On the properties of two binary NiTi shape memory alloys. Effects of surface finish on the corrosion behaviour and in vitro biocompatibility

The present paper compares the transformation behaviour and mechanical properties of two orthodontic wires of close chemical compositions. The effects of surface topography and surface finish residues on the potentiodynamic corrosion behaviour and biocompatibility are also reported. The cytotoxicity tests were performed on both alloys in fibroblast cell cultures from human gingiva using the MTT test. It is shown that the surface finish and the amounts of surface finish residues affect dramatically the corrosion resistance. Bad surface finish results in lower corrosion resistance. The in vitro biocompatibility, though not affected to the extent of corrosion resistance, is also reduced as the surface roughness and the amounts of residues increase. This is thought to be due to surface effects on corrosion and metallic ions release.

Optimizing the biomechanical compatibility of orthopedic screws for bone fracture fixation

Progressive loosening of bone fixation screws is a well-documented phenomenon, induced by stress shielding and subsequent adaptive bone remodeling which results in bone loss around the screw. A set of two-dimensional computational (finite element) models was developed in order to test the effect of various engineering designs of fixation screws on the predicted screw-bone stress transfer, and consequently, on the biomechanical conditions for osteosynthesis. A dimensionless set of stress-transfer parameters (STP) was developed to quantify the screw-bone load sharing, enabling a convenient rating to be given of the biomechanical compatibility of practically any given screw design according to the nature of the simulated mechanical interaction. The results indicated that newly proposed screw designs, i.e. a "graded-stiffness" composite screw with a reduced-stiffness-titanium core and outer polymeric threads and an "active-compression" hollow screw which generates compressive stresses on the surrounding bone, are expected to provide significantly better biomechanical performances in terms of the STP criteria, compared with conservative screw designs. Accordingly, the present work demonstrates that finite element computer simulations can be used as a powerful tool for design and evaluation of bone screws, including geometrical features, material characteristics and even coatings.

The influence of short-term water storage on the flexural properties of unidirectional glass fiber-reinforced composites

OBJECTIVE

The aim of this study was to determine flexural properties of unidirectional E-glass fiber-reinforced composite (FRC) with polymer matrices of different water sorption properties.

METHODS

Rhombic polymer and FRC test specimens made of three commercially available diacrylate resin (Sinfony Activator, Triad Gel, 3M Scotchbond Adhesive) and different volume fractions of fibers were tested with three-point bending test according to ISO 10477 after storing in water for 30 days. Water sorption of specimens was also measured.

RESULTS

Flexural strength of specimens with 45 vol% fraction E-glass fibers varied from 759 to 916 MPa in dry conditions. Water-stored specimens showed flexural strengths of 420-607 MPa. ANOVA analysis revealed that the fiber-volume fraction and the water sorption of the polymer matrix had a significant effect (p < 0.001) on the flexural properties. Dehydration of specimens recovered the mechanical properties. Decrease of flexural properties after water immersion was considered to be mainly caused by the plasticizing effect of water and the decrease depended on water sorption.

SIGNIFICANCE

Use of polymers with low-water sorption seems to be beneficial in order to optimize the flexural properties of FRC.

Bone destruction patterns of the rheumatoid elbow: a radiographic assessment of 148 elbows at 15 years

A cohort of 74 patients with rheumatoid arthritis (RA) was followed prospectively for 15 years. At the end of the study, 148 elbows were radiographed with standard methods. The bone destruction of the humerus was measured from the anteroposterior (AP) radiograph as the bone attrition of the trochlea (TM) and the capitellum (CM). The bone destruction of the ulna was measured from the AP radiograph as the width (WO) and from the lateral radiograph as the thickness (TO) of the olecranon. Moreover, elbow joint destruction was graded by the Larsen system on a scale of 0 to 5. The relation of bone destruction to Larsen grade of the elbows was examined. The mean TM of the nonaffected (Larsen grades 0 to 1, n = 73) joints was 17.5 mm (SD, 2.1 mm; range, 10-22 mm), whereas the mean of Larsen grade 3 to 5 joints (n = 26) was 11.5 mm (SD, 5.2 mm). The mean CM of the nonaffected joints was 19.6 mm (SD, 2.6 mm; range, 15-25 mm), and the corresponding mean of Larsen grade 3 to 5 joints 15.5 mm (SD, 4.5 mm). The mean TO of the nonaffected joints was 18.9 mm (SD, 1.5 mm; range, 17-23 mm), and the mean of Larsen grade 3 to 5 joints was 13.9 mm (SD, 4.1 mm). The mean WO of the nonaffected joints was 23.3 (SD, 2.4 mm; range, 18-28 mm), and the mean of Larsen grade 3 to 5 joints was 22.4 mm (SD, 6.2 mm). Spearman correlation coefficients between TM, CM, and TO and Larsen grade of the joint were -0.45 (95% CI, -0.31 to -0.57), -0.38 (95% CI, -0.23 to -0.51), and -0.46 (95% CI, -0.31 to -0.57), respectively. Bone destruction in both the humerus and the olecranon appears to be a late consequence of rheumatoid elbow involvement. Bone loss is always present in the situation of rheumatoid elbow replacement, and it is most remarkable in Larsen grade 5 joints; the risk of preoperative and intraoperative complications due to bone destruction is significantly increased in this group.

Synthesis and evaluation of organosilicon inhibitors of active purine transport in human osteoblasts

In the search for new compounds that might, once incorporated into biomaterials, stimulate the natural processes of bone regeneration, a new series of silicon-containing alkyl nucleobase analogues has been synthesized. An active hypoxanthine transport process in human osteoblasts was demonstrated, with an apparent Michaelis constant of 2.3 microM and a maximum possible rate of 0.47 pmol s(-1) x 10(6) cell. The synthesized analogues were tested for toxicity in human osteoblasts. Nontoxic analogues were tested in competition transport studies with [(14)C]hypoxanthine. Two of them were found to inhibit the active transport of hypoxanthine in human osteoblasts, with IC(50) values of 6.5 and 11.6 microM.

Synthesis of hydroxyapatite via mechanochemical treatment

Hydroxyapatite powder was synthesized with calcium pyrophosphate (Ca2P2O7) and calcium carbonate (CaCO3) through solid-state reaction. The two powders were mixed in acetone and water, respectively, and the single phase of hydroxyapatite was observed to occur only in the powder milled in water, without the additional supply of water vapor during heat-treatment at 1100 degrees C for 1 h. The results were explained in terms of the mechanochemical reaction that could supply enough amount of hydroxyl group to the starting powders to form a single phase of hydroxyapatite. Practical implication of the results is that the powder of high crystalline hydroxyapatite can be obtained by the simple milling in water and subsequent heat-treatment.

The pH dependence of monofilament sutures on hydrolytic degradation

Hydrolytic degradation of two nonabsorbable sutures, four absorbable sutures, and a new type of absorbable suture was studied in buffered media of various pHs at 37 degrees C. The pH levels fixed in this study were 1.0, 7.4, 8.5, and 10.5. Physical measurements were made on the retention of tensile strength and melting temperature of the sutures after hydrolysis for 12 weeks. Sutures containing glycolic acid as a comonomer exhibited enhanced degradation in alkaline media, similar to polyglycolide multifilament sutures. Poly-p-dioxanone (PDS II) suture lost strength to a significant extent at pH 1.0, suggesting that care should be taken when this suture is used for closing tissues in contact with acidic media, such as the stomach. In marked contrast, the degradation of lactide-epsilon-caprolactone copolymer [P(LA/CL)] suture was not sensitive to the pH of media. The surface morphology of hydrolyzed sutures varied, depending on the pH of media. Particularly, moon-crater-shaped impressions were observed on glycolide-epsilon-caprolactone copolymer (MONOCRYL) and glycolide-trimethylene carbonate-dioxanone copolymer (BIOSYN) sutures. Among the nonabsorbable sutures, nylon (ETHILON) exhibited the fastest loss of strength in acidic buffer solution, and polypropylene (PROLENE) suture retained most of its initial strength at all pHs studied.

Quantitative characterization of polyethylene debris isolated from periprosthetic tissue in early failure knee implants and early and late failure Charnley hip implants

This study isolated and characterized UHMWPE particles from 3 explant groups: early Charnley hip failures (ECE; < 10 years), late Charnley hip failures (LCE; > 10 years) and early knee failures (EKE; < 10 years). Debris isolated from the 3 groups had percentage particle number and percentage volumetric concentration distributions that were not significantly different. The greatest number of particles were found in the 0.1-0.5 microm size range and 19-20.6% of the volumetric concentration was below 1 microm in size in all groups. However, there were significant differences in the total volumetric concentration of debris isolated per g of tissue. LCE had significantly higher volumes of debris than ECE and EKE, there was no significant difference in the volume of debris from the EKE and ECE. The mean aspect ratio and mean irregularity ratio of the LCE group were also significantly higher than the ECE and EKE, suggesting that different wear mechanisms were occurring in the late Charnley group compared to the early Charnley and knee groups. These results also suggest that early knees, with normal surface wear, may have similar wear mechanisms to early Charnley hips and indicate that similar volumes of biologically active micrometer and sub-micrometer UHMWPE particles were produced. This may have important implications in the longer-term outcome of total knee arthroplasties, because it indicates a similar potential for osteolysis induced by wear debris.

The use of synthetic polymers for delivery of therapeutic antisense oligodeoxynucleotides

Developed over the past two decades, the antisense strategy has become a technology of recognised therapeutic potential, and many of the problems raised earlier in its application have been solved to varying extents. However, the adequate delivery of antisense oligodeoxynucleotides to individual cells remains an important and inordinately difficult challenge. Synthetic polymers appeared on this scene in the middle 1980s, and there is a surprisingly large variety used or proposed so far as agents for delivery of oligodeoxynucleotides. After discussing the principles of antisense strategy, certain aspects of the ingestion of macromolecules by cells, and the present situation of delivery procedures, this article analyses in detail the attempts to use synthetic polymers as carrier matrices and or cell membrane permeabilisation agents for delivery of antisense oligodeoxynucleotides. Structural aspects of various polymers, as well as the results, promises and limitations of their use are critically evaluated.

Enhanced osteoblast response to a polymethylmethacrylate-hydroxyapatite composite

Hydroxyapatite (HA)-reinforced polymers have been proposed as a method of improving the biological properties of bone cements and implant materials. For example, bone cements based on polymethylmethacrylate (PMMA) have long been used to secure orthopedic implants to the skeleton. This composite could also be used as a polished coating on other materials or in bulk form, shaped or molded, to custom fit a specific clinical need. However, complications may occur as a result of the limited mechanical and biological properties of PMMA. The purpose of this investigation was to determine whether the incorporation of HA in a PMMA matrix would enhance the biological properties of osteoblast response as compared to PMMA alone. Fetal rat calvarial osteoblasts were plated on discs of PMMA, PMMA/HA, commercially pure titanium (CpTi) and tissue culture polystyrene (control). Osteoblast attachment and day 2 proliferation were similar on all implant materials, whereas, day 8 proliferation on PMMA/HA was significantly higher than on PMMA and similar to CpTi and control. Extracellular matrix production was examined by immunohistochemistry which indicated that osteoblasts cultured on PMMA/HA showed a more distinct networked pattern of organized fibronectin. Histochemical staining of mineralization was examined by confocal microscopy which demonstrated a higher degree of mineralization in nodules formed on PMMA/HA as compared to PMMA. Together, these results indicate that the addition of HA in a PMMA matrix improves osteoblast response as compared to PMMA alone. Therefore, the incorporation of HA into a PMMA matrix may be a useful method to provide PMMA materials with enhanced osteogenic properties.

Design optimization of cementless femoral hip prostheses using finite element analysis

Implant separation from bone tissue, resulting in the necessity for revision surgery, is a serious drawback of cementless total joint replacement. Unnatural stress distribution around the implant is considered the main reason for the failure. Optimization of the implant properties, especially its geometric parameters, is believed to be the right way to improve reliability of joint prosthetics. An efficient numerical model of thefemur-implant system is presented in the paper, including the finite element formulation featuring computation of sensitivity gradients, parametric mesh generator, and a gradient-based optimization scheme. Numerical examples show results of shape optimization of an implant for two sets of design parameters and for the initial stability criterion taken as the optimization goal. The optimum shape appears to be relatively long and proximally porous-coated on about half of its length. The method can be flexibly adjusted to various implant types, stress- and displacement-based optimum criteria, and geometric design parameters.

Tumor cytotoxicity of peritoneal macrophages induced by OK-432

In the present study we investigated the enhancement of cytotoxicity of peritoneal macrophages induced by OK-432. Rats received an i.p. injection of OK-432 at doses of 0.1, 0.5 or 1.0 KE/rat. Two days later, rats were sacrificed and peritoneal macrophages were isolated. Then the number of macrophages was counted, and the macrophages were analyzed for their lactic dehydrogenase (LDH) activity, acid phosphatase (ACP) activity, phagocytic activity, secretion of nitric oxide (NO) and cytotoxicity. The number of peritoneal macrophages, the activity of LDH and ACP, phagocytic activity, NO secretion, and cytotoxicity were increased with the increasing doses of OK-432. The results suggested that OK-432 enhanced tumor cytotoxicity of peritoneal macrophages by three steps. The first step is to attract a great number of macrophages into the peritoneal cavity. The second step is to enhance the phagocytic and eliminating function of these macrophages. The last step is to increase the non-contact cytotoxicity of macrophages.

Isolation and morphological characterisation of UHMWPE wear debris generated in vitro

Wear tests are generally carried out on materials used in prosthetic hip implants, in order to obtain a better understanding of the tribological processes involved and improve the quality control of joint prostheses, directed towards reducing the risk of implant failure of innovative prostheses. Ceramic femoral heads of mixed alumina-zirconia oxides as well as zirconia and alumina single oxide heads were tested against UHMWPE acetabular cups in a hip joint simulator. Polyethylene cups and ceramic femoral heads were mounted in a simulator apparatus moving according to a sinusoidal function, under load and in the presence of bovine calf serum as lubricant. Wear particles were isolated from the bovine calf serum collected during the wear tests. An easy to follow method was used to separate the wear particles from the lubricant. Chemical digestive methods were used to separate the wear particles from the lubricant and the isolated particles were studied using scanning electron microscopy. The morphologies of the polyethylene debris showed considerable differences, both in size and shape of the particles, as a function of the coupled head material.

Creation of microrough surface on sintered bioactive glass microspheres

Bioactive glasses are surface-active, generally silica-based, synthetic materials that form a firm chemical bond to bone. The aim of this study was to further enhance the bioactivity of glasses by creating a microroughness on their surface. Microroughness increases potential surface area for cell attachment and biomaterial-cell interactions. Three bioactive glasses of different composition were studied. Each material was flame-sprayed into microspheres, and a selected fraction of the spheres (250-300 microm) was sintered to form porous bioactive glass specimens. To create microrough surfaces, different acid etching techniques were tested. Atomic force microscopy (AFM) and back-scattered electron imaging of scanning electron microscopy (BEI-SEM) were used to characterize surface roughness. The degree of roughness was measured by AFM. A novel chemical-etching method, developed through intensive screening of different options, was found consistently to create the desired microroughness, with an average roughness value (R(a)) of 0.35-0.52 microm and a root mean-square roughness value (R(rms)) of 0.42-0.64 microm. Microroughening of the glass surface was obtained even in the internal parts of the porous glass matrices. Measured by BEI-SEM, the etching of a bioactive glass surface did not interfere with the formation of the characteristic surface reactions of bioactive glasses. This was confirmed by immersing the etched and control glass bodies in a simulated body fluid and tris(hydroxymethyl) aminomethane/HCl. The etching process did not significantly affect the mechanical strength of the sintered bioactive glass structures. Based on these experiments, it seems possible to create a reproducible microroughness of appropriate size on the surface of porous bioactive glass. The biologic benefits of such a surface treatment need to be validated with in vivo experiments.

Comparison of three joint simulator wear debris isolation techniques: acid digestion, base digestion, and enzyme cleavage

Quantification of ultrahigh molecular weight polyethylene (UHMWPE) wear debris remains a challenging task in orthopedic device analysis. Currently, the weight loss method is the only accepted practice for quantifying the amount of wear generated from a PE component. This technique utilizes loaded soak controls and weight differences to account for polymeric material lost through wear mechanisms. This method enables the determination of the amount of wear in the orthopedic device, but it provides no information about debris particulate size distribution. In order to shed light on wear mechanisms, information about the wear debris and its size distribution is necessary. To date, particulate isolation has been performed using the base digestion technique. The method uses a strong base, ultracentrifugation, and filtration to digest serum constituents and to isolate PE debris from sera. It should be noted that particulate isolation methods provide valuable information about particulate size distribution and may elucidate the mechanisms of wear associated with polymeric orthopedic implants; however, these techniques do not yet provide a direct measure of the amount of wear. The aim of this study is to present alternative approaches to wear particle isolation for analysis of polymer wear in total joint replacements without recourse to ultracentrifugation. Three polymer wear debris isolation techniques (the base method, an acid treatment, and an enzymatic digestion technique) are compared for effectiveness in simulator studies. A requirement of each technique is that the wear particulate must be completely devoid of serum proteins in order to effectively image and count these particles. In all methods the isolation is performed through filtration and chemical treatment. Subsequently, the isolated polymer particles are imaged using scanning electron microscopy and quantified with digital image analysis. The results from this study clearly show that isolation can be performed without the use of ultracentrifugation and that these methods provide a viable option for wear debris analysis.

Degradation and fracture of Ni-Ti superelastic wire in an oral cavity

Superelastic Ni-Ti wire is widely used in orthodontic clinics, but delayed fracture in the oral cavity has been observed. Because hydrogen embrittlement is known to cause damage to Ti alloy systems, orthodontic wires were charged with hydrogen using an electro-chemical system in saline. Tensile tests were carried out, and fracture surfaces were observed after hydrogen charging. The strength of the Co-Cr alloy and stainless steel used in orthodontic treatment, was not affected by the hydrogen charging. However, Ni-Ti wire showed significant decreases in strength. The critical stress of martensite transformation was increased with increasing hydrogen charging, and the alloy was embrittled. The fractured surface of the alloys with severe hydrogen charging exhibited dimple patterns similar to those in the alloys from patients. In view of the galvanic current in the mouth, the fracture of the Ni-Ti alloys might be attributed to the degradation of the mechanical properties due to hydrogen absorption.

Structure and surface of TiNi human implants

The surface and the "bulk" structure of TiNi implants were characterized using scanning electron microscopy (SEM), transmission electron microscopy (TEM), X-ray photoemission spectroscopy (XPS), and scanning Auger microprobe analysis (AES). TiNi implants were compared with otherwise identically prepared non-implanted specimens, and sputter-cleaned and reoxidized samples. Non-implanted and implanted samples had essentially the same surface topography and microstructure. Ti, O, and C were the dominant elements detected on the surface. Trace amounts (approximately 1 at%) of Ni and Ca, N, Si, B, and S were also detected. Ti was present as TiO2 on the surface, while nickel was present in metallic form. A significant difference in Ni peak intensity was observed when retrieved or non-implanted control samples (a very low nickel content) were compared with sputter-cleaned and reoxidized samples (well-detected nickel). It is evident that the method of passivation is crucial for nickel loosening. No major changes occurred in the TiNi samples bulk structure or in the surface oxide during the implantation periods investigated.

Effect on composition of dry mechanical grinding of calcium phosphate mixtures

For diverse reasons, calcium phosphates used to prepare hydraulic calcium phosphate cements can be ground mixed. The grinding with a rotating micromill of monocalcium phosphate monohydrate or anhydrous, dicalcium phosphate dihydrate or anhydrous with calcium oxide, calcium hydroxide, calcium carbonate, tetracalcium phosphate, or alpha- or beta-tricalcium phosphate was studied for different calcium to phosphate (Ca/P) ratios, rotating rates, masses of balls, and environmental conditions. During dry grinding by ball milling, anhydrous or hydrated acid calcium phosphates can mechanochemically react with anhydrous or hydrated basic calcium salts to form dicalcium phosphate dihydrate or anhydrous, noncrystalline calcium phosphate, and/or calcium deficient or stoichiometric hydroxyapatite, depending on the Ca/P ratio in the mixture and the time of grinding. The reaction rate is a function of the rotation rate and the mass of the balls. Water is not necessary to initiate the reaction but facilitates it because hydrated salts react faster than the corresponding anhydrous salts. Neither carbon dioxide nor carbonate ions seem to have any influence on the transformation kinetics. The transformations that occur during grinding influence the final mechanical properties of hydraulic calcium phosphate cements prepared from these materials. Thus, if a grinding step of the starting materials is planed, the grinding conditions will have to be particularly well defined to obtain reproducible results.

Effect on composition of dry mechanical grinding of calcium phosphate mixtures

For diverse reasons, calcium phosphates used to prepare hydraulic calcium phosphate cements can be ground mixed. The grinding with a rotating micromill of monocalcium phosphate monohydrate or anhydrous, dicalcium phosphate dihydrate or anhydrous with calcium oxide, calcium hydroxide, calcium carbonate, tetracalcium phosphate, or alpha- or beta-tricalcium phosphate was studied for different calcium to phosphate (Ca/P) ratios, rotating rates, masses of balls, and environmental conditions. During dry grinding by ball milling, anhydrous or hydrated acid calcium phosphates can mechanochemically react with anhydrous or hydrated basic calcium salts to form dicalcium phosphate dihydrate or anhydrous, noncrystalline calcium phosphate, and/or calcium deficient or stoichiometric hydroxyapatite, depending on the Ca/P ratio in the mixture and the time of grinding. The reaction rate is a function of the rotation rate and the mass of the balls. Water is not necessary to initiate the reaction but facilitates it because hydrated salts react faster than the corresponding anhydrous salts. Neither carbon dioxide nor carbonate ions seem to have any influence on the transformation kinetics. The transformations that occur during grinding influence the final mechanical properties of hydraulic calcium phosphate cements prepared from these materials. Thus, if a grinding step of the starting materials is planed, the grinding conditions will have to be particularly well defined to obtain reproducible results.

Corroded nitinol wires in explanted aortic endografts: an important mechanism of failure?

PURPOSE

To analyze surface alterations and fractures observed in the nitinol stent wires of explanted endovascular grafts used for treatment of abdominal aortic aneurysm.

METHODS

Twenty-one explanted Stentor devices and 1 Cragg stent were received from investigators in Germany and France. After macroscopy and photography, the explants were cleaned and the polyester coating removed. The frame was examined completely by stereomicroscopy, and irregularities were assayed by scanning electron microscopy and energy dispersive x-ray analysis (EDAX). The observed alterations were classified according to stereomicroscopic and electron microscopic morphology.

RESULTS

The mean implantation interval for the endografts was 29.1 +/- 13.2 months (range 5-46). All examined explants, even those retrieved after only a few months in situ, showed pitlike surface damage 10-25 microm in diameter. Larger, irregularly shaped surface alterations were observed in approximately 70% of the explants. Older explants (age >32 months) presented vast regions of decay, with bending of the wire and stress cracks in some areas. EDAX examination revealed decreased nickel concentration in the corroded regions.

CONCLUSIONS

Corrosion of the nitinol wire in endovascular grafts is confirmed. Presumably, the observed pitting and irregularly shaped corrosion defects are the precursors of material failure. They weaken the thin wire, which leads to stress cracks and eventually fracture of the stent wire under circulatory pulsation. Cell-induced electrochemical corrosion and active cellular destruction of surfaces are well-known mechanisms that must be investigated for their possible roles in the corrosion of stent metals.

In vitro and in vivo investigations into the biocompatibility of diamond-like carbon (DLC) coatings for orthopedic applications

Diamond-like carbon (DLC) shows great promise as a durable, wear- and corrosion-resistant coating for biomedical implants. The effects of DLC coatings on the musculoskeletal system have not been investigated in detail. In this study, DLC coatings were deposited on polystyrene 24-well tissue culture plates by fast-atom bombardment from a hexane precursor. Two osteoblast-like cell lines were cultured on uncoated and DLC-coated plates for periods of up to 72 h. The effects of DLC coatings on cellular metabolism were investigated by measuring the production of three osteoblast-specific marker proteins: alkaline phosphatase, osteocalcin, and type I collagen. There was no evidence that the presence of the DLC coating had any adverse effect on any of the parameters measured in this study. In a second series of experiments, DLC-coated cobalt-chromium cylinders were implanted in intramuscular locations in rats and in transcortical sites in sheep. Histologic analysis of specimens retrieved 90 days after surgery showed that the DLC-coated specimens were well tolerated in both sites. These data indicate that DLC coatings are biocompatible in vitro and in vivo, and further investigations into their long-term biological and tribological performance are now warranted.

Lifetime predictions for resin-based composites using cyclic and dynamic fatigue

Because dental restorative materials undergo fatigue in use, testing is often performed in the laboratory to evaluate material responses to cyclic loading. The purpose of this study was to compare the lifetime predictions resulting from two methods of fatigue testing: dynamic and cyclic fatigue. Model composites were made in which one variable was the presence of a silanizing agent, and specimens tested in 4-point flexure. Cyclic fatigue was carried out at a frequency of 5 Hz, while dynamic fatigue testing spanned seven decades of stress rate application. Data were reduced and the crack propagation parameters for each material were calculated from both sets of fatigue data. These parameters were then used to calculate an equivalent static tensile stress for a 5-year survival time. The 5-year survival stresses predicted by dynamic fatigue data were approximately twice those predicted by cyclic fatigue data. In the absence of filler particle silanization, the survival stress was reduced by half. Aging in a water-ethanol solution reduced the survival stresses by a factor of four to five. Cyclic fatigue is a more conservative means of predicting lifetimes of resin-based composites.

Porcelain adherence to dental cast CP titanium: effects of surface modifications

OBJECTIVES

A reaction layer forms on cast titanium surfaces due to the reaction of the molten titanium with the investment material. Such a layer prevents strong adhesion between titanium and porcelain. This study characterized the effects of surface modifications on cast titanium surfaces and titanium-ceramic adhesion.

METHODS

ASTM grade II CP titanium was cast into an MgO-based mold. Castings were devested by sandblasting with alumina particles, and subjected to surface modification by immersion in one of the following solutions: (1) 35% HNO3-5% HF at room temperature for 1min; (2) 50% NaOH-10% CuSO4 x 5H2O at 105 degreesC for 10min; (3) the NaOH-CuSO4 solution followed by the HNO3-HF solution; (4) 50% NaOH-10% NaSO4 at 105 degreesC for 10 min; (5) the NaOH-NaSO4 solution followed by the HNO3-HF solution; and (6) 50% NaOH solution at 105 degreesC for 10min. Surfaces only sandblasted with alumina were used as controls. Specimen surfaces were characterized by XRD and SEM/EDS, and hardness-depth profiles were determined. All specimens were sandblasted with 110 microm alumina particles before porcelain firing. An ultra-low-fusing porcelain (Vita Titankeramik) was fused on the titanium surfaces. The titanium-ceramic adhesion was characterized by a biaxial flexure test, and area fraction of adherent porcelain (AFAP) was determined by X-ray spectroscopy.

RESULTS

EDS analyses revealed a substantial amount (13-17 wt%) of Al on the control, and specimens modified with Methods 2, 4, and 6. XRD revealed residual stress in the titanium surfaces and corundum on the control, and Methods 2, 4, and 6 specimens. A new Ti(Cu, Al)2 phase was identified on the titanium surfaces modified by immersion in 50% NaOH-10% CuSO4 x 5H2O aqueous solution. Reduced residual stress was observed on Method 1, 3, and 5 specimens. No corundum peaks were detected on these specimens. Compared to the control, significantly lower (P < 0.05) hardness values were found for Methods 1-3 and Method 5 specimens at 20 microm below the surfaces and for Method 1-5 specimens at 50 microm below the surfaces. Significantly higher (P < 0.05) AFAP values were found for surfaces modified with Methods 2-6 compared to the control and Method 1, and no significant differences were found among Methods 1-6, and between control and Method 1.

SIGNIFICANCE

Based on the results from the present study, porcelain adherence to cast CP titanium can be improved by the caustic baths used in the study.

Synthetic hydrogels as carriers in antisense therapy: preliminary evaluation of an oligodeoxynucleotide covalent conjugate with a copolymer of 1-vinyl-2-pyrrolidinone and 2-hydroxyethyl methacrylate

A major challenge of the antisense therapeutic strategies is the development of improved systems for the delivery of antisense oligodeoxynucleotides (AS ODNs) in order to enhance the cellular uptake, to assure a better efficiency in reaching the target tissue, and to provide sustained delivery over longer periods of time. Because the current methods for delivery (liposomes and cationic polymers) present some disadvantages, the attention was directed toward the use of neutral polymers as carriers for the AS ODNs. Based on our previous work on synthetic hydrogels for vitreous substitution, we developed a poly[1-vinyl-2-pyrrolidinone-co-(2-hydroxyethyl methacrylate)] hydrogel as a potential carrier for AS ODNs. We have previously demonstrated that such hydrogels are not cytotoxic, and they may have growth-promoting effects on cultured fibroblasts. This copolymer also has the advantage of being injectable. In this study, a specific AS ODN was synthesized and then covalently bound to the copolymer via carbodiimide coupling method. The resulting conjugate was subjected to in vitro release experiments over 46 days in the presence of bovine vitreous humor. Compared with the control (no enzyme present), a significant amount of covalently bound ODN was released from the ODN-hydrogel conjugate, suggesting the possibility of using such systems for the sustained delivery of AS ODNs.

AB-polymer networks based on oligo( -caprolactone) segments showing shape-memory properties

Although shape-memory metal alloys have wide use in medicine and other areas, improved properties, particularly easy shaping, high shape stability, and adjustable transition temperature, are realizable only by polymer systems. In this paper, a polymer system of shape-memory polymer networks based on oligo(epsilon-caprolactone) dimethacrylate as crosslinker and n-butyl acrylate as comonomer was introduced. The influence of two structural parameters, the molecular weight of oligo(epsilon-caprolactone) dimethacrylate and the weight content of n-butyl acrylate, on macroscopic properties of polymer networks such as thermal and mechanical properties has been investigated. Tensile tests above and below melting temperature showed a decrease in the elastic modulus with increasing comonomer weight content. The crystallization behavior of the new materials has been investigated, and key parameters for the programming procedure of the temporary shape have been evaluated. Shape-memory properties have been quantified by thermocyclic experiments. All samples reached uniform deformation properties with recovery rates above 99% after 3 cycles. Whereas strain recovery increased with increasing n-butyl acrylate content, strain fixity decreased, reflecting the decreasing degree of crystallinity of the material.

Evaluation of a canine total-elbow arthroplasty system: a preliminary study in normal dogs

OBJECTIVE

Short-term, in vivo evaluation of a total-elbow arthroplasty (TEA) system in normal dogs.

STUDY DESIGN

Prospective evaluation comparing pre- and postoperative findings.

ANIMALS

Six normal, skeletally mature, large-breed dogs.

METHODS

Physical, radiographic, and force-plate gait examinations were performed on all dogs before surgery. TEA was performed in the dogs using a canine TEA system. Examinations were repeated every 8 weeks for 24 weeks, with an additional examination at 52 weeks. Pre- and postoperative findings were compared.

RESULTS

The TEA led to an excellent outcome in 3 of 6 dogs. Force-plate gait examination found that the dogs continued to improve over time and had a peak vertical force (PVF) in the surgical limb that was 99.6% of normal (range, 95.8% to 106.4%) 52 weeks after surgery. Major problems encountered during the postoperative time period were non-weight-bearing lameness (1 dog), osteomyelitis (1 dog), and fracture of the ulna (1 dog).

CONCLUSIONS

TEA can be successfully performed in dogs.

CLINICAL RELEVANCE

Based on 1-year data, TEA can be successfully performed in dogs and could be considered as a treatment alternative for adult dogs with severe osteoarthritis and lameness of the elbow joint.

Unalloyed titanium for implants in bone surgery

Commercially pure (c.p.) titanium has proven its suitability as an implant material in bone surgery over many years in the fields of osteosynthesis, oral implantology, and in certain applications in joint prosthetics. Excellent biocompatibility and corrosion resistance are outstanding features. Furthermore, c.p. titanium is known for not causing allergic reactions. The different grades of c.p. titanium and their minimum mechanical properties are specified in ISO and ASTM standards for implant materials. Typical mechanical properties are given for AO ASIF implant applications. The properties and clinical performance of c.p. titanium are discussed and compared to those of implant stainless steel and titanium alloys. In brief some specific features relating to c.p. titanium implant material are treated, including biocompatibility and soft tissue and bone response and taking into account the effects of implant surface configurations at the same time. In addition, issues are addressed which arise from frequent inquiries from clinics.

Calcium orthophosphates in medicine: from ceramics to calcium phosphate cements

Calcium phosphate (CaP) compounds are becoming of increasingly great importance in the field of biomaterials and, in particular, as bone substitutes. Recent discoveries have accelerated this process, but have simultaneously rendered the field more complicated for the everyday user. Subtle differences in composition and structure of CaP compounds may have a profound effect on their in vivo behaviour. Therefore, the main goal of this article is to provide a simple, but comprehensive presentation of CaP compounds. Reference is made to the most important commercial products.

Computerized infrared thermographic imaging and pulpal blood flow: Part 2. Rewarming of healthy human teeth following a controlled cold stimulus

AIM

To investigate the rewarming pattern and rewarming rate of clinically healthy teeth following a controlled cold stimulus using TI techniques.

METHODOLOGY

A controlled cold stimulus was developed using an air stream at 20 degrees C. Gingival and incisal sites on 12 healthy maxillary lateral incisors in six patients were imaged under rubber dam following 20 s cooling. Images were captured at 10 s intervals during a 3-min rewarming period and the data used to construct graphs of the rewarming rate. Log transformation of the data was used to produce 'best fit' straight line graphs. Linear regression analysis was used to examine three variables, viz. the side of the mouth (right or left), the site of measurement (gingival or incisal) and the phase of rewarming (early 0-90 s, late 91-180 s).

RESULTS

The mean temperature change (delta t degree C) during rewarming was 8.5 degrees C (SD 1.0 degree C) for gingival sites and 7.2 degrees C (SD 1.1 degrees C) for incisal sites. The slope of the 'best fit' straight line data enabled a rewarming index to be calculated for each site on each tooth. Linear regression analysis showed that the phase of rewarming was highly significant but the other variables were not. A one-way ANOVA showed no significant differences between or within groups.

CONCLUSIONS

Three min is an appropriate time to record rewarming of teeth cooled for 20 s with an airstream at 20 degrees C. The side or site used to record surface temperatures using this technique is not significant. Rewarming is exponential and log transformation of the data produces a well-fitting straight line graph. The slope of this line provides a rewarming index which should enable comparison of TI and laser Doppler flowmetry in determining pulpal blood flow as a measure of tooth vitality.

The effect of nitrogen diffusion hardening on the surface chemistry and scratch resistance of Ti-6A1-4V alloy

Modular, head-stem, mixed-metal connections are susceptible to mechanically mediated electrochemical interactions. Any attempt to improve the performance of these connections should center around increasing their resistance to mechanical damage, particularly the titanium alloy (Ti64). This study investigated the effect of a nitrogen-diffusion-hardening process on Ti64, with specific reference to changes in composition, chemistry, electrochemistry and its ability to resist and/or repassivate scratch damage. The nitrogen-diffusion-hardened Ti64 alloy had TiN and TiNO complexes at the immediate surface and sub-surface layers. The diffusion-hardened samples also had a deeper penetration of oxygen compared to regular Ti64 alloy samples. The electrochemical impedance spectroscopy data corroborated the increased thickness of the barrier oxide on the diffusion-hardened samples. The nitrogen-diffusion-hardened samples were more resistant to scratch damage and repaired/repassivated faster after such damage. The results suggest that the nitrogen-diffusion-hardened titanium alloy should exhibit increased resistance to mechanical-electrochemical interactions in mixed-metal modular interfaces in total hip prostheses.

Patient satisfaction needs as related to knee stability and objective findings after ACL reconstruction using the LARS artificial ligament

The purposes of this study are to compare patient satisfaction with the objective measurement of knee stability and assess early complications following ACL reconstruction using a LARS artificial ligament. Forty-seven patients were reviewed 8-45 months after surgery. Assessment was made by the Knee and Osteoarthritis Outcome Score for patient satisfaction, a modified International Knee Documentation Committee form for clinical knee stability, and a Telos stress radiography for PA stability. Complications were assessed at interview and were double-checked with charts. The LARS artificial ligament may be a safe device to reconstruct an ACL tear. Documenting mechanical stability of the knee is inadequate when reporting follow-up studies and a questionnaire assessing patient satisfaction should be added to provide a better picture of the outcome and results.

Mechanical properties of medical grade expanded polytetrafluoroethylene: the effects of internodal distance, density, and displacement rate

Expanded polytetrafluoroethylene (e-PTFE) is used successfully in a multitude of biomedical and clinical applications. The success of this biomaterial is due to its microporous structure that allows biointegration for fixation, as well as overall mechanical integrity. The mechanical properties and degree of tissue ingrowth depend on the microstructure of the expanded polymer foam, yet little is known about the correlation of the internodal distance and other microstructural features with the monotonic tensile properties. Complete structure-property correlation can be used to provide invaluable knowledge for the design of biomedical devices. The purpose of this study was to investigate the monotonic tensile properties of e-PTFE over a range of medically relevant microstructural features and manufacturing parameters. The microstructural and manufacturing parameters considered were internodal distance, linear density, volumetric density, and reduction ratio. Additionally, the effect of displacement rate on mechanical properties was studied. We found that the ultimate stress and strain increased linearly with linear density (R2 = 0.88 and 0.67, respectively). Surprisingly, elastic modulus did not correlate with any parameter measured and only weak correlations were found between all properties and internodal distance. The yield and ultimate stresses increased with increasing displacement rate (R2 = 0.88 and 0.57, respectively). The findings from this study indicate that linear density is a better predictor of mechanical properties than internodal distance and may be the preferred parameter to control when specifying a material for implantation in load bearing situations.

Effect of low-level laser therapy (LLLT) on viscoelasticity of the contracted knee joint: comparison with whirlpool treatment in rats

BACKGROUND AND OBJECTIVE

The purpose of this study was to compare the effect of Low-Level Laser Therapy (LLLT) with sham and whirlpool treatment on the contracted knee joint in rat.

STUDY DESIGN/MATERIALS AND METHODS

Forty-eight Wistar rats were operated on to immobilize knee joint, and 1 week after operation they were randomly assigned to four treatment groups: laser 40 mW (3.9 W/cm2), laser 60 mW (5.8 W/cm2), whirlpool (42 degrees C), and sham laser. Tunable Ga-Al-As semiconductor (810 nm) laser was used for another 2 weeks of treatment. Removing and preparing bilateral hind legs, degree of knee contracture was assessed by measuring the knee flexion angle, weight of the gastrocnemius muscle, and periarticular connective tissue viscoelasticity measuring phase-lag and stiffness.

RESULTS AND CONCLUSION

Laser irradiation showed no significant changes except the phase-lag of laser 60 mW. Under the conditions of this study, LLLT stimulation did not provide a significant effect for minimizing the degree of experimental joint contracture over whirlpool treatment.

Effect of modification of oxide layer on NiTi stent corrosion resistance

Because of its good radiopacity, superelasticity, and shape memory properties, nickel-titanium (NiTi) is a potential material for fabrication of stents because these properties can facilitate their implantation and precise positioning. However, in vitro studies of NiTi alloys report the dependence of alloy biocompatibility and corrosion behavior on surface conditions. Surface oxidation seems to be very promising for improving the corrosion resistance and biocompatibility of NiTi. In this work, we studied the effect on corrosion resistance and surface characteristics of electropolishing, heat treatment, and nitric acid passivation of NiTi stents. Characterization techniques such as potentiodynamic polarization tests, scanning electron microscopy, Auger electron spectroscopy, and X-ray photoelectron spectroscopy were used to relate corrosion behavior to surface characteristics and surface treatments. Results show that all of these surface treatments improve the corrosion resistance of the alloy. This improvement is attributed to the plastically deformed native oxide layer removal and replacement by a newly grown, more uniform one. The uniformity of the oxide layer, rather than its thickness and composition, seems to be the predominant factor to explain the corrosion resistance improvement.

Interfacial properties of self-reinforced composite poly(methyl methacrylate)

Total joint prostheses are often fixed in the bone using bone cement. The cement mantle, however, is prone to fatigue fracture that can lead to failure of the mantle, evolution of bone cement particles, and eventual loosening and failure of the prosthesis. A new material, self-reinforced composite poly(methyl methacrylate) (SRC-PMMA) was developed previously by the authors. This material has a similar chemical composition to bone cement, with the matrix and reinforcing fibers both fabricated from PMMA. One potential use for this material is as a precoat for hip prostheses or other stemmed prostheses. This study sought to examine the strength of the bonds that SRC-PMMA forms with simulated prostheses and bone cement. SRC-PMMA was woven about Co-Cr rods and push out tests were performed. Samples were tested in air as processed or after immersion in saline for 30 days at 37 degrees C. Three different weaves were investigated and compared to bone cement. Bone cement and SRC-PMMA formed interfacial bonds with Co-Cr rods that failed at an average load (stress) of 980 N (2.0 MPa). After saline immersion, the bone cement's interfacial bond strength was 642 N (1.23 MPa) and the tight weave SRC-PMMA was statistically stronger at 973 N (1.86 MPa). The shear strength within bone cement alone as measured by push out tests was an order of magnitude higher at 9210 N (15.2 MPa) in air and 9900 N (15.7 MPa) after saline immersion. The bond between SRC-PMMA and bone cement was 10,900 N (17.9 MPa) in air and 9610 N (15.8 MPa) after immersion in saline. Woven SRC-PMMA performed as well or better than bone cement in these push out tests.

Preliminary investigation of the effects of surface treatments on biological response to shape memory NiTi stents

Nickel-titanium (NiTi) offers many advantages for the fabrication of coronary stents: shape memory, superelasticity, and radiopacity. However, many authors highlighted the selective dissolution of Ni from the alloy during the corrosion process that could lead to potential toxicity. The improvement of the NiTi stent's corrosion resistance by different surface treatments (electropolishing, heat treatment, and nitric acid passivation) was reported in a previous article. In the present study a comparative biocompatibility evaluation of such stents was performed through in vitro and in vivo assays. A cell proliferation test was completed to evaluate the cytotoxicity of surface treated NiTi using human fibroblasts. Then a stent implantation was performed in rabbit paramuscular muscle to study the inflammatory response generated by the same implants. Cell proliferation tests generally indicated an in vitro biocompatibility of our samples similar to the control group. An in vivo implantation study demonstrated the gradual overall reduction with time of the fibrocellular capsule thickness surrounding the implants. After a 12-week implantation period, the fibrous capsules surrounding the different implants tended toward the same value of 0.07 mm, which suggested that all surface treatments produced a similar biological response. This low value of the fibrocellular capsule indicated that our NiTi surface treated implants were relatively inert.

Organ culture in 3-dimensional matrix: in vitro model for evaluating biological compliance of synthetic meshes for abdominal wall repair

A new in vitro method to evaluate the early critical interactions between synthetic prosthetic materials and growing tissues is reported. The correct spatial organization and proper cell to cell interaction required to mimic the in vivo environment was obtained in a 3-dimensional (3-D) embryo organ culture. The clot formed by plasma and chick-embryo extract provided a natural 3-D extracellular matrix that was able to support the growth and differentiation of intestinal tissue dissected from 12-day-old chick embryos. Different materials used for the repair of abdominal wall defects were taken as standards; all the prosthetic materials were devoid of any evident cytotoxic potential over a 10-day culture period, so they did not interfere with the organogenesis process. A polyglactin mesh (Vicryl) was fully incorporated into the growing tissue, but early signs of its degradation were detectable. The biologically inert materials polyethylene terephthalate (Mersilene) and polypropylene (Marlex, Prolene, and Herniamesh) retained their structural integrity when incubated with cultured tissue at 37 degrees C, and they did not hinder cellular proliferation or fibroblast migration. However, the outgrowth behavior was very different while the connective tissue invaded the interstices of the polyethylene terephthalate mesh; the explants and the migrating cells were repelled by hydrophobic polypropylene meshes. These findings are in agreement with other reported results in in vivo studies. Therefore, this method can be considered as reliable and predictable for the evaluation of biopolymers.

Third-body wear of cobalt-chromium-molybdenum implant alloys initiated by bone and poly(methyl methacrylate) particles

The potential for bone and poly(methyl methacrylate) (PMMA) debris to initiate wear on ASTM-F75 and ASTM-F799 CoCrMo alloys articulating against ultrahigh molecular weight polyethylene (UHMWPE) was investigated. Third-body wear particles of bone and PMMA bone cement (with and without the radiopacifier, barium sulfate) were introduced between CoCrMo and UHMWPE in a reciprocating sliding wear test. A scanning electron microscope and a white light interference surface profilometer were used to study the surface damage and quantify the surface roughnesses of the worn alloys. The CoCrMo alloys, which are widely used as the femoral components in total artificial knees and hips, showed surface damage as the result of wear in the presence of bone or PMMA debris. Severe scratches were generated within 2700 cycles (94.5-m sliding distance) on the alloy's surface. Ploughing was the major wear mechanism. Carbides in the F75 alloy surface appeared to be unaffected by the debris. A quantitative study was performed on the surface roughness (average roughness, R(a), and root mean square roughness, RMS) of the alloy after wear testing. A nonparametric Wilcoxon rank sum test of wear severity (R(a) and RMS) was performed based on the surface roughness data. The surfaces of the specimens tested with the PMMA and bone particles were significantly rougher than those of the controls (p < 0.01). Small scratches also occurred on some of the control specimen surfaces and may have been second-body wear caused by defects and impurities in the UHMWPE.

A system for monitoring the response of uniaxial strain on cell seeded collagen gels

The success of cell seeded constructs for the repair of collagenous tissues may be improved by the use of mechanical stimulation in vitro. A mechanical loading apparatus, termed the cell straining system, was developed according to a set of design criteria, to enable cell seeded constructs to be cyclically loaded in tension. A suitable cell seeded collagen gel model system was used to characterise the apparatus. These gels were subjected to a cyclic strain of 10% superimposed on two separate tare loads of 2 and 10 mN, while being maintained in cell culture conditions. The computer controlled apparatus was shown to be capable of monitoring the individual loads on six specimens simultaneously, to an accuracy of 0.02 mN. Results indicated a wide variability between individual specimens. Following cyclic loading, the cell seeded collagen gels exhibited an increase in structural stiffness compared with the unloaded controls. This novel and versatile apparatus will provide a means of enhancing structural and mechanical integrity of tissue engineered repair systems.

The in-vivo wear performance of prosthetic femoral heads with titanium nitride coating

This paper reports the study performed on four titanium nitride (TiN) coated prosthetic femoral heads collected at revision surgery together with patient data. Surface topology has been examined using Scanning Electron Microscopy (SEM) and elemental analysis of both coating and substrate have been evaluated using energy-dispersive X-ray spectrometry. Quantitative assessment of the surface topography is achieved using contacting profilometry. The average Ra roughness value is calculated at five different locations for each femoral head. The UHMWPE counterface worn volume has been measured directly on the acetabular components. TiN fretting and coating breakthrough occurred in two of the four components examined. In the damaged coating areas the surface profile is macroscopically saw-toothed with average tooth height 1.5 microm. The average Ra value is 0.02 microm on the undamaged surfaces and 0.37 microm on the damaged ones. Failure of the coating adhesion resulted in the release of TiN fragments and of metallic particulate from the substrate fretting corrosion and in the increase of the head surface roughness affecting counterface debris production. Our results suggest that TiN-coated titanium alloy femoral heads are inadequate in the task of resisting third body wear mechanisms in vivo.

Bone marrow stromal cells: characterization and clinical application

The bone marrow stroma consists of a heterogeneous population of cells that provide the structural and physiological support for hematopoietic cells. Additionally, the bone marrow stroma contains cells with a stem-cell-like character that allows them to differentiate into bone, cartilage, adipocytes, and hematopoietic supporting tissues. Several experimental approaches have been used to characterize the development and functional nature of these cells in vivo and their differentiating potential in vitro. In vivo, presumptive osteogenic precursors have been identified by morphologic and immunohistochemical methods. In culture, the stromal cells can be separated from hematopoietic cells by their differential adhesion to tissue culture plastic and their prolonged proliferative potential. In cultures generated from single-cell suspensions of marrow, bone marrow stromal cells grow in colonies, each derived from a single precursor cell termed the colony-forming unit-fibroblast. Culture methods have been developed to expand marrow stromal cells derived from human, mouse, and other species. Under appropriate conditions, these cells are capable of forming new bone after in vivo transplantation. Various methods of cultivation and transplantation conditions have been studied and found to have substantial influence on the transplantation outcome. The finding that bone marrow stromal cells can be manipulated in vitro and subsequently form bone in vivo provides a powerful new model system for studying the basic biology of bone and for generating models for therapeutic strategies aimed at regenerating skeletal elements.

Biomaterials used in the posterior segment of the eye

The treatment of posterior segment eye disease and related conditions has improved greatly in recent years with the advent of new therapies, materials and devices. Vitreoretinal conditions, however, remain significant causes of blindness in the developed world. Biomaterials play a major role in the treatment of many of these disorders and the success rate of vitreoretinal surgery, especially in the repair of retinal detachment and related conditions, would increase with the introduction of new and improved materials. This review, which focuses on disorders that feature retinal detachment, briefly describes the anatomy of the eye and the nature and treatment of posterior segment eye disorders. The roles, required properties and suitability of the materials used in vitreoretinal surgery as scleral buckles, tamponade agents or drug delivery devices, are reviewed. Experimental approaches are discussed, along with the methods used for their evaluation, and future directions for biomaterial research in the posterior segment of the eye are considered.

Evaluation of bioactive bone cement in canine total hip arthroplasty

Total hip arthroplasties (THAs) were performed in beagle dogs using a bioactive bone cement (BABC) consisting of a silane-treated apatite- and wollastonite-containing glass-ceramic (AW glass-ceramic) powder and a silica glass powder as the filling particles and a bisphenol-A-glycidyl dimethacrylate-based resin (Bis-GMA-based resin) as the organic matrix. The outcomes were compared with the results of polymethylmethacrylate (PMMA) bone cement. The mechanical properties of the BABC were stronger than those of PMMA bone cement. The bonding strength of the BABC to bone in the dogs' femora increased with time and reached 3.7 MPa at 24 months after implantation whereas that of PMMA bone cement was 2.0 MPa (p < 0.05). Histological examination showed direct bonding between the BABC and the femoral bone for up to 24 months after implantation. However, with PMMA bone cement an intervening soft-tissue layer consistently was observed at the bone-cement interface. Direct bonding at the interface between the BABC and the bone through a calcium phosphorous layer 30 microm-thick was revealed by scanning electron microscopy. Femoral bone resorption was observed at 24 months after implantation in the BABC group, but it was not observed in the PMMA bone cement group. Direct bonding between BABC and the bone may have accelerated femoral bone resorption. Cement fractures of the BABC were observed on the acetabular side 24 months after implantation. Weak bonding between the BABC and an acetabular component made of ultrahigh molecular weight polyethylene (UHMWPE), relatively high elastic characteristics of BABC, and weakness of the calcium phosphorous layer formed on the surface of this cement seemed to lead to failure at 24 months on the acetabular side.

Biomechanical study of pediatric human cervical spine: a finite element approach

Although considerable effort has been made to understand the biomechanical behavior of the adult cervical spine, relatively little information is available on the response of the pediatric cervical spine to external forces. Since significant anatomical differences exist between the adult and pediatric cervical spines, distinct biomechanical responses are expected. The present study quantified the biomechanical responses of human pediatric spines by incorporating their unique developmental anatomical features. One-, three-, and six-year-old cervical spines were simulated using the finite element modeling technique, and their responses computed and compared with the adult spine response. The effects of pure overall structural scaling of the adult spine, local component developmental anatomy variations that occur to the actual pediatric spines, and structural scaling combined with local component anatomy variations on the responses of the pediatric spines were studied. Age- and component-related developmental anatomical features included variations in the ossification centers, cartilages, growth plates, vertebral centrum, facet joints, and annular fibers and nucleus pulposus of the intervertebral discs. The flexibility responses of the models were determined under pure compression, pure flexion, pure extension, and varying degrees of combined compression-flexion and compression-extension. The pediatric spine responses obtained with the pure overall (only geometric) scaling of the adult spine indicated that the flexibilities consistently increase in a uniform manner from six- to one-year-old spines under all loading cases. In contrast, incorporation of local anatomic changes specific to the pediatric spines of the three age groups (maintaining the same adult size) not only resulted in considerable increases in flexibilities, but the responses also varied as a function of the age of the pediatric spine and type of external loading. When the geometric scaling effects were added to these spines, the increases in flexibilities were slightly higher; however, the pattern of the responses remained the same as found in the previous approach. These results indicate that inclusion of developmental anatomical changes characteristic of the pediatric spines has more of a predominant effect on biomechanical responses than extrapolating responses of the adult spine based on pure overall geometric scaling.

In vitro sodium fluoride exposure decreases torsional and bending strength and increases ductility of mouse femora

Fluoride exposure in vivo can reduce the material strength of bone, an effect that has been attributed to a change in mineral structure. An in vitro model of fluoride exposure offers the potential to study directly the effects of fluoride on bone mineral. Previous investigators have reported that soaking bones in sodium fluoride in vitro reduces bone strength. However, long soaking times and the absence of physiological buffering ions from their treatment solutions may have caused mineral dissolution that contributed to the decrease in bone strength. Our objectives were to further characterize the effects of in vitro fluoride exposure on bone mechanical properties and to determine if the changes reported in previous studies of bovine cortical bone would be observed for whole rodent bones. We soaked 60 mouse femora in sodium fluoride solutions, with and without physiological buffering ions, and evaluated their torsional and bending properties. Fluoride soaked bones had a 30-fold increase in fluoride content and a 23% increase in water content compared to controls. These changes were associated with average reductions in ultimate load of 45%, reductions in rigidity of 70%, and increases in deformation to failure of 80%. The effect of fluoride was similar for bones treated in buffered and non-buffered solutions, and was observed in both torsion and bending. Our findings confirm those of previous studies and highlight the strong effect that in vitro fluoride exposure has on bone mechanical properties. The in vitro model of fluoride exposure offers a tool to further study the effects of ion substitution in bone.

Immersion behavior of RF magnetron-assisted sputtered hydroxyapatite/titanium coatings in simulated body fluid

The focus of the present study was on the dissolution/degradation behavior of a series of magnetron-sputtered, single-layered HA/Ti coatings on Ti-6Al-4V substrate immersed in SBF. Changes in coating morphology, crystal structure, and adhesion strength with immersion time are characterized. XRD, FTIR, and LVSEM results consistently indicate that highly crystalline monolithic HA coating is very dissolvable in SBF. The monolithic HA coating is largely delaminated in 3 weeks and entirely peeled off the substrate in 7 weeks. The dissolution is even greater for 95HA/5Ti coating, which severely disintegrated in only 1 week. The amorphous-like coatings sputtered from targets comprising 10 vol % or more Ti, however, appeared almost intact, and their adhesion strengths, which were all higher than 60 MPa, did not change much (within 10%) even after 14 weeks of immersion. The coatings from targets comprising roughly 10-50 vol % Ti combine advantages of high and nondeclining adhesion strength, high resistance to SBF attack, and possibly much higher bioactivity (with large amounts of Ca, P, etc., dissolved in the coatings) than that of Ti.