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Ivanovski S, Breik O, Carluccio D, Alayan J, Staples R, Vaquette C. 3D printing for bone regeneration: challenges and opportunities for achieving predictability. Periodontol 2000 2023; 93:358-384. [PMID: 37823472 DOI: 10.1111/prd.12525] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 07/18/2023] [Accepted: 08/26/2023] [Indexed: 10/13/2023]
Abstract
3D printing offers attractive opportunities for large-volume bone regeneration in the oro-dental and craniofacial regions. This is enabled by the development of CAD-CAM technologies that support the design and manufacturing of anatomically accurate meshes and scaffolds. This review describes the main 3D-printing technologies utilized for the fabrication of these patient-matched devices, and reports on their pre-clinical and clinical performance including the occurrence of complications for vertical bone augmentation and craniofacial applications. Furthermore, the regulatory pathway for approval of these devices is discussed, highlighting the main hurdles and obstacles. Finally, the review elaborates on a variety of strategies for increasing bone regeneration capacity and explores the future of 4D bioprinting and biodegradable metal 3D printing.
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Affiliation(s)
- Saso Ivanovski
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Queensland, Herston, Australia
| | - Omar Breik
- Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, Queensland, Australia
| | - Danilo Carluccio
- Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, Queensland, Australia
| | - Jamil Alayan
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Queensland, Herston, Australia
| | - Ruben Staples
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Queensland, Herston, Australia
| | - Cedryck Vaquette
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Queensland, Herston, Australia
- Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, Queensland, Australia
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Dai M, Xu K, Xiao D, Zheng Y, Zheng Q, Shen J, Qian Y, Chen W. In Situ Forming Hydrogel as a Tracer and Degradable Lacrimal Plug for Dry Eye Treatment. Adv Healthc Mater 2022; 11:e2200678. [PMID: 35841368 DOI: 10.1002/adhm.202200678] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 06/10/2022] [Indexed: 01/27/2023]
Abstract
Lacrimal plug is an effective and widely therapeutic strategy to treat dry eye. However, almost all commercialized plugs are fixed in a certain design and associated with many complications, such as spontaneous plug extrusion, epiphora, and granuloma and cannot be traced in the long-term. Herein, a simple in situ forming hydrogel is developed as a tracer and degradable lacrimal plug to achieve the best match with the irregular lacrimal passages. In this strategy, methacrylate-modified silk fibroin (SFMA) is served as a network, and a self-assembled indocyanine green fluorescence tracer nanoparticle (FTN) is embedded as an indicator to develop the hydrogel plug using visible photo-crosslinking. This SFMA/FTN hydrogel plug has excellent biocompatibility and biodegradability, which can be noninvasively monitored by near-infrared light. In vivo tests based on dry eye rabbits show that the SFMA/FTN hydrogel plug can completely block the lacrimal passages and greatly improve the various clinical indicators of dry eye. These results demonstrate that the SFMA/FTN hydrogel is suitable as an injectable and degradable lacrimal plug with a long-term tracking function. The work offers a new approach to the development of absorbable plugs for the treatment of dry eye.
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Affiliation(s)
- Mali Dai
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, 325001, China
| | - Kejia Xu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, 325001, China
| | - Decheng Xiao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, 325001, China
| | - Yujing Zheng
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, 325001, China
| | - Qinxiang Zheng
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, 325001, China
| | - Jianliang Shen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, 325001, China.,Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, Zhejiang, 325001, China
| | - Yuna Qian
- Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, Zhejiang, 325001, China
| | - Wei Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, 325001, China
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Prospective Evaluation of Two Wall Orbital Fractures Involving the Medial Orbital Wall: PSI Reconstruction versus PDS Repair—Worth the Effort? J Pers Med 2022; 12:jpm12091389. [PMID: 36143174 PMCID: PMC9500717 DOI: 10.3390/jpm12091389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 08/23/2022] [Accepted: 08/25/2022] [Indexed: 11/18/2022] Open
Abstract
Proper treatment of the two-wall fractured orbit is still controversial. Specifically, there is no consensus on the issue of the necessity of medial orbital wall repair. With anatomically critical structures at risk during the surgical approach, surgeons’ view on the necessity of medial orbital wall repair often is restricted and an aesthetically disturbing enophthalmos is more likely to be accepted. Therefore, treatment options range from leaving the medial wall without repair to reconstruction with autogenous tissue or alloplastic materials, which can lead to moderate to severe side effects. However, emerging technologies such as patient-specific implants (PSI) offer a reliable and anatomically correct reconstruction of the bony orbit. This study aimed to evaluate the outcome of full orbital reconstruction using PSIs compared to only orbital floor repair using PDS (bioresorbable polydioxanone) foils leaving the medial orbital wall untouched in traumatic two-wall orbital fractures. Of all patients treated at the University Hospital of Düsseldorf between 2017 and 2019 who suffered from traumatic orbital fracture, only patients with a two-wall orbital fracture involving both the orbital floor and the medial wall (n = 68) were included. Patients were treated either with a PSI (n = 35) or a PDS foil (n = 33). Primary outcome parameters were ophthalmological disturbances analyzed via clinical investigation and intra-orbital angles, volumes and implant position analyzed with radiological 3D-datasets. While a two-wall reconstruction using PSIs led to a significant improvement of the enophthalmos, the rate of postoperative enophthalmos was significantly increased in cases of only orbital floor repair with PDS foils. Radiologically, a significant reconstruction of the three-dimensional bony orbit succeeded with the simple use of PSIs leading to a significant reduction in the traumatically enlarged orbital volume. PSI also led to a significant reduction in the traumatically enlarged medial angle of the orbit. This was not the case for single-floor repair with PDS foil. The results of this study suggest that complex orbital fractures can be reconstructed at an even higher degree of accuracy with selective laser-melted PSIs than PDS foils. In order to achieve a true to original reconstruction of the bony orbit, surgical treatment of the medial orbital wall can be advocated for in the long term depending on the indication.
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Zeden JP, Baldauf J, Schroeder HWS. Repair of the sellar floor using bioresorbable polydioxanone foils after endoscopic endonasal pituitary surgery. Neurosurg Focus 2021; 48:E16. [PMID: 32480371 DOI: 10.3171/2020.3.focus2064] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 03/03/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Postoperative CSF leakage is the most common unwanted sequela of transnasal pituitary surgery. The individual anatomy, the extent of the sellar opening, and the occurrence of an intraoperative CSF leak add to the risk of postoperative rhinorrhea. Despite the current sophistication and recent developments in pituitary surgery, watertight closure of the sellar floor remains a matter of concern. Improvements and additions to the technical armamentarium of sellar reconstruction are therefore still desirable. METHODS The authors present a closure technique of the sellar floor using a bioresorbable polydioxanone foil, which is placed between the dura and the bony margins of the open sellar floor to keep the intrasellar implants in place and to withstand the pressure arising from the intracranial compartment. RESULTS The technique was used in a technical case series of 30 patients, and in all patients the floor could be sufficiently reconstructed. CSF flow intraoperatively was documented in 10 cases (33.3%). Postoperative CSF rhinorrhea was detected in one patient (3.3%). No complications could be attributed to the technique or the material during a mean follow-up period of 477 days. The foils can easily be identified on MR images and CT scans and therefore do not affect the postoperative radiological assessment. CONCLUSIONS The described technique is an easy, inexpensive, and reliable method for sellar floor reconstruction and has a low CSF leakage rate. It is recommended when the risk of a postoperative CSF leak is high and there is still enough bony margin of the sellar floor left that enables a sufficient fixation of the foil.
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Saska S, Pilatti L, Silva ESDS, Nagasawa MA, Câmara D, Lizier N, Finger E, Dyszkiewicz Konwińska M, Kempisty B, Tunchel S, Blay A, Shibli JA. Polydioxanone-Based Membranes for Bone Regeneration. Polymers (Basel) 2021; 13:polym13111685. [PMID: 34064251 PMCID: PMC8196877 DOI: 10.3390/polym13111685] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/15/2021] [Accepted: 05/17/2021] [Indexed: 01/14/2023] Open
Abstract
Resorbable synthetic and natural polymer-based membranes have been extensively studied for guided tissue regeneration. Alloplastic biomaterials are often used for tissue regeneration due to their lower immunoreactivity when compared with allogeneic and xenogeneic materials. Plenum® Guide is a synthetic membrane material based on polydioxanone (PDO), whose surface morphology closely mimics the extracellular matrix. In this study, Plenum® Guide was compared with collagen membranes as a barrier material for bone-tissue regeneration in terms of acute and subchronic systemic toxicity. Moreover, characterizations such as morphology, thermal analysis (Tm = 107.35 °C and crystallinity degree = 52.86 ± 2.97 %, final product), swelling (thickness: 0.25 mm ≅ 436% and 0.5 mm ≅ 425% within 24 h), and mechanical tests (E = 30.1 ± 6.25 MPa; σ = 3.92 ± 0.28 MPa; ε = 287.96 ± 34.68%, final product) were performed. The in vivo results revealed that the PDO membranes induced a slightly higher quantity of newly formed bone tissue than the control group (score: treated group = 15, control group = 13) without detectable systemic toxicity (clinical signs and evaluation of the membranes after necropsy did not result in differences between groups, i.e., non-reaction -> tissue-reaction index = 1.3), showing that these synthetic membranes have the essential characteristics for an effective tissue regeneration. Human adipose-derived stem cells (hASCs) were seeded on PDO membranes; results demonstrated efficient cell migration, adhesion, spread, and proliferation, such that there was a slightly better hASC osteogenic differentiation on PDO than on collagen membranes. Hence, Plenum® Guide membranes are a safe and efficient alternative for resorbable membranes for tissue regeneration.
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Affiliation(s)
- Sybele Saska
- M3 Health Ind. Com. de Prod. Med. Odont. e Correlatos S.A., 640 Ain Ata, Jundiaí 13212-213, Brazil; (L.P.); (E.S.d.S.S.); (M.A.N.); (S.T.); (A.B.)
- Correspondence: (S.S.); (J.A.S.); Tel.: +55-11-3109-9045 (J.A.S.)
| | - Livia Pilatti
- M3 Health Ind. Com. de Prod. Med. Odont. e Correlatos S.A., 640 Ain Ata, Jundiaí 13212-213, Brazil; (L.P.); (E.S.d.S.S.); (M.A.N.); (S.T.); (A.B.)
| | - Edvaldo Santos de Sousa Silva
- M3 Health Ind. Com. de Prod. Med. Odont. e Correlatos S.A., 640 Ain Ata, Jundiaí 13212-213, Brazil; (L.P.); (E.S.d.S.S.); (M.A.N.); (S.T.); (A.B.)
| | - Magda Aline Nagasawa
- M3 Health Ind. Com. de Prod. Med. Odont. e Correlatos S.A., 640 Ain Ata, Jundiaí 13212-213, Brazil; (L.P.); (E.S.d.S.S.); (M.A.N.); (S.T.); (A.B.)
- Department of Periodontology and Oral Implantology, Dental Research Division, University of Guarulhos, Guarulhos 07023-070, Brazil
| | - Diana Câmara
- Nicell—Pesquisa e Desenvolvimento Ltd.a, 2721 Av. Indianápolis, São Paulo 04063-005, Brazil;
| | - Nelson Lizier
- CCB—Centro de Criogenia Brasil, 1861 Av. Indianápolis, São Paulo 04063-003, Brazil;
| | - Eduardo Finger
- Hospital Israelita Albert Einstein, 627 Av. Albert Einstein, São Paulo 05652-900, Brazil;
| | | | - Bartosz Kempisty
- Department of Histology and Embryology, Poznań University of Medical Sciences, 60-781 Poznan, Poland;
- Department of Veterinary Surgery, Institute of Veterinary Medicine, Nicolaus Copernicus University in Toruń, 87-100 Torun, Poland
- Prestage Department of Poultry Science, North Carolina State University, Raleigh, NC 27695-7608, USA
| | - Samy Tunchel
- M3 Health Ind. Com. de Prod. Med. Odont. e Correlatos S.A., 640 Ain Ata, Jundiaí 13212-213, Brazil; (L.P.); (E.S.d.S.S.); (M.A.N.); (S.T.); (A.B.)
| | - Alberto Blay
- M3 Health Ind. Com. de Prod. Med. Odont. e Correlatos S.A., 640 Ain Ata, Jundiaí 13212-213, Brazil; (L.P.); (E.S.d.S.S.); (M.A.N.); (S.T.); (A.B.)
| | - Jamil Awad Shibli
- M3 Health Ind. Com. de Prod. Med. Odont. e Correlatos S.A., 640 Ain Ata, Jundiaí 13212-213, Brazil; (L.P.); (E.S.d.S.S.); (M.A.N.); (S.T.); (A.B.)
- Department of Periodontology and Oral Implantology, Dental Research Division, University of Guarulhos, Guarulhos 07023-070, Brazil
- Correspondence: (S.S.); (J.A.S.); Tel.: +55-11-3109-9045 (J.A.S.)
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Bourry M, Hardouin JB, Fauvel F, Corre P, Lebranchu P, Bertin H. Clinical evaluation of the efficacy of materials used for primary reconstruction of orbital floor defects: Meta-analysis. Head Neck 2020; 43:679-690. [PMID: 33145908 DOI: 10.1002/hed.26518] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/12/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The aim of this network meta-analysis (NMA) was to compare the clinical results obtained after primary reconstruction of orbital floor fractures (OFF) using different materials. METHODS PubMed, Cochrane, and Google Scholar databases were screened from 1989 to 2019. For a study to be eligible, it had to evaluate two or more materials and report the following clinical parameters: diplopia and/or enophthalmos and/or other complications. RESULTS Nine studies involving 946 patients presenting with an OFF were included. After the surgical procedure, 105 patients (11%) had diplopia, while 43 patients (4.5%) suffered from enophthalmos. The NMA revealed that less postoperative diplopia and enophthalmos were obtained either by using polydioxanone (PDS), or a polymer of l-lactic acid and dl-lactic acid (P[L/DL]LA), or porous polyethylene, or titanium mesh compared with the use of autologous bone grafts. CONCLUSION P(L/DL)LA and PDS seem to be the best options for small and intermediate defects, whereas the association of porous polyethylene and titanium should be preferred for larger defects.
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Affiliation(s)
- Maeva Bourry
- Department of Maxillofacial Surgery, Nantes University Hospital, Nantes Cedex 1, France
| | | | - Fabien Fauvel
- Department of Maxillofacial Surgery, Saint-Nazaire Hospital, Saint-Nazaire, France
| | - Pierre Corre
- Department of Maxillofacial Surgery, Nantes University Hospital, Nantes Cedex 1, France.,Regenerative Medicine and Skeleton (RMeS), Faculty of Dental Sciences, Nantes, France
| | - Pierre Lebranchu
- Department of Ophthalmology, Nantes University Hospital, Nantes, France.,UMR 6597 CNRS, Image and Video Communication Team, Polytech-Nantes, Nantes, France
| | - Hélios Bertin
- Department of Maxillofacial Surgery, Nantes University Hospital, Nantes Cedex 1, France.,Bone sarcoma and remodeling of calcified tissues (PhyOs, UMR 1238), Faculty of Medicine, Nantes Cedex, France
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de Gabory L, Boudard P, Bessède JP, Maillard A, Lacomme S, Gontier E, Durand M, Fricain JC, Bénard A, Bordenave L. Multicenter Pilot Study to Assess a Biphasic Calcium Phosphate Implant for Functional and Aesthetic Septorhinoplasty. Facial Plast Surg Aesthet Med 2020; 23:321-329. [PMID: 32700976 DOI: 10.1089/fpsam.2020.0184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Importance: A validated biomaterial would have several medical advantages in septorhinoplasties requiring a large-volume graft such as avoiding donor site morbidity, making ambulatory surgery possible, and reducing surgical costs. Objective: To assess the safety and efficacy of a ceramic to treat saddle and crooked noses. The main endpoint was the biocompatibility of the implant. The secondary endpoint was its functional and aesthetic efficacy. Design, Setting, and Participants: The nasal septum (NASEPT) study is a pilot multicenter noncomparative prospective phase IIa clinical trial. The biomaterial tested was a biphasic calcium phosphate implant composed of 75% hydroxyapatite and 25% beta tri calcium phosphate. This versatile material can be used to replace septal skeleton when it is absent or nonusable. We included 25 patients with a multifractured osseous and cartilaginous framework after several traumas or surgeries. The implant placement technique was identical to an extracorporeal septoplasty through the external approach. Main Outcomes and Measures: The primary endpoint was the occurrence of expected adverse and severe adverse events. The secondary endpoints were clinical functional and aesthetic results and histological microscopic modifications. Results: Any extrusion, infection, pain, and epistaxis were observed. All implants were placed in a sagittal, straight, and solid position without extralobular depression. Comparisons between pre- and postoperative symptoms showed that nasal comfort (p < 10-4) and quality of life (p < 10-4) were dramatically improved in all patients. The nasolabial angle (p = 0.047) and the columellar projection (p = 0.024) were improved after surgery. Histological data showed little submucosal inflammation at 6 months with well-differentiated epithelium. The mean follow-up was 23 months: three patients underwent revision surgery for functional or aesthetic details and four implants were removed (16%) owing to a foreign body reaction between 17 and 74 months. Conclusion and Relevance: The NASEPT implant meets functional and aesthetic requirements in complex septorhinoplasties but its long-term biocompatibility needs to be improved. It could potentially avoid donor site morbidity.
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Affiliation(s)
- Ludovic de Gabory
- University Hospital of Bordeaux, Department of Otorhinolaryngology, Bordeaux, France.,CHU Bordeaux, CIC 14-01 IT, Bordeaux, France.,University of Bordeaux, Bordeaux, France
| | - Philippe Boudard
- Department of Otorhinolaryngology, Saint Augustin Hospital, Bordeaux, France
| | | | - Aline Maillard
- CHU Bordeaux, Public Health Unit, Clinical Epidemiology Unit (USMR) & CIC 14-01 EC, Bordeaux, France
| | - Sabrina Lacomme
- University of Bordeaux, UMS 3420 CNRS, US4 INSERM, Bordeaux Imaging Center, Bordeaux, France
| | - Etienne Gontier
- University of Bordeaux, UMS 3420 CNRS, US4 INSERM, Bordeaux Imaging Center, Bordeaux, France
| | - Marlène Durand
- CHU Bordeaux, CIC 14-01 IT, Bordeaux, France.,University of Bordeaux, Bordeaux, France.,INSERM, Tissue Bioengineering, U1026, Bordeaux, France
| | | | - Antoine Bénard
- CHU Bordeaux, Public Health Unit, Clinical Epidemiology Unit (USMR) & CIC 14-01 EC, Bordeaux, France
| | - Laurence Bordenave
- CHU Bordeaux, CIC 14-01 IT, Bordeaux, France.,University of Bordeaux, Bordeaux, France.,INSERM, Tissue Bioengineering, U1026, Bordeaux, France
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Abstract
BACKGROUND Orbital fractures are one of the most common sequelae of facial trauma. OBJECTIVE The objective of this study was to summarize published data for resorbable implants in orbital reconstruction, including polymer composition, degradation characteristics, osteoconductivity, and complications such as enophthalmos, diplopia, and peri-implant inflammation. A literature search of the National Library of Medicine was performed via PubMed using the keyword resorbable orbital implant. A total of 27 studies were reviewed. Strength of data was assessed according to the Oxford Centre criteria. RESULTS Most commercially available implants provide adequate tensile strength for up to 6 months (with the exception of polydioxanone, which loses strength within 1 month, and poly(D,L-lactide) within 3 months). This is sufficient for the isolated orbital floor or medial wall (tensile strength, ~300 MPa) but insufficient for reconstruction of load-bearing areas (eg, the inferior orbital rim with tensile strength of ~1.2 GPa). Thicker products (>1 mm) have increased risk for delayed inflammation than thinner products. Postoperative complications including delayed inflammation (0%-9%), eyelid malposition (0%-5%), enophthalmos (5%-16%), diplopia (0%-16%), infection (0%-2%), and infraorbital nerve hypesthesia (2%-18%) are variably distributed across implants with several notable exceptions: poly(L-lactide) has an increased risk of delayed inflammation, and polydioxanone has a risk of delayed enophthalmos and hematoma. CONCLUSIONS Resorbable implants are suitable for isolated medial wall or floor fractures with intact bony buttresses and function as a barrier rather than a load-bearing support.
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A Comparison of Endoscopic Reduction for Medial Blowout Fractures Using a Bioresorbable Panel and Silastic Sheet. J Craniofac Surg 2019; 30:e160-e163. [PMID: 30664556 DOI: 10.1097/scs.0000000000005083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The aim of the study was to compare the effectiveness of endoscopic endonasal reduction using a bioresorbable panel and silastic sheet packed with Merocel for blowout fractures of the medial orbital wall. DESIGN Retrospective study. METHODS The study group consisted of 147 patients who underwent endoscopic endonasal reduction of a blowout fracture of the medial orbital wall between January 2005 and December 2016. Fifty-seven fractures were repaired using a splint formed by a silastic sheet and Merocel (splint group), whereas 90 fractures were repaired using a bioresorbable panel for interposition (interposition group). Postoperative complications and surgical outcomes of the 2 groups were compared. RESULTS Preoperative diplopia in both groups (n = 30) was resolved except 1 in interposition group after the reduction. Enophthalmos was resolved in 10 cases in the splint group and in 6 cases in the interposition group. In postoperative CT scans, 20 of the 57 cases in the splint group exhibited under- or overcorrection, compared with 9 of the 90 cases in the interposition group (P < 0.05). There were no sinus infections or implant-related side effects in the interposition group except for implant extrusion in 4 cases, whereas 7 cases developed sinusitis in the splint group (P < 0.05). CONCLUSIONS Endonasal endoscopic reduction using a bioresorbable panel may be considered as a surgical alternative for the treatment of medial orbital blowout fractures.
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Kumar D, Babu G, Krishnan S. Study on mechanical & thermal properties of PCL blended graphene biocomposites. POLIMEROS 2019. [DOI: 10.1590/0104-1428.05318] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Rippy MK, Baron S, Rosenthal M, Senior BA. Evaluation of absorbable PLA nasal implants in an ovine model. Laryngoscope Investig Otolaryngol 2018; 3:156-161. [PMID: 30062129 PMCID: PMC6057223 DOI: 10.1002/lio2.166] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 03/11/2018] [Accepted: 04/11/2018] [Indexed: 11/07/2022] Open
Abstract
Objective To examine biocompatibility and absorption profile of a poly (L‐lactide‐co‐D,L‐lactide) 70:30 nasal implant. Methods In an ovine model, 66 rod‐shaped absorbable implants were placed in 11 nasal dorsa. The sheep were sacrificed at 1.5 (N = 3), 6 (N = 3), 12 (N = 3), 18 (N = 1), and 24 months (N = 1). The nasal dorsum was harvested from each animal. Gross and histopathological examinations were performed. Results There were no postoperative complications, signs of infection, or tissue rejection throughout follow‐up time points. Upon sacrifice, no abnormalities were identified during gross pathological examinations. The histology of the implant sites at all time points showed the implants were fully encapsulated through 12 months. The inflammatory reaction to the implants was minimal to mild at 1.5, 6, and 12 months. At 18 months the implant material was in the mass loss phase, being actively absorbed. During this phase, the inflammatory reaction within the fibrous connective tissue capsule reached expected moderate levels. By 24 months, the inflammatory reaction had diminished in most implantation sites and complete absorption of the rod implants was noted at some sites with nodular bundles of mature collagenized fibrous tissue replacing the implant, devoid of an inflammatory infiltrate. Conclusion Biocompatibility of the poly (L‐lactide‐co‐D,L‐lactide) 70:30 material was demonstrated when used as a nasal implant in the nasal dorsum ovine model. Absorption of the implant occurred approximately 18 to 24 months postoperatively, and the implant site was replaced with collagenized fibrous tissue. Level of Evidence NA.
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Affiliation(s)
| | | | | | - Brent A Senior
- Department of Otolaryngology-Head and Neck Surgery University of North Carolina at Chapel Hill Chapel Hill North Carolina U.S.A
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Tissue Engineering in Ophthalmology: Implications for Eyelid Reconstruction. Ophthalmic Plast Reconstr Surg 2017; 33:157-162. [PMID: 27749619 DOI: 10.1097/iop.0000000000000792] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
PURPOSE Bioengineering aims to produce functional tissue replacements to repair defects and has been widely investigated over the past few decades. We aimed to review the available literature on the application of tissue engineering in ophthalmology, with a particular focus on ophthalmic plastic surgery and potential applications for eyelid reconstruction. METHODS A literature search was performed on the MEDLINE database using the keywords "bioengineering," "tissue engineering," and "ophthalmology." Articles written in English were included. RESULTS There is a substantial body of work on tissue engineering of the cornea. Other structures in ophthalmology investigated include the conjunctiva, lacrimal gland, and orbital bone. We also discuss the potential application of tissue engineering in eyelid reconstruction. CONCLUSION Tissue engineering represents the future of regenerative and reconstructive medicine, with significant potential applications in ophthalmic plastic surgery.
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Lutz R, Sendlbeck C, Wahabzada H, Tudor C, Prechtl C, Schlegel KA. Periosteal elevation induces supracortical peri-implant bone formation. J Craniomaxillofac Surg 2017; 45:1170-1178. [PMID: 28606438 DOI: 10.1016/j.jcms.2017.05.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 04/12/2017] [Accepted: 05/11/2017] [Indexed: 01/27/2023] Open
Abstract
PURPOSE The aim of the study was to evaluate the possibility of supracortical peri-implant bone formation after periosteal elevation. MATERIALS AND METHODS Periosteal elevation with an elevation height of 5 or 10 mm was performed in an animal experiment with 24 female domestic pigs. For this purpose, four implants were inserted in the frontal bone of each animal. The implants protruded from the local bone by 5 or 10 mm. In the test groups, the periosteum was attached to the protruding implants. In the control groups, the implants were covered with biocompatible degradable periosteal-shielding devices. Each 8 animals were sacrificed after 20, 40 and 60 days. De novo bone formation was evaluated radiographically and histologically. RESULTS Bone formation rate was higher in the test groups compared to the control groups after 20, 40 and 60 days. After 40 and 60 days, a statistically significant higher (P < 0.01) bone formation rate was found for both elevation heights. The maximum height of the generated bone was statistically significantly higher (P < 0.01) in the test groups for both elevation heights, compared to the control groups for all time points investigated. CONCLUSION Periosteal elevation by dental implants is a treatment option for supracortical peri-implant bone formation.
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Affiliation(s)
- Rainer Lutz
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Med. Dr. Med. Dent. Dr. H.C. Friedrich Wilhelm Neukam), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Östliche Stadtmauerstrasse 27, 91054, Erlangen, Germany.
| | - Christina Sendlbeck
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Med. Dr. Med. Dent. Dr. H.C. Friedrich Wilhelm Neukam), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Östliche Stadtmauerstrasse 27, 91054, Erlangen, Germany
| | - Hommeira Wahabzada
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Med. Dr. Med. Dent. Dr. H.C. Friedrich Wilhelm Neukam), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Östliche Stadtmauerstrasse 27, 91054, Erlangen, Germany
| | - Christian Tudor
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Med. Dr. Med. Dent. Dr. H.C. Friedrich Wilhelm Neukam), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Östliche Stadtmauerstrasse 27, 91054, Erlangen, Germany
| | - Christopher Prechtl
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Med. Dr. Med. Dent. Dr. H.C. Friedrich Wilhelm Neukam), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Östliche Stadtmauerstrasse 27, 91054, Erlangen, Germany
| | - Karl Andreas Schlegel
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Med. Dr. Med. Dent. Dr. H.C. Friedrich Wilhelm Neukam), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Östliche Stadtmauerstrasse 27, 91054, Erlangen, Germany
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Histologic and Histometric Analysis of Bone Repair at the Site of Mandibular Body Osteotomy and at the Bone-Screw Interface After Using a Biodegradable 2.0-mm Internal Fixation System. J Craniofac Surg 2015; 26:1214-9. [PMID: 26080160 DOI: 10.1097/scs.0000000000001723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The aim of the study was to evaluate histologically and histometrically the bone repair at the mandibular body osteotomy and at the bone-screw interface after using a biodegradable 2.0-mm internal fixation system. Six dogs were subjected to an osteotomy in the mandibular body, which was stabilized by applying a fixation device manufactured with poly-L-DL-lactic acid (70:30). The dogs were euthanized at 2 and 18 weeks. Each screw was sectioned along its long axis, and the osteotomy sites were divided into 3 parts: the upper part was labeled the tension third (TT); the lower part, compression third (CT); and the part between the TT and CT, intermediary third (IT). Histologic analysis showed areas of direct contact between the screw surface and the parent lamellar bone at 2 weeks. At 18 weeks, 3 microscopically distinct layers at the bone-screw interface were noted. At the osteotomy sites, union between the bone fragments was observed at 18 weeks. Statistically significant differences in the newly formed bone among TT, IT, and CT (P = 0.019) were observed. In conclusion, the biomechanical environment created by the biodegradable IF system used in this study facilitated bone repair at the osteotomy site.
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Beck-Broichsitter BE, Acar C, Kandzia C, Jochens A, Wiltfang J, Becker ST. Reconstruction of the orbital floor with polydioxanone: a long-term clinical survey of up to 12 years. Br J Oral Maxillofac Surg 2015; 53:736-40. [PMID: 26051867 DOI: 10.1016/j.bjoms.2015.05.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 05/13/2015] [Indexed: 11/19/2022]
Abstract
Fractures of the orbital floor are common in injured patients, who often require operation to prevent complications and, among other materials, polydioxanone is widely used. The aim of this study was to evaluate the long-term outcomes of fractures of the orbital floor that had been reconstructed with polydioxanone foil. A total of 101 patients (73 men and 28 women) who had reconstruction of the orbital floor for defects of 2cm(2) or smaller with polydioxanone implants, over a mean (SD) time period of 8 (2) years were evaluated. Sensitivity of the infraorbital nerve, ocular motility, and diplopia were evaluated and correlated with perioperative values. Persistent hyperaesthesia was found in 15 patients, whereas in another 15 the hyperaesthesia recovered completely over time. Three patients had double vision during follow-up. Twenty patients with preoperative diplopia had no persistent double vision postoperatively, and 15 patients with disturbed ocular motility recovered completely. Two patients had persistently disturbed motility, and one patient had enophthalmos. There was a significant association between hyperaesthesia preoperatively and postoperatively (p= 0.005). In most patients reconstruction of the orbital floor with polydioxanone was successful. Long-term complications such as diplopia, compromised bulbar motility, and hyperaesthesia of the cheek were seen in a few cases, but might not have been solely related to the use of polydioxanone.
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Affiliation(s)
| | - Carolin Acar
- Schleswig-Holstein University Hospital, Department of Oral and Maxillofacial Surgery, Arnold-Heller-Straße 3, Haus 26, 24105 Kiel, Germany.
| | - Christian Kandzia
- Schleswig-Holstein University Hospital, Department of Ophthalmology, Arnold-Heller-Straße 3, Haus 25, 24105 Kiel, Germany.
| | - Arne Jochens
- Schleswig-Holstein University Hospital, Institute of Medical Informatics and Statistics, Brunswiker Straße 10, 24105 Kiel, Germany.
| | - Jörg Wiltfang
- University Professor and Head of the Department, Schleswig-Holstein University Hospital, Department of Oral and Maxillofacial Surgery, Arnold-Heller-Straße 3, Haus 26, 24105 Kiel, Germany
| | - Stephan T Becker
- Schleswig-Holstein University Hospital, Department of Oral and Maxillofacial Surgery, Arnold-Heller-Straße 3, Haus 26, 24105 Kiel, Germany.
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Mahserejian S, Ryan P, Djellouli R, Cohen R. Numerical investigation of the electrical current effect on the fibrous tissue growth around biomaterials. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2015; 2014:3017-20. [PMID: 25570626 DOI: 10.1109/embc.2014.6944258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The objective of this study is to assess numerically the effect of applying electrical current on the fibrous tissue growth around polyethylene disk-shaped implants while subcutaneously placed inside 60 day old male Han-Wistar rats. This problem can be formulated as a design problem where the goal is to determine the parameters of a partial differential operator to achieve a desired effect. These electrical current parameters are computed using a regularized iterative method. The obtained results reveal that employing an appropriate electrical current profile can reduce the fibrous tissue concentration around the considered implant by up to 80%. This preliminary study tends to demonstrate the effectiveness of this novel and non-invasive approach to shield the implant from intolerable levels of fibrous tissue growth, which consequently expands the lifespan and functionality of implanted devices, as well as avoids costly and traumatic surgical procedures.
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Kum CH, Seo SH, Kang SN, Park BJ, Ahn DJ, Joung YK, Han DK. Effect of magnesium hydroxide nanoparticles with rod and plate shape on mechanical and biological properties of poly(L-lactide) composites. Macromol Res 2014. [DOI: 10.1007/s13233-014-2140-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Olms K, Randt T, Reimers N, Zander N, Schulz AP. Ultrasonically assisted anchoring of biodegradable implants for chevron osteotomies - clinical evaluation of a novel fixation method. Open Orthop J 2014; 8:85-92. [PMID: 24851140 PMCID: PMC4026760 DOI: 10.2174/1874325001408010085] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 03/31/2014] [Accepted: 04/06/2014] [Indexed: 11/22/2022] Open
Abstract
Reconstructive osteotomies for the treatment of Hallux valgus are among the most prevalent procedures in foot
and ankle surgery.
The combination of biodegradable materials with an innovative method for fixation by application of ultrasonic energy
facilitates a new bonding method for fractures or osteotomies. As clinical experience is still limited, the aim of this study
was to assess the safety and performance of the SonicPin system for fixation of Austin/Chevron osteotomies.
Chevron osteotomy was performed on 30 patients for the treatment of Hallux valgus. The used SonicPins were made from
polylactide and are selectively melted into the cancellous bone structure during insertion by ultrasonic energy. Patients
were followed for one year, which included X-ray and MRI examinations as well as evaluation of life quality by EQ-5D
(EuroQol).
The MRI after three months showed adequate bone healing in all cases and no signs of foreign body reactions, which was
again confirmed by MRI 12 months postoperatively. The bony healing after 12 months was uneventful without any signs
of foreign body reactions.
In summary, based on the low complication rate and the significant improvement in health related quality of life (EQ-5D)
reported in this study, fixation of an Austin/Chevron osteotomy with a SonicPin for treatment of Hallux valgus can be
considered to be safe and efficient over the short term. Level of Clinical Evidence: Therapeutic Level III.
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Affiliation(s)
- Kai Olms
- Praxisklinik Am Park, Bad Schwartau, Germany
| | | | | | | | - Arndt P Schulz
- Department of Orthopedics and Trauma, University Hospital Lübeck, UKSH, Ratzeburger Allee 160, D-23538 Lübeck, Germany
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Huang K, Ding X, Lv B, Wei L, Sun J, Xu Z, Qin X, Tang H. Reconstruction of large-size abdominal wall defect using biodegradable poly-p-dioxanone mesh: an experimental canine study. World J Surg Oncol 2014; 12:57. [PMID: 24625138 PMCID: PMC3995574 DOI: 10.1186/1477-7819-12-57] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 02/19/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Reconstruction of large-size abdominal wall defect (AWDs) is a huge challenge faced in current surgical practice. In this study, we aimed to evaluate the effectiveness and safety of biodegradable poly-p-dioxanone (PDO) mesh for reconstructing large-size AWDs in an experimental canine model. METHODS Eighteen experimental canines were randomly and equally divided into three groups, namely, a PDO group, a Marlex group and a control group (n = 6 each). Following the creation of a 6 cm × 5.5 cm AWD, PDO mesh and Marlex mesh were used to reconstruct the defect in the PDO and Marlex groups, respectively. The defect was closed using relaxation sutures alone in the control group. Animals were killed 24 weeks after surgery, and reconstruction outcomes were evaluated using radiography, histology and biomechanical testing. RESULTS All animals except those in the control group survived the experiment. The PDO group showed no wound dehiscence, herniation or infection, whereas the animals in the Marlex group exhibited marked foreign body reactions. The PDO group had less intraabdominal adhesion than the Marlex group. As shown by radiography, histology and biomechanical testing, PDO mesh exhibited complete degradation and favorable biochemical strength at 24 weeks postsurgery. CONCLUSIONS PDO mesh implantation is an effective, safe treatment modality for reconstructing large-size AWDs.
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Affiliation(s)
| | | | | | | | | | | | - Xiong Qin
- Department of Thoracic and Cardiovascular Surgery, Changzheng Hospital, the Second Military Medical University, 415 Fengyang Road, Shanghai 200003, China.
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Li G, Chen Y, Hu J, Wu X, Hu J, He X, Li J, Zhao Z, Chen Z, Li Y, Hu H, Li Y, Lan P. A 5-fluorouracil-loaded polydioxanone weft-knitted stent for the treatment of colorectal cancer. Biomaterials 2013; 34:9451-61. [PMID: 24011711 DOI: 10.1016/j.biomaterials.2013.08.055] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2013] [Accepted: 08/19/2013] [Indexed: 12/11/2022]
Abstract
In-stents restenosis caused by tumour ingrowth is a major problem for patients undergoing stent displacement because the conventional stents often lack a sustained anti-tumour capability. The aim of this paper was to develop a weft-knitted polydioxanone stent which can slow release 5-fluorouracil (5-FU). In order to determine the most suitable drug concentration, the 5-FU safe concentration in vivo and appropriate loading percentage in the membranes were investigated, and then 5-FU-loaded poly-l-lactide membranes at concentration of 3.2%, 6.4% and 12.8% were coated onto the stent using electro-spinning method, respectively. The morphology, chemical structure and in vitro drug release property of the coating membranes were subsequently examined. Their anti-tumour activity and mechanism were assessed in vitro and in vivo using a human colorectal cancer cell line HCT-116 and tumour-bearing BALB/c nude mice. The half maximal inhibitory concentration (IC50) and the median lethal dose (LD50) demonstrated that the 6.4% and 12.8% membranes had better anti-tumour effects than pure 5-FU due to the sustainable drug releasing property of the coated membranes on the stent. The membranes possessing appropriate drug loading doses, such as 6.4% or 12.8% also provided better anti-in-stents restenosis effects than other groups tested. Therefore, it is concluded that the drug-loaded stents have great potential for the use in the treatment of intestinal cancers in the future.
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Affiliation(s)
- Gang Li
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Kowloon, Hong Kong; Guangdong-HK International Textile Bioengineering Joint Research Center, The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, PR China
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Wang DK, Varanasi S, Fredericks PM, Hill DJ, Symons AL, Whittaker AK, Rasoul F. FT-IR characterization and hydrolysis of PLA-PEG-PLA based copolyester hydrogels with short PLA segments and a cytocompatibility study. ACTA ACUST UNITED AC 2013. [DOI: 10.1002/pola.26930] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- David K. Wang
- Australian Institute for Bioengineering and Nanotechnology; The University of Queensland; Brisbane Queensland 4072 Australia
- Centre for Advanced Imaging; The University of Queensland; Brisbane Queensland 4072 Australia
| | - Srinivas Varanasi
- School of Dentistry; The University of Queensland; Brisbane Queensland 4000 Australia
| | - Peter M. Fredericks
- School of Chemistry, Physics and Mechanical Engineering, Science and Engineering Faculty; Queensland University of Technology; 2 George Street Brisbane Queensland 4001 Australia
| | - David J.T. Hill
- School of Chemistry and Molecular Biosciences; The University of Queensland; Brisbane Queensland 4072 Australia
| | - Anne L. Symons
- School of Dentistry; The University of Queensland; Brisbane Queensland 4000 Australia
| | - Andrew K. Whittaker
- Australian Institute for Bioengineering and Nanotechnology; The University of Queensland; Brisbane Queensland 4072 Australia
- Centre for Advanced Imaging; The University of Queensland; Brisbane Queensland 4072 Australia
| | - Firas Rasoul
- Australian Institute for Bioengineering and Nanotechnology; The University of Queensland; Brisbane Queensland 4072 Australia
- Centre for Advanced Imaging; The University of Queensland; Brisbane Queensland 4072 Australia
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Li G, Li Y, Lan P, Li J, Zhao Z, He X, Zhang J, Hu H. Biodegradable weft-knitted intestinal stents: Fabrication and physical changes investigation in vitro
degradation. J Biomed Mater Res A 2013; 102:982-90. [DOI: 10.1002/jbm.a.34759] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Revised: 03/08/2013] [Accepted: 04/17/2013] [Indexed: 12/25/2022]
Affiliation(s)
- Gang Li
- Institute of Textiles and Clothing; The Hong Kong Polytechnic University; Hung Hom Kowloon Hong Kong
| | - Yi Li
- Institute of Textiles and Clothing; The Hong Kong Polytechnic University; Hung Hom Kowloon Hong Kong
| | - Ping Lan
- Department of Colorectal Surgery; the Sixth Affiliated Hospital of Sun Yat-Sen University; Guangzhou 510655 China
| | - Jiashen Li
- Institute of Textiles and Clothing; The Hong Kong Polytechnic University; Hung Hom Kowloon Hong Kong
| | - Zheng Zhao
- Institute of Textiles and Clothing; The Hong Kong Polytechnic University; Hung Hom Kowloon Hong Kong
| | - Xiaowen He
- Department of Colorectal Surgery; the Sixth Affiliated Hospital of Sun Yat-Sen University; Guangzhou 510655 China
| | - Jing Zhang
- Institute of Textiles and Clothing; The Hong Kong Polytechnic University; Hung Hom Kowloon Hong Kong
| | - Hong Hu
- Institute of Textiles and Clothing; The Hong Kong Polytechnic University; Hung Hom Kowloon Hong Kong
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Tang H, Wu B, Qin X, Zhang L, Kretlow J, Xu Z. Tissue engineering rib with the incorporation of biodegradable polymer cage and BMSCs/decalcified bone: an experimental study in a canine model. J Cardiothorac Surg 2013; 8:133. [PMID: 23688344 PMCID: PMC3695786 DOI: 10.1186/1749-8090-8-133] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 05/13/2013] [Indexed: 11/10/2022] Open
Abstract
Background The reconstruction of large bone defects, including rib defects, remains a challenge for surgeons. In this study, we used biodegradable polydioxanone (PDO) cages to tissue engineer ribs for the reconstruction of 4cm-long costal defects. Methods PDO sutures were used to weave 6cm long and 1cm diameter cages. Demineralized bone matrix (DBM) which is a xenograft was molded into cuboids and seeded with second passage bone marrow mesenchymal stem cells (BMSCs) that had been osteogenically induced. Two DBM cuboids seeded with BMSCs were put into the PDO cage and used to reconstruct the costal defects. Radiographic examination including 3D reconstruction, histologic examination and mechanical test was performed after 24 postoperative weeks. Results All the experimental subjects survived. In all groups, the PDO cage had completely degraded after 24 weeks and been replaced by fibrous tissue. Better shape and radian were achieved in PDO cages filled with DBM and BMSCs than in the other two groups (cages alone, or cages filled with acellular DBM cuboids). When the repaired ribs were subjected to an outer force, the ribs in the PDO cage/DBMs/BMSCs group kept their original shape while ribs in the other two groups deformed. In the PDO cage/DBMs/BMSCs groups, we also observed bony union at all the construct interfaces while there was no bony union observed in the other two groups. This result was also confirmed by radiographic and histologic examination. Conclusions This study demonstrates that biodegradable PDO cage in combination with two short BMSCs/DBM cuboids can repair large rib defects. The satisfactory repair rate suggests that this might be a feasible approach for large bone repair.
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Affiliation(s)
- Hua Tang
- Department of Thoracic and Cardiovascular Surgery, Shanghai Changzheng Hospital, The Second Military Medical University, No. 415 Fengyang Road, Shanghai 200003, China
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Kum CH, Cho Y, Joung YK, Choi J, Park K, Seo SH, Park YS, Ahn DJ, Han DK. Biodegradable poly(l-lactide) composites by oligolactide-grafted magnesium hydroxide for mechanical reinforcement and reduced inflammation. J Mater Chem B 2013; 1:2764-2772. [PMID: 32260983 DOI: 10.1039/c3tb00490b] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Biodegradable polymers, such as poly(l-lactide) (PLLA), are very useful in many biomedical applications. However, their degradation by-products have been much of a concern as they are the sources of inflammatory reactions in the body. In this work, we suggest a novel composite system composed of PLLA and oligolactide-grafted magnesium hydroxide (Mg-OLA) that can overcome drawbacks caused by poor mechanical properties and inflammatory response of PLLA for biomedical applications. Mg-OLAs were synthesized by ring opening polymerization and the structure, morphology, pH change, thermal, and mechanical properties were analyzed using FTIR, SEM, pH meter, TGA, and UTM. In particular, the tensile strength and modulus of PLLA/Mg80-OLA20 (0-20 wt%) were higher than those of PLLA/magnesium hydroxide. The PLLA/Mg80-OLA20 composite was also very effective in neutralizing the acidic environment caused by the degradable by-product of the PLLA matrix. In vitro cell viability and the expression levels of COX-2 and IL-6 proteins in the PLLA composites were also evaluated. Cell viability increased to around 100% with increasing the amount of Mg80-OLA20 from 0 to 20 wt%. The expression levels of IL-6 and COX-2 were reduced dramatically when increasing the proportion of Mg80-OLA20 from 0 to 50 wt%. As a result, the incorporation of Mg-OLAs into the PLLA matrix could reinforce the mechanical properties as well as reduce the inflammatory response of the hybrid PLLA. Therefore, this hybrid composite system blending oligomer-grafted magnesium hydroxide in biodegradable polymers would be a promising strategy for avoiding current fatal problems in biomedical applications.
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Affiliation(s)
- Chang Hun Kum
- Center for Biomaterials, Biomedical Research Institute, Korea Institute of Science and Technology, Hwarangno 14-gil 5, Seongbuk-gu, Seoul 136-791, Korea.
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Forces affecting orbital floor reconstruction materials – A cadaver study. J Craniomaxillofac Surg 2013; 41:e24-8. [DOI: 10.1016/j.jcms.2012.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2012] [Revised: 05/11/2012] [Accepted: 05/14/2012] [Indexed: 11/22/2022] Open
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Theoretical study of the fibrous capsule tissue growth around a disk-shaped implant. J Math Biol 2012; 67:833-67. [DOI: 10.1007/s00285-012-0566-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Revised: 07/10/2012] [Indexed: 10/28/2022]
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Abstract
The objective of this study was first to establish a method to measure forces and displacement of the orbital content in defects of the orbital floor in truncated fresh and unfixed heads and second to characterize reconstruction materials with regard to punctuation strength and compression.Orbital floor defects (10 × 20 mm and 15 × 20 mm; 3 mm behind the orbital rim) were prepared after Le Fort I osteotomy. The values of force and displacement were recorded in 6 freshly frozen human heads. In addition, the punctuation strength of 2 reconstruction materials (polydioxanone [PDS] foil and collagen membrane) was evaluated using a Zwick Z010 TN1 universal testing machine. The forces of the orbital content (28.41 [SD, 1.6] g) applied to the defects of 10 × 20 mm and 15 × 20 mm with an intact periorbita were 0.04 (SD, 0.003) N (0.0002 MPa) and 0.07 (SD, 0.02) N (0.0002 MPa), respectively, and with a split periorbita were 0.06 (SD, 0.03) N (0.0003 MPa) and 0.08 (SD, 0.06) N (0.00026 MPa), respectively. The displacement values without reconstruction materials of the 10 × 20-mm and 15 × 20-mm defects were 0.94 (SD, 0.7) mm and 1.2 (SD, 0.5) mm, respectively. The PDS foil could withstand forces of 118.9 (SD, 14.1) N (0.375 MPa), and the collagen membrane could withstand forces of 44.5 (SD, 5.3) N (0.14 MPa). This is the first study to report forces charging the orbital floor. The presented results support the use of PDS foils and collagen membranes as reconstruction materials for orbital floor defects, at least in smaller and medium-sized fractures.
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Xiao C, Zhou H, Liu G, Zhang P, Fu Y, Gu P, Hou H, Tang T, Fan X. Bone marrow stromal cells with a combined expression of BMP-2 and VEGF-165 enhanced bone regeneration. Biomed Mater 2011; 6:015013. [DOI: 10.1088/1748-6041/6/1/015013] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Comparison of collagen membranes and polydioxanone for reconstruction of the orbital floor after fractures. J Craniofac Surg 2011; 21:1066-8. [PMID: 20613556 DOI: 10.1097/scs.0b013e3181e62c5f] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Orbital floor fractures, often combined with zygomatic fractures, are common fractures of the midface. Surgery of orbital fractures is done to free incarcerated or prolapsed orbital tissue and to restore the anatomic skeletal size of the orbit. Lyodura was a standard for the reconstruction of the orbital floor until cases of Creutzfeldt-Jakob disease were reported, so that polydioxanone (PDS) is widely used today. However, infections around the implant are reported. In a randomized controlled clinical study on 24 patients with orbital floor defects of approximately 1 cm, we evaluated the use of a collagen membrane compared with a PDS foil. Computed tomography controls and ophthalmologic examinations were performed after 6 months in 10 patients per group.Intraoperative complications occurred neither in the collagen membrane group nor in the PDS group. In case of orbital rim fractures, the collagen membrane could additionally cover these defects. Perioperatively and postoperatively, no complications such as infections were observed. After 6 months, computed tomography controls revealed a complete reposition of orbital tissue and even bone regeneration in both groups. Diplopia and hypoesthesia were completely reversed after half a year.Smaller defects (up to 1 cm) of the orbital floor can be restored with a PDS foil or a collagen membrane. However, for larger defects, stability may not be sufficient.
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Lieger O, Schaller B, Zix J, Kellner F, Iizuka T. Repair of Orbital Floor Fractures Using Bioresorbable Poly-L/DL-Lactide
Plates. ACTA ACUST UNITED AC 2010. [DOI: 10.1001/archfaci.2010.91] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Olivier Lieger
- Department of Cranio-Maxillofacial Surgery, Cantonal Hospital Lucerne, Lucerne, Switzerland (Dr Lieger); and Departments of Cranio-Maxillofacial Surgery (Drs Schaller, Zix, and Iizuka) and Radiology (Dr Kellner), University Bern, University Hospital, Bern, Switzerland
| | - Benoit Schaller
- Department of Cranio-Maxillofacial Surgery, Cantonal Hospital Lucerne, Lucerne, Switzerland (Dr Lieger); and Departments of Cranio-Maxillofacial Surgery (Drs Schaller, Zix, and Iizuka) and Radiology (Dr Kellner), University Bern, University Hospital, Bern, Switzerland
| | - Jürgen Zix
- Department of Cranio-Maxillofacial Surgery, Cantonal Hospital Lucerne, Lucerne, Switzerland (Dr Lieger); and Departments of Cranio-Maxillofacial Surgery (Drs Schaller, Zix, and Iizuka) and Radiology (Dr Kellner), University Bern, University Hospital, Bern, Switzerland
| | - Frauke Kellner
- Department of Cranio-Maxillofacial Surgery, Cantonal Hospital Lucerne, Lucerne, Switzerland (Dr Lieger); and Departments of Cranio-Maxillofacial Surgery (Drs Schaller, Zix, and Iizuka) and Radiology (Dr Kellner), University Bern, University Hospital, Bern, Switzerland
| | - Tateyuki Iizuka
- Department of Cranio-Maxillofacial Surgery, Cantonal Hospital Lucerne, Lucerne, Switzerland (Dr Lieger); and Departments of Cranio-Maxillofacial Surgery (Drs Schaller, Zix, and Iizuka) and Radiology (Dr Kellner), University Bern, University Hospital, Bern, Switzerland
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Pillai CKS, Sharma CP. Review Paper: Absorbable Polymeric Surgical Sutures: Chemistry, Production, Properties, Biodegradability, and Performance. J Biomater Appl 2010; 25:291-366. [DOI: 10.1177/0885328210384890] [Citation(s) in RCA: 209] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Among biomaterials used as implants in human body, sutures constitute the largest groups of materials having a huge market exceeding $1.3 billion annually. Sutures are the most widely used materials in wound closure and have been in use for many centuries. With the development of the synthetic absorbable polymer, poly(glycolic acid) (PGA) in the early 1970s, a new chapter has opened on absorbable polymeric sutures that got unprecedented commercial successes. Although several comparative evaluations of suture materials have been published, there were no serious attempts of late on a comprehensive review of production, properties, biodegradability, and performance of suture materials. This review proposes to bring to focus scattered data on chemistry, properties, biodegradability, and performance of absorbable polymeric sutures.
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Affiliation(s)
- Chennakkattu Krishna Sadasivan Pillai
- Division of Biosurface Technology, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences & Technology, Poojappura, Thiruvananthapuram 695 012, India
| | - Chandra P. Sharma
- Division of Biosurface Technology, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences & Technology, Poojappura, Thiruvananthapuram 695 012, India,
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33
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Characterization of the Inhibition of Vein Graft Intimal Hyperplasia by a Biodegradable Vascular Stent. Cell Biochem Biophys 2010; 59:99-107. [DOI: 10.1007/s12013-010-9118-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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34
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You Q, Wang F, Duan L, Du X, Xiao M, Shen Z. Construction of Small-Caliber, Polydiaxanone Cyclohexanone Vascular Stents. Cell Biochem Biophys 2010; 57:35-43. [DOI: 10.1007/s12013-010-9081-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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35
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Asamura S, Ikada Y, Matsunaga K, Wada M, Isogai N. Treatment of orbital floor fracture using a periosteum–polymer complex. J Craniomaxillofac Surg 2010; 38:197-203. [DOI: 10.1016/j.jcms.2009.06.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2008] [Revised: 06/15/2009] [Accepted: 06/24/2009] [Indexed: 10/20/2022] Open
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Peeters G, Decloedt J, Nagels H, Cambier B. Treatment of the severe or recurrent inverted nipple by interposition of a resorbable polydioxanone sheet. J Plast Reconstr Aesthet Surg 2009; 63:e175-6. [PMID: 19595657 DOI: 10.1016/j.bjps.2009.06.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2009] [Accepted: 06/08/2009] [Indexed: 11/30/2022]
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37
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Osseous alterations at the interface of hydrogel expanders and underlying bone. J Craniomaxillofac Surg 2009; 37:258-62. [DOI: 10.1016/j.jcms.2009.01.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2008] [Revised: 01/21/2009] [Accepted: 01/22/2009] [Indexed: 11/21/2022] Open
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38
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Witte F, Calliess T, Windhagen H. [Biodegradable synthetic implant materials : clinical applications and immunological aspects]. DER ORTHOPADE 2009; 37:125-30. [PMID: 18214423 DOI: 10.1007/s00132-008-1193-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
In the last decade biodegradable synthetic implant materials have been established for various clinical applications. Ceramic materials such as calcium phosphate, bioglass and polymers are now routinely used as degradable implants in the clinical practice. Additionally these materials are now also used as coating materials or as microspheres for controlled drug release and belong to a series of examples for applications as scaffolds for tissue engineering. Because immense local concentrations of degradation products are produced during biodegradation, this review deals with the question whether allergic immune reactions, which have been reported for classical metallic and organic implant materials, also play a role in the clinical routine for synthetic biodegradable materials. Furthermore, possible explanatory theories will be developed to clarify the lack of clinical reports on allergy or sensitization to biodegradable synthetic materials.
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Affiliation(s)
- F Witte
- Labor für Biomechanik und Biomaterialien, Orthopädische Klinik der Medizinischen Hochschule Hannover, Anna-von-Borries-Str. 1-7, 30625, Hannover, Deutschland.
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39
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Long-term bone tissue reaction to polyethylene oxide/polybutylene terephthalate copolymer (Polyactive®) in metacarpophalangeal joint reconstruction. Biomaterials 2008; 29:2509-15. [DOI: 10.1016/j.biomaterials.2008.02.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2007] [Accepted: 02/13/2008] [Indexed: 11/21/2022]
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40
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Modeling capsule tissue growth around disk-shaped implants: a numerical and in vivo study. J Math Biol 2008; 57:675-95. [PMID: 18488226 DOI: 10.1007/s00285-008-0184-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2007] [Revised: 02/08/2008] [Indexed: 10/22/2022]
Abstract
We propose a new mathematical model that describes the growth of fibrous tissue around rigid, disk-shaped implants. A solution methodology based on an efficient regularized iterative method is presented to calibrate the model from some measurements of the capsule tissue concentration. Numerical results obtained with synthetic data are presented to demonstrate the ability of the proposed solution methodology to determine the model parameters corresponding to a given implant. In addition, numerical results obtained with experimental data are presented to illustrate the validity of the proposed model.
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41
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Watzinger F, Wutzl A, Wanschitz F, Ewers R, Turhani D, Seemann R. Biodegradable polymer membrane used as septal splint. Int J Oral Maxillofac Surg 2008; 37:473-7. [PMID: 18337063 DOI: 10.1016/j.ijom.2008.01.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2007] [Revised: 09/12/2007] [Accepted: 01/09/2008] [Indexed: 10/22/2022]
Abstract
The treatment of a crooked nose is one of the most challenging rhinoplastic procedures. Correction of the abnormally curved or fractured septum has been reported using mostly scoring techniques, septoplasty and submucous resection techniques; cartilaginous spreader grafts can also be sutured to the distorted septum. Extracorporal septal straightening and repositioning/refixation is another useful but difficult technique. A common problem of septal cartilaginous grafting techniques is to harvest enough straight cartilage to correct the deformity. (Other donor sites such as rib cartilage are used, but harvesting additional cartilage is a time-consuming procedure and carries the risk of donor site morbidity.) Recent studies have been published using alloplastic internal splinting of the deformed septum. The use of poly p-dioxanone foils and porous polyethylene has been suggested before. In this study, a novel grafting material, a PolyMax membrane that has potential advantages over both materials, is presented. This is a porous biodegradable polymer made out of 70:30 poly(L-lactide-co-D,L-lactide) that remains stable for at least 7 months. Poly p-dioxanone loses its stability after only 2 months, whereas porous polyethylene is a permeable material that is controversial due to possible complications in cases of membrane exposure and infection. In this preliminary report the PolyMax membrane was used successfully in 3 patients.
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Affiliation(s)
- F Watzinger
- University Hospital for Craniomaxillofacial and Oral Surgery, Vienna, Austria.
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42
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The use of biodegradable scaffold as an alternative to silicone implant arthroplasty for small joint reconstruction: An experimental study in minipigs. Biomaterials 2008; 29:683-91. [DOI: 10.1016/j.biomaterials.2007.10.037] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2007] [Accepted: 10/25/2007] [Indexed: 11/19/2022]
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Bertoldi C, Zaffe D, Consolo U. Polylactide/polyglycolide copolymer in bone defect healing in humans. Biomaterials 2008; 29:1817-23. [PMID: 18234328 DOI: 10.1016/j.biomaterials.2007.12.034] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2007] [Accepted: 12/25/2007] [Indexed: 01/27/2023]
Abstract
This pilot study aims to evaluate the healing of a large defects in the human jawbone filled with a Poly-Lactide-co-Glycolide (PLG) polymer (Fisiograft) by means of clinical, radiological and histological methods and to compare the results with those of platelet-rich plasma (PRP) clot or autologous bone (AB) fillings. Bone cysts, where previous non-surgical treatments failed to promote healing, underwent surgery. Nineteen consenting male patients were randomly split into three groups, packed with PRP, AB or PLG. A core biopsy was performed 4 and 6 months after surgery. All treated defects showed clinical, radiological and histological progresses over time. AB provided the best clinical and histological performance and PLG had overlapping outcomes; PRP filling was statistically different. Six months after surgery, bone activities were enhanced in sites treated with PLG and fairly good with PRP. Additionally, PLG showed some new lamellar formations. In conclusion, outcomes were best with AB graft, but suitable results were achieved using PLG to promote healing of severe bone defects. PLG shows only a delayed regenerative capability but does not require a secondary donor site.
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Affiliation(s)
- Carlo Bertoldi
- Department of Neurosciences, Head-Neck and Rehabilitation, Section of Dentistry and Maxillofacial Surgery, University of Modena and Reggio Emilia, Modena, Italy
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Bouletreau P. Tissue Response to the Degradation of Resorbable Copolymers in Orthognathic Surgery. J Oral Maxillofac Surg 2006. [DOI: 10.1016/j.joms.2006.06.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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