钛合金植入体表面抗感染涂层的制备及其体外抑菌性能研究

临床中,内植物引起的相关感染是矫形外科以及创伤外科面临的重要问题。以聚乳酸（PDLLA）为载体,采用溶剂浇铸（solvent-casting）的方法,在钛合金植入物基体表面制备了载万古霉素（VCM）的PDLLA涂层,期望通过缓释万古霉素来抑制细菌感染。体外释药实验表明,涂层具有良好的缓释作用,在磷酸盐缓冲液（PBS）中持续释放VCM20天以上;涂层对引起感染的主要致病菌（金黄色葡萄球菌）具有超过15天的抑制作用。提示该涂层钛合金植入物有望在预防植入材料相关感染方面获得应用。     

Attitudes towards contraceptive implants and injectables among present and former users in Singapore

In a comparison of present and past users of contraceptive implants (Norplant) or injectables (DMPA) and discontinuers of Norplant or DMPA, information concerning the women's knowledge and perception of, and attitude to, implants and injectable contraceptives, was studied. The long duration of action (5 years) of implants was perceived positively by all groups as compared to the shorter 3-month duration of injectables, though this was seen as an advantage over the pill. It appears that the Norplant system has potential for wider use in Singapore in the future.     

Effects of melatonin implants in pony mares. 1. Acute effects

The effects of melatonin implant treatment over a four week period on LH, estradiol (E2) and progesterone (P4) secretion during the breeding season were studied in ovary-intact and ovariectomized pony mares. Mares with melatonin implants had significantly higher daytime melatonin concentrations than mares with sharm implants (P = 0.0065). In ovariectomized mares, LH secretion did not differ between mares with melatonin and sham implants. In ovary-intact mares, melatonin implants altered the pattern of LH secretion (P = 0.0023) in such a way that an increase in LH secretion was observed during the periovulatory period. Estradiol and P4 secretion were unaffected by melatonin implants. These results suggest that constant administration of melatonin may enhance the secretion of LH during the periovulatory surge but does not adversely affect E2, P4 or basal LH secretion in mares during the breeding season.     

The cultivation of cells on the porous titanium implants with the different structure

The data on human dermal fibroblasts and rabbit mesenchymal stromal cells cultivation on porous titanium implants are presented in given paper. Two types of implants were used: type 1--with irregular pores formed by pressed titanium particles and type 2--with regular pores formed by coalescence of one-size titanium particles into implant. The goal of this study was to choose the type of titanium implant porosity which ensures the tightest interaction of titanium implant with surrounding tissue cells after implantation in the body. Cells were cultivated on implants for 7 days and in both cases they formed confluent monolayer on the implants surfaces. That indicated adhesion, migration and proliferation of cells on such implants. Condition of cells cultured on titanium implants was controlled by scanning electron microscopy. The character of fibroblasts interaction with given implants was different depending on porosity type of implants. On implants with irregular pores, the cells were more spread and overlapped the pores spreading over neighbored particles. On implants with regular pores that formed by one-size particles into implant, the fibroblasts covered these particles not overlapping the pores and seldom interacted with neighbored particles by small outgrowths. There was no tight interaction of particles into implant. In implants formed by pressed particles, the cells grew not only on the surface but also in the depth of implant. Thereby, we suppose that more tight interaction of cells with titanium implant and, supposedly, tissues with implant in an organism will take place in the case of implant structure formed by pressed titanium particles.     

Kinetics of chondrocyte growth in cell-polymer implants

In vitro cultivation of cartilage cells (chondrocytes) on biodegradable polyglycolic acid (PGA) scaffolds resulted in implants which could potentially be used to repair damaged joint cartilage or for reconstructive surgery. Cell growth kinetics were studied to define conditions under which the cellularity of implants made from isolated calf chondrocytes reached that of the parent calf cartilage. In static cultures, condrocyte growth rates decreased as either implant thickness or implant cell density increased. Over 4 weeks of cultivation, implant permeability to glucose decreased to 3% that of the plain polymer scaffold; this effect was attributed to the decrease in effective implant porosity associated with cartilage tissue regeneration.In a well-mixed culture, implants 1 cm in diameter by 0.3 cm thick maintained high cell growth rates over 7 weeks and hard normal cell densities. Regenerated cartilage with these dimensions is large enough to resurface small joints such as the trapezium bone at the base of the human thumb. Such implants could not be grown statically, since cell growth stopped at 3-4 weeks and cell densities remained below normal. Optimization of the tissue culture environment is thus essential in order to cultivate clinically useful cartilage implants in vitro. (c) 1994 John Wiley & Sons, Inc.     

Mandibular augmentation

Porous polyethylene implants are available that are designed to augment the mandibular ramus and body. They can be used to increase the bigonial distance in patients with normal mandibular anatomy who desire an increase in lower facial width. When used in combination with extended chin implants, they can camouflage the skeletal contour inadequacies associated with class II mandibular deficiency. The implants are placed through intraoral incisions and fixed with titanium screws. In a clinical experience with 11 patients over 6 years, this technique has proven to be safe and effective.     

Inhibition of inflammatory angiogenesis by distant subcutaneous tumor in mice

We investigated angiogenesis, inflammatory cells accumulation and endogenous production of cytokines in sponge implants of tumor-bearing mice. Seven days after inoculation of Ehrlich tumor cells (2.5 x 10(6)), sponge discs were implanted subcutaneously in the dorsa of mice to induce the formation of fibrovascular tissue. The implants of tumor-bearing and non tumor-bearing animals were assessed for neovascularization and leukocyte accumulation, together with levels of relevant cytokines, vascular endothelial growth factor VEGF), tumor necrosis factor alpha (TNF-alpha), CXCL1-3/KC and CCL2/JE. In the implants of tumor-bearing animals angiogenesis (assessed by hemoglobin content and VEGF levels in the implants) and leukocyte accumulation (assessed by myeloperoxidase -MPO- and N- acetylglucosaminidase-NAG-enzyme activities) were all significantly less than those in the implants of non tumor-bearing animals. Although the chemokine CXCL1-3/KC was lower in the implants of tumor-bearing animals, the chemokine CCL2/JE was increased in this group. The production of TNF-alpha in the implants was not modified by the presence of the subcutaneous tumor. The combination of the methodologies used in this study has provided a novel approach to investigate the interaction between two distinct proliferating tissues that share common features (angiogenesis, cell recruitment, inflammation) and has shown that the predominant inhibitory effect of a tumor mass over repair process is associated with altered cytokine production.     

Aesthetic augmentation of the malar-midface structures

Based on extensive experience with bone grafts for augmentation of the midface-malar region, an implant design has been developed using Proplast. After careful preoperative assessment, a very specific surgical method, described herein, allows precise implant positioning without the need for suture fixation. In many instances, the 6-mm implant can be inserted unchanged. One-hundred and six patients have been operated on using 176 implants over the past 6 years. There were four unilateral infections (2.3 percent of implants and 3.8 percent of patients). None had permanent motor or sensory nerve problems. Fifteen implants (8.5 percent) in 12 patients (11.3 percent) were either removed or repositioned. In those having augmentation for entirely aesthetic reasons, 3 of 60 patients (5.0 percent) required implant removal or repositioning. The incidence of needing to remove or reposition implants has decreased as the technique has evolved.     

Retrospective cephalometric analysis of mandibular bone absorption under silicone rubber chin implants.

A longitudinal study was conducted on 85 patients who received silicone rubber implants to the chin. Over half of these patients were found to have some absorption of the bone beneath the implants, and much other information was obtained. There were no concomitant changes in the soft tissue profile in the patients who demonstrated bone absorption under their implants. It appeared that the bone absorption was less when the implant was placed over the hard bone of the lower part of the mandible, rather than higher or over alveolar bone.     

Biomechanical analysis and comparison of 12 dental implant systems using 3D finite element study

Finite element analysis plays an important role in dental implant design. The objective of this study was to show the effect of the overall geometry of dental implants on their biomechanics after implantation. In this study, 12 dental implants, with the same length, diameter and screw design, were simulated from different implant systems. Numerical model of right mandibular incisor bone segment was generated from CT data. The von-Mises stress distributions and the total deformation distributions under vertical/lateral load were compared for each implant by scores ranking method. The implants with cylindrical shapes had highest scores. Results indicated that cylindrical shape represented better geometry over taper implant. This study is helpful in choosing the optimal dental implant for clinical application and also contributes to individual implant design. Our study could also provide reference for choice and modification of dental implant in any other insertion sites and bone qualities.     

Predicting bone remodeling around tissue- and bone-level dental implants used in reduced bone width

The objective of this study was to predict time-dependent bone remodeling around tissue- and bone-level dental implants used in patients with reduced bone width. The remodeling of bone around titanium tissue-level, and titanium and titanium–zirconium alloy bone-level implants was studied under 100 N oblique load for one month by implementing the Stanford theory into three-dimensional finite element models. Maximum principal stress, minimum principal stress, and strain energy density in peri-implant bone and displacement in x- and y- axes of the implant were evaluated. Maximum and minimum principal stresses around tissue-level implant were higher than bone-level implants and both bone-level implants experienced comparable stresses. Total strain energy density in bone around titanium implants slightly decreased during the first two weeks of loading followed by a recovery, and the titanium–zirconium implant showed minor changes in the axial plane. Total strain energy density changes in the loading and contralateral sides were higher in tissue-level implant than other implants in the cortical bone at the horizontal plane. The displacement values of the implants were almost constant over time. Tissue-level implants were associated with higher stresses than bone-level implants. The time-dependent biomechanical outcome of titanium–zirconium alloy bone-level implant was comparable to the titanium implant.     

The use of metallic implants in the study of facial growth in children: method and application

On the basis of experience gained over a number of years, an account is given of the technique for insertion of the implants, the radiographic method, and the graphic procedure for preparation of growth tracings. Small pins of hard tantalum are hammered into the bone under local analgesia with a pencil-shaped instrument, in the tip of which the implant is placed. No surgical exposure is necessary. Because of remodeling resorption of the bone and eruption of the teeth, the implants can be placed only in certain places in the maxilla and mandible. In implant studies it is necessary to observe a high level of reproducibility in positioning the head in the cephalostat. An X -ray cephalostat with a built-in image intensifier has been designed which enables the position to be monitored by televison. In the graphic procedure, drawings of the arches from dental casts are incorporated in tracings of profile radiographs; the paths of eruption of the teeth and development or the arches can then be examined with the metallic implants as references.     

Experimental evidence supporting a mathematical theory of the physiological mechanism regulating follicle development and ovulation number

In higher vertebrates, follicular development is regulated so that the number of follicles that periodically mature and ovulate is controlled within a narrow range. Lacker has proposed a simple mathematical model of follicle development that can account for the regulation of ovulation number. To support the assumption of the theory that follicle interactions are mediated by estradiol acting as a chemical messenger to communicate follicular maturity to the pituitary and other follicles, we have presented data to demonstrate that in the rabbit physiological concentrations of circulating estradiol inhibit follicle maturation. Implants containing estradiol were placed subcutaneously after surgical rupture of the existing follicles that were 1 mm in diameter or larger. Serum estradiol concentrations were maintained near physiological concentrations by the implants. Concentrations of circulating estradiol were 74 +/- 5.7 pg/ml in the untreated groups, whereas the concentrations with the implants were increased by approximately 50 pg/ml/implant over this basal concentration with a range of 100-300 pg/ml. In the control groups, the average number of follicles before surgical rupture was 27 +/- 2.9 and there was no significant difference (p greater than 0.05) in the number of follicles, 26 +/- 1.9, three days after follicle rupture. The follicles ranged in size from 1 mm to 4 mm, and only those over 3 mm were considered mature. In the first group of animals with implants, the total number of follicles before surgery was 19 +/- 3; three days after follicle rupture, the number of follicles was only 9 +/- 1.1.(ABSTRACT TRUNCATED AT 250 WORDS)     

Stress distribution of three-unit fixed partial prostheses (conventional and pontic) supported by three or two implants: 3D finite element analysis of ductile materials

In implantology, when financial or biological feasibility limitations appear, it is necessary to use prostheses with geometries that deviate from the conventional, with a pontic in the absence of an intermediate implant. The aim of this study was analyze and understand the general differences in the stresses generated in implants, components and infrastructures according to the configuration of the prosthesis over three or two implants. Thus, this paper analyzes the von Mises equivalent stresses (VMES) of ductile materials on their external surfaces. The experimental groups: Regular Splinted Conventional Group (RCG), which had conventional infrastructures on 3 regular-length Morse taper implants (4x11?mm); Regular Splinted Pontic Group (RPG), which had infrastructures with intermediate pontics on 2 regular-length Morse taper implants (4x11?mm). The simulations of the groups were created with Ansys Workbench 10.0 software. The results revealed that the RPG presented greater areas of possible fragility due to higher stress concentrations, for example, in the cervical area of the union between the implant and component the top platform of the abutment, as well as greater coverage of the stress by the cervical implant threads. The RPG infrastructure was also more affected by stresses in the connection areas between the prostheses and on the occlusal surface. There is an advantage to using prostheses supported by a greater number of implants (RCG) because this decreases the stress in the analyzed structures and consequently improves stress dissipation to the supporting bone, which would preserve the system.     

Relationship between serum luteinizing hormone and estradiol in prepubertal boars

Effects of estradiol on serum luteinizing hormone (LH) were studied in prepubertal boars. In Exp. 1, 15-wk-old boars were given (iv) 50 mug estradiol, 1 mg testosterone or 1.5 ml ethanol. Estradiol (P<0.05) decreased LH over a 2.5-hr period, but testosterone did not. In Exp. 2, an estradiol implant reduced LH sample variance (P<0.01) while LH (547 +/- 96 vs 655 +/- 43 pg/ml) and estradiol (14.2 +/- 3.3 vs 18.4 +/- 1.0 pg/ml; control vs implant) were unchanged in 12-wk-old boars. Pulsatile LH releases (4.3 +/- 1.1 vs 3.0 +/- 0.4 pulses/pig/8 hr; control vs treated) and pulse amplitude (272 +/- 34 vs 305 +/- 40 pg/ml) were not affected. The implant tended to decrease serum testosterone (4.86 +/- 0.75 vs 7.66 +/- 1.51 ng/ml; P<0.10). In Exp. 3, LH was higher after zero implants than after four implants (279 +/- 7 vs 227 +/- 9 pg/ml; P<0.01), and LH after two implants was also higher than after four implants (263 +/- 7 pg/ml; P<0.01) in 14-wk-old boars in a Latin square design. Peak LH after 40 mug gonadotropin releasing hormone (GnRH) was less after two and four implants (1,100 +/- 126 and 960 +/- 167 pg/ml, respectively; P<0.01) than after zero implants (1,742 +/- 126 pg/ml). Slope of the first 20 min of LH response to GnRH was greater after zero implants (45.3 pg/min; P<0.05) than after either two or four implants (20.6 and 16.9 pg/min, respectively). Implant treatment decreased serum testosterone (P<0.025) but increased estradiol (P<0.10). Small changes in serum estradiol resulted in changes in LH. These changes in sample variance and mean LH were recognized by boars as different from normal because serum testosterone decreased. Changes in LH may result from estradiol's negative effect on pituitary responsiveness to endogenous GnRH because response to exogenous GnRH was depressed by estradiol.     

Silicone gel-filled breast implant integrity: a retrospective review of 478 consecutively explanted implants

Concern has been expressed over the long-term integrity of silicone gel breast implants. There are no large series representing experience with these implants outside of the United States. A retrospective case note review of explanted silicone breast implants was performed; 478 implants have been explanted during the past 11 years and relate to the use of these devices since 1971. Loss of implant integrity was not simply related to its age in vivo. Failure was more likely with implants of the late 1970s and early 1980s (second generation) and with subpectoral placement. Implant failure was independent of capsular contracture as the indication for removal (p = 0.09). There is no evidence that the currently used textured silicone gel breast implants are subject to the same loss of integrity as previous examples of these devices. The life span of these implants, the first of which are approaching 10 years in vivo, is at present unknown. Information concerning the integrity of silicone gel breast implants is essential in the current climate for counseling of both new and old implant recipients.     

Evaluation of HTR polymer as a craniomaxillofacial graft material

An experimental animal study was undertaken to evaluate the potential use of HTR polymer as a craniomaxillofacial reconstructive material. Its properties of marked hydrophilicity, a negative surface charge, and extensive porosity combined with a calcium graft coating suggested favorable osteoconductive properties. Four sites of the rabbit craniomaxillofacial skeleton were evaluated by placement of both inlay and onlay implants. Postoperative assessment at 60, 120, and 240 days consisted of histologic evaluation by tetrachrome staining of calcified sections. At 60 days, extensive osseous ingrowth into the inlay implants had occurred extending up to 2000 microns. The onlay implants, however, exhibited more limited ingrowth extending only 100 to 200 microns into the material. Over the ensuing 120- and 240-day postoperative periods, the average depth of bony ingrowth did not progress in either the inlay or onlay specimens over that observed at 60 days. Differences also were noted between the inlayed skeletal sites, with increased marrow at the recipient site resulting in increased bony ingrowth. The material appears to be biocompatible, with no evidence of infection, inflammatory reaction, or bone resorption observed around any of the implants. The implants exhibited a significant osteoconductive capability that was most manifest when implants were exposed to bleeding cortical/marrow surfaces as inlay grafts.     

Finite element analysis of different loading conditions for implant-supported overdentures supported by conventional or mini implants

The effect of implants’ number on overdenture stability and stress distribution in edentulous mandible, implants and overdenture was numerically investigated for implant-supported overdentures. Three models were constructed. Overdentures were connected to implants by means of ball head abutments and rubber ring. In model 1, the overdenture was retained by two conventional implants; in model 2, by four conventional implants; and in model 3, by five mini implants. The overdenture was subjected to a symmetrical load at an angle of 20 degrees to the overdenture at the canine regions and vertically at the first molars. Four different loading conditions with two total forces (120, 300 N) were considered for the numerical analysis. The overdenture displacement was about 2.2 times higher when five mini implants were used rather than four conventional implants. The lowest stress in bone bed was observed with four conventional implants. Stresses in bone were reduced by 61% in model 2 and by 6% in model 3 in comparison to model 1. The highest stress was observed with five mini implants. Stresses in implants were reduced by 76% in model 2 and 89% increased in model 3 compared to model 1. The highest implant displacement was observed with five mini implants. Implant displacements were reduced by 29% in model 2, and increased by 273% in model 3 compared to model 1. Conventional implants proved better stability for overdenture than mini implants. Regardless the type and number of implants, the stress within the bone and implants are below the critical limits.     

种植体稳定系数测定与种植体负重时机选择

目的:通过测量ITI和Osstem-SS种植系统的稳定系数(ISQ),评价这两种种植体的骨结合情况,为临床确定其上部结构修复时机提供依据。方法:93例牙列缺损患者共植入179颗种植体,根据患者种植区骨量情况分为两组,其中A组为种植区骨量良好,不需骨增量手术病例(62例);B组为种植区骨量不足,需进行骨增量手术病例(31例)。A组共植入125颗种植体,其中ITI种植系统64颗,OSSTEM-SS种植系统61颗;B组共植入54颗种植体,其中ITI种植系统28颗,OSSTEM-SS种植系统26颗。术后即刻及第4、6、8、12、16、24周分别测量各时期种植体稳定系数(ISQ),并同期进行临床和影像学检查。结果:A组中ITI种植系统术后8周ISQ值平均(74.17±1.85),进行负重;OSSTEM-SS种植系统术后12周ISQ值平均(72.00±2.59),进行负重。B组中ITI种植系统术后16周ISQ值平均(65.09±3.42),进行负重;OSSTEM-SS种植系统术后24周ISQ值平均(62.09±6.16),进行负重。负重后临床随访3-24个月所有病例均成功,咀嚼功能良好,患者满意。结论:种植体稳定系数(ISQ)能反应种植体骨结合情况,可以协助医生选择种植后合适的冠修复时机。     

Suppression of follicle wave emergence in cyclic ewes by supraphysiologic concentrations of estradiol-17beta and induction with a physiologic dose of exogenous ovine follicle-stimulating hormone

Follicle waves are preceded by follicle-stimulating hormone (FSH) peaks in ewes. The purpose of the present study was to see whether estradiol implant treatment would block FSH peaks to create a model in which the effect of the timing and mode of FSH peaks could be studied by ovine FSH (oFSH) injection. In Experiment 1, 10 ewes received estradiol-17beta implants on Day 4 after ovulation (Day 0, day of ovulation); five ewes received large implants, and five ewes received small implants. Five control ewes received empty implants. In Experiment 2, 12 ewes received large implants on Day 4. On Day 9, six ewes received oFSH twice, 8 h apart (0.5 microg/kg; s.c.). Implants were left in place for 10 days in both experiments. In both studies, ovarian ultrasonography and blood sampling was done daily. In Experiment 1, estradiol concentrations were significantly higher in ewes with large implants (10.4 +/- 0.7 pg/ml) compared with controls (3.9 +/- 0.7 pg/ml) and ewes with small implants (5.4 +/- 0.7 pg/ml; P < 0.001). A significant reduction was found in mean FSH peak concentration (31%; P < 0.05) and FSH peak amplitude (45%; P < 0.05) in ewes with large implants compared with controls. Mean and basal FSH concentrations were unaffected by the large implants. The large implants halted follicle-wave emergence between Day 0 and 8 after implant insertion. The small follicle pool (2-3 mm in diameter) was unaffected by the large implants. When oFSH was injected into ewes with large implants, a follicle wave emerged 1.5 +/- 0.5 days after injection; however, in ewes given saline alone, a follicle wave emerged 4.8 +/- 0.8 days after injection (P < 0.01). We concluded that truncation of FSH peaks by estradiol implants prevented follicle-wave emergence, but injection of physiologic concentrations of oFSH reinitiated follicle-wave emergence.