0
selected
-
1.
Comparison of Whole-Blood Metal Ion Levels Among Four Types of Large-Head, Metal-on-Metal Total Hip Arthroplasty Implants: A Concise Follow-up, at Five Years, of a Previous Report.
Hutt, J, Lavigne, M, Lungu, E, Belzile, E, Morin, F, Vendittoli, PA
The Journal of bone and joint surgery. American volume. 2016;(4):257-66
Abstract
Few studies of total hip arthroplasty (THA) implants with a large-diameter femoral head and metal-on-metal design have directly compared the progression of metal ion levels over time and the relationship to complications. As we previously reported, 144 patients received one of four types of large-diameter-head, metal-on-metal THA designs (Durom, Birmingham, ASR XL, or Magnum implants). Cobalt, chromium, and titanium ion levels were measured over five years. We compared ion levels and clinical results over time. The Durom group showed the highest levels of cobalt (p ≤ 0.002) and titanium ions (p ≤ 0.03). Both the Durom and Birmingham groups demonstrated significant ongoing cobalt increases up to five years. Eight patients (seven with a Durom implant and one with a Birmingham implant) developed adverse local tissue reaction. Six Durom implants and one Birmingham implant required revision, with one pseudotumor under surveillance at the time of the most recent follow-up. We found that ion generation and related complications varied among designs. More concerning was that, for some designs, ion levels continued to increase. Coupling a cobalt-chromium adapter sleeve to an unmodified titanium femoral trunnion along with a large metal-on-metal bearing may explain the poor performances of two of the designs in the current study.
-
2.
Complex skull defects reconstruction with САD/САМ titanium and polyetheretherketone (PEEK) implants.
Eolchiyan, SA
Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko. 2014;(4):3-13
Abstract
UNLABELLED Predictable and stable functional and aesthetic result is the aim of priority for the neurosurgeon dealing with the reconstruction of large cranial bone defects and complex-formed skull defects involving cranio-orbital region. AIM: the paper presents the experience with САD/САМ titanium and polyetheretherketone (PEEK) implants for complex-formed and large skull bone defects reconstruction. MATERIAL AND METHODS Between 2005 and 2013 nine patients (5 females and 4 males) underwent cranioplasty and cranio-facial reconstruction with insertion of the customized САD/САМ titanium and PEEK implants. Computer-assisted preoperative planning was undertaken by the surgeon and the engineer together in 3 cases to provide accurate implant design. Eight patients had complex-formed and large posttraumatic defects of fronto-orbital (7 cases) and parietal (one case) regions. In two of these cases one-step reconstruction surgery for posttraumatic fronto-orbital defects combined with adjacent orbital roof (one case) and orbito-zygomatic (one case) deformities was performed. One patient underwent one-step primary cranioplasty after cranio-orbital fibrous dysplasia focus resection. Titanium implants were used in 4 cases while PEEK implants - in 5 ones. The follow-up period ranged from 6 months till 8,5 years (median 4,4 years). RESULTS The accuracy of the implant intraoperative fit was perfect in all cases. Postoperative wounds healed primary and there were no any complications in the series presented. Post-op clinical assessment and CT data testified to high implants precision, good functional and aesthetic outcomes in all patients. CONCLUSION САD/САМ titanium and PEEK implants application should allow for optimal reconstruction in the challenging patients with complex-formed and large skull bone defects providing predictable good functional and aesthetic result together with surgery morbidity and duration reduction. Computer-assisted preoperative planning should be undertaken for САD/САМ implants creation in the cases of posttraumatic defects combined with adjacent bone structures deformities and benign bone tumors of cranio-orbital region, thus enabling one-step reconstructive surgery resulted in essential symmetry attained.
-
3.
A 5-year prospective multicenter clinical trial of non-submerged dental implants with a titanium plasma-sprayed surface in 200 patients.
Cochran, DL, Jackson, JM, Jones, AA, Jones, JD, Kaiser, DA, Taylor, TD, Weber, HP, Higginbottom, FL, Richardson, JR, Oates, T
Journal of periodontology. 2011;(7):990-9
Abstract
BACKGROUND Endosseous dental implants are a popular treatment to replace missing teeth. Although many advances have occurred and affected the macrogeometry and surface characteristics of dental implants, among other aspects, it is important to document how the implants perform in patients over time. Such evaluations are helpful not only to document the clinical survival of the implants but also patient satisfaction over an extended period. METHODS A formal prospective multicenter human clinical was performed at five centers involving 200 patients and 626 implants. Specific inclusion and exclusion criteria were used and detailed data collected at specified times using case report forms. An independent study monitor reviewed all study data before entry into the study database. Two implant designs were used in two different clinical indications. A non-submerged titanium plasma-sprayed (TPS) hollow cylindrical implant with a smooth transgingival collar was evaluated in the maxillary anterior sextant and a non-submerged TPS solid screw implant with similar collar in the mandible. RESULTS Over the course of the 5-year clinical trial, there was one early failure occurring before definitive prosthesis delivery. Three late failures were documented, one occurring at each of the 6, 12, and 18 months postoperative visits. Life table analysis at 5 years revealed a 99.4% survival rate and a 92.5% success rate. Patient satisfaction was rated as good to excellent for 96.1% of implants in regards to esthetics after 5 years; 98.8% for appearance; and 99.4% for prosthesis comfort, ability to chew and taste, fit, and general satisfaction. No serious adverse events were reported. CONCLUSIONS Implant success and survival was over 92% and 99%, respectively, in a formal 5-year prospective multicenter clinical trial involving 200 patients and 626 non-submerged TPS implants. These implants included hollow cylinder implants in the anterior maxilla and solid screw implants placed in the mandible. These findings document the predictability and patient satisfaction of tooth replacement using a non-submerged surgical technique involving a tissue-level, rough surfaced endosseous dental implant.
-
4.
A clinical trial to evaluate the effects of prophylactic fluoride agents on the superelastic properties of nickel-titanium wires.
Vo, J, Chudasama, DN, Rinchuse, DJ, Day, R
World journal of orthodontics. 2010;(2):135-41
Abstract
AIM: To study the effects of a prophylactic fluoride regimen on the mechanical properties of nickel-titanium (Ni-Ti) archwires under clinical conditions. METHOD The unloading properties of 100 Ni-Ti wires were tested using a three-point bending test at five deflections (0.5 mm, 1.0 mm, 2.0 mm. 3.0 mm, and 3.1 mm). Sixty-six 0.016 3 0.022-inch Ni-Ti wires were tested after being used intraorally for 6 weeks using two protocols. Thirty-three wires were evaluated after the use of fluoride-containing Crest toothpaste (sodium fluoride 0.243%, 0.15% w/v fluoride ion) and Equate fluoride rinse (sodium fluoride 0.05%, fluoride ion 0.0226%). Another 33 wires were examined after a nonfluoridated natural toothpaste (Tom's of Maine; calcium carbonate, xylitol, myrrh, propolis, sodium lauryl sulfate, carrageenan, spearmint and peppermint oils, glycerin, and water) was used. Another 34 Ni-Ti wires served as a control; they were tested as received. Statistical analyses were carried out with a linear-mixed model (analysis of variance [ANOVA]). RESULTS Force degradation occurred within both groups of intraorally used wires but not in the unused archwires. When compared to unexposed wires, those with fluoride exposure exhibited slightly higher force degradation at 3.1 and 3.0 mm deflection, but they displayed less force degradation at 0.5 and 1.0 mm deflection. CONCLUSIONS Topical fluoride regimens decreased the unloading property of Ni-Ti wires at higher deflections but increased it at lower deflections.
-
5.
Efficacy of anterior cervical fusion: comparison of titanium cages, polyetheretherketone (PEEK) cages and autogenous bone grafts.
Chou, YC, Chen, DC, Hsieh, WA, Chen, WF, Yen, PS, Harnod, T, Chiou, TL, Chang, YL, Su, CF, Lin, SZ, et al
Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia. 2008;(11):1240-5
Abstract
This retrospective study was designed to analyze and compare the efficacy and outcomes of anterior cervical fusion using titanium cages, polyetheretherketone (PEEK) cages and autogenous tricortical bone grafts. Fifty-five patients who underwent segmental anterior discectomy with a follow-up period up to 12 months enrolled in this study. They were divided into three groups: titanium cage with biphasic calcium phosphate ceramic (Triosite; Zimmer, Berlin, Germany) in group A (n=27); PEEK cage with Triosite in group B (n=9); and autogenous tricortical iliac crest bone graft in group C (n=19). The fusion rates after 6 months were 37.21% in group A , 93.3% in group B, and 84.85% in group C. The fusion rates after 1 year in groups A, B, and C were 46.51%, 100% and 100%, respectively. The PEEK cage is a viable alternative to autogenous tricortical bone grafts in anterior cervical fusion.