Impact of the Habit of Alcohol Consumption on the Success of the Implants: A Retrospective Study

Introduction

A recent study has demonstrated that social factors have an impact on the condition of dental implants. The present investigation investigated how varied alcohol intake quantities might alter the condition of dental implants and related peri-implant inflammation.

Materials and Methods

This retrospective research was piloted in a tertiary care center, and implants inserted between 2010 and 2022 were evaluated through a retrospective cohort analysis. Within 3 months following implant implantation, information on alcohol intake was gathered from the health maintenance records and employed as the predictor variable. The implant results as well as peri-implantitis were examined at follow-up visits. Using the logistic regression model, the Wald test analysis analyzed the statistical consequences of each parameter. The findings were translated using an odds ratio that was determined with a 95% confidence level. The data were generated and analyzed using descriptive statistics, with statistical significance defined as P < 0.05.

Results

At the time of implant placement, the enrolled patients were 59 ± 11.3 years old on average. The median time before peri-implantitis occurred was 31.3 ± 22.2 months. Within the first 2 years following implant implantation, the majority of people experienced peri-implantitis. The incidence of peri-implantitis was the lowest among light and moderate alcoholics (11.5%) and the highest among heavy alcoholics (46.2%). Moderate alcohol use was associated with a 79.1% decrease in peri-implantitis when compared to not drinking (P = 0.0365), whereas light alcohol consumption was connected to a 51.3% decrease (P = 0.026). The incidence of peri-implantitis among heavy drinkers was significantly significant (P = 0.0001).

Conclusion

According to the findings of the current retrospective cohort analysis, drinking alcohol at mild-to-moderate levels is connected to a reduction in the incidence rate of peri-implantitis compared to heavy drinkers. In contrast, high alcohol consumption was found to be associated with an increase in the prevalence of peri-implantitis among the participants who had dental implants.

Assessment of Role of Bisphosphonates on Dental Implant Treatment in Post-menopausal Ladies

Objectives

To examine the impact of bisphosphonates (BPs) on dental implant treatment and alveolar bone in post-menopausal ladies.

Materials and Methods

Twenty post-menopausal ladies who had at least one dental implant within the previous 5 years participated in the current study. Ten subjects were categorized into two groups: Group A had BP medication for 1.5 years, and group B received parathyroid hormone (PTH). Both groups' bone thickness and bone mineral density (BMD) were measured.

Result

Group A had 5%, and group B had 5% of dental implants failures. BMD of cortical bone was 1468 ± 136 mg/mL and 1008 ± 84 mg/mL in groups A and B, correspondingly. The cortical and cancellous bone densities in both the groups were statically significant. Cortical bone thickness was insignificant in comparison.

Conclusion

Both cortical and cancellous bones' bone mineral density decreased in both groups. With continued usage of BPs, the cortical bone thickness increased.

Radiographic Evaluation in Implant Patients: A Review

Diagnostic imaging is crucial in assessing dental implant patients. The height, width, and shape of the bone are precisely depicted and measured by these tests, which help pinpoint the locations of significant anatomical structures adjacent to the implant placement sites. The type of implant to be utilized, the positioning of the remaining dentition, and the degree to which bone quality or quantity is in question all play a role in determining the radiologic approach that is most suited for a given patient. This review is an update on the current knowledge in the field of radiographic evaluation in implant placement. Considering the radiation exposure and the expense of each test, it is important to carefully determine whether pre-implant imaging is acceptable in each situation. Although multislice computed tomography is the gold standard from the authors' perspective, not every implant situation can justify such a test.

Treatment of Residual Palatal Collapse in Hypoglossal Nerve Stimulation Using a Palatal Device

Hypoglossal nerve stimulation (HNS) has increasingly become an alternative therapy for obstructive sleep apnea patients with CPAP intolerance. Stimulation of the hypoglossal nerve during sleep enhances airway patency and alleviates collapse. Suboptimal responses to HNS often stem from insufficient palatal coupling and residual velar collapse. Combining palatal devices, such as Velumount®, with HNS represents a simple and cost-effective strategy to treat residual palatal collapse. Patients desiring conservative treatment for residual palatal obstruction under HNS may consider this combined approach. Laryngoscope, 2024.

Balancing beauty and science: a review of facial implant materials in craniofacial surgery

Facial reconstruction and augmentation, integral in facial plastic surgery, address defects related to trauma, tumors infections, and congenital skeletal deficiencies. Aesthetic considerations, including age-related facial changes, involve volume loss and diminished projection, often associated with predictable changes in the facial skeleton. Autologous, allogeneic, and alloplastic implants are used to address these concerns. Autologous materials such as bone, cartilage, and fat, while longstanding options, have limitations, including unpredictability and resorption rates. Alloplastic materials, including metals, polymers, and ceramics, offer alternatives. Metals like titanium are biocompatible and used primarily in fracture fixation. Polymers, such as silicone and polyethylene, are widely used, with silicone presenting migration, bony resorption, and visibility issues. Polyethylene, particularly porous polyethylene (MedPor), was reported to have one of the lowest infection rates while it becomes incorporated into the host. Polyether-ether-ketone (PEEK) exhibits mechanical strength and compatibility with imaging modalities, with custom PEEK implants providing stable results. Acrylic materials, like poly-methylmethacrylate (PMMA), offer strength and is thus mostly used in the case of cranioplasty. Bioceramics, notably hydroxyapatite (HaP), offer osteoconductive and inductive properties, and HaP granules demonstrate stable volume retention in facial aesthetic augmentation. Combining HaP with other materials, such as PLA, may enhance mechanical stability. 3D bioprinting with HaP-based bioinks presents a promising avenue for customizable and biocompatible implants. In conclusion, various materials have been used for craniofacial augmentation, but none have definitively demonstrated superiority. Larger randomized controlled trials are essential to evaluate short- and long-term complications comprehensively, potentially revolutionizing facial balancing surgery.

Early removal of the etonogestrel contraceptive implant in Spanish women: a prospective cohort study

Purpose

To know the discontinuation rate and characterize predictors and reasons of contraceptive implant removal within 12 months of insertion in our community setting.

Methods

This prospective cohort study included women receiving the etonogestrel contraceptive implant at sexual and reproductive health centers between September 2019 and September 2020. The variables collected were implanted insertion timing, reproductive and demographic characteristics, medical conditions, sexual activity and counseling. Our primary outcome was implant discontinuation. Kaplan-Meier survival curves were used to show the cumulative discontinuation rate of implants contraceptive within the first year of insertion. We also identified factors that increased the risk of implant removal using the log-rank test and the Cox regression model. Reasons for discontinuation were documented.

Results

199 women were followed up. Implant discontinuation was documented in 17.1% of implant users prior to 12 months. Factors that increase the risk of implant removal are living with a partner, being aged 25-34 years and not receiving comprehensive and structured counseling from the midwife. The main reason for removal was unsatisfactory bleeding (97.1%), but this was combined with other reasons such as cessation of sexual intercourse (58.8%), worsening mood (58.8%), weight gain (55.9%) or decreased libido (50.0%).

Conclusion

The rate of discontinuous implant uses in the first year is relevant in relation to cost-effectiveness, there is room for improvement that should not be overlooked. Comprehensive and structured midwife-led counseling can reduce early implant abandonment removal. The development in different countries of the role of midwives in the management of contraceptives can contribute to the economic benefit of health services and the satisfaction of women.

Bacterial Surface Appendages Modulate the Antimicrobial Activity Induced by Nanoflake Surfaces on Titanium

Bioinspired nanotopography is a promising approach to generate antimicrobial surfaces to combat implant-associated infection. Despite efforts to develop bactericidal 1D structures, the antibacterial capacity of 2D structures and their mechanism of action remains uncertain. Here, hydrothermal synthesis is utilized to generate two 2D nanoflake surfaces on titanium (Ti) substrates and investigate the physiological effects of nanoflakes on bacteria. The nanoflakes impair the attachment and growth of Escherichia coli and trigger the accumulation of intracellular reactive oxygen species (ROS), potentially contributing to the killing of adherent bacteria. E. coli surface appendages type-1 fimbriae and flagella are not implicated in the nanoflake-mediated modulation of bacterial attachment but do influence the bactericidal effects of nanoflakes. An E. coli ΔfimA mutant lacking type-1 fimbriae is more susceptible to the bactericidal effects of nanoflakes than the parent strain, while E. coli cells lacking flagella (ΔfliC) are more resistant. The results suggest that type-1 fimbriae confer a cushioning effect that protects bacteria upon initial contact with the nanoflake surface, while flagella-mediated motility can lead to elevated membrane abrasion. This finding offers a better understanding of the antibacterial properties of nanoflake structures that can be applied to the design of antimicrobial surfaces for future medical applications.

Toward Digital Twin Development for Implant Placement Planning Using a Parametric Reduced-Order Model

Real-time stress distribution data for implants and cortical bones can aid in determining appropriate implant placement plans and improving the post-placement success rate. This study aims to achieve these goals via a parametric reduced-order model (ROM) method based on stress distribution data obtained using finite element analysis. For the first time, the finite element analysis cases for six design variables related to implant placement were determined simultaneously via the design of experiments and a sensitivity analysis. The differences between the minimum and maximum stresses obtained for the six design variables confirm that the order of their influence is: Young's modulus of the cancellous bone > implant thickness > front-rear angle > left-right angle > implant length. Subsequently, a one-dimensional (1-D) CAE solver was created using the ROM with the highest coefficient of determination and prognosis accuracy. The proposed 1-D CAE solver was loaded into the Ondemand3D program and used to implement a digital twin that can aid with dentists' decision making by combining various tooth image data to evaluate and visualize the adequacy of the placement plan in real time. Because the proposed ROM method does not rely entirely on the doctor's judgment, it ensures objectivity.

Vapor-Phase-Deposited Ag/Ir and Ag/Au Film Heterostructures for Implant Materials: Cytotoxic, Antibacterial and Histological Studies

Using gas-phase deposition (Physical Vapor Deposition (PVD) and Metal Organic Chemical Vapor Deposition (MOCVD)) methods, modern implant samples (Ti alloy and CFR-PEEK polymer, 30% carbon fiber) were functionalized with film heterostructures consisting of an iridium or gold sublayer, on the surface of which an antibacterial component (silver) was deposited: Ag/Ir(Au)/Ti(CFR-PEEK). The biocidal effect of the heterostructures was investigated, the effect of the surface relief of the carrier and the metal sublayer on antibacterial activity was established, and the dynamics of silver dissolution was evaluated. It has been shown that the activity of Ag/Ir heterostructures was due to high Ag+ release rates, which led to rapid (2-4 h) inhibition of P. aeruginosa growth. In the case of Ag/Au type heterostructures, the inhibition of the growth of P. aeruginosa and S. aureus occurred more slowly (from 6 h), and the antibacterial activity appeared to be due to the contribution of two agents (Ag+ and Au+ ions). It was found, according to the in vitro cytotoxicity study, that heterostructures did not exhibit toxic effects (cell viability > 95-98%). An in vivo biocompatibility assessment based on the results of a morphohistological study showed that after implantation for a period of 30 days, the samples were characterized by the presence of a thin fibrous capsule without volume thickening and signs of inflammation.

Feasibility of a Shape-Memory-Alloy-Actuator System for Modular Acetabular Cups

Hip implants have a modular structure which enables patient-specific adaptation but also revision of worn or damaged friction partners without compromising the implant-bone connection. To reduce complications during the extraction of ceramic inlays, this work presents a new approach of a shape-memory-alloy-actuator which enables the loosening of ceramic inlays from acetabular hip cups without ceramic chipping or damaging the metal cup. This technical in vitro study exam-ines two principles of heating currents and hot water for thermal activation of the shape-memory-alloy-actuator to generate a force between the metal cup and the ceramic inlay. Mechanical tests concerning push-in and push-out forces, deformation of the acetabular cup according to international test standards, and force generated by the actuator were generated to prove the feasibility of this new approach to ceramic inlay revision. The required disassembly force for a modular acetabular device achieved an average value of 602 N after static and 713 N after cyclic loading. The actuator can provide a push-out force up to 1951 N. In addition, it is shown that the necessary modifications to the implant modules for the implementation of the shape-memory-actuator-system do not result in any change in the mechanical properties compared to conventional systems.

Osteoblast Attachment on Bioactive Glass Air Particle Abrasion-Induced Calcium Phosphate Coating

Air particle abrasion (APA) using bioactive glass (BG) effectively decontaminates titanium (Ti) surface biofilms and the retained glass particles on the abraded surfaces impart potent antibacterial properties against various clinically significant pathogens. The objective of this study was to investigate the effect of BG APA and simulated body fluid (SBF) immersion of sandblasted and acid-etched (SA) Ti surfaces on osteoblast cell viability. Another goal was to study the antibacterial effect against Streptococcus mutans. Square-shaped 10 mm diameter Ti substrates (n = 136) were SA by grit blasting with aluminum oxide particles, then acid-etching in an HCl-H2SO4 mixture. The SA substrates (n = 68) were used as non-coated controls (NC-SA). The test group (n = 68) was further subjected to APA using experimental zinc-containing BG (Zn4) and then mineralized in SBF for 14 d (Zn4-CaP). Surface roughness, contact angle, and surface free energy (SFE) were calculated on test and control surfaces. In addition, the topography and chemistry of substrate surfaces were also characterized. Osteoblastic cell viability and focal adhesion were also evaluated and compared to glass slides as an additional control. The antibacterial effect of Zn4-CaP was also assessed against S. mutans. After immersion in SBF, a mineralized zinc-containing Ca-P coating was formed on the SA substrates. The Zn4-CaP coating resulted in a significantly lower Ra surface roughness value (2.565 μm; p < 0.001), higher wettability (13.35°; p < 0.001), and higher total SFE (71.13; p < 0.001) compared to 3.695 μm, 77.19° and 40.43 for the NC-SA, respectively. APA using Zn4 can produce a zinc-containing calcium phosphate coating that demonstrates osteoblast cell viability and focal adhesion comparable to that on NC-SA or glass slides. Nevertheless, the coating had no antibacterial effect against S. mutans.

Antibiofilm peptides enhance the corrosion resistance of titanium in the presence of Streptococcus mutans

Titanium alloys have gained popularity in implant dentistry for the restoration of missing teeth and related hard tissues because of their biocompatibility and enhanced strength. However, titanium corrosion and infection caused by microbial biofilms remains a significant clinical challenge leading to implant failure. This study aimed to evaluate the effectiveness of antibiofilm peptides 1018 and DJK-5 on the corrosion resistance of titanium in the presence of Streptococcus mutans. Commercially pure titanium disks were prepared and used to form biofilms. The disks were randomly assigned to different treatment groups (exposed to S. mutans supplied with sucrose) including a positive control with untreated biofilms, peptides 1018 or DJK-5 at concentrations of 5 μg/mL or 10 μg/mL, and a negative control with no S. mutans. Dynamic biofilm growth and pH variation of all disks were measured after one or two treatment periods of 48 h. After incubation, the dead bacterial proportion, surface morphology, and electrochemical behaviors of the disks were determined. The results showed that peptides 1018 and DJK-5 exhibited significantly higher dead bacterial proportions than the positive control group in a concentration dependent manner (p < 0.01), as well as far less defects in microstructure. DJK-5 at 10 μg/mL killed 84.82% of biofilms and inhibited biofilm growth, preventing acidification due to S. mutans and maintaining a neutral pH. Potential polarization and electrochemical impedance spectroscopy data revealed that both peptides significantly reduced the corrosion and passive currents on titanium compared to titanium surfaces with untreated biofilms, and increased the resistance of the passive film (p < 0.05), with 10 μg/mL of DJK-5 achieving the greatest effect. These findings demonstrated that antibiofilm peptides are effective in promoting corrosion resistance of titanium against S. mutans, suggesting a promising strategy to enhance the stability of dental implants by endowing them with antibiofilm and anticorrosion properties.

Decoding the "Fingerprint" of Implant Materials: Insights into the Foreign Body Reaction

Foreign body reaction (FBR) is a prevalent yet often overlooked pathological phenomenon, particularly within the field of biomedical implantation. The presence of FBR poses a heavy burden on both the medical and socioeconomic systems. This review seeks to elucidate the protein "fingerprint" of implant materials, which is generated by the physiochemical properties of the implant materials themselves. In this review, the activity of macrophages, the formation of foreign body giant cells (FBGCs), and the development of fibrosis capsules in the context of FBR are introduced. Additionally, the relationship between various implant materials and FBR is elucidated in detail, as is an overview of the existing approaches and technologies employed to alleviate FBR. Finally, the significance of implant components (metallic materials and non-metallic materials), surface CHEMISTRY (charge and wettability), and physical characteristics (topography, roughness, and stiffness) in establishing the protein "fingerprint" of implant materials is also well documented. In conclusion, this review aims to emphasize the importance of FBR on implant materials and provides the current perspectives and approaches in developing implant materials with anti-FBR properties.

The influence of steroidal implants and manganese sulfate supplementation on growth performance, trace mineral status, hepatic gene expression, hepatic enzyme activity, and circulating metabolites in feedlot steers

Angus-cross steers (n = 144; 359 kg ± 13.4) were used to assess the effect of dietary Mn and steroidal implants on performance, trace minerals (TM) status, hepatic enzyme activity, hepatic gene expression, and serum metabolites. Steers (n = 6/pen) were stratified by BW in a 3 × 2 factorial. GrowSafe bunks recorded individual feed intake (experimental unit = steer; n = 24/treatment). Dietary treatments included (MANG; 8 pens/treatment; Mn as MnSO4): (1) no supplemental Mn (analyzed 14 mg Mn/kg DM; Mn0); (2) 20 mg supplemental Mn/kg DM (Mn20); (3) 50 mg supplemental Mn/kg DM (Mn50). Within MANG, steers received a steroidal implant treatment (IMP) on day 0: (1) no implant; NO; or (2) combination implant (Revalor-200; REV). Liver biopsies for TM analysis and qPCR, and blood for serum glucose, insulin, non-esterified fatty acids, and urea-N (SUN) analysis were collected on days 0, 20, 40, and 77. Data were analyzed as a randomized complete block with a factorial arrangement of treatments including fixed effects of Mn treatment (MANG) and implant (IMP) using PROC MIXED of SAS 9.4 using initial BW as a covariate. Liver TM, serum metabolite, enzyme activity, and gene expression data were analyzed as repeated measures. No MANG × IMP effects were noted (P ≥ 0.12) for growth performance or carcass characteristic measures. Dietary Mn did not influence final body weight, overall ADG, or overall G:F (P ≥ 0.14). Liver Mn concentration increased with supplemental Mn concentration (MANG; P = 0.01). An IMP × DAY effect was noted for liver Mn (P = 0.01) where NO and REV were similar on day 0 but NO cattle increased liver Mn from days 0 to 20 while REV liver Mn decreased. Relative expression of MnSOD in the liver was greater in REV (P = 0.02) compared to NO and within a MANG × IMP effect (P = 0.01) REV increased liver MnSOD activity. These data indicate current NASEM Mn recommendations are adequate to meet the demands of finishing beef cattle given a steroidal implant. Despite the roles of Mn in metabolic pathways and antioxidant defense, a basal diet containing 14 mg Mn/kg DM was sufficient for the normal growth of finishing steers. This study also provided novel insight into how implants and supplemental Mn influence genes related to arginine metabolism, urea synthesis, antioxidant capacity, and TM homeostasis as well as arginase and MnSOD activity in hepatic tissue of beef steers.

Bibliographic analysis and evaluation of the mesh keywords in the journal of prosthodontics: Implant, esthetic, and reconstructive dentistry

BACKGROUND

Various studies have been conducted to analyze data via bibliometric analysis in different dentistry, including prosthetic dentistry. However, these studies evaluated the most cited published articles in dentistry.

OBJECTIVE

To analyze and evaluate the characteristic development of several mesh keywords in the Journal of Prosthodontics - Implant, Esthetic, and Reconstructive Dentistry between 1992 and 2022.

METHODS

The Scopus databases was searched to retrieve the data related to 8 categories, including published articles, most cited documents, authors and organizations, and maximum articles cited during the evaluation period. The data retrieved were exported to a Microsoft Excel sheet and were analyzed using the bibliometrix package. The data were first analyzed for ten years and then for 30 years. The highest of 10 were reported for each category, and co-authorship, reoccurrence, and linked data were also reported.

RESULTS

2603 published documents were recorded from the Scopus databases. Articles comprised 87.9% of the total published work, followed by review articles at 5.46%. The most productive decade was between 2013 and 2022. 3793 terms were used during the evaluation period, with the maximum number in 2003-2012 (2481). A total of 5392 keywords were used during 1992-2022, with the highest number (3232) from 2013 to 2022. A total of 6108 authors were acknowledged, with the maximum number (3964) from 2013 to 2022 and the fewest (767) from 1992 to 2002. Authors from different countries increased from 17 countries in 1992-2002 to 52 countries in 2013-2022 (total = 63 countries). Similarly, the number of organizations increased from 312 organizations in 1992-2002 to 1315 organizations in 2013-2022 (total = 1976 organizations).

CONCLUSION

The current bibliometric analysis delivered a comprehensive overview about more spread research topics and its impactful role in contemporary dentistry, especially prosthetic dentistry.

Assessment of Psychological Implications and Quality of Life After Different Cardiac Device Implantation in Saudi Arabia

BACKGROUND

Cardiac device therapy is likely to affect different aspects of patients' psychological well-being, such as their quality of life. The aim of this study was to examine the mental health status, specifically the conditions of depression and anxiety regarding implantable cardiac device patients.

METHODS

A cross-sectional retrospective study was conducted in January 2022. This study was conducted at King Abdul-Aziz University Hospital in Jeddah, Saudi Arabia. All patients aged more than 18 years old who underwent heart device implantation for six months or more formed the study population. A total of 30 implantable cardioverter defibrillator (ICD) subtypes were used in our patients (45.8%), including cardiac resynchronization therapy device (CRT-D) in seven patients (14.6%) and one subcutaneous ICD (2.1%). A pacemaker was used in 18 patients (37.5%). Binary logistic regression analysis was conducted to identify the association between type of cardiac implantation device and the likelihood of having abnormal depression and anxiety score.

RESULTS

A total of 48 patients participated in this study. Hypertension was the most frequently associated risk factor in our sample (64.6%; n=31). In comparison between ICD users and pacemaker users in terms of the SF-36 general health survey, a marginally significant difference was noted in the role of limitations due to emotional health (63 ± 28.6) for ICD patients compared to pacemaker patients (81.8 ± 28.1), (p=0.050). However, pacemaker patients showed a significant favourable social functioning score (90.1 ± 17.7) compared to ICD patients (71.5 ± 19), (p=0.001). There is no significant difference noted regarding the other domains. Binary logistic regression analysis identified that patients who are using ICD were seven times more likely to have abnormal anxiety score (odds ratio: 7.00 (95% confidence interval: 1.36-35.9) (p=0.020).

CONCLUSION

This study identified a potential association between cardiac devices and the anxiety and quality of life of patients. Nonetheless, further investigation is warranted to assess the psychological and physiological effects of cardiac device therapy on patients, in addition to examining the effects of implantation and follow-up on cardiac function and cardiac symptoms.

Macrophages in the process of osseointegration around the implant and their regulatory strategies

PURPOSE/AIM OF THE STUDY

To summarize and discuss macrophage properties and their roles and mechanisms in the process of osseointegration in a comprehensive manner, and to provide theoretical support and research direction for future implant surface modification efforts.

MATERIALS AND METHODS

Based on relevant high-quality articles, this article reviews the role of macrophages in various stages of osseointegration and methods of implant modification.

RESULTS AND CONCLUSIONS

Macrophages not only promote osseointegration through immunomodulation, but also secrete a variety of cytokines, which play a key role in the angiogenic and osteogenic phases of osseointegration. There is no "good" or "bad" difference between the M1 and M2 phenotypes of macrophages, but their timely presence and sequential switching play a crucial role in implant osseointegration. In the implant surface modification strategy, the induction of sequential activation of the M1 and M2 phenotypes of macrophages is a brighter prospect for implant surface modification than inducing the polarization of macrophages to the M1 or M2 phenotypes individually, which is a promising pathway to enhance the effect of osseointegration and increase the success rate of implant surgery.

Prosthetic Rehabilitation of Narrow Mandibular Ridge by Two-Stage Split Technique: A Case Report

Subsequent to dental extraction, residual ridge resorption manifests as an inherent biological process unfolding over an approximate duration of one year. This intrinsic phenomenon entails a substantial diminution, occasionally reaching 50%, in the initial bucco-lingual dimensions of the mandibular bone. To address this issue, a dental procedure known as the two-stage ridge split intervention is employed. This process involves two distinct stages: ridge splitting and extension. In the first stage, the dentist splits the alveolar crest to create a widening gap. This allows for the subsequent placement of dental implants. The splitting process is carefully executed to ensure that there's enough space for the implants to be securely embedded, and in the second stage, the widened gap generated through the split and extension of the alveolar crest is replenished with a suitable material. Two common options are hydroxyapatite, a synthetic bone-like substance that promotes bone regeneration, or autogenous bone grafts, which are harvested from the patient's bone, often from another site within the mouth. Following this two-stage procedure, the next step is to place dental implants. However, there's typically a waiting period of eight to 12 weeks. This interval allows for proper healing and integration of the grafted or filled material with the existing bone before the implants are installed. In this case report, a specific patient's experience with the two-stage ridge split procedure in the mandibular region is mentioned. Such case studies are valuable in assessing the success and viability of this dental intervention in narrow mandibular-width cases.

Advances in Synthetic Grafts in Spinal Fusion Surgery

Degenerative spine disease is increasing in prevalence as the global population ages, indicating a need for targeted therapies and continued innovations. While autograft and allograft have historically demonstrated robust results in spine fusion surgery, they have significant limitations and associated complications such as infection, donor site morbidity and pain, and neurovascular injury. Synthetic grafts may provide similar success while mitigating negative outcomes. A narrative literature review was performed to review available synthetic materials that aim to optimize spinal fusion. The authors specifically address the evolution of synthetics and comment on future trends. Novel synthetic materials currently in use include ceramics, synthetic polymers and peptides, bioactive glasses, and peptide amphiphiles, and the authors focus on their success in both human and animal models, physical properties, advantages, and disadvantages. Advantages include properties of osteoinduction, osteoconduction, and osteogenesis, whereas disadvantages encompass a lack of these properties or growth factor-induced complications. Typically, the use of synthetic materials results in fewer complications and lower costs. While the development and tuning of synthetic materials are ongoing, there are many beneficial alternatives to autografts and allografts with promising fusion results.

Hierarchical Hybrid Coatings with Drug-Eluting Capacity for Mg Alloy Biomaterials

A hierarchical hybrid coating (HHC) comprising a ceramic oxide layer and two biodegradable polymeric (polycaprolactone, PCL) layers has been developed on Mg3Zn0.4Ca cast alloy in order to provide a controlled degradation rate and functionality by creating a favorable porous surface topography for cell adhesion. The inner, ceramic layer formed by plasma electrolytic oxidation (PEO) has been enriched in bioactive elements (Ca, P, Si). The intermediate PCL layer sealed the defect in the PEO layer and the outer microporous PCL layer loaded with the appropriate active molecule, thus providing drug-eluting capacity. Morphological, chemical, and biological characterizations of the manufactured coatings loaded with ciprofloxacin (CIP) and paracetamol (PAR) have been carried out. In vitro assays with cell lines relevant for cardiovascular implants and bone prosthesis (endothelial cells and premyoblasts) showed that the drug-loaded coating allows for cell proliferation and viability. The study of CIP and PAR cytotoxicity and release rate indicated that the porous PCL layer does not release concentrations detrimental to the cells. However, complete system assays revealed that corrosion behavior and increase of the pH negatively affects cell viability. H2 evolution during corrosion of Mg alloy substrate generates blisters in PCL layer that accelerate the corrosion locally in crevice microenvironment. A detailed mechanism of the system degradation is disclosed. The accelerated degradation of the developed system may present interest for its further adaptation to new cancer therapy strategies.

Biomechanical and Biological Assessment of Polyglycelrolsebacate-Coupled Implant with Shape Memory Effect for Treating Osteoporotic Fractures

Poly(glycerol sebacate) is a biocompatible elastomer that has gained increasing attention as a potential biomaterial for tissue engineering applications. In particular, PGS is capable of providing shape memory effects and allows for a free form, which can remember the original shape and obtain a temporary shape under melting point and then can recover its original shape at body temperature. Because these properties can easily produce customized shapes, PGS is being coupled with implants to offer improved fixation and maintenance of implants for fractures of osteoporosis bone. Herein, this study fabricated the OP implant with a PGS membrane and investigated the potential of this coupling. Material properties were characterized and compared with various PGS membranes to assess features such as control of curing temperature, curing time, and washing time. Based on the ISO 10993-5 standard, in vitro cell culture studies with C2C12 cells confirmed that the OP implant coupled with PGS membrane showed biocompatibility and biomechanical experiments indicated significantly increased pullout strength and maintenance. It is believed that this multifunctional OP implant will be useful for bone tissue engineering applications.

Layer-by-Layer Deposition of Regenerated Silk Fibroin─An Approach to the Surface Coating of Biomedical Implant Materials

Biomaterials and coating techniques unlock major benefits for advanced medical therapies. Here, we explored layer-by-layer (LbL) deposition of silk fibroin (SF) by dip coating to deploy homogeneous films on different materials (titanium, magnesium, and polymers) frequently used for orthopedic and other bone-related implants. Titanium and magnesium specimens underwent preceding plasma electrolytic oxidation (PEO) to increase hydrophilicity. This was determined as surface properties were visualized by scanning electron microscopy and contact angle measurements as well as Fourier transform infrared spectroscopy (FTIR) analysis. Finally, biological in vitro evaluations of hemocompatibility, THP-1 cell culture, and TNF-α assays were conducted. A more hydrophilic surface could be achieved using the PEO surface, and the contact angle for magnesium and titanium showed a reduction from 73 to 18° and from 58 to 17°, respectively. Coating with SF proved successful on all three surfaces, and coating thicknesses of up to 5.14 μm (±SD 0.22 μm) were achieved. Using FTIR analysis, it was shown that the insolubility of the material was achieved by post-treatment with water vapor annealing, although the random coil peak (1640-1649 cm-1) and the α-helix peak (at 1650 cm-1) were still evident. SF did not change hemocompatibility, regardless of the substrate, whereas the PEO-coated materials showed improved hemocompatibility. THP-1 cell culture showed that cells adhered excellently to all of the tested material surfaces. Interestingly, SF coatings induced a significantly higher amount of TNF-α for all materials, indicating an inflammatory response, which plays an important role in a variety of physiological processes, including osteogenesis. LbL coatings of SF are shown to be promising candidates to modulate the body's immune response to implants manufactured from titanium, magnesium, and polymers. They may therefore facilitate future applications for bioactive implant coatings. However, further in vivo studies are needed to confirm the proposed effects on osteogenesis in a physiological environment.

Role of PLGA Variability in Controlled Drug Release from Dexamethasone Intravitreal Implants

Long-acting injectable formulations based on poly(lactide-co-glycolide) (PLGA) have been commercialized for over 30 years in at least 20 FDA-approved products. These formulations offer several advantages, including reduced dosing frequency, improved patient compliance, and maintenance of therapeutic levels of drug. Despite extensive studies, the inherent complexity of the PLGA copolymer still poses significant challenges associated with the development of generic formulations having drug release profiles equivalent to those of the reference listed drugs. In addition, small changes to PLGA physicochemical properties or the drug product manufacturing process can have a major impact on the drug release profile of these long-acting formulations. This work seeks to better understand how variability in the physicochemical properties of similar PLGAs affects drug release from PLGA solid implants using Ozurdex (dexamethasone intravitreal implant) as the model system. Four 50:50, acid-terminated PLGAs of similar molecular weights were used to prepare four dexamethasone intravitreal implants structurally equivalent to Ozurdex. The PLGAs were extensively characterized by using a variety of analytical techniques prior to implant manufacture using a continuous, hot-melt extrusion process. In vitro release testing of the four structurally equivalent implants was performed in both normal saline and phosphate-buffered saline (PBS), yielding drastically different results between the two methods. In normal saline, no differences in the release profiles were observed. In PBS, the drug release profiles were sensitive to small changes in the residual monomer content, carboxylic acid end group content, and blockiness of the polymers. This finding further underscores the need for a physiologically relevant in vitro release testing method as part of a robust quality control strategy for PLGA-based solid implant formulations.

Clinical Outcomes of Trapeziometacarpal Arthrodesis with a Mean 3-Year Follow-up

Background  This paper's purpose was to analyze clinical results obtained with trapeziometacarpal arthrodesis and complications comparing different osteosynthesis systems. Methods  Thirty-seven trapeziometacarpal arthrodesis were performed in our center in a 7-year period, with a mean age of 52 years and 34 months of follow-up. The implants were distributed homogenously into three groups, using bone grafts in 12.5% of them. Results  A 75% achieved complete consolidation with a mean postsurgical Visual Analog Scale (VAS) of 2.4, Kapandji Opposition Score (KOS) of 8.1, lateral pinch strength of 12.1 kg, tripod pinch strength of 3.6 kg, and tip-to-tip strength of 1.5 kg. Consolidation was not achieved in nine patients, of which five were asymptomatic, three reoperated on trapeziectomy and tenosuspension, and one rearthrodesis. No statistical association was found between the implant used and pseudoarthrosis ( p  = 0.17), VAS ( p  = 0.06), or KOS ( p  = 0.45). Conclusions  Trapeziometacarpal arthrodesis reduces pain for well-chosen patients. Nonunion has low clinical significance in most cases and does not seem to depend on the use of allograft or the type of implant but on an appropriate surgical technique.

A review of emerging tyrosine kinase inhibitors as durable treatment of neovascular age-related macular degeneration

INTRODUCTION

Current treatment for age-related macular degeneration poses a large burden on patients and the inability of patients to adhere to this immense burden can lead to worse visual outcomes. Novel treatments have been proposed to extend treatment intervals and reduce visit burden.

AREAS COVERED

This review article summarizes phase I and phase II clinical trials of tyrosine kinase inhibitors as durable treatment options for patient with neovascular age-related macular degeneration.

EXPERT OPINION

Tyrosine kinase inhibitors have shown substantial promise in reducing treatment burden while maintaining visual acuity and anatomic outcomes with favorable safety profiles. Several platforms have shown positive outcomes in initial trials and are currently moving toward phase III clinical trials.