTI breast reconstructions in 77 patients between 2006 and 2015 is presented. The series is further subdivided into 74 reconstructions in 43 patients in whom their reconstruction was performed before the use of a patented 2-dimensional (2-D) template, and 60 reconstructions in 34 patients in whom the template was used. The overall complication rate requiring reoperation in the first 54 reconstructions was 50% versus 15% in the last 84. Failure of the reconstruction, defined by explantation, occurred in 11 of 74 reconstructions (14.9%) before the use of 2-D templates, and in 5 of 60 reconstructions (8.3%) in which templates were used, representing a 44% reduction. The revision rate specifically for implant malposition dropped from 18.6% before the use of templates to 2.9% after the incorporation of templates. Fifty-three reconstructions in 33 patients (40%) had no complications and no reoperations, correctly described as "one and done." Direct to implant reconstruction can be technically more demanding and exacting than 2-stage expander/implant reconstructions. A review of this

  18. Multisite Infection with Mycobacterium abscessus after Replacement of Breast Implants and Gluteal Lipofilling.

    Science.gov (United States)

    Rüegg, Eva; Cheretakis, Alexandre; Modarressi, Ali; Harbarth, Stephan; Pittet-Cuénod, Brigitte

    2015-01-01

    Introduction. Medical tourism for aesthetic surgery is popular. Nontuberculous mycobacteria (NTM) occasionally cause surgical-site infections. As NTM grow in biofilms, implantations of foreign bodies are at risk. Due to late manifestation, infections occur when patients are back home, where they must be managed properly. Case Report. A 39-year-old healthy female was referred for acute infection of the right gluteal area. Five months before, she had breast implants replacement, abdominal liposuction, and gluteal lipofilling in Mexico. Three months postoperatively, implants were removed for NTM-infection in Switzerland. Adequate antibiotic treatment was stopped after seven days for drug-related hepatitis. At entrance, gluteal puncture for bacterial analysis was performed. MRI showed large subcutaneous collection. Debridement under general anaesthesia was followed by open wound management. Total antibiotic treatment was 20 weeks. Methods. Bacterial analysis of periprosthetic and gluteal liquids included Gram-stain plus acid-fast stain, and aerobic, anaerobic and mycobacterial cultures.  Results. In periprosthetic fluid, Mycobacterium abscessus, Propionibacterium, and Staphylococcus epidermidis were identified. The same M. abscessus strain was found gluteally. The gluteal wound healed within six weeks. At ten months' follow-up, gluteal asymmetry persists for deep scarring. Conclusion. This case presents major complications of multisite aesthetic surgery. Surgical-site infections in context of medical tourism need appropriate bacteriological investigations, considering potential NTM-infections.

  19. Implant breast reconstruction followed by radiotherapy: Can helical tomotherapy become a standard irradiation treatment?

    Energy Technology Data Exchange (ETDEWEB)

    Massabeau, Carole, E-mail: cmassabeau@hotmail.com [Department of Radiation Oncology, Institut Curie, Paris (France); Fournier-Bidoz, Nathalie; Wakil, Georges; Castro Pena, Pablo; Viard, Romain; Zefkili, Sofia; Reyal, Fabien; Campana, Francois; Fourquet, Alain; Kirova, Youlia M. [Department of Radiation Oncology, Institut Curie, Paris (France)

    2012-01-01

    To evaluate the benefits and limitations of helical tomotherapy (HT) for loco-regional irradiation of patients after a mastectomy and immediate implant-based reconstruction. Ten breast cancer patients with retropectoral implants were randomly selected for this comparative study. Planning target volumes (PTVs) 1 (the volume between the skin and the implant, plus margin) and 2 (supraclavicular, infraclavicular, and internal mammary nodes, plus margin) were 50 Gy in 25 fractions using a standard technique and HT. The extracted dosimetric data were compared using a 2-tailed Wilcoxon matched-pair signed-rank test. Doses for PTV1 and PTV2 were significantly higher with HT (V95 of 98.91 and 97.91%, respectively) compared with the standard technique (77.46 and 72.91%, respectively). Similarly, the indexes of homogeneity were significantly greater with HT (p = 0.002). HT reduced ipsilateral lung volume that received {>=}20 Gy (16.7 vs. 35%), and bilateral lungs (p = 0.01) and neighboring organs received doses that remained well below tolerance levels. The heart volume, which received 25 Gy, was negligible with both techniques. HT can achieve full target coverage while decreasing high doses to the heart and ipsilateral lung. However, the low doses to normal tissue volumes need to be reduced in future studies.

  20. Multisite Infection with Mycobacterium abscessus after Replacement of Breast Implants and Gluteal Lipofilling

    Directory of Open Access Journals (Sweden)

    Eva Rüegg

    2015-01-01

    Full Text Available Introduction. Medical tourism for aesthetic surgery is popular. Nontuberculous mycobacteria (NTM occasionally cause surgical-site infections. As NTM grow in biofilms, implantations of foreign bodies are at risk. Due to late manifestation, infections occur when patients are back home, where they must be managed properly. Case Report. A 39-year-old healthy female was referred for acute infection of the right gluteal area. Five months before, she had breast implants replacement, abdominal liposuction, and gluteal lipofilling in Mexico. Three months postoperatively, implants were removed for NTM-infection in Switzerland. Adequate antibiotic treatment was stopped after seven days for drug-related hepatitis. At entrance, gluteal puncture for bacterial analysis was performed. MRI showed large subcutaneous collection. Debridement under general anaesthesia was followed by open wound management. Total antibiotic treatment was 20 weeks. Methods. Bacterial analysis of periprosthetic and gluteal liquids included Gram-stain plus acid-fast stain, and aerobic, anaerobic and mycobacterial cultures.  Results. In periprosthetic fluid, Mycobacterium abscessus, Propionibacterium, and Staphylococcus epidermidis were identified. The same M. abscessus strain was found gluteally. The gluteal wound healed within six weeks. At ten months’ follow-up, gluteal asymmetry persists for deep scarring. Conclusion. This case presents major complications of multisite aesthetic surgery. Surgical-site infections in context of medical tourism need appropriate bacteriological investigations, considering potential NTM-infections.

  1. The Poly Implant Prothèse breast prostheses scandal: Embodied risk and social suffering.

    Science.gov (United States)

    Greco, Cinzia

    2015-12-01

    This article examines the 2010 scandal surrounding the use and subsequent recall of adulterated Poly Implant Prothèse (PIP) silicone breast prostheses in France. It uses a mixed method approach that includes 12 interviews with French PIP prosthesis recipients, analyses of medical literature, policy documents of French and EU regulatory agencies, and an online forum for PIP recipients. These data are used to explain how the definition of "acceptable risk" in the silicone implants controversy of the 1990s in the US influenced the PIP scandal later on in France. Additionally, PIP recipients had an embodied experience of risk that clashed with the definition of risk used by authorities and some surgeons. The coverage of re-implantation was also defined at different policy levels, leading to variation in patients' suffering. The combination of fraud and lack of recognition from part of the medical system constitutes an example of social suffering for the patients involved. The PIP scandal is a useful case for analyzing the interconnection of embodied experience and professional and public policy definitions of medical risk through the concepts of moral economy and biological citizenship. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Evaluation of titanium implants with surface modification by laser beam: biomechanical study in rabbit tibias

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    Rafael Silveira Faeda

    2009-06-01

    Full Text Available The purpose of the present study was to evaluate, using a biomechanical test, the force needed to remove implants with surface modification by laser (Nd:YAG in comparison with implants with machined surfaces. Twenty-four rabbits received one implant with each surface treatment in the tibia, machined surface (MS and laser-modified surface (LMS. After 4, 8 and 12 weeks of healing, the removal torque was measured by a torque gauge. The surfaces studied were analyzed according to their topography, chemical composition and roughness. The average removal torque in each period was 23.28, 24.0 and 33.85 Ncm for MS, and 33.0, 39.87 and 54.57 Ncm for LMS, respectively. The difference between the surfaces in all periods of evaluation was statistically significant (p < 0.05. Surface characterization showed that a deep and regular topography was provided by the laser conditioning, with a great quantity of oxygen ions when compared to the MS. The surface micro-topography analysis showed a statistical difference (p < 0.01 between the roughness of the LMS (Ra = 1.38 ± 0.23 μm when compared to that of the MS (Ra = 0.33 ± 0.06 μm. Based on these results, it was possible to conclude that the LMS implants' physical-chemical properties increased bone-implant interaction when compared to the MS implants.

  3. 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

    that may increase adhesion of bone proteins, and bone cells at the implant surface. Nanocoating with pectins, plant cell wall-derived polysaccharides, is frequently done using rhamnogalacturonan-I (RG-I). AIM: The aim of the study was to evaluate the effect of nanocoating titanium implants with plant cell......) 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....... The bone response to the nanocoated implants was analyzed qualitatively and quantitatively after 2, 4, 6, and 8 weeks of healing using light microscopy and histomorphometric methods. RESULTS: The RG-I coating influenced the surface chemical composition; wettability and roughness, making the surface more...

  4. Bacteria-material surface interactions: methodological development for the assessment of implant surface induced antibacterial effects.

    Science.gov (United States)

    Zaborowska, Magdalena; Welch, Ken; Brånemark, Rickard; Khalilpour, Poroshat; Engqvist, Håkan; Thomsen, Peter; Trobos, Margarita

    2015-01-01

    The choice of material for implanted prostheses is of great importance concerning bacterial colonization and biofilm formation. Consequently, methods to investigate bacterial behavior are needed in order to develop new infection resistant surfaces. In this study, different methodological setups were used to evaluate the antimicrobial effect of photocatalytic titanium oxide and silver surfaces. Biofilm formation and eradication under static and dynamic culture conditions were studied with the use of the following analytical techniques: viable colony-forming unit (CFU) counting, imprinting, fluorescence, and bioluminescence. The present study demonstrates that different methods are needed in order to evaluate the prophylactic and treatment effects on planktonic and biofilm bacteria and to assess the antimicrobial effect of different surface treatments/coatings. Choosing the right antibacterial testing model for the specific application is also of great importance. Both in situ approaches and indirect methods provide valuable complementary information. © 2014 Wiley Periodicals, Inc.

  5. Influence of a nanoporous zirconia implant surface of on cell viability of human osteoblasts

    NARCIS (Netherlands)

    Aboushelib, M.N.; Osman, E.; Jansen, I.; Everts, V.; Feilzer, A.J.

    2013-01-01

    Purpose: The dense nonretentive surface of zirconia implants was modified into a nanoporous surface using selective infiltration etching surface treatment. The aim of this study was to investigate the influence of such a nanoporous modified zirconia surface on the attachment of human osteoblasts.

  6. Implant Surface Temperature Changes during Er:YAG Laser Irradiation with Different Cooling Systems.

    Directory of Open Access Journals (Sweden)

    Abbas Monzavi

    2014-04-01

    Full Text Available Peri-implantitis is one of the most common reasons for implant failure. Decontamination of infected implant surfaces can be achieved effectively by laser irradiation; although the associated thermal rise may cause irreversible bone damage and lead to implant loss. Temperature increments of over 10ºC during laser application may suffice for irreversible bone damage.The purpose of this study was to evaluate the temperature increment of implant surface during Er:YAG laser irradiation with different cooling systems.Three implants were placed in a resected block of sheep mandible and irradiated with Er:YAG laser with 3 different cooling systems namely water and air spray, air spray alone and no water or air spray. Temperature changes of the implant surface were monitored during laser irradiation with a K-type thermocouple at the apical area of the fixture.In all 3 groups, the maximum temperature rise was lower than 10°C. Temperature changes were significantly different with different cooling systems used (P<0.001.Based on the results, no thermal damage was observed during implant surface decontamination by Er:YAG laser with and without refrigeration. Thus, Er:YAG laser irradiation can be a safe method for treatment of periimplantitis.

  7. Biofilm formation on surface characterized micro-implants for skeletal anchorage in orthodontics

    NARCIS (Netherlands)

    Chin, Yeen; Sandham, John; de Vries, Jacob; van der Mei, Henderina; Busscher, Hendrik

    Micro-implants are increasingly popular in clinical orthodontics to effect skeletal anchorage. However, biofilm formation on their surfaces and subsequent infection of peri-implant tissues can result in either exfoliation or surgical removal of these devices. The present study aimed to assess

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

    DEFF Research Database (Denmark)

    Gurzawska, Katarzyna; 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 an...

  9. Three-dimensional imaging provides valuable clinical data to aid in unilateral tissue expander-implant breast reconstruction.

    Science.gov (United States)

    Tepper, Oren M; Karp, Nolan S; Small, Kevin; Unger, Jacob; Rudolph, Lauren; Pritchard, Ashley; Choi, Mihye

    2008-01-01

    The current approach to breast reconstruction remains largely subjective and is based on physical examination and visual-estimates of breast size. Thus, the overall success of breast reconstruction is limited by the inability of plastic surgeons to objectively assess breast volume and shape, which may result in suboptimal outcomes. A potential solution to this obstacle may be three-dimensional (3D) imaging, which can provide unique clinical data that was previously unattainable to plastic surgeons. The following study represents a prospective analysis of patient volunteers undergoing unilateral tissue expander (TE)-implant reconstruction by one of the two senior authors (MC, NSK). All patients underwent unilateral mastectomy with immediate or delayed insertion of a TE, followed by an exchange for a permanent silicone or saline implant. 3D scans were obtained during routine pre- and postoperative office visits. The 3D breast-volume calculations served as a guide for surgical management. Twelve patients have completed 3D-assisted unilateral breast reconstruction to date. These patients represent a wide range of body habitus and breast size/shape; 3D volume range from 136 to 518 cm(3). The mean baseline breast asymmetry in this group was 12.0 +/- 10.8%. Contralateral symmetry procedures were performed in eleven patients, consisting of the following: mastopexy (n = 6), augmentation (n = 1), mastopexy/augmentation (n = 2), and reduction mammoplasty (n = 2). Reconstruction was completed in a total number of 2 (n = 10) or 3 (n = 2) operations. Overall breast symmetry improved at the completion of reconstruction in the majority of patients, with an average postoperative symmetry of 95.1 +/- 4.4% (relative to 88% preoperatively). 3D imaging serves a valuable adjunct to TE-implant breast reconstruction. This technology provides volumetric data that can help guide breast reconstruction, such as in choosing the initial TE size, total volume of expansion, and final implant size

  10. 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....

  11. Enhanced osseointegration of titanium implants with nanostructured surfaces: an experimental study in rabbits.

    Science.gov (United States)

    Salou, Laëtitia; Hoornaert, Alain; Louarn, Guy; Layrolle, Pierre

    2015-01-01

    Titanium and its alloys are commonly used for dental implants because of their good mechanical properties and biocompatibility. The surface properties of titanium implants are key factors for rapid and stable bone tissue integration. Micro-rough surfaces are commonly prepared by grit-blasting and acid-etching. However, proteins and cells interact with implant surfaces in the nanometer range. The aim of this study was to compare the osseointegration of machined (MA), standard alumina grit-blasted and acid-etched (MICRO) and nanostructured (NANO) implants in rabbit femurs. The MICRO surface exhibited typical random cavities with an average roughness of 1.5 μm, while the NANO surface consisted of a regular array of titanium oxide nanotubes 37±11 nm in diameter and 160 nm thick. The MA and NANO surfaces had a similar average roughness of 0.5 μm. The three groups of implants were inserted into the femoral condyles of New Zealand White rabbits. After 4 weeks, the pull-out test gave higher values for the NANO than for the other groups. Histology corroborated a direct apposition of bone tissue on to the NANO surface. Both the bone-to-implant contact and bone growth values were higher for the NANO than for the other implant surfaces. Overall, this study shows that the nanostructured surface improved the osseointegration of titanium implants and may be an alternative to conventional grit-blasted and acid-etched surface treatments. Copyright © 2014 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  12. Complications of Radiotherapy after Immediate Breast Reconstruction with Implant: Risk Factors and Management - Our Institute’s Experience

    Directory of Open Access Journals (Sweden)

    Heba G. El-Sheredy

    2016-01-01

    Full Text Available Background: Breast cancer is the most frequent malignant tumor in women worldwide. In recent years, defined reconstruction principles along with numerous surgical techniques with volume replacement have been published. Autologous breast reconstruction is more natural but leaves donor site morbidity. It provides the opportunity to restore the breast mound without the need for scars. This study aims to evaluate the complications of radiotherapy after immediate breast reconstruction with implants in breast cancer patients who submitted to skin sparing mastectomy and nipple sparing mastectomy by taking into consideration the risk factors and management at our institution. Methods: The current study prospectively included patients with invasive breast cancer admitted between January and June 2012 who were scheduled for skin sparing mastectomy or nipple sparing mastectomy and axillary dissection followed by immediate breast reconstruction with implant. Patients received adjuvant chemotherapy followed by conventional fractionated radiation. Complications were classified as either minor or major. The minor complications included capsular contracture (Baker 1-2, seroma, minor skin infection and skin dehiscence without exposure of the implant. Major complications included capsular contracture (Baker 3-4, severe infection and major wound dehiscence with implant exposure. Capsular contracture was scored according to the modified Baker classification. Results: The study included 38 patients. Of these, 28 had skin sparing mastectomy while 10 underwent nipple sparing mastectomy. The overall complication rate was 71%. We observed minor complications in 18 patients while 9 patients had major complications. Complications occurred with a median time of 13 months following radiotherapy completion. All minor complications were managed conservatively whereas all major complications required repeat surgery. No loco-regional recurrences occurred during the follow up

  13. Comparison of the Explantation Rate of Poly Implant Prothèse, Allergan, and Pérouse Silicone Breast Implants within the First Four Years after Reconstructive Surgery before the Poly Implant Prothèse Alert by the French Regulatory Authority

    Directory of Open Access Journals (Sweden)

    Alexandre Leduey

    2015-01-01

    Full Text Available Background. In March 2010, ANSM (Agence Nationale de Sécurité du Medicament, the French Medical Regulatory Authority, withdrew Poly Implant Prothèse (PIP breast implants from the market due to the use of non-medical-grade silicone gel. The aim of this study was to compare the removal rate (and reasons thereof of breast implants produced by different manufacturers before the ANSM alert. Materials and Methods. From October 2006 to January 2010, 652 women received 944 implants after breast cancer surgery at the Gustave Roussy Comprehensive Cancer Center, Paris (France. The complications and removal rates of the different implant brands used (PIP, Allergan, and Pérouse were evaluated and compared. Results. PIP implants represented 50.6% of the used implants, Allergan 33.4%, and Pérouse 16%. The main reasons for implant removal were patient dissatisfaction due to aesthetic problems (43.2%, infection (22.2%, and capsular contracture (13.6%. Two years after implantation, 82% of Pérouse implants, 79% of PIP, and 79% of Allergan were still in situ. There was no difference in removal rate among implant brands. Conclusion. Before the ANSM alert concerning the higher rupture rate of PIP breast implants, our implant removal rate did not predict PIP implant failure related to the use of nonapproved silicone gel.

  14. The effect of metal ion implantation on the surface mechanical properties of Mylar (PET)

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, W.; Sood, D.K. [Royal Melbourne Inst. of Tech., VIC (Australia); Yao, X.; Brown, I.G. [California Univ., Berkeley, CA (United States). Lawrence Berkeley Lab.

    1993-12-31

    Ion implantation of polymers leads to the formation of new carbonaceous materials, the revolution during implantation of various species consists of (1) ion beam induced damage: chain scission, crosslinking, molecular emission of volatile elements and compounds, stoichiometric change in the surface layer of pristine polymers; and (2) chemical effect between ion and target materials: microalloying and precipitation. Literature regarding ion implanted polymers shows that the reorganisation of the carbon network after implantation can dramatically modify several properties of pristine polymers solubility, molecular weight, and electrical, optical and mechanical properties. However, ion implantation of polymers is actually a very complex interaction which depends on not only ion species, implantation condition, but also polymer type and specific structure. In this paper the effect of Ag or Ti ions implantation on surface mechanical properties of PET (polyethylenne terephthalate) polymer is reported. There was a clear deterioration in wear resistance after implantation of both Ag and Ti ions. It is suggested that the increment of wear after implantation may result from not only ion damage but also chemical effect between ion and target material. 3 refs., 1 tab., 2 figs.

  15. MRI screening for silicone breast implant rupture: accuracy, inter- and intraobserver variability using explantation results as reference standard

    Energy Technology Data Exchange (ETDEWEB)

    Maijers, M.C.; Ritt, M.J.P.F. [VU University Medical Centre, Department of Plastic, Reconstructive and Hand Surgery, De Boelelaan 1117, PO Box 7057, Amsterdam (Netherlands); Niessen, F.B. [VU University Medical Centre, Department of Plastic, Reconstructive and Hand Surgery, De Boelelaan 1117, PO Box 7057, Amsterdam (Netherlands); Jan van Goyen Clinic, Department of Plastic Surgery, Amsterdam (Netherlands); Veldhuizen, J.F.H. [MRI Centre, Amsterdam (Netherlands); Manoliu, R.A. [MRI Centre, Amsterdam (Netherlands); VU University Medical Centre, Department of Radiology, Amsterdam (Netherlands)

    2014-06-15

    The recall of Poly Implant Prothese (PIP) silicone breast implants in 2010 resulted in large numbers of asymptomatic women with implants who underwent magnetic resonance imaging (MRI) screening. This study's aim was to assess the accuracy and interobserver variability of MRI screening in the detection of rupture and extracapsular silicone leakage. A prospective study included 107 women with 214 PIP implants who underwent explantation preceded by MRI. In 2013, two radiologists blinded for previous MRI findings or outcome at surgery, independently re-evaluated all MRI examinations. A structured protocol described the MRI findings. The ex vivo findings served as reference standard. In 208 of the 214 explanted prostheses, radiologists agreed independently about the condition of the implants. In five of the six cases they disagreed (2.6 %), but subsequently reached consensus. A sensitivity of 93 %, specificity of 93 %, positive predictive value of 77 % and negative predictive value of 98 % was found. The interobserver agreement was excellent (kappa value of 0.92). MRI has a high accuracy in diagnosing rupture in silicone breast implants. Considering the high kappa value of interobserver agreement, MRI appears to be a consistent diagnostic test. A simple, uniform classification, may improve communication between radiologist and plastic surgeon. (orig.)

  16. 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.

  17. Comparison of the impact of scaler material composition on polished titanium implant abutment surfaces.

    Science.gov (United States)

    Hasturk, Hatice; Nguyen, Daniel Huy; Sherzai, Homa; Song, Xiaoping; Soukos, Nikos; Bidlack, Felicitas B; Van Dyke, Thomas E

    2013-08-01

    The purpose of this study was to compare the impact of the removal of biofilm with hand scalers of different material composition on the surface of implant abutments by assessing the surface topography and residual plaque after scaling using scanning electron microscopy (SEM). Titanium implant analogs from 3 manufacturers (Straumann USA LLC, Andover, Maine, Nobel BioCare USA LLC, Yorba Linda, Cali, Astra Tech Implant Systems, Dentsply, Mölndal, Sweden) were mounted in stone in plastic vials individually with authentic prosthetic abutments. Plaque samples were collected from a healthy volunteer, inoculated into growth medium and incubated with the abutments anaerobically for 1 week. A blinded, calibrated hygienist performed scaling to remove the biofilm using 6 implant scalers (in triplicate), 1 scaler for 1 abutment. The abutments were mounted on an imaging stand and processed for SEM. Images were captured in 3 randomly designated areas of interest on each abutment. Analysis of the implant polished abutment surface and plaque area measurements were performed using ImageJ image analysis software. Surface alterations were characterized by the number, length, depth and the width of the scratches observed. Glass filled resin scalers resulted in significantly more and longer scratches on all 3 abutment types compared to other scalers, while unfilled resin scalers resulted in the least surface change (p < 0.05). Filled resin-graphite reinforced scalers, carbon fiber reinforced resin scalers and titanium scalers resulted in more superficial scratches compared to glass filled resin, as well as more scratches than unfilled resin. No statistically significant differences were found between scalers and abutments with regard to plaque removal. The impact of scalers on implant abutment surfaces varies between abutment types presumably due to different surface characteristics with no apparent advantage of one abutment type over the other with regard to resistance to surface

  18. Bone healing at implants with different surface configurations: an experimental study in dogs.

    Science.gov (United States)

    Beolchini, Marco; Lang, Niklaus P; Gómez Moreno, Gerardo; Iezzi, Giovanna; Botticelli, Daniele; Calvo Guirado, José Luis

    2016-02-01

    To study osseointegration of implants with surface modifications by the use of fluoroboric acid and/or H2 O2 installed in conventional sites or sites with circumferential marginal defects. Four implants with different surfaces were used. One basic surface (ZirTi(®)) was sandblasted with zirconium microspheres and acid etched additionally with hydrofluoric acid. A second surface was treated with fluoroboric acid instead of hydrofluoric acid. The remainder of the other two surfaces was additionally treated with H2O2. The edentulous mandibles of 6 foxhound dogs were used to randomly install 8.5-mm-long implants with the different surfaces and to study the histological healing after 1 and 3 months. To study osteoconductivity, additional four recipient sites were prepared with the coronal region being widened so that a 4 mm deep and 0.85 mm wide marginal defect resulted after the placement of the four implants with different surfaces. No filler material or membranes were used, and a fully submerged healing was allowed for 3 months. At the conventional sites, new bone formation ranged between 68.5% and 74.9% after 1 month. After 3 months, bone-to-implant contact ranged from 72.6% at the ZirTi(®) surface to 84.1% at the fluoroboric acid-treated implants, the difference being statistically significant. At the sites with marginal defects, bone formation ranged from 0.77 mm at the surface treated with fluoroboric acid and H2O2 , to 1.93 mm at the surface treated with fluoroboric acid alone. Fluoroboric acid treatment alone of titanium implant surfaces resulted in improved osseointegration and osteoconductivity after 3 months. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Immediate breast reconstruction with a saline implant and AlloDerm, following removal of a Phyllodes tumor

    Directory of Open Access Journals (Sweden)

    Roller Michael D

    2011-03-01

    Full Text Available Abstract Background Phyllodes tumors are uncommon tumors of the breast that exhibit aggressive growth. While surgical management of the tumor has been reported, a single surgical approach with immediate breast reconstruction using AlloDerm has not been reported. Case presentation A 22-year-old woman presented with a 4 cm mass in the left breast upon initial examination. Although the initial needle biopsy report indicated a fibroadenoma, the final pathologic report revealed a 6.5 cm × 6.4 cm × 6.4 cm benign phyllodes tumor ex vivo. Treatment was a simple nipple-sparing mastectomy coupled with immediate breast reconstruction. After the mastectomy, a subpectoral pocket was created for a saline implant and AlloDerm was stitched to the pectoralis and serratus muscle in the lower-pole of the breast. Conclusions Saline implant with AlloDerm can be used for immediate breast reconstruction post-mastectomy for treatment of a phyllodes tumor.

  20. Implantes mamarios y mastopexía: colgajos mamarios laterales y mediales, una opción técnica Breast Implants and Mastopexy: lateral and Medial Breast Flaps, a Technical Option

    Directory of Open Access Journals (Sweden)

    R. Goulart Jr.

    2012-12-01

    Full Text Available La mastopexia asociada al uso de implantes mamarios es actualmente una de las prácticas más desafiantes en Cirugía Plástica; en ella, el cirujano tiene que utilizar al máximo sus capacidades y conocimientos para decidir con exactitud la mejor relación entre el tamaño ideal del implante y el exceso de piel a retirar. El objetivo de este artículo es presentar una técnica a base de colgajos mamarios laterales y mediales (CMLM para cirugía de mastopexia con implantes mamarios en busca de una mejor definición de la mama y de una mayor duración del resultado final. Esta técnica se crea en base a la circulación mamaria y en los excedentes de tejido al final de la cirugía utilizando la marcación en T. Los resultados inmediatos han sido muy satisfactorios en términos de definición de la forma mamaria, de la solidez de la nueva estructura glandular y de la protección del implante mamario. La duración a largo plazo aún debe ser evaluada. Creemos que se trata de una técnica fácil de ejecutar, que permite un resultado estético satisfactorio, proporciona una percepción de mayor seguridad en el posicionamiento del implante, aunque somos conscientes de que su sostenibilidad y duración a largo plazo aún necesitan tiempo para una mejor evaluación.The breast implant associated with mastopexy actually is one of most difficult plastic surgeries. In fact, it is a surgery where the surgeon has to use his higher capabilities and skills in order to decide with precision the best relationship between ideal sizes of the breast implant and skin excess. The purpose in this paper is to present a breast lateral and medial flaps technique for augmentation mastopexy surgery looking for a better breast design and resistance on the final result. The technique was created on breast circulation basis, skin excess and better definition and resistance about the aesthetical breast results in the augmentation mastopexy surgery utilizing the T scar technique

  1. Improvement of in vitro corrosion and cytocompatibility of biodegradable Fe surface modified by Zn ion implantation

    Science.gov (United States)

    Wang, Henan; Zheng, Yang; Li, Yan; Jiang, Chengbao

    2017-05-01

    Pure Fe was surface-modified by Zn ion implantation to improve the biodegradable behavior and cytocompatibility. Surface topography, chemical composition, corrosion resistance and cytocompatibility were investigated. Atomic force microscopy, auger electron spectroscopy and X-ray photoelectron spectroscopy results showed that Zn was implanted into the surface of pure Fe in the depth of 40-60 nm and Fe2O3/ZnO oxides were formed on the outmost surface. Electrochemical measurements and immersion tests revealed an improved degradable behavior for the Zn-implanted Fe samples. An approximately 12% reduction in the corrosion potential (Ecorr) and a 10-fold increase in the corrosion current density (icorr) were obtained after Zn ion implantation with a moderate incident ion dose, which was attributed to the enhanced pitting corrosion. The surface free energy of pure Fe was decreased by Zn ion implantation. The results of direct cell culture indicated that the short-term (4 h) cytocompatibility of MC3T3-E1 cells was promoted by the implanted Zn on the surface.

  2. A review on the wettability of dental implant surfaces II: Biological and clinical aspects.

    Science.gov (United States)

    Gittens, Rolando A; Scheideler, Lutz; Rupp, Frank; Hyzy, Sharon L; Geis-Gerstorfer, Jürgen; Schwartz, Zvi; Boyan, Barbara D

    2014-07-01

    Dental and orthopedic implants have been under continuous advancement to improve their interactions with bone and ensure a successful outcome for patients. Surface characteristics such as surface topography and surface chemistry can serve as design tools to enhance the biological response around the implant, with in vitro, in vivo and clinical studies confirming their effects. However, the comprehensive design of implants to promote early and long-term osseointegration requires a better understanding of the role of surface wettability and the mechanisms by which it affects the surrounding biological environment. This review provides a general overview of the available information about the contact angle values of experimental and of marketed implant surfaces, some of the techniques used to modify surface wettability of implants, and results from in vitro and clinical studies. We aim to expand the current understanding on the role of wettability of metallic implants at their interface with blood and the biological milieu, as well as with bacteria, and hard and soft tissues. Copyright © 2014 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  3. Effects of oral implant surface roughness on bacterial biofilm formation and treatment efficacy

    NARCIS (Netherlands)

    Lin, H.Y.; Liu, Y.; Wismeijer, D.; Crielaard, W.; Deng, D.M.

    2013-01-01

    Purpose: The aim of this study was to investigate the influence of oral implant surface roughness on bacterial biofilm formation and antimicrobial treatment efficacy. Materials and Methods: Titanium disks with low-roughness pickled surfaces and with moderately rough sandblasted, acid-etched surfaces

  4. Characteristics of women with cosmetic breast implants compared with women with other types of cosmetic surgery and population-based controls in Denmark.

    Science.gov (United States)

    Kjøller, Kim; Hölmich, Lisbet R; Fryzek, Jon P; Jacobsen, Poul Harboe; Friis, Søren; McLaughlin, Joseph K; Lipworth, Loren; Henriksen, Trine F; Jørgensen, Signe; Bittmann, Sven; Olsen, Jørgen H

    2003-01-01

    Herein the authors describe characteristics of women with breast implants compared with women with other types of cosmetic surgery as well as population controls. All women who acquired breast implants from 1977 to 1997 were identified from the files of two private plastic surgery clinics in Denmark. Patient characteristics were obtained through a self-administered questionnaire. The magnitude of differences between patient and control groups was estimated using odds ratios and 95% confidence intervals. Women with breast implants had a significantly lower body mass index and reported a two-fold greater incidence of current smoking compared with women from the general population and compared with women with other cosmetic surgery. Women with implants reported a greater number of full-term pregnancies and were less likely than controls to have had their first birth at age 30 years or older. Women with implants were not more likely than women in either control group to report a history of diseases, including connective tissue diseases, cancer, or depression before their implant surgery. Women with cosmetic breast implants differ from women with other forms of cosmetic surgery and from general population controls with respect to characteristics that may importantly influence health outcomes and that need to be addressed in future breast implant studies.

  5. Identification card and codification of the chemical and morphological characteristics of 14 dental implant surfaces.

    Science.gov (United States)

    Dohan Ehrenfest, David M; Vazquez, Lydia; Park, Yeong-Joon; Sammartino, Gilberto; Bernard, Jean-Pierre

    2011-10-01

    Dental implants are commonly used in daily practice; however, most surgeons do not really know the characteristics of these biomedical devices they are placing in their patients. The objective of this work is to describe the chemical and morphological characteristics of 14 implant surfaces available on the market and to establish a simple and clear identification (ID) card for all of them, following the classification procedure developed in the Dohan Ehrenfest et al (2010) Codification (DEC) system. Fourteen implant surfaces were characterized: TiUnite (Nobel Biocare), Ospol (Ospol), Kohno HRPS (Sweden & Martina), Osseospeed (AstraTech), Ankylos (Dentsply Friadent), MTX (Zimmer), Promote (Camlog), BTI Interna (Biotechnology Institute), EVL Plus (SERF), Twinkon Ref (Tekka), Ossean (Intra-Lock), NanoTite (Biomet 3I), SLActive (ITI Straumann), Integra-CP/NanoTite (Bicon). Three samples of each implant were analyzed. Superficial chemical composition was analyzed using X-ray photoelectron spectroscopy/electron spectroscopy for chemical analysis, and the 100 nm in-depth profile was established using Auger electron spectroscopy. The microtopography was quantified using light interferometry. The general morphology and nanotopography were evaluated using a field emission-scanning electron microscope. Finally, the characterization code of each surface was established using the DEC system, and the main characteristics of each surface were summarized in a reader-friendly ID card. From a chemical standpoint, of the 14 different surfaces, 10 were based on a commercially pure titanium (grade 2 or 4), 3 on a titanium-aluminum alloy (grade 5 titanium), and one on a calcium phosphate core. Nine surfaces presented different forms of chemical impregnation or discontinuous coating of the titanium core, and 3 surfaces were covered with residual aluminablasting particles. Twelve surfaces presented different degrees of inorganic pollutions, and 2 presented a severe organic pollution

  6. Modification of anti-bacterial surface properties of textile polymers by vacuum arc ion source implantation

    Energy Technology Data Exchange (ETDEWEB)

    Nikolaev, A.G., E-mail: nik@opee.hcei.tsc.ru [High Current Electronics Institute, Siberian Branch of the Russian Academy of Sciences, Tomsk 634055 (Russian Federation); Yushkov, G.Yu.; Oks, E.M. [High Current Electronics Institute, Siberian Branch of the Russian Academy of Sciences, Tomsk 634055 (Russian Federation); Oztarhan, A. [Izmir University, Izmir 35140 (Turkey); Akpek, A.; Hames-Kocabas, E.; Urkac, E.S. [Bioengineering Department, Ege University, Bornova 35100, Izmir (Turkey); Brown, I.G. [Lawrence Berkeley National Laboratory, Berkeley, CA 94708 (United States)

    2014-08-15

    Highlights: • Ion implantation. • Anti-bacterial properties. • Textile polymer. • Vacuum arc ion source. - Abstract: Ion implantation provides an important technology for the modification of material surface properties. The vacuum arc ion source is a unique instrument for the generation of intense beams of metal ions as well as gaseous ions, including mixed metal–gas beams with controllable metal:gas ion ratio. Here we describe our exploratory work on the application of vacuum arc ion source-generated ion beams for ion implantation into polymer textile materials for modification of their biological cell compatibility surface properties. We have investigated two specific aspects of cell compatibility: (i) enhancement of the antibacterial characteristics (we chose to use Staphylococcus aureus bacteria) of ion implanted polymer textile fabric, and (ii) the “inverse” concern of enhancement of neural cell growth rate (we chose Rat B-35 neuroblastoma cells) on ion implanted polymer textile. The results of both investigations were positive, with implantation-generated antibacterial efficiency factor up to about 90%, fully comparable to alternative conventional (non-implantation) approaches and with some potentially important advantages over the conventional approach; and with enhancement of neural cell growth rate of up to a factor of 3.5 when grown on suitably implanted polymer textile material.

  7. Effects of Zafirlukast on the Capsular Fibrosis of Silicone Breast Implants

    Directory of Open Access Journals (Sweden)

    Emre Hocaoglu

    2014-06-01

    Methods: Forty-eight adult female Sprague-Dawley rats were divided into four groups. Smooth-surfaced, gel-filled prostheses were implanted in 36 rats. Group A: The day of the operation, 12 animals received Zafirlukast treatment for 14 weeks (oral gavage, once a day, 6 days a week, 4 mg/kg/day; Group B: 10 weeks after the operation, 12 animals received Zafirlukast treatment for 4 weeks; Group C: 12 animals were implanted but did not receive treatment; Group D: 12 animals did not have an operation, but for 14 weeks received oral gavage containing water instead of Zafirlukast. At the end of the 14 weeks, the implants with the surrounding capsules were extracted. Blind macroscopic inspectional evaluation of the capsules was performed, and microscopic capsular thickness measurements were made. Results: The mean capsular thickness was 0.033 mm (SD: 0.011 in Group A, and 0.089 mm (SD: 0.023 and 0.125 mm (SD: 0.025 in Groups B and C, respectively. Differences between Groups A and C and between Groups A and B were significant (p0.05. Similarly, Macroscopic Inspectional Fibrosis Scoring showed a significant difference between Groups A and C and a non-significant difference between Groups B and C. Conclusion: Daily prophylactic oral administration of Zafirlukast immediately after implantation significantly diminishes the development of fibrotic capsules around the silicone prostheses. [Arch Clin Exp Surg 2014; 3(3.000: 139-146

  8. The Influence of Surface Roughness on the Displacement of Osteogenic Bone Particles during Placement of Titanium Screw-Type Implants

    NARCIS (Netherlands)

    Tabassum, A.; Walboomers, F.; Wolke, J.G.C.; Meijer, G.J.; Jansen, J.A.

    2011-01-01

    Background: Previously, we demonstrated that bone debris, which is translocated during dental implant placement, has osteogenic potential. Therefore, it was hypothesized that implant surface roughness can influence the amount of translocated bone debris/particles and thereby the osteogenic response.

  9. Risk of pacemaker implantation subsequent to radiotherapy for early-stage breast cancer in Denmark, 1982-2005

    DEFF Research Database (Denmark)

    Rehammar, Jens Christian; Videbaek, L.; Brock Johansen, J.

    2015-01-01

    Introduction: Adjuvant radiotherapy reduces the risk of recurrence and death for early-stage breast cancer. However, dose to the heart should be considered since recent data suggest an increasing risk of ischemic heart disease with increasing dose to the heart. Conduction abnormalities have been...... reported after mediastinal radiation for Hodgkin's disease, but the risk of conduction disorders and arrhythmias does not appear to be increased subsequent to breast cancer radiotherapy. Such conduction abnormalities constitute a quite heterogenous group covering mild as well as severe disorders....... Objectives: The aim of this study was to examine the risk of severe conduction abnormalities evaluated by implantation of a pacemaker, subsequent to breast cancer radiotherapy. Methods: From the database of the Danish Breast Cancer Collaborative Group, we identified women treated with radiotherapy for early...

  10. Surface decomposition and annealing behavior of GaN implanted with Eu

    CERN Document Server

    Liu Hua Ming; Chen Chang Chun; Wang Sen; Zhu De Zhang; Xu Hong Jie

    2002-01-01

    Investigations on surface decomposition of GaN implanted with low energy (80 keV) Eu ion to a low dose (1 x 10 sup 1 sup 4 cm sup - sup 2), and its annealing behavior under high temperature (1050 degree C) in N sub 2 are performed. The as-grown, as-implanted and annealed GaN films are characterized by proton elastic scattering (PES), Rutherford backscattering spectrometry (RBS), photoluminescence (PL) and atomic force microscopy (AFM). The results show that Eu ion implantation induces radiation defects and decomposition of GaN. The GaN surface decomposition is more serious during high temperature annealing. The atomic ratio of N in as-grown, as-implanted and annealed GaN film is 47 at.%, 44 at.% and 40 at.%, respectively. As a result, a rough Ga-rich layer is formed at the surface, though the lattice defects are partly removed after high temperature annealing

  11. Analysis of surface morphological change in PET films induced by tungsten ion implantation

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, G., E-mail: guzhou@bnu.edu.c [Analysis and Testing Center, Beijing Normal University, Beijing 100875 (China); Wang, R.; Zhang, T.H. [Key Laboratory of Beam Technology and Materials Modification of Ministry of Education, College of Nuclear Sciences and Technology, Beijing Normal University, Beijing 100875 (China); Beijing Radiation Center, Beijing 100875 (China)

    2010-09-15

    Surface morphological changes and metal nanograin formation of polyethylene terephthalate films with tungsten ion implantation were studied. Tungsten ions were accelerated with a voltage of 40 kV and implanted at fluences from 5 x 10{sup 16} to 2 x 10{sup 17} cm{sup -2} using a metal vapor vacuum arc implanter. Scanning electron micrographs at the highest fluence show semi-spherical hills, indicating formation of tungsten nanograins on the polymer. The tungsten nanograin formation in the polymer film is confirmed by cross-sectional observation using transmission electron microscopy. Depth profiles of tungsten atoms obtained from energy dispersive X-ray spectra indicate densification and sputtering of the polymer surface layer during implantation. These results indicate that surface morphological change is related with the effects of a critical fluence and tungsten nanograin formation.

  12. Complex radiological diagnosis of a breast cancer at women after augmentation mammоplasty of silicone gel implants

    Directory of Open Access Journals (Sweden)

    T. A. Shumakova

    2014-01-01

    Full Text Available One of leading problems of mammology is early diagnostics of a breast cancer. The work purpose studying of opportunities of a complex of radiological research techniques in diagnostics of a breast cancer at women after augmentation mammoplasty silicone gel implants. By results of сomplex kliniko-radiological examination of 630 women aged from 18 till 72 years (middle age made 35 ± 0.43 years with 1260 implants the breast cancer was revealed at 7 (1.1 % patients. The invasive pro-current cancer with local widespread type of body height of tumoral knot is histologically diagnosed. Sensitivity and specificity of methods of radiodiagnosis in identification of a cancer of mammary glands at women after endoprosthesis replacement made mammography – 28.6 % and 66.1 %, ultrasonography – 71.4 % and 85.7 %, magnetic resonance imaging – 85.7 % and 98.2 %, respectively. Thus, complex application of radiology research techniques raises level of diagnostics of breast cancer at patients after augmentation mammoplasty silicone gel implants that allows to choose an adequate method of treatment.

  13. Bio-activated titanium surface utilizable for mimetic bone implantation in dentistry – Part III: Surface characteristics an bone-implant contact formation

    Czech Academy of Sciences Publication Activity Database

    Strnad, J.; Strnad, Z.; Šesták, Jaroslav; Urban, K.; Povýšil, C.

    2007-01-01

    Roč. 68, - (2007), s. 841-843 ISSN 0022-3697 R&D Projects: GA AV ČR IAA100100639 Grant - others:GAMPO(CZ) FT-TA/087 Program:FT Institutional research plan: CEZ:AV0Z10100521 Keywords : implants * surface * titanium * bioactivity Subject RIV: BM - Solid Matter Physics ; Magnetism Impact factor: 0.899, year: 2007

  14. Effect of implant vs. tissue reconstruction on cancer specific survival varies by axillary lymph node status in breast cancer patients.

    Directory of Open Access Journals (Sweden)

    Qian Ouyang

    Full Text Available To compare the breast cancer-specific survival (BCSS between patients who underwent tissue or implant reconstruction after mastectomy.We used the database from Surveillance, Epidemiology, and End Results (SEER registries and compared the BCSS between patients who underwent tissue and implant reconstruction after mastectomy. Cox-regression models were fitted, adjusting for known clinicopathological features. The interaction between the reconstruction types (tissue/implant and nodal status (N-stage was investigated.A total of 6,426 patients with a median age of 50 years were included. With a median follow up of 100 months, the 10-year cumulative BCSS and non-BCSS were 85.1% and 95.4%, respectively. Patients who underwent tissue reconstruction had tumors with a higher T-stage, N-stage, and tumor grade and tended to be ER/PR-negative compared to those who received implant reconstruction. In univariate analysis, implant-reconstruction was associated with a 2.4% increase (P = 0.003 in the BCSS compared with tissue-reconstruction. After adjusting for significant risk factors of the BCSS (suggested by univariate analysis and stratifying based on the N-stage, there was only an association between the reconstruction type and the BCSS for the N2-3 patients (10-year BCSS of implant vs. tissue-reconstruction: 68.7% and 59.0%, P = 0.004. The 10-year BCSS rates of implant vs. tissue-reconstruction were 91.7% and 91.8% in N0 patients (P>0.05 and 84.5% and 84.4% in N1 patients (P>0.05, respectively.The implant (vs. tissue reconstruction after mastectomy was associated with an improved BCSS in N2-3 breast cancer patients but not in N0-1 patients. A well-designed, prospective study is needed to further confirm these findings.

  15. Interference of silicone breast implants on bioimpedance measurement of body fat.

    Science.gov (United States)

    Yamaguchi, Camila M; Faintuch, Joel; Silva, Maira M; Modolin, M; Hayashi, Silvia Y; Cecconello, I

    2012-08-01

    No study targeting the impact of silicone breast implants on body composition measured by bioimpedance analysis was identified. Aiming to clarify this question a prospective clinical study was designed. Adult candidates were submitted to conventional analysis at baseline and two months after the surgical intervention. In addition, unwrapped prostheses were positioned in the axillary cavity before operation and bioimpedance was measured, both with and without application of ultrasound gel for improved conductivity (sham implantation). Patients (N = 20) were young and healthy (26.8 ± 3.6 years old, BMI 22.1 ± 3.7 kg/m(2)). In comparison with preoperative results, sham procedures pointed out increased body fat and body resistance (13.2 ± 5.6 vs 13.6 ± 5.4 kg, P = 0.017 and 523 ± 54 vs 569 ± 53 Ω, P = 0.003, respectively). Two-month follow-up confirmed the same pattern after surgical intervention, with minor discrepancies (13.2 ± 5.6 vs 13.8 ± 5.7 kg, P = 0.011 and 523 ± 54 vs 549 ± 62 Ω, P = 0.032, respectively). BMI remained stable and did not correlate with bioimpedance changes. Silicone was recognized as adipose tissue. Difference in total body fat (approximately 600 g) was consistent with used amount. Copyright © 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  16. 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.

  17. The role of angiogenesis, inflammation and estrogen receptors in breast implant capsules development and remodeling.

    Science.gov (United States)

    Segreto, Francesco; Carotti, Simone; Marangi, Giovanni Francesco; Tosi, Daniele; Zingariello, Maria; Pendolino, Alfonso Luca; Sancillo, Laura; Morini, Sergio; Persichetti, Paolo

    2017-12-13

    Capsular contracture is the most common complication following breast implant placement. The multiple factors unbalancing the physiological response to the foreign body have not been fully elucidated. The aim of this study was to investigate the role of neo-angiogenesis, inflammation and estrogen receptors in peri-prosthetic tissue development and remodeling. The study enrolled 31 women who underwent expander substitution with definitive implant. Specimens were stained with hematoxylin/eosin, Masson trichrome, immunohistochemistry and immunofluorescence for alpha-smooth muscle actin, estrogen receptor-α (ER-α), estrogen receptor-β (ER-β), Collagen type I and III, CD31 (as a marker of neo-angiogenesis) and vascular endothelial growth factor (VEGF). Inflammatory infiltration was quantified and analyzed. Transmission electron microscopy was performed for ultrastructural evaluation. Myofibroblasts, mainly localized in the middle layer of capsular tissue, expressed VEGF, ER-α and ER-β. ER-β expression positively correlated with Collagen type I deposition (p= 0.025). Neo-angiogenesis was predominant in the middle layer. CD31 expression positively correlated with Collagen type I expression (p=0.009) and inflammatory infiltration grade (p= 0.004). The degree of inflammatory infiltration negatively correlated with the time from implantation (p = 0.022). The middle layer is key in the development and remodeling of capsular tissue. Myofibroblasts produce VEGF, that induces neo-angiogenesis. New vessels formation is also correlated to the inflammatory response. Collagen deposition is associated with ER-β expression and neo-angiogenesis. These findings may prelude to targeted pharmacologic therapies able to control such interactions, thus hampering the self-sustaining loop promoting the progression of physiologic fibrosis toward pathologic contracture. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier

  18. AFM-investigation of differently treated Ti-surfaces with respect to their usability for dental implants

    Energy Technology Data Exchange (ETDEWEB)

    Wille, Sebastian; Adelung, Rainer [Funktionale Nanomaterialien, Institut fuer Materialwissenschaft, CAU Kiel Kaiserstr. 2 24143 Kiel (Germany); Yang, Bin [Klinik fuer Zahnaerztliche Prothetik, Propaedeutik und Werkstoffkunde, Arnold-Heller-Strasse 16, 24105 Kiel (Germany); Groessner-Schreiber, Birte [Klinik fuer Zahnerhaltungskunde und Parodontologie, Arnold-Heller-Str. 16, 24105 Kiel (Germany)

    2008-07-01

    Microbial adherence to dental implant surfaces is one initiating step in the formation of plaque and is considered to be an important event in the pathogenesis of peri-implant disease. Besides good connective tissue adhesion in the transmucosal part of an implant, titanium implants exposed to the oral cavity require surface modification to inhibit the adherence of oral bacteria. Surface roughness and chemical composition of the implant surface were found to have a significant impact on plaque formation. The aim of the present study was to examine bacterial adherence of differently modified potential implant surfaces. Therefore the surface roughness was decreased and for example a thin ceramic or composite layer of antibacterial material was deposited on abutment surface by sputtering. We analyze the new surface with AFM to control the roughness. For further characterization contact angle measurements were carried out. Biocompatibility and antibacterial effects will be determined in cooperation with the dental clinic at the University Kiel.

  19. Biofunctionalization of the implant surface with different concentrations of a synthetic peptide (P-15).

    Science.gov (United States)

    Lutz, R; Prechtl, C; Nonhoff, J; Weisel, T; Damien, C J; Schlegel, K A

    2013-07-01

    This study aimed at identifying the ideal concentration of a biofunctional surface coating of dental implants with a synthetic peptide (P-15). In a previous study, P-15 was shown to enhance osseointegration parameters. Implants (modified ANKYLOS(®) A8; FRIADENT Plus(®) surface) with five different concentrations (0-400 μg/ml) of a P-15 coating as well as uncoated controls were inserted in the frontal bone of 45 adult domestic pigs. The histomorphometric and microradiographic findings for the coated implants were compared to those for the uncoated ones after 7, 14, and 30 days. No significant differences were observed comparing the peri-implant bone density between the coated and uncoated implants The bone-to-implant contact, as the primary histological parameter for osseointegration, showed high rates for all surfaces investigated (between 73.3 ± 17.9% for the control and 81.9 ± 15.2% for P15 20 μg/ml after 30 days). No significant benefit on osseointegration of a biofunctional P-15 coating of dental implants could be displayed in the present study. © 2012 John Wiley & Sons A/S.

  20. Expander/implant breast reconstruction before radiotherapy. Outcomes in a single-institute cohort

    Energy Technology Data Exchange (ETDEWEB)

    Aristei, C.; Palumbo, I. [Perugia Univ. (Italy). Radiation Oncology Section; Santa Maria della Misericordia Hospital, Perugia (Italy); Falcinelli, L.; Petitto, R.P.; Perrucci, E. [Santa Maria della Misericordia Hospital, Perugia (Italy). Radiation Oncology Div.; Bini, V. [Perugia Univ. (Italy). Dept. of Internal Medicine; Farneti, A. [Perugia Univ. (Italy). Radiation Oncology Section; Gori, S. [Santa Maria della Misericordia Hospital, Perugia (Italy). Medical Oncology Div.

    2012-12-15

    Background and purpose: Radiotherapy (RT) of reconstructed breasts was associated with major complications and poor cosmetic outcome. The present study assessed complication rates, the link between risk factors and prosthesis removal, as well as cosmetic outcomes. Patients and methods: From 1997 to 2009, 101 consecutive patients received RT after breast reconstruction because of risk factors for relapse (92) or because relapse had occurred (9). At RT, 90 patients had temporary tissue expanders and 11 had permanent implants. Twelve patients underwent neo-adjuvant chemotherapy; all patients received adjuvant chemo- and/or hormone therapy. Results: At a median follow-up of 50 months, late toxicities occurred in 28 patients: pain in 7, lymphedema in 6, G1 cutaneous toxicity in 5, and subcutaneous toxicity in 19 (2G1, 9G2, 7G3, 1G4), with more than one side effect in 12. In 8 patients the prosthesis ruptured (3), was displaced (3), was displaced and ruptured (1), or lost shape (1). Capsular contracture was classified in 89 patients as IA in 14, IB in 47, II in 10, III in 11, and IV in 7. Twelve prostheses (11.9%) were removed. The only significant factor for prosthesis removal was age (p = 0.007). Judgments of cosmetic results were available from 81 physicians and 84 patients. Outcome was excellent/good in 58/81 physician judgments and in 57/84 patient evaluations. Overall inter-rater agreement on outcome was good ({kappa}-value 0.64; 95% CI: 0.48-0.79). Conclusion: RT to reconstructed breasts was associated with low rates of late toxicity and prosthesis removal. Cosmetic outcomes were, on the whole, good to excellent. (orig.)

  1. Surface Damage on Dental Implants with Release of Loose Particles after Insertion into Bone.

    Science.gov (United States)

    Senna, Plinio; Antoninha Del Bel Cury, Altair; Kates, Stephen; Meirelles, Luiz

    2015-08-01

    Modern dental implants present surface features of distinct dimensions that can be damaged during the insertion procedure into bone. The aims of this study were (1) to quantify by means of roughness parameters the surface damage caused by the insertion procedure of dental implants and (2) to investigate the presence of loose particles at the interface. Three groups of dental implants representing different surface topographies were inserted in fresh cow rib bone blocks. The surface roughness was characterized by interferometry on the same area before and after the insertion. Scanning electron microscopy (SEM)-back-scattered electron detector (BSD) analysis was used to identify loose particles at the interface. The amplitude and hybrid roughness parameters of all three groups were lower after insertion. The surface presenting predominance of peaks (Ssk [skewness] > 0) associated to higher structures (height parameters) presented higher damage associated to more pronounced reduction of material volume. SEM-BSD images revealed loose titanium and aluminum particles at the interface mainly at the crestal cortical bone level. Shearing forces during the insertion procedure alters the surface of dental implants. Loose metal particles can be generated at bone-implant interface especially around surfaces composed mainly by peaks and with increased height parameters. © 2013 Wiley Periodicals, Inc.

  2. Comparison of Outcomes with Tissue Expander, Immediate Implant, and Autologous Breast Reconstruction in Greater Than 1000 Nipple-Sparing Mastectomies.

    Science.gov (United States)

    Frey, Jordan D; Choi, Mihye; Salibian, Ara A; Karp, Nolan S

    2017-06-01

    Nipple-sparing mastectomy permits complete preservation of the nipple-areola complex with excellent aesthetic results and with oncologic safety similar to that associated with traditional mastectomy techniques. However, outcomes have not been directly compared for tissue expander-, immediate implant-, and autologous tissue-based breast reconstruction after nipple-sparing mastectomy. All patients undergoing nipple-sparing mastectomy from 2006 to June of 2016 were identified at a single institution. Demographics and outcomes were analyzed and compared among different types of breast reconstruction. A total of 1028 nipple-sparing mastectomies were performed. Of these, 533 (51.8 percent) were tissue expander-based, 263 (25.6 percent) were autologous tissue-based, and 232 (22.6 percent) were immediate implant-based reconstructions. Tissue expander-based reconstructions had significantly more minor cellulitis (p = 0.0002) but less complete nipple necrosis (p = 0.0126) and major mastectomy flap necrosis (p < 0.0001) compared with autologous tissue-based reconstructions. Compared to immediate implant-based reconstruction, tissue expander-based reconstructions had significantly more minor cellulitis (p = 0.0006) but less complete nipple necrosis (p = 0.0005) and major (p < 0.0001) and minor (p = 0.0028) mastectomy flap necrosis (p = 0.0059). Immediate implant-based reconstructions had significantly more minor cellulitis (p = 0.0051), minor mastectomy flap necrosis (p = 0.0425), and partial nipple necrosis (p = 0.0437) compared with autologous tissue-based reconstructions. Outcomes were otherwise equivalent among the three groups. Tissue expander, immediate implant, and autologous tissue breast reconstruction techniques may all be safely offered with nipple-sparing mastectomy. However, reconstructive complications appear to be greater with immediate implant- and autologous tissue-based techniques compared with tissue expander-based reconstruction. Therapeutic, III.

  3. Silver-based antibacterial surfaces for bone implants

    NARCIS (Netherlands)

    Necula, B.S.

    2013-01-01

    Total hip arthroplasty (THA) is the most effective and safest method for treating severe degenerative, post-traumatic and other diseases of the joints. With an aging population that is increasingly active, the use of biomedical implants will continue to rise. It is estimated that more than 1,000,000

  4. Biomechanical evaluation and surface characterization of a nano-modified surface on PEEK implants: a study in the rabbit tibia

    Science.gov (United States)

    Johansson, Pär; Jimbo, Ryo; Kjellin, Per; Currie, Fredrik; Chrcanovic, Bruno Ramos; Wennerberg, Ann

    2014-01-01

    Polyether ether ketone (PEEK) is today frequently used as a biomaterial in different medical operations due to its excellent mechanical and chemical properties. However, the untreated surface of PEEK is bioinert and hydrophobic, and it does not osseointegrate in its pure form. The aim of this study was to evaluate a unique nano-modified surface of PEEK with respect to osseointegration. Forty-eight threaded, non-cutting PEEK implants were inserted bilaterally in the tibia of 24 rabbits. Half of the implants (n=24) were coated with nanocrystalline hydroxyapatite (test) and the remaining implants (n=24) were left uncoated (control). Half of the animals (n=12) were euthanized after 3 weeks of healing and the remaining (n=12) after 12 weeks. The implant retention was measured with a removal torque apparatus. Surface analysis was performed with interferometry, scanning electron microscopy, and X-ray photon spectroscopy to relate the removal torque to the applied surface. The test implants revealed a significantly higher retention after 3 weeks (P=0.05) and 12 weeks (P=0.028) compared to controls. The result of the present study proves that the addition of nanocrystalline hydroxyapatite coating to PEEK surfaces significantly increases its removal torque and biocompatibility. PMID:25152620

  5. Si+ ion implantation reduces the bacterial accumulation on the Ti6Al4V surface

    Science.gov (United States)

    Gallardo-Moreno, A. M.; Pacha-Olivenza, M. A.; Perera-Núñez, J.; González-Carrasco, J. L.; González-Martín, M. L.

    2010-11-01

    Ti6Al4V is one of the most commonly used biomaterials in orthopedic applications due to its interesting mechanical properties and reasonable biocompatibility. Nevertheless, after the implantation, microbial adhesion to its surface can provoke severe health problems associated to the development of biofilms and subsequent infectious processes. This work shows a modification of the Ti6Al4V surface by Si+ ion implantation which reduces the bacterial accumulation under shear forces. Results have shown that the number of bacteria remaining on the surface at the end of the adhesion experiments decreased for silicon-treated surface. In general, the new surface also behaved as less adhesive under in vitro flow conditions. Since no changes are observed in the electrical characteristics between the control and implanted samples, differences are likely related to small changes observed in hydrophobicity.

  6. Enhancing the antibacterial performance of orthopaedic implant materials by fibre laser surface engineering

    DEFF Research Database (Denmark)

    Chan, Chi-Wai; Carson, Louise; Smith, Graham C.

    2017-01-01

    to the effort on enhancing osseointegration, wear and corrosion resistance of implant materials. In this study, the effects of laser surface treatment on enhancing the antibacterial properties of commercially pure (CP) Ti (Grade 2), Ti6Al4V (Grade 5) and CoCrMo alloy implant materials were studied and compared...... for the first time. Laser surface treatment was performed by a continuous wave (CW) fibre laser with a near-infrared wavelength of 1064 nm in a nitrogen-containing environment. Staphylococcus aureus, commonly implicated in infection associated with orthopaedic implants, was used to investigate the antibacterial...... properties of the laser-treated surfaces. The surface roughness and topography of the laser-treated materials were analysed by a 2D roughness testing and by AFM. The surface morphologies before and after 24 h of bacterial cell culture were captured by SEM, and bacterial viability was determined using live...

  7. Giant desmoid tumour of the thorax following latissimus dorsi and implant breast reconstruction: case report and review of the literature

    LENUS (Irish Health Repository)

    Collins, AM

    2017-03-01

    The case of a giant thoracic desmoid tumour in a 44-year-old woman, who presented two years following a breast reconstruction with a latissimus dorsi (LD) flap and implant, is reported. Clinical findings included a rapidly growing, painless mass. Computed tomography (CT) suggested skin and intercostal soft tissue invasion. The tumour was resected en bloc with the LD muscle, implant capsule and underlying rib segments. The resultant thoracic and abdominal wall defects were reconstructed with Dualmesh® and polypropylene meshes respectively. There was no evidence of recurrence at thirty-six months follow-up.

  8. Temperature evaluation of dental implant surface irradiated with high-power diode laser.

    Science.gov (United States)

    Rios, F G; Viana, E R; Ribeiro, G M; González, J C; Abelenda, A; Peruzzo, D C

    2016-09-01

    The prevalence of peri-implantitis and the absence of a standard approach for decontamination of the dental implant surface have led to searches for effective therapies. Since the source of diode lasers is portable, has reduced cost, and does not cause damage to the titanium surface of the implant, high-power diode lasers have been used for this purpose. The effect of laser irradiation on the implants is the elevation of the temperature surface. If this elevation exceeds 47 °C, the bone tissue is irreversibly damaged, so for a safety therapy, the laser parameters should be controlled. In this study, a diode laser of GaAsAl was used to irradiate titanium dental implants, for powers 1.32 to 2.64 W (real) or 2.00 to 4.00 W (nominal), in continuous/pulsed mode DC/AC, with exposure time of 5/10 s, with/without air flow for cooling. The elevation of the temperature was monitored in real time in two positions: cervical and apical. The best results for decontamination using a 968-nm diode laser were obtained for a power of 1.65 and 1.98 W (real) for 10 s, in DC or AC mode, with an air flow of 2.5 l/min. In our perspective in this article, we determine a suggested approach for decontamination of the dental implant surface using a 968-nm diode laser.

  9. Early osseointegration driven by the surface chemistry and wettability of dental implants

    Directory of Open Access Journals (Sweden)

    Suelen Cristina SARTORETTO

    2015-06-01

    Full Text Available Objective The objective of this study was to investigate the impact of two different commercially available dental implants on osseointegration. The surfaces were sandblasting and acid etching (Group 1 and sandblasting and acid etching, then maintained in an isotonic solution of 0.9% sodium chloride (Group 2. Material and Methods X-ray photoelectron spectroscopy (XPS was employed for surface chemistry analysis. Surface morphology and topography was investigated by scanning electron microscopy (SEM and confocal microscopy (CM, respectively. Contact angle analysis (CAA was employed for wetting evaluation. Bone-implant-contact (BIC and bone area fraction occupied (BAFO analysis were performed on thin sections (30 μm 14 and 28 days after the installation of 10 implants from each group (n=20 in rabbits' tibias. Statistical analysis was performed by ANOVA at the 95% level of significance considering implantation time and implant surface as independent variables. Results Group 2 showed 3-fold less carbon on the surface and a markedly enhanced hydrophilicity compared to Group 1 but a similar surface roughness (p>0.05. BIC and BAFO levels in Group 2 at 14 days were similar to those in Group 1 at 28 days. After 28 days of installation, BIC and BAFO measurements of Group 2 were approximately 1.5-fold greater than in Group 1 (p<0.05. Conclusion The surface chemistry and wettability implants of Group 2 accelerate osseointegration and increase the area of the bone-to-implant interface when compared to those of Group 1.

  10. Surface morphology analysis of dental implants following insertion into bone using scanning electron microscopy: a pilot study.

    Science.gov (United States)

    Deppe, Herbert; Grünberg, Christina; Thomas, Mücke; Sculean, Anton; Benner, Klaus-Ulrich; Bauer, Florian J M

    2015-11-01

    Dental implants have become essential in reconstructive dentistry. Primary healing is determined by the design of their surface. The aim of this pilot study has been to investigate whether the morphology of the sandblasted and acid-etched (SLA(®) ) surface remains unaffected after the insertion process into human bone. Two edentulous-atrophied human jaw specimens were used. Six brand new Straumann Standard RN implants with an SLA(®) surface and having a diameter of 3.3 mm and a length of 12 mm were inserted. Another two implants of the same type, but not inserted into bone, served as a reference. After explantation, the four implants were cleaned in an ultrasonic bath and two were left uncleaned. All eight implants were inspected by SEM for qualitative surface changes. All four implants showed relevant changes of the topography at the apical thread flanks. The non-cleaned implants showed an almost complete coverage of the surface by a honeycomb-like structure, consistent with bone residues. The reference implants showed no changes. The results indicate that, for the osseointegration of dental implants, subtractive modifications of implant surfaces are less important than the reestablishment of the destroyed TiO2 layer. Further studies of other implant surfaces are required to verify the present results. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. 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.

  12. Cinnamon Oil and Chitosan Coating on Orthopaedic Implant Surface for Prevention of Staphylococcus Epidermidis Biofilm Formation

    Directory of Open Access Journals (Sweden)

    R Magetsari

    2014-11-01

    Full Text Available S. Epidermidis is among the most frequently isolated microorganisms found in -infection related to implanted devices and the formation of biofilm will be more resistantcompared to the planktonic form. This study was carried out determine the effect of coating on stainless steel orthopaedic implants surfaces with cinnamon oil and chitosan as bioadhesive to prevent biofilms formation of S. Epidermidis.The rod shaped stainless steel 316 L orthopaedic implant with 5 mm diameters was coated 2 times using a mixture of cinnamon oil and chitosan 3% and 2% respectively with serial concentration of cinnamon from 0.125% to 2%. The coated implants were then put into tubes that contained bacterial suspension and incubated. Subsequently, the implants were washed with PBS solution followed by MTT soulution and isopropanol acid solution that related to biofilm formation. The results were expressed in numbers which represents the absorbance level at ELISA readings on 575 nm (A575 wavelength.The stainless steel implant coated with chitosan and cinnamon oil 2% and 1% has lower absorbance level compared with the absorbance level of S.Epidermidis biofilm only. This study showed that mixture of cinnamon oil and chitosan coated on the surface of stainless steel orthopaedic implant has an effect against S.Epidermidis biofilm formation with minimum cinnamon oil concentration of 1%.

  13. Morphology and Differentiation of MG63 Osteoblast Cells on Saliva Contaminated Implant Surfaces

    Directory of Open Access Journals (Sweden)

    Neda Shams

    2015-11-01

    Full Text Available Objectives: Osteoblasts are the most important cells in the osseointegration process. Despite years of study on dental Implants, limited studies have discussed the effect of saliva on the adhesion process of osteoblasts to implant surfaces. The aim of this in vitro study was to evaluate the effect of saliva on morphology and differentiation of osteoblasts attached to implant surfaces.Materials and Methods: Twelve Axiom dental implants were divided into two groups. Implants of the case group were placed in containers, containing saliva, for 40 minutes. Then, all the implants were separately stored in a medium containing MG63 human osteoblasts for a week. Cell morphology and differentiation were assessed using a scanning electron microscope and their alkaline phosphatase (ALP activity was determined. The t-test was used to compare the two groups.Results: Scanning electron microscopic observation of osteoblasts revealed round or square cells with fewer and shorter cellular processes in saliva contaminated samples, whereas elongated, fusiform and well-defined cell processes were seen in the control group. ALP level was significantly lower in case compared to control group (P<0.05.Conclusion: Saliva contamination alters osteoblast morphology and differentiation and may subsequently interfere with successful osseointegration. Thus, saliva contamination of bone and implant must be prevented or minimized.

  14. 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

  15. RE: Prosthetic Breast Implant Rupture: Imaging-Pictorial Essay : Full Cooperation Between Surgeon and Radiologist: "The Best of Both Worlds".

    Science.gov (United States)

    Marcasciano, M; Conversi, A; Kaciulyte, J; Dessy, L A

    2017-12-01

    Cooperation between plastic surgeons and radiologists is fundamental when breast prosthesis rupture is suspected. We describe our experience managing the case of suspected implant rupture in a patient that underwent CT scan imaging for thoracic pain. Poor clinical information given to radiologists leads to wrong diagnosis: during surgery, both prostheses were checked revealing no signs of rupture. Full communication among different specialists involved in the multidisciplinary approach is always recommended, and an easy-to-use national breast implant register would allow a better management of patients' follow-up and eventual preoperative planning. Level of evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  16. Fringe projection application for surface variation analysis on helical shaped silicon breast

    Science.gov (United States)

    Vairavan, R.; Ong, N. R.; Sauli, Z.; Shahimin, M. M.; Kirtsaeng, S.; Sakuntasathien, S.; Alcain, J. B.; Paitong, P.; Retnasamy, V.

    2017-09-01

    Breast carcinoma is rated as a second collective cause of cancer associated death among adult females. Detection of the disease at an early stage would enhance the chance for survival. Established detection methods such as mammography, ultrasound and MRI are classified as non invasive breast cancer detection modality, but however they are not entire non-invasive as physical contact still occurs to the breast. Thus requirement for a complete non invasive and non contact is evident. Therefore, in this work, a novel application of digital fringe projection for early detection of breast cancer based on breast surface analysis is reported. Phase shift fringe projection technique and pixel tracing method was utilized to analyze the breast surface change due to the incidence of breast lump. Results have shown that the digital fringe projection is capable in detecting the existence of 1 cm sized lump within the breast sample.

  17. Effect of implantoplasty on fracture resistance and surface roughness of standard diameter dental implants.

    Science.gov (United States)

    Costa-Berenguer, Xavier; García-García, Marta; Sánchez-Torres, Alba; Sanz-Alonso, Mariano; Figueiredo, Rui; Valmaseda-Castellón, Eduard

    2018-01-01

    To assess the effect of implantoplasty on the fracture resistance, surface roughness, and macroscopic morphology of standard diameter (4.1 mm) external connection dental implants. An in vitro study was conducted in 20 screw-shaped titanium dental implants with an external connection. In 10 implants, the threads and surface were removed and polished with high-speed burs (implantoplasty), while the remaining 10 implants were used as controls. The final implant dimensions were recorded. The newly polished surface quality was assessed by scanning electron microscopy (SEM) and by 3D surface roughness analysis using a confocal laser microscope. Finally, all the implants were subjected to a mechanical pressure resistance test. A descriptive analysis of the data was made. Also, Student's t tests were employed to detect differences regarding the compression tests. Implantoplasty was carried out for a mean time of 10 min and 48 s (standard deviation (SD) of 1 min 22 s). Macroscopically, the resulting surface had a smooth appearance, although small titanium shavings and silicon debris were present. The final surface roughness (S a values 0.1 ± 0.02 μm) was significantly lower than that of the original (0.75 ± 0.08 μm S a ) (p = .005). There was minimal reduction in the implant's inner body diameter (0.19 ± 0.03 mm), and no statistically significant differences were found between the test and control implants regarding the maximum resistance force (896 vs 880 N, respectively). Implantoplasty, although technically demanding and time-consuming, does not seem to significantly alter fracture resistance of standard diameter external connection implants. A smooth surface with S a values below 0.1 μm can be obtained through the use of silicon polishers. A larger sample is required to confirm that implantoplasty does not significantly affect the maximum resistance force of standard diameter external connection implants. © 2017 John Wiley & Sons A/S. Published

  18. Human fetal osteoblast behavior on zirconia dental implants and zirconia disks with microstructured surfaces. An experimental in vitro study.

    Science.gov (United States)

    Delgado-Ruíz, Rafael Arcesio; Gomez Moreno, Gerardo; Aguilar-Salvatierra, Antonio; Markovic, Aleksa; Mate-Sánchez, Jose Eduardo; Calvo-Guirado, José Luis

    2016-11-01

    To measure the lateral surface area of microgrooved zirconia implants, to evaluate the cell geometry and cell density of human fetal osteoblasts seeded on zirconia microgrooved implants, to describe the surface roughness and chemistry, and to evaluate the activity of human fetal osteoblasts seeded on zirconia microgrooved disks. This experimental in vitro study used 62 zirconia implants and 130 zirconia disks. Two experimental groups were created for the implants: 31 non-microgrooved implants (Control) and 31 microgrooved implants (Test); two experimental groups were created for the disks: 65 non-microgrooved disks (Control) and 65 microgrooved disks (Test). The following evaluations of the implants were made: lateral surface area (LSA), cell morphology, and density of human fetal osteoblasts seeded on implant surfaces. On the disks, surface parameters (roughness and chemistry) and cell activity (alkaline phosphatase - ALP and alizarin red - ALZ) were evaluated at 7 and 15 days. LSA was lower for control implants (62.8 mm) compared with test implants (128.74 mm) (P implants presented cells rich in lamellipodia prolongations, attached to the inner walls or to the borders of the microgrooves and in the flat areas between the microgrooves. Cell density was higher in the test group compared with controls (P implants with microgrooves. (ii) The LSA of microgrooved zirconia implants is greater and provides more available surface compared with implants of the same dimensions without microgrooves. (iii) Microgrooves on zirconia implants modify the morphology and guide the size and alignment of human fetal osteoblasts. (iv) Zirconia surfaces with microgrooves of 30 μm width and 70 μm separation between grooves enhance ALP and ALZ expression by human fetal osteoblasts. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Surface characteristics and bioactivity of a novel natural HA/Zircon nanocomposite coated on dental implants

    NARCIS (Netherlands)

    Karamian, E.; Khandan, A.; Motamedi, M.R.K.; Mirmohammadi, H.

    2014-01-01

    The surface characteristics of implant which influence the speed and strength of osseointegration include surface chemistry, crystal structure and crystallinity, roughness, strain hardening, and presence of impurities. The aim of this study was to evaluate the bioactivity and roughness of a novel

  20. Enhanced osteointegration of medical titanium implant with surface modifications in micro/nanoscale structures

    Directory of Open Access Journals (Sweden)

    Liwen Lin

    2014-01-01

    Full Text Available Biomimetic design and substrate-based surface modification of medical implants will help to improve the integration of tissue to its material interfaces. Surface energy, composition, roughness, and topography all influence the biological responses of the implants, such as protein adsorption and cell adhesion, proliferation and differentiation. In the current study, different surface structures of Ti implants were constructed using facile surface techniques to create various micro-, nano-, and nano/micro composite scale topography. We have fabricated three types of hierarchical structures of TiO2 coating on Ti implants, including nanotube structure, nano sponge-like structure, and nano/micro nest-like structure. The osteointegration and biomechanical performance of the coated Ti screws were evaluated by histology and removal of torque force test in vivo. We found that the nano/micro nest-like and nanotube structured surface possessed better osteointegration ability. It indicated that the alkaline hydrothermally treated Ti substrate was the best for bone-implant integration in terms of all in vitro and in vivo testing parameters. The alkaline hydrothermally treated surface displayed a hydrophilic (contact angle value 5.92 ± 1.2, higher roughness (Ra value 911.3 ± 33.8 nm, higher specific surface area (8.26 ± 1.051 m2/g, and greater apatite inductivity. The electrochemical surface modification may become a powerful approach to enhance metal implant to bone integration in orthopaedic applications.

  1. Nanomodified Peek Dental Implants: Bioactive Composites and Surface Modification—A Review

    Directory of Open Access Journals (Sweden)

    Shariq Najeeb

    2015-01-01

    Full Text Available Purpose. The aim of this review is to summarize and evaluate the relevant literature regarding the different ways how polyetheretherketone (PEEK can be modified to overcome its limited bioactivity, and thereby making it suitable as a dental implant material. Study Selection. An electronic literature search was conducted via the PubMed and Google Scholar databases using the keywords “PEEK dental implants,” “nano,” “osseointegration,” “surface treatment,” and “modification.” A total of 16 in vivo and in vitro studies were found suitable to be included in this review. Results. There are many viable methods to increase the bioactivity of PEEK. Most methods focus on increasing the surface roughness, increasing the hydrophilicity and coating osseoconductive materials. Conclusion. There are many ways in which PEEK can be modified at a nanometer level to overcome its limited bioactivity. Melt-blending with bioactive nanoparticles can be used to produce bioactive nanocomposites, while spin-coating, gas plasma etching, electron beam, and plasma-ion immersion implantation can be used to modify the surface of PEEK implants in order to make them more bioactive. However, more animal studies are needed before these implants can be deemed suitable to be used as dental implants.

  2. Laser-induced novel patterns: As smart strain actuators for new-age dental implant surfaces

    Energy Technology Data Exchange (ETDEWEB)

    Celen, Serap, E-mail: serap.celen@ege.edu.tr [Ege University, Faculty of Engineering, Mechanical Engineering Department, Izmir, 35100 (Turkey); Oezden, Hueseyin [Ege University, Faculty of Engineering, Mechanical Engineering Department, Izmir, 35100 (Turkey)

    2012-12-15

    Highlights: Black-Right-Pointing-Pointer It is time for that paradigm shift and for an exploration of novel surfaces. Black-Right-Pointing-Pointer We developed novel 3D smart surfaces as strain actuators by nanosecond laser pulse energies. Black-Right-Pointing-Pointer We analyzed these smart surface morphologies using FEM. Black-Right-Pointing-Pointer We estimated their internal stiffness values which play a great role on stress shielding effect. Black-Right-Pointing-Pointer We gave the optimum operation parameters. - Abstract: Surface morphologies of titanium implants are of crucial importance for long-term mechanical adaptation for following implantation. One major problem is the stress shielding effect which originates from the mismatch of the bone and the implant elasticity. It is time for a paradigm shift and for an exploration of novel smart surfaces to prevent this problem. Several surface treatment methods have traditionally been used to modify the surface morphology of titanium dental implants. The laser micro-machining can be considered as a unique and promising, non-contact, no media, contamination free, and flexible treatment method for modifying surface properties of materials in the biomedical industry. The aim of the present study is two folds; to develop novel 3D smart surfaces which can be acted as strain actuators by nanosecond laser pulse energies and irradiation strategies. And analyze these smart surface morphologies using finite element methods in order to estimate their internal stiffness values which play a great role on stress shielding effect. Novel 3D smart strain actuators were prepared using an ytterbium fiber laser ({lambda} = 1060 nm) with 200-250 ns pulse durations on commercial pure titanium dental implant material specimen surfaces and optimum operation parameters were suggested.

  3. Safety and efficacy of additive and subtractive surface modification of Ti6Al4V endosseous implant in goat bone.

    Science.gov (United States)

    Mistry, Surajit; Roy, Subhasis; Jyoti Maitra, Nilendu; Roy, Rajiv; Datta, Someswar; Chanda, Abhijit; Sarkar, Soumya

    2016-04-01

    Growing interest of endosseous implant research is focused on surface modification to achieve early and strong osseointegration. The present study compared the behaviour of hydroxyapatite coated, zinc doped hydroxyapatite coated and hydrothermally treated titanium (Ti6Al4V) with machined Ti6Al4V implants (control) on osseointegration. The surface characterization and bacterial affinity test for implants were performed. Forty eight (48) cylinders (4 types in each animal) were placed in the humerus bone of 12 black Bengal goats. Bone-implant interface was examined with histological, radiological parameters and scanning electron microscopy on 42nd, 90th, and 180th day post-implantation. Surface roughness alterations of bone-detached implants with time were analyzed by non-contact profilometer. Push-out test (90th day) was performed to assess the strength of bony integration of implants. The coated implants revealed direct and early bone-implant contact but high bacterial affinity and coating resorption/cracks. Low bacterial affinity and strongest osseointegration was observed with hydrothermally treated implants. Poor bacterial affinity and delayed but strong fixation were evident with control implant. Based on the results of laboratory and animal experiments, we conclude that the hydrothermal modification of titanium implant is the more suitable way to achieve safe and effective osseointegration than the other three implant types for endosseous application. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. 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.

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

    Science.gov (United States)

    Shah, Furqan A; Johansson, Martin L; 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 which

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

    Directory of Open Access Journals (Sweden)

    Furqan A Shah

    Full Text Available 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

  7. Intraoperative instillation of ropivacaine during the placement of sub-muscular cosmetic breast implants: Is there a clinical benefit?

    Science.gov (United States)

    Picard, F; Niddam, J; De Runz, A; Chaouat, M; Mimoun, M; Boccara, D

    2017-10-09

    The sub-muscular placement of cosmetic breast implants leads to substantial pain due to the muscular distention. The aim of this study was to assess the efficiency of intraoperative ropivacaine instillation to reduce postoperative pain the day after surgery. We conducted a prospective, controlled, single-blinded study comparing the intraoperative instillation of 7.5mg of ropivacaine through Redon drains with the standard procedure in 72 patients undergoing sub-muscular cosmetic breast augmentation for the first time. Pain at the awakening on postoperative day 1 was 4.8 on a simple numeric pain scale in the treatment group and 5.1 in the control group (P>0.05). On postoperative day 3, pain at awakening was 3.7 in both groups (P>0.05), and on postoperative day 5, pain was 2.8 in the treatment group and 2.7 in the control group (P>0.05). Local instillation of ropivacaine in the implant pocket during surgery did not decrease postoperative pain on day 1, day 3 and day 5. From now on, we are able to tell to patients that the postoperative pain after sub-muscular cosmetic breast implants surgery is about 5/10 on postoperative day 1, 4/10 at day 3 and 3/10 at day 5. Level II. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  8. Axillary Lymphadenopathy: An Outstanding Presentation for Breast Implant-Associated ALK-Negative Anaplastic Large Cell Lymphoma.

    Science.gov (United States)

    Tardío, Juan C; Granados, Rosario

    2015-08-01

    Till date, there is only one reported case of breast implant-associated ALK-negative anaplastic large cell lymphoma (ALCL) with an axillary presentation that followed an aggressive behavior. We report the case of a 50-year-old female presenting with an axillary lymphadenopathy 8 years after breast prostheses implantation. Clinical examination, ultrasound, and magnetic resonance imaging detected no mammary lesions. The lymph node showed intrasinusoidal infiltration by large pleomorphic cells expressing CD30 and lacking ALK-immunoreactivity. Tumor staging was negative. Cells with identical features were found in the ipsilateral periprosthetic capsule. The patient was treated with CHOP and radiotherapy, and she is alive without evidence of disease after a 30-month follow-up. The diagnosis of an ALK-negative ALCL in an axillary lymph node of a patient with ipsilateral breast prosthesis and negative staging should prompt removal of the implant with capsulectomy, since the pathological study of this specimen allows the correct diagnosis with important prognostic implications. © The Author(s) 2015.

  9. In vitro comparison of two titanium dental implant surface treatments: 3M?ESPE? MDIs versus Ankylos?

    OpenAIRE

    Dhaliwal, Jagjit Singh; Marulanda, Juliana; Li, Jingjing; Alebrahim, Sharifa; Feine, Jocelyne Sheila; Murshed, Monzur

    2017-01-01

    Background An ideal implant should have a surface that is conducive to osseointegration. In vitro cell culture studies using disks made of same materials and surface as of implants may provide useful information on the events occurring at the implant-tissue interface. In the current study, we tested the hypothesis that there is no difference in the proliferation and differentiation capacities of osteoblastic cells when cultured on titanium disks mimicking the surface of 3M?ESPE? MDIs or stand...

  10. Surface area analysis of dental implants using micro-computed tomography.

    Science.gov (United States)

    Schicho, Kurt; Kastner, Johann; Klingesberger, Roman; Seemann, Rudolf; Enislidis, Georg; Undt, Gerhard; Wanschitz, Felix; Figl, Michael; Wagner, Arne; Ewers, Rolf

    2007-08-01

    In this study, we present and evaluate a micro-computed tomography (micro-CT)-based method for the calculation of the potential bone/implant contact area (p-BICA) on the surface of dental implants. For seven commercially available implants (Ankylos implant, Brånemark System, Frialit CELLplus, Replace((R)) Select Tapered, Straumann Solid screw, XiVE S CELLplus, 3i Osseotite XP Threaded Miniplant, the p-BICA surface is determined by means of three-dimensional X-ray computed-tomography and computer-based data processing. Measurements were repeated two times, and the stability and repeatability of the measurement method were evaluated. Our analysis revealed a p-BICA of 118 mm(2) for the XiVE S CELLplus implant, 134 mm(2) for the Ankylos, 136 mm(2) for the Frialit CELLplus, 138 mm(2) for the Brånemark System, 139 mm(2) for the Replace((R)), 159 mm(2) for the 3i Osseotite XP and 199 mm(2) for the Straumann Solid screw implant. The measurement method proved to be stable and led to reproducible results. The micro- and macrostructure of dental implants define the surface and the p-BICA. Precise determination of this parameter can be achieved by means of the micro-CT-based method as presented in this study. The value of p-BICA lies in the predictability of industrial design before preclinical and clinical testing. Based on this method, dental implant properties become comparable even if geometrical details are not disclosed by the manufacturer.

  11. Electrostatic self-assembly of multilayer copolymeric membranes on the surface of porous tantalum implants for sustained release of doxorubicin.

    Science.gov (United States)

    Guo, Xinming; Chen, Muwan; Feng, Wenzhou; Liang, Jiabi; Zhao, Huibin; Tian, Lin; Chao, Hui; Zou, Xuenong

    2011-01-01

    Many studies in recent years have focused on surface engineering of implant materials in order to improve their biocompatibility and other performance. Porous tantalum implants have increasingly been used in implant surgeries, due to their biocompatibility, physical stability, and good mechanical strength. In this study we functionalized the porous tantalum implant for sustained drug delivery capability via electrostatic self-assembly of polyelectrolytes of hyaluronic acid, methylated collagen, and terpolymer on the surface of a porous tantalum implant. The anticancer drug doxorubicin was encapsulated into the multilayer copolymer membranes on the porous tantalum implants. Results showed the sustained released of doxorubicin from the functionalized porous tantalum implants for up to 1 month. The drug release solutions in 1 month all had inhibitory effects on the proliferation of chondrosarcoma cell line SW1353. These results suggest that this functionalized implant could be used in reconstructive surgery for the treatment of bone tumor as a local, sustained drug delivery system.

  12. Prophylactic Nipple-Sparing Mastectomy and Direct-to-Implant Reconstruction of the Large and Ptotic Breast

    DEFF Research Database (Denmark)

    Gunnarsson, Gudjon L; Bille, Camilla; Reitsma, Laurens C

    2017-01-01

    BACKGROUND: Nipple-sparing mastectomy with simultaneous hammock technique direct-to-implant reconstruction is increasingly offered to patients opting for risk-reducing mastectomy. Despite this promising method, patients with macromastia and ptotic breasts remain a challenging group to treat...... satisfactorily and more often end up undergoing a difficult corrective procedure and experience an unacceptably high rate of failed reconstruction. The authors examined whether targeted preshaping mastopexy/reduction could prepare these patients for a successful nipple-sparing mastectomy....../direct-to-implant reconstruction. METHODS: Patients seeking risk-reducing nipple-sparing mastectomy/direct-to-implant reconstruction at the authors' institutions deemed unfit for a one-stage procedure based on their previous experience were offered a targeted two-stage, risk-reducing mastopexy/reduction followed by a delayed...

  13. Cyclic volatile methylsiloxanes in human blood as markers for ruptured silicone gel-filled breast implants.

    Science.gov (United States)

    Rosendahl, Pia; Hippler, Joerg; Schmitz, Oliver J; Hoffmann, Oliver; Rusch, Peter

    2016-05-01

    The replacement of medical-grade silicone with industrial-grade silicone material in some silicone gel-filled breast implants (SBI) manufactured by Poly Implant Prothèse and Rofil Medical Nederland B.V., reported in 2010, which resulted in a higher rupture tendency of these SBI, demonstrates the need for non-invasive, sensitive monitoring and screening methods. Therefore a sensitive method based on large volume injection-gas chromatography coupled to mass spectrometry (LVI-GC/MS) was developed to determine octamethylcyclotetrasiloxane (D4), decamethylcyclopentasiloxane (D5), and dodecamethylcyclo-hexasiloxane (D6) in blood samples from women with intact (n = 13) and ruptured SBI (n = 11). With dichloromethane extraction, sample cooling during preparation, and analysis extraction efficiencies up to 100 % and limits of detection of 0.03-0.05 ng D4-D6/g blood were achieved. Blood samples from women with SBI were investigated. In contrast to women with intact SBI, in blood from women with ruptured SBI higher D4 and D6 concentrations up to 0.57 ng D4/g blood and 0.16 ng D6/g blood were detected. With concentrations above 0.18 D4 ng/blood and 0.10 ng D6/g blood as significant criteria for ruptured SBI, this developed analytical preoperative diagnostic method shows a significant increase of the recognition rate. Finally a higher precision (error rate 17%) than the commonly used clinical diagnostic method, mamma sonography (error rate 46%), was achieved.

  14. Incorporating three-dimensional ultrasound into permanent breast seed implant brachytherapy treatment planning.

    Science.gov (United States)

    Morton, Daniel; Batchelar, Deidre; Hilts, Michelle; Berrang, Tanya; Crook, Juanita

    Planning permanent breast seed implant (PBSI) brachytherapy using CT alone may reduce treatment accuracy because of differences in seroma visualization compared with ultrasound (US). This study evaluates dosimetric effects of seroma delineation in PBSI and the potential impact of incorporating three-dimensional (3D) US into PBSI treatment planning. Spatially coregistered CT and 3D US images from 10 patients were retrospectively analyzed to simulate the PBSI procedure. Seromas contoured on CT and US defined clinical target volumes, CTVCT and CTVUS, which were expanded to create planning target volumes (PTVs). PBSI plans were generated using PTVCT alone, and the resulting coverage to PTVUS was evaluated. To assess the potential impact of transferring to an US-guided procedure, the CT-based plans were centered on CTVUS. The volume encompassed by both PTVs was used to evaluate how 3D US can affect the planning procedure. Median (range) PTVCTV100 was 95.6% (93.3-97.3%), resulting in PTVUS coverage of 91.5% (80.5-97.9%). Centering plans on CTVUS decreased PTVCTV100 by a mean of 10 ± 8%, and increased PTVUSV100 by 5 ± 4%. The combined PTVs were a mean 9±6% larger than PTVCT. Acceptable dosimetry to the combined PTVs resulted in sufficient coverage to individual PTVs but with a mean 11 ± 24% increase to skin dose and 6 ± 8% increase in breast V200. Differences in seroma visualization have dosimetric effects in PBSI. CT-based plans can underdose US-defined volumes and may not adequately translate to an US-guided procedure. Implementing 3D US into planning can potentially compensate for differences in delineation. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  15. Clinical Significance of Accounting for Tissue Heterogeneity in Permanent Breast Seed Implant Brachytherapy Planning.

    Science.gov (United States)

    Mashouf, Shahram; Fleury, Emmanuelle; Lai, Priscilla; Merino, Tomas; Lechtman, Eli; Kiss, Alex; McCann, Claire; Pignol, Jean-Philippe

    2016-03-15

    The inhomogeneity correction factor (ICF) method provides heterogeneity correction for the fast calculation TG43 formalism in seed brachytherapy. This study compared ICF-corrected plans to their standard TG43 counterparts, looking at their capacity to assess inadequate coverage and/or risk of any skin toxicities for patients who received permanent breast seed implant (PBSI). Two-month postimplant computed tomography scans and plans of 140 PBSI patients were used to calculate dose distributions by using the TG43 and the ICF methods. Multiple dose-volume histogram (DVH) parameters of clinical target volume (CTV) and skin were extracted and compared for both ICF and TG43 dose distributions. Short-term (desquamation and erythema) and long-term (telangiectasia) skin toxicity data were available on 125 and 110 of the patients, respectively, at the time of the study. The predictive value of each DVH parameter of skin was evaluated using the area under the receiver operating characteristic (ROC) curve for each toxicity endpoint. Dose-volume histogram parameters of CTV, calculated using the ICF method, showed an overall decrease compared to TG43, whereas those of skin showed an increase, confirming previously reported findings of the impact of heterogeneity with low-energy sources. The ICF methodology enabled us to distinguish patients for whom the CTV V100 and V90 are up to 19% lower compared to TG43, which could present a risk of recurrence not detected when heterogeneity are not accounted for. The ICF method also led to an increase in the prediction of desquamation, erythema, and telangiectasia for 91% of skin DVH parameters studied. The ICF methodology has the advantage of distinguishing any inadequate dose coverage of CTV due to breast heterogeneity, which can be missed by TG43. Use of ICF correction also led to an increase in prediction accuracy of skin toxicities in most cases. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Bone Response to Two Dental Implants with Different Sandblasted/Acid-Etched Implant Surfaces: A Histological and Histomorphometrical Study in Rabbits

    Directory of Open Access Journals (Sweden)

    Antonio Scarano

    2017-01-01

    Full Text Available Background. Scientific evidence in the field of implant dentistry of the past 20 years established that titanium rough surfaces have shown improved osseointegration rates. In a majority of dental implants, the surface microroughness was obtained by grit blasting and/or acid etching. The aim of the study was to evaluate in vivo two different highly hydrophilic surfaces at different experimental times. Methods. Calcium-modified (CA and SLActive surfaces were evaluated and a total of 18 implants for each type of surface were positioned into the rabbit articular femoral knee-joint in a split model experiment, and they were evaluated histologically and histomorphometrically at 15, 30, and 60 days of healing. Results. Bone-implant contact (BIC at the two-implant surfaces was significantly different in favor of the CA surface at 15 days (p=0.027, while SLActive displayed not significantly higher values at 30 (p=0.51 and 60 days (p=0.061. Conclusion. Both implant surfaces show an intimate interaction with newly formed bone.

  17. 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.

  18. The biomedical properties of polyethylene terephthalate surface modified by silver ion implantation

    Energy Technology Data Exchange (ETDEWEB)

    Wang Jin [Key Laboratory for Advanced Technologies of Materials of Ministry of Education, Southwest Jiaotong University, Chengdu, Sichuan 610031 (China); Li Jianxin [Key Laboratory for Advanced Technologies of Materials of Ministry of Education, Southwest Jiaotong University, Chengdu, Sichuan 610031 (China); Shen Liru [Southwestern Institute of Physics, Chengdu, Sichuan 610041 (China); Ling Ren [Key Laboratory for Advanced Technologies of Materials of Ministry of Education, Southwest Jiaotong University, Chengdu, Sichuan 610031 (China); Xu Zejin [Southwestern Institute of Physics, Chengdu, Sichuan 610041 (China); Zhao Ansha [Key Laboratory for Advanced Technologies of Materials of Ministry of Education, Southwest Jiaotong University, Chengdu, Sichuan 610031 (China); Leng Yongxiang [Key Laboratory for Advanced Technologies of Materials of Ministry of Education, Southwest Jiaotong University, Chengdu, Sichuan 610031 (China); Huang Nan [Key Laboratory for Advanced Technologies of Materials of Ministry of Education, Southwest Jiaotong University, Chengdu, Sichuan 610031 (China)]. E-mail: nhuang@263.net

    2007-04-15

    Polyethylene terephthalate (PET) film is modified by Ag ion implantation with a fluence 1 x 10{sup 16} ions/cm{sup 2}. The results of X-Ray diffraction (XRD) and X-ray photoelectron spectroscopy (XPS) indicate that silver has been successfully implanted into the surface of PET. The PET samples modified by silver ion implantation have significantly bactericidal property. The capacity of the staphylococcus epidermidis (SE) adhered on the Ag{sup +} implanted PET surface is 5.3 x 10{sup 6} CFU/ml, but the capacity of the SE adhered on the untreated PET film is 2.23 x 10{sup 7} CFU/ml. The thromboembolic property is evaluated by in vitro platelet adhesion test, and there is not statistically difference between the untreated PET and the Ag{sup +} implanted PET for the number of adhered and activated platelets. The PET implanted by silver ion has not acute toxicity to endothelial cell (EC) which was evaluated by the release of lactate dehydrogenase (LDH) test.

  19. A Double-Blind Randomized Trial Comparing Implants with Laser-Microtextured and Machined Collar Surfaces: Microbiologic and Clinical Results.

    Science.gov (United States)

    Guarnieri, Renzo; Rappelli, Giorgio; Piemontese, Matteo; Procaccini, Maurizio; Quaranta, Alessandro

    2016-01-01

    The purpose of this study was to compare the clinical outcome of and determine the differences in periodonto-pathogenic microbiota around two types of implant collar surfaces: laser-microtextured (test) vs machined (control). Seventeen patients (11 periodontally healthy, and 6 periodontally compromised) were selected to receive the two different implants, placed randomly, in two edentulous sites. Six months following the surgical placement of the dental implants, subgingival plaque samples were collected using paper points from the peri-implant sulcus and from the sulcus of an adjacent tooth. The presence of five putative periodontal pathogens, namely, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Treponema denticola, and Tannerella forsythensis, was assessed using real-time polymerized chain reaction (RT-PCR). Peri-implant parameters and intraoral radiographs were recorded up to 1 year after abutment connection. In the main population, and in the periodontally compromised subgroup, the total number of periodontal pathogens around test implant sites was lower than control implant sites and adjacent tooth sites, with a statistically significant difference (P < .05). In periodontally healthy patients, the mean probing pocket depth for the test implant was 1.31 ± 0.51 mm, compared with 2.66 ± 0.83 mm for the control implant, while in periodontally compromised patients, it was 1.61 ± 0.58 mm for the test implant, compared with a mean value of 2.84 ± 1.0 mm for the control implant. Implants with a laser-microtextured collar surface are not more vulnerable to pathogenic microflora colonization than implants with a machined collar surface. In both of the subgroups of patients (periodontally healthy and periodontally compromised), implants with a laser-microtextured collar surface have a better clinical outcome at 1 year of loading, compared with implants with a machined collar surface.

  20. Is the shear wave sonographic elastography correlated with pain after breast augmentation with silicone implants an indication of inflammatory activity? A preliminary report

    Directory of Open Access Journals (Sweden)

    Paweł Rzymski

    2011-12-01

    Full Text Available Introduction: Formation of a capsule is a natural inflammatory response to a foreign body such as a breast implant.Breast capsular contracture is the most severe complication of implant surgery. Aim: To evaluate breast tissues and the periprosthetic reaction with sonoelastography. Material and methods: Nineteen patients aged 20-41 underwent breast augmentation with silicone-filled implants.Their 38 breasts were evaluated before surgery, and 7 and 14 days after surgery. Whole breast stiffness was measuredby applanation tonometry. Patients underwent shear wave elastography and Young’s moduli of breast tissues and theperiprosthetic capsule were estimated. During surgery patients underwent standard anaesthesia and were releasedhome 2 days later after removal of drainage. Each day, patients completed the pain visual analogue scale questionnaireseparately for left and right breasts. Results: Applanation tonometry did not correlate with any parameter. In shear wave elastography we observed statisticallysignificant changes in elasticity of all breast tissues with the highest values on day 7 after surgery and decreasingon day 14. The correlations between pain and capsule elasticity in lower quadrants measured were significantbetween days 4 and 10, whereas correlations of pain with applanation tonometry were insignificant. Glandular tissueelasticity in lower quadrants did not correlate with pain, whereas in upper quadrants there was a significant correlationon days 6-10. Fatty tissue, muscle and thoracic fascia elasticity did not correlate with breast pain. Breast implantvolume correlated with pain only shortly after surgery, but did not correlate with any sonoelastographic parameters. Conclusions: Breast pain correlates strongly with periprosthetic stiffness in elastography 4 to 10 days after breast augmentation,suggesting the possible role of an inflammatory reaction.

  1. Surface modification of Ti dental implants by Nd:YVO{sub 4} laser irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Braga, Francisco J.C. [Materials Science and Technology Center, Institute of Energetic and Nuclear Research, Box 11049 (05422-970), Sao Paulo (Brazil); Marques, Rodrigo F.C. [Magnetic Materials and Colloid Group, Institute of Chemistry, Sao Paulo State University, Box 355, Araraquara (Brazil); Filho, Edson de A. [Biomaterials Group, Institute of Chemistry, Sao Paulo State University, Box 355, Araraquara (Brazil); Guastaldi, Antonio C. [Biomaterials Group, Institute of Chemistry, Sao Paulo State University, Box 355, Araraquara (Brazil)], E-mail: guastald@iq.unesp.br

    2007-09-30

    Surface modifications have been applied in endosteal bone devices in order to improve the osseointegration through direct contact between neoformed bone and the implant without an intervening soft tissue layer. Surface characteristics of titanium implants have been modified by addictive methods, such as metallic titanium, titanium oxide and hydroxyapatite powder plasma spray, as well as by subtractive methods, such as acid etching, acid etching associated with sandblasting by either AlO{sub 2} or TiO{sub 2}, and recently by laser ablation. Surface modification for dental and medical implants can be obtained by using laser irradiation technique where its parameters like repetition rate, pulse energy, scanning speed and fluency must be taken into accounting to the appropriate surface topography. Surfaces of commercially pure Ti (cpTi) were modified by laser Nd:YVO{sub 4} in nine different parameters configurations, all under normal atmosphere. The samples were characterized by SEM and XRD refined by Rietveld method. The crystalline phases {alpha}Ti, {beta}Ti, Ti{sub 6}O, Ti{sub 3}O and TiO were formed by the melting and fast cooling processes during irradiation. The resulting phases on the irradiated surface were correlated with the laser beam parameters. The aim of the present work was to control titanium oxides formations in order to improve implants osseointegration by using a laser irradiation technique which is of great importance to biomaterial devices due to being a clean and reproducible process.

  2. Hybrid micro/nanostructural surface offering improved stress distribution and enhanced osseointegration properties of the biomedical titanium implant.

    Science.gov (United States)

    Hou, Ping-Jen; Ou, Keng-Liang; Wang, Chin-Chieh; Huang, Chiung-Fang; Ruslin, Muhammad; Sugiatno, Erwan; Yang, Tzu-Sen; Chou, Hsin-Hua

    2018-03-01

    The aim of the present study was to investigate the surface characteristic, biomechanical behavior, hemocompatibility, bone tissue response and osseointegration of the optimal micro-arc oxidation surface-treated titanium (MST-Ti) dental implant. The surface characteristic, biomechanical behavior and hemocompatibility of the MST-Ti dental implant were performed using scanning electron microscope, finite element method, blood dripping and immersion tests. The mini-pig model was utilized to evaluate the bone tissue response and osseointegration of the MST-Ti dental implant in vivo. Data were analyzed by analysis of variance using the Student's t-test (P ≤ 0.05). The hybrid volcano-like micro/nanoporous structure was formed on the surface of the MST-Ti dental implant. The hybrid volcano-like micro/nanoporous surface played an important role to improve the stress transfer between fixture, cortical bone and cancellous bone for the MST-Ti dental implant. Moreover, the MST-Ti implant was considered to have the outstanding hemocompatibility. In vivo testing results showed that the bone-to-implant contact (BIC) ratio significantly altered as the implant with micro/nanoporous surface. After 12 weeks of implantation, the MST-Ti dental implant group exhibited significantly higher BIC ratio than the untreated dental implant group. In addition, the MST-Ti dental implant group also presented an enhancing osseointegration, particularly in the early stages of bone healing. It can be concluded that the micro-arc oxidation approach induced the formation of micro/nanoporous surface is a promising and reliable alternative surface modification for Ti dental implant applications. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Spectroscopy in the analysis of bacterial and eukaryotic cell footprints on implant surfaces

    OpenAIRE

    E Kaivosoja; Virtanen, S.; Rautemaa, R.; Lappalainen, R.; YT Konttinen

    2012-01-01

    We tested the suitability of two spectroscopic methods, x-ray photoelectron spectroscopy (XPS) and time of flight secondary ion mass spectrometry (ToF-SIMS), in the recognition of bacterial and eukaryotic cell footprints on implant surfaces. Human mesenchymal stem cells (MSCs) and Staphylococcus aureus were cultured on sample surfaces and detached using trypsin. Scanning electron microscopy confirmed that the processed surfaces did not contain any human or microbial cells. The footprints were...

  4. A 2-year report on maxillary and mandibular fixed partial dentures supported by Astra Tech dental implants. A comparison of 2 implants with different surface textures

    DEFF Research Database (Denmark)

    Karlsson, U; Gotfredsen, K; Olsson, C

    1998-01-01

    In 50 partially edentulous patients, 133 (48 maxillary; 85 mandibular) Astra Tech dental implants of 2 different surface textures (machined; TiO-blasted) were alternately installed, supporting 52 fixed partial dentures (FPDs). Before abutment connection 2 machined implants (1 mandibular; 1...... maxillary) were found to be non-osseointegrated and were replaced. Another implant could not be restored due to a technical complication. Two FPDs were remade because of technical complications, both because of abutment fractures. Thus, after 2 years in function, the cumulative survival rates were 97.......7% and 95.7% for implants and prostheses, respectively. There was no statistically significant difference in survival rate between the 2 types of implants, 100% (TiO-blasted) vs 95.3% (machined), P = 0.24. After 2 years in function, when both jaw and type of implants were combined, the mean (SD) marginal...

  5. On the Mechanisms of Hydrogen Implantation Induced Silicon Surface Layer Cleavage

    Energy Technology Data Exchange (ETDEWEB)

    Hochbauer, Tobias [Univ. of Marburg (Germany)

    2001-11-01

    The “Ion-Cut”, a layer splitting process by hydrogen ion implantation and subsequent annealing is a versatile and efficient technique of transferring thin silicon surface layers from bulk substrates onto other substrates, thus enabling the production of silicon-oninsulator (SOI) materials. Cleavage is induced by the coalescence of the highly pressurized sub-surface H2-gas bubbles, which form upon thermal annealing. A fundamental understanding of the basic mechanisms on how the cutting process occurs is still unclear, inhibiting further optimization of the Ion-Cut process. This work elucidates the physical mechanisms behind the Ion-Cut process in hydrogen-implanted silicon. The investigation of the cleavage process reveals the cut to be largely controlled by the lattice damage, generated by the hydrogen ion irradiation process, and its effects on the local stress field and the fracture toughness within the implantation zone rather than by the depth of maximum H-concentration. Furthermore, this work elucidates the different kinetics in the H-complex formations in silicon crystals with different conductivity types, and examines the mechanically induced damage accumulation caused by the crack propagation through the silicon sample in the splitting step of the Ion-Cut process. Additionally, the influence of boron pre-implantation on the Ion-Cut in hydrogen implanted silicon is investigated. These studies reveal, that both, the atomic interaction between the boron implant and the hydrogen implant and the shift of the Fermi level due to the electrical activation of the implanted boron have a tremendous enhancing effect on the Ion-Cut process.

  6. On the Mechanisms of Hydrogen Implantation Induced Silicon Surface Layer Cleavage

    Energy Technology Data Exchange (ETDEWEB)

    Hochbauer, Tobias Franz [Univ. of Marburg (Germany)

    2002-08-01

    The “Ion-Cut”, a layer splitting process by hydrogen ion implantation and subsequent annealing is a versatile and efficient technique of transferring thin silicon surface layers from bulk substrates onto other substrates, thus enabling the production of silicon-oninsulator (SOI) materials. Cleavage is induced by the coalescence of the highly pressurized sub-surface H2-gas bubbles, which form upon thermal annealing. A fundamental understanding of the basic mechanisms on how the cutting process occurs is still unclear, inhibiting further optimization of the Ion-Cut process. This work elucidates the physical mechanisms behind the Ion-Cut process in hydrogen-implanted silicon. The investigation of the cleavage process reveals the cut to be largely controlled by the lattice damage, generated by the hydrogen ion irradiation process, and its effects on the local stress field and the fracture toughness within the implantation zone rather than by the depth of maximum H-concentration. Furthermore, this work elucidates the different kinetics in the H-complex formations in silicon crystals with different conductivity types, and examines the mechanically induced damage accumulation caused by the crack propagation through the silicon sample in the splitting step of the Ion-Cut process. Additionally, the influence of boron pre-implantation on the Ion-Cut in hydrogen implanted silicon is investigated. These studies reveal, that both, the atomic interaction between the boron implant and the hydrogen implant and the shift of the Fermi level due to the electrical activation of the implanted boron have a tremendous enhancing effect on the Ion-Cut process.

  7. Enhancing the antibacterial performance of orthopaedic implant materials by fibre laser surface engineering

    Science.gov (United States)

    Chan, Chi-Wai; Carson, Louise; Smith, Graham C.; Morelli, Alessio; Lee, Seunghwan

    2017-05-01

    Implant failure caused by bacterial infection is extremely difficult to treat and usually requires the removal of the infected components. Despite the severe consequence of bacterial infection, research into bacterial infection of orthopaedic implants is still at an early stage compared to the effort on enhancing osseointegration, wear and corrosion resistance of implant materials. In this study, the effects of laser surface treatment on enhancing the antibacterial properties of commercially pure (CP) Ti (Grade 2), Ti6Al4V (Grade 5) and CoCrMo alloy implant materials were studied and compared for the first time. Laser surface treatment was performed by a continuous wave (CW) fibre laser with a near-infrared wavelength of 1064 nm in a nitrogen-containing environment. Staphylococcus aureus, commonly implicated in infection associated with orthopaedic implants, was used to investigate the antibacterial properties of the laser-treated surfaces. The surface roughness and topography of the laser-treated materials were analysed by a 2D roughness testing and by AFM. The surface morphologies before and after 24 h of bacterial cell culture were captured by SEM, and bacterial viability was determined using live/dead staining. Surface chemistry was analysed by XPS and surface wettability was measured using the sessile drop method. The findings of this study indicated that the laser-treated CP Ti and Ti6Al4V surfaces exhibited a noticeable reduction in bacterial adhesion and possessed a bactericidal effect. Such properties were attributable to the combined effects of reduced hydrophobicity, thicker and stable oxide films and presence of laser-induced nano-features. No similar antibacterial effect was observed in the laser-treated CoCrMo.

  8. Structural and quantitative analysis of a mature anaerobic biofilm on different implant abutment surfaces.

    Science.gov (United States)

    de Avila, Erica Dorigatti; Avila-Campos, Mario Julio; Vergani, Carlos Eduardo; Spolidório, Denise Madalena Palomari; Mollo, Francisco de Assis

    2016-04-01

    The longevity of dental implants depends on the absence of inflammation in the periimplant tissue. Similar to teeth, pathogenic bacteria can adhere on implant abutment surfaces and cause periimplant disease and consequently implant loss. The purpose of this in vitro study was to evaluate the influence of physical and chemical properties of 2 common materials used as implant abutments, titanium (Ti) and zirconia (ZrO2), and the use of bovine enamel (BE) as a positive control on biofilm formation. Biofilm formation was analyzed by growing Porphyromonas gingivalis and Fusobacterium nucleatum as monospecies and mixed species biofilms on the surfaces. The mean roughness (Ra) and surface free energy were evaluated for each material. Mature biofilm, formed after 7 days of incubation, was analyzed quantitatively and qualitatively by colony-forming unit and confocal laser scanning microscopy. The mean roughness in all disks was ≤0.21 μm and did not affect the bacterial adhesion. Titanium showed a greater degree of hydrophilicity compared with BE after 90 minutes of immersion in saliva. The surface free energy did not show differences, with the highest values for BE. Monospecies biofilms formed by P. gingivalis on Ti, and mixed species biofilm on ZrO2 exhibited small numbers of cells on disk surfaces. By confocal imaging, the mixed species biofilm appeared as a thin layer on ZrO2 surfaces. Material surfaces could have a significant impact on biofilm formation. ZrO2 implant abutment surfaces showed a decrease in anaerobic biofilm compared with Ti and BE. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  9. Effects of surface topology on titanium release from implants into rabbit bone after 1-year follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Ektessabi, A. [Kyoto Univ. (Japan). Faculty of Engineering; Wennerberg, A.

    1996-12-31

    The material composition and surface structure of dental and orthopaedic implants have important effects on integration of the implants with the surrounding bone, and at the same time, the release of the constituent elements of the implants into the surrounding tissues. It is the aim of this paper to study the degree of release of Ti in relation to the surface roughness of the implants. For this purpose, screw shaped implants were prepared with two different surface topographies; one group was left as-machined, i.e. as machine-turned surface, and the second group was blasted with 25 {mu}m Al{sub 2}O{sub 3} particles. The surface topography was measured with a confocal laser scanning profilometer and the surface roughness was characterized using height and spatial descriptive parameters. The as-machined surfaces had an average surface roughness (S{sub a}) of 0.96 {mu}m and the blasted surfaces had an S{sub a} value of 1.16 {mu}m. The implants were inserted into rabbit bone for 1 year. Six samples (three of each type) were prepared for PIXE analysis. The PIXE analysis was done using proton beams from a tandem type accelerator, with an energy of 2 MeV. The results show that at distances of about 2 mm from implant surface, titanium release into hard tissues was found at similar amounts for the as-machined and the blasted implants inserted in the tibia. (author)

  10. Evaluation of the rupture of silicone breast implants by mammography, ultrasonography and magnetic resonance imaging in asymptomatic patients: correlation with surgical findings

    Directory of Open Access Journals (Sweden)

    Anabel Medeiros Scaranelo

    Full Text Available CONTEXT: Different imaging methods can identify the integrity of breast implants and also the extent of possible silicone leakage. Mammography, ultrasonography and magnetic resonance imaging are often used to evaluate the integrity of breast implants, usually in patients that are symptomatic for rupture. A group of clinically asymptomatic patients was taken as a sample. These patients wanted to remove or change their breast implants for psychological or cosmetic reasons. OBJECTIVE: The purpose of this study was to compare the efficacy of mammography, sonography and magnetic resonance imaging in the detection of breast implant rupture in an asymptomatic population. TYPE OF STUDY: Prospective study. SETTING: Department of Diagnostic Imaging, Universidade de São Paulo, São Paulo, Brazil. METHODS: The participants were 44 asymptomatic patients who subsequently had implants surgically removed. Eighty-three implants were evaluated by both film-screen mammography and high-resolution sonography and 77 implants were evaluated by magnetic resonance imaging. The sensitivity and specificity of mammography, ultrasonography and magnetic resonance imaging were assessed using predetermined diagnostic criteria for implant rupture. All radiological signs were discussed and false positives and false negatives were retrospectively evaluated to identify the pitfalls in the investigations. RESULTS: The respective sensitivity and specificity of mammography were 20% and 89%; sonography, 30% and 81%; and magnetic resonance imaging, 64% and 77%. The differences between patients with breast implants for cosmetic and oncological reasons were discussed. CONCLUSIONS: Our experience suggests that magnetic resonance imaging seems to be the best imaging method on its own for the evaluation of rupturing among asymptomatic patients.

  11. Soft, Brown Rupture: Clinical Signs and Symptoms Associated with Ruptured PIP Breast Implants

    Directory of Open Access Journals (Sweden)

    Yvette Godwin, FRCS

    2014-11-01

    Conclusions: Preoperative signs can be predictive of PIP implant failure. Brown-stained implants are more prone to rupture. The presence of iodine in the gel suggests unacceptable permeability of the shell early in the implant’s life span. A noninvasive screening test to detect brown implants in situ could help identify implants at risk of failure in those who elect to keep their implants.

  12. Effects of zinc-substituted nano-hydroxyapatite coatings on bone integration with implant surfaces.

    Science.gov (United States)

    Zhao, Shi-fang; Dong, Wen-jing; Jiang, Qiao-hong; He, Fu-ming; Wang, Xiao-xiang; Yang, Guo-li

    2013-06-01

    The purpose of this study was to investigate the effects of a zinc-substituted nano-hydroxyapatite (Zn-HA) coating, applied by an electrochemical process, on implant osseointegraton in a rabbit model. A Zn-HA coating or an HA coating was deposited using an electrochemical process. Surface morphology was examined using field-emission scanning electron microscopy. The crystal structure and chemical composition of the coatings were examined using an X-ray diffractometer (XRD) and Fourier transform infrared spectroscopy (FTIR). A total of 78 implants were inserted into femurs and tibias of rabbits. After two, four, and eight weeks, femurs and tibias were retrieved and prepared for histomorphometric evaluation and removal torque (RTQ) tests. Rod-like HA crystals appeared on both implant surfaces. The dimensions of the Zn-HA crystals seemed to be smaller than those of HA. XRD patterns showed that the peaks of both coatings matched well with standard HA patterns. FTIR spectra showed that both coatings consisted of HA crystals. The Zn-HA coating significantly improved the bone area within all threads after four and eight weeks (P<0.05), the bone to implant contact (BIC) at four weeks (P<0.05), and RTQ values after four and eight weeks (P<0.05). The study showed that an electrochemically deposited Zn-HA coating has potential for improving bone integration with an implant surface.

  13. The iBRA (implant breast reconstruction evaluation) study: protocol for a prospective multi-centre cohort study to inform the feasibility, design and conduct of a pragmatic randomised clinical trial comparing new techniques of implant-based breast reconstruction.

    Science.gov (United States)

    Potter, Shelley; Conroy, Elizabeth J; Williamson, Paula R; Thrush, Steven; Whisker, Lisa J; Skillman, Joanna M; Barnes, Nicola L P; Cutress, Ramsey I; Teasdale, Elizabeth M; Mills, Nicola; Mylvaganam, Senthurun; Branford, Olivier A; McEvoy, Katherina; Jain, Abhilash; Gardiner, Matthew D; Blazeby, Jane M; Holcombe, Christopher

    2016-01-01

    Implant-based breast reconstruction (IBBR) is the most commonly performed reconstructive procedure in the UK. The introduction of techniques to augment the subpectoral pocket has revolutionised the procedure, but there is a lack of high-quality outcome data to describe the safety or effectiveness of these techniques. Randomised controlled trials (RCTs) are the best way of comparing treatments, but surgical RCTs are challenging. The iBRA (implant breast reconstruction evaluation) study aims to determine the feasibility, design and conduct of a pragmatic RCT to examine the effectiveness of approaches to IBBR. The iBRA study is a trainee-led research collaborative project with four phases:Phase 1 - a national practice questionnaire (NPQ) to survey current practicePhase 2 - a multi-centre prospective cohort study of patients undergoing IBBR to evaluate the clinical and patient-reported outcomesPhase 3- an IBBR-RCT acceptability survey and qualitative work to explore patients' and surgeons' views of proposed trial designs and candidate outcomes.Phase 4 - phases 1 to 3 will inform the design and conduct of the future RCT All centres offering IBBR will be encouraged to participate by the breast and plastic surgical professional associations (Association of Breast Surgery and British Association of Plastic Reconstructive and Aesthetic Surgeons). Data collected will inform the feasibility of undertaking an RCT by defining current practice and exploring issues surrounding recruitment, selection of comparator arms, choice of primary outcome, sample size, selection criteria, trial conduct, methods of data collection and feasibility of using the trainee collaborative model to recruit patients and collect data. The preliminary work undertaken within the iBRA study will determine the feasibility, design and conduct of a definitive RCT in IBBR. It will work with the trainee collaborative to build capacity by creating an infrastructure of research-active breast and plastic surgeons

  14. Characteristics of Women Who Have Had Cosmetic Breast Implants That Could Be Associated with Increased Suicide Risk: A Systematic Review, Proposing a Suicide Prevention Model

    Directory of Open Access Journals (Sweden)

    Nikolaos Manoloudakis

    2015-03-01

    Full Text Available Literature indicates an increased risk of suicide among women who have had cosmetic breast implants. An explanatory model for this association has not been established. Some studies conclude that women with cosmetic breast implants demonstrate some characteristics that are associated with increased suicide risk while others support that the breast augmentation protects from suicide. A systematic review including data collection from January 1961 up to February 2014 was conducted. The results were incorporated to pre-existing suicide risk models of the general population. A modified suicide risk model was created for the female cosmetic augmentation mammaplasty candidate. A 2-3 times increased suicide risk among women that undergo cosmetic breast augmentation has been identified. Breast augmentation patients show some characteristics that are associated with increased suicide risk. The majority of women reported high postoperative satisfaction. Recent research indicates that the Autoimmune syndrome induced by adjuvants and fibromyalgia syndrome are associated with silicone implantation. A thorough surgical, medical and psycho-social (psychiatric, family, reproductive, and occupational history should be included in the preoperative assessment of women seeking to undergo cosmetic breast augmentation. Breast augmentation surgery can stimulate a systematic stress response and increase the risk of suicide. Each risk factor of suicide has poor predictive value when considered independently and can result in prediction errors. A clinical management model has been proposed considering the overlapping risk factors of women that undergo cosmetic breast augmentation with suicide.

  15. Characteristics of women who have had cosmetic breast implants that could be associated with increased suicide risk: a systematic review, proposing a suicide prevention model.

    Science.gov (United States)

    Manoloudakis, Nikolaos; Labiris, Georgios; Karakitsou, Nefeli; Kim, Jong B; Sheena, Yezen; Niakas, Dimitrios

    2015-03-01

    Literature indicates an increased risk of suicide among women who have had cosmetic breast implants. An explanatory model for this association has not been established. Some studies conclude that women with cosmetic breast implants demonstrate some characteristics that are associated with increased suicide risk while others support that the breast augmentation protects from suicide. A systematic review including data collection from January 1961 up to February 2014 was conducted. The results were incorporated to pre-existing suicide risk models of the general population. A modified suicide risk model was created for the female cosmetic augmentation mammaplasty candidate. A 2-3 times increased suicide risk among women that undergo cosmetic breast augmentation has been identified. Breast augmentation patients show some characteristics that are associated with increased suicide risk. The majority of women reported high postoperative satisfaction. Recent research indicates that the Autoimmune syndrome induced by adjuvants and fibromyalgia syndrome are associated with silicone implantation. A thorough surgical, medical and psycho-social (psychiatric, family, reproductive, and occupational) history should be included in the preoperative assessment of women seeking to undergo cosmetic breast augmentation. Breast augmentation surgery can stimulate a systematic stress response and increase the risk of suicide. Each risk factor of suicide has poor predictive value when considered independently and can result in prediction errors. A clinical management model has been proposed considering the overlapping risk factors of women that undergo cosmetic breast augmentation with suicide.

  16. Enhancing the antibacterial performance of orthopaedic implant materials by fibre laser surface engineering

    DEFF Research Database (Denmark)

    Chan, Chi-Wai; Carson, Louise; Smith, Graham C.

    2017-01-01

    to the effort on enhancing osseointegration, wear and corrosion resistance of implant materials. In this study, the effects of laser surface treatment on enhancing the antibacterial properties of commercially pure (CP) Ti (Grade 2), Ti6Al4V (Grade 5) and CoCrMo alloy implant materials were studied and compared...... for the first time. Laser surface treatment was performed by a continuous wave (CW) fibre laser with a near-infrared wavelength of 1064 nm in a nitrogen-containing environment. Staphylococcus aureus, commonly implicated in infection associated with orthopaedic implants, was used to investigate the antibacterial....... Such properties were attributable to the combined effects of reduced hydrophobicity, thicker and stable oxide films and presence of laser-induced nano-features. No similar antibacterial effect was observed in the laser-treated CoCrMo....

  17. Boston Type I Keratoprosthesis Implantation Following Autologous Submandibular Gland Transplantation for End Stage Ocular Surface Disorders.

    Science.gov (United States)

    Gu, Jianjun; Zhai, Jiajie; Liao, Guiqing; Chen, Jiaqi

    2016-10-11

    To describe the results of Boston keratoprosthesis implantation in a patient with Stevens-Johnson syndrome following autologous submandibular gland transplantation. Observational case report. We report the case of a man diagnosed with Stevens-Johnson syndrome. Autologous submandibular gland transplantation was performed in the right eye in 2008 to ameliorate tear film deficiency. Due to the improvement in the microenvironment of the ocular surface, Boston keratoprosthesis implantation was performed in the right eye in 2011. He maintained a VA of 20/100 for 12 months. At the last follow-up visit (54 months), his VA had declined to finger count level due to de novo glaucoma, which was treated with glaucoma drainage device implantation, cyclophotocoagulation and topical anti-glaucoma medications. The procedures described provide patients with end-stage ocular surface disease an option to lessen the severity of keratoconjunctivitis sicca and to regain their VA.

  18. 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...

  19. DIEP Flap Breast Reconstruction Using 3-dimensional Surface Imaging and a Printed Mold

    Directory of Open Access Journals (Sweden)

    Koichi Tomita, MD, PhD

    2015-03-01

    Full Text Available Summary: Recent advances in 3-dimensional (3D surface imaging technologies allow for digital quantification of complex breast tissue. We performed 11 unilateral breast reconstructions with deep inferior epigastric artery perforator (DIEP flaps (5 immediate, 6 delayed using 3D surface imaging for easier surgery planning and 3D-printed molds for shaping the breast neoparenchyma. A single- or double-pedicle flap was preoperatively planned according to the estimated tissue volume required and estimated total flap volume. The DIEP flap was then intraoperatively shaped with a 3D-printed mold that was based on a horizontally inverted shape of the contralateral breast. Cosmetic outcomes were assessed as satisfactory, as confirmed by the postoperative 3D measurements of bilateral breasts. We believe that DIEP flap reconstruction assisted with 3D surface imaging and a 3D-printed mold is a simple and quick method for rebuilding a symmetric breast.

  20. The micropolyurethane foam-coated Diagon/Gel4Two implant in aesthetic and reconstructive breast surgery – 3-year results of an ongoing study

    Directory of Open Access Journals (Sweden)

    Brunnert, Klaus E.

    2015-12-01

    Full Text Available Background: Breast implants are worldwide in use since 1962. Initially there were some problems with capsular contracture and the palpability of the rim of the implant. In 1968 this led to the introduction of the micropolyurethane foam-coating and then in 1970 to the first micropolyurethane foam-coated implant by F.A. Ashley. As a result of additional technical refinements in manufacturing this new implant design significantly reduced complications i.e. capsular contracture and implant rotation. Methods: This study reports a single surgeon’s experience with aesthetic and reconstructive breast surgery, in primary and secondary cases with the sole use of micropolyurethane foam-coated Diagon/gel4Two implants, partly in combination with the additional use of synthetic meshes, acellular dermal matrices and lipofilling. The trial is a prospective, single center cohort study designed to demonstrate the safety and effectiveness of the new implant design in primary and secondary aesthetic and reconstructive breast surgery. The reported data provide an interim report of the implantations performed from November 2010 to December 2013.Results: 90 patients were admitted to the study with 152 implants. The majority of the implants (n=95, 62.5% were used in reoperative cases for either oncological (n=52, 34.2% or aesthetic reasons (n=43, 28.3%. The median age of the study cohort was 45 years; the median body mass index was 21; the median observation time is 41 months. There was a very low complication rate, both short term within 6 weeks after the implantation of the silicone gel implant and in the follow up in November 2015. There were no serious complications needing explantation, no capsular fibrosis or implant rotation or rupture so far. There were only 4 minor complications (1.97%. There was 1 local recurrence 4 years after skin and nipple sparing mastectomy.Conclusion: The micropolyurethane foam-coated Diagon/gel4Two implant is a very reliable silicone

  1. Ion implantation effects on surface-mechanical properties of metals and polymers

    Energy Technology Data Exchange (ETDEWEB)

    Rao, G.R.

    1993-04-01

    Fatigue of 8 complex alloys based on Fe-13Cr-15Ni-2Mo-2Mn-0.2Ti-0.8Si- 0.06C, and single-crystal Fe-15Cr-15Ni, implanted with 400-keV B[sup +] and 550-keV N[sup +] (total dose 2.3[times]10[sup 16] ions/cm[sup 2]) was examined. 600 C creep was also examined. The dual implantation increased hardness but decreased fatigue life of the 8 complex alloys. An optimum strengthening level and a shift to grain boundary cracking were determined. The single crystals also showed reduced fatigue life after implantation. High temperature creep of E1 and B1 alloys were improved by the dual implantation. Four polymers (PE, polypropylene, polystyrene, polyethersulfone) were implanted with 200keV B[sup +] to 3 different doses. PS was also implanted with both B[sup +] and Ar[sup +]. Near-surface hardness and tribological properties were measured. The hardness increased with dose and energy; wear also improved, with an optimum dose. (DLC)

  2. Ion implantation effects on surface-mechanical properties of metals and polymers

    Energy Technology Data Exchange (ETDEWEB)

    Rao, G.R.

    1993-04-01

    Fatigue of 8 complex alloys based on Fe-13Cr-15Ni-2Mo-2Mn-0.2Ti-0.8Si- 0.06C, and single-crystal Fe-15Cr-15Ni, implanted with 400-keV B{sup +} and 550-keV N{sup +} (total dose 2.3{times}10{sup 16} ions/cm{sup 2}) was examined. 600 C creep was also examined. The dual implantation increased hardness but decreased fatigue life of the 8 complex alloys. An optimum strengthening level and a shift to grain boundary cracking were determined. The single crystals also showed reduced fatigue life after implantation. High temperature creep of E1 and B1 alloys were improved by the dual implantation. Four polymers (PE, polypropylene, polystyrene, polyethersulfone) were implanted with 200keV B{sup +} to 3 different doses. PS was also implanted with both B{sup +} and Ar{sup +}. Near-surface hardness and tribological properties were measured. The hardness increased with dose and energy; wear also improved, with an optimum dose. (DLC)

  3. Studies on the surface modification of TiN coatings using MEVVA ion implantation with selected metallic species

    Energy Technology Data Exchange (ETDEWEB)

    Ward, L.P., E-mail: liam.ward@rmit.edu.au [School of Civil, Environmental and Chemical Engineering, RMIT University, GPO Box 2476, Melbourne 3001 (Australia); Purushotham, K.P. [Nanometrology Group, National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, MD 20899 (United States); Manory, R.R. [M& H Materials Pty Ltd, PO Box 1033, Elsternwick, Vic 3185 (Australia)

    2016-02-01

    Highlights: • Reduced surface roughness was observed after ion implantation. • W implantation increased residual stress. • Reduced friction and wear accompanied Mo implantation. • Mo implanted layer was more resistant to breakdown during wear testing. • Ion implantation effects can be complex on various implanting species properties. - Abstract: Improvement in the performance of TiN coatings can be achieved using surface modification techniques such as ion implantation. In the present study, physical vapor deposited (PVD) TiN coatings were implanted with Cr, Zr, Nb, Mo and W using the metal evaporation vacuum arc (MEVVA) technique at a constant nominal dose of 4 × 10{sup 16} ions cm{sup −2} for all species. The samples were characterized before and after implantation, using Rutherford backscattering (RBS), glancing incident angle X-ray diffraction (GIXRD), atomic force microscopy (AFM) and optical microscopy. Friction and wear studies were performed under dry sliding conditions using a pin-on-disc CSEM Tribometer at 1 N load and 450 m sliding distance. A reduction in the grain size and surface roughness was observed after implantation with all five species. Little variation was observed in the residual stress values for all implanted TiN coatings, except for W implanted TiN which showed a pronounced increase in compressive residual stress. Mo-implanted samples showed a lower coefficient of friction and higher resistance to breakdown during the initial stages of testing than as-received samples. Significant reduction in wear rate was observed after implanting with Zr and Mo ions compared with unimplanted TiN. The presence of the Ti{sub 2}N phase was observed with Cr implantation.

  4. Management of Implant Exposure in One-Stage Breast Reconstruction Using Titanium-Coated Polypropylene Mesh: Sub-Mammary Intercostal Perforator Flap.

    Science.gov (United States)

    De Riggi, Michele Antonio; Rocco, Nicola; Gherardini, Giulio; Esposito, Emanuela; D'Aiuto, Massimiliano

    2016-12-01

    One-stage implant-based breast reconstruction using titanium-coated polypropylene mesh is a novel approach widely used in Europe. Complication rates in breast reconstruction with the use of titanium-coated meshes seem to be comparable to those in patients with implant-based breast reconstruction alone. However, the use of synthetic meshes in implant-based breast reconstructive surgery leads to new clinical scenarios with the need for the breast surgeon to face new complications. We present an innovative treatment of implant exposure in the absence of infection in patients who underwent nipple-sparing mastectomy and immediate breast reconstruction with silicone implants and titanium-coated polypropylene mesh by using a pedicled sub-mammary intercostal perforator flap. Four patients who experienced implant exposure without infection have been treated with the use of a sub-mammary intercostal perforator flap. Whole coverage of the exposed implant/mesh with a sub-mammary intercostal perforator flap was obtained in all cases. No post-operative complications have been observed, whereas a pleasant aesthetic result has been achieved. Patients' post-operative quality of life and satisfaction levels were measured by the European Organisation for Research and Treatment of Cancer breast cancer-specific quality of life QLQ-BR23 questionnaire and showed an average good satisfaction with the post-operative outcomes (mean QLQ-BR23 score 1.9). For the first time, a sub-mammary intercostal perforator flap has been used with the aim of treating implant exposures without removing the prosthesis even in the presence of synthetic meshes, when wound infection was excluded. Although tested on a small series, the sub-mammary intercostal perforator flap might represent a simple, versatile and cost-effective procedure for the management of implant exposure following nipple-sparing mastectomy and immediate reconstruction with silicone implants and synthetic meshes. It should be considered to

  5. The evolution of FDA policy on silicone breast implants: a case study of politics, bureaucracy, and business in the process of decision-making.

    Science.gov (United States)

    Palley, H A

    1995-01-01

    The central issue facing federal regulation of breast implants is that while such devices are not functionally necessary or needed for survival, the side effects may be harmful and have not been proven unharmful. The Medical Device Amendments of 1976 appear to require such evidence prior to the FDA permitting the unrestricted marketing of these devices. However, only recently have such requirements been imposed by the FDA. The author examines the FDA's decision-making process, particularly as applied to silicone breast implants, and the factors that appears to have affected such decisions. In pursuing this study, the activities of a number of interest-group actors, as well as congressional responses and the role of federal bureaucratic actors, were examined. In 1992, the FDA established a regulatory protocol that effectively withdrew most silicone breast implants from the market for the purpose of breast augmentation and allows for the monitoring of the impact of new implants on women's health. This increase concern for determining the safety of breast implants is due to a number of factors, which are examined in this article.

  6. Plasma immersion ion implantation of polyurethane shape memory polymer: Surface properties and protein immobilization

    Science.gov (United States)

    Cheng, Xinying; Kondyurin, Alexey; Bao, Shisan; Bilek, Marcela M. M.; Ye, Lin

    2017-09-01

    Polyurethane-type shape memory polymers (SMPU) are promising biomedical implant materials due to their ability to recover to a predetermined shape from a temporary shape induced by thermal activation close to human body temperature and their advantageous mechanical properties including large recovery strains and low recovery stresses. Plasma Immersion Ion Implantation (PIII) is a surface modification process using energetic ions that generates radicals in polymer surfaces leading to carbonisation and oxidation and the ability to covalently immobilise proteins without the need for wet chemistry. Here we show that PIII treatment of SMPU significantly enhances its bioactivity making SMPU suitable for applications in permanent implantable biomedical devices. Scanning Electron Microscopy (SEM), contact angle measurements, surface energy measurements, attenuated total reflection Fourier transform infrared (ATR-FTIR) spectroscopy and X-ray photoelectron spectroscopy (XPS) were used to characterise the PIII modified surface, including its after treatment aging kinetics and its capability to covalently immobilise protein directly from solution. The results show a substantial improvement in wettability and dramatic changes of surface chemical composition dependent on treatment duration, due to the generation of radicals and subsequent oxidation. The SMPU surface, PIII treated for 200s, achieved a saturated level of covalently immobilized protein indicating that a full monolayer coverage was achieved. We conclude that PIII is a promising and efficient surface modification method to enhance the biocompatibility of SMPU for use in medical applications that demand bioactivity for tissue integration and stability in vivo.

  7. Surface analysis of an encapsulation membrane after its implantation in mini-pigs

    Energy Technology Data Exchange (ETDEWEB)

    Henry, Marie [Universite Catholique de Louvain, PCPM, Croix du Sud 1, B1348 Louvain-La-Neuve (Belgium); Ulrichs, Karin [University of Wuerzburg Hospital (Germany); Moskalenko, Vasily [University of Wuerzburg Hospital (Germany); Bonneau, Michel [Institut National de la Recherche Agronomique, Paris (France); Kang, Chantal [Institut National de la Recherche Agronomique, Paris (France); Belcourt, Alain [Centre Europeen d' Etude du Diabete, Strasbourg (France); Bertrand, Patrick [Universite Catholique de Louvain, PCPM, Croix du Sud 1, B1348 Louvain-La-Neuve (Belgium)

    2007-03-01

    The biocompatibility of membranes aiming at being a part of a bioartificial pancreas has been tested. For that purpose, we have studied a polycarbonate membrane surface after its implantation in mini-pigs. The membranes were made hydrophilic by an argon plasma surface treatment followed by a dipping in a hydrophilic polymer solution. Two polymers were tested: polyvinylpyrrolidone (PVP) and hydroxypropylmethylcellulose (HPMC). To test their biocompatibility, an encapsulation device for pig Langerhans islets, with external membranes treated as described above, was implanted in different mini-pigs. The pigs received no further treatment. The devices were explanted after in vivo exposure and the membranes were analysed by XPS (x-ray photoelectron spectroscopy) and ToF-SIMS (time-of-flight secondary ion mass spectrometry). After this time, the substrate with the PVP or HPMC treatment was still detected on the different samples. The surface treatment signal, however, was attenuated. This is explained by the detection of other components partly covering the surface. XPS and ToF-SIMS analyses revealed the presence of biological molecules on the two faces of the membrane: the outside face in contact with the biological environment and the inside face in contact with the device. ToF-SIMS images show the inhomogeneity of the biological molecules on the membrane surface. In conclusion, biological molecules adhered to the encapsulation membrane surface after implantation but the surface treatments remained unaltered.

  8. Surface modification of titanium using steel slag ball and shot blasting treatment for biomedical implant applications

    Science.gov (United States)

    Arifvianto, Budi; Suyitno; Mahardika, Muslim

    2013-08-01

    Surface modification is often performed using grit or shot blasting treatment for improving the performances of biomedical implants. The effects of blasting treatments using steel slag balls and spherical shots on the surface and subsurface of titanium were studied in this paper. The treatments were conducted for 60-300 s using 2-5 mm steel slag balls and 3.18 mm spherical shots. The surface morphology, roughness, and elemental composition of titanium specimens were examined prior to and after the treatments. Irregular and rough titanium surfaces were formed after the treatment with the steel slag balls instead of the spherical shots. The former treatment also introduced some bioactive elements on the titanium surface, but the latter one yielded a harder surface layer. In conclusion, both steel slag ball and shot blasting treatment have their own specialization in modifying the surface of metallic biomaterials. Steel slag ball blasting is potential for improving the osseointegration quality of implants; but the shot blasting is more appropriate for improving the mechanical properties of temporary and load bearing implants, such as osteosynthesis plates.

  9. Enhanced osteointegration on tantalum-implanted polyetheretherketone surface with bone-like elastic modulus.

    Science.gov (United States)

    Lu, Tao; Wen, Jin; Qian, Shi; Cao, Huiliang; Ning, Congqin; Pan, Xiaoxia; Jiang, Xinquan; Liu, Xuanyong; Chu, Paul K

    2015-05-01

    Polyetheretherketone (PEEK) possesses a similar elastic modulus as bones but yet suffers from bio-inertness and poor osteogenesis. In this work, tantalum ions are implanted energetically into PEEK by plasma immersion ion implantation (PIII) to form Ta2O5 nanoparticles in the near surface. Nanoindentation reveals that the surface elastic modulus of the Ta ion implanted PEEK is closer to that of human cortical bones. In vitro cell adhesion, alkaline phosphatase activity, collagen secretion, extracellular matrix mineralization, and real-time PCR analyses disclose enhanced adhesion, proliferation, and osteogenic differentiation of rat bone mesenchymal stem cells (bMSCs) on the Ta-PIII modified PEEK. In vivo evaluation of the cortico-cancellous rat femur model by means of micro-CT, sequential fluorescent labeling, and histological analysis after 8 weeks confirms significantly improved osteointegration. The bone-like elastic modulus and modified surface topography of the Ta-PIII modified PEEK synergistically induce osteogenic differentiation of bMSCs and the surface-modified materials have large potential in dental and orthopedic implants. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. The effects of mechanical instruments on contaminated titanium dental implant surfaces: a systematic review

    NARCIS (Netherlands)

    Louropoulou, A.; Slot, D.E.; van der Weijden, F.

    2014-01-01

    Objective The objective of this systematic review was to evaluate the ability of mechanical instruments to clean contaminated implant titanium surfaces. Materials and methods MEDLINE, Cochrane-CENTRAL and EMBASE databases were searched up to May 2013 to identify controlled studies on the cleaning

  11. Influence of mechanical instruments on the biocompatibility of titanium dental implants surfaces: a systematic review

    NARCIS (Netherlands)

    Louropoulou, A.; Slot, D.E.; van der Weijden, F.

    2015-01-01

    Objective The objective of this systematic review was to evaluate the effect of mechanical instruments on the biocompatibility of titanium dental implant surfaces. Materials and methods MEDLINE, Cochrane-CENTRAL and EMBASE databases were searched up to December 2013, to identify controlled studies

  12. Water wettability and zeta-potential of polystyrene surface modified by Ne or Na implantation

    Energy Technology Data Exchange (ETDEWEB)

    Nakao, Aiko; Suzuki, Yoshiaki; Iwaki, Masaya [Inst. of Physical and Chemical Research, Wako, Saitama (Japan). Div. of Surface Characterization

    1998-01-15

    A study has been made of the modification of the wettability and the surface potential of polystyrene by ion bombardment and implantation. Substrates used were polystyrene (PS) dishes. Ne bombardment and Na ion implantation were performed at energies of 50 and 150 keV with fluences between 1 {times} 10{sup 14} to 1 {times} 10{sup 17} ions/cm{sup 2}. The surface potential was examined by measurements of {zeta}-potential and the wettability was examined by the contact angle of water. The contact angle of water and the {zeta}-potential are found to change, depending on ion species and fluences. Two kinds of relationships between the contact angle of water and the {zeta}-potential are found, classified by region A and region B. From XPS results, region A means that PS surfaces modified by radiation effects of Ne-bombardment or Na-implantation have new functional groups and amorphous carbon. In region B, Na implanted PS surfaces with a high fluence show not only new functional groups and amorphous carbon but also Na atoms with chemical bonding states.

  13. Surface topography of zirconia implants does not alter action potentials of isolated rat sciatic nerves

    NARCIS (Netherlands)

    Ertan, A.A.; Celebi, N.; Bayolken, M.; Onur, M.A.; Aboushelib, M.N.; Feilzer, A.J.; Cehreli, M.

    2009-01-01

    The purpose of this study was to explore the effects of airborne-particle abrasion and selective infiltration etching of a yttrium-partially stabilized tetragonal zirconia polycrystal (Y-TZP) implant surfaces on nerve conduction. Particle-abraded Y-TZP (P/Y-TZP), selective infiltration etched Y-TZP

  14. Room-temperature attachment of PLGA microspheres to titanium surfaces for implant-based drug release

    Science.gov (United States)

    Xiao, Dongqin; Liu, Qing; Wang, Dongwei; Xie, Tao; Guo, Tailin; Duan, Ke; Weng, Jie

    2014-08-01

    Drug release from implant surfaces is an effective approach to impart biological activities, (e.g., antimicrobial and osteogenic properties) to bone implants. Coatings of polylactide-based polymer are a candidate for this purpose, but a continuous (fully covering) coating may be non-optimal for implant-bone fixation. This study reports a simple room-temperature method for attaching poly (lactide-co-glycolide) (PLGA) microspheres to titanium (Ti) surfaces. Microspheres were prepared with polyvinyl alcohol (PVA) or polyvinylpyrrolidone (PVP) as the emulsifier. Microspheres were attached to Ti discs by pipetting as a suspension onto the surfaces followed by vacuum drying. After immersion in shaking water bath for 14 d, a substantial proportion of the microspheres remained attached to the discs. In contrast, if the vacuum-drying procedure was omitted, only a small fraction of the microspheres remained attached to the discs after immersion for only 5 min. Microspheres containing triclosan (a broad-spectrum antibiotic) were attached by porous-surfaced Ti discs. In vitro experiments showed that the microsphere-carrying discs were able to kill Staphylococcus aureus and Escherichia Coli, and support the adhesion and growth of primary rat osteoblasts. This simple method may offer a flexible technique for bone implant-based drug release.

  15. In vivo and in vitro studies of epithelial cell behavior around titanium implants with machined and rough surfaces.

    Science.gov (United States)

    Atsuta, Ikiru; Ayukawa, Yasunori; Furuhashi, Akihiro; Ogino, Yoichiro; Moriyama, Yasuko; Tsukiyama, Yoshihiro; Koyano, Kiyoshi

    2014-10-01

    The surface roughness of a dental implant affects the epithelial wound healing process and may significantly enhance implant prognosis. We explored the influence of surface roughness on peri-implant epithelium (PIE) sealing and down-growth by comparing machine-surfaced (Ms) and rough-surfaced (Rs) implants. (1) Maxillary first molars were extracted from rats and replaced with Ms or Rs implants. (2) We also compared changes in the morphology of cultured rat oral epithelial cells (OECs) grown on Ms or Rs titanium (Ti) plates. (1) After 4 weeks, the PIE around Ms and Rs implants showed a similar structure to junctional epithelium (JE). At 16 weeks, Rs implants appeared to form a weak epithelial seal at the tissue-implant interface and exhibited markedly less PIE down-growth than Ms implants but was deeper than that observed in natural teeth. (2) We observed less expression of adhesion proteins in OECs cultured on Rs plates than in cells grown on Ms plates. Additionally, cell adherence, migration, and proliferation on Rs plates were lower, whereas apoptosis was reduced on Ms plates. Ms implants are a better choice for integration with an epithelial wound healing process. © 2013 Wiley Periodicals, Inc.

  16. Early loading of titanium dental implants with an intra-operatively conditioned hydrophilic implant surface after 21 days of healing.

    Science.gov (United States)

    Hicklin, Stefan Paul; Schneebeli, Esther; Chappuis, Vivianne; Janner, Simone Francesco Marco; Buser, Daniel; Brägger, Urs

    2016-07-01

    The aim of the present observational medical device performance study was to test whether implants with an intra-operatively conditioned hydrophilic surface can be safely reconstructed when applying an early loading protocol after 21 days in partially edentulous posterior mandibles. Partially edentulous patients with missing teeth in the posterior mandible were recruited. Immediately after implant placement, the implant position was indexed using a pickup impression technique. ISQ values were measured after 21 days of healing. When ISQ values were ≥70, the implants were directly restored with provisional reconstructions in occlusal contact allowing an early loading protocol. ISQ values were repeated again at 1, 3, and 6 months postloading. Clinical parameters (mPLI, mSBI, PPD, DIM, and CAL) were assessed. Standardized periapical radiographs were obtained after surgery, at implant loading and 3 and 6 months later. Changes over time were analyzed for statistical significance using the nonparametric method by Brunner & Langer (SAS Proc Mixed). Fifteen partially edentulous patients with healed sites in the posterior mandible received 20 implants. All implants healed uneventfully. At 21 days, all implants achieved an ISQ value of ≥70 (mean of 3 measurements) and were reconstructed at this time point with provisionals. ISQ values showed a gradual increase from baseline to 3 and 6 months postloading. The assessment of clinical parameters revealed stable tissue integration. The evaluation of the radiographs showed that 3 and 6 months after loading the median mesial and distal marginal bone levels had stabilized at the border between the rough surface and the 1-mm machined implant collar. Functional occlusal loading of implants with a hydrophilic, moderately rough endosseal surface 3 weeks after placement appears to be a safe and predictable treatment option in healed sites in the posterior mandible without need of bone augmentation procedures. © 2015 John

  17. 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.

  18. Effect of low direct current on anaerobic multispecies biofilm adhering to a titanium implant surface.

    Science.gov (United States)

    Sahrmann, Philipp; Zehnder, Matthias; Mohn, Dirk; Meier, André; Imfeld, Thomas; Thurnheer, Thomas

    2014-08-01

    Peri-implantitis is caused by biofilm adhering to the implant. It has been shown that bactericidal electrolysis products are generated when a low direct current is applied to a titanium implant used as the anode. The hypothesis of this study was that low-current electrolysis would eradicate viable bacteria in a simulated subgingival multispecies biofilm adhering to a titanium implant surface. Biofilms consisting of eight anaerobic species were grown on pellicle-coated titanium discs with sand-blasted, acid-etched, large-grit (SLA; Straumann, Basel, Switzerland) surface. After 40.5 hours of growth, discs were treated with 10 mA for 10 minutes in an electrolytical setup with physiological saline and gelatin. Low direct current at discs used as the cathode caused a reduction of three to four orders of magnitude in viable counts, while no viable bacteria were recovered from anode discs (Mann-Whitney U-test, p biofilm detachment at the cathode and reduced viability at the anode. Electrochemical treatment of diseased implants appears to be promising and well worth investigating further. © 2012 Wiley Periodicals, Inc.

  19. Silicon and matrix macromolecules: new research opportunities for old diseases from analysis of potential mechanisms of breast implant toxicity.

    Science.gov (United States)

    Brawer, A E

    1998-07-01

    An understanding of the normal and essential integration of the element silicon in biosystems, as well as knowledge of its fundamental chemistry, are crucial to understanding its role in health and disease. Modern organosilicon chemistry, based in part on the artificial silicon-carbon bond, coincided with the emergence of the biomaterials and bioengineering fields fifty years ago, and was thought to be a fortunate coincidence according to conventional wisdom that high-molecular-weight polymeric siloxanes were chemically and biologically inert. These concepts have been challenged by reports of silicone migration and degradation following insertion of gel-filled breast implants, claims of a novel systemic illness appearing in many breast implant recipients, and investigations implicating varied and permeating immunotoxic mechanisms of disease causation by breast devices. The present study develops additional potential pathogenetic ideas based on alterations of cell biochemistry by silicon-containing compounds, and offers correlation of the patients' diverse clinical features with plausable disruption of basic biological processes. This in turn raises new questions concerning everyday environmental exposure, has broad implications for multiple other diseases, can provide alternative directions for future investigative research, and may contribute to the ongoing redefinition of immune dysfunction and inflammation.

  20. Evaluation of the perceptions and cosmetic satisfaction of breast cancer patients undergoing totally implantable vascular access device (TIVAD) placement.

    Science.gov (United States)

    Liberale, Gabriel; El Houkayem, Michel; Viste, Claire; Bouazza, Fikri; Moreau, Michel; El Nakadi, Issam; Veys, Isabelle

    2016-12-01

    Totally implantable vascular access devices (TIVADs) are widely used to administer chemotherapy to cancer patients. While great progress has been made with respect to breast surgical reconstruction to take into account both aesthetics and patients' perceptions of body integrity, these aspects have not been considered with regard to the impact of TIVAD. In order to address this practice gap, we have adapted our TIVAD implantation technique to improve cosmetic results. The aim of this study was to assess breast cancer patients' comfort level and aesthetic satisfaction with regard to TIVAD insertion. Patients with breast cancer admitted for chemotherapy at an outpatient clinic completed a previously validated survey evaluating three main domains: symptoms (pain, discomfort) related to the TIVAD itself in daily activity, information received before and during the surgical procedure, and cosmetic aspects regarding the port insertion site (scar, port, and catheter location). Between September 2010 and June 2011, 232 patients were evaluated. Cosmetic satisfaction with scar location was high (93.3 %). Information given to patients before and during the procedure had a major impact on both symptom perception in daily activity and on cosmetic satisfaction. Obtaining a more aesthetic scar by placing the TIVAD in the deltopectoral groove contributed to a high rate of cosmetic satisfaction. Furthermore, the relevance of information given to patients before and/or during surgery had a major impact on symptom perception. Therefore, we suggest including a pre-operative information session in the care pathway.

  1. Protocol for a systematic review and meta-analysis on the clinical outcomes and cost of deep inferior epigastric perforator (DIEP flap versus implants for breast reconstruction

    Directory of Open Access Journals (Sweden)

    Ankur Khajuria

    2017-11-01

    Full Text Available Abstract Background Mastectomy in the context of breast malignancy can have a profoundly negative impact on a woman’s self-image, impairing personal, sexual and social relationships. The deep inferior epigastric perforator (DIEP flap and implants are the two commonest reconstructive modalities that can potentially overcome this psychological trauma. The comparative data on clinical outcomes and costs of the two modalities is limited. We aim to synthesise the current evidence on DIEP versus implants to establish which is the superior technique for breast reconstruction, in terms of clinical outcomes and cost-effectiveness. Methods A comprehensive search will be undertaken of EMBASE, MEDLINE, Google Scholar, CENTRAL and Science citation index databases (1994 up to August 2017 to identify studies relevant for the review. Primary human studies evaluating clinical outcomes and cost of DIEP and implant-based reconstruction in context of breast malignancy will be included. Primary outcomes will be patient satisfaction and cosmetic outcome from patient-reported outcome measures (scores from validated tools, e.g. BREAST-Q tool, complications and cost-analysis. The secondary outcomes will be duration of surgery, number of surgical revisions, length of stay, availability of procedures and total number of clinic visits. Discussion This will be the first systematic review and meta-analysis in available literature comparing the clinical outcomes and cost-effectiveness of DIEP and implants for breast reconstruction. This review is expected to guide worldwide clinical practice for breast reconstruction. Systematic review registration PROSPERO CRD42017072557 .

  2. RTV silicone rubber surface modification for cell biocompatibility by negative-ion implantation

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, Chenlong [Key Laboratory of Beam Technology and Material Modification Ministry of Education, College of Nuclear Science and Technology, Beijing Normal University, 100875 Beijing (China); Wang, Guangfu, E-mail: 88088@bnu.edu.cn [Key Laboratory of Beam Technology and Material Modification Ministry of Education, College of Nuclear Science and Technology, Beijing Normal University, 100875 Beijing (China); Beijing Radiation Center, 100875 Beijing (China); Chu, Yingjie; Xu, Ya; Qiu, Menglin; Xu, Mi [Key Laboratory of Beam Technology and Material Modification Ministry of Education, College of Nuclear Science and Technology, Beijing Normal University, 100875 Beijing (China)

    2016-03-01

    Highlights: • The radiation effect has a greater influence than doping effect on the hydrophilicity of RTV SR. • The implanted ions result in a new surface atomic bonding state and morphology. • Generating hydrophilic functional groups is a reason for the improved cell biocompatibility. • The micro roughness makes the hydrophilicity should be reduced due to the lotus effect. • Cell culture demonstrates that negative-ion implantation can improve biocompatibility. - Abstract: A negative cluster ion implantation system was built on the injector of a GIC4117 tandem accelerator. Next, the system was used to study the surface modification of room temperature vulcanization silicone rubber (RTV SR) for cell biocompatibility. The water contact angle was observed to decrease from 117.6° to 99.3° as the C{sub 1}{sup −} implantation dose was increased to 1 × 10{sup 16} ions/cm{sup 2}, and the effects of C{sub 1}{sup −}, C{sub 2}{sup −} and O{sub 1}{sup −} implantation result in only small differences in the water contact angle at 3 × 10{sup 15} ions/cm{sup 2}. These findings indicate that the hydrophilicity of RTV SR improves as the dose is increased and that the radiation effect has a greater influence than the doping effect on the hydrophilicity. There are two factors influence hydrophilicity of RTV: (1) based on the XPS and ATR-FTIR results, it can be inferred that ion implantation breaks the hydrophobic functional groups (Si−CH{sub 3}, Si−O−Si, C−H) of RTV SR and generates hydrophilic functional groups (−COOH, −OH, Si−(O){sub x} (x = 3,4)). (2) SEM reveals that the implanted surface of RTV SR appears the micro roughness such as cracks and wrinkles. The hydrophilicity should be reduced due to the lotus effect (Zhou Rui et al., 2009). These two factors cancel each other out and make the C-implantation sample becomes more hydrophilic in general terms. Finally, cell culture demonstrates that negative ion-implantation is an effective method

  3. Stiffness, compliance, resilience, and creep deformation: understanding implant-soft tissue dynamics in the augmented breast: fundamentals based on materials science.

    Science.gov (United States)

    Vegas, Manuel R; Martin del Yerro, Jose L

    2013-10-01

    Postoperative tissue stretch deformities are among the possible complications in breast augmentation. These deformities are responsible for many potential risks such as bottoming-out deformity, breakdown of the inframammary fold, permanent tissue atrophy, sensory loss, and breast distortion (visible implant edges and traction rippling), among others. Although the elastic properties of the breast are a major concern for plastic surgeons, concepts such as stiffness, compliance, elasticity, and resilience have not been sufficiently defined or explored in the plastic surgery literature. Similar to any other material, living tissues are subject to the fundamentals of the mechanics of materials. Based on their experience with more than 5,000 breast augmentations, the authors explored the basic fundamentals of the mechanics of materials in search of a rational explanation for long-term results in breast augmentation and augmentation-mastopexy. A basic law of the mechanics of materials determines that when a material (e.g., breast) is loaded with a force (e.g., implant), it produces a stress that causes the material to deform (e.g., breast augmentation), and this behavior might be graphed in a theoretical material's stress-stress curve. This deformation will increase with time although the load (implant) remains constant, a concept termed "creep deformation." Because the breast, like all human tissues, is a viscoelastic material, the application of concepts such as elastic and plastic deformation, stiffness, compliance, resilience, and creep deformation can and should be applied to breast augmentation surgery. The authors have found that the principles of the mechanics of materials can provide plastic surgeons with some clues for a predictable, long-lasting good result in breast augmentation and augmentation-mastopexy. Future studies are needed to develop these concepts and evaluate how they might individually determine the mid- and long-term outcomes of augmented breasts.

  4. Cluster-surface interaction: from soft landing to implantation

    DEFF Research Database (Denmark)

    Popok, Vladimir; Barke, Ingo; Campbell, Eleanor E.B.

    2011-01-01

    energy and what effects are induced under different energetic regimes. The review starts with an introduction to the field and a short history of cluster beam development. Then fundamental physical aspects of cluster formation and the most common methods for the production of cluster beams are overviewed...... for efficient smoothing of surfaces on the macroscopic scale. Several examples of successful applications of the cluster beam technique for polishing of surfaces are given. We also discuss how the physical sputtering can be combined with reactive accelerated cluster erosion. The latter can be an efficient tool...

  5. Surface evaluation of orthopedic hip implants marketed in Brazil

    Science.gov (United States)

    Souza, M. M.; Trommer, R. M.; Maru, M. M.; Roesler, C. R. M.; Barros, W. S.; Dutra, M. S.

    2016-07-01

    One of the factors that contribute to the quality of total hip prostheses is the degree of accuracy in the manufacturing of the joint surfaces. The dimensional control of joint components is important because of its direct influence on the durability and, consequently, in the patients’ life quality. This work presents studies on the form and roughness of orthopedic hip prostheses marketed in Brazil. The results provide data for quality control of the surfaces of the femoral heads and acetabular components of hip prostheses and indicate the need of improvement in the procedures used to this control.

  6. Evaluation of dental implants as a risk factor for the development of bisphosphonate-related osteonecrosis of the jaw in breast cancer patients.

    Science.gov (United States)

    Matsuo, Akira; Hamada, Hayato; Takahashi, Hidetoshi; Okamoto, Ayako; Kaise, Hiroshi; Chikazu, Daichi

    2016-09-01

    It remains unclear whether dental implants are a risk factor for the development of bisphosphonate-related osteonecrosis of the jaw (BRONJ). We retrospectively evaluated the status of dental implants in patients given intravenous bisphosphonates (BPs) in a breast cancer cohort to elucidate the risk for BRONJ at the implant site. We established a BRONJ oral monitoring program for 247 breast cancer patients given intravenous BP in our institution. The 3-year cumulative incidence rate was determined. The systemic and local risk factors of 44 patients who completed comprehensive oral examinations were evaluated by logistic regression analysis. The 3-year cumulative incidence rate of the 247 patients was 0.074 % (8/247, 95 % CI 0.0081-0.014). In the 44 orally examined patients, 6 (13.6 %: 6/44) had dental implants. Of these 6 patients, 1 developed BRONJ at the implant site. There were no significant differences in the age, total BP treatment period, number of residual teeth, time of regular oral monitoring, oral hygiene level, or dental implant insertion. Although a case of ONJ was identified, dental implants which were inserted before intravenous BP administration were not a risk factor for the development of ONJ in breast cancer patients.

  7. High surface hole concentration p-type GaN using Mg implantation

    CERN Document Server

    Long Tao; Zhang Guo Yi

    2001-01-01

    Mg ions were implanted on Mg-doped GaN grown by metalorganic chemical vapor deposition (MOCVD). The p-type GaN was achieved with high hole concentration (8.28 x 10 sup 1 sup 7 cm sup - sup 3) conformed by Van derpauw Hall measurement after annealing at 800 degree C for 1 h. this is the first experimental report of Mg implantation on Mg-doped GaN and achieving p-type GaN with high surface hole concentration

  8. Combination of chemical suppression techniques for dual suppression of fat and silicone at diffusion-weighted MR imaging in women with breast implants

    Energy Technology Data Exchange (ETDEWEB)

    Koh, Dow-Mu; Hughes, J. [Royal Marsden Hospital, Department of Radiology, Sutton (United Kingdom); Blackledge, M.; Leach, M.O.; Collins, D.J. [Institute of Cancer Research, CR UK-EPSRC Cancer Imaging Centre, Sutton (United Kingdom); Burns, S. [Nuada 3T MRI Centre, London (United Kingdom); Stemmer, A.; Kiefer, B. [Siemens Healthcare, Erlangen (Germany)

    2012-12-15

    Silicone breast prostheses prove technically challenging when performing diffusion-weighted MR imaging in the breasts. We describe a combined fat and chemical suppression scheme to achieve dual suppression of fat and silicone, thereby improving the quality of diffusion-weighted images in women with breast implants. MR imaging was performed at 3.0 and 1.5 T in women with silicone breast implants using short-tau inversion recovery (STIR) fat-suppressed echo-planar (EPI) diffusion-weighted MR imaging (DWI) on its own and combined with the slice-select gradient-reversal (SSGR) technique. Imaging was performed using dedicated breast imaging coils. Complete suppression of the fat and silicone signal was possible at 3.0 T using EPI DWI with STIR and SSGR, evaluated with dedicated breast coils. However, a residual silicone signal was still perceptible at 1.5 T using this combined approach. Nevertheless, a further reduction in silicone signal at 1.5 T could be achieved by employing thinner slice partitions and the addition of the chemical-selective fat-suppression (CHESS) technique. DWI using combined STIR and SSGR chemical suppression techniques is feasible to eliminate or reduce silicone signal from prosthetic breast implants. (orig.)

  9. Breast reconstruction - natural tissue

    Science.gov (United States)

    ... muscle flap; TRAM; Latissimus muscle flap with a breast implant; DIEP flap; DIEAP flap; Gluteal free flap; Transverse upper gracilis flap; TUG; Mastectomy - breast reconstruction with natural tissue; Breast cancer - breast reconstruction ...

  10. Early bone healing around implant surfaces treated with variations in the resorbable blasting media method. A study in rabbits.

    Science.gov (United States)

    Jeong, Ryan; Marin, Charles; Granato, Rodrigo; Suzuki, Marcelo; Gil, Jose N; Granjeiro, Jose M; Coelho, Paulo G

    2010-01-01

    this study aimed to histomorphologically and histomorphometrically evaluate the in vivo response to three variations in the resorbable blasting media (RBM) surface processing in a rabbit femur model. screw root form implants with 3.75 mm in diameter by 8 mm in length presenting four surfaces (n=8 each): alumina-blasted/acid-etched (AB/AE), bioresorbable ceramic blasted (TCP), TCP + acid etching, and AB/AE + TCP were characterized by scanning electron microscopy (SEM) and atomic force microscopy (AFM). The implants were placed at the distal femur of 8 New Zeland rabbits, remaining for 2 weeks in vivo. After sacrifice, the implants were nondecalcified processed to 30 micro m thickness slides for histomorphology and bone-to-implant contact (BIC) determination. Statistical analysis was performed by one-way ANOVA at 95% level of significance considering implant surface as the independent variable and BIC as the dependent variable. SEM and AFM showed that all surfaces presented rough textures and that calciu-hosohate particles were observed at the TCP group surface. Histologic evaluation showed intimate interaction between newly formed woven bone and all implant surfaces, demonstrating that all surfaces were biocompatible and osseoconductive. Significant differences in BIC were observed between the AB/AE and the AB/AE + TCP, and intermediate values observed for the TCP and TCP + Acid surfaces. irrespective of RBM processing variation, all surfaces were osseoconductive and biocaompatible. The differences in BIC between groups warrant further bone-implant interface biomechanical characterization.

  11. Preclinical trial of a novel surface architecture for improved primary fixation of cementless orthopaedic implants.

    Science.gov (United States)

    Harrison, Noel; Field, John R; Quondamatteo, Fabio; Curtin, William; McHugh, Peter E; Mc Donnell, Pat

    2014-09-01

    A new surface architecture for cementless orthopaedic implants (OsteoAnchor), which incorporates a multitude of tiny anchor features for enhancing primary fixation, was tested in an ovine hemi-arthroplasty pilot study. Test animals were implanted with a hip stem component incorporating the OsteoAnchor surface architecture produced using additive layer manufacturing and control animals were implanted with stems containing a standard plasma sprayed titanium coating. Intra-operative surgeon feedback indicated that superior primary fixation was achieved for the OsteoAnchor stems and rapid return to normal gait and load bearing was observed post-operation. Following a 16-week recovery time, histological evaluation of the excised femurs revealed in-growth of healthy bone into the porous structure of the OsteoAnchor stems. Bone in-growth was not achieved for the plasma sprayed stems. These results indicate the potential for the OsteoAnchor surface architecture to enhance both the initial stability and long term lifetime of cementless orthopaedic implants. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Periostin improves cell adhesion to implantable biomaterials and osteoblastic differentiation on implant titanium surfaces in a topography-dependent fashion.

    Science.gov (United States)

    Galli, C; Piergianni, M; Piemontese, M; Lumetti, S; Ravanetti, F; Cacchioli, A; Macaluso, G M; Passeri, G

    2014-11-01

    Periostin is a matricellular protein highly expressed in periodontal ligament and periostium and has been shown to be required for tissue development and maintenance. We showed that the adhesion of murine osteoblastic MC3T3 cells to thiolated hyaluronic acid/polyethyleneglycol hydrogels was greatly improved by enrichment with periostin. Polished or sand-blasted/acid-etched (SLA) commercially pure titanium surfaces were also coated with this protein and periostin ameliorated cell adhesion and dramatically affected cell morphology on both surfaces, as assessed at fluorescence microscopy, scanning electron microscopy, and chemiluminescence-based viability assay. Moreover, periostin increased the expression of alkaline phosphatase, osteoprotegerin, connective tissue growth factor, collagen 1a1, osteocalcin, Runx2, and osterix transcription factors on smooth surfaces. However, it did not affect, or even decreased, the expression of these genes on SLA discs. Transcript levels for connexin 43 were greatly increased on both surfaces in the presence of periostin. Taken together, these results show that periostin coatings can be a viable approach to improve cell adhesion and differentiation on implantable biomaterials. © 2013 Wiley Periodicals, Inc.

  13. Biological characterization of implant surfaces - in vitro study

    Directory of Open Access Journals (Sweden)

    Priscilla Barbosa Ferreira Soares

    Full Text Available AbstractObjectiveEvaluate the biological performance of titanium alloys grade IV under different surface treatments: sandblasting and double etching (Experimental surface 1; Exp1, NEODENT; surface with wettability increase (Experimental surface 2; Exp2, NEODENT on response of preliminary differentiation and cell maturation.Material and methodImmortalized osteoblast cells were plated on Exp1 and Exp2 titanium discs. The polystyrene plate surface without disc was used as control group (C. Cell viability was assessed by measuring mitochondrial activity (MTT at 4 and 24 h (n = 5, cell attachment was performed using trypan blue exclusion within 4 hours (n = 5, serum total protein and alkaline phosphatase normalization was performed at 4, 7 and 14 days (n = 5. Data were analyzed using one-way ANOVA and Tukey test.ResultThe values of cell viability were: 4h: C– 0.32±0.01A; Exp1– 0.34±0.08A; Exp2– 0.29±0.03A. 24h: C– 0.43±0.02A; Exp1– 0.39±0.01A; Exp2– 0.37±0.03A. The cell adhesion counting was: C– 85±10A; Exp1- 35±5B; Exp2– 20±2B. The amounts of serum total protein were 4d: C– 40±2B; Exp1– 120±10A; Exp2– 130±20A. 7d: C– 38±2B; Exp1– 75±4A; Exp2– 70±6A. 14 d: C– 100±3A; Exp1– 130±5A; Exp2– 137±9A. The values of alkaline phosphatase normalization were: 4d: C– 2.0±0.1C; Exp1– 5.1±0.8B; Exp2– 9.8±2.0A. 7d: C– 1.0±0.01C; Exp1– 5.3±0.5A; Exp2– 3.0±0.3B. 14 d: C– 4.1±0.3A; Exp1– 4.4±0.8A; Exp2– 2.2±0.2B. Different letters related to statistical differences.ConclusionThe surfaces tested exhibit different behavior at dosage of alkaline phosphatase normalization showing that the Exp2 is more associated with induction of cell differentiation process and that Exp1 is more related to the mineralization process.

  14. Direct-to-Implant Breast Reconstruction without the Use of an Acellular Dermal Matrix Is Cost Effective and Oncologically Safe.

    Science.gov (United States)

    Serrurier, L Charles J; Rayne, Sarah; Venter, Marisse; Benn, Carol-Ann

    2017-04-01

    Direct-to-implant breast reconstruction is a predictable, reliable, and cost-effective reconstruction. Most units performing direct-to-implant reconstructions recommend the use of an acellular dermal matrix or a mesh to reinforce the lower pole of the breast reconstruction. Two hundred seventy-two consecutive patients with 488 immediate direct-to-implant breast reconstructions performed in a 34-month period are included in this group. Mean follow-up of this group is 35 months. Four hundred eight reconstructions were performed through a lazy-S mastectomy, and 80 were performed through a Wise pattern mastectomy. Two local recurrences occurred. Minor complications accounted for 5.5 percent (n = 27): seromas, 3.4 percent (n = 17); wound healing problems, 0.6 percent (n = 3); and grade 2 capsular contracture, 1.4 percent (n = 7). Major complications accounted for 4.3 percent (n = 21): infection, 0.8 percent (n = 4); prosthetic loss, 0.4 percent (n = 2); hematoma, 0.4 percent (n = 2); and wounds requiring débridement, 2 percent (n = 10). The additional cost of acellular dermal matrix is dependent on manufacturer and size, but increases the cost of the procedure by 35.5 to 47.7 percent. This reconstruction method compares very favorably with published data from other units as far as early and late complications and cosmetic outcome are concerned. It has a complication rate similar to that of reconstructions using an acellular dermal matrix and is more cost effective. Therapeutic, IV.

  15. High power density vertical-cavity surface-emitting lasers with ion implanted isolated current aperture.

    Science.gov (United States)

    Higuchi, Akira; Naito, Hideyuki; Torii, Kousuke; Miyamoto, Masahiro; Morita, Takenori; Maeda, Junya; Miyajima, Hirofumi; Yoshida, Harumasa

    2012-02-13

    We report on GaAs-based high power density vertical-cavity surface-emitting laser diodes (VCSELs) with ion implanted isolated current apertures. A continuous-wave output power of over 380 mW and the power density of 4.9 kW/cm2 have been achieved at 15 °C from the 100-μm-diameter aperture, which is the highest output characteristic ever reported for an ion implanted VCSEL. A high background suppression ratio of over 40 dB has also been obtained at the emission wavelength of 970 nm. The ion implantation technique provides an excellent current isolation in the apertures and would be a key to realize high power output from a VCSEL array.

  16. The influence of surface roughness on the displacement of osteogenic bone particles during placement of titanium screw-type implants.

    Science.gov (United States)

    Tabassum, Afsheen; Walboomers, Frank; Wolke, Johannes G C; Meijer, Gert J; Jansen, John A

    2011-12-01

    Previously, we demonstrated that bone debris, which is translocated during dental implant placement, has osteogenic potential. Therefore, it was hypothesized that implant surface roughness can influence the amount of translocated bone debris/particles and thereby the osteogenic response. Small titanium implants were left turned (smooth) or blasted and acid etched. The implants were placed in fresh cadaver bone. After explantation, the implants were incubated in a culture medium containing β-glycerophosphate and dexamethasone up to 24 days. Subsequently, histology, scanning electron microscopy (SEM), DNA analysis, and calcium (Ca) content measurements were performed. For both types of implant during implant placement, bone particles were translocated because of inherent roughness of the implant. SEM and histology confirmed the presence of a bone-like tissue on the surface of both types of implants, as also confirmed by DNA and Ca measurements. However, the significantly higher roughness of the etched implants accounted for more bone debris and accordingly elevated osteogenic response. Control samples, which had not been placed into bone, did not show mineralization in the same medium. The present study, for the first time, demonstrated that implant surface roughness can increase the amount of the translocated bone particles and thereby also have a beneficial effect on the osteogenic response of these bone particles. It is hypothesized that these bone fragments behave like miniature auto-grafts and thereby play a significant role to enhance peri-implant osteogenesis. Optimization of surface topography should be evaluated to take advantage of this additional effect of surface roughness. © 2009 Wiley Periodicals, Inc.

  17. 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.

  18. 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.

  19. TiLoop® Bra mesh used for immediate breast reconstruction: comparison of retropectoral and subcutaneous implant placement in a prospective single-institution series.

    Science.gov (United States)

    Casella, Donato; Bernini, Marco; Bencini, Lapo; Roselli, Jenny; Lacaria, Maria Teresa; Martellucci, Jacopo; Banfi, Roberto; Calabrese, Claudio; Orzalesi, Lorenzo

    2014-01-01

    Immediate implant reconstruction after a conservative mastectomy is an attractive option made easier by prosthetic devices. Titanized polypropylene meshes are used as a hammock to cover the lower lateral implant pole. We conducted a prospective nonrandomized single-institution study of reconstructions using titanium-coated meshes either in a standard muscular mesh pocket or in a complete subcutaneous approach. The complete subcutaneous approach means to wrap an implant with titanized mesh in order to position the implant subcutaneously and spare muscles. Between November 2011 and January 2014, we performed immediate implant breast reconstructions after conservative mastectomies using TiLoop® Bra, either with the standard retropectoral or with a prepectoral approach. Selection criteria included only women with normal Body Mass Index (BMI), no large and very ptotic breasts, no history of smoking, no diabetes, and no previous radiotherapy. We analyzed short-term outcomes of such procedures and compared the outcomes to evaluate implant losses and surgical complications. A total of 73 mastectomies were performed. Group 1 comprised 29 women, 5 bilateral procedures, 34 reconstructions, using the standard muscular mesh pocket. Group 2 comprised 34 women, 5 bilateral procedures, 39 reconstructions with the prepectoral subcutaneous technique. Baseline and oncologic characteristics were homogeneous between the two groups. After a median follow-up period of 13 and 12 months, respectively, no implant losses were recorded in group 1, and one implant loss was recorded in group 2. We registered three surgical complications in group 1 and two surgical complications in group 2. Titanium-coated polypropylene meshes, as a tool for immediate definitive implant breast reconstruction, resulted as safe and effective in a short-term analysis, both for a retropectoral and a totally subcutaneous implant placement. Long-term results are forthcoming. A strict selection is mandatory to

  20. Interactions Between Peg Brushes in Aqueous Medium: Soft Surface Modification for Implants and Biomaterials

    Science.gov (United States)

    Raviv, Uri; Frey, Joseph; Laurat, Pierre; Tadmor, Rafael; Klein, Jacob

    2001-03-01

    Poly(ethylene glycol) (PEG) is a water soluble polymer compatible with the immune system of the human body. Thus it may be a good candidate to modify surfaces of artificial implants, or to serve as a soft spacer for modifying surfaces with different biomolecules. To examine this, direct measurements of the normal and shear forces between two atomically smooth mica surfaces bearing functionalised PEG immersed in pure (conductivity) water have been carried out as a function of surface separation. PEG (Mw=3.4k) that has been functionalised on both ends, was introduced into water and adsorbed only at one end onto the mica surface. A monotonically-increasing force-distance law was indicated, beginning at surface separations of 100nm. This repulsion is shorter ranged than in the conductivity water, due to the shorter Debye length in the presence of higher ion concentration. High repulsion forces starting at 5nm are due to the extensive compression of the grafted polymer layers. The range of the high repulsion forces (3-5nm) and the AFM images indicate that the modified PEG molecules form a uniform monolayer on the surface. Shear motion was then applied between the surfaces, at separations from some tens of nanometers down to closest approach distance, and the lubricating properties of the layers were investigated. Results, which suggests that such PEG molecules can be readily used for surface modification of implants as well as precurser for active biomolecules, will be presented at the meeting.

  1. Analysis of the surface deformation of dental implants submitted to pullout and insertion test

    Directory of Open Access Journals (Sweden)

    Mariana Lima da Costa Valente

    2014-01-01

    Full Text Available Objective: The aim of the present study was to evaluate the possible deformations in the surface of dental implants submitted to pullout and insertion test in polyurethane synthetic bone, using scanning electron microscopy. Material and Methods: Four different types of implants were used: Master Screw, Master Porous, Master Conect AR and Master Conect Conical (n = 8. These implants were into the femoral head synthetic bone (Synbone and removed through the pullout test, performed with a universal testing machine (EMIC MEM 2000. All the screws, before and after the mechanical tests, were micro structurally analyzed in a Scanning Electron Microscope (SEM - Zeiss EVO50, utilizing a magnification of 35 times. The results were subjected to ANOVA and Tukey tests (α =0.05. Results: Only the Master Conect Conical and Master Porous implants presented statistically significant difference to pullout and maximum deformation (P = 0.014 and P = 0.009, respectively. The SEM images did not show morphological changes of the implants when compared before and after the mechanical tests. Conclusion: We concluded that Master Porous presented higher pullout resistance, suggesting a greater primary stability.

  2. Laser-assisted surface modification of Ti-implant in air and water environment

    Science.gov (United States)

    Trtica, M.; Stasic, J.; Batani, D.; Benocci, R.; Narayanan, V.; Ciganovic, J.

    2018-01-01

    A study of the surface modification of titanium CP grade 2 implant/target with high intensity picosecond (Nd:YAG) laser, operating at 1064 nm wavelength and pulse duration of 40 ps, in gaseous (air) and liquid (water) medium, is presented. The exposure of Ti to a laser pulse energy of 17 mJ in both media - gaseous and liquid, induced specific surface features and phenomena: (i) enhancement of the implant surface roughness (higher in water). In this context, the damage depth is more prominent in water (as high as ∼40 μm) vs. air (∼14 μm). Also, the appearance of laser induced periodic surface structures (LIPSS) is recorded in both media, at periphery area, while in water they are registered at lower pulse count; (ii) variation of chemical surface content depending on the applied medium. Thus, in the central irradiation region, the oxygen was absent in air while its concentration was relatively high (6.44 wt%) in case of water; (iii) possibility of direct collection of synthesized titanium based nanoparticles in water environment, and (iv) formation of the plasma above the sample in both mediums, more volumetrically confined in water. These investigations showed that surface structuring and observed phenomena are in strong correlation with the medium used. The liquid - water seems like the medium of choice in regard to titanium implant biocompatibility and bio-activity (the water is a favorable medium for build-up of the oxide layer which affects bioactivity). The process of laser interaction with titanium implant targets was accompanied by the formation of plasma plume, which provides the additional sterilizing effect facilitating contaminant-free conditions.

  3. Bone healing with or without platelet-rich plasma around four different dental implant surfaces in beagle dogs.

    Science.gov (United States)

    Streckbein, Philipp; Kleis, Wilfried; Buch, Rainer S R; Hansen, Torsten; Weibrich, Gernot

    2014-08-01

    Surface development is one of the major aims in dental implant engineering. Additive application of substances could possibly improve the new bone formation around dental implants. The present study evaluated the bone reaction on four different implant surfaces with or without platelet-rich plasma (PRP). Four self-tapping titanium screw implants (Brånemark MK III [Nobel Biocare, Göteborg, Sweden], Osseotite [3i, Miami, FL, USA], Xive [Densply Friadent, Mannheim, Germany], and Compress [IGfZ eG, Diez, Germany]) with different surfaces were inserted in each hemimandible of 12 female beagle dogs; the implant positions and the application of PRP were randomized. After intravital fluorochrome staining, sacrifices and biopsies harvesting were performed after 6 weeks (five dogs; one dog died before) and 12 weeks (six dogs) and the respective specimens were analyzed. The only significant difference in bone remodeling was found for the Compress implants with increased bone formation compared with the Brånemark implants at 12 weeks (sign test, p = .03). Comparing the histological and histomorphometric specimens of all other implant surfaces with respect to peri-implant bone remodeling and the resulting bone-implant contact rates (BICRs), no statistically significant differences were seen in the PRP or non-PRP groups (sign test, all p values ≥ .063). This study found no significant differences in the BICR for roughened implant surfaces compared with machined surfaces. In this animal model, the addition of PRP did not demonstrate evidence of faster bone formation or the resulting BICR. © 2013 Wiley Periodicals, Inc.

  4. Surface coatings for improvement of bone cell materials and antimicrobial activities of Ti implants.

    Science.gov (United States)

    Das, Kakoli; Bose, Susmita; Bandyopadhyay, Amit; Karandikar, Balu; Gibbins, Bruce L

    2008-11-01

    Ti surface was modified to simultaneously improve bone cell materials and antimicrobial activities. Titanium surface was first anodized in sodium fluoride and sulfuric acid electrolytic solution to form titania nanotube on the surface to improve the biocompatibility of the surface. Silver was electrodeposited on the titania nanotube surface at 5 V. Silver added titania nanotube surface was tested for compatibility with bone-cell materials interactions using human osteoblast bone cells. The antibacterial effect was studied using Pseudomonas aeruginosa. Our results show that silver-treated titania nanotube surface may provide antibacterial properties to prevent implants against postoperative infections without interference to the attachment and proliferation of bone tissue on titanium, which is commonly used in dental and orthopedic surgical procedures.

  5. A nationwide study of connective tissue disease and other rheumatic conditions among Danish women with long-term cosmetic breast implantation

    DEFF Research Database (Denmark)

    Fryzek, Jon P; Holmich, Lisbet; McLaughlin, Joseph K

    2007-01-01

    population-based cohort study of Danish women with cosmetic breast implants (n = 2761) and comparison groups of women with other types of cosmetic surgery (n = 8807). All women were followed from January 1977 through December 2001. Hospitalization and outpatient data for CTD and ill-defined and other...... (standardized rate ratio = 1.5; 95% confidence interval = 1.4 to 1.7) cohorts. In analyses of diagnoses validated by chart review, women with cosmetic breast implants compared with those having other types of plastic surgery or consultation for plastic surgery had no statistically significant excess for any...

  6. Cell surface heparan sulfate proteoglycans control adhesion and invasion of breast carcinoma cells

    DEFF Research Database (Denmark)

    Lim, Hooi Ching; Multhaupt, Hinke A. B.; Couchman, John R.

    2015-01-01

    phenotype of mammary carcinoma cells. Finally, both syndecan-2 and caveolin-2 were upregulated in tissue arrays from breast cancer patients compared to normal mammary tissue. Moreover their expression levels were correlated in triple negative breast cancers. Conclusion: Cell surface proteoglycans, notably...

  7. Surface modification of investment cast-316L implants: microstructure effects.

    Science.gov (United States)

    El-Hadad, Shimaa; Khalifa, Waleed; Nofal, Adel

    2015-03-01

    Artificial femur stem of 316L stainless steel was fabricated by investment casting using vacuum induction melting. Different surface treatments: mechanical polishing, thermal oxidation and immersion in alkaline solution were applied. Thicker hydroxyapatite (HAP) layer was formed in the furnace-oxidized samples as compared to the mechanically polished ones. The alkaline treatment enhanced the precipitation of HAP on the samples. It was also observed that the HAP precipitation responded differently to the different phases of the microstructure. The austenite phase was observed to have more homogeneous and smoother layer of HAP. In addition, the growth of HAP was sometimes favored on the austenite phase rather than on ferrite phase. Copyright © 2014 Elsevier B.V. All rights reserved.

  8. Reduction of biofilm infection risks and promotion of osteointegration for optimized surfaces of titanium implants.

    Science.gov (United States)

    Gasik, Michael; Van Mellaert, Lieve; Pierron, Dorothée; Braem, Annabel; Hofmans, Dorien; De Waelheyns, Evelien; Anné, Jozef; Harmand, Marie-Françoise; Vleugels, Jozef

    2012-01-11

    Titanium-based implants are widely used in modern clinical practice; however, complications associated with implants due to bacterial-induced infections arise frequently, caused mainly by staphylococci, streptococci, Pseudomonas spp. and coliform bacteria. Although increased hydrophilicity of the biomaterial surface is known to be beneficial in minimizing the biofilm, quantitative analyses between the actual implant parameters and bacterial development are scarce. Here, the results of in vitro studies of Staphylococcus aureus and Staphylococcus epidermidis proliferation on uncoated and coated titanium materials with different roughness, porosity, topology, and hydrophilicity are shown. The same materials have been tested in parallel with respect to human osteogenic and endothelial cell adhesion, proliferation, and differentiation. The experimental data processed by meta-analysis are indicating the possibility of decreasing the biofilm formation by 80-90% for flat substrates versus untreated plasma-sprayed porous titanium and by 65-95% for other porous titanium coatings. It is also shown that optimized surfaces would lead to 10-50% enhanced cell proliferation and differentiation versus reference porous titanium coatings. This presents an opportunity to manufacture implants with intrinsic reduced infection risk, yet without the additional use of antibacterial substances. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  9. Implantation of looped epicardial cardioverter defibrillator coil on the surface of the right ventricular outflow tract.

    Science.gov (United States)

    Ozyuksel, Arda; Ersoy, Cihangir; Akdeniz, Celal; Akcevin, Atif; Turkoglu, Halil; Tuzcu, Volkan

    2015-04-01

    We present the early results of looped epicardial cardioverter defibrillator coil implantation on the anterior surface of right ventricular outflow tract in infants and children. Patients with a surgical history of an epicardial implantable cardioverter defibrillator system between 2013 and 2014 were included in the study. Patient age, gender, body weight, indications for a cardioverter defibrillator system implantation, defibrillation threshold values, and defibrillation therapies were retrospectively evaluated. There were eight patients with a mean age of 4.4 ± 2.9 years and a mean body weight of 19.5 ± 11.7 kg. Five of the patients had been diagnosed with long QT syndrome, one patient had been diagnosed with genetic channelopathy and noncompaction of the left ventricle, and two patients had been diagnosed with univentricle physiology. The implantable cardioverter defibrillator system was composed of pace-sense leads, an abdominal active can, and a defibrillation coil placed below the pulmonary valve annulus on the anterior surface of the heart. The mean defibrillation threshold was 6.6 ± 2.3 joules. There were four appropriate therapies in two patients in a mean follow-up of 9 ± 6.5 months. The significantly low defibrillation thresholds with the defibrillation coils located below the pulmonary valve annulus are encouraging. However, a larger patient series will be necessary to evaluate the safety and reliability of this technique. © 2015 Wiley Periodicals, Inc.

  10. Modification in surface properties of poly-allyl-diglycol-carbonate (CR-39 implanted by Au+ ions at different fluences

    Directory of Open Access Journals (Sweden)

    Sagheer Riffat

    2016-06-01

    Full Text Available Ion implantation has a potential to modify the surface properties and to produce thin conductive layers in insulating polymers. For this purpose, poly-allyl-diglycol-carbonate (CR-39 was implanted by 400 keV Au+ ions with ion fluences ranging from 5 × 1013 ions/cm2 to 5 × 1015 ions/cm2. The chemical, morphological and optical properties of implanted CR-39 were analyzed using Raman, Fourier transform infrared (FT-IR spectroscopy, atomic force microscopy (AFM and UV-Vis spectroscopy. The electrical conductivity of implanted samples was determined through four-point probe technique. Raman spectroscopy revealed the formation of carbonaceous structures in the implanted layer of CR-39. From FT-IR spectroscopy analysis, changes in functional groups of CR-39 after ion implantation were observed. AFM studies revealed that morphology and surface roughness of implanted samples depend on the fluence of Au ions. The optical band gap of implanted samples decreased from 3.15 eV (for pristine to 1.05 eV (for sample implanted at 5 × 1015 ions/cm2. The electrical conductivity was observed to increase with the ion fluence. It is suggested that due to an increase in ion fluence, the carbonaceous structures formed in the implanted region are responsible for the increase in electrical conductivity.

  11. Formation of interstitial atoms in surface layers of helium-implanted tungsten

    Science.gov (United States)

    Dudka, O. V.; Ksenofontov, V. A.; Masilov, A. A.; Sadanov, E. V.

    2013-11-01

    Using a method of field ion microscopy, the atomic structure of surface and near-surface layers of a perfect dislocation-free tungsten irradiated by helium ions with energies below the threshold of displacement was studied. We have found the output of tungsten atoms from the bulk as a result of their displacement from regular lattice positions occupied by implanted helium atoms and the formation of interstitial tungsten atoms. It is shown that high concentrations of helium and the presence of image forces have a considerable effect on the development of these processes. Depleted zones consisting of helium-vacancy complexes are revealed within the irradiated near-surface layer.

  12. Effect of Mo Ion Implantation on Stability of Nanocrystalline Copper Surface Layers

    Directory of Open Access Journals (Sweden)

    XI Yang

    2016-08-01

    Full Text Available The surface of pure copper was modified using the surface mechanical attrition treatment (SMAT method, and molybdenum ions were implanted in the nanosurface using a metal vapor vacuum arc (MEVVA. The results of the SMAT were observed by optical microscopy (OM, X-ray diffraction (XRD and scanning electron microscopy (SEM. An obvious nanocrystalline layer and a deformation region exist on the surface. The size of the nanocrystalline layer was characterized using atomic force microscopy (AFM. The results indicate remarkable suppression on grain size, the nanocrystalline layer grows to 163nm after annealing and reduces to only 72nm due to the Mo ion implantation. In addition, the hardness of the topmost surface of the material is 3.5 times that of the SMATed copper, which is about 7 times of the value of the matrix. The above improvements most likely result from the dispersion of the Mo ions and the reactions of the crystal defects due to the SMAT and ion implantation.

  13. A single-centre, retrospective proof-of-concept review of salvage of infected or exposed implant breast reconstructions with explantation and one-stage free flap replacement.

    Science.gov (United States)

    Bramhall, Russell J; Hernan, Izaro; Harris, Paul A

    2017-10-18

    Implant-based breast reconstruction has relatively high complication rates. Removal of infected implants and immediate autologous reconstruction is a safe single-stage procedure that preserves the native breast skin envelope. A single-centre, retrospective proof-of-concept review of all salvage procedures performed for acute/chronic infected or exposed implant-based reconstructions by a single surgeon over a 6-year period. We present 13 cases of a particularly difficult subgroup of acute/chronic infection/extrusion over a 6-year period. All were successfully salvaged in a single procedure by implant removal and immediate free flap reconstruction with no significant complications. All patients had a change of pocket from subpectoral to subcutaneous and partial capsulectomies. Four patients had unilateral DIEP flaps for unilateral reconstruction, 3 bi-pedicle DIEP flaps for unilateral reconstruction, 2 bilateral TUG flaps for unilateral reconstruction, 3 bilateral DIEP flaps for bilateral reconstruction and 1 unilateral DIEP and implant for unilateral reconstruction. These patients are often slim with limited donor sites and pose technical challenges, often requiring double free flap reconstructions. Single-stage implant removal and autologous reconstruction preserves the breast skin envelope to maximise cosmesis in a single procedure. The introduction of healthy, well-vascularised tissue may also help treat the infection. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  14. A strontium-incorporated nanoporous titanium implant surface for rapid osseointegration

    Science.gov (United States)

    Zhang, Wenjie; Cao, Huiliang; Zhang, Xiaochen; Li, Guanglong; Chang, Qing; Zhao, Jun; Qiao, Yuqin; Ding, Xun; Yang, Guangzheng; Liu, Xuanyong; Jiang, Xinquan

    2016-02-01

    Rapid osseointegration of dental implants will shorten the period of treatment and enhance the comfort of patients. Due to the vital role of angiogenesis played during bone development and regeneration, it might be feasible to promote rapid osseointegration by modifying the implant surface to gain a combined angiogenesis/osteogenesis inducing capacity. In this study, a novel coating (MAO-Sr) with strontium-incorporated nanoporous structures on titanium implants was generated via a new micro-arc oxidation, in an attempt to induce angiogenesis and osteogenesis to enhance rapid osseointegration. In vitro, the nanoporous structure significantly enhanced the initial adhesion of canine BMSCs. More importantly, sustained release of strontium ions also displayed a stronger effect on the BMSCs in facilitating their osteogenic differentiation and promoting the angiogenic growth factor secretion to recruit endothelial cells and promote blood vessel formation. Advanced mechanism analyses indicated that MAPK/Erk and PI3K/Akt signaling pathways were involved in these effects of the MAO-Sr coating. Finally, in the canine dental implantation study, the MAO-Sr coating induced faster bone formation within the initial six weeks and the osseointegration effect was comparable to that of the commercially available ITI implants. These results suggest that the MAO-Sr coating has the potential for future use in dental implants.Rapid osseointegration of dental implants will shorten the period of treatment and enhance the comfort of patients. Due to the vital role of angiogenesis played during bone development and regeneration, it might be feasible to promote rapid osseointegration by modifying the implant surface to gain a combined angiogenesis/osteogenesis inducing capacity. In this study, a novel coating (MAO-Sr) with strontium-incorporated nanoporous structures on titanium implants was generated via a new micro-arc oxidation, in an attempt to induce angiogenesis and osteogenesis to

  15. 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.

  16. Effect of ion implantation on fatigue strength of martensitic stainless steel and surface hardness evaluation by ultra micro hardness tester

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, Tsuneshichi [Ritsumeikan Univ., Kyoto (Japan). Faculty of Science and Engineering; Nakayama, Hideaki; Kato, Masahiko

    1995-02-01

    The effect of surface modification by ion implantation on the fatigue strength of 13Cr martensitic stainless steel was first described. Then the relationship between the fatigue performance and the surface microhardness of the material was dealt with. N{sup +} ions were implanted into the specimen surface with doses in the range of 5x10{sup 13} ions/cm{sup 2} - 5x10{sup 17} ions/cm{sup 2} with energy level of 350 keV. The results of out-of-plane bending fatigue tests revealed that the fatigue strength was improved by the ion implantation with implantation doses more than 2x10{sup 17} ions/cm{sup 2}, and that the further increase of fatigue strength was attained by the post heat treatment following the ion implantation. The microhardness of ultra-thin surface layer of submicron order was evaluated by the method previously proposed by the authors. The results indicated that the surface layer was hardened by the ion implantation and the hardness was increased by the post heat treatment. A remarkable increase in hardness was observed at the surface layer after the fatigue test, and this increase of the microhardness well coincides with the improvement of fatigue strength by ion implantation and post heat treatment. (author).

  17. THE INFLUENCE OF SURFACE-FREE ENERGY ON SUPRAGINGIVAL AND SUBGINGIVAL PLAQUE MICROBIOLOGY - AN IN-VIVO STUDY ON IMPLANTS

    NARCIS (Netherlands)

    QUIRYNEN, M; VANDERMEI, HC; BOLLEN, CML; VANDENBOSSCHE, LH; DOORNBUSCH, GI; VANSTEENBERGHE, D; BUSSCHER, HJ

    THE INFLUENCE OF SURFACE FREE ENERGY on supra- and subgingival plaque microbiology was examined in 9 patients with functional fixed prostheses supported by endosseous titanium implants. Two abutments (trans-mucosal part of the 2 stage implant) were replaced by either a new titanium abutment or a

  18. Direct delayed breast reconstruction with TAP flap, implant and acellular dermal matrix (TAPIA)

    DEFF Research Database (Denmark)

    Børsen-Koch, Mikkel; Gunnarsson, Gudjon L; Udesen, Ann

    2015-01-01

    BACKGROUND: The latissimus dorsi (LD) flap is considered one of the working horses within the field of breast reconstruction and it offers several advantages. However, donor-site morbidity may pose a problem. This article describes a new and modified technique for delayed breast reconstruction co...... there is a learning curve, this simple modified technique does not demand any perforator or other vessel dissection. Any trained plastic surgeon should be able to adopt the technique into the growing armamentarium of breast reconstruction possibilities....

  19. Bio-mimicking nano and micro-structured surface fabrication for antibacterial properties in medical implants.

    Science.gov (United States)

    Jaggessar, Alka; Shahali, Hesam; Mathew, Asha; Yarlagadda, Prasad K D V

    2017-10-02

    Orthopaedic and dental implants have become a staple of the medical industry and with an ageing population and growing culture for active lifestyles, this trend is forecast to continue. In accordance with the increased demand for implants, failure rates, particularly those caused by bacterial infection, need to be reduced. The past two decades have led to developments in antibiotics and antibacterial coatings to reduce revision surgery and death rates caused by infection. The limited effectiveness of these approaches has spurred research into nano-textured surfaces, designed to mimic the bactericidal properties of some animal, plant and insect species, and their topographical features. This review discusses the surface structures of cicada, dragonfly and butterfly wings, shark skin, gecko feet, taro and lotus leaves, emphasising the relationship between nano-structures and high surface contact angles on self-cleaning and bactericidal properties. Comparison of these surfaces shows large variations in structure dimension and configuration, indicating that there is no one particular surface structure that exhibits bactericidal behaviour against all types of microorganisms. Recent bio-mimicking fabrication methods are explored, finding hydrothermal synthesis to be the most commonly used technique, due to its environmentally friendly nature and relative simplicity compared to other methods. In addition, current proposed bactericidal mechanisms between bacteria cells and nano-textured surfaces are presented and discussed. These models could be improved by including additional parameters such as biological cell membrane properties, adhesion forces, bacteria dynamics and nano-structure mechanical properties. This paper lastly reviews the mechanical stability and cytotoxicity of micro and nano-structures and materials. While the future of nano-biomaterials is promising, long-term effects of micro and nano-structures in the body must be established before nano-textures can

  20. Surface modification of biomaterials using plasma immersion ion implantation and deposition

    OpenAIRE

    Lu, Tao; Qiao, Yuqin; Liu, Xuanyong

    2012-01-01

    Although remarkable progress has been made on biomaterial research, the ideal biomaterial that satisfies all the technical requirements and biological functions is not available up to now. Surface modification seems to be a more economic and efficient way to adjust existing conventional biomaterials to meet the current and ever-evolving clinical needs. From an industrial perspective, plasma immersion ion implantation and deposition (PIII&D) is an attractive method for biomaterials owing to it...

  1. The microstructure and surface hardness of Ti6Al4V alloy implanted with nitrogen ions at an elevated temperature

    Energy Technology Data Exchange (ETDEWEB)

    Vlcak, Petr, E-mail: petr.vlcak@fs.cvut.cz [Department of Physics, Faculty of Mechanical Engineering, Czech Technical University in Prague, Technicka 4, 16607 Prague (Czech Republic); Cerny, Frantisek [Department of Physics, Faculty of Mechanical Engineering, Czech Technical University in Prague, Technicka 4, 16607 Prague (Czech Republic); Drahokoupil, Jan [Department of Metals, Institute of Physics, AS CR, v.v.i., Na Slovance 2, 182 21 Prague (Czech Republic); Sepitka, Josef [Department of Mechanics, Biomechanics and Mechatronics, Faculty of Mechanical Engineering, Czech Technical University in Prague, Technicka 4, 16607 Prague (Czech Republic); Tolde, Zdenek [Department of Materials Engineering, Faculty of Mechanical Engineering, Czech Technical University in Prague, Technicka 4, 16607 Prague (Czech Republic)

    2015-01-25

    Highlights: • The Ti6Al4V samples were implanted with 90 keV nitrogen ions. • The samples were annealed at 500 °C during the ion implantation process. • An elevated temperature increases the mobility of the atoms and the quantity of TiN. • The hardness showed a significant increase compared to room temperature implantation. - Abstract: The effect of an elevated temperature during nitrogen ion implantation on the microstructure and on the surface hardness of Ti6Al4V titanium alloy was examined. The implantation process was carried out at fluences of 1 ⋅ 10{sup 17}, 2.7 ⋅ 10{sup 17} and 6 ⋅ 10{sup 17} cm{sup −2} and at ion energy 90 keV. The implanted samples were annealed at 500 °C during the implantation process. X-ray diffraction analysis was performed to obtain a phase characterization and a phase quantification in the implanted sample surface. The surface hardness was investigated by nanoindentation testing, and the nitrogen depth distribution was measured by Rutherford Backscattering Spectroscopy. Elevated temperature led to increased formation of a TiN compound. It was found that a mixture of TiN and an α-Ti(+N) solid solution had a predominant amount of TiN for samples with fluence of 2.7 ⋅ 10{sup 17} cm{sup −2} or higher. Elevated temperature during ion implantation caused an increase in surface hardening more towards the depth of the substrate in comparison with room temperature implantation. The hardness showed a remarkably significant increase at a fluence of 1 ⋅ 10{sup 17} and 2.7 ⋅ 10{sup 17} cm{sup −2} compared to samples implanted at the same fluences and at room temperature. There is a discussion of such mechanisms that explain the observed hardening more towards the depth of the substrate, and the increase in hardness.

  2. Initial Bacterial Adhesion on Different Yttria-Stabilized Tetragonal Zirconia Implant Surfaces in Vitro

    Directory of Open Access Journals (Sweden)

    Lamprini Karygianni

    2013-12-01

    Full Text Available Bacterial adhesion to implant biomaterials constitutes a virulence factor leading to biofilm formation, infection and treatment failure. The aim of this study was to examine the initial bacterial adhesion on different implant materials in vitro. Four implant biomaterials were incubated with Enterococcus faecalis, Staphylococcus aureus and Candida albicans for 2 h: 3 mol % yttria-stabilized tetragonal zirconia polycrystal surface (B1a, B1a with zirconium oxide (ZrO2 coating (B2a, B1a with zirconia-based composite coating (B1b and B1a with zirconia-based composite and ZrO2 coatings (B2b. Bovine enamel slabs (BES served as control. The adherent microorganisms were quantified and visualized using scanning electron microscopy (SEM; DAPI and live/dead staining. The lowest bacterial count of E. faecalis was detected on BES and the highest on B1a. The fewest vital C. albicans strains (42.22% were detected on B2a surfaces, while most E. faecalis and S. aureus strains (approximately 80% were vital overall. Compared to BES; coated and uncoated zirconia substrata exhibited no anti-adhesive properties. Further improvement of the material surface characteristics is essential.

  3. One stage rescue procedure after capsular contracture of breast implants with autologous fat grafts collected by water assisted liposuction (“BEAULI Method”

    Directory of Open Access Journals (Sweden)

    Ueberreiter, Klaus

    2013-01-01

    Full Text Available With increasing number of patients with silicone implants for breast augmentation or reconstruction we are confronted with more and more cases of capsular contracture. Not every case is resolved by resection of the capsule and exchange of implants. Many patients rather bear the consequences of severe fibrosis than to have their implants removed. The one stage procedure of implant removal and lipofilling proved to be highly efficient with good to excellent results and high patient satisfaction. Between January 2008 and October 2012 a total of 64 patients (124 breasts with capsular fibrosis Baker III to IV were treated with autologous fat grafts collected with the body-jet by water-assisted liposuction (“BEAULI Method”. Magnetic resonance imaging (MRI of the breasts was performed in 5 patients preoperatively and 6 month postoperatively, a clinical examination and photo documentation of all patients was done on day 1 and after 4 weeks, 12 weeks and 6 months postoperatively. The procedure included implant removal and lipofilling of the subcutaneous and intramuscular space in a single procedure by means of the BEAULI Method. The average gross amount of grafted fat was 260 ml. The average drainage time was one day. The shape of the breast changed to a more natural and ptotic form. Negative side effects like oily cysts or infections were not observed. The time of the overall procedure including liposuction was 70±15 min. Reoccurring capsular contracture is one of the hazards in plastic surgery. Until now the treatment of choice after more than two failed implant changes combined with resection of the capsule is usually the final removal of implants with or without possible additional autologous tissue transfer (microvascular flaps. We could add a relatively simple and efficient procedure to resolve and improve those cases by autologous fat transfer using water-assisted liposuction and the BEAULI Method.

  4. Platelet adhesion and plasma protein adsorption control of collagen surfaces by He{sup +} ion implantation

    Energy Technology Data Exchange (ETDEWEB)

    Kurotobi, K. E-mail: kurotobi@postman.riken.go.jp; Suzuki, Y.; Nakajima, H.; Suzuki, H.; Iwaki, M

    2003-05-01

    He{sup +} ion implanted collagen-coated tubes with a fluence of 1 x 10{sup 14} ions/cm{sup 2} were exhibited antithrombogenicity. To investigate the mechanisms of antithrombogenicity of these samples, plasma protein adsorption assay and platelet adhesion experiments were performed. The adsorption of fibrinogen (Fg) and von Willebrand factor (vWf) was minimum on the He{sup +} ion implanted collagen with a fluence of 1 x 10{sup 14} ions/cm{sup 2}. Platelet adhesion (using platelet rich plasma) was inhibited on the He{sup +} ion implanted collagen with a fluence of 1 x 10{sup 14} ions/cm{sup 2} and was accelerated on the untreated collagen and ion implanted collagen with fluences of 1 x 10{sup 13}, 1 x 10{sup 15} and 1 x 10{sup 16} ions/cm{sup 2}. Platelet activation with washed platelets was observed on untreated collagen and He{sup +} ion implanted collagen with a fluence of 1 x 10{sup 14} ions/cm{sup 2} and was inhibited with fluences of 1 x 10{sup 13}, 1 x 10{sup 15} and 1 x 10{sup 16} ions/cm{sup 2}. Generally, platelets can react with a specific ligand inside the collagen (GFOGER sequence). The results of platelets adhesion experiments using washed platelets indicated that there were no ligands such as GFOGER on the He{sup +} ion implanted collagen over a fluence of 1 x 10{sup 13} ions/cm{sup 2}. On the 1 x 10{sup 14} ions/cm{sup 2} implanted collagen, no platelet activation was observed due to the influence of plasma proteins. >From the above, it is concluded that the decrease of adsorbed Fg and vWf caused the antithrombogenicity of He{sup +} ion implanted collagen with a fluence of 1 x 10{sup 14} ions/cm{sup 2} and that plasma protein adsorption took an important role repairing the graft surface.

  5. Surface modification of traditional and bioresorbable metallic implant materials for improved biocompatibility

    Science.gov (United States)

    Walker, Emily K.

    Due to their strength, elasticity, and durability, a variety of metal alloys are commonly used in medical implants. Traditionally, corrosion-resistant metals have been preferred. These permanent materials can cause negative systemic and local tissue effects in the long-term. Permanent stenting can lead to late-stent thrombosis and in-stent restenosis. Metallic pins and screws for fracture fixation can corrode and fail, cause loss of bone mass, and contribute to inflammation and pain at the implant site, requiring reintervention. Corrodible metallic implants have the potential to prevent many of these complications by providing transient support to the affected tissue, dissolving at a rate congruent with the healing of the tissue. Alloys of iron and manganese (FeMn) exhibit similar fatigue strength, toughness, and elasticity compared with 316L stainless steel, making them very attractive candidates for bioresorbable stents and temporary fracture fixation devices. Much attention in recent years has been given to creating alloys with ideal mechanical properties for various applications. Little work has been done on determining the blood compatibility of these materials or on examining how their surfaces can be improved to improve cell adhesion, however. We examined thethrombogenic response of blood exposed to various resorbable ferrous stent materials through contact with porcine blood. The resorbable materials induced comparable or lower levels of several coagulation factors compared with 316L stainless steel. Little platelet adhesion was observed on any of the tested materials. Endothelialization is an important process after the implantation of a vascular stent, as it prevents damage to the vessel wall that can accelerate neointimal hyperplasia. Micromotion can lead to the formation of fibrous tissue surrounding an orthopedic implant, loosening, and ultimately failure of the implant. Nanoscale features were created on the surfaces of noble metal coatings, silicon

  6. Mechanism of cell integration on biomaterial implant surfaces in the presence of bacterial contamination.

    Science.gov (United States)

    Yue, Chongxia; van der Mei, Henny C; Kuijer, Roel; Busscher, Henk J; Rochford, Edward T J

    2015-11-01

    Bacterial contamination during biomaterial implantation is often unavoidable, yielding a combat between cells and bacteria. Here we aim to determine the modulatory function of bacterial components on stem-cell, fibroblast, and osteoblast adhesion to a titanium alloy, including the role of toll-like-receptors (TLRs). Presence of heat-sacrificed Staphylococcus epidermidis, Staphylococcus aureus, Escherichia coli, or Pseudomonas aeruginosa induced dose and cell-type dependent responses. Stem-cells were most sensitive to bacterial presence, demonstrating decreased adhesion number yet increased adhesion effort with a relatively large focal adhesion contact area. Blocking TLRs had no effect on stem-cell adhesion in presence of S. aureus, but blocking both TLR2 and TLR4 induced an increased adhesion effort in presence of E. coli. Neither lipopolysaccharide, lipoteichoic acid, nor bacterial DNA provoked the same cell response as did whole bacteria. Herewith we suggest a new mechanism as to how biomaterials are integrated by cells despite the unavoidable presence of bacterial contamination. Stimulation of host cell integration of implant surfaces may open a new window to design new biomaterials with enhanced healing, thereby reducing the risk of biomaterial-associated infection of both "hardware-based" implants as well as of tissue-engineered constructs, known to suffer from similarly high infection risks as currently prevailing in "hardware-based" implants. © 2015 Wiley Periodicals, Inc.

  7. The Quest for Nonthrombotic Surface Modifications to Achieve Hemocompatibility of Implantable Devices.

    Science.gov (United States)

    Tchouta, Lise Nadine; Bonde, Pramod Narayan

    2015-01-01

    The use of blood-contacting implantable devices is limited by surface-induced thrombosis, which has led to the development of thromboresistant surfaces. Multidisciplinary efforts have promoted the development of surface modifications to minimize thrombosis by targeting surface-induced coagulation. To this date, no material has been identified that remains irrevocably hemocompatible with time but many options are now available with their own limitations. Essential to this review is the understanding of some of the challenges in this field and newer opportunities for hemocompatibility research. This report will also briefly review many of the achievements in the development of hemocompatible biomaterial coating, including surface modifications against protein adsorption and platelet adhesion, biomimetism, and endothelialization.

  8. Does incorporating collagen and chondroitin sulfate matrix in implant surfaces enhance osseointegration? A systematic review and meta-analysis.

    Science.gov (United States)

    Kellesarian, S V; Malignaggi, V R; Kellesarian, T V; Bashir Ahmed, H; Javed, F

    2018-02-01

    Implant surface modification has been used to improve osseointegration. However, evidence regarding improved new bone formation (NBF) and osseointegration with the use of collagen-chondroitin sulfate (CS) matrix coated implants remains unclear. The aim of this study was to assess the efficacy of collagen-CS matrix coating on the osseointegration of implants. The focused question was "Does the incorporation of collagen-CS matrix in implant surfaces influence osseointegration?" To answer the question, indexed databases were searched up to July 2017 using various combinations of the key words "collagen", "chondroitin sulfate", "osseointegration", and "implants". The initial literature search identified 497 articles, of which 18 reporting experimental studies fulfilled the inclusion criteria. Thirteen of the studies included (72%) reported that implants coated with a collagen-CS matrix presented higher NBF, bone-to-implant contact, and/or bone volume density. The strength of this observation was supported by meta-analysis results. Nevertheless, the results should be interpreted with caution due to the lack of standardization regarding the dosage formulation of collagen-CS, short-term follow-up, and lack of assessment of confounders. On experimental grounds, the incorporation of collagen-CS matrix into implant surfaces appears to promote osseointegration. From a clinical perspective, the results from animal models support phase I studies in healthy humans. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  9. 3D printed Ti6Al4V implant surface promotes bone maturation and retains a higher density of less aged osteocytes at the bone-implant interface.

    Science.gov (United States)

    Shah, Furqan A; Snis, Anders; Matic, Aleksandar; Thomsen, Peter; Palmquist, Anders

    2016-01-01

    For load-bearing orthopaedic applications, metal implants having an interconnected pore structure exhibit the potential to facilitate bone ingrowth and the possibility for reducing the stiffness mismatch between the implant and bone, thus eliminating stress-shielding effects. 3D printed solid and macro-porous Ti6Al4V implants were evaluated after six-months healing in adult sheep femora. The ultrastructural composition of the bone-implant interface was investigated using Raman spectroscopy and electron microscopy, in a correlative manner. The mineral crystallinity and the mineral-to-matrix ratios of the interfacial tissue and the native bone were found to be similar. However, lower Ca/P ratios, lower carbonate content, but higher proline, phenylalanine and tyrosine levels indicated that the interfacial tissue remained less mature. Bone healing was more advanced at the porous implant surface (vs. the solid implant surface) based on the interfacial tissue ν1 CO3(2-)/ν2 PO4(3-) ratio, phenylalanine and tyrosine levels approaching those of the native bone. The mechanosensing infrastructure in bone, the osteocyte lacuno-canalicular network, retained ∼40% more canaliculi per osteocyte lacuna, i.e., a 'less aged' morphology at the interface. The osteocyte density per mineralised surface area was ∼36-71% higher at the interface after extended healing periods. In osseointegration research, the success of an implant surface or design is commonly determined by quantifying the amount of new bone, rather than its maturation, composition and structure. This work describes a novel correlative methodology to investigate the ultrastructure and composition of bone formed around and within 3D printed Ti6Al4V implants having an interconnected open-pore structure. Raman spectroscopy demonstrates that the molecular composition of the interfacial tissue at different implant surfaces may vary, suggesting differences in the extent to which bone maturation occurs even after long

  10. Surface Characterization of Retrieved Metal-on-Metal Total Hip Implants from Patients with Adverse Reaction to Metal Debris

    Directory of Open Access Journals (Sweden)

    Maria Burbano

    2014-03-01

    Full Text Available The use of metal-on-metal (MoM total hip implants has decreased recently due to reports of high failure rates and adverse local tissue reaction (ALTR. It has been hypothesized that wear metal debris released from CoCr bearing surfaces may provoke delayed hypersensitivity reactions. The goal of this study is to evaluate the microscopic bearing surface characteristics of implants revised due to evidence of ALTR. The bearing surface of each head and cup was analyzed using multiple microscopy techniques for characterization of the surface features. The presence of severe mechanical scratching was a common characteristic found in all of the implants evaluated. Mechanical factors seemed to be the prevalent failure mode related to the appearance of ALTR with this particular set of retrieved implants.

  11. Endothelialization of implanted cardiovascular biomaterial surfaces: the development from in vitro to in vivo.

    Science.gov (United States)

    Liu, Tao; Liu, Shihui; Zhang, Kun; Chen, Junying; Huang, Nan

    2014-10-01

    Restenosis and thrombosis formation after cardiovascular devices implantation continue to be problematic. Although various platforms and parameters of cardiovascular devices have been designed and optimized over the years, postoperative complications are hard to avoid. The native vascular endothelium always provide a nonthrombogenic surface as well as prevent intimal overproliferation, thereby, the presence of a confluent endothelial cell layer on material surfaces have been widely accepted as an ideal approach to improve the biocompatibility of implanted cardiovascular materials. Endothelialization on biomaterial surfaces is initially developed by in vitro cell seeding. However, numerous no-perfect parts of this method are existed for clinical use. The emergency of endothelial progenitor cells may provide a promising way for setting these limitations. Over the last decades, countless researches about EPCs-based in vivo induced self-endothelialization have been reported and mainly focused on cellular therapy, pharmacological therapy, materials designing, or surface biofunctional modification. This review details the development of endothelialization on cardiovascular material surfaces from in vitro to in vivo. Endothelialization progress on the basis of molecular biological level and bioinformatics theory is expected to be the key point in the coming decades. © 2013 Wiley Periodicals, Inc.

  12. The combination of digital surface scanners and cone beam computed tomography technology for guided implant surgery using 3Shape implant studio software: a case history report.

    Science.gov (United States)

    Lanis, Alejandro; Álvarez Del Canto, Orlando

    2015-01-01

    The incorporation of virtual engineering into dentistry and the digitization of information are providing new perspectives and innovative alternatives for dental treatment modalities. The use of digital surface scanners with surgical planning software allows for the combination of the radiographic, prosthetic, surgical, and laboratory fields under a common virtual scenario, permitting complete digital treatment planning. In this article, the authors present a clinical case in which a guided implant surgery was performed based on a complete digital surgical plan combining the information from a cone beam computed tomography scan and the virtual simulation obtained from the 3Shape TRIOS intraoral surface scanner. The information was imported to and combined in the 3Shape Implant Studio software for guided implant surgery planning. A surgical guide was obtained by a 3D printer, and the surgical procedure was done using the Biohorizons Guided Surgery Kit and its protocol.

  13. Current practices in corrosion, surface characterization, and nickel leach testing of cardiovascular metallic implants.

    Science.gov (United States)

    Nagaraja, Srinidhi; Di Prima, Matthew; Saylor, David; Takai, Erica

    2017-08-01

    In an effort to better understand current test practices and improve nonclinical testing of cardiovascular metallic implants, the Food and Drug Administration (FDA) held a public workshop on Cardiovascular Metallic Implants: corrosion, surface characterization, and nickel leaching. The following topics were discussed: (1) methods used for corrosion assessments, surface characterization techniques, and nickel leach testing of metallic cardiovascular implant devices, (2) the limitations of each of these in vitro tests in predicting in vivo performance, (3) the need, utility, and circumstances when each test should be considered, and (4) the potential testing paradigms, including acceptance criteria for each test. In addition to the above topics, best practices for these various tests were discussed, and knowledge gaps were identified. Prior to the workshop, discussants had the option to provide feedback and information on issues relating to each of the topics via a voluntary preworkshop assignment. During the workshop, the pooled responses were presented and a panel of experts discussed the results. This article summarizes the proceedings of this workshop and background information provided by workshop participants. Published 2016. This article is a U.S. Government work and is in the public domain in the USA. J Biomed Mater Res Part B: Appl Biomater, 105B: 1330-1341, 2017. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

  14. The non-specific symptoms of breast implant-associated anaplastic large cell lymphoma resulting in delayed diagnosis: A case-based review

    Directory of Open Access Journals (Sweden)

    Reem Dina Jarjis

    2015-12-01

    Full Text Available Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL is a rare entity that has become known as a distinct clinical condition recently. In general, BIA-ALCL patients with a history of breast implants present with non-specific implant-related complications, resulting in delayed diagnosis and appropriate treatment because of the lack of awareness of BIA-ALCL. The cause and pathogenesis have still not been identified, and there are no evidence-based guidelines on how this condition should be detected, treated or followed up because of the rarity of available data. We present the first published Danish case of anaplastic lymphoma kinase negative BIA-ALCL, and review the current literature to raise awareness of and discuss management options for this rare clinical entity.

  15. Breast prothesis leakage and malignant changes of the breast.

    Science.gov (United States)

    Al-Lawati, Taha; Kutty, Rajyashree

    2009-04-01

    A breast implant is a prosthesis used to enhance the size of a woman's breasts. Silicon implants are most commonly used, but as with all surgical implants it has some complications. The question is whether it can induce breast cancer? During the last year, a case of reconstructed breast with prosthesis which leaked was presented. The aim of this report is to review current literature to evaluate whether there are reported correlations between breast cancer and breast implants. The conclusion derived from this report is that there is no available evidence directly correlating breast cancer to breast implants.

  16. Initial clinical experience with the Strut-Adjusted Volume Implant brachytherapy applicator for accelerated partial breast irradiation.

    Science.gov (United States)

    Yashar, Catheryn M; Blair, Sarah; Wallace, Anne; Scanderbeg, Dan

    2009-01-01

    Accelerated partial breast irradiation is becoming increasingly popular. The Cianna single-entry high-dose-rate applicator, Strut-Adjusted Volume Implant (SAVI, Cianna Medical, Aliso Viejo, CA), contains peripheral struts allowing greater planning flexibility for small-breasted women, technically easier insertion, and normal tissue exposure minimization. This study evaluates early clinical experience. Thirty patients treated with the SAVI with a median followup of 12 months were evaluated. The median age was 59.5. Tumor size averaged 0.9cm. Fifteen cancers were ductal carcinoma in situ (50%), 1 was invasive lobular (3.3%), 4 were tubular (6.7%), and the rest infiltrating ductal (40%). Most of them were estrogen receptor (ER) positive (90%). Nine women (30%) were premenopausal. Dosimetry was outstanding with median V90, V150, and V200 of 96.2%, 24.8, and 12.8cc. There were no symptomatic seromas, and one report of asymptomatic fat necrosis seen on mammogram at 1 year. In patients who had skin spacing of less than 1cm, the median skin dose was 245cGy/fraction. The median rib and lung dose per fraction for those patients with either structure less than 1cm was 340 and 255cGy (75% of prescribed dose), respectively. There have been no local recurrences to date. Early clinical experience with the SAVI demonstrates the ease of placement of a single-entry brachytherapy device combined with the increased dose modulation of interstitial brachytherapy. Dose to normal structures has remained exceedingly low. Almost half of evaluated patients were not candidates for other single-entry brachytherapy devices because of skin spacing or breast size, demonstrating an expansion of candidates for single-entry partial breast brachytherapy.

  17. Double breast contour in primary aesthetic breast augmentation: incidence, prevention and treatment.

    Science.gov (United States)

    Médard de Chardon, Victor; Balaguer, Thierry; Chignon-Sicard, Bérengère; Lebreton, Elisabeth

    2010-04-01

    , physiopathogeny, prevention and treatment. Type I major risk factor is subpectoral augmentation of ptotic breasts (with medium to bad skin quality and loses muscle to gland attachments). The muscle at the inferior pole of the breast is a "brake" preventing implant to fill the envelope. This risk is increased with implant malposition, constitutional ptosis asymmetry with symmetrical implant placement and selection of an insufficient implant projection or dimensions. This deformity can be avoided with selection of a subglandular or dual plane (type II or III) placement, a sufficient implant volume or projection and anatomic prosthesis. Type II is related to a lowering of a well-defined submammary fold more commonly in constricted and dens glandular breasts. This deformity can be avoided with respecting the inframammary fold, radial incisions on the gland's posterior surface, and selection of anatomic implants.

  18. An experiment on the dynamics of ion implantation and sputtering of surfaces

    Energy Technology Data Exchange (ETDEWEB)

    Wright, G. M.; Barnard, H. A.; Kesler, L. A.; Peterson, E. E.; Stahle, P. W.; Sullivan, R. M.; Whyte, D. G.; Woller, K. B. [Plasma Science and Fusion Center, MIT, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139 (United States)

    2014-02-15

    A major impediment towards a better understanding of the complex plasma-surface interaction is the limited diagnostic access to the material surface while it is undergoing plasma exposure. The Dynamics of ION Implantation and Sputtering Of Surfaces (DIONISOS) experiment overcomes this limitation by uniquely combining powerful, non-perturbing ion beam analysis techniques with a steady-state helicon plasma exposure chamber, allowing for real-time, depth-resolved in situ measurements of material compositions during plasma exposure. Design solutions are described that provide compatibility between the ion beam analysis requirements in the presence of a high-intensity helicon plasma. The three primary ion beam analysis techniques, Rutherford backscattering spectroscopy, elastic recoil detection, and nuclear reaction analysis, are successfully implemented on targets during plasma exposure in DIONISOS. These techniques measure parameters of interest for plasma-material interactions such as erosion/deposition rates of materials and the concentration of plasma fuel species in the material surface.

  19. Temperature effect of irradiated target surface on distribution of nanoparticles formed by implantation

    CERN Document Server

    Stepanov, A L; Popok, V N

    2001-01-01

    The composition layers, containing the metal nanoparticles, synthesized thorough implantation of the Ag sup + ions with the energy of 60 keV and the dose of 3 x 10 sup 1 sup 6 ion/cm sup 2 into the sodium-calcium silicate glass by the ion current of 3 mu A/cm sup 2 and the sublayer temperature of 35 deg C are studied. The obtained implantation results are analyzed in dependence on the temperature effects, developing for the glass samples of various thickness. The data on the silver distribution, the metal nanoparticles formation and growth by depth are obtained from the optical reflection spectra. It is demonstrated that minor changes in the surface temperature of the irradiated glass sublayer lead to noticeable diversities in the regularities of the nanoparticles formation in the sample volume

  20. Transaxillary Endoscopic Breast Augmentation

    Directory of Open Access Journals (Sweden)

    Hyung-Bo Sim

    2014-09-01

    Full Text Available The axillary technique is the most popular approach to breast augmentation among Korean women. Transaxillary breast augmentation is now conducted with sharp electrocautery dissection under direct endoscopic vision throughout the entire process. The aims of this method are clear: both a bloodless pocket and a sharp non-traumatic dissection. Round textured or anatomical cohesive gel implants have been used to make predictable well-defined inframammary creases because textured surface implants demonstrated a better stability attributable to tissue adherence compared with smooth surface implants. The axillary endoscopic technique has greatly evolved, and now the surgical results are comparable to those with the inframammary approach. The author feels that this technique is an excellent choice for young patients with an indistinct or absent inframammary fold, who do not want a scar in the aesthetic unit of their chest.

  1. Surface modification of single crystal LiTaO{sub 3} by H and He implantation

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Changdong [Department of Radiation Oncology, Qilu Hospital, Shandong University, Jinan, Shandong 250012 (China); School of Information Science and Engineering, Shandong University, Jinan, Shandong 250100 (China); Lu, Fei, E-mail: lufei@sdu.edu.cn [School of Information Science and Engineering, Shandong University, Jinan, Shandong 250100 (China); Jin, Lei [Ernst Ruska-Centre (ER-C) for Microscopy and Spectroscopy with Electrons & Peter Grünberg Institute (PGI): Microstructure Research Centre Jülich, 52425 Jülich (Germany); Xu, Bo; Fan, Ranran [School of Information Science and Engineering, Shandong University, Jinan, Shandong 250100 (China)

    2017-02-01

    Highlights: • Hydrogen and helium ions coimplantation on blistering of the Z-cut LiTaO{sub 3} surface is experimentally analyzed. • The accumulated lattice damage in He-first sample is significantly larger than that of H-first sample. • Blistering or splitting of LiTaO{sub 3} surface is more easily achieved by He{sup −} first in coimplantation. • Chemical bonding between H ions and O atoms forming of O-H structure is analyzed by infrared spectroscopy. - Abstract: Defects production and evolution in H and He ions co-implanted LiTaO{sub 3} under different implantation order (H + He and He + H) are investigated. Rutherford backscattering spectrometry (RBS), infrared (IR) spectroscopy and transmission electron microscopy (TEM) are used to study the lattice damage, composition and structure change in the buried damage region. Obvious differences of ions aggregation mechanism are found in H and He implanted LiTaO{sub 3}. Blistering or splitting of LiTaO{sub 3} is more easily achieved in the case where He is implanted first compared to the reverses case. Significant damage enhancement and micro-fractures are observed in samples with He preimplant. The dispersed damage in H-first sample is due to the destruction by He post-bombardment of H-clusters. This order effect indicates the strong aggregation and trapping ability of He ions and He bubbles. The effect of coimplantation parameters on the cleaving of LiTaO{sub 3} is discussed.

  2. 10-year survival rate and the incidence of peri-implant disease of 374 titanium dental implants with a SLA surface: a prospective cohort study in 177 fully and partially edentulous patients

    NARCIS (Netherlands)

    van Velzen, F.J.J.; Ofec, R.; Schulten, E.A.J.M.; ten Bruggenkate, C.M.

    2015-01-01

    Purpose This prospective cohort study evaluates the 10-year survival and incidence of peri-implant disease at implant and patient level of sandblasted, large grid, and acid-etched titanium dental implants (Straumann, soft tissue level, SLA surface) in fully and partially edentulous patients.

  3. 10-year survival rate and the incidence of peri-implant disease of 374 titanium dental implants with a SLA surface: a prospective cohort study in 177 fully and partially edentulous patients

    NARCIS (Netherlands)

    van Velzen, F.J.J.; Ofec, R.; Schulten, E.A.J.M.; ten Bruggenkate, C.M.

    2015-01-01

    Purpose: This prospective cohort study evaluates the 10-year survival and incidence of peri-implant disease at implant and patient level of sandblasted, large grid, and acid-etched titanium dental implants (Straumann, soft tissue level, SLA surface) in fully and partially edentulous patients.

  4. Magnesium ion implantation on a micro/nanostructured titanium surface promotes its bioactivity and osteogenic differentiation function

    Science.gov (United States)

    Wang, Guifang; Li, Jinhua; Zhang, Wenjie; Xu, Lianyi; Pan, Hongya; Wen, Jin; Wu, Qianju; She, Wenjun; Jiao, Ting; Liu, Xuanyong; Jiang, Xinquan

    2014-01-01

    As one of the important ions associated with bone osseointegration, magnesium was incorporated into a micro/nanostructured titanium surface using a magnesium plasma immersion ion-implantation method. Hierarchical hybrid micro/nanostructured titanium surfaces followed by magnesium ion implantation for 30 minutes (Mg30) and hierarchical hybrid micro/nanostructured titanium surfaces followed by magnesium ion implantation for 60 minutes (Mg60) were used as test groups. The surface morphology, chemical properties, and amount of magnesium ions released were evaluated by field-emission scanning electron microscopy, energy dispersive X-ray spectroscopy, field-emission transmission electron microscopy, and inductively coupled plasma-optical emission spectrometry. Rat bone marrow mesenchymal stem cells (rBMMSCs) were used to evaluate cell responses, including proliferation, spreading, and osteogenic differentiation on the surface of the material or in their medium extraction. Greater increases in the spreading and proliferation ability of rBMMSCs were observed on the surfaces of magnesium-implanted micro/nanostructures compared with the control plates. Furthermore, the osteocalcin (OCN), osteopontin (OPN), and alkaline phosphatase (ALP) genes were upregulated on both surfaces and in their medium extractions. The enhanced cell responses were correlated with increasing concentrations of magnesium ions, indicating that the osteoblastic differentiation of rBMMSCs was stimulated through the magnesium ion function. The magnesium ion-implanted micro/nanostructured titanium surfaces could enhance the proliferation, spreading, and osteogenic differentiation activity of rBMMSCs, suggesting they have potential application in improving bone-titanium integration. PMID:24940056

  5. Magnesium ion implantation on a micro/nanostructured titanium surface promotes its bioactivity and osteogenic differentiation function.

    Science.gov (United States)

    Wang, Guifang; Li, Jinhua; Zhang, Wenjie; Xu, Lianyi; Pan, Hongya; Wen, Jin; Wu, Qianju; She, Wenjun; Jiao, Ting; Liu, Xuanyong; Jiang, Xinquan

    2014-01-01

    As one of the important ions associated with bone osseointegration, magnesium was incorporated into a micro/nanostructured titanium surface using a magnesium plasma immersion ion-implantation method. Hierarchical hybrid micro/nanostructured titanium surfaces followed by magnesium ion implantation for 30 minutes (Mg30) and hierarchical hybrid micro/nanostructured titanium surfaces followed by magnesium ion implantation for 60 minutes (Mg60) were used as test groups. The surface morphology, chemical properties, and amount of magnesium ions released were evaluated by field-emission scanning electron microscopy, energy dispersive X-ray spectroscopy, field-emission transmission electron microscopy, and inductively coupled plasma-optical emission spectrometry. Rat bone marrow mesenchymal stem cells (rBMMSCs) were used to evaluate cell responses, including proliferation, spreading, and osteogenic differentiation on the surface of the material or in their medium extraction. Greater increases in the spreading and proliferation ability of rBMMSCs were observed on the surfaces of magnesium-implanted micro/nanostructures compared with the control plates. Furthermore, the osteocalcin (OCN), osteopontin (OPN), and alkaline phosphatase (ALP) genes were upregulated on both surfaces and in their medium extractions. The enhanced cell responses were correlated with increasing concentrations of magnesium ions, indicating that the osteoblastic differentiation of rBMMSCs was stimulated through the magnesium ion function. The magnesium ion-implanted micro/nanostructured titanium surfaces could enhance the proliferation, spreading, and osteogenic differentiation activity of rBMMSCs, suggesting they have potential application in improving bone-titanium integration.

  6. [RGD peptide-modified chitosan as a gene carrier of implant surface].

    Science.gov (United States)

    Zhang, Di; Liu, Changhong; Zhang, Jincai; Cai, Dehong; Yang, Xiaoyu; Li, Shiyi; Zhong, Huilan

    2014-08-01

    This study is conducted to explore new methods to perform surface biomodification of titanium implants and improve osteogenic efficiency. An RGD peptide and chitosan (CS) were combined by acylation reaction, forming RGD-CS. An RGD-CS/pDNA complex was subsequently prepared using a complex coacervation method and grafted on a pure titanium surface after physical and biochemical treatments were performed. The chemical structural characteristics of RGD-CS were evaluated using an infrared spectrometer and an elemental analyzer. The shape of this complex was then assessed by gel electrophoresis combined with atomic force microscopy. The grafting effect of this complex on the titanium surface was detected by EB staining. CS and RGD peptides were coupled by an amide bond. The RGD-CS/pDNA complex was completely composited at N/P > or = 2. Atomic force microscopy results showed that the morphology of this complex was mainly spherical. EB staining experiments showed that this complex was successfully grafted on the titanium plate. RGD peptide-modified CS can be used as a titanium implant surface plasmid package carrier of pDNA.

  7. A noninterventional study documenting use and success of implants with a new chemically modified titanium surface in daily dental practice.

    Science.gov (United States)

    Luongo, Giuseppe; Oteri, Giacomo

    2010-01-01

    A new chemically modified titanium surface, SLActive, has recently been developed. The results obtained in controlled clinical trials indicate that this implant can be safely used and that it offers predictable results. The goal of this noninterventional study was to verify that the success rates of implants used in daily dental practice are comparable to those reported in controlled clinical trials. This study was a prospective, noninterventional study using implants with a chemically modified surface according to the daily dental practice procedures applied by private practitioners. The choice of the implantation procedure and the loading protocol were the responsibility of the investigator and were chosen according to the patient's needs. Thirty clinical centers actively participated in this study, and 226 patients were treated, of which, 8 patients were lost to follow-up. Because of the noninterventional design of the study, the patients were not selected according to strictly defined inclusion/exclusion criteria. Thus, the study included individuals with risk factors such as smoking (24%), untreated gingivitis or periodontitis (9%), and bruxism (6%). The implants were equally distributed between mandible (46%) and maxilla (54%). A bone augmentation procedure was done in 31% of the cases. Early loading (functional loading between 48 hours and 3 months after implant insertion) was applied most frequently (48%), followed by the conventional loading protocol (3 to 6 months after implant placement, 34%). Immediate restoration and immediate loading were rare (7% and 2%, respectively). Of 276 implants inserted and documented, 5 implants failures were reported, all of which were associated with a sinus floor augmentation procedure. The survival rate was 98.2% at the 1-year follow-up visit. The results showed that implants with a chemically modified surface can be successfully restored with success rates similar to those reported in formal clinical trials under more

  8. Revisiting Triple Antibiotic Irrigation of Breast Implant Pockets: A Placebo-controlled Single Practice Cohort Study

    Directory of Open Access Journals (Sweden)

    James J. Drinane, BSci

    2013-10-01

    Conclusions: Triple antibiotic breast irrigation is not associated with a significant reduction in the incidence or severity of capsular contracture compared with sterile saline when high-quality surgical technique is used.

  9. Is Single-Stage Prosthetic Reconstruction Cost Effective? A Cost-Utility Analysis for the Use of Direct-to-Implant Breast Reconstruction Relative to Expander-Implant Reconstruction in Postmastectomy Patients.

    Science.gov (United States)

    Krishnan, Naveen M; Fischer, John P; Basta, Marten N; Nahabedian, Maurice Y

    2016-09-01

    Prosthetic breast reconstruction is most commonly performed using the two-stage (expander-implant) technique. However, with the advent of skin-sparing mastectomy and the use of acellular dermal matrices, one-stage prosthetic reconstruction has become more feasible. Prior studies have suggested that one-stage reconstruction has economic advantages relative to two-stage reconstruction despite a higher revision rate. This is the first cost-utility analysis to compare the cost and quality of life of both procedures to guide patient care. A comprehensive literature review was conducted using the MEDLINE, EMBASE, and Cochrane databases to include studies directly comparing matched patient cohorts undergoing single-stage or staged prosthetic reconstruction. Six studies were selected examining 791 direct-to-implant reconstructions and 1142 expander-implant reconstructions. Costs were derived adopting both patient and third-party payer perspectives. Utilities were derived by surveying an expert panel. Probabilities of clinically relevant complications were combined with cost and utility estimates to fit into a decision tree analysis. The overall complication rate was 35 percent for single-stage reconstruction and 34 percent for expander-implant reconstruction. The authors' baseline analysis using Medicare reimbursement revealed a cost decrease of $525.25 and a clinical benefit of 0.89 quality-adjusted life-year when performing single-stage reconstructions, yielding a negative incremental cost-utility ratio. When using national billing, the incremental cost-utility further decreased, indicating that direct-to-implant breast reconstruction was the dominant strategy. Sensitivity analysis confirmed the robustness of the authors' conclusions. Direct-to-implant breast reconstruction is the dominant strategy when used appropriately. Surgeons are encouraged to consider single-stage reconstruction when feasible in properly selected patients.

  10. 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.

  11. Clinical o