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Rodriguez Betancourt A, Kripfgans OD, Meneghetti PC, Mendonça G, Pereira R, Teixeira W, Zambrana N, Samal A, Chan HL. Intraoral ultrasonography image registration for evaluation of partial edentulous ridge: A methodology and validation study. J Dent 2024; 148:105136. [PMID: 38885734 DOI: 10.1016/j.jdent.2024.105136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 06/11/2024] [Accepted: 06/14/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVES Ultrasound (US) reveals details for diagnosing soft- and hard-tissue dimensions around teeth, implants, and the edentulous ridge, not seen in 2D radiographs. Co-registering free-hand US scans with other 3D modalities presents reliability challenges. This study first aims to develop and validate a registration method to longitudinally reproduce US images of the jawbone on a simulator. In addition, it also evaluates the degree of the anatomical match in humans between US images acquired by the proposed registration method and the commonly used freehand acquisitions in comparison to cone beam computed tomography (CBCT) and intra-oral optical scan (IOS), used as references. METHODS A previously introduced ultrasound phantom was employed as a CBCT-US hybrid, suitable for training and technique development of US guides in edentulous ridges. After establishing feasibility in the phantom, the methodology was validated in a cohort of 24 human subjects (26 cases). Soft tissues were delineated on US and IOS, and hard tissues on US and CBCT. US accuracy and repeatability from both guided and freehand scans (non-guided) was assessed as the average distance between US and the references. RESULTS Guided US images resembled the references more closely than freehand (non-guided) scans. Notably, delineation of soft and hard tissues was significantly more accurate when employing guides. In the phantom, guided scans exhibited an absolute mean deviation of 81.8 µm for gingiva and 90.4 µm for bone, whereas non-guided scans showed deviations of 150.4 µm and 177.2 µm, respectively. Similarly, in vivo, guided US outperformed non-guided US, with gingiva deviations of 125 µm and 196 µm, and bone deviations of 354 µm and 554 µm, respectively. CONCLUSIONS By using a registration method, guided US scans improved repeatability and accuracy of mapping hard and soft tissue of the edentulous ridge when compared to non-guided scans. CLINICAL RELEVANCE This guided US imaging method could lay the foundation for longitudinal evaluation of tissue behavior and dimensional changes with improved accuracy.
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Affiliation(s)
- Amanda Rodriguez Betancourt
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA; Department of Periodontics, University of Illinois Chicago, College of Dentistry, Chicago, IL, USA
| | - Oliver D Kripfgans
- Department of Radiology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Priscila Ceolin Meneghetti
- Department of Restorative Sciences, University of Alabama School of Dentistry, Birmingham, AL, USA; Department of Biologic and Material Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Gustavo Mendonça
- Department of Biologic and Material Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA; Department of General Practice, School of Dentistry, Virginia Commonwealth University, Richmond, VA, USA
| | - Rafael Pereira
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Wendel Teixeira
- Department of Biologic and Material Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Nataly Zambrana
- Department of Biologic and Material Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Ankita Samal
- Department of Radiology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA; Department of Periodontics, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA; Division of Periodontology, the Ohio State University, College of Dentistry, Columbus, OH, USA.
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Rodriguez AB, Alhachache S, Velasquez D, Chan HL. A systematic review of oral wound healing indices. PLoS One 2024; 19:e0290050. [PMID: 38330054 PMCID: PMC10852230 DOI: 10.1371/journal.pone.0290050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 07/31/2023] [Indexed: 02/10/2024] Open
Abstract
Wound healing monitoring for abnormality identification and intervention is crucial to securing a successful surgical outcome. Indices have been used to summarize the degree of healing. Given the increasing frequency of regenerative procedures which preserve dentition and implant stability, and the higher esthetic demands, an appraisal of the available indices is needed to identify the current knowledge gap. This study aimed to systematically review published oral wound healing indices and scores. MATERIALS AND METHODS A complete literature electronic search in 5 databases was conducted by two reviewers. A combination of keywords related to oral wound healing was used. RESULTS A total of 11 articles were included in the evaluation of various procedures (conventional periodontal procedures, guided tissue regeneration, soft tissue reconstruction procedures, and tooth extractions), at different time points (1 day to 12 weeks), with a focus on diverse clinical signs and symptoms. Frequently evaluated parameters included wound dehiscence/epithelialization (91%), tissue color (redness) (73%), suppuration (55%), swelling/edema (55%), and hemostasis (55%). Other less commonly used parameters include esthetics-related and patient-centered outcomes. CONCLUSION The available indices evaluate a diverse group of subjective clinical signs and symptoms to estimate the underlying biological healing events and assess the degree of clinical success. The majority of the included indices are not validated. Quantitative and objective subclinical parameters including blood perfusion, biomaterial stability, and completeness of epithelialization, are needed for customized wound healing care and better outcome prediction.
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Affiliation(s)
- Amanda Beatriz Rodriguez
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Sara Alhachache
- Department of Periodontics, University of Louisville School of Dentistry, Louisville, Kentucky, United States of America
| | - Diego Velasquez
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
- Private Practice, Fenton, Michigan, United States of America
| | - Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
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Kim HM, Jin BR, Lee JS, Jo EH, Park MC, An HJ. Anti-atopic dermatitis effect of fish collagen on house dust mite-induced mice and HaCaT keratinocytes. Sci Rep 2023; 13:14888. [PMID: 37689763 PMCID: PMC10492863 DOI: 10.1038/s41598-023-41831-w] [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: 04/07/2023] [Accepted: 08/31/2023] [Indexed: 09/11/2023] Open
Abstract
Collagen, a major structural protein in mammalian tissues, is effective against skin wounds and osteoarthritis. Although bovine and porcine collagens have mainly been used, several potential risks of mammalian collagen have led to the use of fish collagen (FC) as an alternative. FC and its peptides are used as common cosmeceutical products because of their antihypertensive, anti-bacterial, and antioxidant activities. Despite the effects of FC on wrinkle reduction, UV-protection, and wound healing, the relationship between FC and atopic dermatitis (AD) has not yet been reported. Therefore, we investigated the anti-AD effects of FC against house dust mite (Dermatophagoides farinae, HDM)-induced AD in NC/Nga mice and TNF-α/IFN-γ-stimulated HaCaT keratinocytes. FC alleviated AD apparent symptoms, such as dermatitis score, transepidermal water loss, epidermal thickness, and mast cell infiltration upon declining pro-inflammatory cytokines and mediators, IL-6, IL-5, IL-13, TSLP, and TNF-α. The skin barrier protein, filaggrin, was also recovered by FC administration in vivo and in vitro. Immune response and skin barrier dysfunction are both mitigated by three routes of FC administration: oral, topical, and both routes via the regulation of IκB, MAPKs, and STATs pathways. In summary, FC could be a potential therapeutic agent for AD by regulating immune balance and skin barrier function.
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Affiliation(s)
- Hye-Min Kim
- Department of Herbology, College of Korean Medicine, Sangji University, Wonju, Gangwon-do, 26339, Republic of Korea
- Department of Oriental Pharmaceutical Science, College of Pharmacy, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Bo-Ram Jin
- Department of Oriental Pharmaceutical Science, College of Pharmacy, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Jin-Sil Lee
- R&D Institute, Haewon Biotech, Inc., Bucheon, Gyeonggi-do, Republic of Korea
| | - Eun Heui Jo
- Department of Acupuncture and Moxibustion, Wonkwang University Korean Medicine Hospital and Research Center of Traditional Korean Medicine, Wonkwang University, Deokjin-gu, Jeonju, Jeollabuk-do, Republic of Korea
| | - Min Cheol Park
- Department of Korean Medicine Ophthalmology and Otolaryngology and Dermatology, Wonkwang University Korean Medicine Hospital and Research Center of Traditional Korean Medicine, Wonkwang University, 460 Iksan-daero, Iksan, Jeollabuk-do, 54538, Republic of Korea.
| | - Hyo-Jin An
- Department of Oriental Pharmaceutical Science, College of Pharmacy, Kyung Hee University, Seoul, 02447, Republic of Korea.
- Department of Integrated Drug Development and Natural Products, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea.
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Kumar P, Dhara S, Gope A, Chatterjee J, Mandal S. Deep Learning based Skin-layer Segmentation for Characterizing Cutaneous Wounds from Optical Coherence Tomography Images. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-4. [PMID: 38083666 DOI: 10.1109/embc40787.2023.10340321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Optical coherence tomography (OCT) is a medical imaging modality that allows us to probe deeper sub-structures of skin. The state-of-the-art wound care prediction and monitoring methods are based on visual evaluation and focus on surface information. However, research studies have shown that sub-surface information of the wound is critical for understanding the wound healing progression. This work demonstrated the use of OCT as an effective imaging tool for objective and non-invasive assessments of wound severity, the potential for healing, and healing progress by measuring the optical characteristics of skin components. We have demonstrated the efficacy of OCT in studying wound healing progress in vivo small animal models. Automated analysis of OCT datasets poses multiple challenges, such as limitations in the training dataset size, variation in data distribution induced by uncertainties in sample quality and experiment conditions. We have employed a U-Net-based model for segmentation of skin layers based on OCT images and to study epithelial and regenerated tissue thickness wound closure dynamics and thus quantify the progression of wound healing. In the experimental evaluation of the OCT skin image datasets, we achieved the objective of skin layer segmentation with an average intersection over union (IOU) of 0.9234. The results have been corroborated using gold-standard histology images and co-validated using inputs from pathologists.Clinical Relevance-To monitor wound healing progression without disrupting the healing procedure by superficial, non-invasive means via the identification of pixel characteristics of individual layers.
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Anisuzzaman DM, Wang C, Rostami B, Gopalakrishnan S, Niezgoda J, Yu Z. Image-Based Artificial Intelligence in Wound Assessment: A Systematic Review. Adv Wound Care (New Rochelle) 2022; 11:687-709. [PMID: 34544270 DOI: 10.1089/wound.2021.0091] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Significance: Accurately predicting wound healing trajectories is difficult for wound care clinicians due to the complex and dynamic processes involved in wound healing. Wound care teams capture images of wounds during clinical visits generating big datasets over time. Developing novel artificial intelligence (AI) systems can help clinicians diagnose, assess the effectiveness of therapy, and predict healing outcomes. Recent Advances: Rapid developments in computer processing have enabled the development of AI-based systems that can improve the diagnosis and effectiveness of therapy in various clinical specializations. In the past decade, we have witnessed AI revolutionizing all types of medical imaging like X-ray, ultrasound, computed tomography, magnetic resonance imaging, etc., but AI-based systems remain to be developed clinically and computationally for high-quality wound care that can result in better patient outcomes. Critical Issues: In the current standard of care, collecting wound images on every clinical visit, interpreting and archiving the data are cumbersome and time consuming. Commercial platforms are developed to capture images, perform wound measurements, and provide clinicians with a workflow for diagnosis, but AI-based systems are still in their infancy. This systematic review summarizes the breadth and depth of the most recent and relevant work in intelligent image-based data analysis and system developments for wound assessment. Future Directions: With increasing availabilities of massive data (wound images, wound-specific electronic health records, etc.) as well as powerful computing resources, AI-based digital platforms will play a significant role in delivering data-driven care to people suffering from debilitating chronic wounds.
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Affiliation(s)
- D M Anisuzzaman
- Department of Computer Science, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Chuanbo Wang
- Department of Computer Science, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Behrouz Rostami
- Department of Electrical Engineering, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | | | | | - Zeyun Yu
- Department of Computer Science, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
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Hassani H, Komendantova N, Unger S, Ghodsi F. The Use of Big Data via 5G to Alleviate Symptoms of Acute Stress Disorder Caused by Quarantine Measures. Front Psychol 2022; 12:569024. [PMID: 35283805 PMCID: PMC8905680 DOI: 10.3389/fpsyg.2021.569024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 11/22/2021] [Indexed: 01/23/2023] Open
Abstract
This article investigates the role of Big Data in situations of psychological stress such as during the recent pandemic caused by the COVID-19 health crisis. Quarantine measures, which are necessary to mitigate pandemic risk, are causing severe stress symptoms to the human body including mental health. We highlight the most common impact factors and the uncertainty connected with COVID-19, quarantine measures, and the role of Big Data, namely, how Big Data can help alleviate or mitigate these effects by comparing the status quo of current technology capabilities with the potential effects of an increase of digitalization on mental health. We find that, while Big Data helps in the pre-assessment of potentially endangered persons, it also proves to be an efficient tool in alleviating the negative psychological effects of quarantine. We find evidence of the positive effects of Big Data on human health conditions by assessing the effect of internet use on mental health in 173 countries. We found positive effects in 110 countries with 90 significant results. However, increased use of digital media and exclusive exposure to digital connectivity causes negative long-term effects such as a decline in social empathy, which creates a form of psychological isolation, causing symptoms of acute stress disorder.
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Affiliation(s)
- Hossein Hassani
- Research Institute for Energy Management and Planning, University of Tehran, Tehran, Iran
| | - Nadejda Komendantova
- Advancing Systems Analysis Program, International Institute for Applied Systems Analysis (IIASA), Laxenburg, Austria
| | - Stephan Unger
- Department of Economics & Business, Saint Anselm College, Manchester, NH, United States
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Mancini JCMA, Garcia MRT, de Oliveira IRS, de Freitas RR, Luz JGC. Analysis of the blood supply to the post-fracture edentulous mandible: study by colour Doppler sonography. Oral Maxillofac Surg 2016; 20:417-424. [PMID: 27695992 DOI: 10.1007/s10006-016-0583-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 09/19/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE This study assessed the arterial blood supply to the mandible of edentulous patients treated for mandibular fractures using colour Doppler ultrasound. METHODS The blood supply of edentulous patients surgically treated for mandibular fractures (group A) and edentulous fracture-free individuals (group B) was assessed. Only the fractured sides were evaluated in the first group (N = 17), whereas each side was evaluated in the second group (N = 20). The arterial flow of six sites was assessed. The systolic-peak maximum velocity (SPV), final diastolic velocity (FDV), resistive index (RI), pulsatility index (PI), acceleration and flow direction of each artery were obtained. Additionally, the presence of local vascular obstructive factors was evaluated. The differences between groups were analysed using the Kruskal-Wallis test, which was complemented by the Mann-Whitney test, for correlations between the degree of alveolar atrophy and the study factors (p < 0.050). RESULTS There was a significant decrease in the flow of certain arteries, especially the submental (SPV, p = 0.007, PI, p = 0.022, and acceleration, p = 0.015), in the fracture group. The facial artery in both groups showed lower values related to local obstructive factors (SPV, p = 0.001, FDV, p = 0.040, and PI, p = 0.030). The submental artery flow was higher (SPV, p = 0.006, and FDV, p = 0.009) in non-atrophic individuals. CONCLUSIONS There was a decreased flow mainly in the submental artery, but there were no cases of major vascular injury in edentulous patients treated for mandibular fractures.
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Affiliation(s)
- Júlio Cezar M A Mancini
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo-USP, Brazil, Av. Prof. Lineu Prestes, 2227-Cidade Universitária, 02036-021, São Paulo, SP, Brazil
| | | | | | | | - João Gualberto C Luz
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo-USP, Brazil, Av. Prof. Lineu Prestes, 2227-Cidade Universitária, 02036-021, São Paulo, SP, Brazil.
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DeBarros M, Causey MW, Chesley P, Martin M. Reliability of Continuous Non-Invasive Assessment of Hemoglobin and Fluid Responsiveness: Impact of Obesity and Abdominal Insufflation Pressures. Obes Surg 2016; 25:1142-8. [PMID: 25399349 DOI: 10.1007/s11695-014-1505-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND During surgery, proper fluid resuscitation and hemostatic control is critical. Pleth variability index (PVI) is advocated as a reliable way of optimizing intraoperative fluid resuscitation. PVI is a measure of dynamic change in perfusion index during a complete respiratory cycle. Non-invasive monitoring of total hemoglobin could provide a reliable means to determine need for transfusion. We analyzed the impact of insufflation and obesity on non-invasive measurements of hemoglobin and PVI in laparoscopic procedures to validate reliability of fluid responsiveness and hemoglobin levels. METHODS A non-invasive hemoglobin and PVI monitoring device was prospectively analyzed in patients undergoing abdominal operations. Patients were stratified by open and laparoscopic approach and obesity (body mass index (BMI) ≥35). PVI and hemoglobin values were assessed before, during, and after insufflation and compared to control patients undergoing open surgery. RESULTS Sixty-three patients were enrolled (mean age 42 years; 71 % male; mean BMI 36) with 24 patients laparoscopic non-obese (LNO), 20 laparoscopic obese (LO), and 19 undergoing open operations. There was no significant blood loss. Hemoglobin did not change significantly before or after insufflation. There was false elevation of PVI with insufflation and more pronounced in obese patients. CONCLUSIONS Insufflation or obesity was not associated with significant variations in hemoglobin. Non-invasive monitoring of hemoglobin is useful in laparoscopic procedures in obese and non-obese patients. PVI values should be used cautiously during laparoscopic procedures, particularly in obese patients.
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Affiliation(s)
- Mia DeBarros
- Department of Surgery, Madigan Army Medical Center, 9040a Fitzsimmons Drive, Tacoma, WA, 98431, USA,
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Belle A, Thiagarajan R, Soroushmehr SMR, Navidi F, Beard DA, Najarian K. Big Data Analytics in Healthcare. BIOMED RESEARCH INTERNATIONAL 2015; 2015:370194. [PMID: 26229957 PMCID: PMC4503556 DOI: 10.1155/2015/370194] [Citation(s) in RCA: 119] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 05/26/2015] [Accepted: 06/16/2015] [Indexed: 02/06/2023]
Abstract
The rapidly expanding field of big data analytics has started to play a pivotal role in the evolution of healthcare practices and research. It has provided tools to accumulate, manage, analyze, and assimilate large volumes of disparate, structured, and unstructured data produced by current healthcare systems. Big data analytics has been recently applied towards aiding the process of care delivery and disease exploration. However, the adoption rate and research development in this space is still hindered by some fundamental problems inherent within the big data paradigm. In this paper, we discuss some of these major challenges with a focus on three upcoming and promising areas of medical research: image, signal, and genomics based analytics. Recent research which targets utilization of large volumes of medical data while combining multimodal data from disparate sources is discussed. Potential areas of research within this field which have the ability to provide meaningful impact on healthcare delivery are also examined.
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Affiliation(s)
- Ashwin Belle
- Emergency Medicine Department, University of Michigan, Ann Arbor, MI 48109, USA
- University of Michigan Center for Integrative Research in Critical Care (MCIRCC), Ann Arbor, MI 48109, USA
| | - Raghuram Thiagarajan
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI 48109, USA
| | - S. M. Reza Soroushmehr
- Emergency Medicine Department, University of Michigan, Ann Arbor, MI 48109, USA
- University of Michigan Center for Integrative Research in Critical Care (MCIRCC), Ann Arbor, MI 48109, USA
| | - Fatemeh Navidi
- Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, MI 48109, USA
| | - Daniel A. Beard
- University of Michigan Center for Integrative Research in Critical Care (MCIRCC), Ann Arbor, MI 48109, USA
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Kayvan Najarian
- Emergency Medicine Department, University of Michigan, Ann Arbor, MI 48109, USA
- University of Michigan Center for Integrative Research in Critical Care (MCIRCC), Ann Arbor, MI 48109, USA
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Body composition using bioelectrical impedance analysis in elite young soccer players: the effects of age and playing position. SPORT SCIENCES FOR HEALTH 2015. [DOI: 10.1007/s11332-015-0226-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ye D, Peramo A. Implementing tissue engineering and regenerative medicine solutions in medical implants. Br Med Bull 2014; 109:3-18. [PMID: 24357734 DOI: 10.1093/bmb/ldt036] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Surgical implants are widely used in the medical field but their long-term performance is limited due to failure of integration with tissues. This manuscript describes very well-known problems associated with implants and discusses novel solutions used in tissue engineering and regenerative medicine that can be implemented in this uncommonly discussed medical area. SOURCES OF DATA General and medical literature describing modifications of medical and surgical implants, biofunctionalization, tissue engineering and regenerative medicine. AREAS OF AGREEMENT Procedures for surgical implantation have grown substantially in the last few decades and provided improved quality of life for patients, regardless of area of implantation and device type and purpose. AREAS OF CONTROVERSY In general, implants fail because of lack of long-term integration with the surrounding tissues. Implant manufacturers have not addressed implant failure from the point of view of biointegration. In addition, some medical practitioners are inclined to treat implant failure by using anti-infection methods to prevent bacterial adhesion. However, both approaches are conceptually limited, as discussed in this manuscript. GROWING POINTS Implantation in the future will not be limited to medically needed procedures but also to a growing number of cosmetic body transformation procedures, which may include perceived 'improved implant functions' over natural tissues or organs. An additional trend is that implant procedures are being progressively performed in younger individuals. AREAS TIMELY FOR DEVELOPING RESEARCH Current implants generally do not allow the physician to have controlled long-term access to internal tissues in contact with the implants, for example to release specific compounds when medically needed to the problem area.
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Affiliation(s)
- Dongxia Ye
- Shanghai Ninth People's Hospital Affiliated to Medical School of Shanghai Jiaotong University, Shanghai, China
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