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Xiao L, Guo J, Wang H, He Q, Xu Y, Yuan L, Yi Q, Zhang Q, Wang J, Min S, Zhao M, Xin X, Chen H. Thermal damage and the prognostic evaluation of laser ablation of bone tissue-a review. Lasers Med Sci 2023; 38:205. [PMID: 37676517 DOI: 10.1007/s10103-023-03868-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 08/28/2023] [Indexed: 09/08/2023]
Abstract
In recent years, an increasing number of scientists have focused on conducting experiments on laser ablation of bone tissue. The purpose of this study was to summarize the prognosis of tissue and the extent of thermal damage in past hard tissue ablation experiments, and review the evidence for the feasibility of laser osteotomy in surgery. An electronic search of PubMed, China National Knowledge Infrastructure (CNKI), and Web of Science (WOS) for relevant English-language articles published through June 2023 was conducted. This review includes 48 literature reports on laser ablation of hard tissues from medical and biological perspectives. It summarizes previous studies in which the ideal ablation rate, depth of ablation, and minimal damage to bone tissue and surrounding soft tissues were achieved by changing the laser type, optimizing the laser parameter settings, or adding adjuvant devices. By observing their post-operative healing and inflammatory response, this review aims to provide a better understanding of pulsed laser ablation of hard tissues. Previous studies suggest that laser osteotomy has yielded encouraging results in bone resection procedures. We believe that low or even no thermal damage can be achieved by experimentally selecting a suitable laser type, optimizing laser parameters such as pulse duration and frequency, or adding additional auxiliary cooling devices. However, the lack of clinical studies makes it difficult to conclusively determine whether laser osteotomy is superior in clinical applications.
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Affiliation(s)
- Liuyi Xiao
- Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, 610072, China
| | - Junli Guo
- Institute of Optics and Electronics, Chinese Academy of Sciences, Chengdu, 610209, China
- Key Laboratory of Optical Engineering, Chinese Academy of Sciences, Chengdu, 610209, China
| | - Huan Wang
- Ophthalmology Department, Eastern Hospital, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, 610072, China
| | - Qianxiong He
- Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, 610072, China
| | - Yang Xu
- Ophthalmology Department, Eastern Hospital, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, 610072, China
- Eye School, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Lu Yuan
- Ophthalmology Department, Eastern Hospital, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, 610072, China
- Eye School, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Qianya Yi
- Ophthalmology Department, Eastern Hospital, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, 610072, China
- Eye School, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Qian Zhang
- West China Forth University Hospital Ophthalmology Department, Chengdu, 610044, China
| | - Jin Wang
- Institute of Optics and Electronics, Chinese Academy of Sciences, Chengdu, 610209, China
- Key Laboratory of Optical Engineering, Chinese Academy of Sciences, Chengdu, 610209, China
| | - Shaokun Min
- Qianjiang Xinhua Middle School, Chongqing, 404100, China
| | - Menghan Zhao
- Pujiang County People's Hospital, Chengdu, 611630, China
| | - Xiaorong Xin
- Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China.
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, 610072, China.
| | - Hui Chen
- Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China.
- Eye School, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China.
- Department of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200080, China.
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, 200080, China.
- National Clinical Research Center for Eye Diseases, Shanghai, 200080, China.
- University of Shanghai for Science and Technology, Shanghai, 200093, China.
- Chengdu Medical College, Chengdu, 610083, China.
- Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection, Chengdu, 610209, China.
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Ran T, Lin C, Ma T, Qin Y, Li J, Zhang Y, Xu Y, Li C, Wang M. Ultra-Pulsed CO 2 Laser Osteotomy: A New Method for the Bone Preparation of Total Knee Arthroplasty. Front Bioeng Biotechnol 2022; 10:858862. [PMID: 35573227 PMCID: PMC9096707 DOI: 10.3389/fbioe.2022.858862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/31/2022] [Indexed: 12/04/2022] Open
Abstract
Cementless total knee arthroplasty (TKA) can achieve long-term biological fixation, but its application is limited by the risk of early aseptic loosening. One of the important reasons for early aseptic loosening is that mechanical osteotomy tools cannot achieve ideal bone preparation because of poor accuracy and serious bone tissue damage produced by them. Therefore, we designed an ultra-pulsed CO2 laser osteotomy system to solve these problems. To reveal the safety at the tissue and cell levels of the ultra-pulsed CO2 laser osteotomy system, a series of experiments on distal femur osteotomy in animals were performed. Then, the bone surface characteristics were analyzed through scanning electron microscopy, and the bone thermal and mechanical damage was evaluated via histological analysis. Finally, mesenchymal stem cells (MSCs) were inoculated on the bone surfaces prepared by the two osteotomy tools, and the effect of cell adhesion was analyzed through a confocal laser scanning microscope (CLSM). We successfully achieved TKA bone preparation of animal knees with the ultra-pulsed CO2 laser osteotomy system. Moreover, the biological evaluation results indicated that compared with the traditional mechanical saw, the laser can preserve the natural bone structure and cause no thermal damage to the bone. In addition, CLSM examination results showed that the laser-cut bone surface was more conducive to cell adhesion and infiltration than the bone surface cut by a mechanical saw. Overall, these results indicate that ultra-pulsed CO2 laser can achieve non-invasive bone cutting, which can be a new option for TKA bone preparation and has the potential to lead in the future.
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Affiliation(s)
- Tianfei Ran
- Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, China
| | - Chuanchuan Lin
- Department of Blood Transfusion, Xinqiao Hospital, Amy Medical University (Third Military Medical University), Chongqing, China
| | - Tianying Ma
- Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, China
| | - Yinyin Qin
- Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, China
| | - Jie Li
- Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, China
| | - Yuan Zhang
- Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, China
| | - Yuan Xu
- Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, China
| | - Changqing Li
- Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, China
| | - Min Wang
- Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, China
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Canteli D, Muñoz-García C, Morales M, Márquez A, Lauzurica S, Arregui J, Lazkoz A, Molpeceres C. Thermal Effects in the Ablation of Bovine Cortical Bone with Pulsed Laser Sources. MATERIALS (BASEL, SWITZERLAND) 2019; 12:E2916. [PMID: 31505836 PMCID: PMC6766215 DOI: 10.3390/ma12182916] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 08/19/2019] [Accepted: 08/24/2019] [Indexed: 12/02/2022]
Abstract
Lasers have advantages as bone surgical tools over mechanical methods, but two goals should be achieved to assure its use: Similar ablation rates to those obtained with mechanical tools (1 mm3/s at least) and to avoid thermal damage, a condition that can prevent proper bone healing. We present results of cow femoral bone with a 355 nm nanosecond (ns) and a 1064 nm picosecond (ps) pulsed laser sources that allow us to discuss the influence on the process of pulse duration and the selective ablation through high energy absorption (as bone highly absorbs 355 nm radiation). The treated samples were characterized by scanning electron microscopy (SEM) and Raman spectroscopy. The evaluation of the thermal effects produced in the samples shows clear differences between both laser sources: On one hand, the ns laser allows reaching high ablation rates (around 1 mm3/s); Raman spectra show no signal of bone carbonization, but unavoidable thermal effects in the form of melted and solidified material have been observed by electron microscopy in the samples treated with this laser. On the other hand, ablation without any sign of thermal effects is obtained using the ps laser, but with lower ablation rates, (around 0.15 mm3/s).
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Affiliation(s)
- David Canteli
- Centro Láser, Universidad Politécnica de Madrid, Alan Turing 1, 28031 Madrid, Spain.
| | | | - Miguel Morales
- Centro Láser, Universidad Politécnica de Madrid, Alan Turing 1, 28031 Madrid, Spain
| | - Andrés Márquez
- Centro Láser, Universidad Politécnica de Madrid, Alan Turing 1, 28031 Madrid, Spain
| | - Sara Lauzurica
- Centro Láser, Universidad Politécnica de Madrid, Alan Turing 1, 28031 Madrid, Spain
| | - Juan Arregui
- Deneb Medical, Paseo Mikeletegui, 83, 20009 San Sebastián, Spain
| | - Aritz Lazkoz
- Deneb Medical, Paseo Mikeletegui, 83, 20009 San Sebastián, Spain
| | - Carlos Molpeceres
- Centro Láser, Universidad Politécnica de Madrid, Alan Turing 1, 28031 Madrid, Spain
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Augello M, Baetscher C, Segesser M, Zeilhofer HF, Cattin P, Juergens P. Performing partial mandibular resection, fibula free flap reconstruction and midfacial osteotomies with a cold ablation and robot-guided Er:YAG laser osteotome (CARLO ®) - A study on applicability and effectiveness in human cadavers. J Craniomaxillofac Surg 2018; 46:1850-1855. [PMID: 30146105 DOI: 10.1016/j.jcms.2018.08.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 07/10/2018] [Accepted: 08/01/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Aim of the study was to prove the safety, accuracy characteristics of contact-free laser osteotomy executed with the cold ablation and robot-guided Er:YAG laser osteotome in a human cadaver test. MATERIAL AND METHODS On six human cadavers mandible resections with a swallowtail like pattern were performed with the laser system on each side. The defects were reconstructed with a fibula graft of identical design and enlarged by 0.2 units. Mandibles and fibulas width as well surgery times were recorded. Additionally a Le Fort I and median mandible split were done. Macroscopically, the bone margins were examined for necrosis. RESULTS Laser osteotomies of the mandible up to a depth of 23 mm were possible without any thermal damage. Repeatability and precision of the system could be easily assessed. With the navigation system precise control of localization was achievable. Mean surgery time for the mandible resection was 13.32 min and for the fibula osteotomy 12.38 min. CONCLUSION The simply transmission of a cold ablation and robot-guided laser osteotome in an operation room identical environment for surgical interventions could be demonstrated. Precise osteotomy patterns with freedom in the design and carbonisation-free cut surfaces have been shown.
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Affiliation(s)
- Marcello Augello
- Department of Cranio-Maxillofacial Surgery, (Head: Prof. Dr. Dr. Dr. H.C. Hans-Florian Zeilhofer), Hospital Aarau, Aarau, Switzerland; Hightech Research Centre of Cranio-Maxillofacial Surgery, University of Basel, Allschwil, Switzerland.
| | | | | | - Hans-Florian Zeilhofer
- Hightech Research Centre of Cranio-Maxillofacial Surgery, University of Basel, Allschwil, Switzerland; Department of Cranio-Maxillofacial Surgery, University Hospital, Basel, Switzerland
| | - Philippe Cattin
- Center for Medical Image Analysis and Navigation, University of Basel, Allschwil, Switzerland
| | - Philipp Juergens
- Hightech Research Centre of Cranio-Maxillofacial Surgery, University of Basel, Allschwil, Switzerland; Department of Cranio-Maxillofacial Surgery, University Hospital, Basel, Switzerland
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Comparative microstructural analysis of bone osteotomies after cutting by computer-assisted robot-guided laser osteotome and piezoelectric osteotome: an in vivo animal study. Lasers Med Sci 2018; 33:1471-1478. [PMID: 29654421 DOI: 10.1007/s10103-018-2502-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 04/02/2018] [Indexed: 10/17/2022]
Abstract
Most industrial laser applications utilize computer and robot assistance, for guidance, safety, repeatability, and precision. In contrast, medical applications using laser systems are mostly conducted manually. The advantages can be effective only when the system is coupled to a robotic guidance, as operating by hand does not reach the required accuracy. We currently developed the first laser osteotome which offers preoperative planning based on CT data, robot guidance, and a precise execution of the laser cuts. In an animal trial, our system was used to create a grid pattern of the same depth on the inner layer of parietal bone in 12 adult sheep. The same bone cuts were done with piezoelectric osteotome on the contralateral side. The micro-CT and histological analysis showed more new mineralized bone in the laser group compared to the piezoelectric group. As well, a cutting pattern with especially a constant osteotomy depth in the laser group was demonstrated. The here presented autonomous osteotomy tool shows not only an advantage in early bone healing stage but additionally sharp bone cuts with a very high accuracy and freely selectable design cuts.
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Troedhan A, Mahmoud ZT, Wainwright M, Khamis MM. Cutting bone with drills, burs, lasers and piezotomes: A comprehensive systematic review and recommendations for the clinician. ACTA ACUST UNITED AC 2017. [DOI: 10.17352/2455-4634.000028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Rajitha Gunaratne GD, Khan R, Fick D, Robertson B, Dahotre N, Ironside C. A review of the physiological and histological effects of laser osteotomy. J Med Eng Technol 2016; 41:1-12. [DOI: 10.1080/03091902.2016.1199743] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Tulea CA, Caron J, Gehlich N, Lenenbach A, Noll R, Loosen P. Laser cutting of bone tissue under bulk water with a pulsed ps-laser at 532 nm. JOURNAL OF BIOMEDICAL OPTICS 2015; 20:105007. [PMID: 26469563 DOI: 10.1117/1.jbo.20.10.105007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Accepted: 09/11/2015] [Indexed: 06/05/2023]
Abstract
Hard-tissue ablation was already investigated for a broad variety of pulsed laser systems, which cover almost the entire range of available wavelengths and pulse parameters. Most effective in hard-tissue ablation are Er:YAG and CO2 lasers, both utilizing the effect of absorption of infrared wavelengths by water and so-called explosive vaporization, when a thin water film or water–air spray is supplied. The typical flow rates and the water layer thicknesses are too low for surgical applications where bleeding occurs and wound flushing is necessary. We studied a 20 W ps-laser with 532 nm wavelength and a pulse energy of 1 mJ to effectively ablate bones that are submerged 14 mm under water. For these laser parameters, the plasma-mediated ablation mechanism is dominant. Simulations based on the blow-off model predict the cut depth and cross-sectional shape of the incision. The model is modified considering the cross section of the Gaussian beam, the incident angle, and reflections. The ablation rate amounts to 0.2 mm3/s, corresponding to an increase by at least 50% of the highest values published so far for ultrashort laser ablation of hard tissue.
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Affiliation(s)
| | - Jan Caron
- Fraunhofer Institute for Laser Technology ILT, Steinbachstraße 15, Aachen 52074, Germany
| | - Nils Gehlich
- Fraunhofer Institute for Laser Technology ILT, Steinbachstraße 15, Aachen 52074, Germany
| | - Achim Lenenbach
- Fraunhofer Institute for Laser Technology ILT, Steinbachstraße 15, Aachen 52074, Germany
| | - Reinhard Noll
- Fraunhofer Institute for Laser Technology ILT, Steinbachstraße 15, Aachen 52074, Germany
| | - Peter Loosen
- Fraunhofer Institute for Laser Technology ILT, Steinbachstraße 15, Aachen 52074, GermanybRWTH Aachen University, Chair for Technology of Optical Systems, Steinbachstraße 15, Aachen 52074, Germany
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9
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Smith JO, Tayton ER, Khan F, Aarvold A, Cook RB, Goodship A, Bradley M, Oreffo ROC. Large animal in vivo evaluation of a binary blend polymer scaffold for skeletal tissue-engineering strategies; translational issues. J Tissue Eng Regen Med 2015; 11:1065-1076. [PMID: 25690518 PMCID: PMC6680145 DOI: 10.1002/term.2007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 08/30/2014] [Accepted: 01/12/2015] [Indexed: 01/11/2023]
Abstract
Binary blend polymers offer the opportunity to combine different desirable properties into a single scaffold, to enhance function within the field of tissue engineering. Previous in vitro and murine in vivo analysis identified a polymer blend of poly(l‐lactic acid)–poly(ε‐caprolactone) (PLLA:PCL 20:80) to have characteristics desirable for bone regeneration. Polymer scaffolds in combination with marrow‐derived skeletal stem cells (SSCs) were implanted into mid‐shaft ovine 3.5 cm tibial defects, and indices of bone regeneration were compared to groups implanted with scaffolds alone and with empty defects after 12 weeks, including micro‐CT, mechanical testing and histological analysis. The critical nature of the defect was confirmed via all modalities. Both the scaffold and scaffold/SSC groups showed enhanced quantitative bone regeneration; however, this was only found to be significant in the scaffold/SSCs group (p = 0.04) and complete defect bridging was not achieved in any group. The mechanical strength was significantly less than that of contralateral control tibiae (p < 0.01) and would not be appropriate for full functional loading in a clinical setting. This study explored the hypothesis that cell therapy would enhance bone formation in a critical‐sized defect compared to scaffold alone, using an external fixation construct, to bridge the scale‐up gap between small animal studies and potential clinical translation. The model has proved a successful critical defect and analytical techniques have been found to be both valid and reproducible. Further work is required with both scaffold production techniques and cellular protocols in order to successfully scale‐up this stem cell/binary blend polymer scaffold. © 2015 The Authors. Journal of Tissue Engineering and Regenerative Medicine published by John Wiley & Sons, Ltd.
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Affiliation(s)
- James O Smith
- Bone and Joint Research Group, Centre for Human Development, Stem Cells and Regeneration, University of Southampton, UK
| | - Edward R Tayton
- Bone and Joint Research Group, Centre for Human Development, Stem Cells and Regeneration, University of Southampton, UK
| | - Ferdous Khan
- School of Chemistry, University of Edinburgh, UK
| | - Alexander Aarvold
- Bone and Joint Research Group, Centre for Human Development, Stem Cells and Regeneration, University of Southampton, UK
| | - Richard B Cook
- nCATS, Faculty of Engineering and the Environment, University of Southampton, UK
| | - Allen Goodship
- UCL Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Mark Bradley
- School of Chemistry, University of Edinburgh, UK
| | - Richard O C Oreffo
- Bone and Joint Research Group, Centre for Human Development, Stem Cells and Regeneration, University of Southampton, UK
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Davies B. Robotic Surgery – A Personal View of the Past, Present and Future. INT J ADV ROBOT SYST 2015. [DOI: 10.5772/60118] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Research into robotic surgery has been undertaken for over 25 years. In that period a small number of companies have been formed to exploit this research and have undertaken clinical trials on patients. However, far fewer clinical applications have been undertaken than would have been expected from the level of research activity. This paper puts forward a number of reasons for this, many of which are not to do with the technology but are a consequence of the clinical and business environments. Recommendations are provided that will hopefully increase the number of clinical systems being applied. Some predictions are made for the future which should increase the number of commercial systems and thus achieve patient benefits.
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Affiliation(s)
- Brian Davies
- Imperial College, London, UK
- Istituto Italiano di Tecnologia, Genova, Italy
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von Salis-Soglio M, Stübinger S, Sidler M, Klein K, Ferguson SJ, Kämpf K, Zlinszky K, Buchini S, Curno R, Péchy P, Aronsson BO, von Rechenberg B. A novel multi-phosphonate surface treatment of titanium dental implants: a study in sheep. J Funct Biomater 2014; 5:135-57. [PMID: 25215424 PMCID: PMC4192609 DOI: 10.3390/jfb5030135] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 08/20/2014] [Accepted: 09/02/2014] [Indexed: 01/18/2023] Open
Abstract
The aim of the present study was to evaluate a new multi-phosphonate surface treatment (SurfLink®) in an unloaded sheep model. Treated implants were compared to control implants in terms of bone to implant contact (BIC), bone formation, and biomechanical stability. The study used two types of implants (rough or machined surface finish) each with either the multi-phosphonate Wet or Dry treatment or no treatment (control) for a total of six groups. Animals were sacrificed after 2, 8, and 52 weeks. No adverse events were observed at any time point. At two weeks, removal torque showed significantly higher values for the multi-phosphonate treated rough surface (+32% and +29%, Dry and Wet, respectively) compared to rough control. At 52 weeks, a significantly higher removal torque was observed for the multi-phosphonate treated machined surfaces (+37% and 23%, Dry and Wet, respectively). The multi-phosphonate treated groups showed a positive tendency for higher BIC with time and increased new-old bone ratio at eight weeks. SEM images revealed greater amounts of organic materials on the multi-phosphonate treated compared to control implants, with the bone fracture (from the torque test) appearing within the bone rather than at the bone to implant interface as it occurred for control implants.
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Affiliation(s)
- Marcella von Salis-Soglio
- Musculoskeletal Research Unit, Equine Hospital, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zürich 8057, Switzerland.
| | - Stefan Stübinger
- Musculoskeletal Research Unit, Equine Hospital, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zürich 8057, Switzerland.
| | - Michéle Sidler
- Musculoskeletal Research Unit, Equine Hospital, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zürich 8057, Switzerland.
| | - Karina Klein
- Musculoskeletal Research Unit, Equine Hospital, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zürich 8057, Switzerland.
| | - Stephen J Ferguson
- Institute for Biomechanics, ETH Zürich, Vladimir-Prelog-Weg 1-5/10, Zürich 8093, Switzerland.
| | - Käthi Kämpf
- Musculoskeletal Research Unit, Equine Hospital, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zürich 8057, Switzerland.
| | - Katalin Zlinszky
- Musculoskeletal Research Unit, Equine Hospital, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zürich 8057, Switzerland.
| | - Sabrina Buchini
- Nano Bridging Molecules SA, Rte Cité Ouest 2, Gland 1196, Switzerland.
| | - Richard Curno
- Nano Bridging Molecules SA, Rte Cité Ouest 2, Gland 1196, Switzerland.
| | - Péter Péchy
- Nano Bridging Molecules SA, Rte Cité Ouest 2, Gland 1196, Switzerland.
| | | | - Brigitte von Rechenberg
- Musculoskeletal Research Unit, Equine Hospital, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zürich 8057, Switzerland.
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Gardel LS, Serra LA, Reis RL, Gomes ME. Use of perfusion bioreactors and large animal models for long bone tissue engineering. TISSUE ENGINEERING PART B-REVIEWS 2013; 20:126-46. [PMID: 23924374 DOI: 10.1089/ten.teb.2013.0010] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Tissue engineering and regenerative medicine (TERM) strategies for generation of new bone tissue includes the combined use of autologous or heterologous mesenchymal stem cells (MSC) and three-dimensional (3D) scaffold materials serving as structural support for the cells, that develop into tissue-like substitutes under appropriate in vitro culture conditions. This approach is very important due to the limitations and risks associated with autologous, as well as allogenic bone grafiting procedures currently used. However, the cultivation of osteoprogenitor cells in 3D scaffolds presents several challenges, such as the efficient transport of nutrient and oxygen and removal of waste products from the cells in the interior of the scaffold. In this context, perfusion bioreactor systems are key components for bone TERM, as many recent studies have shown that such systems can provide dynamic environments with enhanced diffusion of nutrients and therefore, perfusion can be used to generate grafts of clinically relevant sizes and shapes. Nevertheless, to determine whether a developed tissue-like substitute conforms to the requirements of biocompatibility, mechanical stability and safety, it must undergo rigorous testing both in vitro and in vivo. Results from in vitro studies can be difficult to extrapolate to the in vivo situation, and for this reason, the use of animal models is often an essential step in the testing of orthopedic implants before clinical use in humans. This review provides an overview of the concepts, advantages, and challenges associated with different types of perfusion bioreactor systems, particularly focusing on systems that may enable the generation of critical size tissue engineered constructs. Furthermore, this review discusses some of the most frequently used animal models, such as sheep and goats, to study the in vivo functionality of bone implant materials, in critical size defects.
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Affiliation(s)
- Leandro S Gardel
- 1 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho , Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Guimarães, Portugal
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Healing of osteotomy sites applying either piezosurgery or two conventional saw blades: a pilot study in rabbits. INTERNATIONAL ORTHOPAEDICS 2013; 37:1597-603. [PMID: 23793460 DOI: 10.1007/s00264-013-1908-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 04/21/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE The purpose of this study was to compare bone healing of experimental osteotomies applying either piezosurgery or two different oscillating saw blades in a rabbit model. METHODS The 16 rabbits were randomly assigned into four groups to comply with observation periods of one, two, three and five weeks. In all animals, four osteotomy lines were performed on the left and right nasal bone using a conventional saw blade, a novel saw blade and piezosurgery. RESULTS All three osteotomy techniques revealed an advanced gap healing starting after one week. The most pronounced new bone formation took place between two and three weeks, whereby piezoelectric surgery revealed a tendency to faster bone formation and remodelling. Yet, there were no significant differences between the three modalities. CONCLUSIONS The use of a novel as well as the piezoelectric bone-cutting instrument revealed advanced bone healing with a favourable surgical performance compared to a traditional saw.
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Plecko M, Lagerpusch N, Pegel B, Andermatt D, Frigg R, Koch R, Sidler M, Kronen P, Klein K, Nuss K, Gedet P, Bürki A, Ferguson SJ, Stoeckle U, Auer JA, von Rechenberg B. The influence of different osteosynthesis configurations with locking compression plates (LCP) on stability and fracture healing after an oblique 45° angle osteotomy. Injury 2012; 43:1041-51. [PMID: 22284334 DOI: 10.1016/j.injury.2011.12.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Revised: 12/08/2011] [Accepted: 12/17/2011] [Indexed: 02/02/2023]
Abstract
BACKGROUND Locking compression plates are used in various configurations with lack of detailed information on consequent bone healing. STUDY DESIGN In this in vivo study in sheep 5 different applications of locking compression plate (LCP) were tested using a 45° oblique osteotomy simulating simple fracture pattern. 60 Swiss Alpine sheep where assigned to 5 different groups with 12 sheep each (Group 1: interfragmentary lag screw and an LCP fixed with standard cortex screws as neutralisation plate; Group 2: interfragmentary lag screw and LCP with locking head screws; Group 3: compression plate technique (hybrid construct); Group 4: internal fixator without fracture gap; Group 5: internal fixator with 3mm gap at the osteotomy site). One half of each group (6 sheep) was monitored for 6 weeks, and the other half (6 sheep) where followed for 12 weeks. METHODS X-rays at 3, 6, 9 and 12 weeks were performed to monitor the healing process. After sacrifice operated tibiae were tested biomechanically for nondestructive torsion and compared to the tibia of the healthy opposite side. After testing specimens were processed for microradiography, histology, histomorphometry and assessment of calcium deposition by fluorescence microscopy. RESULTS In all groups bone healing occurred without complications. Stiffness in biomechanical testing showed a tendency for higher values in G2 but results were not statistically significant. Values for G5 were significantly lower after 6 weeks, but after 12 weeks values had improved to comparable results. For all groups, except G3, stiffness values improved between 6 and 12 weeks. Histomorphometrical data demonstrate endosteal callus to be more marked in G2 at 6 weeks. DISCUSSION AND CONCLUSION All five configurations resulted in undisturbed bone healing and are considered safe for clinical application.
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Vescovi P, Romeo U, Merigo E, Del Vecchio A, Palaia G, Meleti M, Nammour S. L’impiego del laser nelle patologie delle ossa mascellari. DENTAL CADMOS 2011. [DOI: 10.1016/j.cadmos.2010.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Stübinger S, Biermeier K, Bächi B, Ferguson SJ, Sader R, von Rechenberg B. Comparison of Er:YAG laser, piezoelectric, and drill osteotomy for dental implant site preparation: A biomechanical and histological analysis in sheep. Lasers Surg Med 2010; 42:652-61. [DOI: 10.1002/lsm.20944] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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